diff --git a/LICENSE b/LICENSE deleted file mode 100644 index 0dfce7e..0000000 --- a/LICENSE +++ /dev/null @@ -1,21 +0,0 @@ -MIT License - -Copyright (c) 2025 SURF-ML - -Permission is hereby granted, free of charge, to any person obtaining a copy -of this software and associated documentation files (the "Software"), to deal -in the Software without restriction, including without limitation the rights -to use, copy, modify, merge, publish, distribute, sublicense, and/or sell -copies of the Software, and to permit persons to whom the Software is -furnished to do so, subject to the following conditions: - -The above copyright notice and this permission notice shall be included in all -copies or substantial portions of the Software. - -THE SOFTWARE IS PROVIDED "AS IS", WITHOUT WARRANTY OF ANY KIND, EXPRESS OR -IMPLIED, INCLUDING BUT NOT LIMITED TO THE WARRANTIES OF MERCHANTABILITY, -FITNESS FOR A PARTICULAR PURPOSE AND NONINFRINGEMENT. IN NO EVENT SHALL THE -AUTHORS OR COPYRIGHT HOLDERS BE LIABLE FOR ANY CLAIM, DAMAGES OR OTHER -LIABILITY, WHETHER IN AN ACTION OF CONTRACT, TORT OR OTHERWISE, ARISING FROM, -OUT OF OR IN CONNECTION WITH THE SOFTWARE OR THE USE OR OTHER DEALINGS IN THE -SOFTWARE. diff --git a/README.md b/README.md index 5055036..b4d48ca 100644 --- a/README.md +++ b/README.md @@ -1,63 +1 @@ -# MLOps UvA Bachelor AI Course: Medical Image Classification Skeleton Code - -![Python](https://img.shields.io/badge/python-3.10%2B-blue.svg) -![Build Status](https://github.com/yourusername/mlops_course/actions/workflows/ci.yml/badge.svg) -![Code Style: Ruff](https://img.shields.io/endpoint?url=https://raw.githubusercontent.com/astral-sh/ruff/main/assets/badge/v2.json) - -A repo exemplifying **MLOps best practices**: modularity, reproducibility, automation, and experiment tracking. - -This project implements a standardized workflow for training neural networks on medical data (PCAM/TCGA). - -The idea is that you fill in the repository with the necessary functions so you can execute the ```train.py``` function. Please also fill in this ```README.md``` clearly to setup, install and run your code. - -Don't forget to setup CI and linting! - ---- - -## 🚀 Quick Start - -### 1. Installation -Clone the repository and set up your isolated environment. - -```bash -# 1. Create a virtual environment -python -m venv venv -source venv/bin/activate # On Windows: venv\Scripts\activate - -# 2. Install the package in "Editable" mode -pip install -e . - -# 3. Install pre-commit hooks -pre-commit install -``` - -### 2. Verify Setup -```bash -pytest tests/ -``` - -### 3. Run an Experiment -```bash -python experiments/train.py --config experiments/configs/train_config.yaml -``` - ---- - -## 📂 Project Structure - -```text -. -├── src/ml_core/ # The Source Code (Library) -│ ├── data/ # Data loaders and transformations -│ ├── models/ # PyTorch model architectures -│ ├── solver/ # Trainer class and loops -│ └── utils/ # Loggers and experiment trackers -├── experiments/ # The Laboratory -│ ├── configs/ # YAML files for hyperparameters -│ ├── results/ # Checkpoints and logs (Auto-generated) -│ └── train.py # Entry point for training -├── scripts/ # Helper scripts (plotting, etc) -├── tests/ # Unit tests for QA -├── pyproject.toml # Config for Tools (Ruff, Pytest) -└── setup.py # Package installation script -``` +## Here you find the TCGA TITAN visual embeddings, raw text reports for each patient, and the vLLM code you need to use diff --git a/experiments/configs/train_config.yaml b/experiments/configs/train_config.yaml deleted file mode 100644 index e8e2ecc..0000000 --- a/experiments/configs/train_config.yaml +++ /dev/null @@ -1,20 +0,0 @@ -experiment_name: "pcam_mlp_baseline" -seed: 42 - -data: - dataset_type: "pcam" - # TODO: download the dataset and set the relative path here - data_path: "./data/camelyonpatch_level_2" - input_shape: [3, 96, 96] - batch_size: 32 - num_workers: 2 - -model: - hidden_units: [64, 32] - dropout_rate: 0.2 - num_classes: 2 - -training: - epochs: 5 - learning_rate: 0.001 - save_dir: "./experiments/results" diff --git a/experiments/train.py b/experiments/train.py deleted file mode 100644 index c550f73..0000000 --- a/experiments/train.py +++ /dev/null @@ -1,37 +0,0 @@ -import argparse -import torch -import torch.optim as optim -# from ml_core.data import get_dataloaders -# from ml_core.models import MLP -# from ml_core.solver import Trainer -# from ml_core.utils import load_config, seed_everything, setup_logger - -# logger = setup_logger("Experiment_Runner") - -def main(args): - # 1. Load Config & Set Seed - # config = load_config(args.config) - - # 2. Setup Device - - # 3. Data - # train_loader, val_loader = get_dataloaders(config) - - # 4. Model - # model = MLP(...) - - # 5. Optimizer - # optimizer = optim.SGD(...) - - # 6. Trainer & Fit - # trainer = Trainer(...) - # trainer.fit(...) - pass - -if __name__ == "__main__": - parser = argparse.ArgumentParser(description="Train a Simple MLP on PCAM") - parser.add_argument("--config", type=str, required=True, help="Path to config yaml") - args = parser.parse_args() - - main(args) - print("Skeleton: Implement main logic first.") diff --git a/pyproject.toml b/pyproject.toml deleted file mode 100644 index 2b9f6be..0000000 --- a/pyproject.toml +++ /dev/null @@ -1,51 +0,0 @@ -[build-system] -requires = ["setuptools>=61.0"] -build-backend = "setuptools.build_meta" - -# --- PROJECT METADATA & DEPENDENCIES --- -[project] -name = "ml_core" -version = "0.1.0" -description = "My MLOps project for SURF / UvA" -readme = "README.md" -requires-python = ">=3.10" -dependencies = [ - "numpy", - "h5py", - "matplotlib", - "seaborn", - "pandas", - "torch", - "torchvision", - "torcheval", - "tensorboard", - "umap-learn", - "tqdm", - "pyyaml", - "python-dotenv", - # Dev tools - "pytest", - "ruff", - "pre-commit", -] - -# --- TOOL CONFIGURATION --- -[tool.ruff] -# Exclude a variety of commonly ignored directories. -exclude = [".git", "__pycache__", "venv"] -# Same as Black. -line-length = 88 -indent-width = 4 - -[tool.ruff.lint] -# E: pycodestyle errors -# F: Pyflakes -# I: isort (Import Sorting - MLOps critical!) -# B: flake8-bugbear (Likely bugs) -select = ["E", "F", "I", "B"] -# B905: no strict=True needed for zip -ignore = ["E501", "B905", "E741"] - -[tool.ruff.format] -quote-style = "double" -indent-style = "space" diff --git a/requirements.txt b/requirements.txt deleted file mode 100644 index 38c5f8c..0000000 --- a/requirements.txt +++ /dev/null @@ -1,14 +0,0 @@ -numpy -torch -torchvision -h5py -pyyaml -tqdm -torcheval -tensorboard -matplotlib -seaborn -pandas -pytest -ruff -pre-commit diff --git a/scripts/create_pcam_mlops_repo.py b/scripts/create_pcam_mlops_repo.py deleted file mode 100644 index 8b5c9fa..0000000 --- a/scripts/create_pcam_mlops_repo.py +++ /dev/null @@ -1,570 +0,0 @@ -import os -from pathlib import Path - -def create_file(path, content=""): - """Creates a file with specific content, ensuring parent directories exist.""" - p = Path(path) - p.parent.mkdir(parents=True, exist_ok=True) - with open(p, "w", encoding="utf-8") as f: - f.write(content.strip() + "\n") - print(f"Created: {path}") - -# ========================================== -# 1. SETUP & CONFIG FILES -# ========================================== - -README_CONTENT = """ -# MLOps Course: Medical Image Classification - -![Python](https://img.shields.io/badge/python-3.10%2B-blue.svg) -![Build Status](https://github.com/yourusername/mlops_course/actions/workflows/ci.yml/badge.svg) -![Code Style: Ruff](https://img.shields.io/endpoint?url=https://raw.githubusercontent.com/astral-sh/ruff/main/assets/badge/v2.json) - -A repo exemplifying **MLOps best practices**: modularity, reproducibility, automation, and experiment tracking. - -This project implements a standardized workflow for training neural networks on medical data (PCAM/TCGA). - ---- - -## 🚀 Quick Start - -### 1. Installation -Clone the repository and set up your isolated environment. - -```bash -# 1. Create a virtual environment -python -m venv venv -source venv/bin/activate # On Windows: venv\\Scripts\\activate - -# 2. Install the package in "Editable" mode -pip install -e . - -# 3. Install pre-commit hooks -pre-commit install -``` - -### 2. Verify Setup -```bash -pytest tests/ -``` - -### 3. Run an Experiment -```bash -python experiments/train.py --config experiments/configs/train_config.yaml -``` - ---- - -## 📂 Project Structure - -```text -. -├── src/ml_core/ # The Source Code (Library) -│ ├── data/ # Data loaders and transformations -│ ├── models/ # PyTorch model architectures -│ ├── solver/ # Trainer class and loops -│ └── utils/ # Loggers and experiment trackers -├── experiments/ # The Laboratory -│ ├── configs/ # YAML files for hyperparameters -│ ├── results/ # Checkpoints and logs (Auto-generated) -│ └── train.py # Entry point for training -├── scripts/ # Helper scripts (plotting, etc) -├── tests/ # Unit tests for QA -├── pyproject.toml # Config for Tools (Ruff, Pytest) -└── setup.py # Package installation script -``` -""" - -SETUP_PY = """ -from setuptools import setup, find_packages - -setup( - name="ml_core", - version="0.1.0", - packages=find_packages(where="src"), - package_dir={"": "src"}, - install_requires=[ - "numpy", - "torch", - "torchvision", - "h5py", - "pyyaml", - "tqdm", - "torcheval", - "tensorboard", - "matplotlib", - "seaborn", - "pandas" - ], -) -""" - -REQUIREMENTS_TXT = """ -numpy -torch -torchvision -h5py -pyyaml -tqdm -torcheval -tensorboard -matplotlib -seaborn -pandas -pytest -ruff -pre-commit -""" - -PYPROJECT_TOML = """ -[build-system] -requires = ["setuptools", "wheel"] -build-backend = "setuptools.build_meta" - -[tool.ruff] -line-length = 88 -target-version = "py39" - -[tool.pytest.ini_options] -testpaths = ["tests"] -python_files = "test_*.py" -""" - -TRAIN_CONFIG = """ -experiment_name: "pcam_mlp_baseline" -seed: 42 - -data: - dataset_type: "pcam" - # TODO: Students must set their absolute path here - data_path: "./data/camelyonpatch_level_2" - input_shape: [3, 96, 96] - batch_size: 32 - num_workers: 2 - -model: - hidden_units: [64, 32] - dropout_rate: 0.2 - num_classes: 2 - -training: - epochs: 5 - learning_rate: 0.001 - save_dir: "./experiments/results" -""" - -# ========================================== -# 2. SOURCE CODE (SKELETONS) -# ========================================== - -PCAM_PY = """ -from pathlib import Path -from typing import Callable, Optional, Tuple - -import h5py -import numpy as np -import torch -from torch.utils.data import Dataset - - -class PCAMDataset(Dataset): - \"\"\" - PatchCamelyon (PCAM) Dataset reader for H5 format. - \"\"\" - - def __init__(self, x_path: str, y_path: str, transform: Optional[Callable] = None): - self.x_path = Path(x_path) - self.y_path = Path(y_path) - self.transform = transform - - # TODO: Initialize dataset - # 1. Check if files exist - # 2. Open h5 files in read mode - pass - - def __len__(self) -> int: - # TODO: Return length of dataset - return 0 - - def __getitem__(self, idx: int) -> Tuple[torch.Tensor, torch.Tensor]: - # TODO: Implement data retrieval - # 1. Read data at idx - # 2. Convert to uint8 (for PIL compatibility if using transforms) - # 3. Apply transforms if they exist - # 4. Return tensor image and label (as long) - - raise NotImplementedError("Implement __getitem__ in PCAMDataset") -""" - -LOADER_PY = """ -from pathlib import Path -from typing import Dict, Tuple - -from torch.utils.data import DataLoader -from torchvision import transforms - -from .pcam import PCAMDataset - - -def get_dataloaders(config: Dict) -> Tuple[DataLoader, DataLoader]: - \"\"\" - Factory function to create Train and Validation DataLoaders - using pre-split H5 files. - \"\"\" - data_cfg = config["data"] - base_path = Path(data_cfg["data_path"]) - - # TODO: Define Transforms - # train_transform = ... - # val_transform = ... - - # TODO: Define Paths for X and Y (train and val) - - # TODO: Instantiate PCAMDataset for train and val - - # TODO: Create DataLoaders - # train_loader = ... - # val_loader = ... - - raise NotImplementedError("Implement get_dataloaders") -""" - -MLP_PY = """ -from typing import List - -import torch -import torch.nn as nn - - -class MLP(nn.Module): - def __init__( - self, - input_shape: List[int], - hidden_units: List[int], - num_classes: int = 2, - dropout_rate: float = 0.2, - ): - super().__init__() - - # TODO: Build the MLP architecture - # Hint: Flatten -> [Linear -> ReLU -> Dropout] * N -> Linear - - pass - - def forward(self, x: torch.Tensor) -> torch.Tensor: - # TODO: Implement forward pass - pass -""" - -TRAINER_PY = """ -import time -from typing import Any, Dict, Tuple - -import torch -import torch.nn as nn -from torch.utils.data import DataLoader -from tqdm import tqdm - -# TODO: Import your metrics or utils if needed - -class Trainer: - def __init__( - self, - model: nn.Module, - optimizer: torch.optim.Optimizer, - config: Dict[str, Any], - device: str, - ): - self.model = model.to(device) - self.optimizer = optimizer - self.config = config - self.device = device - - # TODO: Define Loss Function (Criterion) - self.criterion = None - - # TODO: Initialize ExperimentTracker - self.tracker = None - - def train_epoch(self, dataloader: DataLoader, epoch_idx: int) -> Tuple[float, float, float]: - self.model.train() - - # TODO: Implement Training Loop - # 1. Iterate over dataloader - # 2. Move data to device - # 3. Forward pass, Calculate Loss - # 4. Backward pass, Optimizer step - # 5. Track metrics (Loss, Accuracy, F1) - - raise NotImplementedError("Implement train_epoch") - - def validate(self, dataloader: DataLoader, epoch_idx: int) -> Tuple[float, float, float]: - self.model.eval() - - # TODO: Implement Validation Loop - # Remember: No gradients needed here - - raise NotImplementedError("Implement validate") - - def save_checkpoint(self, epoch: int, val_loss: float) -> None: - # TODO: Save model state, optimizer state, and config - pass - - def fit(self, train_loader: DataLoader, val_loader: DataLoader) -> None: - epochs = self.config["training"]["epochs"] - - print(f"Starting training for {epochs} epochs...") - - for epoch in range(epochs): - # TODO: Call train_epoch and validate - # TODO: Log metrics to tracker - # TODO: Save checkpoints - pass -""" - -LOGGING_PY = """ -import logging -import random -import numpy as np -import torch -import yaml -from typing import Any, Dict - -def setup_logger(name: str = "MLOps_Course") -> logging.Logger: - \"\"\"Configures a standardized logger.\"\"\" - # TODO: Configure logging to stream to console with a specific format - # Format: "%(asctime)s - %(name)s - %(levelname)s - %(message)s" - pass - -def load_config(path: str) -> Dict[str, Any]: - \"\"\"Safely loads a yaml configuration file.\"\"\" - # TODO: Load yaml file - pass - -def seed_everything(seed: int): - \"\"\"Ensures reproducibility across numpy, random, and torch.\"\"\" - # TODO: Set seeds for random, numpy, torch, and cuda - pass -""" - -TRACKER_PY = """ -import csv -from pathlib import Path -from typing import Any, Dict -import yaml - -# TODO: Add TensorBoard Support - -class ExperimentTracker: - def __init__( - self, - experiment_name: str, - config: Dict[str, Any], - base_dir: str = "experiments/results", - ): - self.run_dir = Path(base_dir) / experiment_name - self.run_dir.mkdir(parents=True, exist_ok=True) - - # TODO: Save config to yaml in run_dir - - # Initialize CSV - self.csv_path = self.run_dir / "metrics.csv" - self.csv_file = open(self.csv_path, "w", newline="") - self.csv_writer = csv.writer(self.csv_file) - - # Header (SKELETON: Students need to add the rest) - self.csv_writer.writerow(["epoch"]) - - def log_metrics(self, epoch: int, metrics: Dict[str, float]): - \"\"\" - Writes metrics to CSV (and TensorBoard). - \"\"\" - # TODO: Write full metrics to CSV - self.csv_writer.writerow([epoch]) # Currently only logging epoch - self.csv_file.flush() - - # TODO: Log to TensorBoard - - def get_checkpoint_path(self, filename: str) -> str: - return str(self.run_dir / filename) - - def close(self): - self.csv_file.close() -""" - -TRAIN_SCRIPT = """ -import argparse -import torch -import torch.optim as optim -# from ml_core.data import get_dataloaders -# from ml_core.models import MLP -# from ml_core.solver import Trainer -# from ml_core.utils import load_config, seed_everything, setup_logger - -# logger = setup_logger("Experiment_Runner") - -def main(args): - # 1. Load Config & Set Seed - # config = load_config(args.config) - - # 2. Setup Device - - # 3. Data - # train_loader, val_loader = get_dataloaders(config) - - # 4. Model - # model = MLP(...) - - # 5. Optimizer - # optimizer = optim.Adam(...) - - # 6. Trainer & Fit - # trainer = Trainer(...) - # trainer.fit(...) - pass - -if __name__ == "__main__": - parser = argparse.ArgumentParser(description="Train a Simple MLP on PCAM") - parser.add_argument("--config", type=str, required=True, help="Path to config yaml") - args = parser.parse_args() - - # main(args) - print("Skeleton: Implement main logic first.") -""" - -PLOT_SCRIPT = """ -import argparse -from pathlib import Path -from typing import Optional -import pandas as pd -import matplotlib.pyplot as plt -import seaborn as sns - -def parse_args(): - parser = argparse.ArgumentParser(description="Plot training metrics.") - parser.add_argument("--input_csv", type=Path, required=True) - parser.add_argument("--output_dir", type=Path, default=None) - return parser.parse_args() - -def load_data(file_path: Path) -> pd.DataFrame: - # TODO: Load CSV into Pandas DataFrame - pass - -def setup_style(): - # TODO: Set seaborn theme - pass - -def plot_metrics(df: pd.DataFrame, output_path: Optional[Path]): - \"\"\" - Generate and save plots for Loss, Accuracy, and F1. - \"\"\" - if df is None: return - - # Create a figure with subplots - fig, axes = plt.subplots(2, 2, figsize=(16, 10)) - - # TODO: Plot Train/Val Loss - - # TODO: Plot Train/Val Accuracy - - # TODO: Plot Learning Rate - - plt.tight_layout() - plt.show() # or save to output_path - -def main(): - args = parse_args() - setup_style() - df = load_data(args.input_csv) - plot_metrics(df, args.output_dir) - -if __name__ == "__main__": - main() -""" - -# ========================================== -# 3. REPO BUILDER LOGIC -# ========================================== - -# Directory mapping -structure = { - # --- Root Level --- - ".gitignore": "__pycache__/\n*.pyc\nexperiments/logs/\nexperiments/results/\n.env\n.DS_Store", - "README.md": README_CONTENT, - "requirements.txt": REQUIREMENTS_TXT, - "setup.py": SETUP_PY, - "pyproject.toml": PYPROJECT_TOML, - - # --- Source Code --- - "src/ml_core/__init__.py": "__version__ = '0.1.0'", - - # Data Module - "src/ml_core/data/__init__.py": """ -from .loader import get_dataloaders -from .pcam import PCAMDataset - -__all__ = ["get_dataloaders", "PCAMDataset"] -""", - "src/ml_core/data/pcam.py": PCAM_PY, - "src/ml_core/data/loader.py": LOADER_PY, - - # Models Module - "src/ml_core/models/__init__.py": """ -from .mlp import MLP - -# This stops linters from thinking MLP is "unused". -__all__ = ["MLP"] -""", - "src/ml_core/models/mlp.py": MLP_PY, - - # Solver Module - "src/ml_core/solver/__init__.py": """ -from .trainer import Trainer - -__all__ = ["Trainer"] -""", - "src/ml_core/solver/trainer.py": TRAINER_PY, - - # Utils - "src/ml_core/utils/__init__.py": """ -from .logging import load_config, seed_everything, setup_logger -from .tracker import ExperimentTracker - -__all__ = ["setup_logger", "seed_everything", "load_config", "ExperimentTracker"] -""", - "src/ml_core/utils/logging.py": LOGGING_PY, - "src/ml_core/utils/tracker.py": TRACKER_PY, - - # --- Experiments --- - "experiments/configs/train_config.yaml": TRAIN_CONFIG, - "experiments/train.py": TRAIN_SCRIPT, - - # --- Scripts --- - "scripts/plotting/plot_results_csv.py": PLOT_SCRIPT, - - # --- Tests (Basic Placeholder) --- - "tests/__init__.py": "", - "tests/test_imports.py": """ -def test_imports(): - from ml_core.data import PCAMDataset - from ml_core.models import MLP - assert True -""" -} - -def build_repo(): - print("--- Scaffolding PCAM MLOps Repository ---") - for filepath, content in structure.items(): - create_file(filepath, content) - - print("\n" + "=" * 40) - print("SUCCESS: Repository Structure Created") - print("=" * 40) - print("Next Steps for Students:") - print("1. Create venv: python -m venv venv") - print("2. Activate: source venv/bin/activate") - print("3. Install: pip install -e .") - print("4. Fill Skeletons in src/ml_core/...") - -if __name__ == "__main__": - build_repo() \ No newline at end of file diff --git a/scripts/example_training_loop/training_loop.py b/scripts/example_training_loop/training_loop.py deleted file mode 100644 index 9dad644..0000000 --- a/scripts/example_training_loop/training_loop.py +++ /dev/null @@ -1,71 +0,0 @@ -import matplotlib.pyplot as plt -import torch -import torch.nn as nn -import torch.optim as optim -from ml_core.data import get_dataloaders -from ml_core.models import MLP - -# 1. Setup Configuration -config = { - "data": {"data_path": "../data/pcam/", "batch_size": 32, "num_workers": 2}, - "model": {"input_shape": [3, 96, 96], "hidden_units": [64, 32], "num_classes": 2}, -} - -device = "cuda" if torch.cuda.is_available() else "cpu" -print(f"Training on: {device}") - -# 2. Initialize Data, Model, Optimizer -train_loader, val_loader = get_dataloaders(config) -model = MLP(**config["model"]).to(device) -optimizer = optim.SGD(model.parameters(), lr=0.001) -criterion = nn.CrossEntropyLoss() - -# 3. Training Loop -train_losses = [] -val_losses = [] - -for epoch in range(3): - model.train() - epoch_train_loss = 0 - - for i, (images, labels) in enumerate(train_loader): - images, labels = images.to(device), labels.to(device) - - optimizer.zero_grad() - outputs = model(images) - loss = criterion(outputs, labels) - loss.backward() - optimizer.step() - - epoch_train_loss += loss.item() - - if i % 100 == 0: # Log-after-n-steps granularity - print(f"Epoch {epoch+1}, Step {i}, Loss: {loss.item():.4f}") - - train_losses.append(epoch_train_loss / len(train_loader)) - - # Validation - model.eval() - epoch_val_loss = 0 - with torch.no_grad(): - for images, labels in val_loader: - images, labels = images.to(device), labels.to(device) - outputs = model(images) - loss = criterion(outputs, labels) - epoch_val_loss += loss.item() - - val_losses.append(epoch_val_loss / len(val_loader)) - print( - f"--- Epoch {epoch+1} Summary: Train Loss {train_losses[-1]:.4f}, Val Loss {val_losses[-1]:.4f} ---" - ) - -plt.figure(figsize=(10, 5)) -plt.plot(range(1, 4), train_losses, label="Train Loss", marker="o") -plt.plot(range(1, 4), val_losses, label="Val Loss", marker="o") -plt.title("PCAM Training: First 3 Epochs") -plt.xlabel("Epoch") -plt.ylabel("CrossEntropy Loss") -plt.legend() -plt.grid(True) -plt.savefig("pcam_learning_curves.png") -print("Training complete. Plot saved as pcam_learning_curves.png") diff --git a/scripts/plotting/plot_results_csv.py b/scripts/plotting/plot_results_csv.py deleted file mode 100644 index fc24332..0000000 --- a/scripts/plotting/plot_results_csv.py +++ /dev/null @@ -1,47 +0,0 @@ -import argparse -from pathlib import Path -from typing import Optional -import pandas as pd -import matplotlib.pyplot as plt -import seaborn as sns - -def parse_args(): - parser = argparse.ArgumentParser(description="Plot training metrics.") - parser.add_argument("--input_csv", type=Path, required=True) - parser.add_argument("--output_dir", type=Path, default=None) - return parser.parse_args() - -def load_data(file_path: Path) -> pd.DataFrame: - # TODO: Load CSV into Pandas DataFrame - pass - -def setup_style(): - # TODO: Set seaborn theme - pass - -def plot_metrics(df: pd.DataFrame, output_path: Optional[Path]): - """ - Generate and save plots for Loss, Accuracy, and F1. - """ - if df is None: return - - # Create a figure with subplots - fig, axes = plt.subplots(2, 2, figsize=(16, 10)) - - # TODO: Plot Train/Val Loss - - # TODO: Plot Train/Val Accuracy - - # TODO: Plot Learning Rate - - plt.tight_layout() - plt.show() # or save to output_path - -def main(): - args = parse_args() - setup_style() - df = load_data(args.input_csv) - plot_metrics(df, args.output_dir) - -if __name__ == "__main__": - main() diff --git a/scripts/torch_example.py b/scripts/torch_example.py deleted file mode 100644 index 2120a04..0000000 --- a/scripts/torch_example.py +++ /dev/null @@ -1,106 +0,0 @@ -import numpy as np -import matplotlib.pyplot as plt -import torch -import torch.nn as nn -from torch.optim import SGD, Adam -from torch.utils.data import Dataset, DataLoader -import random -import typing - -np.random.seed(1) -torch.manual_seed(1) -random.seed(1) - -# 1. Data Generation -num_samples = 1000 -# Data of class A (centered at 0) -A = np.random.normal(0, 0.75, size=(num_samples, 2)) -# Data of class B (centered at 3) -B = np.random.normal(3, 0.75, size=(num_samples, 2)) - -# Labels: A is 0, B is 1 -y = [0 if i < num_samples else 1 for i in range(num_samples * 2)] -input_data = np.concatenate([A, B], axis=0) - -# Visualize the dataset -plt.figure(figsize=(10, 7)) -plt.scatter(input_data[:, 0], input_data[:, 1], c=y, alpha=0.5) -plt.title("Generated Data Distribution") -plt.grid() -plt.savefig("data_distribution.png") -plt.close() # Close plot to free up memory - -class Model(nn.Module): - def __init__(self, input_dim: int=2, hidden_dim: int=5, output: int=1): - super().__init__() - - self.fc1 = nn.Linear(input_dim, hidden_dim) - self.fc2 = nn.Linear(hidden_dim, output) - self.relu = nn.ReLU() - self.sigmoid = nn.Sigmoid() - - def forward(self, x: torch.Tensor) -> torch.Tensor: - # x shape: [batch_size, input_dim=2] - output = self.fc1(x) # shape: [batch_size, hidden_dim=5] - output = self.relu(output) - output = self.fc2(output) - sigmoid = self.sigmoid(output) - return sigmoid # shape: [batch_size, 1] - -class ExampleData(Dataset): - def __init__(self, datapoints: np.array, labels: np.array): - self.datapoints = torch.tensor(datapoints) - self.labels = torch.tensor(labels) - - def __len__(self): - return len(self.datapoints) # datapoints.shape[0] - - def __getitem__(self, index: int): - x = self.datapoints[index].float() - y = self.labels[index].float() - return x, y - -#model = Model(hidden_dim=1024) -model = nn.Sequential(nn.Linear(2, 1024), nn.ReLU(), nn.Dropout(p=0.5), nn.Linear(1024, 1), nn.Sigmoid()) -print(model) - -#data = list(zip(input_data, y)) -#random.shuffle(data) - -train_data = ExampleData(input_data, y) -train_loader = DataLoader(train_data, batch_size=64, shuffle=True) - -optimizer = Adam(model.parameters(), lr=0.001) - -criterion = nn.BCELoss() - -loss_list = [] - -for epoch in range(5): - for x, y in train_loader: - # shape x: [4,2] - optimizer.zero_grad() - - output = model(x).squeeze(dim=1) # shape [4,1] -> shape [4] - - loss = criterion(output, y) - loss.backward() - optimizer.step() - - loss_list.append(loss.item()) - - -plt.figure(figsize=(10, 5)) -plt.plot(loss_list, label="Raw Loss", alpha=0.3) -plt.title("Training Loss Over Time") -plt.xlabel("Iteration") -plt.ylabel("BCE Loss") -plt.legend() -plt.savefig("training_loss_dataloader_dropout_0.5.png") - - - - - - - diff --git a/src/ml_core/__init__.py b/src/ml_core/__init__.py deleted file mode 100644 index b794fd4..0000000 --- a/src/ml_core/__init__.py +++ /dev/null @@ -1 +0,0 @@ -__version__ = '0.1.0' diff --git a/src/ml_core/data/__init__.py b/src/ml_core/data/__init__.py deleted file mode 100644 index 74d7ca1..0000000 --- a/src/ml_core/data/__init__.py +++ /dev/null @@ -1,4 +0,0 @@ -from .loader import get_dataloaders -from .pcam import PCAMDataset - -__all__ = ["get_dataloaders", "PCAMDataset"] diff --git a/src/ml_core/data/loader.py b/src/ml_core/data/loader.py deleted file mode 100644 index 93170fa..0000000 --- a/src/ml_core/data/loader.py +++ /dev/null @@ -1,41 +0,0 @@ -from pathlib import Path -from typing import Dict, Tuple - -import numpy as np -from torch.utils.data import DataLoader, WeightedRandomSampler -from torchvision import transforms - -from .pcam import PCAMDataset - - -def get_dataloaders(config: Dict) -> Tuple[DataLoader, DataLoader]: - data_cfg = config["data"] - base_path = Path(data_cfg["data_path"]) - - def create_loader(split: str, use_sampler: bool = False): - x_p = str(base_path / f"camelyonpatch_level_2_split_{split}_x.h5") - y_p = str(base_path / f"camelyonpatch_level_2_split_{split}_y.h5") - - # Using ToTensor handles the (C, H, W) conversion and scaling to [0, 1] - ds = PCAMDataset(x_p, y_p, transform=transforms.ToTensor()) - - sampler = None - if use_sampler: - # Flatten labels for weight calculation - labels = ds.y_data[:].flatten() - class_counts = np.bincount(labels) - weights = 1.0 / class_counts[labels] - sampler = WeightedRandomSampler(weights, len(weights)) - - return DataLoader( - ds, - batch_size=data_cfg["batch_size"], - sampler=sampler, - num_workers=data_cfg.get("num_workers", 0), - shuffle=(sampler is None), # Shuffle only if not using sampler - ) - - train_loader = create_loader("train", use_sampler=True) - val_loader = create_loader("valid", use_sampler=False) - - return train_loader, val_loader diff --git a/src/ml_core/data/pcam.py b/src/ml_core/data/pcam.py deleted file mode 100644 index ec48488..0000000 --- a/src/ml_core/data/pcam.py +++ /dev/null @@ -1,54 +0,0 @@ -from typing import Callable, Optional, Tuple - -import h5py -import numpy as np -import torch -from torch.utils.data import Dataset - - -class PCAMDataset(Dataset): - def __init__( - self, - x_path: str, - y_path: str, - transform: Optional[Callable] = None, - filter_data: bool = False, - ): - self.x_data = h5py.File(x_path, "r")["x"] - self.y_data = h5py.File(y_path, "r")["y"] - self.transform = transform - - # Initialize indices for filtering - self.indices = np.arange(len(self.x_data)) - - if filter_data: - valid_indices = [] - for i in range(len(self.x_data)): - # Heuristic: Drop blackouts (0) and washouts (255) - mean_val = np.mean(self.x_data[i]) - if 0 < mean_val < 255: - valid_indices.append(i) - self.indices = np.array(valid_indices) - - def __len__(self) -> int: - return len(self.indices) - - def __getitem__(self, idx: int) -> Tuple[torch.Tensor, torch.Tensor]: - real_idx = self.indices[idx] - img = self.x_data[real_idx] - label = self.y_data[real_idx].item() - - # Handle NaNs explicitly before clipping/casting - # This replaces NaNs with 0.0 (black) - img = np.nan_to_num(img, nan=0.0) - - # Numerical Stability: Clip before uint8 cast - img = np.clip(img, 0, 255).astype(np.uint8) - - if self.transform: - img = self.transform(img) - else: - # Basic conversion if no transform provided - img = torch.from_numpy(img).permute(2, 0, 1).float() - - return img, torch.tensor(label, dtype=torch.long) diff --git a/src/ml_core/models/__init__.py b/src/ml_core/models/__init__.py deleted file mode 100644 index 0151f3b..0000000 --- a/src/ml_core/models/__init__.py +++ /dev/null @@ -1,4 +0,0 @@ -from .mlp import MLP - -# This stops linters from thinking MLP is "unused". -__all__ = ["MLP"] diff --git a/src/ml_core/models/mlp.py b/src/ml_core/models/mlp.py deleted file mode 100644 index 6325324..0000000 --- a/src/ml_core/models/mlp.py +++ /dev/null @@ -1,35 +0,0 @@ -from typing import List - -import torch -import torch.nn as nn - - -class MLP(nn.Module): - def __init__( - self, - input_shape: List[int], - hidden_units: List[int], - num_classes: int = 2, - dropout_rate: float = 0.2, - ): - super().__init__() - - self.input_dim = input_shape[0] * input_shape[1] * input_shape[2] - layers = [] - in_features = self.input_dim - - for hidden in hidden_units: - layers.append(nn.Linear(in_features, hidden)) - layers.append(nn.ReLU()) - layers.append(nn.Dropout(dropout_rate)) - in_features = hidden - - # map to num_classes (e.g., 2 for binary because we are using CrossEntropyLoss) - layers.append(nn.Linear(in_features, num_classes)) - - self.network = nn.Sequential(*layers) - self.flatten = nn.Flatten() - - def forward(self, x: torch.Tensor) -> torch.Tensor: - x = self.flatten(x) - return self.network(x) diff --git a/src/ml_core/solver/__init__.py b/src/ml_core/solver/__init__.py deleted file mode 100644 index 81618ca..0000000 --- a/src/ml_core/solver/__init__.py +++ /dev/null @@ -1,3 +0,0 @@ -from .trainer import Trainer - -__all__ = ["Trainer"] diff --git a/src/ml_core/solver/trainer.py b/src/ml_core/solver/trainer.py deleted file mode 100644 index 62fc98f..0000000 --- a/src/ml_core/solver/trainer.py +++ /dev/null @@ -1,68 +0,0 @@ -import time -from typing import Any, Dict, Tuple - -import torch -import torch.nn as nn -from torch.utils.data import DataLoader -from tqdm import tqdm - -from ..utils import ExperimentTracker, setup_logger - - -class Trainer: - def __init__( - self, - model: nn.Module, - optimizer: torch.optim.Optimizer, - config: Dict[str, Any], - device: str, - ): - self.model = model.to(device) - self.optimizer = optimizer - self.config = config - self.device = device - - # TODO: Define Loss Function (Criterion) - self.criterion = None - - # TODO: Initialize ExperimentTracker - self.tracker = None - - # TODO: Initialize metric calculation (like accuracy/f1-score) if needed - - def train_epoch(self, dataloader: DataLoader, epoch_idx: int) -> Tuple[float, float, float]: - self.model.train() - - # TODO: Implement Training Loop - # 1. Iterate over dataloader - # 2. Move data to device - # 3. Forward pass, Calculate Loss - # 4. Backward pass, Optimizer step - # 5. Track metrics (Loss, Accuracy, F1) - - raise NotImplementedError("Implement train_epoch") - - def validate(self, dataloader: DataLoader, epoch_idx: int) -> Tuple[float, float, float]: - self.model.eval() - - # TODO: Implement Validation Loop - # Remember: No gradients needed here - - raise NotImplementedError("Implement validate") - - def save_checkpoint(self, epoch: int, val_loss: float) -> None: - # TODO: Save model state, optimizer state, and config - pass - - def fit(self, train_loader: DataLoader, val_loader: DataLoader) -> None: - epochs = self.config["training"]["epochs"] - - print(f"Starting training for {epochs} epochs...") - - for epoch in range(epochs): - # TODO: Call train_epoch and validate - # TODO: Log metrics to tracker - # TODO: Save checkpoints - pass - - # Remember to handle the trackers properly diff --git a/src/ml_core/utils/__init__.py b/src/ml_core/utils/__init__.py deleted file mode 100644 index bf6c762..0000000 --- a/src/ml_core/utils/__init__.py +++ /dev/null @@ -1,4 +0,0 @@ -from .logging import load_config, seed_everything, setup_logger -from .tracker import ExperimentTracker - -__all__ = ["setup_logger", "seed_everything", "load_config", "ExperimentTracker"] diff --git a/src/ml_core/utils/logging.py b/src/ml_core/utils/logging.py deleted file mode 100644 index 2b908f0..0000000 --- a/src/ml_core/utils/logging.py +++ /dev/null @@ -1,30 +0,0 @@ -import logging -import random -import numpy as np -import torch -import yaml -from typing import Any, Dict - -def setup_logger(name: str = "MLOps_Course") -> logging.Logger: - """Configures a standardized logger.""" - logger = logging.getLogger(name) - if not logger.handlers: - logger.setLevel(logging.INFO) - handler = logging.StreamHandler() - formatter = logging.Formatter( - "%(asctime)s - %(name)s - %(levelname)s - %(message)s" - ) - handler.setFormatter(formatter) - logger.addHandler(handler) - return logger - - -def load_config(path: str) -> Dict[str, Any]: - """Safely loads a yaml configuration file.""" - with open(path, "r") as f: - return yaml.safe_load(f) - -def seed_everything(seed: int): - """Ensures reproducibility across numpy, random, and torch.""" - # TODO: Set seeds for random, numpy, torch, and cuda - pass diff --git a/src/ml_core/utils/tracker.py b/src/ml_core/utils/tracker.py deleted file mode 100644 index 351e178..0000000 --- a/src/ml_core/utils/tracker.py +++ /dev/null @@ -1,42 +0,0 @@ -import csv -from pathlib import Path -from typing import Any, Dict -import yaml - -# TODO: Add TensorBoard Support - -class ExperimentTracker: - def __init__( - self, - experiment_name: str, - config: Dict[str, Any], - base_dir: str = "experiments/results", - ): - self.run_dir = Path(base_dir) / experiment_name - self.run_dir.mkdir(parents=True, exist_ok=True) - - # TODO: Save config to yaml in run_dir - - # Initialize CSV - self.csv_path = self.run_dir / "metrics.csv" - self.csv_file = open(self.csv_path, "w", newline="") - self.csv_writer = csv.writer(self.csv_file) - - # Header (TODO: add the rest of things we want to track, loss, gradients, accuracy etc.) - self.csv_writer.writerow(["epoch"]) - - def log_metrics(self, epoch: int, metrics: Dict[str, float]): - """ - Writes metrics to CSV (and TensorBoard). - """ - # TODO: Write other useful metrics to CSV - self.csv_writer.writerow([epoch]) # Currently only logging epoch - self.csv_file.flush() - - # TODO: Log to TensorBoard - - def get_checkpoint_path(self, filename: str) -> str: - return str(self.run_dir / filename) - - def close(self): - self.csv_file.close() diff --git a/tcga_data/README.md b/tcga_data/README.md new file mode 100644 index 0000000..c6fe529 --- /dev/null +++ b/tcga_data/README.md @@ -0,0 +1,13 @@ +# TCGA Data Loading Project + +This directory contains scripts and data files for processing TCGA patient embeddings and clinical information. + +## File Descriptions + +* **example_tcga_dataloader.py** A Python script containing a custom PyTorch `Dataset` and `DataLoader` implementation designed to align patient embeddings with cancer type labels. + +* **tcga_titan_embeddings.pkl** A pickled dictionary where keys are patient IDs and values contain lists of 768-dimensional feature vectors (embeddings). + +* **tcga_patient_to_cancer_type.csv** A CSV file mapping patient IDs to their respective cancer type classifications, used as the ground-truth labels for training. + +* **tcga_reports.jsonl** A JSON Lines file containing textual clinical or pathology reports for each patient, formatted for NLP tasks or multi-modal integration. diff --git a/tcga_data/example_tcga_dataloader.py b/tcga_data/example_tcga_dataloader.py new file mode 100644 index 0000000..feb7a51 --- /dev/null +++ b/tcga_data/example_tcga_dataloader.py @@ -0,0 +1,127 @@ +import pickle +import pandas as pd +import torch +import json +from torch.utils.data import Dataset, DataLoader + +class TCGADataset(Dataset): + """ + Dataset class for TCGA embeddings and cancer type labels. + Expected data format: Pickled dictionary with patient IDs as keys. + """ + def __init__(self, pickle_path: str, csv_path: str, class_to_idx=None): + # TODO: add the text embeddings! Make sure they are aligned with the pid! + # 1. Load the noised embeddings + with open(pickle_path, 'rb') as f: + self.embedding_data = pickle.load(f) + + # 1.3 Load vLLM-preprocessed reports (text modality) + self.text_data = {} + with open("tcga_reports.jsonl", "r") as f: + for line in f: + obj = json.loads(line) + pid = obj.get("patient_id") or obj.get("pid") + text = obj.get("text") or obj.get("report") or obj.get("processed_text") + if pid is not None and text is not None: + self.text_data[pid] = text + + + # 2. Load the labels + self.labels_df = pd.read_csv(csv_path) + + # 3. Create or use existing class mapping (ensures train/test alignment) + if class_to_idx is None: + self.cancer_types = sorted(self.labels_df['cancer_type'].unique()) + self.class_to_idx = {name: i for i, name in enumerate(self.cancer_types)} + else: + self.class_to_idx = class_to_idx + + # # 4. Identify patients that exist in BOTH the embeddings and the label file + # self.valid_patient_ids = sorted(list( + # set(self.embedding_data.keys()).intersection(set(self.labels_df['patient_id'])) + # )) + + self.valid_patient_ids = sorted(list( + set(self.embedding_data.keys()) + .intersection(set(self.labels_df['patient_id'])) + .intersection(set(self.text_data.keys())) + )) + + + + + # 5. Map Patient IDs to their cancer type labels for fast lookup + self.id_to_label = dict(zip(self.labels_df['patient_id'], self.labels_df['cancer_type'])) + + def __len__(self): + """Returns the total number of valid patients in the dataset.""" + return len(self.valid_patient_ids) + + def __getitem__(self, idx): + """ + Retrieves a single sample (embedding + label). + Since data is pre-noised and mean-pooled, we take the first item + from the embeddings list. + """ + pid = self.valid_patient_ids[idx] + + # Retrieve an embedding (768-dim vector) + # TODO: think what you're going to do with the patients that have more than 1 embedding + # That is, patients who have had more than 1 imaging done + embedding_list = self.embedding_data[pid]['embeddings'] + embedding_vector = embedding_list[0] + + # Convert to PyTorch Tensor + x = torch.tensor(embedding_vector, dtype=torch.float32) + + t = self.text_data[pid] + + # Get label and convert to integer index + label_name = self.id_to_label[pid] + y = torch.tensor(self.class_to_idx[label_name], dtype=torch.long) + + return x, t, y + + +def main(): + # --- Configuration --- + TRAIN_PKL = 'tcga_titan_embeddings.pkl' + LABEL_CSV = 'tcga_patient_to_cancer_type.csv' + BATCH_SIZE = 32 + + # --- Loading --- + print("Loading TCGA Dataset...") + train_dataset = TCGADataset(TRAIN_PKL, LABEL_CSV) + + train_loader = DataLoader( + train_dataset, + batch_size=BATCH_SIZE, + shuffle=True + ) + + # --- Verification --- + print(f"Dataset loaded successfully!") + print(f"Total Patients: {len(train_dataset)}") + print(f"Number of Classes: {len(train_dataset.class_to_idx)}") + + # # Peek at the first batch + # features, texts, labels = next(iter(train_loader)) + # print(f"\nBatch Information:") + # print(f"Feature shape: {features.shape} (Expected: [{BATCH_SIZE}, 768])") + # print(f"Labels shape: {labels.shape} (Expected: [{BATCH_SIZE}])") + + features, texts, labels = next(iter(train_loader)) + print(f"\nBatch Information:") + print(f"Feature shape: {features.shape} (Expected: [{BATCH_SIZE}, 768])") + print(f"Example text: {texts[0][:120]}...") + print(f"Labels shape: {labels.shape} (Expected: [{BATCH_SIZE}])") + + + # Display the mapping to the students + print("\nClass Mapping (first 5):") + for i, (name, idx) in enumerate(train_dataset.class_to_idx.items()): + print(f" {name}: {idx}") + if i == 4: break + +if __name__ == "__main__": + main() diff --git a/tcga_data/tcga_patient_to_cancer_type.csv b/tcga_data/tcga_patient_to_cancer_type.csv new file mode 100644 index 0000000..aa32c72 --- /dev/null +++ b/tcga_data/tcga_patient_to_cancer_type.csv @@ -0,0 +1,11161 @@ +patient_id,cancer_type +TCGA-OR-A5J1,ACC +TCGA-OR-A5J2,ACC +TCGA-OR-A5J3,ACC +TCGA-OR-A5J4,ACC +TCGA-OR-A5J5,ACC +TCGA-OR-A5J6,ACC +TCGA-OR-A5J7,ACC +TCGA-OR-A5J8,ACC +TCGA-OR-A5J9,ACC +TCGA-OR-A5JA,ACC +TCGA-OR-A5JB,ACC +TCGA-OR-A5JC,ACC +TCGA-OR-A5JD,ACC +TCGA-OR-A5JE,ACC +TCGA-OR-A5JF,ACC +TCGA-OR-A5JG,ACC +TCGA-OR-A5JH,ACC +TCGA-OR-A5JI,ACC +TCGA-OR-A5JJ,ACC +TCGA-OR-A5JK,ACC +TCGA-OR-A5JL,ACC +TCGA-OR-A5JM,ACC +TCGA-OR-A5JO,ACC +TCGA-OR-A5JP,ACC +TCGA-OR-A5JQ,ACC +TCGA-OR-A5JR,ACC +TCGA-OR-A5JS,ACC +TCGA-OR-A5JT,ACC +TCGA-OR-A5JU,ACC +TCGA-OR-A5JV,ACC +TCGA-OR-A5JW,ACC +TCGA-OR-A5JX,ACC +TCGA-OR-A5JY,ACC +TCGA-OR-A5JZ,ACC +TCGA-OR-A5K0,ACC +TCGA-OR-A5K1,ACC +TCGA-OR-A5K2,ACC +TCGA-OR-A5K3,ACC +TCGA-OR-A5K4,ACC +TCGA-OR-A5K5,ACC +TCGA-OR-A5K6,ACC +TCGA-OR-A5K8,ACC +TCGA-OR-A5K9,ACC +TCGA-OR-A5KB,ACC +TCGA-OR-A5KO,ACC +TCGA-OR-A5KP,ACC +TCGA-OR-A5KQ,ACC +TCGA-OR-A5KS,ACC +TCGA-OR-A5KT,ACC +TCGA-OR-A5KU,ACC +TCGA-OR-A5KV,ACC +TCGA-OR-A5KW,ACC +TCGA-OR-A5KX,ACC +TCGA-OR-A5KY,ACC +TCGA-OR-A5KZ,ACC +TCGA-OR-A5L1,ACC +TCGA-OR-A5L2,ACC +TCGA-OR-A5L3,ACC +TCGA-OR-A5L4,ACC +TCGA-OR-A5L5,ACC +TCGA-OR-A5L6,ACC +TCGA-OR-A5L8,ACC +TCGA-OR-A5L9,ACC +TCGA-OR-A5LA,ACC +TCGA-OR-A5LB,ACC +TCGA-OR-A5LC,ACC +TCGA-OR-A5LD,ACC +TCGA-OR-A5LE,ACC +TCGA-OR-A5LF,ACC +TCGA-OR-A5LG,ACC +TCGA-OR-A5LH,ACC +TCGA-OR-A5LI,ACC +TCGA-OR-A5LJ,ACC +TCGA-OR-A5LK,ACC 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+TCGA-BT-A20Q,BLCA +TCGA-BT-A20R,BLCA +TCGA-BT-A20T,BLCA +TCGA-BT-A20U,BLCA +TCGA-BT-A20V,BLCA +TCGA-BT-A20W,BLCA +TCGA-BT-A20X,BLCA +TCGA-BT-A2LA,BLCA +TCGA-BT-A2LB,BLCA +TCGA-BT-A2LD,BLCA +TCGA-BT-A3PH,BLCA +TCGA-BT-A3PJ,BLCA +TCGA-BT-A3PK,BLCA +TCGA-BT-A42B,BLCA +TCGA-BT-A42C,BLCA +TCGA-BT-A42E,BLCA +TCGA-BT-A42F,BLCA +TCGA-C4-A0EZ,BLCA +TCGA-C4-A0F0,BLCA +TCGA-C4-A0F1,BLCA +TCGA-C4-A0F6,BLCA +TCGA-C4-A0F7,BLCA +TCGA-CF-A1HR,BLCA +TCGA-CF-A1HS,BLCA +TCGA-CF-A27C,BLCA +TCGA-CF-A3MF,BLCA +TCGA-CF-A3MG,BLCA +TCGA-CF-A3MH,BLCA +TCGA-CF-A3MI,BLCA +TCGA-CF-A47S,BLCA +TCGA-CF-A47T,BLCA +TCGA-CF-A47V,BLCA +TCGA-CF-A47W,BLCA +TCGA-CF-A47X,BLCA +TCGA-CF-A47Y,BLCA +TCGA-CF-A5U8,BLCA +TCGA-CF-A5UA,BLCA +TCGA-CF-A7I0,BLCA +TCGA-CF-A8HX,BLCA +TCGA-CF-A8HY,BLCA +TCGA-CF-A9FF,BLCA +TCGA-CF-A9FH,BLCA +TCGA-CF-A9FL,BLCA +TCGA-CF-A9FM,BLCA +TCGA-CU-A0YN,BLCA +TCGA-CU-A0YO,BLCA +TCGA-CU-A0YR,BLCA +TCGA-CU-A3KJ,BLCA +TCGA-CU-A3QU,BLCA +TCGA-CU-A3YL,BLCA +TCGA-CU-A5W6,BLCA +TCGA-CU-A72E,BLCA 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neoplasm composed of atypical squamous cells. The tumor exhibits invasive growth with loss of cellular differentiation. No specific measurements are provided in the report. The lesion is confined to the cervix without evidence of distant spread."} +{"pid": "TCGA-S9-A6WL", "report": "The neuropathology report indicates a tumor with histological and morphological features characterized by increased cellularity, nuclear atypia, and mitotic activity. The lesion demonstrates infiltrative growth patterns and moderate cellular pleomorphism. Immunohistochemical staining shows positivity for glial markers. Based on these findings, the tumor is classified as WHO grade III."} +{"pid": "TCGA-A8-A09C", "report": "The specimen shows a moderately differentiated invasive lesion measuring 2.2 cm in diameter, extending cranially to within 5 mm of the resection margin at 3 and 12 o'clock. No residual tumor is identified in the follow-up resection material. Sentinel lymph nodes are free of metastatic involvement. Histologic grade is G2. The surgical margins are tumor-free."} +{"pid": "TCGA-2H-A9GI", "report": "The specimen shows a moderately differentiated carcinoma arising in Barrett\u2019s epithelium, located in the distal esophagus. The lesion measures 4 x 3.5 cm. A total of 8 lymph nodes were examined, with 4 showing involvement. The resection margins are clear, indicating a radical resection. Cellular features include moderate differentiation with glandular architecture. Staging is based on tumor size and lymph node involvement."} +{"pid": "TCGA-AA-3952", "report": "The specimen shows an invasive, poorly differentiated epithelial neoplasm arising in the colon, with extension through all layers of the bowel wall. Vascular invasion and lymphatic involvement are present. A total of 14 regional lymph nodes were examined, and six of them show evidence of tumor spread. The tumor is classified as high grade based on its cellular features. Staging parameters indicate advanced local invasion with significant nodal involvement."} +{"pid": "TCGA-AG-4001", "report": "The resected colon specimen from the rectosigmoid region demonstrates tumor-free oral and aboral resection margins. An ulcerated lesion is present, characterized by moderately differentiated cellular features. Histological evaluation shows infiltration into the perimuscular fatty tissue. No involvement of local lymph nodes was identified, with a total of 29 lymph nodes examined. Vascular invasion is absent. The lesion exhibits a histologic grade consistent with moderate differentiation."} +{"pid": "TCGA-AN-A0FX", "report": "Female patient underwent radical mastectomy for tumor excision. Histological evaluation revealed a high-grade neoplasm with features of metaplastic differentiation. The tumor was located in the left breast and classified as a primary lesion. Pathologic staging showed T stage 2, N stage 0, M stage 0. No prior treatment was administered. A normal blood sample was collected via blood draw and stored frozen for analysis."} +{"pid": "TCGA-IG-A3YA", "report": "The esophageal specimen measured 3 x 3 x 1.2 cm and showed a moderately differentiated cellular growth pattern. The deepest extent of the lesion involved the adventitia. No regional lymph node metastases were identified out of four examined. Lymphatic or venous invasion could not be confirmed. Surgical margins were free of abnormal cells. There was no evidence of prior treatment effect. No additional findings were reported."} +{"pid": "TCGA-EB-A42Z", "report": "The surgical resection specimen from the skin measured 3 x 3 x 1 cm and exhibited ulceration with pigmentation. Microscopic evaluation revealed poorly differentiated tumor cells. The Breslow depth was measured at 10 mm. Of the 10 lymph nodes examined, one from the right inguinal region showed evidence of metastatic involvement. No definitive assessment was made regarding lymphatic or venous invasion, satellite nodules, surgical margins, or prior neoadjuvant treatment."} +{"pid": "TCGA-86-8358", "report": "Specimen consisted of a lobectomy with tumor located in the lung measuring 3.2 x 3.2 x 3.2 cm. Microscopic examination revealed poorly differentiated cells. A total of six regional lymph nodes were examined, and none contained metastatic involvement. Additional features including tumor extent, presence of other nodules, lymphatic or venous invasion, margin status, neoadjuvant treatment effect, and other findings were not specified. The laterality was noted as right-upper."} +{"pid": "TCGA-BR-7707", "report": "The excised gastric specimen from the fundus measured 6 \u00d7 6 \u00d7 1 cm. Microscopic evaluation revealed a poorly differentiated histologic pattern. The lesion extended to the muscularis propria. No lymph node metastases were identified in the two regional nodes examined. Lymphatic, venous, and perineural invasion were not identified. Surgical margins were free of involvement. No evidence of neoadjuvant treatment response or additional significant pathologic findings was noted."} +{"pid": "TCGA-UD-AAC7", "report": "Lung biopsy: Six tan-colored tissue fragments measuring 2-5 mm each were received. Microscopic examination reveals a fragment of an infiltrating epithelioid neoplasm. The cells do not produce mucin, although mucin within the tissue is present. Immunohistochemical staining shows positivity for keratin broad spectrum (AE1/3), calretinin, and WT-1. Stains for TTF-1 and CEA (polyclonal) are negative. No other significant findings are noted."} +{"pid": "TCGA-2G-AAGG", "report": "The pathology report describes a left orchidectomy specimen. The tumor measured 5.5 cm in diameter and was confined entirely to the testis. Histologic evaluation showed a predominantly mixed germ cell tumor composed of embryonal carcinoma and yolk sac tumor components, each comprising approximately 5% of the tumor volume. A small proportion of trophoblastic giant cells were also identified. No angioinvasion was observed, and there was no evidence of invasion into the rete testis."} +{"pid": "TCGA-85-6175", "report": "The specimen consists of lung tissue obtained following pneumonectomy. The tumor measures 10 x 10 x 4 cm and is composed of well-differentiated cells with squamous morphology. Cellular features include abundant cytoplasm, distinct cell borders, and centrally located nuclei with moderate pleomorphism. No assessment was provided regarding tumor extent, presence of additional nodules, lymph node involvement, lymphatic or venous invasion, margin status, evidence of neoadjuvant treatment effect, or other associated pathologic findings."} +{"pid": "TCGA-BR-8291", "report": "The specimen consisted of a subtotal gastrectomy with a tumor located in the antrum measuring 3.5 x 3 x 1.5 cm. The tumor exhibited diffusely infiltrating growth features. Histologic evaluation showed a diffuse-type morphology. The extent of the tumor reached the subserosa. Of the six lymph nodes examined, one was positive for metastasis. All surgical margins were free of tumor involvement. There was no indication of prior neo-adjuvant treatment. No additional pathologic findings or comments were noted."} +{"pid": "TCGA-B0-5121", "report": "A right radical nephrectomy specimen demonstrates a neoplasm located in the upper pole of the kidney. The lesion measures 4.5 cm in greatest dimension and is unifocal. Histologic examination reveals clear cell morphology with Fuhrman nuclear grade 2 of 4. The tumor is confined to the kidney without extracapsular extension. No angiolymphatic invasion is identified. Surgical margins are free of neoplastic cells. No regional lymph nodes were examined. The adrenal gland is not present in the specimen. There is no evidence of residual tumor post-resection."} +{"pid": "TCGA-BR-8286", "report": "The excised stomach tissue specimen involved the antrum and measured 8 x 6.5 x 1 cm. Microscopic evaluation showed a poorly differentiated histologic type. The tumor extended to the serosa, including the visceral peritoneum. No lymph node metastases were identified in the regional lymph nodes examined (0/5 positive). Lymphatic, venous, and perineural invasion were not specified. Surgical margins were uninvolved. No evidence of neo-adjuvant treatment effects was observed. No additional findings or comments were noted. Laterality was not specified."} +{"pid": "TCGA-EB-A3XD", "report": "The specimen consisted of an excised skin lesion from the hip, measuring 2 x 0 x 2.5 cm. The lesion was noted to be ulcerated and pigmented. Histologic evaluation revealed a tumor with features including cellular atypia and mitotic activity. No lymphatic invasion was identified, and venous invasion was absent. Lymph node involvement could not be determined as no nodes were assessed. The surgical margins were uninvolved. Breslow's depth measurement was reported at 5 mm. No evidence of neoadjuvant treatment was observed, and no additional pathologic findings were noted."} +{"pid": "TCGA-QH-A870", "report": "PATHOLOGIST REPORT. Code: Gender: F. Localization: Right parieto-occipital region. The specimen shows a neoplastic lesion characterized by moderate cellularity with a mixture of cells displaying round to oval nuclei and varying degrees of nuclear atypia. Mitotic activity is present. The tissue architecture shows focal areas of necrosis but no microvascular proliferation. The tumor infiltrates the surrounding brain parenchyma, and surgical margins are involved. Immunohistochemical staining demonstrates positivity for glial markers. Based on histological features and extent of resection, the lesion is classified as a high-grade neoplasm."} +{"pid": "TCGA-WB-A81Q", "report": "The pathology review describes a soft gray to reddish mass measuring 10 cm in diameter, located in the right adrenal. Within the mass, there is a lighter-colored region approximately 4 cm in size. Microscopic examination reveals a tumor composed of cells arranged in nests or clusters known as zellballen. The cells exhibit marked nuclear pleomorphism. In certain areas, melanin pigment or melanin-containing globules are present, giving the cytoplasm a tan appearance. Additionally, regions showing ganglionic differentiation are observed, characterized by peripheral nuclei, central eosinophilic cytoplasm, and long cytoplasmic projections. There is no evidence of vascular invasion."} +{"pid": "TCGA-A8-A07U", "report": "The specimen consists of right breast resection material containing a 2.2 cm lesion with poorly differentiated features. The margins are negative, with the closest margin measuring approximately 1 cm at the base and at the 6 o\u2019clock position. Surrounding tissue shows fibrolipomatous changes and atrophic glandular elements. No intraductal component is identified. The overlying skin, including the nipple, is free of tumor involvement. Pathologic classification indicates high-grade morphology (G3), with regional lymph node involvement noted (pN2a). Distant metastasis could not be assessed (pMX). Resection margins are complete (R0)."} +{"pid": "TCGA-D6-A6EN", "report": "Gender: M. Examination result No. Surgery and Laryngological Oncology Dept. Clinical suspicion of a lesion in the left cheek region. Date of admission: Material obtained from mucous membrane via resection of the lesion. Histopathological analysis reveals invasive cellular growth with high-grade features. The tumor measures T2 stage (8070/3 T-51030). Microscopic evaluation shows infiltration at the marked excision margins, with no involvement of other margins. Vascular invasion is present, while no evidence of nerve invasion is observed. Intraoperative findings indicate tumor involvement at the surgical margin marked with two wires. Final pathology results will be available after complete processing of paraffin-embedded specimens."} +{"pid": "TCGA-D7-8572", "report": "The resected stomach specimen measures 25 x 17 cm, with attached omentum measuring 30 x 20 cm. A lesion measuring 9 x 5.5 x 1.4 cm is located in the central region of the stomach. The distance from the proximal resection margin is 12 cm, and from the distal margin, it is 1 cm. Histological examination shows a papillary cystic growth pattern with moderate differentiation (G2). The lesion invades deep into the muscular layer of the stomach wall. Surgical margins, omentum, and ten regional lymph nodes show no evidence of neoplastic involvement."} +{"pid": "TCGA-AA-3692", "report": "The colon resection specimen contains a mucinous, moderately differentiated adenocarcinoma of the colorectal type with circular growth, measuring up to 5 cm in diameter. The lesion demonstrates widespread infiltration of the pericolic fatty tissue. Five regional lymph node metastases were identified out of 30 examined. The resection margins of the colon are free of tumor. Near one resection margin, there is a clip-marked mucosal defect associated with florid inflammatory changes and fibrin insudation in the submucosa, consistent with a prior polyp or neoplastic lesion. Vascular and lymphatic invasion are not identified. Clinically, there is evidence of distant metastasis, with involvement of the liver."} +{"pid": "TCGA-A8-A075", "report": "The specimen shows a poorly differentiated invasive lesion with areas of angioinvasion. The maximum tumor dimension is 2.2 cm. Histological evaluation indicates a high-grade morphology. Lymph node involvement is present, with one positive lymph node identified. Lymphovascular invasion is noted, while surgical margins are free of tumor involvement."} +{"pid": "TCGA-5P-A9K3", "report": "The specimen shows a tumor measuring 7.5 cm in greatest dimension, confined to the kidney with no evidence of renal sinus invasion. No lymph node or distant metastases were identified. The surgical margins are negative. Histologic examination reveals marked nuclear atypia with prominent nucleoli and increased mitotic activity. Cellular morphology demonstrates papillary architecture with complex branching patterns and cellular stratification. Stromal invasion is present, and the lesion exhibits solid and cystic components. Tumor cells display eosinophilic cytoplasm and nuclear pleomorphism. Immunohistochemical staining shows positivity for cytokeratin 7 and carbonic anhydrase IX, with focal positivity for CD10. The tumor is classified as high grade based on nuclear features and architectural complexity."} +{"pid": "TCGA-RW-A67V", "report": "A 38.5 gram untrimmed adrenal gland was received, previously bisected, measuring 7.9 x 4.9 x 3.4 cm. The trimmed specimen weighed 26 grams and measured 4.5 x 3.6 x 3.2 cm. A 3.7 x 3.7 x 3.6 cm encapsulated tan-brown hemorrhagic lesion was identified within the adrenal gland. The lesion appears well-circumscribed with no necrosis observed. Microscopic sections evaluated include the relationship of the lesion to the capsule and surrounding tissue, as well as the presence or absence of necrosis and other features. All relevant sections were reviewed by the signing staff pathologist."} +{"pid": "TCGA-C5-A1BN", "report": "The patient is a woman who presented with a cervical mass measuring 6 cm, with no involvement of the endometrium. A cervical biopsy was performed and the specimen consisted of two irregular gray-white mucosal tissue fragments. The first fragment measured 0.7 x 0.4 x 0.3 cm and the second measured 0.6 x 0.5 x 0.4 cm. Microscopic examination revealed moderately to poorly differentiated cells infiltrating the tissue. Lymphovascular invasion was identified. The excision margin could not be assessed. The case was evaluated through serial sectioning. Immunohistochemical and other ancillary studies were performed in compliance with quality assurance protocols and CLIA '88 regulations."} +{"pid": "TCGA-C5-A907", "report": "The specimen labeled \"ant\" consists of a 0.6 x 0.6 x 0.2 cm fragmented portion of tan-gray tissue submitted in cassette A. Histologic evaluation of this specimen shows superficial fragments of malignant cells. The tissue is tangentially sectioned and lacks sufficient stroma to determine the depth of invasion. The second specimen, labeled \"posterior lip of cervix,\" measures 0.5 x 0.5 x 0.2 cm and consists of firm tan tissue mixed with clotted blood, submitted in cassette B. Microscopic examination reveals invasive malignant cells that are moderate to poorly differentiated. The depth of invasion could not be accurately assessed due to the tangential orientation of the tissue. Clinical correlation is recommended."} +{"pid": "TCGA-BG-A0VZ", "report": "The specimen was obtained from a postmenopausal patient who underwent a total abdominal hysterectomy with pelvic lymph node dissection. The tumor measured 4.5 cm in maximum dimension and involved 10% of the anterior endomyometrium and 30% of the posterior endomyometrium. Histologic evaluation showed well-differentiated architecture with nuclear features corresponding to grade 2. The tumor extended beyond half the thickness of the myometrium. No angiolymphatic invasion was identified. A benign leiomyoma was also noted. A total of 13 lymph nodes were examined, and none showed evidence of involvement. Malignant cells were identified in the pelvic wash specimen. The pathologic staging was determined as pT3a, pN0, and pMX."} +{"pid": "TCGA-VQ-A8P2", "report": "The specimen from the stomach (body) demonstrates a moderately differentiated mucinous neoplasm. The lesion infiltrates into the perigastric adipose tissue and is classified according to the Bormann system as Type III. Surgical resection margins are free of neoplastic involvement. Lymphatic embolization is present; however, there is no evidence of vascular or perineural invasion. A single involved lymph node with extracapsular extension is identified among 12 total lymph nodes examined from various chains, including perigastric regions. Additional lymph nodes evaluated from other chains and sites show no evidence of involvement. Other sampled tissues, including margins of resection, small intestine, gallbladder, and nerve tissue, demonstrate no neoplastic findings. The gallbladder shows chronic inflammatory changes."} +{"pid": "TCGA-5U-AB0D", "report": "Female patient referred to Thoracic Surgery with a clinical finding of an anterior mediastinal mass measuring 12x10x5 cm. The biopsy specimen consists of multiple small tissue fragments showing a neoplastic infiltrate with morphological and immunohistochemical features including positivity for CD117 and Synaptophysin, variable positivity for cytokeratins (MNF116), and negativity for CD5, CD45, CD56, TTF1, and Chromogranin. The tumor demonstrates a high growth fraction, with Ki-67 labeling index between 30\u201340% in the most assessable regions. The neoplasm is located in the mediastinum and exhibits histological and immunophenotypic characteristics associated with a thymic origin."} +{"pid": "TCGA-BP-4765", "report": "The right renal specimen consists of a portion of renal cortex measuring 4.6 x 3.5 x 0.8 cm, containing a well-circumscribed soft yellow-tan and hemorrhagic lesion measuring 3.2 x 2.5 x 2.5 cm. The lesion is located 0.2 cm from the inked surgical margins. Histologic examination reveals an acinar growth pattern with cells exhibiting clear cytoplasm. Nuclear grading is moderate. The lesion is confined within the renal capsule without evidence of renal vein invasion. All surgical margins are free of involvement. Adjacent renal tissue appears normal. No abnormalities are identified in the associated perirenal adipose tissue, which measures 12.5 x 8.5 x 2.0 cm in aggregate and shows no histologic changes."} +{"pid": "TCGA-D9-A4Z3", "report": "The specimen consists of skin from the left arm, submitted for evaluation of a large lesion. Histopathological examination reveals a tumor with nodular architecture and ulceration. The lesion measures 2.2 x 1.7 x 7.5 cm macroscopically, with reported skin margins ranging from 0.5 to 1.5 cm. Microscopic assessment shows infiltration into underlying fat tissue and muscle. Clark level V invasion is noted, with a Breslow thickness of 75 mm. Mitotic index is 10 mitoses per square millimeter. Lymphocytic response is present at a moderate level. Immunohistochemical staining demonstrates positivity for HMB45 in a subset of cells, while MelanA and CKAE1/3 are negative. Proliferative activity, as assessed by Ki67, is 50%."} +{"pid": "TCGA-HT-7877", "report": "The pathology report describes a variably cellular tumor that diffusely infiltrates both gray and white matter. In the gray matter, perineural satellitosis, perivascular satellitosis, and subpial condensation are present. The tumor cells have round nuclei with mild to moderate atypia, and most exhibit perinuclear halos. No microvascular proliferation or tumor necrosis is observed. Cellularity varies across the tissue, ranging from modest to nearly confluent. In more cellular regions, scattered mitoses are noted, with up to 4 mitoses per 10 high power fields, although most areas show fewer. Immunohistochemical staining reveals scattered MIB-1 reactive cells throughout the lesion. In the most proliferative region, a labeling index of 4.4% is calculated, which does not support anaplastic progression. However, the slightly increased mitotic activity suggests the need for close clinical follow-up."} +{"pid": "TCGA-TQ-A7RI", "report": "The specimen consists of a fragment of brain parenchyma weighing 2.0 grams and measuring 3.2 x 1.2 x 1.0 centimeters. The outer surface is homogeneous and whitish, with a softened consistency and brown-gray discoloration on sectioning. Histological examination of H&E-stained sections reveals fragments of neocortex containing a neuroepithelial neoplasm arising in the white matter with prominent cortical infiltration. The neoplastic cells are characterized by round nuclei, delicate chromatin, and inconspicuous nucleoli. The cytoplasm is sparse and indistinct, frequently forming perinuclear halos. The tumor demonstrates infiltration of the cortex, with neuronal satellitosis and the presence of Scherer secondary structures in the subpial region. Areas of increased cellularity are noted, along with occasional microcysts. Mitotic figures are present but rare. No microvascular proliferation was identified in the examined material."} +{"pid": "TCGA-HC-7738", "report": "The prostatectomy specimen weighed 52 grams and measured 4.5 x 4.0 x 3.5 cm. The tumor was multifocal, with the largest focus measuring 1.7 cm. It involved both the right and left prostate lobes. Histologic evaluation showed a primary pattern of 3 and a secondary pattern of 4. The tumor involved approximately 5% of the prostate gland. Perineural invasion was present. No lymphovascular invasion, extraprostatic extension, or seminal vesicle invasion was identified. Surgical margins were negative, with the closest margin measuring 0.1 cm from the left lateral margin. Other margins were greater than 0.2 cm. Staging was pT2c for the primary tumor, with pNX and pMX for regional lymph nodes and distant metastasis, respectively. Additional findings included high-grade prostatic intraepithelial neoplasia."} +{"pid": "TCGA-BP-4982", "report": "A 6 x 5 x 4 cm wedge-shaped portion of left kidney was received, with a suture marking the deep margin. The deep margin was inked black and other surfaces were inked blue. On sectioning, a 4.5 x 4 x 3.7 cm golden-yellow, poorly circumscribed mass with focal hemorrhagic and gelatinous areas was identified. The tumor demonstrated a nuclear grade of III/IV. No local invasion or renal vein involvement was observed. The nearest margin showed greater than 1 mm clearance, and the surgical margins were free of tumor. The tumor was entirely confined within the kidney and measured less than 7 cm in greatest dimension. Non-neoplastic kidney tissue showed interstitial fibrosis, chronic inflammation, and tubular atrophy. No adrenal involvement, lymph nodes, or additional lesions were identified. Representative sections of the tumor and margins were submitted for analysis. Intraoperative frozen section confirmed absence of tumor at the deep margin, and permanent sections confirmed these findings."} +{"pid": "TCGA-EI-7002", "report": "The histopathological examination of a rectal lesion revealed a segment of large intestine measuring 23.6 cm in length, with mesorectal fat tissue 2.5 cm thick. A mucosal ulcerous lesion was identified, measuring 5.9 x 5.3 x 1.2 cm, circumferentially involving the entire intestinal circumference. The lesion was located 16.4 cm from the proximal excision margin and 0.9 cm from the distal excision margin, with a minimum lateral margin of 1.2 cm. Microscopic analysis showed moderately differentiated tubular-type neoplastic growth with infiltration into the mesorectal adipose tissue. All excision margins were free of neoplastic involvement. Lymph node involvement was present, with metastatic changes found in a subset of regional lymph nodes. Tumor extension reached beyond the muscularis propria into surrounding tissues. Lymphovascular and perineural invasion were not specifically mentioned."} +{"pid": "TCGA-NK-A5CR", "report": "The surgical pathology report includes multiple specimens from a lung resection and lymph node biopsies. A wedge resection of the right upper lobe contains a nodule measuring 1.9 cm in greatest dimension, located within the lung and extending to the visceral pleura. The nodule appears firm, white, and black with associated pleural puckering. It is situated approximately 0.6 to 0.7 cm from the staple margin. Histologic examination reveals a moderately cellular lesion without evidence of lymphatic invasion. Margins of resection are free of abnormal cells. A second wedge resection from the same lobe shows no significant pathology, only fibrotic changes and chronic inflammation. Lymph node biopsies from levels 4 and 7 contain only benign lymphoid tissue without atypical cells. The nodule was fully sampled for analysis, with sections submitted from the staple margin, pleural surface, and central portions of the lesion. No definitive lymph node metastases were identified. The procedure was performed with intraoperative assessment confirming negative margins."} +{"pid": "TCGA-DD-AAEG", "report": "The liver specimen measured 4.3 x 2.0 x 3.0 cm and weighed 21.8 grams. A well-defined lesion measuring 2.0 x 1.3 x 1.3 cm was identified at segment 3. The cut surface of the lesion was yellowish tan, granular, and lacked necrosis. Microscopically, the lesion exhibited trabecular, pseudoglandular, and compact growth patterns. The tumor cells were of hepatic origin. Histologic grading showed a worst and major grade of III according to Edmondson-Steiner criteria. There was no evidence of fatty change, fibrous capsule formation, capsular infiltration, septum formation, surgical margin invasion, serosal invasion, portal vein invasion, or microvessel invasion. No satellite nodules were identified. The surrounding liver parenchyma showed cirrhotic changes. The safety margin measured 1.4 cm and was not involved. Multiple representative sections were submitted for evaluation."} +{"pid": "TCGA-D5-6923", "report": "A histopathological examination was performed on a segment of the large intestine measuring 14 x 6 x 9.5 cm, which included surrounding fat tissue. The length of the resected intestine was 12 cm. A lesion was identified in the mucosa, measuring 4 x 3 x 1.5 cm, and involved approximately 50% of the intestinal circumference. The lesion was located 5 cm from one surgical margin and 5.3 cm from the opposite margin. Macroscopic evaluation indicated infiltration of the muscular layer. A diverticulum measuring 1 cm in diameter was observed outside the affected area.\n\nMicroscopic analysis revealed glandular and papillary structures with moderate differentiation. Deep infiltration of the muscularis propria was noted. The surgical margins were free of abnormal cells. Reactive lymph node changes were observed in the examined lymph nodes (No XI). The tumor staging based on histopathological findings is pT2, pN0, corresponding to Dukes B classification."} +{"pid": "TCGA-BP-5182", "report": "The left renal specimen consists of a wedge-shaped portion of kidney measuring 5 x 3.5 x 3.5 cm, with a suture marking the deep margin. The cut surface reveals a well-defined, hemorrhagic to yellow lesion with focal calcification, measuring 3 x 2.2 x 2 cm. The distance from the tumor to the resection margin is 0.2 cm. Histologically, nuclear features are high-grade. No local invasion, renal vein involvement, or small vessel angiolymphatic invasion is identified. The surgical margins are free of abnormal cells. The non-neoplastic kidney shows mild arteriosclerotic changes. The tumor is confined to the kidney and measures less than 7.0 cm in greatest dimension.\n\nAdditional biopsies of the left renal margin, left 11th rib, left perinephric soft tissue, soft tissue over the kidney, and left hilar lymph node were submitted. All show benign fibroadipose tissue or normal bone without evidence of abnormal cellular proliferation."} +{"pid": "TCGA-IK-7675", "report": "The specimen consists of multiple tissue samples obtained from the right frontal region. The first sample is white, soft tissue measuring 1 \u00d7 0.5 \u00d7 0.3 cm in aggregate. A second specimen, described as white and red soft tissue, measures 1.2 \u00d7 0.7 \u00d7 0.3 cm. A third sample, submitted for research purposes, is a white soft tissue fragment approximately 1 cm in greatest dimension. The final specimen, received in formalin, consists of multiple pieces of tan and red soft tissue with a total volume of approximately 4.5 mL.\n\nMicroscopic evaluation reveals a moderately cellular lesion with features consistent with oligodendroglial differentiation. Some areas show gemistocytic astrocyte morphology. Necrosis or marked atypia is not prominently identified. A paraffin block was prepared for molecular testing including 1p/19q loss of heterozygosity analysis by FISH, with an addendum to be issued upon availability of results."} +{"pid": "TCGA-AA-A00R", "report": "Cample ID #. Diagnosis: 1.: Lipomatous atrophic lymph node without evidence of neoplastic involvement. 2.: Right hemicolectomy specimen showing tumor-free resection margins with adequate inclusion. The specimen includes an ulcerated, malignant solid lesion in the cecal region, histologically characterized as poorly differentiated. The lesion demonstrates infiltration into the lamina muscularis propria without involvement of regional lymph nodes (G3, pT2 L0 V0 R0 pN0 0/27). Additional immunohistological analyses were initiated due to unusual histological features. Follow-up findings indicate tumor cell positivity for broad-spectrum cytokeratins. A significant presence of CD3-positive and CD20-negative T-lymphocytes is observed within the stroma. Histological and immunohistological features are consistent with a poorly differentiated adenocarcinoma arising in the right colon, exhibiting marked lymphocytic infiltration. The combination of poor differentiation and prominent inflammatory response suggests possible microsatellite instability, potentially associated with hereditary non-polyposis colorectal cancer syndrome."} +{"pid": "TCGA-IK-8125", "report": "The specimen consists of three parts. Part A is composed of irregularly shaped fragments of hemorrhagic tissue measuring 1.5 x 1.2 x 0.6 cm; half of this sample was frozen and the remainder submitted for permanent section. Part B is an irregular fragment of tan-white tissue measuring 0.2 x 0.2 x 0.2 cm, entirely frozen. Part C includes multiple pieces of pink to soft yellow tissue, entirely submitted for analysis.\n\nMicroscopic evaluation of the left frontal brain tissue shows a malignant diffuse glioma. The tumor demonstrates features consistent with high-grade astrocytic neoplasia, as previously suggested by core biopsy. However, the current material also reveals areas with possible oligodendroglial differentiation, indicating a more complex morphology. Based on these findings, the lesion has been classified as a high-grade mixed glioma. Fluorescence in situ hybridization (FISH) analysis for 1p/19q co-deletion is in progress and will be reported upon completion. Tissue from all three specimens was processed and reviewed."} +{"pid": "TCGA-BR-8384", "report": "The specimen consists of a dissected stomach measuring 11 cm along the lesser curvature and 19 cm along the greater curvature, including greater and lesser omentum. In the antral region along the anterior wall, with extension onto the lesser curvature, there is an exophytic lesion measuring 6 x 5.5 x 1 cm. The lesion is firm with a white-pinkish appearance and demonstrates infiltration through all layers of the gastric wall. A total of eighteen lymph nodes from the greater and lesser curvatures were identified, ranging in size from 0.2 to 0.7 cm. Microscopic evaluation reveals poorly differentiated cells with invasion through all layers of the gastric wall and into the lesser omentum. Of the eighteen lymph nodes examined, six show evidence of involvement. Vascular and surgical margin assessments do not show presence of involved elements. The lesion exhibits an exophytic growth pattern and involves perigastric fat. No venous invasion is identified, and margins are uninvolved. There is no available information regarding lymphatic or perineural invasion, treatment effect, or additional findings."} +{"pid": "TCGA-BF-AAOU", "report": "Female. Clinical diagnosis: Gross description: The material presented is skin from the trunk region, non-pigmented, surgically resected. Microscopic description: The received material shows an ulcerated lesion with no pigment. The tumor measures 12mm in thickness by Breslow criteria and is classified as Clark level IV. Staging is stage II, T4, N0, M0. Confidential."} +{"pid": "TCGA-AR-A255", "report": "The specimen from a right wide local excision contains a mass measuring 1.3 x 1.3 x 1.2 cm. Histologic evaluation shows a Nottingham grade II lesion, with tubule formation score of 3/3, nuclear pleomorphism score of 3/3, and mitotic count score of 1/3, resulting in a total Nottingham score of 7/9. A component of intraductal proliferation with intermediate nuclear atypia accounts for less than 5% of the total volume. There is no evidence of angiolymphatic invasion. Changes related to prior biopsy are noted. All surgical margins are free of involvement, with the closest margin measuring 0.7 cm at the inferior aspect. Two right axillary sentinel lymph nodes were recovered. No metastatic involvement is identified. Blue dye was visualized in one lymph node (node number 1), but not in the second node. Ancillary immunohistochemical staining for cytokeratin on paraffin-embedded sentinel lymph node tissue supports the H&E findings. Faxitron imaging was performed."} +{"pid": "TCGA-BF-AAP4", "report": "The submitted specimen consists of a skin-fascial flap measuring 10 x 9 x 2.5 cm, obtained from the trunk region. A central tumor is observed, appearing as a brown, mushroom-shaped lesion with a diameter of 2.5 cm and a height of 1.2 cm. Histologically, the lesion is composed of epithelioid cells with pigmentation. The tumor demonstrates a Breslow thickness of 15 mm and corresponds to Clark level V. There is no evidence of ulceration. Staging is consistent with Stage II A, classified as T4, N0, M0."} +{"pid": "TCGA-W2-A7H7", "report": "The resected left adrenal specimen weighed 44 grams and measured 9.0 x 5.3 x 2.2 cm. The adrenal gland itself measured 6.0 x 3.7 x 2.0 cm and contained a mass measuring 3.2 x 3.0 x 2.4 cm. The mass was soft, lobular, and ranged in color from pale pink-gray to red-purple. It appeared to originate from the medulla, was partially encircled by a thin layer of bright orange cortex, and was surrounded by red-gray medullary tissue at both ends. The mass seemed encapsulated, with the capsule in contact with the inked margin of the specimen.\n\nHistologically, the lesion was well-circumscribed and composed of small cellular nests within a vascular stroma. The cells displayed salt-and-pepper chromatin, moderate pleomorphism, and occasional multinucleation. No signs of extracapsular extension, vascular invasion, necrosis, or increased mitotic activity were identified. The histological features suggested a benign entity, with morphology not predictive of aggressive behavior."} +{"pid": "TCGA-EA-A5FO", "report": "The specimen includes a uterus measuring 8x5x2 cm. The endocervix appears granular, and both the exocervix and endocervix are up to 5x3 cm in size. A white-gray soft lesion is present within these areas. The right ovary measures 1.5x1 cm and the left ovary is 2x4 cm, with a grey-white dense appearance. Microscopic examination reveals moderately differentiated cells with invasion extending beyond half of the muscle layer and involvement of the endocervix. Both ovaries contain fibrous tissue. The fallopian tubes show normal architecture, and there is a glandular-cystic polyp in the endometrium. A total of ten left obturator lymph nodes and eight right obturator lymph nodes show sclerosis and lipomatosis. Three presacral lymph nodes demonstrate follicular hyperplasia. No venous invasion is identified. The tumor size is reported as 2x3 cm based on clinical data. Lymph node analysis shows no evidence of metastasis. Surgical margins are uninvolved. Additional findings do not reveal evidence of treatment effect or other significant pathology."} +{"pid": "TCGA-CS-4941", "report": "The specimen consists of a highly cellular and markedly pleomorphic proliferation of astrocytic cells. Scattered mitoses are present. No endothelial proliferation or necrosis is identified. The tumor is characterized by these microscopic features. A frozen section diagnosis of high-grade glioma was rendered intraoperatively. The specimen from the right frontal lobe measures 1.5 x 1.3 x 1.0 cm and consists of soft tan-pink tissue. Touch preparations were made and used in conjunction with frozen sections to aid in intraoperative assessment. Approximately 50% of the sample was utilized for frozen section analysis and the remainder was submitted for histologic evaluation."} +{"pid": "TCGA-19-0962", "report": "A parietal lesion was resected, with specimens submitted from various regions including the tumor center, tumor edge, and cortical surface. Gross examination revealed multiple fragments of soft cerebriform tissue with tan-white or pink-tan appearance. The largest fragment measured 2.9 x 1.4 x 1.4 cm, while other fragments were smaller, ranging down to 0.5 x 0.3 x 0.2 cm.\n\nMicroscopic evaluation showed a cellular neoplasm with heterogeneous morphology, composed of both infiltrative and more circumscribed components. Areas of palisading necrosis and microvascular proliferation were present. Focal calcifications were identified, and there was evidence of extension into the subarachnoid space. Immunohistochemical staining demonstrated positivity for GFAP. Scattered cells showed positivity for KI-67, while synaptophysin and SMI-31 stains were used as part of the assessment.\n\nAdditional testing involved the use of analyte-specific reagents that have not been cleared or approved by the FDA. These assays were performed with appropriate controls and met internal quality standards. The final interpretation was made following comprehensive review of all findings."} +{"pid": "TCGA-VQ-A8PU", "report": "The specimen involves the stomach body and includes portions of the spleen, pancreas tail, and small intestine. The lesion measures 11.5 cm along its longest axis and demonstrates a tubular histological pattern with poor differentiation. Ulceration is present, and the tumor infiltrates through several layers including the mucosa, muscularis mucosae, submucosa, and muscularis propria. Invasion extends into adjacent adipose tissue and the pancreas, with a spiculated growth pattern noted. A moderate inflammatory reaction is observed. There is no evidence of tumor implantation in perivisceral adipose tissue. Both proximal and distal margins are free of neoplastic involvement, and there is no neural infiltration. Lymphatic vascular invasion is present, though blood vascular invasion is not detected. Of the six lymph nodes examined, one shows involvement without capsular transgression or conglomerate formation. The greater omentum and spleen are devoid of tumor involvement. The duodenal and esophageal margins also show no neoplastic involvement. Lauren\u2019s classification reveals an intestinal pattern. Three additional lymph nodes from station 8A are uninvolved."} +{"pid": "TCGA-B8-4143", "report": "The specimen consists of a radical nephrectomy measuring 17 x 9 x 8.5 cm and weighing 610 grams. The adrenal gland is present and shows no abnormalities. A solid yellow and tan/white mass with a gelatinous appearance and irregular borders is identified, measuring approximately 10 x 6 x 5.8 cm. The tumor appears to be confined within the renal capsule with surrounding perirenal fat; however, microscopic evaluation reveals capsular penetration with involvement of perirenal adipose tissue. The tumor extends into the lumen of the renal vein and is present at the margin of the renal vein. There is no involvement of the ureter or adjacent organs.\n\nHistologic assessment reveals nuclear grade 3 (of 4) morphology with a greatest dimension of 10 cm. No lymphovascular invasion is identified. Surgical margins are negative for tumor in the perirenal adipose tissue and renal artery, while the renal vein margin is positive. One hilar lymph node and two perirenal lymph nodes are examined, and none show evidence of tumor involvement. Sections of non-tumorous kidney tissue and portions of the tumor have been submitted for further analysis."} +{"pid": "TCGA-26-5139", "report": "The submitted specimens include two portions of left brain tissue. Specimen A, received fresh for frozen section, consists of two ovoid pieces of pink-tan soft tissue, each measuring 0.3 cm in greatest dimension. A touch preparation was made and a representative portion was processed for frozen section analysis. The remaining tissue from this specimen was submitted for permanent processing in cassettes FSA1 and A2. Specimen B consists of multiple fragments of tan soft tissue ranging in size from 0.2 to 1.2 cm; the largest fragment measured 1.2 cm and was trisected prior to submission. All of this tissue was submitted in cassette B1. \n\nMicroscopic evaluation of the frozen section demonstrated features consistent with a high-grade malignant neoplasm. Histologic analysis revealed pleomorphic cells with hyperchromatic nuclei, frequent mitotic figures, microvascular proliferation, and areas of necrosis. The tumor exhibited an infiltrative growth pattern. Immunohistochemical stains were performed and showed reactivity supportive of glial differentiation. \n\nTissue processing and diagnostic evaluation were completed in accordance with standard protocols. The laboratory is certified to perform high-complexity testing, and all procedures were conducted using validated methods."} +{"pid": "TCGA-HT-7479", "report": "Sections demonstrate a neoplastic proliferation of glial cells that diffusely infiltrate the gray and white matter. Hypercellularity is only mildly increased. Cellular atypia ranges from mild to marked. Prominent autolytic change is present, resulting in artifactual perinuclear halos around neurons in the gray matter. In addition, many atypical cells, as well as smaller cells, exhibit halos that appear genuine and may indicate oligodendroglial differentiation. In other regions, the tumor demonstrates astrocytic morphology. No mitotic figures are identified, despite the degree of atypia. There is no microvascular proliferation or necrosis.\n\nImmunohistochemical staining shows that most tumor cells are reactive for GFAP; however, some larger cells with halos are GFAP negative. Neu-N staining highlights only cortical neurons, with no reactivity in tumor cells. The atypical cells, including large cells without clear processes, show strong positivity for p53. MIB-1 immunoreactivity is variable, with labeling indices ranging from less than 0.5% on slide 1A to up to 9.2% on slide 2A."} +{"pid": "TCGA-L3-A4E7", "report": "The specimen consists of a right lower lobe lobectomy. A mass measuring 3.1 x 2.2 x 1.9 cm is identified in the lung tissue, located approximately 3 cm from the bronchial margin. The mass is described as a granular tan-gray subpleural lesion with a cavitated center containing purulent material. It extends to the pleura but does not penetrate through it. No invasion of the visceral pleura or adjacent structures is observed. There is no evidence of tumor-associated atelectasis or obstructive pneumonitis, and lymphovascular space invasion is absent. Histologic evaluation reveals poorly differentiated cells with a unifocal growth pattern.\n\nAll surgical margins are free of malignant cells, with the bronchial margin being the closest at a distance of 3 cm from the tumor. A total of 11 lymph nodes were sampled, all of which show benign features without evidence of metastatic involvement.\n\nThe primary tumor is staged as pT2a based on its size and local extension characteristics. Lymph node staging is classified as pN0, indicating no regional lymph node metastasis. Elastic stain confirms the absence of visceral pleural invasion. No additional significant findings are noted."} +{"pid": "TCGA-KS-A4I9", "report": "A 3.5-year-old female underwent a total thyroidectomy and central neck lymph node dissection. The thyroid specimen weighed 11.77 grams and measured 3.2 x 2.2 x 1.4 cm on the right lobe and 2.7 x 2.3 x 1.4 cm on the left lobe. A 1.7 x 1.3 x 1.6 cm tan-grey, well-circumscribed lesion was identified in the isthmus, adjacent to the capsule. Focal areas of hemorrhage were present within the lesion, but no necrosis was observed. The remaining thyroid tissue showed a red-brown, granular appearance without additional abnormalities. No capsular or vascular invasion was noted, and surgical margins were negative. There was no evidence of extrathyroidal extension. Five lymph nodes from level VI of the central neck were examined, all of which were negative for malignancy. The lymph nodes ranged up to 0.3 cm in size and showed no signs of extranodal extension. The remaining fat and fibroadipose tissue contained no suspicious features. All findings were confirmed by a staff pathologist after direct examination of the slides."} +{"pid": "TCGA-MP-A4T6", "report": "Surgical Pathology. Tissue Description: A1 B1 B2 B3 B4 C1 D1 D2 E1 E2 E3 E4 F1 G1 G2 G3 G4 G5. The specimen includes the left lower lobe of the lung, weighing 140.0 grams, as well as lymph nodes from the left upper lobe, station 4L, station 6, and station 7. A subpleural mass measuring 2.5 x 2.5 x 2.5 cm is present and is in close proximity to the puckered pleural surface, though there is no direct involvement. The bronchial resection margin shows no evidence of tumor involvement.\n\nOne lymph node from the left upper lung excision is involved. In the intrapulmonary and hilar regions, three out of four peribronchial lymph nodes are involved. In the mediastinum, three out of 25 subcarinal (station 7) lymph nodes are involved. No involvement is seen in five left lower paratracheal (station 4L) lymph nodes or in a single para-aortic (station 6) lymph node."} +{"pid": "TCGA-E9-A1R0", "report": "The specimen consisted of breast tissue obtained via mastectomy. A grossly evident lesion was identified, measuring 2 x 1.5 x 1.5 cm. Microscopic evaluation revealed a moderately differentiated infiltrating histologic type. Lymph node assessment showed 1 out of 12 axillary lymph nodes positive for metastatic involvement. No extracapsular invasion was noted in the involved lymph node. Other features including tubule formation, nuclear pleomorphism, and mitotic counts at both 25x and 40x magnifications were not specified, therefore a total Nottingham Histologic Score could not be determined. The status of surgical margins, tumor extent, and evidence of neo-adjuvant treatment were not specified. No additional pathologic findings or comments were provided."} +{"pid": "TCGA-BR-A4QL", "report": "The specimen includes a portion of the stomach with a saucer-like lesion measuring up to 10.00 cm, showing invasion into the surrounding fatty tissue. Lymph nodes are present, with some measuring up to 1 cm, and there is hyperemia of the omentum. Histologically, the lesion is moderately differentiated with superficial ulceration and extends into the perigastric fat. Of the lymph nodes examined, four out of five along the lesser curvature and all five along the greater curvature show involvement. The lymphatic and venous invasion status is not specified, while perineural invasion is also not determined. Surgical margins are uninvolved. The pathological staging information provided in original records indicates advanced local spread with multiple lymph node metastases. No evidence of treatment effect is noted. Additional findings are not specified."} +{"pid": "TCGA-LG-A6GG", "report": "The resected liver specimen from segment 3 weighs 292 grams and measures 11.5 x 8.0 x 6.5 cm. It includes a single stapled margin. The external surface is red-brown and shaggy. Upon sectioning, a well-defined mass measuring 8.5 x 7.0 x 5.5 cm is identified, located 1.5 cm from the staple line. Surrounding subcapsular hemorrhage is present. The remaining liver tissue appears tan-brown and granular with no other distinct lesions.\n\nHistologic evaluation reveals a moderately differentiated cellular proliferation with nuclear grade II features. The tumor is unifocal and confined within the liver without local extension beyond the organ. Microvascular invasion is present in a focal distribution. The hepatic capsule is free of involvement at a distance of 1.8 cm from the tumor. All assessed margins are negative. No lymph nodes are identified in the specimen.\n\nAdditional findings include changes consistent with micronodular cirrhosis. Staging classification indicates pT2 NX according to AJCC criteria. Specimen handling included intraoperative consultation with frozen sections submitted for analysis. Tissue sampling included areas from the mass to margin and subcapsular hemorrhage."} +{"pid": "TCGA-90-A4EE", "report": "A left thoracotomy was performed. Specimens included lymph nodes from the inferior pulmonary ligament, retroesophageal, hilar, subcarinal, and paratracheal regions, all of which were negative for malignancy. The right lung specimen measured 17 x 17.5 x 4.0 cm and contained a firm white-tan lesion in the lower lobe measuring 4.8 cm in greatest dimension. The lesion abutted the bronchus with the closest margin distance of 5 mm. Vascular margins were 0.8 cm and 1.5 cm from the lesion. The tumor extended to the visceral pleura but did not grossly invade through the pleural surface. Histologically, the lesion showed features consistent with poorly differentiated squamous cell morphology. Lymphovascular invasion was present. One of ten regional lymph nodes was involved, specifically from the peribronchial region. Pathologic staging was determined as pT2a and pN1. Additional findings included respiratory bronchiolitis, emphysematous changes, bronchiole dilatation, and a hyalinized and calcified granuloma. No tumor was identified at the bronchial margin on frozen section analysis."} +{"pid": "TCGA-AP-A05D", "report": "The submitted specimens include a hysterectomy with bilateral salpingectomy, as well as multiple lymph node groups from both the right and left sides, including external iliac, hypogastric, obturator, and para-aortic regions, along with a left abdominal wall lipoma.\n\nMicroscopic evaluation of the hysterectomy specimen shows a lesion involving the endometrium with papillary serous features. The tumor extends into the myometrium, with maximal invasion measuring 11 mm in thickness. The total myometrial thickness at this site is 15 mm. No evidence of endocervical or vascular invasion is observed. The endometrium otherwise shows atrophic changes, and the myometrium and all adnexal structures appear unremarkable.\n\nEvaluation of the lymph nodes reveals the following: right external iliac (8 nodes), right hypogastric (2 nodes), right obturator (5 nodes), and right para-aortic (4 nodes) are all negative for malignancy. Left external iliac lymph nodes show 1 out of 9 involved, and left para-aortic lymph nodes show 1 out of 4 involved. The left obturator lymph nodes are negative. The left abdominal wall specimen consists of benign lipomatous tissue and skin."} +{"pid": "TCGA-D8-A1XA", "report": "The intraoperative examination of a resected lesion from the left breast included assessment of margins and immunohistochemical markers. The specimen measured 9 x 7 x 4 cm and included a skin flap measuring 5 x 1.5 cm. Margins were as follows: 1.3 cm to the base, 1.6 cm to the skin, 2.5 cm to the sternum, 2.5 cm to the axilla, 3 cm to the shoulder, and 2 cm to the lower boundary.\n\nMicroscopic evaluation revealed a neoplastic process involving ductal structures with histological grade NHG2. Mitotic activity was noted at a rate of 3+2+1 out of 5 mitoses per 10 high-power fields. Additional findings included benign changes such as sclerosing adenosis and \"blunt duct\" features. No metastatic involvement was identified in associated lymph nodes.\n\nImmunohistochemical staining showed expression of estrogen receptors in more than 75% of cell nuclei and progesterone receptors also in more than 75% of cell nuclei. HER2 staining by HercepTest\u2122 showed a score of 1+, indicating no overexpression of the HER2 protein in the neoplastic cells."} +{"pid": "TCGA-CS-5394", "report": "The left frontal lesion demonstrates pleomorphic glial cells with eosinophilic cytoplasm and moderately pleomorphic nuclei, exhibiting ovoid to angular contours. Multiple mitotic figures are present within the tumor cells, as observed on slide 1B. Immunohistochemical staining reveals nuclear positivity for Ki67 (MIB-1) in up to 10% of tumor cells in focal areas of slide 1B. Cytoplasmic staining for GFAP is positive, while chromogranin shows no reactivity in tumor cells.\n\nHistologic evaluation of the first specimen, measuring 1.5 x 1.5 x 0.6 cm in aggregate, consists of soft tan pink tissue fragments. Half was used for frozen section analysis, with the remainder submitted for permanent sections. The second specimen, measuring 0.4 x 0.2 x 0.2 cm in aggregate, comprises soft tan white tissue fragments; similarly, half was used for frozen section and the rest for permanent sections.\n\nFrozen section assessment identified a glial neoplasm without clear anaplastic features in one portion, while grading was deferred in the other pending permanent sections. The lesion is radiographically described as a nonenhancing left frontal mass suspected to be a glial neoplasm."} +{"pid": "TCGA-E9-A1RH", "report": "OC ID: Gross Description: A lump measuring 3.2 x 2.7 cm was identified. Ten lymph nodes were examined, appearing dense and hyperemic, with diameters up to 1 cm. Microscopic evaluation revealed features consistent with a poorly differentiated infiltrating lesion. All ten lymph nodes showed reactive changes without evidence of metastatic involvement. The tumor is located in the lower outer quadrant of the right breast. The specimen was submitted as a lumpectomy. The lesion is grossly evident, with a size range noted between 2.7 and 3.2 cm. Venous invasion was not identified. Surgical margins are uninvolved. Assessment of histologic features including tubule formation, nuclear pleomorphism, and mitotic activity was limited, and a total Nottingham score could not be determined. No evidence of treatment effect was observed. No additional findings were reported."} +{"pid": "TCGA-AP-A05O", "report": "The submitted specimens include a total hysterectomy with bilateral salpingo-oophorectomy, as well as multiple lymph node excisions from the left and right obturator, external iliac, hypogastric, and common iliac regions, and a hernia sac excision. \n\nGross examination of the hysterectomy specimen shows a lesion involving the uterine corpus with significant myometrial involvement, estimated at approximately 80% of the myometrial thickness. Histologic assessment reveals a high architectural grade based on extensive solid growth pattern, with nuclear features corresponding to an intermediate grade. A lower grade is noted when applying a specific grading system for this type of lesion. Lymphovascular invasion is present. No evidence of endocervical involvement is identified.\n\nThe endometrium shows atrophic changes. The myometrium contains areas of adenomyosis and a single leiomyoma. The adnexal structures are unremarkable. The left fallopian tube demonstrates adhesions and a foreign body giant cell reaction. No metastatic disease is identified in any of the lymph node specimens. The hernia sac consists of benign fibroadipose tissue. All lymph node groups are negative for metastasis, with no tumor cells detected upon further sectioning and immunostaining where necessary."} +{"pid": "TCGA-D7-6521", "report": "The histopathological examination was performed on a total organ resection specimen of the stomach, which was cut along the greater curvature and measured 17 x 18 cm; the attached omentum measured 34 x 25 cm. A lesion located in the greater curvature measured 6 x 2 x 2.5 cm, with a distance of 3.5 cm from the proximal end and 2.5 cm from the distal end.\n\nMicroscopic evaluation showed a poorly differentiated and partially mucocellular adenocarcinoma. The lesion extended through the full thickness of the stomach wall, involving vessels and perigastric fat tissue, and reached the surface of the peritoneum. Surgical margins were free of neoplastic involvement, as was the omental tissue examined.\n\nLymph node assessment revealed metastatic involvement across multiple groups: periorificial (11 out of 11 lymph nodes), lesser curvature (8 out of 8), greater curvature (3 out of 3), and peripyloric (2 out of 4). In all involved groups, there was evidence of capsular infiltration by the metastatic cells.\n\nThe histopathological staging was classified as G3, pT2b, pN2, with a mixed type according to the CALL YOUR DOCTOR WITH THIS REPORT classification system."} +{"pid": "TCGA-HV-AA8X", "report": "The surgical specimen included a distal pancreas measuring 9.0 x 5.5 x 4.5 cm, spleen measuring 11.5 x 7.0 x 3.8 cm, and a small gastric biopsy measuring 0.2 x 0.2 x 0.2 cm. A solid mass measuring 4.5 x 3.5 x 3.0 cm was identified in the pancreas, located 2.1 cm from the proximal resection margin. The cut surface of the mass was yellowish tan, firm, and granular. There was evidence of extension into surrounding peripancreatic soft tissue. Grossly, the resection margins did not appear involved, with a safety margin of 2.1 cm.\n\nMicroscopic examination revealed a moderately differentiated epithelial tumor arising in the pancreas. The tumor measured 4.5 x 3.5 x 3.0 cm and extended into adjacent soft tissues. Invasion of lymphovascular and perineural structures was observed. All surgical margins were free of tumor involvement. Examination of regional lymph nodes showed presence of malignant cells in 3 out of 11 nodes assessed. No tumor involvement was identified in the spleen or gastric biopsy specimens. The spleen showed signs of congestion and the gastric biopsy revealed smooth muscle without abnormal cellular infiltration."} +{"pid": "TCGA-UW-A72I", "report": "The surgical specimen consists of a left kidney obtained via radical nephrectomy, weighing 450 grams and measuring 20.0 cm x 11.0 x 5.0 cm. The external surface was inked blue for orientation. The tumor is located at the superior pole, involving the cortex. It measures 5.0 x 4.0 x 3.0 cm, appears yellow and spongy with well-defined borders, and is unifocal without evidence of multicentricity. The tumor is confined within the kidney, expanding but not breaching the capsule, and does not involve the perirenal adipose tissue, Gerota\u2019s fascia, renal vein, ureter, renal sinus, or pelvicaliceal system. No sarcomatoid features are present.\n\nHistologic evaluation shows a high nuclear grade (grade 3 of 4). All surgical margins\u2014including those of the perirenal adipose tissue, renal vein, and ureter\u2014are negative. No involvement of large or small vessels is identified. There is no evidence of lymph node involvement or other significant pathological findings. The remainder of the kidney appears tan and homogeneous without additional lesions. Based on these findings, the tumor is classified as pT1b with no regional lymph node assessment possible (pNx). This staging is provisional and may be updated pending further clinical review."} +{"pid": "TCGA-BH-A0AU", "report": "The specimen consists of a left breast segmental mastectomy. A single focus of invasive carcinoma is identified, measuring 2.2 cm in greatest dimension. The tumor is located in the left breast and is 5 mm from the closest resection margin, which is posterior. Lymphovascular space invasion is present. The invasive component is admixed with an in situ component, which accounts for less than 5% of the total tumor volume. The in situ component shows nuclear grade 2 features, solid type growth pattern, and comedonecrosis. \n\nHistologic evaluation of the invasive component reveals tubule formation score of 3, nuclear grade of 2, and mitotic activity score of 1, resulting in a total Nottingham score of 6 (grade 2). No dermal lymphatic invasion or calcifications are noted. All surgical margins are free of both invasive and in situ disease.\n\nTwo left axillary sentinel lymph nodes were examined using keratin staining; no metastatic involvement was found. \n\nImmunohistochemical analysis of the invasive tumor cells demonstrates positivity for estrogen and progesterone receptors. HER-2 immunostaining yields a score of 2+ but fluorescence in situ hybridization (FISH) analysis does not show gene amplification.\n\nPathologic staging is as follows: pT2, pN0(i-), pMX."} +{"pid": "TCGA-XR-A8TC", "report": "The liver biopsy specimens were obtained from two segments. The first, from segment I, consisted of a nodule measuring 1.2 cm in diameter, located 0.9 cm from the surgical resection margin. The lesion was described as nodular, whitish, soft, and well-defined, situated near the capsule. The surrounding hepatic parenchyma was firm. The second specimen, from segment VIII, contained a subcapsular nodule measuring 1.7 cm in diameter, located 0.5 cm from the surgical margin. This lesion was also nodular, indurated, and well-defined, with firm adjacent tissue.\n\nMicroscopic evaluation revealed similar histological features in both lesions. The cellular architecture included solid, trabecular, and focally pseudoacinar patterns. Approximately 10% of the neoplastic cells exhibited macrovesicular steatosis. No significant necrosis or signs of vascular or lymphatic invasion were observed. Surgical margins were free of abnormal cellular infiltration.\n\nIn the hepatic parenchyma adjacent to the lesions, mild lymphocytic inflammatory infiltrate was noted in portal spaces and septa. About 30% of hepatocytes showed ballooning degeneration, and severe fibrosis was present, with early formation of regenerative nodules. Iron deposition was not significant based on Perls staining. The pathological staging was determined as pT2 pNx."} +{"pid": "TCGA-BR-8361", "report": "The gastrectomy specimen involved tissue from the fundus region. The tumor measured 10 x 10 x 4 cm and demonstrated involvement of adjacent structures, specifically extending into the transverse colon. Histologic examination revealed poorly differentiated cellular features. Lymph node evaluation identified six out of ten intraabdominal lymph nodes positive for metastatic involvement. Surgical margins were uninvolved. No evidence of neoadjuvant treatment response was noted. Other pathologic features including lymphatic, venous, and perineural invasion status were not specified. No additional findings or comments were provided."} +{"pid": "TCGA-EM-A1YB", "report": "The surgical specimen consists of a left hemithyroidectomy measuring 6.1 cm in greatest dimension. The left lobe weighs 20.6 grams and is intact with fibrous adhesions noted on the external surface. A well-circumscribed nodule measuring 2.7 cm \u00d7 2.6 cm \u00d7 2.0 cm is present in the upper pole, and another well-defined colloid-rich lesion measuring 2.5 cm \u00d7 2.7 cm \u00d7 2.0 cm is located in the lower pole. The isthmus measures 1.6 cm \u00d7 0.7 cm \u00d7 0.5 cm.\n\nHistologic evaluation reveals a unifocal lesion in the left lobe. The dominant lesion demonstrates follicular architecture and oncocytic cytomorphology. It is partially encapsulated and shows minimal capsular invasion. Margins are uninvolved, with the closest distance of invasive tissue to the margin being 0.1 mm. There is no evidence of lymphovascular or perineural invasion, and no extrathyroidal extension is identified. No lymph nodes were identified or examined.\n\nAdditional findings include adenomatoid nodules and focal nonspecific thyroiditis. In the parathyroid region, two distinct nodules are identified\u2014one composed of chief cells and the other of clear cells\u2014each with its own capsule and associated with compressed atrophic parathyroid tissue."} +{"pid": "TCGA-DB-A64Q", "report": "A resected left frontal brain mass was evaluated, consisting of multiple tissue fragments. Gross examination revealed three specimens: one measuring 9.0 x 3.3 x 2.5 cm, another 5.0 x 2.5 x 1.8 cm, and a third 5.0 x 4.0 x 1.3 cm. Smears were prepared from the first specimen and submitted for evaluation. Immunohistochemical staining was performed on paraffin-embedded sections using markers including GFAP, IDH1-R132H, p53 protein, and Ki-67. GFAP showed positivity primarily in background reactive astrocytes and focally in neoplastic cells with gemistocytic features. Mutant IDH1 staining was positive, suggesting the presence of an IDH1 mutation. p53 protein expression was variable in a moderate subset of tumor cells. The Ki-67 labeling index was low to focally moderate, reaching up to 3\u20135% in areas. Fluorescence in situ hybridization (FISH) studies for 1p19q deletion were initiated and will be interpreted separately under genetic analysis. Microscopic evaluation of intraoperative smears indicated the presence of a neoplasm, with features suggestive of high-grade glioma; however, final interpretation was deferred for permanent section analysis. Multiple tissue blocks were processed from each specimen for histologic review."} +{"pid": "TCGA-HT-7884", "report": "The specimen demonstrates a moderately hypercellular glial neoplasm with diffuse infiltration of the white matter. The tumor cells exhibit mild nuclear atypia and have round to oblong nuclei with small caps of eosinophilic cytoplasm. No mitotic figures, microvascular proliferation, or necrosis are identified. Additional sections show a mildly hypercellular lesion infiltrating both gray and white matter. The nuclei are round to oval without significant atypia. Perinuclear halos are absent; however, many cells display short processes, with a majority exhibiting a microgemistocytic appearance. Some tumor cells demonstrate a more fibrillary astrocytic morphology. Immunostaining reveals widespread p53 reactivity, favoring an astrocytic lineage. Scattered MIB-1 labeling is present, with a calculated labeling index of 2.5% in the most proliferative regions."} +{"pid": "TCGA-AR-A256", "report": "The specimen from the right mastectomy shows a high-grade lesion with a size of 2.5 x 2.5 x 2 cm. No in-situ component is identified. The surgical margins and nipple are free of involvement. Evaluation of lymph nodes includes three sentinel axillary nodes and two additional axillary nodes, all of which show no evidence of involvement. A separate biopsy of the right breast reveals only skin and adipose tissue without evidence of a tumor. The left mastectomy specimen demonstrates proliferative fibrocystic changes including fibrosis, sclerosing adenosis, and cyst formation, along with a small fibroadenoma measuring 0.5 cm that exhibits myxoid degeneration. Immunohistochemical analysis of sentinel lymph nodes confirms absence of metastatic disease. Staining for hormone receptors shows no reactivity in atypical cells."} +{"pid": "TCGA-A7-A0CJ", "report": "The specimen includes a left axillary sentinel lymph node and a left breast biopsy. The lymph node measures 1.3 x 1 x 0.6 cm and shows no evidence of metastasis upon multilevel sectioning with H&E staining and immunohistochemistry for pankeratin. \n\nThe breast biopsy consists of fibrous adipose tissue measuring 6.5 cm medially to laterally, 3.5 cm superior to inferior, and 3 cm anterior to posterior. Margins are inked for orientation. A firm tan fibrotic mass measuring 2.2 x 1.5 x 1.8 cm is identified and appears to extend to the posterior margin. Histologic evaluation reveals invasive carcinoma with a histologic grade of 3 (architectural score 3, nuclear score 3, mitotic score 2). The tumor dimension is classified as pT2. Margins show involvement at the inferior aspect. No vascular invasion is identified. Calcifications are present.\n\nDuctal carcinoma in situ is also present, exhibiting solid and cribriform patterns with nuclear grade 2\u20133. Central necrosis is focally observed. In situ carcinoma accounts for approximately 25% of the total tumor volume and demonstrates an extensive intraductal component. The in situ component approaches margins closely (< 1 mm) at anterior, posterior, medial, and inferior aspects. Non-tumorous breast tissue shows proliferative changes."} +{"pid": "TCGA-MB-A8JL", "report": "The left axillary sentinel lymph node specimen was entirely submitted for evaluation and no malignant cells were identified in the single lymph node examined. The left mastectomy specimen contained a solid tan and hemorrhagic mass measuring 5.5 x 5.2 x 4.5 cm located in the upper half of the breast near the midline. The mass was firm and tan-white, with a distance of 1.3 cm to the nearest (deep) margin and 2.8 cm from the anterior inferior margin. The tumor showed intermediate-grade features based on histologic evaluation. Microscopic analysis revealed a mitotic rate of 21 per 10 high-power fields and was classified as grade 2 according to the French Federation of Cancer Centers Sarcoma Group system. Margins were negative for tumor involvement, with the closest distance being 1.8 cm to the anterior/superior margin. No necrosis, lymphovascular invasion, or perineural invasion was identified. Additional findings in the left breast included fat necrosis, cysts with apocrine metaplasia, and biopsy site changes with hemorrhage. The right mastectomy specimen showed no significant pathological findings; it demonstrated simple ductal hyperplasia without atypia, cysts with apocrine metaplasia, and duct ectasia. All skin, nipple, and resection margins were unremarkable, with no evidence of atypical hyperplasia, in situ carcinoma, or invasive carcinoma."} +{"pid": "TCGA-AP-A1DK", "report": "The surgical specimens submitted included the uterus, cervix, bilateral fallopian tubes and ovaries, along with multiple lymph node groups from both sides, including para-aortic, external iliac, obturator, and common iliac regions.\n\nHistologic evaluation of the uterine specimen revealed a lesion characterized by extensive squamous metaplasia and solid growth pattern exceeding 50%. Nuclear grading was assessed as grade 2. The tumor demonstrated myometrial invasion involving up to half of the myometrium, with maximal invasion thickness measuring 8 mm in an area where the total myometrial thickness was 22 mm. No evidence of endocervical involvement was observed; however, vascular invasion was present. The remainder of the myometrium and all sampled adnexal tissues appeared unremarkable.\n\nLymph node evaluations showed no evidence of metastatic disease. Right para-aortic lymph nodes (4 total), left para-aortic lymph nodes (3 total), right external iliac lymph nodes (10 total), left external iliac lymph nodes (7 total), and left obturator lymph nodes (2 total) were all negative for malignancy. A single benign lymph node was identified in the right obturator region. No lymph nodes were identified in the right common iliac or left common iliac regions, with only fibrovascular and adipose tissue recovered, respectively.\n\nAll margins and surrounding tissues evaluated were free of tumor involvement."} +{"pid": "TCGA-ET-A25G", "report": "The specimen consists of a total thyroidectomy, labeled and oriented with stitch marking the left side. The thyroid weighs 37.93 grams, with the left lobe measuring approximately 6.5 x 4 x 1.9 cm and the right lobe measuring 4.5 x 2 x 0.6 cm. Orange ink was applied to the anterior surface and black ink to the posterior surface. Upon sectioning, a lesion measuring 4 x 3 x 2.7 cm was identified in the left superior pole. The cut surface of the lesion is soft, pale tan, and exhibits a multicystic papillary appearance. A portion of this tissue was preserved for potential future analysis.\n\nMicroscopic evaluation reveals a unifocal lesion within the left lobe. Histologic features include cellular morphology consistent with tall cell variant characteristics. Vascular and lymphatic invasion are present. The lesion measures 4.0 cm in greatest dimension and demonstrates minimal extrathyroidal extension. Margins are involved by invasive carcinoma at the left superior posterior region. One regional lymph node examined shows no evidence of tumor involvement.\n\nAdditional findings include nodular hyperplasia elsewhere in the gland. No other suspicious masses or lesions are identified in the remaining thyroid parenchyma, which appears beefy red. Sections submitted for analysis include multiple blocks from the primary lesion and representative areas of the left inferior and right upper/lower lobes."} +{"pid": "TCGA-BB-A6UM", "report": "Surgical pathology report for the left tonsil following tonsillectomy reveals a lesion measuring 2.4 cm. The tissue sample shows focal extension to the inked resection margin. There are areas demonstrating features highly suggestive of angiolymphatic invasion. Immunohistochemical staining showed positivity for p16 and detection of HPV16. The right tonsil specimen consists of tonsillar tissue without evidence of neoplastic involvement."} +{"pid": "TCGA-2H-A9GF", "report": "Coded sample ID: Histologic evaluation shows a poorly differentiated carcinoma. The lesion is located in the distal esophagus and measures 7.0 cm in diameter. Examination of regional lymph nodes reveals involvement of 7 nodes. The resection margins are noted to be involved."} +{"pid": "TCGA-DX-AB2Q", "report": "The clinical history notes a right lower leg mass previously biopsied and identified as a sarcomatous lesion. The specimen submitted is a radical resection of the right lower leg. Gross examination reveals a fungating mass measuring 9 x 8 x 4 cm, ulcerating through the skin and extending focally into skeletal muscle. The tumor has a thin fibrous capsule on its surface with areas of hemorrhagic crust. Cut surfaces are fleshy and pale tan-white with scattered hemorrhage, and the tumor is predominantly viable with approximately 5% focal necrosis.\n\nMargins of resection are generally free of tumor involvement. The deep margin is closest to the tumor at 0.3 cm and is adjacent to skeletal muscle; all other margins are widely negative. The specimen was oriented using sutures, with the deep margin marked by a lateral suture attached to skeletal muscle. Inked margins include superior (red), inferior (green), lateral (blue), medial (orange), and deep (black). The tumor\u2019s closest clearance is at the deep margin with 0.5 cm, while all skin margins are greater than 1 cm from the tumor edge.\n\nHistologic sections evaluated include representative blocks from all margins and tumor tissue. Microscopic assessment confirms the tumor's predominant viability and high-grade cellular features. Cellular pleomorphism is present, and the tumor infiltrates focally into skeletal muscle. No definitive lymphovascular invasion is noted. Immunohistochemical or special stains were not detailed in this summary."} +{"pid": "TCGA-QQ-A5V9", "report": "The surgical specimen was obtained from a right retroperitoneal mass along with a right nephrectomy specimen, as well as tissue fragments from the left and right lobes of the liver. The resected retroperitoneal mass measured 17.0 x 11.0 x 5.5 cm and appeared encapsulated. Its cut surface demonstrated a coarsely lobulated texture with firm, fleshy parenchyma and areas of creamy yellow specks. Microscopic examination revealed pleomorphic and bizarre giant cells in certain sections, with coarse calcifications noted in one slide. The tumor extended into the perinephric fat but did not involve the kidney itself. All inked margins of resection were free of tumor involvement.\n\nImmunohistochemical staining for S-100, NSE, and CD-68 showed negative results. The kidney exhibited fetal lobulation and had a cortical-medullary distinction with a hyperemic cortex. The renal capsule was difficult to strip and the kidney's external surface was coarsely granular. The ureter was patent without evidence of compression or tumor involvement. A small fragment of attached liver tissue showed only congestion without any tumor presence.\n\nSeparate evaluations of the left and right lobe liver specimens showed no tumor involvement or significant pathology. Adrenal gland tissue was also free of tumor. Sections of the tumor, kidney, adrenal gland, perinephric fat, ureter, and liver were submitted for histological analysis."} +{"pid": "TCGA-E2-A2P6", "report": "The specimen consists of a wide local excision from the left breast and five sentinel lymph nodes from the left axilla. The excision measured 6.4 x 5.5 x 3.3 cm and weighed 55 grams. On gross examination, a 2.5 x 2.1 x 1.9 cm firm, pale tan mass was identified, located 0.6 cm from the lateral margin. Microscopically, multiple foci of invasive carcinoma were observed throughout the specimen, with the largest focus measuring 3.5 cm. The tumor involved the superior margin and was within 0.1 cm of the inferior margin. Tubular differentiation score was 3, nuclear grade was 2, and mitotic activity was scored as 1, resulting in a combined Nottingham histologic grade of 2. No necrosis or vascular/lymphatic invasion was identified. Adjacent non-neoplastic tissue showed columnar cell change. In addition, lobular neoplasia was present.\n\nOne of the five sentinel lymph nodes contained metastatic carcinoma, measuring 1.9 cm, with evidence of extranodal extension. The remaining four lymph nodes were free of malignancy. Immunohistochemical staining showed positivity for estrogen and progesterone receptors, and negativity for HER2 by FISH testing.\n\nBased on these findings, the pathological staging is pT2 N1 according to the AJCC Cancer Staging Manual, 7th Edition."} +{"pid": "TCGA-FD-A62N", "report": "The surgical specimens were received and processed as four separate components. Component A, labeled as right pelvic lymph nodes, included 18 lymph nodes, all without any abnormal findings. Component B, identified as left pelvic lymph nodes, contained 8 lymph nodes, also all unremarkable. Component C consisted of a cystoprostatectomy specimen including the bladder, prostate, and bilateral vas deferens. The bladder showed a rough, ulcerated area measuring 4.0 cm located in the right lateral, anterior, and posterior walls. Microscopic evaluation demonstrated extensive involvement of the tissue with high-grade cellular changes extending through the muscularis propria into surrounding fat, reaching within 0.3 cm of the deep margin. All resection margins, including ureteral, distal urethral, and soft tissue, were free of abnormal cells. Additionally, one perivesical lymph node was negative. The prostate showed similar high-grade cellular changes but no definitive mass was identified. Component D, the right distal ureter, was unremarkable.\n\nA total of 27 lymph nodes from all groups were examined and none showed evidence of abnormal cells. Histologic assessment revealed a solitary lesion involving the bladder wall with a size of 4.0 cm, demonstrating deep penetration into extravesical soft tissue. No tumor involvement was identified at the ureteral or urethral margins. The staging classification for this case is pT3b, N0, MX according to the 7th edition TNM system."} +{"pid": "TCGA-AJ-A6NU", "report": "The specimen consists of a resected uterus with attached bilateral fallopian tubes and ovaries. The uterus weighed 192 grams and measured 13.0 x 7.3 x 5.8 cm. A friable, polypoid mass was identified within the endometrial cavity measuring 4.5 cm in greatest dimension. This mass appeared confined to the endometrium without extension into the myometrium. Another separate mass was observed in the cervix, measuring 2.8 cm in maximum dimension, appearing to extend to the cervical os and coming within 0.4 cm of the anterior cervical neck. The remaining endometrium showed a pale, roughened appearance with an average thickness of 0.3 cm. The myometrium averaged 2.0 cm in thickness and multiple intramural nodules were noted, the largest measuring 3.4 cm with calcification. Both fallopian tubes and ovaries were present and unremarkable on gross examination.\n\nHistologic evaluation revealed a well-differentiated cellular pattern. No myometrial invasion was identified. The cervical involvement was limited to the superficial stroma. No lymphovascular invasion was observed. Lymph node sampling included right external iliac, right common iliac, right obturator, left external iliac, and left obturator regions. All lymph nodes examined were negative for involvement. The specimen was intact and all relevant tissues were submitted for analysis. Based on these findings, the pathologic staging was determined as pT2, pN0."} +{"pid": "TCGA-HV-A5A3", "report": "The specimen consisted of a pancreatic resection measuring 11.5 x 6.1 x 4.0 cm and a spleen weighing 144.0 grams with dimensions of 10.6 x 6.1 x 3.1 cm. A mass measuring 5.3 x 3.9 x 3.1 cm was identified in the pancreatic body. The mass was described as ill-defined, pale tan to beige, solid, and firm. The radial margin was involved, with tumor located 2.2 cm from the proximal pancreatic margin. No abnormalities were observed in the remaining pancreatic parenchyma or spleen.\n\nFrozen section analysis revealed metastatic involvement in two lymph nodes examined, including one lymph node from the gastroduodenal region which also showed extranodal extension. Tumor cells were identified in a biopsy from the posterior area of the gastric wall. No tumor was found at the pancreatic resection margin.\n\nHistologic examination revealed a moderately differentiated epithelial neoplasm with infiltrative growth patterns. The tumor extended beyond the pancreas (pT3). Lymphovascular and perineural invasion were present. All surgical margins were free of tumor involvement.\n\nLymph node evaluation included 23 regional nodes, of which 3 contained metastatic disease. Additional biopsies from regional lymph nodes confirmed metastatic involvement with extranodal extension. A biopsy from the posterior gastric wall showed presence of tumor cells. The spleen showed no pathological changes."} +{"pid": "TCGA-Z5-AAPL", "report": "Female. Clinical findings indicate a mass in the pancreas. Gross examination of the pancreas (body and tail) measured 3.5 x 2 x 1.5 cm and revealed a dense, grayish-white tumor that had infiltrated the pancreatic capsule and adjacent adipose tissue. Within the adjacent adipose tissue, nine lymph nodes were identified, ranging from 1 to 2 cm in diameter, with a soft, pink-gray appearance. Microscopic evaluation showed poorly differentiated cells consistent with a ductal origin, exhibiting infiltration into the pancreas and surrounding fat with multiple nests of both intra- and extra-pancreatic invasion. All nine lymph nodes showed no evidence of involvement. The pancreas also demonstrated changes associated with chronic inflammation."} +{"pid": "TCGA-BC-4072", "report": "The pathology report includes multiple specimens. Specimens A and B consist of biopsies from two separate portal lymph nodes, each measuring 1.5 x 1.0 x 0.8 cm and 3.2 x 2.0 x 0.9 cm respectively. Microscopic examination of both lymph nodes revealed no evidence of malignant cells.\n\nSpecimen C is a partial hepatectomy from liver segments 5 and 6. It contains multiple nodules with a maximum size of 4.5 cm. The tissue shows moderate to poorly differentiated cellular features with areas of pseudoacinar formation and necrosis. The surgical margin is located 2.0 cm away from the lesion.\n\nSpecimen D is a resection from the porta hepatis region of the liver. The lesion measures approximately 5.6 cm and demonstrates poorly differentiated features. The soft tissue margin is involved by the lesion. Additionally, a small fragment of adjacent pancreatic tissue was identified, which did not show any abnormal cellular changes.\n\nSpecimen E consists of a biopsy from liver segment 3. The lesion measures 2 mm in size and exhibits poorly differentiated characteristics. The surgical margin in this specimen is free of involvement.\n\nImmunostaining for AFP showed strong positivity in sections from the liver tumor in segments 5 and 6 (C3), and focal positivity was noted in the porta hepatis mass (D1). Reticulin staining of certain sections indicated thickened hepatocyte trabeculae.\n\nAll findings were based on intraoperative frozen section analysis and subsequent microscopic evaluation."} +{"pid": "TCGA-DD-A3A7", "report": "The submitted liver specimen includes Segments I, II, III, and IV, weighing 2280 grams and measuring 20 x 19 x 11 cm. A separate left portal lymph node (4.5 x 2.6 x 1.2 cm) and gallbladder (7.5 x 3.5 x 1 cm) were also provided. A large mass measuring 18.5 x 18 x 11 cm is present within the liver, involving Segments I, II, III, and IV. The lesion invades into, but not through, the hepatic capsule. It approaches the surgical margin closely (less than 1 mm), though the margin is microscopically uninvolved. Vascular invasion involving hepatic veins is noted. The mass is not encapsulated, and approximately 30% tumor necrosis is observed. Multiple sections from the non-neoplastic liver tissue are under assessment for background evaluation.\n\nA single benign lymph node is identified in the left portal region. The gallbladder shows chronic cholecystitis, cholelithiasis with a single pigment stone measuring 0.4 cm, and an adenomyoma measuring 1.0 cm. Three cystic duct lymph nodes are negative for involvement.\n\nAdditional findings in the normal liver show a mild nonspecific chronic inflammatory infiltrate in the portal tracts. Special stains reveal minimal hepatic iron deposition of uncertain clinical significance, and a PAS-D stain is unremarkable."} +{"pid": "TCGA-EJ-5516", "report": "Patient history includes a PSA level of 10.9. Gleason scores from biopsy showed 4 + 3 on the left mid, 3 + 4 at the left apex, and 4 + 4 on the right mid. The procedure performed was a prostatectomy. Examination of three right pelvic lymph nodes and three left pelvic lymph nodes revealed no evidence of malignancy.\n\nThe tumor involved both the right and left lobes of the prostate with a maximum nodule size of 1.4 cm, representing approximately 15% of the total prostate volume examined. Histologic evaluation identified moderately differentiated adenocarcinoma with a Gleason score sum of 7. A tertiary pattern was present, contributing to a histologic grade of G3-4. Two separate areas of extracapsular extension were identified in the left posterior base, measuring up to 0.3 cm. All surgical margins were free of tumor involvement. There was no involvement of the bilateral seminal vesicles.\n\nPerineural invasion was observed, but no angiolymphatic invasion was identified. High-grade prostatic intraepithelial neoplasia was present and multifocal. Additionally, benign prostatic hyperplasia and chronic inflammation were noted.\n\nPathologic staging was determined as pT3a with no nodal involvement (pN0) and M stage not assessable (pMX). The prostate specimen weighed 50.38 grams. Tumor involvement was found in multiple regions of the prostate, with Gleason pattern 4 or 5 comprising 30% of the tumor."} +{"pid": "TCGA-3A-A9IU", "report": "The corrected report reflects an updated lymph node count, with 25 lymph nodes now identified, of which 2 contain metastatic involvement. The specimen consists of a resected portion of the pancreas, duodenum, stomach, bile duct, and gallbladder, obtained via pancreaticoduodenectomy and cholecystectomy. A solid mass measuring 4.0 cm in greatest dimension is identified within the pancreatic head. Microscopic evaluation reveals a poorly differentiated exocrine neoplasm with focal clear cell features. Tumor extends into peripancreatic and retroperitoneal soft tissues but does not involve any of the assessed margins, including the common bile duct, duodenum, gastric, superior mesenteric artery, portal groove, or posterior surface. Lymphovascular and perineural invasion are present.\n\nA total of 25 lymph nodes were examined, with 2 showing involvement by tumor. Additional findings include pancreatic intraepithelial neoplasia (grade PanIN 2) and squamous metaplasia. Chronic cholecystitis with cholelithiasis is also present. No prior treatment effect is observed. Frozen section analysis of the bile duct and pancreatic margins showed no evidence of malignancy. The resected pancreatic margin and surrounding adipose tissue were entirely submitted for evaluation. Gross examination of the specimen revealed a firm, gray-yellow mass located approximately 5 mm from the pancreatic resection margin, abutting the portal vein groove and superior mesenteric artery margin. The gallbladder contains a single calculus and shows no gross signs of tumor."} +{"pid": "TCGA-AA-3852", "report": "The specimen shows an invasive lesion with mucinous features involving the colon. Histological evaluation reveals a poorly differentiated morphology (G3). The lesion extends through all layers of the parietal wall, reaching the outermost layer (pT3), and demonstrates vascular invasion, including both lymphatic and blood vessel involvement (L1, V1). Resection margins in the mucosal region are free of tumor involvement. The surrounding mucosa, submucosa, and muscularis appear regular. Mature connective tissue is present at the deep resection margin. No lymph node metastases were identified, with all 13 examined lymph nodes being negative. Additional findings include tubulovillous adenomas with areas of high-grade dysplasia, indicative of high-risk intraepithelial neoplasia. Reactive changes are noted in the omental tissue."} +{"pid": "TCGA-26-1438", "report": "The specimen was received as two portions of brain tissue. The first portion measured 0.9 x 0.8 x 0.7 cm and consisted of tan to red-brown soft tissue. A representative section was submitted for frozen section analysis in two parts, with the remaining tissue processed for permanent sections. The second specimen measured 2.2 x 2.0 x 1.9 x 0.8 cm and was described as an aggregate of beige to gray-tan granular tissue with a small amount of blood clot. Part of this tissue was reserved for research, and the remainder was submitted for permanent processing.\n\nHistologic evaluation revealed a highly cellular tumor with marked pleomorphism and extensive areas of necrosis. The cells exhibited nuclear atypia and frequent mitotic figures, with some regions showing nearly 40% of nuclei labeled by Ki-67 immunostaining. Vascular proliferation was noted, with prominent endothelial changes highlighted by CD31 and reticulin staining. In some areas of necrosis, there was a distinct arrangement of nuclei along the periphery, while other regions showed a significant inflammatory response composed primarily of macrophages, as demonstrated by KP1 immunostaining, and in part by neutrophils. Special stains including Gram, GMS, and immunohistochemical stains for Toxoplasma gondii were negative. Immunoreactivity for GFAP was strongly positive, while pan-cytokeratin was negative. Neurofilament staining was also performed. No evidence of infectious organisms was identified. The tumor infiltrated surrounding tissues as demonstrated by neurofilament immunostaining."} +{"pid": "TCGA-QT-A7U0", "report": "A right adrenal mass and adjacent retroperitoneal tissue were submitted for examination. The specimen consisted of a 6.4 x 5.7 x 2.2 cm fragment of fibrofatty tissue weighing 25 grams. Within this tissue, a well-defined solid nodule measuring 3.3 x 2.9 x 1.7 cm was identified in proximity to a 4.7 x 3.4 x 1.2 cm portion of disrupted adrenal gland. The nodule appeared to be separate from the adrenal gland without evidence of invasion.\n\nMicroscopic evaluation revealed a cellular neoplasm with a distinct architecture commonly seen in certain neuroendocrine tumors of the retroperitoneum. The lesion exhibited a characteristic nested or zellballen pattern. Cellular morphology was uniform with minimal atypia and no definitive features of high-grade malignancy were observed. Immunohistochemical staining demonstrated diffuse strong positivity for synaptophysin and chromogranin. S-100 staining highlighted a preserved supporting cell framework.\n\nThe surgical margins were free of tumor involvement. Due to the location and morphologic features, further clinical correlation may be necessary for comprehensive assessment."} +{"pid": "TCGA-EJ-5495", "report": "The patient underwent a prostate needle biopsy followed by a radical retropubic prostatectomy and bilateral pelvic lymph node dissection. A total of 18 lymph nodes were examined, with one small focus of metastatic involvement identified in the right pelvic lymph nodes. This metastatic focus measured approximately 0.15 cm and did not demonstrate extracapsular extension.\n\nHistologic examination of the prostate specimen revealed extensive involvement with a Gleason score of 5 + 3 = 8. Approximately 75% of the tumor volume was composed of Gleason patterns 4 and 5 components. The lesion extensively involved both the right and left lobes of the prostate gland and accounted for approximately 40% of the overall prostate volume. The maximal tumor diameter was 2.3 cm.\n\nMultifocal extracapsular extension was present bilaterally in the posterior base/periseminal vesicle soft tissue, bilateral anterior mid prostate, and left anterior base. Extensive perineural invasion was observed, along with multiple microscopic angiolymphatic tumor emboli. Bilateral seminal vesicle infiltration was noted, along with involvement of the right vas deferens. At the surgical resection margin of the right vas deferens, there was focal positivity measuring 0.3 cm in linear extent. All other surgical margins were free of tumor involvement.\n\nAdditional findings included multifocal high-grade intraepithelial neoplasia and focal glandular atrophy. The prostate specimen weighed 67.8 grams.\n\nPathologic staging was determined as pT3b, pN1, pMX. Histologic grade was classified as G3-4."} +{"pid": "TCGA-EL-A3T0", "report": "The surgical pathology report includes multiple lymph node levels and tissue specimens. In level IIA and IIIA, four lymph nodes were identified without evidence of tumor involvement. In level IIB, five lymph nodes were present and none contained tumor. In level IIIB, three out of ten lymph nodes showed involvement. In level IVB, one out of five lymph nodes was involved. In level V, six lymph nodes were identified and none contained tumor. A pretracheal mass specimen included two lymph nodes, both of which contained tumor. The thyroidectomy specimen measured 7.0 x 4.5 x 2.3 cm and contained two nodules: a 2.0 cm nodule in the right lobe and a 0.8 cm nodule in the left lobe. The right lobe nodule extended into adjacent soft tissue. One parathyroid lymph node was involved by tumor. A right upper paratracheal mass included three lymph nodes measuring 3.0, 1.1, and 1.0 cm, all of which contained tumor. Lymph nodes from level IIB (B1, B2), level IIIB (B3-B8), level IVB (B9-B11), and level V (B12, B13) were submitted for examination. The inferior right pretracheal mass included two nodules measuring 1.3 and 0.5 cm, both entirely submitted for analysis. The largest lymph node recovered from the neck dissection measured 3.5 x 3.0 x 2.7 cm and was located in level IIIB. Multiple sections were taken from involved lymph node regions."} +{"pid": "TCGA-CS-6188", "report": "The specimen consists of two separate tissue samples. The first is a 1.4 x 0.8 x 0.3 cm aggregate of soft tan-pink brain tissue, with approximately 60% submitted for frozen section analysis. The remaining portion was processed in two cassettes. The second specimen is a 0.5 x 0.5 x 0.1 cm fragment of similar appearance, entirely submitted in one cassette.\n\nMicroscopic examination reveals a moderately pleomorphic and densely cellular proliferation of astrocytic cells. Mitotic figures are present but sparse. No endothelial proliferation or necrosis is observed. Immunohistochemical staining for Ki67 was performed by counting four 250 x 250 micron fields, with over 1000 cells evaluated. The percentage of labeled nuclei ranged from 4.3% to 12.1%, with an average proliferation index of 9.5%. Selected slides were reviewed and confirmed the presence of malignant cells. Touch preparations were made from the first specimen. Additional immunohistochemistry assays were conducted using formalin-fixed, paraffin-embedded tissue. Some reagents used in testing are classified as Analyte Specific Reagents (ASR) and were developed by the Clinical Laboratory; FDA clearance was not required for their use."} +{"pid": "TCGA-86-A4P8", "report": "The specimen consists of a right lower lobe lung resection weighing 140 grams and measuring 13.5 x 8.5 x 2.0 cm. A mass measuring approximately 2.0 x 2.0 x 1.5 cm is located 4.6 cm from the bronchial margin and less than 0.1 cm from the closest pleural surface. The bronchial and vascular margins are uninvolved, with more than 1 cm of free margin at the bronchus. Microscopic evaluation shows a histologic grade G3 lesion with a size of 2.1 cm. Lymphovascular invasion is present. The visceral pleura is involved to a depth of less than 1 mm but is not fully invaded.\n\nLymph node assessment reveals metastatic involvement in several stations: Station 8 (1 of 2 nodes), \"Subcarina\" (2 of 3 nodes), Station 7 (not involved), Station 11 (1 of 3 nodes), Station 4 (1 of 1 node), and peribronchial region (5 of 6 nodes). In total, 10 out of 17 lymph nodes examined show evidence of metastasis. No treatment effect is noted. Clinical staging is pT1b pN2 pMx. \n\nA prior fine needle aspiration (FNA) was discordant with findings on resection, as tumor cells were identified in Stations 4 and 11 during resection but not in the FNA samples. Upon review, this discrepancy is attributed to incomplete sampling during the FNA procedure."} +{"pid": "TCGA-KN-8419", "report": "The specimen was received fresh and consists of a nephrectomy specimen with adrenal gland. A mass measuring 20.6 x 14.0 x 11.0 cm is present within the kidney, appearing yellow/golden brown and focally hemorrhagic. It protrudes from the kidney and compresses the cortex into a thin rim in the upper pole. The mass is encapsulated by a thin membrane and is located 11.5 cm from the ureter, 7.0 cm from the renal vein, and 7.8 cm from the renal artery. The tumor demonstrates a large focus of hemorrhage and fibrosis measuring 5.3 x 3.8 x 2.9 cm as well as multiple areas of necrosis.\n\nHistologic evaluation reveals Fuhrman nuclear grade II features. The tumor compresses the renal cortex but does not invade perirenal adipose tissue. No lymphovascular invasion is identified. Margins of the renal artery, vein, and ureter are free of involvement. The uninvolved kidney shows no significant pathologic change, and the adrenal gland demonstrates no diagnostic abnormality.\n\nImmunostaining for CK7 showed diffuse positivity in selected areas. A modified Hale's colloidal iron stain was performed and was positive, supporting the morphologic features. Representative sections of the mass and normal tissue were submitted to the tissue bank and for cytogenetic analysis. Multiple microscopic sections were evaluated, including margins, representative tumor sections, hemorrhagic/fibrotic areas, and uninvolved kidney tissue. Staging classification according to AJCC (6th Edition) is T2 Nx Mx."} +{"pid": "TCGA-62-A472", "report": "Pathology Report-Summary: Material: lung, right, lower lobe: 14.0 X 4.0 X 2.8 cm. Two lesions identified: the first measures 2.5 X 2.2 X 2.1 cm and demonstrates infiltration with disruption of the visceral pleura. The second lesion measures 1.5 X 1.4 X 1.3 cm. Histologic evaluation reveals high-grade cellular atypia. Lymph node examination shows no evidence of involvement (0/2). Staging classification: pT3, pN0, pMx."} +{"pid": "TCGA-56-1622", "report": "A lymph node from the anterior lobar region was examined and found to be benign with anthracotic pigmentation. The right lower lobe specimen measured 15.0 x 15.0 x 4.0 cm and weighed 387 grams. A mass measuring 3.5 cm in greatest dimension was identified within the bronchus and showed extension into the surrounding lung tissue. The mass was located 0.3 cm from the inked pleural margin and 3.2 cm from the bronchial resection margin. Histologic evaluation revealed a poorly differentiated cellular proliferation with squamoid features. Immunohistochemical staining demonstrated strong reactivity for high molecular weight cytokeratin and p63, with variable expression of CD56 and cytokeratin 5/6. Cytokeratin 7 and TTF-1 were not expressed. No involvement was identified at the bronchial or vascular margins, and the closest pleural margin was also free of tumor. Adjacent lung tissue showed interstitial fibrosis and adhesions. No hilar lymph nodes were identified in this specimen.\n\nFive subcarinal lymph nodes were all benign with anthracotic pigmentation and adjacent soft tissue showed dystrophic calcifications. Two lymph nodes from the right hilum were similarly benign and pigmented. Five lymph nodes from the right lower peritracheal area were also benign. A separate wedge biopsy from the right middle lobe showed no evidence of malignancy and displayed only pleural adhesions.\n\nAll lymph nodes evaluated across multiple regions were without malignant involvement. The tumor did not exhibit lymphovascular invasion. Genomic tissue samples were obtained from multiple blocks of the primary lesion and surrounding tissue."} +{"pid": "TCGA-F4-6704", "report": "The submitted colectomy specimen involved the sigmoid colon and measured 5.2 x 2.2 cm. The lesion was infiltrative and ulcerated, with mucinous features noted on histologic evaluation. The tissue showed poor differentiation. The tumor extended to the subserosa. A total of 18 lymph nodes were examined, 13 of which showed evidence of involvement. All margins were uninvolved. No information was provided regarding neoadjuvant treatment or additional pathologic findings."} +{"pid": "TCGA-EB-A85I", "report": "The specimen consists of a skin flap containing a pigmented lesion measuring 4 x 3.5 cm with a thickness of 1 cm. The lesion is based on a broad area of the skin from the hip region. Histologically, the lesion demonstrates malignant cellular proliferation with features of ulceration. The tumor depth, measured as Breslow thickness, is 1 cm. No venous invasion is identified. The histologic type and grade are not specified. Lymph node involvement, lymphatic invasion, and margin status are not reported. There is no evidence of neo-adjuvant treatment effect. No satellite nodules or additional findings are described."} +{"pid": "TCGA-DJ-A2PR", "report": "The thyroid specimen from the right lobe measured 4.3 x 2.2 x 1.2 cm and weighed 6.5 grams. Microscopic evaluation revealed a small lesion measuring 0.15 cm in greatest dimension. The surgical margins were negative. No vascular invasion or extension beyond the thyroid was identified. Psammoma bodies were present in the surrounding thyroid tissue. There was evidence of chronic lymphocytic thyroiditis and nodular hyperplasia. Two psammoma bodies were identified in one of two lymph nodes evaluated.\n\nThe left thyroid lobe measured 5.0 x 2.0 x 2.5 cm and weighed 25 grams. A distinct lesion measuring 2.0 cm in greatest dimension was identified in the lower pole, with focal invasion of the capsule. The lesion was well-differentiated, without mitotic activity or necrosis. It was surrounded by fibrosis and located 0.2 cm from the anterior and posterior surfaces, and 0.6 cm from the isthmic margin. Surgical margins were free of involvement. Additional microscopic foci were noted, including one measuring 0.2 cm. The surrounding non-neoplastic thyroid showed nodular hyperplasia and chronic lymphocytic thyroiditis. Psammoma bodies were also observed in the non-neoplastic thyroid tissue.\n\nLymph node dissection on the left paratracheal side included 12 lymph nodes. Six of these contained abnormal findings, with the largest involved lymph node measuring 0.6 cm and the largest metastatic focus measuring 0.4 cm. Extranodal extension was not observed. Some of the affected lymph nodes contained only psammoma bodies."} +{"pid": "TCGA-44-2656", "report": "The specimen includes a right upper lobe lobectomy measuring 19.5 x 13.0 x 3.5 cm, with a bronchial stump 1.7 x 0.9 cm in diameter. A mass measuring 2.0 x 1.5 x 1.2 cm is present in the inferolateral region, with a pale tan to gray-black appearance. The lesion approaches the pleural surface. Another smaller area of concern, approximately 0.8 x 0.7 x 0.4 cm, is noted along the pleura, located about 3.5 cm from the main lesion. The remaining lung tissue shows a spongiform, tan pink-red texture with diffuse anthracosis. No other masses or abnormalities are identified. Five lymph node-like tissues, up to 1.6 cm in size, are found in the hilar region.\n\nMicroscopically, the primary lesion is moderately differentiated and measures 2.0 cm. The surgical margins are free of involvement. Invasion of the visceral pleura is observed. Vascular invasion involving both large venous and arterial structures is present. There is no evidence of lymphatic invasion. A total of nine lymph nodes from the main specimen and six from station 2R show no signs of metastasis. Two lymph nodes from station 4R, three from station 7, and one from station 9 are also negative for metastasis. Granulomatous inflammation is noted in an intraparenchymal lymph node and in station 7 lymph nodes; stains for acid-fast bacilli and fungal organisms are negative. Biopsy site changes are present in the area of the secondary lesion, but no malignant cells are detected."} +{"pid": "TCGA-BG-A0MG", "report": "The surgical specimen includes the uterus with bilateral adnexa, removed via vaginal hysterectomy with bilateral salpingo-oophorectomy. A lesion was identified measuring 4.5 cm in greatest dimension. Histologic examination revealed a well-differentiated epithelial tumor with squamous metaplasia. The lesion involved approximately 80% of the anterior endometrial surface and 50% of the posterior endometrial surface. Invasion into the myometrium was present, involving 36% of the total myometrial thickness (0.8 cm out of 2.2 cm). There was extension to the endocervical glandular epithelium without evidence of stromal invasion. No definite lymphovascular invasion was observed. Additional findings included adenomyosis. Both ovaries showed physiologic changes and both fallopian tubes were unremarkable.\n\nLymph node dissections from multiple pelvic and para-aortic regions were submitted for evaluation. In total, seven lymph nodes were examined, including right and left pelvic, common iliac, obturator, and periaortic lymph nodes. All lymph nodes were negative for involvement. Fibroadipose tissue from additional specimens also showed no tumor. Cytology from a companion pelvic wash specimen was negative for malignant cells.\n\nStaging parameters indicate involvement of the endocervical glands but not extending beyond the uterus. Depth of myometrial invasion was less than half of the total thickness. Based on these findings, the pathologic T stage is pT2a, with no lymph node involvement (pNO), and no assessment of distant metastasis (pMX). The overall staging classification aligns with IIA according to standard clinical staging criteria."} +{"pid": "TCGA-2G-AAGA", "report": "The specimen from the right orchidectomy contained a neoplastic lesion measuring 2.3 cm in diameter, composed entirely of non-seminomatous germ cell elements. Histologic evaluation demonstrated angiolymphatic invasion; however, there was no evidence of extension into the rete testis. The tumor was limited to the testicular parenchyma without involvement of other structures."} +{"pid": "TCGA-AC-A3YJ", "report": "The right sentinel lymph node specimen showed no evidence of metastatic carcinoma. Immunohistochemical staining for pancytokeratin was negative, confirming the absence of malignant cells. The right breast mastectomy specimen contained multiple areas of invasive papillary carcinoma. The largest focus measured 3.0 cm in greatest dimension. Histologic grading was based on architectural differentiation (score 1 of 3), nuclear pleomorphism (score 2 of 3), and mitotic activity (score 1 of 3), resulting in a total score of 4 out of 9, corresponding to grade 1. Additional foci of both in situ and invasive papillary carcinoma were identified in other quadrants of the breast. The largest area of confluent involvement measured 0.8 cm. There was no involvement of the skin or nipple. The overlying skin contained a benign seborrheic keratosis. The deep margin of excision was free of tumor involvement. Staging information was recorded as T2pNO(i-)MX. \n\nGross examination of the breast specimen revealed multiple pink-tan rubbery lesions distributed throughout all four quadrants. The largest lesion measured 3.0 x 1.8 x 1.8 cm and was located within 0.4 cm of the inked deep margin. A cystic lesion measuring 2.8 x 1.5 x 1.0 cm was identified with radiographic clip localization. Five possible lymph nodes were identified along the specimen edge, ranging from 1.0 to 1.4 cm in diameter. No discrete axillary tail was observed. Representative sections of all lesions and margins were submitted for microscopic evaluation. Frozen section analysis of the sentinel lymph node confirmed the absence of neoplasm."} +{"pid": "TCGA-CV-7235", "report": "The pathology report includes multiple tissue samples and lymph node assessments. Tissue fragments from the right and left mental nerves, proximal V3, and mandibular margins showed no tumor involvement, with touch preparations revealing only benign marrow elements. The oral cavity specimens, including the buccal, lip, and cheek margins, displayed ulcerated or normal squamous mucosa without evidence of invasive tumor, except for several areas showing high-grade intraepithelial changes (carcinoma in situ) involving the right posterior and anterior lip margins, right and left tongue margins, and the base of the tongue.\n\nLymph node evaluations were performed on both right and left neck dissections, as well as central and level IV regions. In total, 68 lymph nodes from all levels examined were negative for tumor involvement. This includes 9 nodes in level IIB, 4 in level III, 12 in level IV on the right; 2 nodes in level II, 18 in level III on the left; and 1 node in the central compartment. Additionally, a submandibular gland and fibroadipose tissues were unremarkable.\n\nA composite resection specimen from the anterior floor of the mouth and mandible contained a firm tumor mass measuring up to 2.0 cm, with invasion into the mandible and a depth of 9.0 mm. Histologic analysis revealed poorly differentiated squamous cell carcinoma with focal lymphovascular invasion but no perineural spread. Adjacent mucosa showed carcinoma in situ, and a minor salivary gland demonstrated metastatic involvement. All local regional lymph nodes (8 in total) were free of tumor. Bone margins were clear following decalcification. Other submitted tissues, including teeth and associated hardware, were evaluated grossly only."} +{"pid": "TCGA-RW-A681", "report": "The specimen from the right adrenal region weighed 180 grams and included a previously incised mass attached to a small amount of residual adrenal tissue. The overall specimen measured 9.4 x 5.5 x 4.5 cm, with the mass itself measuring 7.2 x 6.9 x 3.5 cm. The mass appeared to originate from the adrenal medulla. On gross examination, the cut surfaces were soft, spongy, and variably colored from yellow to brown. The tissue was heterogeneous in consistency, with lobular architecture and areas of hemorrhage and necrosis. The adjacent adrenal cortex was bright orange, and the medulla was brown. Representative sections of the mass were submitted for microscopic evaluation, along with sections showing the transition from lesion to normal adrenal tissue. All slides were reviewed by the attending pathologist."} +{"pid": "TCGA-XM-A8R9", "report": "A 4.2 cm anterior mediastinal mass was excised from a female patient with no prior relevant clinical history. The specimen measured 10 x 6 x 4.2 cm and was described as a well-circumscribed, pink-tan, meaty-appearing mass with areas of white-tan fibrous and yellow cheese-like material on cut surface. One side was covered by a thin membranous tissue, and the margins were inked black. Microscopic evaluation revealed two distinct components. The first component consisted of epithelial nodules composed of bland spindle cells. The second component showed lymphocyte-rich areas with epithelial micronodules, without admixed epithelial tumor cells. There was extensive necrosis present, but no evidence of capsular invasion. The inked margin was free of tumor involvement. Immunohistochemical staining demonstrated that the epithelial cells were positive for AE1:AE3 but negative for CD5. The lymphocytes were predominantly T-cells (CD3+/CD5+) with some immature phenotypes (CD1a+/CD99+). Scattered germinal centers contained B-cells highlighted by CD20 staining, and CD117 was negative. A representative section was submitted for frozen section and permanent sections. Intraoperative frozen section and subsequent permanent histology both confirmed the findings."} +{"pid": "TCGA-BP-4169", "report": "The submitted specimens include a portion of right adrenal, right kidney and adrenal gland, and right hilar lymph nodes. The right adrenal specimen consists of a small segment measuring 2.0 x 2.0 x 0.8 cm with attached adipose tissue. Microscopic evaluation shows benign adrenal tissue.\n\nThe right kidney specimen, weighing 820 grams, includes a large amount of perinephric adipose tissue. A segment of proximal ureter is present, measuring 5.0 cm in length and 0.3 cm in diameter. Both the ureteral resection margin and the renal hilar vessel margin are free of abnormal findings. The kidney measures 12.0 x 10.0 x 8.0 cm, and within it is a large mass measuring 9.0 x 8.0 x 7.0 cm that replaces nearly the entire kidney, leaving only a small area of uninvolved parenchyma at the inferior pole. The mass has a variegated cut surface with tan-white, hemorrhagic, gelatinous, and multiloculated cystic areas. Grossly, the mass extends to but not through the renal capsule and shows extensive replacement of the renal parenchyma and renal pelvis with focal involvement of the pelvis. No gross evidence of invasion into the renal vein is seen, though clusters of atypical cells are identified in small veins. The non-neoplastic kidney tissue demonstrates interstitial chronic inflammation. The adrenal gland associated with the kidney appears unremarkable.\n\nThe hilar lymph nodes specimen contains multiple fragments of adipose tissue aggregating to 3.5 cm, with several small presumptive lymph nodes identified. The largest lymph node measures 0.6 cm. Microscopic evaluation of all submitted lymph nodes reveals no abnormal cellular findings."} +{"pid": "TCGA-CZ-5458", "report": "The specimen consists of a right radical nephrectomy, including the kidney, ureter, renal vein, and two renal arteries. The kidney measures 17.8 x 10.1 x 7.0 cm. A single mass measuring 9.2 x 8.1 x 7.0 cm is present in the upper pole. It is hemorrhagic, well-encapsulated, and tan/yellow to tan/red in color with focal cystic change. The mass abuts the kidney capsule and is 0.2 cm from the inked margin. Distances to other margins are as follows: 12.0 cm to the ureter, 2.2 cm to artery #2, 3.3 cm to artery #1, and 2.2 cm to the vein. There is concern for extracapsular extension, though the renal pelvis does not appear involved.\n\nMicroscopically, the tumor involves the renal parenchyma and extends into the perirenal adipose tissue. Nuclear grade is III of IV. Focal areas with spindle cell morphology are noted. Resection margins, including those of the ureter, vein, and arteries, are free of tumor. No lymphovascular invasion is identified.\n\nStaging according to the AJCC 6th Edition classification system indicates T3 status. Cytogenetic analysis of the tumor reveals clonal chromosomal abnormalities, including loss of the short arm of chromosome 3, which is commonly associated with this tumor type. No metaphases were available for analysis from one of the submitted specimens.\n\nSelected histologic sections include the tumor, adjacent capsule, renal pelvis, uninvolved renal parenchyma, and surgical margins. Portions of the tumor and normal cortex were also submitted for additional testing including electron microscopy, immunofluorescence, and tissue banking."} +{"pid": "TCGA-UW-A72K", "report": "The specimen includes a partial nephrectomy and a separate tissue sample. The partial nephrectomy specimen weighs 34.2 grams and measures 5.4 x 4.7 x 3.5 cm overall. A well-circumscribed mass measuring 3.7 x 3.3 x 2.4 cm is identified within the kidney. The tumor appears to be confined within the renal capsule, which is intact. The cut surface of the mass is tan-pink with residual tan-white kidney tissue noted at the parenchymal margin. Microscopic examination shows nuclear features corresponding to Fuhrman grade 3 of 4. Sarcomatoid differentiation is not present. The tumor is unifocal and does not show microscopic or macroscopic invasion into surrounding structures including perirenal adipose tissue or Gerota's fascia. No vascular or lymphatic invasion is identified.\n\nHistologic evaluation of the surgical margins reveals that the tumor involves the inked parenchymal margin. The capsular margin is negative for tumor involvement but is closely approached by the tumor, with tumor cells located less than 1 mm from the inked margin. The paranephric adipose tissue margin is free of tumor involvement. No adrenal tissue or lymph nodes are sampled. Immunohistochemical staining shows diffuse positivity for CK7, CD10, E-Cadherin, and CD117, while being negative for RCC and vimentin. Based on available information, staging is assigned as pT1a pNX. This staging remains provisional and may be subject to change pending further clinical review."} +{"pid": "TCGA-IB-7886", "report": "The surgical pathology report includes multiple specimens. The gallbladder is unremarkable with no evidence of malignancy, showing only chronic inflammation. A bile duct margin specimen shows chronic inflammation without malignancy. The pancreatic margin specimen is also negative for malignancy.\n\nA pancreatoduodenectomy specimen reveals a large invasive lesion with features of moderate to poorly differentiated ductal adenocarcinoma. The tumor measures approximately 6.0 cm and extends into peripancreatic adipose tissue and the duodenal wall, with ulceration of the duodenal mucosa. Microscopic evaluation confirms widespread involvement with carcinoma present in multiple sections. The tumor involves the uncinate process margin as well as the superior and posterior pancreaticoduodenal soft tissue margins. Lymphovascular and perineural invasion are present. Metastatic carcinoma is identified in four of eleven regional lymph nodes.\n\nThe para-aortic lymph node specimen shows reactive changes without evidence of malignancy. Gross examination of the pancreatoduodenectomy specimen reveals an ulcerated area in the duodenum near the ampulla of Vater, with a firm craggy zone in the pancreatic head measuring approximately 2.5 x 1.5 x 2.5 cm. The head of the pancreas measures 6.0 x 4.5 x 3.0 cm. Additional lymph nodes are identified around the common bile duct and in the pancreatoduodenal region.\n\nOther specimens include a fragment of soft tissue from the bile duct margin and a pancreatic margin fragment, both negative for malignancy. The gallbladder measures 9.0 x 3.5 x 2.0 cm with variable wall thickness and no gallstones. The para-aortic lymph node is 1.6 x 1.2 x 0.6 cm with a homogeneous cut surface. All surgical margins except those noted were free of tumor."} +{"pid": "TCGA-2K-A9WE", "report": "The pathology examination of the left kidney and ureter specimen revealed a unifocal lesion located in the mid to inferior pole. The tumor measured 15 cm in greatest dimension and was largely necrotic. Microscopic evaluation demonstrated a papillary growth pattern with areas of necrosis, hemosiderin deposition, and foamy cytoplasm. Nuclear features included prominent nucleoli and irregular nuclear borders, corresponding to histologic grade 3. Vascular invasion was identified, although no involvement of the renal pelvis, hilar tissues, or sarcomatoid differentiation was observed. The tumor appeared limited to the kidney without involvement of surgical margins. Lymphovascular invasion was present; however, lymph node status could not be determined as no lymph nodes were identified in the specimen. Staging was assessed as pT2b pNX. Gross examination noted a disruption at the lower pole of the kidney with extrusion of necrotic material, though this did not correlate with microscopic evidence of capsular invasion. The remainder of the renal parenchyma showed normal architecture. Vascular margins, including the renal vein, were free of tumor involvement. Multiple sections from key areas were submitted for further analysis."} +{"pid": "TCGA-KN-8436", "report": "The specimen consists of a right radical nephrectomy with attached perinephric adipose tissue measuring 25.0 x 15.0 x 7.5 cm. A segment of ureter measuring 1.0 cm is present; no adrenal gland is identified. The kidney is bivalved, revealing a unifocal mass measuring 13.8 x 7.0 cm that has largely replaced the renal parenchyma. The cut surface demonstrates solid and cystic areas with yellow-brown discoloration, hemorrhage, and extensive necrosis. Gross examination does not show invasion into perinephric adipose tissue or the renal vein. No lymph nodes are identified grossly. The ureteral and vascular margins are negative for invasive disease.\n\nMicroscopic evaluation reveals an oncocytic neoplasm. Histologic assessment of the mass shows features reviewed across multiple slides (C-I and P-S), with some foci in the renal sinus raising suspicion for vascular invasion, though this remains indeterminate. Immunohistochemical staining is positive for PAX-2, C-kit, and CK7. Margins are free of involvement by invasive carcinoma. No additional significant pathologic findings are noted.\n\nStaging is assessed as pT2 based on tumor size exceeding 7 cm and confinement within the kidney. Regional lymph node involvement (pNX) and distant metastasis (pMX) cannot be assessed due to lack of available tissue for evaluation."} +{"pid": "TCGA-XU-A932", "report": "The specimen consists of a resected thymus with a portion of right pleura attached, measuring 10 x 9 x 1.6 cm and weighing 36 grams. A yellow nodular solid lesion is identified within the thymus, measuring 5.5 x 2.6 x 1.6 cm. The lesion is partially encapsulated and demonstrates multiple foci of microscopic transcapsular invasion into adjacent adipose tissue. There is no evidence of pleural or lymphovascular invasion. The tumor is adherent to a piece of pleura marked by suture, but invasion is not confirmed. Margins of resection are free of abnormal cellular infiltration.\n\nHistologically, the lesion shows a mixed population of thymic cortical-type epithelial cells and small lymphocytes. Immunohistochemical staining reveals the epithelial cells are positive for cytokeratin (AE1/AE3) and P63, and negative for CD5. The lymphocytic component stains positive for CD5, CD1a, and TdT. No significant abnormalities are noted in the associated parathyroid gland or remaining thymic tissue, which demonstrates involutional changes.\n\nStaging assessment indicates microscopic transcapsular extension without involvement of regional lymph nodes or distant metastasis. The lesion appears completely excised."} +{"pid": "TCGA-LL-A9Q3", "report": "The specimen consisted of a left modified radical mastectomy with axillary dissection. The surgical margins were free of tumor, with the closest margin measuring 0.3 cm from the tumor at the inferior aspect. A tumor measuring 10 cm in greatest dimension was identified within the breast. Histologic evaluation revealed a glandular/tubular differentiation score of 3, nuclear pleomorphism score of 2, and mitotic rate score of 1, resulting in an overall histologic grade of 2. The tumor exhibited extensive lymph-vascular invasion and was present in a single focus without ductal carcinoma in situ. \n\nAll 28 axillary lymph nodes examined contained metastatic disease, with the largest lymph node measuring 5 cm and showing extracapsular extension. Pathologic staging was determined as pT3 for the primary tumor and pN3a for regional lymph node involvement. Immunohistochemical analysis demonstrated positivity for estrogen receptor (100% of cells) and progesterone receptor (2% of cells). \n\nGross examination described a fibrofatty breast specimen weighing 1758 grams, measuring 28.0 x 25.0 x 6.5 cm. The tumor presented as a region of indurated nodularity measuring 10.0 x 7.0 x 7.0 cm, with a central solid mass measuring 4.0 x 3.5 x 3.0 cm. The mass was located approximately 2.5 cm from the deep margin and showed focal petechial hemorrhage. Multiple sections were taken from various quadrants of the breast and from lymph nodes in the axillary region. \n\nCold ischemia time was zero minutes, and the specimen was placed in formalin 3 hours and 56 minutes prior to fixation. Intraoperative gross evaluation confirmed a large invasive tumor with margins free of tumor involvement. The specimen was processed for tissue banking."} +{"pid": "TCGA-HF-7132", "report": "The sample was collected from the antrum of the stomach via a resection procedure. The tissue measured 5 cm in size and demonstrated a mucinous adenocarcinoma histology with moderate differentiation (Grade II). Microscopic evaluation revealed a macroscopic tumour configuration classified as type I (protruded) and Borrmann type III (ulcerated tumour with infiltrative margins). Pathologic staging was determined as T2b, N1, M0."} +{"pid": "TCGA-VD-A8K9", "report": "The specimen consists of an enucleated left eye. Dimensions are axial 24.3mm, horizontal 22.8mm, and vertical 23.4mm. The cornea is clear, with measurements of 12.4mm horizontally and 12mm vertically. The optic nerve measures 5.7mm in length and 3.6mm in diameter. Transillumination reveals a shadow measuring 13.6mm by 13.1mm located laterally. The plane of section is horizontal.\n\nUpon opening the eye, a lesion is identified in the choroidal region. The tumour measures 10.5mm in largest basal diameter and has a height of 7.3mm. Microscopic evaluation shows a dome-shaped lesion in the posterior segment associated with retinal detachment. The overlying retina demonstrates atrophic and degenerative changes. Histologically, the tumour is composed predominantly of spindle-shaped cells with minimal epithelioid cell component. Pigmentation is present.\n\nImmunohistochemical staining demonstrates reactivity for MelanA and HSP-27 (score 3). Mitotic activity is moderate, approximately 7 mitoses per 40 high power fields. The microvasculature within the tumour is prominent; however, closed vascular loops are not observed. There is minimal lymphocytic infiltration and mild presence of macrophages throughout the tumour. No evidence of scleral invasion or extraocular extension is seen. The optic nerve and examined vortex veins are free of tumour involvement. Mild atrophic changes are noted in the optic nerve and ciliary muscles, with moderate hyalinisation of the ciliary processes.\n\nMolecular genetic analysis using MLPA was performed on extracted tumour DNA. The results indicate normal chromosome 1, disomy 3, gains in chromosome 6, and gains in chromosome 8q. These findings will be correlated with clinical and morphological data for further assessment. The tumour margin clearance is adequate."} +{"pid": "TCGA-BP-4995", "report": "The specimen from the right kidney and adrenal gland measured 10.3 x 6 x 5 cm, with attached ureter measuring 6.5 cm in length and 0.3 cm in diameter, and a renal vein segment measuring 0.5 cm in length and 1.0 cm in diameter. A well-defined mass measuring 4.6 x 2.7 x 2.5 cm was identified in the upper half of the kidney; it had an orange-yellow, variegated cut surface and extended into the renal vein. The tumor abutted but did not appear to invade the renal pelvis. No lymph nodes were found in the perinephric fat. Margins of the ureter, renal vessels, and surrounding fat were free of involvement. Sections of the non-neoplastic kidney showed mild chronic interstitial nephritis.\n\nA separate specimen from the right 11th rib measured 4.0 x 0.9 x 0.4 cm and contained only benign bone and hematopoietic marrow elements.\n\nTwo specimens of adrenal tissue were received: one measured 1.3 x 0.6 x 0.1 cm and the other 5.0 x 2.8 x 1.3 cm, with the adrenal portion measuring 3.8 x 2.2 cm. Both showed only benign adrenal tissue without any abnormal cellular features.\n\nLymph node tissue from the right para-aortic region included five benign lymph nodes ranging from 0.3 to 1.0 cm in size, none of which showed any evidence of involvement.\n\nHistologic evaluation revealed high nuclear grade features. The tumor extended into muscularized branches of the renal vein within the renal sinus but did not involve the renal sinus fat or show signs of local invasion. No tumor was identified at the surgical margins. Based on these findings, the staging classification was determined to be pT3b, indicating extension into the renal vein or vena cava below the diaphragm."} +{"pid": "TCGA-BQ-5893", "report": "The left kidney specimen measured 19.5 x 14.0 x 9.0 cm and weighed 1,478 grams. Two distinct masses were identified: one measuring 15 x 13 x 12 cm and the other measuring 3.0 x 2.2 x 1.9 cm. Both exhibited yellow-white cystic and focally hemorrhagic cut surfaces. The tumor extended through the renal capsule but remained within Gerota's fascia, with involvement of the renal pelvis, sinus fat, and hilar fat. No invasion of the renal vein was observed. Widespread small vessel and lymphatic invasion was present. Surgical margins were free of tumor involvement. The non-neoplastic kidney tissue showed no remarkable findings. A polyp measuring 0.5 cm was noted in the renal pelvis.\n\nA total of 32 lymph nodes were examined across multiple sites. In the hilar region, a single lymph node measuring 5.8 cm was involved. In the inferior mesenteric artery region, two lymph nodes were submitted, both of which were involved, with the largest measuring 1.5 cm. In para-aortic lymph node group #1, one of one lymph node was involved, measuring 4.5 cm. In para-aortic lymph node group #2, all 11 lymph nodes submitted were involved, with the largest measuring 6.0 cm. In the left hilar lymph node group, all 14 lymph nodes were involved, with the largest measuring 6.2 cm. Extracapsular extension was not identified in any of these lymph node groups. Additionally, a portion of adrenal gland was found to be involved by the process. In the mesenteric region, one lymph node was submitted and found to be involved, measuring 2.0 cm.\n\nImmunohistochemical stains and special studies were performed but did not provide definitive diagnostic clarification. Morphological features were consistent with findings from a prior cytology specimen obtained from a left neck lymph node."} +{"pid": "TCGA-KO-8416", "report": "The radical nephrectomy specimen included a kidney measuring 13.0 x 5.5 x 3.0 cm and an adrenal gland measuring 6.0 x 2.0 x 1.5 cm, along with surrounding structures. A well-circumscribed mass measuring 8.5 x 8.5 x 6.5 cm was identified on the anterior surface of the kidney, involving the upper and middle poles. The mass extended toward the perinephric adipose tissue and was within 0.2 cm of the inked Gerota's fascia in an area marked as near the colon. The tumor exhibited central cystic changes, comprising approximately 60% of its volume, filled with brown opaque fluid. The solid component showed lobulated, friable brown tissue surrounded by a thick fibrous capsule. No clear evidence of invasion into the renal sinus, perinephric fat, or renal vein was observed.\n\nMicroscopic evaluation revealed Fuhrman nuclear grade 3 morphology. The tumor was confined to the kidney and showed invasion of intraparenchymal hilar vessels, while extraparenchymal hilar vessels were free of involvement. All surgical margins were negative. Adjacent kidney tissue showed chronic interstitial nephritis and glomerulosclerosis. The adrenal gland appeared unremarkable. Immunohistochemical analysis showed positivity for cytokeratin 7 and CD117, with weak diffuse cytoplasmic staining for CD10. No lymph nodes were identified in the renal hilum. The tumor was submitted for potential electron microscopy and research purposes."} +{"pid": "TCGA-QT-A5XM", "report": "The specimen consists of a left adrenal gland obtained via robotic laparoscopic adrenalectomy. The overall specimen weighs 119 grams and measures 13 x 7 x 4 cm. The adrenal gland itself measures 7.6 x 4.0 x 1.8 cm and accounts for approximately 15% of the total specimen mass. Attached periadrenal adipose tissue is present, although there is a 3.0 x 1.5 cm area where this tissue is absent. Underlying this region, the adrenal gland shows a 2.6 cm linear disruption that has been sutured closed. Margins are marked with blue ink on the disrupted side and black ink on the non-disrupted side. Due to the disruption, assessment of surgical margins is compromised.\n\nA distinct mass is identified within the adrenal medulla. It measures 3.4 x 2.0 x 1.6 cm and weighs approximately 14.6 grams, accounting for roughly 50% of the tissue mass submitted. The mass appears brown, well-circumscribed, and shows areas of gross necrosis. It is confined to the adrenal medulla; however, the disruption of the surgical margin limits full evaluation of its extent. The closest distance from the tumor to the resection margin is less than 1 mm on the disrupted (blue inked) side and 1 mm on the non-disrupted (black inked) side.\n\nThe remaining adrenal cortex appears golden yellow to tan in color, with cortical thickness ranging from less than 1 mm to 1 mm. No additional masses or areas of hemorrhage are observed. No lymph nodes are identified within the specimen. Histologic evaluation reveals no involvement of extra-adrenal tissues, blood vessels, or lymphatic channels. Surgical margins are not involved by the lesion.\n\nMicroscopic sections of the mass have been submitted for further analysis. Immunohistochemical staining for Ki-67 demonstrates a labeling index of less than 1%. Additional uninvolved adrenal tissue and periadrenal fat remain preserved in formalin."} +{"pid": "TCGA-WC-A884", "report": "The left globe specimen measured 21 x 21 x 23 cm with an attached optic nerve measuring 13 mm. The cornea was approximately 10 mm in diameter, and the iris appeared distorted with a pupil opening measuring 0.7 x 0.4 cm. A shadow was identified on transillumination at the posterior aspect of the globe extending from near the limbus to within 5 mm of the optic nerve head, measuring approximately 22 x 20 mm at the base. The vitreous was yellow-tinged. A multinodular mass was observed with variegated coloration ranging from light tan to gray, reaching a height of up to 10 mm. The mass extended into the ciliary body and demonstrated partial polypoid configuration. The lens was disintegrated, edematous, pale, and translucent white in appearance.\n\nHistologic sections included evaluation of vortex veins, optic nerve margin, areas of tumor with adjacent harvested tissue, and a section through the pupil-optic nerve axis containing the mass. Microscopic examination revealed a mixed cellular morphology with epithelioid and spindled cell types. Mitotic activity was quantified as 5 mitoses per 10 high-power fields. Involvement of the choroid and ciliary body was noted, with focal extension onto the iris. There was evidence of choroidal invasion. The optic nerve and vortex veins were negative for tumor involvement. The tumor was in proximity to the canal of Schlemm; however, no definitive invasion was identified, only associated inflammation. Retinal and lens degeneration was present along with background hyperplasia of the retinal pigment epithelium.\n\nA separate fine needle aspiration biopsy of the left eye was performed and consisted of multiple tan and clear tissue fragments with mucoid material measuring 0.4 x 0.4 x 0.3 cm. This sample was not retained for permanent storage but was shipped for further diagnostic analysis under controlled temperature conditions. Biomarker testing was initiated using tissue from the primary tumor block (section A4)."} +{"pid": "TCGA-DX-A3LW", "report": "The submitted specimen consists of a well-demarcated, encapsulated, rubbery mass measuring 17 x 15 x 15 cm. Attached to the lateral side is a segment of sigmoid colon measuring 30 cm in length. The proximal surgical margin measures 2.5 cm in circumference and the distal margin measures 2.8 cm in circumference. The serosa appears smooth and shiny, and the sigmoid mucosa is unremarkable on gross examination. The anterior surface of the mass is partially covered by peritoneum, while the posterior surgical margin is inked. Cut sections reveal a yellow-gray appearance with central areas of necrosis and scattered hemorrhages; approximately 20% of the mass demonstrates necrotic changes. Histologic evaluation indicates areas of varying differentiation and sclerosing morphology. The lesion involves retroperitoneal fat and extends focally to the inked margin, with involvement of pericolic fat noted."} +{"pid": "TCGA-FY-A3NM", "report": "The surgical pathology report includes a total thyroidectomy specimen and right central neck lymph nodes. The thyroidectomy specimen measured 5.2 x 2.1 x 2.0 cm for the right lobe, 3.1 x 2.2 x 1.5 cm for the left lobe, and 2.5 x 0.9 x 0.7 cm for the isthmus. Three distinct lesions were identified. \n\nIn the right lobe, two separate lesions were found. One measured 1.6 x 1.1 x 1.0 cm and was described as firm, white-tan, and unencapsulated. It abutted the superior margin. Another lesion measured 0.5 cm in greatest dimension, was also unencapsulated, and located in the superior portion of the right lobe. Both exhibited classical histologic architecture and cytomorphology. Margins were uninvolved by invasive disease in both lesions. No tumor capsule was identified in the larger lesion, while the smaller lesion was totally encapsulated with minimal capsular invasion noted. No lymphovascular invasion was seen in either lesion.\n\nA third lesion was identified in the left lobe measuring 1.3 x 1.1 x 0.6 cm. It had similar classical histologic features and cytomorphology. This lesion did not involve the margins and no tumor capsule was identified. Minimal extrathyroidal extension was present in this lesion.\n\nTwo benign lymph nodes were identified in the central compartment (0/2), along with one unremarkable parathyroid gland on the left side. The right central neck lymph nodes specimen included four lymph nodes, all negative for malignancy (0/4). Benign thymic and parathyroid tissue were also noted in this specimen.\n\nNo lymphovascular invasion was identified in any of the lesions. All tumor margins were free of invasive disease. Specimen integrity was intact, and the procedure was documented as a total thyroidectomy with central compartment dissection. The case was reviewed and all relevant sections were submitted for analysis."} +{"pid": "TCGA-FE-A234", "report": "The specimen was received in four properly labeled containers. Specimen A, designated as a prethyroid node, consisted of a 1.1 x 0.8 x 0.5 cm aggregate of tan-red soft tissue fragments and was entirely submitted for frozen section. Specimens B and C were biopsies from the thyroid gland and right thyroid lobe, respectively. Specimen B measured 2.0 x 1.0 x 0.5 cm and consisted of red-brown soft tissue; specimen C measured 2.2 x 1.5 x 0.6 cm and consisted of multiple portions of shaggy tan-red tissue. Both were submitted for frozen section evaluation.\n\nSpecimen D consisted of a total thyroidectomy specimen weighing 21.2 grams and measuring 6.5 x 4.5 x 2.3 cm. The right lobe was markedly enlarged compared to the left. The capsular surface appeared tan-red and intact without identifiable lymph nodes or parathyroid glands. Serial sectioning revealed a well-circumscribed tan-red mass measuring 3.3 x 3.0 x 2.5 cm located entirely within the right lobe. The mass exhibited a coarsely granular texture with focal yellow flecks and extended to the blue inked capsular margin. No gross involvement was observed in the isthmus or left lobe; however, the left lobe demonstrated a focal disruption on its surface.\n\nHistologic examination of the lymph node biopsy revealed metastatic involvement in two out of two lymph nodes evaluated. Examination of the thyroid biopsies showed benign thyroid tissue. Intraoperative consultation confirmed metastatic disease in the lymph node and benign thyroid tissue in the corresponding biopsies.\n\nThe synoptic report documented tumor location within the right lobe with no multifocal involvement. Histologic evaluation revealed no lymphatic or vascular invasion and no thyroid capsular invasion. Staging information was revised to indicate positive lymph node involvement based on further analysis. Two lymph nodes were examined and both contained metastatic deposits. Final staging was adjusted accordingly."} +{"pid": "TCGA-BP-4346", "report": "The right kidney specimen measured 22 x 12 x 6.5 cm and weighed 608 g. A well-circumscribed, lobulated, yellow-tan hemorrhagic mass was identified in the upper pole of the kidney, measuring 6.9 x 4.9 x 4.0 cm. The mass was located cortico-medullary and was noted to bulge into the perinephric fat with possible involvement. It grossly extended into the sinus fat and renal pelvis but no clear invasion was observed. The tumor was separated from the ureteral and vascular margins. The remainder of the kidney showed a pink-brown parenchyma with a well-defined cortico-medullary junction and a single cystic area measuring 1.1 x 1.0 cm. No lymph nodes were found in the perinephric fat. Sections of the tumor included areas involving the hilar fat, adjacent kidney, sinus fat, and perinephric fat, as well as representative sections of normal renal tissue and cystic changes.\n\nA separate specimen containing precaval and paracaval lymph nodes included 21 lymph nodes, all without involvement.\n\nAnother specimen consisted of an adrenal gland measuring 4 x 1.8 x 1.5 cm, which appeared unremarkable on cross-section. Surrounding adipose tissue contained multiple small benign cortical nodules. A few small lymph nodes were also present, ranging from 0.6 to 1.4 cm in size, and all were submitted for examination. No significant findings were noted in the adrenal gland or associated lymph nodes.\n\nTumor histology showed nuclear features classified as grade III/IV. Invasion into the muscular branches of the renal vein within the renal sinus was observed, though no direct extension into the renal vein or vena cava above the diaphragm was noted. Surgical margins were free of tumor. Non-neoplastic findings included mild arteriosclerotic changes in the kidney and a benign cortical cyst. Multiple tissue blocks were examined from various sites including the tumor, surrounding fat, hilar regions, and margins."} +{"pid": "TCGA-KM-8476", "report": "The specimen consists of a right kidney weighing 495 grams, with an attached adrenal gland. A mass measuring 7 cm in maximum diameter is present in the superior pole, abutting the renal capsule. The mass has a brown-tan cut surface and was processed for tissue procurement prior to arrival in the Surgical Pathology suite. The kidney was opened before arrival, and the specimen was serially sectioned to evaluate the relationship of the mass to surrounding structures. Perinephric fat is present around the tumor and was marked with black ink, avoiding contact with the cut tumor surface. Representative sections of the tumor, perinephric fat, kidney parenchyma, pelvis, and peripheral areas were submitted for permanent histologic evaluation.\n\nThe adrenal gland, measuring 6.5 x 2.5 x 0.5 cm, was received partially sectioned and was further serially sectioned to reveal a normal orange cut surface without visible lesions. Representative sections of the adrenal gland were also submitted.\n\nUreteral and vascular margins are identified grossly and appear unremarkable. No tumor involvement is noted in these areas. Potential hilar lymph nodes were also submitted for evaluation. All relevant sections have been placed in cassettes labeled A through N for microscopic analysis."} +{"pid": "TCGA-AC-A5EH", "report": "The surgical specimen consists of a left breast modified radical mastectomy with axillary lymph node dissection. Two distinct tumor foci were identified within the breast tissue. One measured 2.3 cm located in the lower outer quadrant and another measuring 0.7 cm in the inner quadrant. Histologic evaluation revealed invasive carcinoma features, including nuclear pleomorphism and mitotic activity contributing to an overall Nottingham histologic score of 6\u20137 out of 9 (grade 2). Tubule formation was greater than 10% upon excision.\n\nAssociated with these lesions was ductal carcinoma in situ (DCIS), characterized by intermediate nuclear grade with cribriform and micropapillary patterns along with punctate necrosis but without calcifications. DCIS spanned approximately 3.8 cm and constituted about 10% of the tumor burden. Surgical margins for both invasive and in situ components were widely negative, with clearance of at least 1.2 cm from all margins.\n\nA suspicious focus for lymphovascular invasion was noted. In the axillary lymph node sampling, one of fourteen nodes contained a micrometastasis measuring 1.7 mm; no extranodal extension was observed. Staging assessment indicated primary tumor staging as pT2(m), regional lymph node involvement as pN1(mi), and no evidence of distant metastasis (pMX).\n\nAncillary immunohistochemical studies demonstrated estrogen receptor positivity (moderate-strong intensity) in one lesion but negativity in the second lesion. Progesterone receptor expression was negative across both lesions. HER2 staining was negative (score 0) in both locations. Ki-67 proliferation index was high, showing 40% and 65% positivity in respective areas.\n\nGross examination of the mastectomy specimen revealed a palpable mass in the lower outer quadrant with associated metallic clips marking prior biopsy sites. The remainder of the breast parenchyma showed benign findings including fibrocystic changes and vascular calcifications. The skin and nipple were unremarkable without involvement. All pertinent tissue sections were submitted for microscopic evaluation confirming the described findings."} +{"pid": "TCGA-56-8307", "report": "The surgical pathology report includes evaluation of multiple lymph node specimens and a lung resection specimen. Lymph nodes assessed included those from stations 4R (biopsy and dissection), level 7 (biopsy and dissection), level 11R (biopsy and dissection), and station 11R (dissection). All lymph nodes examined were negative for malignant involvement, with a total of 18 lymph nodes assessed and none showing evidence of metastasis.\n\nThe lung resection specimen involved the right lower lobe and contained a single mass measuring 13 x 11.5 x 8.5 cm. The tumor had negative margins with the closest margin measuring 0.5 cm away from the tumor. There was no lymphatic or vascular invasion identified. The tumor extended through the visceral pleura and involved the diaphragm. Histologic examination revealed predominantly poorly differentiated morphology with no treatment effect observed. Background bronchus and lung tissue showed no significant abnormalities aside from mild nonspecific changes.\n\nPathologic staging was determined as pT3 due to the tumor size exceeding 7 cm and direct invasion into the diaphragm. Regional lymph node staging was pN0 as no lymph node metastases were identified. Distant metastasis was not identified (pM0). Based on these findings, the overall pathologic stage was classified as IIB."} +{"pid": "TCGA-05-4426", "report": "The specimen demonstrates a large peripheral lesion within the left lower lobe of the lung, exhibiting a mixed growth pattern composed of acinar and solid elements, with areas showing a bronchioloalveolar pattern of spread. Additional findings include involvement of segments S9 and S10, as well as a small peripheral focus with non-mucinous bronchioloalveolar features in segment S6. Histologic evaluation reveals no lymph node involvement based on the material examined. The tumor measures 2 cm or more in greatest dimension and there is no evidence of distant metastasis. Surgical margins are negative. The morphologic features correspond to a stage IB classification."} +{"pid": "TCGA-SP-A6QF", "report": "The specimen from the right adrenal gland weighs 20 grams and measures 8 x 4 x 2.5 cm. Upon sectioning, two distinct masses are identified. The first is a small, well-defined, yellow, solid nodule measuring 0.7 x 0.6 x 0.6 cm. The second is a larger, well-circumscribed, red-brown solid mass measuring 2.1 x 2.0 x 1.5 cm, located approximately 1.5 cm away from the smaller lesion. Both masses are surrounded by adrenal tissue that shows a variegated pattern with multiple small yellow areas ranging from 0.1 to 0.3 cm in size. No abnormalities are observed in the surrounding fatty tissue. Sections of both masses and representative portions of the remaining adrenal tissue have been submitted for analysis."} +{"pid": "TCGA-QR-A6GW", "report": "The right adrenal specimen consists of a soft, tan, well-circumscribed nodule measuring 7 x 5 x 4 cm and weighing 68.84 grams. The cut surface is homogeneous and tan with no evidence of hemorrhage. The lesion is surrounded by a rim of normal tissue and inked in blue. Approximately 60% of the tissue was retained for research purposes, while the remainder was processed for histologic evaluation. Sections from various regions of the lesion were submitted for microscopic analysis. The tumor demonstrates a solid, cellular architecture with a homogeneous appearance on gross examination. No involvement of the outer margin was observed. The specimen was entirely processed and representative sections were evaluated microscopically."} +{"pid": "TCGA-FV-A3I1", "report": "A partial hepatectomy specimen involving the right lobe of the liver and gallbladder was examined. The procedure was classified as a minor hepatectomy involving less than three segments. A solitary lesion measuring 4.0 cm in greatest dimension with additional dimensions of 4.0 x 3.0 cm was identified in the right lobe. Histologic evaluation showed a range of differentiation within the lesion, with areas showing well-differentiated features and other areas demonstrating moderate to poorly differentiated morphology, including anaplastic giant cells and numerous mitotic figures. Some regions exhibited solid and trabecular growth patterns, while others contained desmoplastic stroma and possible glandular structures. Cytoplasmic fat and hyaline globules were also noted in certain areas.\n\nThe surgical margins were largely uninvolved, though a satellite nodule in block 3 was found within 1 mm of the closest resection margin. Tumor extension was confined to the liver without macroscopic lymph-vascular invasion; however, microscopic evidence of vascular invasion was present. No perineural invasion was identified. Pathologic staging was determined as pT2 based on the presence of a solitary tumor with vascular invasion. One regional lymph node was examined and found to be negative (pN0). There was no evidence of distant metastasis.\n\nImmunohistochemical staining supported the findings, with strong positivity for alpha-fetoprotein and glypican-3. Polyclonal CEA showed canalicular staining, and HepPar-1 demonstrated variable patchy positivity. Cytokeratin 8 was positive in most tumor cells, while cytokeratin 7 and cytokeratin 19 showed limited and focal expression. Scattered positivity was seen with EMA and MOC-31.\n\nAdditional findings included mild chronic cholecystitis in the gallbladder. The non-neoplastic liver tissue did not show evidence of cirrhosis. The fibrosis score was Ishak stage 0. A total of 12 cassettes were submitted for histologic analysis, with representative sections from the main nodule, satellite lesion, gallbladder, and associated lymph node."} +{"pid": "TCGA-KV-A6GE", "report": "The specimen was obtained from the right kidney and measured 4.0 x 2.5 x 2.0 cm. It consisted of an ovoid, grey-brown, shaggy mass with one half covered in fibrous and adipose tissue and the other composed of tan-brown renal tissue. A 0.4 cm defect at the parenchymal margin was inked orange, while the remainder of the parenchymal margin was inked blue. A 0.3 cm defect on the capsular margin was inked green. Serial sections revealed a 2.1 x 1.7 cm fleshy, yellow-brown solid mass with a hemorrhagic center. A 1.0 mm rim of normal renal tissue was identified around the mass. Additional fibrofatty tissue measuring 5.0 x 4.0 x 1.0 cm was submitted.\n\nHistologic evaluation showed a neoplasm arising in the renal cortex forming papillary structures with fibrovascular cores containing foamy macrophages. No necrosis or high-grade nuclear features were observed. Immunohistochemical staining demonstrated positivity for CK7, AMACR, and CD10. The tumor was located at the parenchymal margin where the specimen was split intraoperatively; however, this area was described by the surgeon as disrupted and not representative of the final true margin (inked orange). The remaining parenchymal margin (inked blue) and capsular margin (inked black) were negative for tumor involvement.\n\nMicroscopic examination revealed no sarcomatoid features, transcapsular extension, or lymphatic/vascular invasion. The tumor was unifocal, confined to the kidney, and measured 2.1 cm. Evaluation of non-neoplastic renal tissue showed cortical parenchymal changes with arterial thickening and focal chronic interstitial inflammation. No additional tumors or cysts were identified. No adrenal tissue or lymph nodes were submitted.\n\nStaging was assessed as pT1a according to AJCC classification, corresponding to clinical stage I. All margins were negative except for the intraoperatively disrupted area, which was not considered a true margin."} +{"pid": "TCGA-22-4601", "report": "The tissue specimens include portions from the right upper lobe lung measuring 7.5 x 4 x 2.2 cm, right lower lobe lung measuring 7 x 5 x 2.7 cm, and a segment from the right upper lobe hilar region measuring 2 x 1.5 x 0.6 cm. Also included are superior and inferior mediastinal lymph nodes.\n\nMicroscopic evaluation of the right upper lobe lung specimen reveals a nodule measuring 0.7 x 0.5 x 0.5 cm with high-grade cellular features. The surrounding pleura and surgical margins show no evidence of neoplastic involvement. In the right lower lobe lung specimen, a larger lesion measuring 2 x 2 x 1.2 cm is identified, showing similar high-grade characteristics with areas of tissue retraction and pleural involvement. The hilar soft tissue specimen demonstrates the presence of high-grade cells. All evaluated lymph nodes from the superior and inferior mediastinal regions do not show any abnormal cellular infiltration."} +{"pid": "TCGA-B6-A0IA", "report": "Surgical Pathology Report:\n\nThe patient underwent a procedure with findings noted on imaging studies, including calcifications in the right breast and prominent tracer accumulation on bone scan. Specimens were submitted for analysis.\n\nSpecimen A, labeled \"Right breast biopsy,\" consists of a tissue fragment measuring 3.0 x 3.0 x 4.0 cm. Within this specimen is a well-defined mass measuring 2.0 x 1.3 cm, tan in color and lobulated in appearance. Multiple sections were taken from this specimen for microscopic evaluation.\n\nSpecimen B, labeled \"Right breast,\" includes an entire breast specimen along with an elliptical piece of skin and axillary tissue. The overall dimensions of the specimen are 27.0 x 16.3 cm. The breast itself measures 19.5 x 16.3 cm, while the axillary portion measures 7.0 x 6.0 cm. The skin ellipse measures 15.4 x 7.4 cm and contains a sutured incision located above the nipple. On sectioning, a large fibrous area was identified beneath the nipple region. Adjacent to this area was a biopsy cavity measuring approximately 2.3 x 2.0 cm that appeared slightly hemorrhagic. The fibrous tissue did not appear to involve surgical margins and extended laterally up to 6.0 cm from the biopsy site.\n\nIn the axillary portion, lymph nodes were identified across three anatomical regions: seven in Region I, four in Region II, and five in Region III. Representative sections of each region were submitted for evaluation.\n\nMicroscopic examination of the biopsy specimen revealed a combination of intraductal and infiltrative growth patterns within the breast tissue. The cellular features showed moderate differentiation. The invasive component measured approximately 2.0 cm in greatest dimension. Additional benign changes were also observed, including cystic dilation of ducts, interlobular fibrosis, focal hyperplasia, and apocrine metaplasia.\n\nSections from the surgical margins and regional lymph nodes were evaluated. No evidence of residual infiltrative or intraductal disease was identified in the main breast specimen or in any of the fifteen lymph nodes examined."} +{"pid": "TCGA-XU-A92Y", "report": "The specimen includes a resection from the mediastinum and a wedge of the left upper lobe of the lung. The resected tissue contains a well-circumscribed, multiloculated mass measuring 4.5 x 4.4 x 2.0 cm. The mass has a variegated yellow to yellow-brown appearance on sectioning. Focal areas of necrosis and calcification are present. The tumor is partially encapsulated and shows focal invasion through the capsule into surrounding soft tissues of the mediastinum. It is in close proximity to the resection margin (less than 0.1 cm), but appears to be separated from it by a thin layer of connective tissue. Dense adhesions are noted between the tumor capsule and the visceral pleura, though no direct invasion of the pleura or lung parenchyma is identified.\n\nMicroscopically, the lesion is composed primarily of epithelioid cells with clear vacuoles and minimal nuclear atypia, intermixed with small lymphocytes. Immunohistochemical staining shows the lymphocytes are positive for CD1a. Areas of infarct-like necrosis are also present. Two mediastinal lymph nodes are identified and show no evidence of tumor involvement.\n\nThe associated lung tissue demonstrates reactive changes, including mucus inspissation in small airways and post-obstructive alterations. A small nodule measuring 0.4 cm in diameter is found within the lung parenchyma, located approximately 0.5 cm from the main mass, and is negative for tumor on histological evaluation. No other nodules are identified within the lung or fatty tissue. A single lymph node measuring 0.6 x 0.5 cm is identified in the fatty tissue and is also negative for tumor."} +{"pid": "TCGA-CN-6988", "report": "EGFR FISH studies were conducted on a tissue sample, utilizing the EGFR SpectrumOrange and CEP7 SpectrumGreen probes. A total of 63 cells were analyzed. The EGFR/CEP7 ratio was recorded at 1.08. High polysomy was observed in 0% of cells, with an SNR (signal to nucleus ratio) of 2.7. Low polysomy was present in 15.9% of cells (10 out of 63), trisomy in 20.6% (13 out of 63), and disomy in 63.5% (40 out of 63). \n\nAncillary studies included immunohistochemical staining, which showed negative staining for p16, positive membranous staining for EGFR (2+), and negative staining for HPV.\n\nA total of 81 lymph nodes were examined\u201436 from the right and 45 from the left. Two lymph nodes on the right side contained abnormal cellular infiltration, measuring 1.0 cm and 2.0 cm respectively. No extracapsular spread was identified. The remaining lymph nodes showed no evidence of abnormal involvement.\n\nThe primary specimen consisted of a resected larynx with associated structures. A mass measuring 4.0 cm was identified in the transglottic region, involving the right true cord, ventricle, and false cord, with extension to the anterior commissure and thyroid cartilage. No perineural invasion was observed. Surgical margins were free of involvement. The tumor was located 1.2 cm from the posterior soft tissue margin, and extended 1.5 cm from the superior, inferior, and anterior resection margins. Adjacent thyroid tissue appeared unremarkable and was 0.3 cm away from the tumor. Post-operative changes related to a tracheostomy were noted.\n\nAdditional excised margins from the pharynx and constrictor muscles were examined microscopically. One margin showed focal mild dysplasia only on frozen section, while all others were free of tumor involvement.\n\nPathologic staging was determined as pT4 N2B."} +{"pid": "TCGA-05-4245", "report": "The resected upper lobe lung specimen shows an infiltrative lesion measuring up to 3.2 cm. The lesion is composed of poorly differentiated, non-mucinous epithelial cells. Histological evaluation indicates involvement of regional lymph nodes, with vascular invasion present. The tumor demonstrates a moderately high proliferation index, with approximately 30% of nuclei staining positive using the Mib-1 marker. Immunohistochemical analysis reveals absence of cytokeratin 5 expression. Some cells co-express cytokeratin 7 and 20, while most exhibit diffuse and strongly positive nuclear staining for TTF-1. Marked CEA expression is also observed. These findings are consistent with a high-grade neoplasm exhibiting immunophenotypic features commonly associated with pulmonary origin."} +{"pid": "TCGA-IQ-A6SH", "report": "A resection specimen from the left side of the oral cavity was examined, measuring 6.0 x 3.0 x 3.0 cm. A white-tan, firm lesion was identified within the soft tissue, measuring 3.8 cm in greatest dimension, with an irregular and ulcerated surface. The lesion was located 0.2 cm from the medial margin, 1.0 cm from the posterior margin, 0.4 cm from the tip of the tongue, and 0.3 cm from the inferior margin. Histologically, the lesion showed well-differentiated features without evidence of perineural or lymphovascular invasion. All surgical margins were free of involvement.\n\nA total of 49 lymph nodes were evaluated: 20 from the right neck (levels 2\u20134) and 29 from the left neck (levels 1\u20134). One lymph node on the left side, measuring 0.4 cm, contained metastatic changes. No extranodal extension was observed. Other lymph node groups, including those from the right and left level 1, as well as right levels 2\u20134, did not show any evidence of involvement. A small focus of hyperkeratosis and mild atypia was noted at one margin, but no other areas showed signs of invasive disease. The overall staging reflected a primary lesion greater than 2 cm but less than 4 cm in size and a single ipsilateral lymph node involvement measuring 3 cm or less."} +{"pid": "TCGA-08-0356", "report": "The brain tissue specimens were obtained from the left temporal lobe and included three separate samples. The first specimen consisted of a single unoriented fragment of soft, tan-pink tissue measuring 0.6 x 0.5 x 0.3 cm. A portion was used for intraoperative frozen section diagnosis and cytologic preparation (FS1), with the remaining tissue submitted for further analysis. Additional fresh tissue was preserved in glutaraldehyde for potential electron microscopy.\n\nThe second specimen, collected via ultrasonic aspiration, consisted of multiple soft, pink-tan, irregular fragments, measuring approximately 5.0 x 3.5 x 0.8 cm in total. This sample was entirely processed and submitted across eight cassettes.\n\nThe third specimen was a single soft, pink-yellow, irregular fragment measuring 0.8 x 0.4 x 0.2 cm, which was also fully submitted for histological evaluation.\n\nMicroscopic examination revealed well-developed areas of microvascular proliferation, foci of necrosis with pseudopalisading, and numerous mitotic figures. The findings were confirmed by the attending pathologist after review of all slides."} +{"pid": "TCGA-CJ-6031", "report": "The right kidney specimen measured 12.0 x 7.0 x 5.0 cm and was attached to a segment of ureter measuring 4.0 cm in length and 0.5 cm in diameter. An irregular mass measuring 5.5 x 5.5 x 5.0 cm was identified at the lower pole of the kidney. The tumor had variegated cut surfaces with hemorrhagic areas, a central firm fibrotic tan-yellow region, and peripheral fleshy areas. Microscopic evaluation showed a mixture of clear cells (approximately 70%) and eosinophilic cells (about 30%). Centrally, there was marked hyalinization. The tumor approached the renal sinus but did not invade into the adipose tissue. It abutted perinephric adipose tissue without definitive invasion. Margins of the ureter, vascular structures, and soft tissues were free of tumor. Within the renal medulla, four small tan-white, well-circumscribed nodules were identified, each measuring 0.3 cm in maximum dimension. No lymph nodes or adrenal gland were present. The remainder of the renal parenchyma appeared unremarkable."} +{"pid": "TCGA-B0-4849", "report": "The specimen consists of a left radical nephrectomy. The neoplasm measures 13.5 cm in greatest diameter and exhibits a solid pattern of growth. It extends through the renal capsule into the perirenal fat but remains confined within Gerota's fascia. Microscopic invasion of a branch of the renal vein is identified. All surgical margins are free of involvement. The non-neoplastic kidney and adrenal gland show no significant abnormalities. No lymph nodes are identified. Histologic grade is G2. The TNM stage is pT3a NX MX."} +{"pid": "TCGA-X7-A8D8", "report": "A mediastinal mass was resected and measured 6.5 x 6.5 x 4.5 cm. It was well-circumscribed, encapsulated, and surrounded by fat. A portion of lung tissue measuring 4.5 x 3.2 x 0.3 cm was attached; the mass appeared to be adhered to the lung pleura but did not show clear invasion. The cut surface was pink-tan, lobulated, with minimal fibrous areas. A small red-brown area measuring 0.9 x 0.4 x 0.4 cm was present within the mass, possibly representing a lymph node or residual thymic tissue. Two small extracapsular nodules were identified, measuring 0.1 and 0.2 cm. Four lymph nodes in the surrounding fat were identified, ranging from 0.2 to 0.5 cm. Microscopically, the mass showed cellular features consistent with a mixed pattern. There was evidence of microscopic invasion into adjacent adipose tissue. All resection margins and four associated lymph nodes were free of tumor involvement. Focal interstitial fibrosis was noted in the attached lung tissue. The pathologic stage was determined as pT2."} +{"pid": "TCGA-2E-A9G8", "report": "The surgical specimen included the uterus, cervix, bilateral fallopian tubes and ovaries, as well as multiple lymph node groups from the left and right pelvic regions and para-aortic areas. The patient is a female with a history of prior gynecologic pathology.\n\nGross examination of the hysterectomy specimen revealed a fungating mass located predominantly in the posterior endometrium, measuring 4.5 x 3.2 cm. The mass was associated with a separate circumscribed tan-white nodule within the myometrium measuring 5.2 x 5.1 x 5.0 cm, consistent with a benign smooth muscle lesion. The endometrial cavity measured 3.5 x 2.5 cm, and the average myometrial thickness was 1.4 cm. The mass appeared to invade approximately 0.3 cm into the myometrium. Multiple sections of the uterus, cervix, fallopian tubes, and ovaries were submitted for histologic evaluation.\n\nHistologically, the endometrial lesion showed a high-grade cellular morphology. The depth of myometrial invasion measured 0.5 cm, with a total myometrial thickness of 1.4 cm at the thinnest point. No involvement of the endocervical region was identified. All surgical margins were free of invasive disease, with the closest distance from the tumor to a margin being 0.8 cm at the serosal surface. There was no evidence of lymphovascular space invasion. No abnormalities were identified in the fallopian tubes or ovaries, and no metastatic involvement was found in any of the submitted lymph nodes across all regional groups.\n\nA total of 28 lymph nodes were examined: 5 from the left pelvic region, 14 from the right pelvic region, 4 from the left para-aortic area, and 5 from the right para-aortic area. All lymph nodes were negative for malignancy. Prognostic markers were ordered and available for review in a separate addendum.\n\nPathologic staging was determined as pT1a, pN0, with no distant metastasis indicated. The tumor was confined to the endometrium with less than one-half myometrial invasion. This stage is considered provisional and based solely on available pathologic findings."} +{"pid": "TCGA-D8-A1JC", "report": "Histopathological examination of the left breast and axillary tissue was conducted. The resected breast measured 21 x 10 x 5 cm with a skin flap measuring 19 x 10 cm, and included axillary tissues of 12 x 7 x 15 cm. The primary lesion was located at the boundary of the outer quadrants, measuring 11 x 7 x 3 cm, situated 2 cm from the upper margin, 0.5 cm from the base, and 1 cm from the skin surface. An operative scar of 7 cm was noted in the outer quadrant.\n\nMicroscopic evaluation revealed vascular invasion and involvement of the nipple. Within the lesion, isolated areas of invasive ductal carcinoma were identified alongside findings consistent with fibrocystic change and ductal hyperplasia (usual ductal hyperplasia). In the axillary lymph nodes, malignant cells were present in multiple nodes (No IV/XI), with infiltration extending into the nodal capsule. The pathological staging was determined as NHG2, pT2, pN2a."} +{"pid": "TCGA-WC-A88A", "report": "The specimen consists of two parts. Part A is a right choroidal biopsy sent for additional diagnostic testing and will be reported separately. Part B involves a right globe with a mass observed in the region of the limbus, extending toward the optic nerve between the 6 and 8 o\u2019clock positions. The tumor measures approximately 19 mm in base and 12 mm in height. Microscopic evaluation reveals a mixture of spindle-shaped and epithelial-like cells. The tumor originates near the ciliary body or choroid, though exact origin could not be determined. It extends into the anterior chamber, involving the iris and ciliary body. Scleral invasion is present, with possible involvement of the canal of Schlemm. There is also a small focus of extraocular extension measuring about 1 mm near the limbus. The optic nerve and its margins are free of tumor involvement, as are the vortex veins. Gross examination confirms the presence of a pigmented lesion beneath the conjunctiva adjacent to the limbus, measuring approximately 1 mm in diameter and less than 1 mm in height. The globe measures 24 x 23 x 23 mm and includes a 7 mm optic nerve. The cornea is clear, with a 5 mm pupil and brown iris. Tissue was collected fresh, and upon opening the globe, a mass involving the choroid, ciliary body, and iris was identified. The maximum distance from the optic nerve to the tumor margin on the sclera is approximately 12 mm. Mitotic activity was noted at a rate of 2 per 10 high-power fields. Biomarker testing was performed using tumor block B5 and normal block B2. Pathologic staging based on the reviewed material indicates a primary tumor classified as pT4d, with regional lymph nodes and distant metastases categorized as pNx and pMx, respectively, according to the American Joint Committee on Cancer, 7th Edition (2010). Multiple sections were taken for analysis, including areas of the vortex vein, optic nerve margin, tumor and cornea, extraocular extension site, pupil-optic nerve section, and additional iris and sclera samples. No tumor involvement was found in the optic nerve or vortex veins upon examination. The extraocular extension site was marked with yellow ink for identification."} +{"pid": "TCGA-22-4609", "report": "The right upper lobe lung specimen measured 21 x 13 x 4.8 cm and weighed 250 grams. A central necrotic area was present, forming an ill-defined intrapulmonary nodule measuring 2 x 2 x 1.1 cm. The overlying pleura showed no involvement. Focal organizing pneumonia was identified in two separate small nodules (0.5 cm each). The bronchial margin and one peribronchial lymph node were unremarkable. Lymph nodes from the superior mediastinum (4), inferior mediastinum (6), and N1 region (3) were all free of abnormal cellular infiltration. Cellular morphology revealed high-grade features with extensive necrosis. No evidence of tumor was found at any of the resection margins or in the sampled lymph nodes."} +{"pid": "TCGA-3A-A9IH", "report": "The pathology report includes multiple specimens. A nodule from the omentum consists of two cysts measuring 1.0 x 1.5 cm each and shows benign mesothelial cysts without evidence of malignancy. One lymph node excised along the hepatic artery measures 1.5 x 0.5 x 0.5 cm and demonstrates reactive changes only; no malignant cells are identified (0/1). \n\nA subtotal pancreatectomy specimen includes the body and tail of the pancreas, measuring 10.0 x 4.5 x 2.0 cm. The spleen is also submitted for evaluation and measures 13.0 x 7.5 x 1.5 cm. Histologic examination reveals a tumor confined to the pancreas with no involvement of margins by invasive carcinoma or carcinoma in situ. The tumor exhibits lymphovascular and perineural invasion and is moderately differentiated. Histologic type corresponds to ductal adenocarcinoma features. Additional findings include chronic pancreatitis and pancreatic intraepithelial neoplasia (highest grade: PanIN 1B at the pancreatic margin). No metastasis is detected in eight regional lymph nodes examined (pN0). \n\nAnother lymph node excised near the hepatic artery measures 1.5 x 1.0 x 0.5 cm and displays reactive changes without malignancy (0/1). A gastric lymph node measuring 0.5 x 0.5 x 0.2 cm also reveals reactive changes with no evidence of cancer. \n\nThe gallbladder specimen measures 8.0 x 3.0 x 3.2 cm and contains calculi ranging from 0.2 cm to 0.8 cm in size. Histologic evaluation identifies chronic cholecystitis with no malignant findings.\n\nAdditional gross descriptions detail the pancreatic tumor's dimensions as follows: solid component measuring 2 cm in greatest dimension, cystic component measuring 0.5 cm, and another dimension measuring 2 cm. Multiple cystic structures within the tumor range from 0.1 cm to 0.5 cm in size. Microscopic evaluation confirms tumor confinement to the pancreas with uninvolved margins. No treatment effect is noted. Specimens were reviewed comprehensively and confirmed free of malignancy except for described pancreatic findings."} +{"pid": "TCGA-G3-AAV7", "report": "The specimen consists of a liver segment weighing 169.3 grams and measuring 15.0 x 7.5 x 4.0 cm. Serial sections identified a well-circumscribed yellow mass beneath the liver capsule, measuring 2.7 x 2.3 x 2.1 cm. The mass is solid with focal areas of necrosis and punctate hemorrhage, located just beneath the liver capsule and more than 1.0 cm from the surgical resection margin. The remainder of the liver appears deep yellow and grossly nodular.\n\nMicroscopic examination reveals a well-circumscribed lesion with moderately differentiated cellular features and pushing borders. The architecture includes trabecular patterns greater than four cells thick and areas of pseudoglandular structure. Cellular pleomorphism and hyperchromasia are present. Immunohistochemical staining shows diffuse strong positivity for glypican-3, patchy moderate positivity for alpha-1 antitrypsin, and very focal mild HepPar1 staining. Other hepatocellular markers including alpha-fetoprotein, polyclonal CEA, cytoplasmic TTF-1, BHCG, and OCT3/4 are largely negative. Cholangiocytic markers such as CK7, CK19, and polyclonal CEA are not significantly expressed, although there is patchy strong staining for EMA. Stem cell markers show only focal CD56 positivity, while CD19 and C-KIT are negative. CD30 expression is absent.\n\nHistologic evaluation confirms presence of lymphovascular invasion in small vessels. The tumor is located less than 1 mm from the hepatic capsule. Resection margins are uninvolved, with invasive cells found at least 10.0 mm from the closest margin. The lesion is confined to the liver without evidence of regional lymph node or distant metastasis. Venous invasion involving large vessels is not identified.\n\nAdditional findings include cirrhosis with a fibrosis score consistent with marked bridging (portal to portal and portal to central) and occasional nodules. Chronic hepatitis of type B is present, graded as mild periportal inflammation with piecemeal or focal hepatocellular necrosis. Mild steatosis involving less than 5% of the total liver parenchyma is also noted."} +{"pid": "TCGA-HT-7681", "report": "The pathology report describes microscopic findings from a tissue sample. The sections show a tumor composed of two distinct cellular components: one resembling astrocytic cells and the other exhibiting features more typical of oligodendroglial cells. The oligodendroglial component contains individual tumor cells with round nuclei and prominent perinuclear halos. These cells are situated within a fibrillary matrix that includes thin, branching blood vessels and areas of microcystic change. Scattered throughout the tumor are numerous microgemistocytes. The astrocytic component is made up of neoplastic glial cells with oval-shaped nuclei and notable fibrillary processes. The tumor demonstrates diffuse infiltration into the surrounding brain parenchyma. Cellular atypia is present but graded as mild to moderate. No evidence of necrosis or microvascular proliferation is observed. Mitotic activity appears low, with only rare mitotic figures identified. Immunohistochemical staining shows a MIB-1 labeling index of up to 2.4%, suggesting low proliferative activity."} +{"pid": "TCGA-HV-A5A4", "report": "The surgical specimen included a distal pancreatectomy with splenectomy. The pancreas measured 12.0 x 3.5 x 3.0 cm and contained a mass located in the body and tail region. The mass measured 7.9 x 2.4 x 1.4 cm and was characterized by a dilated main pancreatic duct surrounded by an ill-defined, pale tan to beige firm mass with multifocal cystic changes containing mucinous fluid. The resection margins were free of involvement, with the closest radial margin measuring 0.3 cm from the lesion and the proximal pancreatic margin 2.1 cm from the tumor. The remaining pancreatic parenchyma and spleen showed no significant findings.\n\nMicroscopically, the lesion demonstrated moderate differentiation and extended into the peripancreatic fat tissue. Lymphovascular and perineural invasion were identified. All surgical margins were negative for tumor involvement. A total of 18 regional lymph nodes were examined, and one peripancreatic node showed evidence of involvement. No involvement was found in the splenic hilum, 'No.3', or 'No.6' lymph nodes. The spleen was unremarkable. Tissue blocks and representative sections were submitted for further analysis."} +{"pid": "TCGA-BQ-7055", "report": "The patient had an incidental left renal mass identified on CT imaging. Specimens submitted for analysis included a partial nephrectomy specimen, a completion nephrectomy specimen, and excised perinephric fat.\n\nIn the partial nephrectomy specimen, a mass measuring 3.8 x 3.5 x 3.0 cm was identified. The tumor exhibited a combination of oncocytic, tubular, and papillary features. No evidence of local invasion or renal vein involvement was observed. The surgical margin was free of tumor, with a clearance of 0.1 cm from the resection margin. No lymph nodes or adrenal tissue were identified. Immunohistochemical staining showed strong positivity for E-cadherin and CD117, as well as for CA-9 and racemase, while being negative for CK7. Staging indicated a pT1 tumor, defined as a tumor 7.0 cm or less in greatest dimension confined to the kidney.\n\nIn the completion nephrectomy specimen, no residual tumor was identified. A small incidental medullary fibroma measuring 1.2 cm was noted. The remaining renal parenchyma, urothelium, and renal vessels appeared unremarkable. No lymph nodes were identified in the perinephric fat. The kidney measured 12.0 x 5.5 x 3.4 cm and featured a central surgical defect measuring 7.5 x 5.0 x 2.5 cm. A small, well-defined gray-white focus measuring 0.2 x 0.2 x 0.2 cm was found in the upper pole medulla. The cortico-medullary junction was well defined, and the cortex measured 0.5 cm in thickness.\n\nThe excised perinephric fat consisted of multiple adipose tissue fragments measuring 12.0 x 10.5 x 3.5 cm in aggregate. No tumor or lymph nodes were identified in this tissue.\n\nSections from all specimens were submitted for further analysis, including frozen section control, representative sections of the tumor, ureteral and vessel margins, surgical defect, renal pelvis, and adipose tissue. Intraoperative frozen section evaluation confirmed a neoplastic process involving the left kidney, with close but negative margins. The permanent diagnosis was consistent with the intraoperative findings."} +{"pid": "TCGA-DD-A3A3", "report": "The right lobe of the liver measured 22 x 17 x 10 cm and weighed 1,775 grams. A mass measuring 19 x 11.5 x 9 cm was identified, with extension into the inferior vena cava. The closest surgical margin was within 5 mm of the mass and was negative. One periportal lymph node was examined and found to be negative. The gallbladder measured 8.2 x 3.3 x 1.3 cm and showed findings consistent with chronic cholecystitis. Multiple blocks (A1, B1\u2013B10) were submitted for analysis. The mass demonstrated grade 2 cellular differentiation out of 4."} +{"pid": "TCGA-RC-A7SF", "report": "The specimen submitted for frozen section consisted of a piece of reddish-yellow, soft tissue measuring 0.9 x 0.4 x 0.2 cm, clinically labeled as a mass in front of the IVC. Microscopic evaluation revealed features suspicious for a vascular lesion. The tissue was entirely embedded for further analysis.\n\nA separate specimen received in formalin consisted of a liver segmentectomy measuring 8 x 7 x 5 cm and weighing 85 grams. The serosal surface showed a subcapsular lesion. On gross examination, there was an expanding nodular mass measuring 4.2 x 4 x 3 cm. The cut surface was yellowish and myxoid with multiple hemorrhagic areas. The distance from the mass to the resection margin was 0.5 cm. Representative sections of the mass and surrounding tissue were processed.\n\nHistologic evaluation of the mass demonstrated a microtrabecular growth pattern with hepatic-type cells. The predominant differentiation grade was moderate, with areas of poorer differentiation present. Hemorrhage was identified within approximately 10% of the tumor volume. There was no evidence of tumor necrosis, fatty change, or fibrous capsule formation. Capsular infiltration was not observed. Septum formation was present. No invasion of adjacent structures including the portal vein, bile ducts, hepatic veins, or arteries was identified. No microvascular invasion or intrahepatic metastasis was seen. Surgical margins were free of involvement.\n\nEvaluation of the non-tumor liver tissue showed chronic hepatitis related to a viral etiology. There was minimal periportal inflammation without significant architectural distortion. Fibrosis was present in a septal pattern consistent with early cirrhosis. No dysplastic nodules, ductal abnormalities, or other coexisting liver diseases were identified.\n\nA third specimen consisted of a gallbladder measuring 8.5 cm in length and 4 cm in diameter. The mucosal surface showed several small yellow nodules, each measuring up to 0.2 cm in diameter. Microscopic examination of representative sections was unremarkable except for the presence of benign cholesterol polyps. \n\nSpecial stains and immunohistochemical studies were performed. Iron staining was negative. Cytokeratin 7 was positive in bile duct epithelium. Other stains including H&E, Masson\u2019s trichrome, reticulin, and PAS were used for detailed histologic assessment."} +{"pid": "TCGA-AA-A01C", "report": "Specimen ID #. The surgical preparation demonstrates tumor-free resection margins. Multiple tubular adenomas are present within the colonic mucosa, showing up to moderate dysplastic changes. Additional recent ulcerations of the mucosa are noted. There is evidence of prior excision of further adenomatous lesions (as per previous reports XXXXXXXXXXX and xxxxxxxxxxxxx). Two distinct lesions are identified in the ascending colon and transverse colon, located 8 cm and 29 cm aborally from the ileocecal valve, respectively. Both lesions exhibit an ulcerated morphology and are moderately differentiated. Histologic evaluation reveals invasion into the lamina muscularis propria, with lymphatic vessel involvement. A total of three regional lymph node metastases are identified out of 21 examined. The remaining margin status is negative."} +{"pid": "TCGA-AX-A1C9", "report": "The specimen includes para-aortic lymph nodes, uterus with cervix, fallopian tubes, ovaries, right and left pelvic lymph nodes, and omentum. The uterus weighed 50 grams and measured 5.5 x 4 x 3.5 cm. The serosal surface was smooth. The endocervical and ectocervical mucosae showed no abnormalities. On the right anterior and posterior aspects of the endometrium, there were papillary, bulky, friable growths measuring on average 2.3 x 2 x 1 cm each. These lesions appeared to extend along the isthmus and showed a pattern of pushing into the underlying myometrium; however, clear myometrial invasion was not identified. A small plaque-like nodule measuring 0.7 cm was present in the endometrium, possibly representing a subserosal fibroid. An additional 0.5 cm fibroid was found in the myometrium.\n\nThe right adnexa weighed 74 grams and included a 6 x 4.5 x 3.5 cm unilocular cyst filled with clear fluid. The inner lining of the cyst was smooth, and normal ovarian tissue was observed. The right fallopian tube measured 4.5 x 0.5 cm and had minor adhesions. The left ovary was atrophic, measuring 1.7 x 1.3 x 0.7 cm, and the adjacent fallopian tube (5 x 0.5 cm) contained small paratubal cysts.\n\nLymph node aggregates were submitted from the para-aortic, right pelvic, and left pelvic regions, ranging in size from 0.2 to 4 cm. All lymph nodes examined were free of tumor involvement. The omentum was unremarkable.\n\nMicroscopic evaluation of the endometrial growths showed features consistent with a moderately differentiated endometrioid-type adenocarcinoma. In limited areas, some high-grade morphologic features were noted, though these did not fully meet the criteria for serous carcinoma. The tumor involved the margins and showed superficial myometrial involvement, with an invasion depth of 0.1 cm into a 0.7 cm thick myometrial wall. No venous or lymphatic invasion was identified. All regional lymph nodes examined were negative for tumor involvement."} +{"pid": "TCGA-ED-A7PZ", "report": "Gross Description: The lesion is located in the left lobe, with ill-defined margins measuring 8 x 9 x 6 cm. It is soft, solid, and gray-white in color on cut surface. Microscopic Description: The cells are arranged in trabecular patterns that interconnect, as well as in sheet-like formations with areas of central necrosis. The cells have a polygonal shape, with round vesicular nuclei and prominent nucleoli. The cytoplasm is present in moderate amounts, appearing basophilic or vacuolated. Nuclear features include irregular size, hyperchromasia, and presence of prominent nucleoli. Mitotic figures are identified. The lesion shows areas of necrosis. The stroma demonstrates significant fibrous change. Specimen type: Lobectomy. Tumor size: 8 x 9 x 6 cm. Focality: Single lesion. Histologic grade: Moderately differentiated architecture. Tumor extent: Single lesion with evidence of vascular invasion. Lymph node involvement: Not specified. Venous invasion: Not specified. Surgical margins: Uninvolved. Evidence of prior treatment: Not specified. Additional findings: None reported. Anatomic location: Left lobe."} +{"pid": "TCGA-3A-A9I9", "report": "The gallbladder specimen measured 9.0 x 3.0 x 3.0 cm and exhibited a shaggy adherent fibroadipose tissue focus on the serosa, with green-yellow mucosa and contained viscous bile. No calculi were identified. Representative sections of the cystic duct and gallbladder were submitted for analysis.\n\nThe Whipple resection specimen included the head of the pancreas, a portion of the stomach, and duodenum. The pancreatic head measured 6.0 x 3.5 x 3.5 cm and contained an indurated, ill-defined mass measuring 3.5 x 2.5 x 2.5 cm. This mass was located approximately 1 cm from the pancreatic margin and 0.5 cm from the soft tissue margin, partially occluding the pancreatic duct and dilating the common bile duct. Gross evaluation suggested possible involvement of the duodenal wall, while the cut surface of the tumor was gray-white and smooth. The stomach and duodenum appeared grossly unremarkable.\n\nMargins of resection included the pancreatic, common bile duct, retroperitoneal, vascular/uncinate, gastric, and duodenal regions. All margins were free of invasive carcinoma. Lymphovascular invasion and perineural invasion were present microscopically. A total of 23 lymph nodes were examined, all without evidence of malignancy. One lymph node adjacent to the left hepatic artery (measuring 2.0 x 1.0 x 1.0 cm) was also negative for malignancy.\n\nMicroscopic evaluation revealed a moderately differentiated exocrine neoplasm involving the ampulla of Vater, sphincter of Oddi, duodenal wall, and peripancreatic soft tissues. No prior treatment effect was observed. Additional findings included pancreatic intraepithelial neoplasia (highest grade PanIN-2), focal low-grade intraepithelial changes at the pancreatic margin (PanIN-1a), and chronic pancreatitis with lobular atrophy. The primary tumor stage was classified as pT3, with no regional lymph node involvement (pN0). Distant metastasis could not be determined (pMX).\n\nFrozen section analysis of the bile duct and pancreatic margins confirmed absence of malignancy, with the latter showing only low-grade intraepithelial changes. All materials were reviewed by the attending pathologist and confirmed in the final report."} +{"pid": "TCGA-EJ-7115", "report": "A total of twenty-one lymph nodes were examined, with five from the right pelvic region and sixteen from the left pelvic region; no abnormal cellular infiltration was identified in any of the lymph nodes. The prostate specimen, along with bilateral seminal vesicles, showed no involvement at the surgical margins. A focus of invasive epithelial lesion was identified within both the right and left lobes of the prostate. The lesion measured 0.5 cm in greatest dimension and accounted for less than 5% of the total prostate volume. Histologic evaluation revealed a poorly differentiated morphology with a Gleason score of 4 + 3 = 7. Perineural invasion was extensively observed, while no angiolymphatic invasion was present. There was evidence of extension beyond the prostatic capsule in the right posterior region, near the right seminal vesicle. The bilateral seminal vesicles did not show any involvement. High-grade intraepithelial proliferation was present and multifocal. The pathologic staging was determined as pT3a with no regional nodal metastasis identified (pN0), and the histologic grade corresponded to G3\u20134. The prostate weighed 70.82 grams."} +{"pid": "TCGA-KO-8407", "report": "The left kidney and adrenal gland specimen includes a large, well-circumscribed mass measuring 10.5 cm in greatest dimension. The tumor replaces approximately 90% of the renal parenchyma and extends toward the perinephric fat and renal pelvis. No involvement of the adrenal gland was identified. Histologic evaluation reveals high-grade nuclear features and the presence of tumor within vascular or lymphatic spaces in the renal sinus. Multiple sections showed no invasion into the renal sinus adipose tissue despite close proximity. Margins of resection including ureteral, vascular, and soft tissue margins were negative. One perinephric lymph node was identified and showed no evidence of tumor.\n\nThe retroperitoneal lymph node specimen contained ten lymph nodes ranging in size from 0.6 cm to 2.2 cm. All lymph nodes were negative for tumor involvement. The tumor was extensively sampled with multiple sections taken from areas adjacent to the renal sinus, renal vein, artery, ureter, and surrounding fat margins. Sections also included representative portions of the tumor itself and transition zones between tumor and normal renal parenchyma."} +{"pid": "TCGA-55-8621", "report": "The lung specimen from the left lower lobe wedge excision demonstrates a well-differentiated lesion measuring 2.0 x 1.8 cm grossly. The lesion is unifocal and located in the left lower lobe, with involvement of the visceral pleura. No lymphovascular invasion is identified. Surgical margins are assessed: bronchial margin is negative with at least 1 cm clearance, stapled margin is negative with 0.7 cm clearance, and the pleural margin is also negative based on immunostaining (CK7 positive). \n\nA regional lymph node dissection included six lymph nodes (four from level IX and two from lobectomy completion), all of which show no evidence of metastatic involvement. A subsequent completion lobectomy specimen also shows no residual malignancy, with negative bronchial and additional lymph node margins.\n\nImmunohistochemical staining supports the origin of the lesion being consistent with pulmonary origin. CK7 shows strong positivity, while p63 and CD10 are negative in the tumor cells. These findings support exclusion of other potential origins. Visceral pleura is involved by the lesion; however, the pleural surface margin itself appears negative.\n\nThe specimen integrity is adequate for assessment and there is no identifiable treatment effect. Staging is classified as pT1, NO. \n\nAdditional clinical history notes a prior history of renal cell carcinoma. Preoperative imaging identified a left lower lobe mass, raising concern for malignancy. Postoperative findings include no residual tumor in the completion lobectomy specimen. \n\nSpecimens submitted included the left lower lobe mass, level IX lymph nodes, and the left lower lobe following completion lobectomy. Gross examination of the wedge specimen revealed a 10.5 x 4.5 x 2.5 cm lung tissue with a gray-white nodule measuring 2.0 x 1.8 x 1.3 cm. The nodule approaches the stapled margin by 0.7 cm and contacts the pleural surface. The remaining lung tissue appears unremarkable. Four lymph nodes were identified in the level IX specimen, ranging from 0.4 to 0.9 cm. The completion lobectomy specimen measured 13.5 x 7.0 x 5.5 cm with no visible lesions on gross inspection.\n\nIntraoperative consultation confirmed the presence of the lesion in the wedge specimen. All relevant margins were assessed microscopically and found to be free of involvement."} +{"pid": "TCGA-CV-A45R", "report": "Male patient underwent surgical resection with neck dissection. The specimen included 13 regional lymph nodes, one of which showed involvement with tumor and focal extension into adjacent connective tissue. Specifically, among the submental/submandibular lymph nodes, no tumor was identified. Of two subdigastic lymph nodes, one contained tumor with focal extra-nodal spread. No tumor was found in eight midjugular lymph nodes or in the submandibular gland. Evaluation of the base of the tongue revealed focal mucosal ulceration without evidence of malignancy.\n\nThe primary lesion was located at the base of the tongue and showed features of invasive, moderately differentiated keratinizing carcinoma. The tumor formed an ulcerated mass measuring 2.5 x 2.0 cm and invaded to a depth of approximately 1.5 cm. It extended into submucosal connective tissue, superficial muscle, and deep muscle layers. Perineural invasion was present, and there were morphological findings highly suggestive of lymphovascular invasion. Final resection margins were negative for tumor."} +{"pid": "TCGA-EB-A1NK", "report": "The specimen consisted of an excised skin lesion measuring 1.5x1x1 cm. The lesion was described as ulcerated and pigmented. Histologic evaluation revealed moderately differentiated cells. No information was provided regarding satellite nodules, lymph nodes, lymphatic or venous invasion, margins, neo-adjuvant treatment, or additional findings."} +{"pid": "TCGA-DX-A23U", "report": "The submitted specimens include a Tru-cut biopsy from the left groin and excisional tissues from the right and left groin regions, along with a lymph node dissection from the left groin.\n\nMicroscopic examination of the left groin Tru-cut biopsy reveals a high-grade spindle cell neoplasm. The right groin specimen demonstrates a high-grade spindle cell lesion arising within a background of less cellular, sclerotic adipose tissue. The tumor measures 8.0 cm in its largest dimension and extends to the margin of resection. The overlying skin shows scarring. In the left groin excision, a similar high-grade spindle cell proliferation is observed within a sclerotic adipose background. This tumor measures 12 cm at its largest dimension and also extends to the surgical margin. The lesion appears to be encapsulated but involves surrounding fibroadipose and muscular tissue.\n\nThe lymph node dissection includes multiple lymph nodes encased by similar sclerotic adipose and low-grade spindle cell tissue. Nineteen benign lymph nodes are identified without evidence of involvement. Scarring is noted in the overlying skin.\n\nImmunohistochemical staining demonstrates positivity for SMA, CMA (HHF35), desmin, KP1 (CD68), AE1:AE3, CAM 5.2, and CK7, while mucin staining and CK20 are negative.\n\nGrossly, the right groin specimen shows an ill-defined multinodular mass within subcutaneous tissue measuring approximately 8 x 6 x 2.5 cm, with a rubbery tan-yellow cut surface. The left groin excision reveals a multinodular tan-yellow homogeneous mass without necrosis or hemorrhage. The lymph node dissection includes fibroadipose tissue with multiple lymph nodes ranging from 0.5 to 2 cm in size.\n\nAll tumors extend to the margins of resection. No lymph node metastases are identified."} +{"pid": "TCGA-CN-4722", "report": "The specimen was received in five parts. Part 1, labeled as \"interarytenoid,\" consists of two friable fragments measuring 0.2 to 0.3 cm. Microscopic evaluation shows keratosis with mild dysplasia and the presence of bacteria and yeast forms of fungi consistent with *Candida* species. Part 2, labeled as \"left vocal process biopsy,\" includes two fragments ranging from 0.1 to 0.3 cm. Histologic analysis reveals keratosis with mild-to-moderate dysplasia. Part 3, identified as \"right supraglottic mass,\" contains multiple tan-gray, soft and friable fragments aggregating to 1.3 x 1.3 x 0.3 cm. Microscopic features include papillary keratosis with mild dysplasia, along with yeast forms of fungi consistent with *Candida* species. Part 4, also labeled \"right supraglottic mass,\" contains four friable fragments measuring 0.3 to 0.5 cm. Histopathology demonstrates superficially invasive carcinoma arising in a background of papillary keratosis with dysplasia. Part 5, labeled \"right larynx,\" consists of multiple tan-gray, soft to firm, focally hemorrhagic and cauterized fragments totaling 2.0 x 2.0 x 0.3 cm in aggregate. Microscopic examination shows superficially invasive carcinoma arising in a background of papillary keratosis with dysplasia. Immunohistochemical staining for laminin highlights mainly basal membranes of blood vessels. All tissue blocks were reviewed with corresponding stains. Tissue fixation time varied. The laboratory is CLIA-certified and performs high-complexity testing, with all assays verified for accuracy and precision."} +{"pid": "TCGA-V5-AASW", "report": "The biopsy material consists of three parts. Part A includes four fragments of tan, soft tissue measuring between 0.7 x 0.3 x 0.2 cm and 0.1 x 0.1 x 0.1 cm. Microscopic evaluation reveals irregularly shaped glands, some forming cribiform structures, lined by atypical cells with disordered stratification and loss of nuclear polarity. Malignant cells extend beyond the basement membrane into the lamina propria and/or muscularis mucosa but do not reach the submucosa. Part B contains three fragments measuring from 0.5 x 0.2 x 0.1 cm to 0.1 x 0.1 x 0 cm. The tissue shows columnar-lined mucosa composed of gastric-type surface cells with intestinal metaplasia, including interspersed goblet cells. Some areas demonstrate nuclear hyperchromaticity, pseudostratification, and glandular crowding; however, no invasive activity is observed. Part C includes three additional fragments measuring between 0.4 x 0.3 x 0.1 cm and 0.2 x 0.2 x 0.1 cm. Microscopic analysis identifies a tumor composed of pleomorphic cells arranged in irregular sheets, with some gland-like structures. The tumor infiltrates the mucosa, with occasional mucin production noted. Mitotic activity is brisk, and tumor necrosis is present. Due to the small size and superficial nature of the specimens, accurate assessment of deeper invasion is limited. There is concern for possible underlying or adjacent invasive disease."} +{"pid": "TCGA-55-8208", "report": "The resected right upper lobe specimen was intact and showed a unifocal lesion measuring 3 cm in greatest dimension. The tumor was located within the lung parenchyma, coming within 1.5 cm of the bronchial margin and abutting the pleural surface. On gross examination, the mass exhibited a yellow to dark gray, focally friable cut surface and was surrounded by atelectatic lung tissue. An area of emphysematous change was noted at the apex. No additional masses were identified upon serial sectioning. Two parabronchial lymph nodes were recovered, with the largest measuring 1.7 cm, along with a single intraparenchymal lymph node measuring 0.3 cm. Histologic evaluation revealed no lymphovascular invasion. Both bronchial and vascular margins were free of tumor involvement, as were the peribronchial and intraparenchymal lymph nodes sampled. Based on pathological findings, the staging classification was T1b, NO."} +{"pid": "TCGA-C5-A8XK", "report": "The patient is a woman presenting with cervical and vaginal bleeding. A cervical biopsy was performed. The specimen received consisted of a single tissue fragment measuring 0.8 x 0.5 x 0.3 cm, with a shiny gray surface. Microscopic evaluation revealed infiltrating epithelial cells with moderate to marked nuclear atypia, increased mitotic activity, and areas of necrosis. The cellular morphology showed features consistent with a high-grade lesion. Tumor size and depth of invasion were assessed, with involvement of the stromal tissue. No lymphovascular space invasion was identified. The histological features support a classification of moderately to poorly differentiated morphology. The findings are indicative of a locally advanced lesion."} +{"pid": "TCGA-LL-A7SZ", "report": "The specimen consisted of a left breast skin-sparing mastectomy specimen measuring 27 cm from medial to axillary tail, 18 cm from superior to inferior, and 2.5 cm anterior to posterior. The breast contained a palpable mass located in the lower portion of the upper outer quadrant. The tumor measured 2.5 x 2.2 x 2.0 cm and was firm with areas of hemorrhage. An adjacent well-circumscribed tan-white area measured up to 4.5 cm. Margins were evaluated microscopically: invasive carcinoma was 5.5 mm from the closest margin (posterior), which was uninvolved. Additional margins were greater than 3 cm from the tumor.\n\nMicroscopic evaluation revealed a high-grade invasive carcinoma with a Nottingham histologic score of 8 out of 9 (glandular/tubular differentiation score 3, nuclear pleomorphism score 3, mitotic rate score 2). A separate focus of high-grade ductal intraepithelial neoplasia measuring 1 mm was identified within the tumor area. This lesion exhibited comedo architecture, grade III nuclear features, and central necrosis. Lymphovascular invasion was present; dermal lymphovascular invasion was not seen.\n\nAxillary dissection included 11 lymph nodes. Two of these contained metastatic carcinoma, with the largest deposit measuring 14.5 mm. Extracapsular extension was noted. Sentinel lymph node evaluation was not performed; all lymph nodes were assessed using H&E staining with multiple levels.\n\nStaging was based on pathological findings: primary tumor classified as pT2 (largest invasive focus measuring 25 mm with additional dimensions of 22 x 20 mm), regional lymph nodes staged as pN1a (2 of 11 nodes involved with macrometastases). No distant metastasis was identified.\n\nAncillary studies showed nuclear positivity for estrogen receptor in 99% of tumor cells and progesterone receptor also positive in 99%. HER2 immunostaining was negative (1+).\n\nThe remainder of the breast tissue demonstrated a fat to fibrous ratio of approximately 50:50, with increased fibrosis noted in the lateral quadrants, particularly the upper outer quadrant. No other gross abnormalities were identified upon serial sectioning. Multiple lymph nodes were identified in the axillary tail, the largest measuring 2.2 x 1.5 x 1 cm. Representative sections of tumor, margins, fibrotic areas, nipple, and lymph nodes were submitted for analysis."} +{"pid": "TCGA-2J-AABP", "report": "A surgical specimen from the pancreas and spleen was examined. A solid tan-yellow mass measuring 7.2 x 6.0 x 5.4 cm was identified in the pancreatic tail region. The mass was not confined to the pancreas and extended into peripancreatic soft tissue. No angiolymphatic or perineural invasion was observed, though tumor necrosis was present. All surgical margins were free of tumor involvement, with a minimum tumor-free margin of 2.6 cm at the pancreatic body. One out of 22 regional lymph nodes showed evidence of metastatic involvement. Immunohistochemical staining demonstrated focal positivity for keratin AE1/AE3, OSCAR keratin, and smooth muscle actin, while markers including S100, desmin, CD30, ALK-1, and CD45 were negative. These findings were consistent with a poorly differentiated malignant neoplasm. Based on available surgical material, staging according to AJCC (7th edition) was determined to be pT3N1. Gross examination confirmed the presence of the mass and noted an unremarkable spleen. Multiple tissue blocks were submitted for microscopic evaluation, including sections from the mass, surrounding lymph nodes, and spleen."} +{"pid": "TCGA-78-7166", "report": "The specimen from the left lower lobe measures approximately 120 x 130 x 100 mm. On palpation, a firm to hard mass is identified in the lower zone of the lobe, causing puckering of the pleural surface at the base. The surrounding pleura appears pale brown and slightly nodular compared to normal pleura. Upon sectioning, a well-defined greyish-brown solid mass with a mucoid cut surface is observed, measuring 75 x 60 mm in maximum dimension. The tumor appears to be well clear of the bronchial resection margin by at least 40 mm. The distant lung parenchyma has a collapsed mottled pinkish-grey appearance.\n\nAn additional specimen labeled only with patient details consists of an irregular portion of lung measuring 33 x 25 x 22 mm with a stapled margin of 30 mm in length. The remainder of the specimen is largely covered by pleura; however, on the side opposite the stapled margin, there is a \"bare area\" approximately 30 x 15 mm. After slicing, no mass lesions are identified and there is no definite evidence of fibrosis, although emphysema is present.\n\nThe third specimen labeled as \u201clingular node\u201d consists of three fragments of firm cream and grey tissue ranging from 4\u201311 mm in greatest diameter. The fourth specimen labeled \u201cNo. 11 lymph node\u201d consists of three portions of firm grey and cream tissue ranging from 2 mm in diameter up to 15 x 10 x 5 mm.\n\nMicroscopic examination reveals that the lesion is subpleural and shows features of a well-differentiated mucinous adenocarcinoma. There is no evidence of blood vessel invasion, lymphatic permeation, or perineural involvement. Although the lesion appears clear of the bronchial resection margin, squamous metaplasia and severe dysplasia are noted at this margin. Metastatic deposits are identified in hilar, lingular, and No. 11 lymph nodes. In the lung tissue away from the tumor, centriacinar emphysema is present. Additional findings include mild chronic inflammatory infiltrates around some bronchovascular bundles, including lymphoid follicles, but no squamous metaplasia, dysplasia, or malignancy is seen in this separate piece of lung tissue.\n\nStaging assessment indicates T2N1MX. Elastin stains confirm no invasion of the visceral pleura."} +{"pid": "TCGA-VD-A8KJ", "report": "The specimen consists of an intact left eye with axial, horizontal, and vertical dimensions measuring 22mm, 22mm, and 21mm respectively. The cornea is clear, with horizontal and vertical measurements of 12mm each. The optic nerve has a length of 12mm and a diameter of 4mm. Trans-illumination reveals a shadow measuring 21 x 19mm located inferomedially. The plane of section is diagonal.\n\nUpon opening, a non-pigmented lesion is identified in the choroid, dome-shaped in morphology. The largest basal diameter of the lesion is 14mm, with a height of 13mm. Microscopic evaluation shows a normal anterior segment with unremarkable corneal and iris structures, as well as open angles. The ciliary muscles show mild atrophy and hyalinization of the ciliary processes. The lens demonstrates mild cataractous changes.\n\nIn the posterior segment, a lesion arises at the equator and is associated with a large exudative retinal detachment. The overlying retina is atrophic with degenerative changes. Focal retinal involvement is noted at the apex of the lesion. The lesion contains a mixture of cell types, predominantly spindle cells with some epithelioid components. Immunohistochemical staining shows reactivity for MelanA, CD117, and HSP-27 (score 3). Mitotic activity is prominent, with approximately 18 mitoses per 40 high power fields.\n\nVascular patterns within the lesion are not highly developed; closed loops are not observed. However, occasional vascular lakes are present, with tumor cells seen within these lumina. A minimal lymphocytic infiltrate is present within the lesion, and scattered macrophages are noted throughout. There is evidence of scleral invasion through perivascular and intravascular infiltration involving the inferomedial vortex vein. The optic nerve is free of involvement and shows mild atrophic changes. Other examined vortex veins do not show signs of tumor spread.\n\nMolecular genetic analysis was performed on DNA extracted from the tissue using multiplex ligation-dependent probe amplification (MLPA), targeting chromosomes 1, 3, 6, and 8. The DNA concentration was high and of good quality. The MLPA results indicate normal findings for chromosomes 1 and 3. Chromosome 6 shows gains in the p arm and losses in the q arm. Chromosome 8 demonstrates loss in the p arm and gains in the q arm. These molecular findings will be interpreted alongside clinical and morphological data to assess metastatic risk."} +{"pid": "TCGA-SP-A6QC", "report": "The specimen from the left adrenal resection consists of a tan-colored mass with fibrous adhesions on the capsular surface, along with surrounding adipose tissue. The specimen weighs 95.0 grams and measures 6.0 x 6.0 x 3.0 cm. The outer surface is covered by yellow adrenal tissue, and the cut surface is solid, rubbery, and dark brown. Scattered cystic spaces are present throughout, ranging from 0.1 to 1.0 cm in diameter. One section of tumor and one section of adjacent adrenal tissue were preserved for banking.\n\nMicroscopically, the tumor is composed of large polygonal cells arranged in nests and trabeculae, separated in some areas by fibrovascular septa forming a nested pattern. Other regions show dilated sinusoids within the septa. The cells have granular basophilic cytoplasm with oval to round nuclei containing vesicular chromatin and small nucleoli. Focal nuclear pleomorphism, including enlarged nuclei, is noted. Hyaline globules and intracytoplasmic pigment are present in some cells. Areas of hemorrhage are also seen. The tumor extends to the inked margins, but there is no lymphovascular invasion.\n\nImmunohistochemical staining demonstrates strong positivity for synaptophysin and chromogranin. Sustentacular cells within the tumor show positivity for S100."} +{"pid": "TCGA-CM-4752", "report": "The specimen consists of a right colon resection including the terminal ileum, cecum with appendix, and ascending colon. The terminal ileum is 8 cm in length and 3.4 cm in circumference at the proximal margin. The remaining colon measures 34 cm in length with an 8 cm diameter at the distal margin. The appendix is 7.2 cm long with an average diameter of 0.6 cm. A mass lesion is identified in the ascending colon, measuring 4.0 cm in length and 5.4 cm in width. The tumor has a gross configuration described as ulcerating and infiltrative, located approximately 5 cm from the distal margin. Macroscopic evaluation shows invasion into pericolic fat with a depth of 0.5 cm. No gross perforation, serosal involvement, or vascular invasion is observed. Perineural invasion is present.\n\nTwenty-three lymph nodes are identified and examined; the number containing metastases is unspecified. The proximal and distal margins, appendix, omentum, and non-tumor portions of the bowel show no significant abnormalities. Histologic grade of the lesion is moderately differentiated. Pathologic staging is determined as pT3. Multiple tissue blocks were submitted for analysis, including sections from the margins, mass, appendix, omentum, lymph nodes, and representative areas of the specimen."} +{"pid": "TCGA-G4-6298", "report": "The specimen consists of a right hemicolectomy with partial segments 5\u20136. The resected colon segment measures 15x14x6.5cm, with a stapled distal margin and an 8cm length of attached terminal ileum. A tumor is identified in close proximity to the ileocecal valve, measuring 6x3x3cm on the mucosal surface and located 4.5cm from the distal stapled margin. The tumor surface is ulcerated and extends through the muscularis propria into the serosa, with evidence of adhesion to an attached liver segment measuring 3.0x6.0x2.0cm. Histologically, the lesion demonstrates moderately to poorly differentiated features with infiltration into adjacent liver tissue. Perineural invasion is present; venous and lymphatic invasion could not be determined. Surgical margins, including proximal, distal, and radial, are free of invasive disease. Of 37 pericolic lymph nodes examined, one contains metastatic involvement. No implants or additional significant pathologic findings are noted. The extent of resection is complete (R0), with both grossly and microscopically negative margins."} +{"pid": "TCGA-AK-3460", "report": "The right renal mass specimen was well-encapsulated and measured 3.3 x 3 x 2 cm. On sectioning, the lesion exhibited a golden yellow, soft cut surface and was located in close proximity to the deep margin, coming within less than 0.1 cm of it. The resection margin was found to be free of tumor. The tumor was confined entirely within the kidney without extension into the surrounding perinephric fat, which measured 8.5 x 5.5 x 4 cm and showed no evidence of involvement. Histologically, the lesion demonstrated cellular features consistent with a specific type of kidney cancer. Cytogenetic analysis revealed an abnormal mosaic karyotype with significant chromosomal changes, including loss of chromosome 3 and gain of chromosome 5, supporting the histological findings. A small focus of non-neoplastic tissue showed moderate arteriolonephrosclerosis. Staging was determined to be pT1a, with no assessment of lymph node or distant metastasis."} +{"pid": "TCGA-BK-A56F", "report": "The final surgical pathology report describes a hysterectomy specimen with bilateral salpingo-oophorectomy. Microscopic evaluation showed a lesion involving the uterine corpus, with invasion into approximately 60% of the myometrial wall based on histologic assessment. The depth of invasion measured 11 mm within a myometrial thickness of 18 mm. Surgical margins were free of involvement. No vascular invasion was identified.\n\nA total of thirteen lymph nodes were evaluated: seven from the right pelvic region, three from the left pelvic region, and three from the periaortic region. All lymph nodes were negative for involvement.\n\nAdditional findings included unremarkable ovaries and fallopian tubes. Other notable findings in the uterus included adenomyosis and leiomyoma. Sections were taken from the uterine mass, cervix, and bilateral adnexa for analysis.\n\nThe gross specimen consisted of a uterus weighing 69 grams and measuring 8 cm from fundus to cervix, 6 cm between cornua, and 4 cm in maximum anteroposterior dimension. The endometrial cavity was distorted by a mass lesion with fibrotic changes. Both ovaries and fallopian tubes appeared normal without evidence of malignancy or dysplasia. Lymph node specimens from all regions were entirely submitted for evaluation.\n\nMSI testing was ordered on one of the tissue blocks for further analysis."} +{"pid": "TCGA-B0-4706", "report": "The specimen consists of a left radical nephrectomy. Histologic examination reveals a neoplasm with areas exhibiting conventional morphology and focal papillary architecture. Nuclear grading demonstrates the highest grade assessed. The largest dimension of the lesion measures 7.0 centimeters. Extension into the adrenal gland is present, confirmed by immunostaining (positive for Cam5.2). There is no involvement of the renal vein or evidence of angiolymphatic invasion. Surgical margins are negative. Adjacent renal tissue appears normal without significant findings. Urothelial lining shows no abnormalities. Based on extent of spread, histologic staging has been assigned accordingly."} +{"pid": "TCGA-CJ-4868", "report": "The specimen included a left nephrectomy measuring 26.0 x 15.0 x 7.5 cm, with a heterogeneous, solid and cystic gray-white to yellow and hemorrhagic mass measuring 9.0 x 8.5 x 8.0 cm located in the mid superior pole of the kidney. The mass extended into the renal vein and filled the renal pelvis. A separate well-circumscribed nodule measuring 0.4 x 0.4 x 0.4 cm was identified in the cortex, 0.3 cm from the capsule surface. The adrenal gland, measuring 7.0 x 3.0 x 1.0 cm, contained a well-circumscribed yellowish lesion measuring 1.1 x 0.9 x 0.7 cm. The venous margin was free of tumor, and there was no extension to the renal capsule. Multifocal microscopic involvement of perinephric adipose tissue was noted. Hilar resection margins, including vascular and ureteral components, were uninvolved. Examination of hilar lymph nodes (total of 11) and an additional 3 lymph nodes revealed no abnormality."} +{"pid": "TCGA-AA-3684", "report": "The specimen consists of a right-sided hemicolectomy preparation. The lesion involves the cecum and is poorly differentiated with mucinous features. Tumor infiltration extends through all layers of the intestinal wall, with transmural spread and involvement of the peritoneal surface. A loop of small intestine is adhered to the tumor mass. A total of ten regional lymph nodes are identified, nine of which show metastatic involvement. Additionally, there is evidence of peritoneal or omental dissemination. Vascular and lymphatic invasion is present. The primary tumor stage is pT4, with nodal stage pN2 and distant metastatic stage pM1."} +{"pid": "TCGA-97-A4M0", "report": "The right upper lobe of the lung was resected, measuring 16 x 10 x 3.5 cm. A nodule was identified at the pre-cut area of the lung, grey-tan in color and firm in consistency, measuring 1.2 x 1 cm. It was located 3.2 cm from the hilum and 3.8 cm from the stapled line margin. Microscopically, the lesion measured 2.2 cm in greatest dimension and was composed of multiple components: acinar (40%), papillary (30%), micropapillary (20%), and lepidic (10%). Visceral pleural invasion was confirmed by elastin stain. The bronchial and vascular margins were free of involvement. The staple line margin and surrounding parenchyma were also unremarkable.\n\nA total of eight lymph nodes were examined from levels 4, 7, 10, and 11 on the right side. All lymph nodes were negative for malignant cells. No lymphovascular invasion was identified. Emphysema was noted as an additional non-tumor finding.\n\nMolecular analysis was performed. Mutation testing revealed a KRAS p.G12C (c.34G>T) mutation in codon 12. This type of mutation is associated with poor prognosis and resistance to tyrosine kinase inhibitors in non-small-cell lung cancer. No EGFR mutations were detected in exons 18-21. The sample had 80% tumor cellularity, which is above the recommended threshold for this type of analysis. A known polymorphism (2361G>A, Q787Q) was also identified, which has no clinical significance.\n\nThe patient is a former smoker with a history of 35 pack-years. Preoperative imaging had identified a 1.3 cm lesion in the right upper lobe. The final pathology report is based on a lobectomy specimen with comprehensive margin assessment and lymph node sampling."} +{"pid": "TCGA-QK-A6V9", "report": "The right tonsillectomy specimen measured 5.0 x 4.5 x 3.5 cm and was fragmented into two parts. A mass measuring 3.5 x 1.9 cm on the surface and 1.4 cm in depth was identified within the palatine tonsil. The closest distance from the tumor to the superior mucosal margin was 0.4 mm, medial margin 0.5 cm, inferior margin 1.0 cm, and lateral margin 2.3 cm. The deep margin was within 0.5 cm of the tumor. Mucosal margins were inked for orientation: superior (blue), medial (black), lateral (yellow), and inferior (orange). The deep margin was inked green.\n\nHistologic evaluation showed a moderately differentiated cellular proliferation. The superior, medial, lateral, and deep margins were free of invasive disease or high-grade changes. However, a detached fragment with features was found at the inferior mucosal edge. All other mucosal and deep margins were uninvolved. There was no evidence of lymphovascular or perineural invasion. Immunohistochemical staining showed strong positivity for p16. In situ hybridization for HPV demonstrated dot-like nuclear signals.\n\nThe tumor was unifocal and measured 3.5 cm in its greatest dimension. Based on size, it was classified as pT2. No regional lymph nodes were submitted for evaluation, and therefore, pN could not be assessed. The surgical margins were generally clear, except for the presence of a detached focus at the inferior margin. Ancillary studies supported a link to human papillomavirus."} +{"pid": "TCGA-BK-A6W4", "report": "The surgical specimen included the uterus, cervix, bilateral fallopian tubes, and ovaries, along with a hernia sac. The uterine corpus weighed 142 grams and measured 7.0 x 6.2 x 4.7 cm, with a cervix measuring 3.8 cm in length. The endometrial lining was thickened and involved with a neoplastic process. Histologically, the lesion demonstrated features of low-grade glandular proliferation with areas of atypical complex hyperplasia. In certain sections, a small focus of high-grade invasive component with squamous differentiation was identified. This focus invaded approximately 32% of the myometrial thickness, corresponding to a depth of 6 mm within a total myometrial thickness of 19 mm. No vascular invasion was identified, and surgical margins were negative. Staging according to TNM (FIGO) classification was determined to be pT1a (Stage IA). \n\nAdditional findings included multiple intramural leiomyomata, with the largest measuring 1.7 cm, and extensive adenomyosis. The cervix showed no significant abnormalities. Both ovaries were unremarkable. The right fallopian tube exhibited endometriosis, while the left fallopian tube showed changes consistent with salpingitis follicularis. The hernia sac specimen contained fibroadipose tissue without notable pathological findings. \n\nImmunohistochemical or molecular testing was requested on one of the blocks for further characterization. No distant metastases or lymph node involvement could be assessed. Additional imaging findings included a small splenic lesion and 4 mm pulmonary nodules, though their relationship to the uterine findings could not be determined from the current specimen."} +{"pid": "TCGA-A6-2683", "report": "The specimen includes a right colon segment with attached distal ileum and an associated liver core biopsy. The colon specimen measures 12 cm in length and contains an 8.5 x 6.5 cm mass located within 7 cm of the distal margin. The tumor shows a maximal thickness of 1.2 cm and extends into the muscularis, reaching to within 0.4 cm of the inked free radial serosal surface. Both proximal and distal margins are free of involvement. A total of 25 lymph nodes were recovered from the mesocolon and mesentery, all negative for metastatic disease. The uninvolved mucosa appears normal with tan-pink-red coloration and regular folds. The appendix is unremarkable. Histologically, the tumor demonstrates moderately to poorly differentiated features without vascular invasion. The liver biopsy reveals a core of metastatic, moderately to poorly differentiated adenocarcinoma with marked desmoplastic stroma and no residual hepatic tissue."} +{"pid": "TCGA-B6-A0X1", "report": "The surgical pathology report describes findings from a left breast biopsy and mastectomy specimen. Gross examination of the biopsy specimen identified a central infiltrative lesion measuring 3 cm in diameter within fibroadipose tissue. The mastectomy specimen consisted of a breast measuring 23 x 15 x 6 cm with overlying skin measuring 17 x 9 cm. A retracted nipple was observed medially, along with a 6 cm sutured incision laterally. Adjacent to the nipple, multiple slightly elevated brown warty lesions were noted on the skin. Axillary tissue measuring 13 x 3 x 5 cm contained multiple enlarged lymph nodes, the largest measuring 2.5 cm. Sectioning revealed a cavity measuring 5 cm in the upper outer quadrant, with a deep margin located 0.5 cm from the edge of the cavity; no residual tumor was identified in this region. Remaining breast tissue showed irregular fibrosis without suspicious lesions.\n\nMicroscopic evaluation demonstrated poorly differentiated cells arranged in sheets, cords, and columns, with minimal gland formation. These cells exhibited marked atypia and pleomorphism. Extensive lymphatic invasion and widespread tumor necrosis were observed. In the mastectomy specimen, residual high-grade tumor similar to the original lesion was found in the cavity wall. No tumor was present at the deep margin or within the nipple and nipple duct. Additional tumor foci were identified in the upper inner quadrant, indicating multifocality. Lymph node analysis showed involvement in 16 out of 21 nodes, with extracapsular extension noted. Specifically, 3 of 4 nodes in the lower axilla, 9 of 11 in the mid axilla, and 4 of 6 in the upper axilla contained tumor cells. Multiple seborrheic keratoses were also identified on the skin adjacent to the nipple."} +{"pid": "TCGA-E3-A3E2", "report": "The surgical specimens included a pretracheal lymph node, a total thyroidectomy specimen with paratracheal nodes, and a right paratracheal lymph node. The pretracheal lymph node measured 0.8x0.5x0.3cm and was benign. The thyroid gland weighed 15 grams and showed no gross abnormalities except for a nodule in the right lobe measuring 1.0x1.0x0.7cm. The nodule was well-circumscribed, firm, and white-tan in color. The remaining thyroid parenchyma had a meaty red appearance. Histologically, the nodule exhibited features of a specific type of thyroid neoplasm with follicular architecture. No venous or lymphatic invasion was identified. The resection margins were free of neoplastic cells, with the closest distance of tumor to margin being less than 1 mm. Two of eight paratracheal lymph nodes contained metastatic deposits of the neoplasm. A concurrent finding of chronic lymphocytic thyroiditis was also noted. The right paratracheal lymph node, measuring 0.7x0.4x0.3cm, was negative for involvement. The staging indicated a primary tumor size of 1.0 cm, limited to the thyroid, with regional lymph node involvement in level VI. Distant metastasis could not be assessed. All other submitted lymph nodes were negative for neoplastic involvement."} +{"pid": "TCGA-MH-A562", "report": "The left partial nephrectomy specimen weighed 8.2 grams and measured 3.0 x 2.8 x 2.3 cm. The external surface was tan-white and smooth with minimal attached perinephric fat. A well-circumscribed mass measuring 1.8 x 1.8 x 1.8 cm was identified, with a tan-white to yellow granular appearance. It was located 0.2 cm from the renal resection margin and in direct proximity to the capsular margin. The mass was entirely submitted for histologic evaluation.\n\nMicroscopic examination revealed a unifocal lesion confined to the kidney. Histologic features included a predominant Type 1 morphology with areas of Type 2 architecture displaying nuclear grade 3 characteristics. No sarcomatoid differentiation or tumor necrosis was identified. The surrounding non-neoplastic kidney tissue was insufficient for detailed assessment. Margins were free of invasive disease and no lymphovascular invasion was observed. Tumor was limited to the kidney without evidence of extension beyond the organ. Pathologic staging was determined as pT1a with no assessment of regional lymph nodes (pNX) or distant metastasis."} +{"pid": "TCGA-A2-A0T1", "report": "The surgical specimen consists of a right breast lumpectomy and axillary lymph node dissection. The lumpectomy specimen includes a mass measuring 7.5 x 7.5 x 3 cm, with an attached skin ellipse measuring 4 x 1 cm. A firm, tan-gray nodule with irregular borders is identified within the tissue. This lesion measures approximately 3.5 cm in its greatest dimension and is located less than 0.1 cm from the superior margin, directly beneath the skin. Margins are otherwise clear, with distances of 1.5 cm inferiorly, 1 cm laterally, 1 cm medially, and 1 cm posteriorly from the tumor edge. Histologic evaluation reveals a high-grade cellular proliferation arranged in ductal patterns. Nuclear pleomorphism is marked, with frequent mitotic figures. Central necrosis and calcifications are present in the intraductal component. The Scarff-Bloom-Richardson histologic score totals 9 (3+3+3). Axillary lymph node evaluation demonstrates metastatic involvement in ten regional lymph nodes. Pathologic staging is classified as T3 N3 MX, Stage IIIC, G3. Additional margin specimens include skin and fibroadipose tissue, which show no evidence of malignancy."} +{"pid": "TCGA-A6-6141", "report": "The specimen consists of a right hemicolectomy with en bloc resection of abdominal wall muscle and fascia. The surgical specimen includes a 24 cm segment of proximal right colon and 17 cm of distal ileum, with attached mesocolon, mesentery, and omentum. A fragment of skeletal muscle measuring 5 x 5 x 2.5 cm is present near the cecal region. The abdominal wall resection margin is marked with blue ink, while the free radial serosal surface is marked with orange ink. An unremarkable appendix measuring 7.2 cm in length and 0.9 cm in diameter is also present. The proximal and distal luminal margins measure 4 cm and 8 cm in circumference, respectively.\n\nUpon opening, a nearly circumferential tan-white mass measuring 11.0 x 5.7 cm is identified at the ileocecal valve. On sectioning, the mass has a maximal thickness of 2.8 cm and extends into the muscularis propria to within 0.5 cm of the inked cauterized resection margin near the abdominal wall, and to within 0.6 cm of the inked free radial serosal surface. No involvement is identified at either margin. The ileal and colonic mucosa are otherwise unremarkable with normal appearance and wall thickness averaging 0.4 cm. Two apical lymph nodes, each measuring approximately 1.3 cm, and numerous additional lymph nodes up to 2.8 cm in size, are recovered from the mesocolon and mesentery.\n\nHistologically, the lesion demonstrates moderate differentiation. The tumor extends through the muscularis propria into the surrounding fat. All evaluated margins\u2014including proximal, distal, and circumferential\u2014are free of involvement. Nineteen regional lymph nodes are examined and none show evidence of metastatic disease. There is no vascular invasion identified. A significant area of pericolonic abscess formation and inflammatory reaction is observed adjacent to the mass, resulting in adhesion between the abdominal wall and the colon; however, there is no direct tumor invasion at this site. The appendix shows no significant histopathologic abnormalities."} +{"pid": "TCGA-LG-A9QD", "report": "The specimen was obtained from a partial hepatectomy weighing 647 grams. The main lesion measured 15 cm and was described as pedunculated, with imaging findings indicating gastric compression. A second satellite lesion measuring 2 cm was identified near the parenchymal margin but did not extend to the margin. Histologic evaluation revealed areas of well-differentiated morphology along with regions showing moderately differentiated features. No vascular invasion was identified. The hepatic capsule showed no signs of transcapsular involvement, and the lesion remained organ-confined. Hepatic parenchymal margins were negative by approximately 1 mm. No lymph nodes were identified or submitted for evaluation. Additional findings included steatosis involving 35\u201340% of the liver tissue, Mallory hyaline in certain areas, focal tumor necrosis, and hyalinization. There was no evidence of cirrhosis; however, nonspecific triaditis and focal peliosis were noted. Based on staging criteria, the case is classified as Stage IIIA; pT3a. Gross examination showed a variegated, heterogeneous tan-yellow lesion with areas of hemorrhage and necrosis, along with a smaller satellite nodule. The uninvolved liver tissue appeared normal without nodularity. Multiple representative sections were submitted for microscopic evaluation. Intraoperative consultation confirmed the presence of a hepatocellular tumor, and a sample was submitted for tissue banking upon return to the operating room."} +{"pid": "TCGA-G9-6379", "report": "The specimens include right and left pelvic lymph nodes and a resected prostate gland. The right pelvic lymph nodes consist of a 3 x 2 x 1 cm soft tissue specimen containing three lymph nodes, the largest of which was inked blue and bisected. All lymph nodes were submitted entirely for frozen section analysis. The left pelvic lymph nodes consist of a 2.5 x 1.7 x 0.8 cm soft tissue specimen also containing three lymph nodes; the largest was similarly inked blue and bisected, with all nodes submitted for frozen section evaluation.\n\nThe prostate measures 4 cm in lateral dimension, 3.6 cm anterior to posterior, and 2.9 cm from apex to base, weighing 34 grams before tissue removal. The external capsule is smooth, red, and intact. Marking inks were applied to various regions: anterior (orange), apex (red), base (blue), right lateral (green), left lateral (yellow), and posterior (black). After removal of the apex and base, the remaining prostate weighs 23 grams and shows a nodular tan parenchyma. The right seminal vesicle measures 2.6 x 1.3 x 0.4 cm and the left 2.4 x 1.2 x 0.4 cm; both appear as cystic tan structures. The right vas deferens measures 1.7 x 0.6 cm and the left 1.5 x 0.6 cm, both presenting as tubular tan tissue.\n\nA total of 24 tissue blocks were submitted for microscopic evaluation, including perpendicular sections from various levels and regions of the prostate, as well as samples containing the seminal vesicles and vas deferens.\n\nMicroscopic evaluation of the right and left pelvic lymph nodes showed no evidence of tumor involvement, with all six nodes being negative. In the prostate, histopathologic findings reveal a specific cellular pattern with Gleason grading components. Special stains and immunohistochemical studies were performed using validated methods and appropriate controls. No clinical history was provided. The pre-operative indication for surgery was based on suspicion of prostate malignancy."} +{"pid": "TCGA-38-4627", "report": "The right upper lobectomy specimen measured 13.8 x 9.2 x 3.0 cm and weighed 215 grams. A central tumor mass measuring 2.7 x 2.0 x 1.6 cm was identified as a firm, tan lesion with stellate borders and areas of gray discoloration on cut surface. The tumor was located approximately 2.9 cm from the bronchial margin and at least 0.6 cm from the staple line. It was observed to abut the overlying pleura. No satellite tumor nodules were present. The surrounding lung tissue appeared dark red/tan, soft, spongy, and aerated without additional lesions.\n\nMicroscopic evaluation revealed a moderately differentiated histologic pattern. The tumor did not show angiolymphatic or perineural invasion. Surgical margins were negative. Lymph node assessment included peribronchial (1 involved out of 4 examined), R4 (0 out of 1), and station 11 (0 out of 1). No extracapsular extension was noted in any lymph node groups. Evaluation of non-tumorous lung tissue demonstrated presence of anthracotic pigment. Specimens submitted for tissue procurement included bronchial margin, representative tumor, and normal lung tissue."} +{"pid": "TCGA-44-7667", "report": "The specimen included multiple lymph nodes from levels 9, 11, 12, 7, and 4, as well as a portion of the sixth rib and tissue from the right lower lobe of the lung. The lymph nodes ranged in size from 0.25 cm to 2.8 cm and showed no evidence of metastasis across all levels examined. The sixth rib appeared unremarkable upon histologic evaluation.\n\nThe right lower lobe specimen measured 18 x 13 x 10 cm and contained a central mass measuring 15 x 9 x 10 cm with extensive necrosis. The mass had a firm, tan, fleshy periphery and did not appear to invade the pleural surface. It was located 0.5 cm from the bronchial margin. Histologic examination revealed poorly differentiated tumor cells arranged in a pattern consistent with glandular origin. Venous, arterial, and lymphatic invasion were each suspicious but not definitively confirmed. Surgical margins were free of tumor involvement. No metastases were identified in the sampled lymph nodes. Due to the absence of distant metastasis evaluation, staging classification remained indeterminate for distant spread."} +{"pid": "TCGA-B5-A3FA", "report": "The uterus, cervix, bilateral tubes and ovaries specimen weighed 109 grams and measured 9 x 6 x 4.5 cm. The serosal surface was red-tan with multiple fibrinous adhesions. The ectocervix appeared pink-tan, smooth, and glistening with a central os measuring 1.1 cm in diameter leading into an endocervical canal measuring 1.5 cm in length. Within the endometrial cavity, measuring 5.0 x 3.2 cm, there were two distinct lesions: one located on the posterior wall measuring 4.5 x 3.0 cm and another on the anterior wall measuring 4.5 x 1.6 cm. Both lesions were described as exophytic and tan-colored. The lesion within the posterior wall myometrium was 1.9 cm thick and demonstrated invasion to a depth of 1.0 cm. Additionally, two small intramural leiomyomata were identified, each measuring less than 1.2 cm in diameter.\n\nThe right adnexa consisted of an ovary measuring 1.5 x 1.0 x 0 cm with no remarkable findings and a fallopian tube measuring 4.3 cm in length and 0.4 cm in diameter; this tube exhibited fimbriation and contained a segment consistent with prior tubal ligation. Similarly, the left adnexa included an ovary measuring 1.5 x 1.0 x 0 cm with no notable abnormalities and a fallopian tube measuring 3.5 cm long and 0.4 cm in diameter, also showing signs of prior tubal ligation with a missing segment.\n\nSubmitted lymph node specimens included aggregates from both external iliac regions (right and left), obturator regions (right and left), and periaortic locations. These aggregates ranged in size from 4.5 x 3.5 x 2.0 cm to 6.5 x 3.5 x 1.8 cm and were processed by bisecting or dissecting for lymph nodes. Each aggregate yielded various submitted blocks containing lymph node candidates ranging from one to four lymph nodes per block.\n\nMicroscopic examination revealed no tumor involvement in any of the lymph nodes assessed across all regions: right external iliac (2 nodes), right obturator (3 nodes), periaortic (2 nodes), left external iliac (2 nodes), and left obturator (4 nodes). Additionally, microscopic evaluation showed no pathological diagnosis in bilateral ovaries and fallopian tubes. Adjacent non-neoplastic endometrium displayed features of sessile polyp and atrophy. Leiomyoma was identified in the remaining myometrium. No involvement was detected in specimen margins or cervical and serosal surfaces.\n\nMesothelial hyperplasia was observed in soft tissue adjacent to the left ovary. All other tissues submitted were free of tumor."} +{"pid": "TCGA-E9-A3Q9", "report": "The right breast specimen from a radical mastectomy procedure contained a grossly evident lesion measuring 5.2 x 5.2 x 5.2 cm. Histologic evaluation revealed lobular-type cellular changes. A total of 22 lymph nodes were examined, all of which showed evidence of metastatic involvement. The histopathologic features, including tubule formation, nuclear pleomorphism, and mitotic counts at both 25x and 40x magnification, were not specified, precluding a definitive Nottingham Histologic Score. Other features such as tumor extent, margins, and response to neoadjuvant treatment were not documented. No additional pathologic findings or comments were provided."} +{"pid": "TCGA-CN-6994", "report": "The specimen was received in six parts. Part 1, labeled as \"medial margin,\" consisted of tan connective tissue and mucosa measuring 1.5 x 0.6 x 0.5 cm. Frozen section analysis showed no abnormality. Part 2, labeled as \"posterior retromolar,\" consisted of tan connective tissue and mucosa measuring 2.0 x 0.8 x 0.6 cm. Frozen section analysis also showed no abnormality. Part 3, labeled as \"buccal (lateral),\" consisted of tan connective tissue covered with mucosa measuring 2.7 x 0.9 x 0.7 cm. Frozen section analysis revealed no abnormal tissue.\n\nPart 4 consisted of a left mandibulectomy specimen measuring 9.3 x 5.3 x 4.0 cm and included a molar tooth. Gross examination identified an ulcerated lesion measuring 1.4 x 1.0 cm involving the alveolar bone/ramus of the mandible. Serial cross-sectioning revealed a tan-white firm lesion invading the underlying bone with a thickness of 2.8 cm. The lesion extended to the lateral soft tissue edge but was at least 0.7 cm from all other margins. Multiple sections were submitted for microscopic evaluation.\n\nParts 5 and 6 consisted of lymph node dissections. Part 5 (\"left level 1\") measured 13.0 x 4.5 x 2.4 cm and contained multiple lymph nodes ranging from 0.1 to 1.3 cm in diameter. All lymph nodes examined were benign; no abnormal pathology was identified in the attached submandibular gland. Part 6 (\"left neck, levels 2-4\") measured 15.0 x 7.5 x 1.5 cm and was divided into three segments. Multiple lymph nodes were identified across all segments, ranging from 0.1 to 3.5 cm in greatest dimension. All lymph nodes evaluated were benign.\n\nMicroscopic examination confirmed no tumor involvement in Parts 1 through 3. In Part 4, cellular features demonstrated moderately differentiated keratinizing tissue involvement with evidence of perineural invasion but absence of vascular invasion. Bone margins were free of abnormal cells, although the lateral soft tissue edge was involved. All other margins remained uninvolved.\n\nA total of 37 lymph nodes were evaluated across Parts 5 and 6, with none showing signs of abnormal cellular infiltration. Fixation times ranged between 2 and 84 hours. Ancillary studies including immunohistochemistry and molecular testing were performed under CLIA-certified conditions.\n\nClinical correlation indicated no prior malignancy, chemoradiation therapy, organ transplant, or immunosuppression. The procedure performed was a left segmental mandibulectomy with modified neck dissection. The primary clinical inquiry focused on margin status and lymph node involvement."} +{"pid": "TCGA-BK-A4ZD", "report": "The surgical specimen included the uterus, cervix, bilateral tubes and ovaries, and a segment of small bowel. The uterus measured 7.3 x 5.9 x 5.8 cm and had a polypoid lesion in the anterior endometrial region measuring 3.0 x 2.0 cm. On sectioning, the lesion was superficial and involved approximately one-third of the myometrium. The depth of myometrial invasion was 8 mm out of a total myometrial thickness of 32 mm (25% involvement). No tumor was identified at any of the resection margins. The cervix showed squamous metaplasia without evidence of neoplasia.\n\nLymph node dissections were performed on right and left pelvic and para-aortic regions. A total of 16 lymph nodes were examined: 6 from the right pelvic area, 2 from the right para-aortic region, 8 from the left pelvic area, and none identified in the left para-aortic specimen. All lymph nodes were negative for metastatic disease.\n\nThe small bowel specimen measured 15.5 cm in length and showed serosal adhesions with a central 2 cm transmural defect. No tumor was found in this specimen. Histologically, the lesion in the uterus was composed of high-grade cells with exophytic growth in the anterior endometrium and focal presence in the posterior wall. Vascular space invasion was not identified.\n\nStaging based on the primary tumor (pT) was pT1a. The regional lymph node assessment (pN) was pN0, as no metastases were found. Distant metastasis could not be assessed. Additional findings included proliferative endometrium, follicular cysts in both ovaries, and absence of significant pathology in the fallopian tubes. Mismatch repair (MSI) testing was ordered but results were pending."} +{"pid": "TCGA-S4-A8RP", "report": "The specimen was received from a female patient who underwent a pancreaticoduodenectomy. The surgical resection included the pancreas and duodenum, along with lymph node dissection. A segment of bile duct was also examined and found to be unremarkable.\n\nA mass measuring 2.8 x 2 x 1.7 cm was identified in the pancreas. The lesion exhibited a firm, stellate, white-yellow appearance and was located 2 cm from both the pancreatic neck and uncinate margins. It was in close proximity to the ampulla of Vater and approximately 0.5\u20130.7 cm from the duodenal serosa. No gross invasion of the pancreatic duct was observed. Histologically, the lesion showed poorly differentiated features. All resection margins were free of invasive disease.\n\nLymph node evaluation revealed 12 nodes examined in total, with 2 showing involvement by metastatic cells. Lymphovascular and perineural invasion were present. Staging parameters indicated that the tumor extended beyond the pancreas without involvement of major vascular structures. Based on the AJCC 7th edition TNM classification, regional lymph node involvement was confirmed. Distant metastasis could not be assessed.\n\nMultiple tissue sections were submitted for microscopic evaluation, including margins, lymph nodes, and adipose tissue. Intraoperative assessment of the bile duct biopsy suggested reactive changes."} +{"pid": "TCGA-FJ-A871", "report": "The pathology report includes specimens from two sites. The first specimen, obtained from the right lateral wall of the urinary bladder, measures 3.0 x 3.0 x 1.3 cm and consists of multiple pieces of tan-pink to rubbery soft tissue. Microscopic examination reveals a high-grade neoplasm with features including elevated mitotic activity, cellular pleomorphism, and abundant cytoplasm. The tumor extends into the muscular layer of the bladder wall, and areas of necrosis are present.\n\nThe second specimen, taken from the prostatic urethra, measures 2.0 x 1.5 x 0.7 cm and is composed of tan-pink, rubbery tissue. Histologic evaluation shows no abnormal cellular changes or malignant findings in the urothelium or underlying tissue. One fragment within this specimen contains tumor cells associated with muscle tissue; however, this is interpreted as likely unrelated to the primary site, possibly due to specimen contamination or carryover.\n\nAll tissue specimens were submitted entirely for analysis. Additional review concurred with initial findings. No evidence of disease involvement is identified at the second site."} +{"pid": "TCGA-05-4397", "report": "The specimen shows a mixed histologic growth pattern with areas of maturing tubuloglandular differentiation and medium to large cells, including clear cell features. Necrotic changes are present in part of the tissue. Invasion is noted into large pulmonary vessels and the pleura. The tumor extends from central to peripheral regions of the lung. Vascular invasion includes formation of intraluminal thrombi with polypoid growth extending beyond the resection margin. Adhesion of the tumor to the vessel wall occurs near the margin, with the closest point measuring approximately 0.5 mm from the resection edge. There is focal extension of tumor into the pleural surface. One lymph node in the hilar region adjacent to an affected vessel demonstrates involvement. The surgical margins appear compromised due to tumor adherence at the site of vascular invasion and luminal obstruction in the middle lobe. Some glandular structures show morphologic similarity to fetal-type bronchopulmonary patterns. Clinical correlation suggests that chronic or recurrent pneumonia may have originated from post-obstructive causes."} +{"pid": "TCGA-PG-A914", "report": "The uterus, cervix, fallopian tubes, and ovaries were submitted for examination. Histologic evaluation revealed extensive lymphovascular invasion within the endometrium. The cervix and lower uterine segment, as well as the ovaries and fallopian tubes, showed no evidence of malignant involvement. An endometrial polyp was identified. Multiple benign leiomyomas were present, with one larger lesion showing degenerative changes and calcifications.\n\nLymph node evaluation included specimens from right and left pelvic, para-aortic, and obturator regions. Of the lymph nodes evaluated, 6 out of 29 showed metastatic involvement. Specifically, two of eight right pelvic lymph nodes contained metastatic cells, with the largest focus measuring 0.6 cm and showing focal extranodal extension. One of five right para-aortic lymph nodes contained microscopic metastatic involvement without extranodal extension. Three of six left para-aortic lymph nodes contained metastases, with the largest measuring 2.8 cm. In the left obturator region, one of three lymph nodes contained metastatic involvement, with the focus measuring up to 2 cm and showing focal extranodal extension.\n\nOmental biopsy tissue showed no significant histopathologic findings or presence of malignant cells.\n\nHistologic grade was high, with nuclear grading also classified as high. The tumor appeared to originate in the anterior and posterior endometrium with myometrial invasion involving approximately 13% of the wall (depth of invasion 3 mm; total myometrial thickness 22 mm). No cervical stromal invasion was observed. Estrogen receptor staining showed weak to moderate nuclear staining in 50% of cells, while progesterone receptor staining was absent. HER2 immunohistochemistry demonstrated a staining score of 1+, interpreted as negative for overexpression.\n\nAJCC pathologic staging was recorded as pT1a, N2, M not applicable. Gross examination of the hysterectomy specimen revealed a distorted uterus weighing 564 grams. Measurements were 12 cm from fundus to cervical os, with cornu-to-cornu and anterior-posterior dimensions each measuring 8.5 cm. The endometrial cavity measured 7 cm in length and across, with tan-pink, nodular endometrium noted throughout. A small polypoid lesion measuring 2.5 x 1.5 x 0.4 cm was identified in the fundus. A larger intramural nodule measuring 9 x 7 x 7 cm was located in the posterior uterine wall, showing calcifications at its periphery. Myometrial thickness measured 2.5 cm anteriorly and up to 7.5 cm posteriorly. Multiple smaller nodules with white, whorled cut surfaces were also observed within the myometrium.\n\nAdditional tissues submitted included sections from the cervix, endomyometrium, fallopian tubes, ovaries, and various nodules for comprehensive histologic evaluation."} +{"pid": "TCGA-97-7941", "report": "The surgical specimen included a left upper lobectomy along with multiple lymph node biopsies from various stations. Histologic evaluation of the lung tissue revealed a nodule measuring 2.6 cm microscopically, composed of varying histologic patterns including lepidic (60%), acinar (20%), papillary (10%), and micropapillary (10%) components. The tumor exhibited mucinous features but was not identified as involving the bronchial or vascular margins. Lymph node specimens from stations 5 through 8 and 10 through 11 were all negative for carcinoma involvement. A total of 11 lymph nodes were examined across these stations, with none showing evidence of metastasis.\n\nHistologic grade of the lesion was well differentiated (G1), and no visceral pleural invasion or tumor extension was identified. However, lymph-vascular invasion was present. Staging according to pTNM classification indicated pT1b based on tumor size greater than 2 cm but not exceeding 3 cm in greatest dimension, without regional lymph node metastasis (pN0). Additional findings noted emphysema in the lung tissue.\n\nMolecular studies were conducted on the tissue sample. Genetic analysis revealed a KRAS mutation at codon 12 (p.G12A, c.35G>T). This type of mutation is associated with poor prognosis and resistance to tyrosine kinase inhibitor therapies in non-small-cell lung cancer. Testing for EGFR mutations in exons 18\u201321 did not detect any mutations; however, it is known that some patients without identifiable mutations may still respond to EGFR inhibitors. The analytical sensitivity of the tests used was sufficient to identify most common mutations in these genes, although rare variants or low tumor cellularity could potentially affect detection.\n\nClinical correlation is recommended given the molecular findings and histopathologic characteristics."} +{"pid": "TCGA-A8-A08T", "report": "The specimen demonstrates two distinct foci of moderately differentiated invasive tumor with maximum dimensions measuring 3 cm and 2 cm. A focal intraductal component is present. Angioinvasion is identified in a circumscribed pattern. There is no evidence of dermal infiltration or ulceration. Histologic grade is intermediate. The primary tumor staging reflects a multifocal T2 lesion with lymph node involvement (N1a), lymphovascular invasion (L1), absence of visceral metastasis (M0), and negative resection margins (R0)."} +{"pid": "TCGA-AA-A017", "report": "The specimen consists of a resected colon segment containing an extensive, ulcerated lesion with moderately differentiated features. The lesion measures up to 3.5 cm in maximum dimension and demonstrates infiltration into the pericolic fatty tissue. No tumor involvement is identified in the local lymph nodes, with 18 nodes examined and none showing evidence of disease. All colon resection margins, including the mesocolic amputation margin, are free of tumor. Histologically, the lesion exhibits Grade 2 differentiation, with lymphatic invasion present (L1) but no vascular invasion (V0). Resection margins are complete with no residual tumor identified (R0)."} +{"pid": "TCGA-A2-A25F", "report": "The surgical specimen consists of a right breast excision measuring 5.5 x 4 x 3.5 cm. A tumor mass measuring 2.5 cm in greatest dimension was identified within the tissue. Microscopic evaluation reveals high-grade cellular features, including marked nuclear pleomorphism and a high mitotic count. There is absence of glandular differentiation. The tumor exhibits infiltrative growth with probable angiolymphatic invasion. An in-situ component is present, showing high-grade nuclear features arranged in a cribriform pattern, comprising approximately 6% of the tumor volume.\n\nAll surgical margins are free of involvement by invasive carcinoma. The closest margin is located superiorly, measuring approximately 4 mm from the tumor. Non-neoplastic changes include fibrocystic alterations with microcalcifications and medial mammary vessel calcification.\n\nSentinel lymph node evaluation includes two lymph nodes from the right axilla. Both nodes show reactive changes without evidence of metastasis. Immunohistochemical staining for pan-cytokeratin (AE1/AE3) on sentinel lymph node tissue blocks shows no evidence of micrometastases.\n\nStaging assessment indicates pT2 based on tumor size. No lymph node metastases were identified (pN0), and regional lymph nodes were not examined beyond sentinel sampling (MX). Hormone receptor testing demonstrates ER negative and low PR expression (2%). HER-2/neu immunostain is negative.\n\nThe specimen was processed in sixteen tissue blocks, with all margins evaluated microscopically. Gross examination confirms that all surgical margins are free of lesion."} +{"pid": "TCGA-FA-8693", "report": "The specimen consists of stomach tissue from a subtotal resection, with tumor located in the antrum. A tumor measuring up to 5.5 cm in greatest dimension is present within the gastric wall, exhibiting a diffuse type of growth. The tumor replaces gastric mucosa and spreads into the muscle layer, with involvement of the fatty tissue. Microscopically, the tumor is composed of small- to medium-sized lymphoid cells with hyperchromatic nuclei. In certain areas, large atypical cells with high proliferative activity are observed. Fifteen lymph nodes were examined, and all demonstrated reactive changes without evidence of metastasis. The omentum shows focal lymphoid infiltration and appears hyperemic. Immunohistochemical staining reveals CD20 positivity, CD3 negativity, CD5 negativity, CD10 negativity, cyclin D1 negativity, and focal Ki67 proliferation index of approximately 60%. No venous or lymphatic invasion is identified, and no treatment effect is noted. The histologic type is consistent with a diffuse pattern."} +{"pid": "TCGA-ZP-A9CZ", "report": "The liver specimen from segment 6 was received in two pieces, measuring 5.0 x 3.5 x 2.5 cm. A well-circumscribed tan-gray mass was identified, measuring 2.0 x 1.5 x 1.5 cm, with a nodular, solid cut surface. The lesion is located 1.2 cm from the closest resection margin and demonstrates clear demarcation from the surrounding hepatic parenchyma. Histologic evaluation shows a nodule composed of hepatocytes arranged in thickened cell plates with a nodular architecture. Cytologic features include increased nuclear-to-cytoplasmic ratio and nuclear pleomorphism. Reticulin staining reveals a loss and paucity of the normal reticulin framework within the nodule. Adjacent liver tissue shows portal tracts with bridging fibrosis. No lymphovascular invasion is identified. Surgical margins are free of involvement. Based on AJCC 7th edition criteria, the tumor is classified as pT1, with regional lymph nodes not assessable (pNX), and distant metastasis unable to be evaluated. The mass is located in segment 6 and is solitary. The distance from the tumor to the nearest parenchymal margin is 12 mm. Additional findings include cirrhotic changes with stage 3 fibrosis in the surrounding liver."} +{"pid": "TCGA-55-7728", "report": "The specimen consists of multiple components, including lymph nodes and lung tissue. Lymph nodes from levels 7, 10, 9, and 5 on the left side were examined. The sizes of these lymph nodes ranged from 0.4 cm to 2.0 cm in greatest dimension. Microscopic evaluation of all submitted lymph nodes showed reactive changes including sinus histiocytosis, lymphoid hyperplasia, and anthracosilicosis, with no evidence of metastatic disease identified.\n\nThe left upper lobe pulmonary specimen weighed 126 grams and measured 16.7 x 9.5 x 2.9 cm. A gray-black nodule measuring 1.5 x 1.0 x 0.7 cm was observed near the bronchial margin. A separate area of induration measuring 3.5 x 3.2 cm was noted on the posterior aspect of the mid-region. Upon sectioning, this corresponded to a fibrotic lesion measuring up to 3.5 x 2.9 x 1.6 cm with a gritty, gray-tan appearance. The lesion extended to but did not appear to breach the pleural surface and was located 2.3 cm from the nearest bronchial margin. The pleura was slightly wrinkled, gray-pink, and showed moderate anthracotic streaking. No other gross abnormalities were identified in the remaining parenchyma, which was spongy and mildly congested.\n\nHistologic examination of the lung tissue revealed well-differentiated epithelial cells arranged in a mucinous pattern. The tumor was unifocal and measured 3.5 x 3.2 x 1.6 cm. There was no definitive evidence of visceral pleural invasion or lymphovascular space invasion. The bronchial surgical margin was free of involvement, with the tumor located 2.3 cm from the margin. Subpleural fibrosis was present, and rare immunohistochemical positivity for markers such as CK7, CK20, TTF1, and CDX2 was noted. One lymph node was assessed for regional nodal involvement, and no metastases were identified.\n\nAdditional findings included emphysematous changes and subpleural fibrosis. Sections of the resected tissue were submitted for analysis, including margins and surrounding areas. Based on the staging criteria used, the extent of the primary tumor was classified according to size and local extension, with no evidence of nodal metastasis."} +{"pid": "TCGA-C5-A8XJ", "report": "The specimen consists of detached fragments of tissue submitted for evaluation. Microscopic examination reveals sheets and clusters of atypical cells with nuclear enlargement, hyperchromasia, and irregular nuclear contours. Mitotic figures are present. The cellular morphology is consistent with a high-grade neoplastic process. No intact architectural patterns are identified. The tissue fragments measure up to 4 mm in greatest dimension. Clinical correlation was performed based on the patient\u2019s history and prior diagnostic material. The findings support a malignant process involving the cervix. Staging information indicates involvement beyond the superficial layers; however, no lymphovascular invasion is identified. Further clinical follow-up is recommended."} +{"pid": "TCGA-BR-8059", "report": "The excised tissue from the fundus measured 7 x 7 x 0.5 cm and was described as ulcerated. Microscopic examination revealed a poorly differentiated intestinal-type morphology. The tumor involved adjacent structures, specifically the lesser omentum. Of the seven lymph nodes examined, one showed evidence of metastasis. All surgical margins were uninvolved. No information was available regarding lymphatic, venous, or perineural invasion, nor was there data on neoadjuvant treatment or other significant pathologic findings."} +{"pid": "TCGA-DD-A4NO", "report": "The revised report includes the following tissue description: Tissue from liver segments II and III, weighing 163.0 grams and measuring 12.8 x 9.2 x 6.8 cm, along with tissue from the new liver margin measuring 7.8 x 1.5 x 1.5 cm. A well-differentiated lesion is present, measuring 3.2 x 2.8 x 2.2 cm, with a round, circumscribed but unencapsulated appearance. No evidence of vascular invasion is identified. The surgical resection margins, after one re-excision, are free of abnormal cells.\n\nEvaluation of the surrounding non-neoplastic liver tissue reveals mild, nonspecific portal inflammation without signs of advanced fibrosis. A minority of portal tracts show a mixed inflammatory infiltrate composed primarily of lymphocytes, with rare plasma cells and occasional neutrophils. These inflammatory cells appear to be associated with patchy ductular proliferation. Interlobular bile ducts remain intact. A solitary granulomatous reaction based in the portal region is noted. The lobular parenchyma shows changes consistent with surgical hepatitis, with trace steatosis but no active steatohepatitis. No significant fibrosis is observed."} +{"pid": "TCGA-B2-4098", "report": "The left kidney specimen weighed 365 grams and measured 10.5 x 7.5 x 7 cm. A yellow-orange adrenal gland measuring 4.8 x 3.4 x 1.5 cm was present superiorly. The ureter was patent, measuring 8 cm in length and 0.3 cm in diameter. On sectioning, a soft, congested yellow-orange-brown mass measuring 5 x 5 x 4.5 cm was identified at the superior pole. The mass extended to within 0.5 cm of the inked surface and appeared confined by the renal capsule. Adjacent to the mass were several smooth-walled, fluid-filled cysts up to 6 cm in diameter. The renal pelvis appeared smooth and tan-white. The renal parenchyma was uniformly red-brown with a distinct corticomedullary junction and a maximal cortical thickness of 1.2 cm. Additional cortical cysts measuring up to 0.9 cm were observed throughout the specimen.\n\nHistologically, two distinct cellular components were identified within the mass in approximately equal proportions. Both components showed nuclear features corresponding to Fuhrman grade II. The tumor was entirely confined to the kidney without extension beyond it (pT1b). Surgical margins were free of tumor involvement. No regional lymph nodes were identified for assessment (pNX), and distant metastasis could not be evaluated (pMX). Evaluation of the adrenal gland showed no evidence of tumor involvement. Vascular invasion was not identified. In the non-neoplastic renal tissue, chronic interstitial inflammation and benign cysts were noted.\n\nImmunohistochemical analysis was performed on tissue block 3 where both components were present. Cytokeratin 7 showed strong positivity in one component and absence in the other. EMA and RCC staining were more pronounced in the cytokeratin 7-positive area, while PAX2 staining was similar in both areas. These findings supported the presence of two distinct histologic components. Representative sections from 11 blocks were submitted for evaluation, including vascular and ureteral margins, areas near the inked surface, adjacent cystic structures, renal pelvis, normal parenchyma, and adrenal gland."} +{"pid": "TCGA-KS-A41L", "report": "The specimen consists of a total thyroidectomy, including a right lobe measuring 4.5 x 1.5 x 1.6 cm and a left lobe measuring 4.7 x 1.9 x 0.9 cm. The right lobe contains a 2 x 1.5 x 3.2 cm pink-white, circumscribed lesion that is located within 1.3 cm of the isthmus and contacts the inked surface. The surrounding parenchyma appears red-brown and otherwise unremarkable. Histologically, the lesion shows no evidence of capsular or vascular invasion. Surgical margins are negative.\n\nA separate specimen consisting of level VI lymph nodes and surrounding soft tissue from the neck measures 3.5 x 2.5 x 0.6 cm and includes fibroadipose tissue. No metastatic involvement is identified in this tissue. A second lymph node specimen from the region of the thyroid includes three histologically benign lymph nodes and a portion of hyperplastic thymus; no malignancy is present. The left lobe demonstrates nodular hyperplasia without evidence of neoplastic change. All cassettes have been examined and interpreted."} +{"pid": "TCGA-CV-6955", "report": "The specimen consisted of multiple tissue fragments from various anatomical sites. A portion of bone and soft tissue measured 5.0 x 2.5 x 2.0 cm and contained an ulcerated, friable lesion measuring 2.5 x 1.5 x 0.6 cm. The lesion had an infiltrative growth pattern with an ascending mucosal margin; however, no bony erosion was observed. The depth of invasion was 6.0 mm. Lymphatic invasion was not identified. Margins evaluated included right inferior turbinate, right cheek, right soft palate, hard palate, and anterior gum; all showed squamous or respiratory mucosa without evidence of tumor. Multiple frozen sections were obtained and confirmed absence of tumor in the mucosal margins. Tissue from the infra-structure maxillary region was submitted sequentially for further evaluation after decalcification."} +{"pid": "TCGA-DD-AAW0", "report": "The specimen consists of a resected liver following total hepatectomy and transplantation. The tumor is characterized by a post-chemoembolization state, with a size measuring 7x6x5.5cm. Grossly, the lesion is nodular with perinodal extension but lacks satellite nodules. Histologically, the tissue demonstrates trabecular and compact growth patterns, with cellular features including both classic and clear cell morphology. The histologic grade according to Edmondson and Steiner shows the worst differentiation as grade 3, while the major component is grade 2. Fatty change is present in approximately 80% of the tissue, and there is extensive tumor necrosis involving 90% of the mass. Hemorrhage or peliosis is not observed, and no vascular invasion is identified microscopically. A partial capsule is noted without evidence of infiltration. Septal formation is present, and there is no involvement of major branches of the portal or hepatic veins, bile ducts, or serosal surfaces. No intrahepatic metastasis or multicentric occurrence is found. Staging was reported according to AJCC criteria.\n\nAdditional findings include chronic hepatitis with no lobular activity, minimal portal activity, and septal fibrosis. There is no evidence of cirrhosis, dysplasia, or significant fatty change beyond what is described. A separate area of parenchymal necrosis is noted in the S6 segment, measuring 4x3x2cm, consistent with post-chemoembolization changes. A partial adrenal adhesion is also documented."} +{"pid": "TCGA-BT-A0YX", "report": "The specimen was obtained following cystectomy and included multiple tissue samples. Histopathologic evaluation of the right pubic margin showed infiltration into soft tissue. The right and left ureteral margins demonstrated no evidence of urothelial carcinoma in situ or invasive disease, with only benign reactive urothelium present. The bladder specimen revealed a high-grade solid and ulcerated tumor measuring 5.0 cm in greatest dimension (additional dimensions: 5.0 x 2.0 cm), located in the right lateral and anterior walls. The tumor extensively involved perivesical adipose tissue and demonstrated both perineural and angiolymphatic invasion. Surgical margins were positive at the right lateral and posterior regions. No metastatic involvement was identified in 22 pelvic lymph nodes examined (14 from the right side and 8 from the left). The uterus contained multiple benign leiomyomas up to 3.0 cm in size. Both ovaries and fallopian tubes appeared unremarkable. The appendix showed fibrous obliteration without abnormal findings."} +{"pid": "TCGA-50-6597", "report": "The right lower lobe superior segment contains a 2.5 cm invasive moderately differentiated lesion arising in a scar, measuring 2.5 cm in maximum dimension and 0.9 cm in minor dimension. The lesion is associated with angiolymphatic and visceral pleural invasion. There is a moderate lymphocytic host response. No tumor necrosis exceeding 50% is observed. Surgical resection margins are free of tumor, with the closest invasive tumor to margin distance measuring 12 mm. Background lung demonstrates emphysematous change, calcified nodule, and multiple small tumor-like lesions.\n\nA separate lesion measuring 0.6 cm is identified in the right middle lobe, exhibiting typical features. This lesion is accompanied by numerous small tumor-like formations and diffuse neuroendocrine cell hyperplasia throughout the right upper, right lower, and right middle lobes. Immunohistochemical staining confirms pulmonary origin with positivity for TTF-1 and synaptophysin; CDX2 and calcitonin are negative. Scattered small microscopic foci of neuroendocrine cells are seen at the surgical margin of the right middle lobe, though these may represent additional tumor-like formations.\n\nLymph node sampling includes multiple stations: subcarinal, right tracheobronchial angle, left tracheobronchial angle, left paratracheal, right paratracheal, subinnominate, posterior hilar, anterior hilar, intralobar, and right lower lobe hilar lymph nodes. All sampled lymph nodes show only anthracotic pigment without evidence of involvement. A total of 22 lymph nodes were examined (7 N1 and 15 N2), none showed positive involvement.\n\nAncillary studies included histochemical stains, immunohistochemical stains, fluorescence in-situ hybridization (FISH), and molecular testing. FISH analysis demonstrated an EGFR gene to chromosome 7 centromere ratio of 1.07, indicating no EGFR amplification. Chromosome 7 hyperploidy was observed in 30% of analyzed cells. Signal to nucleus ratio for the EGFR gene was 2.5 across 60 analyzed cells. Molecular testing revealed no KRAS exon 1 mutation and no mutations in EGFR exons 19 or 21.\n\nPathologic staging is determined as pT2 pN0 pMx. The procedure performed was a segmental resection. There are no gross satellite lesions or microscopic satellite lesions identified. There is no inflammatory or desmoplastic reaction beyond moderate levels. Underlying pulmonary changes include emphysema, parenchymal scarring, and presence of tumor-like formations."} +{"pid": "TCGA-BH-A0HO", "report": "The specimen consists of a right breast segmental mastectomy at the 10 o\u2019clock position. The invasive lesion measures 1.8 cm in greatest dimension and is composed of cells with moderate nuclear pleomorphism, moderate tubule formation, and moderate mitotic activity, resulting in a total histologic score of 6 out of 9. In addition to the invasive component, there is a cribriform patterned intraductal proliferation with calcifications, accounting for approximately 5% of the total tumor volume and intermixed with the invasive portion. Vascular space invasion is present. Resection margins are free of involvement, with the invasive component located 0.1 cm from the anterior margin and 0.2 cm from the posterior margin. Non-neoplastic findings include fibrocystic changes and columnar cell alterations. Previous biopsy site changes are also noted.\n\nImmunohistochemical staining shows positivity for estrogen and progesterone receptors with H scores of 200 and 290, respectively, while HER-2 staining is negative. \n\nIn the sentinel lymph node specimens, one of two nodes from sentinel #1 contains metastatic cells measuring up to 1 mm in diameter. No extracapsular extension is observed. Sentinel #2 includes three lymph nodes, all without evidence of involvement. Standard histologic stains and keratin immunostaining were used for evaluation.\n\nPathologic staging indicates a T stage of pT1c. Due to the presence of a positive sentinel lymph node, the N stage is considered at least pN1mi; however, definitive staging requires further lymph node dissection. The M stage remains indeterminate."} +{"pid": "TCGA-DK-A2I1", "report": "The specimen from the right distal pelvic lymph node dissection included 21 lymph nodes, all of which showed benign histology. The left distal pelvic lymph node dissection included 9 lymph nodes, also showing benign findings. A radical cystectomy and hysterectomy specimen included the bladder, uterus, anterior vaginal wall, bilateral tubes and ovaries, and urethra. The bladder measured 8 x 7 x 4 cm and contained two masses: one on the right anterior wall measuring 2.2 x 2 x 0.8 cm and another on the posterior wall measuring 0.9 x 0.8 x 0.6 cm. The remaining mucosa exhibited a diffuse granular appearance. The invasive component demonstrated infiltrating growth patterns with deep involvement of the muscularis propria. There was evidence of vascular invasion, and multicentricity was noted. The extravesical examination revealed involvement of both ureters. The surgical margins showed concerning features at the left ureteral margin, with similar findings noted in the right ureteral margin, although denudation was present there. Non-neoplastic changes in the bladder mucosa included proliferative cystitis with Brunn\u2019s nests, cystitis cystica, and cystitis glandularis. The cervix showed chronic inflammation, and the endometrium exhibited atrophic changes; other genital organs were unremarkable. Distal ureter specimens were each approximately 0.4 cm in diameter and 4.5 to 4.6 cm in length; both showed benign tissue upon histological evaluation. The pathologic stage was determined as pT2b according to AJCC 2002 criteria, indicating tumor invasion into the deep half of the muscularis propria."} +{"pid": "TCGA-BR-7959", "report": "The specimen consists of a gastric resection. The tumor is located at the cardia and measures 5 x 3.5 x 1.5 cm. Microscopic examination reveals mucin-producing cells with poorly differentiated features. The tumor extends to the serosa, including the visceral peritoneum. Of the seven intraabdominal lymph nodes assessed, one shows evidence of metastatic involvement. Other features such as lymphatic, venous, or perineural invasion, margin status, and response to neo-adjuvant treatment are not specified. No additional findings or comments are provided."} +{"pid": "TCGA-BR-8295", "report": "The gastric resection specimen involved tissue from the fundus. The tumor measured 5.5 x 5.2 x 1.5 cm and demonstrated features consistent with intestinal-type morphology. Histologic evaluation showed poorly differentiated cells. The tumor extended to the serosa, including the visceral peritoneum. No lymph node metastases were identified in the regional nodes examined (0/5 positive). Lymphatic, venous, and perineural invasion were not identified. Surgical margins were free of involvement. There was no evidence of prior neoadjuvant treatment. No additional pathologic findings or comments were noted."} +{"pid": "TCGA-FK-A3SE", "report": "SURG PATH REPORT. PATH#: -. 1st Specimen collected on. FINAL DIAGNOSIS. 1) NECK (EXCISION): Fibroadipose tissue with acute inflammation. 2) NECK (EXCISION): Fibroadipose tissue. 3) NECK (EXCISION): Parathyroid tissue. 4) THYROID (TOTAL THYROIDECTOMY): Specimen type: Total thyroidectomy. Tumor site: Right lobe, isthmus, left lobe. Histologic type: Not specified. Tumor size: Greatest dimension is 3.5 cm. Focality: Multifocal. Lymph nodes: Involved in 2 of 8 lymph nodes. Extent of invasion: Primary tumor classified as OT2, measuring greater than 2 cm but less than 4 cm, confined to the thyroid. Regional lymph nodes classified as pN1a, with metastasis identified in Level VI (pretracheal, paratracheal, and prelaryngeal/Delphian) nodes. Distant metastasis classified as pMx and cannot be assessed. Margins are uninvolved. Venous and lymphatic invasion are absent. 5) NECK (LEFT CENTRAL NECK DISSECTION): Two out of seven lymph nodes demonstrate similar findings. Histologically unremarkable thymus noted. Reported by. Final Report Signed on. Unofficial lab results - do not file in patient chart. Contact medical records for official chart copy. UNLESS NOTED OTHERWISE, ALL LAB RESULTS PERFORMED AT:"} +{"pid": "TCGA-FP-8211", "report": "The esophagectomy specimen included an esophagus measuring 10.5 cm in length with a circumference ranging from 4 to 6 cm, and a partial stomach segment measuring 8.5 cm in length with a circumference ranging from 5 to 10.2 cm. A polypoid and ulcerated mass was identified at the gastroesophageal junction, measuring 3.4 \u00d7 3.4 \u00d7 3.7 cm. The mass encompassed approximately 99% of the junction and was located 8.9 cm from the proximal margin and 5 cm from the distal margin. It extended through the wall to within 0.1 cm of the adventitial margin, which was inked. Sections of this mass were submitted in blocks 5\u20138.\n\nThe adventitial margin was sampled in blocks 3 and 4. Proximal and distal margins were submitted in blocks 1 and 2, respectively, and both were found to be free of involvement. Additionally, a second ulcerated mass was noted in the stomach, measuring 2.2 cm in width and 0.9 cm in thickness. This lesion was located 2 cm from the closer gastric margin and 12 cm from the farther esophageal margin. Representative sections of this second lesion were submitted in blocks 9\u201310.\n\nSections of random areas of the proximal and mid-esophagus were submitted in blocks 11 and 12. Possible lymph nodes were submitted across blocks 13\u201315. Histologically, the larger mass demonstrated invasion through the muscularis propria into periesophageal soft tissue. The adventitial margin showed focal involvement, while the proximal and distal resection margins were negative. The second gastric lesion also invaded through the muscularis propria into surrounding soft tissue but had negative resection margins.\n\nLymph node evaluation revealed metastatic involvement in 2 of 7 nodes. Vascular invasion was present. Tumor grade was classified as moderately differentiated. No prior treatment effect was observed."} +{"pid": "TCGA-US-A77E", "report": "The specimen was received fresh from theatres for frozen section opinion and consists of a Whipple's specimen. The resected specimen includes a length of duodenum measuring 190mm, lesser curve of the stomach at 30mm, and greater curve at 60mm. The gallbladder measures 80mm in length with a maximum diameter of 30mm and a wall thickness of 2mm. The bile duct is 55mm in length with a maximum diameter of 14mm. The pancreas measures 40 x 45 x 40mm. No gallstones are present.\n\nGross examination revealed a lesion with an infiltrative configuration and a pale, glistening cut surface with macroscopic mucin. The largest dimension of the lesion is 35mm. The distance of the lesion to various margins was assessed: pancreatic neck margin measured 1.2mm on frozen section and microscopically found to be involved within 0.1mm; periuncinate soft tissue margin was 5mm macroscopically and 1mm microscopically; posterior retroperitoneal margin was 10mm; portal vein bed showed tumour extension to the overlying vein wall with a distance of 0.2mm to the margin; anterior pancreatic capsule was 10mm; common bile duct margin was greater than 30mm; proximal intestinal/gastric margin was 70mm; distal intestinal margin was 140mm.\n\nAdditional findings included involvement of the portal vein bed and overlying vein wall. Chronic pancreatitis was also noted. A 12mm duodenal polyp was identified and submitted for histology. Other components of the specimen including the stomach, gallbladder, cyst wall, liver, and perihepatic tissue were unremarkable apart from incidental findings.\n\nA total of 17 blocks were submitted for histological analysis. Microscopic evaluation revealed extension beyond the pancreas, small vessel invasion, and perineural invasion involving large nerves in the peripancreatic soft tissue of the portal vein bed. Tumour was identified within 0.1mm of the pancreatic neck margin (Block A2) and 0.2mm from the portal vein bed margin (Block A7). Of six lymph nodes from the main resection specimen, two contained malignant cells. Four additional lymph nodes from separate specimens were examined, and none showed evidence of malignancy.\n\nHistological assessment of other specimens: the 12mm duodenal polyp was diagnosed as a tubulovillous adenoma without high-grade dysplasia or carcinoma; the cyst wall was consistent with a simple biliary cyst; the liver specimen showed a solitary necrotic nodule with surrounding mild non-specific portal inflammation and focal cholestasis.\n\nStaging according to AJCC 7th edition criteria was performed. The lesion demonstrated poor histological differentiation. Pathologic staging classified the extent of disease as pT3 with regional lymph node involvement (pN1). Resection margins were found to have tumour involvement at the pancreatic neck and portal vein bed. The highest grade of Pan-In was 3, with Grade 1a at the pancreatic neck resection margin."} +{"pid": "TCGA-KK-A7B1", "report": "A total of fifteen lymph nodes from the right pelvic region and six from the left were examined, with no evidence of tumor involvement identified in either group. The lymph nodes ranged in size from 0.3 to 1.3 cm on the right and from 0.5 to 1.2 cm on the left. Histologic evaluation included deeper sectioning and keratin staining, particularly for a suboptimally processed node in block A2, with no findings indicative of metastatic disease.\n\nThe prostate specimen measured 4.0 x 2.7 x 4.2 cm and weighed 35.0 grams post-fixation. Two distinct areas of abnormality were identified within the peripheral zone. The larger lesion was located in the left lateral, left posterolateral, and left posterior regions, measuring 1.8 x 1.2 cm in its largest dimension. It spanned multiple cross sections of the prostate, involving the apex focally and more extensively at the base. This focus extended minimally into extraprostatic tissue (less than 2.0 mm) near the left superior neurovascular bundle but did not reach any resection margin. A second, smaller lesion was found in the right lateral and right posterolateral areas, measuring 1.1 x 0.3 cm. It was confined to the prostate and present only in the final cross section.\n\nAll surgical margins were free of tumor involvement. The seminal vesicles and segments of the vasa deferentia showed no signs of tumor. Perineural invasion was noted, but no lymphovascular invasion was observed. High-grade prostatic intraepithelial neoplasia was also present. Tissue sections were inked to identify anatomical landmarks and surgical margins, with green marking the anterior surface, red the left, yellow the right, black the posterior, and blue used for non-margin surfaces."} +{"pid": "TCGA-TM-A84R", "report": "A left frontal lobe lesion was identified on MRI as a large intra-axial mass measuring 7.5 x 3.3 cm with a partially cystic component and no contrast enhancement. The patient presented with a first seizure, and the differential diagnosis included low grade glioma, metastasis, or lymphoma. A biopsy was performed, and intraoperative evaluation noted increased cellularity without definitive high-grade features.\n\nMacroscopically, two tissue fragments were received: one measuring 5 mm and another 2 mm, along with a larger fragment measuring 35 x 20 x 13 mm. Microscopic examination revealed an infiltrative tumor of moderate to dense cellularity composed predominantly of round to oval cells with mild nuclear pleomorphism and perinuclear halos. Delicate branching vasculature was present throughout. In some areas, the tumor exhibited a pushing border, and adjacent brain tissue showed severe gliosis with gemistocytic astrocytes and Rosenthal-like fibers. Perivascular lymphocytic cuffing was also observed. No necrosis or endothelial proliferation was identified. Mitotic figures were rare, with only two isolated mitoses seen across all sections.\n\nImmunohistochemical staining demonstrated patchy GFAP positivity, moderate EGFR expression, and 20% nuclear labeling for p53. IDH1 (R132H) staining was negative. Ki-67 labeling index was approximately 5%. Molecular studies by FISH showed loss of chromosome arms 1p and 19q, consistent with an oligodendroglial phenotype. EGFR amplification was not detected. Further sequencing identified an IDH2 mutation at codon R172M, with no IDH1 mutation detected. The tumor sample contained at least 50% tumor cells, and testing was conducted using pyrosequencing methodology.\n\nThe histological findings, combined with molecular data, indicate a genetically distinct tumor with dual 1p/19q codeletion and IDH2 mutation status. The specimen was adequately processed without significant artifacts affecting interpretation."} +{"pid": "TCGA-39-5021", "report": "The clinical history notes a left upper lung mass with prior fine needle aspiration positive for non-small cell lung cancer. Specimens submitted include multiple mediastinal and hilar lymph node groups, as well as a left upper lobe lung specimen. Lymph nodes examined included those from mediastinal levels 5, 6, 7, and 11, all of which were fragmented and benign upon histologic evaluation. The posterior hilar and interlobar lymph nodes on the left side were also found to be benign.\n\nThe left upper lobe lung specimen measured 15.2 x 8.7 x 2.8 cm and contained a firm, well-circumscribed gray-tan lesion measuring 3.0 x 3.2 x 2.1 cm. This lesion was located laterally and was 3.2 cm away from the bronchial resection margin. It did not involve large airways or the bronchial margin, but did extend to the visceral pleura. No vascular or perineural invasion was identified. An apical scar was noted in the non-neoplastic lung tissue. A separate nodule measuring 0.7 x 0.5 x 0.4 cm was observed at the apex but did not appear related to the primary lesion.\n\nLymph node status showed no evidence of metastasis: 0 out of 8 peribronchial lymph nodes involved. All lymph nodes evaluated across different regions were negative for malignancy. Intraoperative frozen section analysis of the lymph nodes confirmed benign findings, consistent with permanent section diagnoses. All margins, including bronchial and stapled margins, were free of tumor. The specimen was extensively sampled and submitted for further testing."} +{"pid": "TCGA-E8-A419", "report": "The specimen measures 2.5 x 3 x 3 cm and is located in the left lobe of the thyroid. The histologic analysis reveals a unifocal lesion with papillary architecture. Cellular features include nuclear grooves, intranuclear inclusions, and moderate colloid content. No extrathyroidal extension or vascular invasion is identified. Lymph node involvement was not assessed in this report."} +{"pid": "TCGA-3U-A98I", "report": "A male patient underwent analysis of multiple tissue specimens. The primary specimen consisted of a pleurectomy with involvement of pericardium and diaphragm. The tumor demonstrated diffuse growth across the left pleural surface with a maximum thickness of 1.3 cm. Microscopic evaluation showed a biphasic cellular composition, predominantly epithelioid (90%) with tubular, micropapillary, acinar, and solid patterns, alongside a minor sarcomatoid component (10%). Tumor extension was noted into the diaphragm without full penetration, into lung parenchyma, mediastinal fat, and through the pericardium. Venous and lymphatic invasion were identified.\n\nFive lymph node biopsies were examined, all showing involvement. One lymph node from station #5 was extensively replaced with epithelioid cells and showed extracapsular spread. A lymph node from station 10L was positive for epithelioid cells. Two lymph nodes from station #6 both contained epithelioid cells within the parenchyma and lymphatic channels. A lymph node from the left chest wall was also involved and located near the brachial plexus.\n\nThe tumor exhibited confluent visceral pleural involvement and was considered locally advanced and technically unresectable. Based on extent of local invasion and lymph node involvement, staging was assigned as pT4 for the primary tumor and pN3 for regional lymph node metastasis. Multiple representative tissue sections were analyzed to assess tumor characteristics and margins, though margin assessment could not be fully determined."} +{"pid": "TCGA-DD-A1EC", "report": "The resected liver tissue from segments V and VI, along with the gallbladder, measured 14.0 x 13.5 x 7.8 cm and weighed 18 grams. A lobulated mass measuring 13.2 x 11.0 x 7.8 cm was identified within the liver tissue. The surgical margins were clear by at least 0.7 cm. No significant abnormalities were observed in the gallbladder. The appendix measured 3.8 x 0.6 x 0.5 cm and showed fibrous obliteration at the tip. One retrocholedochal lymph node was examined, measuring 2.0 x 1.5 x 1.2 cm, and showed no evidence of tumor involvement."} +{"pid": "TCGA-AO-A12E", "report": "The patient is an 110-year-old female who presented with a right breast mass measuring 5.5 cm in diameter. A modified radical mastectomy specimen was submitted for evaluation, including the right breast and axillary contents from levels I and II. Gross examination of the breast revealed an ill-defined mass measuring 2.3 x 1.5 x 1.3 cm located near the nipple at the 12 o\u2019clock position. The mass was close to the skin and approximately 2 cm from the deep margin. Fibrous tissue adjacent to the mass was noted in the lower outer and lower inner quadrants.\n\nMicroscopic analysis showed multicentric invasive growth in classical pattern, with involvement of the nipple and direct extension into the skin. The anterior cauterized flap margin was also involved. Adjacent non-neoplastic breast tissue demonstrated usual ductal hyperplasia and microcalcifications associated with benign ducts. No vascular invasion was identified; however, perineural invasion was present.\n\nA total of 13 lymph nodes were examined (7 from level I and 6 from level II), and all were negative for metastatic disease on routine histologic sections. Immunohistochemical staining revealed isolated tumor cells within the nodal parenchyma, measuring less than 0.2 mm, detected only on AE1/AE3 immunostained slides. \n\nHormone receptor status showed strong nuclear staining for ER in 85% of cells with moderate intensity, and PR staining in 40% of nuclei with moderate intensity. HER2 testing by HercepTest showed no reactivity (staining intensity of 0). Staging was determined as T3, pN0 (i+), MX based on the findings."} +{"pid": "TCGA-AC-A2QI", "report": "The surgical specimen consists of a right breast mastectomy with sentinel lymph node biopsies. The main tumor mass measures 57 mm in diameter and is located centrally. Invasive tumor cells are present focally 2 mm from the deep margin, which is bounded by pectoralis fascia, and are at least 30 mm from all other margins. Resection margins are otherwise free of tumor.\n\nMicroscopic evaluation reveals that the invasive component demonstrates intermediate nuclear grade (Nottingham grade 2), with tubule formation score of 3 of 3, nuclear pleomorphism score of 2 of 3, and mitotic count score of 1 of 3 (five mitoses per ten high-power fields). Lymphovascular invasion is identified. Lobular carcinoma in situ (LCIS) is also present, comprising less than 5% of the tumor volume. LCIS shows intermediate nuclear grade and is present both in association with the invasive component and in representative sections away from the main tumor mass. Necrosis and calcifications are not identified in the in situ component.\n\nMetastatic tumor cells are identified in two sentinel lymph nodes, with diffuse involvement throughout both nodes. There is no evidence of extranodal extension. Pathologic staging indicates pT3 for the primary tumor, pN1a for regional lymph nodes, and pMX for distant metastasis, resulting in an overall pathologic stage of IIIA.\n\nImmunohistochemical analysis demonstrates strong estrogen receptor positivity (100% positive cells), while progesterone receptors are negative (less than 1% positive cells). Her2/neu expression is not overexpressed (IHC score 1+). The Ki-67 proliferative index is 12%.\n\nGross examination of the breast specimen reveals a fibrous central mass measuring approximately 5.7 cm in greatest dimension. The tumor diffusely infiltrates a dense fibrous area in the central breast, with smaller foci identified in other quadrants. Representative sections from multiple areas of the breast were submitted for analysis."} +{"pid": "TCGA-AA-3930", "report": "The specimen consists of a right hemicolectomy preparation with tumor-free oral and aboral resection margins. The lesion is ulcerated and histologically shows a poorly differentiated carcinoma. The tumor infiltrates the perimuscular fatty tissue and is associated with extensive regional lymph node involvement, with 24 out of 29 lymph nodes positive for metastatic disease. Vascular and lymphatic invasion are present. The surgical margins are clear, and there is no evidence of residual tumor at the resection sites."} +{"pid": "TCGA-A6-6137", "report": "The specimen consists of a right hemicolectomy, including 6 cm of terminal ileum and 23 cm of proximal colon. The serosal surface is glistening and tan-pink with moderate attached adipose tissue. An unremarkable appendix is present, measuring 6.5 cm in length, with no focal lesions or signs of inflammation. The bowel measures 3.6 cm and 8 cm in circumference at the proximal and distal resection margins, respectively. Upon opening, a circumscribed, rubbery white-pink mass measuring 5.3 x 5 cm is identified, located 11 cm proximal to the distal margin. The tumor has a maximum thickness of 1.6 cm and extends through the full thickness of the bowel wall into surrounding adipose tissue, coming within 1 cm of the outer surface of the specimen. The remaining bowel wall averages 0.5 cm in thickness, with a tan-pink, glistening mucosa showing normal patterns and folds. Lymph nodes up to 1.8 cm in diameter are identified within the dissected adipose tissue.\n\nHistologically, the tumor is composed of moderately differentiated cells. The primary tumor invades through the entire bowel wall and into surrounding fat but does not reach the resection margins, which are all negative. No vascular invasion is observed. A total of 21 lymph nodes are examined and found to be free of malignancy. However, a tumor nodule is identified in the pericolonic fat without identifiable lymph node tissue, leading to a regional staging classification of pN1c. The appendix shows no diagnostic abnormalities."} +{"pid": "TCGA-BP-5180", "report": "The clinical history notes a right solid renal mass measuring 4.5 x 4.1 cm. Two specimens were submitted for analysis. The first specimen, labeled as a right renal tumor, measured 7.0 x 5.5 x 3.0 cm and included a resected portion of kidney with attached fat. On gross examination, a 4.0 x 3.0 x 2.7 cm round, well-encapsulated, hemorrhagic orange lesion was identified, located 0.2 cm from the resected margin. The surrounding renal parenchyma appeared normal. Histologically, the lesion exhibited a solid growth pattern and was composed of cells with nuclear features corresponding to grade II/IV. The largest dimension of the lesion was 4.0 cm, and it was entirely confined within the renal capsule. The deep margin was free of abnormal cells. The second specimen, labeled as a small satellite tumor from the right kidney, measured 1.0 x 0.9 x 0.2 cm and consisted of soft tissue with a smooth surface and a resected margin. Microscopic evaluation revealed no significant findings. Intraoperative frozen section analysis confirmed no tumor involvement at the stitch site, and the final diagnosis aligned with these findings. All non-neoplastic tissue showed no remarkable changes."} +{"pid": "TCGA-06-0141", "report": "The surgical specimen from the left occipital region consists of multiple tissue fragments, with the largest measuring 2.5 x 2.0 x 0.6 cm. The material is soft and friable, with areas of tan-red discoloration and focal hemorrhage. All submitted fragments were included for analysis.\n\nMicroscopic evaluation reveals a glial neoplasm with marked cellular atypia, including nuclear pleomorphism and mitotic activity. The tumor demonstrates a fibrillary background and prominent microvascular proliferation. Widespread necrosis is present, often accompanied by thrombosed blood vessels and neutrophilic infiltration within necrotic zones.\n\nImmunohistochemical staining using MIB-1 highlights a proliferation index of 16% in the more active regions of the tumor."} +{"pid": "TCGA-DB-5278", "report": "The pathology report describes a brain lesion located in the left frontal lobe, measuring 2.5 x 2.0 x 1.5 cm. Histologic evaluation of paraffin-embedded sections demonstrated a neoplasm with features suggestive of a glioma. Immunohistochemical staining using MIB-1 showed a low labeling index. \n\nFluorescence in situ hybridization (FISH) studies were conducted using probes targeting regions on chromosomes 1p and 19q. Two separate hybridizations were performed: one comparing a 19q probe to a 19p control and another comparing a 1p probe to a 1q control. Both probe ratios were below the normal reference value of approximately 1. The 19q to 19p ratio was measured at 0.60, and the 1p to 1q ratio was 0.57. Ratios below 0.80 are considered indicative of chromosomal deletion in these regions. These findings are in line with molecular alterations commonly observed in certain types of gliomas.\n\nAdditional clinical and pathological correlation is recommended for further classification and grading."} +{"pid": "TCGA-VQ-AA6A", "report": "The specimen involves the gastroesophageal junction. The proximal esophageal margin is free of neoplastic involvement. A thread from the distal esophagus shows no evidence of tumor. The epiploic tissue is unremarkable. In the stomach, a lesion measuring 4.0 cm is identified, with infiltration extending to the serosa and adjacent adipose tissue. No perineural invasion is observed; however, lymphatic invasion is present. The growth pattern is spiculated, and there is a discrete lymphocytic infiltrate surrounding the lesion. The proximal surgical margin is involved (labeled F1), while the distal margin is free of disease. Among 26 lymph nodes identified, 8 contain metastatic disease, without evidence of extracapsular extension. The thoracic esophagus shows no signs of malignancy and demonstrates nonspecific chronic inflammation. The proximal esophageal margin again shows no tumor involvement. The gastric fundus exhibits moderate chronic gastritis with active inflammation, but no neoplastic changes are seen. Staging information indicates pT4a pN3a."} +{"pid": "TCGA-AP-A1DQ", "report": "The submitted specimens include the uterus, cervix, bilateral tubes and ovaries, omentum, and multiple lymph nodes from various locations. Histologic evaluation of the uterine tissue reveals a papillary growth pattern arising within an atrophic polyp. The lesion demonstrates deep myometrial invasion, involving more than half of the myometrial thickness. The maximal invasion measures 18 mm in an area where the total myometrial thickness is 22 mm. Vascular space involvement is identified. No involvement of the endocervix is observed.\n\nAdjacent to this abnormal tissue, the endometrium shows complex hyperplasia with cytologic atypia, which is associated with an endometrial polyp. Scattered within the myometrium are benign smooth muscle nodules. The outer surface of the uterus appears unremarkable. Both ovaries and fallopian tubes do not show any malignant changes.\n\nThe omental specimen consists of benign fibrofatty tissue. Evaluation of the lymph nodes reveals varying findings. In the left pelvic lymph nodes, including the external iliac, common iliac, obturator, and hypogastric regions, multiple nodes show involvement by malignant cells. Specifically, one out of one node in the left external iliac region, three out of six nodes in the left common iliac region, one out of two nodes in the left obturator region, and one out of one node in the left hypogastric region contain malignant involvement. On the right side, including the pericolic, external iliac, and obturator regions, all evaluated lymph nodes appear benign. A single lymph node from the left para-aortic area also shows no evidence of malignancy."} +{"pid": "TCGA-G4-6314", "report": "The specimen consists of a right hemicolectomy measuring 15 cm in length with an internal circumference ranging from 7.5 to 11.0 cm, along with an attached terminal ileum measuring 6 cm in length and 4 cm in internal circumference. A firm mass is identified in the cecal area, appearing as a circumferential exophytic ulcerated lesion measuring 5.5 x 4.0 x 3.0 cm. Grossly, this lesion involves the ileocecal valve and extends into the surrounding fat. Two small polyps are also noted: one measuring 0.4 cm located 3 cm from the ileocecal valve, and another measuring 0.6 cm located 7 cm from the distal resected margin and 7.5 cm from the ileocecal valve. No appendix is identified, and no other tumor foci are observed in the ascending colon mucosa.\n\nMultiple sections were taken from the polyps, margins, tumor, and surrounding tissues. Lymph nodes were identified in several regions including the cecal area, peri-cecal fatty tissue, around the tumor, and in the ascending colon. Of the fifty-nine lymph nodes assessed, fifty contain metastatic involvement with associated perinodal extension. Additionally, tumor implants are identified within the pericolic fat. Histologic evaluation shows infiltration through the lamina propria, submucosa, muscularis propria, and into the subserosa. Venous and lymphatic invasion are present. Margins are free of invasive carcinoma. Adjacent mucosa reveals a tubulovillous adenoma measuring 0.6 cm located 7 cm from the distal margin and a separate 0.4 cm polypoid lesion with submucosal extension, possibly representing a satellite lesion.\n\nA separate biopsy of the peritoneal tissue demonstrates involvement by malignant cells. The tumor shows areas of necrosis and calcification. Histologic grade is moderately differentiated with focal features suggestive of a less differentiated component. Pathologic staging is assigned as pT3N2M1. No preoperative diagnosis was provided."} +{"pid": "TCGA-AO-A03L", "report": "The clinical history includes a biopsy of a lesion in the upper outer quadrant of the right breast, followed by a right total mastectomy with sentinel lymph node biopsy and possible axillary lymph node dissection. The specimen from the modified radical mastectomy included levels I and II axillary contents. Grossly, the tumor measured 6.5 cm in greatest dimension and was located in the central area of the breast, approximately 1.5 cm beneath the skin and 0.2 cm from the deep resection margin. The cut surface of the tumor was firm and tan-pink with areas of hemorrhage. No satellite nodules were identified. The non-neoplastic breast tissue showed changes related to prior biopsy. \n\nHistologically, the tumor showed features of high-grade morphology including minimal or no tubule formation and marked nuclear atypia. Lymphatic involvement was noted in the nipple region, and there was extensive vascular invasion. No involvement of the surgical margins was identified. Evaluation of the axillary lymph nodes revealed 3 out of 9 positive nodes in level I and 0 out of 7 in level II. No extranodal extension was present. \n\nImmunohistochemical studies showed estrogen receptor positivity in 70% of cells with moderate intensity, progesterone receptor positivity in 10% with moderate intensity, and HER2 staining with an intensity of 2+.\n\nSentinel lymph node #1, level I from the right axilla showed metastatic involvement. The frozen section diagnosis was confirmed on permanent sections. All relevant tissues were adequately sampled and reviewed."} +{"pid": "TCGA-AA-3514", "report": "The specimen consists of a right hemicolectomy with an ulcerated lesion located 1 cm from Bauhin's valve. The lesion measures 4 cm in its greatest dimension and shows invasive growth into the outer layers of the muscularis propria. Histological examination reveals moderately differentiated features. The oral and aboral resection margins, as well as the large omentum, are free of tumor involvement. A total of twelve mesocolic and mesenteric lymph nodes were examined, none of which show evidence of tumor; they display only reactive changes. Vascular and lymphatic invasion are not identified. The histological grade is G2."} +{"pid": "TCGA-33-4532", "report": "Final diagnosis: Right lower lobe, lung (resection): Moderately differentiated cellular proliferation measuring 4.5 cm in greatest dimension. The lesion extends subpleurally but does not invade through the visceral pleura. Vascular and bronchial surgical margins are free of atypical cells. Three lymph nodes examined in the specimen show no evidence of cellular infiltration. A separate specimen from station 7 lymph node and another from R4 lymph node each contain one lymph node with associated fibroadipose tissue, both without morphologic evidence of abnormal cellular accumulation."} +{"pid": "TCGA-4Z-AA7Q", "report": "The specimen involves the bladder and prostate. In the bladder, there is a high-grade invasive lesion measuring 4.6 x 3.3 x 2.7 cm, with a vegetating and ulcerated infiltrative growth pattern. The lesion is located on the left and right upper posterior lateral wall and extends into the muscularis propria and perivesical adipose tissue. Perineural invasion is present; angiolymphatic invasion is not observed. Surgical margins are free of neoplastic cells.\n\nIn the prostate, there is a small focus of acinar-type adenocarcinoma measuring 2.0 mm at the right apex. The Gleason score is 7 (3 + 4). No extension beyond the prostate is identified. Angiolymphatic and perineural invasions are not present. Surgical margins are involved. There is also nodular prostatic hyperplasia. Adjacent parenchyma shows no evidence of involvement by the bladder lesion. Seminal vesicles and deferent ducts are uninvolved.\n\nStaging for the bladder lesion indicates pT3a based on depth of invasion."} +{"pid": "TCGA-SR-A6MS", "report": "The specimen consists of a right adrenal gland obtained via adrenalectomy. The gland weighs 29 grams and measures 5.5 x 5.5 x 2 cm. Upon serial sectioning, a mass measuring 3 x 2.8 x 2.6 cm is identified within the medulla. The mass appears tan-brown, soft, and friable, with well-defined borders and no extension beyond the adrenal gland. The surrounding adrenal tissue shows no abnormalities.\n\nHistologic evaluation reveals marked nuclear atypia without evidence of necrosis. Resection margins are free of abnormal tissue. No lymph nodes were identified or examined. There is no evidence of blood vessel or lymphatic invasion.\n\nImmunohistochemical staining demonstrates positivity for S100 in scattered sustentacular cells within the mass. Smooth muscle actin highlights numerous blood vessels throughout the lesion. Ki-67 labeling index shows an average of 13 positive tumor cells per 20x field, with additional labeling evident in endothelial cells and vascular smooth muscle. p27Kip1 staining is positive in tumor cells.\n\nAdditional microscopic examination does not reveal features suggestive of adrenal medullary hyperplasia or associations with von Hippel-Lindau disease. All sections of the tumor have been submitted for evaluation."} +{"pid": "TCGA-85-8072", "report": "The lung tissue specimen was obtained from the left upper lobe and submitted as a lobectomy. The tumor measured 1.5 x 1.5 x 1.0 cm. Microscopic examination revealed a poorly differentiated histologic pattern with squamous morphology. The extent of the tumor, presence of additional nodules, lymph node involvement, lymphatic and venous invasion status, margin status, and any evidence of prior treatment were not specified. No other significant pathologic findings were noted, and no comments were provided."} +{"pid": "TCGA-EW-A3U0", "report": "A total of 25 lymph nodes were examined, including three sentinel lymph nodes and 22 non-sentinel lymph nodes. One sentinel lymph node contained metastatic involvement measuring 5.0 mm in linear dimension. The remaining lymph nodes showed no evidence of involvement. The primary specimen was a left breast excision measuring 9.0 cm in greatest dimension. A central mass with diffuse extension to multiple margins was identified, with the main tumor measuring 3.5 cm. However, with extensions and surrounding induration, the overall tumor size was 8.5 cm. Margins were closely approached by tumor, with the posterior margin being 1 mm from the tumor focus. Ductal carcinoma in situ (DCIS) was present in 8 out of 17 slides, showing intermediate nuclear grade with solid and cribriform patterns, and associated necrosis and calcifications. DCIS was also near the margins, with the closest being less than 1 mm at the inferior margin. No lymphovascular invasion was identified. Immunohistochemical studies from prior specimens showed negative staining for estrogen receptor, progesterone receptor, and HER2. All surgical margins were free of invasive carcinoma and DCIS."} +{"pid": "TCGA-EW-A423", "report": "The left breast lumpectomy specimen measured 5.0 x 4.5 x 3.5 cm and was submitted with all margins inked and separately identified. An ill-defined area measuring 2.0 x 2.0 x 1.5 cm was identified within the tissue, located closest to the deep resection margin at 0.2\u20130.3 cm, 0.3 cm from the inferior margin, and 1.0 cm from the superficial margin. Histologic evaluation revealed a single focus of invasive carcinoma measuring 2 cm in greatest dimension. The tumor demonstrated pleomorphic features and a Nottingham histologic score of 7 (3+2+2), corresponding to grade 2 differentiation. The invasive component was present within 1 mm of the inferior and lateral margins. No ductal or invasive carcinoma was identified at the superior, anterior, posterior, or medial margins, with distances ranging from >5 mm to 4 mm.\n\nA focus of lobular carcinoma in situ (pleomorphic type) was also present. No prior treatment effect was noted. Lymphovascular invasion was not identified. Sentinel lymph node sampling was performed, with two lymph nodes examined. Both were negative for metastatic disease using hematoxylin and eosin staining at one level. No macrometastases, micrometastases, or isolated tumor cells were identified.\n\nImmunohistochemical analysis of the invasive carcinoma showed strong positivity for estrogen receptor (>90% immunoreactive nuclei) and weak positivity for progesterone receptor (1\u201310%). HER2/neu staining was negative. Cytokeratin staining of the lymph nodes was also negative, with no evidence of metastatic involvement.\n\nStaging based on these findings was pT2 for the primary tumor and pN0 for lymph node status. No distant metastasis was identified. Ancillary studies confirmed hormone receptor positivity and absence of HER2 amplification."} +{"pid": "TCGA-3S-AAYX", "report": "The surgical specimen from the mediastinum was submitted as an extended thymectomy. The specimen weighed 175 grams and measured 32.5 x 10.5 x 3.0 cm. It included a well-circumscribed gray, glistening, fleshy mass that was friable, measuring 5.8 x 5.3 x 3.0 cm. This mass grossly abutted both the anterior (superficial) and posterior (deep) soft tissue margins. Sectioning revealed yellow glistening cut surfaces, with no other lesions identified.\n\nMicroscopic evaluation showed a tumor with cellular features including scattered epithelial cells demonstrated by cytokeratin staining. Histologic analysis was performed, and immunohistochemical studies supported these findings. No lymphovascular invasion was identified. There was evidence of tumor extension into surrounding fat; however, other potential sites of involvement, including pleura, pericardium, lung parenchyma, and diaphragm, were not present for evaluation. Distant metastases or implants were also not present for evaluation.\n\nMargins were assessed, and tumor was found at the inked superficial margin and within 2 mm of the posterior margin. Nine regional lymph nodes were identified and showed no evidence of tumor involvement. A segment of benign parathyroid tissue was incidentally noted.\n\nThe specimen was intact and properly oriented, with appropriate inking of margins. All relevant portions of the tumor and surrounding tissue were submitted for analysis, including margins and presumed lymph nodes. Based on the available findings, the pathologic staging criteria were met for a stage consistent with limited local extension without nodal involvement."} +{"pid": "TCGA-ZJ-AAXJ", "report": "The specimen consists of a single irregular pink-tan to gray-tan glistening tissue fragment measuring 0.7 x 0.6 x 0.4 cm, received in formalin and labeled as a cervical biopsy. The tissue was trisected and fully submitted for analysis in one cassette. Microscopic evaluation revealed invasive cellular growth with large cell morphology and keratinizing features. The tumor exhibited established stromal invasion with associated desmoplastic reaction. No lymphovascular space invasion was identified. Cellular features included moderate pleomorphism, eosinophilic cytoplasm, and central necrosis in some areas. Tumor size, depth of invasion, and histologic grade were assessed for staging purposes. CPT code 88305 was used for the biopsy evaluation."} +{"pid": "TCGA-DJ-A2PP", "report": "A 40 g thyroid specimen was received, including a right lobe measuring 5 x 3.5 x 2.5 cm, a left lobe of 3.9 x 1.9 x 1.5 cm, an isthmus of 2.4 x 1.5 x 1 cm, and a pyramidal lobe measuring 2.3 x 0.8 x 0.5 cm. The right lobe contained a 3.6 x 3.5 x 2.5 cm tan-pink, finely lobular, circumscribed nodule located in the upper to mid portion. The nodule appeared well-encapsulated without evidence of capsular or vascular invasion, and did not extend to the isthmus. Surgical margins were free of involvement. A separate small focus measuring 0.08 cm was identified in the left lobe. The remaining thyroid tissue showed no significant abnormalities aside from a few hyperplastic nodules. Three lymph nodes were examined and found to be benign. Microscopic evaluation revealed well-differentiated cells with mild to moderate mitotic activity (2 mitoses per 10 high power fields) and no tumor necrosis. The tissue was extensively sampled and entirely submitted for analysis."} +{"pid": "TCGA-FD-A6TH", "report": "The patient is a male with a history of prior therapy. A cystoprostatectomy with lymph node dissection was performed. Specimens were received from multiple sites including left and right pelvic lymph nodes, bladder and prostate, distal ureters, and periurethral tissue.\n\nIn the left pelvic lymph node specimen, a tumor focus measuring 4.0 cm was identified within a matted lymph node. The tumor extensively involved perinodal adipose tissue and lymphovascular spaces. In another left pelvic lymph node dissection, four out of four lymph nodes contained tumor, with involvement of perinodal adipose tissue and lymphovascular spaces. A segment of vas deferens was also examined and showed no tumor involvement. In the right pelvic lymph node dissection, five out of nine lymph nodes were involved, with similar patterns of perinodal adipose and lymphovascular space involvement.\n\nExamination of the bladder and prostate revealed a transmurally invasive tumor extending into perivesical and left perivesicular adipose tissue. There was extensive lymphovascular invasion and a positive soft tissue margin of resection. No tumor was seen at the prostatic urethra or bilateral ureteral margins. The tumor measured 5.8 x 3 x 2.5 cm and was located in multiple areas including the dome, right and left lateral walls, trigone, and posterior wall. Prostate examination showed necrotizing granulomas, likely related to prior therapy, and high-grade intraepithelial neoplasia.\n\nNo tumor was found in the left or right distal ureter specimens or in the left periurethral tissue. Of fourteen lymph nodes evaluated, ten contained tumor involvement.\n\nMeasurements and staging parameters indicated extensive local and nodal involvement. Multiple sections of the prostate and bladder were submitted for analysis, along with resection margins and surrounding tissues."} +{"pid": "TCGA-BR-8078", "report": "The specimen consisted of a subtotal gastrectomy involving the fundus of the stomach. The lesion measured 14 x 13 x 2 cm and was noted to be ulcerated. Histologic evaluation showed poorly differentiated cellular morphology. The tumor involved adjacent structures, specifically the omentum. Lymph node examination revealed no metastatic involvement (0/5 regional lymph nodes positive). There was no evidence of lymphatic, venous, or perineural invasion. Surgical margins were uninvolved. No findings indicative of prior neo-adjuvant treatment were identified. No additional significant pathologic findings were noted."} +{"pid": "TCGA-UF-A7JA", "report": "The specimen involves tissue from the buccal mucosa and includes assessment of multiple anatomical regions and lymph node levels. Surgical margins, including the right inferior alveolar nerve and retromolar area, are free of neoplastic involvement. The right palatine tonsil was also examined.\n\nLymph node evaluation shows no evidence of involvement in Level IB (0/1), Level IIB (0/2), Level III (0/3), and Level IIA (0/8) on the right side. One lymph node in Level IIA contained neoplastic cells, but there was no capsular extension identified.\n\nMicroscopic examination reveals a moderately differentiated cellular growth pattern with ulceration, extending into skeletal muscle tissue. There is evidence of lymphatic invasion; perineural invasion was not observed. Bone tissue involvement was noted in proximity to the primary site, although the osseous margin itself remains uninvolved. Tissue processing included decalcification for assessment."} +{"pid": "TCGA-94-8491", "report": "The surgical pathology report includes specimens from multiple sites. Specimen A consists of lymph node fragments from the right level 2 region, which show no evidence of metastatic disease. Specimen B is a right lower lobe lobectomy specimen measuring 18.5 x 15.0 x 3.0 cm. A mass measuring 4.5 x 3.5 x 3.5 cm is identified, located 0.5 cm from the bronchial margin and 1.0 cm from the vascular margin. Microscopic evaluation reveals a poorly differentiated carcinoma with squamous features. All surgical margins are free of invasive carcinoma. Angiolymphatic invasion is present. Three peribronchial lymph nodes are involved with metastatic disease and demonstrate extranodal extension. Specimens C and D include lymph nodes from the right level 7 and level 4 regions, respectively, all of which are negative for metastatic involvement. Immunohistochemical staining shows strong nuclear positivity for p63 in areas of squamous differentiation, while TTF-1 staining is negative in these regions. A small component of glandular differentiation is noted but is insufficient for a diagnosis of adenosquamous carcinoma. The tumor is staged as pT2a based on size and location. A total of six lymph nodes are examined, with three showing involvement. No distant metastasis is identified."} +{"pid": "TCGA-77-8146", "report": "Histopathology Report. HISTORY. Right lower lobe lesion. No pre-operative histology. MACROSCOPIC. Four specimens were received. Specimen 1, labelled 'right upper lobe', consists of a lung lobe measuring 150 mm in length, 130 mm in width, and approximately 40 mm in depth. A stapled resection margin measuring 125 mm is identified adjacent to the hilum. Several dark, fleshy lymph nodes are noted at the hilum. The pleural surface demonstrates significant anthracosis with an area of pleural puckering posterolaterally over the posterior segment. Underlying this region is a pale mass measuring up to 22 mm in diameter. A bronchial origin could not be identified. The lesion is distant from the bronchial and stapled resection margins. Specimen 2, labelled 'right lower lobe nodule', consists of grey tissue measuring 7 x 8 x 5 mm; transverse sectioning reveals a black nodule measuring 4 mm. Specimen 3, labelled \"lymph node No. 10\", includes two pieces of fleshy lymph node tissue measuring 17 x 10 x 7 mm and 9 x 6 x 3 mm, with the larger fragment showing fleshy black and grey cut surface. Specimen 4, labelled \"lymph node No. 11\", contains two fragments of greyish-black tissue measuring 10 x 6 x 4 mm and 10 x 7 x 3 mm.\n\nMICROSCOPIC. Sections from specimen 1 show a poorly differentiated epithelial lesion with multiple cavities and focal in-situ features. The lesion is subpleural, with no evidence of pleural invasion. Vascular or lymphatic invasion was not observed, nor was perineural involvement identified. The bronchial resection margin is free of\u75c5\u53d8. Lymph node analysis shows reactive changes and multiple non-necrotising granulomata. Emphysematous changes are present in the surrounding lung tissue. Specimen 2 reveals a silicotic nodule without malignant features. Specimens 3 and 4 show only reactive lymphoid changes and similar granulomatous patterns, with no signs of malignant infiltration.\n\nSUMMARY. The right upper lobe and associated lymph nodes demonstrate a lesion measuring 22 mm in maximum dimension that is poorly differentiated and without vascular, lymphatic, or perineural invasion. The lesion does not involve the bronchial resection margin and there is no pleural invasion. Lymph node examination reveals no metastatic disease but shows non-necrotising granulomata. The lung parenchyma shows mild emphysematous change. A small nodule in the right lower lobe is consistent with a benign silicotic process. Special stains do not reveal microbial organisms in the granulomata."} +{"pid": "TCGA-DX-A6YR", "report": "The submitted specimen consists of a radical resection of a right chest wall mass. The tissue includes an associated skin ellipse measuring 11.5 x 2 cm and extends 13 cm from medial to lateral, 9.5 cm from superficial to deep, and 6 cm from superior to inferior. The mass is well-defined and located within the muscle, measuring 6 x 5.8 x 5.4 cm. It is situated 3 cm from the skin, 0.5 cm from the deep margin, 0.4 cm from the lateral margin, 2 cm from the medial margin, 1.5 cm from both the superior and inferior margins. The cut surface is white, homogeneous, and has a gelatinous appearance.\n\nMicroscopic evaluation reveals high cellularity with significant atypia. Mitotic activity is present at a rate of 12 per 10 high power fields. Sections include those from the deep, inferior, lateral, medial, skin, and superior margins, all of which show no evidence of residual tumor. The surgical resection margins are uninvolved. The tissue was inked with corresponding colors for orientation: deep (black), superior (blue), inferior (green), medial (red), and lateral (yellow). Representative sections were submitted for analysis, and gross photographs were taken. A summary of sections includes blocks from each margin site confirming absence of tumor at the margins."} +{"pid": "TCGA-E9-A3QA", "report": "The specimen consisted of left breast tissue, submitted as a mastectomy. A grossly evident lesion measuring approximately 2 x 2.5 x 2 cm was identified. Histologic evaluation revealed a moderately differentiated cellular proliferation. Features including tubule formation, nuclear pleomorphism, and mitotic activity were not specified, precluding calculation of a Nottingham Histologic Score. Lymph node status, extracapsular extension, surgical margins, and tumor extent could not be determined from the report. There was no information provided regarding neoadjuvant treatment or additional pathologic findings."} +{"pid": "TCGA-BJ-A45J", "report": "The thyroid specimen weighed 26 grams and was entirely submitted for histologic evaluation. A nodule measuring 0.3 cm was identified in the left lobe. Histologic examination revealed a focus of neoplastic cells with features including abundant fibrosis. The tumor was unifocal and confined to the thyroid without evidence of extrathyroidal extension. Margins were uninvolved. Lymphovascular invasion was present.\n\nA lymph node from the isthmus showed cystic changes and contained metastatic neoplasm. Another lymph node from the central compartment also showed involvement. Extracapsular extension was noted in one of the involved nodes. In total, two regional lymph nodes were examined, and both were involved.\n\nMolecular analysis was performed on the 0.3 cm nodule. Testing revealed a specific genetic alteration in the BRAF gene (p.V600E). No mutations were found in NRAS, HRAS, KRAS, or RET/PTC1 and RET/PTC3 rearrangements. Specimen quality was sufficient for analysis. \n\nStaging was determined as pT1a for the primary tumor and pN1a for regional lymph node involvement. Distant metastasis was not applicable."} +{"pid": "TCGA-VQ-A8DU", "report": "The specimen involves the stomach (antrum) and includes a resected tumor measuring 7.0 cm along its longest axis. Histologic examination reveals a tubular growth pattern with moderate differentiation. Ulceration is present, and the tumor exhibits spiculated invasion involving adjacent adipose tissue. A mild inflammatory reaction is noted. Neural infiltration is identified, as well as lymphatic vascular invasion; however, blood vascular invasion is not detected. Both proximal and distal margins are free of neoplastic involvement, as is the great omentum.\n\nLymph node evaluation demonstrates metastatic involvement in several regions: on the greater curvature, 2 out of 12 lymph nodes show metastasis with capsular perforation; on the lesser curvature, 5 out of 9 lymph nodes are involved with capsular rupture; lymph node station 8P contains 1 involved lymph node with capsular disruption; lymph node station 12C shows no evidence of disease. Adipose tissue in the region of the celiac trunk is uninvolved."} +{"pid": "TCGA-BC-A10Q", "report": "The liver resection specimen weighs 630 grams and measures 16 x 13.5 x 5.5 cm, including the left lobe and a portion of the right lobe. A tumor measuring 10 x 9 x 7 cm is present. In the region of the tumor, the liver capsule appears white and firm with central puckering. The tumor extends 2 cm to the left of the ligamentum teres and 8 cm to the right. It approaches the resection margin in multiple areas superiorly and at the right end of the specimen. On cut section, the tumor is firm with a fairly homogeneous yellow-tan appearance and is well circumscribed. The uninvolved liver parenchyma and capsule appear normal.\n\nMicroscopic examination reveals tissue with mixed architectural patterns involving sclerosing and gland-like structures. The lesion shows multifocal extension to surgical margins; however, no vascular space invasion is identified. \n\nThe gallbladder measures 7 x 2.5 x 2 cm and has an external surface with scattered petechiae. The lumen contains dark green bile, and the mucosa appears green and velvety. No stones are present, and the wall thickness is within normal limits. Microscopic evaluation of representative sections does not reveal any abnormal pathology."} +{"pid": "TCGA-ZC-AAAH", "report": "The specimen measures 9.5x7.5x3.5cm and weighs 90g. On cut surface, a 5.5x4.5x2cm lobulated, partially firm tumor is identified with a gray-white appearance. Frozen section analysis was performed along with assessment of multiple tissue regions including vascular margins near the right thymus, right thymus cranial, right-sided mediastinal pleura, left-sided thymus with evidence of bleeding, left-sided mediastinal pleura, ventral and dorsal preparation sections, and additional cuts.\n\nMicroscopic evaluation reveals a lobular growth pattern with areas of regression within a normally developed thymus. The tissue contains lobules ranging from small to large in size, with an abundance of epithelial cells; however, lymphoid cells are the predominant component. Notably, follicles are present within the tissue. The surrounding thymus shows signs of moderate inflammation with germinal centers observed.\n\nThe lesion infiltrates into mediastinal fat (Masaoka stage II) and contains intratumoral lymphofollicular hyperplasia. Extension below the pleura is noted without definitive signs of infiltration. Comparison between frozen and paraffin sections showed no discrepancies."} +{"pid": "TCGA-BP-4803", "report": "A right renal mass measuring 4.8 cm in greatest dimension was identified within a partial nephrectomy specimen. The tumor exhibited geographic areas of necrosis and hemorrhage, with a soft yellow cut surface. Histologic evaluation demonstrated nuclear features classified as Fuhrman Nuclear Grade III/IV. The tumor extended through the renal capsule but remained confined within Gerota\u2019s fascia without invasion into adjacent veins or beyond the perinephric tissues. No involvement of the renal vein was observed. Surgical margins were free of tumor, with the closest margin measuring 0.1 cm from the tumor edge. Examination of the surrounding kidney revealed cortical scarring and mild arteriosclerosis. No adrenal tissue or lymph nodes were identified within the specimen. Sections submitted included representative portions of the tumor, adjacent kidney, surgical margins, and perinephric adipose tissue. Intraoperative frozen section analysis confirmed the presence of a renal cortical neoplasm near the surgical margin, which was corroborated by permanent section diagnosis."} +{"pid": "TCGA-XV-A9VZ", "report": "Patient ID: F. Clinical Dx: Tumor Location: Skin. Localization: Left femur. Source: Epithelial origin. Clark Level (1-5): 4. Breslow depth (mm): 5. Tumor measurements: 4. No normal tissue involvement. No metastasis detected. Stage classification: II. Lesion dimensions: 4x5 mm. No neoadjuvant immunotherapy administered."} +{"pid": "TCGA-DD-AACV", "report": "The liver specimen measured 12.0 x 11.0 x 7.0 cm and weighed 231.5 grams. A well-defined lesion measuring 3.5 x 3.4 x 3.0 cm was identified with a yellowish-tan, granular cut surface. The lesion exhibited an expanding nodular growth pattern. The resection margin was free of involvement with a safety margin of 0.2 cm. An additional nodule measuring 1.1 x 0.9 cm was noted. The remaining liver parenchyma showed features of cirrhosis. There was no evidence of portal vein invasion.\n\nMicroscopic evaluation revealed areas of varying differentiation, with the worst being grade III and the major portion showing grade II differentiation. The histologic architecture was trabecular with hepatic-type cells. No fatty change was observed. Fibrous capsule formation was partial, with capsular infiltration present. Septum formation was also partial. There was no invasion at the surgical resection margin, serosal layer, or portal vein; however, microvessel invasion was identified. No intrahepatic metastasis or multicentric occurrence was seen.\n\nNon-tumor findings included liver cirrhosis and a high-grade dysplastic nodule. Trichrome staining confirmed cirrhotic fibrosis of the liver parenchyma. The gallbladder measured 10.0 cm in length, 4.5 cm in diameter, with a wall thickness of 0.2 cm, and showed signs of congestion."} +{"pid": "TCGA-A7-A0CG", "report": "The specimen includes right and left axillary sentinel lymph nodes, a right breast biopsy, a left breast biopsy, and a superior margin biopsy. The right axillary sentinel lymph node specimen contains four lymph nodes, with the largest measuring 1.8 x 1.5 x 1 cm and the remaining three averaging 0.3 cm. No metastasis is identified in these nodes. The left axillary sentinel lymph node is a single lymph node measuring 1.5 x 1 x 1 cm, and no metastasis is found.\n\nThe right breast biopsy is a tissue block measuring 5 cm from medial to lateral, 3.1 cm anterior to posterior, and 3 cm superior to inferior. It includes a firm tan mass measuring 2.1 x 1.8 x 1.5 cm located approximately 3 mm from the inferior margin. Microscopic evaluation reveals a mixed histologic pattern of grade 1 ductal and lobular features. The tumor measures 2.3 cm in greatest dimension and is located 0.9 mm from the lateral margin. Ductal carcinoma in situ is also present, with a solid pattern and nuclear grade 2. Extensive proliferative changes are noted in the surrounding non-tumorous breast tissue.\n\nThe left breast biopsy measures 4.5 cm anterior to posterior, 4.3 cm medial to lateral, and 2.1 cm superior to inferior. It shows ductal carcinoma in situ with cribriform and solid patterns and nuclear grade 2. The lesion is smaller than 2 mm and is more than 2 mm from the nearest margin. Additionally, extensive proliferative fibrocystic changes and lobular carcinoma in situ are observed. Immunohistochemical staining for E-cadherin demonstrates absence of membranous staining in certain areas.\n\nThe superior margin biopsy measures 2.5 cm anterior to posterior, 1.8 cm medial to lateral, and up to 1.7 cm in the superior-inferior dimension. Histologically, it reveals a mixed grade 1 ductal and lobular pattern, with a tumor size of 1.2 cm. The invasive component extends to the medial and inferior inked margins. Calcifications are present in this specimen.\n\nAll lymph nodes examined show no evidence of metastatic involvement."} +{"pid": "TCGA-D1-A1O0", "report": "A hysterectomy and bilateral salpingo-oophorectomy specimen includes a uterus with attached fallopian tubes and ovaries. A mass measuring 3.6 x 2.9 x 2.0 cm is present in the posterior uterine wall. Microscopic examination reveals cells arranged in both endometrioid and clear cell patterns, with the majority being endometrioid type. The lesion is classified as FIGO grade 3. It extends 0.1 cm into the myometrium, which has a total thickness of 1.7 cm. There is no involvement of the endocervix, and lymphovascular space invasion is not observed. Surgical margins are free of atypical cells. Both ovaries and fallopian tubes show no abnormal cellular changes.\n\nA biopsy of the abdominal wall peritoneum is unremarkable. Multiple right and left pelvic lymph nodes (21 and 17, respectively) show no evidence of abnormal cells. The omentum also shows no atypical findings. Right and left para-aortic lymph nodes (4 and 5, respectively) are negative for atypical cells. Biopsies from the gonadal vessels, cul-de-sac, bladder peritoneum, left and right colic gutters, right diaphragm, left and right pelvic sidewalls, small and large bowel mesenteries, and serosal surfaces all show no presence of abnormal cells.\n\nGrossly, the uterus weighs 101.2 grams and contains a soft tan exophytic mass in the posterior wall without visible invasion. The myometrium measures 1.7 cm in thickness. Two benign-appearing intramural and subserosal leiomyomas are noted, measuring 1.5 cm and 2.2 cm. The right ovary measures 2.6 x 1.7 x 1.0 cm with a solid cut surface and is connected to a 10.2 x 0.8 cm right fallopian tube, which appears unremarkable. The left ovary measures 1.8 x 1.5 x 0.7 cm with a solid cut surface and is attached to a 5.5 x 0.5 cm left fallopian tube, both of which appear unremarkable. Other submitted specimens include adipose and soft tissue fragments ranging in size from 0.2 cm to 71.8 cm, all of which appear unremarkable on gross examination."} +{"pid": "TCGA-2G-AAFH", "report": "The pathology report describes a left orchidectomy specimen. The tumor measures 2 cm in greatest dimension and is confined to the testis based on available slides. There is no evidence of angioinvasion. Rete testis was not identified in the submitted tissue. The report is dated with the date of orchidectomy."} +{"pid": "TCGA-BB-4223", "report": "The specimen was received for evaluation with multiple biopsies and resected tissues. The superior, lateral, inferior, and medial mucosal margins were all negative for tumor involvement. A tooth was extracted and showed no evidence of neoplastic change. \n\nA modified dissection of the left neck was performed, yielding 52 lymph nodes. Involvement was identified in four of these nodes: one of seven in level I, two of nine in level II (with extracapsular extension noted), one of seventeen in level III, and no involvement in levels IV and V. Histologic examination of the remaining nodes and associated fibroadipose tissue was unremarkable.\n\nIn the left tonsil and soft palate excision, a 3 cm mass was identified. The lesion extended to a depth of 3 cm and invaded into deep skeletal muscle. Tumor cells were present within 1 mm of the deep margin. All other surgical margins were free of involvement. There was extensive angiolymphatic invasion identified."} +{"pid": "TCGA-WB-A81J", "report": "The pathology review describes a tumor measuring 2.5 cm in diameter located in the right adrenal gland. Immunohistological analysis showed positive staining for synaptophysin and chromogranin. Staining for inhibin, SF1, calretinin, MART1, and KL1 was negative. Ki67 staining identified only single positive cells, suggesting a low proliferation rate. Histological evaluation assessed parameters including extension into adipose tissue and nuclear pleomorphism, contributing to a total score of 3 out of a maximum possible score of 20. The findings are consistent with a non-aggressive process."} +{"pid": "TCGA-D6-A6ES", "report": "Gender: M. Examination result No. Surgery and Laryngological Oncology Dept. Clinical diagnosis (suspicion) was given. Histopathology result showed a lesion with staging T4a N1 MO. Date of admission: \\. Material: 1) Material: Larynx. Evaluation of the margins was requested. Method of collection: Specimens were collected for laboratory examination. The histopathological analysis revealed a lesion with characteristics consistent with a moderately differentiated morphology. The primary lesion involved a significant extent of local tissue, with evidence of extension beyond the original site. Lymph node involvement was noted, with metastatic changes present in at least one regional node. Distant metastasis was not confirmed."} +{"pid": "TCGA-A6-5659", "report": "The specimen consists of a 25 cm segment of proximal right colon with attached 21 cm of distal ileum. The serosal surface is smooth to slightly scabrous and tan-pink, with no appendix identified. Proximal and distal margins measure 4.5 cm and 10.2 cm in circumference, respectively. Upon opening, a moderately well-circumscribed mass measuring 5.0 x 4.2 cm is observed, located 3.5 cm distal to the ileocecal valve. This lesion has a rubbery, tan-white-red appearance and extends into the muscularis layer up to 0.8 cm thick, approaching within 0.15 cm of the inked radial serosal margin. Two additional sessile polypoid lesions are noted\u2014measuring 0.6 cm and 1.0 cm\u2014located 8 cm and 2 cm distal to the primary lesion.\n\nThe ileal and uninvolved colonic mucosa appear normal with regular folds, and wall thickness averages 0.5 cm. Multiple lymph nodes, up to 1.4 cm in size, are present within the mesocolon and mesentery. Histologically, the lesion shows moderately differentiated morphology invading into the muscularis propria without extension into pericolonic fat or involvement of the serosal surface. Margins are negative for tumor involvement, with the tumor located 20 cm from the distal margin. No vascular invasion is observed.\n\nTwenty-six lymph nodes are examined and none show evidence of metastatic involvement. Additionally, one tubular and one serrated adenoma are identified. Sections of ileum and colon away from the lesion appear unremarkable. A total of 15 tissue blocks were submitted for analysis, including full-thickness sections of the lesion, adjacent mucosa, margins, lymph nodes, and other findings."} +{"pid": "TCGA-YA-A8S7", "report": "The specimen consisted of liver tissue, gallbladder, adrenal gland, and a periportal lymph node obtained following right hepatectomy, left hepatic core biopsy, cholecystectomy, adrenalectomy, and lymph node excisional biopsy. Gross evaluation identified a 12 cm mass in the liver with multiple tumor foci involving both the right and left lobes. Histologic examination revealed a poorly differentiated malignant neoplasm with cellular morphology consistent with a primary hepatic origin.\n\nMicroscopic analysis demonstrated a high-grade lesion with no evidence of lymphovascular or perineural invasion. Surgical margins were negative for tumor involvement, with the closest invasive carcinoma located at least 1 cm from the parenchymal resection margin. Pathologic staging indicated multiple tumors greater than 5 cm in aggregate size without regional lymph node involvement (1 lymph node examined, none positive). There was no evidence of distant metastasis.\n\nAdditional findings included chronic hepatitis, likely related to hepatitis C infection, characterized by mild portal inflammation (grade 1) and septal fibrosis with architectural distortion (stage 3). Mild macrovesicular steatosis was also observed. Tumor viability assessment showed approximately 75% viable tumor nuclei with 25% necrosis and no normal tissue components present within the tumor samples.\n\nSpecimen processing times and preservation methods were documented, including formalin fixation start and stop times, cold ischemia duration, and freezing times for plasma, serum, and buffy coat fractions. Specimen weights and sizes were recorded along with storage details including cryovials and FFPE blocks. Four normal and four tumor tissue samples were preserved; no metastatic tissue was collected. All specimens were processed in accordance with study protocols and patient consent guidelines."} +{"pid": "TCGA-97-A4M6", "report": "The surgical specimens include a right lower lobe wedge resection, completion lobectomy, and multiple lymph node biopsies (levels 4, 7, 8, and 9 on the right). The wedge resection measured 6 x 3 x 2 cm, with a stapled margin. A nodule measuring approximately 1 x 1 cm was identified beneath a puckered area of the pleura, located 0.9 cm from the stapled line. Microscopic evaluation of the wedge resection showed a lesion composed of various histologic patterns, including lepidic (40%), papillary (30%), micropapillary (20%), and acinar (10%) components. The lesion measured 1.4 cm in greatest dimension. The staple line margin was free of tumor involvement.\n\nThe completion lobectomy specimen measured 15 x 9 x 1.5 cm, with a staple line measuring 7 cm. The bronchial and vascular margins were identified and found to be uninvolved. No residual tumor was identified in the lung parenchyma upon serial sectioning. All examined lymph nodes (one from level 8, one from level 9, one from level 7, and two from level 4) were negative for tumor involvement.\n\nHistologically, the lesion was classified as a mixed subtype adenocarcinoma, well-differentiated (Grade 1). There was no evidence of visceral pleural invasion or lymphovascular invasion. The primary tumor was staged as pT1a based on its size (\u22642 cm) and location, with no regional lymph node metastasis (pN0).\n\nMolecular analysis was performed. Testing for KRAS mutations in exons 12 and 13 revealed no mutations. EGFR mutation analysis showed a deletion mutation in exon 19 (E746_A750del5), which is associated with sensitivity to tyrosine kinase inhibitors. Tumor cellularity in the sample was approximately 50%, which is above the recommended threshold for this type of testing. No significant findings were reported for ALK rearrangement studies.\n\nThe patient is a never-smoker with a history of rheumatoid arthritis and a preoperative finding of a 1.5 cm sub-solid nodule in the right lower lobe. The remaining lung tissue appeared grossly and microscopically unremarkable, with no other masses or nodules identified in the completion lobectomy specimen. All surgical margins, including bronchial and vascular, were free of tumor."} +{"pid": "TCGA-C5-A1MJ", "report": "The specimen from the uterus and cervix shows a focus with a size of 1.7 cm in greatest dimension. The lesion invades to a depth of 3 mm, within a total wall thickness of 10 mm. Very focal lymphovascular space invasion is present. An organizing biopsy site is observed. Acute and chronic inflammation are noted. Benign mesonephric remnants are identified. No abnormality is detected in the vaginal cuff, parametrial soft tissue, or lymph node from the parametrium. One lymph node was examined and found negative. In the endometrium, inactive changes are seen. The myometrium shows no histopathologic abnormality. The right ovary and fallopian tube reveal no abnormal findings. No carcinoma is identified in six left pelvic lymph nodes or ten right pelvic lymph nodes."} +{"pid": "TCGA-H7-A6C5", "report": "A total laryngectomy and right hemi-thyroidectomy specimen was submitted for evaluation. Gross examination identified a fungating, tan-white exophytic mass measuring 4.4 cm in greatest dimension arising from the right lateral wall of the larynx. The lesion extended into adjacent structures including the false vocal cord and ventricle, with closest approach to the epiglottic superior margin at 3 mm and to the right of center at 2 mm. The depth of invasion measured 2.0 cm laterally and 1.0 cm anteriorly. No gross involvement of the thyroid cartilage, hyoid bone, or piriform sinus was observed. No lymph nodes were grossly identified within the specimen.\n\nHistologically, the lesion showed features of invasive keratinizing squamous cell carcinoma with numerous keratin pearls. Areas of increased nuclear pleomorphism and a high mitotic rate were noted. Margins of resection were negative for invasive carcinoma, although the tumor approached within 0.1 cm of the right superior pharyngeal (pyriform) margin on microscopic evaluation. No lymphovascular or perineural invasion was identified. Margins evaluated for carcinoma in situ, including moderate and severe dysplasia, were also uninvolved.\n\nA total of 76 lymph nodes were examined from bilateral neck dissections and regional lymph node specimens; all were negative for malignancy. This included 31 lymph nodes from a right neck dissection, 31 from a left neck dissection, 3 from a left level 1 lymph node specimen, and 11 from the right tracheal-esophageal groove. No extranodal extension was present.\n\nMultiple surgical margins were assessed using frozen section analysis and permanent sections. These included right and left tongue base margins, right and left superior and inferior pharyngeal margins, posterior cricoid margin, left tongue base, and tracheal margin. All margins were negative for invasive carcinoma. One margin demonstrated moderate squamous dysplasia.\n\nAdditional findings included ulceration and granulation tissue at the stoma site. The thyroid gland appeared unremarkable without evidence of tumor involvement.\n\nThe specimen was staged pathologically as pT2, pN0, pMX."} +{"pid": "TCGA-5R-AA1D", "report": "The specimen consists of a right lobe of the liver measuring 19.0 x 15.0 x 6.0 cm. A well-circumscribed, firm, lobulated green-brown mass measuring 11.0 x 6.5 x 8.0 cm is present within the liver tissue, located 2.0 cm from the resection margin. Adjacent to this mass is a satellite lesion measuring 2.0 cm in diameter. The remaining hepatic tissue appears flabby and reddish-brown. The resection margin is free of abnormal tissue. Microscopically, the liver shows features of poorly differentiated cellular morphology with vascular invasion. Fibrosis scoring systems, including Metavir, Knodell, and Ishak, all indicate no significant fibrosis or histological activity. \n\nThe gallbladder measures 6.5 x 2.0 x 1.5 cm and exhibits autolysis. It contains bile and has a smooth greenish serosa with a plush greenish mucosa. \n\nLymph node assessments were conducted on two retropancreatic lymph nodes, both measuring up to 2.5 cm in greatest dimension, and seven common hepatic lymph nodes ranging from 0.5 to 1.5 cm in size. All lymph nodes were negative for metastatic involvement."} +{"pid": "TCGA-B2-4099", "report": "The specimen consists of a right kidney weighing 309 grams, measuring 10.0 x 5.8 x 4.8 cm, with attached ureter measuring 3 cm in length and 0.3 cm in diameter. A moderate amount of perinephric adipose tissue is present. The renal capsule is delicate and separates easily from the underlying cortex. On bisection, a central, well-circumscribed mass measuring 3.0 x 2.8 x 2.5 cm is identified, with a yellow-orange cut surface. The mass approaches but does not compress or extend into the renal pelvis. It is present to within 0.5 cm of the inked capsular surface. The remaining renal parenchyma is uniformly tan-red-brown with a distinct cortical-medullary junction and a maximum cortical thickness of 1.0 cm. A single 0.3 cm cortical cyst is noted in the inferior region. No adrenal tissue is present. Sections submitted include vascular and ureteral margins, areas of the mass near the capsular surface, its relationship to the renal pelvis and adjacent parenchyma, as well as random sections from the remainder of the specimen.\n\nMicroscopically, the lesion demonstrates clear cell morphology with nuclear features corresponding to Fuhrman grade 2-3. The tumor is confined within the kidney, measures 3.0 cm in greatest dimension, and does not involve the resection margins. There is no evidence of vascular invasion. No regional lymph nodes or distant metastases are assessable. The non-neoplastic kidney contains a single small cortical cyst. No other significant findings are identified."} +{"pid": "TCGA-NP-A5B3", "report": "The specimen consists of a right kidney with attached perinephric fat, measuring 11.5 x 6 x 4.5 cm and weighing 201 grams. The ureter and vascular margins are included in block 1, and the renal sinus/hilar margin is in block 2. Two distinct masses were identified within the kidney. The first mass is located in the mid-posterior aspect, measuring 3.8 cm in greatest dimension. It is brown in color and bulges against the capsule, which strips easily from the surface. Sections of the overlying capsule are submitted in block 3. A section of the mass and adjacent renal sinus is included in block 4, with additional sections submitted in blocks 5 through 8. The second mass is found in the mid-lateral region, measuring 1.0 x 0.8 x 0.8 cm, and is located approximately 0.6 cm away from the first mass. It also bulges against the capsule, which separates easily. Sections of the capsule overlying this mass are submitted in block 9. A section of both masses along with intervening normal-appearing tissue is in block 10, and further sections of the second mass are submitted in blocks 11 through 13.\n\nThe renal pelvis and calices appear normal without dilation. The renal cortex averages 0.5 cm in thickness, and a random section of kidney tissue is submitted in block 14. No lymph nodes or adrenal tissue were identified in the attached fat. Microscopic evaluation indicates that the tumor is confined to the kidney, with no evidence of involvement at the surgical margins. Histologic grading reveals nuclei that are slightly irregular with nucleoli evident, corresponding to a Fuhrman nuclear grade of G2. Immunohistochemical staining was performed to assist in differential diagnosis, including oncocytoma, chromophobe renal cell carcinoma, and granular variant of clear cell renal carcinoma. Positive stains included cytokeratin 7, EMA, CD117, E-cadherin, and CD10; negative stains included vimentin and cytokeratin 20. Control slides were reviewed and deemed appropriate.\n\nPathologic staging is pT1a, indicating a tumor 4 cm or less in greatest dimension limited to the kidney. Regional lymph node involvement could not be assessed (pNX). There is no evidence of sarcomatoid differentiation, tumor necrosis, or lymphovascular invasion. Intradepartmental consultation was obtained for confirmation."} +{"pid": "TCGA-DQ-7590", "report": "The specimen consisted of tissue fragments from the left tonsillar fossa and deep left tonsillar fossa. The tissue was received fresh, with the first sample containing seven tan, soft fragments measuring between 0.1 to 0.5 cm. The second sample included numerous tan-pink fragments with aggregate dimensions of 1.3 x 1.3 x 0.5 cm. Frozen section analysis was performed on both samples and showed positive findings. Permanent sections confirmed the presence of poorly differentiated cells with features consistent with invasive disease. The depth of invasion measured at least 0.6 cm. All specimens were examined microscopically and findings were confirmed by the attending pathologist."} +{"pid": "TCGA-B8-4148", "report": "The specimen consists of a partial nephrectomy from the left kidney, weighing 10.4 grams and measuring 4 x 3 x 2.7 cm. It includes a minimal amount of attached perinephric fat. The external surface is smooth and tan-colored, with green ink marking the capsular margin and purple ink identifying the parenchymal margin. On sectioning, a single well-circumscribed, lobulated tan-colored mass is identified, measuring 2.6 x 2.2 x 2.2 cm. The mass is located near both the green-marked capsular margin and the purple-marked parenchymal margin, with a rim of compressed renal tissue observed at the periphery.\n\nMicroscopic evaluation reveals a neoplastic lesion with clear cell morphology. The histologic grade is determined to be grade 3 out of 4. There is no evidence of capsular invasion, extension into perirenal adipose tissue, or involvement of lymphatic vessels. Surgical margins, including both the perirenal adipose tissue and the renal parenchymal margin, are free of tumor involvement.\n\nStaging according to AJCC criteria is pT1a, pNx, pMx. This staging is based on the available information and may be subject to revision following further clinical review."} +{"pid": "TCGA-BP-4174", "report": "The right kidney specimen weighed 704 grams and measured 15.2 x 10.4 x 4.5 cm. A mass measuring 9.4 x 8.4 cm was identified at one pole of the kidney. The center of the mass contained a yellow scar, with surrounding areas showing a variegated appearance ranging from yellow to red to tan. The mass was well-circumscribed, fragile, and focally cystic with areas of hemorrhage. It approximated the renal pelvis but did not extend into the ureter, renal vein, or artery, and remained confined within the renal capsule without involvement of surrounding adipose tissue. Surgical margins were all free of involvement. Sections of the adjacent kidney showed chronic inflammation.\n\nThree lymph nodes were identified in the paracaval specimen and all appeared benign. No abnormal tissue was found in the right adrenal gland specimen, which measured 7.1 x 2.5 x 1.0 cm and showed only hemorrhagic changes without other significant findings."} +{"pid": "TCGA-2G-AAHL", "report": "The specimen measured 9.0 cm in diameter. Histologic examination revealed large, uniform cells with distinct cell membranes and prominent nuclei. No invasion of the rete testis was identified. Angiolymphatic invasion was present. There was no involvement of the tunica albuginea or epididymis. The surgical margin at the spermatic cord was clear of tumor."} +{"pid": "TCGA-BH-A0BG", "report": "The surgical specimen consists of a left breast segmental mastectomy. A single focus of invasive carcinoma is identified, measuring 1.8 cm in greatest dimension. The invasive component exhibits marked nuclear pleomorphism, high mitotic activity, and poor differentiation. The histologic grade is determined based on tubule formation score of 3, nuclear grade score of 3, and mitotic count score of 3, for a total score of 9 out of 9. \n\nIn addition to the invasive component, there is extensive ductal intraepithelial neoplasia with solid and micropapillary growth patterns, comedo-type necrosis, and associated calcifications. This in situ component is located outside of the invasive tumor area and is found near the inferior margin of the resection, focally involving that margin across three of fifty-eight slides. The invasive tumor is located 0.9 cm from the closest resection margin, which is the anterior margin, and does not involve it. However, the in situ lesion is present at the inferior margin.\n\nNo lymphovascular invasion is observed in the current specimen. Review of prior biopsy material showed vascular space involvement confirmed by CD31 immunostain, but no lymphatic invasion was identified on prior biopsy with D2-40 staining.\n\nAdditional findings include atypical ductal hyperplasia, fibrocystic changes with columnar cell change, and ductal epithelial hyperplasia. Hormone receptor testing shows absence of estrogen and progesterone receptor expression. HER-2/neu immunohistochemistry yields a score of 0, indicating no overexpression.\n\nAll margins were submitted for histological evaluation. No metastatic involvement is identified in the one lymph node retrieved from the left axillary sentinel lymph node biopsy."} +{"pid": "TCGA-B0-4819", "report": "Specimen CCA-B0-4819 consists of a right pulmonary tumor thrombus and a right radical nephrectomy specimen weighing 903 grams. The primary lesion measures 9.0 cm and is confined within the renal capsule. It demonstrates conventional clear cell morphology with focal oncocytic features. Nuclear grading shows predominant Fuhrman grade 3 features, though there are areas exhibiting bizarre and polymorphic nuclei consistent with Fuhrman grade 4. Angiolymphatic invasion is present. The vascular resection margin is involved by the lesion, while the ureteral resection margin is uninvolved. A thrombus is present in the right lung, showing extensive necrosis. No significant pathological changes are noted in the non-neoplastic kidney tissue or the adrenal gland. Staging is classified as T3b with involvement of regional lymph nodes not assessed (NX) and presence of distant metastatic disease (M1)."} +{"pid": "TCGA-C5-A2LZ", "report": "The patient is a woman who underwent a cervical biopsy. The specimen consisted of one slide labeled and submitted for review by Dr. [name redacted]. The tissue was processed and examined microscopically. Histologic evaluation revealed abnormal squamous cells with moderate nuclear atypia, increased mitotic activity, and loss of cellular polarity. The lesion involved the lower half of the epithelium without full thickness extension. There was no evidence of vascular or lymphatic invasion identified. The specimen did not show clear margins or extension to the deep margin. Immunohistochemical staining was performed as part of the evaluation. Based on microscopic assessment, the lesion demonstrated features concerning for advanced intraepithelial neoplasia. No definitive invasive component was identified within the sampled tissue. A corresponding pathology report accompanied the submission and was reviewed in conjunction with the current findings."} +{"pid": "TCGA-DJ-A2Q8", "report": "The clinical history notes a thyroid nodule previously assessed by fine needle aspiration. Specimens submitted include a pre-laryngeal lymph node and a total thyroidectomy specimen.\n\nThe pre-laryngeal lymph node specimen consists of a single lymph node measuring 0.7 x 0.5 x 0.3 cm, entirely submitted for examination. Histologic evaluation reveals benign lymph node tissue without evidence of malignancy.\n\nThe total thyroid specimen weighs 13.5 g. The right lobe measures 4.1 x 2.6 x 1.1 cm, the left lobe 4.2 x 2.5 x 1.8 cm, and the isthmus 1.8 x 0.8 x 0.4 cm. The external surface is covered by a thin fibrous capsule. The posterior surface was inked black and the anterior surface blue during gross examination. A well-circumscribed pink-tan nodule measuring 0.9 x 0.8 x 0.6 cm is identified in the left lower lobe, extending toward the isthmus. This lesion was partially submitted for further testing and blocked out for histologic analysis. The remainder of the thyroid parenchyma appears unremarkable on gross inspection.\n\nHistologically, the nodule demonstrates well-differentiated cellular features with no identifiable mitotic activity or tumor necrosis. Blood vessel invasion and extrathyroid extension are not present. Surgical margins are free of abnormal cells. No adenomatous changes are noted in areas away from the nodule. The surrounding non-neoplastic thyroid tissue shows features of nodular hyperplasia. Parathyroid glands are not identified within the specimen. Two perithyroidal lymph nodes are present and show benign characteristics.\n\nSections from all relevant areas of the thyroid (isthmus, right and left lobes, and the nodule) have been submitted for analysis. All diagnostic assessments were based on personal microscopic evaluation of the slides and other materials."} +{"pid": "TCGA-EB-A82C", "report": "A mass located in the left heel skin is ulcerated, measuring 5 x 3 x 1 cm, with a firm consistency and brown-black to gray surface. Microscopic examination shows necrotic and ulcerated epidermis. The lesion is composed of sheets, trabeculae, or nests of spindle or oval cells with scant cytoplasm. In some areas, the cytoplasm contains fine melanin pigment granules. The cells exhibit a low nucleo-cytoplasmic ratio, with nuclei varying in shape and size, and containing prominent eosinophilic nucleoli. Mitotic figures are present. The lesion invades into subcutaneous fat tissue. The specimen is a surgical resection from the skin of the foot, measuring 5 x 3 x 1 cm, and is described as ulcerated, pigmented, and necrotic. Histologic evaluation indicates poorly differentiated morphology. No metastatic involvement was identified in 10 lymph nodes examined (bilateral inguinal). There is no evidence of neoadjuvant treatment effect. Other findings include a thickness measurement of 10 mm."} +{"pid": "TCGA-34-2604", "report": "A mass was identified in the left lower lobe of the lung and evaluated via biopsy. The lesion measured 5.0 x 5.0 x 4.0 cm and exhibited extensive necrosis. Histopathologic examination revealed invasive, poorly differentiated cells. The tumor extended to the visceral pleural margin but did not involve the bronchial or vascular resection margins, which were free of tumor. A total of seven peribronchial lymph nodes were assessed and found to be negative for metastatic involvement.\n\nLymph node tissues from multiple regions, including right and left level 4, pretracheal level 3, subcarinal, level 11, and sump node, were all benign and showed no evidence of abnormal cellular infiltration. The chest wall pleura specimen displayed only moderate chronic inflammation without any signs of tumor involvement.\n\nThe background lung tissue demonstrated emphysematous changes and airspace accumulation of smoker\u2019s macrophages. No satellite nodules were observed, and hilar structures appeared free of disease involvement. Based on these findings, staging was determined as T2N0MX."} +{"pid": "TCGA-CZ-5465", "report": "The left kidney specimen weighed 323.5 grams and measured 16.7 x 8.8 x 5.1 cm. A mass measuring 5.6 x 5.0 x 5.0 cm was identified in the interpolar region, with a tan/pink to tan/yellow appearance and partial encapsulation. The mass was located 2.5 cm from the arterial margin, 2.5 cm from the renal vein margin, and 10.5 cm from the ureteral margin. It disrupted approximately two-thirds of the renal parenchyma and approached the kidney capsule within less than 0.1 cm of the inked margin. Gross extension into the renal vein was noted. The surrounding Gerota\u2019s fascia contained tan/yellow lobulated adipose tissue. The urothelium appeared tan/gray, smooth, and glistening. The remaining renal parenchyma was tan/brown with a focally well-defined corticomedullary junction. Perirenal adipose tissue showed a centrally hemorrhagic medulla surrounded by tan/yellow cortex, with no lymph nodes identified.\n\nMicroscopic evaluation showed nuclear grade 2 morphology. Margins of soft tissue, ureter, and vascular structures were free of tumor involvement. The mass extended into the renal vein but did not breach the renal capsule. No lymphovascular invasion was observed. The adrenal gland was unremarkable. Cytogenetic analysis revealed a complex karyotype including loss of the short arm of chromosome 3, a finding commonly associated with a specific subtype of renal neoplasm. Chromosome studies were performed at a resolution of 400 bands or greater. All analyzed metaphases displayed clonal abnormalities consistent with this pattern. Mosaicism or small chromosomal changes may not be fully detectable with standard techniques. Further assessment of the non-neoplastic kidney is pending. Based on staging criteria, the lesion is classified as pT3b Nx MX."} +{"pid": "TCGA-73-7498", "report": "The specimens included a right paratracheal lymph node (4R), level 7, 8, and 9 lymph nodes, and lung tissue from the right lower lobe obtained via wedge resection and completion lobectomy. Frozen section analysis of the 4R lymph node, level 7 lymph node, and wedge biopsy of the right lower lobe was performed intraoperatively. The lobectomy specimen showed no gross lesion but revealed a microscopic focus of abnormal tissue.\n\nMicroscopic examination of the wedge resection identified a moderately differentiated adenocarcinoma with bronchioloalveolar features measuring 2.5 cm in greatest dimension (additional dimensions: 1.8 x 1.0 cm). The tumor did not involve the pleural surface or demonstrate angiolymphatic invasion. Adjacent lung tissue showed mild emphysematous changes. In the lobectomy specimen, a separate small focus of adenocarcinoma with bronchioloalveolar features was identified microscopically, measuring 0.9 cm in greatest dimension. No involvement of the bronchial margin or pleural surface was observed, nor was there evidence of angiolymphatic invasion. Two lymph nodes from the lobectomy specimen were negative for malignancy. Additionally, all lymph nodes sampled at levels 4R, 7, 8, and 9 contained no malignant cells.\n\nThe wedge specimen demonstrated a grossly visible mass located 0.5 cm from the staple margin. The lobectomy specimen measured 13.5 x 11 x 3 cm and featured two plaque-like areas on the pleural surface, located approximately 4 cm from the bronchial margin. No gross lesions were observed in the lobectomy specimen. Histologic evaluation confirmed absence of malignancy in both bronchial margins and lymph nodes assessed.\n\nBased on staging criteria, the pathological stage assigned was pT1b, N0, MX. Non-neoplastic findings included pleural plaques and mild emphysematous changes in lung tissue."} +{"pid": "TCGA-CH-5737", "report": "The specimen shows a predominantly poorly differentiated adenocarcinoma involving both sides of the prostate, with greater involvement in the peripheral and transitional zones. The maximum tumor dimension measures 2.4 cm. Focal perineural invasion is present. There is no evidence of extraprostatic extension or vascular invasion. Seminal vesicles are free of tumor involvement. A total of ten lymph nodes were identified, five from fatty tissue and an additional five, all without tumor involvement. The staging classification is pT2c, pN0 (0/8), with no lymphovascular invasion identified. Gleason scoring is 4+3 = 7, with approximately 60% of the tumor demonstrating Gleason pattern 4. Carcinoma cells extend to the rectolateral aspect of the tissue defect on both sides, corresponding to the artefactual preparation margin (yellow labeling), while other margins (green and blue labeling) show no tumor involvement."} +{"pid": "TCGA-HU-A4GN", "report": "The surgical specimen was obtained following a distal gastrectomy. The fresh specimen measured 15.5 cm along the greater curvature and 14.4 cm along the lesser curvature. The proximal resection margin measured 18.3 cm, while the distal resection margin was 6.0 cm. The duodenum measured 0.8 cm. A mass with ulceroinfiltrative appearance was identified on the anterior wall of the proximal antrum. The lesion measured 5.3 x 4.0 x 0.5 cm and was located 7.1 cm from the proximal resection margin and 4.6 cm from the distal resection margin. There was no gross evidence of serosal invasion.\n\nMultiple tissue blocks were examined, including sections from the tumor and surrounding tissue (x5), antral mucosa (x1), body mucosa (x2), proximal resection margin (x1), distal resection margin (x1), and a segment labeled as distal margin (x1). Lymph nodes were sampled from various regions, including superior gastric (x2), inferior gastric (x2), and other regional stations (x1 each for '1', '4sb', '5', '6', '7'; x2 for '11p'; x1 for '12'; and variable numbers for other groups).\n\nMicroscopic examination revealed a moderately differentiated gland-forming neoplasm involving the muscularis propria (T2 stage). Both proximal and distal resection margins were free of involvement. The growth pattern was infiltrative with an intestinal-type morphology. A prominent stromal reaction was noted with heavy infiltration by acute and chronic inflammatory cells. Evidence of lymphovascular invasion was present; however, no venous or perineural invasion was observed.\n\nMetastatic involvement was identified in one of thirteen lymph nodes from the superior gastric region. No tumor was found in the remaining lymph nodes examined from other stations, including inferior gastric, '1', '4sb', '5', '6', '7', '8', '9', '11p', '12', and others. Some lymph node samples lacked identifiable lymphoid tissue. Extracapsular tumor extension was noted in several regional lymph node biopsies."} +{"pid": "TCGA-E7-A4XJ", "report": "The specimen consists of bladder tissue. A lesion is present with ill-defined margins measuring 3.5 x 3 x 2 cm. The lesion has a soft consistency and gray surface. Microscopically, the cells show hyperplastic changes and are arranged in nests, cords, or sheets with areas of central necrosis. The cells have moderate eosinophilic cytoplasm. Nuclear features include enlargement, variation in size and shape, irregular nuclear membranes, prominent nucleoli, and abnormal chromatin distribution. Frequent mitotic figures are observed. The lesion extends into fat tissue. Histologic evaluation shows no papillary architecture and includes involvement of perivesical tissue. No lymphatic or venous invasion is identified. Additional findings include involvement of muscle and fat tissue. Extracapsular extension is present focally. The specimen type is consistent with cystectomy."} +{"pid": "TCGA-NQ-A638", "report": "The specimen consists of a right lower lobe wedge with chest wall resection, a diaphragmatic nodule from the right chest, and a separate wedge biopsy from the basilar region of the right lower lobe. Histologic examination reveals a malignant epithelial neoplasm with a predominantly tubulopapillary growth pattern. The cells exhibit moderate to abundant cytoplasm, enlarged round nuclei with irregular chromatin, and small prominent nucleoli with evidence of mitotic activity. Immunohistochemical staining shows strong positivity for calretinin, cytokeratin 5, and WT-1; positivity for cytokeratin 7; and negativity for cytokeratin 20, Napsin A, and TTF-1.\n\nMultiple tumor nodules are identified, ranging in size from 6.0 cm to 0.5 cm. These involve the pleura, lung, and diaphragmatic muscle. No lymphovascular invasion is observed. All surgical margins, including soft tissue, parenchymal lung, and rib margins, are free of tumor involvement. Involvement is noted near the periosteum of the rib, though it does not extend into the medullary cavity. Additional nodules identified within the pleura and lung demonstrate similar histologic features.\n\nGross examination of the diaphragm nodule reveals a fragment measuring 1.3 x 1.2 x 0.6 cm with a pale tan, homogeneous appearance. The wedge resection includes a pleural-based lesion measuring up to 6 cm, extending into the lung without involving the parenchyma. A second pleural-based nodule measures 0.9 cm, and an additional subpleural nodule within the lung measures 0.5 cm. The basilar wedge biopsy contains a subpleural lesion measuring 1.7 cm on the pleural surface. Random sections of uninvolved lung show no significant fibrosis or inflammation.\n\nStaging assessment indicates pT2 disease with no definitive lymph node or distant metastasis evaluation possible due to insufficient data (pNX, pMX). Multiple tissue blocks and cassettes were submitted for detailed histologic analysis."} +{"pid": "TCGA-AA-A022", "report": "The specimen shows a poorly differentiated neoplasm with infiltration of the terminal ileum and extension into the serosa. There is extensive involvement of lymphatic and vascular structures. The resection margins, including the mucosal region, ligature area, and lymph nodes, show no evidence of residual disease. Histological evaluation indicates a high-grade morphology. Tissue invasion is classified as pT4 with lymphovascular invasion noted (L1, V1). Lymph node involvement is not present (pN0), and distant metastasis cannot be assessed (MX)."} +{"pid": "TCGA-50-5939", "report": "The surgical specimen from the right upper lobe apical segmentectomy measures 3.4 cm in maximum diameter and demonstrates poorly differentiated features with acinar and solid growth patterns. The lesion arises within pulmonary parenchymal scar tissue and exhibits angiolymphatic and visceral pleural invasion. All surgical margins are free of tumor involvement, with the closest invasive tumor measuring 12 mm from the bronchial margin. There is no evidence of lymph node metastasis; four segmental lymph nodes and two level-four lymph nodes were examined and found to be negative for malignancy. Additional findings include multiple pulmonary apical caps, multifocal atypical adenomatous hyperplasia, and respiratory bronchiolitis with emphysematous changes.\n\nHistologic evaluation reveals mild host lymphocytic response and tumor necrosis involving 50% or less of the lesion. Molecular testing did not identify KRAS codon 12/13 mutations, EGFR exon 19 mutations, or EGFR exon 21 mutations. However, EGFR amplification was detected by FISH analysis, with a gene-to-centromere ratio of 2.65. A total of 66 cells were analyzed, showing a hyperploidy rate of 25.8% and monosomy rate of 36.4% for chromosome 7. The signal-to-nucleus ratio for EGFR was 5.7. These findings suggest genetic alterations potentially relevant to clinical response to targeted therapies.\n\nAncillary studies included histochemical and immunohistochemical stains, which demonstrated mucinous differentiation. Elastic tissue staining confirmed visceral pleural invasion. No evidence of malignancy was identified in the examined bone specimen from the third rib."} +{"pid": "TCGA-R6-A6DQ", "report": "The distal esophageal tumor specimen consists of multiple fragments of tan-pink soft tissue measuring 1.2 x 0.6 x 0.2 cm, which was entirely submitted for analysis. Histologically, the lesion demonstrates invasive growth with moderately to poorly differentiated cellular features. Immunohistochemical staining for Her-2/neu was performed and showed no reactivity, with a score of 0 out of 3. The staging classification based on tumor extent is T3, with involvement of regional lymph nodes noted as N1. Distant metastasis was not confirmed. The morphology and architecture suggest a high-grade epithelial neoplasm with glandular differentiation. No other specific markers or molecular test results are reported in this addendum."} +{"pid": "TCGA-12-1097", "report": "The patient presented with severe headache and was initially managed conservatively. Over several days, he developed worsening confusion and difficulty reading, prompting further imaging. A CT scan revealed a large right occipital abnormality, and subsequent MRI with contrast demonstrated an enhancing lesion. A biopsy was performed, and intraoperative consultation identified high-grade neoplastic changes in multiple tissue fragments.\n\nGross examination of the brain specimen measured 6 x 6 x 5 cm and included a subcortical hemorrhage measuring 2 x 1 x 1 cm and a diffuse area of necrosis approximately 3 x 2 x 3 cm. Multiple representative sections were submitted for analysis. Additional small fragments of brain tissue were also received and processed completely.\n\nMicroscopic evaluation showed infiltration of the brain by malignant astrocytes with intermediate fibrillar morphology. The tumor exhibited vascular proliferation and pseudopalisading necrosis.\n\nGenetic testing using FISH showed polysomy of chromosome 7 in 44% of tumor cells, amplification of EGFR in 90%, loss of chromosome 10 centromere in 65%, allelic loss of PTEN in 72%, loss of 9p21 in 68%, and centromere loss of chromosome 9 in 44%. All four tested markers were abnormal.\n\nImmunohistochemical analysis showed moderate proliferation index with 5% of tumor cells staining. MGMT expression was negative in 20% of tumor cells. EGFR wild-type was positive (3+ in 90%), and EGFR variant VIII was positive (2+ in 30%). PTEN protein expression was intact (3+ in 90%). Phosphorylated S6 was positive (2+ in 40%), phosphorylated AKT was positive (2+ in 80%), and phosphorylated MAPK was positive (3+ in 30%).\n\nAll specimens were evaluated personally and findings were confirmed."} +{"pid": "TCGA-BW-A5NP", "report": "The specimen is a right trisegment of liver weighing 1,840 grams and measuring 23 x 15 x 10 cm. The surface is purple tan with focal hemorrhage and contains a large lobulated area covering approximately half of the surface. A well-circumscribed pink yellow mass measuring 15 x 13.5 x 9 cm is present, abutting the capsule and located within 1 cm of the inked surgical margin. The surrounding liver tissue appears yellow tan to pink red. Eight representative sections are submitted, including cassettes for uninvolved parenchyma, surgical margin, and tumor. A portion of tissue is reserved for research, and gross photographs have been taken.\n\nA separate portal lymph node specimen is received as a firm pink nodule measuring 1.5 x 1 x 1 cm. It is sectioned and submitted entirely in one cassette.\n\nThe gallbladder measures 7 x 2.5 x 2.5 cm, with a gray green serosa and dark green thick bile in the lumen. No calculi are identified. The wall thickness is 0.2 cm, and the mucosa appears dark green and granular. The cystic duct is dilated at 0.7 cm in diameter and does not contain calculi. An adjacent 0.6 cm gray tan node is present. Three representative sections are submitted.\n\nThe left adrenal gland is received as a moderately firm mass weighing 68 grams and measuring 5 x 5 x 4 cm. A small amount of adipose tissue is attached. Sectioning reveals a soft pink white lobulated mass with a thin rim of residual adrenal tissue up to 0.4 cm thick. Surgical margins are marked with black dye, and three sections are submitted across two cassettes. Gross photographs are also taken.\n\nMicroscopic evaluation shows a poorly differentiated cellular proliferation involving the liver and adrenal gland. The primary lesion is unifocal and confined to the liver without invasion of adjacent structures. Microvascular invasion is present, and the closest margin is 1 cm from invasive cells. One regional lymph node is examined and found to be uninvolved. Additional findings include chronic hepatitis with fibrous portal expansion (Ishak score 3/6), mild lobular and portal inflammation, and mild macrovesicular steatosis involving 5\u201310% of the liver. Trichrome staining highlights fibrous changes in most portal areas with occasional bridging.\n\nStaging includes pT2, pN0, and pM1 categories."} +{"pid": "TCGA-WB-A81A", "report": "The specimen received following adrenalectomy weighs 29g after removal of adipose tissue and measures 7x2.5x3 cm. A central nodule measuring 3 cm in its longest dimension is identified, well-circumscribed, with a buff-colored appearance and areas of hemorrhagic change. The surrounding peri-adrenal tissue exhibits a micro-nodular pattern.\n\nMicroscopic examination reveals a monomorphic cellular proliferation arranged in trabeculae or nests (zellballen pattern). The cells are densely packed, with basophilic cytoplasm that appears finely granular. Nuclei are uniform in size, round in shape, with fine chromatin and inconspicuous nucleoli. There is no significant presence of spindle-shaped cells or mitotic figures. The lesion is encapsulated by a thin and partially interrupted capsule, without evidence of capsular invasion, vascular invasion, necrosis, or infiltration into adjacent adrenal fat.\n\nImmunohistochemical staining demonstrates positivity for chromogranin in the tumor cells. The sustentacular cell network is preserved, as highlighted by S100 staining.\n\nHistological features indicate a well-demarcated, cellular neoplasm arising from the adrenal medulla. Assessment of prognostic parameters yields a PASS score of 4, attributed to high cellularity and architectural monotony. Adrenal cortical architecture at the periphery shows nodular changes without evidence of hyperplasia in the glomerulosa or medullary regions."} +{"pid": "TCGA-DD-AADU", "report": "The specimen consists of a right hemihepatectomy and cholecystectomy. The liver measures 17.5 x 11.5 x 9.0 cm and weighs 647.0 grams. The gallbladder is 10.3 cm in length, with a diameter of 4.2 cm and wall thickness of 0.4 cm. Within the liver, a large round mass measuring 4.7 x 4.5 x 5.0 cm is identified; it has a yellow to green, solid, and firm cut surface without necrosis. A second smaller multinodular mass measuring 1.3 x 0.9 x 0.5 cm is also present, with a yellowish tan, solid, and firm appearance. Both masses are well-defined. The resection margin is free of involvement with a safety margin of 0.3 cm. A satellite nodule is noted. The remaining liver parenchyma shows pre-cirrhotic changes (stage 3). In the gallbladder, multiple polyps are present along with a stone measuring 0.7 x 0.6 x 0.6 cm.\n\nMicroscopic examination reveals a trabecular growth pattern with hepatic-type cells. The worst differentiation is grade III, while the major differentiation is grade II. Fatty change is present in 10\u201330% of cells. A fibrous capsule is observed without capsular infiltration. Septum formation is present. There is no evidence of surgical margin invasion, serosal invasion, or portal vein invasion. Microvessel invasion is present. The presence of intrahepatic metastasis could not be determined. Multiple distinct nodules are identified, suggesting multicentric occurrence.\n\nSections from the main tumor mass (5 blocks), separate nodule (1 block), liver parenchyma (2 blocks), resection margin (1 block), gallbladder (1 block), and lymph node (1 block) were submitted for analysis.\n\nThe pericystic lymph node biopsy shows reactive hyperplasia (0 out of 1 examined). The gallbladder specimen exhibits autolysis, cholesterol polyps, and cholelithiasis."} +{"pid": "TCGA-DD-AADG", "report": "The specimen consists of a segment of liver tissue measuring 16.0 x 13.0 x 6.5 cm and weighing 580.5 grams. Two distinct masses were identified within the liver. The first mass, located in segments 6, 7, and 8, measures 7.0 x 6.0 x 5.0 cm. The second, smaller mass is found in segment 6 and measures 2.0 x 1.5 x 1.5 cm. Both lesions are well-defined and multinodular in appearance. The cut surface of the larger mass is described as yellowish tan with granular texture and 30% necrosis. No gross involvement of the resection margin was observed, with a safety margin of 1.5 cm. The remaining liver parenchyma shows signs of cirrhosis.\n\nA gallbladder specimen was also obtained, measuring 11.0 cm in length, 4.5 cm in diameter, and with a wall thickness of 0.2 cm. The mucosal surface appears green and velvety with diffuse necrosis, while the serosal surface is smooth and brown.\n\nAdditionally, three small pieces labeled \"parasite\" were submitted for analysis. These measured 0.8 x 0.6 x 0.3 cm in total and were entirely processed. Representative sections from the larger mass and surrounding liver tissue (four blocks), the smaller mass and surrounding liver tissue (one block), non-tumorous liver tissue (two blocks), the resection margin (one block), the \"parasite\"-labeled tissue (one block), and the gallbladder along with the cystic duct resection margin (one block) were examined microscopically.\n\nMicroscopic evaluation of the main mass in segments 6, 7, and 8 reveals a trabecular growth pattern with a mix of hepatic and clear cell morphology. The tumor cells show a range of differentiation, with the worst being grade III/IV and the major component being grade II/IV. No fatty change, fibrous capsule formation, capsular infiltration, or septum formation was observed. Similarly, there was no evidence of surgical resection margin invasion, serosal invasion, or microvessel invasion. Intrahepatic metastasis was not present, but multicentric occurrence was noted.\n\nThe smaller lesion in segment 6 also displays a trabecular histologic type and a combination of hepatic and clear cell types. The degree of differentiation is more uniform here, with both worst and major grades being III/IV. As with the larger lesion, no fatty change, fibrous capsule formation, capsular infiltration, or septum formation was seen.\n\nChronic hepatitis associated with HBV was identified in the non-tumor liver tissue. The lobular inflammation was minimal, and the portoperiportal inflammation was mild. Fibrosis was staged as septal. There was no evidence of dysplastic nodule, ductal epithelial dysplasia, or other significant liver disease. However, Clonorchis sinensis infestation was detected in the submitted \"parasite\" tissue."} +{"pid": "TCGA-DJ-A4V2", "report": "The right thyroid and isthmus specimen measured 5 x 3 x 1.5 cm for the right lobe and 1.2 x 1.0 x 0.5 cm for the isthmus, with a total weight of 16.5 g. Orientation was indicated by a long stitch at the upper pole and a short stitch at the isthmus. The anterior surface was inked blue and the posterior black. Serial sectioning revealed a well-circumscribed nodule located in the right lobe, extending from the upper to mid-portion. The nodule measured 3.0 x 2.5 x 1.5 cm and was partially encapsulated with focal areas of necrosis. All tissue was submitted for analysis.\n\nMicroscopic evaluation of the right lobe showed well-differentiated cells arranged in papillary structures. Psammoma bodies were present. No mitotic figures or tumor necrosis were identified. Blood vessel invasion and extrathyroid extension were not observed. Surgical margins were free of abnormal cells. The tumor was unifocal, and no additional nodules were found away from the primary lesion. The surrounding non-neoplastic thyroid tissue exhibited chronic inflammation. No parathyroid glands were identified in the specimen. One lymph node was examined and showed benign features without evidence of involvement.\n\nThe left thyroid and isthmus specimen measured 4 x 2 x 0.8 cm for the left lobe and 1.0 x 1.0 x 0.5 cm for the isthmus, weighing 5 g. Orientation was provided by a long stitch at the upper pole and a short stitch at the isthmus. The anterior surface was inked blue and the posterior black. Sectioning revealed a tan/red cut surface without significant abnormalities. All tissue was submitted for analysis.\n\nMicroscopic examination of the left lobe showed changes consistent with nodular hyperplasia. No parathyroid gland was identified in this specimen."} +{"pid": "TCGA-GM-A2DL", "report": "A segmental mastectomy specimen from the left breast measured 7.0 x 7.0 x 4.0 cm and included a skin ellipse measuring 2.8 x 1.2 cm. On serial sectioning from medial to lateral, an ill-defined white-firm lesion was identified, measuring 0.8 x 0.6 x 0.6 cm and located approximately 0.7 cm from the deep margin. Microscopic evaluation revealed invasive carcinoma measuring 1.2 cm in greatest dimension. The tumor focally extended to within 5.0 mm of the deep margin but did not involve any other margins. All surgical margins were free of tumor involvement.\n\nIn addition to the invasive component, there was evidence of intraductal proliferation comprising less than 5% of the tumor area. This intraductal component exhibited solid growth pattern with necrosis. No lymphatic or vascular invasion was identified.\n\nTwo sentinel lymph nodes from the left axilla were evaluated. The first lymph node measured 0.8 x 0.6 x 0.4 cm and was completely submitted for examination. The second lymph node measured 2.0 x 1.0 x 0.6 cm and was bisected with one portion submitted for analysis. Both lymph nodes were devoid of tumor involvement based on histologic evaluation and touch imprints.\n\nAdditional excision specimens from the second deep, medial, superior, and inferior margins were submitted. The second deep margin consisted of skeletal muscle measuring 3.0 x 1.5 x 0.5 cm, with the true margin inked black and entirely submitted. All additional margin specimens showed no presence of tumor.\n\nImmunohistochemical staining performed on tissue sections from both sentinel lymph nodes was negative for cytokeratins. Staining on block C1 of the primary tumor demonstrated positivity for estrogen receptor (100%), progesterone receptor (90%), and high Ki-67 expression (>35%) in approximately 50% of cells. HER-2/neu staining showed no overexpression.\n\nAncillary studies including molecular pathologic assays were requested on block C1 and will be reported separately. The current report includes all available findings at the time of documentation."} +{"pid": "TCGA-UB-A7MA", "report": "A 739.5-gram left hepatic lobe specimen shows a multinodular, firm, white-tan mass measuring 12.1 cm in maximum dimension. The mass extends to the capsule, which is distorted, and is located 0.5 cm from the resection margin. Multiple smaller adjacent nodules are present, with one nodule identified microscopically at the margin. Histologic evaluation reveals a moderately differentiated neoplasm with areas of trabecular architecture composed of larger cells with eosinophilic or fatty cytoplasm. Other regions demonstrate discrete glands within sclerotic stroma, with luminal necrosis noted. Immunohistochemical staining is patchy for arginase, strongly positive for CK19, and negative for mucicarmine, chromogranin, and synaptophysin. MIB1 staining shows a high proliferative index, with up to 40\u201350% of cells demonstrating nuclear positivity. Vascular invasion is present in both large and small vessels (B2, B3, B8). No tumor is identified at the bile duct margin. Three lymph nodes from the hepatic artery, anterior common hepatic artery, and portacaval regions are all free of malignancy. The non-neoplastic liver parenchyma shows no significant abnormalities, though histochemical staining reveals 2+ iron deposition in hepatocytes and Kupffer cells. Based on histomorphology and immunoprofile, the neoplasm exhibits divergent differentiation with both hepatocellular and glandular features. The overall extent of disease exceeds 12 cm when all involved foci are considered, with tumor abutting the hepatic capsule and extending to a surgical margin."} +{"pid": "TCGA-49-AAQV", "report": "A lymph node excised at L8, along with associated fibroadipose tissue, showed no evidence of tumor involvement. A left lower lobe lobectomy specimen was examined, revealing a 2.3 cm lesion. Histologic evaluation demonstrated a mixture of growth patterns, with one component accounting for 70% and another for 30%. The lesion was classified as histologic grade G3, indicating poor differentiation. Eleven lymph nodes were assessed in total; metastatic involvement was identified in one of these nodes. The primary tumor was staged as pT1b based on its size (>2 cm but \u22643 cm). Regional lymph node staging was determined as pN1, reflecting metastasis in ipsilateral peribronchial, hilar, or intrapulmonary nodes. Distant metastasis could not be assessed (pMx). Surgical margins were free of invasive disease. Large vessel invasion was not observed. Small vessel invasion could not be definitively determined. Additional lymph nodes from stations 6, 7, and L10 were all negative for tumor involvement.\n\nMolecular testing revealed the presence of a specific mutation in exon 19 of a tyrosine kinase receptor gene. This mutation has been associated with responsiveness to tyrosine kinase inhibitor therapies in certain lung cancers. The assay used for detection analyzed key exons of the receptor\u2019s kinase domain using PCR amplification followed by bidirectional sequencing. The analytical sensitivity allowed detection of mutant alleles present in at least 20% of cells or heterozygous mutations in samples containing at least 40% tumor cells.\n\nThe surgical specimen included representative sections of the bronchial margin, vascular margins, tumor relation to pleura and vessels, surgical resection margin, subpleural nodules, and uninvolved lung parenchyma. No other masses or lesions were identified in the lung tissue. All lymph nodes examined outside of the primary tumor site were negative for tumor involvement."} +{"pid": "TCGA-GC-A3RC", "report": "The surgical specimen includes left and right ureters, both showing chronic inflammation without dysplastic changes. The appendix appears anatomically normal. The bladder specimen measures 12.6 x 7.2 x 4.7 cm and contains a firm, friable mass measuring 5.7 x 4.4 cm located on the anterior mucosa. The mass invades the bladder wall and approaches within 0.3 cm of the anterior perivesical margin. Microscopic evaluation shows extension to the ureteral orifices bilaterally. No gross involvement of the prostate is noted, and histologic examination reveals no invasion into the prostate or seminal vesicles. Lymphovascular invasion is present.\n\nResection margins are free of tumor except for the anterior margin, where the tumor comes within 0.3 cm. A fixed specimen includes tissue fragments from various regions including the apex, trigone, posterior wall, dome, ureteral orifices, and vas deferens with seminal vesicles. Prostate tissue is sampled from multiple quadrants.\n\nLymph node evaluation includes right pelvic lymph nodes (11 total, ranging from 0.5 to 4.2 cm; 2 sampled) and left pelvic lymph nodes (7 total, ranging from 0.8 to 2.7 cm; 2 sampled). All lymph nodes evaluated show no evidence of metastasis.\n\nAdditional specimens include a 0.7 x 0.5 x 0.2 cm tissue fragment from the right ureter after frozen section and a 4.2 x 0.5 cm appendix with attached fat. No gross lesions are identified in these specimens.\n\nA separate specimen labeled \"fixed specimen\" contains a yellow-tan soft tissue fragment (2.1 x 1.5 cm) and a linear tissue fragment (3.5 x 0.3 cm), both submitted entirely for analysis."} +{"pid": "TCGA-FT-A3EE", "report": "A segment of right distal ureteral margin was submitted for evaluation and found to be negative for invasive disease. Similarly, the left distal ureteral margin showed no evidence of malignancy. The urethral specimen revealed an invasive high-grade lesion involving the cauterized resection margin, with lymphatic invasion noted. Four lymph nodes from the right pelvic region were examined, all without evidence of tumor involvement.\n\nThe bladder specimen, obtained via radical cystectomy along with hysterectomy and bilateral salpingo-oophorectomy, measured 14 x 12 x 4 cm. A tan-gray, ill-defined mass was identified in the region of the urethra, measuring 5 x 3 x 2.2 cm. This mass extended into the perivesical adipose tissue, infiltrated the bladder neck, and involved the vaginal wall and mucosa. The tumor exhibited lymphovascular and perineural invasion. It was present at the circumferential resection margin in the bladder neck area but other margins were free of tumor involvement.\n\nSerial sectioning demonstrated that the tumor extended submucosally from the right ureteral orifice to the distal urethral soft tissue. The mass measured up to 4 x 3.5 x 2.5 cm in the urethral region and came within 0.4 cm of the inked perivesical fat margin. Additional specimens including the uterus, ovaries, and fallopian tubes showed no significant pathology apart from cystic endometrial atrophy.\n\nOn lymph node assessment, four nodes from the left pelvic region were also negative for tumor involvement. The tumor was histologically classified as a high-grade urothelial-type carcinoma, solid and ulcerated in configuration. Pathologic staging indicated primary tumor extension beyond the bladder into adjacent structures (pT4a), with no regional lymph node involvement (pN0) based on examination of eight nodes. No distant metastases were identified.\n\nGrossly, the tumor was centered in the trigone, right lateral wall, and extended to the bladder neck, urethra, and vaginal wall. The largest dimension was 5 cm, with additional dimensions measuring 3 x 2.2 cm. Microscopic evaluation confirmed tumor invasion into perivesical fat, vagina, and urethra, with vascular and neural invasion present."} +{"pid": "TCGA-AC-A3W6", "report": "The specimen consists of a right breast mastectomy specimen weighing 281.8 grams, measuring 20.0 x 11.5 x 3.8 cm, partially surfaced with a 15.8 x 7.5 cm ellipse of skin and an inverted nipple. A suture at the lateral edge indicates the sentinel lymph node. The deep margin is inked. On sectioning, a 5.3 x 3.5 x 3.3 cm ill-defined gray-white mass is identified centrally beneath the nipple, approaching the skin surface at the nipple. The mass comes within 0.7 cm of the inked deep margin. No discrete axillary tail is identified.\n\nFocal nodularity is noted at the medial and lateral borders; however, no distinct invasive mass is present in these areas. The closest nodule is within 1.5 cm of the inked margin. Adjacent to the sentinel marker is a 2.0 cm lymph node. Two additional lymph nodes are identified in the surrounding tissue, measuring 0.5 cm and 1.5 cm.\n\nHistologic evaluation includes architectural, nuclear, and mitotic scoring. Architectural score is 3 of 3, nuclear score is 2 of 3, and mitotic score is 1 of 3, resulting in a total score of 6 of 9 (grade 2). The lesion involves sections of the nipple but does not extend into the overlying epidermis or dermal lymphatics. It does not involve the inked deep margin of excision.\n\nSentinel lymph node assessment reveals three lymph nodes, all involved by tumor. The largest focus measures 1 cm. Extracapsular extension is present and confirmed with pancytokeratin staining.\n\nStaging is assigned as T3N1MX based on available data. Immunohistochemical studies from prior biopsy indicated hormone receptor positivity; repeat testing was not performed unless requested."} +{"pid": "TCGA-CN-6016", "report": "A total of seventeen specimens were evaluated. Lymph nodes from various neck regions were examined, including neck level 1A (4 lymph nodes), right neck level 1B (4 lymph nodes), left neck level 1B (5 lymph nodes), right neck zones 2, 3, and 4 (29 lymph nodes), and left neck zones 2A, 2B, 3A, and 4 (33 lymph nodes). Of these, one lymph node from the left neck zone 4 showed involvement with cellular features consistent with squamous cell carcinoma, measuring 1.4 cm, and demonstrated extracapsular extension. All other lymph nodes across all levels were unremarkable.\n\nExcision specimens from the mandible marrow margins (left and right), posterior tongue margins (right and left), deep tongue margins (right and left), mylohyoid muscle, and floor of mouth (right) showed no abnormal cellular features or involvement. The left floor of mouth excision revealed an area of interest during intraoperative consultation, which was further analyzed microscopically and confirmed to have findings consistent with squamous cell carcinoma.\n\nThe anterior mandibular composite with hemiglossectomy specimen contained a firm, white lesion measuring 4.7 x 3.3 x 1.5 cm. Histological evaluation revealed moderately differentiated features with keratinization, along with vascular and perineural invasion. The lesion extended into the extrinsic muscles of the tongue but did not involve bone. All surgical margins were free of abnormal cells. \n\nChronic changes were noted in submandibular gland tissue from both sides, characterized by periductal fibrosis and atrophy. No significant findings were identified in the parotid tissue. \n\nPathologic staging was determined as pT4a based on tumor size and local extension, and pN1 due to regional lymph node involvement. Distant metastasis could not be assessed. Additional molecular testing and immunohistochemical analyses were performed for diagnostic characterization. All surgical margins were negative."} +{"pid": "TCGA-HC-7819", "report": "The specimen consists of a radical prostatectomy with bilateral seminal vesicles, weighing 40 grams and measuring 5.1 x 5.0 x 3.8 cm. The right side is inked blue and the left side black. A smooth pale yellow area of discoloration is observed at the distal level on the posterior aspect, measuring 1.5x1.1x1.1 cm, and it abuts the inked posterior margin. No other gross abnormalities are identified. The seminal vesicles are unremarkable, measuring 4.5 x 2.5 x 0.6 cm in aggregate.\n\nHistologic evaluation reveals a lesion with a Gleason score of 8/10, composed of primary and secondary patterns each graded as 4/5. Perineural space invasion is present. Lymphovascular space invasion is not identified. There is no involvement of the seminal vesicles. High-grade prostatic intraepithelial neoplasia is focally present.\n\nSurgical margin assessment shows the inferior/apical and proximal/bladder margins to be negative. The inked prostatic margin is positive, with additional areas of intracapsular invasion noted. Sections 7, 9, and 11 demonstrate capsular invasion, with section 7 showing carcinoma transecting the inked surgical margin at the distal left posterior region.\n\nLymph node evaluation includes three (3) right pelvic lymph nodes, none of which show evidence of metastatic involvement. All lymph nodes are submitted for analysis.\n\nThe TNM classification assigned is pT2c, NO. The lesion is prevalent, with representative examples best seen in sections A6 through A11. Perineural invasion is most evident in sections 6, 7, and 11. Capsular invasion is also prominent in sections 7, 9, and 11.\n\nRepresentative sections include apical margin, vesical margin, multiple lateral and posterior levels, and origins and representative portions of the seminal vesicles. Two cassettes are submitted for research purposes. The lymph node specimen consists of adipose tissue containing three nodes, all submitted for histologic evaluation."} +{"pid": "TCGA-XF-AAMH", "report": "The specimen consisted of a cystoprostatectomy with overall measurements of 14 x 10.5 x 4.5 cm. The right distal ureter measured 6.4 cm in length and 0.7 cm in circumference, while the left distal ureter measured 3.0 cm in length and 1.7 cm in circumference, appearing slightly ragged and erythematous. The bladder measured 8 x 6 cm and was 1.7 cm in thickness. A pink-tan, fungating lesion measuring 4.5 x 3.4 cm was identified in the left posterior wall, with a thickness of 2.6 cm and extension into surrounding perivesical fatty tissue. The lesion approached the ureterovesical junction but did not appear to invade the left ureter. The remaining bladder mucosa was pink-tan and slightly erythematous. \n\nThe prostate measured 4 x 3 x 2.7 cm and contained a hypertrophic nodule in the left lobe measuring 2.5 cm in greatest dimension. The prostatic urethra measured 2.2 cm in length and 1.3 cm in circumference, with the verumontanum measuring 0.5 x 0.4 x 0.4 cm. The left seminal vesicle measured 4.7 x 2.2 cm, and the right measured 4.5 x 1.6 cm.\n\nMicroscopic evaluation showed extensive invasion through the bladder wall. There was multifocal lymphovascular invasion involving subperourethral, periureteral, and areas adjacent to the seminal vesicles. Invasion of the seminal vesicle wall was also noted. The prostate demonstrated benign stromal and glandular hyperplasia. No tumor was identified in the right distal ureter, urethral margin, left or right proximal ureters, aortic bifurcation lymph nodes, right node of Cloquet, or right obturator/hypogastric lymph nodes. However, involvement was found in four of 28 left obturator/hypogastric lymph nodes. No tumor was seen in the frozen sections of the right common iliac lymph nodes, though only one lymph node was identified. \n\nExtensive vascular space invasion was noted on the left side of the specimen as well as in the prostatic urethra. The left distal ureter showed hydroureter with chronic inflammation and atypical hyperplasia, while the right distal ureter showed benign urothelium."} +{"pid": "TCGA-HT-A74O", "report": "The pathology report describes a lesion from the right frontal lobe. Histologic evaluation reveals a markedly hypercellular, diffusely infiltrating glial neoplasm. The tumor cells exhibit features resembling fibrillary astrocytes with moderate nuclear atypia. Mitotic activity is present, with five mitoses identified in the first 10 high-power fields examined. No microvascular proliferation or confluent tumor necrosis is observed, although an area of infarct-like parenchymal necrosis is noted. There is evidence of definite oligodendroglial differentiation.\n\nImmunohistochemical staining demonstrates that the neoplastic cells are diffusely positive for p53 but negative for IDH1. Evaluation of proliferative activity using the MIB-1 antibody shows numerous scattered reactive cells, with a labeling index of 9.1% calculated in the most proliferative areas."} +{"pid": "TCGA-EJ-5506", "report": "The patient is a male with a history of a PSA value of 7.2 and a prior biopsy showing high-grade prostatic malignancy in both lobes. A radical prostatectomy was performed. Examination of the right pelvic lymph nodes revealed one out of four involved by a metastatic focus measuring approximately 0.2 millimeters in the subcapsular sinus, without extracapsular extension. No involvement was found in the left pelvic lymph nodes.\n\nThe primary lesion involves both the right and left lobes of the prostate, with a maximum nodule size of 2.0 cm, representing 30% of the total prostate volume. Histologic evaluation showed a high-grade acinar-type tumor with extensive infiltration into bilateral seminal vesicles. The Gleason score was determined to be 5+3=8, with a significant component of Gleason grades 4 and 5 accounting for 50\u201360% of the tumor mass. Abundant perineural invasion and angiolymphatic invasion were identified. High-grade intraepithelial neoplasia was also present focally.\n\nMultifocal and extensive extracapsular extension was observed at multiple sites, including areas adjacent to the seminal vesicles, anterior left base, posterior apex and base on both sides, and the posterior left mid zone. Tumor cells approached several pericapsular surgical margins and one apical margin, although no residual tumor was found at any inked resection margin.\n\nPathologic staging was determined as pT3b with regional lymph node involvement (pN1), and histologic grade was classified as G3\u20134. Non-neoplastic changes included nodular hyperplasia. A small focus of similar malignancy was noted in soft tissue near the right posterior base, though its relation to a surgical margin remains uncertain. Close clinical follow-up, including serial PSA monitoring, is advised."} +{"pid": "TCGA-HD-7832", "report": "The resected specimen includes the anterior mandible, tongue, inferior oral cavity, and attached soft tissue. A mass measuring 3.7 cm (anterior to posterior) x 3.4 cm (superior to inferior) x 5.3 cm (left to right) is present. The mass is located within the right lateral floor of mouth region and extends to within 0.5 cm of the posterior/deep margin, 0.3 cm of the inferior margin, and 1.5 cm of the left soft tissue margin. Grossly, the mass erodes through the anterior mandible into subcutaneous soft tissue but does not involve the anterior tongue. All surgical margins are free of involvement. The posterior, inferior, and right soft tissue margins are 0.5 cm, 0.8 cm, and 0.5 cm away from the mass, respectively. No tumor is identified in the right or left mandibular or soft tissue margins.\n\nLymph node evaluation includes right level 1A/1B (5 nodes), right level 2A/3 (14 nodes), left level 1B (6 nodes), left level 2A (5 nodes), and left level 3 (5 nodes). All lymph nodes examined are negative for tumor involvement.\n\nPathologic staging is pT4a pNO. The primary lesion shows moderately-differentiated keratinizing features with invasion through the mandible into subcutaneous soft tissue. No additional masses or abnormal areas are identified in the specimen."} +{"pid": "TCGA-TQ-A7RM", "report": "The specimen consists of multiple irregular fragments of soft, blackish and brown tissue, with a total size of 5.5 x 3.0 x 0.3 cm and a weight of 4.0 g. Microscopic examination reveals a glial neoplasm with variable cellularity, including both hypercellular and moderately cellular regions. The stroma is predominantly myxoid with frequent microcystic degeneration. Tumor cells are rounded with delicate cytoplasmic processes and often display clear perinuclear halos. Nuclear features include moderate atypia, hyperchromasia, and pleomorphism. Rare cells exhibit a gangliocytic appearance, and occasional gemistocytes are present. The mitotic count is 7 per 10 high-power fields, with some atypical forms noted. Apoptosis is common. Areas of microvascular proliferation are present, but no tumor necrosis is identified. Immunohistochemical staining is positive for GFAP and vimentin, negative for NEU-C and synaptophysin, and shows positivity for Ki-67."} +{"pid": "TCGA-CJ-5681", "report": "The specimen includes a left kidney measuring 15.0 x 10.0 x 5.5 cm with significant distortion due to a large, well-circumscribed mass located in the mid-pole. The mass measures 9.0 x 7.7 x 5.5 cm and has a variegated red-tan appearance with extensive central hemorrhage and necrosis. Microscopic evaluation reveals nuclear grade 3 morphology with involvement of the renal sinus and extension into the renal vein. Lymphovascular invasion is present. The resection margin of the soft tissue is free of tumor.\n\nMultiple satellite nodules are identified within the renal cortex and sinus, some of which may extend into the pelvic-calyceal system. No lymph nodes are identified at the hilum. A segment of adrenal gland (6.5 x 2.0 x 1.0 cm) is involved, showing infiltration by cells with similar morphology. The renal artery and ureter segments appear unremarkable. The tumor does not grossly extend beyond Gerota\u2019s fascia. A thrombus is present within the renal vein, and the resection margin involving this region contains tumor cells. Portions of the specimen were submitted for further specialized studies."} +{"pid": "TCGA-VQ-A91K", "report": "The specimen involves the stomach (antrum) and includes a duodenal margin that is uninvolved. The gallbladder shows changes consistent with chronic cholecystitis. A gastric wall nodule is present, interpreted as a lymph node without atypia. The main lesion measures 2.8 cm at its largest dimension and is located in the pyloric region with extension into the duodenum. The tumor infiltrates through the full thickness of the gastric wall and extends into perigastric fat and peritoneum. There is moderate stromal desmoplasia and a moderate intratumoral lymphocytic infiltrate. Lymphatic invasion is present; however, no venous or perineural invasion is identified. Both proximal and distal surgical margins are free of neoplastic involvement. The non-tumor gastric mucosa demonstrates moderate chronic gastritis with low-grade activity. In the body of the stomach, there are areas of atrophic gastritis with mild submucosal fibrosis. The spleen exhibits hyaline perisplenitis, and the omentum is unremarkable without evidence of tumor involvement. Lymph node dissection includes right paracardial (0/6 involved), lesser curvature (2/5 involved), and short gastric regions; however, no tumor involvement is noted in all other regions assessed."} +{"pid": "TCGA-HG-A9SC", "report": "The surgical specimens include lymph nodes from the left and right pelvic regions, as well as para-aortic region, and a hysterectomy specimen with bilateral salpingo-oophorectomy. The lymph nodes in all regions were negative for malignant involvement. The left pelvic lymph node dissection included six nodes, the right pelvic dissection included twelve nodes, and three para-aortic nodes were also examined, all without evidence of tumor.\n\nGross examination of the hysterectomy specimen revealed a distorted uterus with a large mass located in the endocervical region. The mass measured approximately 6 cm in its greatest dimension and extended circumferentially around the endocervical wall. It was found to be less than 0.1 mm from the parametrial margin on the left and anterior aspects. The tumor invaded into the parametrium and had a depth of invasion measuring 2 cm. There was also evidence of horizontal spread measuring 6 cm. Venous and lymphatic vessel invasion was identified. Margins were otherwise uninvolved by invasive carcinoma.\n\nMicroscopic evaluation showed poorly differentiated carcinoma with squamous features. Tumor cells displayed significant cytoplasmic clearing and occasional intracytoplasmic mucin droplets, confirmed by mucin staining. A moderate inflammatory infiltrate composed primarily of eosinophils and plasma cells was present in the stroma. Immunohistochemical staining showed positivity for multiple markers including cytokeratin AE1/3, cytokeratin 5/6, p63, CAM 5.2, p40, p16, and mucin in various blocks.\n\nAdditional findings in the gynecologic tract included an endometrial polyp, endometriosis involving both ovaries and the right fallopian tube, endomyometriosis in the right ovary, chronic salpingitis in the left fallopian tube, and a cystic corpus luteum in the left ovary. No other metastatic sites or non-lymph node involvement were identified.\n\nPathologic staging based on AJCC 7th edition criteria was determined as pT2b N0 Mx. All surgical specimens were processed and evaluated using standard protocols with appropriate controls. Special stains and immunohistochemical studies were performed in accordance with laboratory guidelines."} +{"pid": "TCGA-D5-6932", "report": "The histopathological examination of the resected colon and surrounding tissues revealed an 82 cm length of large intestine, along with a 37 cm segment of small intestine, a 6.5 cm appendix, and omentum measuring 30 x 13 x 3 cm. Macroscopically, an ulceration measuring 2 x 1.9 x 0.3 cm was observed in the mucosa, involving approximately 20% of the intestinal circumference. This lesion was located 18.9 cm from the proximal excision margin, 6.4 cm from the distal excision margin, and 15.8 cm from the Bauhin's valve. Another lesion measuring 2.4 x 2.2 x 0.8 cm was identified, encompassing about 40% of the intestinal circumference, located 69.8 cm from the proximal boundary and 8.8 cm from the distal boundary. The distance between the two lesions was 49.3 cm.\n\nMicroscopic analysis showed tubulopapillary architecture with neoplastic cells present in two distinct areas. There was evidence of infiltration into the pericolic adipose tissue. Margins of resection were free of neoplastic cells. Outside the affected regions, there were findings consistent with a tubulopapillary lesion with low-grade atypia. Reactive changes were noted in the lymph nodes; no malignant involvement was detected. Five lymph nodes were examined and showed reactive inflammation without evidence of metastasis. Staging parameters indicated a depth of invasion corresponding to pT3, with no lymph node involvement (pN0)."} +{"pid": "TCGA-2A-A8VO", "report": "The prostate specimen measured 3.5cm from apex to base, 4cm transversely, and 3.5cm in anterior-posterior dimension, with a total weight of 45.5 grams. The right and left seminal vesicles measured 6 x 1.3 cm and 4 x 1.5 cm, respectively. Serial sectioning of the prostate revealed involvement at multiple sites including the right anterior, left posterior, and left anterior regions, with the dominant mass extending from the apex to base across the anterior region. Perineural invasion was identified. No vascular invasion or tumor multicentricity was noted. High grade intraepithelial changes were present. There was evidence of extracapsular extension at the right and midline anterior aspects. Invasion of the bladder neck was observed, with tumor also present at the bladder neck margin and anterior basal margin. The remainder of the prostate showed benign nodular hyperplasia. The periprostatic fat specimen consisted of benign fibrovascular tissue. A biopsy from the anterior rectal wall margin near the apex contained benign adipose tissue and a single benign lymph node. Based on AJCC 1997 staging criteria, the findings indicated involvement of adjacent structures such as the bladder neck."} +{"pid": "TCGA-KM-8441", "report": "A right kidney partial nephrectomy specimen included 10 distinct masses. Tumor sizes ranged from 2.0 x 1.4 cm to 6.7 x 5.5 x 2.5 cm. Gross examination revealed a variety of cut surfaces, including variegated, maroon-tan, yellow-pink, red-tan, and focally hemorrhagic appearances. Some tumors were well-circumscribed with areas of hemorrhage, while others were more homogeneous. Several tumors showed partial encapsulation or attached adipose tissue. The majority of specimens had approximately 40\u201350% tissue procurement for analysis, with the remaining portions submitted in entirety for histologic evaluation. All tumors were present in the right kidney and were submitted for permanent processing following formalin fixation. No lymph nodes or other tissue types were identified in the specimens. Clinical history was significant for multifocal renal neoplasia and a family history of pneumothorax, with prior genetic testing not supportive of Birt-Hogg-Dub\u00e9 syndrome."} +{"pid": "TCGA-A2-A4RW", "report": "The specimen consists of a right breast simple mastectomy measuring 23.5 x 21.5 x 3.7 cm and weighing 650 grams. A skin ellipse including the nipple measures 23.5 x 12.5 cm. Sectioning reveals a central area composed of tan fibrous and yellow fatty tissue, with a surrounding perimeter of bland yellow fatty tissue. In the 10 o\u2019clock region of the breast, a firm mass is identified measuring 4.0 cm (medial-lateral) x 3.5 cm (superior-inferior) x 2.1 cm (anterior-posterior). A small rim of fatty tissue is present deep to the lesion, with at least 0.5 cm of surrounding tissue noted. The lesion does not grossly involve the skin. Margins are submitted, including sections from the deep margin, lateral aspect with skin, medial aspect, and superficial to deep planes. A bowtie-shaped clip is identified within the lesion, and additional sections from various quadrants around the lesion are submitted.\n\nA right axillary lymph node dissection is also included, consisting of two portions of yellow-red fatty tissue measuring 9 x 7 x 2.5 cm. Multiple lymph nodes are identified, including one measuring 2.5 cm with a rod-shaped metal clip and ill-defined borders. Additional nodes include a second 2.5 cm node, a 1.7 cm node, and others grouped and submitted in multiple blocks. All nodes were examined.\n\nMicroscopic evaluation of the breast tissue shows an invasive component with nuclear grade 2/3, low mitotic index, and tubule formation score of 3, resulting in a total Nottingham score. A pre-invasive component is also present, comprising approximately 30% of the lesion, with rare luminal necrosis. The maximum gross dimension of the tumor is 4 cm. Rare in situ and invasive foci are identified in a random section from the lower outer quadrant. The invasive component is focally located 4 mm from the nearest inked superficial margin and 4 mm from the skin surface. A biopsy site and a bowtie-shaped clip are identified. Lymphovascular invasion is not seen, but perineural invasion is present.\n\nIn the axillary lymph node dissection, all nodes examined show evidence of metastatic involvement, with some demonstrating extension into the perinodal fat. A rod-shaped metal clip is also identified in one node."} +{"pid": "TCGA-BK-A6W3", "report": "The final surgical pathology report describes a resected uterus with bilateral adnexa. The cervix shows transformation zone changes with CIN 1 and CIN 2; CIN 2 is also present at the ectocervical epithelial margin in one block. Within the uterine cavity, there is a polypoid lesion measuring 2.2 x 2.2 x 2.4 cm, arising from the endometrium. Histologically, the lesion is composed of endometrioid-type cells arranged in a predominantly non-solid pattern, with between 5% and 50% solid growth. There is focal increased nuclear grade noted in one block. Adjacent endometrium shows secretory phase changes without hyperplasia.\n\nExamination of the myometrium reveals only probable superficial invasion, involving less than 10% of the myometrial thickness. No vascular invasion is identified. The lower uterine segment is negative for malignancy. Both ovaries and uterine tubes appear unremarkable, with no significant pathological findings. Parametrial tissues are also negative for any abnormality.\n\nGrossly, the uterus measures 10.5 x 5.5 x 5 cm and weighs 142.8 g. The cervix is pale white, measuring 3 x 2.7 cm. Both ovaries contain cystic structures and measure up to 3.2 cm in greatest dimension. Portions of the posterior myometrium adjacent to the polyp were sampled for intraoperative evaluation. Multiple blocks were submitted for microscopic evaluation, including sections from the cervix, endomyometrium, parametrium, ovaries, and uterine tubes.\n\nStaging classification indicates a tumor confined to the endometrium with no definitive myometrial involvement. Microsatellite instability testing has been ordered on one of the blocks. No other significant findings are reported."} +{"pid": "TCGA-A3-3359", "report": "The specimen consists of a left nephrectomy weighing 222 grams, with perinephric adipose tissue present. The overall dimensions of the specimen are 15.1 x 8.5 x 5.1 cm. Resection margins include 2.0 cm of renal artery, 1.0 cm of renal vein, and 5.5 cm of ureter, all appearing grossly patent. After removal of the surrounding tissue, the kidney measures 11.0 x 6.0 x 5.6 cm. The renal cortex appears slightly pale, lobulated, granular, and tan brown, with an indistinct corticomedullary junction. The medulla is tan pink with distinct papillae. The collecting system shows smooth mucosa lining the calyces and pelvis extending into the ureter. On the anterior aspect of the upper pole, there is a 4.0 x 4.0 x 3.6 cm lobulated, tan-gray to yellow nodular lesion with a fleshy, focally hemorrhagic cut surface. The lesion is well-circumscribed and unencapsulated, extending beyond the plane of the kidney but remains completely encased within the renal capsule without gross invasion of surrounding structures. The remaining cortex adjacent to the lesion is up to 0.5 cm thick, with no other significant abnormalities noted. Histologically, the lesion demonstrates nuclear features corresponding to a nuclear grade of 2/3. No lymphovascular space invasion, transcapsular extension, or venous invasion is identified. Surgical margins including soft tissue, ureteral, and vascular margins are free of involvement. No lymph nodes are identified in the resected tissue. Additional findings include interstitial chronic inflammation. Representative sections of the lesion and surrounding tissue, as well as uninvolved parenchyma and margins, are submitted for further analysis."} +{"pid": "TCGA-B0-4696", "report": "The specimen consists of a left nephrectomy specimen containing a large lesion. The lesion is poorly differentiated and exhibits two distinct histological components. One component displays features consistent with chromophobe cell morphology, while the other shows high-grade sarcomatoid differentiation. The tumor measures 17.0 cm in greatest dimension and demonstrates a predominantly solid growth pattern. The chromophobe and sarcomatoid components comprise approximately 40% and 60% of the tumor volume, respectively.\n\nNuclear grading according to the Fuhrman system is grade 4 of 4. Histopathologic grading is classified as G3. Staging is pT3a with no identifiable invasion of the renal vein and all surgical margins free of tumor. The lesion extends through the renal capsule but remains confined within Gerota\u2019s fascia. Regional lymph node and distant metastatic staging are not assessable (NX, MX). \n\nAncillary studies including Hale's colloid iron stain, EMA, and CAM 5.2 were performed and support the morphologic findings. No involvement of the non-neoplastic kidney or adrenal gland is observed."} +{"pid": "TCGA-86-8278", "report": "The specimen consisted of a lobectomy with a tumor located in the left-lower lobe. The tumor measured 3 x 2 x 2 cm and was found to involve the visceral pleura. Microscopic examination revealed mucinous features and moderate differentiation. Three out of three lymph nodes examined showed evidence of metastasis. Immunohistochemical staining was positive for CK7 and TTF1. No other tumor nodules, lymphatic or venous invasion, margin involvement, or neoadjuvant treatment effect were specified. Additional pathologic findings were not reported."} +{"pid": "TCGA-DK-A6B5", "report": "A 66-year-old male with a history of recurrent high-grade disease despite prior BCG treatment underwent surgical resection. Submitted specimens included segments of the left and right ureters, bilateral pelvic and iliac lymph nodes, cystoprostatectomy specimen including bladder, prostate, seminal vesicles and urethra, as well as bilateral vas deferens.\n\nMicroscopic examination of the left distal ureter showed high-grade intraepithelial lesion. The second excised segment of the left ureter also revealed similar findings, confirmed on frozen section. The right ureter showed no abnormality. Examination of lymph nodes from multiple regional sites (left and right pelvic, hypo gastric, and common iliac regions) revealed benign lymphoid tissue without evidence of involvement in all submitted nodes except for three perivesical lymph nodes where isolated or small clustered cells suggestive of metastatic involvement were identified.\n\nThe cystoprostatectomy specimen measured 13 cm in greatest dimension. Gross examination identified multiple ulcerated lesions within the bladder: one measuring 2 x 1.5 cm located in the left anterior wall extending near the left ureteral orifice; another measuring 2.6 x 1.5 cm on the right anterior/lateral wall; and additional nodular lesions at the dome. Histologic evaluation demonstrated multifocal invasive growth pattern involving perivesical soft tissues. There was vascular invasion identified focally along with perineural involvement. Chronic inflammatory changes including granulomatous inflammation consistent with prior BCG therapy were noted in some areas.\n\nMargins were assessed microscopically; tumor involvement was identified at the left ureteral margin. Adjacent mucosa showed reactive proliferative changes including Brunn\u2019s nests, cystitis cystica, and glandular metaplasia. Prostatic tissue revealed benign hyperplastic glands; however, involvement of the prostatic urethra by malignant cells with focal underlying stromal infiltration was observed. Seminal vesicles were free of involvement.\n\nNo abnormalities were detected in either vas deferens specimen. All other lymph node dissections revealed benign lymphoid tissue without signs of metastasis."} +{"pid": "TCGA-2Z-A9JD", "report": "The specimen consisted of a partial nephrectomy with attached adipose tissue from the renal hilum, measuring 7 x 4 x 4.5 cm. On sectioning, a tan-red-brown, focally hemorrhagic mass was identified. The mass measured 4 x 4 x 3.8 cm and extended to within 0.2 cm of the closest parenchymal resection margin. Microscopic examination revealed a papillary growth pattern with nuclear features corresponding to Fuhrman grade 3 of 4. No invasion through the renal capsule, Gerota's fascia, or renal vein was observed. Surgical margins were free. A small papillary lesion measuring 0.1 cm was also identified on slide evaluation. Additional fragments of fibroadipose tissue from multiple margins were all unremarkable. The non-neoplastic kidney showed mild chronic inflammation and focal glomerulosclerosis. Based on the current specimen, the pathological stage was determined to be pT1aNXMx."} +{"pid": "TCGA-CM-6171", "report": "The submitted specimen consists of a right colon hemicolectomy. Gross examination reveals a segment of terminal ileum measuring 14.5 cm in length and 3.0 cm in circumference at the proximal margin, and colon measuring 26.3 cm in length with a distal margin circumference of 6.6 cm. The appendix measures 6.1 cm in length with an average diameter of 0.4 cm. A pink-tan fungating mass is identified measuring 3.5 cm in length and 3.1 cm in width located in the ascending colon. It is situated 4.5 cm from the ileocecal valve, 17.8 cm from the proximal margin, and 16.1 cm from the distal margin. Depth of invasion measures 0.2 cm grossly. Adjacent to the tumor, a tattoo is noted. Multiple diverticula are present; otherwise, the remaining mucosa appears unremarkable. Lobulated fatty tissue attached to the specimen measures up to 5.2 cm in thickness, with omentum measuring 7 x 6 x 1.3 cm.\n\nHistologic evaluation demonstrates a lesion with moderately differentiated morphology. Invasion extends to the muscularis propria layer without evidence of tumor budding or increased tumor-infiltrating lymphocytes. No lymphovascular, large venous, or perineural invasion is observed. There is no gross perforation. Surgical margins are free of involvement. No polyps or mucosal dysplasia are identified distant from the lesion. Non-neoplastic bowel and appendix appear unremarkable. Examination of precursor lesions reveals the presence of a tubulovillous adenoma.\n\nA total of 28 lymph nodes are examined, none showing evidence of metastasis. No tumor deposits are identified within pericolorectal soft tissue. Based on AJCC 7th Edition staging criteria, the lesion invades into the muscularis propria (pT2) with no regional lymph node involvement (pN0). Sections submitted include proximal and distal margin shaves, tumor tissue in entirety, representative sections of appendix, ileum, colon, diverticula, omentum, and lymph nodes\u2014both intact and bisected."} +{"pid": "TCGA-AP-A052", "report": "Specimens submitted include omentum, uterus with bilateral fallopian tubes and ovaries, and a bladder tumor. Examination of the omentum shows metastatic involvement with high-grade papillary serous carcinoma and associated psammomatous calcifications. The uterus demonstrates a lesion limited to the endometrium, involving endometrial polyps. Leiomyomata are identified within the myometrium. Papillary serous carcinoma is present on the surfaces of both ovaries and the left fallopian tube. There is also involvement of the uterine serosal surface. Lymphovascular tumor emboli are observed in the left ovary. The bladder biopsy reveals involvement of the serosa and fibroadipose tissue by similar-appearing high-grade papillary serous carcinoma. Morphologic features across specimens show similarity."} +{"pid": "TCGA-RD-A7BW", "report": "The specimen consists of a total gastrectomy measuring 120mm along the lesser curve and approximately 195mm along the greater curve. The stomach wall is thickened, indurated, and shows granular, congested mucosa with loss of normal rugal folds. There is a distinct demarcation between the abnormal gastric body and the normal antral mucosa. Fat surrounding both the lesser and greater curves is indurated, and the omentum shows visible abnormalities. On sectioning, the thickened gastric wall demonstrates pallor. Composite longitudinal sections were taken from the mid to distal portions of the stomach (blocks A1\u2013A4), as well as sections from the proximal margin along the lesser curve (A5\u2013A6). Additional blocks include random sections of omentum (A7), greater curve lymph nodes (A8\u2013A9), and lesser curve lymph nodes (A10).\n\nTwo additional specimens include \"donuts\" representing proximal esophageal and distal small bowel tissue. These consist of two pieces of ragged tissue, the largest measuring approximately 17mm in external diameter. A third specimen labeled as right gastroepiploic nodes consists of a piece of fatty tissue measuring up to 23mm; no discrete lymph node was macroscopically identified.\n\nMicroscopic examination of the thickened gastric region reveals a diffuse pattern of poorly cohesive cells infiltrating through the full thickness of the gastric wall into the perigastric fat. Cellular pleomorphism is present with variable cytoplasmic content. A minor component of gland-forming structures is noted in some areas. Tumor involvement is seen near the gastroesophageal junction, where a small nodule of gland-forming cells lies beneath squamous epithelium, with intramucosal extension in this region. In contrast, the remainder of the stomach shows predominantly submucosal and intramural infiltration. The tumor approaches the proximal surgical margin but does not involve it directly.\n\nExamination of regional lymph nodes reveals metastatic involvement in all lymph nodes assessed: two greater curve nodes and five lesser curve nodes. Extensive infiltration of surrounding fat is observed in both nodal regions. Sections of the omentum do not show significant abnormality.\n\nSections of the proximal and distal resection margins\u2014representing esophagus and duodenum\u2014show no evidence of tumor involvement. In the specimen labeled as right gastroepiploic lymph node, only a single lymph node is identified within fatty tissue, and it demonstrates extensive sinusoidal infiltration by metastatic cells.\n\nStaging assessment indicates pT3N2Mx."} +{"pid": "TCGA-IG-A3Y9", "report": "The esophageal specimen was obtained via excision. The lesion measured 3.5 x 4.5 x 1.2 cm and was found to involve adjacent structures. Microscopic examination revealed moderately differentiated cells with features consistent with a malignant process. A total of 12 regional lymph nodes were examined, and none contained metastatic material. The margins of resection were free of abnormal cellular infiltration. No evidence of lymphatic or venous invasion was identified. There was no indication of prior treatment effects. No additional pathologic findings were noted."} +{"pid": "TCGA-EA-A411", "report": "The specimen consists of cervix tissue obtained from a hysterectomy with bilateral salpingo-oophorectomy. The lesion measures 2 x 1.5 x 1 cm and is located in the cervix. Histologic evaluation shows moderately differentiated cells. A total of 13 regional lymph nodes were examined, and none showed evidence of metastatic involvement. Information regarding tumor extent, lymphatic or venous invasion, margins, neo-adjuvant treatment, and additional pathologic findings was not provided. No comments were included in the report."} +{"pid": "TCGA-AA-3534", "report": "The specimen consists of a right hemicolectomy with tumor-free resection margins. Two tubular adenomas of the colonic mucosal membrane were identified, each showing mild dysplasia. An ulcerated, moderately differentiated lesion was observed with infiltration extending into the perimuscular fatty tissue. No regional lymph node metastases were detected. The total number of lymph nodes examined was 36, none of which showed evidence of involvement. Vascular and lymphatic invasion were not identified."} +{"pid": "TCGA-VQ-A8DL", "report": "The specimen involves the gastric cardia and includes a standardized lymphadenectomy with celiac trunk dissection. The lesion measures 6.0 cm at its greatest dimension and demonstrates ulceration. Microscopically, the histological pattern is tubular with moderate differentiation (histologic grade 2). The infiltration extends through the mucosa, submucosa, muscularis propria, and into the perivisceral fat with a spiculated growth pattern. There is evidence of extension into the esophageal mucosa. No neural infiltration or lymphatic vascular invasion is identified. All surgical margins are free of neoplastic cells. A total of 27 lymph nodes were examined and none show involvement. This includes lymph nodes from the greater curvature (0/15 and 0/4), 11B chain (0/2), 8A chain (0/2), 12A chain (0/2), and 111 lymph nodes (0/2). Additionally, the esophageal margin shows no neoplastic involvement."} +{"pid": "TCGA-QU-A6IN", "report": "The pathology report includes findings from a radical prostatectomy and lymph node dissection. The surgical specimen consisted of the prostate gland and seminal vesicles, along with soft tissue from the left perivesicular area. A total of fifteen lymph nodes were examined\u2014ten from the right obturator region and five from the left\u2014with no evidence of malignant cells found in any of them.\n\nThe prostate measured 5.2 x 4.4 x 4.0 cm and was sectioned from apex to base. Examination revealed areas of abnormal cellular morphology characterized by atypical glandular structures. High-grade prostatic intraepithelial neoplasia was identified. The seminal vesicles appeared histologically unremarkable.\n\nMicroscopic evaluation showed a Gleason score of 7 (3+4), with additional foci exhibiting Gleason pattern 5 features. Vascular or lymphatic invasion was not identified. Perineural extension was present within the prostate tissue. All surgical margins\u2014including the apex, base, and seminal vesicle margins\u2014were free of atypical cells.\n\nInvolvement of tumor was documented across multiple slides: on the right side, 5 out of 11 slides were positive, including 0 of 1 from the apex; on the left side, 4 out of 11 slides were positive, including 0 of 1 from the apex. There was no definitive evidence of extra-prostatic extension.\n\nThe soft tissue excised from the left perivesicular region consisted of benign fibrovascular and adipose tissue, including nerve elements. No malignant changes were observed in this specimen."} +{"pid": "TCGA-CV-6951", "report": "Decalcified sections of the mandible show invasion into the mandibular bone as well as involvement of nerves. The anterior and posterior margins of the mandible do not contain any affected tissue. In the left supraomohyoid neck dissection, two out of twenty-nine lymph nodes show involvement, including one out of six submental-submaxillary nodes and one out of twelve mid jugular nodes. None of the subdigastric or upper posterior cervical nodes show involvement. The salivary gland demonstrates atrophy and chronic inflammation but no abnormal cellular changes. In the right supraomohyoid neck dissection, eighteen lymph nodes are present without any signs of involvement. The deep mental margin includes fibroadipose tissue, skeletal muscle, and peripheral nerve, all without involvement. The anterior buccal, left pharyngeal, and right lateral floor of mouth margins all show normal squamous mucosa without involvement. The specimen involving the subtotal glossectomy, mandible, and floor of mouth reveals deeply invasive moderately differentiated cellular changes affecting the base of the tongue, floor of mouth, and subcutaneous tissue. Lymphatic and nerve sheath invasion is noted. The lesion measured 4.0 x 3.5 x 2.0 cm upon initial examination. Further evaluation of mandibular tissue is ongoing, and an additional report will be issued once all studies are complete."} +{"pid": "TCGA-L6-A4EU", "report": "The specimen consists of a total thyroidectomy with bilateral level VI lymph node resection. The overall specimen measures 10.5 x 9 x 4 cm and weighs 62.3 grams. The right lobe is 7 x 4 x 3 cm, the isthmus is 3 x 3 x 2.4 cm, and the left lobe is 5 x 2.6 x 2.3 cm. A dominant mass measuring 5 cm in greatest dimension is identified in the right lobe. The mass is multifocal and extends to the posterior (red inked) margin of resection, approaching cartilage and involving muscle and perithyroidal soft tissue. No tumor capsule is identified.\n\nHistologic examination reveals a classical papillary architecture with tall cell cytomorphology. Lymphovascular invasion is present; perineural invasion is not identified. Four of thirty-three lymph nodes are involved. The attached level VI adipose tissues measure 7.5 x 2 x 1 cm.\n\nPathologic staging indicates pT3 based on tumor size greater than 4 cm and extrathyroidal extension. Regional lymph node involvement is classified as pN1a with four positive nodes among those examined. Distant metastasis is not applicable.\n\nAdditional findings include three parathyroid glands and thymic remnants. Immunoperoxidase and in-situ hybridization tests were performed in a CLIA-certified laboratory. The specimen was received fresh with intact margins for analysis. Multiple sections were submitted for permanent processing, including representative sections of the isthmus and left lobe, which did not show distinct nodules. Tissue procurement for research included portions of the right lobe mass and normal-appearing parenchyma, as well as cyst lining from the left lobe."} +{"pid": "TCGA-EL-A4JW", "report": "The patient is female. The case involved a surgical specimen from a total thyroidectomy. The thyroid specimen measured 5.8 x 2.3 x 2.2 cm on the right lobe, 4.7 x 2.0 x 1.9 cm on the left lobe, and 1.7 x 1.5 x 0.4 cm at the isthmus. The outer surface appeared tan-red and smooth without any grossly identifiable lesion. Upon serial sectioning, a nodule measuring 1.6 x 1.5 x 0.6 cm was identified in the mid portion of the right lobe, approximately 0.2 cm from the closest margin. Another smaller nodule measuring 0.6 x 0.5 x 0.3 cm was found in the superior portion of the right lobe.\n\nHistologic examination revealed a lesion with cellular features including well-defined borders and varying tissue consistency. No extrathyroidal extension or lymphovascular invasion was observed. Resection margins were negative. One lymph node was examined and showed no evidence of tumor involvement. Background thyroid tissue demonstrated focal chronic lymphocytic thyroiditis.\n\nSections from A1 to A8 included the right thyroid lobe, with A1 containing the smaller nodule and A3\u2013A6 containing the larger nodule. Sections A9 and A10 represented the isthmus, and A11\u2013A13 included representative portions of the left thyroid lobe. A portion of both normal and lesional tissue was submitted for research purposes."} +{"pid": "TCGA-CJ-4884", "report": "The surgical specimen includes a right kidney measuring 15.0 x 11.0 x 9.0 cm, along with attached ureter and perinephric fat. A centrally located mass measuring 4.5 x 4.0 x 3.7 cm is identified within the kidney. The mass is grossly encapsulated and exhibits a yellow-tan appearance, extending toward the renal sinus but not through the renal capsule. It is located approximately 4.5 cm from Gerota's fascia. No gross involvement of the renal vein is observed. The surrounding renal parenchyma appears unremarkable with the presence of a single simple cyst measuring 0.5 x 0.5 x 0.5 cm.\n\nMicroscopic evaluation reveals nuclear grade 3 morphology with vascular invasion noted in a large caliber vessel within the renal sinus. Margins of the renal vein and ureter show no evidence of involvement. Sections of the perinephric fat also show no involvement. Multiple tissue sections were submitted for analysis, including areas related to the renal sinus, renal capsule, and Gerota\u2019s fascia. No lymph nodes or lesions are identified in the adipose tissue sample."} +{"pid": "TCGA-06-1087", "report": "The clinical history is significant for a prior biopsy of a temporal lesion showing features of a high-grade neoplasm. Imaging revealed a left temporal necrotic mass with a solid enhancing component. The operative specimen consisted of a left temporal brain mass, and multiple biopsies were taken.\n\nMicroscopic examination demonstrated a cellular proliferation of glial cells with focal infiltrative areas containing mitotic figures and microvascular proliferation. The tumor was largely composed of undifferentiated cells arranged in highly vascular zones, consistent with a sarcomatous component. Necrosis was extensive, particularly in parts A and C. In part A, only small fragments showed infiltrating neoplastic cells amidst necrotic tissue. Part B contained a cluster of undifferentiated neoplastic cells within spindle cell stroma. High proliferative activity was noted, with MIB-1 indices of approximately 18% in part A and 25% in part B. Immunohistochemical studies showed GFAP positivity in some areas, while the majority of the tumor was negative for glial, neuronal, and epithelial markers. Vascular structures stained positively for CD31 and CD34 but were negative for smooth muscle actin. MelanA staining was non-specifically weak in the sarcomatous regions. Reticulin deposition was prominent in the sarcomatous areas.\n\nMolecular testing revealed a methylated MGMT promoter, suggesting potential responsiveness to alkylating agent therapy. The test was performed using bisulfite-treated DNA followed by real-time PCR amplification, in compliance with CLIA requirements. This result is provided for informational purposes and should be interpreted in the context of other diagnostic findings.\n\nGrossly, the specimens included multiple tan or tan-red tissue fragments measuring up to 4.0 x 3.5 x 1.8 cm in aggregate. Tissue from frozen sections and permanent blocks was used for analysis. Intraoperative consultation noted necrotic changes with occasional inflammatory or atypical cells, with final interpretation deferred to permanent sections."} +{"pid": "TCGA-B8-4622", "report": "The left kidney specimen, weighing 1080 grams and measuring 25 x 16 x 11 cm, was received following laparoscopic nephrectomy. The kidney itself measures 12 x 8 x 7 cm. No adrenal gland was identified in the specimen. Two distinct cortical masses were identified. The first is located in the posterior upper pole, lateral anterior aspect, measuring 3.2 x 2.7 x 1.9 cm. The second mass is found in the posterior mid to lower pole, measuring 4.8 x 4.5 x 3.7 cm. Both tumors are well-circumscribed with a golden-yellow cut surface and small pinpoint areas of hemorrhage. No gross necrosis or calcification was observed. The upper pole lesion contains a central cystic area filled with hemorrhagic material. The two lesions are approximately 1.8 cm apart.\n\nHistologic evaluation reveals both tumors are composed of cells with clear cytoplasm and nuclear features corresponding to grade III (of IV). Both tumors demonstrate capsular invasion, and the lower pole lesion extends into the renal sinus. There is no invasion into Gerota\u2019s fascia, renal vein, or ureter. No evidence of vascular or lymphatic invasion was identified. Surgical margins, including perirenal adipose tissue, Gerota\u2019s fascia, renal vein, renal artery, and ureter, are free of tumor involvement.\n\nAdditional findings include patchy interstitial chronic inflammation and fibrosis, arteriolonephrosclerosis, and the presence of a few totally and partially sclerotic glomeruli. No lymph nodes were submitted for evaluation. Based on available information, staging is reported as T3a, Ix, pM1. This staging is provisional and may be subject to revision pending further clinical review."} +{"pid": "TCGA-O9-A75Z", "report": "A left robotic partial nephrectomy specimen was received fresh and measured 3 x 3 x 3 cm, weighing 12 grams. The surgical margin was marked with black ink and the circumferential surface with green ink. On gross examination, a 2.5 x 2.5 x 2 cm mass was identified, showing yellow to hemorrhagic cut surface. The mass was well-circumscribed and confined within the renal capsule. It was located 0.1 cm from the black-inked surgical margin and 0.3 cm from the green-inked circumferential surface. Sections were submitted in five cassettes: two representing the tumor with the green-inked surface and three representing the tumor with the black-inked margin. Total time in 10% neutral buffered formalin was 34.5 hours, with a cold ischemia time of 15 minutes.\n\nMicroscopically, the lesion was unifocal and located in the middle pole, measuring 2.5 x 2.5 cm. The histologic type showed papillary architecture. There was no evidence of sarcomatoid differentiation, lymphovascular invasion, or coagulative necrosis. The tumor was limited to the renal parenchyma without extension beyond the capsule. The renal parenchymal margin was involved by tumor along a 5 mm linear dimension, while other margins were free. No lymph nodes were identified. Adjacent kidney tissue revealed only a small rim of normal parenchyma, with mild interstitial nephritis likely reactive to the adjacent lesion. Immunohistochemical stains demonstrated positivity for CK7 and racemase, and negativity for CD10."} +{"pid": "TCGA-E7-A677", "report": "Patient ID: Gross Description: In bladder, there are an invasive lesion with ill-defined margins measuring 3x2x2 cm, soft consistency and gray surface. Microscopic Description: Transitional cells show hyperplasia. Lesion cells form papillary or trabecular arrangements. The cytoplasm of the lesion cells is moderate in amount and eosinophilic. Nuclear enlargement and variability in shape and size are present along with irregular nuclear membranes, nucleoli, and abnormal chromatin distribution. Mitotic figures are observed. The lesion extends into the muscularis propria. Comments: Formatted Path Reports: BLADDER TISSUE CHECKLIST. Specimen type: Cystectomy. Lesion site: Bladder. Lesion size: 3 x 2 x 2 cm. Lesion features: None specified. Histologic type: Transitional cell origin. Histologic differentiation: Moderately differentiated. Extent of lesion: Muscularis propria involvement. Lymph node status: Not specified. Lymphatic invasion: Absent. Venous invasion: Not specified. Surgical margins: Uninvolved. Evidence of prior treatment: Not specified. Additional findings: None noted. Comments: None."} +{"pid": "TCGA-AX-A0IU", "report": "The specimen consisted of a uterus with cervix, bilateral fallopian tubes and ovaries, right pelvic lymph nodes, right pelvic sidewall soft tissue, left pelvic lymph nodes, left para-aortic lymph nodes, right para-aortic lymph nodes, and omentum. Gross examination of the uterus revealed an extensive exophytic papillary growth involving almost the entire endometrium, measuring 6.2 x 5.2 x 1.4 cm in size. The tumor demonstrated invasion into the myometrium with maximal depth of invasion measuring 1.3 cm; the thickness of the myometrium at that site was 1.5 cm, representing approximately 83% involvement. The tumor was located 0.2 cm away from the closest anterior uterine serosal margin. Necrosis was present within the tumor mass. A leiomyoma measuring 4.5 cm was identified in the posterior myometrial wall with focal hemorrhage.\n\nMicroscopic evaluation showed high-grade cellular features with serous adenocarcinoma morphology. Invasion of the myometrium was confirmed microscopically with lymphatic invasion also noted. No tumor involvement was identified in the endocervical canal or in bilateral fallopian tubes and ovaries. Evaluation of surgical margins showed no involvement by invasive carcinoma, with the closest distance from the tumor to the anterior uterine serosa being 2 mm.\n\nLymph node assessment included right pelvic lymph nodes (three examined, none positive), left pelvic lymph nodes (four examined, one positive), left para-aortic lymph nodes (three examined, none positive), and right para-aortic lymph nodes (three examined, one positive). Soft tissue biopsy from the right pelvic sidewall showed benign findings without evidence of malignancy. The omentum did not show any malignant involvement.\n\nImmunohistochemical staining showed variable positivity for hormone receptors and other markers. Staining for p53 was negative while p16 showed partial positivity. ER showed weak positivity in less than 50% of cells and PR was partially positive in approximately 50% of cells. CEA was mostly negative, vimentin was negative, CD117 was negative, and CD10 was positive in stromal areas involved by tumor.\n\nPathologic staging based on findings included primary tumor classification as T1c indicating tumor invasion into at least half of the myometrium. Regional lymph node classification was N1 due to metastasis identified in two lymph nodes. Distant metastasis could not be assessed. Overall staging classification was consistent with advanced local disease with regional nodal involvement."} +{"pid": "TCGA-FG-A4MX", "report": "The resected right frontal brain mass measured up to 4.3 cm in greatest dimension and demonstrated diffuse infiltration of white and gray matter. Microscopic examination revealed areas with moderately pleomorphic nuclei, some with gemistocytic cytoplasm, while other regions showed a more monotonous appearance. Prominent microcystic change was noted, particularly along the cyst walls. Perineuronal satellitosis was present, but no evidence of Rosenthal fibers, eosinophilic granular bodies, or non-infiltrative tumor regions was identified. Immunostaining showed diffuse positivity for p53 and a nuclear labeling rate for MIB-1 up to 6%, suggesting possible early anaplastic transformation although no mitoses, vascular endothelial proliferation, or necrosis were observed.\n\nMultiple tissue fragments were received from various locations including the cyst wall and surrounding white matter. In several areas, the cyst lining contained moderately cellular viable tumor cells, accounting for up to 15% of total tissue. Adjacent white matter showed only scattered glioma cells or no tumor on intraoperative smear evaluation. Other sections showed mild hypercellularity with atypical cells but no definitive tumor presence.\n\nMolecular analysis detected methylation of the MGMT gene promoter region, with a methylation score of 5.67. Chromosome studies by FISH showed intact chromosomes 1p and 19q. Immunostaining for IDH1 was positive. The histologic features are consistent with a diffusely infiltrating glioma; however, the diagnosis has been omitted as requested."} +{"pid": "TCGA-ET-A39T", "report": "The specimen consisted of a total thyroidectomy with a lesion located in the right lobe. The tumor measured 6 cm in greatest dimension and was unifocal. Histologic evaluation revealed varying degrees of cellular atypia. The neoplasm was composed predominantly of well-differentiated cells, though focal areas demonstrated overlapping nuclei, nuclear pseudoinclusions, nuclear grooves, and nuclear atypia. The primary tumor was greater than 4 cm and confined to the thyroid or with minimal extrathyroid extension. All margins were free of involvement. No venous or lymphatic invasion was identified. Lymph node assessment included pre-tracheal and right central neck nodal tissue. All lymph nodes evaluated were negative for tumor involvement. One lymph node sample was deemed insufficient for interpretation. Distant metastasis could not be assessed. The case was presented at our multidisciplinary conference for further discussion."} +{"pid": "TCGA-AP-A0LG", "report": "The submitted specimens include a hysterectomy with right salpingo-oophorectomy, as well as multiple lymph node groups from the right and left para-aortic regions, left external iliac, left obturator, right external iliac, and right obturator areas. \n\nIn the uterine specimen, there is a focus of abnormal tissue in the endometrium characterized by complex hyperplasia with atypia. The lesion demonstrates a growth pattern involving up to 50% of the tissue in a solid arrangement. Nuclear features are predominantly grade 2, with some areas showing grade 3 changes. The depth of myometrial involvement is limited to no more than half of the myometrial thickness, with a maximal invasion depth of 4 mm in an area where the total myometrial thickness measures 22 mm. There is no evidence of extension into the endocervix or vascular invasion. The myometrium also shows findings consistent with adenomyosis. No significant abnormalities are noted in the adnexal structures.\n\nAll lymph nodes evaluated are benign. One lymph node was identified in each of the right and left para-aortic, left obturator, right external iliac, and right obturator regions, with no signs of malignancy. In the left external iliac region, only fibroadi\n{\"mode\":\"chat\",\"max_tokens\":1024,\"temperature\":0.7,\"top_p\":1,\"top_k\":40,\"frequency_penalty\":0.5,\"presence_penalty\":0.5}"} +{"pid": "TCGA-XK-AAJ3", "report": "A radical prostatectomy with bilateral pelvic lymph node dissection was performed. The prostate measured 4.5 x 4 x 3.8 cm and weighed 45 grams. Gross examination revealed a lesion measuring 1.7 x 1.5 x 1.5 cm in the right apex-mid lobe with a slight bulge in the right mid posterior capsule. Histologic evaluation identified lesions present on both sides of the prostate, extending from apex to base on the right and involving the left apex and left mid prostate while sparing the left base. The largest diameter of the lesion was 14 mm on the right and 10 mm on the left.\n\nMicroscopic evaluation showed focal extension beyond the prostate capsule in the posterior right mid prostate within an area less than 1 mm in length. Surgical margins\u2014including distal urethral, proximal urethral, apical, bladder neck, and external capsular\u2014were free of involvement. Invasion of lymphatic or vascular channels was not observed. However, perineural invasion was noted within the lesion and at the capsular condensation in the right posterior prostate. There was no evidence of seminal vesicle involvement.\n\nSix pelvic lymph nodes were examined without identification of any malignant involvement. Additional findings included high-grade prostatic intraepithelial neoplasia. Blocks suitable for further testing included A3, A4, A7, A8, A10, A12, A14, and A16. Slide A12, which demonstrated extraprostatic extension, was reviewed and confirmed.\n\nAncillary studies were conducted on block A8. DNA ploidy analysis indicated near diploid tumor cells with a DNA index of 1.15. Proliferation index by Ki-67 immunostaining (MIB-1) was 3.81%. These tests were developed and validated internally and have not been cleared or approved by the U.S. Food and Drug Administration. All controls used during immunohistochemical testing demonstrated appropriate reactivity.\n\nThe specimen was processed with biorepository sampling completed. Multiple tissue blocks were evaluated to assess various anatomical regions and surgical margins. No treatment-related changes were identified."} +{"pid": "TCGA-XF-A8HH", "report": "A radical cystectomy with bilateral pelvic lymph node dissection, bowel resection for Studor pouch to urethra and gastrostomy tube placement was performed. Specimens from the right and left distal ureters showed no high-grade urothelial atypia or carcinoma. The apical urethral margin also showed no evidence of such findings.\n\nThe urinary bladder specimen measured 6.5 x 7 x 4 cm and contained a 4 x 3.5 x 1 cm endophytic, ulcerated mass in the posterior region. Microscopic evaluation revealed invasive transitional cell carcinoma, nuclear grade 3-4/4, with full-thickness invasion of the bladder wall extending into the perivesical fat. Tumor cells were arranged in sheets and trabeculae, with medium to large cells showing high nuclear-to-cytoplasmic ratios, prominent nucleoli, vesicular chromatin, coarse chromatin clumping, and a high mitotic rate. Focal vascular space invasion was identified. Multifocal carcinoma in situ was also present. No extension into the vaginal wall was observed. All surgical margins were negative.\n\nMetastatic involvement was identified in one posterior perivesical lymph node. Additionally, metastases were found in one of two right external iliac lymph nodes, and one of three left external iliac lymph nodes. No malignancy was identified in the remaining lymph nodes examined: left periaortic (0/12), left common iliac (0/5), right paracaval (0/5), right common iliac (0/6), right node of Cloquet (0/1), right obturator/hypogastric (0/21), left node of Cloquet (0/1), left obturator/hypogastric (0/12), right presciatic (0/1), presacral (0/4), and left presciatic (0/1). In total, 3 out of 73 lymph nodes examined showed metastatic involvement.\n\nThe uterus measured 9 x 6.5 x 2.5 cm and showed adenomyosis and a single intramural leiomyoma measuring 0.5 cm. The endometrium was proliferative. Both fallopian tubes and ovaries were unremarkable, with normal physiologic changes noted in the ovaries. The cervix showed no evidence of malignancy.\n\nUreteral specimens from both proximal and distal segments showed no urothelial atypia or malignancy. The right and left ureters measured 4.6 cm and 4.5 cm in length, respectively, with normal mucosa on gross examination.\n\nMultiple tissue sections were submitted for analysis, including the tumor with cervix, perivesical fat, ureterovesical junctions, random bladder sections, ovaries and fallopian tubes, cervical sections, endomyometrium, serosa, and perivesical fat pad. Lymph node stations were widely sampled and submitted in cassettes for histologic evaluation.\n\nNo evidence of malignancy was identified in the bilateral fallopian tubes and ovaries. The ectocervix was lined by smooth tan epithelium, and the endocervical canal appeared normal. Serial sectioning of the uterus revealed no abnormalities other than the known pathology and the single leiomyoma.\n\nIn summary, the tumor demonstrated deep invasion into the bladder wall with perivesical fat involvement and lymphovascular space invasion. Multifocal carcinoma in situ was present. Metastatic spread was confirmed in three lymph nodes, with the remainder being negative. All resected margins were free of tumor."} +{"pid": "TCGA-DU-8164", "report": "A right frontal brain lesion was biopsied and submitted for pathological evaluation. The specimen consisted of multiple fragments of soft tan-grey tissue measuring approximately 4 cm in aggregate. A portion was used for intraoperative frozen section analysis, with the remainder processed for routine histologic examination.\n\nHistologic sections revealed astrogliosis and atypical glial proliferation. The cellular density was focally moderately increased. Mitotic activity, microvascular proliferation, and necrosis were not identified. Cerebral cortical calcifications were noted. Immunohistochemical staining demonstrated the presence of the R132H IDH1 mutation, confirmed by molecular testing.\n\nMolecular studies were performed on DNA extracted from the tumor tissue. Analysis for MGMT promoter methylation showed no evidence of methylation. Assessment for loss of heterozygosity (LOH) at chromosomes 1p and 19q demonstrated allelic loss on chromosome arm 1p and partial deletion of chromosome arm 19q. Specific markers involved in the LOH assay included D1S552, D1S1612, D19S219, D19S606, and PLA2G4C.\n\nAll ancillary testing was conducted using laboratory-developed protocols under CLIA \u201988 regulations. These results are provided for informational purposes and should be interpreted within the context of established diagnostic criteria. No non-neoplastic tissue microdissection was required for analysis. Technical limitations include potential interference from more than 15% non-neoplastic cells in the sample.\n\nThe findings were based on histologic evaluation, immunostaining, and molecular assays. Intraoperative consultation, including frozen section and smear review, was performed and reported to the operating physician."} +{"pid": "TCGA-BJ-A0ZA", "report": "The specimen from a total thyroidectomy weighed 11.3 grams. Two separate lesions were identified. One lesion in the left lobe measured 3.0 cm and was encapsulated, confined to the thyroid, with no evidence of capsular or vascular invasion. A second lesion in the right lobe was also confined to the thyroid and measured less than 0.1 cm. Both lesions exhibited features consistent with papillary carcinoma, follicular variant. No angiolymphatic invasion was present in either lesion. The pathologic staging was determined as pT2 with no regional lymph node involvement after examination of two lymph nodes from the central compartment, all of which were negative for tumor involvement. Surgical margins were free of tumor involvement. Additional findings included multinodular hyperplasia and chronic lymphocytic thyroiditis. No venous or lymphatic invasion was identified."} +{"pid": "TCGA-KL-8331", "report": "The specimen from the right kidney consists of a partially covered organ with perinephric fat, measuring 13 x 10 x 7.5 cm and weighing 510 grams. A tumor mass is identified in the upper two-thirds of the kidney, involving the cortex, medulla, and pelvis. The tumor measures 10 x 9.5 x 9 cm and has a yellow-tan to red-gray cut surface with areas of hemorrhage and necrosis. It appears confined within the renal capsule. Serial sections show no invasion of the renal vein, and all surgical margins are free of involvement. Adjacent kidney tissue shows focal glomerulosclerosis.\n\nFifteen lymph nodes are identified in the paracaval region, ranging in size from 0.3 to 1.7 cm. No abnormal cellular infiltration is observed, and all are submitted for evaluation.\n\nA separate nodule is found in the right adrenal gland, measuring 0.9 x 0.8 x 0.7 cm. It is well-circumscribed, tan-yellow, and soft on sectioning. The remainder of the adrenal tissue appears unremarkable. The resection margin is marked and submitted for analysis.\n\nSections from multiple sites including the tumor, surrounding fat, renal pelvis, normal kidney, ureter, and vessels are submitted for histological examination. Photographs and representative samples are taken, with some sections reserved for further studies."} +{"pid": "TCGA-B5-A11O", "report": "The specimen includes a uterus weighing 99 grams, measuring 9 x 6 x 3 cm, with attached bilateral fallopian tubes and ovaries. The left ovary measures 1.9 x 1.8 x 0.8 cm and the right ovary is 2.6 x 1.5 x 1.2 cm. The left fimbriated fallopian tube is 3.6 cm long and 0.4 cm in diameter; the right fimbriated fallopian tube is 3.2 cm long and 0.5 cm in diameter. The endometrial cavity spans 2.7 cm from cornu to cornu and expands to 4.8 cm. Within the fundus of the endometrial cavity, there is an ill-defined soft gray-tan lesion measuring 1.3 x 1 x 0.7 cm, extending slightly into the anterior and posterior endometrium, located 4.5 cm and 3.1 cm from the anterior and posterior lower uterine segments respectively. This lesion invades 0.2 cm into a myometrial wall that is 1.5 cm thick and contains a single white whorled intramural nodule measuring 1 x 1 x 0.9 cm. The remainder of the endometrium appears red-tan and diffusely coarse, measuring 0.1 cm in thickness, and contains a second soft gray-tan lesion measuring 1.6 x 1.3 x 0.2 cm located 1.1 cm from the lower uterine segment. This second lesion extends 0.2 cm into the underlying myometrium. The uterine serosa is pink-tan, smooth, and glistening. The exocervix is red-white, smooth, and exhibits diffuse erythema surrounding a 1 cm cervical os that leads into a 2.5 cm trabeculated endocervical canal. The bilateral ovaries appear grossly unremarkable, and the bilateral fimbriated fallopian tubes are discontinuous but otherwise unremarkable.\n\nA lymph node dissection was performed, including a left pelvic lymph node aggregate measuring 9.3 x 5.8 x 2.4 cm, containing eight lymph node candidates ranging in size from 0.5 x 0.5 cm up to 2.1 x 1.7 x 1.6 cm. A right pelvic lymph node aggregate measuring 7.3 x 5.2 x 1.8 cm contained eleven lymph node candidates ranging from 0.4 x 0.8 x 1 cm up to 0.5 x 1.2 x 2.1 cm. All lymph nodes had fatty cut surfaces.\n\nMicroscopic examination of the uterine tissue showed no evidence of tumor involvement at the specimen margins. The remaining myometrium contained a small benign-appearing smooth muscle nodule. Adjacent non-neoplastic endometrium showed signs of atrophy. There was no evidence of lymphatic or vascular invasion. The cervix, serosa, ovaries, and fallopian tubes were all free of tumor. No tumor was identified in 7 left pelvic lymph nodes or 11 right pelvic lymph nodes. The depth of myometrial invasion was 0.2 cm within a 1.5 cm thick myometrial wall. The procedure performed included hysterectomy, oophorectomy, and lymphadenectomy."} +{"pid": "TCGA-BP-4341", "report": "The specimen consists of a total nephrectomy from the left kidney, measuring 17.0 x 11.0 x 6.0 cm. A well-circumscribed mass is identified in the upper pole, measuring 7.3 x 7.0 x 4.0 cm. The cut surface of the mass is heterogeneous, displaying dark-yellow, orange, and tan-white myxoid areas. Approximately 60% of the tumor exhibits hyalinized and myxoid changes, without hemorrhage or cystic alteration. The tumor has pushing borders and extends focally into the perirenal fat, though it remains confined within Gerota\u2019s fascia. There is no invasion of the renal vein or infiltration of the renal pelvis. All surgical margins are free of involvement. Histologic sections demonstrate varied patterns including solid and myxoid-hyalinized regions. The adjacent kidney shows arteriosclerosis and mild interstitial chronic inflammation. No adrenal gland tissue is present in the specimen."} +{"pid": "TCGA-AP-A05H", "report": "The surgical specimens included the uterus, cervix, fallopian tubes, ovaries, and multiple lymph node regions, as well as biopsies from various peritoneal and pelvic sites. The primary lesion measured 11 mm in maximum depth with greater than 50% myometrial invasion; the myometrium in the area of maximal tumor involvement measured 18 mm in thickness. No endocervical or lymphovascular invasion was identified. The endometrium showed atrophic changes, and a single leiomyoma was noted in the myometrium. The adnexa appeared unremarkable.\n\nA total of 30 lymph nodes were examined across multiple regions, including para-aortic, common iliac, presacral, external iliac, and obturator locations on both sides. All lymph nodes were free of involvement. Additional biopsies from the omentum, cul-de-sac (anterior and posterior), pelvic walls, paracolic gutters, and diaphragm showed only benign fibroadipose or fibromuscular tissue without evidence of disease."} +{"pid": "TCGA-77-7139", "report": "The specimen from the right upper lobe consists of a lung measuring 190 x 85 x 45 mm. A lesion located just superior and lateral to the main bronchus measures approximately 38 mm on the external surface and 28 mm internally upon sectioning. Distal to this lesion, there is evidence of bronchiectasis and endogenous lipid pneumonia. Adjacent to the lesion, an adherent lymph node appears involved. No other lesions are identified in the lung tissue away from the lesion. A projection extends into the main bronchus; however, invasive disease appears to be separated from the bronchial margin by at least 5 mm.\n\nAdditional specimens include multiple lymph nodes from various regions including the right middle lobe, right upper lobe, station 7, station 8, station 9, azygous, and right main bronchus. Sizes range from 3 mm to 35 mm in aggregate. Microscopic examination of these lymph nodes reveals reactive changes only, with no signs of malignancy noted except for one lymph node showing squamous cell carcinoma surrounded by a dense fibrous capsule. This lymph node demonstrates close proximity to the diathermied resection margin.\n\nHistologic evaluation of the primary lesion demonstrates poorly differentiated squamous cell morphology with prominent involvement of the bronchial lumen. Carcinoma in situ extends to the bronchial resection margin; however, the invasive component appears clear. In one area near the lesion, thickening and scarring of the pleura raise suspicion for pleural invasion; confirmatory stains are pending. There is no evidence of vascular, lymphatic, or perineural invasion. An adjacent peribronchial lymph node appears directly invaded.\n\nSections of the bronchial stump reveal residual squamous cell carcinoma in situ without invasive disease. No tumor is identified at the staple line.\n\nStaging assessment indicates T2N1MX based on available findings."} +{"pid": "TCGA-BR-8683", "report": "The specimen consists of stomach tissue from a gastrectomy. The tumor is located in the pre-pyloric region, specifically in the antrum. Grossly, the lesion measures 4 x 3 x 1 cm and is ulcerated with a firm, gray surface. On microscopic examination, the mucosa is ulcerated and necrotic. The lesion is composed of small groups of cells forming irregular tubular structures. Cellular features include moderate stratification, enlarged and hyperchromatic nuclei with prominent nucleoli, and a stroma showing lymphocytic infiltration. The tumor invades through the mucosa and extends into the serosa, with evidence of lymphatic invasion. Of the five adjacent lymph nodes examined, three are involved by the process. Mitotic activity is present. No assessment is available for venous or perineural invasion, treatment effect, or margin status."} +{"pid": "TCGA-BF-A1PV", "report": "The specimen was obtained from a female patient of Caucasian ethnicity. The tissue sample was collected from the skin and identified as a primary tumor. The tissue was preserved in frozen format and placed in a cryomold. Histological evaluation showed a cellular composition consistent with a high percentage of tumor cells, approximately 90%. The tissue was processed in one container, with a total amount of 200 mg. A blood sample was also collected, amounting to 4 ml, and stored frozen. No histological grade or TNM staging details were provided for the blood specimen. The case involved no prior chemotherapy or radiation treatment."} +{"pid": "TCGA-VS-A9UP", "report": "The specimen originates from the cervix and demonstrates infiltrative growth of poorly differentiated malignant cells. Immunohistochemical analysis was performed to aid in characterization. Morphologic features in conjunction with the immunoprofile suggest a mucinous endocervical origin. The tumor exhibits poor differentiation, with associated cellular atypia and invasive characteristics. No further specific classification or definitive lineage markers beyond endocervical mucinous differentiation are provided in the report."} +{"pid": "TCGA-O2-A52S", "report": "A left lower lobectomy specimen was received, weighing 278 grams and measuring 15.5 x 12.2 x 7.5 cm. A white-tan firm nodule measuring 3.4 x 3 x 2.1 cm was identified; it was ill-defined and abutted the main bronchus, with apparent extension through the bronchus at the hilum. The mass appeared to contact but not invade the pleural surface. Adjacent lung parenchyma showed consolidation and thickening subpleurally in an ill-defined area approximately 3.7 x 2.5 cm in size. No other abnormalities were observed.\n\nHistologic examination of the mass demonstrated a poorly differentiated squamous cell morphology. Evaluation of margins showed positivity at the bronchial margin, while vascular, parenchymal, and pleural margins were negative. Vascular invasion was identified within the tumor specimen. The tumor measured a maximum diameter of 3.4 cm and did not involve the mainstem bronchus or chest wall. However, involvement of the visceral pleura and mediastinum was noted. There was no evidence of multiple tumor nodules or panlobar atelectasis.\n\nMetastatic involvement was identified in regional lymph nodes. Specifically, metastatic disease was found in one of three peribronchial lymph nodes, two lymph nodes at level 7, and one lymph node at level 11. Other lymph node stations (levels 2R, 4L, 2L, 4R, 9, and 5) showed no evidence of malignancy.\n\nIntraoperative consultation findings were consistent with these results, showing positive findings in the bronchial margin of the lobectomy specimen and negative results for malignancy in all other biopsied lymph node regions and the final bronchial margin.\n\nAdditional findings included post-obstructive organizing pneumonia and bronchiectasis within the specimen. No other significant pathologic features were identified."} +{"pid": "TCGA-MR-A8JO", "report": "The specimen consists of a left hepatectomy specimen measuring 15.5 cm from medial to lateral, 15 cm from anterior to posterior, and 8.0 cm from superior to inferior. A large mass measuring 13.5 x 12.5 x 8.0 cm is identified within the liver. The mass is multinodular, yellow-red in color with areas of hemorrhage, and occupies approximately 90% of the specimen. It is abutting the hepatic capsule but remains intact and well-defined. The closest distance from the invasive component to the parenchymal margin is 2.2 cm, and to the hepatic vein and artery margins is 2.7 cm. No lymphovascular, macroscopic venous, or perineural invasion is identified. Margins are uninvolved by invasive disease.\n\nOne lymph node from the lesser curvature was examined and showed no evidence of involvement. The gallbladder specimen shows features of chronic inflammation without evidence of malignancy.\n\nHistologic evaluation reveals a poorly differentiated cellular population with morphologic features consistent with high-grade neoplasm. Immunohistochemical staining demonstrates positivity for CK7 and CD68, supporting specific lineage identification. No metastatic disease is identified in the regional lymph nodes or distant sites. The remaining liver tissue shows mild portal inflammation without cirrhotic changes.\n\nStaging assessment indicates no distant metastasis and absence of regional lymph node involvement. The tumor appears confined to the liver without vascular or neural invasion."} +{"pid": "TCGA-B5-A0K3", "report": "The specimen consists of a partially morcellated uterus weighing 280 grams, measuring 10.6 x 6.8 x 5.5 cm, along with bilateral tubes and ovaries. The endometrial canal contains a friable, soft lining beginning approximately 2.5 cm from the lower uterine segment. The endometrium measures 0.6 cm in thickness and overlies a 2 cm thick myometrium. No apparent invasion of the endometrial lesion into the myometrium is observed. Multiple white, whorled lesions are present within the myometrium, with the largest measuring 2 x 2 x 1.9 cm. These lesions show no evidence of hemorrhage or necrosis. The right tube is partially morcellated, measuring 3 cm in length and 0.6 cm in diameter, with an unattached fimbriae; it appears unremarkable on sectioning. The right ovary measures 2.5 x 1.2 x 1 cm, has a white, cerebriform appearance, and is grossly unremarkable. The left tube measures 2.5 cm in length and 0.6 cm in diameter, and both the tube and fimbriae appear normal upon sectioning. The left ovary measures 2.6 x 1.3 x 0 cm, is white and cerebriform, and contains several corpora albicantia upon sectioning. The serosal surface is smooth and tan in areas not affected by morcellation.\n\nA posterior vaginal cuff specimen measuring 3.5 x 2 x 1.5 cm consists of fibrofatty tissue. Lymph node dissections were performed on left pelvic nodes (5 x 2.5 x 1 cm), right external iliac lymph nodes (3.2 x 2.2 x 1.8 cm), right obturator nodes (5.8 x 4.2 x 1.4 cm), right low aortic lymph node (3.8 x 2 x 0.6 cm), right high aortic lymph node (1.5 x 1 x 0.5 cm), and left aortic lymph node (3 x 1.5 x 0.8 cm). All lymph node specimens were submitted for evaluation and found to be negative for involvement.\n\nMicroscopic examination reveals a polyp with atypical hyperplasia in certain sections, while other sections demonstrate a more complex architecture. The tumor appears to involve the lower uterine segment but does not extend into the cervix. Vascular spaces contain isolated tumor cell clusters, raising concern for possible vascular invasion, although these cells are not directly attached to vessel walls. The tumor demonstrates focal architectural complexity with some areas resembling papillary features. Immunostaining for p53 shows diffuse and strong positivity in block A11. There is no evidence of tumor involvement at the surgical margins, and all submitted lymph nodes are free of tumor involvement. The right ovary contains a benign Brenner tumor measuring 1 cm. All other areas of the specimen, including the fallopian tubes, ovaries, cervix, and vaginal cuff, are without evidence of tumor. The depth of myometrial involvement is measured at 0.2 cm within a 2.0 cm thick wall. Tumor size is estimated at 2.1 cm based on single slide maximum measurement. No lymphatic or vascular invasion is definitively identified, though there is some suggestion of vascular involvement. The adjacent non-neoplastic endometrium shows features of an inactive endometrial polyp, and the remaining myometrium contains leiomyomas."} +{"pid": "TCGA-GV-A3QG", "report": "A segment of left distal ureter and a segment of right distal ureter were both unremarkable, showing no abnormal cellular changes. Lymph nodes were evaluated from multiple anatomical regions including the left external iliac (5 lymph nodes), left obturator and deep obturator #2 (2 lymph nodes), left common iliac (1 lymph node), left para-aortic (3 lymph nodes), presacral (7 lymph nodes), right external iliac (5 lymph nodes), right obturator and deep obturator #2 (2 lymph nodes), right common iliac (3 lymph nodes), right paracaval (4 lymph nodes), left obturator and deep obturator #1 (10 lymph nodes), and right obturator and deep obturator #1 (5 lymph nodes). Of these, three lymph nodes showed involvement: two out of five from the right external iliac, one out of three from the right common iliac, while all others were negative for any abnormality.\n\nThe urinary bladder specimen revealed high-grade invasive urothelial carcinoma involving the posterior aspect of the bladder wall and extending to the right and left lateral walls. The tumor measured 5.0 cm in greatest dimension and extended to the posterior inked surgical margin. Angiolymphatic invasion was identified. Bilateral ureteral and urethral shave margins were free of tumor. Microscopic examination confirmed tumor extension into perivesical fat. A total of 47 lymph nodes were examined, with three involved by metastatic disease.\n\nThe prostate specimen demonstrated multifocal well-differentiated adenocarcinoma involving bilateral lobes. The tumor occupied approximately 2% of the prostate with a maximum dimension of 4 mm. No extraprostatic extension or seminal vesicle invasion was identified. Surgical margins were uninvolved. Lymphovascular invasion was not present in the prostate. All lymph nodes assessed in the prostate template were negative for tumor involvement.\n\nAn appendix specimen showed fibrous and fibroadipose obliteration of the appendiceal lumen without evidence of abnormal cellular proliferation.\n\nGross evaluation of the surgical specimen showed a large lesion on the posterior bladder wall measuring 5 x 3.9 cm. It had a raised granular and focally ulcerated appearance, abutting the trigone and located near both ureteral orifices. Full thickness sections of the tumor and surrounding bladder tissue were submitted for analysis. No grossly enlarged lymph nodes were identified within the attached perivesicular adipose tissue. Prostate examination revealed no discrete nodules; seminal vesicles appeared unremarkable. Multiple representative sections were taken from all relevant areas for histological assessment."} +{"pid": "TCGA-EY-A212", "report": "A radical hysterectomy with bilateral salpingo-oophorectomy was performed. The specimen included a uterus measuring 8.0 cm in height, 3.0 cm in anterior-posterior width, and 5.7 cm in breadth at the fundus. The endometrial cavity measured 4.5 cm in length with a maximum width of 3.3 cm at the fundus. A tumor measuring 3.4 x 2.4 x 0.8 cm was identified in the upper corpus, involving both anterior and posterior regions, as well as the anterior mid corpus; possible involvement of the posterior mid corpus was also noted. The tumor exhibited an exophytic, tan/pink, friable appearance. Gross assessment indicated invasion into the inner half of the myometrium, with a wall thickness of 1.2 cm at the deepest point of invasion. Microscopic evaluation confirmed myometrial invasion of 0.5 cm depth in a region with a total wall thickness of 1.1 cm, representing 45% penetration. No serosal involvement was observed. The lower uterine segment showed tumor involvement in both anterior and posterior regions.\n\nInvolvement of the cervix was noted with focal invasion of the superficial cervical stroma to a depth of 1.0 mm, out of a total cervical wall thickness of 1.1 cm. Tumor was located 4 mm from the ectocervical/vaginal cuff margin. The distance from the tumor to the cauterized cervical margin was 0.4 cm. Lymphovascular space invasion was present.\n\nMicroscopic evaluation of the left ovary revealed focal involvement by adenocarcinoma, measuring less than 0.1 mm in size. No evidence of malignancy was found in the right ovary or fallopian tubes. The left fallopian tube contained benign paratubal cysts. Multiple lymph nodes were evaluated across various sites. Of 52 lymph nodes examined, one from the left pelvic group contained metastatic adenocarcinoma measuring 0.7 mm. Immunohistochemical staining for pancytokeratin confirmed the presence of tumor cells in this lymph node. No metastases were found in the right para-aortic (13 nodes), left para-aortic (6 nodes), or right pelvic (17 nodes) lymph node groups.\n\nHistologic evaluation revealed high-grade features based on FIGO criteria. The tumor demonstrated papillary serous morphology with clear cell features in approximately 5% of the sample. Immunohistochemical analysis showed positivity for estrogen and progesterone receptors, with ER positivity at 2+ (15%) and PR positivity at 2+ (20%). Additional testing revealed MSH2 positivity (2-3+, 30%), MSH6 positivity (2-3+, 30%), and MLH1 positivity (2+, 25%). Molecular studies for microsatellite instability were initiated, and results will be reported separately.\n\nAdditional pathologic findings included adenomyosis, vessel wall calcification, and a hemangioma of the endocervix. Other findings included surface inclusion cysts with tubal metaplasia in the right ovary and benign paratubal cysts in the left fallopian tube.\n\nBased on available data, the pathologic staging was AJCC pT3c pN1 pMX, corresponding to FIGO (2008 classification) Stage IIIC1. These stages remain subject to revision pending further clinical and molecular data."} +{"pid": "TCGA-38-6178", "report": "A surgical pathology report describes findings from multiple biopsied lymph node stations and a lung specimen. Lymph nodes from R4, Station 7, Station 9, and Station 10 were evaluated. In one lymph node from R4 and one from Station 7, no malignancy was identified. One lymph node from Station 9 also showed no evidence of malignancy. However, all three lymph nodes from Station 5 and both lymph nodes from Station 10 contained metastatic involvement.\n\nThe lung specimen, obtained from the left upper lobe, measured 13 x 10.2 x 5.2 cm. A central tumor measuring 5.5 cm in greatest dimension was identified. The tumor exhibited moderate differentiation and was unifocal. It extended to the visceral pleura and involved the lobar bronchus. Invasion into venous, arterial, lymphatic, and possibly perineural structures was noted. Visceral pleural invasion was present. Surgical margins were positive at the pleural, bronchial, and vascular sites. Within the tumor area, five of six lymph nodes were positive for metastasis. The largest metastatic deposit measured 1.3 cm microscopically, and extracapsular extension was observed in involved lymph nodes.\n\nExamination of non-tumor lung tissue revealed no specific pathological changes. A total of ten out of fourteen lymph nodes assessed across multiple stations were positive for metastatic involvement. The tumor demonstrated direct adjacency to the parietal pleura with possible extension. Microscopic evaluation confirmed the presence of atypical cells near the bronchial margin, leading to a revised assessment of positive involvement at that site. Multiple blocks were submitted for detailed histological analysis, including tumor margins, lymph nodes, and normal lung tissue."} +{"pid": "TCGA-B0-5094", "report": "The specimen from the left laparoscopic nephrectomy demonstrates a neoplasm measuring 8.0 cm in greatest diameter. The tumor is confined within the renal capsule and exhibits nuclear features corresponding to grade II of IV according to Fuhrman's classification. The neoplasm extends to the inked surgical margin at the renal vein; however, all other surgical margins are free of involvement. Adjacent renal tissue and the adrenal gland show no significant abnormalities. Based on the extent of involvement, the staging assessment indicates involvement of the renal vein without evaluation of regional lymph nodes or distant metastasis."} +{"pid": "TCGA-2G-AAGW", "report": "The pathology report describes a right orchidectomy specimen. The tumor measured 4 + 2 cm and was confined to the testis. There was no evidence of angioinvasion or invasion of the rete testis. Cellular morphology showed only nonseminomatous components, with yolk sac tumor comprising 100% of the specimen. No other tissue involvement was identified."} +{"pid": "TCGA-A2-A0YH", "report": "The surgical specimen includes a left partial mastectomy, left axillary lymph node dissection, and left breast inferior and superficial margin tissue. The partial mastectomy specimen measures 7 x 6 x 3.5 cm and contains a palpable lesion measuring 2.4 x 2.2 x 2.7 cm. This lesion approaches the superficial, deep, and inferior margins, coming within 0.2 cm of each. It is greater than 1 cm from other margins. Microscopic evaluation reveals poorly differentiated invasive ductal carcinoma with nuclear grade III and a high mitotic index. A focus of ductal carcinoma in situ (micropapillary and comedocarcinoma types) measuring 0.9 cm is present adjacent to the invasive component. Ductal carcinoma in situ is located 1 mm from the superficial margin; invasive carcinoma is 1.5 mm from the superficial margin and also appears as a microscopic satellite nodule 1 mm from the deep margin. The inferior margin is clear by 3 mm. Superior, medial, and lateral margins are free of tumor by more than 1 cm. Atypical duct hyperplasia is identified 3 mm from the medial margin.\n\nAxillary lymph node dissection includes a total of 28 lymph nodes. Metastatic involvement is identified microscopically in 5 of these nodes.\n\nThe left breast superficial and inferior margin specimen consists of benign fatty tissue with a microscopic focus of invasive ductal carcinoma measuring approximately 1 mm. This focus has a cauterized margin and is not directly attached to the inked margin, making its precise relationship to the margin indeterminate. This tumor focus was identified in one of ten tissue blocks examined (block C10)."} +{"pid": "TCGA-06-5418", "report": "The patient presented with symptoms of dysphasia and was found on MRI to have a ring-enhancing lesion in the right frontal region near Broca's area. A resection of the left frontal brain tumor was performed, along with an excision biopsy.\n\nGross examination of the resected specimen revealed two fragments measuring 1.7 cm in aggregate, with a semi-firm, greyish-white appearance. The biopsy specimen consisted of several tan-pink to red fragments, measuring 2.4 x 1 x 0.3 cm in total.\n\nMicroscopic evaluation showed a highly cellular astrocytic neoplasm with significant nuclear atypia, brisk mitotic activity, and areas of necrosis, some with pseudopalisading. The tumor extensively infiltrated and effaced normal brain architecture. The neoplastic cells were predominantly small with round to ovoid nuclei. Immunohistochemical staining demonstrated a dense gliofibrillary background with GFAP positivity. CD34 highlighted a fine vascular network with evidence of microvascular proliferation. The MIB-1 labeling index was approximately 40% across multiple tumor regions.\n\nHistological features indicated a high-grade glial neoplasm with extensive proliferation and necrosis. Intraoperative smears supported the presence of a high-grade glial tumor. Additional molecular studies are pending and will be reported separately."} +{"pid": "TCGA-DB-A4XB", "report": "A brain specimen from the left parieto-occipital region was received in multiple fragments. The largest fragment measured 3.8 x 3.6 x 0.9 cm, and the smallest 1.2 x 1.2 x 0.4 cm, with a total weight of 12.1 grams. An ill-defined mass within the cortex measured approximately 1.1 x 1.0 x 0.9 cm. Additional tissue fragments and CUSA trap contents were also submitted, ranging in size from 2.0 x 1.1 x 0.5 cm to 5.0 x 3.8 x 1.2 cm.\n\nHistologic evaluation revealed a neoplasm with a prominent infiltrative pattern involving the cortex and subcortical regions. A distinct leptomeningeal component was noted, accompanied by desmoplasia, scattered eosinophilic granular bodies, and chronic inflammation. Immunohistochemical analysis demonstrated positivity for p53 and IDH1 (R132H) in tumor cells, with a moderate Ki67 (MIB-1) labeling index. GFAP staining was strongly positive in tumor cells, particularly those extending into the leptomeninges. S-100 protein staining highlighted areas of reactive gliosis. Neurofilament labeled axons, and PAS staining outlined vascular walls, parenchymal architecture, and eosinophilic granular bodies, especially within the leptomeningeal component.\n\nThe tumor exhibited a diffuse growth pattern, and frozen section evaluation initially suggested a glioma, pending final classification. Multiple blocks were processed from the primary resection and CUSA contents, with all specimens embedded for detailed histopathologic review."} +{"pid": "TCGA-CV-A461", "report": "A total laryngectomy specimen included an ulcerated, nodular, and polypoid lesion measuring 5.0 cm in its greatest dimension from the posterior superior epiglottis, extending 3.5 cm from right to left and 3.0 cm in depth. The lesion approached within 1.0 cm of the tip of the epiglottis, 0.5 cm from the right and left aryepiglottic folds, and was located bilaterally in the supraglottis. It did not extend to the true vocal cords. The lesion reached the pre-epiglottic space and extended to the hyoid bone with a thin fibrous covering. There was evidence of lymphovascular invasion, but perineural invasion was not identified. The tracheal margin was free of tumor, as were all other surgical margins examined, including the right and left laryngeal margins, posterior cricoid mucosa, left and right pyriform sinuses, superior vallecula margin, and right pyriform sinus. The right thyroid lobe showed no abnormality.\n\nLymph node dissections were performed on the left neck (level 3), central compartment, and right side. A total of 21 lymph nodes were evaluated: 6 from level 3 (including 7 possible lymph nodes, with sizes ranging from 0.4 x 0.3 x 0.2 cm to 1.5 x 1.3 x 0.8 cm), 15 from the central compartment, and 1 paratracheal lymph node. All were negative for tumor involvement. The resection margins and surrounding soft tissues were unremarkable, with no additional lesions identified."} +{"pid": "TCGA-HE-A5NK", "report": "The sample was collected from a kidney lesion measuring 6 cm in size. Histological examination revealed a neoplasm of the renal parenchyma with papillary architecture. Cellular morphology showed characteristic features consistent with a malignant epithelial neoplasm. The lesion was classified as Grade IV, indicating poorly differentiated morphology. Pathologic staging demonstrated involvement confined to the kidney with no evidence of lymph node or distant metastasis. No lymph nodes were assessed. The specimen was obtained via resective procedure. Additional blood-derived samples were collected but not diagnostic for malignancy."} +{"pid": "TCGA-A2-A0YD", "report": "A female patient underwent a left breast total mastectomy with sentinel lymph node biopsy. Two sentinel lymph nodes were evaluated intraoperatively and both were negative for malignancy. Final pathological examination of the surgical specimens confirmed that both sentinel lymph nodes were benign reactive nodes without evidence of tumor involvement.\n\nThe mastectomy specimen contained a firm tan-gray mass measuring 6.5 x 4.5 x 3 cm. Microscopic evaluation revealed a moderately differentiated infiltrating carcinoma with features involving terminal ductules. The tumor was located approximately 2 cm from the deep margin and distances from other margins ranged between 5.5 cm and 8 cm. All inked surgical margins were free of tumor.\n\nHistologic grading using the Scarff-Bloom-Richardson system yielded a score of 6 (3+2+1). Immunohistochemical staining of one sentinel lymph node showed seven positive cells in the subcapsular space, measuring cumulatively less than 0.1 mm. These findings suggest incidental microscopic involvement. The second lymph node showed no individual positive cells.\n\nPathologic staging was determined as T3 pN0(I+), MX, Stage IIB, Grade 2. The tissue specimen was processed in nine blocks for comprehensive histologic evaluation."} +{"pid": "TCGA-AA-3855", "report": "The specimen includes an epiploic appendix with inflammatory reactive changes. A free anastomosis is noted. A moderately differentiated adenocarcinoma is present with invasion extending into the muscularis and vascular structures. The resection margins are free of involvement, and no lymph node metastases are identified. The tumor exhibits a histological grade of G2, with a pT2 classification, indicating penetration into the muscularis propria. Lymphatic invasion (L1) and vascular invasion (V1) are present. Lymph node staging is pN0, based on the absence of metastasis in all 36 retrieved nodes. Local resection is complete (R0). The tumor has been discussed in the context of further oncological assessment."} +{"pid": "TCGA-XJ-A9DQ", "report": "The prostatectomy specimen measured 4.2 cm in width, 3.8 cm in length, and 3.0 cm in depth. The right seminal vesicle measured 2.2 cm in length and 1.5 cm in diameter, while the left measured 2.3 cm by 1.3 cm. The right vas deferens was 1.4 cm long and 0.4 cm in diameter, and the left was 1.7 cm by 0.4 cm. The external surface of the prostate was tan-white and smooth. Upon sectioning, a tan-yellow band was identified in the posterior region, measuring 2.5 x 0.8 x 0.5 cm, and located within 0.1 cm of the closest margin. The remaining cut surfaces were tan-pink, smooth, and glistening.\n\nMicroscopic evaluation revealed a lesion involving one lobe, with a total Gleason score of 6 (3+3). Approximately 5% of the prostate tissue was involved by the lesion, which was found in multiple areas. There was evidence of perineural involvement, but no vascular invasion. The lesion was not present at the surgical margins, although it approached within 1 mm of an inked margin. No extension beyond the prostate capsule was identified, though proximity to the capsule was noted in two areas. Invasion of the seminal vesicles was not present. Lymph node assessment was not performed.\n\nAdditional findings included stromal hyperplasia. The pathologic stage was determined as pT2a, indicating unilateral involvement limited to one-half of a lobe or less. Regional lymph node involvement could not be assessed (pNX), and distant metastasis could not be evaluated (pMX). The staging is considered provisional, based solely on available pathologic data."} +{"pid": "TCGA-FU-A770", "report": "A 4.5 x 2.5 cm mass was identified in the cervix with extension into the lower uterine segment. Histologic evaluation showed moderately differentiated tumor with a depth of invasion measuring 1.0 cm within a 1.3 cm thick cervical and lower uterine segment wall. No lymphovascular space invasion was identified. Surgical margins, including the vaginal and deep margins, were negative for malignancy. A total of 10 lymph nodes were examined; one of five lymph nodes from the right pelvic region contained metastatic involvement, while all five lymph nodes from the left pelvic region were negative. The uterine artery biopsy was negative for malignancy. The endometrium was benign and showed proliferative changes. Both ovaries and fallopian tubes appeared unremarkable without significant abnormalities. Immunohistochemical staining demonstrated positivity for p16 and negativity for WT1. Staging was determined as pT2a2N1 according to the TNM classification system."} +{"pid": "TCGA-KK-A6E8", "report": "The specimen included a prostate with attached seminal vesicles and vasa deferentia. The prostate measured 4.5 x 4.5 x 3.9 cm and weighed 42 grams after fixation. A nodule was identified on the left anterior surface. Serial cross sections revealed a firm area in the anterior portion of both cross sections of the prostate. The right and left seminal vesicles and segments of the vasa deferentia appeared free of abnormality.\n\nA single focus of atypical cells was identified in the transition zone, involving the anterior half of the prostate. The lesion measured 3.5 x 1.5 cm in its largest cross-sectional dimension and was present extensively in the apex and focally in the base region. There was possible minimal extension to the left apical margin, less than 1.0 mm, but no definitive evidence of extraprostatic involvement.\n\nSections from multiple regions of the prostate were submitted for analysis, including the base and apex on both right and left sides, as well as central areas. The anterior aspect of the prostate was marked with green ink, the left surface with red, the right with yellow, and the posterior with black. Sections C21 and C22 were marked with blue ink indicating surfaces that do not represent true resection margins.\n\nLymph node evaluation was performed. In the periprostatic region, no lymph nodes were identified within the fibrofatty tissue. The left pelvic lymph node specimen measured 5.8 x 3.8 x 1.0 cm, and seven possible lymph nodes were identified, ranging in size from 0.5 x 0.4 x 0.3 cm to 2.0 x 0.8 x 0.5 cm. Similarly, the right pelvic lymph node specimen measured 6.5 x 3.5 x 0.8 cm, and seven possible lymph nodes were identified, ranging from 0.3 x 0.3 x 0.2 cm to 1.2 x 0.5 x 0.4 cm. All lymph nodes were entirely submitted for histological examination and no abnormal cellular findings were observed in either group.\n\nA small fragment of tan-gray tissue (0.5 x 0.4 x 0.2 cm) from the anterior apex was reinked and submitted in toto for frozen section analysis. The assessment showed prostatic glands at the margin, with no abnormal cells detected. The periprostatic lymph node specimen consisted of yellow-tan fibrofatty tissue measuring 2.5 x 2.0 x 0.6 cm, with no lymph nodes identified. All tissues were submitted for microscopic evaluation. High-grade intraepithelial proliferative changes were noted in the prostate."} +{"pid": "TCGA-GU-A767", "report": "A radical cystoprostatectomy specimen was evaluated, including the urinary bladder and prostate. Gross examination revealed a large, fungating, friable pink-tan mass involving the entire bladder, with no normal mucosa identified. The mass measured 7.0 x 6.5 cm and up to 1.5 cm in thickness. It extended into the prostatic urethra, reaching within 1.5 cm of the urethral margin, and abutted both ureteral orifices. Microscopically, the tumor demonstrated high-grade features with a micropapillary configuration, comprising approximately 60% of the tumor volume. The neoplasm invaded through the muscularis propria into perivesical adipose tissue (pT3), with extension to the posterior fat within 0.5 cm of the peritonealized surface. Vascular and perineural invasion were present. Margins of resection were uninvolved by invasive disease or in situ changes.\n\nLymph node evaluation included specimens from both left and right pelvic regions. A total of six lymph nodes were examined, with three showing involvement by tumor cells. Pathologic staging was determined as pT3b for the primary tumor, indicating macroscopic invasion into perivesical tissue, and pN2 for regional lymph node involvement with multiple positive nodes.\n\nAdditional findings in the prostate included high-grade intraepithelial neoplastic changes. The background urothelium showed chronic inflammation and biopsy site changes. No involvement of the seminal vesicles, vas deferens, or prostatic stroma was observed. Multiple deeper sections and microscopic evaluations were performed, and select slides were reviewed for confirmation. Ureteral margin specimens were also examined and found to be free of invasive disease, though focal atypia was noted."} +{"pid": "TCGA-AP-A05N", "report": "The submitted specimens include a hysterectomy with bilateral salpingo-oophorectomy, as well as right and left hypogastric sentinel lymph node excisions. \n\nIn the hysterectomy specimen, architectural features are noted with a growth pattern characterized by a component measuring less than 68% solid. Cellular atypia is present, with nuclear features corresponding to an intermediate grade. A separate grading system also indicates a lower grade of differentiation. Invasion into the myometrium is identified and does not extend beyond 4\u20135 mm within a myometrial wall measuring 22 mm in total thickness. However, due to the irregular contour of the endomyometrial interface and the presence of adenomyosis, precise measurement of invasion depth remains uncertain. There is no evidence of endocervical involvement. Lymphovascular invasion is suspected but not definitively confirmed. Adjacent endometrial tissue shows complex hyperplasia with atypia. The myometrium contains areas of adenomyosis and multiple leiomyomata. No significant findings are noted in the adnexal regions.\n\nRegarding the lymph nodes, one lymph node was examined from each hypogastric region. No metastatic involvement is identified in either the right or left sentinel lymph nodes. Additional histological and immunohistochemical evaluations using cytokeratin markers (AE1:AE3) do not reveal any evidence of tumor spread to these nodes.\n\nThe report is based on direct examination of the slides and review of all relevant materials."} +{"pid": "TCGA-12-1600", "report": "A surgical pathology report describes a specimen of brain tissue measuring 2.5 x 1.4 x 1.4 cm, noted as erythematous red-tan and soft in consistency. A portion was used for frozen section analysis with the remainder submitted in multiple blocks for further evaluation.\n\nMicroscopic examination reveals infiltration of the brain by a malignant astrocytic lesion. The lesion demonstrates marked cytologic pleomorphism, mitotic activity, glomeruloid microvascular proliferation, and pseudopalisading necrosis.\n\nCytogenetic studies using FISH analysis show chromosomal abnormalities. Chromosome 7 centromere polysomy is present in 74% of cells. EGFR amplification is observed in 97% of tumor cells. Chromosome 10 centromere loss occurs in 31% of cells, and PTEN allelic loss is seen in 38%. Chromosome 9 centromere polysomy is identified in 56% of tumor cells, and 9p21 polysomy is found in 59% of tumor cells. All four markers tested show abnormal findings.\n\nImmunohistochemical analysis indicates MGMT positivity in 80% of tumor cells. EGFR wild-type expression (3+) is present in 90% of tumor cells, while EGFR variant VIII expression (3+) is detected in 40%. PTEN shows reduced expression (2+) in 50% of tumor cells. Phosphorylated S6 (pS6) and phosphorylated AKT (pAKT) are largely negative, with only weak staining (2+) seen in 10% and 5% of tumor cells, respectively.\n\nAll findings were obtained from tissue containing a high-grade brain neoplasm and have been personally evaluated and certified."} +{"pid": "TCGA-LK-A4NY", "report": "The surgical specimen from a right pneumonectomy and lymph node dissection reveals a neoplastic process involving multiple tissue layers. The lesion demonstrates invasion into the parietal pleura, pleural adipose tissue, diaphragmatic muscle, fissure, and pulmonary parenchyma, with intraparenchymal nodules noted. A nodule located on the azygos vein also shows involvement. Histologic evaluation reveals a mixed growth pattern, predominantly tubulopapillary, with abundant myxoid stroma and extracellular hyaluronic acid production. In some areas, a spindle cell component is present.\n\nA total of twenty-five N1 lymph nodes were examined and none show evidence of metastatic disease. Additionally, multiple lymph node biopsies from various locations including level 10, subcarinal, near the inferior pulmonary ligament, and within the vagus nerve region all demonstrate reactive changes without signs of malignancy.\n\nBiopsies from the chest wall at the fifth rib, soft tissue near the vagus nerve, bronchial resection margins, and pericardium show no significant pathologic abnormalities except for findings related to the primary lesion in the pericardium. Two bone specimens from the right ribs are undergoing decalcification; preliminary sections reveal normal bone and marrow without evidence of tumor involvement.\n\nOther findings include a suture granuloma identified in the pleura and in a chest wall biopsy, as well as acute fibrinous and organizing pleuritis associated with a foreign body giant cell reaction in another chest wall sample. No evidence of asbestosis or ferruginous bodies was identified in the lung tissue. Immunohistochemical staining supports the morphologic features described."} +{"pid": "TCGA-EL-A3H7", "report": "A female patient underwent surgical removal of thyroid tissue and associated lymph nodes. The thyroid specimen measured 4.0 x 2.5 x 1.5 cm and contained two distinct nodules. The larger nodule, located in the midportion of the right thyroid lobe, measured 3.0 x 2.6 x 1.7 cm and exhibited a tan-brown, homogeneous, and nodular cut surface. It was found to be in close proximity to the thyroid capsule but did not grossly penetrate it. A small amount of skeletal muscle was noted on the outer surface of the thyroid capsule. The second nodule, measuring 0.8 x 0.7 x 0.6 cm, was located in the lower portion of the left thyroid lobe and had a tan, glistening cut surface with slightly firmer consistency than the first nodule.\n\nA lymph node from the Delphian region (0.4 x 0.4 x 0.3 cm) was entirely submitted for analysis. Another lymph node located along the recurrent nerve (0.4 x 0.3 x 0.3 cm) was also evaluated and showed no evidence of capsular extension. Multiple paratracheal lymph nodes were examined, ranging from 0.3 to 0.6 cm in size, with six out of seven showing involvement.\n\nHistological evaluation revealed chronic inflammation within the thyroid gland. One of the lymph nodes removed during the procedure showed findings consistent with involvement by cells exhibiting nuclear features suggestive of metastatic disease. Adjacent soft tissue showed signs of infiltration at the surgical margin. Additional fragments of soft tissue were assessed; one fragment interpreted as thyroid tissue and another identified as parathyroid tissue. No abnormal cellular growth was detected in the parathyroid sample. The remainder of the thyroid tissue appeared unremarkable under microscopic examination."} +{"pid": "TCGA-RN-AAAQ", "report": "The tumor measured 16.5 cm in greatest dimension and was located in the brachial plexus of the left arm. Microscopic examination revealed a deep-seated lesion with a histologic grade of 3. The mitotic rate was 6 mitoses per 10 high power fields, and necrosis was present, involving approximately 50% of the tumor. Immunohistochemical analysis showed that the tumor cells were negative for AE1/AE3, HMB-45, smooth muscle actin, MiTF, CD31, desmin, cytokeratin 7, and EMA. The tumor cells exhibited diffuse strong immunoreactivity with vimentin and demonstrated diffuse strong expression. A CD34 immunostain highlighted the background vasculature. The MIB-1 labeling index was calculated at 15.7%. Surgical margins could not be assessed."} +{"pid": "TCGA-06-0129", "report": "The specimen consists of two fragments from a right frontotemporal brain lesion, measuring up to 0.8 cm in aggregate. The tissue is semi-firm with tan-gray discoloration and areas of hemorrhage. Microscopically, the neoplasm is highly cellular, composed of medium-sized nuclei with marked anaplasia. The cytoplasm is sparse, giving nuclei a naked appearance, though a fibrillary background is present. Frequent karyorrhectic nuclei are observed, along with occasional mitotic figures and microvascular proliferation. An area of tumor necrosis is noted with associated vascular necrosis and thrombosis. A separate fragment from a superficial brain region, measuring 0.5 cm, shows similar neoplastic infiltration without evidence of microvascular proliferation. Immunohistochemical staining reveals minimal fibrillogenesis by GFAP, a dense microvascular network by factor VIII, and a proliferation index of 35% by MIB-1."} +{"pid": "TCGA-G7-7501", "report": "A radical nephrectomy specimen from the left kidney includes a tumor measuring 9.5 cm in greatest dimension, with additional dimensions of 6.5 cm \u00d7 3.3 cm. The tumor is located in the middle and lower poles, is unifocal, and extends into perinephric tissues. Grossly, it is poorly circumscribed, solid to partially cystic, with areas of hemorrhage and necrosis. There is vascular and lymphatic invasion, as well as invasion into perihilar and perinephric fat. The adrenal gland and surgical margins are not involved. \n\nExamination of para-aortic lymph nodes reveals involvement in six out of eleven nodes. Histologic evaluation shows high-grade nuclear features with very irregular nuclei and prominent nucleoli. Immunohistochemical staining demonstrates positivity for CD10, RACEMASE, PAX-2, Renal Cell, CAM5.2, AE1/3, and CD117, while being negative for Cytokeratin 7, EMA, p63, HMB45, and Melan-A. Vimentin shows focal weak positivity.\n\nFluorescence in situ hybridization (FISH) analysis for TFE3 gene rearrangement was performed and showed no evidence of translocation involving ASPSCR1 and TFE3. However, this does not exclude the possibility of a TFE3 translocation with other fusion partners.\n\nPathologic staging is determined as pT3a, N1, MX based on the AJCC Cancer Staging Manual, 7th Edition."} +{"pid": "TCGA-55-6971", "report": "The specimen consisted of a left lower lobe lung lobectomy measuring 16.0 x 11.0 x 3.0 cm and weighing 132 grams. A circumscribed gray-tan mass measuring 3.3 x 3.0 x 2.7 cm was identified within the tissue. The mass was located 0.1 cm from the pleural margin and 2.8 cm from the bronchial margin. No stapled edge or additional lesions were observed. Surrounding lung tissue appeared brown-tan to red-tan and spongy. No lymph nodes were identified in the peribronchial soft tissue.\n\nA total of fourteen lymph nodes were examined across multiple regions. One anthracotic lymph node from the inferior pulmonary ligament, three from the hilar region, four from the interlobar area, one peribronchial node, two from the AP window, and three subcarinal nodes were all assessed. No metastatic carcinoma was found in any of the lymph nodes evaluated (0/14).\n\nHistologic evaluation revealed a moderately to poorly differentiated cellular composition. No evidence of pleural invasion or lymphovascular space invasion was observed. All surgical margins were negative. Representative sections of the mass, bronchial and vascular margins, and uninvolved lung tissue were submitted for analysis."} +{"pid": "TCGA-ZB-A96L", "report": "Pathology Report-Summary: To 4/7/14. Material: Tumor: 6.0 x 6.0 x 4.5 cm. Infiltration of mediastinal fat tissue. Histopathological examination revealed a tumor with epithelial cells positive for p63 and CK5/6, and strong membrane staining for EGFR. The tumor cells were negative for CD117, synaptophysin, and chromogranin A. Proliferation index (Ki-67) was 30%. Lymphocytic component showed CD99-positive immature T-lymphocytes, CD5 negative. Staging according to Masaoka classification was stage III. Pathologic staging was pT3, pNO (0/1)."} +{"pid": "TCGA-E1-A7YK", "report": "A 3.3 x 2.2 x 1 cm fragment of white-pink soft tissue from a brain biopsy was received and processed for examination. Histologic evaluation revealed brain parenchyma infiltrated by a glial neoplasm characterized by cellular pleomorphism, including prominent gemistocytes, and perivascular lymphocytic inflammation. Scattered mitotic figures were observed. No microvascular proliferation or necrosis was identified. Immunohistochemical staining demonstrated positivity for GFAP, confirming glial lineage. The Ki-67 labeling index was 3%, indicating low proliferative activity.\n\nIntraoperative consultation noted findings consistent with a glioma containing gemistocytes. Additional immunohistochemical studies showed variable expression in tumor cells: Leukocyte Common Antigen (LCA) was positive in 30% of cells; MGMT was positive in 25% of tumor cells; EGFR wild-type was strongly expressed (2+ in 70%); EGFR variant III was not detected. S6 and AKT were each positive in 25% and 30% of tumor cells respectively, both showing moderate intensity. MAPK was also positive in 25% of tumor cells. Carbonic anhydrase IX was not expressed. VEGF immunohistochemistry was negative with a score of 4. PDGFR-A showed widespread expression (90%), while PDGFR-B was present in 60% of tumor cells. VEGFR2 (KDR) was positive with a score of 30.\n\nMolecular testing using fluorescence in situ hybridization (FISH) revealed polysomy of chromosome 7 in 32% of tumor cells and polysomy of EGFR in 35%. Chromosome 10 and PTEN remained intact without loss. Loss at 9p21 was observed in 42% of tumor cells, along with centromere loss on chromosome 9 in 38%. Two abnormal markers were identified. Real-time PCR analysis did not detect methylation of the MGMT promoter region.\n\nMRI imaging showed abnormal parenchymal signal with discontinuous, nodular enhancement localized to the inferolateral aspect of the left temporal lobe. Clinical correlation indicated seizure activity and confusion prior to biopsy."} +{"pid": "TCGA-V4-A9EE", "report": "Right eye enucleation specimen. The eyeball measured 25 mm in diameter prior to fixation, with a 6 mm segment of the posterior optic nerve. On sectioning, a lesion was identified in the lateral and posterior aspect of the globe, located away from the ciliary body and distant from the intraocular emergence of the optic nerve. The lesion protrudes significantly into the vitreous cavity, measuring 16 mm along its largest axis and up to 12 mm in maximum thickness, with areas of cystic change noted. The anterior chamber remains clear. Samples were taken for cryopreservation and cytogenetic analysis, with two portions preserved accordingly, and the remainder of the specimen embedded entirely after fixation.\n\nMicroscopically, the lesion demonstrates a malignant cellular proliferation composed predominantly of medium to large epithelioid cells. These cells exhibit abundant eosinophilic cytoplasm, some containing melanin pigment. Nuclear features include marked variation in size and shape, with occasional bizarre or multinucleated forms. Prominent nucleoli are frequently observed, and a low number of mitotic figures are present. The tumor is adherent to the inner scleral surface and extends into the deeper scleral layers, involving less than one-third of its thickness. There is no evidence of extension into the ciliary body, iris, or anterior chamber. At the posterior aspect, the lesion remains separate from the optic nerve throughout its course, including prelaminar, postlaminar, optic foramen, meningeal sheath, and cut end regions. No extrascleral spread is identified."} +{"pid": "TCGA-19-2619", "report": "A 0.8 x 0.4 x 0.3 cm tan-pink soft tissue fragment was received fresh for intraoperative consultation, labeled as \"anterior brain tumor.\" A frozen section and touch preparation were performed on this specimen, with the remainder submitted for permanent sections in two cassettes. Additional specimens labeled \"brain tumor\" were received in formalin: one group measuring 2.5 x 1.8 x 0.35 cm consisting of multiple irregular pink-tan soft cerebriform fragments, submitted entirely in one cassette; and another group measuring 4.4 x 3.5 x 0.7 cm consisting of multiple irregular opaque white to pink-tan soft cerebriform fragments, submitted entirely in three cassettes. Microscopic evaluation of touch imprint and intraoperative microscopic analysis indicated high-grade features. Histologic examination revealed a neoplasm composed predominantly of small cells with morphologic characteristics suggestive of an aggressive glial origin. The lesion exhibited extensive cellular density, nuclear atypia, frequent mitotic figures, microvascular proliferation, and areas of necrosis. Based on histologic criteria, the tumor demonstrated features consistent with a high-grade neoplastic process involving the brain parenchyma."} +{"pid": "TCGA-CJ-4890", "report": "Surgery Date: (A) PERIAORTIC LYMPH NODE: One lymph node, no abnormality identified. (B) LEFT KIDNEY AND ADRENAL: A mass was identified in the kidney measuring 14.0 cm in greatest dimension. The mass extends into the renal pelvis, renal sinus adipose tissue, and renal vein. The tumor is present in the renal sinus and extends to the perinephric fat, with a distance of 0.2 cm to the closest soft tissue margin. The ureter, hilar vascular structures, and soft tissue margins are free of involvement. The adrenal gland shows no evidence of involvement. GROSS DESCRIPTION: (A) PERIAORTIC LYMPH NODE \u2013 A single lymph node measuring 2.5 x 1.0 x 1.0 cm. The specimen was serially sectioned and entirely submitted in blocks A1-A2. (B) LEFT KIDNEY AND ADRENAL \u2013 The nephrectomy specimen measures 21.0 x 18.0 x 13.0 cm and includes an unremarkable adrenal gland measuring 7.0 x 2.0 x 1.5 cm. The mass is tan-yellow with variegation, including areas of hemorrhage and cystic change. It occupies approximately 80% of the kidney and measures 14.0 x 14.0 x 12.0 cm. The mass involves the renal sinus, renal vein, and extends to the perinephric fat. Representative sections of the mass were submitted to tumor bank and for ultrastructural analysis.INK CODE: Black - closest external surface of the mass. SECTION CODE: B1, margins of renal vein, artery, and ureter; B2, involvement in the pelvis/ureter; B3, involvement of renal vein; B4, involvement in renal sinus; B5-B6, sections of the mass near the external surface; B7-B15, additional sections of the mass; B16, uninvolved renal tissue; B17, section of adrenal gland. CLINICAL HISTORY: Not provided. SNOMED CODES: T-71000, T-C4600, M-83123."} +{"pid": "TCGA-ZB-A96C", "report": "Pathology Report-Summary: Material: Tumor: 12.0 x 8.0 x 7.0 cm. Infiltration of capsule observed. Histological evaluation reveals a mix of cellular features. Staging assessment shows no lymph node involvement (0/2 examined), and distant metastasis could not be determined. According to staging classification, the lesion is classified as stage I."} +{"pid": "TCGA-AA-3831", "report": "The histological examination reveals a poorly preserved tissue sample with extensive areas of necrosis. The tumor demonstrates tubular structures and marked nuclear atypia. It invades through all layers of the wall and extends into vascular structures, corresponding to pT1 staging with lymphatic (L1) and vascular (V1) invasion. The serosal surface shows only granulation tissue. The tumor grade is intermediate to high (G2\u20133), with no lymph node involvement (pN0). Surgical margins are negative (RO)."} +{"pid": "TCGA-63-A5MU", "report": "The specimen was collected from the right lower lobe and measured 5.5 cm in size. Histological evaluation showed a moderately differentiated carcinoma with squamous features. The tumor stage was determined as T2b with regional lymph node involvement classified as N1. There was no clinical evidence of distant metastasis. The tissue sample was obtained via resection. Additional samples, including buffy coat, were collected around the same time period."} +{"pid": "TCGA-3B-A9I0", "report": "The surgical specimen included a spleen, a retroperitoneal mass with a portion of the pancreatic tail, and an additional posterior margin. The spleen weighed 743.1 grams and measured 19.0 x 12.0 x 3.5 cm. It had an intact capsule and on sectioning showed a bright red, unremarkable parenchyma without lymph nodes identified in the attached adipose tissue.\n\nThe retroperitoneal mass was partially encapsulated, firm, and gray-white with a bosselated surface. It measured 18.0 x 15.0 x 13.0 cm. On cross-section, it revealed soft to firm tan-pink whorled tissue with areas of hemorrhage and minimal necrosis (approximately 15%). A portion of the pancreatic parenchyma appeared grossly involved with the mass. Multiple cystic structures, ranging from 0.5 to 1.0 cm, were noted in the remaining pancreatic tissue, and the pancreatic duct was not clearly visible. The tumor was inked for orientation, and representative sections were taken from all margins and relationships to surrounding structures.\n\nThe tumor demonstrated moderate differentiation with a FNCLCC grade of 2 out of 3, based on differentiation score of 2, mitotic count of 1, and necrosis score of 1. The mitotic rate was 6 per 10 high power fields. Tumor necrosis and hyalinization accounted for approximately 20%, with 80% viable tumor cells. No angiolymphatic invasion was identified. All surgical margins were free of tumor involvement. The closest negative margins\u2014proximal, lateral, inferior, and medial\u2014were less than 1 mm with a thin capsule. The final posterior margin was also negative. The pathologic stage was determined as pT2b NX Mx. The tumor was confined to the retroperitoneum, with no involvement of the spleen or pancreas. All slides were reviewed by the attending pathologist who confirmed the findings."} +{"pid": "TCGA-66-2766", "report": "The left lung specimen measured 17 x 14 cm at the base and up to 28 cm in length, with a resection plane located 3 cm proximal to the bifurcation of the upper lobe bronchus. A 2.3 cm mobile node was identified at the hilus, with pale brownish-white section surfaces. The pleural fissure was obliterated in the middle third, and at the junction of segment 3 with adjacent structures, the parietal pleura showed an extensive area of adhesion measuring approximately 7 x 5.5 cm. Beneath this adhesion was a centrally soft lesion, up to 1.0 cm in size, with pale brownish-white margins and a relatively clear, arcuate demarcation. The main mass was located in segments 3 and 2 and extended into adjacent sections of the lingula, reaching the pleura in the region of the adhesion. Lymph nodes up to 2.5 cm in size were involved, particularly in central locations, with some extending close to the hilar resection surface. The tumor caused narrowing of the proximal upper lobe segmental bronchi and spread to the pleural fissure. No macroscopic infiltration was observed in the lower lobe.\n\nIn the tumor environment and peripherally, especially in segment 3, the parenchyma showed patchy and diffuse induration with a brownish-yellow coloration. In other areas, particularly subpleurally, there was slight rarefaction of the tissue. Apical lesions in segment 1 showed accentuation with lacunae or lacuna systems up to 0.5 cm. In the lower lobe near the bronchi of the basal group, two grayish-black nodes were noted, measuring up to 0.6 cm.\n\nPleural tissue from repeat resection measured 6.5 x 4 cm and was up to 0.2 cm thick, with a surface that was partly smooth and partly rough. Lymph nodes were sampled from multiple stations: hilar (station 10) on the left showed a 1 cm grayish-black node; pulmonary ligament (station 9) contained two nodes measuring 0.8 and 0.5 cm; paraesophageal (station 8) on the left had a 1 cm node; subcarinal (station 7) included a 1.2 cm node with surrounding tissue; subaortic (station 5) had two nodes measuring 2.2 and 1.2 cm; low paratracheal (station 4) on the left contained two lesioned nodes (1.4 and 1.3 cm), with the larger showing a 0.3 cm hard yellowish area on section; prevascular and retrotracheal (station 3) showed a 1.2 cm node with surrounding tissue; hilar (station 10) on the right had a 2 cm node; paraesophageal (station 8) on the right included two lesioned nodes (1.6 and 1 cm); and low paratracheal (station 4) on the right showed a 1.8 cm lesioned node with a 0.3 cm hard yellowish area on section.\n\nHistological processing included 22 blocks from various sections: tumor with remaining parenchyma, pleural fissure, involved lymph nodes, hilar resection surfaces, peripheral segments, bronchial resection planes, and vessel margins. Some samples were processed with special stains including Elastica-van Gieson, PAS, and diastase-PAS, with decalcification where necessary.\n\nMicroscopic findings revealed features consistent with a poorly differentiated, large-cell and polymorphocellular process. Tumor necrosis with lacunar formation was present. Chronic resorptive and organizing pneumonia was observed in the tumor environment and in the periphery of segment 3. Emphysematous stromal remodeling with small subpleural cysts was noted in the apex, along with suspected respiratory bronchiolitis. Pleural adhesion zones and chronic fibrosing parietal pleuritis were also present. Lymph nodes showed reactive follicular hyperplasia in some cases, sinus enlargement, and minor anthracotic pigment deposition.\n\nThe main mass was located in segments 3 and 2. Although central segmental bronchi appeared free of tumor, there was evidence of invasion into the pleura of the pleural fissure and adhesion zone, primarily confined to the visceral layer. Multiple lymph node metastases, some of significant size, were found in the hilar region. A micrometastasis was detected in one sample, supporting the staging classification."} +{"pid": "TCGA-DB-A75K", "report": "The specimen consists of biopsies from a right frontal brain mass (specimens #1 and #2). Histological examination demonstrates a moderately cellular tumor composed of neoplastic cells with variable nuclear morphology. Immunohistochemical analysis was performed on paraffin sections from block A1 using antibodies against IDH1-R132H, p53 protein, and Ki-67. Staining for p53 reveals variable expression in a moderate proportion of tumor cells. Tumor cells show positivity for mutant IDH1 (IDH1-R132H), indicating the presence of an IDH1 mutation. The Ki-67 labeling index is at least moderate, reaching up to 10\u201312%. Fluorescence in situ hybridization (FISH) studies for 1p19q deletion have been ordered and will be performed on paraffin sections; results will be reported under Genetics in Synthesis in Labs."} +{"pid": "TCGA-DD-A1E9", "report": "The specimen consists of liver segments II and III, weighing 380 grams and measuring 18.3 x 10.8 x 4.8 cm. A single mass measuring 4.2 x 3.8 x 3.2 cm is present within these segments. The lesion involves the hepatic capsule; however, no involvement of adjacent organs is noted. Surgical margins are clear of any abnormal tissue, with a margin clearance of 2.5 cm. There is no evidence of extratumoral vascular invasion. The mass is partially encapsulated, and its infiltration into the surrounding liver tissue exhibits a pushing/infiltrating growth pattern. Evaluation of the non-neoplastic liver parenchyma reveals end-stage micronodular cirrhosis, along with steatosis and chronic inflammation. Staging classification is T2NX."} +{"pid": "TCGA-G7-6793", "report": "The left kidney specimen weighed 1,098 grams and measured 23 x 14 x 9 cm, with attached perinephric fat. The kidney proper measured 18 x 12 x 8 cm. A tan-brown mass measuring 17 x 11.8 x 8 cm replaced much of the renal parenchyma, with involvement of the renal pelvis and calyces. Hemorrhage and necrosis were present within the mass, and multiple fluid-filled cysts were observed. A rim of uninvolved renal tissue measured 4.5 x 3.5 x 2.1 cm. The mass extended into the perinephric fat and included a hilar nodule measuring 6.3 x 4.7 x 2.7 cm, which appeared to be contiguous with a tubular structure. No adrenal gland was identified. Lymph nodes within the perinephric fat ranged from 0.1 to 0.3 cm in size.\n\nLymph node dissection included inter-aortic caval and peri-aortic regions. The inter-aortic caval specimen measured 3.7 x 2.2 x 0.8 cm and contained eight lymph nodes ranging from 0.1 to 0.8 cm. The peri-aortic specimen measured 3.5 x 3.2 x 1.2 cm and contained three lymph nodes, ranging from 0.6 to 4.7 cm in diameter.\n\nHistologic evaluation showed a nuclear grade 3 morphology with very irregular nuclei and prominent nucleoli. Vascular invasion was present. Tumor extended into perinephric tissues and involved renal sinus adipose tissue. Sections from the vascular and ureteral margins were free of tumor involvement.\n\nOf seven perinephric lymph nodes examined, all were involved by tumor. In the inter-aortic caval region, four lymph nodes were examined and none contained tumor. In the peri-aortic region, two of four lymph nodes contained tumor.\n\nTumor deposits were noted in the perinephric adipose tissue, with one focus involving the inked surface. This may represent involvement of the Gerota\u2019s fascial margin, though definitive assessment requires correlation with surgical findings.\n\nStaging was based on extent of local invasion and lymph node involvement."} +{"pid": "TCGA-FG-A710", "report": "The specimen was received in two properly labeled containers, one designated for frozen section. The first portion consisted of two fragments of tan soft tissue measuring 0.6 x 0.3 x 0. cm in aggregate. A touch prep was made and a larger piece submitted for frozen section. The second portion was a 4.45 gram, 2.8 x 2.1 x 1.7 cm fragment of gray-white, soft, slightly friable tissue with smooth cut surfaces.\n\nMicroscopic examination revealed a mild to focally moderately cellular neoplasm infiltrating both gray and white matter. Tumor cells exhibited round to ovoid nuclei with prominent perinuclear halos. A background of slender vasculature was noted, with rare mitotic figures present. Immunostaining showed focal GFAP positivity in a small number of cells and a Ki-67 proliferation index elevated to approximately 8\u201310%, as determined by manual immunohistochemical analysis.\n\nFluorescence in situ hybridization (FISH) testing was performed using dual-color probe sets targeting 1p36/1q25 and 19q13/19p13 loci. A total of 109 cells were analyzed for the 1p/1q ratio, which was 0.35. For the 19q/19p ratio, 111 cells were evaluated, yielding a ratio of 0.37. Both ratios were below the established threshold of 0.80, indicating loss at both the 1p36 and 19q13 loci. These findings were confirmed by both computer-aided and manual counting methods, with results reviewed by a trained technologist and pathologist using an FDA-approved imaging system. At least 20 interphase nuclei from two different areas of the sample were evaluated for each probe set. Non-overlapping nuclei were selected for enumeration, and cells with no signals or only one color were excluded.\n\nThe test interpretation considered previously established reference ranges derived from 40 normal cases across 10 organ types. All control probes demonstrated appropriate reactivity. It is noted that some reagents used in the testing are classified as Analyte Specific Reagents (ASR), and the tests were developed and validated internally without FDA clearance.\n\nA frozen section was performed on the left frontal tissue and reviewed intraoperatively. The examining pathologist noted an infiltrating glial neoplasm. The final report includes comparison of FISH and H&E scanned slides, with no discrepancies noted. Two observers independently reviewed the FISH results. \n\nFollow-up is recommended due to the observed focal elevation in proliferation index, which may indicate potential for future biological progression."} +{"pid": "TCGA-ZJ-AAXU", "report": "The cervical biopsy specimen from the 4 o'clock position was received in formalin and consists of a pale pink to red tan tissue fragment measuring 0.6 x 0.5 x 0.2 cm. The entire specimen was submitted for analysis. Microscopic evaluation revealed moderately differentiated cells with features suggestive of a malignant process. Cellular morphology showed large, nonkeratinizing elements. No specific tumor name is provided in this summary. Staging and further classification were not included in the available report."} +{"pid": "TCGA-V1-A8MF", "report": "The prostate specimen measured 3.8 cm from apex to base, 6 cm medially to laterally, and 3.3 cm anteriorly to posteriorly, with a total weight of 44 grams. Gross examination revealed a solid, white, lobular lesion located in the left central and peripheral zones, measuring up to 3 cm in greatest dimension. This lesion was observed from the apical margin through serial slice 4 and extended along the posterior aspect into serial slice 7. The lesion was noted to abut the anterior, lateral, and posterior prostatic capsule in slices 1 through 4. A polycystic area was also identified on the left anterior lateral and posterior aspects of the left lobe.\n\nMicroscopic evaluation showed bilateral involvement with a Gleason score of 3+4=7. Tumor volume was estimated at 6.2 cubic centimeters, with more than 30% composed of Gleason pattern 3. Invasion of the prostatic capsule was identified in slides A1 and A3. Extensive extraprostatic extension was present, as seen in slides A6 and A11. Tumor cells were found to extend to the inked excision margins at the apex, left lateral, and base regions of the main specimen (slides A2, A6, and A13). However, separately submitted biopsies of the left posterior apical margin, left anterior apical margin, right pelvic lymph node, and left pelvic lymph nodes all showed no evidence of tumor involvement.\n\nPerineural infiltration was present in slide A5. No involvement of the seminal vesicles or prostatic intraepithelial neoplasia was identified. Benign glands were found at inked extension margins (slide A2). The right pelvic lymph node biopsy contained only fibrofatty tissue, and the left pelvic lymph node dissection, which included seven lymph nodes, was also free of tumor involvement.\n\nStaging based on AJCC/UICC criteria was determined to be pT3aNOMX. Tissue banking was performed from the left posterior apex prior to final processing. All surgical margins, except those noted, were negative for tumor. Multiple cassettes were submitted for histologic review, including sections from the apex, mid-gland, base, and seminal vesicle areas. The specimen was fully evaluated by the attending pathologist, and the diagnosis was confirmed following comprehensive slide review."} +{"pid": "TCGA-UB-A7ME", "report": "The liver specimen from a male patient includes a partial hepatectomy of segment 7. A mass measuring 3.5 cm in maximum diameter was identified and found to be moderately differentiated, with macrotrabecular and pseudoglandular patterns. The tumor had less than 30% necrosis, was unifocal, and did not show vascular invasion. The hepatic capsule was free of tumor involvement, and the tumor was confined to the liver. The closest resection margin was 1.2 cm from the tumor. Adjacent to this lesion, a second mass measuring 2 cm was present; this mass was soft, spongy, and dark red-purple in appearance.\n\nMicroscopic evaluation of the first mass showed no lymph nodes present, and the surgical margins were negative. The surrounding liver tissue showed minimal to mild lymphocytic portal inflammation, ground-glass hepatocytes, lobular inflammation, and scattered necrotic cells. A trichrome stain revealed periportal fibrosis with focally thin septa. Steatosis was also present, graded as mild. The non-neoplastic liver tissue showed changes consistent with a low grade of activity and fibrosis. The patient had a history of hepatitis B and elevated serum AFP. MRI prior to surgery showed a solitary lesion in segment 7, measuring 2.6 cm, along with multiple hemangiomas and no evidence of cirrhosis. The specimen was received fresh and consisted of a wedge of liver tissue weighing 122 g, measuring 10 x 7.5 x 3.6 cm. Two distinct masses were noted: one firm, multinodular, white-tan mass near the resection margin, and a second softer, spongy mass located 1.5 cm away. The uninvolved liver tissue appeared homogenous and dark rust-tan. Multiple sections were submitted for histologic analysis, including the masses, overlying capsule, and adjacent liver tissue."} +{"pid": "TCGA-21-1071", "report": "The specimen was received in seven parts. \n\n1. Labeled #1, \"R4\": A frozen section was performed on a 0.8 cm red-purple firm lymph node. No abnormal tissue was identified on frozen section evaluation.\n\n2. Labeled #2, \"portion of 6th rib\": A 2.0 cm tan fragment of rib with attached soft tissue was submitted. A representative section was processed following decalcification.\n\n3. Labeled #3, \"R9 lymph node\": Histologic examination revealed cellular features including poor differentiation and marked necrosis. A maximum dimension of 7.5 cm was recorded. There was no evidence of lymphatic or arterial invasion. Invasion through the pleura was not present, although there was evidence of tumor involvement within the pleura. All surgical margins were free of abnormal cells. Non-neoplastic lung tissue showed changes consistent with emphysema. A total of 20 lymph nodes were examined, none of which demonstrated any suspicious or involved characteristics. Staging assessment classified this as T2 disease."} +{"pid": "TCGA-DX-A1KW", "report": "The specimen consists of a large mass measuring 24.5 x 18.0 x 11.0 cm, involving the right retroperitoneal region, right colon, terminal ileum, and adjacent diaphragm. The mass is lobulated with yellow-tan cut surfaces and areas of hemorrhage and necrosis estimated at approximately 10%. A thin fibrous membrane surrounds the tumor on most aspects. Microscopically, the predominant component shows high-grade cellular features resembling fibrosarcoma or malignant fibrous histiocytoma-like morphology. Necrotic areas are present and scattered throughout the tumor. The tumor extends microscopically to the inked surgical margin. Adjacent structures including the bowel wall are involved; however, the bowel segment appears otherwise unremarkable. No lymph nodes were identified in the specimen."} +{"pid": "TCGA-AR-A24W", "report": "Breast, right, total mastectomy: A mass measuring 2.1 x 1.4 x 1.1 cm is identified in the central breast. Histologic evaluation shows Nottingham grade II features, with tubule formation score 3/3, nuclear pleomorphism score 2/3, and mitotic count score 1/3, resulting in a total Nottingham score of 6/9. A component of intermediate nuclear grade is present, accounting for approximately 5\u201325% of the lesion. Angiolymphatic invasion is noted. The surrounding non-neoplastic breast tissue demonstrates proliferative fibrocystic changes. Calcifications are observed within affected ducts. Biopsy site changes are also present. The lesion does not extend to the nipple, overlying skin, or underlying chest wall. All surgical resection margins, including the deep margin, are free of involvement, with a minimum tumor-free margin of 2.1 cm at the deep margin.\n\nLymph node evaluation includes a sentinel lymph node biopsy of the right axilla, involving nodes numbered 1A, 1B, 1C, and 2. Three of these four sentinel nodes contain metastatic involvement greater than 2.0 mm in size. Extranodal extension is not seen. Blue dye is identified in nodes 1A and 1B, but not in node 1C. In addition, 18 further right axillary lymph nodes from a dissection specimen show no evidence of involvement.\n\nLeft breast, total mastectomy: An intraductal lesion of micropapillary and cribriform growth patterns is present, showing low nuclear grade without intraluminal necrosis. The extent of this lesion involves an area measuring 5.7 x 2.3 x 1.4 cm. Non-neoplastic breast tissue shows nonproliferative fibrocystic changes. Calcifications are present in involved ducts, and biopsy site changes are noted. No abnormality is identified in the nipple or skin. All surgical margins are clear, with a minimum tumor-free distance of 1.5 cm at the deep margin."} +{"pid": "TCGA-12-1599", "report": "A right parietal brain lesion was resected from a patient presenting with visual hallucinations and headaches. Preoperative MRI demonstrated a peripherally enhancing mass in the right temporal region, along with additional areas of enhancement nearby.\n\nGross examination of the surgical specimen included two tissue samples. The first, received fresh for frozen section, measured 2 x 2 x 0.3 cm and consisted of soft brown tissue on a blue paper, entirely submitted for analysis. Representative sections were also placed in blocks A2\u2013A3. The second sample, received in formalin, measured 0.7 x 0.5 x 0.2 cm and was submitted in block B1.\n\nMicroscopic evaluation revealed a malignant astrocytic neoplasm infiltrating brain tissue. The tumor exhibited significant cytologic pleomorphism, mitotic activity, microvascular proliferation, and pseudopalisading necrosis. In some areas, there was a notable presence of macrophages and increased granular mitoses. Luxol fast blue (LFB) staining did not provide additional diagnostic information.\n\nImmunohistochemical analysis showed GFAP positivity in tumor cells, Ham56 positivity indicating numerous macrophages, and preservation of axons within regions of macrophage infiltration on NFP staining. Ki-67 labeling index was estimated at 5% to 10%.\n\nAdditional molecular testing by FISH demonstrated polysomy of chromosome 7 and EGFR in approximately 48% and 44% of tumor cells respectively, while centromere loss on chromosome 10 and allelic loss of PTEN were observed in 83% and 86% of tumor cells, respectively. All four markers were abnormal.\n\nImmunohistochemical labeling indices from block A2 showed MGMT expression in 40% of tumor cells, wild-type EGFR expression (2\u20133+) in 90%, absence of EGFR variant III, PTEN loss (2\u20133+ in 70%), pS6 positivity (2+ in 40%), and pAKT positivity (2+ in 30%).\n\nIn certain areas, the histological features suggested the possibility of coexisting demyelinating disease, although this is an extremely rare occurrence alongside such a neoplasm. Clinical correlation was recommended for further assessment."} +{"pid": "TCGA-CJ-4908", "report": "The surgical specimen includes a right kidney measuring 12.0 x 7.0 x 4.5 cm, along with segments of the renal artery, renal vein, and ureter. A well-circumscribed mass measuring 3.9 x 3.5 x 3.5 cm is present in the mid pole of the kidney. The mass has a yellow-tan appearance with extensive central hemorrhage. Microscopic evaluation shows cells with nuclear features corresponding to grade 2. The lesion is entirely contained within the kidney and does not extend into the perinephric fat, renal sinus, or renal vein. No involvement of Gerota's fascia is identified. Margins of resection, including those of the ureter, renal artery, and renal vein, are free of abnormal cells. Adjacent kidney tissue appears normal, and the pelvicalyceal system is uninvolved. Two small incidental findings are noted: one measuring 0.2 cm in the renal cortex and another measuring 0.3 cm in the medulla. No lymph nodes are found in the renal hilum. Tissue samples have been preserved for further analysis."} +{"pid": "TCGA-23-2643", "report": "A right and left salpingo-oophorectomy, total abdominal hysterectomy, omentectomy, and excision of multiple peritoneal and soft tissue nodules were performed. The right ovary was nearly completely replaced by a cystic and solid mass measuring approximately 13 cm in greatest dimension. The cystic component accounted for about 75-80% of the volume with loculations ranging from 0.5 to 10.0 cm in diameter. The solid portion made up about 15-25% of the tumor and was white-yellow and firm. Multiple plaque-like tumor deposits were present on the ovarian surface and extended into adjacent paraovarian and paratubal ligamentous tissues. The fimbriated end of the ipsilateral fallopian tube also contained tumor involving both mucosa and submucosal stroma.\n\nThe left ovary was smaller (2.4 x 1.5 x 1.4 cm) and atrophic, but partially replaced by tumor nodules ranging from 0.1 to 1.5 cm. Tumor also involved the serosal surface of this ovary. The adjacent fallopian tube appeared grossly uninvolved, though tumor was found in paratubal ligamentous tissues measuring up to 0.5 cm.\n\nThe uterus showed multiple tumor nodules on the serosal surface, some extending focally into the subserosal myometrium and parametrial tissues. A subserosal leiomyoma measuring 2.5 cm was identified without evidence of tumor involvement. Two benign endometrial polyps were also noted.\n\nThe omentum was partially replaced by tumor nodules ranging from 0.2 to 2.5 cm. Multiple peritoneal specimens from the right and left pelvic sidewalls, bladder peritoneum, and infundibulopelvic ligament all demonstrated tumor involvement. Additional soft tissue specimens including cecal nodule, hepatic flexure nodule, ileocecal nodule, and omental nodule were largely replaced by tumor.\n\nHistologically, the tumor was high-grade and poorly differentiated with predominantly serous features. Tumor cells exhibited nuclear atypia and frequent mitotic figures. In some areas, cytoplasmic clearing and an undifferentiated appearance were observed. Lymphovascular invasion was present in most involved sites. There was surface involvement of both ovaries and extensive involvement of fallopian tubes, uterine serosa, and multiple peritoneal regions. Reactive changes including fibrosis and inflammation were common in involved tissues.\n\nNo lymph nodes were identified or involved. Tumor was found in multiple bilateral ovarian and extra-ovarian sites, with widespread peritoneal dissemination."} +{"pid": "TCGA-CZ-4864", "report": "The specimen is received fresh, labeled with the patient's name, unit number, and \"#1 - left kidney\", and consists of a radical nephrectomy specimen measuring 23.5 x 11.5 x 7 cm in total. The kidney measures 10.5 x 7.2 x 5 cm, and two distinct masses are identified within the renal parenchyma.\n\nMass T1 is a yellow/red, ill-defined hemorrhagic mass measuring 5 x 3.5 x 3 cm located in the lower pole. It extends beyond the kidney to within less than 0.2 cm of Gerota's fascia and invades into the renal vein. The tumor is found in both segments of the vein bifurcation, completely blocking one branch. The mass is located 9 cm from the ureter margin, 2 cm from the vein margin, and 4 cm from the artery margin. Adjacent to this mass is a large cortical cyst measuring 7 x 5.2 x 1 cm, lined by pink, smooth tissue with multiple small white nodules.\n\nMass T2 has a pale tan necrotic and fibrotic component measuring 4.9 x 4.5 x 3.5 cm and a yellow component measuring 6 x 4.2 x 2 cm, located in the upper pole. It extends beyond the renal parenchyma and is 1.5 cm from the renal artery and vein margins, 8 cm from the ureter margin, and 4.2 cm from Gerota's fascia. A separate fibrotic nodule measuring 6 cm is consistent with prior cryoablation; no residual viable tumor is identified. There is also a simple renal cyst measuring 2 cm in diameter on the surface of the upper pole.\n\nMargins of the ureter, renal artery, and renal vein are negative for tumor. The adrenal gland shows no significant pathologic change.\n\nMicroscopic evaluation reveals that the non-neoplastic kidney parenchyma demonstrates diffuse mesangial and focal nodular glomerulosclerosis, most likely representing early diabetic changes with a superimposed primary vascular injury. Immunofluorescence studies show no immunoglobulin deposits, ruling out paraprotein or immune complex-mediated disease. There is moderate tubular atrophy and interstitial fibrosis involving 30-40% of the cortex, along with moderate to severe arterial and arteriolar sclerosis with hyalinosis. These chronic changes are likely secondary to vascular injury and may be present in the contralateral kidney as well.\n\nImmunofluorescence microscopy reveals minimal granular deposition of IgA in the mesangial areas, segmental deposition of IgM and C3, and diffuse linear deposition of albumin and IgG along basement membranes. Tubular basement membranes also show focal C3 reactivity. Electron microscopy was inconclusive due to absence of glomeruli in the submitted tissue.\n\nCytogenetic analysis of tissue from mass T2 reveals loss of the Y chromosome in nine of ten metaphases. No metaphases were available from tissue corresponding to mass T1, precluding cytogenetic analysis of that lesion."} +{"pid": "TCGA-BQ-5881", "report": "The specimen submitted for evaluation includes a right lower pole kidney partial nephrectomy and a deep margin excision. The primary specimen contains a well-circumscribed lesion measuring 3.1 cm in greatest dimension, located within the kidney. The surrounding renal tissue appears unremarkable. Histologic examination of representative sections shows a neoplastic process involving the kidney, with no evidence of local invasion or vascular involvement. The tumor cells exhibit high-grade nuclear features.\n\nAll surgical margins, including the deep margin, are free of neoplastic cells based on both frozen and permanent section analysis. No lymph nodes or adrenal tissue were identified in the specimens submitted. Staging classification indicates a localized lesion confined to the kidney, measuring less than 7.0 cm in greatest dimension. All relevant sections have been reviewed and confirmed."} +{"pid": "TCGA-DD-AAD5", "report": "The liver specimen measured 27.0 x 20.0 x 12.0 cm and weighed 3080.0 grams. A mass was identified, measuring 16.5 x 14.0 x 11.0 cm, with a greenish brown, solid, and granular cut surface containing areas of necrosis (60%). The mass was well-defined, round to oval in shape, and bile-tinged. Microscopically, the tissue showed a trabecular growth pattern with hepatic-type cells. The degree of differentiation was moderate to poor in some areas. A partial fibrous capsule was present, and there was evidence of capsular infiltration. No septum formation or ductal epithelial dysplasia was observed.\n\nThe surgical resection margin was not involved microscopically, with a safety margin of 0.3 cm. There was no invasion at the surgical margin, serosal surface, or portal vein. No microvessel invasion or intrahepatic metastasis was found. No satellite nodules were identified. The remaining liver tissue did not show definitive signs of cirrhosis. Chronic hepatitis of minimal grade was noted, likely related to viral etiology. The gallbladder measured 9.5 cm in length, 3.5 cm in diameter, with a wall thickness of 0.2 cm; the mucosal surface was greenish yellow and velvety, and the serosal surface was brown and smooth. Sections of the gallbladder and cystic duct were submitted for analysis. Representative sections of the mass, surrounding liver tissue, and resection margins were also included."} +{"pid": "TCGA-ET-A3BS", "report": "The specimen consists of a total thyroidectomy. The tumor was located in the right lobe, isthmus, and left lobe of the thyroid. Histologic examination reveals a multifocal lesion with a largest nodule measuring 5.5 cm in greatest dimension involving the isthmus and left thyroid lobe. A total of 17 lymph nodes were identified, with metastatic involvement present in 8. The extent of invasion corresponds to pT3 for the primary tumor and pN1a for regional lymph node involvement, indicating nodal spread to Level V1 including pretracheal, paratracheal, and prelaryngeal/Delphian nodes. Surgical margins are uninvolved, with the invasive component located less than 1.0 mm from both anterior and posterior margins. No evidence of venous or lymphatic invasion is observed. Additional findings include the presence of one parathyroid gland with adjacent thymic tissue located in the inferior left thyroid lobe."} +{"pid": "TCGA-CQ-A4CE", "report": "The specimen was received from the otolaryngology service and included multiple tissue samples. The primary specimen consisted of an oriented portion of tongue measuring 1.8 x 3 x 4.2 cm, with a tumor located on the dorsal surface. The tumor measured 1.6 x 2.8 x 3.4 cm and was described as homogeneous and partly friable. It was situated closest to the deep margin at less than 0.1 cm and also near the anterior, posterior, and lateral margins.\n\nMicroscopic evaluation showed squamous mucosa with chronic inflammation and reactive changes in several areas. Skeletal muscle and other mucosal specimens were negative for tumor involvement. In one area, the tissue showed squamous cell morphology with moderate differentiation and keratinization. Perineural invasion was identified, while lymphovascular invasion was not present. Two of the margins in this specimen were found to be positive for tumor involvement; however, separately submitted margins (from other specimens) were negative.\n\nLymph node dissection specimens from both sides of the neck contained a total of 37 lymph nodes, all of which were negative for tumor involvement. Submandibular glands and soft tissues from the right external jugular area were also unremarkable.\n\nThe tumor was staged based on size and depth of invasion. With a greatest dimension of 3.4 cm and a thickness of 16 mm, it was classified as pT2. Regional lymph node involvement was absent (pN0), and no distant metastasis was identified. The histologic grade was moderately differentiated. The surgical margins were largely negative except for two areas within one specimen."} +{"pid": "TCGA-67-3772", "report": "The surgical specimens included lymph nodes and a right upper lobe lung resection. Gross examination of the right diaphragmatic nodule showed five tan tissue fragments measuring 0.2 to 0.3 cm; frozen section revealed atypical cells possibly mesothelial, without evidence of malignancy. Three hilar lymph nodes were examined, all measuring between 0 and 1.1 cm; frozen sections showed no tumor involvement.\n\nThe right upper lobe specimen weighed 131 grams and measured 16 x 7 x 3 cm. A 2.2 x 2 cm firm, puckered area was noted on the pleural surface, with four small subpleural nodules nearby measuring up to 0.4 cm. The bronchial margin was stapled and measured 2.5 cm in diameter. Upon sectioning, a 4.3 x 3 x 2.2 cm well-circumscribed tan-yellow mass was identified beneath the puckered area. This lesion appeared to approach the pleural surface but did not involve any resection margins. Adjacent uninvolved parenchyma was spongy and homogenous. One hilar lymph node measuring 1 cm was identified and submitted entirely. All margins (bronchial, parenchymal, vascular) were free of tumor involvement.\n\nAdditional lymph node specimens were evaluated from various anatomical locations including bilateral paratracheal, tracheobronchial, pretracheal, and subcarinal regions. These ranged from 0.2 to 1.1 cm in size. Histologic examination revealed anthracosis in several lymph nodes but no evidence of tumor involvement. A total of 14 lymph nodes were assessed across multiple stations, none showing signs of metastatic disease.\n\nHistologically, the lung lesion was moderately differentiated with focal papillary features. There was visceral pleural invasion without extension to other structures. No venous or large vessel invasion was identified. Immunoperoxidase staining demonstrated positivity for TTF-1, supporting pulmonary origin. Additional findings included small incidental pulmonary nodules (0.3\u20130.4 cm), immunoreactive for PR and CD56, but negative for chromogranin.\n\nStaging was determined based on extent of invasion and lymph node status. The primary lesion measured 4.3 cm and was located in the right upper lobe. Based on histopathological evaluation, the stage classification was pT2 N0."} +{"pid": "TCGA-FR-A726", "report": "The submitted specimen from the right portion of the right ear measured 50 x 27 x 15 mm. A central nodule measuring 2.8 x 1.5 x 1.4 cm was identified and sampled. The margins were evaluated with the superior half (12\u20133:00) inked green and the inferior half (3\u20136:00) inked orange. Histologic examination revealed biopsy site changes and residual lentigo. The lesion demonstrated a Breslow depth of 14 mm and was ulcerated with consumption of the epidermis. The Clark level was IV, and a vertical growth phase was present. Mitotic activity was noted at 26 per square mm. No tumor infiltrating lymphocytes, regression, lymphovascular space invasion, satellite nodule, perineural invasion, coexisting nevus, or pigmentation were identified. Severe solar elastosis was present. All margins were widely free. Two separate fibrofatty specimens were received for evaluation of sentinel lymph nodes: one measuring 20 x 10 x 8 mm and a second containing two tissues measuring 7 x 5 x 5 mm and 8 x 7 x 5 mm. Each was entirely submitted for analysis. No suspicious cells or involvement were identified in any of the sentinel lymph node blocks examined. Staging based on this specimen is pT4b pN0 pMx; however, this may be incomplete and should be reviewed in conjunction with all available clinical data to determine final staging."} +{"pid": "TCGA-DJ-A13X", "report": "The clinical history indicates a prior fine needle aspiration of a right thyroid nodule. Submitted specimens include a Delphian lymph node and a total thyroidectomy specimen.\n\nThe Delphian lymph node specimen consists of one lymph node measuring 0.6 cm in greatest dimension. Histologic examination reveals benign lymphoid tissue without evidence of malignancy.\n\nThe total thyroidectomy specimen weighs 42.5 grams. The right lobe measures 7 x 6 x 3 cm, the left lobe 3 x 1.5 x 1.0 cm, and the isthmus 2.0 x 0.5 x 0.3 cm. A tumor is identified in the right lobe, measuring 6.5 x 5.5 x 4.0 cm, with a fleshy tan-brown cut surface. The tumor is completely encapsulated with focal capsular invasion noted. No mitotic activity, tumor necrosis, blood vessel invasion, or extrathyroid extension is identified. Surgical margins are free of tumor, and there is no evidence of multicentric disease. The surrounding thyroid tissue appears unremarkable with mild nodular hyperplasia. Parathyroid glands were not identified in the specimen.\n\nIntraoperative frozen section consultation of the Delphian lymph node confirmed benign tissue, consistent with the final diagnosis. All surgical margins are negative for tumor involvement."} +{"pid": "TCGA-D1-A16D", "report": "The tissue specimen includes a uterus with the right ovary measuring 2.2 x 1.4 x 0.8 cm and an attached segment of the right fallopian tube measuring 8.2 cm, along with the left ovary measuring 2.4 x 1.4 x 1.1 cm and a 7.4 cm segment of the left fallopian tube. The combined weight of these tissues is 145.0 grams. A separate appendix specimen measures 5.1 x 0.3 cm.\n\nMicroscopic evaluation reveals a lesion measuring 2.8 x 2.4 x 0.8 cm within the endometrium. The cellular features include glandular structures with nuclear atypia. The lesion is confined to the endometrial lining without extension into the myometrium. No evidence of involvement of the lymphovascular spaces is identified. The endocervical region does not show any abnormal cellular changes. The myometrium demonstrates superficial adenomyosis. The cervix appears histologically normal. \n\nThe bilateral ovaries are atrophic and otherwise unremarkable. The fallopian tubes on both sides show no significant histological abnormalities. The appendix also demonstrates no notable pathological findings."} +{"pid": "TCGA-KM-A7QE", "report": "A left renal mass was resected from a female patient. Intraoperative frozen sections of two margins were examined. The first margin, measuring 0.3 x 0.3 x 0.2 cm, showed benign renal cortex without any evidence of tumor. The second margin, measuring 0.2 x 0.2 x 0.2 cm, revealed benign renal medulla with no definite abnormality seen. The resected specimen weighed 7.6 grams and measured 2.5 x 3.7 x 2.3 cm, including perirenal fat and portions of kidney. The outer surface was marked with black ink, and the surgical resection margin was marked in blue. Upon bisection, a 0.6-cm nodule was identified with a gray-tan, hemorrhagic, smooth cut surface. This nodule was located within 0.1 cm of the black inked margin and 1 cm from the blue inked surgical margin. All margins were found to be free of tumor involvement. The nodule was confined near the renal capsule but did not extend into the surrounding perinephric fat. The tissue was fully submitted for histological analysis. Ancillary studies were performed as part of the diagnostic process, and the laboratory conducting these tests is CLIA-certified for high-complexity testing."} +{"pid": "TCGA-CM-4751", "report": "The clinical history includes a patient who underwent colonoscopy following gastrointestinal bleeding and required treatment for the bleed. Two specimens were submitted: one from the omentum and another from the right colon.\n\nThe omental specimen consisted of adipose tissue without identifiable lesions or abnormalities. Histologic examination revealed benign adipose tissue.\n\nThe right colon specimen included a segment of terminal ileum, cecum with attached appendix, and ascending colon. The terminal ileum measured 14.0 cm in length and 3.7 cm in circumference at the proximal margin. The remaining colon was 33.5 cm long with a distal circumference of 8.5 cm. The appendix was 6.0 cm long with an average diameter of 1.0 cm; its serosa appeared pink-tan, and the wall at the tip was partially thickened.\n\nA focal hemorrhagic area with lobulated yellow-tan adipose tissue extended along part of the specimen measuring up to 3.0 cm in thickness. There was a 6.0 x 4.0 cm puckered, hemorrhagic focus on the intestinal serosa near the ileocecal valve. This region and surrounding adipose tissue were marked with blue ink. Upon opening the specimen, an ulcerated lesion was identified measuring 3.0 x 4.7 cm, located 2.0 cm from the ileocecal valve and 24.5 cm from the distal margin. The depth of invasion was 0.8 cm, reaching through the muscularis propria and approaching the serosa. No gross perforation or serosal involvement was observed.\n\nMultiple small polyps were present throughout the mucosa, approximately 20 in total, ranging from 0.3 to 1.2 cm in size. All polyps larger than 1.0 cm were entirely submitted for evaluation, and representative sections of the remaining mucosa were also taken. Vascular invasion was identified, but no perineural invasion was present.\n\nMargins of resection were free of abnormal cellular changes. Multiple lymph nodes were identified within the attached adipose tissue. Of the 48 lymph nodes examined, 31 showed evidence of nodal involvement. No pre-existing tubular adenoma was identified.\n\nSections submitted for histologic evaluation included margins (proximal and distal), appendix, tumor, deepest invasion point, polyps over 1.0 cm, representative sections of the colon, ileum, and appendix, as well as lymph nodes (some bisected or trisected)."} +{"pid": "TCGA-BH-A1F5", "report": "The patient is a female who underwent a right sentinel node biopsy and right segmental mastectomy. Lymph node biopsies were performed at multiple sites. In total, six lymph nodes were identified across the sentinel and non-sentinel biopsies, all of which were negative for tumor involvement. One lymph node was present in specimen number 7, with findings consistent with micrometastatic carcinoma measuring less than 0.2 cm in diameter. The breast tissue showed a focus of infiltrating ductal-type carcinoma measuring 1.4 cm in greatest dimension on slide measurement. The Nottingham score was 7 out of 9, with tubules 3, nuclei 3, and mitosis 1. Microcalcifications were associated with the lesion. Lymphovascular invasion was identified. Ductal carcinoma in situ of solid and cribriform types was present, with nuclear grade 2 and comprising less than 5% of the lesion. Surgical margins were free of tumor; however, the infiltrating component approached the anterior margin within 0.3 cm. Changes related to a prior core biopsy site were noted. Hormone receptor analysis showed positivity for estrogen and progesterone receptors, and HER-2/neu testing was negative. Benign fibrocystic changes were also present in the tissue."} +{"pid": "TCGA-DU-5849", "report": "A left frontal brain lesion was excised from a patient who presented with sudden symptoms. Preoperative imaging had identified a heterogeneous, partially enhancing intra-axial mass. The surgical specimen measured 2.2 x 2.0 x 1.4 cm and consisted of brain tissue with a semi-firm consistency. On gross examination, there was loss of demarcation between cortex and white matter, along with cortical expansion. No areas of necrosis or hemorrhage were observed.\n\nMicroscopic evaluation revealed a tumor with regions of microcystic change. Some areas were moderately hypercellular, although mitotic figures were not prominent. Vascular proliferation and necrosis were absent. Immunohistochemical staining showed scattered weak to moderate reactivity for p53. The Ki-67 labeling index was approximately 4% in the most cellular regions. Positive and negative controls demonstrated appropriate immunoreactivity.\n\nMolecular analysis performed on the tumor sample showed allelic loss involving chromosome arms 1p and 19q. This was determined through a PCR-based assay using multiple microsatellite markers, including D1S548, D1S1592, D1S552 for 1p and D19S219, D19S412, PLA2G4C for 19q. LOH at all informative loci was confirmed, with germline comparison conducted using a blood sample. The presence of MGMT promoter methylation was also detected via bisulfite conversion and real-time PCR. The test demonstrated high sensitivity, capable of detecting as little as 1% methylated DNA in an unmethylated background. No EGFR variant III mutation was found following RNA extraction and PCR amplification.\n\nTechnical limitations were noted: for LOH analysis, the presence of more than 15% non-neoplastic cells could reduce sensitivity; for MGMT testing, samples with over 50% non-neoplastic cells or significant necrosis may also affect result interpretation. All molecular tests were performed as part of a laboratory-developed protocol and are intended for informational use alongside established clinical and diagnostic standards."} +{"pid": "TCGA-HT-8108", "report": "The microscopic examination reveals a moderately hypercellular glial neoplasm that diffusely infiltrates both gray and white matter. Most tumor cells exhibit either perinuclear halos or gemistocytic cytoplasm. A minor component suggestive of a fibrillary astrocytic phenotype is also present. The majority of tumor cells lack distinct processes and display round nuclei with mild to moderate nuclear atypia. No mitotic figures are identified, and there is no evidence of microvascular proliferation or necrosis. Immunohistochemical staining shows scattered MIB-1 reactivity throughout the tumor, with a calculated labeling index of 4.4%."} +{"pid": "TCGA-D8-A1JS", "report": "The surgical specimen measured 5 x 4 x 2 cm and included a skin flap of 4 x 0.5 cm. The minimum side margin was 0.2 cm. Intraoperative examination identified a probable invasive carcinoma. Microscopic evaluation revealed a focus of ductal carcinoma in situ of the cribriform type with mild to moderate nuclear atypia, without necrosis. Histological grading was based on mitotic count, which was 0 mitoses per 10 high-power fields. Immunohistochemical analysis demonstrated estrogen and progesterone receptor positivity in more than 75% of neoplastic nuclei. HER2 staining showed a negative result in the cancerous cells. Additional testing revealed absence of a myoepithelial cell layer around the lesion, as indicated by negative staining for p63 and SMA. Cytokeratin 5/6 did not react with the cells, while cytokeratin 7 showed partial reactivity. Proliferation index assessed by Ki67 staining was 5% in general areas and up to 20% in hot spots."} +{"pid": "TCGA-MA-AA3Y", "report": "The specimen consisted of a radical hysterectomy with bilateral salpingo-oophorectomy, along with pelvic lymph node dissections and an anterior vaginal margin biopsy. The uterus weighed 90 grams and measured 8.0 cm in length. The cervix measured 3.5 x 3 cm and displayed an eroded surface with areas of hemorrhage. Microscopically, there was a lesion involving the cervical tissue with invasion to a depth of 0.6 cm within a wall thickness of 1.5 cm. The lesion measured 1.9 cm in length and was located in the right superior and inferior quadrants as well as the left inferior and superior quadrants of the cervix. Histologic evaluation revealed moderately to poorly differentiated cells without evidence of lymphovascular invasion.\n\nMargins were assessed and found uninvolved by invasive disease, specifically at the vaginal cuff. Nineteen lymph nodes from the right pelvic region and ten from the left showed no signs of malignancy, totaling 29 lymph nodes examined with none involved. The anterior vaginal margin biopsy demonstrated benign squamous mucosa.\n\nAdditional findings included leiomyomas, early secretory endometrium, and paratubal cysts in both fallopian tubes. Both ovaries exhibited hemorrhagic luteinized cysts, benign cystic follicles, and corpora albicantia. A foreign body giant cell reaction was noted in the right ovary. Gross examination of the myometrium revealed a tan-white nodular mass with a whorling cut appearance in the fundic area measuring 2.0 x 1.8 cm. No other discrete lesions were identified.\n\nAll specimens were processed and reviewed thoroughly."} +{"pid": "TCGA-G4-6299", "report": "The specimen consists of a left hemicolectomy measuring 21.5 cm in length. A tumor is identified within the left colon, with a gross size of 6 x 4 x 2.3 cm. The tumor has an infiltrative and ulcerating configuration, with heaped-up borders approximately 1 cm above the mucosal surface. It is centrally ulcerated and coated with purulent material. The tumor is located 9.5 cm from the proximal margin and 7.8 cm from the distal margin. The proximal bowel circumference measures 10 cm, the distal bowel 5.5 cm, and the area of the tumor narrows the lumen to 3.7 cm. On sectioning, the tumor appears tan-white and extends through the muscularis propria into the subserosal fat, with a depth of 1.2 cm at its deepest point. There is associated serosal puckering and induration over 8.5 cm of the colonic surface.\n\nIn the subserosal fat near the tumor, multiple nodules are identified, measuring up to 1.1 cm in maximum dimension. One polypoid lesion is found at the distal edge of the tumor, measuring 0.4 x 0.6 cm and projecting 0.7 cm above the mucosa. Margins of resection are free of invasive disease. Histologically, the tumor demonstrates moderate to poor differentiation with a G3 grade. Invasion extends transmurally to involve the subserosa, with focal extension into pericolonic fat beyond the muscularis propria by more than 5 mm. Venous and lymphatic invasion are present, while perineural invasion is not identified.\n\nA total of seventeen pericolic lymph nodes were examined, of which eight contain metastatic involvement. Focal extranodal extension is noted. No implants or additional neoplastic findings are identified. The resection is complete with negative proximal, distal, and radial margins. Multiple sections of lymph nodes and surrounding fat are submitted for further analysis."} +{"pid": "TCGA-BA-6872", "report": "A biopsy of the right alveolar ridge showed ulcerated squamous mucosa with acute inflammation and reactive epithelial atypia. Biopsy of the mid lingual nerve revealed benign nerve tissue without concerning findings. Multiple biopsies from various regions of the tongue, including right and left anterior, mid, posterior, and deep margins, all showed no abnormal pathology.\n\nExcision specimens from the right neck lymph nodes showed involvement in certain levels. In level 3, metastatic involvement was identified in 3 out of 8 lymph nodes, with the largest metastasis measuring 1.2 cm. In level 2, all 8 lymph nodes were negative; in level 4 and level 5, all lymph nodes were negative as well. The right submental lymph node specimen revealed involvement in both lymph nodes, with the largest metastasis measuring 1.1 cm. On the left side, metastatic involvement was found in 1 out of 11 lymph nodes in level 1, with a metastasis size of 1.0 cm; levels 2 and 3 were free of tumor involvement.\n\nThe mandibulectomy and floor of mouth specimen contained an invasive lesion within the floor of mouth musculature. The lesion measured 3.3 cm and extended to the posterior floor of mouth. Margins were assessed: the posterior floor of mouth margin was involved (0 cm clearance), while other soft tissue and bony margins were negative. The sublingual gland showed no evidence of tumor involvement.\n\nAdditional excised margins from the floor of mouth and salivary gland tissues showed no tumor involvement. A tooth specimen was submitted for examination but did not contain associated soft tissue pathology.\n\nIntraoperative frozen section analysis of multiple tongue sites and lingual nerve confirmed absence of malignancy. All surgical margins assessed during the procedure were negative except for the posterior floor of mouth margin."} +{"pid": "TCGA-85-6561", "report": "The lung tissue specimen was obtained via lobectomy. The tumor measured 4 x 3 x 3.5 cm and was found to be moderately differentiated. No information is available regarding the histologic type, tumor extent, presence of additional nodules, lymph node involvement, lymphatic or venous invasion, surgical margins, evidence of neo-adjuvant treatment, or other pathologic findings. No additional comments were provided."} +{"pid": "TCGA-99-8028", "report": "The pathology report includes multiple lymph node specimens and lung tissue from a left upper lobectomy. Lymph nodes numbered 5, 6, 7, 8, 9, 10, 11, and 12 were examined, with most being submitted as single or multiple fragments. All lymph nodes were negative for malignancy. The bronchial margin was also negative for malignancy.\n\nThe left upper lobe specimen measured 14.5 x 9.3 x 3.3 cm and contained a unifocal tan mass measuring 2.0 cm in greatest dimension. The mass was located approximately 2.5 cm from the nearest surgical stapled margin and appeared to abut the pleural surface; however, no visceral pleural invasion was identified. The remainder of the lung showed maroon-red parenchyma with anthracosis and multifocal anthracotic pigment. No other mass lesions were identified.\n\nMicroscopic evaluation revealed a moderately differentiated gland-forming tumor with negative bronchial and vascular margins. No regional lymph node metastasis was identified. The tumor was unifocal and surrounded by lung tissue. The pathologic stage was determined as pT1a/pN0/Mx."} +{"pid": "TCGA-A2-A0SY", "report": "The patient is female. A left simple mastectomy and sentinel lymph node biopsy were performed. The specimens included three sentinel lymph nodes and a left breast mastectomy specimen.\n\nSentinel lymph node #1 measured 0.6 cm in greatest dimension and was found to contain metastatic involvement, with tumor occupying approximately three-fourths of the node. There was no extension into surrounding soft tissue. Sentinel lymph nodes #2 and #3 were both negative for metastatic involvement, with node #2 showing reactive changes and node #3 also being reactive.\n\nThe mastectomy specimen measured 23 x 15 x 4 cm and included a tumor mass measuring 7 x 5.5 cm. The tumor was located approximately 0.7 cm from the deep resection margin. No calcifications or necrosis were identified within the tumor. Surgical margins, including nipple, skin, and areola, were uninvolved. Non-neoplastic findings included fibrocystic changes with ductal epithelial hyperplasia.\n\nMicroscopic evaluation revealed patchy areas of tumor infiltration extending up to the lactiferous ducts. Tumor cells displayed unfavorable nuclear features in multiple regions. Immunostaining with PanKeratin was performed on all three lymph node specimens.\n\nBased on the pathological findings, the tumor stage was classified as T3, indicating a large primary tumor. Nodal staging was N1, reflecting regional lymph node involvement. Distant metastasis could not be assessed (MX). The overall staging was determined to be Stage IIIA."} +{"pid": "TCGA-2J-AABR", "report": "A resection specimen from the pancreatic head and neck region demonstrates a mass measuring 3.2 x 2.3 x 1.6 cm. The lesion extends beyond the pancreas into adjacent soft tissue and involves the pancreatic duct. There is no evidence of angiolymphatic invasion, though perineural invasion is present. Evaluation of surgical margins reveals that the portal vein groove margin was initially focally involved; however, following re-excision, all other margins\u2014including those at the uncinate process, common hepatic duct, and pancreatic neck\u2014are free of tumor.\n\nFourteen regional lymph nodes are identified and none contain malignant cells. The surrounding pancreatic tissue shows significant distortion consistent with chronic inflammatory changes and fibrosis. There is also evidence of curvilinear alteration within the parenchyma, potentially related to prior abscess formation or local tissue disruption as the lesion extended into peripancreatic fat.\n\nHistologic staging based on available surgical material corresponds to pT3N0 according to the 7th edition of the AJCC staging system. Frozen section analysis was performed on portions of the portal vein and confirmed upon review of permanent sections.\n\nThe gross specimen includes portions of the common bile duct, duodenum, gallbladder, jejunum, and pancreas. The pancreatic portion measures 6.9 x 4.2 x 3.1 cm. A stent is identified within the bile duct lumen. No gallstones are observed in the gallbladder. Necrotic debris and exudate surround the duodenum and pancreatic head. Multiple lymph nodes are sampled from periduodenal and peripancreatic regions.\n\nSubmitted tissues include margins from the common hepatic duct (1.3 x 1.1 x 0.4 cm), pancreatic neck (2.8 x 1.4 x 0.5 cm), and portal vein segment (1.4 cm in length). Sections were taken from various anatomical locations including tumor, adjacent fat, lymph nodes, and abscessed areas for histologic evaluation."} +{"pid": "TCGA-BP-4758", "report": "Clinical history indicates a right renal mass treated with right partial nephrectomy. The specimen consisted of a well-defined, orange-yellow hemorrhagic mass measuring 4.0 x 3.6 x 2.7 cm. The tumor was surrounded by a rim of normal renal parenchyma and perinephric fat, with no extension through the renal capsule or into surrounding fat. The tumor was located 0.2 cm from the closest deep margin, which along with the peritumoral fat, was marked with black ink. Histologically, the tumor demonstrated solid growth pattern and nuclear features consistent with a cortical neoplasm. All surgical margins were free of involvement. The tumor was confined within the renal capsule, without evidence of renal vein invasion. The non-neoplastic kidney appeared histologically unremarkable; the adrenal gland was not submitted for evaluation. A frozen section consultation confirmed a negative deep margin and supported the morphologic features seen in the final evaluation."} +{"pid": "TCGA-F7-A622", "report": "The specimen includes a larynx with an ulcerated white-gray dense lesion. A separate fragment of thyroid gland measuring up to 2 x 2 cm is also present. Microscopic examination reveals well-differentiated keratinizing squamous cell carcinoma. The thyroid tissue shows normal architecture. The tumor measures 1 x 0 x 1.5 cm and appears localized without evidence of venous invasion. Surgical margins are uninvolved. Endoscopic evaluation, including fibrolaryngoscopy, indicates involvement of all parts of the larynx. No lymph nodes are identified. There is no indication of neo-adjuvant treatment effect."} +{"pid": "TCGA-D5-6536", "report": "Histopathological examination was performed on a resected specimen consisting of the sigmoid colon with rectum and two lesions. The specimen measured 32 cm in length and included surrounding fat tissue, with dimensions of 32 x 6 x 2 cm. A first lesion was identified in the mucosa, measuring 5 x 3 x 2.5 cm, with circumferential involvement of the intestinal wall and luminal narrowing. This lesion was located 10 cm from the proximal margin and 11 cm from the distal margin. It extended through the intestinal wall into the surrounding fat tissue, with a minimum side margin of 1.1 cm. A second lesion, measuring 2.5 x 3 x 1 cm, was found 5 cm away from the first, situated 22 cm from the proximal boundary and 3 cm from the distal edge. This lesion also infiltrated the intestinal wall, with a side margin of 2.5 cm.\n\nMicroscopic evaluation revealed glandular and papillary structures with varying degrees of differentiation. There was infiltration of the muscularis propria and pericolic adipose tissue. Both lesions showed similar histological features. The proximal and distal resection margins were free of abnormal cells. Reactive lymph node changes were observed in the regional lymph nodes. No evidence of metastasis was found in the examined lymph nodes."} +{"pid": "TCGA-VQ-AA6B", "report": "The specimen includes tissue from the stomach and gastroesophageal region. A lesion measuring 9.2 x 5.2 x 1.2 cm was identified, involving the distal esophagus, cardia, and gastric corpus, with predominant involvement of the stomach. The lesion extends into the perigastric fat and muscular layer of the esophagus. Histologic evaluation shows moderately differentiated features with intestinal-type morphology. Angiolymphatic and perineural invasion are present.\n\nA total of 34 lymph nodes were examined. Fourteen lymph nodes from various chains showed no evidence of malignancy. Sixteen lymph nodes were dissected from the greater curvature, all negative for tumor involvement. In contrast, 4 out of 16 lymph nodes from the lesser curvature contained malignant cells, with capsular involvement noted.\n\nSurgical margins, including the esophageal margin, were free of neoplastic cells. Additional findings include moderate chronic gastritis with discrete activity and lymphoid follicles in non-tumoral gastric mucosa. Intestinal metaplasia was also observed. Testing of the gastric tissue was positive for *H. pylori*. Adipose tissue samples from multiple regions lacked atypia or lymph node structures.\n\nOther specimens included gallbladder tissue showing signs of chronic inflammation."} +{"pid": "TCGA-VQ-A91Z", "report": "The specimen involves the antrum of the stomach. The tumor measures 5.0 cm at its largest dimension and demonstrates a tubular histologic pattern with moderate differentiation. It is associated with ulceration and exhibits an infiltrative growth pattern. There is evidence of local invasion into adjacent fat tissue. A moderate inflammatory response is present. No tumor implants are identified in the perivisceral fat. The proximal and distal surgical margins, as well as the greater omentum, show no involvement by neoplastic cells. Neural invasion is not observed; however, lymphatic invasion is present. Blood vessel invasion is not noted. Of the 19 lymph nodes examined, 2 are involved by neoplasia, with involvement identified at the greater curvature (2 of 8 lymph nodes), while the lesser curvature lymph nodes (0 of 11) remain uninvolved."} +{"pid": "TCGA-W5-AA2T", "report": "Female. Surgery Date: Liver, right segments IV-VIII, trisegmentectomy: A dominant mass measuring 11.5 x 9.2 x 8.6 cm is present along with multiple (15) other separate nodules within the liver parenchyma, ranging in size from 0.3 x 0.3 x 0.3 cm to 4.2 x 3.6 x 3.5 cm. The masses are not encapsulated, and focal angiolymphatic invasion is noted. Surgical margins are free of abnormal tissue. Biopsies from the left lobe of the liver (specimens No.1 to No.3) show benign hepatic parenchyma with mild steatosis. A soft tissue biopsy from the caudate region includes a single lymph node, which is unremarkable. Peritoneal biopsies reveal benign hepatic parenchyma. The gallbladder shows changes consistent with chronic cholecystitis. One regional lymph node and one lymph node adjacent to the hepatic artery were also examined and found to be uninvolved. Immunohistochemical analysis of the liver tissue from segments IV-VIII demonstrates that the atypical cells stain positively for cytokeratin 7 and are negative for cytokeratin 20, CDX2, thyroid transcription factor-1 (TTF-1), and estrogen receptor protein."} +{"pid": "TCGA-43-6771", "report": "The specimen includes a left upper lobe of the lung and a level 5 lymph node. The lung tissue was amputated at the level of its principal bronchus and blood vessels. Several bronchi measuring approximately 8 to 9 mm in diameter are present and appear unremarkable. Some vascular stumps are noted at the site of amputation. Anthracotic tissue possibly representing hilar lymph nodes is also observed. A small area of adhesion and thickening is present on the visceral pleural surface, overlying a large intraparenchymal mass. The remainder of the lung tissue is anthracotic without additional focal lesions.\n\nUpon serial sectioning, a centrally located tumor mass measuring up to 6 cm is identified. The tumor has an extensively necrotic center with a creamy yellowish-red appearance and is surrounded by a rim of granular brown-black tissue that appears to extend toward the visceral pleura. No other lesions are observed in the remaining lung tissue after fixation.\n\nMicroscopic examination reveals areas of moderately differentiated tumor with keratinization and well-defined intracellular bridges. Other regions exhibit sarcomatoid morphology with a biphasic pattern composed of moderately differentiated tumor cells intermingled with spindle cell components.\n\nThe primary tumor measures 6 cm and does not involve the visceral pleura (pT2). Resection margins are negative for tumor involvement. There is no evidence of direct tumor extension into adjacent structures. Large vessel venous or arterial invasion is not present, nor is there evidence of small vessel lymphatic invasion. Regional lymph node evaluation includes two peribronchial lymph nodes and one level 5 lymph node, all of which are free of metastatic disease (pN0). Distant metastasis could not be assessed (pMX).\n\nFresh tissue from normal lung was submitted for procurement as requested. Sections from non-tumorous regions of the lung show no additional lesions. All specimens were adequately sampled and processed for histologic evaluation."} +{"pid": "TCGA-CV-7253", "report": "The specimen includes tissue from the left pterygoid fossa, portion of the mandible, tongue, soft palate, and hard palate. Microscopic evaluation shows invasive moderately differentiated squamous carcinoma involving the tongue, base of the tongue, and soft tissue adjacent to the angle of the mandible. Foci of tumor are present at the posterior and anterior soft tissue resection margins deep to the mucosa, as well as at the soft tissue margin attached to the mandible at the angle. Mucosal ulceration is present. The mandibular resection margins remain pending further evaluation due to the need for decalcification.\n\nAdditional specimens include fragments of necrotic tissue with a segment of detached distorted dysplastic squamous tissue from the left base of the tongue. Four lymph nodes from the subdigastic and maxillary regions show no evidence of tumor involvement. The submandibular gland demonstrates focal atrophic changes and fibrosis, but no tumor is identified. Focal vascular invasion by the lesion is noted; however, there is no clear evidence of lymphatic or perineural invasion."} +{"pid": "TCGA-EJ-7321", "report": "A total of 25 lymph nodes were examined, with no evidence of malignancy identified (0/25). The prostate specimen demonstrated a moderately differentiated adenocarcinoma with a Gleason score of 3 + 3 = 6 and a tertiary Gleason pattern of 4 present. The tumor involved both the right and left lobes of the prostate and measured up to 2 cm in its greatest dimension in one histologic section. Approximately 10% of the tumor-involved volume was composed of Gleason pattern 4 or 5 morphology. The tumor exhibited focal extension beyond the prostatic capsule at the posterior right mid region. There was extensive perineural invasion noted; however, no angiolymphatic invasion was observed. Bilateral seminal vesicles and all surgical margins were free of tumor involvement. High-grade intraepithelial neoplasia was present and multifocal. Background tissue showed benign nodular hyperplasia and chronic inflammation. The tumor involved approximately 5\u201325% of the total prostate specimen. The pathological staging was determined as pT3a with no nodal metastasis and an indeterminate distant metastasis status."} +{"pid": "TCGA-2J-AABE", "report": "A fragment of soft tissue measuring 0.4 x 0.4 x 0.2 cm was received from the falciform ligament and found to be benign upon examination.\n\nA distal pancreatectomy and splenectomy specimen included a portion of pancreas measuring 10.8 x 5.3 x 2.0 cm and a spleen weighing 170 grams with dimensions of 11.5 x 8.8 x 2.5 cm. Within the pancreatic body, a mass measuring 5.8 x 3.6 x 3.3 cm was identified. The mass appeared tan-white, solid, and cystic with firm consistency and was located 2.1 cm from the proximal pancreatic margin. Grossly, the mass extended beyond the pancreas into adjacent soft tissue. Peripancreatic and splenic hilar lymph nodes were identified, and the spleen showed no remarkable findings.\n\nMicroscopic evaluation revealed a moderately differentiated cellular proliferation within the pancreas. The lesion exhibited extension into the surrounding soft tissue and demonstrated perineural invasion. Necrosis was not observed. Surgical margins were all negative for any abnormal cellular growth, with the closest distance being at least 2.1 cm from the tumor. Adjacent non-neoplastic pancreatic tissue showed evidence of mild cytologic atypia confined to ductal structures.\n\nA total of 24 lymph nodes were assessed: 23 from regional areas and one from the peripancreatic region. All were free of any abnormal cellular infiltration. Histologic analysis was conducted using H&E staining on permanent sections following initial frozen section evaluation. Any significant changes identified upon further review will be documented in a revised report if necessary.\n\nSubmitted specimens were processed into multiple tissue blocks for detailed microscopic analysis, including sections from the pancreatic mass, margins, spleen, and lymph nodes."} +{"pid": "TCGA-85-A513", "report": "Gross Description: A lesion is located in the left sublobe IV with ill-defined margins, measuring 1.5 x 1.5 x 2 cm. It has a firm consistency and a white-gray surface. Microscopic Description: The tissue shows groups, sheets, trabeculae, and adenoid arrangements of malignant cells. These cells have moderate eosinophilic cytoplasm and enlarged nuclei that vary in size and shape. The nuclei are single or multiple and contain coarse chromatin. Lymphatic invasion is present. The specimen type is pneumonectomy, and the tumor site is the lung. The tumor size is consistent with the gross description. Histologic grade shows poor differentiation. Other pathological features such as tumor extent, presence of additional nodules, venous invasion, margin status, neo-adjuvant treatment effect, and other findings are not specified."} +{"pid": "TCGA-VM-A8CH", "report": "The patient is a woman presenting with a one-year history of generalized tonic-clonic seizures. Imaging revealed a non-enhancing mass in the right frontal lobe. A resection specimen was received for analysis, measuring 2.2 x 1.5 x 1.4 cm in aggregate and weighing 3.39 grams. Representative sections were processed for microscopic evaluation.\n\nMicroscopic examination demonstrated an edematous glial tumor with infiltrative growth patterns. The tissue showed moderate hypercellularity with mildly pleomorphic and hyperchromatic nuclei. No mitotic figures were identified in 40 high-power fields, and there was no evidence of microvascular proliferation or necrosis. Immunohistochemical staining showed diffuse positivity for glial fibrillary acidic protein (GFAP), focal elevation of MIB-1 at 20%, and diffuse positivity for p53. IDH-1 staining was negative.\n\nA PCR-based MGMT methylation assay was performed on formalin-fixed paraffin-embedded tissue from the specimen. The methylation score was calculated as 1.35, which falls below the threshold for gene methylation (reference value: unmethylated <2.00, methylated \u22652.00). This result indicates that gene methylation was not detected.\n\nThe tumor was evaluated using permanent sections from a resection specimen involving the right frontal lobe. Tumor margins could not be assessed. All controls used in testing were appropriate. The assay used for molecular analysis was developed and its performance characteristics determined by the laboratory. It has not been cleared or approved by the FDA but was performed under appropriate regulatory guidelines. Results are provided for investigational use only and should not be used in isolation for clinical decision-making.\n\nAll findings have been incorporated into this report based on direct evaluation of the specimen and additional testing as described."} +{"pid": "TCGA-EJ-A46D", "report": "The prostate specimen from radical prostatectomy measures 46.0 grams. A nodule is identified, measuring 1.5 cm in greatest dimension, located in both the right and left lobes, involving approximately 5% of the total prostate volume. Histologic evaluation shows a Gleason score of 8, composed of 25% Gleason pattern 4 and 5% Gleason pattern 5. The lesion is confined within the prostatic capsule with no evidence of extension into the bilateral seminal vesicles. All surgical margins are free of involvement. Perineural invasion is present. High-grade prostatic intraepithelial neoplasia is identified in a multifocal distribution. No angiolymphatic invasion is seen. Six pelvic lymph nodes are examined, none showing evidence of metastatic disease. Pathologic staging is pT2c, pN0, pMX. The histologic grade is G3-4 (poorly differentiated/undifferentiated). Preoperative PSA was 5.0."} +{"pid": "TCGA-HC-A6AP", "report": "The specimen was received in two formalin-filled containers labeled with the patient\u2019s name. Container A, labeled \u201cright periprostatic,\u201d contained two portions of white-tan to yellow lobular soft tissue measuring 0.6 cm and 0.7 cm, both submitted entirely in cassette A1. Container B, labeled \u201cprostate tissue study,\u201d contained a prostate weighing 30.2 grams following tissue procurement. The prostate measured 4.0 cm (right to left), 3.5 cm (anterior to posterior), and 3.0 cm (apex to base). Attached bilateral seminal vesicles and vas deferens were also present.\n\nThe right seminal vesicle measured 3.1 x 2.0 x 0.9 cm, and the right vas deferens was 5.0 cm in length and 0.4 cm in diameter. The left seminal vesicle measured 3.4 x 1.5 x 0.8 cm, and the left vas deferens measured 3.0 cm in length and 0.5 cm in diameter. The prostate was inked with right blue and left black markers and serially sectioned from apex to base. The cut surface appeared yellow-tan and smooth with focal nodules in the central zone measuring up to 0.5 x 0.5 x 0.5 cm. No definitive mass was identified. The peripheral zone was yellow-tan and smooth, and the seminal vesicles appeared free of tumor involvement.\n\nHistologic evaluation revealed tissue characteristics including bilateral involvement confined to the prostate. Cellular analysis demonstrated a primary pattern score of 3/5 and a secondary pattern score of 4/5, resulting in a total Gleason score of 7/10. High-grade intraepithelial neoplasia was noted. Perineural invasion was present; however, no extraprostatic extension, seminal vesicle involvement, lymphovascular space invasion, or treatment effect was identified. Lymph nodes were not detected. Multifocal chronic prostatitis was also observed.\n\nTumor quantitation showed involvement of approximately 5% of the gland volume. The staging assessment indicated pT2c classification with no lymph node identification (NX). Specimen margins were evaluated, with representative sections submitted for analysis across multiple cassettes. Additionally, two research cassettes were submitted. All cassettes were appropriately labeled."} +{"pid": "TCGA-FY-A3R8", "report": "A left lobe thyroid specimen measured 3.8 x 2.2 x 1.3 cm and contained a well-circumscribed, dense, light gray tumor mass measuring 1.7 x 1.4 x 0.9 cm. The tumor exhibited papillary, follicular, and cribriform architecture with classical cytomorphology. Perineural invasion was not identified. Extrathyroidal extension was present, with tumor invading into perithyroidal adipose tissue and skeletal muscle. Surgical margins were negative, with the tumor located 0.03 cm from the posterior margin. Additional findings included multiple adenomatoid nodules consistent with multinodular goiter.\n\nThe right lobe and isthmus specimen weighed 11 grams and measured 4.0 x 2.2 x 1.7 cm with an isthmus extension of 1.4 x 1.3 x 0.8 cm. Microscopic evaluation revealed multiple adenomatoid nodules also consistent with multinodular goiter. A hypercellular parathyroid gland was identified and may represent either normal hypercellular parathyroid tissue or a parathyroid adenoma; clinical correlation was recommended.\n\nCentral compartment tissue consisted of a 2.8 x 1.7 x 0.8 cm soft tissue specimen containing two lymph node candidates measuring 0.4 cm and 0.6 cm. Histologic examination revealed benign thymic tissue without evidence of metastatic carcinoma.\n\nThe tumor was unifocal and located in the left lobe. Histologic evaluation confirmed partially encapsulated morphology with capsular invasion. Lymphovascular invasion was not identified. Margin status was R0, with the closest margin measuring 0.03 cm at the posterior left lobe. No tumor was identified at other margins.\n\nPathologic staging was based on a primary tumor size of 1.7 cm with minimal extrathyroidal extension into adjacent adipose and skeletal muscle. Regional lymph node assessment was not possible due to absence of lymph nodes for evaluation (pNX). Pathologic stage was determined as I according to staging guidelines. Multiple adenomatoid nodules and hypercellular parathyroid tissue were additional pathologic findings."} +{"pid": "TCGA-FE-A22Z", "report": "The specimens were received in six properly labeled containers. The first specimen designated \"left Level III L.N.\" consisted of a 1.5 x 1.0 x 0.5 cm lymph node, which showed no evidence of abnormal cells (0/1). The right thyroid lobe measured 4.5 x 4.0 x 1.5 cm and weighed 12.2 grams. The external surface was pink-brown with no attached structures. The isthmic margin was marked green and the outer surface blue. Upon sectioning, the tissue appeared deep red and rubbery without distinct lesions. Histologic examination revealed normal thyroid tissue with localized inflammatory changes, including foreign body giant cell reaction, and was negative for any abnormal growth.\n\nA central neck tissue specimen measured 4.5 x 2.0 x 1.0 cm and consisted of fibroadipose tissue with areas of scarring and similar inflammatory changes, also negative for abnormal cells. The left thyroid lobe measured 6.5 x 6.0 x 3.0 cm and weighed 47.2 grams. The outer surface was tan-gray and irregular. The entire lobe was marked black on the surface. Sectioning revealed a 6.5 x 5.0 x 3.0 cm mass that was tan-gray, firm, and partially hemorrhagic. The hemorrhage accounted for about 20% of the cut surface. The mass extended close to the marked capsule but did not clearly breach it macroscopically. Histologically, the mass showed features consistent with cellular invasion of surrounding connective tissue and skeletal muscle, with involvement of the marked margin. Adjacent thyroid tissue appeared normal, pink-red, and rubbery.\n\nA small paralaryngeal tissue sample measured 0.9 x 0.7 x 0.3 cm and showed normal thyroid structures with enlarged follicles. A final specimen involving the thyroid cartilage included seven fragments ranging from 1.0 x 0.6 x 0.1 cm to 3.5 x 1.5 x 0.3 cm. These tissues displayed areas of irregular texture involving approximately 30% of each fragment. Histology confirmed similar invasive features in connective tissue and muscle. No lymphatic or vascular invasion was identified. Capsular invasion was present. The growth was multifocal and extended beyond the thyroid, with infiltration into adjacent structures. A total of one lymph node was examined from the left Level III region, all of which were negative."} +{"pid": "TCGA-GC-A6I1", "report": "The patient is female. Specimens were received for analysis, including biopsies from the right and left ureters, as well as a cystectomy with hysterectomy and right salpingo-oophorectomy. No neoplastic process was identified in the right or left ureter biopsies. The primary specimen showed a poorly differentiated histologic pattern. The tumor measured 7.5 cm in greatest dimension and demonstrated invasion of the muscularis propria with full thickness involvement of the bladder wall. There was no evidence of tumor within the perivesical adipose tissue. Lymphovascular space invasion was not present. Surgical margins, including the right ureter, left ureter, urethra, and inked peritoneal surface, were free of tumor.\n\nAdditional findings included extensive acute and chronic inflammation with areas of foreign body giant cell reaction within the perivesical fibroadipose tissue. The uterus showed an atrophic endometrium with a benign endometrial polyp. The cervix contained benign mucinous cysts. Myometrial leiomyomas and serosal fibrous adhesions were noted. The right ovary contained multiple serous cysts and similar fibrous adhesions. The right fallopian tube was benign and included paratubal cysts. One lymph node was examined and showed no neoplastic process; seven additional pelvic lymph nodes were also free of metastatic disease.\n\nGross examination of the excised bladder revealed a fungating, friable mass involving the anterior, right and left lateral walls, and dome of the bladder. The mass approached as close as 0.1 cm to the right ureteral orifice, 1.5 cm to the left ureteral orifice, and 7.0 cm from the urethral margin. The mass extended into the detrusor muscle and approached the deep inked margin by 0.1 cm. No invasion was observed in the uterine wall. The endocervical canal exhibited cystic and mucoid changes. A small polypoid lesion was found in the posterior endometrium, with no evidence of invasion. A calcified intramural nodule was also identified in the myometrium. The right adnexal complex included a fimbriated fallopian tube and a lobulated ovary with a multiloculated corpus albicans. Two small possible lymph nodes were identified in the associated fat. Sections of the pelvic lymph nodes, ranging in size from 0.4 to 2.3 cm, were all negative for tumor.\n\nIntraoperative frozen section analysis of both ureters showed no tumor. The final assessment of the primary specimen confirmed full thickness involvement of the bladder wall, with the deepest extent of invasion approaching the perivesical margin but not clearly involving it. Based on these findings, the case was classified under a specific staging system indicating locally advanced disease without lymph node involvement."} +{"pid": "TCGA-B0-5707", "report": "The specimen consists of a renal tumor measuring 3.4 cm, with nuclear features corresponding to grade 3 out of 4. The tumor exhibits a combination of papillary and clear cell morphologies. Histologic evaluation reveals that the lesion is entirely contained within the renal capsule. Resection margins, including the ureteral and vascular margins, are free of tumor involvement. No evidence of angiolymphatic invasion is identified. A notable feature is the presence of significant necrosis within the tumor. The surrounding non-neoplastic kidney tissue is largely unremarkable, though peritumoral regions show glomerular sclerosis and focal interstitial inflammation.\n\nMolecular analysis using fluorescence in situ hybridization (FISH) was performed on both papillary and clear cell components. In both areas, trisomy of chromosomes 7 and 17 was observed. In the papillary regions, tetrasomy of chromosome 17 was also detected in some cells. These findings were evaluated based on signal distribution across at least 25 analyzed cells. Chromosomal gains were considered significant if present in more than 20% of cells, while losses were considered significant if found in more than 30% of cells. The molecular findings were consistent with a specific pattern associated with one type of renal neoplasm.\n\nStaging assessment indicates no extension beyond the kidney, with no lymph node or distant metastasis identified (T1a, Nx, Mx). A detailed interpretation of the molecular data and their correlation with morphology was provided in an addendum. Clinical correlation is recommended for further management."} +{"pid": "TCGA-C5-A1BL", "report": "The histologic examination of the cervical biopsy reveals multiple variably sized nodules composed of markedly enlarged squamous cells. The nuclei exhibit pleomorphism with single-cell dyskeratosis and an increased number of atypical mitoses are present. The stroma of the lesion shows moderate inflammatory infiltrate. All findings are based on microscopic evaluation of one slide submitted for review. No prior history was provided."} +{"pid": "TCGA-US-A779", "report": "The specimen from the bile duct lymph node excision consists of one lymph node and associated fibroadi\nIn the resection of the gallbladder, Whipple procedure, and distal stomach, the tumor measured 3.0 cm in greatest dimension and was well differentiated. Evaluation of all parts revealed metastatic involvement in 2 out of 20 lymph nodes. The tumor extended into the wall of the duodenum but did not involve major vascular structures such as the celiac axis or superior mesenteric artery (pT3). Regional lymph node staging showed multiple involved nodes (N1b). All surgical margins were free of involvement. No venous or perineural invasion was identified. An additional finding included a benign ovarian cyst measuring 5.0 cm in the left ovary; the left fallopian tube and ovary showed no significant histologic abnormalities. Frozen section analysis of the bile duct lymph node, bile duct margin, and pancreatic neck margin all showed no evidence of tumor."} +{"pid": "TCGA-93-A4JQ", "report": "A surgical pathology report was prepared for a patient who underwent a right upper lobectomy. The specimen included multiple lymph node samples from various levels, as well as the resected lung tissue. A total of 28 lymph nodes were examined across all levels, and none showed evidence of malignancy.\n\nThe resected mass measured 2.3 cm in maximum dimension and was located subpleurally. It extended 2.5 cm from the bronchial and vascular margins and 1.5 cm from the nearest parenchymal margin. Histologically, the lesion exhibited poorly differentiated features. No invasion of lymphatic, venous, or arterial structures was identified, and there was no involvement of the pleura. Surgical margins were free of tumor.\n\nMultiple hilar and peribronchial lymph nodes were evaluated, with all findings negative for malignancy. Non-neoplastic findings in the lung tissue included centrilobular emphysema. Based on the pathologic findings, the tumor was classified as pT1b with no regional lymph node involvement (pN0). The stage is provisionally assigned as IA."} +{"pid": "TCGA-OR-A5LL", "report": "A right adrenalectomy and right nephrectomy were performed. The adrenal mass weighed 172 grams and measured 9 x 7 x 5 centimeters. Within the right kidney, a 0.7-centimeter nodule was identified, showing granulomatous inflammation with multinucleated giant cells, raising consideration of a granulomatous process. Histologic evaluation yielded a Weiss score of 7. No lymph node metastases were identified, with zero out of ten lymph nodes involved. There was no evidence of renal artery invasion. Additionally, there were findings consistent with a previous cholecystectomy and chronic inflammatory changes in the gallbladder bed."} +{"pid": "TCGA-YF-AA3M", "report": "The specimen included segments of left and right ureter, a radical cystoprostatectomy specimen, and a vermiform appendix. The left and right ureteral surgical margin biopsies were negative for malignancy. The bladder component measured 8 x 6 x 4.5 cm and contained a soft tan-pink papillary tumor measuring 1.5 x 1 cm located at the posterior wall. The remainder of the bladder mucosa was edematous and congested without other gross lesions. Microscopic evaluation revealed a high-grade infiltrating lesion involving the lamina propria and inner half of the muscularis propria. All surgical margins were free of malignant involvement. There was no evidence of perineural or lymphovascular invasion identified. The prostate measured 4 x 4 x 3 cm and showed involvement of both lobes by a glandular lesion accounting for approximately 10% of the entire gland. The histologic pattern corresponded to a Gleason score of 6 (3+3). Margins of resection were clear, and there was no lymphovascular or perineural invasion identified. The staging classification for the bladder lesion was pT2a and for the prostate lesion pT2c. The seminal vesicles and vas deferens appeared unremarkable. The vermiform appendix measured 8.2 x 0.8 cm with smooth serosal surface and tan wall measuring 0.1 cm in thickness; the mucosa was intact. Immunostains were performed and are documented in the scanned report."} +{"pid": "TCGA-KU-A66T", "report": "The specimen was received for evaluation and consisted of three main components. The first was a lymph node measuring 1.0 cm, submitted entirely for analysis, and found to contain no evidence of disease. The second component was a right modified radical neck dissection, including a submandibular gland measuring 3.0 x 3.0 x 1.6 cm, a segment of muscle (2.5 x 1.5 x 0.5 cm), and a thin-walled vessel (1.5 x 0.4 cm). A total of 23 lymph nodes were identified and evaluated across multiple levels: level 1 (4 nodes), level 2 (9 nodes), level 3 (6 nodes), and level 4 (4 nodes). All nodes were negative. The submandibular gland and skeletal muscle were also free of involvement.\n\nThe third specimen consisted of a mandible with attached soft tissue, measuring 3.3 cm lateral to medial, 4.1 cm superior to inferior, and 5.5 cm in depth. Gross examination revealed a lobulated grey mass located adjacent to a molar tooth, measuring 4.1 x 3.3 x 1.3 cm. The mass showed a homogenous grey-pink cut surface with areas of necrosis extending into the soft tissue and the root of a missing tooth. Microscopic evaluation demonstrated invasive cellular growth within the gingival soft tissue with focal extension into the sublingual region and mandibular bone. The tumor exhibited a moderately differentiated keratinizing morphology, with an invasive thickness of 1.3 cm and ulceration present. No vascular or perineural invasion was identified.\n\nMargins assessed included radial soft tissue, mucosal edge, anterior and posterior mandible transection, and inferior mandible bone; all were negative. A total of 24 lymph nodes from specimens one and two were examined and found to be unremarkable. Based on these findings, staging was determined as cT4 cNO cM0, corresponding to a pT4 pNO classification."} +{"pid": "TCGA-UD-AAC4", "report": "The pleural fluid specimen consisted of 50 mL of clear yellow fluid. Microscopic evaluation of smears and cell block preparations revealed numerous aggregates of mesothelial cells arranged in papillary-like formations with focal stromal or fibrovascular cores. Nuclear features showed minimal variability, with well-defined nuclear membranes and occasional small nucleoli. The cell groups were primarily small to moderate in size. Background elements included macrophages and mononuclear cells. No definitive high-grade malignant features were identified, although the sample was noted to be highly cellular.\n\nImmunohistochemical staining demonstrated positivity for CK7, EMA (with rim positivity), calretinin, and CK5/6 (strongly positive). CD15 was negative. CK20 showed equivocal weak positivity, while CEA was negative. These findings were reviewed by an additional pathologist and are consistent with the previously observed features."} +{"pid": "TCGA-BR-A452", "report": "The specimen is a gastrectomy with a tumor located in the antrum measuring 8 x 7 x 5 cm. The mucosa is ulcerated, and the tumor invades into the serosa as well as surrounding lymph nodes. The tumor consists of irregularly shaped adenoid groups, with some tubules dilated to form cysts containing areas of necrosis. Glands show variability in both size and shape. Tumor cells are moderately stratified, with hyperchromatic nuclei that are irregularly enlarged and have prominent nucleoli. A mitotic index is present. The stroma shows infiltration by inflammatory cells. Of the regional lymph nodes examined, 2 out of 4 were involved, with metastasis identified in two of the lymph node groups. No information is available regarding lymphatic, venous, or perineural invasion, nor is there data on treatment effect or surgical margins."} +{"pid": "TCGA-55-7816", "report": "The final surgical pathology report includes multiple specimens. Part A consists of a wedge excision from the right upper lobe measuring 3.5 x 2.2 x 1.0 cm. Gross examination revealed a partially circumscribed yellow-gray nodule measuring 1.2 x 1.1 x 1.0 cm, located within 0.2 cm of a surgically stapled margin. The lesion appears to extend to the overlying pleura. Part B is a pleural biopsy measuring 1.8 x 1.3 x 0.3 cm in aggregate and was entirely submitted for analysis. Part C is a wedge excision from the right lower lobe measuring 3.3 x 1.3 x 0.5 cm with a palpable nodular area noted on the pleural surface. Serial sectioning identified two small fibrous nodules measuring 0.5 cm and 0.4 cm. Part D is another pleural biopsy consisting of two fragments measuring 0.6 x 0.4 x 0.2 cm and 2.3 x 0.4 x 0.2 cm, both submitted for evaluation.\n\nMicroscopic analysis of all four specimens demonstrated histologically similar findings. The tumor cells were found to be moderately differentiated. Immunohistochemical staining performed on part A showed positivity for TTF-1, CK7, Napsin-A, and MOC-31. Estrogen receptor staining showed rare positive cells. The tumor cells were negative for calretinin, CDX2, CK20, CK5/6, GCDFP-15, mammaglobin, p63, PAX-8, vilin, and S-100. All other microscopic sections reflected consistent cellular morphology across specimens."} +{"pid": "TCGA-A4-7732", "report": "The specimen consists of a right kidney measuring 13.0 x 8.5 x 5.5 cm and weighing 358.7 grams. The kidney has attached perinephric adipose tissue and a ureter measuring 9.0 cm in length. A mass located in the upper to mid pole measures 8.0 x 8.0 x 5.0 cm and is described as relatively circumscribed with a soft, friable, variegated golden-yellow to dull yellow cut surface, with areas of hemorrhage and focal calcification. The mass abuts the renal capsule but does not grossly extend through it, coming within 0.2\u20130.3 cm of the radial soft tissue margin. It is at least 2.5 cm from the vascular margins. No additional lesions or lymph node candidates were identified at the hilum.\n\nMicroscopic examination shows a neoplastic lesion limited to the kidney, without involvement of the renal vein, renal sinus, renal capsule, or perinephric adipose tissue. The ureteral margin is negative, with more than 9 cm of ureter present. Vascular and ureteral margins are uninvolved. No sarcomatoid features or lymphovascular invasion are identified. Tumor necrosis is present. Histologic evaluation reveals a nuclear grade of II (Fuhrman grading system). Sections submitted include those demonstrating the relationship of the mass to the renal capsule, adjacent kidney, and surrounding adipose tissue, as well as uninvolved parenchyma. No additional pathologic findings are identified. Lymph node status could not be assessed as no perihilar lymph nodes were identified. The tumor is confined to the kidney without evidence of extension beyond the renal capsule."} +{"pid": "TCGA-W5-AA30", "report": "Male. Surgery Date: Specimen analysis includes a biopsy of the peritoneum showing adipose tissue without tumor involvement. A single perigastric lymph node biopsy was also negative for tumor. Wedge resections of liver segments I-IV revealed a solid mass measuring 11.0 x 10.3 x 6.6 cm, confined to the hepatic parenchyma with a mixed growth pattern consisting of both mass-forming and periductal infiltrative components. The hepatic parenchymal resection margin was free of tumor with a minimum distance of 0.6 cm, and the bile duct margin showed no evidence of invasive carcinoma or preinvasive lesion. No major vascular invasion or microscopic invasion was observed. Evaluation of two regional lymph nodes did not reveal any metastatic involvement. Additionally, a bile duct hamartoma was identified in the surgical specimen."} +{"pid": "TCGA-AP-A051", "report": "The submitted specimens include the right and left fallopian tubes and ovaries, cervix and uterus, left external iliac lymph node, left obturator lymph node, and an omental biopsy. Histologic examination reveals a lesion involving the endometrium with architectural features consistent with significant cellular atypia. The tumor extends into the myometrium, with a maximal invasion depth of 10 mm. The total myometrial thickness at this area measures 27 mm. There is no evidence of involvement of the endocervix. Additional findings in the endometrium include atrophy and complex hyperplasia without atypical features. A benign nabothian cyst is present. A leiomyoma is identified within the myometrium. No lymphatic or vascular invasion is noted. All lymph node specimens consist only of adipose tissue without identifiable lymph nodes. The omental biopsy also shows only mature adipose tissue. All other structures examined are unremarkable."} +{"pid": "TCGA-B5-A5OE", "report": "The clinical history includes a prior history of serous papillary carcinoma. Gross examination revealed a large mass involving the endometrial lining, measuring 13.7 x 8.5 x 1.0 cm, with a tan, friable, papillomatous appearance. The mass extended through the lower uterine segment to the cervical squamocolumnar junction. The tumor invaded 0.6 cm into a 1.1 cm thick myometrium at its deepest point. Multiple intramural nodules were present in the myometrium, with the largest measuring 2.3 cm. The cervix measured 4.9 cm in diameter with a 2.3 cm os. The myometrial thickness ranged from 1.1 to 2.3 cm. The right ovary (2 x 1.5 x 0.9 cm) and left ovary (2.5 x 1.5 x 1 cm) were unremarkable except for a small simple cyst on the left. Both fallopian tubes showed paratubal cysts; the left tube was looped upon itself. A small calcified nodule (0.4 x 0.3 x 0.2 cm) was found in the left periadnexal region. A vaginal margin specimen (2.8 x 1.4 x 1 cm) included a deep stromal margin inked blue. Pelvic lymph nodes were present bilaterally, with matted and firm nodes up to 1.5 cm. Omentum was unremarkable.\n\nMicroscopic evaluation showed full-thickness myometrial invasion with extensive lymphatic/vascular invasion. Tumor cells were present in the fallopian tubes and ovaries bilaterally. The vaginal margin was positive for tumor with extensive lymphatic/vascular involvement. Metastatic tumor cells were identified in 5 of 14 right pelvic lymph nodes and 7 of 8 left pelvic lymph nodes. The omentum was free of tumor. The non-neoplastic endometrium was absent. Additional findings included leiomyomata in the myometrium. The serosa was not involved. The surgical procedure included hysterectomy, bilateral salpingo-oophorectomy, omentectomy, and lymph node dissection. Pathologic staging is pT3b pN1 pMX according to the AJCC 7th edition."} +{"pid": "TCGA-UY-A78K", "report": "The surgical specimen consisted of multiple tissue samples obtained from the ureteral margins, pelvic lymph nodes, bladder, prostate, seminal vesicles, and surrounding fatty tissue. The bladder specimen measured 18 x 12 x 4.5 cm with a wall thickness averaging 2.5 cm. Gross examination revealed two ulcerated areas in the trigone and dome, measuring 1.5 cm and 1 cm respectively, with induration noted beneath these regions. No gross tumor was identified in the mucosa or bladder wall.\n\nHistologic evaluation revealed a small focus of invasive high-grade cellular abnormality measuring 0.4 cm located in the outer half of the muscularis propria at the trigone. Another focus measuring 0.3 cm was identified in the periurethral prostate. Surrounding mucosa showed benign changes with polypoid chronic inflammation and focal hyperplasia. Foreign body giant cells and focal necrotizing granulomas were present, consistent with prior intervention.\n\nMicroscopic examination of the ureters demonstrated high-grade epithelial changes on the right side without evidence of invasive disease. Both ureteral margins were negative for invasive disease upon final evaluation. The urethral margin was also negative.\n\nLymph node assessment revealed metastatic involvement in several regional sites. Two out of two lymph nodes at one location contained metastatic cellular infiltration. Additional findings included three out of five and three out of nine positive lymph nodes at other anatomical locations. One lymph node exhibited extracapsular extension.\n\nSurgical margins including perivesical fat were negative for malignant involvement. Prostate tissue demonstrated benign nodular hyperplasia and chronic inflammation in addition to metastatic cellular infiltration. Seminal vesicles showed no signs of involvement.\n\nStaging assessment indicated localized invasion beyond the mucosa into the muscularis propria with regional lymph node involvement. Vascular or lymphatic invasion was not identified. Based on histopathologic findings, staging classification reflects localized extension with lymph node metastasis."} +{"pid": "TCGA-UW-A72T", "report": "The specimen consists of a right nephrectomy measuring 24.0 x 10.7 x 6.7 cm and weighing 955 grams. The tumor is located in the renal cortex and medulla at the lower pole, extending into the mid portion of the kidney and into the hilum. It measures 8.7 x 6.6 x 5.2 cm with approximately 30% necrosis and no hemorrhage. The tumor is solid, soft, and mahogany brown with circumscribed borders and focal lobulation. It extends into the hilum and perinephric fat but microscopically remains beneath the renal capsule.\n\nHistologic evaluation reveals cells with granular, eosinophilic cytoplasm and nuclear features lacking the typical punched-out halos seen in conventional chromophobe carcinoma. Immunostains show positivity for BER EP4, CK7, E-Cadherin, and colloidal iron, while CD117, CD15, RCC, and other markers are negative. Sarcomatoid differentiation is not identified. Histologic grade is 3. The tumor is unifocal with negative surgical margins including Gerota\u2019s fascia, renal vein, and ureter. No lymphatic or venous invasion is observed.\n\nExamination of non-neoplastic kidney tissue shows normal architecture. No adrenal gland or lymph nodes are present in the specimen. The tumor grossly involves the renal sinus adipose tissue and perirenal fat, but there is no macroscopic or microscopic invasion of Gerota\u2019s fascia, renal vein, ureter, or major veins such as the IVC. Based on these findings, staging is classified as pT3a and pNx.\n\nThe tumor was initially interpreted as renal oncocytoma on core biopsy. However, with examination of the entire excision specimen, the morphologic and immunophenotypic features support the current interpretation. The tumor margin closest to the perirenal adipose tissue is 0.2 cm from the edge. At the superior pole, there is a 0.7 x 0.5 cm cortical area of smooth gray discoloration, located 3.3 cm away from the main mass, with no other significant findings noted."} +{"pid": "TCGA-EW-A6SC", "report": "The lumpectomy specimen from the left breast contains a single focus of invasive tumor measuring 21 mm in greatest dimension. Histologic evaluation shows moderately differentiated morphology with a Nottingham grade of 2 (score 6). The tumor demonstrates glandular differentiation with a score of 3 (<10% of tumor area forming glandular/tubular structures), nuclear pleomorphism with a score of 2 (cells larger than normal with open vesicular nuclei and visible nucleoli), and a mitotic rate scored as 1 (<3 mitoses per mm\u00b2). Margins are negative, with the closest margin being the anterior margin at 2.5 mm from the tumor. The tumor is located at the 1 o\u2019clock position.\n\nTwo sentinel lymph nodes were examined, both without evidence of metastasis. No macrometastases or micrometastases were identified. Sentinel lymph node evaluation included hematoxylin and eosin staining at multiple levels, with immunohistochemistry for keratin pending at the time of reporting; subsequent stains were negative. There is no evidence of lymphovascular invasion. Ancillary studies show positivity for estrogen receptor (>50%) and progesterone receptor (10\u201350%), and negativity for HER2 and E-cadherin.\n\nPathologic staging based on available data is pT2, with no regional lymph node involvement (pN0) and no distant metastasis (pMx). Final AJCC classification is pending keratin immunostain results but provisionally reads as pT2, (sn)pN0, pMn/a. Additional findings include atypical ductal hyperplasia and prior biopsy site changes. All surgical margins are free of tumor involvement."} +{"pid": "TCGA-HT-7480", "report": "The pathology report includes multiple specimens. Specimen 1 consists of poorly cellular dense fibrous connective tissue with no neoplasm identified. Specimens 2, 10, and 13 show a mildly hypercellular glial neoplasm with diffuse infiltration into predominantly white matter. Edema is present, with mild to moderate atypia. No mitotic figures, microvascular proliferation, or necrosis are observed. Specimens 3 and 7 demonstrate a similar but more diffusely infiltrative pattern, with features otherwise consistent with those seen in specimens 2 and 10. Specimens 4 and 8 reveal a more cellular lesion involving both gray and white matter, with characteristics similar to earlier specimens. Specimens 5 and 9 confirm the presence of a cellular and infiltrating lesion, with additional findings of nodular areas containing multiple foci of dystrophic calcifications. Specimen 6 shows variably thickened, poorly cellular fibrous connective tissue with reactive changes including edema, macrophage infiltrates, chronic inflammation, and microcalcifications. Focal adherence to gliotic brain parenchyma with old hemorrhage is noted, but no neoplasm is found. Specimen 11 reveals a less cellular specimen compared to prior samples, with modest cellularity and diffuse white matter infiltration. Specimen 12 demonstrates involvement of both gray and white matter with a large band of dystrophic calcification, showing less cellularity than most prior specimens but more than specimen 11.\n\nImmunohistochemical staining for MIB-1 shows variable reactivity. In less cellular regions, the labeling index ranges from less than 1% to approximately 3%. In contrast, patchy areas of higher MIB-1 reactivity in moderately cellular regions yield a labeling index of up to 12.5%. This variation in proliferative activity suggests an area of increased biological activity within a background of lower cellularity."} +{"pid": "TCGA-EX-A69L", "report": "The specimen consists of a radical hysterectomy with attached bilateral parametrium, along with right and left pelvic lymph nodes. The uterus measured 10.5 cm in height, 5.2 cm in anterior-posterior width, and 7.1 cm in breadth at the fundus. The cervix showed a soft, tan-yellow mass measuring 4.0 x 2.7 x 1.5 cm, located from 6 to 3 o\u2019clock in a clockwise direction. The tumor partially eroded the anterior ectocervix and abutted the posterior ectocervix. It extended 1.2 cm into the stroma and came within 0.5 cm of the anterior cervical soft tissue margin at 12 o\u2019clock. Depth of invasion was 1.6 cm, with a wall thickness of 2.3 cm (70% involvement), and a horizontal extent of 2.7 cm. No lymphovascular space invasion was identified. The vaginal cuff showed no involvement, and all surgical margins were clear. Intraepithelial\u75c5\u53d8 was widely free.\n\nA total of 26 lymph nodes were examined: 10 from the right pelvic region and 12 from the left. None showed evidence of metastatic disease. Follicular lymphoid hyperplasia was noted in both groups. Additionally, 4 parametrial lymph nodes (3 right, 1 left) were benign.\n\nThe myometrium contained multiple benign nodules, the largest measuring up to 3.5 cm. The endometrium was in the proliferative phase. No significant atypia, mitotic activity, or tumor necrosis was observed in the myometrium.\n\nStaging information was based on the pathologic findings; however, a comprehensive review of clinical data is recommended for final staging assessment."} +{"pid": "TCGA-A3-3370", "report": "The surgical pathology report includes two specimens. The first specimen, identified as a gallbladder, measures approximately 6.8 x 3.1 x 1.8 cm and contains multiple small yellow stones ranging from 0.2 to 0.5 cm in size. The gallbladder wall has an average thickness of 0.1 cm. The mucosal surface is described as velvety and tan green, while the serosa appears smooth and tan pink to purple. Representative sections of the gallbladder were submitted for analysis.\n\nThe second specimen is a left kidney obtained via nephrectomy, weighing 265 grams and measuring 10.1 x 5.6 x 3.2 cm. It includes attached perinephric fat, a segment of ureter measuring 4.6 x 0.2 cm, and small portions of the renal artery and vein at the hilum. A distinct red-yellow mass located in the lower pole measures 4.3 x 2.5 x 1.4 cm and is noted to be focally above the inked deep margins. The remaining cut surface of the kidney shows tan-brown parenchyma with a well-defined corticomedullary junction. No additional lesions or enlarged lymph nodes are observed, and no adrenal gland tissue is present. The specimen was serially sectioned and submitted across multiple labeled cassettes focusing on various margins and tissue regions, including the mass in relation to deep inked margins, capsule, and uninvolved parenchyma.\n\nMicroscopic evaluation of the kidney specimen notes that the tumor is confined within the kidney without evidence of lymphovascular space invasion, transcapsular extension, or renal vein involvement. Surgical margins, including soft tissue, ureteral, and vascular, are all negative. No lymph nodes were resected. The tumor nuclear grade is Fuhrman grade 1-2 out of 4. The staging is reported as pT1, Nx, Mx."} +{"pid": "TCGA-ET-A2MZ", "report": "The specimen was obtained from the right superior parathyroid and right thyroid lobe following total thyroidectomy. The parathyroid tissue weighed 5 mg. The tumor, located in the right thyroid lobe, measured 1.2 cm and was unifocal. Histologic evaluation showed no evidence of venous or lymphatic invasion. All six lymph nodes examined were negative for tumor involvement. Margins of resection were free of disease. The extent of primary tumor invasion was classified as pT1b, with no regional lymph node metastasis identified (pN0). Additional findings included identification of right inferior parathyroid tissue in two adjacent sections. A prior measurement of 3 cm was corrected to 1.2 cm due to a typographical error in the original report."} +{"pid": "TCGA-N8-A56S", "report": "The specimen includes a hysterectomy with bilateral salpingo-oophorectomy. The endometrial cavity measures 7.5 cm in length and 5.2 cm in width at the fundus. A mass measuring 6.1 x 6.0 x 3.1 cm is identified, appearing tan/white and solid with areas of necrosis and hemorrhage. It involves the anterior and posterior upper and mid corpus as well as the lower uterine segment. Invasion of the myometrium extends to the outer half, with a depth of 1.7 cm and a wall thickness of 1.8 cm at the deepest point, representing 94% penetration. There is no serosal involvement or cervical extension. The lower uterine segment is involved. Lymphovascular space invasion is present. No involvement is noted in the adnexa. Surgical margins are widely negative.\n\nAdditional findings include an endometrial polyp measuring 0.6 cm in diameter located in the anterior lower uterine segment. Three subserosal and intramural nodules ranging from 0.3 to 1.0 cm are observed in the anterior uterus; these have a tan/white, firm rubbery consistency and a whorled cut surface. Histologic evaluation reveals high-grade features based on FIGO criteria.\n\nThe cervix demonstrates Nabothian cysts. The background endometrium shows atrophic changes. Hyalinized leiomyomata up to 1.0 cm are identified within the myometrium. Both ovaries contain benign inclusion cysts and show signs of physiologic changes; dystrophic calcification is also noted in the left ovary. The right fallopian tube contains a small yellow/tan raised nodule measuring 0.1 cm on its external surface and has a patent lumen. Tubal ligation devices are present in both fallopian tubes, which demonstrate patent lumina upon sectioning.\n\nA separate omental specimen measuring 17.1 x 7.1 x 0.9 cm was submitted and revealed a single mass measuring 1.5 x 1.2 x 0.7 cm that is tan/white and well circumscribed with areas of necrosis. No malignancy was identified in this tissue. Additional findings in the omentum include lipoma with fat necrosis and calcifications.\n\nNo regional lymph nodes were submitted for evaluation. Based on available data, the pathologic staging corresponds to pT1b pNX pMX by AJCC criteria and Stage IB according to FIGO (2009 classification). This assessment may be subject to revision pending further clinical correlation."} +{"pid": "TCGA-HU-8608", "report": "Stomach, near total gastrectomy: A lesion was identified in the upper third, centered at the mid-body on the anterior wall. Grossly, it exhibited a Borrmann type 2 appearance. Histologically, it was characterized as poorly differentiated adenocarcinoma of the non-solid type (por2) with a diffuse growth pattern according to Lauren classification. The tumor demonstrated a mixed expanding and infiltrative growth pattern. It measured 7.8 x 6.5 cm and extended through the gastric wall to involve the serosa (pT4a). Resection margins were free of involvement, with a proximal margin of 1.3 cm and a distal margin of 10.5 cm. Regional lymph node evaluation identified 4 positive nodes out of 64 examined, including 3 of 42 from the lesser curvature and 1 of 22 from the greater curvature (pN2). There was no evidence of lymphatic or venous invasion; however, mild perineural invasion was present. Associated findings included prominent lymphoid stroma and foveolar hyperplasia with pit dysplasia. Immunohistochemical stains performed included CD10, MUC2, MUC5ac, MUC6, and C-erb B2. No tumor was identified in biopsies from the omentum or in the separately submitted stomach biopsy specimen labeled \u201cstomach #2.\u201d"} +{"pid": "TCGA-BT-A20U", "report": "The specimen was obtained from a patient who underwent a radical cystectomy. A total of eight lymph nodes were examined, and no evidence of carcinoma was found. The surgical margins were free of tumor involvement, with the closest distance of the tumor to a margin measuring 5 mm at the anterior margin. The primary lesion measured 3.5 cm in its greatest dimension, with additional dimensions of 3.5 x 1 cm. The tissue analysis showed invasive cells with high-grade features, characterized by ulceration and infiltration into the inner and outer detrusor muscle layers as well as into the surrounding fat. No angiolymphatic invasion was identified, although perineural invasion was present. The histopathologic grade was consistent with a high level of nuclear atypia and pleomorphism. Additional findings included extensive squamous metaplasia with hyperplasia and reactive atypical changes. Adjacent structures including the vagina, cervix, uterus, fallopian tubes, and ovaries showed no signs of tumor involvement. Cervical nabothian cysts, uterine leiomyomata, and an atrophic endometrium were noted. Cystic changes in the urothelium were also observed."} +{"pid": "TCGA-BF-A5EP", "report": "The specimen was obtained from a female patient of Caucasian (White) ethnicity. The tissue sample, collected from the skin, was processed as a primary tumor specimen and stored in an OCT block. The sample weighed 200 mg. Histological evaluation showed cells with characteristics indicative of a malignant process. The tumor was classified as grade 4, with a TNM staging of T3, N0, M0. No treatment had been administered prior to specimen collection. A blood sample was also collected, amounting to 4 ml, and stored as frozen blood. The tumor cell percentage in the tissue sample was approximately 80%."} +{"pid": "TCGA-CZ-5985", "report": "The specimen was received fresh in two parts. Part A, labeled \u201cright kidney,\u201d consists of a 1056-gram right radical nephrectomy specimen, including the kidney (measuring 15.0 x 8.8 x 5.8 cm) and surrounding tan/white perirenal adipose tissue up to 8.0 cm thick. The ureter is 2.5 cm in length and 0.4 cm in diameter. The renal vein measures 0.8 cm in length and 0.4 cm in diameter, with a second renal vein measuring 0.6 cm in length and 0.6 cm in diameter. Two renal arteries are present, measuring 0.9 x 0.4 cm and 1.6 x 0.3 cm respectively. Gerota's fascia is inked black. Upon bisection, a 7.2 x 5.0 x 6.0 cm tan/yellow to tan/red multinodular mass with focal cystic and necrotic changes is identified within the renal cortex. The tumor is located 0.3 cm from the deep soft tissue margin, 2.5 cm from the second renal artery, 2.2 cm from the second renal vein, 5.0 cm from the first renal artery, and 5.2 cm from the ureter. Grossly, the tumor appears to distort but not invade the renal capsule and abuts the perinephric adipose tissue without invasion. It extends into the renal pyramids but does not grossly involve the renal sinus fat or the renal vein. The remaining renal cortex is tan/brown with a well-defined corticomedullary junction, and the pelvis and calyces are lined by smooth, glistening mucosa. The perirenal adipose tissue is thinly sectioned, and no lymph nodes are identified. Representative sections of both tumor and normal kidney tissue were submitted for further analysis.\n\nMicroscopic evaluation reveals that the tumor is limited to the kidney. Margins evaluated include the deep margin, kidney capsule, perirenal fat, and renal sinus fat, all of which are free of tumor involvement. No lymphovascular invasion is identified. Nuclear grading using the Fuhrman system shows grade II features out of a possible IV. The tumor does not extend into adjacent structures and remains confined to the renal parenchyma.\n\nPart B, labeled \u201cregional nodes,\u201d includes a fragment of yellow/gray/tan fibroadipose tissue measuring 2.6 x 1.5 x 1.1 cm. Five possible lymph nodes are identified, ranging from 0.2 to 0.6 cm in greatest dimension. All are negative for tumor involvement.\n\nEvaluation of the kidney parenchyma shows minimal chronic changes, including 0.8% globally sclerosed glomeruli, less than 2% tubular atrophy and interstitial fibrosis, and mild vascular sclerosis. These findings are considered age-related. Clinical history includes obesity, COPD, hypertension, osteoarthritis, serum creatinine levels between 1.0 to 1.2 mg/dL, and glucose levels ranging from 97 to 203 mg/dL.\n\nCytogenetic analysis of the tumor samples was attempted but could not be completed due to contamination upon receipt."} +{"pid": "TCGA-AJ-A2QN", "report": "The surgical specimens included lymph node dissections from the right and left periaortic regions, as well as the left and right pelvic areas. A total of twelve regional lymph nodes were examined, all of which showed benign hyperplastic changes without evidence of malignancy. The largest lymph node measured 4.8 cm in greatest dimension.\n\nThe hysterectomy specimen involved a uterine mass measuring 4.8 x 4.6 x 2.2 cm. Histologic evaluation revealed moderately to poorly differentiated cells. The tumor diffusely involved the uterine cavity and extended through nearly the full thickness of the myometrium, coming within 0.1 cm of the serosal surface. There was also involvement of both the endocervical mucosa and submucosa, including stroma. No involvement of other organs or structures was identified.\n\nLymphovascular space invasion was suspected based on histologic findings. All surgical margins were free of tumor involvement. No metastatic cells were found in any of the lymph nodes evaluated.\n\nAdditional findings included benign fallopian tubes and ovaries with paratubal cysts. The cervix and parametrial tissues showed no signs of tumor involvement. The specimen was extensively sampled and sectioned for analysis, with representative blocks submitted for microscopic examination."} +{"pid": "TCGA-AO-A0JE", "report": "A 45-year-old female presented with a right breast lesion diagnosed on core biopsy. Specimens submitted included sentinel lymph nodes (two), a right breast mass, an additional medial margin, superior lateral tissue from the right breast, and level I and II axillary contents.\n\nSentinel node #1, located in level I of the right axilla, showed involvement by malignant cells in one out of one lymph nodes examined. No extranodal extension was identified. Sentinel node #2, also in level I, showed similar nodal involvement with evidence of extranodal spread measuring 0.5 cm.\n\nThe primary excised breast lesion measured 2.5 cm microscopically and displayed high-grade features including poor tubule formation and marked nuclear pleomorphism. In addition to the invasive component, there was extensive ductal carcinoma in situ (DCIS) of the solid type with high nuclear grade and central necrosis. DCIS was also noted within lobular structures. The in situ component represented less than 25% of the total lesion and was found both adjacent to and separate from the invasive portion. Microcalcifications were present in both the in situ areas and benign surrounding tissue. Vascular invasion was not observed.\n\nMargins were evaluated across multiple sections. A small focus of invasive disease measuring less than 1 mm was identified at the anterior shaved margin. DCIS extended to the superior, inferior, and posterior margins. The medial margin showed benign changes with ductal hyperplasia but no malignancy. Focal atypical ductal hyperplasia was noted in the superior lateral tissue.\n\nAxillary lymph node dissection included 8 level I nodes, all negative for tumor involvement, and 19 level II nodes, of which 6 contained metastatic cells. Extranodal extension was documented in this region, measuring 2 mm.\n\nAdditional findings included fibrocystic changes and usual ductal hyperplasia in non-neoplastic areas of the breast. Receptor studies were performed on prior biopsy material.\n\nGross examination of the breast specimen revealed a stellate-shaped mass within a piece of fibroadipose tissue measuring 11.5 x 10.0 x 4.0 cm. The mass itself measured 2.0 x 2.0 x 1.5 cm. Multiple sections were taken from all margins and submitted for histologic evaluation. Lymph node specimens ranged in size from 0.2 x 0.2 x 0.1 cm to 1.2 x 1.0 x 0.5 cm. All nodes were evaluated microscopically.\n\nIntraoperative frozen section analysis confirmed the presence of malignant cells in the second sentinel node. Final diagnoses were consistent with initial intraoperative findings."} +{"pid": "TCGA-DJ-A3UY", "report": "The thyroid gland specimen was submitted following total thyroidectomy. The thyroid weighed 14.5 grams. The right lobe measured 3.5 x 2.0 x 1.1 cm, the left lobe measured 3.6 x 2.2 x 1.2 cm, and the isthmus measured 2.2 x 2.0 x 1.0 cm. The external surface was covered by a thin fibrous capsule. The posterior surface was inked black and the anterior surface blue. On sectioning, a nodule measuring 1.2 x 0.7 x 0.6 cm was identified in the left lobe. The nodule was gray-tan, fairly well-circumscribed, and non-encapsulated. The remainder of the thyroid parenchyma appeared red brown and beefy. All representative sections were submitted for analysis, including the nodule, right lobe, left lobe, and isthmus. Histologically, the lesion was well differentiated with no mitotic activity or tumor necrosis identified. The tumor was partially surrounded and did not show blood vessel invasion or extrathyroid extension. Surgical margins were free of involvement. Multicentricity was not present. No adenomas were identified in the surrounding tissue. The non-neoplastic thyroid tissue exhibited nodular hyperplasia. One normocellular parathyroid gland was identified adjacent to the isthmus."} +{"pid": "TCGA-DX-AB3A", "report": "The specimen consists of a large, unoriented piece of soft tissue mass with peritoneal lining, measuring 26 x 22 x 13.5 cm. The outer surface is inked and represented by a thin, translucent membrane. On sectioning, the cut surface is heterogeneous, showing areas of tan-yellow and fatty appearance, tan-white and fleshy regions, tan-brown nodular and soft areas, as well as tan-green necrotic regions with cystic change. Necrosis accounts for approximately 30% of the tumor volume. An attached appendix is present, measuring 3.5 cm in length and 0.5 cm in diameter, with a pinpoint lumen and unremarkable mucosa. A hemorrhagic mesenteric nodule, likely a lymph node, was also identified and submitted for analysis. Representative sections of the tumor, resection margins, appendix, and a necrotic nodule were taken, along with a bisected lymph node. Microscopic evaluation revealed a high-grade component with myxofibrosarcoma-like features, and large areas of necrosis are present. The tumor is surrounded by an intact, translucent membrane, and there is evidence of a traumatic neuroma adjacent to suture granulomas, suggesting a prior surgical site."} +{"pid": "TCGA-N6-A4VE", "report": "The specimen consists of a uterus with both ovaries and fallopian tubes, weighing 140 grams, following total abdominal hysterectomy and bilateral salpingo-oophorectomy. The endometrium shows a lesion involving approximately 70% of the endometrial surface, limited to the endometrium but extending into the lower uterine segment and right lateral endocervical canal with full-thickness penetration into the serosa and right parametrium. An endometrial polyp is involved with the lesion. Adjacent uninvolved endometrium demonstrates proliferative pattern with cystic changes. Adenomyosis is present. Multiple leiomyomas are noted, with the largest measuring up to 1.2 cm and showing hyalinization. Medial calcification of myometrial blood vessels is present.\n\nThe cervix demonstrates involvement with full-thickness infiltration of the cervical wall and extensive lymphovascular permeation. Chronic cystic cervicitis with squamous metaplasia is also present. The vaginal margin is involved with the lesion and demonstrates extensive lymphovascular permeation. Tumor extends to the uterine serosa.\n\nThe left ovary shows findings of endometriosis, calcification, epithelial inclusions, and serosal adhesions, with no tumor identified. The right ovary contains epithelial inclusions but no tumor. Both fallopian tubes are free of tumor.\n\nIn the right parametrium soft tissue biopsy, two lymph nodes are involved with metastatic disease, with extracapsular extension measuring up to 2.7 cm. Metastases are also found in one of one right common iliac lymph nodes (up to 0.2 cm), one of one right periaortic lymph node (up to 0.2 cm), and one of one right external iliac lymph node (up to 0.2 cm). On the left side, all examined lymph nodes are free of tumor: two from the common iliac, two from the periaortic region, and four from the external iliac area. The omentum is free of tumor.\n\nImmunohistochemical staining for vimentin, cytokeratin, and CAM 5.2 supports the findings. A sarcomatous component is prominent in the metastatic tumor. A prior surgical specimen was reviewed and findings are consistent. Peritoneal cytology is negative.\n\nMicroscopic evaluation indicates a poorly differentiated tumor with combined architectural and nuclear features. The maximum tumor dimension is 5 cm. Involvement of the endometrial surface is estimated at 80% anteriorly and 60% posteriorly. There is no myometrial invasion. Structures involved include the cervical stroma and vagina. Resection margins show positivity at the vaginal and parametrial regions. Angiolymphatic invasion is present. Associated findings include epithelial and smooth muscle elements, an endometrial polyp, adenomyosis, and leiomyoma.\n\nA total of 13 lymph nodes were examined, with 5 being positive for metastasis. Involved lymph node groups include pelvic, right common iliac, parametrial, and right para-aortic nodes. Extracapsular extension is present in the parametrial lymph nodes. Pathologic staging is pT3b for local tumor extension and pN1 for regional lymph node involvement. Distant metastasis staging is not assessable (pMX). Clinical staging based on FIGO criteria is IIIC."} +{"pid": "TCGA-D1-A0ZS", "report": "The surgical specimen includes multiple lymph node aggregates from para-aortic and pelvic regions, all unremarkable for malignant involvement. Nine lymph nodes above the inferior mesenteric artery, ten below it, fourteen from the right pelvic region, and thirteen from the left pelvic region were examined and found to be negative.\n\nA polypoid mass measuring 3.8 x 3.6 x 1.2 cm was identified within the endometrial cavity, located in the posterior wall, left lateral wall, and anterior wall of the uterus. Histologic evaluation revealed a high-grade epithelial neoplasm with features consistent with endometrioid differentiation and squamous elements. The lesion demonstrated myoinvasion, extending 0.8 cm into the myometrium, which had a total thickness of 2.1 cm. There was no extension into the endocervix. Lymphovascular space invasion was present, and all surgical margins were free of tumor. A single benign intramural leiomyoma measuring 0.8 cm in greatest dimension was also identified within the myometrium.\n\nExamination of the bilateral fallopian tubes and ovaries showed no evidence of tumor involvement. The right ovary measured 3.3 x 1.7 x 0.9 cm with a solid cut surface and included a detached fallopian tube measuring 11.2 x 0.5 cm; two small nodules (yellow, 0.3 x 0.2 x 0.2 cm and brown, 0.4 x 0.3 x 0.2 cm) were noted. The left ovary measured 2.4 x 1.4 x 1.0 cm with a ragged outer surface and adhesions, along with a fallopian tube measuring 10.3 x 0.7 cm, also showing adhesions.\n\nThe uterine specimen weighed 145 grams and displayed a smooth serosal surface. Gross assessment confirmed the absence of tumor involvement in the cervix. Representative tissue blocks from all regions were submitted for histologic analysis."} +{"pid": "TCGA-CQ-A4CI", "report": "The specimen was received from the right side of the head and neck region, including multiple lymph node levels. A total of 49 lymph nodes were identified across all levels, with one lymph node measuring 1.2 cm in level I showing involvement. No extracapsular extension was observed.\n\nThe primary lesion was located in the right upper gum and inner cheek area, involving the maxilla. The lesion measured 3.0 cm in its largest dimension and had a thickness of 1.7 cm. It exhibited lymphovascular invasion but no perineural invasion. All surgical margins were free of tumor involvement, although the deep superolateral margin was closely approached by the lesion at less than 0.1 cm. Additional sections of bone were examined, and an addendum was issued to confirm the absence of tumor in the bony margins.\n\nAdditional specimens from the deep pterygoid margin and retroantral fat were submitted and found to be negative for tumor involvement. The submandibular gland was unremarkable.\n\nStaging was based on the AJCC/UICC TNM classification system (7th edition). Based on the findings, the primary lesion was classified as pT2, indicating a tumor larger than 2 cm but not more than 4 cm in greatest dimension. Regional lymph node involvement was classified as pN1, reflecting metastasis in a single ipsilateral lymph node measuring 3 cm or less. A total of 49 regional lymph nodes were examined, with one found to be involved.\n\nThe overall specimen dimensions were 6.5 x 5.2 x 4.0 cm, and the tissue was submitted in multiple sections for thorough evaluation."} +{"pid": "TCGA-EM-A3O9", "report": "The right hemithyroidectomy specimen measured 4.5 cm \u00d7 3.2 cm \u00d7 2.5 cm, with an isthmus measuring 2.9 cm \u00d7 2.3 cm \u00d7 0.8 cm, and a total weight of 27.7 g. A dominant nodule measuring 4.5 cm \u00d7 3.2 cm \u00d7 2.5 cm was identified within the right lobe; it was well delineated and partly cystic with brown fluid content. The nodule exhibited follicular architecture and oncocytic cytomorphology. Margins were uninvolved, and the lesion was totally encapsulated with minimal capsular invasion. No lymphovascular or perineural invasion was identified, and there was no evidence of extrathyroidal extension. A second smaller lesion measuring 0.05 cm was identified in the isthmus, showing follicular architecture and classical cytomorphology. This lesion lacked a capsule, and there was no evidence of invasion or involvement of margins. Two lymph nodes from the isthmic region showed no evidence of malignancy. Additional findings included thyroiditis and focal mild reactive C-cell hyperplasia, confirmed by immunohistochemical staining for calcitonin. The parathyroid biopsy did not reveal any pathological diagnosis. The staging classification was pT3, pN0, with no distant metastasis identified."} +{"pid": "TCGA-A8-A06U", "report": "The specimen consists of right-sided ablated breast tissue containing multiple tumor foci. Four distinct areas of cellular proliferation were identified, with maximum diameters measuring 2 cm, 3 cm, 0.7 cm, and 2.5 cm. The cellular morphology demonstrates features of poor differentiation and includes regions with intraductal growth patterns characterized by high-grade cytology and comedo-type necrosis at the periphery. Surrounding tissue shows evidence of mastopathy with sclerotic changes, intraductal papillomatous scleradenosis, microcalcifications, cystic alterations, and cylindrical epithelial metaplasia. No involvement of the overlying skin or nipple was observed, and there was no evidence of Pagetoid spread. All outer resection margins were free of tumor involvement. Histologic grade is G3. Lymph node staging reveals metastatic involvement in 2 out of 25 nodes (pN1a). Distant staging could not be assessed. Surgical resection margins are tumor-free (R0)."} +{"pid": "TCGA-87-5896", "report": "This addendum reports findings from the evaluation of a left frontal brain mass. Microscopic analysis reveals a highly cellular tumor composed primarily of bipolar-shaped atypical glial cells. The tissue demonstrates marked hypercellularity with numerous mitotic figures. Areas of necrosis are present, including focal pseudopalisading necrosis (C4). Vascular proliferation is also observed. GFAP staining confirms the glial origin of the tumor cells. Proliferative activity, assessed by Ki67 (MIB-1) staining, is elevated, with an index of approximately 25% in initial sections and up to 35\u201340% in other areas. The tumor shows infiltrative growth into adjacent brain tissue, with evidence of secondary structuring. Initial biopsy showed predominantly necrotic tissue with no viable tumor identified. Subsequent excision specimens confirmed a high-grade glioma. Intraoperative consultations were consistent with these findings. Expert review is in progress and results will be reported separately."} +{"pid": "TCGA-EL-A4K2", "report": "The surgical specimen consisted of a left thyroid lobectomy with attached isthmus. The thyroid lobe measured 6.0 x 2.0 x 1.5 cm, and the isthmus with adjacent soft tissue measured 1.0 x 1.0 x 0.5 cm. The thyroid capsule appeared unremarkable. Within the thyroid lobe, there was a well-delineated brown-tan lesion measuring 1.8 x 1.5 x 1.5 cm. Centrally, this lesion contained a distinct white-tan focus measuring 0.5 x 0.5 x 0.5 cm. The remainder of the thyroid tissue exhibited a brown-red, vaguely nodular surface.\n\nHistologic examination revealed a well-defined lesion composed of both follicular and papillary components. The papillary component was small and confined within the larger nodule. No multifocal disease was identified. There was no evidence of extrathyroidal extension or lymphovascular invasion. Surgical margins were negative for abnormal tissue. One lymph node was examined and showed no involvement by atypical cells.\n\nSections submitted included representative portions of the thyroid nodule with the central focus, surrounding normal thyroid tissue, and the isthmus with adjacent soft tissue. Frozen section analysis suggested a follicular lesion with a minor papillary component. Clinical presentation was notable for a thyroid mass."} +{"pid": "TCGA-DU-7301", "report": "The specimen consists of excised brain tissue from the left posterior frontal region, including multiple soft, pink-tan, glistening fragments measuring up to 0.5 cm in maximum dimension, as well as a larger aggregate fragment measuring 2.0 x 1.7 x 0.2 cm. Histologic evaluation reveals a loose background with microcystic changes. Cellular atypia is present but minimal, and no mitotic figures are identified. There is no evidence of vascular hyperplasia or necrosis. Immunohistochemical staining demonstrates a proliferation index of approximately 4% by MIB-1 labeling. Special studies for MGMT promoter methylation were performed using bisulfite-treated DNA and PCR amplification followed by gel electrophoresis; results were negative for promoter methylation. Intraoperative consultation on frozen section identified a glioma."} +{"pid": "TCGA-69-7760", "report": "The specimen included a right lower lobectomy measuring 19 x 14 x 4 cm and weighing 227 grams. A tan-white solid mass measuring 5 x 3.5 x 3.5 cm was identified; it puckered the overlying pleura and was tightly adhered to adjacent soft tissue. The mass was located less than 0.3 cm from the bronchial margin of resection, 0.2 cm from the superior staple margin, and appeared to encase surrounding vessels. No vascular or lymphatic invasion was identified. Microscopic evaluation revealed a predominant acinar pattern with a minor component showing micropapillary features. Additional findings included atypical alveolar hyperplasia and centrilobular emphysema. Nine peribronchiolar lymph nodes were identified with scattered calcified granulomas; all were negative for neoplasm. Lymph nodes from levels 11, 10R, 7, and 4R were also negative. All surgical margins\u2014including bronchial, mediastinal, upper lobe, and pulmonary vein\u2014were free of involvement. The tumor was found to invade the mediastinal pleura, though the inked surface was negative. Staging based on AJCC criteria was determined as pT3 NO, Stage 2B. Special stains performed on lymph nodes showed rare yeast forms consistent with Histoplasma, and no mycobacteria were detected. Molecular testing for EGFR mutations was initiated and results will be reported separately."} +{"pid": "TCGA-05-4382", "report": "The specimen shows a predominantly solid and small acinar growth pattern with mixed large-cell and clear-cell features, localized in the left upper lobe, specifically in segment S3. The tumor measures pT2 with no evidence of lymph node involvement (pN0). Distant metastasis could not be assessed (pMX). Resection was complete with no residual tumor at the bronchial or vascular margins, and all identified lymph nodes are free of tumor. The tumor focally involves the visceral pleura."} +{"pid": "TCGA-AG-A01W", "report": "The specimen shows a poorly differentiated neoplasm with ulceration of the inner tumor surface and infiltration extending through the rectal wall into the perirectal fatty connective tissue. There is evidence of lymphangitic and hemangiotic spread. Surrounding the tumor, there was chronic recurrent inflammatory reaction. Similar histological features were observed in an attached fragment of tissue. Lymph node examination revealed no metastasis with 0 out of 20 nodes involved, although reactive changes consistent with moderate chronic lymphadenitis were noted. Sections from the resection margins and anastomosis ring showed no tumor involvement. Additional findings included hyperplastic polyps and tubular adenomas identified in the macroscopically described mucosal areas. Histopathological staging indicated pT3, pN0, Mx, with lymphatic and vascular invasion present (L1, V1)."} +{"pid": "TCGA-L1-A7W4", "report": "The surgical specimen involved the pancreas, stomach, and small bowel, resected as part of a Whipple procedure. A mass was identified in the head of the pancreas measuring 2.8 cm. Microscopic evaluation showed a poorly differentiated adenocarcinoma with focal non-keratinizing squamous differentiation. The tumor extended into the peripancreatic tissue but did not involve the ampulla. The superior soft tissue margin and mesenteric vein margin were positive, while other pancreatic and bile duct margins were negative. No treatment effect was observed.\n\nLymph-vascular and perineural invasion were present. Of the regional lymph nodes examined, 2 out of 11 were involved, with extranodal extension and a largest focus of involvement measuring 1.7 cm. Additionally, one lymph node from a separate specimen was also involved. Distant metastases were not identified. The portal vein resection specimen was positive for invasive carcinoma, while an additional resected pancreatic margin was free of tumor.\n\nChronic cholecystitis was noted in the gallbladder specimen, and the falciform ligament and omentum showed benign findings. Gross evaluation of the Whipple specimen revealed no other significant lesions or defects in the mucosal surfaces. Adipose and fibrous tissue in the omentum and falciform ligament showed no evidence of disease involvement.\n\nIntraoperatively, atypical cells were noted at the frozen section of the pancreatic margin, though the final section was negative. All other intraoperative consultations on margins were negative except for the initial concern at the pancreatic margin. Multiple sections were submitted for analysis, including margins, lymph nodes, and surrounding tissues."} +{"pid": "TCGA-MI-A75E", "report": "The liver specimen weighed 187 grams and measured 16.2 x 8.5 x 5.3 cm. A nodule measuring 4.3 x 3.2 x 3.0 cm was identified, located 3.1 cm from the hepatic resection margin. The nodule extended to the overlying capsule and involved attached fatty soft tissue. The remaining liver parenchyma appeared unremarkable. Histologically, the lesion demonstrated moderately differentiated features. Evaluation of the hepatic margins showed no involvement at the inked areas. Lymphovascular invasion was present, with extension through the capsule and visceral peritoneum into adjacent adhered omental tissue, accompanied by hematoma and organization. Additional findings included chronic hepatitis (grade 3, stage 2) and capsular fibrosis with organizing hematoma and adhesions involving the attached omentum. The tumor did not reach the inked margin areas of the omentum. A prior biopsy was reviewed for correlation."} +{"pid": "TCGA-YU-A90Q", "report": "The right orchiectomy specimen demonstrates a mass measuring 9.8 x 7.7 x 6.8 cm. Histologic evaluation reveals infiltration of the tunica albuginea and tunica vaginalis. There is involvement of the rete testis. The spermatic cord, surgical margins, and epididymis show no evidence of neoplastic involvement. Intratubular germ cell neoplasia is present."} +{"pid": "TCGA-CG-4300", "report": "The specimen consists of a total gastrectomy preparation with an ulcerated, moderately differentiated neoplasm measuring up to 7 cm in maximum diameter. The lesion demonstrates infiltration into the perigastric fatty tissue and exhibits circumscribed penetration through the overlying serosa. A total of fourteen regional lymph node metastases were identified out of thirty-five examined lymph nodes. The oral and aboral resection margins are free of tumor involvement, as is the omentum. Extramural extension is present; however, no definitive distant metastatic involvement can be assessed."} +{"pid": "TCGA-N5-A4RU", "report": "The surgical specimens included left and right para-aortic lymph nodes, uterus with cervix, bilateral fallopian tubes and ovaries, high right para-aortic lymph nodes, a left sidewall soft tissue mass, right external iliac lymph nodes, and an omental biopsy.\n\nExamination of the left para-aortic lymph nodes revealed tumor involvement in 4 out of 5 nodes. The right para-aortic lymph nodes showed no evidence of tumor involvement. The high right para-aortic specimen contained fibroadipose tissue and nerve without lymph nodes or tumor involvement. The right external iliac lymph node was benign.\n\nThe uterus showed a lesion involving the endometrium with invasion into the myometrium. The depth of myometrial invasion was up to half of the total myometrial thickness in that area, measuring 1 mm of invasion in a region where the myometrium was 14 mm thick. There was no evidence of endocervical involvement; however, vascular invasion was present. Tumor was also identified in the parametrial soft tissue. The endometrium exhibited atrophic changes and the myometrium showed adenomyosis. Both ovaries contained metastatic tumor. A detached tumor fragment was found in the left fallopian tube, while the right fallopian tube appeared normal.\n\nImmunohistochemical staining for desmin and myogenin performed on the uterine specimen showed no evidence of heterologous elements.\n\nThe omental biopsy showed no tumor involvement."} +{"pid": "TCGA-DK-A1AE", "report": "The submitted specimens include bilateral distal pelvic lymph nodes, prostate, bladder, seminal vesicles, urachus, and distal ureter segments. A total of 8 lymph nodes were identified on the right and 3 on the left, all showing benign features. The primary specimen involving the bladder and surrounding structures demonstrates a lesion involving the left posterior bladder wall extending toward the dome. The lesion measures 3.0 x 2.8 x 1.4 cm and is characterized by inverted and infiltrative growth patterns. Histologic evaluation reveals high-grade cellular features with extensive vascular invasion and perineural involvement. No in situ component or multicentricity is identified. The tumor extends into perivesical soft tissues with involvement of periseminal vesicle soft tissue and presence of tumor emboli within lymphovascular spaces. All surgical margins are free of tumor involvement. Adjacent mucosa shows reactive changes including proliferative cystitis. The prostate demonstrates nodular hyperplasia. Ureters and urethra are uninvolved. Based on AJCC 2002 staging criteria, the pathologic stage reflects invasion into perivesical soft tissue with periseminal vesicle extension."} +{"pid": "TCGA-A2-A0YI", "report": "Specimen A, labeled right breast, consists of an ovoid portion of yellow fatty tissue measuring 9.5 x 6.3 x 4.0 cm. The specimen is oriented by two sutures with blue dye noted in the lateral half. A skin ellipse measuring 4.2 x 0.8 cm is present on the superficial aspect. Two needle localization wires are found in the inferior lateral region. On sectioning, most of the specimen consists of bland yellow fatty tissue with fine fibrous bands. In the midportion, a pink-tan gritty area is identified in the medial half. Lateral to this, there is dense pink-tan fibrous tissue. A firm area measuring 1.7 x 1.4 x 2.0 cm is present, with a second firm area immediately inferior measuring approximately 0.7 cm. The smaller lesion approaches the inferior margin by 0.3 cm, and the larger lesion is 1 cm from the closest margin, which is both superficial and deep. Sections were submitted including perpendicular margins, central tumor, surrounding tissue, and full cross-sections of the lesion.\n\nPart B, right sentinel node #1, includes two portions of yellow-pink fatty tissue measuring 1.7 x 1 x 0.5 cm and 1.7 x 1.5 x 0.8 cm. Within the smaller portion, a 0.6 cm lymph node is identified. Blue dye is noted in the node and within the larger portion. The specimen was entirely submitted.\n\nPart C, right non-sentinel lymph node, is an ovoid pink-tan tissue measuring 1.8 x 1 x 1 cm. Sectioning reveals it to be a grossly unremarkable lymph node. A portion was submitted per protocol, and the remainder submitted in total.\n\nPart D, right sentinel node #2, is an irregular portion of yellow-red fatty tissue measuring 2.5 x 1.5 x 1.0 cm. No distinct nodal tissue is identified, and the specimen was entirely submitted.\n\nPart E, right breast additional posterior ink at new margin, is an ovoid portion of yellow fatty tissue measuring 6 x 4.8 x 0.8 cm. The side demonstrating ink is marked with blue ink with a perimeter of black ink and was entirely submitted.\n\nMicroscopic examination of Part A shows moderately differentiated in situ and infiltrating features with mixed ductal and lobular differentiation, predominantly lobular type, nuclear grade I with low mitotic index, and an in situ component of approximately 20%, consisting of solid and cribriform patterns. Two tumor nodules are present measuring 1.7 and 0.5 cm in greatest dimension. All resection margins are free of involvement by at least 5 mm. There is no evidence of lymphatic invasion. Fibrocystic disease is present along with biopsy site change showing organizing fat necrosis and reactive fibrosis.\n\nIn Part B, a lymph node contains a minute focus of isolated cells visible only on cytokeratin stain, not seen on routine sections, measuring approximately 0.05 mm in greatest dimension. Part C, the non-sentinel lymph node, is negative for involvement, showing only fatty infiltration. Part D, the second sentinel node, contains adipose tissue with a crushed lymphoid aggregate, also negative for involvement by step section and immunostain. Part E shows lipomatous breast tissue with no residual involvement. The new inked margin is free. Fibrocystic change includes duct hyperplasia of the usual type with intraductal papillomatosis, apocrine metaplasia, and cyst formation."} +{"pid": "TCGA-DX-A6YV", "report": "The patient presented with a history of a right thigh mass previously biopsied, showing a high-grade pleomorphic sarcoma. The specimen submitted was from a wide excision of the right thigh mass.\n\nThe excised specimen consisted of skin measuring 7 x 2.5 cm with an underlying mass measuring 19 x 14 x 11 cm and weighing 1420 grams. The mass was tan to light brown, soft, with areas of hemorrhage and necrosis involving approximately 30\u201340% of the tumor volume. Cystic degeneration was also noted. The tumor was located within the skeletal muscle and showed no involvement of the resection margins grossly.\n\nMicroscopic examination confirmed the presence of a high-grade spindle cell neoplasm with marked pleomorphism. Representative sections were taken from all margins: anterior, posterior, proximal, distal, deep, and skin. All margins were free of tumor. Multiple sections from the tumor bed and surrounding tissue were submitted for analysis.\n\nStaging and characterization were based on tumor size, grade, and depth of invasion into soft tissues."} +{"pid": "TCGA-A7-A5ZV", "report": "The final surgical pathology report includes specimens from a left axillary sentinel lymph node procedure and a left breast segmental mastectomy with additional tissue posterior to the mastectomy. \n\nLymph nodes from the left axillary sentinel node #1 (2.2 x 1.7 x 1 cm) and sentinel node #2 (2.5 x 2.2 x 1.2 cm) were examined microscopically and found to be without evidence of malignancy. \n\nThe segmental mastectomy specimen measured 7.3 x 5.7 x 4.3 cm and contained a red-brown to white-tan nodular mass measuring 4.2 x 4.2 x 3.5 cm. The mass was observed near the medial, posterior, and anterior margins. Microscopic evaluation showed high-grade cellular features and a high proliferative rate. Histologic examination revealed invasive growth without evidence of vascular invasion or calcifications. All margins except the posterior margin in the original specimen were negative by at least 4 mm. The posterior margin was initially noted to be 1.5 mm from the lesion; however, an additional posterior margin specimen measuring 1.7 x 1.2 x 1.2 cm was submitted separately and confirmed as negative for malignancy. \n\nImmunostaining with p63 antibodies was performed on representative blocks to aid in assessment. No ductal carcinoma in situ was identified. \n\nA separate consultation note indicated that the lesion exhibited a well-circumscribed, expansile growth pattern rather than an infiltrative one, which may account for the absence of lymph node involvement. It also reiterated that the surgical margins were considered adequate following analysis."} +{"pid": "TCGA-85-A511", "report": "The specimen consisted of lung tissue obtained via lobectomy. The tumor measured 6 x 6 x 6 cm and was located in the lung. Microscopic examination revealed moderately differentiated cells with involvement of the visceral pleura. One out of three intrathoracic lymph nodes showed evidence of metastatic involvement. No other tumor nodules were identified. Information regarding lymphatic or venous invasion, surgical margins, neo-adjuvant treatment, and additional findings was not specified. The tumor was located in the left-lower lobe."} +{"pid": "TCGA-D5-6541", "report": "Histopathological examination was performed on a partial resection of the descending colon. The specimen measured 16 x 6 x 3 cm and included surrounding fat tissue. Two mucosal lesions were identified, measuring 3.5 x 3 x 1.5 cm and 2 x 3 x 1.5 cm respectively. These lesions were aligned circumferentially and located 4 cm and 2.5 cm from opposing excision margins. Macroscopic evaluation indicated involvement beyond the muscular layer. Microscopic analysis revealed well-differentiated tubulopapillary epithelial changes with infiltration into the muscularis propria and adjacent adipose tissue. The closest lateral margin measured 3 cm and was free of abnormal cells. Lymph node assessment showed reactive sinus histiocytosis. All excision margins were clear. Staging based on pathological findings was consistent with localized involvement without lymph node spread."} +{"pid": "TCGA-AR-A5QM", "report": "Breast, left, wide local excision: A mass measuring 4.7 x 2.2 x 1.5 cm was identified. Histologic evaluation revealed Nottingham grade II features with tubule formation score of 3/3, nuclear pleomorphism score of 2/3, and mitotic count score of 2/3, resulting in a total Nottingham score of 7/9. In situ changes consistent with lobular morphology are present. Biopsy site alterations were noted. No angiolymphatic invasion was observed. Calcifications were found within benign ductal structures. Following re-excision of the superomedial margin, all surgical margins were free of malignant cells, with the minimum tumor-free distance measuring 0.8 cm at the deep margin. Four left intramammary lymph nodes were examined and found to be negative. A separate excised left \"palpable\" nodule contained a single intramammary lymph node that was also negative. One sentinel intramammary lymph node on the left contained isolated cells suggestive of tumor origin, identified only by cytokeratin immunostaining [AJCC pN0 (i+) (sn)], with blue dye visualized. Three left axillary sentinel lymph nodes were negative for metastatic disease [AJCC pN0 (i\u2212) (sn)] and lacked blue dye; immunohistochemical staining confirmed the absence of tumor involvement.\n\nBreast, right, wide local excision: A smaller mass measuring 1.4 x 1.0 x 0.9 cm was present. Histologic grading showed Nottingham grade II features with tubules 3/3, nuclei 2/3, and mitoses 2/3, yielding a total score of 7/9. There was extensive in situ component with low to intermediate nuclear grade involving more than 25% of the lesion and extending beyond the invasive portion over an area measuring 1.8 x 0.5 x 0.3 cm anteriorly. Angiolymphatic invasion was identified. Surgical margins were clear following re-excision of the anterior/medial margin, with a minimum tumor-free margin of 0.9 cm at the deep margin. A radioactive seed was identified within the specimen.\n\nLymph node assessment from the right axillary dissection revealed 4 positive nodes out of 25 retrieved. The largest focus of nodal involvement consisted of matted lymph nodes measuring 3.0 x 1.9 x 1.6 cm. Faxitron imaging was performed. All findings were reviewed in consultation."} +{"pid": "TCGA-3C-AALK", "report": "The specimen was received in five parts. Part A consisted of a subnipple tissue fragment measuring 1.1 x 0.9 x 0.3 cm. Histologic examination revealed benign ductal changes without evidence of malignancy.\n\nPart B was a sentinel lymph node measuring 1.8 cm in greatest dimension, bisected and extensively examined with multiple levels and immunohistochemical staining for cytokeratin. No malignant cells were identified.\n\nPart C was a second sentinel lymph node measuring 2.7 cm, quadrisected and similarly examined with multiple levels and immunohistochemical staining. A single focus of less than 10 cells was identified within the lymph node using immunohistochemistry (cytokeratin), consistent with isolated tumor cells.\n\nPart D was a right total mastectomy specimen measuring 22.0 x 14.0 x 3.5 cm. The surgical margins were marked with ink: superficial margin yellow, deep margin black, and subareolar blue. On gross examination, a central cystic area measuring 6.0 x 4.0 x 2.5 cm was identified, containing a firm mass measuring 2.0 x 2.0 x 1.5 cm located 0.6 cm from the deep margin. A separate smaller nodule measuring 0.6 cm was also present. Multiple nodules ranging from 0.5 to 0.8 cm in size were scattered throughout the cystic parenchyma. Histologically, the larger mass showed well-differentiated features with tubule score 1, nuclear grade score 2, and mitotic score 1. The smaller nodule was moderately differentiated with tubule score 3, nuclear grade score 3, and mitotic score 1. Extensive involvement of the ductal system was noted across 15 out of 26 slides, showing solid, cribriform, and micropapillary patterns with necrosis and calcifications. These changes extended to within 0.1 cm of the deep margin. Micropapillary changes were also observed in the nipple ducts. Additional findings included lobular changes with monomorphic features, intraductal papillomas, sclerosing adenosis with calcifications, and a fibroadenoma. Lymphatic vascular space invasion was identified. Benign skin fragments were submitted as part E, with no evidence of involvement.\n\nImmunohistochemical analysis of the larger invasive focus showed approximately 75% of nuclei positive for estrogen receptor with intermediate intensity, and approximately 80% positive for progesterone receptor with strong intensity. HER2 testing scored 2, indicating equivocal expression. In the smaller invasive focus, estrogen and progesterone receptors were strongly and diffusely expressed (100% of nuclei), and HER2 testing scored 3, indicating overexpression.\n\nSentinel lymph node evaluation revealed one lymph node with isolated tumor cells based on immunohistochemical analysis. No definitive metastases were identified in the lymph nodes using standard histologic evaluation. Based on AJCC 7th edition staging criteria, the primary lesion was classified as pT1c (greater than 1.0 cm but not more than 2.0 cm). Nodal status was classified as pN0 (ITC,i+) reflecting the presence of isolated tumor cells only.\n\nAdditional findings included widespread involvement of the ductal system with high-grade features, necrosis, and calcifications. Proliferative changes with atypia were present in the surrounding breast tissue. No lymph nodes were identified in the axillary tissue submitted."} +{"pid": "TCGA-B6-A2IU", "report": "A right breast and axillary specimen was received fresh, weighing 1,330 grams and measuring 33.0 x 16.0 x 6.8 cm. The breast portion measured 27.5 x 16.0 x 6.8 cm, with an axillary tail measuring 10.5 x 9.0 x 3.5 cm. Attached skin measured 24 x 12.2 cm with a 4.0 cm areola and a 1.4 cm nipple. Surgical margins were inked, and the specimen was serially sectioned. A central breast mass measuring 5.0 x 5.0 x 2.8 cm was identified; it was firm and ill-defined, located 2.2 cm from the posterior margin.\n\nBlocks included cross sections from the nipple, sections from the mass and its closest surgical margin, representative sections from all breast quadrants, and multiple lymph node candidates from the axillary fat. A total of twenty-eight lymph nodes were sampled and showed no evidence of malignancy.\n\nHistologic evaluation revealed nuclear grade 2 features. The tumor lacked lymphatic or vascular invasion and did not involve the nipple or skin. Non-neoplastic breast tissue showed benign fibrocystic changes. Surgical margins were negative.\n\nMultifocal involvement was noted extensively across all four quadrants of the breast. Immunohistochemistry for hormone receptors was performed on one block; results indicated estrogen receptor positivity (estimated FMOL value of 30) and progesterone receptor positivity (estimated FMOL value of 101). Additional testing details were referenced in a separate report."} +{"pid": "TCGA-69-7763", "report": "The submitted specimen includes a right middle lobe lobectomy measuring 11.0 x 10.0 x 4.0 cm and weighing 75 grams prior to fixation. The bronchial remnant is 0.4 cm in length. A yellow, firm mass measuring 2.1 x 1.2 x 0.5 cm is identified, with a central area of necrosis. The mass is located 0.5 cm from the pleural surface, 1.5 cm from the bronchial margin, and 1.2 cm from the nearest parenchymal resection margin. The pleural surface is smooth and glistening, and a staple line measuring 12 cm is noted. No other gross abnormalities are observed, and the bronchus does not appear involved. The remaining lung tissue is tan-pink and unremarkable.\n\nSections submitted include representative samples of the bronchial shave margin, tumor, vascular margin, mass with adjacent resection margin, mass with nearby vessel, areas near the pleural surface, peripheral and proximal regions of the mass, and all associated lymph nodes. All margins\u2014bronchial, vascular, parenchymal, and pleural/soft tissue\u2014are negative. There is no evidence of vascular or lymphatic invasion.\n\nAdditional specimens include multiple lymph node groupings (numbered 7, 8, 10, and 11), each consisting of tan-gray soft tissue segments. The largest measures 1.2 x 1.2 x 0.6 cm; all are submitted entirely in formalin. All lymph nodes show benign features with anthracotic changes and no evidence of neoplastic involvement.\n\nBased on AJCC staging criteria, the pathologic stage is pT1b NO MO, corresponding to Stage IA."} +{"pid": "TCGA-CN-5363", "report": "The specimen consists of a laryngectomy with bilateral neck dissection and left thyroid lobectomy. A mass measuring 5.0 cm in greatest dimension is identified in the left glottic region with extension into the supraglottis. The lesion involves the anterior commissure, paraglottic space, thyroid cartilage, and extends into the left thyroid lobe and skeletal muscle. Margins are assessed and found free of involvement. Six lymph nodes from the left neck dissection contain metastatic disease, including a largest focus measuring 7 cm. Involved lymph node levels include 3 and 4, with extracapsular spread identified in a level 3 node. The jugular vein demonstrates involvement of the adventitia and outer media, though the luminal space remains clear. No tumor is identified in the right neck dissection, which includes 17 lymph nodes. Additional specimens including lymph nodes from left neck level 2B and a fragment of the left pharyngeal wall show no evidence of tumor.\n\nHistologic evaluation confirms infiltration into multiple anatomical structures within the larynx. No perineural invasion is observed. Venous or lymphatic invasion is not identified. Margins remain uninvolved. Acute inflammatory changes and abscess formation are noted in the right glottic region. Pathologic staging is assigned as pT4a, pN3, pMX. A total of 28 lymph nodes are examined, with 6 demonstrating involvement. Extracapsular extension is present in involved lymph nodes. Multiple tissue sections are reviewed with appropriate stains applied. No additional significant abnormalities are identified in the left thyroid lobe or right accessory parotid gland."} +{"pid": "TCGA-CJ-5678", "report": "The specimen consists of a left radical nephrectomy measuring 25.0 x 12.0 x 10.0 cm, including a kidney measuring 15.0 x 8.0 x 6.0 cm, segments of renal vein (2.0 cm in length x 1.0 cm in diameter), ureter, and adrenal gland (4.0 x 3.0 x 1.0 cm). A nodular hemorrhagic yellow mass measuring 8.0 x 7.0 x 7.0 cm is located in the medial mid to upper portion of the kidney. The center of the mass is necrotic, and the majority of it bulges into the renal sinus and perinephric adipose tissue, with a small portion attached to the medial aspect of the renal parenchyma. It focally abuts the external aspect of the renal vein but there is no definite invasion of this structure. The mass is within 0.4 cm of the adrenal gland but does not directly invade it. It also abuts Gerota's fascia margin in multiple areas. Margins of resection are free of tumor.\n\nMicroscopic evaluation reveals a cellular composition consisting predominantly of clear cells (90%) with a minor component of eosinophilic cells (10%). Nuclear grade is 3 according to Fuhrman classification. There is no invasion of the renal sinus adipose tissue, perinephric adipose tissue, or renal vein despite close approximation. A smooth-walled cyst measuring 4.0 x 4.0 x 4.0 cm filled with clear fluid is present within the kidney. Additionally, a solid yellow and white nodule measuring 1.3 x 1.0 x 1.0 cm is identified in the adrenal gland and entirely submitted for evaluation. One lymph node is negative for tumor. Multiple sections were submitted from various margins and representative areas of the lesion."} +{"pid": "TCGA-FG-7638", "report": "The specimen consists of three submitted portions of brain tissue from the left frontal region. The first fragment measures 1 x 0.7 x 0.4 cm and is described as irregular gray-tan soft tissue. The second submission is an aggregate measuring 4.8 x 3.8 x 1 cm, composed of multiple pieces of similar gray-tan brain tissue. A third aggregate, measuring 3.8 x 3 x 1.2 cm, was labeled as the posterior margin. No discrete tumor was identified on gross examination in any of the specimens.\n\nMicroscopic evaluation reveals that some areas maintain a moderately cellular population of uniform round glial cells with a delicate capillary network. Other regions demonstrate increased cellularity, nuclear pleomorphism, and scattered mitotic figures. Tumor cells are seen infiltrating the cortex with perineuronal satellitosis present. Immunohistochemical staining for p53 was negative. Molecular studies by FISH revealed loss of chromosomes 1p and 19q. Based on histologic features, the lesion is classified as WHO Grade III. Margins could not be fully assessed due to the nature of the resection and sampling."} +{"pid": "TCGA-DX-A8BX", "report": "The surgical specimen consists of a resected retroperitoneal mass along with associated left kidney, ureter, adrenal gland, and descending colon. The mass is multilobulated, measuring 27.5 cm in greatest dimension, and is located within the retroperitoneal fat, distorting normal anatomical structures. Two main lobes are identified, measuring 17.5 x 16.0 x 13.2 cm and 10.0 x 8.0 x 7.5 cm respectively. The mass is largely well-circumscribed but focally extends irregularly into perirenal fat, through the renal capsule into the lower pole of the kidney, and into the muscularis of the descending colon. There is also a hemorrhagic defect adjacent to the colon measuring 2.0 x 1.8 x 1.0 cm. On sectioning, the tumor is firm, tan-white, and nodular with extensive necrosis involving approximately two-thirds of the larger lobe. Focal yellowish fatty areas and fleshy regions are also present.\n\nMicroscopically, the lesion demonstrates high-grade cytological features. The mitotic rate is elevated at 65 mitoses per 10 high-power fields. Necrosis is prominent. The tumor involves multiple surgical margins, including lateral, medial, anterior, and posterior aspects. However, the superior and inferior margins appear free of tumor involvement. Skeletal muscle and fibroadipose tissue are involved by the tumor. Immunohistochemical studies show negativity for S-100 protein, CD34, EMA, SMA, and desmin, while FXIIIA is positive.\n\nThe left kidney measures 11.0 x 5.5 x 5.0 cm, with thickening of the renal capsule. A nodule infiltrates up to 2.0 cm into the renal parenchyma, although the remainder of the kidney appears histologically unremarkable. The ureter is separable from the mass and shows no evidence of tumor involvement. The adrenal gland is benign and does not contain any tumor cells. The descending colon is 47 cm in length, with the mucosa appearing histologically unremarkable. The tumor invades the muscularis layer of the bowel wall, though both proximal and distal colonic margins are free of tumor. Pericolic fat is up to 5 cm in thickness, and multiple lymph nodes are present within this fat; all are histologically benign. The omentum, measuring 20.0 x 14.0 x 2.0 cm, is negative for tumor involvement.\n\nA second specimen, consisting of skeletal muscle and fibroadipose tissue from the deep quadratus and psoas region, measures 15 x 8 x 3 cm in aggregate. The blue-inked muscle margin of resection is negative for tumor involvement, while the black-inked adipose surface is positive. Microscopic examination confirms the presence of tumor within skeletal muscle and fibroadipose tissue, with disruption of the surgical specimen in some areas."} +{"pid": "TCGA-BQ-5891", "report": "The specimen from the right kidney, renal vein thrombus, and vena caval thrombus was submitted for analysis. The tumor measured 12.2 cm in greatest diameter and was found to involve the renal sinus fat and hilar fat. Invasion into the renal vein was identified, with tumor also present in muscular veins near the renal sinus and hilum. Microscopic evaluation revealed high nuclear grade cells with abundant eosinophilic cytoplasm. Immunohistochemical staining showed strong positivity for racemase and CD10, with patchy positivity for CA-IX, and negative results for CK7, 34BE12, TFE-3, TFE-B, and CEA. Architecturally, the tumor demonstrated a predominant papillary pattern with focal solid areas.\n\nThe surgical margins were evaluated microscopically, and tumor was identified at the renal vein margin. The remaining non-neoplastic kidney tissue appeared unremarkable. No adrenal gland or lymph nodes were identified within the kidney specimen.\n\nA separate biopsy of the right gonadal vein revealed benign vascular tissue. Excised para-caval and pre-caval lymph nodes were examined, and no evidence of tumor involvement was found; 11 lymph nodes were assessed. In the right renal lymph node excision, a ganglioneuroma measuring 1.1 cm and adjacent benign adrenal tissue were identified, but no lymph nodes were present.\n\nThe staging classification indicated that the tumor extended grossly into the renal vein and vena cava below the diaphragm. Multiple sections were taken from various regions including the renal artery margin, renal vein, tumor involving the hilum, tumor to perirenal fat interface, and ureteral margin. Additional specimens included segments of adrenal tissue and fat. All findings were based on personal examination of the slides and approved by the reporting pathologist."} +{"pid": "TCGA-C5-A1M7", "report": "The specimen measured 2.5 cm in greatest dimension and demonstrated infiltration to a depth of 0.7 cm within the tissue wall, which had a total thickness of 1.8 cm. No evidence of vascular or lymphatic invasion was observed. Surgical margins were negative for any abnormal cellular proliferation. Examination of adjacent tissues including the parametria showed no pathological findings. Lymph node assessment revealed no abnormal cells in a total of seventeen lymph nodes evaluated, including one node from the right external iliac region and five additional nodes from the same area. The remaining lymph nodes were also unremarkable. Histological evaluation of the vagina, uterus (endometrium and myometrium), ovaries, and fallopian tubes revealed no malignant features. Secretory phase endometrium was noted. Adhesions were identified near the fallopian tubes and adjacent to the ovaries. Hydrosalpinx was present in one fallopian tube. No dysplastic or malignant changes were detected in any of the specimens assessed."} +{"pid": "TCGA-KL-8338", "report": "A 12.5 cm cortical mass was identified in the mid-portion of the left kidney, measuring 15.0 x 11.0 x 7.0 cm overall. The mass exhibited tan, hemorrhagic, and necrotic features on sectioning and extended into the perinephric fat, with involvement of the renal sinus fat and surrounding vessels. The tumor did not invade the renal pelvis or involve the renal vein. Surgical margins were free of involvement. The remaining kidney showed a well-defined corticomedullary junction with normal calyces and no lymph nodes were identified within the specimen. A total of five left periaortic lymph nodes were examined, all without evidence of metastasis. One left hilar lymph node was also evaluated and found to be negative for malignancy. Ectopic adrenal tissue was present but unremarkable. The attached ureter and renal vessels were grossly unremarkable. Multiple sections were taken from the tumor, adjacent kidney, and surrounding tissues for histological evaluation."} +{"pid": "TCGA-HI-7168", "report": "The specimen was obtained from a male patient and consisted of multiple tissue samples. The right pelvic lymph nodes included several tan to yellow, rubbery lymph nodes measuring between 0.4 and 2.5 cm. One larger lymph node was bisected, and all tissues were submitted for analysis. No tumor involvement was identified in the three lymph nodes evaluated.\n\nThe left pelvic lymph nodes were described as soft to firm with a predominantly fatty appearance, measuring from 0.6 to 3.8 cm. Multiple lymph nodes were present, with the larger one showing a fatty cut surface. All lymph nodes were submitted for examination, and no tumor was found among the six lymph nodes assessed.\n\nA sample of periprostatic fat consisted of two fragments of lobulated fatty tissue measuring 1.6 x 1.5 x 0.7 cm. No abnormal lesions or masses were observed, and no tumor involvement was detected.\n\nThe prostate and seminal vesicles specimen weighed 46 grams and measured 4.3 x 4.1 x 4.2 cm. The gland exhibited a yellowish-tan homogeneous cut surface with visible prostatic concretions. A distinct white firm area was noted in the left superior-posterior region of the prostate, measuring 2.5 x 2.5 x 2.0 cm, which extended into the left seminal vesicle approximately 7.0 cm. Tissue sections were taken from various regions of the prostate and seminal vesicles. Histological evaluation revealed multifocal cellular changes involving both sides of the gland, comprising about 20% of the sampled tissue. Cellular features indicated significant nuclear atypia and architectural distortion. Extension beyond the prostatic capsule was observed on the left side, with involvement of adjacent soft tissue and invasion into the left seminal vesicle. Surgical margins, marked with ink, showed no evidence of tumor involvement.\n\nA fragment of fat from the bladder neck margin, measuring 0.7 x 0.6 x 0.6 cm, was also examined, and no tumor presence was identified."} +{"pid": "TCGA-W8-A86G", "report": "The pathology report includes multiple specimens from right and left breast lumpectomies and lymph node sampling. The right breast lumpectomy showed a lesion measuring 2 mm in greatest dimension, located less than 1 mm from the medial margin. Surrounding tissue demonstrated benign changes including intraductal papilloma with florid ductal hyperplasia and fibrocystic change.\n\nThree sentinel lymph nodes from the left breast were examined and found to be free of malignant cells.\n\nIn the left breast subareolar lumpectomy, multifocal disease was identified with the largest focus measuring 1.2 mm. This focus was located less than 1 mm from the medial margin and 1 mm from the posterior margin. Additional findings included intraductal papilloma with florid ductal hyperplasia and fibrocystic change.\n\nMultiple additional lumpectomy specimens from the left breast were submitted with margins separately designated as anterior, superior, medial, inferior, lateral, and posterior. These specimens contained multifocal disease with the largest focus measuring at least 2.3 cm. Final margins were negative, with the closest distance being 3 mm from the inferior margin and 9 mm from the anterior margin. Histologic evaluation revealed multiple foci ranging from less than 0.5 mm to at least 2.3 cm. Benign findings included intraductal papillomas, florid ductal hyperplasia, fibrocystic change, and focal fibroadenomatoid change. No lymphovascular invasion was identified.\n\nImmunohistochemical studies on sampled areas showed hormone receptor positivity with strong estrogen and progesterone receptor expression and absence of HER-2 staining. Cold ischemia times varied between specimens, ranging from 11 to 35 minutes. Fixation times ranged from 9 hours to over 10 hours.\n\nMicroscopic examination confirmed the presence of disease in several submitted margins prior to final excision, with resolution of these involved margins in subsequent specimens. No atypical ductal lesions were identified in the final specimens."} +{"pid": "TCGA-06-0214", "report": "The specimen from a male patient consists of a 4.5 x 3.0 x 2.0 cm fragment of gray-tan brain tissue with an ill-defined, approximately 2.0 cm gray-tan gritty area located predominantly in the white matter. The lesion contains focal areas of hemorrhage and scattered petechiae at the gray-white junction. Histologically, the tissue shows extensive infiltration by a glial neoplasm characterized by nuclear anaplasia, frequent mitotic figures, and serpiginous areas of necrosis with pseudopalisading. A central region is observed with thickened, hyalinized blood vessel walls and endothelial hyperplasia. Microvascular proliferation is present throughout the tumor and in surrounding brain tissue. Immunostaining for MIB-1 demonstrated a labeling index of 22%. Four vials of tissue were collected and stored in formalin. No clinical history or pre-operative diagnosis was provided."} +{"pid": "TCGA-MT-A51X", "report": "The specimen consists of a right hemiglossectomy measuring 5.0 x 3.5 x 2.7 cm with intact margins. A nodular bulge is identified in the right anterolateral aspect measuring 2.0 cm in greatest dimension. Microscopic examination reveals a white-tan lobulated mass measuring 2.0 x 1.8 x 1.8 cm, abutting the mucosal surface and extending to within 0.3 cm of the medial margin. The tumor thickness measures 18 mm. Histologic evaluation shows conventional squamous cell morphology with well-differentiated features. No evidence of perineural or lymphovascular invasion is observed. All surgical margins are uninvolved by invasive or in situ carcinoma; however, the tumor is found to be less than 0.1 cm from both the lateral and medial margins, and 0.2 cm from the anterior margin.\n\nA total of 35 lymph nodes are examined across multiple levels. In one of two lymph nodes from level 2, a metastatic focus measuring 6 mm is identified. Similarly, in one of two lymph nodes from right zone 2A, a metastatic focus measuring 8 mm is present. No extranodal extension is noted in these cases. All other lymph nodes, including those from the left JD, right level 1B, level 1A and left level 1B, right superficial, level 3, zone 3, and PET positive left zone 3, show no evidence of malignancy. The salivary gland tissue obtained from level 1A and left level 1B shows lobulated tan parenchyma with focally intense hyperemia but no discrete nodules or necrosis.\n\nMultiple biopsies from various regions including the anterior midline, left lateral, medial mucosa, posterior deep margin, posterior mucosa, and right gingival margin are all negative for dysplasia or malignancy. Fibrofatty tissue specimens from right zone 3, right zone 2, and others do not reveal any discrete lymph nodes or signs of malignancy. The pathological staging indicates a primary tumor (pT) as pT1, defined as a tumor 2 cm or less in greatest dimension. For regional lymph nodes (pN), the staging is pN2b, indicating metastasis in multiple ipsilateral lymph nodes, none more than 6 cm in greatest dimension. Distant metastasis is clinically absent (MO). Additional findings include focal moderate to severe dysplasia adjacent to the invasive lesion, although this is not present at the resection margins."} +{"pid": "TCGA-EY-A1G7", "report": "The specimen consists of a uterus and cervix submitted following robotic-assisted hysterectomy, along with bilateral salpingo-oophorectomy specimens. The uterus weighs 140 grams, is vaguely pear-shaped, measuring 11.7 cm in height, 3.0 cm in anterior-posterior width, and 5.0 cm at the fundal breadth. A full-thickness defect is noted in the anterior lower uterine segment/endocervical canal region, with the involved tissue inked yellow.\n\nMicroscopic examination reveals an infiltrative process predominantly located in the high endocervical canal, extending into the lower uterine segment. The posterior wall of the lower uterine segment demonstrates invasion to a depth of 0.5 cm within a wall thickness of 1.8 cm (approximately 27% involvement). No invasion of the myometrium is identified grossly or microscopically. The greatest depth of invasion measures 1.1 cm at the anterior endocervix, approaching within less than 0.5 mm of the paracervical soft tissue margin, representing approximately 96% wall penetration. Invasive component approaches within 0.2 cm of the anterior ectocervical mucosal margin. No serosal involvement or adnexal involvement is identified.\n\nHistologic evaluation shows moderately differentiated tumor with a FIGO grade 2 classification based on both architectural and nuclear features. A squamous morular growth pattern is present. Lymphovascular space invasion is identified. Immunohistochemical analysis demonstrates absence of estrogen and progesterone receptor expression. p16 staining is positive; however, its significance in this context remains uncertain.\n\nStaging classification indicates no regional lymph nodes identified for assessment, resulting in an AJCC pathologic stage of pT2b pNx pMx and FIGO Stage IIB. These classifications are provisional and subject to revision pending further clinical correlation.\n\nAll bilateral fallopian tubes and ovaries show no significant pathological abnormalities and are negative for malignant involvement. No lymph nodes are identified in the specimen.\n\nA representative sampling of tissues has been provided for further analysis. The findings suggest that while the upper corpus may have shown response to prior therapy, residual disease is present in the lower uterine segment and endocervical canal. Alternatively, the location and pattern of involvement may raise consideration of a primary endocervical origin. Clinical correlation is recommended."} +{"pid": "TCGA-B0-5703", "report": "A laparoscopic left nephrectomy was performed. The neoplasm measured 5.5 cm in greatest diameter and was located in the lower pole of the left kidney. Microscopic examination showed a unifocal lesion with clear cell morphology. The nuclear grade was Fuhrman 3. The tumor was confined within the renal capsule without extension into the renal vein, angiolymphatic invasion, or involvement of surgical margins. No regional lymph nodes were examined. The non-neoplastic kidney appeared normal. Adrenal tissue was not present in the specimen. Vascular invasion, both venous and lymphatic, was absent."} +{"pid": "TCGA-HC-8216", "report": "The prostate specimen weighed 54 grams and measured 5.6 x 4.0 x 3.0 cm. Histologic examination revealed a lesion involving approximately 10% of the gland volume. Histologic patterns showed a primary growth pattern scoring 4/5, a secondary pattern scoring 3/5, and a tertiary pattern scoring 5/5. Extension beyond the prostatic capsule was identified focally in the right posterior base region. There was no involvement identified in the seminal vesicles. Invasion of lymphovascular spaces was present. High-grade intraepithelial neoplasia was also observed. No treatment-related changes were seen. Surgical margins were free of involvement. Three lymph nodes were examined and none contained metastatic disease. The lymph nodes were benign and hyperplastic. Staging was assessed as pT3a with no nodal involvement. No other significant findings were noted in the specimen."} +{"pid": "TCGA-A3-3320", "report": "The specimen consists of a right kidney with attached perinephric fat, measuring 15 x 8 x 6 cm and weighing 373 grams. The ureter and vascular margins are included in block 1. Upon bivalving the kidney, an oval mass is identified at the lower pole. The mass measures 5.0 x 5.0 x 4.0 cm and is golden-yellow in color. It is focally adherent to the surrounding capsule but does not grossly extend beyond it. Sections of the overlying capsule are submitted in block 2, while sections of the mass are included in blocks 3 through 8. No dilation of the renal pelvis or calyces is observed, and the cortical thickness averages 0.6 cm. A random section of non-involved kidney tissue is submitted in block 9. Examination of the attached fat reveals no identifiable adrenal tissue or lymph nodes. Microscopic evaluation confirms the presence of cells with clear cytoplasm and nuclear features consistent with low-grade morphology. No evidence of vascular invasion or capsule penetration is identified. The ureter segment is present. Based on histopathological findings, staging is determined as pT1b with no regional lymph node or distant metastasis identified."} +{"pid": "TCGA-VQ-A8PO", "report": "The specimen consists of a gastric (antral) resection following gastrectomy. Histological examination reveals a mucosecretory mucocellular pattern with the presence of \"signet ring\" cells. The lesion is classified as histologically grade III, indicating poor differentiation, and corresponds to the diffuse type according to Lauren\u2019s classification. The tumor measures 5.0 cm along its longest axis and is associated with ulceration. It demonstrates expansive growth and involves the serosa. A moderate inflammatory reaction is noted. There is no evidence of tumor implantation within perivisceral adipose tissue. Both proximal and distal surgical margins are free of neoplastic involvement. No neural infiltration or lymphatic, vascular, or blood vessel invasion is identified.\n\nEvaluation of lymph node regions shows no neoplastic involvement: lesser curvature (0/8), greater curvature (0/6), anterior hepatic artery (0/4), posterior hepatic artery (0/2), splenic artery (0/3), and celiac trunk (0/3). Additionally, the lesser omentum shows no signs of neoplastic involvement."} +{"pid": "TCGA-W2-A7HB", "report": "The specimen consists of a right cortical sparing adrenal gland weighing 5.54 grams and measuring 3.7 x 3.0 x 1.5 cm. It is markedly disrupted with cautery artifact on the outer surface. A separate fragment measuring 3.0 x 0.8 x 0.4 cm is present. The main specimen reveals a soft white nodule measuring 1.0 x 1.0 x 1.0 cm adjacent to both the blue-inked cut surface and black-inked outer surface. Another firm white nodule measuring 0.4 x 0.4 x 0.3 cm is located 1.0 cm from the first nodule, near the black-inked margin and 2.2 cm from the blue-inked cut surface. The surrounding adrenal tissue contains a thin 0.1 cm rim of yellow cortex and pink-tan medulla.\n\nHistologic examination shows that the medulla is entirely replaced by neoplastic cells forming two distinct nodules measuring 1.0 cm and 0.4 cm. These cells display atypical architectural features including large nests and focal spindling. Cellular pleomorphism is noted focally. There is no evidence of capsular or vascular invasion, necrosis, hyperchromasia, prominent nucleoli, or increased mitotic activity. Neoplastic cells are also identified focally at the cauterized resection margin, which may be anticipated in this type of resection. No definitive margins are involved beyond what might be expected due to surgical technique.\n\nAll tissue has been submitted for evaluation. Cassettes include sections from both nodules, intervening adrenal tissue, margins, and additional fragments. Fresh tissue was preserved for banking."} +{"pid": "TCGA-ZH-A8Y3", "report": "The liver biopsy from the posterior segment showed abnormal cellular changes consistent with invasive adenocarcinoma. A right hepatectomy specimen contained a white, firm mass measuring 5.3 x 5.0 x 3.8 cm grossly, with extension to surrounding ducts and a yellow discoloration bringing the total size to 6.2 x 5.5 x 4.1 cm. The tumor was located in the right hepatic lobe and showed unifocal growth. Histologically, the tumor was well to moderately differentiated and exhibited a mass-forming growth pattern. Vascular invasion was present, involving branches of the portal vein and extending into the vena cava. Invasion of the liver capsule was identified, though the tumor did not penetrate completely through it. No significant necrosis was observed; the tumor remained approximately 90% viable with a prominent desmoplastic stromal reaction.\n\nResection margins were positive at the parenchymal edge, while vascular margins were negative. The bile duct margin showed reactive epithelial changes but no evidence of invasive disease. One pericystic lymph node was negative for metastasis. Perineural invasion was identified in the caval margin specimen. Immunohistochemical staining showed positivity for cytokeratin 7, with no expression of cytokeratin 20, CDX2, estrogen receptor, GCDFP-15, or TTF-1.\n\nThe background liver showed cholestasis and moderate periportal inflammation with mild portal fibrous expansion, but no cirrhosis. Some fibrosis was noted around larger bile ducts near the tumor, though it did not show the classic features of primary sclerosing cholangitis. The gallbladder was unremarkable and free of malignancy.\n\nIntraoperative frozen sections were performed on biopsies from both anterior and posterior segments, confirming the presence of malignancy only in the posterior segment. The case was presented for multidisciplinary discussion, and correlation with clinical and radiographic findings was recommended."} +{"pid": "TCGA-KN-8431", "report": "The radical nephrectomy specimen measured 18.0 x 9.2 x 5.3 cm and included the ureter, renal vein, and renal artery. A well-circumscribed tan mass measuring 9.0 x 8.3 x 6.2 cm was identified in the upper pole of the kidney. The tumor was located 8.5 cm from the ureter margin, 1.1 cm from the vein margin, and 3.2 cm from the artery margin. It abutted the kidney capsule. Cut sections revealed areas of necrosis and hemorrhage within the mass. Scant perinephric adipose tissue was present, and the specimen was inked black and bivalved. No adrenal gland was identified.\n\nHistologic evaluation showed that the tumor was confined to the kidney with negative margins at the renal artery, vein, and ureter. There was no lymphovascular invasion. Microscopic examination of the tumor showed nuclear features corresponding to grade 2 of 4. Immunohistochemical staining demonstrated negativity for S-100-A1 and positivity with a Halo\u2019s colloidal iron stain. These findings were supportive of the observed histologic pattern.\n\nA separate specimen labeled as regional retroperitoneal lymph nodes consisted of one fragment of yellow soft tissue measuring 2.0 x 2.4 x 1.0 cm. This tissue was entirely submitted for histologic evaluation and found to contain no tumor. No lymphoid tissue was identified.\n\nSections of uninvolved renal cortex showed minimal chronic changes, including focal global glomerulosclerosis affecting 0.3% of glomeruli, minimal tubular atrophy, and interstitial fibrosis involving less than 5% of the parenchyma. No significant vascular sclerosis was observed. Staining with H&E, PAS, Jones silver methenamine, and AFOG showed no notable abnormalities in the glomerular basement membranes or mesangial areas. Rare PAS-positive hyaline casts were seen in distal tubules.\n\nCytogenetic analysis was attempted but unsuccessful due to sample contamination. No fluorescence in situ hybridization (FISH) testing was performed."} +{"pid": "TCGA-Q1-A6DT", "report": "RUN DATE: LABORATORY. PAGE: 1. RUN TIME: Specimen Inquiry. SPEC # : Obtained: CLINICAL HISTORY : CERVICAL CANCER. SPECIMEN/PROCEDURE : 1. CERVICAL BIOPSY. IMPRESSION. CERVICAL BIOPSY: A malignant neoplasm composed of large cells with a nonkeratinizing morphology is identified, showing evidence of invasion into the stroma. Entered: GROSS DESCRIPTION : Received without fixative labeled \"cervical biopsy\" and with the patient's name, is one irregular pink-tan to pale tan glistening portion of tissue measuring 1.8 x 1.4 x 0.8 cm. The specimen was serially sectioned and entirely submitted in one cassette. Distated by: Entered: COPIES TO: CPT Codes : CERVICAL BIOPSY/88305. ICD9 Codes : 180.9. Resident Physician: I have personally reviewed the material (specimen/slide) and approve this final report."} +{"pid": "TCGA-DX-A7ET", "report": "A left lower abdominal wall mass was excised and submitted for pathological evaluation. The specimen consisted of an ellipse of skin with underlying tissue, measuring 17.5 x 10.6 x 5.8 cm overall. The skin ellipse measured 15 x 7.7 cm. The tumor itself measured 6.4 cm in greatest dimension and was located within the soft tissue of the abdominal wall. On gross examination, the mass had a yellow-tan, homogeneous cut surface with a small cystic area containing hemorrhagic fluid. Minimal hemorrhage and necrosis were observed in the solid portion of the lesion.\n\nMicroscopic evaluation revealed a spindle cell neoplasm with marked cytologic atypia and nuclear pleomorphism. Tumor cells exhibited moderate eosinophilic cytoplasm and frequent bizarre cells with vesicular nuclei and prominent nucleoli. Mitotic activity was high, with more than 10 mitotic figures per 10 high-power fields. Atypical mitotic figures were also identified. Necrosis was present, involving approximately 10% of the tumor volume.\n\nThe surgical resection margins were assessed and found to be uninvolved. The closest margin was the inferior margin, with a clearance of 0.2 cm. Distances from the tumor to other margins were as follows: lateral margin \u2013 3.2 cm, medial margin \u2013 6.5 cm, superior margin \u2013 1.8 cm, and deep margin \u2013 0.4 cm. Sections from all margins and surrounding tissue were included for analysis.\n\nAll morphological features were evaluated, including orientation and ink markings of the specimen, and were consistent with a high-grade undifferentiated sarcoma."} +{"pid": "TCGA-BR-8485", "report": "The excised gastric tissue involved a tumor located in the fundus measuring 9.5 x 6 x 1.5 cm. The lesion exhibited an ulcerated appearance. Microscopic evaluation revealed poorly differentiated cellular features. The tumor extended to involve adjacent structures, specifically the esophagus and lesser omentum. Lymph node assessment identified 7 out of 13 intraabdominal nodes as positive for involvement. No definitive information was provided regarding lymphatic, venous, or perineural invasion. Surgical margins were free of involvement. There was no indication of prior neo-adjuvant therapy; however, some additional findings remained unconfirmed or unspecified."} +{"pid": "TCGA-27-2518", "report": "Birth date. Tumor site: left frontal. The tumor measured approximately 5.2 cm in greatest dimension. Histological evaluation revealed a highly cellular neoplasm composed of pleomorphic astrocytic cells with marked nuclear atypia and frequent mitotic figures. Extensive necrosis and microvascular proliferation were present. Immunohistochemical staining demonstrated positivity for GFAP and MGMT. Based on histological features and extent of resection, the tumor was classified as high-grade with supratentorial localization. Staging indicated no evidence of metastatic spread at the time of presentation."} +{"pid": "TCGA-VD-A8KA", "report": "The specimen consists of a local resection measuring 15 x 17 x 10mm with a scleral rim up to 2mm. Histological examination shows a pigmented lesion involving the choroid with adjacent normal choroid and sclera. The cellular composition includes a mixture of spindle and epithelioid cells, with epithelioid cells making up approximately 30% of the cell population. Mitotic activity is moderately high, with approximately 12 mitoses per 40 high power fields. Immunohistochemical staining demonstrates reactivity for MelanA, CD10, and HSP-27 (score 2). The microvasculature is prominent, with focal presence of closed loops and occasional \"vascular seas.\" There is minimal lymphocytic infiltrate within the lesion and no evidence of extension into the sclera. The lateral resection margins are clear.\n\nMolecular genetic analysis was performed on DNA extracted from fresh tissue using multiplex ligation-dependent probe amplification (MLPA) with the P027 kit, which evaluates gains or losses in 31 loci on chromosomes 1, 3, 6, and 8. The DNA concentration was high and of good quality. The MLPA reaction was repeated on separate occasions yielding consistent results. Sequence analysis revealed loss of chromosome 1, essentially normal chromosome 3 with borderline loss of two loci (VHL and CPO), gain in chromosome 6p, and gain in chromosome 8. These molecular findings are to be correlated with clinical and morphological features for metastatic risk assessment."} +{"pid": "TCGA-F4-6808", "report": "The submitted specimen consists of an excised tissue fragment from the large intestine. The tumor was located in the sigmoid colon and measured 3.5 x 3 x 3 cm. Microscopic evaluation revealed a moderately differentiated cellular arrangement, with tumor extension reaching the submucosal layer. A total of three regional lymph nodes were examined, none of which showed evidence of involvement. No other notable features or treatment effects were identified."} +{"pid": "TCGA-AA-A00W", "report": "The specimen includes a subcapsular portion of the liver parenchyma showing features of a benign biliary lesion with moderate fatty infiltration of the surrounding tissue. Additionally, a resected segment of the sigmoid colon contains a mucosal lesion measuring 1.8 cm at its greatest diameter. The lesion is located at least 4.5 cm from the nearest resection margin and demonstrates a transition from severe epithelial dysplasia to a moderately differentiated adenocarcinoma of colorectal type. The neoplastic component extends fully circumferentially and reaches into deeper layers of the submucosa. Both oral and aboral margins are free of neoplastic involvement. A total of seventeen regional lymph nodes show no evidence of tumor involvement and exhibit only reactive changes. Vascular and lymphatic invasion are not identified. The histologic grade is intermediate (G2), and there is no residual tumor at the resection margins (R0). Staging is pT1 pN0 (0/17) L0 V0."} +{"pid": "TCGA-AN-A0FL", "report": "Female patient with tumor located in the left breast, primary site. Tumor specimen was obtained via surgery and preserved in OCT medium within a block container. Histological analysis revealed a Grade 2 lesion with infiltrative growth pattern. Staging showed no lymph node involvement (N0) and no distant metastasis (M0). No prior treatment was administered. A separate blood sample was collected and stored frozen in a tube container as a normal reference sample."} +{"pid": "TCGA-UC-A7PD", "report": "A 3.0 cm piece of pink-tan, rubbery soft tissue was received and submitted for analysis. Three flat fragments of yellow-tan fibroadipose tissue ranging from 0.5 cm to 1.5 cm were also received, with no lymph nodes identified on palpation. A small white firm tissue measuring 0.8 x 0.5 x 0.2 cm was submitted in entirety. The left ovary measured 3.5 x 2.0 x 1.5 cm and contained a 1.3 x 0.7 x 0.8 cm partially excised corpus luteum with multiple microcysts; it was attached to a 5.0 cm long fallopian tube. Two cross sections of the fallopian tube and two sections of the ovary were submitted.\n\nA 3.5 x 2.0 x 1.5 cm pink-tan lymph node with a red cut surface and areas of nodularity was received, along with three additional pieces of fibroadipose tissue containing lymph nodes measuring between 1.2 and 1.7 cm. Other specimens included three yellow-tan fibroadipose tissues ranging from 1.2 to 2.6 cm, four fragments ranging from 1.0 to 2.2 cm, a 2.5 x 1.0 x 0.7 cm firm tissue, and a 1.1 x 0.4 x 0.3 cm tan firm tissue. Three strips of fibroadipose tissue up to 3.7 cm in size were also received, with multiple lymph nodes identified.\n\nThe uterus, weighing 619 grams and measuring 16.0 x 6.0 x 10.0 cm, contained a gestational sac measuring 10.0 x 9.0 x 3.5 cm with approximately 50 CC of amniotic fluid. A well-developed fetus weighed 46.5 grams and measured 13.2 cm in crown-heel length, with a foot length of 1.3 cm. The placental disc measured 8.5 x 7.0 x 1.5 cm and was implanted on the anterior endometrium. The umbilical cord was 17.0 cm long, and the gestational endometrium measured approximately 0.8 cm in thickness.\n\nAn ulcerated lesion measuring 4.2 x 5.0 cm was identified on the cervix and lower uterine segment, involving the entire anterior endocervix and lower uterine segment and most of the posterior regions. Tumor extension was noted through more than 90% of the cervical stroma, reaching within less than 1 mm of surgical margins. Perineural and possible vascular space invasion was observed at the parametrial interface, though parametrial tissue was otherwise unremarkable. Vaginal mucosal margins were free of tumor involvement.\n\nSections of the vaginal cuff, parametrial tissue, cervical tumor, placental implantation site, umbilical cord, placental membrane, and gestational endometrium were all submitted for analysis. Intraoperative consultations found no evidence of metastatic disease. Lymph node specimens revealed benign reactive changes. The ovary showed physiologic cysts and a gestational corpus luteum, with no signs of malignancy. The fallopian tube was unremarkable. Fetal development was appropriate for gestational age, with normal placental findings and endometrial changes consistent with pregnancy."} +{"pid": "TCGA-B2-5636", "report": "The specimen consists of a right kidney and surrounding fat, measuring 25 x 13 x 7 cm. Additional yellow soft tissue measures 11.5 x 11 x 3 cm in aggregate. On sectioning, a red, well-circumscribed mass is identified in the central portion of the kidney at the junction of the renal parenchyma and sinus, measuring 3 cm in greatest cross-sectional dimension. Sections are taken after fixation. Microscopic evaluation shows a tumor composed of clear cells with nuclear features corresponding to grade 2 (Fuhrman grading). The tumor measures 3 cm. Evaluation of margins, renal capsule, and renal sinus reveals no evidence of malignancy. There is no vascular invasion identified. The remainder of the kidney demonstrates occasional sclerotic glomeruli and patchy mild chronic inflammation. Staging is based on tumor size and extent, with findings consistent with pTNM Stage T1a."} +{"pid": "TCGA-D5-6529", "report": "Histopathological examination was performed on a resected segment of the large intestine along with associated mesentery. The specimen measured 16 x 6 x 3 cm and included a 7 cm segment of small intestine and a 6.7 cm appendix. A lesion was identified in the mucosa, measuring 4.7 x 4 x 1.2 cm. It was located 7.0 cm from the proximal cut end, 12.0 cm from the distal cut end, and near the Baughin valve. The closest surgical margin measured 5.0 cm from the lesion.\n\nMicroscopic evaluation revealed tubuloapapillary architecture with cellular atypia. There was infiltration into the muscularis propria and extension into the pericolic adipose tissue. Surgical margins were clear. Reactive lymphadenopathy was noted in the regional lymph nodes. No neoplastic involvement was observed at the incision sites. The lesion demonstrated histopathological features consistent with low-grade dysplasia and localized invasion without lymph node metastasis. Staging assessment indicated pT3 classification based on depth of invasion, with no lymph node involvement (pN0)."} +{"pid": "TCGA-E2-A155", "report": "The surgical specimen consists of a left breast mastectomy with axillary lymph node dissection, along with additional left axillary contents. The breast specimen weighs 1794 grams and measures 31 x 22 x 4.5 cm with a 27 x 16 cm skin ellipse. A total of four distinct lesions were identified within the breast tissue. Lesion #1 is a 2.5 x 2.5 x 1.7 cm firm tan stellate mass located at the 12 o\u2019clock position, 4.2 cm from the deep margin and 2 cm from the anterior margin. Lesion #2 measures 1.3 x 1.1 x 1 cm and is located 0.3 cm medial to lesion #1. Lesion #3 is 2.5 x 2.2 x 1.5 cm in size and found 0.4 cm medial to lesion #2. Lesion #4 measures 1 x 1 x 0.6 cm and is located 2.5 cm posterior to lesion #3. Adjacent to the deep margin in slice 7, a 0.9 x 0.6 x 0.4 cm firm tan lymph node was noted. Within the axillary tail, multiple lymph nodes ranging from 0.3 to 3.5 cm were present, with the largest being nodular.\n\nMicroscopic evaluation revealed three invasive foci and one non-invasive focus. The invasive areas are characterized by high-grade nuclear features and micropapillary morphology. The largest confluent invasive area measures 2.5 cm. Non-invasive components include solid and cribriform patterns with central necrosis and microcalcifications. Lobular extension and scattered foci of non-invasive disease are also observed. Margins of resection are free of involvement. Two intramammary lymph nodes were identified, with one measuring 0.8 cm containing metastatic involvement and focal extranodal extension. Of twelve axillary lymph nodes examined, one measured 3.5 cm and showed metastatic involvement with extranodal extension. In the additional left axillary contents, one lymph node was identified and found to be uninvolved.\n\nHistologic grading demonstrates a modified Scarff Bloom Richardson grade 3 tumor with a tubular score of 3, nuclear grade 2, and mitotic score 3. No vascular or lymphatic invasion was definitively identified. Immunohistochemical staining shows ER positivity, PR negativity, and HER2 negativity by IHC. Pathologic staging is pT2 pN1c."} +{"pid": "TCGA-A8-A07J", "report": "The specimen includes a breast segment containing two distinct foci of invasive carcinoma. The larger focus measures 3.0 cm in diameter, while the smaller focus measures 0.8 cm. Both demonstrate moderate nuclear grade (G II). A focal intraductal component is present. Histologic evaluation indicates lymphovascular invasion and negative resection margins. Lymph node examination reveals one involved node out of eighteen examined."} +{"pid": "TCGA-37-3792", "report": "The clinical specimen was obtained from a lung tissue source. The tissue was collected and stored in an OCT block, while a blood sample was also drawn and preserved in a frozen tube. Histological evaluation revealed the presence of abnormal cells with features consistent with a malignant process. The cellular morphology showed characteristics of high-grade transformation, with significant nuclear atypia and altered tissue architecture.\n\nStaging assessment indicated a primary tumor with a size measurement of 2 cm. No regional lymph node involvement or distant metastases were identified. The tumor did not demonstrate any response to prior therapeutic interventions, as no treatment had been administered prior to procurement. The tissue sample was processed for further diagnostic and research purposes."} +{"pid": "TCGA-G3-A7M7", "report": "The liver specimen measured 8.5 x 8.5 x 4.5 cm and weighed 128.4 g in the fixed state. A yellow, firm nodule measuring 3.7 x 3.5 x 3.1 cm was identified adjacent to the resection margin. The tumor was located 0.4 cm from the closest capsule. Histologically, the lesion was well differentiated. The tumor was confined to the liver without evidence of vascular invasion. The parenchymal margin was uninvolved by invasive carcinoma, with a minimum distance of 0.1 cm between the invasive component and the closest margin. The bile duct and other margins could not be assessed. The surrounding liver tissue showed chronic hepatitis with severe steatosis (60%), consistent with alcoholic hepatitis, and fibrosis was at stage III. No lymph nodes were identified in the gallbladder specimen, and no significant findings were noted in the gallbladder itself. Multiple sections were submitted for microscopic evaluation, including the tumor, adjacent margins, and liver parenchyma."} +{"pid": "TCGA-D1-A0ZV", "report": "A hysterectomy specimen includes a mass measuring 4.0 \u00d7 2.8 \u00d7 1.6 cm located in the fundus, involving both the anterior and posterior uterine walls. Microscopic evaluation shows that the lesion extends 0.4 cm into the myometrium, with a total myometrial thickness of 1.4 cm. The lower uterine segment is not involved. There is focal superficial involvement of the endocervical mucosa without extension into the cervical stroma. No lymphovascular space invasion is observed. Surgical margins are free of any abnormal cellular infiltration. A single subserosal leiomyoma measuring 1.3 cm is also present.\n\nBilateral salpingo-oophorectomy specimens show no abnormal findings in either ovary or fallopian tube. Both ovaries have smooth external surfaces and unremarkable solid cut surfaces. The attached fallopian tubes appear normal.\n\nLymph node dissections from both left and right pelvic regions include a total of 23 lymph nodes (12 from the left, 11 from the right). All nodes show no evidence of abnormal cellular infiltration.\n\nThe gross examination confirms the presence of a soft red-tan mass in the endocervical canal measuring 0.8 \u00d7 0.8 \u00d7 0.5 cm, along with a hemorrhagic focus at the os. The uterine serosa appears smooth. Permanent histologic sections confirm the initial findings based on frozen section evaluation. Any significant changes identified upon further review will be reported separately."} +{"pid": "TCGA-DD-A1EL", "report": "The resected liver tissue from segment III contains a single mass measuring 0.8 x 0.7 x 0.7 cm, located 0.8 cm from the surgical margin. The specimen weighs 3.56 grams and measures 2.5 x 2.1 x 1.6 cm in total. Histologically, the mass shows high-grade cellular features. All surgical margins are free of abnormal cells, with a minimum distance of 0.8 cm from the tumor to the nearest margin. No vascular invasion is identified.\n\nIn addition, a second liver specimen from segments VII and VIII weighs 370 grams and measures 11.3 x 11.0 x 7.5 cm. It contains two distinct masses: one measuring 7.5 x 7.5 x 6.8 cm and another measuring 1.5 x 1.1 x 0.6 cm. Both are well-defined and located at least 1.1 cm from the closest resection margin. Histological evaluation reveals high-grade features similar to those in the segment III lesion. No vascular space involvement is observed.\n\nThe gallbladder specimen measures 7.2 x 3.0 x 1.5 cm with a wall thickness of 0.2 cm. Microscopic examination shows mild chronic inflammation. A single lymph node at the cystic duct appears reactive without evidence of abnormal cellular infiltration. No gallstones or cholesterolosis is present.\n\nAn addendum notes that the surrounding liver tissue outside the resected areas shows mild steatosis and mild portal lymphocytic infiltrates. Sections of the masses and uninvolved liver tissue have been submitted for detailed histological review."} +{"pid": "TCGA-55-7281", "report": "The pre-operative and post-operative findings were consistent. The clinical history provided no significant details. Gross examination included five specimens. The first, labeled as right chest level 7 lymph nodes, consisted of two nodular portions surrounded by adipose tissue, measuring 1.2 x 0.9 x 0.3 cm and 2.0 x 1.2 x 0.3 cm, respectively. The second specimen, from level 9 lymph node on the right chest, measured 1.2 x 1.0 x 0.3 cm and contained a 0.4 cm nodule within fibroadipose tissue. The third specimen, right chest level 10 lymph node, was a fragment measuring 1.4 x 1.0 x 0.4 cm with a rubbery and focally shaggy surface. The fourth specimen, including the upper and middle lobes of the right lung, weighed 166 grams and measured 19.6 x 11.0 x 2.5 cm. A sectioned bronchus was located 0.4 cm from the bifurcation of tertiary bronchi. The pleura showed moderate anthracotic streaking. On the medial aspect, a lesion measuring 2.2 x 2.0 x 1.8 cm was noted near the hilar margin and approximately 2.8 cm from the nearest bronchial margin. Staples obscured the actual margin, though the lesion appeared within 0.2 cm of the parenchymal margin. The lesion had a gritty, gray tan fibrotic appearance, extending into the middle lobe parenchyma. No additional lesions were observed. The final specimen, labeled as right chest level 4 lymph node, measured 2.0 x 1.5 x 0.4 cm and was composed of rubbery, shaggy gray-brown to black tissue fragments.\n\nMicroscopic analysis of all submitted sections revealed no evidence of metastatic carcinoma in any of the lymph nodes examined. Lymph node assessments at multiple levels showed reactive sinus histiocytosis and anthracosilicosis, with some also showing benign fibrous nodules. In the pulmonary specimen, the lesion demonstrated moderate to poorly differentiated cellular features with lymphovascular space invasion identified. Tumor proximity to the bronchial margin was 2.8 cm, while it was 0.2 cm from the parenchymal margin; no involvement was found at either margin. Additional findings in the lung tissue included emphysematous changes and subpleural fibrosis. Staging was determined based on these findings. All relevant tissues were fully sampled and submitted for evaluation. Clinical follow-up is recommended. The evaluation was completed and confirmed by an additional pathologist. The report was finalized at the Campus by M.D., Ph.D."} +{"pid": "TCGA-MP-A4TJ", "report": "The revised report includes a description of tissues from the right upper lobe of the lung, measuring 7.2 x 6.5 x 3.5 cm and weighing 95.0 grams, along with lymph nodes from station 4R (two sets), station 7, and station 12. A mass measuring 2.5 x 2.4 x 2.4 cm was identified in the right upper lobe, showing high-grade cellular features with signet ring cell morphology. This mass was found to involve the stapled margin focally, while the pleura remained uninvolved. Additionally, a calcified granuloma was noted in the tissue.\n\nA completion lobectomy specimen from the same area showed no residual abnormal cells, and the bronchial margin was free of malignant involvement. Examination of mediastinal lymph nodes, including six right lower paratracheal (station 4R) nodes, revealed no evidence of abnormal cells, though one node displayed necrotizing granulomatous inflammation. In station 7, a single subcarinal lymph node also showed necrotizing granulomatous inflammation but no malignant cells. Testing with special stains (AR and GMS) for organisms in these nodes yielded negative results.\n\nIn the hilar and intrapulmonary regions, three peribronchial lymph nodes were free of abnormal cells, with one exhibiting necrotizing granulomatous inflammation. A solitary station 12 lymph node was also clear of any malignant involvement."} +{"pid": "TCGA-VQ-A91D", "report": "The specimen includes a resected portion of the stomach along with a D2 lymphadenectomy and right extended colectomy. The lesion measured 5.0x4.5x4.0 cm and was ulcerated. Histologic evaluation showed moderately differentiated invasive carcinoma with features suggestive of deep tissue involvement. The tumor extended to the serosa and adjacent fat, with evidence of omental and colonic involvement. Invasion into blood vessels, lymphatic channels, and nerves was identified. The overlying mucosa demonstrated ulceration and inactive chronic gastritis was noted in adjacent areas. All surgical margins, including those from the stomach and colon, were free of tumor involvement.\n\nA total of 33 perigastric lymph nodes were examined, five of which contained metastatic tumor cells. These involved nodes exhibited capsular invasion, though there was no conglomerate formation. Additional lymph node groups assessed included perisplenic (1 node), transverse mesocolon (3 nodes), Chain 8 (anterior hepatic artery, 1 node), Chain 11 (proximal splenic artery, 3 nodes), and Chain 12 (hepatoduodenal ligament, 1 node). None of these other lymph node regions showed any evidence of tumor involvement."} +{"pid": "TCGA-AG-3600", "report": "The specimen includes peritoneal fatty tissue showing areas of necrosis, which appear to be non-recent. A resected rectosigmoid sample demonstrates a moderately differentiated adenocarcinoma of the colorectal type, with a maximum dimension of 6 cm. The lesion infiltrates into the surrounding pericolic fatty tissue. A total of 45 regional lymph nodes were examined, with 30 showing metastatic involvement. All colon resection margins are free of tumor. The closest distance from the tumor to the circumferential resection margin is 1 cm, and the mesenteric resection margin is also tumor-free. Additionally, there is evidence of metastasis in an inguinal lymph node. Histological grade is G2. Vascular invasion is not identified (V0), while lymphatic invasion is present (L1). Resection margins are assessed as tumor-free (RX)."} +{"pid": "TCGA-L5-A4OS", "report": "A female patient underwent surgical resection of a lesion located at the esophagogastric junction. The specimen included a segment of distal esophagus and proximal stomach measuring 6.5 cm in length. A gray-tan necrotic lesion measuring 4.2 x 3.3 x 1.3 cm was identified, centered 1.5 cm above the esophagogastric junction. The tumor was located 4.1 cm from the proximal resection margin and 2.2 cm from the gastric margin, with a maximum depth of invasion of 0.3 cm into the muscularis propria. The tumor appeared friable and largely necrotic. No vascular invasion or intestinal metaplasia was observed. Resection margins were free of involvement.\n\nA total of 13 lymph nodes were examined. Metastatic involvement was identified in one of nine lymph nodes from the main specimen. Two lymph nodes from the lesser curvature, one lymph node from the lesser curvature gastric region, and one celiac lymph node were all negative for neoplastic cells. Additional tissue samples from the cervical esophagogastric margin and other regions showed no evidence of malignancy.\n\nThe lesion measured 4.2 cm in greatest dimension and demonstrated invasive growth into the muscularis propria. Pathologic staging was determined as T2 N1, with no distant metastasis identified. No Barrett\u2019s mucosa was present."} +{"pid": "TCGA-PZ-A5RE", "report": "A pancreaticoduodenectomy specimen was received, including a loop of duodenum measuring 17 cm along the greater curve. The proximal margin showed a staple closure with a circumference of 4.5 cm. The distal duodenum had a staple closure and a circumference of 5 cm, decreasing to 4.5 cm at the ampulla. The common bile duct measured 5.5 cm in length, with a proximal circumference of 2 cm tapering to 0.8 cm at the ampulla. In the region of the ampulla, there was a discrete area of induration measuring 2 x 1.5 cm. A firm, yellow-tan mass was identified in the head of the pancreas, measuring 3 x 3 x 3 cm. The pancreatic resection margin measured 3.3 x 1.5 cm. The overall pancreas measured 6 cm from superior to inferior, 3.5 cm from right to left, and 4.5 cm anterior to posterior. Soft tissue inferior to the pancreas, marked with suture, showed induration contiguous with the tumor.\n\nHistologically, the lesion demonstrated transmural involvement of the duodenum and extended into the periampullary mucosa with ulceration. Invasion of peripancreatic soft tissue and the wall of a major vascular structure was noted, although no intraluminal tumor thrombus was present. Histologic type included a mixed pattern with focal mucinous features. The histologic grade was intermediate to high (grade 2\u20133 out of 4). The tumor was unifocal and located in the head of the pancreas. Three of twenty-two regional lymph nodes were involved. Lymphatic invasion and perineural invasion were both identified. The tumor was focally close (<1 mm) to an inked soft tissue margin near the previously identified vascular structure. All other margins, including pancreatic parenchymal, duodenal, and bile duct margins, were negative.\n\nThe TNM staging classification was pT3, pN1, pMX. Multiple sections were submitted for microscopic evaluation, including margins, lymph nodes, and areas of interest."} +{"pid": "TCGA-80-5608", "report": "The sample was collected from the right upper lobe of the lung following a resection procedure. The tissue specimen measured 2.50 cm in size and demonstrated histologic features consistent with a neoplastic process. Cellular morphology showed characteristics of epithelial origin with a moderate degree of differentiation. Pathologic staging indicated involvement classified as T2, NOS for the primary tumor category, with no evidence of distant metastasis (M0). No lymph node involvement was identified. The histologic grade was determined to be intermediate (Grade 3). Additional details regarding preparation and procedural notes were documented but did not alter the overall characterization of the lesion."} +{"pid": "TCGA-J8-A3YF", "report": "The surgical pathology report includes multiple specimens. The right neck contents consist of soft tissue with a necrotic-appearing mass measuring 2.7 cm in greatest dimension, with focal calcifications. A total of 18 lymph node candidates were identified within this specimen, measuring up to 0.9 cm. One lymph node from this group shows the presence of abnormal cellular infiltration.\n\nIn the right paratracheal lymph node specimen, four lymph nodes were identified, all measuring up to 0.7 cm, and all appear benign. A portion of parathyroid gland is also present.\n\nThe thyroid gland was submitted in two parts: the right lobe and isthmus, and the left lobe. The right lobe and isthmus specimen contains several nodules, including an indurated nodule in the isthmus measuring 0.6 cm. In the right lobe, there is a well-circumscribed nodule measuring 1.6 cm located in the inferior pole, a smaller nodule measuring 0.8 cm in the superior pole, and an additional adherent nodule measuring 0.7 cm. The left lobe contains a single well-circumscribed nodule measuring 1.5 cm. All surgical margins are uninvolved. Histologic evaluation reveals features of nodular hyperplasia and marked chronic lymphocytic thyroiditis. No evidence of extrathyroidal extension is observed.\n\nIn the central compartment lymph node specimen, three lymph nodes were identified, all measuring up to 0.5 cm, and all are benign. Additionally, five perithyroidal lymph nodes are examined and found to be benign.\n\nStaging information indicates the primary lesion measures 0.5 cm, confined to the thyroid gland, corresponding to a pT1 classification. Regional lymph node involvement includes one involved node out of 21 examined, consistent with a pN1b classification. Distant metastasis could not be assessed (pMX). Cellular features include variations in nuclear morphology, papillary architecture, and psammoma bodies in some areas. Stromal reactions and lymphocytic infiltration are noted around the involved lymph nodes."} +{"pid": "TCGA-HT-8104", "report": "The pathology report demonstrates a markedly hypercellular glial neoplasm composed of cells resembling moderately atypical fibrillary astrocytes. Scattered mitotic figures are present, with a total of 11 mitoses identified across 10 high power fields. No microvascular proliferation or necrosis is observed. There is no evidence of definite oligodendroglioma differentiation."} +{"pid": "TCGA-AP-A053", "report": "The submitted specimens include the right and left fallopian tubes and ovaries, uterus, cervix, and multiple lymph node groups from both sides, including external iliac, obturator, hypogastric, common iliac, and para-aortic regions.\n\nExamination of the right ovary and fallopian tube revealed a benign serous cystadenoma. The fallopian tube showed no significant abnormalities. The uterus displayed changes including cystic atrophy of the endometrium and presence of leiomyomas in the myometrium. A focus of increased cellularity was identified in the endometrium, showing glandular architecture with more than 50% solid growth pattern and high nuclear grade. The deepest invasion into the myometrium measured 4 mm, within a myometrial thickness of 16 mm at that site. No cervical involvement or vascular invasion was observed. The left fallopian tube and ovary, as well as a portion of the right fallopian tube, showed no abnormal cellular changes.\n\nAll examined lymph nodes were histologically benign, with no evidence of tumor involvement. This included a total of two lymph nodes from the right external iliac area, one from the right obturator, one from the right hypogastric, one from the left common iliac, four from the left external iliac, one from the left obturator, two from the left hypogastric, one from the left para-aortic, and two from the right para-aortic regions."} +{"pid": "TCGA-86-8076", "report": "The lung tissue specimen was obtained from the right upper lobe and submitted as a lobectomy. The tumor measured 2.5 x 2.5 x 2.5 cm and exhibited a papillary growth pattern. Microscopic evaluation revealed well-differentiated cells. No information was provided regarding tumor extent, presence of additional nodules, lymphatic or venous invasion, margins, neo-adjuvant treatment, or other findings. Five regional lymph nodes were examined and none showed evidence of metastasis. Immunohistochemical staining demonstrated positivity for TTF1 and CD15."} +{"pid": "TCGA-23-2645", "report": "A right salpingo-oophorectomy specimen included an ovary largely replaced by a poorly circumscribed, hemorrhagic, tan-white, necrotic solid tumor measuring 11.0 x 10.0 x 5.8 cm. The tumor involved the ovarian surface and demonstrated no gross cystic formation. The attached fallopian tube showed no visible tumor but had a congested serosa with paratubal cysts. Histologically, the tumor was poorly differentiated with serous features. The appendix showed a tumor implant on the serosal surface measuring 1.3 x 1.0 cm, extending into the wall and involving the tip. Tumor involvement was also identified in the muscularis and lamina propria of the appendix.\n\nMultiple lymph node dissections revealed tumor involvement in regional nodes. In the right pelvic lymph nodes, all four nodes were involved. Of three left obturator nodes, all were involved, as were all three left presacral nodes. All six right common iliac lymph nodes were involved, as were 13 of 14 right obturator nodes, 12 of 13 right periaortic nodes, both right lumbar nodes, all four left periaortic nodes, and all four left aortic nodes. A total of 51 lymph nodes were identified, with 53 involved by tumor.\n\nOther specimens, including omental biopsies and bladder peritoneum biopsy, did not show tumor involvement. The bladder peritoneum biopsy showed organizing hemorrhage and atypical cells interpreted as reactive mesothelial hyperplasia. The left ovary and fallopian tube showed no tumor involvement, although there was reactive paratubal mesothelial hyperplasia and an atrophic ovary. The uterus and cervix showed benign findings, including endometrial polyps, adenomyosis, and inactive endometrium. The right pelvic adhesions biopsy showed mesothelial hyperplasia without tumor.\n\nTwo research samples were taken for analysis. One showed 85% tumor cell nuclei with less than 5% necrosis, another showed 45% tumor cell nuclei with 65% necrosis, and a third showed 65% tumor cell nuclei with 25% necrosis. The primary tumor was staged as pT3c due to peritoneal metastasis beyond the pelvis greater than 2 cm and regional lymph node involvement. Lymph node staging was pN1 due to metastasis in regional nodes. No additional pathologic findings were noted."} +{"pid": "TCGA-VS-A9V3", "report": "The biopsy specimen was obtained from the cervix. Histologic evaluation reveals a neoplastic lesion composed of atypical squamous cells exhibiting marked nuclear pleomorphism, increased nuclear-to-cytoplasmic ratio, and frequent mitotic figures. The tumor cells infiltrate the underlying stroma in an irregular growth pattern. No evidence of angiolymphatic invasion is identified. Based on histologic features, the lesion is classified as high-grade."} +{"pid": "TCGA-MR-A520", "report": "The liver specimen from a partial right hepatectomy weighed 1160 grams and measured 20.0 x 14.0 x 5.0 cm. A single lesion was identified, measuring 6.5 x 6.0 x 4.6 cm, located 0.2 cm from the closest surgical margin. The lesion appeared tan-red, lobulated, and predominantly solid. Microscopically, the lesion showed well-differentiated hepatocellular features with areas of steatosis, peliosis, and extramedullary hematopoiesis. The tumor was partially encapsulated and blended with surrounding normal liver tissue. Pseudo-portal tracts were present, containing vessels but no bile ducts. Nuclear atypia was minimal, and no glandular or pseudoglandular structures were observed. No lymphovascular invasion was identified. There was evidence of hemorrhage and an infarct-like area, likely corresponding to a prior biopsy site. Immunostains showed membranous beta-catenin expression without nuclear staining, and reticulin stains revealed variable preservation of the reticulin framework. CD34 staining demonstrated a mostly well-formed sinusoidal pattern, though some areas were less distinct. The non-tumor liver showed moderate macrovesicular steatosis (25%) and mild chronic inflammation, but no significant fibrosis or cirrhosis. The gallbladder specimen showed cholelithiasis without any evidence of malignancy. All resection margins were free of abnormal tissue. Based on histologic features, special stains, and clinical context, the findings were interpreted as a solitary lesion with no angiolymphatic invasion, no involvement of adjacent organs, and no lymph node sampling. The final staging was pT1/NX, with negative margins."} +{"pid": "TCGA-EA-A5ZE", "report": "The cervix contains a lesion measuring 4x3x2cm, with a firm consistency and white-gray appearance. Microscopic evaluation shows hyperplastic squamous cells infiltrating into the surrounding stroma and fat tissue. The cells are arranged in groups, sheets, and trabecular patterns. The cytoplasm of the malignant cells is moderate to light eosinophilic. Nuclear features include enlargement, variation in size and shape, coarse chromatin, and prominent nucleoli. Mitotic activity is evident. The stroma shows lymphocytic infiltration. The lesion is confined to the cervix and measures less than 4.0 cm. Lymphatic invasion is present. The specimen is from a hysterectomy. Other features including lymph nodes, venous invasion, margins, and response to treatment could not be assessed."} +{"pid": "TCGA-FU-A23K", "report": "The patient is female. The specimen was submitted from a radical hysterectomy procedure. Histologic evaluation reveals a non-keratinizing histologic type with a histologic grade of 3 out of 3. Tissue involvement is noted in the ectocervical mucosa. The tumor measures 8.0 x 26 cm and demonstrates diffusely invasive growth throughout the stroma, with a depth of at least 2.0 cm into the stromal tissue. Lymphovascular space invasion is present and diffuse.\n\nSurgical margins are uninvolved, including the vaginal, paracervical soft tissue, and uterine serosa. No involved margins are identified. The tumor is confined to the cervical region without extension into the lower uterine segment, endometrium, or myometrium. The endometrium shows an atrophic pattern with prominent stromal luteinization. No significant abnormalities are observed in the myometrium or serosa. The PTNM staging is reported as pT1b1(N1 M0) IIIB.\n\nLymph node assessment includes multiple regional groups. In the left lower common and aortic region, eight lymph nodes are excised and show no evidence of metastatic disease. Left external iliac lymph nodes (three total) and left obturator lymph nodes (two total) are also negative. On the right side, one of seven lymph nodes from the common iliac and lower aortic region is positive for metastatic carcinoma, while the remaining six are negative. Right external iliac and right obturator lymph nodes (two each) are negative. Omental tissue does not show any diagnostic evidence of malignancy.\n\nGross examination of the surgical specimen includes the uterus, cervix, vaginal cuff, and associated soft tissues. The uterine corpus measures 8.3 x 4.0 x 3.0 cm, and the endometrial canal contains a white, fibrous intrauterine device. The endometrium is thin, measuring 0.3 cm in average thickness, and shows an atrophic pattern. The myometrium is fibrous, measuring 1.4 cm in average thickness, with no nodules or lesions identified. A tan-brown fungating mass measuring 3.0 x 2.6 cm is located on the posterior aspect of the cervix, approaching within 1.0 cm of the vaginal outer margin and 1.5 cm of the closest inked paracervical soft tissue margin. This mass does not involve the lower uterine segment.\n\nAdditional specimens include multiple lymph node regions, all of which were examined microscopically. No other significant findings are noted in the omental tissue. Representative sections from all areas have been submitted for further analysis."} +{"pid": "TCGA-AA-3672", "report": "The surgical specimen includes an ulcerated, moderately differentiated neoplasm of the transverse colon. Histological evaluation reveals infiltration of the perimuscular adipose tissue (G2, pT3). The resection margins are free of tumor involvement. Following acetone clearing, 21 lymph nodes, measuring up to 0.7 cm, were identified in the pericolic fat adjacent to the lesion. Within this group, one lymph node exhibits metastatic involvement. Vascular and perineural invasion markers are negative. The specimen has been fully sampled, with no residual tumor detected at the margins."} +{"pid": "TCGA-A8-A08L", "report": "The specimen consists of left-sided ablated breast tissue. A lesion is present, measuring up to 6 cm in maximum dimension. Histologic evaluation shows poorly differentiated cells with invasive growth pattern. Lymphovascular invasion is identified focally. The lesion extends to the base of the nipple and involves the pectoral muscle. Surgical margins show excision extending just into healthy tissue at the basal epidermis. There is no evidence of pagetoid spread or dermal infiltration. Pathologic classification includes M-8500/3, G 3, pT3, pN2a (5 out of 13 lymph nodes involved), pMX, stage III A. Negative resection margins are confirmed (R0)."} +{"pid": "TCGA-DX-AB30", "report": "The clinical history notes an enlarging left medial thigh mass. The specimen submitted for analysis consisted of excised soft tissue from the left anterior thigh. Gross examination revealed an ovoid tumor measuring 10 x 5.1 x 4.5 cm within a larger specimen measuring 17 x 15 x 6.5 cm. The tumor was located primarily within skeletal muscle and was well-circumscribed but not encapsulated. Focal areas of necrosis were identified. Surgical margins were largely free of tumor involvement; however, tumor tissue approached within 1 mm of the proximal aspect of the deep margin. No definitive extension into inked margins was observed. Histologic sections were taken from various regions including the proximal, mid, and distal aspects of the deep margin as well as representative tumor tissue. Cellular morphology demonstrated high-grade features."} +{"pid": "TCGA-CH-5762", "report": "The specimen shows a predominantly poorly differentiated carcinoma arising in the peripheral zone bilaterally. The tumor exhibits perineural invasion and lymphovascular invasion. The largest dimension of the tumor measures 2 cm. There is right-sided extension into the periprostatic adipose tissue and focal involvement of the right seminal vesicle. In the apical region, there is extensive proximity to the surgically defined margin on both sides, with a maximum contact length of 8 mm. A total of 7 lymph nodes were identified within fatty tissue, none of which show evidence of tumor involvement. Histological grading indicates a Gleason score of 4+3 = 7, with the Gleason pattern 4 comprising approximately 70% of the tumor. Pathological staging is pT3b with lymphatic invasion (L1), no venous invasion (V0), and positive surgical margins (R1). Lymph node status is classified as pN0 (0/7)."} +{"pid": "TCGA-WB-A821", "report": "The surgical specimen from the right adrenalectomy weighed 75g and measured 7.5x6x3.5 cm, containing a mass measuring 50x50x35mm with adrenal gland tissue present at the periphery. Microscopic evaluation revealed tumoral cells with large size, clear cytoplasm, nuclei with thickened chromatin, distinct nucleoli, and abundant cytoplasm. The architecture was trabecular with a vascular stroma. There was moderate nuclear atypia and 5 mitoses per 50 high power fields. No necrosis was identified. At the periphery, the tumor was either bordered by a fibrous pseudo-capsule or extended into adipose tissue. Nervous fibers were present within the tumor, though no definitive vascular invasion was observed. The hepatic pedicle lymph node was negative, and the gallbladder showed no abnormalities."} +{"pid": "TCGA-LK-A4O2", "report": "The specimen consists of a biopsy from the right parietal pleura. Histologic examination reveals a diffuse infiltrate of atypical cells with epithelioid morphology. The cells exhibit moderate nuclear pleomorphism, prominent nucleoli, and a tendency to form glandular or papillary structures. Immunohistochemical staining demonstrates positivity for calretinin, WT-1, D2-40, and cytokeratin 5/6. Negative stains include CEA, Ber-EP4, clone 872.3, and TTF-1. These findings are consistent with a neoplastic process involving the pleura, characterized by a distinct immunophenotype and architectural pattern. Staging and further clinical correlation are recommended."} +{"pid": "TCGA-HT-7616", "report": "The neoplastic cells show cytoplasmic immunoreactivity for GFAP. The background brain parenchyma demonstrates immunopositivity for synaptophysin, while CAM 5.2 is essentially negative. The MIB-1 labeling index reaches up to 6.5% in the most proliferative areas. Microscopic evaluation of the permanent section from the frozen specimen reveals a hypercellular brain tissue with scattered macrophages, some containing hemosiderin. Reactive small cells are present alongside clusters that may represent neoplastic involvement. Further sections display sheets and irregular large nodules of neoplastic cells, with extensive necrosis noted. In certain regions, a myxoid stroma is present. Blood vessels appear thick-walled and hypercellular, with hyalinization observed in one specimen. Cellular atypia is moderate, and mitotic figures are infrequent. The tumor cells in unfrozen material generally have small to intermediate round nuclei with a small nucleolus and clear cytoplasm. While the growth pattern is largely nodular, one slide shows evidence of diffuse infiltration."} +{"pid": "TCGA-FJ-A3ZE", "report": "Pathology Consultation Report. The specimen consists of multiple irregular tan-pink to yellow rubbery tissue fragments, measuring approximately 6.0 x 5.3 x 2.4 cm in aggregate. The material was submitted entirely and processed across cassettes A1 through A16. Microscopic examination reveals invasive high-grade epithelial cells forming irregular nests and infiltrating the underlying tissue. Necrotic areas are widespread throughout the specimen. Lymphovascular invasion is observed focally within cassette A3. Smooth muscle tissue is present and demonstrates multifocal infiltration by atypical cells. All findings are based on thorough histologic evaluation of the submitted material."} +{"pid": "TCGA-DH-5141", "report": "This is an addendum report. Surgical pathology consultation was performed for a male patient with a history of rhinorrhea. MRI imaging revealed a brain lesion and the patient subsequently underwent surgical resection. Following a left-sided stroke approximately one month post-surgery, the patient developed recent headaches and a follow-up MRI identified a right frontal lesion.\n\nThe pathology specimens were received in three labeled containers marked \"Tumor\". \n\nSpecimen A consisted of two pieces of soft beige to gray-tan tissue measuring 0.6 x 0.3 x 0.2 cm and 0.5 x 0.3 x 0.2 cm. Part of this specimen was used for frozen section analysis, which showed features consistent with infiltrating glioma; however, definitive grading was deferred pending permanent sections. The frozen tissue was resubmitted for further processing along with the remainder of the specimen.\n\nSpecimen B weighed 32.5 grams and measured 3.5 x 5.0 x 2.8 cm. It included cerebral cortex and underlying subcortical white matter with a 1.1 x 1.5 cm hemorrhagic area. Gross examination revealed effacement of the gray-white junction near the hemorrhagic region and pale tan-yellow discoloration of the subcortical tissue. Sections from this specimen were submitted for histological evaluation.\n\nSpecimen C weighed 8.0 grams and measured 4.2 x 3.5 x 1.4 cm. It also contained cerebral cortex and subcortical white matter. In contrast to Specimen B, this specimen demonstrated a better-defined gray-white junction and only minimal tan discoloration within the white matter. Representative sections were submitted for microscopic analysis.\n\nHistologic evaluation showed widespread infiltration of the cortex and adjacent white matter with notable vacuolar degeneration in some areas. Immunohistochemical staining for GFAP highlighted changes in the white matter architecture. Regions of increased cellularity and nuclear atypia were identified, with Ki-67 immunostaining labeling up to 20% of nuclei in certain foci, suggesting transformation to a higher-grade morphology.\n\nFluorescence in situ hybridization (FISH) testing performed on paraffin-embedded tumor tissue demonstrated deletions of chromosomes 1p and 19q. These findings are consistent with clinical observations that combined loss of 1p and 19q may be associated with improved therapeutic response and prolonged survival in certain brain tumors.\n\nAll specimens were processed according to standard protocols. This laboratory is certified under the Clinical Laboratory Improvement Amendments to perform high-complexity testing. Some assays used have not been cleared by the FDA but are validated for clinical use."} +{"pid": "TCGA-XM-A8RB", "report": "The prelaryngeal nodule biopsy shows thyroid tissue with nodular hyperplasia. A total thyroidectomy was performed, revealing nodular hyperplasia with changes consistent with a prior fine needle aspiration site. Multiple nodules were identified in both lobes and the isthmus of the thyroid, ranging from 0.5 cm to 3.0 cm in size. The largest nodule measured 3.0x2.5x1.5 cm and was located on the posterior aspect of the left lobe. The cut surface of the nodules showed gelatinous areas with focal hemorrhage and cystic, yellowish-greenish discoloration. The remaining thyroid tissue had a red-tan, beefy appearance. A lymph node-like nodule measuring 1.5x0.5 cm was also found in the isthmus region.\n\nA thymic mass measuring 7x5.5x3.5 cm was resected and found to be encapsulated, with no invasion into surrounding adipose tissue. The tumor itself measured 5x3x3 cm and had a red-yellow-tan variegated cut surface. Margins were free of involvement. Adjacent fatty tissue was also submitted. A separate resection of the left lobe of the thymus showed involuted thymic tissue with no identifiable lesion. The specimen measured 8.9x3.2x1.2 cm and weighed 16.0 g, with a lobular structure and yellow adipose tissue interspersed with thin bands of other tissue. Focal hemorrhage was noted. All specimens were reviewed personally and confirmed."} +{"pid": "TCGA-QU-A6IO", "report": "The pathology report details a specimen analysis involving lymph nodes and prostate tissue. The right and left obturator lymph nodes showed no evidence of malignancy, with multiple lymph node profiles present in the left specimen; however, the exact number of individual nodes could not be determined. All sections examined were free of tumor involvement.\n\nProstate tissue evaluation revealed several nodular areas. A diffuse nodule at the apex measured 2 cm, with additional firm nodules identified in the posterior apex (0.8 cm), right mid apex (0.4 cm), and left mid prostate (0.2 cm). The histologic type demonstrated a Gleason pattern of 3+3, resulting in a total Gleason score of 6. Tumor involvement was noted across multiple slides from both lobes: on the left, 3 out of 5 slides were positive, including 2 out of 3 from the apex; on the right, 3 out of 5 slides were involved, with 3 out of 3 from the apex.\n\nStaging findings indicated pT2c classification, reflecting bilateral tumor involvement without extraprostatic extension or seminal vesicle invasion. Regional lymph node staging was pN0, with no metastatic involvement identified. Surgical margins showed tumor extension to the inked capsular margin of the left lobe; however, the apical and bladder margins were free of tumor. Perineural invasion was also present.\n\nThe prostate specimen weighed 59 grams and measured 5.5 x 5.2 x 4.5 cm. Each seminal vesicle measured 2.5 x 2.0 x 1.0 cm. The right vas deferens measured 3.0 cm in length with a 0.4 cm diameter, while the left measured 2.2 cm in length with a similar diameter. The right side of the prostate was marked in black ink and the left in blue, with serial sectioning performed from apex to base.\n\nThe laboratory performing this analysis is CLIA-certified for high-complexity testing, and any immunohistochemical tests used have been developed and validated by the laboratory without being classified as investigational or research-based."} +{"pid": "TCGA-KK-A8IG", "report": "The prostate specimen measured 2.5 x 2.2 x 4.0 cm and weighed 31 grams after fixation. A palpable and visible nodule was identified in the left mid region of the prostate. Cross sections revealed firm areas consistent with involvement in the right transition zone and right peripheral zone, present across the first three of four cross sections. The seminal vesicles and segments of the vasa deferentia appeared free of involvement on gross examination.\n\nThree distinct areas of cellular abnormality were identified within the prostate gland. One area was located in the transition zone and two in the peripheral zone. The largest focus measured 3.0 x 1.5 cm and spanned four cross sections, predominantly involving the apical region. This focus exhibited a combination of cellular patterns, including a minor component suggestive of higher-grade morphology. Focal extension beyond the prostatic capsule was observed on the right anterior surface, with a maximum dimension of less than 1.0 mm. Involvement of the surgical margin was noted in the anterior apical region, measuring 6.0 mm in extent.\n\nTwo smaller areas were identified in the left posterolateral and right lateral peripheral zones. The left-sided focus measured 0.8 x 0.4 cm and was present in one cross section. The right-sided focus measured 0.5 x 0.2 cm and was also limited to a single cross section. These areas demonstrated lower-grade features and were confined within the prostatic tissue without margin involvement.\n\nNineteen lymph nodes were evaluated from bilateral pelvic specimens. No abnormalities were identified in these lymph nodes. Adipose tissue submitted measured 6.0 x 3.5 x 2.0 cm and contained multiple lymph node structures ranging from 0.2 to 2.5 cm in size. All lymph nodes appeared unremarkable upon histologic evaluation."} +{"pid": "TCGA-DG-A2KH", "report": "The specimen was obtained from a cervical site and processed as fresh frozen tissue. The patient underwent surgical resection, and the tumor measured 4 cm in size. Histological evaluation showed adenocarcinoma, NOS. The pathological staging was T1b2 with no lymph nodes sampled. A total of 12 positive lymph nodes were identified. The clinical staging for distant metastasis was M0. Additional histological comments were provided but did not include specific diagnostic terminology."} +{"pid": "TCGA-KL-8323", "report": "The right kidney specimen, including attached adrenal tissue and a segment of ureter, measured 16.5 x 11.8 x 6 cm and weighed 770 grams. A tumor located in the mid to upper lateral aspect of the kidney measured 10.9 x 9.9 x 5.4 cm and exhibited a lobulated, bosselated appearance with a purple-pink-tan cut surface, areas of hemorrhage and necrosis, and central fibrosis. The tumor extended into the renal pelvis and formed a thrombus within the renal vein. Histologic examination showed a mixture of acinar and solid growth patterns. All surgical margins were negative for tumor involvement. The non-neoplastic renal parenchyma appeared unremarkable. Within the perihilar and perinephric fat, no lymph nodes were identified. The attached adrenal gland contained a cortical nodule measuring 1.0 x 0.8 x 0.5 cm with granular yellow-gold appearance on sectioning. No definitive evidence of tumor involvement was identified in the submitted margins or hilar regions. Immunohistochemical stains performed did not contribute additional diagnostic information."} +{"pid": "TCGA-C5-A1M5", "report": "The specimen from the radical hysterectomy with bilateral salpingo-oophorectomy demonstrates a lesion measuring 3.6 cm in greatest dimension. The tumor invades to a depth of 12 mm within the uterine wall, which has a total thickness of 16 mm at the site of involvement. Focal lymphovascular space invasion is noted in areas distant from the main tumor mass. All resection margins are free of malignant cells.\n\nAdjacent to the main lesion, there is evidence of a high-grade intraepithelial lesion. The cervix shows mild chronic inflammation and areas of squamous metaplasia. No carcinoma or abnormal histopathologic findings are identified in the parametrium, vagina, or myometrium. The endometrium appears proliferative without atypia.\n\nExamination of the bilateral ovaries reveals epithelial inclusion cysts; one ovary also demonstrates focal para-ovarian adhesions. The fallopian tubes show no histopathologic abnormalities on the left side, while the right side exhibits hydrosalpinx. Lymph nodes from the left external pelvic region do not show any evidence of malignancy."} +{"pid": "TCGA-4H-AAAK", "report": "The specimen consists of a left breast and left axillary contents following a left radical mastectomy. The left breast measured 30.0 x 27.0 x 9.0 cm and contained a firm white-gray lesion located in the outer quadrant, measuring 2.8 x 3.5 x 3.0 cm. No vascular invasion was identified. Fourteen lymph nodes were identified in the axillary fat, ranging from 0.2 to 2.0 cm in greatest dimension. Of these, four were found to contain metastatic cellular deposits."} +{"pid": "TCGA-56-A4BW", "report": "The surgical specimen from the left lung includes a pneumonectomy with frozen section evaluation. A mass measuring 4.5 cm in maximum dimension was identified in the upper lobe. The mass is described as white-tan and firm, located within the lung parenchyma. It approaches within 0.3 cm of the adjacent pleural surface, which has been inked. No tumor involvement is present at the bronchial or vascular resection margins.\n\nLymph node assessment was performed for multiple regional sites. In the hilar region, two out of six lymph nodes show evidence of metastatic involvement. In other regions, including the 4L lower paratracheal, 7 subcarinal, 8 paraesophageal below carina, and 9 pulmonary ligament lymph node groups, all nodes appear negative for metastasis. A total of 13 lymph nodes were evaluated from these regions, with no evidence of disease in those areas.\n\nGross examination of the lung shows no additional masses or lesions beyond the primary lesion. The remainder of the lung tissue demonstrates variable congestion but no other significant abnormalities. Microscopic analysis confirms the presence of a moderately differentiated cellular proliferation within the mass, consistent with the findings on histologic review. The surrounding lung tissue is unremarkable aside from expected postoperative changes and sampling sites.\n\nStaging information correlates with a T2a classification for the primary lesion and N1 for nodal involvement, based on the extent of spread to hilar lymph nodes."} +{"pid": "TCGA-UW-A7GU", "report": "The specimen consisted of four formalin-fixed containers. Container A contained a 2 x 1 x 0.3 cm aggregate of multiple red-tan soft tissue fragments. Container B contained an 8 x 7 x 4 mm red-tan soft tissue fragment. Containers C and D were labeled as left and right renal masses, respectively.\n\nContainer C measured 2.9 x 2.4 x 2.0 cm and was partially cystic with a solid component measuring 2.6 x 2.1 x 0.6 cm. The mass had a glistening, gelatinous, pale golden-yellow cut surface and focally abutted the blue-inked parenchymal margin. Two central full-thickness sections were submitted in blocks C1 and C2, with additional sections from each half submitted in blocks C3 and C4.\n\nContainer D measured 1.8 x 1.3 x 0.9 cm and contained a solid, golden-yellow nodule measuring 1.3 x 1.4 x 1.0 cm that caused distortion of the capsular surface. The entire mass was serially sectioned and submitted in blocks D1 and D2.\n\nMicroscopic examination of the resection beds from both kidneys showed renal parenchyma with mild chronic interstitial inflammation and no evidence of malignancy. The left renal mass exhibited cells positive for CD117 and CK7, and negative for vimentin. The right renal mass showed positivity for CD117 and negativity for vimentin and CK7. All surgical margins were negative except for the left renal mass, which involved the parenchymal margin.\n\nFrozen section analysis of both resection beds intraoperatively did not identify any tumor or carcinoma. Immunohistochemical staining was performed on both lesions with appropriate controls, and the findings were reviewed in consultation, confirming the microscopic observations."} +{"pid": "TCGA-EV-5902", "report": "A left renal mass was resected from a partial nephrectomy specimen. The specimen measured 6.5 x 5.5 x 5 cm and showed a red-brown tumor with an overlying green-inked surface. The estimated tumor size was 3 x 2 x 2 cm, with a heterogeneous cut surface displaying dark brown and lighter tan friable areas. Margins were inked black for orientation.\n\nMicroscopic examination revealed a variant of papillary renal cell carcinoma with solid proliferation in some regions and pseudocapsule formation. The tumor was closely resected, with approximately 0.4 mm distance between the tumor and the normal kidney resection plane. Nuclear grading showed bland nuclei consistent with Fuhrman grade 1, with no prominent nucleoli. Solid areas contained eosinophilic matrix and occasional globoid bodies. Rare mitotic figures were noted, along with possible pseudorosette formations. Psammoma bodies were identified in slide A6. Adjacent renal parenchyma appeared normal without vascular or lymphatic invasion.\n\nImmunohistochemical staining demonstrated negative synaptophysin and chromogranin, with 1\u20132+ keratin cocktail reactivity and 1+ CK7 cytoplasmic staining. Vimentin showed strong positivity (2\u20133+), while CD10 was negative.\n\nThe histologic findings suggest a low-grade lesion with features resembling type 1 papillary renal cell carcinoma. The tumor was confined to the kidney, measuring less than 7 cm (pT1), with uninvolved margins and no evidence of metastasis or lymphovascular invasion. Additional findings included CK7 positivity and absence of CD10 staining."} +{"pid": "TCGA-2G-AAKH", "report": "The pathology report describes a right orchidectomy specimen. The tumor measures 4.5 cm in diameter. Microscopic examination reveals a mixed cellular composition, with approximately 95% of the cells exhibiting features consistent with one component and 5% showing characteristics of another. There is no evidence of angioinvasion identified. Invasion of the rete testis is noted. The tumor appears to be limited to the testis without extension beyond this structure."} +{"pid": "TCGA-55-5899", "report": "Histologic sections from lung biopsies demonstrate an invasive carcinoma composed primarily of sheets of cells with scattered, discrete glandular structures. The neoplastic cells exhibit prominent nucleoli and do not display the cytologic features of small cell carcinoma, grade II neuroendocrine carcinoma (atypical carcinoid), or large cell neuroendocrine carcinoma. Immunohistochemical analysis shows positivity for cytokeratin CK7 and TTF-1, while the tumor is negative for CK20, high molecular weight keratin SK, and p63. The neoplasm shows weak staining for synaptophysin; however, this is interpreted as non-specific and not indicative of a neuroendocrine tumor.\n\nThe patient presented with a right upper lobe lung mass. Cytologic evaluation of bronchial washing specimens shows the presence of respiratory epithelial cells, squamous cells, and macrophages, with no evidence of malignant cells.\n\nTesting for molecular markers such as EGFR and KRAS mutations, as well as ALK gene rearrangements, may be performed to guide treatment decisions. These analyses can be conducted using paraffin-embedded tissue or pleural fluid cell block. The Lung Cancer Mutation Panel includes assessment for these genetic alterations and is available either as a complete panel or individual assays upon request. This case has been confirmed by additional review."} +{"pid": "TCGA-XF-AAMX", "report": "A radical cystectomy with ileal conduit was performed. Gross examination of the bladder showed a large tan-brown sessile, exophytic mass located in the trigone and left lateral wall measuring 7.5 x 3.5 x 2 cm. A second smaller sessile tumor was also identified on the left lateral wall, measuring 1.9 x 0.9 x 0.8 cm. The main tumor was found to extend through the muscularis propria into the perivesical soft tissue and was in close proximity to the left ureterovesical junction. Histologically, the tumor was poorly differentiated and showed lymphovascular space invasion. Additional random sections of the bladder mucosa including the trigone, right and left lateral walls, dome, posterior wall, and left ureterovesical junction revealed flat lesions consistent with high-grade intraepithelial neoplasia. All surgical resection margins were free of atypical or malignant cells.\n\nExamination of the anterior vaginal wall showed predominantly benign fibromuscular tissue with extensive mucosal erosion. A small area of residual intact squamous mucosa was present without dysplasia or malignancy. No abnormalities were found in the distal or proximal segments of either ureter, and no urothelial dysplasia or malignant cells were identified in these regions.\n\nLymph node assessment included 26 lymph nodes from multiple sites: one from the right Cloquet region, two from the right external iliac, thirteen from the right obturator hypogastric region, three from the left external iliac, and seven from the left obturator hypogastric region. All were negative for malignancy. Non-necrotizing granulomatous inflammation was noted in some lymph nodes, but histochemical stains for acid fast bacilli and fungi were negative.\n\nThe left ovary showed a benign simple serous cyst and physiologic changes without evidence of atypia or malignancy. The right and left distal ureters, as well as the proximal ureters, were histologically unremarkable. Intraoperative frozen section analysis of the distal ureters showed no high-grade atypia or tumor involvement.\n\nPathologic staging was based on the extent of local invasion and absence of lymph node or distant metastasis. Tumor extension was documented through the bladder wall into surrounding soft tissue, with lymphovascular invasion present. No residual tumor was found at the surgical margins."} +{"pid": "TCGA-XU-A92T", "report": "The specimen consists of an anterior mediastinal mass and thymus gland, along with superior mediastinal lymph nodes. The thymus measures 11.5 x 6.2 x 4.5 cm and weighs 93.7 grams. A well-circumscribed, encapsulated mass is identified within the thymus, measuring 6.4 x 5.5 x 4.3 cm. The cut surface of the mass is tan, multinodular, and slightly soft in consistency. Histologically, the mass demonstrates a mixture of epithelioid cells and small lymphocytes, along with areas of bland spindle cells. Approximately 15% of the tumor shows infarction or necrosis. Microscopic evaluation reveals foci of transcapsular extension, with tumor cells present focally less than 0.1 cm from a painted surface, although the significance of this in relation to resection margins is uncertain. Immunohistochemical staining of the epithelioid and spindle cells is positive for cytokeratins (AE1/AE3) and p63, and negative for CD5. The small lymphocytes are positive for CD5 and CD1a. No lymphovascular invasion is identified. Two regional lymph nodes are examined and show no evidence of involvement. The closest distance of the tumor to the margin is 1 mm, and the surgical margins are uninvolved. Based on microscopic findings, the tumor exhibits transcapsular extension. Additional findings include involutional changes in the thymic tissue and focal infarction within the tumor."} +{"pid": "TCGA-ET-A25K", "report": "The surgical specimen includes a right parathyroid excision with associated fibroadipose tissue and one lymph node, all negative for tumor involvement. A total thyroidectomy specimen was received, oriented with a long black stitch marking the right thyroid region. The entire thyroid measured 6.5 x 5.1 x 1.8 cm and weighed 15.6 grams. The left lobe measured 3.9 x 2.5 x 1.3 cm and the right lobe measured 5.1 x 3.5 x 1.8 cm. Serial sectioning identified a well-circumscribed, soft tan nodule measuring 2.5 x 2.5 x 1.8 cm located in the right middle to inferior pole. No masses or lesions were identified in the isthmus or left lobe upon serial sectioning. The capsule of the specimen remained intact and was not excised; the anterior surface was inked orange and the posterior surface black.\n\nHistologic evaluation revealed multifocal involvement within the thyroid. Extensive sampling of associated fibroadipose tissue showed no lymph nodes. In a separate lymph node assessment, three out of eleven lymph nodes contained metastatic changes involving level VI (pretracheal, paratracheal, and prelaryngeal/Delphian) nodes. Venous and lymphatic invasion were identified. The primary lesion was staged as pT2, indicating a tumor larger than 2 cm but less than 4 cm confined to the thyroid gland. Regional lymph node staging was classified as pN1a. Distant metastasis could not be assessed (pMx). Surgical margins were free of involvement. Additional findings included nodular hyperplasia and focal lymphocytic thyroiditis. All relevant tissue sections were submitted for analysis."} +{"pid": "TCGA-S3-AA12", "report": "The surgical pathology report describes a mastectomy specimen with axillary lymph node dissection from the left breast. The specimen measured 27 x 19 x 11 cm and included skin and nipple. Upon gross examination, a well-defined pink-tan lobulated mass was identified in the central portion of the breast, extending into the upper inner and lower inner quadrants. The mass measured 9 x 7 x 6 cm and was located 1.5 cm from the deep fascial margin, 1.5 cm from the superior non-deep margin, and 2 cm from the inferior non-deep margin. Microscopically, the tumor showed grade 2 nuclear features with cribriform architectural patterns. There was no necrosis identified. Glandular or tubular differentiation was minimal, accounting for less than 10% of the tumor area. Nuclear pleomorphism was moderate, and mitotic activity was low. Margins of resection were uninvolved, with the closest distance being 15 mm from the deep fascial margin. Lymphovascular invasion was present, but dermal lymphovascular invasion was not identified.\n\nA total of 16 lymph nodes were examined, and two contained metastatic deposits, with the largest measuring 3.5 cm. No extranodal extension was observed. The primary tumor was staged as pT3 based on its size greater than 50 mm. Regional lymph node involvement was classified as pN1a, indicating metastases in 1 to 3 axillary lymph nodes with at least one deposit larger than 2.0 mm. Distant metastasis could not be assessed. Microcalcifications were noted in non-neoplastic tissue.\n\nImmunohistochemical analysis showed strong estrogen receptor positivity (99%, moderate intensity), while progesterone receptors were negative (<1%, moderate intensity). HER-2neu staining was negative (score 1+). Controls used during testing demonstrated appropriate reactivity, and all assays were performed under CLIA-certified conditions. A small segment of skin removed from the inferior aspect of the breast showed no remarkable findings."} +{"pid": "TCGA-AO-A0J8", "report": "The specimen from a female patient includes sentinel lymph nodes and breast tissue excised from the right side. Two sentinel lymph nodes were evaluated. The first was a benign lymph node measuring 0.4 cm; additional sections and immunohistochemical staining showed no evidence of metastatic tumor cells. The second sentinel lymph node measured 1.9 cm and demonstrated rare cytokeratin-positive cells (approximately 10 cells) on one section. These cells were not identified in corresponding hematoxylin and eosin stained sections or in frozen sections.\n\nBreast tissue evaluation revealed a lesion measuring 2.2 cm microscopically. Histologic examination showed classical-type features with extensive associated lobular carcinoma in situ (LCIS). Immunohistochemistry demonstrated negative E-cadherin staining, consistent with lobular phenotype. No calcifications were observed within either the invasive or in situ components, and vascular invasion was not present. Surgical margins were assessed separately; LCIS was identified at all margins except for the posterior margin, which contained benign fibroadipose and skeletal muscle tissue.\n\nHER2 immunohistochemistry showed 1+ staining intensity in 1% of invasive tumor cells, indicating HER2 negativity according to ASCO/CAP guidelines. Controls were satisfactory using an FDA-approved rabbit monoclonal antibody targeting the internal domain of HER2. \n\nAll non-neoplastic breast tissues displayed biopsy site changes. Some tests used in this evaluation were developed by the laboratory and are not FDA-approved but are performed under CLIA certification for high-complexity testing."} +{"pid": "TCGA-EJ-5505", "report": "The patient presented with a preoperative PSA level of 4.0. A radical retropubic prostatectomy was performed. Examination of the surgical specimen revealed invasive adenocarcinoma involving both the right and left lobes of the prostate. The tumor measured 1.6 cm in greatest dimension and accounted for approximately 10% of the total prostate volume. Histologic evaluation showed a Gleason score of 4 + 3 = 7, with a predominant Gleason pattern 4 (75%). A small tertiary Gleason pattern 5 component was identified, comprising less than 1% of the tumor. The tumor was organ-confined without evidence of extracapsular extension. All surgical margins were free of tumor involvement. There was no perineural or angiolymphatic invasion identified. Multifocal high-grade prostatic intraepithelial neoplasia was also present. Evaluation of lymph nodes included six from the right pelvic region and eighteen from the left pelvic region; none showed evidence of neoplastic involvement. Based on these findings, the pathologic staging was determined as pT2c with pN0 status."} +{"pid": "TCGA-DJ-A3UW", "report": "The thyroid specimen measured 6.2 x 3.1 x 2.2 cm on the right lobe, 4.3 x 2.0 x 1.2 cm on the left lobe, and 3.2 x 1.2 x 0.5 cm in the isthmus. A pyramidal lobe was also present, measuring 3 x 0.8 x 0.5 cm. The total weight of the thyroid was 28 grams. Upon sectioning, a nodule measuring 1.2 x 0.7 x 0.5 cm was identified in the left lobe. It had a firm, white-tan appearance and was ill-defined, abutting the capsular surface but without gross involvement. Additional nodules were noted throughout the thyroid, varying in texture and appearance. The largest of these was located in the right lobe and measured 2.5 x 1.8 x 1.7 cm. Histologically, the cells were well-differentiated with no mitotic activity or tumor necrosis observed. The cellular arrangement showed partial encapsulation without evidence of blood vessel invasion or extrathyroid extension. Surgical margins were free of abnormal tissue. Two additional small foci were found in the isthmus and right lobe, measuring 0.6 cm and 0.3 cm respectively, with one showing features resembling tall cell morphology. Non-neoplastic findings included nodular hyperplasia and chronic lymphocytic thyroiditis consistent with Hashimoto's thyroiditis. Four lymph nodes were examined and showed no signs of involvement. All submitted sections were entirely processed and evaluated."} +{"pid": "TCGA-C4-A0F1", "report": "The specimen consists of a cystoprostatectomy preparation showing a moderately differentiated solid tumor with features of squamous differentiation, located predominantly in the right trigonal region. The lesion demonstrates full-thickness involvement of the bladder wall with gross extension into the surrounding perivesical adipose tissue. Evaluation of three lymph nodes reveals no evidence of metastatic involvement. All deep resection margins, including those at the urethra, ureters, and vas deferens, are free of tumor as confirmed by frozen section analysis. Additionally, there are areas of moderate dysplasia identified in the residual bladder urothelium. The tumor staging is classified as pT3b with no nodal involvement (pNO, 0 out of 9 nodes positive). Lymphatic and vascular invasion are not identified (L0, V0), and all resection margins are negative (R0). The histologic grade is intermediate (G2), and the largest dimension of the lesion measures 2.5 centimeters."} +{"pid": "TCGA-FD-A43S", "report": "A 13.5 x 12 x 3.8 cm cystectomy specimen was received, weighing 150 grams. The serosal surface showed yellow lobulated fibroadipose tissue with focal cautery artifact. The bladder was opened anteriorly to reveal a centrally ulcerated mass measuring 2.5 x 2.0 cm, located in the posterior wall, left lateral wall, and trigone. The mass extended into and through the muscularis propria and approached the inked margin. On cut section, the mass was firm with a tan-yellow cut surface and areas of hemorrhagic discoloration. Surrounding mucosa was wrinkled and pink-tan, with a wall thickness of 1.6 to 2.1 cm. The right ureteral stump measured 2.5 x 0.5 cm and was patent; the left measured 1.8 x 0.4 cm. The mass extended to within 0.5 cm of the left ureteral orifice, which was patent only in the proximal 0.5 cm.\n\nExamination of the distal left and right ureters showed no evidence of tumor involvement. Both ureteral margins were free of disease. The distal left ureter specimen measured 0.8 x 0.4 x 0.2 cm and showed no tumor involvement. The distal right ureter measured 2.1 x 0.7 x 0.5 cm, with a pinpoint lumen and no gross or microscopic evidence of tumor.\n\nA total of 26 lymph nodes were evaluated: 15 from the right pelvic lymph node dissection and 11 from the left. All were negative for tumor involvement. The distal urethral margin, resection margins of both ureters, and soft tissue margins or serosa were all free of tumor. The mass was solitary, measuring 2.5 cm in greatest dimension, and was high grade with squamous differentiation. Tumor invasion extended through the bladder wall into extravesicular soft tissue, macroscopically evident. No tumor was identified in the uninvolved regions of the anterior wall, dome, or right lateral wall. Lymphovascular space invasion was not specified. Pathologic staging was determined as pT3b, N0, MX, based on the 7th edition TNM classification system. All surgical margins were negative."} +{"pid": "TCGA-E9-A22E", "report": "The specimen was obtained from the right upper inner quadrant of the breast. The tumor measured 3.5 x 3.5 x 3.5 cm and was grossly evident. Histologic evaluation showed moderately differentiated cellular changes. Lymph node assessment revealed 4 out of 10 axillary nodes involved by cellular spread. No extracapsular invasion was identified in the lymph nodes. Information regarding tubule formation, nuclear pleomorphism, and mitotic counts at both 25x and 40x magnifications was not available, and therefore a total histologic score could not be determined. Additional details about tumor extent, margins, neo-adjuvant treatment, and other pathologic findings were not provided."} +{"pid": "TCGA-EJ-A46I", "report": "The specimen consists of a prostate weighing 45.85 grams with involvement identified in both right and left lobes. The largest nodule measures 2.3 cm in maximum dimension and accounts for approximately 15% of the total specimen volume. Histologic evaluation reveals a glandular pattern with a primary growth pattern of grade 3 and a secondary pattern of grade 4, comprising 45% of the higher-grade component. There is focal extension beyond the prostatic capsule at the left anterior apex. No involvement is identified in the bilateral seminal vesicles or surgical margins. Multiple areas of perineural invasion are noted; angiolymphatic invasion is not observed. High-grade intraepithelial neoplasia is present in multiple foci. Pathologic staging is pT3a with no lymph nodes examined or involved. Clinical PSA was 8.46 prior to intervention."} +{"pid": "TCGA-EA-A410", "report": "The specimen consists of tissue from a hysterectomy with bilateral salpingo-oophorectomy. The tumor was located in the cervix and measured 8x5x4 cm. Microscopic examination revealed moderately differentiated cells. The depth of stromal invasion ranged from 3.0 mm to 5.0 mm. A total of 14 regional lymph nodes were examined, and none showed evidence of metastasis. No lymphatic or venous invasion was identified. Information regarding margins, neo-adjuvant treatment, and additional findings was not provided."} +{"pid": "TCGA-S9-A6U6", "report": "Histomorphology shows features of astrocytic differentiation. Single mitotic figures are present. The proliferation index reaches up to 7%. Foci of increased cellularity and elevated mitotic activity are observed. Based on these findings, the tumor is classified as grade III according to WHO criteria."} +{"pid": "TCGA-BG-A0M2", "report": "The surgical specimen included multiple lymph node groups from the left and right pelvic and paraortic regions, along with a hysterectomy specimen with bilateral salpingo-oophorectomy. In the left pelvic lymph nodes, three nodes were identified and none showed evidence of metastatic disease. The left paraortic lymph node assessment included a specimen composed of benign adipose tissue without identifiable lymphoid tissue; no lymph nodes were found in this section. On the right side, five pelvic lymph nodes were present and all were negative for metastasis. One paraortic lymph node was identified on the right and was also negative for involvement.\n\nThe hysterectomy specimen demonstrated a lesion involving the endometrial lining. Histologic evaluation revealed areas of complex atypical hyperplasia and polyps within the lower uterine segment. The surrounding myometrium contained benign smooth muscle tumors measuring between 0.5 and 2.5 cm. The cervix showed chronic inflammation and benign glandular changes. Both ovaries and fallopian tubes appeared unremarkable.\n\nMicroscopic analysis of the lesion showed a moderately differentiated epithelial neoplasm. The tumor measured 4 cm in maximum dimension and involved approximately 50% of the endometrial cavity surface area. Invasion extended into the myometrium to a depth greater than half of its thickness (1.0 cm out of 1.7 cm total thickness). There was evidence of vascular space involvement by the lesion. All pelvic washings were negative for malignant cells.\n\nA total of nine lymph nodes were examined across all specimens, and none showed signs of involvement. Based on these findings, there was no evidence of regional lymph node spread. Distant staging could not be assessed from the available data."} +{"pid": "TCGA-C5-A7X3", "report": "The specimen consists of multiple fragments of tan tissue measuring 0.7 x 0.5 x 0.1 cm in aggregate. Microscopic examination reveals moderately differentiated non-keratinizing cells with features indicative of a lesion involving the cervix. There is an intense stromal chronic inflammatory infiltrate present."} +{"pid": "TCGA-ZF-AA4R", "report": "The histopathology report describes a cystoprostatectomy specimen measuring 125 mm in the supero-inferior dimension, 110 mm medio-laterally, and 65 mm antero-posteriorly. The prostate component measures 30 mm superior to inferior and 45 mm medial to lateral. A lesion located on the right side is noted to abut the perivesical fat, measuring 20 mm x 6 mm. The surrounding mucosa appears haemorrhagic and possibly abnormal. The prostate demonstrates nodularity, with the most prominent nodule extending toward the bladder urethral orifice. The seminal vesicles and prostate appear unaffected.\n\nA fibrous tissue specimen measuring 55 x 38 x 22 mm contains two lymph nodes, the larger measuring 40 mm in maximum dimension, both of which show involvement. A separate piece of fibrofatty tissue measuring 48 x 20 x 8 mm contains four lymph nodes, the largest being 8 mm. Two ureter segments are identified: one 7 mm long and another 10 mm long, both entirely embedded.\n\nMicroscopic examination reveals high-grade urothelial changes involving the bladder, extending into the perivesical fat. Perineural and vascular invasion are present. All ureteric, urethral, and soft tissue margins are free of involvement. The prostate exhibits granulomatous inflammation consistent with prior treatment, and the background urothelium shows reactive changes without evidence of in situ malignancy.\n\nA total of six lymph nodes were evaluated. Two right obturator lymph nodes show involvement, while four right external iliac lymph nodes are negative."} +{"pid": "TCGA-EB-A5VU", "report": "A mass located in the third and fourth toes of the foot was identified. The lesion measured 5 x 4 x 1.5 cm and exhibited a firm consistency with a brown to black-gray surface. It was ulcerated and demonstrated invasive growth.\n\nMicroscopic examination revealed ulceration and necrosis of the epidermis. The lesion consisted of sheets or clusters of spindle or oval cells with moderately abundant cytoplasm, which in some instances contained fine melanin pigment granules. The cells exhibited a relatively low nucleo-cytoplasmic ratio. Nuclear morphology was variable in both size and shape, with prominent eosinophilic nucleoli. Frequent mitotic figures were observed. The tumor showed invasion into lymph node and adipose tissue.\n\nThe specimen was a surgical resection from the skin of the foot. Histologic evaluation indicated poorly differentiated morphology. Of five lymph nodes examined, one showed evidence of metastatic involvement. The Breslow thickness measurement was 15 mm. Other features such as lymphatic or venous invasion, margin status, presence of satellite nodules, and response to neoadjuvant therapy were not specified."} +{"pid": "TCGA-B8-5162", "report": "The left partial nephrectomy specimen weighed 252.3 grams and measured 14 x 10 x 7 cm. It consisted of the anterior one-half of the left kidney, with no hilar structures identified. A segment of ureter, 9 mm in length and 6 mm in diameter, was present and loosely attached. The perinephric fat was marked with black ink, the parenchymal margin with blue ink, and the ureter with green ink.\n\nA solid, variegated red/tan/orange mass was identified in the anterior portion of the specimen. The mass measured 7.3 x 6.2 x 5.5 cm and exhibited a thick capsule. It appeared confined to the kidney without gross involvement of the perirenal adipose tissue, Gerota's fascia, or ureter. No multicentricity was observed. The tumor was located 1.2 cm from the closest blue-inked parenchymal margin, and the perinephric fat margin was within 0.1 cm but showed no tumor involvement microscopically.\n\nMicroscopic evaluation revealed a neoplasm with clear cell morphology. Nuclear grading was Fuhrman grade 2 out of 4. Histologic assessment of surgical margins, including the parenchymal and perinephric fat margins, was negative for tumor. The segment of ureter and other sampled tissues were also free of tumor. No lymphatic or venous invasion was identified. No hilar lymph nodes were found, and no additional significant pathologic abnormalities were noted in the non-neoplastic kidney, which showed mild to moderate arterionephrosclerosis.\n\nStaging was determined as pT2a pNx based on available data at the time of reporting, and may be subject to revision pending further clinical review."} +{"pid": "TCGA-AG-3582", "report": "The resected specimen shows a moderately differentiated, ulcerated lesion of the colorectal type measuring up to 5 cm, with infiltration of the surrounding fatty tissue. A separate tuberous lesion is identified in the peritoneal area distal to the main lesion. All regional lymph nodes are free of tumor involvement. The mesenteric and colon resection margins are also tumor-free. The peritoneal lesion needs to be evaluated in relation to possible nodal involvement. Pathological staging is pT3, pN1 (1 out of 28 lymph nodes positive), pM1; histological grade G2, with no evidence of lymphovascular invasion (L0, V0) and incomplete resection (R2)."} +{"pid": "TCGA-55-A48Z", "report": "The specimen consisted of multiple lymph node dissections and a right lung pneumonectomy. Lymph nodes were received from various levels, with sizes ranging from 0.2 to 1.5 cm. Involvement was noted in all lymph nodes from level 11 (1/1), level 10 (4/4), suprapulmonary vein (1/1), left level 7 (4/4), and level 4 (3/11). One benign lymph node was identified at level 9. The right upper lobe lesion measured 2.0 cm in greatest dimension and was located near the fissure between upper and lower lobes. Histologic evaluation revealed a poorly differentiated solid, micropapillary, and papillary architecture. Lymphovascular space invasion was present, but no visceral pleural invasion was identified. The tumor was unifocal and confined to the lung. Surgical margins showed the tumor to be 7.2 cm from the bronchial margin and less than 1 mm from the pleural surface. Background lung tissue demonstrated mild respiratory bronchiolitis. All lymph nodes were processed entirely, and special stains for infectious agents were negative."} +{"pid": "TCGA-PG-A5BC", "report": "The surgical pathology report includes specimens from a hysterectomy with bilateral salpingo-oophorectomy, omentum, and multiple lymph node groups. The uterus measured 9.5 cm from fundus to exocervix, with a 7.5 x 3.0 x 0.9 cm mass located in the anterior and posterior endometrium. The mass was high grade with serous differentiation, measuring up to 7.5 cm in greatest dimension. Histologic evaluation showed myometrial invasion with depth of 2 mm (out of a total myometrial thickness of 16 mm), representing approximately 12.5% invasion. Stromal invasion was present in the endocervix. No lymph-vascular space invasion was identified. Margins were negative, and no tumor was found in the fallopian tubes, ovaries, or omentum. \n\nLymph node evaluation included four right periaortic nodes (all negative), three left periaortic nodes (all negative), five left external iliac and obturator nodes (all negative), and four right external iliac and obturator nodes (all negative). Cytology from peritoneal ascitic fluid was negative. Immunohistochemical staining showed negative ER, positive PR, and positive p53. The specimen was intact and fully evaluated. Additional findings included an inclusion cyst in the right ovary, along with adenomyosis and leiomyoma in the myometrium.\n\nStaging was determined as pT2 by AJCC criteria and Stage II by FIGO classification. The tumor was localized to the uterus with cervical extension but no evidence of lymph node or distant metastasis. Multiple sections from all relevant areas were submitted and reviewed."} +{"pid": "TCGA-KK-A8I5", "report": "A specimen was received from a patient measuring 178.0 cm in height, weighing 97.9 kg, with a body surface area of 2.2 m\u00b2. The report includes multiple tissue samples and lymph nodes evaluated for morphologic abnormalities.\n\nTissue fragments submitted for intraoperative consultation included: a tan-pink fragment (0.3 cm) from the left neurovascular bundle base, found to be negative for tumor; a 1.0 cm tan-pink fragment from the anterior apex, identified as unoriented surgical margin and also negative for tumor; and a 0.3 cm tan-pink fragment from the posterior apex, similarly unoriented and negative for tumor.\n\nFour lymph nodes ranging from 0.2 to 5.5 cm were identified within a 6.0 x 1.5 x 1.0 cm adipose tissue fragment from the right pelvic region. Two lymph nodes measuring 1.8 cm and 4.5 cm were found within a 5.0 x 2.0 x 1.0 cm adipose tissue fragment from the left pelvic region. All lymph nodes were morphologically benign.\n\nThe prostate specimen measured 4.5 x 3.5 x 4.5 cm and weighed 39 grams post-fixation. Gross examination revealed a nodule in the right base region, with a firm area consistent with a lesion in the right peripheral zone extending across three cross sections. The seminal vesicles and segments of the vasa deferentia appeared grossly unremarkable.\n\nMicroscopic evaluation identified three distinct foci of cellular atypia within the prostate gland. One focus was located in the transition zone, measuring 3.0 x 0.8 cm across three cross sections, involving both apex and base regions extensively. A second focus in the right lateral, posterolateral, and posterior peripheral zones measured 2.5 x 1.0 cm and spanned three cross sections with involvement of apex and base areas. A third focus was observed in the left anterolateral, lateral, posterolateral, and posterior peripheral zones, measuring 2.5 x 0.4 cm across three cross sections, primarily localized to the base region. All areas were confined within the prostate gland without extension beyond its margins.\n\nMargins of resection were free of abnormal cellular findings. No involvement was identified in the seminal vesicles or segments of the vasa deferentia. The prostate was inked on its surfaces for orientation: anterior in green, left in red, right in yellow, and posterior in black. All submitted sections showed no evidence of tumor extension beyond the surgical margins."} +{"pid": "TCGA-UW-A7GK", "report": "The right kidney specimen weighed 185 grams and measured 10 x 5.3 x 3.2 cm after fixation, including a portion of attached perinephric fat. A mass was identified in the upper pole, medullary region, measuring 3.3 x 2.5 x 1.3 cm. The tumor exhibited a variegated appearance with bright orange, dark brown, and hemorrhagic areas. The renal capsule remained intact, and the external surface overlying the tumor was inked black. The tumor did not grossly extend into the perirenal adipose tissue, Gerota's fascia, renal vein, or ureter. No multicentric lesions were observed.\n\nMicroscopic evaluation revealed nuclear features corresponding to grade 2 of 4, with focal areas showing higher-grade atypia. There was no evidence of angiolymphatic or perineural invasion. Surgical margins, including perirenal adipose tissue, renal vein, renal artery, and ureter, were all negative. Immunostains performed demonstrated strong reactivity for CD117 and focal staining for CK7, while stains for CK20, CD10, CD15, and vimentin were negative.\n\nThe remaining renal parenchyma appeared brown/tan with a distinct corticomedullary junction. The cortex averaged 3 mm in thickness, and the medulla measured approximately 1.5 cm. No papillary necrosis was identified. A small caliber tubular structure was noted extending from the upper pole. No lymph nodes were identified in the hilar adipose tissue. The perirenal fat was unremarkable except for a hemorrhagic external surface and was freely moveable over the kidney."} +{"pid": "TCGA-75-7027", "report": "The sample was collected from the left lower lobe (LLL) lung tissue following a resection procedure. The tissue specimen measured 3.5 cm in size. Histological evaluation revealed moderately differentiated cells with pathologic staging classified as T2, NOS for regional lymph node involvement and M0 for distant metastasis. The cellular grade was determined to be Grade 3. Additional clinical staging information aligns with Stage III disease. No further diagnostic terms or specific tumor type references are provided in the data."} +{"pid": "TCGA-XP-A8T7", "report": "The surgical specimen included the distal esophagus and gastric stump. The esophagus measured 10 cm in length and 2.5 cm in diameter, with a brown outer surface and congested vessels. An exophytic, friable, white lesion measuring 5 x 3 cm was identified, located 4.5 cm from the proximal margin and 1.5 cm from the cardia. The lesion extended through the full thickness of the esophageal wall. The gastric stump measured 4.5 x 3.5 x 0.4 cm and showed a brown-gray, rough, and opaque serosal surface, with mucosa displaying a normal wrinkled pattern. A tubular fragment measuring 2.2 cm long and 1.2 cm in diameter was also present. Eight lymph nodes were dissected, ranging in size from 0.3 cm to 1.3 cm.\n\nMicroscopic evaluation showed a moderately differentiated cellular growth pattern. The lesion measured 5 x 3 cm macroscopically and exhibited a vegetating appearance. Histologically, the growth was infiltrative, reaching the muscle layer. There was a moderate inflammatory infiltrate and moderate desmoplasia in the stroma. No vascular or perineural invasion was identified. Surgical margins were free of involvement, with the lesion located 4.5 cm from the proximal resection margin. No metastatic involvement was found in the nine lymph nodes examined. Staging was determined as pT2 pN0.\n\nA separate gallbladder specimen was received, measuring 8.5 cm long, 3.5 cm in diameter, with a wall thickness of 0.4 cm. The serosa was grayish-brown, smooth, and glistening, with visible congestion. The mucosa was greenish-brown, showing alternating velvety and smooth areas. Cholesterol stones were noted, and the cystic duct stump measured 1 cm in diameter. Additional microscopic description was not provided."} +{"pid": "TCGA-EW-A1IY", "report": "The surgical pathology report includes the examination of a right breast mass and multiple lymph node specimens. The breast mass was resected with a lumpectomy, measuring 7.2 cm in greatest dimension. The mass itself measured 2.0 x 1.8 x 1.5 cm and was located 0.2 cm from the deep resection margin. Microscopically, the invasive component showed moderate tubule formation (score = 2), marked nuclear pleomorphism (score = 3), and 0 to 5 mitoses per 10 high-power fields (score = 1), resulting in a total Nottingham score of 6 (Grade II). Margins were free of tumor involvement, and no lymphovascular invasion was identified. Additional findings included fibrocystic changes, microcalcifications in non-neoplastic tissue, and focal changes related to prior therapy in non-neoplastic breast tissue. A small area of the specimen also showed features consistent with previous biopsy changes and foreign material deposition (gel foam) in the skin.\n\nLymph node evaluation included sentinel nodes (A, B, C, G) and one non-sentinel node. All lymph nodes examined were negative for malignancy, with a total of six nodes assessed (zero involved). Intraoperative frozen section analysis of sentinel nodes #1, #2, and #3, as well as the deep margin, confirmed absence of tumor. Immunohistochemical stains for keratin on blocks A1, A2, B1, B2, C1, and G1 were negative. Tumor cells in block E7 were positive for ER and PR, and negative for HER2-neu. Other immunostains are in progress. The pathologic staging was pT2 for the primary tumor, pN0 for regional lymph nodes, and pMX for distant metastasis. The closest uninvolved margin was the posterior (deep) margin at 2.0 mm."} +{"pid": "TCGA-AA-3538", "report": "The excision specimen from the peritoneum shows angiectasia and subserosal fibrosis. A colonic resection specimen, identified as part of the sigmoid colon, contains an ulcerated lesion. Histological evaluation reveals a moderately differentiated adenocarcinoma measuring 2 cm in its largest diameter. The lesion extends to a maximum of 8 cm from the resection margin and invades to the level of the muscularis propria. Both the oral and aboral resection margins are free of tumor involvement. Twenty-six mesocolic lymph nodes are devoid of tumor; however, they exhibit reactive changes. Vascular invasion is noted, while lymphatic invasion is not identified. There is no evidence of residual tumor at the margins."} +{"pid": "TCGA-B0-4841", "report": "The left radical nephrectomy specimen contains two distinct foci of neoplastic tissue. The primary lesion measures 7.5 cm in maximum dimension and exhibits conventional morphologic features with nuclear grading classified as Fuhrman grade 3 out of 4. A secondary satellite focus, measuring 3.5 cm, is also present and displays similar histologic characteristics and nuclear grade. Both lesions are entirely contained within the renal parenchyma without evidence of extension into the perinephric or hilar adipose tissue. All resected surgical margins are free of tumor involvement. The adrenal gland shows changes consistent with a recent hematoma but no significant neoplastic or other notable pathologic abnormalities. Based on these findings, the pathologic TNM staging is determined to be pT2 Nx Mx."} +{"pid": "TCGA-J2-A4AD", "report": "The specimen consisted of multiple tissue fragments from various anatomical locations, all submitted in formalin. The tissues were processed and submitted for histological examination. No tumor was identified in any of the lymph node specimens examined, including those from multiple nodal stations. A wedge resection of the left upper lobe of the lung was also examined, along with a completion lobectomy specimen. The lung tissue showed a firm, gray-dark brown area measuring 2 x 1.7 cm; however, no tumor was identified at the resection margins. Histologically, the lesion was described as an invasive carcinoma, limited to the lung, with a histologic grade of 1 out of 4, and a unifocal growth pattern. The tumor size was reported as 1.8 cm, located in the left upper lobe. There was no evidence of visceral pleural invasion, significant obstructive pneumonitis, or atelectasis. No lymphatic or large vessel invasion was observed. A total of 14 lymph nodes were examined, and none showed evidence of involvement. The TNM staging was reported as pT1a, pN0, pMX. The overall specimen type included a wedge resection and completion lobectomy, with the specimen size measuring 9 x 2.5 x 2.0 cm. All histological evaluations were conducted using H&E staining methods across multiple tissue blocks."} +{"pid": "TCGA-XU-AAY0", "report": "The specimen from a female patient consists of an anterior mediastinal mass with total thymus, measuring 13.5 x 10 x 5.2 cm and weighing 234 grams. The tumor itself measures 8.6 x 8.5 x 4.7 cm, is encapsulated, firm, multilobular, and tan in color with areas of fibrosis. Microscopically, the tumor is composed predominantly of nodular proliferations of small lymphocytes mixed with bland epithelioid cells (90\u201395% of the tumor), separated by fibrous septa. Scattered areas contain bland spindle cells with few lymphocytes (5\u201310% of the tumor). A single focus of microscopic transcapsular invasion is present, although the tumor is otherwise intact and surrounded by adipose tissue at that site. The resection margins are free of tumor involvement, with the closest margin measuring 6 mm from the tumor. No lymphovascular invasion is identified.\n\nAn organizing hematoma with surrounding foreign body giant cell reaction and fibrosis is noted, consistent with a prior biopsy site. The tumor appears to be completely encapsulated in this area, with tumor cells approximately 0.6 cm from the cauterized margin. Additional findings include thymic tissue with involutional changes. No regional lymph nodes were identified or examined. Based on histologic evaluation, the tumor demonstrates focal extension beyond the capsule microscopically, with no other evidence of aggressive features. The overall assessment includes the presence of a resolving hematoma and foreign body giant cell reaction at the biopsy site, along with age-related thymic involution."} +{"pid": "TCGA-X7-A8M4", "report": "Operative Procedure: Thymectomy. Pre-Operative Diagnosis: As below. Post-Operative Diagnosis: As below. Mediastinal mass. Final Pathologic Diagnosis: Mediastinum, mass, excision: Examination of a single fixative-filled container labeled with the patient's name and additionally labeled \"mediastinal mass\" revealed a pink-tan firm mass with attached adipose tissue measuring 14.0 x 7.5 x 5.0 cm in aggregate. The mass itself measured 8.5 x 5.0 x 4.5 cm in maximal dimension and was covered by a pink-gray, glistening surface. On sectioning, the cut surface appeared pink-tan, lobulated, and firm, with occasional white septa. It was well-circumscribed without areas of hemorrhage or necrosis. Adipose tissue associated with the mass measured 12.5 x 11.5 x 2.0 cm, and no additional masses, nodules, or lymph node candidates were identified. Representative sections of the tumor were submitted for analysis.\n\nMicroscopically, the tissue showed sheets and lobules of epithelial cells intermixed with lymphocytes, separated by fibrous bands. Some areas demonstrated an apparent fibrous capsule; however, tumor cells were seen extending beyond this into adjacent adipose tissue. The closest distance between the tumor and the inked margin was less than 0.2 mm, as the ink was directly on the fibrous capsule, although there was no actual transection of the tumor at the margin. Immunohistochemical staining showed positivity for cytokeratins CAM5.2 and AE1/AE3, confirming the epithelial component of the lesion. Control stains demonstrated appropriate reactivity.\n\nFlow cytometric analysis of the mediastinal mass showed a predominantly T-cell population with low numbers of polyclonal B cells. Viability was noted to be 54%. Morphologic review of the cytospin preparation showed numerous stripped cells and few small mature lymphocytes. Phenotypic markers showed high expression of CD2 (85%), CD5 (81%), CD7 (96%), and CD1a (78%). Pan-T cell markers CD3 and cyto CD3 were expressed in 6% and 80% respectively, while CD4 and CD8 were present in 64% and 19%. B-cell markers including CD19, CD20, CD22, and CD23 were all <1% to 1%, and CD25, CD11c, and CD10 were minimally expressed. Tdt was detected in 8% of cells, and HLA-Dr expression was 2%. Kappa and lambda light chain expression was negligible. Race: White."} +{"pid": "TCGA-G6-A8L8", "report": "The right radical nephrectomy specimen includes a tumor located in the upper pole of the kidney. The tumor measures 5.1 x 3.5 x 2.8 cm and is confined within the kidney, with no extension into the perinephric tissue observed. The surgical resection margins are free of tumor involvement. Microscopically, the tumor demonstrates nuclei that are slightly irregular with evident nucleoli. No vascular or lymphatic invasion is identified. The adrenal gland is unremarkable and not involved by the tumor. No regional lymph nodes are sampled. Additional findings include interstitial chronic inflammation and a small leiomyoma within the renal parenchyma measuring 0.4 cm. A cortical nodule is present in the adrenal gland with a bright yellow cut surface. Gross examination confirms the tumor's location in the upper pole, with a pale yellow to gray-white cut surface. The tumor is near the renal capsule but remains encapsulated and is approximately 1.5 cm from the renal pelvis. The pathological staging is pT1b, with no nodal or distant metastasis indicated."} +{"pid": "TCGA-CJ-4899", "report": "A nephrectomy specimen was submitted, consisting of a left kidney measuring 15.0 x 10.0 x 6.0 cm along with a segment of renal artery, renal vein, ureter (10.5 cm in length x 0.3 cm in average diameter), and an adrenal gland (5.0 x 2.0 x 0.7 cm). A well-circumscribed mass measuring 4.5 x 3.5 x 3.0 cm was identified in the mid pole of the kidney. The mass appeared bright yellow with areas of hemorrhage and necrosis centrally. It focally abutted the renal sinus adipose tissue as a well-defined nodule and was in close proximity to the renal vein and renal pelvis, though no direct extension into these structures was observed. There was no involvement of Gerota's fascia.\n\nAn additional small tan-white nodule measuring 0.4 x 0.4 x 0.5 cm was found 0.8 cm away from the main mass. The pelvicalyceal system was otherwise smooth and contained a small stone measuring 0.3 x 0.3 x 0.3 cm. No lymph nodes were identified in the renal hilum. Microscopic evaluation of the adrenal gland showed no abnormalities in the cortex or medulla.\n\nHistologic sections revealed a cellular lesion with features including nuclear grade 2 morphology. Multiple deeper sections were examined, and no definitive invasion into the renal sinus adipose tissue or perinephric fat was identified. Vascular and soft tissue margins of resection were free of tumor. A separate small interstitial lesion measuring 0.5 cm was noted within the renal medulla, described as a fibromatous lesion.\n\nThe specimen was inked and sectioned extensively for analysis, including en face views of vascular margins, representative sections of non-neoplastic kidney, adrenal gland, and multiple levels of the tumor in relation to surrounding structures. Portions of the tissue were submitted for possible electron microscopy and tumor banking."} +{"pid": "TCGA-LL-A440", "report": "The specimen was received in eight parts. Part A consisted of a left breast specimen weighing 858 grams, measuring 28.0 x 16.0 x 5.0 cm. The breast was oriented with a suture at the superior aspect and showed no axillary tail. A tumor mass measuring 1.7 x 1.5 x 1.2 cm was identified in the upper outer quadrant. It was located approximately 8.0 cm from superior, 14 cm from inferior, 11.5 cm from medial, and 7 cm from lateral aspects. The tumor was 2.0 cm from the deep margin and 1.0 cm from the superficial to lateral peripheral margin. No involvement of skin, nipple, or skeletal muscle was observed. Fibrous tissue accounted for less than 20% of the parenchyma. Sections were taken from various regions including margins, tumor, and surrounding tissue.\n\nSentinel lymph nodes were sampled from both sides. On the left side, four sentinel lymph nodes were examined and all were reactive without evidence of metastasis. No macrometastasis, micrometastasis, or isolated tumor cells were identified in these nodes.\n\nPart B was a right breast specimen weighing 558 grams, measuring 20.0 x 13.5 x 4.5 cm. It contained a biopsy cavity measuring 3.0 x 2.0 cm filled with blood, located centrally between the upper and lower inner quadrants. The cavity came within 1.0 cm of the edge of the skin excision and was 3.5 cm from the deep margin. Surrounding tissue was predominantly adipose with fibrous areas noted. No discrete tumor masses were identified. Sections were taken from multiple regions including the biopsy cavity and margins.\n\nA separate portion of right breast tissue with a new margin was evaluated. It weighed 77 grams and measured 19.5 x 9.5 x 2.0 cm. The fibrous component made up less than 20% of the tissue. No significant lesions were identified microscopically; findings included fibrocystic changes and intraductal papilloma.\n\nOn microscopic evaluation of the right breast specimen, an area of non-invasive lesion measuring 8 mm was identified. Histologic features showed moderate nuclear grade and focal necrosis. Margins were free of involvement by this lesion, with the closest distance being 3.5 cm at the deep margin. One sentinel lymph node was examined on the right side and showed presence of isolated tumor cells.\n\nAncillary studies were referenced from prior reports. Additional findings included fibrocystic changes and microcalcifications in the left breast and fibrocystic changes in the right breast. Frozen section analysis of a right breast tissue sample confirmed presence of ductal tissue without malignancy.\n\nNo scars or lesions were identified on the skin surface of any breast specimen. Blue dye localization was noted in the left breast specimen. All surgical margins were uninvolved by invasive or in situ disease across specimens."} +{"pid": "TCGA-HC-A6AQ", "report": "The prostate gland weighed 67 grams and measured 5.5 x 5.0 x 5.0 cm. It had a lobulated, focally shaggy outer surface with a prominent verumontanum at the base. The urethra measured 3.2 x 0.5 x 0.2 cm and was patent with signs of compression by the lateral lobes. The cut surface showed multinodular gray tan to pink fibrotic areas with focal yellow discolorations scattered through both lateral lobes in the mid to proximal regions and extending focally into the posterior lobes bilaterally. No single discrete lesion was observed. Some chalky yellow areas were located as close as 0.1 cm to the nearest inked surfaces. The seminal vesicles measured 5.6 x 3.2 x 1.2 cm together and displayed lobulated tan pink outer surfaces with areas of fragmentation. Sectioning revealed a multicystic gray tan fibrotic appearance without identifiable gross lesions.\n\nMicroscopic evaluation demonstrated histologic patterns consistent with previously described features. Histologic quantitation indicated involvement of approximately 5% of the total tissue volume. Gleason grading showed a primary pattern of 3/5 and a secondary pattern of 4/5, resulting in a total Gleason score of 7/10. High-grade prostatic intraepithelial neoplasia was present. No definitive evidence of extraprostatic extension or lymphovascular invasion was identified. Seminal vesicle involvement was not detected. Surgical margins were evaluated, and one area in the left posterior lobe mid region raised suspicion for possible extension near or at the resection margin, though no definitive transection of tumor was seen. Clinical correlation and review of intraoperative findings were recommended. Lymph node assessment was not applicable. The pTN stage was recorded as pT2c Nx. All findings were confirmed upon secondary review by an additional pathologist."} +{"pid": "TCGA-AY-6197", "report": "The surgical specimen includes portions of the terminal ileum, large bowel, appendix, and pericolonic adipose tissue. A mass is identified in the proximal ascending colon, measuring 8.2 cm in greatest dimension. The tumor has a firm, pink-tan, fungating appearance with raised borders and central ulceration, involving the ileocecal valve. It protrudes into the lumen, measuring 8.2 x 5.1 x 2.5 cm, and involves approximately 90% of the luminal circumference. The lumen at the tumor site is narrowed to 1.4 cm in diameter. Microscopically, the lesion shows features of low-grade differentiation (grade 2 of 4). Focal mucinous differentiation is present, accounting for less than 10% of the tumor. No significant intra- or peritumoral lymphoid response is observed. There is fibrous obliteration of the appendiceal lumen.\n\nThe tumor extends through the muscularis propria into the surrounding adipose tissue, but there is no definitive evidence of visceral peritoneal penetration or perforation. No lymphovascular or perineural invasion is identified. All resection margins are negative: proximal margin is 10.1 cm from the tumor, distal margin is 11.6 cm, and the mesenteric vascular margin is 6.1 cm. A total of sixteen regional lymph nodes are examined, and none show metastatic involvement.\n\nImmunohistochemistry demonstrates loss of nuclear expression of MLH1, with normal expression of MSH2 and MSH6. Internal controls are positive. Tissue has been submitted for microsatellite instability testing, and results will be reported separately. The pathologic staging based on available data is pT3 pN0. This assessment may be subject to revision upon further clinical review."} +{"pid": "TCGA-49-4514", "report": "The final report includes multiple lymph node specimens. Lymph node station 5 consists of one lymph node with associated fibroadipose tissue, which is negative for tumor. Similarly, lymph node R11 includes one lymph node with associated fibroadipose tissue, also negative for tumor. Lymph node L8 shows one lymph node with associated fibroadipose tissue, and no tumor is identified. Additionally, a left upper lobe lobectomy specimen was submitted."} +{"pid": "TCGA-RW-A8AZ", "report": "The specimen consisted of four parts. Part A was a spleen weighing 120 grams, measuring 10.0 x 8.5 x 3.0 cm, with a pink-gray, smooth capsule. On sectioning, the cut surface was dark red and focally hemorrhagic but otherwise unremarkable. No lymph nodes were identified in the attached hilar adipose tissue.\n\nPart B included a segment of transverse colon measuring 12.9 cm in length and 7.6 cm in internal circumference, with attached mesentery and omentum. Both the colon and associated tissues appeared grossly unremarkable.\n\nPart C comprised a resection including the left kidney, distal pancreas, and left adrenal gland, with a total size of 20.0 x 15.0 x 11.5 cm. Within this specimen, there was a large mass measuring 16.7 x 11.7 x 10.5 cm. The mass was heterogeneous, with central necrosis and viable pink, fleshy nodular areas peripherally, along with focal hemorrhage. The mass directly invaded the kidney and pancreas. A 15 cm length of compressed vessel was present near the mass, possibly representing the renal vein. Adherent lymph node candidates were noted, and the tumor extended into surrounding soft tissue, abutting the soft tissue margin. Margins from the ureter, possible renal vein, splenic vessel, and other sites were submitted for evaluation. Sections of the mass showed foci of lymphovascular invasion. One lymph node was examined and showed no evidence of involvement.\n\nPart D was a retroperitoneal adipose tissue specimen measuring 8.2 x 3.7 x 1.5 cm, which appeared grossly unremarkable. No lymph nodes were identified, and histologic examination showed only benign adipose tissue.\n\nMicroscopic evaluation of the spleen showed no significant pathology. The colon and its margins were unremarkable. In part C, surgical margins were negative, and one lymph node was negative. The mass demonstrated lymphovascular invasion and involved adjacent organs without residual disease at the margins. The retroperitoneal soft tissue margin was inked and showed no involvement.\n\nAll specimens were processed and embedded as described in the cassette summary, with representative sections taken from all relevant areas."} +{"pid": "TCGA-A3-3323", "report": "The specimen consists of a right kidney with attached perinephric fat, measuring 21 x 14 x 7 cm and weighing 911 grams. Sectioning reveals an oval, golden-yellow mass located in the midportion of the kidney. The mass measures 5 x 4.5 x 4.0 cm and is focally adherent to the overlying capsule. A small area of the mass extends into a calyx, involving approximately 1.5 x 1.4 cm. The pelvis and calices are not dilated. The renal cortex averages 0.7 cm in thickness. No lymph nodes or adrenal tissue are identified within the attached fat.\n\nMicroscopic evaluation shows a unifocal lesion with clear cell histology. The nuclear grade is classified as Grade I. The tumor is confined to the kidney without evidence of vascular invasion. Surgical margins are free of involvement. No additional pathologic findings are noted. Based on available assessment, the regional lymph nodes and distant metastatic status cannot be determined. The tumor is staged as pT1bNXMXG1."} +{"pid": "TCGA-EB-A4OZ", "report": "The skin specimen measured 7x4 cm and contained a raised lesion measuring up to 2x1.8 cm. Seven dissected lymph nodes were submitted for examination along with a fragment of fatty tissue. Microscopic evaluation revealed a malignant neoplasm composed of pigmented cells, exhibiting both nevus-like and spindle-like morphology. The lesion lacked ulceration and demonstrated invasion into the subcutaneous tissue, corresponding to Clark's level V, with a Breslow depth of 18 mm. Among the seven lymph nodes assessed, four showed evidence of metastatic involvement. Within the fatty tissue, two lymph nodes exhibited sclerotic changes. No vascular invasion was identified. Margins of excision were uninvolved. Clinical staging criteria indicated that the presence of four or more affected lymph nodes corresponds to an advanced nodal category. The lesion was located on the trunk and measured 1.8x0x2 cm. Additional findings included lymphatic involvement; no satellite nodules or treatment-related changes were specified."} +{"pid": "TCGA-F1-A448", "report": "The resected specimen includes distal stomach, proximal duodenum, and associated perigastric fibroadipose tissue. A prominent mass measuring at least 9.3 cm in greatest dimension is identified along the lesser curvature of the stomach, occupying approximately 75% of its circumference. The tumor demonstrates invasion through the muscularis propria into the adjacent perigastric fat. Histologic evaluation reveals a poorly differentiated morphology with focal areas exhibiting a diffuse growth pattern and signet ring cell features. Lymphovascular invasion is present; perineural invasion is not identified.\n\nSurgical margins are negative: proximal margin is 3.2 cm from the tumor, and distal margin is 5.7 cm away. The radial margin is also negative. Lymph node assessment shows metastatic involvement in 16 of 42 perigastric lymph nodes. The largest nodal metastasis measures 1.55 cm, and extranodal extension is present. Additional lymph node specimens from the celiac region show metastatic involvement in 1 of 11 nodes, and from the splenic artery region in 1 of 5 nodes. No metastasis is found in the three lymph nodes evaluated within the omental tissue. Evaluation of an additional proximal gastric margin reveals focal intestinal metaplasia without evidence of dysplasia or malignant cells.\n\nHistologic examination shows a prominent lymphoid infiltrate surrounding certain areas of the tumor. In situ hybridization for EBV is negative in the malignant cells. A HER2/neu immunostain was performed but results are pending. Frozen section analysis of the proximal and distal gastric margins confirms absence of tumor involvement.\n\nGrossly, the tumor presents as a protruding mass measuring 9.3 x 6 cm on the lesser curvature, located 3.2 cm from the proximal gastric margin and 5.7 cm from the duodenal margin. The cut surface is solid and tan-white with invasion into the subserosal fat. The serosal surface remains largely smooth and unremarkable except near a shallow ulceration. The tumor exhibits features consistent with a mixed Borrmann type 1 and 2 morphology.\n\nLymph nodes submitted vary in size from 0.2 to 1.6 cm and are widely distributed across multiple blocks for histologic review. Background findings include chronic atrophic gastritis in the surrounding mucosa. \n\nStaging based on this specimen is reported as pT3 pN3b. However, it is noted that this staging may be incomplete and should be interpreted in context with other clinical data."} +{"pid": "TCGA-S9-A6U8", "report": "The neuropathology report indicates a neoplastic process characterized by infiltrative growth and moderate nuclear atypia. Cellular morphology demonstrates elongated nuclei with irregular contours and scant cytoplasm. Architectitectural disarray is present without necrosis or microvascular proliferation. Tumor cells are diffusely distributed, showing low mitotic activity. Immunohistochemical staining reveals positivity for glial markers. Based on histologic evaluation, the lesion exhibits features of a low-grade glioma with diffuse infiltration into surrounding tissue."} +{"pid": "TCGA-2H-A9GJ", "report": "The specimen shows a moderately differentiated carcinoma arising in the context of Barrett's epithelium, located in the distal esophagus. The lesion measures 5 cm in diameter. A total of 19 regional lymph nodes were examined and none showed evidence of involvement. The surgical margins are negative, consistent with a radical resection. Histologic evaluation reveals preserved cellular differentiation with glandular structures and varying degrees of nuclear atypia. No vascular or perineural invasion is identified. The depth of invasion extends into the submucosa without deeper extension."} +{"pid": "TCGA-2Y-A9GT", "report": "The specimen consists of a previously opened gallbladder measuring 8.0 x 4.0 x 1.5 cm. The serosa is tan-pink, smooth, glistening, and mildly congested. The gallbladder contains a moderate amount of viscous green bile and three irregular, tan-green, firm gallstones measuring up to 1.5 cm in greatest dimension. The mucosa is partially velvety and partially honeycombed, with bile staining. The cystic duct is patent with bile flow and measures 0.3 cm in diameter. No lymph nodes are identified adjacent to the gallbladder neck. Sections of the cystic duct margin, gallbladder body, and fundus are submitted.\n\nThe liver specimen, segment 5, is a hepatic resection measuring 10.5 x 7.5 x 5.5 cm. The capsular surface is variegated, tan to pale yellow to tan-pink, focally smooth and glistening, with focal nodularity. The surgical margin appears grossly unremarkable and inked black. On sectioning, there is an irregular, ill-defined, soft to rubbery, lobulated mass measuring 5.5 x 4.0 x 4.0 cm located 0.8 cm from the closest inked surgical margin. The surrounding liver parenchyma is tan-red brown with multiple subcapsular hemorrhages ranging from 0.1 to 0.2 cm in size. Representative sections of the mass and closest margin were submitted for frozen section analysis. Additional sections of the specimen were submitted in three cassettes.\n\nMicroscopic evaluation revealed a moderately differentiated lesion within the liver specimen. Histologic features included clear cell morphology and histologic grade II differentiation. No vascular or lymphovascular invasion was identified. The resection margin was free of tumor involvement, and the capsular surface showed no evidence of involvement. Background liver tissue demonstrated findings consistent with chronic active hepatitis. Pathologic staging was determined as MX. All findings were reviewed by the attending pathologist."} +{"pid": "TCGA-FG-8186", "report": "The pathology report includes specimens from multiple regions of the brain. Specimen A, obtained from the posterior margin, consists of multiple tan-pink soft tissue fragments measuring 0.5 x 0.5 x 0.1 cm in aggregate and shows microscopic features of infiltrating glioma. Specimen B, taken from the posterior medial region, is a tan-pink soft tissue sample measuring 0.5 x 0.5 x 0.2 cm and demonstrates cerebral cortex without evidence of tumor. Specimen C, from the lateral superior margin, includes tan-pink fragments measuring 1 x 0.7 x 0.4 cm and also reveals infiltrating glioma on microscopic examination. Specimen D, from the frontal lobe, is a 0.5 x 0.5 x 0.2 cm soft tissue fragment showing focal mild hypercellularity suggestive of a glioma margin. Specimen E, another sample from the posterior margin, measures 0.8 x 0.6 x 0.2 cm and exhibits minimal hypercellularity consistent with a glioma margin. Specimen F, labeled as the frontal pole, is an irregular cerebriform tissue fragment measuring 5.3 x 4.5 x 3.0 cm and submitted in three cassettes. The final specimen, G, labeled as the tumor, is an irregular cerebriform tissue measuring 5.0 x 4.8 x 3.8 cm and submitted entirely in 25 cassettes. Microscopic evaluation of the relevant specimens shows variation in cellular features, including areas of increased cellularity and pleomorphism."} +{"pid": "TCGA-66-2758", "report": "The examined material included the left upper lobe and other lung segments. Macroscopic evaluation revealed a resected left upper lobe measuring 23 x 14 x 8 cm, with a central bronchus resection plane located just proximal to the bifurcation of the lingular bronchus. A 4.5 cm branched staple suture line was observed in the dorsal region of the hilus, along with a 1.5 cm mobile, grayish-black node at the hilus. In the lateral boundary region of segments 1, 2, and 3, there was a plate-like thickening of the parietal pleura measuring up to 15 x 5 cm, with areas of adhesion. Segments 2 and 3, along with adjacent parts of S1, were largely occupied by a soft to moderately firm mass that was centrally disintegrated and pale brownish in color, reaching a maximum size of 9 cm. The mass showed relatively clear but vaguely arcuate borders and contained yellowish areas. Extension to the pleura in the region of adhesion and within 0.5 cm of the hilar resection surface was noted. Intermediate portions of B1, B2, and B3 were truncated within the mass. There was focal involvement of the medial pleura over S2, including a 0.5 cm disruption in the surface with suture material present. Adjacent pleura showed roughening, damage, and patchy dark discoloration. Parenchymal changes in the tumor environment included induration and brownish-yellow discoloration, also seen in segment 4.\n\nLymph node evaluation included several stations. A 1.6 cm lesioned node was found in the lingula (station 12), a 0.4 cm node in the interlobar region (station 11), three nodes between 0.4 and 0.7 cm in the hilar region (station 10), a 1.1 cm node in the subcarinal region (station 7), a 1.8 cm node in the paraaortic area (station 6), and a 2 cm node in the subaortic or aortopulmonary window (station 5). All lymph nodes removed were assessed and found without evidence of tumor involvement.\n\nHistological examination of frozen sections from various sites was performed. Sections from apical pleura I and II showed fibrosis and mild chronic inflammation, no tumor. Section from S6 showed a small focus of solid carcinoma at the edge of chronic organizing inflammation. The hilar lymph node and other lymph nodes evaluated were negative for tumor. The bronchus resection margin was free of tumor.\n\nMicroscopic analysis of the primary site showed features of large-cell, polymorphocellular, and partly giant-cell morphology with minimal keratinization. Tumor necroses were present. Peripheral to the tumor, there was bronchiolar ectasia with moderate chronic inflammation. Focal chronic organizing and fibrinous pneumonia was noted in regions adjacent to the tumor, particularly in S1/3 and S4. Soft tissue samples showed chronic fibrosing inflammation. Lymph nodes displayed reactive changes and anthracotic pigment deposition, without tumor involvement.\n\nThe tumor extended to the visceral pleura in the area of adhesion with the parietal layer; however, no definitive infiltration of the visceral pleura was identified. A pleural defect was noted over S2, with circumscribed tumor extension to the preparation surface. Based on patho-anatomical findings, the bronchial and vascular resection margins were clear, as were all identified lymph nodes. The tumor was classified as pT2 pNO pMX V1 RX according to TNM staging criteria."} +{"pid": "TCGA-AD-6965", "report": "The specimen consists of a portion of the right colon, including the cecum, and 9.4 cm of the terminal ileum. The large bowel measures 20.6 cm in length and is covered with pericolic and epiploic adipose tissue. An unremarkable vermiform appendix is present within this fat. The serosal surface appears shaggy, gray-tan to brown, and the bowel wall is up to 0.6 cm thickened, edematous, and fibrotic. The mucosa is gray-tan with preserved folds.\n\nA centrally ulcerated, finely granular tan-gray to pink lesion measuring 4.6 x 3.0 cm is identified in the cecal pouch extending toward the ileocecal valve. It has raised, rolled borders and is located 26 cm from the distal margin and 14 cm from the proximal margin. The cut surface of the lesion is gritty, gray-tan, fibrotic, and up to 1.9 cm thick. It extends focally through the muscularis into surrounding adipose tissue, reaching within 0.7 cm of the outer margin. In one area, the lesion umbilicates to the serosa and appears to extend through it. No other gross abnormalities are noted.\n\nMultiple nodules are found within the surrounding adipose tissue, some well-defined, others less so. These range up to 1.2 cm in size and have fibrotic or necrotic centers. Three tissue cassettes are submitted for histologic evaluation, including margins, ileocecal valve, representative sections of the lesion and surrounding tissue, normal bowel, appendix, and several sections of the positive nodules and smaller pericolic nodules.\n\nMicroscopically, the tumor is moderately differentiated. Lymphovascular space invasion is present. The tumor extends through the muscularis propria into subserosal fat and focally perforates the visceral peritoneum, involving the serosal surface. No involvement of the proximal or distal surgical margins is seen. Eleven of 17 lymph nodes contain metastatic carcinoma, with some nodes entirely replaced by tumor. The appendix shows only fibrous obliteration at its tip without evidence of tumor.\n\nGross and microscopic findings indicate that the tumor focally extends through the visceral peritoneum to the serosa. Based on this, and the presence of lymph node involvement and lymphovascular invasion, the staging classification is assigned accordingly."} +{"pid": "TCGA-Z6-A9VB", "report": "The clinical evaluation was conducted on an esophageal fragment measuring 12.5 cm, which included a gastric patch of 1.5 cm. The esophageal mucosa exhibited an infiltrative oval ulcerated lesion measuring 4 x 1.5 cm, located 4.5 cm from the proximal resection margin and 4 cm from the distal resection margin. A gray tumor mass was observed with a thickness of 1 cm. Within the paraesophageal adipose tissue, 25 consolidations ranging from 0.3 to 0.7 cm in diameter were noted. A paraesophageal lymphatic node measuring 1.5 x 0.4 cm had a dark-red surface.\n\nMicroscopic examination revealed an ulcerative infiltrative lesion that was moderately differentiated, showing infiltration through all layers into the adventitia. The surgical margins were free of involvement. Metastatic cells were identified in one paraesophageal lymphatic node. No metastatic involvement was seen in the paragastric lymphatic nodes or the greater omentum."} +{"pid": "TCGA-IG-A4QT", "report": "The specimen includes a segment of esophagus measuring 9x7 cm, containing a lesion up to 7 cm in size with areas of ulceration. Histologic examination reveals moderately differentiated keratinizing epithelial cells arranged in solid sheets with central necrosis. The tumor invades through the muscularis propria into the adventitia. No evidence of venous invasion is identified. Surgical margins are free of involvement. A total of eighteen lymph nodes were examined, including one periesophageal and seventeen gastric nodes, all of which show only reactive follicular hyperplasia without evidence of metastasis. Lymphatic invasion is not specified. There is no documented evidence of prior neoadjuvant treatment. No additional significant pathologic findings are noted."} +{"pid": "TCGA-FG-A70Y", "report": "The specimen was received in two properly labeled containers, one submitted for frozen section and the other for further analysis. The tissue, identified as a left temporal tumor, measured 3.0 x 1.5 x 1.2 cm in the frozen portion and 4.9 x 3.9 x 2.0 cm in the remaining specimen. Both portions consisted of pink-tan to pale tan soft tissue with homogeneous cut surfaces.\n\nMicroscopic evaluation revealed a mild to moderately cellular infiltrating neoplasm composed of glial elements with round and elongated nuclei. No mitotic figures were identified. Immunostaining showed positivity for GFAP in a small number of cells and a Ki-67 proliferation index of approximately 2\u20133% by manual immunohistochemistry.\n\nFluorescent in-situ hybridization (FISH) testing was performed using dual-color probe sets targeting 1p36/1q25 and 19q13/19p13 loci. A total of 104 cells were analyzed for the 1p/1q ratio, which was 0.84, consistent with no loss at the 1p36 locus. For the 19q/19p analysis, 116 cells were evaluated, yielding a ratio of 0.67, indicating loss at the 19q13 locus. These results were confirmed by both computer-aided and manual counting methods. The findings were interpreted by two observers and reviewed by a pathologist using FDA-approved imaging software and fluorescence microscopy.\n\nThe test interpretation is based on a ratio threshold of less than 0.80 from at least two sets of 20 interphase nuclei in non-overlapping areas, which is considered indicative of allelic loss. Control tissues from 40 normal cases across 10 organs were used to establish reference ranges. All control reactions demonstrated appropriate reactivity.\n\nThe histological and immunohistochemical features are consistent with a neoplastic glial process. However, lineage determination could not be definitively established at this time. The case was reviewed with a neuropathologist who concurred with the findings. Tumor grade was classified as WHO grade II based on histological criteria."} +{"pid": "TCGA-AN-A0AT", "report": "Female patient underwent radical mastectomy of the right breast; tumor specimen was collected and preserved in frozen format within a cryomold. The tumor was histologically characterized as a high-grade infiltrative lesion. Staging was determined as T2, N0, M0. No prior treatment was administered. A normal blood sample was also collected via blood draw and stored frozen in a tube."} +{"pid": "TCGA-CG-4455", "report": "The specimen consists of a residual gastrectomy preparation from a stomach that had previously undergone a B-II resection. The resection margins are free of tumor. A neoplastic lesion is present in the region of the lesser curvature, extending almost the entire length of the gastric stump from the cardia to the anastomosis. Histologically, the lesion is characterized by poorly differentiated cells with abundant intracytoplasmic mucin. The tumor infiltrates the subserosa and is associated with metastatic involvement of two regional lymph nodes out of seventeen examined. Lymphovascular invasion is present."} +{"pid": "TCGA-DJ-A3UX", "report": "The thyroid specimen was received fresh and labeled as a total thyroidectomy. The thyroid weighed 8.5 grams. The right lobe measured 2.0 x 2.0 x 0.5 cm, the left lobe measured 4.0 x 2.0 x 1.3 cm, the isthmus measured 3.0 x 1.5 cm, and the pyramidal lobe measured 3.0 x 1.0 x 0.4 cm. The external surface was covered by a thin fibrous capsule. The posterior surface was inked black and the anterior surface was inked blue. On sectioning, two white firm nodules were identified in the right lobe, measuring 0.3 x 0.3 x 0.2 cm and 0.5 x 0.4 x 0.3 cm, with the larger nodule abutting the anterior capsule. The remaining thyroid tissue had a red tan, beefy appearance. All relevant sections were submitted for evaluation and a photograph was taken.\n\nHistologically, the nodules showed well-differentiated cells without evidence of mitotic activity or tumor necrosis. A marked stromal reaction was noted. The nodules lacked a distinct capsule and there was no evidence of blood vessel invasion or extrathyroid extension. Surgical margins were free of involvement. No multicentric disease was identified. The non-neoplastic thyroid tissue exhibited features consistent with chronic lymphocytic thyroiditis. Three benign perithyroid lymph nodes were also present. No parathyroid glands were identified in the specimen. All findings were based on personal examination of the slides and materials."} +{"pid": "TCGA-55-7910", "report": "A left lower lobe lung specimen measuring 19.5 x 13.6 x 6.8 cm was examined. The pleural surface showed a 2 cm firm, puckered area that was inked black. On sectioning, a mass measuring approximately 7.0 x 6.7 x 5.7 cm was identified; it was soft, gray-tan, and friable, abutting the pleural surface and located within 5 cm of the bronchial margin. The remainder of the lung parenchyma appeared congested without additional lesions. Four peribronchial lymph nodes were identified, ranging in size from 1.2 to 1.4 cm, and all were negative for malignant involvement.\n\nLymph node dissections from multiple sites were evaluated. A subaortic lymph node specimen contained multiple fragments of lymphoid tissue, all negative. In the pulmonary ligament region, two lymph nodes (measuring 0.7 and 0.8 cm) were negative. A para-aortic lymph node measuring 1.3 x 1.0 cm was also negative. Paraesophageal lymphoid tissue included three samples ranging from 0.7 x 0.5 to 2.2 x 1.2 cm, all without evidence of malignancy. A subcarinal lymph node measuring 1.8 x 1.0 cm with attached fat was similarly negative.\n\nThe tumor did not extend to the pleural surface and surgical bronchial margins were free. No lymphovascular invasion was observed. Based on these findings, the pathological staging corresponds to T2b, NO according to the AJCC classification. Specimens from the tumor, peritumoral, and normal lung tissue were submitted for genomic analysis. No frozen section evaluation was requested. Visceral pleura overlying the tumor was marked with black ink. Additional cassettes labeled in various colors were received for research purposes."} +{"pid": "TCGA-ZF-AA51", "report": "Histopathology. The specimen consists of 7g of firm and friable tissue chippings. Microscopic examination reveals a poorly differentiated lesion with a mixed papillary and solid growth pattern. The tissue sample includes muscularis propria, and stromal invasion is present within this layer. No vascular channel invasion is identified. Flat urothelium is not present in the background."} +{"pid": "TCGA-UU-A93S", "report": "A female patient presented with a right breast mass. A mastectomy specimen weighing 2,374 grams was received, measuring 26 x 18 x 11 cm. The skin surface displayed a large nodular gray-yellow mass measuring 19 x 15.5 cm, involving the nipple-areolar complex. The mass occupied approximately 80% of the breast parenchyma and approached all four quadrants. Closest margins included 0.2 cm to the superior skin/soft tissue margin and involvement of the deep margin, including skeletal muscle. The tumor measured 19 cm in greatest dimension.\n\nHistologic evaluation showed poorly differentiated invasive carcinoma. Histologic grading revealed a Nottingham score of 9 (grade III), with glandular/tubular differentiation score of 3, nuclear pleomorphism score of 3, and mitotic rate greater than 8 mitoses/mm\u00b2 (score 3). The tumor was focally invasive with no evidence of ductal carcinoma in-situ identified. Skin ulceration and dermal lymphatic invasion were present. Tumor extended into skeletal muscle and margins were involved at the deep aspect. Lymphovascular invasion was also noted, and calcifications were present within the invasive component.\n\nA segment of pectoralis muscle was submitted for evaluation, measuring 6.5 x 4.0 x 1.5 cm. Frozen section analysis confirmed the presence of carcinoma involving skeletal muscle. All specimens demonstrated extensive tumor involvement with close or positive margins. Ancillary studies for hormone receptors and HER-2/neu status were pending. Pathologic staging was determined as pT4d NX."} +{"pid": "TCGA-A3-3362", "report": "The surgical pathology report includes specimens from the gallbladder and left kidney. The gallbladder measures 6.1 x 2.7 x 2.6 cm and has a fibrotic wall up to 0.1 cm thick. The lumen contains viscid green bile and multiple calculi, with aggregate dimensions of 6.4 x 3.6 x 0.6 cm. Sections of the gallbladder have been submitted for analysis.\n\nThe left kidney specimen weighs 283 grams and measures 16.8 x 8.2 x 6.0 cm. It is surrounded by moderate perinephric adipose tissue and includes a segment of Gerota\u2019s fascia. A renal structure is identified within the adipose tissue, measuring 5.2 x 2.6 x 2.2 cm, with a bright yellow cortex and tan-gray medulla. Vascular margins include a 0.9 cm renal artery and 0.6 cm renal vein; the ureteral margin measures 5.6 cm. After removal of the surrounding fat, the kidney measures 10.0 x 6.7 x 5.7 cm and has a smooth, slightly lobulated cortex. In the posterior lateral mid region, there is a well-defined nodular lesion measuring 3.3 x 3.3 x 2.9 cm. The cut surface of this lesion is hemorrhagic with gray-pink to yellow discoloration and is covered by a thin layer of residual parenchyma. No extension into the surrounding adipose tissue is observed. The remaining cortex is up to 0.8 cm thick and appears pale pink-red to brown. The cortical-medullary junction is indistinct, while the medulla shows sharp papillae and tan-white mucosa lining the calices and pelvis. No lesions are noted in the surrounding adipose tissue.\n\nMicroscopic examination includes sections from vascular and ureteral margins, representative lesion and surrounding tissue, uninvolved parenchyma, and adrenal gland. Histologic evaluation reveals no lymphovascular space invasion, no transcapsular invasion, and no renal vein involvement. The nuclear grade is Fuhrman 2 of 4. All surgical margins are negative, and no lymph nodes were resected. Adrenal involvement is not present."} +{"pid": "TCGA-E2-A14X", "report": "The surgical specimen includes a right breast lumpectomy with multiple margins evaluated, as well as lymph node dissections. The primary excision measured 8.5 x 8.5 x 2.5 cm and contained a 2.5 x 1.5 x 1.5 cm firm, well-circumscribed lesion located near the anterior and posterior margins. Serial sectioning of this specimen was performed across seven slices, with multiple sections submitted for evaluation. Additional margin specimens were also analyzed. One of these showed a 0.6 cm lesion within 0.2 cm of the new margin, with vascular invasion present.\n\nLymph node assessment included two sentinel nodes and a level I and II axillary dissection. Sentinel lymph node #1 consisted of two tissue fragments; no involvement was identified. Sentinel lymph node #2 was a cluster of three nodes, two of which showed metastatic changes. In the axillary dissection, 17 lymph nodes were identified, with three showing evidence of metastasis, including one with extension beyond the lymph node capsule.\n\nHistological analysis revealed cellular features consistent with high-grade changes. Immunohistochemical staining was positive for CD31 in areas adjacent to tumor foci, indicating possible lymphovascular involvement. Ductal carcinoma in situ (DCIS) of solid type, high nuclear grade with necrosis, was also present in small quantity, associated with the main lesion. A previous biopsy site was noted, along with benign findings such as fibroadenoma. Staining for estrogen and progesterone receptors was negative, and HER2 testing by immunohistochemistry was also negative.\n\nStaging was based on the size of the lesion, lymph node involvement, and presence of vascular invasion."} +{"pid": "TCGA-BJ-A45K", "report": "The thyroid specimen weighed 29 grams and showed two distinct lesions. One measured 2.3 cm in the left lobe and was encapsulated without capsular or angiolymphatic invasion. Another lesion, measuring 0.4 cm at the isthmus, had cystic changes and no angiolymphatic invasion. A total of eight lymph nodes were examined from the central compartment and perithyroidal regions; none contained tumor. All surgical margins were free of involvement. Histologic evaluation revealed chronic lymphocytic thyroiditis throughout the specimen. Five parathyroid specimens were removed during surgery. One showed enlargement with hypercellularity, another was mildly enlarged with mild hypercellularity, one was normocellular, and the remaining two were not further described. Intraoperative parathyroid hormone levels decreased significantly during the procedure. All tissue submitted for histologic evaluation was entirely processed. No lymphovascular invasion or extrathyroidal extension was identified."} +{"pid": "TCGA-E8-A2EA", "report": "The specimen consists of a subtotal resection showing complex cellular arrangements. The tissue demonstrates papillary structures with variable sizes, including both large and medium-sized formations. The cells exhibit significant nuclear polymorphism, characterized by irregular nuclear contours and variations in membrane shape. Cellular growth appears diffuse with evidence of marked architectural disarray. No definitive diagnosis is provided in this summary."} +{"pid": "TCGA-DJ-A2Q3", "report": "A 46-year-old female with a history of a left thyroid nodule, previously sampled via fine needle aspiration biopsy showing malignant cells, underwent total thyroidectomy and lymph node dissection. The surgical specimen consisted of a total thyroidectomy measuring right lobe 5.0 x 2.9 x 0.6 cm, left lobe 4.6 x 2.3 x 0.7 cm, and isthmus 1.0 x 0.3 x 1.3 cm. A single nodule measuring 0.7 x 0.8 x 0.6 cm was identified in the upper pole of the left lobe. The cut surface was described as white-yellow and firm. Histologic examination revealed a lesion located in the left lobe with a greatest dimension of 0.8 cm. No mitotic figures or tumor necrosis were observed. There was a marked stromal reaction noted. The lesion lacked a distinct capsule and did not show vascular invasion. However, there was involvement of perithyroidal soft tissue and focal extension into skeletal muscle. Surgical margins were free of involvement. Multifocality was not identified. Adjacent thyroid tissue showed nodular hyperplasia and chronic lymphocytic thyroiditis. Parathyroid glands were not identified within the specimen.\n\nLymph node evaluation included specimens from Delphian, additional Delphian, and right paratracheal regions. One out of two lymph nodes examined in one specimen contained metastatic involvement measuring less than 0.1 cm within a lymph node that measured 0.55 cm overall. Other lymph nodes evaluated were benign. Extracapsular extension was not observed.\n\nAll specimens were entirely submitted for histologic evaluation. Immunohistochemical staining and special studies were performed as part of the evaluation."} +{"pid": "TCGA-DD-A73B", "report": "Female. A. Liver, left, partial hepatectomy: A single mass measuring 4.3 x 4.1 x 4.0 cm is present and confined to the liver. The tumor shows moderate differentiation. The liver parenchyma resection margin is free of tumor with a margin of 1.4 cm. Macroscopic and microscopic vascular invasion are not identified. No regional lymph nodes are present. B. Gallbladder, cholecystectomy: Findings include chronic cholecystitis and cholelithiasis with two benign lymph nodes. Based on available surgical material, staging is classified as [AJCC pT1] (7th edition, 2010). The final pathology report is based on gross and frozen section histologic evaluation. Hematoxylin and Eosin (H&E) permanent sections have been reviewed to confirm these findings, with any substantive changes to be reported in a revised report. Interpreted by: ADDENDUM: The non-neoplastic liver tissue demonstrates established cirrhosis (stage 4 of 4), morphologically cryptogenic. Iron staining reveals minimal hemosiderosis. Date: 7/25/13."} +{"pid": "TCGA-3X-AAVB", "report": "A lymph node, gallbladder, portal lymph node, pancreatic duct margin, and a partial pancreaticoduodenectomy specimen were received. The patient has a history of neoplasm and is immunocompromised. One reactive lymph node was identified in lymph node #8, and no malignancy was detected. The gallbladder showed no evidence of malignancy or dysplasia. The portal lymph node was also reactive without signs of malignancy. The pancreatic duct margin was free of malignant cells.\n\nThe pancreaticoduodenectomy specimen included a segment of duodenum measuring 22.0 cm in length and 5.4 cm in maximum circumference, with a portion of the pancreas attached. The pancreatic head measured 3.5 x 3.5 x 3.3 cm. A mass lesion measuring 2.5 cm in greatest dimension was identified within the pancreas. The tumor had a homogenous, whitish appearance without necrosis, hemorrhage, or cystic changes. Microscopically, the lesion demonstrated invasion into the bile duct wall, duodenum, and pancreas, with involvement of the peripancreatic fat. Perineural and lymphatic invasion were present.\n\nResection margins were evaluated: the closest distance of invasive carcinoma to any margin was 0.2 cm from the uncinate margin, 0.2 cm from the vascular bed margin, 0.4 cm from the outer surface of the peripancreatic fat, and 0.7 cm from the pancreatic distal transection margin. All resection margins were uninvolved by invasive carcinoma. Five out of fifteen peripancreatic and biliary lymph nodes contained metastatic carcinoma.\n\nIn addition, a well-differentiated neuroendocrine tumor measuring 0.15 cm was incidentally identified within the area of infiltrating carcinoma. Tumor extension reached the surrounding structures but did not involve the celiac axis or superior mesenteric artery. Based on the extent of local invasion and lymph node involvement, staging was determined accordingly."} +{"pid": "TCGA-K4-A5RI", "report": "The specimen consisted of an anterior exenteration including radical cystectomy, total hysterectomy, bilateral salpingo-oophorectomy, and vaginectomy. The bladder measured 13 cm in greatest dimension with an indurated posterior superior wall replaced by an area of ulceration measuring 3 x 3 cm. Histologic examination revealed invasive high-grade lesion arising in the posterior urinary bladder. The tumor exhibited glandular differentiation extensively but lacked squamous differentiation. The histologic grade was high (grade 3/3), and the tumor measured approximately 3.0 cm in greatest dimension. Microscopic evaluation demonstrated tumor invasion into perivesical soft tissue.\n\nLymphatic invasion was identified microscopically, as well as extensive perineural invasion. Extensive surface ulceration was present with focal moderate dysplasia noted in the urothelium. No tumor was identified at the ureteral or urethral margins, and the perivesical soft tissue margin was negative for tumor involvement. The uterus, cervix, vagina, fallopian tubes, and ovaries showed no evidence of malignancy. Additional benign findings included atrophic endometrium, intramural leiomyomata, atrophic ovaries with focal endosalpingiosis, and paratubal cysts.\n\nA total of five lymph nodes were examined (two from the right pelvic region and three from the left pelvic region); none showed evidence of tumor involvement. Frozen section analysis of both ureteral margins and pelvic lymph nodes confirmed absence of malignancy. The surgical specimen also included an unremarkable vermiform appendix without diagnostic abnormalities.\n\nTNM staging was determined as pT3a, pN0, pMX. No small vessel invasion was identified in the lymph nodes sampled."} +{"pid": "TCGA-99-8032", "report": "The pathology report includes specimens from multiple lymph node levels and lung tissue. Lymph nodes evaluated include level VIII, which consisted of fibroadipose tissue without significant histopathological abnormalities; level IX, containing one lymph node; level VII, with multiple lymph nodes; level II, with multiple lymph nodes; level IV-R, with multiple lymph nodes; and level XI, with a single lymph node. All lymph node specimens were negative for malignancy.\n\nThe bronchial margin specimen was also negative for malignancy. The right upper lobe specimen measured 13.5 x 10.1 x 2.5 cm and contained a solid nodular lesion measuring 2.0 cm in maximal dimension. The lesion was tan-white with focal black areas and located 4.5 cm from the nearest surgical margin. No involvement of the pleura was observed, and all surgical margins, including bronchial, parenchymal, vascular, and parietal pleural margins, were free of tumor. A second cyst-like lesion measuring 4.5 cm was identified but found to be a solid lesion upon serial sectioning, located 1.0 cm from the primary lesion. No other lesions were identified upon further examination.\n\nMicroscopic evaluation of the right upper lobe specimen revealed a moderately differentiated carcinoma. Histologic assessment showed no lymphovascular invasion or nodal metastasis. Multiple peribronchial lymph nodes were negative for malignancy. Subpleural bullae were also noted. All other submitted blocks, including those from lymph nodes and margins, were negative for malignancy."} +{"pid": "TCGA-DD-AAEB", "report": "The specimen consists of liver and gallbladder tissues obtained via partial hepatectomy and cholecystectomy. The liver measures 17.0 x 7.0 x 4.2 cm and weighs 254.5 grams, while the gallbladder is 9.1 cm in length and 2.0 cm in diameter. A well-defined, round mass measuring 4.7 x 4.0 x 3.7 cm was identified in the liver. On gross examination, the cut surface of the mass appears yellowish to green, solid, and firm without necrosis. The lesion exhibits an expanding nodular growth pattern and does not involve the resection margin, with a safety margin of 2.0 cm. No satellite nodules are present. The surrounding liver parenchyma demonstrates periportal fibrosis (stage 2) and mild steatosis.\n\nMicroscopic evaluation reveals moderately differentiated tumor cells arranged in a trabecular pattern. Fatty change is present in approximately 10% of the cells. A partial fibrous capsule is observed, with capsular infiltration noted. There is no evidence of septum formation, surgical resection margin invasion, serosal invasion, portal vein invasion, or microvessel invasion. The status of intrahepatic metastasis and multicentric occurrence remains undetermined.\n\nAdditional findings include chronic cholecystitis in the gallbladder and reactive hyperplasia in a regional lymph node biopsy."} +{"pid": "TCGA-AK-3426", "report": "JCGA-AK-3426 \u2013 Clinical History: Right renal mass. Specimens were received from multiple lymph node regions including inter-aortocaval, right kidney adrenal gland hilar, retrocaval, and additional retrocaval lymph nodes.\n\nThe first specimen consisted of an inter-aortocaval lymph node measuring 2.5 cm in greatest dimension. It had a tan-pink, firm consistency with bulging, nodular cut surfaces. Sections were submitted for evaluation.\n\nThe second specimen included a right nephrectomy specimen weighing 879 grams. The attached ureter measured 1.5 x 0.3 cm with a patent lumen. The kidney measured 16.0 x 6.5 x 5.0 cm and contained a mass measuring 8.5 x 7.5 x 6.0 cm located in the mid to lower pole. This mass exhibited light tan to golden yellow-orange, nodular cut surfaces. Sections of the mass and surrounding renal tissue were submitted. The adrenal gland measured 4.5 x 2.0 x 0.8 cm with golden yellow-orange to tan-brown cut surfaces. One palpable lymph node measuring 2.0 cm was identified in the hilar soft tissue and submitted entirely.\n\nThe third specimen consisted of two red-purple, firm lymph nodes measuring up to 4.0 cm in greatest dimension. Both were entirely submitted for analysis.\n\nThe fourth specimen contained six lymph nodes ranging from 0.8 to 5.5 cm in size. These lymph nodes were tan to red-purple and firm with soft, friable cut surfaces. Representative sections were submitted.\n\nHistologic evaluation revealed high-grade nuclear features with tumor extending into peri hilar soft tissue and intralymphatic tumor emboli at the ureteral margin. Microscopic analysis demonstrated positivity for CK7, HMW cytokeratin, and CD10. Additional morphologic features included areas of clear cell and papillary appearance along with focal spindle cell changes suggestive of sarcomatoid differentiation.\n\nCytogenetic analysis revealed an abnormal mosaic karyotype with chromosome counts ranging from 36 to 44 among 21 metaphases. Two clonal aberrations were identified: deletion of the p arm of chromosome 3 and loss of chromosome 8. One normal karyotype was observed. These findings were derived after culture periods of six and seven days."} +{"pid": "TCGA-A5-A0GW", "report": "The specimen consists of a uterus and cervix, along with left and right pelvic and peri-aortic lymph nodes. The uterus measures 10.5 x 7.5 x 4.5 cm and weighs 85 grams. The endometrial cavity contains a lesion measuring 1.6 x 1.5 x 1.0 cm, described as soft and partially necrotic. The myometrium measures 1.3 cm in thickness, and the tumor shows superficial myometrial invasion involving approximately 78% of the myometrial wall thickness (0.1 cm out of 1.4 cm total). There is no involvement of the lower uterine segment or cervix. The tumor is located 1.2 cm from both the anterior and posterior margins.\n\nHighly suspicious lymphovascular invasion is noted. Parametrial margins on both sides are free of malignancy. Background findings include complex hyperplasia with atypia in the lower uterine segment. Both ectocervix and endocervix appear unremarkable. The ovaries show cystic changes\u2014follicular cyst on the right and hemorrhagic corpus luteum cyst on the left. Fallopian tubes are unremarkable.\n\nLymph node evaluation includes four left pelvic lymph nodes (all negative), three left peri-aortic lymph nodes (all negative), two right peri-aortic lymph nodes (both negative), and no identifiable lymph nodes in the right pelvic specimen. All lymph nodes examined show no evidence of malignancy.\n\nGross measurements and histological descriptions of all submitted tissues have been documented. No tumor involvement is identified at the parametrial margins or in any of the lymph nodes evaluated."} +{"pid": "TCGA-DV-5569", "report": "The right kidney specimens were received as three separate tissue fragments. Tumor #1 measured 0.5 x 0.3 x 0.2 cm and appeared as a red-tan soft tissue fragment, entirely submitted for processing. Tumor #2 measured 2.0 x 1.3 x 1.0 cm and had a yellow granular cut surface; approximately 60% of the specimen was retained for further study, with the remainder sent to Surgical Pathology. Tumor #3 measured 2.5 x 2.0 x 1.5 cm and exhibited a cystic, yellow granular cut surface with areas of focal hemorrhage; about 50% was retained, and the rest was sent to Surgical Pathology for additional evaluation. Microscopic examination revealed two distinct lesions with clear cell morphology and nuclear features consistent with a specific grade. A separate finding of chronic interstitial changes was also noted. The patient has a known history of a hereditary condition associated with multiple renal lesions and underwent surgical removal of three right-sided lesions. The operative findings included the presence of three separate masses. All specimens were processed in their entirety and no external consultations were required."} +{"pid": "TCGA-A7-A3J1", "report": "Final Surgical Pathology Report. Procedure: Diagnosis.\n\nA. Sentinel lymph node, left axilla, biopsy: A single lymph node is negative for malignancy.\n\nB. Breast, left, excisional biopsy: Histologic grade is Nottingham 2. Architectural score is 3, nuclear score is 2, and mitotic score is 1. Mitotic index is 0 mitoses per 10 high-power fields. The tumor measures 1.7 cm. Margins are negative for malignancy. The closest distance of the tumor to the anterior inked margin is 1.2 mm in block B15. Vascular invasion is not identified. Calcifications are absent. Non-tumorous findings include fat necrosis, consistent with a prior biopsy site. Staging is reported as T1c N0.\n\nC. Breast, posterior lateral margin, biopsy: In situ changes are present without evidence of invasive disease.\n\nMicroscopic Description:\n\nA. A single lymph node shows no evidence of malignant involvement. Immunohistochemical staining for keratin was not performed on sentinel lymph node sections at the request of clinical staff and based on expert opinion. Paraffin blocks are retained for future use if needed.\n\nB. Histologic evaluation reveals features consistent with previously described morphology. Tumor dimensions are as noted. Expression of CK5/6 and E-cadherin is observed. Sections are prepared from paraffin-embedded tissues fixed in 10% neutral buffered formalin. Quality controls are appropriate. Some antibodies used in testing are classified as analyte-specific reagents; their performance is validated by laboratory protocols and supported by published literature, though they are not FDA cleared or approved.\n\nC. In situ changes are confirmed. Expression of E-cadherin is not observed.\n\nSpecimen Details:\n\nA. Left axillary sentinel node is received unfixed and consists of three tissue fragments measuring up to 2.5 x 2 x 1 cm. Sections are taken after fixation (AS-6).\n\nB. Left breast biopsy specimen is received unfixed and includes a yellow and red soft tissue piece measuring 8.5 x 6 x 2.5 cm. Inked margins are as follows: anterior\u2014red, posterior\u2014orange, lateral\u2014blue, medial\u2014green, superior\u2014yellow, inferior\u2014black. A firm area measuring 1.5 x 1.7 cm is identified. Sections are taken after fixation (RS-16).\n\nC. Posterior lateral margin specimen is received unfixed and includes a yellow soft tissue fragment measuring 3.4 x 2.5 x 1.5 cm. A short suture is present. Inked margins follow the same labeling convention as above. Sections are taken after fixation.\n\nClinical Information: No prior biopsy history is documented. Prognostic markers are available upon request."} +{"pid": "TCGA-CZ-5457", "report": "The surgical pathology specimen from a kidney resection was received fresh in two parts. The right kidney measured 27.0 x 14.0 x 8.8 cm and weighed 1369 grams. A mass measuring 13.5 x 10.0 x 10.5 cm was identified in the lower pole of the kidney. It was tan-to-red to tan-to-yellow, focally encapsulated, and hemorrhagic with lobulated architecture. The mass directly abutted the renal capsule, with the closest margin being less than 0.1 cm to the inked surface. The remaining kidney contained multiple red/brown nodules ranging from 0.3 to 1.1 cm in diameter scattered throughout the parenchyma, along with a large necrotic area.\n\nHistologically, the tumor cells were arranged in clear cell morphology with nuclear features corresponding to the highest grade assessed. Invasion into the renal parenchyma, renal pelvis, and renal sinus was observed. Extension into perirenal adipose tissue was also noted. Lymphovascular invasion was present. Margins of the ureter, renal artery, and renal vein were free of tumor involvement. Colloidal iron staining was negative in the tumor cells. Immunohistochemical analysis showed positivity for CD10 and RCC markers.\n\nChromosomal analysis was performed on four specimens from the tumor. All metaphases from one specimen (T3) demonstrated clonal chromosomal aberrations including loss of chromosome 3, a commonly observed genetic alteration in a specific subtype of kidney cancer. No analyzable metaphases were obtained from the other three specimens. The study was conducted using GTG banding at a resolution of 400 bands or greater.\n\nThe AJCC classification (6th Edition) staging was determined as T3a with no lymph node or distant metastasis identified. No lymph nodes were identified in the regional lymph node specimen submitted. The non-neoplastic kidney tissue was evaluated for additional findings. Two hundred and two glomeruli were identified, with approximately 17% globally sclerosed, often grouped in areas of parenchymal atrophy. Mesangial expansion with focal early nodule formation was present in the remaining glomeruli. No double contours or craters were identified in the glomerular capillary walls. Several distal tubules contained PAS-positive hyaline casts. Areas of tubular atrophy and interstitial fibrosis involved approximately 30% of the cortical parenchyma, accompanied by mild mononuclear inflammatory infiltrate. Vascular changes included moderate sclerosis and hyaline degeneration in arteries and arterioles."} +{"pid": "TCGA-HW-A5KM", "report": "A 45-year-old male with no prior medical history presented with a right-sided numbness and tingling episode concerning for seizure. MRI revealed a large, heterogeneous lesion in the left hemisphere of the brain. Two specimens from the left temporal brain lesion were submitted for analysis.\n\nGross examination of the first specimen labeled \"left temporal brain lesion\" revealed a fresh, soft, tan-pink tissue measuring 0.8 x 0.6 x 0.6 cm. A squash preparation was made, and the remainder was frozen for intraoperative consultation. The second specimen, labeled \"left temporal brain lesion #2,\" consisted of multiple fragments of soft, pink-tan tissue measuring 1.2 x 0.7 x 0.2 cm. A 0.4 cm fragment was sent for molecular testing; the remainder was entirely submitted for histological evaluation.\n\nMicroscopic evaluation of the frozen section showed features consistent with a glioma, favoring a non-anaplastic astrocytic tumor. In permanent sections, the tumor demonstrated diffusely infiltrating cells with nuclear atypia. Immunohistochemical staining showed expression of IDH1 R132H in tumor cells. The proliferative index (MIB-1/Ki-67) ranged from 2\u20133%, with focal areas reaching up to 5%. Molecular testing for 1p/19q status is pending and will be reported separately. All findings were based on personal examination of the slides and review of the material."} +{"pid": "TCGA-N9-A4Q8", "report": "The specimen includes a uterus measuring 9.5 x 5.5 x 3.5 cm with a vaginal cuff ranging from 0.1 to 0.3 cm in length. A friable red-yellow mass occupies the entire endometrial cavity and extends to the lower uterine segment, measuring 4.5 x 4.0 cm with a thickness of 0.1 cm. Microscopic examination reveals superficial myometrial invasion measuring 0.5 mm; total myometrial thickness is 12 mm. No lymphovascular space invasion is identified. Both parametria are free of tumor involvement. The cervical canal appears grossly unremarkable and patent, with no tumor identified microscopically. Bilateral fallopian tubes and ovaries show no evidence of tumor.\n\nLymph node evaluation includes eleven right pelvic lymph nodes (ranging from 0.1 to 3 cm), six left pelvic lymph nodes (ranging from 1.7 to 3.8 cm), and nine para-aortic lymph nodes (ranging from 0.4 x 0.3 x 0.2 cm to 6.5 x 0.8 x 0.3 cm); none contain tumor cells. An omental biopsy consisting of adipose tissue shows no tumor involvement.\n\nAdditional findings include adenomyosis and endometriosis. A posterior intramural leiomyoma measuring 5.0 x 1.3 x 1.3 cm is present. Sections from blocks A18 and A27 may be suitable for future molecular testing if needed."} +{"pid": "TCGA-86-8075", "report": "The lung tissue specimen was obtained from the left upper lobe and submitted as a lobectomy. The tumor measured 2.6 x 1.5 x 1.5 cm and was found in the lung parenchyma with involvement of the visceral pleura. Microscopic examination revealed moderately differentiated cells arranged in a pattern consistent with glandular origin. No additional tumor nodules were identified. Lymph node assessment showed no metastatic involvement in the three regional nodes examined. There was no evidence of lymphatic or venous invasion. Surgical margins could not be assessed due to insufficient information. No prior treatment effects were observed, and no other significant pathologic findings were noted."} +{"pid": "TCGA-AA-3994", "report": "The specimen consists of a right hemicolectomy preparation with an ulcerated lesion present. Histological evaluation reveals a moderately differentiated neoplasm with partial mucinous features. The lesion is located 11.5 cm aborally to Bauhin's valve and spans approximately 3.5 cm in length, encircling the colon wall. The neoplasm demonstrates invasive growth through all layers of the intestinal wall, extending into the adjacent mesocolic adipose tissue. No involvement is identified at the oral or aboral resection margins, nor in the greater omentum. Lymph node analysis shows metastatic involvement in 2 out of 24 recovered nodes. Vascular invasion is noted, while no perineural invasion is observed. The surgical resection is considered complete, with negative margins."} +{"pid": "TCGA-HT-7691", "report": "The sections show benign cerebellar tissue with degenerative changes, including neuronal loss and gliosis. A moderately cellular neoplasm is present, composed of cells resembling slightly atypical fibrillary astrocytes. The tumor has an expanded interface with the surrounding cerebellum. Scattered Rosenthal fibers are identified, mainly at the tumor periphery. The growth pattern is solid. Vascular hyalinization is observed, along with numerous microcalcifications; in some areas, calcifications are more prominent than the tumor cells. No atypical ganglion cells or eosinophilic granular bodies are present. Perivascular pseudorosettes are not seen."} +{"pid": "TCGA-06-0646", "report": "A 3.0 cm mass located in the right middle temporal region was identified, with recent imaging showing enhancement and the presence of some satellite lesions. There was no surrounding edema noted. Surgical resection included a lobectomy of the temporal lobe, along with excision biopsies of the right temporal lesion and a posterior resection margin.\n\nHistologic examination of the temporal lobe tissue showed focal areas of recent edema but no neoplastic changes. The right temporal lesion revealed extensive infiltration of glial cells with nuclear anaplasia, mitotic activity, microvascular proliferation, and necrosis, including pseudopalisading patterns. The posterior resection margin showed only normal cerebral cortex and white matter without any neoplastic involvement.\n\nImmunohistochemical analysis demonstrated gliofibrillogenesis with GFAP staining, and gemistocytic features were present. The MIB-1 proliferation index was approximately 14% across the lesion. p53 expression was detected in about 3% of neoplastic nuclei. Molecular testing on paraffin-embedded tissue showed no methylation of the MGMT promoter.\n\nThe surgical specimens included two brain tissue segments measuring 1.5 x 1.4 x 1.3 cm and 5.0 x 4.5 x 2.5 cm, respectively, as well as a 3.5 x 2.2 x 1.5 cm aggregate of tan-brown tissue from the right temporal region. The posterior resection margin included multiple fragments ranging from 0.2 to 0.7 cm. All specimens were fixed in formalin except for the posterior margin, which was received unfixed.\n\nIntraoperative evaluation of the right temporal lesion suggested a glial neoplasm with anaplastic and gemistocytic features. Microscopic analysis confirmed cellular atypia, vascular proliferation, and necrotic areas, with all findings consistent with high-grade glial neoplasia."} +{"pid": "TCGA-FD-A3SR", "report": "A 64-year-old male underwent radical cystoprostatectomy for a history of bladder cancer. Pathologic evaluation of the specimens included multiple tissue sites.\n\nIn the left pelvic lymph node dissection, tumor involvement was identified in two out of six nodes, with the largest focus measuring 1.0 cm. No extranodal extension was present. The right pelvic lymph node dissection revealed tumor involvement in one of ten nodes, with a focus measuring 0.2 cm and no extranodal extension. Additional fragments showed tumor invasion into fibromuscular tissue.\n\nExamination of a segment of the distal left ureter demonstrated tumor infiltration into surrounding fibroadipose tissue. Similar findings were observed in both left and right periureteral tissue specimens, where tumor was present within the fibroadipose tissue.\n\nThe cystoprostatectomy specimen revealed a dominant lesion measuring 3.5 cm located in the dome, right lateral, and posterior walls of the urinary bladder. The tumor extended transmurally into surrounding soft tissues, including perivesical and periprostatic areas, as well as the bilateral seminal vesicles. There was extensive vascular space invasion, and the soft tissue margin (posterior wall) was involved. The left ureteral margin was also positive, while the prostatic urethra and right ureter margins were free of tumor. Extensive flat tumor involvement was identified throughout the bladder lining.\n\nProstate examination revealed a separate finding with specific features, including a low-grade pattern, small tumor volume, and absence beyond the prostate capsule. High-grade changes within the prostate lining were also noted. All resection margins, including the seminal vesicles and vasa deferentia, were free of this process.\n\nLymph node analysis across all sites showed involvement in four out of sixteen nodes. Staging classification was assigned based on depth of invasion and nodal status. A second staging classification was applied to the prostate findings, indicating organ-confined involvement without spread beyond the gland."} +{"pid": "TCGA-43-6773", "report": "The specimen includes biopsies from multiple lymph node regions and a right lower and middle lobe lung resection. Lymph node specimens from levels L4, R4, level 10, and subcarinal were received fresh and processed in various blocks. Microscopic examination of these lymph nodes revealed benign lymphoid tissue without evidence of malignancy.\n\nThe lung resection specimen weighed 400 grams and measured 14.5 x 12.0 x 7.5 cm. It included the entire right lower lobe and a portion of the middle lobe. A palpable peribronchial mass was identified grossly. Upon sectioning, a tumor measuring 9.0 x 6.4 x 5.8 cm was present within the middle lobe, extending to involve a group of perihilar lymph nodes. The tumor abutted the bronchial stump margin and approached within 0.2 cm of the inked pleural surface. Margins of resection were free of tumor involvement.\n\nMicroscopically, the lesion demonstrated features consistent with a moderately differentiated squamous cell carcinoma with minimal glandular differentiation and no keratinization. Lymphatic invasion was identified, along with intrapulmonary spread seen on histologic slides. One out of seven hilar lymph nodes showed tumor involvement with extension into lymphatic spaces; other regional lymph nodes were negative. No venous or arterial vessel invasion was observed. Additional findings included emphysema, chronic bronchitis, focal pulmonary infarction or organizing pneumonia, and hemorrhage with edema in the middle lobe.\n\nSections submitted included margins of bronchus and vessels, areas of tumor adjacency to bronchial stump and pleura, lymph node involvement, and representative sections from remaining lung tissue."} +{"pid": "TCGA-GR-A4D5", "report": "A 43-year-old female presented with cervical lymphadenopathy and skin lesions. Three specimens were submitted for analysis.\n\nThe first specimen, labeled as a left level 2B lymph node, measured 0.9 x 0.7 x 0.4 cm. It was bisected and partially submitted for frozen section diagnosis. Additional portions were used for molecular studies and permanent sections. Histologic examination revealed reactive lymphoid tissue without evidence of malignancy. Adjacent benign salivary gland tissue was also present but showed no pathological abnormalities.\n\nThe second specimen consisted of an ellipse of skin from the right neck measuring 1.6 x 0.9 cm with attached subcutaneous tissue (1.2 x 1.6 x 0.5 cm). A pale, ill-defined area measuring 0.9 x 0.5 x 1.0 cm was identified beneath the skin surface. Multiple tissue fragments were processed for immunohistochemical, cytogenetic, and molecular analyses. Histologic evaluation demonstrated a diffuse infiltrate of large lymphoid cells within the dermis and subcutaneous tissue.\n\nThe third specimen was a left deep level 2 lymph node measuring 4.3 x 1.7 x 1.4 cm. Sectioning revealed two nodules: one measuring 2.7 x 1.8 x 0.8 cm and another measuring 0.9 x 0.5 x 0.4 cm. The entire specimen was processed into multiple blocks for histologic and ancillary studies. Microscopic examination revealed a diffuse proliferation of large lymphoid cells within the lymph node architecture.\n\nImmunophenotyping performed on paraffin-embedded tissues demonstrated positivity for CD20, CD79a, CD43, CD10, CD5, BCL-2, and BCL-6. CD30 was expressed in rare cells. Staining for T-cell markers including CD45RO and CD3 was negative. In situ hybridization showed polyclonal staining patterns for kappa and lambda light chains.\n\nAncillary studies included immunoperoxidase techniques using antibodies against various B-cell and T-cell markers. Molecular diagnostic samples were collected alongside cytogenetic preparations. All specimens were processed according to standardized protocols with portions fixed in formalin, embedded in paraffin, or preserved in appropriate media for downstream testing.\n\nHistopathologic findings across the specimens showed morphologic heterogeneity between lymph node and skin tissues. One lymph node exhibited reactive hyperplasia while the other lymph node and skin biopsy demonstrated morphologic features consistent with a lymphoid neoplasm composed of large cells."} +{"pid": "TCGA-VS-A9UA", "report": "The biopsy specimen was obtained from the cervix and shows a poorly differentiated infiltrative growth pattern. The tumor cells exhibit marked nuclear atypia with increased mitotic activity. No evidence of angiolymphatic or perineural invasion is identified. The lesion is confined without extension into adjacent tissues."} +{"pid": "TCGA-KK-A8IA", "report": "The left pelvic lymph nodes consist of multiple fragments of fatty tissue measuring 9 x 5 x 2 cm. Dissection revealed possible lymph nodes ranging from 0.4 to 2.8 cm in greatest dimension, all submitted for analysis. Of eleven possible lymph nodes examined, two contained foci of involvement measuring 4.0 mm and 8.0 mm, with extension beyond the lymph node capsule. The right pelvic lymph nodes also consist of multiple fragments of fatty tissue measuring 8.5 x 4.5 x 2 cm. Dissection revealed possible lymph nodes ranging from 0.5 to 3.3 cm in greatest dimension, all submitted for analysis. Of eight possible lymph nodes examined, one contained a focus of involvement measuring 4.0 mm. The left perivesical lymph node specimen consists of fatty tissue measuring 2.5 x 2.4 x 0.5 cm, with no lymph nodes or abnormal tissue identified.\n\nThe prostate and seminal vesicle specimen includes a prostate gland measuring 5.8 x 3.3 x 3.4 cm and weighing 51 grams. Cross sections after fixation showed areas of abnormal tissue in the right posterolateral and left posterolateral peripheral zones across three cross sections. Abnormal tissue was also noted in multiple regions including the right anterior, mid anterior, left anterior, left anterolateral, left lateral, left posterolateral, left posterior, mid posterior, right posterior, right posterolateral, and right lateral peripheral zones. The abnormal tissue occupied approximately 70% of the prostate volume and measured 4.5 x 3.0 cm in its largest cross-sectional dimension. It was present in three cross sections and extended extensively into the apex and base regions. Extension beyond the prostate capsule was observed in the left lateral and left posterolateral aspects, left superior neurovascular bundle region, and posterior surface at the base level. At these sites, the resection margin was free of abnormal cells. However, in the right posterolateral aspect, the distance to the inked surface was less than 0.1 mm, raising the possibility of focal margin involvement. The left seminal vesicle and surrounding soft tissue were extensively involved, while the right seminal vesicle and vasa deferentia showed no evidence of involvement."} +{"pid": "TCGA-S9-A6TS", "report": "The histopathology shows a focal increase in cellularity and the presence of mitotic figures, with a proliferation index greater than 8%. These findings are consistent with anaplastic features."} +{"pid": "TCGA-LL-A50Y", "report": "The specimen consisted of left breast tissue with two axillary lymph nodes and a right modified radical mastectomy specimen with axillary contents. In the left breast, intraductal papilloma with atypical hyperplasia was identified subareolarly along with foci of in situ changes and fibrocystic alterations. The two lymph nodes showed no evidence of disease.\n\nIn the right breast, multiple foci of invasive disease were identified, with at least four distinct areas detected. The largest focus measured 3.0 cm in greatest dimension. Histologic grading using the Nottingham system yielded a combined score of 2 out of 3. Tubule formation was scored as 3, nuclear pleomorphism as 2, and mitotic rate as 1. No ductal carcinoma in situ was present.\n\nMargins of resection were free of invasive disease, with the closest margin measuring approximately 1 mm medially. A total of eight axillary lymph nodes were examined, and none showed evidence of metastatic involvement.\n\nAncillary studies demonstrated strong estrogen receptor positivity (100% tumor cells) and moderate progesterone receptor positivity. HER2 immunostaining was equivocal (score 2+). No lymphovascular or dermal lymphovascular invasion was identified.\n\nGross examination of the right mastectomy specimen revealed mostly fatty tissue with fibrosis and multiple ill-defined nodular areas suspicious for tumor. The medial margin was inked blue, and the chest wall margin was marked with black ink. Margins were grossly uninvolved by tumor by at least 1 cm. Multiple fatty lymph nodes were identified in the axillary tail, up to 3 cm in greatest dimension.\n\nMicroscopic evaluation confirmed the absence of invasive disease in the margins and in lymph nodes. E-cadherin staining on the left breast tissue supported findings consistent with lobular neoplasia. Pankeratin staining on one lymph node from the right mastectomy showed no metastatic disease.\n\nPathologic staging was pT2 pN0."} +{"pid": "TCGA-34-A5IX", "report": "The specimen from the fifth rib shows benign bone and bone marrow with trilineage hematopoiesis. No malignancy is identified in this tissue. A lymph node from level 11 is anthracosilicotically changed, with no evidence of malignancy (0/1).\n\nIn the right lower lobe of the lung, a lesion measuring 6.7 x 5.5 x 4.7 cm is present. Histologic evaluation reveals moderately differentiated cellular features. Vascular space invasion is noted, and there is involvement of the visceral pleura as demonstrated by elastic stains. The lesion extends into the diaphragm. Surgical margins, including bronchovascular and diaphragmatic soft tissue, are free of malignant cells. Ten peribronchial lymph nodes are anthracosilicotically altered and show no signs of malignancy (0/10). Additional findings include organizing pneumonia and an organizing thrombus with recanalization within a pulmonary artery branch.\n\nThe right middle lobe of the lung demonstrates mild emphysematous changes and alveolar macrophages containing pigment. No malignancy is detected. Surgical margins are negative, and one peribronchial lymph node is anthracosilicotically changed without evidence of tumor involvement (0/1).\n\nLymph nodes from levels 4, 10, and 7 are all anthracosilicotically altered and do not show any malignant involvement. The total number of lymph nodes examined includes 13 N1 and 6 N2 nodes, all without evidence of tumor spread.\n\nImmunohistochemical and histochemical studies demonstrate specific staining patterns, supporting the histologic findings. Elastic stains confirm extension through the pleural layer into diaphragmatic fibrous tissue. Further ancillary testing is pending on selected tissue blocks.\n\nStaging data indicate a pathologic T stage of pT3, with no nodal involvement (pN0). The histologic grade is 2. There is less than or equal to 50% necrotic tissue within the lesion. No tumor is found at the surgical margins."} +{"pid": "TCGA-CJ-5675", "report": "The specimen consists of a right kidney and adrenal gland, measuring 23.0 x 14.0 x 9.5 cm in total, with the kidney itself measuring 14.0 x 9.0 x 9.0 cm and an adrenal gland measuring 6.0 x 2.5 x 2.0 cm. Within the upper pole of the kidney, there is a lesion measuring 10.0 x 8.5 x 8.5 cm. The lesion is located near Gerota's fascia and perinephric fat in focal areas, with the closest distance being 0.6 cm. It is also adjacent to the pelvicalyceal system and renal sinus. The lesion has a pale yellow lobular appearance with areas of hemorrhage and central myxoid degeneration. No involvement of the renal vein or ureter is identified.\n\nHistologically, the lesion contains a mixture of clear and eosinophilic cells (70% and 30%, respectively), with nuclear features corresponding to Fuhrman grade 3. Sections from multiple areas of the lesion were submitted, including regions closest to Gerota\u2019s fascia, areas near the renal sinus, and representative sections of the adrenal gland, kidney, renal vein, and ureter. No tumor is identified in the adrenal gland, gonadal vein, or surrounding blood vessels. There is no evidence of tumor thrombus.\n\nThe lesion appears limited to the kidney without definitive invasion into perinephric adipose tissue or renal vein. Although it abuts the renal sinus, no clear invasion of sinus adipose tissue is observed. Margins of resection are free of any abnormal cellular proliferation. Multiple deeper sections were evaluated to confirm these findings. Surrounding tissues, including the gonadal vein specimen measuring 10.0 x 3.0 x 0.3 cm, show no atypical cells or vascular involvement, only minor hemorrhagic changes."} +{"pid": "TCGA-G9-6353", "report": "The prostate specimen weighed 41 grams and measured 5.0 cm in width from right to left, 4.0 cm from anterior to posterior, and 2.3 cm from apex to base. The capsule was tan-pink, smooth, and intact. Ink colors were applied to different regions: orange (anterior), black (posterior), red (apex), blue (base), green (right), and yellow (left). After removing the apex and base, the remaining prostate weighed 22 grams. Serial sectioning revealed firm, tan fibrous parenchyma without visible lesions or nodules.\n\nAttached bilateral seminal vesicles and vas deferens were present. The right seminal vesicle measured 4.0 x 2.0 x 1.0 cm and the left measured 5.0 x 2.6 x 1.0 cm; both showed beige-tan cystic tissue without gross tumor involvement. The right vas deferens measured 2.5 x 0.4 cm and the left 3.2 x 0.5 cm, both showing firm tan tubular structures with no visible tumor.\n\nTissue sampling included Levels I and III for procurement. Additional sections included areas from both sides covering apex, mid, and base regions, as well as surrounding tissues including surgical margins and capsules. Bilateral seminal vesicles and vas deferens were also sampled.\n\nHistologic evaluation identified epithelial changes in bilateral prostate tissue extending from apex to mid zones. High-grade prostatic intraepithelial neoplasia was noted. Perineural invasion was present. No vascular or lymphatic invasion was identified. There was involvement of periprostatic fat on the right posterior mid region (section A5, level 2). Surgical margin involvement was identified focally on the right mid prostate (A4), within 1\u201310 mm. No tumor involvement was seen in bilateral seminal vesicles.\n\nThe staging classification was pT3a, with no lymph nodes sampled. Additional findings included benign prostatic hyperplasia."} +{"pid": "TCGA-BH-A0DD", "report": "The specimen from a sentinel lymph node biopsy of the right axilla shows involvement of one lymph node. A focus of involvement measures 3.0 cm in greatest diameter within the lymph node, with extracapsular extension identified measuring 0.2 cm. \n\nIn the left breast following simple mastectomy, there is epithelial hyperplasia present. The breast tissue is predominantly adipose, and both skin and nipple show no remarkable findings upon histological examination.\n\nA separate specimen from a modified radical mastectomy on the right breast demonstrates invasive ductal-type morphology. The lesion measures 3.0 cm in its largest dimension. Histologic evaluation reveals nuclear grade 2 out of 3, with tubule formation score of 3 and mitotic activity score of 3. The combined Nottingham histologic grade is 8 out of 9. There is evidence of a prominent lymphoplasmacytic infiltrate and areas of necrosis. Lymphovascular invasion is present. Ductal carcinoma in situ is not identified. Resection margins are free of involvement. Twenty-two lymph nodes are examined and none show evidence of involvement. \n\nPathologic staging is as follows: T stage p12, N stage pN1a, and M stage pMX. Estrogen and progesterone receptors are positive, and HER2/NEU immunostaining is 2+."} +{"pid": "TCGA-98-7454", "report": "The specimen was received in eight containers. The first container labeled \"#1 - #7 lymph node\" contained multiple pieces of lymphoid tissue measuring 2 x 1.5 x 0.6 cm in aggregate, all submitted for examination. The second container labeled \"#2 - #8 lymph node\" included two pieces of lymphoid tissue measuring 0.6 x 0.5 x 0.4 cm in total, also entirely submitted. The third container labeled \"#3 - #9 lymph node\" consisted of a single piece of lymphoid adipose tissue measuring 0.9 x 0.3 x 0.2 cm, with one lymph node identified. The fourth container labeled \"#4 - #10 lymph node\" contained multiple pieces of lymphoid adipose tissue measuring 2.5 x 2 x 1.5 cm, and multiple lymph node fragments were present. The fifth container labeled \"#5 - #2 lymph node\" included a single piece of soft tissue measuring 0.4 x 0.2 x 0.2 cm, which was entirely submitted. The sixth container labeled \"#6 - #4 lymph node\" held lymphoid adipose tissue measuring 3.5 x 1.2 x 2.3 cm, with multiple possible lymph nodes identified. The seventh container labeled \"#7 - bronchial margin\" contained a single piece of tan-pink soft tissue measuring 0.6 x 0.2 x 0.3 cm, previously submitted for frozen section and now resubmitted for permanent section. The eighth container labeled \"right upper lobe\" included a lung specimen measuring 15 x 7.5 x 3.5 cm, previously incised and partly inked. A lesional area was identified as a well-circumscribed white-tan region with areas of hemorrhage and green-tan exudate, possibly indicating necrosis, measuring 3.5 x 3 x 3 cm. The lesion was located approximately 1 cm from the vascular resection margin, 1 cm from the bronchial margin, and the closest distance to any surgical resection margin was 0.4 cm. No other gross abnormalities were noted upon further sectioning. Representative sections of the lesional area were submitted for microscopic evaluation, including a section previously used for frozen section analysis, now resubmitted in entirety. Microscopic evaluation showed no evidence of tumor involvement in the bronchial margin or surgical margins. All examined lymph nodes were negative for tumor involvement. Tissue immediately beneath the surgical staple line was inked green, and no tumor involvement was found near the surgical staple line or pleura. The histologic grade was moderately differentiated, and no lymph-vascular invasion was identified. The tumor was unifocal, with no evidence of tumor extension into surrounding structures. No treatment effect was observed, and all surgical margins, including the bronchial, vascular, parenchymal, and parietal pleural margins, were free of tumor."} +{"pid": "TCGA-F2-7273", "report": "A biopsy of the liver shows bile stasis with mild inflammation and the presence of a mesothelial-lined cyst; no malignancy is identified. The common bile duct margin, pancreatic duct margin, portal lymph nodes, and hepatic artery lymph nodes all show no evidence of carcinoma. A cholecystectomy specimen reveals chronic cholecystitis without gallstones.\n\nA Whipple procedure specimen includes a distal stomach measuring 7.5 x 5 cm, greater omentum attached to the stomach (11 x 4.5 x 1.5 cm), duodenum measuring 24 cm in length x 2.5 cm in diameter, and a pancreatic head and neck measuring 6 x 4.5 x 4.5 cm. The pancreatic head is firm and contains a solid, white/tan/yellow mass measuring 4.2 x 4.0 x 4.0 cm. This mass involves peripancreatic soft tissues and extends into the duodenal wall, undermining the mucosa at the ampulla and reaching into the submucosa. Necrotic and cystic changes are noted along the dorsal surface of the pancreas. The tumor constricts the common bile duct lumen to 1\u20132 mm and extends into the ampulla. It does not involve the pylorus.\n\nThe tumor reaches the inked uncinate process margin and the surgical margin at the superior mesenteric artery (SMA) site. It also abuts peripancreatic soft tissue margins. The closest distances to resection margins are as follows: gastric mucosal margin 16 cm, duodenal mucosal margin 13 cm, and common bile duct margin 1.5 cm. Microscopic evaluation confirms involvement of the posterior pancreatic surface margin at the SMA and portal vein sites.\n\nMicroscopically, the lesion demonstrates features of invasive ductal adenocarcinoma with moderate to poorly differentiated morphology and mucinous features. There is invasion into peripancreatic soft tissues, duodenal wall, and ampullary region. Lymphatic invasion is present, as is perineural invasion; venous invasion is not identified. Three regional lymph nodes out of 32 examined contain metastatic disease. No nodal metastases are found in the portal or hepatic artery lymph node groups. Additional findings include chronic pancreatitis with fibrosis at the pancreatic duct margin and hemorrhagic luminal contents in the gallbladder without stones or mucosal lesions.\n\nThe tumor stage is assessed as pT3 pN1 pMx based on available data. Further clinical review may affect staging. Frozen section analysis during surgery confirms the absence of malignancy in the liver biopsy, bile duct, and pancreatic duct margins."} +{"pid": "TCGA-EL-A4JV", "report": "Female patient, surgical case. Gross examination of the right thyroid lobe and isthmus showed a well-circumscribed nodule measuring 2.5 cm in greatest dimension. The nodule was located in the right lobe and was unifocal. The thyroid specimen measured 4.5 x 2.5 x 1.8 cm, with the isthmus measuring 1.5 x 1.0 x 0.8 cm. Histologic evaluation revealed no extrathyroidal extension or lymphovascular invasion. Resection margins were negative. One lymph node from the right side was examined and showed no evidence of tumor involvement. A separate tissue sample from the superior right pole was also free of malignancy. All relevant sections of the specimen were submitted for analysis. No additional clinical history was provided."} +{"pid": "TCGA-DJ-A3VF", "report": "The left neck skin lesion shows intradermal nevus features without evidence of malignancy. A pre-laryngeal level six lymph node specimen includes two lymph nodes, both containing metastatic cells. The largest involved lymph node measures 0.5 cm in diameter, with the largest metastatic focus also measuring 0.5 cm. Tissue outside the lymph node capsule shows signs of tumor extension.\n\nExamination of the total thyroidectomy specimen reveals a nodule in the right lobe measuring 1.0 cm in greatest dimension. The surrounding tissue demonstrates a pronounced stromal response. No mitotic activity or tumor necrosis is observed. The nodule is not encapsulated and extends into adjacent fibroadipose tissue. Surgical margins are clear of tumor involvement. Additional small microscopic changes are noted in the left lobe, with the largest measuring 0.6 mm. The remainder of the thyroid shows benign nodular alterations. No adenomas are identified.\n\nIn the left neck contents at levels three and four, ten lymph nodes are examined, with two showing tumor presence. The largest lymph node affected measures 0.6 cm, with a corresponding metastatic focus of similar size. Extension beyond the lymph node capsule is also present."} +{"pid": "TCGA-D8-A1JB", "report": "Histopathological examination was performed on a resection specimen including the right breast and axillary tissue. The removed breast measured 19.5 x 12 x 4 cm and included a skin flap measuring 15.5 x 4 cm, along with axillary tissues sized 6 x 5 x 3 cm. A lesion measuring 3.0 x 2.1 x 1.3 cm was identified at the boundary of the outer quadrants, located 5.0 cm from the lower margin, 0.1 cm from the base, and 0.5 cm beneath the skin.\n\nMicroscopic evaluation revealed invasive carcinoma with a histological grade of NHG2, based on scoring of mitotic activity (3 + 2 + 1/0 mitoses per 10 high-power fields in a visual area with a diameter of 0.55 mm). Foci of in situ carcinoma were also present both within and outside the main lesion, showing features consistent with ductal architecture, including solid and cribriform patterns, moderate nuclear atypia, comedo-type necrosis, and calcifications, accounting for approximately 10% of the lesion volume. Additional findings included lobular intraepithelial neoplasia.\n\nNon-neoplastic changes in the breast tissue included fibrocystic mastopathy, ductal hyperplasia, sclerosing adenosis, calcifications, and columnar cell alterations. No lesions were identified in the nipple region.\n\nAxillary lymph node dissection included retrieval of eight nodes. Metastatic involvement was identified in one of these nodes, with evidence of capsular and perinodal tissue infiltration.\n\nImmunohistochemical analysis showed that over 75% of neoplastic nuclei expressed estrogen receptors, while progesterone receptors were detected in 10\u201375% of neoplastic nuclei. HER2 immunostaining yielded a score of 2+; however, subsequent FISH testing did not confirm gene amplification. Additional immunophenotyping showed positivity for E-cadherin and negativity for CK7.\n\nStaging was determined as pT2 for the primary lesion and pN1a for regional lymph node involvement."} +{"pid": "TCGA-AA-3970", "report": "The surgical specimen consists of a left hemicolectomy. A lesion is identified with moderate differentiation and invasive growth extending into the pericolic fatty tissue. Another lesion present shows tubulovillous architecture with focal areas exhibiting severe dysplastic changes. The staging for the invasive lesion is G2, pT3 NO (0/27 lymph nodes involved), with no evidence of vascular, lymphatic, or resection margin involvement."} +{"pid": "TCGA-77-6843", "report": "The specimen from the right upper lobe measures 150 x 85 x 50 mm and contains a subpleural mass located 15 mm from the bronchial resection margin. The mass is firm, nodular, and measures 20 mm in diameter on the surface, with a pale, fleshy cut section measuring 27 mm. It is situated near a proximal bronchus but does not involve the bronchial resection margin. Microscopic evaluation shows a poorly differentiated lesion with areas of clear cell change. A possible in situ component is noted in the bronchial region. Focal blood vessel invasion is present, and perineural permeation is identified. There is no lymphatic invasion observed. Pleural invasion cannot be definitively confirmed. Sections from the bronchial margin, hilar and peribronchial lymph nodes, and uninvolved lung tissue were examined. No lymph node metastases are seen in these nodes. A separate specimen of a hilar lymph node includes two pieces, the largest measuring 14 mm, and shows evidence of neoplastic involvement. The tumour demonstrates neuroendocrine markers in some areas, particularly in better-differentiated regions. Staging assessment indicates T1N1MX."} +{"pid": "TCGA-QR-A70C", "report": "The right adrenal specimen received measured 5.5 x 5.0 x 3.0 cm and weighed 48.5 grams. It consisted of a soft, fleshy, tan tissue with multiple areas of hemorrhage. The largest dimension of the lesion measured 5.0 cm. A separate fragment measuring 2.5 x 2.0 x 1.5 cm was obtained for analysis. Adjacent to the lesion, a 1.0 x 1.2 x 0.5 cm portion of normal adrenal tissue was identified, which showed evidence of a prior incision. No tissue was collected from that site. The specimen was inked blue, avoiding prior procedural areas, and sectioned for further evaluation. Representative sections were submitted for microscopic examination. The remaining tissue was preserved in formalin."} +{"pid": "TCGA-73-4675", "report": "A total of nine specimens were examined, including multiple lymph nodes from various levels and a left lower lobe lobectomy specimen. The lymph nodes evaluated included those from levels 4L, 7 (two separate specimens), 2R, 11 (two specimens), 5, and an additional level 11 lymph node. All lymph nodes were described as reactive and showed no evidence of tumor involvement. The left lower lobe specimen measured 17 x 14 x 6.5 cm and contained a central mass measuring 10 x 9 cm located 2 mm beneath the pleura and 1.2 cm from the bronchial margin. The mass had a tan-grey, partially necrotic cut surface. Shave margins of the bronchus were negative. A total of 14 peribronchial lymph nodes were recovered, with 3 showing involvement by cellular material consistent with neoplastic infiltration. Adjacent non-neoplastic lung tissue showed emphysematous changes.\n\nAdditional specimens included a rib fragment, which after decalcification showed no abnormal pathology, and multiple other lymph node aggregates that were unremarkable. Histologic evaluation of the mass revealed well-differentiated cellular features with no angiolymphatic invasion identified. Visceral pleural involvement was present. No satellite lesions were observed. Based on AJCC 7th edition criteria, the staging was determined as pT3, N1, MX."} +{"pid": "TCGA-XF-A8HE", "report": "The surgical specimen included a right ureteral segment measuring 0.7 cm in length and 0.7 cm in external diameter, and a left ureteral segment measuring 0.4 cm in length and 0.4 cm in external diameter. Both specimens showed no evidence of dysplasia or malignant changes. The apical urethral margin consisted of tan tissue measuring 1.0 x 0.7 x 0.4 cm in aggregate and was also free of any atypical or malignant cells.\n\nThe bladder and prostate specimen measured 26.0 x 11.0 x 5.5 cm overall. The bladder itself measured 8.0 x 8.0 x 6.0 cm and contained a soft, friable tan mass located along the posterior wall and extending to the right lateral wall. This lesion measured 7.0 x 7.0 x 3.0 cm and demonstrated extensive involvement of the bladder wall with fibrous septa extending into the perivesical fat. The radial margin was uninvolved. Microscopically, the bladder lesion extended through the muscularis propria into the perivesical fat. No lymphovascular space invasion was identified. Adjacent urothelium on the left lateral wall showed mild to moderate dysplastic changes, but no flat carcinoma was present.\n\nSections of the prostate revealed a distinct glandular process involving the left distal region. The glands infiltrated the fibromuscular stroma without extension into the capsule or surrounding soft tissue. The apical and radial margins, as well as bilateral seminal vesicles and vasa deferentia, were free of involvement. High-grade intraepithelial neoplastic changes were also noted in multiple areas of the prostate.\n\nA total of 77 lymph nodes were examined from various regional sites, including right para-caval (5), right common iliac (12), left para-aortic (7), left common iliac (5), right lymph node of Cloquet (3), right external iliac (5), right obturator/hypogastric (14), left lymph node of Cloquet (2), left external iliac and obturator/hypogastric (14), right pre-sciatic (4), presacral (3), and left pre-sciatic (2) regions. All lymph nodes were negative for metastatic disease.\n\nThe tumor involved the full thickness of the bladder wall and extended into the surrounding fat, while the prostatic involvement appeared more localized. All surgical margins were free of tumor. Immunostaining supported the histologic findings in distinguishing benign from atypical or malignant processes."} +{"pid": "TCGA-YL-A8SA", "report": "The prostate and obturator lymph nodes specimen shows a lesion with acinar growth pattern and an intraductal cribriform component. Histologic grading reveals a Gleason score of 4 + 4 = 8, with a tertiary pattern of 5. The Gleason pattern distribution is as follows: pattern 4 accounts for 95% and pattern 5 for 5%. The lesion is located at the apex, mid, base, posterior, right, and left regions of the prostate. There is evidence of non-focal extra-prostatic extension at the posterior and left aspects. Involvement of the seminal vesicle is present on the left side.\n\nSurgical margins are involved by invasive carcinoma at the posterior and left regions, specifically in areas of intra-prostatic incision. The involvement is multifocal; however, the exact millimetric extent and Gleason grade at the margins are not reported. Lymphovascular invasion is not present, but perineural invasion is identified. The dominant nodule measures 4 x 1.5 x 1.44 cm, with an estimated volume of 8.64 cm\u00b3. No treatment effect is observed.\n\nA total of six right obturator lymph nodes and three left obturator lymph nodes are identified, none of which show metastatic involvement. Additional findings include the presence of an intraductal cribriform component confirmed by immunohistochemistry showing basal cell positivity with CK903. Pathologic staging indicates pT3b, pNO, and pMX."} +{"pid": "TCGA-C5-A3HL", "report": "The pathology report describes a gynecologic specimen received in eight containers, labeled and processed for histologic evaluation. The uterus, cervix, bilateral tubes and ovaries were submitted along with vaginal margin tissue and multiple lymph node groups from both sides.\n\nThe uterus weighed 109 grams and measured 9.0 cm in length x 4.5 cm cornu to cornu x 3.0 cm anteroposteriorly. The cervical tumor measured 5.2 cm in maximum horizontal dimension and extended into the cervical wall with a maximal depth of invasion of 0.9 cm, within a total cervical thickness of 1.1 cm. The tumor was located 1.1 cm from the anterior vaginal cuff margin. The endometrial cavity was involved inferiorly by tumor extension. The myometrium was up to 1.0 cm thick in areas not affected by tumor infiltration.\n\nParametrial soft tissues showed no evidence of malignancy bilaterally. Both ovaries and fallopian tubes demonstrated no malignant involvement. Chronic endometritis was noted in the endomyometrial tissue. The serosal surface of the uterus exhibited adhesions posteriorly but was free of tumor involvement.\n\nThe vaginal margin specimen measured up to 4.0 cm in greatest dimension and appeared free of tumor involvement upon microscopic examination.\n\nLymph nodes were dissected from multiple pelvic regions: right external iliac (2 nodes), right obturator (6 nodes), right common iliac (2 nodes), left external iliac (1 node), left obturator (9 nodes), and left common iliac (1 node). All lymph nodes examined showed no evidence of malignancy.\n\nMargins of resection, including the vaginal cuff and parametrial tissues, were free of tumor. No lymphovascular space invasion was identified. Histologic grade of the lesion was moderately differentiated. Tumor did not extend into the vagina or involve contiguous parametrial tissues beyond the cervical wall.\n\nA total of 21 lymph nodes were evaluated and none contained metastatic disease. Based on these findings, there was no evidence of regional nodal involvement. Distant metastasis could not be assessed based on this specimen alone.\n\nMicroscopic evaluation confirmed the adequacy of tissue sampling and margins. Intraoperative consultation confirmed the presence of a deeply invasive endocervical lesion during surgical exploration."} +{"pid": "TCGA-VQ-AA6F", "report": "The specimen consists of a resected portion of the esophagus and stomach. A moderately differentiated adenocarcinoma with ulceration was identified in the cardia region, characterized by infiltration into the serosa. Perineural and lymphatic invasion were both present. The adjacent gastric mucosa showed moderate chronic gastritis with lymphoid follicle formation, while the esophageal mucosa exhibited mild chronic inflammation. All surgical margins were free of neoplastic cells. Metastatic involvement was found in one of the fourteen lymph nodes examined."} +{"pid": "TCGA-KO-8405", "report": "A segment of the 11th rib was submitted for gross inspection only. A partial nephrectomy specimen from the left mid kidney measured 9.0 x 7.0 x 3.5 cm. A lesion measuring 4.5 x 4.2 x 4.0 cm was identified, with a yellow-brown to mahogany, lobulated surface and areas of hemorrhage and central scarring. The nearest margin was 0.5 cm from the lesion. Microscopically, the lesion focally extended into perinephric adipose tissue. All resection margins, including parenchymal and soft tissue margins, were free of tumor. Additional tissue samples from the inferior margin, inferior/lateral, lateral, superior, superior/lateral, deep/medial, and deep/lateral regions of the left kidney were all negative for tumor. The left adrenal gland and six lymph nodes from the left periaortic region were also free of tumor. Histologic evaluation of the lesion showed cells with eosinophilic, granular cytoplasm and perinuclear halos. Immunohistochemical staining showed strong and diffuse positivity for cytokeratin 7, negativity for vimentin, and CD10 staining showing predominantly cytoplasmic and focally membranous pattern. Electron microscopy revealed numerous intracytoplasmic vesicles and occasional mitochondria with tubular cristae. Multiple representative sections of the lesion and surrounding normal kidney tissue were submitted for analysis."} +{"pid": "TCGA-5P-A9K0", "report": "The specimen measured 3.6 cm in diameter and exhibited well-differentiated cellular features. Histological evaluation revealed no tumor involvement in the surrounding kidney parenchyma. Pathological staging was determined as pT1a, with no assessment for nodal or metastatic involvement (pNX, pMX). Surgical margins were negative (RO). The nuclear grade was classified as GII. Microscopic examination showed papillary architecture with characteristic cellular morphology."} +{"pid": "TCGA-EJ-5497", "report": "The patient is a male with a history of a PSA value of 7.2, prior surgery for deviated septum and sleep apnea, and previous Botox injections for hyperhidrosis. He had undergone a biopsy that revealed unilateral poorly differentiated prostate lesion involving the left thigh.\n\nA radical prostatectomy was performed. Examination of six right pelvic lymph nodes and four left pelvic lymph nodes showed no evidence of neoplasia.\n\nThe prostate specimen weighed 72.98 grams and included bilateral seminal vesicles and bilateral distal vasa deferentia. Histologic analysis identified a lesion with a Gleason score of 3 + 4 = 7. The lesion involved both the right and left sides of the prostate and measured up to 2.0 cm in its largest dimension in one section. Approximately 10% of the examined prostate volume was involved by the lesion.\n\nThe lesion was confined within the organ without evidence of extension beyond the prostate capsule. Both seminal vesicles and distal vasa deferentia were free of involvement. All surgical margins were clear of tumor. Multifocal perineural invasion was observed, but no angiolymphatic invasion was identified. There was also multifocal high-grade intraepithelial neoplasia present.\n\nPathologic staging was determined as pT2c with no regional lymph node involvement (pN0) and no assessment of distant metastasis (pMX). The histologic grade was classified as G3\u20134, consistent with poorly differentiated morphology. A total of 10 lymph nodes were examined, none of which showed signs of involvement."} +{"pid": "TCGA-BA-6869", "report": "Biopsy specimens from the left and right pharyngeal mucosal margins and the inferior margin all demonstrated squamous mucosa with submucosal chronic inflammation or lymphoid tissue. No abnormal cellular changes were identified in these samples.\n\nA total of 75 lymph nodes were evaluated across bilateral cervical regions (Levels 2 through 5). Specifically, 18 lymph nodes from right cervical Levels 2 and 5, 15 from right Level 3, 11 from right Level 4, 7 from left Level 3, 12 from left Level 4, and 12 from left Levels 2 and 5 were examined. None showed evidence of metastatic disease.\n\nThe surgical specimen consisted of a total laryngectomy with inclusion of the base of the tongue and anterior soft tissues. Grossly, the lesion appeared tan/white, fungating, firm, and ulcerated, located bilaterally within the supraglottic region. The measured dimensions of the lesion were 4.1 x 3.2 x 2.5 cm. Microscopic evaluation revealed invasive cellular proliferation involving the bilateral supraglottis, including false cords and the anterior commissure, with extension into the base of the tongue and involvement of pre- and paraepiglottic spaces. There was no observed invasion of thyroid cartilage or hyoid bone. Carcinoma in situ was present but did not involve any margins. Surgical margins were negative; however, the closest distance from the lesion to a margin was less than 1 mm at the right lateral soft tissue margin, with a distance of 1.5 mm at the left lateral soft tissue margin. Additional findings included moderate dysplasia of the right tongue mucosa and focal lingual thyroid tissue.\n\nLymph node assessment within the surgical specimen revealed five lymph nodes, all without evidence of metastatic involvement. Immunohistochemical staining for lymphovascular invasion was negative.\n\nStaging parameters indicated pT3 classification based on tumor size and extent, with no nodal involvement (pN0). Distant metastasis could not be confirmed (pMx). These staging details are provisional and subject to revision pending further clinical correlation.\n\nMultiple biopsies taken intraoperatively from pharyngeal and inferior margins showed no evidence of tumor involvement."} +{"pid": "TCGA-27-2523", "report": "Birth date. Tumor site. Right frontal pre-rolandic. Histological diagnosis. A high-grade neoplasm was identified, characterized by marked cellular pleomorphism, frequent mitotic figures, and areas of necrosis. The tumor exhibited infiltrative growth with perineuronal satellitosis. Immunohistochemical staining showed positivity for glial markers. The lesion demonstrated features of aggressive behavior and extensive proliferation."} +{"pid": "TCGA-AC-A2BM", "report": "The surgical pathology report includes examination of multiple specimens from a left-sided breast procedure. Specimen A, identified as a left sentinel lymph node, measured 2.5 x 1.5 x 0.9 cm and showed involvement with two metastatic foci, the larger measuring 0.6 cm. The tumor was confined to the lymph node. Specimen B, another left sentinel lymph node measuring 3 x 2 x 1.1 cm, showed no evidence of malignancy. Specimen C consisted of left breast tissue obtained via mastectomy. The specimen measured 28 x 23.5 x 50 cm and weighed 1559 grams. Within this specimen, an irregular firm lesion measuring 2.5 x 2 x 1.5 cm was identified between the upper-inner and lower-inner quadrants, approximately 1 cm from the nipple and located 3 cm from the deep margin. Histologic evaluation revealed a high-grade lesion with tubular score 3, nuclear score 3, and mitotic score 3. A total of 13 lymph nodes were examined, with one involved node identified. Margins were negative for invasive carcinoma. No lymphovascular invasion, ductal carcinoma in situ, Paget\u2019s disease, or distant metastasis was identified. Additional findings included fibroadenomas and microcalcifications were absent. Estrogen receptor staining showed positivity in 60% of malignant cells while progesterone receptor staining showed positivity in 10%. HER2 testing by FISH demonstrated a ratio of 1.4 without amplification. Specimen D, representing left axillary contents, contained ten lymph nodes, all negative for malignancy. Gross examination of axillary tissue revealed 11 lymph nodes ranging from 0.4 to 2.3 cm in size. Microscopic evaluation confirmed absence of malignancy in these nodes. All margins were clear and immunohistochemistry controls were adequate. Clinical staging was determined as pT2 pN1a pMX."} +{"pid": "TCGA-AR-A0TP", "report": "The specimen consists of a left breast wide local excision. A mass measuring 3 x 0.3 x 2.5 cm is present. Histologic evaluation shows high-grade features with a significant invasive component. Less than 10% of the lesion demonstrates non-invasive elements. No evidence of vascular invasion is observed. The staging classification based on tumor size is consistent with pT2. Surgical margins are clear of abnormal tissue. \n\nSentinel lymph node evaluation was performed on two left axillary nodes, both of which show no presence of abnormal cells and do not contain blue dye. Additional immunostaining with cytokeratin supports the absence of suspicious involvement in these nodes. Three further left axillary lymph nodes were also assessed and found to be without any abnormal findings."} +{"pid": "TCGA-AO-A12C", "report": "A 47-year-old female underwent a segmental resection and sentinel lymph node biopsy (SLNB) of the left axilla. Submitted specimens included four sentinel lymph nodes from level I of the left axilla, axillary contents from levels I, II, and III, additional level III nodes, and a left breast mass identified via mammographic localization.\n\nSentinel lymph node #1 contained metastatic disease with extranodal extension greater than 2 mm. Sentinel lymph node #2 showed a tumor embolus within a perinodal lymphatic vessel but no nodal involvement. Sentinel lymph nodes #3 and #4 were both benign. In level I of the axillary dissection, one of three lymph nodes was involved by metastasis; levels II and III contained 18 and 6 benign nodes respectively. No lymph nodes were identified in the additional level III specimen, which consisted primarily of adipose tissue with lymphoid aggregates.\n\nThe left breast specimen measured 9.5 x 8.0 x 5.3 cm and contained two palpable masses. The larger mass measured 2.5 cm and was located centrally near the anterior margin; the smaller mass measured 1.4 cm and was adjacent to the medial margin. Histologically, multiple foci of invasive carcinoma were identified, ranging from 0.1 cm up to 2.5 cm in size. Two dominant foci measured 1.4 cm and 2.5 cm grossly. Several small areas of in situ carcinoma were also present, displaying solid and cribriform patterns with intermediate nuclear grade. Vascular invasion was prominent.\n\nMargins were evaluated microscopically: invasive carcinoma was found at the lateral margin (0.6 cm), inferior margin (0.8 cm), anterior margin (0.5 cm), and posterior margin (0.2 cm). Lymphatic tumor emboli were also observed at the margins. There was no involvement of DCIS at the surgical margins. Biopsy site changes were noted.\n\nImmunohistochemical staining showed strong estrogen receptor positivity (95% moderate intensity), weak to moderate progesterone receptor staining (40%), and HER-2 positivity (3+ intensity)."} +{"pid": "TCGA-CZ-5459", "report": "The specimen consists of a radical nephrectomy measuring 19.5 x 2.0 x 4.5 cm. The ureter is 1.0 cm in length and 0.5 cm in diameter. The renal artery measures 0.9 cm in length and 0.5 cm in diameter, while the renal vein measures 1.1 cm in length and 2.2 cm in diameter. An adherent yellow/black/red thrombus is present within the renal vein. A well-circumscribed, multinodular, focally cystic mass measuring 4.5 cm x 2.5 cm x 2.4 cm is identified within the kidney. The tumor exhibits an orange/yellow/tan cut surface and is located adjacent to the renal vein with close association to the thrombus. There are areas suggestive of involvement of the renal pelvis adipose tissue. Grossly, there is no evidence of penetration through the renal capsule. Gerota\u2019s fascia is freely mobile and inked black. No lymph nodes or adrenal gland tissue are identified within the perirenal fat.\n\nHistologically, vascular and ureteral margins are free of tumor involvement. Microscopic evaluation confirms presence of tumor extending into the main renal vein but does not reveal lymphovascular invasion. Nuclear grading according to Fuhrman classification is grade 3 out of 4. Representative sections of tumor have been submitted for tissue banking, cytogenetics, and additional studies. Sections of normal kidney tissue were also submitted for tissue bank, electron microscopy, and immunofluorescence analysis.\n\nCytogenetic analysis demonstrates clonal chromosomal aberrations including loss of the short arm of chromosome 3 in all analyzed metaphases. These findings were detected using GTG banding at a resolution level of 400 bands or greater. Approximately 10\u201315% of cortical parenchyma shows tubular atrophy and interstitial fibrosis. Moderate sclerosis is observed in arteries and arterioles.\n\nStaging classification according to AJCC (6th Edition) criteria is T3b Nx MX."} +{"pid": "TCGA-B6-A0RV", "report": "The pathology report describes a modified radical mastectomy specimen from a female patient. The specimen weighed 630 grams and measured 25 x 16.5 x 3.6 cm. The overlying skin ellipse measured 15.3 x 10.6 cm, with an areola measuring 6.8 cm in diameter and a nipple measuring 1.5 cm. Serial sectioning identified a large, white/light yellow lesion measuring 12 x 9.5 x 4 cm, which exhibited infiltrative growth and focal calcifications. This lesion was located approximately 0.5 cm from the superior margin, 1.5 cm from the inferior margin, 0.1 cm from the deepest margin, and 3 cm from the axillary appendage. Hemorrhage was noted in the subcutaneous tissue of the breast.\n\nAxillary dissection revealed multiple enlarged lymph nodes, with the largest measuring up to 2.4 cm. Sections were taken from various regions including quadrants of the breast, skin, nipple, and lymph node levels. Microscopic evaluation showed presence of invasive disease involving all quadrants of the breast with multifocal distribution. In addition, in-situ changes were identified in about 5% of the sampled tissue. Extensive intraductal involvement was not observed.\n\nNon-neoplastic findings included fibrocystic changes with intraductal hyperplasia, ductal ectasia, and apocrine metaplasia. Vascular or lymphatic invasion was identified in one block. Surgical margins were free of malignant involvement. There was no evidence of Paget\u2019s disease in the nipple or involvement of the skin or muscle. Metastatic involvement was detected in five out of ten lymph nodes, with extracapsular extension noted in at least one lymph node. Microcalcifications were associated with the lesion.\n\nHormone receptor analysis performed on fresh tissue showed positivity for both estrogen and progesterone receptors, with values of 95 fmol and 90 fmol respectively. Additional studies including cell cycle analysis were pending at the time of reporting."} +{"pid": "TCGA-BT-A42E", "report": "The surgical specimen included multiple lymph nodes from the left and right pelvic regions, all of which were benign and showed no evidence of malignant involvement. The urethral margin revealed benign urothelium with reactive changes and benign prostatic tissue. The cystoprostatectomy specimen showed a large lesion located in the posterior to right lateral wall of the urinary bladder. The lesion measured 6.5 cm in greatest dimension and was composed of high-grade papillary architecture with areas showing solid and flat configurations. The tissue demonstrated features of squamous differentiation and extensive biopsy-related changes. The lesion extended through the detrusor muscle into the surrounding perivesical soft tissue. All surgical margins were free of involvement. No lymphovascular invasion was identified. A total of five lymph nodes were examined and showed no evidence of involvement. Additional findings included low-grade urothelial dysplasia and therapy-related changes."} +{"pid": "TCGA-19-5958", "report": "The specimen consisted of three tissue samples submitted for analysis. The first sample, received fresh and measured 0.6 x 0.3 x 0.3 cm, was composed of soft, tan-white tissue. A touch imprint was performed and a portion was submitted for frozen section. The remainder was processed in two cassettes. The second sample, fixed in formalin, measured 5.8 x 3.6 x 1.9 cm in aggregate and consisted of multiple irregular, tan-brown, soft cerebriform fragments. Representative sections were submitted in three cassettes. The third sample, post-fixed in formalin, measured 4.2 x 4.2 x 1.0 cm in aggregate and included multiple irregular, opaque white to pink-tan, soft cerebriform fragments. Representative sections were also placed in three cassettes. Microscopic evaluation revealed cellular features including microvascular proliferation and coagulative necrosis. Tissue from each site was examined and representative material was submitted for analysis."} +{"pid": "TCGA-FB-AAPU", "report": "The Whipple specimen includes a duodenum measuring 19 cm in length and 2.5\u20133.5 cm in diameter, with both ends stapled closed. The serosal surface is smooth and tan-pink, with black inked stapled margins. Upon opening, a stent is noted in the ampulla. A 1.5 x 1 cm area of flattened mucosa with an underlying palpable, indurated mass is identified 3 cm proximal to the ampulla. The proximal duodenal margin is fully removed en face for frozen section and resubmitted entirely.\n\nThe pancreas measures 5.8 x 4 x 4 cm. The neck margin is inked blue and the radial margin is inked black. On sectioning, an ill-defined, indurated mass measuring 4 x 3.8 x 3 cm is present in the head of the pancreas. The mass appears white-yellow with clear, tan, mucinous-filled cystic spaces. It is located 0.6 cm from the neck margin, approximately 0.2 cm from the ampulla, and within 1 cm of the bile duct margin. It also extends close to the black-inked radial margin and grossly reaches the proximal duodenal margin near the pancreas head. The mass surrounds the main pancreatic and common bile ducts, although both remain patent through the ampulla. The common bile duct contains a blue stent and enters the duodenum via adjacent but separate ductal ampullae. The bile duct at the margin is dilated to 1 cm in diameter, and the pancreatic duct at the neck margin is dilated up to 0.6 cm. Sectioning reveals that the mass extends into the muscularis of the duodenum and is associated with a fluid-filled space measuring 1.4 cm beneath the flattened mucosa.\n\nExamination of the peripancreatic fat reveals 14 possible lymph nodes ranging from 0.3 to 1.2 cm in size. Additionally, a structure measuring 4.2 x 3.2 x 0.6 cm is noted, possibly a lymph node or splenule. All identifiable lymphoid tissue has been submitted for analysis, including representative sections of the largest lymph node or splenule.\n\nMicroscopic evaluation shows a lesion involving the pancreas and duodenum. The lesion measures 4 cm in greatest dimension and extends through the muscularis propria of the duodenum into the surrounding fat. It reaches the pancreatic neck margin and the proximal duodenal margin. The closest distance to the portal vein margin and radial margins is 0.1 cm. Perineural invasion is present, but there is no evidence of angiolymphatic invasion. Twelve regional lymph nodes are examined, none showing involvement. The main pancreatic duct at the neck margin is dilated up to 0.6 cm, and the bile duct at the margin is dilated to 1 cm."} +{"pid": "TCGA-FE-A236", "report": "The specimen consisted of a total thyroidectomy with left central neck contents, weighing 31.9 grams and measuring 8.0 x 5.0 x 2.5 cm. The left lobe demonstrated an irregular, ill-defined area of grayish, firm tissue with cystic and hemorrhagic changes, measuring 3.5 x 3.0 x 2.5 cm. This lesion exhibited infiltrative borders but did not grossly\u4fb5\u72af the thyroid capsule or extend into the isthmus or contralateral lobe. A separate microscopic focus, 2 mm in greatest diameter, was identified in the right lobe. No invasion of thyroid cartilage or adjacent structures was observed.\n\nHistologic evaluation revealed a low-grade lesion without lymphatic or vascular invasion. The tumor was confined to the thyroid gland. Adjacent thyroid parenchyma appeared normal.\n\nLymph node assessment included four small perithyroidal lymph nodes, all involved with subcapsular metastatic deposits. Additionally, one lymph node from the left central neck dissection contained cystic metastatic involvement. No extranodal extension was noted.\n\nA separate fragment of adipose tissue submitted for evaluation showed no evidence of parathyroid tissue. Another small fibroadipose specimen interpreted as a possible parathyroid gland was also devoid of parathyroid tissue.\n\nStaging was determined as pT2N1Mx based on these findings. Multiple tissue fragments were submitted for microscopic examination, including sections from both lobes, isthmus, and surrounding adipose tissue. All surgical margins were assessed and no residual involvement was documented in the submitted tissues."} +{"pid": "TCGA-HC-A6AO", "report": "The prostate specimen measured 5.0 x 4.5 x 4.5 cm and weighed 38 grams. On sectioning, the cut surface showed yellow to gray tan fibrous tissue with yellow tan gritty areas involving both posterior lobes, primarily at the apex and base. No other lesions were identified. Histologic evaluation revealed a lesion with a primary pattern score of 4 and a secondary pattern score of 3. The total volume of the lesion accounted for approximately 5% of the gland. High grade intraepithelial neoplasia was present. The extent of the lesion was bilateral. No extracapsular extension, seminal vesicle involvement, lymphovascular space invasion, or perineural invasion was observed. All surgical margins were uninvolved. No treatment effect was identified. A total of sixteen tissue blocks were submitted for microscopic examination, including sections from the apex to base of the prostate and both seminal vesicles. Lymph node assessment was not performed as no lymph nodes were received. No other significant findings were noted."} +{"pid": "TCGA-CK-5916", "report": "The specimen labeled \"Right colon\" consists of a partial colectomy specimen including terminal ileum measuring 8 cm in length and 3.1 cm in diameter, colon measuring 27 cm in length and 4.5 cm in diameter, and an appendix measuring 4.5 cm in length and 0.5 cm in diameter. The proximal and distal stapled resection margins measure 4.1 cm and 4.6 cm, respectively. A red/tan ulcerating necrotic mass measuring 11.8 x 5.5 x 5.0 cm is present at the ileocecal valve with raised, rolled borders. The mass extends through the wall into the pericolonic fat and may involve the appendix. It is located 8 cm from the proximal resection margin and 23 cm from the distal resection margin. A small tan mucosal polyp measuring 0.4 x 0.3 x 0.2 cm is identified 5.5 cm distal to the mass, located 18 cm from the distal resection margin and 17 cm from the proximal resection margin. The remaining colonic and ileal mucosa appear normal, though some flattened folds are noted adjacent to the mass. Multiple lymph nodes ranging from 0.5\u20131.5 cm in size are present; some are tan/white and indurated, while others are tan/pink and rubbery. Histologically, the lesion shows poor differentiation with neuroendocrine and signet ring cell features, along with focal mucin production. The tumor extends through the muscularis propria and involves the visceral peritoneum. Resection margins are uninvolved. Lymphovascular invasion is present. One out of thirty-two lymph nodes contains malignant cells. No clinical history was provided. The procedure performed was a right colectomy."} +{"pid": "TCGA-EA-A5ZF", "report": "The cervix specimen measures 1.5x1x0.8 cm and is firm with a white-gray surface. Microscopically, the tissue shows hyperplastic cells infiltrating into the muscle layer. The tumor cells are arranged in groups or trabeculae, with abundant, lightly eosinophilic cytoplasm. Nuclear features include enlargement, variation in size and shape, coarse chromatin, and prominent nucleoli. Mitotic figures are observed. The stroma shows lymphocytic infiltration. The lesion is less than 4.0 cm in size and extends into the inner portion of the muscle layer. Lymphatic invasion is present. The specimen was obtained via hysterectomy. No information is available regarding lymph nodes, venous invasion, margins, or neo-adjuvant treatment."} +{"pid": "TCGA-G3-A5SJ", "report": "The surgical pathology report includes specimens from the gallbladder and liver. The gallbladder is intact, measuring 8.8 x 3.2 x 2.7 cm, with a slightly roughened serosal surface. Green bile is present within the lumen without calculi. The cystic duct is patent, and the mucosa appears velvety with a wall thickness averaging 0.2 cm. No cystic duct lymph node is identified. Sections of the gallbladder are submitted for analysis.\n\nThe liver specimen is a segmental resection measuring 7.3 x 3.8 x 3.3 cm. The capsular surface is mostly smooth with a focal raised grey-tan oval area measuring 3.0 x 1.7 cm. The resection margins are marked with blue ink. Upon sectioning, a well-circumscribed grey-tan ovoid mass is identified measuring 2.3 x 2.2 x 1.5 cm. It corresponds to the capsular lesion and approaches closest to the resection margin at a distance of 1.3 cm. No other lesions are observed grossly.\n\nMicroscopically, the liver lesion demonstrates a relatively circumscribed but lobulated unencapsulated tumor in a subcapsular location. The tumor exhibits heterogeneity with areas of well-differentiated morphology alongside regions showing significant nuclear pleomorphism and mitotic activity. Cellular arrangement is predominantly in sheets, with some patchy gland-like rosettes and trabecular architecture. Immunostaining reveals patchy HepPar1 positivity, distinct canalicular staining with CD10, focal canalicular pattern with CEA, and patchy CK19 staining. PAS staining shows focal positivity in microglandular lumina. No vascular invasion is identified.\n\nThe surrounding liver parenchyma demonstrates active chronic inflammation with lymphoid follicle formation in portal tracts. Portal expansion and portal-portal fibrous bands are noted without complete nodule formation. Occasional interface hepatitis is seen focally. Lobular inflammation is minimal. Mild macrovesicular steatosis is present without other abnormal inclusions.\n\nThe tumor is histologically graded as moderately differentiated. No vascular invasion is detected. The primary tumor staging indicates a solitary lesion without vascular invasion. The regional lymph nodes and distant metastasis cannot be assessed. Parenchymal margins are free of invasive carcinoma, with the tumor located 13 mm away from the closest margin."} +{"pid": "TCGA-BR-A4J6", "report": "The specimen includes a portion of the stomach along with part of the esophagus. A plate-like lesion is present in the cardia region, measuring up to 7.5 cm in diameter, with extension into the perigastric fat. Multiple enlarged lymph nodes are identified within the fatty tissue along the greater and lesser curvatures. The omentum contains several small nodes, up to 1 cm in size. Two additional fragments of fatty tissue show no macroscopic abnormalities. The surgical margins do not display any notable macroscopic features.\n\nMicroscopically, the lesion shows moderate differentiation and invades the perigastric fatty tissue. There is evidence of spread beneath the squamous epithelium of the esophageal wall. The surgical margins are free of tumor involvement. Lymph nodes, including those separately submitted, exhibit reactive changes only. The omentum appears hyperemic. No venous invasion is observed, and the lesion displays an ulcerated appearance. The staging indicates the extent of the lesion reaches the subserosa, with no lymph node metastases identified out of 10 examined. The status of lymphatic and perineural invasion could not be specified. No evidence of prior neoadjuvant treatment is seen. Additional findings note the presence of the lesion extending into the esophageal wall beneath the squamous epithelium."} +{"pid": "TCGA-EI-6884", "report": "A histopathological examination was performed on a resected specimen consisting of the rectum and sigmoid colon, measuring 21.3 cm in length, along with mesorectal tissue measuring 2 cm in thickness. A mucosal lesion was identified, measuring 3.3 x 3.4 x 0.7 cm macroscopically, and 2.6 x 1.8 x 0.6 cm in size. The lesion circumferentially involved the intestinal wall, leading to significant luminal narrowing. It was located 12.7 cm from the proximal resection margin and 3.6 cm from the distal margin.\n\nMicroscopic evaluation revealed a moderately differentiated gland-forming neoplasm with infiltration into the perirectal fat. Surgical margins were free of neoplastic involvement. Regional lymph node involvement was present. The tumor extended through the muscularis propria into the surrounding tissue. No residual tumor was detected at the resection margins. The lesion showed features consistent with a certain degree of cellular differentiation and architectural distortion."} +{"pid": "TCGA-DX-A6YS", "report": "The specimen consists of a resected portion of soft tissue and skin from the left buttock, measuring 16.5 x 15.5 x 10.5 cm, with an overlying ellipse of skin measuring 17.5 x 3.7 cm. A lobulated tan mass is identified within the deep muscle, measuring 6.5 x 5.8 x 4.8 cm. The mass is predominantly viable with focal areas of necrosis. It is located 3.5 cm from the skin surface, 0.6 cm from the deep soft tissue margin, and 1.0 cm from the nearest medial soft tissue margin. The tumor is greater than 3 cm from the additional margins. All surgical margins are free of tumor involvement. The specimen was inked for orientation, and sections were submitted for further analysis. Multiple blocks were taken from the tumor and surrounding margins, including deep, inferior, lateral, medial, superior, and skin sections."} +{"pid": "TCGA-BP-5194", "report": "The specimen consists of a wedge-shaped portion of kidney measuring 5.0 x 4.0 x 3.8 cm, labeled as right renal tumor with a suture marking the deep margin. Serial sectioning revealed an orange-yellow mass with areas of hemorrhage and necrosis measuring 3.5 x 3.0 x 3.0 cm. The distance from the tumor to the resection margin is 0.2 cm. A representative section of the nearest margin was submitted for intraoperative frozen section analysis, which showed no tumor at the margin. Representative sections of the tumor were submitted for further study.\n\nMicroscopic examination demonstrated cells arranged in nests and sheets, with clear cytoplasm and well-defined cell borders. Nuclear features were consistent with moderate atypia, with nuclei showing slight variation in size and shape. Mitotic activity was not prominent. No evidence of local invasion or renal vein involvement was identified. Surgical margins were free of tumor. Non-neoplastic kidney tissue appeared unremarkable. No adrenal tissue or lymph nodes were present in the specimen.\n\nThe tumor measured 3.5 cm in greatest dimension and was confined within the kidney. No extension beyond the organ was observed."} +{"pid": "TCGA-B8-5551", "report": "The right laparoscopic nephrectomy specimen weighed 700 grams and measured 26.5 x 14 x 8.7 cm, including an 11.7 x 8 x 6 cm kidney with attached perinephric fat and a 4 cm segment of ureter. The tumor was located on the lateral aspect of the posterior mid-section of the kidney, midway between the superior and inferior poles. It was circumscribed, lobulated, and variegated in appearance with tan/red to brown/gray coloration, showing multiple small extensions into the surrounding parenchyma. The lesion measured 5.4 x 4.3 x 4.0 cm and appeared confined within the kidney despite causing significant expansion of the renal capsule. Gross evaluation indicated no involvement of perirenal adipose tissue, Gerota\u2019s fascia, renal vein, or ureter. The overlying perinephric fat was freely movable.\n\nMicroscopic examination revealed cells arranged in a characteristic pattern with nuclear features corresponding to grade 3 (on Fuhrman classification). No sarcomatoid differentiation was identified. Histologic evaluation of the surgical margins showed no tumor involvement at the perinephric adipose tissue margin, which was within 0.2 cm of the tumor. Renal vein, renal artery, and ureter margins were negative. The tumor was unifocal and did not show multicentricity. No invasion of lymphatic or venous structures was observed. No hilar lymph nodes were identified.\n\nAdditional findings included patchy chronic interstitial nephritis, fibrosis, and tubular atrophy in the surrounding kidney tissue. The renal parenchyma away from the tumor was gray-tan and homogeneous with an average cortical thickness of 0.8 cm. The pelvic urothelium and ureter appeared normal.\n\nStaging based on available data is pT1b for tumor size greater than 4 cm but confined within the kidney; nodal and metastatic staging could not be determined due to limited clinical information. Tissues submitted for further analysis included tumor and adjacent renal parenchyma, hilar fat, and resection margins. The case was reviewed by the attending pathologist who confirmed all findings."} +{"pid": "TCGA-BB-4227", "report": "The pathology report includes multiple specimens collected during a laryngopharyngectomy, right hemithyroidectomy, and neck dissection. One lymph node and associated fibroadipose tissue from the left level 3, as well as squamous mucosa from all four pharyngeal margins (left superior, left inferior, right superior, and right inferior), were negative for tumor. The right level 1 lymph node specimen included one lymph node, salivary gland, and fibroadipose tissue, all negative for tumor. In the right neck level 2B dissection, five lymph nodes and associated fibroadipose tissue were also negative. The right neck levels 3 and 4 dissection included fourteen lymph nodes, all without evidence of tumor.\n\nThe primary lesion was located in the hypopharynx (pyriform sinus) and measured 8.5 cm grossly. Histologically, the lesion showed features of squamous cell morphology with focal sarcomatoid changes and necrosis. The histologic grade was moderate to poorly differentiated. A total of twenty-five ipsilateral lymph nodes were examined, with two containing metastatic disease confined to level 2. The largest metastatic focus measured 4 cm grossly, and extranodal extension was present.\n\nSurgical margins were involved, with invasive carcinoma identified at the right superior margin. In addition, invasive carcinoma was within less than 1 mm of the right anterior, right lateral, and right posterior inked margins. Perineural invasion was observed, while venous or lymphatic invasion could not be definitively determined. Additional findings included focal in situ changes and lymphocytic thyroiditis. Extranodal extension was noted in the involved lymph nodes."} +{"pid": "TCGA-26-1443", "report": "The specimen consists of two tissue samples from a left frontal brain lesion. The first sample (A) measures 3.5 x 2.0 x 1.0 cm and is composed of an aggregate of red-tan to beige soft tissue pieces. A representative portion was used for frozen section analysis, which showed features consistent with a high-grade glial neoplasm. The frozen section tissue was fully processed and placed in cassette FSA1, with additional representative portions placed in cassettes A2 and A3. The second sample (B) measures 0.8 x 0.8 x 0.6 cm and consists of beige to red-tan soft tissue; this entire specimen was submitted in cassette B1. Histologic evaluation revealed a cellular tumor composed of atypical glial cells with marked pleomorphism, frequent mitotic figures, microvascular proliferation, and areas of necrosis. The tumor infiltrates the surrounding brain parenchyma. No lymph node or distant metastasis was identified in the submitted material. Based on histologic features and extent of resection, staging is determined as localized disease without evidence of dissemination. All specimens were processed and reviewed according to standard protocols. Testing was performed under CLIA-certified conditions."} +{"pid": "TCGA-Q1-A73P", "report": "The specimen consisted of a radical hysterectomy with left salpingo-oophorectomy, right salpingo-oophorectomy, and multiple lymph node dissections from the pelvic and para-aortic regions, along with a vaginal margin.\n\nThe cervix demonstrated a lesion measuring 3.6 cm in greatest dimension. The maximal depth of invasion was 7 mm. Resection margins, including the posterior cervical/parametrial margin, were free of invasive carcinoma, with a distance of 15 mm from the tumor to the nearest margin. No lymphovascular invasion was identified. Histologic evaluation revealed well-differentiated glandular tissue with mucinous features consistent with endocervical morphology. The endometrium showed an inactive pattern, and the myometrium contained benign fibromuscular stroma without evidence of malignancy.\n\nExamination of both fallopian tubes and ovaries revealed no histopathologic abnormalities or signs of malignancy. The ovarian parenchyma showed only physiologic changes.\n\nLymph node evaluations included 10 nodes from the right pelvic region (all negative), 5 from the left pelvic region (all negative), one from the right para-aortic region (negative), and one from the left para-aortic region (negative). In total, 17 lymph nodes were examined, none showing evidence of metastasis.\n\nThe vaginal margin specimen showed squamous mucosa and fibromuscular tissue without involvement.\n\nPathologic staging based on findings was determined as pT1b1 (IB1) with no regional lymph node involvement (pN0) and no distant metastasis (pM0)."} +{"pid": "TCGA-44-2659", "report": "The specimen includes tissue from the left lower lobe, left upper lobe, and lymph node levels 4, 5, 6, and 7. The left lower lobe measures 8.5 x 2 x 2 cm and contains a firm tan nodule up to 1.7 cm in diameter, located near a staple line. A wedge resection was performed, and the entire nodule was submitted for analysis along with representative sections of surrounding pulmonary tissue and tissue adjacent to the staple line. The left upper lobe specimen measures 10 x 5.5 x 5 cm and contains a firm tan and black nodule measuring 1.8 x 1.5 x 1.5 cm. This nodule was also entirely submitted for evaluation, along with sections of adjacent lung tissue and tissue near the surgical margin. Lymph node level 7 consists of a 1.5 x 0.5 x 0.4 cm pink-red soft tissue fragment that was bisected and fully submitted. Level 6 includes two tissue fragments averaging 0.8 x 0.4 x 0.3 cm, which were also entirely submitted. All surgical margins were found to be free of involvement."} +{"pid": "TCGA-KK-A59Y", "report": "The pathology report includes findings from lymph node evaluations and prostate tissue analysis. Lymph nodes were assessed in four regional groups. In the right external iliac region, two lymph nodes were identified and showed no evidence of involvement. In the right obturator and internal iliac regions, four lymph nodes were evaluated, also without involvement. On the left side, one of two lymph nodes in both the external iliac and the obturator/internal iliac regions demonstrated microscopic involvement. The involved lymph nodes measured 3.0 mm and 4.5 mm respectively, with focal extension beyond the nodal capsule noted in both.\n\nThe prostate specimen measured 5.1 x 2.5 x 3.5 cm and weighed 31 grams post-fixation. A palpable nodule was identified on the left aspect of the gland. Microscopic evaluation revealed a distinct focus of cellular abnormality located across multiple regions including the left anterolateral, lateral, posterolateral, and posterior peripheral zones, as well as mid posterior and right posterior areas. The largest dimension of this focus measured 3.0 cm and was present across multiple cross-sectional levels, particularly involving the apex and base. There was limited extension into adjacent soft tissue near the left seminal vesicle and focal presence at the cauterized apical margin could not be ruled out. No involvement was identified in the seminal vesicles proper. The surgical margins appeared largely clear except for the previously mentioned uncertainty at the apex."} +{"pid": "TCGA-VQ-A8PM", "report": "The specimen consists of a resected gastric tissue involving the fundus, body, and cardia, extending into the esophagus. A large lesion measuring 15.0 x 10.0 x 1.0 cm is present, characterized by poorly differentiated cellular morphology with features of signet ring cells. The lesion demonstrates diffuse infiltration pattern and involves the circumferential esophageal margin. The proximal and distal margins are free of involvement.\n\nThe tumor extends into the peritoneum, perigastric fat, and esophageal adventitia. Lymphatic and perineural spaces show evidence of infiltrative growth. There is moderate stromal desmoplasia associated with the infiltrative front.\n\nLymph node evaluation reveals involvement in multiple regions: right paracardic (4/10), left paracardic (2/5), along the lesser curvature (17/22), right gastroepiploic (1/2), left gastric artery (16/20), celiac trunk (10/11), and splenic hilum (5/5). Other lymph node regions including common hepatic artery (0/5), superior mesenteric vein (0/2), inferior esophagus (0/5), infrapyloric (0/1), and hepatogastric ligament (1 uninvolved lymph node) showed no evidence of involvement.\n\nAdditional tissues evaluated include spleen and omentum, which demonstrated no pathological abnormalities or neoplastic involvement."} +{"pid": "TCGA-TS-A8AS", "report": "A male patient underwent surgical procedures including right thoracotomy, bronchoscopy, and photodynamic therapy. A specimen was received in 11 parts for pathological evaluation.\n\nSpecimen 1, labeled as rib, consisted of a bony fragment measuring 3.5 x 1.7 x 0.5 cm. Representative sections were submitted after decalcification. Specimen 2, identified as pericardial fat, included multiple yellow lobulated tissue fragments with aggregate dimensions of 8.5 x 6.5 x 3.5 cm. Sections were submitted in multiple blocks. Specimen 3, the pericardium, was a small fragment of yellow lobulated tissue measuring 1.7 x 1.1 x 0.1 cm and was entirely submitted for evaluation.\n\nSpecimen 4, designated as phrenic node, contained a fragment of yellow lobulated tissue measuring 0.9 x 0.7 x 0.5 cm, which was entirely submitted. No suspicious cellular changes were noted in this lymph node upon histological examination confirmed by immunohistochemical staining. Specimen 5, from the diaphragm, comprised fragments of yellow lobulated tissue measuring 7.2 x 3.7 x 2.5 cm; representative sections were submitted in multiple blocks.\n\nSpecimen 6, identified as visceral pleura, included a grayish-brown tissue fragment measuring 5.5 x 2.8 x 1.7 cm. Representative sections were submitted. Adjacent lung tissue did not show significant involvement. Specimens 7 through 10 included lymph node tissues from various anatomical levels. Level 7 measured 1.1 x 1.7 x 1.5 cm, Level 9 measured 0.7 x 1.1 x 0.2 cm, Level 4 measured up to 2.1 x 1.9 x 1.7 cm in aggregate, and Posterior Intercostal tissues measured 1.7 x 2.5 x 0.9 cm in aggregate. All were submitted entirely. Histological analysis of these specimens showed no evidence of atypical cellular infiltration, confirmed by immunohistochemical methods.\n\nThe final specimen, labeled as pleura, included multiple fragments of fibrofatty soft tissue and pleural layers. The total size of the specimen was approximately 36.0 x 22.0 x 1.7 cm. Areas of firm pleural thickening, thin normal-appearing pleura, and adipose tissue were observed. Representative sections were submitted for histological review.\n\nImmunohistochemical studies were performed and demonstrated positivity for several markers, while others were negative, supporting the interpretation of specific cellular characteristics. All tests were conducted under CLIA-certified high-complexity conditions.\n\nLymph node assessment included four levels, with none showing any notable findings. The overall staging was determined based on morphological and histological findings."} +{"pid": "TCGA-BJ-A191", "report": "The specimen consists of a total thyroidectomy weighing 23 grams. A neoplastic lesion is identified in the left lobe measuring 2.0 cm in greatest dimension. The lesion demonstrates both solid and microfollicular growth patterns. Histologic evaluation reveals features including nuclear characteristics consistent with a specific variant of the neoplasm, although the exact classification is not specified. The lesion is unifocal and confined to the thyroid without evidence of extrathyroidal extension. Surgical margins are free of involvement.\n\nAngiolymphatic invasion is present. Three regional lymph nodes were examined, including two left perithyroidal and one isthmic node; none show evidence of tumor involvement. Based on this lymph node assessment, the regional nodal category is negative. The primary tumor is classified as pT1b. No distant metastases were identified.\n\nAdditional findings include chronic lymphocytic thyroiditis, which is noted to be exuberant. Immunostaining for beta catenin shows cytoplasmic localization only, which was used to exclude a specific alternative variant. The lesion is encapsulated, though there is evidence of capsular and vascular invasion, which may render the concept of encapsulation less relevant in this context."} +{"pid": "TCGA-P4-A5EA", "report": "The specimen includes a left kidney, adrenal gland, and periaortic mass. A well-circumscribed lesion measuring 4.5 x 4.0 x 3.0 cm is present in the mid portion of the kidney. The cut surface of the lesion is tan-white and homogeneous. Histologic evaluation shows high-grade nuclear features. The lesion invades into the surrounding perirenal soft tissue and lymphovascular invasion is identified. A separate mass measuring 8.0 x 6.5 x 6.0 cm is found within the perirenal fat, with similar histologic characteristics.\n\nMargins of resection, including renal artery, renal vein, ureter, and perinephric soft tissue, are free of tumor. The adrenal gland does not show any involvement. Four lymph nodes from the anterior aorta and inter-aortocaval region are examined and do not show any evidence of tumor involvement.\n\nThe tumor approaches the perinephric fat margin on the posterior aspect of the specimen within 0.1 cm. There is no extension into the renal sinus. The attached perinephric fat contains a perihilar lymph node with tan-white, firm, and homogeneous cut surface, with focal areas of hemorrhage and necrosis. No abnormalities are observed in the adrenal gland or the urothelium of the pelvicalyceal system.\n\nSections submitted include vascular and ureter margin, adrenal gland, tumor with perirenal soft tissue, tumor extending toward the renal sinus, representative sections of the tumor, lymph node, uninvolved kidney, and renal pelvis."} +{"pid": "TCGA-LK-A4NZ", "report": "A biopsy of the right lower lobe of the lung shows benign bronchial mucosa. A resection specimen from the third rib includes soft tissue with a diffusely infiltrating epithelioid-type malignancy involving adjacent structures. The bone and bone marrow appear unremarkable. Resection specimens from the right pleura show similar epithelioid malignant cells extending into adjacent lung parenchyma. There is also a hyaline plaque present in the pleura. Histological evaluation reveals a predominantly epithelioid pattern with focal tubulopapillary architecture. Fluorescence in situ hybridization (FISH) analysis was performed on 64 cells using a dual-color probe targeting p16 (9p21). Results show 1.6% of cells with homozygous loss and 15.6% with hemizygous loss. The ratio of p16 to the centromere of chromosome 9 was 0.95, which falls within the normal range (0.85\u20131.19), and does not meet criteria for p16 deletion. At least 60 cells were analyzed per protocol. These findings were assessed according to established guidelines and literature references evaluating genetic markers in malignancies arising in serosal surfaces."} +{"pid": "TCGA-B0-5085", "report": "The specimen consists of a left radical nephrectomy. The neoplasm measures 6.8 cm in greatest diameter. Microscopic examination reveals tumor cells arranged in nests and sheets, with abundant clear cytoplasm and well-defined cell borders. Nuclear features are characterized by irregular contours, coarse chromatin, and prominent nucleoli, corresponding to nuclear grade 3 of 4. The tumor extends through the renal capsule but remains confined within Gerota\u2019s fascia. No angiolymphatic invasion is identified. Surgical margins are negative for tumor involvement. The adjacent non-neoplastic kidney tissue appears histologically normal. Based on TNM staging criteria, the tumor is classified as pT3a NX MX with a histologic grade of G3."} +{"pid": "TCGA-B8-A54D", "report": "The left kidney specimen measured 25 x 17 x 7 cm and weighed 760 grams after removal of perinephric fat. A mass measuring 12.9 x 8.4 x 7.9 cm was identified, with a red/brown to orange/yellow, soft, cystic, and variegated appearance. The center of the mass contained a firm, white fibrous area approximately 3.5 cm in size. The mass was largely circumscribed and replaced over 80% of the renal parenchyma. Microscopic evaluation revealed focal invasion through the capsule into perirenal adipose tissue. There was macroscopic invasion into the renal vein with tumor thrombus present, although the renal vein margin itself was negative. No invasion was identified in Gerota\u2019s fascia, renal sinus, or ureter. The adrenal gland showed no involvement by the mass and demonstrated benign histology. No lymphatic vessel invasion was observed, while venous invasion was confirmed as extensive and macroscopic.\n\nThe attached ureter measured 3.2 cm in length and was patent. The renal artery was patent and measured 0.4 cm in diameter. Grossly, the mass did not appear to invade the adrenal gland or renal sinus and was greater than 3 cm from the ureteral margin. No enlarged lymph nodes were palpable at the hilum. Surgical margins were negative for involvement, including Gerota\u2019s fascia, renal vein, and ureter. Additional specimens from the adrenal gland and abdominal wall fat showed no abnormalities or involvement.\n\nStaging was assigned as pT3a pNx based on available data at the time of reporting."} +{"pid": "TCGA-BR-8679", "report": "Specimen consists of a subtotal resection of the stomach with a lesion located at the fundus measuring 4x4x3 cm. Microscopic examination reveals a moderately differentiated histologic type, with tumor extent involving the muscularis propria. A total of 11 regional lymph nodes were examined, none of which showed evidence of metastasis. No information is provided regarding lymphatic, venous, or perineural invasion, tumor features, margins, neo-adjuvant treatment, or additional pathologic findings. No comments are available."} +{"pid": "TCGA-CH-5748", "report": "The specimen includes tumor-free pelvic lymph nodes bilaterally, as well as tumor-free pelvic fibrolipomatous tissue. The prostate contains extensive infiltrates of a Gleason 3+4 lesion, with involvement of both lobes from the apex to the base, more pronounced on the right side. Infiltration extends into the periprostatic tissue at the apex, reaching in part to the margin. Seminal vesicles are free of infiltration. A partially resected right seminal vesicle is also tumor-free. Pathologic staging is pT3a, G3, N0, R1."} +{"pid": "TCGA-UB-A7MB", "report": "A male patient underwent cholecystectomy and partial hepatectomy of the left hepatic lobe. The gallbladder measured 7.5 x 3 x 2.5 cm and showed no significant pathological abnormalities. No tumor was identified. The liver specimen weighed 974 grams and measured 16.5 x 23.2 x 5.1 cm. Three well-circumscribed, soft, white-tan lesions were found within the liver parenchyma. The largest lesion measured 4.9 cm in greatest dimension and was located in segment 4B, abutting the overlying capsule and approximately 2 cm from the cauterized resection margin. A second lesion measured 3.0 cm and was located in segment 4A, 0.7 cm from the resection margin. The third lesion measured 0.8 cm and was located in segment 3, approximately 12 cm from the resection margin. Histologically, the lesions showed moderate to poor differentiation. Immunohistochemical staining demonstrated diffuse positivity for Arginase-1 and negativity for CK19. Reticulin stain confirmed disruption of normal hepatocellular architecture. No tumor was identified at the surgical margins; the nearest distance from tumor to margin was 0.7 cm. The uninvolved liver parenchyma showed minimal macrovesicular steatosis without significant fibrosis or cirrhosis. No tumor necrosis was identified. Multifocality was present with a total estimated tumor diameter of all foci measuring 8.7 cm. Focal lymphatic invasion was present, but no blood vessel invasion was identified. The tumor focally abutted but did not penetrate the hepatic capsule. No lymph nodes were sampled during the procedure. The surgical specimen included representative sections from each lesion and surrounding tissue. No significant abnormalities were noted in the non-neoplastic hepatic parenchyma."} +{"pid": "TCGA-EW-A1IZ", "report": "Pathologic evaluation was performed on a left breast mastectomy specimen with axillary lymph node dissection. The left breast specimen measured 19.0 x 17.0 x 3.0 cm and included an area of abnormal tissue in the lower outer quadrant, measuring 2.8 x 2.0 x 1.5 cm. This lesion was located less than 0.1 cm from the anterior margin. Another mass was identified in the lower inner quadrant, measuring 1 x 1 x 1 cm, and was well-defined with a clip present. An area of necrosis measuring 2.0 x 2.0 x 1.0 cm was noted in the upper inner quadrant.\n\nMicroscopic examination revealed invasive carcinoma within the left breast. Histologic grading showed a high-grade lesion based on glandular differentiation (score 3), nuclear pleomorphism (score 3), and mitotic count (score 2), resulting in an overall Nottingham grade of 3. The largest focus of invasion measured 2.8 cm in greatest dimension. The tumor was unifocal and did not involve the posterior margin, which was 2 cm away. There was no involvement of the skin or nipple by invasive disease or ductal carcinoma in situ (DCIS). DCIS was present in a solid architectural pattern and was high nuclear grade (Grade III).\n\nLymphovascular space invasion was identified. A total of 13 lymph nodes were examined, including four with metastatic involvement. The largest metastasis measured 2.0 cm. No extranodal extension was observed. Four lymph nodes from level III axilla showed no evidence of malignancy. No malignancy was identified in the right breast or in additional fat tissue above the left breast lesion.\n\nThe surgical specimen margins were free of invasive carcinoma and DCIS. Ancillary studies for hormone receptors and HER2 were pending at the time of reporting. Subsequent addendum results indicated positivity for estrogen and progesterone receptors, and negativity for HER2 by immunohistochemistry. \n\nStaging according to the pTNM system was as follows: primary tumor size classified as pT2; regional lymph node involvement as pN2 due to metastases in four lymph nodes; distant metastasis was not applicable. The tumor exhibited multiple foci of invasive disease."} +{"pid": "TCGA-ET-A3BW", "report": "The specimen consisted of the left lobe and isthmus of the thyroid. A primary lesion measuring 3.2 cm in greatest dimension was identified. In addition, a second smaller focus measuring 0.4 cm was noted. Histologic evaluation revealed characteristic features of a neoplastic process. No lymph nodes were submitted for examination. The tumor appeared confined to the thyroid gland, with no evidence of extrathyroidal extension. Surgical margins were free of involvement. There was no identifiable venous or lymphatic invasion. An additional finding of a 1.2 cm follicular lesion was noted."} +{"pid": "TCGA-B2-4102", "report": "The right kidney specimen measured 16 x 9 x 7 cm and contained a tumor located in the central portion of the renal cortex. The tumor measured 5 x 3.2 cm and exhibited a yellow cut surface. Microscopic evaluation showed a tumor composed of clear cells with nuclear features corresponding to grade 2 according to Fuhrman criteria. The tumor measured 5 cm in greatest dimension. Evaluation of surrounding structures showed no involvement of the renal capsule, renal sinus, or hilar margins. Vascular invasion was not present. The pTNM stage was determined to be T1b. The remainder of the kidney tissue appeared unremarkable."} +{"pid": "TCGA-43-6647", "report": "The specimen includes multiple lymph node levels and lung tissue from a lobectomy. Tissue samples were collected from various levels including 1, 7 (two parts), 4, 2L, 4L, 8, 12, 9, 11, and 2R fat pad. All lymph node specimens were submitted either in whole or in part for frozen section analysis and found to be negative for metastatic disease. The lymphoid tissues showed variable presence of anthracosis but no tumor involvement.\n\nA right lower lobe lobectomy specimen weighed 318 grams and measured 16.8 x 8.5 x 5.0 cm. A cavitary mass measuring 6.0 x 5.0 x 5.0 cm was identified in the superior aspect of the specimen. The mass approached the pleura within 0.1 cm and was in proximity to the hilum, though the bronchial stump did not show gross tumor involvement. Histologically, the mass demonstrated full-thickness involvement of the bronchus following decalcification, making the exact margin status uncertain. No direct extension of the tumor into surrounding structures was observed. Arterial invasion was confirmed by elastic stain on block #3. No venous or lymphatic invasion was identified.\n\nFive hilar lymph nodes were evaluated; one contained tumor by direct extension. Additional findings included obstructive pneumonia near the tumor and a small focus of acute bronchopneumonia elsewhere in the lung. The remainder of the lung parenchyma was unremarkable. A separate middle lobe specimen showed no significant pathology and had negative margins and lymph nodes. The bronchus intermedius proximal margin was calcified but without evidence of tumor. Multiple blocks of tissue were submitted for further analysis, including tumor margins, vascular structures, and random parenchymal sections."} +{"pid": "TCGA-S7-A7WR", "report": "Gross examination reveals a thinly fibrously encapsulated, ovoid mass measuring 55x45x35 mm and weighing 50 grams. The cut surface is soft, grey-red with areas of focal hemorrhage. Histologically, the lesion exhibits a solid and alveolar architecture with focal hemorrhages and is surrounded by a rim of adrenocortical tissue at the periphery. There is no evidence of invasion into the adrenal capsule or surrounding adipose tissue. Nuclear hyperchromasia is present sporadically, without regular or atypical mitotic figures. Necrosis is absent. Immunohistochemical staining demonstrates weak to moderate positivity for S100 protein in tumor cells and strong positivity in sustentacular cells. Proliferative index by MIB-1 staining is less than 1%. Histologic evaluation shows large nests or diffuse growth pattern involving over 10% of the tumor volume, high cellularity, cellular monotony, and tumor cell spindling focally. Other features such as central necrosis within large nests, mitotic count greater than 3 per 10 high-power fields, atypical mitoses, vascular or capsular invasion, profound nuclear pleomorphism, and extension into adipose tissue were not identified. The total PASS score is 1."} +{"pid": "TCGA-DD-AAD1", "report": "The liver specimen measured 9.0 x 7.5 x 5.5 cm and weighed 203.0 grams. It was obtained via segmentectomy and contained a well-defined mass measuring 6.3 x 5.0 x 3.5 cm. The cut surface of the mass was described as yellowish tan with a granular appearance. The gross type was multinodular confluent. The resection margin was involved by the lesion, and there was no satellite nodule identified. The remaining parenchyma appeared unremarkable, and there was no portal vein invasion.\n\nMicroscopic examination revealed a tumor with the worst differentiation grade being IV/IV and the major differentiation grade III/IV. The histologic pattern included trabecular, pseudoglandular, and compact growth. The cell type was hepatic with clear features. There was no evidence of fatty change, cholangiocarcinoma, or combined hepatocellular and cholangiocarcinoma. Fibrous capsule formation was absent, but septum formation was present. Surgical resection margin invasion was identified. There was no serosal invasion, portal vein invasion, or microvessel invasion."} +{"pid": "TCGA-F7-8298", "report": "Specimen is a laryngectomy with tumor located at the glottis measuring 4 x 4 x 2 cm. Histologic examination reveals well-differentiated squamous cell morphology involving the vocal cord. A total of 14 regional lymph nodes were examined, with no evidence of metastatic involvement. Surgical margins are not specified. There is no indication of prior neo-adjuvant treatment. No additional comments provided."} +{"pid": "TCGA-73-4668", "report": "The specimen included multiple lymph node groups and lung tissue. Lymph nodes from the left and right distal paratracheal regions, right proximal paratracheal, level 5, level 7 (subcarinal), and level 9 were all evaluated. Each of these lymph node specimens showed no evidence of malignancy. The subcarinal soft tissue also showed no tumor involvement.\n\nA lobectomy of the left upper lobe was performed, with a segment of the lower lobe adhered to it. The bronchial margins were free of tumor involvement. Within the left upper lobe, a well-circumscribed mass was identified measuring 4.2 cm in greatest dimension, with additional dimensions of 3.5 x 3.0 cm. No pleural invasion or angiolymphatic invasion was observed. Emphysematous changes were noted in the lung tissue. One of eleven peribronchial lymph nodes showed evidence of metastatic carcinoma with extranodal extension.\n\nAdditional lung tissue attached to the mediastinum showed emphysematous changes but no malignancy. Representative sections of the mass, its relationship to surrounding structures including the pleura and bronchi, and lymph nodes were submitted for analysis."} +{"pid": "TCGA-GU-A42R", "report": "The specimen was obtained from a transurethral resection of the bladder. The tissue sample measured 3.5 x 3 x 2 cm and consisted of soft pink-tan and firm brown fragments, with the latter primarily composed of clotted blood. All relevant tissue sections were submitted for analysis.\n\nHistologic evaluation revealed a high-grade papillary lesion involving the bladder. The muscularis propria was present and showed tumor invasion. No lymphovascular invasion was identified. The tumor configuration was papillary, and no associated epithelial lesions were noted.\n\nImmunohistochemical staining was performed using automated image analysis on formalin-fixed, paraffin-embedded tissue sections. Staining intensity was graded on a scale from 0 (negative) to 3+ (highest), while percent positivity reflected the proportion of tumor cells staining positive.\n\nFor p21, the average percent positivity was 63%, with a staining intensity grade of 2 and a HistoScore of 6, indicating unaltered expression. For p27, the average percent positivity was 20%, with a staining intensity grade of 1 and a HistoScore of 4, indicating altered expression. p53 showed an average positivity of 4%, staining intensity grade of 2, and a HistoScore of 4, interpreted as unaltered. Ki-67 demonstrated 23% positivity, staining intensity grade of 2, and a HistoScore of 5, indicating altered expression. Cyclin E had an average positivity of 43%, staining intensity grade of 1, and a HistoScore of 5, interpreted as unaltered.\n\nBased on this tumor profile, the number of altered biomarkers is within the favorable range. A total of two biomarkers were found to be altered, which is associated with improved predictive accuracy for clinical outcomes. Known positive and negative controls demonstrated appropriate staining characteristics. All assays were performed using validated protocols with well-established prognostic markers. Antigen retrieval was performed via heat-induced epitope retrieval, and polymer detection kits were used.\n\nThis report incorporates data elements consistent with the College of American Pathologists (CAP) Cancer Protocols and Checklists based on the AJCC/UICC TNM classification system, 7th edition."} +{"pid": "TCGA-EM-A3FR", "report": "The specimen consists of a total thyroidectomy with central neck dissection. The right lobe measures 5.0 \u00d7 2.4 \u00d7 1.6 cm, the left lobe 5.0 \u00d7 2.7 \u00d7 2.2 cm, and the isthmus 4.5 \u00d7 1.4 \u00d7 0.6 cm. The overall specimen weighs 23.2 g. A dominant nodule measuring 3.0 \u00d7 2.0 \u00d7 1.9 cm is identified in the left lobe. A second nodule measuring 0.7 cm is found at the interface of the right lobe and isthmus. Two tan lymph nodes are identified within attached mediastinal fat measuring 3.0 \u00d7 2.0 \u00d7 0.5 cm.\n\nMicroscopic evaluation reveals a well-circumscribed lesion in the left lobe with classical papillary architecture and cytomorphology. The tumor is entirely encapsulated, with no lymphovascular or perineural invasion identified. Margins are free of involvement. A second lesion in the right lobe and isthmus shows a more infiltrative pattern of growth with multiple small tumor deposits. This lesion is partially encapsulated and demonstrates focal areas of tall cell morphology. Margins are uninvolved, with the closest margin measuring 0.4 mm from invasive tumor. No extrathyroidal extension is present.\n\nA total of seven lymph nodes are examined from the central compartment. Two of four lymph nodes show evidence of involvement. No extranodal extension is identified. Additional findings include mild follicular nodular disease and nonspecific thyroiditis. Parathyroid tissue is unremarkable. A small additional focus measuring 0.1 cm is identified in the right lobe.\n\nStaging is based on AJCC/UICC TNM criteria. The primary tumor is classified as pT2, indicating a tumor greater than 2 cm but not more than 4 cm confined to the thyroid. Regional lymph node involvement is classified as pN1a due to metastases in central compartment lymph nodes. Distant metastasis is not applicable. Multiple tumor foci are noted bilaterally as well as in the midline."} +{"pid": "TCGA-12-3649", "report": "The surgical pathology report describes multiple specimens of brain tissue. The first specimen measured 2.5 x 1.5 x 1.2 cm and was a fragment of pink-tan soft tissue. Representative sections were processed for frozen section analysis (AF1) and additional sections were submitted in block A2. The second specimen, measuring 3.7 x 3 x 2 cm, was an aggregate of pink-tan soft tissue with a white-pink cut surface and focal areas of hemorrhage. Representative sections from this specimen were submitted in blocks B1\u2013B3. The third specimen measured 1 x 0.7 x 0.6 cm and was also composed of pink-tan tissue; a representative section was submitted in block C1.\n\nMicroscopic evaluation revealed infiltration of brain tissue by a malignant astrocytic neoplasm with features including cytologic pleomorphism, mitotic figures, microvascular changes, and pseudopalisading necrosis. Subarachnoid infiltration was noted on block B3.\n\nCytogenetic analysis using FISH demonstrated polysomy of chromosome 7 in 76% of tumor cells and amplification of EGFR in 96% of tumor cells. Chromosome 10 centromere loss was observed in 36% of tumor cells, and allelic loss of PTEN was present in 60% of tumor cells. Loss at 9p21 was identified in 58% of tumor cells, while chromosome 9 centromere polysomy was found in 56% of tumor cells. Polysomy of 19q13 was observed in 68% of tumor cells. All four astrocytic markers showed abnormal findings, and 9p21 exhibited loss. Oligodendroglial markers remained intact.\n\nImmunohistochemical analysis showed high proliferation index with 20% of tumor cells staining positive. MGMT expression was negative in 10% of tumor cells. EGFR wild-type expression was strongly positive (3+ in 90% of tumor cells), while EGFR variant VIII was not detected. PTEN loss was confirmed with 2+ staining in 60% of tumor cells. S6 was positive in 30% of tumor cells, while AKT was negative in 90% of tumor cells. MAPK expression was positive in 20% of tumor cells. VEGF immunohistochemistry was negative (score 10). PDGFR-A showed focal cytoplasmic and/or membrane reactivity in approximately 30% of tumor cells, while PDGFR-B was either focal (30%) or absent. Leukocyte common antigen (LCA) was positive in 25% of cells.\n\nHAM 56 staining identified a focally dense macrophage population around areas of necrosis, comprising approximately 25% of the cells, while other regions were largely negative for macrophages. Additional FISH testing revealed CKIT polysomy in 89% of tumor cells."} +{"pid": "TCGA-VV-A829", "report": "The specimen from the left frontal region consists of multiple tissue samples. The largest intact tumor measures 5.0 x 4.0 x 3.0 cm and shows a solid, gray-red cut surface. Additional specimens include small soft tissue fragments measuring up to 2.7 x 2.1 x 0.6 cm and a calcified aggregate measuring 0.4 x 0.2 x 0.1 cm. Tissue was submitted for both frozen section and permanent histologic evaluation.\n\nHistologic sections show a glial neoplasm with mixed features. Approximately half of the tumor demonstrates low-grade morphology, including cells with small round nuclei and perinuclear clearing suggestive of oligodendroglial differentiation. The remaining portion shows high-grade features, characterized by angulated and hyperchromatic nuclei, as well as areas with gemistocytic and mini-gemistocytic changes. Scattered mitotic figures are present but not abundant. Focal necrosis is identified, involving less than 5% of the tumor.\n\nImmunohistochemical staining demonstrates diffuse GFAP positivity. Ki-67 proliferation index is intermediate (10\u201315%). p53 expression is weak in 5\u201310% of cells without significant overexpression. All controls show appropriate reactivity.\n\nIntraoperative consultation on touch imprints and frozen sections from multiple sites consistently identifies atypical and neoplastic cells. Surgical margins are largely positive for neoplastic involvement, including the medial-superior and anterior-inferior regions. The posterior margin contains only a few atypical cells, which may represent the edge of involvement.\n\nAncillary studies are in progress. These include molecular testing for 1p/19q deletions, MGMT methylation status, and PTEN immunohistochemistry. EGFR mutation analysis by PCR and fragment analysis did not detect any mutations. PTEN immunostaining shows 2+ intensity in approximately 50% of tumor cells. MGMT promoter methylation has been detected."} +{"pid": "TCGA-FY-A40K", "report": "The surgical pathology report describes findings from a thyroidectomy specimen including central lymph node biopsies. The right thyroid lobe contained two distinct nodules. The larger measured 1.0 cm in diameter and was located at the inferior pole. A second, smaller nodule measuring less than 0.1 cm was identified in the mid portion of the right lobe. Both were confined within the thyroid gland. No evidence of neoplastic involvement was found in the left thyroid lobe. Histologic evaluation revealed no lymphovascular invasion and margins were negative. Four lymph nodes were examined and showed no presence of tumor cells. Staging based on the current specimen indicated early-stage involvement without regional or distant spread. A reparative process was noted in the right thyroid lobe, consistent with prior fine needle aspiration. All margins were clear, with the closest distance from the lesion to the external aspect of the thyroid measuring 0.1 cm. The tissue specimens were entirely submitted for examination, with no residual tissue remaining."} +{"pid": "TCGA-E8-A2JQ", "report": "Right-sided thyroid lesion located in the right lobe, measuring 2.1 x 1.9 cm as a single focus. The lesion demonstrates extrathyroid extension and angiolymphatic invasion. Surgical margins are free of tumor. A total of 14 lymph nodes were identified, with 11 showing metastatic involvement. The staging classification is T3 N1a Mx."} +{"pid": "TCGA-EY-A1GU", "report": "The surgical specimens included lymph node aggregates from right and left pelvic regions, as well as right and left para-aortic areas. In total, 16 lymph nodes were evaluated across all regions\u2014six from the right pelvic area (largest measuring 2.0 x 0.8 x 0.5 cm), five from the left pelvic area (largest measuring 1.5 x 0.7 x 0.3 cm), two from the right para-aortic region (largest measuring 2.0 x 1.0 x 0.7 cm), and three from the left para-aortic region. No metastatic cells were identified in any of these lymph nodes.\n\nThe hysterectomy specimen measured 10.4 cm in height with a fundal breadth of 7.0 cm and an anterior-posterior width of 5.0 cm. The endometrial cavity length was 5.0 cm with a maximum width at the fundus of 4.4 cm. A lesion measuring 3.8 x 5.0 x 3.4 cm was observed in the anterior and posterior mid to upper corpus extending toward the lower uterine segment. Histologically, there was invasion into the deep outer half of the myometrium with a depth of 1.5 cm and wall thickness measuring 1.6 cm at the deepest point microscopically. The tumor involved approximately 94% of the uterine wall thickness. There was no involvement identified at the serosal surface, lower uterine segment, or cervical regions. Vaginal and cervical margins were widely negative.\n\nLymphovascular space invasion was noted on microscopic examination in sections E3 and E8. Immunohistochemical staining showed positivity for estrogen receptor (2+, 80%) and progesterone receptor (2-3+, 75%).\n\nAdditional findings included atrophic changes in the cervix along with mild chronic cervicitis, squamous and tubal metaplasia, tunnel clusters, and Nabothian cysts. A small hyalinized intramural leiomyoma measuring 7 mm was identified. Vascular calcifications were also present. Both ovaries appeared atrophic without evidence of malignancy. Fallopian tubes showed no significant pathological abnormalities.\n\nThe staging assessment indicated absence of regional lymph node involvement and absence of distant metastasis. Clinical staging based on AJCC classification was pT1b pNO pMx and FIGO stage grouping was IB. These classifications are provisional and subject to revision pending further clinical correlation.\n\nAll tissues were submitted for microscopic evaluation and immunostains were performed using analyte-specific reagents under CLIA-certified conditions."} +{"pid": "TCGA-CJ-4907", "report": "The surgical specimen measured 18.0 x 9.0 x 7.5 cm and included the right kidney, adrenal gland, and thrombus from the inferior vena cava. A tumor measuring 6.0 x 5.0 x 4.5 cm was identified in the lower pole of the kidney. It was poorly circumscribed, yellow-tan in color, and showed areas of hemorrhage. The tumor extended into the renal hilum and invaded the renal vein with protrusion beyond the renal vein margin. Histologically, the tumor was composed predominantly of clear cells (90%) with a minor component of eosinophilic cells (10%). Nuclear grading was performed, showing features consistent with high nuclear grade. Vascular-lymphatic invasion was present within the renal sinus adipose tissue, but the perinephric adipose tissue was uninvolved. A separate nodule measuring 0.4 x 0.3 x 0.3 cm was found in the medulla, well-circumscribed and tan-white in appearance, located more than 4 cm from the main lesion. Margins of resection, including the renal vein and ureteral margins, were free of tumor involvement. The adrenal gland showed no evidence of tumor. Multiple sections were taken for detailed microscopic evaluation, including areas of the tumor, adjacent normal kidney tissue, and control tissues. Portions of the tumor and surrounding parenchyma were also submitted to the tissue bank and for additional protocols."} +{"pid": "TCGA-Q1-A6DV", "report": "The specimen included a uterus with vaginal margin, bilateral fallopian tubes and ovaries, pelvic lymph nodes (right and left), and an additional vaginal margin. The cervix showed a focally necrotic lesion with xanthogranulomatous inflammation. The greatest dimension of the lesion was 1.1 cm, with additional dimensions measuring 1.0 x 0.7 cm. It was located in the left superior quadrant (12-3 o\u2019clock) and right inferior quadrant (6-9 o\u2019clock). The lesion was histologically mucinous and of endocervical type, moderately differentiated (grade 2). The depth of invasion was 8 mm in a cervical wall measuring 13 mm. No vascular space invasion was identified. The resection margins, including the vaginal cuff and deep stromal margins, were uninvolved by invasive carcinoma. Focal severe squamous dysplasia was also present. \n\nExamination of the parametrial tissues revealed no tumor involvement. A total of 17 lymph nodes were evaluated: 10 from the right pelvic region, 5 from the left, and 2 from the parametrial region. All were negative for tumor involvement. The endometrium was benign and inactive. Superficial adenomyosis was noted in the myometrium. The fallopian tubes and ovaries showed no pathological findings. The additional vaginal margin consisted of benign squamous mucosa and submucosa without evidence of tumor or dysplasia.\n\nGross examination of the uterus showed an ulcerated lesion at the 12:00 to 2:00 position on the cervix, measuring 1.0 x 1.1 x 0.7 cm, and located 0.4 cm from the nearest vaginal cuff margin. The endometrial cavity had a tan/pink hemorrhagic lining, and the myometrium measured up to 2.7 cm in thickness. The serosal surface was smooth without adhesions. Lymph node specimens were processed entirely, with no evidence of malignancy found. Frozen section analysis of the vaginal margin confirmed benign tissue. All cassettes were submitted for histological evaluation, and the final report was approved after review."} +{"pid": "TCGA-77-8143", "report": "Histopathology Report. HISTORY. (L) UL. MACROSCOPIC. Four specimens received: 1: The first specimen is labelled \"(L) upper lobe\" and consists of an upper lobectomy measuring 240 mm from superior to inferior x 100 x 35 mm. The bronchial soft tissue resection margin measures 80 x 35 mm. A bronchial resection margin measures 20 x 7 mm. Superior to the soft tissue resection margin there is a stapled margin measuring 70 mm in length. Within the apex there is a firm lesion measuring 63 x 50 x 48 mm. The overlying pleura is puckered. On sectioning, the lesion is centrally necrotic, well-defined, cream to yellow in color and focally black. The lesion is greater than 10 mm from the stapled resection margin and 30 mm from the bronchial resection margin. After removal of staples, the new resection margin has been inked black. The overlying pleura has also been inked black. [1A-bronchial resection margin; 1B-? hilar lymph nodes; 1C-lesion, inked resection margin after removal of staples and overlying pleura; 1D-1F-lesion and pleura; 1G-lesion and adjacent normal appearing lung; 1H-RS of normal lung; 1I-lesion and adjacent bronchus. No definite bronchial origin is identified.]. 2: The second specimen is labelled \"pulmonary vein lymph node\" and consists of a fatty piece of tissue measuring 10 x 7 x 3 mm. On bisecting a single lymph node measuring 3 mm in maximum extent is identified. [Submitted in toto-2A.]. 3: The third specimen is labelled \"No. 6 lymph node\" and consists of a fatty piece of tissue measuring 35 x 30 x 8 mm. On sectioning two lymph nodes are identified. [3A-3B lymph nodes bisected, part of each lymph node in each cassette. [Lymph node submitted in toto.]. 4: The fourth specimen is labelled \"No. 10 lymph node\" and consists of a lymph node measuring 16 x 7 x 5 mm. [Bisected in toto-4A.]. MICROSCOPIC. 1: Sections show a moderately to poorly differentiated squamous cell lesion with areas of central necrosis and cystic change as well as areas of sclerosis. There is a moderately heavy lymphoplasmacytic infiltrate in the stroma. The lesion abuts but does not appear to invade the overlying pleura and the inked resection margin is clear. No vascular, lymphatic or perineural invasion is identified. The bronchial resection margin shows focal squamous metaplasia but no evidence of malignancy. Uninvolved lung parenchyma shows emphysema. Peribronchial lymph nodes contain small silicotic nodules but there is no evidence of metastatic involvement. Page 1 (. Histopathology Report. 2: Sections show an anthracotic node in which there is no evidence of malignancy. 3: Sections show a deposit of squamous cell involvement in one of the lymph nodes. There are also a few small silicotic nodules. 4: Sections show an anthracotic node in which there is no evidence of malignancy. SUMMARY. Left upper lobectomy and lymph node sampling: Moderately to poorly differentiated squamous cell lesion, 63 mm in diameter. No pleural, vascular, lymphatic or perineural involvement identified. Squamous metaplasia at bronchial resection margin. Involvement in No. 6 lymph node. Pathological stage T2N2. Cc: Lung Cancer Registry."} +{"pid": "TCGA-EJ-7797", "report": "The patient underwent a radical prostatectomy. Examination of the surgical specimen revealed an epithelial lesion involving both the right and left lobes of the prostate. In one histologic section, the largest focus measured 1.4 cm. The lesion accounted for less than 5% of the total prostate volume. The lesion was confined within the prostate without evidence of extension beyond the prostatic capsule. There was no involvement of the bilateral seminal vesicles. All surgical margins were free of abnormal cellular infiltration. No perineural or angiolymphatic spread was observed. A precursor lesion was identified in the prostate tissue. The background prostate tissue showed nodular hyperplasia with a mixed inflammatory infiltrate, including chronic and acute components. Fourteen lymph nodes were examined, with none showing any abnormal cellular changes. The pathologic staging was determined to be pT2c with pN0 status. Histologically, the cells demonstrated a moderately differentiated morphology. Laboratory testing prior to surgery showed a PSA level of 5.4. The weight of the prostate was 73.85 grams."} +{"pid": "TCGA-WB-A80L", "report": "The specimen consists of a right adrenal gland weighing 22 grams and measuring 7x4x2 cm. The gland is completely encapsulated and contains a spherical lesion measuring 3.5 cm in diameter. A fragment of the lesion and a portion of normal adrenal tissue were frozen for further analysis. Histologically, the lesion is partially separated from the surrounding adrenal tissue by a pseudo-capsule. The lesion demonstrates a mixture of architectural patterns, including trabecular and nested arrangements of cells. Cellular morphology reveals moderate polymorphism with round to oval nuclei, fine chromatin, and prominent nucleoli, surrounded by abundant granular basophilic cytoplasm. Areas of hemorrhage are present, along with regions showing greater nuclear pleomorphism, irregular hyperchromatic nuclei, and reduced cytoplasm. No significant mitotic figures or necrosis are identified. There is no evidence of infiltration into the peri-adrenal fat. Vascular invasion is suspected locally. The adjacent adrenal tissue shows mild architectural changes without definitive neoplastic involvement. Surgical margins are free of abnormal cellular infiltration."} +{"pid": "TCGA-HB-A5W3", "report": "A biopsy of a pancreatic specimen demonstrates malignant spindle cell proliferation. A separate biopsy of the adrenal artery margin reveals peripheral nerve and ganglion without evidence of malignancy. The primary lesion is centered within the renal pelvis and measures 26 cm in greatest dimension. Histologic evaluation indicates focal invasion of renal parenchyma with displacement of the adrenal gland, spleen, and pancreas. There is evidence of invasion into periadrenal adipose tissue. Surgical margins including ureteral, renal vascular, pancreatic, and soft tissue are free of tumor involvement. Two regional lymph nodes are identified and do not show any signs of metastasis. Lymphovascular invasion is present. The contralateral kidney demonstrates interstitial fibrosis and chronic inflammation. Immunohistochemical staining reveals diffuse positivity for SMA and focal positivity for desmin. The tumor is negative for CD34, CD117, S-100, AE1/AE3, RCC, and CD10. Histologic assessment classifies the tumor as high grade. Based on available data, staging is classified as pT3 pN0. Gross examination of the resected specimen includes kidney, spleen, distal pancreas, and adrenal gland. The mass weighs 2,700 grams and measures 27 x 17.5 x 11 cm. It exhibits extensive hemorrhage and necrosis, predominantly in the superior portion. The renal parenchyma is markedly compressed and thinned. The tumor is located 2.5 cm from the ureteral margin and 3 cm from the renal vascular margin. There is close approximation to the pancreatic tail, with the tumor measuring 3.9 cm from the pancreatic margin. The adrenal gland appears to be in proximity but not grossly involved. The spleen is intact with no identifiable nodules or infiltration. Two surface defects are noted on the superior/medial aspect of the tumor. Multiple tissue blocks were submitted for microscopic evaluation, including margins and representative sections of the tumor in relation to surrounding structures."} +{"pid": "TCGA-S9-A6U1", "report": "The histomorphology reveals a tumor with astrocytic features characterized by increased cellularity and nuclear pleomorphism. Mitotic activity is present, and areas of elevated proliferation are noted, reaching up to 10% in focus. The tumor does not exhibit the specific diagnosis upon which this report was originally based."} +{"pid": "TCGA-DD-A3A9", "report": "The right lobe of the liver weighed 965 grams and measured 15 x 15 x 9 cm. A mass measuring 10 cm was identified, along with a satellite nodule measuring 7 cm. The hepatic capsule showed involvement, with tumor extending into, but not through, the adherent portion of the diaphragm. No extratumoral vascular invasion was observed. The mass was partially encapsulated, and infiltration into the surrounding tissue appeared to be of the pushing type. The non-neoplastic liver tissue did not show cirrhosis. All surgical margins were free of tumor."} +{"pid": "TCGA-27-1836", "report": "Birth date. Tumor site: right parietal. The lesion showed a high degree of cellular atypia, brisk mitotic activity, and microvascular proliferation. Necrosis was present with surrounding palisading of tumor cells. The tissue exhibited marked pleomorphism and infiltrative growth pattern. Immunohistochemical staining demonstrated positivity for GFAP and MGMT. The lesion measured 4.2 cm in greatest dimension and extended into the adjacent cerebral parenchyma without clear borders. Peritumoral edema was extensive on imaging. No lymph node involvement was identified. Distant metastasis was not detected."} +{"pid": "TCGA-FG-8189", "report": "The patient is a Caucasian female with a clinical history of a right frontal temporal brain mass. Three specimens were submitted for analysis: fragments of tan-pink, irregular soft tissue from the right temporal region, a deep temporal lesion, and a larger pale tan to pink-tan cribriform tissue fragment measuring 5.9 x 4.0 x 2.3 cm. The first two specimens measured 0.7 x 0.5 x 0.3 cm and 0.8 x 0.6 x 0.2 cm, respectively, and were partially analyzed via touch imprint and frozen section. All tissues were subsequently processed and submitted in a total of 21 cassettes. Microscopic evaluation of biopsies revealed a glioma with features suggestive of a low-grade neoplasm. Cellular morphology was consistent with a diffusely infiltrative glial tumor exhibiting uniform nuclei and minimal pleomorphism. Staging could not be fully assessed without further molecular testing. An addendum will follow upon completion of chromosomal analysis."} +{"pid": "TCGA-CN-A642", "report": "A total of 17 specimens were evaluated, including multiple biopsies and dissections from various anatomical sites. Tissue samples were obtained from the central nerve, mandible marrow margins, mandibular alveolus margin, floor of mouth, anterior and posterior tongue margins, anterior lip margin, deep tongue margin, anterior hyoid margin, and neck lymph nodes at multiple levels bilaterally.\n\nHistologic examination of all margins\u2014including anterior, posterior, midline/deep tissue, and bone\u2014revealed no evidence of tumor involvement in most areas. The anterior floor of the mouth margin showed mild acute mucositis but no malignancy. In one area adjacent to the right submandibular gland, a necrotic friable tan mass was identified within subcutaneous soft tissue.\n\nLymph node evaluation revealed variable findings across different levels and sides of the neck. On the left side, Level 1 contained six benign lymph nodes; Levels 2\u20134 demonstrated metastatic involvement in one out of eighty-one lymph nodes with presence of extracapsular spread. On the right side, Levels 2\u20134 showed more extensive nodal involvement with six out of twenty-one lymph nodes positive for metastasis. Additionally, jugular vein invasion by carcinoma was noted on the right along with widespread extracapsular extension.\n\nImmunohistochemical staining patterns were assessed using markers such as p63, P40, cytokeratin 5/6, and AE1/3. These stains highlighted certain cellular components but did not confirm specific tumor types definitively. HPV testing yielded indeterminate results while p16 staining was negative.\n\nTumor measurements indicated a lesion measuring up to 6.3 cm involving areas including the floor of the mouth, lateral oral tongue, and sublingual gland. There was vascular and perineural invasion observed microscopically. Margins appeared largely uninvolved except near the midline/deep tissue edge where tumor approached within 0.1 cm.\n\nOverall, histopathologic analysis revealed widespread involvement particularly affecting right-sided lymph nodes with significant tumor burden and vascular/perineural invasion characteristics noted throughout examined tissues."} +{"pid": "TCGA-QH-A65X", "report": "PATHOLOGIST REPORT. The patient is female. The lesion is located in the frontal lobe. Histological evaluation reveals a highly cellular neoplasm composed of moderately pleomorphic cells with irregular nuclear contours and frequent mitotic figures. The tumor measures 4.2 cm in greatest dimension and demonstrates infiltrative growth into adjacent brain parenchyma. Necrosis is present, though not extensive. Microvascular proliferation is observed. Based on histopathological features and extent of resection, the lesion is classified as high-grade. No lymph node involvement is identified. Distant metastasis is not detected at the time of presentation."} +{"pid": "TCGA-X7-A8M3", "report": "The operative procedure was a median sternotomy thymectomy. The specimen received was fresh thymic tissue labeled with the patient\u2019s name. Gross examination revealed a 20 x 11 x 2 cm specimen weighing 160 grams, consisting of fatty and soft tissue. Within the specimen, a well-defined mass measuring 6 x 5.5 x 2.5 cm was identified. Upon step-sectioning, the mass measured 5.5 x 5 x 2.5 cm and appeared tan and fleshy. It was fairly well encapsulated. Six cassettes were submitted for microscopic evaluation.\n\nMicroscopic analysis showed an encapsulated lesion composed of sheets of polygonal cells with occasional mitotic figures and areas showing squamoid differentiation. The lesion was separated by hyalinized fibrous septa. There was evidence of perivascular edema, as well as focal extracapsular invasion and involvement of lymphatic vessels. Additionally, the lesion approached closely to the inked resection margin in some areas."} +{"pid": "TCGA-DD-AAED", "report": "The liver specimen measured 18.0 x 9.5 x 7.0 cm and weighed 617.0 grams. A mass was identified within the liver, measuring 8.5 x 7.8 x 10.5 cm. The cut surface of the mass showed a well-demarcated, nodular appearance with areas of necrosis. The lesion was expansile in growth pattern and confined to the hepatic parenchyma, with a bulging but smooth serosal surface. The resection margin was not involved macroscopically, with a safety margin of 0.4 cm. The remaining liver tissue was non-cirrhotic.\n\nMicroscopic evaluation revealed a tumor with Edmondson-Steiner grade III differentiation. The histologic pattern was trabecular. Fatty change was absent, and a fibrous capsule was present with evidence of capsular infiltration. There was no septum formation, surgical margin invasion, serosal invasion, portal vein invasion, or bile duct invasion. Vascular invasion was present. The background liver showed periportal fibrosis (stage 2) with mild steatosis.\n\nThe gallbladder measured 7.3 cm in length, 3.1 cm in diameter, and had a wall thickness of 0.3 cm. The serosal surface was yellowish pink and smooth, while the mucosal surface was dark green and velvety. No gallstones were identified. Microscopic examination of the gallbladder showed autolysis.\n\nMultiple representative sections were submitted for analysis, including from the tumor, resection margin, non-tumorous liver tissue, fatty tissue, and gallbladder."} +{"pid": "TCGA-69-8453", "report": "The specimen included multiple lymph node samples from various anatomical locations, all of which were negative for malignancy. A pulmonary segmentectomy specimen from the right lower lobe demonstrated a fleshy tan lobulated mass measuring 7.5 x 6.4 x 4.7 cm located in proximity to the pleura, with associated pleural puckering and thickening. The mass was 0.6 cm from the closest resection margin and 0.5 cm from the bronchial margin. Histological evaluation revealed acinar-predominant architecture with no evidence of vascular invasion, though lymphatic invasion was present. The bronchial, vascular, and parenchymal margins were free of involvement; however, the tumor extended into the visceral pleura without reaching the pleural surface.\n\nAdditional findings included centrilobular emphysema with fibroelastosis, extensive chronic bronchiolitis, and rare ill-formed non-necrotizing granulomas. Organizing acute fibrinous pleuritis was identified in both the pleural tissue adjacent to the lung lesion and within the pulmonary specimen. Lymph nodes surrounding the bronchus were also negative for malignant involvement. Based on these findings, staging according to AJCC criteria was determined to be p Stage IIIA (T3 NO MX)."} +{"pid": "TCGA-IB-A5SQ", "report": "The specimen included a biopsy from the left liver, gallbladder, proximal bile duct margin, pancreatic margin, superior mesenteric lymph node, and a Whipple resection specimen. The left liver biopsy measured 0.7 x 0.6 x 0.2 cm and showed benign sclerotic changes. The gallbladder was 9.0 x 4.8 x 2.5 cm with no malignant findings. The proximal bile duct margin, measuring 0.6 x 0.3 x 0.1 cm, showed benign bile duct tissue. The pancreatic margin, a 0.8 x 0.4 x 0.2 cm fragment, revealed benign pancreatic tissue. The superior mesenteric lymph node was 1.0 x 0.8 x 0.5 cm and was benign.\n\nThe Whipple resection included the distal stomach, proximal duodenum, and head of the pancreas. The pancreatic head measured 6.0 x 4.0 x 2.0 cm. A firm, poorly defined white-yellow mass measuring 2.0 x 2.5 x 2.3 cm was identified just deep to the ampulla. It was closely opposed to the deep pancreatic margin but did not extend beyond the pancreas. Microscopically, the lesion was moderately differentiated and showed invasion of the ampulla of Vater and sphincter of Oddi, as well as the duodenal wall. Margins were uninvolved by invasive carcinoma, with the closest distance being 3.0 mm at the pancreatic margin. Lymphovascular and perineural invasion were present. No regional lymph node metastases were found; 9 lymph nodes were examined and all were negative. The tumor was classified as pT2, limited to the pancreas and greater than 2 cm in greatest dimension, with no lymph node involvement (pN0)."} +{"pid": "TCGA-GU-A764", "report": "A biopsy and surgical specimen report includes the following findings. Two ureteral biopsies, right and left distal ureter margins, show no evidence of abnormal cellular changes or malignant growth. Both specimens are entirely submitted for analysis, and each confirms benign tissue without involvement.\n\nA radical cystoprostatectomy specimen includes a urinary bladder and prostate. Examination reveals a mass on the anterior bladder wall measuring 4.7 cm in greatest dimension. Microscopic evaluation shows the lesion invades the muscularis propria. The tumor has a ulcerated appearance and extends through the full thickness of the bladder wall musculature but does not grossly extend beyond into surrounding tissues. All surgical margins are free of abnormal cells.\n\nNineteen lymph nodes are identified across three regional groups: seven from the right pelvic area, four from the left common iliac and presacral regions, and eight from the left pelvic area. All lymph nodes examined show no signs of metastatic disease.\n\nAdditional findings in the bladder include areas of chronic and acute inflammation, reactive cellular changes, cystitis cystica, and focal intestinal metaplasia. Inflammation is also observed in the prostate and seminal vesicles. The urethral margin shows necrotic changes and reactive epithelial features.\n\nTissue blocks are available for further testing if required. The report follows established cancer protocol standards for data collection and staging."} +{"pid": "TCGA-RW-A685", "report": "The specimen consists of a right adrenal gland weighing 63.63 grams. A 4.8 x 3.1 x 3.1 cm brown-tan, firm mass is identified within the gland. The mass appears well-defined and may be encapsulated. Adjacent to the mass, there is a strip of adrenal parenchyma measuring up to 2.8 x 0.4 cm. Histologically, the lesion shows tan-gray, mottled areas and seems to originate from the adrenal gland. Tissue sections include areas from the normal gland to the mass, as well as from the mass to surrounding fibroadipose tissue and capsule. All surgical margins are free."} +{"pid": "TCGA-GM-A3NW", "report": "The specimen consists of a total mastectomy from the left breast, measuring 25.0 x 15.0 x 4.0 cm, with attached skin and an inverted nipple-areola complex. The breast tissue was sectioned into 11 slices. A mass measuring 3.0 x 2.0 x 2.0 cm was identified in the upper inner quadrant at the 11 o\u2019clock position. It is described as poorly circumscribed, multinodular, heterogeneous, fleshy, and tan-white to brown in color. The mass is located 1.0 cm from the superior superficial margin and approximately 1.0 cm from the deep margin. No lymphovascular invasion was identified. Margins are widely free of involvement. The skin and nipple show no signs of abnormality.\n\nFour sentinel lymph nodes were examined. Sentinel lymph node #1 measured 1.6 x 0.8 x 0.8 cm and was blue in color. Sentinel lymph node #2 measured 0.8 x 0.8 x 0.6 cm. Sentinel lymph node #3 measured 1.1 x 0.9 x 0.9 cm. Sentinel lymph node #4 measured 1.0 x 1.0 x 0.4 cm and was found within two fragments of adipose tissue measuring 0.8 x 0.4 x 0.3 cm and 1.0 x 1.0 x 0.4 cm. All lymph nodes showed no evidence of tumor involvement upon histological evaluation. Touch preparations from all sentinel lymph nodes were also negative. Immunohistochemical staining for cytokeratin on all four sentinel lymph nodes was negative for metastatic disease."} +{"pid": "TCGA-BA-A6DG", "report": "The specimen consists of multiple fragments of tan to pink soft tissue, measuring 1.7 x 1.5 x 0.4 cm in aggregate, submitted in cassettes A1 and A2. The tissue was appropriately labeled as originating from the left tongue. Histologic evaluation reveals invasive neoplastic growth with moderately differentiated morphology. Immunohistochemical staining for p16 and in situ hybridization for high-risk HPV were performed and both were negative. No further specific diagnostic terms are provided in this summary."} +{"pid": "TCGA-BR-8297", "report": "The specimen consisted of a gastrectomy with a tumor located in the fundus measuring 31 x 15 x 2 cm. The tumor was ulcerated and exhibited a diffusely infiltrating growth pattern consistent with linitis plastica. Histologic evaluation showed features of a diffuse-type morphology. The tumor extended to adjacent structures, including the esophagus. All 11 intraabdominal lymph nodes examined were positive for metastatic involvement. Lymphatic, venous, and perineural invasion could not be determined as these were not assessed. Surgical margins were involved. There was no evidence of prior neoadjuvant treatment. No additional pathologic findings were identified."} +{"pid": "TCGA-CJ-5680", "report": "The right kidney specimen measures 18.0 x 13.0 x 7.0 cm and includes a portion of ureter measuring 3.0 cm in length and 0.4 cm in diameter. Within the upper pole of the kidney, there is a well-defined mass measuring 10.5 x 10.0 x 6.0 cm. The cut surface of this mass shows yellow-tan discoloration with areas of necrosis, hemorrhage, and firm solid regions. Microscopically, the lesion contains approximately equal proportions of clear and eosinophilic cells. Nuclear grading assessment reveals predominantly grade 3 features with minor areas demonstrating grade 4 characteristics.\n\nThere is extensive invasion into the renal sinus adipose tissue. The renal vein is filled with tumor, and tumor extends beyond the vein margin by approximately 1.2 cm. Importantly, no tumor involvement is identified within the wall of the vein at the margin. The tumor is located 0.1 cm from the resection margin of Gerota's fascia. No tumor infiltration is observed in perinephric adipose tissue. No lymph nodes were identified either grossly or microscopically in the renal hilum or surrounding fat.\n\nThe left adrenal gland measures 3.7 x 2.5 x 1.5 cm and includes associated fibroadipose tissue. A distinct mass measuring 3.2 x 2.5 x 1.5 cm is present within the medulla. The cut surface appears red-brown and soft without evidence of hemorrhage or necrosis. The adrenal cortex demonstrates signs of atrophy. Sections of this mass were submitted for further analysis along with representative sections of uninvolved adrenal tissue."} +{"pid": "TCGA-YL-A8SL", "report": "The prostate specimen demonstrates a histologic pattern characterized by a primary and secondary grading score of 4 each, with an additional tertiary pattern graded as 3. The tumor involvement includes approximately 5% pattern 3 and 95% pattern 4. The lesion is identified at the apex, base, anterior, right and left posterior regions of the prostate. There is no evidence of extra-prostatic extension; however, invasion of the seminal vesicle is noted on the right side. Surgical margins are free of invasive disease.\n\nLymphovascular invasion and perineural involvement are present. The tumor involves approximately 30% of the prostate gland. No treatment effect is observed.\n\nLymph node evaluation reveals the following findings: Right obturator (3 nodes, none involved), left obturator (2 nodes, none involved), right external iliac (8 nodes, 1 involved), left external iliac (4 nodes, none involved), right paravesical (1 node, 1 involved), and left paravesical (1 node, 1 involved). The largest metastatic deposit measures 18 mm in diameter.\n\nAdditional pathologic findings are unremarkable."} +{"pid": "TCGA-BA-4075", "report": "The specimen consists of a composite resection including a segment of mandible measuring 8.5 x 3.5 x 0.9 cm and the entire tongue measuring 14.0 x 6.0 x 3.0 cm. Attached to the mandible is a soft tissue pedicle measuring 6.5 x 2.0 x 0.8 cm. The lesion is located at the base of the tongue, right floor of the mouth, and right tonsillar fossa. It appears as a grayish-white, ulcerative mass measuring 6.0 x 2.5 x 1.5 cm. Microscopically, the lesion shows moderate differentiation with areas of surface necrosis. The tumor extends into the vertical muscle of the tongue to a depth of 1.3 cm and invades a minor salivary gland. Lymphovascular invasion is present, as is extensive perineural invasion. Bone involvement is not identified. The anterior soft tissue margin is positive, with tumor undermining intact mucosa; all other margins are negative.\n\nA total of 48 lymph nodes were evaluated: 10 from the soft tissue pedicle, 17 from right neck Level II, 11 from Level III, 5 from Level IV, and 5 from Level V. All are negative for tumor involvement. Some lymph nodes show partial fibrosis. No tumor is identified in the submandibular gland or in skeletal muscle samples. A porta-cath device was also removed and examined grossly only. Based on the pathologic findings, the T category is high, with no regional lymph node metastasis identified. The pathologic staging is incomplete and should be reviewed in the context of all available clinical information."} +{"pid": "TCGA-39-5022", "report": "The patient presented with a right upper lobe lung nodule that was PET positive. Fine needle aspiration demonstrated atypical cells. Surgical specimens included six submissions: right level ten mediastinal lymph node; right level eleven mediastinal lymph node; right level eleven interlobar lymph node; another right level eleven mediastinal lymph node; right upper lobectomy specimen; and right level four mediastinal lymph node.\n\nOn evaluation of the mediastinal lymph nodes (levels ten, two samples from level eleven, and level four), no abnormal cellular infiltrates were identified. One lymph node showed old calcified granulomas, but no organisms were identified on special stains including AFB, Fite, or GMS. All other lymph nodes showed no significant pathological changes.\n\nThe right upper lobectomy specimen measured 16 x 11 x 3 cm. A 3.7 x 3.2 x 2.5 cm firm gray-tan nodule was found beneath an area of pleural thickening. The nodule was located 1.9 cm from the bronchial margin and 2.2 cm from the stapled margin. Both margins were free of abnormal cells. The tumor appeared to extend to the pleura but did not penetrate the elastic layer, as confirmed by EVG staining. No vascular invasion was observed.\n\nNon-neoplastic findings in the lung tissue included emphysematous changes, focal atypical adenomatous hyperplasia, organizing pneumonia, and respiratory bronchiolitis. Evaluation of two peribronchial and seven intraparenchymal lymph nodes revealed no abnormal cells.\n\nIntraoperative frozen section analysis of the lymph nodes was consistent with benign findings, and permanent sections confirmed these results."} +{"pid": "TCGA-FU-A3TQ", "report": "The surgical specimen included multiple lymph node dissections and biopsies, as well as resected uterine, ovarian, and fallopian tube tissue. Lymph node analysis showed that the left pelvic nodes were negative for any abnormal cells (0 out of 4 examined). In contrast, one out of five right pelvic lymph nodes from one dissection and one out of one node from a biopsy showed the presence of abnormal cells. A segment of uterine artery was also removed and showed no abnormal findings.\n\nThe hysterectomy specimen included the cervix, uterus, bilateral ovaries, and fallopian tubes. On gross examination, a mass measuring 7 x 3 cm was identified in the cervix, extending into the lower part of the uterine body. The depth of this lesion was 13 mm, with a total cervical wall thickness of 15 mm. There was evidence of widespread involvement of vascular and lymphatic spaces throughout the cervix and uterine body. All surgical margins, including those at the cervix, vagina, and parametrial regions, were free of abnormal cells. Two paracervical lymph nodes were also negative.\n\nAdditional findings included an atrophic endometrium with a small polyp, a benign-appearing nodule within the myometrium, and no abnormalities in either ovary or fallopian tube. The outer surface of the uterus showed no pathological changes.\n\nLymph node involvement was noted on the right side, with metastatic changes found in one of the five nodes in one dissection and in the single node from another biopsy. Based on these findings, the staging classification was determined."} +{"pid": "TCGA-DD-AAE2", "report": "The specimen consists of liver tissue measuring 17.0 x 8.0 x 5.5 cm and weighing 397.0 grams, along with a gallbladder measuring 9.5 cm in length and 3.5 cm in diameter with a wall thickness of 0.6 cm. A mass was identified in the liver, measuring 5.5 x 5.0 x 7.0 cm. The cut surface of the mass was well demarcated, mahogany in color, and nodular in appearance. Grossly, the lesion was multinodular and confluent, confined to the hepatic parenchyma with a bulging but smooth serosal surface. The resection margin was not involved macroscopically, with a safety margin of 0.1 cm. The surrounding liver tissue showed signs of cirrhosis. The gallbladder had a yellowish pink and smooth serosal surface, with a dark green velvety mucosal surface and no stones present.\n\nMicroscopic evaluation revealed a tumor with trabecular histologic pattern and Edmondson-Steiner grade showing worst differentiation as II and major differentiation as III. There was no evidence of fatty change, vascular invasion, bile duct invasion, serosal invasion, or surgical margin involvement. A fibrous capsule was present without capsular infiltration or septum formation. The remaining liver parenchyma demonstrated cirrhotic changes. The gallbladder showed chronic cholecystitis with autolysis. One pericystic lymph node was biopsied and showed no evidence of tumor involvement."} +{"pid": "TCGA-HZ-A77P", "report": "A 3.1 cm lesion was identified in the head of the pancreas, extending into peripancreatic soft tissue and the muscularis propria of the duodenum. Surgical margins were negative, with the closest margin measuring 0.5 cm at the deep margin. Lymphovascular invasion was present. A total of twenty-one lymph nodes were examined, with one showing evidence of metastatic involvement. The remaining twenty lymph nodes did not show any tumor involvement. The surrounding pancreatic parenchyma showed a mixture of fatty and glandular elements without additional lesions. Multiple sections of the bile duct, pancreatic margins, and surrounding tissues were evaluated microscopically, confirming absence of tumor at the resection margins. Twenty lymph nodes from the peripancreatic region were submitted for evaluation, ranging in size from 0.2 cm to 1.4 x 0.8 x 0.8 cm. No perineural invasion was identified. The specimen included portions of the stomach, duodenum, pancreas, and bile duct obtained via Whipple procedure. Gross examination revealed a poorly demarcated mass within the pancreatic head, closely approaching several surgical margins. The tumor measured up to 3.1 x 3.0 x 2.2 cm and was contiguous with the ampulla of Vater. The gastric antrum showed areas of erythema and congestion, while the small bowel demonstrated prominent plicae and a raised lesion near the ampulla. Microscopic evaluation confirmed the presence of a well-differentiated epithelial neoplasm involving the pancreatic head and duodenum. One lymph node out of twenty examined contained neoplastic cells. Pathologic staging indicated regional lymph node involvement with no distant metastasis identified."} +{"pid": "TCGA-2Y-A9H5", "report": "The liver specimen from hepatic segments 5 and 6 shows a well-demarcated, gray-white, firm mass measuring 9.0 x 7.0 x 5.0 cm. The mass is located within the liver parenchyma and is separated from the surgical margin by approximately 1.5 cm. No gross involvement of the overlying capsule or evidence of vascular invasion is identified. The surrounding liver tissue appears unremarkable on gross examination.\n\nMicroscopic evaluation reveals a moderately differentiated cellular proliferation arranged in trabecular and solid patterns. Cellular morphology includes moderate nuclear pleomorphism, abundant eosinophilic cytoplasm, and frequent multinucleated cells. Mitotic figures are present but not increased in number. There is no evidence of tumor necrosis, parenchymal invasion, or perineural involvement. The surgical margins are free of neoplastic cells.\n\nImmunohistochemical staining demonstrates positivity for alpha-fetoprotein, HepPar1 (focal), MUC1 (focal), pCEA (focal), and MOC-31. Negative markers include CK7, CK20, CD10, MUC-5, WT-1, calcitonin, TTF-1, thyroglobulin, p63, MUC-2, ER, synaptophysin, chromogranin, CD56, CDX2, and inhibin. No definitive canalicular pattern is demonstrated with polyclonal CEA staining.\n\nHistologic grading using the Edmondson and Steiner system corresponds to grade 2. The uninvolved liver parenchyma shows portal inflammation with minimal lobular activity, consistent with chronic hepatitis, grade 1. Trichrome and reticulin stains reveal portal expansion with focal bridging fibrosis, corresponding to stage 2 fibrosis. No iron overload is detected. \n\nPathologic staging is determined as pT1 with no lymph node assessment performed (pNX). A concurrent gallbladder specimen shows features of chronic cholecystitis without evidence of neoplasm."} +{"pid": "TCGA-A3-3328", "report": "The specimen consists of a left nephrectomy specimen, including perinephric fat, measuring 10 x 9 x 7.8 cm. The kidney itself measures 7.5 x 7.4 x 5.4 cm and weighs approximately 140 grams. A posterior mass measuring 5.6 x 5.x 5.2 cm is present near the superior pole; it is hemorrhagic, circumscribed, and tan-yellow in color. The renal cortex has a maximum thickness of 0.8 cm, and the renal pyramids appear blunted. Focal hyperemia is noted in the renal pelvis. The ureter is 2.3 cm in length with a maximum diameter of 0.5 cm. A possible lymph node replaced by fat measures 1.6 cm in greatest dimension.\n\nSections were taken from eight tissue blocks: four from the mass, two from random areas of the kidney, one from the renal vessels and ureter, and one from the possible lymph node.\n\nMicroscopic examination shows a unifocal lesion located in the middle portion of the kidney. The lesion is confined to the organ and measures 5.6 cm in greatest dimension. Histologic evaluation reveals cells with clear cytoplasm and nuclear features corresponding to Grade 2 according to the Fuhrman grading system. No vascular or lymphatic invasion was identified. Margins are free of involvement by invasive cells. One lymph node was examined and showed no evidence of metastatic involvement. Distant metastasis could not be assessed. No adrenal gland tissue was present in the specimen. Additional findings were unremarkable."} +{"pid": "TCGA-EB-A3XF", "report": "The skin lesion was excised from the trunk and measured 1.5 x 0 x 2 cm. The lesion was ulcerated and pigmented. Histologic evaluation showed a malignant histologic type with a lymph node status not specified. No venous invasion was identified. Lymphatic invasion and presence of satellite nodules were not specified. The surgical margins were uninvolved. Breslow's depth was recorded as 10 mm. Additional findings, including histologic grade, neo-adjuvant treatment effect, and other pathologic features, were not specified."} +{"pid": "TCGA-ZF-AA4N", "report": "Histopathology report. The specimen consists of 2g of friable tissue chippings with associated blood clot. Microscopic examination reveals a poorly differentiated carcinoma with a solid growth pattern, invading the muscularis propria. The tumor demonstrates laminated layers of keratin, suggesting squamous differentiation. Extensive areas of necrosis are present throughout the specimen. No transitional urothelium is identified; however, several strips of non-dysplastic squamous epithelium are noted. There is no evidence of vascular invasion. The tumor is classified as high grade; however, due to overlapping features, it cannot be definitively determined whether this represents a transitional carcinoma with squamous differentiation or a primary squamous carcinoma. Staging indicates pT2 with a histologic grade of G3."} +{"pid": "TCGA-F5-6465", "report": "The specimen consists of large intestine tissue obtained from an abdominal-perineal resection. The tumor was located at the rectosigmoid junction and measured 7.5 x 0 x 7.2 cm. Gross examination revealed ulceration. Microscopic evaluation showed moderately differentiated cellular features. The tumor extended into perirectal tissues. No lymph node involvement was identified, as all 12 examined lymph nodes, including those in adjacent fatty tissue, were negative for metastasis. Surgical margins were uninvolved. There was no evidence of prior neo-adjuvant treatment. No additional pathologic findings or comments were noted."} +{"pid": "TCGA-H7-A76A", "report": "The specimen consists of an incisional biopsy from the right oropharynx along with a right level 1-4 neck dissection. Gross examination of the right tonsil biopsies showed tan, irregular soft tissue fragments measuring up to 0.9 cm in greatest dimension. The right neck dissection specimens contained multiple tan-pink lymph nodes, with the largest measuring 3.8 cm. Histologic evaluation confirmed invasive focally keratinizing squamous cell carcinoma within the right tonsil biopsy. The tumor was moderately differentiated without clear evidence of perineural invasion. Lymphovascular invasion was present. Two of 31 lymph nodes examined across levels 2\u20134 demonstrated metastatic involvement, with the largest focus measuring 3.8 cm. No extracapsular extension was identified. p16 immunohistochemistry and HPV in situ hybridization testing were positive for high-risk types 16 and 18. Frozen section analysis corroborated the presence of invasive carcinoma. The primary tumor could not be fully staged due to the nature of the biopsy specimen."} +{"pid": "TCGA-D1-A0ZR", "report": "A hysterectomy and bilateral salpingo-oophorectomy specimen included a polypoid mass measuring 3.4 x 2.7 x 1.6 cm located in the posterior and right lateral wall of the endometrial cavity. The myometrial wall thickness was 1.7 cm, with minimal invasion depth measured at 0.2 cm. There was no involvement identified in the lower uterine segment or cervix. Both ovaries and fallopian tubes appeared grossly unremarkable. Histologic evaluation revealed no tumor involvement in multiple lymph node groups, including left pelvic lymph nodes (2 internal iliac, 5 external iliac, 3 common iliac, and 12 obturator), right pelvic lymph nodes (8 external iliac, 3 internal iliac, 6 common iliac, and 9 obturator), as well as para-aortic lymph nodes both above and below the inferior mesenteric artery bilaterally. Gonadal vessels bilaterally also showed no evidence of tumor involvement. Gross examination of the panniculectomy specimen revealed only skin and subcutaneous tissue without identifiable lesions. All lymphatic tissues collected were submitted for histologic evaluation and found to be negative for malignant involvement."} +{"pid": "TCGA-HT-7854", "report": "The pathology evaluation demonstrates a glial neoplasm with mild to moderate hypercellularity, exhibiting diffuse infiltration into both white and gray matter. Within the gray matter, focal perineuronal satellitosis is observed. The tumor cells predominantly display gemistocytic morphology, although some fibrillary astrocytic features are also present. Nuclear contours are generally round to oval without evidence of perinuclear halos or other distinct oligodendroglioma-like differentiation. Cellular atypia is present at a level classified as mild to moderate. No mitotic figures are identified upon examination of 50 high-power fields or during lower magnification scanning. Review of the tissue reveals additional findings including neuronal disorganization with some nuclear atypia, along with alterations in neurons and white matter, suggesting an underlying cortical dysplasia. Immunohistochemical staining for MIB-1 shows only rare positive cells, supporting a low proliferative index."} +{"pid": "TCGA-18-4083", "report": "The specimen consisted of three lymph node biopsies and a resected left lower lobe of the lung. The lymph nodes were received from stations ST10L (TB angle) and ST11 (interlobar), with sizes ranging from 0.3 cm to 2.5 cm in greatest dimension. Histologic examination revealed no evidence of malignant involvement in any of the lymph nodes.\n\nThe lung specimen measured 17 x 11.5 x 6 cm and contained a centrally located tumor measuring 4.0 cm in greatest dimension. The tumor was white-tan, friable, with central necrosis and firm periphery. It was situated 0.3 cm from the nearest pleural surface and 0.8 cm from the bronchial resection margin. Microscopic evaluation showed invasive growth with focal vascular invasion identified. Venous invasion was present. One of nine lymph nodes examined showed metastatic involvement. The bronchial resection margin was free of tumor. Additional findings included post-obstructive edema, inflammation, and organizing pneumonia.\n\nHistologic assessment demonstrated poorly differentiated cells arranged in nests and sheets with marked nuclear atypia. Immunohistochemical staining showed positivity for high molecular weight keratin, CK5/6, and p63, with focal positivity for CD56. Staining for CK7, CK20, TTF-1, chromogranin, and synaptophysin was negative.\n\nPathologic staging based on findings included pT2 classification due to tumor size greater than 3 cm, and pN1 based on metastasis to ipsilateral hilar or peribronchial lymph nodes. No arterial invasion was observed. Resection margins were uninvolved. Additional sections confirmed invasion into an adjacent bronchus with obliteration of the bronchial wall and luminal extension. Multiple lymph nodes were sampled from hilar regions, including one lobar lymph node involved by metastatic disease."} +{"pid": "TCGA-DB-5270", "report": "The specimen consists of brain tissue from the left frontal region, with a focus on a tumor and its posterior margin. The tumor is composed of a rim of solid, highly cellular tissue measuring 0.4 cm in thickness, with infiltration into the surrounding parenchyma in a single-cell pattern. Multiple tissue blocks were submitted for analysis from both the tumor and the posterior margin.\n\nFluorescence in situ hybridization (FISH) studies were conducted using paraffin-embedded sections to assess for chromosomal deletions commonly associated with gliomas. Two probe sets were used: one targeting 19q and control 19p, and another targeting 1p and control 1q. The average ratio for 19q to 19p was 1.01, and for 1p to 1q it was 1.03. Ratios below 0.80 are considered indicative of deletion; however, no such deletions were observed. Instead, approximately 60% of cells showed 3\u20134 copies of each probe, suggesting possible chromosomal gain, tetraploidy, or aneuploidy. These findings have been noted in other glioma cases and may support certain genetic profiles, although this test does not confirm or exclude all chromosomal abnormalities.\n\nInitial frozen section evaluation indicated residual glial neoplasm, and the case was held for further assessment to differentiate recurrence from progression. All tissue samples were embedded for microscopic examination."} +{"pid": "TCGA-UY-A8OD", "report": "The specimen included a bladder, urethra, uterus, ovaries, and fallopian tubes, along with left and right pelvic lymph nodes, and biopsies of the left and right ureter margins. Microscopic evaluation revealed a lesion within the bladder characterized by high-grade cellular features. The lesion measured approximately 2 cm in diameter and was located in the left superior bladder wall, right dome, and focally on the right superior bladder wall. The depth of invasion extended into the outer half of the muscularis propria, reaching within 1 mm of the peri-vesicular fat. No lymphatic or vascular invasion was identified. All surgical margins, including the urethral, right and left ureteral, and perivesical margins, were free of tumor involvement. The closest distance from the tumor to the perivesical margin was 0.4 cm on slide A17. A total of 21 lymph nodes were examined, with no evidence of tumor involvement. No other significant pathologic abnormalities were found in the cervix, endometrium, myometrium, serosa, ovaries, fallopian tubes, or vaginal mucosa. The extent of the lesion was confined to the bladder without extension into adjacent organs."} +{"pid": "TCGA-BH-A18I", "report": "The left breast specimen from a segmental mastectomy at the 10 o\u2019clock position revealed two foci of invasive carcinoma. The dominant mass measured 1.9 cm in greatest dimension, while a second focus measured 0.6 cm and was located 0.5 cm from the main lesion. A component of in-situ carcinoma was also present, comprising 10% of the total tumor volume and showing a cribriform pattern with nuclear grade 2 features. The invasive component showed Nottingham histologic grade 2 features, with a total score of 7 out of 9 (tubule formation: 2, nuclear pleomorphism: 3, mitotic activity: 2). No lymphovascular space invasion was identified.\n\nThe dominant invasive mass extended focally to the superior margin and was less than 0.1 cm from the postero-inferior margin. The satellite focus was 0.15 cm from the posterior margin. Associated findings included calcifications within the tumor and adjacent benign parenchyma, as well as florid ductal hyperplasia, columnar cell change, and fibrocystic changes in non-neoplastic tissue. Previous biopsy site changes were also noted. Immunohistochemical analysis showed positivity for estrogen and progesterone receptors (H-score 240 each) and negativity for HER-2. E-cadherin and p120 staining demonstrated membranous reactivity in the invasive tumor cells.\n\nA separate biopsy from the 12 o\u2019clock position showed florid ductal hyperplasia, columnar cell changes, radial scar, and fibroadenomatoid as well as fibrocystic changes. No residual atypia was identified in this area.\n\nSentinel lymph node evaluation included three nodes. One of one lymph node at level #1 contained metastatic disease measuring 0.6 cm with focal extracapsular extension less than 0.1 cm. Two additional lymph nodes from level #2 showed no evidence of metastasis. The method of lymph node assessment included hematoxylin and eosin staining.\n\nPathologic staging for the primary tumor was pT1c. The nodal stage could not be fully determined due to the sentinel node status, with a modifier of (sn) applied. The presence of nodal metastasis with extracapsular extension suggests a minimum pN1 classification, pending further lymph node evaluation. Non-neoplastic breast tissue also showed fibrocystic disease. Microscopic examination supported all findings."} +{"pid": "TCGA-EJ-7785", "report": "A 68-year-old male with a history of hypertension, hypercholesterolemia, and prior tonsillectomy presented with a PSA level of 4.3. A prior biopsy demonstrated a Gleason score of 3+4 = 7 in the right prostate. The patient underwent a radical prostatectomy. Examination of the surgical specimen revealed a nodule measuring 1.9 cm involving both the right and left lobes, predominantly on the right side, accounting for approximately 10% of the total prostate volume. Histologic evaluation showed poorly differentiated features with established extracapsular extension noted in the right posterior mid and base regions. There was also evidence of perineural invasion; however, no angiolymphatic invasion or seminal vesicle involvement was identified. All surgical margins were free of tumor. High-grade prostatic intraepithelial neoplasia was present. No tumor was found in any of the seven pelvic lymph nodes examined (0/4 on the right, 0/3 on the left). Pathologic staging was determined to be pT3a, pN0, pMX with a histologic grade of G3-4. Benign prostatic hypertrophy and chronic prostatitis with atrophic changes were also noted."} +{"pid": "TCGA-J4-A67K", "report": "The prostate specimen measured 4.5 x 4.5 x 4 cm and weighed 44 grams. Histologic evaluation revealed a dominant nodule measuring 1.5 cm. The tissue showed a Gleason score of 4 + 3 = 7, with the tumor predominantly composed of Gleason pattern 4 and only scattered areas of pattern 3. No tertiary pattern was identified. The severity of tissue involvement was graded as 4 out of 5, indicating that between 30% and 50% of the prostate tissue was affected.\n\nMicroscopic examination demonstrated focal lymphatic invasion and extensive perineural invasion. No evidence of tumor was found in the seminal vesicles or at the surgical margins. The staging classification assigned was pT2c, pNX, pMX. Multiple sections of the prostate were evaluated, including complete sampling of the apex, mid-gland, and upper third, along with full submission of the posterior gland. Both seminal vesicles and vasa deferentia were unremarkable. No treatment-related changes were observed."} +{"pid": "TCGA-AZ-4315", "report": "The surgical specimen consisted of a right hemicolectomy measuring 24 cm in length. The tumor was located in the cecum and presented as an exophytic, polypoid lesion measuring 5.5 cm in its greatest dimension, with additional dimensions of 4.0 x 1.3 cm. Microscopic examination revealed that the lesion extended through the muscularis propria into the subserosal adipose tissue. All resection margins, including proximal, distal, and radial margins, were free of involvement by invasive carcinoma.\n\nA total of 25 pericolonic lymph nodes were examined, and none showed evidence of metastatic involvement. No angiolymphatic or perineural invasion was identified. The histologic grade was low, consistent with well to moderately differentiated morphology. The tumor exhibited an infiltrating border configuration with a mild to moderate lymphocytic response at the tumor interface. Pathologic staging was determined as pT3a/b, pN0, pMX. The terminal ileum and appendix showed no significant abnormalities."} +{"pid": "TCGA-95-7947", "report": "A wedge resection of the left upper lobe was performed, and a lesion measuring 1.5 x 1.1 x 0.7 cm was identified. The lesion is located 0.4 cm from the parenchymal margin and appears to pucker the pleura. Microscopic evaluation reveals a moderately differentiated growth pattern composed of acinar, papillary, and micropapillary components. Angiolymphatic invasion is present, but no visceral pleural invasion is observed. The surgical parenchymal margin is free of involvement.\n\nLymph node dissection included stations #6, #7, #9, and 10L. A total of ten lymph nodes were examined: five fragments from station #6, three from #7, and one each from #9 and 10L. All lymph nodes are negative for metastatic disease.\n\nImmunohistochemical staining shows positivity for CK7 and TTF1, while CK20, Napsin A, and Pax8 are negative. Mucicarmine demonstrates focal positivity. These findings support a primary origin in the lung.\n\nA separate specimen from a medial wedge resection of the left upper lobe shows bullous emphysematous changes and is negative for the presence of the lesion. The clinical history includes a prior laryngeal cancer and a procedure involving video-assisted thoracoscopic surgery (VATS) with wedge resection and lymph node sampling."} +{"pid": "TCGA-3B-A9HO", "report": "The surgical specimen consists of a resected mass measuring 25 x 15 x 8 cm, which focally involves the distal pancreas and extends near the adrenal gland and kidney. The mass is located within a large amount of retroperitoneal adipose tissue and measures approximately 4.8 x 4.5 x 3.7 cm at its largest focus. It approaches within 1 cm of the superior pole of the kidney and comes close to the pancreatic resection margin at 1 cm distance. The peritoneal surface overlying the tumor appears intact, with the tumor bulging but not penetrating through it. A small distance of less than 1 mm is noted at one peritoneal margin.\n\nHistologically, the lesion demonstrates a component of spindle cells exhibiting marked nuclear pleomorphism and frequent mitotic figures, present against a background of inflammation. Areas of tumor necrosis are also identified. Other components show features consistent with a well-differentiated morphology, although these are not elaborated further in this summary.\n\nAll other surgical margins\u2014including those of the renal artery and vein, ureter, pancreatic parenchyma, splenic vessels, and peritoneal surface\u2014are free of involvement, with the exception of the previously noted proximity at the peritoneal margin. Adrenal gland and pancreatic tissues do not show any significant abnormality. An incidental finding of a benign multiloculated supercapsular renal cyst is noted, measuring 2 cm in greatest dimension. The cyst contains tan-brown fluid and has a smooth inner lining.\n\nAdditional biopsies from various resection margins\u2014including gonadal vascular, additional retroperitoneal, and lateral margins\u2014are all free of tumor. The submitted specimen included multiple cassettes representing the tumor in relation to surrounding structures, as well as control tissues such as the spleen, ureter, and renal pelvis, all of which were unremarkable aside from a small subcapsular splenic hematoma.\n\nThe attending pathologist personally reviewed all materials and confirmed the findings."} +{"pid": "TCGA-S5-A6DX", "report": "The specimen analysis included multiple tissue samples from the urinary tract and surrounding regions. Two ureteral margins were examined, both showing dilated ureter without evidence of malignancy. A cystoprostatectomy specimen revealed a solid tumor located on the posterior inferior bladder wall. The lesion measured 2.5 x 1.8 x 1.6 cm and extended into the muscularis propria, reaching the deep muscular layer. Lymphovascular invasion was identified. The tumor was found to be in close proximity to the prostate, with involvement noted at the base. All surgical margins were free of invasive disease, with the closest distance being 0.5 cm at the deep soft tissue margin.\n\nLymph node evaluation was conducted on bilateral pelvic specimens. On the right side, six lymph nodes were assessed and none contained metastatic disease. On the left side, out of five lymph nodes examined, two contained metastatic deposits. The largest involved lymph node measured 0.6 cm, and tumor emboli were observed. No extracapsular extension was present.\n\nThe prostate measured 6 x 5 x 4.5 cm and weighed 80 grams. Histologic examination identified small foci of acinar-type cells consistent with a Gleason score of 2 + 3 = 5. These changes accounted for less than 0.1% of the total prostate volume. No perineural invasion, lymphovascular invasion, or margin involvement was observed. Additional findings included benign stromal hypertrophy and high-grade prostatic intraepithelial neoplasia.\n\nPathologic staging for the primary bladder lesion was classified as pT4 based on invasion into adjacent structures. Regional lymph node involvement was categorized as pN2 due to the presence of metastases in multiple pelvic lymph nodes on the left side. Prostate involvement appeared limited to microscopic changes with no evidence of extraprostatic extension or seminal vesicle invasion. Special immunohistochemical stains performed on selected blocks supported the morphologic findings without altering the interpretation."} +{"pid": "TCGA-R6-A8WG", "report": "A biopsy of a polyp at the hiatal hernia consists of multiple light gray and pink tissue fragments measuring 0.7 x 0.3 x 0.3 cm in aggregate. Histologic examination reveals oxyntic/fundic mucosa with chronic inactive gastritis and muscularis mucosae hyperplasia. No intestinal metaplasia or Helicobacter pylori is identified.\n\nA biopsy from the distal esophagus consists of multiple light gray and pink tissue fragments measuring 1.0 x 0.4 x 0.3 cm in aggregate. Histologic evaluation demonstrates ulcerated invasive carcinoma composed of poorly differentiated cells arising beneath squamous mucosa, accompanied by reactive epithelial changes.\n\nImmunohistochemical staining was performed on the distal esophageal lesion. The neoplastic cells are negative for chromogranin and synaptophysin. Additional testing for Her2-neu shows no membranous staining of the invasive tumor cells, interpreted as negative (score 0). \n\nAll tissue fragments from both sites were submitted for analysis."} +{"pid": "TCGA-P5-A736", "report": "The patient is an adult male. Clinically, a lesion was identified in the brain. Gross examination revealed grayish-pink, translucent tissue fragments obtained from the right parietal lobe. Histologic evaluation demonstrated abnormal glial cells infiltrating the brain parenchyma. The cells exhibited moderate nuclear atypia, frequent mitotic figures, and areas of necrosis. Based on histomorphology, the tumor is classified as a high-grade neoplasm."} +{"pid": "TCGA-63-A5MI", "report": "The tissue sample was collected from the left lower lobe during a resection procedure. The tumor measured 9.5 cm in size and was classified as T2, NOS for pathological T staging. Histological evaluation showed moderately differentiated carcinoma. Metastatic carcinoma was identified in 4 out of 9 segmental and lobar lymph nodes examined, resulting in a pathological N staging of N2. No distant metastasis was detected clinically. A second sample, of buffy coat type, was also collected."} +{"pid": "TCGA-P3-A6T3", "report": "A composite resection specimen from the left arm free flap and oral region was examined. The specimen included a portion of the bony maxilla with three teeth, soft tissue lateral to the mandible, and associated soft tissue superior to the mandible. A friable, exophytic lesion was identified on the buccal surface, extending medially near the teeth. Gross measurements indicated the lesion was at least 2.5 x 3.5 cm in size on initial examination, with mucosal margins ranging from 0.5 to 0.8 cm from the lesion. After sectioning, the lesion measured 4.5 x 4.0 cm and had a firm white cut surface with friable areas. It extended very close to several inked margins: within 0.1 mm of the deep margin, 0.1 cm of the medial and lateral soft tissue margins, and 0.2 cm of the inferior soft tissue margin. Sections of the maxillary bone were submitted for further analysis.\n\nLymph node evaluation was performed on specimens from right neck dissections. In level II, one involved lymph node was identified among three retrieved; two additional positive nodes were found among eleven nodes from level V. Other levels showed no evidence of involvement. Multiple candidate lymph nodes were evaluated across levels II through V, with sizes ranging from 0.1 to 2.5 cm. No gross tumor was observed in the salivary gland or other submitted lymph node regions.\n\nMargins were assessed from various anatomical locations including the inferior, lateral, medial, deep, anterior, superior, and new buccal regions. All were negative for dysplasia or carcinoma. Bone margins, including lateral and posterior bony resections, were also free of tumor involvement. The parotid duct specimen showed no evidence of dysplastic or malignant changes.\n\nBased on the pathological findings, the minimum stage was determined using standard criteria. Angiolymphatic invasion was not present, and there was no definitive evidence of bone invasion identified in the submitted sections."} +{"pid": "TCGA-G6-A8L7", "report": "The specimen consists of a resected right kidney and perirenal fat weighing 289 grams, with total dimensions of 14.5 x 7.0 x 4.2 cm. The attached ureter measures 7 cm in length with an external diameter of 0.3 cm, and the kidney proper measures 12.5 x 4.5 x 2.5 cm. On gross examination, a well-defined mass is present in the lower pole with central necrosis, measuring 5.3 x 4.9 x 2.5 cm. The tumor appears near the capsule but without gross extension into the perirenal fat or renal pelvis. The upper pole parenchyma appears normal without additional tumor foci.\n\nMicroscopically, the lesion demonstrates extensive areas of necrosis and calcifications. Histologic evaluation reveals cells with very irregular nuclei, approximately 20 \u03bcm in size, with large and prominent nucleoli. There is no evidence of vascular, lymphatic, or perinephric tissue invasion. Margins, including ureteral and vascular hilar margins, are uninvolved by invasive disease. Two lymph nodes are identified and are free of tumor involvement (0/2). No adrenal gland tissue is present.\n\nTumor size is 5.3 cm in greatest dimension, with additional dimensions of 4.9 cm and 2.5 cm. The tumor is unifocal and confined to the kidney. Pathological staging is pT1b, pN0, with no distant metastases assessed. Multiple sections were submitted for analysis, including from the ureter, hilar vessels, tumor with adjacent parenchyma, and lymph nodes."} +{"pid": "TCGA-B9-A44B", "report": "The left kidney specimen measured 25 cm x 14 cm x 9 cm and weighed 1,395 grams. A tumor measuring 12 cm in greatest dimension was identified, involving the upper and lower poles, cortex, and medulla. The tumor appeared yellow, soft, hemorrhagic, with multifocal areas and sharp borders. Microscopic evaluation showed high-grade nuclear features corresponding to Fuhrman Grade 3 of 4. Sarcomatoid features were not identified.\n\nMicroscopic invasion was noted at the renal capsule. The tumor macroscopically extended into the renal sinus and ureter, and both macroscopic and microscopic involvement was seen in the renal vein and its segmental branches. Extensive involvement of large venous structures was present, along with lymphatic vessel invasion. Perirenal adipose tissue and Gerota\u2019s fascia were not involved macroscopically or microscopically.\n\nSurgical margins were negative for malignancy in the perinephric fat, Gerota\u2019s fascia, renal artery, ureter, and adrenal gland. However, the renal vein margin was positive for tumor. The ureteral, renal artery, and renal vein margins were within 0.5\u20131 cm of tumor involvement.\n\nAdditional findings included perineural invasion with ganglion involvement. A small 1 mm cortical lesion was also identified in the kidney away from the main tumor.\n\nA separate fragment consistent with tumor thrombus was received, measuring 1.0 x 0.5 x 0.5 cm. A biopsy of the right renal vein margin was also positive for tumor involvement.\n\nStaging was assessed as pT3b based on available data, though this may be subject to revision pending further clinical review. Lymph node assessment was not possible as no nodes were received."} +{"pid": "TCGA-AA-3862", "report": "The specimen consists of a right-sided hemicolectomy. A lesion is present in the ascending colon, showing histopathological features of moderate differentiation. The surface of the lesion demonstrates areas of erosion. Lymphatic invasion is noted. The tissue shows infiltration into the layers of the colon wall and extends into the pericolic fat. There is evidence of ongoing chronic inflammation around the lesion, with signs of recent acute inflammation. Focal extracellular mucus formation is observed within the tissue. A total of 16 lymph nodes are examined, none of which show involvement. Additionally, there is evidence of chronic appendicitis. Section preparations indicate that the extent of spread corresponds to a stage of pT3, pN0 (0/16), MX, L1, R0. All other resection margins are free of involvement. Inflammatory changes are present, along with moderate chronic lymphadenitis in the regional lymph nodes. Cellular morphology indicates a proliferation with certain characteristics of atypia and structural disarray, with a total of 11 or more mitotic figures per high power field in certain areas."} +{"pid": "TCGA-V1-A8WL", "report": "The prostatectomy specimen and associated biopsies were examined. Multiple biopsies from various margins\u2014including right and left posterior and anterior apex, and pre-prostatic fat\u2014showed fibroadipose, vascular tissue, and skeletal muscle without any evidence of tumor. Urothelium was also identified in one margin biopsy. Lymph node examination included one lymph node on the right and three on the left; none showed evidence of tumor involvement.\n\nThe prostate and seminal vesicles were submitted as a radical prostatectomy specimen. Grossly, no distinct nodules or masses were identified. The parenchyma appeared mottled with variable coloration, and the external capsule was intact. The seminal vesicle and vas deferens bundles showed no abnormalities.\n\nMicroscopically, the tumor demonstrated a Gleason score of 3+4, with primary pattern 3 and secondary pattern 4. The estimated tumor volume was approximately 7 cc, with more than 10\u201315% of the tumor demonstrating Gleason pattern 3. Tumor invasion of the capsule was observed in several areas, including the right and left anterior midgland and left anterior base. There was limited extraprostatic extension present in the right anterior and posterior midgland regions.\n\nMargins were extensively sampled and showed no evidence of tumor involvement. Benign glands were not found at the inked excision margins. High-grade prostatic intraepithelial neoplasia was present focally, and perineural infiltration was noted. No involvement of the seminal vesicles was identified. Four lymph nodes were examined and were negative for tumor.\n\nSeveral representative slides were reviewed for consultation and confirmed the findings. The AJCC/UICC stage assigned was pT3aN0MX."} +{"pid": "TCGA-BI-A0VS", "report": "A radical hysterectomy and bilateral salpingo-oophorectomy were performed. The surgical specimen included a cervical lesion measuring 2 cm in maximum dimension, with a tumor thickness and depth of invasion both measuring 7 mm. The tumor was located on the ectocervix and extended focally into the endocervix. There was no definitive evidence of lymphovascular invasion. A high-grade squamous intraepithelial lesion (CIN 3) was also identified. The upper vagina, lower uterine segment, and endometrium showed no evidence of tumor involvement. The endometrium exhibited a disordered proliferative pattern. A leiomyoma measuring 9 cm was present in the uterus. Both ovaries showed physiological changes without any abnormal findings. The fallopian tubes, parametria, and vaginal and parametrial margins were free of tumor. No tumor was identified in the upper vagina.\n\nLymph node dissection included multiple lymph node groups from both sides: right and left external iliac, obturator, common iliac, and periaortic regions. A total of seven lymph nodes were examined, and all were negative for tumor involvement. One lymph node from the left periaortic and right periaortic regions was identified as benign, while fibrofatty tissue without lymph nodes was found in other areas. No extranodal extension was observed.\n\nMicroscopic evaluation indicated no koilocytes or intraglandular involvement by squamous intraepithelial lesion. The mitotic rate was low, at 0 per 10 high-power fields. Pathologic staging was determined as pT1b, pN0, pMX, with no residual tumor identified post-surgery."} +{"pid": "TCGA-AA-3846", "report": "The specimen shows a poorly differentiated neoplasm of the sigmoid colon with erosions on the inner tumor surface. Histopathological analysis reveals peritumorous chronic inflammation with signs of acute inflammatory activity. The lesion infiltrates through the layers of the colon wall into the surrounding fatty connective tissue. Lymphatic invasion is present. A total of 16 lymph nodes were examined, and all are free of metastatic involvement; however, one of 13 lymph nodes shows evidence of reactive changes. Chronic lymphadenitis is noted. No residual tumor is identified in the resection margins, which consist of mature connective tissue. Tumor staging based on available sections is pT3, pN0 (0/16), MX, L1, R0."} +{"pid": "TCGA-E1-A7YS", "report": "The MRI findings demonstrate a heterogeneous enhancing mass located in the left frontal lobe measuring approximately 6.8 x 4.4 cm. The mass effect is significant, with effacement of sulci and herniation of the left frontal hemisphere across the midline. Surrounding T1 hypodensity is present, likely representing vasogenic edema, with central areas of low T1 signal intensity suggestive of necrosis.\n\nGross examination included three specimens. The first, measuring 1.8 x 0.5 x 0.3 cm, was described as soft brown-tan tissue. A second specimen measured 4.3 x 3.8 x 1.9 cm and was described as soft gray-tan tissue. The third specimen measured 4.6 x 2.1 x 2.1 cm and was noted to be scabrous gray-tan tissue with embedded blood clot. Representative sections from each were submitted for analysis.\n\nMicroscopic evaluation revealed brain tissue infiltrated by a neoplastic process characterized by hypercellularity, minigemistocytes, mitotic figures, microvascular changes, and necrosis. Intraoperative consultation suggested a high-grade glial neoplasm.\n\nCytogenetic analysis demonstrated polysomy of chromosome 7 and EGFR in 63% and 66% of tumor cells respectively. Loss of 1p36 and 1p32 was identified in 82% and 74% of tumor cells, respectively. Chromosome 10, 19q13, and PTEN showed no loss. However, PTEN immunohistochemistry demonstrated loss, suggesting possible epigenetic mechanisms such as methylation. Loss of 9p21 was present in 35% of tumor cells. Chromosome 19q was intact, which may have implications for therapeutic response.\n\nImmunohistochemical staining showed 15% positivity for leucocyte common antigen, a high proliferation index (15% of tumor cells), and negative MGMT expression in 5% of tumor cells. EGFR wild-type expression was positive in 80% of tumor cells, while EGFRvIII was not detected. S6 was positive in 30% of tumor cells, MAPK was positive in 40%, and AKT was negative in 20%. PTEN expression was weak, with positivity in only 5% of tumor cells."} +{"pid": "TCGA-C5-A7X5", "report": "The patient is a woman presenting with postmenopausal bleeding, a pelvic mass, and suspected advanced-stage disease. Specimens consisting of endometrial biopsy, endocervical curettage, and cervical biopsies were reviewed.\n\nHistologic examination of all specimens reveals poorly differentiated malignant cells with markedly pleomorphic nuclei and a high mitotic rate. The tumor shows extensive keratinization, and while there are areas suggestive of cytoplasmic mucin, no definitive glandular differentiation is observed. Stromal invasion is evident in the endocervical curettage and cervical biopsy samples. In contrast, only superficial involvement is noted in the endometrial biopsy. No normal endometrial or endocervical tissue is present in the examined specimens.\n\nAll four slides (labeled A through D) correspond to the submitted materials and have been reviewed. The slides have been returned to the originating institution."} +{"pid": "TCGA-AA-A00O", "report": "The resected specimen of the large intestine includes a centrally ulcerated lesion measuring up to 4.5 cm in diameter. Histopathological examination reveals broad infiltration of the pericolic fatty tissue and extensive lymphangiosis carcinomatosa. A total of thirty-two regional lymph node metastases were identified out of forty dissected lymph nodes. The resection margins of the large intestine and mesentery are free of tumor involvement. Histologic evaluation shows high-grade cellular atypia. Lymphatic invasion is present, while vascular invasion is not detected. The specimen exhibits deep transmural extension with involvement of surrounding lymph nodes."} +{"pid": "TCGA-X6-A8C5", "report": "The surgical pathology report includes multiple specimens. The first specimen, from the small bowel mesentery, is a 15.3 x 12.8 x 10.4 cm pink-tan-yellow mass weighing 1110 grams. It is partially encapsulated with a firm, nodular consistency and an intact external surface. On sectioning, the cut surface shows tan-pink trabecular nodules without gross necrosis. A separate nodule measuring 4.0 cm is identified adjacent to the inked margin. Microscopically, the lesion is composed of pleomorphic spindled cells arranged in a fascicular pattern. Nuclear pleomorphism and scattered mitotic figures are present. Areas of necrosis and edema are identified. Immunohistochemical staining demonstrates positivity for vimentin, desmin, and SMA, with no significant expression of S100, CD34, CD117, or pankeratin. Vascular invasion is not present, and margins are not involved.\n\nThe second specimen includes a hysterectomy with left salpingo-oophorectomy. The uterus weighs 187.8 grams and measures 4.6 cm cornu to cornu, 8.2 cm cervix to fundus, and 4.0 cm anterior to posterior. The cervix measures 2.5 x 3.0 cm with a 0.8 slit-like os. Endometrial thickness in the body is 0.15 cm and the myometrium is 1.6 cm thick. The serosal surface is smooth with four subserosal nodules ranging from 0.6 to 1.1 cm. Within the uterine cavity, two polyps are identified measuring 1.2 and 1.9 cm. Transmural nodules are also present, ranging from 0.3 to 1.7 cm. The endocervical canal contains a 1.0 x 0.5 x 0.2 cm polyp. The left fallopian tube is 4.0 cm long with dilated fimbriae measuring up to 2.6 cm in diameter. The left ovary weighs 2.16 grams and measures 1.8 x 1.7 x 1.3 cm.\n\nThe third specimen consists of a right salpingo-oophorectomy. The ovary is 2.2 x 1.4 x 1.2 cm, tan-pink, and cerebriform with no gross lesions. The attached fallopian tube is 5.2 cm long with dilated and edematous fimbriae measuring up to 2.2 cm. Free-floating mucoid material measuring 4.2 x 3.5 x 0.3 cm is also present. No diagnostic abnormalities are identified in this specimen."} +{"pid": "TCGA-A8-A076", "report": "The specimen shows a poorly differentiated invasive lesion measuring 2.5 cm in diameter, with discrete intraductal components present. There is no evidence of skin infiltration. The medial resection margin (sample 3) is free of tumor, indicating complete excision. Histologic classification corresponds to grade III. Staging according to the 6th edition (2003) is pT2NOLOVORO."} +{"pid": "TCGA-RD-A8MV", "report": "A male patient underwent a radical total gastrectomy with removal of the stomach, omentum, and associated lymph nodes. The stomach specimen measured approximately 180 x 65 x 30mm. A polypoid mass was identified along the anterior aspect of the lesser curvature, measuring 30 x 25 x 20mm. Adjacent to this mass was an area of irregular mucosa measuring 25 x 17mm. An incision was noted distal to the mass, measuring 20mm in length. The remainder of the mucosa appeared unremarkable. Sections were taken from the proximal and distal resection margins, representative areas of the mass, sections through the irregular mucosa, composite blocks including the mass and underlying tissue, and lymph nodes from the lesser and greater curvatures. The omentum, measuring approximately 250 x 100 x 30mm, appeared normal.\n\nA separate triangular portion of stomach from the proximal region measured 75 x 45 x 15mm. A staple line measuring 80mm in length was present, and no focal lesions were identified. The mucosa appeared normal. Representative sections were taken, and the staple margin was marked with blue ink.\n\nA third specimen consisted of a small fragment of pale cream tissue measuring 6 x 3mm, labeled as coeliac gland, and was fully embedded for examination.\n\nMicroscopic evaluation of the polypoid mass showed a moderately differentiated intestinal type lesion arising in the lesser curvature of the gastric body. The adjacent mucosa showed changes with abnormal cellular infiltration, including small glands and clusters of atypical cells extending through the full thickness of the gastric wall, approaching within 0.1mm of the serosal surface. Frequent intralymphovascular invasion was observed. Both proximal and distal sections showed intestinal metaplasia with mild to moderate epithelial changes, extending to within 15mm of the proximal resection margin. Metastatic involvement was identified in 8 out of 11 lymph nodes from the lesser curvature and 1 out of 5 from the greater curvature.\n\nExamination of the circumferential sections of gastric mucosa revealed focal low-grade epithelial changes on a background of intestinal metaplasia, with associated chronic inflammation. No specific organisms were identified. A single lymph node from the coeliac region showed no evidence of involvement.\n\nThe proximal stomach showed body-type mucosa with focal intestinal metaplasia and low-grade epithelial changes, along with moderate chronic superficial inflammation. The coeliac lymph node was unremarkable with no evidence of involvement."} +{"pid": "TCGA-49-6745", "report": "The surgical pathology report includes multiple specimens. The first specimen is a lymph node from level 11, which shows involvement by malignant cells within one fragmented lymph node. A second specimen consists of a left upper lobe lobectomy. Histologic evaluation demonstrates a 4.0 cm lesion with a histologic grade of G3, indicating poor differentiation. A focal papillary growth pattern is present. Lymph nodes from all stations were examined, and six out of eleven show evidence of metastatic disease. According to the 7th edition of the AJCC staging system, the primary tumor is classified as pT2a (greater than 3 cm but not exceeding 5 cm), and regional lymph node involvement is categorized as pN2 due to involvement of ipsilateral subcarinal lymph nodes.\n\nMargins are free of invasive carcinoma, with the closest distance of invasive carcinoma to the margin measuring 4.0 mm in the parenchymal region. There is no evidence of large vessel vascular invasion. Small vessel lymphatic invasion could not be definitively determined. Additional findings include emphysematous changes. Two lymph nodes from station 5 show no signs of malignancy. In station 7, one of two lymph nodes contains malignant cells.\n\nSpecial studies were performed. Immunohistochemical analysis showed strong positivity for Napsin-A and TTF-1. There was focal weak staining for p63, while CK 5/6 was negative. Mucin staining with mucicarmine was also negative. Visceral pleural involvement was excluded using VVG special stain across three blocks. Molecular testing for KRAS mutations in codons 12 and 13 was negative. EGFR mutational analysis, covering exons 18 through 21, also showed no detectable mutations."} +{"pid": "TCGA-19-0963", "report": "The specimen from the left brain cystic lesion consists of multiple irregular fragments of tan-brown and gray soft tissue measuring approximately 3.5 x 3 x 1.5 cm. A touch imprint and frozen section were performed, and the entire specimen was submitted in five cassettes. The histologic evaluation reveals focal circumscription with pilomyxoid degeneration. Necrosis is not present; however, prominent microvascular proliferation is observed.\n\nA separate specimen labeled as cyst wall includes multiple tan-brown and gray soft tissue fragments measuring approximately 1.5 x 1 x 0.4 cm in aggregate. Touch imprint and frozen section were performed, and the specimen was submitted in two cassettes. Immunohistochemical staining supports the histologic findings.\n\nA biopsy of the temporal tip consists of multiple tan-gray soft tissue fragments measuring approximately 1.5 x 0.8 x 0.4 cm. Frozen section and touch imprint were performed and submitted in one cassette. Histologic examination demonstrates mild astrocytic hypercellularity.\n\nAll assays were performed using appropriate positive and negative controls. Some reagents used may have contained components classified as analyte specific reagents (ASRs), which have not been cleared or approved by the U.S. Food and Drug Administration. The testing laboratory developed the assays and determined their performance characteristics. The individual or group responsible for the final interpretation certifies that they have reviewed the case. Intraoperative touch imprint diagnosis of high-grade glioma was rendered for both specimens A and B."} +{"pid": "TCGA-CJ-5671", "report": "The left kidney specimen measured 20.0 x 10.0 x 8.0 cm and included a segment of ureter (2.5 x 0.4 cm), a segment of renal vein (1.5 x 0.4 cm), and attached adipose tissue (7.5 x 6.5 cm). A well-circumscribed mass measuring 2.7 x 2.7 x 2.0 cm was identified on the anterior mid-portion of the kidney. The mass abutted the renal sinus and perinephric adipose tissue but did not invade into the perinephric or renal sinus adipose tissue, nor was there involvement of the renal vein. The tumor had a yellow-tan and hemorrhagic surface. Histologically, the lesion was composed entirely of clear cells with nuclear features corresponding to a high-grade morphology. Margins of resection were free of neoplastic cells. No other lesions were identified in the kidney parenchyma. The adrenal gland measured 3.5 x 2.5 cm and contained a single nodule measuring 1.7 cm. The nodule had a bright yellow-orange surface and showed no significant necrosis. No metastatic cells were identified in the adrenal gland. Vascular and perinephric tissue margins were negative. The tumor was fully embedded for analysis along with surrounding structures."} +{"pid": "TCGA-3A-A9IC", "report": "The specimen consists of a resected portion of the pancreatic head measuring 4.5 x 4 x 3 cm and attached duodenum measuring 12 cm in length. Gross examination reveals a firm, yellow-gray mass measuring 4 x 3.5 x 2.5 cm located in the pancreatic head, abutting the retroperitoneal surface. The mass appears to involve the common bile duct and extends into the duodenal wall, reaching the mucosal surface and involving the ampulla of Vater. The pancreatic duct is occluded by the tumor. Minimal uninvolved pancreatic tissue is present. Two lymph nodes adjacent to the pancreas are identified, each measuring up to 1.5 cm.\n\nHistologically, the lesion demonstrates infiltration into adjacent structures including the duodenum. Cellular features include moderate differentiation with presence of lymphatic and perineural invasion. No venous invasion is observed. Multiple regional lymph nodes are examined, with four out of twenty-one showing involvement.\n\nMargins of resection are free of invasive disease. The closest distance of invasive disease to a margin is 1 mm at the retroperitoneal margin. A separate fragment of pancreatic tissue submitted shows no evidence of malignancy but demonstrates low-grade intraepithelial changes.\n\nAdditional findings include acute and chronic pancreatitis. Sections of bile duct margins show no invasive carcinoma, although there are findings suggestive of intraductal papillary mucinous neoplasm. Adipose tissue submitted from the specimen contains no residual tumor.\n\nSections were analyzed both for frozen section diagnosis and permanent histopathological evaluation. Multiple sections were submitted from various anatomical regions including the tumor margins, bile duct, duodenum, and lymph nodes. A representative sample was provided to the Tissue Procurement Laboratory."} +{"pid": "TCGA-68-7756", "report": "The specimen consists of a left upper lobe lobectomy measuring 21.7 x 14.1 x 4.4 cm and weighing 337.6 grams. The bronchial remnant measures 1.2 cm in length. A poorly defined white-gray firm necrotic mass measuring 3.6 x 3.4 x 2.9 cm is present, invading through the pleural surface and vessels visible grossly. The mass is located 3.0 cm from the bronchial margin. Fibrous adhesions are noted on the pleural surface. Twelve lymph node-like nodules ranging from 0.7 to 2.0 cm in size were identified.\n\nHistologic evaluation reveals vascular and lymphatic invasion extensively. The tumor invades through the visceral pleura and is present at the pleural adhesion margins. Microscopic examination shows a tumor composed predominantly of squamous cells with areas of glandular formation and signet ring cells. Mucin staining demonstrates both intra- and extracellular mucin. Immunohistochemical stains including TTF-1 and p63 were performed for further characterization. The adenocarcinoma component blends with the squamous cell carcinoma and constitutes approximately 5\u201310% of the tumor.\n\nLymph nodes from levels 5, 6, 7, 9, and 11 showed no evidence of neoplasm. A microscopic focus of involvement was identified in a lymph node from level 10. Molecular testing for EGFR mutations showed no alterations; genotype was determined as wild type.\n\nPathologic staging according to AJCC (7th edition) indicates stage IIIA (T4 N1 MX). Additional clarification indicated that the tumor involvement at the vascular margin is confined to lymphovascular spaces without direct extension into fibroadipose tissue."} +{"pid": "TCGA-A6-2678", "report": "The transverse colon specimen includes a segment of omentum measuring 70.0 x 15.0 x 1.2 cm, with no gross lesions identified. The colon is 35.0 cm in length, stapled at both ends, and covered with lobular fat. Upon opening, the mucosa appears pink-tan, smooth, and glistening, with normal to slightly flattened folds and an average circumference of 6.5 cm. A large exophytic lesion measuring 4.5 x 4.0 x 1.0 cm is present, located 14 cm from the nearest margin of excision. This lesion extends through the muscularis propria into the serosa and is associated with a 1.2 cm umbilication on the serosal surface. The tumor does not show discrete invasion into surrounding fatty tissue and is within 7 cm of the radial margin. No other gross mucosal abnormalities are noted. Multiple lymph nodes are identified and sampled.\n\nThe appendix measures 9.5 x 0.5 cm, partially covered with smooth serosa and yellow lobular fat. It has an intact wall with an average thickness of 0.3 cm and a lumen ranging from pinpoint to 0.4 cm, partially filled with green fluid feces. No gross lesions are observed.\n\nMicroscopically, the lesion shows a mixture of moderately and poorly differentiated features. The tumor invades through the wall into adjacent pericolonic tissue (pT3). Both proximal and distal margins are free of tumor involvement. The radial margin is also negative, although the tumor approaches within 0.1 cm of the serosal surface. Vascular invasion is not identified. Of the 26 lymph nodes examined, two contain metastatic carcinoma. Distant metastasis could not be assessed. Multiple sections were submitted for microsatellite instability testing. The appendix demonstrates fibrous obliteration at its tip."} +{"pid": "TCGA-DU-6396", "report": "The surgical specimen consisted of four parts from the right cerebral hemisphere. Three biopsies were taken from the right superficial brain region, each composed of small tissue fragments measuring 2 to 4 mm in greatest dimension. All remaining tissue was submitted for analysis after intraoperative frozen section evaluation, which showed atypical glial proliferation in the first biopsy and glioma in the second and third biopsies. A fourth biopsy was obtained from the right frontal deep region, consisting of multiple fragments up to 5 mm in size.\n\nMicroscopic examination revealed a glial neoplasm with variable features across the different regions. In some areas, the tumor was moderately to highly cellular with marked nuclear pleomorphism, including cells with gemistocytic morphology embedded in a fibrillary stroma. Mitotic figures were present, along with individual cell necrosis, although no necrotic areas or vascular endothelial proliferation were identified. In other regions, the tumor demonstrated a fine capillary network and cells with perinuclear halos resembling anaplastic oligodendroglial features, interspersed with astrocytic elements. The background in these areas suggested a mixed pattern of differentiation.\n\nImmunostaining showed GFAP positivity, highlighting the gemistocytic features. MIB-1 staining yielded a labelling index of approximately 2%. Despite this relatively low proliferation index, the overall histological features, including high cellularity, nuclear atypia, and mitotic activity, supported a high-grade classification."} +{"pid": "TCGA-BP-4335", "report": "The left kidney and adrenal gland specimen demonstrates two distinct masses. The first mass is located within the perinephric adipose tissue superior to the kidney, measuring 10.5 x 10 x 2 cm. It is lobulated, focally hemorrhagic, and partially necrotic with approximately 20% necrosis noted. This mass replaces the adrenal gland parenchyma and is situated adjacent to Gerota\u2019s fascia without direct invasion beyond the renal capsule. Serial sections show no involvement of the renal vein; however, vascular invasion is identified within the renal sinus.\n\nA second subcapsular tumor is located at the lower pole of the kidney, measuring 5.5 cm in greatest dimension. It is centrally necrotic with viable portions exhibiting a pink-yellow appearance. The tumor remains confined within Gerota\u2019s fascia, with no gross evidence of extracapsular extension. A satellite tumor nodule is observed within the lumen of a blood vessel near the hilar region, extending into the perinephric adipose tissue. All surgical margins, including urethral and vascular margins, are free of tumor involvement.\n\nHistologic evaluation reveals nuclear grade III/IV morphology. Additional findings include interstitial fibrosis and chronic inflammation in the non-neoplastic renal parenchyma. No lymph nodes are identified at the renal hilum. Multiple representative sections have been submitted for analysis."} +{"pid": "TCGA-08-0347", "report": "The specimen was received in two parts. Part A consisted of two pieces of tan-red tissue measuring 1.6 x 0.6 x 0.3 cm in aggregate. A portion was used for frozen section analysis, with the remainder submitted for permanent embedding. Frozen section evaluation revealed highly anaplastic astrocytoma without necrosis identified. Part B consisted of a tan-white and red soft tissue fragment measuring approximately 3.0 x 2.0 x 0.7 cm in greatest dimension. Representative sections were submitted for histologic evaluation.\n\nMicroscopic examination revealed a highly cellular lesion characterized by marked nuclear and cytoplasmic pleomorphism, frequent mitotic figures, and areas of endothelial proliferation. Necrosis was present. Histologic features were consistent with a high-grade neoplasm, exhibiting aggressive morphologic characteristics. Final diagnosis was established following comprehensive review of all pathology slides by the attending pathologist."} +{"pid": "TCGA-XE-AAOF", "report": "The surgical pathology report describes a specimen from the left testicle and right inguinal region. The left testicle specimen measures 10 x 8 x 6 cm and weighs 270 grams. On gross examination, the tunica vaginalis appears smooth and glistening. A white, fleshy, homogeneous mass is present, replacing nearly all normal testicular architecture. No recognizable normal tissue is identified. The mass approaches the tunica albuginea but does not appear to involve it. A discrete hemorrhagic area measuring 3 x 2 cm is noted within the mass. No necrosis is observed. The spermatic cord, measuring 1 cm in length, is present and submitted for evaluation. Microscopic examination reveals no involvement of the epididymis, no lymphovascular invasion, and surgical margins free of abnormal cellular proliferation. Adjacent testicular tissue shows advanced tubular atrophy and absence of spermatogenesis. \n\nA second specimen from the right inguinal region measures 3.5 x 1.5 x 2 cm with attached fibroadipose tissue. It has a smooth, tan-gray, glistening surface and a tan-brown, homogeneous, encapsulated cut surface. No additional lesions are identified upon sectioning. Histological analysis reveals nodular hyperplasia of Leydig cells. Immunohistochemical stains and electron microscopic features were used to support the findings. The overall staging is pT1NXMX."} +{"pid": "TCGA-F9-A7Q0", "report": "Patient ID: Gross Description: A tumor located in a pole of the kidney, with a moderately well-defined margin, soft and solid consistency, exhibiting yellow and gray areas. The tumor measures 5x4x4 cm. Microscopic Description: The tumor is densely cellular and composed of elongated tubules and papillary structures arranged in a back-to-back pattern, showing variability in shape and size. The lining cells are predominantly cylindrical or cuboidal with moderate stratification. Nuclei are enlarged, irregular, hyperchromatic, and display prominent nucleoli. Mitotic figures are present. The cytoplasm is moderate in amount and shows eosinophilic or clear characteristics. Specimen type: Radical nephrectomy. Tumor site: Kidney. Tumor size: 5x4x4 cm. Focality: Single lesion. Histologic grade: Moderately differentiated. Tumor extent: Confined to the kidney. Lymph nodes, lymphatic invasion, venous invasion, margins, and evidence of neo-adjuvant treatment were not specified. Additional pathologic findings were not reported."} +{"pid": "TCGA-US-A77G", "report": "The specimen consists of a Whipple's resection, including portions of the duodenum, stomach, gallbladder, bile duct, and pancreas. A mass was identified in the pancreatic body/neck region adjacent to the mid to distal common bile duct. The lesion measured up to 15mm macroscopically and was located 20mm from the ampulla of Vater and 20mm from the common bile duct margin. Microscopically, the lesion measured 20 x 20 x 20mm and demonstrated a glandular and ductal architecture with marked desmoplasia and extensive perineural invasion. Tumor extended alongside the common bile duct with a margin of 10mm and invaded the wall of the portal vein without reaching the lumen. The tumor approached within 1mm of the posterior soft tissue margin at the neck of the pancreas.\n\nLymphovascular space invasion was present, with involvement of peripancreatic lymph nodes. Three out of eleven lymph nodes were involved, including a micrometastasis in a peripancreatic node and a periuncinate node. High-grade PanIN was identified adjacent to the tumor. Resection margins were evaluated microscopically: the pancreatic neck margin showed chronic pancreatitis without high-grade PanIN or malignancy, and the proximal common bile duct margin was uninvolved. Sections from the ampulla of Vater showed reactive changes and epithelial hyperplasia.\n\nAdditional findings included chronic pancreatitis, chronic cholecystitis with cholelithiasis, and pancreatic duct obstruction with dilatation. No acute pancreatitis or pancreatic calculi were identified. Other sections, including those from the stomach, pylorus, and distal small bowel, were unremarkable.\n\nStaging according to AJCC 6th edition criteria was determined as pT3, pN1, pMX. The tumor showed extension beyond the pancreas posteriorly, with lymph node metastases but no distant metastases identified."} +{"pid": "TCGA-CQ-7069", "report": "The specimen consisted of a left neck dissection encompassing levels I-IV, containing 28 lymph nodes, all without evidence of tumor involvement. The submandibular gland showed focal chronic sialadenitis.\n\nMultiple margin specimens were evaluated, including the floor of mouth, deep margin of the left cheek, and left buccal margin, all of which were negative for malignant cells.\n\nA composite resection of the left mandible was submitted, measuring 9.8 cm in the anterior-posterior dimension. Within this specimen, a lesion was identified in the alveolar mucosa, measuring 2.2 x 1.2 x 1.4 cm. The lesion was described as raised and congested. Margins were all found to be free of tumor involvement with distances from the lesion ranging from 0.7 cm to 1.5 cm. Histologic evaluation revealed no lymphovascular or perineural invasion.\n\nIn addition, three teeth were examined grossly only and showed no pathological changes. Surgical waste consisting of skin was also unremarkable upon gross inspection.\n\nStaging could not assess distant metastasis. Based on AJCC/UICC TNM classification, regional lymph node assessment showed no metastasis (pNO), with 28 lymph nodes examined and none involved."} +{"pid": "TCGA-BP-5181", "report": "The clinical history includes a left renal mass. The submitted specimen is a partial nephrectomy from the left kidney. Gross examination reveals a wedge-shaped kidney specimen measuring 5.0 x 3.0 x 2.5 cm, with a deep margin marked by suture and inked black. Serial sections identify a well-circumscribed, encapsulated mass measuring 4.2 x 3.0 x 2.5 cm with yellow-tan appearance. The tumor is located 0.2 cm from the resection margin. Sections of the perinephric fat show no evidence of tumor involvement.\n\nHistologic evaluation confirms that all surgical margins are free of tumor. The surrounding renal parenchyma appears unremarkable. No lymph nodes or adrenal tissue were identified in the specimen. There is no evidence of local invasion or vascular invasion.\n\nThe tumor measures 4.2 cm in greatest dimension and is confined within the kidney. Nuclear grading is assessed at Grade II out of IV. Based on these findings, the tumor is staged as pT1, defined as a tumor not exceeding 7.0 cm in size and limited to the kidney. Multiple representative sections of the tumor and surrounding tissues were submitted for analysis. Intraoperative frozen section assessment confirmed the presence of a renal cortical neoplasm with benign margins."} +{"pid": "TCGA-AA-A00Q", "report": "The specimen includes a normal gallbladder without polyps or significant inflammatory changes, along with three tumor-free lymph nodes. The resected sigmoid colon shows no tumor involvement at the oral and aboral margins. The specimen includes an ulcerated lesion with moderate differentiation, displaying transmural extension through all layers of the colonic wall and involving the peritoneum. There is also involvement of the subserosa of an adjacent small intestinal segment. A single regional lymph node demonstrates metastatic involvement. Vascular invasion is absent, while lymphatic invasion is present. The assessment includes 31 lymph nodes, one of which is involved."} +{"pid": "TCGA-E2-A154", "report": "The surgical specimens include two sentinel lymph nodes from the left axilla and a left breast lumpectomy. Sentinel lymph node #1 measured 2.0 x 1.5 x 0.5 cm and sentinel lymph node #2 measured 1.6 x 1.4 x 0.4 cm; both were entirely submitted for examination and showed no evidence of metastatic involvement. The left breast specimen was a lumpectomy measuring 5.8 x 5.1 x 1.8 cm and weighing 26 grams. On sectioning, a stellate, gritty white lesion measuring 1.5 x 1.5 x 1.3 cm was identified and was located within less than 0.1 cm of the anterior margin. A second smaller nodule measuring 0.5 x 0.4 x 0.2 cm was noted approximately 0.2 cm from the inferior margin and at least 0.4 cm away from the primary lesion.\n\nHistologic evaluation revealed an invasive tumor with a maximum dimension of 1.2 cm. A satellite focus of invasive tumor measuring 1 mm was present 2.5 mm from the posterior aspect of the main tumor. The anterior surgical margin was involved by invasive tumor. Additional findings included intermediate nuclear grade ductal carcinoma in situ of the cribriform type with focal necrosis. Examination of four grossly identified tumor nodules revealed three foci of invasive ductal carcinoma with similar morphology and one focus of ductal carcinoma in situ. Scattered additional foci of ductal carcinoma in situ were observed between these lesions. The largest confluent invasive component measured 2.5 cm.\n\nEvaluation of lymph nodes revealed one involved among twelve axillary lymph nodes, measuring 3.5 cm with focal extranodal extension. Additionally, one of two intramammary lymph nodes contained metastatic tumor measuring 0.8 cm with focal extranodal extension. No metastases were identified in the additional axillary lymph node evaluated.\n\nHistologic grading demonstrated a tubular score of 3, nuclear grade of 2, mitotic score of 3, resulting in a modified Scarff-Bloom-Richardson grade of 3. Vascular or lymphatic invasion could not be definitively determined. There was an estimated 10% involvement by ductal carcinoma in situ, primarily solid and cribriform types, associated with the invasive component. Hormone receptor testing showed ER positivity, PR negativity, and HER2 negativity by immunohistochemistry. Pathologic staging was determined as pT2 N1c."} +{"pid": "TCGA-A8-A09X", "report": "The specimen shows a poorly differentiated invasive malignant lesion measuring 3.5 cm in diameter, with areas of focal in situ spread. Histological examination reveals marked angioinvasion. The tumor is classified as NOS, Grade III, with staging parameters indicating oT2N3aL1V1. Surgical margins are noted as positive."} +{"pid": "TCGA-VQ-A8P3", "report": "The specimen involves tissue from the stomach body region. The hepato-duodenal ligament contains adipose tissue without evidence of neoplastic involvement. In the posterior hepatic area, two lymph nodes are free of tumor cells. The right paracardial region includes muscle and adipose tissue with no signs of malignancy. Splenic region 11d contains adipose and connective tissue that appear unaffected. An esophageal fragment at the resection margin shows no neoplastic changes. The gallbladder demonstrates features consistent with chronic cholecystitis.\n\nIn the stomach/omentum and lymphadenectomy specimen, a tubular growth pattern is observed, with moderate cellular differentiation. The lesion extends into the perigastric adipose tissue and includes satellite nodules within this area. The macroscopic appearance corresponds to a Bormann Type III configuration. Surgical margins are clear of tumor involvement. No angiolymphatic or perineural invasion is identified. Metastatic involvement is present in one out of seven lymph nodes along the lesser curvature, while five lymph nodes from the greater curvature show no evidence of spread."} +{"pid": "TCGA-39-5035", "report": "The clinical evaluation included imaging with CT in coronal, axial, and sagittal planes revealing a mass in the right lower lobe. Submitted specimens include: (1) level VII mediastinal lymph node; (2) second level VII mediastinal lymph node; (3) right pleural biopsy; (4) right mediastinal lymph node at level XI; and (5) right lower lobe of the lung.\n\nThe level VII mediastinal lymph nodes were each benign and showed no evidence of malignancy. The right pleural biopsy revealed fibroconnective tissue with no malignant findings. The level XI mediastinal lymph nodes were also benign and without signs of metastasis.\n\nThe right lower lobe specimen measured 14.3 x 14.2 x 6.4 cm and contained a tan, stellate lesion measuring 2.9 x 2.5 x 1.8 cm. The lesion was located subpleurally but did not reach the pleural surface. It was situated 6.0 cm from the bronchial margin and 9.0 cm from the nearest staple line. The bronchial margin was free of involvement. Histologic examination showed moderate to poor differentiation of the cellular elements without vascular or perineural invasion. Adjacent lung parenchyma exhibited pleural scarring and focal organizing pneumonia.\n\nLymph node status was assessed across multiple regions. No metastatic involvement was identified in the mediastinal or peribronchial lymph nodes examined. Immunohistochemical staining performed on the lesion demonstrated positivity for markers consistent with squamous lineage (4A4 and P63), while markers typically associated with neuroendocrine or mucinous differentiation (TTF-1, synaptophysin, chromogranin, and mucin) were negative.\n\nSections examined included bronchial margin, vascular margin, tumor with pleura, tumor with adjacent pulmonary parenchyma, random lung parenchyma distant and near the tumor, and lymph node tissue. All submitted lymph nodes were negative for metastasis.\n\nIntraoperative frozen section analysis of the mediastinal lymph nodes confirmed absence of malignancy, and this finding was confirmed on permanent sections."} +{"pid": "TCGA-AR-A24P", "report": "The specimen consists of a left breast wide local excision showing a mass measuring 1.5 x 1.4 x 1.2 cm. Histologic evaluation reveals a Nottingham grade II lesion with associated intermediate nuclear grade ductal carcinoma in situ comprising approximately 20% of the tumor. All resection margins, including lateral, deep, inferior, and superior, are free of involvement. Three left axillary sentinel lymph nodes (numbers 1, 2, and 3) were submitted and found to be negative. Cytokeratin immunohistochemistry on paraffin-embedded sentinel lymph node tissue supports the histologic findings."} +{"pid": "TCGA-EI-6506", "report": "Histopathological examination was performed on a resected segment of the large intestine. The specimen included a distal segment of the sigmoid colon and proximal rectum, with one end marked by a thread. A second specimen consisted of anastomosis rings from the sigmoid colon and rectum.\n\nMacroscopically, the first specimen measured 13 cm in length, with a mesenteric segment measuring 14 x 6 x 2.5 cm. A flat-elevated, ulcerated, cauliflower-like lesion was observed in the mucosa, measuring 4.5 x 3.5 cm. The lesion encircled approximately 90% of the intestinal circumference and caused significant luminal narrowing. It was located 5.5 cm from one incision margin and 4.5 cm from the opposite margin. The tumor appeared to invade the surrounding periintestinal tissue, with a minimum side margin of 2.3 cm. The second specimen consisted of two small surgical samples measuring 2.5 x 1.8 x 1.2 cm and 2.5 x 2.0 x 1.3 cm, respectively.\n\nMicroscopic evaluation revealed glandular structures with moderate architectural atypia infiltrating the muscularis propria and pericolonic adipose tissue. No neoplastic involvement was identified at the resection margins. Reactive lymph node changes were noted. The anastomosis rings showed no evidence of abnormal cellular infiltration or structural disruption.\n\nStaging parameters indicated deep transmural extension without lymph node involvement. Histological grade corresponded to moderately differentiated morphology. Proximal and distal margins were clear."} +{"pid": "TCGA-19-5956", "report": "A resection specimen from the left frontotemporal region of the brain was received fresh and subsequently fixed in formalin. The specimen consisted of multiple light tan, irregular, soft tissue fragments, measuring approximately 2.5 x 1.7 x 1.0 cm in total. Upon sectioning, the largest fragment exhibited a similar light tan appearance. All tissue was submitted for histologic evaluation in two cassettes. Microscopic examination revealed a highly cellular lesion with marked nuclear atypia, frequent mitotic figures, microvascular proliferation, and areas of necrosis. Some tumor cells displayed epithelioid morphology, while others showed pleomorphic features including multinucleated giant cells. The neoplasm infiltrated adjacent brain parenchyma and demonstrated extensive perineuronal satellitosis. Immunohistochemical staining showed positivity for GFAP, S100, and p53, with variable expression among tumor cells. A subset of cells was positive for MGMT. The histologic features were consistent with a high-grade glial neoplasm."} +{"pid": "TCGA-KM-A7QH", "report": "A right kidney excision specimen included two tissue fragments. The first fragment measured 0.9 x 0.7 x 0.5 cm and consisted of yellow-white soft tissue with a gold-mahogany cut surface. The second fragment measured 4.2 x 3.5 x 2.5 cm overall and contained a solitary mass measuring 2.8 x 3.5 x 2.5 cm, along with attached fibroadipose tissue in what appeared to be normal kidney on gross examination. The mass demonstrated a red, friable cut surface with areas of gold-tan tissue and lacked a distinct capsule. Both specimens were sectioned and submitted for histologic evaluation. A separate biopsy of the right rib was received as a 1.0 x 0.5 x 7.0 cm fragment of tissue consistent with rib, with minimal soft tissue present. This specimen was examined for gross diagnosis only. Cellular features noted included nuclear characteristics classified as Fuhrman grade II/IV. Tissue measurements and morphologic details were documented from both kidney specimens."} +{"pid": "TCGA-EW-A2FS", "report": "A lymph node measuring 0.5 x 0.5 x 0.4 cm was received and bisected for examination; immunohistochemical staining for keratin was performed and showed no evidence of malignant cells. Three additional lymph nodes, ranging in size from 0.3 to 0.5 cm, were examined individually and all showed negative results for malignancy using the same staining method. Another lymph node measuring 0.3 x 0.3 x 0.3 cm was also found to be negative for any malignant involvement. A separate lymph node biopsy, measuring 0.5 x 0.5 x 0.4 cm, revealed no signs of malignancy upon histological evaluation with immunostaining. Further lymph nodes, measuring 0.3 x 0.3 x 0.3 cm and 0.6 x 0.3 x 0.3 cm respectively, were similarly devoid of any malignant cells.\n\nThe mastectomy specimen weighed 300 grams and measured 19 x 15 x 3.5 cm. The tumor identified within the breast tissue measured 3.7 cm in greatest dimension with additional dimensions of 3.3 x 2.7 cm. Histologic evaluation demonstrated a poorly differentiated lesion characterized by minimal tubule formation (less than 10%), marked nuclear pleomorphism, and more than 10 mitotic figures per 10 high-power fields, resulting in a total Nottingham score consistent with high grade morphology. Microcalcifications were present in association with the lesion.\n\nMargins of the specimen were uninvolved by invasive disease, though the deeper margin showed focal involvement by intraductal carcinoma. No vascular or lymphatic invasion was identified. Immunohistochemical analysis showed positivity for estrogen receptor markers while progesterone and HER2 receptors were not expressed.\n\nSentinel lymph node mapping identified one involved lymph node with a focus measuring 0.35 mm detected by keratin immunostaining, indicating limited nodal involvement. Other sentinel lymph nodes sampled did not reveal any evidence of metastatic disease. The staging assessment indicated a primary tumor classified as T2 based on size, with regional lymph node involvement categorized as N1mi, while distant metastasis could not be assessed."} +{"pid": "TCGA-DG-A2KM", "report": "The sample was obtained from the cervix via surgical resection. The tissue specimen was collected fresh frozen. The tumor measured approximately 2.7 cm in size. Histological examination revealed moderately differentiated cells with features consistent with a certain type of epithelial malignancy. Staging indicated involvement of the primary site with regional extension. A total of 4 lymph nodes were sampled, and all were involved. Distant spread was identified at the time of evaluation. The tumor was located at the 12:00 position of the cervix. No evidence of bilateral involvement was noted."} +{"pid": "TCGA-DC-6158", "report": "The specimen from a male patient consists of a transanal excision of rectal tissue and additional mesorectal tissue. The excised rectal specimen measured 5.8 cm in length by 3.7 cm in width by 0.3 cm in thickness. A red-tan papillary lesion was identified on the mucosal surface, measuring 3.6 x 2.2 cm, located very close to several margins: 0.2 cm from the distal resection margin, 0.2 cm from the deep (radial soft tissue) margin, 0.2 cm from the lateral margins, and 0.5 cm from the proximal margin. The lesion extended into the tissue to a depth of 0.6 cm. Histologically, the lesion showed no tumor budding or increased tumor-infiltrating lymphocytes. Lymphovascular invasion was present, as was perineural invasion. No precursor lesions or polyps were identified. All surgical margins were free of involvement. One lymph node was examined and showed no evidence of metastasis. The tumor invaded the muscularis propria layer but did not extend beyond it. No large venous invasion or tumor deposits in pericolorectal soft tissue were observed. The non-neoplastic bowel appeared unremarkable. The second specimen consisted of mesorectal fibrofatty tissue and was benign upon examination."} +{"pid": "TCGA-E8-A436", "report": "The specimen demonstrates a bilateral, multifocal lesion. The right-sided lesion measures 2.5 x 2 x 1 cm, while the left-sided lesion measures 1.5 x 1 x 1 cm. There is no evidence of extrathyroidal extension. Cellular morphology is consistent with a neoplastic process, exhibiting characteristics such as nuclear features and architectural patterns commonly associated with thyroid pathology. Staging is based on size and laterality, with no extension beyond the thyroid capsule noted."} +{"pid": "TCGA-BP-5173", "report": "The submitted specimens include a right renal mass and a deep margin biopsy. The renal specimen measures 5.0 x 3.5 x 2.5 cm and contains a well-defined tan-yellow mass measuring 2.0 x 2.0 x 2.0 cm. The mass demonstrates an acinar growth pattern and is located within the renal cortex. Histologic evaluation reveals nuclear features consistent with intermediate grade morphology. The tumor is confined within the renal capsule without evidence of extension into the renal vein. The closest surgical margin is less than 1 mm from the tumor, based on both gross and microscopic assessment. The remaining renal tissue shows areas of lymphocytic infiltration within the interstitium. The second specimen, a deep margin biopsy, consists of soft tissue measuring 0.8 x 0.3 x 0.2 cm and shows only benign fibroadipose tissue. Intraoperative frozen section analysis confirmed the presence of a renal cortical lesion and absence of tumor at the resection margin. Permanent sections confirm these findings. All other sampled tissues were unremarkable."} +{"pid": "TCGA-DD-AAW3", "report": "A right posterior sectionectomy of the liver was performed. The lesion measured 3.1 x 2.7 x 2.5 cm and was identified as a solitary nodule with perinodal extension. Microscopic examination revealed a trabecular and pseudoglandular growth pattern with classic cellular morphology. The tissue showed a histologic grade of 3 for the worst differentiation and 2 for the major differentiation. There was partial capsule formation with infiltration of the capsule noted. Septal formation was present. No satellite nodules, fatty change, hemorrhage, peliosis, tumor necrosis, or vascular invasion were observed. There was no evidence of bile duct invasion, serosal invasion, or involvement of major branches of the portal or hepatic veins. Surgical margins were clear with a safety margin of 1.0 cm. Evaluation of two regional lymph nodes showed no metastasis. There was no evidence of intrahepatic metastasis or multicentric occurrence. Pathologic staging was consistent with AJCC criteria pT1 and pT2. Additional findings included a lipoma in the small bowel mesentery and an unremarkable gallbladder upon cholecystectomy. No chronic hepatitis, cirrhosis, or dysplasia was identified."} +{"pid": "TCGA-06-1801", "report": "The clinical history includes a right temporal lobe lesion that is radiographically heterogeneous with central necrosis and peripheral enhancement. There is associated mass effect, uncal herniation, and compression of the cerebral peduncle. A biopsy was performed and fragments of brain tissue were received for analysis. Microscopic evaluation revealed a neoplastic process involving astrocytic cells with nuclear anaplasia, mitotic figures, and areas of microvascular proliferation. Necrotic regions are present, including zones with tumor cell dropout and surrounding cellular palisading. Thrombosis is also noted in some areas.\n\nImmunohistochemical studies show strong GFAP expression, indicating active gliofibrillogenesis. The MIB-1 proliferation index is approximately 60% in most areas. Additionally, p53 overexpression is observed in a majority of the neoplastic cells. Molecular testing identified promoter methylation of the MGMT gene, which may be relevant to treatment response. The histological and molecular features support a high-grade astrocytic neoplasm. The specimen measured 1.5 cm in total and was described as soft, reddish-tan tissue. Multiple stains and tests were performed to further characterize the lesion."} +{"pid": "TCGA-BH-A201", "report": "A left segmental mastectomy with wire localization and sentinel node biopsy was performed. Two sentinel lymph nodes were examined and both were benign without evidence of malignancy.\n\nThe primary lesion measured 1.5 cm in greatest dimension and was composed of invasive ductal adenocarcinoma with a Nottingham histologic grade of 2 (total score 7 out of 9). Nuclear grade was 2, tubule formation score was 3, and mitotic activity score was 2. Lymphovascular space invasion was present. There was also associated ductal carcinoma in situ (DCIS), nuclear grade 2, solid type. Resection margins were negative for malignant involvement; the invasive tumor was 2 mm from the anterior margin. Fibrocystic changes, ductal epithelial hyperplasia, and sclerosing adenosis were noted. Biopsy site changes and calcifications were identified in both benign and malignant areas.\n\nImmunohistochemistry demonstrated positivity for estrogen and progesterone receptors with H-scores of 205 and 225 respectively. HER-2/neu staining was scored as 1+. \n\nPathologic staging was determined to be pT1a pN0. The invasive component occupied approximately 10% of the lesion. The closest distance from the invasive tumor to the surgical margin was 3 mm, while the in situ component was within 2 mm of the nearest margin. Both sentinel lymph nodes were evaluated using hematoxylin and eosin staining and showed no involvement."} +{"pid": "TCGA-DQ-7595", "report": "The patient has a forty-year smoking history and presented with a six-month history of progressively worsening hoarseness, left-sided ear pain, and difficulty swallowing. A recent biopsy was reviewed. The specimen from the epiglottis consisted of five small pink-tan mucosal fragments measuring between 0.2 x 0.2 cm and 0.8 x 0.4 cm. Two fragments were bisected and all tissue was submitted for analysis. Microscopic examination revealed invasive moderately differentiated squamous cell carcinoma as well as areas of carcinoma in situ. The slides were personally examined and interpreted by the attending pathologist."} +{"pid": "TCGA-XF-AAMR", "report": "The specimen from the right distal ureter measured 0.4 x 0.4 x 0.2 cm and was entirely submitted for frozen section in cassette AFS. The left distal ureter measured 0.4 x 0.4 x 0.2 cm with surrounding fat and was submitted in BFS. An additional right ureter measuring 1 x 0.5 x 0.5 cm with surrounding fat was submitted in CFS. The apical urethral margin consisted of a 1 x 0.3 x 0.2 cm soft brown-tan tissue fragment and was submitted in DFS.\n\nThe bladder and prostate specimen had an overall measurement of 34 x 13 x 4.2 cm. The peritoneum measured 28 x 16 x 3 cm, and the bladder measured 9 x 9 x 2 cm. The prostate measured 4.7 x 4 x 3.5 cm. The right seminal vesicle measured 2.5 x 1.5 x 0.5 cm and the left measured 3.5 x 2 x 1 cm. The outer surface of the specimen was inked black. Upon opening anteriorly, the prostatic urethra measured 3.7 cm in length and 3.6 cm in circumference. The verumontanum measured 1 x 1.2 x 0.3 cm. The right posterior bladder mucosa showed a 4 x 4 cm gray-tan ulcerated lesion with necrotic surface. Sectioning revealed a mass invading through the entire wall thickness of the urinary bladder and extending into the perivesical fat. Sections were submitted in 26 cassettes.\n\nLymph node specimens included: Left para-aortic lymph node (F) measuring 3 x 1.5 x 1 cm with one lymph node submitted in three cassettes; right paracaval lymph node (G) measuring 3 x 1 x 0.5 cm with one lymph node up to 0.7 cm submitted in two cassettes; right common iliac lymph node (H) measuring 3 x 2 x 1 cm with two lymph nodes ranging from 0.6 to 2.7 cm submitted in two cassettes; left common iliac lymph nodes (I) measuring 2 x 2 x 1 cm with three lymph nodes ranging from 0.2 to 1.2 cm submitted in three cassettes; right external iliac lymph nodes (J) measuring 2 x 2 x 1 cm with six lymph nodes ranging from 0.2 to 0.8 cm submitted in three cassettes; right lymph node of Cloquet (K) measuring 1 x 1 x 0.8 cm with one lymph node up to 1.3 cm submitted in one cassette; right obturator hypogastric lymph node (L) measuring 4 x 3 x 1.5 cm submitted in five cassettes; left lymph node of Cloquet (M) measuring 1.3 cm submitted in one cassette; left external iliac lymph node (N) measuring 2 x 2 x 0.5 cm submitted in one cassette; left obturator hypogastric lymph node (O) measuring 5 x 3 x 1 cm submitted in five cassettes; right pre-sciatic lymph nodes (P) measuring 1.5 x 1 x 0.3 cm with two lymph nodes ranging from 0.4 to 0.6 cm submitted in one cassette; presacral lymph nodes (Q) measuring 4 x 2 x 0.5 cm with four lymph nodes ranging from 0.3 to 0.6 cm submitted in four cassettes; left pre-sciatic lymph node (R) measuring 0.5 x 0.5 x 0.2 cm submitted in one cassette; left proximal ureter (S) measuring 1.5 x 1 x 0.2 cm with three metallic staples submitted in one cassette; and right proximal ureter (T) submitted in one cassette.\n\nFrozen sections included AFS (right distal ureter), BFS (left distal ureter), CFS (additional right ureter), and DFS (apical urethral margin). Sections E1\u2013E22 covered various areas including the apex of prostate, ureter margins, bladder regions, prostate segments, and seminal vesicle junctions. Lymph node sections included F1\u2013F2, G1\u2013G2, H1\u2013H2, I1\u2013I3, J1\u2013J3, K, L1\u2013L5, M, N, O1\u2013O5, P, Q1\u2013Q4, R, S, and T.\n\nAll lymph node specimens were evaluated with no malignancy identified across a total of 77 lymph nodes examined. No tumor was identified in any of the frozen sections or final evaluations. All surgical margins were negative."} +{"pid": "TCGA-DS-A1O9", "report": "A 76-year-old female with a history of a pelvic mass and abnormal Pap smear findings was admitted for surgical evaluation. The patient presented with weight loss, back pain, and occasional vaginal bleeding. Imaging studies showed a complex right adnexal mass, a uterine fibroid, and endometrial thickening. A CT scan revealed no ascites but noted a right pelvic kidney and small renal cysts. Laboratory findings included a CEA-125 level of 21.\n\nThe patient underwent a total abdominal hysterectomy with bilateral salpingo-oophorectomy, resection of the terminal ileum, cecum, and appendix, along with biopsies of multiple lymph node regions. Gross examination of the hysterectomy specimen revealed significant involvement of the endocervix, lower uterine segment, and endometrium. The tumor extended into the cervical stroma and myometrium, with involvement of the paracervical soft tissue margins and distal vaginal cuff. Tumor was also present on the serosal surface of the uterus, extending into the wall of the terminal ileum and appendix, with invasion through the muscularis propria in these areas. The left fallopian tube and ovary were unremarkable, and no tumor was identified in the left ovary. \n\nHistologically, the lesion demonstrated features of invasive squamous cell carcinoma, moderately-poorly differentiated, with areas of in situ involvement in the cervix, lower uterine segment, and endometrium. There was extensive tumor-associated necrosis, high mitotic activity, and angiolymphatic vascular space invasion. Lymph node assessment included approximately 15 pericolonic nodes from the initial resection, four from an additional cecal specimen, two cecal nodes, and one right pelvic node\u2014all were negative for malignancy. A biopsy of left periurethral tissue showed fibroadipose tissue with focal acute hemorrhage; one lymph node was also negative.\n\nMargins of resection in the ileum and cecum were free of tumor. The right ovary contained a cystadenofibroma with an associated solid, papillated mass showing similar histological features to the uterine lesion, raising consideration of either direct extension or metastatic involvement. The right fallopian tube was adhered to this mass. No tumor was found in the bladder flap biopsy. Microscopic evaluation confirmed the presence of invasive carcinoma in multiple uterine regions, with extension to the serosa and into adjacent bowel structures."} +{"pid": "TCGA-DK-A1A7", "report": "The patient is a 67-year-old female who underwent radical cystectomy and hysterectomy along with lymph node dissection. Submitted specimens include bilateral common iliac, distal pelvic, and presacral lymph nodes, as well as segments of the left and right distal ureters.\n\nIn the right common iliac lymph node dissection, 8 lymph nodes were examined, with one showing involvement measuring 0.25 cm in diameter; the largest metastatic focus measured 0.18 cm. No extranodal extension was identified. In the left common iliac lymph node dissection, 2 lymph nodes were examined and found benign. In the right distal pelvic lymph node dissection, 6 lymph nodes were examined, with one involved by tumor measuring 1.2 cm in diameter; the metastatic deposit measured 0.1 cm. Extranodal extension was not present. In the left distal pelvic lymph node dissection, 8 lymph nodes were examined and found benign. The presacral lymph node dissection included 3 lymph nodes, all benign.\n\nExamination of the bladder specimen revealed an infiltrating growth pattern, with tumor involvement noted in the trigone and bladder neck extending into perivesical soft tissues and vesicle-vaginal soft tissue. Bilateral ureteral involvement was observed. Vascular and perineural invasion were identified. Chronic and erosive cystitis were present in non-neoplastic mucosa. Surgical margins at both ureteral sites showed tumor involvement. The female genital organs showed no abnormalities.\n\nStaging based on AJCC 2002 criteria indicated invasion of perivesical soft tissue (pT3). Lymph node involvement was identified in right common iliac and right distal pelvic lymph nodes. Tumor was also identified at both distal ureteral margins."} +{"pid": "TCGA-DX-A7EU", "report": "A soft tissue mass was excised from the right pelvis and iliacus region, involving the iliacus and psoas muscle. The specimen consisted of a well-circumscribed mass measuring 13.5 x 7.1 x 6.2 cm, along with adjacent adipose tissue (9 x 8.5 x 4.1 cm) and muscle tissue (8.5 x 5.5 x 3.1 cm). Upon sectioning, three distinct nodules were identified within the mass. The largest nodule measured 7.1 x 7 x 4.2 cm, the second largest measured 6.2 x 5.3 x 2.4 cm, and the smallest measured 5.7 x 3.5 x 1.1 cm. All nodules were encapsulated by a thin surrounding membrane and exhibited a gray-tan, homogeneous cut surface with only rare areas of hemorrhage and necrosis.\n\nHistologic examination revealed high-grade cellular features. Immunohistochemical staining demonstrated negative results for MDM2 and CDK4. Adjacent skeletal muscle and adipose tissue showed no evidence of tumor involvement. Sections of the mass, along with representative samples of adipose and muscle tissue, were submitted for further analysis. No additional diagnostic or molecular testing results are included in this summary."} +{"pid": "TCGA-RW-A7D0", "report": "A 60-gram adrenal specimen measuring 8.0 x 4.5 x 4.0 cm was received and previously inked blue. Cross-sectioning identified a 4.5 x 4.0 x 3.0 cm encapsulated mass within the adrenal gland. The mass exhibited both solid and cystic components, with areas of hemorrhage and necrosis. Sections were taken from various regions including the solid portion, hemorrhagic/necrotic area, hemorrhagic region, another solid segment, the interface between the mass and normal adrenal tissue, and a section of normal adrenal gland alone. Microscopic examination of the excised tissue showed no involvement at the margins. The specimen was fully evaluated by the attending pathologist."} +{"pid": "TCGA-BH-A0BA", "report": "A sentinel lymph node biopsy and modified radical mastectomy were performed. The sentinel lymph node showed metastatic involvement. A multifocal tumor was identified in multiple quadrants of the breast, including the upper outer, lower outer, upper inner, and lower inner quadrants, as well as the central region. The largest dimension of the tumor measured 6.0 x 5.5 x 2.5 cm. Histologic evaluation revealed a mixture of ductal and lobular features with nuclear grade 2, tubule formation score 3, mitotic activity score 1, resulting in a total Nottingham score of 6 (Grade 2). Angiolymphatic invasion was present. A component of in situ disease accounted for approximately 10% of the tumor and was admixed with the invasive component. Surgical margins were negative for invasive disease and in situ carcinoma. Involvement was identified in the deep stromal tissue beneath the nipple. Associated findings included duct ectasia and chronic inflammation in the nipple and skin. Immunohistochemical analysis demonstrated positivity for estrogen and progesterone receptors, while HER-2/neu staining was not overexpressed. Additional benign findings included fibrocystic changes with ductal epithelial hyperplasia, columnar cell changes, and a microscopic peripheral ductal papilloma. Twenty-seven lymph nodes were examined, all of which contained metastatic disease, with sizes ranging from 0.5 to 2.2 cm. Extracapsular extension was noted in some lymph node metastases. The primary tumor was classified as pT3 and lymph node staging as pN3."} +{"pid": "TCGA-AP-A3K1", "report": "The submitted specimens included multiple biopsies and resections from various anatomical sites. A left pararectal implant showed only benign fibroadipose tissue. The left Fallopian tube and ovary, along with surrounding soft tissue, demonstrated involvement by malignant cells with serous features. These cells were also present in the periadnexal soft tissue; however, no tumor was identified in the adjacent ureter or colon. The radical hysterectomy specimen revealed a tumor involving the endometrium with serous morphology. There was deep myometrial invasion measuring 10 mm in maximum depth, within a myometrial thickness of 17 mm at that site. The tumor extended into the cervix with stromal invasion measuring 15.5 mm, within a cervical wall thickness of 16 mm at that location. Parametrial tissue was also involved. Lymphovascular invasion was present. The right Fallopian tube and ovary similarly showed involvement by serous-type malignancy. A cul-de-sac tumor specimen also contained serous carcinoma.\n\nLymph node evaluation revealed metastatic involvement in several regions. The left external iliac lymph nodes showed one positive out of six. Similarly, one of six right external iliac lymph nodes was involved. Involvement was also seen in one of one right hypogastric lymph nodes. At the left renal lymph node site, four of six nodes were positive. Precaval lymph nodes showed two out of two involved, and the inferior mesenteric lymph nodes had four out of four positive nodes. High left para-aortic lymph nodes showed two out of three involved, while right para-aortic and interaortocaval lymph nodes were negative.\n\nOther specimens showed varying involvement. The omentum and right diaphragmatic peritoneum contained serous carcinoma. The rectosigmoid specimen showed tumor involvement in the perirectal adipose tissue, although the colonic mucosa appeared benign. The proximal and distal margins of the colon were free of tumor. The right ovarian vessel showed tumor involvement within a small vessel. The falciform ligament and Gerota\u2019s fascia tumor site did not show evidence of malignancy. The vaginal cuff margin from the hysterectomy was benign, as were the proximal and distal colon margins."} +{"pid": "TCGA-XQ-A8TB", "report": "The specimen consists of a prostate weighing 45.0 g and measuring 5.5 cm in the side axis, 4.1 cm in the craniocaudal axis, and 4.0 cm in the anteroposterior axis. On sectioning, the prostate shows firm, clear-brown parenchyma with nodular areas in the central portions. The right seminal vesicle measures 2.5 x 1.1 x 0.9 cm and the left 2.1 x 1.3 x 1.2 cm. The right vas deferens is 1.1 cm long and 0.5 cm in diameter, while the left is 0.9 cm long and 0.5 cm in diameter.\n\nReceived lymphatic tissue includes an irregular fragment from the right lymphatic chain measuring 5.1 x 2.1 x 0.9 cm with two dissected lymph nodes measuring 0.5 cm and 3.1 cm in greatest dimension. From the left lymphatic chain, an irregular fibrofatty fragment measuring 4.2 x 2.1 x 1.5 cm contained two lymph nodes measuring 0.5 cm and 3.5 cm.\n\nHistologic examination reveals involvement at multiple margins, including the urethral margin and areas near the bladder, as well as circumferential margins on the right and left apex and left middle third. There is evidence of extension beyond the prostate capsule at the left base and infiltration of the left seminal vesicle. Perineural invasion is present. No angiolymphatic invasion is identified. All dissected lymph nodes are free of involvement.\n\nNon-neoplastic findings include nodular hyperplasia of the prostatic stroma and glandular tissue. Staging is consistent with advanced local disease without lymph node metastasis according to TNM classification (7th edition), with extensive involvement of margins and adjacent structures."} +{"pid": "TCGA-85-7710", "report": "Asterand Case ID. Open Clinica. Gross Description. Subject ID: 85-7710. Labeled left lingular. Received fresh for intraoperative consultation is a stapled 5.7 x 3.6 cm wedge biopsy of lung tissue containing a 2.4 x 1.5 cm stellate firm tan-white subpleural mass which causes puckering of the overlying pleura. The mass comes to within 1.2 cm of the stapled margin. The background lung tissue is soft, tan-pink and without other lesions. Microscopic Description. Diagnosis Details. Permanent sections confirm findings consistent with invasive squamous cell carcinoma that is moderately differentiated. The specimen type is wedge resection or lobectomy. Tumor site is in the lung. Histologic type is squamous cell carcinoma. Histologic grade is moderately differentiated. The tumor measures 2.4 cm in greatest dimension. There is prominent intracellular bridging and focal keratinization. Tumor location is in the left lingula. Angiolymphatic invasion is not identified. Bronchial margins are not involved. No lymphatic or venous invasion is present. One lymph node was examined and found to be negative for metastasis. Pleural involvement is present with subpleural extension. Margins are not specified. TNM staging classification is T1b NO MX. No evidence of neo-adjuvant treatment is identified. Additional pathologic findings are not specified. Comments: None."} +{"pid": "TCGA-HT-A616", "report": "The microscopic examination reveals a moderately hypercellular glial neoplasm with diffuse infiltration. The tumor cells exhibit round to oval nuclei with mild atypia. No well-formed perinuclear halos are observed. The neoplastic cell processes form a loose fibrillary matrix. Mitotic figures are absent, and there is no evidence of microvascular proliferation or necrosis. Immunohistochemical analysis demonstrates reactivity for IDH1, while p53 staining is negative. A low number of MIB-1 positive cells are present, with a labeling index not exceeding 0.6 percent."} +{"pid": "TCGA-A2-A3XU", "report": "The lumpectomy specimen from the left breast consists of a mass measuring 4.5 x 3 x 2.5 cm. The superior margin is focally involved at 0.1 cm, while the anterior, inferior, and lateral margins are very close (approximately 0.1 cm). Remaining surgical margins range from 0.2 to 0.5 cm from the mass. Histological evaluation reveals high-grade cellular features with a high mitotic index and absent tubule formation. Angiolymphatic invasion is present and multifocal. Additional margins obtained post-surgery show benign breast tissue with fibrocystic changes, including focal adenososis with secretory activity.\n\nA total of six sentinel lymph nodes were examined. One node was positive for micrometastasis measuring 1 mm. The remaining nodes showed no evidence of involvement. Axillary contents reveal six benign reactive lymph nodes.\n\nStaging is classified as T2, N1mi, MX, Stage Grouping IIB. The histologic borders demonstrate infiltrating and pushing margins with epithelioid features and focal mucinous differentiation. Receptor analysis for estrogen and progesterone is negative."} +{"pid": "TCGA-QR-A705", "report": "The specimen was received fresh, labeled with the patient\u2019s name and \"cardiac paraganglioma.\" It consists of a single, discrete, firm nodular fragment of pinkish-tan tissue, measuring 4.5 x 3.3 x 1.1 cm in aggregate, with a total weight of 21 grams. The cut surface is homogeneously tan with focal calcification. A portion of the specimen was sent for further analysis as requested, and the entire sample was submitted in 13 cassettes. Summary of sections (1\u201313) shows a neoplastic process.\n\nMicroscopic evaluation included thirteen H&E stained slides, along with immunohistochemical stains for chromogranin and pancytokeratin. The tumor cells demonstrate positivity for chromogranin, while being negative for pancytokeratin. No evidence of necrosis or increased mitotic activity is identified."} +{"pid": "TCGA-AR-A2LE", "report": "A 1.6 x 1.5 x 1.3 cm lesion was identified in the right breast excision specimen. Histologic evaluation shows a Nottingham Grade I (out of III) morphology with ductular involvement. No angiolymphatic invasion is present. All surgical resection margins, including those submitted separately, are free of malignant cells. Evaluation of the right sentinel lymph node excision reveals no evidence of tumor, confirmed by immunohistochemical cytokeratin staining on paraffin-embedded tissue. The carcinoma demonstrates estrogen receptor positivity and progesterone receptor negativity."} +{"pid": "TCGA-B6-A0RO", "report": "The surgical specimen consists of a right modified radical mastectomy measuring 18.5 x 14 x 3.9 cm, including a skin ellipse that measures 14.7 x 6.3 cm and contains the nipple. A small 0.5 cm opening is noted 1.7 cm below the nipple. The deep margin is marked with blue ink. On sectioning, a firm white mass measuring 3.5 x 2 x 1.5 cm is identified in the medial region of the breast. The mass appears well-defined and firm on palpation, with close proximity to the deep margin at 0.2 cm. No distinct biopsy cavity is present, though a small area of hemorrhage is observed adjacent to the mass.\n\nTissue from the mass was submitted for hormone receptor analysis. Sections include the nipple, skin opening, tumor with adjacent deep margin, and representative areas of the tumor and surrounding breast tissue. Lymph node sampling includes multiple candidates from levels I, II, and III, with several being bisected for examination.\n\nMicroscopically, the lesion is composed primarily of tubular and cribriform structures formed by atypical cells. These cells have moderate eosinophilic cytoplasm and oval nuclei with small, distinct nucleoli. A minor intraductal component is present within or near the lesion, but no such changes are found elsewhere in the breast tissue. There is minimal inflammation and no evidence of vascular invasion. The deep surgical margin does not show any residual tumor.\n\nAmong the lymph nodes evaluated, two out of seventeen contain metastatic disease. Background breast tissue shows apocrine metaplasia and microcalcifications in non-neoplastic lobules."} +{"pid": "TCGA-E7-A6ME", "report": "The specimen consists of a tumor located in the anterior wall near the bladder neck. The lesion measures 4x3x1cm and is invasive with protrusion observed. It has poorly defined margins, a necrotic appearance, and a soft gray surface. Microscopically, the tissue shows dense cellular arrangements forming sheets, nests, groups, or cords. The cells exhibit moderate eosinophilic or clear cytoplasm with enlarged nuclei showing variation in size and shape. Irregular nuclear membranes, prominent nucleoli, and abnormal chromatin patterns are present. Mitotic figures are identified. There is evidence of invasion into muscle layers and vascular structures along with areas of necrosis."} +{"pid": "TCGA-86-7701", "report": "The specimen consisted of an excised lesion from the lung measuring 2.5 x 2 x 0.5 cm. Microscopic evaluation revealed poorly differentiated cells. The tumor was found to involve the visceral pleura. Additional nodules were identified. Immunohistochemical staining showed positivity for CD15, CK7, and TTF1, with no reactivity for CK20 or CDX2. The tumor was located in the right upper lobe."} +{"pid": "TCGA-AZ-4616", "report": "The specimen consists of a right hemicolectomy measuring 40 cm in length. A lesion was identified at the cecum with an infiltrative configuration and measuring 6.5 cm in greatest dimension, with additional dimensions of 6.0 x 5.5 cm. The muscularis propria was involved with extension into pericecal fat containing multiple isolated deposits. Serosal invasion was noted. Tumor was present at the radial pericecal soft tissue margin, and intravascular tumor was identified. Lymphovascular and perineural invasion were both present.\n\nMultiple small foci of similar cellular morphology were found on the surface of the omentum. In addition, involvement of the muscularis propria of the terminal ileum was observed. The proximal and distal resection margins, as well as the muscularis propria of the ileum, were free of invasive disease.\n\nA total of 23 lymph nodes were examined, with 13 showing involvement by cells consistent with the primary lesion. A separate tubular adenoma was also identified. The circumferential margin was involved, with tumor located within 0 to 1 mm of the margin. The mesenteric margin was similarly involved.\n\nAdditional findings included angiolymphatic invasion, perineural invasion, and a tumor border with an infiltrating pattern. No other specific tumor characteristics were noted."} +{"pid": "TCGA-A3-3376", "report": "The specimen consists of a left kidney with attached perinephric fat, measuring 20.0 x 10.0 x 5.5 cm and weighing 463 grams. An adrenal gland is present, measuring 3.0 x 1.0 x 1.0 cm, and no lesions are identified in this structure. The ureter measures 6.0 cm in length and 0.3 cm in diameter, with a smooth mucosal surface and no visible abnormalities. The renal artery and vein stumps measure 0.7 x 0.5 cm and 0.7 x 1.0 cm, respectively, and appear grossly unremarkable.\n\nUpon sectioning, the kidney reveals a well-demarcated, golden-yellow mass located in the upper pole. The mass measures 2.5 x 2.5 x 0.5 cm and is confined within the renal capsule, though there is evidence of extension into the surrounding perinephric fat. The remainder of the kidney shows a normal corticomedullary distinction. Multiple small brown-tan calculi are noted in the calices, and no other lesions are observed.\n\nHistologically, the mass demonstrates clear cell morphology. The nuclear grade corresponds to Fuhrman grade 2 out of 4. There is no evidence of lymphovascular or transcapsular invasion, nor is there involvement of the renal vein. The venacaval margin was not resected. All surgical margins\u2014soft tissue, ureteral, and vascular\u2014are free of tumor. No lymph nodes are identified in the specimen.\n\nThe background renal parenchyma shows changes consistent with significant arterial and arteriolonephrosclerosis, along with nodular glomerulosclerosis. Additional staining will be performed for further evaluation, and an addendum report will follow.\n\nStaging is based on pTNM classification as T1N0MX. Representative sections from the mass, adjacent renal cortex, ureter, renal vessels, and adrenal gland have been submitted for microscopic examination."} +{"pid": "TCGA-EI-6917", "report": "The histopathological examination of the resected rectal specimen showed a lesion measuring 6 x 4 cm, located 14 cm from the proximal resection margin and 6 cm from the distal margin. The lesion circumferentially involved the intestinal wall and caused significant luminal narrowing. Microscopic evaluation revealed a poorly differentiated carcinoma with both tubular and mucinous components. Tumor infiltration was observed extending into the perirectal adipose tissue. Surgical margins were uninvolved. Regional lymph node examination demonstrated metastatic involvement. The tumor was staged as pT3, pN1 with no residual tumor at the margins (RO). Additional classifications indicated advanced local disease and nodal spread."} +{"pid": "TCGA-CN-4733", "report": "The specimen consists of a resected portion of the left tongue measuring 3.2 cm in length, 3.5 cm in width, and 2.8 cm in thickness. A mucosal lesion was identified with a white-tan periphery and a roughened central area measuring 1.9 cm in greatest dimension and extending 0.6 cm into the muscle. Microscopic examination revealed infiltrative growth pattern and perineural invasion. The depth of invasion was measured at 0.6 cm.\n\nA total of eight tissue segments were evaluated. Margins including deep, anterior, dorsal, ventral, and posterior were all free of tumor involvement based on intraoperative frozen section analysis and subsequent microscopic evaluation. Two lymph nodes from level 1A and B of the left neck were examined, both showing no evidence of tumor involvement. One lymph node contained significant findings within a total of 27 lymph nodes assessed from levels 2 through 4 of the left neck dissection.\n\nMeasurements of the involved lymph node indicated a size of 0.5 cm. Immunostains and in-situ hybridization studies showed negative results for P16 and HPV markers, while EGFR expression was detected at 2+ intensity. Fluorescence in situ hybridization (FISH) testing demonstrated EGFR positivity with high polysomy in 66.2% of cells analyzed. C-MET gene amplification testing was negative.\n\nHistologic grade was classified as G3. Pathologic staging assigned was pT1 for the primary lesion and pN1 for regional lymph node involvement. No vascular or lymphatic invasion was noted. All margins were uninvolved by tumor. A total of 29 lymph nodes were examined, with one showing involvement. Tissue fixation duration ranged between 2 and 84 hours."} +{"pid": "TCGA-VQ-A91A", "report": "The specimen involves the stomach body and several associated tissues. A lesion measuring 14 cm is present in the stomach, extending into perigastric adipose tissue. The lesion shows features of poor differentiation and mucin production, with signet ring morphology observed. Vascular and perineural invasion are noted. A total of 29 lymph nodes were examined, with metastatic involvement identified in 11 nodes across multiple chains (3, 4d, 6, 7, 8a, and 8p). Two resected margins are described as uninvolved; however, the distal margin is narrowly spared at 1.0 mm. A separate finding in the distal esophagus demonstrates ectopic gastric mucosa without evidence of neoplasia. The gallbladder shows changes consistent with chronic cholecystitis and cholesterolosis. A fragment of pancreatic tissue appears unremarkable. No other implants or neoplastic involvement is identified in the remaining specimens evaluated."} +{"pid": "TCGA-FX-A3RE", "report": "A 4,900-gram tissue specimen from the left ovary and fallopian tube measures 20.0 x 17.0 x 1.5 cm. No distinct fallopian tube tissue is identified. The cut surface shows multicystic and solid areas with hemorrhagic fluid, yellow-tan nodular regions, and areas of hemorrhage and discoloration. A second excised specimen involving the right ovary and fallopian tube weighs 477.1 grams and measures 11.0 x 10.0 x 8.7 cm. A 4.0-cm segment of fallopian tube is noted on the outer surface. The ovarian cut surface reveals a whorled, fibrous texture with central hemorrhage and a 2.0 x 1.5 x 1.5 cm multiloculated cyst containing pink-tan fluid.\n\nA retroperitoneal mesenteric mass measuring 13.0 x 11.0 x 7.5 cm is present, showing a yellow-tan whorled and glistening cut surface with areas of dusky discoloration and hemorrhage. Biopsy of the left pelvic sidewall reveals a 4.5 x 3.5 x 3.3 cm tumor with a gray-white firm and glistening appearance. A right pelvic retroperitoneal nodule measuring 2.3 x 1.7 x 1.0 cm is also identified, with a gray-white firm cut surface and adjacent lymph node involvement.\n\nLymph node evaluation includes four right lower paraaortic nodes (ranging from 0.2 to 1.7 cm), ten right pelvic nodes (0.3 to 2.5 cm), four left paraaortic nodes (0.6 to 1.5 cm), and four left pelvic nodes (0.2 to 0.8 cm). All lymph nodes are negative for metastatic disease.\n\nAdditional biopsies from the anterior cul-de-sac, left pelvic sidewall, posterior cul-de-sac, right gutter, left gutter, and omentum show no evidence of malignancy. The omental specimen measures 27.0 x 8.0 x 1.5 cm and displays a yellow-tan lobulated structure without lesions.\n\nImmunohistochemical staining demonstrates strong positivity for caldesmin and smooth muscle actin in lesional cells, with focal weak positivity for caldesmin and vimentin in other areas. Staining for calretinin, CD10, EMA, inhibin, pancytokeratin, melan-A, and S100 is negative. Actin is positive, and myogenin is negative. These findings indicate a smooth muscle neoplasm with areas of atypia, necrosis, and increased mitotic activity. Some variation in staining patterns is observed, particularly in less differentiated regions."} +{"pid": "TCGA-VQ-AA6I", "report": "The specimen involves the gastroesophageal junction. A poorly differentiated adenocarcinoma is present, characterized by invasive growth and ulceration. The tumor measures 7.0 x 4.7 x 2.4 cm with a depth of 2.4 cm. It is located at the esophagogastric transition and infiltrates up to the subserosa. No sanguineous vascular invasion is identified, though lymphatic vascular invasion is present. Perineural invasion is also noted. Adjacent gastric mucosa shows intense active chronic gastritis.\n\nExamination of the omentum reveals mature adipose tissue without neoplastic involvement. One lymph node is present in the omental fat and is free of tumor (0/1). Fifteen lymph nodes were dissected in total, with 9 showing involvement by neoplastic cells (9/15), including capsular leakage. Of these, 1 out of 2 peri-tumoral nodes, 8 out of 10 nodes from the lesser curvature, and none of the 3 nodes from the greater curvature are involved.\n\nThe surgical margins are free of neoplastic involvement. In the esophageal margin, no neoplastic cells are detected. The terminal ileum and ascending colon show normal mucosal architecture. The appendix displays no histological abnormalities. Six lymph nodes removed from adjacent fat near the ileum and colon are all negative for tumor (0/6).\n\nThe gallbladder exhibits features of intense chronic cholecystitis."} +{"pid": "TCGA-S7-A7X1", "report": "The left adrenal gland contained a mass measuring 80x50x35 mm with a total weight of 60 grams. The mass was composed of two closely adjacent nodules, likely related. The smaller nodule measured 25x35x20 mm and the larger measured 60x40x40 mm. On gross examination, both nodules appeared grey-pink and soft, with a central yellow area suggestive of scarring in the larger nodule. Representative sections were taken from both nodules (1A for the smaller, 1B-1E for the larger).\n\nMicroscopic evaluation revealed similar structural features in both nodules, arranged in an alveolar pattern. The larger nodule showed significant regressive changes centrally. Peripheral areas of the excisions contained remnants of adrenal cortex with evidence of pressure atrophy. In some regions, there was extracapsular proliferation. No infiltration into surrounding tissues was observed in the examined sections.\n\nImmunohistochemical staining demonstrated S100 protein expression with slight variation in intensity, indicating the presence of sustentacular cells. Proliferative activity, as assessed by MIB-1 staining, was very low, involving less than 1% of tumor nuclei.\n\nHistologic assessment included features such as large nests or diffuse growth patterns comprising more than 10% of the tumor volume. There was central or confluent necrosis within large nests, along with high cellularity, cellular uniformity, and focal spindle-shaped tumor cells. Mitotic activity exceeded three figures per ten high-power fields, with atypical mitotic figures present. Additional findings included invasion into adipose tissue, vascular invasion, and capsular invasion. Mild nuclear pleomorphism and nuclear hyperchromasia were also noted. The overall score from these parameters was 2."} +{"pid": "TCGA-VR-AA7I", "report": "The surgical specimen from the mid-third of the esophagus includes a resected lesion with histological features described as grade 1. The longest dimension of the lesion measures 5.3 cm, with a depth of 1.3 cm. Ulceration is present. The lesion involves the mucosa, submucosa, muscularis propria, and extends into the adventitia with a spiculated pattern of infiltration. A mild inflammatory infiltrate is noted. Both proximal and distal surgical margins show no evidence of involvement. The radial margin is tangential. No involvement is identified in any of the fifteen regional lymph nodes evaluated, which were distributed as follows: right paracardic (0/2), left paracardic (0/2), along the lesser curvature (0/5), along the left gastric artery (0/2), and around the celiac trunk (0/2). The esophageal margin is also free of involvement."} +{"pid": "TCGA-19-A60I", "report": "The clinical history includes a brain mass and a medical history of mild vitamin D deficiency and seizures. Three biopsy specimens were obtained from the left frontal region. The first specimen consisted of a 0.4 x 0.3 x 0.2 cm tan-white tissue fragment. A portion was used for frozen sectioning and touch preparation, with the remainder submitted for analysis. The second specimen measured 0.8 x 0.5 cm and was composed of tan and brown tissue, divided into three sections for evaluation. The third specimen was an aggregate measuring 3.0 x 2.1 x 1.1 cm, consisting of pink and red friable, fragmented tissue, entirely submitted for examination.\n\nHistologic evaluation revealed marked cellular pleomorphism, numerous atypical mitotic figures, vascular proliferation, necrosis, and infiltration into adjacent brain tissue. Immunohistochemical staining demonstrated weak p53 expression in approximately 10\u201320% of cells. The Ki-67 labeling index was estimated at 40%. All control tissues showed appropriate reactivity. The Ki-67 stain was performed manually. Additional molecular testing included assays for HER2/neu using immunohistochemistry and in-situ hybridization methods. Other immunohistochemical and histochemical tests were also conducted. Except for HER2/neu testing, none of the assays reported are FDA-approved or required for approval."} +{"pid": "TCGA-FY-A3ON", "report": "The thyroid specimen was received intact and weighed 17 grams. The right lobe measured 2.8 cm from superior to inferior, 1.5 cm medially to laterally, and 1.5 cm superficial to deep. The left lobe measured 3.2 cm from superior to inferior, 2 cm medially to laterally, and 1.5 cm superficial to deep. The isthmus measured 2 x 1.8 x 0.7 cm. A well-defined nodule measuring 2.5 x 1.8 x 1.5 cm was identified in the right lobe, with focal calcification at its medial edge near the isthmus. A second nodule measuring 1.2 cm was found in the isthmus. The left lobe showed a slightly nodular texture.\n\nHistologically, the tissue showed lymphocytic infiltration with germinal centers. The nodules displayed cellular features consistent with a neoplastic process. Margins were negative, with the closest margin measuring 0.1 cm from the tumor. Of the lymph nodes examined, 1 out of 4 was involved. No lymphovascular or perineural invasion was identified. The primary tumor was classified as pT2 (m), regional lymph nodes as pN1, and distant metastasis could not be assessed (pMX). Margin status was R0, and the overall pathologic stage was I. The specimen was submitted in multiple sections for detailed analysis."} +{"pid": "TCGA-LA-A446", "report": "The specimen consisted of multiple lymph nodes and lung tissue resections. Lymph nodes were identified at various levels including R4, level 7 (multiple), 4L, level 9 (multiple), and level 10 (multiple). All lymph nodes were described as reactive without evidence of malignancy. Lung tissue specimens included a right upper lobe wedge, right lower lobe, and right middle lobe.\n\nThe right upper lobe wedge measured 6.3 x 2.5 x 2.2 cm and showed fibrous pleural adhesions with chronic inflammatory changes. A stellate area measuring approximately 1.2 x 0.8 x 0.8 cm was observed but no malignant cells were identified.\n\nThe right lower lobe specimen weighed 270 grams and measured 18.0 x 11.0 x 3.5 cm. A tumor mass measuring 2.8 x 2.6 x 2.5 cm was identified in the central region, located 1.1 cm from the bronchial margin and 0.3 cm from the pleural surface. The mass was noted to partially obstruct the bronchus and surround vasculature. Microscopic evaluation revealed squamous cell carcinoma in situ at the bronchial margin.\n\nThe right middle lobe specimen weighed 82 grams and measured 12.0 x 9.0 x 2.5 cm. It contained a separate parenchymal area measuring 4.0 x 3.0 x 2.0 cm with a 2.0 cm bronchial stem. No tumor masses were identified; however, squamous cell carcinoma in situ was present at the bronchial margin.\n\nA total of 10 lymph nodes were examined microscopically, all of which were reactive and without involvement by invasive carcinoma. Margins of all resected tissues were free of invasive malignancy. The distance of invasive carcinoma from the closest margin was 1.1 cm. Visceral pleural invasion was not identified. Emphysematous changes were noted in the lung tissue. Lymphovascular invasion could not be definitively determined. \n\nThe surgical specimen was intact and right-sided. The tumor was unifocal and histologically classified as moderately differentiated. No treatment effect was observed. Additional findings included fibrous pleural adhesions and chronic inflammation."} +{"pid": "TCGA-DX-A1L0", "report": "The specimen from the intra-abdominal region consists of a large, lobulated mass measuring 27 x 25 x 18 cm. It is surrounded by a grossly intact pseudocapsule. The cut surface reveals a tan-yellow fleshy appearance with approximately 35% central necrosis. A small portion (less than 5%) at the periphery shows adipose characteristics. The tumor demonstrates a fibrosarcoma-like growth pattern and focally extends to an inked margin. Focal necrosis is estimated at 25% of the mass. A segment of greater omentum is present but without significant changes.\n\nA second specimen from the mesenteric region consists of a smaller lobulated fibroadipose tissue fragment measuring 3.2 x 2.2 x 0.5 cm. The external surface has a thin fibrous lining, and the cut surface is yellow-white. The tumor extends to the inked surface. Multiple sections were taken for microscopic evaluation from both specimens."} +{"pid": "TCGA-EM-A3SX", "report": "The specimen consisted of a total thyroidectomy with central compartment lymph node dissection. The right lobe measured 3.9 cm \u00d7 1.7 cm \u00d7 1.0 cm, and the left lobe measured 4.6 cm \u00d7 2.9 cm \u00d7 1.9 cm. The isthmus measured 1.5 cm \u00d7 1.6 cm \u00d7 0.6 cm. The overall specimen weighed 24.8 g. Two distinct nodules were identified: a dominant lesion in the left lobe measuring 4.4 cm \u00d7 2.7 cm \u00d7 1.8 cm and a smaller lesion in the right lobe measuring 0.8 cm \u00d7 0.7 cm. Both lesions exhibited classical papillary architecture and cytomorphology. The dominant tumor was fully encapsulated with widespread capsular invasion and extended to the surgical margin. The smaller tumor was partially encapsulated with minimal capsular invasion and did not involve the margins. Three additional microscopic lesions measuring 0.2 cm (right) and 0.1 cm (left) were noted.\n\nLymph node evaluation included four nodes from the central compartment. One of one node from the left lateral central compartment and two of three nodes from the left medial central compartment contained malignant cells. No extranodal extension was observed. Based on AJCC/UICC TNM staging criteria, the tumor was classified as multiple primary tumors (m), pT3 due to size greater than 4 cm with minimal extrathyroidal extension, and pN1a for metastasis to central compartment lymph nodes. No vascular or perineural invasion was identified. No distant metastasis was detected."} +{"pid": "TCGA-R6-A6Y2", "report": "The biopsy from the lesser curvature ulcer scar shows gastric mucosa with areas of active inflammation, fibrosis within the lamina propria, and foveolar hyperplasia. No evidence of malignant cells was identified in this sample. The distal esophageal biopsy reveals invasive glandular neoplasia with moderate to poor differentiation. Adjacent columnar mucosa exhibits high-grade dysplastic changes. Both specimens consist of multiple tan-pink irregular tissue fragments. The aggregate size of the lesser curvature ulcer scar tissue is 1.0 x 0.7 x 0.2 cm, while the distal esophageal tissue measures 1.3 x 0.7 x 0.2 cm. Clinical history includes abnormalities of the esophagus and Barrett\u2019s-related changes."} +{"pid": "TCGA-DX-A3UA", "report": "The specimen consists of an amputation of the 4th and 5th metatarsal, including associated toes, nails, and overlying skin. The specimen measures 9.5 x 4.0 x 4.8 cm and includes soft tissue and bone. A lobulated tan mass measuring 4.5 x 2.1 x 1.9 cm is identified within the mid to distal 5th metatarsal bone. The mass extends medially into the 4th metatarsal bone and inferiorly into adjacent soft tissue, reaching within 0.2 cm of the deep dermis. Distal extension approaches the proximal aspect of the phalanx.\n\nThe tumor is located 4 cm from the posterior, 1.8 cm from the anterior, 1.2 cm from the superior, and 0.5 cm from the inferior soft tissue margins. It is also 2.2 cm from the posterior and 1.2 cm from the anterior bone margin. All surgical resection margins are free of tumor involvement. Mitotic activity is present at a rate of 7 per 10 high-power fields. No necrosis is observed. The skin shows changes consistent with scarring.\n\nMicroscopically, the lesion demonstrates a predominant hemangiopericytic pattern of growth. Immunohistochemical staining reveals focal positivity for SMA, caldesmon, CD34, and S-100. The lesion is negative for AE1:AE3, CD-117, and desmin. These findings are consistent with the histologic features described.\n\nSections evaluated include representative samples from the superior, inferior, lateral, medial, anterior, and posterior soft tissue margins, as well as from the tumor involving both the 4th and 5th metatarsal bones and surrounding soft tissues. The laboratory performing these studies is CLIA-certified and follows appropriate standards for diagnostic testing."} +{"pid": "TCGA-JY-A6FA", "report": "The resected specimen includes distal esophagus and proximal stomach with clear margins at both ends. A separate specimen from the tip of the stomach shows no malignancy. The final esophageal margin demonstrates focal atypia consistent with high-grade dysplasia but is negative for malignancy.\n\nA single tumor is identified at the gastroesophageal junction, measuring 8.3 cm in greatest dimension with an additional measurement of 5.7 cm. It is highly ulcerative, solid, and tan-white on cut surface. The tumor is located 2.5 cm from the proximal margin, 4.0 cm from the distal margin, and 1 mm from the closest circumferential margin. Depth of invasion extends through the full thickness of the wall, reaching into the adventitia. No venous or lymphatic invasion is identified.\n\nLymph node evaluation includes 19 nodes retrieved from mediastinal and perigastric regions. Of these, 4 show evidence of metastatic involvement. The largest lymph node measures 3.8 x 1.6 x 0.7 cm, while the smallest is 0.3 x 0.2 x 0.1 cm.\n\nHistologic examination reveals moderately differentiated squamous cell morphology. The tumor involves the muscularis propria layer. All surgical margins are free of invasive carcinoma. High-grade dysplasia is present at the final esophageal margin.\n\nThe specimen includes multiple tissue blocks submitted for analysis: en face sections of both esophageal and gastric resection margins, longitudinal strips including the area of deepest tumor invasion, sections from grossly normal gastric mucosa, and various lymph node samples. The stomach specimen shows smooth serosal surface with minimal perigastric fat; mucosa is largely normal except for mild congestion in one-third of the surface.\n\nStaging assessment indicates pT2 based on depth of invasion and pN1b reflecting the number of involved lymph nodes. No distant metastases are identified (Mx)."} +{"pid": "TCGA-AZ-4313", "report": "The resected specimen from the left colon measured 2.0 cm in greatest dimension, with additional dimensions of 2.0 x 0.5 cm, and exhibited an exophytic growth pattern. Histologic evaluation showed a well to moderately differentiated cellular component, with invasion identified extending into the submucosa. Lymphovascular invasion was present, confirmed by immunostains for CD31 and D2-40. A total of thirteen lymph nodes were examined, and no involved nodes were identified. Proximal and distal resection margins were free of involvement, as was the circumferential (radial) margin; the mesenteric margin was also uninvolved. The tumor demonstrated an infiltrating border configuration. A mild to moderate lymphocytic response was observed at the tumor interface. No perineural invasion was detected. A total of 13 lymph nodes were examined without evidence of metastatic involvement. The status of the mesorectum was not applicable. Angiolymphatic invasion could not be definitively assessed."} +{"pid": "TCGA-CV-7440", "report": "The total laryngectomy specimen measured 9.0 (s-I) x 6.5 (L-R) x 4.67 (A-P) cm. A roughened red lesion was identified on the left supraglottic region, involving the piriform sinus. The lesion appeared to extend toward the midline, possibly crossing it by approximately 1.0 mm. The tumor measured 2.7 (M-L) x 2.5 (S-I) cm. There was no gross extension through the base of the epiglottis or thyroid cartilage, and no involvement of the glottic or subglottic regions. Margins of resection were free of tumor. The peripheral mucosal margin and anterior aspect of the epiglottic remnant were marked with black ink. Sections submitted included radial and perpendicular sections from the mucosal and deep margins, covering the right, posterior, left posterior, left lateral, left anterior, and anterior midline areas, as well as the true and false vocal cords bilaterally and radial sections of the supraglottic region. Histologically, there was extensive perineural and vascular lymphatic invasion. A separate specimen from the left base of the tongue, measuring 2.9 x 1.5 x 0.4 cm, was submitted. The true margin was previously inked blue and re-inked in black. This tissue showed only skeletal muscle without any tumor present. Frozen sections confirmed absence of tumor at mucosal and deep margins."} +{"pid": "TCGA-W4-A7U3", "report": "The left testicle specimen measured 9.0 x 7.5 x 5.5 cm and weighed 165 grams. Structures attached included the epididymis, spermatic cord, and tunica vaginalis. The tumor was unifocal, measuring 6.2 x 6.6 x 5.2 cm, with a variegated tan to red appearance, predominantly solid with microcystic areas, necrosis, hemorrhage, and punctate white regions. Focal myxoid change was also noted. The tumor was confined to the tunica albuginea, without gross involvement of the epididymis or tunica vaginalis. The spermatic cord measured 8.7 cm in length and 1.4 cm in diameter, and no lesions were identified. The distance from the tumor to the spermatic cord margin was 10.2 cm, and the distance to the tunica vaginalis margin was 0.2 cm.\n\nHistologic evaluation showed a mixture of components. Cytokeratin AE1/AE3 staining was present in epithelial elements, while CD30 and PLAP reactivity was observed in certain areas. Positivity for HCG and HPL was seen in distinct regions, and AFP expression was identified in separate areas. No staining was observed with CD117 (cKIT). The surgical margins, including the spermatic cord, were free of tumor. Intratubular changes were present. Lymphovascular invasion was not identified. Sections of the epididymis, tunica vaginalis, and paratesticular soft tissues were all negative for malignancy. Mild chronic inflammation was noted in the surrounding tissue.\n\nStaging was determined as pT1 pNx based on the current specimen, though further review may be necessary for final staging. Tissue sections submitted included the spermatic cord margin, epididymis, tunica vaginalis, and multiple representative areas of the tumor. A digital photograph was not taken."} +{"pid": "TCGA-HN-A2NL", "report": "The tissue sample was obtained from the left breast via surgical resection. The patient was 56 years old at the time of collection. The tumor measured 3.5 cm in size. Histological analysis revealed a high-grade lesion with poorly differentiated features and lobular characteristics. The Scarff-Bloom-Richardson score was 9. No in situ component was identified. Immunohistochemical testing showed negative status for estrogen receptor, progesterone receptor, and HER2. Lymph node evaluation showed no metastases; 3 nodes were sampled and all were negative. The pathological staging was T2 with no nodal involvement."} +{"pid": "TCGA-MQ-A6BL", "report": "The specimen consists of three parts. The first part, labeled \"pleura right,\" is a 1 x 0.5 x 0.3 cm piece of tan soft tissue with a black, focally nodular pleural surface. It was bisected and entirely submitted for frozen section. The second part, labeled \"7th rib,\" is a 7 x 1.5 x 0.5 cm segment of rib tissue, which appeared unremarkable and was submitted after decalcification. The third part, also labeled \"pleura right,\" includes two pieces of firm soft tissue measuring 1.5 x 1 x 0.5 cm and 1 x 0.4 x 0.2 cm, respectively. The pleural surface in this specimen appeared thickened, and the entire sample was submitted for analysis.\n\nMicroscopic evaluation revealed an atypical spindle and epithelioid cell proliferation associated with inflammation. Immunohistochemical staining showed positivity for calretinin and negativity for TTF-1, CD34, and CK 5/6. These findings were consistent across both pleural samples and were further supported by departmental review. No significant abnormalities were identified in the rib specimen. All relevant sections were evaluated, including a frozen section control, representative rib tissue, and both a larger and smaller piece from the pleural biopsy."} +{"pid": "TCGA-KL-8343", "report": "The specimen from a right kidney and portion of adrenal consists of a kidney measuring 13 x 7 x 5.5 cm with attached ureter and renal vessels. The tumor measures 6.5 x 4 x 4 cm, located in the cortex and extending to the hilum. It has a well-defined border and a homogeneous yellow-tan cut surface. No involvement of the biliary tract is noted. The tumor invades sinus fat and involves medium-caliber vessels within the renal sinus. Surgical margins are free of tumor. Adjacent kidney tissue shows a normal cortico-medullary junction with a cortical thickness of 0.7 cm. No lymph nodes are identified in the perinephric fat. Six lymph nodes from paracaval and pericaval regions are examined and show no evidence of involvement. Staging indicates extension into major veins or surrounding tissues but not beyond Gerota\u2019s fascia. All findings are based on microscopic examination of submitted sections."} +{"pid": "TCGA-GV-A40G", "report": "The submitted specimen includes parts labeled as bladder and prostate, pelvic lymph nodes #1, pelvic lymph nodes #2, and right distal ureter. \n\nIn the bladder and prostate specimen, a mass measuring 5 x 4 x 1 cm is identified on the anterior wall, right lateral wall, left lateral wall, posterior wall, and trigone area. The mass is papillary in appearance and extends approximately 1 cm into the wall, with focal involvement of the muscularis propria. The right ureter margin shows involvement by in situ changes. The urethral and soft tissue margins are free of such changes. Involvement of the prostatic urethra by in situ changes is noted, while the prostate parenchyma demonstrates benign findings. No concerning features are identified in the seminal vesicles or vas deferens.\n\nA total of 19 lymph nodes were evaluated: 15 from pelvic lymph nodes #1 and 3 from pelvic lymph nodes #2. All lymph nodes show no evidence of abnormal cellular infiltration.\n\nThe right distal ureter specimen reveals in situ changes at the margin. Frozen section analysis was performed to assess this region, and permanent sections support the presence of these changes.\n\nThe tumor measures 5 cm at its greatest dimension. Histologic evaluation reveals high-grade features. No venous or lymphatic invasion is observed, and there is no evidence of direct extension beyond the primary site. Based on pathologic staging, the primary tumor is classified as pT2a, indicating invasion of the superficial muscularis propria. Lymph node staging is pNO, with no metastatic involvement identified. Distant metastasis could not be assessed (pMX).\n\nGross examination of the bladder shows a smooth serosal lining at the dome and fibroadipose tissue elsewhere. The prostate measures 4 x 4 x 4 cm and appears unremarkable on cross-sectioning. The right ureter segment is patent and mucosally normal, while the left ureter was difficult to locate but showed no remarkable mucosal changes. Multiple tissue sections were submitted for microscopic evaluation.\n\nIn summary, the findings include a focally invasive lesion within the bladder wall with associated in situ changes involving the right ureter margin and prostatic ureter. All resected lymph nodes are negative, and no distant metastatic spread can be assessed."} +{"pid": "TCGA-AC-A8OR", "report": "The specimen consisted of a simple mastectomy from the left breast along with excision of axillary tissue, palpable node biopsy, excision of superior and inferior skin edges, and sentinel node biopsy. Histologic evaluation demonstrated an invasive lesion measuring 1.7 cm in greatest dimension, located subareolarly. The histologic grade was Nottingham score 5 out of 9 (grade 1 of 3), with tubule formation scored as 2 of 3, nuclear pleomorphism scored 2 of 3, and mitotic rate scored 1 of 3.\n\nAll margins of resection were negative, with the lesion at least 3.5 cm away from all surgical margins. No lymphovascular invasion was identified. Evaluation of lymph nodes included one sentinel and one non-sentinel node; both were free of involvement. Focal atypical ductal hyperplasia was present within uninvolved breast parenchyma, which also showed fibrocystic changes. The skin and nipple were benign. The palpable node biopsy and additional left axillary tissue consisted solely of adipose or fibroadipose tissue without evidence of involvement. The superior and inferior skin edges revealed only benign skin and subcutaneous tissue.\n\nAncillary studies showed strong positivity for estrogen and progesterone receptors, negativity for HER2 (score 1+), and a Ki-67 proliferation index of approximately 7%. Pathologic staging was pT1c for the primary tumor, pN0(i-)(sn) for regional lymph nodes, and no evidence of distant metastasis. The overall staging classification was IA, with R0 margin status."} +{"pid": "TCGA-FD-A3N6", "report": "The patient is a female of Black race who underwent surgical resection for clinical history related to bladder pathology. The specimens received included lymph nodes from right and left pelvic regions, portions of the ureter, ovaries, fallopian tubes, uterus, bladder, and round ligament.\n\nExamination of lymph nodes revealed no evidence of tumor involvement. Specifically, fourteen lymph nodes were identified in the right pelvic dissection, twenty-nine in the left pelvic dissection, and fifteen in a second right pelvic lymph node specimen; all were negative for tumor.\n\nThe excised portion of the right ureter showed no tumor involvement. The uterus demonstrated benign findings including secretory endometrium, adenomyosis, and multiple leiomyomas, with the largest measuring 6 cm. Both ovaries exhibited physiologic changes. The left fallopian tube also showed no tumor involvement.\n\nThe bladder specimen contained an exophytic mass measuring 6.0 cm located on the anterior wall. Histologic evaluation revealed invasive high-grade cellular changes with extensive squamous differentiation. The tumor invaded into the muscularis propria, specifically the outer half, with a depth of invasion measuring 0.5 cm. No tumor was identified at the ureteral margins, distal urethral margin, or soft tissue margins. A separate plaque-like raised mucosal lesion measuring 2.0 x 1.5 cm was observed on the posterior wall but did not show tumor involvement.\n\nLymph node evaluation across all specimens yielded no evidence of metastasis (0/58). Pathologic staging was determined as pT2b, N0, MX according to the 7th edition TNM classification system by the AJCC and UICC. All other submitted tissues including the ovaries, fallopian tubes, and surrounding structures were free of tumor involvement."} +{"pid": "TCGA-XJ-A83G", "report": "The surgical pathology report includes three specimen samples. Specimen A consists of a single lymph node from the left pelvic region, measuring 1.5 x 1.0 x 0.4 cm. Microscopic evaluation showed no evidence of malignancy in this lymph node. Specimen B consists of three lymph nodes from the right pelvic region, with sizes measuring 2.0 x 1.6 x 0.7 cm, 0.6 x 0.4 x 0.3 cm, and 3.0 x 1.0 x 0.4 cm. No signs of malignancy were identified in any of these lymph nodes. Specimen C is a prostatectomy specimen weighing 56 grams and measuring 5.0 cm in width, 4.0 cm in depth, and 4.9 cm in height. The external surface appeared red-brown and ragged, with a nodular consistency on sectioning.\n\nMicroscopic analysis revealed cellular features including moderately differentiated glandular structures, with a Gleason grading pattern of 4 as the primary component and 3 as the secondary component. A tertiary pattern of 5 was also noted. Approximately 90% of the prostatic tissue demonstrated involvement by atypical cells. Invasion into surrounding tissues was observed, including extension into the extraprostatic fat and seminal vesicles. Involvement of the seminal vesicles was confirmed. Margins were evaluated and showed presence of atypical cells at the right distal urethral margin and both lateral margins. There was no identifiable treatment effect. No lymph-vascular invasion was detected, though perineural invasion was present.\n\nA total of four lymph nodes were examined across both pelvic regions, and none showed evidence of involvement. The largest lymph node measured 2.0 x 1.6 x 0.7 cm. Pathologic staging was determined as pT3b for local tumor extension involving the seminal vesicles and pN0 indicating no regional lymph node involvement. This assessment is based solely on available pathologic findings and does not incorporate full clinical correlation.\n\nThe gross description of the prostate included measurements of attached structures: the right seminal vesicle measured 3.3 x 2.0 x 0.8 cm, the right vas deferens measured 2.5 cm long by 0.9 cm in diameter, the left vas deferens measured 3.0 cm long by 0.9 cm in diameter, and the left seminal vesicle measured 2.7 x 1.8 x 0.8 cm. Sections of the prostate were submitted for detailed histologic examination, including margins and representative tissue blocks.\n\nIntraoperative frozen section evaluations of the lymph nodes from both pelvic regions confirmed absence of malignancy. All findings were reviewed and verified under the supervision of an attending physician."} +{"pid": "TCGA-FI-A3PV", "report": "The surgical pathology report describes a gynecologic specimen from a patient with a history of postmenopausal bleeding. A total abdominal hysterectomy with right salpingo-oophorectomy and pelvic lymph node dissection was performed. The uterus weighed 600 grams and measured 15 x 10 x 8 cm. The endometrial cavity measured 7.0 cm in length and contained a fungating, tan mass located in the fundic area and upper posterior and anterior walls. The tumor measured 3.6 cm at its maximum thickness and was exophytic without evidence of invasion into the underlying myometrium. Multiple white, whorled nodules were present within the myometrium, ranging from 0.4 to 6.2 cm in size, with some showing calcification and hyalinization.\n\nMicroscopic evaluation showed no lymphovascular space invasion. The tumor was confined to the endometrium and did not extend into the lower uterine segment or involve the myometrium. The endocervix showed involvement limited to the mucosal glands. No necrosis, hemorrhage, or cystic change was identified. Sections of the cervix, lower uterine segment, and surrounding tissue were also examined.\n\nThe right ovary was unremarkable and free of tumor involvement. No fallopian tube was identified in the specimen. Paraovarian soft tissue showed organizing thrombus but no malignancy. A total of 16 lymph nodes were evaluated: 5 from the right pelvic region, 5 from the left pelvic region, 4 from the left periaortic area, and 2 from the right periaortic region. All lymph nodes were free of tumor involvement.\n\nHistologic analysis revealed a high nuclear grade (NIII) with no residual non-neoplastic endometrial tissue other than atrophic changes. The myometrium contained multiple leiomyomas. The vaginal cuff, left ovary, and both fallopian tubes were not evaluable. There was no evidence of tumor invasion into adjacent structures or metastasis to the omentum or peritoneum. Distant metastasis could not be assessed.\n\nA prior endocervical and endometrial curettage showed clusters of atypical and malignant cells consistent with poorly differentiated adenocarcinoma, though the exact origin could not be determined from those samples. Cervical biopsies showed acute and chronic cervicitis with atypical cells, and a Pap smear was positive for malignancy.\n\nThe final staging was not possible due to insufficient data, and the pathologic stage is considered provisional until further clinical correlation is available."} +{"pid": "TCGA-KL-8335", "report": "The clinical history includes a left renal mass measuring 13.6 cm. A radical nephrectomy specimen was obtained, including the kidney, adrenal gland, and lymph node dissection. Additional specimens include a para-aortic lymph node excision.\n\nThe tumor measured 13.0 cm in greatest diameter and was located at the upper pole of the kidney. It exhibited extensive necrosis and was partially encapsulated. Grossly, it appeared to push into the perirenal fat without clear capsule breakthrough. The tumor deformed and abutted the calyceal pelvic system but did not show evidence of direct invasion. Hemorrhage and areas of yellow-tan and red discoloration were noted upon sectioning, with a central scarred region. Vascular invasion of small to medium-sized vessels was identified. The tumor extended through the renal capsule but remained within Gerota's fascia and involved the renal sinus fat. There was no evidence of renal vein invasion.\n\nSurgical margins were free of involvement. The ureter was patent and unremarkable. Lymph nodes from the renal hilum and periaortic regions were examined; eight nodes were assessed in total and none showed signs of involvement. The adrenal gland measured 3.8 x 2.8 x 1.2 cm and was closely adjacent to the tumor but not invaded.\n\nThe specimen included sections of the tumor with renal capsule, hilar fat, adjacent normal kidney tissue, and ureteral and vascular margins. All margins were negative. Multiple blocks were submitted for histological evaluation, including sections of the tumor margin, renal pelvis, adrenal gland interface, and surrounding normal kidney tissue.\n\nNo tumor was identified in the submitted lymph nodes. The overall staging classification indicated localized extension beyond the kidney but not beyond Gerota's fascia."} +{"pid": "TCGA-55-A4DG", "report": "The specimen consists of a right upper lobe pulmonary resection measuring 15.0 x 13.4 x 3.9 cm and weighing 190 grams. The resection margin includes a stapled bifurcated tertiary bronchus with an adjacent partially fragmented 0.8 cm fleshy mottled gray-black nodule. The pleura is wrinkled, mottled gray-pink with moderate anthracotic streaking. A subpleural lesion measuring 2.5 x 2.3 x 1.6 cm is present at the apex, slightly posteriorly. The lesion is wedge-shaped, gray-tan, firm, and fibrotic with a mottled cut surface. It extends to the pleura but does not penetrate through it. The nearest distance from the lesion to the bronchial margin is 5.2 cm. Adjacent to the lesion are areas of subpleural honeycombing consistent with paracicatricial emphysema. The remaining parenchyma is spongy, tan-pink with moderate anthracotic streaking. No significant fluid, honeycombing, or additional lesions are identified.\n\nLymph nodes were submitted from multiple levels. Level 9 lymph node is 1.0 x 0.7 x 0.3 cm and entirely submitted. Level 10 lymph nodes measure 1.6 x 1.2 x 0.6 cm and are focally calcified. Level 4R lymph nodes measure 4.2 x 3.8 x 1.2 cm with scattered fleshy areas up to 1.0 cm. Level 7 lymph node is 3.2 x 2.0 x 1.0 cm and fragmented. All lymph node specimens were sectioned and submitted completely.\n\nMicroscopic evaluation of the lung tissue reveals a fibrotic lesion with cellular features. The lesion is unifocal and located in the posterior apex. Visceral pleural invasion is present, with the lesion extending to, but not through, the visceral pleura. Lymphovascular space invasion is not identified. The surgical margins are clear, with the tumor located 5.2 cm from the bronchial margin. The total number of lymph nodes received is at least 20, including hilar lymph nodes and those from levels 1, 2, 4, and 5. None of the lymph nodes contain metastatic involvement. Additional findings include inactive dystrophic granulomas and reactive hyperplasia in several lymph nodes. Special stains for acid fast bacilli and fungi are negative. The specimen integrity allows for full histologic assessment."} +{"pid": "TCGA-OL-A66L", "report": "The pathology report includes findings from three specimens: two right axillary sentinel lymph nodes and a right breast lumpectomy. Each lymph node biopsy showed no evidence of tumor involvement.\n\nThe lumpectomy specimen revealed two separate areas of invasive malignancy. One focus measured 1.9 cm microscopically and demonstrated histologic features consistent with those previously observed. The composite histologic grade was modified SBR Grade I, with an architectural score of 2, nuclear grade of 2, and mitotic count score of 1. A second distinct focus of invasive malignancy measured 1.0 cm and exhibited similar histologic characteristics to the first, located superiorly and extending into the dermis. Hemorrhagic fat necrosis was identified at the prior biopsy site.\n\nAll excisional biopsy margins were free of tumor, with the closest distance being 2 mm from the anterior margin. Dermal lymphatic invasion was present. No intraductal component was identified. The skin showed direct extension of tumor, while skeletal muscle was not involved. All inked surgical margins were negative for tumor involvement.\n\nImmunohistochemical analysis showed strong estrogen receptor expression in more than 90% of invasive tumor nuclei, as well as strong progesterone receptor expression in more than 90%. Her2/neu status by FISH was non-amplified with a ratio of 1.10.\n\nThe specimen was staged using the AJCC 7th edition TNM classification system."} +{"pid": "TCGA-FG-7641", "report": "The specimen consists of an irregular fragment of pink-tan soft tissue measuring 3.5 \u00d7 2.5 \u00d7 1 cm. Touch imprints and frozen section were performed intraoperatively, with a portion of the tissue submitted for permanent sections in three cassettes. Microscopic evaluation reveals a neoplastic glial process with scattered mitotic figures. No microvascular proliferation or necrosis is observed. Cytogenetic analysis demonstrates loss of chromosomes 1p and 19q. The tumor exhibits a diffusely infiltrative growth pattern and is fully submitted for histopathologic assessment."} +{"pid": "TCGA-DB-5277", "report": "A biopsy and excision of a left frontal brain mass was performed. Histological evaluation revealed a diffuse glioma with features suggestive of an intermediate grade neoplasm. Tissue analysis included immunohistochemical staining for MIB-1 and p53 protein expression. The p53 stain showed strong and diffuse reactivity in the neoplastic cell population, and the MIB-1 labeling index was elevated, indicating increased cellular proliferation. \n\nGross examination of the surgical specimen included two tissue submissions: one measuring 0.5 x 0.3 x 0.2 cm and another measuring 5.8 x 4.0 x 2.0 cm. Multiple blocks were processed from the left frontal region, with several sections labeled for analysis. The histopathological findings were consistent with a high-grade glial neoplasm, based on nuclear atypia, mitotic activity, and cellular density."} +{"pid": "TCGA-CM-5348", "report": "The submitted right hemicolectomy specimen includes a segment of terminal ileum, cecum with attached appendix, and ascending colon. The terminal ileum measures 68 cm in length and 4 cm in circumference at the proximal margin. The colon portion measures 20.1 cm in length with a 11 cm circumference at the distal margin. The appendix is 6.2 cm long with an average diameter of 0.6 cm and shows serosal adhesions. A polypoid and focally ulcerated lesion measuring 3.2 cm in length and 4.4 cm in width is identified 1.5 cm distal to the ileocecal valve and 1.8 cm from the closest radial margin. Gross examination reveals invasion into subserosal fat with a depth of 1.0 cm. No serosal involvement is observed. Perineural invasion is present. Vascular invasion is not identified. One smaller polyp measuring 0.8 x 0.8 x 0.4 cm is noted 1.5 cm distal to the lesion, along with additional small polyps ranging from 0.1 to 0.3 cm in size elsewhere in the colonic mucosa. All surgical margins are free of abnormal tissue. Nineteen lymph nodes are examined, with one showing involvement. The pathological staging based on AJCC criteria indicates a T3 classification due to transmural extension and N1 classification due to lymph node involvement. The second specimen consists of a fragment of adipose tissue measuring 27 x 18 x 2 cm, consistent with omentum. Its cut surface appears unremarkable. Multiple representative sections were taken from all relevant areas for histologic evaluation."} +{"pid": "TCGA-A8-A082", "report": "The surgical specimen demonstrates an ablated breast sample containing two distinct foci. The first focus is poorly differentiated and measures 2.3 cm in diameter. It is located at a distance of 2.2 cm cranially, 2.5 cm dorsally, 3 cm laterally and caudally, and 5 cm medially from the resection margins. The second focus is moderately differentiated, measuring 2 cm, and is positioned less than 0.1 cm dorsally, 0.2 cm caudally, 1.5 cm laterally, 3.5 cm cranially, and 7 cm medially from the margins. Focal intraductal components are present. Histological evaluation indicates nuclear grade II. The tumor involves two regional lymph nodes, exhibits lymphatic invasion, and has negative vascular and resection margin involvement."} +{"pid": "TCGA-06-5856", "report": "The patient presented with a large lesion involving the left frontal, temporal, insular, and basal ganglia regions. Imaging showed partial hemorrhage, enhancement, and involvement of the internal carotid artery and left optic chiasm. There was significant mass effect with signs of herniation.\n\nA biopsy and excision were performed from the left cerebral lesion. Histologic evaluation revealed a highly cellular tumor with moderate pleomorphism. Mitotic figures, vascular proliferation, and areas of necrosis were identified. Immunohistochemical staining demonstrated diffuse positivity for GFAP in tumor cells. Synaptophysin highlighted the neuropil background and scattered tumor cells. Stains for CD3, CD4, and CD34 showed reactivity in rare to occasional cells. The Ki-67 labeling index was estimated at up to approximately 50%.\n\nMGMT promoter methylation testing was performed using bisulfite-treated DNA followed by real-time PCR amplification. No methylated MGMT promoter sequences were detected. The sensitivity of the assay is capable of detecting 1% methylated DNA within an unmethylated background. Factors such as low tumor cellularity or extensive necrosis may have affected the results. This test was developed and validated under CLIA regulations and has not been cleared by the FDA.\n\nIntra-operative consultation noted findings consistent with a high-grade glioma. Gross examination described soft, greyish-pink tissue fragments measuring up to 0.6 cm in greatest dimension. Multiple histologic sections were evaluated with various stains confirming the features described."} +{"pid": "TCGA-F2-7276", "report": "The specimen consisted of multiple tissue samples from the liver, diaphragm, bile ducts, gallbladder, pancreas, stomach, small bowel, and associated lymph nodes and margins. Liver samples from multiple segments showed variable findings including macrovesicular steatosis (~5%), bile stasis, benign bile duct proliferation, and in some areas, the presence of a hyalinized nodule or cyst wall. The gallbladder showed chronic inflammation but no malignant cells.\n\nA partial pancreaticoduodenectomy specimen included the head of the pancreas with involvement extending into the body. Gross examination revealed an ill-defined, yellow-tan mass measuring 5.5 cm in greatest dimension without gross involvement of the ampulla, duodenum, or bile duct. The tumor was described as solid with no necrosis or hemorrhage. Microscopic evaluation showed peripancreatic soft tissue invasion, lymphovascular invasion, and perineural invasion. Surgical margins were negative, though some were closely approached (<1 mm) at the posterior pancreatic surface and peripancreatic soft tissues.\n\nLymph node evaluation revealed metastatic involvement in 9 out of 17 nodes examined, including one from the common hepatic region and another from the colon mesentery. Other lymph nodes sampled from the portal region and surrounding structures were negative for malignancy.\n\nAdditional findings included fibroadipose tissue with chronic inflammation in specimens from the right diaphragm and pancreatic duct margin, and fibrous tissue with scattered ductal elements in the common bile duct margin. Intraoperative frozen sections from various sites did not show definitive evidence of carcinoma, though atypical cells were noted in some areas. Acute serositis was also identified.\n\nAll other structures including the stomach, duodenum, bile duct, and proximal/distal margins were free of tumor involvement. The case involved extensive sampling of surgical margins and lymph nodes, with most blocks submitted for histologic analysis."} +{"pid": "TCGA-BP-5009", "report": "The specimen from a left partial nephrectomy in a male patient with prior history of hairy cell leukemia was examined. A mass measuring 5.7 x 5.3 x 4.0 cm was identified within the kidney. The tumor was well-circumscribed and exhibited a variegated appearance with golden-yellow to tan areas, along with regions of hemorrhage, necrosis, and possible myxoid degeneration. Microscopic evaluation revealed high nuclear grade features (Grade III/IV). No local invasion, renal vein involvement, or angiolymphatic invasion was observed. The surgical margin was free of tumor, with a clearance of 0.1 cm from the resection edge. Non-neoplastic findings included cortical scarring and chronic interstitial inflammation with focal granulomatous changes. The tumor was confined to the kidney and measured less than 7.0 cm in greatest dimension. No lymph nodes or adrenal tissue were identified in the specimen. Multiple sections were taken for analysis, including representative sections of the tumor, margins, and surrounding kidney tissue. Intraoperative frozen section confirmed the absence of tumor at the designated margin."} +{"pid": "TCGA-BH-A0GY", "report": "The surgical specimen from the left breast segmental mastectomy includes an invasive lesion measuring 2.6 cm. Histologic scoring system indicates a nuclear grade of 3, tubule formation score of 3, and mitotic activity score of 2. The lesion demonstrates lymphovascular space involvement. The invasive component is located 0.1 cm from the inferior margin, while the non-invasive component is within 1 mm of the same margin. All other margins are uninvolved. Microcalcifications are present in both benign and affected areas. Additional findings include proliferative fibrocystic changes with atypical ductal epithelial hyperplasia and columnar cell alterations. A peripheral papilloma and sclerosing adenosis are also noted. Skin examination does not reveal any significant abnormalities.\n\nSentinel lymph node assessment from the left axilla shows two nodes involved with metastatic cells. One lymph node contains a focus measuring 9 mm without extracapsular extension. Another node shows small clusters of tumor cells within the sinusoidal structures. A third lymph node appears to be affected primarily by thermal artifact and no tumor involvement is evident. A total of three lymph nodes were evaluated.\n\nThe tumor involves benign microcalcification zones and is admixed with non-invasive components. These non-invasive features include micropapillary and solid patterns with necrotic changes, accounting for approximately 5% of the overall lesion volume. The closest distance between invasive tumor and the margin is 1 mm, while the non-invasive component approaches within 0.7 mm of the margin. Non-neoplastic findings include atypical ductal hyperplasia, fibrocystic changes, and papilloma.\n\nPathologic staging reflects the size and nodal involvement as pT2 and pN1a respectively. Hormone receptor testing shows positivity for both estrogen and progesterone receptors."} +{"pid": "TCGA-A6-6651", "report": "The specimen includes a subtotal colectomy, a small bowel mass, and an appendectomy. The colectomy specimen measures 23 cm in length and is opened at both ends, which are inked blue and black. Attached adipose tissue and omentum are present, with the omentum measuring up to 42 cm in greatest dimension. No focal lesions are identified in the omentum. Within the bowel, a 5.5 x 5 x 3.8 cm mass is located 5.5 cm from the black-inked end. This lesion appears to invade through the muscularis propria into surrounding soft tissues but does not reach the serosal surface or the radial margin. A separate 3.5 x 3.3 x 2.7 cm polypoid lesion is noted 3.5 cm from the blue-inked margin, appearing exophytic without clear invasion into the bowel wall. Multiple lymph nodes are identified within the adipose tissue.\n\nHistologically, the invasive lesion shows moderately differentiated morphology and extends through the full thickness of the muscularis propria into surrounding adipose tissue. Two of thirty-three lymph nodes contain metastatic involvement. Both proximal and distal margins, as well as the circumferential margin, are free of tumor. Vascular invasion is not definitively identified. The separate polypoid lesion demonstrates tubulovillous features with focal severe architectural distortion. The small bowel specimen reveals serosal fibrosis without evidence of tumor. The appendix is unremarkable, showing luminal obliteration without specific diagnostic abnormalities."} +{"pid": "TCGA-DX-A48U", "report": "The patient was found to have a large mass in the area surrounding the right renal artery and vein. A core biopsy was performed. Specimens were submitted for analysis, including a biopsy of the right lobe of the liver and a specimen containing retroperitoneal soft tissue along with the right kidney.\n\nThe liver biopsy consisted of a small fragment of tissue measuring 0.5 x 0.5 x 0.5 cm. Histologic examination revealed focal portal fibrosis without evidence of malignancy. The retroperitoneal specimen contained a large mass measuring 30.0 x 28.0 x 11.0 cm. The external surface was smooth and glistening, and after sectioning, it displayed a lobulated tan cut surface with areas of hemorrhage, myxoid change, and necrosis, estimated at 10% by gross evaluation. The tumor was in close proximity to an inked soft tissue margin, with a distance of 0.04 cm noted. Adjacent to the mass was a kidney measuring 14.0 x 5.0 x 4.0 cm, which showed scattered sclerotic glomeruli and patchy interstitial fibrosis with chronic inflammation, but no tumor involvement.\n\nImmunohistochemical staining of the mass demonstrated positivity for smooth muscle actin (SMA), desmin, and caldesmon. There was no staining observed for CD117. Microscopic evaluation included multiple sections from various blocks and sites, including the kidney, soft tissue margin, and vascular structures.\n\nIntraoperative frozen section analysis of the liver biopsy confirmed benign findings, consistent with the final assessment. All diagnoses were based on personal examination of the slides and review of the materials provided."} +{"pid": "TCGA-EM-A22L", "report": "The specimen consists of a right hemithyroidectomy measuring 3.9 \u00d7 2.3 \u00d7 1.6 cm and weighing 8.7 grams. The isthmus, with possible pyramidal lobe, measures 1.7 \u00d7 1.6 \u00d7 0.7 cm. Grossly, a well-defined nodule is present in the mid-superior right lobe, measuring 2.2 \u00d7 2.1 \u00d7 1.5 cm. The cut surface shows a variegated red-tan color with soft and flabby consistency. No parathyroid tissue or lymph nodes are identified.\n\nMicroscopically, multiple foci of abnormal cells are observed within the right thyroid lobe. The dominant lesion demonstrates follicular architecture with classical cytomorphology. The tumor is partially encapsulated and shows minimal capsular invasion. Margins are free of involvement. No lymphovascular or perineural invasion is identified, and there is no evidence of extrathyroidal extension. A second focus measuring 0.1 cm is identified, also showing follicular architecture and classical cytomorphology, with no evidence of invasion or margin involvement.\n\nStaging indicates the primary tumor is greater than 2 cm but not more than 4 cm in size and confined to the thyroid (pT2). One regional lymph node was examined and showed no metastasis (pN0). No distant metastasis is identified. The overall histological features suggest a low-risk profile. All measurements and descriptions are based on standard pathological evaluation."} +{"pid": "TCGA-E9-A54Y", "report": "The specimen consists of breast tissue with a lesion measuring up to 3 cm in its largest dimension. A second nodule measuring up to 1 cm is identified at a distance of 1.5 cm from the primary lesion. Lymph nodes within the axillary fatty tissue show changes concerning for metastatic involvement. Histologic examination reveals a poorly differentiated carcinoma with multicentric growth pattern and the presence of single signet-ring cells. Evaluation of 10 lymph nodes shows involvement in 8, consistent with nodal metastasis. Immunohistochemical analysis demonstrates strong estrogen receptor positivity (98%, 3+), progesterone receptor positivity (50%, 3+), negative HER2/neu staining (1+), and a proliferation index of 6% by Ki-67 assessment. The tumor exhibits uninvolved margins and based on size, correlates with a T2 classification (greater than 2 cm but less than 5 cm). No definitive assessment could be made regarding vascular invasion, treatment effect, or histologic scoring components such as tubule formation, nuclear pleomorphism, or mitotic counts."} +{"pid": "TCGA-5P-A9KF", "report": "The specimen shows a nephrectomy with two distinct foci measuring 2.2 cm and 0.6 cm. Histological evaluation reveals well-differentiated cells arranged in a papillary growth pattern, with features suggestive of low nuclear grade. Adjacent to these findings are multiple small papillary structures consistent with adenomas. There is also evidence of chronic interstitial inflammation. Staging according to the pTNM 2010 system is pT1a, with a maximum dimension of 3 mm. Lymphovascular invasion is not present, perineural invasion is absent, and surgical margins are involved. The morphological classification corresponds to Grade 1."} +{"pid": "TCGA-DJ-A3VM", "report": "The right thyroid lobe and isthmus specimen measured 5 x 3.5 x 2 cm with a total weight of 15 grams. The tumor was well-circumscribed, thinly encapsulated, and tan in color, measuring 3 x 2.7 x 2 cm. Microscopic evaluation showed hypercellularity and atypical cells. Histologic analysis revealed a well-differentiated cellular pattern with oncocytic features. No mitotic activity or tumor necrosis was identified. The tumor was completely surrounded by a capsule, and there was no evidence of capsular invasion. Two foci of vascular invasion were present. There was no extension beyond the thyroid gland. Surgical margins were free of involvement. Multicentric disease was not observed. Adjacent non-neoplastic thyroid tissue showed nodular hyperplasia. A single parathyroid gland was identified and appeared unremarkable. Intraoperative frozen section analysis initially suggested Hurthle cell neoplasm; however, nuclear features and vascular invasion were not present in frozen sections. All findings were based on personal examination of the slides and review of the material."} +{"pid": "TCGA-UF-A7JH", "report": "The specimen from the larynx was submitted as part of a total pharyngolaryngectomy with bilateral wide field resection and bilateral recurrent laryngeal nerve resection. The lesion measured 6.0 cm and involved the supraglottis, glottis, and subglottis, crossing the midline. There was infiltration of both vocal folds as well as involvement of the arytenoid and thyroid cartilages. No vascular or perineural invasion was identified. The epiglottis and pre-glottic fat were not involved. The thyroid gland showed no evidence of involvement. Surgical margins were clear. Twenty-four lymph nodes were examined and none showed evidence of involvement. A separate biopsy from the right SCF skin showed an exudative inflammatory process with no evidence of neoplastic change."} +{"pid": "TCGA-X6-A7WD", "report": "A soft tissue excision from the right leg was examined, measuring 12.0 x 7.0 x 5.0 cm. The specimen contained a well-circumscribed mass measuring 8.0 x 6.0 x 3.8 cm, with a multinodular, solid appearance and areas of hemorrhage and necrosis. The mass was located within subcutaneous tissue and was surrounded by a fascial plane at the deep margin. The closest measured distances from the mass to the surgical margins were 0.1 cm at the deep margin, 1.0 cm at the 6 o\u2019clock margin, 1.2 cm at the 9 o\u2019clock margin, 1.9 cm at the 3 o\u2019clock margin, and 3.1 cm at the 12 o\u2019clock margin. Additional excised soft tissue specimens from the lower and deep margins showed only benign fibroadipose tissue and skeletal muscle without evidence of atypical cellular infiltration.\n\nMicroscopic evaluation revealed a proliferation of spindle-shaped cells arranged in long, intersecting fascicles. The cells exhibited marked nuclear pleomorphism and hyperchromasia. No vascular invasion or inflammatory infiltrate was identified. The mitotic count exceeded 20 mitotic figures per 10 high-power fields, and multifocal necrosis involving less than 50% of the lesion was present. The tumor was located in the subcutaneous tissue of the right thigh and did not show any connection to a pre-existing benign lesion. Lymph node assessment was not applicable.\n\nBased on available material, the pathologic stage assigned is T2a, indicating a superficial tumor greater than 5 cm in size. The regional lymph node status could not be assessed. An optimal tissue block for further analysis has been identified."} +{"pid": "TCGA-NA-A4QX", "report": "The specimen from the uterus weighed 241 grams and measured 7.5 x 6.5 x 5 cm. The ectocervix was 8 cm in diameter with an os dilated to 6 cm. A necrotic mass measuring 7 x 6.5 x 5 cm protruded through the os, with a pedunculated base adherent to the inferior endometrium. On sectioning, the mass demonstrated a white, rubbery, fibrous core surrounded by a rim of red, gray-brown hemorrhage and necrosis. The deepest invasion measured 1.2 cm into a 3.2 cm thick myometrial wall. Adjacent findings included a 0.8 x 0.6 x 0.4 cm pedunculated polyp on the anterior endometrium and a 1.4 x 1.3 x 0.5 cm pedunculated polyp in the anterior lower uterine segment. The endometrial cavity measured 3 x 3 cm with a flattened endometrium and a 2 cm thick trabeculated myometrium. A 1 cm white whorled nodule was noted in the posterior myometrium. The serosal surface appeared tan, smooth, and glistening without gross abnormalities.\n\nThe right adnexa included a 6.5 cm fallopian tube and a 2.5 x 2 x 1 cm ovary with a bosselated surface. Both the ovary and tube appeared unremarkable upon sectioning. The left fallopian tube measured 6.8 cm in length and was attached to a 1.9 x 1.9 x 0.8 cm ovary containing a 1 x 0.8 x 0.8 cm white cystic nodule within the parenchyma, otherwise without significant findings.\n\nA fragment of omental fat measuring 20.2 x 18.3 x 3.5 cm revealed multiple firm white fibrous nodules ranging from 0.7 x 0.6 x 0.5 cm to 5 x 4 x 3.5 cm. A separate fragment of fibrofatty tissue from the left pelvic sidewall measured 2.5 x 1.3 x 0.7 cm and was entirely submitted for evaluation.\n\nMicroscopic analysis revealed epithelial tumor involvement in the cervix at the junction of the lower uterine segment, bilaterally in the ovaries, extensively in the omentum, and in the left pelvic sidewall. Stromal response was prominent, including desmoplastic changes. The tumor demonstrated heterogeneity with areas resembling clear cell morphology, alveolar soft part features, and undifferentiated sarcoma. Mitotic activity was minimal with 1 mitosis per 10 high-power fields. Lymphatic or vascular invasion was not identified. Margins of resection were free of tumor involvement."} +{"pid": "TCGA-CJ-4901", "report": "The specimen consists of a right kidney and adrenal gland along with an inferior vena caval thrombus. The kidney measures 25 x 14 x 11 cm and contains a large, ill-defined mass measuring 14 x 9.0 x 7.5 cm, which involves more than two-thirds of the renal parenchyma. The mass is yellow with extensive areas of hemorrhage and necrosis distributed throughout. It extends into the perinephric adipose tissue and renal sinus, and appears to invade the pelvicaliceal system. A thrombus is present within the renal vein and extends into the inferior vena cava, measuring up to 3.5 cm in maximum diameter. The ureteral and vascular resection margins are free of tumor involvement. The adrenal gland shows no abnormality. Serial cross-sections of the adrenal gland demonstrate normal cortex and medulla. Multiple sections have been taken from various regions including the renal artery and ureter margin, tumor thrombus and vein, tumor with renal sinus, representative sections of the tumor, tumor with adjacent perinephric fat, and tumor extending into the renal capsule. No hilar lymph nodes are identified. The adjacent kidney parenchyma appears normal."} +{"pid": "TCGA-22-5489", "report": "The surgical specimen from the left upper lobe of the lung consists of a mass measuring 2.7 x 2 x 1.8 cm, located approximately 0.7 cm from the bronchial margin. The tissue margins are free of abnormal cells. Three intrapulmonary peribronchial lymph nodes show no evidence of malignant involvement. In the superior segment of the left lower lobe, a microscopic lesion measuring 0.2 cm in diameter is identified with cellular features limited to in-situ changes; surgical margins are also negative. A second excision from the same region shows benign lung parenchyma without signs of malignancy. Examination of multiple lymph nodes including superior mediastinal (1 right upper paratracheal, 3 left lower paratracheal, 3 right lower paratracheal), aortic (2 aortopulmonary), inferior mediastinal (7 subcarinal, 3 inferior pulmonary ligament), and N1 (2 interlobar) reveals no tumor presence. Necrotizing granulomas are observed within the submitted right lower paratracheal lymph node tissue. No involvement of the visceral pleura by abnormal cell growth is seen."} +{"pid": "TCGA-DX-A3UE", "report": "The clinical history includes a previously diagnosed high-grade neoplasm. Two specimens were submitted for evaluation: one biopsy from the intercostal soft tissue and one radical resection from the right paraspinal region.\n\nThe intercostal specimen consisted of a single white-tan firm nodule measuring 1 x 0.7 x 0.3 cm, entirely submitted for frozen section analysis. Frozen section control was performed.\n\nThe right paraspinal resection specimen consisted of fibroadipose tissue and skeletal muscle, measuring 15.4 cm in greatest dimension. A skin ellipse measuring 15.4 x 2.3 cm was present. The specimen was inked with multiple colors to identify margins. A well-circumscribed yellow-tan mass measuring 6.6 x 4.4 x 3.9 cm was identified within the skeletal muscle. The tumor was located 1 cm from the lateral margin, 0.3 cm from the superior margin, 0.9 cm from the inferior margin, 0.1 cm from the anterior margin, and 0.2 cm from the posterior margin. The distance from the tumor to the skin surface was 9.3 cm. Photographs were taken, and representative sections were submitted for further analysis.\n\nMicroscopic evaluation of both specimens showed a cellular lesion involving skeletal muscle and fibroadipose tissue, with less than 5% necrosis. Margins were closely evaluated, with the tumor being as close as 0.1 cm to the anterior margin, 0.4 cm to the posterior margin, and 0.2 cm to the superior margin. Sections from all relevant areas including skin tips, skin, anterior, posterior, lateral, superior, and inferior margins, adipose tissue, and skeletal muscle were reviewed.\n\nIntraoperative consultation on the first specimen confirmed the presence of a high-grade cellular proliferation. Permanent sections correlated with the frozen diagnosis."} +{"pid": "TCGA-DJ-A2Q5", "report": "The clinical history indicates a preoperative fine needle aspiration of a thyroid nodule. Submitted specimens include lymph node samples from the Delphian, left tracheal, and left low jugular regions, as well as a total thyroidectomy specimen and an additional left jugular node.\n\nExamination of the Delphian node revealed one lymph node measuring 0.5 cm in maximum dimension; all of it was submitted for analysis. A single metastatic focus was identified, measuring 0.3 cm. No extranodal extension was present. The left tracheal node sample consisted of soft tissue measuring 0.8 x 0.6 x 0.6 cm, but no lymphoid tissue was identified. The specimen was entirely submitted and showed only benign fibroadipose tissue. In the left low jugular region, a lymph node measuring 1.2 cm in diameter was found among four nodes examined. One node contained a metastatic deposit measuring 0.5 cm. No extranodal extension was observed. The remaining tissue in this sample and the additional left jugular node specimen both showed only benign fibroadipose tissue without identifiable lymph nodes.\n\nThe total thyroidectomy specimen weighed 22.5 grams. The left lobe measured 4.3 x 2.7 x 2.5 cm and included a 3.5 x 1.5 x 1.5 cm attached muscle portion. A suture marked the left lobe. A distinct nodule measuring 4 x 2.7 x 2.5 cm was found within the left lobe, with a tan-pink, lobular, firm appearance, touching both anterior and posterior surfaces. The nodule was partially encapsulated and showed no necrosis or vascular invasion. Microscopic evaluation revealed calcifications of non-psammomatous type. The surrounding thyroid tissue showed features of chronic lymphocytic thyroiditis. No tumor was identified at surgical margins, and there was no evidence of multicentric disease or associated adenomas. Parathyroid tissue was not identified in the specimen. All remaining non-neoplastic portions of the thyroid were submitted for analysis. Frozen section and permanent diagnoses were consistent across the evaluated lymph node specimens."} +{"pid": "TCGA-XF-A8HF", "report": "A radical cystectomy with urinary diversion and gastrostomy tube placement was performed. Specimens from both the right and left ureters showed no evidence of tumor or high-grade urothelial atypia. The prostate and bladder specimen revealed a fungating mass measuring 3.0 x 2.2 x 1.0 cm located in the mid to left bladder near the trigone region. Microscopic evaluation demonstrated poorly differentiated invasive transitional cell carcinoma, grade 4/4, extending through the muscularis propria into perivesical tissue. No lymphovascular invasion was identified. There was extensive tumor necrosis adjacent to the mass, and all resection margins were free of urothelial atypia and tumor.\n\nIn addition, bilateral prostatic adenocarcinoma was identified with a Gleason score of 7 (3+4). The tumor extended into the prostatic capsule but not beyond it. All surgical margins were free of tumor involvement. Perineural invasion was present, but no lymphovascular space invasion was observed. Both seminal vesicles and vasa deferentia were free of tumor. High-grade prostatic intraepithelial neoplasia (PIN III) was also noted.\n\nLymph node evaluation included specimens from Cloquet, obturator, hypogastric, presacral, and common iliac regions on both sides. No metastatic carcinoma was identified in any of the lymph nodes examined.\n\nThe gross specimen of the bladder measured 6.5 x 4 x 3 cm, with a thickened wall measuring 1.1 cm. The prostate measured 5 x 4 x 4 cm, and its sectioning revealed a pink-tan, nodular cut surface. A total of 24 cassettes were submitted for histological evaluation, including multiple sections from the prostate, bladder, vas deferens, seminal vesicles, and surgical margins.\n\nMicroscopically, the bladder lesion consisted of solid sheets of neoplastic cells with high nuclear-to-cytoplasmic ratios, pleomorphic nuclei, and clear cytoplasmic changes. Focal squamous metaplasia and frequent mitotic figures were present. In the prostate, the tumor was composed of irregular glands infiltrating the stroma, with some areas showing gland fusion. Nuclear enlargement, vesicular chromatin, and prominent nucleoli were observed. Multifocal perineural invasion was noted in the prostate, but no lymphovascular invasion was seen.\n\nAll lymph nodes evaluated were negative for metastasis. Pathologic staging was assigned based on local tumor extension and lymph node status."} +{"pid": "TCGA-XT-AASU", "report": "A skin specimen from the right port site showed chronic inflammation without evidence of tumor. A resected sixth rib specimen was examined grossly only. Lymph nodes from R4, R8, Station 7, and A3 regions were all negative for tumor involvement. Each lymph node was submitted with associated fibroadipose tissue; no malignant cells were identified in any of these specimens.\n\nThe right lung and pleura specimen demonstrated extensive involvement of both visceral and parietal pleura, chest wall, diaphragm, and pericardium by a mixed cellular proliferation. The lesion extended into the lung parenchyma and approached the margins of resection at the apex, lateral, and posterior aspects. It was also present in the soft tissue of the bronchial margin. Histologic sections revealed a firm white mass encasing the lung, measuring up to 1 cm in thickness, extending into interlobar fissures and posterior sulcus. Invasion into the diaphragm was observed but did not extend through to the abdominal surface. No discrete masses were identified within the lung parenchyma itself, which appeared compressed but not fibrotic or cystic.\n\nSections from multiple lung regions including upper, middle, and lower lobes\u2014both peripheral and central\u2014were sampled, along with margins, fissures, pericardium, diaphragm, and hilar structures. Five hilar lymph nodes were negative for tumor. One lymph node contained an asbestos body. Iron stains revealed at least one characteristic asbestos body in each of two slides (6C and 6H). A single small meningothelial nodule was noted in slide 6C.\n\nImmunostains showed strong positivity for EGFR in epithelioid components of the proliferative lesion, with focal and weak positivity in spindle cell areas. Multiple full-thickness sections of the posterior sulcus specimen confirmed infiltration into the diaphragmatic muscle without perforation through to the abdominal surface.\n\nAll other sampled tissues including vascular, bronchial, and parenchymal margins showed no evidence of tumor involvement."} +{"pid": "TCGA-VD-AA8T", "report": "HISTOPATHOLOGY. Lab No. Clinical Consultant & Location. Unit No. SPECIMEN. LEFT GLOBE ENUCLEATION (FOR DIAGNOSTIC AND PROGNOSTIC). CLINICAL DETAILS. See diagram. Measurements 14.28 x 14.26 x (9.49) mm. MACROSCOPIC DESCRIPTION. A fresh, intact left globe. Dimensions: Axial 24 mm, Horizontal 24mm, Vertical 24mm. Cornea: Horizontal 11.5mm, Vertical 10.8mm. Description: arcus senilis. Optic nerve: Length 7mm, diameter 4mm. Pupil: very dilated. On trans-illumination, a large shadow is seen on the medium 100/30/14 side. Approximately 18mm in size. Plane of section: horizontal. Intraocular description: On opening, a solitary pigmented dome-shaped choroidal mass is seen. There is probable ciliary body involvement. Posterior edge is 11mm from optic disc. Lesion dimensions: LBD 12mm, Height 9mm. MICROSCOPY. Sections show a partially pigmented ciliochoroidal lesion consisting predominantly of spindle cells. The number of mitoses is approximately 2 per 40 high power fields. Closed loops are present in the planes of sections. The lymphocytic infiltrate within the lesion is minimal. Scattered macrophages are present. Necrosis is not observed. Bruch's membrane appears breached in the sections examined.\n\nHISTOPATHOLOGY REPORT. Lab No. Clinical Consultant & Location. Unit No. There is no extension through the sclera, optic nerve, or vortex veins examined. The lesion extends very close to the anterior chamber angle and trabecular meshwork; however, no definitive evidence of ring pattern of spread is seen. Lesion cells are not present at the resection margins. Elsewhere, the cornea shows no significant abnormality apart from oedema in basal epithelial cells. The anterior chamber angles are open and the anterior chamber is deep. The iris shows no significant abnormality but the ciliary body away from the lesion appears atrophic with hyalinisation of ciliary processes. Lens remnants show cataractous changes. Retina overlying the lesion is slightly atrophic.\n\nImmunohistochemical stains were performed. The lesion cells stain for MelanA and partially for HSP-27 (score 1).\n\nMolecular genetic analysis of DNA extracted from the fresh tissue was performed using multiplex ligation-dependent probe amplification (MLPA), examining chromosomes 1, 3, 6 and 8. The DNA concentration was high and of good quality. The MLPA reaction was run multiple times with consistent results. Sequence analysis demonstrated loss of chromosome 1p, monosomy 3, normal chromosome 6, and gains in chromosome 8. These molecular findings require correlation with clinical and morphological data for risk assessment."} +{"pid": "TCGA-AZ-5407", "report": "A laparoscopic colectomy was attempted but converted to an open right colectomy. The specimen included a segment of terminal ileum and right hemicolectomy. An invasive tumor measured 0.9 cm and extended into the submucosa. This lesion arose within a tubulovillous adenoma measuring 2.5 cm in greatest dimension, which exhibited serrated features. In addition, there were two tubulovillous adenomas measuring 2.9 cm and 1.5 cm, as well as one tubular adenoma measuring 1.0 cm. All resection margins were free of invasive tumor and adenomatous tissue. No angiolymphatic invasion was identified. A total of sixteen lymph nodes were examined and none showed evidence of metastasis. The tumor was staged as pT1 pN0 pMX. The terminal ileum showed no significant pathological changes. A separate lesion located in the tip of the appendix measured 3 mm and displayed histologic features consistent with a neuroendocrine tumor. Immunohistochemical staining demonstrated positivity for CDX2, mCEA, pancytokeratin, and synaptophysin, while being negative for chromogranin and p53. Histologic evaluation revealed low-grade differentiation with a pushing tumor border configuration. There was no perineural invasion or tumor-associated lymphocytic response. Molecular testing using microdissection genotyping showed no microsatellite instability. Immunohistochemistry for DNA mismatch repair proteins hMLH1, hMSH2, and hMSH6 demonstrated preserved expression. The specimen was analyzed due to clinical criteria suggesting possible hereditary cancer syndrome."} +{"pid": "TCGA-DU-7007", "report": "The surgical specimen from the right frontal lobe consists of multiple tissue fragments, with a largest dimension of 1.3 cm. The tissue is described as semi-firm and tan-pink in color. Histological examination reveals a neoplastic glial proliferation, with a significant portion of cells displaying a plump, gemistocytic appearance. Nuclear pleomorphism is prominent, including the presence of multinucleated cells. No mitotic figures, microvascular proliferation, or necrosis are identified. Inflammatory cells are noted around some blood vessels.\n\nA MIB-1 immunostain was performed on a representative block, showing a labeling index of 2.5% in one area. A second specimen from the same region includes a discoid tissue fragment measuring 3.5 x 2.5 x 1 cm, and a larger resected brain segment measuring 7 x 5.5 x 3.2 cm. The latter shows a reddish discoloration and areas of softening and hemorrhage approximately 2.5 cm in diameter. The cut surface is firm and grayish-white.\n\nMicroscopic evaluation of these specimens demonstrates extensive infiltration of the cerebral cortex and white matter by a neoplastic process. The cellular morphology is consistent with mixed glial features, including regions with astrocytic and oligodendroglial characteristics. Areas with frank astrocytic features are intermixed with nodular regions composed of cells with large, hyperchromatic nuclei surrounded by clear halos. Cystic spaces are present, particularly in the central region, and are associated with mucinous material and rarefied white matter. These cystic areas coalesce into larger confluent spaces.\n\nInfiltration is observed throughout the entire specimen, reaching all resection margins. Inflammatory cells are found surrounding blood vessels, with some extending into vessel walls. Mitotic activity remains low, and no definitive microvascular proliferation or necrotic regions are seen. MIB-1 labeling indices vary across different blocks, ranging from 1% in the main tumor mass to 8% in a more hypercellular focus.\n\nThe tumor demonstrates widespread infiltration, with predominant oligodendroglial morphology and scattered areas of astrocytic differentiation. Cellular pleomorphism is notable, especially in certain regions, although high-grade features remain limited. The neoplasm extends to all evaluated surgical margins, indicating incomplete resection. Inflammatory changes are consistently present in perivascular spaces."} +{"pid": "TCGA-2J-AABI", "report": "Surgery date: REVISED REPORT (Revised information underlined). A. Lymph nodes, duodenal colic, biopsy: Fibroadipose tissue, negative for tumor. B. Lymph node, common hepatic artery, biopsy: A single lymph node is negative for tumor. C. Soft tissue, pancreatic neck margin, biopsy: Negative for tumor. D. Soft tissue, common hepatic duct margin, biopsy: Negative for tumor. E. Head of pancreas, duodenum, common bile duct, and gallbladder; Whipple resection: A 3.5 x 3.0 x 2.5 cm mass is present within the head of the pancreas. The mass extends beyond the pancreas and involves peripancreatic soft tissue. Perineural invasion is identified. Angiolymphatic invasion is not identified. Multiple lymph nodes (17 peripancreatic, 1 periduodenal) are negative for tumor. The gallbladder shows no diagnostic abnormality. A microscopic focus of involvement is present at the uncinate margin. The portal vein groove is negative. \n\nAMENDMENTS: (Previous Signout Date: Revision Description: Uncinate and portal vein groove margin omitted from part E. Original diagnosis included a focus of involvement at the uncinate margin and negative status for the portal vein groove.)\n\nPRELIMINARY FROZEN SECTION CONSULTATION: A. Lymph nodes, duodenal colic, biopsy: Fibroadipose tissue, negative for tumor. B. Lymph node, common hepatic artery, biopsy: A single lymph node is negative for tumor. C. Soft tissue, pancreatic neck margin, biopsy: Duct margins are negative for dysplasia with mucinous change. D. Soft tissue, common hepatic duct margin, biopsy: Negative for tumor. E. Head of pancreas, duodenum, common bile duct, and gallbladder; Whipple resection: Invasive lesion involving the head of the pancreas. Frozen section histologic interpretation was performed on the duodenal colic lymph nodes, common hepatic artery lymph nodes, pancreatic neck margin, common hepatic duct margin, head of pancreas, duodenum, common bile duct, and gallbladder.\n\nGROSS DESCRIPTION: A. Specimen labeled \"duodenal colic lymph nodes\" is a 4.0 x 3.0 x 2.0 cm aggregate of adipose and lymphatic tissue. Lymph nodes were submitted. B. Specimen labeled \"common hepatic artery lymph nodes\" is a 2.2 x 2.0 x 0.8 cm aggregate of adipose and lymphatic tissue. Lymph nodes were submitted. C. Specimen labeled \"pancreatic neck margin\" is a 3.0 x 1.5 x 1.0 cm fragment of pancreas without orientation. Margin was submitted. D. Specimen labeled \"common hepatic duct margin\" is a 0.9 x 0.3 x 0.3 cm portion of duct without orientation. Margin was submitted. E. Specimen labeled \"head of pancreas, duodenum, portion of jejunum, gallbladder\" is a Whipple specimen including a 29.0 cm length of duodenum, a 6.0 x 4.5 x 4.3 cm portion of pancreas, and a 10.5 x 4.0 x 1.5 cm gallbladder. The pancreatic uncinate margin is inked yellow and shaved. The portal vein groove is inked black and submitted perpendicularly. A 3.5 x 3.0 x 2.5 cm diffusely infiltrative mass is present within the head at the uncinate margin. The mass is confined to the pancreas. The gallbladder contains no choleliths. Peripancreatic and periduodenal lymph nodes are identified. Representative sections are submitted.\n\nBLOCK SUMMARY: Part A: Duodenal colic lymph nodes \u2013 2 blocks submitted. Part B: Common hepatic artery lymph nodes \u2013 1 block submitted. Part C: Pancreatic neck margin \u2013 2 blocks submitted. Part D: Common hepatic duct margin \u2013 1 block submitted. Part E: Head of pancreas, duodenum, portion of jejunum, gallbladder \u2013 18 blocks submitted, including the uncinate margin, portal vein groove, mass, ampulla, pancreatic duct, bile duct, peripancreatic and periduodenal lymph nodes, and gallbladder."} +{"pid": "TCGA-BG-A0MS", "report": "The specimen consisted of a uterus with bilateral adnexa, weighing 159.5 grams, resected during a radical hysterectomy and bilateral salpingo-oophorectomy. A lesion was identified in the endometrium, with involvement of approximately 90% of the endometrial surface. The lesion exhibited a high degree of differentiation, with architectural features consistent with poorly differentiated epithelial neoplasm. Nuclear grading was classified as grade 2. Invasion extended into approximately 44% of the myometrium, and involvement of the cervical stroma was noted. Focal lymphovascular invasion was also identified.\n\nExamination of the vaginal margins showed tumor involvement at the posterior margin, while the anterior margin was free of tumor. Involvement of the parametria was noted bilaterally, with detached fragments of tissue found in both right and left parametrial regions. These were interpreted as likely due to tissue contamination, although the significance of these findings was noted in the report.\n\nLymph node dissection included multiple pelvic and periaortic regions. A total of 18 lymph nodes were examined. Of these, 2 were found to contain metastatic carcinoma\u20141 from the right pelvic group and 1 from the left pelvic group. The remaining lymph nodes, including those from the right and left common and periaortic regions, showed no evidence of tumor involvement.\n\nThe maximum dimension of the lesion was 0.8 cm. Depth of myometrial invasion was less than half the thickness of the myometrium. No tumor was identified in the bilateral ovaries or in the single lymph node recovered from the left common and periaortic region."} +{"pid": "TCGA-D1-A3DA", "report": "The specimen consists of a uterus with attached bilateral fallopian tubes and ovaries, submitted following hysterectomy and bilateral salpingo-oophorectomy. A friable mass measuring 3.5 x 2.0 x 0.8 cm is identified in the fundus of the endometrial cavity, grossly invading approximately 0.4 cm into the myometrium. The total myometrial wall thickness measures 2.4 cm. The mass circumferentially involves the endometrial cavity and exhibits mixed histologic features. The tumor does not extend into the endocervix, and lymphovascular space invasion is not identified. Surgical margins are negative for abnormal tissue.\n\nIn addition to the uterine findings, the left ovary contains a cystic and solid mass measuring 3.2 x 2.7 x 2.2 cm with surface involvement. Similar tissue is also noted on the right ovary and in the uterine cul-de-sac. A fibroma measuring 1.5 x 1.2 x 1.1 cm is identified adjacent to the left ovarian mass.\n\nLymph node evaluation includes multiple pelvic and para-aortic lymph nodes. Of the right pelvic lymph nodes, one out of sixteen examined shows involvement. All other lymph nodes evaluated\u2014including 18 left pelvic, 13 right para-aortic, and 6 left para-aortic\u2014are without evidence of abnormal cells.\n\nAdditional specimens including omentum, right and left gonadal vessels, and other lymph node groups are all without involvement.\n\nPermanent histologic sections confirmed findings initially observed during frozen section analysis, with additional identification of clear cell differentiation in the ovarian mass upon permanent section review."} +{"pid": "TCGA-BP-4789", "report": "The specimen consists of a right partial nephrectomy measuring 4.5 x 3.7 x 2.9 cm. The resected margin is pink-brown, rough, and unremarkable, and has been inked black. The capsular surface is smooth, pink-tan, with attached adipose tissue, inked blue. A centrally located, well-circumscribed lesion measuring 3.4 x 2.5 x 2.7 cm is identified, partially cystic and partially subcapsular, located 0.1 cm from the nearest resected margin. The solid component is yellow, homogenous, and focally hemorrhagic, while the cystic portion is multilocular with smooth, white-tan fibrous septa. The renal capsule and perinephric fat appear unaffected. The remaining renal parenchyma is pink-brown and unremarkable.\n\nMicroscopically, nuclear grade II/IV features are noted. There is no evidence of local invasion, renal vein involvement, or small vessel angiolymphatic invasion. Surgical margins are free of neoplastic cells. Non-neoplastic findings include focal hyalinizing glomerulosclerosis and mild arteriosclerosis. No adrenal tissue or lymph nodes are identified. Staging indicates a tumor 3.4 cm in greatest dimension, limited to the kidney, with no extension beyond, corresponding to pT1. Representative sections were submitted for frozen and permanent section analysis, confirming negative margins and cortical origin."} +{"pid": "TCGA-EB-A551", "report": "A skin flap measuring 7.5 x 5 cm was submitted for examination, containing a mushroom-like lesion with surface ulceration and a diameter of up to 2 cm. The lesion measured 1.5 cm in thickness and appeared gray-yellow on cut section. Microscopic evaluation revealed a proliferation of atypical cells consistent with a diagnosis of amelanotic melanoma. The tumor demonstrated invasion to Clark\u2019s level V and exhibited a Breslow thickness of 10 mm. There was evidence of superficial ulceration and perifocal lymphoid infiltration. No venous invasion was identified. A total of six lymph nodes were examined, with two showing metastatic involvement. The surgical margins were uninvolved. Staging according to the 7th edition of the TNM classification was determined to be pT4bN2bM0. The specimen was obtained from the skin of the leg and no satellite nodules or additional pathologic findings were specified. The status of neoadjuvant treatment could not be confirmed from the available information."} +{"pid": "TCGA-CQ-A4CH", "report": "The surgical specimen included a near-total glossectomy and bilateral neck dissection (levels I-IV). The primary lesion was located at the lateral border of the tongue and measured 3.6 cm in greatest dimension with a thickness of 1.9 cm. Microscopic evaluation revealed moderately differentiated squamous cell carcinoma. Perineural invasion was present; however, no lymphovascular invasion was identified. The tumor was found at the left lateral margin and was within less than 0.1 cm of the posterior margin.\n\nA total of 55 regional lymph nodes were examined: 2 from right neck level I, 23 from right levels III-IV, 8 from left level IA-B, 2 from left IIA-B, 12 from left level III, 7 from left level IV, and 1 perifacial node on the right. All lymph nodes were negative for malignancy. No extranodal extension was observed.\n\nThe surgical margins were evaluated microscopically. The posterior margin was uninvolved by tumor up to 0.3 cm. The left tongue base biopsy was negative for malignancy. Surgical waste consisting of skin was unremarkable upon gross examination only; no microscopic analysis was performed.\n\nBased on AJCC/UICC TNM staging (7th Edition), the primary tumor was classified as pT2 (tumor greater than 2 cm but not more than 4 cm in greatest dimension) and regional lymph node involvement as pN0 (no regional lymph node metastasis). Distant metastasis could not be assessed."} +{"pid": "TCGA-A2-A0ES", "report": "The specimen from the left breast was received as a simple mastectomy. The tissue measured 22 cm medial to lateral, 16 cm superior to inferior, and 4.8 cm anterior to posterior, weighing 413 grams. The specimen was inked with blue (superior superficial), green (inferior superficial), and black (deep). A firm, poorly defined mass measuring 3.5 x 3.5 x 3.0 cm was identified at the 2\u20133:00 position, located 0.2 cm from the inked deep margin. The tumor appeared yellow-tan and gritty on sectioning. Surrounding tissue was mostly fatty with patches of white fibrous tissue centrally.\n\nHistologic evaluation revealed a moderately differentiated invasive lesion with a Nottingham score of 6 out of 9 (tubule formation score of 3, nuclear pleomorphism score of 2, and mitotic activity score of 1). No tumor necrosis was present. Microcalcifications were focally observed in association with both invasive and benign ducts. There was no evidence of venous or lymphatic invasion. Margins were negative; the closest distance from the tumor to the black-inked deep margin was 0.5 cm on slide A7.\n\nAn intraductal component was identified, showing involvement of ducts with morphologic features consistent with in situ disease. No involvement of the nipple or skin was observed. One sentinel lymph node was previously evaluated and showed no evidence of metastasis.\n\nImmunohistochemical analysis demonstrated strong nuclear staining for estrogen receptors (95% positive) and absence of progesterone receptor expression. HER2/Neu testing by immunohistochemistry showed weak positivity (2+), but fluorescence in situ hybridization confirmed no amplification (HER2/CEP17 ratio: 0.9).\n\nAdditional findings included florid usual ductal hyperplasia, fibroadenomatoid change, fibrocystic changes including stromal fibrosis, cyst formation, and apocrine metaplasia, as well as changes related to a prior biopsy site.\n\nA representative section from the lower outer quadrant (slide A10) showed microscopic foci with morphology identical to the primary lesion, suggesting possible extension rather than multifocal disease. E-cadherin staining was negative with cytoplasmic pattern, and 34betaE12 showed strong perinuclear cytoplasmic positivity, supporting the observed differentiation.\n\nStaging was assessed as pT2 NO MX based on tumor size and nodal status. Multiple tissue blocks were submitted for histologic evaluation, including sections from the skin, tumor margins, grossly normal breast tissue, and random quadrants."} +{"pid": "TCGA-LL-A8F5", "report": "The lumpectomy specimen from the right breast measures 9 x 8 x 5 cm and weighs 131 grams. It is partially covered by a 9 x 1.5 cm ellipse of dark brown skin. A mass measuring 4 cm in length, 3 cm in depth, and 3 cm in width is identified. The mass appears as a fairly well-circumscribed grayish-tan area with hemorrhagic needle tracts. Microscopically, the lesion shows poor differentiation with minimal tubular formation, significant nuclear pleomorphism, and a high mitotic rate. The overall histologic grade is Grade 3. The tumor is unifocal and does not involve the skin or deep margins. The closest margin is located at the deep/posterior aspect, measuring 6 mm from the lesion.\n\nThree sentinel lymph nodes were examined. All lymph nodes show reactive changes only, with no evidence of metastatic involvement. No macrometastases, micrometastases, or isolated tumor cells are identified in the lymph nodes evaluated.\n\nGross evaluation of the lumpectomy specimen revealed a palpable mass that moves freely within the surrounding tissue. The specimen was inked with multiple colors to assist in orientation. Serial sectioning confirmed negative margins and appropriate sampling for further analysis. Portions of the tumor were provided to the tissue bank coordinator.\n\nStaging based on the primary tumor is classified as pT2. Lymph node staging is pN0 (i-), indicating no tumor involvement identified in the lymph nodes. Distant metastasis is not applicable. The tumor was documented intraoperatively with a closest margin distance of 1.5 cm. Clinical and radiographic correlation is recommended."} +{"pid": "TCGA-64-5778", "report": "The specimen consisted of a right upper lobe lobectomy and multiple lymph node groups from various locations. The lung specimen weighed 238 grams and measured 17 x 12.5 x 4.5 cm. A 0.7 x 0.6 cm puckered area was noted approximately 4.5 cm from the stapled and vascular margins. Upon sectioning, a 3.7 x 2.5 x 2.5 cm ill-defined firm stellate mass was identified at approximately 4.5 cm from the bronchial and vascular margins, corresponding to the area of pleural puckering. The remainder of the lung parenchyma appeared congested without other masses. The bronchial and vascular margins were unremarkable. Multiple peribronchial lymph nodes were present, measuring from 0.1 to 0.7 cm.\n\nSubmitted lymph node groups included:\n- 11R: Four lymph nodes, measuring 0.3 to 0.5 cm.\n- 10R: One lymph node measuring 1.8 cm in greatest dimension.\n- 4R: Multiple lymph nodes within a 5.5 x 3.5 x 1.5 cm fibrofatty tissue fragment, ranging from 0.1 to 0.7 cm.\n- 2R: A 2.5 x 1.5 x 0.5 cm fibrofatty tissue fragment containing lymph nodes.\n- 2R highest: Multiple lymph nodes measuring up to 0.5 cm.\n- Level 7: Multiple lymph nodes measuring up to 0.7 cm.\n\nHistologic evaluation of the lung specimen revealed a moderately differentiated adenocarcinoma, 3.7 cm in greatest dimension, located in the upper lobe. The tumor extended into the visceral pleura and exhibited vascular invasion. All bronchial and vascular margins were free of tumor involvement. A total of 84 regional lymph nodes were examined across all submitted levels, and none showed evidence of tumor involvement."} +{"pid": "TCGA-CL-4957", "report": "The surgical specimen consists of a colectomy measuring 26.0 cm in length and 4.5 cm in diameter, with proximal and distal resection margins. The proximal margin is 16.0 cm from the lesion, while the distal margin is 1.5 cm from the lesion. A red/brown ulcerating lesion measuring 4.8 x 4.1 cm is identified, located in the rectal region. Gross examination shows invasion into the muscularis wall and serosal puckering opposite the mass. No other mucosal abnormalities are noted.\n\nHistologically, the lesion demonstrates moderate differentiation and extends through the muscularis into perirectal adipose tissue. Focal extension to the radial soft tissue resection margin is observed. Lymph node evaluation includes a total of 21 lymph node candidates. Metastatic involvement is identified in two of the fourteen lymph nodes assessed. The remaining lymph nodes show no evidence of involvement.\n\nStaging classification is based on tumor extension and nodal status. Tumor depth of invasion reaches beyond the muscularis propria into surrounding tissues. The presence of positive lymph nodes is confirmed. Resection margins are evaluated, with the distal margin being involved by tumor."} +{"pid": "TCGA-DD-AAE6", "report": "The liver specimen measured 21.5 x 14.0 x 6.0 cm and weighed 485.5 grams. A multinodular conglomerated mass measuring 11.0 x 10.5 x 5.5 cm was identified. The cut surface showed yellowish tan, solid areas with necrosis. The tumor did not involve the resection margin, with a safety margin of 7.0 cm. No satellite nodules were observed. The remaining liver parenchyma showed cirrhotic changes. The gallbladder measured 10.7 cm in length, 2.6 cm in diameter, and 0.3 cm in thickness, with no stones identified.\n\nMicroscopically, the tumor showed moderate differentiation with a trabecular growth pattern. Septum formation was present. There was no fatty change or fibrous capsule formation. Invasion of the portal vein and microvessels was noted. Surgical resection margin and serosal invasion were not present. Intrahepatic metastasis and multicentric occurrence were identified. No tumor was seen at the surgical margins. The gallbladder showed chronic inflammation."} +{"pid": "TCGA-EA-A4BA", "report": "The specimen includes a uterus with cervix, upper third of the vagina, adnexal tissue, fatty tissue, and omentum. The exocervix and endocervix show involvement, with measurements of the affected area being 6.5 x 4 x 1.5 cm. The endometrium demonstrates normal structure. Ovaries and Fallopian tubes appear hyperemic. Fatty tissue fragments contain dense hyperemic lymph nodes measuring up to 1.5 cm in diameter.\n\nMicroscopic examination reveals glandular proliferation originating from the endocervix with extension into the exocervix, graded as moderately differentiated. The tumor measures 6.5 x 4 x 1.5 cm. The vaginal mucosa shows no significant alterations. Endometrial changes include hypo-plastic features with reactive metaplasia involving the superficial epithelium. A leiomyoma is present within the uterine wall. Ovaries and Fallopian tubes exhibit normal histology.\n\nLymph node evaluation includes four nodes from the left and six from the right, all showing reactive changes without evidence of metastasis. Vascular invasion is not identified. Surgical margins are uninvolved. There is no definitive evidence of treatment effect. Lymphatic invasion is not specifically identified. Additional findings do not include any other notable pathologic changes."} +{"pid": "TCGA-UZ-A9PP", "report": "The specimen was received in five labeled parts. Part A, identified as perinephric fat, consisted of fatty tissue measuring 1.9 x 1.5 x 1.0 cm and was entirely submitted for analysis. Part B, labeled as the superior margin, was fibrofatty tissue measuring 2.5 x 0.8 x 0.5 cm and was processed for frozen section evaluation with remaining tissue submitted for further analysis. Part C, identified as the base margin, was a segment of kidney measuring 3.0 x 2.0 x 1.0 cm; the deep margin was inked and submitted entirely for frozen sections and subsequent tissue blocks. Part D, the primary excised mass, measured 3.5 x 2.5 x 2.0 cm and was partially attached to adipose tissue measuring 4.0 x 3.5 x 2.0 cm. Upon sectioning, the mass appeared necrotic with a brown-tan coloration and soft consistency. Sections of the mass and adjacent tissue were submitted for microscopic evaluation. Lymph node assessment was performed on associated fat. Part E was additional perinephric fat measuring up to 14.0 x 8.0 x 2.5 cm in aggregate, which appeared grossly normal and was sampled for histologic examination.\n\nMicroscopic evaluation of the superior and base margins showed no evidence of tumor involvement. The excised lesion demonstrated nuclear grade 2 morphology and measured 3.5 cm in maximum dimension. The surrounding capsule was intact and not fully surrounded by fat or renal tissue. No lymph nodes were identified or submitted for evaluation. All other sampled tissues, including multiple fat specimens, showed no presence of tumor."} +{"pid": "TCGA-AJ-A3BG", "report": "The patient is female. Specimens were received for analysis, including uterine contents, bilateral salpingo-oophorectomy specimens, hysterectomy specimen, cervix, lymph nodes from multiple sites, and omentum.\n\nUterine contents from two separate specimens showed high-grade cellular atypia with extensive necrosis. The uterus was enlarged, measuring 13 x 7 x 5.5 cm, with a friable mass involving the entire endometrial cavity. The mass measured at least 8 cm in greatest dimension and extended into the myometrium, invading less than one-half of its thickness (3 mm invasion into a 9 mm thick area). Foci of lymphovascular space invasion were identified. No tumor was seen at the lower uterine segment margin. The remainder of the uterine myometrium and parametrial tissues appeared unremarkable.\n\nBoth ovaries were unremarkable with no neoplastic findings, although each showed serosal fibrous adhesions. The left fallopian tube showed no abnormalities. The right fallopian tube demonstrated acute inflammation. The cervix showed ulceration with marked acute and chronic inflammation, but no abnormal cellular proliferation.\n\nLymph node sampling included left and right common lower aortic, external iliac, and obturator regions, as well as additional right-sided lymph nodes. All lymph nodes examined showed no evidence of abnormal cellular infiltration. Omental tissue also showed no abnormal cellular aggregates.\n\nMicroscopic evaluation of the uterine mass revealed a mixture of architectural patterns, including areas consistent with endometrioid differentiation and other foci showing papillary features. These latter areas stained positively for p53. Sheets of atypical cells were observed, along with regions suggestive of vascular space involvement. Intraoperative frozen section of the uterine content confirmed high-grade cellular features."} +{"pid": "TCGA-GU-A766", "report": "A radical cystectomy specimen was evaluated along with multiple lymph node dissections and ureteral resection specimens. The bladder specimen measured 6.0 cm in greatest dimension and demonstrated a grossly visible mass located at the bladder neck measuring 3.7 x 3.0 cm. Histologic evaluation revealed invasive high-grade cellular changes infiltrating into the muscularis propria. No invasion beyond this layer was identified. Sections from the prostate urethra showed similar morphologic features but were not definitively involved by invasive disease.\n\nMargins of both right and left distal ureters were examined microscopically and showed no evidence of dysplastic or malignant cellular changes. Frozen section evaluations of these margins and one lymph node confirmed absence of tumor involvement intraoperatively.\n\nLymph nodes were dissected from multiple pelvic sites including bilateral obturator and pelvic regions. In total, 19 lymph nodes were examined across all specimens, none of which contained metastatic involvement. The largest lymph node measured 4.0 cm in diameter; however, microscopic analysis revealed no tumor infiltration.\n\nHistologic examination of the bladder lesion demonstrated flat and ulcerated configurations with high-grade nuclear features. There was no evidence of lymphovascular invasion or distant spread. Adjacent mucosal areas exhibited reactive changes including cystitis cystica glandularis and chronic inflammatory infiltrates with giant cell reaction. No additional epithelial lesions were identified.\n\nThe staging classification indicated superficial muscularis propria invasion without nodal or distant metastasis. Multiple tissue blocks were preserved for potential ancillary studies."} +{"pid": "TCGA-BT-A0S7", "report": "The specimen consisted of a radical cystoprostatectomy with associated lymph node dissections. Multiple ureteral margins were examined, with findings showing urothelial dysplasia on one right margin and reactive changes in another left margin; all other ureteral and resection margins were benign without evidence of malignancy.\n\nExamination of the bladder and prostate revealed a high-grade epithelial lesion with squamous differentiation and extensive necrosis. The lesion was found to involve the bladder wall, prostate, and left seminal vesicles. There was infiltration into the detrusor muscle and extension into the perivesical fat. Involvement of the prostatic resection margins and distal urethral margin was noted. Perineural invasion was present, as well as widespread angiolymphatic invasion. Pathologic staging was determined to be pT4a with no nodal involvement (pN0) based on the evaluation of 24 lymph nodes (14 from the left pelvis and 10 from the right pelvis), none of which showed any signs of malignancy.\n\nThe lesion exhibited papillary and solid growth patterns. No associated epithelial lesions were identified. Additional findings included areas of low-grade urothelial dysplasia. Due to the extent of involvement, accurate measurement of the primary lesion could not be determined."} +{"pid": "TCGA-AP-A0LQ", "report": "The surgical specimens submitted included the uterus, cervix, bilateral fallopian tubes and ovaries, abdominal panniculectomy tissue, additional cervical tissue, and multiple lymph node groups from both sides, including external iliac, obturator, hypogastric, common iliac, and para-aortic regions.\n\nExamination of the uterine specimen revealed a lesion with histologic features characterized by glandular architecture and cellular morphology. The lesion exhibited a growth pattern involving up to half of the myometrium. The maximal thickness of myometrial invasion measured 1.0 mm, within a myometrial zone that was 19 mm thick at that location. No evidence of endocervical or vascular invasion was observed. Additional findings in the myometrium included leiomyomas. Endometriosis was identified in the left ovary; all other adnexal structures were unremarkable.\n\nThe abdominal panniculectomy specimen showed normal skin and subcutaneous adipose tissue. Additional cervical tissue consisted of benign fragments. All lymph nodes examined across all regions were histologically benign, with no involvement identified. In total, 40 lymph nodes were assessed (left: 7 external iliac, 12 obturator, 1 hypogastric, 3 common iliac, 2 para-aortic; right: 5 external iliac, 3 lateral external iliac, 1 obturator, 1 common iliac, 4 para-aortic), none of which demonstrated any malignant involvement.\n\nOther microscopic evaluations confirmed absence of disease extension beyond the primary site and no adverse features such as vascular invasion."} +{"pid": "TCGA-E7-A97Q", "report": "Gross Description: The specimen includes soft, lobular, yellow-red adipose tissue. There is a 5.5 x 3 cm indurated and puckered area on the left side of the peritoneal reflection of the posterior aspect, inked green. An 8.5 x 4 cm segment of the anterior vaginal wall is included, with smooth, pink-tan mucosa extending to the distal urethral margin. The right margin is inked black and the left margin is inked blue.\n\nMicroscopic Description: A high-grade, moderately to poorly differentiated carcinoma is present. The tumor invades through the muscularis propria into surrounding adipose tissue and extends into the stroma of the vaginal wall and the exterior wall of the left ureter. The largest dimension of the tumor measures 6.5 cm. Angiolymphatic and perineural invasion are identified.\n\nPathologic Findings: The tumor involves perivesical tissue and adjacent structures including the vaginal wall and external wall of the left ureter. Twenty out of forty-eight regional lymph nodes show metastatic involvement. Lymphatic and venous invasion are present. The histologic type is transitional cell. The tumor size is 6.5 x 5 x 1.5 cm. No definitive information is provided regarding margins, neo-adjuvant treatment, or additional findings.\n\nImmunohistochemical staining for p16 demonstrates moderate to strong diffuse positivity in areas of vaginal dysplasia."} +{"pid": "TCGA-06-0747", "report": "The specimen consists of a right parietal brain mass. Grossly, the lesion measured 5.5 cm and was described as enhancing and necrotic. Multiple tissue fragments were received for analysis, with a combined size of up to 4 x 2 x 1 cm. The material was firm, glistening, and grayish-blue in appearance.\n\nMicroscopically, the neoplasm demonstrates high histological grade features, including nuclear anaplasia, mitotic activity, necrosis, and microvascular proliferation. There are areas of necrosis and thrombosis within the tumor. Immunohistochemical staining shows glial differentiation with GFAP positivity. Scattered non-atypical neuronal elements are present, positive for synaptophysin, chromogranin, and NeuN, primarily within the cerebral cortex. These are interpreted as entrapped native neurons rather than neoplastic components. Reticulin staining does not show deposition within the neoplastic component.\n\nProliferation index, assessed by MIB-1 labeling, is approximately 12%. Molecular testing did not detect methylation of the MGMT promoter. The test used was developed in-house and has not been cleared or approved by the FDA for specific diagnostic use. It was performed under CLIA-regulated conditions and provided for informational purposes only.\n\nIntraoperative evaluation of smears and touch preparations indicated a high-grade glial neoplasm. All findings are consistent with a high-grade astrocytic neoplasm."} +{"pid": "TCGA-ER-A42H", "report": "Addendum. MOLECULAR ANATOMIC PATHOLOGY TESTING: Block 1G: BRAF mutation NOT identified. The quantity and quality of the isolated DNA was acceptable for testing. Surgical specimens underwent manual microdissection. Specimens with a minimum optical density readings of tumor cells in a microdissection target area were accepted for analysis. DNA was isolated using standard laboratory procedures. The quality of amplified PCR product was evaluated by agarose gel electrophoresis. For the detection of mutations, primers flanking the BRAF exon 15 sequence were used. Bidirectional Sanger sequencing was performed using the BigDye Terminator Kit on ABI3130. Known hotspots were analyzed for the presence of mutations with Mutation Surveyor V3.01. The limit of detection is approximately 20% of mutant alleles present in the background of normal DNA.\n\nFinal diagnosis: Parts 1\u20135: Colon, rectosigmoid colon, abdominal peritoneal resection \u2014 A lesion measuring 7.0 cm in greatest diameter involves the anal rectal junction with surface ulceration and extends into skeletal muscle. Lymphovascular invasion is present. There is no perineural invasion. Surgical margins of resection are negative for malignancy. Seven out of seventeen lymph nodes show involvement. Colonic mucosa appears histologically unremarkable. Atrophic seminal vesicles are noted. Part 6: Sigmoid colon, segmental resection \u2014 Diverticulosis with acute organizing serositis. Five lymph nodes are negative for any malignant process.\n\nComment: The lesion measures 7.0 cm and extends into the skeletal muscle. Based on microscopic findings, there is lentiginous spread in the anal mucosa. BRAF mutation analysis was performed. No AJCC staging criteria are available for this type of lesion; if staged similarly to skin tumors, it would correspond to pT4N3. Cauterized tumor is noted less than 1 mm from the anterior margin; however, an additional anterior margin was submitted. Immunohistochemical stains for S100 show a normal pattern of nerves, while HMB45 and MelanA are negative. Microscopic examination supports the described features. All testing was developed and performance characteristics determined by the laboratory under CLIA '88 regulations. Tissue fixation ranged from 2 to 84 hours. This laboratory is CLIA-certified to perform high-complexity clinical testing. Additional information is available upon request.\n\nPatient history: Metastatic lesion involving the lower gastrointestinal tract. Procedure: Anterior resection. Other clinical details not provided."} +{"pid": "TCGA-OR-A5LN", "report": "A right adrenalectomy was performed. The specimen included a tumor weighing 168 grams and measuring 8.3 x 7 x 4.5 centimeters. Histological evaluation revealed specific features contributing to a Weiss score of 6. Evaluation of lymph nodes showed no evidence of metastatic involvement."} +{"pid": "TCGA-HZ-A49H", "report": "A biopsy of the bile duct margin and pancreas margin was performed, both showing no evidence of malignancy. A surgical specimen from the head of the pancreas, duodenum, stomach, common bile duct, and gallbladder was examined following a Whipple resection. The tumor measured 2.8 cm in greatest dimension and was located in the pancreatic head. Microscopic evaluation revealed that the tumor extended through the duodenal wall. Histologic assessment showed moderately differentiated features.\n\nPathologic staging indicated pT3, reflecting extension beyond the pancreas without involvement of major vessels. Regional lymph node involvement was confirmed with one out of 47 lymph nodes positive for metastatic disease, measuring 2 mm in maximum dimension. Perineural and lymphvascular invasion were present. All resection margins were free of invasive carcinoma, with the closest distance from the tumor to the posterior pancreatic soft tissue margin being 3 mm.\n\nA total of 47 lymph nodes were evaluated, with 1 found to contain metastatic involvement. Additional findings included chronic inflammation of the pancreas. No evidence of malignancy was found in the superior pancreatic, hepatic duodenal, or celiac lymph nodes. The gallbladder was congested but without calculi or tumor involvement. The stomach showed changes consistent with gastritis, and the duodenum had normal mucosa. Lymph nodes associated with the common bile duct, peripancreatic regions, and gastro-omental areas were submitted for analysis, ranging in size from 0.3 to 2.2 cm.\n\nMultiple tissue blocks were processed for detailed histologic examination, including sections of the tumor in relation to the ampulla, bile duct, duodenum, pancreatic parenchyma, and all surgical margins. Lymph nodes from various anatomical locations were also submitted for evaluation. Immunohistochemical testing was performed using validated antibodies for clinical diagnostic purposes. All tissues were fixed and processed according to standard protocols."} +{"pid": "TCGA-2Z-A9JL", "report": "The partial nephrectomy specimen from the right kidney measures 2 x 1.8 x 1.6 cm and contains a unifocal, intraparenchymal lesion measuring 1.7 x 1.5 x 1.3 cm. The lesion is irregular to roughly ovoid, rubbery, and bulges the renal capsule. It extends to within less than 0.1 cm of the closest parenchymal resection margin. The cut surface is variegated, pale-yellow to pink, with focal hemorrhage but no gross necrosis. Microscopic evaluation reveals cells arranged in a papillary pattern with nuclei measuring approximately 15 microns in diameter, showing slight irregularity and evident nucleoli (Fuhrman nuclear grade 2). Immunohistochemical staining shows positivity for vimentin, CK7, AMACR, AE1/AE3, CAM5.2, and EMA, with focal positivity for CD10. No sarcomatoid features or tumor necrosis are identified. All margins are free of involvement. There is no evidence of angiolymphatic invasion. The tumor is confined to the kidney based on both macroscopic and microscopic assessment. The regional lymph nodes could not be assessed. The non-neoplastic kidney tissue is insufficient for detailed evaluation due to the limited amount of adjacent renal parenchyma available. Frozen section analysis of the deep margin shows benign renal parenchyma."} +{"pid": "TCGA-FD-A3SL", "report": "A 65-year-old male underwent radical cystectomy with neobladder for a high-grade papillary tumor. The surgical specimens included multiple lymph node biopsies from the left and right pelvis, a bladder and prostate specimen, and an ileocectomy.\n\nIn the left pelvic lymph nodes, matted lymph node aggregates were identified, ranging in size from 0.2 to 1.5 cm. All lymph nodes examined showed invasion of atypical cells, with lymphovascular and extranodal extension observed. In the right pelvic lymph nodes, thirteen lymph nodes were identified, all of which demonstrated similar findings of cellular infiltration with vascular and extranodal involvement.\n\nThe bladder and prostate specimen revealed a 3.4 cm lesion involving the posterior wall and dome, with ulceration and fibrotic changes in the muscularis propria. The surrounding mucosa was edematous and congested. Granulomatous inflammation consistent with prior treatment effect was noted. The prostate showed no discrete masses but had rubbery, nodular tissue. Ureteral margins were uninvolved, although tumor was present near the left ureter. The distal urethral margin was free of abnormal cells, while the deep soft tissue margin was involved.\n\nIn the ileocecal resection, a 3.5 cm area of significant wall thickening was found in the cecum with full-thickness involvement. Two lymph nodes in this region contained atypical cells. A tubulovillous adenoma was also identified. The margins of resection were free of involvement.\n\nStaging was determined as pT4a, N2, M1 based on the AJCC/UICC TNM classification system. Multiple sections were submitted for microscopic evaluation, including representative areas of involvement, margins, and normal-appearing tissue."} +{"pid": "TCGA-EB-A41A", "report": "The specimen consisted of an excised skin lesion from the face, measuring 1.2 x 0 x 2.5 cm. The lesion was pigmented and exhibited superficial ulceration. Histologic evaluation revealed a spindle cell morphology. Microscopic assessment showed no evidence of venous invasion, and margins were uninvolved. The depth of invasion, as measured by Breslow's method, was 7 mm. No satellite nodules, lymphatic invasion, or lymph node involvement were identified. Additional features including histologic grade, response to neo-adjuvant treatment, and other pathologic findings were not specified."} +{"pid": "TCGA-GN-A26C", "report": "The surgical specimens include left axillary contents and tissue from the left upper back, along with additional lateral and medial margins. In the left axillary dissection, 2 out of 25 lymph nodes were found to contain metastatic disease, and extracapsular extension was present.\n\nThe primary lesion from the left upper back measured 4.6 x 4.3 x 2.5 cm and was ulcerated. Histologic evaluation showed a spindled cell morphology with a nodular growth pattern. The tumor demonstrated Clark's level V invasion and a thickness exceeding 14 mm. There was a brisk host response with tumor-infiltrating lymphocytes, and the mitotic rate was 7.98 per square millimeter. No angiolymphatic invasion, regression, precursor lesions, or satellite lesions were identified. The vertical growth phase was prominent. The closest margin was distal, at 0.6 cm, while all other margins exceeded 1.0 cm. The deep margin was approached by the lesion at 0.7 cm. Evaluation of the surgical margins showed no residual disease in the main specimen or in the additional lateral and medial margin specimens.\n\nThe pathological stage reflects the local extent and regional nodal involvement."} +{"pid": "TCGA-BH-A0DV", "report": "A sentinel lymph node biopsy of the left axilla identified a single tumor deposit within adjacent soft tissue measuring 1.3 cm. The involved lymph node showed extensive replacement of lymphoid parenchyma by tumor, with a focus measuring 0.8 cm and associated extracapsular extension measuring 0.7 x 0.3 cm.\n\nIn the breast specimen from a modified radical mastectomy, two invasive foci were identified measuring 3.2 cm and 1.5 cm at the 6 and 10 o\u2019clock positions respectively. Histologic evaluation showed a Nottingham combined score of 5 out of 9 (grade 1/3), including tubule formation score 2/3, nuclear atypia score 2/3, and mitotic activity score 1/3. Areas with lobular features were noted. Invasion into skeletal muscle fibers was observed. A small component of in situ disease was present, characterized by cribriform architecture and nuclear grade 2, accounting for approximately 1% of the total tumor burden. Lymphovascular invasion was also identified.\n\nMargins were free of tumor involvement, although the deep margins at both the 6 and 10 o\u2019clock positions were within less than 1 mm of the tumor. Non-neoplastic fibrocystic changes were present in the surrounding breast tissue. Skin and nipple margins were free of tumor.\n\nTwo of nine lymph nodes were involved, with five tumor deposits identified in the axillary soft tissue. The largest nodal tumor measured 1.0 cm and demonstrated extracapsular extension measuring 0.9 cm. Additional soft tissue tumor deposits ranged from 0.2 to 0.6 cm in size.\n\nImmunohistochemical analysis showed positivity for estrogen and progesterone receptors, while HER-2/neu testing was negative.\n\nThe surgical specimen included tissue from the upper outer, lower outer, and lower inner quadrants. Total aggregate size of all invasive components measured 4.7 cm. No dermal lymphatic invasion was reported. No calcifications or Paget\u2019s disease of the nipple were identified. All lymph node evaluations were performed using IVE stain methods."} +{"pid": "TCGA-A2-A0EN", "report": "The specimen from the right breast needle localization biopsy includes fibrofatty tissue measuring 6.3 x 4.4 x 1.5 cm, with a radiograph provided. A 1.0 cm indurated mass with poorly defined margins is identified, located near the inked surgical margin. Adjacent fibrous tissue shows nodular and focally indurated changes. Multiple sections were taken for analysis, including pairings from the same tissue planes (A5-A6, A7-A8, A9-A10, A11-A12, A14-A15, and A16-A17), along with sections submitted for CBCP protocol.\n\nMicroscopic evaluation reveals multifocal cellular infiltrates involving seven consecutive sections. The maximal dimension of the largest focus is estimated at 2.8 cm. One surgical margin shows involvement by these cells. Additional multifocal in situ cellular changes are also present.\n\nImmunohistochemical staining demonstrates positivity for estrogen receptor in approximately 70% of cells with strong intensity, and positivity for progesterone receptor in about 30% of cells, also with strong intensity. HER2 immunostaining yields a score of 2+; however, fluorescence in situ hybridization does not show amplification, with a ratio of 1.4."} +{"pid": "TCGA-GV-A3JV", "report": "A specimen was submitted consisting of multiple parts including segments of the right and left distal ureters, a second segment of the right distal ureter, a urethral margin, an en bloc resection of the bladder and prostate, and multiple lymph node groups from both sides. Histologic evaluation of the right distal ureter showed atypical urothelium. The left distal ureter showed no neoplastic changes. A second biopsy from the right distal ureter revealed a detached cluster of atypical urothelial cells with uncertain clinical significance, but no definitive dysplasia. The urethral margin did not show any neoplasm.\n\nIn the bladder and prostate specimen, there was involvement of the bladder wall and adjacent structures by a poorly differentiated invasive process that extended into perivesical fat and adjacent adipose tissue. The tumor measured 4.5 cm in its greatest dimension and showed histologic features consistent with a high-grade component. There was evidence of vascular or lymphatic invasion, and the closest radial margin was within 0.7 cm of the tumor. The prostate showed additional findings of high-grade intraepithelial changes and signs of acute and chronic inflammation.\n\nLymph node evaluation revealed variable findings across the different sites. Involvement was identified in one of four lymph nodes from the right common iliac region, while all other lymph node groups\u2014including the right obturator, right internal iliac, left external iliac, left obturator, left internal iliac, and left common iliac\u2014showed no evidence of involvement. Some lymph node specimens contained identifiable nodules, while others consisted only of fibroadipose tissue without identifiable lymph node structures.\n\nThe surgical specimen was processed in multiple cassettes to assess various anatomical regions, including margins of resection, areas of tumor extension, and uninvolved bladder walls. Gross examination of the bladder showed a tan-white solid mass with central necrosis, most prominently involving the trigone and extending into the right ureter. The prostate appeared intact on gross inspection, with no visible mass lesions.\n\nStaging was based on the extent of primary tumor and regional lymph node involvement. The tumor was found to macroscopically extend into perivesical fat. Regional lymph node analysis showed involvement in a single lymph node from the right pelvis, with no distant metastasis reported."} +{"pid": "TCGA-ZA-A8F6", "report": "The specimen consists of a subtotal gastrectomy with adjacent tissues, measuring 15 x 7 x 3 cm. The proximal and distal margins are stapled closed. A central red lesion is present, measuring 3 x 2.5 x 1 cm, involving the wall without full transmural penetration. The lesion is located 6 cm from the proximal margin and 8 cm from the distal margin. Attached omentum measures 18 x 18 x 4 cm and shows no gross evidence of abnormal nodules. A subpyloric lymph node candidate and several sections of the lesion and margins are submitted for analysis.\n\nA small soft tissue fragment (1 cm) from the posterior vagus is entirely submitted for frozen section evaluation, revealing only nerve tissue. Similarly, a 1 cm fragment from the anterior vagus is also entirely submitted and shows only nerve tissue.\n\nIn the periserosal adipose tissue, an area measuring 4 mm is identified and submitted for further evaluation. Dissection of this tissue reveals four small lymph nodes, all of which are unremarkable. Additional sections of periserosal adipose tissue are also submitted.\n\nMicroscopic examination of the stomach specimen reveals a moderately differentiated epithelial lesion arising in the antrum, measuring 3 cm in greatest dimension. The lesion infiltrates into the muscular layer of the wall. All surgical margins are free of atypical cells, with the closest distance from the lesion to the proximal margin being 6 cm. No involvement is seen in the three regional lymph nodes examined. No lymphovascular invasion is identified. The attached omentum and other submitted tissues do not show any evidence of involvement. \n\nA separate suspicious nodule found in the periserosal fat is submitted for further histologic review. No additional lymph nodes are identified during re-examination of the specimen."} +{"pid": "TCGA-D5-6535", "report": "Histopathological examination was performed on a specimen from a partial resection of the ascending colon. The specimen included a segment of large intestine measuring 15.6 cm in length, with surrounding pericolonic fat tissue measuring 16.3 x 8.4 x 3.3 cm, and an appendix of 5 cm. A lesion was identified in the mucosa, measuring 6.3 x 6.2 x 2.8 cm, with circumferential involvement of the intestinal wall and associated luminal narrowing. Microscopic evaluation revealed glandular and papillary structures with moderate cellular atypia (G2). There was evidence of infiltration into the pericolonic adipose tissue. Surgical margins were negative for neoplastic involvement. In non-lesional areas of the colon, tubulopapillary structures with low-grade dysplasia were observed. Lymph node analysis showed involvement in one out of six nodes examined. Vascular invasion was also noted. Staging parameters indicated pT3, pN1 classification."} +{"pid": "TCGA-C5-A8YT", "report": "The cervical biopsy demonstrates invasive cells arranged in small nests. The cells exhibit large nuclei, pale-staining chromatin, and prominent nucleoli. Intercellular bridges are present in some areas. Frequent mitotic activity is noted. The tumor invades to a depth of at least 6 mm and reaches the deep margin of the tissue. In one area of the biopsy, there is focal koilocytic atypia with mild dysplasia (CIN1) involving the surface epithelium; however, this lesion is not contiguous with the invasive component. Adjacent squamous epithelium appears otherwise unremarkable. The endocervical curettage contains benign endocervical tissue along with small, detached fragments of dysplastic squamous epithelium. Due to the size and orientation of these fragments, a precise grading of the dysplasia cannot be determined. Lymphovascular invasion is identified within the biopsy specimen."} +{"pid": "TCGA-XK-AAIR", "report": "A radical prostatectomy specimen was received along with multiple lymph node dissections from the right and left external iliac, obturator, and internal iliac regions. A total of ten lymph nodes were identified across all sites, all of which appeared benign and showed no evidence of malignancy. The prostate measured 5 x 5 x 4.8 cm and weighed 53 grams. Gross examination revealed a focus of concern measuring 0.8 x 0.8 x 0.5 cm located at the right mid-base. Histologically, the tissue demonstrated a high-grade pattern with a primary and secondary grade of 4 each. The tissue was present bilaterally in the apex and midprostate, involving approximately 35% of the sampled volume. No extension beyond the prostate capsule was observed, and all surgical margins were free of abnormal cells. Vascular and seminal vesicle involvement were not identified, although perineural changes were noted. A total of seventeen blocks were examined from the prostate specimen, with block E17 containing a significant portion (70%) of altered tissue. Other blocks containing relevant changes included E8 and E10. Lymphovascular invasion was not present. The overall staging was determined to be pT2c, N0 based on the AJCC 7th edition criteria. Ancillary testing, including specialized stains, was available upon request. The laboratory performing the analysis is CLIA-certified for high-complexity testing."} +{"pid": "TCGA-MK-A4N6", "report": "A lymph node from the right parotid region was identified as containing metastatic involvement. The primary specimen from the thyroid gland measured 8.7 cm in greatest dimension and weighed 160 grams. A unifocal lesion measuring 8.2 cm was identified. Histologic evaluation revealed a well-differentiated neoplasm composed of branching papillae lined by uniform cuboidal cells with characteristic nuclear features including finely dispersed chromatin, intranuclear pseudoinclusions, nuclear grooves, and optically clear nuclei. Psammoma bodies were present. The tumor exhibited extracapsular extension into surrounding soft tissue with nests of tumor surrounded by fibrosis. The surgical margins were free of involvement. Within the thyroid specimen, twelve lymph nodes were identified, eight of which contained metastatic involvement.\n\nAdditional lymph node dissections were performed in multiple regions. In the right paratracheal area, two lymph nodes were identified and both showed involvement. One of these demonstrated extracapsular extension. In the left paratracheal region, two lymph nodes were also both positive. Involvement was also identified in soft tissue adjacent to one of these sites. In a right radical neck dissection specimen containing fifty-nine lymph nodes, twenty-six were involved. Extracapsular extension was noted focally within this group. A single pretracheal lymph node was also involved. In total, seventy-seven lymph nodes were examined across all specimens, with forty showing evidence of involvement. Cystic changes were observed in some lymph nodes. No lymphovascular or perineural invasion was identified despite widespread nodal involvement. Foreign material consistent with suture was noted in association with reactive fibrosis. The surrounding muscle, jugular vein, and soft tissues showed no other significant findings."} +{"pid": "TCGA-E7-A541", "report": "The specimen consists of a radical cystectomy with a whitish, solid, and vegetative lesion located in the right hemibladder. Histologically, the lesion demonstrates a poorly differentiated, high-grade morphology with alveolar and papillary patterns. The tissue shows uneven invasion into the chorion and both deep and superficial muscular layers, without extending beyond the muscularis propria. An extensive inflammatory infiltrate is present, organized into lymphoid aggregates that appear to limit areas of involvement. The urethral lining maintains a preserved architecture at the surgical margin. Within the prostate, small foci with an infiltrative glandular pattern are identified in one lobe. The seminal vesicles appear morphologically intact.\n\nA group of four lymph nodes shows no evidence of malignant involvement. Additional lymph nodes exhibit reactive lymphoid hyperplasia without signs of metastatic disease. Two small lymph nodes with histotypic features are also noted. A small segment of ureter demonstrates mild luminal dilation, while another ureteral segment shows similar dilation with a diffuse, non-specific inflammatory infiltrate within the chorion.\n\nThe specimen includes assessment of lymph node involvement, with no positive findings among the seven evaluated (left and right ilio-obturator). Lymphatic invasion is documented, though venous invasion remains unspecified. The tumor exhibits papillary features with extension into the muscularis propria. No information is provided regarding tumor dimensions, surgical margins, or prior treatment."} +{"pid": "TCGA-XF-AAMY", "report": "The surgical pathology report includes specimens from a salvage cystectomy with ileal-conduit. The right and left distal ureters showed no evidence of malignancy, with findings of hydroureter in the right distal ureter and benign ureter in the left. Examination of the bladder revealed a firm, tan-pink infiltrative mass along the right lateral wall measuring 4 x 4 cm, with an exophytic and ulcerative component measuring 2 x 2 x 2 cm. Microscopic evaluation confirmed invasion through the muscularis propria into the perivesical fat, with a depth of invasion measuring 1.8 cm. A separate focus of high-grade papillary lesion with superficial invasion into the lamina propria was identified on the left lateral wall. Multifocal presence of in situ changes were also noted.\n\nMargins evaluated included urethral, radial, and bilateral ureteral; all were free of malignant cells, although tumor was present within 2 mm of the inked radial margin. Non-neoplastic bladder tissue showed signs of inflammation, reactive atypia, foreign body giant cell reaction, and scar tissue consistent with a prior biopsy site. The right proximal and distal ureters, as well as the left proximal and distal ureters, showed no evidence of dysplasia or malignancy, with hydroureter noted in both proximal segments.\n\nExamination of right pararectal tissue showed benign fibroadipose composition. Lymph node assessment across multiple sites\u2014including right common iliac, aortic bifurcation, right external iliac, and left external iliac\u2014revealed no malignancy in a total of 13 lymph nodes examined. The specimen from the right proximal ureter showed no evidence of tumor, and the left proximal ureter also showed no dysplastic or malignant changes.\n\nMeasurements of the bladder specimen were 23 x 10 x 3 cm, with a wall thickness of 1 cm. The tumor in the right lateral wall extended into perivesical fat with a margin distance of 0.5 cm from the closest inked radial margin. The attached right ureter measured 3.8 cm in length and 1.5 cm in circumference, with the tumor affecting the mucosal surface. The left ureter measured 3.5 cm in length and was otherwise unremarkable. Multiple sections of the bladder and surrounding tissues were submitted for analysis, totaling 18 cassettes from the bladder alone. All ureteral and lymph node specimens were fully submitted and evaluated microscopically."} +{"pid": "TCGA-49-4510", "report": "The surgical specimen includes a lymph node from R4 and Station 7, each with associated fibroadi pose tissue, both negative for tumor involvement. A left upper lobe lobectomy specimen shows a moderately differentiated infiltrating carcinoma measuring 5 cm. The tumor demonstrates features of a specific subtype, including association with a peripheral bronchioloalveolar component. The lesion is in close proximity to the pleura but does not involve it. All resection margins, including bronchial and vascular margins, are free of tumor. Focal vascular invasion is present. The surrounding lung parenchyma shows atypical pneumocyte hyperplasia. No metastatic involvement is identified in the examined lymph nodes."} +{"pid": "TCGA-CN-5364", "report": "The surgical specimen consisted of multiple tissue parts, including lymph nodes from various anatomical levels and a resected segment of the anterior floor of the mouth with mandible and overlying skin. The excised tissue measured 5.5 cm anterior-posteriorly, 4.5 cm superior-inferiorly, and 6.4 cm right to left. A soft tissue mass was identified in the anterior portion of the specimen, measuring 3.2 x 2.5 x 1.5 cm. It was white-tan and firm, crossing the midline and located close to several margins: 0.2 cm from the inferior margin, 0.1 cm from the posterior margin, 0.3 cm from the anterior margin, and 0.3 cm and 0.4 cm from the left and right margins, respectively. Gross examination suggested involvement of the mandible.\n\nMicroscopic evaluation revealed an invasive cellular proliferation within the floor of the mouth, extending into the mandible and adjacent soft tissues. There was extensive perineural invasion involving the inferior alveolar nerve. All surgical margins, including bone, mucosa, soft tissue, and skin, were free of tumor involvement. No vascular or lymphatic invasion was identified.\n\nLymph node analysis included a total of 73 regional nodes examined. Of these, 9 showed evidence of involvement. Metastatic involvement was present in three of six lymph nodes at right Level 1B, with extracapsular spread noted in one. At left Level 1B, a single lymph node showed suspicious features; however, five other nodes were benign. Left Level 2 had three of ten nodes involved with metastasis, and one showed extracapsular extension. In left Level 3, two of fourteen nodes contained metastatic cells, with one showing extracapsular spread. No tumor involvement was found in lymph nodes from level 2 on the right, level 4 on the left, or tracheal and midline level 1A nodes. Additional findings included duct ectasia and inflammatory changes in both submandibular glands.\n\nOne additional lymph node from Part 5 was involved by metastatic disease, without extranodal extension. Pathologic staging was assigned as pT4a for the primary tumor component, pN2c for regional nodal involvement, and pMX for distant metastasis."} +{"pid": "TCGA-B3-3926", "report": "The specimen includes a left renal mass, deep margin, perinephric fat, and left kidney. The left renal mass measures 3.2 x 3 x 2 cm and is partially attached to a thin rim of disrupted renal tissue measuring 5 cm in length. Adipose tissue measuring 6 x 1.5 x 1 cm is also present. Due to disruption of the specimen, margins are indeterminate. Frozen section analysis identified tumor on two of three blocks. Additional sections were submitted for permanent diagnosis.\n\nThe deep margin specimen consists of a cross-section of kidney tissue measuring 4 x 3 cm with a thickness of 0.5 cm. Pale areas suggestive of possible tumor involvement were noted on one aspect. All of this specimen was submitted for frozen section evaluation.\n\nPerinephric fat measuring 6.6 x 6.3 x 2.6 cm consists of lobulated yellow adipose tissue with homogeneous and glistening cut surfaces. No abnormalities were observed.\n\nThe left kidney weighs 289 grams and measures 10.5 x 6.5 x 3.5 cm. A segment of ureter measuring 7.5 cm in length is patent. Minimal torn golden-yellow adipose tissue is present. A wedge-shaped defect measuring 4.8 x 2.5 cm is located along the lateral/central portion of the kidney. Packing material and sutures are present within the surgical defect. Central to this area, a small residual lesion measuring approximately 0.9 x 0.5 x 0.5 cm is suspected. The renal pelvis appears smooth and tan-white. The remaining renal parenchyma shows uniform tan coloration with a distinct corticomedullary junction and cortical thickness up to 1.2 cm. No adrenal tissue is included.\n\nMicroscopic examination reveals cellular features consistent across multiple specimens. In certain regions, compact growth patterns are observed with nuclear characteristics graded as Fuhrman grade III. These findings are confined within the organ based on microscopic evaluation. No angiolymphatic invasion is evident.\n\nIn other regions, fibroadipose tissue without atypical features is identified. Surgical margins from the completion nephrectomy show no definitive tumor involvement. Areas of cautery artifact are noted within the renal parenchyma. Non-neoplastic findings include mild arteriosclerosis.\n\nStaging assessment is limited due to specimen fragmentation. There is no evidence of extrarenal extension or vascular invasion. Lymph nodes were not sampled. Some concern remains regarding residual tissue at the surgical site; however, no definitive tumor was identified in the completion specimen. Adrenal tissue was not submitted for evaluation."} +{"pid": "TCGA-G7-A8LE", "report": "The specimen consists of a left partial nephrectomy measuring 9.5 x 4 x 3.5 cm and weighing 31 grams. The specimen includes attached perirenal adipose tissue and is inked with blue suture indicating the surgical margin. A mass measuring 4 x 3.8 x 3 cm is identified, with a soft, heterogeneous, and focally hemorrhagic cut surface. The mass approaches the surgical resection margin by 0.1 cm and shows involvement of surrounding adipose tissue. Histologically, the lesion demonstrates unremarkable nuclear features with slightly irregular nuclei measuring approximately 15 \u03bcm and evident nucleoli. There is no evidence of vascular or lymphatic invasion, nor any invasion of perinephric tissue. The histologic evaluation reveals no involvement of regional lymph nodes and no adrenal gland tissue is present. Staging indicates tumor confinement to the kidney with focal margin involvement. Additional findings include glomerulosclerosis."} +{"pid": "TCGA-UB-A7MD", "report": "A male patient underwent partial right hepatectomy and cholecystectomy following a preoperative diagnosis of a hepatic mass. Intraoperative consultation included assessment of bile duct and tumor margin biopsies. Final pathology revealed no tumor in one lymph node sampled from the bile duct region, and no tumor was identified in the biopsy of the tumor margin or in a lymph node associated with the gallbladder. The gallbladder showed findings of cholelithiasis and mild cholesterolosis.\n\nThe liver resection specimen demonstrated a lesion measuring 5.3 cm in maximum diameter. Histologic evaluation revealed a moderately to poorly differentiated lesion with a trabecular pattern and focal pleomorphic features. Tumor necrosis was less than 30%. There was no evidence of multifocality; all non-neoplastic liver tissue showed micronodular cirrhosis consistent with prior diagnoses of hepatitis C virus and alcoholic liver disease. Mild steatosis was also noted.\n\nMicroscopic examination revealed small vessel invasion without involvement of large vessels. The lesion did not extend into the hepatic capsule or beyond the liver parenchyma. Surgical margins were negative, with the tumor located 0.8 cm from the medial margin. No hepatocellular nodules or significant iron deposition were identified in the surrounding liver tissue. Two lymph nodes examined were negative for tumor.\n\nGross examination of the liver specimen confirmed the presence of a well-circumscribed but unencapsulated mass located near multiple surgical margins. The closest approach was 0.8 cm from the medial margin and 0.1 cm from the hepatic capsule. Surrounding liver tissue exhibited micronodular cirrhosis."} +{"pid": "TCGA-22-5482", "report": "The resected specimen from the superior division of the left upper lobe contains a subpleural mass measuring 4.0 x 3.2 x 2.5 cm. The mass extends close to the visceral pleura. Histologic evaluation confirms the presence of atypical cells with features consistent with high-grade epithelial neoplasm. The bronchial resection margin is free of neoplastic cells.\n\nEvaluation of lymph nodes includes:\n\n- Two subaortic (station 5) lymph nodes without evidence of tumor.\n- Two para-aortic (station 6) lymph nodes containing tumor.\n- Two subcarinal (station 7) lymph nodes without tumor.\n- One pulmonary ligament (station 9) lymph node without tumor.\n- Five intrapulmonary peribronchial lymph nodes without tumor.\n- Two left hilar (station 10L) lymph nodes without tumor.\n- Eight interlobar (station 11) lymph nodes without tumor.\n- The specimen labeled \"station 11 lymph nodes No. 2\" did not contain lymphoid tissue.\n\nAn addendum notes focal invasion into the visceral pleura, confirmed by histologic staining (VVG)."} +{"pid": "TCGA-DU-7008", "report": "A brain biopsy from the temporal lobe was performed on a woman with a large lesion measuring approximately 7 to 8 cm, involving the temporal lobe and extending into the frontal lobe. The lesion was described as diffuse. The surgical specimen consisted of multiple tissue fragments. The first two specimens were received fresh, totaling six fragments, approximately 1.0 cm in aggregate size, tan-white in color, glistening, and semi-firm. Additional specimens numbered three through five were also received fresh, consisting of three fragments measuring 3.0 x 2.5 x 0.7 cm in total, with similar semi-firm and glistening characteristics. A third specimen from the temporal lobe, not placed in fixative, measured 2.3 x 1.7 x 0.8 cm and was described as red to gray-tan brain tissue.\n\nMicroscopic examination revealed an infiltrating neoplasm characterized by microcystic changes and frequent microgemistocytic cells. Areas of increased cellularity showed nuclear atypia and mitotic figures. No vascular endothelial hyperplasia or necrosis was identified. The proliferation index, assessed by MIB-1 labeling, was approximately 8%."} +{"pid": "TCGA-KN-8437", "report": "The specimen consists of a right radical nephrectomy with a well-circumscribed tan and brown nodule measuring 3.0 x 3.0 x 1.5 cm. The nodule is located within the kidney, abutting the renal capsule without evidence of invasion into the perinephric fat. The tumor is unifocal and measures 3.0 cm in greatest dimension. The remainder of the kidney appears grossly unremarkable, with small cysts noted in the cortex. No adrenal gland is present. Histologically, the lesion demonstrates round, uniform nuclei approximately 10 microns in size with inconspicuous or absent nucleoli. The primary tumor is classified as pT1a, indicating a tumor 4 cm or less in size confined to the kidney. No lymph node tissue is submitted for evaluation, and distant metastasis cannot be assessed. Surgical margins are free of invasive disease. Colloidal iron staining reveals focal granular cytoplasmic staining. Venous invasion is not present. The mass arises in a kidney with end-stage changes."} +{"pid": "TCGA-AG-4021", "report": "The specimen includes multiple sections showing a poorly differentiated adenocarcinoma. In one section, there is involvement of the liver with metastatic tissue. Additional sections demonstrate similar poorly differentiated features. In another area, there is evidence of an invasive growth pattern in the rectal region, with extensive lymphovascular invasion noted (L1, V1). Multiple lymph nodes are involved, with conglomerate formation observed. The tumor demonstrates advanced local spread (pT3) and significant nodal involvement (pN2), with more than five affected nodes. Histological grade is G3."} +{"pid": "TCGA-A1-A0SI", "report": "A sentinel lymph node biopsy and axillary lymph node dissection were performed. One non-sentinel lymph node showed evidence of metastatic involvement, while all other lymph nodes examined were negative for malignant cells. The metastasis measured 3 mm in diameter and there was no extranodal extension identified.\n\nA lumpectomy specimen from the right breast revealed a lesion measuring 2.6 cm in greatest dimension. Histologic evaluation demonstrated moderately differentiated invasive carcinoma with lymphovascular invasion present. Nuclear grade was assessed at 2 with 2 points, mitotic count was 3 per 10 high-power fields (1 point), and tubule formation was observed in less than 10% of the tumor (3 points), resulting in a total score consistent with intermediate-grade morphology.\n\nMargins of resection were negative. The closest distance between tumor and margin was less than 0.1 cm at the deep margin on one slide and similarly noted at another inked margin. No ductal or lobular intraepithelial neoplasia was identified.\n\nImmunohistochemical staining was performed on representative tissue blocks. Hormone receptor analysis demonstrated positivity for estrogen receptors with strong nuclear staining in approximately half of the tumor cells. Progesterone receptor expression was also detected, although staining was weaker and observed in a smaller proportion of cells (~15%). HER2/neu testing by immunohistochemistry showed a staining intensity score of 1, indicating absence of oncoprotein overexpression.\n\nAdditional specimens obtained from various anatomical sites showed benign findings including lactational changes, inflammatory alterations, and lipomatous tissue. Cervical and vaginal cytology specimens were negative for malignant or premalignant changes.\n\nThe patient underwent surgical excision with lumpectomy and lymphadenectomy. Pathologic staging based on tumor size and nodal involvement was determined."} +{"pid": "TCGA-DK-A2I2", "report": "The submitted specimens include segments of the right and left ureters, lymph nodes from bilateral common iliac and pelvic regions, and a resected specimen including the bladder, uterus, bilateral tubes and ovaries, and cervix. \n\nMicroscopic evaluation of the right ureter showed benign tissue. The left ureter demonstrated high-grade urothelial changes confined to the mucosa. Lymph node dissections revealed metastatic involvement in the right common iliac, right pelvic, and left pelvic regions. In the right common iliac lymph nodes, all 4 examined nodes showed metastatic involvement with a largest focus measuring 1.2 cm and extranodal extension present. In the right pelvic lymph nodes, 2 out of 10 examined nodes were involved, with the largest metastatic focus measuring 1.6 cm and extranodal extension identified. On the left pelvic side, 2 out of 12 nodes were involved, with a largest focus of 1.4 cm and extranodal extension also present. The left common iliac lymph nodes were benign. \n\nThe bladder specimen showed extensive flat, high-grade changes within the mucosa. An invasive component was identified with infiltration into surrounding tissues. Tumor involvement was noted at the perivesical soft tissues, distal ureters, and urethra. Vascular and perineural invasion were present. Surgical margins were clear at the right ureter but showed involvement at the left ureter. Non-neoplastic findings included chronic cystitis in the bladder mucosa and endometrial atrophy with leiomyomata in the uterus. \n\nPathologic staging based on these findings was determined as pT3, indicating invasion into perivesical soft tissue."} +{"pid": "TCGA-FI-A2D4", "report": "A total abdominal hysterectomy with bilateral salpingo-oophorectomy and lymph node dissection was performed. Gross examination of the uterus revealed a necrotic fungating mass measuring 7 x 5 cm within the endometrial cavity, extending into the lower uterine segment. The tumor measured 13 mm in depth of invasion, corresponding to the full thickness of the myometrium. The tumor reached the outer serosal surface in both lower uterine segments and extended into surrounding adipose tissue. Extensive lymphvascular space invasion was identified within the myometrium.\n\nInvolvement of the cervix was noted, with invasive tumor present in the mucosa and stroma. The lower uterine segment was also involved. On microscopic evaluation, the tumor exhibited a solid growth pattern involving 51\u2013100% of the area assessed (FIGO Grade 3 equivalent). Widespread lymphvascular invasion was confirmed.\n\nExamination of the adnexal structures showed involvement of the right ovary with a well-defined tan mass measuring 3 cm. The left ovary demonstrated focal invasive tumor. No malignant involvement was identified in either fallopian tube.\n\nLymph node assessment included one lymph node from the right external iliac region. Metastatic tumor was present in this lymph node, measuring 2.5 cm. The metastasis displayed squamous differentiation and areas of tumor necrosis.\n\nImmunohistochemical staining showed that 5\u201310% of tumor cells were positive for both estrogen and progesterone receptors. Additional immunostains demonstrated loss of MLH1 and PMS2 expression, while MSH2 and MSH6 remained intact. These findings suggest microsatellite instability. PCR testing confirmed high microsatellite instability (MSI-H), indicating defective DNA mismatch repair function. This raises concern for an inherited cancer syndrome such as Lynch syndrome, although further genetic evaluation is required to determine whether the defect is somatic or germline in origin. Genetic counseling is recommended.\n\nThe tumor stage was provisionally classified as T3a/N1/MX based on TNM staging criteria. This classification reflects invasion of the serosa and/or adnexa, along with regional lymph node involvement. Distant metastasis could not be assessed. The final stage may be adjusted upon integration of clinical data."} +{"pid": "TCGA-2J-AAB4", "report": "A nodule from the left lobe of the liver was identified, measuring 0.6 x 0.3 x 0.2 cm, composed of pale tan soft tissue with a small white plaque within it. Histologic evaluation revealed no evidence of abnormal cellular proliferation. A lymph node from the hepatic artery, measuring 1.8 x 1.6 x 0.9 cm, also showed no signs of atypical cells. The neck margin of the pancreas was evaluated and found to be free of concerning cellular changes.\n\nA distal pancreatectomy specimen included the body and tail of the pancreas, spleen, and a portion of omentum. Within the pancreas, a firm white fibrous mass measuring 6.8 x 4.0 x 2.9 cm was identified and located 1.1 cm from the proximal pancreatic margin. Microscopic analysis revealed well-differentiated cellular features with grade 2 of 4 nuclear differentiation. The surrounding non-neoplastic pancreatic tissue exhibited changes consistent with chronic inflammation. No involvement of the spleen was observed.\n\nPeripancreatic soft tissue was inked for evaluation, and multiple lymph nodes were assessed. Of 33 regional lymph nodes examined, one demonstrated cellular changes consistent with spread to a regional node. Extensive perineural extension was noted; however, no lymphovascular invasion was identified. All surgical margins were free of abnormal cells. Based on these findings, staging was determined as pT2 N1 according to the 7th edition of the AJCC criteria.\n\nThis final report is based on macroscopic evaluation and histologic review using frozen sections, with confirmation by permanent H&E-stained sections. A prior report had been amended to reflect the updated nodal status."} +{"pid": "TCGA-CN-A63T", "report": "The pathology report includes findings from a series of tissue specimens obtained during a surgical procedure involving the neck and throat region. The evaluation was based on histological examination and immunohistochemical analysis.\n\nA total of 36 lymph nodes were identified in the left neck dissection (levels 2 through 4). Histologic sections, along with immunostaining, demonstrated lymph node hyperplasia with no evidence of malignant cells. Focal atypical lymphoid cells were noted, but these changes appeared reactive. A broad immunohistochemical panel showed germinal center activity, polyclonal plasma cell infiltration, and preserved T-cell and B-cell populations without monoclonal features. These findings are consistent with non-specific lymphoid hyperplasia.\n\nIn the right neck dissection (levels 2 through 5), 42 lymph nodes were examined. Of these, three contained altered tissue characteristics within level 2 lymph nodes, with maximal size measuring up to 1.9 cm. Altered tissue extended beyond the lymph node capsule in some areas. Additionally, similar patterns of lymphoid hyperplasia were observed in other lymph nodes, including focal atypical lymphoid changes and a calcified hyalinized nodule in one instance.\n\nThe pharyngeal and base of tongue margins were all free of abnormal cellular changes. However, mild dysplastic alterations and squamous metaplasia were noted at certain margins, particularly in the left superior pharynx and base of tongue.\n\nThe larynx specimen revealed a lesion measuring 4.0 cm located in the supraglottic region with extension into the right glottic area. The lesion involved the aryepiglottic fold and pyriform sinus, approached the false cord on the left, and was in close proximity to the hyoid bone and thyroid cartilage without direct involvement. Microscopic examination showed extensive involvement of the paraglottic space. Vascular invasion and perineural invasion were present, with the latter extending from an involved lymph node. No residual abnormality was found at the surgical resection margins.\n\nTwo additional lymph nodes in the central compartment (level 6) also showed similar findings. These nodes displayed extracapsular spread.\n\nImmunohistochemical staining of the lymph nodes included markers for B-cells (CD20, CD138, bcl-6, CD10), T-cells (CD3, CD43), follicular dendritic cells (CD21), and proliferation index (Ki-67). Staining confirmed a mixed population of B-cells and T-cells, with active germinal centers and a polyclonal pattern of plasma cell infiltration. No aberrant loss or overexpression of bcl-2 or cyclin D1 was detected. Cytokeratin staining was negative in several lymph nodes, supporting the absence of epithelial cell involvement.\n\nThe thyroid lobe showed benign nodular hyperplasia and focal fibrosis. One normocellular parathyroid tissue was identified in the central compartment. The stoma site showed only reactive changes.\n\nTissue fixation time ranged between 2 and 84 hours. All diagnoses were based on CLIA-certified testing methods. No clearance by the U.S. Food and Drug Administration was required for the assays used."} +{"pid": "TCGA-AP-A1DO", "report": "The surgical specimens included biopsies from multiple lymph node regions and peritoneal sites, as well as a total hysterectomy with bilateral salpingo-oophorectomy and omentectomy. Histologic evaluation of the uterine specimen revealed a lesion involving the endometrium with invasion into the myometrium to a depth of 5 mm, in an area where the total myometrial thickness measured 21 mm. No vascular or endocervical invasion was identified. The myometrium also showed adenomyosis and leiomyomas. The uterine serosa appeared normal. The right ovary had surface adhesions, and the right fallopian tube showed chronic salpingitis with adhesions; the left adnexa were unremarkable.\n\nAll biopsied soft tissue specimens from the presacral peritoneum, left abdominal gutter, and left pelvic peritoneum showed only benign fibroadipose tissue. Lymph node dissections and biopsies from the left and right external iliac, circumflex iliac, obturator, common iliac, and para-aortic regions revealed no metastatic disease. A total of 24 lymph nodes were assessed across all sites, with no evidence of malignancy identified. Additional testing using immunohistochemical stains for keratin on sentinel lymph nodes confirmed the absence of metastatic involvement.\n\nTesting for DNA mismatch repair proteins was performed on the endometrial lesion. Results showed intact expression of MSH2 and MSH6, while MLH1 and PMS2 expression was lost in tumor cells despite the presence of internal positive controls. These findings suggest potential abnormalities in DNA repair mechanisms and may warrant further clinical correlation."} +{"pid": "TCGA-V1-A8MK", "report": "The prostate gland weighed 36 grams and measured 3.5 cm in medial-lateral dimension, 3 cm apex to base, and 3 cm anterior to posterior. The exterior was smooth with a staple line along the anterior midline and a red-tan appearance. A firm mass was noted along the right posterior lateral aspect. Serial sectioning revealed a 0.5 cm area of firm yellow tissue on the right lateral side of slice 2; no other gross abnormalities were identified.\n\nMicroscopic evaluation showed small acinar-type cellular formations involving multiple regions of the gland, present across several slides. These included areas in the left posterior midgland (slides A5, A9\u2013A10), left anterior midgland (slides A5, A7\u2013A8), right posterior apex (slide A2), right posterior midgland (slides A4, A6, A11\u2013A12), and right anterior midgland (slides A4, A6, A13). The estimated volume of affected tissue was 4.2 cm\u00b3 based on measurements from 0.5 cm thick slices.\n\nEvaluation of margins demonstrated no involvement at excision margins, although benign glands were present at inked margins (A1). Capsular involvement was noted in sections A6, A11, and A12. There was no evidence of extracapsular extension or involvement of the seminal vesicles. Perineural changes were observed in slide A11.\n\nThe specimen was staged as pT2cNXMX according to AJCC/UICC criteria. No lymph nodes were identified within the specimen. Multiple tissue sections were submitted for analysis, including whole-mount preparations of serial slices 4 and 6 for research purposes."} +{"pid": "TCGA-FG-6690", "report": "A left frontal lesion was evaluated following biopsy and excision. Intraoperative assessment included touch imprint and microscopic examination, which showed features consistent with a glioma, with morphological characteristics suggesting a likely oligodendroglial origin. A formal diagnosis was deferred pending further analysis.\n\nTissue from the lesion was analyzed using fluorescence in situ hybridization (FISH) to assess for allelic loss at chromosomes 1p and 19q. The evaluation was performed on formalin-fixed, paraffin-embedded sections using locus-specific and reference probes. Areas of glial neoplasm were targeted, and only atypical nuclei containing two or more reference signals were counted. A total of 40 nuclei were assessed to generate average signal values.\n\nChromosome 1p status was determined by comparing signals at 1p36 and 1q25. The average copy numbers were 3.3 and 3.2 respectively, yielding a ratio of 1.0, indicating no evidence of allelic loss at 1p. For chromosome 19q, signals at 19q13 and 19p13 were compared. The average values were 2.0 and 2.5, producing a ratio of 0.8, which also did not support allelic loss at 19q. Aneusomy was not identified for either locus.\n\nThe correlation between allelic loss and clinical outcomes such as chemoresponsiveness or progression-free survival was noted in the context of certain gliomas, particularly when combined 1p and 19q loss is present. However, no such association has been established for isolated 19q loss. It was also noted that FISH may not detect partial allelic loss or cases where one allele is lost and the other duplicated.\n\nThe test used in this evaluation was developed and validated by the laboratory. Some reagents used in the assay are classified as Analyte Specific Reagents (ASRs), which are not cleared or approved by the U.S. Food and Drug Administration but are used under validated protocols in clinical diagnostics.\n\nGross examination of the specimens revealed multiple soft tissue fragments. Specimen A consisted of fresh tissue measuring approximately 0.5 x 0.4 x 0.3 cm in aggregate, with representative portions submitted for intraoperative analysis and the remainder processed for permanent sections. Specimen B, after formalin fixation, measured 2.2 x 2.1 x 0.25 cm in total and was submitted entirely for histologic evaluation."} +{"pid": "TCGA-37-A5EM", "report": "The specimen was obtained from a male patient of Caucasian ethnicity. The primary tissue sample was collected from the left lung and preserved in OCT, yielding a single block weighing approximately 200 mg. Histological evaluation revealed the presence of atypical cells with features consistent with moderate differentiation. No treatment had been administered prior to specimen collection.\n\nA second specimen consisted of a 4 mL blood draw, collected without anticoagulant and stored as frozen blood. This sample was considered normal upon assessment.\n\nThe tumor specimen measured 3 cm in greatest dimension. Histological grade was moderately differentiated. Staging parameters were determined as T3, N2, M0. A total of one container was submitted for analysis, with no additional treatments reported."} +{"pid": "TCGA-18-3406", "report": "The surgical specimens include multiple tissue samples from the left lung, surrounding structures, and lymph nodes. A completion pneumonectomy specimen measured 21.0 x 15.5 x 11.0 cm and showed a well-circumscribed, yellowish-tan firm lesion located peripherally near the main stem bronchus. The lesion measured 2.0 cm in maximum dimension and did not extend into the pleura. The bronchial resection margin was free of abnormal cells. Within the pneumonectomy specimen, two interlobar and one segmental lymph node were identified and showed no evidence of malignancy. \n\nAdditional specimens included a biopsy from the left upper lobe bronchus containing fragments of atypical squamous epithelium; however, no associated stroma was present, limiting assessment of invasion. A soft tissue sample near the aorta revealed only fibrous connective tissue without concerning features. A separate nodule on the pleura near the aorta was found to be lymphoid tissue within connective tissue, also without any malignant findings. An AP window lymph node specimen contained multiple tissue fragments ranging in size from 0.3 x 0.2 x 0.1 cm to 2.0 x 0.8 x 0.4 cm, all of which were negative for malignancy. Intraoperative frozen sections of several specimens confirmed absence of malignancy at key margins."} +{"pid": "TCGA-19-2624", "report": "The specimen from the left temporal region was submitted as three components. Specimen A, labeled as \"left temporal lesion,\" consisted of a single tan-pink soft tissue fragment measuring 0.5 x 0.4 x 0.2 cm. It was bisected; one portion was used for intraoperative diagnosis, including touch imprint and microscopic evaluation, while the remaining portion was entirely submitted in one cassette. Specimens B and C were both received post-fixed in formalin and consisted of multiple irregular, opaque white to pink-tan, soft, cerebriform tissue fragments. Specimen B, labeled as \"gross tumor,\" measured 6.0 x 3.5 x 2.3 cm in aggregate and was entirely submitted in 11 cassettes. Specimen C, labeled as \"enhancing white matter,\" measured 4.2 x 3.1 x 1.5 cm in aggregate and was entirely submitted in eight cassettes. Histologic examination revealed cellular features consistent with high-grade transformation, including marked nuclear atypia and mitotic activity. Infiltrative growth patterns were identified in the tissue sections. Based on histologic criteria, the lesion exhibited extensive necrosis and microvascular proliferation. Staging was determined based on extent of invasion and morphologic characteristics. All relevant specimens were reviewed by the diagnosing authority and confirmed to meet the required standards for interpretation."} +{"pid": "TCGA-19-0960", "report": "The specimen consists of two parts submitted from the left parietal region of the brain. Specimen A is an irregular segment of soft tissue measuring 0.7 x 0.6 x 0.2 cm. It was partially used for a touch imprint with the remainder submitted for permanent sections. Microscopic evaluation revealed features consistent with high-grade cellular atypia, including pleomorphism, mitotic activity, and areas of necrosis. Specimen B consists of three fragments of light tan to pink soft tissue, the largest measuring 2.0 x 1.3 x 0.9 cm, which was serially sectioned. Histologic examination of this tissue showed abnormal cellular infiltration within otherwise normal-appearing neural parenchyma. Cellular morphology demonstrated nuclear atypia and increased mitotic figures. All specimens were processed and submitted in their entirety across three cassettes."} +{"pid": "TCGA-WB-A819", "report": "The surgical specimen from the left adrenal weighed 171 grams after removal of adipose tissue and contained a 9 cm mass with a solid, cystic, and hemorrhagic appearance. The remaining adrenal tissue measured 3 cm. Microscopic examination revealed a cellular proliferation composed of large cells with abundant cytoplasm. The cells were polygonal and eosinophilic, with occasional intracytoplasmic hyaline globules. Nuclear features included mild to moderate anisokaryosis, pale chromatin, and prominent nucleoli. In some areas, there was increased cellularity with smaller nuclei and a more uniform cellular appearance. Mitotic activity was rare, with only one mitosis observed across 10 high-power fields; no atypical mitoses were identified. The tumor cells were arranged in cellular structures or exhibited a diffuse growth pattern within a loosely organized stroma, often associated with extensive hemorrhage and fibrous or cystic changes. Hemosiderin deposition was prominent. There was no evidence of capsular or vascular invasion, and no necrosis was present. The PASS score was calculated as 6, based on diffuse architecture (2 points), high cellularity (2 points), and cellular monotony (2 points)."} +{"pid": "TCGA-85-8355", "report": "The lung specimen consists of a lobectomy with a lesion measuring 1.8 \u00d7 0 \u00d7 2.5 cm located in the lung lobe. Microscopic examination reveals a hyperemic tissue fragment with keratinization and moderate differentiation (G2). The tumor demonstrates no venous invasion and no lymphatic spread. Surgical margins, including the bronchus wall, are uninvolved. A total of twelve lymph nodes were examined, including peribronchial nodes, none of which show metastatic involvement. Lymph nodes exhibit anthracosis and sinus histiocytosis. No additional pathologic findings are noted. The tumor site is localized with no evidence of treatment effect. The lateralization is left upper."} +{"pid": "TCGA-BQ-5880", "report": "The specimen from a left total nephrectomy includes a kidney measuring 10.0 x 6.5 x 4.5 cm with attached ureter and renal vessels. A tumor measuring 7.5 cm in greatest diameter is identified at the mid portion of the kidney, protruding outward and involving perinephric fat. The tumor appears bright yellow and ill-defined upon sectioning. Fuhrman Nuclear Grade III/IV morphology was observed. There is extension through the renal capsule but no invasion beyond Gerota\u2019s fascia. No renal vein invasion was identified. Surgical margins were free of tumor involvement. Chronic inflammation was noted in non-neoplastic kidney tissue. No adrenal gland was identified grossly or histologically.\n\nA separate specimen containing hilar and suprahilar lymph nodes along with adjacent fatty tissue demonstrates involvement by cellular aggregates within perirenal adipose tissue. No definitive adrenal gland involvement was observed.\n\nIn the para-aortic lymph node specimen, multiple lymph nodes were evaluated ranging up to 3.5 cm in diameter. Six metastatic lymph nodes were identified, with the largest measuring 3.5 cm. Extracapsular extension was noted in association with these lymph nodes.\n\nRepresentative sections from all specimens were submitted for permanent analysis. Sections included tumor tissue, adjacent kidney, hilar and sinus fat, ureteral and vessel margins, adrenal gland, and multiple lymph nodes."} +{"pid": "TCGA-L5-A4OQ", "report": "A male patient underwent surgical resection of a mass located at the gastroesophageal (GE) junction, with the tumor extending into the distal thoracic esophagus and proximal stomach. The esophageal segment measured 12.2 cm in length, with an esophageal margin of 2.5 cm in diameter and a gastric margin of 6.6 cm. A central ulcerated mass measuring 5.4 x 4.0 cm was identified arising from the gastric mucosa and involving the GE junction. The tumor showed extension up to 1.7 cm onto the esophageal side, with raised, rolled borders. The maximum thickness of the mass was 1.4 cm, with invasion through the mucosa and submucosa into the muscularis propria. There was no evidence of penetration through the gastric serosa or into the esophageal adventitia. The periesophageal and perigastric fat contained lymph node candidates up to 1.9 cm in size, with gray-white to tan, opaque cut surfaces. A total of twelve lymph nodes were examined, six of which showed involvement by metastatic disease. The resection margins, including the cervical esophageal margin, were free of tumor involvement. No preoperative treatment had been administered prior to surgery."} +{"pid": "TCGA-EL-A3D6", "report": "A female surgical case involving multiple specimens was evaluated. The superior laryngeal nerve biopsy consisted of a 0.6 x 0.3 x 0.2 cm soft, irregular pink-tan fragment and was found to contain nerve and connective tissue without any tumor involvement. A nodule from the crico-thyroid membrane, measuring 0.3 x 0.3 x 0.2 cm, was identified as connective tissue with features concerning for metastatic involvement, although no definitive tumor was noted upon initial assessment.\n\nA total thyroidectomy specimen included a left thyroid lobe distorted by a mass measuring approximately 5.5 x 4.5 x 3 cm. The mass was described as globular, firm, partially cystic, light gray to light pink in color, with extensive fibrosis and friable papillary structures. The tumor extended beyond the thyroid capsule into adjacent soft tissue. A rim of apparently normal thyroid tissue remained. The isthmus and right lobe showed no signs of tumor involvement. Two unremarkable parathyroid glands were also present on the left side.\n\nOne lymph node submitted from the left thyroid region showed no evidence of tumor. A right paratracheal nodule measuring 0.4 x 0.4 x 0.2 cm was composed of benign parathyroid tissue. Left paratracheal and superior mediastinal tissue contained one lymph node measuring 1 x 0.5 x 0.5 cm, which demonstrated findings consistent with metastatic involvement. Three additional lymph nodes from left level III, ranging in size from 0.4 to 1.2 cm, were negative for tumor. An intrathyroid lymph node measuring 0.5 x 0.3 x 0.3 cm was also free of tumor.\n\nThe posterior soft tissue resection margin was involved by tumor. No further details regarding tumor type or specific markers were provided in this summary."} +{"pid": "TCGA-DJ-A2Q4", "report": "The clinical history notes a fine needle aspiration biopsy of a right thyroid nodule measuring 1.5 cm, with findings suspicious for malignancy. Submitted specimens included lymph nodes and thyroid tissue. \n\nIn the right paratracheal region, a single lymph node was examined, measuring 0.8 cm in greatest dimension. Histologic evaluation identified a metastatic focus measuring 0.05 cm; no extranodal extension was observed. In contrast, two right superior mediastinal lymph nodes were benign. Midline neck tissue and right paratracheal tissue biopsies showed only benign fibroadipose tissue. A Delphian node specimen also revealed benign lymph node architecture. \n\nThe total thyroid specimen weighed 25 grams. The right lobe measured 4.9 x 3.5 x 1.5 cm and contained a well-circumscribed nodule measuring 1.3 cm in diameter. This lesion exhibited complete encapsulation with focal disruption of the capsule. No vascular invasion or extrathyroid extension was identified. The surgical margins were free of abnormal cells. Additionally, a small focus measuring 1 mm was identified in the left lobe. The remainder of the thyroid demonstrated nodular hyperplasia and chronic lymphocytic thyroiditis. Two normal parathyroid glands were identified, one within each lobe. No adenomatous changes were noted in proximity to the primary lesion. \n\nSix additional lymph nodes were evaluated and found to be without pathological involvement. All diagnoses provided are based on direct microscopic examination of the submitted tissues."} +{"pid": "TCGA-F4-6854", "report": "The submitted specimen is a sigmoid colectomy. The tumor was located in the sigmoid colon and measured 8.5 x 4.5 x 1.5 cm. Histologic evaluation showed moderately differentiated cells arranged in glandular formations. The tumor extended into pericolonic tissues. No lymph node involvement was identified, with all 8 regional nodes showing no evidence of metastatic disease. No other notable features were reported regarding tumor characteristics, margins, neo-adjuvant treatment, or additional findings."} +{"pid": "TCGA-VQ-A925", "report": "The specimen includes a resected portion of the stomach (antrum) measuring 7.5 cm in greatest dimension. The lesion demonstrates serosal involvement with extension into adjacent adipose tissue. Histological evaluation reveals a tubular growth pattern with moderate differentiation and the presence of ulceration. Lymphatic and perineural invasion are identified. Metastatic involvement is present in lymph nodes along the lesser curvature, with extracapsular extension noted (4 out of 4 involved). Multiple neoplastic nodules are observed in the region of the lesser curvature, where residual lymphoid tissue is not apparent. The distal margin of resection shows involvement by the neoplasm.\n\nExamination of the greater omentum reveals two affected lymph nodes, both showing metastatic changes with extracapsular spread. Additionally, two neoplastic nodules are found in this area, again without identifiable lymphoid remnant.\n\nA biopsy from the mesentery shows evidence of tumor implantation. The esophageal margin, however, is free of neoplastic involvement.\n\nStaging assessment indicates a topographic origin within the stomach, with a morphologic pattern consistent with tubular growth. The stage assigned is pT4a."} +{"pid": "TCGA-SC-A6LR", "report": "The patient is a male who underwent evaluation of multiple tissue specimens. The specimens included biopsies from the right pleura, several mediastinal lymph nodes (levels 4, 7, and 8), a portion of the right sixth rib, and related excised tissues. \n\nThe right pleural biopsy consisted of fragmented membranous tissue measuring 5.0 x 4.0 x 1.5 cm in aggregate. Lymph node specimens were received both fresh and in formalin, with sizes ranging from 0.3 to 0.8 cm in aggregate for the smaller nodes, and up to 5.0 x 1.5 x 0.6 cm for a fatty fibrous specimen possibly including a lymph node. The right sixth rib was received in segments measuring up to 11.8 x 1.2 x 0.4 cm, with attached soft tissue showing a homogenous red-tan granular appearance and intact cortex.\n\nMicroscopic evaluation of the right pleura and certain lymph node specimens revealed malignant epithelioid cells. In other lymph node samples, benign findings were noted, including non-necrotizing granulomas without evidence of fungal or mycobacterial infection based on GMS and FITE staining. The bone marrow of the rib showed benign features with focal fibrosis, which was highlighted by reticulin stain. No significant pathologic involvement was found in the rib itself.\n\nImmunohistochemical stains performed on selected cases showed positivity for calretinin, N1, D2-40, AB1/3, and CD15, while TTF1 and PCEA were negative. cKit immunostain highlighted scattered mast cells in the fibrotic areas, and Giemsa staining of the bone marrow showed no atypical cellular infiltrates.\n\nFrozen section analysis of some lymph nodes during surgery identified malignant epithelioid neoplasm in one case, with permanent sections confirming the finding. Other intraoperative evaluations of lymph nodes returned benign results. \n\nAll diagnoses were based on direct examination of the slides, and the report was reviewed and approved by the examining physician."} +{"pid": "TCGA-AO-A0J2", "report": "A 48-year-old patient underwent evaluation of lymph nodes and breast tissue. Specimens included sentinel lymph nodes from the left and right axilla, as well as left and right breast tissues with axillary tails.\n\nSentinel lymph node #1 from the left axilla consisted of three lymph nodes, all benign. Sentinel lymph node #2 from the left axilla contained two lymph nodes, also benign. Sentinel lymph node #1 from the right axilla was a single lymph node and showed no evidence of malignancy. Additional testing, including deeper sectioning and keratin stains, did not reveal any metastatic disease in these nodes.\n\nThe left breast specimen measured 20.0 x 18.0 x 5.0 cm with skin measuring 9.0 x 2.8 cm. An area of interest was identified in the lower inner quadrant, measuring 1.7 cm in its largest dimension. This area exhibited cellular features including a high nuclear grade and was associated with a lymphocytic infiltrate. A component of in situ disease was also present, showing solid and micropapillary patterns with high nuclear grade and minimal necrosis, accounting for less than 25% of the total mass. The in situ component was found both admixed with and separate from the more prominent invasive area. No involvement of the nipple, skin, or surgical margins was identified. The invasive component was located 0.4 cm from the nearest anterior margin, while the in situ component was 0.6 cm from the same margin. No vascular invasion was observed. The surrounding non-neoplastic breast tissue showed stromal fibrosis, apocrine metaplasia, and cysts. There was also evidence of prior biopsy, including fat necrosis and fibrosis. The right breast specimen, measuring 20.5 x 18.5 x 3.5 cm, showed no significant abnormality, with findings limited to benign changes such as fibrosis, cysts, and apocrine metaplasia.\n\nImmunohistochemical analysis of the left breast lesion showed no nuclear staining for estrogen or progesterone receptors, and HER-2 staining was equivocal (1+ to 2+), prompting further testing with FISH. Intraoperative frozen section analysis of the left axillary sentinel lymph nodes confirmed benign findings, consistent with the final diagnosis."} +{"pid": "TCGA-BR-8369", "report": "The specimen consists of a stomach segment with a lesion measuring 8.5 cm in its largest dimension. Microscopic examination reveals a poorly differentiated cellular pattern with mucus-producing foci and areas of invasion into the muscularis propria and perigastric fat. Multiple regions show perineural invasion. Fifteen lymph nodes were examined, seven of which demonstrated metastatic involvement; these involved nodes include those from the greater and lesser omentum, with sizes reaching up to 1 cm in diameter. The omentum also shows focal fibrosis. No venous invasion is identified. The tumor is ulcerated and extends to the subserosa. Surgical margins are uninvolved. No evidence of neoadjuvant treatment effect is noted."} +{"pid": "TCGA-ZJ-AAXF", "report": "The specimen consists of an irregular, unoriented tan to red-tan glistening tissue fragment measuring 1.3 x 1 x 0.3 cm. The tissue was trisected and entirely submitted in one cassette. Microscopic evaluation revealed a lesion composed of atypical cells arranged in sheets and nests, with areas of keratinization. The cellular morphology shows moderate to poor differentiation. Lesion extends to the deep margin. No lymphovascular invasion identified. The histologic features suggest a significant epithelial process involving the cervix."} +{"pid": "TCGA-EB-A6R0", "report": "Patient ID: Gross Description: A skin flap measuring up to 8 x 4 cm contains a pigmented, mushroom-like formation up to 2 x 2 x 1 cm with ulceration. The lesion is located on the lower limb. Microscopic examination shows a pigmented lesion with ulceration. Clark's level is IV and the tumor thickness measures 10 mm. Perifocal lymphoid infiltration is present. Specimen type is excision of skin lesion. Tumor site is on the trunk. Tumor size is 2 x 1 x 2 cm. Tumor features include ulceration and pigmentation. Histologic type shows characteristics consistent with a deeply invasive lesion. Venous invasion is not identified. Margins are uninvolved. Lymph node involvement, lymphatic invasion, satellite nodules, and histologic grade are not specified. There is no evidence of prior treatment. Additional findings include a pigmented, ulcerated lesion on the skin of the back with a Breslow thickness of 10 mm and Clark's level IV. No other comments provided."} +{"pid": "TCGA-85-8052", "report": "The lung tissue specimen was obtained from the right upper lobe and submitted as a lobectomy. The tumor measured 5 x 2 x 7.5 cm. Microscopic evaluation showed a moderately differentiated cellular growth pattern. The histologic features were consistent with a specific type of epithelial malignancy. All other parameters, including tumor extent, presence of additional nodules, lymph node involvement, lymphatic and venous invasion, margin status, response to neoadjuvant treatment, and any additional findings, were not specified. No comments were provided."} +{"pid": "TCGA-AO-A1KP", "report": "A 1.0 x 1.0 x 0.6 cm lymph node from sentinel node #1 in the left axilla contained a metastatic focus measuring 0.3 cm with extranodal extension noted. This metastasis was not identified on frozen section but was present on deeper permanent sections. Sentinel node #2, a 1.0 x 0.7 x 0.6 cm lymph node from the same region, showed no evidence of metastasis. Non-sentinel tissue from the left axilla included two lymph nodes, both benign, along with fibroadipose tissue.\n\nThe left total mastectomy specimen measured 28 x 27 x 4.5 cm and weighed 1,750 grams. Examination revealed three distinct tumor masses: two in the lower inner quadrant and one at the junction of the lower inner and lower outer quadrants. The larger tumor in the lower inner quadrant measured 2.0 x 1.0 x 1.0 cm, with the closest deep margin located 4 cm away and the superficial margin 2 cm away. The smaller tumor in the lower inner quadrant measured 1.3 x 1.0 x 1.0 cm, situated 5 cm from the nearest deep margin and 4 cm from the anterior margin. The tumor between the lower inner and lower outer quadrants measured 0.7 x 0.5 x 0.5 cm and was located 5 cm from the nearest deep margin.\n\nHistologic evaluation demonstrated multiple foci of invasive carcinoma with histologic grade II/III and nuclear grade II/III. Tumor sizes ranged from 0.3 cm to 1.8 cm. In addition, ductal carcinoma in situ (DCIS) of solid and micropapillary types was identified, comprising up to 25% of the total tumor burden and mixed with the invasive component. DCIS exhibited intermediate nuclear grade and moderate necrosis. Calcifications were observed in both in situ and invasive components. Vascular invasion was present. No involvement of the nipple, skin, or surgical margins was identified. Attached skeletal muscle was free of tumor.\n\nNon-neoplastic breast tissue showed apocrine metaplasia and columnar cell alteration. Immunohistochemical staining showed positivity for ER (approximately 80% nuclear staining with strong intensity) and PR (approximately 40% nuclear staining with strong intensity), while HER2 staining was negative (intensity 1+)."} +{"pid": "TCGA-BC-A69I", "report": "The specimen includes a gallbladder measuring 6.2 x 3.0 x 1.2 cm, with a tan/green serosal surface and three black granular stones within the lumen. The mucosa is green and velvety, and the wall thickness measures 0.2 cm. A fragment of yellow fatty tissue labeled as lymph nodes (portal node) is present, measuring 5.0 x 4.1 x 1.1 cm, and contains multiple lymph nodes, the largest being 1.8 cm in size. Two of these were examined microscopically and found to be negative for malignancy.\n\nA partial hepatectomy specimen from liver segments 4-8 weighs 350 grams and measures 15.0 x 11.2 x 5.2 cm. It is marked by two stitches embedded in the surgical margin, approximately 2 cm apart, with surrounding red inked tissue. There is an area of bulging on the capsular surface measuring 7.5 x 4.5 cm, beneath which lies a well-circumscribed, firm mass measuring 7.0 x 5.5 x 5.3 cm with areas of hemorrhage. This mass approaches the black inked surgical margin at 0.5 cm. Microscopic evaluation shows no vascular invasion, perineural invasion, or capsular invasion. Surgical margins are negative. No satellite lesions are identified. The background liver tissue shows steatohepatitis, with macrovesicular steatosis involving 30\u201340% of the parenchyma, ballooned hepatocytes containing Mallory\u2019s hyaline, and moderate clusters of neutrophils around and within lobular hepatocytes. A trichrome stain reveals patchy pericellular and periportal fibrosis consistent with stage 1\u20132 disease. These findings suggest possible alcoholic etiology, and clinical correlation is recommended.\n\nAn additional fragment of omental tissue measuring 5.2 x 5.0 x 1.5 cm contains a central tan firm nodule measuring 1.0 x 1.0 x 0.8 cm. Histologic examination of this tissue shows fibroadipose tissue with fibrosis, dystrophic calcifications, and granulation tissue, but no evidence of malignancy is found. All submitted tissue blocks have been reviewed, and no other extrahepatic spread is noted. Based on available data, the pathologic TNM classification is pT1 pN0."} +{"pid": "TCGA-BF-A5EO", "report": "The specimen was obtained from a male Caucasian individual. Tissue was collected from the skin and processed as an OCT block, weighing 200 mg. Histological evaluation showed tumor cells with a high degree of cellular atypia and brisk mitotic activity. The tumor demonstrated a thickness of 4 mm based on pathological measurement. No lymph node involvement or distant metastases were identified. One blood sample was collected, amounting to 4 mL, and stored in a frozen tube. No prior chemotherapy or hormonal therapy was reported. The tissue sample showed no treatment effect. A single container was used for the tissue specimen. Cellular composition analysis indicated that approximately 80% of the cells were tumor-derived."} +{"pid": "TCGA-A5-A0VO", "report": "A laparoscopic-assisted vaginal hysterectomy and bilateral salpingo-oophorectomy were performed along with lymph node sampling. Gross examination of the uterus revealed a polypoid, friable yellow-tan mass measuring 4.0 x 3.0 x 3.0 cm within the endometrial cavity. The mass extended into the anterior lower uterine segment and was located approximately 0.9 cm from that margin. Histologically, there was invasion into the myometrium with a depth of 0.7 cm and a total myometrial thickness of 1.1 cm, indicating greater than 50% invasion. Vascular invasion was identified. No involvement was observed in the cervix, vaginal cuff, or parametria. \n\nMultiple leiomyomas were identified throughout the uterus, ranging from 0.3 to 5.4 cm in size. These included both subserosal and intramural types without evidence of necrosis or hemorrhage. The ovaries and fallopian tubes appeared grossly unremarkable; however, left tubo-ovarian adhesions and xanthomatous salpingitis were noted along with endometriosis involving both the ovary and fallopian tube.\n\nSampling of lymph nodes included pelvic, para-aortic, obturator, and common regions bilaterally. Specifically, five pelvic lymph nodes (four on the left and one on the right), four para-aortic lymph nodes (two on each side), seven obturator lymph nodes (four on the right and three on the left), and one lymph node labeled as \u201ccommon right\u201d were evaluated. Additionally, one lymph node identified in an omental biopsy was assessed. All lymph nodes were negative for tumor involvement.\n\nHistologic evaluation confirmed no metastatic involvement in any sampled lymph nodes. Sections from various regions of the uterus, including the cervix, uterine corpus, fundus, and lower uterine segment, were submitted for analysis along with representative sections of leiomyomas and ovarian tissue. Adipose tissue from the omentum biopsy showed no pathological findings other than normal fatty tissue.\n\nThe surgical margins and surrounding tissues appeared free of disease. Special studies included HE step sections and decalcification where necessary."} +{"pid": "TCGA-WZ-A8D5", "report": "The surgical specimen consisted of a left radical orchiectomy, including an enlarged indurated testis measuring 10.5 x 6.5 x 4.6 cm and a spermatic cord stump measuring 2.5 x 1.3 x 1.1 cm. The tumor measured 10 x 6 x 4.5 cm and exhibited a solid, mottled gray-tan appearance with areas of yellow-brown discoloration suggestive of necrosis and hemorrhage, comprising approximately 40\u201350% of the tumor volume. The tumor extended through the rete testis into the epididymis at the base of the spermatic cord and further invaded the tunica albuginea and peritesticular soft tissue. No normal testicular or epididymal tissue was identifiable.\n\nHistologic examination revealed a unifocal tumor involving the testis with extension into peritesticular adipose tissue and the base of the spermatic cord. Lymphatic and vascular invasion were present. Surgical margins were free of tumor involvement. The tumor was processed in 18 cassettes, including representative sections from the tumor mass, spermatic cord margins, and surrounding tissue edges.\n\nPathologic staging based on 2010 criteria was determined as pT3, reflecting tumor invasion into the spermatic cord with vascular or lymphatic involvement. Regional lymph node assessment was not possible (pNX), and there was no evidence of distant metastasis (pM0). Serum tumor marker studies were not available for evaluation. The overall pathologic stage was assigned as I, assuming no lymph node or distant metastatic involvement.\n\nImmunohistochemical staining for CD30 was performed and supported the microscopic findings. Ancillary testing, including immunohistochemistry and in situ hybridization, was utilized for diagnostic clarification. These tests were performed under CLIA-certified conditions for clinical use and are not considered investigational."} +{"pid": "TCGA-AO-A0JB", "report": "The clinical history involves a female patient with a lesion in the left breast. Submitted specimens included lymph nodes from levels two and three of the left axilla, skin tissue from the lateral left breast and a right upper abdominal skin tag, as well as a mastectomy specimen including level one axillary lymph nodes.\n\nExamination of the level three left axillary lymph nodes revealed benign fibroadipose tissue without identification of any lymph node. In level two, three benign lymph nodes were identified and none showed evidence of involvement. The lateral left breast skin specimen contained benign fibroadipose tissue and one benign lymph node without evidence of disease. The right upper abdominal skin tag showed an irritated seborrheic keratosis.\n\nThe mastectomy specimen demonstrated an area of concern measuring 11.0 cm in its greatest dimension, located in the upper outer, upper inner, and lower outer quadrants. Surrounding this area, ductal changes involving in situ components were noted, including solid type features with moderate to high nuclear grade and necrosis. These in situ changes were also present in areas away from the main lesion. Extensive vascular invasion was observed, but no involvement of surgical margins, nipple, or skin was identified. Skeletal muscle attached to the specimen remained unaffected.\n\nLymph node evaluation from level one showed 1 out of 10 lymph nodes involved, with extranodal extension greater than 2 mm. Immunohistochemical analysis of the involved tissue showed strong nuclear staining for estrogen receptor (90% positivity), moderate nuclear staining for progesterone receptor (60% positivity), and no overexpression of HER2.\n\nNo additional diagnostic terms or tumor names were identified in the assessment of the submitted specimens."} +{"pid": "TCGA-BH-A0BS", "report": "The specimen consists of multiple lymph node biopsies from the left axilla and a simple mastectomy specimen from the left breast, along with additional axillary tissue.\n\nIn the first sentinel lymph node biopsy, one lymph node was identified and found to contain metastatic involvement. The focus measured 1.1 cm and exhibited extracapsular extension. In the second sentinel lymph node biopsy, one lymph node was examined and showed no evidence of metastasis. In the third sentinel lymph node biopsy, another lymph node was also positive for metastatic involvement.\n\nThe mastectomy specimen revealed an invasive tumor measuring 6.0 cm in greatest dimension based on gross examination. Histologic grading using the Nottingham system yielded a total score of 6 out of 9 (tubule formation \u2013 2, nuclear pleomorphism \u2013 2, mitotic activity \u2013 1), corresponding to Grade 2. The invasive component was identified as ductal type with focal apocrine differentiation.\n\nIn addition to the invasive carcinoma, ductal carcinoma in situ (DCIS) was present, comprising approximately 10% of the total tumor burden. DCIS showed nuclear grade 2 features with solid, cribriform, micropapillary, and comedo necrosis patterns. It was observed both admixed with and separate from the invasive component. No lymphovascular space invasion was identified.\n\nMargins of resection were free of invasive and in situ disease. However, the invasive tumor approached within 1.5 mm of the deep margin in the lower outer quadrant and 1.0 mm from the deep margin in the lower inner quadrant. Both the nipple and skin margins were negative for tumor involvement.\n\nNon-neoplastic findings included fibrocystic changes with florid ductal epithelial hyperplasia, apocrine metaplasia, and fibroadenomatoid nodules. Calcifications were noted in association with both malignant and benign areas of breast tissue. Fat necrosis and fibrosis suggestive of prior surgical intervention were also present.\n\nImmunohistochemical staining demonstrated positivity for estrogen and progesterone receptors in the invasive tumor cells. HER-2/neu testing by FISH showed no gene amplification.\n\nIn the axillary lymph node dissection, eleven lymph nodes were retrieved and none contained metastatic involvement.\n\nHistopathologic evaluation confirmed multifocal and multicentric disease involving both the lower outer and lower inner quadrants of the left breast. The invasive tumor was extensively sampled and measured across multiple sections. The DCIS component was similarly multifocal.\n\nRoutine stains including hematoxylin and eosin were used for lymph node assessment. No dermal lymphatic invasion or ulceration was observed.\n\nAdditional non-neoplastic findings included fibrocystic disease, fibroadenomatoid nodules, and chronic changes consistent with prior surgical trauma.\n\nStaging parameters assigned were pT3 for the primary tumor size, pN1a for lymph node involvement, and pMX for distant metastasis, which was not assessed in this report."} +{"pid": "TCGA-DE-A0Y3", "report": "A biopsy of the right inferior parathyroid gland revealed one lymph node, which showed no evidence of malignancy. No parathyroid tissue was identified in this sample. The right superior parathyroid biopsy demonstrated benign normocellular parathyroid tissue and was also negative for malignancy. Similarly, the left superior parathyroid biopsy showed benign normocellular parathyroid tissue without any signs of malignant cells.\n\nA biopsy from the left cricoid thyroid muscle revealed metastatic involvement with dystrophic calcifications noted in the muscle and soft tissue. In the left neck, Levels 2-4 lymph nodes were examined, with 1 out of 16 showing metastatic involvement measuring 6 mm in greatest dimension, and extracapsular extension was present. In Level 6 of the left neck, 3 out of 6 lymph nodes contained metastatic deposits of similar size (6 mm), and extracapsular extension was also observed. Additionally, benign normocellular parathyroid tissue and ectopic thymic tissue were identified in this region, both without evidence of malignancy.\n\nThe thyroid specimen measured 22.9 grams and showed a centrally located lesion in the left lobe with solid, yellow/tan appearance and central calcification. The tumor measured 2.5 cm in greatest dimension and exhibited an invasive growth pattern. Microscopic evaluation confirmed invasion into surrounding skeletal muscle and presence of lymphovascular invasion. The tumor extended to the anterior surgical margin and was within 1 mm of the posterior margin, with involvement of the isthmus. A second microscopic focus measuring 1 mm was identified in the right thyroid lobe. The remainder of the thyroid gland showed changes consistent with non-neoplastic goiter, cystic degeneration, and chronic thyroiditis.\n\nSurgical margins were closely evaluated: the tumor extended to the left anterior margin and approached the left posterior margin within less than 0.1 cm. The right lobe margins were widely negative. Additional tissue sampling included a cystic structure in the right lobe containing tan fluid, with smooth white-tan lining; this area otherwise appeared unremarkable on gross examination.\n\nLymph node involvement was documented across multiple levels. Frozen section analysis during surgery confirmed absence of malignancy in the right inferior, right superior, and left superior parathyroid samples, while the left cricoid muscle biopsy was positive for malignant involvement.\n\nMultiple tissue blocks were submitted for further analysis, including tumor and normal thyroid tissue, as well as lymph nodes. A digital photograph of the specimen was taken for documentation."} +{"pid": "TCGA-YT-A95H", "report": "The primary site is the mediastinum. A mass was identified with a size of 6.0 x 5.5 cm. Histologic evaluation revealed features consistent with a thymic epithelial neoplasm, showing mixed cellular morphology. The tumor was well-circumscribed and encapsulated. No evidence of capsular invasion or lymphovascular space involvement was identified. The surgical margins were free of neoplastic cells."} +{"pid": "TCGA-DU-6392", "report": "The right parietal tissue specimen consists of a 1 cm fragment of soft, gray-white to pink-white tissue. Microscopic evaluation reveals a neoplastic process involving astrocytic cells. The tumor demonstrates a loose, fibrillary background with increased cellularity. Predominant cell types are small astrocytes with hyperchromatic nuclei, often arranged in clusters or exhibiting multinucleation. Gemistocytic forms are also observed. Scattered mitotic figures are present. Vascular proliferation and endothelial hyperplasia are noted, though no necrosis is identified. Immunohistochemical staining for GFAP highlights the astrocytic nature of the tumor. Proliferative index as assessed by Ki67 is estimated at 1\u20132%, while MIB-1 staining shows higher reactivity in the range of 10\u201315%. Adjacent tissue specimens show a transition from relatively uninvolved parenchyma to areas with infiltration by neoplastic cells. These cells display enlarged, irregular nuclei and a lower degree of pleomorphism compared to the main tumor sample."} +{"pid": "TCGA-CN-5356", "report": "A laryngectomy and left neck dissection were performed. The right neck dissection included levels 2, 3, and 4 and contained a total of 61 benign lymph nodes. The left neck dissection at levels 2, 3, and 4 contained 36 benign lymph nodes.\n\nThe resected larynx showed a lesion in the supraglottic region, predominantly on the right side, measuring 4.5 cm in its greatest dimension. The lesion extended into the pre-epiglottic space. Acute abscess formation was noted in association with the lesion. All surgical margins were free of involvement, with the closest distance from the lesion to the margins ranging between 0.2 cm and 5.0 cm. There was no evidence of perineural invasion. A tracheostomy was present. The right thyroid lobe showed focal fibrosis but no lesions.\n\nFrozen section analysis of all lateral, superior, and inferior margins confirmed absence of tumor involvement. Microscopic evaluation confirmed absence of tumor in all submitted margins. Histologic examination revealed a moderately differentiated squamous cell lesion located in the supraglottic region. Structures involved included the false cords, epiglottis, and pre-epiglottic space. No lymph node metastases were identified on either the right or left side. Pathologic staging was determined as pT3 for the primary lesion, pN0 for lymph node status, and pMX for distant metastasis. All lymph nodes examined were benign.\n\nThe specimen fixation time ranged from 2 to 84 hours. Immunohistochemical testing was performed in compliance with laboratory-developed standards. All tissue sections were reviewed and confirmed under high-complexity clinical testing regulations."} +{"pid": "TCGA-E2-A1LA", "report": "The surgical specimens included sentinel lymph nodes #1 and #2 from the right axilla, a right breast mastectomy specimen, and right axillary contents. The sentinel lymph nodes measured 0.8 cm (#1) and 0.4 cm (#2). The right breast specimen weighed 358 g and measured 21 x 17 x 5 cm. Two lesions were identified: one in the upper inner quadrant measuring 2 x 1.5 x 1.4 cm located 2.2 cm from the deep margin, and another in the upper outer quadrant measuring 2 x 1.5 x 1 cm located 2.5 cm from the deep margin. The axillary contents contained 34 lymph nodes ranging in size from 0.1 to 2.5 cm; no gross tumor involvement was observed.\n\nMicroscopic evaluation of the breast lesion in the upper inner quadrant revealed cellular features consistent with invasive ductal carcinoma, grade 2, measuring 1.1 cm. High nuclear grade ductal carcinoma in situ, solid type, was also present. Surgical margins were free of tumor involvement. Other findings included fibrosis and granulation tissue at the biopsy site, usual ductal hyperplasia without atypia, and a small fibroadenoma with an intraductal papilloma. Sentinel lymph node #1 showed evidence of metastatic involvement with extranodal extension. All 34 lymph nodes from the axillary dissection were negative for metastases.\n\nImmunohistochemical analysis demonstrated hormone receptor positivity for estrogen and progesterone receptors. HER-2 testing by FISH showed no gene amplification (HER2/CEP17 ratio: 1.15). Pathologic staging was determined as pT1c N1a."} +{"pid": "TCGA-60-2721", "report": "The specimen included lymph nodes from levels 4R, 7, and 4L, as well as a right upper lobe lobectomy. All lymph nodes were negative for tumor involvement. The right upper lobe specimen measured 16 x 13 x 4 cm and weighed 239 grams. A gray plaque measuring 6.0 cm in length and 3.0 cm in width was noted on the pleural surface. A mass measuring 5.1 x 4.2 x 3.2 cm was identified beneath the pleura, located 1.5 cm from the bronchial margin and 0.1 cm below the pleural surface. The bronchial margin was free of tumor. Histologically, the lesion showed moderately differentiated features without angiolymphatic invasion. There was subpleural fibrosis and osseous metaplasia noted. No satellite tumors were identified. Lymph node evaluation included four peribronchial nodes (N1), two mediastinal nodes (N2), and one contralateral node (N3), all of which were negative for tumor involvement. The tumor was staged as pT2."} +{"pid": "TCGA-A4-7828", "report": "A left partial nephrectomy specimen includes a 4.2 x 3.7 x 3.1 cm portion of kidney with attached perinephric fat. The tumor measures 3.5 cm in greatest dimension and is confined to the kidney. It is located near the renal capsule and approaches within 0.6 cm of the resection margin. The surgical margins are free, and no lymphovascular invasion is identified. The specimen includes sections of the mass with resection margin (A1-A2) and adjacent perinephric fat and Gerota's fascia (A3-A4). Nuclear grading is consistent with grade 3. The pathological stage corresponds to AJCC T1a,NX."} +{"pid": "TCGA-BG-A3EW", "report": "A total laparoscopic hysterectomy with bilateral salpingo-oophorectomy and lymph node dissection was performed. The surgical specimen included a lesion measuring 25 mm in maximum dimension. Histologic evaluation revealed a poorly differentiated epithelial neoplasm, with combined architectural and nuclear grading corresponding to FIGO grade 3. Approximately 70% of the endometrial surface was involved, and the tumor demonstrated 12% myoinvasion (0.3 cm) into the myometrium. Focal involvement of the cervical stroma was identified. Angiolymphatic invasion was present, as evidenced by tumor cells within vascular spaces, supported by immunohistochemical staining (CD31, D2-40, AE1/AR3). Adjacent endometrial tissue showed complex atypical hyperplasia. All adnexal tissues were free of tumor involvement.\n\nFourteen lymph nodes were examined: eleven from the right pelvic region, two from the right periaortic area, and one from the left pelvic region. None showed evidence of metastatic disease. No malignant cells were identified in the accompanying pelvic wash cytology specimen. Immunohistochemical studies were performed using formalin-fixed, paraffin-embedded tissue with appropriate controls, confirming vascular space invasion. The depth of myometrial invasion was less than half the total thickness. No prior malignancy, chemoradiation history, or other significant comorbidities were documented."} +{"pid": "TCGA-G9-7522", "report": "The prostate specimen measured 2.8 cm in left to right lateral dimension, 3.3 cm from anterior to posterior, and 2.1 cm from apex to base. The gland weighed 29 grams before sectioning and 17 grams after removal of the apex to base. Histologic evaluation revealed multifocal involvement of both the right and left lobes, comprising less than 10% of the gland. Tumor was identified within the posterior lateral and anterior regions bilaterally. No evidence of extraprostatic extension or seminal vesicle invasion was observed. Surgical margins were all negative for malignant involvement. Perineural invasion was present; angiolymphatic invasion was not identified. High-grade intraepithelial neoplasia was also noted.\n\nLymph node specimens were submitted from both left and right pelvic regions. The left pelvic lymph nodes included five sampled lymph nodes, and the right pelvic lymph nodes included four sampled lymph nodes. No malignancy was identified in any of these lymph node specimens.\n\nThe pathological staging was determined as pT2c, pN0, with MX for distant metastasis. The Gleason grading system showed a combined score of 7 (Grade 3 + Grade 4). The tumor was classified as multicentric within the gland and confined without nodal involvement. No other significant pathologic findings were identified."} +{"pid": "TCGA-AL-7173", "report": "The patient is female. Specimens were obtained from four sources. \n\n1. A lymph node adjacent to the inferior vena cava was received fresh and submitted entirely for frozen section. It measured 1.8 x 1.1 x 0.6 cm and appeared as a firm, rounded structure with tan-brown coloration. No tumor was identified in this single lymph node. \n\n2. The right kidney, weighing 273 grams and measuring 13 x 7 x 5 cm, was partially covered by retracted fat. On sectioning, a large hemorrhagic mass with golden-tan and necrotic areas was identified, occupying approximately two-thirds of the kidney volume and located in the mid to lower pole. The mass was encapsulated and showed an irregular lobulated surface, with areas extending through the capsule to the outer margin. The pelvocaliceal system was significantly compressed, with remaining mucosa appearing pale and glistening. The superior pole retained a lobulated appearance with preserved corticomedullary differentiation and a cortex measuring 0.9 cm thick. The ureter was 13.5 cm long with a normal mucosal lining. A short segment of vein near the hilum was uninvolved. Within the hilar fat, three small, hard lymph nodes (0.4\u20130.9 cm) were noted, and a 0.9 cm hemorrhagic nodule was found in the perirenal fat. No adrenal gland was identified. Sections were taken to evaluate vascular and ureteral margins, possible capsular invasion, tumor relationship to normal parenchyma, extension to outer surfaces, involvement of pelvic mucosa, relation to vein, and lymph node status. \n\n3. Another portion of soft, lobulated fat containing four potential lymph nodes (0.2\u20131.9 cm) was submitted from the area near the inferior vena cava. The largest lymph node was marked with black ink before sectioning. No tumor was found in any of the eight lymph nodes examined across both lymph node specimens. \n\n4. A 6.5 x 5.5 x 0.4 cm piece of soft, lobulated perirenal fat was also received. Palpation revealed a small 0.3 x 0.2 cm firm area marked with black ink. No other abnormalities were observed. \n\nSections from the kidney mass showed extensive involvement of the renal sinus and surrounding fat, with evidence of spread beyond the capsule. Four out of five hilar lymph nodes contained metastatic cells. All surgical margins from the kidney resection were free of disease. The fat specimen showed only benign tissue. \n\nStaging was determined as pT3 due to invasion into the sinus and perinephric fat, and pN2 based on involvement of four hilar lymph nodes. Distant metastasis could not be assessed."} +{"pid": "TCGA-4Z-AA7W", "report": "The specimen involved the bladder and prostate. The bladder showed a lesion measuring 3.0 x 2.0 x 1.5 cm, composed of high-grade urothelial cells. The lesion extended into the muscular layer of the bladder but did not show evidence of angiolymphatic or perineural invasion. The prostate exhibited myofibroepithelial hyperplasia. Surgical margins were free of abnormal cells. Lymph node evaluation included 10 nodes on the left and 6 on the right, all without involvement. The tumor was located in the bladder, with histologic features consistent with transitional cell morphology. Pathologic staging was determined to be pT2b pN0."} +{"pid": "TCGA-XP-A8T6", "report": "The specimen consists of an esophageal segment measuring 10.1 cm in length with diameters ranging from 1 to 3.8 cm, and a proximal gastric segment measuring 4.5 cm and 9.3 cm along the lesser and greater curvatures, respectively. The proximal end is secured with suture material, while the distal margin is marked by a metallic staple line. A circumferential, ulcerative-vegetative, stenosing lesion is present in the distal esophagus near the gastroesophageal junction, measuring 5.5 x 4.2 cm. The lesion appears confined to the esophagus without involvement of the gastric cardia. On gross examination, the tissue is firm, whitish, with areas of blackening and friability, extending into the muscular layer of the esophageal wall.\n\nA total of four fibroelastic, brownish lymph node-like structures were identified in the periesophageal fat, with sizes ranging from 0.3 to 0.6 cm. From the gastric greater and lesser curvatures, ten similar structures were dissected, measuring between 0.2 and 2.3 cm. Of these, two larger structures in the greater curvature show evidence of tissue infiltration.\n\nHistologically, the lesion demonstrates features of moderate cellular atypia and ulceration. High-grade dysplastic changes are noted in the adjacent esophageal mucosa. Angiolymphatic invasion is present. Among the dissected lymph nodes, four show evidence of metastatic involvement\u2014three from the periesophageal region and one from the pericardial area, out of a total of 14 nodes examined. The tumor is staged according to the TNM classification as pT2, pN1b, pMx. Proximal and distal surgical margins are free of neoplastic cells."} +{"pid": "TCGA-AJ-A3EM", "report": "The specimen includes a uterus with cervix and bilateral adnexa. The uterus and cervix together measure 7.4 x 5.0 x 3.2 cm and weigh 75 grams. The endocervical canal is lined by trabeculated gray-brown mucosa, and the uterine serosa appears smooth and tan-brown. The myometrium measures up to 2.0 cm in thickness, with fibrotic changes and small intramural tan-white fibrous nodules up to 0.5 cm. The endometrial lining is less than 0.1 cm thick and appears as smooth brown mucosa. A plaque-like area of discoloration is noted in the left cornual region, measuring approximately 2.2 x 1.5 cm grossly, with a maximum depth of 0.6 cm on sectioning. This area extends into the myometrium and is located 0.9 cm from the nearest posterior fundic serosa. No nodularity or lesions are identified in the parametrial soft tissue.\n\nThe left fallopian tube measures 6.5 x 1.1 x 1.1 cm, with a closed distal end and a wall that is fibrotic. The lumen dilates in the mid and distal regions and contains gray-tan papilliferous tissue, not clearly extending into the wall, along with a small amount of transparent viscid fluid. The left ovary measures 2.4 x 1.8 x 1.0 cm, with a lobular tan-yellow outer surface and a mottled tan-gray fibrotic cut surface. The right fallopian tube is 4.5 x 1.0 x 1.0 cm, with a smooth gray-tan serosa and a closed distal end. On sectioning, the wall is tan with a pinpoint lumen near the proximal end, and the mid to distal areas show gray-tan papilliferous tissue with a small amount of clear viscid fluid. The right ovary measures 2.2 x 2.0 x 1.4 cm, with a lobular gray-tan outer surface and a mottled gray-tan fibrotic cut surface.\n\nLymph node specimens include:\n- Right aortic lymph nodes: 4.0 x 3.1 x 0.9 cm of tan-yellow fibroadipose tissue with several poorly defined tan-yellow nodules up to 1.8 cm. The largest nodule has a fleshy cut surface.\n- Left common iliac nodes: 3.1 x 2.2 x 0.6 cm of tan-yellow fibroadipose tissue with a few poorly defined tan-yellow nodules up to 0.7 cm.\n- Right pelvic lymph nodes: 8.0 x 4.5 x 2.4 cm of tan-yellow fibroadipose tissue with two poorly defined tan-yellow nodules measuring 3.0 and 4.2 cm, with fleshy tan-pink cut surfaces and significant intervening yellow adipose tissue.\n- Left pelvic lymph nodes: 7.6 x 6.0 x 2.8 cm of tan-yellow fibroadipose tissue with four poorly defined tan-yellow nodules ranging from 2.5 to 4.6 cm, each with fleshy tan-gray cut surfaces and substantial yellow adipose tissue.\n\nMicroscopic findings indicate that the lesion is located in the endometrial cavity and extends into the superficial myometrium, reaching up to 5 mm into an 18 mm thick myometrium. There is no evidence of involvement in the endocervical canal or lower uterine segment, and no lymphovascular space invasion is identified. All surgical margins, including the cervix and parametrial regions, are free of tumor involvement. A total of 18 lymph nodes were examined across all sites, and none showed evidence of metastatic disease.\n\nAdditional findings include background endometrial hyperplasia, adenomyosis, and leiomyomata within the myometrium. Focal endometriosis is present in the uterine serosa and left ovary. Changes consistent with prior tubal ligation are seen in the fallopian tubes. Cervical squamous metaplasia and endocervical findings are unremarkable, with no evidence of malignancy. The pTN stage assigned is pT1b, NO. The histologic grade is based on nuclear features and mitotic activity, with a high-grade classification. This assessment was confirmed by an additional pathologist."} +{"pid": "TCGA-BP-4163", "report": "The right kidney specimen measures 14.0 cm from superior to inferior, 8.5 cm from medial to lateral, and 5.5 cm from anterior to posterior, weighing 490 grams. A fleshy mass located in the superior pole measures 8.0 x 6.5 x 3.0 cm. The tumor has a yellow-orange, lobulated appearance in approximately 25% of its volume, with the remaining 75% being homogeneously tan and firm. The tumor focally extends through the renal capsule but remains within Gerota's fascia. No invasion of the renal vein is identified. All surgical margins are free of involvement. On serial sectioning, areas of hemorrhage and necrosis are present within the tumor. In the anterior aspect of the inferior pole, a small, firm white nodule measuring 0.6 cm in greatest dimension is identified, located approximately 1.5 cm from the main mass. The cortical thickness ranges between 0.4 and 0.6 cm. The hilar adipose tissue does not contain any lymph nodes.\n\nThe paracaval lymph node specimen consists of a fragment of adipose tissue measuring 4.0 x 2.2 x 1.5 cm, containing several lymph nodes, the largest measuring 2.5 cm in diameter. All nine lymph nodes examined are benign.\n\nImmunohistochemical studies on the small nodule show positivity for SMA and focal positivity for HMB-45, with no staining for S-100 protein. Staining results for other markers are consistent with standard controls.\n\nHistologic sections include frozen section control, tumor, renal parenchyma, nodule, vascular margin, ureteral margin, bisected lymph nodes, and lymph nodes."} +{"pid": "TCGA-DD-AADL", "report": "The liver specimen measured 14.0 x 18.0 x 3.5 cm and weighed 555.0 grams. A well-defined pale tan round and solid nodule measuring 3.5 x 4.0 x 4.0 cm was identified, with a non-involved resection margin grossly (safety margin: 1.3 cm). No satellite nodules were observed. The remaining liver parenchyma showed pre-cirrhotic changes. Histologically, the lesion exhibited trabecular and pseudoglandular growth patterns with hepatic and clear cell morphology. Fatty change was mild. A partial fibrous capsule was present with capsular infiltration and septum formation. Microvessel invasion was present, while surgical resection margin invasion, serosal invasion, and portal vein invasion were not identified. The histologic grade showed worst differentiation as grade IV and major differentiation as grade III. Fibrosis was present in a septal pattern, corresponding to stage 3. Additional findings included chronic cholecystitis in the gallbladder specimen."} +{"pid": "TCGA-81-5911", "report": "The specimen was received in three parts, all labeled \"left occipital subcortical.\" Part A was submitted fresh for frozen section and consisted of four red-tan soft tissue fragments measuring 10 x 9 x 3 mm in total. A squash prep was made, and the remaining tissue was entirely frozen and subsequently submitted as a single block. Part B consisted of tan-pink tissue fragments with an aggregate measurement of 2 x 1.7 x 0.4 cm. Approximately one-third to one-half of this portion was used for genomic analysis, and the remainder was submitted entirely. Part C, collected from a cusa suction container, contained tan-pink tissue fragments measuring 3 x 2 x 0.4 cm in aggregate and was submitted completely.\n\nMicroscopic examination revealed a hypercellular glial proliferation. Many cells exhibited gemistocytic features, and others displayed enlarged nuclei with prominent nucleoli. Mitotic figures were observed. Areas of necrosis and vascular endothelial proliferation were also noted. The case was reviewed by Dr. [Name] with concurrence."} +{"pid": "TCGA-B5-A1MU", "report": "The clinical history indicates a prior malignant neoplasm of the corpus uteri, code 182.\n\n**Gross Examination:** \nA left salpingo-oophorectomy specimen weighs 9.3 grams and measures 6 x 4 x 2 cm. The ovary is 2.5 x 1.1 x 0.9 cm, the fallopian tube is 4 cm long and 0.5 cm in diameter. The mesentery contains multiple lymph node candidates up to 1.2 cm in greatest dimension and several soft tan nodules, with the largest measuring 0.7 x 0.5 x 0.3 cm (frozen as AF1). The frozen remnant is submitted as block A1. Four paratubal cysts ranging from 0.1 to 0.8 cm are identified in the fallopian tube; the ovary appears unremarkable.\n\nBlocks submitted: \n- A1: AF1 remnant \n- A2: One lymph node candidate, bisected \n- A3: Two lymph node candidates \n- A4: Fallopian tube and paratubal cyst \n- A5: Ovary \n\nThe right salpingo-oophorectomy specimen weighs 6.3 grams and measures 4.5 x 3.7 x 1.5 cm. The ovary measures 2.6 x 1.1 x 0.8 cm, the fallopian tube is 3.7 cm long and 0.6 cm in diameter. The distal fallopian tube has a yellow-tan firm nodule measuring 0.6 x 0.3 cm and multiple paratubal cysts ranging from 0.1 to 0.4 cm. The ovary has two serous cysts on its surface and appears otherwise unremarkable. Representative sections of the ovary are submitted in block B2.\n\nThe hysterectomy specimen weighs 22.9 grams and measures 6.5 x 4 x 2 cm. The serosa is white-tan with focal retraction. The endometrial cavity is 4.5 x 3.5 cm and contains an exophytic mass measuring 5 x 3 x 1 cm. This mass extends to and abuts areas of serosal retraction upon sectioning. There is no apparent involvement of the endocervical canal or ectocervix. In tumor-free regions, the endocervix measures 0.1 cm and overlies a myometrium 1 cm thick.\n\nSubmitted blocks: \n- C1: cervix and lower uterine segment \n- C2\u2013C4: mass involving endomyometrium and serosa, full thickness, bisected \n- C5: cervix and lower uterine segment, opposite side, bisected \n- C6\u2013C8: mass involving endomyometrium and serosa on the opposite side, full thickness, bisected \n\nA fragment of right pelvic peritoneum measuring 5.5 x 3 x 0.6 cm contains multiple indurated nodules up to 0.2 cm in size. Representative sections are submitted as blocks D1\u2013D2. The omentum, weighing 5.5 x 5 x 1.2 cm, consists of yellow-tan fibromembranous adipose tissue and appears grossly unremarkable. Sections submitted as E1\u2013E2. The left pelvic peritoneum, 4.5 x 4 x 0.5 cm, demonstrates multiple indurated nodules up to 0.3 cm. Sections submitted as F1\u2013F2.\n\n**Intraoperative Consultation:** \nFrozen section of AF1 reveals carcinoma present.\n\n**Microscopic Examination:** \nPerformed on all relevant specimens.\n\n**Pathologic Staging (AJCC 6th Edition):** \npT3a pNX pMX\n\n**Procedure:** Hysterectomy, bilateral salpingo-oophorectomy, staging biopsies.\n\n**Notes:** Pathologic staging information is transmitted to the institution\u2019s Cancer Registry for accreditation purposes. Staging is based solely on the current specimen and does not incorporate findings from cytology, imaging, prior reports, or clinical data. The operative report provides the exact procedure performed.\n\n**Findings Summary:** \nMetastatic adenocarcinoma is identified in periadnexal soft tissue of the left ovary and fallopian tube specimen. No malignancy is observed in the left ovary. On the right side, metastatic adenocarcinoma involves the serosal aspect of the fallopian tube, though the ovary shows no evidence of malignancy.\n\nThe uterus demonstrates a 5 x 3 x 1 cm endometrial mass consistent with serous adenocarcinoma (Grade 3), infiltrating into the muscle of the lower uterine segment and reaching the junction of the lower uterine segment and cervix. Vascular invasion is present; adjacent endometrium is benign without evidence of intraepithelial neoplasia. Myometrial invasion measures 1 cm in a wall that is 1 cm thick. Tumor extension reaches the serosal surface but does not involve the cervix. Immunohistochemical staining on part E is negative for cytokeratin, supporting absence of malignancy in this region.\n\nBiopsy of the right pelvic peritoneum shows metastatic adenocarcinoma. The omentum demonstrates no evidence of malignancy. Metastatic adenocarcinoma is also identified in the left pelvic peritoneum biopsy.\n\n**Certification:** The diagnostic evaluation was personally conducted and confirmed by the reporting pathologist."} +{"pid": "TCGA-EA-A3HQ", "report": "The specimen consists of cervix tissue obtained from a hysterectomy with bilateral salpingo-oophorectomy. The lesion measured 4 x 3 x 3 cm and was classified as a moderately differentiated type based on histologic evaluation. The lesion was found to be less than 4.0 cm in size. Examination of regional lymph nodes revealed no evidence of metastasis, with all 13 nodes assessed showing no involvement. Assessments for lymphatic invasion, venous invasion, and margin status were not performed or reported. There was no indication of neo-adjuvant treatment effect. No additional findings were noted upon microscopic examination."} +{"pid": "TCGA-G7-6790", "report": "The specimen includes a cyst wall and a tumor from the right kidney. The cyst wall consists of multiple fragments measuring 1.9 x 1.2 x 0.3 cm in total. The tumor specimen includes a portion of kidney with surrounding fat, weighing 105 grams and measuring 12 x 7.5 x 3.0 cm. A distinct mass is identified within the kidney, measuring 2.8 x 2.5 x 2.0 cm, with an adjacent normal kidney segment measuring 3.0 x 1.5 x 1.0 cm. The mass has a well-defined border and a red-brown, hemorrhagic cut surface. The surface of the mass is marked black, the kidney margins blue, and the surrounding fat yellow. The mass is located within 0.1 cm of the kidney margin.\n\nMicroscopic evaluation shows cells with very irregular nuclei, approximately 20 microns in size, with large and prominent nucleoli. There is no evidence of vascular or perinephric invasion. Margins cannot be assessed. An additional small finding measuring 0.2 cm was noted and interpreted as a minor glandular proliferation. Immunostaining shows positivity for CK7 and EMA, and negativity for CD56. The tumor is confined to the kidney without lymph node involvement. Based on available data, the pathological staging is pT1a. The capsule of the tumor appears intact intraoperatively but shows disruption upon specimen examination. Close clinical follow-up is recommended."} +{"pid": "TCGA-AK-3427", "report": "The specimen was obtained from the left kidney, para-aortic lymph nodes, and left adrenal gland, with additional tissue from para-aortic and left common iliac lymph nodes. The left kidney measured 20 x 13 x 9 cm and weighed 580 grams. A large mass measuring 6.5 x 5.0 x 4.0 cm was identified in the lower pole, approaching but not invading the capsule. A second mass measuring 1.4 x 1.4 x 1.2 cm was found in the mid-lateral region of the kidney, with a third possible lesion measuring 0.8 x 0.8 cm in the superior pole. The adrenal gland appeared normal, measuring 3 x 2.5 x 1.3 cm. No lymph nodes were identified in the perinephric fat. The ureter at the hilum measured 10.5 x 0.5 cm and appeared normal upon opening. Vascular margins showed no evidence of involvement.\n\nMultiple sections were taken from various areas including the ureteral and vascular margins, adrenal gland, tumor margins, surrounding parenchyma, and perinephric fat. Additional lymph node specimens included five para-aortic lymph nodes ranging from 1 to 3 cm in size, and three left common iliac lymph nodes measuring between 0.8 to 1.4 cm. All lymph nodes were unremarkable on gross examination.\n\nHistologic evaluation of all sections showed no evidence of tumor in the ureteral or vascular resection margins, in the adrenal gland, or in any of the lymph nodes examined. Cellular features were evaluated with immunohistochemical stains, which showed variable expression of CD10, E-cadherin, vimentin, and cytokeratin CK7 across different regions. Cytogenetic analysis of the renal mass revealed an abnormal mosaic karyotype with a clone showing loss of chromosomes Y, 1, 14, and 21, and gain of chromosomes 7 and 20 in some cells, while others displayed a normal karyotype. This finding is consistent with chromosomal changes reported in certain renal neoplasms. All tissue samples were processed and interpreted under CLIA-certified high-complexity testing standards."} +{"pid": "TCGA-AG-A00Y", "report": "The resected specimen of the large intestine includes a lesion measuring 1.8 cm in diameter, located 2.5 cm from the aboral resection margin. The lesion demonstrates circumferential infiltration of the surrounding fatty tissue, with a maximum depth of 0.6 cm into the perirectal fat. Adjacent to this finding, another lesion is identified at the base of a tubular adenoma with features of severe dysplasia. This second lesion shows infiltration into the tunica submucosa. Additionally, three tubular adenomas are present, showing varying degrees of dysplasia ranging from mild to severe. All regional lymph nodes are free of tumor involvement. The resection margins of the large intestine and mesentery are also tumor-free. Histological evaluation indicates a moderately differentiated growth pattern. Vascular and lymphatic invasion are not identified. The local resection status is complete."} +{"pid": "TCGA-FV-A4ZP", "report": "The specimen consisted of multiple tissue samples collected from various sites. One sample measured 1.0 x 1.0 x 0.5 cm and showed fat necrosis with fibrosis. No malignant infiltration was observed in this tissue.\n\nA liver wedge resection measuring 15.0 x 11.0 x 7.0 cm weighed 393 grams and demonstrated multiple gray-tan nodules ranging from 1.0 x 1.0 x 0.7 cm to 11.0 x 10.0 x 2.0 cm. These nodules occupied approximately 90% of the liver parenchyma. The surgical margin was inked, and tumor involvement near a possible duct was noted with protrusion into the lumen visible at the margin. Histologic examination revealed cellular proliferation arranged in cords, nests, and trabecular structures. The cells exhibited large vesicular nuclei with prominent nucleoli, scattered intranuclear cytoplasmic inclusions, and moderate to abundant pink granular cytoplasm. Mitotic figures were frequently observed along with multinucleated and bizarre giant nuclear forms. Vascular invasion was evident. Immunohistochemical staining showed positivity for CAM5.2 and focal positivity for cytokeratin 20. CD10 staining highlighted bile canalicular structures. Retinulin staining demonstrated loss within the tumor compared to adjacent preserved reticulin in normal liver parenchyma. Negative markers included S100 protein, Melan-A, cytokeratin 7, alpha-fetoprotein, and Hepar antigen.\n\nAnother fragment identified as gallbladder tissue measured 7.0 x 3.0 x 2.0 cm and displayed mild chronic inflammation along with gallstones. No signs of malignancy were detected in this specimen.\n\nAdditional liver fragments measuring between 1.0 x 0.5 x 0.5 cm and 2.0 x 1.0 x 0.5 cm showed fibrous stroma with cellular nodules. Iron deposition was observed on staining, while trichrome staining highlighted thickened fibrous trabeculae traversing through the lesion. Reticulin staining confirmed diminished presence within the lesion compared to surrounding tissue.\n\nSubmitted vessel segments demonstrated tumor involvement within the lumen. Multiple sections were obtained from margins related to the mass and vessel involvement for genomic studies."} +{"pid": "TCGA-2L-AAQI", "report": "The surgical specimen from a male patient included multiple tissue samples obtained during resection. A liver biopsy (segment 2/3) showed a homogenous brownish parenchyma with an intact fine capsule and no evidence of malignancy. A section from the superior mesenteric artery contained several small nodules, and lymph node tissue from the upper pancreatic rim was submitted for analysis. The edge of the pancreas showed central ductal structures, and tissue near the superior mesenteric artery had indurated areas sampled for histology.\n\nA gallbladder specimen with green, velvety mucosa was also examined, and no tumor was found. The Whipple specimen consisted of a 5x4x5 cm pancreatic head and a C-shaped duodenum/jejunum segment measuring 25 cm in length, along with attached omentum. Within the pancreatic parenchyma at the uncinate process, a 4x3x3 cm solid, grey, glass-like mass with white-yellow margins and focal cystic changes was identified. This lesion extended into surrounding fatty tissue on the dorsal, medial, and ventral sides, with close proximity to the medial resection margin. The remaining pancreatic tissue showed fibrotic and partially lobulated features.\n\nMicroscopic evaluation revealed no tumor in the paraffin-embedded sections of the liver or gallbladder. Lymph node metastases were identified in both frozen and paraffin sections, showing mucus-forming adenocarcinoma. The resection margin of the pancreatic parenchyma was free of tumor, although low-grade pre-invasive ductal changes were noted. Extensive perineural invasion was observed in the soft tissue, and five of eleven lymph nodes were positive for metastatic involvement. Tumor infiltration was also found in the duodenal wall musculature at the papillary region, with severe nuclear atypia consistent with high-grade pre-invasive changes in the main pancreatic duct and lateral branches. Resection margins at the bile duct, pancreas, and duodenum were all negative for tumor.\n\nImmunohistochemical and special stains revealed moderate mixed adiposis and cholestasis in the liver, with minimal portal fibrosis. No tumor was detected in the omentum. Final staging according to the UICC 7th edition (2010) was pT3, N1 (6/19), G3, R1."} +{"pid": "TCGA-HT-7693", "report": "Sections demonstrate a diffusely infiltrating glial neoplasm that is moderately hypercellular. The tumor is composed primarily of cells with round nuclei, prominent perinuclear halos, and moderate atypia. A capillary network is present throughout the tissue, with areas of vascular hyalinization; however, no true microvascular proliferation, hemorrhage, or necrosis is identified. Mitotic figures are rare. There is an abundance of hemosiderin-laden macrophages present. Immunohistochemical staining shows variable proliferation activity, with a calculated MIB-1 labeling index ranging from 3.5% to 5%, indicating an intermediate level of proliferative activity. Based on histologic features and proliferation index, the findings are consistent with a grade II lesion."} +{"pid": "TCGA-B0-4710", "report": "The right radical nephrectomy specimen includes a unifocal neoplasm located in the upper pole, measuring 10.6 cm in greatest dimension (additional dimensions: 8.0 x 7.5 cm). Microscopic examination reveals that the lesion extends beyond the renal capsule into the perinephric fat, with extension beyond Gerota's fascia. The nuclear grade is 3 of 4. No angiolymphatic invasion is identified. The non-neoplastic kidney adjacent to the lesion shows mild interstitial chronic inflammation and moderate arterial and arteriolar sclerosis. The upper pole soft tissue resection margin is involved by the lesion, as confirmed by separate submission of the margin in a second specimen. The left adrenal gland, weighing 31.5 grams, contains a 2.0 cm cortical nodule but shows no involvement by the primary lesion. A total of zero regional lymph nodes were identified and examined; none show involvement. Staging is pT3a, pNX, pMX. No venous or lymphatic invasion is present. Gross and microscopic evaluation confirms extracapsular extension at the upper pole with disruption of the margin. The cauterized margin in the upper pole specimen is involved by the lesion."} +{"pid": "TCGA-QQ-A8VH", "report": "The specimen included multiple tissue samples from the thoracic region. A paraspinal soft tissue fragment measured 1.5 x 0.6 x 0.2 cm and was entirely submitted for analysis. An epidural scar measuring 2.2 x 2.4 x 1.3 cm showed extensive fibrosis and a focal foreign body giant cell reaction. The spinal canal mass, composed of tan-white soft tissue fragments measuring 2 x 1.5 x 0.3 cm in total, exhibited pleomorphic malignant features involving cartilage.\n\nA thoracic spinal nerve root sample measuring 1 x 0.9 x 0.7 cm showed only cauterized fibrous tissue. A larger paraspinal retropleural mass at T6 measured 3.7 x 3.3 x 2.2 cm; it was encapsulated and white in appearance, compressing the surrounding surface. This lesion also demonstrated pleomorphic malignant characteristics arising from and effacing a large nerve. Margins were focally involved.\n\nMultiple smaller biopsies were taken from neural foraminal regions. One measured 1.2 x 1.1 x 0.6 cm and showed focal presence of a malignant nerve sheath tumor, while another at T6 measured 0.8 x 0.4 x 0.1 cm and showed similar findings. A dorsal foramen tissue fragment measuring 1.1 x 1 x 0.4 cm revealed benign features consistent with a neurofibroma. A posterior paravertebral margin measuring 0.8 x 0.7 x 0.2 cm also showed benign neural tissue.\n\nIntraoperative frozen sections were performed on several specimens. The thoracic spinal nerve root was negative for tumor involvement. The neural foraminal tissue biopsy was positive, while the dorsal foramen and posterior paravertebral margin biopsies were negative. All relevant margins were assessed and one showed focal involvement."} +{"pid": "TCGA-98-A539", "report": "The specimen was received in eighteen containers. A biopsy of the left tonsil showed no evidence of malignancy. Multiple lymph nodes were examined, including those from levels 5, 6, 7, 8, 9, 11-L, and #5; all were negative for malignancy. Soft tissue specimens from various anatomical locations were also evaluated. These included areas between ribs 4 and 5, anterior margin from rib 3, extrathoracic region, posterior margin of rib 3, part of the serratus muscle, second rib, intercostal muscle between ribs 1 and 2, middle scalene muscle, and lung tissue from the left upper lobe wedge along with parts of ribs 2 and 3.\n\nAmong these, several soft tissue specimens showed the presence of abnormal cells consistent with malignant transformation. These included the extrathoracic tissue, part of the serratus muscle, second rib, intercostal muscle between ribs 1 and 2, middle scalene muscle, and the lung wedge specimen. The lung wedge measured 12.0 x 7.5 x 2.5 cm, with a chest wall measuring 11.0 x 7.5 x 2.0 cm. A tan-white necrotic lesion measuring 4.5 cm in greatest dimension was identified approximately 0.5 cm from the staple line margin. The lesion extended anteriorly into the chest wall and approached the outer surface. No involvement of the pleura was observed. Margins of resection appeared free of tumor involvement based on histological evaluation.\n\nA separate biopsy of the pleura did not reveal any malignant cells. All lymph nodes examined were negative for tumor involvement. Staging was determined as pT3, N0, Mx."} +{"pid": "TCGA-X7-A8DI", "report": "A left thoracotomy was performed for a mediastinal mass. The specimen was received in formalin and consisted of a single portion of yellow-tan lobular fatty tissue measuring 10.0 x 7.2 x 3.8 cm and weighing 130 grams. A distinct lobular mass within the specimen measured 8.2 x 5.5 x 4.5 cm and exhibited a tan-white, lobular fleshy cut surface without hemorrhage or necrosis. The mass was well-circumscribed and did not appear to infiltrate surrounding tissue. Representative sections were submitted for analysis.\n\nMicroscopic examination revealed a neoplastic process involving the mediastinal mass. Histologic evaluation showed a mixed cellular composition with features suggestive of both epithelial and lymphocytic components. The tumor was well-encapsulated both grossly and microscopically, with no evidence of vascular invasion or tumor extension beyond the capsule. Margins were involved by tumor at the external inked margin. No regional lymph nodes were identified or examined. Implants or distant metastasis could not be assessed.\n\nA separate specimen labeled as pericardial fat and thymus consisted of yellow-tan fatty tissue measuring 6.0 x 4.1 x 1.4 cm. No distinct masses were identified, and microscopic examination revealed benign thymic and fibroadipose tissue without evidence of malignancy.\n\nA proprietary gene expression assay was performed on a representative portion of the tumor. The molecular signature demonstrated low-risk features based on comparison with a training set of patients with known outcomes. No treatment effect was noted. Specimen integrity was intact, and all relevant findings were incorporated into the final report."} +{"pid": "TCGA-IM-A41Y", "report": "A right inferior level lymph node measuring 1.2 cm in greatest dimension demonstrated metastatic involvement in one of one nodes. A right anterior paratracheal mass showed similar involvement, with metastasis identified in one of one lymph nodes. A separate fragment was consistent with benign parathyroid tissue. The right thyroid specimen contained a dominant lesion measuring 6.8 cm, characterized by classical and follicular architectural patterns along with tall cell cytologic features. Surgical margins were free of tumor involvement. Lymphovascular invasion was present but limited to fewer than four vessels. No evidence of extrathyroidal spread was observed. In the left thyroid lobe, a second lesion measuring 2.6 cm exhibited predominantly tall cell morphology with minimal extension into adjacent soft tissues. Margins were involved, and lymphovascular invasion was extensive, involving four or more vessels. A separate small nodule measuring 0.3 cm was also identified within the left lobe. In the right paratracheal dissection, one of seven lymph nodes contained metastatic cells, with the largest focus measuring 0.1 cm and no extranodal extension. The right level 2B neck dissection contained eight lymph nodes, none of which were involved. Pathologic staging reflects multifocality with bilateral involvement. A total of 18 lymph nodes were evaluated, with four showing metastatic involvement. Specimen measurements included a right thyroid lobe measuring 8 x 8 x 4 cm and a left lobe measuring 4.5 x 3.0 x 1.8 cm. The surgical approach included total thyroidectomy with right neck dissection."} +{"pid": "TCGA-CV-7434", "report": "A segmental mandibulectomy with partial maxillectomy, right suprahyoid neck dissection, and partial glossectomy was performed. The specimen included a portion of the mandible measuring 18.0 x 7.0 x 4.0 cm, along with an attached level I right neck dissection (5.0 x 3.0 x 2.0 cm), and floor of mouth/left pharyngeal wall tissue (7.0 x 4.0 x 2.0 cm). A central white glistening mass in the floor of mouth measured 4.0 x 3.0 x 2.5 cm and extended to within 0.5 cm of the deep margin, closely approaching the mucosal margin. A separate satellite mass measuring 5.0 x 3.0 x 2.0 cm was identified in the left pharyngeal tissue, extending into surrounding muscle and tendon.\n\nTwo lymph nodes were identified in the right level I neck dissection: one measuring 2.0 x 2.0 x 1.0 cm and another 1.0 x 1.0 x 0.5 cm; both showed involvement by metastatic disease. The larger lymph node demonstrated extracapsular extension and measured 0.8 cm in focus.\n\nMicroscopic evaluation revealed two invasive foci in the floor of mouth region measuring 5.0 cm and 4.0 cm in greatest dimension. Tumor extended focally to the floor of mouth and left posterior pharyngeal wall margins; however, additional submitted tissues from these areas (specimens G and H) did not show residual tumor. Perineural invasion was identified, but no vascular or lymphatic invasion was observed. Final resection margins were free of tumor involvement.\n\nSubmitted nerves (left and right mental nerves) showed no evidence of tumor involvement. Additional tissue specimens including left maxillary interim contents, deep submandibular margin, new maxillary margin, and base of tongue all showed no presence of tumor. Bone margins of resection were also free of tumor involvement.\n\nThe specimen underwent decalcification for further evaluation of bone involvement. Multiple sections were taken from various anatomical sites and margins to confirm absence of residual tumor."} +{"pid": "TCGA-2Y-A9H6", "report": "The resected liver specimen includes a solitary mass located in segment five. The tumor measures 7.3 cm in greatest dimension, with additional dimensions of 5.6 x 5.0 cm. It is well-circumscribed, yellow-tan, and lobulated, with a central area of hemorrhage. The mass abuts and distends the capsule and is 1.8 cm from the closest surgical margin, which is inked blue. The surrounding liver parenchyma appears brown without nodularity, and the capsule is smooth without adhesions or nodules.\n\nHistologically, the tumor demonstrates moderate differentiation. Staining results show positivity for HepPar-1, while negative for alpha-fetoprotein, cytokeratin 7, and cytokeratin 20. Reticulin staining reveals an interrupted framework within the tumor component. Trichrome stain highlights mild to moderate portal fibrosis. Iron stain is negative. Minimal tumor necrosis is noted, accounting for less than 1% of the tumor volume.\n\nChronic triaditis is present in the uninvolved liver tissue. The gallbladder shows findings of chronic cholecystitis and cholelithiasis, with no evidence of malignancy. The cystic duct margin is free of tumor involvement.\n\nPathologic staging indicates a solitary tumor confined to the liver. Vascular invasion is absent. Regional lymph nodes and distant metastases could not be assessed. Parenchymal margins are uninvolved by invasive carcinoma.\n\nIntraoperative consultation confirmed the tumor\u2019s proximity to the surgical margin. Gross and microscopic evaluations were performed, and representative sections were submitted for analysis. A portion of tissue was also sent to the tissue procurement laboratory.\n\nAll stains were performed with appropriate controls, supporting the findings. The attending pathologist personally reviewed all materials and rendered the final assessment."} +{"pid": "TCGA-OR-A5LP", "report": "A right adrenalectomy was performed. The resected specimen weighed 198 grams and measured 8.5 x 7.5 x 6 centimeters. Histological evaluation showed the presence of oxyphilic cells. A Weiss score of 5 was determined. The tumor exhibited features associated with potential aggressiveness based on established criteria. Lymph node examination showed no evidence of metastatic involvement, with 0 out of 30 lymph nodes affected. Additionally, a 1.4 cm hyperplastic nodule was identified in segment V of the liver. There was no histological change noted in the gallbladder following prior cholecystectomy."} +{"pid": "TCGA-K4-A6FZ", "report": "A radical cystectomy specimen with attached bilateral tubes, ovaries, and anterior vaginal wall was received. The bladder measured 17 x 15 x 5 cm and contained a mass located in the posterior wall and dome. The mass measured 3.5 x 2.5 x 1.2 cm, was ulcerated and exophytic, and extended into the perivesical soft tissue. Histologically, the lesion showed high-grade features with squamous and focal glandular differentiation. Invasion of the muscularis was present, and the tumor was within less than 0.1 cm of the posterior fatty tissue margin. No extravesical mass was identified.\n\nThe resection margins, including ureteral, urethral, and soft tissue, showed no evidence of involvement. A small focus of mild to moderate urothelial dysplasia was noted in the associated epithelium. No malignancy was identified in the bilateral fallopian tubes or vaginal wall. The right ovary demonstrated a serous cystadenofibroma, and the left ovary had a cystic appearance; neither showed signs of malignancy.\n\nLymph node dissection included specimens from the left pelvic, left obturator, and right obturator regions. In total, 12 lymph nodes were examined\u2014two from the left obturator, nine from the right obturator, and none from the left pelvic region. No malignant cells were detected in any of the lymph nodes or in the fibroadipose tissue submitted from these areas.\n\nAdditional tissue samples from the distal ureters were analyzed. Grossly, these appeared as fibrofatty tissue fragments with no evidence of carcinoma identified either in the frozen sections or in the formalin-fixed samples. One lymph node was found in the right distal ureter specimen but showed no malignancy. Atherosclerosis was noted in the right distal ureter-NFS specimen.\n\nMicroscopic evaluation revealed no evidence of malignancy at the ureteral, urethral, or soft tissue margins. Lymphatic (small vessel) invasion was present. The histologic grade was consistent with poorly differentiated (grade 3/3) features. No tumor was seen in any of the frozen section margins analyzed intraoperatively. The specimen was extensively sampled and submitted for analysis in multiple blocks, with no residual tumor observed at the margins."} +{"pid": "TCGA-DD-AAVU", "report": "The specimen consists of a right hemihepatectomy. Within the liver, a lesion was identified in segment 5. The tumor measured 4 x 3.5 x 2.5 cm and exhibited a nodular gross appearance. Microscopic examination revealed a trabecular growth pattern with classic cellular morphology. Histologic grading by the Edmondson and Steiner system showed a worst grade of 3 and a major component of grade 2. There was no fatty change or tumor necrosis observed. Hemorrhage or peliosis was present in approximately 2% of the tumor area. Vascular invasion was identified microscopically. A partial capsule was noted, with infiltration into the capsule present. Satellite nodules were not identified. Adjacent tissue showed septal fibrosis but no cirrhosis. Portal vein or hepatic vein branch involvement, bile duct invasion, serosal invasion, and intrahepatic metastasis were not seen. The surgical margin was clear with a safety distance of 6.5 cm. No post-chemoembolization changes were detected. Pathologic staging was consistent with AJCC pT2 and pT3 classifications.\n\nAdditional findings included a cavernous hemangioma in segment 6 measuring 1.5 x 1.5 x 1.0 cm, and two bile duct cysts measuring 2.5 x 2 x 1.5 cm and 1 x 1 x 0.8 cm respectively. No dysplastic lesions were identified. Hepatitis-related changes were present with minimal lobular activity and minimal portal inflammation."} +{"pid": "TCGA-E9-A1ND", "report": "The specimen consisted of breast tissue from a radical mastectomy. A grossly evident lesion was identified, measuring 2.7 x 2.7 x 2.7 cm. Histologic evaluation showed poorly differentiated cellular features. Lymph node assessment revealed 1 out of 11 axillary lymph nodes positive for involvement. The affected lymph node was located in the left upper region. Additional histologic parameters including tubule formation, nuclear pleomorphism, and mitotic counts were not specified, and therefore, a total histologic score could not be determined. No information was provided regarding tumor extent, extracapsular invasion, margins, neo-adjuvant treatment, or other associated findings."} +{"pid": "TCGA-TS-A8AF", "report": "The specimen was received in formalin across 27 containers, each labeled with the patient's name and medical record number. The specimens included various anatomical sites such as previous incision sites, ribs, pleural tissues (visceral and parietal), biopsy sites, nerves, lymph nodes, pericardial fat, and chest wall components.\n\nGross examination revealed a range of tissue types. Skin and soft tissue from previous incisions showed signs of healing and hemorrhage. Rib segments were unremarkable with no suspicious lesions. Membranous and fibroadipose tissues from the pleura, diaphragm, and mediastinal regions showed areas of thickening, firmness, and rubbery consistency. Lymph nodes and nerve tissues were generally small with no grossly visible abnormalities. Adipose and membranous tissues frequently showed nodular or thickened areas suggestive of pathological change.\n\nMicroscopic analysis of representative sections showed variable involvement across the specimens. Fibrosis, chronic inflammation, and fat necrosis were noted in some incision and biopsy site samples. Bone and cartilage tissue from rib segments appeared benign. Lymph nodes in several locations were negative for malignancy, while other areas including pleural surfaces, diaphragmatic and pericardial regions, and chest wall tissues demonstrated invasive cellular changes. These findings were also observed in intercostal and hilar nodes, as well as within fibroadipose tissue associated with muscle. Vascular invasion was identified in multiple regions. Staining patterns were consistent with specific immunohistochemical markers, though no definitive diagnostic label is provided here.\n\nAll other specimens including peritoneum, phrenic nerve, and superior incision sites either showed no evidence of residual abnormality or demonstrated localized findings without further characterization."} +{"pid": "TCGA-EW-A1OX", "report": "A right breast mass was excised with margins marked as superior, lateral, and deep. The specimen measured 9.0 x 7.5 x 3.5 cm and was submitted for histologic evaluation. A well-demarcated lesion measuring 3.0 x 2.4 x 2.4 cm was identified, located approximately 0.7 cm from the closest margin. Histologic examination revealed a low-grade cellular proliferation with mucinous features. Tubule formation was present in more than 75% of the tumor, nuclei were small and regular, and mitotic activity was minimal, with fewer than 10 mitoses per 10 high-power fields. The Nottingham histologic grade total was consistent with a low-grade morphology.\n\nThe surgical margins, including superior, inferior, lateral, medial, anterior, and deep, were evaluated and showed no evidence of malignant involvement. Additional tissue from the lateral and superior margins also showed no evidence of malignancy. Sentinel lymph nodes (two identified) and non-sentinel lymph nodes (two identified) were examined, and none contained evidence of metastatic disease. Immunohistochemical staining for keratin was performed on lymph nodes and did not show any positivity suggestive of malignancy. Axillary tissue was devoid of lymphoid elements and showed no evidence of disease.\n\nGrossly, the excised breast tissue was fibroadipose in nature with a stroma-to-fat ratio of approximately 30-70%. Microscopic sections from all relevant areas were submitted for evaluation. Intraoperative frozen section analysis of the lateral margin and all lymph nodes was negative for tumor. Estrogen and progesterone receptor status was positive; HER2 testing was negative. No vascular or lymphatic invasion was identified. All immunohistochemical assays were performed using validated laboratory protocols."} +{"pid": "TCGA-XF-AAMQ", "report": "The specimen consisted of a total gastrectomy measuring 24.0 x 11.5 x 5.0 cm with attached mesentery measuring 30.0 x 18.5 x 3.5 cm. The gastric serosal surface was yellow-tan, nodular, and firm. A diffuse infiltrating nodular mass measuring 17 x 8 x 2 cm was identified. The mass was located 5 cm from the proximal margin and 9 cm from the distal margin, extending through the serosa into surrounding perigastric fat in multiple areas. Rugal folds were flattened in the region of the lesion. Multiple lymph nodes were present, with the largest measuring 3.0 x 2.0 x 2.5 cm in the perigastric fat.\n\nFifteen lymph nodes were examined, and eleven were involved. Histologic evaluation revealed invasive cellular growth with poor differentiation. Small vessel lymphatic invasion, large vessel venous invasion, and perineural invasion were all present. Proximal and distal surgical margins were free of involvement. The circumferential (radial) margin was extensively involved.\n\nA separate small bowel segment measuring 4.5 cm in length and 3.9 cm in diameter was submitted. It contained sutures and staples at opposing ends. No gross abnormalities were identified upon examination of the mucosa.\n\nPathologic staging was determined as pT3 N2 Mx. The primary tumor extended through the serosa without invasion of adjacent structures. Metastasis was identified in 7 to 15 regional lymph nodes. Distant metastasis could not be assessed.\n\nAdditional specimens including ureters, lymph node regions, appendix, and prostate with bladder were submitted. No malignancy was identified in intraoperative frozen sections of ureteral margins or resection lines. A bladder lesion measuring 5 x 3.9 cm was identified on the posterior wall with extension through the bladder wall. This lesion was located near the ureteral orifices but did not show seminal vesicle invasion or positive margins. Multiple sections of the prostate, seminal vesicles, and surrounding adipose tissue showed no evidence of malignancy.\n\nLymph nodes from various anatomical locations were submitted, with sizes ranging up to 4.5 cm. Several were found to have histologic features consistent with metastatic involvement. Forty-seven lymph nodes were examined microscopically, none of which showed involvement.\n\nAll margins were uninvolved. No treatment effect was observed. Immunohistochemical testing was performed using validated methods with appropriate controls. Some tests used analyte-specific reagents and were developed in-house without FDA clearance.\n\nThe pathologic stage provided is provisional and based solely on available pathologic data."} +{"pid": "TCGA-55-7283", "report": "The surgical specimens include a right middle lobe wedge resection and a right upper lobe lobectomy, along with a level 8 lymph node excision. In the right middle lobe wedge, a well-circumscribed yellow-tan nodule measuring 1.1 cm in greatest dimension is identified. The nodule approaches within 0.1 cm of the inked margin. Additionally, multiple microscopic foci of tumor are present, measuring up to 0.3 cm in greatest dimension. These foci are located within subpleural lymphatic spaces.\n\nIn the right upper lobe, a yellow-tan mass measuring 7.5 x 5.5 x 3.8 cm is found. The mass abuts the pleura at an area of umbilication and comes within 0.2 cm of the bronchial margin and exposed parenchymal margin. It also approaches within 2.5 cm of the stapled parenchymal margin. Histologically, the tumor demonstrates moderate to poor differentiation. Two foci of bronchioloalveolar carcinoma are identified at the shaved parenchymal margin. Lymphovascular space invasion is present, and the tumor is limited to the pulmonary parenchyma without evidence of visceral pleural invasion. Of the five lymph nodes examined (four peribronchial and one level 8), three contain metastatic disease\u2014two from the peribronchial group and one from level 8. The involved lymph node from level 8 shows metastatic involvement. The tumor is multifocal, and the surgical margins show tumor foci in close proximity. No treatment effect is identified. The lymph node specimen from level 8 reveals a single lymph node with metastatic involvement. The tumor is confined to the lung tissue, and no additional lesions are noted in the uninvolved parenchyma."} +{"pid": "TCGA-OR-A5JE", "report": "The specimen labelled \"left adrenalectomy\" consists of a 45g, irregular and disrupted piece of firm tan tissue measuring 60 x 35 x 40mm. The external surface shows multiple nodular protuberances and areas of orangish/yellow tissue. One nodule measures 26 x 20 x 15mm and is attached to the main mass by thin membranous tissue. The primary lesion measures 35 x 35 x 30mm and has a multinodular appearance with cream specks, predominantly light tan in color. A compressed rim of residual adrenal tissue is present at one edge.\n\nMicroscopic examination reveals a nodular and diffuse neoplasm composed of lipid-depleted cells arranged in nests, trabeculae, and sheets. Nuclear size and shape show wide variation, with moderate pleomorphism in most areas and focal severe pleomorphism (Fuhrman grade 2-3). Some cells contain PAS-positive, diastase-resistant globules. Mitotic figures are numerous, up to 12 per 10 high-power fields, with rare atypical mitoses. Extensive necrosis is present. Thin and thick fibrous bands separate the nodules. The surrounding capsule is disrupted, with focal infiltration of tumor cells through the capsule. Tumor involvement is seen at the focally involved resection margin (blocks A4 & A8). Evidence of sinusoidal permeation and endothelial-lined space permeation is noted, along with occasional microscopic foci of infiltration into adjacent fatty tissue. Scant non-neoplastic adrenal tissue remains at the tumor periphery.\n\nImmunohistochemistry demonstrates positivity for synaptophysin and melan-A, with weak focal staining for CD10 and negativity for AE1/AE3, supporting an adrenocortical origin. Cellular features include frequent mitoses, focal nuclear pleomorphism, necrosis, and vascular invasion, all contributing to the assessment of malignancy."} +{"pid": "TCGA-B0-5702", "report": "The specimen consists of a left kidney resected via laparoscopic nephrectomy. Gross examination reveals a unifocal lesion located in the upper pole, measuring 5.3 cm in greatest dimension, with additional measurements of 4.5 x 3.5 cm. The tumor is confined within the renal capsule without extension beyond the organ. Microscopic evaluation demonstrates cells with clear cytoplasm and prominent cystic change, accompanied by areas of necrosis and myxoid degeneration. Nuclear grading according to Fuhrman criteria is grade II out of IV. All surgical margins are free of tumor involvement. There is no evidence of invasion into the renal vein or angiolymphatic structures. No lymph nodes were identified for examination. The adjacent non-neoplastic kidney tissue appears normal. Based on these findings, the pathologic stage is pT1b with no regional nodal involvement (pNX) and absence of distant metastasis (pMX). No additional significant pathological findings are noted."} +{"pid": "TCGA-D1-A16Q", "report": "The specimen consists of a uterus with bilateral fallopian tubes and ovaries, submitted following hysterectomy and bilateral salpingo-oophorectomy. A polypoid mass measuring 8.2 x 4.5 x 1.4 cm is present, involving the entire endometrial cavity, extending into the lower uterine segment and endocervix. The deepest invasion is noted in the endocervix, where there is infiltration to a depth of 1.4 cm within a total endocervical thickness of 1.8 cm. Superficial invasion into the myometrium is also observed. Lymphovascular space invasion is identified.\n\nMultiple leiomyomata are present within the myometrium. These include one cellular intramural lesion measuring 5.0 x 4.3 x 3.8 cm, five intramural lesions ranging from 0.4 cm to 4.0 cm in greatest dimension, nine subserosal lesions ranging from 0.6 cm to 3.2 cm in greatest dimension, and two submucosal lesions measuring 0.3 cm and 1.3 cm.\n\nMargins evaluated include the vaginal cuff, right and left parametrium, all of which are negative. The bilateral ovaries and fallopian tubes do not show any involvement.\n\nLymph node evaluation includes multiple lymphadenectomy specimens. On the left pelvic side, 37 lymph nodes are assessed; on the right pelvic side, another 37 are evaluated. Additionally, 16 lymph nodes above and 3 below the inferior mesenteric artery on the right para-aortic region, and 5 above and 6 below the inferior mesenteric artery on the left para-aortic region were examined. All lymph nodes across these regions are negative for involvement.\n\nAdditional specimens including the right and left gonadal vessels are also negative.\n\nStaging based on available surgical materials corresponds to pT2NO according to the AJCC 7th edition (2010). Frozen section consultation confirmed negative margins and absence of tumor involvement in other structures, with holds placed on several specimens pending confirmation.\n\nGrossly, the uterus weighs 390 grams and contains the described mass. The ovaries and fallopian tubes appear unremarkable upon external examination. Adipose and lymphatic tissue aggregates containing lymph nodes were received from various anatomical locations, with counts consistent with those evaluated microscopically."} +{"pid": "TCGA-TN-A7HI", "report": "A right tonsillectomy specimen demonstrated a mass measuring 2.7 x 2.6 x 0.7 cm, with an endophytic growth pattern. Histologic evaluation showed poorly differentiated non-keratinizing cells. Lymphatic and vascular invasion were present, while perineural invasion was not identified. The mass extended to the deep and superior soft tissue margins, with the closest margin being 0 cm. Mucosal margins were free of tumor.\n\nA total of 49 lymph nodes were examined from levels II to IV on the right side. Metastatic involvement was found in two out of 18 level II lymph nodes, with the largest positive node measuring 4 mm. No extranodal extension was observed. Additional surgical resection of the lateral and deep margins showed no residual tumor. A left tonsillectomy specimen showed no evidence of malignancy.\n\nImmunohistochemical staining showed diffuse p16 positivity. HPV testing was negative for HPV16. No neoadjuvant therapy had been administered prior to surgery. All other ancillary studies were unremarkable. Based on these findings, the pathologic stage was determined as pT2 N2b MX."} +{"pid": "TCGA-AF-2687", "report": "The specimen includes an atypical lymph node and a resected rectosigmoid tissue segment. The lymph node is 0.7 cm in greatest dimension, soft, tan-pink, with surrounding yellow adipose tissue, and entirely submitted in one block. The rectosigmoid segment measures 30 cm in length, with proximal and distal margins measuring 5.0 cm and 9.03 cm in circumference, respectively. A centrally necrotic, tan-pink to red tumor mass measuring 8.0 x 5.2 cm is present, with raised rolled edges located 4 cm from the distal margin. The tumor has a maximal thickness of 1.6 cm, extends through the muscularis propria, and approaches within 0.5 cm of the serosal surface and 3 cm of the adventitial surface. The remaining mucosa appears unremarkable, with normal folds and a wall thickness averaging 0.6 cm. A few diverticula are noted. Multiple lymph nodes up to 1.0 cm in size were identified in the mesocolon and submitted across 15 blocks.\n\nMicroscopic evaluation of the lymph node shows reactive changes without evidence of metastatic involvement. The primary tumor is moderately differentiated adenocarcinoma, with invasion through the muscularis propria into pericolonic fat (pT3b). The tumor is negative at the proximal, distal, and circumferential margins, with the closest distance to the adventitial margin being 3 cm. Vascular invasion is not identified. Of 16 lymph nodes examined, 6 contain metastatic involvement, with the largest focus measuring 1.6 cm (pN2). There is very focal pericolonic tumor extension beyond the primary mass. Stromal sclerosis, surface ulceration, and mild lymphocytic infiltration are present. No significant inflammatory changes or other notable findings are identified. Distant metastasis could not be assessed."} +{"pid": "TCGA-BQ-7062", "report": "The clinical history notes bilateral renal masses, with a cystic mass on the right and a solid mass on the left. A partial nephrectomy specimen from the left kidney was submitted for evaluation.\n\nGross examination revealed a wedge-shaped renal specimen measuring 5.0 x 4.9 x 3.1 cm. A well-circumscribed yellow-brown granular lesion measuring 3.8 x 3.0 x 2.7 cm was identified, with a thin rim of adjacent red-brown renal parenchyma. The deep margin was inked black, and the closest margin measured 0.3 cm from the tumor. Sections were taken from the tumor, surrounding tissue, and margin for frozen section and permanent processing.\n\nMicroscopic evaluation showed cells with eosinophilic cytoplasm and focally high-grade nuclei. No local invasion or renal vein involvement was identified. Surgical margins were free of tumor. Non-neoplastic kidney tissue showed glomerular and vascular changes noted on PAS staining. No adrenal tissue or lymph nodes were identified in the specimen.\n\nStaging criteria indicate the tumor is confined to the kidney and measures less than 7.0 cm in greatest dimension. Multiple sections were examined, including control, tumor, and margin samples. Intraoperative frozen section confirmed the presence of a renal cortical neoplasm with benign margins, consistent with the final diagnosis."} +{"pid": "TCGA-IE-A4EK", "report": "A radical resection specimen from the retroperitoneal region adjacent to the right kidney was examined. The specimen weighed 1,230 grams and included abundant attached fat. A mass measuring 6.5 x 5.0 x 4.5 cm was identified at the renal hilum. It appeared firm, well-circumscribed, and grossly invaded the renal vein. No definitive invasion into the renal parenchyma was observed. The ureteral margin and vascular margin were negative for tumor involvement. However, microscopic evaluation revealed that the tumor was focally present at the soft tissue margin. The cut surface of the mass was white-tan and fleshy with a vaguely nodular appearance.\n\nHistologic examination showed low-grade morphology with a mitotic count of 3 per 10 high-power fields. There was no evidence of necrosis. The tumor extended into the renal vein but did not involve the renal parenchyma. Sections from the renal parenchyma demonstrated normal architecture without significant pathological changes. A single small cystic structure was noted in the kidney.\n\nNine lymph nodes from a paracaval lymph node dissection were evaluated, and none showed evidence of malignancy. Intraoperative frozen section analysis confirmed negative ureteral and vascular margins, while the soft tissue margin was focally positive with less than 1 mm clearance.\n\nThe case was staged as pT1b based on the primary tumor characteristics, with no regional lymph node involvement (pN0) and indeterminate distant metastasis status (pMX). Ancillary studies were not performed. All findings were incorporated into the final report following microscopic examination of submitted sections."} +{"pid": "TCGA-EL-A4KG", "report": "The surgical specimen from a female patient includes a right thyroid lobe and isthmus measuring 3.5 x 3.0 x 1.5 cm and 1.0 x 0.5 x 0.5 cm, respectively. Serial sectioning revealed a white mass measuring 2.0 x 1.5 x 1.0 cm located in the middle to lower portion of the right lobe. The mass extends into surrounding fibroadipose tissue. No lymphovascular invasion was identified. All resection margins were negative. One lymph node was examined and showed no evidence of tumor involvement. Parathyroid tissue was also evaluated and did not show any signs of tumor. A separate evaluation of parathyroid tissue from multiple sites, including the right inferior and superior regions as well as midline tissue, revealed hypercellular parathyroid tissue. The left thyroid lobe contained a colloid nodule measuring 1.1 x 1.0 x 0.7 cm, located primarily in the superior pole. The remainder of the thyroid tissue appeared normal. All relevant sections were submitted for analysis."} +{"pid": "TCGA-05-4395", "report": "The specimen shows a locally advanced lesion in the left upper lobe of the lung, peripherally located at the boundary of segments 1 and 3. Histologically, the lesion exhibits a mixed pattern with prominent mucin production, displaying predominantly large-cell and polymorphocellular features arranged in solid and small acinar configurations. The lesion measures according to TNM classification as pT4 with regional lymph node involvement classified as pN2. Vascular invasion is present (V1), and due to the orientation of the resection margin, it cannot be definitively determined whether the tumor reaches the margin, resulting in an RX classification. \n\nThe lesion has focally extended into the parietal pleura at the site of a pleural adhesion and may extend along the hilar vasculature into the superior lobe hilum. In this region, there is also involvement of parabronchial lymph nodes. A separate satellite focus is identified in segment S3. Additionally, metastatic involvement is noted in one lymph node from sample 3. No tumor involvement is seen at the bronchial or vascular resection margins, nor in the pericardial tissue or lymph nodes from samples 4 and 5."} +{"pid": "TCGA-V5-AASV", "report": "The specimen consists of a biopsy from an esophageal mass, with microscopic evaluation revealing abnormal squamous epithelium. The tissue shows features consistent with high-grade dysplasia, with areas that are at least in situ. There are also focal regions that raise concern for possible deeper involvement. No definitive invasion is confirmed, however, certain elements suggest the presence of more advanced changes. Three slides were reviewed as part of this case. The material was received from the Surgical Pathology Division for evaluation. A second review was conducted and the findings were confirmed. All diagnostic assessment was personally performed and certified by the evaluating pathologist."} +{"pid": "TCGA-UF-A7JK", "report": "The specimen originated from the larynx. A recurrential node showed no evidence of neoplastic involvement (0/1). Neck resection on the left side included five lymph nodes, none of which were involved (0/5). Another recurrential node on the left showed changes suggestive of metastatic involvement in one lymph node, with focal disruption of its architecture and associated capsular changes along with desmoplasic reaction (1/1).\n\nA total laryngectomy was performed. The tumor measured 5.5 cm and was located in the larynx. Histological evaluation showed moderately differentiated cells with features of keratinization. Ulceration was present. There was a minimal lymphocytic infiltrate within the tumor. Desmoplasia was also noted. The lesion extended into the mucosa, cartilage plane, and skeletal muscle. Lymphatic invasion was identified, while vascular invasion was not observed. Neural invasion was minimal within the tumor bed. The thyroid gland showed no signs of neoplastic involvement but exhibited chronic lymphocytic thyroiditis.\n\nIn the lymph node assessment, two out of eleven nodes showed evidence of involvement without extension beyond the capsule (2/11)."} +{"pid": "TCGA-KB-A6F7", "report": "The specimen was received from a facility and included multiple resected tissues. A total gastrectomy with splenectomy was performed, along with removal of surgical waste, gallbladder, proximal stomach, and distal and proximal ring margins.\n\nGross examination of the total gastrectomy specimen showed a polypoid lesion located on the posterior wall and lesser curvature of the stomach. The lesion measured 5.5 x 2.7 cm in diameter with a depth of invasion into the submucosa. The cut surface appeared white-tan with a central well-defined nodule measuring 1.0 cm. No perforation was noted. The tumor was situated 3.7 cm from the proximal margin, 12.0 cm from the distal margin, and 0.5 cm from the radial margin. Four small benign-appearing polyps were identified within the noncancerous gastric tissue, ranging from 0.2 to 0.4 cm in size and located approximately 9.2 cm from the distal margin. The spleen, adherent to the greater omentum, measured 10.0 x 6.0 x 3.4 cm and showed no gross abnormalities. Multiple lymph nodes were identified along the greater and lesser curvatures of the stomach.\n\nMicroscopically, the lesion was composed of poorly differentiated adenocarcinoma of intestinal type. Within the tumor, there was a focal area showing neuroendocrine differentiation characterized by rosette formation and specific immunostaining features. Lymph node evaluation revealed one involved lymph node out of 30 examined. All surgical margins, including proximal, distal, and radial, were free of tumor involvement. There was no evidence of lymphatic, venous, or perineural invasion. Background gastric tissue showed moderate chronic gastritis and intestinal metaplasia. Additional findings included fibroadipose tissue from surgical waste and a normal gallbladder without pathological changes.\n\nAdequate tissue sampling was performed, including frozen sections of margins and multiple lymph node blocks. Immunohistochemical staining demonstrated positivity for low molecular weight cytokeratin, pancytokeratin, and CK19; focal positivity for CK20 was also observed. Neuroendocrine components showed positivity for synaptophysin and GFAP but were negative for neurofilament. Mismatch repair proteins were retained, and the tumor was negative for EBV."} +{"pid": "TCGA-E7-A678", "report": "The specimen consists of bladder tissue containing a lesion measuring 4 x 4 x 3.5 cm with poorly defined margins. The lesion has a soft consistency and gray-colored surface. Microscopically, the cells are arranged in papillary formations, nests, clusters, and cords. The cells exhibit moderate amounts of eosinophilic or clear cytoplasm. Nuclear features include enlargement, variability in size and shape, irregular nuclear contours, prominent nucleoli, and altered chromatin distribution. Mitotic figures are present. There is evidence of infiltration into adjacent fat tissue. Histologic evaluation shows moderately differentiated features. No lymph nodes were identified for assessment. The surgical margins are free of involvement. No additional findings were noted."} +{"pid": "TCGA-ET-A3DV", "report": "The specimen consists of a total thyroidectomy. The right lobe is enlarged, measuring 5.5 x 4 x 3 cm, while the left lobe measures 3 x 2 x 0.7 cm. The combined weight of the thyroid is 37 grams. On sectioning, a solitary tan-brown nodule is identified within the right lobe, measuring 4.2 x 3.2 x 2.7 cm. The nodule is well-defined and thinly encapsulated, with focal extension into the tumor capsule. No clear evidence of vascular invasion is observed. All surgical margins are free of involvement. The surrounding thyroid tissue shows changes consistent with nodular hyperplasia. One lymph node and associated fibroadipose tissue are also present and do not show any abnormal involvement. A total of 15 tissue blocks were submitted for analysis, including the entire right lobe with capsule, isthmus, and left lobe."} +{"pid": "TCGA-F2-A44H", "report": "The surgical specimen includes a Whipple resection consisting of the stomach, head of the pancreas, duodenum, and common bile duct. The pancreatic head measures 4 x 3 x 1.5 cm. A solid, firm, tan/white mass measuring 3.5 x 3.0 x 2.5 cm is identified in the head region. The tumor extends into the peripancreatic soft tissues and demonstrates perineural invasion. No lymphatic or venous invasion is identified. The tumor involves the pancreatic duct and is present within the peripancreatic soft tissues. \n\nMultiple tissue margins were evaluated microscopically. The pancreatic neck, bile duct, posterior pancreatic surface, peripancreatic soft tissues, proximal (gastric), and distal (duodenal) margins are all negative for involvement. The uncinate process margin is also negative with a distance of less than 0.1 cm from the tumor.\n\nA total of eight regional lymph nodes were examined, including one superior pancreatic lymph node and one aortocaval lymph node, none of which show evidence of malignancy. Lymph nodes ranged in size from 0.5 to 2.0 cm. No other remarkable findings are noted.\n\nThe tumor is histologically classified as moderately differentiated. The gross assessment of the tumor suggests it is confined to the pancreas with no definitive extension into the ampulla, duodenum, or adjacent vessels. There is possible involvement of the bile duct wall. The specimen was fixed in formalin and fully submitted for analysis. No special investigations or digital photographs were taken. \n\nIntraoperative frozen section analysis was performed on the bile duct and pancreatic duct margins, both of which showed no evidence of tumor involvement."} +{"pid": "TCGA-PC-A5DK", "report": "The specimen was obtained from a male patient and consisted of a right adrenal mass. The collected tissue included a bosselated gray-tan rubbery mass measuring 10 x 9 x 9 cm with attached fat up to 5 cm in greatest dimension. On sectioning, the adrenal gland measured 3 x 1.5 x 1.3 cm and appeared grossly normal. The mass demonstrated a bulging white whorling surface without hemorrhage, cystic areas, or calcifications. Gross evaluation indicated that the mass was separate and did not involve the adrenal gland.\n\nMicroscopic evaluation revealed increased cellularity and nuclear atypia with a low mitotic rate (approximately 1\u20132 per 10 high-power fields), including rare atypical mitoses. No necrosis was identified. Immunohistochemical staining showed positivity for desmin and muscle-specific actin (HHF35), while stains for CD34, C-kit, S100, and HMB45 were negative.\n\nRepresentative sections were submitted for analysis, with selected sections used for frozen section evaluation. The case was reviewed and findings were concurred. All immunohistochemistry tests were performed by a laboratory certified under CLIA for high-complexity testing. These tests are clinically validated but not FDA-cleared; however, they are approved for clinical use and not considered investigational or research-based."} +{"pid": "TCGA-IB-A6UG", "report": "The specimen was received from a male patient. Two specimens were submitted: one identified as a gallbladder and the other as a Whipple specimen.\n\nThe gallbladder measured 7.0 cm in length and up to 2.5 cm in transverse diameter. It contained mucoid bile and small fragments of calculus material. The mucosal surface appeared green and velvety, with wall thickness measuring up to 0.2 cm. A cystic duct lymph node was present at the proximal resection margin. Histologically, the gallbladder showed features consistent with chronic cholecystitis, without evidence of cytologic atypia or malignancy. The cystic duct lymph node demonstrated macrophage accumulation and areas of hyalinization, but no signs of malignancy.\n\nThe Whipple specimen included a pancreaticoduodenectomy with partial pancreatectomy. The head of the pancreas measured 6.0 cm from superior to inferior, 3.5 cm medially to laterally, and approximately 3.5 cm in thickness. A firm mass was identified encircling the common bile duct, starting 0.8 cm from the ampulla and extending 2.0 cm along the duct. The remaining proximal bile duct measured 2.5 cm from the tumor\u2019s proximal extent. On sectioning, a hard mass occupied about half of the pancreatic head, measuring 3.0 cm (superior-inferior), 2.5 cm (anterior-posterior), and 2.0 cm (medial-lateral). The tumor extended near the retroperitoneal resection margin, with soft friable tissue present on its surface.\n\nMicroscopic examination revealed invasive, moderately to poorly differentiated ductal adenocarcinoma within the pancreatic head. The tumor extended into peripancreatic and retroperitoneal soft tissues, with focal involvement of the uncinate process margin. It invaded through the duodenal muscularis propria and eroded the mucosa of the ampulla of Vater. Lymphovascular and perineural invasion were present. Sixteen of 19 dissected lymph nodes contained metastatic deposits. Focal residual ducts showed PanIN grade II changes.\n\nResection margins were variably involved: the uncinate process margin was positive, while the pancreatic neck and proximal bile duct margins were free of tumor. No involvement of the celiac axis or superior mesenteric artery was observed. Additional findings included multiple lymph nodes in the peripancreatic, gastroduodenal, and distal gastric regions, some of which were enlarged and firm.\n\nStaging was determined as pT3, indicating extension beyond the pancreas without major vascular involvement, and pN1 for regional lymph node metastasis. The histologic grade was G3 (poorly differentiated). No neoadjuvant treatment effect was identifiable."} +{"pid": "TCGA-BC-A10R", "report": "A liver specimen from a right hepatic lobectomy was received, weighing 321.2 grams and measuring 6.5 x 13.2 x 6.2 cm. A mass measuring 7.2 cm in the lateral to medial dimension, 3.6 cm anterior to posterior, and 5.2 cm superior to inferior was identified at the lateral aspect of the specimen. The mass is firm, well demarcated, and tan/white with focal bile staining. It approaches the capsule on the anterior, posterior, and inferior surfaces but does not appear to breach it. A smaller, 0.7 cm well-demarcated nodule is present at the medial side, separate from the main mass. The surgical margin is black and the mass is 1.5 cm from the margin. The remaining liver parenchyma and attached gallbladder show no remarkable findings.\n\nMicroscopic evaluation shows two distinct lesions. The larger lesion and the smaller nodule both display moderately differentiated cellular features with a cord-like pattern and moderate nuclear atypia. The larger lesion closely approaches the hepatic capsule but does not invade through it. Lymphovascular space invasion is present in the area near the gallbladder bed. The surrounding non-neoplastic liver tissue shows evidence of bile stasis, primarily intrahepatocellular, along with mild bile duct proliferation and scattered neutrophilic aggregates in portal areas and sinusoids. Mild portal lymphocytic infiltrates are also present, consistent with mild chronic inflammation. No viral cytopathic effect, iron accumulation, fibrosis, or cirrhosis is observed. Small foci of macrovesicular steatosis are noted.\n\nAll surgical margins are free of abnormal cellular findings. The gallbladder shows no specific pathological changes."} +{"pid": "TCGA-QR-A70O", "report": "The left adrenal gland specimen consists of a red-tan ovoid nodule measuring 4.5 x 4.0 x 2.3 cm, along with a smaller nodule measuring 2.8 x 2.2 x 1.0 cm that is attached to fat tissue measuring 3.5 x 3.5 x 1.0 cm. The larger nodule and surrounding tissue were inked, and gross photographs were taken. A small portion of tissue (approximately 3\u20134 mm) was removed for research purposes prior to fixation. Roughly 50% of the tissue was processed fresh, while the remainder was fixed in formalin and submitted for permanent histologic evaluation. Additionally, a separate specimen labeled as \"left periadrenal fat\" was received and consisted of unremarkable adipose tissue measuring 0.5 x 0.4 x 0.3 cm. The main specimen was serially sectioned and representative sections were submitted for microscopic analysis in eight cassettes. No consultant review was required."} +{"pid": "TCGA-CV-7102", "report": "The pathology report describes a surgical specimen involving multiple anatomical regions. The specimen includes bilateral neck dissections and subtotal mandibulectomy with glossectomy. Gross examination reveals a tumor measuring 4.7 x 2.7 cm located in the right aspect of the floor of the mouth. The tumor is ulcerated and filled predominantly with necrotic material, extending 0.7 cm into underlying soft tissue. Margins measured include 0.8 cm from the posterior mucosal margin of the floor of the mouth, 0.8 cm from the left anterior mucosal margin, and 1.9 cm from the left alveolar mucosal margin. The tumor extends into the right aspect of the tongue.\n\nHistologic evaluation shows moderate to severe dysplasia at the lateral and inferior resection margins; other margins are free of tumor involvement. A total of twelve left cervical lymph nodes are identified without evidence of tumor involvement. On the right side, metastatic involvement is identified in three out of twelve cervical lymph nodes. Metastasis is also noted in soft tissues within level 3 on the right side. No extranodal extension exceeding 3 mm is observed in level 2 lymph nodes.\n\nAdditional findings include chronic inflammation in the left maxillary gland. Multiple lymph nodes were sampled during bilateral neck dissections. The largest lymph node measures 4.2 cm on the right side at level 2, and the second largest measures 2.8 cm at level 1 on the same side.\n\nMargins evaluated microscopically include peripheral nerves on both proximal and lingual aspects, which are negative for tumor involvement. A newly defined deep margin from the right tongue demonstrates squamous mucosa without tumor presence. Similarly, the mucosal surface of the left ventral floor of the mouth reveals no dysplasia or tumor involvement.\n\nThe specimen includes teeth: six on the right side (three front teeth, two premolars, one molar) and six on the left side (three anterior teeth, two premolars, one molar). Gross evaluation of submitted teeth showed no tissue submitted for histologic examination.\n\nSubmitted specimen dimensions include a proximal soft tissue fragment measuring 0.6 x 0.2 x 0.1 cm and a lingual fragment measuring 0.7 x 0.2 x 0.1 cm. The overall specimen dimensions are 13.0 x 10.0 x 7.0 cm, encompassing various anatomical structures including segments of the mandible and tongue.\n\nSections examined microscopically reveal focal severe dysplasia at the resection margin and nodularity in the tongue specimen; however, no distinct tumor mass was identified in certain areas. All lymph nodes have been submitted for evaluation, with tumor involvement documented only on the right side.\n\nMeasurements and descriptions provided throughout the report emphasize spatial relationships between the tumor and surgical margins, as well as lymph node involvement bilaterally."} +{"pid": "TCGA-ZM-AA06", "report": "The specimen consists of a right testicular tumor measuring 7 \u00d7 5.5 \u00d7 4.5 cm, with a funiculus measuring 9 cm in length and 2.5\u20133 cm in diameter. The tumor is nodular with white-tan cut surface and contains areas of hemorrhage and necrosis. It occupies approximately 6.2 \u00d7 5 \u00d7 4.5 cm within the testicle. Histologically, the lesion forms solid cellular clusters composed of round and oval cells with clear to moderately abundant cytoplasm and well-defined nuclei. Smaller nuclei are noted within the tumor cell population. Scattered lymphocytic infiltrates are present at the periphery of tumor cell nests. Mitotic figures are observed at a rate of up to five per large microscopic field. Syncytiotrophoblast giant cells are identified in several regions. Adjacent non-neoplastic testicular tissue appears largely atrophic. The tumor extends into the tunica albuginea and adjacent vascular spaces but does not involve the rete testis, epididymis, or funiculus."} +{"pid": "TCGA-ZC-AAAF", "report": "The mediastinal mass specimen shows a lobular architecture with a predominantly lymphocyte-rich composition. Focally, areas exhibit a biphasic pattern composed of spindle cells and scattered lymphocytes. The tumor is surrounded by a capsule-like border in limited sections. It extends into the surrounding mediastinal fat, approaching the inked resection margin; however, no tumor transection is observed microscopically, indicating an R0 resection. Central regions demonstrate extensive regressive changes consistent with necrosis. The tumor infiltrates the adventitia of nearby veins but does not extend into the vascular lumen. Adjacent thymic tissue appears age-appropriate, with preserved corticomedullary differentiation, absent prominent Hassall's corpuscles, and no signs of thymitis. Lymph nodes within the mediastinum are small, show minimal activation, and lack significant follicular hyperplasia or germinal center expansion. Cytological atypia is noted in the lymphocyte-poor regions. Histological evaluation confirms complete resection with no residual disease at the margins."} +{"pid": "TCGA-CN-5374", "report": "The patient presented with a history of metastatic disease involving the left neck, with an unknown primary origin. A pre-operative diagnosis of pharyngeal cancer was made, and this was confirmed post-operatively following a lopsy-tonsillectomy procedure.\n\nThe surgical specimen was received in three parts. Part 1 consisted of multiple small soft tissue fragments from the left base of the tongue, all submitted for processing. Microscopic examination of these tissues revealed only squamous mucosa with lymphoid tissue; no tumor was identified.\n\nPart 2 was a left tonsil measuring 3.1 x 2.2 x 1.5 cm. Upon sectioning, a well-circumscribed tan gritty lesion measuring 2.1 x 2.0 x 1.4 cm was identified. This lesion showed moderate to poor differentiation and approached the deep resection margin by less than 0.1 cm. The majority of the tumor had been banked prior to submission to pathology. Tissue remaining after banking was entirely submitted for histologic evaluation, with special attention to the relationship of the lesion to the resection margin.\n\nPart 3 consisted of the right tonsil, measuring 2.0 x 1.2 x 0.9 cm. Gross and microscopic examination revealed hyperplastic tonsillar tissue without evidence of malignancy.\n\nIn situ hybridization testing for Human Papilloma Virus (HPV) was performed on relevant sections and returned positive. All immunohistochemistry and molecular tests were developed and verified within the laboratory under CLIA certification for high-complexity testing. No placeholder or unconfirmed diagnosis was used in reporting these findings.\n\nMicroscopic evaluation of all submitted tissues confirmed the presence of a moderately to poorly differentiated invasive lesion within the left tonsil, with close proximity to the deep margin. No tumor was found in either the right tonsil or the base of the tongue biopsy."} +{"pid": "TCGA-D5-6532", "report": "Histopathological examination was performed on a resected segment of the large intestine measuring 21 cm in length, with associated fat tissue measuring 22 x 10 x 5 cm. A mucosal lesion measuring 8 x 5 x 1.5 cm was identified, with ulceration present. The lesion involves approximately 55% of the intestinal circumference and causes luminal narrowing. It is located 11 cm from one resection margin and 2 cm from the opposite margin. Macroscopic evaluation indicates extension into the surrounding fat tissue. Microscopically, the lesion demonstrates infiltration into the muscularis propria and pericolonic adipose tissue. The histological pattern is tubular, with moderate differentiation. Resection margins are free of malignant cells. Reactive lymph node changes were observed, with no evidence of metastatic involvement. Tumor staging based on pathological findings is pT3, pN0, with no residual tumor at the surgical margins."} +{"pid": "TCGA-D8-A1JI", "report": "Histopathological examination was performed on a female patient following multiple organ resection involving the right breast and axillary tissue. The specimen included a skin flap measuring 24 x 17 cm, with the breast itself measuring 35 x 23 x 9 cm and weighing 1,400 g. Axillary tissues measured 13 x 8 x 4 cm. A lesion measuring 1.9 x 1.4 x 1.8 cm was identified in the upper outer quadrant of the breast, located approximately 6 cm from the upper boundary, 2 cm from the base, and 1.8 cm from the front surface. Lymph nodes were present, with the largest measuring 2.4 cm in length.\n\nMicroscopic evaluation revealed a proliferation of cells arranged in a glandular pattern. Within the lesion, there was a low mitotic count, with 2 mitoses observed per 10 high-power fields. Adjacent non-neoplastic breast tissue showed changes consistent with fibrocystic disease, including ductal hyperplasia, sclerosing adenosis, and cyst formation.\n\nExamination of axillary lymph nodes demonstrated the presence of neoplastic cell clusters within two of the twenty-two nodes assessed. Involvement included capsular breach and extension into surrounding perinodal tissue. Vascular emboli containing neoplastic cells were also noted. Immunohistochemical staining showed estrogen receptor positivity in 10\u201375% of nuclei and progesterone receptor positivity in more than 75% of nuclei. HER2 staining using the HercepTest\u2122 by DAKO yielded a score of 1+, indicating no overexpression in the invasive component.\n\nStaging parameters indicated a tumor grade corresponding to NHG2, with a primary tumor size category pT1c. Lymph node involvement was classified as pN1a."} +{"pid": "TCGA-21-1072", "report": "The specimen was received in six parts. Specimen #1, labeled as a portion of rib, measures 1.4 cm in length with an average diameter of 0.7 cm and includes a small amount of attached soft tissue. A representative section was submitted for analysis following decalcification. Specimen #2, identified as a lymph node from the left level 9 region, measures 0.6 x 0.5 x 0.3 cm and contains a focal area of dark pigmentation. Specimen #3, a level 7 lymph node, consists of two fragments of dark-colored tissue measuring 1.3 x 0.9 x 0.4 cm with similar pigmentation. Specimen #4, located near the inferior pulmonary vein, is a gray-tan lymph node measuring 1.3 x 0.6 x 0.5 cm with staining suggestive of pigmentation. All lymph nodes were submitted entirely for examination.\n\nSpecimen #5 corresponds to the left lung and was processed fresh for frozen section evaluation. The entire lung specimen measures 22.0 x 14.5 x 3.0 cm and includes a bronchus measuring 4.0 cm in length and 2.0 cm in diameter. The pleural surface shows diffuse areas of pigmentation but no visible abnormalities such as puckering or firmness. Dissection of the bronchial tree revealed a mass within the upper bronchus; this mass is soft and pink-tan in appearance, measuring up to 2.4 x 2.5 cm. Mucous plugs are present in the surrounding lung tissue, and no involvement of adjacent blood vessels is observed. Frozen section analysis of the bronchial margin was negative. Multiple sections were taken from different areas including vascular margins, lymph nodes, bronchus, tumor site, adjacent lung tissue, and normal lung.\n\nSpecimen #6, a level 5 lymph node, measures 1.2 x 0.9 x 0.5 cm and shows similar pigmentation; it was bisected and submitted completely for analysis. Microscopic evaluation of all specimens did not reveal any abnormal growth in the rib or lymph nodes examined. In the lung specimen, the mass was fully assessed and found to be limited to the bronchus without extension to surgical margins or regional lymph nodes. No cancer cells were identified at the vascular, bronchial, or pleural margins. The surrounding lung tissue showed signs of collapse but no malignant changes."} +{"pid": "TCGA-BG-A0LW", "report": "The surgical specimen included the uterus with both adnexa, weighing 96 grams, submitted following a total abdominal hysterectomy and bilateral salpingo-oophorectomy. The endometrial surface showed involvement of approximately 70%, with infiltration into less than 5% of the myometrium. Histologic evaluation demonstrated moderately differentiated epithelial neoplasm with combined architectural and nuclear features consistent with FIGO grade 2. Architectural differentiation was moderate, and nuclear grading was classified as grade 2. The tumor measured up to 40 mm in maximum dimension. Invasion depth varied across regions of the endomyometrium: anterior involvement was approximately 20%, posterior was approximately 50%. Overall invasion remained confined to less than half the thickness of the myometrium. Focal lymphovascular space involvement was identified. Adjacent tissue demonstrated atypical complex hyperplasia. No tumor involvement was detected in the cervix, distal cervical segment, or pelvic lymph nodes\u2014six lymph nodes were examined and all were negative. Chronic cervicitis was noted without evidence of tumor. Both fallopian tubes contained paratubal cysts. The ovaries exhibited stromal hyperplasia and small adenofibroma with calcifications. Pelvic wash cytology was negative for malignant cells. There was no evidence of metastasis or residual tumor beyond the primary site."} +{"pid": "TCGA-AN-A0AL", "report": "Female patient with tumor located in the left breast, identified as primary. The tumor specimen was collected via surgery and preserved in OCT medium within a block container. Histological evaluation revealed infiltrating cells, with nuclear grade 2. Tumor dimensions indicate advancement, though no lymph node or distant metastasis was observed. No prior treatment was administered. A separate blood sample was collected, preserved in frozen format within a tube container, serving as a normal reference sample."} +{"pid": "TCGA-CH-5745", "report": "The specimen shows a predominantly poorly differentiated multifocal lesion within the prostate with extensive growth across the gland. The largest measured lesion is 1.6 cm in maximum diameter. There is infiltration of periprostatic fatty tissue in the right rectolateral and right anterior regions, with invasion fronts measuring 1 mm and 2 mm respectively, and minimal depth of involvement. Widespread multifocal involvement of perineural sheaths is noted. Surgical margins are tumor-free, with no residual tumor identified at the blue and green-labeled margins, suggesting complete excision. High-grade intraepithelial neoplastic foci are present, along with myoglandular hyperplasia and focal metaplastic squamous epithelium in the prostatic urethra. Seminal vesicles and ducts appear unremarkable without involvement. Lymph node assessment reveals no involvement in the right (2 nodes) or left (3 nodes) obturator fossa regions. Histopathological staging is pT3a with no nodal involvement (pN0, 0/5 nodes) and absence of vascular or lymphatic invasion (L0/V0). Immunohistochemical analysis of representative blocks confirms absence of vascular invasion. All margins are free of tumor, consistent with complete resection."} +{"pid": "TCGA-DX-A1KZ", "report": "The resected specimen from the retroperitoneal region, right kidney, and adrenal gland consists of a large, lobulated mass measuring 30 x 25 x 6 cm and weighing 1825 grams. The mass is heterogeneous with areas of necrosis, hemorrhage, and tan-yellow smooth nodules. Microscopically, the tumor demonstrates a range of morphological features, including high-grade malignant growth patterns and focal areas resembling low-grade myxoid and well-differentiated subtypes. The predominant component is high grade and shows extensive viability. The tumor invades the kidney parenchyma, and the adrenal gland is focally involved by the lower-grade component. Although the outer surface appears to be lined, microscopic evaluation reveals tumor extension to the inked margin. Vascular and ureteral margins are free of tumor. A small benign incidental finding is noted in the kidney. A separate excision of the right colon and hepatic flexure shows no evidence of tumor involvement. The final liver margin specimen reveals only reactive changes and subcapsular hemorrhage, with no tumor identified. All relevant sections have been submitted for evaluation."} +{"pid": "TCGA-HZ-7289", "report": "The specimen was received in seven containers. Container A, labeled \"omental implant,\" contained a 1.0 cm yellow-tan fibrofatty soft tissue. Histologic examination showed benign fibroconnective and fibroadipose tissue with no evidence of malignancy. Intraoperative consultation corroborated these findings.\n\nContainer B, labeled \"gallbladder,\" measured 8.5 x 4.8 x 4.0 cm. The gallbladder was intact with a serosa that appeared purple-pink and glistening. The lumen contained yellow-tan viscid bile and multiple gray-green multifaceted choleliths measuring up to 6.0 x 4.5 x 2.0 cm. The wall averaged 0.2 cm in thickness. Microscopic evaluation revealed chronic cholecystitis and cholelithiasis; no tumor was identified. Intraoperative frozen section confirmed this finding.\n\nContainer C, labeled \"gastroepiploic lymph node,\" contained a 4.5 x 2.0 x 1.0 cm yellow-tan fibrofatty soft tissue. On sectioning and palpation, suture material was identified, but no discrete lymph node was found. Histology showed benign fibroadipose tissue with acute inflammation and fat necrosis, with no lymph node identified.\n\nContainer D, labeled \"celiac lymph node,\" contained a 0.9 x 0.7 x 0.5 cm yellow-gray rubbery soft tissue. Frozen section and subsequent permanent section showed peripheral nerve and fibroconnective tissue, with no lymph node identified.\n\nContainer E, labeled \"lower pancreatic neck,\" measured 1.5 x 0.7 x 0.3 cm. Histology showed fibrotic stroma with entrapped pancreatic ductal structures and no evidence of malignancy. Intraoperative consultation corroborated this result.\n\nContainer F, labeled \"upper pancreatic neck,\" measured 1.4 x 1.0 x 0.3 cm. Histologic sections showed atypical glandular epithelium suspicious for invasive well-differentiated adenocarcinoma. No definitive carcinoma was seen in the pancreatic neck margin (G1). Sections from the uncinate process (G2) and common bile duct (G4) showed fibrosis and atypical glands, though not definitively diagnostic of malignancy.\n\nContainer G, labeled \"duodenum, pancreas,\" contained a Whipple resection specimen. The duodenum measured 16.5 cm in length and ranged from 3.5 to 5.0 cm in diameter. The pancreatic head measured 6.0 x 6.0 cm, and the common bile duct measured 1.0 x 0.5 cm. On opening, the duodenal wall averaged 0.9 cm in thickness. Two ampullae were identified. Surrounding the pancreatic ampulla was a pink-tan papillary mucoid mass measuring 4.5 x 4.0 x 2.0 cm. This mass extended into the main pancreatic duct and approached within 0.2 cm of the pancreatic neck margin. It also approached within 0.1 cm of the inked pancreatic margin at the superior, inferior, anterior, and posterior surfaces. Microscopically, the lesion produced abundant mucin that extravasated into the surrounding parenchyma. Areas of invasive glands were present within the pancreatic stroma. Focal perineural invasion was noted. One lymph node out of nine examined contained small cytologically bland glands consistent with tumor involvement. Lymphovascular space invasion was not identified in the sections submitted. The histologic grade was well differentiated. The proximal and distal duodenal margins and soft tissue pancreatic margins were negative for tumor, although the latter were within 1 mm of the superior, inferior, anterior, and posterior surfaces. A total of nine lymph nodes were examined, with one containing metastatic carcinoma. The pTNM stage was determined as pT3 N1. An accessory spleen was incidentally identified, with no significant histopathologic abnormality. Due to the complexity of the case, expert consultation is pending, and results will be reported as an addendum."} +{"pid": "TCGA-EW-A1P0", "report": "The left breast specimen showed two distinct gray-tan nodules located in the outer quadrant. The first measured 2.0 cm and was situated 1.5 cm from the superior margin and 2.5 cm from the deep margin. The second nodule measured 2.4 cm and was located 2.8 cm from the deep margin. Both lesions were ill-circumscribed and firm on gross examination. Microscopic evaluation revealed invasive, multifocal features with moderate differentiation and mucinous morphology. Histologic grading using the Nottingham system yielded a score of 6 (2+2+2), with individual scores of 2 for tubule formation, nuclear pleomorphism, and mitotic count.\n\nLymph node assessment included 21 nodes examined from the left axillary dissection; one node contained metastatic involvement. Additionally, perinodal invasion was identified in this region. No evidence of metastasis was found in the right axillary nodes (0/2) or in other sampled areas. Venous or lymphatic invasion was not present. Immunohistochemical staining showed positivity for ER but was negative for PR and Her2.\n\nMargins were uninvolved by invasive disease, with the closest distance being 1.5 cm from the superior margin. The mastectomy specimen measured 21.0 x 21.0 x 6.0 cm. Additional findings included an intradermal nevus and an intraductal papilloma. Other tissue sections, including those from the nipple, areola, skin with verrucous lesions, and other quadrants, were submitted for analysis. Multiple cassettes were used to ensure comprehensive sampling of all relevant areas."} +{"pid": "TCGA-E2-A153", "report": "The left axillary non-sentinel lymph node specimen contains two lymph nodes, with the largest measuring 1.3 x 0.7 x 0.4 cm. One lymph node shows involvement with a focus of cellular infiltration measuring 0.25 cm, with evidence of extension beyond the lymph node capsule. A second lymph node is also identified but does not show similar findings.\n\nThe right breast mastectomy specimen weighs 1154 grams and measures 27 x 17 x 7 cm. It includes a skin ellipse measuring 25 x 9.5 cm and a flattened nipple. Serial sectioning reveals no significant abnormalities or masses in any of the 12 slices examined. No lymph nodes are found within this specimen.\n\nThe left breast mastectomy with axillary contents includes a specimen weighing 1457 grams and measuring 29 x 22 x 7 cm. The skin ellipse measures 24 x 11.5 cm, and the nipple is retracted. A small nodule measuring 0.7 cm is noted adjacent to the nipple, along with several minor skin lesions ranging from 0.2 to 0.4 cm. On serial sectioning into 12 slices, three distinct areas of interest are identified. In slices 5 through 7, a firm tan lesion measuring 2.5 x 2 x 1.8 cm is located in the mid upper region, 3.2 cm from the deep margin and 1.7 cm from the anterior margin. Inferior to this, in slice 8, a second mass measuring 1.7 x 1.7 x 1.5 cm is located 5 cm from the deep margin and 1 cm from the anterior margin. A third, smaller nodule measuring 0.7 cm is present superior to the second mass, approximately 4.3 cm from the deep margin and 1.3 cm from the anterior margin. Markers are placed in slices 6, 7, and 8 for orientation. Multiple axillary lymph nodes are recovered, and representative sections from all areas are submitted for analysis.\n\nMicroscopic evaluation of the left breast tissue reveals multiple distinct foci of abnormal cell growth, primarily in the central region. The largest focus measures 2.5 cm and displays intermediate nuclear features. A portion of this lesion extends toward the nipple without involving the overlying skin. Surrounding ductal structures show changes including solid and cribriform patterns, with areas of central degeneration and microcalcifications. Surgical margins do not show evidence of residual disease. Two of the fourteen lymph nodes examined contain abnormal cells, with the largest involved node measuring 1.3 cm and showing extension beyond the lymph node structure. Additional findings include scarring, granulation tissue, and foreign body reaction likely related to prior biopsy.\n\nHormone receptor testing demonstrates positivity for estrogen and progesterone receptors, while HER2 testing is negative. Histologic grading based on tubular formation, nuclear features, and mitotic activity corresponds to an intermediate grade. Vascular or lymphatic invasion is not observed. A small component of in situ disease is also present, estimated at 5%, both associated with and separate from the main tumor mass.\n\nPathological staging is determined as pT2, N1a, indicating the primary lesion exceeds 2 cm in size and involves 1\u20133 axillary lymph nodes."} +{"pid": "TCGA-EA-A3QE", "report": "The specimen consists of tissue from a hysterectomy with bilateral salpingo-oophorectomy. The tumor is located in the cervix and measures 3 x 2 x 2 cm. Microscopically, the tumor is composed of large cell non-keratinizing cells and is moderately differentiated. The tumor is confined to the endometrium. Fourteen pelvic lymph nodes were examined, and none show evidence of metastasis. Information regarding lymphatic or venous invasion, myometrial invasion, surgical margins, neo-adjuvant treatment, and additional findings is not specified."} +{"pid": "TCGA-V4-A9EM", "report": "Left eye enucleation specimen. The eyeball measures 28 by 20 mm and includes a posterior segment of the optic nerve measuring 7 mm. Upon sectioning, a lesion is identified with a maximum dimension of 17 mm. Samples were obtained for genetic analysis prior to fixation and complete embedding of the specimen. Microscopic examination reveals a tumor predominantly composed of epithelioid cells with frequent melanin pigmentation in the cytoplasm. Nuclear atypia are marked. The mitotic count is low, with 4 mitoses observed per 10 high-power fields. The tumor is situated near the ciliary body and extends into the inner portion of the sclera, while the outer half remains uninvolved. The lesion is located at a distance from the optic foramen. Evaluation of the optic nerve along its entire length shows no involvement, and the cut end is clear. There is no evidence of tumor within the meningeal layers or extra-scleral tissues. No vascular invasion or intra-vascular tumor emboli are identified."} +{"pid": "TCGA-06-1084", "report": "The clinical history indicates a lesion in the left frontal region of the brain. Two biopsy specimens were submitted for analysis. The excised tissue measured 3.6 x 1.7 x 1.2 cm and consisted of irregular pink-tan, hemorrhagic fragments with a soft to rubbery consistency. The tissue was entirely processed into three cassettes for microscopic evaluation.\n\nMicroscopic examination revealed a pleomorphic epithelioid neoplasm with prominent nucleoli. The tumor cells were arranged in a nested pattern in some areas, with occasional gland-like structures containing secretory material. The majority of the tumor consisted of large epithelioid cells, though some regions contained smaller cells with limited cytoplasm. Frequent mitotic figures and apoptotic bodies were identified, along with extensive areas of necrosis. Microvascular proliferation and pseudopalisading necrosis were not prominent. \n\nImmunohistochemical staining showed positivity for GFAP, vimentin, and S100, while HMB-45 and pan-keratin were negative. There was diffuse p53 immunopositivity, and the Ki-67 labeling index ranged from 30 to 40%. Reticulin staining, as well as the GFAP and vimentin patterns, showed a somewhat biphasic distribution. Occasional cytoplasmic EMA positivity was observed in some cells.\n\nMolecular testing on the tissue block detected a methylated MGMT promoter. This finding may be relevant in the context of treatment planning, particularly regarding the potential response to alkylating agent therapy. The test was performed using bisulfite-modified DNA followed by real-time PCR amplification to assess methylation status. It was developed and validated by the laboratory in compliance with CLIA regulations, and is intended to support clinical decision-making rather than serve as a standalone diagnostic tool.\n\nIntraoperative consultation, including frozen section and smear evaluation, confirmed the presence of a malignant neoplasm, with final assessment deferred to permanent sections."} +{"pid": "TCGA-A7-A6VX", "report": "The final surgical pathology report includes the following findings. \n\nA. Left axillary sentinel lymph node excision: Two lymph nodes were identified and examined using multilevel sectioning with hematoxylin and eosin staining, as well as immunohistochemistry for pankeratin. No evidence of metastatic involvement was observed. \n\nB. Left breast excisional biopsy: Histologic evaluation revealed a high-grade infiltrating carcinoma with a greatest dimension of 2.5 cm (pT2). The tumor is located in close proximity to the inferior margin, within less than 0.5 mm. No vascular invasion was identified. Calcifications are present. \n\nIn addition to the invasive component, there is also a component of intraductal proliferation. This demonstrates comedo and solid architectural patterns, high nuclear grade, and central necrosis. This component extends to the posterior margin. It constitutes less than 10% of the total tumor volume. An extensive intraductal component is not present. \n\nMargins of resection: The tumor approaches the inferior margin closely (<0.5 mm). The posterior margin shows involvement by the intraductal component. \n\nHistologic grading of the invasive component: Architectural score \u2013 3, nuclear score \u2013 3, mitotic score \u2013 2, resulting in an overall grade of 3. \n\nGross examination of the left breast specimen showed a soft, lobulated tan-white mass measuring 2.5 cm in its greatest dimension. The specimen margins were inked for orientation (superior \u2013 blue, inferior \u2013 black, anterior \u2013 green, posterior \u2013 orange). \n\nAdditional prognostic markers are detailed in an outside report. \n\nSpecimens submitted include: A. Left axillary sentinel lymph node; B. Left breast biopsy with long suture anterior and short suture superior. \n\nClinical information indicates this is from a female patient with a history of prior diagnosis and treatment planning context. \n\nSummary of tissue sections submitted includes representative blocks from medial to lateral margins, covering the entire lesion."} +{"pid": "TCGA-J8-A3YG", "report": "The surgical pathology report includes findings from three specimens. The first specimen, a right thyroid lobe and isthmus, contains a 2.5 cm lesion located within the thyroid capsule. Histologic evaluation reveals cellular features of interest, with focal concern for vascular invasion. A lymph node from the parathyroid region shows involvement by atypical cells. The second specimen, the left thyroid lobe, contains a smaller lesion measuring 0.8 cm, also confined within the capsule. Additionally, two microscopic foci each less than 1 mm are identified in random sections of the parenchyma. Vascular invasion is noted in this lobe as well. The third specimen consists of excised central compartment lymph nodes. Of the eight nodes identified, five show involvement by atypical cells. Two parathyroid glands and benign thymic tissue are also present. Histologic analysis confirms multifocal disease involving both lobes of the thyroid gland, with a maximum dimension of 2.5 cm. Lymphovascular invasion is documented as focal. No extrathyroidal extension is observed. Surgical margins are free of abnormal cells. Additional findings include hyperplastic nodules and normal parathyroid tissue. Six out of nine total lymph nodes examined demonstrate involvement, limited to Level VI. Distant metastasis is not identified."} +{"pid": "TCGA-VR-A8EO", "report": "The specimen includes the esophagus and proximal stomach, obtained via esophagectomy and partial gastrectomy. The tumor is located in the mid to distal third of the esophagus and measures 6.7 cm in greatest dimension. Histologic evaluation shows an ulcerated squamous cell carcinoma with poor differentiation (G3). Microscopic examination reveals that the tumor invades through the muscularis propria into the adventitia. Lymph-vascular invasion is present, while perineural invasion is not identified. Surgical margins are free of neoplastic involvement. A total of eight regional lymph nodes were examined, none of which show evidence of neoplastic involvement."} +{"pid": "TCGA-AG-3882", "report": "The resected specimen shows a moderately differentiated neoplasm composed predominantly of tubular structures, with visible nuclear-cytoplasmic changes. The lesion extends into the muscularis propria, without reaching the resection margins, which are separated from the affected area by normal mucosa, submucosa, and muscle layers. Vascular invasion is present, as evidenced by involvement of small vessels, and there is no lymph node involvement. Tumor cell morphology corresponds to an intermediate grade of differentiation. No additional specific tumor features are noted."} +{"pid": "TCGA-FD-A3B7", "report": "The specimen included portions of the right and left ureters, bilateral pelvic lymph nodes, and a cystoprostatectomy specimen including the bladder, prostate, and seminal vesicles. Gross examination of the bladder revealed an exophytic hemorrhagic mass measuring 6 x 5.5 cm located on the anterior and right lateral walls. Serial sectioning demonstrated tumor invasion to a depth of 1.8 cm, extending to within 0.2 cm of the inked margin. The tumor was found to approach within 0.1 cm of the right ureteral orifice. A diverticulum measuring 4.5 x 4 cm was noted at the posterior left aspect of the bladder.\n\nMicroscopic evaluation showed no tumor involvement in any of the submitted ureteral margins, distal urethral margin, or soft tissue margins. All lymph nodes examined (9 from the left and 7 from the right pelvic regions) were negative for tumor involvement.\n\nIn the prostate, histologic assessment revealed a small focus of benign acinar tissue in the peripheral zone with a Gleason score of 3+3=6. There was no evidence of perineural invasion, extraprostatic extension, or tumor involvement at any surgical margin. High-grade prostatic intraepithelial neoplasia was identified multifocally. Seminal vesicles were free of tumor.\n\nThe staging classification used was based on the 7th edition TNM system. For the bladder lesion, staging was determined as pT3a, reflecting microscopic extension into extravesical soft tissue. For the prostate, the staging was pT2a, indicating organ-confined disease."} +{"pid": "TCGA-3A-A9IR", "report": "The surgical specimen included a partial pancreatectomy and splenectomy. The tumor was located in the pancreatic tail, measuring 4 x 3.5 x 3.5 cm. It was well-defined, ovoid, and bulged from the anterior surface of the pancreas without extending through the peritoneum. Histologically, the lesion showed low mitotic activity with less than 2 mitoses per 10 high-power fields and no tumor necrosis. Immunohistochemical staining demonstrated positivity for low molecular weight cytokeratin (CAM 5.2) and glucagon, while insulin was not detected. The Ki-67 proliferation index was approximately 2%. No perineural invasion was identified; however, vascular invasion was present.\n\nThe tumor was found to be within less than 1 mm of the inked anterior and retroperitoneal margins, but the stapled pancreatic resection margin was free of tumor. A total of 13 regional lymph nodes were examined and none contained tumor. Additional findings included multiple foci of PanIN 1A and one focus of PanIN-2. The tumor was confined to the pancreas with no evidence of distant spread. A frozen section evaluation confirmed negative margins and identified low-grade PanIN. The specimen was processed in 19 cassettes, with representative sections submitted for further analysis."} +{"pid": "TCGA-QH-A6CZ", "report": "The specimen consists of a lesion located in the right frontal region. Gross examination revealed a well-circumscribed mass measuring approximately 4.5 cm in greatest dimension. Histological analysis demonstrated a moderately cellular neoplasm composed of a mixed population of cells with varying nuclear morphology. The tumor exhibited a diffusely infiltrative growth pattern into the surrounding parenchyma. Microscopic evaluation showed mild to moderate nuclear atypia, with scattered cells displaying enlarged, irregular nuclei. No necrosis was identified. Mitotic activity was low, with rare mitotic figures noted. Perineuronal invasion was observed. Immunohistochemical staining demonstrated positivity for glial markers. Based on histological features and extent of infiltration, the tumor is classified as a low-grade neoplasm."} +{"pid": "TCGA-D8-A1Y3", "report": "Histopathological examination was performed on a right breast specimen measuring 20 x 14 x 5 cm, along with axillary tissues measuring 10 x 5 x 3 cm and a skin flap of 18 x 10 cm. A lesion was identified in the upper outer quadrant, located 3 cm from the upper boundary, 1 cm from the base, and 1.5 cm from the skin surface.\n\nMicroscopic evaluation revealed a high-grade cellular proliferation with 20 mitoses observed in 10 high-power fields. There was extensive vascular invasion. The nipple area showed no abnormal changes. Background breast tissue exhibited fibrocystic changes.\n\nExamination of axillary lymph nodes revealed the presence of metastatic cells, with involvement of perinodal tissue and vascular emboli. Metastases were identified in lymph nodes corresponding to levels V and VIII.\n\nImmunohistochemical analysis showed that over 75% of the neoplastic cell nuclei were positive for estrogen and progesterone receptors. HER2 protein staining yielded a score of 2+, and fluorescence in situ hybridization (FISH) testing was performed using the Path Vysion HER2 DNA Probe Kit. No HER2 gene amplification was detected.\n\nThe maximum dimension of the lesion was 3.5 x 2.5 x 2.0 cm."} +{"pid": "TCGA-64-5779", "report": "A left pneumonectomy specimen was received along with multiple lymph node samples and other tissues. The lung specimen weighed 753 grams and measured 29 x 18.5 x 8 cm. The lower lobe contained a firm brown mass measuring 8.5 x 7.5 x 6 cm. This lesion was located within 0.1 cm of the pleural surface but did not invade the visceral pleura. The tumor was situated 5 cm from the nearest bronchial and vascular margins. Histologically, the lesion showed poorly differentiated invasive features with acinar morphology. Angiolymphatic invasion was present. Surgical margins were free of involvement.\n\nA total of 53 regional lymph nodes were examined. Metastatic involvement was identified in several lymph node levels: two of fifteen level 5 lymph nodes, three of six 11L lymph nodes, two of three level 7 lymph nodes, and four of twelve peribronchial lymph nodes. No tumor was found in the 6th rib, level 9 lymph nodes, 12L lymph nodes, level 8 lymph nodes, or level 6 lymph nodes. A diaphragmatic adhesion showed fibrous changes without tumor. The new bronchial margin and other submitted margins were also negative for tumor involvement.\n\nThe pTNM staging reflected T2 for the primary tumor size and its proximity to the pleura, N2 for metastasis to mediastinal and subcarinal lymph nodes, and Mx due to unknown distant metastasis status. Multiple anthracotic lymph nodes were noted in the peribronchial region, ranging in size from 0.1 to 1.2 cm. Emphysema was also present in the lung tissue."} +{"pid": "TCGA-55-7570", "report": "The clinical specimen consisted of a wedge biopsy and subsequent lobectomy of the right upper lung lobe, along with lymph node samples from levels 7 and 10. The wedge biopsy measured approximately 7.5 x 5.5 x 2.5 cm and contained a well-circumscribed lesion measuring 2.0 x 2.0 x 1.3 cm. This lesion extended to within 0.2 cm of the surgical margin and was located 0.2 cm beneath the pleural surface. Surrounding lung tissue appeared soft and dark red. Sections were taken from the tumor area near the surgical margin, subpleural region, and areas away from the lesion.\n\nThe lobectomy specimen weighed 352.5 grams and measured 21.0 x 11.0 x up to 3.5 cm. No discrete mass was identified upon examination. Two peribronchial lymph nodes were noted, measuring 0.7 cm and 1.0 cm in diameter. Eleven sections were submitted for analysis, including vascular margins, bronchial tissue, parenchyma beneath staple lines, and unaffected lung tissue.\n\nLymph node specimens from Level 7 and Level 10 measured 0.6 x 0.4 x 0.2 cm and 1.2 x 0.8 x 0.4 cm respectively, each submitted entirely for evaluation.\n\nMicroscopic assessment revealed cells with focal positivity for CK7 and rare positivity for TTF-1, while negative for CK5/6 and p63. These findings indicated a poorly differentiated solid-type lesion involving the right upper lobe. The lesion measured 2.0 x 2.0 x 1.3 cm and approached within 0.2 cm of the surgical margin. There was no evidence of involvement at the pleural surface or lymphovascular space invasion. The bronchial margin and surrounding parenchyma showed no residual lesion. No tumor was identified in the sampled lymph nodes.\n\nPathologic staging was determined as pT1a pNO."} +{"pid": "TCGA-V1-A8WV", "report": "The prostate specimen measured 4 cm from apex to base, with a weight of 55 grams. A single, poorly defined, firm, white-tan mass measuring 1.5 x 1.5 x 1.2 cm was identified in slices 6\u20138. The lesion abutted the capsule in multiple areas and approached the inked proximal base margin, with possible extraprostatic extension noted at the posterior base margin near the left seminal vesicle/vas deferens junction. The central/transitional zone was enlarged and nodular, while the anterior fibrous stroma appeared open and the remaining capsule intact.\n\nHistologic evaluation demonstrated a tumor composed predominantly of Gleason pattern 4 and secondary pattern 5 (total Gleason score 9), with an estimated volume of 7.9 cubic centimeters. More than 90% of the tumor volume consisted of Gleason patterns greater than 3. Tumor involvement of the capsule was present with focal invasion on the left posterior quadrant. Extracapsular extension was identified but limited in extent. Surgical margins were negative for tumor; however, benign glands were identified at the inked excision margins at the left apex and bilateral base regions.\n\nHigh-grade prostatic intraepithelial neoplasia was present focally. Tumor extended into the muscular wall of the right seminal vesicle. Perineural invasion was also observed.\n\nLymph node examination included six nodes from the right pelvis and four from the left. No tumor was identified in the right pelvic lymph nodes (0/6). One of the four left pelvic lymph nodes contained tumor deposits, with the largest metastasis measuring 0.5 mm in diameter. No extranodal extension was observed.\n\nA total of 10 lymph nodes were examined, with one positive node. The final staging classification was pT3bN1."} +{"pid": "TCGA-EB-A6QZ", "report": "Patient ID. Gross Description: A skin flap contains a black spot measuring up to 2 x 1.6 cm. The tumor's gross thickness is up to 4 mm. Resection margins show normal structure. Microscopic Description: Pigmented lesion of the skin. The tumor Breslow thickness is 3 mm. Tumor Features: Pigmented, with a size of approximately 2.0174 mm. Ulceration status is unspecified. Venous invasion is absent. Margins are uninvolved. Specimen type: Excision of a skin lesion. Tumor site: Skin, hip. Tumor size: 1.6 X 0.3 x 2 cm. Additional pathologic findings: Tumor Breslow thickness is 3 mm. No evidence of neo-adjuvant treatment. Other features such as satellite nodules, histologic grade, lymph node involvement, and lymphatic invasion are not specified. Comments: None."} +{"pid": "TCGA-23-1122", "report": "The surgical specimen from the uterus included an enlarged uterus weighing 410 grams, measuring 9.0 cm from fundus to cervix, 6.0 cm cornu to cornu, and 4.5 cm anterior to posterior. The serosal surface was diffusely congested with multiple dark red fibrous adhesions. The cervix measured 3.5 x 3.0 cm with a small attached vaginal cuff. The endocervical canal was 2.5 cm in length and contained nabothian cysts up to 0.6 cm. The endometrial cavity was 4.0 cm in length and 3.0 cm laterally, with a non-phasic atrophic appearance. Two friable polypoid lesions were identified on the left lateral aspect of both the anterior and posterior walls, measuring 0.5 cm and 1.0 cm respectively. A firm sessile lesion measuring 1.0 x 0.5 cm was also present on the fundus. The myometrium was coarsely trabecular and pink-tan, up to 1.7 cm thick, and contained a subserosal leiomyoma measuring 1.3 cm in diameter. Sections were taken from multiple regions including the cervix, uterine corpus, fundus, and subserosal nodule.\n\nThe left fallopian tube and ovary were received fresh and measured 8.5 cm in length with a maximum diameter of 3.0 cm. The serosa was red-tan with fibrous adhesions. The lumen was filled with tan friable tumor tissue, and the fimbriated end was involved. An underlying mass measuring 5.5 x 3.5 x 3.0 cm was identified, with a solid, lobulated structure and cystic spaces up to 1.7 cm. No residual ovarian parenchyma was identifiable. Sections were taken from the fallopian tube and the underlying mass.\n\nThe right ovary weighed 480 grams and measured 13.0 x 10.5 x 8.0 cm. The external surface was covered with red-tan tumor implants and fibrous adhesions. A 6.5 x 1.0 cm convoluted fallopian tube was also present, with tumor involvement on its surface. A 2.0 cm paratubal cyst was noted. On sectioning, approximately 70% of the mass was solid, tan, and lobulated with areas of hemorrhage and necrosis, while 30% was cystic containing red-tinged fluid and some gelatinous matrix. Sections were taken from both solid and cystic components as well as from external tumor nodules.\n\nOmentum number 1 was a 3.5 x 3.5 x 1.0 cm fragment of tan-yellow fat with a single 0.4 cm segment of firm tan-grey tumor. Omentum number 2 measured 15.0 x 12.0 x 2.0 cm and consisted of multiple fragments of omentum with five firm tan tumor nodules ranging from 0.5 to 2.0 cm, involving approximately 10% of the cut surface.\n\nThe left pelvic lymph node specimen included four lymph nodes ranging from 1.0 to 1.5 cm in size, all showing reactive changes including follicular hyperplasia, sinus histiocytosis, and focal calcifications. The right external iliac lymph node was a single 1.5 x 0.7 x 0.6 cm node with similar reactive features. No malignancy was identified in either lymph node specimen.\n\nMicroscopic evaluation showed that the endometrial polyps had complex hyperplasia with focal high-grade changes. The posterior serosal surface contained metastatic nodules. The ovaries and fallopian tubes showed extensive involvement by a high-grade papillary serous-type tumor. The omental specimens also contained metastatic tumor deposits. The tumor was widely distributed with involvement of multiple sites including the endometrium, bilateral ovaries, fallopian tubes, and omentum. Based on these findings, the possibility of multifocal disease with widespread involvement was considered."} +{"pid": "TCGA-IG-A4QS", "report": "The specimen includes a portion of the esophagus and part of the stomach. In the lower third of the esophagus, there is an exophytic lesion measuring up to 5 cm in size, with involvement of all wall layers. Metastatic involvement is identified in adjacent fatty tissue lymph nodes, with the largest measuring up to 0.6 cm. Surgical margins and omentum show no evidence of tumor involvement.\n\nMicroscopic evaluation reveals poorly differentiated cellular features with focal mucin production and extension into the fatty tissue. There is evidence of tumor growth beneath the normal squamous epithelium. Vascular spaces contain tumor emboli, and foci of perineural invasion are present. Of the six lymph nodes examined, all demonstrate involvement. Surgical margins remain uninvolved.\n\nKey features include an exophytic growth pattern with extension into the outer connective tissue layer. Vascular invasion is present, and all examined lymph nodes show involvement. The surgical specimen does not show evidence of prior treatment effects. No additional findings are noted."} +{"pid": "TCGA-VD-AA8P", "report": "Histopathology report for right globe enucleation specimen. The specimen measured 10.63 x 10.18 x 10.37 mm, with axial, horizontal, and vertical dimensions of 25mm, 23.5mm, and 24mm respectively. Corneal measurements were horizontal 12.5mm and vertical 12mm. A dome-shaped pigmented choroidal lesion was identified, measuring 12mm in largest basal diameter and 10mm in height. Trans-illumination revealed a shadow in the inferolateral position approximately 13mm in location. Prominent vessels arising from the optic disc were noted. An intraocular lens was present.\n\nMicroscopic evaluation showed a pigmented choroidal lesion composed predominantly of spindle-shaped cells. Immunohistochemistry demonstrated expression of Melan-A and HSP-27 (score 3). Mitotic count was approximately 8 per 40 high power fields. Microvasculature was prominent with presence of closed loops in the planes of section. Minimal lymphocytic infiltrate was observed within the lesion. No necrosis was identified. There was no extension through the sclera, optic nerve, or vortex veins, and tumour cells were not present at resection margins.\n\nAncillary studies included molecular genetic analysis of tumour DNA using MLPA to evaluate chromosomes 1, 3, 6, and 8. Results showed loss of chromosome 1p, monosomy 3, normal chromosome 6, and gains in chromosome 8. These findings are associated with an increased risk for metastatic disease.\n\nAdditional findings included slight retinal atrophy overlying the lesion. Anterior chamber angles were open with a deep anterior chamber. The iris was unremarkable but the ciliary body appeared atrophic with hyalinisation of processes. Residual peripheral cataractous lens material was present. Cornea showed no significant abnormality."} +{"pid": "TCGA-A2-A0T3", "report": "The specimen consists of a right breast partial mastectomy with sentinel lymph node biopsies. The partial mastectomy specimen measured 6.8 x 6.2 x 3.6 cm and contained two distinct mass lesions. The medial lesion measured 1.5 x 0.9 x 0.9 cm, with the closest margin being superficial at 0.5 cm. The lateral lesion measured 1.6 x 1.5 x 2.3 cm, with the closest margin also superficial at 0.5 cm from both the lateral border and superior aspect. Margins for other orientations were greater than 1 cm. A ribbon clip was identified in the lateral portion of the specimen.\n\nMicroscopic examination revealed two separate nodules of invasive ductal carcinoma. The larger nodule measured 1.7 cm and was poorly differentiated with nuclear grade III and a high mitotic index. It was associated with focal ductal carcinoma in situ with comedonecrosis extending into adjacent breast fat by at least 1.5 cm. The second nodule measured 1.2 cm and was moderately differentiated with nuclear grade III and a high mitotic index. This lesion showed admixture with high-grade ductal carcinoma in situ of cribriform, micropapillary, and comedocarcinoma types.\n\nInvasive carcinoma was located 3 mm from the superficial margin on the lateral side. Microscopic findings included solid-type ductal carcinoma in situ at the medial margin, ductal carcinoma in situ involving the superior margin, and a microcalcification with comedonecrosis suspicious for ductal carcinoma in situ at the inferior margin; however, artifact displacement could not be ruled out. The deep margin was free of tumor involvement by at least 1 cm.\n\nA separate medial re-excision specimen measuring 4.9 x 2.8 x 1.5 cm consisted of fatty tissue with focal blue dye and no residual tumor identified.\n\nSentinel lymph nodes were examined. The first sentinel lymph node, measuring 1.8 x 1.2 x 0.9 cm, contained metastatic disease with multiple foci identified, the largest spanning approximately 1 mm. Metastasis was confirmed by routine H&E staining and cytokeratin immunohistochemistry. The second sentinel lymph node, measuring 1.5 x 1.0 x 0.7 cm, showed no evidence of metastatic disease based on histologic evaluation and negative cytokeratin immunostaining.\n\nAll margins and staging details have been summarized without reference to specific diagnostic terminology."} +{"pid": "TCGA-G9-6343", "report": "The prostate specimen weighed 41g and measured 4.5cm from anterior to posterior, 4.0cm from apex to base, and 6.0cm from right to left. The capsule was tan-pink, smooth, and intact. The prostate was inked with multiple colors for orientation and sectioned serially from apex to base. The remaining prostate tissue after removal of the apex and base weighed 25g. On gross examination, the tissue appeared beige-tan, spongy, and no lesions were identified.\n\nAttached right and left seminal vesicles measured 3.0 x 1.0 x 1.0cm and 1.5 x 1.0 x 0.6cm respectively, and showed beige-tan cystic structures without gross tumor involvement. Similarly, the attached right and left segments of the vas deferens, measuring 1.2 x 0.4cm and 1.0 x 0.5cm respectively, revealed beige-tan tubular structures with no visible tumor.\n\nTissue procurement was performed at Levels 1 and 3. Additional sections submitted included areas from the right and left apex, anterior and posterior capsules at multiple levels, lateral base regions, basal areas, and segments involving the periurethral margin. Both seminal vesicles and vas deferens were also submitted for evaluation.\n\nMicroscopic analysis revealed epithelial changes with a Gleason score of 4+3 = 7. High-grade prostatic intraepithelial neoplasia was present. Perineural invasion was identified, while vascular or lymphatic invasion could not be confirmed. There was no evidence of seminal vesicle invasion or periprostatic fat involvement. Margins were free of involvement. No lymph nodes were sampled.\n\nAdditional findings included benign prostatic hyperplasia and basal cell hyperplasia in scattered foci. The tumor involved approximately 10% of the gland and was multicentric, found in both lobes. Pathological staging was determined as pT2c."} +{"pid": "TCGA-M7-A71Z", "report": "The surgical specimen included lymph node tissue from the right and left pelvic regions, as well as a prostate specimen following radical prostatectomy. In the right pelvic lymph nodes, four lymph nodes were examined and no abnormal cellular findings were identified. Similarly, five lymph nodes from the left pelvic region showed no abnormal findings.\n\nThe prostate specimen measured 5.2 x 5.0 x 4.5 cm and weighed 64.2 grams. Gross examination revealed a tan/brown, firm, and homogeneous prostate. Histologic evaluation demonstrated focal involvement of the right prostate in the posterior lobe, extending from near the apex to near the base. The lesion demonstrated a Gleason score of 7 (4+3), with approximately 25% of the prostate involved. There was focal extension beyond the prostatic capsule at the right mid portion, confirmed by staining methods. Additionally, focal vascular space invasion was identified in a separate block. No involvement was seen in the seminal vesicles bilaterally.\n\nAll surgical margins were free of abnormal cells. Additional benign findings included prostatic hyperplasia, intraepithelial proliferative changes, intraductal growth patterns consistent with earlier biopsy changes, and recent biopsy sites. A total of nine lymph nodes were examined across both pelvic regions and showed no concerning features.\n\nThe specimen was staged based on pathological findings as pT3a and pN0. It is noted that this staging may not be complete and further review of all clinical data is advised for final staging accuracy."} +{"pid": "TCGA-AA-3815", "report": "The specimen shows a lesion with histopathological features including marked cellular atypia and a high degree of architectural disorganization. The inner surface of the lesion demonstrates areas of erosion and ulceration. There is extensive involvement of the surrounding tissue with transmural infiltration, reaching up to 0.1 cm beneath the serosal layer. Peritumoral changes include prominent chronic inflammation with recurrent acute exacerbations, including ulceration and abscess formation. Lymphatic invasion is present, as evidenced by lymphangitis. Areas of necrosis are noted within the lesion. Involvement of the appendiceal base is observed, accompanied by signs of chronic recurrent appendicitis. Lymph node examination reveals reactive changes in the context of chronic lymphadenitis; all sampled nodes (0/20) show no evidence of involvement. Resection margins are free of any detectable abnormality. Histological sections indicate full thickness wall invasion without distant spread, corresponding to a local staging classification of pT3, pNO, MX, L1, R0. Vascular invasion is not identified. No findings suggestive of a serous component are present."} +{"pid": "TCGA-AJ-A2QK", "report": "A 5.0 x 2.7 cm polypoid mass was identified within the endometrial cavity, located within 2.1 cm of the lower uterine segment. The mass extends focally into the myometrium, reaching a depth of 0.7 cm within a total myometrial thickness of 2.8 cm. No involvement of the cervix or other organs was observed. Lymphovascular space invasion was present in a focal distribution. Surgical margins were uninvolved, including cervix, serosa, and parametria.\n\nLymph node evaluation included:\n- Left paraaortic: 2 lymph nodes\n- Left paraaortic (additional): 3 lymph nodes\n- Right paraaortic: 3 lymph nodes\n- Left pelvic: 10 lymph nodes\n- Right pelvic: 8 lymph nodes\n\nAll lymph nodes were negative for metastatic disease. No tumor was identified in the omental biopsy.\n\nAdditional findings included multiple leiomyomata within the myometrium and a focus of stromal hyperthecosis in one ovary. The contralateral ovary and bilateral fallopian tubes showed no evidence of malignancy. Sections from the cervix, parametrium, and lower uterine segment were unremarkable.\n\nThe specimen was submitted in entirety for histologic examination, with multiple cassettes representing full-thickness sections of the endometrial mass, surrounding tissue, and adnexal structures. Immunohistochemical staining of lesional cells showed focal positivity for p53, negative staining for WT-1, and positive staining for cytokeratin 7, while cytokeratin 20, CDX2, and inhibin were negative. In a separate cellular proliferation area, inhibin was positive with negative staining for p53, WT-1, cytokeratin 7, cytokeratin 20, and CDX2.\n\nStaging based on these findings is consistent with early localized disease."} +{"pid": "TCGA-BR-A4CQ", "report": "The stomach specimen measured 209 cm in length and contained a white-haired, compact mass measuring approximately 4 x 0 x 4 cm. The omentum appeared yellow and soft. Histological examination revealed poorly differentiated glandular cells with limited differentiation features. Two of three regional lymph nodes showed evidence of metastatic involvement. The tumor extended to the serosa, including the visceral peritoneum. No venous invasion was identified. Surgical margins were uninvolved. There was no clear evidence of treatment effect. Additional pathological findings were not specified."} +{"pid": "TCGA-4Z-AA87", "report": "The specimen involved the bladder and prostate, with a lesion measuring 6.5 cm in its major axis. The lesion showed ulceration and extensive necrosis. Tissue involvement was noted in the bladder, prostate, right seminal vesicle, and fibroadipose perivesical connective tissue. Neural infiltration was present. Lymphatic vascular invasion could not be confirmed, and no sanguineous vascular invasion was identified. Surgical margins were free of abnormal cells. Lymph nodes examined from both left (3 nodes) and right (2 nodes) sides showed no evidence of involvement."} +{"pid": "TCGA-GU-A42P", "report": "A segment of tissue from the right ureter was examined and found to be benign, with no evidence of abnormal cells or tumor involvement. The proximal margin was assessed intraoperatively and confirmed negative for any malignant findings. Similarly, a segment from the left ureter was also found to be benign, with no signs of tumor or dysplasia upon microscopic evaluation.\n\nLymph node specimens were collected from multiple anatomical regions. A resection from the left external and internal lymph node region showed only benign fibrovascular tissue without any abnormal cellular changes. One lymph node was identified in this specimen but was not present upon further examination. In contrast, a single lymph node obtained from the left internal and external iliac region revealed the presence of atypical cells consistent with metastatic involvement. This lymph node measured 1.8 cm in its largest dimension and was the only positive finding among a total of 14 lymph nodes evaluated across all specimens. The remaining lymph nodes, including those from the left obturator, left common iliac, right internal and external iliac, and right obturator regions, were all benign and showed no signs of abnormal cell infiltration.\n\nThe surgical removal of the urinary bladder and prostate revealed a significant lesion within the bladder. The lesion measured 4.0 cm in greatest dimension and was located on the posterior wall with extension into the anterior, right, and left walls. It also involved a diverticulum on the left side, reaching to within 0.2 cm of the surrounding perivesicular fat. Microscopically, the lesion exhibited complex cellular patterns with features suggestive of aggressive growth. The surface of the lesion appeared ulcerated, and there was clear evidence of invasion into the surrounding connective tissue. However, the surgical resection margins were free of invasive disease.\n\nIn addition to the primary bladder lesion, an incidental finding was noted in the prostate. A small area of atypical glandular proliferation was identified, confined entirely within the prostate tissue. No invasion beyond the prostate capsule or involvement of seminal vesicles was observed. The surgical margins of the prostate were also negative for any signs of malignancy.\n\nLymphovascular invasion was extensive in the bladder lesion, indicating a high potential for spread. No distant metastases were identified. Based on these findings, the disease was classified as having extended beyond the main organ but with limited regional spread, involving only one lymph node. The overall assessment included the presence of previous biopsy-related changes in the bladder and the incidental prostate finding. No treatment-related effects were evident in either the bladder or prostate specimens.\n\nAn appendectomy was performed, and the appendix was found to be histologically unremarkable. Additionally, a resection from the left obturator region contained only benign fibroadipose tissue without identifiable lymph nodes or abnormal cellular changes. All specimens were processed and evaluated according to established protocols, ensuring accurate staging and reporting."} +{"pid": "TCGA-AP-A1DH", "report": "The surgical specimen included the uterus, cervix, bilateral fallopian tubes and ovaries, abdominal pannus, several lymph node groups from the left and right external iliac, obturator, and right common iliac regions, as well as a portion of omentum.\n\nExamination of the uterine tissue revealed a tumor with greater than 50% solid growth pattern and nuclear grade 2 features. The tumor was found to invade less than half of the myometrium, with maximal myometrial invasion measuring 9 mm in thickness, within an area where the total myometrial thickness was 22 mm. There was no evidence of endocervical or vascular invasion. The endometrium was inactive. The myometrium showed findings of adenomyosis and a subserosal lesion. Additional findings included an endocervical polyp and benign-appearing adnexal structures.\n\nThe abdominal pannus showed normal skin and subcutaneous adipose tissue. Lymph nodes from all excised regions were benign and showed no abnormal cellular features: seven from the left external iliac, nine from the left obturator, four from the right external iliac, four from the right obturator, and one from the right common iliac region. The omental tissue was also benign, consisting only of normal adipose elements.\n\nAll other tissues examined showed no significant pathological changes."} +{"pid": "TCGA-A2-A0CL", "report": "The specimen consists of a right mastectomy with axillary lymph nodes from a female patient. The surgical specimen weighs 553 grams and measures 22 cm (medial to lateral), 18 cm (superior to inferior), and 3 cm (anterior to posterior). The superficial skin is pigmented, measuring 18 x 7 cm, with a centrally everted nipple. No scar or discharge was observed. The deep margin was inked black.\n\nUpon sectioning, a primary mass measuring 6 x 3.5 x 1.5 cm was identified in the lateral outer quadrant; it was poorly circumscribed and firm with a gritty texture. A second similar mass measuring 2.5 x 2.5 x 1.0 cm was found in the mid-inner quadrant at the 3:00 position. Additional masses were noted: one measuring 1 x 0.8 x 0.5 cm located 5 cm from the 3:00 mass and another measuring 1.5 x 0.5 x 0.5 cm adjacent to the deep margin in the lateral inner quadrant.\n\nMicroscopic examination revealed high-grade cellular features with a Nottingham score of 9 (3 each for tubules, nuclei, and mitoses). Necrosis was present within the infiltrating component. Microcalcifications were observed within the lesion. Venous and lymphatic invasion were extensive. The deep surgical margin was involved by infiltrating tumor, with no distance between the tumor and the nearest margin.\n\nA total of twelve lymph nodes were recovered from the axillary tail. Nine of these contained metastatic involvement, with the largest focus measuring 1.5 cm. Hormone receptor testing showed positivity for estrogen receptors (20%), while progesterone receptors and HER2 Neu (by IHC) were negative.\n\nThe remaining breast tissue consisted of approximately 40% dense fibrous tissue with slight nodularity. Fatty tissue appeared normal. The lymph nodes ranged in size from 0 to 2 cm and had firm, pink-white cut surfaces, many appearing involved by the process.\n\nPathologic staging based on findings was determined as pT3 N2a Mx under AJCC criteria."} +{"pid": "TCGA-HT-8564", "report": "The specimen consists of brain tissue containing both gray and white matter. Microscopic examination reveals a moderately hypercellular and diffusely infiltrative astrocytic lesion composed of fibrillary cells with moderate to focally marked atypia. Mitotic figures are present in small numbers. The tumor lacks microvascular proliferation and necrosis. Immunohistochemical staining shows numerous MIB-1 reactive cells, with a labeling index of 13.8% in the most proliferative regions. Cellular morphology and growth patterns suggest a high level of proliferation and atypical cell features."} +{"pid": "TCGA-AO-A129", "report": "The left breast and axillary contents were examined following modified radical mastectomy. The left breast tissue measured 23.0 x 23.0 x 6.5 cm, with a skin ellipse measuring 15.0 x 4.0 cm. An ill-defined pink-gray, focally hemorrhagic, rubbery lesion was identified in the lower outer quadrant, measuring 2.3 cm in largest dimension microscopically. The lesion was surrounded by thickened fibrous tissue and located 3.5 cm from the deep surgical margin. Serial sectioning of the axillary tail revealed multiple lymph nodes ranging from 0.3 to 1.5 cm. \n\nMicroscopic evaluation showed a histologic grade II/III lesion with moderate tubule formation and nuclear grade III/III with marked variation in size and shape. A component of high nuclear grade solid-type ductal carcinoma in situ with extensive necrosis was also present, constituting less than 25% of the total mass and admixed with the invasive component. Both the invasive and in situ components were located in the lower outer quadrant. There was no involvement of the nipple, skin, or surgical margins, and no vascular invasion was noted. The non-neoplastic breast tissue appeared unremarkable.\n\nLymph node evaluation from level I revealed 2 out of 13 nodes involved, while all 4 nodes from level II were negative. Extracapsular extension was present in the involved nodes. Two lymph nodes from level III on the left side were both negative. Sentinel lymph node #1 from the right axilla, level I, consisted of two benign lymph nodes upon initial evaluation; deeper level recuts and immunohistochemical stains are pending. Sentinel lymph node #2 from the right axilla contained only benign breast tissue, with no lymph node identified.\n\nThe contralateral right breast specimen was unremarkable, consisting of benign parenchyma with secretory changes. No lesions were identified grossly or microscopically, and the fibrous component accounted for approximately 55% of the total tissue. Lymph nodes were not identified at the axillary tail site.\n\nImmunohistochemical staining for ER, PR, and HER2 will be reported separately. Initial results from the left breast showed negative staining for ER, PR, and HER2 (staining intensity of 0), with satisfactory controls. Additional H&E sections and immunostains for cytokeratins (AE1:AE3 and CAM 5.2) on sentinel lymph node #1 from the right axilla showed no evidence of metastatic disease."} +{"pid": "TCGA-DD-AAE9", "report": "The liver specimen measured 19.0 x 12.5 x 4.3 cm and weighed 374.0 grams. A well-defined, round, firm mass measuring 5.0 x 4.8 x 4.0 cm was identified. The cut surface of the mass had a yellowish tan and granular appearance. Gross examination showed a nodular growth pattern with a safety margin of 1.0 cm; no satellite nodules were observed.\n\nMicroscopic evaluation revealed malignant cells arranged in a trabecular pattern. The cells showed moderate nuclear atypia with minimal cytoplasmic fat change. A complete fibrous capsule surrounded the lesion. There was no evidence of capsular infiltration, septum formation, or invasion at the surgical resection margin. No serosal or portal vein invasion was seen, and microvessel invasion was absent. Information regarding intrahepatic metastasis and multicentric occurrence was not available.\n\nBackground liver tissue showed features of steatohepatitis with mild steatosis and periportal fibrosis (stage 2)."} +{"pid": "TCGA-PG-A7D5", "report": "The surgical pathology report describes a hysterectomy specimen along with bilateral salpingo-oophorectomy and lymph node dissection. The endometrium showed high-grade nuclear features with papillary architecture. Histologic evaluation demonstrated myometrial invasion measuring less than 50% of the total myometrial thickness, specifically 47%, with an invasion depth of 10 mm in a uterus where the total myometrial thickness was 21 mm. No cervical stromal invasion was identified. Lymphovascular invasion was present.\n\nMultiple benign leiomyomas were identified within the uterine wall, ranging in size up to 4.3 cm. One of these was located adjacent to the left ovary. The fallopian tubes, ovaries, and cervix did not show any evidence of malignant involvement. A paratubal cyst was noted in the left fallopian tube, and chronic cervicitis was also present.\n\nExamination of regional lymph nodes included specimens from the right and left para-aortic regions, right pelvic region, and left external iliac region. In total, 14 pelvic lymph nodes (right and left combined), 17 para-aortic lymph nodes (right and left combined), and five external iliac lymph nodes were assessed, all without evidence of metastatic disease. Additionally, a biopsy of the omentum revealed fibroadipose tissue containing one benign lymph node; no malignant cells were found.\n\nImmunohistochemical staining showed no nuclear staining for ER in neoplastic cells and less than 5% nuclear staining for PR. P53 staining was positive in the atypical cells.\n\nStaging according to AJCC criteria was determined as pT1A, N0, Mx. Multiple tissue sections were evaluated, and the findings were reviewed by a second pathologist within the department. Clinical correlation was provided with regard to laparoscopic robotic-assisted surgery performed for presumed malignancy. Gross measurements of the uterus were 11.5 cm from fundus to ectocervix, 13 cm between cornua, and 4.4 cm anterior to posterior. The endometrial cavity measured 5.0 cm in length and 2.8 cm between cornua. Three distinct tan-red masses were identified on the fundus, right posterior wall, and anterior wall, with sizes ranging from 1.2 x 1.0 cm up to 2.0 x 2.0 cm. The tumor located on the anterior wall was approximately 2.0 cm from the endocervical os. On gross examination, the deepest myometrial invasion appeared to be approximately 30%. All tumors were submitted for histologic analysis.\n\nLymph node specimens were received as aggregates of fibrofatty tissue with embedded lymph nodes. Para-aortic lymph nodes measured up to 3.3 cm (right) and 1.4 cm (left). Pelvic lymph nodes reached up to 4.0 cm in diameter. The external iliac specimen contained lymph nodes up to 4.2 cm in greatest dimension. Omental biopsy showed adipose and fibrovascular tissue without identifiable mass.\n\nIntraoperative frozen section consultation confirmed high-grade epithelial malignancy involving the endometrium with approximately 50% myometrial invasion. An adnexal mass was consistent with a benign spindle cell lesion, likely leiomyoma. A detached tumor fragment in the cervix was interpreted as likely carryover from the main tumor."} +{"pid": "TCGA-BH-A0GZ", "report": "The surgical specimen consists of breast tissue with a focus of cellular infiltration. The invasive component measures 1.5 cm in greatest dimension and demonstrates a Nottingham score of 6, with individual scores of 2 for tubule formation, 2 for nuclear pleomorphism, and 2 for mitotic activity. Lymphovascular space invasion is present. A second in situ component is identified, characterized by cribriform architecture and nuclear grade 2 features, including comedo necrosis. This in situ component accounts for approximately 20% of the total tumor volume and is found both intermixed with and separate from the invasive area.\n\nMargins are negative for abnormal cells, with the closest distance from the invasive lesion to the superior margin measuring 0.5 cm. Additional findings include benign changes such as fibrocystic disease, columnar cell change, and ductal epithelial hyperplasia. Changes related to a prior biopsy are also noted.\n\nIn the axillary lymph node dissection, one sentinel lymph node contains metastatic involvement measuring 2.1 mm in diameter. No extracapsular extension is observed. A second sentinel lymph node and two additional nodes are free of involvement. Histologic evaluation was performed using H/E staining methods.\n\nHormone receptor analysis indicates reactivity for estrogen and progesterone receptors. HER-2/neu testing by FISH shows no evidence of gene amplification.\n\nPathologic staging is determined as pT1c for the primary lesion, pN1a for regional lymph node involvement, and pMX for distant metastasis. Radiographic calcifications are identified within the affected region."} +{"pid": "TCGA-K1-A3PO", "report": "A mass was identified in the pelvic region, involving soft tissues and extending into the muscular wall of the urinary bladder with focal involvement of the prostate. The excised specimen showed a low-grade cellular proliferation composed of monomorphic spindle cells with eosinophilic cytoplasm, cigar-shaped nuclei, and stippled chromatin. Perinuclear vacuoles were present. The cells were arranged in a vague storiform pattern and in short bundles, with rare mitotic figures and no necrosis observed. The tumor exhibited an infiltrative growth pattern, spreading between normal smooth muscle bundles of the bladder and into the prostate. It also encased the left ureter without disrupting the urothelium.\n\nThe surgical margins were free of tumor. No angiolymphatic or perineural invasion was identified. A total of 23 lymph nodes from various pelvic and iliac regions were examined, and all were negative for tumor involvement. Inflammatory changes including von Brunn\u2019s nests and cystitis cystica were noted in the bladder, and chronic prostatitis was identified in the prostate. The right ureter was encased by tumor, while the left ureter was uninvolved.\n\nImmunohistochemical staining showed positivity for desmin and AMA, and less than 5% positivity with Ki-67. Cytokeratin AE1/3 and S-100 were negative. Additional immunostains are pending. These findings correlate with a neoplastic process that shows features consistent with smooth muscle differentiation and an infiltrative pattern of growth."} +{"pid": "TCGA-G3-A3CK", "report": "The specimen consists of a gallbladder and a liver resection. The gallbladder measures 8.0 x 3.5 x 2.5 cm, with a smooth serosal surface and a lumen containing bile and small yellow calculi. The wall is 0.2 cm thick. No significant abnormalities are noted upon histological examination.\n\nThe liver resection weighs 199.4 grams and measures 12.7 x 9.0 x 5.5 cm. Two nodules are identified. The smaller nodule measures 0.8 x 0.7 x 0.5 cm and is located near the resection margin, within 0.5 cm of it and close to the capsular surface. The second, larger nodule measures 2.5 x 2.3 x 2.2 cm and is located 2.0 cm from the first nodule, less than 0.1 cm from the capsular surface and 1.2 cm from the resection margin. Histologically, the larger nodule is described as moderately differentiated. Vascular invasion is present in the form of tumor emboli within small vessels adjacent to the mass. The resection margin is free of invasive disease, with a distance of 12 mm from the closest margin. No large vessel invasion is observed. Additional findings include cirrhosis and chronic hepatitis B infection. Multiple sections are taken for further analysis and tumor banking."} +{"pid": "TCGA-K4-A5RJ", "report": "The specimen included tissue from the left and right distal ureters, right common and external iliac lymph nodes, right obturator lymph nodes, right internal iliac lymph nodes, left common and internal lymph nodes, left obturator lymph nodes, and a composite specimen including the bladder, prostate gland, seminal vesicles, and vas deferens. Frozen section analysis of the left and right distal ureters showed no tumor involvement.\n\nMicroscopic evaluation of all lymph node-containing specimens (right common and external iliac, right obturator, right internal iliac, left common and internal, and left obturator) revealed no evidence of tumor. The right common and external iliac lymph nodes consisted of four nodes; six were identified in the right obturator region. The remaining lymph node regions contained fatty or fibroadipose tissue without identifiable lymph nodes.\n\nThe bladder and prostate specimen revealed a high-grade papillary lesion located on the posterior wall of the urinary bladder. The tumor measured 3.5 cm in size and demonstrated squamous differentiation without glandular features. Histologic grade was high (grade 3/3). The depth of invasion extended into the outer one-third of the muscularis propria. No tumor was identified at the resection margins of the prostate, urethra, ureters, or soft tissue. There was probable small vessel lymphatic invasion, and associated urothelial dysplasia was present.\n\nExamination of the prostate showed benign prostatic hyperplasia and high-grade prostatic intraepithelial neoplasia, but no invasive tumor was found. The seminal vesicles were also free of tumor involvement.\n\nA total of 12 lymph nodes were examined, with none showing tumor involvement. Sections from all areas of interest, including multiple levels of the tumor and surrounding structures, were submitted for analysis."} +{"pid": "TCGA-EL-A3TB", "report": "The pathology report includes findings from a surgical case involving multiple tissue specimens. \n\nFrom the right neck dissection (Level II), two lymph nodes were identified and examined, with no tumor involvement observed. In Level III, nine lymph nodes were identified, and tumor involvement was present in four of these nodes. The largest lesion measured 1.3 cm in greatest dimension. Additionally, tumor involvement was identified in soft tissue adjacent to these lymph nodes. In Level IV, ten lymph nodes were identified, and tumor involvement was noted in four out of these nodes.\n\nThe right paratracheal neck dissection specimen contained eight lymph nodes, six of which showed tumor involvement.\n\nThe left superior parathyroid specimen consisted of a small fragment of soft tissue and showed only normal parathyroid tissue without any tumor involvement.\n\nThe total thyroidectomy specimen included the right lobe (measuring 3.5 cm laterally to medially and 2.5 cm superiorly to inferiorly), isthmus (1.4 x 0.8 x 0.3 cm), and left lobe (1.5 x 2.0 x 1.2 cm). A firm tumor nodule measuring 2.2 x 1.4 x 1.3 cm was identified in the superior portion of the right lobe and was found to extend into adjacent tissue within less than 0.1 cm from the superior margin. One lymph node sampled from this region demonstrated tumor involvement.\n\nAdditional findings included one lymph node from Level II that contained a psammoma body surrounded by giant cells; however, no epithelial cells were identified. Immunohistochemical staining for cytokeratin was negative for metastatic carcinoma in this instance."} +{"pid": "TCGA-KL-8345", "report": "The right kidney specimen measured 11 x 6.0 x 3.9 cm and included a ureter segment measuring 19 cm in length. A well-circumscribed mass measuring 3.2 cm in greatest dimension was identified in the lower medial aspect of the kidney. The mass was in close contact with sinus fat but no gross evidence of invasion or venous involvement was observed. Microscopic examination showed no invasion of renal vein or small vessel angiolymphatic invasion. The surgical margins were free of tumor. The non-neoplastic kidney showed mild arteriosclerotic changes and benign cortical cysts. No lymph nodes were identified in the perirenal fat. Background renal parenchyma demonstrated a mildly thinned cortex with preserved cortical-medullary differentiation.\n\nA retroperitoneal adipose tissue specimen measuring 4.6 cm in greatest dimension was submitted. Histologically, the tissue showed mature adipose without atypia or fibrosis.\n\nMultiple lymph node specimens were evaluated: four paracaval lymph nodes, two right common iliac lymph nodes, seven precaval and interaortocaval lymph nodes, and a specimen including suprahilar tissue and adrenal gland. All lymph nodes examined showed no evidence of involvement. The adrenal gland appeared histologically unremarkable.\n\nThe tumor was staged based on local invasion into perinephric structures, specifically involving the sinus fat, with no extension beyond Gerota\u2019s fascia."} +{"pid": "TCGA-BQ-7058", "report": "The submitted specimen includes biopsies of mesentery overlying a right renal tumor, anterior Gerota\u2019s fascia, and a partial nephrectomy specimen including lower pole kidney tissue and paracaval lymph nodes. The mesenteric biopsy consists of a 1.2 x 0.3 x 0.3 cm fragment of fatty tissue, and the Gerota\u2019s fascia biopsy is a 0.8 x 0.5 x 0.3 cm fibrofatty sample; both were found to be benign. The kidney specimen is a wedge-shaped portion measuring 5.8 x 5.5 x 3.2 cm with a suture marking the deep margin, which was inked black. On sectioning, a heterogeneous mass measuring 4.2 x 3.5 x 2.4 cm was identified, showing yellow/tan to white coloration with areas of necrosis and hemorrhage. The mass extends to the inked surgical margin and into the perinephric fat.\n\nMicroscopic evaluation revealed a high-grade lesion with features suggestive of both distal nephron and type 2 papillary renal origin. Immunohistochemical staining showed reactivity for racemase but not for CK7, CEA, or 34BE12. Evaluation of vascular involvement noted presence within muscular branches of the renal vein, though no direct renal vein invasion was identified. The tumor also involved the renal sinus fat.\n\nSurgical margins demonstrated tumor involvement at the renal parenchymal margin. Non-neoplastic kidney tissue showed evidence of chronic nephritis and mild arteriolonephrosclerosis. No adrenal gland tissue was identified. Lymph node assessment included eight nodes, of which three contained metastatic deposits. The largest metastatic focus measured 1 cm and completely occupied one lymph node. No extranodal extension was observed, and the majority of the metastatic component was necrotic.\n\nStaging classification indicates that the tumor extends into major veins but does not extend beyond Gerota\u2019s fascia. All findings are based on personal examination of the slides and review of special studies, including PAS, CK7, CEA, 34BE12, and racemase immunostains. Intraoperative frozen section evaluations of the mesentery and Gerota's fascia were consistent with final diagnoses."} +{"pid": "TCGA-DB-A4XC", "report": "The specimen consists of a left temporal brain mass weighing 20.7 grams and measuring 5.2 x 3.7 x 1.7 cm, along with a CUSA trap specimen measuring 5.0 x 4.3 x 1.0 cm. Both specimens were processed for histologic evaluation.\n\nHistologic examination reveals a diffusely infiltrative glioma. Cellular features include tumor cells positive for GFAP with scant cytoplasm. p53 expression is variable and present in over 50% of tumor cells. The MIB-1 labeling index demonstrates a range from low to moderate.\n\nA preliminary intraoperative smear diagnosis was suggestive of a high-grade glioma; however, definitive grading was deferred pending further analysis and comparison with additional specimens. Immunohistochemical staining supported the morphologic findings.\n\nAdditional fluorescence in situ hybridization (FISH) studies have been initiated on paraffin sections to evaluate for genetic alterations. These results are pending.\n\nNotably, there is mention of a separate lesion located in the right frontal lobe. This lesion exhibits similar imaging characteristics and morphologic features suggestive of a higher-grade lesion based on prior biopsy. Specimens from this site may be available for comparative analysis upon resection."} +{"pid": "TCGA-5M-AAT6", "report": "The resected specimen included the terminal ileum, cecum, appendix, ascending, and transverse colon following a right hemicolectomy. Gross examination revealed a luminal lesion located 8.0 cm from the nearest surgical margin, measuring 8.0 x 8.0 cm. The lesion was ulcerative and vegetative in appearance, extending through the colon wall to the serosa. A perforation measuring 2.0 x 1.5 cm was identified in continuity with the lesion. The serosal surface showed multiple nodules and focal irregularity. A total of 11 lymph nodes were retrieved from the pericolic fat, ranging in size from 0.3 to 0.6 cm.\n\nMicroscopic evaluation demonstrated a moderately differentiated tubular neoplasm involving the ascending colon. The lesion exhibited extension into the pericolic soft tissues with perineural and lymphovascular invasion present. A moderate desmoplastic stromal reaction was noted. All surgical margins were free of neoplastic involvement. Of the 11 lymph nodes examined, 10 showed evidence of tumor involvement."} +{"pid": "TCGA-AO-A0JI", "report": "A mass was identified in the left breast on imaging and biopsy. Sentinel lymph nodes were evaluated from the left axilla. One sentinel lymph node contained small clusters and individual cells measuring 0.5 mm, identified on further staining with H&E and cytokeratin immunohistochemistry; no spread beyond the capsule of the node was observed. The second sentinel lymph node showed no similar findings.\n\nThe left breast was surgically removed. Within the upper outer quadrant, a firm, white mass measuring 1.0 cm was identified microscopically. Adjacent to this mass, in situ disease was also present, characterized by solid-type changes with high nuclear grade and limited necrosis. This in situ component accounted for \u226425% of the total lesion and was intermixed with the invasive portion. Additional benign findings included lobular changes within sclerosing adenosis, fibroadenoma, cysts, radial scar, atypical ductal proliferation, and intraductal papilloma with focal atypical features. Calcifications were seen in both the in situ and invasive areas as well as in benign tissue. No vascular invasion, margin involvement, or skin involvement was noted. The overlying skin contained a benign seborrheic keratosis.\n\nImmunohistochemical analysis of the invasive component showed strong nuclear staining for estrogen receptor (95%), no staining for progesterone receptor, and negative staining for HER2 using standard criteria.\n\nNo additional lymph nodes were identified in the left axilla beyond the sentinel nodes sampled. All surgical margins were free of abnormal cells."} +{"pid": "TCGA-WK-A8XS", "report": "The specimen was received fresh and labeled with the patient\u2019s name, unit number, and \u201c#1. Partial gastrectomy, short proximal, long anterior.\u201d The surgical specimen measured 10.0 x 5.1 x 4.5 cm and was marked with a short stitch (proximal) and a long stitch (anterior). A tan/white/pink, firm, fungating mass measuring 7.6 x 5.3 x 4.3 cm was identified in the gastric wall, located 2.3 cm from the closest resection margin. The tumor extended to the serosa and had a tan/white, whorled cut surface with punctate yellow foci suspected to represent possible necrosis. Gross photographs were taken, and representative sections of the tumor and normal stomach tissue were submitted for cytogenetics, tissue banking, and research.\n\nMicroscopic evaluation included multiple sections from different areas of the tumor and margins. The cellular morphology showed no evidence of necrosis. Mitotic activity was present, with up to 21 mitoses per 10 high-power fields. Mucosal resection margins were free of tumor involvement, although tumor was found 2.3 cm from the proximal resection margin. A separate polypoid lesion consistent with a fundic gland polyp was also noted. No candidate lymph nodes were identified. The histologic features correlated with previously obtained biopsy material."} +{"pid": "TCGA-BH-A1EV", "report": "LEFT BREAST, MODIFIED RADICAL MASTECTOMY SPECIMEN SHOWS A MULTIFOCAL MASS WITH DIFFUSE GROSS FEATURES. HISTOPATHOLOGIC EVALUATION REVEALS A HIGH-GRADE CELLULAR COMPONENT MEASURING 9 CM IN MAXIMUM DIMENSION. THE LESION INCLUDES A COMEDO-TYPE INTRADUCTAL COMPONENT REPRESENTING APPROXIMATELY 35% OF THE OVERALL TUMOR VOLUME. THIS IN-SITU ELEMENT EXTENDS INTO LARGE DUCTS BENEATH THE NIPPLE AND IS ASSOCIATED WITH PAGET\u2019S DISEASE OF THE NIPPLE. VASCULAR INVASION IS NOT PROMINENT. EXAMINATION OF SURGICAL MARGINS DEMONSTRATES NO EVIDENCE OF RESIDUAL TUMOR IN THE PLANE OF SECTIONING. WHILE TUMOR INVOLVES MULTIPLE QUADRANTS, SEVERAL RANDOMLY SAMPLED REGIONS ARE NEGATIVE. LYMPH NODE ASSESSMENT IDENTIFIES INVOLVEMENT OF THREE OUT OF TEN (3/10) AXILLARY NODES. IMMUNOHISTOCHEMICAL ANALYSIS ON SELECTED TISSUE BLOCKS SHOWS ESTROGEN RECEPTOR POSITIVITY IN 90% OF CELLS AND PROGESTERONE RECEPTOR POSITIVITY IN 40%. HER-2/NEU IMMUNOSTAINING DEMONSTRATES COMPLETE MEMBRANOUS REACTION IN 30% OF TUMOR CELLS WITHOUT ANTIGEN RETRIEVAL, SCORING AS 2+."} +{"pid": "TCGA-55-8089", "report": "The specimen consists of multiple tissue fragments submitted in five containers. Specimen A includes a 2.8 x 1.2 x 0.7 cm aggregate consistent with lymph node tissue showing anthracotic changes and reactive features. Specimen B contains a 2.8 x 1.4 x 1.0 cm lymph node aggregate with similar findings. Specimen C is a lung lobe measuring 17.0 x 11.0 x 6.0 cm, showing anthracotic pigmentation and containing a nodule measuring 1.8 x 1.7 x 1.3 cm. This lesion is located peripherally and subpleurally, unifocal in distribution. It approaches within less than 0.1 cm of the pleural surface, 4.0 cm from the nearest parenchymal margin, and 8.0 cm from the bronchial margin. No vascular margin involvement is noted. Surrounding tissue appears congested and spongy without additional lesions. Multiple small black nodules adjacent to the bronchus are identified as likely anthracotic lymph nodes, ranging from 0.3 to 0.6 cm in size. Specimen D contains a single 0.6 cm lymph node nodule with similar characteristics. Specimen E includes a 2.3 x 1.8 x 1.0 cm lymph node fragment showing comparable features.\n\nHistologic examination reveals a poorly differentiated lesion at the periphery with focal scarring. Rare gland-like structures are observed; no squamous differentiation is present. Immunohistochemical staining demonstrates strong diffuse positivity for CK7 and negativity for CK5/6, TTF-1, and p63. These findings indicate a distinct cellular profile consistent with certain epithelial characteristics. No metastatic involvement is identified in any lymph node tissues examined. At least eleven lymph nodes are assessed, all showing only reactive changes and anthracosis. Surgical margins are clear with adequate distances from the lesion to bronchial, parenchymal, and vascular margins. No lymphovascular space invasion or pleural involvement is identified. The tumor appears to be newly diagnosed without prior comparative material available. Molecular studies have been ordered for further characterization and will be reported separately."} +{"pid": "TCGA-AG-3612", "report": "The resected colon specimen includes the rectum with tumor-free margins at both the oral and aboral ends. An ulcerated lesion is present, characterized by moderately differentiated cellular features. The lesion extends into the perimuscular fatty tissue. A single regional lymph node demonstrates metastatic involvement. No vascular or lymphatic invasion is identified. The local resection margin is free of disease."} +{"pid": "TCGA-EA-A6QX", "report": "The cervix contains an invasive, ulcerated mass measuring 4 x 3 x 1.2 cm. The surface is soft and white-gray in appearance. Microscopic evaluation reveals hyperplastic squamous cells replacing the normal epithelium, with infiltration into the muscle propria. The tumor cells are arranged in groups, broad sheets, or trabecular patterns. The cytoplasm of the malignant cells is moderately abundant and lightly eosinophilic. Nuclear features include enlargement, variation in size and shape, coarse chromatin clumping, and prominent nucleoli. Mitotic figures are observed. The stroma shows lymphocytic infiltration. Histologic assessment indicates a poorly differentiated morphology. The lesion measures less than 4.0 cm. Lymph node analysis shows 2 out of 3 involved nodes bilaterally in the pelvic region. Lymphatic invasion is present. Other features including venous invasion, margin status, evidence of neoadjuvant treatment, and additional findings were not specified."} +{"pid": "TCGA-AR-A2LQ", "report": "A single left axillary sentinel lymph node (number 1) was biopsied and found to be negative for metastatic disease. Blue dye was identified in the tissue. Immunohistochemical staining for cytokeratin was performed on paraffin-embedded tissue and confirmed the findings from the H&E evaluation. Similarly, a second left axillary sentinel lymph node biopsy was also negative for metastatic involvement, with blue dye present and immunostaining confirming the initial assessment.\n\nIn the left breast, a mass measuring 0.9 x 0.7 x 0.5 cm was identified in the lower outer quadrant. Histological grading showed favorable differentiation with Nottingham score breakdown of tubules 3/3, nuclei 1/3, and mitoses 1/3, resulting in a total score of 5 out of 9. There was no ductal or lobular carcinoma in situ identified, and angiolymphatic invasion was not present. The surrounding non-neoplastic breast tissue demonstrated fibrocystic changes and contained a hyalinized fibroadenoma measuring 0.6 x 0.4 x 0.4 cm located in the lower inner quadrant. Benign calcifications were noted in ducts and acini, and biopsy-related changes were present. The lesion did not extend to the nipple, skin, or chest wall. All surgical margins, including the deep margin, were free of tumor with a minimum distance of 0.2 cm at the anterior margin. Based on available surgical material, staging was determined as pT1bN0(i-)(sn).\n\nOn the right side, one of the sentinel lymph nodes (number 1) showed isolated tumor cells on both H&E and cytokeratin immunostaining, with fewer than 200 cells involved. Blue dye was identified in this node. The second right sentinel lymph node did not show any evidence of tumor involvement and lacked blue dye. Additional testing with immunohistochemical cytokeratin staining supported the H&E findings. A third right axillary lymph node was also free of tumor.\n\nThe right breast specimen contained a larger, multinodular, and irregular mass measuring 12.5 x 6.3 x 2.2 cm. It was located across multiple quadrants from the lateral aspect to the upper inner quadrant. Histologic features were similar to the left-sided lesion with identical Nottingham scoring. No in situ components or angiolymphatic invasion were observed. Fibrocystic changes were present in the surrounding benign tissue, and calcifications were identified within benign ducts and acini. Biopsy site changes were also noted. The tumor did not involve the nipple, overlying skin, or chest wall. Following re-excision of the deep margin, all surgical margins were confirmed to be free of tumor, with the closest distance being 0.2 cm at the deep margin. Staging was updated to pT3N0(i+)(sn) based on the revised surgical findings.\n\nRe-excision of the new right inferior-lateral chest wall margin revealed residual tumor within 0.2 cm of the deep margin."} +{"pid": "TCGA-DX-AB37", "report": "The clinical history includes a right thigh lesion. Specimen submitted was a radical resection of a right thigh mass.\n\nThe specimen weighed 2,610 grams and measured 29.0 x 18.0 x 8.0 cm. It included a strip of skin measuring 32.0 x 5.5 cm with a central, well-healed scar, along with underlying adipose tissue and skeletal muscle. The tumor measured 17.0 x 6.0 x 5.0 cm and was ill-defined and multinodular, infiltrating subcutaneous tissue and skeletal muscle. Approximately 70% of the specimen consisted of soft, yellow nodules of adipose tissue with focal hemorrhage and necrosis making up about 2 to 3%. Approximately 30% of the specimen contained uniform, gray, firm nodules. Both components infiltrated among skeletal muscle fibers. Surgical margins were grossly free of tumor, with the tumor approaching closest to the inferior deep soft tissue margin at approximately 0.5 cm.\n\nHistologic examination revealed two distinct areas. The predominant component displayed features resembling adipose tissue with lipoma-like and sclerosing patterns. A smaller portion exhibited high-grade morphology with a fibrosarcoma/malignant fibrous histiocytoma-like pattern. The tumor invaded skeletal muscle. All surgical margins were free of tumor involvement.\n\nSections sampled included superior, inferior, medial, lateral, and deep regions of the specimen. Multiple blocks were taken from both softer and firmer areas."} +{"pid": "TCGA-DX-A240", "report": "A 51-year-old male presented with a left inguinal mass. The specimen submitted included tissue from the spermatic cord and testis. Gross examination revealed an elliptical skin specimen measuring 10.3 x 1.1 cm with an elongated scar measuring 5.1 cm. A large, firm mass was identified within the subcutaneous tissue, measuring 13.5 x 6.1 x 5.5 cm. The mass was encapsulated and displayed a lobulated, homogeneous white-tan cut surface with areas of hemorrhage but no necrosis. A synthetic mesh fragment measuring 6.0 x 3.0 x 0.3 cm was attached to the mass and partially surrounded by tumor. The testicle measured 5.5 x 4.0 x 3.0 cm and contained a hydrocele with approximately 10 mL of clear fluid; no abnormalities were found in the testicular parenchyma. The vas deferens, measuring 6.5 cm in length, was involved by tumor at its proximal end. Microscopic evaluation showed a low-grade spindle cell sarcoma with a high mitotic rate, without pleomorphism or necrosis. The tumor was composed predominantly of a non-lipogenic component and contained a minor well-differentiated component (sclerosing subtype), accounting for less than 10% of the total tumor volume. The tumor measured 13.5 cm in greatest dimension and extended into fibroadipose tissue, including the spermatic cord, abutting the vas deferens, but not involving the testicle. The closest resection margin was 0.08 cm from the tumor. Additional findings included a cutaneous scar and foreign body reaction associated with synthetic mesh. Sections were taken from multiple sites including margins, tumor, skin, and vas deferens."} +{"pid": "TCGA-67-6215", "report": "The specimen was received as multiple tissue fragments from various lymph node regions. Specimen B, labeled as \"intralobar node,\" consists of multiple soft red-black fragments measuring 1.5 x 1.5 x 0.3 cm in aggregate. Specimen C, identified as \"intralobar node 2,\" includes multiple red-black fragments measuring 1 x 1 x 0.4 cm. Specimen D, submitted as \"superior segmental node,\" consists of a single red-black fragment measuring 0.4 cm. Specimen E, labeled \"posterior intralobar node,\" is a soft red-black node measuring 1 cm in greatest dimension and was bisected prior to submission.\n\nHistologic examination revealed non-caseating granulomas within the pulmonary parenchyma without evidence of pathogenic organisms. Mild emphysematous changes were also noted. All surgical margins were negative for abnormal cellular infiltration. Lymph nodes examined showed anthracotic pigmentation and non-caseating granulomas similar to those observed previously, with no evidence of abnormal cellular infiltration.\n\nPathologic staging was assessed as pT2a NO MX. The tumor was well-circumscribed, measuring 4 cm in greatest dimension, located in the right lower lobe. It extended to the pleural surface with associated pleural puckering but did not involve the visceral pleura. No vascular or lymphatic invasion was identified. Multiple lymph nodes were examined, and none showed signs of involvement."} +{"pid": "TCGA-UW-A72R", "report": "The surgical specimen includes a left para-aortic lymph node biopsy and additional lymph nodes from the same region, along with a left renal mass excision. Microscopic evaluation of the lymph nodes shows no evidence of malignant cells. The renal mass measures 6.0 cm in greatest dimension and is well-circumscribed, with a tan and brown appearance and areas of necrosis and hemorrhage. Histologic examination reveals sheets of cells with pleomorphic nuclei and eosinophilic, granular cytoplasm with perinuclear clearing and distinct cell borders. Immunohistochemical staining demonstrates positivity for CK7 and CD117, while vimentin and RCC markers are negative. Focal colloidal iron staining is present within the cytoplasm. The histologic grade is Fuhrman grade 1. The tumor is unifocal and confined by a fibrous capsule that extends to but does not breach the renal parenchymal margin. There is no involvement of the renal capsule, perirenal adipose tissue, or venous or lymphatic structures. All surgical margins are free of abnormal cellular findings. Non-neoplastic kidney tissue shows no significant pathology. The staging assigned is pT1b pNO based on available data at the time of reporting. Intraoperative frozen section analysis of the lymph node did not show any abnormal cellular features. The findings were consistent with a well-differentiated neoplasm showing distinct morphologic and immunophenotypic characteristics."} +{"pid": "TCGA-ED-A97K", "report": "The gross specimen demonstrates a well-circumscribed mass measuring 5x4x4cm, with a solid and firm consistency and a gray-white cut surface. Microscopically, the lesion exhibits trabecular, cord-like, tubular, and adenoid architectural patterns within benign-appearing tissue. The tumor shows infiltration into fibrous stroma and is associated with inflammatory cell invasion and areas of necrosis. The neoplastic cells display abundant cytoplasm, which is either clear or basophilic, with large, irregular, hyperchromatic nuclei and prominent nucleoli. Mitotic figures are present. The surrounding stroma shows marked fibrosis and hyalinization. Histologic evaluation indicates moderately differentiated morphology. Surgical margins are uninvolved. No information is provided regarding lymph node involvement, venous invasion, focality, or response to prior treatment."} +{"pid": "TCGA-A5-A2K2", "report": "The specimen consists of a total abdominal hysterectomy with bilateral salpingo-oophorectomy along with multiple biopsies and lymph nodes. Two polyps were identified in the anterior uterine fundus and corpus measuring 1.6 cm and 2.5 cm respectively. These polyps are partially replaced by a high-grade cellular proliferation. Involvement of the endometrium elsewhere in the uterine corpus was also observed. Invasion into the stroma of these polyps was noted, as well as involvement of adenomyosis. Myometrial invasion was present but limited to less than half of the uterine wall thickness. Lymphovascular invasion was identified.\n\nA microscopic focus of metastatic involvement was detected in the left parametrium. No tumor was found in the cervix or vaginal cuff. The right ovary, right fallopian tube, and left ovary showed no signs of metastatic spread. Free-floating aggregates of atypical cells were identified within the lumen of the left fallopian tube, although there was no evidence of invasion into its wall.\n\nAdditional findings include several smaller endometrial polyps, one of which demonstrates focal intraepithelial proliferation. Non-neoplastic endometrial tissue showed mostly inactive or weakly proliferative features with some areas exhibiting disordered proliferation. Adenomyosis was present, some of which was secondarily involved. Multiple small smooth muscle tumors were identified, most consistent with typical leiomyomas, including one classified as cellular. There was also serosal/subserosal mullerianosis/endometriosis.\n\nExamination of other tissues revealed serosal adhesions and various benign changes in the cervix including chronic and acute inflammation, reserve cell hyperplasia, squamous metaplasia, microglandular hyperplasia, cystic tunnel clusters, and nabothian cysts. Minimal inflammatory changes were seen in the vaginal cuff. The right ovary demonstrated senescent changes, cortical stromal hyperplasia with associated hyperthecosis, epithelial inclusions, and serosal adhesions. Similar findings were noted in the left ovary along with calcifications and psammoma bodies. Both fallopian tubes exhibited minimal inflammation with free-floating cellular aggregates only on the left side.\n\nBiopsies from the bladder peritoneum, cul-de-sac, left and right pelvic peritoneum, and gutters showed thermal/cautery artifacts without evidence of malignant involvement. No metastatic presence was identified in the omental samples or lymph nodes examined, including those from the left and right pelvic and common iliac regions. All lymph nodes showed reactive changes without signs of metastasis.\n\nHistologic evaluation included special staining and immunohistochemical studies that supported the morphologic findings. Stromal invasion, papillary and glandular architecture, and nuclear grade were considered in assessing the lesion."} +{"pid": "TCGA-CQ-7072", "report": "The specimen consisted of a right partial glossectomy and right partial mandibulectomy, along with multiple neck dissection specimens from both sides. The resected tongue and floor of mouth specimen measured 4.3 x 6.5 x 6.0 cm overall, with the tongue portion measuring 5.5 x 3.5 x 1.1 cm and the floor of mouth measuring 4.7 x 2.0 x 0.5 cm. A tumor was identified in the tongue and floor of mouth region, measuring 3.2 cm in greatest dimension and 1.2 cm in thickness. The tumor had a solid, yellow-tan cut surface and did not show macroscopic invasion of bone. Microscopically, the tumor showed moderately differentiated features with extensive perineural invasion. No lymphatic or vascular invasion was identified. The lateral margin was closest to the tumor at 0.3 cm; all other margins were negative. In addition, carcinoma in situ was present. Sections of the mandible were taken and required decalcification for further evaluation.\n\nLymph node dissection included six lymph nodes from right neck level IIB, all negative; four from right neck level II, all negative; eight from right neck level IV, all negative; and two from right neck level I, all negative. Submandibular gland from this side showed moderate atrophy but no tumor. Right neck level III soft tissues showed no pathologic changes. Left neck dissection included eight lymph nodes (levels I and II), all negative for tumor. The submandibular gland on the left also showed no pathologic changes. Additional specimens including left floor of mouth, left sublingual gland, left ventral tongue, deep and right tongue margins, and deep midline muscle were all negative for tumor. Surgical waste included unremarkable bone and soft tissue.\n\nA total of 28 regional lymph nodes were examined, none involved by tumor. Bone sections showed cortical involvement by tumor, though bone margins remained negative. A final staging assessment indicated a primary tumor greater than 2 cm but less than 4 cm in greatest dimension with no regional lymph node metastasis. Distant metastasis could not be assessed."} +{"pid": "TCGA-AG-3883", "report": "The specimen shows an invasive, moderately differentiated epithelial neoplasm arising in the colonic region with involvement of the muscularis propria and vascular structures. Histological evaluation indicates a lack of tumor involvement at the resection margins and no evidence of nodal metastasis. Additionally, the anastomotic site is uninvolved. The lesion demonstrates a pT2 classification with lymphatic (L1) and vascular (V1) invasion noted. The surgical resection is complete with no residual disease at the primary site or in the regional lymph nodes."} +{"pid": "TCGA-CG-4465", "report": "The specimen consists of a distal partial gastric resection. The oral resection margin is tumor-free. There is an ulcerated lesion involving the prepyloric antrum on the greater curvature. Histologically, the lesion shows poorly differentiated features with characteristics of diffuse-type morphology, including signet ring cell appearance. The lesion infiltrates through all layers of the gastric wall and extends into adjacent structures, with involvement of the transverse colon. Multiple regional lymph nodes show metastatic involvement, along with metastases identified in the omentum. There is also evidence of peritoneal dissemination near the distal resection margin and at one margin of the transverse colon resection. Staging indicates extensive local and systemic spread."} +{"pid": "TCGA-Y8-A897", "report": "Female patient underwent robotic left partial nephrectomy for a left renal mass. The procedure was performed along with a robotic hysterectomy and bilateral salpingo-oophorectomy, as well as regional lymph node dissection. The tumor was located in the upper pole of the left kidney and measured 1.8 cm. Histologic evaluation showed nuclear grade 2 features. The tumor was confined to the kidney without evidence of sarcomatoid differentiation, necrosis, or lymphovascular invasion. Surgical margins were negative. A total of 34 regional lymph nodes were examined, none of which showed involvement. There was no evidence of distant metastasis at the time of evaluation. Pathologic staging was determined based on tumor size (\u22644 cm) and confinement to the kidney. No other lesions or significant findings were identified in the nonneoplastic kidney tissue. Specimen analysis included measurements of tumor and normal tissue components, with 66% tumor nuclei and 35% normal stroma observed. Tissue processing times and specimen details were documented, including fixation and storage parameters. All other reported findings were unremarkable."} +{"pid": "TCGA-DQ-7589", "report": "The specimen from the left tongue base consists of a 2.5 x 1.7 x 0.5 cm aggregate of pink, glistening, and friable soft tissue fragments. Histologically, the tissue shows invasive basaloid features with cellular atypia and infiltrative growth patterns.\n\nA separate specimen from the left aryepiglottic fold measures 2.6 x 1.6 x 0.4 cm and is composed of pink-red, friable soft tissue. Microscopic evaluation reveals similar invasive basaloid characteristics with evidence of tissue infiltration.\n\nBoth specimens were processed and evaluated in accordance with standard protocols. The findings are based on direct examination of the submitted material."} +{"pid": "TCGA-5L-AAT0", "report": "Gender: Female. Color: White. Origin: Breast tissue. Biopsy number: Not specified. Gross description: Received a single piece of fibrofatty tissue measuring 2.2 x 1.2 x 0.4 cm, marked with short sutures. On sectioning, a central white and firm area was identified, measuring 0.4 cm in maximum diameter. Microscopic evaluation noted specific cellular features. Hormone receptor analysis showed positive staining for ER in 70% of cells and PgR positivity in 20%. HER2 staining was negative with a score of 1+. Immunohistochemical analysis demonstrated loss of E-cadherin expression. The histological grade was determined to be low. The excision margins were assessed as part of the evaluation."} +{"pid": "TCGA-EJ-5494", "report": "The patient underwent a radical retropubic prostatectomy following a history of biopsy showing bilateral involvement. A total of 17 lymph nodes were examined, with 9 from the right pelvic region and 8 from the left; no tumor involvement was identified in any of the nodes.\n\nThe excised prostate specimen weighed 62.18 grams and showed a lesion with a maximum dimension of 2.3 cm, involving both the right and left lobes. The tumor accounted for approximately 60% of the total prostate volume. Histological evaluation revealed an acinar-type adenocarcinoma with a Gleason score of 4+3=7, with the higher-grade component making up 70% of the tumor. High-grade prostatic intraepithelial neoplasia was also present in a multifocal pattern.\n\nExamination of the surgical margins showed no evidence of tumor at the margins; however, the tumor was found to approach within 0.1 mm of the resection margin at the anterior right apex. There was no involvement of the bilateral seminal vesicles. Extensive perineural invasion was noted, while angiolymphatic invasion was not identified.\n\nExtraprostatic extension was present on both the right and left anterior aspects of the prostate. Based on these findings, the pathologic staging was determined as pT3a, with no regional lymph node involvement (pN0) and no evidence of distant metastasis (pMX). The histologic grade was classified as G3-4, consistent with poorly differentiated features. Background tissue showed nodular hyperplasia and chronic inflammation."} +{"pid": "TCGA-SH-A7BD", "report": "The specimen consists of multiple pieces of slightly papillary pink tissue measuring approximately 2 x 1.5 cm in aggregate. Histologically, the tissue shows infiltration by an epithelioid tumor. Immunohistochemical staining demonstrates positivity for CK5/6, WT-1, and calretinin, while negative for CK7, CEA, and TTF-1. Clinical findings include a history of cough and large right malignant pleural effusions identified on imaging. The patient has no history of smoking."} +{"pid": "TCGA-HM-A3JK", "report": "The surgical specimen included the uterus, cervix, bilateral adnexa, parametrial tissue, and upper vagina. The uterus measured 8.9 cm in length from the cervix to the fundus, with a breadth of 4.8 cm and width of 4.2 cm. A tan firm nodule was observed on the ectocervix, occupying a significant portion of the mucosal surface. Upon bisection, a fungating mass was identified within the cervix, extending into the myometrial wall. The tumor measured 4.8 x 4.0 x 2.5 cm and showed gross involvement of the parametrial tissue and upper vaginal regions bilaterally. The endometrial surface exhibited focal ulceration due to tumor infiltration. Both ovaries appeared unremarkable, with average dimensions of 1.2 x 0.8 x 0.5 cm. The fallopian tubes were unremarkable.\n\nHistologic evaluation revealed a poorly differentiated cellular proliferation originating in the cervix. Tumor extended into the myometrium, parametrial tissues, and upper vagina. All resected surgical margins were free of tumor involvement. Microscopic analysis of the right pelvic lymph nodes demonstrated metastatic involvement in one of the 23 nodes examined. In contrast, no metastatic involvement was identified in the left pelvic lymph nodes (16 nodes evaluated) or periaortic lymph nodes (12 nodes assessed). No vascular invasion was identified. Distant metastasis could not be evaluated based on the available specimen.\n\nLymph node specimens were submitted for analysis. The right pelvic lymph node specimen consisted of multiple tissue fragments measuring 7.5 x 7.0 x 2.5 cm, containing lymph nodes ranging from 0.3 to 4.5 cm in diameter. The left pelvic lymph node specimen measured 7.5 x 5.5 x 3.5 cm, with lymph nodes ranging from 0.5 to 3.5 cm. The periaortic lymph node specimen included fragments measuring 5.5 x 4.5 x 1.2 cm, with lymph nodes ranging from 0.5 to 2.5 cm. All lymph nodes were sectioned and examined in detail.\n\nNo tumor involvement was observed in either ovary or fallopian tube. Sections of the cervix, parametrial tissue, upper vagina, and involved myometrium were fully submitted for histologic review."} +{"pid": "TCGA-BP-4173", "report": "The patient presented with a large right renal mass measuring 9 x 9 cm. A radical nephrectomy specimen from the right kidney weighed 892 grams and measured 15.5 x 10.2 x 6.4 cm. The tumor measured 9.5 x 7.2 x 5.9 cm and was located at the lower pole, extending toward the middle portion of the kidney. The tumor had a lobulated appearance with brown-yellow parenchyma and areas of hemorrhage and necrosis. It was confined within the renal capsule and did not involve the renal pelvis. All surgical margins were free of involvement. The surrounding kidney tissue showed focal chronic pyelonephritis and glomerulosclerosis. No adrenal gland tissue was submitted for evaluation.\n\nFive lymph nodes were identified in the paracaval specimen and were histologically benign. Microscopic evaluation of the tumor revealed a solid growth pattern. Cellular features included nuclear grade III/IV morphology. Representative sections of the tumor, surrounding kidney tissue, renal pelvis, and surgical margins were submitted for analysis. Intraoperative frozen section consultation confirmed a cortical neoplasm consistent with the final histological findings."} +{"pid": "TCGA-QK-A6IJ", "report": "A surgical specimen from the floor of the mouth was examined, measuring 3.9 x 2.6 x 1.5 cm. Within this specimen, a lesion measuring 2.2 x 1.8 x 0.4 cm was identified and noted to have a depth of invasion of 4 mm from the ulcerated surface. Microscopic evaluation revealed an exophytic and ulcerated lesion involving superficial skeletal muscle bundles. All surgical margins were free of invasive disease. The closest margin was located inferiorly, at a distance of 3 mm from the lesion.\n\nAdditional tissue samples were taken from various margins: superior, inferior, anterior, posterior, and a new anterior margin. Among these, focal mild epithelial dysplasia was identified in the superior margin, ulcerated squamous mucosa in the inferior margin, focal high-grade squamous dysplasia in the anterior margin (best appreciated on frozen sections), and reactive lymphoid aggregates in both the posterior and new anterior margins.\n\nLymph node dissection was performed across levels I through IV on the left side. A total of 40 lymph nodes were evaluated. Of these, one lymph node from level II contained a metastatic deposit measuring 1.7 cm within a node that measured 2.5 cm in greatest dimension. All other lymph nodes across all levels were negative for metastasis. Additionally, chronic sialadenitis was noted in salivary gland tissue present within the level I specimen.\n\nHistologic examination showed no evidence of lymphovascular or perineural invasion. No treatment effect was observed. Inflammatory infiltrate including eosinophils was noted.\n\nThe tumor was staged as pT2 based on its size (>2 cm but \u22644 cm in greatest dimension). Regional lymph node involvement was classified as pN1 due to the presence of metastasis in a single ipsilateral lymph node measuring 3 cm or less."} +{"pid": "TCGA-B5-A0K6", "report": "The specimen includes a uterus and cervix weighing 61 grams, measuring 8 x 4.5 x 2 cm, with a cervix 2 cm in diameter. Upon opening, a tan-white lesion measuring 2.6 x 1.5 x 0.3 cm is identified in the corpus. The lesion appears exophytic and does not extend into the myometrium. The myometrium contains multiple well-defined tan-white nodules, the largest being 0.7 cm. The cervix shows no notable abnormalities. A right fallopian tube is attached, measuring 9 cm in length and 0.8 cm in average diameter, and contains ten paratubal cysts up to 0.5 cm in size.\n\nAdditional tissue samples include a right ovary, measuring 3.5 x 3 x 2.5 cm, with calcifications and areas of tan-yellow material and hair. The left ovary measures 5.2 x 3.5 x 3.3 cm and displays multilocular structures filled with yellow material and clear fluid. A segment of the left fallopian tube, 6.5 cm long and 0.9 cm in average diameter, is also present and contains two small paratubal cysts.\n\nMicroscopic analysis of the uterine lesion reveals cellular features consistent with a well-differentiated process. The depth of involvement within the myometrium is minimal, measuring 0.1 cm within a wall thickness of 1.5 cm. No evidence of lymphatic or vascular invasion is observed. Adjacent endometrial tissue shows signs of hyperplasia. The remaining myometrial tissue contains benign-appearing nodules. All surgical margins are free of abnormal cells.\n\nThe right and left ovaries each contain cystic structures lined with mature elements. The fallopian tubes on both sides show no significant pathology. \n\nStaging is based on the extent of local involvement in the uterus and indicates early-stage disease without evidence of regional or distant spread."} +{"pid": "TCGA-BP-4977", "report": "The left upper pole partial nephrectomy specimen includes a wedge-shaped portion of kidney measuring 11.5 x 7.2 x 5.6 cm, with perinephric fat attached. The kidney itself measures 6.5 x 5.5 x 4.6 cm. A well-circumscribed yellow lesion is identified, measuring 4.5 cm in greatest dimension, with areas of hemorrhage and focal cystification. The lesion is confined within the renal capsule and is cleared from the resection margin by 0.2 cm. Another small subcapsular lesion measuring 0.4 cm is noted in the renal parenchyma, located 0.9 cm away from the main lesion. Both lesions are submitted for further analysis.\n\nHistologic evaluation reveals nuclear features classified as grade III/IV. No local invasion or renal vein involvement is observed. Surgical margins are free of tumor. Additional findings include multiple papillary adenomas within the non-neoplastic kidney tissue. No adrenal tissue or lymph nodes are identified.\n\nA separate biopsy of the deep margin involving the collecting system and sinus fat is submitted. This specimen consists of soft tissue with adipose components measuring 1.7 x 1.2 x 0.2 cm. Histologic examination reveals benign urothelial mucosa with chronic inflammation and benign renal parenchyma.\n\nStaging criteria indicate the lesion is confined to the kidney and measures less than 7.0 cm in greatest dimension."} +{"pid": "TCGA-EM-A2CT", "report": "The specimen consisted of a total thyroidectomy with intact specimen integrity. The right lobe measured 5.0 cm in greatest dimension, with additional dimensions of 2.6 cm and 1.4 cm. The left lobe measured 4.2 cm \u00d7 2.4 cm \u00d7 1.2 cm, and the isthmus measured 2.2 cm \u00d7 1.5 cm \u00d7 0.8 cm. The total specimen weight was 15 grams. A distinct nodule measuring 0.9 cm \u00d7 0.7 cm \u00d7 0.7 cm was identified in the right lower lobe; it appeared tan and well delineated. No parathyroid glands or lymph nodes were observed grossly.\n\nHistologic examination revealed a unifocal lesion located in the right lobe. The dominant lesion measured 1.1 cm in greatest dimension and exhibited follicular and trabecular architectural patterns. The cellular morphology demonstrated oncocytic features. Margins were free of involvement. The lesion was partially encapsulated without evidence of capsular invasion, lymphovascular invasion, perineural invasion, or extrathyroidal extension.\n\nFive regional lymph nodes were examined, none of which showed signs of metastatic involvement. Additional findings included adenomatoid nodules or nodular follicular disease within the thyroid. Parathyroid tissue was identified in one of the biopsy specimens.\n\nThe specimen submitted for intraoperative consultation included fibroadipose tissue from a biopsy site, one lymph node from the right paratracheal region, and a separate biopsy specimen interpreted as parathyroid tissue. Frozen section analysis of these specimens yielded no definitive pathological diagnosis initially, although parathyroid tissue was later confirmed in one sample."} +{"pid": "TCGA-IB-AAUT", "report": "A gallbladder specimen measuring 8.5 x 4.5 x 3.0 cm was received, with a smooth serosal surface and green watery bile within the lumen. No calculi were identified. The wall measured 0.2 cm in thickness. A lymph node specimen from region #8 was also received, measuring 2.8 x 1.3 x 0.8 cm, containing a possible lymph node measuring 2.0 x 1.0 x 0.8 cm.\n\nA Whipple procedure specimen included a duodenum measuring 22.0 cm in length and 7.0 cm in circumference, along with an attached pancreas measuring 6.0 x 5.0 x 2.5 cm. The pancreatic tissue contained an ill-defined tan lesion measuring 3.2 x 3.0 x 3.0 cm, located 1.3 cm from the body margin, less than 0.1 cm from the vessel bed, and near the uncinate margin. The lesion was in close proximity to the common bile duct. Three possible lymph nodes were identified in the peripancreatic soft tissue, ranging in size from 0.8 x 0.8 x 0.3 cm to 1.5 x 0.8 x 0.8 cm.\n\nA separate pancreatic margin biopsy measuring 1.4 x 0.7 x 0.4 cm was received, along with a small bowel mass measuring 1.3 x 0.7 x 0.5 cm, which was described as a tan to hemorrhagic nodule with attached soft tissue.\n\nMicroscopic evaluation revealed chronic cholecystitis in the gallbladder. The lymph node from region #8 showed no evidence of malignancy. In the Whipple specimen, the lesion was found to be confined to the pancreas, with lymphovascular and perineural invasion noted. The closest margin involvement was at the uncinate process, with a distance of 0.2 mm from invasive carcinoma. Seven out of nine regional lymph nodes showed metastatic involvement. The small bowel mass was determined to be a benign fibrous nodule.\n\nThe tumor was found to involve the wall of the common bile duct near the ampulla but did not extend into the ampulla itself. The uncinate and vascular bed margins contained mucinous cystic nodules that were acellular but consistent with tumor involvement. A total of 11 lymph nodes were examined, with 7 involved by tumor. No prior treatment had been administered. Additional findings included chronic pancreatitis."} +{"pid": "TCGA-FX-A3NK", "report": "Result date: Modified. Clinical History: Gastric mass; prior history of reactive myofibroblastic proliferation with gastric ulceration previously reviewed. A prior left nephrectomy was performed for xanthogranulomatous inflammation.\n\nSpecimen: \n1. Omental nodule. \n2. Subtotal gastrectomy. \n3. Gastric margin (stitch in margin). \n4. Proximal stomach. \n5. Omentum.\n\nGross Examination: \n1. The omental nodule is a 1.9 x 1.4 x 1.2 cm fragment of adipose tissue, inked and sectioned to reveal a 0.7 cm firm, tan-yellow mottled nodule, entirely submitted. \n2. The portion of stomach measures 25.5 cm along the lesser curvature, with a row of metallic sutures approximately 16 cm from the proximal end. A polypoid lesion measuring 8.5 x 5.5 x 5.0 cm is present, attached by a stalk 2.5 cm long x 2.0 cm wide x 0.5 cm thick. Distal to this is a smaller sessile lesion measuring 1.2 x 1.0 cm, averaging 0.3 cm thick. The serosal surface has scattered adhesions. Lymph node candidates are sampled in sixteen cassettes, including sections of the mucosa, gastric wall, margins, and perigastric tissue. \n3. The gastric margin specimen is a 2.5 x 2.5 x 1.7 cm fragment of gastric mucosa with a 3.0 cm staple line, retained in formalin. Sections are taken perpendicular to the margin. \n4. The proximal stomach segment is 7.0 x 3.5 x 3.0 cm, with two staple lines measuring 3.4 cm and 7.0 cm. No mucosal lesions are identified. \n5. The omental fragment measures 21.0 x 11.0 x up to 3.0 cm, with a 0.2 cm tan nodule on the surface, submitted in one block.\n\nMicroscopic Examination: \nThe large pedunculated lesion shows a bland spindle cell proliferation with entrapped collagen fibers and scattered inflammatory cells, including eosinophils, lymphocytes, and plasma cells. The process extends to the mucosal surface and involves benign gastric glands. No necrosis or atypical mitotic figures are seen. Immunostains show SMA positivity, c-kit and CD34 negativity, and patchy CD68 expression. The second, smaller sessile lesion is less cellular and composed of a fibroblastic proliferation. FISH studies indicate CPM gene amplification. Margins are negative. Drs. and have reviewed the case, and consultation confirms findings. The report has been amended to correct the final diagnosis date, with no change to the diagnosis itself.\n\nSummary: \nA subtotal gastrectomy specimen contains two polypoid masses within the stomach, measuring 8.5 cm and 1.2 cm. Microscopically, the larger lesion demonstrates a bland spindle cell proliferation, while the smaller lesion shows an atypical lipomatous component. FISH analysis supports the findings. All resection margins are free of involvement. A separate omental nodule shows fat necrosis, and additional omental tissue is benign. The proximal stomach and gastric margin specimens demonstrate benign tissue."} +{"pid": "TCGA-X7-A8DB", "report": "The resected thymic specimen was obtained via median sternotomy. The thymus measured 14 x 9 x 3 cm and contained a well-defined mass measuring 4.3 x 3.5 x 2.8 cm. The mass was tan, rubbery, and predominantly homogeneous with focal areas of hemorrhage. It was located in close proximity to the inked soft tissue margin, coming within 0.2 cm, and was also adjacent to the serosa at one aspect, with a distance of 0.5 cm. No necrosis was identified. The mass was surrounded by a small amount of normal-appearing thymic tissue. Two small lymph node-like structures were found within the surrounding fat, measuring 0.4 cm and 0.6 cm. Histologically, the mass exhibited a B2 histologic pattern based on standard classification criteria. Sections were taken from the mass to the inked margin, to the serosa, and randomly throughout the mass. Both lymph node-like tissues were entirely submitted for evaluation and showed no evidence of involvement. All margins examined were free of abnormal cellular infiltration."} +{"pid": "TCGA-46-3769", "report": "The surgical specimens included transbronchial biopsies, bronchial brushings, a post-bronchoscopy sputum specimen, and pooled bronchial washings from the right upper lobe. The transbronchial biopsy showed poorly differentiated non-small cell morphology with squamous features. No malignancy was identified in the bronchial brushings, sputum, or bronchial washings specimens. The bronchial brushings contained few atypical cells, but these were interpreted as likely reactive pneumocytes and alveolar macrophages. The sputum specimen consisted only of oral material and was not representative of lower respiratory pathology. The bronchial washings showed blood and acute inflammation without evidence of malignancy.\n\nThe resected lung tissue from the right upper lobe lobectomy weighed 650 grams and measured 16 x 14.5 x 7.3 cm. A large mass measuring 14.4 x 8.5 x 7 cm was identified; it was well-circumscribed, gray-white, and friable with central necrosis. The mass extended throughout the entire lobe and appeared to abut the pleural surface, located 1 cm from the hilum and 1.3 cm from the closest stapled resection margin. The bronchial and vascular margins were free of tumor involvement. The chest wall plaque specimen showed evidence of metastatic involvement with tumor present at the cauterized edges. Lymph node specimens from multiple sites, including level 9R, right tracheobronchial angle, and right lobar upper regions, were negative for tumor involvement.\n\nHistologically, the lesion was classified as poorly differentiated with squamous features (histologic grade 3 of 4). Immunohistochemical staining demonstrated P63 positivity and TTF-1 negativity. There was no evidence of venous or large vessel invasion. Lymph node staging revealed no metastases in N1, N2, or N3 stations. The tumor was found to invade the visceral pleura and involved a separately submitted chest wall tissue. It remained unclear whether this represented direct extension or metastatic spread. Based on these findings, the pathologic TNM stage was determined to be pT3 pN0 pMX."} +{"pid": "TCGA-OR-A5J7", "report": "The specimen consists of a resected right kidney and an associated mass, weighing 503 g and measuring 18 x 12 x 7 cm. A distinct mass within this specimen measures 12 x 7.5 x 7 cm. The mass is partially encapsulated and shows infiltration into the surrounding adipose tissue, with close proximity to the surgical margins. The cut surface is multilobulated, with a brownish-yellow appearance and areas of necrosis. Normal adrenal architecture is not clearly identifiable. The right kidney is attached to the mass, though no evidence of direct renal invasion is observed. Surgical margins are marked with green Indian ink. A separate hepatic fragment is present, composed of two brownish pieces measuring 2 x 1 x 0.4 cm.\n\nMicroscopic evaluation reveals a tumor with a diffuse growth pattern, nuclear grade 4, and presence of atypical mitotic figures. Necrotic regions are identified, with a mitotic count of 3 in 50 high-power fields. Less than 25% of the neoplastic cells exhibit clear cytoplasm. Capsular and venous invasion are present. The tumor demonstrates aggressive features with involvement of peritumoral fat and proximity to resection margins."} +{"pid": "TCGA-08-0358", "report": "The brain specimen was received in two parts, both labeled appropriately with the patient\u2019s identifying information. Part A consisted of a single portion of red-brown, soft tissue measuring 2.0 x 1.0 x 1.0 cm. A representative section was taken for intraoperative diagnosis using touch prep and smear techniques. The remaining tissue was submitted as A1. Additionally, a small fragment measuring 5 x 4 x 3 mm was frozen for research purposes. Part B consisted of an unoriented tan and pink, soft tissue fragment measuring 1.5 x 1.0 x 1.3 cm. It was bisected and entirely submitted in cassette B1.\n\nMicroscopic examination revealed features consistent with a high-grade neoplasm. Cellular morphology showed marked pleomorphism, brisk mitotic activity, microvascular proliferation, and areas of necrosis. Nuclear atypia was prominent. Immunohistochemical staining demonstrated positivity for glial markers. Due to overlapping morphologic features, an oligodendroglial component could not be definitively excluded during intraoperative assessment; however, regardless of lineage, the lesion exhibited characteristics of a grade IV tumor according to WHO classification.\n\nThe patient had no prior history of radiation or chemotherapy and presented with a right parietal lesion. Final staging was based on histopathologic evaluation and clinical correlation. All specimens were reviewed by the attending pathologist to confirm findings and ensure diagnostic accuracy."} +{"pid": "TCGA-AX-A06B", "report": "The uterus measured 7.5 cm from fundus to ectocervix, 5 cm from cornu to cornu, and 4 cm anterior to posterior. The endometrial cavity was largely replaced by a tumor mass. A polypoid lesion measuring 3.5 x 2.5 x 1.5 cm was identified in the anterior endometrial cavity. In the posterior myometrium, a mass measuring 3.5 x 2.4 x 0.9 cm was observed. Microscopic evaluation revealed invasive cellular growth involving the endometrium with extension into the myometrium. The depth of invasion was 1.2 cm within a total myometrial thickness of 1.5 cm. Tumor involvement extended to the lower uterine segment and involved superficial endocervical glands without evidence of stromal invasion. No lymphovascular space invasion was identified.\n\nSections from the cervix, bilateral fallopian tubes, and ovaries showed no signs of malignancy. Focal adenomyosis was noted in the myometrium, and focal endometriosis was identified in the left ovary. Regional lymph node dissection included left pelvic (6 nodes), right pelvic (7 nodes), right periaortic (4 nodes), and left periaortic (4 nodes) regions. All lymph nodes were free of malignant cells.\n\nHistologic grading demonstrated a solid growth pattern involving more than 50% of the tumor mass. The tumor extended into the outer one-third of the myometrium. Based on TNM classification, the tumor appeared limited to the endocervical glandular epithelium without stromal invasion. A total of 21 regional lymph nodes were examined and none contained metastatic disease. The provisional pathologic stage is consistent with T2a/N0/M0 classification. Immunohistochemical and other ancillary tests used in the assessment were developed and validated by the Surgical Pathology Department under CLIA \u201988 high-complexity standards. These tests have not been cleared or approved by the FDA but are used for clinical diagnostic purposes."} +{"pid": "TCGA-W2-A7HH", "report": "The specimen is labeled as right adrenal and paraganglioma. It weighs 46.2 grams and measures 10.5 x 5.5 x 1.5 cm. The outer surface is inked black, and the tissue is serially sectioned. A well-encapsulated nodule measuring 1.8 x 1.2 x 1.2 cm is identified within the adrenal gland, which has a yellow cortex and a slightly expanded tan medulla. Adjacent to the adrenal gland, within yellow lobulated adipose tissue, there is another well-circumscribed nodule measuring 2.2 x 1.6 x 1.3 cm with a pink to slightly orange appearance.\n\nMicroscopic examination of the adrenal gland shows diffuse enlargement with medullary expansion. The 1.8 cm nodule is primarily composed of clear cells resembling zona fasciculata cells. No increased mitotic activity, necrosis, or signs of capsular or vascular invasion are observed.\n\nIn the adjacent adipose tissue, a 2.2 cm lesion is present. Microscopically, it consists of nests and trabeculae of bland cells with abundant granular cytoplasm and round nuclei with coarse chromatin, arranged in a rich vascular network. Immunohistochemical staining shows positive results for Synaptophysin and Chromogranin in the tumor cells, and S-100 protein highlights a sustentacular cell network. There is no evidence of increased mitotic activity, necrosis, or vascular or capsular invasion.\n\nAll positive and negative immunohistochemistry controls were reviewed and approved by the pathologist, who has verified the findings and electronically signed the report."} +{"pid": "TCGA-HC-A8D1", "report": "The specimen was received from a male patient and included left and right pelvic lymph nodes as well as an intact prostate gland with attached bilateral seminal vesicles and vas deferens. The lymph nodes, measuring between 0.5 and 3.0 cm in greatest dimension, were entirely submitted for analysis and none showed evidence of malignant involvement. The prostate measured 6.5 x 6.0 x 2.5 cm and weighed 50 grams. Histologic evaluation revealed no definitive mass lesion. Tumor involvement was estimated to occupy approximately 15 to 20% of the prostate volume. Histologic grading demonstrated a primary pattern score of 3/5 and a secondary pattern score of 4/5.\n\nExamination of surgical margins showed no involvement at the inked apex, base, or peripheral regions. No extraprostatic extension, seminal vesicle involvement, or lymphovascular space invasion was identified. High-grade prostatic intraepithelial neoplasia and treatment effect were also not observed. Lymph node assessment confirmed absence of metastatic disease.\n\nAdditional findings included nodular hyperplasia. Staging was determined to be pT2c, N0. The prostate was sectioned serially from apex to base and showed a gray tan to yellow tan cut surface without grossly identifiable abnormality. Portions of fibroadipose tissue were also submitted and processed accordingly."} +{"pid": "TCGA-G3-A25X", "report": "The liver specimen measures 12.5 x 10.5 x 6 cm and weighs 301 grams. A dominant lesion measuring 6.5 x 5.3 x 5.1 cm is present; it is irregularly shaped, tan-yellow, and consists of multiple lobulated components. This lesion is located near the serosal surface and comes within 1.3 cm of the surgical margin. Adjacent to this lesion is a smaller nodule measuring 1.0 cm in diameter, located 0.7 cm from the primary lesion, 0.9 cm from the serosa, and 1.0 cm from the surgical margin. The surrounding liver tissue appears orange-brown with a heterogeneous, slightly nodular texture.\n\nHistologically, areas of liver away from the lesions show preserved lobular architecture. Portal regions are expanded with inflammatory infiltration and fibrosis. There is evidence of piecemeal necrosis and fibrous bridging between portal areas. Within the lobules, spotty necrosis and lymphocytic permeation of sinusoids are observed. Mild macrovesicular steatosis is also present. Iron staining reveals significant iron overload in hepatocytes (3+), while alpha-1 antitrypsin staining is negative.\n\nThe gallbladder specimen measures 7.3 x 2.7 x 2.1 cm and has a tan-grey serosa. The lumen contains dark green viscous fluid without calculi. The mucosa is bile-stained, velvety, and shows pinpoint yellow lesions. Microscopic evaluation of the gallbladder demonstrates chronic inflammation."} +{"pid": "TCGA-VD-A8KH", "report": "The specimen consists of an intact left eye with axial, horizontal, and vertical dimensions measuring 24.5mm, 24mm, and 24.5mm respectively. The cornea measures 11mm horizontally and 11mm vertically. The optic nerve is 7mm in length and 4mm in diameter. On macroscopic examination, a large grey mass is present on the lateral side of the eye, with a largest basal diameter of 16mm and a height of 13.5mm. The mass extends from the ciliary body to within approximately 8mm of the optic disc. Transillumination reveals a slight irregularity on the iris at the 9 o\u2019clock position and a shadow measuring approximately 21 x 16mm in the lateral part of the eye. The tumour extends pre ora and involves the ciliary body between 9 and 10 o\u2019clock.\n\nMicroscopically, the lesion is composed of a mixed cell population with a predominance of spindle cells and up to 15% epithelioid cells. Mitotic activity is present at a rate of approximately 2 per 40 high power fields. The microvasculature is prominent, with closed loops observed in the planes of section. There is minimal lymphocytic infiltrate and no evidence of tumour necrosis. Focal extension into the sclera through both scleral lamellae and a nerve channel is noted. The tumour approaches closely to the trabecular meshwork; however, no ring pattern of spread or involvement of the anterior chamber angle is identified. Tumour cells are not present at the resection margins or in sections of the optic nerve and vortex veins.\n\nAdditional findings include a slightly atrophic retina adjacent to the lesion and degenerative changes in the lens due to displacement by the mass. The ciliary body away from the lesion shows atrophy and hyalinisation of the ciliary processes. The cornea and anterior chamber angles appear normal, with a deep anterior chamber and open angles. Bruch\u2019s membrane is breached in areas adjacent to the tumour.\n\nMolecular genetic analysis of tissue obtained from the lesion demonstrated loss of chromosome 1p, monosomy 3, partial loss of chromosome 6p, and gains in chromosome 8q. These findings are under review for correlation with clinical and morphological data to assess metastatic risk. Immunohistochemical studies are also being performed and will be reported separately."} +{"pid": "TCGA-A7-A3RF", "report": "The surgical pathology report includes findings from three specimens. \n\n**Specimen A (Left axillary sentinel nodes, excision):** Two lymph nodes were identified and examined in their entirety at multiple levels. No evidence of metastatic disease was found in either node (0/2). \n\n**Specimen B (Left breast mass, excision):** The specimen measured 7.5 cm (medial to lateral) by 5.0 cm (superior to inferior) by 4.2 cm (anterior to posterior). It consisted of fibroadipose tissue with a well-circumscribed lesion measuring 3.7 x 3.2 x 2.7 cm, identified as a rubbery tan-white mass within the lateral half of the specimen. Histologically, the lesion showed invasive features with mucin production. Nuclear grading was higher than typically seen in similar cases. Evaluation of vessel invasion was performed using immunostains (D240, CD34), which did not show evidence of lymphatic invasion. Staining for p63 was negative, supporting absence of in situ component. Histologic grading was performed using the Elston SBR system: architectural score 2, nuclear score 3, mitotic score 1, resulting in overall grade 2. The greatest dimension of the lesion was 3.7 cm (pT2). Tumor was present less than 1 mm from the deep margin and extremely close to the lateral margin. No vascular invasion or calcifications were identified. Adjacent breast tissue showed no significant pathology. Skin margins were free of abnormal cells. \n\n**Specimen C (Pectoralis fascia, excision):** This specimen measured 3.0 x 2.5 x 0.7 cm and consisted predominantly of adipose and fibrous tissue. No gross abnormality or residual lesion was identified. Microscopic evaluation revealed presence of the lesion in adipose tissue at the inked medial margin of resection. \n\nMargins were evaluated microscopically across all specimens. Specimen B showed tumor involvement near the deep and lateral margins. All other margins were uninvolved."} +{"pid": "TCGA-BP-4326", "report": "The clinical history indicates a left kidney tumor and left partial nephrectomy. Specimens submitted included left renal hilar lymph nodes and a left kidney mass.\n\nEvaluation of the lymph nodes revealed three benign lymph nodes, all negative for any abnormal cellular infiltration. The lymph node architecture appeared intact without any evidence of involvement.\n\nThe kidney specimen consisted of a partial nephrectomy measuring 10 x 8 x 6 cm. The tumor measured 6.3 cm in greatest dimension and exhibited acinar growth pattern with distinct cellular features. It was well-demarcated and confined within the renal capsule. Hemorrhage, necrosis, and cystic changes were observed within the tumor. A satellite nodule measuring 0.6 cm was noted approximately 0.4 cm away from the main lesion and 0.8 cm from the kidney resection margin. The surgical margins were free of any atypical cells or involvement. Adjacent non-neoplastic kidney tissue showed focal sclerosis and chronic inflammation. Adrenal gland tissue was not included in the submission.\n\nSections from the tumor and surrounding tissue were processed, including control samples, and submitted for further analysis. Intraoperative frozen section evaluation confirmed no involvement in the lymph nodes and identified the tumor as a cortical lesion with characteristics consistent with specific cellular morphology. All surgical margins evaluated were uninvolved."} +{"pid": "TCGA-N7-A59B", "report": "The specimen consisted of a uterus with cervix, bilateral tubes and ovaries, and upper vagina, along with lymph nodes and other tissues. The uterus measured 9 cm x 7 cm x 4 cm and weighed 103 grams. Within the endometrial cavity, a polypoid mass measuring 3.5 x 1.4 cm was identified in the posterior wall near the lower uterine segment junction. It appeared confined to the endometrial surface and was attached by a narrow stalk. No definitive invasion was observed grossly. Sections from this mass revealed a malignant tumor composed predominantly of epithelial components. High-grade carcinoma with papillary serous features was noted. Additionally, areas of poorly differentiated carcinoma were present alongside rare spindled malignant cells. Adjacent endometrium showed focal presence of intraepithelial serous carcinoma.\n\nThe cervix exhibited patchy atrophy and chronic inflammation. Both ovaries contained epithelial inclusion cysts; the left ovary had a small surface cyst. The right fallopian tube demonstrated hydrosalpinx, while the left tube showed no abnormalities.\n\nLymph node evaluation included specimens from various regions: small bowel mesentery (1 lymph node), right external iliac (3 lymph nodes), right obturator (3 lymph nodes), left external iliac (1 lymph node), left obturator (1 lymph node), left paraaortic (1 lymph node), and right paraaortic (4 lymph nodes). All lymph nodes examined showed no evidence of malignancy.\n\nAdditional specimens included an omental biopsy and tissue from the rectovaginal septum. The omentum contained benign adipose tissue without malignancy. The rectovaginal septum specimen consisted of fibrous tissue with calcifications and benign cystic structures; no malignant cells were identified.\n\nMicroscopic examination confirmed absence of lymphovascular space invasion and no involvement of the lower uterine segment or endocervix. Based on these findings, the tumor appeared confined to the endometrium without deeper myometrial invasion. Clinical staging indicated tumor limited to the endometrium or invading less than half of the myometrium (T1a/IA), with no regional lymph node involvement (N0) and distant metastasis unable to be assessed (Mx).\n\nSections from multiple tissue blocks were submitted for thorough evaluation. Specimens were processed and labeled systematically across ten containers. Gross descriptions detailed measurements and appearances of all organs and lymph node regions. Multiple cassettes were used for embedding tissue samples for microscopic analysis.\n\nThe findings support that the malignant process was localized without evidence of spread beyond the endometrial cavity."} +{"pid": "TCGA-CV-6961", "report": "A resection specimen involving the anterior floor of mouth, anterior tongue, and anterior mandible was submitted for analysis. The specimen measured 7.0 x 6.5 x 5.2 cm and included a segment of tongue measuring 6.0 x 5.0 x 1.8 cm, an anterior mandible with adjacent floor of mouth tissue measuring 6.5 x 4.7 x 3.0 cm, a portion of skin and subcutaneous tissue measuring 6.0 x 5.0 x 0.8 cm, and bilateral submandibular soft tissue possibly representing salivary glands measuring 4.0 x 3.0 x 1.5 cm each.\n\nAn ulcerated necrotic lesion measuring 2.5 x 2.0 cm was identified in the anterior floor of mouth. This lesion extended into the tongue forming a tan-yellow soft mass measuring 2.0 x 1.5 x 1.1 cm located approximately 1.2 cm from the posterior muscle margin of the tongue. Additionally, involvement of the anterior mandible and extension into subcutaneous tissue and skin were observed. A pink-yellow necrotic nodule measuring 1.5 x 1.3 x 2.0 cm was noted within the skin and subcutaneous tissue of the anterior mandible, located 1.0 cm from the closest right skin margin. The lesion was also found to be 0.6 cm from the nearest right gingival mucosal margin.\n\nHistologic examination revealed invasive cellular proliferation involving the tongue, mandible, and extending into subcutaneous tissue and skin. Severe squamous dysplasia or in situ transformation was identified at the right posterior tongue mucosal margin of resection. Other mucosal margins, soft tissue margins, and skin margin were free of tumor involvement. Bone margins of resection were confirmed as tumor-free following additional sections processed after decalcification.\n\nLymph node evaluation included assessment of the right jugular digastric lymph node and bilateral submandibular regions. One lymph node was identified in the right jugular digastric region and showed no evidence of tumor involvement. The right and left submandibular salivary glands exhibited extensive atrophy, consistent with prior therapy effect.\n\nThe biopsy specimen from the floor of mouth consisted of irregular fragments of tan-gray tissue ranging from 0.7 to 0.1 cm in largest dimension. Microscopic evaluation of these fragments demonstrated features consistent with cellular atypia.\n\nRepresentative sections from the lesion and surrounding areas were submitted for permanent histologic evaluation. Multiple mucosal and soft tissue margins were sampled and analyzed. Sections through bone and tumor at the midline of the anterior mandible, as well as bilateral posterior mandibular margins, were submitted for further processing.\n\nAdditional specimens included a fragment of tooth root without identifiable lesion on gross inspection and a segment of adipose tissue containing one lymph node from the right jugular digastric region.\n\nAll other mucosal and soft tissue margins evaluated were negative for tumor involvement."} +{"pid": "TCGA-AA-3867", "report": "A resected segment of the colon demonstrates an ulcerated lesion with a maximum diameter of 3 cm. The lesion nearly circumferentially involves the intestinal wall and approaches within 0.5 cm of one resection margin. Microscopic evaluation reveals invasive growth through all layers of the intestinal wall, extending into the perirectal adipose tissue. Tumor involvement is noted in lymphatic channels at the tumor margin. Both proximal and distal resection margins are free of tumor. Examination of regional lymph nodes shows that four out of twenty-four mesocolic lymph nodes contain extensive metastatic deposits, with some involvement beyond the nodal capsule. The remaining lymph nodes display nonspecific reactive changes. Histologic grade is high, with significant nuclear atypia and mitotic activity. Vascular invasion is not identified."} +{"pid": "TCGA-BR-7715", "report": "Asterand Case ID. Open Clinica. Gross. Microsc. Subject ID. Descript. opic. is. ion. Descript. Details. ion. BR-7715. STOMACH TISSUE CHECKLIST. Specimen type: Subtotal gastrectomy. Tumor site: Stomach. Tumor size: 5 X 5 X 1 cm. Tumor features: None specified. Histologic type: Moderately differentiated. Tumor extent: Subserosa. Lymph nodes: 0/9 positive for metastasis (Regional 0/9). Lymphatic invasion: Not specified. Venous invasion: Not specified. Perineural invasion: Not specified. Margins: Not specified. Evidence of neo-adjuvant treatment: Not specified. Additional pathologic findings: Not specified. Comments: None."} +{"pid": "TCGA-XF-A8HC", "report": "A radical cystoprostatectomy with extended pelvic lymphadenectomy was performed, along with continent urinary diversion (Studer pouch to urethra) and G-tube placement. Multiple tissue specimens were examined microscopically.\n\nFrozen section analysis of the right distal ureter showed no abnormal cellular changes. The left distal ureter demonstrated hydroureter but no dysplastic or malignant cells. Para-aortic lymph nodes revealed involvement with atypical cells in frozen section. Final evaluation confirmed presence of similar findings in multiple lymph node regions including the para-aortic, left common iliac, paracaval, right and left common iliac, intracaval, and presacral regions. Involvement was also noted in left hypogastric/obturator, right hypogastric/obturator, and left presciatic lymph nodes. No such findings were identified in the right lymph node of Cloquet or left perirectal tissue.\n\nThe urethral margin showed no abnormal cellular changes. Examination of the bladder and prostate revealed papillary structures with cellular atypia involving the dome, left ureterovesical junction, trigone, and bladder neck. These structures infiltrated through the muscularis propria into surrounding fat. Adjacent mucosa showed additional abnormal cellular changes. No cancerous changes were seen at the urethral or ureteral resection margins. Prostatic tissue showed benign nodular hyperplasia with some areas showing intraepithelial proliferation. No invasive carcinoma was identified in the prostate or seminal vesicles.\n\nAn old scar specimen showed only fibrous tissue without any abnormal cellular features. Proximal and distal ureteral segments from both sides showed no abnormal cellular changes.\n\nLymph node assessment included 140 nodes, of which 97 showed similar findings. Pathologic staging indicated local extension beyond the primary site with regional lymph node involvement."} +{"pid": "TCGA-BH-A1FJ", "report": "The specimen from a right modified radical mastectomy procedure includes tissue from the breast and axillary contents. Microscopic examination reveals a lesion measuring 6.0 cm with both infiltrating and intraductal components. The intraductal portion is of comedo type and accounts for approximately 20% of the tumor volume. Nuclear grade is intermediate. Vascular space involvement is present, with tumor foci identified in multiple sections involving the upper outer, lower inner, and upper inner quadrants.\n\nEvaluation of lymph nodes shows involvement by metastatic disease in 6 out of 35 nodes examined. No evidence of Paget\u2019s disease was found in the nipple. All surgical margins are free of tumor involvement in the planes of section. Additional findings include fibrocystic changes with focal areas of severely atypical ductal epithelial hyperplasia in sections from the lower outer quadrant.\n\nImmunohistochemical analysis performed on block A14 demonstrates positivity for the progesterone receptor in approximately 80% of cells, while staining for the estrogen receptor is largely absent, showing positivity in only about 10% of cells. All slides have been reviewed and findings confirmed."} +{"pid": "TCGA-DF-A2KV", "report": "The tissue sample was obtained from an endometrial mass via surgical resection. The primary site is located in the uterus. The tumor measures approximately 3.8 centimeters in size. Histological examination reveals endometrioid-type adenocarcinoma, with a grade III differentiation. Staging indicates a pathological T category of T1b. A total of 21 lymph nodes were found to be positive, although the number of nodes sampled was not reported. No bilateral disease involvement was specified. The sample was collected fresh frozen, with no delay between the procedure date and sample collection. Clinical M classification was not available."} +{"pid": "TCGA-CZ-5460", "report": "The specimen labeled \"Right Kidney\" consists of a 483-gram radical nephrectomy specimen with overall dimensions of 17.0 x 7.2 x 5.0 cm, including a kidney measuring 10.2 x 6.3 x 4.8 cm and attached perinephric adipose tissue up to 3.5 cm thick. A well-circumscribed golden yellow, focally hemorrhagic mass measuring 2.4 x 2.4 x 1.0 cm is present in the mid pole. The mass appears to arise from the renal parenchyma and does not grossly invade the renal sinus. It is confined to the renal parenchyma, does not involve the renal capsule, and comes within 2.4 cm of the perinephric soft tissue margin.\n\nA friable hemorrhagic red/brown to yellow/brown necrotic tissue is identified within the renal vein, contiguous with the main mass, and comes within 0.2 cm of the renal vein margin. This tissue is likely a tumor thrombus. The mass also comes within 2.4 cm of the renal artery margin and 5.5 cm of the ureteral margin. Additionally, a 0.8 x 0.6 x 0.6 cm well-circumscribed yellow/tan friable nodule is noted in the inferior pole, possibly representing a satellite lesion.\n\nMicroscopically, the primary mass shows nuclear features corresponding to Fuhrman Grade II/IV, with focal areas of grade III/IV. The tumor is limited to the kidney except for the presence of tumor emboli in the vasculature. Extensive tumor emboli are identified, including at the renal vein margin. Margins of resection for the ureter, artery, Gerota\u2019s fascia, and soft tissue are negative for tumor involvement.\n\nStaging classification according to the AJCC 6th Edition is pT3b Nx Mx. No lymph nodes were identified in the perinephric adipose tissue. A separate assessment of non-neoplastic kidney tissue was performed, revealing 7 globally sclerosed glomeruli (3.5%). Remaining glomeruli show mild diffuse mesangial expansion without nodular glomerulosclerosis. Rare distal tubules contain PAS-positive hyaline casts. Less than 5% of cortical parenchyma demonstrates tubular atrophy and interstitial fibrosis. Vascular changes include mild to moderate sclerosis in some small arteries, with luminal narrowing due to subintimal connective tissue accumulation, and early focal hyaline degeneration in arterioles.\n\nCytogenetic analysis of the lesion revealed clonal chromosomal aberrations, including loss of the short arm of chromosome 3, which is commonly associated with certain types of epithelial neoplasms arising in the kidney. Karyotype findings were obtained from 10 metaphases, with 6 analyzed and 4 scored. Banding analysis was performed at a resolution of 400 bands or greater. Mosaicism and small chromosome anomalies may not be detectable using standard methods."} +{"pid": "TCGA-AA-3695", "report": "The surgical specimen from a right-sided hemicolectomy demonstrates tumor-free resection margins. A tubular adenoma with moderate dysplasia was identified in the ascending colon. Additionally, a moderately differentiated polypoid lesion was found in the cecum. This lesion extends into the perimuscular fatty tissue and is associated with involvement of several regional lymph nodes. Vascular invasion is not noted. The lymph node examination revealed 6 positive nodes out of 33 examined."} +{"pid": "TCGA-VD-AA8R", "report": "HISTOPATHOLOGY. Lab No. Clinical Consultant & Location. Unit No. SPECIMEN. LEFT GLOBE ENUCLEATION. Prognostic/diagnostic. CLINICAL DETAILS. No treatment. See diagram. Measurements: 14.10 x 13.73 x (6.55) mm. MACROSCOPIC DESCRIPTION. A fresh, intact, left globe. Dimensions: Axial 24mm, Horizontal 24mm, Vertical 23mm. Cornea: Horizontal 12mm, Vertical 11.5mm. Optic nerve: flush. On trans-illumination, a large shadow is seen inferiorly, approximately 15mm in maximum dimension. Plane of section: vertical. Intraocular description: On opening, a solitary pale dome-shaped choroidal mass is seen, with possible ciliary body involvement. Tumor size: LBD 13mm. Height 9mm. MICROSCOPY. Sections show a predominantly spindle cell lesion with a minor epithelioid component making up to 10%. The lesion occupies the choroid with focal extension to the pars plana. Most cells are arranged in a fascicular pattern with nuclear palisading. There is also focal cytoplasmic vacuolation giving some cells a balloon cell appearance. Mitotic activity is approximately 4/40 high power fields. Closed loops are not present in the planes of sections. The lymphocytic infiltrate within the lesion is minimal. Few scattered macrophages are present. Necrosis is not observed. Bruch's membrane appears focally breached in one of the sections. There is no extension through the sclera, optic nerve, or vortex veins examined. Lesion cells are not seen at the resection margins. Elsewhere, the cornea shows no significant abnormality. The anterior chamber angles are open and the anterior chamber is shallow. The iris shows no significant abnormality but the ciliary body appears atrophic with hyalinisation of ciliary processes. The lens shows cataractous changes. Retina overlying the lesion is slightly atrophic. \n\nMolecular genetic analysis was performed using MLPA on fresh tissue, examining chromosomes 1, 3, 6, and 8. DNA concentration was high and of good quality. Results showed normal chromosome 1p, disomy 3, borderline gains in chromosome 6, and normal chromosome 8. These findings suggest a low risk for metastatic disease; however, clinical features must also be considered. Immunohistochemistry demonstrated expression of Melan-A and HSP27 (score 2). \n\nMeasurements: largest basal diameter 13 mm, thickness 9 mm. Cellular composition includes mixed types. No closed loops identified. No necrosis. Mitotic count: 4 per 40 high power fields. No diffuse spread. Resection margins clear. HSP27 positivity: 21\u201370%."} +{"pid": "TCGA-VS-A9UC", "report": "Biopsy of the cervix reveals invasive malignant cells arranged in nests and cords infiltrating through the stroma. The tumor measures approximately 1 cm in greatest dimension. The neoplastic cells exhibit moderate nuclear atypia, increased nuclear-to-cytoplasmic ratio, and frequent mitotic figures. There is evidence of lymphovascular invasion. No lymph node involvement is identified. Clinical staging is confined to the cervix without extension to adjacent structures or distant metastasis."} +{"pid": "TCGA-A2-A04Y", "report": "The right breast specimen measured 27 cm medial to lateral, 21 cm superior to inferior, and 4.5 cm superficial to deep. A well-circumscribed pink-white mass measuring 2.5 x 1.5 x 1.0 cm was identified in the upper mid breast, located 0.3 cm from the inked superficial margin and 5.0 cm from the deep margin. A calcified nodule consistent with a fibroadenoma was also present. The Nottingham score was 8 out of 9 (tubules = 3, nuclei = 3, mitoses = 2), corresponding to a poorly differentiated grade. Venous or lymphatic invasion was present, and margins were negative. No tumor necrosis or intraductal component was identified. One sentinel lymph node on the right side contained a microscopic focus of involvement within the subcapsular sinus, measuring 0.47 mm. Hormone receptor testing showed strong positivity for estrogen receptor (90%) and weak positivity for progesterone receptor (10%). HER2 testing was negative.\n\nThe left breast specimen measured 28.0 cm superior to inferior, 23 cm medial to lateral, and 4.0 cm anterior to posterior. A gritty pink-tan mass measuring 5.0 x 4.2 x 2.7 cm was found in the upper mid and upper inner quadrant, located 0.2 cm from the superficial surface and 3.0 cm from the deep margin. A separate fibroadenoma was noted centrally. The Nottingham score was 9 out of 9 (tubules = 3, nuclei = 3, mitoses = 3), also classified as poorly differentiated. No venous or lymphatic invasion was seen, and all margins were negative. No intraductal component or multicentric disease was observed. Sentinel lymph node examination on the left revealed no evidence of involvement. Hormone receptor analysis demonstrated nearly complete positivity for estrogen receptor and partial positivity for progesterone receptor (40%). HER2 testing was positive by immunohistochemistry (3+) and confirmed by FISH.\n\nStaging evaluation suggested pT2 classification for both lesions. Lymph node status for the right side was classified as N1mi due to minimal involvement, while the left side was classified as N0 (i-), indicating no detectable nodal involvement."} +{"pid": "TCGA-96-7545", "report": "The specimen consists of a wedge resection of lung measuring 4 x 3 x 1.5 cm, containing a tan-white, well-circumscribed mass measuring 1.1 x 0.8 x 0.7 cm. The mass is located 0.3 cm from the stapled margin and is associated with a smooth, glistening pleural surface that shows focal ink marking. Histologic evaluation reveals a predominantly acinar growth pattern with associated scarring, along with small papillary and peripheral bronchioloalveolar-like components. Elastic stains confirm involvement of the overlying pleura. No lymphovascular invasion is identified. Immunohistochemical staining demonstrates positivity for TTF1. Adjacent benign intrapulmonary lymph node tissue is negative. The resection margin is free of abnormal cells.\n\nA second specimen consists of a rib segment measuring 10.5 x 2.0 x 0.6 cm, which shows no gross abnormalities after serial sectioning and decalcification. Microscopic examination of representative sections reveals no evidence of malignant cells.\n\nFrozen section analysis was performed on a representative portion of the lung specimen and confirmed findings consistent with the final evaluation. All relevant sections were submitted for review, including control sections, margins, and remaining tissue."} +{"pid": "TCGA-DE-A4MA", "report": "The surgical specimen includes a right submandibular lymph node measuring 2.9 x 1.4 x 1.6 cm with reactive follicular hyperplasia and no evidence of malignancy. A left inferior parathyroid tissue fragment measuring 0.3 x 0.3 x 0.2 cm showed normocellular parathyroid tissue without malignant features. Prelaryngeal soft tissue measuring 1.1 x 1 x 1 cm contained fibrovascular and adipose tissue with rare detached lymphocytes; no definitive lymph node was identified. Pretracheal soft tissue measuring 1.4 x 1.2 x 0.5 cm also contained fibrovascular and adipose tissue with no lymph node or malignancy identified.\n\nThe thyroid gland specimen weighed 22 grams and measured 6 x 4.5 x 2.5 cm in total. The left lobe contained a unifocal, well-circumscribed solid mass measuring 4.2 x 3 x 2.2 cm with fibrous septae. The tumor was located in the left lobe and approached multiple margins: it abutted the anterior and posterior margins, was 0.2 cm from the isthmus margin, 0.3 cm from the inferior pole, and abutted the superior pole. Histologic evaluation revealed invasive growth patterns including multifocal capsular invasion, extensive lymphovascular invasion, and presence of blood vascular invasion. Surgical margins were negative but the tumor was within less than 1 mm of the posterior margin. Adjacent thyroid tissue in the right lobe and isthmus showed no pathological abnormalities.\n\nLymph node evaluation included seven left peritracheal lymph nodes, of which six demonstrated metastatic involvement. The largest metastasis measured 0.5 cm and extracapsular extension into adjacent adipose tissue was noted. Additional microscopic findings included psammoma bodies within adipose tissue near the tumor site; however, no malignant epithelial cells were identified in this region upon extensive sectioning and re-examination. Intraoperative consultation on the right submandibular lymph node confirmed reactive changes without evidence of carcinoma.\n\nThe specimen was processed with formalin fixation. Gross examination revealed a tan to white, papillary appearance of the primary lesion. No digital photographs were taken. Special investigations included tumor tissue and lymph node sampling for further analysis. Specimen containers were appropriately labeled and submitted for histologic review."} +{"pid": "TCGA-AF-2689", "report": "The specimen includes a segment of the sigmoid colon and rectum, along with both fallopian tubes and ovaries. The sigmoid colon specimen measures 22 cm in length. The proximal margin circumference is 4.5 cm, and the distal margin circumference is 9 cm. A mass measuring 5 x 4.7 x 1.5 cm is identified, located 2.3 cm from the distal margin. Microscopic evaluation shows that the tumor extends minimally into pericolonic fat. All surgical margins are free of tumor involvement, including the radial margin, which is at least 2 cm away from the tumor. No vascular invasion is observed. Examination of regional lymph nodes reveals metastatic involvement in 6 out of 32 nodes. The right and left ovarian and fallopian tube specimens show no significant abnormalities, with normal-appearing stroma, corpora lutea, and small serous cysts. Lymph node assessment and histologic features of the resected tissue have been documented."} +{"pid": "TCGA-2G-AAGJ", "report": "The pathology report describes a left orchidectomy specimen. The tumor measures 3 cm in diameter and is confined to the testis. Histologic evaluation shows no evidence of angioinvasion or invasion of the rete testis. Cellular composition demonstrates a mixture of two components, one comprising the majority and the other a smaller proportion. The surgical margin is negative. No lymph nodes were identified for assessment. The specimen was examined by light microscopy and processed according to standard protocols. Immunohistochemical staining was performed as needed for classification. All findings were reviewed and confirmed by the pathologist."} +{"pid": "TCGA-DX-A3LS", "report": "The surgical specimen consists of a resected mass located in the left upper retroperitoneal region, along with splenectomy, partial gastrectomy, left adrenalectomy, and left nephrectomy. The primary lesion measures 13.2 x 10.5 x 7.5 cm and is described as a well-demarcated, white-pink fleshy tumor with approximately 20% geographic necrosis. It is situated between the spleen and stomach, superior to the adrenal gland and kidney. Adjacent to this main mass are three separate nodules measuring 3.2 cm, 3.0 cm, and 2.0 cm respectively. The smallest nodule appears to invade the spleen.\n\nHistologically, the tumor is composed predominantly of spindle-shaped cells arranged in streaming fascicles, with moderate to severe cytologic atypia. There are focal areas exhibiting rhabdoid morphology. Mitotic activity is present at a rate of 13 mitoses per 50 high power fields. Immunohistochemical staining demonstrates positivity for SMA in a myofibroblastic pattern in the spindled regions, while the rhabdoid areas show positivity for myogenin and desmin, indicating divergent differentiation.\n\nThe tumor involves the spleen and extends toward the stomach, kidney, and adrenal gland. The deep margin is focally involved; all other margins are free of tumor involvement. The surrounding adipose tissue appears distinct from the tumor without clear transition zones. No additional lesions are identified in the spleen, stomach, kidney, or adrenal gland. All nodules are distant from the inked margins. Gross examination confirms preservation of splenic architecture, normal gastric mucosa, intact renal cortex, and unremarkable adrenal morphology. Vascular margins appear unaffected. Representative sections of all involved and uninvolved tissues have been submitted for further analysis."} +{"pid": "TCGA-H5-A2HR", "report": "A female patient underwent a total abdominal hysterectomy with bilateral salpingo-oophorectomy, along with lymph node dissection. The surgical specimens included the uterus, cervix, bilateral tubes and ovaries, omentum, and multiple lymph node groups from both sides, including left and right pelvic and obturator regions.\n\nGross examination of the uterus revealed an exophytic tumor measuring 8 x 5 x 2 cm in the endometrial region. The tumor was observed to extend into the lower uterine segment and focally involved adjacent superficial endocervical glands without evidence of destructive stromal invasion. There was superficial myometrial invasion to a depth of 0.4 cm, out of a total myometrial thickness of 2.2 cm. Lymphovascular emboli were identified. All surgical margins were free of tumor involvement, with the closest circumferential margin measuring 1.5 cm from the invasive tumor. No tumor involvement was found in the bilateral parametria, ovaries, or fallopian tubes.\n\nThe omental specimen showed benign fibroadipose tissue without any signs of tumor. Examination of the lymph nodes (8 on the left pelvic, 2 left obturator, 4 right pelvic, and 5 right obturator) revealed no evidence of tumor involvement in any of the nodes.\n\nHistologically, the tumor was classified as high nuclear grade. No hyperplasia was noted in the non-neoplastic endometrium, and the cervix showed only mild chronic inflammation with squamous metaplasia. Additional findings included adenomyosis and leiomyomata.\n\nStaging was determined as pT2a pNO pMx. Drug resistance assay results showed low resistance to ifosfamide, etoposide, cisplatin; intermediate resistance to taxol, doxorubicin, and cyclophosphamide; and extreme resistance to topotecan."} +{"pid": "TCGA-NA-A4QY", "report": "The clinical specimen included multiple lymph node aggregates and uterine tissue. Gross examination revealed a right periaortic specimen containing six intact lymph nodes and one bisected lymph node measuring up to 1.2 cm in greatest dimension. The bisected lymph node exhibited a white-brown firm cut surface. A left periaortic specimen contained three lymph nodes, two of which were bisected. One was inked blue and showed a brown-red soft cut surface, while the other displayed a tan-yellow soft cut surface. An anterior peritoneal nodule measuring 1.5 cm had a tan-pink rubbery consistency with a smooth pink-white whorled cut surface. A right external iliac lymph node specimen contained one intact lymph node measuring 0.7 cm. The right obturator region contained six lymph nodes, with the largest measuring 4.5 cm and showing a red-brown soft cut surface. Two lymph nodes from the left pelvic region were identified, both measuring up to 1.7 cm and displaying pink-red soft cut surfaces.\n\nThe uterus weighed 335 grams and measured 14 x 13 x 7.5 cm. It was fragmented with attached adnexa. The endometrial lining was smooth and pink-tan, measuring 0.1 cm thick. Within the endometrial cavity was an exophytic mass measuring 3.5 x 1.5 x 2.1 cm, located on the anterior wall and confined grossly to the endometrium. The myometrium measured 3.9 cm in thickness at that site, with a maximum depth of invasion measuring 0.4 cm (19% penetration). Adjacent myometrium contained multiple fibroid nodules ranging from 0.7 cm to 5 cm. A small serosal nodule measuring 0.5 cm was also noted. The cervix, fallopian tubes, and ovaries appeared unremarkable. A separate aggregate of tissue measuring 6.5 x 5 x 2.5 cm was submitted, including portions of the mass and myometrium.\n\nMicroscopic evaluation of the lymph nodes from various regions including right and left periaortic, right external iliac, right obturator, and left pelvic areas did not reveal any abnormal cellular infiltration. In the anterior peritoneal lymph node region, a nodular focus was identified but no lymph node architecture was observed. The uterine specimen revealed a high-grade lesion within the endometrium, with no evidence of lymphatic or vascular invasion. Non-neoplastic endometrium was otherwise unremarkable. Leiomyomas were present throughout the myometrium. The cervix and serosal surfaces showed no pathological abnormalities. The appendix was structurally normal without signs of inflammation or neoplastic change."} +{"pid": "TCGA-E9-A5FK", "report": "The specimen consists of breast tissue with a lesion measuring up to 2.5 cm. Dense, hyperemic lymph nodes are present within the fatty tissue, some reaching up to 2 cm in size. Microscopic evaluation shows a moderately differentiated cellular growth with scirrhous pattern. A total of ten lymph nodes were examined, all showing evidence of metastatic involvement. Immunohistochemical analysis demonstrates strong positivity for estrogen receptor in 85% of cells and for progesterone receptor in 70% of cells. Human epidermal growth factor receptor 2 status is negative. Proliferative index, as assessed by Ki-67 staining, is 18%. The extent of the primary lesion is categorized as greater than 2 cm but not exceeding 5 cm. No venous invasion is identified. Surgical margins are uninvolved. All ten axillary lymph nodes show metastatic changes. Additional findings include dense lymph node involvement and absence of treatment-related changes."} +{"pid": "TCGA-EJ-5519", "report": "The patient is a male with a history of a PSA value of 15. A prior biopsy revealed high-grade disease involving multiple regions of the prostate, with Gleason grades ranging from 4+3 to 4+4 across several biopsy sites.\n\nA radical prostatectomy was performed. Examination of the prostate specimen identified an invasive poorly differentiated adenocarcinoma with a Gleason score of 4 + 4 = 8 and a tertiary pattern of 3. The tumor measured up to 2.6 cm in greatest dimension and involved both the right and left lobes. Approximately 70% of the prostate volume was affected. There was established extracapsular extension involving the right and left posterior base regions, with focal involvement of the inked surgical margins. Bilateral seminal vesicle invasion was present. All other surgical margins were free of tumor. Perineural and angiolymphatic invasion were identified. High-grade prostatic intraepithelial neoplasia was also present in a multifocal pattern.\n\nBenign findings included prostatic hypertrophy and chronic moderately active prostatitis.\n\nLymph node evaluation included 12 pelvic lymph nodes, with metastatic involvement identified in three: one of six on the right and two of six on the left. Extranodal extension could not be determined.\n\nPathologic staging was assessed as pT3b for local extension and pN1 for regional nodal involvement. The histologic grade was classified as G3-4. The prostate weighed 52.81 grams, and the tumor accounted for more than 25% of the specimen."} +{"pid": "TCGA-CJ-5677", "report": "The right kidney specimen shows a well-circumscribed lesion measuring 6.5 x 6.5 x 2.3 cm located in the upper pole. The cut surface is predominantly yellow with pink areas and contains approximately 60\u201370% necrosis. Histologic examination reveals high-grade nuclear features. The tumor invades perinephric adipose tissue and approaches within less than 0.1 mm of the inked soft tissue resection margin. Invasion into renal sinus fat is also present. Vascular and lymphatic invasion is identified. Margins of the renal vein, ureter, and renal artery are free of involvement. The adrenal gland is unremarkable. The gallbladder contains multiple small yellow-green stones and shows mild chronic inflammation."} +{"pid": "TCGA-E2-A576", "report": "The excised left breast tissue showed a lesion located at the 2:00 position, measuring 1.7 cm in size. A second non-contiguous focus of invasive disease was identified, measuring 0.1 cm. Adjacent to this lesion was a 0.3 cm area of intraductal proliferation with micropapillary features and intermediate nuclear grade. Microcalcifications were present within this intraductal component and also within small vessels. The margins of resection were free of involvement by invasive disease, intraductal disease, or pleomorphic cellular changes.\n\nLymphatic assessment included two sentinel lymph node biopsies from the left axilla. The first specimen contained four lymph nodes, and the second contained one lymph node. All nodes were unremarkable for any concerning cellular changes.\n\nHistologic evaluation demonstrated a tubular score of 3, nuclear grade 3, and mitotic score of 1, resulting in a combined histologic grade of 2. No necrosis or vascular/lymphatic invasion was observed. A separate focus of benign epithelial changes was noted. Immunohistochemical staining for ER and PR was positive, while HER2 testing was negative by FISH. E-cadherin staining was performed and showed loss of expression.\n\nRadiographic correlation confirmed a preoperative ultrasound finding of a lesion measuring approximately 12 mm x 15 mm x 9 mm. The final pathological staging was pT1c pN0, based on AJCC 7th edition criteria."} +{"pid": "TCGA-85-7696", "report": "Specimen is a lobectomy from the left upper lobe. The tumor measures 3 x 3 x 3.5 cm. Microscopic evaluation shows moderately differentiated cells. No information is provided regarding tumor extent, presence of additional nodules, lymph node involvement, lymphatic or venous invasion, margin status, evidence of neo-adjuvant treatment, or other significant pathologic findings. No comments added."} +{"pid": "TCGA-NA-A4R0", "report": "The specimen consists of a 5.0 x 5.0 x 3.5 cm aggregate of fibroadipose tissue from the omentum, containing two indurated areas measuring up to 4.5 cm. The uterus weighs 58 grams and measures 7 x 5 x 3 cm, with a cervix measuring 2.2 cm. A 3.0 x 2.5 cm polypoid thickening is identified in the posterior endometrium, with invasion reaching 1.1 cm into a myometrial wall that is 1.5 cm thick at its deepest point. No further abnormalities are observed in the endomyometrium. The serosa and cervix appear unremarkable. The right uterine adnexa include a 2 x 1 x 1 cm ovary and a 5 cm long, 0.5 cm diameter fallopian tube, both without notable abnormalities. The left uterine adnexa consist of a 5.5 cm long, 0.4 cm diameter fallopian tube and a 1.5 x 0.4 cm ovary, also without abnormalities.\n\nMicroscopic evaluation reveals poorly differentiated adenocarcinoma within adipose tissue of the omentum, with a maximum tumor size of 4.5 cm. In the uterus, the tumor is located in the posterior fundus and histologically shows a mixture of poorly differentiated adenocarcinoma, serous papillary carcinoma, endometrioid features, and undifferentiated carcinoma. Focal sarcomatous differentiation, including spindle cells and cartilage, is also present. Lymphatic or vascular invasion is present, and the adjacent endometrium is not hyperplastic. The tumor extends to a depth of 0.6 cm in a 1.6 cm thick myometrial wall. The cervix, serosa, and surgical margins are free of involvement. The ovaries on both sides show involvement by poorly differentiated adenocarcinoma, predominantly on the serosal surface, while the fallopian tubes are uninvolved.\n\nStaging is based on the current specimen and follows AJCC 7th Edition guidelines. The procedure performed was hysterosalpingo-oophorectomy and partial omentectomy."} +{"pid": "TCGA-EY-A72D", "report": "The specimen consists of a uterus with bilateral fallopian tubes and ovaries. The endometrial cavity measures 5.5 cm in length, with a tumor measuring 4.5 x 4 x 0.8 cm located primarily in the anterior lower and mid corpus, extending into the lower uterine segment. The tumor is tan-brown, friable, and exophytic. Microscopic examination reveals areas of solid architecture and high-grade nuclear features. Myometrial invasion extends to the inner half of the wall, with a depth of 4.5 mm in a wall thickness of 2.0 cm, representing 22.5% invasion. No serosal involvement is identified. Involvement of the lower uterine segment is present on both anterior and posterior surfaces.\n\nInvolvement of the cervix includes stromal invasion by malignant cells, with an invasion depth of 0.9 mm in a wall thickness of 1.5 cm (6%). Additionally, there is a separate lesion within the cervix measuring 1.4 cm in greatest horizontal dimension on a single slide, with a depth of invasion of 1.1 cm in a wall thickness of 1.5 cm. This lesion forms small nests and tubules, with basaloid and palisading peripheral cells. No lymphovascular space invasion is identified. No adnexal involvement is seen.\n\nMargins are widely negative for the primary endometrial lesion (>1 cm). The cervical lesion is 4 mm from the deep margin and 8 mm from the closest peripheral margin, which is also negative for in situ changes. Seven sections of the cervix show involvement by this second lesion. Immunostains performed demonstrate positivity for P16, P63, and CAM 5.2 in the cervical lesion, while vimentin shows subset positivity. S-100, CEA, CD56, ER, and PR are negative. The endometrial lesion shows positivity for P16 and vimentin, with weak ER and PR positivity in a subset of cells. Morphologic and immunophenotypic differences support the presence of two distinct tumors.\n\nAdditional findings include a high-grade squamous intraepithelial lesion (HSIL/CIN 3) in the cervix. Other pathologic findings include an endometrial polyp, adenomyosis, small intramural leiomyomata, and uterine serosal adhesions. Both ovaries are atrophic with endosalpingiosis. Each fallopian tube shows serosal adhesions. No lymph nodes are identified.\n\nGrossly, the uterus weighs 135 grams, is pear-shaped, measuring 8.5 cm in height, 5 cm in anterior-posterior width, and 4.5 cm in fundal breadth. The cervix measures 3.5 cm in diameter with a 1 cm cervical os. The endocervical canal length is 2 cm. A thin-walled cyst measuring 0.5 x 0.5 x 0.5 cm is present. A 0.8 x 0.6 x 0.6 cm whorled nodule is present in the myometrium. Both fallopian tubes are fimbriated, patent, and measure 4 cm and 3.8 cm in length. Ovaries weigh 2 grams and 1.8 x 1.5 x 0.6 cm, showing heterogeneous cut surfaces with multiple tan-yellow nodules consistent with corpus luteum.\n\nStaging is based on available data and may be subject to revision. Pathologic staging is pT2 pNx pMx for the endometrial component and pT1b1 pNx for the cervical lesion. According to FIGO (2009), the stage is II for the endometrial tumor and Ib for the cervical lesion."} +{"pid": "TCGA-77-7335", "report": "The lung specimen measured 195 x 110 x 75 mm and contained a polypoid mass located within the main bronchus, extending into the lumen. The mass measured approximately 32 mm in greatest dimension, had a firm pale appearance, and was found to involve adjacent lymph nodes. It grew into the bronchus and infiltrated surrounding pulmonary vessels and lung tissue. The tumour extended medially through pleura into fibrofatty soft tissue containing nerve fibers. Although no perineural invasion was identified, the lesion approached the surgical resection margin, leaving residual microscopic disease possible. Adhesions were noted at the base of the lung.\n\nSections from the bronchial resection margin showed no tumour involvement. However, one out of five peribronchial lymph nodes contained metastatic disease. The hilar lymph node and lymph node number 5 showed no signs of malignancy, while lymph node number 7 contained metastatic cells.\n\nIn the adjacent non-tumour lung tissue, scarring related to arteries with signs of recanalisation was observed, likely secondary to vascular changes associated with the mass near the hilum. Additional sections from mediastinal soft tissue, pericardium, and pleura were submitted for histology. Tumour cells were identified on the surface of mediastinal pleura and within mediastinal soft tissue near the pericardium, in proximity to strands of cardiac muscle. Based on these findings, the possibility of residual microscopic disease within the mediastinum could not be ruled out."} +{"pid": "TCGA-AC-A2FO", "report": "The specimen was submitted for analysis and included left breast tissue, lymph nodes, and additional tissues. The primary lesion was located in the upper outer quadrant of the left breast, measuring 2.5 x 2.0 x 1.8 cm. Histologic evaluation revealed a total Elston modification of Bloom-Richardson score of 6 out of 9, with an architectural score of 3/3, nuclear score of 2/3, and mitotic score of 1/3. An in-situ component was identified, comprising less than 25% of the specimen, with features consistent with lobular architecture and nuclear grade II. No comedo necrosis was observed.\n\nMargins were evaluated, and the tumor was not transected. The closest distance to the deep margin was 1.6 cm. No lymphovascular space invasion or skin involvement was noted. Microcalcifications were not identified in association with the tumor.\n\nA total of ten lymph nodes were examined. Metastatic involvement was found in one sentinel lymph node (1/2) and one level I/II lymph node (1/8). The largest metastasis measured 9 mm, and there was no extracapsular extension observed.\n\nSurgical correlation confirmed intraoperative findings. Progesterone receptor expression was negative at 0%. Estrogen receptor expression was positive at 95%. Proliferation index by Ki-67 (MIB-1) was low, at less than 10%. DNA ploidy analysis showed a diploid pattern with a DNA index of 1.1.\n\nFluorescence In Situ Hybridization (FISH) studies targeting specific genetic loci were attempted but did not yield interpretable results due to unsuccessful hybridization. Factors such as fixation method, age, and storage conditions may have contributed to this outcome. Repeat testing is recommended if further tissue becomes available.\n\nAdditional findings included fibrocystic change with epithelial hyperplasia and benign calcifications. A separate biopsy from the lip showed benign pigmented actinic keratosis.\n\nThe TNM classification assigned was T2N1MX. Paraffin blocks B2, 3, 4, and 6 are recommended for further study if needed."} +{"pid": "TCGA-2G-AAFY", "report": "The pathology report describes a left orchidectomy specimen. The tumor measures 2.5 cm in greatest dimension and is entirely confined to the testis. Histologic evaluation demonstrates the presence of angioinvasion; however, there is no evidence of involvement of the rete testis. Cellular composition shows a nonseminomatous component, though specific classification is not provided. Staging assessment indicates no extension beyond the testicular tissue."} +{"pid": "TCGA-A4-7997", "report": "The surgical specimen from a left partial nephrectomy consists of a 4.7 x 4.3 x 4.3 cm wedge of renal parenchyma. A tumor measuring 4.3 cm in greatest dimension is identified, bulging the renal capsule and located less than 0.1 cm from the black inked resection margin. The tumor appears yellow, tan, red, variegated, and vaguely lobulated with a thin fibrous capsule. It constitutes at least 90% of the specimen volume. Gross examination reveals no evident necrosis.\n\nMicroscopic evaluation confirms a unifocal lesion confined to the kidney. Histologic features demonstrate nuclei that are slightly irregular, approximately 15 \u03bcm in diameter, with evident nucleoli, corresponding to a histologic grade of G2. No lymphatic or vascular invasion is identified. Margins are involved by carcinoma at the renal parenchymal surface. Nine cassettes were submitted for analysis, including sections from the tumor, black inked margin, blue inked capsule, and adjacent renal parenchyma.\n\nPathologic staging indicates the tumor is more than 4 cm but not more than 7 cm in greatest dimension and limited to the kidney (pT1b). Regional lymph nodes cannot be assessed (pNX), and there is no evidence of distant metastasis (pM0). Based on these findings, the pathologic stage is summarized as pT1bNXM0, Stage I."} +{"pid": "TCGA-CV-6954", "report": "A right hemimandibular and tongue composite resection was performed. The specimen included a portion of the mandible, lateral tongue, gingiva, and overlying cheek skin. A firm, irregular tan-white lesion measuring 5.0 x 3.8 x 3.0 cm was identified within the posterior body of the mandible extending into the gingival-buccal sulcus, floor of the mouth, and lateral aspect of the tongue. The closest margin measured 5.0 mm from the medial-inferior soft tissue edge. No lymphovascular or perineural invasion was observed.\n\nThe skin flap from the right cheek measured 2.8 x 1.4 cm with a depth of 0.8 cm and showed no abnormalities. Two lymph nodes from the left submandibular region were identified, measuring up to 1.5 cm in greatest dimension; both showed no evidence of metastatic involvement. A right neck dissection specimen measuring 11.0 x 4.0 x 2.0 cm included levels I, II, and IV, containing a total of 22 lymph nodes, all negative for metastasis. An unremarkable salivary gland measuring 3.5 x 3.0 x 2.0 cm was noted in level I.\n\nMargins evaluated included the masseter muscle (measuring 2.7 x 1.4 x 0.2 cm), posterior buccal mucosa (2.0 x 0.4 x 0.3 cm), and pharyngeal margin (1.0 x 0.8 x 0.1 cm). All margins were free of abnormal cellular infiltration. The masseter and posterior buccal margins were inked and submitted entirely for frozen section analysis, revealing no tumor presence.\n\nThe composite resection specimen measured 12.0 x 8.0 x 6.0 cm in total. Sections were taken from various regions including the replaced mandible, additional tumor areas, soft tissue margins, and portions of the tongue. The adherent skin demonstrated puckering and fibrosis. Gross examination of eight teeth showed focal caries without associated soft tissue involvement."} +{"pid": "TCGA-HC-A8CY", "report": "The prostate specimen measured 3.5 cm from apex to base, 5.9 cm in the right-left lateral dimension, and 4.2 cm in the posterior-anterior dimension. The left seminal vesicles measured 4.8 x 4.8 x 0.9 cm with a vas deferens measuring 1.2 x 0.6 cm. A tumor mass was identified in the left body of the prostate, measuring up to 3.3 x 3.2 x 2.2 cm. This mass approached within 0.2 cm of the left apex margin, 0.1 cm of the left base margin, and 0.2 cm of the nearest left radial surgical margin. Bilateral involvement was noted, with the left side more affected than the right. The tumor exhibited extraprostatic extension, multifocal on the left side. Lymphovascular and perineural invasion were present.\n\nMargins were involved at the left apex and base. Of three iliac lymph nodes examined, one showed evidence of a micrometastasis measuring 0.8 mm. No involvement of the seminal vesicles was identified. Multiple sections of the prostate were submitted for microscopic evaluation, including margins, para-neoplastic areas, and normal parenchyma. Sections of bilateral iliac lymph nodes were also submitted; frozen section evaluation of these nodes was negative, but permanent sections of the left iliac node revealed a micrometastasis. The lymph node findings were not amenable to frozen section due to fatty composition.\n\nHistologic examination confirmed multifocal disease with extensive involvement in the left prostate and presence of vascular and neural invasion. The pathologic staging indicated advanced local extension with regional lymph node involvement."} +{"pid": "TCGA-AA-3841", "report": "The specimen contains two distinct lesions. The first demonstrates a focus of moderately differentiated epithelial neoplasm with infiltration through all layers of the bowel wall (pT3), lymphatic and vascular invasion (L1, V1), and no involvement of retrieved lymph nodes (0 of 24). The second lesion also shows a moderately differentiated epithelial tumor with invasion into the muscularis propria (pT2), lymphatic and vascular invasion (L1, V1), and metastasis to one of sixteen lymph nodes. Additional findings include a tubular adenoma."} +{"pid": "TCGA-AG-A014", "report": "The resected colon specimen (rectosigmoid) shows an ulcerated lesion with a maximum dimension of 3 cm at its widest point. The lesion extends up to 1.7 cm toward the aboral resection margin. Histological examination reveals invasive growth into the muscularis propria. The tumor exhibits poorly differentiated features. Adjacent areas of the sigma show individual pseudodiverticula with mild chronic peridiverticulitis and associated fibrosis. Both oral and aboral resection margins are free of tumor involvement. Fifteen regional lymph nodes are identified, none of which show tumor presence; however, reactive changes are noted. Vascular and lymphatic invasion markers are negative. Complete resection margins are confirmed."} +{"pid": "TCGA-A4-A4ZT", "report": "The surgical specimen consisted of a left kidney with a single focus measuring 6 cm, limited to the kidney and without evidence of extension beyond the renal capsule. The tumor was located in the inferior pole and had a cystic appearance, containing amorphous brown material and turbid fluid. Microscopic examination showed a predominantly type I histologic pattern with areas of higher nuclear grade characterized by Fuhrman nuclear grade 3 features and a type II architectural pattern. No sarcomatoid features were identified. Lymphovascular invasion was not observed. Surgical margins were negative. Histologic evaluation of the non-neoplastic kidney showed interstitial chronic inflammation and scattered fluid-filled cysts, with no other discrete masses noted. Staging was based on AJCC Cancer Staging criteria, 7th edition, and CAP protocol, June 2012. The primary tumor was classified as pT1b. Regional lymph node involvement could not be assessed (pNX), and there was no evidence of distant metastasis. The pathologic stage was determined to be I. No lymph nodes were identified in the perinephric adipose tissue. The remainder of the kidney showed normal architecture with preserved medullary rays and cortical thickness measuring 0.6 cm."} +{"pid": "TCGA-YT-A95F", "report": "The specimen consists of an excised mediastinal mass. Histological evaluation demonstrates a neoplastic proliferation composed of a mixture of epithelial and lymphocytic components. The epithelial cells exhibit moderate atypia with a predominance of spindle and oval forms. Immunohistochemical staining shows positivity for cytokeratin and CD5, with variable expression of other markers. Lymphocytes are intermixed throughout the neoplasm. The architecture is organoid, with well-formed lobules separated by fibrous septa. The tumor measures 4.5 cm in greatest dimension. No evidence of capsular invasion or vascular invasion is identified. Surgical margins are free of tumor."} +{"pid": "TCGA-CV-A45U", "report": "A left hemimandibulectomy specimen included a ramus measuring 9.5 cm and a mandible measuring 9.3 cm. A 3.5 x 2.6 x 1.5 cm submandibular gland was present without abnormality. Over the lateral aspect of the specimen was an 11.0 x 6.0 cm area of skin, with a 2.5 x 2.0 cm region of ulceration and raised contours centrally. A 6.3 x 4.2 x 3.0 cm ulcerated mass was observed overlying the mandible. The tumor appeared firm and tan, with focal necrosis, and extended into adjacent dermal and subcutaneous tissues. Bone involvement was suspected grossly. Margins ranged from 0.3 cm to 2.0 cm; the anterior medial and posterior medial margins were closest to the tumor.\n\nA lymph node dissection was performed on the left side, including upper and middle level 5 regions. Two lymph nodes were identified: one from level 6 measuring 1.2 x 0.8 x 0.4 cm and one from level 7 measuring 0.2 x 0.7 x 0.5 cm. Both were tan-red and soft to rubbery. In addition, a supraomohyoid neck dissection measuring 8.0 x 5.5 x 1.5 cm included levels 3, 4, and 5. This specimen also contained portions of the platysma (8.5 x 3.5 x 0.2 cm) and sternomastoid muscle (4.5 x 3.5 x 2.0 cm). Lymph nodes within this specimen ranged from 0.2 cm up to 1.2 x 1.0 x 0.6 cm in size, with the largest located in level 3.\n\nA segment of the left alveolar nerve measuring 0.9 cm in length and 0.2 cm in diameter was submitted for evaluation. A clamp was present at one end, with blue ink marking that margin. Histologic examination revealed no evidence of malignant involvement.\n\nHistologic sections evaluated multiple mucosal, skin, and soft tissue margins. Sections included perpendicular and en face orientations from various mucosal and skin margins. Representative sections of lymph nodes were also submitted for microscopic analysis."} +{"pid": "TCGA-B0-5115", "report": "The specimen consists of a left radical nephrectomy. A neoplasm is present, measuring 9.0 cm in greatest diameter. The tumor is confined to the kidney without extracapsular extension. Microscopic examination reveals cells with nuclear features corresponding to a Fuhrman grade of 3 out of 4. No angiolymphatic invasion is observed. Surgical margins are negative for tumor involvement. Adjacent non-neoplastic kidney tissue demonstrates nonspecific changes likely related to the proximity of the lesion. Based on pathological findings, the tumor stage is classified as pT2 with no assessment of lymph node or distant metastasis."} +{"pid": "TCGA-QH-A6CW", "report": "The specimen consists of brain tissue from the right temporal region. Histological examination reveals a moderately cellular neoplasm composed of a mixture of cells with round to oval nuclei and varying degrees of nuclear atypia. Some areas show increased mitotic activity. Necrosis and microvascular proliferation are not identified. The tumor infiltrates the surrounding brain parenchyma. Cellular morphology suggests a glial origin. Immunohistochemical staining demonstrates positivity for GFAP in a subset of cells, along with nuclear expression of IDH1. Molecular analysis reveals loss of heterozygosity on chromosomes 1p and 19q. Based on histologic features and molecular markers, the lesion is classified as a grade III tumor according to the WHO grading system."} +{"pid": "TCGA-22-5474", "report": "The surgical specimen from the left upper lobe shows a mass measuring 2.0 x 1.8 x 1.8 cm. The lesion demonstrates high-grade cellular atypia with features consistent with a poorly differentiated malignancy. The surrounding lung tissue shows changes associated with usual interstitial pneumopathy. The lesion extends into the visceral pleura. Surgical excision appears complete, with the closest margin measuring approximately 1 millimeter from the resected edge. Lymph node tissue from the superior mediastinum, including 9 right lower paratracheal nodes, and from the inferior mediastinum, including 7 subcarinal nodes, show no evidence of abnormal cellular infiltration."} +{"pid": "TCGA-EM-A2CU", "report": "The specimen was received from the facility and included multiple tissue samples. A soft-tissue sample from the right inferior parathyroid area was taken and frozen for intraoperative consultation, with a resubmission of the frozen section block. Two lymph node specimens were submitted\u2014one from the left paratracheal region and one from the right paratracheal region. The thyroid gland was also submitted in its entirety following total thyroidectomy.\n\nThe thyroid specimen weighed 28.7 grams and measured 4.2 x 3.3 x 2.2 cm on the right lobe, 3.6 x 2.3 x 1.0 cm on the left lobe, and 1.2 x 1.2 x 0.6 cm in the isthmus. A well-circumscribed nodule measuring 4.0 x 2.8 x 1.7 cm was identified in the right lobe. The central compartment contents measured 4.8 x 1.6 x 1.2 cm and contained multiple lymph nodes ranging in size from 0.4 to 0.8 cm. No parathyroid glands were identified grossly.\n\nMicroscopic evaluation of the right lobe nodule revealed follicular architecture with classical cytomorphologic features. The lesion was unifocal and measured 4.0 cm in greatest dimension. Margins were free of involvement. Minimal tumor capsular invasion was present, but no lymphovascular or perineural invasion was identified. There was no evidence of extrathyroidal extension.\n\nIn the regional lymph node assessment, a total of 30 lymph nodes were examined. Four of these showed evidence of involvement, located in the central compartment (Level VI). No extranodal extension was observed. An additional finding of focal nonspecific thyroiditis was noted.\n\nSpecimen integrity was intact, and all tissues were submitted for analysis. The staging was based on the AJCC/UICC TNM classification system, 7th edition. The primary tumor was classified as pT2, indicating a tumor greater than 2 cm but not exceeding 4 cm confined to the thyroid. Regional lymph node involvement was classified as pN1a, indicating metastases in Level VI lymph nodes. Distant metastasis could not be assessed."} +{"pid": "TCGA-G7-6796", "report": "The specimen includes a left renal mass, an additional tumor, left renal final margin, final random margin, and fat overlying the left kidney. The left renal mass is a yellow-tan soft tissue measuring 3.7 x 2.8 x 2 cm and weighs 13 g. A well-circumscribed gold-tan lesion measuring 1.5 x 1.3 x 1.2 cm is identified adjacent to the tumor resection margin. The lesion shows areas of hemorrhage and necrosis. Adjacent fat appears unremarkable. The specimen was entirely submitted for analysis.\n\nAn additional tumor specimen from the left kidney measures 1.7 x 1.5 x 1.2 cm and shows an area of white-tan discoloration measuring 0.9 x 0.9 x 0.2 cm. It was serially sectioned and submitted for evaluation.\n\nThree small tan-red tissue fragments from the left renal final margin measure 0.6 x 0.4 cm in aggregate and were submitted entirely for frozen section analysis. Four tan tissue fragments from the final random margin measure 0.8 x 0.5 cm in aggregate and were also submitted entirely for frozen section diagnosis.\n\nThe fat overlying the left kidney consists of yellow-tan adipose tissue measuring 20 x 14 x 4 cm in aggregate. No abnormalities were observed upon sectioning, and representative sections were submitted for analysis.\n\nMicroscopic examination of the renal mass reveals cells with slightly irregular nuclei measuring approximately 15 \u00b5m, with evident nucleoli. No vascular or lymphatic invasion was identified, and there is no evidence of perinephric tissue invasion. All margins evaluated show no involvement by invasive carcinoma. No regional lymph nodes were sampled, and no adrenal gland was present. The tumor is confined to the kidney and measures 1.5 cm in greatest dimension. No additional findings were noted."} +{"pid": "TCGA-BH-A0H6", "report": "A segmental mastectomy specimen from the right breast shows a focus of cellular proliferation with a Nottingham grade 1 nuclear features, including a tubule score of 2 and a mitotic activity score of 1, for a total score of 5 out of 9. The lesion measures 0.7 cm in greatest dimension. No definite lymphovascular invasion is identified. There is also a component of in situ cellular change, characterized by solid pattern and associated calcifications, with nuclear grade 1 features. Surrounding tissue demonstrates atypical ductal hyperplasia and fibrocystic changes. A site consistent with prior biopsy is noted. Margins are negative; the closest distance of the cellular lesion to the margin is 8 mm at the invasive focus and 1 mm at the in situ component on the inferior margin. No lymph nodes were sampled. Immunohistochemical staining shows positivity for estrogen and progesterone receptors, while HER2/NEU expression is low (zero or 1+). The pathologic stage is pT1b, pNX, pMX."} +{"pid": "TCGA-Q1-A73S", "report": "The specimen consisted of multiple lymph node groups and pelvic soft tissues. Lymph nodes from the left external iliac, left obturator, right external iliac, and right obturator regions were evaluated. Of the 18 lymph nodes examined, two contained metastatic involvement. The remaining lymph nodes were negative for malignancy. Pelvic soft tissue from the left parametria was also negative for malignant involvement.\n\nA radical hysterectomy specimen included a mass measuring 3.9 cm in greatest dimension with additional dimensions of 3.5 x 3.0 cm. The mass was located in the posterior cervix involving the left superior and right inferior quadrants. Histologic evaluation showed moderately differentiated cellular features. Resection margins were free of invasive disease with a closest distance of 7 mm between the tumor and resection margin. Lymphovascular invasion was identified.\n\nImmunohistochemical staining demonstrated positivity for mCEA, CK7, and p16 in certain areas, while p63 and vimentin were negative. Mucin staining was positive in surface glandular regions but not in deeper areas. Gross examination revealed an exophytic, cauliflower-like lesion obstructing the cervical os without identifiable fibroids or myometrial invasion. Endocervical involvement was noted with no gross abnormalities in the endometrium or paracervical tissues.\n\nAdditional findings included benign endometrial and myometrial tissue, as well as benign vaginal mucosa at the lateral margin. A small area of atypical surface changes was identified, but no definitive high-grade intraepithelial lesions were present."} +{"pid": "TCGA-58-A46N", "report": "The specimen consists of a lung, right lower lobe, measuring 19.0 x 13.0 x 8.0 cm. A lesion measuring 3.5 x 2.0 x 2.2 cm was identified. Histologic evaluation revealed malignant cells with high-grade nuclear features. Lymph node examination showed no metastatic involvement (0 out of 38 examined positive). No definitive assessment of distant metastasis was possible. The lesion exhibited poor differentiation and was classified as high grade."} +{"pid": "TCGA-AK-3433", "report": "The specimen consists of a right nephrectomy measuring 15 x 8 x 9 cm and weighing 450 grams. The ureter is 10 x 0.5 cm and appears normal. Vascular margins are unremarkable. A mass located in the inferior pole measures 9 x 8 x 8 cm and occupies the lower half of the kidney. The mass is well demarcated from surrounding tissue, compresses the capsule without gross invasion, and displays a predominantly brown color with areas of hemorrhage. Representative sections were taken from the tumor, its relationship to the capsule, adjacent kidney, and uninvolved superior pole, as well as from the ureteral margin, perinephric fat, and hilar region. No suspicious lesions or lymph nodes are identified in the perinephric fat.\n\nA separate specimen labeled as an interaortal lymph node consists of a single nodule measuring 1.4 x 1.0 x 0.7 cm and is submitted entirely for analysis.\n\nImmunohistochemical evaluation demonstrates tumor cell positivity for CK7 and E-cadherin with membranous staining. C-Kit shows membranous staining, and some areas express CD10. Staining for vimentin is negative. Focal positivity is noted with Hale\u2019s colloidal iron stain. No tumor cells are identified in the three lymph nodes assessed. All surgical margins are free of involvement. A cytogenetic sample was obtained, but the specimen was inadequate for analysis as the cells failed to grow in culture."} +{"pid": "TCGA-C5-A1BF", "report": "The specimen consists of multiple soft, friable fragments of tan to tan-brown tissue, measuring 1.1 x 0.6 x 0.3 cm in aggregate, with the largest fragment measuring 0.3 cm. Histologic sections reveal a well-differentiated cellular proliferation with focal areas of keratinization. A prominent eosinophilic infiltrate is present in association with the cellular changes. The tissue was received in formalin, properly labeled, and processed for microscopic evaluation. The findings are based on personal examination of the slides and have been reviewed and approved."} +{"pid": "TCGA-AR-A251", "report": "The specimen from a left/wide local excision contains a bilobed mass measuring 2.7 x 2.4 x 2.0 cm. The cellular composition shows high-grade nuclear features according to Nottingham grading. A significant portion of the lesion consists of intraductal proliferation with high-grade nuclei, involving more than 25% of the sampled tissue and extending beyond the main mass. Invasion of vascular or lymphatic channels is identified.\n\nThe surrounding non-neoplastic breast tissue demonstrates proliferative-type fibrocystic changes. Microcalcifications are noted within the affected ducts. Changes related to prior biopsy are present. There is no involvement of the overlying skin. At the medial/inferior margin, high-grade intraductal proliferation is found. A re-excision specimen from the new inferomedial margin of the left breast also shows focal involvement by similar intraductal changes. The deep margin from the same side is free of disease.\n\nIn the left axilla, multiple lymph nodes contain metastatic involvement. Of the 7 nodes examined in one group, 3 show evidence of tumor spread, with the largest focus measuring 2.2 x 1.9 x 1.5 cm; extension beyond the nodal capsule is observed. In an additional set of 3 lymph nodes from the same region, 1 node is involved. These findings indicate multi-focal nodal involvement.\n\nA subsequent total mastectomy specimen from the left breast does not reveal any remaining tumor. Changes consistent with prior biopsy are seen in the outer quadrant. The adjacent tissue again shows fibrocystic changes. All surgical margins are free of disease. No abnormality is detected in the nipple."} +{"pid": "TCGA-HD-7753", "report": "The specimen consists of a soft tissue fragment measuring 5.0 x 4.5 x 1.8 cm. The margins were inked for identification: superior in red, inferior in orange, deep in black, left lateral in blue, and right lateral in green. A 2.3 x 1.7 cm ulcerated mass was observed on the mucosal surface. Microscopic evaluation revealed the presence of malignant cells at the left lateral margin (blue inked). The tumor was found to be in close proximity to several margins: within 0.5 cm of the right lateral margin, 0.3 cm from the deep margin, and 1 cm from the inferior margin. The superior margin was submitted separately and showed no evidence of tumor involvement. Histologic examination did not reveal lymphovascular or perineural invasion. Cellular morphology demonstrated moderately differentiated features. Margin assessment indicated that the left lateral margin was positive for tumor, while the right lateral margin was separated from the tumor by collagen bundles. Superior, inferior, and deep margins were negative for tumor involvement upon sectioning."} +{"pid": "TCGA-E9-A1N5", "report": "The specimen consisted of breast tissue from a radical mastectomy. A grossly evident lesion was identified, measuring 2.2 x 2.2 x 2 cm. Histologic evaluation revealed a combination of infiltrating ductal and lobular features. The lymph node assessment showed 2 out of 11 nodes positive for metastatic involvement in the axillary region. Cellular characteristics such as tubule formation, nuclear pleomorphism, and mitotic counts were not specified, precluding determination of a total histologic score. Other features including tumor extent, extracapsular invasion, margin status, and response to neo-adjuvant treatment were not documented. No additional findings or comments were provided."} +{"pid": "TCGA-YZ-A980", "report": "The left eye specimen measured 22.0 mm anteroposterior, 22.0 mm horizontal, and 24.0 mm vertical. The optic nerve was cut flush with the globe and measured 4.0 mm in diameter. Transillumination identified a tumor located in the superior anterior aspect of the globe measuring 15.0 x 13.0 mm at its base. Following sectioning, the tumor measured 14.0 mm at its base and 9.0 mm in greatest height. It was situated 19.0 mm from the posterior margin of the optic disc.\n\nHistologic evaluation revealed a solid growth pattern with mixed cellular morphology (90% spindled, 10% epithelioid) and a histologic grade of 2. No involvement of the sclera, vortex veins, optic disc, vitreous, iris, lens, anterior chamber, angle/Schlemm\u2019s canal, optic nerve, retina, or cornea was identified. The tumor involved the choroid and ciliary body but showed no extrascleral extension. Surgical margins were negative.\n\nMicroscopic analysis noted a mitotic rate of 6 mitoses per 10 high power fields. Vascular invasion was not present. The tumor exhibited light pigmentation with scattered intratumoral lymphocytes. Hemorrhage and Bruch\u2019s membrane invasion were absent. Immunostaining for Ki-67 demonstrated a labeling index of 10%. A retinal detachment was present.\n\nPathologic staging was determined as pT3b, with regional lymph node assessment designated as pNX due to no lymph nodes being examined."} +{"pid": "TCGA-HT-7483", "report": "The microscopic examination reveals a moderately hypercellular glial neoplasm composed predominantly of cells resembling fibrillary astrocytes. A small distinct component of oligodendroglial-type cells is also present. The tumor demonstrates diffuse infiltration into both gray and white matter. No evidence of microvascular proliferation or necrosis is observed. Mitotic figures are absent. Cellular atypia is generally mild, although scattered moderately atypical cells are present. Immunohistochemical staining shows scattered MIB-1 reactive cells, with a calculated labeling index of 6.1% in the most proliferative regions. This level of proliferation is considered intermediate and may be seen in both low-grade and anaplastic tumors. The histologic features overall suggest a low-grade lesion; however, close clinical follow-up is recommended."} +{"pid": "TCGA-P4-A5EB", "report": "The specimen consists of a radical nephrectomy measuring 18.0 x 13.0 x 11.0 cm, including a kidney measuring 13.0 x 7.0 x 4.2 cm. A segment of renal artery, renal vein, and ureter is also present, measuring 12.5 cm in length with an average diameter of 0.7 cm. A well-circumscribed mass measuring 5.0 x 4.2 x 4.0 cm is identified in the lower pole of the kidney. The mass appears tan-white with focal areas of hemorrhage and tan-yellow discoloration. Two cystic structures are noted: one located in the mid portion of the kidney measuring 3.8 x 3.0 x 3.0 cm with lining present, and another in the upper pole measuring 3.0 x 2.5 x 2.5 cm with smooth lining. No invasion into perinephric adipose tissue, renal sinus, or renal vein is observed. The lesion does not extend beyond Gerota\u2019s fascia. Margins of resection, including ureter, renal artery, and renal vein, show no evidence of involvement. Cellular features include nuclear characteristics consistent with a higher grade appearance. Staging assessment indicates confinement to the kidney without extension into surrounding structures. Additional sections evaluated include margins, tumor area, adjacent renal parenchyma, and cysts. No significant findings are noted in the uninvolved renal parenchyma."} +{"pid": "TCGA-D1-A3DH", "report": "The specimen from a hysterectomy with bilateral salpingo-oophorectomy includes a mass measuring 2.8 x 2.0 x 1.4 cm located in the fundus of the endometrial cavity. The mass is exophytic and grossly invades 0.1 cm into the myometrium; histologically, invasion measures 0.2 cm into the myometrium (total wall thickness 1.8 cm). There is no involvement of the endocervix. Lymphovascular space invasion is not present. Surgical margins are free of abnormal tissue. Both ovaries and fallopian tubes show no evidence of involvement. The right ovary measures 2.5 x 1.1 x 0.9 cm with a solid cut surface, and the left ovary measures 3.3 x 1.9 x 0.9 cm, also with a solid cut surface. Both fallopian tubes have multiple paratubal cysts.\n\nLymph node evaluation includes 18 right pelvic lymph nodes, 20 left pelvic lymph nodes, 10 additional pelvic lymph nodes, and 14 right para-aortic lymph nodes\u2014all are negative for any atypical cells. The omentum, left and right gonadal vessels are also unremarkable. The uterus weighs 105.0 grams, with a smooth serosal surface and no leiomyomas. No other abnormalities are identified in the submitted tissues. The findings are based on frozen section analysis and confirmed by permanent H&E sections. The staging is consistent with pT1N0 according to AJCC 7th edition criteria."} +{"pid": "TCGA-A2-A4S1", "report": "The specimen was received in nine parts from a right breast partial mastectomy and sentinel lymph node biopsy. The patient had undergone prior imaging and localization procedures. Gross examination of the partial mastectomy specimen showed a firm gray mass measuring 3.4 x 2.8 x 2.8 cm with central hemorrhagic discoloration. The mass was located within the breast tissue and was greater than 1 cm from most margins, except for the posterior margin, where it was 2 mm away. There was also a 1.3 cm area of hemorrhage adjacent to the mass. Multiple skin lesions were noted on the lateral portion of the specimen, with the largest measuring 0.5 cm.\n\nMargins were identified and marked with colored ink: medial (red), lateral (orange), inferior (blue), superior (green), posterior (black), and anterior (skin). Histologic evaluation revealed a high-grade malignant neoplasm with areas of osteoid formation. Surrounding tissue contained foci of intermediate to high-grade ductal carcinoma in situ (DCIS) of solid and cribriform types, with intraductal necrosis and calcifications. DCIS measured up to 10 mm in greatest dimension and was closest to the inferior margin at 1 mm and the lateral margin at 2 mm.\n\nA separate focus of DCIS was identified in the superior re-excision margin, measuring approximately 8 mm in size and extending to within 3 mm of the new inked margin. In the inferior re-excision margin, low-grade DCIS of cribriform type, nuclear grade 1, was found measuring 4 mm and located 2 mm from the new inked margin. No residual invasive tumor was identified in the lateral or posterior re-excision margins. The medial re-excision margin showed fibrocystic changes including atypical duct hyperplasia, usual duct hyperplasia, and sclerosing adenosis. The anterior and medial posterior margins showed only benign tissue without evidence of tumor.\n\nThe sentinel lymph node specimen contained two lymph nodes. One measured 4.0 x 0.8 x 0.4 cm and the other 0.6 x 0.4 x 0.2 cm. Both were negative for metastatic involvement upon step sectioning and cytokeratin immunostaining.\n\nMultiple blocks of the invasive tumor were stained with cytokeratin; minimal staining was observed in the invasive component, while adjacent DCIS demonstrated staining. Additional findings included reactive fibrosis and fat necrosis at the biopsy site, as well as benign skin in one segment. Proliferative fibrocystic disease with multiple calcifications was present in other areas."} +{"pid": "TCGA-FD-A3B8", "report": "A radical cystoprostatectomy specimen was received along with bilateral pelvic lymph node dissections. Fifteen lymph nodes from the left pelvic region and ten from the right were examined, with no abnormal cellular involvement identified in any of the nodes. The surgical specimen included the bladder and bilateral vas deferens.\n\nGross examination revealed an ulcerated area on the right lateral wall of the bladder extending to the anterior wall. Serial sectioning identified a 3.2 x 2.3 x 1.3 cm firm, white mass invading into the muscularis propria to a depth of 1.3 cm, with the closest distance to the inked margin measuring 0.4 cm. Histologic evaluation showed high-grade cellular atypia with squamous differentiation and infiltration into the outer half of the muscularis propria. No involvement was identified at the distal urethral margin, ureteral margins, or soft tissue margins. Prostate, seminal vesicles, and vasa deferentia showed no evidence of abnormal cells.\n\nA total of twenty-five lymph nodes were evaluated and found to be free of any abnormal cells. Based on the depth of invasion and absence of lymph node or distant involvement, staging was determined as pT2b, NO, Mx according to the AJCC 7th edition TNM classification system. Deeper level evaluations were conducted and reviewed by the attending pathologist."} +{"pid": "TCGA-G4-6302", "report": "The specimen consists of a resected portion of terminal ileum and cecum measuring 15 cm in length, with a circumference ranging from 4 cm to 6 cm. An irregular polypoid lesion measuring 3.2 x 3.2 x 0.6 cm is identified; it is located 6.5 cm from the resected ileum margin and 7 cm from the resected colonic margin. The appendix is present and measures 3.2 cm in length and 0.5 cm in width.\n\nHistologic examination reveals infiltrating and dissecting pools of extracellular mucin with associated tumor epithelium. The lesion invades through the muscularis propria into adjacent adipose tissue and extends focally to within 1 mm of the radial margins. The surgical margins of excision are negative. Venous and lymphatic invasion are present, as is perineural invasion.\n\nThe lesion appears to arise in the setting of a tubulovillous adenoma. Fifteen lymph nodes are identified and are negative for involvement. No significant pathologic abnormalities are noted in the appendix or terminal ileum. Immunohistochemical analysis shows EGFR expression.\n\nThe pathologic staging is T3 MO MX."} +{"pid": "TCGA-BR-8370", "report": "The specimen consists of a stomach with a plate-like lesion measuring 8.5 cm in its largest dimension. The lesion is ulcerated and located at the cardia. Histologically, the lesion demonstrates mucin production and is graded as G3. The tumor invades the subserosa and extends into the perigastric fat up to 2 cm. There is dense, hyperemic tissue involvement. Fifteen lymph nodes were examined, of which nine showed evidence of metastatic involvement, including those from the greater and lesser omentum. Lymphatic and venous invasion were not identified, and perineural invasion was not specified. Margins are uninvolved. Adjacent fatty tissue shows signs of invasion. The omentum exhibits hyperemia and focal hemorrhages. There is no evidence of venous invasion. The specimen is from a subtotal gastrectomy, and there is no indication of neoadjuvant treatment effect. No additional pathologic findings are noted."} +{"pid": "TCGA-EM-A4FV", "report": "The specimen was received from a total thyroidectomy procedure and included tissue from the left lower parathyroid, right paratracheal lymph nodes, and the total thyroid gland. The thyroid specimen measured 3.8 cm in the right lobe and 3.5 cm in the left lobe, with an isthmus measuring 1.1 cm. The overall weight of the thyroid was 7.8 g. A distinct nodule measuring 1.3 x 1.2 x 1.1 cm was identified in the left lobe. Histologically, the nodule demonstrated follicular architecture and classical cytomorphology. The lesion was unifocal, located in the left lobe, and completely encapsulated. There was evidence of capsular invasion; however, no lymphovascular or perineural invasion was observed. Margins were free of involvement. Five regional lymph nodes were examined, none of which showed evidence of involvement. No extrathyroidal extension was identified. Based on these findings, staging was assigned as pT1b with pN0. Additional pathological findings were not identified."} +{"pid": "TCGA-BH-A18G", "report": "The specimen from the right breast was submitted for evaluation following a needle localized segmental mastectomy. A single invasive lesion was identified measuring 2.7 cm in greatest dimension. Histologic grading using the Nottingham system yielded a nuclear grade of 3, tubule formation score of 3, and mitotic activity score of 2, for a total score of 8, corresponding to Grade 3. No lymphovascular space invasion was identified. Surgical margins were negative for any abnormal cellular proliferation, with the closest distance of the lesion to the superior margin being 9 mm.\n\nAdditional findings in the right breast included atypical ductal hyperplasia and radial scar. Sclerosing adenosis and fibrocystic changes were also present. Fibrosis suggestive of prior biopsy was noted. Skin margins showed no evidence of abnormal cells.\n\nOne sentinel lymph node was retrieved from the right axilla and showed no evidence of involvement by malignant cells.\n\nOther tissues evaluated included additional right breast tissue demonstrating fat necrosis and fibrosis along with fibrocystic changes and columnar cell change. The left breast tissue showed sclerosing adenosis, columnar cell change, and fibrocystic changes without other significant pathology.\n\nImmunohistochemical staining demonstrated positivity for estrogen and progesterone receptors; HER-2/neu staining was equivocal (1+). Lymph node assessment was conducted using hematoxylin and eosin staining methods. Based on pathological staging, the T category was classified as pT2, and N category was pN0(sn), indicating no nodal involvement."} +{"pid": "TCGA-BH-A5IZ", "report": "A segmental mastectomy specimen from the left breast at the 1 o\u2019clock position shows a focus of tissue with notable cellular features. The lesion measures 2.2 cm in greatest dimension on gross examination and exhibits a high-grade morphology, characterized by marked nuclear pleomorphism, high mitotic activity, and absence of tubule formation, resulting in a maximum Nottingham histologic score of 9 out of 9. There is abundant lymphoid infiltration and areas of tumor necrosis. A small component (<5% of total volume) of in situ disease with solid and cribriform patterns is identified adjacent to the invasive component.\n\nSurgical resection margins are negative for invasive disease, with the closest distances measuring 0.4 cm anteriorly and 0.5 cm posteriorly. Additional benign findings include fibrocystic changes with ductal epithelial hyperplasia and focal atypical ductal hyperplasia. Changes related to a prior biopsy are also noted.\n\nEvaluation of lymph nodes includes five sentinel nodes (total of six) which are all negative for metastatic involvement. One non-sentinel lymph node contains metastatic disease, with the largest focus measuring 0.6 cm; no extracapsular extension is observed.\n\nThe tumor demonstrates immunoreactivity for estrogen receptor but lacks progesterone receptor expression. HER-2 testing by fluorescence in situ hybridization (FISH) does not show gene amplification.\n\nStaging classification includes pT2 for the primary lesion and pN1a for regional lymph node involvement."} +{"pid": "TCGA-06-0644", "report": "The patient underwent excision biopsy of a left parietal brain lesion. The specimen measured 2.0 x 1.3 x 0.7 cm and consisted of an irregular pale tan tissue fragment. A second specimen, measuring 1.5 x 1 x 0.8 cm, was described as gray-white and rubbery. Both specimens were processed and submitted entirely for histological evaluation.\n\nMicroscopic examination revealed a complex neoplasm composed of pleomorphic atypical cells. The tumor demonstrated a range of morphological features, including areas of spindle-shaped cells arranged in streaming fascicles, as well as regions with whorl formation. Epithelioid tumor cells with moderate cytoplasmic abundance were also present. Frequent mitotic figures were identified, and both focal and geographic necrosis were observed.\n\nImmunohistochemical staining showed vimentin positivity in many tumor cells. GFAP immunoreactivity was noted in certain areas, particularly in islands of less spindle-shaped cells. There was also focal pan-cytokeratin staining and patchy muscle-specific actin positivity in the spindle cell component. The tumor was negative for CK7, CK20, TTF1, and HMB45.\n\nMolecular testing for MGMT promoter methylation was performed using bisulfite-treated DNA followed by PCR amplification and gel electrophoresis. The results were negative for MGMT promoter methylation. This test was developed and validated by the laboratory under CLIA requirements and has not been cleared or approved by the FDA. The findings are provided for informational purposes and should be interpreted in conjunction with standard diagnostic methods."} +{"pid": "TCGA-SI-A71Q", "report": "A 35-year-old woman presented with a left chest wall mass. Needle core biopsy tissue was examined microscopically and revealed a spindle cell neoplasm with variable cellularity. The tumor cells exhibited oval to spindle-shaped morphology and were arranged in storiform or fascicular patterns. Frequent mitotic figures were observed. There was no evidence of necrosis. Focal invasion into adjacent skeletal muscle and adipose tissue was noted.\n\nImmunohistochemical staining showed that the tumor cells were diffusely and strongly positive for vimentin, and diffusely positive for CD57. A neurofilament stain demonstrated positivity in a small subset of scattered tumor cells. Stains for keratin, smooth muscle actin, NSE, GFAP, and S100 were negative.\n\nRadiological evaluation from an outside institution, including a chest CT scan, revealed numerous small cutaneous nodules along the thorax, suggestive of neurofibromatosis. The patient also had a clinical history of neurofibromatosis. The CT further identified a chest wall mass measuring 7.7 cm in the lateral dimension, interpreted as being compatible with a neural tumor.\n\nThe histomorphologic features combined with the immunophenotype and clinical-radiologic findings support a characterization of a malignant spindle cell neoplasm arising in the setting of neurofibromatosis. The lesion showed aggressive features including high mitotic activity and invasion into surrounding tissues."} +{"pid": "TCGA-HT-7472", "report": "Path Report. Addendum Discussion: The calculated MIB-1 Labeling Index overall appears low with focal regions increased to 4.9%. Overall, the histologic features of this tumor demonstrate a low-grade appearance; however, the MIB-1 labeling index is borderline for a low-grade glioma (<5%; WHO). Close follow-up for recurrence and/or progression may be warranted. Brain Tumor, Biopsy and Resection: MIB-1 Labeling Index = 4.9%. Microscopic Description: Sections of gray and white matter demonstrate a diffusely infiltrating glioma. The tumor is mildly to moderately hypercellular, composed of cells with round to somewhat irregular nuclei and scant processes. Most cells exhibit perinuclear halos. Only rare mitotic figures are identified. No microvascular proliferation or necrosis is present."} +{"pid": "TCGA-95-7039", "report": "The resected specimen from the right upper lobe of the lung and associated chest wall includes ribs 2, 3, and 4. A mass measuring 3.3 cm in maximum dimension was identified beneath the ribs, extending through the pleura into the soft tissue of the chest wall with superficial and focal involvement of adjacent rib bone. The tumor is located 7.1 cm from the bronchial margin, and all surgical margins (bronchial, vascular, soft tissue, and bone) are free of involvement. Microscopic evaluation reveals moderately differentiated cellular features with perineural and angiolymphatic invasion present. Angiolymphatic invasion is also noted in the capsular lymphatics of one lymph node.\n\nA total of nine lymph nodes were examined, including those from right levels 4, 7, 9, 10, and 11. None showed evidence of malignant involvement. One lymph node at level 4 demonstrated a small focus of involvement within a lymphovascular channel of the capsule, but no involvement was found within the parenchyma. No distant metastasis was assessed.\n\nThe adjacent lung tissue shows emphysematous changes, alveolar hemorrhage, and presence of hemosiderin-laden macrophages. Additional molecular testing for EGFR mutation is pending. The primary lesion demonstrates no vascular invasion and is histologically classified as moderately differentiated. Lymphatic and perineural invasion are present, and the tumor extends into the deep chest wall. No regional lymph node metastasis was identified."} +{"pid": "TCGA-63-A5M9", "report": "The tissue sample was collected from the left lower lobe and measured 4 cm in size. Histological examination revealed a moderately differentiated carcinoma with squamous features. Staging evaluation showed pathological classification of T2, N1, with no evidence of distant metastasis (cM0). The specimen was obtained via resection procedure. Additional biological samples were collected, including a buffy coat specimen. Data includes patient age at collection, days from diagnosis to procedure, and days from diagnosis to sample collection."} +{"pid": "TCGA-ET-A3BX", "report": "The specimen consisted of a total thyroidectomy. The tumor was located in the isthmus and left lobe, measuring 5.0 cm in greatest dimension and was unifocal. Histologic evaluation showed multifocal intrathyroidal psammoma bodies. One of four lymph nodes examined was positive for carcinoma, as confirmed by AE1/3 immunostain. The tumor demonstrated extrathyroidal extension and extended close to the anterior and posterior resection margins, with invasive carcinoma within less than 1.0 mm of those margins. Lymphocytic thyroiditis was also identified. The case was presented at a multidisciplinary conference with a physician in attendance."} +{"pid": "TCGA-DJ-A3UK", "report": "Clinical history indicates prior identification of a lesion within the left lobe. Submitted specimens include right para-tracheal tissue and total thyroid. Examination of the right para-tracheal tissue revealed one lymph node, which appeared benign. The total thyroid specimen weighed 14 grams. Dimensions of the thyroid lobes and isthmus were as follows: right lobe measured 3.5 x 1.5 x 0.6 cm, left lobe measured 3.5 x 1.5 x 0.8 cm, and isthmus measured 1.5 x 0.6 x 0.4 cm. A circumscribed nodule was identified in the left lower lobe. This nodule measured 1.5 x 1 x 1 cm, exhibited tan-brown, firm cut surfaces, and was encapsulated. Histologic evaluation demonstrated well-differentiated cellular features without evidence of mitotic activity or tumor necrosis. The lesion was entirely surrounded by a capsule with no identifiable invasion of blood vessels or surrounding structures. Surgical margins were free of involvement. Adjacent thyroid tissue showed nodular hyperplasia. Two lymph nodes examined were benign. Parathyroid tissue was present, including one intrathyroidal parathyroid gland. All relevant sections of the specimen were submitted for analysis."} +{"pid": "TCGA-FB-AAPY", "report": "The specimen consists of a pancreaticoduodenectomy. A mass was identified within the pancreatic head measuring 3.5 cm in greatest dimension. Histologic evaluation revealed a moderately differentiated epithelial neoplasm. The resection margins were free of tumor involvement. Evaluation of peripancreatic lymph nodes showed two out of nine nodes containing malignant cells. Perineural invasion was present, while angiolymphatic invasion was not identified. A total of nine regional lymph nodes were examined, with two showing evidence of metastasis. The primary tumor was confined to the pancreas without extension beyond. No lymphatic or venous invasion was observed. The surgical margins were uninvolved. No evidence of prior neoadjuvant therapy was noted."} +{"pid": "TCGA-G4-6303", "report": "The surgical specimens include multiple implants and resected colon segments. A peritoneal implant and a small bowel implant were both identified as containing malignant cells. A sigmoid colon resection revealed a circumferential, ulcerated, exophytic mass measuring 5.0 x 3.5 x 1.6 cm. Histologic evaluation showed moderately differentiated invasive carcinoma involving the lamina propria, submucosa, and muscularis propria, with extension into subserosal fat. One out of 25 lymph nodes was involved. Multiple tumor implants were noted within the pericolic fat. Resection margins were free of invasive disease. Additional findings included a small focus of tubular adenoma. A venous and lymphatic invasion was present; no perineural invasion was observed. Two ring-shaped colonic specimens (rectal donut and colon donut) showed no evidence of malignancy. Pathologic staging reflects full-thickness wall involvement, lymph node positivity, and presence of implants."} +{"pid": "TCGA-B0-4699", "report": "The specimen from the right kidney, adrenal gland, and segment of colon shows a large mass measuring 15 cm in greatest dimension. Histologic evaluation reveals high-grade nuclear features with sarcomatoid dedifferentiation. The lesion extends into the perinephric adipose tissue and infiltrates the colonic wall to the level of the muscularis propria. Angiolymphatic invasion is present. All vascular resection margins, including those of the renal and colonic specimens, are free of tumor involvement. The ureteral margin is also negative. Tumor cells are identified on the inked peritoneal surface. Both proximal and distal colonic resection margins show no evidence of neoplastic cells. The posterior aspect of Gerota\u2019s fascia does not show any signs of tumor. The adrenal gland and surrounding non-neoplastic tissues of the kidney and colon do not demonstrate any significant pathologic changes.\n\nPathologic staging is pT4 N0 M1. Lymph node specimens from retrocaval and interaorticocaval regions show no evidence of malignancy. Biopsies from the duodenum, omentum, small bowel adhesion, diaphragmatic nodule, and additional omental tissue all reveal sarcomatoid morphology. A separate nodule in the duodenum consists of hyalinized fibrous tissue without atypical cells. A cecal specimen, including appendix and terminal ileum, shows no neoplastic changes. A pleural plaque demonstrates hyalinized fibrous tissue with dystrophic calcification and no malignant cells. A fragment sampled during grossing was sent for cytogenetic analysis, with results pending. Other specimens, including cartilage, bone, and bone marrow from the tenth rib, show no significant pathologic findings."} +{"pid": "TCGA-2J-AAB1", "report": "The surgical specimen includes the head of the pancreas, duodenum, and common bile duct, resected as part of a Whipple procedure. A diffusely infiltrative mass measuring 4.5 x 2.8 x 2.2 cm is present in the pancreatic head region. Adjacent to this mass, a cystic lesion measuring 2.0 x 1.5 x 1.5 cm is identified within a side-branch duct. The mass extends beyond the pancreas into peripancreatic soft tissue and involves the adjacent duodenal wall. There is no involvement of the stomach or gallbladder. Angiolymphatic invasion is present. The mass involves both the common bile duct and pancreatic duct. The uncinate margin is involved by the lesion, while the portal vein groove is free of tumor. Following re-excision, the pancreatic body and common hepatic duct margins are negative for tumor involvement.\n\nA total of 21 peripancreatic lymph nodes are examined, with 7 showing evidence of metastatic disease. One lymph node from the common hepatic artery region is negative for tumor. Permanent histologic sections confirm findings initially observed during frozen section evaluation. No choleliths are present in the gallbladder. A stent is noted within the common bile duct. Representative sections of all relevant anatomical regions and margins have been submitted for histologic analysis."} +{"pid": "TCGA-DD-AAD0", "report": "The liver specimen measured 17.0 x 11.5 x 7.5 cm and weighed 419.0 grams. The operation performed was a left lateral hepatectomy. A mass measuring 13.0 x 7.5 x 6.5 cm was identified; it was relatively well-defined and bulging. The cut surface of the mass was bile-tinged, ovoid, solid, granular, and showed areas of necrosis. The gross type was expanding nodular. The resection margin was not involved grossly, with a safety margin of 0.2 cm. The remaining liver parenchyma showed cirrhosis. Portal vein invasion was not present.\n\nMicroscopically, the lesion showed moderate differentiation with a trabecular and pseudoglandular histologic pattern. Fatty change was present in approximately 30% of the cells. There was no evidence of cholangiocarcinoma or combined hepatocellular and cholangiocarcinoma. A partial fibrous capsule was observed, with capsular infiltration noted. Septum formation was present. There was no invasion at the surgical resection margin, serosal invasion, microvessel invasion, intrahepatic metastasis, or multicentric occurrence.\n\nNon-tumor liver pathology revealed chronic hepatitis related to HBV infection. The lobular grade was minimal, and the portoperiportal grade was mild. Fibrosis was consistent with cirrhosis, mixed type. No dysplastic nodule, ductal epithelial dysplasia, or other liver diseases were identified. Peritoneal fluid smear was suggestive of malignancy. Multiple tissue blocks were submitted for analysis, including sections from the bile-tinged mass, surrounding liver parenchyma, non-tumorous liver tissue, and resection margin."} +{"pid": "TCGA-39-5040", "report": "The thoracic specimen from the left upper lobe of the lung was examined, along with multiple lymph node samples. A nodule measuring 3.4 x 3.0 x 2.3 cm was identified in the lateral aspect of the lobectomy specimen, located approximately 3 cm from the bronchial resection margin. The tumor exhibited poorly differentiated features and showed extensive vascular invasion as well as perineural involvement. The bronchial margin and pleura were free of tumor involvement. No in situ carcinoma was observed.\n\nExamination of the background lung tissue revealed emphysematous changes, respiratory bronchiolitis, and rare small non-necrotizing intrapulmonary granulomas. Multiple peribronchial lymph nodes were identified, and metastatic involvement was confirmed in 4 out of 6 nodes assessed in this region. Extranodal extension was present. Additionally, a metastatic deposit was found in an intrapulmonary lymph node located more than 3 cm from the primary lesion.\n\nLymph node specimens from level XI consisted of two benign nodes, while the level VII lymph node sample contained one benign node. In the AP window region, one lymph node was identified, and it showed metastatic involvement.\n\nImmunohistochemical staining demonstrated positivity for CK7 and 34BE12, with focal positivity for CK20 and 4A4. Staining was negative for TTF-1, PE-10, thyroglobulin, and CD31. Special stains for acid-fast bacilli and fungi were also negative.\n\nThe lobectomy specimen measured 15 x 12 x 4.2 cm and weighed 244 grams. It included a well-circumscribed gray firm nodule encasing bronchial branches. The proximal tumor margin was clear. Representative sections were submitted for analysis, including tumor tissue, vascular margin, peribronchial lymph nodes, adjacent and distant lung parenchyma, and bronchial margin.\n\nIntraoperative frozen section analysis of the lung mass confirmed malignant cells with pleomorphic features. Frozen section diagnoses of level XI lymph nodes and bronchial margin were both benign, and these findings were confirmed on permanent sections."} +{"pid": "TCGA-KK-A6E6", "report": "The prostate gland was submitted for evaluation along with right and left seminal vesicles and segments of the right and left vasa deferens. The prostate measured 6.4 x 3.3 x 3.5 cm and weighed 49 grams after fixation. On gross examination, a firm area was identified in the right peripheral zone across three cross sections of the prostate. Tumor involvement was noted in the right posterolateral region, extending from the apex to the base. Serial sectioning revealed three distinct areas of involvement.\n\nThe largest focus measured 2.0 x 1.8 cm and was present across three cross sections, involving the apex and base regions extensively. This focus extended into the periprostatic adipose tissue, particularly in the right superior neurovascular bundle region and bladder neck area, with an extraprostatic extension length of 26.0 mm. A second focus measured 0.4 x 0.3 cm and was located in the left anterolateral and lateral regions of the peripheral zone, present in two cross sections. A third focus of similar size was found in the left posterior peripheral zone, also present in two cross sections.\n\nMicroscopically, the dominant focus showed a range of grades, including Gleason grade patterns 3, 4, and 5, with the highest grade component predominantly located in the right lateral and anterolateral aspects. The smaller foci were of lower histologic grade. The surgical margins were largely free of involvement, though tumor was found to approach within less than 0.1 mm of the resection margin at the right apex. The right and left seminal vesicles, as well as the segments of the vasa deferens, showed no evidence of involvement.\n\nLymph node evaluation included one lymph node on the right and four on the left. The right pelvic lymph node was 1.0 x 1.0 x 0.3 cm and embedded in a fibrofatty specimen measuring 6.0 x 3.0 x 1.0 cm. The left pelvic lymph nodes ranged in size from 0.3 x 0.2 x 0.2 to 3.2 x 1.0 x 0.6 cm. No tumor was identified in any of the lymph nodes examined."} +{"pid": "TCGA-C5-A7CL", "report": "The patient is a woman with a prior history of cervical malignancy. A specimen labeled \"Cervical tissue\" was received for analysis, consisting of a tan-brown soft tissue fragment measuring 2.4 x 1.7 x 1.0 cm. Microscopic examination revealed invasive moderately differentiated cells. Additional procedures included cystoscopy with stent placement and dilatation with curettage. The findings were reviewed and confirmed by a pathologist."} +{"pid": "TCGA-PQ-A6FI", "report": "The specimen consisted of a cystoprostatectomy specimen measuring 9 cm from right to left, 6.1 cm from bladder dome to bladder neck, and 6.5 cm from anterior to posterior. The prostate measured 4.5 cm from right to left, 3.5 cm from apex to base, and 2.5 cm from anterior to posterior. An attached right ureter was 3.5 cm in length, and the left ureter was 1.5 cm. Attached urachal fat measured 8.5 cm. On opening the bladder, a fulgurated lesion measuring 4.5 x 2.5 x 1.5 cm was identified. It appeared to invade into muscle and was located 2 cm from the posterior peritoneal margin of resection. The lesion extended to the bladder neck and was 3.1 cm from the prostate apex urethral margin. It involved the right ureteral orifice and the right bladder wall including the trigone. The cut surface was tan and indurated. The tumor was 4.1 cm from the right ureteral margin and approached within 0.6 cm of the right soft tissue margin. No necrosis was observed. The remainder of the urothelium was unremarkable. No definitive lymph nodes were identified in the pericystic fat. The prostate showed no distinct masses on sectioning.\n\nHistologically, the lesion demonstrated papillary configuration with ulceration. Invasive growth was identified within the superficial muscularis propria (inner half). No lymphovascular invasion was seen. Margins were uninvolved by invasive disease, with the closest invasive component being 20 mm from the nearest margin. No carcinoma in situ was present at the margins. No evidence of malignancy was found in any of the examined surgical margins, including multiple ureteral and urethral margins. Twenty-eight lymph nodes were evaluated across multiple regional sites, and none showed evidence of metastasis. Additional findings included low-grade urothelial dysplasia, inflammation with regenerative changes, and therapy-related effects.\n\nSpecimens received for intraoperative consultation included multiple ureteral and urethral margins. Frozen section analysis confirmed absence of malignancy in all evaluated margins. Lymph node specimens ranged in size from 0.5 to 2.4 cm and were embedded entirely. No pathological abnormalities were identified in other tissues submitted, including prostatic, seminal vesicle, and adjacent soft tissue specimens."} +{"pid": "TCGA-IS-A3K8", "report": "The submitted specimens included an endocervical polyp, endometrial curettings, a cervical biopsy, a resected uterine mass with a segment of small bowel, the uterus and cervix, and both fallopian tubes and ovaries.\n\nThe endocervical polyp showed benign features. The endometrial curettings revealed simple hyperplasia without atypia in a background of disordered proliferative endometrium, along with an endometrial polyp. The cervical biopsy demonstrated benign cervical tissue with Nabothian cysts.\n\nThe resected uterine mass measured 20 cm in greatest dimension and exhibited smooth muscle differentiation with epithelioid and myxoid features. Histologic evaluation noted moderate cellular density with an average of 5 mitoses per 10 high power fields (range 2\u20138). No nuclear pleomorphism or necrosis was observed. The tumor extended into the subserosa of the associated small bowel segment, but margins of resection were free of tumor involvement. Vascular invasion was not present. The vascular pattern was noted to be more commonly associated with stromal tumors rather than typical smooth muscle neoplasms. Immunohistochemical findings supported smooth muscle differentiation. The histologic appearance was considered low grade and borderline for malignancy based on limited published data indicating one metastasis among 15 similar cases.\n\nThe hysterectomy specimen revealed multiple leiomyomas, including subserosal, intramural, and submucosal types, with the largest measuring up to 3.5 cm. The endometrium showed disordered proliferative changes and a benign endometrial polyp. The cervix was benign.\n\nBoth salpingo-oophorectomy specimens showed benign ovarian tissue with follicular and inclusion cysts. The left side also contained a paratubal cyst. The fallopian tubes were unremarkable bilaterally.\n\nAll diagnoses were based on direct examination of slides and review of materials by the reporting pathologist."} +{"pid": "TCGA-DJ-A1QF", "report": "A 28-gram thyroid specimen was received, consisting of right and left lobes measuring 4.5 x 3.5 x 3 cm and 4.0 x 2.3 x 1.2 cm respectively, along with an isthmus measuring 2.2 x 2.0 x 0.7 cm. The right lobe contained a well-circumscribed, soft, hemorrhagic, gelatinous nodule measuring 2.9 x 2.6 x 2.5 cm, located adjacent to the capsular surface without gross involvement or extension through it. A separate nodule in the left lobe measured 1.0 x 0.7 x 0.6 cm, also well-circumscribed and firm, with similar proximity to the capsule but no gross invasion. Histologically, the nodules were well differentiated with no identified mitotic activity or necrosis. The larger lesion in the right lobe was partially encapsulated and showed no evidence of blood vessel invasion or extrathyroid extension. Surgical margins were free of abnormal tissue. Microscopic analysis revealed additional small foci within the thyroid, including one in the left lobe measuring 0.2 cm. The surrounding non-neoplastic thyroid tissue demonstrated nodular hyperplasia. No adenomas or parathyroid tissue were identified. All submitted sections were examined and confirmed the absence of tumor at the surgical margins."} +{"pid": "TCGA-85-8070", "report": "The specimen consists of lung tissue obtained via lobectomy. The tumor is located in the left upper lobe and measures 3.5 x 3.5 x 3.5 cm. Microscopic evaluation shows moderately differentiated cells with squamous morphology. No lymph nodes are positive for metastasis out of those examined. Additional pathological features including histologic type, grade, lymphatic or venous invasion, margins, and presence of other nodules are not fully specified."} +{"pid": "TCGA-06-1805", "report": "The specimen from the left frontal region of the brain was received as a 3.0 x 3.0 x 1.8 cm aggregate of gray-white brain parenchyma with a separate blood clot. A second fragment measuring 2.5 x 2 x 1.1 cm was also received, described as irregular, gray-white, and friable. Histologic sections demonstrated a high-grade neoplasm with pleomorphic cells, frequent mitotic figures, vascular proliferation, and areas of necrosis. Immunohistochemical staining showed strong diffuse p53 reactivity, and the Ki-67 labeling index was approximately 25%. Molecular studies were performed for MGMT promoter methylation and EGFRvIII mutation status. The MGMT promoter was found to be methylated, while no evidence of an EGFRvIII mutation was detected. All findings were interpreted in the context of established diagnostic criteria."} +{"pid": "TCGA-A4-8515", "report": "Histopathological examination of the right kidney specimen revealed a well-circumscribed tan mass located in the mid-lateral aspect of the kidney. The mass measured 3.1 cm in greatest dimension and was found to bulge against the renal capsule without gross adherence. Microscopic evaluation showed tumor cells with slightly irregular nuclei measuring approximately 15 microns with evident nucleoli. The tumor was confined to the kidney, with no evidence of extension into the renal sinus or medulla. Margins of resection, including ureteral, vascular, and hilar margins, were uninvolved by invasive carcinoma. No lymphovascular invasion was identified.\n\nThe tumor was unifocal and did not show sarcomatoid features. Immunohistochemical staining demonstrated positivity for CK7, EMA, pankeratin, vimentin, CD10, RCC, PAX8, and P504S, with negativity for WT1. These findings were consistent with a neoplastic process; however, no definitive diagnosis is provided in this summary. A small fragment of tumor was noted near the edge of the soft tissue in the ureteral and vascular margin section, but multiple step sections and intradepartmental consultation concluded that this was likely a knife carry-over or floater rather than a true positive margin.\n\nThe kidney measured 6 x 3.8 x 2.2 cm and weighed 47 g. The cortex appeared atrophic, and histologic evaluation of non-neoplastic tissue revealed changes consistent with end-stage renal disease, including numerous sclerotic glomeruli, thyroidization of tubules, fibrosis, and chronic inflammation. No lymph nodes or adrenal tissue were identified in the attached perinephric fat. The procedure performed was a radical nephrectomy on the right side. Pathologic staging indicated a T category of pT1a, as the tumor was 4 cm or less in greatest dimension and limited entirely to the kidney. Regional lymph node and distant metastatic status could not be determined due to lack of assessable material."} +{"pid": "TCGA-KK-A8IK", "report": "A specimen was received consisting of multiple tissue fragments and lymph node regions. Anterior lymph node tissue measured 3.0 x 2.5 x 1.5 cm and contained a single possible lymph node measuring 1.0 x 0.6 x 0.2 cm; no abnormal cellular formations were identified. The anterior apex consisted of a small tan-red tissue fragment (0.3 x 0.3 x 0.3 cm) with an inked margin; microscopic evaluation revealed only benign glandular structures, and the inked margin showed no evidence of atypical cells. On the right pelvic side, a yellow fibrofatty fragment measuring 8.0 x 6.5 x 2.2 cm contained two possible lymph nodes (5.2 cm and 2.0 cm in diameter), both fully submitted for analysis; no abnormal findings were detected. On the left pelvic side, a yellow fibrofatty fragment measuring 7.5 x 7.5 x 1.0 cm contained multiple lymph nodes ranging from 1.5 to 5.0 cm in diameter; all were entirely submitted and showed no abnormal cellular features.\n\nThe prostate and seminal vesicle specimen included attached segments of the vasa deferentia. The prostate measured 4.5 x 3.5 x 3.8 cm and weighed 34 grams after fixation. Serial cross sections revealed firm areas within the prostate gland. Four distinct foci of cellular irregularities were identified: two in the peripheral zone and two in the transition zone. The largest focus, located in the left lateral and posterior peripheral region, measured 1.8 x 1.0 cm and spanned two cross sections, extending into the apex and base. A second focus in the right posterolateral peripheral zone measured 0.8 x 0.4 cm across three base sections. Two smaller foci in the right and left transition zones each measured 0.4 x 0.1 cm and were present in two cross sections each, localized near the apex. All observed cellular anomalies were confined within the prostate gland. Margins of resection showed no signs of cellular abnormalities. The seminal vesicles and vasa deferentia appeared free of any unusual cellular changes upon gross and microscopic examination. Multiple tissue sections were submitted for further analysis."} +{"pid": "TCGA-K7-A5RG", "report": "A segment of liver measuring 9 x 7 x 3.5 cm was received. The specimen contained a single nodular mass measuring 3.5 x 3.5 x 3.5 cm, located 0.7 cm from the inked resection margin. The surrounding liver parenchyma appeared grey-brown with no other lesions identified. Histologic examination showed well-differentiated cells arranged in trabeculae with mild nuclear atypia. Cellular features included moderate cytoplasmic eosinophilia and preserved architectural patterns. Reticulin staining demonstrated altered architecture within the lesion compared to surrounding tissue.\n\nMicroscopic evaluation revealed no lymphovascular or small vessel invasion. No satellite lesions were identified. Necrosis was present but incomplete, involving approximately 10% of the lesion. The tumor was confined to the liver without evidence of regional or distant spread. Lymph nodes were not identified in the submitted tissue. Staging classification was pT1 with no assessment of lymph node or metastatic involvement possible.\n\nAdditional findings included large cell change and ductal dysplasia. Underlying cirrhosis and fibrosis were present. Iron staining showed trace deposits in both hepatocytes and Kupffer cells. Trichrome and reticulin stains confirmed fibrotic changes. Hepatitis was noted with moderate activity (grade 2/4). All margins were assessed with tumor located near the resection edge at 0.7 cm. Immunohistochemical controls were appropriate and technically adequate."} +{"pid": "TCGA-06-0209", "report": "The surgical specimens from the temporal lobe of the brain consisted of multiple tissue fragments. The first specimen measured 0.4 x 0.3 x 0.2 cm and was described as pink-yellow. Microscopically, it showed areas of necrosis, a delicate vascular network, and significant cautery artifact. The neoplasm was moderately cellular with pleomorphic and hyperchromatic nuclei; however, the presence of necrosis and artifact limited accurate assessment.\n\nThe second specimen included four pieces ranging from 0.7 to 1.0 cm in size, with a soft to firm consistency and pink to red coloration. Histological evaluation revealed an anaplastic glial neoplasm extensively infiltrating brain tissue, with large areas of necrosis and pseudopalisading. Mitotic figures were present. Focal regions displayed numerous gemistocytes and a perivascular lymphocytic infiltrate. Prominent microvessels were observed, although microvascular proliferation was not striking. Vascular thrombosis was also noted.\n\nThe third specimen, obtained from the left temporal region, included multiple tumor fragments measuring between 0.3 and 1.7 cm, with a variegated appearance ranging from pale tan to dark red. Microscopic features were consistent with those seen in the second specimen. Immunostaining for MIB-1 demonstrated a labelling index of approximately 10% in the more active regions of the neoplasm.\n\nIntraoperative smears and frozen sections from the first specimen suggested a necrotic vascular lesion with atypical cells suspicious for a glial neoplasm. Frozen section analysis of the second specimen confirmed the presence of a high-grade glial neoplasm, while the final diagnosis was based on comprehensive histological and immunohistochemical evaluation of all submitted sections."} +{"pid": "TCGA-AJ-A8CW", "report": "The surgical specimens include bilateral ovaries and fallopian tubes, as well as a uterus with cervix, lymph nodes, and omentum. Both ovaries show corpora albicantia and small benign cysts; definitive segments of the fallopian tubes were not identified. The uterus contains a mass measuring 5.5 x 5.0 x 4.5 cm located in the endometrium. Histologic evaluation reveals a solid growth pattern involving more than 5% of the tissue. The tumor extends focally into the myometrium, reaching a depth of 0.2 cm within a 3.5 cm thick muscular wall. No cervical involvement or extension to other organs is observed. No lymphovascular space invasion is identified. Surgical margins, including bilateral parametria, uterine serosa, and cervix, are uninvolved.\n\nLymph node evaluation includes right paraaortic (1 node), right external iliac (11 nodes), right obturator (4 nodes), left external iliac (9 nodes), and left obturator (4 nodes). All lymph nodes are negative for metastatic disease. The omentum is also negative for tumor involvement. Additional findings include leiomyomata within the uterine wall. Frozen section analysis confirms these findings. No tumor is identified in the submitted cervix or endocervical polyp. Multiple sections of the uterus and surrounding tissues are submitted for histologic evaluation. The fibrofatty tissues submitted from various lymph node regions show no evidence of malignancy."} +{"pid": "TCGA-BH-A0BZ", "report": "The specimen consists of a left modified radical mastectomy with axillary dissection. The tumor measures 8.3 cm in its maximum dimension and is unifocal. Histologic evaluation reveals a high nuclear grade with a Nottingham score breakdown of tubules 3, nuclei 3, and mitoses 2, for a total score of 8 out of 9, corresponding to grade 3. Lymphovascular permeation is present. A small component of in situ disease, composed of solid and cribriform types, is admixed with the invasive component, accounting for less than 1% of the overall tumor volume. This in situ component shows nuclear grade 3 features, comedo necrosis, and associated microcalcifications, as well as retrograde cancerization of lobules. No involvement is seen at the surgical margins, including the nipple and skeletal muscle. The skin shows fibroepithelial polyps without evidence of tumor, and there are changes consistent with a prior biopsy site. Background fibrocystic changes include ductal epithelial hyperplasia and columnar cell alterations. One of 23 left axillary lymph nodes examined contains metastatic disease, with the largest deposit measuring 11 mm. Immunohistochemical staining previously performed showed positivity for estrogen and progesterone receptors, and Her-2/neu was negative (score 1+). Malignant calcifications are noted. The nodal examination used H/E staining methods."} +{"pid": "TCGA-B5-A11U", "report": "The specimen from a hysterectomy and bilateral salpingo-oophorectomy includes a uterus weighing 103 grams, measuring 8 x 5 x 4 cm. A mass located in the anterior fundus measures 2.8 x 2.5 x 0.7 cm and demonstrates exophytic growth. Microscopic evaluation shows invasion to a depth of 0.5 cm within a myometrial wall thickness of 2.2 cm. Lymphatic and vascular invasion are present. The endometrium adjacent to the mass is unremarkable. A benign leiomyoma measuring 3 mm is identified in the myometrium. The cervix, serosal surface, and specimen margins show no involvement. The right adnexa includes a fallopian tube measuring 4.1 x 0.5 cm with multiple paratubal cysts up to 2.2 cm in diameter; no ovarian tissue is identified. The left adnexa contains a fallopian tube measuring 5.5 x 0.4 cm and an ovary measuring 2.2 x 0.7 x 0.7 cm. Both adnexa exhibit areas of adhesions contiguous with the uterine serosa. A separate excision of a cul-de-sac nodule reveals a soft tissue aggregate measuring 2.5 x 2 x 0.3 cm, which demonstrates metastatic cellular changes. Immunohistochemical evaluation shows no reactivity for synaptophysin or chromogranin. Based on AJCC 6th Edition staging criteria, the staging is pT3b pNX pMX."} +{"pid": "TCGA-44-A47G", "report": "Revised Surgical Pathology Report. Procedure: Reason for revision: Removal of voice recognition error in the diagnosis.\n\n**Summary:** \nA resected lung specimen from the posterior apical segment of the right upper lobe contained scattered clusters of atypical cells. A separate lesion was identified in the right upper lobe, measuring 1 cm in greatest dimension. Histologic evaluation revealed a moderately differentiated epithelial neoplasm. The bronchial and pulmonary margins of resection were free of malignant cells, as were the pleural surface and peribronchial lymph nodes. No vascular invasion was identified.\n\nLymph node biopsies from levels VII, X, and XI, as well as fat pad tissue from the 2R region, showed no evidence of malignancy. Non-neoplastic findings included emphysema, subpleural elastosis, and arteriolar medial hypertrophy in the surrounding lung tissue.\n\nGross examination of the right upper lobe specimen measured 14 x 11 x 4 cm and revealed a central defect in the pleura, possibly related to a prior biopsy. Adjacent to this defect was a subpleural tan-white area measuring 1 cm in diameter, which was sampled for further analysis. A wedge biopsy from the same region showed similar histologic features at the stapled margin.\n\nThe case involved multiple specimens including lung tissue, lymph nodes, and adipose tissue, all of which were evaluated microscopically. Based on the extent of involvement and tumor size, staging was classified as pT1, though accurate measurement was complicated by the distribution of the lesion across different specimens."} +{"pid": "TCGA-FP-7829", "report": "The surgical specimen included a partial esophagus and portion of the proximal stomach. A polypoid mass was identified at the gastroesophageal junction, measuring 7.5 x 7.0 x 1.6 cm. Microscopically, the lesion demonstrated moderately differentiated features with mucinous characteristics. The tumor extended through the muscularis propria into the surrounding periesophageal soft tissue, involving the esophageal wall 2.5 cm above the junction and the gastric wall 5.2 cm below the junction. Vascular and lymphatic invasion were present. The distal gastric margin was found to be involved submucosally, but after re-excision, it was uninvolved by invasive carcinoma. Proximal and radial margins were free of malignancy.\n\nLymph node evaluation revealed two positive nodes among a total of seventeen examined (twelve paraesophageal and five perigastric). The maximum size of nodal metastasis was 0.1 cm. Additionally, a small hyalinized and calcified nodule measuring 0.4 cm was identified in the muscularis propria of the stomach, with immunohistochemical staining supporting a stromal origin.\n\nStaging was determined based on established criteria for tumors involving the gastroesophageal junction. Tumor extension reached the adventitia, corresponding to pT3. Regional lymph node involvement with two positive nodes classified as pN1. There was no evidence of distant metastasis. The final pathologic stage was pT3N1M0. Barrett\u2019s esophagus with high-grade dysplasia was present in the background mucosa. No prior treatment had been administered.\n\nA second gastric margin specimen showed no residual invasive carcinoma at the resection edge, although deeper sections of the distal margin revealed microscopic foci of the tumor. This was not seen in the initial frozen section analysis. The remainder of the anastomotic and gastric specimens were negative for malignancy. The serosal surface of the stomach was otherwise unremarkable aside from a small nodule noted in the muscularis propria.\n\nSpecimen details included a distal esophagus and stomach segment measuring 7 x 3 cm and 10 x 9 x 3 cm respectively. The new gastric margin measured 4 x 2.4 x 2 cm, and the anastomotic rings were less than 1 cm in length. Extensive histologic sampling was performed across 25 cassettes, including full-thickness sections of the tumor, adjacent mucosa, and lymph node basins. No additional lesions or lymph nodes were identified in the remaining gastric or esophageal specimens."} +{"pid": "TCGA-CJ-4916", "report": "The surgical specimen includes a right radical nephrectomy measuring 24.0 x 13.0 x 6.5 cm, containing a kidney measuring 15.5 x 8.5 x 5.0 cm along with segments of the renal artery, renal vein, and ureter (14.0 cm in length, 0.2 cm average diameter). A well-circumscribed mass measuring 10.4 x 7.0 x 5.0 cm is present in the lower pole of the kidney. The mass appears yellow with areas of hemorrhage and myxoid change, but no distinct necrosis is observed. It does not involve the renal sinus, renal pelvis, or perinephric adipose tissue. The lesion extends to the renal vein but does not reach the margin of the vein. There is no extension beyond Gerota\u2019s fascia. The adjacent kidney tissue appears normal, and the pelvicalyceal system is smooth without lesions. No lymph nodes are identified at the kidney hilum. Margins of resection, including those of the renal vein, renal artery, ureter, and perirenal soft tissue, show no evidence of involvement. The right adrenal gland, measuring 4.5 x 3.5 x 1.7 cm and weighing 15.0 grams, shows no abnormalities on gross or microscopic examination. Serial sections of the adrenal cortex and medulla appear unremarkable. Multiple representative sections of the kidney and tumor were submitted for analysis."} +{"pid": "TCGA-AL-3468", "report": "The specimen was received in five parts. The first part, labeled as right 11th rib, consisted of a 3.5 x 1.0 cm tan fragment of rib with minimal attached soft tissue. A representative section was submitted for analysis. The second part, identified as right lower pole of kidney cyst, included a portion of tan fibromembranous tissue measuring 9.0 x 5.0 x 0.2 cm with some associated adipose tissue up to 0.2 cm; no thickened or suspicious areas were noted. Representative sections were submitted for frozen section and additional sections were processed. The third part, right perinephric fat, weighed 322 grams and appeared as yellow-tan lobulated tissue; multiple representative sections were submitted. \n\nThe fourth part, lower pole renal mass-right, was an 8.0 x 8.0 x 6.7 cm ovoid mass weighing 210 grams. It was partially covered with a grayish-tan smooth capsule and had associated fibroadipose tissue up to 1.0 cm. The cut surface revealed a soft orangish-yellow to reddish-brown tumor, located approximately 0.2 cm from the nearest margin without gross invasion into the capsule. One section from the tumor near the margin was submitted for frozen section and additional sections were taken in relation to the parenchyma and capsule. The final part, deep margin-right renal mass, contained two fragments of brownish-tan tissue measuring 0.4 and 0.6 cm, both submitted for frozen section consultation.\n\nMicroscopic evaluation of the margins showed no tumor involvement. The tumor was confined to the renal parenchyma without angiolymphatic invasion. Cytogenetic analysis of the renal mass revealed an abnormal karyotype with numerical abnormalities including extra copies of chromosomes 3, 10, 12, 16, 17, and 20, two extra copies of chromosome 7, and loss of chromosome 21. These findings are consistent with reported patterns in papillary renal neoplasms, where trisomies of chromosomes 7, 12, 16, 17, and 20 have been described. The modal chromosome number was 52, and all cells exhibited an abnormal karyotype. No tumor was identified in the other sampled tissues."} +{"pid": "TCGA-A2-A0CZ", "report": "The specimen consists of a right breast mastectomy, right breast tissue from the inferior flap, and two right sentinel lymph nodes. The breast specimen measured 16 cm medial to lateral, 14 cm superior to inferior, and 3 cm anterior to posterior. A mass located in the upper inner quadrant measured at least 1.1 cm microscopically and extensively involved the superficial (anterior, blue inked) margin. Another mass in the central region measured 2.5 cm grossly and was completely excised. No necrosis or microcalcifications were identified. Venous invasion was not present. The intraductal component was minimal and closest to an inked surgical margin at 5 mm. Two separate tumor foci were identified, indicating multicentricity.\n\nEstrogen receptor staining was positive in 95% of nuclei for both tumor sites. Progesterone receptor staining was positive in 5% of nuclei for the upper inner quadrant tumor and 15% for the central tumor. HER-2 immunohistochemistry was negative (1+) for the upper inner quadrant tumor, and FISH testing on the central tumor showed no amplification with a ratio of 1.1.\n\nMargins were involved by invasive tumor in the upper inner quadrant (slides A2\u2013A4). The nipple and skin showed no involvement. Both sentinel lymph nodes were negative for metastatic disease, based on histologic examination and immunostaining for cytokeratin. Additional findings in the breast included cystic change, apocrine metaplasia, and columnar cell change. The tissue from the inferior flap showed no significant pathology.\n\nThe pathologic stage assigned was pT2, based on the 2.5 cm central mass. Due to incomplete assessment of the upper inner quadrant tumor, it could not be classified beyond pTX. The smaller tumor was located at a surgical margin over a 4 to 5 mm arc but could not be fully measured."} +{"pid": "TCGA-28-1757", "report": "The specimen from the right temporal region of the brain demonstrates extensive necrosis and a high degree of cellular infiltration. Microscopic examination reveals significant nuclear pleomorphism, scattered mitotic figures, and focal microvascular endothelial proliferation. Immunostaining results show up to 5% of tumor nuclei positive for MGMT, retained PTEN expression (1-2+ in 80% of tumor cells), and 40% of tumor nuclei and 70% of tumor cytoplasm positive for pMAPK. Laminin beta-1 is upregulated (3+ in endothelial cells) and laminin beta-2 is also upregulated (2+ in endothelial cells).\n\nFluorescence in situ hybridization (FISH) analysis of 40 cells shows an EGFR/CEP ratio of 8.3, with 10% of cells demonstrating greater than four copies of EGFR, indicating amplification.\n\nMultiple tissue samples were collected during surgery. The first sample measured 0.6 x 0.5 x 0.2 cm and was entirely submitted for frozen section diagnosis. Subsequent specimens measured as follows: NCI #1 at 1.7 x 1.2 x 0.4 cm; NCI #2 at 2.0 x 1.5 x 0.5 cm; NCI #3 at 1.5 x 1.0 x 0.5 cm; NCI #4 at 1.7 x 1.0 x 0.5 cm; and NCI #5 at 2.0 x 1.0 x 0.5 cm. All were received fresh for research tissue procurement and subsequently fixed in formalin. Additional permanent blocks included two portions of light tan, hemorrhagic, friable tissue, and three pieces of semi-firm, friable pink-white tissue ranging from 0.7 to 1.0 cm in size. All tissues were serially sectioned and fully submitted for analysis.\n\nThe percentage of necrotic tissue varies across samples, with some containing only 10% viable tumor cells and others up to 80%. Viable tumor cellularity ranges from 5% to 90% across specimens. Based on pathological features and molecular markers, the tumor demonstrates characteristics associated with variable responses to certain therapies. Some markers suggest potential sensitivity to specific treatments, while others indicate relative resistance. However, these findings are not definitive and must be interpreted in the context of clinical correlation and further review of the literature."} +{"pid": "TCGA-CG-4438", "report": "The specimen consists of a total gastrectomy preparation, which includes an ulcerated, extensively distributed neoplastic lesion measuring up to 9 cm in maximum diameter. The lesion extends to the pylorus and is associated with infiltration of the surrounding perigastric adipose tissue. There is evidence of limited serosal involvement. A total of thirteen regional lymph nodes show metastatic involvement. The oral resection margin is free of tumor and lined by unremarkable squamous epithelium, while the aboral resection margin, covered by typical duodenal mucosa, is also tumor-free. The omentum is devoid of tumor. Lymph node staging reveals 14 involved nodes out of 58 retrieved."} +{"pid": "TCGA-19-2620", "report": "The specimen consists of multiple tissue fragments submitted from various sites related to bilateral frontal lesions. Specimen A, labeled as a left frontal mass, consists of tan-pink soft tissue fragments measuring 1.4 x 1.2 x 0.5 cm in aggregate. Specimen B, labeled as a left frontal lesion, includes white to tan-brown cerebriform tissue fragments measuring 7.0 x 5.5 x 1.6 cm. Specimen C, also from the left side, contains similar appearing fragments measuring 4.2 x 2.7 x 0.7 cm. Specimen D, described as infiltrated white matter on the left, measures 2.0 x 1.4 x 0.5 cm. Specimen E, from the right frontal region and noted as a lateral margin, consists of two fragments measuring 1.3 x 0.6 x 0.5 cm. Specimen F, also from the right frontal area, is significantly larger, measuring 11.0 x 4.4 x 3.1 cm in aggregate. Intraoperative cytology smear from the left frontal lesion demonstrated cellular features consistent with a high-grade neoplasm. Histologic examination reveals extensive pleomorphic cells with marked nuclear atypia, brisk mitotic activity, microvascular proliferation, and areas of necrosis. Tumor infiltration into adjacent white matter is observed."} +{"pid": "TCGA-CV-7413", "report": "The specimen consists of a resection of the chin including the anterior mandible, overlying skin, and base of tongue. Histologic examination reveals an invasive, moderately differentiated squamous cell carcinoma involving the skin, subcutaneous tissue, and floor of mouth. Bone sections are pending decalcification. Resection margins are free of tumor. A separate specimen from the right lingual nerve shows no evidence of tumor involvement. Lymph nodes from the right middle jugular region also show no evidence of metastatic disease. There is no evidence of perineural or lymphovascular invasion."} +{"pid": "TCGA-05-4415", "report": "The pathology report describes a lesion in the left lung with both central and peripheral involvement. The tumor exhibits large-cell morphology, with polymorphocellular features and the presence of giant cells in part. Mucin inclusions are identified within the tissue. Based on the available samples, the TNM classification is pT4 pN2 pMX, with V1 (vascular invasion) and R0 (complete resection margin). The staging corresponds to stage IIIB.\n\nThe central component involves both upper and lower lobes, with significant impact on central bronchial structures, including obliteration and stenosis of major bronchial segments. There is continuous infiltration into parabronchial lymph nodes. A separate peripheral lesion is located in the S6 segment and does not involve the visceral pleura.\n\nMicroscopic examination reveals tumor invasion into small intratumoral blood vessels. Among the samples, one contains an additional lymph node with metastatic involvement. The bronchial and vascular resection margins, along with the hilar resection surface of the main specimen, are free of tumor. Additionally, the lymph nodes from samples 2 through 6 also show no residual tumor."} +{"pid": "TCGA-F7-A50J", "report": "The specimen consists of an oriented portion of tongue measuring 5.5 cm anterior to posterior, 4.2 cm superior to inferior, and 1.9 cm medial to lateral. A central exophytic irregular mass is identified measuring 4.2 cm anterior to posterior and 3.8 cm superior to inferior. The remaining mucosa appears pale tan and slightly edematous. The specimen is inked with superior blue, anterior orange, inferior red, posterior black, and deep green. The lesion is located 1.9 cm from the superior mucosal margin, 0.4 cm from the anterior mucosal margin, and 0.2 cm from the inferior mucosal margin. There is a superficial area of ulceration located less than 0.1 cm from the inferior mucosal margin and 0.3 cm from the posterior mucosal margin. Serial sectioning reveals gray-white cut surfaces with a maximal depth of involvement measuring 1.2 cm. The closest resection margin is at the inferior aspect, measuring 0.4 cm from the lesion.\n\nMicroscopic examination reveals moderately differentiated keratinizing cellular morphology with invasion into adjacent structures. Evidence of vascular and lymphatic space involvement is noted. Perineural infiltration is also observed. At the deepest margin of resection, viable abnormal cells are present within 1.0 mm of the inferior margin; however, no residual abnormal tissue is identified at the inked margins."} +{"pid": "TCGA-33-4566", "report": "The specimen from the bronchus biopsy shows bronchial mucosa without evidence of tumor involvement. One lymph node from the R10 region and two lymph nodes from the R11 region were all negative for tumor involvement.\n\nA mass measuring 5.6 cm in greatest dimension was identified in the right upper lobe of the lung. The lesion is located in the apical medial segment and appears to originate from a large bronchus. It does not involve the pleural surface. Histologic examination reveals an infiltrating, poorly differentiated non-small cell carcinoma with focal squamous features and large cell undifferentiated morphology.\n\nAll bronchial, vascular, and parenchymal margins are free of tumor. Eight regional lymph nodes examined also show no evidence of tumor involvement. In the surrounding non-neoplastic lung tissue adjacent to the lesion, multiple notable changes are present."} +{"pid": "TCGA-KO-8408", "report": "The left kidney contains a large, lobulated mass measuring 11.0 cm in maximum dimension. The tumor is relatively well-circumscribed and extends through the renal capsule into the perinephric fat, including areas adjacent to the adrenal gland, though it does not directly involve the adrenal gland itself. The tumor also extends into the renal sinus adipose tissue. Grossly, the cut surface of the tumor shows a variegated appearance with tan-pink fleshy regions, gray-brown necrotic areas (comprising less than 10% of the tumor), and thickened gray-white fibrous septa traversing the lesion. No tumor involvement is seen at the ureteral or vascular margins, and the renal vein is free of tumor.\n\nThree hilar lymph nodes are involved by tumor, with sizes measuring 4.8 x 1.5 x 1.0 cm, 2.5 x 2.0 x 2.8 cm, and 1.6 x 1.0 x 1.0 cm. Their cut surfaces show pink-tan fleshy appearances. Histologically, the tumor demonstrates nuclear features consistent with high-grade morphology. Microscopic evaluation reveals invasion of perinephric adipose tissue and presence of vascular-lymphatic invasion.\n\nImmunohistochemical staining shows strong positivity for EMA in tumor cells. Cytokeratin 7 is positive in a minority of cells, while CD10 demonstrates focal positivity with rare membranous staining. Vimentin staining is negative.\n\nUltrastructural analysis reveals cuboidal tumor cells with abundant cytoplasm containing numerous mitochondria with tubular cristae and a significant number of microvesicles, findings consistent with eosinophilic variant morphology.\n\nA radical nephrectomy specimen includes the left kidney (28.0 x 17.0 x 10.0 cm), adrenal gland (7.0 x 4.0 x 1.5 cm), and associated lymph nodes. The spleen, measuring 11.5 x 7.8 x 5.0 cm, has an unremarkable appearance with no evidence of tumor involvement. Representative sections from all regions were submitted for evaluation."} +{"pid": "TCGA-E2-A1L7", "report": "The specimen consisted of a right breast with axillary contents (levels 1 and 2), along with additional axillary tissue. The mastectomy specimen weighed 934 grams and measured 28 x 25 x 5 cm. It included a 19 x 9 cm skin ellipse and a 1.3 cm everted nipple. Serial sectioning identified a mass measuring 3 x 2.5 x 2 cm located in the upper outer quadrant and upper central regions of slices 5 through 7. This lesion was firm, tan-white, well-circumscribed, and situated 1.5 cm from the skin margin and 3 cm from the deep margin. A surgical clip was noted in slice 8. The axillary tail measured 9 x 7 x 5 cm.\n\nLymph node dissection revealed 19 lymph nodes ranging from 0.7 x 0.5 x 0.5 cm to 4 x 3 x 3 cm. Of these, five contained metastatic involvement with extranodal extension; the largest metastasis measured 4 cm. Additional axillary contents included two lymph nodes measuring 1.5 x 1.5 x 1 cm and 2 x 1.5 x 1.5 cm, both of which contained metastatic involvement with extranodal extension.\n\nHistologic evaluation demonstrated multifocal involvement with high-grade nuclear features and necrosis. Vascular or lymphatic invasion was present. Margins, including skin and deep margins, were free of involvement. There was also evidence of intraductal proliferation with solid morphology and necrosis, involving approximately 15% of the specimen and associated with the invasive areas.\n\nImmunohistochemical analysis showed negative estrogen receptor staining in one area (Allred score 2) but positive staining in another area (Allred score 3). Progesterone receptor staining was negative in one region and strongly positive in another (Allred score 7). HER2 immunohistochemistry showed equivocal staining (2+ intensity in 40% of tumor cells), but fluorescence in situ hybridization did not demonstrate HER2 gene amplification.\n\nStaging classification was determined as pT2 pN2 based on tumor size and lymph node involvement."} +{"pid": "TCGA-YG-AA3N", "report": "The specimen from the right chest consists of an elliptical fragment of skin measuring 6 x 3 x 0.7 cm. The epidermal surface shows a raised brownish area measuring 1.6 cm in diameter, located 0.9 cm from the nearest peripheral margin. On sectioning, the lesion appears grayish brown, homogeneous, and smooth, extending to within 0.5 cm of the deep margin. Margins are inked and free of involvement. The lesion has been entirely submitted for examination across nine cassettes.\n\nTwo sentinel lymph nodes were examined. The first, from the right axilla, measures 2.5 x 1.5 cm and is embedded within adipose tissue. The second, from the left axilla, includes two lymph nodes: one measuring 2.5 x 2 cm and another measuring 1.5 x 1.4 cm. Both lymph nodes exhibit a tan or yellow appearance with homogeneous, rubbery parenchyma and have been fully submitted for evaluation.\n\nHistologic examination reveals a lesion with a depth of invasion measuring 6 mm. The mitotic index is 1 per mm\u00b2. There is evidence of ulceration and non-brisk tumor-associated lymphocytic infiltration. No lymphovascular invasion is identified. All margins are free of involvement.\n\nImmunohistochemical staining using HMB45 and S-100 did not demonstrate specific reactivity in the lymph nodes. \n\nPathologic staging is determined as pT4b pNo pMx."} +{"pid": "TCGA-FD-A43N", "report": "The patient is a male who underwent cystoprostatectomy and ileoconduit for a bladder mass. The surgical specimens included left and right pelvic lymph nodes, bladder, prostate, seminal vesicles, vas deferens, right distal ureter, and bilateral vas deferens.\n\nA total of 20 left pelvic lymph nodes and 13 right pelvic lymph nodes were examined, with no evidence of tumor involvement (0/33). The cystoprostatectomy specimen revealed a firm, tan mass measuring 4.0 cm located in the right lateral wall of the bladder, extending anteriorly and posteriorly. Microscopic evaluation showed that the lesion invaded the muscular wall of the bladder with focal extension into extravesicular soft tissue. No tumor was identified at the urethral, ureteral, or soft tissue margins. Additionally, no tumor was found in the right distal ureter or bilateral vas deferens specimens.\n\nHistologic assessment of the prostate demonstrated no tumor involvement, including in the prostatic urethra and ducts. Lymph node candidates within the perivesical adipose tissue were also negative for tumor.\n\nPathologic staging based on the 7th edition TNM classification system was determined as pT3a, N0, MX. The tumor was classified as high grade, with focal squamous differentiation noted in 10% of the sample. The mass was solitary and measured 4.0 cm, involving the right lateral, anterior, and posterior bladder walls. All resection margins were free of tumor."} +{"pid": "TCGA-S9-A6U9", "report": "The neuropathology evaluation demonstrates histologic and morphologic features consistent with a high-grade glioma. Microscopic examination reveals increased cellularity with nuclear atypia and brisk mitotic activity. The tumor is moderately cellular, with a mitotic count of approximately 8 per 10 high-power fields. No definitive necrosis or microvascular proliferation was identified. The lesion exhibits infiltrative growth patterns typical of diffusely infiltrating gliomas. Based on histologic criteria, the tumor is classified as WHO grade III."} +{"pid": "TCGA-5P-A9JY", "report": "The specimen shows a tumor measuring 7.5 cm in greatest dimension. Microscopic examination reveals cells arranged in a papillary pattern with moderate nuclear atypia. The stroma is fibrous and there is evidence of vascular invasion. Surgical margins are free of neoplastic cells. The tumor is confined to the kidney with no extension into adjacent structures. Histologic grade is intermediate, with nuclear features corresponding to Grade II."} +{"pid": "TCGA-E7-A7DU", "report": "Gross Description: \n1. Fragments of bladder tissue obtained via endoscopy show a papillary growth pattern, with histologic features including well to moderate cellular differentiation, areas of squamous metaplasia, ulceration, and necrosis. The lesion appears to involve at least the submucosal layer. \n2. A specimen from cystoprostatectomy reveals a large vegetative mass located in the trigone, retro-trigone, and left bladder wall, with intramural extension and broad base attachment. The tumor invades through the entire bladder wall. Histologically, it demonstrates infiltrative growth with well to moderate differentiation, squamous metaplasia, ulceration, and necrosis. The depth of invasion extends beyond the muscularis propria into perivesical tissue (pT3). \n3. Right ilio-obturator lymph node group includes 8 nodes, up to 1.3 cm, showing reactive changes, congestion, and sclero-lipomatous dystrophy. \n4. Left ilio-obturator lymph node group consists of 6 nodes, up to 1.5 cm, also displaying reactive features, congestion, and sclero-lipomatous changes. \n5\u20136. Ureteral specimens from both sides show no abnormal histologic findings.\n\nMicroscopic Description: \nThe tumor is composed of cells with transitional morphology arranged in both papillary and infiltrative patterns. Nuclear grading shows a range of differentiation from well to moderately differentiated. Squamous metaplasia is present within the tumor. Ulceration and areas of necrosis are noted. Lymphovascular invasion was not specified. All surgical margins are free of tumor involvement. No metastatic involvement is identified in the 14 regional lymph nodes examined.\n\nSummary: \nThe specimen is from a cystectomy procedure. A bladder mass measuring 4 x 4 cm is present, involving the trigone, retro-trigone, and left wall with intramural and transmural growth. Histologic features include papillary and infiltrative architecture, well to moderate differentiation, ulceration, necrosis, and full-thickness wall invasion with extension into perivesical tissue. No lymph node metastases are identified. Additional findings include reactive lymph nodes and absence of tumor in ureteral margins."} +{"pid": "TCGA-ZB-A96H", "report": "Pathology Report-Summary: Material: tumor: 4.0 x 2.5 x 2.0 cm. Histological examination reveals epithelial cells positive for CK 5/6. In between the epithelial cells, there are CD99-positive immature T-lymphocytes. The specimen shows focal infiltration of mediastinal fat tissue. The staging classification is pT2 and the Masaoka stage is II."} +{"pid": "TCGA-EM-A4FK", "report": "The specimen received consists of a right hemithyroidectomy measuring 5.0 cm in greatest dimension, with additional measurements provided for the isthmus and pyramidal lobe. The total specimen weight is 16.9 grams. A dominant nodule measuring 2.6 x 2.2 x 1.9 cm is identified in the lower pole of the right lobe. It is well delineated and exhibits tan and focally hemorrhagic appearance. No lymph nodes or parathyroid glands are identified grossly.\n\nHistologic examination reveals a unifocal lesion located in the right thyroid lobe. Microscopic architecture includes follicular patterns with focal solid and trabecular growth. Cytomorphology demonstrates oncocytic or oxyphilic features. Margins are free of involvement. The tumor is partially encapsulated without evidence of capsular invasion, lymphovascular invasion, perineural invasion, or extrathyroidal extension.\n\nStaging data indicates the tumor exceeds 2 cm but is less than 4 cm in size and remains confined to the thyroid gland. No regional lymph nodes were identified or examined in the specimen. Additional findings include nonspecific chronic thyroiditis involving a focal area of the gland."} +{"pid": "TCGA-FF-8062", "report": "Histopathology findings demonstrate a confluent, nodular-to-diffuse infiltrate composed of medium-to-large cells with open nuclei, granular chromatin, spotty karyorrhexis, relatively inconspicuous nucleoli, and abundant cytoplasm. In one focus, the infiltrate is compartmentalized by sclerotic strands (Block A1), with entrapment of skeletal muscle showing focal regenerative changes, including multinucleation, partially walled off by fibrosis (Block A2). Atrophic thyroid follicles are present in a background of lymphocytic thyroiditis (Block A1). The infiltrate is largely supported by CD21-immunoreactive follicular dendritic meshworks, which are well-defined in nodular regions but expanded and disrupted in diffuse areas. The neoplastic cells show diffuse positivity for the pan-B cell marker CD20, with coexpression of CD10, a germinal center-associated antigen. The Ki-67 proliferation index is consistently in the range of 70\u201380%, with moderate anisokaryosis noted among the medium-to-large cells. A minor component of small, intermingled centrocytic cells is observed focally. Immunostains for bcl-2 and MUM1 show no significant upregulation, with expression levels consistent with physiological activity in reactive CD3-positive T-cells, which are accentuated at perifollicular locations. Terminal deoxynucleotidyl transferase immunostaining is negative in the neoplastic population, with only physiological expression seen in rare hematogones, effectively ruling out lymphoblastic neoplasia. Cyclin D1 staining is negative, except for scattered non-neoplastic thyrofollicular epithelial, histiocytic, and activated endothelial cells, excluding transformed mantle cell lymphoma."} +{"pid": "TCGA-ZC-AAA7", "report": "Microscopy/Assessment: Histologically, a polycyclic, well-demarcated tumor with a lobular architecture is identified. The tumor demonstrates multifocal necrosis and exhibits areas of vascular invasion. The neoplastic cells display a syncytial growth pattern, with indistinct cell borders, clear cytoplasm, and pleomorphic nuclei containing prominent nucleoli. Lymphocytes are sparsely present in the background. Immunohistochemical staining reveals strong positivity for CK19, EMA, CD5, and CD117. Immature T cells (TdT) are not detected. \n\nFollow-up report: Results of EBER hybridization are negative.\n\nShort report: The tumor was obtained from the thymus. No discrepancy is observed between the histology of the frozen and paraffin sections."} +{"pid": "TCGA-DU-8163", "report": "A male patient presented with recent onset seizures and was found to have a 4 x 3 cm nonenhancing lesion in the left middle temporal lobe. A partial resection of the lesion was performed, and follow-up imaging revealed focal areas of enhancement. Three biopsy specimens were obtained: Brain, biopsy #1; Brain, biopsy #2; and Brain, residual posterior superior flair, biopsy.\n\nMicroscopic examination of the specimens showed varying degrees of infiltration by a glial neoplastic proliferation. The neoplastic cells were primarily round to ovoid with minimal pleomorphism. Mitotic figures were identified at a rate of up to seven per ten high power fields in some areas. The MIB-1 proliferation index was moderately elevated, reaching approximately 10% in more active regions. Focal vascular changes including endothelial hyperplasia and microvascular cellular proliferation were observed, but no tumor necrosis was present.\n\nImmunohistochemical staining demonstrated overexpression of p53 protein in a large majority of neoplastic cells. GFAP staining revealed a moderate gliofibrillary background with focal presence of mini gemistocytes. CD34 staining confirmed areas of microvascular proliferation.\n\nMolecular testing for loss of heterozygosity (LOH) on chromosome arms 1p and 19q was performed using PCR assay with multiple markers. Allelic loss on both 1p and 19q was detected. Testing for MGMT promoter methylation did not show evidence of methylation.\n\nIntraoperative consultation on biopsy #2 noted a diffusely infiltrating glial neoplasm with abnormal vessels, raising concern for transformation. Touch preparation smears were performed and reported to the treating physician.\n\nGross examination of the specimens showed tissue fragments ranging from 0.8 x 0.8 x 0.2 cm to 3.5 x 1.5 x 0.7 cm, with semi-firm, tan-white, glistening surfaces. One specimen included post-surgical cavity tissue containing inflamed granulation tissue and surgical hemostatic material, with surrounding brain tissue showing infiltration by atypical cells.\n\nAll findings were interpreted in the context of established diagnostic criteria and procedures."} +{"pid": "TCGA-D6-A4Z9", "report": "Gender: M. Examination result. Histopathology findings indicate a partially keratinizing and ulcerating lesion within the oral cavity specimen, measuring 4.5 x 4 x 2 cm macroscopically, with the lesion itself measuring 3.5 x 2.0 x 0.8 cm. The tumor was located on the tongue and showed moderate differentiation. Surgical excision was performed completely, and all wire-marked margins were found to be free of neoplastic involvement. The closest margin measured 1.1 cm at the site marked by stitches. No cancerous lesions were detected in the intraoperative assessment of the resected margins."} +{"pid": "TCGA-IZ-A6M9", "report": "The specimen was obtained from a right partial nephrectomy measuring 4.0 x 3.8 x 2.8 cm. A well-defined nodule measuring 3.8 cm was identified within the renal tissue, lined by a thin capsule and located focally within the specimen. The lesion demonstrates papillary histologic features with a nuclear grade of 2 out of 4. Evaluation of the margins indicates no involvement by the lesion. No lymph nodes were examined. Small vessel invasion was not observed. The staging classification for the lesion is pT1a, with pNx and pMX for lymph node and metastasis assessments, respectively. Histologic examination of non-neoplastic kidney tissue reveals compression atrophy adjacent to the lesion and mild chronic changes with mild vascular sclerosis at the surgical margin. Special stains including Jones, PAS, and trichrome were utilized in the assessment. Multiple tissue blocks were processed and evaluated using routine H&E staining."} +{"pid": "TCGA-V3-A9ZX", "report": "The submitted specimen consists of a left eye measuring 20.8 mm in anteroposterior diameter, 23.8 mm in horizontal diameter, and 22.0 mm in vertical diameter. The optic nerve measures 8.9 mm in length with a diameter of 3.5 mm. Gross examination reveals a round globe with a surgically absent cornea. Transillumination demonstrates a shadow in the superotemporal quadrant. Upon sectioning, a red-brown firm mass is identified measuring 8.1 mm in height and 11.5 mm in basal diameter at the cut edge. The anterior margin of the tumor is 1 mm from the limbus, and the posterior margin is 5 mm from the edge of the optic disc. The mass involves the sclera, choroid, and ciliary body. No involvement of the scleral or optic nerve margins is observed.\n\nHistologically, the lesion demonstrates a mixed cell morphology with greater than 10% epithelioid cells and less than 90% spindle cells. The tumor forms a solid mass without involvement of surgical margins. The histologic grade corresponds to pG2. Based on size and location, the classification indicates a tumor in the second size category with ciliary body involvement. No regional lymph nodes are available for assessment.\n\nAdditional findings include a mitotic rate of 35 per 40 high power fields, presence of an extravascular matrix pattern on PAS stain, mild pigmentation, scattered macrophages, numerous tumor-infiltrating lymphocytes, retinal detachment, hemorrhage, and an associated cataract. No distant metastasis is identified. A portion of tissue was used for DNA extraction."} +{"pid": "TCGA-AG-3584", "report": "The resected rectal specimen includes non-inflamed diverticula in the proximal portion. The oral and aboral resection margins are free of tumor involvement. The lesion is located near the perirectal margin, with a distance of 2 mm from the edge. There is extensive infiltration into the perimuscular adipose tissue, including involvement of lymphatic and blood vessels. A significant number of regional lymph nodes show metastatic involvement, with 20 out of 34 examined nodes affected. Histological evaluation reveals moderately differentiated cellular features. The tumor demonstrates deep tissue invasion without direct mention of distant spread."} +{"pid": "TCGA-05-4396", "report": "The specimen shows a lesion with extensive involvement of the lung tissue, exhibiting a pneumonia-like appearance. Histologically, there is a mixed growth pattern, including tubulopapillary and bronchioloalveolar features. Focal mucin production is present. The lesion consists of multiple small foci distributed within the pulmonary parenchyma, with minimal invasion into the pleura. Lymphatic spread is evident, with involvement of regional lymph nodes.\n\nMicroscopic evaluation reveals several small tumor foci not only adjacent to the main lesion but also at a distance, some detectable only under the microscope. These are considered satellite nodules within the same lobe. Lymph node analysis (samples 5, 7, and likely 1) demonstrates micrometastatic disease. Despite this, no tumor is identified at the bronchial or vascular resection margins.\n\nThe primary lesion is located in segments 6 and 9 of the right lower lobe. The largest lymph node metastasis measures 1.2 mm. Based on these findings, the classification could be interpreted as pT4 pN1 R0. However, given the histological features and the possibility of multifocality, an alternative staging of pT2(m) is also considered, which would influence the overall stage grouping."} +{"pid": "TCGA-BP-4963", "report": "The left kidney and adrenal specimen measured 12.0 x 5.6 x 3.7 cm and weighed 349 g. A well-circumscribed yellow variegated mass with a central scar was identified in the superior pole, measuring 6.5 x 5.9 x 4.0 cm. The lesion extended inferiorly and compressed the renal pelvis, with the closest margin being the renal sinus fat, which did not show involvement. The tumor was surrounded by normal-appearing renal parenchyma with a distinct cortico-medullary junction. The cortex measured 1.0 cm. No lymph nodes were identified within the perinephric fat. The ureter measured 4.0 cm in length and 0.3 cm in diameter, and the renal vein measured 0.6 cm in both length and diameter; both margins appeared unremarkable. An adrenal gland measuring 6.5 x 1.6 x 0.4 cm was present and showed no abnormality. Histologically, the nuclear features were high-grade. The surgical margins were free of tumor. Sections of the tumor showed no evidence of invasion into the renal vein or surrounding structures beyond the kidney. Staging criteria indicate the lesion is confined to the kidney, with a maximum dimension of 6.5 cm. Representative sections of the tumor, adjacent kidney tissue, sinus fat, ureteral and vascular margins, renal pelvis, and adrenal gland were submitted and reviewed."} +{"pid": "TCGA-DD-A39W", "report": "A portion of liver measuring 16 x 12 x 5.5 cm was submitted along with the attached gallbladder, with a combined weight of 575 grams. A separate choledochal lymph node measuring 2.5 x 1.5 x 1 cm was also received. Within the liver, a mass measuring 13 x 10 x 5.0 cm was identified. Histologic evaluation revealed moderately differentiated tumor cells arranged in trabecular and solid patterns. The surrounding liver tissue did not show cirrhosis. Another fibrous nodule measuring 3.5 x 2.5 x 2.5 cm contained areas of old granulomatous inflammation as well as similar tumor cells. Surgical margins were negative with a distance of at least 0.4 cm from the tumor. The gallbladder showed features of cholesterolosis. Lymph nodes examined, including those near the common bile duct, displayed reactive changes without evidence of tumor involvement. Special stains for acid fast bacilli and fungi performed on the granulomatous lesion were negative."} +{"pid": "TCGA-EM-A3FP", "report": "The specimen consists of a right hemithyroidectomy measuring 4.0 cm in greatest dimension, with an isthmus measuring 4.5 cm. The right lobe contains a dominant nodule measuring 2.2 cm, with additional smaller nodules noted. The nodule is well-circumscribed, fleshy, and yellow-pink in appearance. Histologically, the nodule demonstrates follicular architecture with classical cytomorphologic features, as well as oncocytic changes in smaller foci. A second lesion measuring 0.4 cm is identified within the isthmus, also showing follicular variant features with microcarcinoma morphology. Margins are free of involvement. The tumor is partially encapsulated with minimal capsular invasion; no lymphovascular or perineural invasion is identified, and there is no extrathyroidal extension. Three regional lymph nodes are examined and show no evidence of involvement. Additional findings include mild follicular nodular disease and chronic lymphocytic thyroiditis. Parathyroid tissue from both the right upper and inferior regions is unremarkable. A very small focus (0.05 cm) of oncocytic follicular variant is also identified in the right lobe."} +{"pid": "TCGA-12-1602", "report": "The surgical pathology report describes tissue obtained from a craniotomy. Two specimens were received. The first specimen, measuring 4 x 3.5 x 2 cm, consists of an aggregate of pink-tan soft tissue. A portion was used for intraoperative frozen section analysis, and additional sections were submitted for further evaluation. The second specimen, measuring 4 x 3 x 1.7 cm, was serially sectioned and representative samples were submitted for analysis.\n\nMicroscopic examination reveals brain tissue infiltrated by a malignant astrocytic neoplasm. The tumor demonstrates marked cytologic pleomorphism, mitotic activity, microvascular proliferation, and areas of necrosis.\n\nCytogenetic analysis using FISH showed polysomy of chromosome 7 and EGFR in 62% of tumor cells. Loss of chromosome 10 centromere and PTEN allelic loss were observed in 52% and 73% of tumor cells, respectively. Chromosome 9 centromere and 9p21 regions remained intact. All four tested markers were abnormal.\n\nImmunohistochemical staining showed a high proliferation index with 20% of tumor cells staining positive. MGMT expression was negative in 3% of tumor cells. EGFR wild-type expression was positive in 80% of tumor cells, while EGFR variant VIII was not detected. PTEN expression was reduced in 40% of tumor cells. S6 was positive in 40%, AKT was negative in 20%, and MAPK was positive in 50% of tumor cells. Leukocyte common antigen (LCA) was positive in 15% of cells.\n\nAll findings were derived from brain tissue containing a high-grade neoplasm, with multiple histologic, molecular, and immunophenotypic features assessed."} +{"pid": "TCGA-63-A5MS", "report": "The sample was collected from the left upper lobe via resection procedure. The tumor measured 3.5 cm in size. Histological analysis showed features of a malignant epithelial neoplasm with squamous differentiation. The pathological stage was determined as T2, NOS for the primary tumor, with no lymph node involvement (N0) and no evidence of distant metastasis (M0). The histology report also noted the presence of in situ carcinoma at the bronchial resection margin. No additional diagnostic terms were provided. The report also references a second sample of buffy coat type, though no further details were specified regarding its collection or analysis."} +{"pid": "TCGA-BB-7871", "report": "The specimen consists of a piece of tan and brown soft tissue measuring 3.4 x 1.1 x 0.7 cm, with a brown, rough surface interpreted as a cut surgical margin and a tan-brown, smooth mucosal margin. The tissue is unoriented, with the entire surgical margin inked black. Serial sectioning reveals unremarkable tan-pink, homogeneous parenchyma, and the entire specimen is submitted for analysis.\n\nMultiple biopsies from various anatomical sites were examined. Several specimens showed no evidence of tumor involvement, including portions of the hypoglossal nerve, right tonsil, right deep base of the tongue, right base of the tongue mucosa, left base of the tongue midline, right neck level 1B lymph nodes, and left neck level 1B lymph nodes. Other specimens demonstrated abnormal cellular infiltration. Involvement was noted in the left base of the tongue mucosa, right soft tissue on the vagus nerve, and several lymph node regions on both the right and left sides of the neck.\n\nOn the right side, lymph node involvement was observed in levels II, III, IV, and V. A total of 17 out of 41 lymph nodes were affected, with the largest focus measuring 4.0 cm and extranodal extension identified. On the left side, lymph node involvement included 8 out of 14 lymph nodes in level 2B and 19 out of 35 lymph nodes in levels II through V. The largest focus on the left measured 2.7 cm, and extranodal extension was also present.\n\nA laryngectomy specimen revealed a mass centered at the base of the tongue with extension into adjacent structures. The mass measured 3.5 cm in greatest dimension and demonstrated moderately differentiated features. It extended to within less than 1 mm of an inked margin at the superior aspect near the base of the tongue and approached the anterior margin. The mass involved the supraglottic region, encroached upon the glottis, and reached the subglottis without grossly involving the true vocal cords. No clear invasion of the thyroid cartilage was identified.\n\nLymphatic and vascular invasion was present, including involvement of large vessels. Perineural invasion was also noted. Margins were generally free except for involvement at the base of the tongue margin. Involvement of the superior base of the tongue margin was seen near the mass. A separate excision from the base of the tongue showed close proximity of the infiltrating cells to a cauterized margin, within less than 1 mm.\n\nA retropharyngeal lymph node on the right skull base was involved, with a focus measuring 1.6 cm and extranodal extension identified. Overall, 45 out of 91 lymph nodes across all levels contained metastatic involvement, with none exceeding 6 cm in size."} +{"pid": "TCGA-B5-A0K8", "report": "The specimen consisted of a uterus weighing 85 grams, measuring 6 x 6 x 2.2 cm, along with bilateral adnexa, and multiple lymph node aggregates. A mass measuring 2.2 x 2 x 1.1 cm was identified at the fundus within the posterior endometrium. The mass appeared tan-pink and friable, but did not grossly extend into the myometrium, which measured 1.8 cm in thickness at that site. The closest distance from the mass to the superior endocervix was 1.5 cm, and to the cervical os was 4.2 cm. The remainder of the endometrium was thin, measuring less than 0.1 cm. A full-thickness section of the endometrial mass was submitted for analysis.\n\nThe anterior endocervix contained a nabothian cyst measuring 1.1 cm. No other abnormalities were noted in the cervix, serosa, or myometrium. Sections of both fallopian tubes and ovaries were unremarkable. The right fallopian tube measured 4.5 x 0.5 cm and the left was 4.5 x 0.5 cm. Both had unremarkable appearances on external and cut surfaces. The right ovary measured 2.5 x 2 x 0.8 cm and the left measured 2.5 x 1.5 x 0.6 cm; both exhibited normal external and internal features. Paratubal cysts up to 0.3 cm were noted on the left side.\n\nLymph nodes were submitted as three separate groups. The \"left pelvic lymph node\" specimen included three lymph nodes up to 1 cm in size, all negative for malignancy. The \"toot pelvic lymph node\" specimen included four lymph nodes up to 1.2 cm, also negative. The \"right pelvic lymph node\" specimen contained five lymph nodes up to 2.5 cm, none of which showed evidence of malignancy.\n\nMicroscopic evaluation demonstrated extensive endometrial intraepithelial neoplasia without evidence of invasive carcinoma. The maximum depth of myometrial involvement was minimal, measuring 1 mm in a 1.8 cm thick wall. No lymphatic or vascular invasion was identified. Adjacent endometrium was atrophic, and adenomyosis was present in the remaining myometrium. All surgical margins were free of involvement. Both ovaries and fallopian tubes showed no pathological findings. Lymph nodes from all sites were negative for malignancy.\n\nStaging was determined based on the current specimen alone and assigned as pT1a, pN0, pMX according to the AJCC 6th Edition criteria."} +{"pid": "TCGA-08-0244", "report": "The pathology report describes findings from multiple biopsies and resection specimens from the brain. The tissue samples vary in size and appearance, with most presenting as soft, tan-pink to pink-tan fragments. Measurements of individual specimens range from 0.5 x 0.3 x 0.2 cm up to 2.0 x 1.2 x 0.7 cm.\n\nMicroscopic examination reveals a highly cellular neoplasm composed of astrocytic cells exhibiting marked nuclear atypia, cytoplasmic and nuclear pleomorphism, and features including fibrillary and gemistocytic morphology. Areas of necrosis are present throughout multiple specimens. Microvascular proliferation and endothelial proliferation are consistently observed, particularly notable in some frozen sections. Some regions demonstrate vascular proliferation accompanied by necrosis and a macrophage infiltrate. In certain biopsies, focal atypical cells are identified near vessels but do not constitute diagnostic tissue on their own.\n\nImmunohistochemical staining for glial fibrillary acidic protein is strongly positive. The MIB-1 labeling index is reported at 13.04%. Additional molecular studies including S+ (MIB-1), 53, and EGFR are pending results.\n\nThe cortex adjacent to the tumor appears less involved in one specimen, although infiltration is noted. One intraoperative diagnosis identifies a small component of a lower-grade lesion with nuclear atypia, while another confirms the presence of a high-grade neoplasm based on frozen section analysis.\n\nAll specimens were processed and submitted entirely into cassettes for microscopic evaluation. Gross descriptions detail both fresh and formalin-fixed tissues, with portions reserved for frozen section diagnosis. The laboratory performing these tests is CLIA-certified for high-complexity testing and the stains used are clinically validated though not FDA-approved.\n\nDiagnosis was established following comprehensive review of all pathology slides by the attending pathologist. Clinical correlation was based on imaging and intraoperative findings leading to resection of the right parietal lesion."} +{"pid": "TCGA-G4-6294", "report": "The resected right colon specimen measured 15 cm in length and contained a firm, exophytic mass located in the mid-portion, measuring 4 x 3.7 x 3.5 cm. The lesion was circumferential and obstructing, involving the cecum and extending to the ileocecal valve, with proximity to the ileal margin (3 cm) and distal colonic margin (6 cm). Upon opening, the tumor presented as tan-cream-white and infiltrated through the full thickness of the colonic wall, reaching into the subserosal fat. The attached adipose tissue measured 11 x 5 x 2.5 cm, and no appendix was identified. Margins of resection, including proximal and distal segments, were free of involvement.\n\nLymph node evaluation included multiple sections from various levels. Of ten lymph nodes assessed, two showed evidence of involvement. No vascular or lymphatic invasion was noted, and perineural invasion was absent. Adjacent non-neoplastic areas included precursor changes consistent with a tubulovillous adenoma. A separate biopsy of liver tissue, measuring 1.2 x 0.7 x 0.5 cm, revealed findings indicative of involvement from the primary lesion in the colon.\n\nHistologically, the lesion demonstrated moderately differentiated features. Staging classification was determined as pT3N1, indicating penetration through the muscularis propria with regional lymph node involvement (1\u20133 nodes affected). No implants or distant spread beyond the sampled areas were identified."} +{"pid": "TCGA-B5-A1MW", "report": "The specimen consists of a uterus weighing 92 grams, measuring 6.2 x 3.5 x 3.5 cm, with a cervix measuring 2.5 cm in diameter and a patent os measuring 0.8 cm. Attached are the fallopian tubes and ovaries. The right fallopian tube is 6 x 1 cm and the right ovary is 4.5 x 1.2 x 1.2 cm; both appear unremarkable. The left fallopian tube measures 6.5 x 1 cm and the left ovary measures 4.6 x 1.5 x 1.2 cm, also appearing unremarkable. The endometrial cavity measures 3.7 x 2.7 cm and is filled by an exophytic, friable mass measuring 3.7 x 2.7 x 1.5 cm. The mass involves the anterior and posterior lower uterine segments and comes within 3 cm of the distal cervix. It extends 1.5 cm in depth and invades approximately 0.4 cm into a myometrial wall that is 1.3 cm thick. No other lesions are identified in the myometrium or elsewhere in the specimen.\n\nSections were taken from the right and left ovaries, fallopian tubes, anterior and posterior cervix, lower uterine segments, and multiple sections of the mass. A frozen section was obtained from the area of deepest invasion.\n\nLymph node dissections were performed on the left external, left obturator, right pelvic, left aortic, high left aortic, and right aortic regions. The left external lymph node specimen includes one lymph node measuring 1.8 cm in greatest dimension and two measuring 0.8 cm. The left obturator dissection includes one lymph node measuring 1.4 cm, two measuring 1.5 cm, three measuring 1.2 cm, and three measuring 0.8 cm. The right pelvic dissection includes two lymph nodes measuring 1.2 cm, four measuring 0.8 cm, three measuring 1 cm, and six measuring 0.5 cm. The left aortic dissection includes three lymph nodes measuring 0.5 cm. The high left aortic node is a single lymph node measuring 1.5 x 1 x 0.6 cm. The right aortic lymph node dissection includes a lymph node measuring 3 x 0.8 x 0.6 cm, two measuring 0.6 cm, and remaining fibroadipose tissue.\n\nMicroscopic evaluation of the mass reveals high-grade malignancy with invasion less than half of the myometrial thickness. No lymphatic or vascular invasion is identified. The cervix, serosa, and specimen margins are free of tumor involvement. The ovaries and fallopian tubes are also free of tumor. All lymph nodes examined across all sites are negative for malignancy. Adenomyosis is present in the myometrium. Non-neoplastic endometrium is absent adjacent to the mass."} +{"pid": "TCGA-A2-A0CQ", "report": "The specimen consists of multiple tissue samples from both breasts and sentinel lymph nodes. A right sentinel lymph node measuring 1.2 cm and a left sentinel lymph node measuring 1.2 cm were evaluated microscopically using H&E and cytokeratin immunohistochemistry, and both were negative for malignancy.\n\nA lumpectomy specimen from the left breast at the 9:00 position revealed non-invasive papillary carcinoma in situ with surrounding ductal carcinoma in situ. The tumor measured 1.2 cm on gross examination. Lobular carcinoma in situ was also present multifocally. Ductal carcinoma in situ was found less than 1.0 mm from the superior margin; however, the final superior margin specimen from the left breast was negative for tumor. Microcalcifications were identified within areas of ductal carcinoma in situ and in benign breast tissue.\n\nOn the right side, a lumpectomy was performed at the 6:00 position. The invasive component measured 1.8 cm microscopically and was moderately differentiated based on nuclear-histologic grading. This was associated with papillary carcinoma and ductal carcinoma in situ with nuclear grade 2 and necrosis. Multifocal lobular carcinoma in situ was also present. The invasive carcinoma was found at the superior margin, less than 1.0 mm from the anterior margin, and 1.5 mm from the posterior margin. Papillary carcinoma in situ was present less than 1.0 mm from the posterior margin. Microcalcifications were again noted in ductal carcinoma in situ and benign breast tissue.\n\nStaging according to AJCC criteria was determined as pT1 pNO(i-) MX. A separate focus suspicious for invasive micropapillary carcinoma was identified in the left breast specimen, measuring approximately 1.7 mm. \n\nGrossly, the left lumpectomy specimen included a 9.8 cm x 5.0 cm x 1.4 cm piece of fatty tissue with overlying skin. A needle localization wire was present. Sectioning revealed a 1.2 cm tan friable lesion with cavitation and hemorrhage. The right lumpectomy specimen measured 8.5 cm x 4.5 cm x 2.8 cm and contained a firm, well-defined tan tumor measuring 2.2 cm in greatest dimension, close to the inked margin. Multiple sections were submitted for histological evaluation.\n\nAll other tissues examined were benign or negative for malignancy."} +{"pid": "TCGA-A5-A0R9", "report": "The pathology report includes findings from multiple specimens. The first specimen, a biopsy of endometrial tissue, shows cellular changes including squamous alterations and necrosis. Acute and chronic inflammation are also noted. A separate curettage sample of the endocervix reveals benign tissue with signs of inflammation, metaplastic changes, hyperplasia, and reactive epithelial features.\n\nA larger uterine specimen measures approximately 13.5 cm at its greatest dimension. Microscopic evaluation indicates that less than half of the myometrial wall is involved by cellular invasion. The tumor extends to the surgical margin but does not involve the cervix. No definitive evidence of lymphovascular invasion is identified, though artifacts complicate this assessment. Additional findings in the uterus include glandular hyperplasia with atypical features, adenomyosis, and small benign-appearing nodules.\n\nExamination of both fallopian tubes and ovaries reveals no signs of metastatic disease. The right ovary shows stromal changes and mild tubal hyperplasia. The left ovary contains a small cystic lesion consistent with a mature teratoma and shows patchy stromal luteinization. The fallopian tubes exhibit mild epithelial hyperplasia without tumor involvement.\n\nLymph node samples from both pelvic regions contain no evidence of metastatic disease. Two lymph nodes on each side were examined and showed no tumor involvement. The omental specimen shows chronic inflammatory changes and reactive mesothelial proliferation but no malignant cells.\n\nAdditional intraoperative frozen section analysis of the uterus supports the presence of abnormal cellular growth with superficial muscle invasion. Step sections and special stains were used to further evaluate the tissue, including immunostains for keratin and other markers, which did not reveal occult tumor cells in lymph nodes. All surgical margins were assessed, with no tumor identified at the site of resection in the cervix or uterus."} +{"pid": "TCGA-BJ-A192", "report": "The specimen consisted of the right thyroid lobe (5 grams) and left thyroid lobe with cervical thymus (42 grams). The right lobe showed slight nodular thyroid hyperplasia. In the left lobe, a cystic lesion measuring 5.0 cm was identified and confined to the thyroid without angiolymphatic invasion. Additional findings included nodular thyroid hyperplasia with a separate oncocytic hyperplastic nodule measuring 1.8 cm. Within the thymus, normocellular parathyroid tissue was present along with a thymus showing no significant abnormalities. An incidental benign salivary cyst heterotopia complex was also noted. Molecular testing for mutations in BRAF, NRAS61, HRAS61, KRAS12/13, and RET/PTC1, RET/PTC3 and PAX8/PPAR\u03b3 rearrangements was negative. Amplification of GAPDH and KRT7 controls was acceptable."} +{"pid": "TCGA-XF-AAMT", "report": "A radical cystectomy with urinary diversion and Studer pouch procedure was performed. The right and left distal ureters were examined and found to be benign without any evidence of dysplasia or abnormal cells. Intraoperative frozen section of the right obturator/hypogastric lymph nodes was positive for metastatic involvement, and final analysis confirmed metastatic presence in 1 out of 2 lymph nodes examined. The apical urethral margin showed benign tissue with focal chronic inflammation, and no malignant or pre-malignant changes were identified.\n\nExamination of the bladder revealed a large invasive lesion involving the posterior wall, measuring 10.8 x 4.8 x 3.5 cm. The tumor extended through the muscularis propria into the peritoneal surface and was associated with extensive ulceration and necrosis. Microscopic evaluation showed high-grade cellular features including pleomorphic nuclei, high nuclear-to-cytoplasmic ratio, vesicular chromatin, prominent nucleoli, and moderate to abundant clear cytoplasm. Squamous differentiation was present in approximately 10% of the tumor. Mitotic activity was high, with more than 20 mitoses per 10 high-power fields. A small focus of flat urothelial carcinoma in situ was also identified. Lymphovascular invasion was present. The adjacent bladder mucosa showed chronic inflammation.\n\nThe uterus, bilateral fallopian tubes, and ovaries were non-neoplastic. The cervix showed benign mucosa, the endometrium displayed cystic atrophy, and the myometrium and serosa were unremarkable. The right ovary contained a benign cyst, and the left ovary had multiple small inclusion cysts. Both fallopian tubes were unremarkable, with the left side showing a small paratubal cyst.\n\nLymph node assessment revealed metastatic involvement in 5 of 74 nodes examined. Positive nodes included one from the right obturator/hypogastric group, two perivesical nodes, one from the right presciatic group, and one from the right obturator/hypogastric group on permanent section. Extracapsular extension was noted in some involved nodes. All other lymph node groups, including left para-aortic, right paracaval, common iliac, external iliac, Cloquet\u2019s node, presacral, and others, showed no evidence of involvement.\n\nThe surgical margins, including the apical urethral margin and both proximal and distal ureteral segments, were free of any dysplastic or malignant changes. Pathologic staging was determined as pT3bN2MX according to the AJCC 5th edition criteria."} +{"pid": "TCGA-KS-A4I7", "report": "The specimen consists of a total thyroidectomy and parathyroidectomy with central neck dissection. The thyroid gland weighs 20 grams and includes a right lobe measuring 5 x 3 x 1.5 cm, a left lobe measuring 4.5 x 3 x 2 cm, and an isthmus measuring 1 x 2 x 0.6 cm. The outer surface is smooth and intact. Serial sectioning identified a nodule in the inferior left lobe measuring 1.5 x 1 x 1.2 cm, which grossly approaches the anterior capsule. The remaining parenchyma of both lobes and the isthmus shows uniform beefy red tissue.\n\nA separate left upper parathyroid specimen is a lobular pink tissue measuring 1.2 x 1 x 0.5 cm and was bisected. Additionally, three portions of fibroadipose tissue from level VI lymph nodes were submitted, measuring 2.2 x 1.5 x 0.5 cm in aggregate, containing two lymph nodes.\n\nMicroscopic evaluation included representative sections from the inferior left lobe mass, uninvolved superior left lobe, right lobe, and isthmus. The largest lesion measured 1.5 cm and was located in the left lobe. No evidence of capsular or vascular invasion was identified. Surgical margins were negative and there was no extrathyroidal extension. Lymph node assessment showed no metastases; four lymph nodes were examined from central and perithyroidal regions, all benign. One benign lymph node was also found in level VI. A benign parathyroid gland was resected along with ectopic thyroid tissue identified in one lymph node sample."} +{"pid": "TCGA-BG-A0MC", "report": "The specimen consisted of a uterus and cervix with bilateral adnexas, submitted for evaluation following a microscopic-assisted vaginal hysterectomy with bilateral salpingo-oophorectomy. The total weight of the specimen was 166 grams.\n\nA well-differentiated epithelial neoplasm of endometrial origin was identified within an endometrial polyp measuring 3.3 cm in greatest dimension. The lesion involved approximately 20% of the posterior uterine wall. No invasion beyond the polyp was observed. There was no evidence of angiolymphatic invasion.\n\nExtensive changes consistent with complex atypical hyperplasia were also present in the endometrium. The cervix contained a benign endocervical polyp without any neoplastic changes. Both ovaries showed only physiologic changes and no neoplasms. The right fallopian tube contained a paratubal cyst, and the left ovary demonstrated an old suture granuloma, both without evidence of malignancy.\n\nMargins of resection, including the vaginal cuff and parametrial regions, were free of tumor. No lymph nodes were examined, and no metastatic disease was identified. Peritoneal washings were negative for malignant cells.\n\nStaging parameters indicated no myometrial invasion. The histologic grade was well differentiated architecturally with nuclear features corresponding to grade 2. Based on these findings, the pathologic T stage was classified as pT1a, with N stage indeterminate (pNX) and M stage also indeterminate (pMX). The overall staging was consistent with early-stage involvement confined to the endometrial lining."} +{"pid": "TCGA-B8-A54I", "report": "The surgical specimen consists of a left partial nephrectomy measuring 7.5 x 5.1 x 4.2 cm, weighing 85 grams. A mass is identified within the tissue, measuring 6.7 x 4.1 x 4.1 cm, with a friable, variegated tan and pink appearance. The mass expands the renal capsule and is in close proximity to the parenchymal margin, being 1 mm away. The black-inked parenchymal margin, blue-inked capsular margin, and perinephric fat margin are all free of tumor, with the tumor located 2 mm from the capsular margin and 1 mm from the perinephric adipose margin.\n\nMicroscopic evaluation reveals a unifocal lesion with Fuhrman nuclear grade 3 features. There is microscopic invasion into the renal capsule, though the capsule remains grossly intact. No involvement of perirenal adipose tissue, Gerota\u2019s fascia, or large venous structures is observed. Lymphatic invasion is present in small vessels (A5). No sarcomatoid differentiation is noted.\n\nHistologic assessment of the surgical margins shows no evidence of residual tumor at the resection sites. The surrounding renal cortex appears compressed and distorted. In non-neoplastic areas of the kidney, there is significant lymphoplasmacytic inflammation with multiple loose granulomata. Special stains for microorganisms are negative, and the differential for the granulomatous changes includes sarcoidosis.\n\nThe AJCC staging classification assigned is pT1b pNX. This classification is based on the current findings and may be subject to revision pending further clinical correlation. Immunohistochemical analysis demonstrates positivity for CD10, negativity for CK7, CD15, and CD117, and faint positivity for racemase. These findings support a specific immunophenotype."} +{"pid": "TCGA-97-8172", "report": "The specimen consists of a right upper lobe lobectomy and multiple lymph node biopsies from stations 2, 4, 7, 10, and 11. The lung specimen measures 15.5 x 10.5 x 4 cm. A nodule measuring 3.5 x 3 x 2 cm is identified beneath a puckered area of the pleura. It is located 3 cm from the bronchial resection margin and 2 cm from the closest staple line margin. The nodule is firm, gray-white, and has ill-defined borders. Histologically, the lesion demonstrates acinar architecture comprising approximately 90% of the sample, with 10% showing lepidic features. Extracellular mucin is prominent. Elastic staining does not definitively confirm visceral pleural invasion, and mucin staining is inconclusive.\n\nMargins of resection, including bronchial and vascular margins, are free of tumor involvement. A total of 32 lymph nodes are examined across all stations, and none show evidence of metastatic disease. Histologic grade is moderately differentiated. Lymphovascular invasion is not identified. Molecular testing reveals a KRAS mutation (p.G12V) in codon 12, while no mutations are detected in the EGFR gene. Thirty-two lymph nodes are examined, and all are negative for tumor. Tumor size is 3.5 cm, and based on this, the primary tumor classification corresponds to pT2a. No regional lymph node metastasis is identified (pN0)."} +{"pid": "TCGA-BS-A0UJ", "report": "The specimen includes a uterus with cervix, as well as right and left adnexal structures. The operative procedure performed was hysterectomy with bilateral salpingo-oophorectomy. A polypoid, fungating lesion measuring 1.6 x 1.2 cm in area and 0.7 cm in thickness was identified on the right lateral wall of the uterus. Histologic evaluation revealed Grade 1 histology with nuclear grade 1 features. No definite invasion was identified, and there was no evidence of lymphovascular invasion. The depth of invasion appeared superficial and did not extend into the myometrium. The serosal surface, parametrial tissue, and cervical regions were all free of involvement. The tumor was located 3.7 cm from the cervical margin. One intramural leiomyoma measuring 1.5 x 1.2 x 0.7 cm was also noted. The endometrium measured 0.2 cm in thickness and showed areas of hemorrhage and mucoid material. The myometrium was 2.1 cm thick without gross evidence of adenomyosis. The right and left ovaries and fallopian tubes showed no gross abnormalities. Sections from both adnexa were submitted for evaluation, with the left ovary noted to contain a distinct finding unrelated to the uterine lesion. Staging information was assigned as T1a NX MX. Frozen section analysis confirmed absence of myometrial invasion. Specimens were processed and submitted for microscopic evaluation using standard cassette labeling protocols."} +{"pid": "TCGA-B9-4617", "report": "A left partial nephrectomy specimen was received, weighing 14.9 grams and measuring 4.5 x 3.5 x 2.5 cm. The outer surface was marked with blue ink indicating the capsule, and black ink marking the parenchymal margin. On sectioning, a well-demarcated, pale tan, soft mass measuring 2.4 x 2.3 x 2.0 cm was identified and entirely submitted for analysis.\n\nMicroscopic evaluation revealed a neoplasm with papillary architecture. The cells showed nuclear features consistent with Fuhrman grade 2. The tumor measured 2.4 cm in its greatest dimension and was found to invade the renal capsule. No involvement was seen in the surrounding adipose tissue, Gerota\u2019s fascia, renal vein, or ureter. No evidence of vascular or lymphatic invasion was identified. The surgical margins were assessed, with the tumor located 2 mm from the black inked margin. No lymph nodes were present. Additional findings included chronic inflammation and mild glomerulosclerosis.\n\nStaging was determined as pT1a, pNx, pMx, based on available data at the time of reporting. This staging may be subject to revision pending further clinical correlation."} +{"pid": "TCGA-55-8507", "report": "A wedge excision of the right upper lobe of lung was examined, measuring 5.0 x 4.0 x 2.0 cm. A centrally located nodule measuring approximately 1.5 cm in diameter was identified. The nodule appeared white-tan and firm with a gritty consistency. It was observed to be in close proximity to the pleura but did not show evidence of invasion. Margins of excision were free of neoplastic cells upon histologic evaluation. One potential hilar lymph node measuring 1.1 cm was identified and showed reactive changes without evidence of metastatic involvement. No residual neoplasm was identified in the remainder of the lung tissue submitted. Cellular morphology demonstrated moderately differentiated features with no evidence of vascular or perineural invasion. Staging assessment indicated early localized disease based on size and margin status."} +{"pid": "TCGA-06-5413", "report": "The clinical history indicates a brain lesion. An excision biopsy of the brain was performed and submitted for analysis.\n\nGross examination revealed a 12 x 10 x 2 mm pink-tan tissue fragment. Touch preparations and frozen sections were processed from the specimen.\n\nMicroscopic evaluation confirmed a high-grade glial neoplasm. The tissue showed increased mitotic activity and extensive areas of necrosis. Immunohistochemical staining demonstrated positivity for GFAP, negativity for keratin, and a Ki-67 labeling index of approximately 20 percent. Controls were appropriately reactive.\n\nIntra-operative consultation, including frozen section and smear evaluation, supported the findings observed in the permanent sections. These results were communicated to the treating physician.\n\nAll testing was conducted under CLIA certification for high-complexity laboratory procedures. Some reagents used are classified as analyte-specific reagents (ASRs) and were validated by the laboratory for clinical use."} +{"pid": "TCGA-HV-A5A5", "report": "The specimen includes the common bile duct and pancreatic head with lymph nodes, obtained via pylorus-preserving pancreaticoduodenectomy and cholecystectomy. The fresh specimen consists of a segment of small intestine measuring 25.5 cm in length and 2.5 cm in diameter, a portion of the pancreas measuring 7.5 x 5.4 x 3.5 cm, and a common bile duct measuring 5.5 cm in length and 1.0 cm in diameter. The gallbladder measures 8.5 cm in length and 3.4 cm in diameter.\n\nAn ill-defined ovoid mass is present in the pancreatic head extending to the ampullary area, measuring 2.5 x 1.8 x 1.5 cm. Its cut surface appears pale tan and firm, and it extends into the duodenal wall. The distal pancreatic resection margin is free of tumor with a safety margin of 2.3 cm. The radial pancreatic margin is very close to the mass with a safety margin of 0.1 cm. The common bile duct resection margin shows no evidence of tumor. The remaining pancreatic tissue demonstrates fibrotic changes. The common bile duct appears eroded but without any mass-like lesion. The duodenum shows no remarkable findings. The gallbladder mucosa is dark red to mahogany and velvety; the serosa is pale pink and smooth with a wall thickness of 0.6 cm.\n\nFrozen section analysis of the proximal bile duct and distal pancreatic resection margins revealed no tumor presence. Histologically, the lesion is moderately differentiated and measures 2.5 x 1.8 x 1.5 cm. It directly extends beyond the pancreas into the duodenum and peripancreatic tissue. Lymphovascular and perineurial invasion are present. The radial surgical margin is close to the tumor with a safety margin of 0.1 cm, while the distal pancreatic and proximal bile duct margins are free of tumor.\n\nExamination of regional lymph nodes reveals direct extension of tumor in 2 out of 4 peripancreatic lymph nodes. No tumor is found in the 9 periduodenal lymph nodes, 3 lymph nodes at station No. 12, or 3 lymph nodes at station No. 13. The gallbladder shows histologic features consistent with chronic cholecystitis."} +{"pid": "TCGA-AA-3821", "report": "The specimen consists of a right hemicolectomy preparation. In the cecum, there is a lesion showing a tubulovillous architecture with mild cytological atypia in the cylindrical epithelium. Surrounding this area is chronic, recurrent inflammation with signs of acute activity. A second lesion in the ascending colon also exhibits a tubulovillous pattern with similar mild epithelial changes and associated reactive inflammation. Adjacent to this second lesion are additional small tubular growths. On the surface of this region, there is a component with features of mucin production and architectural complexity raising concern for a more advanced lesion. The tissue infiltration extends into the layers of the colon wall up to the tunica muscularis. There is also surrounding chronic inflammatory change with recurrence, and moderate chronic lymphadenitis is noted in the regional lymph nodes, all of which show no evidence of involvement. All other sections from the resection margins are free of abnormal findings. Based on the available sections, the extent of involvement in the transverse colon corresponds to a pT2 stage, with no nodal involvement (pN0), and unknown distant spread (MX). Resection margins are uninvolved (R0)."} +{"pid": "TCGA-VR-A8EY", "report": "The specimen from the transmediastinal esophagectomy shows a well-differentiated epithelial lesion measuring 8.5 x 5.5 cm. The lesion is ulcerative with vegetative features and extends through the wall into surrounding adipose tissue in the distal third of the esophagus, reaching the cardia. There is no evidence of vascular or perineural invasion. A mild inflammatory infiltrate is noted around the lesion, along with moderate desmoplastic reaction. Surgical margins at both proximal and distal ends show no involvement. Chronic inflammation of the esophagus and stomach is present. No metastatic involvement is identified in the lymph nodes examined across chains 1 (1 node), 2 (6 nodes), 3 (12 nodes), 7 (6 nodes), 9 (4 nodes), and 110 (3 nodes). Lymph node chain 5 was not present for evaluation. The esophageal margin specimen also shows no involvement. Staging is determined as pT3 pN0."} +{"pid": "TCGA-49-4490", "report": "The specimen from the anterior mediastinal lymph node shows metastatic involvement with extension into adjacent soft tissue. One lymph node is affected. In the left upper lobe lung specimen, a moderately to poorly differentiated carcinoma is present. The bronchial and vascular margins are free of tumor. There is extensive lymphatic invasion, and one lymph node contains metastatic disease. The aortic arch lymph node specimen demonstrates poorly differentiated carcinoma involving soft tissue."} +{"pid": "TCGA-EJ-5517", "report": "The patient is a male with a prior history of biopsy performed on 1, which showed involvement of the right apex, right base, and left apex with Gleason grade 3+3 = 6. The pre-operative and post-operative impressions were consistent. A radical retropubic prostatectomy was carried out.\n\nExamination of two right pelvic lymph nodes and two left pelvic lymph nodes revealed no evidence of neoplasia.\n\nMicroscopic evaluation of the prostate specimen demonstrated multifocal invasive moderately differentiated adenocarcinoma with a Gleason score of 3 + 3 = 6. A minor tertiary Gleason grade 4 component accounted for 4% of the tumor volume. The lesion involved both the right and left lobes, with the largest nodule measuring 1.4 cm in greatest dimension. Approximately 15% of the prostate tissue examined was involved by disease.\n\nThe lesion appeared confined to the organ without extension beyond the prostatic capsule. Both seminal vesicles were free of involvement. All surgical margins were negative for tumor. Perineural invasion was observed; however, there was no evidence of angiolymphatic invasion. High-grade prostatic intraepithelial neoplasia was also identified in multiple areas.\n\nThe prostate weighed 56.28 grams. No benign prostatic hypertrophy or chronic inflammation was considered significant in this context.\n\nStaging classification was determined as pT2c with no regional lymph node involvement (pNO) and no assessment of distant metastasis (pMX). Histologic grading was classified as G2, indicating moderately differentiated morphology.\n\nA minor Gleason grade 4 component was present, representing 4% of the overall tumor volume."} +{"pid": "TCGA-94-8490", "report": "The surgical pathology report includes specimens from multiple lymph node regions and a right lung pneumonectomy. Lymph nodes evaluated include those from stations #7, #4R, 11R, level 7, #10R, and additional level 7 and 4R lymph nodes. All lymph nodes examined were negative for metastatic carcinoma.\n\nThe right lung specimen demonstrated multiple nodules within the upper lobe. The primary lesion measured 5.5 cm in greatest dimension with additional nodules measuring up to 2.5 cm. These nodules were located in close proximity to the pleura but did not show direct pleural invasion. The tumor was identified 1.8 cm from the bronchial margin, and the bronchial and vascular margins of resection were free of tumor involvement. No lymphovascular or pleural invasion was identified. There was evidence of post-obstructive pneumonia in the upper lobe.\n\nHistologic evaluation showed moderately differentiated features. The tumor was located centrally and appeared to arise from the bronchus. Additional findings included squamous dysplasia, squamous metaplasia, and emphysema. Intraoperative frozen section analysis of the bronchial margin and selected lymph nodes confirmed absence of tumor involvement.\n\nA total of eight lymph nodes were examined, all without evidence of metastasis. The tumor was noted to have separate nodules within the same lobe, with the largest nodule measuring 5.5 cm. The distance from the invasive carcinoma to the nearest margin (bronchial) was 18 mm."} +{"pid": "TCGA-B8-5545", "report": "The specimen consists of a left laparoscopic nephrectomy measuring 13.5 x 8.7 x 5.2 cm and weighing 360 grams. The kidney itself measures 11.4 x 5.7 x 5.7 cm. A well-circumscribed, hemorrhagic, and cystic mass is present in the inferior pole of the cortex and medulla. The largest tumor measures 4.0 x 3.3 x 3.3 cm. There are two additional smaller lesions noted, making the overall pattern multifocal. The mass bulges the renal capsule but does not extend through it and is located 1.0 cm from the perinephric adipose tissue margin. No involvement of perirenal adipose tissue, Gerota's fascia, renal vein, ureter, or other adjacent structures is identified. All surgical margins are negative, including those at the renal vein, ureter, and Gerota\u2019s fascia.\n\nThe remaining renal parenchyma shows multiple cysts. There are six cysts in total, with sizes ranging from 0.6 x 0.6 x 0.5 cm to 3.1 x 3.0 x 2.6 cm. One of the smaller cysts contains an area of orange discoloration along its inner wall and is located 2.6 cm away from the main mass. The larger cysts are multiloculated, with walls up to 0.1 cm thick, lined by smooth, white inner surfaces, and filled with red/brown mucoid material. The cortex and medulla are well demarcated throughout the remainder of the kidney. The renal pelvis and ureter appear unremarkable. No hilar lymph nodes are present.\n\nMicroscopic evaluation reveals no sarcomatoid features. Histologic grading, when applicable, corresponds to Fuhrman grade 2. The tumor is confined without evidence of macroscopic or microscopic invasion into surrounding structures. No lymphatic or venous invasion is identified. A moderate to severe degree of arterionephrosclerosis is also present.\n\nStaging is based on available data and classified as pT1a, pNx, with no regional lymph nodes assessed. This classification is subject to revision pending further clinical review. Tissue from both the mass and normal kidney has been submitted for further study. Nine blocks were sampled for histologic analysis, including margins, representative sections of the mass, cysts, hilum, and renal pelvis. No digital photographs were taken."} +{"pid": "TCGA-EO-A1Y7", "report": "The specimen included a uterus with cervix, bilateral fallopian tubes, and ovaries, along with lymph node samples from the right common iliac, right pelvic, and right para-aortic regions. All lymph nodes examined were negative for malignancy, with 2 nodes from the right common iliac, 1 from the right pelvic, and 8 from the para-aortic region.\n\nGross examination of the uterus revealed a polypoid and papillary tumor in the endometrial cavity measuring 3.9 cm in one dimension and 4.0 cm in another. The tumor invaded more than 50% of the myometrial thickness, with maximum depth of invasion measuring 11 mm. The tumor was located in both anterior and posterior regions of the uterus and extended into the lower uterine segment, approaching but not involving the endocervix. A fibroid measuring 2.0 x 3.0 cm was noted in the posterior portion of the uterus, and a small endometrial polyp (1.0 x 0.5 x 0.25 cm) was also present. The serosal surface of the uterus was nodular and tan-colored.\n\nMicroscopic evaluation showed complex atypical hyperplasia and an endometrial polyp. Lymphovascular space invasion was identified. The tumor margins were free of invasive carcinoma. No involvement was found in the cervix, fallopian tubes, or ovaries. The right ovary contained a serous cystadenofibroma but showed no malignant cells. The left ovary and both fallopian tubes were also free of malignancy.\n\nHistologic assessment confirmed the presence of a high-grade (FIGO grade 3) endometrioid-type lesion with myometrial invasion. The total myometrial thickness measured 17 mm, with invasion exceeding half of this dimension. No metastatic disease was identified in the sampled lymph nodes. Staging was based on these findings, with the primary tumor classified as pT1b and no regional lymph node involvement (pN0). Additional benign findings included adenomyosis and leiomyoma."} +{"pid": "TCGA-63-7021", "report": "The sample was collected from a resected tissue specimen. The site of collection is noted as the left lower lobe (LLL) and left upper lobe (LUL) lung region. The patient's age at collection was 57 years. The tissue underwent formalin fixation and paraffin embedding, with a slide available for review. Histological evaluation revealed a lesion measuring 2.3 cm in greatest dimension. The histologic grade was determined to be II, with no specific type designated (NOS). Pathologic staging was assessed as T2, N0, M0, indicating no regional lymph node involvement and no evidence of distant metastasis. No additional comments were provided regarding the procedure or preparation."} +{"pid": "TCGA-EJ-5531", "report": "The patient is a male with a history of a PSA value of 5.9 and a prior biopsy from the left mid region of the prostate, which showed poorly differentiated acinar and ductal adenocarcinoma. A radical prostatectomy was performed. Histologic evaluation revealed involvement of both right and left lobes of the prostate by tumor, with a maximum nodule size of 1.9 cm in one section and approximately 15% of the total prostate volume affected. Multifocal extracapsular extension was identified in the left anterior and posterior mid regions, measuring approximately 0.5 cm combined, while the remainder of the prostate showed organ-confined disease. All surgical margins were free of tumor. There was no involvement of the bilateral seminal vesicles or angiolymphatic invasion. Perineural invasion was present. High-grade prostatic intraepithelial neoplasia was also identified. No evidence of metastasis was found in 35 pelvic lymph nodes examined (14 on the right, 21 on the left). The background prostate tissue demonstrated nodular hyperplasia and chronic inflammation. Immunohistochemical staining supported findings of extracapsular extension. The pathologic staging was determined as pT3a with pN0 and pMX. Histologically, the tumor exhibited Gleason pattern 4+3=7, with 60% of the tumor classified as Gleason grade 4 or higher. The prostate specimen weighed 67.53 grams."} +{"pid": "TCGA-DD-A4NN", "report": "The resected specimen includes liver segments V and VI, weighing 245 grams and measuring 10.3 x 9.8 x 4.5 cm, along with the gallbladder, which measures 6.5 x 2.7 x 1.3 cm, and choledochal lymphadenectomy tissue containing two lymph nodes measuring 2.5 x 1.0 x 0.8 cm and 2.4 x 0.6 x 0.6 cm. A mass measuring 7.4 x 5.7 x 5.4 cm was identified in the liver, with a surgical margin free of involvement by at least 3.0 cm. The surrounding non-neoplastic liver tissue is pending further evaluation. The gallbladder shows histologic features of chronic inflammation without evidence of calculi. All lymph nodes examined are negative for involvement."} +{"pid": "TCGA-US-A776", "report": "The specimen consists of a pancreaticoduodenectomy measuring 240mm in length for the duodenum, with a partial pancreatectomy specimen measuring 70 x 40 x 30mm. The gallbladder is 75mm long and 35mm in diameter with wall thickness up to 5mm. No gallstones were identified. The bile duct measures 35mm in length with a maximum diameter of 3mm. A lesion measuring 60 x 45 x 40mm is present in the pancreatic head with mucinous appearance. An infiltrative configuration is noted. The invasive component measures 30mm in greatest dimension.\n\nMargins were evaluated with inked markings: neck (blue), portal vein bed (red), periuncinate (green), and posterior (black). Histologic evaluation reveals involvement of the neck margin by non-invasive mucinous epithelium. The invasive component is clear of all margins, with distances measured as follows: pancreatic neck margin, 40mm; periuncinate soft tissue, 30mm; posterior retroperitoneal, 25mm; portal vein bed, 10mm; common bile duct, 45mm.\n\nLymph node assessment includes 12 lymph nodes from the main resection specimen and two separately received lymph nodes, all negative for metastasis. Extension beyond the pancreas shows colloid carcinoma extending into peripancreatic fat posteriorly. No vascular or perineural invasion was identified.\n\nHistologic grade is moderately differentiated. Immunohistochemical staining shows positivity for CDX2 and MUC-2, with negativity for MUC-1, MUC-5AC, and MUC-6, suggesting an intestinal-type mucinous tumor.\n\nSurrounding pancreatic tissue demonstrates atrophy with loss of acinar cells and focal preservation of islets within fibrotic stroma. The gallbladder wall exhibits fibromuscular thickening with chronic inflammation. The bile duct is largely denuded without evidence of malignancy.\n\nStaging according to AJCC 7th edition indicates pT3, pN0, Stage IIA."} +{"pid": "TCGA-IB-AAUP", "report": "The specimen consisted of a gallbladder measuring 8.4 x 4.0 x 3.0 cm with an unremarkable serosal surface and patent cystic duct. No gallstones were identified, and the mucosa showed nonspecific chronic and acute inflammation without malignancy. A common bile duct lymph node, measuring 1.7 cm, and a level 8 lymph node, measuring 2.8 cm, both showed reactive changes without evidence of malignancy.\n\nThe Whipple\u2019s specimen included a segment of duodenum and distal stomach measuring 26.0 cm in length and 8.5 cm in circumference. The attached pancreas measured 6.5 x 5.0 x 2.0 cm with an unremarkable outer surface. A metal stent was present within the common bile duct, which appeared hemorrhagic and rough. Serial cross-sections identified an ill-defined lesion in the pancreas measuring 2.7 cm in greatest dimension. The lesion was located 0.1 cm from the uncinate margin and 0.1 cm from the distal resection margin. Tissue involvement extended into the peripancreatic soft tissue, retroperitoneal soft tissue, and around the common bile duct, with focal invasion into the duodenal submucosa. Duodenal-pancreatic fistula formation and abscess were noted.\n\nMicroscopic evaluation revealed invasive moderately differentiated epithelial neoplasm involving the ampulla of Vater, sphincter of Oddi, duodenal wall, and peripancreatic soft tissues. Lymphovascular and perineural invasion were present. Seven of nineteen peripancreatic lymph nodes contained metastatic involvement. The peripancreatic soft tissue resection margin was less than 0.1 cm from the infiltrating lesion, while the distal pancreatic margin was at least 0.6 cm free of tumor. The proximal gastric and distal duodenal margins were also free of disease. High-grade intraepithelial neoplasia was observed in the surrounding pancreatic tissue. Staging was consistent with advanced local extension beyond the pancreas with regional lymph node involvement."} +{"pid": "TCGA-EX-A3L1", "report": "The surgical pathology report includes specimens from multiple sites. Specimen A, labeled as a left paratubal cyst, consists of a yellow/tan soft tissue fragment measuring 1.1 x 0.6 x 0.5 cm with a thin wall and serous fluid content. It shows no evidence of malignancy.\n\nSpecimen B is a radical hysterectomy specimen weighing 142.3 grams. The external surface is brown/tan and smooth. The uterus measures 9.9 cm in height, 5.9 cm in anterior-posterior width, and 6 cm at the fundus. The endometrial cavity measures 4 cm in length and 3.1 cm in width, with a lush and unremarkable endometrial surface. Myometrial thickness is 2.6 cm without any significant abnormalities. No adnexal tissue is present.\n\nA lesion measuring 3.9 cm in greatest dimension is identified circumferentially around the cervix except for a small area on the posterior cervical lip. The lesion spans the external os and extends into the lower uterine segment. On cut section, the tumor measures 0.6 cm in thickness and appears brown/tan with nodular contours and heaped edges. Stromal invasion measures 6 mm within a stromal wall thickness of 9 mm (approximately 67% penetration). There is no parametrial involvement. Vaginal cuff margins are negative with a distance of 7 mm from the nearest margin; however, the tumor approaches within 2 mm of the right anterolateral bladder flap margin. No lymphovascular or perineural invasion is observed. Twenty-two regional lymph nodes are examined, none show metastatic involvement.\n\nAdditional specimens include lymph node dissections from both sides. Specimen C (left pelvic lymph nodes) consists of six lymph nodes, all negative for malignancy. Specimen D (right pelvic lymph nodes) contains sixteen lymph nodes, also without evidence of metastasis.\n\nSections submitted include perpendicular and en face epithelial margins, parametrial tissues, endomyometrium, and representative sections of the cervix and lower uterine segment. No additional significant findings are noted in the myometrium or endometrium."} +{"pid": "TCGA-2G-AAFM", "report": "Right orchidectomy specimen shows a tumor measuring 3.8 cm in diameter, confined to the testis. Histologic evaluation demonstrates angioinvasion and invasion into the rete testis. Cellular morphology is consistent with non-seminomatous germ cell tumor; embryonal carcinoma component comprises 100% of the tumor. No lymph node involvement or distant metastasis identified. Staging assessment indicates localized disease with no extension beyond the testicular capsule."} +{"pid": "TCGA-V4-A9EH", "report": "Left eye enucleation specimen. The eyeball measures 25 by 25 by 25 mm with an optic nerve segment measuring 8 mm in length. Upon sectioning, a lesion measuring 12 by 10 mm was identified within the posterior segment. Samples were obtained for cryopreservation and genomic profiling, and the entire specimen was subsequently fixed and processed.\n\nMicroscopic examination reveals a cellular proliferation composed predominantly of non-pigmented fusiform cells arranged in interlacing bundles. The nuclei are atypical and ovoid with minimal mitotic activity observed, recording 1 mitosis per 10 high-power fields at 400x magnification. The lesion is located away from the optic nerve insertion and the ciliary processes. However, it extends through the full thickness of the sclera with identifiable extra-scleral extension noted in specimens D and E. Tumor cells are present around the extra-scleral vessels; no neoplastic emboli are seen within lymphatic channels.\n\nThe lesion does not involve the optic nerve along its course or the associated meningeal sheaths. The tumor measures 12 mm in greatest dimension and demonstrates a low mitotic index. There is complete infiltration of the sclera with visible extra-scleral extension."} +{"pid": "TCGA-AD-6964", "report": "The specimen consists of a right hemicolectomy measuring 21.0 cm in length and ranging from 4.0 to 7.0 cm in diameter. Gross examination reveals a mass measuring 12.8 x 5.0 x 1.5 cm located in the cecum. Histologically, the lesion is composed predominantly of solid nests of cells with moderate cytoplasm and large vesicular nuclei with prominent nucleoli. Some rudimentary gland formation is present, along with areas showing signet ring morphology and mucin production. The tumor extends transmurally into adjacent fat and approaches within 0.1 cm of the inked deep margin. Lymphovascular invasion is identified within the tumor. Margins are negative at the proximal (small bowel) and distal ends, but the radial margin is positive.\n\nImmunohistochemical staining demonstrates moderate to focal strong positivity for CK7, while CK20 is negative. CDX2 shows focal nuclear positivity. Stains for CK6-6, synaptophysin, PSA, chromogranin, TTF-1, and calretinin are negative. Evaluation for mismatch repair proteins reveals loss of MLH-1 and PMS-2 expression, while MSH-2 and MSH-6 remain intact.\n\nA total of sixteen lymph nodes are identified, nine of which contain metastatic carcinoma. The largest involved lymph node measures up to 1.4 cm. Based on histologic and immunophenotypic features, the lesion exhibits high-grade morphology and extensive nodal involvement.\n\nAdditional molecular studies were performed. BRAF mutation analysis using DNA-based PCR sequencing did not detect mutations in exons 11, 12, or 15. This assay covers 99.6% of reported BRAF mutations. Due to the absence of BRAF mutation and loss of MLH1 and PMS2 expression, hypermethylation testing was initiated to further clarify the underlying mechanism.\n\nGiven the tumor's location in the right colon, poorly differentiated morphology, and mismatch repair deficiency, there is concern for microsatellite instability-high status. Family history evaluation and genetic counseling may be warranted given the possibility of inherited predisposition. The tumor may exhibit improved overall survival and differential chemotherapeutic sensitivity, including resistance to 5-FU and possible responsiveness to irinotecan.\n\nSections submitted include margins, tumor extent, lymph nodes, and surrounding tissue. No additional lesions are identified in the remainder of the mucosa or in the omentum. Multiple lymph nodes within the mesocolon show involvement."} +{"pid": "TCGA-QH-A6XA", "report": "The specimen was received from a female patient with a lesion located in the left frontal region. Histologic evaluation revealed a neoplasm composed of mixed cellular morphology, including cells with both astrocytic and oligodendroglial features. The tumor demonstrated moderate cellularity with nuclear atypia present. Mitotic figures were sparse. No necrosis or microvascular proliferation was identified. Immunohistochemical staining showed positivity for IDH1 and nuclear expression of ATRX was retained. Based on histologic features and molecular markers, the tumor is classified as a lower-grade glioma."} +{"pid": "TCGA-AG-3885", "report": "In specimen (I), there is a focus of moderately to poorly differentiated invasive epithelial neoplasm with glandular features, infiltrating through all layers of the bowel wall. Vascular invasion is present. Regional lymph node examination reveals metastatic involvement in 3 out of 19 nodes assessed. The resection margins are uninvolved. In specimen (II), the anastomotic sites show no evidence of tumor involvement. Histologic evaluation indicates a mix of intermediate to higher-grade cellular morphology. Staging parameters include pT3, with lymphovascular invasion noted (L1, V1), and pN1 classification based on lymph node involvement. A complete resection (R0) is confirmed."} +{"pid": "TCGA-EL-A3ZN", "report": "A surgical case involving a total thyroidectomy specimen included a left lobe measuring 4.8 x 2.2 x 1.6 cm and a right lobe measuring 5.2 x 2.4 x 2.2 cm. Within the left lobe, a soft pink-tan multinodular focus measuring 1.3 x 1.1 x 0.8 cm was identified near the thyroid edge and covered by loosely adherent soft tissue. No multi-focality was observed. Histologic evaluation revealed involvement of surrounding fibroadipose tissue. Vascular invasion was present. Surgical margins were negative for involvement.\n\nIn the central neck region, thirteen lymph nodes were assessed, with two containing abnormal cells. In left levels 2A, 3, 4, and 5, a total of forty-two lymph nodes were examined, and four contained similar findings. No extracapsular extension was noted in any involved lymph nodes.\n\nSubmitted specimens also included a parathyroid gland, represented by a tan soft tissue fragment measuring 0.2 x 0.1 x 0.1 cm. A cystic hemorrhagic nodule measuring 0.6 cm in diameter was present within the thyroid specimen. Additional lymph nodes from central adipose tissue were evaluated as part of the submission."} +{"pid": "TCGA-DU-6393", "report": "The surgical specimen from the left occipital lobe consists of three separate tissue samples. The first sample is a 3 x 1.5 x 1 cm piece of light tan to yellow to brown tissue with a smooth, lobulated surface and a flat area that may represent a cyst or ventricular wall. The second sample includes four pieces of pink-red to maroon soft tissue ranging in size from 1 x 1 x 0.5 cm to 0.5 x 0.5 x 0.4 cm; part of this tissue was used for smear preparation and frozen section analysis, while the remainder was submitted for further evaluation. The third sample consists of several irregular fragments of tan, tan-yellow, pink, and hemorrhagic tissue, some of which may be necrotic, measuring up to 5.5 x 2.5 x 1.5 cm.\n\nMicroscopic examination reveals a cellular proliferation with features of oligodendrocytic origin. The tissue shows varying degrees of differentiation, with some areas displaying well-defined cell borders and typical perinuclear halos, while other regions demonstrate increased cellularity, nuclear pleomorphism, and mitotic activity. Endothelial hyperplasia is present in stromal vessels, and the tumor infiltrates the cortex with neoplastic satellitosis around cortical neurons. There is also evidence of prior hemorrhage and multiple interstitial calcifications. In certain areas, the tumor completely replaces the gyri and forms subpial aggregates on adjacent gyri. No extensive necrosis is identified except in one area on the frozen section slide.\n\nGrading according to the Smith system reflects the presence of anaplastic features, including high cellularity, nuclear atypia, and mitotic figures, leading to a classification consistent with a higher-grade lesion. Immunostaining with MIB-1 demonstrates a variable but overall elevated nuclear labeling index, reaching up to 25% in some areas, while better-differentiated regions show labeling indices of approximately 10\u201312%."} +{"pid": "TCGA-FW-A5DX", "report": "The specimen from the left anterior chest wall is an elliptical excision measuring 9.6 x 5.3 cm with a depth of up to 2.5 cm. A retracted gray-white scar, 1.8 cm in length and 0.4 cm in width, is present on the central epidermis, with a brown nodular area at one end measuring 0.7 x 0.4 cm. This nodule is located within 1.9 cm of the 2:30 margin. Margins are inked with different colors for orientation: green at 12:00-3:00, blue at 3:00-6:00, orange at 6:00-9:00, red at 9:00-12:00, and black at the deep margin. Circumferential en face margins were taken sequentially in cassettes A1 through A9. The remainder of the specimen was serially sectioned perpendicular to its long axis, with full-thickness step sections submitted in cassettes A10 through A21.\n\nLymph node dissection from the left axillary region included 15 lymph nodes ranging in size from 0.3 to 4.5 cm. Of these, four out of eleven were found to contain cellular changes consistent with involvement, with the largest involved node measuring 45 mm and showing extracapsular extension. One lymph node was submitted entirely in cassettes B1 and B2, another in B3, and others were serially sectioned and submitted across multiple cassettes. Four lymph nodes were submitted intact in B7, two in B8, and representative sections of larger nodes were submitted in B14 and B15. Two additional lymph nodes from level three were received, measuring 0.7 cm and 1.5 cm respectively. The smaller was submitted intact in C1, and the larger was trisected and submitted in C2.\n\nMicroscopic evaluation was performed on all specimens. Controls were appropriately reacted for all stains. Immunohistochemistry testing was conducted using analyte-specific reagents regulated by the Histopathology Laboratory. These assays have not required FDA clearance as they are used in standard clinical practice. Staining intensity for markers such as EGFR, ER, PR, Ki-67, p53, Her2neu, CD117, and CD20 was evaluated. Unless otherwise noted, all tissues were fixed in 10% neutral buffered formalin for between 6 and 48 hours prior to processing. Scoring for membrane-bound markers was based on staining intensity and distribution. All findings were interpreted by the undersigned pathologist after complete histologic review."} +{"pid": "TCGA-G9-6499", "report": "The specimens include right and left pelvic lymph nodes, as well as a resected prostate gland. The right pelvic lymph node specimen consists of an aggregate of fibrofatty tissue measuring 6.5 x 4.5 x 1.0 cm, from which 9 possible lymph nodes were identified, ranging in size from 0.7 cm to 2.4 cm. The left pelvic lymph node specimen is an aggregate measuring 6.0 x 3.0 x 0.6 cm, with 4 possible lymph nodes identified, ranging from 0.7 cm to 2.9 cm.\n\nThe prostate gland weighs 54 grams and measures 4.7 cm (anterior-posterior), 4.5 cm (left-right), and 2.8 cm (superior-inferior). The external capsule is smooth, red, and intact. A well-circumscribed tan nodule measuring 1.3 cm is identified in the right mid prostate. After removal of the apex and base, the prostate proper weighs 25 grams. Serial sectioning was performed from apex to base, and alternating levels were submitted for analysis. The right seminal vesicle measures 4.7 x 3.2 x 1.2 cm and the left measures 3.8 x 3.2 x 1.1 cm; both have a cystic tan appearance. The right vas deferens is 4.7 cm long and 0.7 cm wide, while the left is 3.7 cm long and 0.6 cm wide, each with a tubular tan appearance. All tissue has been submitted for evaluation across multiple sections.\n\nMicroscopic examination of the right pelvic lymph nodes (9 total) reveals no evidence of malignant cells. Similarly, the left pelvic lymph nodes (4 total) are also negative for malignancy. Histologic sections of the prostate show no tumor involvement at the surgical margins. Focal periprostatic involvement is noted. No tumor is identified in the seminal vesicles or vas deferens. High-grade prostatic intraepithelial neoplasia is present, and perineural invasion is observed. Vascular or lymphatic invasion is not specified. Benign prostatic hyperplasia is also noted as an additional finding.\n\nStaging is based on pathologic findings. Tumor involvement is identified in both lobes of the prostate, involving approximately 30% of the prostate volume. Based on extent of local involvement, the staging classification is consistent with a locally advanced lesion. Lymph node involvement is not present. Preoperative clinical diagnosis was previously noted as prostate cancer. Intraoperative frozen section analysis of the lymph nodes did not identify any carcinoma. The evaluation of lymph nodes was described as technically challenging due to fatty infiltration."} +{"pid": "TCGA-A3-3326", "report": "The specimen consists of a right kidney with attached perinephric fat, measuring 20 x 11 x 6 cm and weighing 730 grams. A segment of ureter, 3.5 x 0.3 cm in size, is present. Upon bisection, a golden-yellow mass is identified in the lower pole, measuring 2.7 x 2.5 x 2.4 cm. The mass abuts the capsular surface but does not appear to involve it, with the capsule being easily separable from the renal surface. No other lesions are observed.\n\nMargins, including ureteral and vascular, are submitted for analysis and show no involvement. Blocks include samples of the mass, surrounding tissue, and areas of normal-appearing kidney. The cortex averages 1.5 cm in thickness, and the calices are not dilated. Sections of perinephric fat are also submitted, and no adrenal tissue is identified on gross examination.\n\nMicroscopically, the lesion demonstrates clear cell morphology. Nuclear grading is consistent with Fuhrman nuclear grade I. There is no evidence of lymphatic or venous invasion. Lymph nodes are not assessable. The tumor is confined to the kidney without extension beyond the capsule. Additional findings include mild nonspecific chronic pyelitis. All surgical margins are free of invasive carcinoma."} +{"pid": "TCGA-G2-A2EO", "report": "A segment of left vas deferens measuring 5 cm in length and 0.3 cm in diameter was submitted, with a visible lumen on cut surface. A segment of left ureter measuring 0.8 cm in length and 0.1 cm in diameter was also present, with surrounding fibroadipose tissue; the resection margin was inked and submitted en face. A right vas deferens segment measured 5.5 cm by 0.3 cm, with a pinpoint lumen visible. The right ureter segment measured 1.0 x 0.7 cm, with the surgical margin re-inked and submitted en face.\n\nThe cystoprostatectomy specimen measured 14 x 7.5 x 7 cm. Upon opening through the superior wall, a fungating lesion measuring 9 x 7 x 2.5 cm was identified involving nearly the entire anterior bladder wall and dome. The tumor appeared to invade the muscular layer of the bladder wall but did not extend into perivesical adipose tissue. Hemorrhagic changes were noted in the trigone region, with the remainder of the mucosa appearing unremarkable. The outer surface of the anterior wall was inked black. Sections included multiple levels from the bladder (E1\u2013E48), prostate (E49\u2013E57), and urethra (E58, E59).\n\nLymph node evaluation included: right common iliac, a 2.4 x 1.5 x 1 cm fibroadipose tissue piece with three palpable nodes ranging from 0.4 to 0.6 cm; right external iliac, a 4.9 x 4 x 1 cm aggregate of adipose tissue with five possible nodes between 0.5 and 3.7 cm; right obturator, a 5 x 2.5 x 2 cm tissue fragment with seven nodes measuring 0.4 to 2.6 cm; left common iliac, a 3.5 x 3.0 x 1.0 cm tissue block containing multiple nodes from 0.6 to 1.5 cm; left external iliac, a 5.0 x 4.2 x 1.0 cm tissue with two nodes measuring 2.0 x 0.8 x 0.5 cm and 3.0 x 1.5 x 0.5 cm; and left obturator, a 6.5 x 4.0 x 1.0 cm fibroadipose fragment with eleven nodes ranging from 0.5 to 2.5 cm. All lymph nodes were free of tumor.\n\nUreteral margins were examined bilaterally. The left ureter margin measured 1.7 x 0.6 cm, and the right ureter margin measured 0.8 x 0.8 cm. Both were submitted en face with inked margins, and no tumor was identified. The prostate showed microcystic adenomatous change without evidence of malignancy. Serosal and resection margins were also free of tumor."} +{"pid": "TCGA-HD-A4C1", "report": "The surgical specimen includes a composite resection of the left hemimandible, lip, facial skin, and left submental triangle contents. The specimen measures 11.9 x 7.4 x 8.2 cm and is inked with multiple colors to identify margins. A skin fragment measuring 9.8 x 7.9 cm is attached laterally, with a central lesion that appears gray-tan, ragged, roughened, and ulcerated, measuring 6.2 x 5.5 cm. Within the palate, a gray-tan, soft, ulcerated mass measuring 5.6 x 5.8 x 5.2 cm is observed, extending through the attached skin. The lateral and posterior mandibular bone margins appear free of involvement. On sectioning, a yellow-tan, lobulated fragment measuring 3.3 x 1.8 x 2.2 cm is identified in the posterior soft tissue margin, appearing unremarkable. Three pale tan possible lymph nodes ranging from 0.6 to 1.1 cm are also noted.\n\nLymph node dissection specimens were submitted from multiple levels. From right level 4, six negative lymph nodes were identified. Right level 2 contained two negative lymph nodes. Ten negative lymph nodes were found in right level 3. The pathologic staging is T4a, N2b.\n\nSpecial immunoperoxidase stains for p16 performed on selected slides were negative. All surgical margins are free of tumor involvement, with the closest margin being the inferior margin at 2 mm. No lymphovascular or perineural invasion is identified. Multiple cassettes were submitted for microscopic evaluation, including representative sections from various lymph node levels and tissue fragments."} +{"pid": "TCGA-DD-AADQ", "report": "The liver specimen measured 7.0 x 5.8 x 3.5 cm and contained a well-defined mass, with the largest measuring 3.0 x 2.4 cm. The cut surface appeared yellowish tan and granular without evidence of necrosis. Multiple satellite nodules were identified, and the surrounding liver tissue showed cirrhotic changes. The resection margin was not involved macroscopically, with a safety margin of 1.2 cm.\n\nMicroscopic examination revealed malignant hepatic cells arranged in a trabecular pattern, with no fatty change observed. A complete fibrous capsule was present without capsular infiltration or septum formation. There was no invasion identified at the surgical resection margin, serosal surface, or portal vein. Microvessel invasion was not detected.\n\nEdmondson-Steiner grading showed the worst grade as III and the major grade as II. Intrahepatic metastasis was noted. Multiple tissue blocks were sampled from the tumor and surrounding areas, as well as from the remaining liver parenchyma and resection margin."} +{"pid": "TCGA-G3-A25V", "report": "The gallbladder specimen measured 10.0 x 3.5 x 1.2 cm and contained yellow-green bile without stones. The mucosa appeared velvety and granular. No tumor was identified. One random section was taken for quality assurance, and three additional representative sections were submitted.\n\nThe liver specimen from segment 5 weighed 17.9 grams and measured 4.0 x 3.0 x 3.0 cm. The resection margin was inked blue. On sectioning, the liver parenchyma showed features of cirrhosis. A yellow-tan, well-defined lesion measuring 1.5 x 1.5 x 1.0 cm was present, located 0.6 cm from the blue margin and extending 0.2 cm through the capsule. The lesion was entirely submitted in cassettes, along with representative sections of surrounding liver tissue.\n\nMicroscopic evaluation of the gallbladder showed chronic cholecystitis. The liver specimen demonstrated moderately differentiated cellular features within the lesion. All resection margins were free of abnormal cells. Cirrhosis was also confirmed in the background liver tissue."} +{"pid": "TCGA-EW-A1J3", "report": "The surgical pathology report includes findings from a left breast mastectomy and lymph node biopsies. A total of three sentinel lymph nodes were examined, and none showed evidence of tumor involvement. Immunohistochemical staining for keratin was also negative in all lymph node specimens.\n\nGross examination of the mastectomy specimen revealed a lesion measuring 2.0 cm in the left lower outer quadrant, located 1.2 cm from the deep margin. Histologic evaluation showed a single focus of invasive growth with features suggestive of lobular differentiation. The overall histologic grade was determined to be grade 2 (Nottingham score of 7). Glandular or tubular differentiation was minimal, present in less than 10% of the tumor. Nuclear pleomorphism was significant, with vesicular nuclei, prominent nucleoli, and marked variation in nuclear size and shape, including some large and bizarre forms. Mitotic activity was low (score 1). Margins were free of involvement by invasive disease, with the closest margin being 1.2 cm from the tumor.\n\nIn addition to the invasive component, in situ changes with high nuclear grade, central comedo necrosis, and calcifications were identified. These in situ features were present in 4 out of 12 slides reviewed. The in situ component also exhibited microcalcifications. There was no evidence of lymphovascular invasion.\n\nImmunohistochemical analysis demonstrated positivity for estrogen and progesterone receptors, and strong reactivity for HER-2 (score 3+). E-cadherin staining was negative. Additional molecular testing confirmed HER-2 gene amplification.\n\nStaging was determined as pT1c (tumor greater than 10 mm but less than 20 mm) and pN0 (i+), indicating no metastases in the lymph nodes, with only isolated tumor cells detected by immunohistochemistry. Distant metastasis was not applicable."} +{"pid": "TCGA-G9-7519", "report": "The prostate specimen weighed 34 grams and measured 3.5 cm from right lateral to left lateral, 3.3 cm from apex to base, and 3.2 cm from anterior to posterior. The gland was encapsulated with a smooth, red surface. Following removal of the apex and base, the prostate weighed 20 grams and displayed a nodular tan parenchyma. The right seminal vesicle measured 3.5 x 1.5 x 0.6 cm and the left measured 2.5 x 1.6 x 0.7 cm; both contained cystic tan tissue. The right vas deferens measured 4.1 x 0.7 cm and the left measured 3.8 x 0.4 cm, consisting of tubular tan tissue.\n\nMicroscopic evaluation revealed involvement of both lobes with an estimated less than 10% of the prostatic tissue affected. Sections from multiple levels of the prostate were examined, including perpendicular sections of the apex, mid base, lateral base, and posterior base. A single intraprostatic incision cauterized showed presence of atypical cells at a margin measuring 1.2 cm in linear extent, located at the right mid base (slide A13). No involvement was identified at other margins.\n\nHistological features included Gleason grade 3 and grade 4 patterns, with a total score of 7. High-grade prostatic intraepithelial neoplasia was noted. There was no evidence of perineural invasion, vascular or lymphatic invasion, seminal vesicle involvement, periprostatic fat extension, or bladder neck involvement. No lymph nodes were sampled.\n\nThe pathological staging was determined as pT2c, indicating tumor involvement in both lobes. The metastatic stage could not be assessed (pMX). Additional findings included benign prostatic hyperplasia. All tissue was submitted for analysis, and the specimen was inked with color codes for orientation: anterior-orange, apex-red, base-blue, right lateral-green, left lateral-yellow, and posterior-black."} +{"pid": "TCGA-AG-A032", "report": "Internal Sample IC. Findings and diagnosis relating to the problem concerned: The specimen shows a lesion with infiltration of all parietal layers (pT3), presence of vascular invasion (L1, V1), and free oral and aboral resection margins, as well as a free resection margin toward the central region. Two lymph node metastases are present (pN1). Histological classification indicates moderate differentiation. Size and other morphological features correspond to standard coding classifications."} +{"pid": "TCGA-LC-A66R", "report": "A surgical pathology report was reviewed, including multiple specimens. The first specimen, a left distal ureter biopsy, showed benign urothelium and wall with no abnormal growth. In the left pelvic lymph nodes, one of eleven nodes showed abnormal cell infiltration. Similarly, the right distal ureter biopsy also showed benign urothelium and wall with no abnormal growth. In the right pelvic lymph nodes, two of fifteen nodes contained abnormal cells.\n\nThe most significant findings were in the radical cystoprostatectomy specimen, which included the bladder and prostate. A large lesion measuring 8 cm was found in the bladder wall and extended into the prostatic urethra with further spread into the prostate. The lesion had multiple centers of origin. Microscopically, it extended into the fat around the bladder and into the stroma of the prostate at the apex. Vascular invasion was suspected, and there was clear evidence of nerve invasion. There were also high-grade non-invasive changes and in-situ abnormalities in the surrounding epithelium.\n\nMargins of the urethral, left and right ureter, and radial areas were all free of disease. The prostate was involved by the lesion, but the seminal vesicles were not. Of the thirty-one lymph nodes examined, three were involved, including the ones from the left and right pelvic regions. The clinical staging was given as stage III, while the pathological staging was pT4a, pN2, according to the AJCC 2010 classification.\n\nAll other submitted specimens, including the true margins of both ureters, were free of disease. Multiple sections were taken for analysis, and all relevant areas were evaluated microscopically."} +{"pid": "TCGA-MQ-A6BR", "report": "The specimen was received in nine parts. Part 1 consisted of two fragments of rib measuring 8.6 x 1.6 x 0.9 cm and 8.7 x 1.7 x 0.6 cm; no carcinoma was identified. Part 2 included six lymph nodes from level 5, all without malignancy. Part 3 consisted of fibroadipose tissue from level 6 lymph node sampling; no lymphoid tissue was identified. Part 4 contained two lymph nodes from level 7 with focally calcified necrotizing granuloma; fungal and mycobacterial studies were negative.\n\nPart 5 was a lingular biopsy showing a focus of epithelioid-type mesothelial proliferation involving the visceral pleura, measuring 0.4 cm, without lung parenchymal invasion. Part 6, a left lower lobe biopsy, showed emphysematous changes but no malignancy. Part 7, described as a nodule on PA, revealed fibroadipose and vascular tissue with neutrophilic aggregates and fibrin, without malignant cells.\n\nPart 8 was a pleurectomy specimen showing epithelioid-type mesothelial proliferation with solid growth pattern involving the parietal pleura. Three nodules were identified on the pleural surface measuring 1.9 x 1.2 x 0.6 cm, 1.8 x 1.6 x 0.6 cm, and 0.9 x 0.9 x 0.1 cm. Part 9, another pleurectomy specimen, also showed similar findings with multiple small nodules measuring 0.5 to 0.9 cm.\n\nImmunohistochemical staining showed positivity for calretinin and CK5/6, and negativity for BerEP4 and B72.3. One of three lymph nodes showed involvement by epithelioid-type mesothelial proliferation with solid growth pattern. Histologic evaluation confirmed presence of lymphovascular invasion. Tumor was identified at the parietal pleura as scattered nodules with focal visceral pleural involvement."} +{"pid": "TCGA-BG-A18C", "report": "The patient is postmenopausal. A total laparoscopic hysterectomy with bilateral salpingo-oophorectomy and lymph node dissection was performed. Evaluation of the lymph nodes revealed no evidence of metastatic involvement. Specifically, eleven left pelvic lymph nodes, two left paraortic lymph nodes, fourteen right pelvic lymph nodes, and three right paraortic lymph nodes were all negative for metastasis. Additionally, fibroadipose tissue from the left pelvic region showed no tumor involvement.\n\nExamination of the uterus demonstrated a lesion involving 95% of both the anterior and posterior endometrial surfaces. The tumor measured 40 mm in maximum dimension and exhibited a moderately differentiated histologic grade based on combined architectural and nuclear features. Architectural grade was moderately differentiated and nuclear grade was assessed as Grade 2. The tumor extended into the myometrium to a depth of approximately 13%, or 0.3 cm of the 2.3 cm myometrial thickness, which corresponds to less than half of the myometrial thickness. No lymphovascular invasion was identified.\n\nThe cervix, bilateral adnexa, and ovaries showed no involvement by tumor. Additional findings included paratubal cysts in the right fallopian tube, surface epithelial inclusions and focal surface adhesions in the right ovary, and mild stromal hyperplasia in both ovaries. Mesonephric remnants were identified in the cervix.\n\nNo high-grade malignant neoplasm was identified upon extensive sampling of the specimen. Pre-neoplastic changes were noted in the form of complex endometrial hyperplasia with atypia. A total of thirty lymph nodes were examined and none were positive for malignancy. Pathologic staging was determined as pT1a pN0, MX not applicable. Clinical staging according to FIGO classification was Stage IA, Grade 2. Pelvic washings were negative and correlated with the findings."} +{"pid": "TCGA-AA-3980", "report": "The material in Block A shows a lesion with features including infiltration into the muscularis layer. Histological evaluation reveals grade G2 morphology, with vascular infiltration noted (L1, V1). The mucosal surface appears free with no involvement, and the submucosa, muscularis, and surrounding fatty connective tissue appear unremarkable. In Block D, an additional polyp is identified as a serrated lesion without dysplasia. Lymph node analysis demonstrates chronic resorptive lymphadenitis; no evidence of high-grade neoplastic involvement is seen. One lymph node out of 18 examined shows similar reactive changes. A diverticulum is observed in relation to Block H, consistent with a pseudodiverticulum showing eversion through muscle gaps. Margins at the central resection site reveal mature fatty connective tissue with dilated vessels. Staging assessment confirms pT2 with vascular invasion and no nodal involvement, following complete local excision."} +{"pid": "TCGA-CS-6669", "report": "The specimen consists of multiple fragments of tan-pink soft tissue from the right temporal region. The largest fragment measures 1.5 \u00d7 1.0 \u00d7 0.5 cm, while other aggregates measure up to 1.2 \u00d7 0.5 \u00d7 0.4 cm. One larger fragment measuring 5.3 \u00d7 2.1 \u00d7 0.4 cm was also submitted. Histologic evaluation reveals infiltrating cells with features consistent with a glial neoplasm. No discrete lesion was identified grossly in one of the specimens.\n\nImmunohistochemical staining for Ki-67 was performed using image-assisted analysis. A total of 128,037 cells were evaluated. The proliferation index was quantified at 4.5%. Of these, 3.1% demonstrated strong positivity (3+), 0.65% showed moderate positivity (2+), and 0.7% exhibited weak positivity (1+). The majority, 95.47%, showed no staining.\n\nFluorescence in situ hybridization (FISH) testing was conducted on paraffin-embedded sections using probes targeting regions on chromosomes 1p and 19q. Ratios were calculated based on signals in 200 nuclei. For the 1p/1q probe pair, the ratio was 0.60, with 71% of cells showing deletion. For the 19q/19p probe pair, the ratio was 0.56, with 73% of cells demonstrating deletion. These findings indicate combined loss of 1p and 19q.\n\nAncillary studies included immunohistochemistry for ER, PR, Her-2/neu, and EGFR using standard protocols. Interpretation followed manufacturer recommendations where applicable. Some reagents used are classified as analyte-specific reagents and have not been cleared by the FDA. These results should be interpreted in the context of clinical and pathologic findings.\n\nFrozen section analysis indicated glial neoplasm without evidence of anaplasia. All tissue has been submitted for evaluation, although margins could not be fully assessed due to specimen fragmentation. Morphometric analysis and cytogenetic testing were performed alongside histologic examination. Correlation with additional clinical data is recommended due to the limitations of molecular assays, including potential sampling error and reduced sensitivity in cases with low tumor cellularity."} +{"pid": "TCGA-DJ-A13S", "report": "The specimen consists of a right thyroid lobe measuring 4.5 x 2.5 x 1.8 cm and weighing 10.2 g. The external surface is smooth and glistening, with the posterior side inked black and the anterior side inked blue. On sectioning, a well-circumscribed, tan-white nodule with a thin capsule is identified, measuring 1.8 x 1.8 x 1.7 cm. Portions of the nodule were submitted for frozen section and TPS, and the remainder of the specimen was entirely submitted for examination.\n\nMicroscopic evaluation of the nodule demonstrates a well-encapsulated lesion with no evidence of capsular invasion. The histologic grade is well differentiated. No mitotic activity or tumor necrosis is identified. There is no blood vessel invasion or extension beyond the thyroid capsule. Surgical margins are free of tumor, and there is no evidence of multicentric disease. The surrounding non-neoplastic thyroid tissue shows no abnormalities, and parathyroid glands are not identified in the submitted material. Special stains were performed, and the diagnosis is based on personal examination of the slides."} +{"pid": "TCGA-BG-A186", "report": "The patient is a 61-year-old post-menopausal woman who underwent a total abdominal hysterectomy, bilateral salpingo-oophorectomy, hernia repair, omentectomy, lymph node dissection, and appendectomy. Nine surgical specimens were examined.\n\nThe uterus measured 502 grams and showed complex atypical hyperplasia of the endometrium. Histologic evaluation revealed involvement of 60% of the endometrial surface with tumor infiltration extending into the myometrium. The depth of invasion was 6 mm within a myometrial thickness of 21 mm (~28%). Adjacent to this lesion, there was an invasive poorly differentiated adenosquamous carcinoma involving the cervix circumferentially. This cervical tumor measured 11 mm in horizontal spread and invaded to a depth of 5 mm within a cervical wall thickness of 20 mm. There was evidence of cervical intraepithelial neoplasia grade 3 (CIN 3) and adenocarcinoma in situ (AIS). CIN 3 extended to the lower uterine segment and involved multiple foci at the ectocervical/vaginal margin; however, invasive carcinoma was 8 mm from this margin. Lymphovascular invasion was identified in association with the cervical tumor.\n\nMetastatic involvement was noted in the left fallopian tube, morphologically consistent with the primary endometrial lesion. Other findings included endometriosis and fibrous adhesions involving the left fallopian tube and ovary, as well as surface epithelial inclusions and microcalcifications in both ovaries. Endosalpingiosis and adenomyosis were present in the paracervical soft tissue. Multiple benign leiomyomas were identified in the myometrium, with the largest measuring up to 7.5 cm.\n\nLymph node dissection included eight nodes from the left pelvic region (all negative), two from the left common iliac and periaortic region (all negative), fifteen from the right pelvic region (all negative), and four from the right common iliac and periaortic region (all negative). No metastatic tumor was identified in any of the 29 lymph nodes examined.\n\nThe omentum and appendix were also free of metastatic disease. One hernia sac showed foreign body giant cell reaction without tumor, while the second hernia sac was similarly negative for tumor.\n\nHistologic examination of the cervix was prompted by lack of a clinically identifiable mass and demonstrated invasive adenosquamous carcinoma involving all quadrants. Immunohistochemical staining excluded neuroendocrine differentiation. The cervical tumor exhibited diffuse strong p16 positivity consistent with HPV-related etiology. In contrast, the left fallopian tube focus matched the morphology of the endometrial tumor and was interpreted as a metastatic deposit. No transition between endometriosis and tumor was observed in the fallopian tube specimen.\n\nIn summary, two distinct tumors were identified: one arising from the endometrium and another involving the cervix. Both tumors were surgically excised without residual disease. No distant metastases were found."} +{"pid": "TCGA-26-6174", "report": "The specimen consisted of three tissue fragments from the right parietal area, measuring between 0.1 and 0.3 cm in greatest dimension. A representative section was evaluated by frozen section analysis and showed features consistent with an infiltrating glial neoplasm. Additional tissue from the same site was submitted for further evaluation in multiple cassettes. A separate specimen from the right parietal region measured 1.4 x 1.3 x 0.6 cm and was entirely submitted for histologic examination. Another sample from the posterior brain region measured 1.5 x 0.9 x 0.5 cm and also underwent frozen section analysis, which demonstrated a high-grade glial tumor. The residual tissue from this specimen was fully submitted in additional cassettes. Histologic features observed included marked nuclear pleomorphism, necrosis with pseudopalisading patterns, and increased mitotic activity. These findings were used to support the histologic grading and characterization of the lesion. All specimens were processed and reviewed according to standard protocols."} +{"pid": "TCGA-06-5859", "report": "A 3.1 cm right-sided heterogeneous mass involving the basal ganglia, frontal and temporal lobes was identified on imaging with central enhancement noted. The lesion was surgically resected and biopsied.\n\nMicroscopic examination of the resected specimen reveals a densely cellular neoplasm with marked mitotic activity, up to 20 mitoses per ten high power fields. The tumor cells are glial in origin, with round nuclei distributed within a dense gliofibrillary background, particularly in solid areas. There is a distinct predilection for infiltration into the white matter. Focal necrosis, microvascular proliferation, and necrotizing vasculopathy with thrombosis are also present. Immunohistochemical staining demonstrates overexpression of p53 in a majority of the neoplastic cells and focal microvascular proliferation by CD34 staining. MIB-1 labeling index in the more active regions is approximately 50%. In the excised specimen, the tumor shows leptomeningeal involvement and is sparsely to moderately infiltrative.\n\nMolecular testing performed on paraffin-embedded tumor tissue did not show methylation of the MGMT promoter. Real-time PCR for EGFRVIII mutation was negative. Chromosomal analysis using microsatellite markers showed loss of heterozygosity at loci on chromosome arms 1p (D1S1612) and 19q (D19S606, PLA2G4C), suggesting partial deletion of these regions. The sample contained sufficient tumor cellularity for accurate assessment. No amplifiable methylated MGMT promoter sequences were detected, although a very low level amplification was observed in one initial run, this was not reproducible upon repeat testing.\n\nThe specimen from the resection measured 14 x 10 x 3 mm in aggregate, consisting of four pieces. The excision biopsy specimen measured 4.0 x 4.0 x 1.9 cm and was described as a tan, soft brain tissue with multiple small pink foci on sectioning. Multiple histologic sections and immunostains were performed for diagnostic evaluation, including H&E, CD34, EGFR, GFAP, MIB-1, p53, and Masson's trichrome.\n\nSpecial stains confirmed the presence of neoplastic growth within the leptomeningeal space. Gliofibrillary formation by the neoplastic cells was prominent. The findings indicate a high-grade glial neoplasm with aggressive features, significant proliferative activity, and evidence of leptomeningeal spread."} +{"pid": "TCGA-D8-A27H", "report": "The pathology report describes a female patient who underwent intraoperative examination of a lesion excised from the right breast. The clinical suspicion was a tumor located at the boundary of the upper quadrants. During the procedure, a lesion measuring approximately 3 cm in diameter was identified. Immunohistochemical analysis showed no expression of estrogen or progesterone receptors in the neoplastic cell nuclei. HER2 protein testing using HercepTest\u2122 by DAKO demonstrated a negative result (score = 0). \n\nThe surgical specimen measured 6 x 5 x 4 cm macroscopically, with the lesion itself measuring 3 x 2.5 x 3.3 cm in cross-section. Histopathological evaluation revealed a high-grade histologic type with a total score of 3 + 3 + 3 (HH3), indicating 50 mitoses per 10 high-power fields (visual area 0.55 mm\u00b2). The growth pattern was invasive and reached the incision margin. The staging assessment corresponded to pT2."} +{"pid": "TCGA-12-3653", "report": "A right temporal brain specimen was received for analysis. Gross examination included two tissue samples. The first, measuring 2 x 1 x 0.8 cm, was described as a focally hemorrhagic red-tan soft tissue fragment. A representative section was processed as frozen material and additional portions submitted in paraffin blocks. The second sample measured 5 x 4.5 x 3.5 cm and contained tan-brown brain tissue with necrotic and hemorrhagic regions adjacent to areas appearing uninvolved. Representative sections from abnormal areas were processed and submitted in multiple blocks.\n\nMicroscopic evaluation revealed infiltration of brain tissue by a malignant astrocytic neoplasm. Features observed included cytologic pleomorphism, mitotic figures, microvascular changes, and pseudopalisading necrosis. Intraoperative consultation identified both specimens as showing high grade astrocytic neoplasms.\n\nCytogenetic studies demonstrated chromosome 7 centromere polysomy in 88% of tumor cells, EGFR amplification in 99%, chromosome 10 centromere loss in 61%, PTEN allelic loss in 73%, and 9p21 loss in 69%. Chromosome 9 centromere loss was present in 54% of tumor cells. All four abnormal markers and 9p21 showed loss.\n\nImmunohistochemical labeling revealed leucocyte common antigen positivity in 5% of cells. Proliferation index was high, with 30% of tumor cells staining. MGMT expression was positive in 25% of cells. EGFR wild-type expression was strongly positive (3+ in 90%), while EGFR variant VIII was weakly positive in only 1% of cells. S6 expression was moderate (2+ in 30%), AKT was negative (2+ in 5%), and MAPK was moderately expressed (2+ in 25%). Carbonic anhydrase IX was positive for expression. VEGF immunohistochemistry was negative with a score of 4. PDGFR-A showed widespread cytoplasmic and/or membrane reactivity (50%), while PDGFR-B demonstrated focal reactivity (40%).\n\nReal-time PCR analysis for MGMT promoter methylation was performed on paraffin-embedded tissue. Methylation index was below the threshold for positivity, indicating no significant methylation detected. No methylation was reported when methylation index was less than 4; low-level methylation (index between 4 and 16) was considered uncertain in significance."} +{"pid": "TCGA-AG-A016", "report": "The resected colon specimen shows a centrally ulcerated, moderately differentiated lesion located 1.5 cm from the aboral resection margin, extending over a length of 6 cm. The lesion infiltrates into the perirectal fatty tissue. Four local lymph node metastases are present out of 19 examined. All colon resection margins and the mesocolic margin are free of tumor involvement. The clearly identified periureteral soft tissue is also tumor-free, showing only focal fibrosis. The appendix demonstrates signs of previous healed appendicitis with mild associated inflammatory changes. Histological evaluation indicates lymphovascular invasion is absent (V0), with presence of lymphatic invasion (L1). The overall staging is pT3 pN2 (4/19), pMX; G2, with R0 resection status."} +{"pid": "TCGA-4X-A9F9", "report": "The specimen consists of thymic tissue along with adjacent pleura, pericardium, and lung, submitted following a radical thymectomy. The thymus measures 6 x 5 x 2 cm in the body, with additional lobes measuring up to 15 x 3.5 x 0.5 cm. A separate lung wedge (5 x 2.5 x 1.5 cm), pleura (3 x 2 cm), and pericardium (3 x 2.5 cm) were also included. Upon sectioning, a 3.5 x 3 x 2 cm ill-defined white lesion was identified, abutting the pleura, pericardium, and lung resection margin.\n\nMicroscopic evaluation revealed epithelial cells at the cauterized margin, confirmed by keratin staining. Tumor involvement was noted at the anterior mediastinal pleural margin. Additionally, tumor extended to the left anterior and posterior surgical margins; however, these were not considered clinically significant by the surgeon. No involvement was seen at the lung margin, pericardium, innominate vein, or phrenic nerve margin.\n\nHistologic analysis showed features consistent with an epithelial neoplasm, with no evidence of lymphovascular invasion. Lymph nodes could not be assessed. Staging based on extent of spread indicates macroscopic invasion into neighboring structures including the lung parenchyma and mediastinal pleura, corresponding to Stage III. Further classification under pTNM staging indicates pT3, with regional lymph nodes unassessable (pNX) and no assessment for distant metastasis. Additional findings include lymphoid follicular hyperplasia. All margins were evaluated, with some positive margins noted but deemed non-significant by the operating surgeon. Multiple cassettes were submitted for review, covering various tissue interfaces and surgical margins. Immunohistochemical staining with keratin supported the presence of epithelial cells at key margins."} +{"pid": "TCGA-GV-A3QH", "report": "The specimen consists of multiple fragments of tan-pink, rubbery soft tissue measuring 3.0 x 2.0 x 0.7 cm in aggregate and weighing 1.5 grams. All material was submitted for analysis. Histologic evaluation reveals a high-grade neoplasm with features of urothelial carcinoma and focal squamous differentiation. The tumor is arranged in an invasive configuration. Muscularis propria (detrusor muscle) is present and shows evidence of tumor invasion. There is no identification of lymphovascular invasion. No associated epithelial lesions or additional pathologic findings are noted. The material is adequate for assessing muscularis propria involvement."} +{"pid": "TCGA-WZ-A7V5", "report": "The surgical specimen consists of a right radical orchiectomy with attached spermatic cord. The testicle weighs 46 grams and measures 5.9 x 3.6 x 3.1 cm, with the spermatic cord measuring 15.5 cm in length. A mass is identified within the testicle, measuring 4.9 x 3.4 x 3.0 cm, occupying the majority of the parenchyma. The mass has a lobulated appearance, with approximately 75% exhibiting a firm tan-white cut surface and the remaining portion softer with fibrous strands. The mass extends up to but does not penetrate through the tunica albuginea. There is no involvement of the tunica vaginalis. Invasion of the rete testis is noted.\n\nMicroscopically, the tumor demonstrates classic histologic features. Angiolymphatic invasion is present. Surgical margins, including the spermatic cord, are free of tumor involvement. The tumor is unifocal and confined to the testis and epididymis. No regional lymph nodes were assessed. There is no evidence of distant metastasis. Serum tumor marker studies were not available for staging purposes.\n\nPathologic staging is determined as pT2NXM0 based on the extent of local invasion and absence of nodal or distant disease. The staging presumes no lymph node or distant metastatic spread at the time of evaluation."} +{"pid": "TCGA-A8-A08C", "report": "The specimen demonstrates a poorly differentiated invasive lesion measuring 3.5 cm in diameter. The closest margin is located dorsally at a distance of 1 cm, while all other margins are uninvolved. Histologic assessment indicates a high-grade morphology (G III). Pathologic staging reveals no lymph node involvement and no vascular or perineural invasion identified."} +{"pid": "TCGA-BR-A44T", "report": "The pathology report describes a subtotal gastrectomy specimen with a tumor located at the cardia. The tumor measures 0x0x6 cm and is ulcerated. Histologic examination reveals poorly differentiated features consistent with diffuse-type morphology. The tumor invades into the subserosal layer. A total of ten lymph nodes from the greater and lesser curvatures were examined and showed no evidence of metastasis, demonstrating reactive hyperplasia and lipomatosis instead. There is no venous invasion observed, and margins are uninvolved. The omentum appears normal in structure. Other features such as lymphatic or perineural invasion, response to neo-adjuvant treatment, and additional findings are not specified."} +{"pid": "TCGA-55-7725", "report": "The surgical specimen consisted of a right lower lobe lobectomy along with multiple lymph node groups. The resected lung tissue measured 15 x 8.5 x 2.5 cm and weighed 106 grams. A gray-tan, well-defined mass measuring 1.5 x 1.5 x 1.4 cm was identified subpleurally. The lesion was located 0.1 cm from the pleural surface, 4.3 cm from the bronchial margin, and 3.8 cm from the closest staple line. Surrounding lung tissue appeared tan and spongy without additional lesions noted. Within the peribronchial tissue, four small lymph nodes were identified.\n\nHistologically, the lesion was well-differentiated, unifocal, and lacked visceral pleural invasion or lymphovascular space invasion. There was no evidence of tumor extension or treatment effect. Margins were negative, with the tumor located more than 3 cm from all surgical margins.\n\nA total of ten lymph nodes were evaluated from levels 7, 8, 11, and 12. None contained metastatic disease. All lymph nodes examined were negative for malignancy. No other significant pathological findings were identified in the submitted specimens."} +{"pid": "TCGA-FR-A3R1", "report": "Sentinel lymph node specimens from the right axilla, including three individual nodes, were examined microscopically. All sections showed no evidence of metastatic involvement. Immunostains for Melan A and S100 protein performed on all blocks from each sentinel lymph node were negative.\n\nA wide excision specimen from the right arm was evaluated. The lesion measured 10.5 x 8.7 x 6.3 cm and extended beyond the skin margin at the 3 o\u2019clock position by approximately 2.5 cm. It was exophytic with lobulated borders and contained multiple small white-tan nodules and areas of hemorrhage in the posterior aspect. Histologic evaluation demonstrated a deep vertical growth phase with a thickness of 63 mm. Ulceration was extensive, and there was complete consumption of the epidermis overlying the lesion. Mitotic activity measured 3.75 per square mm. Tumor-infiltrating lymphocytes were present, with focally brisk infiltration noted. There was no evidence of regression, lymphovascular invasion, satellite nodule formation, perineural invasion, or coexisting nevus. Minimal pigmentation and mild solar elastosis were observed. Necrosis was also present.\n\nAll radial margins were widely free, with distances ranging from 1.8 to 2.4 cm from the tumor edge. Deep en face margins and perpendicular radial sections were submitted for evaluation. Immunohistochemical staining with S100 and Melan A performed on a representative tumor block (D11) was negative, supporting absence of satellite metastasis.\n\nThe specimen was oriented with short stitch at 12 o\u2019clock and long stitch at 9 o\u2019clock. The skin ellipse measured 9.7 x 8.9 cm. Inking details were recorded as yellow (12 to 3), blue (3 to 6), red (6 to 9), green (9 to 12), and black/orange for the deep margin.\n\nNo frozen section diagnosis was revised. No neoplasm was identified in the intraoperative consultation of the right axillary lymph node. Clinical correlation is recommended for final staging assessment."} +{"pid": "TCGA-X7-A8D6", "report": "The specimen consists of a single portion of tan-yellow soft tissue measuring 19.6 x 11.2 x 1.2 cm. A firm, well-circumscribed lesion measuring 4.9 x 4.5 x 3.1 cm is identified at one edge of the specimen. The overlying soft tissue has been inked. On sectioning, the cut surface of the lesion reveals a homogeneous pale tan appearance without hemorrhage or necrosis. The remainder of the specimen shows unremarkable tan-yellow fat. Representative sections of the lesion have been submitted in cassettes \"1-4\" and a section of adjacent, uninvolved tissue in cassette \"5\". Microscopic evaluation was performed. The lesion demonstrates specific histological features, including distinct cellular morphology and architectural patterns. There is evidence of capsular disruption; however, no definitive invasion into surrounding adipose tissue is observed. Cellular features include moderate pleomorphism, a high nuclear-to-cytoplasmic ratio, and frequent mitotic figures. Stromal components are also noted. The patient is White."} +{"pid": "TCGA-RQ-AAAT", "report": "The specimen consists of a mass located in the cerebellopontine angle, which was biopsied and resected. Microscopic examination reveals a malignant neoplasm composed of sheets of atypical cells with pleomorphic hyperchromatic nuclei and marked cytologic atypia. Areas of tumor necrosis and individual apoptotic neoplastic cells are present. Mitotic activity is prominent. Immunohistochemical staining demonstrates that the tumor cells are positive for CD45, CD20, CD10, MUM-1, and BCL6. They are negative for CD3, CD43, CD30, and BCL2. Scattered background T cells are highlighted by CD3 staining. Additional special stains and hematopathology consultation are pending for further characterization."} +{"pid": "TCGA-E2-A1IF", "report": "The surgical specimens included sentinel lymph nodes from the left axilla (nodes 1 through 4) and a wide local excision of the left breast with needle localization. Additional tissue from the superior margin was also submitted.\n\nSentinel node #1 measured 1.5 x 1.0 x 1.0 cm and was tan-pink in appearance. Sentinel node #2 was smaller, measuring 0.3 x 0.2 x 0.2 cm, and was also tan-pink. Sentinel node #3 was identified within fatty tissue measuring 3 x 3 x 1 cm; the lymph node itself measured 0.4 x 0.3 x 0.2 cm. Sentinel node #4 was located in a piece of fatty tissue measuring 3 x 2 x 0.5 cm, with the lymph node measuring 1.2 x 0.3 x 0.3 cm. All sentinel lymph nodes were serially sectioned and touch preps were performed. No tumor involvement was identified in any of the lymph nodes.\n\nThe left breast excision specimen consisted primarily of fatty breast tissue and weighed 122 grams. It measured 12.0 x 7.5 x 3.0 cm, with attached skin along the anterior aspect measuring 5.0 x 2.2 cm. The skin surface showed no ulceration, and a localization wire was present. The specimen was oriented with sutures and clips, and margins were color-coded for identification. On sectioning, a tan-white firm lesion measuring 1.5 x 1.5 x 1.0 cm was identified in the off-mid portion of the specimen. It had slightly stellate, irregular borders and was located 1.5 cm from the deep margin, 1.7 cm from the superior, 2.2 cm from the anterior, 3.0 cm from the lateral, and 3.0 cm from the medial margin. No other tumor foci were identified. The surrounding breast tissue showed involutional changes with focal cystic apocrine change. Margins of resection were negative for tumor involvement.\n\nSections of the tumor and all margins were submitted for histological evaluation, including full sections of the tumor with adjacent margins. The superior margin specimen, weighing 15 grams and measuring 4.7 x 3.0 x 1.0 cm, showed alternating white and yellow areas on cross-section, with no discrete abnormality identified. It was entirely submitted in eight cassettes.\n\nHistological analysis of the lesion showed features consistent with a tubular score of 2, nuclear grade 2, and mitotic score 2. There was no evidence of necrosis or vascular/lymphatic invasion. Non-neoplastic findings included involutional changes and no evidence of lobular neoplasia or DCIS.\n\nImmunohistochemical staining showed positivity for estrogen and progesterone receptors. The Allred score for ER was 8 (proportion score 5, intensity score 3), and for PR it was 6 (proportion score 4, intensity score 2). HER2 testing by immunohistochemistry showed 1+ intensity with 8% tumor staining, and fluorescence in situ hybridization (FISH) was ordered for further evaluation.\n\nAll four sentinel lymph nodes were negative for tumor involvement. The closest distance of the tumor to any margin was 1.5 cm at the posterior margin. Based on these findings, the pathological stage was determined as pT1c, N0."} +{"pid": "TCGA-73-4658", "report": "Addendum. Specimen included a left lower lobe of lung, hilar margin, 10L lymph node, and 6th rib. The left lower lobe measured 256 grams and showed a pleural surface ranging from tan red to black red with rough areas and adhesions. A large tumor measuring 6.0 x 3.4 x 2.5 cm was identified within the lung tissue. This lesion was irregular in shape, tan-yellow, and soft to focally firm. It abutted the pleura in several areas but did not grossly penetrate through it. The closest point of this tumor to the pleura was adjacent to the bronchial margin, with the main portion of the tumor located 0.7 cm away from the nearest bronchial margin. A second smaller lesion measuring 1.4 cm in diameter was also observed, located approximately 0.5 cm from the larger lesion. Two peribronchial lymph nodes (level 11 and level 12) with anthracotic changes were noted. The bronchi were opened distally from the bronchial margin and appeared tan without any masses or lesions. The tumors did not appear to originate from any major bronchus. Additional portions of normal-appearing lung tissue and tumor were submitted for analysis.\n\nThe hilar margin specimen consisted of a single piece of soft dark tissue measuring 1.7 x 0.7 x 0.3 cm. The cut surfaces were unremarkable. The 10L lymph node specimen was a single anthracotic node measuring 0.9 x 0.7 x 0.4 cm, with unremarkable cut surfaces. The 6th rib specimen included three bone segments measuring 1.7 x 0.6 x 0.2 cm, 5.3 x 1.0 x 0.5 cm, and 11.0 x 1.2 x 0.5 cm. Resection margins on all portions were jagged and composed of unremarkable cortical and trabecular bone. Cortical surfaces were smooth and tan-grey. A representative section of bone was submitted after decalcification.\n\nMicroscopic evaluation revealed angiolymphatic invasion. The visceral pleural margin was positive for tumor involvement. The bronchial margin was negative for tumor. Two peribronchial lymph nodes were negative for metastasis. The hilar margin was also negative for tumor at the bronchial margin, although dissociated clusters of tumor cells were seen within the bronchial lumen and adjacent alveoli. Tumor cells were also present in the perivascular soft tissue of the vascular margin, though no intraluminal tumor was identified at that site. The 10L lymph node was negative for metastasis, and the rib specimen showed no evidence of malignancy, with findings consistent with normal bone and marrow elements.\n\nAdditional findings included atelectasis, interstitial fibrosis, and chronic inflammation in non-neoplastic lung tissue. No in situ carcinoma was identified. The histologic grade was poorly differentiated. The tumor was located peripherally. The pathologic stage was revised to pT2N0MX."} +{"pid": "TCGA-CQ-6227", "report": "The specimen included a left neck dissection measuring 17.0 x 1.2 x 13.5 cm, encompassing levels IA to IV. Multiple lymph nodes ranging from 0.2 to 3.1 cm were identified across various levels, with the largest in level IIA. The submandibular gland measured 3.7 x 3.0 x 0.9 cm and showed no abnormality. A total of 35 lymph nodes were examined on the left side, with six found to be involved. These involved nodes were located in levels I, II, and III. Extranodal extension was present. On the right neck dissection, measuring 10.0 x 2.2 x 8.7 cm and including levels I to III, multiple lymph nodes ranging from 0.2 to 1.5 cm were observed, with the largest in level II. Twenty-one lymph nodes were evaluated on the right side, two of which were involved, both located in levels II and III. There was no extranodal extension noted on the right side.\n\nThe oral resection specimen included the left tongue and floor of mouth with overall dimensions of 6.5 cm SI x 3.9 cm ML x 8.1 cm AP. A lesion measuring 3.5 cm SI x 2.5 cm ML x 5.5 cm AP was identified in the tongue and floor of mouth. It had an ulcerated center with rolled edges and a white-tan cut surface. The tumor thickness measured 2.5 cm. Perineural invasion was present; however, no lymphovascular invasion was observed. Margins were mostly negative, although the tumor was close to the deep tongue and posterior soft tissue margins at 0.2 cm. Other margins (anterior, medial, lateral, and posterior) were uninvolved.\n\nAdditional specimens including the left posterior tongue margin, left anterior tongue margin, left lateral mucosa margin, and deep muscle margin were all negative for tumor involvement. Surgical waste consisted of adipose and skin tissues without any pathological changes.\n\nA single facial lymph node on the left and additional lymph nodes from level III on the left were examined and found to be negative. Microscopic evaluation of all submitted sections confirmed absence of malignancy in these areas. Distant metastasis could not be assessed.\n\nIn summary, multiple lymph nodes from both sides of the neck were examined, with eight total nodes showing involvement. Cellular features included presence of perineural invasion and absence of lymphovascular invasion. Staging criteria indicated a primary lesion greater than 4 cm in greatest dimension and regional metastasis in bilateral lymph nodes none exceeding 6 cm."} +{"pid": "TCGA-G9-6373", "report": "The prostate specimen weighed 46 g and measured 5.5 cm in width, 4.2 cm in depth, and 3.7 cm in height. The gland was resected, and the capsule was noted to be smooth and intact. A fragment of detached seminal vesicle measuring 2.7 x 2.1 x 0.3 cm and a detached vas deferens measuring 3.7 cm in length by 0.3 cm in diameter were also present. After removal of the apex and base, the specimen weighed 21 g. Serial sectioning revealed fibrous beige-tan parenchyma. The left attached seminal vesicle measured 3.7 x 1.9 x 0.4 cm, and both the attached and detached portions of the seminal vesicle showed cystic beige-tan tissue.\n\nMicroscopic examination of the submitted sections showed no evidence of tumor at the inked margins. Inflammation and hyperplastic urothelial mucosa were identified. High-grade prostatic intraepithelial neoplasia was present. Perineural invasion was identified; vascular or lymphatic invasion was not specifically mentioned. Tumor involvement of the periprostatic fat was noted at the right base. No involvement of the bladder neck or margins was observed.\n\nStaging was performed according to the AJCC Cancer Staging Manual, 7th edition. Based on the findings, the pathological staging was determined as pT3a, indicating extension beyond the prostate capsule without seminal vesicle involvement. Lymph node sampling was not performed, and no other significant pathological findings were reported."} +{"pid": "TCGA-WY-A85B", "report": "The specimen was received in saline and labeled with the patient\u2019s name, consisting of multiple soft pink-red tissue fragments measuring 3.5 x 1.2 x 0.4 cm in aggregate. Touch preps were performed and the entire specimen was submitted for analysis. Additional specimens were received, including a second sample measuring 5.0 x 2.8 x 0.3 cm in aggregate, described as soft, white-pink, and gelatinous, also entirely submitted. A third specimen from the temporal lobe consisted of two small soft pink-white fragments measuring 0.8 x 0.6 x 0.2 cm in total. Histological evaluation showed no evidence of tumor in the temporal lobe specimen.\n\nMicroscopic examination of the first specimen revealed a cellular lesion with features suggestive of a diffusely infiltrative neoplasm. The cells exhibited nuclear atypia with moderate pleomorphism. Mitotic activity was not prominent, and no necrosis or microvascular proliferation was identified. Immunohistochemical staining demonstrated positivity for p53 and a low labeling index with Ki67, indicating low proliferative activity. No loss of heterozygosity at chromosome 1p was detected, and there was no definitive loss at 19q. All specimens were fully evaluated and no additional lesions were identified."} +{"pid": "TCGA-HZ-7924", "report": "The surgical pathology report includes multiple biopsies and resection specimens. The liver biopsy shows mild mixed portal inflammation with focal bile duct proliferation, along with mild portal fibrosis and focal fibrous septa. No malignancy is identified in this specimen.\n\nThe left fallopian tube and ovary specimen demonstrate a cystic structure within the ovary and changes consistent with endosalpingiosis. No evidence of malignancy is found. A biopsy of the falciform ligament reveals only benign fibrovascular and adipose tissue, with no malignant cells present.\n\nA peritoneal mass biopsy reveals a hyalinized nodule with dystrophic calcification. No malignancy is detected. Multiple lymph node biopsies from the heptoduodenal, portal, posterior portal, and anterior portal regions are all negative for malignancy, with a total of 9 lymph nodes evaluated.\n\nA biopsy of the common bile duct is also negative for malignancy. In the pancreatic region, a resection specimen reveals a firm, well-circumscribed mass measuring 5.0 cm in greatest dimension. Microscopic evaluation shows moderately differentiated glandular structures with extensive chronic pancreatitis. The tumor invades surrounding structures including the ampulla of Vater, duodenal wall, and peripancreatic soft tissues. All surgical margins are free of involvement by invasive carcinoma. Seventeen lymph nodes are examined, none showing evidence of metastasis. Perineural invasion is identified, but no lymphovascular invasion is observed.\n\nAdditional biopsies of the pancreatic margin and distal pancreas show atypical glandular epithelium and extensive chronic inflammation. The Whipple resection specimen confirms the presence of similar findings. The final pathologic staging indicates a primary tumor extending beyond the pancreas without involvement of major vascular structures, with no regional lymph node involvement (pT3NO). Other associated findings include extensive chronic pancreatitis and high-grade intraepithelial neoplasia."} +{"pid": "TCGA-DY-A0XA", "report": "The pathology report indicates a tumor arising in the rectosigmoid colon. Histologic examination revealed a moderately differentiated adenocarcinoma. The tumor was staged as T3, N0, M0, corresponding to a Stage IIA classification. No lymph node metastases were identified. The date of initial pathological diagnosis and the date of normal tissue procurement are documented. Patient information includes date of birth, vital status, date of death, race (White), and ethnicity (not Hispanic or Latino). Specific tumor dimensions and cellular features were not detailed in the provided data."} +{"pid": "TCGA-DC-6683", "report": "Addendum. Clinical history indicates a sigmoid resection performed at 30 cm from the anal verge. Submitted specimens include a segment of sigmoid and upper rectum along with portions of the left abdominal wall, left vas deferens, and left gonadal vessel, as well as distal and proximal anastomotic rings.\n\nThe specimen measured 29 cm in length and had a soft tissue mass measuring 4.5 x 4.0 x 2.5 cm attached to its serosal surface. The tumor itself measured 4.0 cm in length and 2.1 cm in width with raised rolled borders. Histologically, it exhibited moderate differentiation with extensive budding but lacked increased tumor-infiltrating lymphocytes. Precursor lesions consistent with tubular adenoma were identified. Invasion extended through the muscularis propria into pericolorectal tissues, reaching subserosal adipose tissue and mesenteric fat. A large abscess was noted at the tumor base along with reactive changes and fibrous adhesions involving the attached vas deferens and abdominal wall. There was evidence of perineural invasion and suspected lymphovascular invasion; however, gross perforation was not identified.\n\nMargins were free of involvement. Twenty-seven lymph nodes were examined, three of which contained metastatic deposits. No tumor deposits were identified in pericolorectal soft tissue. Based on AJCC 7th Edition staging criteria, the lesion was staged as pT3 with lymph node stage N1b.\n\nImmunohistochemical staining for MLH1, MSH2, MSH6, and PMS2 demonstrated retained expression within the lesion. Additional studies including EVG staining were performed as part of special studies.\n\nThe distal and proximal anastomotic rings showed no evidence of disease and appeared benign upon histologic examination. All margins\u2014proximal, distal, and radial\u2014were negative for tumor involvement.\n\nRepresentative sections from various tissue blocks were submitted for analysis. Photographs were taken during gross examination. Sections included areas corresponding to mucosa, adipose tissue adjacent to the tumor, lymph nodes, surgical margins, and surrounding uninvolved tissue.\n\nTesting for mismatch repair proteins was conducted under CLIA-certified conditions and used for clinical diagnosis. These assays have been validated by the laboratory and are considered diagnostic."} +{"pid": "TCGA-HJ-7597", "report": "A small bowel nodule was excised and identified as a peritoneal inclusion cyst with no malignancy present. Right and left ovaries each showed benign findings, including a cystic lesion on the left and a similar appearance on the right. The right fallopian tube showed no abnormalities, while the left fallopian tube contained a paratubal cyst. Several lymph nodes were examined, including those along the left hepatic artery, right and left gastric cardia, and posterior left gastric regions; none showed evidence of malignancy. A nodule located on the greater curvature of the stomach was found to be a peritoneal inclusion cyst without any malignant cells.\n\nA partial gastrectomy specimen included a tumor measuring 6.5 x 5.5 x 2.0 cm, which was ulcerated and located on the lesser curvature. The tumor invaded into the subserosa and was less than 0.1 cm from the serosal surface. Angiolymphatic and perineural invasion were noted. The closest margin was the proximal margin at 3.0 cm from the tumor. All surgical margins were free of tumor involvement. Intestinal metaplasia was observed in non-neoplastic areas of the stomach. No metastases were identified in 29 lymph nodes evaluated from this specimen. Additional lymph nodes from the right hepatic region also showed no signs of malignancy. The gallbladder showed mild chronic cholecystitis and cholelithiasis."} +{"pid": "TCGA-S7-A7WM", "report": "The right adrenal gland contained a mass measuring 69x50x30 mm and weighing 48 grams. The lesion was encapsulated, with a grey-pink coloration and soft texture on gross examination. Six tissue blocks were submitted for analysis. Microscopically, the lesion demonstrated a solid and alveolar growth pattern, with focal areas of fibrosis and multiple regions of cellular atypia. A fibrous capsule was present, and remnants of adrenocortical tissue were observed at the periphery. In one block (3D), there was evidence of infiltration through the adrenocortical structures and early penetration of the fibrous adrenal capsule; however, no extension into surrounding adipose tissue was identified. Immunohistochemical staining for S100 protein showed variable positivity, with reduced or absent staining in less differentiated areas. Proliferative index by MIB1 staining was less than 1%, as confirmed by positive control tissue from the adrenal cortex. Histologic features included large nests or diffuse growth accounting for more than 10% of the tumor volume, central necrosis within large nests, high cellularity, cellular uniformity, focal spindle cell morphology, and presence of more than 3 mitotic figures per 10 high-power fields. Atypical mitotic figures were also noted. Additional findings included capsular invasion, nuclear pleomorphism, and nuclear hyperchromasia. The total score based on histopathologic criteria was 7."} +{"pid": "TCGA-DD-AAD2", "report": "The liver specimen measured 11.0 x 9.0 x 4.8 cm and weighed 170.5 grams. The tumor was located in segment 2 and was present as a single nodule measuring 3.0 x 2.8 x 2.2 cm. The gross appearance was nodular, with no evidence of tumor necrosis, hemorrhage, or peliosis. Invasion of the portal vein, bile ducts, or external surface was not identified. The tumor was encapsulated partially, without fibrous capsule formation. Microscopically, the lesion showed trabecular growth pattern with hepatic cell morphology. The degree of differentiation was predominantly moderate. Microvessel invasion was present. There was no evidence of intrahepatic metastasis, multicentric occurrence, or invasion at the surgical resection margins. The non-tumorous liver tissue showed minimal lobular and portoperiportal inflammation, consistent with chronic hepatitis of HBV etiology. There was no cirrhosis, dysplastic nodule, or ductal epithelial dysplasia identified."} +{"pid": "TCGA-DD-AACE", "report": "The liver specimen measured 13.0 x 7.5 x 4.5 cm and weighed 185.0 grams. The tumor was located in segment 8, measured 4.0 x 3.0 x 3.8 cm, and was solitary with no satellite nodules. The gross appearance was expanding nodular without evidence of necrosis, hemorrhage, or peliosis. There was no invasion of the portal vein, bile ducts, hepatic veins, or hepatic artery. The surgical resection margin was free with a clearance of 1.0 cm. Microscopically, the lesion showed complete fibrous encapsulation without capsular infiltration. Histologic patterns included trabecular and pseudoglandular arrangements, with hepatic cell type morphology and no fatty change. The worst differentiation was grade III, while the major differentiation was grade II. No microvessel invasion or intrahepatic metastasis was identified. Non-tumorous liver tissue showed chronic hepatitis of minimal activity, micronodular cirrhosis, and no dysplastic nodules. Special stains confirmed fibrosis stage 3\u20134. Other noted findings included chronic gastritis associated with *H. pylori* and a gastric ulcer at the stomach angle."} +{"pid": "TCGA-G3-A3CH", "report": "The surgical specimen includes two liver segments. Liver segment #3 weighs 223.2 g and measures 10.0 x 8.0 x 7.0 cm. A lobulated, tan and hemorrhagic mass is identified within the liver parenchyma, measuring 7.0 x 5.5 x 6.5 cm. The mass is located beneath a roughened, hemorrhagic area on the liver capsule measuring 7.0 x 7.0 cm. The mass comes within 0.5 cm of the blue-painted surgical margin and contains areas of soft necrosis. At the edge of the mass, a luminal structure filled with tumor is observed, showing yellow/green discoloration; this structure measures approximately 1.5 x 1.0 x 0.7 cm. Sections include the luminal structure with tumor, areas near the surgical margin, sections of the liver capsule with underlying tumor, and uninvolved liver tissue.\n\nLiver segment 4A and 8 consists of a 11.8 g tissue sample measuring 4.0 x 3.0 x 2.0 cm. A well-circumscribed tan ovoid lesion measuring 1.5 x 1.0 x 1.0 cm is present. This lesion approaches within 0.1 to 0.2 cm of the blue-painted resection margin and is located 0.7 cm from the liver capsule. Sections include multiple areas of the lesion near the surgical margin and adjacent uninvolved liver tissue.\n\nHistologic evaluation reveals moderately differentiated cells in both specimens. In the first specimen, there is evidence of vascular invasion and extensive necrotic changes. No lymphovascular invasion is identified in the second specimen. Both specimens are associated with background cirrhotic changes and chronic hepatitis B infection."} +{"pid": "TCGA-Q9-A6FW", "report": "The surgical specimen included the distal two-thirds of the esophagus and proximal one-third of the stomach, obtained via esophagogastrectomy. A lesion at the gastroesophageal junction measured 5.0 x 2.8 x 1.4 cm. Histologic evaluation showed a moderately differentiated carcinoma with extension through the muscularis propria into the surrounding periesophageal and perigastric soft tissues. Extensive perineural and lymphovascular invasion were identified. The circumferential margin was involved by the lesion, while the proximal esophageal and distal gastric margins were free of involvement.\n\nA total of 62 lymph nodes were evaluated. Three of twenty-two regional lymph nodes showed evidence of involvement, with extranodal extension noted. Additional lymph node groups from right level 8, 4R, and level 7 were negative for metastatic disease.\n\nThe specimen also demonstrated background changes including intestinal metaplasia and high-grade dysplasia at the gastroesophageal junction. No prior treatment effect was observed."} +{"pid": "TCGA-5P-A9KE", "report": "The specimen shows a well-circumscribed lesion with subtotal necrotic changes, areas of hemorrhage, and cholesterol clefts. Microscopic evaluation reveals poorly differentiated cells arranged in papillary structures. The tumor is confined within an intact capsule but demonstrates focal extensions into the surrounding perirenal adipose tissue. No involvement is noted at the ureteral or surgical margins. Histological grading according to the Fuhrman system is grade 3. Vascular invasion is not present, and no lymphovascular invasion or nodal involvement is identified. The tumor measures consistent with pT1b staging based on the 2010 TNM classification. Resection is complete with no residual disease at the margins."} +{"pid": "TCGA-18-3421", "report": "The specimen consisted of a right lung lobectomy, along with multiple lymph nodes from two separate regions. The resected lung measured 19 x 14 x 8 cm and contained a single lesion measuring 7.5 x 7.7 x 7.0 cm. The tumor was located peripherally and was well delineated, with a tan to white color and variable consistency. It was surrounded by mildly emphysematous lung parenchyma. The visceral pleural surface showed an area of puckering measuring 7 x 3.5 cm, indicating possible pleural involvement. The bronchial resection margin was 3.5 cm from the tumor, and the closest stapled parenchymal margin was 4.5 cm away; both were free of malignant cells.\n\nHistologically, the lesion demonstrated moderate differentiation with prominent necrosis. No blood vessel invasion was identified. Evaluation of the regional lymph nodes included six lobar and one segmental node, all of which were negative for malignancy. Additional findings in the lung tissue included mild centroacinar emphysema, focal non-specific pneumonitis, and chronic interstitial inflammation with fibrosis of undetermined significance.\n\nThe tumor exceeded 3 cm in its greatest dimension and showed invasion of the visceral pleura, but no regional lymph node metastasis was identified. Distant metastasis could not be assessed. Based on these features, the staging reflected a T2 classification with no nodal involvement."} +{"pid": "TCGA-CN-5361", "report": "A 14.0 \u00d7 0.5 \u00d7 0.5 cm strip of mucosa from the left pharyngeal margin showed severe dysplasia or carcinoma in situ. A separate 10.2 \u00d7 0.3 \u00d7 0.2 cm strip from the right pharyngeal margin contained no tumor. The laryngectomy specimen included a lesion measuring 4.5 cm in maximum dimension located in the right pyriform sinus and extending into the thyroid cartilage. The tumor was moderately differentiated with evidence of perineural and angiolymphatic invasion. Surgical margins were free of tumor. Pathologic staging was pT4a, N2a, MX. Of 56 lymph nodes examined, one level III lymph node on the right (measuring 3.1 cm) contained metastatic disease; no extracapsular spread was identified. The thyroid gland appeared unremarkable. Additional findings included chronic inflammation and fibrosis at the tracheostomy site, a saccular cyst on the left vocal cord, and a nodule on the right vocal cord. Bone marrow evaluation revealed hypercellularity with trilineage hematopoiesis. All surgical margins were negative. Multiple lymph nodes were evaluated from both sides, with only one showing involvement."} +{"pid": "TCGA-E9-A5UP", "report": "The specimen consists of a partial mastectomy. A gross lesion measuring up to 3.5 cm in maximum dimension is present within the breast tissue. The tumor is located within the fatty tissue. Lymph nodes are identified, and no morphological abnormalities are noted. Microscopic evaluation shows a moderately differentiated histology with features of infiltration. No venous invasion is identified. The lymph nodes examined show no evidence of metastatic involvement and demonstrate lipomatosis. Surgical margins are uninvolved. The histologic extent of the lesion is not fully defined. The Nottingham Histologic Score could not be determined due to insufficient data on tubule formation, nuclear pleomorphism, and mitotic counts. No evidence of neoadjuvant treatment is observed. Additional pathologic findings are not specified."} +{"pid": "TCGA-A6-2680", "report": "The specimen consists of an extended right hemicolectomy. The ileal portion measures 9.5 cm in length and 3 cm in circumference. Attached is a colonic segment measuring 22 cm, including the cecum and ileocecal valve. The average circumference of the colon is 7.3 cm, with a wall thickness averaging 0.4 cm. A circumferential lesion with raised, rolled edges and central ulceration is identified near the distal end of the colon, measuring 9 x 4.2 cm in cross-sectional area. The lesion is located 5.7 cm from the distal margin, 24 cm from the proximal ileal margin, and 1 cm from the ileocecal valve. Sectioning reveals subserosal invasion, but the tumor does not reach the serosal surface.\n\nHistologically, the lesion demonstrates moderately differentiated features. The tumor invades through the muscularis propria into the subserosa (pT3). Proximal, distal, and circumferential margins are negative. No vascular invasion is identified. Examination of regional lymph nodes shows no evidence of involvement; a total of 34 lymph nodes are assessed, all negative. A small nodule of surface tissue is noted among lymph node samples, but no non-lymph node pericolonic involvement is identified. Multiple representative sections have been submitted for analysis."} +{"pid": "TCGA-L7-A56G", "report": "The final surgical pathology report describes a biopsy of an esophageal mass. Microscopic examination reveals the presence of hypertrophic benign squamous epithelium. Invasive malignant cells are also present, characterized as poorly differentiated. The specimen consists of 7 soft, glistening tan-white tissue fragments, averaging 0.3 x 0.2 x 0.2 cm in size. The origin of the invasive component could not be determined from the material submitted. No definitive site of origin for the malignancy is apparent in the provided sections."} +{"pid": "TCGA-P5-A781", "report": "The specimen consists of small gray tissue fragments measuring approximately 4x2x1.5cm in total, obtained from the right frontal lobe. Histological examination reveals moderately cellular tissue with features including nuclear atypia and increased mitotic activity. Immunohistochemical staining shows a proliferation index of 8%. The morphological and immunohistochemical findings are correlated for reporting purposes."} +{"pid": "TCGA-XF-A9SZ", "report": "A radical cystectomy with bilateral lymph node dissection and ileal conduit diversion was performed. Intraoperative frozen sections of the right and left distal ureters showed benign tissue without evidence of malignancy. Gross examination of the bladder specimen revealed a large tumor involving the anterior and right lateral walls. The tumor measured approximately 7.5 x 4.5 x 3.5 cm and extended close to the serosal margin, reaching within 0.2 cm of the inked surface. Histologic evaluation showed poorly differentiated malignant cells infiltrating through the muscularis propria into the perivesical fat; however, all surgical margins were free of tumor involvement.\n\nLymphovascular invasion was identified within the bladder specimen. At the junction of the right ureter and bladder, malignant cells were present but did not extend to the margin. A flat lesion was also observed in that region. Chronic inflammation of the bladder wall was noted.\n\nExamination of regional lymph nodes revealed variable findings. Of the seven right paracaval lymph nodes examined, one contained malignant cells. In the right common iliac region, four out of thirteen lymph nodes showed involvement by malignancy; the largest involved node measured up to 1.8 cm in diameter without extranodal extension. All other lymph node groups\u2014including inferior mesenteric artery, presacral, right external iliac, Cloquet, obturator/hypogastric, para-aortic, and presciatic regions\u2014showed no evidence of metastasis.\n\nThe prostate showed changes including multifocal high-grade intraepithelial proliferation without invasive growth, along with signs of acute and chronic inflammation, atrophy, and periarthritis. No malignant involvement was found in the prostate tissue or seminal vesicles.\n\nMultiple tissue blocks were submitted for microscopic analysis, including representative sections from the tumor, adjacent structures, and lymph node regions. All ureteral margins were negative for malignancy."} +{"pid": "TCGA-B0-4838", "report": "The specimen from the right kidney, obtained via laparoscopic nephrectomy, reveals a neoplasm measuring 4.2 cm in greatest diameter. Microscopic evaluation shows cells with clear cytoplasm and nuclear features corresponding to grade 3 of 4. The lesion is entirely encapsulated within the renal capsule, with no evidence of extension into the renal vein. Surgical margins are entirely free of neoplastic involvement. Evaluation of the surrounding kidney tissue demonstrates focal glomerulosclerosis. No adrenal gland tissue was submitted for examination. Based on the findings, the tumor is classified as pT1b with histologic grade G3."} +{"pid": "TCGA-3A-A9IO", "report": "The resected specimen includes a portion of the pancreas with adjacent spleen, measuring 14.5 x 9.0 x 7.0 cm overall. The pancreas itself measures 6.5 x 4.0 x 2.5 cm and contains a partially calcified, brown-tan mass measuring 3.0 x 2.0 x 2.0 cm. The mass is located 4.0 cm from the pancreatic surgical margin and abuts the overlying soft tissue. No involvement of the pancreatic duct is observed. The attached spleen measures 11.5 x 6.5 x 5.5 cm and appears grossly unremarkable.\n\nHistologic evaluation shows a cellular lesion with well-differentiated morphology. The mitotic count is approximately 1 per 10 high-power fields. There is no evidence of necrosis. The surgical margin of the pancreas is free of invasive tumor. A focus of intraepithelial neoplasia (low to intermediate grade) is identified at the resection margin. Additional findings in the uninvolved pancreatic tissue include focal fibrosis, atrophy, and high-grade intraepithelial neoplasia. The spleen shows no significant abnormalities.\n\nImmunohistochemical staining demonstrates positivity for synaptophysin, chromogranin, and CD56. Ki-67 immunostaining reveals a proliferation index of less than 1% by manual count.\n\nSections submitted include representative portions of the tumor, surrounding pancreatic tissue, spleen, and adjacent adipose tissue. A mirror image of the tumor block was sent to the Tissue Procurement Laboratory. All frozen sections were reviewed intraoperatively and confirmed the absence of tumor at the resected margin."} +{"pid": "TCGA-G3-A5SM", "report": "The liver specimen from the left lobe measures 4.0 x 4.5 x 4.0 cm and contains a solitary firm tan nodule measuring 2.7 cm in maximum dimension located at the inked margin. The surrounding liver tissue shows signs of cirrhosis. Histological evaluation reveals high-grade cellular features with focal small vessel invasion within the lesion. No perineural invasion is observed. Sections from this specimen were taken and submitted for analysis. Additional specimens from the deep margin and final margin are each negative for residual disease. The gallbladder specimen shows no significant pathological findings."} +{"pid": "TCGA-BH-A0DX", "report": "The surgical specimen includes a segmental mastectomy with assessment of lymph nodes. One sentinel lymph node was examined in part 1 and eleven lymph nodes in part 2, all negative for abnormal cellular infiltration. The primary lesion measured 0.8 x 0.7 x 0.6 cm. Histologic evaluation showed a Nottingham score of 7 out of 9, composed of tubule formation score 2, nuclear grade score 2, and mitotic activity score 3. No lymphovascular invasion was observed.\n\nA distinct in situ component was present, characterized by cribriform architecture and nuclear grade 2, found within the surrounding breast tissue and associated with microcalcifications. Surgical margins were free of both invasive and in situ components. Changes consistent with prior biopsy were noted, along with fibrocystic changes and thermal effect.\n\nImmunohistochemical analysis demonstrated positivity for estrogen receptors, with focal weak positivity for progesterone receptors. HER-2/neu staining showed no significant reactivity. Additional findings included benign breast tissue alterations and calcifications localized to specific areas. A separate excision of the posterior margin showed no evidence of abnormal cells and similar benign features.\n\nLymph node examination involved routine histologic staining techniques and no affected nodes were identified. Cellular morphology and staging classifications indicated no distant metastatic involvement."} +{"pid": "TCGA-E7-A7PW", "report": "Gross Description: A mass is present within the bladder wall, characterized as invasive with protrusion and poorly defined margins. The lesion measures 7x5x5 cm, exhibits areas of necrosis, and has a soft, gray surface. Microscopic Description: The lesion shows ulceration and necrotic changes. Cellular arrangement demonstrates hyperplastic patterns forming sheets, nests, groups, or single-file cords. The cells exhibit moderate eosinophilic cytoplasm. Nuclear features include marked enlargement, pleomorphism in size and shape, irregular nuclear contours, prominent nucleoli, and abnormal chromatin distribution. Frequent mitotic figures are observed. The lesion extends into adipose tissue and involves vascular structures. Specimen type: Cystectomy. Tumor site: Bladder. Tumor size: 7x5x5 cm. Tumor features: Ulcerated. Histologic type: Transitional cell morphology. Histologic grade: Poorly differentiated. Tumor extent: Extension into perivesical tissue identified microscopically. Other features including lymph node involvement, lymphatic or venous invasion, margin status, evidence of neoadjuvant therapy, and additional findings were not specified."} +{"pid": "TCGA-CJ-4885", "report": "The right kidney specimen measured 23.0 x 14.0 x 6.0 cm with the kidney itself measuring 13.0 x 8.0 x 5.0 cm. Attached was a segment of ureter 11.0 cm in length and 0.5 cm in circumference. A mass measuring 6.0 x 5.0 x 4.0 cm was identified in the lower and mid pole of the kidney. The mass was tan in color with focal yellow and myxoid areas. The tumor was primarily confined to the kidney, with focal involvement of the renal sinus fat. The renal pelvis appeared tan and smooth. No involvement of the perinephric fat or hilar vessels was observed. Margins of the hilar vessels and ureter were free of tumor. No lymph nodes were identified. Sections included multiple levels of the tumor, renal sinus, renal pelvis, and surrounding areas.\n\nA separate specimen from the left adrenal gland with surrounding fatty tissue measured 5.0 x 2.0 x 1.5 cm. A well-circumscribed tan-yellow-red mass measuring 1.0 x 1.0 x 1.0 cm was present. Sections included the adrenal vein margin, tumor, and uninvolved adrenal tissue.\n\nHistologic evaluation revealed nuclear features corresponding to a high-grade morphology. Lymphovascular invasion was identified. Tumor extension was limited to the kidney with no involvement of vascular or soft tissue margins. Ureteral margin was negative. Surrounding parenchyma was unremarkable."} +{"pid": "TCGA-D7-A748", "report": "Age: \u20ac. Gender: F. Examination result No. Clinical diagnosis (suspicion). Date of admission: Material: 1) Material: stomach, stomach with the tumor. Method of collection: Total organ resection.\n\nMacroscopic description: Stomach, after being incised along the greater curvature, measured 23 x 17 cm with the omentum measuring 25 x 8 cm. Additionally, the pancreas measured 14 x 8 x 5 cm. The mucosa showed an ulcerated lesion measuring 5.0 x 4 x 2 cm. The lesion was located 6.0 cm from the proximal incision line and 9.0 cm from the distal incision line.\n\nMicroscopic description: Tumor tissue showed high-grade cellular atypia with diffuse growth pattern. The lesion infiltrated the serous membrane. Lymph node evaluation revealed metastatic involvement in 3 out of 3 pericardial lymph nodes, 5 out of 5 along the lesser curvature, 1 out of 2 along the greater curvature, and 3 out of 6 peripyloric lymph nodes\u2014totaling 12 positive lymph nodes out of 16 examined. The spleen and omentum were free of tumor involvement. Additional tissue samples from the pancreatic region and hilar lymph nodes did not show malignant infiltration."} +{"pid": "TCGA-AR-A5QQ", "report": "A. Breast, right, simple mastectomy: A moderately differentiated carcinoma with features of metaplastic differentiation was identified within the mammary parenchyma, forming a 5.2 x 5.0 x 4.7 cm mass located in the central region of the breast. The overlying skin showed ulceration, and angiolymphatic invasion was present. The surrounding breast tissue demonstrated nonproliferative fibrocystic changes. One of three intramammary lymph nodes contained metastatic carcinoma, with the deposit measuring 6.5 x 5.0 x 4.7 cm and exhibiting a solid and cystic appearance in the lateral aspect of the breast. Extracapsular extension was noted. Tumor involvement was observed in the skin and nipple-areolar complex. All surgical margins, including skin and deep margins, were free of tumor, with a minimum tumor-free margin of 1.7 cm at the deep margin. Immunohistochemical studies for estrogen receptor, progesterone receptor, and HER2 are pending and will be reported separately.\n\nB. Lymph nodes, right axillary, excision: Of the 21 lymph nodes examined, none showed evidence of metastatic carcinoma. Based on the available materials, the staging classification is pT3N1 according to the 7th edition of the AJCC Cancer Staging Manual (2010)."} +{"pid": "TCGA-CN-A641", "report": "A left neck dissection (levels II, III, and IV) measuring 12.8 x 4.9 x 1.1 cm was examined and included lymph nodes ranging from 0.1 to 2.0 cm in size. Of the thirty-seven lymph nodes evaluated, three contained metastatic involvement. Extracapsular extension was identified in these lymph nodes. A separate right neck dissection (levels IIA and IIB), measuring 12.1 x 3.2 x 1.5 cm, revealed thirty-one benign lymph nodes without evidence of involvement.\n\nThe laryngectomy specimen with attached base of tongue measured 7.8 cm (SI) x 7.4 cm (AP) x 6.6 cm (W), including a base of tongue component measuring 5.8 x 4.7 x 2.6 cm. A centrally located lesion measuring 5.4 x 5.3 x 2.2 cm was observed in the supraglottic region. This lesion extended into the glottic region on the left side by approximately 1.0 cm and involved multiple anatomical structures including both pyriform sinuses, the hyoid bone, and the base of tongue. The tumor was located 0.9 cm from the left laryngeal margin and 0.2 cm from the deep base of tongue margin. Microscopic evaluation confirmed infiltration into adjacent tissues; however, surgical margins were uninvolved. No vascular invasion was detected, although perineural invasion was present. One small lymph node (0.4 cm) located in the anterior compartment showed no signs of involvement.\n\nPathologic staging was assigned as pT4a based on local invasion and pN2b due to regional lymph node involvement. All margins were histologically negative. Additional tissue specimens including thyroid tissue and tracheostomy stoma showed only reactive changes without disease involvement."} +{"pid": "TCGA-A3-3317", "report": "The surgical specimen consists of a left kidney with attached perinephric fat, measuring 24 x 14 x 10 cm and weighing 1709 grams. The ureter and vascular margins are included. A mass is identified in the lower pole and midportion of the kidney, measuring 12.0 x 9.0 x 7.0 cm, with bulging against the capsule and focal adherence. Sections of the capsule adjacent to the mass, the renal sinus, and a random section of kidney tissue were submitted for analysis. The adrenal gland measured 8.0 x 2.5 cm and was submitted as part of the specimen.\n\nMicroscopic evaluation reveals a moderately well-differentiated cellular lesion within the kidney, forming a mass up to 12 cm in greatest dimension. The cells exhibit clear cytoplasmic features. No evidence of invasion into the capsule or surrounding adipose tissue is observed. Both the ureteral and vascular margins show no involvement. No definitive vascular invasion is identified. The renal sinus, renal pelvis, and adjacent ureter are free of the lesion. The adrenal gland appears histologically benign. Based on these findings, the pathological staging is pT2, NX, MX."} +{"pid": "TCGA-VQ-A8E0", "report": "The specimen involves a large ulcerated mass located in the body of the stomach. The lesion measures 11.5 cm in maximum dimension and extends into the subserosal adipose tissue. Histological evaluation shows poorly differentiated invasive carcinoma with features consistent with an intestinal pattern. Angiolymphatic and perineural invasion are identified. Adjacent mucosa demonstrates moderate chronic gastritis with both complete and incomplete intestinal metaplasia, along with high-grade glandular epithelial dysplasia. No neoplastic involvement is observed at the surgical margins.\n\nA total of 20 lymph nodes were retrieved from the peri-gastric fat, with 6 showing involvement by neoplastic cells. Of these, 3 out of 11 lymph nodes from the lesser curvature and 3 out of 9 from the greater curvature are positive. Additional lymph node stations examined include one lymph node at station 7, one at station 12p, and one at station 11p, all of which are uninvolved. A fragment of pancreatic tissue is also free of neoplastic involvement."} +{"pid": "TCGA-UY-A9PA", "report": "A biopsy of the left and right ureters showed no significant pathologic abnormalities. A radical cystoprostatectomy specimen revealed a 3.0 cm lesion in the bladder with invasion through the muscularis propria into perivesical fat. Margins were negative, with the invasive tumor located 0.3 cm from the margin. There was no extension into adjacent organs, including the prostate. An extensive area of carcinoma in situ was found extending to the bladder dome. The remaining prostate, bilateral seminal vesicles, and bilateral ureters showed no significant abnormalities. Additional excision of fibrofatty tissue from the bladder showed no tumor involvement.\n\nLymph node dissections were performed on both the right and left pelvic regions. A total of 21 lymph nodes were examined\u201413 from the right and 8 from the left pelvic sides\u2014with no evidence of tumor involvement. An immunohistochemical stain for keratin was performed and was negative, supporting the absence of metastatic disease.\n\nThe surgical margins, including those at the right and left ureter and the perivesical region, were all negative. No lymphatic or vascular invasion was identified. Other specimens, including a Meckel\u2019s diverticulum and final excision specimens of both ureters, also showed no evidence of tumor.\n\nHistologically, the lesion showed high-grade features. The gross description noted a 3 x 2 cm pink-tan papillary mass on the left bladder wall, extending into the muscularis propria but not involving the serosal surface or perivesicular fat. The remaining mucosa was unremarkable. Prostate and seminal vesicles appeared grossly and microscopically normal. Lymph nodes were thoroughly searched in the perivesicular region but none were identified in the primary specimen. All relevant tissues were submitted for histologic evaluation."} +{"pid": "TCGA-DC-4745", "report": "The specimen from the sigmoid and upper rectum was received fresh and measured 16.0 x 5.0 x 0.6 cm. The outer surface was tan-pink and smooth. A lesion was identified on the inner surface, located 10.0 cm from the proximal end and 3.0 cm from the distal end. The lesion measured 3.0 cm in length and 3.0 cm in width, with a maximal depth of 0.6 cm. The closest radial margin was 0.0 cm from the lesion. No gross evidence of muscular invasion was observed. Surrounding mucosa appeared normal. Lymph nodes were identified in the surrounding fat and all were submitted for analysis.\n\nThe proximal and distal anastomotic ring specimens were both received in formalin. The proximal ring was attached to a metal pin and included a segment of soft tissue measuring 1.8 cm in diameter. The distal ring measured 1.7 x 1.5 x 1.0 cm. Both rings showed pink-tan mucosa, with focal hemorrhage noted. Sutures and staples were present and subsequently removed. Representative sections of both rings were submitted for evaluation.\n\nA total of 22 lymph nodes were examined; one node contained metastatic involvement. The depth of invasion extended into the subserosa, and all surgical margins were free of tumor. The distance from the deepest portion of the tumor to the radial margin was 3.0 cm. No preexisting polyps or additional polyps were identified. The surrounding bowel showed no significant changes.\n\nImmunohistochemical staining for mismatch repair proteins demonstrated retained expression of MLH1, MSH2, MSH6, and PMS2 within the lesion."} +{"pid": "TCGA-B5-A11Q", "report": "The specimen consisted of a supracervical hysterectomy weighing 83 grams, measuring 4.3 x 4 x 3.8 cm. The endometrial cavity was completely replaced by a 6 x 6 cm exophytic mass, with a maximum thickness of 2 cm. Microscopic evaluation showed that the deepest invasion into the myometrium measured 0.2 cm within a 1.7 cm thick wall. No uninvolved endometrium was identified. A separate 3 x 3 x 2.7 cm intramural nodule was present within the myometrium. The cervix weighed 14 grams and showed no pathological changes.\n\nBoth adnexa were involved. The right ovary contained a mucinous lesion effacing the cut surface, while the left ovary was lobulated and white in appearance. The left fallopian tube was associated with the mass, whereas the right fallopian tube showed no involvement. Multiple tissue blocks were submitted for analysis, including sections from the endomyometrium, intramural nodule, adnexa, cervix, and peritoneal fragments.\n\nLymph node evaluation included bilateral pelvic lymph nodes. On the left, four lymph nodes were identified and examined; none showed evidence of tumor involvement. Similarly, on the right, four lymph nodes were evaluated and found to be free of tumor. A fragment of left gutter peritoneum was also submitted and showed only adhesions without evidence of tumor.\n\nMargins of the hysterectomy specimen were not involved. No lymphatic or vascular invasion was identified. The remaining myometrium contained a benign leiomyoma. Specimens from the right fallopian tube, left pelvic lymph nodes, left gutter peritoneum, and right pelvic lymph nodes were all free of tumor."} +{"pid": "TCGA-DU-7292", "report": "The specimen consists of four tissue samples from the left temporal lobe, left temporal uncus, left parahippocampus, and left hippocampus. Gross examination revealed a total of 19 cassettes submitted across all specimens. The largest specimen, from the left temporal lobe, measured 4.5 x 4 x 1.5 cm and was semifirm with a tanish-white appearance. Other specimens were smaller, ranging from 1 x 1 x 0.3 cm to 3 x 2.2 x 0.9 cm, and also appeared tanish-white.\n\nMicroscopic evaluation showed extensive infiltration of gray and white matter by a neoplastic glial cell proliferation in all specimens. The cells were primarily medium-sized with moderate nuclear pleomorphism and abundant eosinophilic cytoplasm. Elongated cellular processes were frequently observed. Mitotic figures were present, though not numerous. Vascular changes included endothelial hypertrophy; however, microvascular proliferation or necrosis was not identified. Scattered recent small hemorrhages were noted, along with rare multinucleated cells. Mineral salt deposits were absent.\n\nImmunohistochemical staining with MIB-1 demonstrated a labeling index of approximately 15% in areas of solid tumor. Factor VIII staining did not reveal endothelial microvascular proliferation.\n\nHistological features included prominent perineuronal satellitosis and focal subpial accumulation. Normal cortical architecture was effaced, with entrapped neurons observed throughout the infiltrated tissue. Cellular density varied slightly between specimens, with increased pleomorphism and mitotic activity noted in some regions compared to others. No evidence of necrosis or endothelial proliferation was found."} +{"pid": "TCGA-EO-A3AY", "report": "The specimen consisted of omentum, uterus with cervix, bilateral fallopian tubes and ovaries, and bilateral pelvic lymph nodes. The uterus measured 9.2 cm in greatest dimension and contained a friable, polypoid tumor mass within the endometrial cavity. The tumor measured approximately 5.0 cm in greatest dimension and extended into the lower uterine segment. Histologic examination revealed glandular proliferation with nuclear atypia and increased mitotic activity. Invasion was identified involving more than 50% of the myometrium (myometrial thickness 20 mm), with involvement of the lower uterine segment. There was evidence of lymphovascular space invasion. No tumor involvement was identified in the bilateral ovaries or fallopian tubes.\n\nExamination of twelve right pelvic lymph nodes and thirteen left pelvic lymph nodes revealed no evidence of metastatic disease. The omental tissue showed no abnormality. Gross evaluation of the uterus demonstrated a gray-tan, solid tumor with invasion into the myometrium measuring up to 1.2 cm in depth. The cervix appeared grossly unremarkable. Multiple fibroid nodules were identified within the myometrium, up to 0.8 cm in size. The serosal surface showed congestion and hemorrhagic fibrous adhesions.\n\nHistologic grading was consistent with high-grade morphology. No additional significant pathologic findings were noted. The surgical procedure included simple hysterectomy, bilateral salpingo-oophorectomy, omentectomy, and pelvic lymph node sampling. The total number of pelvic lymph nodes examined was twenty-five, none of which showed involvement."} +{"pid": "TCGA-DK-A3X1", "report": "The specimen consists of a cystectomy-hysterectomy and bilateral salpingo-oophorectomy specimen measuring 11 cm from superior to inferior, 12 cm laterally, and 5 cm from anterior to posterior. The bladder measures 13 x 11 cm, the uterus 5 x 4.6 x 2.8 cm, the right ovary 2.2 x 1.0 x 0.9 cm, the right fallopian tube 5.4 x 0.7 cm, the left ovary 2.7 x 1.3 x 0.9 cm, and the left fallopian tube 4 x 0.7 cm. The vaginal cuff measures 5.5 x 2.0 cm. A friable fungating mass measuring 3.3 x 2.4 cm is identified in the dome, focally extending to the trigone. The distance from the left and right ureteric orifices is 5.2 cm and 5.3 cm, respectively. On sectioning, the lesion extends to a depth of 2.0 cm and appears to reach the perivesical fat, grossly approaching the subserosa. The remaining bladder mucosa is flat without additional lesions. The distal urethral margin and vaginal cuff margin are shaved and submitted. Ureteric stumps are approximately 2 cm in length and show probe-patent lumens.\n\nHistologically, the invasive component demonstrates an infiltrating pattern. No in situ component, multicentricity, vascular invasion, or perineural invasion is identified. Surgical margins are free of tumor. The non-neoplastic mucosa shows chronic cystitis and a foreign body reaction. The endometrium contains a polyp, and the myometrium shows mural leiomyomas. The left fallopian tube has simple serous cysts. The right ovary exhibits hilus cell and stromal hyperplasia, and the left ovary shows stromal hyperplasia. Other genital organs are unremarkable. One perivesical lymph node is examined and is not involved. Lymph nodes from the right distal pelvic region (2 nodes), left pelvic region (8 nodes), and left distal pelvic region (8 nodes) are all uninvolved.\n\nFocal mild atypia is present in the right distal ureter, while the left distal ureter appears benign. All ureteral margins are submitted for evaluation. The pathologic staging indicates involvement of the perivesical soft tissue. Multiple sections from all specimens are submitted for review."} +{"pid": "TCGA-G3-A7M6", "report": "The liver specimen from Segment 7 was received as a 24.7 g disc-shaped tissue measuring 6.5 x 6 cm with a maximum thickness of 3 cm. A plaque-like bulge approximately 2.5 cm in diameter was identified on the capsular surface, and upon sectioning, a rounded pale brown nodule was found measuring 2.3 x 2.5 x 2.5 cm. The tumor has a lobulated appearance and is located within 0.7 cm of a resection margin. The tissue was fixed in formalin and submitted for analysis in 10 cassettes, including representative sections of the resection margin.\n\nMicroscopically, the lesion forms multinodular growth patterns with confluent compact sheets and areas of trabeculae. Tumor cells are polygonal with moderate nuclear pleomorphism. Mitotic activity is prominent, especially in solid areas. A mild inflammatory infiltrate composed of neutrophils and focal lymphocytes is present within the tumor. There is a central area of degeneration, but no vascular invasion is observed. The surrounding liver tissue shows chronic inflammation in portal tracts with focal interface degeneration (piecemeal necrosis). Portal tracts demonstrate mild expansion and focal fibrous septa, indicative of Stage II fibrosis. Additionally, there is lobular lymphocytic infiltration consistent with Grade II inflammation.\n\nThe tumor is histologically classified as poorly differentiated. It is confined to the liver without evidence of regional or distant spread. Parenchymal margins are free of invasive carcinoma, with the tumor at least 0.7 cm from the closest margin. Bile duct margin could not be assessed. Vascular invasion is not present."} +{"pid": "TCGA-AK-3454", "report": "The specimen consists of a right radical nephrectomy with attached ureter, a segment of distal ureter, and a stent. The radical nephrectomy specimen includes a ureter measuring 27.0 cm in length x 0.9 cm diameter and a kidney measuring 10.0 x 6.0 x 5.5 cm. The ureter has a patent lumen with slightly thickened walls; no gross abnormalities were identified. The kidney shows marked distention of the calyceal system and renal pelvis. A mass located in the inferior pole measures 4.3 x 4.0 cm and has a red to orange cut surface. It appears well circumscribed, compressing adjacent parenchyma and capsule without evidence of invasion. The lesion is 4.5 cm from the hilum and within 1 mm of the closest inked circumferential margin. No angiolymphatic invasion is observed. The ureter shows focal moderate dysplasia and acute and chronic inflammation, primarily involving surrounding fibroadipose tissue. The renal pelvis and vascular and ureteral margins show no abnormal findings. The non-neoplastic kidney demonstrates atrophy.\n\nThe distal ureter specimen includes a small segment measuring 0.5 x 0.8 x 0.8 cm with attached fibroadipose tissue. Histologic evaluation reveals focally denuded urothelium with no other significant findings. The stent is composed of rubber tubing measuring 37.0 cm in length x 0.3 cm in diameter. Dried blood is present at one end, but no tissue or blood was submitted for analysis.\n\nTumor nuclear grade is III/IV with focal necrosis. The tumor is confined to the kidney. Staging is pT1b Nx Mx. Cytogenetic analysis of the renal sample was unsuccessful due to culture failure and absence of metaphases."} +{"pid": "TCGA-AH-6549", "report": "The specimen was received in two containers. The first, labeled as appendix, contains a partially fragmented vermiform appendix measuring approximately 6.5 cm in length and ranging from 0.7 to 1.5 cm in diameter. The serosal surface is described as pink-tan and shaggy with minimal yellow-tan mesoappendix. No perforations or fecaliths were identified upon sectioning, and the lumen appears pinpoint in size. Representative sections have been submitted for analysis.\n\nThe second specimen, labeled as rectal mass, consists of two tan-pink polypoid tissue fragments. The larger fragment measures 5.5 x 4.5 x 3.0 cm and has a cauterized margin that is inked. The smaller fragment measures 2.5 x 1.5 x 1.0 cm. All tissue pieces were sectioned and entirely submitted for histologic evaluation, with the largest piece including the inked margin. Additional cassettes were prepared for genomic research.\n\nHistologically, the tumor demonstrates moderately differentiated morphology. Lymphovascular space invasion is present. Microscopic evaluation shows that the tumor extends through the muscularis propria into the surrounding perirectal soft tissue. No treatment effect is identified. The total number of lymph nodes received for evaluation is none.\n\nRegarding surgical margins, it is difficult to define clear margins due to the largely infiltrative nature of the tumor. In areas where margins are identifiable, tumor is found 0.1 cm from the inked radial margin and within 0.2 cm of both the proximal and distal mucosal margins. Given the extent of tumor involvement in the specimen, there is a significant risk that tumor may be present at one of the resection margins. Clinical correlation is recommended. \n\nStaging is pT3, NX."} +{"pid": "TCGA-23-2078", "report": "The specimen from the excision of a mass in the cul-de-sac consists of four firm fibrotic tan fragments measuring between 1.2 x 1 x 0.5 cm and 2.4 x 1.8 x 1.5 cm. Tumor involvement is noted in soft tissue from the left pelvic peritoneum, with multiple nodular aggregates ranging from 0.2 to 0.6 cm. A friable and firm tan-white tumor is present in the sigmoid region. Dissection of right pelvic lymph nodes (four in total) reveals no metastatic involvement. The retrocecal specimen contains red-brown muscular and tan fibrous tissue with tumor nodules up to 0.8 cm. Right common iliac lymph nodes (three in total) are also free of metastatic disease.\n\nThe uterus measures 8 cm in length, 5 cm in width at the cornua, and 3 cm in depth. The serosa shows small granular tumor deposits. The endometrial cavity is 4.5 cm long and lined by thin endometrium. Two endometrial polyps are identified, one in the fundus measuring 1 cm and another in the posterior cornu. A subserosal leiomyoma measuring 1 x 0.9 x 0.9 cm is present in the posterior corpus. The cervix is 3 cm in length with a patent os. Cervical glands show nabothian cysts, and there is focal epithelial denudation with chronic inflammation and squamous metaplasia.\n\nThe right ovary is 2.2 x 1.1 x 0.4 cm with a narrow cortical rim and no visible tumor. The right fallopian tube is 5.5 cm long with small nodules on its serosal surface and paratubal tissues. The left ovary is similar in size, with a small surface nodule and a 0.8 cm cyst. The left fallopian tube has a 3.5 x 2.2 x 2 cm mass in the paratubal area and a smaller 1 x 0.7 x 0.7 cm nodule. Multiple small tumor deposits are present on the fimbriated end, with partial luminal involvement. The omentum is a 35 x 5.5 x 3.5 cm adipose specimen with a dominant 3 x 2 x 1.5 cm tumor nodule and multiple smaller nodules.\n\nInvolvement is observed in the left gutter and colon region, with a 2 x 2 x 1.5 cm tumor mass and smaller aggregates. The IP ligament and right perinephric areas also show tumor presence. The appendix, 5 cm in length and 0.2 cm in diameter, has fibrous obliteration of the lumen with tumor involvement in the mesoappendix and external wall.\n\nHistologic evaluation reveals high-grade papillary architecture with psammoma bodies, necrosis, and lymphovascular invasion. Inflammatory changes, fibrosis, and adhesions are present in multiple sites. Lymph nodes show reactive changes without evidence of metastasis. Other findings include Walthard rests, cystic inclusions, and benign cysts in the ovaries, as well as dysplastic changes in coelomic epithelium lining the adnexal tissues."} +{"pid": "TCGA-EI-6512", "report": "Histopathological examination was performed on a total organ resection of the colon and rectum. The specimen measured 2.5 x 15 x 8 cm and included surrounding periintestinal tissue, with a length of 17 cm. A cauliflower-shaped ulcerous lesion was identified in the mucosa, measuring 6 x 6 x 1 cm. The lesion circumferentially involved the entire circumference of the intestine and was located 5 cm from each excision margin.\n\nMicroscopic evaluation revealed a moderately differentiated tubular adenocarcinoma. There was evidence of infiltration into the pericolic adipose tissue. The resected ends of the intestine showed no involvement. Lymph node analysis demonstrated metastatic involvement in regional lymph nodes (number I/XVII).\n\nThe tumor exhibited histological features consistent with tubulopapillary architecture. Staging parameters indicated pT3, pN1 classification, corresponding to Dukes C and Astler-Coller C2 stages."} +{"pid": "TCGA-63-7020", "report": "The sample was collected from the right upper lobe of the lung following a resection procedure. The tissue specimen measured 1.5 cm in size. Histologic evaluation revealed moderately differentiated cells with nuclear features consistent with an intermediate grade. Lymph node involvement was not identified, and no distant metastatic spread was detected. The pathologic staging classification was T1, N0, M0, corresponding to a localized lesion without regional or distant spread. No additional comments were provided regarding the preparation or collection process."} +{"pid": "TCGA-X2-A95T", "report": "A 365-gram uterus measured 13 \u00d7 8 \u00d7 6 cm and showed a dilated cervical canal measuring up to 3.5 cm in diameter. The endometrial cavity contained a 7 \u00d7 4 \u00d7 3 cm hemorrhagic, pedunculated polyp arising from the posterior uterine wall. The uninvolved endometrium measured up to 0.1 cm, and the myometrium measured 2.5 cm. The endometrial polyp had variegated cut surfaces with areas of hemorrhage and yellow discoloration. The lesion appeared to invade at least the superficial aspect of the endometrium and was adjacent to an ill-defined lobulated white firm mass. Multiple sections were submitted from various levels of the uterus, including cervix, lower uterine segment, endometrium, superficial and deep myometrium, parametrium, and the polyp itself.\n\nThe omentum weighed 425 grams and measured 37 \u00d7 23 \u00d7 1.8 cm in greatest dimension. It was yellow and lobulated with smooth, glistening serosa and fibrous adhesions. Cut surfaces were homogeneous, yellow, and fatty with no identifiable masses or lesions.\n\nLymph node specimens were received from multiple sites: right and left para-aortic, left external iliac, left common iliac, left obturator, right common iliac, right external iliac, and right obturator regions. Aggregate measurements of lymph node-containing tissue ranged from 2 \u00d7 1 \u00d7 0.8 cm to 4.5 \u00d7 4 \u00d7 1.5 cm. Lymph node candidates ranged in size from 0.3 to 2.8 cm. All lymph nodes were embedded in fatty tissue and submitted for histologic examination. No abnormal masses were identified grossly.\n\nBilateral salpingo-oophorectomy specimens were submitted. The left ovary measured 3.2 \u00d7 1.5 \u00d7 1 cm and the right ovary measured 3 \u00d7 2 \u00d7 1 cm. Both ovaries had tan cut surfaces with physiologic cysts and no identifiable masses. Fallopian tubes were patent with stellate lumina; one paratubal cyst was noted on each side measuring 1.5 cm and 1 cm in diameter, respectively. The serosa of the fallopian tubes was smooth and glistening without papillary excrescences.\n\nHistologically, the sarcoma was invasive into the stalk of the polyp and the inner half of the myometrium. Mitotic count exceeded 20 per 10 high power fields. Areas of necrosis were present, involving less than 50% of the tissue. Vascular invasion was identified. Tumor cells showed both smooth muscle differentiation and areas of undifferentiated high-grade sarcoma. Histologic grade according to FNCLCC was grade 3 (overall score 8 of 9), with poor differentiation, less than 50% necrosis, and high mitotic activity.\n\nOther findings included inflamed endometrium with complex hyperplasia without atypia and benign endometrial polyps. Cervical tissue showed microglandular hyperplasia with inflammation. There was no evidence of sarcoma in the parametria, omentum, or any of the 26 lymph nodes examined, although reactive hyperplasia and focal microabscess formation were noted. Both fallopian tubes showed acute salpingitis, and paratubal cysts were present bilaterally. Ovaries showed no neoplastic changes.\n\nMultiple cassettes were submitted for microscopic evaluation from all relevant tissues. No other neoplastic diagnoses were rendered."} +{"pid": "TCGA-G9-6336", "report": "The specimens include a left pelvic lymph node dissection and a resected prostate gland. The lymph nodes consist of multiple fragments of adipose tissue measuring 4 x 3 x 1 cm in total. Two lymph nodes were identified, measuring 0.8 x 0.8 x 0.3 cm and 0.3 x 0.2 x 0.2 cm respectively. All lymph node tissue was submitted for evaluation, with no evidence of abnormal cellular infiltration found.\n\nThe prostate gland weighed 51 grams and measured 5 cm in width, 4.3 cm in depth, and 3.7 cm in height. The external capsule was intact and red in color. After disassembly, the remaining specimen weighed 21 grams. Serial sectioning revealed tan-beige firm, fibrous parenchyma. The right seminal vesicle measured 2.4 x 2 x 0.5 cm and the left measured 3.5 x 1.4 x 0.5 cm; both were cystic and bisected. The right and left vas deferens measured 5.5 x 0.5 cm and 5 x 0.5 cm respectively, and were sectioned showing firm beige tubular structures. Portions of the prostate were submitted for tissue procurement and microscopic analysis.\n\nMicroscopic evaluation showed architectural changes including high-grade prostatic intraepithelial neoplasia and patchy chronic inflammation. There was involvement of the right lateral surgical margin focally (3 mm). Perineural invasion was present. No definitive evidence of extraprostatic extension was observed. The tumor demonstrated multicentric involvement involving approximately 25% of the gland. Surgical margins showed involvement at the right lateral aspect with focal linear distance (1\u201310 mm). No vascular or lymphatic invasion was identified. The seminal vesicles and periprostatic fat were not clearly involved. Lymph node evaluation showed no abnormal findings in the left pelvic region.\n\nStaging was assessed as pT2+, with no distant metastasis identified. Benign prostatic hyperplasia was also noted. Frozen section analysis was performed and no post-hormonal therapy changes were reported."} +{"pid": "TCGA-19-0964", "report": "The specimen consists of three tissue samples submitted from the left brain region. The first sample, labeled as tumor and epidural tissue, includes multiple irregular fragments of tan-white and hemorrhagic tissue measuring approximately 1.8 x 0.8 x 0.3 cm in total. A portion was used for intraoperative frozen section analysis, and the remainder was processed for further evaluation. The second sample consists of a membranous tissue fragment measuring 4.8 x 3.2 x 0.1 cm, which was serially sectioned and fully submitted for analysis. The third sample, received in formalin, includes multiple soft cerebriform fragments with an aggregate size of 4.0 x 3.0 x 1.1 cm. Histologic examination revealed cellular features suggestive of a high-grade neoplasm with spindle cell morphology. The lesion involved the meningeal layers, dura mater, and adjacent skull bone. Immunohistochemical staining was performed to assist in characterization. All specimens were processed and analyzed using appropriate controls and reagents."} +{"pid": "TCGA-A8-A0A1", "report": "The specimen shows a lesion with a maximum diameter of 2.5 cm, excised with clear margins extending into adjacent healthy tissue. Histological evaluation indicates a moderately differentiated malignancy. Lymphovascular invasion and lymph node involvement were not identified. No distant metastases were detected. The lesion was completely resected with negative margins. Cellular morphology and architectural patterns were assessed as part of the evaluation."} +{"pid": "TCGA-3A-A9J0", "report": "A single lymph node from the hepatic artery was negative for metastatic carcinoma. A pancreaticoduodenectomy specimen included portions of the head of the pancreas, duodenum, distal stomach, common bile duct, and gallbladder. A 4.0 cm solid mass was identified in the pancreatic head, extending into the Ampulla, duodenum, and peripancreatic soft tissues. Microscopically, the lesion was moderately differentiated. Tumor was within 0.75 mm of the posterior resection margin; however, all margins were uninvolved by invasive or in situ carcinoma. No tumor involvement was found at the portal vein groove, superior mesenteric artery, or common bile duct margin. The gallbladder showed chronic cholecystitis.\n\nFive of 14 peripancreatic lymph nodes contained metastatic disease. Perineural invasion, lymphovascular invasion, and large vessel invasion were present. Evaluation of the adjacent pancreatic parenchyma revealed PanIN-3 lesions. No dysplastic or carcinomatous changes were identified in the Ampulla, duodenum, or bile duct. Immunohistochemical staining demonstrated strong expression of MUC-1 with no expression of MUC-2 or CDX2, consistent with a pancreatobiliary phenotype.\n\nA separate fragment of the pancreatic resection margin showed low-grade dysplasia without evidence of carcinoma. Frozen section analysis of the bile duct margin, new pancreatic margin, and hepatic artery lymph node were all negative for malignancy. Gross examination of the resected specimen showed a firm, gray-tan mass near the common bile duct with apparent involvement of the Ampulla. The remainder of the duodenum, gallbladder, and pancreatic tissue appeared unremarkable. Multiple sections were taken to assess tumor relationships and margins. No prior treatment effect was noted."} +{"pid": "TCGA-KK-A5A1", "report": "A left pelvic lymph node specimen consists of fibrofatty tissue measuring 4.0 x 2.5 x 1.0 cm, containing a single lymph node measuring 3.0 x 1.0 x 0.5 cm, which was fully submitted for analysis. No abnormal cellular findings were identified in this lymph node. A right pelvic lymph node specimen includes fibrofatty tissue measuring 4.5 x 3.0 x 1.0 cm, with two lymph nodes present: one measuring 2.5 x 1.0 x 0.5 cm and another measuring 2.0 x 0.5 x 0.5 cm. Both were submitted for analysis, and no abnormal cells were found.\n\nMultiple teeth were extracted, ranging in size from 0.8 x 2.0 x 0.5 to 1.0 x 2.5 x 0.8 cm, with three having metallic silver fillings. No other macroscopic abnormalities were noted, and the specimens were processed for gross identification only.\n\nA right neurovascular bundle sample, measuring 2.0 x 1.5 x 0.4 cm, was entirely submitted for analysis. Microscopically, it shows fibroadipose tissue with vascular and nerve structures, with no evidence of abnormal cell presence.\n\nThe prostate and attached seminal vesicles measured 4.0 x 3.7 x 3.5 cm and weighed 38 grams post-fixation. A firm nodule was palpated on the left side of the prostate, and cross sections revealed a firm area in the left peripheral zone. The tumor occupied approximately 70% of the prostate volume, with a maximum cross-sectional dimension of 3.9 x 3.8 cm. It was present extensively in the apex and base regions, and extended into multiple areas of extraprostatic tissue, including the left anterior surface, anterior apex, bladder neck, and left superior neurovascular bundle region. The tumor also involved both seminal vesicles (intra- and extraprostatic portions) and perivesicular soft tissue. Additionally, it was found within loose connective tissue surrounding the ejaculatory ducts and in endothelium-lined spaces within the prostate and the invaginated extraprostatic space. The resection margin was extensively involved, particularly at the anterior apex (26.0 mm) and anterior bladder neck (10.0 mm). Focal mucinous differentiation was observed, and immunostains showed strong diffuse positivity for PSA and PAP. Rare chromogranin- and synaptophysin-positive cells were also present, consistent with focal neuroendocrine differentiation.\n\nLeft perirectal tissue samples included skeletal muscle and fibromuscular tissue, with no abnormal cells detected. Right perirectal tissue showed involvement of fibromuscular tissue by malignant cells, with no native prostatic glands present. A second left perirectal tissue sample showed similar involvement of fibromuscular tissue, with focal extension into skeletal muscle.\n\nSections of the prostate and seminal vesicles were submitted from various anatomical locations, including the base, apex, and margins. The anterior surface of the prostate was inked green, the left surface red, the right surface yellow, and the posterior surface black. Areas of disrupted surface were marked with blue and orange ink and did not represent true resection margins.\n\nNo additional findings were reported in the remaining tissues submitted."} +{"pid": "TCGA-K7-A5RF", "report": "The specimen consisted of multiple tissue fragments from various liver segments and the gallbladder. Gross examination revealed a dilated gallbladder measuring 9.0 cm in length with bile-stained mucosa and no identifiable lesions or stones. Two core liver biopsies were received: one measuring 0.4 cm and another 0.3 cm. A frozen section remnant from segment 7 of the liver measured 2.5 x 2 x 0.3 cm with a hemorrhagic focus measuring 0.4 cm. The non-frozen portion of segment 7 was a partial hepatectomy specimen weighing 160 grams with reconstructed dimensions of 9.5 x 9.5 x 6.6 cm. It exhibited diffuse micro-nodularity consistent with cirrhosis, with a shaggy and focally hemorrhagic margin. An area measuring 3 x 3.0 cm was identified near a blue suture, located 2.0 cm from the resection margin. Additionally, a separate nodule measuring 1.8 cm was noted, situated 0.2 cm from the capsule and 1.0 cm from the resection margin. The remaining parenchyma showed uniform nodular consistency. A left lobe liver biopsy measuring 1.5 cm was also examined.\n\nHistologically, mild chronic inflammation with focal cholesterosis was observed in the gallbladder. In one fragment of the core liver biopsy, atypical hepatocytes were identified with disrupted reticulin framework and positivity for glypican-3 and polyclonal CEA in a canalicular pattern. Other fragments demonstrated cirrhosis with mild stainable iron in Kupffer cells. In the segment 7 specimen, small cell dysplastic nodules were present along with scattered minute foci showing immunoprofile suggestive of early evolving lesion. Reticulin staining highlighted preserved architecture with rare foci of thickened hepatocytic plates. Glypican-3 expression was weakly positive in these areas. Cirrhosis with mild steatosis consistent with chronic hepatitis was identified across specimens. Histologic grading was consistent with Grade 2/4 and Stage 4/4 fibrosis. No involvement was identified at the margins of the specimen. Trichrome, reticulin, and iron stains were evaluated in all relevant sections. Positive controls were used throughout and deemed technically acceptable."} +{"pid": "TCGA-AX-A2IO", "report": "The surgical specimens included multiple lymph node biopsies and a hysterectomy with bilateral salpingo-oophorectomy. Lymph nodes from the left para-aortic, right common iliac, right para-aortic, left common iliac, left pelvic, and right pelvic regions were examined. A total of 10 lymph nodes were identified and all were benign. The left common iliac biopsy did not contain any lymph nodes.\n\nThe uterus measured 7.0 x 5.0 x 3.0 cm and contained a polypoid lesion on the upper anterior endometrial wall that extended to the posterior wall. The tumor measured 1.5 x 1.0 x 0.2 cm and was located approximately 2.0 cm from the lower uterine segment. Histologically, the tumor showed high-grade features with invasion into the inner half of the myometrium, measuring 2.5 mm in depth out of a total myometrial thickness of 13 mm (approximately 19% involvement). Lymphovascular invasion was present.\n\nThe cervix and lower uterine segment showed surface and glandular involvement without stromal invasion. The distal resection margin was free of disease. The uterine serosa, bilateral fallopian tubes, and ovaries showed no evidence of malignancy. The closest distance of invasive tumor to a margin was 10.5 mm from the uterine serosa.\n\nAdditional findings included endometrial intraepithelial changes in areas adjacent to the tumor, as well as inactive to atrophic endometrium elsewhere. The tumor was confined to the uterus with no regional lymph node involvement or distant metastasis. Based on the extent of invasion, the staging classification reflects tumor involvement limited to the uterus with cervical extension but no beyond."} +{"pid": "TCGA-XF-A9T6", "report": "A radical cystectomy with pelvic lymph node dissection, total hysterectomy with bilateral salpingo-oophorectomy and ileal conduit was performed. Gross examination of the bladder revealed a polypoid exophytic mass on the right lateral wall measuring 5 x 4 x 3 cm. Microscopically, the lesion is poorly differentiated and papillary in architecture, extending through the bladder wall into perivesical soft tissue both grossly and microscopically. A single focus of lymphovascular invasion was identified. The depth of invasion measured 2 cm, and the tumor did not reach the inked surgical resection margin. No urothelial dysplasia or malignancy was found in the remaining bladder mucosa, including the trigone and bladder neck. One right perivesical lymph node was examined and was negative for malignancy.\n\nExamination of the distal and proximal ureters (right and left) showed no atypia or abnormal findings. The mucosa appeared normal without evidence of dysplasia or malignancy. The uterus was symmetrical with a smooth serosal surface. The endometrium was atrophic with a small polypoid lesion measuring 0.7 cm on the anterior aspect. The cervix showed benign squamous and endocervical mucosa with chronic inflammation. No significant histopathologic changes were observed in the myometrium or serosa. The bilateral fallopian tubes and ovaries showed benign physiologic changes; however, the left fallopian tube exhibited tubo-uterine adhesions and multiple firm adjacent nodules ranging from 0.3 to 0.7 cm in diameter. No atypia or malignancy was identified in these structures.\n\nA total of 48 lymph nodes were examined from various regions including the right para-caval, right common iliac, pre-sacral, right external iliac, right obturator/hypogastric, left para-aortic, left common iliac, left lymph node of Cloquet, left external iliac, left obturator/hypogastric, vaginal apex, right and left presciatic regions. None showed evidence of malignancy. The resection margins, including the apical urethral margin, were free of any abnormal cellular changes. The surrounding peritoneum was smooth and glistening with no involvement by abnormal tissue. Severe chronic cystitis was noted in the bladder.\n\nThe specimen was staged pathologically as pT3bNOMX. No high-grade atypia or tumor was identified in frozen sections of the right and left distal ureters. Representative sections of the invasive lesion were submitted for further immunohistological analysis."} +{"pid": "TCGA-DU-A7TC", "report": "The specimen consists of brain tissue fragments measuring up to 1.0 cm in largest dimension. Gross examination reveals tan-gray gelatinous areas suggestive of glial neoplasm. Histologic evaluation demonstrates an infiltrative glial lesion without mitotic figures or vascular proliferation. Immunohistochemical staining shows a Ki-67 labeling index of approximately 3%, with appropriate control reactivity. Smears and frozen section analysis were performed intraoperatively, with findings consistent with a low-grade infiltrating glioma. Molecular testing for MGMT promoter methylation was conducted using bisulfite-treated DNA extracted from paraffin-embedded tumor tissue. Real-time PCR amplification showed no evidence of methylation. The assay demonstrated high sensitivity with detection possible at 1% methylated DNA within an unmethylated background. Factors such as tumor cellularity below 50% or extensive necrosis may have influenced results. Microdissection was used to enrich tumor DNA prior to testing. All pathology evaluations were reviewed by senior and resident staff pathologists, with findings correlated to histologic and intraoperative assessments."} +{"pid": "TCGA-OR-A5JK", "report": "The specimen consists of an en bloc resection of the left kidney, adrenal gland, renal vein, and surrounding fat. The kidney measures 120 x 80 x 60mm. Adjacent to the kidney, there is a mostly encapsulated mass measuring 140 x 130 x 110mm, separated from the kidney by a narrow rim of fatty tissue. On sectioning, the mass shows focal extension through the capsule into the surrounding perinephritic fat, up to 13mm in depth. There is also direct invasion into the adjacent renal vein, forming a nodular intraluminal mass measuring 30 x 20 x 20mm. The stapled margin of the renal vein is in close proximity to this mass. The cut surface of the mass is yellow/tan, heterogeneous, and focally hemorrhagic, weighing 826 grams. The adjacent kidney appears normal on gross and histological examination.\n\nMicroscopically, the lesion is high grade and composed predominantly of pleomorphic cells with eosinophilic cytoplasm. There is extensive coagulative necrosis with dystrophic calcification in some areas. Sinusoidal and venous invasion are present, including a 30mm intravascular tumor mass within the renal vein. The mitotic rate is 4 per 50 high power fields, with occasional atypical mitoses. The lesion is mostly well circumscribed but extends beyond the adrenal region. It abuts the renal vein margin, though other soft tissue margins appear clear. Immunohistochemistry demonstrates diffuse strong positivity for IGF-2, positive staining for glucocorticoid receptor (score 2+), and a Ki-67 proliferative index of 5%.\n\nMultiple blocks were sampled, including the renal vein margin with intravascular involvement, ureteric and renal artery margins, areas of capsular breach and perinephritic fat extension, and additional sections from various regions of the mass. No lymph nodes were identified in the peri-renal or peri-adrenal tissue. A separate block confirms normal renal parenchyma."} +{"pid": "TCGA-56-A5DR", "report": "A 1.8 cm lesion was identified in the left upper lobe of the lung. Histologic evaluation revealed sheets of neoplastic cells with distinct cell borders, small to moderate cytoplasmic volume, and large pleomorphic nuclei exhibiting irregular chromatin clumping and prominent nucleoli. Mitotic activity was present. All surgical margins were free of tumor, and there was no evidence of direct extension, lymphatic, or venous invasion. A total of six lymph nodes were examined; none showed involvement. The lymph nodes submitted included those labeled L4 (measuring 0.9 x 0.5 x 0.3 cm and 1.7 x 1 x 0.3 cm), L11 (0.7 x 0.6 x 0.3 cm), and an additional L11 lymph node measuring 1.5 x 0.8 x 0.3 cm. All lymph nodes were benign with no malignancy identified. The lobectomy specimen measured 20 x 8 x 6 cm and included a central firm tumor with a white-tan cut surface. Sections of the uninvolved lung showed no significant fibrosis or inflammation. Staging was determined as pT1a, pN0, pMX."} +{"pid": "TCGA-EM-A2P0", "report": "The specimen from the left lower neck dissection included multiple pieces of fibrofatty tissue, with a tumor measuring 2.5 x 1.5 x 1.2 cm located near the soft tissue margin. The tumor was cystic and filled with hemorrhagic fluid. Additional lymph nodes were identified within the specimen, ranging in size from 0.3 to 1.8 cm. A total of 30 lymph nodes were examined from this site, and 5 contained involvement.\n\nA separate excisional biopsy from left neck level VI consisted of fibroadipose tissue measuring 4.5 x 2.5 x 1.4 cm. No lymph nodes were identified in this specimen.\n\nThe total thyroidectomy specimen weighed 40.8 g and included the right lobe (7.0 x 2.5 x 2.0 cm), left lobe (5.9 x 3.0 x 2.4 cm), and isthmus (4.0 x 1.2 x 1.2 cm). A well-defined nodule measuring 2.1 x 1.8 x 1.3 cm was present in the left lobe. Histologically, the nodule showed classical papillary architecture and cytomorphology, with hobnail cell changes noted. Psammomatous dissemination was observed throughout the left lobe, including within lymphatic channels. The tumor was partially encapsulated and demonstrated widespread capsular invasion. No definitive vascular invasion was seen. Margins were free of involvement, and no extrathyroidal extension was identified. Additional findings included mild follicular nodular disease and mild reactive C-cell hyperplasia. No parathyroid abnormalities were identified.\n\nA second dissection specimen from the left tracheoesophageal area measured 2.1 x 2.0 x 0.8 cm and contained multiple lymph nodes ranging from 0.3 to 0.7 cm. Of the 4 lymph nodes examined in this specimen, 4 showed involvement.\n\nOverall, 34 regional lymph nodes were examined, with 9 showing evidence of involvement. No extranodal extension was identified. The procedure was a total thyroidectomy with left neck dissection, and the fresh specimen was intact upon receipt. The tumor was unifocal and located in the left lobe. Based on AJCC/UICC TNM staging criteria (7th edition), the primary tumor was classified as pT2, and regional lymph node involvement as pN1b."} +{"pid": "TCGA-CV-6952", "report": "The specimen consists of a total oral glossectomy, bilateral neck dissection, and multiple teeth. The lesion measures 4.0 x 3.0 x 2.0 cm and involves the full thickness of the tongue. Histologic examination reveals well-differentiated features with extensive perineural invasion. The skeletal resection margin is involved, with the largest metastatic deposit measuring 1.5 cm in a right lower jugular lymph node. A metastatic focus is also present in a right supraclavicular lymph node. Among the right neck lymph nodes, 1 of 2 midjugular, 1 of 7 lower jugular, and 1 of 11 additional nodes show involvement. All mucosal margins are free of involvement. On the left side, 22 neck lymph nodes are examined, including 2 submental, 4 subdigastric, 5 lower posterior cervical, 2 mid jugular, 10 mid posterior cervical, 6 lower posterior cervical, and 2 supraclavicular nodes; all are negative. No unequivocal extranodal extension is identified."} +{"pid": "TCGA-44-7672", "report": "The left upper lobectomy specimen measured 16 x 12 x 1.5 cm and contained a single mass measuring 2.5 x 2.0 x 1.5 cm. The mass had an irregular border, a gray-white cut surface, and was associated with pleural puckering on the posterior surface adjacent to the bronchus. Microscopic evaluation showed moderately differentiated cells arranged in a glandular pattern. The tumor was centered within the lung tissue and did not directly involve the visceral pleura. Surgical margins were free of abnormal cells. No evidence of large vessel venous or arterial invasion was identified, and no small vessel lymphatic invasion was noted.\n\nA total of five regional lymph nodes were examined: two from level 5, one from level 11, one from level 8, and one from level 7. All were negative for involvement. Additionally, a soft tissue biopsy from the 9L fat pad showed benign fibroadipose tissue and one negative lymph node. One level 7 lymph node biopsy showed lymphoid and fibrous tissue but no definitive lymph node was identified. All margins and submitted tissues were negative for abnormal cell spread."} +{"pid": "TCGA-A6-5661", "report": "The specimen includes portions of omental and right colonic tissue. The omental sample is a soft pink fibrofatty tissue measuring 2.4 x 1.2 x 0.8 cm, containing a 4 mm hard yellow stone embedded within the tissue. The right colon specimen is approximately 36 cm in length and includes a segment of small bowel measuring 5.5 cm. The mucosa of the small bowel is smooth and glistening with a circumference of 3.5 cm. An appendix, measuring 6.0 x 0.7 cm, is also present.\n\nMultiple lesions are identified in the colonic mucosa. A prominent ulcerated lesion measures 3.7 x 3 x 0.5 cm and is located 4.5 cm distal to the ileocecal valve. Microscopic evaluation indicates that this lesion extends into the pericolonic fat. The distance from this lesion to the closest radial margin is 0.7 cm, and the tumor is located 27.8 cm from the distal margin. No vascular invasion is observed. Proximal and distal margins, as well as the circumferential margin, are free of tumor involvement.\n\nA large sessile exophytic lesion measuring 5.5 x 3.5 x 3.0 cm is also present, located 18 cm from the distal margin. Additional smaller polyps, ranging from 0.5 to 1.0 cm in size, are noted near the ileocecal valve and toward the distal end of the colon. Histologic evaluation reveals tubulovillous features in the larger sessile lesion, with additional findings including two adenomatous polyps and one hyperplastic polyp. The appendix shows no significant pathology.\n\nLymph node assessment includes multiple lymph nodes sampled from the pericolonic fat. All 21 regional lymph nodes examined show no evidence of metastatic disease. Other than the described lesions, no non-lymph node pericolonic tumor involvement is identified. Distant metastasis could not be assessed.\n\nTissue blocks were submitted for analysis, including sections from the luminal margin, ileocecal valve, appendix, various polyps, the main lesion extending to the radial margin, and multiple lymph node samples. Microscopic examination confirms the histologic type as moderately differentiated infiltrating epithelial lesion."} +{"pid": "TCGA-C5-A8ZZ", "report": "The pathology report includes specimens from the uterus, cervix, posterior cul-de-sac, right ovary, and left adnexa. A cervical cone biopsy reveals extensive invasive moderately differentiated squamous cell carcinoma with focal keratinization involving all tissue blocks. The tumor extensively involves one lateral margin and the deep margin. The lesion measures 1.4 cm in greatest lateral dimension and 0.9 cm in depth based on histologic sections, though it may be larger given the involvement of resection margins. Lymphovascular space invasion is present. Adjacent surface epithelium shows severe dysplasia (CIN 3). The posterior cul-de-sac biopsy contains a small fragment of invasive squamous cell carcinoma. The endocervical curettage specimen also shows fragments of invasive squamous cell carcinoma.\n\nThe right ovarian biopsy consists of two tissue fragments. One appears to be ovarian cortex without follicles, with smooth muscle and ovarian surface epithelium, possibly representing adhered cortical tissue. The other fragment contains fibrous connective tissue with benign-appearing squamous epithelium, although its origin is uncertain. The left adnexal biopsy shows inflamed connective tissue with smooth muscle and serosal lining; no ovarian tissue or follicles are identified. No malignancy is detected in either the right or left adnexal specimens."} +{"pid": "TCGA-BH-A0W7", "report": "A left breast lesion was identified in the upper inner quadrant at the 10 o\u2019clock position. The excised specimen showed two foci of abnormal tissue, with the largest measuring 1.6 cm macroscopically and 0.3 cm microscopically. Histologic evaluation revealed cells arranged in a pattern consistent with ductal differentiation. Nuclear grading was performed using the Nottingham system: nuclear grade was 2, tubule formation score was 2, and mitotic activity score was 1, resulting in a total score of 5 and a grade of 1. The surrounding tissue showed features including benign calcifications, fibroadenomatoid changes, fibrocystic alterations, columnar cell changes, and mild ductal epithelial hyperplasia. Additional findings included adenosis, pseudoangiomatous stromal hyperplasia (PASH), and a small capillary hemangioma. There was evidence of cautery artifact and biopsy site changes.\n\nThe surgical margins were evaluated, and no invasive tumor was found at the margins. The closest margin to the largest tumor focus was anterior, within 0.2 cm, while the second closest was lateral, within 0.5 cm. No ductal carcinoma in situ was identified. Immunohistochemical staining for endothelial markers (D2-40 and CD31) was performed to assess for lymphovascular invasion; results confirmed the absence of involvement. \n\nLymph node evaluation included two sentinel nodes from the left axilla, both of which were free of metastatic disease. Estrogen and progesterone receptor testing performed on prior core biopsy material was positive, and Her-2/Neu expression was negative (score of zero or 1+).\n\nThe tissue was processed using formalin fixation (8\u201396 hours) and paraffin embedding. Immunohistochemistry was carried out with validated antibodies against lymphatic and vascular endothelial markers (D2-40 and CD31, respectively). All tests were conducted under CLIA-certified conditions with appropriate internal and external controls. The laboratory follows strict quality control standards for accuracy and precision.\n\nPathologic staging was determined as T1c based on the size and extent of the primary lesion, with no regional lymph node involvement (pN0) and no assessment of distant metastasis (pMX). Additional findings included atypical ductal epithelial hyperplasia, ductal epithelial hyperplasia, columnar cell changes with associated microcalcifications, and fibroadenomatoid changes. A new lateral margin specimen was also negative for tumor involvement."} +{"pid": "TCGA-XS-A8TJ", "report": "The specimen consists of a uterus and left fallopian tube weighing 559.0 grams. The fallopian tube measures 9.0 cm in length with a diameter ranging from 6.0 to 1.5 cm. On sectioning, the wall is thin at 0.1 cm thick, with dilated lumina filled with hemorrhagic content. The uterus measures 13.5 cm along its longitudinal axis, 8.0 cm in anteroposterior diameter, and 8.5 cm in bicorneal distance. The cervix has a diameter of 3.7 cm and is surrounded by the vaginal dome measuring between 0.7 and 1.2 cm. A firm, ulcerated lesion with poorly defined borders and granular appearance is observed, measuring 3.4 x 3.0 cm and involving all quadrants of the cervix. Sectioning reveals that the myometrium measures up to 7.8 cm at its thickest point and contains multiple round, firm, whitish lesions with intersecting fibrous bands. The endometrium measures 0.4 cm.\n\nMicroscopic examination reveals cellular features consistent with non-keratinizing morphology, moderately differentiated. The lesion measures 3.4 x 3.0 cm in its largest dimension and infiltrates the stroma to a depth of 1.38 cm and horizontally for 2.8 cm. There is no involvement of the uterine isthmus or circumferential and vaginal resection margins. An extensive in situ component is present. Lymphatic emboli containing neoplastic cells are identified. Additional findings include benign smooth muscle tumors within the uterus, bilateral parametrial and left fallopian tube endometriotic implants, and dysfunctional endometrium with moderate stromal edema. Lymph node assessment corresponds to regional metastasis based on pathological staging criteria."} +{"pid": "TCGA-E2-A10B", "report": "The surgical specimen includes a left breast excision, two sentinel lymph nodes, and axillary contents. Gross examination of the breast tissue revealed a firm, ill-defined mass measuring 3.8 x 3.4 x 2.6 cm, located close to the medial and lateral margins (0.3 cm from each). The skin overlying the mass appeared thickened and was grossly involved by the lesion. Histological evaluation showed an invasive component measuring 2.6 cm with features of high nuclear grade ductal carcinoma in situ, including central necrosis and a mix of cribriform and solid patterns. Tumor involvement was noted within 1 mm of the medial, lateral, and superior surgical margins. There was evidence of focal perineural and lymphovascular invasion. No lobular neoplasia was identified.\n\nFibrocystic changes were present, including fibrosis and sclerosing adenosis. Immunohistochemical analysis showed positive estrogen and progesterone receptor status with Allred scores of 8 for both. HER2 immunohistochemistry was equivocal (2+ staining in 10% of tumor cells), and subsequent FISH testing did not demonstrate HER2 gene amplification.\n\nSentinel lymph node #1 contained metastatic disease in both lymph nodes present, with the largest deposit measuring 0.8 cm and showing focal extranodal extension. Sentinel lymph node #2 showed no evidence of metastasis. A total of 25 lymph nodes were identified in the axillary dissection specimen, all negative for metastatic disease. The pathological stage assigned was pT2 N1a."} +{"pid": "TCGA-A8-A084", "report": "The specimen shows a poorly differentiated invasive lesion with a tumor diameter measuring 3.5 cm. There is evidence of focally marked intraductal patterns of spread. Histologic classification indicates Grade III differentiation. Staging assessment reveals pT2 primary tumor size, with involvement of regional lymph nodes classified as N1a. No vascular invasion is identified. The surgical margins appear to be free of tumor involvement."} +{"pid": "TCGA-ZP-A9CV", "report": "The surgical pathology report includes specimens from the gallbladder, a segment of the liver (segment 5), and a liver biopsy from the junction of segments 2 and 3. The patient presented with liver lesions and gallstones. Fresh tissue from the liver segment was preserved for tissue banking.\n\nThe gallbladder specimen measured 9.0 x 5.5 x 1.3 cm and contained two black-green stones within the lumen, measuring 1.8 and 2.5 cm in greatest dimension. The gallbladder wall thickness ranged between 0.2 and 1.0 cm. Histological evaluation showed no evidence of malignancy, with intact mucosa and focal fibrosis in the wall. A small lymph node candidate adjacent to the cystic duct was also submitted for analysis.\n\nThe liver segment 5 specimen weighed 26.8 grams and measured 4.6 x 3.1 x 2.5 cm. A well-circumscribed green-tan lesion was identified, measuring 2.0 x 2.0 x 1.5 cm, and extended to the hepatic capsule. The lesion was located 0.5 cm from the closest resection margin marked with black ink. Microscopic examination revealed a proliferation of broad, trabeculated, polyhedral cells with oval, central nuclei, forming a distinct mass. No severe dysplasia or lymphovascular invasion was identified. The surrounding liver tissue exhibited marked fatty change and micronodular cirrhosis. Resection margins were free of abnormal cells.\n\nThe liver biopsy from the junction of segments 2 and 3 consisted of two cores measuring 1.1 and 2.0 cm in length. Histological analysis showed micronodular cirrhosis with a well-developed pattern of regenerative nodules. These nodules displayed severe macrovesicular steatosis, and there was no evidence of dysplasia or abnormal cell growth. Iron staining demonstrated 2+ siderosis.\n\nStaging for the liver segment 5 specimen was based on AJCC 7th edition criteria and classified as pT1 pNX pMX. This indicates a solitary tumor without vascular invasion, with inability to assess regional lymph nodes or distant metastasis. The parenchymal margin was uninvolved, with a distance of 0.5 cm from the tumor to the nearest margin."} +{"pid": "TCGA-B9-A5W7", "report": "The right kidney specimens were obtained via partial nephrectomy. Three distinct masses were identified. The first mass measured 1.5 cm in greatest dimension and was located in the anterior region of the right kidney. Histologic grade was 3, and the tumor was multifocal. Sarcomatoid features were not present. Microscopic evaluation showed that the mass was at least 1 mm from the blue inked margin, and the surgical margin was positive. No capsular or perirenal adipose invasion was observed.\n\nThe second mass was located in the posterior medial region of the right kidney and measured 3.8 cm. It was also grade 3. The tumor was multifocal without sarcomatoid differentiation. The mass was 0.1 cm from both the blue and black inked margins, but the surgical margin was negative. There was no evidence of capsular or perirenal adipose tissue invasion.\n\nThe third mass, located in the posterior lateral region of the right kidney, measured 2.5 cm and was grade 3. It was multifocal and lacked sarcomatoid features. The mass was 0.2 cm from the black inked resection margin, and the surgical margin was negative. Capsular or perirenal adipose invasion was not present.\n\nStaging was reported as prT1a, pNx. All specimens were derived from the right kidney, and each mass demonstrated distinct histologic features. No normal renal parenchyma was identified in one of the specimens. Hemorrhage and necrosis were noted in one mass, and fibroadipose tissue was attached to another. The surgical approach and margin status varied among the specimens."} +{"pid": "TCGA-HT-7604", "report": "The microscopic examination reveals a moderately hypercellular glial neoplasm with diffuse infiltration of the parenchyma. The lesion exhibits a prominent myxoid and microcystic pattern. The predominant tumor cells display morphology similar to fibrillary astrocytes, although minor populations of small gemistocytes and cells with perinuclear halos are also present. Cellular atypia is generally mild, with only a few scattered nuclei showing moderate atypia. No mitotic figures are identified. There is no evidence of microvascular proliferation or necrosis.\n\nIn the addendum, MIB-1 staining demonstrates highly variable proliferative activity within the tumor. In the most active regions, the labeling index reaches 10.4%. In these areas, occasional mitotic figures are observed that were not apparent on H&E sections. This level of proliferation is notably higher than typically seen in certain low-grade tumors. However, the overall histologic features do not meet criteria for a higher grade classification. Given the elevated proliferation rate, there may be early progression toward more aggressive behavior, and close clinical monitoring is recommended."} +{"pid": "TCGA-BA-A6DE", "report": "A biopsy of the posterior floor of mouth margin revealed benign squamous mucosa and submucosa without dysplasia or malignancy. Similarly, the anterior floor of mouth margin showed benign squamous mucosa and submucosa with no evidence of dysplasia or malignancy. The deep tongue margin and anterior deep margin biopsies both contained skeletal muscle without signs of invasive malignancy.\n\nLymph node dissections from various neck levels were examined. Right neck level 1B contained a salivary gland and one lymph node candidate, both without metastatic malignancy. Midline level 1A had four lymph node candidates, none showing metastasis. Left neck level 1B included a salivary gland and one lymph node, both negative for metastasis. Left levels 2B, 2A, 3, and 4 contained multiple lymph node candidates (ranging from 6 up to 9 nodes per level), all without evidence of metastatic involvement. Right neck level 2B had eight lymph node candidates, none positive for malignancy. Additional dissections from right levels 4, 2A, and 3 also showed no signs of metastatic disease.\n\nThe primary specimen, a partial glossectomy from the right side, measured 5.3 cm (anterior-posterior) \u00d7 4.7 cm (superior-inferior) \u00d7 1.7 cm (medial-lateral). Gross examination revealed an ulcerated lesion on the lateral tongue/floor of mouth measuring approximately 3.4 \u00d7 2.5 cm in diameter and 0.9 cm in depth. Microscopically, the lesion demonstrated moderately differentiated features without vascular or perineural invasion. Bone invasion was not applicable. Margins were negative, with closest distances ranging from 0.4 cm to 1.7 cm from various tumor edges.\n\nFrozen section analysis confirmed negative margins for malignancy at multiple sites including the posterior floor of mouth, anterior floor of mouth, deep tongue margin, and anterior deep margin. One fragment was noted as a floater with suspicious features possibly related to a prior case, though no definitive malignancy was identified.\n\nHistologic staging was determined as pT2 pNO pMx according to the AJCC system for oral cavity lesions. Ancillary studies, including P16 immunohistochemistry and high-risk HPV in situ hybridization, were performed on block M7 and returned negative results. These findings are based on available data and may be subject to revision pending further clinical evaluation."} +{"pid": "TCGA-VS-A9UJ", "report": "The cervix biopsy demonstrates a poorly differentiated and invasive neoplasm composed of squamous cells. The tumor infiltrates the underlying tissue and exhibits high-grade cytological features. No specific diagnosis is provided, but the findings are consistent with an advanced stage of cervical malignancy."} +{"pid": "TCGA-A3-3367", "report": "The surgical pathology report describes a left nephrectomy specimen weighing 800 grams, partially sectioned and surrounded by a large amount of perinephric adipose tissue. The specimen measures 26.2 x 11.6 x 8.9 cm upon reconstruction. The adrenal gland, located in the superior antral medial aspect, measures 7.2 x 5.0 x 1.6 cm and appears grossly unremarkable. A small 0.3 x 0.3 x 0.2 cm nodule of yellow-orange tissue is noted in the hilar adipose region, possibly representing a benign focus. Margins of resection include 1.9 cm of renal artery, 0.5 cm of renal vein, and 3.7 cm of ureter, all patent on gross examination.\n\nThe kidney itself measures 13.2 x 8.5 x 6.4 cm after removal of the capsule, which stripped with slight difficulty. The renal cortex is granular, lobulated, and red to brown in color. Two cystic structures are present: one measuring 1.8 cm in the cortex with a thin wall and smooth lining, and another 1.8 cm cyst on the anterior surface of the lower pole containing viscid gray-brown fluid. Adjacent to the lower pole cyst is a well-circumscribed nodular lesion measuring 4.9 x 4.4 x 3.9 cm. The lesion has a focally hyalinized and hemorrhagic gray-pink to yellow cut surface. It appears encapsulated, compressing surrounding parenchyma, and shows focal extension into adjacent vasculature but not beyond the renal plane or into surrounding fat.\n\nThe remaining renal parenchyma has a cortex up to 0.8 cm thick, homogeneously red-brown, with a well-defined cortical-medullary junction. The medulla is slightly hyalinized, tan-gray to brown, with distinct papillae. The calices and pelvis are lined with smooth gray-white mucosa extending into the ureter.\n\nMicroscopic evaluation reveals no involvement of the adrenal gland, hilar nodule, or resection margins. No lymphovascular or venous invasion is identified. The surrounding tissue shows findings consistent with chronic pyelonephritis, glomerulosclerosis, benign retention cysts, and nephrocalcinosis. Tissue sections were submitted from the lesion, surrounding areas, vascular/ureteral margins, normal parenchyma, adrenal gland, and hilar nodule. The final staging is pT1b, with no evidence of metastasis."} +{"pid": "TCGA-ZF-A9RL", "report": "Specimen: Bladder TURT. Clinical details: History of high-grade non-invasive bladder tumor. Current findings show two lesions \u2013 one papillary located at the bladder neck and another at the dome of the bladder. Macroscopy: Four tissue fragments received, with the largest measuring 6 mm. Microscopy: Only one specimen was received for analysis. The tissue is grade 3 and poorly differentiated. Growth pattern is papillary. Muscularis propria is present. Stromal invasion assessment shows fragmentation at the base of the tumor with individual cells appearing to invade the superficial lamina propria; this may be due to artifact, but early stromal invasion cannot be ruled out. No vascular channel invasion is identified. Background urothelium shows flat morphology without dysplasia. Summary: Bladder tissue with equivocal staging. Pathologists - Dr."} +{"pid": "TCGA-EY-A2ON", "report": "The specimen includes a resection of omental tissue measuring 15 cm x 16 cm x 7 cm with multiple tumor nodules, the largest being 11.5 cm in greatest dimension. The cut surface of these nodules is yellow and firm. Tumor involvement is present in both ovaries with foci measuring up to 5 mm, including surface involvement. Both fallopian tubes show tumor involvement on the serosal surface with detached fragments seen within the lumen but no epithelial involvement.\n\nIn the uterine specimen, tumor involvement is identified in both the anterior and posterior endometrium. Histologic evaluation reveals high-grade features with associated calcifications. The tumor extends through the myometrium into the outer half and reaches near the serosa in the uterine body, with involvement of the serosa in the posterior lower uterine segment. Involvement of the cervix is present, with microscopic foci identified in soft tissue attached to the posterior cervix. Vaginal margin distance measures 6 mm. Lymphovascular space invasion is present.\n\nMultiple benign leiomyomas are identified, with the largest measuring 3.2 cm. Additional findings include chronic cervicitis with reactive epithelial changes. Immunohistochemical staining for hormone receptors demonstrates weak positivity for estrogen receptor (10% staining, very weak intensity) and positivity for progesterone receptor (10%, 1\u20132+ intensity).\n\nStaging classification according to AJCC is pT3a pNx, with FIGO (2008 classification) staging provided based on available data at the time of reporting. Further clinical review may affect final staging."} +{"pid": "TCGA-B5-A0JS", "report": "The clinical specimen includes lymph node tissue and a uterus with bilateral adnexa. Gross examination of the left pelvic lymph node specimen, measuring 8 x 7 x 1 cm, revealed multiple lymph node candidates. Similarly, the right pelvic lymph node specimen, measuring 8.5 x 6.5 x 2.5 cm, also contained multiple lymph node candidates. Both specimens were sectioned and submitted for histologic evaluation.\n\nThe uterus weighed 167.4 grams and measured 8 x 7.5 x 5 cm. The endometrial cavity showed areas of heaped, shaggy pink-gray mucosa involving the anterior and posterior endometrium with measurements of 3.0 x 2.9 cm and 3.9 x 1.1 cm, respectively. There was evidence of involvement of the underlying myometrium. The remaining endometrial cavity measured 3.2 cm from cornu to cornu and 7 cm in length, with a 0.2 cm thick endometrium overlying a 2 cm mildly trabecular pink myometrium. The uterine serosa appeared smooth and glistening without adhesions. The cervical os was patent and measured 0 cm. The cervix was smooth and glistening on both ectocervical and endocervical surfaces.\n\nThe left adnexa included a tan-white ovary measuring 2.7 x 1.3 x 0.9 cm and a tan-pink fallopian tube measuring 6.7 x 0.5 cm. The fallopian tube contained multiple small paratubal cysts, with the largest measuring 0.6 cm. Sectioning of the ovary revealed an unremarkable tan-pink cut surface. The right adnexa consisted of a tan-white ovary measuring 2.3 x 1.7 x 1.7 cm and a similarly unremarkable fallopian tube ranging from 0.5 cm to 0.9 cm in diameter.\n\nMicroscopic evaluation revealed no malignancy in 18 lymph nodes from the left pelvic region or in 10 lymph nodes from the right pelvic region. In the uterus, histologic findings included well-differentiated cellular features within the endometrium. Two gross nodules measured 3.7 cm and 3.9 cm. The depth of involvement within the myometrium was challenging to assess due to extensive presence of adenomyosis. The maximum depth of involvement was noted at 0.7 cm within a 2.6 cm thick myometrium; however, most of the lesion was within the adenomyotic tissue, which is considered non-invasive. Small foci suggestive of deeper involvement were identified, though the overall depth of true involvement likely ranged between 0.1 and 0.3 cm. No lymphatic or vascular involvement was observed. Adjacent non-neoplastic endometrium demonstrated intraepithelial changes. Adenomyosis was present in the remaining myometrium. Margins of the specimen, cervix, serosa, ovaries, and fallopian tubes were free of involvement, except for the right fallopian tube lumen, where tumor was identified as free-floating.\n\nPathologic staging based on AJCC 6th Edition criteria was reported as pT1B pNO pMX. The surgical procedure included hysterectomy, bilateral salpingo-oophorectomy, and pelvic lymph node dissection."} +{"pid": "TCGA-DD-AADK", "report": "The specimen consists of two resected liver segments. Segment 3 contains a well-demarcated, pale tan, solid, and lobulated mass measuring 3.5 x 2.5 x 2.5 cm. The gross type is multinodular confluent with bulging but smooth extent. The resection margin is not involved with a safety margin of 1.1 cm. The cut surface shows homogeneity. Microscopically, the lesion exhibits trabecular and insular histologic patterns with hepatic cell type, fatty change, and septum formation. Vascular invasion is present, while surgical resection margin invasion, serosal invasion, portal vein invasion, and bile duct invasion are not seen. The nuclear grade for differentiation is moderately high.\n\nIn segment 7, there is an additional well-demarcated, homogenous, pale tan, solid mass measuring 0.9 x 0.8 x 0.8 cm. It also has a multinodular confluent appearance with bulging and smooth extent. The resection margin is uninvolved with a safety margin of 0.6 cm. Histologically, this lesion displays a trabecular pattern with hepatic cell type and fatty change. There is no evidence of fibrous capsule formation or septum formation. No invasion of the surgical resection margin, serosa, portal vein, vasculature, or bile duct is identified. The primary differentiation grade is moderate.\n\nCirrhosis is present in the remaining liver tissue along with mixed steatosis and mild changes. Representative sections from both masses and surrounding tissue have been submitted for analysis."} +{"pid": "TCGA-BJ-A0ZJ", "report": "The specimen consists of a total thyroidectomy measuring 22 grams. A tumor measuring 2.5 cm in the right lobe is well-circumscribed and demonstrates a predominantly follicular architecture with transcapsular invasion. In the left lobe, a second small focus of growth is identified measuring less than 1 cm. Chronic lymphocytic inflammation is present throughout the gland. One lymph node attached to the right and pyramidal lobes contains involved tissue, while no involvement is seen in five additional central compartment nodes. No extranodal extension is observed.\n\nHistologic evaluation shows that the larger lesion has features including nuclear changes and architectural disarray. Lymphovascular invasion is noted. The smaller lesion also demonstrates similar morphologic features. Surgical margins are free except for the left lobe microfocus which extends to the margin. No extrathyroidal spread is identified.\n\nStaging is as follows: primary tumor size greater than 2 cm without gross extrathyroidal extension (pT2), regional lymph node involvement with one positive node (pN1a). Distant metastasis is not applicable. Margins are negative except for the left lobe focus.\n\nMolecular testing was performed on microdissected tissue containing adequate tumor cellularity. Real-time PCR followed by melting curve analysis and Sanger sequencing did not detect mutations in BRAF V600E, NRAS codon 61, HRAS codon 61, or KRAS codons 12/13. FISH analysis for RET/PTC rearrangement was negative. A total of 60 cells were analyzed using fluorescence probes; only 4 cells (6.6%) showed any pattern suggestive of rearrangement, below the threshold for positivity.\n\nAdditional findings include lymphocytic thyroiditis and absence of identifiable parathyroid tissue within the specimen."} +{"pid": "TCGA-CG-4476", "report": "The specimen consists of a total gastrectomy preparation. A neoplastic lesion is present, extending to within 5 cm of the oral resection margin at its closest point, located along the lesser curvature. The lesion measures up to 3.5 cm in maximum diameter. Histological examination reveals a poorly differentiated adenocarcinoma. The tumor invades through all layers of the gastric wall, reaching the subserosa, and extends into the perigastric tissue as well as involving a small portion of adjacent pancreatic peripancreatic fatty tissue. Both the oral and aboral resection margins, as well as the omentum, are free of tumor. Metastatic involvement is identified in 12 out of 33 lymph nodes examined. Additional lymph nodes show only reactive changes. Vascular or lymphatic invasion is not identified. The staging is assessed as pT4 pN3a (12/33) with no evidence of vascular invasion."} +{"pid": "TCGA-FG-5964", "report": "The specimen consists of biopsies from the left parietal region of the brain, submitted as three separate samples. Sample A, received fresh, includes a single irregular tan-red tissue fragment measuring 1.1 x 0.9 x 0.2 cm. A touch imprint was performed and a portion was used for intraoperative frozen section analysis, with the remainder submitted in two cassettes for permanent sections. Sample B, received in formalin, contains multiple soft tissue fragments measuring 1.5 x 1.0 x 0.5 cm in total, described as light tan to focally red-brown, and submitted entirely in one cassette. Sample C, also in formalin, consists of multiple light tan to pink-tan fragments measuring 1.3 x 0.8 x 0.6 cm in aggregate, and submitted in one cassette.\n\nMicroscopic evaluation during intraoperative consultation revealed features consistent with a high-grade glioma. Subsequent fluorescence in situ hybridization studies demonstrated loss of genetic material involving chromosomes 1p and 19q. Cellular morphology and histologic features were assessed, with findings supporting a neoplastic process involving glial cells. The lesion exhibited characteristics suggestive of a diffuse infiltrative pattern within the brain parenchyma. Histologic grading was based on nuclear atypia, mitotic activity, and architectural disarray. No evidence of necrosis or microvascular proliferation was identified. Immunohistochemical staining supported the glial lineage of the lesion. Final staging incorporated histologic grade and extent of resection."} +{"pid": "TCGA-D1-A176", "report": "A hysterectomy and bilateral salpingo-oophorectomy specimen included a polypoid mass measuring 4.7 x 3.2 x 1.7 cm located in the posterior and right lateral wall of the uterine cavity. Microscopic evaluation showed that the lesion extended 0.3 cm into the myometrium, with a total myometrial thickness of 2.3 cm. There was no involvement of the endocervix, and no lymphovascular space invasion was identified. All surgical margins were free of abnormal cellular activity. An incidental intramural leiomyoma measuring 0.4 cm was noted within the myometrium. The posterior uterine serosa and cul-de-sac showed findings consistent with endometriosis.\n\nThe bilateral ovaries and fallopian tubes did not demonstrate any pathological abnormalities. Examination of pelvic and para-aortic lymph nodes revealed no evidence of tumor involvement. Specifically, 7 external iliac, 7 internal iliac, 6 common iliac, and 12 obturator lymph nodes were assessed on the right pelvic side; all were unremarkable. Similarly, 8 external iliac, 2 internal iliac, 3 common iliac, and 12 obturator lymph nodes from the left pelvic region were negative for tumor involvement. In addition, 11 right and 12 left para-aortic lymph nodes above the inferior mesenteric artery, along with 5 right and 5 left para-aortic lymph nodes below the inferior mesenteric artery, were devoid of tumor cells. Both right and left gonadal vessels were also free of malignant involvement.\n\nGross examination of the uterus showed focal adhesions on the posterior serosa and cul-de-sac suggestive of endometriosis. The right ovary measured 2.7 x 1.8 x 1.2 cm with a solid cut surface, while the left ovary measured 3.3 x 1.4 x 1.0 cm and similarly presented with a solid cut surface. All tissue samples were adequately submitted for histological evaluation."} +{"pid": "TCGA-FI-A2D6", "report": "The specimen consists of a uterus, cervix, bilateral fallopian tubes, and ovaries following hysterectomy and bilateral salpingo-oophorectomy. The uterus weighed 162.75 grams and measured 10 x 8 x 4 cm. An exophytic red-tan partially necrotic mass measuring 5 x 4 cm was identified in the endometrial cavity. The tumor appears to invade into the outer portion of the myometrium, with invasion measuring 17 mm out of a total myometrial thickness of 23 mm. Lymphovascular space invasion is present.\n\nMicroscopic evaluation reveals areas of moderately differentiated adenocarcinoma adjacent to an undifferentiated component comprising most of the tumor. Focal regions demonstrate neuroendocrine and neuroectodermal morphology. Immunostaining shows limited positivity for synaptophysin and CD99, with diffuse staining for NSE. Chromogranin, neurofilaments, and cytokeratin 5/6 stains are negative. These findings suggest but do not definitively confirm neuroendocrine or neuroectodermal differentiation.\n\nNo evidence of malignancy is identified in the cervix, bilateral ovaries, or bilateral fallopian tubes. The tumor margin is 0.4 cm from the outer surface. Histologic sections include multiple levels of the endomyometrium and adnexal regions.\n\nStaging assessment indicates tumor invasion into one-half or more of the myometrium (T1c). Lymph node and distant metastasis status cannot be assessed. Based on available data, the provisional pathologic stage is T1c/NX/MX. Clinical correlation may affect final staging."} +{"pid": "TCGA-B6-A0RI", "report": "The surgical specimen includes a Tru-cut breast biopsy, which consists of a 1 cm x 0.1 cm tan piece of breast tissue and two smaller remnants measuring 0.8 x 0.1 x 0.1 cm and 0.7 x 0.1 x 0.1 cm. These were submitted entirely for analysis.\n\nA second specimen from the right breast includes an ellipse of skin with a central nipple, measuring 11.5 x 4 cm. The underlying breast tissue measures 15 x 11 x 2 cm, with an attached axillary tail measuring 7.8 x 3.5 cm. The deep surgical margin was inked blue, while lateral margins were inked black. Upon sectioning, a firm mass measuring 1.5 x 2.8 x 1.0 cm was identified in the upper outer quadrant, showing radial retraction of adjacent tissue and located approximately 0.2 cm from the deep surgical margin. Other areas of the breast parenchyma appeared unremarkable.\n\nSections closest to the deep surgical margin were submitted in Blocks B1 through B4. Additional sections included sampling from all quadrants of the breast (Blocks B5\u2013B10). The axillary tail was dissected and sections submitted from different zones; lymph nodes were evaluated across Zones 2 and 3 (Blocks B13\u2013B16). Zone 1 did not show definite lymph nodes.\n\nHistologic evaluation revealed cellular features consistent with moderately differentiated morphology and presence of vascular invasion. One out of two lymph nodes assessed in Zone 2 contained involvement, while six out of fifteen lymph nodes overall showed evidence of metastatic involvement."} +{"pid": "TCGA-YL-A8SO", "report": "The radical prostatectomy specimen demonstrates a histologic pattern characterized by acinar glandular architecture with a GleASON score of 4 + 5 = 9. The tumor is located at the apex, anteriorly, and involves both right and left posterior regions. There is evidence of non-focal extension beyond the prostatic capsule, involving the anterior and left posterior aspects. No invasion of the seminal vesicles is identified. Surgical margins are involved by invasive carcinoma, specifically in the anterior left region; however, the nature, extent, and Gleason composition of the positive margins are not specified. Other features such as lymphovascular or perineural invasion, tumor volume, and treatment effect could not be assessed based on the current report. No lymph nodes were submitted for evaluation. Pathologic staging is determined to be pT3a with pNX and pMX classification."} +{"pid": "TCGA-AO-A0JA", "report": "The right breast specimen revealed two distinct lesions. The first lesion measured 3.6 cm in greatest dimension and was located in the upper inner quadrant at 1:00. Histologic evaluation demonstrated moderate tubule formation with nuclear grade II/III features, characterized by moderate variation in nuclear size and shape. A second lesion, measuring 2.5 cm, was identified in the lower inner quadrant. Both lesions displayed a mix of invasive and in situ components. The in situ elements were classified as ductal carcinoma in situ (DCIS), with micropapillary and solid/cribriform growth patterns, respectively. Intermediate nuclear grading was noted for both DCIS components, with minimal necrosis in the first lesion and moderate necrosis in the second. In both cases, the in situ component constituted \u226425% of the total tumor mass and was intermixed with the invasive portion.\n\nVascular invasion was identified in both lesions, with extensive vascular invasion present in the first. Surgical margins were free of involvement by either invasive or in situ components. The distance from the invasive component to the deep margin was 3.3 cm for the first lesion and 4.5 cm for the second.\n\nAxillary lymph node assessment included sentinel, Rotter's, and additional level I, II, and III nodes. Metastatic involvement was identified in multiple lymph node sites on the right side, including sentinel nodes, Rotter\u2019s node, and additional level I, II, and III nodes. Involvement ranged from small clusters of tumor cells (<0.2 mm) to larger deposits (up to 1.2 cm). Extracapsular extension was present in several nodes, including in the metastatic focus measuring 1.2 cm. On the left side, all examined sentinel lymph nodes were negative.\n\nNon-neoplastic breast tissue showed benign changes including usual ductal hyperplasia, papillary apocrine hyperplasia, columnar cell change, and cysts. No significant findings were identified in the contralateral breast. Immunohistochemical staining showed variable expression of estrogen and progesterone receptors across the two lesions, with no HER2 overexpression detected."} +{"pid": "TCGA-BJ-A28W", "report": "The thyroid specimen weighed 45 grams and showed two distinct nodules. The larger nodule measured 3.0 cm and was located in the right lobe. It exhibited well-defined borders and predominantly follicular architecture. A second, smaller nodule measuring 0.8 cm was identified in the left lobe, displaying a tall cell morphology. All identified nodules were confined within the thyroid gland without evidence of angiolymphatic invasion. Four lymph nodes were retrieved from the central compartment and none contained tumor cells. Chronic lymphocytic thyroiditis was also noted in the background thyroid tissue. The surgical margins were free of involvement. No extrathyroidal extension or lymphovascular invasion was observed. A total of four regional lymph nodes were examined, all negative for tumor."} +{"pid": "TCGA-2Z-A9JE", "report": "The pathology report includes findings from four specimens. \n\n**Specimen A** (\"Skin lesion x3 right flank\") consists of three lesions on an ellipse of skin measuring 4.5 x 1 cm. Lesions range from 0.2 to 0.6 cm in greatest dimension. Histologic evaluation reveals two lesions with features consistent with seborrheic keratosis, both involving the inked surgical margin. A third lesion shows lichenoid changes and is completely excised. \n\n**Specimen B** (\"Right kidney biopsy\") consists of a small tissue fragment measuring 0.7 x 0.5 x 0.2 cm. Microscopic examination shows fibroconnective tissue with atrophic renal tubules and focal mild chronic inflammation. No malignant cells are identified. \n\n**Specimen C** (\"Right renal mass\") is a hemispherectomy specimen measuring 6 x 5 x 4.5 cm. The main lesion is a well-circumscribed mass measuring 4 x 3.5 x 3.3 cm with yellow-brown and necrotic areas. Histologically, it exhibits papillary architecture with nuclear features corresponding to Fuhrman nuclear grade 2 of 4. The surgical margin is free of tumor involvement. Adjacent kidney tissue demonstrates glomerulosclerosis, tubular atrophy, and mild chronic inflammation. Two small incidental nodules, each less than 1 mm, are also present within the kidney and interpreted as benign. A portion of adrenal gland is identified and appears structurally intact without pathological changes. \n\n**Specimen D** (\"Right adrenal gland\") is a soft yellow-tan tissue weighing 14.1 grams. Grossly, it contains a hemorrhagic focus measuring 3.5 x 2 x 1 cm. Histologic sections show adrenal tissue with hemorrhage but no evidence of malignancy or architectural distortion. \n\nAll surgical margins for the renal mass are free of tumor. There is no invasion through the renal capsule or into Gerota\u2019s fascia. Renal vein involvement is not observed. Lymph nodes were not assessed. The non-neoplastic kidney tissue shows chronic changes including glomerulosclerosis and tubular atrophy. Based on these findings, the stage assigned is pT1aNXMX."} +{"pid": "TCGA-CV-7418", "report": "The specimen consists of a total laryngectomy, partial pharyngectomy, thyroidectomy (left lateral), and neck dissection. A representative section of the thyroid cartilage was examined in sections A41 and A42, and a representative section of the hyoid bone in A43. The primary lesion measured 4.0 x 3.5 x 2.0 cm and originated in the left pyriform sinus. Extension was noted into the left aryepiglottic fold, pre-epiglottic space, and subepithelial connective tissue of the left true vocal cord. Focal involvement reached the subepithelial connective tissue at the left inferior lateral pyriform sinus margin of resection. All other margins, including tracheal, soft tissue, and mucosal margins, were free of disease. No tumor was identified in the left thyroid lobe or in four perithyroidal lymph nodes. Metastatic cells were detected in two out of twenty-six cervical lymph nodes: one in the subdigastic region (1/8) and one in the lower jugular region (1/11). Sections from the tumor and adjacent thyroid cartilage, as well as the hyoid bone, required decalcification and were not fully assessed at the time of reporting; a follow-up report will be issued upon completion."} +{"pid": "TCGA-DU-8158", "report": "A 3.5 x 2.2 x 1.8 cm firm, homogeneously glistening and tannish-gray brain specimen with focal areas of hemorrhage was received, along with two other fragments measuring 1.1 cm and 1.3 cm. Microscopic examination revealed a glial neoplastic proliferation diffusely infiltrating the brain parenchyma, including the cerebral cortex and white matter. The cells exhibited round or ovoid nuclei with prominent nucleoli, and the background showed heavy fibrillary content with capillary-type vasculature. Mitotic figures, microvascular proliferation, and necrosis were noted in some regions. In more cellular areas, the nuclei were hyperchromatic and moderately pleomorphic, with a gemistocytic phenotype present. A sparse lymphoid infiltrate was observed, particularly around some blood vessels. In less cellular regions, the nuclear atypia remained but mitotic activity was minimal, and microvascular proliferation and necrosis were absent. Immunohistochemistry showed strong GFAP positivity, indicating significant gliofibrillogenesis. Proliferation indices measured between 2% and 3% in the most active areas. Morphological features included focal hypercellularity, nuclear anaplasia, and low proliferative activity, suggesting a transformation from a lower-grade glial neoplasm."} +{"pid": "TCGA-VF-A8A9", "report": "The surgical pathology report describes a right orchiectomy specimen from a male patient with a right testicular mass. The specimen includes a testis measuring 5.2 x 4.9 x 2.4 cm and a spermatic cord measuring 8.3 cm in length. A firm, white-tan mass measuring 2.4 x 2.0 x 1.9 cm was identified within the testis. The mass did not grossly involve the epididymis or rete testis. A separate cystic structure measuring 1.6 cm in greatest dimension was noted at the inferior aspect of the testis; it had a smooth lining and contained clear fluid.\n\nMicroscopic evaluation revealed a neoplastic lesion involving the rete testis with lymphovascular invasion present. There was no invasion into the tunica vaginalis or epididymis. The spermatic cord margin was free of tumor. Additional findings included intratubular germ cell neoplasia and focal Leydig cell hyperplasia. A benign-appearing epididymal cyst measuring 1.6 cm was also present.\n\nSections of the tumor were submitted entirely for examination, along with representative sections of non-involved testicular tissue and other structures. The clinical history and pre- and post-operative diagnoses were not specified. The procedure was performed via an inguinal approach. No specific questions were outlined for evaluation."} +{"pid": "TCGA-B4-5838", "report": "The specimen was obtained from the left kidney and submitted as a primary tissue sample. The tumor tissue weighed 350 mg and was preserved in a cryomold. A separate blood sample was collected, amounting to 4 mL, and stored in a frozen tube. Histological evaluation showed a cellular composition with approximately 70% tumor content. The tumor measured 2 cm in greatest dimension. Histologic grade was determined to be moderately differentiated. No lymph node involvement or distant metastasis was identified. The tissue was processed fresh without prior hormonal therapy or radiation. Additional chemotherapy details were not available."} +{"pid": "TCGA-22-4595", "report": "The submitted specimen includes a left lower lobe lung measuring 330 grams and 17 x 17 x 6 cm, along with a portion of the left lingula measuring 8.5 x 4.5 x 2.2 cm. Several lymph node groups were also excised, including aortic (aortopulmonary), inferior mediastinal (subcarinal, inferior pulmonary ligament), and left fissure lymph nodes.\n\nA mass measuring 6 cm in greatest dimension is identified in the left lower lobe. The lesion extends through the pleura and involves the adjacent mediastinal fat. All margins of resection, including the bronchial margin, show no evidence of tumor involvement.\n\nEvaluation of lymph nodes reveals involvement by malignant cells in multiple lymph nodes. Among the intrapulmonary peribronchial lymph nodes, 5 out of 6 are involved. In the inferior mediastinal region, 1 of 3 subcarinal and 1 of 3 inferior pulmonary ligament lymph nodes contain malignant cells. The aortic lymph nodes (3 aortopulmonary) and a single left fissure lymph node do not show any malignant involvement.\n\nThe excised lingula demonstrates normal lung parenchyma without significant pathological findings."} +{"pid": "TCGA-V5-A7RE", "report": "The specimen consists of endoscopic biopsies from an esophageal ulcer and an esophageal polyp. The ulcer biopsy shows fragments of a neoplastic lesion with areas of ulceration. Microscopic evaluation reveals invasion into the lamina propria; however, there is no definitive evidence of submucosal involvement in this sample. The polyp biopsy demonstrates Barrett\u2019s esophagus with high-grade dysplasia. The findings suggest early-stage disease, though further correlation with endoscopic assessment is recommended. A total of two slides were reviewed from an outside case, and all evaluations were performed by the certifying pathologist."} +{"pid": "TCGA-BH-A0BJ", "report": "The specimen from a left breast segmental mastectomy shows a moderately differentiated cellular proliferation. The tumor measures 2.5 cm in greatest dimension. Histologic evaluation reveals a tubule formation score of 2, nuclear grade of 2, and mitotic activity score of 2, resulting in an overall Nottingham histologic score of 6 out of 9 (Grade 2). No lymphovascular invasion is identified. A component of in-situ proliferation with solid and cribriform patterns is present, comprising approximately 25% of the total lesion and occurring in association with the invasive component. All margins of resection are free of both in-situ and invasive disease; however, the closest posterior margin is noted to be 1 mm away from the tumor. Additional findings include fibrocystic changes, ductal epithelial hyperplasia, columnar cell hyperplasia, atypical ductal hyperplasia, sclerosing adenosis, and prior biopsy site changes. Immunohistochemical staining demonstrates positivity for estrogen and progesterone receptors, while HER-2/neu staining shows weak reactivity without amplification. Evaluation of the lateral margin excision reveals no evidence of in-situ or invasive disease, with similar benign changes noted. Sentinel lymph node biopsies reveal one positive lymph node out of five examined, containing a metastatic deposit measuring 1 cm with extracapsular extension identified. The remaining lymph nodes show only benign features. Based on these findings, the pathologic staging reflects a T stage of pT2 and an N stage of pN1."} +{"pid": "TCGA-C5-A7X8", "report": "Surgical pathology evaluation was performed on biopsy specimens from the cervix and endocervical canal. The superior and inferior cervical biopsies both show invasive adenocarcinoma, moderately differentiated. The tumor exhibits extensive involvement with areas showing large nests of cells having moderate pleomorphism, abundant mucinous cytoplasm, and a high mitotic rate. These features are present across multiple sections from the larger biopsies. Several margins are affected, including inked and cauterized edges. Additionally, detached fragments of adenocarcinoma are identified in the endocervical canal biopsy. Morphologic assessment is partially limited due to cautery artifact; however, viable tumor regions display consistent features across all sampled sites."} +{"pid": "TCGA-VR-A8EP", "report": "The specimen consists of esophagus and proximal stomach obtained via esophagogastrectomy. The tumor is located in the mid third of the esophagus and measures 6.2 cm in greatest dimension. Histologic evaluation shows poorly differentiated morphology with invasion through the muscularis propria into the periesophageal fat tissue. Lymph-vascular and perineural invasion are present. Surgical margins are free of malignant involvement.\n\nExamination of the gastric mucosa reveals moderate chronic gastritis with lymphoid follicular hyperplasia; no carcinoma is identified. The esophageal segment demonstrates normal morphologic features without evidence of neoplasia.\n\nLymph node assessment includes 15 periesophageal nodes, of which 3 contain metastatic involvement without capsular extension; 11 perigastric nodes include 1 positive for metastasis, also without capsular involvement. One additional regional lymph node was examined and showed no evidence of tumor. The esophageal margin is uninvolved by malignancy."} +{"pid": "TCGA-BH-A209", "report": "The submitted specimen from the left breast segmental mastectomy includes a firm mass measuring 2.0 \u00d7 2.0 \u00d7 1.5 cm, located 0.3 cm from the anterior margin. Microscopic evaluation reveals a poorly nuclear graded infiltrating lesion with a lymphocytic component. The tumor measures 2.0 cm in greatest dimension and does not involve the surgical margins. No angiolymphatic or perineural invasion is identified. Axillary lymph node dissection yielded twelve (12) lymph nodes, all free of tumor involvement. Estrogen and progesterone receptor status was assessed."} +{"pid": "TCGA-DU-7011", "report": "The surgical specimens were obtained from multiple regions of the brain, including the right temporal and right frontal lobes, as well as an area of enhancement. Gross examination revealed several tissue fragments ranging in size from 1.0 cm to 2.2 cm. The tissues were described as tan-gray to brownish-red, with areas of softness and focal hemorrhage.\n\nMicroscopic evaluation showed a neoplastic glial proliferation present in all specimens. The tumor cells exhibited uniform hyperchromatic nuclei, either rounded or elongated, and were diffusely distributed within a rarefied cerebral parenchyma. There was a consistent presence of astrocytic proliferation with plump, star-like cytoplasmic morphology. In some areas, particularly in the region associated with enhancement, the tumor appeared more cellular and demonstrated infiltration into the cerebral cortex with perineuronal satellitosis. Focal effacement of the cortical architecture was noted, along with a loose, scant fibrillary background suggestive of microcystic change.\n\nVascular abnormalities were observed in one specimen, including mild endothelial hyperplasia. However, no mitotic figures, microvascular proliferation, or necrotic areas were identified across any of the samples. Immunohistochemical staining for GFAP highlighted a diffuse infiltration of astrocytes with prominent cytoplasmic processes. The MIB-1 labeling index ranged from 1.5% to 2.0% in the more cellular regions.\n\nAll specimens displayed similar histological features, characterized by a low-grade glial neoplasm with diffuse infiltration, absence of high-grade anaplastic features, and variable architectural disruption depending on the site of origin."} +{"pid": "TCGA-EM-A22K", "report": "The specimen was received from a total thyroidectomy with neck dissection. The thyroid measured 3.6 cm x 1.8 cm x 1.0 cm on the right lobe and 3.0 cm x 1.0 cm x 0.9 cm on the left lobe, with an isthmus measuring 2.5 cm x 0.9 cm x 0.6 cm. The attached level 6 neck dissection measured 3.5 cm x 1.5 cm x 0.6 cm. Multiple nodules were identified: two in the right lobe measuring 0.6 cm and 0.7 cm x 0.9 cm x 0.6 cm, and one in the left lobe measuring 1.1 cm x 0.8 cm x 0.5 cm. An adherent nodule on the left lobe measured 2.2 cm x 1.0 cm x 0.5 cm and was partially calcified. No parathyroid glands were identified grossly.\n\nHistologically, multiple foci of cellular proliferation were observed with features including classical papillary architecture, follicular architecture, and columnar cell morphology. The dominant focus measured 1.1 cm and showed involvement of surgical margins. It was partially encapsulated with minimal capsular invasion and no lymphovascular or perineural invasion. A second focus in the right lobe measured 0.9 cm and displayed follicular variant features; surgical margins were uninvolved. Additional microscopic proliferative elements were noted in both lobes, ranging from 0.1 cm to 0.6 cm.\n\nLymph node evaluation included level 6 neck dissection with 4 lymph nodes identified, and a separate level 2\u20135 left neck dissection containing 79 lymph nodes. Involvement was identified in 1 of 2 lymph nodes from the left perithyroidal region, 3 of 4 from level 6, and 5 of 75 from levels 2\u20135. No extranodal extension was observed. The specimen weight was 12.8 g, and all surgical margins were assessed. Sections from all nodules and representative normal tissue were submitted for analysis.\n\nA separate excisional biopsy from the left parathyroid region revealed similar proliferative features within a 0.5 x 0.4 x 0.3 cm tissue fragment. No definitive parathyroid tissue was identified in this specimen.\n\nStaging parameters indicated tumor confined to the thyroid with multiple intraglandular foci. Regional lymph node involvement was present unilaterally. A total of 83 lymph nodes were examined, with 10 showing evidence of involvement. No distant metastatic spread was identified. Additional findings included nodular hyperplasia and adenomatoid changes."} +{"pid": "TCGA-G4-6315", "report": "The specimen consists of a resected segment of the left colon measuring 28 cm in length with an external circumference of 8.2 cm. The serosal surface contains multiple adhesions and a firm nodule measuring 11 x 8.5 x 6 cm. The surgical specimen was opened to reveal an annular, indurated, ulcerated mass with irregular borders measuring 10.7 x 8.5 x 6 cm. This lesion is necrotic and extends through the muscularis propria into the mesocolonic fat. It is located 8 to 10 cm from the surgical margins and approximately 2.5 cm from another pedunculated polyp measuring 4.5 x 3.7 x 3 cm. The surrounding mucosa contains multiple small polyps ranging from 0.1 to 0.3 cm in size.\n\nHistologic examination reveals a lesion with infiltration through the muscularis propria into the subserosa. There is extensive intramural suppurative necrosis and evidence of perineural invasion. A separate tubulovillous adenoma with focal high-grade dysplasia is identified. Multiple hyperplastic polyps are also present. Surgical margins are negative for invasive disease.\n\nLymph node evaluation includes a total of 82 lymph nodes, one of which contains metastatic involvement. No venous or lymphatic invasion is identified. There is no extranodal extension or implants. The histologic grade is moderately differentiated. The extent of resection is complete with no residual tumor at the margins microscopically. The pathological staging is pT3 N1."} +{"pid": "TCGA-EI-6882", "report": "A histopathological examination was performed on a segment of the large intestine measuring 21 cm in length, which included 3 cm of mesorectal tissue. A cauliflower-shaped lesion was identified in the mucosa, measuring 5.7 x 5.2 x 1 cm. The lesion involved approximately 90% of the intestinal circumference and was located 13.5 cm from the proximal resection margin and 2.1 cm from the distal margin. The minimum surgical margin was 3 cm.\n\nMicroscopic evaluation revealed a tubulopapillary and partially mucinous growth pattern with high-grade cellular atypia. There was evidence of infiltration into the muscularis propria and perirectal fat. No neoplastic involvement was identified at the resection margins. Lymph node assessment showed reactive changes without evidence of metastatic disease.\n\nStaging parameters indicated pT3, pN0, R0. The lesion demonstrated features consistent with Dukes B and Astler-Coller B2 classifications."} +{"pid": "TCGA-55-8097", "report": "The specimen consists of four parts. A lymph node specimen labeled as level 10 includes tissue measuring 2.0 x 1.0 x 0.4 cm with a shaggy gray-pink to brown-black appearance. It contains staple lines, and as much tissue as possible away from the staple line has been submitted for analysis. The right upper lobe pulmonary specimen weighs 150 grams and measures 14.7 x 9.6 x 2.8 cm. Within this specimen, two cassettes were identified. The resection margin includes stapled tertiary bronchi surrounded by gray-black fleshy nodules up to 1.0 cm in size. The pleura appears smooth and tan-pink with moderate anthracotic streaking. On the medial aspect of the apex, there is a previously sectioned area measuring 2.0 x 1.5 x 1.5 cm with slight induration and umbilication. Beneath this region, a plaque-like lesion measuring 1.7 x 1.6 x 0.9 cm is identified. It has a consolidated gray-tan appearance with a chalky tan-gray to pink cut surface. This lesion is located 4.8 cm from the bronchial margin and extends close to the pleura but does not penetrate through it. No distinct gross bronchial connection is observed. The remaining parenchyma appears spongy and tan-pink with focal anthracotic streaking; no other lesions are noted. Representative sections include A - shaved bronchial margin and peribronchial nodules; B-E - lesion and surrounding tissue; F - uninvolved parenchyma. Additional lymph node specimens include level 9 measuring 1.0 x 0.7 x 0.6 cm and level 11 measuring 1.7 x 0.8 x 0.4 cm, both submitted entirely for examination.\n\nMicroscopic evaluation reveals multiple fragments of benign lymph nodes without evidence of malignant cells in sections examined. The lesion demonstrates intact specimen integrity and originates from the right upper lobe. Histologic features show moderately differentiated cellular morphology with unifocal distribution. The lesion measures 2.0 x 1.5 x 1.5 cm and is located at the medial aspect of the apex within the lung parenchyma. There is no definitive extension into the elastic layer of the visceral pleura despite proximity to the pleural surface (less than 1 mm distance). No unequivocal lymphovascular space invasion is observed. Surgical margins indicate the lesion is 4.8 cm from the bronchial margin. Evaluation of lymph nodes reveals three peribronchial lymph nodes negative for malignancy. Additional lymph nodes at levels 9 and 11 also show benign characteristics without metastatic involvement. Calcified granulomata are present, though no acid-fast or fungal organisms are identified. Emphysematous changes are noted within the pulmonary tissue. Staging assessment indicates localized involvement confined to the lung parenchyma with no regional lymph node involvement. Sections demonstrate cellular features suggestive of fibrosis and morphologic patterns requiring clinical correlation for further classification."} +{"pid": "TCGA-DX-A6BA", "report": "The radical resection specimen includes a large soft tissue mass measuring 28 x 22 x 12 cm, along with segments of small bowel, colon, and ureter. The mass is encapsulated and has a nodular appearance with a tan-white trabeculated cut surface. Focal necrosis is present, involving less than 10% of the tumor by gross assessment and 15% microscopically. Hemorrhagic areas and multiple cystic spaces are also noted. Microscopic evaluation reveals high-grade cellular morphology with a mitotic index of 28 mitoses per 10 high-power fields. Surgical margins of the tumor, ureter, small bowel, and colon are all uninvolved. Adjacent small bowel and sigmoid colon segments show no malignant involvement and appear histologically benign. A segment of distal small bowel demonstrates endometriosis but no malignancy. The left broad ligament specimen contains benign ovarian and fallopian tube tissue. Immunohistochemical staining shows positivity for SMA and desmin, supporting the morphologic findings. No tumor involvement is identified at any of the surgical margins. Multiple sections from various sites have been evaluated and submitted for further analysis."} +{"pid": "TCGA-D8-A27R", "report": "Histopathological examination was performed on a total organ resection of the right breast with axillary tissues. The right breast measured 14.4 x 11.2 x 4.2 cm and weighed 330 g. Axillary tissues measured 8 x 5 x 2 cm, and a skin flap measured 12.2 x 8.8 cm. A lesion measuring 3.2 x 2.3 x 2.6 cm was identified at the boundary of the upper quadrants, located 1.6 cm from the upper boundary, 0.5 cm from the base, and 1.2 cm from the skin.\n\nMicroscopic evaluation revealed a high-grade cellular proliferation with a histological score of NHG3 (3 + 3 + 3). Mitotic activity was notable at 20 mitoses per 10 high-power fields within a visual area of 0.55 mm. Extensive in situ components were observed within the lesion, characterized by solid-type growth, significant nuclear atypia, comedo necrosis, and calcifications, comprising approximately 20% of the lesion volume. There was extensive vascular invasion and evidence of tumor emboli in the mammary vessels. The surrounding glandular tissue appeared structurally normal. In situ lesions were found to be excised with a margin of 0.1 cm at the base.\n\nExamination of axillary lymph nodes revealed multiple sites of involvement with associated perinodal tissue infiltration and vascular tumor emboli.\n\nImmunohistochemical analysis showed strong expression of estrogen receptors in more than 75% of neoplastic nuclei. Progesterone receptors were detected in 10\u201375% of neoplastic nuclei. HER2 staining yielded a score of 2+, for which fluorescence in situ hybridization testing is recommended for further clarification."} +{"pid": "TCGA-DD-AAVP", "report": "The specimen consists of an extended left hemihepatectomy. A mass was identified in the caudate lobe measuring 5.0 x 4.0 x 3.4 cm. The gross appearance is nodular with perinodal extension. There is no satellite nodule present. Histologically, the lesion demonstrates a microtrabecular pattern with cirrhotomimetic cells. The Edmondson and Steiner grading system indicates the worst differentiation as grade 2, while the major differentiation is grade 1. No fatty change or hemorrhage/peliosis is observed. Necrosis is present, involving approximately 30% of the lesion. Microscopic vascular invasion is absent. The tumor has a partially formed capsule with evidence of capsular infiltration. There is no septal formation or invasion of major branches of the portal or hepatic veins, nor bile duct or serosal invasion. Surgical margins are negative with a safety margin of 0.5 cm. There is no intrahepatic metastasis or multicentric occurrence. Pathologic staging corresponds to AJCC (pT2). Additional findings include active cirrhosis without chronic hepatitis or dysplasia. The gallbladder shows no diagnostic abnormalities."} +{"pid": "TCGA-MU-A51Y", "report": "The surgical specimen included a radical hysterectomy with bilateral salpingectomy and removal of multiple lymph node groups. The lymph nodes were evaluated from both the right and left pelvic regions, with a total of 27 lymph nodes examined across all specimens; none showed evidence of malignancy. The primary resected lesion was located in the cervix and measured 2.9 x 2.3 x 1.4 cm, involving approximately 80% of the cervical circumference. Histologically, the lesion demonstrated invasive cellular growth with features consistent with a moderately differentiated pattern. The tumor extended focally into the surrounding soft tissue and exhibited lymphovascular space invasion. The depth of invasion measured 1.8 cm in a resection thickness of 2.1 cm. All resection margins, including the vaginal cuff, were free of abnormal cells. The endometrium showed a proliferative pattern, and the myometrium contained areas of adenomyosis. No abnormalities were found in the fallopian tubes. Staging was based on the absence of lymph node involvement and the extent of local invasion, with no evidence of distant spread. All margins of resection were uninvolved by invasive disease. A total of 27 lymph nodes were examined, with none showing signs of involvement."} +{"pid": "TCGA-F1-A72C", "report": "The distal portion of the stomach was resected following a prior gastrojejunostomy. A mass measuring 5.9 x 3.6 x 2.4 cm was identified grossly, located in close proximity to the surgical anastomosis site. The mass is firm and fungating with heaped borders and central ulceration. On sectioning, it appears tan/white, firm, and smooth, with infiltrative growth extending into subserosal soft tissues. There is no involvement of the visceral peritoneum.\n\nMicroscopically, the tumor shows moderately differentiated features. Lymphovascular and perineural invasion are focally present. All surgical margins are free of tumor involvement, with the closest margin measuring 1.3 cm from the proximal small bowel margin. A total of 13 lymph nodes were examined across specimens A and C, and none showed evidence of tumor involvement. No extranodal extension or nodal metastasis was identified.\n\nAdditional findings include chronic active gastritis and intestinal metaplasia. An intact surgical anastomosis with multifocal suture granulomata is also noted. A separate specimen of omentum showed no abnormality, and regional lymph nodes from the left gastric area were also negative for tumor.\n\nStaging based on this specimen is pT3 pN0. However, this may be incomplete and should be reviewed in the context of all available clinical data to determine final staging. Intraoperative frozen section confirmed the absence of tumor at the proximal gastric margin, which was consistent with the final histologic evaluation. Multiple blocks were submitted for histologic analysis, including sections of the tumor, surrounding normal tissue, and lymph node regions."} +{"pid": "TCGA-A2-A0YF", "report": "The specimen was received as a surgical pathology submission. Part A consisted of left breast tissue from a reduction mammoplasty, weighing 643.5 grams. The tissue included fibrofatty and skin components submitted in two pieces, one including areolar-type tissue. Gross examination revealed bland yellow fatty tissue with fine fibrous bands. No areas of myelofibrosis or mass were identified. Sections were taken from various regions including the superior skin margin, medial and lateral aspects.\n\nPart B consisted of a right simple mastectomy specimen measuring 21 x 21.5 x 6.6 cm. The nipple appeared unremarkable. A 21.2 x 12.5 cm skin ellipse was noted, with a suture marking the 12 o\u2019clock position. The superficial margin was inked blue, and the deep margin black. A well-healed scar measuring 5.0 cm was present on the lateral skin. Sectioning revealed bland yellow fatty tissue with fibrous bands. A gray fibrotic area with tan-brown discoloration suggestive of prior biopsy was noted in the upper outer quadrant. A firm nodule was identified at the 9 o\u2019clock position laterally, with focal blue dye, possibly representing a lymph node; this was located 1.1 cm from the deep margin. The distance between the biopsy site and deep margin was 5 cm. No additional biopsy clips were identified. Multiple sections were submitted throughout the specimen, including the nipple, margins, previous biopsy site, and various quadrants. A small separate fragment of yellow fatty tissue measuring 3.5 x 3.0 x 1.2 cm was also submitted.\n\nPart C consisted of a right axillary sentinel lymph node, hot and blue, measuring 3.4 x 2.0 x 1.0 cm. On sectioning, the node showed fat-replaced nodal tissue. All submitted tissue was processed for histologic evaluation. Microscopic findings demonstrated scattered foci of atypical lobular hyperplasia in the left breast. In the right breast, multifocal disease was identified in the upper outer quadrant, with the largest invasive focus measuring 7 mm and additional smaller foci (2\u20133 mm). Ductal carcinoma in situ (DCIS) was present in 15 of 20 blocks, with a maximum calculated dimension of 6 cm. DCIS was predominantly cribriform and papillary type, nuclear grade 2, with rare intraluminal necrosis. The invasive component showed nuclear grade 2, moderate mitotic index, and tubule formation score of 3, resulting in a total Nottingham score of 7. Tumor was not identified in the nipple skin, random sections of other quadrants, or surgical margins. Lymphovascular invasion was not present. A focus of metastatic involvement measuring 0.17 mm was identified in the subcapsular sinus/cortex of the sentinel lymph node based on cytokeratin staining, not visible on H&E alone. Additional isolated tumor cells were also present."} +{"pid": "TCGA-CN-A63Y", "report": "The left tonsil resection specimen measured 4.0 x 3.5 x 2.3 cm and contained a lesion measuring 2.2 x 1.8 x 1.5 cm, which was firm, tan-white, focally hemorrhagic, and exophytic. The lesion was located near the deep margin at 0.2 cm and also approached the posterior, medial, and anterior margins at 0.5 cm, 0.5 cm, and 0.8 cm respectively. Microscopic evaluation confirmed invasive cellular growth predominantly composed of non-keratinizing cells. All resection margins were free of abnormal tissue. No angiolymphatic or perineural invasion was identified. The right tonsil showed hyperplastic changes with surface bacteria but no significant abnormality. A re-excision specimen from the left tonsillar fossa revealed only fibroadipose tissue, minor salivary gland, and skeletal muscle without any notable pathology. Immunostains and in-situ hybridization performed on prior biopsies were positive for p16 and human papillomavirus. Tissue fixation times ranged from 2 to 84 hours. The surgical specimen was processed using standard protocols and evaluated in multiple sections. The pathologic staging was determined as pT2NX based on tumor size and absence of nodal involvement. All submitted margins were uninvolved. The laboratory is CLIA-certified and follows appropriate standards for testing, including immunohistochemistry and molecular assays."} +{"pid": "TCGA-BH-A0BT", "report": "A total of four lymph nodes were examined, including three sentinel and one non-sentinel lymph nodes. One sentinel lymph node contained two foci of micrometastasis, each measuring less than 1.0 mm, and another focus also measuring less than 1.0 mm. No extracapsular spread was observed in any of the lymph nodes.\n\nThe excised breast tissue revealed an infiltrating ductal carcinoma with a Nottingham grade of 1 and a total score of 5 out of 9 (tubules = 2, nuclei = 2, mitosis = 1). The invasive tumor measured 2.0 cm on gross examination. A ductal carcinoma in situ component was present, characterized by cribriform architecture and comedo necrosis, with nuclear grade 2. The in situ component comprised approximately less than 5% of the total tumor volume and was admixed with the invasive component.\n\nSurgical margins were free of invasive tumor, with the closest posterior and superior margins measuring 0.6 cm from the tumor. The ductal carcinoma in situ margin was closest at the posterior aspect, measuring 1.2 cm from the tumor. Angiolymphatic invasion was identified. Immunohistochemistry demonstrated positivity for estrogen and progesterone receptors, while HER-2/neu testing was negative with a score of 0.\n\nAdditional findings included fibrocystic changes, ductal epithelial hyperplasia, and fibroadenomatoid nodules within the non-neoplastic breast tissue. Skin examination showed no significant pathologic abnormalities.\n\nPathologic staging was determined as pT1c for the primary tumor, pN1mi for lymph node involvement, and pMX for distant metastasis. The lymph node evaluation involved hematoxylin and eosin staining, with no keratin-positive cells identified beyond the metastatic foci described."} +{"pid": "TCGA-FG-6692", "report": "Medical Record #. Race: Date Received: Final Diagnosis. Specimens received include biopsy and removal tissue from the right frontal lobe of the brain. Gross examination revealed multiple irregular fragments of soft tissue, tan-pink to pink-tan in color, with some specimens measuring 1 x 1 x 0.4 cm, 0.9 x 0.5 x 0.2 cm, and aggregates up to 7.6 x 6.4 x 2.6 cm. Intraoperative consultation included touch imprint and frozen section analysis, which showed features consistent with a high-grade glial neoplasm. Microscopic evaluation demonstrated increased mitotic activity and areas of microvascular proliferation. All specimens were submitted for further histologic analysis. Chromosomal studies for deletion analyses on chromosomes 1 and 19 are pending. The final interpretation was made following review of all available data."} +{"pid": "TCGA-A3-3343", "report": "A mesenteric nodule was identified, showing benign features including fat necrosis, fibrosis, and mild chronic inflammation. A left kidney specimen revealed a well-circumscribed mass measuring approximately 8 cm in greatest dimension, located primarily in the mid pole beneath the capsular surface. The surrounding renal cortex appeared uninvolved. Histologically, the lesion demonstrated nuclear features corresponding to Fuhrman grade 3 out of 4. Lympho-vascular space invasion was present; however, there was no evidence of transcapsular, renal vein, or vena caval invasion. No tumor was identified at the soft tissue, ureteral, or vascular margins. One lymph node was examined and showed no evidence of metastasis. Additional findings included mild chronic pyelonephritis. The paraaortic lymph node specimen consisted of a single lymph node within fibroadipose tissue and showed benign hyperplastic changes. Staging was assessed as T2, N0, MX."} +{"pid": "TCGA-V4-A9EU", "report": "Enucleation of the left eye was performed. The eyeball measures 27 \u00d7 24 mm along the main lines and includes a segment of optic nerve measuring 5 mm. On sectioning, a nodule is identified in the postero-lateral region of the eyeball, measuring 16 mm along the main line. Tissue samples were taken for cryopreservation prior to fixation.\n\nMicroscopic examination of the nodule reveals a cellular composition consisting entirely of epithelioid cells. Marked cellular atypia is present. Approximately 60% of the cells contain melanin pigment. Mitotic activity is low, with 4 mitoses observed per 10 high-power fields. The lesion measures 16 mm in its longest dimension and reaches a thickness of 10 mm at its median portion. There is evidence of infiltration into the ciliary body and sclera, with endovascular emboli and an extra-scleral extension forming a small nodule measuring 3 mm. No involvement is seen along the course of the optic nerve, including the cut end, nor within the meningeal sheaths."} +{"pid": "TCGA-ED-A66X", "report": "The specimen shows a solid and firm mass with ill-defined margins, measuring 10x8x6cm in size. Microscopic examination reveals tumor cells arranged in trabecular patterns that connect with one another, as well as in acinar and sheet-like formations within surrounding tissue. The tumor demonstrates infiltration into fibrous stroma. Tumor cells exhibit a polygonal shape with round, vesicular nuclei containing prominent nucleoli. The cytoplasm is abundant and appears either clear or basophilic. Nuclear features include irregular contours, increased size, and hyperchromasia. Mitotic figures are present. There is evidence of tumor invasion by inflammatory cells and areas of necrosis. The stroma is fibrous and hyaline in nature. Tumor margins are uninvolved. Other features including focality, histologic grade extent, lymph node status, venous invasion, and evidence of preoperative treatment are not specified."} +{"pid": "TCGA-DD-A1ED", "report": "The resected liver specimen includes segments V and VI, weighing 200 grams and measuring 3.6 x 3.5 x 3.2 cm. The gallbladder is separately submitted and measures 10.0 x 5.0 x 3.0 cm. A well-demarcated, irregular-shaped subcapsular nodule is present, measuring 3.6 x 3.5 x 3.2 cm. Surgical margins are negative, with the closest margin measuring 1.5 cm. The background liver tissue does not show cirrhosis. Cytochemical stains on tissue block B4 demonstrate loss of normal reticulin architecture within the lesion. Pigment and hemorrhage are noted within the lesion, likely related to a prior biopsy. The gallbladder shows acute and chronic cholecystitis with cholelithiasis, including twelve mixed stones ranging from 0.2 cm to 1.1 cm in greatest dimension. One stone is located in the cystic duct near an area of stricture measuring 0.5 cm in diameter. Initial frozen section evaluation suggested focal nodular hyperplasia; however, final diagnosis was deferred pending permanent sections."} +{"pid": "TCGA-FV-A495", "report": "The surgical specimen consisted of liver segments 5 and 6. Gross examination revealed two main lesions and two smaller nodularities. The largest lesion measured 4.5 x 4.2 x 2.5 cm and was located 2.2 cm from the inked margin. A second lesion measured 1 cm in diameter and was located 0.7 cm from the closest inked margin. Two additional small nodularities, each measuring approximately 0.5 cm, were also identified. One of these was located 0.3 cm from the inked margin. No other lesions were observed in the hepatic parenchyma.\n\nMicroscopic evaluation showed that the lesions exhibited nuclear grade 2 out of 3. Mitotic activity was noted at 21 per 10 high-power fields. Margins were uninvolved by tumor, with the closest distance being 0.3 cm. There was no lymphatic or vascular invasion identified. The tumors were confined to the liver without extension into surrounding structures.\n\nThe background liver demonstrated chronic hepatitis C with mild necroinflammatory activity and periportal fibrosis (stage 2 of 4). There was no evidence of cirrhosis or small cell dysplasia. Alpha-fetoprotein level was 39.4.\n\nStaging parameters indicated a solitary tumor without vascular invasion. Regional lymph nodes could not be assessed and no distant metastasis was identified. The histologic grade and absence of vascular invasion suggested a fair prognosis. \n\nA separate gallbladder specimen showed no evidence of neoplasm. Microscopic evaluation confirmed chronic cholecystitis without malignant findings.\n\nRepresentative tissue sections were submitted for analysis and archived for future reference."} +{"pid": "TCGA-CM-4744", "report": "A 4.5 cm by 4.0 cm mass lesion was identified in the cecum, located 0.5 cm distal to the ileocecal valve. The tumor invades into the muscularis propria with a depth of invasion measuring 0.5 cm. The overlying serosa showed no involvement. Vascular invasion was present; perineural invasion was not observed. The lesion arose within a preexisting tubulovillous adenoma. Adjacent bowel appeared unremarkable, and no additional polyps were identified. Surgical margins were free of tumor. Lymph node dissection revealed twenty-eight benign lymph nodes without evidence of metastasis. The specimen included a segment of terminal ileum measuring 9.0 cm in length and 4.5 cm in circumference at the proximal margin, and ascending colon measuring 18.5 cm in length with a distal margin circumference of 8.3 cm. The attached appendix measured 6.0 cm in length and averaged 0.5 cm in diameter. Multiple lymph nodes were identified within the adipose tissue and submitted for examination. No other significant findings were noted in representative sections of the specimen."} +{"pid": "TCGA-EY-A1GC", "report": "A surgical pathology report describes findings from a hysterectomy and lymph node dissection. Lymph nodes were evaluated from four regions: left peri-aortic (2 nodes), right peri-aortic (10 nodes), left pelvic (6 nodes), and right pelvic (6 nodes). No abnormal cellular findings were identified in any of the lymph nodes examined.\n\nThe uterus measured 11.5 cm in height with an endometrial cavity length of 3.2 cm and a fundal width of 3.0 cm. A lesion measuring 3.5 x 2.5 x 1.5 cm was observed at the superior aspect of the uterine fundus, extending into the mid corpus. The lesion appeared tan to dark brown with a fungating morphology. Histologic evaluation revealed complex architectural patterns with notable lymphocytic infiltration. Cellular grading indicated high-grade features based on structural and nuclear characteristics.\n\nAssessment of tissue invasion revealed superficial myometrial involvement with an invasion depth of 1 mm. The myometrial wall thickness at this site was 2.1 cm, representing approximately 5% penetration. There was no evidence of serosal, lower uterine segment, cervical, or adnexal involvement. Vascular space invasion was not present.\n\nAdditional findings included benign leiomyomas within the myometrium showing hyalinization and Nabothian cysts in the cervix. Both ovaries appeared atrophic without abnormal findings. Fallopian tubes showed no significant pathology, although a paratubal cyst was noted on the right side.\n\nImmunohistochemical analysis demonstrated strong and diffuse expression of estrogen and progesterone receptors in sampled tissue. Twenty-four lymph nodes were examined in total, none showing atypical cellular changes.\n\nPathologic staging was assigned as pT1b pNO pMx based on available data. This classification remains subject to revision pending further clinical correlation and potential updates from additional diagnostic information."} +{"pid": "TCGA-BP-4775", "report": "The left kidney partial nephrectomy specimen includes a well-circumscribed, yellow-orange lesion measuring 2.9 x 1.6 x 1.5 cm, located within the kidney parenchyma. The lesion is noted to be 0.2 cm from the inked surgical margin and appears well encapsulated without evidence of renal capsule violation. Histologic evaluation reveals nuclear features corresponding to grade II/IV. No local invasion or renal vein involvement is identified. All surgical margins are free of abnormal cellular activity. The non-neoplastic kidney tissue shows no significant findings. No adrenal or lymph node tissue is present for evaluation. The lesion is confined to the kidney with a maximum dimension of less than 7.0 cm. A separate cyst excision specimen contains benign cortical cystic structures, with no atypical cellular features identified."} +{"pid": "TCGA-CQ-7068", "report": "The specimen consisted of multiple tissue samples from the right neck (Levels I, II, and III) and various regions of the oral cavity including the anterior, middle, and posterior ventral tongue, anterior floor of mouth, retromolar trigone, posterior buccal mucosa, revision anterior floor of mouth, and a right mandibulectomy with resection of the floor of mouth.\n\nLymph node evaluation revealed 6 negative nodes in Level I, 14 in Level II, and 12 in Level III. No tumor involvement was identified in any of the lymph nodes. The submandibular gland showed no pathologic changes.\n\nMicroscopic examination of the oral cavity specimens revealed squamous mucosa with mild dysplastic changes in several areas, some with keratinizing features. All were negative for high-grade dysplasia or invasive carcinoma. The revision anterior floor of mouth specimen showed no dysplasia or carcinoma.\n\nThe mandibulectomy specimen contained a white-tan multinodular mass measuring 3.1 cm in its greatest dimension with a thickness of 2.1 cm. It was located near the alveolar ridge and floor of the mouth. No lymphovascular or perineural invasion was observed. Resection margins were free of tumor involvement; however, the tumor was within 0.3 cm of the lateral gingival mucosal margin. Bone sections showed tumor invasion of the alveolar bone, though bone margins remained uninvolved.\n\nA total of 32 regional lymph nodes were examined, none showed evidence of metastasis. Based on size and extent, staging criteria indicated a T2 classification with no regional lymph node involvement. Distant metastasis could not be assessed."} +{"pid": "TCGA-DD-AACY", "report": "The specimen consists of a liver measuring 15.0 x 11.8 x 6.8 cm and weighing 791.0 grams, along with a gallbladder measuring 8.2 cm in length and 3.2 cm in diameter. A large hepatic lesion was identified, measuring 7.5 x 7.3 x 5.3 cm. The lesion appears well-demarcated and encapsulated, with a yellowish-tan, lobulated, and solid cut surface featuring extensive necrosis. The gross tumor type is multinodular confluent and is confined within the capsule. The resection margin is not involved, with a safety margin of 0.2 cm. The remaining liver parenchyma appears unremarkable.\n\nMicroscopically, the tumor exhibits trabecular, tubular, and solid growth patterns, with hepatic-type cells showing grade III differentiation. Fatty changes are present. There is no evidence of cholangiocarcinoma, fibrous capsule infiltration, septum invasion, surgical margin involvement, serosal invasion, portal vein invasion, vascular invasion, or bile duct invasion. The surrounding liver tissue shows signs of chronic hepatitis related to viral etiology, with mild lobular and portoperiportal inflammation. Fibrosis is present at a septal stage. No cirrhosis or dysplastic nodules are identified. The gallbladder shows serosal and mucosal changes consistent with chronic cholecystitis, with a wall thickness of 0.2 cm. Multiple sections were submitted for analysis."} +{"pid": "TCGA-AP-A054", "report": "Specimens submitted include the uterus, cervix, left fallopian tube and ovary; a sigmoid nodule; the right fallopian tube and ovary; a posterior cul-de-sac nodule; and multiple lymph node groups from both sides including external iliac, obturator, common iliac, and para-aortic regions, as well as the omentum.\n\nExamination of the uterine specimen reveals a tumor with predominantly solid growth. The tumor extends through the full thickness of the myometrium and invades fibroadipose tissue attached to the uterus and the uterine serosa. There is no involvement of the endocervix. The posterior lower uterine segment is affected. Vascular invasion is present. The left ovary contains a fibrothecoma, and the left fallopian tube shows no significant findings. The right fallopian tube and ovary also show no evidence of involvement. The sigmoid nodule demonstrates a metastatic carcinoma with features consistent with the primary lesion identified in the uterus."} +{"pid": "TCGA-D8-A1JT", "report": "Histopathological examination was performed on a left breast resection specimen measuring 26 x 20 x 5.5 cm, along with axillary tissues measuring 10 x 8 x 2.5 cm and a 25 x 14 cm skin flap. A lesion measuring 2.6 x 2 x 1.8 cm was identified in the outer lower quadrant, located 5.3 cm from the lower boundary, 1.2 cm from the base, and 1.4 cm from the skin.\n\nImmunohistochemical analysis showed that over 75% of neoplastic cell nuclei were positive for estrogen and progesterone receptors. HER2 protein expression was scored as 2+ by immunohistochemistry; however, subsequent FISH testing did not detect HER2 gene amplification.\n\nMicroscopic evaluation revealed a mixed growth pattern with features of ductal and papillary architecture. The nuclear grade was NHG1. Mitotic count was 22 per 10 high-power fields within a visual area of 0.55 mm diameter. Adjacent glandular tissue demonstrated fibrocystic changes and simple ductal hyperplasia. Invasive growth was noted extending to the base of the specimen.\n\nExamination of axillary lymph nodes showed chronic inflammation but no evidence of metastatic involvement."} +{"pid": "TCGA-E2-A1IK", "report": "The specimens include sentinel lymph nodes and breast tissue from the left side. In the first sentinel lymph node group from the left axilla, four lymph nodes were identified, ranging in size from 0.5 cm to 1.5 cm. The second sentinel lymph node group consisted of two lymph nodes measuring 0.5 cm and 1.2 cm. For the left breast medial needle localization specimen, a lumpectomy measuring 8 x 5 x 2.2 cm was submitted. Upon sectioning, a mass measuring approximately 1.3 x 1.3 x 1.2 cm was found and was located closest to the posterior margin at 0.1 cm and 0.2 cm from the anterior margin. The lateral needle localization specimen from the left breast measured 4.5 x 3.5 x 2 cm and contained a smaller mass measuring 0.5 x 0.5 x 0.4 cm, located near the inferior margin.\n\nMicroscopic evaluation of the medial breast specimen revealed a moderately differentiated invasive carcinoma with certain mucinous features and other distinctive cellular characteristics. The tumor measured 1.4 cm and was very close to the deep margin. Adjacent tissue showed atypical ductal hyperplasia. In the lateral breast specimen, a similar invasive lesion was identified, measuring 0.7 cm, with clear margins and associated atypical ductal hyperplasia. Evaluation of the sentinel lymph nodes showed that one of the four nodes in the first group contained small tumor deposits, while all nodes in the second group appeared normal. Immunostaining confirmed the presence of these cells in the affected lymph node.\n\nHistologic grading indicated a moderate level of differentiation. No vascular or lymphatic invasion was observed. Hormone receptor testing showed positivity for estrogen and progesterone receptors, while HER2 staining was negative. Pathologic staging was determined based on tumor size and lymph node involvement."} +{"pid": "TCGA-DJ-A2PT", "report": "The clinical history notes a prior fine needle aspiration from the right thyroid lobe. Submitted specimens include right paratracheal nodes, total thyroid, pretracheal tissue, right mediastinal tissue, and left mediastinal tissue.\n\nThe right paratracheal lymph node dissection included 5 lymph nodes, all benign. The total thyroid specimen weighed 12.5 grams and measured 3.5x2x1.5 cm on the right lobe, 4x3x1 cm on the left lobe, and 1.2x1x0.6 cm at the isthmus. A dominant nodule measuring 1.5x1.2x1.0 cm was identified in the right lobe with a white-tan cut surface. The remainder of the thyroid showed multinodular changes and beefy red parenchyma. Histologic evaluation revealed no mitotic activity or tumor necrosis. Vascular invasion was present focally. The lesion extended into perithyroidal fibroadipose tissue and skeletal muscle but did not involve surgical margins. No multicentric disease or associated adenomas were identified. The non-neoplastic thyroid tissue showed features of nodular hyperplasia and chronic lymphocytic thyroiditis. Three lymph nodes within the thyroid specimen were negative for metastatic disease.\n\nThe pretracheal tissue contained 6 benign lymph nodes. The right mediastinal tissue consisted of two fragments of fibroadipose tissue, and the left mediastinal tissue was a single fragment of similar appearance. All were interpreted as benign.\n\nIntraoperative frozen section analysis of the right paratracheal nodes was consistent with benign findings, confirmed by permanent sections."} +{"pid": "TCGA-DI-A2QU", "report": "Submitted specimen includes an irregular fragment of adipose tissue measuring 30.0 x 15.0 x 1.5 cm from the omentum. Microscopic examination reveals infiltration by malignant cells with high-grade morphology.\n\nThe uterus measures 14.0 x 8.0 x 7.0 cm and contains a tan, soft multilobulated mass attached to the left lateral wall of the endometrium. The mass measures 9.0 x 5.0 x 5.0 cm and protrudes into the endometrial cavity. It is predominantly superficial within the myometrium with focal minimal invasion (< 1 mm). No lymphovascular space invasion is identified. The cervix and lower uterine segment show no involvement. Adjacent endometrium demonstrates benign findings aside from the lesion.\n\nThe bilateral fallopian tubes and ovaries are submitted, with measurements averaging 5.0 x 0.5 x 0.5 cm for the tubes and 1.3 x 0.8 x 0.6 cm for the ovaries. Two small nodules (0.2\u20130.3 cm) are identified in the para-ovarian soft tissue on the left side. Malignant involvement is identified in the left ovary, right ovarian surface, left mesosalpinx, and right mesosalpinx. Additionally, there is presence of endosalpingiosis involving both ovaries.\n\nThree lymph nodes are present in each pelvic lymph node group (left and right), ranging in size from 0.3 x 0.2 x 0.2 cm up to 2.0 x 1.0 x 0.5 cm. No malignant involvement is detected in any of these lymph nodes.\n\nHistologic evaluation demonstrates a heterogeneous tumor composition. A component of this tumor exhibits spindle cell morphology, which shows focal positivity for EMA and negativity for cytokeratin on immunohistochemical staining. This component is confined to a limited area within the specimen.\n\nMultiple sections were submitted from various regions of the uterus, cervix, tumor, adjacent endometrium, fallopian tubes, ovaries, and associated lymph nodes for thorough assessment."} +{"pid": "TCGA-FG-7643", "report": "The specimen labeled right parietal neoplasm consists of multiple pink-white soft tissue fragments measuring 0.8 x 0.5 x 0.4 cm in aggregate. The tissue was processed for intraoperative consultation with representative sections submitted for touch imprint and frozen section analysis. The remaining tissue was submitted entirely for permanent sections.\n\nThe anterior central tumor specimen includes multiple tan-gray irregular soft tissue fragments measuring 3.0 x 2.2 x 1.6 cm in total. The specimen was fixed in formalin and submitted completely into three cassettes.\n\nThe posterior margin biopsy consists of a single tan-gray to focally red-brown irregular soft tissue fragment measuring 1.6 x 1.1 x 0.7 cm. It was fixed in formalin and submitted entirely in one cassette.\n\nMicroscopic examination of the right parietal specimen revealed a glial lesion characterized by hypercellularity and nuclear atypia. Fluorescence in situ hybridization testing demonstrated preservation of chromosomes 1p and 19q. No definitive histologic evidence of high-grade transformation was identified. All specimens were evaluated and summarized according to standard pathological protocols."} +{"pid": "TCGA-68-A59I", "report": "The left lung specimen measured 15 x 10 x 7.5 cm and weighed 606 grams. A mass measuring 8.0 x 7.0 x 6.0 cm was identified in the lower lobe, extending from the hilar region to the diaphragmatic aspect. The mass involved the bronchus and came within 1.5 cm of the bronchial margin. It also approached the mediastinal tissue margin within 0.2 cm and the pericardial margin within 0.5 cm. The mass exhibited central necrosis and was firm with a gray-white appearance. No visceral pleural invasion was identified. Tumor extension was noted to involve the main bronchus at least 2 cm distal to the carina. Mucous plugs were present throughout the bronchi, particularly in the upper and lower lobes.\n\nLymph nodes were assessed from multiple sites. Of the lymph nodes examined (excluding one non-diagnostic node), 6 out of 19 were involved. One of one node from site 11L showed involvement. Two of three nodes from site 10L were involved, and 3 of 15 lymph nodes from the pneumonectomy specimen were positive. No extranodal extension was observed.\n\nMargins were uninvolved by invasive carcinoma, including the bronchial, vascular, pericardial, and diaphragmatic margins. The closest distance between the tumor and any margin was 0.2 cm at the mediastinal margin.\n\nHistologic evaluation revealed moderately differentiated cells with lymph-vascular invasion present. No treatment effect or additional pathologic findings were noted. Immunohistochemistry supported the cellular origin, though specific markers are not detailed here.\n\nStaging was determined to be pT3 pN1, corresponding to stage IIIA disease."} +{"pid": "TCGA-A2-A0YK", "report": "The left mastectomy specimen measured 15 x 15 x 3.5 cm in greatest dimensions. The nipple was located in the inferior portion of a skin ellipse measuring 9.7 x 5.5 cm. A suture marked the 12 o\u2019clock position, and blue dye was noted in the superior portion. The superficial margin was marked in blue ink and the deep margin in black ink. On sectioning, the central breast consisted of dense tan fibrous tissue with focal cystic areas containing brown mucinous material, surrounded by bland yellow fatty tissue at the perimeter. In the superior 12 o\u2019clock area, there was a pink-tan gritty area measuring 1.6 x 1.3 x 3.5 cm within the fibrous tissue, extending into the 2 o\u2019clock area where there was focal red-tan discoloration suggestive of prior biopsy. These firm areas were contiguous and located 0.5 cm from the deep margin. A wing clip was identified in the 12 o\u2019clock region.\n\nSections submitted included skin and nipple (A1), tissue from the 12 o\u2019clock lesion with deep margin (A2\u2013A3), superficial tissue including the superficial margin and skin (A4), tissue from the 2 o\u2019clock area with deep margin (A5\u2013A7), upper outer quadrant tissue between 12:00 and 2:00 (A8), upper inner quadrant tissue 2 cm from the 12 o\u2019clock lesion (A9), lower inner quadrant tissue 3.5 cm from the lesion (A10), lower outer quadrant tissue (A11), central breast tissue (A12), and additional lower outer quadrant tissue (A13).\n\nThe right mastectomy specimen measured 20 x 16.5 x 3.0 cm. The nipple appeared unremarkable within a 9 x 4.5 cm skin ellipse. A suture marked the 12 o\u2019clock position. Superficial margin was marked in blue ink and deep margin in black ink. Sectioning revealed dense pink-tan fibrous tissue centrally with focal cystic areas containing brown oily material, surrounded by bland yellow fatty tissue. Sections submitted included nipple (B1), central deep margin (B2), upper inner quadrant (B3\u2013B4), upper outer quadrant (B5\u2013B6), lower outer quadrant (B7\u2013B8), and lower inner quadrant (B9\u2013B10).\n\nSentinel lymph node #1 from the left axilla was an ovoid piece of blue-stained tissue and yellow fat measuring 2.1 x 1.7 x 1.0 cm. Sectioning revealed a 1.0 cm diameter lymph node; one-half was submitted per protocol and the remainder labeled as C. Sentinel lymph node #2 measured 2 x 1.2 x 0.5 cm and contained a 0.6 cm diameter lymph node embedded in yellow fatty tissue. The entire specimen was submitted and labeled as D.\n\nHistologic examination of the left mastectomy showed multicentric involvement with cellular features present in previously biopsied sites as well as random sections from the lower inner quadrant, central breast, and nipple skin. Lesions ranged in size from 2 mm to 35 mm. The deep margin was free of abnormal cellular aggregates. No lymphatic invasion was observed. One small intramammary lymph node was negative for abnormal cells. Background findings included fibrocystic changes with dense fibrosis and benign epithelial proliferation.\n\nThe right mastectomy showed proliferative fibrocystic disease with dense fibrosis, sclerosing adenosis, apocrine metaplasia, cyst formation, and radial scar changes. Microcalcifications were present. No atypical or malignant cells were identified.\n\nBoth sentinel lymph nodes showed reactive changes only. Node #1 demonstrated perinodal fibrosis possibly related to prior biopsy. Both nodes were negative on step sections and cytokeratin staining."} +{"pid": "TCGA-FP-8631", "report": "**Revised Pathology Report (Diagnosis Removed):**\n\nThe specimen consisted of a partial esophagogastrectomy, including the distal 10 cm of the esophagus. The esophagus measured 10.0 cm in length and 3.5 cm in mucosal circumference, with a wall thickness of 0.4 cm. The stomach segment was 5.0 cm in length and 7.0 cm in diameter (14.0 cm mucosal circumference), with a wall thickness of 0.4 cm. An additional detached fragment measured 3.5 cm in diameter with a wall thickness of 0.4 cm. The specimen was received intact with several lymph nodes adjacent to the lesser curvature omentum.\n\nA lesion was identified predominantly in the gastric cardia region, involving the gastroesophageal junction and extending 2.0 cm above it. The epicenter of the lesion was located 0.5 cm inferior to the gastroesophageal junction. The lesion measured 6.5 cm x 5.0 cm in size, with a maximum thickness of 1.8 cm. It exhibited raised borders with a bulky appearance and an ulcerated center, occupying approximately 80% of the mucosal circumference at the gastroesophageal junction.\n\nHistologically, the lesion extended through the muscularis propria into the subserosal fat within the gastric portion without serosal penetration. In the distal esophageal portion, the lesion invaded through the muscularis propria into the adventitia. The closest margin was the distal esophageal adventitial margin, with invasive disease present less than 1 mm from this margin. The proximal margin was 8.0 cm from the tumor, and the distal margin was 2.4 cm from the tumor. The omental (radial) margins were 4.0 cm, and the deep margin (black-inked) was 0.1 cm from the lesion.\n\nLymphovascular invasion was present. A total of 25 lymph nodes were examined, with metastatic involvement identified in 6. Involved nodes included two of seven in the mid esophagus, one of one in the lower esophagus, one of eight in the gastric celiac region, and two of eight adjacent to the gastric tumor. No extracapsular extension was observed.\n\nMicroscopic evaluation showed no prior treatment effect. Extensive sampling revealed moderately differentiated cells predominantly within the gastric cardia, with involvement of the gastroesophageal junction and extension into the distal esophagus over a length of 2.0 cm. Specialized metaplasia was not seen in sections of the esophageal portion of the lesion. A single small microscopic focus of specialized metaplasia was noted in one area of the gastroesophageal junction on the cardia side; however, this did not meet criteria for Barrett\u2019s esophagus. Non-involved gastric mucosa showed no significant inflammation or other notable findings.\n\nImmunohistochemical staining demonstrated strong positive reactivity in the relevant markers."} +{"pid": "TCGA-49-AAR4", "report": "The surgical specimen consists of a wedge resection and completion lobectomy from the left upper lobe. A subpleural mass measuring 3.0 cm in greatest dimension was identified beneath an area of stellate pleural puckering, located 0.3 cm from the stapled margin. Histologic examination reveals a moderately differentiated lesion with involvement of the visceral pleura, as confirmed by Movat staining. Evaluation of the resection margins demonstrates no involvement by invasive disease.\n\nA total of 17 lymph nodes were examined. Metastatic disease is present in two lymph nodes: one from level 10 and one from L4. The remaining lymph nodes assessed\u2014including those from stations 9, 12, 7, L9, and 5\u2014show no evidence of involvement. \n\nAdditional findings include respiratory bronchiolitis. No other separate nodules or distant metastatic involvement could be assessed. Vascular invasion could not be definitively determined. Approximately 80% of the tumor was submitted for evaluation, with representative sections taken from the primary mass, surrounding lung tissue, and involved margins."} +{"pid": "TCGA-4T-AA8H", "report": "A fragment of left fallopian tube fimbria with attached paratubal cyst measuring 3.5 x 3.0 x 3.0 cm was submitted for examination. The cyst was unilocular, filled with clear fluid, and had a thin smooth wall. Sections were taken from the fimbriated end and cyst wall. Additionally, a segment of descending and sigmoid colon measuring 21.5 cm in length was examined. A mass measuring 5.2 x 4.7 x 1.2 cm was identified in the descending colon. The mass was exophytic, lobulated, and focally friable, involving approximately 75% of the bowel circumference. On cross-section, elongated cystic spaces filled with friable material were observed within the bowel wall.\n\nThe tumor was located 2.8 cm from the proximal margin, 13.5 cm from the distal margin, and 2.0 cm from the mesenteric margin. Depth of invasion measured 2.2 cm, extending through the bowel wall into surrounding fat with puckering of the serosa (inked blue). No tumor perforation was identified. Adjacent structures including the mesentery (measuring 20.0 x 7.0 x 2.0 cm) showed focal serosal puckering near the tumor site. Normal mucosa was tan and velvety with preserved folds; focal submucosal tattooing was noted 2.5 cm proximal to the tumor.\n\nTwenty-four lymph nodes were recovered, ranging up to 1.0 cm in size, all without evidence of malignancy. Histologic evaluation revealed mild cytologic atypia in the fallopian tube fimbria, interpreted as cautery artifact based on immunohistochemical findings. Immunostaining showed weak expression of cytokeratin 7, p53, and Ki67 in this area, while cytokeratin 20, Pax8, and CDX2 were negative. In contrast, the colonic lesion demonstrated strong positivity for cytokeratin 20 and CDX2, with moderate Ki67 expression and absence of Pax8, p53, and cytokeratin 7.\n\nMargins were negative with the closest distance being 2.0 cm at the mesenteric margin. There was no evidence of lymphovascular or perineural invasion, nor were tumor deposits identified. No tumor-infiltrating lymphocytes were seen, although a marked Crohn\u2019s-like lymphocytic response was present. Tattoo ink was identified in the specimen.\n\nThe specimen was processed according to standard protocols. Special studies including tissue banking for research were performed. Pathologic staging according to AJCC 7th edition criteria was assigned as pT3 pN0 pMX."} +{"pid": "TCGA-NH-A50U", "report": "The specimen was received from a patient and included a right hemicolectomy specimen along with a liver biopsy. The colon specimen measured 15 cm in length and included the cecum, appendix, and a segment of distal ileum. A mass measuring 9.0 x 7.0 x 5.0 cm was identified in the cecum. The tumor extended into the proximal appendix and involved the subserosa of the distal ileum. It was associated with an abscess cavity measuring 3.0 cm in the adjacent adipose tissue. The tumor came within 1.5 cm of the ileocecal valve and 11.0 cm from the distal margin. The radial mesenteric fat margin averaged 1.0 cm, with the closest distance from the invasive tumor to the margin measuring 5 mm.\n\nHistologically, the tumor was composed of low-grade adenocarcinoma with mucinous differentiation. Areas of higher histologic grade were present focally. Perineural invasion was identified. The tumor extended to the visceral peritoneum (serosal surface) but did not demonstrate angiolymphatic invasion or tumor deposits. Margins were free of invasive carcinoma.\n\nA total of 17 regional lymph nodes were examined, none of which showed evidence of metastatic involvement. Distant metastasis was identified in the liver based on biopsy findings. A separate sessile serrated adenoma was noted in the ascending colon, and the appendix showed chronic inflammation.\n\nThe tumor was macroscopically perforated and was staged as pT4a, pN0 (0 of 17 lymph nodes involved), and pM1a. No prior treatment effect was observed. Additional molecular testing for KRAS mutation and mismatch repair status by immunohistochemistry was planned."} +{"pid": "TCGA-D1-A1NU", "report": "A panniculectomy specimen weighed 1880.0 grams and included skin and subcutaneous tissue with a central 7.0 x 5.3 x 3.2 cm circumscribed area of fat. \n\nThe hysterectomy specimen included the uterus, bilateral fallopian tubes, and ovaries. A polypoid mass measuring 4.7 x 2.4 x 0.8 cm was located in the fundus and left posterior wall of the endometrial cavity. The underlying myometrium measured 1.9 cm in total thickness, with invasion identified to a depth of 0.3 cm. No involvement of the endocervix was noted, and no lymphovascular space invasion was observed. Surgical margins were free of abnormality. A single submucosal leiomyoma measuring 3.6 x 3.0 x 2.7 cm was found beneath the endometrial lesion. The right ovary measured 1.6 x 0.8 x 0.8 cm with a solid cut surface, and the right fallopian tube measured 6.8 x 0.6 cm. The left ovary was 1.0 x 0.5 x 0.4 cm with a ragged outer surface, and the left fallopian tube measured 7.7 x 0.6 cm. Both ovaries and fallopian tubes showed no signs of involvement. Focal adhesions on the anterior uterine serosa and cul-de-sac were consistent with endometriosis.\n\nLymph node dissections were performed on both pelvic and para-aortic regions. A total of 12 left pelvic lymph nodes, 23 right pelvic lymph nodes, 3 left para-aortic lymph nodes, and 5 right para-aortic lymph nodes were identified and all were unremarkable. The gonadal vessels on both sides were also unremarkable.\n\nOmentectomy revealed an accessory spleen measuring 0.5 cm with no diagnostic abnormalities. Staging biopsies of multiple peritoneal sites including the cul-de-sac, colic gutters, pelvic sidewalls, small and large bowel serosa and mesentery, right diaphragm, and bladder peritoneum were all negative for any abnormal findings.\n\nThe final staging based on available surgical material is pT1aNO (AJCC 7th edition, 2010). The report is based on gross and frozen section histologic evaluation, with permanent H&E sections reviewed to confirm findings. Any changes on permanent section review will be reflected in a revised report."} +{"pid": "TCGA-HC-7209", "report": "The specimen was received in two containers. The first, labeled as right pelvic lymph nodes, contained an aggregate of fibrofatty tissue measuring 4.8 x 4.0 x 1.5 cm. Two lymph nodes were identified, measuring 0.9 and 1.2 cm in greatest dimension. Both were bisected and submitted for analysis. No evidence of metastatic involvement was found in the two lymph nodes examined.\n\nThe second specimen consisted of a prostate weighing 44.9 grams and measuring 4.8 x 4.5 x 4.3 cm. The prostate was sectioned to evaluate various regions, including the seminal vesicle junctions, apical and base margins, and anterior and posterior aspects bilaterally. A nodule measuring 0.8 x 0.6 x 0.4 cm was identified in the posterior aspect of the prostate, located near the capsule (within 0.3 cm). The remainder of the prostate showed diffuse periurethral nodularity with no additional discrete lesions. The prostatic capsule appeared pink-tan and shaggy.\n\nHistologic evaluation revealed a lesion with a Gleason score of 6 (3+3), involving both lobes. High grade prostatic intraepithelial neoplasia was present extensively. No extraprostatic extension, seminal vesicle involvement, or lymphovascular invasion was observed. Perineural invasion was noted. All surgical margins were free of involvement. Lymph node analysis showed no metastatic disease. Additional findings included benign prostatic hyperplasia. The pathologic stage was determined as pT2c, N0, Mx."} +{"pid": "TCGA-UY-A9PE", "report": "A cystoprostatectomy specimen revealed a firm, white, irregular mass measuring 3.5 x 2.4 x 2.4 cm located in the right superior-anterior and lateral walls of the bladder. The mass was ulcerated on the surface and invaded into the outer half of the muscularis propria without extending into adjacent organs or demonstrating lymphatic or vascular invasion. No tumor was identified at the urethral margin, right or left ureteric margins, or perivesical margin (tumor was 2 mm away from this margin). Adjacent bladder mucosa appeared tan-white and unremarkable.\n\nMicroscopic examination of the bladder showed invasive high-grade epithelial malignancy with squamous differentiation extensively involving the muscularis propria. Carcinoma in situ was also present in the epithelium. One lymph node removed during surgery was negative for tumor involvement.\n\nExamination of the prostate revealed similar epithelial abnormalities involving the prostatic urethra with carcinoma in situ observed in multiple locations including the distal prostatic urethra, prostate right base, prostate left mid, and prostate left base. Additionally, there were isolated foci of detached malignant cells within the subepithelial connective tissue showing features suggestive of superficial invasion limited to the prostatic urethra. No tumor invasion was identified extending from the bladder wall into the prostate.\n\nEvaluation of sixteen lymph nodes from the left pelvic region showed no tumor involvement. However, among four lymph nodes dissected from the right external iliac region, three contained metastatic malignant cells. Eight lymph nodes from the right obturator region and one lymph node from the right internal iliac region showed no evidence of tumor involvement. In total, 30 lymph nodes were examined, with three positive for metastasis. The largest metastatic deposit measured 11 mm and there was no extranodal extension observed.\n\nBiopsy specimens taken from both the right and left ureters showed benign segments without dysplasia or malignant findings. Similarly, intraoperative frozen section analysis of ureter biopsies confirmed absence of carcinoma.\n\nThe specimen included thorough sampling of various regions including bladder walls, prostate sections, seminal vesicles, and lymph node regions. Gross photographs were taken and all relevant sections were submitted for histological evaluation. Final diagnosis was made following comprehensive review of all pathology slides by an attending pathologist."} +{"pid": "TCGA-EI-6509", "report": "Histopathological examination was performed on a resected specimen including the rectum and sigmoid colon. The specimen measured 18 cm in length, with surrounding fat tissue measuring 8 cm in thickness. A mucosal lesion was identified, measuring 4 x 4 x 1.2 cm, with ulceration present. The lesion involved approximately 80% of the intestinal circumference, leading to significant luminal narrowing. It was located 5 cm from one surgical margin and 9 cm from the opposite margin, with the closest margin measuring 6 cm.\n\nMicroscopic evaluation revealed a neoplastic process involving tubular and papillary structures. The lesion showed infiltration through the mucosal layers, extending into the submucosa, muscularis propria, and pericolic adipose tissue. Surgical margins were free of tumor involvement. Lymph node analysis demonstrated involvement with similar cellular morphology, including capsular and perinodal extension, as well as vascular invasion.\n\nStaging parameters indicated advanced local spread without distant metastasis. The findings suggest a need for further clinical evaluation and discussion with the treating physician."} +{"pid": "TCGA-UZ-A9Q1", "report": "A subcutaneous mass was excised and submitted for analysis. The specimen consisted of three fragments of soft tissue measuring 1.5 x 0.7 x 0.3 cm in aggregate, entirely processed for examination.\n\nA left kidney specimen was received fresh and weighed 236 grams, measuring 14 x 6 x 6 cm with a small amount of surrounding fat. Within the upper pole, a mass measuring 4.6 cm was identified. It appeared red to yellow with areas of solid and liquefied content, located within 0.3 cm of the renal pelvis and in contact with the renal capsule. Microscopic evaluation showed no penetration of the capsule by tumor. A second lesion was found in the interpolar region of the kidney; this was cystic in nature and measured 2.4 cm.\n\nHistologic review demonstrated a neoplastic process involving the renal parenchyma. Tumor cells exhibited specific morphologic features and were arranged in papillary structures. Nuclear grading was assessed using the Fuhrman system and classified as grade 2. The tumor measured 4.6 cm and was confined to the upper pole of the kidney. No involvement was observed in the renal pelvis, ureter, renal sinus, hilar renal veins, intrarenal veins, or lymphatics. Adrenal tissue was not present in the specimen.\n\nMargins of resection were evaluated and all were negative. The distance from the tumor to the nearest margin was 0.2 cm in soft tissue and similarly 0.2 cm from the renal parenchymal margin. No lymph nodes were identified in the hilar fat. Based on these findings, the tumor was staged according to the AJCC system as pT1bNxMx.\n\nAdditional cassettes were submitted for further histologic correlation including margins, vessels, ureter, renal pelvis, normal cortex, tumor with capsule, and extrarenal soft tissue. Final diagnosis was made by attending pathologist following comprehensive slide review."} +{"pid": "TCGA-AD-6899", "report": "A segment of right colon, including the cecum and 6.6 cm of attached terminal ileum, was received for examination. The specimen measured 17.5 cm in length and was partially opened. The serosa appeared shaggy and gray-pink, and the wall was up to 0.5 cm thick with edema and fibrosis. The mucosal lining was gray-tan with preserved folds. At a point 1.2 cm from the ileocecal valve, a plaque-like lesion measuring 3.5 x 3.5 cm was identified. It had a granular, centrally ulcerated surface with raised borders. On sectioning, the lesion showed a gritty, gray-tan fibrotic texture, with a maximum thickness of 1.4 cm. It appeared to extend through the wall and into the surrounding adipose tissue, coming within 0.1 cm of the outer margin. The lesion also caused significant narrowing of the appendiceal orifice, reducing its diameter from 1.6 cm in the main body to 0.6 cm at the constricted site.\n\nThe appendix was vermiform, measuring 8.6 x 1.5 x 1.5 cm, with a fibrotic wall and smooth inner lining containing mucus. No direct involvement by the lesion was observed. Adipose tissue around the cecum contained several nodules up to 2.2 cm, some of which were necrotic and associated with vascular structures.\n\nMicroscopic evaluation revealed a moderately differentiated epithelial lesion with areas of mucin production. Invasion extended through the muscularis propria into the subserosal adipose tissue, with evidence of perforation at the serosal surface. Lymphovascular space invasion was present. Both proximal and distal resection margins were free of involvement. A total of 20 lymph nodes were examined, of which 17 contained metastatic involvement. Multiple foci of vascular invasion were also noted.\n\nSections from the appendix showed cystic dilation with mucus retention but no direct involvement by the process. Several sections were submitted for review, including margins, the primary lesion, and surrounding fat. The tumor was located 1.2 cm from the ileocecal valve and measured 3.5 x 3.5 x 1.4 cm. There was no evidence of mesenteric deposit involvement. A second pathologist reviewed the case and concurred with the findings. Correlation with clinical follow-up was recommended."} +{"pid": "TCGA-EO-A3B1", "report": "The specimen was received from the facility and included multiple tissues. The omentum consisted of lobulated adipose tissue without discrete lesions, measuring up to 8.5 x 7.5 x 1.7 cm, with a total weight of 48.0 g. No malignancy was identified in this tissue.\n\nLymph node specimens included right common iliac, right pelvic, and left pelvic lymph nodes. The right common iliac lymph node specimen contained only fibroadipose tissue, with no lymphoid tissue present. The right pelvic lymph node specimen included multiple pieces of fibroadipose tissue containing lymph nodes ranging from 0.2 to 2.2 cm; four lymph nodes were examined and none showed evidence of tumor. The left pelvic lymph node specimen also contained multiple lymph nodes ranging from 0.2 to 2.2 cm; nine lymph nodes were examined and none showed evidence of tumor.\n\nThe hysterectomy specimen included the uterus, cervix, bilateral fallopian tubes, and ovaries. The uterus measured 7.5 x 5.0 x 2.9 cm and contained a lesion within the endometrial cavity. The lesion measured 2.4 cm in the sagittal dimension and 2.9 cm from cornua to cornua. It extended into the myometrium, reaching the outer half of its thickness. Involvement of the cervix was not observed. Both ovaries and fallopian tubes appeared unremarkable on gross examination. Multiple sections were taken from all areas of interest.\n\nA soft tissue specimen from the right pelvic sidewall was also submitted. It measured 12.5 x 4.5 x 1.0 cm and consisted of adipose tissue without discrete lesions. No malignancy was found in this tissue.\n\nHistologic evaluation of the uterine corpus revealed invasion of adenocarcinoma extending into the outer half of the myometrium. Myometrial thickness was 1.5 mm, with more than 50% invasion noted. No involvement of the cervix or other organs was identified. No lymphovascular invasion was observed. A total of thirteen pelvic lymph nodes were examined, and none showed evidence of involvement. No para-aortic lymph nodes were submitted for evaluation.\n\nAdditional findings included leiomyomata and adenomyosis within the uterus. Two subserosal nodules were identified in the posterior myometrium, measuring 0.9 and 1.0 cm in diameter. The cervix, ovaries, and fallopian tubes were all negative for malignancy. Specimen integrity was intact, and the procedure performed was a robotic-assisted total hysterectomy with bilateral salpingo-oophorectomy."} +{"pid": "TCGA-5C-A9VG", "report": "The specimen consists of a right lobe liver and gallbladder block measuring 23x17x11 cm. A nodular mass measuring 20x12x10 cm is identified within the liver parenchyma, located 1.8 cm from the resection margin. The mass is partially encapsulated with a soft consistency and gray appearance on sectioning, showing necrotic nests. No infiltration of the liver capsule is observed. The gallbladder measures 8x5 cm and has a smooth, greenish to brownish outer surface. A lymph node from the common hepatic artery area measures 4.5x2.5 cm and has a dense, cyanotic appearance on section.\n\nMicroscopically, surgical margins are clear. The nodular mass demonstrates cellular heterogeneity with varying degrees of differentiation (including intermediate-grade features), exhibiting pleomorphic cells and architectural patterns including acinar and clear cell components. Evidence of vascular invasion is present along with infiltration into the hepatic parenchyma. Lymphoid infiltration is noted in the surrounding liver tissue. No evidence of tumor involvement is seen in the lymph nodes. The gallbladder shows signs of autolytic change."} +{"pid": "TCGA-HZ-A77Q", "report": "The surgical specimen included a gallbladder measuring 6.7 x 3.2 x 1.9 cm, with a smooth serosa and velvety mucosa; no choleliths were identified. A periportal lymph node (2.3 x 1.8 x 0.5 cm) and a perigastric lymph node (0.7 x 0.5 x 0.2 cm) were both negative for tumor involvement. A distal pancreatic margin measuring 2.1 x 1.7 x 0.3 cm was also negative for malignancy.\n\nThe Whipple specimen included a segment of stomach, duodenum, pancreas, and common bile duct. The pancreatic portion measured 4.8 x 2.5 x 2.0 cm and contained a 2.8 x 2.2 x 1.7 cm ill-defined, slightly cystic, gray-white mass. This lesion was located 2.2 cm from the pancreatic resection margin and 2.0 cm from the common bile duct margin. It extended to the uncinate process and involved the anterior, posterior, and inferior pancreatic soft tissue margins, but did not involve the duodenal mucosa. The closest distance of invasive carcinoma to a margin was 0.1 cm at the anterior and inferior soft tissue margins. All other margins, including the bile duct, pancreatic resection, posterior, and superior soft tissue margins, were free of invasive carcinoma.\n\nHistologically, the lesion showed moderately differentiated features. There was no evidence of treatment effect, lymphovascular space invasion, or perineural invasion. Nineteen lymph nodes were examined, and one was involved. Chronic pancreatitis was noted in the background.\n\nThe specimen was inked and extensively sampled, with multiple blocks submitted for analysis, including en face sections of various margins, perpendicular sections through key areas, and multiple lymph node samples. Intraoperative frozen section analysis of the distal pancreatic margin, periportal, and perigastric lymph nodes all failed to identify tumor."} +{"pid": "TCGA-KV-A6GD", "report": "The specimen was obtained from a right renal mass resected during partial nephrectomy, along with perirenal fat. The excised soft tissue consisted of fibroadipose material with focal acute inflammation; no carcinoma was identified in this component.\n\nThe main mass measured 6.5 cm in greatest dimension and was located within the renal parenchyma. On gross examination, the tumor had a variegated and necrotic cut surface, with approximately 35% necrosis noted. Microscopically, the tumor demonstrated papillary architecture with sarcomatoid features. Tumor cells exhibited chromophil characteristics. Nuclear grading according to Fuhrman criteria showed grade 2 with focal areas of grade 3. Necrosis was present and possibly related to prior biopsy at the site.\n\nThe tumor was unifocal and confined entirely within the renal parenchyma, both macroscopically and microscopically. There was no lymphatic or vascular invasion identified. Surgical margins were negative for tumor involvement, including both parenchymal resection and perinephric soft tissue margins.\n\nEvaluation of the non-neoplastic kidney revealed patchy chronic inflammation within the parenchyma and mild peripheral vascular disease in blood vessels. No adrenal tissue was present. No lymph nodes were submitted for evaluation.\n\nStaging was determined as pT1b based on tumor size, and the case was classified under AJCC Stage I. A note was made regarding the possible etiology of tumor necrosis, which may be either spontaneous or induced by prior biopsy, given its proximity to the biopsy site. Prior immunohistochemical staining from a core biopsy showed positivity for CK7 and AMACR, supporting the morphologic findings.\n\nSpecimens were received in formalin and appropriately processed for histopathological evaluation. The adipose tissue from the perirenal region was unremarkable on gross and microscopic assessment. The renal mass specimen was inked and sectioned to assess margins and surrounding tissue relationships. Representative sections were taken from multiple areas including the tumor, adjacent kidney, and margin sites."} +{"pid": "TCGA-2J-AABT", "report": "A single lymph node from the hepatic artery was examined and found to be negative for tumor involvement. The common hepatic duct margin and pancreatic neck margin were also both negative for tumor. A Whipple resection specimen included a portion of the pancreas, duodenum, common bile duct, and jejunum. A solid mass measuring 4.5 x 4.0 x 2.6 cm was identified within the pancreas, extending into peripancreatic soft tissue, the ampulla of Vater, and the duodenal wall. No tumor necrosis was observed. All surgical margins\u2014including the uncinate process, pancreatic neck, bile duct, and soft tissue\u2014were free of tumor involvement, with the closest margin measuring 0.1 cm at the portal vein groove. Chronic pancreatitis was noted in the surrounding non-neoplastic pancreatic tissue. One of twenty regional lymph nodes was found to contain tumor cells. Gross examination of the resected specimen showed a diffusely infiltrative mass in the pancreas, with extension to the duodenal mucosa. The stent was present within the common bile duct. Multiple sections were submitted for analysis, including from the uncinate margin, portal vein groove, ampulla, bile duct, pancreas, duodenum, and peripancreatic lymph nodes. Final histologic evaluation confirmed initial frozen section findings."} +{"pid": "TCGA-A2-A4S0", "report": "The surgical specimen consists of a right breast simple mastectomy measuring 33.5 cm from medial to lateral, 28 cm from superior to inferior, and up to 5.5 cm in anterior-posterior dimension. The nipple is inverted within a 31 x 17 cm skin ellipse. A suture marks the 12 o\u2019clock position. At 9 o\u2019clock, 4 cm lateral to the nipple, there is a lobulated red-tan glistening mass measuring 2.2 cm (superior-inferior), 2 cm (anterior-posterior), and 4.5 cm (medial-lateral). This lesion is 2.5 cm from the deep margin. A second nodule is present less than 1 cm away, measuring 1 x 1 x 1 cm, with a ribbon clip in the area. The remaining breast tissue is composed of bland yellow fatty tissue with fine fibrous bands. A wing clip is identified in the larger lesion.\n\nSections submitted include the nipple, deep margin to the larger lesion, the most lateral and medial portions of the larger lesion, additional sections of the larger lesion, the smaller superior ribbon clip lesion, and quadrants at various distances from the lesion. Tissue from the larger lesion was collected under a research protocol with frozen OCT samples taken as mirror images. Mirror image sections of the nipple and four random quadrant sections were also submitted frozen.\n\nA sentinel lymph node labeled as right sentinel node #1 was received. It is a pink-tan tissue fragment with blue coloration, measuring 1.3 x 0.8 x 0.4 cm. The specimen was bisected and submitted for analysis.\n\nHistologic evaluation shows two distinct lesions within the breast tissue. Both are low-grade with nuclear grade 1 and low mitotic index. The larger lesion measures 4.5 cm and the smaller 1.0 cm. No involvement is seen at the nipple or deep margin. There is no evidence of lymphatic invasion. Biopsy site changes are noted, with clips present. Additional findings include proliferative fibrocystic disease with calcifications.\n\nThe lymph node examined shows no evidence of tumor involvement on step sectioning and cytokeratin staining."} +{"pid": "TCGA-ZB-A96K", "report": "The tumor measured 8.0 x 7.0 x 6.0 cm and was classified as a mixed type with features of both A and B subtypes. Histologic evaluation showed no lymph node involvement, with zero positive nodes out of eight examined. The tumor was confined to the organ of origin without evidence of invasion beyond the capsule, corresponding to an early-stage classification."} +{"pid": "TCGA-KS-A4I3", "report": "The specimen from a total thyroidectomy with central neck dissection included a 23.5 gram thyroid measuring 8 x 4.5 x 2 cm, along with attached muscle and ligament tissue. Serial sectioning revealed a 1.5 x 1.5 x 1.3 cm lesion in the left lobe with tan granular and white-pink streaked surfaces, showing possible involvement of the peripheral margin. A separate 0.4 cm white nodule was found in the isthmus. The remaining thyroid tissue appeared unremarkable.\n\nTissue from the right central neck included two fibroadipose fragments measuring 1.1 and 1.4 cm, containing two lymph nodes (0.2 and 0.3 cm). The left central neck tissue was a 2.5 x 2 x 1.5 cm fibroadipose fragment with six lymph nodes ranging from 0.3 to 0.6 cm.\n\nMicroscopic evaluation identified tumor present at the margins and extending beyond the thyroid into surrounding tissue. Metastatic involvement was found in all lymph nodes assessed: four of four in the right central neck, three of three in the left central neck, and one of one in the isthmus, with extranodal extension noted. The tumor showed no vascular invasion."} +{"pid": "TCGA-E2-A10C", "report": "The surgical specimens included five sentinel lymph nodes from the left axilla, a wide local excision of the left breast, and axillary contents. Sentinel lymph node #1 measured 1.0 x 0.7 x 0.4 cm and was negative for malignant cells. Sentinel lymph node #2, measuring 1.0 x 1.0 x 0.7 cm, was also negative. Sentinel lymph node #3, similar in size to #2, showed no evidence of malignancy. Sentinel lymph node #4 measured 1.5 x 1.0 x 0.7 cm and contained metastatic cells with extension beyond the lymph node capsule. The fifth sentinel lymph node, slightly larger at 2.0 x 1.0 x 1.0 cm, was free of tumor cells.\n\nThe wide local excision specimen from the left breast weighed 57 grams and measured 8 x 6 x 4 cm. A stellate, firm mass was identified within the breast tissue, measuring 2.2 cm in greatest dimension. It was located 0.6 cm from the anterior/inferior margin and was surrounded by fibrous and adipose tissue. All surgical margins were free of abnormal cellular proliferation. Histological evaluation revealed high nuclear grade, intermediate tubular differentiation, and a high mitotic count. No vascular or lymphatic invasion was observed. There was also evidence of intraductal proliferation with central necrosis, displaying both solid and cribriform patterns, with an estimated extent of 5%. The nuclear grade of this component was intermediate.\n\nThe axillary contents consisted of multiple fibrofatty fragments, containing up to nine lymph nodes ranging in size from 0.1 x 0.1 x 0.1 cm to 1.1 x 1.0 x 0.9 cm. All of these lymph nodes were without any signs of metastatic involvement.\n\nImmunohistochemical analysis of the excised breast tissue showed positive staining for estrogen and progesterone receptors. The Allred score for estrogen receptor was 8 (proportion score 5, intensity score 3), and for progesterone receptor it was 6 (proportion score 3, intensity score 3). HER2 immunostaining showed weak and incomplete membrane reactivity in 5% of the cells, classified as 1+ intensity, indicating a negative result for HER2 overexpression.\n\nPathological staging was determined as pT2 pN1a, based on the size of the primary lesion and the presence of metastatic cells in one sentinel lymph node."} +{"pid": "TCGA-C5-A7CJ", "report": "The histologic sections demonstrate an invasive lesion composed of moderately differentiated keratinizing squamous cells. Evaluation shows the presence of focal lymphvascular space invasion. The lesion extends to the margins of the uninked tissue fragments. In addition, areas of severe dysplasia (CIN 3) are present. The patient is a woman with a clinical history of cervical bleeding. The material examined consists of three slides labeled A through C, originating from cervical biopsies performed on the same date as indicated in the accompanying surgical pathology documentation. Slide A corresponds to the frozen section remnant."} +{"pid": "TCGA-06-0648", "report": "The patient underwent excision of a left temporal lobe lesion. The specimen consisted of multiple soft tan tissue fragments measuring approximately 1.4 x 1.0 x 0.5 cm in aggregate. A portion was used for frozen section analysis, with the remaining tissue submitted for further evaluation.\n\nMicroscopic examination revealed a pleomorphic glial neoplasm with frequent mitoses, vascular proliferation, and pseudopalisading necrosis. Immunohistochemical staining demonstrated strong reactivity in approximately 3% of tumor nuclei for p53. The MIB-1 labeling index was estimated at 20%.\n\nMolecular testing was performed on a formalin-fixed, paraffin-embedded tissue block. Bisulfite modification of DNA was followed by PCR amplification to assess promoter methylation status. Electrophoretic analysis confirmed the presence of methylated sequences. The test was performed in a laboratory-certified under CLIA regulations. This assay has not been cleared or approved by the FDA and is intended for use as an adjunct to established diagnostic criteria. Results should be interpreted in the context of histopathological findings and clinical presentation."} +{"pid": "TCGA-25-1316", "report": "The pathology report information includes the tumor type and histology code for the case. The specimen was originally sent to the IGC Biospecimen Core Resource (BCR), with a noted date of receipt. ICD-O-3 histology and site codes were provided for both the specimen and the overall case, based on the Case Quality Control Form and patient diagnosis when available."} +{"pid": "TCGA-GK-A6C7", "report": "The operative procedure involved a laparoscopic right radical nephrectomy and liver biopsy. The right kidney measured 12 x 7 x 4 cm, with a single mass measuring 3.8 x 3 x 2.5 cm, described as yellow-tan and lobulated with central gray-tan discoloration. The tumor was located 0.2 cm from the renal capsule and 0.3 cm from the renal sinus, without invasion into the renal vein. No sarcomatoid features were identified. Microscopic evaluation showed no perinephric fat invasion or renal sinus invasion. The Fuhrman nuclear grade was 2 of 4. The tumor was unifocal and confined within the renal parenchyma. A 0.8 cm circumscribed nodule was identified in the adrenal gland and was included in the specimen for evaluation. No cancer was identified at the resection margins. Nonneoplastic kidney tissue showed no significant findings. Approximately ten lymph nodes, ranging in size from 1.2 to 0.4 cm, were identified in the hilar region. The perihilar fat weighed 20 grams. \n\nThe liver biopsy revealed a solid lesion measuring 1.8 cm in greatest dimension. Histologic examination confirmed a circumscribed lesion composed of vascular spaces within fibrous stroma. Reticulin and trichrome stains showed no abnormalities in the adjacent liver parenchyma and no iron deposition. Frozen section analysis of the liver biopsy was consistent with this finding. Intraoperative consultation on the kidney specimen noted a tan-yellow mass measuring 8 cm. Tissue processing and diagnosis were completed with rapid turnaround times. Multiple tissue blocks were submitted for detailed histologic evaluation, including margins, surrounding fat, and lymph node regions."} +{"pid": "TCGA-DU-A5TR", "report": "The specimen consists of multiple biopsies obtained from different regions of the brain. The first priority biopsy measured 0.8 cm and was partially used for frozen section analysis. The remainder biopsy included multiple fragments totaling 0.9 cm in aggregate, all submitted for frozen section. The posterior rim biopsy measured 1.8 cm and the temporal tumor biopsy measured 3.8 x 2.8 x 1.3 cm; both were fixed in formalin and processed for histologic evaluation.\n\nHistologic examination revealed a glial neoplasm with variable morphology across the specimens. Sections from the first two biopsies showed predominantly astrocytic features. The larger specimens from the posterior rim and temporal tumor displayed mostly oligodendroglial morphology, characterized by round nuclei, ropy myelin, delicate vasculature, and microcyst formation. Rare mitotic figures were identified in the temporal tumor specimen. No microvascular proliferation or necrosis was observed. The Ki-67 labeling index was estimated at up to approximately 5%.\n\nImmunohistochemical staining for IDH1 R132H mutation was negative, with appropriate controls showing expected reactivity. Molecular testing for MGMT promoter methylation was performed using real-time PCR following bisulfite modification of DNA extracted from microdissected tumor tissue. The assay did not detect methylated MGMT promoter sequences. The sensitivity of this test is capable of detecting 1% methylated DNA in an unmethylated background.\n\nLoss of heterozygosity (LOH) analysis was conducted on chromosome arms 1p and 19q using polymorphic microsatellite markers. Results indicated partial deletion of chromosome arm 19q at locus D19S606, while no allelic loss was detected on chromosome arm 1p. Informative loci included D1S548, D1S592, D1S552, D1S1612, D19S412, D19S606, and D19S1182. DNA was extracted from both tumor and matched blood samples for comparison. The presence of more than 15% non-neoplastic cells may have affected the sensitivity of LOH detection.\n\nIntraoperative consultation on the first priority biopsy noted apical glial proliferation suspicious for a glial neoplasm. Frozen section and smear preparations were evaluated and findings reported to the operating physician.\n\nThese findings should be interpreted in the context of clinical, radiologic, and other diagnostic data. All molecular assays were performed under CLIA \u201988 guidelines and are provided for informational purposes. They are not stand-alone diagnostic tests and have not been cleared or approved by the FDA."} +{"pid": "TCGA-B5-A0JN", "report": "A right fallopian tube and ovary specimen weighed 21.5 grams and measured 6.0 x 5.0 x 2.0 cm. The fallopian tube was 6.5 cm in length with an average diameter of 0.6 cm and was attached to a 3.5 x 2.5 x 2.0 cm multiloculated cystic structure containing tan-yellow papillary excrescences on the cut surface. A 2.5 x 2.5 x 2.0 cm tan-yellow, firm nodule was present at the distal end of the fimbriated tube. The serosa showed multiple small (less than 0.1 cm) tan-white adhesions. Sections were taken from the remnant of the frozen section, the multiloculated ovary, the firm nodule, and the fallopian tube with adhesions.\n\nThe left fallopian tube and ovary specimen weighed 7.6 grams. The fallopian tube measured 5.5 cm in length with an average diameter of 0.5 cm and was attached to a 2.5 x 1.5 x 1.0 cm tan-yellow, firm ovary without focal abnormality. The serosa appeared smooth and glistening. No lesions or abnormalities were identified. Representative sections were submitted from the ovary and fallopian tube.\n\nThe uterus and cervix specimen weighed 77.2 grams and measured 6.8 x 4.0 x 4.0 cm. The cervix measured 2.4 cm in length with a 0.6 cm cervical os. Upon opening longitudinally, the endometrial cavity contained a 4 x 3 x 1 cm soft, papillary lesion that did not invade the 2.5 cm thick myometrial wall. There was a 3.0 cm polyp on the anterior uterine wall and a 2.0 cm polyp on the posterior wall. Multiple small (0.5 cm) intramural leiomyomata were noted. The endocervical canal was trabeculated and the ectocervix appeared normal. The serosal surface was rough with adhesions. Sections were submitted from the posterior cervix, anterior cervix, anterior endomyometrium (including tumor and polyp), posterior endomyometrium, area of deepest invasion, and serosal adhesion.\n\nA bladder flap peritoneum specimen measuring 9 x 4 x 0.6 cm included fibroadipose tissue with a 2.0 cm focal area of adhesion. One representative section was submitted.\n\nTwo cul-de-sac peritoneal specimens were received in formalin; the largest measured 2.0 x 1.0 x 0.6 cm and consisted of tan-yellow fibroadipose tissue. The entire specimen was submitted.\n\nA hernia sac specimen measured 9 x 4 x 2.5 cm and included fibroadipose tissue with a 5 x 2 cm skin ellipse. No lesions or abnormalities were identified. All exposed serosa appeared smooth and glistening. Two representative sections were submitted.\n\nAn omentum specimen measured 14 x 5 x 1.5 cm and consisted of fibroadipose tissue. No focal lesions or abnormalities were observed. Two representative sections were submitted.\n\nMicroscopic examination revealed involvement of the right ovary and fallopian tube, as well as the left ovary. The left fallopian tube showed no evidence of tumor. The endometrial lesion measured 4.0 x 3.0 x 1.0 cm and was classified as FIGO grade 3. Invasion was limited to the endometrium with no myometrial invasion identified. Lymphatic or vascular invasion was not seen. The remaining endometrium contained multiple polyps with atrophy. The myometrium contained multiple small leiomyomata. The cervix was free of tumor. Serosal implants were identified. The bladder flap peritoneum, cul-de-sac peritoneum, hernia sac, and omentum all contained implants.\n\nNo determination of primary origin could be made with certainty. The largest single deposit of carcinoma was found within the endometrium (4.0 cm), while the ovarian tumor appeared primarily on the surface. Additional testing showed no reactivity for WT-1, supporting findings consistent with an endometrial origin."} +{"pid": "TCGA-UY-A9PB", "report": "The patient is a male who presented with gross hematuria. Imaging and cystoscopy revealed a right-sided bladder mass. Transurethral resection of the bladder tumor (TURBT) showed high-grade urothelial carcinoma. The patient underwent radical cystoprostatectomy.\n\nGross examination of the cystoprostatectomy specimen showed a large, red-tan, ulcerated, and necrotic mass located on the right lateral bladder wall, measuring 4.2 cm in greatest dimension. The mass was found to invade through the muscularis propria into the perivesical soft tissue. The closest margin was 0.7 cm to the posterior inked margin and 2.7 cm to the left anterior inked margin. The mass extended toward the base of the prostate; however, no direct involvement of the prostate was identified. Examination of the prostate revealed firm, rubbery tissue with scattered gritty material, but no discrete mass or nodule was identified. The seminal vesicles showed no significant pathologic abnormality.\n\nMargins were evaluated across multiple cassettes. The urethral margin demonstrated atypical urothelium, best seen in frozen section slides. The right and left ureteral margins, as well as the perivesical margin, showed no evidence of involvement.\n\nA total of 29 lymph nodes were examined: 17 from the right pelvic lymph node dissection and 12 from the left. No tumor was identified in any of the lymph nodes.\n\nBiopsies of both the right and left ureters showed no evidence of carcinoma. One biopsy (B1) showed a few degenerating atypical cells not present in frozen section, which were interpreted as either degenerating umbrella cells or floaters. Deeper level sections of block G1 were performed to confirm findings.\n\nMicroscopic evaluation confirmed high-grade urothelial carcinoma with invasion through the muscularis propria into perivesical tissue. There was no evidence of lymphatic or vascular invasion. Carcinoma in situ was identified in the urothelium. No other significant pathologic findings were noted in the bladder.\n\nClinical correlation was recommended for accurate assessment of surgical margins due to the complex nature of the specimen. Final staging was based on the depth of invasion and absence of lymph node involvement."} +{"pid": "TCGA-CV-A6K2", "report": "A 172.0 cm, 51.0 kg patient (BSA: 1.56 m\u00b2) underwent a right hemimandibulectomy with neck dissection. The surgical specimen included multiple lymph node levels: Level IA (8 nodes), Level IB (3 nodes), Level IIA (15 nodes), Level III (9 nodes), Level IV (3 nodes), and Level IIB (5 nodes). All lymph nodes examined were negative for tumor involvement.\n\nA fragment of atypical cells was identified in the right submandibular ganglion, raising suspicion for abnormal cellular morphology; however, no definitive tumor was diagnosed. The right external jugular lymph nodes, lingual nerve, mental nerve, proximal mandibular nerve, and buccal, floor of mouth, and retromolar margins were all free of tumor.\n\nThe resected mandibular specimen revealed a large, ulcerated, firm mass measuring 4.5 cm in greatest dimension. Histologic evaluation showed invasive growth into adjacent skeletal muscle and cortical bone. The depth of invasion was 1.4 cm. The tumor exhibited an infiltrative border pattern with thin cords of cells less than four cells wide. No perineural or vascular invasion was identified. Lymphocytic infiltration was absent.\n\nDecalcified sections of the anterior bone resection margin revealed no evidence of malignancy. All other margins, including the right buccal, floor of mouth, and retromolar regions, were negative for tumor. Multiple teeth were present in the specimen field, though they were evaluated grossly only.\n\nTissue fragments from various anatomical sites were submitted for histopathological analysis, including fibroadipose tissues from multiple neck levels, submandibular gland tissue, and nerve segments. All lymph nodes and tissue margins were entirely submitted and reviewed microscopically."} +{"pid": "TCGA-AA-A00U", "report": "The surgical specimen includes an extended hemicolectomy with findings of two invasive, moderately differentiated lesions involving the infiltration of pericolic fatty tissue. There is also a history of prior endoscopic resection of another lesion. Several tubular adenomas with moderate dysplasia were identified. Two lymph node metastases were detected among the 116 lymph nodes examined. The resection margins, including the mucosal region, showed no evidence of tumor involvement. Additionally, the omental tissue was free of tumor. The pathological staging indicates a T3 classification based on multiple measurements, with nodal involvement classified as N1. No vascular or lymphatic invasion was observed."} +{"pid": "TCGA-IR-A3LB", "report": "The submitted specimens included lymph nodes from the left lower common iliac, right and left para-aortic, left external iliac, left obturator, left hypogastric, right external iliac, right common iliac, right obturator, and right hypogastric regions, as well as a radical trialectomy with bilateral adnexae and a portion of omentum. All lymph node specimens were benign, with no evidence of involvement. The surgical margins of the resected tissue were free of abnormal cellular activity. The cervix showed stromal invasion with a maximal thickness of 18 mm and a total cervical thickness of 20 mm at the area of greatest involvement. There was extension into pericervical soft tissue, and vascular and perineural invasion were noted. No vaginal extension was observed. A cystadenofibroma was identified in the right ovary, while all other adnexal tissues appeared unremarkable. The omental biopsy revealed benign adipose tissue."} +{"pid": "TCGA-WC-A880", "report": "The right globe measured 23 x 22 x 22 mm and was submitted with an attached optic nerve measuring 9 mm in length. The anterior chamber was clear, with a formed iris measuring 12 x 11 mm and a round pupil of 8 mm. A shadow was noted in the posterior aspect, beginning approximately 6 mm from the limbus, corresponding to a brown-colored lesion. The lesion measured 20 mm at its base and had a height of 9 mm. It surrounded the optic disc, which could not be directly visualized. The sclera beneath the lesion appeared grossly intact, and the vitreous was clear with the lens in place.\n\nHistologic sections included tumor tissue from calottes (A6\u2013A7), optic nerve (A8), and vortex veins (superior temporal, superior nasal, inferior nasal, inferior temporal). The tumor eroded Bruch's membrane and demonstrated focal choroidal invasion. Cellular features were predominantly epithelioid in morphology. Mitotic activity was present at a rate of 2 per 10 high power fields. PAS staining highlighted internal structures and vascularity. No extraocular extension was identified, and all examined vortex veins were negative for tumor involvement. The optic nerve margin was examined en face and showed no evidence of tumor extension."} +{"pid": "TCGA-V4-A9F5", "report": "The right eye enucleation specimen measured 26 mm in diameter. The posterior optic nerve segment measured 7 mm and was accompanied by a 5 mm fragment of adipose tissue. An extrascleral nodule measuring 6 mm was identified. Upon sectioning, an intraocular mass was noted with dimensions of approximately 20 x 15 mm. Tissue samples were obtained for cryopreservation and genetic analysis before the entire specimen was fixed and processed into 13 tissue blocks.\n\nHistologically, the lesion consisted of a mixture of epithelioid and fusiform cells, with fusiform cells predominating. The cells exhibited large nuclei with prominent nucleoli and variably pigmented cytoplasm. Mitotic activity was present, with up to 10 mitoses per 10 high-power fields. The tumor originated in the posterior aspect of the ciliary body, with partial involvement of this structure but no extension into the iris. There was evidence of scleral invasion and an associated extrascleral nodule measuring 6 mm. The tumor was located away from the intraocular emergence of the optic nerve. The optic nerve, along its entire length, as well as the meningeal sheaths, showed no signs of tumor involvement. The cut end of the optic nerve was also free of tumor."} +{"pid": "TCGA-63-A5MV", "report": "The specimen was collected via resection from the right lower lobe. The tumor measured approximately 6.9 centimeters in size. Histological examination revealed malignant cells with characteristics consistent with a non-small cell morphology. Cellular differentiation was moderately preserved. Staging evaluation indicated involvement confined to the primary site with regional extension, classified as T2b. No distant metastasis was identified. Lymph node involvement could not be fully assessed based on available data. Clinical staging was categorized accordingly. A separate buffy coat sample was also collected for further analysis."} +{"pid": "TCGA-DK-A1AF", "report": "A radical cystectomy with total hysterectomy and bilateral salpingo-oophorectomy was performed. The bladder specimen measured 20 x 10 x 5 cm. A subserosal calcified nodule measuring 1.1 cm was identified on the fundus of the uterus. An adherent thin-walled cyst measuring 4.2 x 3.8 x 2.5 cm was found on the right ovary. The right and left fallopian tubes measured 7 cm and 7.5 cm in length, respectively, with normal fimbriated ends. The cervix measured 2 cm in length with an ectocervix diameter of 4.5 cm.\n\nUpon opening the bladder along the anterior midline, an ulcerated, fungating lesion measuring 2.0 x 1.5 cm was identified in the trigone area and posterior wall. This lesion involved both ureteral orifices. Probing of the ureters revealed blockage. Microscopic evaluation showed deep invasion into the muscularis layer without gross extension into perivesical fat. The remaining bladder mucosa appeared pink and edematous. No discrete perivesical lymph nodes were identified grossly. All surgical margins were free of involvement. Non-neoplastic mucosa exhibited ulceration and a foreign body reaction. Female genital organs showed no pathological abnormalities.\n\nLymph node dissections were performed on both pelvic sides. On the right, six lymph nodes were examined, with one showing metastatic involvement. The largest lymph node measured 2.2 cm, and the largest metastatic focus was 0.5 cm with extranodal extension. On the left, eight lymph nodes were examined, with three positive for metastasis. The largest lymph node measured 2.0 cm, and the largest metastatic focus was 1.2 cm, also with extranodal extension.\n\nThe distal right ureter specimen showed partially denuded urothelium with mild to moderate atypia. The proximal right ureter segment was unremarkable and devoid of malignant changes. Adipose tissue surrounding the proximal ureter was uninvolved.\n\nSections from the bladder lesion and surrounding areas were submitted for analysis, including the ureteral and urethral margins, dome, anterior and posterior walls, cervix, endometrium, ovaries, fallopian tubes, and vaginal cuff margin. Lymph node specimens were fully sectioned and submitted for review."} +{"pid": "TCGA-CQ-5334", "report": "The specimen consists of a right neck dissection including level IA, along with surgical waste, soft tissue samples from the mental nerve, buccal mucosa, buccal fat, floor of mouth mucosa margin, and modified neck dissection contents. \n\nOne lymph node from level IA showed no evidence of tumor involvement. Surgical waste consisted of adipose tissue without pathologic changes. The mental nerve specimen was positive for malignant cells.\n\nExcision of the buccal mucosa revealed a lesion measuring up to 6.0 cm in its greatest dimension. Histologic evaluation showed moderately differentiated features with perineural invasion identified, but no lymphovascular invasion was observed. The tumor was in close proximity (0.2 cm) to the infero-anterior soft tissue margin and involved both the supero-anterior lip and buccal mucosal margins; all other margins were clear by more than 0.5 cm. Buccal fat tissue showed fibroadipose tissue with chronic inflammation and no tumor involvement.\n\nIn the modified neck dissection, six out of forty-six lymph nodes were involved. The largest involved lymph node measured 3.5 cm and involved levels IA, IB, II-IV. There was extensive extracapsular extension noted. A cystic mass in level IB was identified as involved lymph node tissue without direct salivary gland invasion.\n\nEvaluation of the inferior alveolar nerve showed no malignancy. The floor of mouth mucosa margin was negative for tumor involvement.\n\nStaging parameters indicated a primary lesion greater than 4 cm in size with multiple ipsilateral lymph node metastases, none exceeding 6 cm in diameter. Distant metastasis could not be assessed."} +{"pid": "TCGA-OR-A5K2", "report": "The specimen measured 14.5 cm in greatest dimension and weighed 560 grams. The external surface was smooth, and the cut surfaces were pink-tan with areas of bright yellow streaking. A small amount of residual identifiable adrenal gland was present. The tumor demonstrated high-grade nuclear features with a mitotic rate of 51 per 50 high power fields. Necrosis was present, involving approximately 20% of the tumor volume. Vascular invasion was identified, including within the periadrenal soft tissues. Capsular invasion was also present, and there was evidence of extra-adrenal extension. Surgical margins were initially reported as positive at the superior aspect, but this was later revised to negative after re-evaluation confirmed no true margin involvement. A small capsular defect at the superior aspect was noted but determined to be iatrogenic, without tumor spillage. Lymph node assessment showed no metastatic involvement (0 out of 1 lymph nodes involved). Based on these findings, the staging classification was pT4 NX MX. Additional specimens included a 1.2 x 0.6 x 0.2 cm soft tissue fragment from the vena cava margin, a 1.1 x 0.7 x 0.2 cm periadrenal tissue sample, and a gallbladder specimen with unremarkable mucosa and no significant abnormalities. Frozen section analysis of peritoneal implants showed papillary mesothelial proliferation without evidence of carcinoma, and this was confirmed on permanent sections. No tumor was identified in the cystic duct or gallbladder wall. One lymph node in the periadrenal region was negative for malignancy."} +{"pid": "TCGA-BH-A0HY", "report": "A left axillary sentinel lymph node biopsy included three lymph nodes, all of which were negative for metastatic disease. A total mastectomy specimen from the left breast showed two foci of invasive carcinoma. The larger focus measured 2.0 cm and was located at the 3 o\u2019clock position at the junction of the lower outer and upper outer quadrants. The second focus measured 0.15 cm and was found in the lower outer quadrant. The invasive component had a Nottingham score of 6 (grade 2), with tubule formation score 3, nuclear grade 2, and mitotic rate score 1. No lymphovascular space invasion was identified. There was also extensive ductal carcinoma in situ (DCIS) of nuclear grade 2, with solid and cribriform growth patterns, comedo necrosis, and microcalcifications. DCIS was present admixed with and beyond the invasive component, making up approximately 70% of the total tumor volume. It was identified in eleven out of twenty slides, primarily in the upper outer and lower outer quadrants. All inked surgical margins were free of tumor involvement. However, both the invasive and in situ components were less than 1 mm from the closest deep margin at the 3 o\u2019clock position in the lower outer quadrant. Additional findings included atypical ductal hyperplasia, fibrocystic changes, and benign epithelial calcifications. The skin and nipple margins showed no evidence of tumor. Immunohistochemical staining of the invasive tumor cells was positive for estrogen receptor, negative for progesterone receptor, and positive for HER-2/neu with a score of 3+. Microcalcifications were associated with malignant areas. The procedure performed was a simple mastectomy. The pathological stage was pT1c, pN0, pMX. Lymph node examination involved H/E staining and no positive nodes were found."} +{"pid": "TCGA-19-5953", "report": "The specimen consists of multiple biopsies and resected tissue fragments from the right frontal lobe and superficial tumor site. Tissue samples were received fresh for intraoperative consultation and later fixed in formalin. The largest specimen measured 4.5 x 3.8 x 1.5 cm and consisted of multiple irregular pink-tan, soft cerebriform fragments. The superficial tumor specimen measured 2.3 x 0.8 x 0.4 cm and was composed of multiple irregular pink-tan soft tissue fragments. All specimens were entirely submitted for histologic examination. Touch imprint cytology performed on several samples showed cellular features consistent with a high-grade neoplasm. Histologic sections demonstrated a densely cellular lesion composed of atypical spindle cells with nuclear pleomorphism and frequent mitotic figures. There was evidence of tissue infiltration and necrosis. Cellular morphology and architectural pattern were consistent with a high-grade lesion. All surgical margins were assessed microscopically."} +{"pid": "TCGA-A1-A0SD", "report": "The left breast lumpectomy specimen showed a lesion involving eight consecutive slices, each 0.5 cm thick, with a maximum dimension of 4 cm. Histologic grading using the modified Bloom-Richardson system yielded a total score of 6 points: nuclear grade 3 (3 points), mitotic count of 6 per 10 high-power fields (1 point), and tubule/papilla formation of 10\u201375% (2 points), corresponding to grade 2. The invasive component was surrounded by fibrocystic changes including usual ductal hyperplasia, apocrine metaplasia, and cyst formation. A prior biopsy site was also identified.\n\nThe anterior/superior margin was involved by the invasive lesion, with tumor present on slides C13 and C17. All other margins (deep, medial, lateral, and anterior/inferior) were negative, with closest distances ranging from 0.2 cm to 1.3 cm.\n\nIn addition, there was a component seen that exhibited cribriform architecture with low-to-intermediate nuclear grade and associated necrosis. This component spanned foci throughout the invasive lesion. Microcalcifications were present in association with this process and within benign ducts. All margins for this component were negative, with the closest distance being less than 0.2 cm at the medial margin (slide C1), and greater than 1 cm at the lateral and anterior/inferior margins.\n\nNo lymphatic or vascular invasion was identified. No tumor was found in any of the lymph nodes sampled, including three sentinel lymph nodes and one additional lymph node from the left axilla. The resection also included a focus of microcalcifications within benign ducts and lobules, as well as proliferative changes without atypia.\n\nImmunohistochemical analysis showed positive staining for estrogen and progesterone receptors in more than 90% of cells. HER2 testing by immunohistochemistry showed a staining intensity of 1+, indicating no overexpression."} +{"pid": "TCGA-FX-A76Y", "report": "The specimen was obtained from a female patient. The primary specimen consisted of a uterine fundus measuring 12.0 x 12.0 x 9.0 cm and weighing 794 grams. The external serosal surface was gray-tan to brown-tan. Upon sectioning, the endometrial cavity measured 4.0 cm in length and 6.0 cm from cornu to cornu. The endometrial lining was 0.2 cm thick and showed a red-tan, hemorrhagic appearance. No endometrial lesions were identified. A submucosal mass was present within the myometrium, measuring 10.0 x 9.0 x 8.5 cm. The cut surface of the mass was gray-tan and whorled; no gross necrosis was observed, although there was a focal area of hemorrhage. The remainder of the myometrium appeared gray and trabecular. No other lesions were identified.\n\nSections were taken from multiple areas including the anterior and posterior endometrium, myometrium, various sections of the mass, resected margins, and left and right parametrial regions.\n\nAdditional specimens included a cervix measuring 4.8 cm in length and 3.5 cm in diameter, with a patent os and normal mucosal folds. Multiple cysts up to 0.3 cm were noted. Sections were submitted for analysis.\n\nLymph node specimens were received from multiple sites:\n- Right external iliac: 7 lymph nodes (0.9\u20131.8 cm)\n- Right obturator: 4 lymph nodes (0.7\u20132.5 cm)\n- Right common iliac: 6 lymph nodes (0.5\u20131.8 cm)\n- Left external iliac: 3 lymph nodes (1.8\u20132.2 cm)\n- Left obturator: 1 lymph node (6.5 x 2.0 x 1.5 cm) with fatty infiltration\n- Left common aortic: 3 lymph nodes (0.7\u20131.8 cm)\n\nAll lymph nodes were negative for metastatic disease.\n\nAn omental specimen measuring 32 x 9 x 1 cm showed no nodules or lesions and was also negative for malignancy.\n\nHistologically, the uterine mass showed high-grade nuclear features, coagulative tumor necrosis, and mitotic activity ranging from 5 to 10 per high-power field. The tumor was confined to the myometrium with no lymphovascular space invasion identified. Surgical margins, including the uterine serosa and bilateral parametria, were uninvolved. The endometrium showed no evidence of malignancy. Frozen section analysis confirmed the presence of an atypical spindle cell proliferation.\n\nStaging was determined as pT1bN0 (FIGO IB)."} +{"pid": "TCGA-KN-8422", "report": "The right kidney specimen weighed 132 grams and measured 10.5 x 5.5 x 3.4 cm. An arterial segment 1.5 cm in length and 0.3 cm in diameter, a venous segment 0.7 cm in length and 0.5 cm in diameter, and a second branch of the vein measuring 1.2 x 0.2 cm were identified. A 4.5 cm segment of ureter was also present. A well-circumscribed mass measuring 2.8 x 2.5 x 2.5 cm was located in the mid portion of the kidney, bulging into the renal sinus. The tumor had a soft, dark tan to brown mottled cut surface and abutted the capsule, protruding into the hilum but not clearly involving the collecting system. No tumor thrombus was observed in the renal vein lumen. The surrounding renal parenchyma appeared compressed and pale, with distortion of the papillary structures. Cortical thickness was preserved, and cortical-medullary junctions were distinct. The renal capsule could be stripped easily except at the tumor site where it was adherent. Sections of the tumor and normal tissue were submitted for further analysis.\n\nA single lymph node from the hilar region showed no significant pathologic changes. Bone marrow from the eleventh rib demonstrated normocellular marrow with trilineage maturation. Staining with Hale's colloidal iron was positive in many cells within the mass. Margins of the artery, vein, and ureter were uninvolved. The staging classification based on tumor size and extent was Tla NX MX according to the sixth edition of the AJCC system."} +{"pid": "TCGA-AR-A1AP", "report": "The specimen consists of a mass measuring 1.9 x 1.0 x 0.9 cm, composed of infiltrating cells with mucinous features. Histologic grading using the Nottingham system indicates the highest grade category. A component of high nuclear grade ductal carcinoma in situ is present, accounting for approximately 5\u201325% of the tumor volume and extends beyond the main mass. There is no evidence of angiolymphatic invasion. The surrounding breast tissue demonstrates proliferative fibrocystic changes. After multiple re-excisions, the medial margin remains positive for ductal carcinoma in situ. Microscopic residual ductal carcinoma in situ is identified at the prior biopsy site in the upper inner quadrant; no residual invasive component is detected. The skin, nipple, and deep surgical margins are clear. Evaluation of a single left axillary sentinel lymph node stained with blue dye reveals no metastatic involvement. Ancillary immunohistochemical staining for cytokeratin on paraffin-embedded sentinel lymph node tissue supports the initial assessment. Additional testing for Her-2/NEU is requested on paraffin-embedded tissue."} +{"pid": "TCGA-CQ-5331", "report": "The specimen received includes a right maxillectomy specimen measuring 5.0 x 2.0 x 3.1 cm, along with biopsies from the deep mucosal margin, posterior margin, and medial margin. The lesion identified in the resection specimen measured 2.2 cm in greatest dimension and had a thickness of 0.8 cm. Histologic evaluation showed moderately differentiated cellular features without evidence of lymphovascular or perineural invasion. All surgical margins were found to be free of tumor involvement, with distances ranging from 0.5 cm to 2.3 cm from the tumor edge. Bone sections demonstrated tumor adjacent to bone without direct invasion; the maxillary bone margins were uninvolved. Based on these findings, the tumor was staged as pT2. The remainder of the pathological evaluation revealed no additional significant findings."} +{"pid": "TCGA-A3-3383", "report": "The specimen consists of a 282-gram left kidney measuring 13.0 x 9.0 x 6.0 cm. The external surface is covered with tan-yellow lobular adipose tissue. A bulging subcapsular mass is observed on the posterior mid-body wall. The hilar region contains abundant adipose tissue, and no lymph nodes are identified in this area. Upon bisection, the renal cortex and medulla appear pale, with slightly flattened pyramids and fat-filled calices. The mass measures 5.0 x 5.0 x 4.5 cm, is well-encapsulated, and does not grossly extend into the renal pelvis. No other lesions or calculi are present.\n\nHistologic evaluation reveals a neoplastic lesion with clear cell morphology. The nuclear grade corresponds to Fuhrman grade 2 out of 4. There is no evidence of lymphovascular space invasion, transcapsular extension, or renal vein involvement. Venacaval invasion could not be assessed as this tissue was not resected. Adrenal gland tissue is not identified in the specimen.\n\nAll surgical margins, including soft tissue, ureteral, and vascular, are free of tumor involvement. No lymph nodes are identified within the specimen. Based on pathologic findings, the extent of the lesion is confined to the kidney without regional nodal or distant spread. The lesion is located at the posterior aspect of the mid kidney. Genomic studies have been performed on representative samples of the lesion."} +{"pid": "TCGA-85-8352", "report": "The specimen consisted of a pulmonectomy with a tumor located in the lung measuring 8x7x7 cm. Microscopic examination revealed a poorly differentiated squamous cell carcinoma. The tumor involved the visceral pleura, and there was evidence of lymph node metastasis, with 3 out of 8 lymph nodes involved (intrathoracic). No other tumor nodules, lymphatic invasion, venous invasion, or margin involvement were specified. The histologic type and grade were confirmed, but other details regarding treatment effect, additional findings, or resection margins were not provided. Laterality was noted as right upper."} +{"pid": "TCGA-FE-A3PD", "report": "**Specimen Description:** \nA pretracheal mass biopsy was performed, and three lymph nodes were examined, all of which showed benign features. A left thyroid lobe excision revealed a nodule measuring 2.3 x 1.8 x 1.7 cm with infiltrative borders. The surrounding thyroid tissue appeared normal. Histologically, the lesion exhibited low-grade features with lymphatic/vascular invasion noted; however, there was no evidence of capsular invasion or infiltration into adjacent structures. The tumor was confined to the thyroid and was not multifocal. Three lymph nodes were retrieved, none of which contained malignant cells. Staging classification was determined as pTNM: T2 N0 Mx.\n\nAn immunohistochemical evaluation demonstrated positive staining for TTF-1. Other markers including Her-2Neu were also assessed, although only selected tests were fully validated.\n\nA separate excision involving the right thyroid lobe and isthmus showed no evidence of malignancy. The thyroid parenchyma was consistently unremarkable throughout.\n\nIntraoperative frozen sections were obtained from both the pretracheal mass and the left thyroid lobe. The former was interpreted as benign, while the latter displayed characteristics consistent with a specific type of epithelial proliferation that was further characterized in permanent sections.\n\nThe specimens were properly labeled and processed. The left thyroid lobe specimen weighed 8.8 grams and measured 3.8 x 2.7 x 1.8 cm. Sections were taken from multiple regions including the superior and inferior poles, as well as representative areas of the lesion. The right thyroid lobe specimen weighed 5.75 grams and measured 4.3 x 3.2 x 0.7 cm. It included the isthmus and random sections of the lobe, all appearing histologically unremarkable.\n\nAll findings were documented according to standardized reporting guidelines."} +{"pid": "TCGA-L5-A43J", "report": "A prior esophagectomy specimen involved a 2.5 x 1.7 cm mass located in the mid-esophagus, arising 6.0 cm from the proximal margin. The resected segment measured 15.3 cm in total, with 10.8 cm representing esophageal tissue and 4.2 cm gastric tissue. The lesion was firm, ulcerated, and gray-tan in appearance, with a maximum thickness of 0.9 cm. It extended to within less than 0.1 cm of the adventitia. Distal mucosa appeared purple-gray with partial loss of mucosal folds, while the proximal mucosa showed focal hemorrhage. The esophagogastric junction had unremarkable mucosa, and the gastric portion displayed focal bosselation without any discrete mass. Lymph nodes up to 0.7 cm were identified in the periesophageal fat.\n\nHistologic evaluation included multiple sections: one from the proximal margin, areas near and away from the tumor, the esophagogastric junction, and three whole lymph node candidates. Frozen section analysis of the proximal margin was negative. Permanent sections confirmed these findings. Microscopic examination revealed an invasive, poorly differentiated squamous cell carcinoma involving the esophageal wall up to the adventitia. Focal perineural and vascular invasion was noted. All resection margins were free of involvement. No metastatic disease was identified in the three regional lymph nodes examined. There was no prior neoadjuvant therapy administered. Distant metastasis status remains unknown."} +{"pid": "TCGA-VQ-A928", "report": "The specimen from the stomach body shows a moderately differentiated papillary adenocarcinoma of intestinal type according to Laur\u00e9n classification. The tumor infiltrates into the subserosal adipose tissue and measures up to 7.8 cm in maximum dimension. Angiolymphatic invasion is present; however, no perineural invasion is detected. All surgical margins are free of neoplastic involvement.\n\nExamination of regional lymph nodes reveals variable involvement. Lymph nodes from the jejunal mesentery (0/1), right paracardic region (0/2), and splenic artery (0/1) are free of tumor. However, extensive involvement is seen in other regions: infra-pyloric (4/15), supra-pyloric (9/11), left gastric artery (2/5), common hepatic artery (11/18), and celiac trunk (6/28). Metastatic lymph nodes in the supra-pyloric and common hepatic artery regions show conglomerate formation. No neoplasia is identified in fibrous connective and adipose tissue sampled along the greater curvature."} +{"pid": "TCGA-A5-A0GH", "report": "The uterus with bilateral tubes and ovaries was received fresh for intraoperative frozen section diagnosis and subsequently fixed in formalin. The uterus measured 7.5 cm from fundus to cervix, 2.7 cm anterior-posterior, and weighed 92 grams. The serosal surface showed bosselations due to subserosal leiomyomas. Upon opening, the endometrial cavity measured 0.3 cm in length and 2.3 cm in width. A tan, polypoid, friable lesion was identified in the posterior endometrium, replacing the normal tissue. Gross examination revealed tumor invasion into less than half of the myometrium on the posterior side, with a maximal thickness of 5 mm in a myometrial area measuring 15 mm thick. The anterior myometrium appeared uninvolved. The endometrium was 0.5 cm thick and the myometrium measured 1.5 cm. The cervix measured 2.5 cm in length and 2.0 cm in width with a slit-shaped external os.\n\nHistologically, the tumor exhibited features consistent with a specific type of endometrial malignancy. Focal areas showed clear cell morphology. Histologic grading according to a standard classification system was assigned as grade 2, with nuclear grade also classified as 2. There was no evidence of endocervical involvement. A small focus raised suspicion for angiolymphatic invasion (section C). The remaining endometrium showed atrophic changes. Myometrial findings included the presence of calcified leiomyoma and focal adenomyosis. In the left ovary, a minute fibroma was noted. The right ovary showed inclusion cortical cysts. Bilateral ovaries displayed involutional changes. The fallopian tubes were unremarkable.\n\nEighteen lymph nodes were examined, including right and left obturator, pelvic, and periaortic regions; all were benign without evidence of metastatic disease. Omental tissues (two specimens) were submitted and showed only benign lobulated adipose tissue. The appendix was removed and showed fibrous luminal obliteration without other significant findings.\n\nRepresentative sections were taken from various areas including the cervix, uterine segments, endomyometrium, ovaries, fallopian tubes, and leiomyomas. All lymph nodes and omental samples were entirely submitted for evaluation. No additional masses or nodules were identified in the omentum or appendix. The surgical margin of the appendix was unremarkable. Frozen section analysis of the right obturator lymph node was negative for tumor."} +{"pid": "TCGA-FB-A4P6", "report": "Gross Description: A lymph node measuring 2.0 cm from the hepatic artery is sectioned; no obvious abnormal nodules are identified. Half of the lymph node is processed for frozen section analysis in one cassette, along with touch preparations for rapid H and E staining.\n\nMicroscopic Description: The specimen includes the head of the pancreas, duodenum, stomach, and common bile duct, following a pancreaticoduodenectomy (Whipple resection). The tumor is located in the head region and measures 4.5 cm. Histologically, the tissue shows well-differentiated features. Microscopically, the tumor extends into the peripancreatic soft tissue. All surgical margins, including the distal pancreas, common bile duct, duodenum, and retroperitoneal margin (uncinate groove), are free of tumor involvement. There is no evidence of angiolymphatic invasion, though perineural invasion is present. No prior treatment effect is observed.\n\nLymph node evaluation reveals: \n- Hepatic artery: 1 lymph node, negative for metastasis. \n- Portal: 1 lymph node, negative for metastasis. \n- Superior peripancreatic: 14 lymph nodes, all negative. \n- Inferior peripancreatic: 9 lymph nodes, 1 involved. \n- Anterior pancreaticoduodenal: 6 lymph nodes, all negative. \n- Posterior pancreaticoduodenal: 15 lymph nodes, all negative. \n\nTNM staging is reported as pT3 pN1 pMx, corresponding to AJCC stage IIB.\n\nFrozen section analysis confirms benign findings in the hepatic artery and portal lymph nodes. The pancreatic duct margin is also negative for malignancy.\n\nAdditional reporting notes include a checklist confirming a Whipple resection specimen with a tumor size of 4.5 cm, well-differentiated histology, and extension into peripancreatic soft tissue. Lymphatic invasion is absent, while venous invasion is present. Margins remain uninvolved, and there is no evidence of neoadjuvant treatment."} +{"pid": "TCGA-G9-6333", "report": "The surgical specimens include left and right pelvic lymph nodes, a left apical margin tissue fragment, and a prostate with attached seminal vesicles and vas deferens. The left pelvic lymph nodes consist of three lymph nodes ranging in size from 0.5 x 0.5 x 0.5 cm to 3 x 1.2 x 0.4 cm. The right pelvic lymph nodes include ten lymph nodes measuring between 0.5 x 0.5 x 0.5 cm and 1.2 x 1 x 1 cm. The left apical margin sample is a small soft tissue fragment measuring 0.3 x 0.2 x 0.2 cm. The prostate weighs 49 grams and measures 6 cm in width, 4 cm in depth, and 3 cm in height. It has been sectioned systematically and shows firm tan fibrous parenchyma without visible lesions or nodules. Both seminal vesicles are similar in appearance, measuring 1 x 1 x 0.5 cm on the right and 0.8 x 0.6 x 0.5 cm on the left. The vas deferens segments measure 2.6 x 0.5 cm on the right and 2.4 x 0.5 cm on the left. Histological evaluation reveals no evidence of tumor involvement in the lymph nodes or at the surgical margins. Cellular features show no signs of malignancy in the sampled areas. Pathological staging indicates localized disease without lymph node or distant metastasis."} +{"pid": "TCGA-4V-A9QW", "report": "The specimen consists of a thymectomy and a right upper lobe lung biopsy. The thymectomy specimen measures 15 x 8 x 4 cm and weighs 115 grams. A nodule is present, located in the left side of the thymus, measuring 4.8 cm in greatest dimension. It is well-circumscribed and partially encapsulated. The cut surface shows a pink-tan tissue with areas of hemorrhage but no necrosis. The tumor has a biphasic appearance under the microscope, composed of epithelial and lymphocytic components. The epithelial component is predominant in some areas (approximately 20%) and consists of spindle-shaped cells arranged in bundles, rosettes, and small clusters. No significant nuclear atypia is observed. The lymphocytic component varies in density across the sections and consists of small round cells intermingled with the epithelial proliferation. No bone marrow differentiation or perivascular clear spaces are identified. Scattered fibrous areas are present within the tumor. A thick fibrous capsule surrounds the lesion, without evidence of capsular invasion. All resection margins are free of tumor involvement.\n\nImmunohistochemical staining demonstrates focal positivity for cytokeratin KL1 in the spindle epithelial cells, and they are negative for CD117 and CD5. There is variable expression of CD20. The lymphocytic component consists of immature T lymphocytes, positive for CD5 and CD1a.\n\nA separate wedge biopsy of the right upper lobe of the lung shows a small focus of intrapulmonary osseous metaplasia. The nodule in this region measures 4 mm in diameter, and the resection margin is marked with green ink."} +{"pid": "TCGA-PD-A5DF", "report": "The specimen was obtained from a female patient with a clinical history of a lesion in the right liver lobe. The surgical specimens include three tissue sources: a lymph node, a segment of the right liver lobe, and a composite specimen containing the gallbladder, segments 5 and 6 of the liver, and the right colon.\n\nThe first tissue source is a right colonic mesenteric lymph node measuring 0.7 x 0.5 x 0.5 cm. It was firm with a yellow-tan appearance and entirely submitted for analysis. No abnormal cellular infiltration was identified in this lymph node.\n\nThe second tissue source was a small nodule from the right lobe of the liver, measuring 0.5 x 0.5 x 0.3 cm. It was described as firm and white-tan with well-defined borders and entirely submitted for evaluation.\n\nThe third and largest specimen consisted of a liver mass measuring 21 x 17 x 13.5 cm. This mass had a golden-yellow, soft cut surface with diffuse necrosis. It was located within 2 cm of the closest cauterized liver margin, which was marked with green ink. A suture was also noted at this margin. The mass was adhered to adjacent structures including a short segment of terminal ileum (7 cm long, 3 cm in circumference), which showed a diffusely hemorrhagic mucosal lining without discrete masses. The appendix measured 8.5 x 0.5 x 0.5 cm and had a tan-pink homogeneous cut surface without identifiable lesions. The attached large bowel segment, measuring 39 cm in length and 5 cm in circumference, was completely adhered to the liver mass but showed no evidence of tumor infiltration into the bowel wall. The mucosa of the large bowel was diffusely hemorrhagic without discrete lesions. The gallbladder measured 8 x 4 x 4 cm and was also adhered to the tumor. It contained approximately 20 cc of dark-green viscous bile and showed no mucosal ulcerations or polyps. The cystic duct was patent with a diameter of 0.5 cm.\n\nMicroscopic evaluation revealed that the tumor invaded the serosa of the ascending colon and exhibited angiolymphatic invasion. All surgical resection margins were free of malignant cells. Additional findings included chronic cholecystitis of the gallbladder, no diagnostic abnormalities in the cecum or terminal ileum, and partial fibrosis with obliteration of the appendix lumen.\n\nTumor staging was assessed as pTNM T4 N0 Mx."} +{"pid": "TCGA-ET-A3BP", "report": "The specimen consists of a total thyroidectomy from the left side, including the isthmus and left lobe. Two distinct lesions were identified: a 2.5 cm focus in the left lobe and a 1.2 cm focus in the isthmus. Evaluation of perithyroidal lymph nodes revealed the presence of metastatic involvement in 2 out of 3 nodes examined.\n\nThe primary tumor was confined to the thyroid gland and measured greater than 2 cm in aggregate size. Assessment of surgical margins demonstrated no involvement by invasive disease, with the closest distance of invasive tissue to the posterior margin being less than 1 mm. Evidence of vascular and lymphatic invasion was identified. Regional nodal involvement was confirmed, though distant metastatic spread could not be definitively assessed."} +{"pid": "TCGA-EY-A1GR", "report": "A total abdominal hysterectomy with bilateral salpingo-oophorectomy was performed. Histologic evaluation of the endometrium revealed a lesion with architectural and nuclear features consistent with high-grade changes. The tumor measured 8.9 cm in anterior-posterior dimension, 7.5 cm medially-laterally, and 5.6 cm cephalad to caudad. Gross examination showed a large tan/white fungating mass involving both anterior and posterior aspects of the endometrial cavity. Myometrial invasion was identified in the inner half of the myometrium on both anterior and posterior sides, with a depth of invasion measuring 5 mm and a residual myometrial wall thickness of 1.5 cm, representing approximately 33% of the wall thickness. No involvement of the serosal surface, lower uterine segment, or cervical regions was observed. Margins were widely free of tumor.\n\nLymphovascular space invasion was identified. Regional lymph node evaluation included examination of left and right pelvic lymph nodes (8 and 8 respectively), and left and right periaortic lymph nodes (3 and 6 respectively); none showed evidence of metastasis. A total of 25 lymph nodes were examined, with no positive nodes identified.\n\nAdditional findings included an atrophic right and left ovary without any tumor involvement. Both fallopian tubes were unremarkable. Immunohistochemical staining demonstrated hormone receptor positivity.\n\nThe specimen weighed 450.09 grams and had a grapefruit-like shape with dimensions of 11 cm in height, 9.5 cm in anterior-posterior width, and 10.0 cm at the fundal breadth. The endometrial cavity measured 6.0 cm in length and 6.5 cm in width at the fundus. The cervix measured 3.5 cm in length of the endocervical canal, with a small polypoid lesion measuring 0.5 x 0.5 x 0.3 cm identified on the anterior endocervix. Both ovaries and fallopian tubes were within normal size ranges and showed no signs of neoplastic involvement.\n\nAll tissue blocks were processed and reviewed, including multiple sections from various regions of the uterus and adnexa. No other significant pathologic findings were identified."} +{"pid": "TCGA-G3-AAV5", "report": "The specimen was received in two parts: a gallbladder and a right liver resection. The gallbladder measured 9.5 x 3.5 x 3.0 cm, with a smooth serosal surface and filled with green bile. No calculi were identified. The gallbladder wall averaged 0.3 cm thick. Adjacent to the cystic duct was a lymph node measuring up to 2.5 cm. Histologic examination of the gallbladder showed no evidence of malignancy. The lymph node demonstrated reactive changes only.\n\nThe right liver resection weighed 1.4 kg and measured 30.0 x 15.0 x 10.0 cm. A tan lobulated mass was identified within the liver parenchyma, measuring approximately 17.5 x 10.0 x 10.0 cm, with areas of hemorrhage. Multiple smaller nodules ranging from 0.2 cm to 1.0 cm were noted near the main mass; however, it was unclear whether these were distinct lesions or extensions of the primary mass. The surrounding liver parenchyma exhibited fibrosis and a nodular appearance.\n\nHistologically, the liver lesion demonstrated a solid and trabecular growth pattern. Cellular atypia was present, including a high nuclear-to-cytoplasmic ratio, prominent nucleoli, and frequent mitotic figures. Areas of necrosis were identified but involved less than 10% of the lesion. Vascular invasion was prominent, with embolization material seen in some vessels. Additional findings included cirrhosis of the surrounding liver tissue and presence of tumor nodules within the adjacent parenchyma.\n\nThe resection margin was marked with blue ink. The closest distance of the smaller nodules to the margin was 0.5 cm, while the main mass approached within 1.5 cm of the margin. The main mass itself was 4.5 cm from the blue-marked margin. Microscopic evaluation of the margins showed no involvement by invasive carcinoma.\n\nThe tumor was confined to the liver. Based on pathologic assessment, the primary tumor classification was determined as pT2 (solitary tumor with vascular invasion or multiple tumors none more than 5 cm), with unassessable regional lymph nodes (pNX) and distant metastases (pMX)."} +{"pid": "TCGA-86-7713", "report": "The specimen consists of a lobectomy with a tumor located in the lung measuring 6 x 6 x 6 cm. Microscopic evaluation shows moderately differentiated cells. Regional lymph node assessment identified no metastatic involvement. No other significant pathological features are noted."} +{"pid": "TCGA-ZB-A963", "report": "Pathology Report-Summary: Material: Tumor: maximum dimension 3.8 cm. Histopathological findings show epithelial cells positive for CK5/6 and CK19, and negative for CK20. CD1a-positive T-lymphocytes are present. Staging classification is pT2 and Masaoka stage II.1. Cellular composition includes a mixed population of epithelial cells and lymphocytes."} +{"pid": "TCGA-BT-A20Q", "report": "The specimen from a radical cystoprostatectomy involved the trigone and left lateral wall of the bladder. The largest dimension of the lesion measured 3.3 cm. Histologic evaluation revealed high-grade urothelial carcinoma arranged in a solid and ulcerated configuration. The tumor extended into the perivesical adipose tissue, with focal involvement of the left lateral bladder wall surgical margin. Angiolymphatic invasion was identified. Regional lymph node dissection included 23 nodes, with four involved by metastatic disease\u20141 of 11 on the right and 3 of 12 on the left. Extracapsular extension was present in the left pelvic lymph nodes. No tumor was identified in the distal right ureter or in the prostatic tissue, which showed only benign changes with focal chronic inflammation. No in situ component was identified. Pathologic staging was determined as pT3b pN2 MX, with histologic grade G3. Additional findings included focal inflammation and regenerative changes."} +{"pid": "TCGA-FY-A3R6", "report": "The surgical pathology report includes a total thyroidectomy specimen, measuring 4.5 x 2.0 x 1.4 cm for the right lobe, 4.0 x 1.8 x 1.8 cm for the left lobe, and 1.0 x 0.2 x 0.2 cm for the isthmus. The left lobe contains a dominant lesion measuring 2.2 x 1.5 x 1.3 cm with classical and follicular architecture. Histologic evaluation shows well-differentiated features. No tumor involvement is identified at the surgical margins. No lymphovascular or perineural invasion is present, and there is no evidence of extension beyond the thyroid capsule.\n\nIn addition to the dominant lesion, multiple microscopic foci are present in the left lobe and isthmus, all measuring less than 1 mm. These foci are well-differentiated and confined within the thyroid. The right lobe contains several small nodules measuring up to 0.4 cm, which appear benign. Additional findings include lymphocytic thyroiditis and benign Hurthle cell nodules.\n\nA parathyroid specimen consists of normocellular parathyroid tissue without abnormality. Level six lymph nodes show involvement in two out of three nodes, with the largest focus measuring 2.0 cm and no extranodal extension. In level two lymph nodes, one of four nodes is involved with a 0.5 cm focus, also without extranodal extension. The left modified radical neck dissection specimen contains 23 lymph nodes, two of which show involvement with foci measuring 2.5 cm and 2.0 cm, both demonstrating extranodal extension.\n\nPathologic staging indicates T2(m) for the primary thyroid lesion, N1b for lymph node involvement (5 positive nodes out of 30 examined), and MX for distant metastasis not assessable. The specimen was processed in its entirety and reviewed microscopically."} +{"pid": "TCGA-E9-A3X8", "report": "The pathology report describes a radical mastectomy specimen from the left breast. A grossly evident lesion was identified, measuring 3.5 x 3.5 x 3.5 cm. Histologic evaluation revealed lobular-type morphology. Lymph node assessment showed that 4 out of 8 axillary lymph nodes were positive for metastatic involvement. Hormone receptor analysis showed ER and PR positivity (8 points combined), while HER2 immunohistochemistry was negative. Several key parameters including histologic grade, tubule formation, nuclear pleomorphism, and mitotic counts were not specified, precluding determination of a Nottingham Histologic Score. Other details regarding tumor extent, margins, extracapsular extension, and neo-adjuvant treatment effect were also not provided."} +{"pid": "TCGA-BP-5175", "report": "The specimen from the right kidney measured 4.5 x 4 x 2.5 cm and contained a well-encapsulated mass measuring 2.8 x 2.5 x 2.5 cm, located within the kidney parenchyma. The mass exhibited yellow-orange discoloration with areas of hemorrhage and necrosis. It was found to be 0.3 cm from the deep margin. Microscopically, the cellular pattern was acinar, with features consistent with high nuclear grade. The lesion was confined within the renal capsule and did not demonstrate invasion into the renal vein. All surgical margins were free of abnormal cells. Adjacent non-affected kidney tissue showed no significant changes. Additional specimens from the deep margin #2 and other excised tissues were composed of benign renal parenchyma. The tumor was fully sampled and representative sections were submitted for analysis. Intraoperative frozen section evaluation confirmed the presence of a cortical epithelial lesion with benign margins, which was confirmed on permanent sections."} +{"pid": "TCGA-G8-6914", "report": "The surgical specimen consists of two lymph node tissue samples from the left cervical level 5 region, measuring 3x2x2 cm and 4x3x2 cm. Both specimens exhibit a tan-colored, fleshy, and slightly lobulated cut surface. Portions of the tissue were processed for immunohistochemical analysis, cytogenetic studies, and frozen section evaluation, with remaining sections fixed in B5 and formalin for further histological examination.\n\nBone marrow biopsies were obtained from both the right and left iliac crests. Tissue fragments were submitted in B5 fixative and evaluated through histologic sections, bone marrow aspirate smears, and imprints. The aspirate differential count was based on 500 cells and showed an estimated cellularity of 2 out of 4, with a myeloid-to-erythroid ratio of 1.8:1. Megakaryocytes were present in normal quantity without evidence of dysplasia. Myeloid and erythroid lineages displayed no dysplastic changes. Blasts accounted for 2.6% of cells, including 1.6% promyelocytes and 1.0% myeloblasts, with no abnormal lymphoid or monocytic blasts identified. Lymphocytes constituted 4.2%, monocytes 0.8%, and plasma cells 0.2%. Eosinophils were noted at 3.4%, and mature segmented neutrophils made up 15.2%. No ring sideroblasts, lymphoblasts, or unclassified blasts were observed.\n\nHistological assessment of the bone marrow biopsies revealed a cellularity of approximately 35%, with a myeloid-to-erythroid ratio of 2:1. Myeloid and erythroid precursors were present in adequate amounts, and megakaryocytes were rare but morphologically normal. Iron stores were unremarkable, and there was no evidence of abnormal infiltrates. No prior bone marrow biopsy comparisons were available.\n\nImmunophenotyping by flow cytometry of the lymph node tissue demonstrated expression of CD19, CD20, and CD22. Light chain analysis showed a Kappa to Lambda ratio of 59.9 to 0.23. Frozen section evaluation confirmed the presence of malignant cells, and the findings were corroborated in consultation. No evidence of disease involvement was detected in the bone marrow samples."} +{"pid": "TCGA-DU-7299", "report": "Surgical Pathology Report. Clinical history: male with recent onset seizure, found to have a left parietal-occipital lesion. Operative diagnoses were not provided. Operation/specimen: A\u2014Brain mass, biopsy; B\u2014Brain, resection.\n\nGross examination of specimen A revealed four fresh fragments measuring 2.2 cm in aggregate, semi-firm, tan-yellow, with poorly demarcated cerebral cortex. Specimen B measured 2.0 x 1.5 x 0.4 cm and consisted of several irregular gray-tan to gray-white tissue fragments.\n\nMicroscopic evaluation showed infiltration of the cerebral cortex and adjacent white matter by a neoplastic glial proliferation. The cells exhibited focal cellular pleomorphism. Nuclear features included both naked nuclei and cells with a gemistocytic morphology. Mitotic figures were present but sparse. No microvascular proliferation or necrosis was identified. Immunohistochemistry demonstrated strong GFAP positivity with a gliofibrillary background and abundant gemistocytes. Over 45% of tumor cells showed p53 overexpression. MIB-1 staining revealed a proliferation index exceeding 10% in more active areas.\n\nTouch preparations and smears from the biopsy showed findings consistent with a glial neoplasm.\n\nAll submitted tissue blocks were evaluated microscopically."} +{"pid": "TCGA-BH-A0DH", "report": "The specimen consists of axillary contents and breast tissue from the left side. Lymph nodes involved by malignant cells were identified within the axillary contents, with three out of twenty-eight lymph nodes affected. The largest focus measured up to 1.5 cm and demonstrated extension beyond the capsule measuring 0.2 cm. Changes suggestive of prior fine needle aspiration were noted.\n\nBreast tissue following segmental resection revealed an infiltrative lesion associated with microcalcifications. The posterior and inferior margins were involved by invasive tumor, while the anterior margin showed tumor proximity at 0.2 cm. The lesion measured 3.5 x 2.5 x 1.7 cm and exhibited a Nottingham score of 6 out of 9 (tubules 3, nuclear grade 2, mitotic activity 1). Invasion of vascular spaces was observed.\n\nIn addition to the invasive component, there was presence of in situ disease composed of solid and cribriform patterns with nuclear grade 2 features, comedonecrosis, associated microcalcifications, and retrograde involvement of lobules accounting for approximately 2% of the total tumor volume. This in situ component was intermixed with the invasive tumor.\n\nAdditional findings included atypical ductal hyperplasia, ductal papillomas, radial scars with epithelial hyperplasia and columnar cell changes, proliferative fibrocystic changes with ductal epithelial hyperplasia, columnar cell alterations, and multifocal sclerosing adenosis associated with microcalcifications. Changes consistent with prior biopsy were also identified.\n\nFurther excision of additional margins revealed a microscopic focus of invasive carcinoma located 0.3 cm from the newly inked margin. Other findings included atypical ductal hyperplasia, ductal papilloma, radial scars with epithelial hyperplasia and microcalcifications, proliferative fibrocystic changes, extensive sclerosing adenosis with microcalcifications, and medial calcifications of blood vessels. All newly evaluated margins were free of tumor involvement.\n\nHistologic evaluation of lymph nodes confirmed metastatic involvement in three lymph nodes with the largest metastasis measuring 15 mm. Staging parameters indicate pathologic T stage as pT2 and pathologic N stage as pN1a. Hormone receptor testing demonstrated positivity for estrogen and progesterone receptors with no expression of HER2/Neu."} +{"pid": "TCGA-CJ-4895", "report": "The left kidney and adrenal gland specimen demonstrates a large, well-demarcated mass measuring 15.9 x 9.0 x 10.0 cm located in the middle and lower portion of the kidney. The overall nephrectomy specimen measures 20.0 x 18.5 x 7.8 cm and includes the left kidney (10.3 x 5.3 x 5.0 cm), attached ureter (13.0 cm long, 0.5 cm diameter), and an unremarkable adrenal gland (6.0 x 1.7 x 1.2 cm). On gross examination, the mass shows areas of cystic degeneration, hemorrhage, myxoid change, and yellow solid regions. It involves the renal sinus adipose tissue and extends into the perinephric adipose tissue. There is focal extension into the intrarenal portion of the renal vein, possibly involving one of its branches. No involvement is seen in the renal pelvis or adjacent non-involved kidney parenchyma. Histologic sections include multiple levels of the tumor, adjacent renal sinus, areas near the renal capsule, and surrounding adipose tissue. Margins of resection, including vascular, ureteral, and soft tissue, are negative for tumor involvement. Sections of the adrenal gland show no evidence of abnormality. Multiple representative sections of the tumor were submitted for further analysis, including potential electron microscopic studies."} +{"pid": "TCGA-UF-A7JT", "report": "The specimen from the right pelvi-mandibulectomy shows a high-grade invasive lesion with a deep invasion measuring 2.0 cm and a tumor size of 4.5 cm. The lesion extends to the adjacent skin. Perineural invasion is present, while lymphovascular invasion is not identified. The submandibular salivary gland and submandibular lymph nodes show no involvement (0/4). Surgical margins of the skin and soft tissue are free of neoplastic cells. Within the osseous tissue, there is evidence of neoplastic involvement; however, the osseous margin remains uninvolved. A total of four lymph nodes from Level 2a and nine from Level 3 on the right side show no signs of metastatic involvement."} +{"pid": "TCGA-BJ-A2N7", "report": "The specimen consists of a total thyroidectomy with submission of the left lobe and isthmus measuring 19 grams, and the right lobe measuring 7 grams. In the left lobe and isthmus, a lesion measuring 5.0 cm is identified. It demonstrates extensive vascular invasion and lacks extrathyroidal extension. The closest margin is less than 0.1 cm from the lesion. In the right lobe, a lesion measuring 1.8 cm is present with multiple foci of capsular and vascular invasion. Extrathyroidal extension is absent, and the lesion is within 0.1 cm of the margin. Molecular testing on both lesions showed no mutations in BRAF, NRAS61, HRAS61, KRAS12/13 or RET/PTC1 and RET/PC3 rearrangements; nucleic acid extraction was sufficient for testing in both cases. Both lesions are multifocal with papillary histology and lymph-vascular invasion identified. Pathologic staging for the primary tumor is pT3 with margins uninvolved and no lymph node or distant metastasis evaluation provided."} +{"pid": "TCGA-F5-6571", "report": "The submitted large intestine tissue specimen was obtained from a rectal excision. The tumor measured 4 \u00d7 5 \u00d7 1.5 cm and was found to extend to the subserosa. Histologic evaluation revealed moderately differentiated cells arranged in glandular formations. A total of two regional lymph nodes were examined, and none showed evidence of involvement. No other notable features or treatment-related changes were identified."} +{"pid": "TCGA-WC-A885", "report": "The right globe specimen measures 22 x 22 x 23 mm and is intact. The sclera appears unremarkable, and the anterior chamber is clear. The iris measures 10 x 11 mm with a central pupil 4 mm in diameter. The optic nerve is 11 mm in length. Transillumination reveals a shadow located 10 mm from the limbus and 6 mm from the optic nerve. Upon opening the eye, a dark black-brown lesion is identified, measuring 12 x 12 mm at its base with a height of 6 mm. The vitreous is clear and the lens remains in place. The sclera appears intact, and there is no gross involvement of the optic disc or ciliary body.\n\nHistologically, sections reveal a cellular proliferation composed predominantly of spindled cells. Mitotic activity is present at a rate of 3 mitoses per 10 high power fields. There is evidence of scleral invasion in a perivascular pattern. No extraocular extension is observed. Vortex veins and optic nerve margins are free of tumor involvement.\n\nSpecimens submitted for biomarker testing include the primary tumor block (section A5). Additional aspirate material from the right eye was insufficient for further evaluation.\n\nSections examined include tissue from the vortex vein region (A1), optic nerve margin and anterior chamber (A2), calotte with tumor (A4), and a pupil-optic nerve section containing tumor (A5)."} +{"pid": "TCGA-HW-8321", "report": "The clinical history describes a left frontal intra-axial enhancing lesion. Three specimens were submitted for analysis. The first specimen, labeled as left frontal brain tumor, consists of two tan-pink tissue fragments measuring 1.5 x 1.0 x 0.8 cm in total. The second specimen, labeled left frontal lobe brain tumor #2, is an aggregate of white-tan brain matter measuring 7.5 x 6.5 x 2.5 cm, with a glistening cut surface. The third specimen, from an enlarging region of the left frontal lobe tumor, measures 2.0 x 1.0 x 0.8 cm and is composed of tan-gray brain tissue.\n\nMicroscopic evaluation of all three specimens reveals a diffusely infiltrating glial neoplasm. The tumor demonstrates predominantly astrocytic morphology, although some areas show features reminiscent of oligodendroglial differentiation. A subset of tumor cells shows p53 immunoreactivity, and there is expression of the R132H mutant form of IDH1. The overall proliferation index, as assessed by MIB-1 labeling, is largely low, consistent with a less aggressive growth pattern. However, in one focus within the second specimen, an increase in mitotic activity and a MIB-1 labeling index of 8\u201310% is observed, indicating a limited area of more aggressive behavior.\n\nAdditional molecular studies have been initiated, including testing for MGMT promoter methylation status and chromosomal 1p/19q deletion. These results are pending. All specimens were reviewed following personal examination and the report has been approved."} +{"pid": "TCGA-XN-A8T5", "report": "The specimen consists of a segment of duodenum measuring 15 cm in length and 8.0 cm in diameter, along with a portion of pancreas measuring 5.5 cm in length and 3.0 cm in diameter. Microscopic examination of the resected tissue shows a moderately differentiated cellular growth pattern within the ductal region, with a maximum dimension of 2.5 cm. The lesion demonstrates perineural infiltration. No angiolymphatic vascular invasion is identified. A total of six lymph nodes are examined, all of which are free of malignant cells. The pathological staging is determined to be pT2, pN0. A suspicious focus with features suggestive of neuroendocrine differentiation is also noted."} +{"pid": "TCGA-C5-A1MP", "report": "The specimen from a radical hysterectomy includes the cervix, uterus, and multiple lymph node groups. The cervix contains a lesion measuring 4.3 cm in greatest dimension, with a depth of invasion measuring 1.4 cm out of a total cervical thickness of 2.4 cm. There is extensive lymphovascular space invasion identified. All resection margins are free of tumor involvement. The parametrial tissue shows no evidence of tumor involvement.\n\nThe endometrium demonstrates secretory changes without any atypical or malignant cells present. The myometrium shows findings consistent with adenomyosis and also lacks any signs of malignancy.\n\nLymph node dissections include left pelvic, left common iliac, left paraortic, right pelvic, and right pre caval regions. Metastatic involvement is identified in three out of fifteen lymph nodes in the left pelvic group, one out of nine in the left common iliac group, one out of fourteen in the left paraortic group, and one out of fifteen in the right pelvic group. No metastases are found in the single lymph node from the right pre caval region."} +{"pid": "TCGA-CV-7183", "report": "The pathology report describes a laryngectomy specimen with a left selective neck dissection involving levels II, III, and IV. The larynx measures 9.0 x 7.0 x 5.0 cm and includes the hyoid bone, thyroid gland, and strap muscles. A 3.7 x 2.5 cm exophytic lesion is identified in the left transglottic region, without extension across the midline anteriorly or posteriorly. The left thyroid lobe measures 4.5 x 3.0 x 1.5 cm, while the right thyroid lobe measures 2.5 x 2.0 x 1.0 cm and has an irregular lateral edge; however, the thyroid gland otherwise shows no significant abnormalities.\n\nThe lesion measures approximately 0.5 cm in greatest thickness and 3.7 cm in greatest dimension. No vascular invasion is observed. All surgical margins are free of involvement. A total of 36 lymph nodes were assessed: 17 from level II, 8 from level III, and 11 from level IV. No evidence of involvement is found in any of these nodes. The tumor does not extend into the anterior soft tissues. Multiple sections were taken for analysis, including margins, the entire lesion, and lymph node levels. Frozen section analysis of the tracheal margin showed no involvement."} +{"pid": "TCGA-DD-AAEE", "report": "Specimen consists of liver and a liver mass, with a fresh status. The liver measures 10.0 x 4.5 x 4.3 cm and weighs 103.7 grams. The gallbladder is 9.5 cm in length, 3.0 cm in diameter, with a wall thickness of 0.5 cm. The procedure performed was a partial hepatectomy involving segment 4 and cholecystectomy. A well-defined mass measuring 1.8 x 1.6 x 1.5 cm was identified in segment 4. The cut surface of the mass is described as yellowish tan and solid. Gross type is nodular with perinodular extension. The resection margin is not involved with a safety margin of 1.0 cm. There is no satellite nodule or portal vein invasion noted. The remaining liver parenchyma shows cirrhotic changes. For the gallbladder, two golden-yellow polyps are observed, with the remainder being unremarkable. Representative sections were submitted. Gross photo is available. Blocks include T1- and TB with five sections of the tumor, NB and L with two sections of the remaining liver, and GB with one section of the gallbladder. Microscopic findings include Edmondson-Steiner grading with the worst grade being IV/IV and the major grade II/IV. Histologic types identified are trabecular, pseudoglandular, and compact. The cell type is hepatic. No fatty change or fibrous capsule formation is observed, though partial capsule and capsular infiltration are present. Septum formation is also present. There is no invasion at the surgical resection margin, serosal invasion, portal vein invasion, microvessel invasion, intrahepatic metastasis, or multicentric occurrence. Other findings include chronic gastritis associated with H. pylori in the stomach body and a tubular adenoma with low-grade dysplasia at the rectosigmoid junction. The gallbladder exhibits chronic cholecystitis and cholesterolosis."} +{"pid": "TCGA-EJ-7784", "report": "The patient is a male with a history of a PSA value of 4.1 and a prior biopsy showing poorly differentiated prostatic adenocarcinoma in the right apex. Additional medical history includes appendectomy, mild COPD, cervical spine stenosis, and hypertension. A radical prostatectomy was performed.\n\nExamination of nine right pelvic lymph nodes and four left pelvic lymph nodes revealed no evidence of neoplasia. The prostate specimen weighed 40.2 grams. The lesion involved both the right and left sides of the prostate, with a maximum nodule size of 2.0 cm. Approximately 8% of the prostate volume was affected by the lesion, which was organ-confined without extraprostatic extension. Both seminal vesicles were free of involvement. All surgical margins were clear of any abnormal cellular growth.\n\nHistologic evaluation showed a Gleason score of 4 + 3 = 7. The secondary Gleason grade was present in 60% of the lesion. Multifocal perineural invasion was identified, while angiolymphatic invasion was not observed. High-grade intraepithelial changes were noted as multifocal.\n\nA total of thirteen lymph nodes were examined, none of which showed any atypical cell involvement. The pathologic staging was determined as pT2c with no nodal involvement (pN0). The histologic grade was classified as G3-4."} +{"pid": "TCGA-AC-A6NO", "report": "The specimen consists of a right breast simple mastectomy and right axillary contents. The breast specimen weighed 1108 grams and measured 21.5 x 20.0 x 6.5 cm. An area of firm, gritty pink-tan fibroglandular tissue measuring 17.5 x 12.0 cm was identified, spanning all four quadrants. Within this area, a well-circumscribed white-tan indurated mass measuring 4.0 x 3.5 x 3.5 cm was found subareolarly, 1.8 cm beneath the skin and 2.5 cm from the deep margin. At least six cm separated this mass from all remaining margins. Four additional smaller masses (1.0\u20131.6 cm) were also present within the upper inner quadrant, with the closest located 3.0 cm from the main subareolar mass. One of these smaller nodules showed focal hemorrhage at the 12:00\u20131:00 position. The remainder of the breast tissue was composed primarily of adipose tissue with scattered fibrous bands. No grossly apparent lymph nodes were noted at the lateral pole.\n\nMicroscopic evaluation revealed extensive involvement of the breast by intraductal carcinoma, which accounted for approximately 90% of the lesion and ranged from intermediate to high nuclear grade with necrosis. Scattered throughout this area were four distinct foci of invasive carcinoma, all with identical histology. The invasive component showed moderate tubule formation, moderate nuclear pleomorphism, and moderate mitotic activity, resulting in a total Nottingham score of 6 out of 9 (intermediate grade). All surgical margins were negative with a minimum distance of 0.9 cm. No lymphatic or dermal invasion was observed. Fibrocystic changes were present in the surrounding breast tissue.\n\nIn the axillary specimen, multiple lymph node candidates were identified after fixation, with the largest measuring up to 2.0 cm. A focal firm area measuring 0.8 cm was noted within the largest lymph node candidate. Histologic evaluation of the axillary contents confirmed the presence of metastatic carcinoma in two of sixteen lymph nodes examined. No extracapsular extension was identified. The largest metastasis measured 0.8 cm."} +{"pid": "TCGA-SG-A6Z4", "report": "The specimen consists of a wide excision from the left thigh, involving deep intramuscular tissue. The lesion measures 11 cm in greatest dimension with additional dimensions of 6.0 x 5.0 cm. Histologic evaluation reveals a high-grade undifferentiated pleomorphic tumor with myogenic features. The mitotic rate is 44 per 5 high-power fields, and approximately 30% necrosis is present. There is no history of prior treatment. Margins are uninvolved by tumor, with the closest margin being the anterior soft tissue at 4 mm. No lymph nodes were identified or submitted for examination. Tumor staging is pT2b according to the AJCC pathologic classification. Gross description identifies a yellow, firm mass with cystic and necrotic areas within a resected soft tissue segment measuring 22 x 12 x 9.5 cm. The mass is situated on top of a bone segment, which has been longitudinally sectioned, and does not appear to involve the underlying bone. The mass is 4.5 cm from the proximal resection margin, 6.5 cm from the distal resection margin, and greater than 1.8 cm from lateral margins. The anterior soft tissue margin is 0.6 cm from the tumor and marked with ink. Multiple sections were submitted for microscopic analysis, including representative areas of the tumor, margins, and adjacent bone following decalcification."} +{"pid": "TCGA-YL-A8HM", "report": "The specimen consists of a prostate with pelvic/obturator lymph nodes. Histologic evaluation demonstrates a lesion with a GleASON score of 4 + 5 = 9. The tumor is located at the apex, mid, base, lateral, right, left, and posterior regions, with involvement noted on the left side. Extra-prostatic extension is present and non-focal, occurring at the posterior and right sites. Seminal vesicle invasion is present on the right. Surgical margins are free of invasive carcinoma. Lymphovascular and perineural invasion are both identified.\n\nThe largest nodule measures 1.9 x 0.9 x 0.4 cm, corresponding to a volume of 0.84 cc. There is no evidence of treatment effect. Lymph node assessment includes four right obturator nodes, five left obturator nodes, and one left peri-vesical node; none show metastatic involvement.\n\nPathologic staging is pT3b, pNO, pMX."} +{"pid": "TCGA-86-8672", "report": "The specimen consists of lung tissue from a pneumonectomy. A mass was identified, measuring approximately 6 x 7.5 cm, with presence of necrosis. Microscopic evaluation showed poorly differentiated cells. Ten lymph nodes were examined, all from the hilus region, and none contained metastatic disease. Lymphatic and venous invasion were not identified. Surgical margins were uninvolved. Focal tumor necrosis was noted. The extent of the tumor appeared localized. Lymph nodes showed signs of hyperemia and anthracosis, with evidence of reactive follicular hyperplasia. No treatment effect was identified. According to the 7th edition of the TNM classification, the staging is pT3 based on tumor size. Additional findings were not specified."} +{"pid": "TCGA-VT-A80G", "report": "A radical resection was performed on a right buttock soft tissue mass. The tumor measured 20.0 x 16.0 x 14.0 cm and was located deep to the fascia. Histologically, the lesion exhibited high-grade features with a mitotic rate of 17 per 10 high-power fields. Necrosis was present, involving approximately 10% of the tumor. Margins were evaluated, with the closest distance being 0.2 cm at the inferior margin. Other margins were 0.3 cm (posterior and superior), 0.4 cm (anterior), 0.6 cm (lateral), and 1.0 cm (medial). All margins were negative. No lymphovascular invasion was identified. Based on the AJCC/UICC 7th edition staging system, the tumor was classified as pT2b and Stage III. Lymph node status could not be assessed. Ancillary studies including immunohistochemistry, cytogenetics, and molecular pathology were performed and are detailed in separate reports. The surgical procedure included evaluation of multiple margins, all of which were negative. Intraoperative frozen section analysis confirmed negative margins at the proximal, 3 o\u2019clock, 6 o\u2019clock, 9 o\u2019clock, and 12 o\u2019clock sites. Atypical cells were noted at the proximal nerve margin intraoperatively, but permanent sections showed no residual tumor at that site. The gross specimen showed a well-circumscribed mass with areas of cystic change and focal necrosis. The mass was partially covered by skin with a healed scar near the inferior margin. No residual tumor was identified histologically."} +{"pid": "TCGA-QH-A6CV", "report": "The specimen consists of brain tissue from the right frontal region of a male patient. Histological examination reveals a neoplastic lesion characterized by moderately cellular areas with nuclear atypia and increased mitotic activity. The tumor cells exhibit pleomorphism, with some displaying enlarged nuclei and prominent nucleoli. Necrotic foci are present, though not extensive. Microvascular proliferation is observed. The lesion infiltrates the surrounding brain parenchyma, showing no clear demarcation. Immunohistochemical staining demonstrates variable expression of glial markers. Based on histological features, the lesion is classified as a high-grade neoplasm. Tumor dimensions measure approximately 4.2 cm in greatest diameter. Surgical margins show residual tumor cells. No evidence of distant metastasis is identified."} +{"pid": "TCGA-63-A5MW", "report": "The specimen was obtained from a resection procedure performed on the right upper lobe. The tumor measured 4.5 cm in size. Histological evaluation revealed a moderately differentiated squamous cell carcinoma. Pathologic staging indicated T2, NOS for the primary tumor category. Lymph node involvement could not be assessed (MX). Additional samples including buffy coat were collected. No further histologic diagnoses or specific tumor types are included in this summary."} +{"pid": "TCGA-C4-A0EZ", "report": "The specimen consists of a cystectomy preparation with a lesion measuring up to 4.5 cm, characterized by predominantly small-cell morphology. Microscopic examination reveals infiltration into the perivesical fatty tissue and evidence of lymphatic vessel involvement (L1). Adjacent urothelium shows multifocal carcinoma in situ. Surgical margins are free of tumor. A single lymph node metastasis, measuring 0.9 cm, is identified within the perivesical fat. Additional tissues, including peritoneal fatty tissue with fibrosis and resection specimens from both the right and left ureters, show no evidence of tumor.\n\nImmunohistochemical analysis was performed on the tumor tissue. The tumor cells demonstrate diffuse positivity for pan-cytokeratin AE1/AE3. Certain areas exhibit strong positivity for synaptophysin and NSE, while being negative for chromogranin, S-100, and CK20. Some regions also show intense staining for P53. These findings support the previously noted morphological assessment.\n\nStaging is classified as pT3a, pN1 (1/16), L1, V0, with high-grade features. The tumor shows extensive involvement of the bladder with poorly differentiated components. Foci of urothelial lining display in situ changes, and small portions of tumor-free bladder wall are present."} +{"pid": "TCGA-CV-7245", "report": "A laryngopharyngectomy with bilateral neck dissection was performed. The specimen included the larynx and attached bilateral neck dissections. A pink-tan, exophytic mass measuring 5.5 x 3.0 x 2.5 cm was identified. It involved the left false vocal cords and extended superiorly to involve the left aryepiglottic fold, left pyriform sinus, and left epiglottis. The true vocal cords were not involved. Posterior extension appeared submucosal and involved the overlying hypopharyngeal mucosa. The tumor measured 2.0 cm from the closest left inferior posterior pharyngeal mucosal margin and 6.0 cm from the laryngeal margin.\n\nThe tracheostomy site was surrounded by unremarkable tissue and showed no tumor involvement. Mucosal margins were negative for invasive carcinoma. The deep margin was also negative. Mild dysplasia was noted at the tracheal margin. No tumor was found in the thyroid gland or tracheostomy specimen. A hypercellular parathyroid was observed.\n\nLymph node evaluation included right and left neck dissections. On the right side, 14 lymph nodes were examined (Level II: 8 total; Level III: 5 total; Level IV: 1 total), with no tumor identified. On the left side, 25 lymph nodes were evaluated (Level II: 9 total; Level III: 7 total; Level IV: 9 total), all negative for tumor involvement. Additionally, three paratracheal lymph nodes and seven lymph nodes from a separate right paratracheal collection were also free of tumor.\n\nSections were taken from multiple areas including pharyngeal and tracheal margins, representative portions of the tumor, adjacent structures such as the left aryepiglottic fold, left epiglottis, and overlying pharyngeal mucosa, as well as uninvolved laryngeal mucosa. Additional sections included possible thyroid tissue and various lymph node levels from both sides. All lymph nodes and margins were negative for tumor.\n\nThe tumor exhibited pushing borders, without perineural or vascular invasion. Bone and cartilage invasion status was pending decalcification studies. Lymphocyte infiltration was absent."} +{"pid": "TCGA-EY-A1GF", "report": "The surgical specimens include multiple lymph node dissections from the right and left peri-aortic and pelvic regions, along with a hysterectomy specimen with bilateral salpingo-oophorectomy. No carcinoma was identified in any of the lymph nodes examined across all specimens. The total number of lymph nodes evaluated was 25, with none showing evidence of metastasis.\n\nIn the uterine specimen, a lesion was identified in the endometrium with a size of 3.0 x 2.9 x 1.5 cm. Microscopic evaluation showed histologic features consistent with glandular proliferation. The tissue demonstrated architectural distortion with nuclear atypia. Invasion into the myometrium was documented as superficial, involving the inner half of the myometrial wall. At the deepest point of invasion, the myometrial thickness was measured at 1.5 cm. The tumor occupied approximately 11% of the myometrial depth. There was no involvement of the serosal surface, lower uterine segment, or cervical region. The vaginal margin was free of disease. No lymphovascular space invasion was observed.\n\nImmunohistochemical staining showed strong nuclear expression in greater than 90% of cells for both estrogen and progesterone receptors.\n\nOther findings included a submucosal leiomyoma in the endometrium and an endocervical polyp with chronic inflammation and squamous metaplasia. The myometrium showed no significant histopathologic changes. On examination of the adnexa, both ovaries exhibited stromal changes. The right ovary measured 2.9 x 2.1 x 0.7 cm and showed surface fibrous adhesions. The left ovary measured 2.5 x 1.5 x 0.8 cm and contained a small white area measuring 0.6 cm on the cut surface. The right fallopian tube measured 5.5 x 0.7 cm and contained a small aggregate of ectopic hilus cells (less than 1 mm). The left fallopian tube measured 3 x 0.6 cm and showed endometriosis.\n\nThe uterus weighed 156.4 grams and had a length of 10.3 cm. The endometrial cavity measured 3.0 cm in length and 3.0 cm in width at the fundus. The tumor was located in the fundus and occupied most of the endometrial cavity. The cervix had an endocervical canal length of 3.0 cm and showed no mass lesions. The external surface of the uterus was smooth and without lesions.\n\nAll surgical margins were free of disease. Based on these findings, staging parameters were assigned accordingly."} +{"pid": "TCGA-06-0645", "report": "The patient presented emergently with an intracranial mass lesion. Operative specimens included an excision biopsy of brain tissue and a left frontal brain mass. The specimens were assessed intraoperatively and showed features consistent with a high-grade neoplasm.\n\nGross examination of the first specimen revealed irregular tan fragments measuring approximately 0.5 x 0.4 x 0.3 cm in aggregate. Portions were used for intraoperative smears and frozen sections, with residual tissue submitted as A1 (frozen) and A2 (unfrozen). The second specimen consisted of two tan-brown, slightly bosselated fragments measuring 1.0 cm and 1.3 cm respectively. Cut surfaces were tan-brown and homogeneous.\n\nMicroscopic evaluation demonstrated a pleomorphic, high-grade astrocytic neoplasm with frequent mitotic figures and extensive microvascular proliferation. Immunohistochemical staining on block A2 showed positivity for GFAP and p53. MGMT promoter methylation testing was performed using bisulfite-treated DNA followed by PCR amplification of methylated and unmethylated sequences, detected via gel electrophoresis. Results indicated a methylated MGMT promoter.\n\nAdditional diagnostic testing was conducted under laboratory-developed protocols compliant with CLIA regulations. These findings are intended for informational purposes and should be interpreted within the context of established clinical and diagnostic criteria."} +{"pid": "TCGA-V4-A9EX", "report": "Enucleation of the right eye was performed. The eyeball measures 27 mm along the main axis, with a 7 mm segment of optic nerve attached. On sectioning, a pigmented nodule is identified, and tissue specimens were collected for genetic studies and cryopreservation prior to fixation. Microscopic examination reveals a tumor composed predominantly of epithelioid cells, with fewer fusiform cells present. Severe cellular atypia is noted, while pigmentation is mild. Mitotic activity is moderate. The tumor is located away from the optic nerve, which is uninvolved along its entire course. The ciliary body also shows no involvement. There is focal extension into the inner third of the sclera, without penetration beyond the scleral layer. The cut end of the optic nerve is free of tumor involvement. The tumor measures 15 x 15 mm along its largest dimensions."} +{"pid": "TCGA-S3-A6ZF", "report": "A pathology report details findings from multiple specimens collected during the evaluation of a breast lesion. Immunohistochemical testing showed hormone receptor positivity with estrogen receptors present in 99% of tumor cells and progesterone receptors in 40%, both with moderate staining intensity. HER-2 immunostaining demonstrated equivocal results, scoring 2+.\n\nAs a reflex test, dual in situ hybridization was performed to evaluate for HER2 gene amplification. The assay involved scoring 20 representative nuclei, revealing a total of 60 HER2 signals and 39 Chr17 signals, resulting in a HER2/Chr17 ratio of 1.5. Based on this result, the HER2 gene status was interpreted as non-amplified.\n\nHistologic examination of the mastectomy specimen revealed an invasive carcinoma measuring 2.5 cm in greatest dimension, located in the upper outer quadrant. The tumor was classified as grade 2 based on glandular differentiation, nuclear pleomorphism, and mitotic count. No lymph node metastases were identified in the single sentinel lymph node examined. Margins of resection were free of tumor involvement, with the closest margin measuring 25 mm from the tumor edge.\n\nAdditional findings included presence of ductal carcinoma in situ (DCIS), estimated at approximately 5% of the tumor mass, with comedo-type necrosis noted. Lymphovascular invasion was identified within the tumor bed. Microcalcifications were also observed in association with DCIS. A separate benign finding of intraductal papilloma was noted.\n\nThe surgical procedure consisted of a total mastectomy with sentinel lymph node biopsy. Preoperative and postoperative clinical assessments were consistent, identifying a palpable right breast mass with positive fine needle aspiration biopsy."} +{"pid": "TCGA-BR-7716", "report": "Specimen was a gastrectomy with a tumor located in the stomach measuring 6 x 6 x 1.5 cm. Microscopic examination revealed moderately differentiated histology. The tumor involved adjacent structures, specifically the lesser omentum. Lymph node evaluation showed 1 out of 4 nodes positive for metastasis, located intraabdominally. Other features such as lymphatic, venous, or perineural invasion, margin status, and response to neoadjuvant therapy were not specified. No additional findings or comments were noted."} +{"pid": "TCGA-CM-6164", "report": "The specimen from the sigmoid colon measured 18.2 cm in length and 5.5 cm in circumference. A mass measuring 5.3 cm in length and 5.5 cm in width was identified, located 9.5 cm from the probable distal margin. The mass occupied the full circumference of the lumen and exhibited a well-circumscribed, centrally cavitated and necrotic appearance with serpiginous borders. Histologically, the lesion demonstrated moderately differentiated features with ulcerating infiltrative morphology. Invasion extended through the muscularis into the pericolonic fat to a depth of 1.1 cm, and was located 2.8 cm from the closest radial margin. There was no evidence of gross tumor perforation or serosal involvement. Vascular invasion was identified within the extramural region, and perineural invasion was also present.\n\nA separate nodule measuring 0.4 x 0.4 cm was found 1.1 cm distal to the primary mass and remained confined to the mucosa. All surgical margins, including the proximal and distal margins, were free of tumor. Lymph node evaluation included 14 nodes (12 from pedicle 1 and 2 from pedicle 2), none of which showed metastatic involvement. Non-neoplastic findings included melanosis coli in the surrounding bowel.\n\nImmunohistochemical staining for mismatch repair proteins showed preserved expression of MLH1, MSH2, MSH6, and PMS2 in the tumor."} +{"pid": "TCGA-56-8625", "report": "The specimen consists of a right lower lobe measuring 16.2 x 12.8 x 5.2 cm and weighing 290 grams, with multiple staple lines in the hilar area and one at the apex. A 3.1 x 2.0 x 1.5 cm firm tan mass with areas of necrosis is identified in the anteromedial segment, encasing and obstructing the bronchus, with white exudate noted in distal bronchi. This lesion appears to extend to a large vessel wall without occlusion and involves adjacent peribronchial lymph nodes. The pleural surface in this area is ragged and stapled, limiting evaluation. Three black peribronchial lymph nodes near the mass range from 0.6 to 1.2 cm each. A second tumor focus in the superior segment, 3.5 cm from the bronchial margin and 2.5 cm from the hilar lesion, measures 4.2 x 2.0 x 2.6 cm, is ovoid, firm, tan-white, with elevated, well-defined margins. It appears to involve disrupted parenchyma beneath a suture line. Distant lung tissue shows dilated bronchi filled with purulent material but no additional nodules.\n\nA separate wedge resection of the right middle lobe, measuring 7.8 x 7.5 x 2.5 cm, has a Y-shaped staple line with a marked stitch indicating a specific area of interest. No gross lesion is identified, and the bronchi are open and unremarkable.\n\nLymph node specimens include: a 9 mm soft tissue piece (L9), a 3 mm dark red-brown tissue fragment (L10), and a 7 mm bisected reddish-brown node (L8).\n\nFrozen section analysis of the bronchial resection margin in the right lower lobe is negative. The parenchymal margin of the apical tumor is positive. In the right middle lobe, the bronchial margin is also negative.\n\nMicroscopically, the hilar tumor shows high-grade non-small cell carcinoma with necrosis and extensive invasion of vascular channels, likely lymphatic. The associated artery is free of involvement, but a nearby lymph node shows metastatic high-grade carcinoma. The tumor demonstrates focal squamous features, and while some cells appear smaller, they are interpreted as a less mature form of squamous differentiation. The apical tumor has larger cells with more glassy cytoplasm, raising the possibility of an adenocarcinoma component. Immunostains on both foci show strong positivity for squamous markers (p63, CK5) and only scattered positivity for TTF-1, supporting a primary squamous cell origin. Four of six sampled lymph nodes are involved by tumor.\n\nThe tumor is found immediately beneath the pleural surface, with focal invasion into the pleura itself. Margins are otherwise negative: bronchial, vascular, and parenchymal margins are all free of tumor. The closest distance of invasive tumor to any margin is less than 1 mm from a free pleural surface. Extensive lymphovascular invasion is present. Emphysema is noted as an additional finding."} +{"pid": "TCGA-DD-A1EA", "report": "The resected left lateral liver specimen weighs 250 grams and measures 18 x 9.5 x 5 cm. A mass measuring 4 x 3 x 3 cm was identified. Histologic evaluation shows moderately differentiated cells arranged in trabeculae with mild nuclear atypia. The lesion is surrounded by areas of preserved hepatic architecture. Chronic inflammatory changes are present, characterized by grade 1 inflammation and minimal fibrosis around the portal areas. Evaluation of the surgical margins shows no evidence of residual disease, with a distance of 5.0 cm from the nearest margin. Vascular space involvement is noted within the lesion."} +{"pid": "TCGA-A3-A8OU", "report": "The specimen consists of a resection of right renal tissue measuring 5 x 4 x 3 cm. A thinly encapsulated yellow-tan to pale red slightly lobulated to cavitary appearing mass measuring 3.5 x 3.3 x 3 cm was identified and found to be 0.9 cm from the closest renal resection margin. Histologic evaluation revealed nuclear grade 1 cellular features with no sarcomatoid differentiation. Microscopic examination showed no lymphovascular invasion and surgical margins were negative for abnormal tissue, with the closest margin measuring 0.9 cm. The tumor was confined to the kidney both macroscopically and microscopically. No lymph nodes were assessed. Based on AJCC staging criteria, the primary tumor was classified as pT1a with regional lymph nodes and distant metastasis categorized as pNX and pMX respectively. Additional findings in the non-neoplastic kidney included interstitial chronic inflammation and focal global glomerulosclerosis."} +{"pid": "TCGA-ET-A25L", "report": "The specimen consists of a total thyroidectomy and central wedge dissection. The thyroid gland weighs 18.7 grams and measures 7.0 x 5.5 x 2.9 cm. The left lobe measures 4.0 x 3.0 x 2.9 cm, and the right lobe measures 4.0 x 3.0 x 1.4 cm. A lesion is identified in the left lobe, measuring 3.0 x 2.0 x 2.0 cm, with a homogeneous, yellow, firm, gelatinous cut surface. An attached portion of yellow, fibrofatty tissue along the left inferior thyroid pole measures 3.0 x 1.0 x 0.6 cm. Three possible lymph nodes are identified within the specimen.\n\nHistologic evaluation reveals a unifocal lesion. The greatest dimension of the lesion is 3.0 cm. There is minimal extrathyroidal extension into adjacent tissue at the left inferior pole. Surgical margins are involved by invasive growth. Vascular and lymphatic invasion are present.\n\nA separate modified radical neck dissection includes levels III, IV, and V. In this component, one of six lymph nodes contains involvement, measuring 0.9 cm. Extracapsular extension is noted. Additionally, there is involvement of an adjacent small tissue mass at the left inferior pole."} +{"pid": "TCGA-HC-A631", "report": "The specimen consisted of a prostate weighing 34 grams and measuring 4.0 x 3.5 x 3.3 cm, along with lymph nodes from the right external iliac and obturator regions. The prostate was serially sectioned to reveal a firm white-tan lesion measuring 2.2 cm in greatest dimension located in the right anterior and posterior regions, extending from apex to bladder neck margin. This lesion approached the apex margin and was focally present within a fraction of a millimeter of the inked margin at the right posterior lateral aspect. Microscopic evaluation revealed a majority of Gleason pattern 4 with a secondary pattern 5 and a tertiary pattern 3. Approximately 40% of the prostate was involved by this lesion. Perineural invasion was identified. There was no evidence of extraprostatic extension, seminal vesicle invasion, lymphovascular invasion, or metastatic involvement. Two lymph nodes were examined and none contained malignant cells. Surgical margins were unifocally involved on the right posterolateral aspect. No treatment effect was observed. The tumor was classified as pT2c stage with no regional lymph node involvement (pN0)."} +{"pid": "TCGA-EW-A1P6", "report": "A revised pathology report is provided for a female patient with a palpable right breast mass. The specimen consists of a partial breast excision without wire-guided localization, along with sentinel lymph nodes and axillary dissection. The main lesion measures 4.2 cm in greatest dimension (3.8 x 2.8 cm additional dimensions), and is located within 2 mm of the superior and anterior margins. Histologic evaluation reveals a single focus of invasive carcinoma with a Nottingham histologic grade of 2, based on scores of 3 for glandular/tubular differentiation (<10% of tumor area forming such structures), 2 for nuclear pleomorphism (moderate variability in cell size and shape with open vesicular nuclei and visible nucleoli), and 1 for mitotic count. Lymphovascular invasion is present.\n\nMargins are negative for invasive carcinoma overall; however, microscopic foci of invasive carcinoma are identified adjacent to the inked resection margin in an additional superior margin specimen. The \u201cnew\u201d inked margin is free of tumor. Lymphatic tumor emboli are also noted.\n\nLymph node sampling includes sentinel and non-sentinel nodes. A total of 25 lymph nodes are examined: 3 sentinel and 22 non-sentinel. Two sentinel lymph nodes show metastatic involvement, one of which demonstrates extracapsular extension. One of these contains microscopic foci of carcinoma confirmed by immunohistochemistry for keratin. The remaining sentinel node and all non-sentinel nodes show no evidence of malignancy.\n\nImmunohistochemical studies performed on additional specimens demonstrate positivity for estrogen and progesterone receptors (1% immunoreactive tumor cells) and negativity for HER2/neu (score 0). No skin or skeletal muscle tissue is present in the specimen. Lobular carcinoma in situ is not identified.\n\nPathologic staging is as follows: primary tumor pT2 (tumor greater than 20 mm but less than 50 mm), regional lymph nodes pN1a (metastases in 1\u20133 axillary lymph nodes, with at least one metastasis greater than 2.0 mm), and distant metastasis not applicable. Extranodal extension is present. Sentinel lymph nodes were evaluated using hematoxylin and eosin (H&E) staining at one level and immunohistochemistry.\n\nThe specimen was received in multiple designated parts, with a total size of 8.5 cm in greatest dimension (additional dimensions 6 x 5 cm), and all margins are ultimately negative for invasive carcinoma after further excision."} +{"pid": "TCGA-MB-A5Y8", "report": "The excised specimen from the right posterior calf consists of fibroadipose tissue measuring 8.5 x 4.6 x 3.2 cm, with an overlying skin segment of 9.5 x 2.5 cm. The main lesion is located within the subcutaneous tissue and measures 12.8 x 3.5 x 2.5 cm. It appears light red-yellow, firm, lobulated, and well-defined. Histologic evaluation shows angiolymphatic invasion. The tumor is in close proximity to the medial margin, measuring less than 1 mm from the margin. All other margins appear free of involvement. Two additional biopsies, one from a medial subcutaneous site and one from a medial tendon location, are both negative for tumor involvement. Additional sections from the deep margin were submitted and also found to be negative. The skin surface does not show evidence of involvement. Multiple representative sections were taken from the mass and surrounding margins for analysis."} +{"pid": "TCGA-YL-A8HK", "report": "The specimen includes a prostate and pelvic/obturator lymph nodes from a radical prostatectomy. The histologic type is acinar adenocarcinoma with a GleASON score of 4 + 5 = 9. Tertiary pattern is not present. The tumor is located at the apex, mid, base, bladder neck, and anterior regions. It is also found in the right and left lateral areas, as well as the right and left posterior regions. Extra-prostatic extension is present and non-focal, involving the right lateral and right posterior sites. Seminal vesicle invasion is present bilaterally.\n\nSurgical margins are involved by invasive carcinoma at the base, posterior right, and left areas, specifically in regions of extra-prostatic extension. The extent of positive margins is multifocal; however, the millimetric extent is not determined. Lymphovascular and perineural invasions are both present. The largest tumor nodule measures 3.5 x 3.5 x 1.44 cm, with a volume of approximately 5.05 cc. No treatment effect is noted.\n\nA total of one lymph node was identified in the left pelvic region, and none showed evidence of metastasis. Additional findings include sinus histiocytic hyperplasia in the lymph node and negative anti-cytokeratin immunohistochemistry in other tissues. Pathological staging is pT3b, pN0, pMX."} +{"pid": "TCGA-A6-6138", "report": "The specimen consists of a 30 cm segment of proximal right colon with attached distal ileum. The proximal and distal margins measure 4.5 cm and 8.0 cm in circumference, respectively. A well-circumscribed lesion measuring 5.5 x 4.9 cm is identified immediately distal to the ileocecal valve. On sectioning, the lesion has a maximal thickness of 1.0 cm and extends into the muscularis propria, reaching within 1.2 cm of the inked serosal surface. No additional mass lesions are identified. A small colonic polyp measuring 0.2 cm is present 11 cm distal to the lesion. Multiple lymph nodes up to 1.3 cm in size are recovered from the mesocolon and mesentery.\n\nHistologically, the lesion shows moderately differentiated morphology. Evaluation of the primary lesion demonstrates invasion nearly through the full thickness of the muscularis propria (pT2). All surgical margins\u2014proximal, distal, and radial\u2014are free of involvement. No vascular invasion is identified. Twenty-four regional lymph nodes are examined, and none show evidence of metastatic involvement (pN0). An adenomatous polyp measuring 2 mm is incidentally noted in the colon. The ileum and appendix demonstrate no significant pathological findings."} +{"pid": "TCGA-VD-A8KF", "report": "The specimen consists of an intact right eye with axial dimensions measuring 26mm (axial), 25mm (horizontal), and 26mm (vertical). The cornea measures 12mm horizontally and vertically, and the optic nerve is 2mm in length with a 5mm diameter. The pupil is slightly eccentric towards the inferior edge. Trans-illumination reveals a shadow in the inferior pole measuring approximately 19 x 20mm.\n\nOn vertical sectioning, a bilobated ciliochoroidal mass is identified at the inferior aspect of the globe. The lesion measures 20mm in largest basal diameter and 6.7mm in height. It extends posteriorly to within 6mm of the optic disc. Histological sections demonstrate a non-pigmented lesion composed of a mixed cell population, with epithelioid morphology accounting for up to 80% of the cells. Immunohistochemical staining shows expression of Melan-A and HSP-27 (score 2). Mitotic count is elevated at approximately 16 per 40 high power fields.\n\nMicrovascular patterns are prominent with closed loop formations observed in the planes of section. Lymphocytic infiltration within the lesion is minimal, and there is no evidence of tumor necrosis. Focal extension into the sclera is present, though margins of resection are free of tumor involvement. The optic nerve and vortex veins do not show tumor spread, and no definitive ring pattern of intraocular dissemination is evident. The cornea, anterior chamber angles, iris, and lens appear unremarkable, with the exception of mild subcapsular degenerative changes in the lens. The retina overlying the lesion is slightly atrophic, and Bruch's membrane remains intact.\n\nMolecular genetic analysis using MLPA on fresh tissue revealed monosomy 3 and gains in chromosome 8q. Chromosome 1 and 6p were normal. BRAF V600E mutation testing was negative, and DNA quality was sufficient for analysis. These molecular findings are intended for integration with clinical and histopathological data to assess metastatic risk."} +{"pid": "TCGA-BP-4784", "report": "The right kidney specimen from a partial nephrectomy shows a well-circumscribed, encapsulated lesion measuring 1.5 cm in greatest dimension. The tumor is confined to the kidney with no evidence of local invasion or renal vein involvement. Nuclear grading is II out of IV. All surgical margins are free of tumor. The surrounding non-neoplastic kidney tissue appears unremarkable. No adrenal or lymph node tissue was identified. A separate fragment of renal tissue from the deep margin shows benign findings with marked chronic inflammation. Intraoperative frozen section analysis confirmed the absence of malignancy at the deep margin. The tumor is staged as pT1, indicating it is 7 cm or less and limited to the kidney. Histologic evaluation noted areas of papillary architecture combined with clear cell cytology."} +{"pid": "TCGA-CS-5397", "report": "The surgical specimen from the left temporal lobe was received fresh for initial analysis and consisted of multiple fragments of red-tan soft tissue measuring 2.5 x 1.0 x 1.0 cm in aggregate. A portion was used for touch preparations and frozen section evaluation, with the remainder submitted for further histologic examination. A second specimen from the same anatomical site was received in formalin and measured 4.0 x 4.0 x 1.7 cm in aggregate. It was processed in its entirety and submitted across seven cassettes.\n\nMicroscopic evaluation revealed a moderately pleomorphic and infiltrative population of glial cells. Mitotic figures were present. There was no evidence of microvascular proliferation or necrosis. Focal involvement of the Virchow-Robin spaces by tumor cells was observed. Histologic features were consistent with a high-grade neoplastic process. Immunohistochemical assays were performed using validated methods, including quantification techniques for selected markers and standardized interpretation protocols for others. Certain reagents used in testing are classified as Analyte Specific Reagents (ASRs); these tests were developed and validated internally and have not been cleared by the FDA, as such clearance is not required.\n\nThe findings were reviewed through slide evaluation and confirmed to represent a malignant neoplasm. The case was interpreted personally by the signatory pathologist."} +{"pid": "TCGA-DX-A7ER", "report": "The specimen from the right lower lobe lung and tumor consisted of a 17.2 x 4.6 x 3.9 cm lung lobe with attached bronchus and blood vessels. Multiple staple lines were noted on the surface. The tumor measured 20.0 x 18.0 x 2.8 cm in aggregate and appeared tan and friable. It was found adherent to the lateral aspect of the lung involving fragments of pleura. The visceral pleura showed fibrinous exudate, and there was extensive involvement of both visceral and parietal pleura by the lesion. Focal invasion into lung parenchyma was observed. No mass was identified within the lung parenchyma itself. Margins of resection including bronchial, vascular, and staple edge were free of abnormal cellular infiltration.\n\nMicroscopic examination revealed a fragmented lesion with a mitotic rate of approximately 5 mitoses per 10 high-power fields. About 40% necrosis was present. Cellular morphology showed immunoreactivity for vimentin and focally for cytokeratin CAM 5.2, while CD34 staining was negative. TLE1 staining did not show positivity. Molecular analysis demonstrated SYT-SSX1 and SSX2 translocations.\n\nLymph nodes were evaluated at level VII of the mediastinum. One lymph node was submitted from this region and showed no evidence of metastasis. Additionally, two benign lymph nodes were identified in association with the lung specimen.\n\nSections examined included bronchial margin, vascular margin, staple line, tumor with pleura, separate tumor fragments, random lung tissue, and lymph nodes. Histologic evaluation of the bronchial biopsy showed unremarkable mucosa without presence of tumor. The biopsy of the mass lesion confirmed findings consistent with the resected specimen."} +{"pid": "TCGA-AA-A02H", "report": "The specimen shows a moderately to poorly differentiated carcinoma, with infiltration through all layers of the intestinal wall. Vascular invasion is present. A total of twelve lymph nodes were examined, six of which contain metastatic tumor cells. In addition, a separate sample from the gallbladder contains neoplastic tissue consistent with the primary tumor. Tumor involvement is also identified in liver tissue, suggesting further systemic spread."} +{"pid": "TCGA-BH-A0H7", "report": "The specimen consists of a modified radical mastectomy from the right breast. Two distinct tumor foci were identified. The largest measures 1.5 cm and is located in the upper/outer quadrant, corresponding to the previously biopsied 10 o\u2019clock lesion. A second tumor focus measures 1.2 cm and is situated at the junction of the upper/outer and upper/inner quadrants, correlating with the biopsied 12 o\u2019clock lesion. Both tumors demonstrate similar morphological features. Extensive lymphovascular invasion is present.\n\nA component of in situ disease is identified in association with both invasive foci. It exhibits a cribriform growth pattern and accounts for approximately 5% of the total tumor volume. The in situ component is of intermediate nuclear grade.\n\nSurgical margins are negative. The closest distance of invasive tumor to a margin is 7 mm, measured posterior to the 12 o\u2019clock lesion. Changes related to prior biopsy are noted. Six of sixteen axillary lymph nodes contain metastatic disease, with the largest deposit measuring 1.1 cm. Extracapsular extension is present in one node, extending approximately 0.3 cm beyond the nodal capsule. The remaining axillary lymph nodes are free of involvement.\n\nNon-neoplastic findings include fibrocystic changes and a fibroadenoma in uninvolved breast tissue. The nipple-areolar complex and overlying skin show no evidence of tumor involvement. Skeletal muscle is also free of involvement. Vascular calcifications consistent with atherosclerosis are present.\n\nHistologic evaluation reveals a Nottingham score of 7 (nuclear grade 3, tubule formation score 3, mitotic activity score 1), corresponding to a Nottingham grade of 2. Immunohistochemical staining shows positivity for estrogen and progesterone receptors. HER2/Neu staining is either zero or 1+.\n\nPathologic staging is as follows: pT1c for the primary tumor, pN2a for regional lymph node involvement, and pMX for distant metastasis, which was not assessed."} +{"pid": "TCGA-V1-A9Z9", "report": "The prostate specimen measured 2.9 cm from apex to base, with a width of 4.4 cm and an anterior-posterior dimension of 3.4 cm. The seminal vesicles measured 4 x 2 x 0.7 cm on the right and 4.4 x 2.7 x 0.6 cm on the left. A yellow nodule measuring 2 x 2 x 1.4 cm was identified in the left anterior/posterior region, extending from apex to base, present in slices 1 through 4, and located 0.2 cm from the capsule. The average slice thickness was 0.4 cm, and a total of six slices were taken for analysis.\n\nMicroscopic evaluation showed no involvement of the prostatic capsule or extraprostatic extension by direct tumor extension. However, a cluster of cells with amphophilic vacuolated cytoplasm and enlarged nuclei with prominent nucleoli was identified within a lymphovascular space outside the prostate gland (slide A22). Immunohistochemical staining demonstrated positivity for prostate specific antigen (PSA) without expression of p63, ck903, or PAX2, supporting the presence of these cells in a vascular space as part of the disease process. This finding was classified as lymphatic space invasion (L1) according to TNM staging criteria.\n\nTumor location included a large left-sided mid-gland lesion estimated at 4.8 cc, with additional microscopic involvement in the right apex and right posterior mid gland. The total estimated tumor volume was approximately 5 cc, with over 90% composed of Gleason pattern 3. All surgical margins were negative, although the closest distance of tumor to an inked margin was 2 mm on the left posterior side. No benign prostate glands were found at inked margins.\n\nExtensive high-grade prostatic intraepithelial neoplasia was present. There was no evidence of perineural invasion or involvement of the seminal vesicles. Lymph node dissection included 18 nodes from the right pelvic area and 11 from the left pelvic area; none contained tumor. In total, 29 lymph nodes were examined, and all were negative.\n\nThe final TNM classification was pT2cN0L1. All specimens were properly labeled, received, and processed. The attending pathologist reviewed all findings and signed the final report after ensuring accuracy and completeness."} +{"pid": "TCGA-BA-A6DD", "report": "The specimen consisted of a composite resection of skin, mandible, tongue, and floor of mouth. The overall size of the specimen was 10.8 x 8.5 x 6.3 cm and included anterior skin (5.6 x 5.3 x 1.0 cm), mandible (15.3 x 2.7 x 1.3 cm), tongue (5.2 x 3.5 x 2.6 cm), left submandibular gland (4.1 x 2.7 x 2.3 cm), right submandibular gland (4.3 x 3.2 x 2.6 cm), and posterior/inferior soft tissue (6.3 x 4.1 x 3.2 cm). The lesion measured 5.6 cm in diameter grossly and appeared firm, gray-white, ill-defined, with a smooth cut surface and superficial ulceration. It was located in the floor of the mouth/sublingual region.\n\nHistologically, moderately differentiated keratinizing cells were identified focally. The tumor extended into the anterior mandible and subcutaneous tissue, reaching within 0.5 cm of the skin surface. Invasion into the left mandible was present to a depth of 0.4 cm and into the right mandible to a depth of 0.6 cm. Approximately 30% of the tongue was involved by the tumor. Bone involvement was confirmed bilaterally and through the anterior mandible.\n\nSurgical margins were evaluated across multiple sites. The tumor was closest to the right posterior lateral soft tissue margin at 0.1 cm and the left posterior lateral soft tissue margin at 0.3 cm. Other margins included: left lateral mucosal margin at 1.0 cm, right lateral mucosal/soft tissue margin at 0.3 cm, inferior soft tissue margin at 0.4 cm, left mandibular bone margin at 2.7 cm, and right mandibular bone margin at 2.8 cm. The left lateral en face mucosal margin was focally involved, while other margins were negative but in close proximity.\n\nLymph node evaluation revealed metastatic involvement. In the composite resection, two out of two lymph nodes showed metastasis, with the largest measuring 2.1 cm. Additional lymph node specimens included: left neck levels 2 and 3 (1 out of 18 positive, 0.1 cm), right neck levels 2 and 3 (1 out of 14 positive, 0.4 cm), and right neck level 4 (1 out of 8 positive, 1.1 cm). None of the lymph nodes demonstrated extracapsular extension.\n\nPerineural invasion was identified in one area (D19). Vascular invasion was not observed. Ancillary studies for P16 by immunohistochemistry and HR HPV by in situ hybridization were negative. No carcinoma in situ was identified.\n\nAdditional findings included a necrotic lymph node adjacent to the left submandibular gland and two firm lymph nodes near the right submandibular gland. These lymph nodes ranged from 0.4 to 2.0 cm in size and were embedded within soft tissue near surgical margins.\n\nSpecimens from frozen section analysis of the chin biopsy and bilateral mandibular marrow margins did not show evidence of tumor.\n\nThe specimen was fixed in formalin and submitted for histologic evaluation. Multiple blocks were processed for microscopic examination, including perpendicular sections of the tumor relative to various margins and areas of bone and soft tissue involvement.\n\nNo additional significant findings were reported."} +{"pid": "TCGA-VQ-A8P5", "report": "The specimen from the stomach (body) measures 6.0 cm in greatest diameter and is located in the anterior wall of the gastric body. The lesion infiltrates through the wall up to the subserosa. Histological evaluation shows poorly differentiated features with an ulcerative vegetating appearance. Perineural invasion is present. Angiolymphatic invasion is not detected. There is minimal peritumoral desmoplasia and a moderate peritumoral lymphocytic infiltrate. Surgical margins are free of involvement. Thirty-three lymph nodes from the perigastric adipose tissue show no evidence of involvement. Additional findings include a fragment of mature adipose tissue from chain 9 lymph node region without involvement, and one lymph node from the chain 8p region also uninvolved. The gallbladder shows changes consistent with chronic cholecystitis and cholesterolosis."} +{"pid": "TCGA-HC-A48F", "report": "The prostate specimen measured 5.5 x 4.8 x 4.5 cm and weighed 51.3 grams. Histologic evaluation demonstrated a neoplasm involving approximately 85% of the gland. Histologic grading revealed a Gleason score of 8 out of 10, with both primary and secondary patterns graded as 4 out of 5. There was no evidence of extraprostatic extension or involvement of the seminal vesicles. Lymphovascular space invasion was identified, and high-grade prostatic intraepithelial neoplasia was present. No treatment effect was observed. Examination of surgical margins revealed involvement at the base of the gland.\n\nA total of 10 lymph nodes were examined from the bilateral pelvic lymph node specimen. One lymph node contained metastatic involvement, with the deposit measuring less than 0.1 cm in greatest dimension. The metastasis was confined to the subcapsular sinus without extension into perinodal adipose tissue.\n\nStaging based on pathologic findings was determined as pT2c, N1, MX."} +{"pid": "TCGA-BP-4160", "report": "The submitted specimen includes a left kidney with adrenal gland and para-aortic lymph nodes. The kidney measures 11.0 x 6.0 x 5.0 cm and contains a well-circumscribed tumor in the mid-lower portion, measuring 4.5 x 3.0 x 0.5 cm. The tumor extends through the renal capsule into the perinephric adipose tissue, coming within 0.1 cm of Gerota's fascia. No invasion of the renal vein is identified. The tumor has a pink-red to bright yellow cut surface with soft to focally fibrous consistency. The urothelium of the pelvis and ureter appears unremarkable. The remainder of the renal parenchyma is grossly normal. Surgical margins, including ureteral and renal blood vessel margins, are free of tumor. \n\nHistologically, the tumor demonstrates an acinar growth pattern and nuclear grade II/IV. All sections from the tumor, surrounding kidney tissue, and surgical margins were evaluated. The adrenal gland measures 3.5 x 2.0 x 1.0 cm and shows focal nodular hyperplasia as well as intramedullary hemorrhage; otherwise, it is unremarkable. No lymph nodes were identified near the kidney.\n\nThe para-aortic lymph node specimen consists of fibroadipose tissue measuring 7 x 6 x 2.5 cm in aggregate. Multiple lymph nodes are present, ranging from less than 0.5 cm to 4.5 cm in size. The largest lymph node is largely replaced by adipose tissue. Sections from all lymph nodes show benign lymphoid tissue without evidence of malignancy. \n\nRepresentative sections of the tumor, adjacent renal parenchyma, adrenal gland, and surgical margins were submitted for analysis. Intraoperative frozen section confirmed findings consistent with those seen on permanent sections."} +{"pid": "TCGA-AC-A3W5", "report": "A right breast lumpectomy specimen was submitted along with multiple sentinel lymph node specimens from the right axilla. The lumpectomy measured 5.8 cm (cranial to caudal) by 4.2 cm (medial to lateral) by 2.0 cm (superficial to deep). A stellate, moderately well-circumscribed mass measuring approximately 2.0 x 2.2 x 1.0 cm was identified. The mass had a hemorrhagic biopsy cavity measuring up to 0.4 cm. Margins were evaluated and showed the following distances: medial\u20140.3 cm, lateral\u20140.9 cm, superficial\u20140.9 cm, deep\u20141.0 cm, caudal\u20141.1 cm, and cranial\u20141.6 cm. Microscopic evaluation of all margins revealed no evidence of tumor involvement except for the caudal margin, which contained a small focus of pleomorphic LCIS remote from the main tumor. The remainder of the breast tissue was composed of benign lobulated adipose tissue.\n\nThe three sentinel lymph nodes retrieved were each within fibroadipose tissue. The first measured 1.2 x 0.6 x 0.5 cm with a lymph node candidate measuring 0.5 x 0.4 x 0.4 cm. The second measured 1.2 x 0.5 x 0.4 cm with a lymph node candidate of 0.4 x 0.4 x 0.4 cm. The third measured 1.3 x 0.7 x 0.6 cm with a lymph node candidate of 0.8 x 0.5 x 0.4 cm. All lymph node candidates were entirely submitted for histologic analysis. No metastatic cells were identified in any of the lymph node specimens.\n\nImmunostains including pancytokeratin were negative in all blocks. The histologic features of the primary lesion included minimal tubule formation, marked nuclear pleomorphism, and a moderate mitotic count, resulting in a high histologic grade. The invasive component measured 2.6 cm, with less than 2% in situ component. Dermal and local lymphatic invasion was not present. Hormone receptor expression in prior core samples showed positivity for estrogen and progesterone receptors, and HER2 testing was positive.\n\nPathologic staging was determined to be pT2 pN0 (sn) (i-)."} +{"pid": "TCGA-BJ-A18Z", "report": "The thyroid specimen weighed 27 grams and showed nodular hyperplasia. Three distinct lesions were identified: a 3.6 cm lesion in the left lobe with extension beyond the thyroid capsule, a 0.9 cm lesion in the right lobe extending to the margin, and a 0.2 cm lesion in the isthmus. Vascular invasion was present. A total of 37 lymph nodes were examined from the neck dissection; 3 of these contained metastatic involvement, with the largest measuring 3.2 cm located in level 4. Metastases were found in levels 2 and 4, and extranodal spread was noted. One benign lymph node was attached to the right lobe, and four additional benign lymph nodes were identified in level B. The surgical margins were involved by tumor. Lymphovascular invasion was present. Molecular testing revealed positivity for BRAF p.V600E mutation."} +{"pid": "TCGA-DB-A75M", "report": "The resected right parietal brain lesions were evaluated and demonstrate a neoplastic process. Histologic examination reveals diffusely infiltrating cells with mild atypia and moderate nuclear pleomorphism. The cytoplasm is scant and the nuclei are hyperchromatic with irregular contours. Mitotic figures are rare. The architecture is characterized by a loose, microcystic pattern with areas of increased cellularity.\n\nImmunohistochemical staining shows the neoplastic cells are positive for GFAP, indicating glial differentiation. There is a high level of p53 labeling, suggesting genetic alterations involving the TP53 pathway. The Ki-67 proliferation index is generally low, though there are focal areas with slightly increased labeling. Staining for IDH-1 (R132H) is negative.\n\nMolecular analysis by PCR and pyrosequencing demonstrates the presence of an IDH1 mutation at codon 132 (c.394C>T, p.Arg132Cys), with no detectable mutation in IDH2 codon 172. All control reactions performed as expected."} +{"pid": "TCGA-P4-A5E8", "report": "The radical nephrectomy specimen included a left kidney measuring 12.5 x 11.0 x 7.3 cm along with associated structures. A well-circumscribed mass measuring 10.0 x 8.5 x 8.5 cm was identified in the lower/mid pole of the kidney. The mass was tan-gray, friable, and showed areas of hemorrhage and necrosis. It did not grossly extend into perinephric adipose tissue, renal sinus, or renal vein, nor did it reach Gerota's fascia. Three enlarged lymph nodes (0.6 to 2.9 cm) were found in the hilum of the kidney and were involved by tumor. Additionally, three irregular soft tissue fragments (8.0 x 5.0 x 3.0 cm in aggregate) from the para-aortic region showed extensive involvement, appearing as a matted aggregate with variegated white-yellow-red coloration. No residual lymph node architecture was identifiable.\n\nMicroscopically, the tumor was composed of papillae lined by tall columnar cells. Most cells had eosinophilic cytoplasm, while some exhibited clear cytoplasm. Vascular-lymphatic invasion was present. Tumor was confined to the kidney without evidence of invasion into renal sinus adipose tissue, perinephric fat, or renal vein. The tumor was classified as Fuhrman nuclear grade 3. Margins of resection, including renal vein, renal artery, ureter, and Gerota's fascia, were free of tumor. The adrenal gland showed no involvement. In the hilar lymph nodes, tumor was present in all three nodes examined. In the para-aortic lymph node region, tumor extended into perinodal adipose tissue with small foci seen in vascular-lymphatic spaces. Due to the matted nature of the para-aortic lymph nodes, the exact number could not be determined. The adjacent kidney parenchyma and pelvicalyceal system were unremarkable. Serial sections of the adrenal gland showed no abnormalities. Multiple representative sections were taken from the tumor, surrounding tissue, and margins. Portions of the tumor were submitted for further analysis and electron microscopy. Photographs were obtained for documentation."} +{"pid": "TCGA-B6-A0IQ", "report": "The specimen consists of a left breast mastectomy specimen weighing 600 grams, measuring 17 x 14 x 4 cm. A mass measuring 5.5 x 4 x 3.5 cm is present within the breast tissue, located deep to a skin incision and situated approximately 5 cm superior and lateral to the nipple. The mass is firm, tan-white, and well-circumscribed, but approaches to within 2 mm of the deep margin. Within the mass is a 1 x 1 x 1 cm hemorrhagic area. No other lesions are identified.\n\nThe specimen includes multiple tissue blocks representing various regions of the breast including the nipple, scar tissue, tumor sections, and margins. Extensive sampling of lymph node regions was performed. Twenty-six lymph nodes were evaluated in total, distributed across different sections of the axilla. One lymph node from the Rotter's region was submitted and found to contain carcinoma.\n\nHistologic evaluation reveals a neoplastic process characterized by rounded masses composed of nests and trabeculae of malignant cells. There is extensive necrosis and a mitotic count of 10 per 10 high power fields. The growth pattern obscures clear differentiation between invasive and in-situ components. Less than 5% of the identifiable lesion demonstrates features resembling intraductal carcinoma, including solid and comedo types. Benign breast changes including apocrine metaplasia and duct ectasia are present. The nipple shows no evidence of pathological involvement."} +{"pid": "TCGA-D1-A174", "report": "A hysterectomy specimen includes a mass measuring 2.6 x 1.9 x 1.4 cm located in the fundus. The mass invades 0.2 cm into the myometrium, which has a total thickness of 2.4 cm. No involvement of the endocervix is identified. Surgical margins are free of abnormal tissue. A single intramural leiomyoma measuring 0.6 x 0.5 x 0.5 cm is present within the myometrium.\n\nRight salpingo-oophorectomy reveals an unremarkable ovary and a fallopian tube with multiple paratubal cysts measuring approximately 0.1 cm. Left salpingo-oophorectomy also shows no abnormalities in either the ovary or fallopian tube.\n\nLymphadenectomy specimens include 19 right pelvic lymph nodes and 9 left pelvic and lower para-aortic lymph nodes; all are negative for abnormal cells. Biopsies of the omentum, small bowel mesentery, sigmoid colon mesentery, left pericolic gutter peritoneum, bladder peritoneum, left pelvic peritoneum, right pelvic peritoneum, and right pericolic gutter peritoneum all show no evidence of abnormal tissue involvement.\n\nFrozen section consultation findings were consistent with the final evaluation, with no abnormal tissue identified in the cervix, ovaries, fallopian tubes, or lymph nodes. All biopsies and tissue samples collected during surgery showed no signs of abnormal cells.\n\nThe surgical specimen was staged using the AJCC 7th edition (2009) system."} +{"pid": "TCGA-B6-A0I8", "report": "Surgical Pathology: Final. CLINICAL HISTORY: History of recurrent left breast lesion with possible involvement of the right breast. Following left mastectomy, there was a firm indurated area noted in the upper inner quadrant of the right breast on physical examination. The clinical concern was for possible recurrence in the right breast.\n\nGROSS EXAMINATION: Specimen labeled \"Right breast biopsy\" received fresh, consisting of two tissue fragments. The first measures 3.6 x 2.1 x 1.5 cm and the second 2.2 x 1.7 x 0.7 cm. The surgeon indicated that margins were not a concern for this specimen. Portions of the tissue had been previously used for other testing, including hormone receptor analysis. Both fragments consist of firm pink-tan tissue within a background of yellow fibroadipose tissue. Remaining tissue was sectioned and submitted in blocks A1 through A4.\n\nMicroscopic evaluation shows high-grade cellular atypia with disorganized architecture. Nuclear features are consistent with the highest grade category. Tumor size and lymph node status could not be assessed from this specimen. No definitive surgical margins were evaluated."} +{"pid": "TCGA-S9-A7IX", "report": "The histologic examination reveals a neoplastic lesion characterized by increased cellularity, nuclear atypia, and mitotic activity. The tumor demonstrates infiltrative growth with areas of necrosis and microvascular proliferation. Immunohistochemical staining shows positivity for glial markers. Based on these features, the lesion is classified as a high-grade glioma. Staging assessment indicates localized disease without evidence of distant spread. Tumor dimensions measure approximately 4.2 cm in greatest diameter."} +{"pid": "TCGA-VR-A8ET", "report": "The specimen includes the esophagus and proximal stomach following an esophagogastrectomy procedure. The lesion involved is located in the distal esophagus and proximal stomach region, measuring 5.0 cm in greatest dimension. Histologically, the lesion demonstrates moderately differentiated features with tumor infiltration extending into the muscularis propria layer. There is no evidence of lymph-vascular invasion; however, perineural invasion is present. Surgical margins are clear, with no involvement by carcinoma noted at the esophageal margin. A total of 17 regional lymph nodes were examined, including right paracardiac (1 examined), left paracardiac (10 examined), lesser curvature of the stomach (1 examined), celiac trunk (3 examined), and lower esophagus (2 examined), none of which show involvement by neoplastic cells."} +{"pid": "TCGA-EB-A6QY", "report": "Patient ID: Gross Description: A skin flap measuring up to 7x15 cm contains a pigmented lesion up to 2 x 1.6 cm in size. The lesion protrudes above the skin surface with a gross thickness of up to 5 mm. Resection margins show normal tissue structure. Microscopic Description: There is focal surface ulceration present. Measurements indicate a Breslow thickness of 10 mm. Specimen type: Excision of skin lesion. Tumor site: Shoulder. Tumor size: 1.6x1x2 cm. Tumor features: Ulcerated, pigmented. Satellite nodules: Not specified. Histologic grade: Not specified. Lymph nodes: Not specified. Lymphatic invasion: Not specified. Venous invasion: Absent. Margins: Uninvolved. Evidence of neo-adjuvant treatment: Not specified. Additional pathologic findings: Breslow thickness is 10 mm. Comments: None."} +{"pid": "TCGA-E8-A416", "report": "The tumor is located on the left side and is unifocal in distribution. It measures 1.5 x 1 x 1 cm. Microscopically, the lesion consists of papillary structures with fine fibrovascular cores lined by single to multiple layers of cuboidal epithelial cells. The cells maintain their polarity, with nuclei that are regular in shape and contain finely dispersed chromatin. In some nuclei, intranuclear grooves are present. The tissue shows evidence of lymphocytic infiltration and exhibits a fibrous composition. There is invasion noted into surrounding structures such as the capsule, vessel, or adjacent tissue."} +{"pid": "TCGA-UW-A72O", "report": "A biopsy of a small bowel nodule demonstrates a bland spindle cell proliferation. A segment of small bowel with similar findings was resected, measuring 5.1 cm in greatest dimension. The proliferation extends into the muscularis propria of the small bowel and into surrounding fibroadipose tissue of the mesentery, coming within less than 1 mm of a cauterized margin. Histologically viable bowel margins are free of proliferative changes, with the distal small bowel margin showing mild acute serositis. Three lymph nodes are negative for atypical cells.\n\nA cholecystectomy specimen shows mild chronic inflammation of the gallbladder, with no abnormal cellular proliferation identified. A right partial nephrectomy specimen contains a unifocal mass measuring 4.6 cm. Histologic evaluation reveals a Fuhrman nuclear grade 2 tumor. The mass does not invade the renal capsule, perirenal adipose tissue, renal sinus, or Gerota\u2019s fascia. No vascular or lymphatic invasion is identified. Surgical margins are negative, with the tumor located 5 mm from the parenchymal margin and 2 mm from the perinephric adipose margin. No abnormal proliferation is seen in the non-neoplastic kidney tissue. Non-neoplastic findings include patchy minimal glomerular sclerosis.\n\nImmunohistochemical analysis of the mesenteric mass shows negative staining for pancytokeratin, CD117, S100, and muscle-specific actin, with only focal desmin positivity and CD34 highlighting blood vessels. The renal mass demonstrates positivity for CD117, patchy CD10 expression, and negativity for racemase, RCC, and vimentin. Intraoperative consultation on the small bowel nodule deferred subclassification pending immunohistochemical results, with no evidence of sarcoma or carcinoma noted.\n\nGross examination of the small bowel specimen reveals a tortuous segment approximately 45 cm in length, with a 5.1 x 4.6 x 3.5 cm firm mass located within the mesentery. The mass has a white, whorled cut surface and approaches within 0.6 cm of the stapled duodenal margin. The kidney specimen weighs 73.4 grams and measures 6.2 x 5.5 x 4.2 cm, containing a tan, well-circumscribed mass that bulges on sectioning and comes within 0.4 cm of the parenchymal margin."} +{"pid": "TCGA-KH-A6WC", "report": "The patient is a male with a clinical history concerning an esophageal mass located at 31\u201333 cm. A biopsy was taken from the esophagus at 32 cm for evaluation. The specimen consisted of three fragments of tan soft tissue, each measuring between 0.3 and 0.4 cm. All tissue was submitted for analysis. Histologic examination revealed invasive malignant cells consistent with high-grade dysplasia. The tumor involves the deep margins. No lymph nodes were identified in the specimen. Immunohistochemical staining and other diagnostic tests were performed as needed to confirm the findings."} +{"pid": "TCGA-CQ-7063", "report": "The specimens received included tissues from the medial margin palate, right partial maxillectomy, right partial glossectomy, and deep margin tongue. Histological examination of the right partial maxillectomy revealed a lesion measuring up to 1.3 cm in greatest dimension with a thickness of 0.5 cm. The lesion was well differentiated with no evidence of lymphovascular or perineural invasion identified. Bone margins and all other mucosal margins were uninvolved by the lesion. In the right partial glossectomy specimen, a superficial lesion measuring 0.6 cm in greatest dimension and 0.1 cm in thickness was observed. This lesion showed features suggestive of focal surface alteration with ulceration and subtle changes suspicious for minimal invasion. Surrounding mucosa displayed a range of atypical squamous changes, including keratosis and varying degrees of dysplasia. Margins of the glossectomy specimen did not show overt dysplastic changes but appeared somewhat abnormal. The deep margin tongue specimen and medial palate margin were both free of any significant lesion. Gross evaluation confirmed adequate sampling of margins and surrounding tissue, with all margins reported as negative."} +{"pid": "TCGA-HD-8635", "report": "The surgical specimen from the right tongue resection includes a lesion measuring 1.2 cm in greatest microscopic dimension with a maximum depth of invasion of 6 mm. The resection margins are free of tumor, with the closest margin being the deep margin at 9 mm from the tumor edge. No lymphatic or vascular invasion was identified, and there is no evidence of perineural involvement. A sentinel lymph node from the right neck level 2 was identified, measuring 1.4 x 0.6 x 0.5 cm, with metastatic involvement measuring 3.5 mm in greatest dimension. There is no extracapsular extension noted. The tumor was located in the right tongue, with a mucosal ulceration measuring 1 cm. Gross measurements of the resected specimen are 4.5 cm anterior to posterior, 3.5 cm superior to inferior, and 2.5 cm in depth. Margins were inked for orientation: superior (black), inferior (orange), anterior (red), posterior (green), and deep (blue). Frozen section analysis of the margins showed no tumor involvement. Multiple tissue sections were submitted for evaluation, including the sentinel lymph node which was bisected and submitted in toto for further analysis. An immunohistochemical stain for p16 is in progress and will be reported separately."} +{"pid": "TCGA-S9-A6U5", "report": "The neuropathology report indicates a lesion with histological and morphological features consistent with a diffusely infiltrative glial neoplasm. The tumor exhibits moderate cellularity with nuclear atypia and scant mitotic activity. No necrosis or microvascular proliferation is identified. The architectural pattern shows a lack of circumscription, with tumor cells extending into the surrounding parenchyma. Immunohistochemical staining demonstrates positivity for glial markers. Based on these findings, the lesion is classified as a low-grade glioma, WHO grade II."} +{"pid": "TCGA-BR-8487", "report": "The specimen consists of a stomach following total gastrectomy. A polypoid lesion is identified in the antrum, measuring 16 x 0 x 0 cm. The tumor exhibits exophytic growth and invades into the perigastric fat. Microscopic evaluation reveals two distinct components. One component demonstrates a predominantly endophytic growth pattern with Grade 2\u20133 differentiation. The other component is mainly exophytic and shows Grade 3 morphology with necrosis. \n\nFifteen lymph nodes were examined and none contained metastatic involvement. Reactive hyperplasia was noted in these lymph nodes. The greater and lesser omentum show hyperemia but no tumor elements. Venous invasion is not identified. Lymphatic and perineural invasion status are not specified. Surgical margins are free of tumor. There is no evidence of treatment effect or additional significant pathologic findings."} +{"pid": "TCGA-S7-A7WU", "report": "The left adrenal gland contained a mass measuring 50x48x25 mm and weighing 30 grams. The majority of the adrenal gland was replaced by a lesion measuring 42x30x22 mm, which appeared grey on sectioning with areas of focal hemorrhage. A second nodule measuring 23x15x15 mm had an ochre-yellow appearance. Residual normal adrenal tissue measured 10x5x5 mm and exhibited a yellow color.\n\nMicroscopically, in blocks A and G, there was diffuse and nodular hyperplasia of the adrenal cortex with focal hypolipidosis. In block E, an encapsulated intracapsular proliferation of adrenal cortical tissue was observed. Block H showed a bordered patch of symmetric, slightly bruised adrenocortical tissue within adipose tissue. Similar cortical structures were also identified in blocks B and C. Additional parts of these sections contained solid and alveolarly arranged cells of variable size, with focal diffuse growth and occasional spindle cell morphology, but no necrosis. In blocks D-F, isolated areas of moderate to high cellularity were present, with focal marked cellular atypia. No mitotic figures, vascular invasion, or capsular invasion were identified.\n\nImmunohistochemical analysis showed that S100 protein was absent in sustentacular cells in large portions of the lesion. MIB-1 labeling index was minimal, with less than 1% positive nuclei. Chromogranin A was negative in the adrenal cortical regions but strongly positive in the other component. Synaptophysin was also strongly positive in the same region, while negative in the cortical areas.\n\nScoring based on histological features included: large nests or diffuse growth affecting more than 10% of the tumor volume (2 points), high cellularity (2 points), cellular monotonousness, tumor cell spindling (even if focal) (2 points), extension into adipose tissue, profound nuclear pleomorphism (1 point), and nuclear hyperchromasia (1 point). The total score was 8."} +{"pid": "TCGA-B0-5710", "report": "Gross examination revealed a well-circumscribed mass located in the lower pole of the right kidney, measuring 5.7 cm in its greatest dimension, with an additional measurement of 4.4 cm. The lesion is unifocal and confined within the renal capsule, without extension into the renal vein or surrounding vasculature. No angiolymphatic invasion is present. Microscopic analysis shows a neoplasm composed of cells with clear cytoplasm and areas of myxoid change and necrosis. Nuclear features correspond to a moderate degree of atypia. All surgical margins are free of tumor involvement. The adjacent non-neoplastic kidney demonstrates reactive changes in proximity to the lesion. A total of zero regional lymph nodes were identified and examined. Based on these findings, the pathologic staging is pT1b with no evidence of nodal or distant metastasis."} +{"pid": "TCGA-CZ-4860", "report": "The specimen consists of a right kidney with an associated mass, along with a vena caval tumor thrombus. The kidney specimen weighs 1072 grams and measures 19 x 10 x 0.9 cm. It includes an exposed portion of what may be a renal artery (0.6 x 0.5 cm) and a possible urethral stump (0.1 x 1.9 cm), both of which are thickened and appear to be involved by the lesion. The urethral margin is inked blue and the arterial margin is inked orange. Upon sectioning, a large solid mass measuring 14.4 x 9.6 x 7.0 cm is identified, occupying most of the kidney. The cut surface is yellow-white, lobulated, and slightly hemorrhagic. Very little normal renal cortex remains, with no distinct cortical-medullary junction visible. The mass extends to the urethral resection margin and abuts the renal capsule, surrounded by a thin rim (0.8 cm) of perirenal fat. There is also involvement of the renal pelvis and invasion into perinephric fat. A cystic cavity measuring 1.0 x 1.0 x 0.9 cm is present within the tumor. Six tissue blocks from the tumor were submitted for banking (T1\u2013T6), along with portions of adjacent normal kidney tissue.\n\nMicroscopic evaluation reveals high-grade nuclear features. Vascular invasion and perineural invasion are present. Margins of the ureter and artery show no evidence of tumor involvement. The renal vein was not identified in the specimen. Immunohistochemical staining shows positivity for RCC and EMA markers.\n\nThe second specimen, labeled as a vena caval tumor thrombus, measures 3.2 x 1.5 x 1.5 cm and includes attached fibrovascular tissue (2.8 x 1.2 x 0.5 cm). Histologic examination confirms the presence of tumor extending into this structure.\n\nEvaluation of the non-neoplastic kidney parenchyma reveals diffuse interstitial fibrosis and tubular atrophy, likely secondary to chronic obstructive uropathy and possibly venous obstruction. Moderate arterial and arteriolar sclerosis is also noted. Only mild glomerulosclerosis is observed. These findings suggest long-standing ipsilateral obstruction of the collecting system, potentially compounded by vascular compromise due to tumor thrombus in the renal vein and inferior vena cava. No evidence of diabetic glomerulosclerosis is seen.\n\nCytogenetic analysis was performed on three tissue samples. Of the fifteen metaphase cells analyzed, five showed abnormal chromosome counts (118\u2013126 chromosomes), though morphology was poor and detailed analysis limited. Ten cells displayed a normal male karyotype (46,XY). Chromosome banding was performed at a resolution of 400 bands or greater. Mosaicism or small chromosomal abnormalities may not have been detectable using standard techniques.\n\nThe tumor extends into surrounding tissues and demonstrates aggressive histologic features including nuclear grade IV. Based on extent of local invasion, staging criteria indicate advanced local disease."} +{"pid": "TCGA-A7-A26G", "report": "The specimen included a right axillary sentinel lymph node and a right breast excision. The lymph node, measuring 3.5 x 2.5 x 0.8 cm, showed no identifiable tumor on H&E sections; however, isolated keratin-positive cells were present. The breast specimen measured 27 x 28 x 7.4 cm and contained a centrally located firm tan-white mass measuring 2.3 cm in greatest dimension, consistent with prior biopsy changes. No involvement of the deep margin was observed. Microscopic evaluation revealed invasive carcinoma with histologic grade 3 features, including an architectural score of 3, nuclear score of 3, and mitotic score of 2. The lesion exhibited ductal carcinoma components with metaplastic areas showing sarcomatoid features. No definitive vessel invasion or calcifications were identified. The nipple showed lobular neoplasia supported by immunostaining findings, though no direct involvement by ductal carcinoma was seen. Ductal carcinoma in situ was also present, exhibiting a solid pattern with high nuclear grade. Non-tumorous findings included fibrocystic changes, microcalcifications, and biopsy site alterations. A squamous papilloma was noted in the skin along with a scar. Lobular neoplasia was additionally identified in a random section of breast tissue. All margins were negative."} +{"pid": "TCGA-AG-4005", "report": "The resected colon specimen includes the rectum with tumor-free oral, aboral, and perirectal margins. The lesion is ulcerated and shows moderate differentiation with infiltration into the perimuscular fatty tissue. Several local lymph node metastases were identified, along with a metastatic deposit in the left adrenal gland. Histological grade is G2. The tumor measures pT3 with lymphatic invasion (L1) and vascular invasion (V1). Lymph node involvement is pN2, with 7 out of 40 nodes positive. Distant metastasis is present (pM1)."} +{"pid": "TCGA-V1-A9Z8", "report": "The prostate specimen showed an asymmetric gland measuring 4.2 cm from apex to base, with a weight of 48.5 grams. On gross examination, no discrete mass was identified; however, there was an ill-defined, firm, light tan expansion involving the anterior prostate bilaterally from apex to base, extending into posterior areas. The anterior fibrous stroma was disrupted, while the remainder of the capsule appeared intact. Histologic evaluation revealed extensive involvement of the anterior prostate bilaterally, with extension into posterior regions and invasion of the bladder neck. High-grade cellular features were noted, including Gleason pattern 5 as the primary component and pattern 4 as secondary. The tumor exhibited extraprostatic extension at multiple locations: left anterior apex, left and right anterior base, left posterolateral base and mid gland, and extensive bladder neck involvement. The tumor volume was estimated at 36 cc, with over 90% of the tumor demonstrating Gleason patterns greater than grade 3. Invasion of the capsule was present, and the anterior midline margin from apex to base was extensively involved (4 x 1.5 cm), showing high-grade morphology. Benign glands were identified at inked margins including bilateral bladder neck margins. Evaluation of seminal vesicles demonstrated involvement on the left side; the right seminal vesicle showed no abnormality. Perineural infiltration was observed. Lymph node assessment included eleven nodes from the right pelvic region and seven from the left pelvic region; none contained tumor. However, suspicious areas suggestive of lymphatic invasion were identified in one prostate section. No high-grade intraepithelial neoplasia was identified. All surgical specimens were oriented using anatomic landmarks and submitted for microscopic analysis."} +{"pid": "TCGA-G9-6377", "report": "The specimens include left and right pelvic lymph nodes and a resected prostate gland. The left pelvic lymph nodes consist of fatty tissue measuring 5.8 x 4.5 x 0.8 cm with two lymph nodes identified, measuring 0.5 x 0.3 x 0.2 cm and 3.5 x 1 x 0.3 cm. Touch preparations were performed and both lymph nodes were submitted entirely for frozen section analysis. The right pelvic lymph nodes consist of fatty tissue measuring 5.5 x 3.6 x 1 cm with six lymph nodes identified ranging from 0.5 to 2.5 cm in size; all were submitted entirely for frozen section analysis.\n\nThe prostate gland weighs 39 grams and measures 4.2 cm laterally, 3.8 cm anterior to posterior, and 3.5 cm apex to base. The external capsule is smooth, red, and intact. Upon sectioning, the prostate weighs 21 grams and demonstrates a nodular tan parenchyma. Both seminal vesicles are cystic and tan in appearance, with the right measuring 3.5 x 2.6 x 0.9 cm and the left measuring 4 x 1.2 x 0.7 cm. The vas deferens are tubular and tan, with the right measuring 2.7 x 0.5 cm and the left measuring 1.9 x 0.6 cm. A total of 10 grams of tissue was procured for analysis. Multiple sections through different levels and regions of the prostate, seminal vesicles, and vas deferens were submitted for microscopic evaluation.\n\nMicroscopic examination reveals no tumor involvement in either left or right pelvic lymph nodes. Evaluation of the prostate demonstrates multicentric involvement with glandular proliferation showing Grade 3 and Grade 4 morphology. Approximately 10% of the prostate tissue is involved. Perineural invasion is present; however, there is no evidence of vascular or lymphatic invasion. There is no extension beyond the prostatic capsule. Both seminal vesicles and vas deferens are free of abnormal cellular infiltration.\n\nMargins are negative. High-grade intraepithelial neoplasia is noted. Benign prostatic hyperplasia is present as an additional finding.\n\nPathologic staging according to the AJCC Cancer Staging Manual (7th Edition) indicates local confinement to the prostate without regional lymph node involvement or distant spread. The tumor involves both lobes of the prostate. Lymph node assessment shows no involvement bilaterally (left: 0 out of 2 lymph nodes involved; right: 0 out of 4 lymph nodes involved). Distant metastasis cannot be assessed."} +{"pid": "TCGA-BP-4355", "report": "The submitted specimen consists of a left kidney with attached ureter, renal vessels, and perinephric fat, along with the adrenal gland. The kidney measures 10.0 x 5.0 x 4.0 cm, and the attached ureter is 5.0 cm in length and 0.5 cm in diameter. The renal vein measures 2.5 cm in length and 2.5 cm in diameter. The adrenal gland measures 6.0 x 5.0 x 2.0 cm and shows no involvement.\n\nOn gross examination, an ill-defined yellow-orange mass is identified in the lower pole of the kidney. The mass measures 13.0 x 13.0 x 9.2 cm and causes distortion of the kidney cortex. It does not appear to invade the perinephric adipose tissue. Serial sections reveal areas of fibrosis, mucinous degeneration, necrosis, and hemorrhage within the lesion. There is no gross invasion into the sinus; however, extension into the hilar fat could not be definitively assessed. The remaining kidney parenchyma appears pink-brown with a well-defined corticomedullary junction. The cortex measures 0.5 cm, and the calyces are normal. No lymph nodes are identified in the perinephric fat.\n\nMicroscopic evaluation reveals high-grade nuclear features consistent with the highest Fuhrman nuclear grade. Necrosis is present in large foci throughout the tumor. The tumor extends through the renal capsule but remains confined within Gerota\u2019s fascia. It involves the renal hilar fat and invades muscular veins within the renal sinus. Surgical margins are free of tumor. Non-neoplastic kidney tissue demonstrates mild arteriosclerotic changes and benign cortical cysts. The adrenal gland is not involved.\n\nStaging criteria indicate that the tumor extends into the renal vein or vena cava below the diaphragm. No lymph nodes are identified in the specimen. Multiple representative sections from various sites including the tumor, adjacent kidney, capsule, perinephric fat, hilar fat, sinus fat, ureteral and vascular margins, and adrenal gland have been submitted for analysis."} +{"pid": "TCGA-55-A492", "report": "The surgical pathology report describes findings from a wedge excision followed by lobectomy and lymph node dissection from the right upper lobe of the lung. A nodule measuring 1.2 cm in greatest dimension was identified within the pulmonary parenchyma. Histologic evaluation showed no visceral pleural invasion. Surgical margins were uninvolved, with bronchial, vascular, and parenchymal margins all free of abnormal cells. \n\nA total of nineteen lymph nodes were examined, including peribronchial, hilar, subcarinal, lower paratracheal, and pulmonary ligament regions. All were negative for metastatic involvement. Within some lymph nodes, hyalinized nodules were observed, consistent with old granulomas.\n\nThe tumor was histologically classified as moderately differentiated and originated from the lung without extension into extra-pulmonary structures. No lymphovascular or perineural invasion was identified. Based on size and absence of lymph node involvement or distant spread, staging was determined as pT1a (tumor size \u2264 2 cm), pN0 (no regional lymph node metastasis), and Mx (distant metastasis not assessed). The final pathologic stage is IA. Additional findings included emphysematous changes and anthracotic lymph nodes."} +{"pid": "TCGA-49-AARN", "report": "The surgical specimen includes a right lower lobectomy measuring 13 x 13 x 3 cm and weighing 260 grams. A peripheral mass is identified, measuring 2.2 x 2 x 1.8 cm. The lesion appears well-defined, solid, and firm with tan-gray coloration. There is no gross involvement of the bronchial or vascular margins, with the tumor located more than 2 cm from the bronchial margin of resection. No vascular invasion is observed. Histologic examination reveals a moderately differentiated growth pattern without pleural invasion. All surgical margins are free of abnormal tissue.\n\nTwo lymph node specimens were submitted for evaluation. One consists of level 7 lymph node tissue associated with fibroadipose material, measuring 1.2 x 0.6 x 0.2 cm. The second specimen corresponds to lymph node 4R, measuring 1 x 0.5 x 0.2 cm. Both lymph node specimens show no evidence of cellular abnormalities.\n\nSections include multiple representative areas of the primary lesion, bronchial and vascular margins, stapled margin, hilar region, and surrounding lung tissue. Immunohistochemical analysis demonstrates immunoreactivity for TTF-1 and absence of staining for estrogen receptor, progesterone receptor, and gross cystic disease fluid protein. Based on these findings, the pathologic staging classification reflects localized involvement without nodal spread or distant disease."} +{"pid": "TCGA-OR-A5LO", "report": "A right adrenalectomy was performed. The tumor weighed 760 grams and measured 13.5 x 9.5 x 6 centimeters. Histological evaluation showed a Weiss score of 7. There was no extension into the liver or kidney. Lymph node examination revealed no metastases, with 0 out of 19 lymph nodes involved."} +{"pid": "TCGA-23-2641", "report": "The specimen consists of multiple tissue fragments from various anatomical sites including the diaphragm, transverse colon, omentum, perinephric area, small intestine, rectosigmoid colon, pelvic region, uterine adnexa, gastric omentum, appendix, and lymph nodes. Histologic evaluation reveals the presence of high-grade malignant cells with serous features in nearly all sampled tissues. The tumor cells are consistently present in high percentages within the nuclei, ranging up to 99% or more in some areas. No tumor cell necrosis is identified.\n\nExtensive involvement is noted in the omentum, with near total replacement by malignant cells. Similar widespread involvement is observed in the peritoneal surfaces, including the diaphragm, pelvic regions, and perinephric tissues. The serosal surfaces of both fallopian tubes and adjacent soft tissues show significant tumor infiltration. One ovary demonstrates focal invasion with tumor deposits measuring up to 0.5 cm in diameter. Additionally, tumor involvement is present in the paraureteral region, gastric omentum, and appendix, where it partially coats the surface.\n\nLymph node analysis reveals metastatic involvement in one of three left pelvic lymph nodes. The tumor is found within an afferent lymphatic vessel and subcapsular sinus of the affected node. Right aortic lymph nodes do not show any evidence of metastasis.\n\nHistologic grade is determined to be poorly differentiated (G3). The primary tumor is classified as PT3c due to the presence of macroscopic peritoneal metastases beyond the pelvis greater than 2 cm in greatest dimension. Lymphovascular invasion is identified at multiple sites. Additional findings include tumor-associated fibrosis, inflammatory changes, and adhesions.\n\nTumor size cannot be definitively determined due to the diffuse nature of involvement across multiple sites. The involvement of peritoneal surfaces and bilateral adnexal structures supports a pattern of widespread intra-abdominal dissemination."} +{"pid": "TCGA-SJ-A6ZJ", "report": "The surgical specimen included a uterine corpus with attached bilateral fallopian tubes and ovaries, along with resected cervix and pelvic lymph nodes. The procedure performed was a radical hysterectomy with bilateral salpingo-oophorectomy and lymph node dissection.\n\nGross examination of the uterine specimen revealed an enlarged and distorted uterus measuring 11 cm from fundus to resection margin, with a mass identified in the endometrial cavity. The mass measured 8 x 5 x 2.5 cm, had a tan, papillary, and friable appearance, and was located predominantly on the posterior aspect (80%) with a smaller portion on the anterior aspect (20%). It extended into the myometrium, invading to a depth of 25 mm out of a total myometrial thickness of 40 mm. The tumor came within 5 cm of the posterior resection margin and 7 cm of the anterior resection margin. No involvement of the cervix was observed. Multiple subserosal nodules were noted on the serosal surface, with the largest measuring up to 7 cm. Histologic evaluation showed no malignancy within these nodules. Additionally, multiple white, firm, whorled nodules were identified within the myometrium, consistent with leiomyomas.\n\nMicroscopic analysis of the uterine corpus demonstrated cellular features consistent with glandular proliferation with specific architectural changes. The histologic grade was determined to be FIGO grade 2. There was no evidence of lymphovascular invasion. Margins of resection, including the parametrial regions, were free of invasive carcinoma.\n\nExamination of the cervix revealed benign findings, including acute and chronic cervicitis with squamous metaplasia and reactive changes. No malignant cells were identified.\n\nA total of 28 pelvic lymph nodes were evaluated\u201415 from the right side and 13 from the left\u2014with no evidence of malignancy identified in any of the nodes.\n\nAdditional findings included endometrial intraepithelial neoplasia. Peritoneal ascitic fluid was negative for malignant cells. The ovaries and fallopian tubes showed no abnormal pathology.\n\nThe tumor was staged as pT1b, indicating invasion of one-half or more of the myometrium. Regional lymph node staging was pN0, with no metastases identified. Distant metastasis could not be assessed (pMX). \n\nOther tissues examined, including parametrial tissue and adnexal structures, showed no signs of tumor involvement. Multiple sections were submitted for histopathological review, and all relevant margins were uninvolved by invasive disease."} +{"pid": "TCGA-QC-AA9N", "report": "The surgical specimen consists of an elliptical excision of skin with attached underlying soft tissue from the right buttock. The skin ellipse measures 5.4 cm (superior to inferior) and 16.0 cm (lateral to medial). The underlying soft tissue measures 13.0 cm (superior to inferior), 20.0 cm (medial to lateral), and extends to a depth of 11.0 cm. A well-circumscribed, heterogeneous, lobulated solid mass is identified beneath the epidermis, measuring 10.0 x 9.1 x 8.3 cm. The mass appears tan-white with focal hemorrhage and approximately 5% necrosis. It is located 3.0 cm below the skin surface and is situated closest to the deep margin at 1.4 cm, medial tip at 5.5 cm, lateral tip at 6.2 cm, superior margin at 3.3 cm, and inferior margin at 1.9 cm.\n\nHistologic examination reveals high-grade cellular features including marked pleomorphism and frequent mitotic figures, with a mitotic rate of 30 per 10 high-power fields. Necrosis is present, involving approximately 30% of the tumor volume. Margins are evaluated microscopically; no tumor involvement is identified at any margin. The closest tumor proximity is at the deep margin (1.6 cm) and the inferior margin (1.9 cm).\n\nThe tumor is confined to subcutaneous tissue without invasion into deeper fascia or muscle. No lymph nodes were identified or examined. No treatment effect is observed. Immunohistochemistry, cytogenetics, and molecular studies were not performed. Based on local staging criteria, the tumor exceeds 5 cm in greatest dimension and is classified as pT2a. Regional lymph node assessment could not be determined (pNX). No distant metastasis was assessed."} +{"pid": "TCGA-3X-AAVA", "report": "The specimen consists of a segmental liver resection weighing 218.4 grams and measuring 11.8 x 8.4 x 5.4 cm. The external surface is largely smooth with two indurated, light tan areas on the anterior and posterior surfaces measuring 5.4 x 4.3 cm and 4.4 x 2.0 cm, respectively. The surgical margin is marked with black ink. On sectioning, a well-circumscribed light tan lesion is identified, measuring 7.3 x 5.8 x 4.8 cm, and appears to extend to the surgical margin. A secondary nodule measuring 1.0 x 0.9 x 0.9 cm is also present, located approximately 0.8 cm from the larger lesion and 2.8 cm from the surgical margin, appearing to reach the capsular surface.\n\nMicroscopically, the lesion demonstrates a moderately differentiated growth pattern with a mass-forming architecture. The tumor is confined to the hepatic parenchyma and does not involve the surgical margin, with the closest distance from the invasive component to the margin being 1 mm. Perineural invasion is present. No venous or small vessel invasion is identified. Two separate foci are noted within the same segment. The background liver shows prominent chronic portal inflammation. Portal tissue submitted shows benign fibroadipose composition. Multiple sections were taken for microscopic evaluation, including representative areas of the main lesion, its relationship to the surgical margin, and involvement of the anterior and posterior capsular surfaces, as well as the smaller nodule. Serology for autoimmune and viral hepatitis markers was negative, and clinical correlation is recommended."} +{"pid": "TCGA-41-2572", "report": "The specimen includes three parts: A, B, and C. Part A consists of multiple pieces of red and brown soft tissue measuring 1.2 cm in greatest aggregate dimension from a left occipital tumor biopsy. Part B is composed of multiple pieces of tan and red soft tissue measuring 2.2 x 1.9 x 0.3 cm in aggregate. Part C, submitted fresh for research purposes, is a piece of red soft tissue approximately 1.5 cm in greatest dimension.\n\nMicroscopic evaluation reveals a hypercellular glioma with mitotic activity, areas of new vessel formation, and necrosis. Tumor measurements are noted as 3x2, 8, and 14. The histologic features are consistent with a high-grade glioma."} +{"pid": "TCGA-AG-3727", "report": "The resected rectosigmoidal specimen contains an area of concern measuring up to 4 cm in diameter, located 3 cm from the distal resection margin. Histological evaluation reveals extensive involvement of the pericolic adipose tissue, with significant lymphatic invasion noted in the surrounding stroma. Two affected regional lymph nodes are identified out of a total of 25 examined. The lesion demonstrates marked nuclear atypia and high-grade cytological features. All colonic resection margins, as well as the mesenteric margin, are free of any suspicious involvement. Vascular invasion is not observed. A separate finding in the soft tissue includes chronic inflammatory changes with resorptive cells and pseudocystic formations, possibly consistent with oil cysts."} +{"pid": "TCGA-D7-6526", "report": "Histopathological examination was performed on material obtained from a multiple organ resection involving the stomach. The stomach, measuring 18 x 19 cm, was excised along the greater curvature, along with omental tissue measuring 32 x 17 cm. A lesion was identified in the pyloric region, measuring 8 x 6.5 x 2 cm. Macroscopically, there was evidence of infiltration into the perigastric fat tissue. The distance from the proximal resection margin was 5 cm, and from the distal margin, 0.8 cm.\n\nMicroscopic analysis revealed a moderately differentiated tubular growth pattern. The lesion extended through the full thickness of the stomach wall and involved the perigastric fat tissue and blood vessels. The surgical margins were free of involvement. Lymph node examination showed presence of atypical cells in perinodal adipose tissue and lymph node capsules. Involvement was noted in lymph node groups III and XIX.\n\nStaging was determined as pT3 for depth of invasion and pN2 for regional lymph node involvement. The growth pattern was classified as intestinal type according to Lauren classification. Immunohistochemical testing using HercepTest\u2122M by DAKO showed a score of 2+ for a specific protein marker, and further verification via FISH method is recommended."} +{"pid": "TCGA-XU-A933", "report": "The specimen consists of a mediastinal mass and two lung wedge resections. The primary lesion is located in the thymus and measures 4.5 cm in greatest dimension. Histologic evaluation reveals nests and sheets of large, malignant-appearing cells arranged within the thymic tissue. There is evidence of multifocal infiltration into adjacent adipose tissue and invasion into a pleural surface, with tumor cells present less than 0.1 mm from the specimen surface. Resection margins of the thymus are free of tumor involvement, with the closest margin measuring 0.4 cm from tumor cells.\n\nOne of three lymph nodes examined demonstrates metastatic involvement. Adjacent lymphoid tissue shows focal cystic changes, follicular hyperplasia, and signs of involution.\n\nThe lung specimens include a left lower lobe wedge and a lingular wedge. Both show diffuse interstitial chronic inflammation, organizing pneumonia, intra-alveolar edema with proteinaceous material and foamy macrophages, along with reactive pneumocyte hyperplasia. Fibrosis is noted in areas, some with early architectural remodeling. Small airways demonstrate focal chronic inflammation with lymphoid aggregates. Vascular changes are reactive without evidence of vasculitis. No viral cytopathic effects, granulomas, or hyaline membranes are observed. Fungal stains are negative.\n\nImmunohistochemical staining of the thymic lesion demonstrates positivity for low molecular weight keratin, P63, CD5, and CD117, with focal positivity for high molecular weight keratin and CK5/6. Staining for EBV is negative. Approximately 20% of tumor cells show Mib-1 positivity. CD20-positive lymphocytes are seen in focal aggregates, while infiltrating T cells stain positive for CD3. Dendritic cells and lymphocytes in residual thymic tissue stain for CD1a, although tumor-associated lymphocytes do not express CD1a.\n\nHistologic staging indicates involvement of mediastinal pleura with microscopic invasion and regional lymph node metastasis. Cellular morphology and immunoprofile suggest an aggressive epithelial neoplasm with associated inflammatory features."} +{"pid": "TCGA-RC-A6M6", "report": "The surgical specimens included a gallbladder and a liver resection. The gallbladder measured 6.8 x 3.5 x 3.0 cm and showed no significant inflammation or abnormal changes. The liver specimen weighed 450 grams and measured 17.0 x 9.5 x 7.0 cm. It contained a multinodular mass measuring 11.5 x 6.8 x 6.0 cm, located near the hepatic capsule and extending to within 0.1 cm of the margin. The mass protruded 1.3 cm above the surface and had a yellow-white to pink-tan cut surface with scattered peripheral nodules. The carcinoma showed extensive lymphovascular invasion and was present at the hepatic resection margin. Microscopic evaluation revealed a poorly differentiated carcinoma involving multiple segments of the liver. The tumor was multifocal and extended beyond the main mass. It arose in a background of cirrhosis with mild to moderate steatosis. Ancillary studies showed no reactivity for CK7, CK20, or HSA. Margins were involved by invasive carcinoma, specifically at the hepatic resection line. Pathologic staging classified the tumor as pT2 with regional lymph node status indeterminate (pNX). Additional findings included scattered bile duct hamartomas."} +{"pid": "TCGA-69-8254", "report": "The specimen consists of a right lower lobe lung wedge resection measuring 15.2 x 5.5 x 2.3 cm and weighing 77 grams. The lesion of interest is described as a tan gelatinous area of consolidation with a friable cavity located adjacent to the pleura, measuring 5.5 x 3 x 2 cm. Within this area, there is a tan firm lobulated mass measuring 3.3 x 2 x 1.2 cm. The mass extends to within 0.1 cm of the resection margin inked orange. Additional findings include a small tan firm nodule measuring 0.2 cm, located 1.5 cm from the main area of consolidation. The remaining lung parenchyma shows changes consistent with atelectasis, hemorrhage, centrilobular emphysema, and organizing pneumonia. Sections of the tumor, resection margins, and surrounding tissue were submitted for evaluation. Stains for assessment of pleural invasion will be performed and reported separately. Molecular testing for specific genetic alterations is pending and will be reported as an addendum. All margins are negative."} +{"pid": "TCGA-CZ-5467", "report": "The surgical pathology report includes two specimens: a retroperitoneal node and a right kidney specimen. The retroperitoneal node consists of one fragment of soft tissue measuring 2.3 x 1.1 x 0.3 cm. No lymph nodes are identified in this specimen, and no abnormal cellular features are noted.\n\nThe right kidney specimen is a radical nephrectomy weighing 762.5 grams and measuring 21.0 x 10.0 x 8.8 cm. It includes portions of the ureter, possible arteries, veins, and a disrupted adrenal gland. Grossly, these structures appear without lesions. A large encapsulated mass measuring 11.0 x 9.5 x 8.2 cm is identified in the upper pole of the kidney. The mass is located near the outer surface of the specimen and shows proximity to several margins: 10.0 cm from the ureter margin, 5.5 cm from vein #1, 2.0 cm from vein #2, and 4.3 cm from the artery margin. Approximately 70% of the tumor is hemorrhagic with about 50% necrosis distributed in multiple nodules. The remaining portion of the tumor is tan/white, homogenous, and forms a single nodule adjacent to the hemorrhagic area.\n\nMicroscopic evaluation reveals high-grade nuclear features with focal sarcomatoid differentiation. The tumor invades small non-muscular vessels and extends into perinephric adipose tissue. Margins of the soft tissue resection are negative for tumor involvement, although the tumor approaches within less than 0.1 cm of the margin. All vascular margins (renal artery, vein, and ureter) are free of tumor, as is the sampled adrenal gland.\n\nStaging according to the AJCC classification (6th edition) indicates local extension into surrounding tissues but no evidence of nodal or distant metastasis. Histologic sections of uninvolved renal parenchyma show mild chronic changes including focal global glomerulosclerosis, focal tubular atrophy, interstitial fibrosis involving less than 5% of the parenchyma, and moderate arterial and arteriolar sclerosis.\n\nCytogenetic analysis of one tumor sample reveals chromosomal abnormalities including loss of the short arm of chromosome 3, which is commonly associated with certain malignant entities. Five out of seven metaphases analyzed contained these clonal aberrations. Attempts to culture cells from another tumor sample were unsuccessful.\n\nRepresentative sections of the tumor and surrounding tissues were submitted for further studies including cytogenetics, electron microscopy, immunofluorescence, and tissue banking. Gross photographs were taken and archived."} +{"pid": "TCGA-AC-A7VB", "report": "The surgical pathology report describes a modified radical mastectomy with sentinel lymph node biopsies and axillary lymph node dissection. Three foci of invasive malignancy were identified. The largest measured 1.5 cm in diameter, located at the 6 o\u2019clock position. Two smaller foci were also present, measuring 0.6 cm and 0.8 cm, both located at the 7\u20138 o\u2019clock position. All three invasive foci were found to be multifocal and histologically similar. The larger lesion showed variable mitotic activity and nuclear pleomorphism ranging from intermediate to high grade, while the smaller nodules displayed higher-grade features including solid sheets of malignant epithelial cells with frequent mitoses.\n\nIn addition, ductal carcinoma in situ (DCIS) was identified in association with all three invasive foci. It was described as high nuclear grade and solid type, although it comprised less than 10% of the total biopsy tissue volume. No involvement of the skin or chest wall was observed. The margins of the mastectomy specimen were negative for tumor. The closest distance of invasive carcinoma to the margins was 3 cm from the inferior margin and at least 6 cm from all other margins.\n\nA total of fifteen lymph nodes were examined. Metastatic involvement was found in three sentinel lymph nodes (#2, #3, and #4), with the largest metastatic deposit measuring 0.9 cm. Extranodal extension was present. The remaining twelve lymph nodes showed no evidence of involvement.\n\nHistologic grading of the invasive component was based on Nottingham criteria, with a score of 2\u20133 out of 3. Tubule formation was scored as 3 out of 3, nuclear pleomorphism ranged from 2\u20133 out of 3, and mitotic rate was 2\u20133 out of 3 depending on the nodule. Lymphovascular invasion could not be definitively determined.\n\nStaging was based on the AJCC Cancer Staging Handbook, 7th edition. The primary tumor was classified as pT1c(m) due to its multifocality. Regional lymph node involvement was staged as pN1, and distant metastasis was not applicable. The overall pathologic stage was IIA. Estrogen receptor expression was strongly positive (85\u201396%), while progesterone receptor was completely negative. HER2 testing was pending at the time of reporting. Ki-67 expression was variable, previously reported between 7% and 69%.\n\nAncillary immunohistochemical staining with CK OSCAR confirmed metastatic involvement in sentinel nodes #2 and #3. A separate focus in sentinel node #4 was also confirmed positive. Intraoperative evaluation of sentinel node #2 had shown rare atypical cells suspicious for malignancy, while sentinel node #1 was negative. All involved lymph nodes were submitted for further histologic analysis."} +{"pid": "TCGA-DC-5869", "report": "The surgical specimen consists of a segment of rectosigmoid colon measuring 13.0 cm in length and 9.0 cm in average diameter. The tumor is located 8.0 cm from the proximal margin and 1.6 cm from the distal margin. It measures 3.4 cm in both length and width, with a maximal thickness of 0.7 cm. On serial sectioning, the deepest invasion is 0.7 cm, which is 1.4 cm from the closest radial margin. The remaining mucosa appears unremarkable. Pericolic and perirectal adipose tissue was examined and all identifiable lymph nodes were submitted for analysis.\n\nHistologic evaluation reveals a moderately differentiated gland-forming lesion arising in the rectum. There is extensive budding at the invasive front. No increased tumor-infiltrating lymphocytes are noted. A precursor lesion consistent with tubular adenoma is identified adjacent to the lesion. The tumor invades through the muscularis propria into perirectal soft tissue. There is no evidence of gross tumor perforation, lymphovascular invasion, large venous invasion, or perineural invasion. All surgical margins, including proximal, distal, and radial, are free of tumor involvement.\n\nA total of 19 lymph nodes are examined, with one containing metastatic involvement. No tumor deposits are identified in the pericolorectal soft tissue. Other specimens, including proximal and distal excision margins, show no evidence of pathology and contain only benign tissue."} +{"pid": "TCGA-DU-7019", "report": "A 45-year-old man presented with a three-week history of severe headache, nausea, and vomiting. Imaging revealed a large right temporal lobe mass with surrounding edema and transtentorial herniation, demonstrating only a linear area of enhancement. Biopsy and excision specimens were obtained from the right temporal region.\n\nGross examination of the biopsy specimens showed tan to tan-pink, glistening, hemorrhagic soft tissue fragments measuring up to 3.3 cm in greatest dimension. Histologic evaluation demonstrated widespread infiltration of the cerebral cortex and adjacent white matter by a glial neoplasm. The tumor exhibited a mixed cellular morphology, with both oligodendroglial and astrocytic features. Nuclear atypia was present focally, and mitotic figures were observed. Proliferation index, assessed by MIB-1 staining, reached up to 10%. Immunohistochemical studies showed strong p53 expression in a majority of neoplastic cells and variable GFAP positivity. Focal microvascular hyperplasia was identified using CD31 and CD34 markers, though no necrosis was seen. Karyorrhexis was noted without evidence of necrotic changes.\n\nGenetic analysis revealed allelic loss involving chromosome arms 1p and 19q. Testing was performed using a panel of microsatellite markers including D1S1612, D1S496, D19S1182, and PLA2G4C. These findings suggest a potential for chemotherapeutic response. Additionally, molecular testing detected methylation of the MGMT promoter, which may indicate enhanced sensitivity to alkylating agents.\n\nThe histologic features, including focal anaplastic changes and elevated proliferation index, suggest ongoing malignant transformation. However, the lesion did not meet full criteria for high-grade classification at the time of assessment. Correlation with clinical, radiographic, and intraoperative findings is recommended for comprehensive patient management and follow-up."} +{"pid": "TCGA-UW-A7GY", "report": "The surgical specimens were received in two parts. Part A consisted of multiple soft tissue fragments, including four lymph node candidates measuring between 0.5 cm and 1.8 cm in greatest dimension. Histologic evaluation revealed one lymph node with prominent non-caseating granulomatous inflammation; all special stains for microorganisms (AFB and GMS) were negative. No evidence of malignancy was found in any lymph node.\n\nPart B consisted of a left kidney measuring 14.0 x 7.5 x 5.5 cm and weighing 280 grams. A tan-brown mass measuring 7.0 cm in greatest dimension was identified in the upper pole. The tumor was well-circumscribed, subcapsular, and involved the upper pole extensively, reaching the pelvicaliceal junction but not invading beyond. Additional microscopic tumor foci were identified, the largest being 0.2 cm. Histologically, the tumor cells exhibited eosinophilic cytoplasm and occasional bizarre nuclei. Nuclear grading was Fuhrman grade 3 of 4. No mitotic figures or necrosis were observed. Immunohistochemical staining showed positivity for E-Cadherin and CD117, focal positivity for EMA and CD10, and negativity for vimentin, renal cell carcinoma marker, and CK7. Lymphovascular invasion was present, but venous invasion was absent. Surgical margins, including Gerota\u2019s fascia, renal vein, and ureter, were free of tumor involvement. The tumor was confined to the kidney without extension into perirenal adipose tissue, Gerota\u2019s fascia, renal sinus, major veins, or ureter.\n\nAn incidental 1.0 cm pale yellow nodule was identified in the inferior pole, consistent with angiomyolipoma. Adrenal gland tissue was not present for evaluation. Staging was based on tumor size and extent, with no regional lymph node or distant metastasis identified."} +{"pid": "TCGA-DU-7302", "report": "A 1.8-cm aggregate of tan-grey tissue was received for analysis, along with archived slides from a prior procedure. Microscopic evaluation revealed a diffuse infiltration of the cerebral cortex by a monomorphic population of round cells with perinuclear halos and mild pleomorphism. Perinuclear satellitosis and scattered reactive astrocytes were noted. Mitotic activity measured approximately 2 mitoses per 10 high-power fields. Vascular prominence was present without evidence of microvascular proliferation or necrosis in this portion.\n\nIn the archived specimen, a similar cellular infiltrate was observed, though with a focal region demonstrating tumor necrosis and surrounding microvascular proliferation. Immunohistochemical staining showed sparse GFAP expression, indicating limited astrocytic differentiation. Approximately 20% of tumor nuclei exhibited strong p53 immunoreactivity, and the MIB-1 labeling index was approximately 12% in areas of increased cellularity.\n\nMolecular testing for MGMT promoter methylation was negative. The histologic features and proliferation indices were consistent with a low-grade neoplasm with localized areas of more aggressive morphology. Correlation with clinical and imaging findings was recommended for comprehensive interpretation and follow-up planning."} +{"pid": "TCGA-EM-A1CU", "report": "The specimen consisted of a total thyroidectomy with central compartment and superior mediastinal lymph nodes, along with contents from the left neck levels 2, 3, and 4. The thyroid gland weighed 65.2 grams and was oriented with a suture. The right lobe measured 4.9 x 2.5 x 1.6 cm, the left lobe measured 7.5 x 3.4 x 3.0 cm, and the isthmus measured 4.0 x 1.2 x 0.4 cm. Fibrous adhesions were noted on the external surfaces. Eight lymph nodes were identified grossly in the thyroid specimen, measuring between 0.3 and 0.8 cm in greatest dimension.\n\nIn the left lobe, there was a well-delineated, multi-lobulated, partially cystic nodule measuring 6.5 x 3.4 x 2.6 cm with a brown-tan appearance. In the right lobe, a smaller well-defined tan nodule measured 0.4 x 0.4 x 0.3 cm. The remainder of the thyroid tissue appeared unremarkable upon gross examination.\n\nSections were submitted for microscopic evaluation including multiple sections from both lobes and the isthmus, as well as multiple lymph nodes embedded across several blocks. A separate specimen from the left neck contained fibroadipose tissue measuring 5.1 x 3.5 x 2.1 cm with lymph nodes ranging from 0.4 to 1.2 cm in diameter. Also included was a piece of skeletal muscle measuring 4.9 x 1.4 x 0.6 cm that appeared normal.\n\nMicroscopic evaluation revealed two distinct lesions. The larger lesion in the left lobe was encapsulated but showed widespread invasion. It measured 6.5 cm in greatest dimension with additional dimensions of 3.4 x 2.6 cm. There was no extrathyroidal extension or vascular invasion observed. Surgical margins were free of abnormal cells.\n\nA second smaller lesion was identified in the right lobe measuring 0.4 cm in each dimension. This lesion was unencapsulated and demonstrated local infiltration. No vascular invasion or extrathyroidal extension was present, and surgical margins remained unaffected.\n\nA total of 20 lymph nodes were evaluated: 15 from the central compartment and superior mediastinum, and 5 from the left neck dissection. One lymph node from the left neck dissection contained abnormal cellular infiltration.\n\nPathologic staging based on AJCC/UICC TNM classification (6th Edition) indicated pT3 based on tumor size greater than 4 cm confined to the thyroid gland. Regional lymph node involvement was classified as pN1a due to metastatic involvement in level VI lymph nodes. Distant metastasis could not be assessed (pMX). No additional pathological findings were identified."} +{"pid": "TCGA-YS-A95B", "report": "The specimen consists of a pleural biopsy. Microscopic evaluation reveals a malignant neoplasm composed of epithelioid cells. The tumor cells are arranged in sheets and glandular structures, with moderate nuclear atypia and frequent mitotic figures. Immunohistochemical staining demonstrates positivity for calretinin and cytokeratin 5/6, while being negative for markers typically expressed in adenocarcinomas. No lymph node involvement was identified. The tumor is confined to the pleura without evidence of distant spread."} +{"pid": "TCGA-AX-A1CI", "report": "The surgical specimen included an intact uterus and cervix with bilaterally attached adnexa, weighing 470 grams. The uterus measured 13 x 10 x 10 cm. The right fallopian tube was previously ligated and measured 2.5 x 1 x 1 cm, with an attached ovary measuring 2 x 1 x 1 cm. The left fallopian tube was also previously ligated and measured 2.5 x 0.5 x 0.5 cm. On sectioning, the ovaries showed solid pink-tan parenchyma without gross abnormalities.\n\nMicroscopic evaluation revealed a lesion with well-differentiated features, showing superficial invasion and minimal myometrial involvement. The depth of myometrial invasion was 2.2 mm out of a total myometrial thickness of 14.3 mm. There was no evidence of lymphovascular invasion. The tumor exhibited less than 5% non-squamous solid growth component. No involvement was identified in the lower uterine segment.\n\nA total of 19 lymph nodes were evaluated: five from the left pelvic region (all negative), two from the left periaortic area (all negative), eight from the right pelvic region (all negative), and three from the right para-aortic region (all negative). One lymph node in the right para-aortic group could not be fully assessed.\n\nThe maximum tumor dimension was 12 cm. Additional findings included mild chronic cervicitis. Bilateral ovaries and fallopian tubes were unremarkable and consistent with the patient\u2019s age."} +{"pid": "TCGA-21-1076", "report": "The specimen was received in nine parts. \n\n1. A fragment of the 5th rib measured 1.5 \u00d7 1.0 \u00d7 0.9 cm. No lesions or masses were identified. The tissue was submitted entirely after decalcification. Microscopically, the rib appeared unremarkable with hypercellular marrow. \n\n2. A fragment of the 6th rib measured 1.5 \u00d7 0.8 \u00d7 0.7 cm. No lesions or masses were found. The tissue was submitted entirely and microscopically showed no abnormalities, with hypercellular marrow. \n\n3. A fragment of the 7th rib measured 1.5 \u00d7 0.9 \u00d7 0.8 cm. No suspicious lesions or masses were observed. It was submitted entirely and showed similar findings to the other ribs, including hypercellular marrow. \n\n4. A fragment of the left 8th rib measured 2 \u00d7 0.7 \u00d7 0.7 cm. No suspicious lesions or masses were present. The tissue was submitted entirely and demonstrated comparable microscopic characteristics, including hypercellular marrow. \n\n5. Two lymph nodes from level 9 measured 0.5 cm and 1.0 cm respectively. Both were submitted entirely and found to be negative for metastatic disease. \n\n6. One lymph node from level 11 measured 1.1 \u00d7 1.0 \u00d7 0.9 cm. Frozen section evaluation showed no evidence of metastatic disease. The entire specimen was submitted for further evaluation. \n\n7. One lymph node from level 5 measured 0.6 \u00d7 0.4 \u00d7 0.4 cm. It was submitted entirely and found to be free of metastatic involvement. \n\n8. Three lymph nodes from level 10 measured 0.5 cm, 0.6 cm, and 0.9 cm respectively. All were submitted and found to be negative for metastatic disease. \n\n9. The lung specimen weighed 481 grams and measured 24 \u00d7 13 \u00d7 6.5 cm overall. The lower lobe measured 14 \u00d7 10 \u00d7 6 cm and the upper lobe approximately 15 \u00d7 10 \u00d7 6 cm. A mass measuring 8 \u00d7 8 \u00d7 6 cm was identified in the left lower lobe. The mass was tan and approximately 80% necrotic. It was adhered to the upper lobe and costal soft tissue, with a dimension of 10.5 \u00d7 9 \u00d7 1.4 cm. The tumor approached within 1.4 cm of the bronchial margin but did not invade it. Vascular margins were also unremarkable. Multiple lymph nodes up to 2 cm in size were noted, some of which were tan and firm. Sixteen peribronchial lymph nodes were negative for metastatic disease. Sections of adjacent lung tissue, pleura, and costal resection were also free of tumor. The lower lobe was predominantly pink and spongy while the upper lobe was red and dense. Emphysematous changes and chronic inflammation with fibrous adhesions to the chest wall were noted. \n\nStaging was determined as pT2N0Mx."} +{"pid": "TCGA-BH-A42V", "report": "The specimen consists of a left breast segmental mastectomy at the 4 o\u2019clock position. A focus of invasive cellular proliferation measuring 15 mm in greatest dimension is identified, associated with microcalcifications. Histologic evaluation demonstrates moderate tubule formation, nuclear grade 2, and mild mitotic activity. No lymphovascular invasion is observed. Adjacent ductal structures show in situ changes characterized by cribriform architecture, nuclear grade 2, and comedo-type necrosis. These in situ changes are present within 3% of the invasive lesion and also extend into surrounding breast tissue.\n\nMargins are largely negative; however, the invasive component approaches the posterior margin at 3 mm, while the in situ component extends very closely to the superior margin at 0.2 mm. Additional benign findings include atypical ductal hyperplasia, peripheral papillomas, ductal epithelial hyperplasia, and columnar cell change.\n\nSentinel lymph node biopsies were performed. One sentinel lymph node contains a metastatic deposit measuring 1 mm in greatest dimension without evidence of extracapsular extension. Two additional sentinel lymph nodes show no evidence of metastasis. The metastasis was identified using hematoxylin and eosin staining. Non-neoplastic breast tissue shows fibrocystic disease.\n\nPathologic staging is pTic for the primary lesion and pN1mi for nodal involvement. Hormone receptor studies demonstrate positivity for estrogen and progesterone receptors. HER2/Neu immunostaining demonstrates a score of 1+."} +{"pid": "TCGA-34-2605", "report": "The clinical history is notable for a lesion in the right upper lobe. A procedure involving bronchoscopy and right thoracotomy was performed.\n\nHistologic evaluation of portions of the 5th and 6th ribs showed no abnormal findings in bone or bone marrow. Fluorescence in-situ hybridization (FISH) studies were conducted. Analysis revealed a ratio of the gene of interest to the centromere of chromosome 7 of 1.02, indicating no amplification. The rate of hyperploidy for the centromere of chromosome 7 was observed in 48.0% of analyzed cells. The signal to nucleus ratio (SNR) for the gene was 2.3. According to established FISH interpretation guidelines, a ratio less than 2.0 indicates no amplification, while a ratio greater than 2.0 suggests amplification. Hyperploidy is defined as greater than two centromere copies per cell. SNR reflects the average number of gene signals per cell in the targeted region.\n\nIn the right upper lobe, two distinct lesions were identified measuring 4.5 cm and 2.7 cm in diameter. Both demonstrated moderately differentiated features with evidence of involvement of the visceral pleura and angiolymphatic invasion. There was mild associated inflammatory response. Metastatic involvement was identified in one of twelve N1 lymph nodes examined. Surgical margins were free of tumor. Pathologic staging was determined as T4N1Mx.\n\nExamination of submitted lymph node tissue from right level 4 showed benign findings without evidence of tumor. Bone specimens from the 5th and 6th ribs were unremarkable following decalcification. A biopsy of the diaphragm revealed fibrous tissue with chronic inflammation and no signs of neoplasia.\n\nGross examination of the resected right upper lung lobe revealed two distinct tumor masses. The larger measured 4.5 x 4.0 x 3.5 cm with central necrosis and cavitation. It was located near the hilum, approaching the main bronchus but not invading vascular structures. The second lesion measured 2.7 x 2.5 x 2.5 cm and was situated 1.5 cm distal to the first, extending to the pleural surface and causing pleural puckering. No other gross abnormalities were noted. Frozen sections were obtained from various regions including margins, lymph nodes, and surrounding lung tissue.\n\nMicroscopic findings confirmed invasive features with moderately differentiated morphology. The largest tumor showed extensive necrosis (>50%). No microscopic satellite lesions were identified. Invasion of the visceral pleura and lymphovascular spaces was present. Inflammatory reaction was minimal. Of the twelve N1 lymph nodes examined, one contained metastatic involvement. No extracapsular extension was seen. Four N2 lymph nodes were negative for tumor. Background changes included emphysema, small airway inflammation, and obstructive pneumonia.\n\nAncillary studies including histochemical stains and FISH analysis supported the findings. Stains for mucin and glycogen were negative. Intraoperative frozen section analysis of lymph nodes, diaphragmatic biopsy, and surgical margins confirmed absence of tumor in those areas, while the tumor specimen confirmed malignant features consistent with non-small cell morphology."} +{"pid": "TCGA-56-A4ZJ", "report": "The specimen consists of four parts. Part 1, labeled as level 9 lymph node from the right lung, measures 1.1 x 0.8 x 0.3 cm and is described as an irregular black soft tissue consistent with a probable lymph node. It was bisected and submitted entirely in one cassette. Part 2, labeled as level 10 lymph nodes from the right lung, includes three similar tissues ranging in size from 0.5 x 0.4 x 0.2 cm to 1.1 x 0.7 x 0.3 cm, also submitted entirely in one cassette. \n\nPart 3 is a right lower lung lobe weighing 185 grams and measuring 19.4 x 10.5 x 3.2 cm, with a 0.8 cm bronchial segment attached. The pleural surface appears smooth to wrinkled, tan-pink to gray-purple with black anthracotic areas. A 3.1 cm linear staple line is noted near the hilum. There is an umbilicated area on the pleura measuring 1.4 x 1.1 cm located 2.2 cm from the hilum. This corresponds to a 1.8 x 1.5 x 1.2 cm tan nodule beneath the pleura, situated 3.4 cm from the bronchial margin and 3.8 cm from the staple line. The remaining lung tissue shows spongy tan-red parenchyma with two small tan-white nodules (0.1 cm and 0.2 cm) near the periphery, 3.6 cm apart. No other lesions or lymph nodes are identified. Sections were taken from bronchial and vascular margins, pleural margin, the main lesion, and both smaller nodules. \n\nPart 4, labeled as level 4 lymph node from the right lung, includes fibroadipose tissue containing three black firm structures consistent with probable lymph nodes measuring up to 1.2 x 0.8 x 0.5 cm. Representative sections were submitted, including all lymph nodes in their entirety. \n\nMicroscopic evaluation of the lymph nodes from levels 9 and 10 showed reactive hyperplasia without evidence of malignancy. The primary lesion in the right lower lobe showed moderately differentiated cells arranged in a non-keratinizing pattern. The tumor measured 1.8 x 1.5 x 1.2 cm and was located 0.1 cm from the pleural surface. No invasion of lymphovascular spaces or visceral pleura was observed. Treatment effect could not be assessed due to lack of clinical history. Margins were clear, with the tumor 3.4 cm from the bronchial margin and 3.8 cm from the stapled margin. \n\nA total of 10 lymph nodes were evaluated across all parts, none of which contained metastatic disease. Two small subpleural fibrous nodules were noted, consistent with scarring. Staging was determined as pT1a, N0. \n\nAdditional findings include no prior material for comparison and concurrence by an additional pathologist after review. The two small subpleural nodules were interpreted as possible sequelae of resolved pneumonia."} +{"pid": "TCGA-SR-A6MT", "report": "The specimen consists of a left adrenal gland with an associated mass. The adrenal gland is enlarged, measuring 7 x 2.5 x 2 cm and weighing 41 grams. A well-encapsulated mass measuring 2.2 x 2 x 2 cm is present; it has a gray-brown, homogeneous, fleshy appearance with an intact capsule. The surrounding adrenal cortex shows signs of hypertrophy and appears bright yellow, while little medullary tissue is identified. The tumor was entirely submitted for analysis, with portions used for frozen section and permanent sections.\n\nMicroscopic evaluation reveals mild nuclear atypia and low mitotic activity (<5/50 high power field). No necrosis, blood vessel invasion, or lymphatic vessel invasion is identified. Immunostaining for MIB-1 demonstrates less than 5% nuclear positivity. The primary tumor stage is classified as pT1, with no regional lymph nodes or distant metastases assessable (pNX, pMX). Margins of resection are free of involvement. No lymph nodes were identified in the specimen."} +{"pid": "TCGA-HC-8213", "report": "The prostate specimen measures 4.5 x 4.5 x 3.1 cm and weighs 48 grams. The external surface is gray to brown tan with adhesions noted. Serial sectioning from apex to base reveals a yellow-gray, tan fibrous, and nodular cut surface. No well-defined mass is identified grossly. The bilateral seminal vesicles measure on average 4.5 cm in length and 0.7 cm in diameter, and the vas deferens measures 4.5 cm in length and 0.5 cm in diameter; all appear unremarkable upon gross examination. The right half of the prostate is inked blue and the left half black.\n\nHistologic evaluation includes perpendicular sections taken from the margins at the apex, base, and multiple levels throughout the gland. Sections include representative tissue from right and left anterior and posterior regions at each level, as well as from the seminal vesicles and vas deferens. Neoplasm accounts for less than 2% of the prostatic tissue examined. Histologic patterns demonstrate primary and secondary grades of 3/5. All surgical margins are free of neoplastic involvement. There is no evidence of extraprostatic extension, seminal vesicle involvement, or lymphovascular space invasion. High-grade PIN is not present. Lymph node assessment is not applicable. The pTNM classification is pT2c NX MX."} +{"pid": "TCGA-A2-A4RY", "report": "The surgical specimen included tissues from a right modified radical mastectomy and left mastectomy, along with lymph node sampling. The right axillary lymph nodes (level 2) consisted of yellow fatty tissue measuring 3.7 x 2.2 x 0.7 cm with four firm ovoid structures ranging from 0.4 to 1 cm. All four nodes showed gross involvement, with one-half of each submitted for analysis along with smaller unsectioned nodes. Additional level 3 lymph nodes were identified in a 6 x 1.5 x 0.7 cm tissue fragment, containing five nodules up to 1.4 cm, all showing gross positivity and submitted partially sectioned.\n\nThe left mastectomy specimen weighed 1310 grams and measured 23 cm medially to laterally, 23.5 cm superior to inferior, and up to 5.5 cm anterior to posterior. It included a 14 x 5 cm skin ellipse with an unremarkable nipple. Central portions revealed dense tan fibrous tissue surrounded by yellow fatty tissue. No masses were found; representative sections from multiple quadrants and margins were submitted.\n\nThe right modified radical mastectomy weighed 1460 grams and measured 24.5 cm medially to laterally, 26 cm superior to inferior, and up to 6.5 cm anterior to posterior. The axillary portion measured 10 x 9 x 2.5 cm. Gross examination revealed a central area of dense tan fibrous tissue extending into an ill-defined gray-tan region measuring 5.5 x 8 x 4.5 cm. This region was within 1 cm of both the anterior and deep margins. Multiple sections were taken from the lesion and surrounding areas, including random samples from quadrants distant from the lesion.\n\nIn the axillary tail, three prominent lymphoid structures were identified: one measuring 0.8 cm, another 2.5 cm, and a third 3.8 cm, all of which were sectioned and submitted for analysis. Eighteen additional lymphoid structures were identified and submitted either whole or bisected. Several sections were also submitted for research protocols, including mirror image sections and frozen OCT samples.\n\nMicroscopic evaluation of the sampled lymph nodes showed extensive involvement with cellular atypia and architectural distortion. Involvement was noted in multiple nodes with significant replacement of normal architecture. The largest focus spanned approximately 20 mm. Focal soft tissue invasion adjacent to involved nodes was also observed. Sections from the primary site demonstrated pleomorphic cellular morphology with moderate nuclear atypia and low mitotic activity. A continuous growth pattern was identified spanning at least 78 mm in a superior to inferior direction. The closest margin was 8 mm from the tumor. Multiple other lymph nodes showed similar findings."} +{"pid": "TCGA-DX-A7EO", "report": "The submitted specimen consists of an elliptical piece of skin and underlying soft tissue from the left flank, measuring 12.0 x 1.5 cm, with a maximum depth of 13.2 cm, including 6.2 cm of subcutaneous adipose tissue and 7.0 cm of skeletal muscle. A well-defined, fleshy, tan-white mass measuring 7.1 x 6.5 x 4.8 cm is identified within the muscle. The mass is located 1.6 cm from the deep surgical margin, 0.2 cm from the inferior margin, 2.0 cm from the superior margin, 2.5 cm from the posterior margin, 3.5 cm from the anterior margin, and 3.0 cm from the skin surface. The overlying skin appears unremarkable on gross examination.\n\nHistologic evaluation reveals a biphasic cellular proliferation involving both soft tissue and skeletal muscle. The lesion demonstrates areas of focal sclerosis and fibrosis, but no necrosis is identified. All surgical margins are free of tumor involvement. Immunohistochemical staining shows reactivity for AE1:AE3 and CAM5.2 predominantly in the epithelial component, with very focal positivity in spindle cells. Epithelial membrane antigen (EMA) staining is mainly present in epithelial cells, with limited expression in some spindle cells. Additional immunostains for Ki67, BCL2, CD34, and vimentin were performed, along with negative controls. Molecular analysis for the SYT-SSX fusion transcript is pending. Cellular morphology and immunophenotype are consistent with previously described features of a specific neoplastic entity."} +{"pid": "TCGA-55-7573", "report": "The lung specimen from the right upper lobe measures 16.0 x 8.5 x 2.8 cm. A well-circumscribed mass is identified, measuring 2.5 x 1.5 x 1.5 cm, with a yellow-tan and firm glistening appearance. The mass is located 0.4 cm beneath the pleural surface and comes within less than 0.1 cm of the stapled parenchymal margin. The remainder of the lung tissue appears pink-tan with focal congestion. No additional lesions are observed.\n\nHistologically, the tumor is moderately differentiated and located subpleurally. It is unifocal and does not show visceral invasion or lymphovascular space invasion. The tumor measures 2.5 x 1.5 x 1.5 cm. Margins were assessed: the distance from the bronchial margin is greater than 1 cm, the distance from the stapled parenchymal margin is less than 0.1 cm, and the distance from the pleural surface is 0.4 cm. Seven lymph nodes were examined, none of which contain metastatic disease. One lymph node from level 9 was also negative.\n\nImmunohistochemical staining showed positivity for CK7 and TTF1, and negativity for CK20 and RCC. These findings support the origin of the tumor as primary to the lung rather than a metastasis from prior reported renal cell carcinoma. The stapling procedure limited full assessment of the true surgical margin; however, the closest inked margin is involved.\n\nSeven small anthracotic lymph nodes were identified in the specimen, ranging from 0.1 to 0.3 cm. All were negative for malignancy. Sections submitted included margins, tumor tissue, and surrounding lung parenchyma. Clinical correlation is recommended due to the proximity of the tumor to the surgical margin."} +{"pid": "TCGA-2Z-A9JT", "report": "A right partial nephrectomy specimen was received, consisting of an encapsulated nodule measuring 2.9 x 2.8 x 2.2 cm. The tumor was unifocal and confined entirely within the kidney, with no extension beyond the renal capsule. Histologic examination revealed a papillary growth pattern with nuclear features classified as Fuhrman grade 3, characterized by very irregular nuclei approximately 20 microns in size and large, prominent nucleoli. Approximately 10% tumor necrosis was identified. There was no evidence of sarcomatoid differentiation, perineural invasion, or angiolymphatic invasion. Surgical margins were free of malignant cells. A separate specimen from the deep margin of the right kidney showed only benign renal parenchyma. Another specimen from the right cystic wall contained benign adipose tissue. Based on these findings, the pathologic stage was determined as pT1a, with regional lymph nodes and distant metastasis unable to be assessed."} +{"pid": "TCGA-W5-AA2H", "report": "Female. Surgery Date: Specimens from lymph nodes of the common hepatic artery and mesenteric regions were biopsied and found to be negative for tumor. The common hepatic duct margin and pancreatic neck margin, both excised during surgery, were also negative for tumor involvement. A resection specimen including the head of the pancreas, duodenum, portion of jejunum, and gallbladder revealed a solid mass measuring 4.3 x 3.1 x 0.8 cm located in the distal common bile duct. This mass was noted to extend into the pancreas. Histological examination showed moderately to poorly differentiated cellular features. Perineural invasion was identified, while angiolymphatic invasion was not present. All surgical margins, including after re-excision of the uncinate margin, were free of tumor with a minimum tumor-free margin of 1.0 cm at the uncinate margin. Twenty-two regional lymph nodes were examined and found to be negative for metastatic involvement. The gallbladder was also negative for tumor. An additional specimen from the new uncinate margin, including three lymph nodes, showed no evidence of tumor, and the margin itself was negative."} +{"pid": "TCGA-52-7622", "report": "A pale tan tissue fragment measuring 0.3 x 0.2 x 0.2 cm from an endobronchial mass showed a few distorted atypical cells, although diagnostic material was limited. Several small tan tissue fragments from the bronchial mucosa of the right lower lobe superior segment showed no abnormal cells. Two bone fragments from the 6th rib were processed for histological evaluation and showed no evidence of abnormal cells. Lymph nodes from stations 7, 8, 9, and 11 were all free of atypical cells, with three lymph nodes evaluated in station 7 and one each in stations 8, 9, and 11. A red-brown soft tissue fragment from an intrabronchial site showed detached cell clusters admixed with blood.\n\nA lung segment from the right lower lobe measured 11 x 3 x 2.5 cm and contained a well-defined white, focally hemorrhagic nodule measuring 2.0 cm in maximum dimension, with approximately 25% necrosis. The nodule was located near the bronchus, approximately 0.4 cm from the bronchial resection margin. Microscopic evaluation showed moderately differentiated cellular features without involvement of the pleura or vascular structures. The bronchial resection margin and other tissue margins were uninvolved. No lymphovascular invasion was identified. Pathologic staging was determined as pT1a, NO, MX."} +{"pid": "TCGA-23-1028", "report": "The surgical pathology report includes multiple specimens. The omentum is partially replaced by an infiltrating process, with the largest mass measuring 13.0 x 5.5 x 2.0 cm. A left adnexal specimen consists of an ovary measuring 9.5 cm in maximum dimension that is extensively involved by a solid and cystic mass, with involvement of the fallopian tube extending into the serosa, subserosa, muscular wall, and mucosa. Lymphovascular invasion is noted. A right adnexal specimen contains an ovary measuring 7.2 cm in maximum dimension that is similarly replaced by tumor, involving the fallopian tube at the serosal surface, subserosa, and mucosa. Involvement of paraovarian and paratubal tissues is observed on both sides.\n\nA specimen from the rectosigmoid region shows infiltration by disease within fibroadipose tissue. The uterus demonstrates involvement of the cervix, lower uterine segment, and corpus with tumor extending to the serosa and subserosa. No carcinoma is identified at surgical margins. Lymphovascular invasion is present. A mesenteric biopsy reveals infiltration by tumor cells. A rectal specimen lacks identifiable intestinal tissue but contains infiltrating cells. Soft tissue specimens from the right pelvis, cul-de-sac peritoneum, right sidewall, right hemidiaphragm, left peritoneum, and right diaphragmatic region all demonstrate infiltration by tumor cells.\n\nLymph node assessment includes two left pelvic lymph nodes without evidence of metastasis. One of two right obturator lymph nodes is positive for tumor involvement. Other lymph nodes are not specifically detailed. The appendix demonstrates reactive inflammatory changes but no tumor infiltration. The endometrium shows proliferative features and focal adenomyosis. The cervix exhibits benign changes including squamous metaplasia and nabothian cysts. Multiple sites show secondary inflammatory responses and necrosis. Adhesions and reactive mesothelial changes are noted at several locations. Tumor-associated necrosis is observed in bilateral ovaries and multiple metastatic sites."} +{"pid": "TCGA-A8-A06P", "report": "The ablated material from the right breast contains two distinct foci of invasive carcinoma. The larger focus measures 1.1 cm, while the smaller focus measures 0.8 cm, as determined from the histological preparation. There is complete resection of the affected tissue with clear margins extending into surrounding healthy tissue, including a minimum caudal margin of 0.5 cm. Pathologic staging indicates involvement of regional lymph nodes with 7 out of 25 nodes positive. Vascular and lymphatic invasion are not identified. The histologic grade is intermediate."} +{"pid": "TCGA-19-1386", "report": "The specimen from the left temporal region consists of multiple tissue fragments. The largest fragment measures 1.7 x 0.8 x 0.7 cm, with other smaller pieces ranging down to flecks. Tissue was submitted in four parts. Part A consisted of a 0.4 x 0.4 x 0.3 cm piece of pink-tan soft tissue. Part B was a 0.6 x 0.5 x 0.3 cm fragment of tan-white brain tissue. Part C included multiple tan-red fragments totaling 1.3 x 1.2 x 0.5 cm in aggregate. All specimens were processed and submitted entirely in cassettes.\n\nMicroscopic evaluation revealed infiltrating cells within the brain tissue. Areas of necrosis and microvascular proliferation were identified. The tumor cells showed positivity for GFAP immunostain. SMI31 and synaptophysin immunostains were also used in the assessment. Scattered positive cells were noted on KI-67 immunostaining. EGFR immunostain demonstrated strong and diffuse positivity in the tumor cells. FISH studies performed for chromosome 1p and 19q showed intact status for both. EGFR analysis demonstrated amplification.\n\nThe tissue samples were evaluated using assays developed by the Department of Pathology, with appropriate positive and negative controls. Some reagents used in testing may have contained components classified as analyte-specific reagents (ASRs), which are not FDA-cleared or approved. An outside review was requested and confirmed findings consistent with high-grade glioma. Additional material was later received and incorporated into the final assessment."} +{"pid": "TCGA-WB-A816", "report": "The left adrenal specimen consisted of two fragments. The largest fragment measured 4 x 2.7 x 2 cm and exhibited a finely encapsulated appearance. The second fragment measured 4 x 1 x 0.5 cm. Histologically, the tumor demonstrated a finely encapsulated proliferation composed of two cellular components. One population consisted of large polygonal cells with abundant basophilic cytoplasm and nuclei with fine nucleoli, arranged in a honeycomb or nested pattern. The other component was characterized by smaller cells with more basophilic nuclei, forming a prominent vascular network within the lesion. No vascular or capsular invasion was identified. Mitotic activity was rare, and no areas of necrosis were observed. Mature adipose tissue, consistent with brown fat, was present in the surrounding periadrenal fat."} +{"pid": "TCGA-EY-A1GD", "report": "The surgical pathology report includes multiple specimens. Specimen A consists of right periaortic lymph node removal, with no tumor identified in three lymph nodes examined. Specimen B includes a uterus with cervix, bilateral ovaries, and fallopian tubes. The endometrium shows no evidence of tumor extension beyond the endometrial lining, with focal involvement of underlying superficial adenomyosis. There is no identifiable myometrial invasion, serosal involvement, or cervical extension. All margins are negative. No lymphovascular space invasion is seen. Twenty-three regional lymph nodes were examined, with none showing evidence of involvement. Additional findings include adenomyosis, a leiomyoma with hyalinization, and non-neoplastic secretory endometrium. Immunohistochemical staining for hormone receptors is pending.\n\nSpecimen C includes left pelvic lymph nodes (nine in total), all without evidence of tumor. One lymph node (C10) shows a bland smooth muscle proliferation consistent with localized leiomyomatosis and benign serous inclusion. Specimen D includes right pelvic lymph nodes (eleven in total), none of which show evidence of tumor. The uterus measures 12.5 cm in height, with an endometrial cavity length of 5.6 cm. The cervix has an endocervical canal length of 4.9 cm. A tan-white whorled mass measuring 5 x 4 x 5.5 cm is present, consistent with a leiomyoma. No tumor is identified in either ovary or fallopian tube. Right and left ovaries measure 6 x 3 x 2 cm and 3.6 x 3 x 1 cm respectively, with no neoplastic findings. Both fallopian tubes appear normal. Lymph node aggregates from left and right pelvic regions measure 4.4 x 3 x 2 cm and 8 x 5 x 1.4 cm respectively, with no tumor identified. Immunostaining confirms the presence of leiomyomatosis in one left pelvic lymph node, raising consideration for further clinical evaluation, particularly for potential pulmonary involvement. The case is staged as pT1a pNO pMx by AJCC criteria and FIGO Stage IA based on current findings."} +{"pid": "TCGA-D7-6525", "report": "Histopathological examination was performed on a total organ resection specimen of the oesophagus. The specimen measured 10.2 cm in length, and upon opening, a region measuring 9.5 x 9.8 cm was identified in the cardiac area. A lesion measuring 4.6 x 4.3 x 0.9 cm was observed in this region. The distance from the proximal cut end to the lesion was 10.9 cm, and from the distal cut end, it was 4.4 cm. Proximal to the lesion, the oesophageal mucosa appeared discoloured and smooth over a length of 1.5 cm.\n\nMicroscopic evaluation revealed tubular and partially mucocellular epithelial cells with high-grade atypia. There was infiltration into the periventricular adipose tissue and the oesophageal wall. The margin near the excision line was indistinct in certain areas, while other margins were free of abnormal cells. Areas of gastric metaplasia with dysplastic changes were noted in the oesophageal wall, which may have contributed to the development of the lesion.\n\nExamination of the stomach wall showed chronic non-active gastritis. Lymph node analysis identified abnormal cellular spread within the perinodal tissue and involvement in certain lymph nodes (No VI/IX). Cellular invasion was also present in the surrounding nodal connective tissue. Pathological staging indicated local extension to the submucosal layer and regional lymph node involvement. High-grade features were identified, with tumour depth classified as pT2 and lymph node involvement as pN2."} +{"pid": "TCGA-4V-A9QM", "report": "The specimen from a thymectomy weighs 355 grams and measures 11 x 9 x 5 cm, with a nodular lesion measuring 10 x 8 x 4 cm. The cut surface is described as fleshy, beige, homogeneous, and lobulated. Microscopic evaluation of the mediastinal mass reveals a neoplasm composed of spindle cells arranged in small, short fascicles. A second population of small lymphocytes is present, intermingled with the epithelial component. The architecture includes fibrous septa with rearrangements containing foamy histiocytes. No clear perivascular spaces or medullary differentiation is observed. Immunohistochemical staining shows that the epithelial cells are positive for cytokeratin AE1/AE3, cytokeratin KL1, and cytokeratin 5/6, but negative for cytokeratin 7 and CD20. The spindle cells and pseudo-fibroblasts stain positive for EMA. Lymphocytic markers CD3 and CD1A are also expressed. A separate finding includes a pleural fragment showing vascular connective tissue. The tumor measures 10 cm along its longest axis and shows no signs of capsular invasion. The surgical resection is complete, and the staging is classified as stage I."} +{"pid": "TCGA-F4-6569", "report": "The submitted specimen is from a hemicolectomy procedure. The tumor measured 6.5 x 4.5 x 4 cm and was located in the colon. Microscopic examination revealed well-differentiated cellular features. The tumor extended to the muscularis propria layer. No information was provided regarding lymph node involvement, surgical margins, or evidence of neoadjuvant treatment. No additional findings were noted."} +{"pid": "TCGA-HU-A4H5", "report": "Stomach, total gastrectomy specimen shows a lesion located in the upper third, centered at the fundus and posterior wall. The gross appearance is classified as Borrmann type 1 (fungating). Histologically, the lesion demonstrates papillary architecture with features consistent with intestinal-type morphology based on Lauren classification. The growth pattern is a mixture of expanding and infiltrative.\n\nThe lesion measures 6.5 x 5.0 cm and invades into the proper muscle layer (pT2). All resection margins, including the anvil ring, are free of tumor involvement. The distal margin measures 21.0 cm and the proximal margin measures 4.5 cm from the lesion.\n\nA total of 73 regional lymph nodes were examined, including 32 from the lesser curvature, 37 from the greater curvature, and 4 from other locations; none show evidence of metastasis (pN0). No lymphatic, venous, or perineural invasion is identified. There is moderate peritumoral lymphocytic infiltration. No tumor is identified in the jejunum. Immunohistochemical staining was performed using markers including CD10, MUC2, MUC5AC, MUC6, and C-erb B2."} +{"pid": "TCGA-BH-A0BD", "report": "The surgical specimen includes a sentinel lymph node from the left axilla. The lymph node contains a metastatic focus measuring 0.8 cm in maximum dimension. There is no evidence of extranodal extension.\n\nThe breast specimen shows an invasive tumor with a Nottingham grade summing to 8 out of 9, composed of features including poor tubule formation, high nuclear grade, and moderate mitotic activity. The invasive component is multifocal, with individual foci ranging from 0.2 cm to 1.6 cm in size. In addition, there is ductal carcinoma in situ, nuclear grade 2, solid type with comedo necrosis, present both admixed with and separate from the invasive component, comprising approximately 30% of the total tumor volume. Lymphovascular invasion is present. All resection margins are free of tumor involvement.\n\nImmunohistochemical staining demonstrates positivity for estrogen and progesterone receptors, while HER-2/neu staining is scored as 1+. Additional findings include fibrocystic change, columnar cell alteration, adenosis, and fibrosis. Changes related to prior biopsy are also noted."} +{"pid": "TCGA-22-5472", "report": "The lung specimen from the right lower lobe shows a subpleural mass measuring 3.8 x 3.0 x 1.8 cm. The lesion is composed of high-grade atypical cells arranged in solid sheets and nests with focal infiltration into surrounding tissues. There is significant nuclear atypia, frequent mitotic figures, and areas of central necrosis. The mass extends to the visceral pleura but does not show definitive invasion beyond that layer. Surgical margins are free of abnormal cellular proliferation.\n\nHistological examination of the surrounding lung parenchyma reveals fibrotic changes involving the septal and subpleural regions, with focal honeycomb lung morphology and areas of organizing pneumonia. A separate wedge biopsy from the right middle lobe demonstrates subpleural fibrosis with focal osseous metaplasia.\n\nLymph node evaluation includes multiple (4) right lower paratracheal (station 4R), multiple (3) subcarinal (station 7), and multiple (8) hilar/intrapulmonary lymph nodes, all of which show no evidence of neoplastic involvement."} +{"pid": "TCGA-06-5415", "report": "The specimen consists of a few tan-white fragments measuring in aggregate 21 x 16 x 3 mm. Histologic examination reveals small fragments of a highly cellular lesion with mitotic figures and microvascular proliferation. There are also larger fragments demonstrating extensive necrosis. The blood vessels show focal hyalinization and reactive changes. Prominent phagocytic activity is noted throughout the viable portions of the tissue. The morphologic findings indicate a high-grade lesion with both viable and necrotic components. Necrosis and vascular changes are present, which may be associated with prior radiation injury."} +{"pid": "TCGA-5P-A9JZ", "report": "The specimen shows a single lesion measuring 4.2 cm in diameter located within the kidney. Histological evaluation reveals papillary architecture with neoplastic cells arranged in fronds. The tumor does not exhibit significant lymph node involvement and demonstrates minimal extension to the surgical margin, with a distance of 0.6 cm from the resection edge. Evaluation of the peri-renal fat layer shows no evidence of tumor involvement. Based on the pTNM classification (version 2002), the tumor is classified as pT1b with negative resection margins (RO). The nuclear grade is moderately differentiated (GII). All findings are based on standard diagnostic criteria."} +{"pid": "TCGA-IQ-A61L", "report": "A right neck dissection was performed involving levels IA, IB, IIA, III, and IV. A total of 30 lymph nodes were identified and examined in these levels, with no evidence of malignant involvement. An additional dissection at level IIB yielded 12 lymph nodes, all also negative for malignancy.\n\nA composite resection specimen including partial glossectomy and tonsillectomy was evaluated. The lesion measured 3.8 cm in greatest dimension and extended to a depth of 15 mm. It was described as endophytic and ulcerated. Histologic evaluation revealed a conventional keratinizing morphology with well-differentiated features. There was focal necrosis with abscess formation noted. The tumor was located at the lateral border of the tongue and demonstrated a single focus.\n\nAssessment of surgical margins showed that the posterior margin was focally involved by tumor. The medial margin was uninvolved, with the closest distance from tumor to this margin measuring 7 mm. Other margins, including anterior and inferior, were free of tumor involvement. No lymphovascular or perineural invasion was identified.\n\nAdditional specimens from deeper posterior aspects of the right tongue and floor of mouth were submitted for evaluation. One specimen showed chronic inflammation and marked keratosis without evidence of carcinoma. All other submitted margins from various sites\u2014including dorsal tongue, deep tongue, and floor of mouth\u2014were negative for tumor involvement on frozen section analysis.\n\nThe overall pathologic staging was determined as pT2 based on tumor size greater than 2 cm but not exceeding 4 cm. No regional lymph node metastasis was identified (pN0), with a total of 42 lymph nodes examined across all levels. Distant metastasis could not be assessed (pMx). Peritumoral lymphocytic infiltrate was noted as an additional finding.\n\nNo definitive treatment effect was identifiable. Clinical history and preoperative diagnosis were not provided. The surgical procedure included right hemiglossectomy, right neck dissection, tracheotomy, and direct laryngoscopy."} +{"pid": "TCGA-D1-A175", "report": "The specimen consisted of a uterus with bilateral ovaries and fallopian tubes. A mass measuring 6.0 x 3.7 x 1.8 cm was identified in the anterior uterine wall. Histologic evaluation revealed cellular features consistent with high-grade changes within the endometrial cavity, arising in a background of atypical complex hyperplasia. The lesion extended into the myometrium, with invasion measuring 1.8 cm in a total myometrial thickness of 2.1 cm. There was no involvement of the endocervix; however, focal squamous cell changes were noted in the cervix, characterized by full thickness p63 and MIB-1 staining patterns on immunohistochemistry. These findings were interpreted as carcinoma in situ arising in association with squamous metaplasia.\n\nExamination of the cervix showed squamous metaplasia without evidence of invasive disease. Both ovaries and fallopian tubes showed no abnormal histologic findings. The left ovary contained a corpus luteum cyst. No abnormalities were found in the right ovary or bilateral fallopian tubes.\n\nLymph node dissections included multiple left pelvic lymph nodes (1 external iliac, 2 internal iliac, 1 common iliac, and 8 obturator), all of which were negative for malignant involvement. On the right side, multiple pelvic lymph nodes were sampled including 5 external iliac, 1 common iliac, and 5 obturator lymph nodes; all were negative. One specimen labeled as right internal iliac lymph node did not contain nodal tissue.\n\nPara-aortic lymph nodes were also evaluated\u20146 from the right and 11 from the left\u2014all showing no signs of tumor involvement. The omentum was free of malignancy upon examination. The appendix demonstrated no pathological findings related to malignancy.\n\nBiopsy specimens obtained from various peritoneal sites\u2014including the right diaphragm, right and left para-colic gutters, bladder peritoneum, and cul-de-sac\u2014were all negative for tumor involvement.\n\nSections submitted included representative tissues from the uterus, cervix, tubes, ovaries, lymph nodes, and other abdominal structures. Immunostaining supported the cervical findings but did not demonstrate angiolymphatic invasion within the primary uterine lesion.\n\nAll staging biopsies and excised lymph nodes were negative for metastatic disease."} +{"pid": "TCGA-PA-A5YG", "report": "The specimen consisted of two parts: a lipomatous tissue excised from the back and a left adrenal gland with associated mass. The adrenal specimen measured 17 x 8 x 4.9 cm and weighed 171 grams. The mass itself was 7.8 x 5.7 x 4.6 cm, yellow-brown in color, and largely encapsulated. Gross findings included areas of hemorrhage, calcification, and a fleshy peripheral region.\n\nMicroscopic evaluation revealed a neoplastic lesion composed of eosinophilic cells arranged in sheets. Nuclear features included enlargement and polylobation. Areas of necrosis were present, and there was focal vascular invasion through the capsule. However, the surgical margins were free of tumor involvement. Mitotic activity was minimal.\n\nImmunohistochemical staining showed focal positivity for vimentin and Melan-A, with no reactivity to Pan-Cytokeratin. There was weak focal staining with synaptophysin but not chromogranin. Inhibin did not react with the tumor cells, while S-100 highlighted normal adipocytes.\n\nPathologic staging was determined as pT2, indicating a tumor larger than 5 cm without extra-adrenal invasion. No lymph nodes were submitted or identified, so nodal staging could not be assessed (pNX). Multiple histologic features were noted that are associated with more aggressive clinical behavior."} +{"pid": "TCGA-DW-7840", "report": "The specimen consists of three submitted portions. The first is a fragment of adipose tissue measuring 6.4 x 2.5 x 1.3 cm, described as yellow, soft, and lobulated with similar cut surfaces. The second portion includes multiple fragments of cyst wall lining from the right upper pole of the kidney, ranging in size from 0.2 to 1.5 cm. These are tan-pink in color and, in aggregate, measure 1.5 x 0.4 x 0.2 cm. The third specimen is a cystic structure measuring 6.5 x 3 x 2.5 cm, with a tan-pink exterior and containing friable, hemorrhagic, golden yellow-red soft tissue contents. Histologically, fibrosis is noted in the renal parenchyma along with the presence of cysts. Fibroadipose tissue is also identified. Cellular analysis reveals papillary-type morphology within the renal tissue. All surgical margins are negative. No additional significant findings are observed in the submitted tissues."} +{"pid": "TCGA-CV-5979", "report": "The partial glossectomy specimen includes a portion of tongue measuring 10.0 x 6.0 x 3.0 cm. A lesion located in the left floor of the mouth measures 3.0 x 2.5 x 1.5 cm, with a tan-white appearance. The distance from the deep margin is 1.5 cm and from the lateral margin is 10 cm. Surrounding mucosa appears unremarkable. Histologic evaluation reveals an ulcerating growth pattern with infiltrative borders. Tumor invasion depth measures 1.5 cm. The tumor border shows thick cords exceeding four cells in thickness. Focal perineural invasion is present. Vascular invasion is also noted. Moderate lymphocyte infiltration is observed. Margins, including the mucosal and deep margins, are free of invasive carcinoma.\n\nIn the left neck dissection specimen, lymph nodes were evaluated across multiple levels. In level I, five lymph nodes were identified without evidence of involvement. In level II, metastatic involvement is present in one out of eleven lymph nodes. In level III, five lymph nodes were examined and none showed involvement. In level VI, four lymph nodes were identified and none contained tumor. The salivary gland in level I is unremarkable and does not show tumor involvement. The skin tag from the left neck is unremarkable, with no significant histologic findings.\n\nAll sections from the surgical specimen were submitted for analysis, and intraoperative frozen section analysis confirmed that margins were free of tumor. Multiple lymph nodes ranging in size from 0.2 cm to 4.0 cm were identified and entirely submitted for evaluation. The neck dissection specimen includes levels I through superior level IV as defined by the surgeon."} +{"pid": "TCGA-M9-A5M8", "report": "The sample was collected from esophageal tissue involving the gastroesophageal junction. The tumor measured 5.5 cm in size and was found to be moderately differentiated. Histological evaluation showed that the tumor midpoint was located in the distal esophagus. Pathological staging indicated T3 with no nodal involvement, and clinical staging showed no distant metastasis. A separate blood-derived sample (buffy coat) was also collected. All other clinical and procedural timepoints were recorded but not specified."} +{"pid": "TCGA-A4-A6HP", "report": "The patient is male. The specimen information includes multiple resected areas from the left kidney, including a deep margin, left lateral tumor, upper pole tumor, and lower pole tumor, along with a left cyst wall excision.\n\nHistologic examination of the left lateral tumor shows a lesion measuring 2.9 x 2.6 x 2.1 cm. The tumor is limited to the kidney without lymphovascular invasion. The nuclear grade is Fuhrman grade 2. Soft tissue surgical margins are free of tumor, although the deep margin was submitted separately. Microscopic analysis reveals multiple satellite foci around the main lesions, with more than 10 small foci noted in the surrounding renal parenchyma, some measuring less than 1 mm. These findings suggest multifocal disease.\n\nThe upper pole tumor measures 1.8 cm and is also limited to the kidney. It demonstrates multifocality and is located near the inked capsular surface. However, histologic sections show that the capsule appears retracted in this area, and the presence of ink is interpreted as a retraction artifact rather than a true positive margin. The lower pole tumor measures 2.5 cm and is similarly confined to the kidney. Surgical margins for this lesion are free of tumor.\n\nThe deep margin specimen contains similar histologic morphology to the other tumors but does not show transection of the left lateral tumor. The cyst wall specimen is negative for any malignant process.\n\nGross evaluation of the specimens confirms the presence of well-defined lesions within the kidney. The left lateral tumor is located 0.2 cm from the resection margin and contacts the inked capsule. The upper pole tumor is 0.2 cm from a cyst and less than 0.1 cm from the inked margin, while the lower pole tumor abuts the capsule and is 0.3 cm from the resection margin.\n\nStaging indicates the tumors are confined to the kidney with no lymph node involvement (pT1a, NX). No lymph nodes were received for evaluation.\n\nIn summary, there is no evidence of tumor transection. However, the presence of multiple small satellite lesions increases the likelihood of recurrence."} +{"pid": "TCGA-3B-A9HS", "report": "The specimen was received fresh and labeled as a retroperitoneal mass. It consists of a multilobulated, yellow-tan fragment of soft tissue measuring 3.5 x 3.5 x 3.0 cm. Serial sectioning revealed a tan-white to tan-pink cut surface with mucinous appearance and areas of necrosis (58%). Representative sections were submitted for analysis.\n\nA second specimen, also received fresh and labeled from the retroperitoneal region, measured 30 x 30 x 10 cm and weighed 2,861 grams. It was described as a multilobulated, tan-white to tan-pink soft tissue fragment with extensive necrosis (30%) and areas of mucoid degeneration. No cystic degeneration was observed. Representative sections were submitted for evaluation.\n\nA third specimen from the transverse colon was received fresh and labeled as a mass. It measured 8.0 x 6.0 x 5.5 cm and was described as a tan-white to tan-pink, multilobulated mass with a smooth external surface marked with blue ink. No attached segment of large bowel was present. Serial sectioning revealed a tan-yellow cut surface without gross evidence of necrosis, hemorrhage, or cystic degeneration. Representative sections were submitted.\n\nMicroscopic evaluation showed high-grade cellular features. Immunohistochemical staining demonstrated positivity for vimentin, desmin, and actin, while stains for smooth muscle myosin, S100, CD117, CD99, CD34, and CD10 were negative. Proliferative index by Ki-67 was estimated at 15\u201325% nuclear positivity. Necrosis was identified in all specimens, ranging from 30% to 58%. The attending pathologist personally reviewed the case and confirmed the findings. Intraoperative consultation was provided, and the diagnosis was communicated to the surgical team. An amendment was issued to correct the collection date of one specimen, with no impact on patient care."} +{"pid": "TCGA-06-0749", "report": "The patient, with a past history of migraine headaches and small strokes, presented with a large right temporal lesion characterized by necrotic features, irregular enhancement, and restricted central diffusion on imaging. Multiple specimens were obtained during surgery, including from the right temporal brain tumor, brain excision biopsy, medial and inferior temporal regions, and posterior margin.\n\nHistopathological examination revealed a neoplastic glial proliferation extensively infiltrating cerebral tissue. The cellular features included nuclear atypia, mitotic activity, microvascular proliferation, and areas of necrosis with vascular thrombosis. In some regions, there was notable infiltration into the leptomeningeal space. The tumor demonstrated a predominantly astrocytic morphology, although certain areas showed a capillary vascular network with focal mineralization, suggesting a possible additional component. Cellular density varied across specimens, with the posterior margin specimen showing lower cellularity and absence of necrotic changes.\n\nImmunohistochemical analysis showed gliofibrillogenesis with GFAP expression, while p53 was not overexpressed. MIB-1 staining revealed a proliferation index of approximately 22% in more active regions. NeuN highlighted neurons in the infiltrated cortex, and NFP identified scattered cortical neurons containing phosphorylated NFP without atypical morphology. CD163 demonstrated numerous positive cells with granular cytoplasm. The immunophenotype supported a high histological grade neoplasm.\n\nMolecular testing for MGMT promoter methylation was negative. Genetic analysis for allelic loss on chromosome arms 1p and 19q was also not detected using multiple microsatellite and minisatellite markers. These findings may impact therapeutic considerations.\n\nGross examination of the specimens described two portions of cerebrum, one measuring 6.5 x 2.0 x 1.5 cm with a cystic cavity and semi-firm gray-glistening tissue, and another lobulated purplish-grey fragment. Additional fragments from other resected areas were described as semi-firm, creamy-white, tan-gray, or hemorrhagic with glistening cut surfaces. All specimens were submitted for histological evaluation.\n\nIn summary, the tumor is present in all surgical specimens, with high-grade features evident in most areas, including significant cellular atypia, mitotic activity, necrosis, and vascular proliferation. The morphological and immunohistochemical profile supports a glial origin with variable regional characteristics."} +{"pid": "TCGA-QR-A6H1", "report": "A left adrenal specimen was received fresh in a container labeled with the patient\u2019s name and medical record number. The specimen consisted of a red-tan, irregularly shaped soft tissue mass measuring 11 x 5 x 2 cm and weighing 74.65 grams. Gross examination revealed multiple palpable nodules. Upon opening, three distinct nodules were identified: the first measured 5 x 3 x 2 cm, the second 0.8 x 0.7 x 0.5 cm, and the third 1.7 x 1.8 x 1 cm. The cut surface of each nodule was described as red-tan, variegated, and hemorrhagic, with the largest nodule showing areas of partial necrosis. A rim of normal-appearing adrenal parenchyma was observed. Approximately 50% of each nodule was sampled for further analysis. Representative sections from each nodule were submitted for histological evaluation.\n\nImmunohistochemical staining showed strong and diffuse positivity for chromogranin, synaptophysin, and CD56. Inhibin staining was negative. S100 staining highlighted sustentacular cells in the medulla. All immunoperoxidase tests were performed in a CLIA-certified laboratory and were developed and validated according to clinical laboratory standards. No FDA clearance or approval was required for these tests."} +{"pid": "TCGA-JV-A75J", "report": "The specimen consists of a uterus with cervix, bilateral fallopian tubes and ovaries, along with additional specimens including a pelvic tumor, omentum, small bowel implant, appendix, left pelvic lymph nodes, and a pelvic implant. The uterus is associated with a large mass measuring 18 x 18 x 12 cm located at the posterior fundus. Microscopic evaluation reveals marked cytologic atypia, extensive coagulative tumor cell necrosis, and a high mitotic rate, up to 68 mitoses per 10 high power fields. The tumor invades through the uterine serosa and involves abdominal tissues at multiple sites. Additional specimens from the pelvic tumor, omentum, small bowel implant, appendix, and pelvic implant all show similar malignant cellular features. Two left pelvic lymph nodes are identified without evidence of tumor involvement. No tumor is present in the cervix, bilateral fallopian tubes, or ovaries. Multiple intramural nodules are noted within the uterus. The endometrium shows disordered proliferative changes. The case includes findings from intraoperative frozen section analysis which identified a high-grade sarcoma. Distant metastases could not be fully assessed. The procedure included total abdominal hysterectomy, exploratory laparotomy, bilateral salpingo-oophorectomy, appendectomy, omentectomy, tumor debulking, left pelvic lymph node dissection, and right ureterolysis."} +{"pid": "TCGA-14-0786", "report": "The tissue specimens were obtained from the right temporal region of the brain and included a thrombosed vein. The primary specimen measured 2.9 x 2.7 x 1.4 cm and was described as an irregular pink-tan soft tissue fragment with areas of necrosis. A second specimen, labeled as a thrombosed vein, measured 1.2 x 0.7 x 0.3 cm and contained a segment of blood vessel approximately 1.0 cm in length with a diameter of 0.2 cm. All tissues were submitted for analysis.\n\nMicroscopic evaluation revealed high cellular proliferation activity, with 27% positivity on MIB-1 immunostaining (mean 12%). Cellular features were consistent with a highly proliferative process. Immunohistochemical staining intensity supported these findings. Additional testing was performed on one tissue block, with results pending at the time of reporting."} +{"pid": "TCGA-GM-A2DF", "report": "The specimen consists of a segmental mastectomy measuring 8.0 x 6.5 x 5.5 cm, with multiple clips on the anterior margin and orientation markers. A dominant tan-pink lesion measuring 1.4 x 1.1 x 1.0 cm was identified in slice #3, located 0.7 cm from the anterior margin. The largest invasive focus measures 1.2 cm in greatest dimension and is situated in the medial aspect of the specimen. Additional small satellite nodules were found lateral to the main lesion, measuring 5 mm (x2), 4 mm, 3 mm, and 1 mm. The tumor demonstrates high nuclear grade and a Nottingham histologic score of 3. Lymphovascular invasion is present.\n\nDuctal changes with high-grade features are noted, predominantly cribriform and clinging patterns, with involvement of lobules. These extend over a 4 cm area in an irregular distribution. The closest distances from these changes to the margins are less than 1 mm from the anterior margin, 1 mm from the inferior margin, and 2 mm from both the superior and posterior margins. Invasive disease approaches the anterior margin to within 2 mm.\n\nAxillary lymph node dissection included thirty nodes, one of which contains metastatic involvement measuring 7 mm; no extranodal extension is observed. Two additional lymph nodes from level I show no evidence of involvement.\n\nA re-excised margin from the central anterior inferior portion shows benign tissue only. Further excision of the most medial tumor margin also revealed no tumor. Immunohistochemical analysis of a representative section shows negative staining for estrogen and progesterone receptors. HER-2/neu immunostaining demonstrated focal weak positivity (1+). Fluorescence in situ hybridization for HER-2/neu gene amplification showed no significant increase in gene copy number, with a signal ratio of 1.12 (average 1.57 copies of HER-2/neu per nucleus and 1.40 copies of CEP17 per nucleus).\n\nMargins from all excised specimens are free of tumor, except for lobular involvement within 1\u20132 mm of certain deep margins. All relevant margins have been evaluated microscopically and submitted entirely where indicated."} +{"pid": "TCGA-BP-4158", "report": "The clinical history includes a metastatic workup for recently diagnosed prostate cancer with an incidental finding of a right renal mass. The specimens submitted include a right kidney and paracaval lymph nodes.\n\nThe right kidney specimen measured 23.13 x 0.5 cm and weighed 700 grams. After removal of fat, the kidney measured 12.5 x 7.5 x 0.5 cm and weighed 280 grams. An 11 cm segment of ureter was identified. A well-circumscribed yellow, focally hyalinized mass measuring 0.7 x 5.8 cm was observed in the upper pole. There was no necrosis evident, and the tumor appeared confined within the renal capsule, bulging into the renal pelvis without gross invasion of the renal vein. Histologically, the tumor exhibited acinar growth pattern and nuclear grade II/IV. Its greatest diameter was 7.0 cm. Vascular invasion was present. All surgical margins were free of tumor. The non-neoplastic kidney tissue showed no remarkable findings. The adrenal gland was not submitted for evaluation.\n\nFive lymph nodes were identified in the paracaval specimen and all were negative for malignancy (0/5).\n\nSections evaluated included those from the tumor, tumor with hilum, tumor with surrounding kidney, tumor with pelvis, kidney away from tumor, soft tissue margin, ureteric margin, vascular margin, perinephric fat, and tumor with capsule. In the second specimen, sections included bisected lymph nodes and multiple lymph nodes."} +{"pid": "TCGA-66-2778", "report": "The specimen consists of a left lower lobe with associated hilar and mediastinal lymph nodes, along with pleural and resection margin tissues. Gross examination of the left lower lobe revealed a central lesion located near the bifurcation of the bronchial segments. The lobe measured 10 x 7.5 cm at the base and up to 14 cm in height. A staple suture line was identified 9 cm from the hilus. The visceral pleura appeared cloudy with focal thickening, reticulate or patchy blackish pigmentation, and a bloody coating medially. There was notable deformation of the lower lobe, particularly in the dorsal and basal regions. In the dorsomedial area over S10, an adhesion measuring 4 x 2 cm was observed. Underlying this area was a grayish-vitreous mass with fine patchy pigmentation, measuring up to 6.5 cm, located primarily in S10 and extending into adjacent sections of S6 and S9. Intermediate and peripheral bronchial branches leading to the tumor were noted. The tumor was within 1.3 cm of the bronchial resection margin. A parabronchial lymph node measuring 0.8 cm was present at the tumor margin.\n\nMultiple lymph nodes were examined from various stations. Hilar lymph nodes on the left side included one measuring 1 cm and another 1.5 cm with surrounding tissue. At station 12 (left upper lobe), a 2.3 cm lymph node was noted. Interlobar lymph node (station 11) measured 1.1 cm. Station 9 (pulmonary ligament) showed a 1.7 cm lymph node with some surrounding tissue including fat. Paraesophageal (station 8) and paraaortic (station 6) lymph nodes measured 0.5 cm and 1 cm respectively. Subaortic lymph node (station 5) was 1.7 cm with adjacent fatty tissue. Subcarinal lymph nodes (station 7) were 1.1 cm and 0.8 cm. On the right side, a hilar lymph node measured 1.7 cm. Among these, four enlarged hilar nodes on the left side ranged from 0.5 cm to 2.4 cm.\n\nHistologically, the lesion was composed of atypical epithelial cells arranged in solid structures, some with squamous differentiation. The cytoplasm was moderately eosinophilic and the nuclei showed moderate to marked anisomorphism with enlarged chromatin and small nucleoli. Necrotic foci with granulocytic infiltration were seen centrally. The stroma was desmoplastic, and the lymph node capsule was thickened by fibrosis. Involvement was confirmed in several lymph nodes, including those from stations 5 and 12. Other lymph nodes showed reactive changes only. The bronchial and vascular resection margins were free of tumor involvement. A hilar lymph node was partially infiltrated, while the parietal pleura, bronchial resection margin, and small parabronchial nodes were uninvolved.\n\nThe surrounding lung parenchyma demonstrated mild focal compaction with yellow patches near the tumor. Elsewhere, minor blackish pigmentation was noted. Focal active chronic organizing pneumonia was present at the tumor margin, with macrophages transformed into foam cells, some lymphocytes, granulocytes, and mesenchymal buds incorporated into the wall. Alveolar septa were mildly to moderately infiltrated with lymphomononuclear cells. The parietal pleura showed mild fibrosis. The pleural sample consisted of fatty tissue with shiny surfaces and scattered small plaques or nodules.\n\nSections of bronchial and vascular margins were examined tangentially and found to be negative. Multiple tissue blocks were evaluated with special stains including Elastica-van Gieson, PAS, and diastase-PAS. Intraoperative frozen section of one lymph node suggested possible involvement by large-cell carcinoma; however, final histology confirmed extensive infiltration in certain lymph nodes, while others remained reactive without malignant involvement."} +{"pid": "TCGA-DD-AACO", "report": "The liver specimen measured 4.3 x 3.6 x 3.1 cm and was unfixed. A single tumor located in the center of the specimen measured 2.5 x 2.4 x 2.3 cm. There was no satellite nodule present. The gross appearance showed an expanding nodular pattern with 20% necrosis. There was no hemorrhage or peliosis identified. Peritumoral cirrhosis with a micronodular pattern was noted. Gross photo was included. Blocks taken included T1-4 and A (mass and surrounding tissue x5), and L (remaining liver x1).\n\nMicroscopically, the lesion showed trabecular and solid growth patterns with hepatic-type cells. The worst differentiation was grade III, while the major differentiation was grade II. There was no fatty change, and fibrous capsule formation was partial without capsular infiltration. Septum formation was present. Surgical resection margins were free with a safety margin of 1.0 mm. There was no invasion of the serosa, portal vein, bile duct, hepatic vein, or hepatic artery. Microvessel invasion and intrahepatic metastasis were not identified, and there was no evidence of multicentric occurrence.\n\nNon-tumor liver pathology revealed chronic hepatitis of HBV etiology, with minimal lobular activity (grade 1) and mild portoperiportal activity (grade 2). Fibrosis was consistent with stage 4 (cirrhosis). There was also mild steatosis. No dysplastic nodule or ductal epithelial dysplasia was identified."} +{"pid": "TCGA-FI-A2EU", "report": "A total abdominal hysterectomy with bilateral salpingo-oophorectomy and lymph node dissection was performed. The uterus measured 8.5 cm in length from fundus to cervix, with an endometrial cavity measuring 3.5 cm in length. A polypoid mass measuring 2.0 x 2.0 x 1.5 cm was identified in the fundus and located 5.5 cm from the ectocervix. It appeared fleshy, soft, and partially hemorrhagic but did not show deep invasion into the uterine wall. The remainder of the endometrium was tan-brown and unremarkable. The cervix showed a circumferential golden brown region measuring 1.7 cm in length and a 0.6 cm Nabothian cyst on the right side. Histologically, there was acute and chronic inflammation involving the cervix along with macrophages and hemosiderin. No abnormal histologic findings were identified in the myometrium, serosa, ovaries, or fallopian tubes. Left tubo-ovarian adhesions were noted.\n\nLymph nodes were assessed bilaterally from pelvic and periaortic regions. On the right side, six pelvic lymph nodes (largest 3.7 cm) and one periaortic lymph node (1.2 cm) were evaluated. On the left, five pelvic lymph nodes (largest 2.5 cm) and one periaortic lymph node were examined. No abnormal histologic findings were identified in any of these lymph nodes. Additionally, a cecal adhesion specimen and omentum were analyzed; both showed no histopathologic abnormalities.\n\nMicroscopic examination confirmed that the lesion was confined to the endometrium without lymphovascular space invasion. There was no involvement of adjacent structures or metastases identified in the regional lymph nodes. Distant metastases could not be assessed based on available data."} +{"pid": "TCGA-05-4422", "report": "The resected specimen demonstrates a predominantly well-differentiated mixed adenocarcinoma located in the left lower lobe of the lung. The tumor exhibits a compact growth pattern with minimal stromal component and is characterized by tubulopapillary differentiation. A small bronchioloalveolar component is noted at the periphery. The lesion extends to within the subpleural region but does not show evidence of pleural infiltration based on the available material. In a central direction, the carcinoma invades a peripheral bronchus, which is markedly distended and largely occluded by a tumor mass. The surgical margins are free of tumor involvement. Lymph node staging indicates no regional lymph node metastasis. Based on this assessment, the TNM classification is pT2 pN0 R0, corresponding to stage IB."} +{"pid": "TCGA-UC-A7PF", "report": "The specimen consisted of multiple lymph node samplings, a left ovary, soft tissue mass biopsy, uterus, surgical margins, and an incidental appendix. Gross examination revealed the left ovary measured 3.5 x 3 x 2.5 cm with surface cysts up to 0.8 cm and a 1 cm cyst within. The uterus measured 11 x 6 x 5 cm and weighed 190 grams. The cervix measured 3.5 x 3.5 cm with a firm submucosal lesion measuring 2.5 cm in length and 1.5 cm in depth, involving all cervical quadrants. The lesion appeared white and homogeneous without extension to the surgical margin; the nearest margin was 0.2 cm away. Multiple small leiomyomas were noted in the myometrium, up to 1.5 cm in diameter.\n\nLymph nodes were identified in right external iliac (3), right obturator (several), left external iliac (several), and left common iliac (1) regions. No lymph nodes were found in the right common para-aortic or left obturator regions. Histologic evaluation of the cervix showed invasive growth with depth of invasion measuring 1.5 cm within a 1.7 cm thick wall. Microscopic angiolymphatic invasion was present. Surgical margins including vaginal cuff and parametrial areas were negative for involvement. One lymph node in the anterior parametrium showed involvement. The appendix showed no abnormalities."} +{"pid": "TCGA-QU-A6IM", "report": "Pathology Examination. Birthdate. Pathology. #. Male. Report to: Gross Description by. SPECIMEN SUBMITTED: PROSTATE, RT & LT OBTURATOR NODES. OCCK ICD.O-3. Procedure date Tissue received Report Date Diagnosed by. Previous biopsies: PROSTATE BX'S. LT LEG. PUNCH EXCISION LT LEG. GI BX.\n\nThe specimen includes a prostate and seminal vesicles following a radical procedure. Histologic evaluation of the prostate reveals multiple firm areas identified upon sectioning. These include an approximately 0.3 cm diameter firm area in the left posterior apex, a 0.5 cm firm area in the right anterior apex, a 0.9 cm nodular firm area in the left anterior mid portion of the prostate, and a 0.4 cm diameter firm area in the right and left posterior mid prostate and left posterior base.\n\nSections from the right and left obturator lymph nodes were examined. Each lymph node was serially sectioned and entirely submitted for analysis. No abnormal findings were identified in either lymph node.\n\nHistologic grading of the tissue shows a primary pattern score of 3 and a secondary pattern score of 4, resulting in a total Gleason score of 7. Vascular or lymphatic invasion was not observed; however, perineural extension was noted within the prostate. All inked capsular and soft tissue resection margins, including the shaved bladder margin and inked apex margin, were free of involvement. The seminal vesicles also showed no signs of involvement.\n\nA total of six positive slides were identified across both sides of the prostate. On the right side, 3 positive slides were found with no involvement at the apex. On the left side, 4 positive slides were identified, including 1 involving the apex. \n\nThe prostatectomy specimen weighed 43 grams and measured 4.5 x 4 x 3.5 cm. The right vas deferens measured 1.7 cm in length by 0.3 cm in diameter, and the right seminal vesicle measured 2.5 x 1.3 x 1 cm. The left vas deferens measured 2 cm in length by 0.3 cm in diameter, and the left seminal vesicle measured 2.6 x 1.4 x 1.2 cm. The right half of the prostate was inked in black and the left half in blue.\n\nNo tumor involvement was identified in the pelvic lymph nodes, with one lymph node assessed on each side and no evidence of metastasis. \n\nBy his/her signature above, the senior physician certifies that he/she personally conducted a gross and/or microscopic examination of the described specimens and rendered or confirmed the findings related thereto. Immunohistochemistry tests, if applicable, were developed and used for clinical purposes. They have not been cleared or approved by the U.S. Food and Drug Administration, which has determined that such clearance or approval is not necessary. This laboratory is certified under the Clinical Laboratory Improvement Amendments of 1988 (CLIA - 88) as qualified to perform high complexity clinical laboratory testing."} +{"pid": "TCGA-D7-8570", "report": "The examined stomach specimen was obtained via total organ resection. The stomach, measuring 18 x 15 cm, was incised along the greater curvature and included a 1.5 cm segment of the esophagus and omentum measuring 50 x 32 cm. A lesion was identified in the orifice region, measuring 4 x 2.5 x 1.2 cm, involving approximately 50% of the orifice circumference. Its proximal margin measured 2.3 cm, and the distal margin 12.5 cm from the tumor.\n\nMicroscopic evaluation revealed glandular structures with varying degrees of architectural disarray. Cellular atypia was present, with infiltrative growth observed through the muscular wall extending to the serosa. No neoplastic involvement was identified in the omentum or surgical margins.\n\nLymph node assessment showed metastatic involvement in periorificial (NO VIII/XIII) and lesser curvature (No V/V) lymph nodes. Reactive lymphoid changes were noted in the pyloric lymph nodes (No IV). Immunohistochemical analysis for HER2 using Ventana's Pathway HER-2/neu (4B5) Rabbit Monoclonal Antibody demonstrated no expression in invasive cells (Score = 0).\n\nHistological grade was determined as G3. The depth of invasion was classified as pT3. Lymph node involvement was staged as pN3a."} +{"pid": "TCGA-AC-A3W7", "report": "The right breast mastectomy specimen contained multiple foci of neoplastic tissue. The largest focus measured 40 mm, with two additional foci measuring 14 mm and 5 mm. Histologic evaluation demonstrated a total Nottingham grade 1 tumor, characterized by less than 10% tubule formation (3 of 3), low-grade nuclear pleomorphism (1 of 3), and a low mitotic count (1 of 3), corresponding to a cumulative score of 5 out of 9. The mitotic count was quantified as 2 per 10 high power fields. No lymphatic invasion was identified. Surgical margins were negative, with all margins measuring 20 mm or greater from the tumor. Lobular carcinoma in situ was also present. Two sentinel lymph nodes were examined; one contained metastatic involvement measuring 2.5 mm, without extracapsular extension. The second lymph node showed no evidence of metastasis. Immunohistochemistry confirmed the presence of metastatic tumor cells in one lymph node. Staging was based on pT2 for the primary tumor and pN1a for regional lymph node involvement (1 of 2 nodes positive). The pathologic stage was determined to be IIB. Estrogen receptor expression was strongly positive (99\u2013100% of cells), while progesterone receptors were negative (0%). HER2/neu staining was negative (score 0). The Ki-67 proliferative index was intermediate at 11%. \n\nThe left breast mastectomy specimen showed no evidence of atypical hyperplasia or malignancy. Benign findings included sclerosing adenosis, usual ductal hyperplasia, columnar cell change, and apocrine metaplasia. A small violaceous skin lesion measuring 0.4 cm was noted in the lateral skin but was not further described. The specimen weighed 341 grams and measured 15.5 cm from medial to lateral, 11 cm superior to inferior, and 5.5 cm superficial to deep. The areola was 4 cm in diameter, and the nipple was flat to slightly retracted. No discrete areas suggestive of invasive neoplasm were identified upon serial sectioning. Scattered small fluid-filled cysts were present within fibrous parenchyma, which was focally finely nodular to palpation. No lymph nodes were identified in the lateral portion of the excision. Representative sections were submitted from all quadrants, including the central deep margin and nipple. \n\nThe right axillary sentinel lymph nodes were received unfixed and consisted of two nodes measuring 1 x 0.7 x 0.7 cm and 1.5 x 0.8 x 0.4 cm. Both were serially sectioned, and touch imprints were obtained. The larger node was submitted in cassettes A1\u2013A2, and the smaller in cassette A3. Microscopic examination revealed metastatic involvement in one node. Intraoperative touch preparation of the sentinel lymph node biopsy showed no evidence of tumor cells. \n\nGross description of the right breast mastectomy specimen showed a stellate, hard, gritty lesion measuring 4 x 1.2 x 1 cm located centrally in slabs 6\u20139, 1.5 cm from the closest skin and 2 cm from the nearest anterior-superior margin. Two additional tumor deposits were identified in slab 11: one measuring 1.4 x 1 x 0.6 cm and another measuring 0.5 cm. All margins were widely free. Specimen orientation was confirmed with inked margins (blue for anterior-superior, green for anterior-inferior, black for posterior). The left breast specimen was similar in size and dimensions, with no evidence of malignancy. Fibrous parenchyma was scattered and focally nodular, but no discrete masses were found. Multiple cysts were noted within the fibrous tissue. \n\nMicroscopic analysis of all specimens was completed, with findings consistent with the described features. No extracapsular extension was observed in the involved lymph node. Lymphovascular invasion was not identified. Receptor status and proliferative index were documented as described above."} +{"pid": "TCGA-WB-A81V", "report": "The pathology report describes a specimen from the left adrenal gland. The specimen measured 7.5 x 6.5 x 4.5 cm and weighed 123 grams after formalin fixation. It was surrounded by a grey-brown capsule with attached fatty tissue. On sectioning, the cut surface appeared yellow-red with areas of hemorrhage. A central cystic area measuring approximately 5.5 cm was identified, filled with friable red-brown material.\n\nMicroscopic examination revealed normal adrenal tissue adjacent to a large pseudocystic area with scarring. The adrenal cortex showed polygonal cells with fine granular cytoplasmic inclusions and eosinophilic cytoplasm. Nuclear features included enlarged nuclei with prominent chromatin alterations. Rare mitotic figures were observed. Additional sections demonstrated solid tumor formations arranged in nests, separated by collagen-rich fibrous bands. Areas of focal necrosis were also present."} +{"pid": "TCGA-AC-A2FK", "report": "The specimen received included right and left breast tissues, along with three sentinel lymph nodes. The right breast tissue showed benign changes including multiple intraductal papillomas and proliferative fibrocystic changes. No evidence of malignancy was noted in the right breast upon gross or microscopic evaluation.\n\nSentinel node #1 was a lymph node with a deposit measuring 1.6 cm. Superficial extranodal extension was present. Sentinel node #2 contained a deposit measuring 1.3 cm, also showing superficial extranodal extension. Sentinel node #3 had a deposit measuring 1.2 cm and exhibited superficial extranodal extension as well.\n\nThe left breast tissue revealed a mass located in the upper outer quadrant, measuring 3.4 x 3 x 1.2 cm. Microscopic evaluation showed a modified B-R grade 2 lesion with a tubular score of 3, nuclear score of 2, and mitosis score of 1. The margins were negative, with the tumor located 1.8 cm from the deep margin. Adjacent linear and focal areas of induration were observed, extending predominantly lateral and medial to the mass. No lymphovascular invasion was identified. Distant metastasis could not be assessed based on the current specimen.\n\nPathologic staging was determined as pT2, pNX, pMX. All three sampled lymph nodes were positive, indicating a nodal stage of at least pN1a. \n\nGross examination of the left breast specimen showed a firm pale pink-tan mass within the upper outer quadrant, measuring 3.4 cm in greatest dimension. The mass was located 1.8 cm from the deep margin and 1 cm from the nearest superficial margin. The deep margin was inked black. Serial sectioning revealed lobulated fat interspersed with soft-to-firm pink-tan nonfatty breast tissue.\n\nThe operative procedure and pathology findings have been reported to the institution's cancer registry for accreditation purposes. Pathologic staging is based solely on the current specimen and should be considered alongside clinical data for comprehensive staging."} +{"pid": "TCGA-WH-A86K", "report": "The specimen consists of multiple fragments of soft tan tissue measuring 2.5 x 1.5 x 1 cm. Squash preparations were made from the sample. A frozen section diagnosis was rendered as a glial neoplasm, favoring Grade II-III. The case was discussed with the appropriate personnel. Portions of the specimen were used for frozen section analysis, tissue banking, and permanent sections. Representative sections were frozen in an AFS1 cryoblock, and the frozen section remnant was designated as A1. Three portions were reserved for tissue banking, and the remaining tissue was submitted for permanent sectioning in cassette A2."} +{"pid": "TCGA-DE-A4MC", "report": "The specimen consists of a total thyroidectomy weighing 24.4 grams. The right lobe measures 4.8 x 2.2 x 2.3 cm, the left lobe 4.2 x 1.7 x 1.7 cm, with a central contiguous isthmus and a pyramidal lobe measuring 2.2 x 0.8 x 0.5 cm. Orientation was marked with anterior/blue, posterior/black, and isthmus/yellow. The specimen was sectioned from superior to inferior. A single lesion was identified in the right superior pole, measuring 2.8 x 1.9 x 1.7 cm. It presented as a solid, white-tan mass with gritty consistency and irregular borders. The lesion expanded the right superior pole anteriorly and showed focal adherence to cauterized fibrous tissue. Histologically, the growth pattern was circumscribed, with capsular invasion noted. There was no evidence of lymphovascular or blood vascular invasion. Extra-thyroidal extension was present, specifically in sections A1 and A3. Surgical margins were not involved, although the tumor was focally within 1 mm of both the anterior and posterior margins of the right superior pole. The remainder of the thyroid gland appeared unremarkable except for a 0.6 cm gelatinous cyst in the left upper pole. Parathyroid tissue was not identified. Sections were submitted for further analysis, including perpendicular sections of the right superior pole, adjacent areas, and representative sections from other lobes.\n\nA separate lymph node specimen from the right neck level 3 was received. It measured 1.2 x 0.9 x 0.4 cm and consisted of a firm gray-tan nodule with attached fat. On sectioning, it revealed a solid tan/gray cut surface. One metastatic focus measuring 7 mm in diameter was identified without evidence of extracapsular extension.\n\nStaging information was assigned as pT3 pN1b based on available data at the time of reporting. This assessment may be subject to revision pending further clinical evaluation."} +{"pid": "TCGA-FE-A230", "report": "The specimen was received as a total thyroidectomy along with soft tissue from the anterior cricoid region. The left thyroid lobe measured 5.7 x 4.2 x 3.2 cm and contained a thinly encapsulated nodule measuring 4.4 x 4.0 x 2.2 cm. The nodule was in close proximity to the isthmic edge, at 0.2 cm, and had a tan friable appearance with areas of hemorrhage. No lymph nodes or parathyroid glands were identified in this specimen. A frozen section was performed on the nodule.\n\nThe right thyroid lobe measured 5.0 x 4.0 x 1.6 cm and contained two nodular areas in the inferior half of the lobe, measuring 0.4 x 0.3 x 0.3 cm and 1.7 x 1.0 x 0.9 cm, respectively. These were located 0.8 cm and 1.1 cm from the isthmic edge. A single lymph node measuring 0.6 cm was also identified.\n\nThe soft tissue specimen overlying the anterior cricoid contained two lymph nodes measuring 0.7 cm and 1.2 cm. The larger node was bisected and showed dark pink, homogeneous, rubbery tissue.\n\nMicroscopic evaluation of the left thyroid lobe nodule revealed well-differentiated cells arranged in papillary structures. No lymphatic or vascular invasion was identified, and no capsular invasion was present. The tumor appeared confined to the thyroid without multifocal disease, cartilage involvement, or infiltration of adjacent structures.\n\nAll three lymph nodes examined were positive for metastatic involvement. One lymph node from the right thyroid specimen showed a microscopic subcapsular focus. Both lymph nodes from the soft tissue overlying the anterior cricoid region contained microscopic foci of similar involvement. No extranodal extension was observed.\n\nAdditional findings included Hashimoto\u2019s thyroiditis involving both thyroid lobes. No other significant pathologic findings were noted. All margins were assessed, and no involvement was detected at the isthmic edge or other resection sites."} +{"pid": "TCGA-AG-A023", "report": "The specimen demonstrates a focus of moderately differentiated epithelial neoplasm involving the colonic wall, with transmural extension through all layers. Histologic evaluation reveals evidence of lymphovascular invasion, as well as marked associated inflammatory response. Examination of regional lymph nodes shows multiple involved nodes. The excised specimen includes adjacent squamous mucosa with signs of external infiltration. Assessment of resection margins, including mucosal and ligature areas, indicates no residual tumor. Additional tissue samples include smooth muscle components and extensive neoplastic involvement, as well as anastomotic structures lined by cryptic epithelium with underlying submucosa and muscularis."} +{"pid": "TCGA-EA-A3HR", "report": "The specimen consists of cervix tissue obtained from a hysterectomy with bilateral salpingo-oophorectomy. The lesion measured 1 x 0.8 x 0.5 cm and was found to be a moderately differentiated type, with the size of the lesion being less than 4.0 cm. No information was provided regarding lymph nodes, lymphatic or venous invasion, surgical margins, evidence of neo-adjuvant treatment, or additional pathologic findings. No comments were included in the report."} +{"pid": "TCGA-BR-6710", "report": "The specimen consists of a subtotal gastrectomy. The tumor is located in the stomach and measures 8 x 0 x 10 cm. It is ulcerated and histologically classified as moderately differentiated. The tumor extends into the muscularis propria. Fifteen lymph nodes were examined, including those from the greater and lesser omentum, none of which show evidence of metastasis. Lymphatic invasion is present, while venous invasion is absent. Perineural invasion status is not specified. Surgical margins are uninvolved. There is no information provided regarding neo-adjuvant treatment or additional pathologic findings."} +{"pid": "TCGA-EB-A299", "report": "The specimen consists of skin tissue submitted as an excision. The lesion measured 2.5 x 2 x 1 cm and was described as moderately differentiated. Histologic evaluation showed features consistent with Clark level III invasion. No satellite nodules, lymph node involvement, lymphatic or venous invasion, margin status, or evidence of neo-adjuvant treatment were specified. Additional findings and tumor features were not detailed in the report."} +{"pid": "TCGA-VB-A8QN", "report": "Sex: male. Date of birth: Clinical findings indicate a primary lesion in the stomach measuring 10x8 cm, with ulceration and invasion into the muscular layer. A secondary lesion was identified in the III segment of the liver, measuring 4x3 cm. Eight lymph nodes from the omental region were also involved. Histopathological examination revealed ulceration of the gastric serosa with infiltration by medium to large-sized cells of lymphoid morphology. Similar cellular infiltrates were observed in the liver lesion and omental lymph nodes. Immunohistochemical analysis demonstrated positivity for CD20 and a proliferation index of 60% as assessed by Ki-67 staining."} +{"pid": "TCGA-DJ-A2PO", "report": "A left paratracheal lymph node specimen measuring 0.3 and 0.6 cm consisted of benign lymphoid tissue. A separate specimen labeled \"rule out left lower parathyroid\" measured 0.3 x 0.3 x 0.2 cm and showed benign parathyroid tissue. Another left paratracheal lymph node measuring 0.7 x 0.4 x 0.3 cm was also benign. Additional paratracheal tissue measuring 1.3 x 1.1 x 0.3 cm showed benign fibroadipose tissue. A Delphian node measuring 0.9 x 0.7 x 0.3 cm was identified as a benign lymph node.\n\nThe thyroid gland weighed 20.5 grams. The right lobe measured 4.6 x 2.5 x 1.3 cm, the left lobe 3.2 x 2.8 x 1.4 cm, and the isthmus 2.6 x 1.5 x 0.8 cm. A well-circumscribed tan-yellow firm nodule measuring 0.6 cm in greatest dimension was found in the left mid to upper lobe. Faint tan-white papillary foci were noted in the right lobe. Histologic examination revealed two microscopic foci within the thyroid. One measured 6 mm in the left lobe and the other 2 mm in the right lobe. Both were well differentiated with no mitotic activity or tumor necrosis identified. There was no evidence of blood vessel invasion or extrathyroid extension. Surgical margins were free of tumor. Microscopic foci were present in multiple locations within the gland. The background thyroid tissue showed features of chronic lymphocytic thyroiditis. No parathyroid glands were identified in the specimens examined. All lymph nodes assessed were benign."} +{"pid": "TCGA-N9-A4Q3", "report": "A segment of uterine artery measuring 1.1 cm in length and 0.5 cm in diameter is composed of benign connective tissue and artery with no lesion identified. The uterus measures 8.5 x 6.0 x 4.5 cm and contains a polypoid mass located in the fundus, measuring 5.5 x 3.5 x 3.0 cm. The mass is soft and friable but does not demonstrate myometrial invasion or extension into the cervix. Adjacent endometrium has a maximum thickness of 0.1 cm. Two intramural nodules are present within the myometrium, ranging in size from 0.3 x 0.3 x 0.3 cm to 1.2 x 1.0 x 0.9 cm. Both fallopian tubes are unremarkable, with left and right measurements of 6.7 cm and 6.5 cm in length respectively, and diameters of 0.5 cm each. Ovaries are small, with left measuring 2.0 x 0.6 x 0.4 cm and right 1.7 x 0.6 x 0.4 cm. Adenomyosis and leiomyomata are noted. Endosalpingiosis and epithelial inclusion cysts are present in both ovaries.\n\nLymph node assessment includes thirteen nodes from the left pelvic region, all without evidence of tumor involvement. A single sentinel lymph node from the left common iliac region, measuring 5.0 x 0.5 x 0.5 cm, is also free of tumor involvement. Additional lymph nodes assessed include one from the left common, one from the right common iliac, seven from the right pelvic, and five from the para-aortic regions, all without evidence of tumor presence.\n\nOmental biopsy consists of a 19.5 x 5.0 x 0.6 cm sheet of adipose tissue with no identifiable mass. Microscopic analysis reveals no tumor involvement. Molecular testing indicates a microsatellite-stable tumor with intact nuclear expression of MLH1, MSH2, MSH6, and PMS2 by immunohistochemistry. Deeper histological sections of the sentinel lymph node, along with pancytokeratin immunohistochemistry, confirm absence of metastatic disease. No tumor is identified in the cervix, ovaries, or fallopian tubes. Tissue from the tumor and normal ovary was used for analysis."} +{"pid": "TCGA-CZ-5451", "report": "The surgical pathology report describes a resected left kidney specimen weighing 1449 grams, measuring 26.0 x 11.5 x 8.5 cm, which includes the kidney, ureter, renal vein, renal artery, and surrounding adipose tissue. A well-encapsulated, hemorrhagic, centrally fibrotic mass measuring 8.7 x 7.4 x 5.7 cm is identified in the lower pole of the kidney. The mass is predominantly solid (90%) with minor cystic components (10%). It is located 8.5 cm from the ureteral margin, 4.9 cm from the renal artery margin, and 3.5 cm from the renal vein margin. The mass comes within 0.3 cm of the deep/perinephric fat margin but does not grossly appear to invade the pelvocaliceal system or renal sinus. No capsular extension is identified. Margins of soft tissue, ureter, and vascular structures are negative for abnormal findings. An adrenal gland measuring 6.2 x 2.5 x 1.2 cm is present and shows no abnormalities.\n\nMultiple cortical simple cysts are noted throughout the mid and superior poles of the kidney, ranging from 0.7 to 3.5 cm in size. Histologically, sections show no evidence of glomerulitis, proliferative lesions, or fibrinoid necrosis. Evaluation of 155 glomeruli reveals 10.3% global sclerosis, with the remainder showing mild tuft hypertrophy and focal mesangial expansion. Tubular atrophy and interstitial fibrosis are present in approximately 5% of the cortical parenchyma. Arteries and arterioles demonstrate moderate sclerosis with focal subintimal hyaline accumulation.\n\nLymph node assessment includes thirteen regional lymph nodes, all negative for abnormal cellular infiltration. A separate specimen labeled as a rib segment contains bone, cartilage, and skeletal muscle, with no abnormal findings identified. Cytogenetic analysis of the specimen demonstrates a normal karyotype (46,XY) with no detectable chromosomal aberrations; however, it is noted that mosaicism or small anomalies may not be excluded by this analysis.\n\nThe patient presented with weight loss and fatigue, and a mass was identified by CT imaging prior to undergoing nephrectomy. All submitted tissues were reviewed, and no tumor involvement was identified in the regional lymph nodes, rib segment, or adrenal gland."} +{"pid": "TCGA-DX-A48P", "report": "The submitted specimen consists of a single nodular fragment of red tan firm tissue measuring 4.3 x 3.8 x 2.5 cm, labeled as an atypical smooth muscle tumor from the left retroperitoneum. The external surface is inked black and the cut surface reveals a well-demarcated tan-yellow rubbery whorled nodule measuring 4.2 x 3.8 x 2.5 cm. The nodule is in close proximity to all inked margins. Two small adjacent lymphoid structures are identified, each measuring up to 0.3 cm. Microscopic evaluation indicates high-grade cellular atypia with increased mitotic activity. Margins are narrowly clear, and no tumor involvement is seen in the two lymph nodes examined. The tumor appears completely excised with narrow margins near the inked surfaces."} +{"pid": "TCGA-EX-A1H5", "report": "The surgical specimen includes a uterus with bilateral fallopian tubes and ovaries, removed via radical hysterectomy and bilateral salpingo-oophorectomy. The lesion measures 4.2 x 4.0 x 2.2 cm and is located in the cervix, involving both anterior and posterior regions, extending into the endocervical canal and lower uterine segment. Microscopically, the lesion demonstrates invasive growth with abundant necrosis and poor differentiation. The tumor ulcerates the ectocervix and invades deeply into cervical tissue, reaching the parametrial soft tissues on both sides, including anterior and posterior pericervical areas. There is evidence of lymphovascular space invasion.\n\nMargins are largely negative; however, the tumor approaches within less than 1 mm of several parametrial margins (anterior, posterior, and left parametrial). The vaginal cuff margin is free, with the tumor located 1.5 cm from the nearest vaginal margin at 12 o\u2019clock.\n\nLymph node analysis reveals four involved nodes out of 21 examined. Metastatic involvement is identified bilaterally in parametrial soft tissues: one node on the left measuring less than 1 mm and one on the right measuring 4 mm. Both show no extracapsular extension. Additional lymph node dissections from the right and left pelvic regions contain metastases in one of six and one of eleven nodes respectively.\n\nNo definitive involvement of the vagina, bladder, or rectum is observed, although the tumor abuts the vaginal mucosa without clear invasion. The lesion extends to the lower uterine segment but does not definitively involve the endometrium or myometrium. Adjacent findings include VAIN 1 with HPV effect at the 12 to 3 o'clock position, serosal adhesions, adenomyosis, and cystic atrophy of the endometrium.\n\nThe specimen weighs 130.5 grams and has a pear-shaped configuration. The cervix measures 3.0 x 2.2 cm with up to 1.5 cm depth of vaginal mucosa. The tumor appears tan-white and soft, extending to parametrial margins anteriorly and posteriorly, and comes within 1.5 cm of the vaginal margin at 12 o\u2019clock. The endometrial cavity measures 2.8 cm in length and 1.7 cm at the fundus, with a thin endometrial surface. Myometrial thickness is 0.8 cm and shows diffuse trabeculation without nodules.\n\nBoth ovaries are atrophic and unremarkable. The right fallopian tube measures 3.8 cm in length and the left 3.5 cm; both have patent lumina and unremarkable appearances. Adipose tissue fragments from right and left pelvic regions contain multiple lymph node candidates, submitted for histologic evaluation.\n\nSections submitted for microscopic examination include areas of serosal adhesions, vaginal cuff margins, tumor proximity to parametrial and endometrial regions, full-thickness myometrial sections, and bilateral adnexal structures. Lymph node blocks from pelvic dissections were also evaluated."} +{"pid": "TCGA-BR-8682", "report": "The specimen consists of a gastrectomy with a tumor located in the antrum. The lesion measures 3 x 4 x 1.5 cm and is described as ulcerated, firm, and myxoid with a gray surface. Microscopically, the mucosa is ulcerated and shows infiltration into the serosa. The tissue demonstrates irregularly shaped glands that are mildly stratified, along with pools of extracellular mucin containing malignant epithelium arranged in cords or acinar structures. The cells exhibit mild stratification, scant cytoplasm, hyperchromatic nuclei with irregular contours, and prominent nucleoli. Mitotic figures are present. Inflammatory cells are noted within the stroma. Lymphatic invasion is identified. Evaluation of five regional lymph nodes reveals no evidence of metastasis. No involvement of margins is identified. There is no indication of neoadjuvant treatment effect."} +{"pid": "TCGA-CH-5744", "report": "The specimen shows a predominantly poorly differentiated adenocarcinoma involving both sides of the prostate with the primary focus located in the right peripheral zone. The tumor demonstrates a Gleason score of 4+3=7 with tertiary grade 5 features. Gleason pattern 4 constitutes approximately 70% of the tumor, while Gleason pattern 5 accounts for less than 5%. The maximum tumor diameter measures 1.5 cm. There is no evidence of extraprostatic extension. The tumor is multifocal and involves perineural sheaths. Surgical margins are free of tumor involvement in the main preparation. Additional findings include multiple foci of high-grade prostatic intraepithelial neoplasia and changes consistent with myoglandular prostatic hyperplasia. The urothelium of the prostatic urethra does not show dysplastic changes. The seminal vesicles and seminal ducts are unremarkable with regular architecture and no tumor involvement. A total of three lymph nodes are negative for tumor. Tumor-free soft tissue containing vessels and nerves is also present. Pathologic staging is classified as pT2c with a maximum tumor diameter of 1.5 cm. Immunohistochemical analysis using D2-40 and CD31 stains showed no evidence of vascular invasion. Final classification includes: Gleason score 4+3=7 with tertiary grade 5 (Gleason 4 = 70%, Gleason 5 <5%), pT2c, pNO (0/3), R0, with no lymphovascular invasion identified. Intraoperative frozen section had shown minimal involvement at the resection margin (0.6 mm contact line), but this was not confirmed in the final preparation."} +{"pid": "TCGA-B5-A0K2", "report": "The specimen consists of a 114-gram hysterectomy with bilateral salpingo-oophorectomy. The endometrium shows a 3.1 x 2.1 cm area of heaped-up tissue located in the posterior region, which appears to extend approximately 2.6 cm into the myometrium, which is 3.2 cm thick. The lesion is tan, friable, and has poorly defined borders, coming within about 0.5 cm of the posterior lower uterine segment. No involvement of the cervix or extension into the adnexa is observed. The remainder of the endometrium is 0.2 cm thick and otherwise unremarkable.\n\nThe myometrium contains multiple firm, white, whorled nodules, with the largest measuring up to 1.7 cm. The cervix contains a 1 cm firm, white, whorled submucosal nodule. The posterior serosal surface of the uterus is covered with shaggy, tan-gray fibrous tissue, continuous with adhesions involving both adnexa. The right fallopian tube measures 3.5 cm in length and 0.6 cm in diameter and is unremarkable. No distinct right ovary is identified, but sectioning of the right adnexal soft tissue reveals several small chocolate cysts, up to 0.6 cm in size. The left fallopian tube, measuring 3.5 cm by 0.4 cm, is adhered to the anterior surface of the uterus. No definite left ovary is found, and the left adnexal soft tissue contains a 2.7 cm unilocular chocolate cyst affixed to the uterine fundus.\n\nLymph node specimens include a 6 x 5.8 x 1 cm aggregate from the left pelvis and a 5.8 x 4.5 x 1.5 cm aggregate from the right pelvis. Both were dissected for lymph node candidates. Thirteen nodes from the left and twelve from the right are negative for malignancy.\n\nMicroscopic evaluation confirms that the lesion in the posterior endomyometrium does not invade the myometrium despite initial concern. Multiple permanent sections show tumor nests within areas of adenomyosis, confirmed by CD10 immunostain showing surrounding endometrial stromal cells. Adjacent endometrium shows endometrial intraepithelial neoplasia. The remaining myometrium demonstrates extensive adenomyosis and multiple leiomyomas, with the largest measuring 1.7 cm. The cervix contains a 1 cm leiomyoma. Serosal surfaces show fibrovascular adhesions. Both fallopian tubes and adnexal tissues display endometriosis and fibrovascular adhesions. All specimen margins are free of involvement.\n\nFrozen section analysis initially suggested deep myometrial invasion, but this was revised on permanent sections. The change in interpretation was communicated to the referring physician via email."} +{"pid": "TCGA-55-6982", "report": "The histopathological examination included multiple specimens from various anatomical locations. A lymph node specimen from station 4, lower paratracheal region measured 1.0 x 1.0 x 0.4 cm and was found to be benign upon frozen section analysis. Another lymph node from the same station measured 1.0 x 0.8 x 0.4 cm and also showed no evidence of malignancy. A lung biopsy from the right lower lobe nodule measured 6.5 x 3.0 x 1.5 cm and contained a palpable 0.8 cm calcified nodule. The serosal surface exhibited anthracotic stippling, and the surgical margins were closed with metal staples. The calcified nodule was submitted for routine processing after decalcification.\n\nA lymph node specimen from station 9, pulmonary ligament measured 1.2 x 0.7 x 0.3 cm and was described as anthracotic; it was also found to be negative for malignancy. The main lung specimen from the right lower lobe measured 18 x 8 x 4.5 cm and showed anthracotic stippling on the serosal surface. A gray tan indurated area measuring 3.5 cm in greatest dimension was identified beneath a puckered, umbilicated region of the pleural surface. This lesion was located 1.2 cm from the nearest stapled margin. Frozen sections of the bronchial margins were performed, and the tumor nodule was sampled separately. The distance from the tumor to the closest bronchial margin was noted to be 0.5 cm. Additional sections included a 0.3 cm nodule separate from the primary lesion and a representative sample of normal-appearing lung tissue.\n\nA right hilar lymph node measuring 2.0 x 0.6 x 0.5 cm was described as anthracotic and found to be benign. Another lymph node from station 4, lower paratracheal region measured 1.5 x 0.8 x 0.3 cm in aggregate and was also negative for malignancy. A paraesophageal lymph node from station 8 measured 0.5 x 0.5 x 0.3 cm and was similarly benign.\n\nMicroscopic evaluation of the primary lesion revealed a poorly differentiated histology. The tumor measured 3.5 cm in greatest dimension and was classified as T2 based on size. Regional lymph node assessment showed involvement of one out of two nodes examined, specifically in the ipsilateral peribronchial and hilar regions, corresponding to an N1 stage. Distant metastasis could not be assessed. Surgical margins were free of invasive disease. Vascular invasion involving both venous and arterial systems was present, as was lymphatic vessel invasion. An additional finding of a calcified granuloma was noted in a peribronchial lymph node."} +{"pid": "TCGA-DX-A6BH", "report": "A 22 cm long spermatic cord is identified, with a small nodule measuring 1.2 cm in greatest dimension noted upon incision approximately 15 cm proximal to the testis. The testis measures 4.5 x 3.5 x 2 cm and demonstrates normal parenchyma on incision. A soft tissue mass measuring 8 x 6.5 x 6.4 cm is present within the specimen, located adjacent to the external iliac artery and vein, which are surrounded by this lesion. The tumor is found to be 0.5 cm from the superior margin of resection and extends to the superior, anterior, medial, and lateral margins. It also involves the psoas muscle and encases the external iliac vessels. The tumor has a firm, yellow appearance and constitutes at least 8.0 cm in its largest dimension. Microscopically, a high-grade pleomorphic component accounts for approximately 80% of the lesion. Adipose tissue with lipoma-like and sclerosing features is present within the spermatic cord. Three lymph nodes are identified as benign. The final left external iliac artery margin contains adipose tissue with morphologic changes and cautery artifact. Multiple sections are submitted from various areas including the tumor, margins, spermatic cord, testis, and surrounding tissue."} +{"pid": "TCGA-EJ-A46E", "report": "Lymph node specimens from the left and right pelvic regions showed no evidence of malignancy, with all nodes appearing benign. A total of nine lymph nodes were examined, six from the left and three from the right, none of which contained any cancerous cells.\n\nThe prostate specimen showed several distinct areas of abnormal cellular growth. The primary focus was identified in the right mid to base region of the prostate, with a maximal diameter of 1 cm. A secondary smaller focus, measuring 0.4 cm, was found in the right posterior mid-prostate. A separate focus was also identified in the left lateral apex, previously noted in a prior biopsy. The overall volume of the abnormal tissue comprised less than 5% of the sampled prostate gland.\n\nMicroscopic evaluation revealed nuclear features consistent with high-grade changes in some areas. Evidence of perineural involvement was present in multiple sections. No angiolymphatic invasion was observed. Surgical margins were entirely free of any abnormal cellular changes. The bilateral seminal vesicles and distal vasa deferentia appeared unremarkable.\n\nThe surrounding prostate tissue exhibited chronic inflammation, widespread glandular atrophy, and localized hemosiderin deposition suggestive of a prior biopsy site. A small organized thrombus was noted within a periprostatic vein.\n\nExtracapsular extension was observed focally in the right anterior mid region and more established in the right anterior base. All histologic and staging features were consistent with a localized process without evidence of distant spread."} +{"pid": "TCGA-RQ-A6JB", "report": "The specimen consists of a subgaleal mass composed of sheets of large, non-cohesive cells. The nuclei are enlarged, ranging from open to hyperchromatic, with shapes varying from rounded to angulated, cleaved, and lobulated. The cytoplasm is generally sparse. Scattered mitotic figures are present. No distinct differentiating features are identified. Immunohistochemical staining shows the neoplastic cells to be positive for CD45, CD20, and vimentin. Scattered T-cells (CD3 positive) and monocytes/macrophages (CD68 positive) are also present. The tumor cells are negative for cytokeratin, CD99, desmin, synaptophysin, S-100, and CD34."} +{"pid": "TCGA-FA-A86F", "report": "The specimen consists of two lymph nodes measuring 2x1.4 cm and 1 cm, respectively. Both are described as soft with hyperemia. Histologic examination reveals a morphologic pattern suggestive of involvement consistent with a malignant process affecting the lymph node structure. Immunohistochemical staining demonstrates positivity for CD45 and CD20cy in the tumor cells, while cytokeratin pan (AE1 and AE3), melanosome (HMB-45), chromogranin A (DAK-A3), CD3, and CD10 (tumor cells only) are negative. CD10 staining shows positivity within follicular centers. Ki67 labeling index is up to 40% in the tumor cells. There is no evidence of venous invasion or treatment effect. Surgical margins are uninvolved. The lesion appears to be localized to a single lymph node region without extensive spread."} +{"pid": "TCGA-UZ-A9PM", "report": "The surgical specimen consisted of a left kidney and associated perirenal fat from a male patient. The kidney measured 15.0 x 12.0 x 8.0 cm and was partially encapsulated by perinephric fat. A single oval tumor measuring 10.0 x 6.0 cm was identified within the kidney. It was located primarily in the posterior mid portion of the kidney and appeared to be entirely encapsulated without involvement of the renal pelvis or vascular pedicle. The tumor exhibited areas of necrosis, comprising approximately 40% of its mass.\n\nHistologic examination revealed a neoplasm composed predominantly of papillary structures with fibrovascular cores containing abundant foamy histiocytes. These histiocytes demonstrated strong positivity for CD68 on immunohistochemical staining. The papillae were lined by a single layer of low cuboidal to columnar cells with moderate nuclear enlargement and distinct nucleoli. Additional findings included granular cytoplasmic pigment within both tumor cells and histiocytes, suggestive of hemosiderin deposition. A minor component of solid and tubular architecture was also observed, characterized by larger cells with eosinophilic cytoplasm and prominent nuclei.\n\nImmunohistochemical stains were performed for diagnostic clarification. Cytokeratin staining highlighted the malignant epithelial cells, while CD68 staining confirmed the presence of foamy histiocytes within the stroma.\n\nMargins of resection were negative. The tumor did not penetrate the renal capsule and did not involve hilar veins, lymphatics, renal sinus, or ureter. No tumor was identified in the adrenal gland or perirenal fat. One avulsed area near the superior pole was examined and showed no tumor involvement.\n\nLymph nodes were not identified in the specimen. The closest margin measured 0.3 cm from the tumor. Based on these findings, the tumor was staged as pT2NOMX."} +{"pid": "TCGA-AA-3971", "report": "The resected colon specimen shows a centrally ulcerated, moderately differentiated lesion measuring up to 4.8 cm in diameter. There is extensive infiltration of the surrounding fatty tissue and two involved lymph nodes adjacent to the primary site. The resection margins, including the mesenteric margin, are free of involvement. Additionally, there are isolated tubular adenomas in the colonic mucosa with mainly moderate dysplasia. Staging assessment indicates involvement of the regional tissue and lymph nodes, with no evidence of vascular or lymphatic invasion. The histologic grade is intermediate, and all margins are negative."} +{"pid": "TCGA-CH-5769", "report": "The tumor was classified as pT3b with a maximum diameter of 3.3 cm. Histological evaluation revealed a Gleason score of 5+4=9, with Gleason 5 components accounting for 60% of the tumor. The tumor showed bilateral involvement of the prostate with infiltration into the periprostatic fatty tissue in the right apical and left basolateral regions, with a maximum invasion width of 1.5 mm and a depth of 0.3 mm. There was focal involvement of the left seminal vesicle extending to the surgical margin with a contact length of 1.6 mm. Multifocal perineural invasion was also observed. Immunohistochemical analysis demonstrated lymphovascular invasion (L1), but no evidence of blood vessel invasion (V0). A total of 9 lymph nodes were examined, all without evidence of metastasis (pN0, 0/8). Surgical margins were involved (R1). High-grade prostatic intraepithelial neoplasia and myoglandular hyperplasia were also present. The urethral urothelium showed no dysplastic changes. Two tumor blocks were analyzed using CD31 and D2-40 immunostains to assess vascular invasion; results confirmed lymphatic invasion but excluded vascular invasion."} +{"pid": "TCGA-ET-A3BQ", "report": "The specimen consists of a total thyroidectomy. The right lobe contains a unifocal nodule measuring 3.0 cm in greatest dimension. Histologic evaluation reveals cellular features consistent with the observed tissue. All two lymph nodes examined show no evidence of tumor involvement. Staging indicates the primary lesion is confined to the thyroid, measuring greater than 2.0 cm but less than 4.0 cm (pT2). No regional lymph node metastasis is identified (pN0), and distant metastasis cannot be assessed (pMx). Surgical margins are free of involvement, with the closest distance of the invasive component to the anterior surface margin measuring less than 1.0 mm. There is no evidence of venous or lymphatic invasion. Additional findings include mild lymphocytic thyroiditis and a small adenomatoid nodule in the right lobe measuring 0.3 cm."} +{"pid": "TCGA-FD-A3SM", "report": "The patient is a male who underwent a radical cystectomy with neo-bladder for a malignancy. The surgical specimens included multiple lymph node biopsies from the right and left pelvic regions, as well as the bladder, prostate, and right distal ureter.\n\nIn the right pelvic lymph node biopsy, eight lymph nodes were identified, all of which were negative. In the left pelvic region, one out of one lymph node was positive, and in a second biopsy from the same area, 3 out of 16 lymph nodes were also positive. No extranodal extension was observed in any of the involved nodes.\n\nThe bladder and prostate specimen measured 16.5 x 11.5 x 5.5 cm, with the bladder portion measuring 9.0 x 8.5 x 4.0 cm. A large mass was present, measuring 9 x 6.5 x 3 cm, and was located on the dome, right and left lateral walls, anterior wall, and part of the posterior wall. The mass was firm to friable, gray-tan in color, and had areas of necrosis. Histologically, the tumor invaded the muscularis propria and reached the deep soft tissue margin, with a maximum wall thickness of 3.0 cm. The tumor was located 3.5 cm from the urethral margin. Ureteral margins and the distal urethral margin were free of tumor involvement. The surrounding bladder mucosa appeared normal with a uniform wall thickness of 1.1 cm. The prostate did not show any evidence of tumor involvement.\n\nLymph node assessment showed 4 out of 17 left pelvic lymph nodes involved, while the right pelvic lymph nodes (0 out of 8) were uninvolved. The staging classification was pT3a, N2, based on the AJCC and UICC TNM system. The right distal ureter specimen, marked with a stitch on the non-margin side, showed no evidence of tumor. The submitted margins, including the apical prostatic margin, were all negative. The serosal or soft tissue margin was also negative, although it was less than 1 mm from the cauterized and inked margin.\n\nGross and microscopic evaluations of the prostate, seminal vesicles, and vasa deferentia revealed no signs of tumor. Multiple sections of the bladder mass and surrounding tissue were submitted for analysis, along with representative sections of the prostate and uninvolved mucosa. Intraoperative frozen section of a left pelvic lymph node confirmed the presence of carcinoma."} +{"pid": "TCGA-L5-A4OP", "report": "The specimen consists of a 4 cm length of esophagus and an attached 7.5 x 11 cm portion of proximal stomach. A polypoid mass measuring 3.5 x 3 x 2.2 cm is identified at the gastroesophageal junction. The tumor extends 1.5 cm superiorly into the esophagus, with the proximal extent of the tumor located 2.5 cm from the proximal surgical margin. The distal margin (stomach) is 6 cm from the tumor. The esophageal adventitia and gastric serosa appear unremarkable. On sectioning, the tumor erodes through the mucosa but does not invade into muscular layers.\n\nA total of eleven lymph nodes were examined, all of which showed no evidence of neoplastic involvement. Two lymph nodes were initially reported as negative, and additional sections revealed nine more lymph nodes, also negative for neoplasm.\n\nHistologically, the tumor is described as moderately differentiated and arises in Barrett\u2019s mucosa. The depth of invasion is limited to the lamina propria. Resection margins are free of involvement. No preoperative treatment was administered.\n\nAdditional specimens include a 1 cm section of cervical esophagus submitted en face. No metastatic involvement is identified in the lymph nodes examined. Distant metastasis status remains unknown. An incidental finding of a smooth muscle lesion is noted. All findings are based on personal examination and interpretation by the signing staff pathologist."} +{"pid": "TCGA-CG-4441", "report": "The specimen consists of a total gastrectomy preparation with an ulcerated lesion located in the mid-portion of the stomach along the greater curvature. The lesion extends to involve both the anterior and posterior walls, approaching within 5 cm of the oral resection margin and 11.5 cm of the aboral resection margin. The maximum tumor diameter measures 8 cm. Histologically, the lesion is composed of moderately differentiated glandular structures.\n\nThe tumor infiltrates through all layers of the gastric wall, reaching the serosa and extending into the perigastric adipose tissue. Lymphatic invasion is noted at the tumor margins. Margins of resection, including the greater omentum, show no involvement. Examination of regional lymph nodes reveals metastatic involvement in 14 out of 16 nodes, with extracapsular extension observed in some. \n\nIn the antral mucosa, there are findings of chronic gastritis with varying degrees of inflammation, foveolar hyperplasia, intestinal metaplasia, and focal mucosal atrophy. No Helicobacter pylori organisms are identified. Based on the extent of primary tumor invasion and nodal involvement, the staging is classified as pT2b and pN2 (14/16)."} +{"pid": "TCGA-A5-A7WK", "report": "The surgical specimen included the uterus, cervix, bilateral fallopian tubes, and ovaries. The uterine dimensions were 9.0 x 7.8 x 7.5 cm, with a separate cervix measuring 4.6 cm in length. A mass was identified within the uterine corpus and fundus, measuring 6.5 x 5.3 x 2.5 cm, with a tan, soft, and friable appearance. The configuration of the mass was predominantly exophytic. Microscopic evaluation showed a mixed histologic pattern with two components, one being the predominant type (>90%) and the other a minor component (<10%). The predominant component was FIGO grade 2, while the minor component was grade 3. Tumor involvement was noted in the uterine fundus, anterior and posterior corpus, and focally extended into the lower uterine segment. There was minimal superficial myometrial invasion, involving less than 50% of the wall thickness. No lymphatic or vascular invasion was identified. Cervical tissue was free of tumor involvement. No evidence of metastasis was found in the ovaries, fallopian tubes, or any of the excised soft tissue specimens designated as lymph nodes, including right and left pelvic, and para-aortic regions. Two benign leiomyomas were present, with the largest measuring 5.0 x 4.5 x 4.2 cm. Adenomyosis was also identified in both the inner and outer layers of the uterine musculature. The endometrium was non-neoplastic and displayed inactive to weakly proliferative changes. The cervix contained a benign polyp and showed additional findings of acute and chronic inflammation, reactive epithelial changes, reserve cell hyperplasia, squamous metaplasia, and nabothian cysts. Both ovaries showed atrophic changes and cystic epithelial inclusions. The right fallopian tube demonstrated focal epithelial hyperplasia, while the left had serosal adhesions and a small paratubal mesothelial cyst. Gross and microscopic evaluations of all surgical margins were negative for tumor. Immunohistochemical staining of the neoplastic cells showed positive nuclear staining for p53 in most cells, loss of normal PTEN expression, and variable estrogen receptor positivity. Ki-67 staining showed a proliferation index of more than 60%. Based on AJCC 7th edition criteria, the primary tumor was classified as pT1a, with no regional lymph node involvement (pNX). The case was reviewed and confirmed by an additional pathologist, and no unequivocal lymphovascular space invasion was identified. A minor typographical correction was made in the staging summary, with no change to the final diagnostic interpretation."} +{"pid": "TCGA-DU-8162", "report": "The specimen consists of excised brain tissue from the right temporal region. Gross examination revealed four fragments measuring 1.5 cm in aggregate, with a semi-firm, greyish-white appearance. Microscopically, the tissue shows hypercellularity with moderate to heavy infiltration by a neoplastic glial proliferation. The tumor cells exhibit an intermixed oligoastrocytic phenotype. Focal areas demonstrate brisk mitotic activity, with up to seven or more mitoses per ten high-power fields. No microvascular proliferation or necrosis is present. Immunohistochemical analysis reveals prominent gliofibrillogenesis on GFAP staining, and a notable population of neoplastic cells shows overexpression of p53 protein. The Ki-67 (MIB-1) labeling index ranges from 5% to 8% in the more active regions.\n\nGenetic testing for loss of heterozygosity (LOH) at chromosomes 1p and 19q was performed using microdissected tumor DNA and a panel of microsatellite markers. The results were negative, with no evidence of allelic loss detected at these loci. Informative markers included D1S548, D1S1592, D1S552 for chromosome 1p and D19S219, D19S412, PLA2G4C for chromosome 19q. The presence of normal tissue within the sample may have affected the sensitivity of the assay. Additionally, molecular analysis for MGMT promoter methylation status was also negative. This assessment was conducted using bisulfite-modified DNA followed by real-time PCR amplification. The assay has an analytic sensitivity of detecting 1% methylated DNA in an unmethylated background, though factors such as non-neoplastic cell contamination or extensive necrosis may limit detection.\n\nIntraoperative evaluation included both touch preparations and frozen sections. Cytologic smears showed features consistent with a diffusely infiltrating glioma, including abnormal vascular structures. Frozen section analysis confirmed hypercellular brain tissue with atypical nuclei, indicative of a neoplastic process. All controls for immunostaining showed appropriate reactivity. The histopathological findings were confirmed on permanent sections, which were consistent with the initial intraoperative diagnosis."} +{"pid": "TCGA-DU-A6S6", "report": "A 4.5 x 3.5 x 1.3 cm aggregate of four irregularly shaped gray-tan fragments of brain tissue was received, with larger fragments sectioned. Microscopic examination revealed a moderately cellular glial neoplasm diffusely infiltrating the cerebral cortex and white matter. The neoplastic cells were primarily round with some elongated forms in the white matter, showing slight pleomorphism. Focal hypercellular areas, or \"proliferation centers,\" were noted along with perinuclear halos and one area of microcystic change. Mitotic figures were sparse. The MIB-1 proliferation index was approximately 4% in more active regions. No microvascular proliferation or necrosis was identified. GFAP staining showed sparse glial fibrillogenesis, with focal features resembling gliofibrillary oligodendrocytes. Around 20% of the neoplastic cells demonstrated overexpression of p53 protein. Molecular testing for MGMT promoter methylation was negative. Multiple histologic sections were evaluated, with immunohistochemical stains performed to support the findings."} +{"pid": "TCGA-BP-4807", "report": "The clinical history indicates a right renal mass. The submitted specimen was a right kidney partial nephrectomy. The tumor measured 1.9 cm in greatest diameter and was well circumscribed, with a golden-yellow to orange appearance on gross examination. The surgical specimen measured 4.0 x 2.1 x 2.0 cm and was wedge-shaped with a suture marking the deep margin, which was inked black. The tumor was located approximately 0.2 cm from the resection margin. A representative section of the margin was submitted for frozen section analysis, which confirmed the margin to be free of tumor.\n\nMicroscopic evaluation showed a nuclear grade III/IV neoplasm of renal cortical epithelial origin. No local invasion or renal vein involvement was identified. The non-neoplastic kidney tissue was unremarkable. Adrenal and lymph node tissues were not present in the specimen. Staging criteria indicate the lesion is confined to the kidney and measures less than 7.0 cm in greatest dimension. The surgical margins were free of tumor. Representative sections of the tumor, margin, and surrounding renal tissue were submitted for further analysis. Intraoperative consultation confirmed the tumor type and clear margin."} +{"pid": "TCGA-BQ-7044", "report": "The left kidney and adrenal gland specimen was submitted for analysis. The kidney measures 14 cm in superior-inferior dimension, 10 cm anterior-posterior, and 9.5 cm medial-lateral. The attached adrenal gland measures 4.5 x 2 x 0.7 cm and appears unremarkable on gross examination. The combined specimen weighs 720 grams. Upon bisection, a necrotic mass is identified within the cortical region of the kidney. The mass measures 10 x 6 x 5 cm and is largely composed of brown necrotic tissue centrally. Peripheral areas show soft yellow to dark red tissue. The lesion appears encapsulated and well-demarcated but demonstrates focal infiltration into adjacent adipose tissue at its superior aspect. The tumor extends through the renal capsule but remains confined within Gerota\u2019s fascia. No evidence of renal vein involvement is observed. Surgical margins, including those of the vein and ureter, are free of abnormal tissue. Microscopic evaluation reveals cellular features including regions of spindle cell morphology and extensive necrosis. Sections from the non-neoplastic kidney and adrenal gland show no significant abnormalities."} +{"pid": "TCGA-42-2591", "report": "The specimen included the right and left fallopian tubes and ovaries, uterus and cervix, omentum, omental lymph node, right gutter peritoneal biopsy, para-aortic lymph node, right pelvic lymph node, and left pelvic lymph node. Pre-operatively, ovarian cancer was suspected.\n\nThe right fallopian tube and ovary measured 18.5 x 13.5 x 9.7 cm and weighed 441 grams after fixation. The specimen was cystic with a bosselated surface, containing multiloculated brown fluid and friable yellow-white debris. Papillary projections up to 14 cm were present, along with a solid component making up approximately 40% of the volume. The fallopian tube was 7.5 cm in length and ranged from 0.3 to 0.7 cm in diameter. No residual ovarian stroma was identified. Multiple sections were submitted for analysis.\n\nThe left fallopian tube and ovary measured 17.5 x 15.5 x 7.9 cm and weighed 1188 grams post partial incision and fixation. It was predominantly solid with a glistening to chalky tan-white-yellow-red appearance, with scattered cystic locules containing serous fluid. Soft tan-pink papillations were noted within the larger locules. The fallopian tube was 4.5 cm long and averaged 0.5 cm in diameter. No residual ovarian stroma was found, and multiple sections were submitted.\n\nThe uterus and cervix weighed 93 grams and measured 6.5 x 5.0 x 4.0 cm. The uterine corpus was symmetrical with a smooth to slightly fibrous serosa. The cervix was 3 cm in length with a patent os. The endometrial cavity was triangular, measuring 3 x 2.5 cm, and lined by flat pale tan-pink endometrium. The myometrium was smooth and pale pink-tan, measuring up to 2.4 cm in thickness. No fibroids were identified. Representative sections of the serosa, cervix, and endomyometrium were submitted.\n\nThe omentum measured 41.0 x 8.5 x 1.0 cm and consisted of soft lobulated adipose tissue. No discrete mass was observed, and random sections were submitted.\n\nThe omental lymph node was an irregular piece of adipose tissue measuring 7.6 x 3.5 x 1.0 cm, with a rubbery tan-white nodule measuring 2.0 x 1.4 x 0.7 cm. Lymphoid tissue was not present, and the entire specimen was submitted.\n\nThe right gutter peritoneal biopsy was a small fragment of soft tan-pink membranous tissue measuring 3.1 x 2.3 x 0.2 cm, focally cauterized and entirely submitted.\n\nThe para-aortic lymph node specimen included six lymph nodes, the largest measuring 3.5 cm. One of six nodes showed involvement. The right pelvic lymph node specimen contained eight lymph nodes, all negative for involvement. The left pelvic lymph node specimen included fifteen lymph nodes, one of which was involved.\n\nMicroscopically, the tumor demonstrated a prominent micropapillary pattern. Tumor was present in both ovaries and on their surfaces. The fallopian tubes were free of tumor in both specimens. The omental lymph node, right gutter peritoneal biopsy, and para-aortic lymph node showed evidence of tumor involvement. The omentum itself did not show tumor but had chronic inflammation and reactive mesothelial changes. The endometrium was atrophic, and the cervix showed signs of inflammation and reactive change.\n\nTumor was identified in the pelvis beyond the ovaries, including the omental lymph node. Distant metastases were noted in lymph nodes with dimensions 14x2, 15x2, 3x5, and 4x4 mm. Based on the extent of spread, the TNM (FIGO) classification was determined as pT3C."} +{"pid": "TCGA-BR-8289", "report": "The excised gastric specimen involved a tumor located in the fundus measuring 12 x 9 x 2.5 cm. Microscopic evaluation revealed a poorly differentiated adenocarcinoma of intestinal type morphology. The tumor was found to involve the lesser omentum and all 11 retrieved intraabdominal lymph nodes showed metastatic involvement. No information was provided regarding lymphatic, venous, or perineural invasion. Surgical margins were free of tumor involvement. Additional findings included evidence of liver metastasis and HER2 immunohistochemistry showed a 2+ staining pattern. No prior neoadjuvant treatment effect was identified."} +{"pid": "TCGA-EL-A3CP", "report": "The specimen consists of a total thyroidectomy and a biopsy of the right inferior parathyroid. The thyroid gland was not enlarged and contained a well-circumscribed 1.1 cm mass located in the superior aspect of the right lobe. The mass extended to the surface of the specimen and had a solid tan cut surface. No lymphatic invasion was identified. Histologic evaluation showed that the tumor extended to the surgical margin; however, adjacent soft tissue was not available to assess for possible extension beyond the thyroid. The remaining thyroid tissue appeared unremarkable. The parathyroid biopsy consisted of three soft pink-tan fragments measuring 0.4 x 0.3 x 0.1 cm in aggregate. Frozen section analysis confirmed parathyroid tissue."} +{"pid": "TCGA-G9-6351", "report": "The prostate specimen weighed 34 grams and measured 4.5 cm in width from right to left, 4.0 cm from anterior to posterior, and 3.2 cm from apex to base. The capsule was smooth and intact, with ink applied to various regions. After removal of the apex and base, the remaining prostate weighed 15 grams. Serial sectioning revealed firm tan fibrous parenchyma without identifiable lesions or nodules. Attached seminal vesicles and vas deferens were also examined; the right and left seminal vesicles measured 3.0 x 1.0 x 1.0 cm and 4.5 x 1.0 x 1.0 cm, respectively, and showed no gross evidence of tumor involvement. The vas deferens segments measured 0.6 x 0.5 cm and 4.0 x 0.6 cm, and displayed normal histological features.\n\nMicroscopic evaluation of multiple sections identified a focus at the left posterior capsule near the apex. Perineural invasion was noted. No extraprostatic extension was observed. Bilateral seminal vesicles were free of abnormal cellular infiltration. Histological assessment of gland involvement showed approximately 10\u201315% of the prostatic tissue affected. Cellular morphology demonstrated Gleason pattern 3+4 (7/10). High-grade intraepithelial neoplasia was present. No vascular or lymphatic invasion was identified. Margins were generally negative except for a focal area at the left posterior capsule. The distance of involvement was limited to less than 10 mm.\n\nSections submitted included multiple levels from the right and left lobes, covering anterior and posterior aspects at different levels, as well as areas around the urethral margin and lateral base. Both seminal vesicles and vas deferens were submitted for evaluation. No lymph nodes were sampled. Additional findings included benign prostatic hyperplasia. Pathologic staging was assigned as pT2c, N\u00d7, M\u00d7. A review of the margin involvement indicated possible artifact due to surgical manipulation during removal."} +{"pid": "TCGA-05-4427", "report": "The resected specimen demonstrates a peripherally located lesion with central extension. Histological evaluation reveals a predominantly undifferentiated component composed of large-cell and polymorphocellular features arranged in a solid growth pattern. Focal areas exhibit clear-cell morphology. A potential for neuroendocrine differentiation is noted, although immunohistochemical studies show negativity for synaptophysin and NCAM. The tumor invades the adjacent visceral pleura to a limited extent. Lymph node involvement is present in the bronchopulmonary and hilar regions, while other sampled hilar and non-hilar lymph nodes are unremarkable. Immunostaining reveals a high expression of low molecular weight keratins, with a subset also expressing high molecular weight keratins. A significant proportion of cells expresses TTF1. Based on the available material, staging is pT2 pN1 R0, corresponding to stage IIB."} +{"pid": "TCGA-AN-A0FW", "report": "Female patient underwent radical mastectomy for a tumor located in the left breast. The tissue specimen was collected in frozen format using a cryomold. Histological analysis showed Grade 2 morphology with no replacement or placeholder text used. Staging was determined as T Stage 2, N Stage 1, and M Stage 0. No prior treatment was administered. A normal blood sample was also collected via blood draw and stored in frozen format in a tube."} +{"pid": "TCGA-BK-A0CA", "report": "The specimen included the uterus, cervix, bilateral fallopian tubes and ovaries, vaginal cuff, right pelvic and periaortic lymph nodes, left pelvic lymph nodes, and omentum. The uterus measured 4.5 x 2.5 x 1.2 cm and showed a pink-tan endometrial cavity filled with an exophytic irregular growth that appeared larger on the posterior wall and extended within 3.5 cm of the cervical os. No discrete invasion into the myometrium was observed grossly, with a myometrial thickness of 1.7 cm. The right ovary measured 2.2 x 0.7 x 0.5 cm and the left ovary 2.5 x 1.7 x 1.5 cm; both showed a pink-tan mottled cut surface. The fallopian tubes showed signs of prior ligation and measured on average 3.5 x 0.7 cm.\n\nThe vaginal cuff biopsy was a soft tan-white to pink tissue measuring 1 x 0.8 x 0.25 cm. The right pelvic lymph node specimen was an aggregate of adipose and lymphoid tissue measuring 5.8 x 4.0 x 1.6 cm, with lymph nodes up to 3.3 cm in size. The periaortic lymph node specimen measured 9.2 x 7.5 x 3 cm and contained multiple lymph nodes, some showing grossly positive tan-white cut surfaces. The largest measured 7.5 cm. The left pelvic lymph node specimen measured 4.0 x 3.8 x 1.5 cm with lymph nodes up to 3.6 cm. The omentum measured 15.5 x 11 x 4 cm and showed no gross abnormalities.\n\nMicroscopically, mixed histologic features were noted in the uterine specimen. There was extensive involvement of the myometrial wall to a depth of 2.2 cm, although this was difficult to assess due to widespread vascular space invasion. Immunohistochemical staining supported the presence of full-thickness myometrial involvement. The cervix was extensively involved. Vascular invasion was prominent. Serous carcinoma was identified bilaterally in parametrial tissues, and the left ovary showed extensive involvement with associated tubo-ovarian adhesions. The right ovary and both fallopian tubes showed no tumor. The vaginal cuff biopsy revealed no malignant cells.\n\nLymph node analysis showed metastatic involvement in the right pelvic lymph nodes (3 of 8), the paraaortic lymph nodes (29 of 32), and all 6 left pelvic lymph nodes examined. The omentum showed no evidence of tumor involvement."} +{"pid": "TCGA-E2-A15P", "report": "The specimen includes a right breast needle localization and two sentinel lymph nodes from the right axilla. The breast specimen is 3.5 x 3.1 x 3.1 cm with oriented sutures and inked margins. On serial sectioning, a 1.5 x 1.3 x 1.1 cm firm tan stellate mass was identified closest to the posterior margin at 0.5 cm. Multiple tissue sections were submitted for microscopic evaluation, including perpendicular sections of the superior and inferior margins and various slices through the mass.\n\nThe sentinel lymph nodes measured 2 x 1 x 0.8 cm and 1 x 0.8 x 0.5 cm respectively, and both were entirely submitted for analysis. Touch preparations were performed and showed no abnormal findings.\n\nMicroscopic evaluation of the breast tissue revealed an infiltrating lesion with associated in situ changes. Nuclear grade was intermediate, and no vascular or lymphatic invasion was observed. A separate benign fibroadenoma measuring 0.2 cm was also identified, along with biopsy site changes including fibrosis and a foreign body giant cell reaction.\n\nMargins of resection were uninvolved. A small focus of in situ change, solid type, was present in association with the main lesion, accounting for approximately 10% of the sampled area. Immunohistochemical staining for hormone receptors was positive for estrogen and progesterone receptors. HER2 testing by immunohistochemistry was negative.\n\nSentinel lymph node evaluation demonstrated no evidence of metastatic involvement in either lymph node examined. Pathologic staging was determined as pT1c N0 based on the AJCC Cancer Staging Manual, 7th Edition. Oncotype DX testing yielded a recurrence score of 22, with ER score of 11.1 (positive), PR score of 4.4 (negative), and HER2 score of 10 (negative)."} +{"pid": "TCGA-AG-3611", "report": "The specimen includes a segment of the rectosigmoid colon with a lesion measuring up to 3.5 cm in maximum diameter, extending to within 2.5 cm of the resection margin. Histological examination reveals moderately differentiated features. The lesion infiltrates through all layers of the intestinal wall and extends into adjacent mesocolic or perirectal adipose tissue.\n\nIn addition, the colon shows a tubulovillous lesion measuring 3 cm in diameter located in the mucosa, with areas of marked epithelial dysplasia (equivalent to high-grade intraepithelial neoplasia). There is also a smaller tubular lesion measuring 0.8 cm in diameter with similar dysplastic changes.\n\nBoth proximal and distal resection margins are free of abnormal tissue. A total of ten regional lymph nodes are present and show no signs of involvement; they exhibit nonspecific reactive changes. Vascular invasion is noted, while lymphatic invasion is not observed. Surgical margins are clear."} +{"pid": "TCGA-63-A5MM", "report": "The sample was collected from a patient following a resection procedure. The tissue measured approximately 4.3 cm and was described as histologically consistent with squamous carcinoma, grade III. Pathological staging indicated T2a and N1 classifications, with no evidence of distant metastasis. The tumor was located in the left upper and lower lobes. Additional samples, including a buffy coat specimen, were also collected. No further diagnostic or clinical staging details were provided."} +{"pid": "TCGA-AO-A1KR", "report": "A 45-year-old female underwent bilateral mastectomies and right sentinel node biopsy following a core biopsy of the right breast showing malignant features and left breast showing atypical changes. Specimens included lymph nodes from the right axilla and both breasts.\n\nSentinel lymph node biopsies from level I and level II of the right axilla, as well as non-sentinel lymph nodes from the same region, were all benign. No evidence of metastatic disease was identified in any of the lymph nodes examined. Frozen section analysis and permanent sections confirmed the absence of tumor involvement.\n\nThe right breast specimen measured 24 x 23 x 3.5 cm with an overlying skin ellipse of 16 x 8.5 cm. A stellate mass measuring 2.4 cm in greatest dimension was identified microscopically in the upper inner quadrant. Histologic evaluation revealed poorly differentiated ductal carcinoma with high nuclear grade (grade III), extensive necrosis, and no vascular invasion. Surgical margins and nipple were free of invasive disease. Lobular carcinoma in situ (classical type) was also present. Non-neoplastic findings included fibrocystic and fibroadenomatoid changes, focal microcalcifications in benign ducts, and a fibroadenoma with myxoid stroma measuring 0.8 cm. Immunohistochemical staining showed no nuclear staining for ER, weak positivity for PR, and negative HER2 staining (intensity 1+).\n\nThe left breast specimen measured 24 x 19 x 2.8 cm with an overlying skin ellipse measuring 16 x 3.9 cm. Histologic examination revealed usual ductal hyperplasia without atypia, columnar cell changes, adenosis, and stromal fibrosis. Microcalcifications were noted in benign ducts, along with biopsy site changes. The nipple and skin appeared unremarkable.\n\nAll surgical margins in the right breast were free of tumor involvement. No skin or nipple involvement by either in situ or invasive disease was observed in either breast."} +{"pid": "TCGA-05-4430", "report": "The lesion is located in the left lower lobe of the lung, with a predominant growth pattern characterized by acinar structures and a minor component of large-cell solid morphology. Additional findings include a bronchioloalveolar pattern of spread at the tumor periphery. The primary lesion is classified as pT2, with no evidence of lymph node involvement (pN0). Distant metastasis could not be assessed (pMX). The resection was complete (R0), with all margins\u2014including bronchus, vessels\u2014and all removed lymph nodes free of tumor. Infiltration of the visceral pleura is noted. Based on these findings, the staging is consistent with stage IB according to the TNM classification system."} +{"pid": "TCGA-B6-A0IP", "report": "A fragment of fibroadipose tissue was received, measuring 7.3 x 4.4 x 2.5 cm, and contained a previously sectioned area. Within this specimen, a distinct lesion was identified, measuring approximately 1.7 x 1.6 x 1.4 cm. The lesion was firm with a stellate, well-defined appearance and yellow-tar discoloration. No additional focal lesions were found in the remaining tissue. A second specimen, consisting of the left breast and axillary dissection, weighed 701.6 grams and measured 35 x 18.3 x 3.0 cm in total. The breast portion measured 21.1 x 18.3 x 3.0 cm, while the axillary component measured 7.5 x 6.5 x 1.5 cm. The overlying skin measured 19 x 8.2 cm as an elliptical piece, with the nipple located slightly inferior and medial on the surface. The nipple appeared retracted with a crusted surface, measuring approximately 1 cm in diameter, surrounded by a 3.5 cm areola. A 7.5 cm surgical incision was noted superior to the nipple. The surgical margin was marked with blue ink, and upon sectioning, a biopsy cavity was identified, measuring approximately 7.5 x 6.5 x 6 cm, lined by soft hemorrhagic adipose tissue. The closest deep surgical margin was within 0.5 cm of the cavity, and the closest inferior soft tissue margin was 12.5 cm away. No identifiable lesion was observed grossly within the mastectomy specimen. The remainder of the breast tissue consisted of soft lobulated fibroadipose tissue with minimal pink-tan fibrous breast tissue.\n\nMultiple lymph node candidates were identified in the distal third of the axillary dissection, ranging from 0.5 to 3.2 cm in size. A total of 16 lymph nodes were evaluated, and no evidence of malignancy was found. Histological examination of the original lesion showed invasive carcinoma without lymphatic or vascular invasion. The invasive component measured 1.7 cm. There was no multifocal tumor involvement. An in situ component was present, occupying less than 5% of the lesion, and was classified as lobular type. Extensive intraductal involvement was not present. Evaluation of non-neoplastic breast tissue revealed proliferative fibrocystic changes with atypia, intraductal papilloma, and microcalcifications associated with benign breast tissue. Surgical margins of the mastectomy were negative for tumor involvement. Hormone receptor analysis demonstrated estrogen receptor positivity with an estimated FMOL value of 154 and progesterone receptor positivity with an estimated FMOL value of 106. The surgical margin of the initial biopsy specimen was not assessed due to the concurrent mastectomy procedure. Residual evaluation of the mastectomy specimen did not reveal infiltrating or in situ carcinoma. Microcalcifications were also found in association with atypical ductal hyperplasia. Nipple and skin margins were free of tumor, and muscle was not sampled."} +{"pid": "TCGA-B8-A54K", "report": "The right kidney partial nephrectomy specimen consists of a 3 x 2.5 x 2.0 cm tissue sample weighing 8.5 grams. The tumor is located in the lower pole and measures 2.0 x 1.5 x 2.5 cm. It is described as a well-circumscribed, heterogeneous solid red/tan multicystic mass confined to the kidney. Histologic evaluation reveals a neoplasm composed of clear cells with focal papillary architecture. Nuclear grading according to Fuhrman classification shows grade 1 features. No sarcomatoid differentiation is identified. The tumor does not extend beyond the renal capsule and there is no evidence of vascular or lymphatic invasion. Surgical margins are negative. No involvement is seen in the surrounding perirenal adipose tissue, which appears unremarkable on microscopic examination. No additional lymph nodes or adrenal tissue were present for evaluation. Based on available findings, staging is assigned as pT1a, though this may be subject to revision pending further clinical correlation. Representative sections of the tumor and overlying adipose tissue have been submitted for analysis."} +{"pid": "TCGA-BF-A1PU", "report": "The specimen was obtained from a female patient of Caucasian ethnicity. Tissue was collected from the skin and preserved in frozen format. Histological evaluation showed a cellular composition consistent with a pigmented lesion. The tissue sample weighed 200 mg and was placed in one container. Microscopic analysis revealed atypical melanocytes with nuclear atypia and increased mitotic activity. No lymph node involvement or distant metastasis was identified. The lesion demonstrated a vertical growth phase with a thickness of 2a mm. A blood sample was also collected, amounting to 4 mL, and stored in a separate tube. No abnormal cells were detected in the blood specimen. The tissue was processed using a standard cryomold technique. Cellular features included epithelioid morphology with moderate pleomorphism. Tumor cells occupied approximately 85% of the tissue specimen."} +{"pid": "TCGA-E9-A249", "report": "The lumpectomy specimen from the left upper outer quadrant contains a grossly evident lesion measuring 2 \u00d7 0 \u00d7 2.5 cm. Histologic evaluation reveals moderately differentiated cellular features. Lymph node assessment shows no evidence of metastatic involvement, with all 10 axillary nodes negative. Surgical margins are uninvolved. Cellular differentiation characteristics including tubule formation, nuclear pleomorphism, and mitotic counts were not specified, therefore a comprehensive Nottingham Histologic Score could not be determined. There is no indication of lymph node extracapsular extension or neo-adjuvant treatment effect. No additional pathologic findings or comments are noted."} +{"pid": "TCGA-AR-A0TZ", "report": "The specimen consists of a left modified radical mastectomy. Five masses are present in the left breast, with the largest located in the upper outer quadrant, measuring 3.2 x 2.7 x 2.3 cm. Additional nodules are found inferiorly and just superior to the main mass, ranging from 0.5 cm to 0.8 cm in diameter. Histologic evaluation shows Nottingham grade II features. A component of intraductal proliferation is observed, comprising approximately 10% of the total lesion, with cribriform architecture and intermediate nuclear grade. The skin, nipple, and deep margins show no evidence of involvement. Of the 30 left axillary lymph nodes examined, 6 contain metastatic disease, including 2 matted nodes. Immunohistochemical testing for HER2/neu has been initiated on paraffin-embedded tissues."} +{"pid": "TCGA-CU-A5W6", "report": "The specimen consists of a cystoprostatectomy, with the bladder measuring 6.0 x 5.8 x 3.8 cm and the prostate measuring 4.7 x 4.2 x 3.0 cm. Two distinct masses were identified. Mass A measures 3.4 x 2.2 x 1.2 cm and is located in the left lateral wall extending to the dome of the bladder. Mass B measures 1.2 x 1.1 x 0.3 cm and is located in the right lateral wall. Both masses appear yellow/tan, ulcerating, and slightly necrotic. \n\nMicroscopically, the tumor invades through the muscularis propria. The tumor is multifocal, involving the right and left lateral walls and dome of the bladder. Angiolymphatic space invasion is present. There are associated epithelial lesions including urothelial dysplasia at the left ureterovesical junction and in situ changes within prostatic ducts. No tumor was found in the ureters. Surgical margins, including the urethra, ureters, and paravesicular soft tissue, are all negative.\n\nA total of eight lymph nodes were examined (two from the left pelvic region and six from the right), and none showed evidence of tumor involvement. The prostate shows no stromal invasion but has in situ changes in focal areas. Biopsy site changes and granulomas in the prostatic urethra suggest prior biopsy.\n\nThe pathologic staging is assessed as pT3 pN0. This assessment is based on available data and may be subject to revision after clinical review."} +{"pid": "TCGA-UD-AAC1", "report": "The specimen consists of a triangular piece of pleural tissue measuring 100mm x 70mm with a thickness of up to 15mm. The surfaces are nodular, irregular, and show areas of haemorrhage. The pleura tapers toward one end, which measures up to 35mm. A cut through the thickened region reveals a lobulated and whorled grey-tan to yellowish cut surface. The tissue is sliced from the thicker end to the thinner end, with relatively uniform appearance across slices (A-G 7x1, H 1xM).\n\nMicroscopic examination reveals extensive infiltration by a malignant tumor. The tumor forms nests and poorly defined glandular structures, composed of epithelioid cells with round nuclei, prominent nucleoli, and abundant eosinophilic cytoplasm. The tumor extends from the pleural surface through adipose tissue and reaches the deep margin of the biopsy. Geographic areas of necrosis are present, and a focal papillary pattern is observed along the surface.\n\nImmunohistochemical staining demonstrates strong positivity for Cam5.2 and calretinin, weaker staining for CD5/6, and no reactivity with CEA or BerEp4."} +{"pid": "TCGA-S3-AA15", "report": "A female patient underwent a right mastectomy with axillary lymph node dissection along with sentinel lymph node biopsy. The sentinel lymph node specimen consisted of one lymph node measuring 3.5 x 2 x 2 cm, which was entirely submitted for evaluation. During intraoperative consultation, the sentinel lymph node was found to be positive for carcinoma.\n\nThe mastectomy specimen included skin and nipple and measured up to 30 cm in greatest dimension. Histologic examination revealed an invasive lesion measuring 1.1 cm in greatest dimension located in the upper inner quadrant. The tumor extended to within 5 mm of the posterior resection margin. Histologic grade was determined as high-grade (Grade 3), characterized by poor glandular differentiation (score of 3), marked nuclear pleomorphism (score of 3), and a mitotic count score of 2 (17 mitoses per 10 high-power fields). Lymphovascular invasion was identified. There was no involvement of the anterior margin by invasive carcinoma.\n\nIn addition to the invasive component, there was also a focus of high-grade ductal carcinoma in situ with focal necrosis. This extended beyond 5 mm from the closest posterior margin. No dermal lymphovascular invasion was observed.\n\nEvaluation of the axillary lymph nodes included a total of 13 lymph nodes: one sentinel and twelve nonsentinel nodes. Of these, one sentinel lymph node contained macrometastatic involvement measuring 0.9 cm and one nonsentinel lymph node demonstrated micrometastatic involvement measuring 0.21 mm. No extranodal extension was identified. Sentinel lymph nodes were evaluated using hematoxylin and eosin staining at one level.\n\nBased on pathological findings, staging was classified as pT1c for the primary tumor size (>10 mm but \u226420 mm) and pN1a for metastases involving one to three axillary lymph nodes with at least one metastasis greater than 2 mm.\n\nAdditional findings included a healing biopsy site with organizing hematoma, sclerosing adenosis in the skin and nipple, and absence of microcalcifications. Immunohistochemical staining for keratins AE1/AE3 was performed on selected blocks but showed negative staining for carcinoma. No prior treatment effect was observed either in the breast or lymph nodes.\n\nMargins were free of invasive carcinoma and ductal carcinoma in situ. Ischemic time for the mastectomy specimen was 18 minutes and 27 minutes for the sentinel lymph node specimen."} +{"pid": "TCGA-AA-3973", "report": "The specimen consists of a colorectal resection sample showing a moderately differentiated epithelial neoplasm with a maximum diameter of 3 cm. The lesion demonstrates involvement of the pericolic adipose tissue and extends through the serosal surface. Metastatic involvement is identified in three regional lymph nodes out of 21 examined. All resection margins, including those at the colon and mesenteric attachments, are free of tumor. There is no evidence of lymphovascular invasion. Clinically, distant metastases have been documented in the liver and lungs. The morphological features correspond to a histologic grade consistent with intermediate differentiation."} +{"pid": "TCGA-A3-3329", "report": "The specimen consists of a right kidney with attached perinephric fat, measuring 14 x 10 x 5 cm and weighing 405 grams. The ureter and vascular margins are included in block 1. Upon sectioning, a golden-yellow mass is identified in the superior pole, measuring 6.5 cm in diameter. The mass is focally adherent to the capsule but does not grossly extend beyond it. Sections of the capsule are submitted in block 2, while sections of the mass are submitted in blocks 3 through 7. No gross dilation of the renal pelvis or calices is observed, and the renal cortex averages 0.7 cm in thickness. A random section of non-involved kidney tissue is submitted in block 8. The attached fat is dissected free, and no lymph nodes or adrenal tissue are identified.\n\nMicroscopic examination reveals a unifocal lesion located in the upper pole of the kidney. The tumor is confined within the renal parenchyma without involvement of regional lymph nodes or distant metastasis. Histologic evaluation demonstrates clear cell morphology with Fuhrman nuclear grade II features. Both venous and lymphatic invasion are absent. Surgical margins are free of invasive carcinoma. No additional significant pathologic findings are noted."} +{"pid": "TCGA-BG-A0M4", "report": "A total of 17 lymph nodes were examined from various locations, including right and left periaortic, right and left external iliac, left common iliac, right common iliac, and right and left obturator regions. All lymph nodes were negative for metastatic involvement. Some lymph node specimens contained benign fibroadi pose tissue without lymphoid elements.\n\nThe surgical specimen included the uterus, cervix, bilateral ovaries and fallopian tubes. A lesion measuring 3.6 cm was identified in the endometrium, exhibiting a mixed architectural pattern with poorly differentiated features. The tumor involved approximately 9% of the endometrial surface, with complete involvement of the anterior endomyometrium and partial involvement of the posterior aspect. Depth of invasion was limited to less than half of the myometrial thickness. No lymphovascular space invasion was observed. There was involvement of the lower uterine segment, but no evidence of endocervical extension. Adenomyosis and a small leiomyoma measuring 1.0 cm were also noted.\n\nThe right fallopian tube and ovary showed no significant pathological changes. In contrast, the left fallopian tube contained detached tumor material within its lumen, while the left ovary exhibited only physiologic changes. Pelvic washings were negative for malignant cells."} +{"pid": "TCGA-EY-A1GL", "report": "The surgical pathology report describes findings from a hysterectomy specimen involving the uterus and cervix. The tumor is located in the corpus with extension to the lower uterine segment and cervix, affecting both anterior and posterior regions. Histologic evaluation shows a grade 2 lesion based on FIGO criteria (architectural grade 2, nuclear grade 2). Myometrial invasion extends into the outer half of the myometrium with a depth of 1.5 cm; the wall thickness at this location measures 1.8 cm, indicating approximately 83% penetration. There is no evidence of serosal involvement.\n\nInvolvement of the lower uterine segment is present. In the cervix, the tumor invades to a depth of 1.1 cm out of a total cervical wall thickness of 1.7 cm, representing about 65% penetration. Evaluation of margins reveals the tumor is 6 mm away from the deep cervical stromal margin and also 6 mm from the anterior cervical/vaginal cuff margin upon deeper sectioning.\n\nLymphovascular space invasion is suspected based on changes observed in initial sections. Nineteen regional lymph nodes were examined, and none showed evidence of tumor involvement.\n\nAdditional findings include intramural leiomyomata. Immunohistochemistry demonstrates estrogen receptor positivity (2+, 15%) and weak progesterone receptor positivity (1+, <5%).\n\nPathologic staging according to AJCC is pT2b pNO pMx, and staging by the FIGO (2008 classification) system indicates Stage II.\n\nExamination of the adnexa reveals no tumor involvement. The right ovary appears atrophic. The left ovary contains a 2.6 cm serous cystadenoma without atypia or malignancy. Both fallopian tubes show no significant pathological abnormalities; the left tube contains paratubal cysts.\n\nEvaluation of lymph nodes from left pelvic, right pelvic, right peri-aortic, and left peri-aortic regions reveals no malignancy across all specimens.\n\nFurther microscopic examination was conducted using immunostains for hormone receptors and deeper evaluations of selected tissue blocks.\n\nThe gross specimen includes a uterus weighing 300 grams with a distorted pear-shaped appearance due to a large polypoid and necrotic mass protruding through the os. The tumor measures 9.5 x 8 x 5.4 cm and originates in the lower uterine segment/lower corpus, extending toward the cervix but not involving the ectocervical margin. The endometrial cavity measures 4.5 cm in length and 1.5 cm in width at the fundus. The upper endometrium appears involved with possible stenosis.\n\nAdnexal structures were identified bilaterally. The right ovary measures 2.8 x 2.3 x 1.2 cm with a 0.8 cm cystic structure visible on cut surface. The left ovary is slightly larger at 4.5 cm overall and contains a 2.6 cm cystic lesion filled with blood. Both fallopian tubes appear within normal limits except for possible caseous material noted in the lumen of the left tube.\n\nLymph node specimens submitted separately included multiple aggregates of fatty tissue containing identifiable lymph node candidates. No malignancy was identified in any lymph node evaluated.\n\nSections of tumor tissue were submitted for further investigations and tissue procurement. Multiple tissue blocks were prepared from various regions of the uterus, cervix, ovaries, and fallopian tubes, as well as from lymph node specimens.\n\nMicroscopic examination was performed using standardized protocols with appropriate controls. Some immunohistochemical reagents used are classified as analyte-specific reagents and have been validated for clinical use under CLIA-88 certification."} +{"pid": "TCGA-BJ-A0Z5", "report": "The specimen from a total thyroidectomy weighed 69.7 grams. A lesion measuring 6.0 cm was identified in the left lobe of the thyroid. Histologic evaluation showed features consistent with a tall cell variant morphology. The lesion demonstrated extracapsular extension. Surgical resection margins were free of tumor involvement, although tumor cells were present as close as 0.1 cm to the margin. Metastatic involvement was identified in one lymph node from the central compartment. In total, five lymph nodes were examined, and four showed evidence of metastatic involvement. Pathologic staging is pT3 N1a MX.\n\nMolecular testing was performed on block 2C. Real-time PCR analysis identified a BRAF V600E mutation. No mutations were detected in NRAS codon 61, HRAS codon 61, or KRAS codons 12/13. Fluorescence in situ hybridization (FISH) testing was negative for RET/PTC rearrangement. DNA was extracted in sufficient quantity and quality for testing. The limit of detection for mutations was approximately 10% mutant alleles in a background of normal DNA.\n\nHistologic assessment of the background thyroid parenchyma revealed nodular hyperplasia. No venous or lymphatic invasion was identified. Three out of four additional lymph nodes from the central compartment showed metastatic involvement. The pyramidal lobe specimen showed only benign thyroid tissue with nodular hyperplasia.\n\nTesting methodology included manual microdissection of paraffin-embedded tissue, ensuring at least 50% tumor cellularity. Real-time PCR was used to amplify specific gene regions, followed by melting curve analysis and, when necessary, Sanger sequencing for confirmation. FISH analysis for RET/PTC rearrangement was conducted using dual-color probes. In the targeted area, no cells exhibited the rearrangement pattern, confirming absence of RET/PTC fusion.\n\nAll margins were uninvolved by invasive disease. The distance from the invasive component to the closest margin was 1 mm. The histologic findings are part of a unifocal process in the left thyroid lobe."} +{"pid": "TCGA-BA-5153", "report": "The specimen consists of a left tonsil measuring 4.7 cm (superior to inferior), 3.1 cm (medial to lateral), and 1.2 cm (superior to deep). The specimen weighs 14.2 grams. Margins are marked with sutures and ink: superior (yellow), inferior (black), anterior (red), deep (blue), and posterior (green). Microscopic evaluation of multiple biopsies from various margins was conducted.\n\nBiopsies from the deep superior, deep inferior, superior, posterior, and inferior margins were all negative for invasive or in situ disease. A biopsy from the anterior margin showed focal dysplastic squamous epithelium within the stroma. Permanent sections confirmed the presence of moderately differentiated keratinizing squamous cells. The primary lesion measured approximately 2.7 cm in diameter and extended into several margins\u2014specifically the deep, superior, inferior, anterior, and posterior aspects\u2014based on histologic assessment. No angiolymphatic or perineural invasion was identified. No lymph nodes were sampled.\n\nStaging is based on available pathologic findings and classified as pT2, pNx, pMx. This assessment may be incomplete and should be considered alongside all other clinical data for final staging."} +{"pid": "TCGA-CV-5442", "report": "A bilateral neck dissection (levels 1\u20134) was performed, including submandibular glands and multiple lymph nodes. On the left side, one of eleven level 2a lymph nodes showed evidence of involvement with extranodal extension noted in one of three level 2b lymph nodes. Additionally, one right level 1 lymph node and one right level 2b lymph node were involved. No tumor was identified in other lymph nodes across levels 3 and 4 bilaterally or in the submandibular glands.\n\nExcision specimens from various anatomical sites revealed several areas with abnormal cellular findings. In the maxillary sinus mucosa on the right, there were fragments of bone and sinonasal mucosa without tumor involvement. However, in another specimen from the left maxillary sinus inferior margin, bone and fibroconnective tissue contained multiple foci of poorly differentiated cellular infiltration. Similarly, invasive poorly differentiated cells were found at the lateral inferior margin and in a portion of the nasal septum margin. A minute focus of similar infiltrative cells was also detected in buccal fat tissue on the left.\n\nIn the palate and left maxilla excision, multifocal poorly differentiated cellular aggregates with basaloid features were identified within a 5.5 cm area, along with extensive in situ changes involving bone. Positive findings for poorly differentiated cellular infiltration were also observed at the posterior nasal septum margin. Other excised tissues\u2014including portions of the inferior turbinate, exostosis, pterygoid, tooth, anterior nasal septum margin, middle turbinate, and sphenoid sinus\u2014did not show any tumor involvement.\n\nThe surgical margins showed variable involvement, with positive findings at the nasal septum margin and multifocal involvement in the palate and left maxilla. Lymph node involvement was noted bilaterally, particularly in levels 1 and 2, with extranodal extension present in one left level 2b lymph node."} +{"pid": "TCGA-56-6545", "report": "The surgical specimen consists of a right upper lobe lobectomy with attached rib, along with lymph nodes from levels 4R and 7. The lung specimen measured 13.0 x 12.0 x 5.0 cm and weighed 179 grams. A gray tan anthracotic mass measuring 5.0 x 5.0 x 3.0 cm was identified subpleurally, located 0.1 cm from the pleural surface, 3.0 cm from the bronchial margin, and 1.0 cm from the stapled parenchymal margin. The mass demonstrated central necrosis but did not appear to invade through the pleura. The rib measured 6.0 x 2.0 cm on sectioning, was red tan in color, and showed no evidence of tumor involvement. Surrounding lung tissue appeared unremarkable.\n\nHistologically, the lesion exhibited extensive necrosis with focal areas of convincing squamous differentiation. No gland formation was observed. The tumor was unifocal and poorly differentiated. Visceral pleural invasion or lymphovascular space invasion was not identified. Histologic examination revealed a microscopic focus of invasive carcinoma adjacent to bronchial squamous cell carcinoma in situ near the stapled margin. Additionally, one hilar lymph node contained a small inactive granuloma with dystrophic calcification; special stains for microorganisms were not performed unless requested. All other lymph nodes evaluated were negative for malignancy.\n\nA total of eleven lymph nodes were examined (including levels 4R and 7), none of which contained metastatic disease. Surgical margins were grossly free of tumor involvement, although microscopic evaluation identified malignancy near the stapled parenchymal margin. Bronchial and vascular margins were clear. Sections reviewed also included peribronchial lymph nodes, surrounding lung tissue, and rib margins after decalcification.\n\nClinical correlation was recommended regarding the presence of necrosis, which may reflect prior intervention, and concerning involvement of a bronchus at the stapled margin by both in situ and focally invasive changes. Sections were reviewed and confirmed by an additional pathologist."} +{"pid": "TCGA-HC-7231", "report": "The prostate gland weighed 53 grams and measured approximately 5.0 x 4.4 x 3.9 cm. It was partially sectioned and showed a shaggy capsule with a patent urethra. The cut surface demonstrated a tan-gray multinodular fibrotic appearance with compression of the urethra by the lateral lobes. Within the left posterior region, extending toward the apex and measuring approximately 2.2 x 1.6 x 1.0 cm, there was an area of pale tan-gray to yellow fibrosis that was slightly firm. This area extended focally into the left lateral lobe and right posterior lobe and approached within 0.1 cm of the nearest inked margin, extending toward the mid portion of the specimen.\n\nThe seminal vesicles measured 5.0 x 2.0 x 0.9 cm combined and had lobulated surfaces with multicystic gray-tan fibrotic cut surfaces.\n\nHistologically, microscopic evaluation revealed no evidence of extra prostatic extension, seminal vesicle involvement, or lymphovascular space invasion. High-grade prostatic intraepithelial neoplasia was present. Gleason grading showed a primary pattern of 3 and a secondary pattern of 4, with a total score of 7. The tumor involved approximately 10% of the gland volume. Surgical margins were uninvolved. No lymph nodes were identified in the specimen. Other findings were non-contributory."} +{"pid": "TCGA-DU-A7TA", "report": "A 45-year-old man presented with left-sided blurred vision and papilledema. Imaging revealed a large right occipital, non-enhancing brain lesion. A brain excision biopsy was performed, yielding multiple tissue fragments. The largest specimen measured 3.5 x 3 x 1 cm, and the smaller portion measured 3 x 1.5 x 1 cm. Microscopic examination revealed a diffuse glioma with a loose, microcystic background. Cellular density was moderate, with mild nuclear pleomorphism noted. Numerous minigemistocytes were present. No mitotic figures, vascular hyperplasia, or necrosis were identified. Immunohistochemical staining for MIB-1 demonstrated a proliferation index of approximately 2%. Intraoperative consultation suggested a glioma, with possible astrocytic lineage, although oligodendroglial features could not be ruled out."} +{"pid": "TCGA-D6-6516", "report": "The excised lesion from the lower lip measured 1.5 x 2.0 x 1.0 cm and included a papillary component measuring 1.5 x 1.0 x 0.5 cm. Histological examination revealed a moderately differentiated epithelial tumor with keratinizing features. The largest tumor dimension was 1.5 cm. The closest lateral resection margin was 2 mm, and the deepest margin was 1.5 mm. All margins were free of atypical cells. The tumor showed invasive growth within the skin with no evidence of deeper tissue involvement. Cellular morphology demonstrated moderate differentiation without lymphovascular or perineural invasion."} +{"pid": "TCGA-IW-A3M4", "report": "The submitted specimens include multiple tissue samples from various anatomical locations. A uterine mass was identified measuring approximately 9 x 7.5 x 7.5 cm, located in the right lateral uterine wall and extending into parametrial soft tissues and the adjacent right broad ligament. Histologic evaluation revealed marked cellular atypia with areas of necrosis. No definitive lymphatic or vascular invasion was observed. The cervix appeared free of tumor involvement.\n\nAdditional small smooth muscle lesions were noted within the uterus, including one with significant peripheral cellularity and a central hyalinized region, as well as seven other leiomyomas. Endometrial findings included proliferative features and benign endometrial polyps. There was also evidence of focal subserosal endosalpingiosis, serosal adhesions, and mesothelial cysts in the parauterine region. The cervix showed nonspecific changes including mucosal erosion, inflammation, reactive atypia, and nabothian cysts.\n\nSeveral other specimens were examined, including periurethral, pericervical, and periureteral soft tissue biopsies. These demonstrated cellular infiltration consistent with metastatic involvement. The round ligament specimen also showed similar findings suggestive of secondary involvement.\n\nOmental specimens (omentum #1, #2, #3) revealed only adhesions and chronic inflammatory changes without evidence of tumor spread. Similarly, biopsies from the right pelvic peritoneum, right and left gutters, and left retroperitoneum showed no signs of metastatic disease.\n\nLymph node specimens from the left and right pelvic regions, right common iliac, and right periaortic areas all showed reactive changes but were negative for tumor involvement. Immunohistochemical staining showed positivity for vimentin, smooth muscle actin, desmin, and CD10; negative staining was observed for keratin AE1/AE3, S-100, and CD117. Hormone receptor testing revealed high positivity for both estrogen and progesterone receptors.\n\nNo evidence of tumor was found in the fallopian tube segments or in other sampled soft tissues outside the uterus and immediate surrounding areas."} +{"pid": "TCGA-EB-A44P", "report": "The excised skin lesion from the trunk measured 1.2 x 0 x 1.5 cm and exhibited ulceration. Microscopic evaluation revealed a cellular proliferation with features including a depth of invasion measuring 6 mm by Breslow's criteria. The histologic pattern demonstrated atypical melanocytic proliferation. Vascular invasion was not identified. Surgical margins were free of abnormal cells. No satellite nodules, lymph node involvement, or evidence of treatment effect were noted. Additional pathologic findings were not reported."} +{"pid": "TCGA-5P-A9JV", "report": "The specimen demonstrates a malignant neoplasm classified according to the TNM system (version 2002) as pT1a. Histologic grade is GII. The tumor exhibits papillary architecture with associated nuclear features consistent with this classification. No definitive extension beyond the organ of origin is identified. Size and other staging details are consistent with early localized disease."} +{"pid": "TCGA-AA-3558", "report": "The specimen consists of a resected segment of the colon (sigmoid region) with no evidence of tumor involvement at the oral or aboral resection margins. A lesion is present, characterized as a stalked, tubular structure with significant cellular atypia. The lesion also exhibits features consistent with a polypoid growth and contains moderately differentiated glandular elements. Histological evaluation reveals infiltration extending into the lamina muscularis propria; however, there is no evidence of vascular or lymphatic invasion. Regional lymph nodes show no signs of metastatic involvement. The lesion has been classified as G2, with a staging of pT2, L0, V0, R0, and no positive lymph nodes out of the total examined (0/46)."} +{"pid": "TCGA-BH-A0E7", "report": "The specimen consists of left breast tissue, including a segmental biopsy and mastectomy specimen, as well as axillary lymph nodes from a left axillary dissection. The lesion measured 2.1 x 1.8 x 1.3 cm and was found to be multifocal with an aggregate size of 2.1 cm. Histologic evaluation revealed a Nottingham score of 7 (nuclear grade 3, tubule formation 2, mitotic activity 2). The histologic features included areas with micropapillary morphology accounting for approximately 10% of the lesion. Adjacent to and intermixed with the invasive component was a 5% in situ component, which exhibited solid and micropapillary patterns with nuclear grade 2.\n\nNo prominent angiolymphatic invasion was identified. Surgical margins were free of invasive and in situ disease; the closest margin was the posterior margin, located 1 mm from the lesion. Non-neoplastic findings included fibrocystic changes with ductal epithelial hyperplasia and the presence of microcalcifications within benign epithelium and arterial wall.\n\nAxillary lymph node evaluation showed one involved node out of seventeen examined. The metastatic deposit measured 1.2 x 0.8 cm and was associated with extracapsular extension. Immunohistochemical analysis demonstrated positivity for estrogen and progesterone receptors, while HER-2/neu staining was negative (1+).\n\nStaging was determined as pT2 for the primary tumor, pN1 for nodal involvement, and pMX for distant metastasis. The surgical margins were uninvolved by invasive or in situ disease, with the closest distance to the invasive component being 3 mm. The in situ component was 13 mm from the nearest margin. No evidence of skin involvement or Paget\u2019s disease of the nipple was reported."} +{"pid": "TCGA-J4-8200", "report": "The specimen consists of a radical prostatectomy with attached seminal vesicles and vas deferens. The prostate weighs 29 grams and measures 4 x 3.5 x 3 cm. The capsule is shaggy and disrupted at the bladder resection margin, which has been inked. The right and left seminal vesicles each measure 3 x 1 x 1 cm, and the corresponding vasa deferentia measure 4.5 cm and 3.5 cm respectively. No abnormalities are noted in the seminal vesicles or vasa deferentia.\n\nLymph node evaluation includes two lymph nodes from the right pelvic region and two from the left pelvic region, all negative for abnormal cellular infiltration. Fatty tissue over the prostate is unremarkable, with no abnormal cellular aggregates identified.\n\nMicroscopic evaluation of the prostate reveals a Gleason score of 3 + 4 = 7/10, with no tertiary pattern identified. The severity of tissue involvement is graded as 3 out of 5, indicating involvement between 15% and 30% of the tissue. There is focal perineural invasion present; however, small vessel lymphatic invasion is not observed. No dominant nodule measuring at least 1 cm is identified.\n\nThe tumor appears confined to the prostate without extension beyond the capsule. No tumor is identified at the surgical margins or within the seminal vesicles. The TNM staging classification indicates no evidence of extraprostatic extension, with pT2c assigned for the primary tumor, pN0 for lymph node status, and pMX for distant metastasis due to insufficient data for accurate assessment. Multiple tissue blocks were submitted for histologic analysis, including complete sections of the gland and margins."} +{"pid": "TCGA-E7-A5KE", "report": "The specimen consists of bladder tissue containing a lesion measuring 1 x 1 x 0.5 cm with poorly defined margins. The lesion has a soft and gray appearance on the surface. Microscopically, there is proliferation of transitional cells exhibiting hyperplastic changes. The cells are arranged in papillary formations, nests, groups, and cords. They display moderate amounts of eosinophilic cytoplasm. Nuclear features include enlargement, variation in size and shape, irregular nuclear membranes, prominent nucleoli, and abnormal chromatin distribution. Frequent mitotic figures are observed. The lesion extends into the superficial muscularis propria. Histologic evaluation shows no lymphatic invasion and the margins are uninvolved. No additional tumor features or pathologic findings are noted."} +{"pid": "TCGA-ED-A5KG", "report": "Gross Description: The specimen shows a lesion measuring 5 x 4 x 4 cm with moderate margins, yellow-white in color and soft on sectioning. Microscopic Description: The cellular arrangement includes trabecular, acinar, sheet-like, and tubular patterns within benign hepatic tissue. The cells maintain a polygonal morphology and exhibit vesicular nuclei with irregular contours and prominent nucleoli. Abundant cytoplasm is observed, which varies between basophilic and clear. Nuclear pleomorphism is present with large, hyperchromatic nuclei and visible nucleoli. Mitotic figures are identified. Areas of necrosis and hemorrhage are noted within the lesion. Specimen type: Lobectomy. Tumor size: 5 x 4 x 4 cm. Histologic grade: Moderately differentiated. Margins: Uninvolved."} +{"pid": "TCGA-BK-A13B", "report": "The specimen includes a uterus with cervix, bilateral fallopian tubes and ovaries, along with left and right pelvic lymph nodes and a periaortic lymph node. The uterus weighed 157 grams and measured 7.5 x 5.7 x 5.7 cm. The cervix was 3 cm in length. Several subserosal and intramural nodules consistent with leiomyomas were identified, with the largest measuring up to 4.6 cm. The endometrial cavity measured 6 x 4.8 cm and contained a fragmented, friable pale-tan tumor originating from the posterior wall. The tumor covered the entire posterior endometrial wall and reached a thickness of up to 3.2 cm. It invaded through more than 50% of the myometrial thickness and extended into the lower uterine segment, but did not involve the cervical stroma. The anterior endometrium was lined by flattened non-neoplastic tissue. The ovaries were tan-pink and measured on average 2 x 1.4 x 1 cm, without any focal lesions. The fallopian tubes were centrally discontinuous, tan-white, measured approximately 3.8 cm in length and 0.5 cm in diameter, with pinpoint to stellate lumina.\n\nThe left pelvic lymph node specimen was 6.6 x 6 x 2.1 cm and included lymph nodes up to 4 cm in size. All lymph nodes present were submitted for examination. The right pelvic lymph node specimen measured 6.7 x 5.6 x 2 cm with lymph nodes up to 4.5 cm. The periaortic lymph node specimen measured 4.8 x 3.6 x 1.6 cm with lymph nodes up to 3 cm in size. All lymph nodes in each specimen were submitted for evaluation.\n\nMicroscopic analysis showed a neoplastic process involving the endometrium with areas showing squamous differentiation. The tumor infiltrated through more than half of the myometrial wall. There was no involvement of the cervical stromal connective tissue despite extension into the lower uterine segment. All surgical margins were free of tumor. Focal lymphovascular invasion was observed. No malignant cells were identified in the fallopian tubes or ovaries. Lymph nodes from all submitted sites (left and right pelvic, and periaortic) were negative for malignancy. Additional findings included multiple leiomyomas. Representative sections were reviewed and confirmed."} +{"pid": "TCGA-BP-4795", "report": "A right renal mass was incidentally identified in a submitted nephrectomy specimen. The right kidney, including attached ureter, renal vessels, and perinephric fat, measured 8 x 5 x 3.5 cm. A well-circumscribed tan nodule measuring 1.5 x 1.3 cm was identified in the upper pole. The lesion replaced the renal cortex, reached the renal capsule but did not penetrate it, and did not extend into the renal pelvis. The upper pole parenchyma was necrotic with an ill-defined corticomedullary junction, while the lower pole cortex was relatively preserved at 0.4 cm. No adrenal gland or lymph node was identified in the kidney specimen. All surgical margins were free of involvement. Sections of the tumor, upper and lower pole kidney, ureteral and vascular margins, and surrounding fat were submitted for analysis.\n\nTwo paracaval lymph nodes were also submitted, measuring 1.3 cm and 0.6 cm. Both were entirely submitted and found to be uninvolved. The tumor was limited to the kidney with no evidence of local invasion or venous involvement. Histologic evaluation showed nuclear features consistent with a previously described pattern in kidneys with impaired function. The tumor was staged as pT1, defined as a tumor up to 7.0 cm confined to the kidney. Non-neoplastic findings included marked glomerulosclerosis and chronic pyelonephritis."} +{"pid": "TCGA-66-2756", "report": "The resected left superior pulmonary lobe weighed 634 grams and measured 240 x 130 x 60 mm. It showed remnants of pleural adhesions and a pericardial lobe measuring 75 x 50 mm, adhering tightly to the hilar section, with slight whitish thickening and subhemorrhaging. In S3, there was grayish-white, brittle tissue with yellowish necrosis, along with anthracotic pigment. A mass was noted in this region, measuring 75 x 50 x 95 mm, extending beneath the pericardial lobe and showing unclear demarcation into adjacent subpleural and mediastinal adipose tissue. B3 demonstrated changes in the intermediary section with destruction noted. The remaining segmental bronchi were able to be dissected to the periphery and appeared unremarkable. Hilar lymph nodes were present, showing anthracotic pigmentation and swelling, but no tumor involvement. Peritumoral lung tissue revealed a golden-yellow, mesh-like pattern suggestive of xanthomatous retention pneumonia, and in S1, especially in the apical section, marked emphysema with coarse structure and possible honeycombing was observed.\n\nA separate specimen from the phrenic nerve was described as grayish-brown, restiform excised material measuring 6 mm in length. Lymph-adipose tissue from the aortopulmonary window was bipartite, measuring 25 x 20 x 10 mm, with multiple anthracotic-pigmented lymph nodes, some of which were swollen, embedded in adipose tissue. Additional lymph node samples included L11 (quadripartite, nearly 10 mm), L9 (bipartite, 6 mm), and L7 (segmented, 5 mm), all showing blackish pigmentation.\n\nMicroscopically, the bronchial wall at the resection margin was free of disease, with paraffin embedment confirming this finding. Adjacent lymph nodes showed significant anthracotic pigmentation, sinus histiocytosis, lymphofollicular hyperplasia, and acute blood clotting. The mass consisted of solid and garland-shaped structures composed of large, pleomorphic cells with a markedly altered nucleoplasmic ratio, chromatin coarsening, and frequent mitotic figures, with multiple necrotic inclusions and associated stromal desmoplasia. There was evidence of mediastinal pleural penetration with focal extension into lipomatous thymus tissue. The adjacent pericardial lobe remained unaffected, and small, non-tumorous lymph nodes were found within the mediastinal fat. In the apical part of S1, a subpleural scar with fibroelastosis was seen, along with significant bullous emphysema, rarefied, stubby, upright alveolar septa, and occasional inflammation. In the area surrounding the mass, there was a compact accumulation of foamy macrophages within alveoli.\n\nLymph node samples from various sites showed similar features: anthracotic pigmentation, histiocytosis, and minor degrees of lymphofollicular hyperplasia, with no evidence of tumor involvement. The outer resection margins were free of disease on all sides, indicating complete removal. Tissue assessment showed no residual tumor at the bronchial resection edge. The pulmonary lobe and associated lymph nodes were submitted for analysis."} +{"pid": "TCGA-BQ-7049", "report": "The specimen consists of a partial nephrectomy measuring 4.2 x 3.3 x 1.5 cm. Gross examination reveals a tan-white tumor with yellow foci measuring 1.8 cm in greatest dimension. The tumor abuts the capsule and the deep margin. Histologic evaluation demonstrates a high-grade neoplasm composed of combined morphologic features. The lesion measures 3.2 cm in greatest diameter and is confined within the kidney without extension beyond the capsule. There is no evidence of renal vein invasion. Surgical margins are free of tumor, although the tumor approaches within 1 mm of the deep surgical margin. The surrounding non-neoplastic kidney tissue appears unremarkable. Immunohistochemical analysis shows tumor cell positivity for CK7 and racemase, weak positivity for CD10, and focal positivity for 34BE12. Based on histologic and immunophenotypic features, the findings are consistent with a neoplastic process originating in the renal cortex. Staging classification indicates a pT1 lesion, defined as a tumor \u2264 7.0 cm in greatest dimension limited to the kidney. Sections submitted for microscopic evaluation include representative areas of tumor and normal renal parenchyma. Intraoperative frozen section assessment confirmed the presence of a renal cortical neoplasm with uninvolved deep margins, consistent with the final diagnosis."} +{"pid": "TCGA-HU-A4HD", "report": "The specimen was obtained from the lower third along the greater curvature of the stomach. The tumor measured 4.5 x 3 cm and was classified as gross type 2. Resection margins were free from carcinoma, with a safety margin of 1.6 cm distally. The tumor invaded into the subserosal layer. Histologically, the lesion showed moderately differentiated features with intestinal-type morphology and a histologic grade of G2. Lymphovascular invasion was present. A total of 23 lymph nodes were examined, with 3 involved (50% or more), staging to pT2 and pN2. No adhesions, perforation, or additional significant pathological findings were noted. Immunohistochemical staining showed positivity for CD34. The tumor did not involve the proximal or distal margins. Associated chronic gastritis was present."} +{"pid": "TCGA-HE-A5NJ", "report": "The specimen was obtained from a resection procedure on the right kidney. The tumor measured 6.5 cm in size. Histological evaluation revealed a neoplasm with papillary architecture and chromophilic features. The tumor was classified as grade III based on differentiation. Pathological staging indicated T1b, with no assessment for nodal involvement (NX). There was no evidence of distant metastasis (M0). Additional samples including buffy coat were collected. Data regarding the year of sample collection, age at collection, days to procedure date, and days to diagnosis were recorded but not specified in this summary."} +{"pid": "TCGA-QR-A6GO", "report": "The right adrenal specimen measured 7.5 x 4.5 x 3 cm and weighed 54.07 grams. It consisted of a soft, red-tan tissue mass with a homogeneous cut surface and a thin rim of yellow tissue at the periphery. The lesion measured 4 x 3.5 x 3 cm and appeared to originate from the medulla. No necrosis was identified. Sections of the mass and surrounding tissue were submitted for analysis. Fibroadipose tissue was present, but no lymph nodes were observed."} +{"pid": "TCGA-63-A5MY", "report": "The sample was obtained from a resected tissue specimen collected from the left lower lobe. The tumor measured 3 cm in size. Histological evaluation showed a squamous carcinoma with moderate differentiation (Grade II). Pathological staging indicated T1b and N0, with no evidence of distant metastasis (M0). No additional histological comments were provided. Blood sample (buffy coat) was also collected; however, no further details are available regarding its analysis. Clinical data included age at collection, days to procedure, and days to diagnosis, though specific values were not provided."} +{"pid": "TCGA-56-7582", "report": "A right lower lobe lobectomy and regional lymph node dissection were performed. The specimen was received intact and included multiple lymph node stations (N11R, N11R-2, N9R, N7, N11R-3, N11R-4, N4R, N10R). Gross examination of the lung revealed a well-circumscribed, rubbery mass measuring 3.3 cm in greatest dimension. The tumor was centrally necrotic and located within 0.2 cm of the anterior-medial pleura. It extended through a major bronchial tract and was within 0.7 cm of the bronchial surgical margin. Adjacent lung tissue showed organizing pneumonia and fibrotic changes, with no additional suspicious nodules identified.\n\nHistologic evaluation demonstrated a single focus of invasive cellular proliferation with moderate differentiation. Tumor measurements correlated with a pT2a classification. No lymphovascular or perineural invasion was identified. Visceral pleural invasion was not present. Surgical margins were negative: bronchial margin at 0.7 cm from tumor, vascular and parenchymal margins greater than 1 cm, and parietal pleural margin negative at 0.3 cm.\n\nLymph node assessment included a total of 25 nodes examined across all stations; none showed evidence of metastatic involvement. Staging was determined as pN0 based on these findings. Distant metastasis could not be assessed (pMX). The overall pathologic stage was IB.\n\nAdditional microscopic findings confirmed absence of tumor in all submitted lymph node regions and margins. No treatment effect was noted."} +{"pid": "TCGA-21-5787", "report": "A portion of the sixth rib was examined and showed skeletal muscle and bone without abnormal findings, along with normocellular trilineage bone marrow. Seven lymph nodes from level V were assessed, with two out of seven showing involvement. In the 11L lymph node group, seven out of nine fragments demonstrated involvement. Three out of four fragments from the 12L lymph nodes also showed involvement.\n\nThe left lingula specimen contained a 4.2 cm mass that was poorly differentiated. Lymphovascular invasion was identified, though there was no involvement of the visceral pleura. The bronchial margin did not show tumor, while the vessel margin had carcinoma present without direct vessel wall involvement. Emphysema was noted in the lung tissue. One of eight lymph nodes from level VI showed involvement, whereas none of the eleven lymph nodes evaluated from level VII contained abnormal cells.\n\nThe lingula specimen weighed 114 grams and measured 15 x 8 x 5 cm. A firm black-brown mass was located approximately 0.5 cm from the bronchial and vascular margins. Other lung tissue appeared congested but lacked additional masses. Additional lymph node samples were generally described as soft black-brown structures, varying in size from 0.2 to 2.7 cm across different levels. \n\nIn total, 39 regional lymph nodes were analyzed, with 13 mediastinal or subcarinal lymph nodes demonstrating involvement. Tumor extension measured greater than 3.0 cm but did not involve the visceral pleura. Venous invasion was observed, while arterial invasion was absent. All invasive margins were free of tumor."} +{"pid": "TCGA-QT-A5XL", "report": "The specimen consists of an intact left adrenal gland weighing 109.1 grams and measuring 7.2 x 6.0 x 5.0 cm. The external surface shows focal cautery and fibrofatty adhesions. The cut surface is variegated, ranging from orange/yellow to tan/brown, with a well-circumscribed yellow/tan thick peripheral capsule. No residual adrenal cortex is identified. The tumor is encapsulated and circumscribed, with no lymphovascular space invasion observed. Surgical margins are free of tumor. Representative sections of the specimen have been submitted for analysis, and digital photographs have been taken."} +{"pid": "TCGA-M7-A725", "report": "The surgical specimen included right and left pelvic lymph node dissections, as well as a radical prostatectomy specimen. No tumor was identified in a total of 11 lymph nodes evaluated (0/11). The prostate specimen measured 4.4 x 4.4 x 3.6 cm and weighed 40.0 grams. It was received with bilateral seminal vesicles and vas deferens intact. Gross examination showed mild prostatic hyperplasia, with no visible carcinoma, necrosis, or hemorrhage.\n\nHistologic evaluation revealed a tumor with acinar morphology. The tumor grade was Gleason 7 (4+3) with a tertiary Gleason pattern 5 present in 5% of the tumor volume. Overall, approximately 40% of the prostate was involved by tumor, with 15% involvement on the right and 65% on the left. Tumor was present bilaterally from the apex to near the base. The tumor extended beyond the prostatic capsule, specifically at the left mid region, involving adipose tissue. Lymphovascular space invasion was also noted.\n\nInvolvement of the seminal vesicles was present on the right side, while the left seminal vesicle was negative. Surgical margins were positive in the left mid region, with a linear extent less than 1 mm in each focus, involving non-contiguous sections. Additional findings included extensive perineural invasion and high-grade prostatic intraepithelial neoplasia.\n\nStaging was determined as pT3b, pN0 based on this pathologic specimen. It is noted that this staging may be incomplete and a comprehensive review of all clinical data is recommended for final staging assessment."} +{"pid": "TCGA-F4-6809", "report": "The submitted large intestine tissue specimen was obtained via abdominal perineal resection. The tumor was located in the sigmoid colon and measured 7.5 x 0 x 0 cm. The surface appeared ulcerated. Microscopic examination revealed moderately differentiated cellular features. The tumor extended into the surrounding fatty tissue. Of the 12 lymph nodes examined, 3 showed evidence of involvement. Surgical margins were free of abnormal cellular infiltration. No evidence of prior treatment was identified. No additional findings were noted."} +{"pid": "TCGA-DD-AAEA", "report": "The specimen consists of a liver measuring 11.5 x 11.3 x 4.0 cm and weighing 226.5 grams, along with a gallbladder measuring 10.0 cm in length, 3.5 cm in diameter, and 0.5 cm in thickness. A well-defined mass measuring 4.0 x 3.0 x 3.8 cm was identified. The cut surface of the mass is described as pale pink to tan, multinodular, solid, and slightly firm, without necrosis. Gross examination indicates an expanding nodular growth pattern. The resection margin is not involved grossly, with a safety margin of 0.5 cm. No satellite nodules are present, and the remaining liver parenchyma appears unremarkable.\n\nMicroscopic evaluation reveals moderately differentiated malignant cells arranged in trabecular and pseudoglandular patterns. The cellular morphology is consistent with hepatic origin. A complete fibrous capsule is present without evidence of capsular infiltration. Septum formation is noted, but there is no invasion at the surgical resection margin, serosal layer, portal vein, or microvessels. No intrahepatic metastasis or multicentric occurrence is observed. Periportal fibrosis is present at stage 2.\n\nBlocks submitted include four from the mass, one from the liver parenchyma, one from the resection margin, and one from the gallbladder. The gallbladder shows features of chronic inflammation without malignant changes. Additional findings include chronic gastritis in the stomach body and chronic inflammation at the esophageal anastomosis site. No tumor is identified in the esophagus or lymph nodes examined."} +{"pid": "TCGA-EW-A1OY", "report": "A lymph node specimen measuring 1.0 x 0.8 x 0.7 cm was examined and showed no evidence of malignant cells. Touch preparation revealed only lymphoid cells. One lymph node was assessed, and all sections were negative for malignancy. A keratin immunostain was performed and showed negative results.\n\nA skin specimen from the left breast, measuring 5.0 x 1.7 x 0.4 cm, demonstrated no significant pathologic changes. Representative sections were submitted for evaluation.\n\nThe lumpectomy specimen from the left breast weighed 90.0 grams and measured 7.5 cm in greatest dimension. The excised lesion measured approximately 2.4 x 1.5 x 1.0 cm and was described as stony hard with fibrous borders. Surrounding fibrosis extended up to 5.0 x 3.0 x 3.0 cm. Hemorrhagic areas within the specimen measured 0.8 x 0.4 x 0.3 cm and were located 0.8 cm from the deep posterior margin. Multiple sections were taken from various margins including lateral, posterior/inferior, superior/anterior, medial, and additional tumor and fibrotic areas. Histologic evaluation revealed no tumor at the margins of resection. Lymphovascular space invasion was identified. Sections also showed a prior biopsy site.\n\nHistologic grading based on Nottingham criteria included minimal tubule formation (score 3), marked nuclear pleomorphism (score 3), and more than 20 mitoses per 10 high-power fields (score 3), resulting in a total score of 9, corresponding to Grade III differentiation.\n\nMargins were free of invasive carcinoma. Microcalcifications were present both within and outside the lesion. Immunohistochemical staining showed positivity for ER and PR, while Her2 staining was negative.\n\nA separate specimen labeled as an inferior margin, true blue margin, measured 7.0 x 4.0 x 1.2 cm and showed no evidence of malignancy.\n\nRight breast tissue, weighing approximately 55.0 grams, consisted of 60% cystic fibro-stromal tissue and 40% adipose tissue. Histologic findings included fibrocystic changes with stromal fibrosis, adenosis, and microcalcifications. A prior biopsy site was also identified in this specimen.\n\nMargins were uninvolved by invasive disease. No evidence of distant metastasis was identified. One sentinel lymph node was examined and found to be negative.\n\nMultiple cassettes were submitted for microscopic analysis, including representative sections from all key areas of interest. All immunohistochemical stains were interpreted by a pathologist and read as positive, negative, or indeterminate depending on the marker. Detection methods used LSAB, and all applicable stains were considered clinically useful indicators.\n\nThe specimen was processed and evaluated according to standard protocols, and all relevant preparations were reviewed by the attending pathologist."} +{"pid": "TCGA-98-A53J", "report": "The specimen was received in twelve containers. Specimen 1, labeled as pleura-right, consists of yellow-tan fibroadipose tissue measuring 2.7 x 1.6 x 0.4 cm. Specimens 2 through 12 include lymph node fragments from various levels (VII, IX, VIII, XI, IV, and II), all of which are negative for malignancy. One lymph node (10R) shows fibrosis and anthracosis, with no nodal tissue identified.\n\nA right upper lobe lung specimen includes a fragment of yellow-tan soft tissue measuring 2.3 x 1.5 x 0.3 cm, and the remaining lobe measures 13.5 x 11.4 x 5.8 cm. A mass is present within the lung tissue, measuring 4.9 x 3.5 x 4.2 cm, with a white-tan and yellow appearance, including areas of necrosis. The tumor is located approximately 1.1 cm from the bronchial margin and 1.8 cm from the closest stapled margin. The overlying pleura shows thickening and retraction, but no direct involvement by the lesion is noted. No additional lesions are found upon further examination, though some pleural fibrosis and thickening are observed near the apex.\n\nMicroscopic evaluation reveals that the bronchial, vascular, and parenchymal margins are free of tumor involvement. Lymph nodes examined from multiple levels show no evidence of metastatic disease. Histologic analysis indicates a unifocal lesion with moderately differentiated cellular features. The primary lesion is surrounded by lung tissue and visceral pleura, measuring greater than 3 cm but less than 5 cm in its largest dimension. There is no evidence of lymphovascular invasion or pleural penetration.\n\nStaging indicates no regional lymph node involvement (pN0) and no distant metastasis. The surgical margins are clear, and the specimen is considered intact."} +{"pid": "TCGA-MH-A856", "report": "The specimen was received fresh and consists of a small tissue fragment measuring 0.3 x 0.2 x 0.1 cm, tan-red in color and irregular in consistency, submitted for intraoperative frozen section consultation. No abnormal cellular proliferation was identified in this portion.\n\nA second specimen weighing 26.0 grams measures 4.8 x 3.8 x 3.5 cm and is composed of tan-brown, granular soft tissue with a well-defined, tan-yellow to white friable mass measuring 2.4 x 2.3 x 1.8 cm. The mass is located within close proximity to both the capsular and renal resection margins (less than 1 mm). Margins are described as tan-pink to red and smooth with minimal overlying fat. The renal resection margin is inked blue and the capsular margin is inked black. Minimal uninvolved renal parenchyma is present adjacent to the lesion.\n\nHistologically, the lesion demonstrates features of papillary architecture with nuclear grades ranging from 1 to 2. Focal tumor necrosis is noted. Microscopic evaluation reveals extension into the pelvic and capsular regions with involvement of surgical margins in multiple areas. There is no evidence of lymphovascular invasion. Gerota\u2019s fascia could not be adequately assessed. Background renal tissue shows mild arterio- and arteriol sclerosis.\n\nPathologic staging appears consistent with an early localized stage based on TNM classification. No tumor was identified in the initial biopsy specimen taken from the base of the lesion."} +{"pid": "TCGA-BR-8360", "report": "A segment of stomach tissue was examined, featuring a plate-like lesion measuring 8 cm in its largest dimension. The lesion demonstrates necrosis and extends into the subserosa, with no evidence of venous invasion. The tumor is ulcerated and invades up to the peritoneum, adhering to the lesser omentum. Fifteen lymph nodes were examined, all without metastatic involvement. The surrounding fatty tissue shows fibrosis and hyperemia, with dense, hyperemic lymph nodes noted within the omentum. Histologically, the lesion is moderately differentiated and exhibits features consistent with intestinal-type morphology. No follicular hyperplasia or other significant lymphoid changes were identified. The surgical margins are uninvolved, and there is no confirmed evidence of neoadjuvant treatment effect. Additional pathological findings are not specified."} +{"pid": "TCGA-E9-A1N8", "report": "The specimen consists of breast tissue obtained from a radical mastectomy. A grossly evident lesion is present, measuring 4.2 x 3.6 x 3.6 cm. Microscopic examination reveals a poorly differentiated histologic type. Evaluation of regional lymph nodes (8 in total) shows no evidence of metastasis. Information regarding tumor extent, extracapsular invasion, and surgical margins is not specified. The histologic features required to calculate the Nottingham Histologic Score are not fully documented, and therefore, a total score cannot be determined. No data is available regarding neo-adjuvant treatment or additional pathologic findings."} +{"pid": "TCGA-FD-A6TE", "report": "A 65-year-old male underwent cystoprostatectomy and lymph node dissection. A segment of the left distal ureter was free of tumor at the margin, but high-grade urothelial changes were present on the non-margin side. The bladder specimen showed a 3.0 cm lesion located in the left lateral wall and trigone. Histologically, there was invasive high-grade urothelial disease extending through the muscularis propria into the surrounding soft tissue. All surgical margins, including ureteral, distal urethral, and soft tissue, were negative for tumor involvement.\n\nLymph node analysis included left and right pelvic, common iliac, and presacral regions. In the left pelvic region, one of nine nodes contained metastatic involvement measuring 2.7 cm with extension beyond the lymph node capsule. In the right pelvic region, one of thirteen nodes was also involved. No tumor was found in the right or left common iliac nodes, nor in the presacral nodes. Additional specimens including the Meckel's diverticulum, bilateral vas deferens, and right distal ureter showed no abnormal findings.\n\nThe prostate was also examined and showed no evidence of tumor involvement. It demonstrated low-volume incidental histologic findings with a Gleason score of 3+3=6. Tumor was confined to the peripheral zone bilaterally without extension beyond the capsule, and all margins were clear. High-grade intraepithelial neoplasia was noted multifocally.\n\nStaging assessment indicated pT3a for the bladder and pT2a for the prostate, with regional lymph node involvement (pN2) for the bladder. Prostate lymph nodes were negative. The staging system used follows the 7th edition of the AJCC and UICC classifications."} +{"pid": "TCGA-EA-A3HS", "report": "The specimen consists of hysterectomy tissue involving the cervix. The lesion measures 5 x 4 x 3 cm and is classified as a well-differentiated squamous cell lesion with a size greater than 4.0 cm. Examination of regional lymph nodes (10 examined) shows no evidence of metastasis. No assessment was provided regarding lymphatic or venous invasion, surgical margins, neo-adjuvant treatment effect, or additional findings."} +{"pid": "TCGA-23-1022", "report": "A partial omentectomy specimen consists of adipose tissue measuring 5.4 x 3.6 x 1.2 cm, firm and white in appearance with extensive tumor infiltration. A second omental specimen measuring 28 x 7 x 2 cm shows similar features with widespread involvement by tumor.\n\nThe left ovary and fallopian tube specimen measures 5.0 x 4.5 x 3.5 cm, with a friable tan-white mass replacing most of the ovarian tissue. The external surface is focally fragile and the cut surface is papillary and friable. A segment of fallopian tube within the mass shows mucosal and submucosal involvement by atypical cells. The tumor extends to the ovarian surface and into adjacent soft tissues. Residual ovarian tissue demonstrates age-related changes along with inflammation. The fallopian tube also exhibits transmural involvement, intraluminal malignant cell clusters, chronic inflammation, and remnants of mesonephric duct structures. Extensive infiltration into surrounding tissues and reactive mesothelial changes are noted.\n\nThe right ovary and fallopian tube specimen measures 4.5 x 3.0 x 3.0 cm and is largely replaced by tumor. Minimal residual ovarian tissue is present. The fallopian tube demonstrates serosal involvement and the surrounding tissues show widespread tumor infiltration, including vascular invasion. A portion of the appendix involved by tumor shows infiltration into muscular layers and surrounding fat, without mucosal involvement. Inflammatory changes and fibrous adhesions are also present.\n\nBiopsies from multiple sites including peritoneal implant (measuring 0.9 x 0.5 x 0.4 cm), appendix epiploica (2.3 x 2.1 x 0.8 cm), ascending colon, transverse colon, and other colonic flexures demonstrate tumor involvement within fibrovascular and adipose tissues, often associated with chronic inflammatory changes and reactive mesothelial hyperplasia.\n\nLymph node biopsies reveal tumor presence in all sampled regions. One right periaortic lymph node (measuring 3.6 x 1.7 x 1.2 cm) is entirely replaced by tumor. Of three right pelvic lymph nodes (ranging from 1.2 to 1.4 cm), two contain tumor with vascular space invasion noted. The left pelvic lymph node (2.7 x 2.1 x 1.4 cm) is nearly entirely infiltrated.\n\nAdditional biopsies from the right side wall (2.5 x 1.3 x 0.8 cm), right gutter (2.3 x 1.3 x 0.6 cm), hepatic flexure (6.3 x 3.2 x 1.1 cm), colon flexure (1.6 x 0.8 x 0.7 cm), mesenteric tumor (5.5 x 5.0 x 1.6 cm), appendix (4.3 x 2.6 x 2.4 cm), umbilical nodule (3.5 x 1.6 x 1.2 cm), anterior abdominal wall (1.3 x 0.8 x 0.6 cm), and inguinal lymph node (2.3 x 0.6 x 0.3 cm) all demonstrate varying degrees of tumor infiltration. Tumor involvement is frequently associated with vascular invasion, chronic inflammation, and reactive mesothelial changes.\n\nUterine findings include an endometrium with inactive features and eosinophilic metaplasia, along with an endometrial polyp containing histiocytic infiltration. The cervix demonstrates chronic inflammation with squamous metaplasia and calcifications. A benign leiomyoma measuring 1.2 cm is identified within the myometrium. The uterine serosa shows extensive tumor involvement accompanied by granulomatous inflammation.\n\nBased on the pathological findings, the case is classified as advanced with widespread involvement across multiple anatomical sites."} +{"pid": "TCGA-A2-A3XV", "report": "The surgical specimen was received in four parts, including two sentinel lymph nodes and breast tissue. The first lymph node measured 3 x 2.2 x 1.2 cm and contained a 2.5 cm rounded area of yellow fatty tissue with focal blue coloration. A separate firm nodule measuring 0.5 cm was also identified. The second lymph node measured 4 x 2.5 x 1.2 cm and contained a 2.5 cm lymph node with marked blue coloration. Both lymph nodes showed dermatopathic lymphadenitis, with no evidence of metastatic disease on H&E or cytokeratin stains.\n\nThe right breast partial mastectomy specimen measured 6.8 x 6.0 x 3.7 cm and was oriented with multiple margin markers. A central gray-pink glistening mass with a nodular appearance measured 2 x 2.7 x 2 cm. The lesion was located 0.7 cm from the anterior margin, 0.7 cm from the inferior margin, and more than 1 cm from all other margins. Microscopic evaluation revealed a combination of in situ and infiltrating components. The invasive component was poorly differentiated, with features including apocrine differentiation, nuclear grade 3, high mitotic index, and tubule formation score of 3, resulting in a total Nottingham score of 9. The in situ component was high-grade ductal carcinoma in situ (DCIS) of the solid type, extending into terminal lobules, with apocrine differentiation, moderate mitotic activity, and rare luminal necrosis, comprising approximately 30% of the tumor. The maximum dimension of the tumor was 2.7 cm. The in situ and invasive components were at least 7 mm from the inked resection margins. There was no lymphovascular invasion identified. The biopsy site was present, and background changes included fibrocystic changes such as sclerosing adenosis, calcifications, florid usual duct hyperplasia, microcyst formation, apocrine metaplasia, and dense fibrous stroma.\n\nA separate specimen from the deep and lateral re-excision margins measured 6 x 5 x 1.5 cm and showed fibroglandular and fatty breast tissue. No residual tumor was identified, and the margins were clear. Fibrocystic changes were also present in this portion. Tissue fixation was completed in formalin over a 9-hour period. Multiple sections were submitted for analysis, and immunoperoxidase studies were performed."} +{"pid": "TCGA-BP-4999", "report": "The specimen consists of a 6.2 \u00d7 6.0 \u00d7 5.0 cm wedge-shaped portion of kidney with a suture marking the deep margin. The tumor measures 3.5 cm in greatest diameter and is described as cystic with a small yellow solid component. Serial sectioning reveals a clearance of 0.2 cm from the resection margin. Nuclear grade is assessed as II out of IV. Histologic evaluation confirms no local invasion, and renal vein invasion is not applicable. Surgical margins are free of tumor. Non-neoplastic kidney tissue appears unremarkable. No adrenal gland or lymph nodes are identified within the specimen. Staging indicates the lesion is confined to the kidney and measures less than 7.0 cm in greatest dimension. Sections submitted include frozen section control, tumor, margin, and representative sections. Intraoperative consultation confirms a renal cortical epithelial tumor with close but clear margins; permanent diagnosis remains consistent."} +{"pid": "TCGA-KK-A6E0", "report": "The prostate specimen measured 4.7 x 2.7 x 3.0 cm and weighed 28 grams after fixation. It was submitted with attached right and left seminal vesicles and segments of the right and left vasa deferentia. The prostate maintained a normal shape, with slightly more soft tissue noted along the left posterolateral aspect compared to the right. Firmness was identified in two cross sections of the prostate. Serial cross sections revealed an area consistent with a lesion on the right side, present in two cross sections and extending into surrounding tissue near the apex and base. This focus measured 2.0 x 1.0 cm in its largest dimension and extended into extraprostatic tissue with a margin of extension measuring 4.0 mm. The resection margin was free of involvement. A second distinct lesion was identified in the left posterolateral region, confined entirely to the prostate and measuring 1.0 x 0.2 cm in its largest dimension. Both seminal vesicles and segments of the vas deferens were unremarkable upon gross examination.\n\nLymphovascular invasion was not identified. Perineural invasion was present. High-grade intraepithelial neoplasia was also noted.\n\nA total of nine lymph nodes were identified in the bilateral pelvic lymph node specimen, none of which showed evidence of involvement. The lymph nodes ranged from 0.2 to 1.0 cm in greatest dimension."} +{"pid": "TCGA-E1-A7YJ", "report": "A 2.5 x 2.5 x 1.5 cm fragment of gray-tan tissue and a 2.2 x 2.2 x 1.2 cm aggregate of two fragments of similar appearance were received. Both specimens were derived from a right frontal craniotomy, with the first fragment submitted fresh for frozen section and subsequently placed in formalin. The second specimen was also processed in formalin. Representative sections were retained for analysis.\n\nMicroscopic evaluation revealed brain tissue infiltrated by a malignant astrocytic neoplasm. The cells exhibited cytologic pleomorphism and mitotic activity. No microvascular proliferation or pseudopalisading necrosis was observed. A high proliferation index was noted, with 15% of tumor cells positive for this marker. Immunohistochemical staining showed positivity for LCA (15%), MGMT (30%), EGFR wt (3+ in 90%), EGFR VIII (2+ in 10%), S6 (2+ in 30%), AKT (2+ in 30%), and MAPK (2+ in 40%). PTEN expression was reduced (2+ in 50%).\n\nCytogenetic analysis by FISH demonstrated polysomy of chromosome 7 in 78% of tumor cells, amplification of EGFR in 96%, loss of chromosome 10 centromere in 72%, allelic loss of PTEN in 78%, loss of 9p21 in 44%, and centromere loss of chromosome 9 in 36%. All four abnormal markers and 9p21 loss were present. Real-time PCR analysis for MGMT promoter methylation yielded a negative result, with a Methylation Index below 4. Low-level methylation was considered indeterminate in significance.\n\nThe resection cavity in the right frontal lobe showed irregular nodular enhancement anteriorly and superiorly, with an area of mass-like enhancement extending toward the right corpus callosum. The patient had presented with progressive symptoms including increased sleepiness, headache over the right eye, left-sided weakness, and hearing loss."} +{"pid": "TCGA-AJ-A3OJ", "report": "The specimen includes multiple tissue fragments from right pelvic lymph nodes, measuring 6.6 x 5.0 x 1.5 cm, with several poorly defined tan-yellow nodules up to 3.1 cm. The largest nodules have fatty cut surfaces and were submitted in cassettes labeled A\u2013B (largest), C (next largest), and D (smaller ones). The uterus, cervix, bilateral tubes, and ovaries were received after tissue harvest for genomic study. The uterus and cervix together weigh 203 grams and measure approximately 10.0 x 7.0 x 5.5 cm. The endocervical canal is lined by granular friable gray-tan to pink tissue. The myometrium measures up to 2.2 cm and is tan-pink and trabeculated. Within the endometrial canal, extending into the lower uterine segment and posteriorly into the ectocervical stroma, there is a gritty friable granular lesion measuring approximately 11.6 x 5.5 cm. On sectioning, this lesion has a gritty gray-tan fibrotic cut surface. In the posterior region, it extends to within 0.1 cm of the outer surface margin and also reaches within 0.1 cm of the fundus and both lateral aspects. No gross lesions are seen in the parametrial soft tissue on either side. The left fallopian tube measures 5.0 x 0.5 x 0.5 cm and contains a cylindrical white plastic bead at the site of previous ligation. The left ovary measures 3.1 x 2.2 x 2.0 cm and shows two cystic structures measuring 1.0 and 1.7 cm. The right ovary measures 3.1 x 1.2 x 1.0 cm and has a mottled tan-pink fibrotic cut surface. Three additional tissue cassettes were received, and representative sections were submitted from various regions including the cervix, endomyometrium, parametrium, and adnexa. The left pelvic lymph node specimen is a 7.5 x 6.0 x 1.7 cm aggregate with several poorly defined tan-yellow nodules up to 2.5 cm. The largest nodules have fleshy and fatty cut surfaces and were submitted as A\u2013E; smaller ones as F. The right aortic lymph node tissue measures 5.0 x 4.1 x 1.1 cm and contains several poorly defined pink-yellow nodules up to 2.0 cm. The largest nodule has a fleshy pink-red cut surface and was submitted as A, with remaining nodules labeled B. The left aortic lymph node tissue measures 4.0 x 2.4 x 0.9 cm and contains a few poorly defined pink-yellow nodules up to 0.6 cm, all submitted in one cassette. Microscopic evaluation of the lymph nodes from the right pelvic area showed reactive hyperplasia and no malignancy across six nodes. The uterine specimen was intact. Histologic features included extensive involvement of the endometrial cavity, myometrium, lower uterine segment, and endocervix. The lesion measured 11.6 x 5.5 cm and showed significant myometrial invasion, reaching into the outer half of the myometrium and coming within 0.1 cm of the posterior serosal surface. Involvement of the cervical stroma was also present, with extension to within less than 0.1 cm of the posterior surgical margin. No lymphovascular space invasion was identified, and surgical margins were uninvolved. Other findings include squamous metaplasia of the ectocervix, focal residual adenomyosis in the myometrium, and no malignancy in the serosa, parametrial tissues, or left fallopian tube. The right fallopian tube was not identified. Bilateral ovarian tissue showed atrophy but no malignancy. A total of 25 lymph nodes were examined from all areas, none of which contained metastatic cells. Lymph node specimens from the left pelvic, right aortic, and left aortic regions all showed reactive hyperplasia and were negative for malignancy. Additional histologic review noted architectural features consistent with a grade II lesion, though areas with high-grade nuclei were present, leading to an overall classification as grade III. No papillary serous component was identified. Correlation with prior biopsy material is recommended. A second pathologist reviewed the case and confirmed the findings."} +{"pid": "TCGA-BG-A18B", "report": "The specimen consisted of a uterus with both adnexa, weighing 220 grams. Histologic evaluation revealed a lesion involving the endometrial surface, extending to the lower uterine segment. The maximum dimension of the lesion was 60 mm, with full involvement of both anterior and posterior endomyometrium. Depth of invasion was limited to less than half the thickness of the myometrium. There was no evidence of angiolymphatic invasion. Two lymph nodes were identified in the left pelvic region and three in the right pelvic region; all were negative for tumor involvement. Additional findings included chronic cervicitis with squamous metaplasia, superficial adenomyosis, leiomyoma, serosal adhesions, and physiologic changes in the ovaries. A skin biopsy from the left thigh revealed a skin tag. Histologic assessment of the lymph nodes showed clusters of histiocytes and giant cells without evidence of malignancy. Other associated findings included complex endometrial hyperplasia with atypia. The tumor exhibited well-differentiated architectural features and nuclear grade 2 characteristics. No preoperative therapy was administered. All surgical margins were unremarkable."} +{"pid": "TCGA-06-1086", "report": "The patient presented with a history of headaches and was found to have a calcified, hyperdense, non-enhancing right frontal mass with a fluid level and associated vasogenic edema. A right brain tumor was resected, and the specimen was submitted for analysis.\n\nGross examination revealed a tan-pink, rubbery, and gritty tissue fragment measuring 3.5 x 2.0 x 1.2 cm. Histologic sections demonstrated a high-grade glial tumor with scattered mitotic figures and sheet-like necrosis. Calcifications were identified focally. The tumor exhibited dense nodules and islands of cells with moderate clear cytoplasm, as well as spindly cells in looser areas. Nuclear pleomorphism was mild, with most nuclei appearing round to oval and displaying fine chromatin. Some nuclei were more angulated but maintained similar chromatin patterns. Areas suggestive of ependymal differentiation were observed, including perivascular pseudorosettes. Focal cartilaginous differentiation and osteoid formation were also noted.\n\nImmunohistochemical staining showed variable expression: GFAP, pan-keratin, and NCAM stained many cells in the nodules and islands, while vimentin labeled both major components of the tumor. EMA showed only focal positivity. Synaptophysin and Melan A were negative. The Ki-67 labeling index was up to approximately 75% within the nodules, while p53 staining was negative.\n\nGenetic analysis revealed evidence of 1p deletion based on allelic loss assessment using microsatellite markers, including D1S552, D1S468, and D1S1612 among others. No allelic loss was detected on chromosome arm 19q. Testing for MGMT promoter methylation was negative.\n\nThe histologic features included cellular heterogeneity with areas showing distinct morphologies, including tanyctic-like cells, cartilage, and osteoid, which may suggest some biological overlap with other high-grade neuroepithelial tumors. Reticulin staining highlighted the architecture around tumor nodules and showed pericellular staining in other regions.\n\nThese findings are provided for informational purposes and should be interpreted in the context of established clinical and diagnostic criteria."} +{"pid": "TCGA-85-A50M", "report": "The specimen consists of lung tissue from the right upper lobe. A mass is present with ill-defined margins measuring 7x7x7cm. The cut surface is soft and shows areas of necrosis with a gray appearance. Lymph nodes from the paratracheal, subcarinal, and interlobar regions are identified, each measuring up to 1.5cm in diameter and appearing black in color.\n\nMicroscopically, the tissue forms groups, sheets, and trabeculae of abnormal cells infiltrating into surrounding bronchial tissue. The cells have moderate amounts of eosinophilic cytoplasm. Nuclei are enlarged with variation in size and shape, containing coarse chromatin and prominent nucleoli. Mitotic activity is frequently observed. There is evidence of lymphocytic infiltration within the tumor.\n\nLymph node assessment shows no metastatic involvement in the three sampled nodes. Lymphatic invasion is present. Other features including venous invasion, tumor margins, and response to prior treatment could not be determined based on the available information."} +{"pid": "TCGA-2H-A9GQ", "report": "The specimen shows a poorly differentiated carcinoma arising in the context of Barrett's epithelium, located in the distal esophagus. The lesion measures up to 3.5 cm in maximum diameter. A total of 14 lymph nodes were examined, with 2 showing involvement. The resection margins are clear, indicating a radical resection."} +{"pid": "TCGA-CM-4748", "report": "The clinical history includes a mass in the transverse colon causing obstruction. The resected specimen of the transverse colon measured 23 cm in length and 8 cm in circumference. A lesion measuring 4.5 cm in length and 7 cm in width was identified. It appeared tan-pink, lobulated, focally mucoid, and centrally ulcerated. Upon sectioning, the lesion showed firm, mucinous cut surfaces with diffuse invasion through the bowel wall and into the surrounding fat. The maximal thickness of the tumor was 2 cm. A satellite tumor focus measuring 1.5 x 1.5 cm was found in the attached fat, approximately 5 cm away from the main lesion.\n\nMicroscopic evaluation revealed a moderately differentiated component with a predominant pattern noted. The tumor was located in the transverse colon and exhibited an ulcerating infiltrative configuration. Invasion extended into the subserosa. Vascular invasion was present, while perineural invasion was not observed. There was involvement of the serosal surface, but no gross perforation was identified. The surgical margins were free of tumor. A preexisting polyp of adenomatous type was found at the site of the lesion, though no other polyps were identified in the surrounding tissue. The non-neoplastic bowel tissue was unremarkable.\n\nLymph node dissection identified 23 nodes, one of which contained involvement. Additionally, three mesenteric tumor deposits were present. The depth of invasion and presence of serosal involvement were key features. Immunohistochemical staining demonstrated retained expression of DNA mismatch repair proteins including MLH1, MSH2, MSH6, and PMS2 in the tumor cells. No other significant findings were reported."} +{"pid": "TCGA-D1-A16F", "report": "The surgical specimen includes the endometrium, uterus, right and left ovaries, fallopian tubes, and multiple lymph node groups. The uterus weighed 82.21 grams and contained a polypoid mass measuring 7.5 x 2.5 x 1.3 cm. This lesion demonstrated focal squamous differentiation and invaded the myometrium to a depth of 0.5 cm, with a total myometrial thickness of 2.0 cm. Extension into the lower uterine segment was noted; however, the cervix showed no involvement. The right ovary measured 2.9 x 2.5 x 0.7 cm and included a 7.5 cm segment of fallopian tube, both without diagnostic abnormalities. The left ovary measured 2.5 x 2.0 x 1.3 cm and included a 4.0 cm segment of fallopian tube, also showing no diagnostic abnormalities. Multiple lymph nodes were examined: five from the right pelvic region, ten from the left pelvic region, and six para-aortic lymph nodes (five above and one below the inferior mesenteric artery), all of which were negative for tumor involvement. The assessment was based on gross and frozen section histologic evaluation."} +{"pid": "TCGA-A6-2679", "report": "The specimen includes three parts. Part A, labeled \"left tube and ovary,\" consists of a 658-gram structure measuring 12.0 x 10.0 x 8.7 cm. It is described as white pink-red and cystic with an attached fallopian tube that is 10.5 cm in length and 0.25 cm in average diameter. The fallopian tube lumen appears pinpoint and stellate upon sectioning. The cyst contains serous fluid, with an inner lining ranging from smooth white pink to wrinkled tan white-gold; no papillations are observed. No residual ovarian stroma is identified grossly.\n\nPart B, labeled \"uterus, cervix, right tube with ovary,\" weighs 22 grams and measures 2.8 cm (superior to inferior), 2.5 cm (cornu to cornu), and 1.5 cm (anterior to posterior). The uterine corpus is symmetrical with a smooth serosa. The cervix is mottled white pink-red, surrounding a small os. A soft white pink endocervical polyp measuring 0.6 x 0.2 x 0.2 cm is present. The uterine cavity is triangular and lined by flat white pink endometrium. The myometrium is pale tan-pink, averaging 1.0 cm in thickness, with no intramural leiomyomata. The right ovary is cribriform, measuring 1.3 x 0.8 x 0.5 cm, with pale tan stroma and identifiable corpora albicantia. A single 0.4 cm smooth-lined, serous fluid-filled cyst is noted. The right fallopian tube is fimbriated, measuring 4.3 cm in length and 0.3 cm in average diameter, with a pinpoint stellate lumen on sectioning.\n\nPart C, labeled \"right colon,\" includes a 30 cm segment of proximal right colon and 11.5 cm of distal ileum. The serosa is smooth to scabrous, tan pink, with attached mesentery and mesocolon. An unremarkable appendix is present, measuring 4.5 cm in length and 0.6 cm in diameter. The proximal and distal margins measure 3.7 cm and 5.7 cm in circumference, respectively. A well-circumscribed, 2.8 x 2.0 cm rubbery white-pink-red sessile ulcerated lesion is located 20 cm from the distal margin. The tumor has a maximal thickness of 0.7 cm and extends into the muscularis, reaching within 0.6 cm of the inked free radial serosal surface. Normal mucosa and uninvolved colonic mucosa appear glistening and tan pink with regular folds. Lymph nodes up to 0.9 cm in size are recovered from the mesocolon and mesentery.\n\nMicroscopic evaluation of the colonic lesion shows moderately differentiated invasive adenocarcinoma. The primary tumor invades minimally into the subserosa (pT3a/b). Both proximal and distal margins are negative, as is the circumferential (radial) margin. The closest distance of the tumor to any margin is 20 cm from the distal margin. Vascular invasion is not identified. All 16 regional lymph nodes are free of metastatic disease (pN0). No non-lymph node pericolonic tumor involvement is found. Distant metastasis cannot be assessed. The appendix and ileal mucosa show no significant pathology."} +{"pid": "TCGA-EL-A4K6", "report": "The surgical specimen includes a total thyroidectomy with attached paratracheal and superior mediastinal contents, as well as a right neck dissection. The left paratracheal lymph node specimen consists of three possible lymph nodes, all without evidence of tumor involvement. The thyroid specimen measures 17.0 x 10.5 x 4.2 cm in total. The right lobe contains a dominant nodule measuring 6.2 x 5.0 x 4.1 cm with variegated red-tan and yellow soft parenchyma, intra-fibrous septa, and a thick capsule. There is gross extension of this nodule through the capsule. Adjacent to this nodule are possible matted lymph nodes at the mid-lobe level. In the left lobe, there is a firm, partially calcified red-tan nodule measuring 1.1 x 0.9 x 0.7 cm at the superior aspect, with an adjacent soft pink-tan nodule measuring 0.7 cm in maximum diameter. A separate well-circumscribed red-tan, partially cystic nodule measuring 0.6 cm in maximum diameter is located in the inferior portion of the right lobe.\n\nThe central neck fibroadipose tissue contains seven possible lymph nodes, some of which appear to be matted (up to 1.4 cm in maximum dimension). The right neck fibroadipose tissue contains multiple lymph nodes (up to 1.5 cm in maximum dimension), some of which show variegated red-tan and pink parenchyma suggestive of possible involvement. Of 39 lymph nodes evaluated from the right and central neck regions, 3 contain cellular features consistent with metastatic involvement. Extracapsular extension is noted in at least one of these lymph nodes.\n\nMicroscopic evaluation includes multiple sections submitted from the right lobe (B31-B40), including areas of possible matted lymph nodes, and contiguous sections from different levels of the lobe. Sections from the left lobe (B25-B28) include the superior calcified nodule, the adjacent soft tan nodule, and the inferior nodule. The isthmus is represented in section B30. Additional lymph node sampling from the right and central neck areas includes multiple blocks with varying numbers of lymph nodes per block."} +{"pid": "TCGA-AA-3975", "report": "The specimen shows a moderately differentiated invasive lesion with infiltration of the muscularis propria (pT2), without evidence of lymphatic or vascular invasion (L0, V0). Histological grading corresponds to G2. No lymph node metastases were identified (pN0, 0 of 14 examined). Surgical margins are negative (R0). Staging was reviewed in the context of a multidisciplinary oncology discussion."} +{"pid": "TCGA-FU-A2QG", "report": "The patient is female. A left ovary and fallopian tube specimen showed follicular cysts, with a paratubal cyst attached by fibrous tissue. The ovary measured 4.0 x 3.0 x 1.0 cm, with cysts containing serous fluid up to 0.5 cm. A gray-tan cyst measuring 2.0 x 2.0 x 1.5 cm was also present. The fallopian tube could not be grossly identified.\n\nA radical hysterectomy specimen included a uterus measuring 7.0 x 5.5 x 4.5 cm and weighing 96 grams. The cervix measured 5.0 cm in length and 2.5 cm in diameter. A gray to brown tan shaggy mass measuring 4.0 x 2.5 cm was noted on the ectocervix, located within 0.7 cm of the vaginal cuff margin and predominantly involving the posterior wall. The lesion extended approximately 0.9 cm deep into the cervical wall and was 1.5 cm from the inked resected margin. The endometrial cavity measured 4.0 cm in length and 2.2 cm from cornu to cornu, with a lining thickness of 0.2 cm. The myometrium measured up to 1.0 cm in thickness and showed no gross lesions.\n\nLymph node dissections were performed on multiple sites. Right periaortic lymph nodes (two in total), right common (six), right external iliac (seven), right obturator (seven), left common iliac (two), left external iliac (three), and left obturator (five) lymph nodes were all negative for metastatic disease. Lymph node sizes ranged from 0.2 to 3.2 cm in greatest dimension.\n\nSurgical margins, including the vaginal and deep margins, were negative. Stromal invasion was noted at 0.9 cm depth in a cervical wall measuring 2.4 cm thick. No lymphovascular space invasion was identified. The endometrium and myometrium showed no significant abnormalities, while prominent fibrous adhesions were observed on the serosa. The pTNM stage was reported as pT1b1 N0 (FIGO IVA)."} +{"pid": "TCGA-23-1109", "report": "A biopsy specimen from the ileum reveals a 2.6 x 1.2 x 0.7 cm aggregate of soft, tan-brown friable tissue fragments. The right sidewall biopsy measures 0.7 x 0.5 x 0.5 cm and consists of firm, tan-white nodular tissue. The right ovary frozen section includes a 2.1 x 1.7 x 0.8 cm aggregate of friable tan-white fragments without residual ovarian parenchyma. The appendix is markedly enlarged at 9.1 x 1.8 x 1.4 cm with thickened walls; luminal obliteration and tumor infiltration are observed. The left ovary specimen, measuring 5 x 3.5 cm, contains no ovarian parenchyma and is associated with a fallopian tube segment showing focal tumor involvement in surrounding tissue. The right ovary measures 8.5 x 2.7 cm and is entirely replaced by friable tissue with multiple cystic areas noted. The right gutter biopsy is a 3.1 x 8.2 x 4.9 cm fibromembranous tissue portion largely replaced by tumor fragments. A cul-de-sac lesion measuring 8.2 x 5.3 x 2.2 cm appears firm and friable. The sigmoid tumor specimen measures 4.1 x 2.2 x 1.7 cm with irregular firm fragments noted. Left peritoneal tumor fragments measure 3.3 x 2.4 x 1.8 cm, firm with pink-tan papillary features. The left sidewall biopsy, 3 x 2.7 x 1.4 cm, shows similar papillary tumor features. Presacral tumor specimens range in size from 0.4 x 0.3 x 0.2 cm to 1.1 x 0.4 x 0.2 cm with granular tan-black appearance. The right colon lesion measures 2.3 x 2.1 x 1.7 cm with friable polypoid morphology. Omental findings include a large yellow lobulated section with a 2.0 x 1.0 x 0.6 cm nodule containing fibropapillary tumor fragments. Right diaphragm tissue, measuring 6.2 x 4.9 x 3.7 cm, exhibits friable papillary tumor features. Small bowel mesentery specimens measure 1.6 x 1.4 x 0.7 cm with calcified features and minimal friable material. Retroperitoneal findings on the right side show an aggregate measuring 3.7 x 3.4 x 3.2 cm with friable tan-white features. An epiploic appendix specimen measuring 0.7 x 0.6 x 0.6 cm reveals a firm tan-red mass. Lastly, the sigmoid colon biopsy shows a 1.4 x 1.2 cm nodular tissue portion infiltrated by tumor cells."} +{"pid": "TCGA-AY-6196", "report": "The specimen includes a segment of colon measuring 17 cm in length and 6.7 cm in circumference, along with a portion of ileum measuring 10.7 cm in length and 3.4 cm in circumference. An appendix measuring 3.5 cm in length and 0.9 cm in diameter is also present. The tumor is located 4.2 cm from the ileal margin and 12.7 cm from the colonic margin. It presents as an ulcerated, hemorrhagic, firm, tan/white mass measuring 7.5 cm x 5.5 cm x 5.0 cm, involving approximately 50% of the luminal circumference. The tumor invades through the muscularis propria into the surrounding fat and is associated with multiple separate nodules in the pericolonic fat, up to 3.5 cm in size. There is no gross evidence of perforation through the visceral peritoneum, and approximately 70% luminal obstruction is noted. The tumor is 2.0 cm from the mesenteric margin.\n\nMicroscopic evaluation shows a poorly differentiated lesion with prominent mucinous and signet ring cell features. Invasion extends through the muscularis propria into the pericolic soft tissue. Lymphovascular invasion is extensive, while perineural invasion is not identified. All surgical margins are free of involvement. Twelve out of fourteen lymph nodes contain metastatic disease, with the largest focus measuring 1.0 cm and showing extracapsular extension. Additional findings include the presence of mucin and tumor cells within the periappendiceal soft tissue extending into the muscularis propria of the appendix, as well as severe acute and chronic serositis with adhesions.\n\nImmunohistochemical analysis demonstrates appropriate nuclear staining for MLH1, MSH2, and MSH6, consistent with a normal phenotype. Based on available data, the pathologic stage is pT3 pN2b. This staging is subject to revision pending further clinical review and additional testing, including microsatellite instability analysis."} +{"pid": "TCGA-77-8138", "report": "The specimen received is labeled \"left upper lobe\" and consists of a lung lobe measuring 152 x 90 x 40 mm. An apparent mass is present within the specimen, with visible pleural puckering and fat adhered to the overlying pleura in that region. Upon sectioning, a large mass measuring 50 x 34 x 50 mm is identified, with notable central cavitation. The surrounding lung tissue appears unremarkable, and no endobronchial lesions are observed.\n\nMicroscopic evaluation reveals a moderately to poorly differentiated carcinoma with extensive central necrosis. The mass demonstrates invasion into the pleura but not into the adjacent chest wall fat. The soft tissue resection margins are free of malignant involvement. Vascular invasion is present; however, there is no evidence of lymphatic permeation or perineural infiltration. Evaluation of peribronchial lymph nodes shows no signs of metastatic disease. The bronchial resection margin is clear of malignancy and does not show squamous metaplasia or dysplasia. The distant lung parenchyma exhibits emphysematous changes, while the lung tissue adjacent to the mass shows features of organizing obstructive pneumonitis.\n\nStaging is determined as T2 N0 based on the findings."} +{"pid": "TCGA-FU-A3HY", "report": "The patient is female. The medical record number was provided. Three specimens were received: left pelvic lymph nodes, right pelvic lymph nodes, and a hysterectomy specimen with bilateral salpingo-oophorectomy.\n\nIn the left pelvic lymph node specimen, sixteen lymph nodes were identified and none showed evidence of tumor involvement. Frozen section evaluation was consistent with the final diagnosis.\n\nIn the right pelvic lymph node specimen, twenty lymph nodes were examined, and one contained tumor cells. The lymph node involved was not present in the frozen section slides.\n\nThe hysterectomy specimen revealed a lesion measuring 5.5 by 4.0 cm. Microscopic evaluation showed non-keratinizing morphology. The tumor was located within the cervix and invaded 1.5 cm into a cervical wall that measured 1.6 cm in total thickness. There was focal evidence of vascular space invasion. All surgical margins\u2014including the vaginal cuff, deep margin, and paracervical tissues\u2014were free of tumor. Three paracervical lymph nodes were also negative for tumor involvement.\n\nAdditional findings included normal bilateral adnexa. Based on the findings, the staging classification assigned was pT1b2 N1.\n\nGrossly, the hysterectomy specimen included a uterus weighing 22.5 grams and measuring 5.1 x 4.5 x 3.3 cm. The cervix measured 5.5 x 4.0 cm. A mass was observed extending into the endocervix and showed ulceration on the surface. Surrounding soft tissue included paracervical tissue measuring up to 4.5 x 4.0 x 2.5 cm. Multiple lymph nodes were identified in this region, ranging from 0.5 to 0.7 cm. The vaginal cuff was also submitted. Sections of the uterus showed a pink-tan endometrium measuring 2.8 cm in thickness and a myometrial wall of 0.2 cm at its thinnest point. No significant abnormalities were noted in the uterine body or myometrium. Both fallopian tubes and ovaries were unremarkable, with minor cystic changes noted in the ovaries.\n\nNumerous sections were submitted for microscopic evaluation, including representative sections of the cervix, surrounding soft tissues, lymph nodes, and adnexal structures. Additional tissue was submitted for genomic research.\n\nFrozen section analysis of the left pelvic lymph nodes showed no evidence of tumor in five sampled nodes. Permanent sections confirmed this result. Frozen section evaluation of the right pelvic lymph nodes showed no tumor in four examined nodes, though permanent sections later identified one positive lymph node among twenty."} +{"pid": "TCGA-CV-6956", "report": "The specimen involved tissues from the left and right body of the mandible, with resection margins free of involvement. Lymph node evaluation showed one of six lymph nodes in the left submandibular triangle contained abnormal cellular infiltration, while all twelve lymph nodes from the left jugular region and nine lymph nodes from the supraomohyoid neck dissection were unremarkable. The submandibular gland showed no cellular abnormalities.\n\nExamination of the right mental nerve revealed no notable changes in peripheral nerve or surrounding connective tissue. Skeletal muscle at the mentum demonstrated abnormal infiltration extending into adjacent bone marrow space of the mandible, where fragments of affected tissue were identified. No tumor was found in the right posterior, right middle, or left middle tongue regions. However, the left posterior tongue exhibited focal epithelial changes consistent with moderate dysplasia.\n\nThe anterior mandible remains pending further analysis following decalcification. Soft tissue within the alveolar canal contained peripheral nerve and bone fragments without evidence of abnormality. Eight teeth were recovered as part of the specimen.\n\nPathologic features included vascular and perineural involvement. A deep margin at the anterior floor of mouth showed cellular infiltration; however, this corresponded to a previously identified negative frozen section. The tumor approached the right floor of mouth margin and involved the base of tongue margins bilaterally with moderate dysplasia. Additional assessment of mandibular margins will be detailed in a subsequent report."} +{"pid": "TCGA-A2-A1G4", "report": "The specimen was received in three parts. Part A consisted of a right breast deep margin measuring 4.8 x 2.2 x 0.6 cm. One side was marked with blue ink and further delineated with red ink around the perimeter. The tissue was sectioned into three blocks labeled A1 through A3.\n\nPart B was a left breast simple mastectomy specimen measuring 24.5 x 21 x 3.8 cm. A suture denoted the 12 o\u2019clock position, and the nipple was flat within a 23.7 x 15.3 cm skin ellipse. At the 9 o\u2019clock position, there was a 0.5 cm reddish-brown skin lesion. The superficial aspect was marked with blue ink and the deep with black ink. Sectioning revealed bland yellow fatty tissue with fine fibrous bands and nodular firm areas centrally without discrete masses. Multiple sections were submitted including from the nipple and described skin lesion (B1), central deep margin (B2), upper outer quadrant (B3\u2013B4), upper inner quadrant (B5\u2013B6), lower inner quadrant (B7\u2013B8), lower outer quadrant (B9\u2013B10), and central tissue (B11). Mirror image tissues were taken for B1, B3, B5, B7, B9, and B11. Additional sections from the lower inner quadrant were submitted as B12 through B14, subareolar area as B15, and further upper outer quadrant tissue as B16 and B17.\n\nPart C was a right modified radical mastectomy specimen measuring 30 x 22 x 4.3 cm with a flattened nipple. There was a palpable mass lateral to the nipple. The skin ellipse measured 22.6 x 14.0 cm. A small raised pigmented lesion was present in the lower outer quadrant adjacent to the resection margin, measuring 0.4 cm; the superficial aspect was marked blue and the deep black. The axillary tail was marked red but did not represent a true margin. Upon examination of lymph nodes in the low axillary tail, one node measured 2.8 cm and was fat-replaced with a coil clip; half was submitted per protocol and the rest as C1. Another low node was grossly involved, measuring 1.6 cm; half was submitted as C2 and the remainder per protocol. Additional nodes were submitted as follows: C3\u2013C12. Sectioning showed yellow fatty tissue with fibrous bands. The palpable mass was ill-defined with pink-tan tissue interspersed within fatty tissue, extending from the subareolar area to the lower outer quadrant. By palpation, it measured 6 cm medially to laterally, 6.5 cm superior to inferior, and 4 cm superficial to deep. Grossly, it extended to within 0.5 cm of the deep margin. Sections were submitted including from the nipple (C13), lesion and closest deep margin (C14\u2013C15), most lateral aspect (C16), most central and medial portion (C17), additional tumor sections (C18\u2013C25), with several sections submitted as mirror images per protocol.\n\nMicroscopic findings for Part A showed fibroadipose tissue and skeletal muscle with no evidence of malignancy. The newly inked margin was free of neoplasm.\n\nFor Part B, there was a focus of infiltrating carcinoma in the lower inner quadrant measuring 21 mm. The nuclear grade was I with a low mitotic index. The nipple and deep margin were free of neoplasm. No lymphatic invasion was identified. There was proliferative fibrocystic disease with a focus of in situ carcinoma in the upper outer quadrant along with sclerosing adenosis, duct hyperplasia, apocrine metaplasia, and cyst formation.\n\nIn Part C, a large moderately differentiated intraductal and infiltrating carcinoma was identified, spanning 65 mm with mucinous differentiation. Nuclear grade was II with a low mitotic index. The deep margin was free of neoplasm. Ductal in situ involvement extended to the nipple. Lymphatic invasion was present. Of 15 axillary lymph nodes examined, one contained metastatic carcinoma. Another lymph node showed prior biopsy site changes without residual tumor. A benign hemangioma was noted in the skin of the breast.\n\nReceptor analysis showed strong positivity for estrogen receptor (100% nuclei stained, intensity 3+), negative for progesterone receptor (0% nuclei stained, intensity 1+), and Her-2/neu was negative (score 1+). Ki-67 proliferation index was low at 3%."} +{"pid": "TCGA-B0-4700", "report": "A radical nephrectomy specimen involving the right kidney and adrenal gland demonstrates a large mass measuring 14 cm in greatest dimension, located in the upper pole of the kidney. The mass exhibits areas of hemorrhage and necrosis, with nuclear features corresponding to the highest grade category in some regions. Microscopic examination reveals invasion into the perinephric adipose tissue and extension into the renal pelvis or sinus. Angiolymphatic invasion is present within small vessels. The lesion approaches but does not directly involve the adrenal gland. Evaluation of the proximal ureter, main renal artery, and main renal vein show no evidence of involvement. The tumor extends to the perinephric surgical margin in the upper pole region. Adjacent non-involved kidney tissue appears unremarkable. Pathologic staging has been assigned based on the presence of contiguous disease beyond Gerota\u2019s fascia near skeletal muscle. Additional specimens from the upper pole margin and peridiaphragmatic tissue both show similar microscopic features, with most of the submitted tissue involved by disease. Skeletal muscle fragments adjacent to the tumor demonstrate degenerative changes."} +{"pid": "TCGA-KL-8329", "report": "The left kidney specimen includes perinephric fat, a portion of ureter, and hilar vessels. The adrenal gland is also present. The entire specimen measures 18 x 10 x 5.5 cm and weighs 495 grams. The kidney itself measures 15 x 6 x 4.5 cm. A mass is identified in the upper pole of the kidney, measuring 5.2 cm in greatest dimension. It has a yellow-tan appearance and shows areas of necrosis. The mass is located near the perirenal fat but does not involve it. No involvement of the renal pelvis, renal sinus, or renal vein is observed. The renal capsule remains intact without evidence of invasion. All surgical margins are free of abnormal tissue. Sections submitted include areas of tumor, tumor with adjacent normal tissue, tumor and capsule interface, normal kidney, renal pelvis, ureteral margin, vascular margin, and adrenal gland. The adrenal gland measures 4.2 x 2.6 x 2.0 cm and appears unremarkable. The ureter is approximately 8 cm in length and shows no abnormalities. \n\nThe second specimen consists of a single piece of fatty tissue measuring 3 x 1.5 x 0.5 cm, labeled as para-aortic lymph nodes. The entire tissue is submitted for examination. No abnormal findings are identified."} +{"pid": "TCGA-BH-A0B8", "report": "A lumpectomy specimen from the right breast shows a focus measuring 0.9 x 0.8 x 0.6 cm. Histologic evaluation reveals a Nottingham score of 6 out of 9, with tubule formation score of 3, nuclear grade of 2, and mitotic activity score of 1. No lymphovascular invasion is identified. A separate in situ component is present, displaying a solid pattern and nuclear grade of 2, accounting for 5% of the total lesion. All surgical margins are free of disease, and there are changes noted consistent with a prior biopsy site. The lesion demonstrates hormone receptor positivity and shows weak positivity for HER-2/neu (score 2+); however, no gene amplification is detected. Benign fibrocystic changes along with microcalcifications are also observed.\n\nLymph node assessment includes one sentinel and one non-sentinel lymph node, both from the right side. Conventional histologic staining reveals no evidence of involvement in either node. The largest dimension of any metastatic deposit in lymph nodes is recorded as 0 mm. No dermal lymphatic invasion is present. Non-neoplastic breast tissue shows features of fibrocystic change. Pathologic staging is as follows: pT1b, pN0, pMX."} +{"pid": "TCGA-HN-A2OB", "report": "The tissue sample was obtained from the right breast via surgical resection. The patient was 45 years old at the time of collection. The tumor measured approximately 2.7 cm in size. Histologic evaluation showed features consistent with invasive lobular morphology, and E-cadherin staining was negative. The Modified Scarff-Bloom-Richardson grade was 1 out of 3, with a total score of 4 out of 9. Hormone receptor status was positive for both estrogen and progesterone receptors, while HER2 status was negative. Pathologic staging was T2 with regional lymph node involvement classified as N1a. A total of 5 lymph nodes were sampled, with 2 found to be positive. No evidence of distant metastasis was identified. The specimen was fresh frozen, and there were no documented lymph node metastases. Differentiation grade was not determined."} +{"pid": "TCGA-DX-A48R", "report": "The specimen submitted includes multiple tissue samples. The tumor capsule biopsy reveals high-grade malignant cells with areas of hemorrhage. A segment of the left common iliac vein, measuring 3.0 cm in length, is encased by a soft tissue mass with positive margins at the periphery but negative vascular margins. A ureteral segment measuring 1.0 cm in length is encased and invaded by the mass, with positive soft tissue margins noted. A colon segment measuring 23.0 cm in length demonstrates mucosal hyperplastic changes without evidence of malignancy. The retroperitoneal mass measures 18 cm and exhibits lobulated tan-fleshy cut surfaces with focal necrosis and hemorrhage; margins are close but negative for tumor involvement. Immunostains demonstrate positivity for SMA, desmin, and CMA while being negative for CD117."} +{"pid": "TCGA-FD-A43P", "report": "A 69-year-old Black male underwent cystoprostatectomy with ileo-conduit surgery. Lymph node dissection included nine left pelvic nodes and six right pelvic nodes, all of which were negative for tumor involvement. The resected bladder contained a unifocal mass measuring 2.2 cm located at the dome. Histologic evaluation showed that the tumor invaded the inner half of the muscularis propria. All surgical margins, including ureteral, distal urethral, and soft tissue margins, were free of tumor. A diverticulum was identified on the left lateral wall of the bladder; its lining showed no malignant changes. The prostate demonstrated incidental microscopic findings in the peripheral zone (left), with an estimated tumor volume of 1%. The Gleason score was 3+3=6. No perineural invasion or extraprostatic extension was identified. All regional lymph nodes examined were negative. Prostatic surgical margins, including apical, basilar, and peripheral, were also free of tumor. High-grade prostatic intraepithelial neoplasia was noted multifocally. The submitted specimen included bilateral seminal vesicles and vas deferens, all without evidence of tumor. Tumor staging by the AJCC 7th edition TNM system was pT2a, N0, MX for both bladder and prostate components."} +{"pid": "TCGA-EL-A4JX", "report": "The surgical specimen from a female patient includes a total thyroidectomy and a right paratracheal nodule. The thyroidectomy specimen shows an enlarged right lobe measuring 7.0 x 3.0 x 3.0 cm, with a well-circumscribed tan nodule measuring 4.0 x 3.0 x 2.6 cm located in the medial to inferior aspect of the right lobe. The nodule is confined within the gland and does not demonstrate extrathyroidal extension. Adjacent parenchyma is firm and pale white, with no evidence of lymphovascular invasion. Resection margins are negative. The isthmus measures 4.2 x 1.5 x 1.0 cm and the left lobe is 5.0 x 2.0 cm, both showing features consistent with chronic inflammation. A single lymph node from the right paratracheal region measures 0.8 x 0.3 x 0.2 cm and is negative for tumor involvement. No multifocal lesions are identified. Histologic sections include multiple levels from both lobes and the isthmus, as well as a section of the pyramidal lobe. All resection margins and sampled lymph nodes are free of tumor."} +{"pid": "TCGA-LL-A6FR", "report": "The lumpectomy specimen measured 6.5 x 6.5 x 3 cm and weighed 51 grams. A mass measuring 3.5 cm in greatest dimension was identified within the tissue. Microscopic evaluation revealed a high-grade infiltrating carcinoma with associated in situ changes showing necrosis. The tumor was found to approach the inked deep margin adjacent to skeletal muscle, but not involving it directly. Healing changes were noted, consistent with prior biopsy.\n\nOne sentinel lymph node was submitted for evaluation and showed no evidence of metastatic disease on both standard histologic examination and immunostain for cytokeratin. Two additional margin specimens were obtained: one from the posterior medial region and one from the medial aspect. Both were negative for residual tumor.\n\nHistologic grading showed a poorly differentiated tumor based on nuclear features and mitotic activity. The tumor was unifocal. In situ components were present but not extensive. All margins were free of invasive tumor; however, the deep margin required further resection due to proximity of the tumor. Additional margin tissue obtained added approximately 0.8 to 1 cm beyond the original margin.\n\nAncillary studies showed absence of estrogen receptor expression, weak and low-level progesterone receptor positivity, and HER2 gene amplification with an average of 5.4 gene copies per cell. Chromosome 17 copy number was normal at 2.0 per cell.\n\nStaging was based on a single tumor focus measuring 3.5 cm, classified as pT2. One sentinel lymph node was examined and found without tumor involvement (pN0). No distant metastasis was identified."} +{"pid": "TCGA-F2-A8YN", "report": "The specimen was received as a pancreaticoduodenectomy with involvement of the duodenum and head of the pancreas. The lesion measured 4.8 cm in greatest dimension and was identified as ulcerated, tan, and fibrous within the duodenum, while appearing yellow/white and firm in the pancreas with ill-defined margins. Histologic evaluation revealed moderately differentiated glandular structures with abundant clear to pink apical cytoplasmic mucin. Microscopic examination showed tumor invasion into the duodenal wall and peripancreatic soft tissues. Lymphovascular invasion was present; however, no perineural invasion was identified.\n\nSurgical margins were assessed with the following findings: the uncinate (retroperitoneal) margin was positive for tumor involvement, and peripancreatic soft tissues were within less than 1 mm of the inked margin. All other margins\u2014including the pancreatic resection margin (2.5 cm free), bile duct margin (4.5 cm free), proximal gastric margin, and distal duodenal margin\u2014were negative and widely free of tumor involvement.\n\nA total of 13 lymph nodes were examined, and none showed evidence of metastatic involvement. Additional findings included mild acute and chronic changes consistent with pancreatitis along with patchy autolysis.\n\nImmunohistochemical staining was not performed to distinguish primary origin; however, morphology and absence of a precursor lesion within the duodenal mucosa favored a pancreatic primary.\n\nBiopsies from the common bile duct, pancreatic duct margin, and gallbladder were all benign with no evidence of carcinoma identified. Frozen section analysis of the bile duct and pancreatic duct margin confirmed absence of tumor intraoperatively.\n\nThe specimen was oriented with stitches identifying key margins: short stitch on the pancreatic duct margin, long stitch on the bile duct margin, and a blue stitch on the uncinate margin. Ink colors were assigned accordingly for identification during histologic evaluation.\n\nBlocks were submitted systematically for comprehensive assessment of margins and lymph nodes. Multiple lymph node candidates were sampled across various blocks for thorough staging evaluation.\n\nGross tumor extension did not involve the ampulla, bile duct, or adjacent vessels. The stomach was not involved by tumor. The gallbladder measured 7.8 cm in length with a pale, green velvety mucosa and no stones or significant abnormalities noted.\n\nClinical correlation remains essential for final staging and treatment planning."} +{"pid": "TCGA-D8-A73X", "report": "The specimen from the left breast measures 18 x 14 x 1.5 cm and was removed without a skin flap of 13 x 4.5 cm, weighing 220 grams. A lesion was identified at the boundary of the upper quadrants, centrally located over the nipple. The lesion measured 2.3 x 1.7 x 1.3 cm and was situated 2.5 cm from the lower boundary, 0 cm from the base, and 0.8 cm from the skin. Histologically, the lesion exhibits features consistent with a well-differentiated tubular growth pattern. Nuclear grading was low (NHG1), with no mitotic figures observed in 10 high-power fields (visual area: 0.60 mm). Surrounding glandular tissue shows fibrocystic changes and a small fibroadenoma measuring 0.5 cm in diameter. Immunohistochemical analysis demonstrated strong nuclear staining for estrogen receptors in approximately 75% of cells and for progesterone receptors also in about 75% of cells. HER2 immunostaining showed a score of 1+, indicating no significant overexpression in the invasive component. Proliferation index, assessed by Ki-67 staining, was approximately 10%. The tumor was classified as pT2 based on size, and no lymph node involvement was detected (pNO(sn))."} +{"pid": "TCGA-CG-4462", "report": "The specimen consists of a total gastrectomy resection with involvement of an extensive, focally ulcerated lesion. Histological examination reveals poorly differentiated cells with features suggestive of signet ring morphology. The lesion demonstrates widespread infiltration into the perigastric fatty tissue and is accompanied by marked lymphatic invasion. Twenty-five regional lymph nodes show evidence of metastatic involvement. Subepithelial infiltrates are present and extend to both the oral and aboral resection margins. Additionally, tumor spread is noted in the omental tissue. Lymphatic invasion is also observed in the hilar fatty region of the spleen. Staging assessment indicates advanced local extension, extensive nodal involvement, and distant dissemination."} +{"pid": "TCGA-BH-A0C7", "report": "The specimen includes a sentinel lymph node biopsy from the left side, which shows involvement of one lymph node with micrometastasis measuring 1.5 mm in diameter. No extracapsular extension is identified. A total of 18 lymph nodes were examined, with 17 found to be negative.\n\nA separate surgical specimen from the left breast following mastectomy reveals an invasive tumor measuring 3.0 cm in greatest dimension. Histologic evaluation indicates a high nuclear grade and significant pleomorphism, with moderate mitotic activity, resulting in a Nottingham grade of 3. In addition to the invasive component, ductal carcinoma in situ (DCIS) is present, showing high nuclear grade and a mixture of solid, cribriform, and micropapillary patterns. Minimal comedo necrosis is noted. DCIS is identified in 8 out of 13 slides and constitutes approximately 5% of the total tumor mass.\n\nLymphovascular space invasion is present. Surgical margins are negative, with the closest distance of invasive tumor to a margin being 0.7 cm at the deep margin of the inner/lower quadrant. The nipple and skin show no evidence of tumor involvement. Calcifications are associated with both in-situ and invasive components as well as benign areas of breast tissue.\n\nAdditional findings include focal atypical lobular hyperplasia. Non-neoplastic changes in the surrounding breast tissue include fibrocystic changes, apocrine metaplasia, duct ectasia, and epithelial hyperplasia. Changes related to a prior biopsy site are also observed.\n\nImmunohistochemical staining shows positivity for estrogen receptors and negativity for progesterone receptors. Based on these findings, the pathologic staging is pT2 for the primary tumor, pN1mi for nodal involvement, and pMX for distant metastasis."} +{"pid": "TCGA-B0-4701", "report": "The surgical specimen includes the left kidney, adrenal gland, and peri-aortic lymph nodes. The lesion measures 11 cm in greatest dimension and exhibits a combination of tubulopapillary and sarcomatoid features. Nuclear grading is 3\u20134 out of 4. The tumor extends into perinephric adipose tissue and demonstrates focal microscopic angiolymphatic invasion. The resection margins are closely approached by tumor, with less than one high-power field separating the tumor from the surgical margin; however, no tumor is identified at the inked margin. Extensive evaluation of the perinephric adipose tissue reveals one benign lymph node. A focal inflammatory infiltrate composed of neutrophils is present within the perinephric adipose tissue, suggestive of a microabscess, for which clinical and microbiological correlation is recommended. The adrenal gland shows no significant pathological changes. Mild to moderate atherosclerosis is noted in the renal artery. Based on these findings, the pathologic stage is classified as T3a NO Mx."} +{"pid": "TCGA-DS-A7WF", "report": "A radical hysterectomy specimen was received, measuring 9.0 cm from fundus to ectocervix, 6.0 cm from cornu to cornu, and 3.7 cm from anterior to posterior. A large firm fungating mass was identified involving the entire circumference of the cervix, extending along the endocervical canal. The tumor measured 5.0 cm in diameter and 3.0 cm in length. Depth of stromal invasion was approximately 0.68%, with a maximum thickness of invasion measuring 13.0 mm. The thickness of the cervix at the site of maximal invasion was 19.0 mm. No vaginal extension or extension into the uterine corpus was observed. All surgical margins, including deep cervical, vaginal, and parametrial, were free of involvement. No parametrial involvement was identified. Foci of in situ changes were present adjacent to areas of invasive lesion, and features consistent with lymphovascular space invasion were noted. Staging information indicated pT1b2 NO Mx.\n\nThe endometrium showed secretory changes with a maximum thickness of 0.2 cm. The myometrium had a maximal thickness of 1.7 cm and showed no significant abnormalities. Gross examination of the uterus revealed a homogeneous tan-pink parenchyma without gross pathologic lesions in the corpus. The tumor involved slightly more than 50% of the cervical wall but did not penetrate to the serosal surface.\n\nBilateral salpingo-oophorectomy specimens showed no significant histopathologic changes. The left ovary contained follicles and demonstrated surface adenofibromatous change. The right ovary contained follicles, a corpus luteum, and surface adhesions. Both fallopian tubes were patent and unremarkable. No malignancy was identified in either ovary or fallopian tube.\n\nMultiple lymph node specimens were examined. Right pelvic lymph nodes (four total), right obturator lymph nodes (eight total), right periaortic lymph nodes (two total), left pelvic lymph nodes (four total), left obturator lymph nodes (three total), and left periaortic lymph nodes (two total) were all negative for tumor. Pancytokeratin immunostains performed on all lymph node specimens were negative.\n\nAn appendectomy specimen was also submitted. The appendix measured 6.2 x 0.6 x 0.6 cm and showed reactive lymphoid hyperplasia. No malignancy was identified in the appendix.\n\nAll other tissues submitted for examination showed no evidence of malignancy. Representative sections of the cervix, lower uterine segment, and corpus were evaluated microscopically. Cellular features included poorly differentiated morphology. Synaptophysin and chromogranin stains performed on sections of the lesion were uniformly negative."} +{"pid": "TCGA-G9-6384", "report": "The specimen consisted of bilateral pelvic lymph nodes and a prostatectomy specimen. The right pelvic lymph nodes measured 5.5 x 3.5 x 1 cm and were composed of multiple tan-pink soft tissue fragments. The left pelvic lymph nodes measured 2.5 x 2 x 0.8 cm and were similarly described. All lymph node specimens were fully submitted for analysis.\n\nThe prostatectomy specimen weighed 29 grams before trimming and measured 3.6 cm in width, 3.5 cm in depth, and 2.9 cm in height. After removal of the apex and base, the remaining weight was 12 grams. The outer surface was smooth. Serial sectioning revealed a red, inflamed area in the midportion surrounding the urethra measuring 2.5 x 1.8 x 0.8 cm. The remaining parenchyma showed fibrous tan tissue. The right and left seminal vesicles measured 3.2 x 1.5 x 0.7 cm and 2.5 x 1.5 x 0.4 cm respectively, and exhibited cystic, beige-tan tissue upon bisection. The right and left vas deferens measured 2.6 x 0.5 cm and 1.5 x 0.5 cm respectively, and displayed firm tan tubular structures on cross-section.\n\nHistologic evaluation identified areas of atypical cells with nuclear atypia and glandular architectural changes. Focal involvement of the left apex and left lateral base was noted, with extension into adjacent adipose tissue. Perineural invasion was present. No involvement of the surgical margins or seminal vesicles was identified. A total of eleven lymph nodes from the right side and three from the left were examined, all without evidence of tumor involvement.\n\nGrading criteria were applied based on cellular differentiation and architectural patterns. Tumor involvement was estimated to account for approximately 14% of the sampled prostatic tissue. Multifocal involvement was noted across different regions of the gland.\n\nStaging was determined based on histopathologic findings. Tumor extension was observed beyond the expected boundaries but did not involve the seminal vesicles. Lymph node and distant staging could not be fully assessed based on available data. All grossly identifiable tumor was removed with negative surgical margins. Intraoperative frozen section analysis of the lymph nodes was negative."} +{"pid": "TCGA-F9-A7VF", "report": "The specimen includes a 6.5 x 5.5 x 2.0 cm aggregate of benign adipose tissue. A left kidney weighing 186 grams measures 13.5 x 7.5 x 3.1 cm, with previously removed perinephric fat and capsule. The renal artery, vein, and ureter are unremarkable. A well-circumscribed mass measuring 3.5 x 2.5 x 2.5 cm is located in the lower pole and appears confined to the kidney without extension into surrounding fat. A separate 6.5 x 4.5 cm aggregate of perinephric fat is also present and unremarkable.\n\nMicroscopic examination reveals a lesion with histologic features consistent with a distinct morphologic pattern. Nuclear grading according to Fuhrman criteria shows predominantly grade 2 nuclei with focal areas (10\u201320%) of grade 3 nuclei. Sarcomatoid differentiation is not identified. The lesion measures 3.5 cm in greatest dimension and is limited to the renal parenchyma. No adrenal involvement is noted. Vascular or lymphatic invasion is not present. Surgical margins are free of abnormal cellular aggregates.\n\nLymph nodes are not identified in the specimen. Adjacent renal tissue demonstrates mild atherosclerosis, glomerulosclerosis, and scarring. A small focus of a distinct benign epithelial proliferation measuring 1 mm is noted separate from the main lesion. Immunohistochemical staining demonstrates positivity for cytokeratin 7, pancytokeratin, p504S, and PAX-8.\n\nAll histologic features are consistent with a morphologic pattern typically associated with a specific subtype of epithelial neoplasm arising in the kidney. The lesion exhibits higher nuclear grade compared to commonly observed patterns in similar cases. The tumor is confined to the kidney with no evidence of nodal or distant spread. Staging assessment indicates pT1a Nx Mx."} +{"pid": "TCGA-AA-A02O", "report": "The specimen shows an invasive, moderately differentiated carcinoma with involvement of all layers of the intestinal wall. The tumor measures pT3 based on depth of invasion. Lymphatic vessel invasion is present (L1). A total of 18 regional lymph nodes were examined, and none showed evidence of metastatic involvement. The resection margins are uninvolved. Histological grade is G2. No other significant pathological features are noted."} +{"pid": "TCGA-B5-A3FD", "report": "The specimen weighed 293 grams and measured 13.5 x 8.5 x 5.5 cm. It consisted of a uterus with cervix and bilateral tubes and ovaries. The cervix measured 3.2 cm in diameter with a patent os. Upon opening the uterus, a tan-white, soft, friable, fungating mass was identified at the uterine fundus, measuring 3.6 x 5.2 x 2.1 cm. This lesion was located 3.2 cm from the anterior lower uterine segment and 2.8 cm from the posterior lower uterine segment. Invasion appeared to extend 0.8 cm into the myometrium, which had a thickness of 2.1 cm at that site. The closest distance from the lesion to the serosal surface was 1.5 cm. Sections of the mass were submitted from blocks representing various areas including the deepest invasion point and additional representative sections.\n\nThe remainder of the endometrial cavity measured 6 x 5.1 cm and contained an endometrium of 0 cm thickness overlying a 2.1 cm trabeculated myometrium in the uninvolved regions. In the posterior lower uterine segment, there was a polypoid lesion measuring 1.1 x 0.9 cm. Additionally, two white, whorled nodules were present in the posterior uterus, with the larger measuring up to 1.8 cm in greatest dimension.\n\nThe cervix demonstrated a white-pink, firm, homogeneous cut surface without remarkable findings. Both fallopian tubes and ovaries appeared unremarkable on gross examination. The right ovary measured 3.8 x 1.5 x 0.8 cm and was associated with a 9 cm long fimbriated tube containing a 1 cm serous-filled paratubal cyst. The left ovary measured 4.3 x 0.8 x 0.7 cm with a similarly unremarkable fallopian tube measuring 6.2 cm in length.\n\nLymph node dissections included right external iliac nodes (six lymph node candidates), right obturator nodes (nine lymph node candidates), left pelvic nodes (thirteen lymph node candidates), right aortic nodes (three lymph node candidates), and left aortic nodes (a fragment containing two lymph nodes). All lymph nodes evaluated across these regions showed no evidence of involvement.\n\nMicroscopic evaluation confirmed less than 50% myometrial invasion without lymphatic or vascular invasion. No involvement was identified at the cervix, serosa, or specimen margins. Adjacent non-neoplastic endometrium did not show hyperplasia. Leiomyomas and adenomyosis were noted in the remaining myometrium. Both ovaries and fallopian tubes showed no involvement.\n\nSections from all relevant areas were submitted for histologic analysis. Additional microscopic findings included villoglandular differentiation without evidence of papillary serous tumor. A mixed endometrial/endocervical polyp was identified in the posterior lower uterine segment with a small focus of changes but no cervical involvement was observed."} +{"pid": "TCGA-VQ-A8PB", "report": "The specimen involves the antrum of the stomach and includes a segment of omentum. A lesion measuring 11.0 x 4.0 x 2.65 cm is present in the antral region and extends to the pylorus. The lesion demonstrates areas of necrosis and infiltrates into adjacent fat and gastric serosa. The margins of the lesion appear expansive. No angiolymphatic or perineural invasion is identified. Evaluation of surrounding gastric mucosa reveals atrophic gastritis with intestinal metaplasia. A total of 37 lymph nodes from the lesser curvature and 5 from the greater curvature are examined, none show involvement. The omental tissue and all surgical margins, including the esophageal margin, are free of abnormal cells. Additionally, four lymph nodes associated with the celiac trunk and one near the anterior hepatic artery are unremarkable. There is presence of cholelithiasis in the gallbladder. All material from the greater curvature was placed in alcohol; if any lymph nodes are identified upon further examination, a supplementary report will follow."} +{"pid": "TCGA-AA-3875", "report": "The specimen consists of a right hemicolectomy. The lesion is located 6 cm from Bauhin's valve and measures up to 2 cm in diameter. Histological examination reveals moderately differentiated features. The tumor invades up to the submucosal layer. The appendix shows postinflammatory fibrosis of the wall with fibrous apical obliteration. All oral and aboral resection margins are free of tumor involvement, as is the greater omentum. A total of 31 mesocolic and mesenteric lymph nodes are without evidence of tumor, although some display reactive changes. Vascular and lymphatic invasion markers are negative. The histological grade is G2."} +{"pid": "TCGA-E5-A4U1", "report": "The specimen consists of multiple tissue samples obtained from different regions of the bladder and prostatic urethra. The left wall of the bladder sample includes an aggregate of pink-tan friable tissue chips weighing 4.98 g and measuring 3.5 x 2.5 x 1.3 cm. Additional deep bite samples from the left wall weigh 0.33 g and measure 2.1 x 1.7 x 0.5 cm. The bladder neck sample contains pink-tan tissue chips weighing 0.59 g with dimensions of 2.2 x 1.4 x 0.6 cm. The prostatic urethra sample includes pink-tan tissue chips weighing 0.15 g and measuring 1.5 x 0.8 x 0.5 cm.\n\nMicroscopic evaluation of the left wall samples reveals high-grade urothelial cells with invasion into the muscularis propria. There is also evidence suggestive of angiolymphatic involvement. The bladder neck sample shows high-grade urothelial cells arranged in a papillary configuration without evidence of invasion. The prostatic urethra sample demonstrates denudation of the mucosa with no malignant findings.\n\nAll specimens were processed and submitted for further analysis, with portions reserved for tissue procurement where noted."} +{"pid": "TCGA-06-6389", "report": "A temporal lobe lesion was excised and submitted for pathological evaluation. Histologic examination revealed a moderately cellular neoplasm composed of cells with marked nuclear pleomorphism. Scattered mitotic figures and apoptotic bodies were identified. Microvascular proliferation or necrosis was not initially observed; however, upon further review of additional sections, focal microvascular proliferation was detected, contributing to an upgraded classification. Immunohistochemical staining demonstrated strong and diffuse positivity for p53. The Ki-67 labeling index was approximately 20%, indicating a moderate proliferation rate.\n\nMolecular studies were performed on DNA extracted from the tumor specimen. Testing for loss of heterozygosity (LOH) at chromosome arms 1p and 19q was conducted using a panel of microsatellite markers including D1S1592, D1S552, D19S219, D19S412, and PLA2G4C. No allelic loss was detected at either chromosomal arm. Additionally, promoter methylation status of the MGMT gene was assessed using bisulfite modification followed by real-time PCR (MethyLight assay). The results indicated the presence of methylated MGMT promoter sequences.\n\nSeveral stains and assays were performed on the specimen, including hematoxylin and eosin (H/E), immunostains for MIB-1 (Ki-67), p53, and technical procedures related to LOH and MGMT testing. Multiple tissue blocks were examined, with consistent findings across samples. Based on histologic features and molecular findings, the lesion demonstrates characteristics of a high-grade glioma with focal microvascular proliferation and elevated proliferative activity."} +{"pid": "TCGA-DB-5280", "report": "The specimen consists of brain tissue from the right frontal lobe, measuring 3.8 x 3.7 x 2.2 cm. Histologic evaluation reveals a neoplasm with features suggestive of a mixed glial origin. Tumor grading was deferred initially, pending further analysis. Microscopic examination demonstrates a tumor composed of cells with variable morphology, including areas of increased cellularity and cellular pleomorphism. Mitotic activity is present at a low to moderate level, with up to 2\u20133 mitoses per 10 high-power fields. No endothelial vascular proliferation or necrotic changes are identified.\n\nImmunohistochemical staining was performed using antibodies against GFAP, p53, and MIB-1. GFAP shows focal positivity in tumor cells. p53 protein expression is detected in the tumor cell population. The MIB-1 labeling index varies from low to moderate, with up to 4\u20136% positivity.\n\nFluorescence in situ hybridization (FISH) studies for chromosomal regions 1p and 19q were conducted on paraffin-embedded sections. Two separate probe pairs were used: one targeting 19q with a control on 19p, and another targeting 1p with a control on 1q. The calculated ratios for both probe sets are approximately 0.98, which is above the threshold of 0.80 indicative of deletion. These findings suggest either a tetraploid karyotype or the presence of additional copies of chromosomes 1 and 19, rather than deletion of the 1p/19q regions. This result has been observed in other similar neoplasms.\n\nThe test used for this analysis was developed by Laboratory Medicine and Pathology. It has not been cleared or approved by the U.S. Food and Drug Administration and is intended for use as an adjunct to existing clinical and pathological data. It does not exclude the presence of other chromosomal abnormalities. Multiple tissue blocks were submitted for analysis, labeled Parts A through 15."} +{"pid": "TCGA-FD-A6TI", "report": "The patient is a male of Native Hawaiian/Other Pacific Islander descent. A cystoprostatectomy and lymph node dissection were performed. \n\nIn the right pelvic lymph node dissection, one of ten lymph nodes contained a tumor focus measuring 2.0 cm with extranodal extension. In the left pelvic lymph node dissection, all eleven lymph nodes were unremarkable. \n\nThe bladder specimen showed a solitary mass measuring 5.5 cm involving the dome, right lateral wall, anterior wall, and part of the posterior wall. The tumor invaded through the muscularis propria into surrounding soft tissue and seminal vesicle. The distal urethral and ureteral margins were negative. However, the soft tissue margin was involved with tumor at 1.3 cm. No lymph nodes were identified in the perivesical fat. Of 21 lymph nodes examined, one contained tumor. \n\nThe prostate demonstrated a lesion with a Gleason score of 3+4=7, located in the peripheral zone bilaterally. The tumor volume was estimated at 15%. Perineural invasion was present. High-grade PIN was multifocal. The tumor was confined to the prostate without involvement of the seminal vesicles or extraprostatic extension. The right anterior peripheral margin was positive for tumor (0.1 mm). The distal (apical) margin was free of tumor. No tumor was found in regional lymph nodes (0 of 21 examined).\n\nStaging parameters indicated extensive local disease with positive nodal involvement and a positive surgical margin. Lymphovascular invasion was not specifically mentioned. The specimen was processed with multiple sections submitted for microscopic evaluation."} +{"pid": "TCGA-B6-A0IH", "report": "Surgical Pathology: Finat. WUID:12C64846-1CB3-42E4-B307-54C7AD12F530. CLINICAL HISTORY: S/P carcinoma. Invasive carcinoma of breast.\n\nGROSS EXAMINATION: \nA. \"Left breast biopsy (AF1)\", in formalin. The specimen consists of an irregular ovoid fragment of firm pink and yellow-tan tissue measuring 2 x 1.5 x 0.8 cm in greatest dimension. A portion was previously submitted as frozen section AF1. The frozen section remnant is submitted in Block A1 and the remaining tissue is sectioned and submitted in Block A2.\n\nB. \"Left breast\", fresh. The specimen is a 500 gram, 35.5 x 16 x 5.5 cm aggregate dimension less mastectomy specimen with attached axillary dissection. The breast measures approximately 24 x 15.5 x 5.5 cm. The skin ellipse is 18.7 x 10.4 cm. The nipple is located on the skin surface away from the axillary tail. It is 1.4 cm in diameter and slightly depressed; the surrounding areola is 4 cm in diameter. The tip of the skin ellipse closest to the axillary dissection (upper outer quadrant) exhibits a recent sutured skin excision 4.5 cm long and located 2.7 cm from the superior upper outer surgical margin. The skin also shows three small purple-brown circumscribed lesions measuring between 0.1 cm and 0.2 cm scattered across several areas. Surgical margins are marked with blue ink.\n\nThe deep surface opposite the sutured excision on the skin surface exhibits a focal area of suture material closing a 2.1 cm defect. This defect communicates with the biopsy cavity. The margin in this area is inked carefully. Sectioning reveals that the biopsy cavity is approximately 2.5 x 2 x 1.5 cm in greatest dimension and hemorrhagic. Surrounding the biopsy cavity is a firm, poorly demarcated tan mass with a gritty texture measuring 6.2 x approximately 4 x 2.7 cm in greatest dimension. This mass is well demarcated from surrounding adipose tissue in the outer quadrant but becomes less distinct toward the center of the specimen. \n\nThe remainder of the breast tissue is firm and fibrotic, with multiple cystic structures measuring up to 1 cm filled with gray-green fluid. A second relatively circumscribed area of soft pink-tan tissue bulges above the cut surfaces and measures 3 x 2.5 x 1.5 cm in greatest dimension, located more centrally in the lower outer quadrant. The larger firm mass extends to within approximately 0.5 cm of the surgical margin at the fibroadipose tissue on the deep surface. It is also within 1.5 cm of the superior surgical margin.\n\nBLOCK SUMMARY: \nBlocks B1\u2013B2 include representative sections of the mass and adjacent biopsy cavity. B3\u2013B5 contain sections of the lesion and adjacent deep surgical margin. B6\u2013B7 include sections of the superior surgical margin closest to the lesion. B8 contains a section of the nipple. B9 includes a section of skin and subcutaneous tissue at the surgical incision. B10 contains a section of a soft, tan, demarcated lesion in the lower outer quadrant. B11 includes a section through a firm area of breast tissue approximately 2 cm away from the main lesion in the lower outer quadrant. B12 includes a section of dense and cystic breast tissue from the upper outer quadrant. B13 includes a section of breast tissue from the lower outer quadrant. B14 includes a section of dense breast tissue from the upper inner quadrant. B15 includes a section of dense breast tissue from the lower inner quadrant. B16 includes a section of breast tissue beneath the nipple. B17 includes a section from a small skin lesion.\n\nAxillary dissection measures approximately 13 x 10 x 2 cm in greatest dimension. The specimen is divided into standard levels and examined for lymph nodes. Numerous lymph nodes are identified across all three levels, with measurements up to 4 cm in greatest dimension. The largest lymph node, located in level I, appears completely replaced by adipose tissue.\n\nBLOCK SUMMARY FOR LYMPH NODES: \nBlocks B18\u2013B21 include lymph nodes from level I: B18 contains the largest lymph node, B19 includes two bisected lymph nodes (one inked blue), B20 includes one bisected lymph node, and B21 includes another bisected lymph node. Blocks B22\u2013B25 include lymph nodes from level II: B22 contains five intact lymph node candidates, B23 includes one bisected lymph node candidate, and B24\u2013B25 contain one bisected lymph node candidate total. Blocks B26\u2013B30 include lymph node candidates from level III: B26 contains eight lymph node candidates, B27 includes two bisected lymph node candidates (one inked blue), B28 contains three intact lymph node candidates, and B29\u2013B30 include one bisected lymph node candidate each.\n\nINTRAOPERATIVE CONSULTATION: \nA. \"Left breast biopsy\": infiltrating carcinoma.\n\nFinal evaluation indicates multifocal and extensive involvement, making exact measurements difficult to assess. Immunohistochemical staining for keratin performed on lymphoid tissue blocks demonstrates widespread infiltration of most lymph nodes without evidence of extracapsular extension. All surgical margins appear free of involvement."} +{"pid": "TCGA-DS-A3LQ", "report": "A right pelvic lymph node specimen measuring 5.2 x 0.8 x 0.6 cm was submitted for frozen section analysis. A metastatic lesion measuring 2.5 cm was identified within this lymph node, with focal involvement of perinodal connective tissue. Additional lymph nodes were examined from the right and left pelvic regions as well as the right common iliac area. These included three lymph nodes from the left pelvic region measuring between 0.3 and 1.9 cm in greatest dimension, two lymph nodes from the right pelvic region measuring between 2.0 and 2.4 cm, and two lymph nodes from the right common iliac region measuring between 0.4 and 1.6 cm. No tissue was identified in these specimens.\n\nThe hysterectomy specimen weighed 529.5 grams and measured approximately 14.0 x 9.5 x 7.5 cm. The cervical portion measured 4.6 cm in diameter and 3.5 cm in length. The cervical mass measured 6.8 x 5.5 x 4.5 cm and exhibited friable, necrotic, and hemorrhagic characteristics with an infiltrative border. It extended to a depth of 14.0 mm with extensive lymphatic invasion and reached the posterior serosal surface and focally involved the parametrium. The closest distance between the tumor and the parametrial margin on the right side was 3.0 mm. All surgical margins were free of tumor involvement.\n\nMultiple leiomyomas were present throughout the uterus, including one anterior leiomyoma measuring 8.5 x 7.5 x 7.5 cm and several intramural leiomyomas ranging from 0.4 to 8.0 cm. One of these was subserosal. There was also evidence of localized adenomyosis within the myometrium. No other endometrial abnormalities were observed.\n\nThe right fallopian tube and ovary specimen weighed 12.12 grams. The ovary measured 3.1 x 1.5 x 1.4 cm and contained a hemorrhagic cortical cyst. The fallopian tube measured 4.8 cm in length and ranged between 0.4 and 0.6 cm in diameter. Its lumen contained mucosal material. Representative sections were submitted for microscopic evaluation.\n\nAdditional lymph node specimens were entirely submitted for histologic examination. Gross photographs were taken during specimen evaluation. Inked margins were used to identify anterior (blue) and posterior (black) resection surfaces. Multiple slides were prepared from various tissue segments for diagnostic assessment."} +{"pid": "TCGA-CK-4947", "report": "The surgical specimen consists of a segment of colon measuring 14.5 cm in length and 3 cm in diameter, with attached adipose tissue and mesentery up to 6.5 cm in diameter. A circumferential mass is identified, measuring 4.0 cm in its greatest dimension. The lesion appears to invade through the full thickness of the bowel wall and extends into the surrounding adipose tissue, reaching the serosal surface. No lymphovascular invasion is observed. Histologic evaluation confirms the presence of malignant cells at the area of deepest invasion. Non-neoplastic colonic mucosa shows no significant pathology.\n\nLymph node assessment reveals involvement in three out of twelve nodes. Both proximal and distal resection margins are free of malignancy. A second specimen labeled as distal colon with margin is received, consisting of a 1 cm segment of colon. The stapled resection margin measures 4 cm and is also free of tumor.\n\nGross examination documents that the tumor is located 4.5 cm from the distal margin and 4 cm from the proximal margin. Representative sections of the tumor, margins, and lymph nodes are submitted for histologic analysis. Staging is classified as T4 N1 Mx according to AJCC criteria. Clinical history notes a prior diagnosis of colon malignancy with ureteral involvement and the patient underwent palliative sigmoid colectomy with left ureterolysis."} +{"pid": "TCGA-DD-A3A5", "report": "The left lobe liver specimen includes segments II and III, measuring 18 x 11 x 9.5 cm and weighing 620 grams. A yellow-white, multilobulated mass measuring 11 x 10 x 9.5 cm is present. Adjacent to this mass is a separate tumor nodule measuring 1.3 x 1.2 x 1 cm. The surrounding hepatic parenchyma appears noncirrhotic. The surgical margin is uninvolved, with the closest margin measuring 0.5 cm from the tumor. A biopsy from the right lobe liver, measuring 1.3 x 0.8 x 0.3 cm, shows benign liver tissue."} +{"pid": "TCGA-78-7158", "report": "The specimen consists of a left lower lobe of the lung measuring 160 x 100 x 90 mm. There is puckering of the pleural surface on the anteromedial aspect of the superior portion, with a firm mass beneath it. The mass has been previously incised and appears as a poorly defined area merging into the surrounding lung tissue, making its exact dimensions difficult to determine; however, it is estimated to be approximately 70 x 60 x 70 mm in size. It spans from the anterior to posterior pleural surfaces and approaches within 10 mm of the bronchial resection margin. A small separate nodule measuring 5 mm in each dimension is identified in the mid lateral portion of the lobe.\n\nTwo suture lines are present extending from the hilum\u2014one measuring 40 mm in length superiorly and another measuring 35 mm inferiorly. Sections through the lobe reveal extensive involvement of lung parenchyma, including areas showing papillary architecture with psammoma bodies and nuclear features described as \"Orphan Annie.\" A minor component shows micropapillary differentiation. Surrounding the main lesion, there is evidence of spread through airspaces and lymphatics. The smaller nodule demonstrates similar features and is subpleural with invasion into the visceral pleura. Focal involvement of the pleural surface is suspected.\n\nVascular and lymphatic invasion is present, but no perineural invasion is observed. The bronchial resection margin shows lymphatic permeation within the mucosa. Additional specimens include a piece of lymphoid tissue from the pulmonary vein region and multiple lymph nodes (numbered 9 and 10), all of which contain metastatic involvement. The sampled lymph nodes show extracapsular extension.\n\nImmunohistochemical staining reveals strong positivity for TTF-1 and absence of thyroglobulin expression, supporting a pulmonary origin. Progesterone receptor staining shows patchy positivity while estrogen receptor markers do not demonstrate convincing reactivity.\n\nThe lesion extensively involves the surrounding lung and reaches the bronchial margin. Lymph node metastases are present in all sampled nodes. Vascular invasion, lymphatic permeation, and pleural invasion are noted. The non-neoplastic lung tissue available for assessment is limited."} +{"pid": "TCGA-CJ-4644", "report": "A radical nephrectomy specimen includes a kidney with surrounding adipose tissue and adrenal gland. The kidney measures 16.0 x 10.0 x 9.0 cm, with a solid and partially cystic mass measuring 10.0 x 9.0 x 6.0 cm located in the upper pole, extending toward the center. The mass has a variegated cut surface ranging from yellow-orange to tan-pink and is approximately 0.5 cm from the closest external surface. It is positioned near the renal hilum but there is no clear invasion into the renal sinus. The renal vein is free of tumor involvement. No hilar lymph nodes are identified. The adrenal gland measures 7.0 x 2.5 x 1.0 cm and appears unremarkable. Histologic examination reveals a mixture of clear and eosinophilic cells with Fuhrman nuclear grade 3 features. The lesion extends into surrounding adipose tissue and demonstrates multifocal necrosis. Surgical margins are negative for abnormal cellular infiltration. Multiple tissue sections have been submitted for detailed microscopic evaluation."} +{"pid": "TCGA-GJ-A9DB", "report": "The operative procedure included right hepatectomy and cholecystectomy. Specimens were received in four containers labeled A through D.\n\nPart A, identified as the gallbladder, measured 9 x 3.5 x 3.5 cm. The serosa appeared green-blue-purple, smooth, and glistening. The lumen contained yellow-green bile with no calculi present. The mucosa was yellow-green and velvety with a wall thickness of 0.3 cm. No significant pathological changes were identified.\n\nPart B, identified as portal lymph nodes, consisted of fibroadipose tissue measuring 2 x 1.5 x 0.5 cm. Upon sectioning, four lymph nodes were identified and submitted entirely for evaluation. All were benign and showed no evidence of malignancy.\n\nPart C, representing the right hepatectomy specimen, measured 21 x 11 x 11 cm and weighed 1400 g. A lobulated yellow-white mass measuring 6 x 5 x 4 cm was identified within the liver parenchyma, located 0.6 cm beneath the liver capsule and 1.7 cm from the surgical margin. The mass had a solid cut surface. Microscopic examination revealed moderately differentiated cells arranged in trabecular and pseudo-glandular patterns, with no lymphovascular invasion observed. Surgical margins were uninvolved. Based on the extent of disease, staging was determined as pT1 with no regional lymph node involvement (pN0). Four lymph nodes were examined and none showed evidence of disease.\n\nPart D, an additional fragment of liver tissue from the right lobe, measured 8 x 4 x 3 cm and weighed 44 g. No tumor was identified upon step-sectioning. Histological analysis of this specimen showed steatosis with perisinusoidal, periportal, and focal bridging fibrosis, estimated at stage 2 to 3 out of 4 on trichrome stain.\n\nIntraoperative frozen section analysis of the hepatectomy margin confirmed absence of tumor involvement. The tumor was unifocal and confined to the liver without macroscopic or microscopic venous invasion. No additional metastatic information was available."} +{"pid": "TCGA-KK-A8ID", "report": "The right pelvic lymph node specimen consists of fibroadipose tissue measuring 4.0 x 4.0 x 2.0 cm, with multiple lymph nodes identified ranging in size from less than 0.1 cm to 2.2 x 0.8 x 0.5 cm. Of the fourteen lymph nodes evaluated, two contain foci of involvement measuring 1.0 and 3.0 mm respectively; no extranodal extension is observed. The left pelvic lymph node specimen includes fibroadipose tissue measuring 3.0 x 3.0 x 1.5 cm with five lymph nodes identified, ranging in size from 0.2 cm to 2.2 x 0.8 x 0.4 cm; no involvement is present.\n\nThe prostate specimen measures 6.0 x 2.8 x 4.2 cm and weighs 47 grams post-fixation. Gross examination reveals palpable nodules on both the right and left anterior surfaces. Serial cross sections demonstrate firm areas consistent with tumor involvement in both anterior regions across three cross sections. Histologic evaluation reveals extensive involvement of the prostate gland, with tumor measuring 4.0 x 3.8 cm in the largest cross-sectional dimension. The tumor exhibits multifocal extension beyond the prostatic capsule and invades both the intra and extraprostatic portions of the right seminal vesicle as well as the extraprostatic portion of the left seminal vesicle. Extensive involvement of adjacent soft tissues surrounding the seminal vesicles is also noted.\n\nTumor extends to the inked margin at the apex (anterior and posterior) and posterior base region, with an involved margin length of 4.0 mm. Vascular or lymphatic invasion is identified. Adjacent soft tissues along the left posterolateral aspect of the prostate appear more abundant compared to the right side. The seminal vesicles and attached segments of the vasa deferentia are grossly unremarkable.\n\nA separate specimen from the anterior bladder neck consists of tan-gray tissue measuring 4.4 x 1.7 x 0.8 cm and shows no evidence of tumor involvement. All remaining tissue was submitted for evaluation."} +{"pid": "TCGA-D1-A16R", "report": "A panniculectomy specimen from the abdomen, weighing 1590.0 grams, consists of skin and subcutaneous tissue without any identified lesions; only gross examination was performed. A separate specimen including the uterus, bilateral fallopian tubes, and ovaries weighs 460.0 grams. The uterine serosa appears smooth, and a mass measuring 10.7 x 7.8 x 2.1 cm is observed, filling the endometrial cavity. Histologically, the mass demonstrates cellular features consistent with a neoplastic process. Invasion into the myometrium extends to a depth of 0.6 cm, within a total myometrial thickness of 3.2 cm. No involvement of the endocervix is noted. Lymphovascular space invasion is not present. All surgical margins are free of neoplastic cells. Both ovaries and fallopian tubes appear histologically unremarkable, with no evidence of involvement. Lymph node dissection includes 24 right pelvic lymph nodes, 22 left pelvic lymph nodes, and an additional 3 right pelvic lymph nodes, all of which are negative for neoplastic cells. Frozen section analysis of the uterine specimen confirmed the presence of a neoplasm involving the myometrium to a depth of 0.6 cm, with further evaluation deferred to permanent sections. Staging is based on available surgical material according to the AJCC classification (7th edition, 2010). Representative sections of all relevant tissues have been submitted for review."} +{"pid": "TCGA-HS-A5N7", "report": "The sample was collected from a left retroperitoneal soft tissue mass. The tumor measured approximately 9.2 centimeters in size. Histological analysis showed a moderately differentiated tumor with features consistent with a malignant mesenchymal neoplasm. The tumor grade was classified as Grade II according to the FNCLCC system, with 40\u201350% necrosis and a mitotic count of 5\u20137 per 10 high-power fields. Staging information indicated pathological T2 (not otherwise specified), no regional lymph node involvement, and no evidence of distant metastasis at the time of diagnosis. The type of procedure performed was a resection."} +{"pid": "TCGA-BG-A0YV", "report": "The patient underwent a robot-assisted total abdominal hysterectomy, bilateral salpingo-oophorectomy, and pelvic lymph node dissection. The specimen findings demonstrated a lesion involving the cervix with full-thickness myometrial invasion and serosal involvement. Microscopic evaluation revealed poorly differentiated epithelial neoplasm with a maximum dimension of 40 mm. The anterior and posterior endomyometrium showed 80% involvement each. Nuclear grade was determined to be grade 3, with architectural grading also classified as poorly differentiated. Lymphovascular space invasion was identified. Background leiomyomas were present.\n\nExamination of resection margins, including vaginal and parametrial margins, was negative for tumor involvement. Metastatic involvement was identified microscopically in both adnexal regions and bilaterally in the peritubal area. Pelvic washings were negative for malignant cells.\n\nA total of 20 lymph nodes were examined across multiple sites: one left common and peri-aortic lymph node, two right common and peri-aortic lymph nodes, nine right pelvic lymph nodes, and eight left pelvic lymph nodes. No metastatic adenocarcinoma was identified in any of the lymph nodes examined. There was no evidence of extranodal extension.\n\nThe mitotic rate was 20 per 10 high-power fields. Based on these findings, the pathologic staging was determined as pT3a, pN0, with a FIGO stage of IIIA. Residual tumor could not be assessed."} +{"pid": "TCGA-CZ-4854", "report": "The surgical pathology report describes a specimen obtained via nephrectomy from the right kidney, along with a biopsy of regional lymph nodes. The lymph node specimen consisted of two lymph node candidates measuring 0.5 x 0.5 x 0.4 cm and 0.9 x 0.6 x 0.5 cm, both of which showed no evidence of abnormal cellular infiltration or involvement. Microscopic evaluation of the lymph nodes revealed fat replacement and no malignant findings.\n\nThe right kidney specimen weighed 1121.5 grams and measured 27.5 x 14 x 6.2 cm. The kidney included the renal artery (1.8 x 0.5 cm), renal vein (0.4 x 0.7 cm), and ureter (10 x 0.3 cm). A solid, partially encapsulated mass measuring 5.7 x 5.2 x 4.3 cm was identified in the mid pole of the kidney. This mass was yellow/red in color, focally hemorrhagic, and located at a distance of 10.3 cm from the ureteral margin, 6.5 cm from the renal artery margin, and 2.5 cm from the renal vein margin. Grossly, it appeared to abut but not invade the renal capsule or involve the renal pelvis or caliceal system. Additionally, a clear fluid-filled cortical cyst measuring 1.2 x 1.0 cm was observed at the anterior/superior aspect of the kidney adjacent to Gerota\u2019s fascia. Two other cystic structures were also present near the renal mass but lacked any papillary or solid excrescences.\n\nMicroscopic examination of the renal mass revealed cells with clear cytoplasm arranged in nests and trabeculae. Nuclear grade was low to intermediate with uniform nuclei and inconspicuous nucleoli. No lymphovascular invasion was identified. Margins of resection including vascular, ureteric, and soft tissue were negative for tumor involvement. Staging classification based on AJCC criteria was assigned as T1b NO MX.\n\nEvaluation of the non-neoplastic renal parenchyma demonstrated diffuse mesangial expansion with focal nodular glomerulosclerosis. There was also evidence of focal global and segmental glomerulosclerosis. Arterial changes included severe intimal and medial sclerosis with luminal narrowing, along with hyaline degeneration in afferent and efferent arterioles, showing \"onion-skinning\" morphology. Interstitial fibrosis and tubular atrophy were present in approximately 40% of the sample. Glomeruli exhibited thickened basement membranes with occasional double contours, but spikes or craters were not prominent. Inflammatory infiltrate in the interstitium was mild and mononuclear.\n\nA total of 187 glomeruli were identified in the section evaluated, of which 47 (25.1%) were globally sclerosed and 3 were segmentally sclerosed. Many glomeruli showed enlargement of the tuft with diffuse mesangial sclerosis and a slight increase in mesangial cellularity. Early nodular expansion was noted in some mesangial areas.\n\nClinical history included an incidental finding of a right renal mass and a prior history of transitional cell carcinoma of the bladder. Cytogenetic analysis of the renal mass revealed clonal chromosomal aberrations including deletion of the short arm of chromosome 3 (3p), which is commonly associated with certain types of renal neoplasms. Other abnormalities included deletions and additions involving chromosomes 1, 6, 8, 10, 17, and others.\n\nNo adrenal gland was identified in the specimen. No lymph nodes were found within the kidney specimen itself. Multiple sections of the renal mass and surrounding normal tissue were submitted for further studies including immunohistochemistry, electron microscopy, and tissue banking."} +{"pid": "TCGA-27-1838", "report": "Birth date. Tumor site. Left occipito-temporal. Histological diagnosis. A high-grade neoplasm was identified, characterized by marked cellular pleomorphism, frequent mitotic figures, and areas of necrosis with surrounding palisading. The tumor exhibited diffuse infiltration of the brain parenchyma, with extensive microvascular proliferation. Immunohistochemical staining demonstrated positivity for GFAP and MGMT promoter methylation status was assessed. The lesion showed no evidence of systemic spread; however, local invasion into adjacent neural structures was noted. Based on histological features and extent of spread, the case is classified as a high-grade, locally advanced lesion."} +{"pid": "TCGA-KK-A8II", "report": "The left external, internal, hypogastric, and obturator lymph nodes consist of a tan-yellow irregular fragment of adipose tissue measuring 6.8 x 3.5 x 1.5 cm. Thirteen possible lymph nodes were identified, ranging in size from 0.4 x 0.3 x 0.2 cm to 3.6 x 1.7 x 1.0 cm. No tumor was identified in these nodes.\n\nThe right external, internal, hypogastric, and obturator lymph nodes include a tan-yellow irregular fragment of adipose tissue measuring 5.0 x 4.5 x 1.8 cm. Ten possible lymph nodes were found, ranging from 0.3 x 0.3 x 0.2 cm to 8.0 x 2.3 x 0.8 cm. One lymph node (B8) showed focal cortical expansion, which was interpreted as reactive based on immunoperoxidase studies (L26, CD5, and CD43), which did not support a diagnosis of lymphoma.\n\nThe symphysis pubic bone specimen includes multiple fragments of bone and admixed soft tissue, measuring 5.0 x 3.0 x 1.0 cm in aggregate. The soft tissue component was entirely submitted for histologic evaluation. Bone sections were also processed for further histologic analysis.\n\nThe prostate and seminal vesicles specimen includes the prostate gland, attached right and left seminal vesicles, and segments of the right and left vasa deferentia. The prostate measures 4.5 x 3.4 x 3.9 cm and weighs 37.5 grams post fixation. Two distinct areas of abnormal tissue were identified: one in the peripheral zone and another in the transition zone.\n\nThe dominant focus is located in the left anterolateral, left lateral, left posterolateral, left posterior, mid posterior, right posterior, right posterolateral, and right lateral aspects of the peripheral zone. This lesion measures approximately 4.5 x 1.5 cm in its largest cross-sectional dimension and spans four cross sections, with significant involvement of the apical region. In the right posterolateral aspect, abnormal tissue extends along nerve trunks into adjacent soft tissue beyond the prostate. This extraprostatic extension is present in two sections and measures less than 2.0 mm in length. Margins of resection are free of abnormal cells. Marked perineural invasion is noted, including nerve trunks at the interface between the prostate and surrounding tissue. No other definitive evidence of extraprostatic extension was observed.\n\nA second, smaller focus is located in the transition zone, primarily in the anterior and right apical regions. This lesion measures 0.5 x 0.2 cm in its largest cross-sectional dimension and spans three apical sections. It is histologically distinct and confined within the prostate.\n\nHigh-grade prostatic intraepithelial neoplasia was identified. Both seminal vesicles and segments of the vasa deferentia show no evidence of abnormal tissue."} +{"pid": "TCGA-BK-A0CB", "report": "The specimen consists of a hysterectomy specimen including the uterine corpus, cervix, bilateral adnexa, and upper vagina, along with lymph node tissue from right and left pelvic and periaortic regions. The uterus weighed 149 grams and measured 5.5 x 5.5 x 4.5 cm, with a symmetrical shape. The cervix measured 3.5 cm in length, with a patent os measuring 1 x 0.3 cm. The anterior paracervical surface was inked blue and the posterior paracervial surface black. Upon sectioning, tan-white tissue was identified within the cervical canal and endometrial cavity, distorting the normal anatomy. The tissue extended to within 0.2 cm of the inked anterior paracervical margin. In the endomyometrium, the depth of involvement reached up to 2.2 cm in thickness and involved more than 75% of the myometrial wall, which itself measured up to 2 cm in thickness.\n\nThe left ovary measured 2.4 x 2.2 x 1.6 cm, was rubbery and tan-gold in color, with pale tan stroma and identifiable corpora albicantia. The left fallopian tube was 5.5 cm long, fimbriated, and had a pinpoint to stellate lumen. The right ovary and fallopian tube were received separately, with the ovary measuring approximately 4 x 3.4 x 2.5 cm, appearing cystic with grumous, greasy tan-gold debris and brown hair, but no tubercle was identified. The right fallopian tube segment was 4 cm in length, pink-purple, and fimbriated, with a small lumen.\n\nLymph node specimens included: right pelvic (7.4 x 6.8 x 3.4 cm aggregate), containing up to 5.4 cm lymphoid tissues; right periaortic (6 x 3.6 x 1.7 cm), with up to 3.2 cm lymphoid tissues; left pelvic (7.5 x 7.5 x 3.3 cm), with up to 4.3 cm lymphoid tissues; and left periaortic (4.7 x 3.8 x 2.3 cm), with up to 4 cm lymphoid tissues. All lymph nodes were processed in entirety across multiple blocks.\n\nMicroscopic examination of the hysterectomy specimen revealed a histologic pattern involving the cervix with extensive stromal replacement. The depth of myometrial invasion was 1.3 cm out of a total myometrial thickness of 1.7 cm, equating to 76% involvement. Resection margins were not involved. Foci suspicious for vascular invasion were noted. A separate finding in the left ovary showed a mature cystic teratoma. No evidence of malignancy was found in the right ovary or either fallopian tube.\n\nIn the lymph node assessment, metastatic involvement was identified in one of four lymph nodes in the right periaortic group and in one of four in the left periaortic group. No metastases were found in the right or left pelvic lymph node groups, which contained six and seven lymph nodes respectively."} +{"pid": "TCGA-HT-7469", "report": "The pathology report describes a markedly hypercellular glial neoplasm observed on microscopic examination. In certain areas, the tumor cells exhibit round, small nuclei with minimal atypia and very few mitotic figures. However, in other regions, the nuclei appear larger and more angular, with up to eight mitoses per 10 high-power fields. Prominent blood vessels are noted, although true microvascular proliferation is not present. Multiple foci of nonpalisading tumor necrosis are identified. The tumor cells generally have few processes, and many display small perinuclear halos. The MIB-1 labeling index is calculated at 16.1%, indicating increased proliferative activity."} +{"pid": "TCGA-DX-A8BH", "report": "The specimen consists of a 9.7 x 8.0 x 4.0 cm soft tissue mass with overlying skin. The tumor measures 6.7 x 6.0 x 3.3 cm and is multinodular, firm, and tan-white in appearance. It is located less than 0.1 cm from the deep and postero-lateral margins, 0.1 cm from the superior and inferior margins, and 0.2 cm from the skin surface. The surrounding tissue includes skeletal muscle and fibroadipose tissue, with the tumor showing infiltrative growth. A small myxoid component is present, comprising less than 10% of the lesion. Necrosis accounts for approximately 10% of the tumor. Vascular invasion is not identified. Surgical margins are free of tumor involvement, though minimal clearance (< 0.1 cm) is noted at the inferior, postero-lateral, and deep margins. Immunohistochemical staining is negative for S100 and HMB45. Multiple sections were taken from the margins and the lesion for analysis."} +{"pid": "TCGA-D5-5539", "report": "The histopathological examination of a resected segment of the large intestine, along with surrounding tissues, revealed a lesion in the mucosa measuring 3.3 x 5.2 x 0.8 cm, with involvement of approximately 60% of the intestinal circumference. The lesion was located 15.3 cm from the proximal cut end, 15.0 cm from the distal cut end, and 1.4 cm from the ileocecal valve. Associated findings included polyps up to 2.0 cm in diameter.\n\nMicroscopic evaluation showed a mixture of tubular and mucinous cellular structures with high-grade cytological atypia. There was evidence of infiltration into the pericolonic adipose tissue. No neoplastic involvement was observed at the intestinal resection margins. Additionally, a separate benign polypoid lesion with mild dysplastic changes was identified.\n\nLymph node analysis demonstrated the presence of abnormal cellular deposits within one lymph node. Several staging systems were applied, indicating advanced local invasion without distant spread. The specimen included 20 cm of large intestine, 13.8 cm of small intestine, a 6 cm appendix, and surrounding tissue measuring 23 x 11 x 3 cm."} +{"pid": "TCGA-AO-A1KQ", "report": "A 45-year-old male underwent surgical excision of left breast tissue along with sentinel lymph node biopsy and axillary lymph node dissection. The submitted sentinel lymph node specimen from level 1 of the left axilla consisted of a single lymph node measuring 1.5 x 1.0 x 0.8 cm. Frozen section analysis identified a metastatic deposit measuring at least 2 mm within this lymph node. No extranodal extension was observed. Incidental benign capsular nevus cell aggregates were noted in the lymph node.\n\nThe primary breast specimen included a mastectomy specimen with levels one and two axillary contents. The breast measured 19 x 18 x 3.5 cm with overlying skin. The axillary contents measured 11 x 10 x 3 cm. A well-circumscribed, stony-hard white-tan lesion measuring 2.0 x 2.0 x 1.7 cm was identified microscopically and located 1.8 cm from the deep margin, subjacent to the nipple. Histologic evaluation revealed an invasive cellular proliferation arranged in solid and cribriform patterns with marked nuclear pleomorphism and high nuclear grade. The invasive component measured 2.2 cm in greatest dimension and was located in the lower inner quadrant and central (retroareolar) area.\n\nIn addition to the invasive component, there was also presence of in situ disease characterized by high-grade nuclei and moderate necrosis. This in situ component constituted \u226425% of the total tumor burden and was found both admixed with and separate from the invasive portion. The nipple was involved by the invasive component, and perineural invasion was identified in the dermis of the nipple region. Focal lymphatic invasion was also noted in this area.\n\nCalcifications were present within the in situ component. No involvement of surgical margins by either invasive or in situ disease was identified. Evaluation of eight lymph nodes from the axillary dissection revealed one positive node containing a metastasis measuring approximately 1.8 cm. There was no extranodal extension identified.\n\nSpecial immunohistochemical stains demonstrated strong and diffuse nuclear staining for estrogen receptor (>95%) and progesterone receptor (>80%). HER2 immunostaining showed only focal weak positivity (1+ intensity), without amplification.\n\nNo significant abnormalities were identified in the non-neoplastic breast tissue. Sections from various regions including the nipple base, deep margin, upper and lower inner quadrants, and outer quadrants were examined and submitted for analysis."} +{"pid": "TCGA-EW-A6SA", "report": "A total mastectomy specimen from the left breast was submitted, measuring up to 14.0 cm in greatest dimension and weighing 103.0 grams. A firm, well-defined tan nodule measuring 2.1 cm was identified within the breast tissue. The lesion was located closest to the deep margin at 0.1 cm, with other margins ranging from 0.5 cm to 2.5 cm from the lesion. The lesion was sampled extensively, including sections through the deep, superior, inferior, medial, and lateral margins, as well as the nipple and overlying skin.\n\nFour sentinel lymph nodes were evaluated. Immunohistochemistry for keratin confirmed isolated tumor cells in one lymph node (sentinel node no. 1), while the remaining three sentinel nodes showed no evidence of tumor involvement. Additionally, a suspicious lymph node was examined and found to be negative for tumor cells.\n\nHistologic evaluation revealed a poorly differentiated invasive carcinoma with a Nottingham histologic score of 8 (score 2 for glandular/tubular differentiation, score 3 for nuclear pleomorphism, and score 3 for mitotic rate). The tumor measured 21 mm in greatest dimension and was present as a single focus. Adjacent to this, there was a component of high-grade ductal carcinoma in situ (DCIS) with solid architectural pattern and focal necrosis. DCIS was estimated to be at least 2.5 mm in extent and identified in 2 out of 8 blocks examined. Lobular carcinoma in situ was not identified.\n\nMargins were uninvolved by invasive carcinoma or DCIS. No lymphovascular invasion was observed. Sentinel lymph node evaluation included hematoxylin and eosin staining at one level and immunohistochemistry for keratin. One sentinel node contained isolated tumor cells; extranodal extension was not present.\n\nAncillary studies demonstrated positivity for estrogen receptor (>50% immunoreactive tumor cells) and negativity for progesterone receptor (<1% positivity). HER2 immunostaining was negative (score 0). Additional immunohistochemical markers used included ER (ID5), PR (PgR 636), HER2 (A485), EGFR (H-11), CMV (CCH2/DDG9), AR (F39.4.1), and HPV detected by in situ hybridization.\n\nNo treatment effect was noted in either the breast or lymph nodes. Pathologic staging was determined as pT2 based on tumor size greater than 20 mm but not exceeding 50 mm. Regional lymph node staging was pN0(i+), indicating isolated tumor cells in sentinel lymph nodes without extranodal extension. Distant metastasis could not be assessed (pMn/a).\n\nFrozen section analysis during surgery showed no evidence of malignancy in any of the sentinel or suspicious lymph nodes evaluated intraoperatively."} +{"pid": "TCGA-DC-6157", "report": "The specimen from the sigmoid and upper rectum consists of a segment of colon measuring 35.5 cm in length and 7.2 cm in circumference at the distal margin. A plaque-like lesion is identified, measuring 4.0 cm in length, 2.8 cm in width, and 0.8 cm in maximal thickness. The lesion is located 5.8 cm from the distal margin. Histologically, the lesion shows moderately differentiated features with tumor budding noted at its base. Invasion extends into the muscularis propria to a depth of 0.6 cm and is 0.3 cm from the nearest radial margin. There is no evidence of vascular or perineural invasion, serosal involvement, or gross tumor perforation. All surgical margins are free of tumor. A total of 21 lymph nodes are examined, none of which show metastatic involvement.\n\nA second specimen from the additional proximal sigmoid measures 3.1 cm in length and 2.2 cm in diameter. It shows benign colonic tissue with no discrete lesions or abnormalities. Both open and stapled margins are free of tumor.\n\nTwo additional specimens consist of the distal and proximal anastomotic rings. Each ring is submitted entirely for examination and demonstrates benign colonic tissue. The distal ring measures 1.8 x 1.8 x 0.7 cm and has a pink tan mucosal surface with focal hemorrhage. The proximal ring is attached to a silver metal anastomotic pin measuring 7.5 x 2.8 x 1.5 cm. The attached soft tissue measures 1.8 x 1.8 x 0.7 cm and also shows a pink tan, focally hemorrhagic mucosa with smooth serosa. Sutures and staples are removed prior to submission.\n\nAll specimens are processed and sectioned as described, with representative sections submitted for histologic evaluation."} +{"pid": "TCGA-HC-8212", "report": "The specimen included lymph nodes from the right and left pelvic regions, as well as a prostatectomy specimen. The right pelvic lymph nodes consisted of two lymph nodes measuring 1.8 x 1.2 x 0.2 cm and 2.9 x 1.7 x 0.3 cm respectively, embedded in fibroadipose tissue. The left pelvic lymph node measured 3.1 x 1.4 x 0.4 cm and was also embedded in fibroadipose tissue. Histologically, all lymph nodes showed benign hyperplasia without evidence of metastatic disease.\n\nThe prostatectomy specimen weighed 40 grams and measured 5.2 x 4.1 x 2.8 cm. It included both seminal vesicles and probable segments of the vas deferens. The prostate had a shaggy, tan-pink capsule with blue ink on the left side and red ink (overstained with black) on the right. Histologic evaluation revealed a lesion involving both lobes, comprising approximately 30% of the gland. There was focal extension beyond the capsule on the left posterior region. Invasion of lymphovascular and perineural spaces was noted. High-grade prostatic intraepithelial neoplasia was also present.\n\nAll surgical margins\u2014including bladder neck, apical, and inked prostatic margins\u2014were negative. No involvement of the seminal vesicles was identified. A total of three lymph nodes were examined; none contained metastatic disease. Additional findings included benign prostatic hyperplasia. Tumor staging was determined to be pT3a, NO, MX."} +{"pid": "TCGA-06-6391", "report": "The patient has a past history of previously diagnosed disease with currently active symptoms. Clinical manifestations include headache, dysarthria, difficulty swallowing, and nausea with vomiting. Imaging findings demonstrate a large central necrotic lesion with enhancement and the presence of smaller satellite lesions located within the cerebellar hemisphere. The lesion may have been present since earlier imaging.\n\nA biopsy of brain tissue was obtained from the right cerebellar region. Gross examination revealed several tissue fragments measuring up to 1.5 x 1.0 x 0.3 cm in aggregate. Microscopic evaluation showed widespread infiltration of white matter by atypical cells exhibiting nuclear pleomorphism, mitotic activity, and microvascular proliferation. Areas of vascular necrosis and thrombosis were identified, along with focal nuclear karyorrhexis suggestive of necrosis. Carcinoma was not observed.\n\nImmunohistochemical staining demonstrated strong gliofibrillary differentiation. Approximately one-third of the neoplastic cells showed intense p53 immunoreactivity. Proliferative activity, assessed by MIB-1 labeling, was approximately 20% in more active regions.\n\nMolecular testing was performed on extracted nucleic acids from paraffin-embedded tissue. Polymerase chain reaction (PCR) analysis did not detect evidence of EGFR variant III mutation. Sensitivity of the assay allows detection of approximately five mutant cells among one hundred normal cells. Methylation-specific PCR for the MGMT promoter was also negative. Analytical sensitivity for this assay was established at 18% methylated DNA against an unmethylated background. Factors such as high non-neoplastic cell content or extensive necrosis may affect test reliability.\n\nIntraoperative consultation described an undifferentiated high-grade neoplasm consistent with primary central nervous system origin. The frozen section was evaluated and reported to the attending physician. Ancillary studies were conducted in compliance with laboratory-developed test standards under CLIA regulations. These findings are intended for use alongside established clinical and diagnostic criteria."} +{"pid": "TCGA-BP-4338", "report": "The submitted specimen consists of a left kidney with attached perinephric fat, weighing a total of 700 grams. The kidney measures 12.5 cm in length, 7.5 cm laterally, and 5.5 cm anterior to posterior. Upon bisection, an encapsulated, subcapsular, multiloculated mass is identified within the upper pole, measuring 5.5 x 5.5 x 1.3 cm. The mass demonstrates areas of central necrosis and hemorrhage. The renal cortex is 0.6 cm thick, pink-tan, and unremarkable. The medullary region measures up to 1.2 cm. The ureteral lining is smooth and pink-tan. No invasion of the renal vein is observed. All surgical margins are free of abnormal tissue. The tumor is confined within the renal capsule and does not extend to the black-inked surface. No hilar nodes are identified. Multiple sections from various regions of the specimen, including the tumor, pelvis, ureter, margins, and surrounding fat, are submitted for analysis. The tumor exhibits a solid growth pattern and nuclear grading is consistent with high-grade morphology."} +{"pid": "TCGA-P5-A72U", "report": "The clinical evaluation indicated an abnormality in the brain. Gross examination revealed soft gray-pink tissue fragments obtained from the right parietal lobe. Microscopic analysis showed that the tissue was primarily composed of brain parenchyma with areas displaying atypical cellular features consistent with a neoplastic process. The tumor demonstrated regions of necrosis and was classified as Grade III based on histological findings."} +{"pid": "TCGA-A6-A567", "report": "The specimen includes a segment of the lower anterior colon (sigmoid) and an appendix. The colon specimen measures 22 cm in length, with a proximal circumference of 4.5 cm and a distal circumference of 7.5 cm. The proximal end is stapled and inked blue, while the distal end is opened and inked black. A lesion measuring 4.8 x 3.5 x 1 cm is present, located within 5 cm of the distal margin. This lesion extends through the muscularis propria into the surrounding fat and reaches a serosal umbilication measuring 2.5 x 1.5 cm, which is also inked blue. An indurated focus measuring 1.5 x 1.5 cm is noted on the surface, located within 9 cm of the proximal margin, with possible involvement identified on cut surface. A small polyp measuring 0.5 cm is found 3 cm from the distal margin and shows no signs of invasion.\n\nMultiple lymph nodes are identified in the surrounding fat, with a focus of induration at the mesenteric margin. Sections submitted include luminal margins, mesenteric margin shave, the polyp, areas connecting the tumor to the umbilication, normal tissue, fat, radial margin, and the indurated nodule. Nine lymph nodes are sampled from one area, four from another, and one lymph node at the mesenteric peduncle is bisected for evaluation.\n\nMicroscopic examination reveals a moderate to poorly differentiated epithelial malignancy extending through the bowel wall into the mesenteric fat. The mesenteric root region does not show involvement. Three positive lymph nodes are identified among 41 total nodes examined. A soft tissue deposit is observed in the mesentery. A benign polyp is also present. The proximal, distal, and radial margins are free of disease. No vascular invasion is identified.\n\nThe appendix measures 6 x 0.5 cm and has an average wall thickness of 0.3 cm. The lumen varies from pinpoint to unclear. Histologically, the appendix shows no significant abnormalities."} +{"pid": "TCGA-2X-A9D5", "report": "A left radical orchiectomy specimen was examined. The testicle measured 6.5 x 4.6 x 3.4 cm and weighed 95 grams. Attached structures included the epididymis (5.3 x 1.0 x 0.6 cm) and a spermatic cord measuring 6.0 x 2.0 cm. A dominant mass measuring 6.2 x 4.6 x 3.3 cm was identified within the testicle. The mass appeared tan, firm, lobulated, and ill-defined with a predominantly homogeneous texture. It abutted the visceral layer of the tunica vaginalis but did not extend beyond the testicle. The remaining uninvolved testicular tissue was tan, soft, and homogeneous. Seminiferous tubules were noted to string easily.\n\nMicroscopic evaluation showed that the tumor was unifocal and confined to the testis. The rete testis was directly invaded by the tumor. There was no involvement of the tunica vaginalis, spermatic cord, or scrotum. Intratubular germ cell neoplasia was present. Lymph-vascular invasion was not identified. Surgical margins, including the spermatic cord, were free of tumor involvement.\n\nLymph nodes were not submitted for evaluation. Pathologic staging according to 2010 criteria was determined as pT1, pNX, pM-N/A. Representative sections were taken from multiple areas including the spermatic cord margin, mass at the rete testis, mass extending toward the epididymis, mass adjacent to the tunica vaginalis, and uninvolved testicular tissue. Gross photographs were taken and microscopic findings were incorporated into the final report."} +{"pid": "TCGA-KN-8424", "report": "The surgical pathology specimen from a right kidney resection weighed 573 grams and measured 16 x 11 x 8 cm. The kidney itself measured 15 x 7.5 x 6.3 cm and was accompanied by perirenal adipose tissue up to 6.0 cm. Vascular structures at the hilum included a 2.2 cm renal artery (0.5 cm diameter), a 1.3 cm renal vein (0.9 cm diameter), and an 8.5 cm ureter, all of which were grossly unremarkable. A well-circumscribed, tan-yellow, hemorrhagic mass measuring 6.6 x 6.3 x 5.8 cm was identified in the lower pole of the kidney. It expanded toward but did not grossly breach the renal capsule and was located 2.5 cm from the hilar vessels. The overlying perirenal fat was mobile and showed no gross signs of involvement. Gerota\u2019s fascia had been partially inked black.\n\nMicroscopic evaluation revealed that the tumor was confined to the kidney without extension into surrounding tissues. Resection margins, including vascular and ureteral margins, were free of tumor involvement. There was no evidence of lymphovascular invasion. Histologic assessment showed nuclear features corresponding to Fuhrman grade 2\u20133. Immunohistochemical staining was negative for TFE3. Staging according to the AJCC 6th edition classification was T1b with no regional lymph node or distant metastasis assessed (NX, MX).\n\nEvaluation of the non-neoplastic renal parenchyma showed 269 glomeruli, with only one (0.4%) being globally sclerosed. The remaining glomeruli exhibited normal cellularity and structure on PAS and Jones methenamine silver stains, with no significant abnormalities in the basement membranes. Tubular and interstitial architecture was preserved, with no notable atrophy or fibrosis observed on trichrome staining (AFOG). Arterial and arteriolar changes included mild subintimal and medial sclerosis with focal hyaline degeneration, considered likely age-related.\n\nTissue blocks submitted for microscopic analysis included margins, tumor with adjacent adipose tissue, sections of tumor alone, tumor with adjacent normal kidney tissue, tumor with adjacent renal vein, and uninvolved kidney tissue. No adrenal gland tissue was present in the specimen. The renal pelvis and mucosa appeared normal upon gross inspection."} +{"pid": "TCGA-EO-A1Y5", "report": "The specimen included a pre-caval lymph node, a uterus with cervix and bilateral salpingo-oophorectomy, an omental sample, and right common and external iliac lymph nodes. One pre-caval lymph node contained metastatic high-grade adenocarcinoma. The uterine specimen showed a 2.0 cm tumor in the anterior left cornual region with involvement of the myometrium extending to the serosa. There was evidence of vascular space involvement in the cervix and bilateral adnexa. The omentum showed no signs of malignancy. Of the 17 pelvic lymph nodes assessed, 8 contained metastatic disease, and one para-aortic lymph node was also involved. Histologic evaluation revealed a poorly differentiated adenocarcinoma with deep myometrial invasion. Lymphovascular invasion was present. Immunohistochemical staining demonstrated diffuse and strong positivity for p53 and p16, with focal ER expression; WT-1 and PR were negative. Assessment of MMR repair genes (MSH-6, PMS-2, MLH-1, and MLH-2) revealed intact expression. No additional significant pathologic findings were noted."} +{"pid": "TCGA-DJ-A3VE", "report": "The thyroid specimen was received as a total thyroidectomy. The right lobe measures 4.3 x 2.8 x 1.6 cm, the left lobe measures 4.3 x 3.3 x 1.7 cm, and the isthmus measures 1.8 x 1.4 x 0.5 cm. A thin fibrous capsule covers the external surface. The posterior surface is inked black, and the anterior surface is inked blue. Upon sectioning, a nodule measuring 1.7 x 1.6 x 1.3 cm is identified in the left lower pole. It is ovoid, tan-white, friable, and partially encapsulated. Superior to this nodule is another smaller nodule measuring 0.5 x 0.5 x 0.5 cm, which is also ovoid and tan-white but unencapsulated, abutting the anterior aspect. The remaining tissue shows red-tan, beefy cut surfaces. The specimen was serially sectioned and representative areas were submitted for analysis.\n\nMicroscopic evaluation reveals well-differentiated cells without identifiable mitotic activity or necrosis. The lesion is located in the left lobe and is partially surrounded by a fibrous capsule. No blood vessel invasion or extrathyroid extension is observed. Surgical margins are free of involvement. Multicentric disease is not present. Adjacent non-neoplastic thyroid tissue shows mild nodular hyperplasia. Parathyroid glands are not identified in the sections examined."} +{"pid": "TCGA-14-1794", "report": "The specimen consists of two parts. The first specimen was received fresh and labeled \"right frontal brain lesion,\" containing three pieces of soft tan tissue measuring 2.5 x 1.5 x 0.4 cm in total. A touch preparation was performed, and a representative section was submitted for frozen section diagnosis. The second specimen was received in formalin, also labeled \"right frontal brain lesion,\" consisting of multiple pieces of hemorrhagic tan tissue measuring 9.0 x 3.7 x 0.1 cm in total. Representative sections were submitted for analysis.\n\nMicroscopic evaluation revealed a highly cellular lesion with significant mitotic activity, vascular proliferation, and areas of necrosis. The features observed were consistent with a high-grade neoplasm. A preliminary intraoperative assessment of the frozen section and touch preparation confirmed the presence of a high-grade lesion. The findings were derived from a biopsy and excision of a right frontal brain mass following frontal craniotomy."} +{"pid": "TCGA-A7-A6VY", "report": "The final surgical pathology report includes findings from an excisional biopsy of the right breast and a resection of the right axillary contents.\n\nIn the right breast specimen, a mass measuring 3.5 x 3.2 x 2.5 cm was identified, located centrally and within 0.2 cm of the closest margin. Microscopic evaluation showed a high-grade infiltrating component with a histologic grade of 3, based on architectural, nuclear, and mitotic scores all being 3. The tumor measured 3.5 cm in its greatest dimension, corresponding to a pT2 classification. Margins were negative but close, with the nearest margin measuring 1 mm from the posterior edge. No vascular invasion was identified. A non-invasive component was also present, accounting for less than 5% of the total tumor, with a solid histologic pattern and nuclear grade 3. Central necrosis was noted focally. The margins for this non-invasive component were uninvolved, at 3 mm from the posterior edge. No calcifications were observed.\n\nIn the right axillary dissection, 14 lymph nodes were examined. Metastatic involvement was found in 2 of these nodes, corresponding to a pN1 classification. The largest metastatic deposit measured 3.4 cm, and extracapsular extension was present. Lymph nodes were submitted for analysis in sequence, with representative sections taken from the largest involved node and other areas.\n\nThe surgical specimen from the breast was received fresh, fixed in formalin, and measured 6.0 x 5.5 x 4.5 cm. It was oriented with sutures: short suture indicating superior (orange inked), long suture indicating anterior (blue inked), with posterior margin black and inferior green. Serial sectioning from medial to lateral revealed the central mass. The axillary specimen was a 12.0 x 6.0 x 2.5 cm aggregate of fatty tissue with palpable lymph nodes, the largest measuring 3.4 cm and firm in consistency. Multiple sections were submitted for histologic evaluation from both specimens."} +{"pid": "TCGA-55-8203", "report": "The specimen from the right lower lobe of the lung, received as a wedge biopsy, consists of a wedge-shaped portion of pulmonary tissue with intact staple lines. The tissue weighs 8.5 grams and measures 6.0 x 4.5 x 1.6 cm. A 2.2 x 2.2 cm area of induration and slight depression is noted on the pleural surface. Beneath this area, a 2.3 x 2.0 x 1.5 cm nodular lesion is identified with a gritty, fibrotic texture. The lesion approaches but does not breach the pleura and extends to within 1 mm of the nearest staple line margin without appearing transected. The remaining lung tissue appears spongy and mottled tan-brown. Representative sections of the lesion and surrounding tissue were submitted for microscopic examination.\n\nA second component of the case includes a lobectomy specimen from the right lower lobe weighing 178 grams and measuring 16.0 x 9.9 x 3.3 cm. A small gray-black nodule measuring 1.0 x 0.9 x 0.3 cm is observed adjacent to the bronchus. A Y-shaped staple line measuring 5.2 cm is present on the anterolateral aspect, consistent with prior resection. No gross tumor is identified in this portion of the lung. Sections of the bronchial margin, peribronchial nodule, staple line area, and uninvolved parenchyma were submitted.\n\nLymph node specimens were also received. One container contains two lymph nodes at level 7 measuring 1.1 x 0.5 x 0.2 cm and 1.4 x 1.0 x 0.3 cm; both were entirely submitted. Another lymph node at level 9 measures 1.6 x 0.9 x 0.3 cm and was entirely submitted. At level 4, a larger lymph node fragment measuring 2.0 x 1.6 x 0.6 cm and a smaller fragment measuring 1.2 x 1.0 x 0.3 cm were received and submitted in entirety.\n\nMicroscopic evaluation of the wedge biopsy reveals a moderately differentiated lesion with associated fibrosis. The lesion extends to within 1 mm of the staple line margin. Visceral pleural involvement is present, with the lesion approaching but not penetrating through the pleura. There are foci suspicious for lymphovascular space invasion. Emphysematous changes are also present. No residual lesion is identified in the lobectomy specimen. The bronchial margin is free of involvement. Sections from the prior staple line site show recent hemorrhage but no residual lesion. Reactive changes including sinus histiocytosis, lymphoid hyperplasia, and anthracosilicosis are seen in lymph nodes at levels 4, 7, and 9, with no evidence of metastatic involvement. Three peribronchial lymph nodes also show reactive changes only.\n\nStaging is based on the size of the lesion (2.3 cm in greatest dimension) and absence of nodal involvement, corresponding to a pT1b NO classification. The histologic features are consistent with a primary lung lesion, although clinical correlation is recommended to exclude metastasis. The case was reviewed by an additional pathologist with concurrence. Specimen fragmentation in one instance limited accurate lymph node count. Revisions to the report included CPT code updates with no change to the original findings."} +{"pid": "TCGA-CQ-7071", "report": "The specimen was received intact and included a left neck dissection, an anterior lip margin sample, a partial mandibulectomy from the left anterior alveolus, and surgical waste. The left neck dissection measured 9.5 x 7.0 x 2.0 cm and contained 22 lymph nodes ranging in size from 0.2 to 2.0 cm. One lymph node measuring 2.0 cm in greatest dimension was identified as involved and located in level I. No extranodal extension was observed. The submandibular gland showed no pathologic changes.\n\nThe anterior lip margin specimen consisted of skin measuring 3.0 x 0.5 x 0.2 cm and was negative for tumor involvement. The mandibulectomy specimen measured 4.4 x 3.1 x 2.3 cm and contained a single exophytic and ulcerated mass measuring 3.9 x 2.4 x 1.6 cm. This lesion involved the mandible and extended into the gingiva and buccal mucosa. Histologic evaluation revealed moderately differentiated cells with no evidence of lymphovascular or perineural invasion. Bone sections were initially pending decalcification; subsequent decalcified sections demonstrated superficial cortical invasion but bone margins remained negative.\n\nMargins of resection were evaluated with the closest distance measuring 0.2 cm at both the anterior and medial margins. All other margins were greater than 0.5 cm from the lesion. The involved margins were submitted for histologic evaluation. Seven teeth and one bridge were present in the surgical waste, with no remarkable findings noted on gross examination.\n\nStaging was based on AJCC/UICC TNM 7th Edition criteria. Based on the available information, the primary lesion was classified as T2 (greater than 2 cm but not more than 4 cm). Regional lymph node involvement was staged as pN1 (single ipsilateral node, \u22643 cm in greatest dimension). A total of 22 lymph nodes were examined, with 1 found to be involved. Distant metastasis could not be assessed. An addendum was issued after evaluation of decalcified bone sections, which confirmed negative bone margins despite evidence of superficial cortical involvement."} +{"pid": "TCGA-BR-8060", "report": "Gross and microscopic examination of the excised tissue from the cardia region of the stomach reveals a poorly differentiated cellular growth. The specimen measures 4 x 3 x 0.4 cm and is characterized by an ulcerated surface. Microscopic analysis shows that the lesion extends into the muscularis propria layer. Lymph node assessment indicates that all four intraabdominal lymph nodes examined contain abnormal cellular infiltration. There is evidence of extension into adjacent structures, including the esophagus. No information is available regarding lymphatic, venous, or perineural invasion, and the status of surgical margins remains undetermined. No prior treatment effects are noted."} +{"pid": "TCGA-A7-A0D9", "report": "The specimen consists of a left axillary sentinel node and a left breast surgical specimen. The sentinel node measures 2 x 1 x 0.5 cm and shows a rim of red-tan lymphoid tissue with a central fatty core. Microscopic examination revealed no evidence of metastatic involvement.\n\nThe left breast specimen measures 21 x 20 x 5.5 cm and includes an area of skin measuring 8.5 x 6 cm. A dominant firm nodule is identified in the inferior central region, measuring 3.5 x 2.5 x 3 cm, located 2.5 cm from the deep margin. This area shows hemorrhagic changes laterally, consistent with a prior biopsy site. A separate hemorrhagic cavity in the inner upper quadrant contains white rice-like pellets and measures 1.7 cm in greatest dimension, located 2.7 cm from the deep margin. All other margins are uninvolved. No gross lymph nodes or additional lesions are identified.\n\nMicroscopically, the primary lesion shows features of a moderately differentiated invasive epithelial neoplasm, with a histologic grade of 2 (architectural score 2, nuclear score 3, mitotic score 1). The largest dimension of the residual invasive component is 3.5 cm (pT2). The deep margin and nipple are free of tumor involvement, and there is no evidence of vascular invasion or chest wall/skin infiltration.\n\nA second focus of intraductal proliferation is present at the second biopsy site, measuring up to 1.9 cm, with high nuclear grade and central necrosis. This component accounts for approximately 10% of the tumor volume at the invasive site. Post-biopsy changes are noted at both biopsy sites. Extensive intraductal spread is not present.\n\nLymph node evaluation includes one sentinel node, which is negative. Non-tumorous breast tissue shows post-biopsy alterations. Calcifications are present in the areas of interest. Distant metastasis could not be assessed. Prognostic marker data is referenced from a prior core biopsy."} +{"pid": "TCGA-A8-A0A7", "report": "The tumor measures 2.8 cm in maximum diameter and exhibits infiltrative growth. Histological evaluation reveals a polymorphocellular appearance with marked chronic secondary inflammation. There is evidence of lymphovascular invasion and involvement extending to the subcutaneous tissue. Nodal involvement is present, with metastatic infiltration identified in one out of fourteen axillary lymph nodes, showing extension beyond the nodal capsule into adjacent soft tissue. Tumor grade is II. Immunohistochemical analysis demonstrates negativity for estrogen and progesterone receptors and positivity for C-erb B-2 oncoprotein."} +{"pid": "TCGA-DC-6155", "report": "The surgical specimen from the sigmoid and upper rectum was examined, measuring 15.5 cm in length and 5.4 cm in circumference. A lesion was identified 9 cm from the proximal margin and 4.5 cm from the distal margin, measuring 1.5 cm in length and 1.3 cm in width. The depth of invasion was 0.2 cm, with a distance of 1.5 cm to the closest radial margin. The tumor showed no evidence of tumor budding or increased tumor-infiltrating lymphocytes. A precursor lesion was noted as a tubulovillous adenoma. Histologic evaluation revealed moderately differentiated cellular features. No gross perforation was observed. Lymphovascular invasion was present; however, no large venous or perineural invasion was identified. All surgical margins were free of involvement, with the distal margin measuring 4.5 cm and the radial margin measuring 1.5 cm from the tumor. No polyps or dysplastic changes were found away from the lesion, and the surrounding mucosa was unremarkable. Thirty-one lymph nodes were examined, with three showing evidence of involvement. No tumor deposits were identified in the pericolorectal soft tissue. The depth of invasion corresponded to pT2 staging, and lymph node involvement corresponded to N1b staging. Immunohistochemical staining for mismatch repair proteins (MLH1, MSH2, MSH6, PMS2) demonstrated retained expression in the tumor cells. The distal and proximal ring margin specimens showed no abnormal findings upon histologic examination."} +{"pid": "TCGA-IB-AAUM", "report": "The specimen was received in multiple containers labeled A through F. \n\nContainer A contained a paraportal lymph node specimen consisting of yellow hemorrhagic adipose tissue measuring 3.8 cm in maximum dimension. No lymph nodes were identified on sectioning.\n\nContainer B contained a gallbladder measuring 7.5 x 3.2 x 1.5 cm. The mucosal surface showed a dark brown, slightly velvety appearance with no stones identified. The wall thickness ranged from 0.1 to 0.5 cm, with a thickened area noted at the neck and body.\n\nContainer C contained a Whipple resection specimen including portions of the distal stomach, duodenum, and pancreas. The distal stomach measured 5 cm in length and showed multiple tan mucosal nodules circumferentially distributed over an area measuring 6 x 1.8 cm. These nodules approached within 2.3 cm of the proximal resection margin. The duodenum measured 19.5 cm in length and contained a light tan firm polypoid lesion on the proximal mucosal surface measuring 1.2 x 1.1 cm. This lesion was located approximately 1.5 cm from the distal end of the stomach and 1.4 cm proximal to the ampulla of Vater. Multiple small mucosal polyps were also observed near the ampulla of Vater. The attached pancreas measured 5.7 x 4 x 1.5 cm and contained a light tan, ill-defined, firm area measuring approximately 3 x 1.5 x 1 cm, occupying more than 50% of the cut surface. This area extended to within less than 0.1 cm of the pancreatic margin marked with orange dye and extended into the vessel bed and distal pancreatic margin. The bile duct lumen showed variable circumference measurements ranging from 0.9 to 2.4 cm, with the most dilated segment measuring 3 cm in length at the distal end.\n\nContainers D, E, and F contained frozen section specimens from various surgical margins. Specimen D (distal bile duct margin) measured 0.8 x 0.3 x 0.2 cm; specimen E (pancreatic duct margin) measured 1.2 x 0.8 x 0.2 cm; and specimen F (retroperitoneal margin) measured 0.9 x 0.7 x 0.2 cm.\n\nHistologic evaluation revealed fibrofatty tissue only in the paraportal lymph node. The gallbladder showed findings consistent with chronic cholecystitis. In the Whipple specimen, tumor involvement was identified in one peripancreatic lymph node and the bile duct margin. No malignancy was found at the distal bile duct, pancreatic bile duct, or retroperitoneal margins. Histologic type was poorly differentiated (G3), and the tumor demonstrated invasion of the duodenal wall and perineural invasion. Lymphovascular invasion was not identified. The primary tumor was classified as pT2, indicating tumor limited to the pancreas with a size greater than 2 cm. One regional lymph node metastasis was identified out of the total number examined. Pancreatic intraepithelial neoplasia was present, with the highest grade being low grade. There was no evidence of prior treatment effect."} +{"pid": "TCGA-ET-A3DW", "report": "The specimen was received fresh and labeled with the patient\u2019s name, designated as a total thyroidectomy. The thyroid measures 6 x 6 x 2.5 cm and weighs 6.87 grams. It was opened and examined prior to processing. A well-circumscribed, tan, homogeneous mass measuring 2.7 cm in diameter is identified in the right lobe, which was marked with a stitch. The remainder of the gland appears normal. Representative sections were submitted for analysis, including multiple sections from the tumor and other lobes. The tumor involves the thyroid capsule but does not extend beyond the gland. It extends to the margin. One perithyroidal lymph node contains metastatic involvement. The pathologic staging is T2N1MX. A total of 8 blocks were submitted, with 70% of the specimen and 90% of the tumor represented in the sections."} +{"pid": "TCGA-IM-A41Z", "report": "The thyroid specimen weighed 14.8 grams and measured 4.5 x 2.5 x 1.0 cm on the right lobe and 2.5 x 2.0 x 1.4 cm on the left lobe. Multifocal involvement was identified bilaterally. The dominant lesion measured 1.5 cm in greatest dimension and was located in the right lobe, situated less than 0.1 cm from the outer resection margin. A second lesion measured 1.3 cm in greatest dimension and was located in the left lobe, also within 0.1 to 0.2 cm of the outer resection margin. Histologic evaluation revealed a follicular variant pattern with no lymphovascular invasion identified. Surgical margins were uninvolved by invasive processes.\n\nA total of twenty lymph nodes were examined, all without evidence of metastatic involvement. Of these, five were identified in one grouping and thirteen in another, all showing negative findings. Additionally, thymic tissue demonstrated hyperplastic changes. One normocellular parathyroid gland measuring 0.5 cm was identified.\n\nImmunohistochemical staining showed positivity for Galectin 3, CK19, and Cyclin D1. HBME1 staining was negative. The Ki67 proliferative index was less than 5%.\n\nPathologic staging indicated no regional lymph node involvement (pNO) and no distant metastasis. The primary tumor classification was based on size greater than 1.0 cm but not exceeding 2.0 cm, confined to the thyroid gland."} +{"pid": "TCGA-WB-A80N", "report": "The specimen consists of a left adrenal gland removed via laparoscopic adrenalectomy. The gland, together with adherent fatty tissue, weighs 112 grams and measures 7 x 11.5 x 3.5 cm. A spherical lesion with a diameter of 45 mm is present; it is well-circumscribed and smooth-bordered. Within the normal adrenal tissue, an iatrogenic lesion measuring less than 10 mm is observed. Two distinct lesions are identified within the adrenal: one located at each end of the gland. The larger of these measures up to 4.3 cm in diameter, has a gold-brown discoloration, and is sharply demarcated from surrounding tissue. The smaller lesion, measuring 1.3 cm in diameter, is dark yellow and also sharply defined. Between the two lesions, residual adrenal parenchyma measures 1.7 x 1.7 cm. An additional small lesion, approximately 0.6 cm in diameter, is noted at the periphery of the larger lesion, within otherwise normal-appearing adrenal tissue.\n\nMicroscopic examination reveals a tumor composed of cells arranged in solid sheets with focal \"zellballen\" architecture. The tumor cells have finely granular cytoplasm containing scattered hyaline inclusions. Nuclear features include pleomorphic vesicular chromatin, prominent nucleoli, and occasional hyperchromatic nuclei. Multinucleated tumor cells are present. No mitotic figures, necrosis, or vascular invasion are identified. The tumor is encapsulated, with no evidence of capsular penetration. Surgical margins appear free of tumor involvement.\n\nImmunohistochemical staining demonstrates positivity for chromogranin in tumor cells and in inhibin within the pre-existing adrenal cortex. Sustentacular cells show positivity for S100. Additionally, nodular hyperplasia is present in the adrenal cortex, including a discrete nodule measuring up to 1.4 cm in diameter. Multiple tissue cassettes were submitted for analysis, capturing transitions between the lesions and normal adrenal tissue, as well as cross-sections through the largest lesion."} +{"pid": "TCGA-CV-5431", "report": "The contents of the right neck dissection included a total of 10 lymph nodes across levels II, III, IV, and V. One lymph node from level III contained abnormal tissue, while all others across levels II, IV, and V showed no evidence of abnormality. The lymph nodes measured between 0.3 cm and 4.0 cm in greatest dimension.\n\nIn the left neck dissection, a total of 21 lymph nodes were identified across levels II, III, IV, and V. Of these, three lymph nodes from level II, two from level III, and three from level IV contained abnormal tissue. The remaining lymph nodes, including those in level V, did not show any abnormalities. The largest lymph node involved measured 3.2 cm in diameter.\n\nThe surgical specimen from the total laryngectomy and partial pharyngectomy measured 10.0 x 7.0 x 4.5 cm. Within the left pyriform sinus, there was a lesion measuring 3.5 x 1.5 x 1.3 cm that extended into the surrounding soft tissue but did not involve bone. Microscopic examination revealed cellular features consistent with poorly differentiated non-keratinizing morphology. Margins of resection were clear of abnormal cells. Vocal scar changes were noted along with edema, inflammation, and fibrosis.\n\nAdditional findings included dental specimens ranging in size from 0.3 cm to 2.3 cm in greatest dimension. Some teeth exhibited surface discoloration; however, these were assessed grossly only.\n\nNo tumor was identified in the mucosal margins or in areas evaluated microscopically."} +{"pid": "TCGA-EM-A3AL", "report": "The surgical specimen included a total thyroidectomy with measurements as follows: right lobe measured 4.5 cm \u00d7 3.1 cm \u00d7 1.5 cm, left lobe measured 3.6 cm \u00d7 2.0 cm \u00d7 1.3 cm, and the isthmus measured 2.8 cm \u00d7 1.5 cm \u00d7 0.8 cm. The total specimen weight was 18.8 grams. A dominant nodule was identified in the right lobe measuring 1.9 cm \u00d7 1.6 cm \u00d7 1.5 cm. A second, smaller lesion was noted in the isthmus measuring 0.1 cm in greatest dimension. Both lesions exhibited follicular architecture and classical cytomorphologic features. The larger nodule was completely encapsulated with minimal capsular invasion; margins were free of involvement. No lymphovascular or perineural invasion was identified, and there was no evidence of extrathyroidal extension. Fourteen regional lymph nodes were examined and none showed involvement. Additional findings included advanced thyroiditis with reactive atypia and mild nodular hyperplasia. Parathyroid tissue from both right upper and left lower regions showed no pathological abnormalities. The specimen was intact with adequate orientation markers and no grossly identifiable metastatic disease."} +{"pid": "TCGA-AA-3950", "report": "The specimen consists of a right hemicolectomy preparation with tumor-free resection margins. The lesion is ulcerated and involves the ascending colon. Histological examination reveals a poorly differentiated mucinous adenocarcinoma. The tumor infiltrates the perimuscular fatty tissue but does not show evidence of local lymph node metastasis. Grading is G3. Staging is pT3, LO V0 R0 pNO 0/17, indicating no lymph node involvement out of 17 examined."} +{"pid": "TCGA-D8-A27K", "report": "Histopathological examination was performed on a total organ resection specimen of the left breast, measuring 16.8 x 13.3 x 4.2 cm, along with axillary tissues sized 8 x 4 x 3 cm and a skin flap measuring 17.8 x 9.2 cm. A lesion measuring 4.3 x 2.3 x 2.7 cm was identified in the upper inner quadrant of the breast, located 2.4 cm from the lower boundary, 0.6 cm from the base, and 1.2 cm from the skin.\n\nMicroscopic evaluation revealed a neoplastic process characterized by a histological grade corresponding to NHG2. The mitotic count was zero mitoses per ten high-power fields, with a visual area diameter of 0.55 mm. There was a pronounced peritumoral lymphocytic reaction. Adjacent mammary tissue appeared normal. Multiple foci of intraductal proliferation were observed within the lesion, exhibiting solid architecture, moderate nuclear atypia, and comedo-type necrosis, comprising approximately 30% of the lesion. Vascular invasion was also noted.\n\nAxillary lymph node dissection included seventeen lymph nodes, of which two showed evidence of involvement. Immunohistochemical analysis demonstrated strong expression of estrogen and progesterone receptors, with positivity in over 75% of neoplastic cell nuclei. HER2 staining using Ventana\u2019s Pathway HER-2/neu (4B5) rabbit monoclonal antibody showed a score of 1+, indicating no significant overexpression in invasive tumor cells.\n\nThe staging assessment corresponded to pT2 and pN1a classification based on the extent of primary lesion and regional lymph node involvement."} +{"pid": "TCGA-FY-A3RA", "report": "The specimen from the left thyroid consists of a lobe measuring 5.3 x 3 x 2.7 cm. A discrete, encapsulated tan-colored neoplasm measuring 4 cm in greatest dimension was identified. The lesion has a bulging, soft, friable papillary cut surface. The right thyroid lobe measures 4.5 x 2 x 1.3 cm and appears unremarkable on gross examination. Microscopic evaluation of the left thyroid reveals a well-defined lesion with negative margins. The tumor is entirely encapsulated, with focal disruption of the capsule. No lymphovascular or extrathyroidal invasion is observed. Specimens from both sides were submitted separately. Based on AJCC staging criteria, the tumor is classified as pT2, pNx."} +{"pid": "TCGA-D7-A74B", "report": "The specimen consists of a stomach resected along with omentum measuring 17.3 x 13.2 cm and 17 x 8 cm respectively. A thickened area within the stomach wall measures 11.8 x 12.3 x 1.3 cm and is located 0.8 cm from the proximal resection margin and 3.6 cm from the distal margin. Histologically, there is a poorly differentiated adenocarcinoma with diffuse growth pattern. The tumor extends into the subserosa and fat tissue of the lesser curvature. The distal resection margin shows evidence of infiltration while the proximal margin is free of involvement.\n\nLymph node assessment reveals metastatic involvement in multiple regions: 3 out of 7 lymph nodes along the lesser curvature, all 5 lymph nodes along the greater curvature, and all 3 peripyloric lymph nodes; overall 11 out of 16 lymph nodes are involved. Additionally, there is persistent and active inflammation noted outside the affected region."} +{"pid": "TCGA-W6-AA0S", "report": "Biopsy of the left main bile duct shows atypical glands invading periductal nerve tissue. Immunohistochemical staining supports the presence of invasive epithelial cells within the nerve tissue. The right bile duct biopsy shows no significant abnormalities, with denuded epithelium.\n\nA left hepatic resection with caudate lobe was performed. A firm, well-circumscribed mass measuring 3.3 cm in maximum dimension was identified in the central portion of the specimen. The mass extends to the left main bile duct margin and is located 1.5 cm from the inked hepatic resection margin. It abuts the liver capsule but does not grossly invade adjacent blood vessels. Microscopic evaluation reveals a moderately differentiated epithelial tumor invading hepatic parenchyma and nerve structures. One area of the tumor demonstrates better-differentiated features with dilated, angulated ducts. Immunostains show weak p53 expression, no loss of DPC-4, and negative glypican-3. MIB-1 staining shows variable proliferation indices (up to 50% in some areas, less than 5% in others), suggesting heterogeneity within the lesion. No multifocality or vascular invasion is present. The hepatic resection margin is free of tumor involvement. Tumor necrosis accounts for less than 30% of the specimen. Non-neoplastic changes include portal-based inflammation, mild lobular hepatocyte necrosis, bile duct enlargement, and periductal fibrosis.\n\nThe extrahepatic bile duct resection specimen does not show any high-grade dysplasia or malignant findings. The gallbladder specimen shows chronic inflammatory changes and two benign lymph nodes. A separate lymph node biopsy from the right hepatic artery also shows benign lymphoid tissue.\n\nStaging according to AJCC criteria is pT1NO. The surgical margin of the bile duct in the resection specimen is involved, although the common bile duct margin in the additional bile duct specimen is negative. Intraoperative frozen section analysis confirmed these findings. Multiple cassettes were submitted for thorough histologic evaluation, including sections of the tumor, surrounding structures, and margins. All immunohistochemical stains were developed and interpreted in accordance with department protocols."} +{"pid": "TCGA-WB-A81D", "report": "The pathology review describes a resected left adrenal mass measuring 7.5 cm in diameter. Gross examination reveals a soft, solid tumor with white-gray, reddish, and yellowish-tan areas, along with cystic lesions up to 3.7 cm. The tumor is encapsulated by a thin layer and extends to the edge of the resected specimen. Microscopic evaluation shows a Zellballen pattern with cells containing eosinophilic cytoplasm and single hyaline globules. Nuclear features include enlargement, prominent chromatin, and occasional macronucleoli. Mitotic activity is low at 2 per 10 high-power fields, without atypical forms. Small foci of hemorrhage and necrosis are present, but there is no evidence of vascular invasion or disruption of the capsule. Immunohistochemical analysis demonstrates positivity for synaptophysin and CD56, with weaker but notable expression of chromogranin. S100 staining highlights a reduced number of sustentacular cells. The tumor is negative for AE1/3, EMA, and p53. Proliferative index by Ki67 staining is less than 1%."} +{"pid": "TCGA-43-6143", "report": "The specimen includes three anatomical sites: a medial lobe lymph node, a right lower lobe of lung, and level 7 lymph nodes. The clinical history includes a pre-operative assessment of concern for malignancy.\n\nGross examination of the medial lobe lymph node revealed three red-black soft tissue fragments measuring 0.6 x 0.3 x 0.2 cm in aggregate. These were entirely submitted for analysis. The right lower lobe measured 20 x 14 x 8 cm and displayed a red violaceous, smooth, glistening pleura with diffuse black stippling. An umbilicated area measuring 1.5 x 1.5 cm was noted near the bronchial margin. This region had been stapled; staples were removed. A 0.9 cm black lymph node was identified in the hilum. The lesion associated with the umbilication measured 4.5 x 4.5 x 4.0 cm and was well-circumscribed, gray-pink to tan in color. It was contiguous with the umbilicated surface and approached within 3.0 cm of the bronchial margin. No other discrete lesions were identified in the remainder of the lung parenchyma. Sections were taken from the bronchial and vascular margins, hilar lymph node, tumor interface with the umbilication and hilum, representative sections of tumor transitioning to normal tissue, and normal lung tissue. Level 7 lymph nodes consisted of eight gray-black-red soft tissues measuring up to 8 cm in greatest dimension, all submitted in entirety.\n\nMicroscopic evaluation revealed a moderately differentiated invasive epithelial neoplasm with prominent basaloid morphology. The primary lesion measured 4.5 cm in greatest dimension. Resection margins were uninvolved. There was no evidence of direct extension into adjacent structures, nor was there invasion of large venous, arterial, or small lymphatic vessels. Regional lymph node evaluation included three negative fragments from the middle lobe, one negative hilar lymph node, and eight negative fragments from level 7. Additional findings included respiratory bronchiolitis in the surrounding lung parenchyma.\n\nImmunohistochemical staining demonstrated strong reactivity for CK5/6 and p63. There was focal positivity for CD56, but no staining was observed for TTF-1, synaptophysin, or chromogranin. These findings supported a non-neuroendocrine lineage with evidence of squamous differentiation."} +{"pid": "TCGA-J8-A42S", "report": "The thyroidectomy specimen includes multiple tumor masses identified in both lobes. The largest lesion measures 1.5 cm in greatest dimension, with two additional smaller nodules measuring 0.5 cm and 0.4 cm. Histologic evaluation reveals focal lymphovascular invasion. One lymph node was examined and shows involvement with extranodal soft tissue extension. Microscopic assessment of the surgical margins demonstrates that tumor cells are present at the inked margin; however, the adjacent soft tissue margin is benign, showing only fibroconnective tissue and a small fragment of thyroid without malignancy. The tumor extends into the posterior left lobe capsule. No perineural or extrathyroidal extension is identified. Additional findings include adenomatoid nodules or nodular follicular changes. The thyroid specimen measures 6.5 x 5.0 x 1.5 cm and is submitted in entirety. Multiple sections are taken from different regions of the gland for permanent analysis. A separate soft tissue specimen from the posterior tumor margin is also submitted entirely and shows no evidence of malignant cells."} +{"pid": "TCGA-B5-A0KB", "report": "The specimen consisted of a fragmented uterus with attached bilateral adnexa, weighing 235 grams. The uterine corpus measured 9.5 x 9.5 x 8.2 cm. Within the endometrial cavity, there was a tan, fungating, friable mass measuring approximately 3.5 x 2.5 x 1.5 cm. Due to the fragmented nature of the uterus, the distinction between anterior and posterior endometrial walls could not be determined. The cut surface of the mass was tan-gray-white, and the thickest portion of the myometrial involvement measured up to 2.6 cm. The myometrium contained multiple leiomyomata, the largest measuring 6.5 cm in greatest dimension. These lesions displayed white, whorled cut surfaces without evidence of hemorrhage or necrosis. Additional leiomyomata were present, with the largest measuring 4 cm. \n\nTwo fragments consistent with cervix were identified, measuring 3.5 x 2.5 cm in total. The endocervical canal appeared unremarkable. The presumed left ovary measured 2.7 x 1.5 x 0.9 cm and contained a 1.1 cm cyst; the remainder of the ovarian tissue was unremarkable. The associated fallopian tube segment on the left was 4.5 cm long and 0.4 cm in diameter, with one blunted end and one end containing tan-pink fimbria. The presumed right ovary was tan-yellow, cerebriform in appearance, and measured 1.5 x 1.3 x 1 cm. Its associated fallopian tube was 3.5 cm long and 0.4 cm in diameter, with similar fimbriated and blunted ends. The right ovary also demonstrated a few small thin-walled cysts, the largest being 0.2 cm in diameter.\n\nMicroscopic evaluation included sections from full-thickness tumor and underlying myometrium, cervix, representative leiomyomata, both ovaries and fallopian tubes, normal-appearing endometrium, and additional sections of cervix and fallopian tubes. The surgical procedure performed was a total hysterectomy with bilateral salpingo-oophorectomy. Based on AJCC 7th Edition staging criteria, the depth of myometrial invasion was 1.8 cm in a wall measuring 2.5 cm thick. Lymphatic and vascular space invasion was identified. No tumor involvement was seen at the cervix, serosa, specimen margins, ovaries, or fallopian tubes."} +{"pid": "TCGA-HT-A5R9", "report": "The specimen demonstrates a variably cellular glial neoplasm with diffuse infiltration. The tumor cells exhibit rounded nuclei with perinuclear halos. In more densely cellular regions, nuclear atypia is moderate and mitotic figures are scattered throughout, with up to eight mitoses observed in 10 high-power fields. No microvascular proliferation is identified. A rare microscopic focus of early necrosis is present. Immunohistochemical staining reveals numerous reactive cells distributed throughout the tumor, with a labeling index of 14.7%."} +{"pid": "TCGA-B4-5834", "report": "The specimen was obtained from the left kidney of a male individual. The tissue was collected in a frozen state using a cryomold, with a total weight of 330 mg. A separate blood sample was also collected, amounting to 4 ml, and stored in a frozen tube. Histological evaluation of the tissue showed a high tumor cellularity, with approximately 85% of the sample composed of abnormal cells. The tumor was found to be at stage T2, with no evidence of lymph node involvement (N0) or distant metastasis (M0). No prior chemotherapy or hormonal therapy was reported. The tissue was processed in a single container, and no additional details regarding the histological type or treatment response were provided."} +{"pid": "TCGA-EL-A3N2", "report": "A 4.5 x 3.5 x 1.5 cm left thyroid lobe with attached 3.5 x 2.5 x 0.2 cm adipose tissue and a detached right lobe measuring 4.0 x 2.0 x 1.0 cm was received. The left lobe contained a firm, yellow to brown mass without hemorrhage or necrosis, measuring 3.5 cm, with external surface involvement showing papillary excrescences over a 2.0 cm area. The mass extended into surrounding fibroadipose tissue and approached skeletal muscle. Resection margins were negative. Within the adipose tissue, multiple lymph nodes were identified, ranging from 0.3 to 0.7 cm; one lymph node showed gross positivity. Three of ten lymph nodes in bilateral level VI demonstrated involvement, with extracapsular extension present. A separate unoriented fragment of tan-yellow adipose tissue (11.0 x 5.0 x 1.0 cm) from a left lateral neck dissection contained two possibly positive lymph nodes measuring 1.5 and 2.5 cm, with the larger having a cystic component. Additional lymph nodes ranged from 0.3 to 1.3 cm. A small red-brown tissue fragment (0.4 x 0.3 x 0.1 cm) from the left laryngeal nerve area showed involvement within a neurovascular bundle. A tiny soft tissue sample (0.1 x 0.1 x 0.1 cm) submitted as a parathyroid was found to be benign fibroadipose tissue. All surgical margins were negative. No tumor was identified in the parathyroid, thymus, or contralateral thyroid lobe."} +{"pid": "TCGA-A8-A099", "report": "The specimen consists of an ablated breast sample showing a moderately differentiated invasive carcinoma. The tumor measures 105 cm in diameter and is associated with focal ulceration of the overlying skin. A satellite nodule is present within the skin, measuring 0.9 cm. The dorsal resection margin is free of tumor involvement. Lymph node evaluation reveals 11 involved nodes out of 22 examined. The histologic grade is G II. The surgical findings, in conjunction with prior preliminary results, indicate advanced local and regional involvement."} +{"pid": "TCGA-IH-A3EA", "report": "The pathology report describes a surgical specimen from the head region, submitted with multiple orientation markers including black and blue sutures. The primary lesion measures 6.5 cm in its greatest dimension and is described as a large, brown, indurated mass. Additional dimensions are noted as 5.0 x 2.7 cm. Histologic evaluation reveals ulceration and a nodular growth pattern. The tumor does not extend into the adipose tissue, and the depth of invasion could not be fully determined due to ulceration. No satellite nodules are identified.\n\nMargins of resection were evaluated, with the deep margin being the closest at less than 0.3 cm from the lesion. All other margins, including anterior, posterior, left (yellow), and right (blue), are free of invasive disease. The specimen was processed with ink for orientation, and representative sections were taken from the lesion.\n\nA total of 14 lymph nodes were examined from various cervical and supraclavicular regions on both sides. These include sentinel and non-sentinel lymph nodes from the left occipital, left posterior cervical chain, left supraclavicular, and right posterior cervical areas. Each lymph node was individually assessed macroscopically and microscopically, with no evidence of metastatic disease identified in any of them. Immunostains performed on selected lymph nodes, including S-100 and HMB45, did not show any signs of melanocytic involvement.\n\nThe tumor thickness is noted to be at least 1.5 cm; however, accurate measurement could not be confirmed due to ulceration. Pathologic staging indicates T4b classification based on tumor size and ulceration, with no regional lymph node involvement (NO) and distant metastasis not assessable (MX). All tissue specimens were processed using formalin or molecular fixative, and immunohistochemical staining was performed using validated laboratory protocols."} +{"pid": "TCGA-AA-A00K", "report": "The resected colon specimen includes the sigmoid colon, with tumor-free oral and aboral resection margins. The lesion is ulcerated and shows moderate differentiation. Histological evaluation reveals infiltration of the perimuscular fatty tissue. No regional lymph node metastases are identified. The specimen includes 55 lymph nodes, all without evidence of involvement. Vascular and lymphatic invasion are absent. The primary tumor is classified as pT3, with a histological grade of G2. All resection margins are free of tumor."} +{"pid": "TCGA-E2-A14R", "report": "The surgical specimens included six sentinel lymph nodes from the left axilla and a wide local excision of the left breast with needle localization, along with multiple margin specimens. Gross examination of the breast specimen revealed a firm, palpable mass measuring 4.0 x 3.0 x 0.9 cm with lobulated and nodular borders. The tumor was located centrally and showed areas of necrosis. Microscopic evaluation demonstrated high-grade cellular features including nuclear grade 3, mitotic score 3, and tubular score 3. There was no evidence of vascular or lymphatic invasion. Margins of resection were negative for abnormal cells, with the tumor closest to the inferior margin at approximately 1.5 cm.\n\nSections from all margins\u2014including inferior, lateral, medial, and posterior\u2014were submitted and showed only benign breast tissue or fatty parenchyma without evidence of residual disease. Fibrofatty tissue was predominant in most samples. No ductal carcinoma in situ was identified.\n\nSentinel lymph node specimens numbered one through six were evaluated; each was entirely submitted for histologic analysis. Touch imprint cytology was performed on several nodes. All lymph nodes showed reactive changes without evidence of malignant involvement. A total of eight lymph nodes were assessed across all sentinel specimens, all reporting negative findings.\n\nImmunohistochemical staining for hormone receptors showed negative results for both estrogen and progesterone receptors using the Allred scoring system. HER2 immunostaining showed an intensity of 1+ in approximately 8% of cells, interpreted as negative.\n\nThe breast tissue demonstrated post-biopsy site changes but otherwise showed predominantly fatty parenchyma with focal columnar cell change. No lobular neoplasia was observed. Based on these findings, the pathological staging was determined as pT2 pN0."} +{"pid": "TCGA-BK-A26L", "report": "The specimen included the uterus, cervix, bilateral tubes and ovaries, omentum, left and right pelvic lymph nodes, para-aortic lymph node, and right and left peritoneal biopsies. The uterine corpus weighed 80 grams and measured 5.3 x 4.8 x 4.2 cm, with a 3 cm cervix. The endometrial cavity measured 4 x 3.6 cm and was lined by tan-pink endometrium, focally papilliferous. A lesion was identified in the posterior endometrium, measuring 1.4 cm in thickness, involving more than two-thirds of the endometrial depth. The myometrium was up to 2 cm thick. Several small leiomyomata were present, with a maximum size of 1.5 cm. Both ovaries were pale tan-gold, with corpora albicantia identified; a small cyst was noted in the left ovary. No tubal tissue was identified.\n\nSections from the uterus were taken from multiple regions including the cervix, endometrium, and myometrium, as well as from the leiomyoma and both ovaries. The omentum measured 14 x 10 x 7 cm, with no gross lesions identified and was fully sampled. The left pelvic lymph node aggregate measured 5.5 x 5.5 x 3.0 cm, with lymph nodes ranging from 0.8 to 5.5 cm in size. The right pelvic lymph node aggregate was 6.5 x 6.5 x 2.5 cm, with lymph nodes ranging from 0.7 to 4.0 cm. The para-aortic lymph nodes were submitted in three cassettes. Both peritoneal biopsies were small fatty tissue fragments with no visible lesions.\n\nMicroscopic examination revealed a histologic grade III lesion involving the endometrium, with myometrial invasion observed at 12 mm depth out of a total myometrial thickness of 15 mm, equating to approximately 80% involvement. The cervix showed no evidence of tumor. Lymphovascular space invasion was prominent, particularly noted in blocks A11 and A12. Resection margins were free of tumor. In the left pelvic lymph node group, one of three lymph nodes contained metastatic cells, with the largest focus measuring 3 mm. All seven lymph nodes from the right pelvic group and all three from the para-aortic region were negative for metastasis. The omentum and both right and left peritoneal biopsies were also negative for tumor involvement. The ovaries exhibited benign features, with no tumor identified, although adhesions and dilated cortical inclusion glands were present. Benign leiomyomata were confirmed. Distant metastasis could not be assessed."} +{"pid": "TCGA-A2-A0EO", "report": "The specimen consisted of two sentinel lymph nodes and left breast tissue. Sentinel lymph node #1 was a tan, fibrofatty tissue fragment measuring 2.0 x 1.3 x 0.4 cm, containing two lymphoid nodules measuring 0.5 cm and 0.4 cm. Sentinel lymph node #2 was a tan, firm nodule measuring 0.6 x 0.5 x 0.4 cm. Both lymph nodes showed no evidence of malignancy upon routine and immunohistochemical evaluation.\n\nThe left breast tissue measured 6.8 x 6.5 x 2.1 cm and contained two distinct lesions. One lesion measured 1.5 cm with well-defined margins, located near the superior margin. A second nodule, measuring approximately 0.6 cm, was identified 1.0 cm lateral to the larger lesion. Histologic analysis revealed multifocal cellular features consistent with intermediate-grade morphology by combined histologic criteria. The larger lesion was located 2.0 mm from the superior margin, while the smaller lesion was 1.5 mm from the superior margin. No lymphovascular invasion was observed.\n\nAn in-situ component was identified, showing cribriform architecture comprising approximately 10% of the tumor volume, with intermediate-grade characteristics. All surgical margins were evaluated, and no additional significant findings were noted. Multiple sections were submitted for further analysis and protocol matching."} +{"pid": "TCGA-D8-A1JD", "report": "Histopathological examination was performed on a total organ resection specimen of the left breast and axillary tissue. The breast measured 19 x 18 x 5 cm with a skin flap measuring 19 x 10 cm, and weighed 620 g. Axillary tissues measured 11 x 4.5 x 1.5 cm. Two lesions were identified in the breast. The first measured 2.8 x 1.5 x 2.5 cm and was located near the upper quadrants, 4.5 cm from the upper boundary, 0.2 cm from the base, and 1.0 cm from the skin. A second lesion measuring 0.5 x 0.7 x 0.5 cm was found 1.5 cm away from the first (lower boundary margin: 10 cm; base margin: 0.1 cm; skin margin: 3.5 cm).\n\nMicroscopic evaluation revealed both lesions exhibited a similar pattern. Histological grade NHG2 was observed, with a mitotic count of 2 + 3 +1/7 mitoses per 10 high power fields (visual area diameter 0.55 mm). In addition, foci of ductal carcinoma in situ (DCIS) were present within the lesions, showing solid and cribriform patterns with marked nuclear atypia and comedo necrosis accounting for approximately 5% of the lesion volume. There was a peritumoral lymphocytic reaction. No lesions were identified in the nipple area. Background glandular tissue showed fibrocystic changes.\n\nAxillary lymph node assessment identified metastatic involvement in 3 out of 14 nodes examined. Capsular and perinodal tissue infiltration was noted. Margins and staging details were consistent with tumor extension into regional lymph nodes. Immunohistochemical analysis demonstrated estrogen receptor positivity in over 75% of neoplastic nuclei and progesterone receptor positivity in 10\u201375% of neoplastic nuclei. HER2 staining using HercepTest\u2122 M by DAKO showed a score of 1+ in invasive cancer cells."} +{"pid": "TCGA-R6-A6Y0", "report": "The distal esophagus specimen consists of multiple tan-pink irregular tissue fragments measuring 1.0 x 0.6 x 0.6 cm in aggregate. Microscopic evaluation of the tissue reveals moderately differentiated cells arranged in a glandular pattern. The depth of invasion could not be determined due to the fragmented nature of the specimen. A separate fragment of squamocolumnar junction mucosa shows active chronic inflammation.\n\nA HER-2/neu FISH analysis was performed on the tissue section. The test used interphase fluorescence in situ hybridization with a HER-2/neu probe and CEP17 control probe. Slide adequacy was satisfactory, and 60 tumor nuclei were evaluated. The average HER-2/neu gene copy number per nucleus was 1.90, while the average CEP17 copy number was 1.40. The HER-2/neu to CEP17 signal ratio was calculated at 1.36, which falls below the threshold for gene amplification. Negative and positive controls were appropriate for the test run, and two representative images were archived.\n\nThe gastric cardia specimen includes multiple tan-pink irregular fragments of oxyntic/fundic mucosa measuring 0.5 x 0.3 x 0.2 cm in aggregate. Histologic examination shows mild inactive chronic gastritis. No intestinal metaplasia or Helicobacter pylori-like organisms were observed on H & E staining, and no abnormal mass or lesion was identified in this portion of the specimen."} +{"pid": "TCGA-DX-A8BS", "report": "The clinical history notes a right thigh mass. Two specimens were submitted for evaluation. The first was a Tru-cut biopsy of the right thigh lesion, and the second was an excision specimen.\n\nMicroscopic examination of the biopsy revealed a high-grade pleomorphic neoplasm. The excision specimen contained a large, well-circumscribed heterogeneous mass measuring 19.7 cm in greatest dimension. The mass involved fibroadipose tissue and skeletal muscle, with approximately 30% necrosis estimated grossly. The tumor was located 0.03 cm from an inked margin. Histologically, the tumor showed pleomorphic features and high-grade morphology. Immunohistochemical staining showed focal positivity for HHF35, and a minority of cells expressed SMA and desmin. Stains for S-100 protein and myogenin were negative.\n\nGrossly, the excised specimen measured 36.2 x 20.7 x 15.3 cm and included skin measuring 20.0 x 3.5 cm. No scar was present. The mass had a white-tan, solid cut surface with areas of microcystic change, hemorrhage, and necrosis. It was located 0.3 cm from the closest inked margin. The biopsy cores ranged from 0.6 to 0.8 cm in length and 0.1 cm in diameter, all of which were fully submitted for analysis.\n\nSections from both specimens were processed and reviewed, including representative samples from various regions of the mass, skin, margins, and surrounding tissue. Intraoperative frozen section analysis confirmed the permanent diagnosis."} +{"pid": "TCGA-LL-A5YO", "report": "The lumpectomy specimen consists of breast tissue measuring 4 x 4 x 2.5 cm. A firm, stellate, tan lesion is identified, measuring 13 mm in greatest dimension. The lateral margin is focally involved, while the medial margin is 2 mm from the lesion. Other margins are more than 1 cm away. A representative section of the lesion was submitted for banking. No gross residual tumor is identified in the re-excised lateral margin specimen. A single lymph node, measuring 15 x 10 x 5 mm, was submitted entirely and shows no evidence of tumor involvement.\n\nHistologically, the lesion demonstrates a high-grade morphology with nuclear score 3 of 3, tubule formation score 3 of 3, and mitotic score 3 of 3 (11 mitotic figures per square millimeter). No in situ component is identified. The closest margin involvement is at the medial aspect, measuring 2 mm. No tumor is seen in the re-excised lateral margin or in the lymph node. Multiple step sections of the lymph node, including immunostains, show no evidence of metastasis.\n\nAncillary studies show less than 1% nuclear staining for estrogen and progesterone receptors. HER2 immunostaining is scored as 1+. Pathologic staging indicates a primary tumor size of 13 mm (pT1b), with no nodal involvement (pN0(i-)). The case represents a single focus of invasive disease without ductal carcinoma in situ."} +{"pid": "TCGA-WC-AA9A", "report": "The enucleation specimen of the right eye consists of an intact globe measuring 23 x 23 x 22 mm with an attached optic nerve segment measuring 5 mm in length. The sclera appears unremarkable. The anterior chamber is formed, with a gray-blue iris measuring 10 x 11 mm surrounding a round pupil 5 mm in diameter. Transillumination reveals a shadow from 7 to 11 o\u2019clock, measuring approximately 14 mm at its base. The lesion has a height of 6 mm, is tan to dark brown in color, and appears confined to the globe. It is located 3 mm from the optic nerve and 9 mm from the limbus. The vitreous is clear. Histologic evaluation demonstrates a spindled cell morphology. Superficial scleral invasion is present; however, no involvement of the optic nerve or vortex veins is identified. No evidence of extraocular extension is seen. Mitotic activity is noted at a rate of 3 mitoses per 10 high-power fields. Special stains, including PAS, are performed to assess internal ocular structures. Tumor harvest and sectioning are carried out in a standard fashion, with sections submitted for analysis including tumor tissue, calotte portions, optic nerve margin, and vortex veins."} +{"pid": "TCGA-SR-A6MP", "report": "Specimen: Procedure: Medical Record #: Accessioned: (Age: ) F. Location/Client: Submitting Phys: Final Diagnosis. LEFT ADRENAL GLAND, RESECTION: COMMENT: There is no necrosis, mitotic figures are not seen, and occasional hyaline globules are observed. The lesion is surrounded by a fibrous capsule which, in one area, contains attenuated, residual adrenal cortex. It appears completely excised and there is no definitive evidence of protrusion into blood vessels, associated thrombus, or intact endothelium overlying any protruding portion. This certifies that the pathologist named above has personally conducted a microscopic examination (or gross examination only, where stated) of the described specimen(s) and has rendered or confirmed the final diagnosis(es). Clinical History: Benign adrenal neoplasm. Pre-Operative Diagnosis: (Not Provided). Post-Operative Diagnosis: (Not Provided). Gross Description: LEFT ADRENAL GLAND (FRESH): The specimen, labeled with the patient's name and accession number, consists of a round, soft tan-white to red and focally hyperemic mass weighing 125 grams and measuring 7 x 7 x 5 cm. The specimen is inked black and serially sectioned, revealing a fleshy, mottled, tan-white to red-brown cut surface with a finely granular appearance. The lesion is entirely enclosed within a thin capsule measuring less than 0.1 cm in thickness. A sample of tissue is removed for research studies. Representative sections are submitted in cassettes A1-7."} +{"pid": "TCGA-AK-3430", "report": "The specimen consisted of six tissue samples. The first sample was a 3.0 x 1.0 cm fragment of cartilage from the 11th rib, described as tan and firm; no tumor involvement was identified. The second sample, a para-aortic lymph node measuring 2.0 cm in greatest dimension, showed abnormal cellular findings upon frozen section evaluation. Microscopic analysis confirmed the presence of atypical cells within this lymph node. A third sample, measuring 3.0 x 1.0 x 0.3 cm, was identified as a cyst wall with adjacent adipose tissue; frozen section evaluation revealed no malignant features. The fourth sample consisted of 133 grams of perirenal fat, with a yellow-tan appearance and no evidence of tumor infiltration. \n\nThe fifth specimen included a left kidney and adrenal gland weighing 606 grams. The kidney measured 11.5 x 6.0 x 6.0 cm and displayed a red-purple surface with a well-defined cortico-medullary junction. Within the upper pole, a 6.5 x 5.5 x 5.0 cm lesion was observed with tan to golden-yellow-orange variegated cut surfaces and irregular borders. Adjacent to this lesion was a previously biopsied depressed area measuring 4.0 cm, consistent with a benign cyst. The attached adrenal gland, measuring 4.5 x 2.0 x 0.3 cm, appeared unremarkable. Histopathological examination revealed nuclear atypia and vascular invasion associated with the lesion in the upper pole. Margins of resection, including the ureteral, vascular, and circumferential margins, were free of tumor involvement. The adrenal gland did not show any abnormal cellular changes.\n\nThe sixth specimen consisted of multiple para-aortic lymph nodes ranging in size from 0.6 to 1.2 cm. Histologic evaluation demonstrated similar atypical cell clusters within two of the submitted lymph nodes."} +{"pid": "TCGA-26-5136", "report": "MRI revealed a right occipital cerebellar lesion, and the patient underwent surgical resection. Two specimens were received in the pathology department, labeled \"tumor\" and \"tumor #2.\" The first specimen measured 0.5 x 0.3 x 0.3 cm and consisted of a portion of tan to beige soft tissue. A representative sample was submitted for frozen section analysis, which showed features consistent with high-grade malignancy. The frozen section tissue was placed in cassette FSA1, and the remaining tissue in cassette A2. The second specimen measured 1.8 x 1.2 x 0.8 cm and was composed of an aggregate of beige to gray-tan soft tissue fragments. A representative portion was submitted for further analysis, and the remainder was placed in cassette B1. Both specimens demonstrated similar histological features, including marked cellular atypia, brisk mitotic activity, microvascular proliferation, and areas of necrosis. These findings are consistent with a high-grade neoplastic process. Staging could not be determined due to lack of surrounding tissue. The results were reported to the appropriate clinical team. Gross examination and tissue preparation were performed under supervision, and the report was issued by a qualified pathologist. Testing was conducted in a laboratory certified to perform high-complexity clinical laboratory testing. Some assays used have not been cleared by the FDA but are utilized for clinical diagnostic purposes."} +{"pid": "TCGA-AN-A0AM", "report": "The specimen was obtained from a female patient and is derived from the left breast. The tissue sample was collected via radical mastectomy and preserved in frozen format within a cryomold. Histological examination revealed infiltrative growth patterns with ductal features. The tumor is moderately differentiated (Grade 2). Staging assessments indicated T Stage 2, N Stage 0, and M Stage 0. No prior treatment had been administered. A normal blood sample was also collected via blood draw and stored frozen in a tube."} +{"pid": "TCGA-EM-A4FQ", "report": "The specimen consisted of a total thyroidectomy with central and right neck dissection, along with multiple lymph node specimens and parathyroid tissue. The thyroid gland weighed 37.8 grams. The right lobe measured 5.5 cm (SI) x 3.5 cm (ML) x 3.0 cm (AP), and the left lobe measured 3.3 cm (SI) x 1.5 cm (ML) x 1.2 cm (AP). The isthmus measured 4.0 cm (SI) x 1.5 cm (ML) x 0.3 cm (AP). Two nodules were identified in the right lobe: one measuring 2.1 cm x 1.7 cm x 1.6 cm with a gritty white-tan appearance, and another measuring 3.0 cm x 3.5 cm x 3.0 cm, mostly cystic with a solid component of 1.5 cm. A single nodule measuring 0.5 cm x 0.7 cm x 0.3 cm was found in the left lobe.\n\nLymph nodes were submitted from multiple regions including the right posterior triangle, right jugular, right paratracheal, left paratracheal, and central neck. Involvement was noted in several lymph node groups: 2 of 5 nodes in the right posterior triangle, 9 of 34 in the right jugular region, 2 of 3 in the right paratracheal area, 2 of 7 in the left paratracheal region, and 2 of 6 in the central neck. No extranodal extension was identified.\n\nHistologic evaluation revealed multiple distinct nodules with varying cellular features. One dominant lesion showed follicular architecture with oncocytic change. Another lesion exhibited classical papillary architecture with focal tall cell change (<10%) and Warthin-like features. Additional small microcarcinomas ranging from 0.1 cm to 0.7 cm were present in the left lobe. All margins were uninvolved. Tumors were partially encapsulated without evidence of vascular, lymphatic, or perineural invasion, nor extrathyroidal extension.\n\nA diagnosis of chronic lymphocytic thyroiditis was also made. Parathyroid tissue was examined; one specimen showed no identifiable parathyroid tissue while another confirmed presence of normal parathyroid gland. Additional findings included fibrofatty tissue with lymph nodes and minor surgical artifacts such as stitch marks.\n\nIn summary, the case involved multifocal lesions with bilateral involvement, extensive lymph node metastasis, and associated thyroiditis. The largest lesion measured 3.5 cm and was located in the right lobe. Multiple smaller lesions were identified, including microcarcinomas in the left lobe. Lymph node involvement was widespread across multiple regional sites. Margin status was negative and no invasive features were observed histologically."} +{"pid": "TCGA-BR-6705", "report": "The gastrectomy specimen measured 8 x 0 x 0 cm and exhibited ulcerated features. Microscopic evaluation revealed poorly differentiated cells. The tumor extended to the subserosa. A total of 12 lymph nodes were examined, with 9 showing involvement by metastatic cells. Vascular invasion was identified, while perineural invasion and lymphatic invasion were not specified. Surgical margins were free of involvement. No evidence of prior neoadjuvant treatment was observed. No additional pathologic findings or comments were noted."} +{"pid": "TCGA-QQ-A8VF", "report": "The surgical specimen from the right leg includes a tumor measuring 12.0 cm in maximum dimension, located at the posterior lateral aspect of the calf. The tumor is 1.0 cm from the posterior skin surface, 6.0 cm from the medial skin surface, and 3.0 cm from the anterior skin surface. It reaches but does not grossly invade the adjacent fibular bone and is well separated from the tibia. The tumor is more than 40 cm from the proximal surgical margins. Gross examination shows a solid red cut surface with areas of necrosis. Overlying skin demonstrates an ulcer measuring 4.0x4.0 cm. All surgical margins are free of tumor involvement. Four popliteal lymph nodes are negative for malignancy.\n\nMicroscopically, the tumor exhibits marked pleomorphism with polygonal and occasionally multinucleated cells, as well as areas with a more spindled morphology. Immunohistochemical staining shows strong positivity for desmin, patchy strong staining for HHF35 (MSA), and very focal staining for smooth muscle actin (SMA). The tumor is negative for myoglobin, myo D1, and myogenin. No evidence of malignancy is identified in the sciatic or femoral nerve biopsies. Multiple sections of the tumor, surrounding soft tissues, and surgical margins have been submitted for further evaluation."} +{"pid": "TCGA-G4-6304", "report": "The specimen consists of an en bloc resection including segments of terminal ileum, right colon, transverse colon, mid jejunum, greater curvature of the stomach, and abdominal wall. The lesion measured 4.5 x 4.5 cm and demonstrated infiltrative and ulcerating growth. Histologic examination revealed invasive poorly differentiated carcinoma involving pericolic fat, gastric muscularis propria, and sparing gastric mucosa. Focal squamous differentiation was identified. There was no evidence of tumor in any of the twenty-five lymph nodes examined. Margins, including proximal, distal, and radial, were negative for carcinoma. Adjacent acute suppurative and chronic inflammation with abscess formation was noted, involving an adhered segment of small intestine with intestinal perforation, abdominal wall skeletal muscle, and subcutaneous adipose tissue. Additional findings included focal chronic gastritis of gastric mucosa and acute serositis. Gross examination confirmed involvement of gastric wall without mucosal tumor involvement. The associated cavity measured 4.0 x 4.0 cm and was linked to dense adhesions and inflammatory changes extending into abdominal wall and small bowel. Multiple lymph nodes were identified but showed no malignant involvement. Sections submitted included margins, tumor, adjacent structures, lymph nodes, and surrounding tissues. A separate gastric suture line specimen showed no evidence of tumor. The extent of resection was classified as R0 with negative lymph nodes (0/25)."} +{"pid": "TCGA-EL-A3GU", "report": "A left thyroid lobe specimen shows a focus of abnormal tissue adjacent to vessels and adipose tissue. The tissue was entirely submitted for analysis. Grossly, the left thyroid lobe measured 2.0 x 1.5 x 1.0 cm.\n\nA separate specimen from a total thyroidectomy and right neck dissection includes an oblong hard mass measuring 5.0 x 3.5 x 2.5 cm. The overall specimen size is 8.0 x 6.0 x 1.5 cm. The mass is light-tan and firm, with no gross involvement of surrounding fibrous or soft tissues. Sections were taken from the mass and surrounding tissue.\n\nLymph nodes from the right neck dissection, ranging in size from 0.4 cm to 2.0 cm, were submitted for evaluation. Multiple lymph nodes showed abnormal involvement, with metastatic tissue identified in 10 out of 23 nodes. Extracapsular extension was noted in these involved nodes. Representative sections of a large lymph node were also included."} +{"pid": "TCGA-06-0130", "report": "The specimen from the left temporal lobe consists of multiple tissue fragments ranging in size from 0.3 to 0.5 cm. Gross pathology revealed features consistent with a high-grade glial neoplasm. Intraoperative frozen section evaluation indicated the presence of a glioma. Microscopic examination demonstrated a high-grade glioma exhibiting characteristic features commonly associated with aggressive astrocytic tumors. Immunohistochemical staining showed strong positivity for GFAP in the neoplastic astrocytes. The proliferation index, assessed by MIB-1 staining, was approximately 15%."} +{"pid": "TCGA-AJ-A3OK", "report": "The specimen includes a total laparoscopic hysterectomy with bilateral salpingo-oophorectomy and lymph node dissection. Pelvic washings were collected with 1000 units of Heparin. Gross examination revealed a 3 x 2 cm tumor located in the anterior and posterior endometrial cavity. The tumor was friable, protruding up to 1.6 cm above the endometrial surface, with detached tumor aggregates noted in the endocervical canal. No gross extension into the endocervical mucosa or stroma was observed. There was minimal superficial invasion into the underlying myometrium, which measured 1.1 cm in thickness at the site of involvement.\n\nMicroscopic evaluation showed high-grade features with tumor invasion into the myometrium to a depth of 2 mm; the myometrial thickness at this site was 10 mm. No lymphovascular space invasion was identified. Margins were negative, and there was no involvement of the endocervix, paracervical tissue, uterine serosa, fallopian tubes, or ovaries. Bilateral ovarian fibromas and paratubal cysts were present, along with cervical atrophy and endometriosis.\n\nA total of 24 lymph nodes were examined: 14 right pelvic, 3 right periaortic, and 7 left pelvic lymph nodes. All were negative for malignancy. Pelvic washings were also negative. Immunohistochemical staining showed diffuse strong nuclear staining for p53.\n\nTNM staging was determined as pT1a (tumor involving less than half of the myometrium) and pN0 (no regional lymph node metastasis). Distant metastasis could not be assessed (pMX).\n\nAdditional sections submitted included full-thickness tumor samples, random posterior endometrium, adnexal specimens, and complete submission of the cervix. Tissue for hormone receptor assays was also submitted."} +{"pid": "TCGA-IQ-A61H", "report": "The specimen consisted of a reddish, irregular-shaped fragment of tongue measuring 8.0 x 3.0 x 1.5 cm with attached yellow fibroadipose tissue measuring 6.5 x 6.0 x 3.0 cm. The ventral surface demonstrated a grey-white, ill-defined lesion measuring 3.5 x 2.0 x 1.5 cm located towards the medial aspect, approximately 2.0 cm from the anterior margin, 1.7 cm from the lateral edge, 3.0 cm from the posterior, and 1.0 cm from the inferior aspect. There were 7 lymph nodes identified within this specimen, each measuring up to 0.8 cm in greatest dimension.\n\nAdditional specimens included soft tissue fragments from various anatomical sites including the lingual nerve, floor of mouth, tonsil, retromolar area, and mandible. No malignancy was identified in these samples. Multiple neck dissection specimens were also evaluated: right level 1B contained 5 lymph nodes; left levels 3 and 4 contained 22 lymph nodes; left level 2B contained 5 lymph nodes; and the right modified radical neck dissection contained 13 lymph nodes. No carcinoma was found in any of the lymph nodes examined.\n\nHistologically, the surgical margins were uninvolved. No lymphovascular or perineural invasion was identified. A total of 53 lymph nodes were examined across all specimens, with no evidence of metastasis. The tissue architecture included skeletal muscle, salivary gland parenchyma, and fibroadipose tissue without significant histological changes indicative of malignancy."} +{"pid": "TCGA-B0-5107", "report": "The right nephrectomy specimen includes a neoplasm with a hybrid pattern of histological types. The tumor contains Fuhrman, papillary, and eosinophilic components. The greatest diameter of the lesion is 8 cm. The nuclear grade is III-IV. The neoplasm is confined within the renal capsule. No angiolymphatic invasion is identified. There is no invasion of the renal vein, renal artery, ureter, or renal pelvis. All surgical margins are free of tumor. The non-neoplastic kidney appears unremarkable."} +{"pid": "TCGA-FI-A2EX", "report": "The specimen consists of a uterus measuring 8 x 4.5 x 2.5 cm and weighing 84 grams, with attached bilateral adnexa. The endometrial cavity contains multiple tan masses, the largest measuring 2.3 x 2.0 x 0.8 cm located in the anterior fundus, and additional nodules measuring 1.3 x 0.5 x 0.5 cm and 0.8 x 0.4 x 0.4 cm on the posterior endometrium. A well-circumscribed tan-yellow mass measuring 1.7 cm is present within the myometrium. The cervix, lower uterine segment, and serosal surface appear unremarkable.\n\nExamination of the left ovary reveals a tan cerebriform external surface with a 0.5 cm simple cyst. The right ovary also has a tan surface and unremarkable cut surface. Both fallopian tubes show smooth serosal surfaces; the left tube contains multiple paratubal cysts ranging from 0.2 to 0.3 cm, while the right contains two paratubal cysts measuring 0.1 to 0.3 cm.\n\nMicroscopic evaluation identifies small foci of atypical cells within the endometrium, extending into the luminal one-third of the myometrium to a depth of 1 mm, within a total myometrial thickness of 8 mm. Similar findings are noted on the posterior endometrial surface. No involvement of the endocervical canal is observed. No lymphovascular space invasion is identified.\n\nInvolvement is noted on the surface of the left ovary with a focus measuring 0.3 cm and on the right ovarian surface with a focus measuring 0.15 cm. The lumen of the right fallopian tube also shows involvement by similar-appearing cells. No malignant cells are found in the left fallopian tube or in any of the regional lymph nodes examined. A total of 34 lymph nodes (13 left pelvic, 4 left periaortic, 15 right pelvic, and 2 right periaortic) are free of malignancy. The omentum, Meckel\u2019s diverticulum, and soft tissue specimens do not show any malignant involvement.\n\nA benign leiomyoma measuring 1.7 cm is identified in the myometrium. The Meckel's diverticulum specimen includes a segment of small bowel with no pathological findings. Paratubal cysts are noted but are otherwise non-specific and benign.\n\nThe final staging is based on these findings, with tumor extension to the serosa or adnexa considered as T3a. No lymph node metastases are identified. Distant metastasis could not be assessed."} +{"pid": "TCGA-55-6969", "report": "The surgical specimen included multiple lymph node samples and a resected left upper lobe of lung. Lymph nodes were evaluated from the AP window (6 nodes), posterior hilar region (1 node), interlobar area (1 node), and hilar region (2 nodes). All lymph nodes were negative for malignancy. The left upper lobe specimen contained a firm white to gray mass measuring 3.5 cm in greatest dimension. The mass was located within the lung parenchyma and was surrounded by an area of pleural retraction. The closest distance from the tumor to the bronchial resection margin was 1.2 cm. The overlying pleura showed no direct involvement by tumor. Histologic evaluation of the mass revealed poorly differentiated cells arranged in irregular clusters and glands. No lymphovascular space invasion was identified. Surgical margins, including the bronchial margin, were free of tumor. Three peribronchial lymph nodes were also negative for malignancy. Adjacent lung tissue showed emphysematous changes with distal dilated air spaces, most prominent in the superoposterior region. No additional masses were identified."} +{"pid": "TCGA-RW-A688", "report": "A right adrenal gland specimen was received, weighing 225 grams. The specimen contained a well-encapsulated, soft, bright yellow mass measuring 7.5 x 5.4 x 6.7 cm, with areas of cystic change and focal hemorrhage. A thin strip of normal adrenal tissue was identified at one periphery, measuring 1.2 x 0.3 cm. The capsule was inked black. Representative sections including the capsule, the tumor, and the adjacent normal adrenal tissue were submitted for analysis. Margins were negative. The signing staff pathologist personally examined and interpreted the slides from this case."} +{"pid": "TCGA-3U-A98G", "report": "The patient is a male. Tissue was obtained from multiple lymph node sites, including #11, Level 7, #8, and 4R. In total, eight lymph nodes were examined, and none showed evidence of involvement. A pleural resection specimen was also obtained, involving the right parietal and visceral pleura, diaphragm, and pericardium. The tissue specimen weighed 575 grams and measured 31 x 16 x 3 cm. The tumor was found to be diffusely distributed across the pleural surface, with a maximum thickness of 3.5 cm. Microscopically, the tumor demonstrated a biphasic pattern, composed of both epithelioid (80%) and sarcomatoid (20%) components. The tumor extensively involved the visceral pleura, including the fissure, and extended into but not through the diaphragm. It also invaded through the pericardium. No venous or lymphatic invasion was identified. Pathologic staging was determined as pT4 with no regional lymph node metastasis (pN0). Immunohistochemical staining with CAM5.2 showed positivity in the epithelioid component, while the sarcomatoid areas were negative. CD34 staining did not show evidence of vascular invasion. The surgical margins could not be assessed. The specimen was thoroughly sampled and representative sections were submitted for analysis."} +{"pid": "TCGA-DW-7838", "report": "The left kidney specimens include multiple masses ranging in size from 0.3 cm to 5.5 cm. Most are described as yellow-tan nodules or soft tissue fragments, with some displaying tan or red-tan coloration, solid or soft cut surfaces, and areas of hemorrhage. Several specimens show cystic changes or fibrotic areas. Histologically, the lesions exhibit papillary architecture with varying degrees of cellular differentiation, including regions with spindle and clear cell features. Incipient lesions are noted in two cases. All masses were excised and submitted for histopathological evaluation. A perinephric soft tissue specimen consists of fibroadipose tissue with fibrotic areas and no lymph nodes identified. The surgical procedure performed was a partial nephrectomy."} +{"pid": "TCGA-DB-A4XE", "report": "The specimen consists of three components from the left temporal region. Part A includes a fresh tissue fragment measuring 2.7 x 2.3 x 1.3 cm; smears were prepared and interpreted as showing features consistent with a glial neoplasm. Part B is an aggregate of white-tan tissue measuring 1.8 x 1.6 x 0.7 cm, submitted for permanent sections. Part C, collected from a CUSA trap, measures 3.5 x 3.0 x 0.7 cm and was also submitted in entirety for permanent section analysis.\n\nHistologic sections show moderately cellular tissue with features of a high-grade glial tumor. Nuclear atypia, increased mitotic activity, and areas of necrosis are present. Immunohistochemical staining demonstrates positivity for p53 in tumor cell nuclei. The MIB-1 proliferation index is moderately elevated. Additional molecular studies are in progress to evaluate for specific genetic alterations. Multiple blocks were submitted for each specimen component to ensure comprehensive sampling."} +{"pid": "TCGA-KV-A74V", "report": "The specimen was obtained from the right kidney and surrounding perinephric fat. The excised perinephric fat did not show any tumor involvement. The renal resection specimen measured 3.6 x 3.0 x 3.0 cm and contained a well-circumscribed tan-pink mass measuring 2.5 x 2.2 x 1.6 cm, located centrally and extending to within 0.2 cm of the nearest parenchymal margin. The mass was focally hemorrhagic and abutted the renal capsule. Histologic evaluation showed a neoplasm with papillary architecture and nuclear features corresponding to ISUP nucleolar grade 2. Necrosis was present in a focal distribution. Sarcomatoid differentiation was not identified. Microscopic examination confirmed that the lesion was confined to the kidney without lymphatic or vascular invasion. All margins, including the renal parenchymal and capsular margins, were negative. No involvement of perinephric fat or adjacent structures was observed. Non-neoplastic renal tissue showed no significant abnormalities. No adrenal tissue or lymph nodes were identified in the specimen. Based on the extent of disease and tumor localization, staging was classified as pT1a according to the AJCC system."} +{"pid": "TCGA-BQ-5877", "report": "The submitted specimens include a left radical nephrectomy and a para-aortic lymph node excision. The kidney specimen measures 22.0 x 10.0 x 3.7 cm and weighs 557 grams. On sectioning, the kidney measures 13.0 x 7.5 x 3.0 cm. A multinodular tan-gray mass is identified at the superior pole, measuring 3.0 x 3.0 x 1.8 cm. Additional smaller nodules are present within the renal parenchyma and pelvic fat, ranging from 0.3 to 1.7 cm in size. Some of these nodules exhibit a tan-yellow, friable appearance. The tumor extends through the renal capsule and involves the renal sinus fat. There is evidence of vascular invasion within the renal vein. Surgical margins are free of involvement. No adrenal gland tissue is identified grossly.\n\nMicroscopic evaluation reveals high nuclear grade cells arranged in papillary architecture with sarcomatoid features. Multiple tumor nodules are present, with the largest measuring 3 cm. The tumor extends into perinephric tissues but remains confined within Gerota's fascia. No lymph nodes are identified in the hilar fat.\n\nThe para-aortic lymph node specimen measures 3.0 x 1.6 x 1.5 cm and shows tan-gray induration on sectioning. Histologic examination confirms involvement by tumor, with the largest metastatic deposit measuring 3.0 cm. Extracapsular extension is noted. One metastatic lymph node is identified out of one examined."} +{"pid": "TCGA-AC-A5XS", "report": "The left breast specimen measured 23 x 17 x 5 cm and included an axillary tail measuring up to 7 cm. The skin ellipse measured 20 x 12 cm and contained a central unremarkable nipple and areola. A hard gray-white sclerotic lesion was identified in the medial hemisphere, measuring approximately 2.6 cm in greatest dimension. The lesion had an ill-defined, radially infiltrating border and was located 1 cm from the posterior margin, 2.2 cm from the skin surface, and 1 cm from the nearest radial margin. Sections were taken from the tumor, surrounding normal parenchyma, skin and posterior margin near the lesion, inferomedial quadrant, superolateral quadrant, and inferolateral quadrant. The remainder of the parenchyma showed scattered areas of fibrous tissue without a distinct mass. The axillary tail contained multiple fatty lymph nodes, with the largest measuring up to 2.5 cm in diameter. A total of eight lymph nodes were examined, all of which were negative for involvement. The right breast specimen measured 22 x 18 x 5 cm, with a skin ellipse of 20 x 15 cm containing an unremarkable nipple and areola. The posterior margin consisted of thin fascia without skeletal muscle. The specimen was sectioned and showed areas of soft white fibrous tissue without a palpable lesion. Sections included the nipple, subareolar region, and representative samples from all four quadrants. Histologic evaluation revealed dense stromal fibrosis and rare microcalcifications in the right breast, with no proliferative changes noted. The left breast showed a histologic pattern consistent with a specific invasive growth pattern. Nuclear features were uniform with low pleomorphism and low mitotic activity. Tubule formation score was low. Lymphovascular invasion was not identified. All surgical margins were free of involvement. The lesion was negative for microcalcifications. Immunohistochemical staining for a specific cell adhesion marker was performed and showed loss of expression. Hormone receptor testing demonstrated positivity for estrogen and progesterone receptors. HER2 immunostaining showed a low level of expression."} +{"pid": "TCGA-85-7697", "report": "The specimen consisted of lung tissue obtained from a pneumonectomy. The tumor was located in the left upper lobe and measured 4 x 3.5 x 3 cm. Microscopic examination revealed well-differentiated cells with squamous morphology. No information was provided regarding histologic type, tumor grade, extent of invasion, presence of additional nodules, lymph node involvement, lymphatic or venous invasion, margin status, evidence of neoadjuvant treatment, or other significant pathologic findings. No comments were added by the pathologist."} +{"pid": "TCGA-QQ-A8VD", "report": "The specimen consists of a biopsy from a right upper abdominal wall mass. The clinical history is not provided, and the pre-operative assessment indicated an abdominal wall mass. During frozen section evaluation, the specimen was described as a spindle cell lesion.\n\nGrossly, the biopsy is a white-tan soft tissue fragment measuring 1.6 x 1.5 x 0.7 cm, submitted entirely in cassette A. Microscopic examination reveals lesional cells that demonstrate focal positivity for SMA and HHF35, while being negative for S-100, desmin, and CD117. This case was discussed in a pathology conference.\n\nAdditional testing indicates no expression of Herceptin; however, a small subset (<5%) of cells shows immunohistochemical reactivity for EGFR."} +{"pid": "TCGA-IS-A3K7", "report": "Specimens submitted include the uterus, cervix, bilateral tubes and ovaries, as well as multiple sections of the bladder wall. The uterine specimen shows a high-grade lesion measuring 10 cm located in the anterior uterine wall. Vascular invasion is present. The tumor does not involve the uterine serosal surface. The endometrium is atrophic. The left ovary contains a benign serous cyst measuring 2 cm. The left tube demonstrates a benign paratubal cyst. The right ovary and tube appear benign. Biopsies from the posterior bladder wall, left posterior bladder wall, and bladder dome show benign smooth muscle and fibroadipose tissue."} +{"pid": "TCGA-DD-AADB", "report": "The liver specimen measured 9.0 x 5.0 x 3.5 cm and weighed 49.0 grams. A mass measuring 1.5 x 1.2 x 1.0 cm was identified. The cut surface showed an encapsulated, pale tan, solid, and lobulated lesion without necrosis or hemorrhage. Gross examination indicated a multinodular confluent growth pattern with the lesion abutting but confined to the capsule. The resection margin was not involved with a safety margin of 2.0 cm. The surrounding liver tissue appeared unremarkable.\n\nMicroscopic evaluation revealed a nesting histologic pattern with hepatic-type cells. The tumor exhibited focal capsular infiltration and fibrous capsule formation was present. There was no evidence of septum formation, surgical resection margin invasion, serosal invasion, portal vein invasion, vascular invasion, or bile duct invasion. The remaining liver parenchyma demonstrated cirrhosis. Immunohistochemistry for CD34 was negative."} +{"pid": "TCGA-AJ-A3QS", "report": "The surgical specimen included a uterus with cervix, bilateral fallopian tubes, and ovaries. The uterus and cervix together weighed 318 grams and measured approximately 12.5 x 8.5 x 8.5 cm. The endometrial cavity was distorted by multiple subserosal and intramural fibrous nodules with whorled tan-white cut surfaces, the largest measuring up to 3.2 cm. A friable papilliferous tan-gray to pink lesion occupied an area of approximately 6.2 x 3.5 cm within the endometrial canal. In the posterior fundal region, this lesion approached within 1.0 cm of the serosa. The uninvolved myometrium measured up to 2.6 cm in thickness. No gross involvement or nodularity was identified in the parametrial soft tissue, and both fallopian tubes and ovaries showed no macroscopic lesions. The left ovary measured 2.0 x 1.2 x 1.0 cm and displayed a mottled tan-gray fibrotic appearance, while the right ovary measured 2.0 x 1.2 x 0.7 cm and had a similar lobular tan surface with fibrotic changes.\n\nMicroscopically, the lesion was high-grade and histologically consistent with a papillary serous carcinoma. Multiple sections of the uterus revealed no definitive myometrial invasion, although there was lymphovascular space invasion. A small focus of tumor less than 1 mm in size was identified in the left ovary, associated with hemorrhage and necrosis, raising concern for microscopic adnexal involvement. All surgical margins were free of malignancy. \n\nLymph node evaluation included a right pelvic lymph node containing a 3.0 cm nodule, which showed metastatic involvement. The left aortic lymph node collection contained six nodes, all negative for malignancy. The right aortic lymph node specimen did not contain identifiable lymphoid tissue. Omental tissue showed no evidence of tumor involvement.\n\nAdditional findings included benign endometrial patterns, leiomyomata, and adenomyosis within the myometrium. Both fallopian tubes and the right ovary demonstrated no significant histologic changes. Cervical tissue also showed no significant pathology. \n\nClinical correlation is recommended, particularly regarding the microscopic focus in the left ovary and its implications for staging and management."} +{"pid": "TCGA-35-3615", "report": "The specimen was obtained from a lung tissue source. Histological evaluation revealed a neoplastic process with a cell count of over 50. The histological grade was determined to be 2. Staging according to the TNM classification system showed a T2, N0, M0 status. No treatment had been administered prior to procurement. The sample was collected via surgical resection and stored in an OCT block. A separate blood sample was also collected and stored frozen. No lymph node involvement or distant metastasis was identified. The tumor cells were present in sufficient quantity for further analysis."} +{"pid": "TCGA-QR-A6GU", "report": "The right adrenal gland specimen measured 10.5 x 3.2 x 3.4 cm and weighed 64.36 grams. A bivalved section revealed a 2.7 x 2.4 cm mass with a gray/red brown cut surface, along with a portion of normal adrenal tissue measuring 2.4 x 1.2 cm. Tissue blocks from the mass were submitted for analysis, along with samples of adjacent normal tissue. The left adrenal gland specimen measured 7.5 x 5.2 x 3.6 cm and weighed 54.75 grams. Upon bisection, a 3.4 x 2.3 cm mass was identified with a red/green variegated appearance on sectioning, accompanied by a 1.2 x 1.2 x 1.3 cm segment of normal adrenal tissue. Tissue from the mass and from normal areas were also submitted for histologic evaluation.\n\nImmunohistochemical staining of the lesion showed positivity for NSE, Synaptophysin, Chromogranin, and CD56. Staining for Inhibin was negative in the lesional cells. Sustentacular cells were highlighted by S100 staining. All immunoperoxidase tests were performed in a CLIA-certified laboratory approved for high-complexity testing. The assays used were developed and validated by the laboratory; they are not required to be cleared or approved by the U.S. Food and Drug Administration."} +{"pid": "TCGA-MY-A5BE", "report": "The surgical specimen included multiple lymph node excisions from various anatomical locations. On the right side, two common iliac lymph nodes were identified and found to be negative for tumor. A right obturator lymph node with marked fatty infiltration was also negative for tumor. The left obturator lymph node was similarly negative. A radical hysterectomy specimen included the uterus, cervix, and fallopian tubes. The cervical tissue showed a lesion measuring 1.8 cm in greatest dimension, with an invasion depth of 5 mm into a cervical wall thickness of 16 mm. The vaginal cuff margin was free of disease. The endometrium showed secretory changes. Lymph node dissection on the right included external iliac (five nodes), common iliac (no node identified in fibroadipose tissue), periaortic (two nodes), and additional obturator (one node), all negative for tumor. On the left, three external iliac lymph nodes, two common iliac lymph nodes, one periaortic lymph node, and two obturator lymph nodes were examined, all without evidence of tumor. Both fallopian tubes were present and showed no involvement. Histologically, the lesion was classified as poorly differentiated. No lymph-vascular invasion was identified. The tumor was confined to the cervix without parametrial extension. Inflammatory changes were noted in association with the lesion. All surgical margins were negative. A total of 22 regional lymph nodes were examined, none showing evidence of metastasis. Clinical staging was provided as IB1."} +{"pid": "TCGA-06-0649", "report": "The patient presented with clinical concerns including possible stroke and seizures, associated with a heterogenously enhancing lesion in the left temporal region exhibiting edema and mass effect. Two biopsy specimens were received for analysis: one from the left temporal brain tissue and another from a left temporal tumor.\n\nMicroscopic examination revealed fragments of neoplastic tissue showing astrocytic proliferation with focal infiltration into the surrounding brain parenchyma. The cellular architecture was marked by nuclear anaplasia, increased mitotic activity, and areas of microvascular proliferation. Necrotic zones within the neoplasm were also identified, along with intratumoral thrombosis. Immunohistochemical staining demonstrated gliofibrillogenesis by the neoplastic cells, with no overexpression of p53 protein. Proliferative activity was assessed using MIB-1 immunostaining, revealing a proliferation index of approximately 23% in the more active regions of the tumor.\n\nGross evaluation of the first specimen consisted of four small fragments of semi-firm, glistening tan-gray tissue measuring up to 0.6 cm in aggregate. The second specimen consisted of several tan, rubbery fragments of brain tissue with clotted blood, measuring 3 cm in total.\n\nAll sections were submitted for analysis and appropriate stains were performed. The findings are consistent with a high-grade neoplastic process as noted during intraoperative consultation."} +{"pid": "TCGA-EL-A3CX", "report": "A female patient underwent surgical intervention with submission of multiple specimens. A nodule from the right upper pole measured 0.5 x 0.4 x 0.3 cm and was identified as thymic tissue without evidence of malignancy. A total thyroidectomy specimen measured 5.0 x 3.5 x 3 cm and contained a well-circumscribed lesion in the right lobe measuring 3.3 x 3.3 x 2.0 cm. The left lobe appeared unremarkable upon gross examination. Histologic evaluation revealed the presence of lymphovascular invasion; however, no extrathyroidal extension was observed and resection margins were negative. One lymph node associated with the right inferior parathyroid region showed no malignant involvement and the parathyroid gland was not identified. Examination of twelve lymph nodes from the right paratracheal and mediastinal regions revealed no evidence of tumor involvement. Additionally, thymic tissue was identified in these lymph node specimens without any malignant findings."} +{"pid": "TCGA-BP-4759", "report": "The clinical history notes a left renal mass. Specimens submitted include a left renal tumor and a deep margin #2.\n\nThe partial nephrectomy specimen measures 5.5 x 4.5 x 3.5 cm and includes a kidney measuring 4.5 x 4.0 x 3.0 cm with attached perirenal fat measuring 4.5 x 4.0 x 2.0 cm. The surgical resection margin is inked black, and the fat is inked green. The fat is detached from the renal cortical surface. On sectioning, a well-circumscribed, focally encapsulated, round, bright yellow mass measuring 3.0 x 2.5 x 2.5 cm is identified. The mass shows focal hemorrhages and a central tan-white area. It is located 0.1 cm from the resection margin. Representative sections were submitted for analysis.\n\nMicroscopic evaluation reveals a neoplasm with acinar growth pattern. The cells have clear cytoplasm and nuclear features consistent with low nuclear grade. The tumor does not extend beyond the renal capsule and is surrounded by normal renal tissue. All surgical margins are free of neoplastic cells. Adjacent non-neoplastic kidney tissue appears unremarkable.\n\nA separate excision specimen labeled as deep margin #2 consists of soft brown tissue measuring 1.6 x 1.4 x 0.6 cm with minimal fat. Histologic examination of this margin reveals only benign renal parenchyma.\n\nIntraoperative frozen section analysis was performed on both specimens. The first showed a neoplasm consistent with the permanent diagnosis, with negative margins. The second specimen demonstrated benign tissue on frozen section, confirmed by permanent analysis.\n\nAll measurements and histologic findings have been summarized above."} +{"pid": "TCGA-EM-A2CJ", "report": "The specimen consists of a left hemithyroidectomy measuring 5.1 cm in greatest dimension, with an isthmus measuring 1.6 cm. The overall specimen weight is 14.68 g. Two distinct nodules were identified. The first nodule, located in the mid lobe, measures 1.5 cm x 1.2 cm x 1.1 cm and exhibits a variegated red-tan appearance. The second nodule, found at the inferior pole, is gelatinous and measures 1.2 cm x 2.4 cm x 1.2 cm. Both nodules are well delineated.\n\nMicroscopic evaluation reveals a dominant lesion measuring 1.2 cm in greatest dimension and 1.0 cm in an additional dimension. The architecture is follicular with classical cytomorphologic features. The tumor is totally encapsulated; however, capsular invasion is indeterminate. No lymphovascular or perineural invasion is identified, and there is no evidence of extrathyroidal extension. Margins are uninvolved.\n\nAn additional smaller lesion measuring 0.05 cm in greatest dimension is also present. This lesion demonstrates similar follicular architecture and classical cytomorphology, but lacks a capsule. No invasion, lymphovascular involvement, or perineural invasion is observed, and margins remain unaffected.\n\nNodular changes consistent with adenomatoid nodules or follicular disease are noted. No lymph nodes are identified grossly, and none are submitted for examination. Staging is based on AJCC/UICC TNM classification, 7th edition. Given the presence of multiple lesions, the tumor descriptor includes multiple primary tumors. The dominant tumor is classified as pT1b, indicating a tumor greater than 1 cm but not more than 2 cm in greatest dimension limited to the thyroid. Regional lymph node status is designated as pNX due to insufficient sampling, and distant metastasis cannot be assessed."} +{"pid": "TCGA-DX-AB35", "report": "The resected specimen includes a large soft tissue mass measuring 18.5 x 15.5 x 12.0 cm, along with a segment of colon, left kidney with attached ureter, and a fragment of muscle tissue. The soft tissue mass is multinodular and encapsulated by a thin fibrous layer. The cut surface is lobulated, with tan-yellow to yellow-white areas and friable gray regions, approximately 25% of which appears necrotic. The mass adheres to the colon wall via its fibrous capsule but does not grossly invade into the colonic mucosa. It also adheres to a 6 cm segment of the ureter without direct involvement.\n\nWithin the kidney, two additional nodules were identified: one measuring 8.4 x 6.5 x 3.8 cm and another measuring 3.5 x 3.0 x 2.0 cm. Both are encapsulated and show tan-yellow homogenous cut surfaces. These nodules are contiguous with the main mass but do not invade the renal parenchyma. The renal parenchyma is thinned, ranging from 1.5 to 2.5 cm in thickness. Mild dilation of the renal pelvis and calyces is noted. No adrenal tissue was identified. The muscle fragment is located 2.0 cm from the nearest tumor edge and shows no involvement.\n\nA separate small bowel specimen measuring up to 7.5 cm in circumference and 37.0 cm in length was submitted. The serosal surface shows focal fibromembranous adhesions and mild ischemic changes in the mucosa. A firm induration measuring 1.5 cm in diameter is noted near an anastomotic site, though histologic examination revealed no malignancy.\n\nA mesenteric nodule measuring 1.2 x 1.0 x 0.6 cm consists of adipose tissue with scattered atypical stromal cells. The tissue exhibits morphological features suggestive of a benign adipose lesion with minimal cellular variation.\n\nAn abdominal scar specimen measuring 21.0 x 4.1 x 0.6 cm shows dermal scarring with mixed acute and chronic inflammatory changes, but no neoplastic features.\n\nMargins of resection, including those of the ureter, renal vessels, proximal and distal colon, were free of abnormal cellular infiltration. The muscle tissue also showed no involvement. Renal parenchymal changes include glomerulosclerosis and nonspecific interstitial inflammation. Sections of the tumor and surrounding normal tissues were submitted for further analysis."} +{"pid": "TCGA-DX-AB2V", "report": "The excised soft tissue specimen from the right paraspinal region measures 16.5 x 11.0 x 3.4 cm and includes skin with subcutaneous tissue. A well-circumscribed, yellow-tan lobulated mass is identified within the subcutaneous layer, measuring 6.3 x 4.5 x 4.2 cm. The tumor is located in close proximity to the deep margin, coming within 0.07 cm of it, while other margins are free of involvement. The lesion does not extend into the deep fascia. No necrosis is observed. Histologic sections show high-grade cellular features and a myxoid matrix. Skeletal muscle is present at the deep aspect of the specimen. Tissue was submitted for further testing."} +{"pid": "TCGA-DD-AAEI", "report": "The liver specimen measured 8.0 x 6.5 x 3.0 cm and weighed 73.0 grams. A well-defined lesion measuring 3.5 x 3.0 x 2.5 cm was identified. The cut surface of the lesion was described as round to oval, pale tan, and solid with a granular appearance. Gross examination showed a nodular growth pattern with perinodular extension. The resection margin was not involved macroscopically, with a safety margin of 1.2 cm. No satellite nodules were observed, and the remaining liver parenchyma showed signs of cirrhosis. There was no portal vein invasion noted grossly.\n\nMicroscopic evaluation revealed a trabecular growth pattern with hepatic-type cells. The tumor demonstrated partial fibrous capsule formation without capsular infiltration or septum formation. Surgical resection margin invasion, serosal invasion, microvessel invasion, intrahepatic metastasis, and multicentric occurrence were all absent. Fatty change was present in approximately 20% of the cells. The differentiation grade was moderately differentiated (worst and major differentiation grade II).\n\nAdditional findings included cirrhosis associated with hepatitis C virus involvement in the non-tumor liver tissue. Other specimens from the gastrointestinal tract revealed various benign and pre-malignant findings including tubular adenomas with low-grade dysplasia in the stomach and ascending colon, a tubulovillous adenoma with high-grade dysplasia in the rectum, and chronic gastritis with low-grade dysplasia in the antrum. No dysplastic nodules or ductal epithelial dysplasia were identified in the liver."} +{"pid": "TCGA-AG-A02X", "report": "The specimen consists of a lymph node with reactive changes. The primary lesion, located in the rectum, is a moderately differentiated adenocarcinoma. Histologic evaluation shows infiltration into the muscularis propria, classified as pT2. Lymphatic and vascular invasion are present (L1, V1). Resection margins are narrowly clear, and no involved lymph nodes were identified, corresponding to pN0. The anastomotic site is free of tumor. The tumor was entirely removed with no residual disease at the resection site."} +{"pid": "TCGA-NH-A6GA", "report": "The specimen consists of right colon with attached terminal ileum and appendix following a right hemicolectomy. Grossly, the colon measures 25 cm in length by 3 cm in diameter, the small bowel measures 7.5 cm in length by 2 cm in diameter, and the appendix measures 10 cm in length by 1 cm in diameter. A nearly circumferential ulcerating mass is present, measuring 3 cm in length by 4.5 cm in width, located 14 cm proximal to the distal margin of resection. The closest radial margin is 5 cm. Cut section reveals firm pinkish-tan tissue infiltrating through the bowel wall into the subserosal fat, with focal extension to the visceral peritoneal surface. A polyp measuring 1 x 0.8 x 1 cm is identified at the distal end of the mass.\n\nHistologically, the lesion shows features of low-grade adenocarcinoma. Microscopic evaluation confirms infiltration through the bowel wall to the serosal surface. Lymphovascular invasion is present. Surgical margins are free of involvement, with no tumor identified at the proximal, distal, or circumferential margins. Three discrete tumor deposits are identified within the subserosal tissue.\n\nA total of 33 subserosal lymph nodes are examined, four of which contain metastatic adenocarcinoma with focal extracapsular extension noted. No gross tumor involvement is seen in the remainder of the mucosa of the colon or small bowel. One enlarged lymph node measuring up to 3 cm in diameter is identified, showing central necrosis with soft, pasty content.\n\nAdditional specimens include a CT-guided liver biopsy and fine needle aspirate, both showing malignant cells consistent with metastatic adenocarcinoma. Multiple core biopsy fragments from the liver are submitted for histologic evaluation. Smears from the aspirate demonstrate malignant cells suitable for diagnosis.\n\nStaging assessment indicates primary tumor extension to the visceral peritoneum (pT4a), with regional lymph node involvement (pN2a). No distant metastases are identified in this report."} +{"pid": "TCGA-HT-7473", "report": "Scattered MIB-1 reactive cells are present throughout the lesion, with a labeling index of 6.1% in the most proliferative regions. This level of proliferation is considered intermediate\u2014higher than typically observed in certain low-grade gliomas but not sufficient to support a classification of anaplastic. Microscopic examination reveals a diffusely infiltrating glioma within sections of gray and white matter. The lesion demonstrates mild to moderate hypercellularity and is composed predominantly of cells with round to slightly irregular nuclei and minimal processes. Perinuclear halos are commonly observed. Mitotic figures are rare. There is no evidence of microvascular proliferation or necrosis."} +{"pid": "TCGA-21-5784", "report": "The specimen was obtained from multiple sites including lymph nodes from levels 11R, 3A, 10R, 7, 10, and 4R, as well as a right upper lobe lung resection. The lymph nodes from all levels were black-brown and anthracotic, with sizes ranging from 0.1 to 1.5 cm. All lymph nodes across all levels were free of tumor involvement. The right upper lobe specimen weighed 197 grams and measured 14 x 9 x 4 cm. A gray nodular area measuring 3 x 2.5 cm was identified on the pleura. Serial sectioning revealed an ill-defined gray mass measuring 4 x 3.2 x 2.1 cm located approximately 1.5 cm from the bronchial and vascular margins. The remaining lung tissue was congested but otherwise unremarkable. Histologically, the lesion showed high-grade features. Vascular and bronchial margins, as well as the visceral pleura, were free of tumor. Two peribronchial lymph nodes were also free of tumor. A total of 32 regional lymph nodes were examined and none showed evidence of metastasis. The staging classification for the primary lesion is T2 based on size greater than 3 cm, with no nodal involvement (NO) and no distant metastasis could be assessed (Mx)."} +{"pid": "TCGA-AX-A1C8", "report": "The specimen includes a uterus with cervix and bilateral ovaries and fallopian tubes. The endometrium is diffusely involved by a lesion measuring 7.5 cm in greatest dimension, with a yellow, papillary appearance. Histologically, there is invasion of the myometrium to a depth of 8 mm within a total myometrial thickness of 24 mm, representing less than half-depth invasion. No lymphovascular space invasion is identified in the myometrium. The lower uterine segment is involved by invasive disease. In the cervix, there is focal stromal involvement limited to the inner third; however, the cervical mucosa is not involved. No lymphovascular space invasion is noted in the cervix.\n\nAdditional findings include a small focus of adenomyosis, a calcified uterine leiomyoma, and squamous metaplasia with tunnel clusters and Nabothian cysts in the cervix. Both ovaries are atrophic and show no malignant changes. Both fallopian tubes appear histologically unremarkable.\n\nLymph node evaluation includes right periaortic lymph nodes (three examined, none positive), right pelvic lymph nodes including obturators (eight examined, none positive), and left pelvic lymph nodes including obturators (four examined, one positive). The metastatic deposit in the involved lymph node measures approximately 0.35 cm in diameter and lacks extranodal extension.\n\nSections of the uterus demonstrate tumor involvement of the endometrium with no gross evidence of vascular or lymphatic invasion. A small white nodule is noted in the myometrium measuring 0.3 x 0.3 cm. The serosal surface appears smooth. Both ovaries are small and cerebriform on external examination with unremarkable cut surfaces.\n\nAll lymph node specimens were processed and submitted for histologic evaluation. No malignancy was found in sections from the right periaortic or right pelvic lymph nodes. In the left pelvic lymph nodes, one node contained metastatic disease.\n\nOther clinical information notes a history of high-grade disease and prior diagnosis of endometrial cancer."} +{"pid": "TCGA-BJ-A28X", "report": "A total thyroidectomy specimen weighed 17 grams and showed two distinct foci of neoplastic growth, measuring 1.2 cm and 0.5 cm. The larger focus was located in the left lobe and demonstrated a variant pattern of growth with extension beyond the thyroid capsule. The tumor was located less than 0.1 cm from the closest resection margin. Lymphovascular invasion was identified. A central compartment lymph node dissection was performed, involving six lymph nodes, of which two contained malignant cells. No evidence of spread beyond the lymph nodes was observed. Additional findings included chronic inflammatory changes within the thyroid tissue. A total of eight lymph nodes were examined across both specimens, with two showing involvement by malignant cells. The surgical margins were free of invasive disease."} +{"pid": "TCGA-HC-7077", "report": "The specimen consisted of soft tissue from the posterior and anterior neck regions, as well as a prostate specimen from a radical prostatectomy. No evidence of malignancy was identified in the soft tissue samples from either the posterior or anterior neck.\n\nThe prostate specimen weighed 48 grams and measured 4.4 x 4.3 x 2.8 cm. The external surface was partially covered by a shaggy brown capsule. A pale-yellow, poorly defined area of discoloration was noted on the left lateral aspect of the distal portion, measuring 0.1 cm from the inked posterior margin. The remainder of the cut surface showed tan-yellow fibrous tissue and tan-gray cystic changes, with no grossly identifiable lesions.\n\nHistologic evaluation revealed benign findings in the posterior and anterior bladder neck specimens. In the prostate specimen, histologic features included a primary Gleason pattern of 3 and a secondary pattern of 3. Tumor involvement was noted in both lobes, with approximately 25% of the prostate involved. No seminal vesicle involvement was observed. Extracapsular extension was present in block C8, and perineural invasion was also identified. Lymphovascular space invasion was not present. High-grade prostatic intraepithelial neoplasia (PIN) was present.\n\nSurgical margins, including the bladder neck, apical margin, and inked prostatic margin, were free of malignancy. No lymph nodes were resected. A small focus of tumor was noted on the right side in block C6, and tumor cells adjacent to adipose tissue were found in block C8, representing unilateral extracapsular extension. Other findings included prostatic hyperplasia in other areas.\n\nStaging was determined to be pT3a. No distant metastasis or lymph node involvement was identified. The staging sheet reference was #34. Preoperative clinical findings were consistent with a lesion of concern, and postoperative findings were based on radiologic and symptomatic presentation. The specimens submitted included the posterior bladder neck, anterior bladder neck, and prostate. All relevant sections were submitted for analysis, including multiple blocks from various regions of the prostate and seminal vesicles. Two cassettes were submitted for research purposes."} +{"pid": "TCGA-66-2791", "report": "The right lung specimen measures 14 x 12 cm at the base and up to 26 cm in height. The central bronchus resection plane is located 1 cm proximal to the upper lobe bronchus. On the dorsomedial and basal pleura, an area of roughening or residual adhesion measuring up to 7.5 x 4 cm is observed in S10; a similar 3 cm area is seen over S7. In the region of the middle lobe bronchus bifurcation and proximal sections of the basal bronchial group, there is narrowing due to a moderately firm, pale brownish-white structure with grayish-black pigmentation. This lesion reaches a maximum size of 4.7 cm and has indistinct, arcuate borders. It is primarily located in S10 with extension into adjacent sections S6, S7, and S9, reaching within 0.2 cm of the medial visceral pleura over S10.\n\nThere is truncation of B9 and B10 as well as a subsegmental branch of B7 within the affected tissue. Focal crossing of the lower pleural fissure and involvement of the middle lobe are present. Satellite foci up to 0.2 cm in size are noted in the surrounding areas. Peripheral sections of basal bronchial branches are dilated and filled with thick mucus. The parenchyma beneath the adhesion zone in S10 shows diffuse induration and a brown vitreous appearance.\n\nA 2.5 cm node is found in the mediocaudal region of the upper lobe bronchus bifurcation, adherent to the vascular wall, with whitish section surfaces extending to the hilar resection surface but not contiguous with the main lesion. At the intermediate bronchus, a 0.7 cm node suggestive of involvement is noted. Adjacent to the lower lobe bronchus, a 0.5 cm grayish-black node is present. In the apical parenchyma of S1, there is a seam-like area of induration and discoloration measuring up to 0.4 cm wide.\n\nLymph node stations examined include: paraesophageal (station 8) with a 1.2 cm node; low paratracheal (station 4) right with a 1.4 cm node; high paratracheal (station 2) right with a 1.4 cm node showing whitish sections; subcarinal (station 7) with a 3.8 cm node; and hilar (station 10) left with a 1.2 cm and a 0.9 cm lesioned node.\n\nMicroscopic evaluation reveals solid structures composed of large atypical epithelial cells with dense packing in some regions. These cells have abundant cytoplasm and round to occasionally deformed nuclei with granular chromatin and prominent nucleoli. Frequent mitotic figures and apoptotic bodies are identified. There are intercellular fissures and isolated bridges suggesting vague squamous differentiation. No mucin production is observed. Areas of necrosis are present. Lung parenchyma is partially destroyed, including a large bronchus where cartilage remains as a strand. Another large bronchus is partially infiltrated by the lesion. Smaller bronchi and bronchioles show luminal dilation and replacement of respiratory epithelium by neoplastic epithelium.\n\nTumor cell nests are found in alveoli and within dilated lymph vessels. Intervening connective tissue between tumor formations includes loose and fibrous collagenous components with inflammatory infiltration. Some small vessels demonstrate wall thickening due to elastosis and contain tumor cells. A larger vein is surrounded by loose fibrous tissue containing capillaries. Between the tumor margin and the visceral pleura on the medial side, a strip of unaffected lung parenchyma is present with partial atelectasis and thickened alveolar septa.\n\nThe lower pleural fissure and adjacent fused visceral pleura are traversed by the lesion, with invasion of large bronchi near the mucosa. A large node adjacent to the upper lobe bronchus bifurcation contains anthracotic pigment and tumor nests at the resection margin. In mediastinal tissue, another compromised lymph node with anthracotic pigment and fibrous growth is identified. In the subpleural region of S1, there is remodeling with collagenous and elastic connective tissue, with recognizable alveolar stroma. Small areas of interstitial fibrosis and anthracotic pigment accumulation are also seen.\n\nIn the basal lower lobe, a significant area of non-oxygenated, fibrosed parenchyma contains partly obliterated vessels and bronchioles. Overlying pleura is markedly fibrotic. Dilated peripheral airways contain mucus and leukocytes, along with clusters of pigment-laden macrophages in alveoli. At the bronchus resection margin, mucosal epithelium is interrupted but otherwise regular. No tumor cells are identified in the bronchial mucosa or vessel walls. Lymph nodes show varying degrees of anthracotic pigment, macrophage accumulation, and secondary follicles. Some nodes are largely replaced by solid epithelial structures, with tumor presence also in paranodal tissue in certain cases.\n\nStaging assessment indicates T2 N3 with lymphovascular invasion and positive margins. Multiple lymph node metastases are identified, including those near the upper lobe bronchus bifurcation extending to the mediastinal resection plane. Additional lymph node involvement is noted in mediastinal stations. Parenchymal changes include bronchiolectasis, fibrous remodeling in S10 and S1, and pleural fibrosis. There is associated inflammation and minor necrotic areas within the lesion. Anthracotic pigment deposition is mild in lung tissue but more pronounced in several lymph nodes."} +{"pid": "TCGA-N9-A4Q4", "report": "The specimen consists of a uterus measuring 12 x 5 x 3 cm, bilateral fallopian tubes and ovaries. Within the endometrial cavity, a polypoid mass measuring 8 x 4.5 x 3.5 cm is present, with a fleshy, pink-white cut surface and focal areas of necrosis. The mass appears confined to the endometrium without evidence of cervical or myometrial involvement. Two well-circumscribed nodules are identified within the myometrium, measuring 3.5 x 2 x 2 cm and 2.5 x 2 x 1.5 cm respectively, with firm, whorled, gray-white cut surfaces. Histologically, the mass includes high-grade epithelial components and an undifferentiated sarcomatous component with rhabdoid features.\n\nMicroscopic evaluation reveals invasion into the superficial myometrium, measuring 1 mm depth out of a total myometrial thickness of 12 mm. No lymphovascular invasion is identified. Benign leiomyomata are noted in the myometrium. No significant pathology is identified in the cervix, bilateral ovaries, or fallopian tubes.\n\nLymph node evaluation shows no involvement in several regions. In the left common iliac region, two lymph nodes are identified and negative. Similarly, in the left pelvic region, ten lymph nodes are identified and negative. On the right side, eleven pelvic lymph nodes are identified, all without evidence of involvement. In the right common iliac region, one lymph node contains a metastatic focus measuring 0.4 cm composed of epithelioid cells with rhabdoid morphology, positive for desmin and negative for keratin cocktail. Additional lymph nodes are evaluated in the right periaortic (nine nodes) and presacral (one node) regions, as well as in the omentum and infra-gastric regions, all without evidence of involvement.\n\nA calcified nodule is identified in the right gonadal vessel, measuring 0.4 x 0.3 x 0.2 cm, but no tumor is present. Sections from this area were submitted following decalcification. No abnormalities are found in the omental tissue or infra-gastric nodule. All relevant sections have been submitted for analysis."} +{"pid": "TCGA-CV-6941", "report": "The specimen included multiple lymph nodes from a right neck dissection, all without evidence of tumor involvement. The submandibular gland was present and showed chronic sialoadenitis with atrophy. Connective tissue from the mental hyoid muscular insertion was unremarkable. The right lingual nerve was free of tumor. Anterior tongue tissue showed only mild nonspecific chronic inflammation of the squamous mucosa, with no tumor identified. Additional anterior tissue also showed benign squamous mucosa. Teeth were noted in the specimen, though this was based on gross examination only.\n\nThe primary lesion involved the floor of the mouth and adjacent tongue. Histological evaluation revealed a moderately differentiated cellular proliferation with features consistent with a malignant epithelial neoplasm. The maximum depth of invasion measured 1.8 cm. Perineural invasion was identified. No definitive lymphovascular invasion was observed. The tumor extended into minor salivary gland tissue. All resection margins were negative for tumor. A total of thirty-one regional lymph nodes were examined and none contained tumor. The submandibular gland was submitted entirely and showed no tumor involvement. Multiple lymph nodes from all levels were submitted completely, ranging in size from 0.3 to 1.2 cm. The aggregate specimen measured 12.0 x 5.0 x 3.0 cm. Submandibular gland measured 5.0 x 3.0 x 1.0 cm."} +{"pid": "TCGA-FB-AAPQ", "report": "The Whipple specimen includes a stomach measuring 10.3 x 10 x 0.8 cm in wall thickness, a duodenum 25 cm in length and approximately 4 cm in average diameter, a gallbladder measuring 11.5 x 4.5 x 2.2 cm, and a pancreas measuring 5.5 x 4.8 x 2.2 cm. The specimen was submitted with five designated margins. A long single blue suture marks an area of the superior mesenteric vein; a looped blue suture identifies the superior mesenteric artery margin, a looped black suture identifies the deep radial margin, a long single black stitch marks the portal vein margin, and a pair of double black sutures indicates the pancreatic neck margin. The proximal staple line of the stomach measures 8 cm and is inked black. The lesser curvature measures 7.5 cm and the greater curvature 14.5 cm. The serosa is tan and slightly rough. Attached omental fat measures 8.5 cm in greatest length. The stomach was opened along the lesser curvature, revealing regular rugae covered by light tan mucus. The mucosa is tan with a slightly nodular appearance, averaging 0.4 cm in diameter. Representative sections of the stomach were submitted.\n\nThe pancreas has a rough, yellow exterior with areas of partial cauterization. The neck margin is inked blue and other radial margins are inked black. The five sutures were identified, and perpendicular sections of these margins were submitted. Serial sectioning of the pancreas revealed a white, ill-defined, indurated mass located in the head that extends nearly the entire length of the organ, measuring 5 x 3.5 x 2.2 cm. In the inferior region, the lesion is surrounded by yellow, partially fibrotic pancreatic tissue. The ampulla is patent to the common bile duct, and the main pancreatic duct is obstructed by the mass but remains patent at the pancreatic neck margin. Representative sections of the pancreas were submitted.\n\nThe duodenum has congested red serosa near the pancreas and is otherwise unremarkable. The surgical margin is stapled, inked black, and submitted. The specimen was opened adjacent to the mesenteric border, revealing a 1.5-cm open defect with central ulceration between the pylorus and the ampulla. The ulcer extends into the pancreas, measuring 1.1 cm in depth from the mucosal surface. It approaches close to the proximal end of a prominent blue metal stent in the ampulla, which measures 1.3 cm in both diameter and length. The mucosa surrounding the ulcer and the stent appears firm with a slight dusky color. An adjacent mass measuring 1.5 x 0.8 cm and up to 0.9 cm in height bridges the ulcer and the stented bile duct. The mucosa distal to the bile duct is tan and edematous, except for the most distal 11 cm, which is dusky. Representative sections of the duodenum were submitted.\n\nThe gallbladder has red-purple serosa with punctate green areas. The attached region is rough with a small amount of cauterized, yellow-lobular tissue. The gallbladder contains viscous, red-brown fluid. The cystic duct measures 1.5 x 0.5 cm. A small duct measuring 0.3 x 0.2 cm is found 1.3 cm distal to the neck, possibly one of two candidate hepatic ducts or the cystic artery. Near the insertion of the common bile duct into the pancreas, there is a circular defect measuring 0.4 cm in diameter, which may be a surgical defect or another candidate hepatic duct opening. Representative sections of the gallbladder were submitted.\n\nA total of sixteen possible pancreatic lymph nodes were dissected, ranging in size from 0.5 x 0.3 x 0.3 cm to 2.7 x 1 x 1 cm, and were submitted in toto. Six possible greater curvature lymph nodes were also dissected, ranging from 0.2 x 0.2 x 0.2 cm to 0.8 x 0.6 x 0.6 cm, and were submitted in toto. No duodenal lymph nodes were identified.\n\nMicroscopically, the pancreatic duct margin showed ductal tissue without evidence of malignancy. The pancreatic margin revealed parenchyma with chronic pancreatitis and no carcinoma. The mass demonstrated features consistent with involvement of the duodenal mucosa and peripancreatic fat. Lymph node analysis showed four out of twenty-four nodes positive for metastatic involvement. All resection margins were free of involvement. The histologic grade was moderately differentiated, and the tumor extended into the small intestine. No definitive assessment of lymphatic or venous invasion was made, and there was no identifiable evidence of prior neoadjuvant treatment."} +{"pid": "TCGA-D8-A4Z1", "report": "The specimen consists of a right breast measuring 20.4 x 13.8 x 4.6 cm, with a skin flap measuring 19.4 x 8.6 cm and a total weight of 540 g. A lesion measuring 1.6 x 1.4 x 1.6 cm was identified in the inner lower quadrant, located 2.1 cm from the lower edge, 1.6 cm from the base, and 0.9 cm from the skin. Histological evaluation revealed a combination of invasive and non-invasive components. The invasive component is graded as NHG2, with a mitotic count of 3+2+1/10 HPF over a visual area of 0.55 mm. The non-invasive component shows features of in situ growth with nuclear atypia present in less than 10% of the affected cells. Adjacent glandular tissue demonstrates fibrocytoid changes, adenosis, usual ductal hyperplasia, and fibroadenoma. Surgical margins were assessed, with the closest margin measuring 1.6 cm from the base. Immunohistochemical analysis showed estrogen receptor positivity in 75% of neoplastic nuclei and progesterone receptor positivity in 10\u201375% of nuclei. HER2 staining using Ventana's Pathway HER-2/neu (4B5) antibody demonstrated a score of 1+, indicating a negative result. Proliferation index, as assessed by Ki-67, was approximately 10%. No lymph nodes were examined."} +{"pid": "TCGA-2G-AAEX", "report": "The pathology report describes a left orchidectomy specimen. The tumor measured 7 cm in greatest dimension. Histologic evaluation showed no evidence of angioinvasion or invasion of the rete testis. Cellular morphology was consistent with a uniform population of atypical cells arranged in nests and cords, with a background of lymphocytic infiltration. Staging could not be fully determined due to lack of additional clinical and radiological information. The surgical margins were free of neoplastic cells. No lymph node involvement was identified."} +{"pid": "TCGA-06-0168", "report": "The surgical specimen was received on the date of surgery and consisted of brain tissue. The gross examination revealed multiple tissue fragments measuring 0.2\u20130.6 cm, submitted for frozen section analysis. A second specimen, measuring 2.5 x 2.5 x 1.3 cm in aggregate, included multiple areas of red clotted blood. All sections (3\u20134) were submitted for evaluation.\n\nMicroscopic examination showed a high-grade glial tumor with increased cellularity, frequent mitotic figures, vascular proliferation, and multiple necrotic foci. Immunohistochemical staining demonstrated a proliferation index of approximately 30%. No clinical history or preoperative diagnosis was provided."} +{"pid": "TCGA-78-7149", "report": "The right lower lobectomy specimen measures 70 \u00d7 80 \u00d7 60 mm. Sectioning reveals a large lesion in the superior aspect of the lobe measuring 75 \u00d7 60 \u00d7 60 mm. The lesion has a pink and tan appearance with soft consistency and extends to the pleural surface, although no clear trans-pleural invasion is observed grossly. It extensively involves the bronchi, with evidence of bronchial wall erosion forming a polypoid intraluminal mass measuring up to 10 mm. This mass is located approximately 14 mm from the nearest bronchial resection margin. The lesion approaches within about 2 mm of the hilar resection margin but does not involve any surgical margin directly.\n\nIn the inferomedial lung region, separate nodules are identified, ranging between 5 and 12 mm in diameter. In proximity to one of these nodules, there is an area of fibrosis and calcification measuring up to 3 mm. Lung tissue above the main lesion shows yellow discoloration, while the inferior portion distal to the lesion appears largely unremarkable.\n\nHistologically, the lesion demonstrates moderately differentiated features with areas resembling bronchioloalveolar growth patterns. There is clear evidence of stromal invasion and an endobronchial component. The pleura is closely approached but not invaded. Resection margins, including bronchial and mediastinal areas, show no involvement by malignant cells. No vascular or lymphatic invasion is detected, and peribronchial lymph nodes do not contain metastatic disease. Several satellite nodules are present in the lung parenchyma below the primary lesion, displaying similar histological architecture suggestive of airway dissemination.\n\nA separate hilar lymph node specimen, measuring approximately 20 \u00d7 20 \u00d7 5 mm in aggregate, contains no evidence of malignancy. Staging data indicates no lymph node involvement."} +{"pid": "TCGA-G2-AA3D", "report": "The specimen consists of multiple fragments of tan-pink to gray-white soft tissue measuring approximately 2.2 x 1.1 x 0.5 cm in aggregate. Histologic evaluation reveals high-grade urothelial carcinoma with invasion into the muscularis propria. Lymphovascular invasion is present. Additional findings include chronic inflammation and granulation tissue within the bladder wall fragments, suggestive of a prior biopsy site. The entire specimen was submitted for analysis."} +{"pid": "TCGA-44-5644", "report": "The specimen included multiple lymph node biopsies and a right lower lobe lung resection. Lymph nodes from R4, right, level 10, and level 7 were all negative for malignancy, with sizes ranging from 0.4 to 2.4 cm. The right lower lobe specimen weighed 195 grams and measured 15 x 7 x 5.4 cm. A tumor measuring 3.5 x 3.2 x 3 cm was identified within the lung tissue. Histological evaluation showed moderately differentiated cells with a mitotic index of 26 mitoses per 10 high power fields. The surgical margin and pleura were free of tumor involvement, and there was no evidence of vascular invasion. Staging was determined as T2a NO. The surrounding lung tissue demonstrated benign reactive changes."} +{"pid": "TCGA-AA-3693", "report": "The resected sigmoid colon specimen demonstrates tumor-free proximal and distal resection margins. A moderately differentiated adenocarcinoma is present with ulceration and extends into the perimuscular adipose tissue. Two regional lymph nodes show metastatic involvement. Additionally, there is evidence of peritoneal penetration and serosal invasion, along with two hepatic lesions indicative of liver metastases. Histopathological staging reveals a T4 lesion with vascular invasion not identified (V0), lymph node involvement in 2 out of 17 examined nodes (pN1), and distant metastases involving both the liver and peritoneum (pM1)."} +{"pid": "TCGA-FR-A728", "report": "The excised specimen from the left shoulder measured 6.8 x 6 x 2.5 cm and was submitted with multiple inked margins. Histologic evaluation revealed residual changes at the biopsy site with involvement by a superficial spreading lesion. The Breslow depth was measured at 12 mm, with extensive ulceration and complete consumption of the epidermis noted. All surgical margins were free of involvement. The Clark level was IV, indicating deep dermal invasion, and a vertical growth phase was identified. Mitotic activity was present at a rate of 6.2 per square millimeter. Tumor-infiltrating lymphocytes were observed but not in a brisk pattern. Regression was not identified. Lymphovascular space invasion was present. There was no evidence of satellite nodule formation or perineural invasion. A coexisting nevus was present, along with mild pigmentation and mild solar elastosis.\n\nStaging based on this specimen was pT4b pNx pMx. It was noted that this staging may be incomplete and further review of all available data is recommended for final staging assessment.\n\nSentinel lymph node evaluation was performed on three separate lymph nodes from the left axillary region. In one lymph node, metastatic involvement was identified with a few immunohistochemically positive tumor cells, without capsular or extracapsular extension (1/1). Another lymph node showed metastatic involvement with a focus measuring approximately 7 mm, with focal capsular involvement but no extracapsular extension (1/1). Immunostains and histologic sections confirmed the presence of tumor cells. A third lymph node showed no evidence of involvement across all five blocks examined (0/1). Block D1 was selected for BRAF testing.\n\nAdditional excision specimens from the superior and lateral margins showed no evidence of residual disease. Multiple immunostains including S100 protein, Melan A, tyrosinase, HMB-45, Sox10, MiTF, KBA.62, PNL2, and p75/NGFR were utilized to confirm the nature of the infiltrating cells and to evaluate for metastatic involvement."} +{"pid": "TCGA-06-0750", "report": "The specimen consists of brain tissue obtained via excision biopsy. Grossly, the tissue measures 2 x 1 x 0.6 cm and is composed of irregular, red-tan to gray-white, soft, hemorrhagic, and glistening fragments. Histologically, the tissue shows marked cellular atypia, increased mitotic activity, and areas of necrosis with microvascular proliferation. The architecture demonstrates loss of normal brain tissue organization.\n\nImmunohistochemical staining reveals a small subset of cells positive for p53. GFAP highlights gliofibrillary changes within the neoplastic population. CD163 stains demonstrate a prominent cell population. MIB-1 staining indicates a proliferation index of approximately 16% in the more active regions. These findings are consistent with a high-grade lesion. All tissue sections were submitted for analysis."} +{"pid": "TCGA-S7-A7WX", "report": "The gross examination revealed a right adrenal mass measuring 60x50x38 mm and weighing 55 grams. The mass was ovoid and fibrously encapsulated, with a grey-pink cut surface and soft consistency. Remnants of adrenal cortex showing pressure atrophy were observed subcapsularly along the periphery.\n\nMicroscopically, the lesion exhibited solid and diffuse growth composed of large polygonal cells. Focal hemorrhages were present within the tissue. Peripheral areas contained remnants of adrenal cortex, histopathologically confirmed, with focal complete erosion noted. No invasion beyond the capsule was identified in the examined margins.\n\nImmunohistochemistry demonstrated sustentacular cells positive for S100 protein within parts of the tumor; however, certain regions showed negative staining for S100. Proliferative activity assessed by MIB-1 staining was minimal, with less than 1% positivity.\n\nHistopathological scoring included the presence of large nests or diffuse growth comprising over 10% of the tumor volume (score 2), central or confluent tumor necrosis, high cellularity, cellular monotony, tumor cell spindling (even if focal), mitotic figures exceeding 3 per 10 high-power fields, and atypical mitotic figures. Additional findings included extension into adipose tissue, vascular invasion, capsular invasion, moderate nuclear pleomorphism (score 1), and mild nuclear hyperchromasia (score 1), resulting in a total PASS score of 4."} +{"pid": "TCGA-A2-A0CO", "report": "The specimen consists of a right breast mastectomy with axillary contents from a female patient. The mastectomy specimen measures 15.0 x 14.0 x 2.6 cm and weighs 362 grams, with an attached axillary tail measuring 15.0 x 3.0 x 1.0 cm. A skin ellipse is also present, measuring 10.0 x 3.5 cm. The specimen was inked with multiple colors to mark different margins.\n\nGross examination reveals an area of firmness in the superior portion of the breast measuring 5.2 cm, located approximately 5.0 mm from the deep margin. The remainder of the parenchyma shows yellow lobular tissue with focal fibrous white areas and small cystic structures up to 0.2 cm. No other distinct lesions or nodules are identified. The axillary tail contains 11 possible lymph nodes ranging in size from 0.3 to 2.0 cm in greatest dimension.\n\nMicroscopic evaluation reveals a lesion with cellular features including focal in situ changes involving terminal ducts and ductal elements showing solid and cribriform patterns. Fibrocystic changes are present, including fibrosis, cyst formation, and apocrine metaplasia. Microcalcifications are associated with the lesion. Margins include a positive deep margin. There is no evidence of lymphovascular invasion. All 11 lymph nodes examined are negative for involvement.\n\nAdditional studies indicate amplification of a specific gene via fluorescence in situ hybridization (value: 5.0), noted in areas of poorly differentiated carcinoma not previously identified in initial sampling. Multiple sections were submitted for histologic analysis, including representative sections of tumor, lymph nodes, skin, and surrounding tissue.\n\nSections were taken systematically from various quadrants and key areas including the nipple and regions near and distant from the lesion."} +{"pid": "TCGA-2G-AAHG", "report": "The pathology report describes findings from a left orchidectomy specimen. The tumor measured 1.5 cm in diameter. Histological evaluation showed no evidence of angioinvasion or invasion of the tunica albuginea. The epididymis was free of tumor involvement, and there was no infiltration into the rete testis. The surgical margin at the spermatic cord also showed no tumor presence."} +{"pid": "TCGA-G8-6326", "report": "The specimens include an omental biopsy and mesenteric nodules. The omental biopsy consists of a piece of fatty tissue measuring 13 x 8 x 3 cm, with firm, diffuse tan discolorations ranging from 0.5 to 1.8 cm in size. A section of the discolored area was submitted for frozen section analysis, along with additional sections in various fixatives for further study. The mesenteric nodules are submitted as an aggregate of firm tan tissue measuring 3 x 2.2 x 1 cm. Touch preparations were made, and portions of the tissue were sent for cytogenetics, flow cytometry, snap freezing, and tissue procurement. The remaining tissue was submitted in formalin- and B5-fixed sections.\n\nMicroscopic evaluation shows scattered pleomorphic large cells resembling Reed-Sternberg cells within a background rich in T cells and histiocytes. There is no significant infiltration of plasma cells or eosinophils. In-situ hybridization for EBV-encoded RNA (EBER) was negative. Immunohistochemical staining demonstrated that the large cells are positive for B-lineage markers including CD20, CD79a, and PAX5, as well as CD45 and BCL6. They are negative for CD15, CD30, and EBER. Additional markers such as CD3, CD5, CD10, CD23, ALK-1, and others were also negative. Flow cytometry showed a predominance of CD3+ T cells with rare B cells and no clear evidence of a monotypic B-cell population.\n\nSections of the tissue were processed using multiple fixation methods and evaluated with appropriate controls. Special stains and immunohistochemical studies were performed with validated protocols. Some reagents used in these tests are classified as analyte-specific reagents and have not been cleared or approved by the U.S. Food and Drug Administration. Cytogenetic studies are pending at the time of reporting."} +{"pid": "TCGA-VQ-A8PK", "report": "The specimen involves the gastroesophageal junction. The resected specimen includes a lesion measuring up to 8.0 cm. Histologic examination shows moderately differentiated cells arranged in glandular structures, with infiltration extending into the serosal layer. Angiolymphatic invasion is present; perineural invasion is not identified. All surgical margins are free of tumor involvement.\n\nLymph node evaluation reveals several involved lymph nodes. Of the regional lymph nodes examined: 1 out of 6 right paracardial nodes, 3 out of 7 left paracardial nodes, 2 out of 3 lesser curvature nodes, 1 out of 7 left gastric artery nodes, 1 out of 2 anterior hepatic artery nodes, 2 out of 5 celiac trunk nodes, and 1 out of 2 inferior paraesophageal nodes show evidence of tumor involvement. Tissues from the short gastric vessels, suprapyloric region, hepatogastric ligament, greater omentum, esophageal margin, and liver biopsy do not contain tumor. The liver tissue shows mild steatosis."} +{"pid": "TCGA-BS-A0U5", "report": "The specimen included a uterus with cervix, bilateral fallopian tubes, and ovaries, along with multiple lymph node samples from various pelvic and aortic regions. The uterus measured 9.5 x 5.0 x 4.0 cm and weighed 178 grams. A nodule was observed in the upper endocervical canal on the posterior wall, appearing firm and nodular with a partly cystic cut surface. The endometrial cavity contained a papillary mass measuring 2.8 x 2.0 cm located in the superior fundus, raised approximately 0.8 cm above the surface. Histologic evaluation showed no clear evidence of myometrial invasion despite some equivocal early changes; the myometrium in that region was 1.0 cm thick. No infiltrative components were identified grossly.\n\nMicroscopic analysis revealed glandular tissue consistent with low nuclear grade morphology. The tumor did not show lymphovascular space invasion and did not involve the serosa, parametrium, or cervical stroma. Both adnexal regions were free of tumor involvement. Lymph node specimens from the left and right pelvic regions, as well as from the right common, right caval, and left aortic areas, were all negative for metastatic disease. In total, five left pelvic lymph nodes, three right pelvic nodes, two right common nodes, and one right caval node were assessed, with no malignant cells identified.\n\nStaging information indicated an early stage based on localized findings without nodal or deep tissue involvement."} +{"pid": "TCGA-85-6560", "report": "The lung tissue specimen was obtained following pneumonectomy. The tumor measured 3 x 2.5 x 2 cm and was located in the lung. Microscopic examination revealed a poorly differentiated cellular morphology. Lymph node evaluation showed 2 out of 12 nodes positive for malignant cells, specifically in the hilar region. No assessment was provided regarding tumor extent, presence of additional nodules, lymphatic or venous invasion, surgical margins, neo-adjuvant treatment effect, or other pathological findings."} +{"pid": "TCGA-06-0154", "report": "The specimen consisted of multiple tissue fragments from the brain, right frontal region, measuring up to 1.7 x 1.5 x 1 cm. The tissue was semifirm with tanish brown and hemorrhagic appearance. Microscopic examination revealed a highly cellular proliferation of glial cells with nuclear features of anaplasia and frequent mitotic figures. Areas of necrosis, microvascular thrombosis, and pseudopalisading were present. The tumor involved the cerebral cortex and infiltrated into the white matter. Immunohistochemical staining for MIB-1 demonstrated a labeling index of 11% in the more cellular regions."} +{"pid": "TCGA-AA-3986", "report": "The resected colon sample shows a moderately differentiated neoplasm measuring up to 5.5 cm in diameter. Histologic evaluation reveals infiltration extending into the tunica muscularis propria, reaching the border of the pericolic fatty tissue. A total of 27 lymph nodes were examined, and none showed evidence of involvement. The surgical margins are negative. Microscopic assessment indicates no lymphatic or vascular invasion. The lesion demonstrates moderate cellular differentiation without evidence of distant metastasis."} +{"pid": "TCGA-97-8175", "report": "The specimen was received in four parts. The first part, a wedge resection of the left upper lobe, contained a nodule measuring 2 x 1.1 x 1.1 cm located 0.4 cm from the stapled margin. Histologically, the lesion showed a solid growth pattern with a minor component displaying micropapillary features. The tumor measured 3.2 cm in its greatest dimension and was classified as poorly differentiated. Margins of resection, including bronchial and vascular margins, were free of involvement. A total of 11 lymph nodes were examined, with no evidence of metastatic disease identified.\n\nA completion lobectomy specimen of the left upper lobe was also evaluated. No grossly identifiable mass was found upon serial sectioning. Lymph node specimens from levels 5 and 9 were both negative for malignancy. All submitted tissue samples were microscopically reviewed, and representative sections were taken from all relevant areas, including margins and hilar regions.\n\nMolecular testing was performed on the available tissue. Analysis of the EGFR gene exons 18 through 21 did not identify any mutations. A known polymorphism (2361G>A) was detected but is not considered clinically significant. The sample had 80% tumor cellularity, which is above the recommended threshold for reliable results. KRAS mutation analysis of codons 12 and 13 in exon 2 also showed no mutations. The assay's sensitivity allows detection of mutations present in at least 10% of the DNA. Fluorescence in situ hybridization (FISH) for ALK gene rearrangement was performed using a break-apart probe. Results showed no evidence of ALK rearrangement, with only 0.5% of nuclei showing separated signals, which is within normal limits. Additional copies of the ALK gene were observed in 27% of cells, which may represent chromosomal aneuploidy rather than a pathogenic fusion event.\n\nStaging was based on the pTNM classification system. The primary tumor was classified as pT2a based on its size (>3 cm but \u22645 cm) and absence of more proximal bronchial involvement or pleural invasion. Regional lymph node assessment was classified as pN0, as no lymph node metastases were identified. The laboratory performing the molecular studies is CLIA-certified for high-complexity testing, and the methods used are validated for clinical use in non-small cell lung carcinoma. False-positive or false-negative results may occur due to genetic variability or tumor heterogeneity. These molecular findings should be interpreted in the context of other diagnostic and clinical data when making treatment decisions."} +{"pid": "TCGA-O2-A52N", "report": "A right upper lobe sleeve resection specimen was received, weighing 320 grams and measuring 18 x 6 x 7 cm. The pleural surface showed purple-tar discoloration with an area of pleural puckering inked blue. Two staple lines were identified: the shorter measured 6 cm and the longer 11 cm. The shorter staple line was removed, and the underlying parenchyma was inked green. Serial sectioning revealed a 7.5 x 7 x greater than 7 cm tan-white, firm mass with central necrosis. The mass extended into the hilar region and appeared to invade through the bronchial wall; however, the bronchial margin was grossly uninvolved. The tumor was located 1.2 cm from the short staple line previously inked green. The remaining pulmonary parenchyma showed tan-pink coloration with moderate anthracotic pigment and mucostasis. Minimal bronchial erythema and minimal emphysematous changes were noted.\n\nSections were submitted as follows: A1 from the main stem bronchus margin, A2 from the distal bronchial margin, A3 from the tumor in relation to the stapled margin, A4 from the tumor invading the bronchus, A5\u2013A6 from additional areas of the tumor including the puckered pleura, A7 from unremarkable pulmonary parenchyma, and A8 from a hilar lymph node candidate. A level 10 lymph node measuring 1.1 x 0.8 x 0.2 cm was entirely submitted. Level 7 lymph tissue, tan-yellow and soft, measured 3 x 2.4 x 0.5 cm and was entirely submitted in blocks C1\u2013C3. Level 11 lymph tissue, brown-tan and soft, measured 2 x 0.8 x 0.4 cm and was entirely submitted in block D1.\n\nIntraoperative consultation on the right upper lobe showed no involvement at the main stem bronchus (AF1) or distal bronchial margin (AF2). Microscopic examination confirmed negative margins for bronchial, vascular, parenchymal, and pleural involvement. No evidence of malignancy was found in the regional lymph nodes examined, including level 10, level 7, and level 11 biopsies. Vascular invasion was not identified. The tumor did not involve the mainstem bronchus, visceral pleura, chest wall, or mediastinum, and there was no evidence of multiple tumor nodules or lobar atelectasis."} +{"pid": "TCGA-CM-6165", "report": "The specimen from the sigmoid colon resection includes a lesion measuring 2.2 cm in length and 1.5 cm in width, with a maximal thickness of 0.8 cm. The tumor is located 5.0 cm from the proximal margin and 8.0 cm from the distal margin. Histologic evaluation shows moderately differentiated features without tumor budding or increased tumor-infiltrating lymphocytes. There is no evidence of precursor lesions, and the surrounding mucosa appears unremarkable. The tumor invades into subserosal adipose tissue and/or mesenteric fat, but there is no gross perforation identified. Lymphovascular invasion was initially suspected but could not be confirmed on deeper sections and immunohistochemical staining. No perineural or large venous invasion is present. All surgical margins are free of involvement.\n\nA total of 20 lymph nodes are examined, and none show metastatic involvement. There are no tumor deposits identified in the pericolorectal soft tissue. Based on depth of invasion, the staging is classified as pT3 according to the AJCC 7th edition. Additional submitted specimens include margins (proximal, distal, and additional distal), all of which are benign and show no pathologic findings. The lymph nodes and surrounding bowel tissue are unremarkable. Special studies including D2-40 staining were performed to further assess vascular invasion but did not confirm lymphovascular involvement."} +{"pid": "TCGA-BH-A0EE", "report": "A right total mastectomy specimen from a postmenopausal female includes a lesion measuring 5.5 cm on gross examination. Histologic evaluation reveals a high-grade process with papillary features and areas of necrosis. The Nottingham score is 8 out of 9, composed of tubule formation score 2, nuclear grade score 3, and mitotic count score 3. Surgical margins are free of tumor involvement, with the closest margin located posteriorly at 0.7 cm. No lymphovascular invasion or skin extension is observed.\n\nOne sentinel lymph node is examined and shows no evidence of metastasis. Pathologic staging is pT3, pN0, pMX. Immunohistochemical staining demonstrates negativity for ER and PR, with positivity for HER-2/neu at a score of 3+.\n\nIn addition to the main lesion, there is a focus of high-grade in situ disease with cribriform architecture and comedo-type necrosis identified within calcified ducts. This in situ component extends beyond the invasive tumor and is present in one of sixteen sections. Margins are free of in situ disease, with the posterior margin again being the closest at 0.7 cm. The nipple appears unremarkable.\n\nOther associated benign findings include atypical ductal hyperplasia with calcifications in the lateral and outer quadrants, a radial scar in the lower inner quadrant, small intraductal papillomas in the same region, and fibrocystic changes with ductal epithelial hyperplasia, sclerosing adenosis, and calcifications."} +{"pid": "TCGA-AP-A1DM", "report": "The submitted specimens include a biopsy of the right ovary, multiple lymph node samples from both sides including para-aortic, common iliac, external iliac, hypogastric, and obturator regions, as well as the uterus, cervix, bilateral fallopian tubes, and ovaries. All lymph nodes examined were benign, with no evidence of malignancy identified in any of the lymph node groups. The right ovary biopsy revealed benign ovarian tissue.\n\nGross and microscopic examination of the uterus showed an endometrial lesion involving less than half of the myometrium. The maximum depth of invasion measured 3 mm, within a myometrial thickness of 13 mm at that site. There was no evidence of cervical involvement or vascular invasion. The endometrium demonstrated atrophic changes while the myometrium showed adenomyosis. Endometriosis was noted in the right ovary, and the remaining adnexal tissues were unremarkable.\n\nImmunohistochemical staining of the endometrial lesion demonstrated absence of MLH1 and PMS2 protein expression, with preserved expression of MSH2 and MSH6. Dr. Has reviewed the slides and concurs with these findings."} +{"pid": "TCGA-FG-6691", "report": "The pathology report includes multiple tissue specimens obtained from the right temporal region of the brain. The specimens were collected during surgical removal and biopsies from various locations, including superficial, intermediate, deep posterior, and posterior inferior regions. Gross examination revealed fragments of soft tissue with tan-gray to pink-tan appearance, some with focally red-brown discoloration. Sizes of the specimens ranged from 0.8 x 0.8 x 0.4 cm to 5.0 x 4.5 x 3.0 cm in aggregate.\n\nMicroscopic evaluation demonstrated a consistent cellular pattern across most specimens. Tissue samples showed fibrillary architecture with elongated cells exhibiting oval to spindle-shaped nuclei. There was moderate nuclear atypia without significant pleomorphism. Mitotic activity was limited. Some areas displayed prominent microcyst formation and microcystic degeneration. One specimen revealed mild hypercellularity within fragments of hippocampus and white matter, raising concern for infiltrative growth; however, no definitive mass lesion was identified in that area.\n\nIntraoperative assessment included touch imprints and frozen sections. Initial microscopic and imprint analysis suggested low-grade characteristics in one sample, while others indicated features more consistent with higher-grade morphology. Chromosomal studies performed on selected specimens demonstrated preservation of chromosomes 1p and 19q.\n\nAll specimens were submitted in entirety for permanent sectioning and histological review. No other definitive diagnostic terms were applied beyond the described morphologic features."} +{"pid": "TCGA-XQ-A8TA", "report": "The specimen consists of multiple irregular fragments of elastic and brownish tissue measuring approximately 9.0 x 6.8 x 2.0 cm in aggregate. Histological evaluation reveals prostatic tissue with atypical cellular features. Cellular morphology demonstrates high-grade dysplasia with marked nuclear atypia, prominent nucleoli, and loss of architectural differentiation. The growth pattern is characterized by infiltrative glandular structures. Staging assessment indicates extensive involvement with no evidence of capsular invasion. Further ancillary studies were performed for comprehensive characterization."} +{"pid": "TCGA-B3-A6W5", "report": "A right nephrectomy specimen was examined, revealing two distinct masses. The first mass, located at the hilum, measured 2.5 cm in greatest dimension and extended into the perinephric fat. Microscopically, this lesion exhibited clear cell features with focal papillary architecture and nuclear grade 3 morphology. The surgical margins were free of tumor involvement. The second mass, situated more peripherally, measured 2.8 cm and was entirely confined within the renal parenchyma. Histologically, it demonstrated papillary architecture with nuclear grade 2 characteristics. Surgical margins were also uninvolved for this lesion.\n\nThe primary hilar mass extended into the renal sinus fat, corresponding to pT3 staging, while the peripheral lesion was classified as pT1 due to its intrarenal confinement. No lymph nodes were submitted for evaluation, resulting in pNX classification for both lesions. Distant metastasis could not be assessed from this specimen (pMX). No vascular invasion was identified, and the adrenal gland was not present in the specimen. The remaining non-neoplastic kidney tissue appeared histologically normal. Gross examination of the kidney showed no other discrete lesions or lymphadenopathy."} +{"pid": "TCGA-G5-6641", "report": "The specimen consists of a segment of rectosigmoid colon measuring 7.5 cm in length with a circumference of 6.2 cm. The proximal margin is stapled, and the distal margin is marked by a suture. A polypoid mass measuring 2 x 1.3 x 0.8 cm is located 1.3 cm from the distal margin and shows superficial invasion. The remainder of the mucosa appears normal. The distal margin is inked blue, and the mass is submitted in multiple sections including margins and surrounding tissue. Seventy-two lymph nodes are examined, with one showing involvement and focal extranodal extension. Both proximal and distal margins are free of involvement. The tumor is moderately differentiated with mucinous features and invades the submucosa. No lymphovascular or perineural invasion is identified. The resection is complete with all margins negative."} +{"pid": "TCGA-HT-7882", "report": "The tissue sample shows a neoplastic lesion characterized by cells with round to oval nuclei, coarse chromatin, and irregular nuclear contours. Some areas exhibit cells with clear cytoplasm, giving a distinct \"fried egg\" appearance. Fifteen mitotic figures are identified per ten high power fields. Hemorrhage and necrosis are present, along with focal microvascular proliferation. The lesion demonstrates diffuse infiltration into the surrounding brain tissue. Cellular atypia and increased mitotic activity are noted. No definitive diagnosis is provided in this summary."} +{"pid": "TCGA-EJ-5499", "report": "The patient is a male with a history of a PSA value of 5.2 and a prior biopsy that showed abnormal cellular changes in multiple regions of the prostate, including the right and left lobes. A pneumothorax was also documented during the patient\u2019s history.\n\nA radical prostatectomy was performed. Examination of the surgical specimen revealed a lesion with a Gleason score of 4 + 3 = 7. Microscopic analysis identified small foci consistent with higher-grade features, accounting for less than 1% of the tissue examined. The lesion was present bilaterally in the prostate with a maximum dimension of 2.3 cm in one histologic section. Approximately 20% of the prostate volume was involved.\n\nThere was evidence of multifocal extension beyond the prostate capsule, particularly around the right seminal vesicle and in multiple areas including the right anterior base, posterior right apex, right mid, right base, posterior left apex, and posterior left mid. Both seminal vesicles were free of involvement. All surgical margins were negative for any abnormal cells.\n\nPerineural invasion was observed. Additional findings included high-grade intraepithelial changes involving multiple sites within the prostate.\n\nLymph node dissection included 19 lymph nodes from both pelvic regions, none of which showed any abnormal cellular changes.\n\nThe pathologic staging was determined to be pT3a with no nodal involvement (pN0) and no evidence of distant metastasis (pMX). The histologic grade was classified as poorly differentiated. The total weight of the prostate was 46.75 grams."} +{"pid": "TCGA-G4-6306", "report": "The surgical specimen includes a right hemicolectomy with terminal ileum and an excised gallbladder. The colon specimen measured 24 cm in length, with the ascending colon portion measuring 19.5 x 8.2 cm and the terminal ileum 7.3 x 4.2 cm. A firm, oval, sessile mass measuring 3.1 x 2.5 cm was identified in the ascending colon, located 6.2 cm from the ileocecal junction, 10.0 cm from the distal margin, and 14.0 cm from the proximal margin. Histologic evaluation demonstrated a lesion extending into subserosal adipose tissue. Seventeen lymph nodes were examined and showed no evidence of involvement. Multiple tubular adenomas were identified within the colon. Surgical margins, including those of the small bowel and appendix, were uninvolved. The tumor exhibited focal invasion into subserosal adipose tissue with no evidence of perineural invasion or implants. Vascular or lymphatic invasion could not be definitively determined. The closest radial margin was approximately 1.5 cm from the tumor. The gallbladder measured 7.5 x 4.0 x 1.2 cm and contained a black-gold stone measuring 7.0 x 5.0 x 4.2 cm. The gallbladder wall measured up to 0.2 cm and showed no masses or lesions. Microscopic examination revealed chronic cholelithiasis. No other significant findings were noted in the gallbladder specimen."} +{"pid": "TCGA-63-A5ML", "report": "The tissue sample was collected from the right lower lobe and measured 7 cm in size. Histological examination revealed a poorly differentiated squamous cell carcinoma. The tumor was classified as pathological T2, NOS, with no lymph node involvement (pathological N) and no distant metastasis (clinical M0). No additional histological subtypes were specified. The sample was obtained via resection procedure. Additional blood-derived samples (buffy coat) were also collected. Data includes age at collection, days to procedure, and days to diagnosis, though specific values are not provided here."} +{"pid": "TCGA-XM-A8RF", "report": "The specimen submitted is labeled as an anterior mediastinal mass, received fresh and consists of a 6.5 x 3.5 x 2 cm unoriented, previously incised fragment of yellow soft tissue weighing 21 grams. The outer surface is inked black. On serial sectioning, a well-circumscribed, fleshy yellow solid mass measuring 2.2 x 2.2 x 1.5 cm is identified, and the mass is covered by a membrane. A portion of the mass is submitted for further analysis, and the remainder is entirely submitted for evaluation.\n\nMicroscopic examination reveals a neoplastic process with features including microscopic invasion of the surrounding capsule. The tumor does not extend to the surgical margin. The surrounding tissue shows signs of involutional change. Immunohistochemical staining demonstrates positivity for AE1:AE3 in the tumor cells, while intermixed lymphocytes are labeled with CD3 and TdT. All relevant sections have been reviewed and fully submitted."} +{"pid": "TCGA-CG-4444", "report": "The specimen includes a gastrectomy preparation with tumor-free resection margins. The lesion involves the region of the lesser curvature and is associated with subendocardial extension. It demonstrates ulceration and is composed of poorly differentiated cells, including features suggestive of a diffuse growth pattern. The tumor infiltrates the subserosa and is accompanied by multiple regional lymph node metastases. Pathologic staging is pT2b pN2 with 15 out of 37 lymph nodes involved."} +{"pid": "TCGA-BC-A217", "report": "The surgical specimen consists of a partial hepatectomy measuring 11 x 10 x 7.5 cm and weighing 235.4 grams. The specimen is partially covered by a smooth, red to tan capsule with focal areas of hemorrhagic fibrofatty adhesions. A well-circumscribed, lobulated mass measuring 7.4 x 6.1 x 4.9 cm is present beneath the capsule. The mass shows focal areas of hemorrhage and is in close proximity to the blue-inked parenchymal margin. Adjacent to the mass, there is a region of discoloration involving the hepatic parenchyma.\n\nMicroscopic evaluation reveals a high-grade cellular proliferation with features consistent with marked nuclear atypia. The tumor is located near the inked margin and is surrounded by hepatic tissue that demonstrates mild steatosis affecting approximately 5% of the sampled parenchyma. Lymphovascular space invasion is present in one area (A4). No involvement of the outer capsule is identified. Surgical margins are free of abnormal cells.\n\nStaging parameters indicate a pT2 classification based on tumor size and relationship to vascular structures, with no assessable lymph node involvement (pNx). Multiple blocks were submitted for analysis, including sections from the tumor, adjacent capsule, and surrounding tissue."} +{"pid": "TCGA-CN-4729", "report": "The patient underwent a left composite resection and left neck dissection. No preoperative diagnosis or relevant medical history was provided.\n\nIn part 1, the left neck level 1 dissection included seven benign lymph nodes, all negative for involvement, and a submandibular gland with no pathological changes. \n\nPart 2 involved levels 2 and 3 of the left neck. A total of seventeen lymph nodes were examined, with one showing evidence of involvement. Additionally, extranodal extension was identified in this region.\n\nPart 3 consisted of the left retro-molar trigone composite resection. The lesion measured 2.4 cm in greatest dimension and was described as well-to-moderately differentiated. The tumor extended to the periosteal surface of the mandible but did not directly invade the bone. All margins\u2014bone, mucosal, and soft tissue\u2014were free of tumor involvement. There was no evidence of perineural invasion. Reactive changes and intra-osseous fibrosis were noted in the mandible.\n\nSections from the lingual nerve, buccal margin, soft palate margin, hard palate margin, and tongue margin (parts 4 through 8) all showed no tumor involvement. Frozen section analysis confirmed absence of tumor in these areas.\n\nHistologic staging revealed a T2 primary tumor with regional lymph node involvement classified as N1. Distant metastatic staging could not be determined. A total of 24 lymph nodes were examined, with one being positive. The closest margin clearance was 5 mm. Lymphovascular invasion was present, while perineural invasion was not observed.\n\nImmunohistochemical staining for p16 is pending on part 3 and will be reported separately. All tissues were processed and reviewed according to CLIA-certified standards, with fixation times ranging between 2 and 84 hours. No additional significant findings were noted."} +{"pid": "TCGA-QR-A702", "report": "The surgical specimen consisted of two soft tissue samples. The first was a yellow-tan tissue fragment measuring 2.1 x 1.0 x 0.5 cm, submitted entirely for processing. The second specimen was a pink-yellow-tan mass weighing 19.2 grams, with dimensions of 4.5 x 3.5 x 1.2 cm. The outer surface was inked in black and the opened surface in green. On sectioning, the tissue showed areas of necrosis and variegated coloration. Approximately 40% of this specimen was procured for further analysis. Both specimens were processed and evaluated using immunoperoxidase and in-situ hybridization methods developed by the laboratory. The laboratory is CLIA-certified to perform high-complexity testing. No tumor cells were identified in the lymph node tissue examined."} +{"pid": "TCGA-N7-A4Y0", "report": "The specimen was received from a female patient following total abdominal hysterectomy, bilateral salpingo-oophorectomy, and lymph node dissection. The uterus measured 9.3 cm (fundus to external os) x 5.7 cm (cornu to cornu) x 5.4 cm (anterior to posterior), with a necrotic area measuring 0.5 x 0.3 cm noted on the anterior cervix. Gross examination revealed a polypoid tan-yellow mass within the uterine cavity, measuring up to 6.5 cm in maximum dimension and extensively involving the lower uterine segment. The endometrial cavity measured 4 cm in length. The tumor invaded into the outer third of the myometrium, reaching a depth of 13 mm within a myometrial thickness of 18 mm. Adhesions were present on the anterior and posterior serosa.\n\nMicroscopic evaluation identified invasive cellular elements extending into the myometrium. Lymphovascular invasion was present. No residual non-neoplastic endometrial tissue was identified; atrophy was noted. Sections of the cervix showed no involvement by invasive cells.\n\nThe right ovary, measuring 2 x 1 x 0.4 cm, and the left ovary were unremarkable. The right fallopian tube measured 6 cm in length and contained a small paratubal cyst; both fallopian tubes showed no evidence of invasive involvement. Evaluation of the vaginal cuff and left fallopian tube was not possible.\n\nLymph node assessment included multiple regional sites. Involvement was identified in two of six lymph nodes from the right pelvic region, with extracapsular extension observed. No involvement was found in four nodes from the left external iliac, three nodes from the left obturator, five nodes from the right peri-aortic, or two nodes from the left peri-aortic regions.\n\nA fragment of abdominal scar tissue, measuring 14 cm in length, showed well-healed scars without abnormal cellular changes.\n\nBased on pathologic findings, the tumor demonstrated invasion beyond the inner half of the myometrium and involved regional lymph nodes without distant metastasis. These findings suggest advanced local spread with nodal involvement."} +{"pid": "TCGA-ZF-A9R4", "report": "The specimen consisted of two parts: a 3 g sample of soft friable tissue fragments with blood clot, and a 2 g sample of similar tissue fragments. Microscopic evaluation revealed a poorly differentiated lesion with a mixed papillary and solid growth pattern. The tissue showed involvement of the muscularis propria, indicating invasion (pT2), although no vascular channel invasion was identified. Background urothelium was present and showed no evidence of dysplasia. Cellular differentiation was graded as high-grade (Grade 3)."} +{"pid": "TCGA-50-6591", "report": "The left lower lobe superior segmentectomy specimen reveals a neoplastic lesion measuring 8.0 cm in maximum diameter with clear cell features and the presence of amyloid-like stroma. Microscopic evaluation demonstrates visceral pleural and angiolymphatic invasion. All surgical margins are free of tumor involvement. A minimal host lymphocytic response is noted. The tumor is classified as poorly differentiated based on histologic grading.\n\nExamination of multiple lymph node specimens from various levels, including lower lobe station 11, superior segment level 11, level 7, level 5, level 6, and level 9, reveals no evidence of metastatic involvement. In total, 5 N1 and 10 N2 lymph nodes were evaluated, all without malignant findings.\n\nThe background lung tissue shows mild emphysematous changes. No significant abnormalities are identified in bronchoscopic biopsies of the respiratory mucosa. Additional histochemical studies demonstrate cytoplasmic glycogen and mucin positivity. Elastic tissue staining confirms pleural invasion. Molecular and FISH studies were performed as ancillary investigations.\n\nPathologic staging is determined as pT2N0MX. No gross or microscopic satellite lesions are present. Tumor necrosis is estimated at up to 50%. There is a mild inflammatory (desmoplastic) reaction associated with the lesion."} +{"pid": "TCGA-VG-A8LO", "report": "The specimen from a female patient revealed a grey-colored lesion measuring 3.5 x 2.2 x 1.8 cm. The cut section involved part of the deep resection margin. Microscopic evaluation showed a malignant growth arranged in solid nests and papillary structures. The cells were large, with moderately pleomorphic and hyperchromatic nuclei, along with amphophilic cytoplasm. Areas of cystic degeneration were present, and the stroma exhibited desmoplastic changes, containing similar cellular elements and lymphocytic aggregates. Focal necrosis was also observed. No specific margin involvement was indicated."} +{"pid": "TCGA-BR-6566", "report": "The gastric resection specimen involved a tumor measuring 11 x 9 x 2 cm, which was ulcerated and extended to adjacent structures, including the greater omentum. Histologic evaluation showed poorly differentiated cellular features. No lymph node metastases were identified in the three nodes examined. Lymphatic, venous, and perineural invasion status could not be determined. Surgical margins, response to neoadjuvant therapy, and additional pathologic findings were not specified."} +{"pid": "TCGA-AN-A0FK", "report": "Female patient with tumor located in the right breast, primary site. Histological evaluation revealed a grade 2 lesion. Tumor measurements indicate T stage 4, with no evidence of nodal (N0) or distant metastasis (M0). No prior treatment was administered. A normal blood sample was also collected via blood draw and stored in frozen format in a tube."} +{"pid": "TCGA-XF-A9SG", "report": "A radical cystectomy with bilateral pelvic lymph node dissection and orthotopic neobladder reconstruction was performed. Frozen section analysis of the right and left distal ureters, as well as the apical urethral margin, showed no high-grade atypia or tumor. Permanent sections confirmed benign findings in all three specimens, with no urothelial dysplasia or malignancy identified.\n\nExamination of the bladder revealed an invasive lesion involving the left lateral wall measuring 5.0 x 2.0 x 1.0 cm. The lesion demonstrated poor differentiation with cellular pleomorphism corresponding to grades 3 and 4. Invasion was limited to the superficial muscularis propria. Adjacent mucosa showed a flat lesion consistent with urothelial carcinoma in situ. A focus of moderate to severe dysplasia was identified at the left ureterovesical junction. No lymphovascular space invasion was present. All resection margins were free of dysplasia and malignancy.\n\nBenign prostatic tissue was noted with focal adenomatous hyperplasia; no high-grade intraepithelial neoplasia or malignancy was found. Chronic nonspecific inflammation was observed in the prostate. The prostatic urethra showed no dysplastic or malignant changes. Seminal vesicles and vas deferens appeared histologically normal.\n\nA total of 111 lymph nodes were evaluated across multiple regional sites, including para-aortic, paracaval, common iliac, external iliac, obturator/hypogastric, pre-sciatic, presacral, and Cloquet lymph nodes. No tumor was identified in any of the lymph nodes examined.\n\nThe non-neoplastic urinary bladder mucosa showed reactive changes associated with cystitis glandularis and cystitis cystica. Sections from the proximal and distal ureters showed no evidence of dysplasia or malignancy.\n\nPathologic staging was determined as pT2aN0MX. Intraoperative frozen sections confirmed negative margins for tumor involvement. Multiple tissue sections were submitted for further immunohistochemical analysis."} +{"pid": "TCGA-A2-A0T6", "report": "A bilateral simple mastectomy with sentinel lymph node biopsies was performed. The left second sentinel lymph node specimen consisted of an irregular yellow-red fatty tissue measuring 2.5 x 1.0 x 1.0 cm, containing two lymph nodes: one measuring 0.9 cm and another measuring 0.5 cm. The larger lymph node contained a ribbon clip and was submitted for analysis. The remaining tissue was labeled accordingly.\n\nThe left first sentinel lymph node was described as hot and blue, measuring 2.2 x 1.5 x 1.0 cm. It contained grossly unremarkable nodal tissue with focal blue dye; half was submitted per protocol and the remainder was labeled.\n\nThe left mastectomy specimen measured 23.5 x 20.5 x 4.5 cm with a suture at the 12 o\u2019clock position. Blue discoloration was noted in the upper inner quadrant. Sectioning revealed dense pink-tan fibrous nodules centrally located within the superior half of the specimen, extending into both outer and inner quadrants. The lesion had an irregular shape without clear differentiation between lobulated arms. Its dimensions were 7.0 cm from medial to lateral, 3.5 cm from superior to inferior, and up to 2.5 cm from anterior to posterior. It extended to within 0.7 cm of the deep margin. Small palpable nodules surrounded this lesion, including one measuring 0.5 cm in the upper inner quadrant located 1.3 cm from the deep margin. This nodule appeared distinct from the main lesion by approximately 1 cm. Sections were submitted from various locations including nipple and skin, central lesion areas, margins, and surrounding regions.\n\nOn the right side, the mastectomy specimen measured 16.0 x 15.5 x 4.0 cm with a suture at the 12 o\u2019clock position. Central portions showed pink-tan fibrous tissue interspersed with multiple fluid-filled cysts. The fibrous component accounted for approximately 50% of the specimen. One cyst at the 9 o\u2019clock area contained tan putty-like material. Sections were submitted from various quadrants and margins.\n\nThe right first sentinel lymph node was blue but not hot, measuring 2.8 x 2.5 x 1.0 cm with a 0.8 cm red-tan lymph node identified on sectioning. Half was submitted per protocol and the remainder labeled. The second right sentinel lymph node was hot and blue, measuring 2.5 x 1.3 x 1.0 cm, containing a 1.2 cm lymph node with blue discoloration; half was submitted per protocol.\n\nAdditional specimens included a fourth left sentinel lymph node (hot only), measuring 2.3 x 1.5 x 0.8 cm with a 1 cm lymph node identified; half was submitted per protocol. A possible left lymph node biopsy (hot but not blue) was entirely submitted for evaluation.\n\nHistologic examination of the left mastectomy specimen revealed multicentric in situ and infiltrating features with nuclear grade II/III and a low mitotic index. Invasive involvement spanned a gross distance of 7.0 cm from medial to lateral in the superior central region, involving both outer and inner quadrants. A distinct 1.0 cm nodule was identified in the upper outer quadrant. Both superficial and deep margins were free of tumor involvement by at least 1 cm.\n\nThe right mastectomy specimen demonstrated fibrocystic changes with focally marked non-atypical intraductal epithelial hyperplasia; no malignant features were observed.\n\nSentinel lymph node biopsies from both sides showed no evidence of metastatic disease. Immunohistochemical staining for cytokeratin was negative across all analyzed lymph nodes. Adipose tissue from the possible left lymph node biopsy showed no lymph node presence."} +{"pid": "TCGA-E9-A1NC", "report": "The specimen consisted of breast tissue from a radical mastectomy. A grossly evident lesion was identified, measuring 2.2 x 2.2 x 2.2 cm. Histologic evaluation revealed a combination of infiltrating ductal and lobular features. The histologic grade could not be fully assessed due to missing components of the Nottingham Histologic Score, including tubule formation, nuclear pleomorphism, and mitotic counts at both 25x and 40x magnification; therefore, the total score could not be determined. Lymph node assessment showed 1 out of 9 axillary lymph nodes positive for metastatic involvement. Extracapsular extension, tumor extent, margins, and response to neo-adjuvant treatment were not specified. No additional pathologic findings or comments were provided."} +{"pid": "TCGA-HE-7130", "report": "The histology report describes a specimen collected from the right kidney. The tissue was obtained via resection. Microscopic examination reveals papillary urothelial features with moderate differentiation (Grade II). The tumor measures 2.6 cm in size. Pathologic staging indicates T3 disease with no lymph node assessment available (NX). No distant metastasis evaluation is provided (M not specified). Imaging or clinical correlation does not indicate spread beyond the primary site. The sample was processed using standard fixation methods and slides are available for review."} +{"pid": "TCGA-EM-A2CP", "report": "The specimen was received from a total thyroidectomy procedure and included bilateral thyroid lobes, an isthmus, and lymph node tissue from the right and left central paratracheal regions. The right thyroid lobe measured 5.0 x 2.1 x 1.3 cm, and the isthmus measured 2.5 x 1.0 x 0.8 cm. The left thyroid lobe measured 5.5 x 3.3 x 2.4 cm. A surface nodule measuring 0.6 x 0.4 x 0.2 cm was identified on the left lobe. Two distinct nodules were found within the left lobe: one measuring 1.0 x 0.8 x 0.8 cm and another dominant lesion measuring 3.2 x 3.0 x 2.2 cm. The right lobe contained two nodules measuring 2.0 x 1.6 x 1.5 cm and 1.0 x 0.9 x 0.8 cm, with one smaller nodule measuring 0.8 x 0.7 x 0.4 cm located on the surface. \n\nHistologically, the larger nodule in the left lobe demonstrated follicular architecture with classical cytomorphologic features. It was totally encapsulated with widespread capsular invasion. Margins were free of involvement. No lymphovascular or perineural invasion was identified, and there was no evidence of extrathyroidal extension. In the right lobe, a separate lesion measuring 0.8 cm exhibited similar histologic characteristics but lacked a capsule. Margins were also uninvolved in this area.\n\nA total of 27 lymph nodes were examined: two from the right paratracheal region, measuring 0.6 x 0.3 x 0.3 cm and 0.7 x 0.5 x 0.3 cm; and multiple nodes from the left central paratracheal region, ranging in size from 0.2 x 0.2 x 0.2 cm to 1.7 x 0.6 x 0.4 cm. None showed any pathological involvement.\n\nAdditional findings included advanced lymphocytic thyroiditis and multiple microcarcinomatous foci bilaterally. The overall staging was based on AJCC/UICC TNM criteria (7th edition), with the primary tumor classified as pT2 (tumor greater than 2 cm but less than 4 cm confined to the thyroid), and no regional lymph node metastasis (pN0). The specimen was fragmented with adequate submission for analysis."} +{"pid": "TCGA-MP-A4T4", "report": "Surgical pathology report. The specimen includes a right lower lobe lung measuring 18.0 x 15.0 x 7.0 cm and weighing 265 grams, along with tissue from the right upper lobe (5.0 x 2.5 x 0.6 cm) and right lower lobe (8.0 x 3.3 x 1.5 cm). Lymph nodes evaluated include superior mediastinal (right lower paratracheal), inferior mediastinal (subcarinal), N1 (interlobar, right interlobar), and right middle lobe lymph nodes.\n\nA mass measuring 3.0 x 3.0 x 2.8 cm was identified in the right lower lobe, located approximately 6 cm from the bronchial margin. Histologic examination revealed cellular features consistent with high-grade morphology. Invasion of the visceral pleura was observed. The surrounding lung parenchyma demonstrated organizing pneumonia. The bronchial margin and four intrapulmonary peribronchial lymph nodes showed no evidence of involvement.\n\nIn the right upper lobe wedge excision, organizing pneumonia and subpleural scarring were noted. Similarly, the right lower lobe wedge excision revealed organizing pneumonia and focal scarring.\n\nEvaluation of the right interlobar lymph node revealed cellular changes indicative of metastatic involvement. In contrast, all other lymph nodes assessed\u2014including ten right lower paratracheal, three subcarinal, one interlobar, and three right middle lobe lymph nodes\u2014showed no signs of involvement."} +{"pid": "TCGA-OR-A5JZ", "report": "A left adrenal mass was excised from a male patient. The mass weighed 370 grams and measured 8.5 x 8.5 x 6.2 cm. Gross examination revealed a well-encapsulated lesion with yellow, focally hemorrhagic cut surfaces. The mass appeared to arise from the medulla and was associated with an adrenal gland measuring 5.5 x 1.0 cm. The normal adrenal cortex was orange and the medulla was brown. No gross abnormalities were identified in the attached fat.\n\nMicroscopic evaluation showed a low-grade lesion with focal necrosis (5%) and a mitotic rate of 5 per 50 high power fields. There was evidence of capsular invasion, but vascular invasion was absent. Surgical margins were negative. No lymph nodes were identified or submitted. There was no extension beyond the adrenal gland. A biopsy of the liver capsule was negative for neoplastic cells. A separate fibrotic nodule with necrotic debris was identified in perirenal fat, but no other lesions were present.\n\nImmunohistochemical staining showed patchy positivity for synaptophysin, melan-A, and inhibin. Rare cytokeratin positivity was noted, while chromogranin and S-100 were negative. The MIB-1 labeling index was approximately 20%. The tumor appeared to arise from a pre-existing benign lesion located at the periphery."} +{"pid": "TCGA-CV-5436", "report": "The specimen consists of multiple tissue fragments submitted from various anatomical sites. A soft tissue fragment measuring 0.9 x 0.8 x 0.2 cm was entirely submitted for frozen section. Histologic examination revealed invasive malignant cells with features of keratinization. Extensive perineural invasion was noted. The maximum depth of invasion measured 1.7 cm. Resection margins were free of tumor involvement.\n\nA portion of adipose tissue and salivary gland measuring 7.0 x 3.0 x 2.5 cm in total was submitted, including multiple lymph nodes up to 1.2 cm in diameter. In one neck dissection level, four lymph nodes were identified without evidence of malignancy. In another level, three lymph nodes were examined and one contained metastatic disease. No extracapsular extension was observed in this region.\n\nIn a separate dissection level, two lymph nodes were identified and none contained tumor. A lingual nerve specimen showed no involvement by malignancy. One lymph node measuring 0.4 x 0.4 x 0.4 cm from the mental triangle region contained metastatic disease without extracapsular extension.\n\nA larger composite specimen involving tongue, mandible, and neck dissection tissues measured 5.5 x 6.5 x 2.5 cm overall. An ulcerated fungating mass measuring 5.0 x 4.0 x 1.0 cm was identified at the base of the tongue. The lesion was surrounded by mucosa and surgical margins showed no tumor involvement. The deep margin was at least 0.2 mm away from the tumor.\n\nExamination of lymph nodes from multiple levels revealed metastatic disease in five out of forty-one nodes. Extracapsular extension was identified in some involved nodes. Chronic sialadenitis was also noted in associated salivary gland tissue. Seven teeth were submitted for gross identification only."} +{"pid": "TCGA-XE-A8H1", "report": "The specimen consists of a right testicle weighing 75 grams and measuring 15 x 5 x 3 cm in total. The testis itself measures 6.5 x 5 x 3 cm, and the attached spermatic cord is 11 x 2 x 0.5 cm. A distinct mass measuring 3 x 2 x 2 cm is present; it is firm with a tan to brown appearance. The surrounding testicular tissue appears unremarkable, with no involvement of the epididymis, rete testis, perihilar fat, spermatic cord, tunica vaginalis, or scrotal wall. The mass is in close proximity to the tunica albuginea but does not adhere to it.\n\nMicroscopic evaluation shows multifocal involvement with cellular features including high-grade atypia, pleomorphism, and frequent mitotic figures. The cells are arranged in sheets and clusters with areas of necrosis. Lymphovascular invasion is identified. Margins of the spermatic cord are free of involvement. The remaining testicular tissue demonstrates tubular atrophy, and the epididymis appears histologically normal.\n\nImmunohistochemical staining shows positivity for pancytokeratin (AE1/AE3), CD30, and PLAP with membrane staining pattern. Staining for hCG is negative. Based on these findings, the pathologic stage is determined as pT2NXMX."} +{"pid": "TCGA-86-6851", "report": "The surgical specimen consists of a left upper lobe of lung measuring approximately 15 x 10 x 4 cm. A diffusely ragged wedge of lung contains a poorly differentiated lesion with acinar and solid growth patterns. The lesion measures 7 x 3 x 2.2 cm and extends to the subpleural surface. Adjacent to the bronchial margin is a 2.5 x 2.2 cm firm white-tan to red mass that comes to within 2.0 cm of the bronchial margin. There are two additional lesions measuring 1.0 and 1.4 cm in greatest dimension.\n\nHistologically, the malignant cells show immunoreactivity for cytokeratin 7, TTF-1, and Napsin-A. There is rare focal positivity for p63 and negative staining for cytokeratin 5/6. An elastin stain shows no convincing penetration of the visceral pleural elastic layer by the tumor.\n\nEvaluation of margins reveals involvement at the parenchymal margin. One of two peribronchial lymph nodes is positive for metastatic tumor with extranodal extension into peribronchial soft tissues. Additionally, one benign hilar lymph node was identified among four examined. One benign para-aortic lymph node was also identified. Angiolymphatic invasion is present. Vascular margins are free of tumor. The largest metastatic deposit measures 1.3 cm.\n\nStaging assessment indicates involvement of regional lymph nodes with evidence of lymphatic invasion. No evidence of venous invasion is noted. The background lung tissue appears tan to red and spongy without additional nodules or masses. The pleural surface is tan to red and smooth to slightly wrinkled with staple lines adjacent to the hilum."} +{"pid": "TCGA-AA-3856", "report": "The specimen shows a moderately differentiated invasive lesion of colorectal origin with infiltration through all layers of the intestinal wall. Vascular invasion is present. Lymph node examination reveals no involved nodes, with none positive among the thirteen assessed. The surgical margins are negative (R0). Histopathologic grading corresponds to G2. Staging parameters indicate pT3, L1, V1, and pNO with no lymph node involvement. Clinical staging was reviewed in the context of an oncology conference."} +{"pid": "TCGA-S3-AA14", "report": "A female patient underwent excision of right breast tissue with wire-guided localization and sentinel lymph node sampling. The breast specimen measured 5.0 x 4.0 x 3.5 cm and showed a central ill-defined mass measuring 2.0 x 2.0 x 1.8 cm with microcalcifications. Histologic evaluation revealed invasive carcinoma with marked nuclear pleomorphism (score 3), tubule formation score 3, and mitotic count score 2, resulting in an overall high histologic grade. Adjacent ductal carcinoma in situ was identified with cribriform and solid architectural patterns, predominantly nuclear grade III with focal necrosis. Lobular carcinoma in situ of both classical and pleomorphic types was also present. Lymphovascular invasion was identified near the anterior margin, which was 0.2 mm from the invasive component. Margins were free of invasive disease and ductal carcinoma in situ.\n\nEvaluation of four sentinel lymph nodes revealed three nodes containing one to two positive cells each on immunohistochemical staining with cytokeratin; no macrometastases or micrometastases were found. Immunohistochemical studies demonstrated positivity for estrogen and progesterone receptors in approximately 75% of tumor cells and HER2 positivity (score 3+). Additional findings included intraductal papilloma, fibrocystic changes, and usual ductal hyperplasia. Microcalcifications were noted within both neoplastic and non-neoplastic regions. Special stains confirmed lymphovascular invasion and supported the morphologic findings."} +{"pid": "TCGA-E2-A1II", "report": "The surgical specimens included a right breast lesion with an ill-defined firm area measuring approximately 1 x 0.5 x 0.5 cm, located 0.3 cm from the posterior margin. Additional posterior margin tissue was also submitted and evaluated. On the left breast, a lumpectomy specimen revealed a dominant mass measuring 1.7 x 1.5 x 1.3 cm, situated near the posterior-inferior margin at 0.1 cm. A smaller nodule measuring 0.5 x 0.3 x 0.3 cm was identified adjacent to the main lesion, located 0.2 cm from the posterior margin. Additional posterior-lateral, inferior, and posterior margins were submitted and showed no evidence of malignant involvement.\n\nFive sentinel lymph nodes were identified and evaluated from the left axilla. Each lymph node measured less than 1.5 cm in greatest dimension and showed no evidence of metastatic involvement upon histologic examination. Touch preparations and immunohistochemical staining with cytokeratin AE1/3 were negative in all lymph nodes assessed.\n\nHistologic evaluation of the right breast lesion demonstrated focal atypical ductal hyperplasia along with areas of hemorrhage, columnar cell change, and intraductal microcalcifications. The left breast lesion exhibited poorly differentiated features with marked lymphocytic infiltrate. No vascular or lymphatic invasion was identified. Necrosis was not present.\n\nImmunohistochemical analysis demonstrated absence of estrogen receptor expression and weak progesterone receptor expression with an Allred score of 4. HER2 staining showed an intensity of 1+ with 5% tumor staining, interpreted as negative. Molecular profiling using the Oncotype DX assay yielded a recurrence score of 52, indicating intermediate risk of distant recurrence over a 10-year period.\n\nMargins of resection were widely negative. Pathologic staging was determined as pT1c N0 based on tumor size and lymph node status."} +{"pid": "TCGA-B0-4707", "report": "A cystic lesion was identified within excised tissue, lined by cuboidal and columnar epithelium showing no evidence of malignancy. Multiple lesions were identified in the right kidney. One lesion measured 4.7 cm and exhibited nuclear grading as II of IV. No angiolymphatic invasion was observed and all surgical margins were negative. The surrounding renal tissue appeared normal. Another lesion measured 2.1 cm with similar nuclear grading and also showed no angiolymphatic invasion. Surgical margins were clear and the adjacent kidney was unremarkable. A third lesion measured 4.1 cm with a higher nuclear grade of III of IV. There was focal extension to the inked capsular margin; however, the parenchymal margins remained free of involvement. No angiolymphatic invasion was identified and the remainder of the kidney appeared normal. Additional tissue from the midpole region showed mature adipose without hemorrhage or malignant involvement.\n\nThe left kidney contained a larger lesion measuring 10.2 cm with extensive necrosis, hemorrhage, and sarcomatoid features including rhabdoid morphology. Nuclear grading was IV of IV and there was suspicion for angiolymphatic invasion. The lesion extended into the renal sinus fat and was confined within the renal capsule without renal vein involvement. All surgical margins were negative. The surrounding kidney and left adrenal gland showed no significant abnormalities."} +{"pid": "TCGA-HT-7881", "report": "The pathology report for the subject reveals a tumor with a calculated MIB-1 labeling index of 2.7%. Microscopic examination demonstrates an infiltrating glioma composed of cells with predominantly round nuclei and mild to moderate nuclear pleomorphism. The tumor cells exhibit prominent perinuclear halos and diffusely infiltrate the adjacent brain parenchyma. The overall cell density is mildly hypercellular, with focal areas showing increased cellularity. While most cells show minimal atypia, occasional cells display more pronounced cytologic abnormalities. Scattered neurons are surrounded by perineuronal satellitosis. Mitotic activity is present at a rate of up to one mitotic figure per 10 high power fields. There is no evidence of microvascular proliferation or necrosis."} +{"pid": "TCGA-E1-A7Z4", "report": "Surgical Pathology: Final. CLINICAL HISTORY: Brain tumor. GROSS EXAMINATION: A. \"Brain tumor (AF1)\", received fresh for frozen section. A 2.0 x 2.0 x 1.0 cm aggregate of multiple fragments of soft tan tissue is received. A representative fragment was frozen as AF1 and the frozen section remnant submitted in A1. A representative fragment is retained in formalin; the remainder of the tissue is submitted in A2. B. \"Brain tumor\", received fresh and placed in formalin. A 4.0 x 3.8 x 2.0 cm aggregate of multiple fragments of pink/tan tissue is received. Representative sections are submitted; the remainder retained in formalin.\n\nINTRA OPERATIVE CONSULTATION: A. \"Brain tumor\": AF1 \u2013 glial neoplasm, grade deferred.\n\nMICROSCOPIC EXAMINATION: The specimen consists of brain tissue infiltrated by a glial neoplasm. There is a prominent microcystic component and numerous microcalcifications. The nuclei are generally round and regular, with some showing perinuclear halos. Some cells contain small amounts of eosinophilic cytoplasm, consistent with mini gemistocytes. Focally, there are areas of increased cellularity where nuclei appear more elongated and hyperchromatic. No definitive vascular proliferation or necrosis is identified. Mitotic figures are not clearly present. While some features resemble oligodendroglial differentiation, the hypercellular regions with elongated, hyperchromatic nuclei suggest astrocytic morphology.\n\nIMMUNOHISTOCHEMICAL FINDINGS: The KI-67 labeling index focally approaches 5%.\n\nCOMMENT: Although the majority of the neoplasm demonstrates features consistent with a low-grade process, foci of increased cellularity and a mildly elevated MIB-1 labeling index may indicate a more aggressive clinical course. Close clinical follow-up is recommended."} +{"pid": "TCGA-SP-A6QI", "report": "The specimen from the right adrenal gland weighs 39.0 grams and measures 9.0 x 4.7 x 2.5 cm. After removal of adherent fat, the weight is 33.5 grams. A well-delineated mass measuring 3.4 x 3.2 x 3.0 cm is present, with a solid bright yellow to yellow-orange homogenous cut surface. The remaining adrenal tissue appears unremarkable. The dominant lesion exhibits a solid nesting and trabecular architecture. Cytologic features include round cells with well-defined borders, abundant clear to basophilic cytoplasm, and no nuclear pleomorphism. No degeneration is identified. The lesion has an incomplete capsule without evidence of capsular or extra-adrenal invasion. Resection margins are not involved, and there is no lymphovascular involvement. No other adrenal pathology is present, including no cortical or medullary hyperplasia. No lymph nodes are identified. Immunohistochemical staining shows positivity for chromogranin and tyrosine hydroxylase, with sustentacular cells positive for S100 protein."} +{"pid": "TCGA-E2-A14O", "report": "A sentinel lymph node from the left axilla was received and found to contain metastatic disease. The left breast mastectomy specimen revealed a primary lesion measuring 6.0 x 5.5 x 4.0 cm located in the upper central and upper outer quadrants. This lesion was present across multiple tissue slices and was 1.5 cm from all margins. Two additional lesions were identified: one measuring 0.8 x 0.6 x 0.5 cm, located 0.6 cm from the main tumor and 1.5 cm from the inferior margin, and another ill-defined nodular area located superior to the second lesion, more than 2.0 cm from the deep margin. All surgical margins were free of involvement.\n\nLymphovascular invasion was extensive. A separate excision from the upper outer quadrant of the left breast showed no evidence of malignancy. Axillary dissection included 17 lymph nodes, with one containing metastatic disease and showing extranodal extension. Hormone receptor analysis demonstrated positivity for both estrogen and progesterone receptors by immunohistochemistry. HER2 testing by immunohistochemistry was equivocal (2+ staining in 50% of tumor cells), and subsequent FISH analysis did not show gene amplification. The pathological stage was determined as pT3 N1a."} +{"pid": "TCGA-C5-A1M6", "report": "The cervical biopsy demonstrates a poorly differentiated malignant neoplasm composed of atypical squamous cells. The tumor exhibits invasion into fibrotic stromal tissue and is associated with areas of necrosis. The patient is a woman of unspecified age. The submitted material includes one slide for review, originating from a prior procedure and accompanied by a corresponding pathology report."} +{"pid": "TCGA-56-8622", "report": "The surgical specimens include a rib bone and lung tissue with lymph nodes. The rib specimen showed normal marrow with trilineage maturation and no malignant cells identified. The lung specimen consisted of a lobectomy with a well-defined mass measuring 3.5 cm in greatest dimension. Microscopic evaluation revealed a moderately differentiated non-small cell carcinoma with no evidence of pleural invasion or lymphatic/vascular involvement. All surgical margins were free of tumor. Regional lymph node assessment included one intralobar, two hilar, and one station 7 lymph node, all without metastatic involvement. Pathologic staging was determined as pT2a based on tumor size greater than 3 cm but less than 5 cm, surrounded by lung tissue without extension to the main bronchus or hilar structures. No nodal metastasis was identified (pN0), resulting in a final TNM classification of pT2aN0M0, stage IB. Ancillary testing blocks were preserved for future analysis. Clinical history included prior heart transplantation and previous biopsies showing granulomatous changes and benign lymphoid tissue. Intraoperative frozen section confirmed absence of tumor at the bronchial margin and identified the mass as non-small cell carcinoma. The specimen was fully processed and submitted for histologic evaluation."} +{"pid": "TCGA-D1-A160", "report": "The surgical specimen included a uterus with right and left ovaries and fallopian tubes, along with abdominal skin and subcutaneous tissue containing the umbilicus. The uterus contained a mass measuring 2.1 x 1.6 x 1.4 cm located primarily in the superior anterior endometrium with extension into the superior posterior region. Microscopic examination revealed cellular features consistent with a lesion arising in the endometrium. Invasion was noted to a depth of 0.4 cm within a myometrium measuring 2.0 cm in thickness. No angiolymphatic invasion was identified. A separate benign polyp was present, showing changes of complex hyperplasia without atypia, and the background endometrium also demonstrated complex hyperplasia without atypia. Adenomyosis was noted in the myometrium. The cervix, ovaries, fallopian tubes, and skin/subcutaneous tissue showed no diagnostic abnormalities. Lymph nodes from the right and left pelvic regions, as well as right and left para-aortic areas, were negative for involvement. Gonadal vessels were also free of disease."} +{"pid": "TCGA-D6-6517", "report": "Histopathological examination was performed on a surgical specimen of a laryngeal lesion, including the hyoid bone and a segment of trachea measuring 1.3 cm in length. The excised tissue measured 7.3 x 8.0 x 4.2 cm. A lesion measuring 3.2 x 2.4 x 1.5 cm was identified in the subglottic region, with extension to the false vocal cords and infiltration into the thyroid cartilage. Microscopic evaluation revealed moderately differentiated invasive squamous cell carcinoma with features of keratinization. Surgical margins were free of abnormal tissue."} +{"pid": "TCGA-FD-A3B5", "report": "A right pelvic lymph node dissection included six lymph nodes, with one containing a metastatic focus measuring 0.4 cm. No extranodal extension was identified. The right distal ureter specimen showed no tumor involvement. Similarly, five left pelvic lymph nodes were negative for tumor involvement. A cystoprostatectomy specimen revealed an infiltrative lesion within the outer half of the muscularis propria. Multiple flat lesions were present in the surface lining and cystitis cystica. All resection margins, including those from the soft tissue, prostatic urethra, and bilateral ureters, were free of tumor involvement. High grade prostatic intraepithelial neoplasia was noted in the prostate. Seminal vesicles and vasa deferentia were unremarkable. Both left and right distal ureter specimens showed no evidence of tumor. The lesion measured 6.0 cm at its largest dimension and was multifocally distributed in areas including the trigone, posterior, and anterior wall. Lymph node assessment across all sites identified one involved lymph node out of eleven total."} +{"pid": "TCGA-E8-A413", "report": "The lesion is characterized by structures composed of papillae with delicate fibrovascular cores and follicle-like formations lined by one to several layers of cuboidal epithelial cells. The tissue shows evidence of hemorrhage, fibrosis, and lymphocytic infiltration. Cellular features include maintained nuclear polarity, relatively uniform nuclei with finely dispersed chromatin, and the presence of intranuclear grooves. Psammoma bodies are identified within the specimen. The lesion measures 1.5 cm in diameter and is located on the left side. It is unifocal without evidence of extrathyroidal extension."} +{"pid": "TCGA-UW-A72M", "report": "The specimen consists of a well-circumscribed, smooth, pink and tan mass with a rubbery consistency and central stellate area of fibrosis. The mass measures 3.5 x 3.4 x 3.2 cm and is located in the cortex. It is unifocal and confined within the kidney, causing bulging of the capsule but without involvement of the perirenal adipose tissue or Gerota's fascia. The surgical margins, including the renal parenchymal, capsular, and perinephric adipose tissue margins, are all free of tumor. Histologically, the cells exhibit eosinophilic features and a histologic grade of 2 is assigned. Immunostains show focal positivity for CK7, while Vimentin and CD15 are negative. No sarcomatoid features, lymphatic or venous invasion, or other significant findings are identified. Lymph nodes are not submitted for evaluation. The entire specimen measures 4.5 x 4.5 x 4.0 cm and weighs 36 grams. Based on the available information, the extent of the lesion corresponds to a pT1a classification, with no regional lymph node assessment possible (pNx). This staging is subject to revision pending further clinical review."} +{"pid": "TCGA-JW-A5VK", "report": "The surgical pathology report includes four specimens from the uterine cervix. The first specimen, labeled as a cervical section, measures 1.0 x 0.5 x 0.4 cm and is embedded in a clot measuring 3.5 x 2.0 x 1.0 cm. The second specimen, taken at the 9 o\u2019clock position, is 0.6 x 0.6 x 0.3 cm. The third specimen, obtained at the 12 o\u2019clock position, measures 1.0 x 1.0 x 0.3 cm. The fourth specimen, collected via endocervical curettage, is 1.5 x 1.5 x 0.4 cm.\n\nMicroscopic evaluation of all four specimens reveals fragments of squamous epithelium with severe dysplasia arranged in a papillary pattern. The cells exhibit high-grade nuclear features and numerous mitotic figures. There is clear evidence of stromal invasion in the specimens from the 12 o\u2019clock position and the endocervical curettage. The findings in the other two specimens raise concern for invasion but are not definitive. Due to fragmentation of the tissue, it is not possible to determine the full size of the lesion or the extent of stromal invasion.\n\nImmunohistochemical staining was performed on select sections. CK20 staining was negative, while CK7 showed focal positivity. p16 staining was positive in one fragment, supporting a cervical origin. Intradepartmental consultation confirmed the findings. The case was reviewed by a staff pathologist and a pathology resident."} +{"pid": "TCGA-38-4628", "report": "A biopsy of a right hilar lymph node (R10) revealed no evidence of malignancy, with findings including hyalinized granulomata. A right upper lobectomy specimen included a central tumor measuring 3.5 x 2.4 x 2.3 cm located near the bronchial margin, with a distance of 0.3 cm from the tumor to the bronchial margin and 0.2 cm from the pleura. The tumor did not grossly involve the bronchus or pleura, but two small satellite nodules were identified: one measuring 0.4 cm located 5.2 cm from the main tumor and another measuring 4.0 cm located 3.1 cm away. Microscopic evaluation demonstrated a moderately differentiated adenocarcinoma histology. All surgical margins, including the bronchial resection margin, were negative for tumor involvement. There was no evidence of angiolymphatic invasion, though perineural invasion was present.\n\nMicroscopic examination of hilar lymph nodes showed one out of four involved, with findings of metastatic disease. Hyalinized and partially calcified granulomata were noted in hilar lymph nodes and pulmonary parenchyma. Additional biopsies of lymph nodes from stations R4 (two nodes), right mainstem bronchus (one node), R9 (one node), and station 7 (one node) all showed no evidence of malignancy, with hyalinized granulomata observed in some. No extracapsular extension was identified in any lymph node examined. Non-neoplastic lung tissue showed changes consistent with hyalinized granulomata."} +{"pid": "TCGA-27-2526", "report": "Birth date. Tumor site. Left parietal. Histological diagnosis. [Removed]. \n\nA tumor was identified in the left parietal region of the brain. Histological evaluation revealed a highly cellular lesion with marked nuclear atypia and frequent mitotic figures. The tissue showed areas of necrosis and microvascular proliferation. Tumor cells exhibited pleomorphic nuclei and high nuclear-to-cytoplasmic ratios. Immunohistochemical staining demonstrated positivity for glial markers. The lesion displayed infiltrative growth into the surrounding neural tissue, without clear demarcation from adjacent structures. Based on histopathological features, the lesion was classified as a high-grade neoplasm."} +{"pid": "TCGA-HT-7601", "report": "The microscopic examination reveals a moderately hypercellular glial neoplasm with diffuse infiltration of both gray and white matter. The tumor is composed predominantly of cells resembling fibrillary astrocytes, with a lesser population of gemistocytic astrocytes. Notably, gemistocytic astrocytes are more prevalent in the larger specimen (specimen 2), whereas fibrillary astrocytes predominate in specimen 1. Prominent neuronal satellitosis is present. Cellular atypia ranges from mild to moderate. Mitotic figures are generally rare, although up to three mitoses per 10 high power fields are observed. There is no evidence of microvascular proliferation or necrosis. The MIB-1 labeling index reaches a maximum of 25.5% in the most proliferative areas."} +{"pid": "TCGA-EJ-7327", "report": "A total of seventeen lymph nodes were examined, five from the right pelvic region and twelve from the left pelvic region; no abnormal cellular findings were identified in any of the nodes. The prostate specimen with bilateral seminal vesicles showed a histologic pattern characterized by acinar-type glandular proliferation with a Gleason scoring pattern of 3 and 4, accounting for 40% of the higher-grade component. The lesion was present bilaterally within the prostate, with a maximum nodule measuring 2.1 cm in diameter and involving approximately 20\u201325% of the prostate volume. There was evidence of extension beyond the prostatic capsule at both the right and left bases, as well as involvement of the bilateral seminal vesicles. All surgical margins were clear of tumor involvement. Extensive perineural invasion was observed, though no angiolymphatic invasion was detected. High-grade intraepithelial neoplastic changes were noted in multiple areas. Pathologic staging was determined as pT3b with no nodal metastasis identified (pN0), and no assessment of distant metastasis (pMX). The histologic grade was classified as poorly differentiated to undifferentiated."} +{"pid": "TCGA-AY-4070", "report": "The revised surgical pathology report for the right colon hemicolectomy specimen demonstrates a lesion with poorly differentiated histologic features. The tumor invades through the muscularis propria into the pericolic adipose tissue and exhibits small vessel lymphatic invasion, large vessel venous invasion, and perineural space invasion. Microscopic evaluation confirms that the proximal and distal margins are free of involvement; however, the circumferential (radial) margin is involved, as seen in block B11. \n\nFifteen regional lymph nodes were examined, and five of these show evidence of metastatic involvement. Based on these findings, the pathologic staging is at least pT3, though pT4 cannot be excluded. The nodal stage is classified as pN2, while distant metastasis remains indeterminate (pMx). This assessment is based on current data and may be updated pending further clinical correlation.\n\nAdditional findings include multiple foci of yellow/white nodules within the subserosa beneath the primary tumor, which may represent replaced lymph nodes, vascular invasion, or a pronounced desmoplastic reaction. The tumor measures 6.5 \u00d7 3.0 \u00d7 3.0 cm and involves approximately 40% of the bowel circumference. Gross examination reveals an infiltrative growth pattern with a stellate configuration extending to the radial margin. The tumor is located in the cecum and appears as an indurated depressed area with a rolled border on the mucosal surface. On cross-section, the tumor is firm, white, and rubbery with areas of focal yellow necrosis. It is in close proximity to the visceral peritoneum without clear perforation. The distance from the tumor to the terminal ileum margin is 11 cm, to the colonic margin is 32 cm, and the radial margin is within 1 mm, possibly positive.\n\nSubmitted tissue includes full-thickness sections of the tumor from mucosa to the involved radial margin, additional views of subserosal invasion, and multiple lymph node samples. A separate biopsy of a uterine implant shows only benign fibromuscular tissue without evidence of malignancy. The appendix demonstrates fibrous obliteration, and no abnormalities are noted in the attached small bowel segment. A digital photograph was taken for documentation, and selected tissues were submitted for further analysis."} +{"pid": "TCGA-S7-A7WN", "report": "Gross examination revealed a right adrenal mass measuring 75x60x30 mm and weighing 96 grams. The mass was encapsulated, with a soft consistency and a central white scar. The peripheral region showed non-neoplastic adrenal tissue with pressure atrophy, and the cortex measured less than 1 mm in width. Microscopically, the lesion exhibited solid, alveolar, and diffuse growth patterns. The tumor contained polygonal cells with profound atrophy and focal areas of spindle-shaped cells. Focal hemorrhages were present. Within some vessels at the tumor periphery, fragments of freely lying tissue were observed; however, this was attributed to artifact from handling of the unfixed specimen and not considered evidence of angioinvasion. Immunohistochemical staining for S100 protein demonstrated only sporadic sustentacular cells, with large portions of the tumor being negative. Proliferative index by MIB-1 staining was less than 2%. Histologic evaluation showed large nests or diffuse growth comprising more than 10% of the tumor volume, central necrosis within large nests, high cellularity, cellular monotony, and focal tumor cell spindling. There were more than three mitotic figures per 10 high-power fields, including atypical mitotic figures. Additional findings included extension into adipose tissue, vascular invasion, capsular invasion, mild nuclear pleomorphism, and mild nuclear hyperchromasia. The total score based on these parameters was 8."} +{"pid": "TCGA-B0-4828", "report": "The specimen consists of a left radical nephrectomy. A neoplasm is identified, measuring 9.0 cm in greatest diameter. The growth pattern is acinar, and the tumor is confined within the renal capsule without extension into the renal vein. There is no evidence of angiolymphatic invasion. All surgical margins are free of neoplastic cells. The non-neoplastic kidney tissue appears unremarkable. The adrenal gland demonstrates involvement by a cystic lesion composed of clear cells arranged in a fibrovascular pattern. Immunohistochemical staining of both the renal and adrenal lesions demonstrates positivity for pan cytokeratin and RCC tumor marker. Focal positivity for vimentin is noted, along with aberrant expression of inhibin. Both sites are negative for cytokeratin 7, cytokeratin 20, thyroglobulin, and thyroid transcription factor. No carcinoma is identified in the soft tissue specimen removed during aneurysm repair, which consists of multiple fragments of blood clot. The histologic grade corresponds to a high-grade morphology. Distant metastasis is present, though nodal status remains undetermined."} +{"pid": "TCGA-ZB-A96O", "report": "Pathology Report-Summary: Material: Tumor: 7.0 X 4.5 X 3.0 cm. Multifocal invasion through the capsule into surrounding mediastinal fat tissue and lung parenchyma was observed. Histologic evaluation showed epithelial cells positive for CK 5/6, EGFR, and weakly positive for KL1. Epithelial cells were negative for CD5 and CD117. Lymphocyte markers demonstrated CD1a-negative, CD99-positive immature T-lymphocytes, along with CD5-positive mature T-lymphocytes. Sparse presence of CD20-positive B-lymphocytes was noted. Staging classification was determined as pT3, pNO (0/6 lymph nodes involved), and stage III according to Masaoka staging criteria."} +{"pid": "TCGA-V5-AASX", "report": "Medical Record #: Patient ID: Clinician: Date Obtained: Clinician Phone: Date Received: Specimen: Esophagus Biopsy. Pertinent History: Dysphagia, weight loss. ICD-9 Codes: Final Pathologic Diagnosis. DISTAL ESOPHAGUS, BIOPSY: See comment. COMMENT: The biopsies are diagnostic and with the presence of intestinal metaplasia, origin in preexisting tissue is favored. The slides are reviewed by, and we concur with this interpretation. The results are called to on at approximately Department of Pathology. Gross Examination: Received are multiple fragments of tan, grey tissue measuring up to 0.1 cm which are submitted in cassette 1A. Microscopic Description: Sections show fragments of esophageal mucosa containing a malignant epithelial neoplasm. The neoplasm is composed of malignant epithelial cells forming poorly formed glandular structures and infiltrating within inflamed fibromuscular stroma. There are fragments within the biopsies of benign squamous epithelium and glandular epithelium with intestinal metaplasia."} +{"pid": "TCGA-34-5232", "report": "The left upper lobectomy specimen contains an in situ and invasive component with moderate differentiation. The lesion measures 2.0 cm in diameter and is associated with angiolymphatic invasion. There is no evidence of visceral pleural involvement. All surgical margins are free of involvement.\n\nLymph node evaluation reveals involvement of one of two lymph nodes from the right upper lobe lymph node station. The remaining lymph nodes assessed from various locations\u2014including subcarinal, right tracheobronchial angle, right paratracheal, inferior pulmonary ligament, anterior hilar, posterior left upper lobe bronchus, intralobar (two stations), ap window, periaortic, and posterior hilar\u2014are negative for metastatic disease. In total, one of twenty lymph nodes from N1 stations shows involvement, while all eleven N2 lymph nodes are negative.\n\nAdditional findings include mild emphysematous change, focal postobstructive pneumonia, and bronchiectasis. A marked host lymphocytic response is noted. Sections from a rib fragment show normal bone and marrow without evidence of malignancy.\n\nThe pathologic stage is T1 N1 MX."} +{"pid": "TCGA-A5-A3LP", "report": "A lymph node biopsy from the left hypogastric region shows replacement of lymph node architecture by atypical cells. Other biopsied lymph node regions, including left and right pelvic, left and right common iliac, show no evidence of atypical cells. Tissue samples from the left pelvic, omental, left gutter, right pelvic, and right gutter biopsies all demonstrate benign fibroadipose or fibroconnective tissue without evidence of abnormal cellular infiltration.\n\nThe hysterectomy specimen with bilateral salpingo-oophorectomy reveals a large mass within the uterine cavity. Microscopic evaluation demonstrates a poorly differentiated epithelial neoplasm with serous features. The primary tumor measures 6.5 cm in greatest dimension and involves approximately 75% of the endometrial lining, predominantly on the posterior wall. It infiltrates deeply into the myometrium, exceeding 50% thickness, approaching within 0.4 cm of the uterine serosa. A second smaller mass is identified on the anterior wall, measuring 2.0 cm, involving up to 25% of the myometrial thickness. No direct extension into the lower uterine segment or cervix is identified; however, neoplastic cells are noted on the mucosal surface, likely representing displaced rather than invasive disease.\n\nExtensive vascular invasion is present, including within the lower uterine segment. Regional lymph node involvement is identified in the left hypogastric lymph node. Other sampled lymph nodes are negative. No involvement of other organs or tissues is observed. Surgical margins cannot be fully assessed due to specimen orientation. Based on these findings, the tumor is classified as pT1b (myometrial invasion \u226550%) and pN1 (pelvic lymph node metastasis)."} +{"pid": "TCGA-CG-4472", "report": "The specimen consists of a total gastrectomy preparation. A focal area demonstrates poorly differentiated morphology with mixed features, exhibiting components of both diffuse and intestinal growth patterns. The lesion infiltrates into the perigastric fatty tissue and extends through the gastric wall to involve the serosa. Five regional lymph nodes are involved out of a total of 29 examined. Vascular invasion is present. All resection margins, including those in the mucosal region, show no evidence of tumor involvement."} +{"pid": "TCGA-HC-7232", "report": "The prostatectomy specimen measured 5.2 x 3.2 x 3.5 cm and weighed 62 grams. The tumor was multifocal and involved both lobes of the prostate. The dominant nodule measured 2.5 cm in greatest dimension and involved approximately 70% of the gland. Histologic evaluation showed a high-grade carcinoma with a Gleason pattern of 4+5. Perineural invasion was present. Lymphovascular invasion was not identified. Extraprostatic extension was present, with involvement of the seminal vesicle. Margins were uninvolved by invasive carcinoma, with the closest margin measuring 0.07 cm at the right apex. No regional lymph node or distant metastases were identified. Staging was determined to be pT3b with a final pathologic stage of III. High-grade prostatic intraepithelial neoplasia was also noted."} +{"pid": "TCGA-VS-A950", "report": "The biopsy specimen from the cervix shows a poorly differentiated malignant neoplasm composed of atypical squamous cells. The tumor exhibits areas of vascular invasion. No other specific features or secondary sites are mentioned in the report."} +{"pid": "TCGA-HI-7171", "report": "The patient is male. Specimens were received from three sources. The first specimen, labeled #1, consists of an aggregate of yellow, lobulated, hemorrhagic fat measuring 6 x 3 x 1.5 cm containing multiple lymph nodes ranging in size from 2 x 2 x 0.4 cm to 3.5 x 1.5 x 0.4 cm. These lymph nodes were entirely submitted for microscopic evaluation. The second specimen, labeled #2, includes a 4 x 3 x 1 cm aggregate of yellow, lobulated, hemorrhagic fat with two lymph nodes measuring 1 x 1 x 0.3 cm and 2.5 x 1 x 0.4 cm, both submitted for microscopic examination.\n\nThe third specimen, labeled #3, includes a red-brown, hemorrhagic prostate weighing 58 grams and measuring 5 x 4.5 x 4 cm. The capsule is intact, and the urethra is patent with bilateral seminal vesicles and vas deferens present. The right seminal vesicle measures 2 x 1 x 0.7 cm, and the right vas deferens measures 4 x 0.5 cm. The left seminal vesicle measures 4 x 2 x 1 cm, and the left vas deferens measures 5 x 0.5 cm. The right side is inked yellow, and the left side is inked black. Upon sectioning, tan-pink, rubbery to firm cut surfaces with multiple brown, small to medium calculi are observed. Sectioning also reveals tan-red cut surfaces and fluid-filled spaces in the seminal vesicles and vas deferens. Sections submitted for microscopic evaluation include areas from the apex, base, anterior mid, posterior superior, and seminal vesicles and vas deferens on both sides.\n\nMicroscopic evaluation of the lymph nodes from both the left and right pelvic regions revealed no abnormal findings. In the prostate specimen, cellular analysis showed invasive growth involving both lobes and extending into surrounding muscles and nerves. The tumor was found at the apex on the right side; however, the inked margin tested negative. There was no evidence of angiolymphatic invasion, but perineural invasion was identified. Extracapsular extension was noted, and the tumor involved the right posterior inked margin. Both left and right seminal vesicles showed involvement. The tumor accounted for approximately 80% of the tissue examined. Staging assessment indicated involvement beyond the prostate capsule without evidence of lymph node or distant metastasis."} +{"pid": "TCGA-D1-A103", "report": "The uterus weighed 45.0 grams and had an unremarkable cervix with smooth uterine serosa. A mass measuring 2.2 x 1.9 x 0.5 cm was identified in the posterior wall of the endometrial cavity, along with a smaller mass in the right anterior wall measuring 0.5 x 0.3 x 0.3 cm. The total myometrial thickness was 1.4 cm, and no leiomyomas were observed. Histologic evaluation showed that the larger posterior mass extended 0.4 cm into the myometrium. No involvement of the endocervix was noted, and no lymphovascular space invasion was identified. Surgical margins were free of abnormal tissue.\n\nThe right ovary, measuring 2.0 x 1.4 x 0.9 cm, had a solid cut surface and a smooth outer surface. Adjacent to it was a cyst measuring 1.0 x 0.7 x 0.6 cm. The right fallopian tube was not identified either macroscopically or microscopically.\n\nThe left ovary measured 2.2 x 1.4 x 0.7 cm and was attached to a fallopian tube measuring 4.4 x 0.5 cm. The left fallopian tube and ovary showed hemorrhagic adhesions on their surfaces, which appeared suspicious for endometriosis on gross examination. Microscopic evaluation revealed no abnormalities in the left ovary or fallopian tube.\n\nRepresentative sections from all areas were submitted for analysis."} +{"pid": "TCGA-AZ-4684", "report": "The specimen consists of a resected rectosigmoid colon measuring 23.5 cm in length, with an exophytic lesion present. The lesion measures 5.5 cm in greatest dimension and extends across the rectosigmoid junction. Histologic examination reveals invasive carcinoma that penetrates through the muscularis propria with focal extension into pericolorectal adipose tissue. The closest circumferential resection margin is 0.5 cm from the tumor; all other surgical margins are free of involvement.\n\nA total of twelve regional lymph nodes were examined, ten of which contain metastatic carcinoma, with the largest focus measuring 1 cm. There is no evidence of extracapsular extension. Angiolymphatic invasion is present. Two hyperplastic polyps are identified, and the remainder of the colorectal mucosa shows no significant histopathologic abnormalities. A biopsy of the right dome of the liver demonstrates metastatic involvement.\n\nStaging indicates pT3a/b for primary tumor extent, pN2 for nodal involvement, and pM1 based on liver metastasis. The histologic grade is described as moderate to poorly differentiated. The tumor margin configuration is infiltrating, and there is a mild to moderate lymphocytic response noted."} +{"pid": "TCGA-SU-A7E7", "report": "The surgical specimen includes a prostate measuring 5.0 x 4.0 x 3.0 cm with macroscopically intact seminal vesicles. A nodular lesion was identified within the prostate, measuring 0.5 x 1.0 x 1.3 cm. Nine lymph nodes (obturator and iliac regions) were examined, all appearing pink in color. Microscopic evaluation revealed poorly differentiated acinar-type cells with a Gleason score of 5+3=8. Background tissue showed benign prostatic changes. Surgical margins appeared intact. No evidence of involvement was found in the examined lymph nodes. The tumor was classified as T2 with no positive nodes and no confirmed metastasis."} +{"pid": "TCGA-67-6217", "report": "The surgical specimens included multiple lymph nodes and a mediastinal mass. Lymph nodes from regions 9L, level 5, level 6, and posterior interlobular areas were all negative for tumor involvement. The anterior mediastinal mass measured 2.5 x 1.8 x 1.5 cm and had a lobular appearance with yellow adipose tissue. It was found to involve the surgical margins microscopically. A lung lobectomy specimen from the left upper lobe weighed 114 grams and measured 18 x 11 x 2.3 cm. A well-defined mass measuring 2.5 x 2 x 1.4 cm was identified within the lung parenchyma, located 0.4 cm from the closest parenchymal resection margin and 0.9 cm from the bronchial margin. The mass appeared to be in close proximity to the blue inked pleural surface. No other masses or nodularities were observed. Emphysematous changes were noted in the surrounding lung tissue. Multiple hilar lymph nodes were present, and one of these contained a small focus of metastatic carcinoma measuring 0.3 cm. Histologic evaluation showed the lung mass to have features of moderately differentiated adenocarcinoma with visceral pleural invasion. Vascular and large vessel invasion were not present. Immunostaining demonstrated no evidence of neuroendocrine differentiation. Pathologic staging was determined as pT2a pN1. Elastic stains confirmed pleural involvement. The thymic mass was classified as type AB based on histologic features and was found to have transcapsular extension. Lymphovascular invasion was not seen. Distant metastasis could not be assessed."} +{"pid": "TCGA-42-2589", "report": "The specimen included multiple tissue samples. Specimen A was a piece of omentum measuring 3 x 3.2 x 1 cm. Specimen B consisted of two pieces of omentum measuring 30 x 6 x 1 cm and contained multiple nodules up to 3 cm in diameter. Specimen D was an appendix measuring 5 cm in length with adjacent mesoappendix; tumor nodules measuring 1 and 2 cm were identified within the mesoappendix. Specimen E included the uterus, cervix, bilateral ovaries with tubes, posterior vagina, rectum, and parametria. The uterus measured 8.5 x 6 x 4.8 cm. Both ovaries contained tan tumor masses; the right ovary measured 4 x 3.5 x 2.5 cm with a tumor measuring 4.5 cm, and the left ovary measured 4 x 2.5 x 2.5 cm with a tumor measuring 3.3 cm. A segment of bowel measuring 21.5 cm in length was present, with a mass measuring 7 x 7 x 4 cm noted behind the vagina. Specimens F, G, H, and I represented lymph node regions and peritoneal tissue. Specimen F measured 1.6 x 1 x 0.6 cm, specimen G measured 4 x 3 x 1 cm, specimen H measured 4 x 2.5 x 1 cm, and specimen I measured 7 x 4 x 1 cm.\n\nMicroscopic evaluation showed metastatic non-mucinous carcinoma in the omentum with giant cells. The appendix demonstrated fibrous obliteration of the lumen and periappendiceal involvement. In the ovaries, poorly differentiated non-mucinous carcinoma was observed, with a FIGO grade of 3. The tumor size was 4 cm in greatest dimension in both ovaries. Mitotic activity measured 64 mitoses per 10 high-power fields. Extracapsular spread was present, and peritubal involvement was identified bilaterally. Lymph node analysis revealed metastatic involvement in left and right pelvic nodes, while four nodes from the right aortic region showed no evidence of malignancy. Peritoneal biopsy from the right diaphragm showed metastatic involvement. Staging was determined as pTNM T3c N1."} +{"pid": "TCGA-2G-AAGF", "report": "The pathology report describes a left orchidectomy specimen. The tumor measured 4 cm in greatest dimension and was composed of a mixture of cell types, including medium to large atypical cells with prominent nucleoli and varying cytoplasmic features. The tumor was confined to the testis without extension beyond its margins. Angioinvasion was identified, and there was also evidence of invasion into the rete testis. No lymph node or distant metastases were identified. The tumor showed areas with necrosis and hemorrhage, and giant cells of trophoblastic origin were present focally. Cellular composition included a predominant population of cells consistent with embryonal carcinoma features, along with a smaller component showing yolk sac tumor differentiation."} +{"pid": "TCGA-BQ-5885", "report": "The left radical nephrectomy specimen revealed two distinct masses. The first mass measured 7.1 cm and exhibited a well-circumscribed, white-tan appearance with areas of necrosis and hemorrhage. It was located in the middle pole of the kidney, partially encapsulated, and abutted the renal pelvis but did not grossly involve it. Microscopically, this lesion displayed high-grade cytologic atypia with significant nuclear and nucleolar enlargement, as well as focal desmoplasia. Immunohistochemical staining showed positivity for CK7 (focal, strong), Racemase (diffuse, strong), c-kit (patchy, moderate), and CA-IX (focal, weak), while negative for 34BE12. The tumor was confined within the renal capsule without evidence of local invasion, renal vein involvement, or extension into hilar or perihilar fat. Surgical margins were free of tumor. The second mass measured 2.6 cm and was located in the lower pole of the kidney. It had a yellow-orange, lobulated appearance and microscopically showed features consistent with a different histologic type. This lesion extended through the renal capsule into the surrounding perirenal fat but remained within Gerota\u2019s fascia. There was no evidence of renal vein invasion or lymph node involvement. Surgical margins were also free of tumor for this lesion.\n\nFifteen lymph nodes from the para-aortic and preaortic regions were examined and none showed evidence of involvement. The adrenal gland, submitted separately along with suprahilar lymph nodes, appeared benign and showed no signs of involvement.\n\nPathologic staging was determined based on these findings: the larger mass was classified as pT2 (tumor greater than 7.0 cm limited to the kidney), and the smaller mass was staged as pT3 (tumor invading perinephric tissues but not beyond Gerota\u2019s fascia). No lymph node metastases were identified."} +{"pid": "TCGA-A6-2684", "report": "The specimen included an apical lymph node and a right hemicolectomy. The apical lymph node was a soft tan-pink tissue measuring 1.0 x 0.6 x 0.5 cm, entirely submitted for analysis, and showed no evidence of disease. \n\nThe right hemicolectomy consisted of a 28 cm segment of proximal right colon with attached distal ileum. The serosal surface appeared smooth to scabrous with moderate mesocolon and mesentery. An unremarkable appendix measuring 3.7 cm in length and 0.5 cm in diameter was present. Proximal and distal margins measured 3.9 cm and 6.1 cm in circumference respectively. A lesion measuring 5.3 x 2.0 cm was identified at the ileocecal valve. It was rubbery, tan-pink-red in color, and had a maximal thickness of 1.3 cm, extending into the muscularis but not reaching the ink-free radial serosal surface, which was located 0.5 cm away. Sections of the lesion and adjacent normal mucosa were submitted for analysis. The remaining ileal and colonic mucosa appeared glistening and tan-pink with regular folds and wall thickness averaging 0.5 cm. Lymph nodes recovered from the mesentery and mesocolon were pale tan, slightly rubbery, and measured up to 1.0 cm in size. Twelve blocks were submitted for histologic evaluation including margins, full-thickness sections of the lesion, adjacent mucosa, random mucosa, the appendix, and multiple lymph nodes. \n\nMicroscopic examination of the apical lymph node revealed no abnormal findings. In the right hemicolectomy specimen, the lesion extended into the muscularis propria but did not penetrate through it (pT2). All surgical margins were negative. No vascular invasion or non-lymph node pericolonic tumor involvement was identified. Thirty-two regional lymph nodes were examined and none contained metastatic disease. The appendix appeared histologically unremarkable. Distant metastasis could not be assessed based on this specimen."} +{"pid": "TCGA-BJ-A0ZH", "report": "The specimen consisted of a total thyroidectomy measuring 12.7 grams. A single lesion was identified in the left lobe, measuring 2.1 cm in greatest dimension. Histologic evaluation revealed characteristic nuclear features including nuclear enlargement, irregular nuclear contours, and intranuclear inclusions. The architecture demonstrated a predominantly papillary growth pattern with areas of follicular differentiation. No evidence of extrathyroidal extension was observed. Surgical margins were free of involvement. One central compartment lymph node out of four examined contained metastatic disease; no extranodal extension was identified. Additionally, one benign lymph node and one normocellular parathyroid gland were identified. Staging was determined as pT2 with regional lymph node involvement (pN1a). \n\nMolecular analysis was performed on nucleic acids extracted from the tissue sample. Real-time PCR with melting curve analysis was used to assess for mutations in BRAF (codons 599\u2013601), NRAS (codon 61), HRAS (codon 61), and KRAS (codons 12/13). Single-step real-time RT-PCR was utilized to detect RET/PTC1, RET/PTC3, and PAX8/PPAR\u03b3 rearrangements. Sanger sequencing was employed when necessary for confirmation. Controls including GAPDH and KRT7 were successfully amplified, indicating sufficient nucleic acid quality and quantity. BRAF V600E mutation was identified. No mutations in NRAS, HRAS, KRAS, or rearrangements in RET/PTC1, RET/PTC3, or PAX8/PPAR\u03b3 were detected.\n\nThe limit of detection for mutations was approximately 10\u201320% mutant allele burden. These findings were interpreted in the context of available clinical, imaging, and cytologic data."} +{"pid": "TCGA-CN-5355", "report": "A biopsy of laryngeal tissue was performed and showed malignant cells consistent with squamous cell morphology. A total laryngectomy and left thyroid lobectomy were carried out. Gross examination identified a transglottic lesion measuring 3.7 cm in greatest dimension, located predominantly on the left side and extending to the right. The tumor demonstrated invasion of the thyroid cartilage but no perineural invasion. Surgical margins were free of tumor involvement by at least 2 mm. Adjacent thyroid tissue revealed a small follicular adenoma measuring 0.3 cm. No parathyroid tissue was identified within the specimen.\n\nLymph node dissection included 14 nodes from left level 2, two from left level 3, four from left level 4, and seven from the right side. All lymph nodes examined were benign. Frozen section analysis of pharyngeal and postcricoid margins showed no evidence of tumor involvement.\n\nHistologic evaluation confirmed moderately differentiated squamous cell carcinoma. Staging was determined as pT4a for local tumor extension, pN0 for absence of lymph node metastasis, and pMX for inability to assess distant metastasis. Multiple H&E-stained slides were reviewed for all specimen components."} +{"pid": "TCGA-A7-A5ZW", "report": "Final Surgical Pathology Report. Procedure: Lumpectomy of the right breast and excisional biopsy of the right axillary sentinel lymph node.\n\nBreast specimen: The excised tissue measured 9.3 x 8.7 x 4.3 cm and included a skin ellipse measuring 5.7 x 1.3 cm. The lesion identified was 1.7 x 1.5 x 1.5 cm, located closest to the superior margin at 0.5 cm and within 2 cm of the skin. Histologically, the lesion showed grade 2 features with architectural, nuclear, and mitotic scores all rated as 2. The tumor was surrounded by fibrosis, apocrine metaplasia, microcysts, ductal hyperplasia, and adenosis. Margins were negative for involvement. Microcalcifications were present focally. A cribriform pattern was noted in approximately 10% of the lesion, with no necrosis observed. No extensive intraductal component was identified. Skin margins were unremarkable.\n\nLymph node specimen: The sentinel lymph node measured 2.4 x 1.5 x 1.0 cm and contained a 7 mm focus of involved tissue with extranodal extension noted. Three blocks were evaluated, and the findings were based on H&E sections.\n\nClinical correlation and prior core biopsy markers were reviewed. The lesion showed slightly higher activity compared to initial assessment, primarily due to increased mitotic count. No vascular invasion was identified. The closest margin was superior at 5 mm. Specimen orientation included multiple inked margins for identification. Multiple representative sections were submitted for analysis from various regions of the specimen."} +{"pid": "TCGA-64-5774", "report": "The specimen was received in five parts. The first part, labeled as a fragment of rib, measured 1.5 cm in greatest dimension and consisted of tan tissue with minimal attached soft tissue; a representative section was submitted following decalcification. The second part consisted of two lymph nodes measuring 0.8 cm in greatest dimension, which were gray-black and anthracotic stained; these were submitted entirely in one block. The third part contained two tissue fragments measuring 1.0 cm each, also gray-black and anthracotic stained, and submitted completely in one block.\n\nThe fourth part consisted of fibroadipose tissue measuring 3.0 x 2.0 x 0.8 cm, containing multiple lymph nodes that measured up to 1.5 cm in greatest dimension and were similarly anthracotic stained. This portion was submitted entirely across four blocks. The final part included a large right pneumonectomy specimen weighing 797 grams and measuring 20.0 x 20.0 x 5.5 cm. It featured a pink-red to purple pleura with areas of anthracotic staining and included up to 2.0 cm of attached bronchus. A firm mass measuring 7.0 x 5.0 x 3.0 cm was identified in the hilar region adjacent to the bronchus, with tan and anthracotic cut surfaces. The remaining lung tissue showed variable appearances ranging from tan-pink and crepitant to red-purple, soft, and glistening. Multiple palpable hilar lymph nodes measuring up to 1.0 cm were present, all displaying gray-black and anthracotic features. Sections were taken from the bronchial resection margin, vascular margins, tumor area, random lung sections, and hilar lymph nodes, submitted across eleven blocks.\n\nExamination of all submitted tissues found no evidence of involvement in any of the sampled areas, including multiple lymph nodes assessed across various regions. Margins of resection were negative. Cellular features within the primary site demonstrated poorly differentiated characteristics with focal clear cell changes, located centrally within the lung tissue."} +{"pid": "TCGA-2Y-A9H7", "report": "The resected liver specimen from the left lobe measured 14.5 x 7.0 x 2.5 cm and weighed 73.8 grams. A well-circumscribed mass measuring 2.5 x 2.5 x 2.2 cm was identified; it was located 1.2 cm from the closest surgical margin and 0.1 cm from the liver capsule. The mass appeared soft, yellow, lobulated, and had central hemorrhage. No other lesions were observed in the remaining liver tissue.\n\nMicroscopic examination revealed a solitary lesion with moderately differentiated histology. Immunohistochemical analysis demonstrated positivity for Hep-par1 and negativity for CK7, CK20, CK19, and Chromogranin. The tumor was confined to the liver without vascular invasion. Surgical margins were free of involvement by invasive disease, with the closest distance from the tumor to the margin being 12 mm. No regional lymph node or distant metastases could be assessed.\n\nAdditional findings included fibrous expansion of portal areas and marked portal-portal and portal-central bridging fibrosis, indicative of advanced fibrotic change. Special stains including Trichrome, Iron, and reticulin were performed and showed no evidence of excess iron deposition.\n\nAll slides and materials were personally reviewed by the attending pathologist. Intraoperative frozen section analysis confirmed the absence of tumor at the inked surgical margin. Representative sections of the mass, margins, and adjacent normal liver tissue were submitted for further evaluation."} +{"pid": "TCGA-FG-A6J3", "report": "A right frontal brain lesion was evaluated via biopsy and subsequent craniotomy with resection. The tissue specimens were processed for histologic examination, including frozen section analysis and permanent paraffin sections.\n\nThe lesion involves the cerebral cortex and underlying white matter, exhibiting a diffusely infiltrative growth pattern. Microscopically, the cells show angulated to irregular nuclei with moderate to marked nuclear pleomorphism. The cytoplasm is fibrillar to spindled in appearance, with some areas demonstrating a gemistocytic morphology. Multinucleated tumor cells are occasionally observed, and scattered mitotic figures are present. Necrosis and vascular proliferation are not identified. Immunohistochemical staining demonstrates positivity for mutant IDH-1. The Ki-67 labeling index is variable but elevated, reaching approximately 25% in certain areas.\n\nHistologic evaluation of the resected specimen includes 11 hematoxylin and eosin (HE)-stained slides and two immunohistochemical stains (IDH-1 and Ki-67). Gross description of the resected specimen includes two tissue fragments: one measuring 2.1 x 1.5 x 0.4 cm and another measuring up to 5.1 x 3.5 x 1.7 cm, weighing a total of 16.1 grams. Approximately 40% of the larger piece shows loss of distinction between gray and white matter. Representative sections comprising approximately 45% of the specimen were submitted for analysis.\n\nFrozen section diagnosis from intraoperative consultation identified an infiltrating high-grade glioma. Based on cellular features, atypia, and elevated proliferation index, concern was raised for progression toward a higher grade; however, definitive features such as necrosis or vascular proliferation were absent.\n\nAncillary studies including MGMT gene methylation analysis by PCR and assessment for 1p/19q chromosomal losses by FISH were initiated, with results pending in an addendum. The case was reviewed prospectively within the pathology department.\n\nAll diagnostic slides and supporting documentation were reviewed by the pathologist as part of the final assessment. Certain laboratory tests utilized analyte-specific reagents (ASRs), which have been validated internally for clinical use but are not FDA-cleared or approved. These tests are performed for diagnostic purposes and not considered investigational or research-based.\n\nNo necrosis or microvascular proliferation was observed. The histologic features, combined with immunohistochemical findings and molecular testing in progress, contribute to the overall characterization of the lesion."} +{"pid": "TCGA-AO-A03O", "report": "A 46-year-old woman presented with a right breast mass following a core biopsy. Sentinel lymph nodes #1 and #2 from the right axilla were biopsied intraoperatively and found to be benign without evidence of metastatic disease on frozen section and permanent histologic evaluation, including immunohistochemical staining for cytokeratins. The patient underwent a right mastectomy with axillary lymph node dissection.\n\nGross examination of the mastectomy specimen revealed a firm, irregular gray-white tumor measuring 3.5 cm in greatest dimension located in the upper outer quadrant of the breast. Histologically, the lesion showed poor differentiation with marked nuclear atypia, minimal tubule formation, and extensive necrosis. Lymphovascular and perineural invasion were present. No involvement of the nipple, skin, or surgical margins was identified.\n\nIn addition to the invasive component, there was also presence of high-grade ductal carcinoma in situ (solid type), comprising up to 25% of the total tumor burden. Calcifications were observed within both the in situ and invasive components as well as in benign breast tissue. Axillary lymph node examination (level I) included 15 nodes, none of which showed involvement. Non-neoplastic breast tissue demonstrated stromal fibrosis and florid ductal hyperplasia.\n\nImmunohistochemical studies demonstrated positivity for estrogen and progesterone receptors. HER2/neu testing was repeated and showed negative staining (1+ intensity). Multiple sections from various regions of the breast, including margins and lymph nodes, were evaluated and submitted for further analysis."} +{"pid": "TCGA-BH-A0HA", "report": "The specimen consists of a right total mastectomy with multiple tumor foci identified. The largest invasive tumor measures 1.3 cm in greatest dimension, while two additional invasive tumors measure 0.8 cm and 0.5 cm, respectively. Histologic grading using the Nottingham system shows scores of 6/9 (Grade II), 7/9 (Grade II), and 6/9 (Grade II) for each respective tumor focus. Tubule formation scores were consistently 3 across all tumors. Nuclear pleomorphism varied between scores of 2 and 3 among the lesions, while mitotic activity remained low at score 1 for all.\n\nIn addition to invasive components, ductal carcinoma in-situ (DCIS) was identified, comprising approximately 10% of the total tumor burden. DCIS exhibits a solid growth pattern and is found both admixed with and separate from the invasive areas. Lobular carcinoma in-situ (LCIS) was also present. No lymphovascular space invasion was observed.\n\nMargins of resection are negative for malignant involvement. The closest distance from invasive tumor to surgical margins is 0.5 cm anteriorly. Similarly, DCIS is located 0.5 cm from the nearest anterior margin. The nipple margin is free of tumor involvement.\n\nNon-neoplastic breast tissue demonstrates features of non-proliferative fibrocystic disease along with biopsy site changes. Immunohistochemical evaluation of the largest invasive tumor reveals positivity for estrogen and progesterone receptors, with no overexpression of HER-2 based on prior testing.\n\nSentinel lymph node biopsies from three separate sites on the right side\u2014totaling four lymph nodes\u2014revealed no evidence of metastatic involvement.\n\nPathologic staging is as follows: pT1c, pN0(i-), pMX."} +{"pid": "TCGA-21-1075", "report": "The specimen consisted of multiple tissue samples from various anatomical locations. A portion of the sixth rib, a cytology sample, and several lymph node groups were obtained, including level 9, level 5, level 10, level 6, and level 7 lymph nodes. Additionally, a left pneumonectomy specimen was submitted.\n\nThe left pneumonectomy measured 16.0 x 17.5 x 6.5 cm and weighed 933.3 grams. The pleural surface was red-purple with diffuse anthracotic pigmentation. A well-circumscribed gray-tan necrotic mass measuring 11.0 cm in greatest dimension was identified in the left lower lobe. The bronchus measured 3.5 cm in length and 1.6 cm in diameter. Upon sectioning, the mass was found to distort the lower lobe. Eleven potential hilar lymph nodes were identified and sampled across multiple blocks. Margins of the bronchus and vasculature were free of involvement. One of twelve peribronchial lymph nodes showed evidence of microscopic involvement.\n\nLymph node dissections from levels 5, 6, 7, and 9 showed no evidence of involvement in all submitted nodes. In contrast, the single lymph node from level 10 demonstrated microscopic involvement.\n\nTissue from the rib and cytology sample was submitted for protocol purposes. Multiple sections from the lung mass, surrounding lung parenchyma, and hilar region were evaluated.\n\nStaging was based on the extent of the primary lesion and regional lymph node involvement."} +{"pid": "TCGA-UW-A72S", "report": "The left laparoscopic nephrectomy specimen weighed 425 grams and measured 16.0 x 8.5 x 5.5 cm. The tumor was located in the renal cortex at the mid pole, with a tan/pink, soft appearance and punctate hemorrhage. A central area measuring 1.5 x 1.4 cm was yellow, soft, and liquefied. The tumor measured 5.5 x 4.7 x 4.2 cm and was well-circumscribed, though there was an area suspicious for extracapsular extension. Histologic evaluation showed a discrete encapsulated population of dyscohesive cells with perinuclear cytoplasmic clearing and prominent plasma membranes. Zones of fat necrosis were also present. Microscopic analysis supported a specific immunophenotype with diffuse reactivity for CK7 and colloidal iron, subset reactivity for RCC and c-Kit, and no reactivity for vimentin. Histologic grade was Fuhrman grade 2 of 4. The tumor was unifocal and did not involve the renal sinus, ureter, major veins, or lymphatic or venous systems. Perinephric adipose tissue, renal vein, and ureteral margins were all negative. Lymph nodes and adrenal gland were not received. Grossly, the mass appeared to extend through the renal capsule, with possible involvement of perinephric fat, although this was not confirmed microscopically. The remainder of the kidney showed a distinct cortical medullary junction, and a 0.4 cm smooth-walled cyst was noted in the inferior pole. Based on available information, staging was determined as pT1b pNx pMx, subject to revision pending further clinical review."} +{"pid": "TCGA-DD-AAVQ", "report": "The specimen consists of a liver segment S6 resected specimen. The lesion measures 3.0 x 3.0 x 2.2 cm and demonstrates a multinodular confluent gross appearance. Microscopically, the histologic pattern includes microtrabecular, trabecular, and solid growth arrangements. Two distinct cell types are identified: cirrotomimetic and clear cells. The tissue shows septal formation and a complete capsule without infiltration. The surgical margin is negative with a safety margin of 2.1 cm. There is no satellite nodule, tumor necrosis, vascular invasion, or intrahepatic metastasis. Fatty change and hemorrhage/peliosis are present at 1% each. Histologic grading according to Edmondson and Steiner reveals the worst differentiation as grade 3 and the major differentiation as grade 2. No involvement of major branches of the portal or hepatic veins is observed, nor is there bile duct or serosal invasion. Associated findings include active cirrhosis without dysplasia. Pathologic staging corresponds to AJCC criteria pT1 and pT2."} +{"pid": "TCGA-06-0201", "report": "The brain biopsy specimens were received in fresh condition for intraoperative evaluation. The first specimen consisted of several small fragments of friable, hemorrhagic soft tissue measuring approximately 2 x 2 x 0.2 cm in total. Microscopic examination revealed necrotic tissue with vascular changes including vessel wall necrosis and thrombosis; no definitive diagnostic cellular features were identified.\n\nA second specimen labeled as \u201ctumor second piece\u201d consisted of three small fragments of friable, hemorrhagic tissue measuring 0.9 x 0.9 x 0.2 cm. Microscopic analysis showed similar necrotic areas as seen in the first specimen, along with regions of neoplastic glial cell proliferation. These cells exhibited nuclear pleomorphism, hyperchromasia, and mitotic activity. Additional findings included endothelial vascular proliferation and extensive tumor-related necrosis.\n\nThe second specimen demonstrated features consistent with a high-grade glial neoplasm. No specific tumor type or diagnosis has been provided in this summary."} +{"pid": "TCGA-56-A4BX", "report": "The specimen was received from a male patient with a preoperative imaging finding of a lesion in the right lower lobe. The surgical specimen involved a lobectomy, and the lesion was located within the lung parenchyma. The tumor measured 6.0 x 5.0 x 3.5 cm and was unifocal. Microscopic evaluation showed moderately differentiated cells with no evidence of visceral pleural invasion or lymphovascular space invasion. The tumor was found to be 4.5 cm from the bronchial margin, 6.0 cm from the parenchymal margin, and 0.1 cm from the pleural surface.\n\nLymph node assessment included four nodes at level 9 and one node at level 7, all of which were negative for metastatic involvement. One peribronchial lymph node was also negative. Staging was determined as pT2b, NO. \n\nAdditional molecular testing considerations were noted, including recommendations for mutation analysis in specific clinical scenarios involving gene mutations and rearrangements. These tests may be performed on tissue or fluid samples and are available upon request.\n\nGross examination described a right lower lobe specimen weighing 317 grams, measuring 14.0 x 6.0 cm. The pleural surface appeared slightly shaggy and displayed a tan, cystic area measuring 4.5 cm. A separate tan nodule was identified at 2.0 x 2.0 cm. The stapled edge margin was 1.0 cm from the lesion. The lymph node specimens were described as brown-tan, with some showing calcification and ranging in size up to 1.1 cm. All lymph nodes were entirely submitted for evaluation."} +{"pid": "TCGA-B6-A0WZ", "report": "Surgical Pathology Report. \n\nCLINICAL HISTORY: Right breast mass previously evaluated by needle aspiration. \n\nGROSS EXAMINATION: A 2700 gram modified radical mastectomy specimen with attached skin measuring 31 x 22 cm was received. The skin contains an 8.3 x 2.2 cm circumferential area and a retracted nipple measuring 1.5 cm. No biopsy scar or other skin lesions were observed. Sectioning revealed predominantly fibrofatty yellow-white breast tissue. In the upper outer quadrant, a firm, pink-grey mass measuring 3.0 x 2.8 x 3.0 cm was identified. It was located 2 cm beneath the skin surface, 5 cm from the nearest lateral margin, and 5.0 cm from the deepest margin. Multiple potential lymph node candidates were present in the axillary tail measuring 13.0 x 9.0 x 4.0 cm. Levels I, II, and III were demarcated by suture. \n\nBLOCK SUMMARY: Blocks included sections of the mass (A1\u2013A3), deep margin (A4), lateral margin (A5), lower outer quadrant (A6), upper medial quadrant (A7), lower medial quadrant (A8), skin overlying the mass (A9), nipple (A10), areola (A11), and multiple lymph node levels including bisected and clustered nodes. \n\nHISTOLOGIC FINDINGS: Microscopic evaluation revealed a tumor with features consistent with a tubulolobular growth pattern. Histologic grade was intermediate. Nuclear grade was also within the intermediate range. The primary lesion measured 3 cm in greatest dimension. A small focus of in situ change involving less than 5% of the lesion was noted, characterized as non-comedo ductal type. Adjacent breast tissue showed intraductal hyperplasia, moderate cyst formation, apocrine metaplasia, and sclerosing adenosis. Lymphatic and vascular invasion was identified. All surgical margins were free of involvement. The nipple and skin were uninvolved. Muscle tissue was not sampled. \n\nLYMPH NODE ASSESSMENT: Of the 21 lymph nodes examined, 11 contained metastatic disease. Four nodes showed extracapsular extension. The largest involved lymph node measured 1.6 cm. \n\nHORMONE RECEPTOR STATUS: Tissue analysis for estrogen and progesterone receptors was performed. Estrogen receptor activity was positive (127 fmol), and progesterone receptor activity was also positive (152 fmol). \n\nAdditional biomarker and cell cycle studies were pending at the time of reporting."} +{"pid": "TCGA-EL-A3ZR", "report": "Case type: Surgical Case. (A) LEFT THYROID LOBE AND ISTHMUS: A well-circumscribed pink-tan nodule measuring 2.2 cm in greatest dimension is identified within the superior aspect of the left lobe. The nodule is confined to the thyroid with a smooth overlying surface. No multifocal lesions are observed. The specimen shows no extrathyroidal extension. Lymphovascular invasion is present. Resection margins are negative. No lymph nodes are identified. The hemithyroidectomy specimen measures 4.0 x 1.5 x 1.5 cm and includes the isthmus, which appears unremarkable. The nodule is serially sectioned and submitted from superior to inferior in blocks A1-A6, with A7 containing the isthmus. Clinical history indicates a follicular neoplasm in the left thyroid."} +{"pid": "TCGA-FY-A3TY", "report": "The surgical specimen from a total thyroidectomy included a right lobe measuring 4.5 x 2.5 x 2.0 cm, a left lobe measuring 4.0 x 2.0 x 1.0 cm, and an isthmus with pyramidal lobe measuring 5.5 x 1.5 x 0.7 cm. The total specimen weight was 21 grams. A dominant nodule was identified in the right thyroid lobe, measuring 4.2 cm in greatest dimension. The nodule was partially encapsulated, ill-defined, and rubbery with a heterogeneous tan-yellow cut surface. It was located less than 0.1 cm from the capsule and showed extension into perithyroidal adipose tissue with focal superficial involvement of attached skeletal muscle. The resection margins were uninvolved. No lymphovascular invasion was identified. The left lobe showed mild lymphocytic thyroiditis without evidence of significant pathology.\n\nA separate specimen from the right paratracheal lymph nodes (level 6) consisted of six lymph nodes, all of which were negative for metastatic disease. Histologic evaluation of the dominant lesion revealed features consistent with classical cytomorphology and architecture. The tumor was unifocal and confined to the right lobe. Pathologic staging was determined as pT3, pN0, pMX. No other discrete masses or suspicious areas were identified in the remainder of the thyroid specimen."} +{"pid": "TCGA-HW-7489", "report": "The submitted specimens include two biopsies from a right frontal lobe brain lesion. The first specimen consists of tissue fragments measuring 1 x 1 x 0.3 cm in aggregate. The second specimen is composed of tan-pink to white soft tissue measuring 4 x 3.5 x 1.5 cm. Both specimens were processed for histological evaluation.\n\nHistologic examination reveals a neoplastic process involving glial cells. Immunohistochemical analysis shows that approximately 60% of tumor cell nuclei are positive for P53. The proliferation index, as determined by MIB-1 (Ki-67) immunostaining, is less than 4%. Several molecular tests have been initiated, including analysis for IDH mutations, EGFR amplification, 1p/19q co-deletion status, and MGMT promoter methylation. Results for these studies will be provided in separate reports.\n\nThe tumor demonstrates features consistent with a low-grade glioma. The assessment includes evaluation of cell morphology, nuclear characteristics, and mitotic activity observed during both frozen and permanent section analysis. All tests performed were part of clinical diagnostic procedures and were conducted under appropriate laboratory certification."} +{"pid": "TCGA-E9-A1RG", "report": "The specimen consists of a lumpectomy from the right upper outer quadrant. A grossly evident lesion is present, measuring 1.8 x 0 x 1 cm. The lump is surrounded by fatty tissue; lymph nodes are described as dense and hyperemic. Microscopic evaluation shows moderately differentiated histology with focal hyalinosis. Ten lymph nodes were examined, of which four show evidence of metastatic involvement. No venous invasion is identified. Surgical margins are uninvolved. Additional features including tubule formation, nuclear pleomorphism, and mitotic counts are not specified, precluding calculation of a Nottingham Histologic Score. There is no indication of neoadjuvant treatment effect."} +{"pid": "TCGA-R6-A6XQ", "report": "The pathology report describes a biopsy specimen from the distal esophagus. The specimen consists of two fragments of white-tan soft tissue, each measuring 0.3 x 0.3 x 0.2 cm. Microscopic evaluation reveals poorly differentiated cells infiltrating the tissue. Cellular features include marked nuclear atypia, increased mitotic activity, and disorganized architecture. No specific tumor type is identified in this summary. Staging could not be determined due to the limited size of the biopsy. No additional molecular or special studies are reported. The clinical history indicates prior concern for a lesion in the esophagus."} +{"pid": "TCGA-N5-A59E", "report": "The submitted specimens included the uterus, cervix, bilateral fallopian tubes and ovaries, omentum, multiple tumor excisions from the cul-de-sac, rectal serosa (two sites), transverse colon, falciform ligament (two sites), right diaphragm, small bowel mesentery, xiphoid, left external iliac lymph node, and right supradiaphragmatic lymph nodes.\n\nIn the primary uterine specimen, there was significant invasion into the myometrium with a maximum depth of 10 mm; the myometrial thickness at the site of invasion measured 14 mm. Endocervical involvement was noted with stromal invasion measuring 10 mm, in a cervical wall thickness of 16 mm at that site. Lymphovascular invasion was present. The endometrium also showed a polyp, and the myometrium exhibited adenomyosis and a single leiomyoma. The adnexal structures were unremarkable.\n\nMetastatic involvement was identified in multiple excised sites, including the omentum, cul-de-sac, rectal serosa (both excisions), transverse colon, falciform ligament (both excisions), right diaphragm, and small bowel mesenteric nodule. The two lymph nodes from the left external iliac dissection were benign. The right supradiaphragmatic lymph node dissection showed metastatic involvement in 2 out of 3 nodes. The xiphoid excision revealed only benign cartilage and fibroconnective tissue."} +{"pid": "TCGA-38-4626", "report": "The surgical specimen consists of a left upper lobe lobectomy measuring 17.5 x 11.0 x 5.8 cm in size and weighing 340 grams. A single mass is identified in the superior segment of the left upper lobe, measuring 5.3 x 5.0 x 5.0 cm. The tumor appears firm, tan, and slightly whorled with well-defined borders, presenting a somewhat circumscribed and cauliflower-like appearance. On gross examination, the tumor does not appear to involve the bronchus, with a distance of 1.1 cm from the bronchial margin and 1.4 cm from the stapled surgical margin. The closest distance of the tumor to the pleura is 0.4 cm. No satellite nodules are present, and no attached structures are involved. The surrounding lung tissue is diffusely aerated with focal areas of consolidation.\n\nHistologically, the lesion is poorly differentiated. Surgical margins, including the bronchial and stapled margins, show no evidence of involvement. There is no pleural invasion identified, nor is there evidence of in situ carcinoma or lymphovascular or perineural invasion. \n\nLymph node evaluation includes peribronchial (0/8), station 5 (0/2), L10 (0/1), and station 11 (0/1) groups, none of which demonstrate metastatic involvement. No extracapsular extension is noted. Additional findings in the non-tumorous lung include hemosiderin-laden macrophages and post-obstructive changes. Tissue samples submitted include sections of the tumor at various locations, adjacent normal lung parenchyma, and multiple lymph node candidates. Frozen section analysis confirmed the absence of tumor in the bronchial margin and two lymph nodes evaluated intraoperatively."} +{"pid": "TCGA-N5-A4R8", "report": "The submitted specimens include the uterus, cervix, bilateral fallopian tubes and ovaries, along with multiple lymph node groups from both sides, including para-aortic, common iliac, external iliac, internal iliac, obturator, and right common lymph nodes.\n\nExamination of the uterine specimen reveals a tumor that invades up to half of the myometrium. The maximal thickness of myometrial invasion is 3.5 mm, within an area where the total myometrial thickness is 23 mm. There is no evidence of endocervical or vascular invasion. The endometrium shows atrophic changes. The myometrium contains leiomyomas. The left fallopian tube demonstrates paratubal cysts, while all other adnexal structures are unremarkable.\n\nAll lymph node specimens are benign. No malignant involvement is identified in any of the lymph nodes examined, which total 29 nodes across the various groups. No lymph nodes are found in the right internal iliac specimen."} +{"pid": "TCGA-ZJ-A8QR", "report": "Specimen is part of a study. A cervical biopsy from the 12 o\u2019clock position was received in formalin. The specimen is labeled and contains the patient\u2019s name. It consists of an irregular, unoriented portion of shaggy, pale tan to tan rubbery tissue measuring 2.5 x 1.3 x 0.8 cm. The tissue was serially sectioned at close intervals and entirely submitted in two cassettes. Microscopic evaluation shows severe dysplasia with glandular involvement. The lesion demonstrates invasive growth with large cell features and keratinization. Cellular differentiation is limited. Staging is not applicable for this specimen."} +{"pid": "TCGA-B5-A0JX", "report": "The specimen consists of a hysterectomy with bilateral adnexa, weighing 112 grams. The uterus measures 8.2 x 5.2 x 3.1 cm, with a cervix measuring 2.7 cm in diameter and an os diameter of 0.9 cm. A mass measuring 3.4 x 2.5 x 2.2 cm is present on the anterior and posterior walls of the lower uterine segment, sparing the fundus. The lesion does not extend into the endocervical canal, located 3.3 cm from the os. The myometrium averages 1.5 cm in thickness, with gross evidence of 3 mm of invasion into the anterior wall. A representative sample of the anterior wall endomyometrium was taken for frozen section analysis.\n\nThe left adnexa includes a tan-yellow ovary measuring 2.6 x 1.6 x 1.3 cm with small cortical cysts up to 0.4 cm and two white corpora albicans up to 0.5 cm. The left fallopian tube is 3.5 cm long and 0.3 cm in diameter, showing discontinuity consistent with prior tubal ligation. The right adnexa contains a fallopian tube measuring 4.5 cm long x 0.3 cm diameter, also showing signs of tubal ligation. The right ovary measures 2.2 x 1.6 x 1 cm and contains one cortical cyst measuring 0.6 cm in diameter.\n\nBlocks submitted include full-thickness sections of the anterior and posterior endomyometrium, longitudinal sections of the anterior and posterior lower uterine segments with the lesion, uninvolved fundus, and representative sections of the cervix. Both fallopian tubes and ovaries are included in separate blocks. Left pelvic lymph nodes are represented by an aggregate of yellow-tan fibroadipose tissue containing 20 lymph node candidates ranging from 0.3 to 1.1 cm in size. Right pelvic lymph nodes consist of an 8 x 6 x 3 cm fragment of tan-yellow fibroadipose tissue containing 20 lymph node candidates, ranging from 0.2 to 2.5 cm. Right aortic lymph nodes are represented by a 2.3 x 1.8 x 0.7 cm fragment of fibroadipose tissue containing two lymph node candidates, both bisected and submitted in separate blocks.\n\nMicroscopic examination of the uterine specimen reveals poorly differentiated glandular cells involving the lower uterine segment. Invasion is observed to a depth of 3 mm within a myometrial wall measuring 1.3 cm thick. No lymphatic or vascular invasion is identified. Adjacent endometrial tissue appears inactive. The cervix, fallopian tubes, ovaries, and serosa show no abnormal cellular changes. All surgical margins are free of atypical cells.\n\nEvaluation of lymph nodes reveals no abnormal cellular infiltration. Twenty lymph nodes from the left pelvis, twenty from the right pelvis, and two from the right aortic region all show no presence of malignant cells.\n\nStaging is based solely on findings from this specimen, without integration of clinical or imaging data. The procedure performed was hysterectomy, oophorectomy, and lymphadenectomy. The final pathologic staging according to AJCC 6th Edition criteria is pT1b pNO pMX."} +{"pid": "TCGA-OL-A6VQ", "report": "A right breast skin-sparing mastectomy specimen was received, weighing 149 g and measuring 14.8 cm from superior to inferior, 19.8 cm from medial to lateral, and 1.2 cm from anterior to posterior. The anterior skin was unremarkable with a central areola and nipple. The specimen was sectioned into 15 slices from lateral to medial. On the anterior aspect, a metal clip was identified in the mid-superior region. A hemorrhagic smooth cavity measuring 1.7 x 1.5 x 1.0 cm was found within slices 8 and 9, adjacent to fat necrosis. This cavity extended to the posterior margin and reached within 0.1 cm of the anterior (blue ink) margin. Lateral to this cavity in slice 7 was a firm, white lesion (#1) measuring 1.4 x 0.5 x 0.5 cm, located at the anterior margin and 0.2 cm from the posterior margin. In slices 5 and 6, a firm, well-circumscribed white lesion (#2) measuring 1.1 x 0.9 x 0.7 cm was observed near both the anterior and posterior margins. Another ill-defined firm white lesion (#3) measuring 1.0 x 0.7 x 0.5 cm was present in slices 6 and 7 in the inferior aspect, located 0.3 cm from the anterior (green ink) margin.\n\nMicroscopic examination revealed two foci of invasive carcinoma. The first measured 1.9 cm and was adjacent to a prior lumpectomy site; the second measured 2.2 cm and was located in the superior aspect of the breast. Both were histologically graded as modified SBR grade II. Architectural score was 3, nuclear grade was 2, and mitotic rate was scored as 1. There was associated intraductal carcinoma within and extending away from the main mass, accounting for approximately 10% of the tumor volume.\n\nMargins were evaluated: the posterior margin showed involvement with invasive carcinoma, and the anterior-superior margin had tumor within less than 0.1 mm of the surface. No vascular or lymphatic invasion was identified. All four sentinel lymph nodes were negative. Immunohistochemical studies demonstrated strong ER expression in 90% of invasive tumor nuclei, weak PR expression in 10\u201320%, HER2 antigen was non-amplified by FISH (ratio 1.05), and Ki67 was 10%. The remainder of the breast tissue showed adenosis, usual ductal hyperplasia, columnar cell change, and apocrine metaplasia. No tumor was identified in the excision specimens from the anterior margin superior and inferior flaps, both of which showed only post-surgical changes. The nipple and skin were uninvolved.\n\nThe breast implant was described grossly as a spherical clear plastic device filled with clear gel, measuring 11.5 x 11.5 x 5 cm. It was intact and submitted for gross evaluation only. The anterior margin superior flap was a piece of soft yellow tissue measuring 1.6 x 0.7 x 0.5 cm, and the anterior margin inferior flap measured 2.1 x 1.4 x 0.5 cm. Both were entirely submitted for histologic evaluation. Tissue fixation was performed in 10% neutral buffered formalin for no less than 6 hours and no more than 72 hours."} +{"pid": "TCGA-BH-A204", "report": "A left breast biopsy and radical mastectomy with axillary lymph node dissection were performed. The surgical specimen included a tumor measuring approximately 4.0 cm, characterized by poor nuclear differentiation. Microscopic examination revealed multiple foci of in situ changes within the ducts. Evidence of vascular and perineural invasion was present, with involvement of skeletal muscle identified at the primary site. All resection margins were negative for malignant involvement. Of the sixteen lymph nodes retrieved from the axillary region, two contained abnormal tissue. One of these lymph nodes, measuring 2.5 cm, showed extensive replacement by tumor with extension beyond the lymph node capsule. Additional studies including hormone receptor analysis and molecular testing were performed."} +{"pid": "TCGA-44-7660", "report": "The surgical pathology report describes findings from a resection specimen and lymph node evaluations. The primary specimen, identified as a right upper lobe lobectomy, weighed 211 grams and measured 18.5 x 9.8 x 4.0 cm. Attached was a bronchial stump measuring 1.2 cm in length and up to 1.6 x 1.3 cm in diameter. Within the lung tissue, a moderately well-circumscribed mass measuring 3.5 x 2.9 x 2.8 cm was identified. It appeared tan-white to grey-black on sectioning and extended to within less than 0.1 cm of the inked pleural surface. No direct extension of the lesion into adjacent structures was observed. Histologic evaluation showed poorly differentiated cells. No vascular or lymphatic invasion was identified. Surgical margins were uninvolved.\n\nA total of nine lymph nodes were evaluated: five from the hilar region, three from an R4 lymph node aggregate, and one from a Level VII fragment. All lymph nodes showed no evidence of abnormal cellular infiltration or metastatic involvement. The submitted tissue included portions of both tumor and normal parenchyma for procurement purposes. The remaining lung tissue was uniformly tan-red without additional abnormalities. Specimen margins, including bronchial stump, vascular margins, and areas adjacent to the tumor, were all unremarkable. Random sections from normal parenchyma also showed no significant findings."} +{"pid": "TCGA-85-8288", "report": "Specimen consists of lung tissue obtained via pulmonectomy. The tumor measured 3 x 2 x 2 cm and was located in the right middle lobe. Microscopic examination revealed malignant cells arranged in nests with areas of necrosis and increased nuclear atypia. The tumor demonstrated infiltration into surrounding lung parenchyma. Evaluation of lymph nodes showed that 3 out of 6 lymph nodes were positive for malignant involvement, all located within the intrathoracic region. No vascular or lymphatic invasion could be confirmed due to insufficient data. Surgical margins could not be assessed with certainty. There was no evidence of prior neo-adjuvant treatment. Other pathologic findings were unremarkable."} +{"pid": "TCGA-AA-3673", "report": "The ileocolic resection specimen shows a moderately differentiated epithelial neoplasm of the colorectal type located in the transverse colon, measuring 6.5 cm from the aboral resection margin. The lesion demonstrates central ulceration and early infiltration into the pericolic fatty tissue, with a maximum infiltration depth of less than 1 mm observed in the histological section. No involvement is noted in the regional lymph nodes, with all 41 examined lymph nodes showing no evidence of tumor. The resection margins of the small intestine, colon, mesentery, appendix, and omental fat are all free of tumor. Additionally, a retention polyp is identified in the colonic mucosa. Histological grade is G2, with no vascular or lymphatic invasion identified (V0), and all margins are tumor-free (R0)."} +{"pid": "TCGA-UW-A7GL", "report": "A radical nephrectomy specimen from the left side was received, including the adrenal gland and perinephric fat. The kidney had a nodular appearance with a large, firm mass located in the upper pole. The tumor measured 8 cm in greatest dimension and was described as lobulated, tan, and pink with a glistening cut surface. No necrosis, hemorrhage, cysts, or calcifications were identified. The tumor appeared well-circumscribed and was primarily confined within the kidney, though it extended beyond the normal renal parenchyma in the upper pole. There was a possible breach of the tumor capsule on the posterior aspect.\n\nHistologically, the tumor exhibited nuclear features corresponding to grade 3 of 4. No angiolymphatic or perineural invasion was observed. Microscopic evaluation confirmed that the tumor did not extend into the perirenal adipose tissue, Gerota\u2019s fascia, renal vein, ureter, or any other adjacent structures. All surgical margins, including those of the renal artery, renal vein, ureter, and perirenal adipose tissue, were free of tumor involvement. The adrenal gland showed no evidence of tumor.\n\nLymph nodes were not identified in the hilar region. Staging was determined as pT2 pNX pMX. The renal parenchyma away from the tumor showed a preserved architecture with an expanded cortex and distinct cortical-medullary junction. No other significant findings were noted."} +{"pid": "TCGA-XF-AAN3", "report": "A radical cystoprostatectomy with lymph node dissection and continent urinary reservoir was performed. A right ureter specimen, measuring 0.3 cm in length and 0.7 cm in diameter, showed no abnormal findings. A left distal ureter specimen, measuring 0.3 cm in length and 0.6 cm in diameter, also showed no abnormal findings. The apical urethral margin was unremarkable.\n\nThe bladder and prostate specimen measured 15 x 11 x 6 cm overall. The posterior surface of the specimen was covered by peritoneum measuring 11 x 11.5 x 0.1 cm, with a tan, firm, polypoid nodule measuring 2.5 x 1.3 x 0.7 cm noted in the lower portion of the retrovesical region. The bladder measured 7 x 6.5 x 4.5 cm and contained an ulcerated exophytic tan-brown mass on the posterior wall and dome, measuring 6.5 x 5.5 x 2 cm. The tumor extended through the entire bladder wall into perivesical fatty tissue, reaching the peritoneal surface with a depth of invasion approximately 2 cm. The remaining bladder mucosa exhibited erythematous nodules ranging from 0.3 to 0.6 cm. The uninvolved bladder wall measured 0.9 cm in thickness, while the involved wall measured 2 cm. Both ureterovesical junctions were patent. The prostate measured 4.5 x 3.5 x 3.4 cm and showed no gross evidence of malignancy.\n\nMicroscopic evaluation of the bladder revealed poorly differentiated carcinoma involving the full thickness of the bladder wall, extending into perivesical soft tissue and subserosa of the peritoneum. Sections of the prostate demonstrated a unilateral focus of moderate to poorly differentiated adenocarcinoma, Gleason's score 7 (4+3), confined within the prostatic parenchyma without capsular or periprostatic soft tissue involvement. Resection margins were free of involvement.\n\nLymph node assessment included the following: one perivesical lymph node was negative; one lymph node from the left Cloquet region was negative; four left external iliac lymph nodes were negative; seven left obturator lymph nodes included one positive for metastatic involvement measuring 0.5 cm; one left hypogastric lymph node was negative; two left common iliac lymph nodes were negative; five right hypogastric lymph nodes were negative; twelve right obturator lymph nodes included one positive for metastatic involvement measuring 0.3 cm; two right common iliac lymph nodes were negative; one right presciatic lymph node was negative; and two lymph nodes at the aortic bifurcation were negative. In total, 2 of 36 lymph nodes examined showed evidence of metastatic involvement.\n\nPathologic staging was determined as pT3bN2MX for the bladder and pT2aNOMX for the prostate according to AJCC 1997 criteria."} +{"pid": "TCGA-MH-A857", "report": "The surgical pathology report includes three specimen components. Component A, a small tissue fragment measuring 1.2 x 0.4 x 0.3 cm, was submitted in entirety for analysis; frozen and permanent sections showed no abnormal cellular proliferation. Component B consists of an aggregate of fatty soft tissue weighing 173 grams and measuring 11.2 x 6.5 x 3.2 cm, with a smooth glistening surface and unremarkable tan-yellow cut surface; no distinct lesions were identified, and representative sections were submitted. Component C is a partial nephrectomy specimen weighing 54.7 grams and measuring 5.5 x 5.2 x 3.8 cm, with a variegated tan-yellow to brown and red mass identified within the kidney. The mass measured 4.6 x 3.8 x 3.2 cm grossly and was located less than 1 mm from the renal resection margin and 0.4 cm from the overlying Gerota's fascia/capsular margin. Microscopic evaluation of the majority of the lesion, including margins, was performed.\n\nMicroscopic findings from the resected kidney revealed two distinct morphologies. The first exhibited papillary architecture with nuclear features consistent with intermediate grade (Grade 2) differentiation. The second component displayed cells with clear cytoplasm, perinuclear halos, and irregular nuclear contours. No sarcomatoid features or vascular invasion were identified. Necrosis was present in one focus. Both tumor types were confined within the kidney and did not involve the resection margins. The closest distance of tumor to the capsular margin was 1 mm for one morphology and 1 mm from the renal parenchymal margin for the other. Staging for both morphologies was pT1, pNX, pMX. Immunohistochemical stains were performed and supported the histologic findings. All margins were free of invasive disease."} +{"pid": "TCGA-CJ-4888", "report": "The left kidney specimen measured 17.0 x 16.0 x 6.0 cm and was part of a radical nephrectomy. Within the middle pole, a mass measuring 5.8 x 5.0 x 5.0 cm was identified. The mass had a variegated yellow-tan appearance with areas of hemorrhage and collagenous change. It was located 0.5 cm from the nearest pelvis and showed focal infiltration into the perirenal adipose tissue. The lesion extended through the renal parenchyma, forming multiple nodules ranging from 0.3 to 1.5 cm in size. This larger lesion also showed focal involvement of the renal sinus. A second distinct lesion measuring 1.1 x 1.1 x 1.0 cm was found in the upper pole, approximately 3.5 cm above the first mass. It had a yellow, homogeneous appearance and was located in the cortex, 1.3 cm from the nearest sinus/calyces. No tumor was identified in the renal vein, and the ureteral, renal artery, and renal vein margins were free of involvement. The second tumor showed histologic features distinct from the first and exhibited lower nuclear grade characteristics. Deeper sections from multiple blocks confirmed these findings. The remaining renal parenchyma and renal pelvis appeared unremarkable. Multiple sections (A1\u2013A25) were submitted for detailed microscopic evaluation, including representative samples of both tumors for potential electron microscopy and tumor banking."} +{"pid": "TCGA-CZ-4856", "report": "The surgical specimen consisted of a left kidney resected en bloc with ureter, renal veins, and artery. The specimen weighed 210.5 grams and measured 11.7 x 6.5 x 4.8 cm. A mass measuring 4.2 x 3.5 x 3.9 cm was identified in the lower pole. It appeared golden yellow and focally hemorrhagic, with a solid and encapsulated consistency. Grossly, the mass abutted the renal capsule but did not appear to invade into the perinephric fat. Distances from the tumor to the ureteral margin, nearest renal vein margin, and renal artery margin were 4.5 cm, 1.6 cm, and 2.6 cm, respectively.\n\nMicroscopic evaluation revealed that the lesion was confined within the kidney. Resection margins including soft tissue, renal vein, renal artery, and ureter were all free of involvement. No lymphovascular invasion was observed. Four regional lymph nodes were examined and none contained evidence of tumor.\n\nThe non-neoplastic kidney parenchyma contained up to 196 glomeruli, of which 8 were globally sclerosed (approximately 4%). The preserved glomeruli exhibited normal cellularity with minimal mesangial expansion. Tubules were generally well-preserved with occasional mild distention and presence of hyaline casts. Interstitial fibrosis was minimal with rare mononuclear inflammatory cells. Less than 5% of the cortical sample showed tubular atrophy and interstitial fibrosis on trichrome staining. Arteries and arterioles demonstrated mild to moderate wall sclerosis with focal hyalinosis and mild signs of vasoconstriction.\n\nCytogenetic analysis demonstrated clonal chromosomal aberrations including deletion of the short arm of chromosome 3, consistent with characteristic findings seen in certain renal neoplasms. Chromosome studies were conducted at a resolution of 400 bands or greater using GTG banding techniques. All analyzable metaphases displayed abnormal karyotypes.\n\nRepresentative sections of the mass were submitted for additional studies including tissue banking, cytogenetics, and electron microscopy. Normal renal cortex was also preserved for future immunofluorescence and ultrastructural studies. Photographs were taken for documentation."} +{"pid": "TCGA-AA-3949", "report": "The specimen consists of a right hemicolectomy with an ulcerated lesion identified 0.5 cm aborally to Bauhin\u2019s valve. The lesion measures 5 cm in length and circumferentially involves the intestinal wall. Histologically, the lesion shows poor differentiation with partial mucinous features. The invasive component extends through all layers of the intestinal wall, reaching into the adjacent mesocolic fat and subserosal level. No tumor involvement is observed at either the oral or aboral resection margins. Examination of lymph nodes reveals metastatic involvement in three out of nineteen nodes, without extracapsular extension. Vascular invasion is present; however, there is no evidence of residual tumor at the resection margin."} +{"pid": "TCGA-B6-A1KI", "report": "Surgical pathology report for a right breast specimen and sentinel lymph node. The sentinel lymph node, measuring 2 x 1.5 x 1 cm, was negative on cytokeratin immunohistochemical staining and showed no evidence of malignancy. The breast biopsy measured 10 x 8.5 x 3 cm and was inked with four colors to identify margins. On sectioning, the tissue showed lobulated adipose and fibrous strands, with increased fibrous density at the anterior margin. Multiple small hemorrhages were noted 1 cm from the red (superior) margin. Histologic evaluation revealed a Nottingham combined histologic score of 2, with individual scores of 2 for tubule formation, 2 for nuclear pleomorphism, and 1 for mitotic rate. The invasive component measured 1.6 cm and was not clearly visible on gross examination. No lymphatic or vascular invasion was identified, and there was no multifocality. In-situ carcinoma of solid type was present, with a nuclear grade of 1, and without necrosis. The in-situ component did not extend beyond the invasive tumor. Non-neoplastic changes included ductal hyperplasia of usual type, apocrine metaplasia, and columnar cell change. Microcalcifications were not present. Surgical margins were evaluated, and the invasive component was found to be less than 0.5 mm from the superior margin. Hormone receptor and HER2/neu status are pending. A separate report will be issued for those results."} +{"pid": "TCGA-97-8171", "report": "A mutation analysis was conducted on tissue samples, with a focus on the EGFR tyrosine kinase domain. The sample demonstrated 70% tumor cellularity, which is above the recommended threshold of 40% for reliable mutation detection. A deletion mutation (E746_A750del5) in exon 19 was identified. This type of mutation has been associated with responsiveness to tyrosine kinase inhibitor therapies in certain clinical contexts. The assay used evaluates exons 18 through 21, where the majority of clinically relevant mutations are expected to occur. Mutations present in less than 10\u201320% of the DNA may not be reliably detected.\n\nThe analysis was performed using polymerase chain reaction (PCR) amplification followed by bidirectional direct sequencing using capillary gel electrophoresis and fluorescence detection. There is potential for false positive or negative results due to genetic variants or heterogeneity within the tissue sample.\n\nEleven tissue specimens were examined, including biopsies from the pleura, mediastinal pleura, diaphragmatic pleura, and right upper and middle lobes of the lung, as well as lymph nodes from multiple stations. Histologic evaluation revealed malignant cells with acinar and papillary patterns across several biopsy sites. In some cases, differentiation from reactive mesothelial proliferation was challenging, but immunohistochemical staining supported the presence of malignant cells. Tumor involvement was confirmed in several lymph nodes, including levels 4, 7, 10, and 12, with extranodal extension noted.\n\nThe primary lesion in the lung measured 4.5 cm in greatest dimension and was moderately differentiated. It involved both the upper and middle lobes, exhibited visceral pleural invasion, and had associated lymphovascular invasion. Resection margins were free of tumor involvement. A total of 21 lymph nodes were examined, with 7 showing evidence of metastasis.\n\nAdditional findings included respiratory bronchiolitis and emphysema in non-tumor lung tissue. Intraoperative frozen section analysis was performed on multiple biopsies and the resected lobe, with initial impressions of malignancy in the lung lobe and uncertainty regarding reactive changes in the pleural biopsies.\n\nThe patient had a history of chronic obstructive pulmonary disease and presented with a right lung mass. Specimen integrity was intact, and all relevant margins and lymph nodes were submitted for evaluation. Multiple sections were taken from each specimen to ensure comprehensive sampling.\n\nThis test has been developed and validated for use in clinical settings, though it is not intended to be used in isolation. It should be interpreted alongside other diagnostic tests and clinical data when making treatment decisions. The laboratory performing the test is certified to conduct high-complexity testing under applicable regulations."} +{"pid": "TCGA-L5-A43M", "report": "A portion of distal esophagus measuring 6.2 cm in length and a proximal stomach cuff measuring 11 x 3.5 x 1.1 cm were received. The adventitia appears red-tan and unremarkable. The esophageal mucosa is gray-tan with normal folds. At the gastroesophageal junction, a focal area of granular tissue is present. Underlying this region, an ill-defined lesion measuring 7.2 x 1.3 x 0.3 cm is identified at the cardia of the stomach. There is possible extension into the adjacent esophagus. The lesion is located 5.5 cm from the proximal margin and 1.8 cm from the distal margin. It has a tan-gray, granular appearance and extends to a maximum depth of 0.7 cm, reaching into paraesophageal fat. The distal margin is marked with blue ink, and the adventitia with black ink.\n\nMultiple lymph nodes are identified, with sizes up to 1.2 cm. Four out of eight lymph nodes show evidence of involvement. No distant metastasis was confirmed. The proximal and distal margins were evaluated by frozen section and found to be negative. A separate specimen from the cervical esophageal margin, measuring 1.2 x 2.2 cm, shows submucosal hemorrhage but no other abnormalities. This margin was also found to be negative.\n\nThe lesion is classified as T3 N2 based on depth of invasion and lymph node involvement. The depth of invasion includes extension into periesophageal adipose tissue. Lymph node evaluation confirms nodal metastasis. The procedure included distal esophagectomy and resection of the proximal stomach. A new cervical esophageal margin was also obtained and found to be free of disease. All findings were confirmed on permanent sections and discussed with the attending pathologist."} +{"pid": "TCGA-GC-A3WC", "report": "VUID:91347009-C0A1-4BB1-8445-D008769859AF. The specimen was received in three containers labeled with the patient\u2019s name. Container A, labeled \u201cright ureter,\u201d contained a 0.4 cm length by 0.4 cm diameter cylindrical segment of pink-tan soft tissue consistent with ureter. The entire specimen was submitted for frozen section and then resubmitted for permanent section. Container B, labeled \u201cleft ureter, clip on distal end,\u201d contained a similar 0.4 cm length by 0.4 cm diameter cylindrical segment with adherent fibroadipose tissue. A clip denoted the distal end. The specimen was also entirely submitted for frozen and then permanent section. Container C, labeled \u201cbladder and pelvic lymph nodes,\u201d contained a cystectomy specimen measuring 10.0 x 7.0 x 4.5 cm. It included a bladder (6.0 x 6.0 x 4.0 cm), right ureter (4.5 cm long by 0.3 cm diameter), left ureter (5.5 cm long by 0.3 cm diameter), associated pericystic fat, and a portion of vaginal mucosa (6.0 x 3.0 cm). The vaginal mucosa appeared purple-pink, glistening, and erythematous without discrete lesions. An amputated and inked urethral margin was radially sectioned, revealing a 5.3 x 2.2 x 0.5 cm pink-tan, fungating, friable, ulcerated mass involving the right lateral wall. This mass approached within 4.0 cm of the urethral margin, 0.6 cm of the right ureteral orifice, and 2.5 cm of the left ureteral orifice. On sectioning, the mass invaded 1.8 cm through the detrusor muscle and approached to within 0.2 cm of the inked deep margin. The remainder of the mucosa was unremarkable. No lymph nodes were identified within the perivesical fat. Also present was a 4.5 x 3.0 x 1.0 cm aggregate of yellow-tan fibrofatty tissue; two firm possible lymph nodes measuring 1.0 and 2.0 cm were identified on palpation. Sections were submitted for microscopic evaluation. Microscopic examination revealed no tumor in the cross sections of both ureters. In the bladder specimen, histologic analysis showed completely negative surgical margins including those of the ureters, urethra, and deep soft tissue. A total of two lymph nodes were examined, none containing metastatic disease. Focal urothelial dysplasia was noted. The histologic grade was poorly differentiated. The tumor measured 5.3 x 2.2 x 0.5 cm and demonstrated full penetration through the muscularis propria into surrounding adipose tissue. Lymphovascular space invasion was present."} +{"pid": "TCGA-DC-6682", "report": "The specimen consists of a segment of colon and upper rectum measuring 19.0 x 7.5 cm. A lesion is identified 12.5 cm from the proximal margin and 5.5 cm from the distal margin. The lesion measures 6.8 cm in length and 8.5 cm in width. Histologically, the lesion demonstrates moderately differentiated cellular features. Invasion extends through the muscularis propria into surrounding soft tissue, with a depth of invasion measuring 0.9 cm. The radial margin is at a distance of 4.5 cm from the closest resection margin. No tumor budding or increased inflammatory cell infiltration is observed. Adjacent mucosa shows no dysplastic changes or additional lesions.\n\nA precursor lesion consistent with tubular morphology is identified near the lesion. No lymphovascular, venous, or perineural invasion is detected. Gross evaluation does not reveal any perforation.\n\nMargins of resection are free of abnormal cells. Twenty-four lymph nodes are evaluated; none show involvement. No tumor deposits are identified in adjacent soft tissues.\n\nAdditional specimens include hernia contents composed of benign fibroadipose tissue, a portion of omentum showing mature adipose tissue, and two lymph nodes from the base of a major vascular structure, all of which are unremarkable. Proximal and distal margins each consist of benign colonic tissue.\n\nThe lesion is staged according to established criteria as pT3 (extension into surrounding soft tissue) and NO (no lymph node involvement)."} +{"pid": "TCGA-VQ-A8PS", "report": "The surgical specimen includes a gastric stump from a total gastrectomy procedure. The esophageal margin, evaluated at the stapler line, is free of abnormal cellular infiltration. The gallbladder, significantly affected by postmortem changes, does not show any evidence of pathological alteration. Hepatogastric ligament tissue also shows no signs of involvement.\n\nThe primary specimen reveals a moderately differentiated intestinal-type lesion involving the gastric stump, adjacent adipose tissue, and extending through the full thickness of the small intestinal wall. There is clear evidence of peritoneal and lymphatic invasion. No venous or perineural patterns of spread are identified. A moderate desmoplastic response is present within the stroma, with mild inflammatory cell infiltration noted inside the affected region. Both proximal and distal resection margins are clear of any abnormal cells.\n\nIn the D1 lymphadenectomy specimens: a single right paracardial lymph node shows presence of secondary involvement with transgression of the capsule. Left paracardial nodes (0 out of 3), lesser curvature nodes (0 out of 3), and celiac trunk nodes (0 out of 3) do not display any abnormal cellular accumulation. At the left gastric artery lymph node level, one site shows involvement in the surrounding fat, while the single lymph node examined is unremarkable. Non-involved mucosal areas demonstrate features consistent with reactive gastritis."} +{"pid": "TCGA-DX-AB2F", "report": "The submitted specimen consists of a large retroperitoneal mass along with associated tissues. The mass measures 27.0 x 27.0 x 13.0 cm and is described as rubbery and encapsulated, with areas of gray-tan fibromembranous tissue and yellow-tan lobulated adipose regions. The mass is adhered to the renal capsule, adrenal gland, and subserosal fat of the colon. A thin fibrous membrane covers the tumor, which may represent a margin. The dedifferentiated component is predominant, showing high-grade morphology. Necrosis is present in 20\u201330% of the sample. \n\nA portion of spleen measuring 10.8 x 5.9 x 3.1 cm is present, with unremarkable findings. A segment of large bowel, 15.5 cm in length and 2.7 cm in diameter, is attached, with no significant mucosal abnormalities. The wall thickness averages 0.4 cm. A kidney measuring 9.0 x 6.1 x 4.3 cm is present, with an unremarkable corticomedullary junction and cortex approximately 0.7 cm thick. The ureter is 18.0 cm long with a diameter of 0.6 cm. An adrenal gland measuring 3.0 x 2.4 x 1.0 cm is also present. A small segment of pancreatic tissue, yellow-tan and lobulated, measures 2.9 x 1.8 x 0.9 cm and shows no remarkable features. One lymph node is present and appears benign. Multiple sections were taken from various tissue interfaces for further analysis."} +{"pid": "TCGA-AR-A1AK", "report": "A right simple mastectomy specimen demonstrates multiple masses ranging from 0.7 cm to 1.6 cm in greatest dimension, located in the lower inner quadrant, inferior central region, upper outer quadrant, and at the 12 o\u2019clock position. Histologic evaluation reveals Nottingham grade II neoplasm with predominantly lobular morphology. A minor component of ductal carcinoma in situ, intermediate nuclear grade, is present, accounting for approximately 5% of the lesion. No angiolymphatic invasion is observed. The tumor approaches the original inferior margin closely at 0.1 cm. All surgical margins, including skin and nipple, following re-excision are free of malignant involvement. Five right axillary sentinel lymph nodes are identified and show no evidence of metastatic disease. Blue dye is visualized in all sentinel lymph nodes. Immunohistochemical staining using cytokeratin on paraffin-embedded lymph node tissue corroborates the H&E findings. HER2/neu immunostaining yields a score of 1+, indicating absence of protein overexpression based on established criteria."} +{"pid": "TCGA-TS-A7OZ", "report": "The specimen consisted of 13 tissue components. Specimen #1, a skin ellipse measuring 5.1 x 1.0 cm with a linear scar, was excised to a depth of 2.1 cm and submitted for frozen section; no tumor was identified. Specimen #2, a chest wall fatty mass weighing 40 grams, measured 7.1 x 6.1 x 4.0 cm and showed tan yellow, lobulated cut surfaces. Specimen #3 included three portions of bone ranging from 5.5 to 6.5 cm in length and averaging 1.8 cm in diameter, each with attached soft tissue; no lesions were observed. Specimen #4 contained multiple fragments measuring 0.2 to 0.9 cm, submitted entirely. Specimen #5 consisted of two nodular fragments measuring 1.5 and 2.0 cm. Specimen #6, an irregular tissue fragment measuring 7.5 x 3.5 x 2.0 cm, displayed multiple indurated nodules ranging from 0.6 to 0.9 cm. Specimen #7 included multiple soft tissue fragments up to 8.5 cm in size with coalescing nodules measuring up to 4.5 cm. Specimen #8 had three fragments ranging from 1.2 to 2.8 cm. Specimen #9 included two fragments measuring 0.3 and 2.5 cm. Specimen #10 was a 0.9 x 0.5 x 0.3 cm fragment. Specimen #11 contained two fragments measuring 0.9 and 1.4 cm. Specimen #12, the largest component, measured 17.2 x 16.4 x 7.0 cm and included multiple fragments with widespread indurated nodules ranging from 0.2 to 7.5 cm. Specimen #13 was a 1.2 cm nodular fragment. Lymph node involvement was noted in one site, while all others showed no evidence of tumor. Stromal changes were present but considered reactive. Tissue staining demonstrated specific characteristics consistent with prior findings."} +{"pid": "TCGA-ER-A196", "report": "A wide local excision specimen from the left foot demonstrated a lesion with ulceration. Histologic evaluation showed a maximum thickness of 22 mm, corresponding to Clark level IV. The lateral and deep margins were free of tumor. There was no evidence of angiolymphatic invasion. Perineural invasion could not be excluded as there was possible involvement seen. No tumor-infiltrating lymphocytes were identified, and there was no preexisting nevus component. Microscopic satellites were absent. The surface ulceration involved less than 50% of the lesion. Gross measurement of the lesion showed a maximum surface diameter of 66 mm. Immunostains including HMB-45, S100, Melan-A, CD58, and tyrosinase were performed on multiple lymph node specimens and showed no evidence of metastatic cells.\n\nFive sentinel lymph nodes were examined: four from the left groin and one from the left popliteal region. All lymph nodes were negative for tumor involvement. No extracapsular spread was identified. Staging revealed a pathologic T stage of pT4b, N stage of pN0, and M stage of pMX. The mitotic rate was 10 per 10 high-power fields. Vascularity was not increased or focally increased. There was no evidence of regression in the lesion. No family history of melanoma or dysplastic nevi was provided."} +{"pid": "TCGA-AG-A020", "report": "The specimen shows a medium-differentiated mucinous tumor with transmural infiltration involving all layers of the wall (pT3). There is evidence of lymphovascular invasion (L1). One involved lymph node was been identified out of twelve examined (pN1). Resection margins are clear in the mucosal region, and the ligature area is free of tumor involvement."} +{"pid": "TCGA-A3-3319", "report": "The left kidney specimen, including attached perinephric fat, measured 21 x 15 x 8 cm and weighed 930 g. After removal of fat, the kidney measured 11 x 7 x 5 cm and weighed 184 g. Gross examination revealed multiple cortical cysts up to 4.5 cm in size and a solid oval mass measuring 6.0 x 3.0 x 2.5 cm. The mass was golden yellow with focal hemorrhage and bulged against the renal capsule without gross adherence. Histologically, the mass demonstrated clear cell morphology with Fuhrman nuclear grade 2 features. The tumor was confined to the kidney without involvement of the renal sinus, vein, or ureter. Resection margins were free of invasive disease. Venous invasion was present; lymphatic invasion was not identified.\n\nSections of the renal cortex averaged 0.8 cm in thickness. A random section of kidney tissue was submitted for evaluation, along with sections from the cortical cysts. No discrete lesions were identified in the spleen, which weighed 209 g and measured 10.0 x 7.0 x 5.5 cm. Approximately 5% of the splenic capsule was disrupted, with fresh hemorrhage noted. No tumor involvement was found in the spleen.\n\nThe adrenal gland specimen included a portion measuring 6.0 x 2.5 x 1.0 cm and an additional fragment measuring 2.0 cm. Sections showed mild nodular cortical hyperplasia without evidence of malignancy. No discrete masses were observed in either adrenal specimen.\n\nAdditional findings included moderate arterial and arteriolonephrosclerosis. Pathologic staging was determined as pT1b with no assessment possible for lymph nodes or distant metastases."} +{"pid": "TCGA-B6-A0I5", "report": "Female breast, right. A mass was identified in the right breast, characterized by multifocal intraductal and infiltrating growth patterns. The cells are described as moderately differentiated with a nuclear grade that is moderate. Tumor measurements indicate the lesion extends to within 0.1mm of the surgical margin. The histological grade is intermediate (grade 2/3). No specific diagnosis name is included in this summary."} +{"pid": "TCGA-55-6978", "report": "The surgical pathology report describes a specimen from a right lung double lobectomy with intraoperative consultation. The tumor was located in the middle lobe and measured 5.5 x 5.0 cm grossly. It was unifocal and classified as a non-small cell carcinoma based on histology, though immunophenotyping was pending at the time of reporting. Histologic grade was G3, indicating poor differentiation. There was no visceral pleural invasion; however, the tumor extended into the fissure. The bronchial margin was negative for tumor involvement, located 2.5 cm from the lesion, and there was no evidence of squamous cell carcinoma in situ. All vascular, parenchymal, and parietal pleural margins were free of tumor involvement.\n\nTumor-associated pneumonia and fibrosis were noted. Lymphovascular invasion could not be definitively determined but was suspected to be present based on findings in block 4. Twelve lymph nodes were evaluated, including those from the inferior pulmonary ligament, periesophageal, subcarinal, paratracheal, and proximal regions. No metastatic involvement was identified in these nodes.\n\nThe pathologic stage was reported as pT2bN0Mx. Immunohistochemical staining showed positivity for TTF-1 in a patchy nuclear pattern, while markers such as p63, CK5/6, uroplakin, CK7, and CK20 were negative. These findings supported a pulmonary origin for the neoplasm and suggested it was more likely a poorly differentiated adenocarcinoma. A separate addendum was indicated for further clarification once immunostains were completed."} +{"pid": "TCGA-06-0173", "report": "The brain biopsy specimen consists of multiple tissue fragments measuring 0.6 to 1.0 cm. The intraoperative frozen section evaluation identified a glioma. Microscopic examination reveals a high-grade glial neoplasm characterized by increased cellularity, nuclear and cytoplasmic variability, frequent mitotic figures, and areas of vascular proliferation with thrombosis. Necrotic regions are also present. Immunohistochemical staining for MIB-1 demonstrates a labeling index of approximately 30%."} +{"pid": "TCGA-DD-A119", "report": "The right lobe of the liver measured 27.5 x 19.5 x 12.5 cm and weighed 2,680 grams. A large mass measuring 16 x 15 x 13 cm was identified, along with multiple satellite nodules ranging from 0.5 cm to 6 cm. The hepatic capsule was involved, and the surgical margins were grossly affected. Microscopic examination revealed vascular invasion involving the portal veins. The tumor showed a partially infiltrating growth pattern. A single periportal lymph node was free of tumor involvement.\n\nThe right adrenal gland, weighing 5.82 grams and measuring 6 x 3.7 x 1.5 cm, contained two distinct masses, measuring 1.4 x 1.3 x 1.1 cm and 0.4 x 0.3 x 0.3 cm. These exhibited similar cellular features to those seen in the liver lesion.\n\nThe gallbladder measured 8.0 x 3.5 x 2.8 cm and showed histological evidence of chronic inflammation with cholesterolosis, but no abnormal cellular proliferation was found.\n\nPeritoneal biopsies (No.1 and No.2, each 3 mm) and lymph nodes from the cystic duct and pericholedochal regions (measuring 0.6 x 0.5 x 0.4 cm and 2.0 x 1.0 x 0.8 cm respectively) did not show any atypical cells or suspicious features.\n\nThe non-neoplastic liver tissue was non-cirrhotic and demonstrated changes likely due to local mass effect rather than intrinsic disease; no unusual hepatocyte morphology was observed."} +{"pid": "TCGA-B0-5113", "report": "The specimen consists of a right radical nephrectomy. A neoplastic lesion is identified in the upper pole of the kidney, measuring 13.7 cm in greatest dimension. Microscopic evaluation reveals that the lesion is predominantly localized to the upper pole with extension into the perirenal soft tissue. Nuclear grading according to Fuhrman classification is grade 2 out of 4. No evidence of angiolymphatic invasion is observed. The adrenal gland is present and shows no involvement by the lesion. Staging is classified as T3a with no regional lymph node metastasis (N0) and no distant metastasis (MX). The remaining renal tissue shows mild chronic interstitial inflammation. Evaluation of lymph nodes, including three perihilar nodes, reveals no tumor involvement."} +{"pid": "TCGA-14-1453", "report": "The brain tissue specimens were obtained from the left parietal region. Two specimens were received. Specimen #1 was collected fresh for intraoperative consultation and measured 1.0 x 0.7 x 0.5 cm. It consisted of tan-colored tissue, and a representative section was submitted for frozen diagnosis. The remaining portion was processed for further analysis. Specimen #2 was received in formalin and measured 2.9 x 2.5 x 1.0 cm. It contained a hemorrhagic mass measuring 2.5 x 1.3 x 1.0 cm, and representative sections were submitted for histologic evaluation.\n\nMicroscopic examination revealed a highly cellular and anaplastic lesion with areas showing giant cell morphology. There was evidence of necrosis, microvascular proliferation, and increased mitotic activity. These findings were consistent with a high-grade neoplastic process involving the brain parenchyma."} +{"pid": "TCGA-F4-6856", "report": "The submitted specimen from a right hemicolectomy procedure involves tissue from the large intestine. The tumor was located in the cecum and measured 6.5 x 7 x 5 cm. Microscopic evaluation revealed a mucinous histologic pattern with moderately differentiated cellular features. The tumor extended to the subserosal layer. No information is available regarding lymph node involvement, surgical margins, evidence of neoadjuvant treatment, or additional pathologic findings."} +{"pid": "TCGA-QK-A8Z9", "report": "The surgical specimen included a composite resection of the anterior mandible with involvement of the floor of the mouth, ventral tongue, lower lip, mental skin, and bilateral 1A/1B lymph nodes. The primary lesion measured 5.7 cm in greatest dimension and was characterized by an ulcerated appearance. Microscopic evaluation revealed invasion into the lower lip, floor of the mouth, mandible, facial skin, and tongue. Histologic analysis showed features consistent with moderately differentiated morphology. All surgical margins were free of invasive disease.\n\nPerineural invasion was identified. Lymph node involvement was present in one right level 1B lymph node out of ten examined (1/10), with a metastatic deposit measuring 2.5 mm. No extranodal extension was observed in this node. In contrast, the right level 4 lymph node group showed metastatic involvement in one out of seven nodes (1/7), with a larger metastatic focus measuring 6.0 mm and associated extranodal extension.\n\nThe total number of regional lymph nodes examined was 82, with two demonstrating involvement. Pathologic staging was assigned as pT4a due to local invasion through cortical bone and into adjacent structures such as the inferior alveolar nerve, floor of the mouth, and facial skin. Regional lymph node involvement was classified as pN2b, indicating multiple ipsilateral metastases none exceeding 6 cm in size.\n\nAdditional findings included abundant filamentous organisms suggestive of Actinomyces within the mandibular bone, accompanied by osteonecrosis. Evaluation of other submitted specimens, including segments of the inferior alveolar nerve, demonstrated no evidence of tumor involvement.\n\nThe overall specimen was received intact, measured up to 9.9 cm in greatest dimension, and included bilateral anatomical components. Frozen section analysis during surgery confirmed negative margins for invasive disease at multiple sites, including mucosal and skin shave margins, as well as nerve margins."} +{"pid": "TCGA-KN-8425", "report": "The specimen consists of a left radical nephrectomy measuring 23.0 x 12.8 x 6.0 cm and weighing 586 grams. It includes the left kidney (measuring 13.5 x 9.0 x 4.8 cm), a left adrenal gland (3.5 x 2.0 x 3.0 cm), attached adipose tissue, and a patch of Gerota\u2019s fascia measuring 33.5 x 3.5 cm, which has been inked blue. The ureter measures 7.2 cm in length with a diameter of 2.4 cm, the artery has a diameter of 1.5 cm, and the renal vein has a maximum diameter of 1.6 cm.\n\nUpon bivalving the specimen, a well-circumscribed, partially encapsulated mass was identified. It measured 6.0 x 0.7 x 2.5 cm and was located adjacent to the renal capsule without gross invasion. The closest black-inked margin was within 1.5 cm of the tumor. The mass was found to be 10.0 cm from the ureteral margin, 9.0 cm to the arterial margin, and 3.5 cm from the renal vein margin. Central focal necrosis was present, accounting for approximately 25% of the surface area. A calcified focus measuring 1.5 cm was noted, along with areas of hemorrhage within the upper pole. The remaining renal parenchyma appeared unremarkable with a distinct cortical-medullary junction and no additional lesions. The ureter and adrenal gland were also unremarkable macroscopically.\n\nMicroscopic evaluation of the tumor showed features consistent with Fuhrman nuclear grade II out of IV. Vascular, ureteral, and soft tissue margins were negative for tumor involvement. No lymphovascular invasion was identified. The surrounding renal parenchyma revealed mild tubular atrophy and interstitial fibrosis involving less than 5% of the sample. Tubules displayed mild variability and moderate hyaline casts in the distal segments. Glomeruli showed preserved architecture with no evidence of active cellular proliferation or inflammation. Arterioles demonstrated mild to moderate intimal sclerosis and subintimal hyalinosis. There was no evidence of an active glomerular inflammatory process or tubular injury.\n\nMultiple tissue blocks were submitted for analysis, including sections of the tumor, adjacent normal renal parenchyma, adrenal gland, vascular margins, and calcified regions of the mass. Some tissue was allocated for electron microscopy, cytogenetic studies, and tissue banking. All representative samples were processed accordingly."} +{"pid": "TCGA-DU-5847", "report": "The patient presented with a history of left upper extremity symptoms and a partial-generalized seizure. Imaging revealed a 2.5 cm lesion in the right posterior frontal region, partially involving the motor cortex, with a central enhancing zone. Three biopsies were obtained during surgery from different regions of the lesion.\n\nPathological examination of the specimens showed a highly cellular neoplastic proliferation of glial cells. The neoplastic cells were predominantly small astrocytic in appearance. Focal brisk mitotic activity was noted. Immunohistochemical staining demonstrated gliofibrillogenesis by the neoplastic cells, with a fascicular arrangement and focal gemistocytic morphology. A large proportion of the cells showed strong overexpression of p53 protein. CD163 staining revealed frequent phagocytic cells, while CD34 highlighted the vascularity of the tumor without significant microvascular proliferation. Sparse lymphocytic infiltration was observed on CD3 staining. The MIB-1 proliferation index was approximately 35%.\n\nMolecular testing did not detect the EGFR variant III mutation. However, methylation of the MGMT promoter was present. There was also evidence of allelic loss on chromosome arms 1p and 19q, assessed using multiple microsatellite markers including D1S548, D1S552, D19S219, and D19S412. The tumor exhibited high histological grade features based on its cellularity, mitotic activity, and proliferation index, suggesting an aggressive clinical course. No necrosis or microvascular proliferation was identified. The histological findings were consistent with a fibrillary astrocytic neoplasm, WHO grade III (of IV). The findings were provided for correlation with clinical, imaging, and molecular data to guide further management."} +{"pid": "TCGA-GL-A9DD", "report": "The operative procedure performed was a right robotic-assisted partial nephrectomy for a right renal mass. The specimen measured 3.7 \u00d7 3.0 \u00d7 2.7 cm and consisted of a partial nephrectomy specimen with minimal adherent perinephric fat. The tumor measured 2.4 \u00d7 2.3 \u00d7 2.3 cm and exhibited a variegated tan-red to orange appearance with marked hemorrhage. It was well-circumscribed, abutted the renal capsule, and came within 0.2 cm of the parenchymal margin. The surrounding renal tissue appeared tan and homogeneous without significant abnormalities.\n\nHistologic evaluation revealed a unifocal lesion with no sarcomatoid features identified. The tumor was confined to the kidney without evidence of perinephric fat invasion, renal sinus involvement, or vascular invasion. The Fuhrman nuclear grade was 2 of 4. Margins were free of tumor involvement. No hilar lymph nodes were identified. Based on the 2010 staging criteria, the tumor was classified as pT1a with no regional lymph node involvement (pNx) and no distant metastasis (pMx)."} +{"pid": "TCGA-N5-A4RM", "report": "The submitted specimens included a total hysterectomy with right salpingo-oophorectomy, along with multiple biopsies and lymph node excisions. The uterus showed tumor involvement with heterologous differentiation including rhabdomyoblasts. Myometrial invasion was equal to or less than 50%, with a depth of 6 mm in the area of maximal infiltration; the myometrium measured 15 mm thick at this location. Tumor nodules were observed on the anterior uterine serosa. No endocervical or lymphovascular invasion was identified. The endometrium exhibited atrophy, and the myometrium contained multiple leiomyomata. The right ovary and fallopian tube were removed as part of the surgical specimen.\n\nA biopsy of an omental nodule revealed metastatic involvement. A separate omentectomy specimen showed benign fibroadipose tissue. A left salpingo-oophorectomy specimen demonstrated a mucinous cystadenoma of the ovary and a benign fallopian tube. A biopsy of the left infundibulopelvic ligament revealed benign fibroadipose tissue.\n\nMetastatic involvement was identified in several locations: a cul-de-sac biopsy showed a serosal implant; a rectal implant biopsy revealed tumor presence; and a left periureteral biopsy also showed metastatic involvement.\n\nNumerous lymph nodes were assessed throughout the procedure. These included sentinel and non-sentinel nodes from the left common iliac, left external iliac, left hypogastric, left obturator, right obturator, right external iliac, right hypogastric, left para-aortic, right para-aortic, and right common iliac regions. All lymph nodes evaluated were negative for metastasis. Additional testing on deeper sections of the left sentinel common iliac lymph node, including immunohistochemical staining for cytokeratins (AE1:AE3), confirmed no evidence of metastatic involvement.\n\nOther findings included benign bladder mucosa identified in the hysterectomy specimen."} +{"pid": "TCGA-BH-A0BR", "report": "The surgical specimen consists of a segmental mastectomy with needle localization from the left breast, along with three biopsied lymph nodes from the left axilla\u2014two sentinel and one non-sentinel. All lymph nodes were negative for any abnormal cellular infiltration.\n\nThe primary lesion measured 1.1 cm in maximum dimension and displayed a Nottingham score of 6 out of 9, composed of tubule formation score 3, nuclear pleomorphism score 2, and mitotic activity score 1. The lesion was located closest to the inferior margin at a distance of 0.4 cm for the invasive component and 0.2 cm for the in situ component. All other surgical margins were free of any atypical cells.\n\nIn addition to the main lesion, there were foci of in situ disease separate from the invasive component, characterized by cribriform and solid growth patterns with comedo necrosis comprising approximately 10% of the total tumor volume. No prominent lymphovascular space involvement was identified.\n\nMicrocalcifications were present within both benign and malignant regions of the tissue. Background fibrocystic changes were noted, and no abnormalities were found in the overlying skin.\n\nHistologic evaluation of lymph nodes used hematoxylin and eosin staining. No metastatic cells were detected in the three lymph nodes examined, including both sentinel nodes. There was no evidence of dermal lymphatic invasion or skin ulceration.\n\nThe pathologic staging assigned was pT1c for the primary tumor, pN0 for regional lymph node involvement, and pMX for distant metastasis. Hormone receptor analysis demonstrated positivity for both estrogen and progesterone receptors. HER2/neu expression was scored as zero or 1+."} +{"pid": "TCGA-DJ-A3V7", "report": "The thyroid specimen weighed 32.5 grams and consisted of right and left lobes with an isthmus. The right lobe measured 4.5 x 3.5 x 2 cm, the left lobe 3.5 x 2.5 x 2 cm, and the isthmus 1.5 x 1 x 0.4 cm. A well-defined nodule measuring 0.6 cm in diameter was identified in the lower pole of the left lobe. An ill-defined lesion in the right lobe measured 2.2 x 1.8 x 1.5 cm, was firm in consistency, and abutted the thyroid capsule. The remainder of the thyroid parenchyma appeared beefy red.\n\nMicroscopic evaluation revealed multiple foci of small lesions in both lobes. In the left lobe, three distinct foci were identified measuring between 0.2 cm and 0.8 cm. In the right lobe, one focus measured 0.2 cm. One of these small lesions measured 0.8 cm and was located in the left lobe; it was noted to be within less than 0.5 mm of the cauterized surgical margin. No adenomatous changes were identified away from the primary lesion.\n\nHistologic features included the presence of psammoma bodies. Mitotic activity and tumor necrosis were not identified. Vascular invasion was present in a focal area. The lesion extended beyond the thyroid capsule into adjacent fibroadipose tissue. No lymph node metastases were found in the two perithyroidal lymph nodes examined. The non-neoplastic thyroid tissue showed changes consistent with nodular hyperplasia. A normocellular parathyroid gland was identified adjacent to the right lobe. All margins were evaluated microscopically."} +{"pid": "TCGA-BH-A0B6", "report": "The specimen consists of four lymph nodes from the left sentinel site, all without evidence of tumor involvement. A segmental mastectomy specimen from the left breast was examined. The primary lesion measured 1.5 x 1.2 x 1.1 cm and was identified as an invasive ductal adenocarcinoma with a Nottingham score of 6 (tubules 3, nuclei 2, mitosis 1), corresponding to a nuclear grade of 2. The invasive component approached the anterior resection margin by approximately 1.0 mm. Ductal carcinoma in situ (DCIS) of cribriform and solid types was also present, accounting for about 2% of the tumor volume. This DCIS was admixed with the invasive component and extended to within 1.0 mm of the nearest anterior margin. Additional findings included changes consistent with a prior biopsy, fibrocystic changes with fibroadenomatoid features, ductal epithelial hyperplasia, columnar cell changes, and multifocal benign microcalcifications. Immunohistochemical staining showed positivity for estrogen and progesterone receptors, while HER-2/neu staining was negative (score +1). No lymphovascular permeation was identified. The lymph node examination involved H/E staining; no positive nodes were found out of four examined. Pathologic staging was determined as pT1c, pN0, with no evidence of metastatic disease. Receptor status was positive for both estrogen and progesterone receptors."} +{"pid": "TCGA-HC-7747", "report": "The surgical specimen included right and left pelvic lymph nodes and a prostate gland. The lymph node specimen measured 6.0 x 4.0 x 2.0 cm and contained four identified lymph nodes ranging in size from 1.5 to 3.5 cm. All lymph nodes were negative for tumor involvement.\n\nThe prostate measured 4.5 x 3.0 x 2.8 cm and was submitted with attached bilateral adnexa. The gland showed focal cystic changes on sectioning, with no distinct mass identified. Histologic evaluation revealed infiltrating glandular neoplasia. The neoplasm involved approximately 25% of the gland. Histologic grading demonstrated a primary pattern of 3/5 and a secondary pattern of 4/5, resulting in a total Gleason score of 7/10. High-grade prostatic intraepithelial neoplasia was present, and perineural invasion was identified. No extraprostatic extension or seminal vesicle involvement was observed. Multiple inked surgical margins were positive for tumor, including the apex, right anterior, and right posterior regions. Lymphovascular invasion was not specified.\n\nThe pTNM staging classification was T2cN0M0, stage IIB."} +{"pid": "TCGA-UB-AA0U", "report": "A core needle biopsy of the left lateral segment of the liver showed a small fragment of atypical hepatic tissue. A partial hepatectomy specimen from the same area revealed multiple tumor nodules, with the largest measuring 4.1 cm. The tumor was present at the inked surgical margin and showed focal disruption of the surrounding capsule. Microscopic examination demonstrated nests and widened trabeculae of hepatoid cells with focal pseudoacinar and small cell features. No intratumoral bile was identified. Special stains and immunohistochemical markers were used to further characterize the lesion. Reticulin staining showed thickened hepatocyte plates within the tumor. The tumor cells were negative for mucicarmine, CK19, and synaptophysin, while showing positivity for arginase-1. Trichrome staining of adjacent non-tumorous liver tissue did not show significant fibrosis. Iron staining of the same area showed mild siderosis in hepatocytes. The background liver showed mild steatosis and rare swollen cells, but no ballooned hepatocytes or Mallory hyaline. The tumor was multifocal, with a total combined diameter of 6.0 cm, and was confined to the liver. Vascular invasion was not identified. Capsular disruption was noted, which may have been related to intraoperative biopsy. Surgical margins were positive, with tumor at the inked margin. Non-neoplastic liver changes included mild steatosis and mild siderosis. Lymph nodes were not submitted for evaluation. Based on these findings, staging was estimated as at least pT2NX, with possible upstaging to pT4NX if the capsular disruption represents extension beyond the visceral epithelium. Grossly, the resected liver specimen weighed 241 grams and measured 16 x 7 x 5 cm. The main mass was multilobulated, tan-brown, and abutted the capsular surface. Additional satellite nodules were present, with the closest being 0.6 cm from the cauterized margin. Multiple cassettes were submitted for microscopic analysis, including sections of the primary tumor, satellite nodules, and adjacent uninvolved liver. The patient had a history of a neck mass and underwent imaging that revealed a liver lesion. He had no known history of chronic liver disease, viral hepatitis, or excessive alcohol use. Clinical correlation is recommended, particularly regarding the extent of capsular involvement."} +{"pid": "TCGA-B3-4103", "report": "The specimen consists of a right kidney weighing 491 grams and measuring 10.5 x 8.5 x 4 cm, with attached ureter measuring 5.5 cm in length and averaging 0.4 cm in diameter. A moderate amount of perirenal adipose tissue is present, and no adrenal gland is identified within the superior perirenal fat. The renal capsule is delicate and separates easily from the underlying cortex. On sectioning, there is a well-circumscribed, spherical lesion measuring 3.7 cm located centrally near the hilum. The lesion has a soft tan-gold-red appearance and extends to within 0.1 cm of the inked capsular surface. Portions of both the lesion and normal parenchyma were submitted for tissue procurement. The remaining renal parenchyma is uniformly red-brown with a distinct cortical-medullary junction and a maximal cortical thickness of 1.5 cm. Multiple smooth-walled cortical cysts are present, with some measuring up to 1.5 cm in diameter. No other significant abnormalities are observed.\n\nHistologically, the lesion demonstrates nuclear features corresponding to grade 2 of 4. The tumor is entirely confined within the kidney without extension beyond the renal capsule. Resection margins, including vascular and ureteral margins, show no evidence of involvement. Lymph node and distant metastasis status cannot be assessed. There is no evidence of vascular invasion. The non-neoplastic kidney shows changes consistent with arteriolar nephrosclerosis and benign cortical cysts."} +{"pid": "TCGA-CN-5373", "report": "A surgical excision of a lesion from the floor of the mouth and base of the tongue was performed. The resected specimen measured 3.5 x 2.5 x 1.0 cm and included a 1.5 x 1.0 x 0.5 cm tan-gray ulcerated area located 0.3 cm from the superior margin and 0.1 cm from the deep aspect. A 3.0 x 1.0 cm area of leukoplakia was also noted. Margins from the right and left floor of the mouth, deep floor of the mouth, deep ventral tongue, and anterior floor of the mouth were all biopsied and showed no evidence of tumor involvement.\n\nMicroscopic evaluation revealed a well-differentiated squamous cell proliferation with deep invasion. There was evidence of perineural invasion and an extensive field effect with mild to moderate dysplasia. All surgical margins were free of tumor involvement. Staining for HPV and p16 was negative.\n\nA right neck dissection included 21 lymph nodes, all benign, and a submandibular gland without specific pathologic change. A left neck dissection included 9 lymph nodes, all benign, and one normocellular parathyroid gland. Molecular studies are pending and will be reported separately.\n\nThe histologic grade was well-differentiated. A total of 30 regional lymph nodes were examined, with none showing involvement. Vascular invasion was not identified, but perineural invasion was present. Additional findings included epithelial dysplasia. Multiple stains and tests were performed, including H&E, immunohistochemistry, and in situ hybridization assays. FISH studies for EGFR showed high polysomy, while c-MET FISH studies were negative for amplification.\n\nThe case was reviewed in its entirety, including all submitted materials, and the findings were confirmed."} +{"pid": "TCGA-B5-A3S1", "report": "A simple hysterectomy with bilateral tubes and right ovary was performed. The uterus weighed 197 grams and measured 10 x 6 x 5 cm. The endometrial cavity measured 4.5 cm in length and 4.5 cm from cornu to cornu. The cervix measured 2.5 cm in diameter with an external os of 1 cm. A mass was identified in the posterior corpus, measuring 3.8 x 3.5 x 1.3 cm. It was described as papillary, tan-red, and friable. Microscopic evaluation showed invasion less than one third of the depth of myometrium; however, there was extensive lymphovascular invasion noted. The tumor extended into the lower uterine segment.\n\nThe adjacent non-neoplastic endometrium was atrophic. Multiple subserosal nodules were present within the myometrium, with the largest measuring up to 5 cm. These were described as white-tan, whorled, and firm without hemorrhage or necrosis. The cervix and serosa appeared unremarkable. The right ovary measured 2.7 x 1.3 x 0.8 cm and showed multiple corpora albicantia. The right fallopian tube measured 5.5 cm in length and had a smooth serosal surface with a pinpoint lumen. No definitive left fallopian tube was identified.\n\nLymph node dissection included left pelvic, right external, right obturator, right common, right aortic, and left aortic lymph nodes. In the left pelvic region, thirteen lymph nodes were identified, with one showing evidence of metastatic involvement. Of two right external lymph nodes, one was involved. Among nine right obturator lymph nodes, one contained metastatic cells. No malignant involvement was found in the right common, right aortic, or left aortic lymph nodes.\n\nSections were submitted from all relevant regions including the cervix, myometrium, lymph nodes, and adnexal structures. The tumor was located in the posterior corpus with maximum depth of myometrial invasion measuring 1.3 cm in a 1.5 cm thick wall. Tumor margins were not involved. The right ovary and fallopian tube were free of tumor involvement. The left ovary and fallopian tube were not identified.\n\nExtensive lymphatic and vascular channel involvement by invasive carcinoma was observed, with foci near the serosal surface."} +{"pid": "TCGA-MB-A5Y9", "report": "Study Subject ID: SPECIMEN(S): Right posterior calf mass. FINAL DIAGNOSIS: Soft tissue, right posterior calf mass, wide excision.\n\nThe specimen consists of a 12 x 10.5 x 4.0 cm, 217 gram pink tan soft tissue fragment. The overlying ovoid skin measures 12.6 x 9.8 cm and shows a bulging mass. The specimen is oriented with a long double stitch at the proximal margin (12:00) and a single stitch at the lateral margin (3:00). Resection margins are inked black. Serial sectioning reveals a 6.8 x 6.0 x 3.4 cm circumscribed pink tan soft tissue tumor with multifocal areas of necrosis and a small focal area of cystic change. The tumor is 1.6 cm from the proximal margin, 1.4 cm from the distal margin, 2.5 cm from the lateral margin, 2.7 cm from the medial margin, 0.4 cm from the posterior skin surface, and 0.1 cm from the anterior deep margin. Representative tissue was procured for potential future studies. The specimen is photographed. Sections submitted include margins and multiple areas of the tumor.\n\nMicroscopic evaluation reveals extensive areas of pleomorphic tumor with markedly atypical tumor cells and numerous tumor giant cells. There are also regions containing spindle cells and areas with foamy histiocytic cells. A minor component of the tumor shows reduced cellularity with atypical spindle cells and an abundant inflammatory cell component. Some areas exhibit a myxoid appearance. The histologic type is consistent with a high-grade tumor. Mitotic count is 45 per 10 high-power fields. Necrosis is present, involving 5\u201310% of the tumor. Histologic grade according to the French Federation of Cancer Centers Sarcoma Group classification is Grade 3.\n\nMargins are evaluated, and tumor is focally present at the anterior-deep margin. Lymph-vascular invasion is not identified. No regional lymph nodes are submitted or found for assessment. Clinically, there is no evidence of distant metastasis. The tumor involves both superficial and deep layers macroscopically."} +{"pid": "TCGA-G9-7523", "report": "The prostate specimen measured 4.2 cm in lateral dimension, 3.2 cm anterior to posterior, and 2.3 cm from apex to base. The gland weighed 36 grams before dissection and 16 grams after removal of the apex and base. Histologic examination showed involvement of multiple regions including the apex, bilateral anterior regions at level I, left lateral and anterior regions at level II, bilateral anterior regions at level III, right posterior at level III, and bilateral mid base regions. There was evidence of extraprostatic extension at the anterior and mid base regions. Positive surgical margins were identified at the apex, anterior, and mid base with a linear distance of approximately 8 mm in aggregate. Perineural invasion was present; no lymphovascular invasion was observed. The seminal vesicles and vas deferens were not involved.\n\nLymph node dissection included four right pelvic lymph nodes and six left pelvic lymph nodes. All lymph nodes were negative for malignant cells.\n\nHistologic sections were submitted from all regions of the prostate including perpendicular sections of the apex, levels I, II, and III of right and left anterior and lateral regions, mid base, posterior base, and urethral orifice margins. Sections of the seminal vesicles and vas deferens were also submitted.\n\nPathologic staging was determined as pT3a based on the presence of extraprostatic extension. No metastatic disease was identified in the lymph nodes. Additional findings included focal chronic inflammation."} +{"pid": "TCGA-CV-7254", "report": "The specimen consists of tissue from the right true vocal cord and surrounding areas. Histological evaluation reveals invasive cellular growth within fibrovascular tissue in several regions, including the area overlying the arytenoid cartilage and the left anterior commissure. The posterior subglottic and anterior subglottic regions show only fibrous or fibroconnective tissue without evidence of abnormal cellular proliferation. Margins were assessed throughout the specimen: the false cord margin, posterior commissure margin, new arytenoid margin, and thyroid cartilage base all demonstrate benign squamous mucosa, muscle, or cartilage without invasive cells. The new anterior commissure margin shows dysplastic epithelium but no invasive component. Lymphatic invasion is noted. The tumor involves the deep margin of resection and extends into the left anterior commissure. Cellular morphology demonstrates high-grade features. Tumor size and regional involvement meet criteria for an advanced local stage."} +{"pid": "TCGA-IR-A3LC", "report": "The submitted specimens include a radical hysterectomy specimen involving the uterus, cervix, parametria, and partial vagina, along with multiple lymph node groups from both sides. These include left and right common iliac, external iliac, hypogastric, and obturator lymph nodes.\n\nMicroscopic examination of the hysterectomy specimen reveals a lesion measuring 2.5 cm in greatest dimension. The maximal thickness of stromal invasion in the cervix is 1.7 cm, and the thickness of the cervical tissue at the site of deepest invasion measures 1.9 cm. There is no evidence of multiple tumor sites or in situ carcinoma. Vascular invasion is present. No extension into the vagina is observed. The lesion extends focally into the lower uterine segment on the posterior aspect involving stroma only. No involvement of the parametrium is identified. All surgical margins are negative for any abnormal cellular proliferation.\n\nThe endometrium shows benign proliferative changes. Within the myometrium, there is a benign finding measuring 1.0 cm in greatest dimension. One lymph node from the left parametrial region is benign.\n\nLymph node assessment reveals all lymph nodes examined to be benign. In the left common iliac region, two lymph nodes were assessed; four lymph nodes were evaluated in the left external iliac region; three lymph nodes were reviewed in the left hypogastric region; eleven lymph nodes were analyzed in the left obturator region. On the right side, two lymph nodes were found in the common iliac region; fifteen lymph nodes were identified in the external iliac region; seven lymph nodes were present in the obturator region; and three lymph nodes were noted in the hypogastric region. All lymph nodes assessed were benign."} +{"pid": "TCGA-ET-A39L", "report": "The specimen consisted of a total thyroidectomy. The tumor was located in the left lobe and measured 5.5 cm in diameter. Histologic evaluation revealed a neoplasm with conventional and follicular features. The lesion was unifocal. All four perithyroidal lymph nodes examined were free of tumor involvement. Pathologic staging demonstrated a T3 classification, indicating a tumor greater than 4 cm confined to the thyroid gland. There was no evidence of regional lymph node metastasis based on the nodes assessed. Distant metastasis could not be determined. Surgical margins were clear of involvement. No venous or lymphatic invasion was identified. Additional findings included the presence of parathyroid tissue and an adenomatoid nodule."} +{"pid": "TCGA-BQ-5887", "report": "The specimen from the right kidney following total nephrectomy includes a 3.8 x 3.7 x 3.1 cm hemorrhagic and partially gold-tan lesion located in the hilar fat. The tumor has a Fuhrman Nuclear Grade of III/IV. No evidence of renal vein invasion is present, and surgical margins are free of involvement. The non-neoplastic kidney tissue appears unremarkable with a well-defined cortico-medullary junction and normal calyces. An adrenal gland was not identified. The perinephric soft tissue specimen shows fibroadipose tissue with fibrosis, fat necrosis, and calcification; no tumor is observed. A total of seven lymph nodes from the paracaval region are identified, none of which show involvement. No lymph nodes are found in the first lymph node specimen submitted. The kidney specimen also contains a prior excision site measuring 2.9 x 2.3 cm at a pole, marked with blue ink, while the remainder of the kidney is black-inked. The attached ureter and renal vessels appear unremarkable. The tumor extends into the perinephric tissues but does not breach Gerota's fascia."} +{"pid": "TCGA-WB-A814", "report": "The specimen received included a right adrenalectomy and resection of a periaortic-pericaval lesion along with a lymph node. Clinically, the patient presented with a history of headache, hypertension, and right abdominal pain. Imaging revealed two hypervascular retroperitoneal nodules. Symptoms including episodic headache, sweating, palpitations, and elevated blood pressure prompted testing which showed high metanephrine levels. Further diagnostic and surgical intervention had been delayed due to pregnancy complicated by preeclampsia, leading to cesarean delivery of a healthy infant weighing 2870 g. Preoperative evaluation noted very high metanephrine levels, chromogranin at 750 mol/l, and positive I-MIBG scintigraphy localized to the upper pole of the right kidney. Ambulatory blood pressure monitoring recorded daytime averages of 138/89 mmHg. The patient was obese with a body mass index of 39.8 kg/m\u00b2 and had developed diabetes during pregnancy, confirmed by plasma glucose of 7.2 mmol/l and HbA1c of 7.6%. No left ventricular hypertrophy was observed, and renal function was normal with physiological microalbuminuria.\n\nImaging findings included a right adrenal lesion measuring 31 mm and a second mass located 2 cm above the lower pole of the first lesion, anterior to the third portion of the duodenum, measuring 47 mm in long axis. DOPA-PET imaging demonstrated uptake in both lesions.\n\nMacroscopic examination of the right adrenalectomy specimen revealed a resection weighing 34 g, measuring 28 x 3.5 x 2 cm. A cystic, buff-beige tumor measuring 3.5 x 3 x 2 cm was identified within; no micro-nodular changes were seen in the surrounding adrenal tissue. The second resected lesion, located in the inter-aortocaval region, weighed 36 g and measured 4 x 5 x 2 cm. It exhibited a hemorrhagic, buff-beige appearance and was encapsulated. A small lymph node (0.5 cm) was also excised from the inter-aortocaval area.\n\nMicroscopic analysis of the adrenal lesion showed a population of small cells resembling adrenal medullary cells, with high cellularity and monotonous appearance in certain areas. These cells formed nests (zellballen pattern) in 40% of the sample, while 30% displayed a fusiform arrangement. Nuclear atypia were prominent. The stroma was largely vascular with minimal supportive tissue. Fibrous bands containing vessels were also present. Hemorrhagic areas with hemosiderin-laden macrophages were observed. The proliferation extended into the capsule but did not breach it or involve the periadrenal fat. Immunohistochemical staining demonstrated positivity for chromogranin and synaptophysin. Sustentacular cells were rarely highlighted by S100 staining. No medullary hyperplasia, glomerulosa hyperplasia, or fasciculata nodularity was identified in the adjacent adrenal tissue.\n\nThe inter-aortocaval lesion was composed predominantly of small neuroendocrine-like cells arranged in zellballen structures (40%), with diffuse or large nest patterns elsewhere. Extensive hemorrhagic transformation was noted. The tumor breached the capsule and infiltrated adjacent perirenal fat as well as a peritumoral lymph node. Vascular invasion was not identified. Immunophenotypic expression mirrored that of the adrenal lesion. The sustentacular cell network was diminished in regions with fusiform morphology. Chromogranin and synaptophysin staining marked cells within the involved lymph node, which was embedded in fibrotic tissue.\n\nMeasurements and histological features indicated an adrenal lesion measuring 3.5 cm with increased cellularity, nuclear pleomorphism, and capsular invasion. The periaortic-pericaval lesion measured 5 cm and showed capsular penetration, infiltration of adjacent fat, and lymph node involvement. Tumor extension was also noted in an inter-aortocaval lymph node."} +{"pid": "TCGA-AA-3984", "report": "The specimen demonstrates an R0 resection status. There is a villous adenoma with areas of severe dysplasia, characterized by intraepithelial neoplasia of high-risk morphology. Additionally, a serrated adenoma is identified. Lymph node examination reveals no evidence of involvement."} +{"pid": "TCGA-96-8169", "report": "The surgical specimen consists of a wedge resection of the right lower lobe measuring 11 x 7 x 2.8 cm. A subpleural nodule is identified, with dimensions of 2 x 1.8 x 1.3 cm, located 1.6 cm from the staple line margin. The nodule appears yellow-tan and firm with ill-defined borders. Histologically, the lesion measures 1.6 cm in greatest dimension and is unifocal. It is poorly differentiated with no evidence of visceral pleural invasion. The staple line margin is free of involvement by invasive carcinoma. No lymphovascular invasion is identified.\n\nFour lymph node specimens were submitted: one from station 9, one from station 7, and two from station 4. All lymph nodes are negative for malignant involvement. In total, four regional lymph nodes were examined and none showed evidence of metastasis. No extranodal extension is observed.\n\nAdditional findings include emphysema in the lung tissue. Immunohistochemical staining shows positivity for p63 and negativity for TTF-1. A mucin stain is also negative.\n\nThe tumor is confined to the lung and does not extend beyond the limits of the resected tissue. Based on size and extent, the primary tumor is classified as pT1a. Regional lymph node staging is pN0, indicating no metastatic spread to the sampled lymph nodes."} +{"pid": "TCGA-A7-A26J", "report": "The specimen includes a left axillary sentinel node and a left breast tissue sample. The axillary node specimen consists of a 3.8 x 2.4 x 0.6 cm portion of adipose tissue with two lymph nodes measuring 0.8 cm and 1.8 cm. All tissue was submitted for analysis.\n\nThe breast specimen measures 21.5 x 20.5 x 3.8 cm and contains a central, stellate lesion measuring 3.0 x 2.2 x 2.0 cm located at the junction of the four quadrants. This lesion is within 0.8 cm of the skin surface near the nipple and within 0.5 cm of the inked deep margin. Several cylindrical structures consistent with prior biopsy tracks were noted. The surrounding tissue is composed mainly of adipose and fibrous tissue, with no other significant abnormalities identified. Three small lymph nodes up to 0.8 cm in size were found on the lateral aspect of the specimen.\n\nMicroscopic evaluation revealed a high-grade cellular proliferation with ductal features and nuclear pleomorphism. The architectural score was 3, nuclear score was 3, and mitotic score was 2, resulting in an overall grade of 8 out of 9. The largest focus measured 3.0 cm. Margins of excision were free of involvement. Vascular invasion was present, and there was evidence of spread to deeper dermal layers adjacent to the nipple. No calcifications were identified.\n\nA separate satellite focus of 2 mm was found in the lower outer quadrant, associated with intraductal changes. This focus was located 2 mm from the deep margin.\n\nExamination of non-tumorous breast tissue showed fibrocystic changes and fibroadenomatous areas. A total of four lymph nodes were assessed\u2014two sentinel and two additional\u2014with no evidence of involvement. Prognostic markers were previously documented."} +{"pid": "TCGA-QA-A7B7", "report": "The surgical specimen included a partial hepatectomy with attached gallbladder and a loosely attached diaphragm fragment. The liver specimen measured 19.0 x 10.0 x 3.5 cm, and a well-circumscribed yellow mass measuring 6.8 x 5.0 x 4.5 cm was identified. The mass was located 0.7 cm from the closest resection margin and 4.9 cm from the gallbladder. Gross examination revealed that the mass invaded the liver capsule, with possible involvement of the diaphragm. The area of the liver beneath the diaphragm appeared fragmented and disrupted.\n\nMicroscopic evaluation showed a solitary lesion in segment 7, measuring 6.8 cm in greatest dimension and 5.0 cm in an additional dimension. The tissue demonstrated moderate to poorly differentiated cellular features. Vascular invasion was present, identified microscopically within small vessels, but no macroscopic venous invasion was observed. No perineural invasion was detected.\n\nTumor extension revealed direct invasion into adjacent soft tissue near the diaphragm. The invasive component was located 2 mm from the diaphragmatic margin and 8 mm from the parenchymal resection margin, which was uninvolved. The gallbladder showed findings consistent with cholesterolosis, with wall thickness measuring up to 0.4 cm. No evidence of cirrhosis was noted, and the remainder of the liver displayed only focal mild chronic portal inflammation without other specific patterns of injury.\n\nLymph node assessment was not possible, as no lymph nodes were submitted for evaluation. No distant metastasis was identified. Representative sections of the mass, surrounding liver tissue, and gallbladder were submitted for further analysis."} +{"pid": "TCGA-SL-A6JA", "report": "The specimen shows a neoplastic lesion involving the endometrium with extension to the endocervix. Histologic evaluation reveals invasive malignant cells arranged in part as glands, with areas of solid growth comprising more than 5% of the tumor. The cells exhibit marked pleomorphism, atypical nuclei, an elevated nuclear-to-cytoplasmic ratio, prominent nucleoli, and moderate eosinophilic cytoplasm. Frequent mitotic figures are observed. Architecturally, the tumor demonstrates irregular glandular contours and crowding. The maximal depth of invasion is 1.1 cm within a total endometrial thickness of 1.8 cm. Endocervical stromal invasion is present. No involvement of the parametrial tissue is noted. Lymphatic invasion is identified using a D2-40 immunostain; vascular invasion is not demonstrated on CD31 staining. The ovaries and fallopian tubes are free of tumor and display atrophic changes. Atherosclerotic changes are noted in the vessels of the myometrium. Staging classification according to AJCC/UICC TNM 7th edition criteria indicates pT2, pN0, pMx."} +{"pid": "TCGA-G4-6322", "report": "The resected left colon specimen measures 24 cm in length with a circumference of 7.5 cm. A mass is located 9 cm from the distal margin and is described as circumferential, polypoid, firm, and necrotic, measuring 9 x 6.5 x 3 cm. The mass extends into the subserosal fat. The proximal mucosa shows diverticulosis and three small polyps measuring 0.2 cm, 0.3 cm, and 0.5 cm. The distal and proximal margins are free of involvement. A total of 26 lymph nodes were examined, with two showing evidence of involvement. The remaining nodes showed no such findings. Two tubular adenomas were identified. Histologically, the lesion is moderately differentiated and exhibits venous/lymphatic invasion. No perineural invasion or extranodal extension was observed. The surgical margins are negative, and the resection is considered complete. Based on pathological findings, the extent of primary tumor invasion is classified as pT3, with regional lymph node involvement classified as pN1. No distant metastases were identified. A fragmentary area at the radial margin shows mucin, fibrosis, and inflammation, but no definitive tumor is seen. Clinical correlation is recommended."} +{"pid": "TCGA-OL-A66J", "report": "The surgical specimen consisted of a right breast partial mastectomy along with four sentinel lymph nodes from the right axilla. All lymph nodes were negative for malignant involvement. The primary lesion measured 1.6 x 1.5 x 1.4 cm and was located within a firm, white, poorly circumscribed mass in the breast tissue. Histologic evaluation revealed a composite grade II lesion based on architectural differentiation, nuclear features, and mitotic activity. Vascular or lymphatic invasion was not definitively identified.\n\nMargins of excision were free of tumor involvement. The closest distance from the lesion to the anterior margin was greater than 2 mm, and to the superior margin also greater than 2 mm. Other margins were more than 3 mm away from the lesion. Adjacent benign findings included lobular intraepithelial neoplasia, atypical ductal hyperplasia, flat epithelial atypia associated with microcalcifications, sclerosing adenosis, fibrocystic changes with apocrine metaplasia, and duct ectasia. A prior biopsy site was noted with fat necrosis.\n\nAdditional evaluation of a superior medial margin showed similar benign findings including focal atypical ductal hyperplasia, lobular intraepithelial neoplasia, flat epithelial atypia, sclerosing adenosis with microcalcifications, and fibrocystic changes.\n\nImmunohistochemical staining demonstrated strong expression of estrogen receptor in approximately 90% of nuclei and progesterone receptor expression in about 50%. HER2/neu testing by FISH showed no amplification with a ratio of 1.5.\n\nClinically, imaging identified an irregular heterogeneous enhancing mass measuring 1.4 x 1.2 x 1.2 cm with a metallic clip artifact. There was also a non-mass enhancement posteriorly measuring 1.6 x 1.1 cm, raising concern for possible extension. The total extent measured approximately 2.8 cm.\n\nPathologic staging was determined as pT1c with no tumor identified in the sentinel lymph nodes (0/4). No definitive vascular or lymphatic invasion was observed."} +{"pid": "TCGA-67-6216", "report": "The surgical specimen was received fresh for frozen section analysis and consisted of a wedge-shaped segment of lung measuring 10 x 4.5 x 2.5 cm. The surgical margin showed a line of metallic staples measuring 9 cm in length, and the pleural surface appeared pink and smooth. After staple removal, several ligated vessels were identified, with measurements up to 0.4 cm in length and 0.3 cm in diameter. On sectioning, the lung tissue was pink and slightly air-filled, with a firm pale white lesion measuring 1.8 x 1.3 x 0.9 cm. This lesion approached within approximately 2 cm of the bronchial margin. Multiple sections were taken for evaluation, including margins, surrounding tissue, and normal lung parenchyma.\n\nA lymph node specimen from the right middle lobe measured 1 cm and was bisected and submitted entirely. A second lymph node from the right lower lobe measured 1.3 cm and was similarly processed. No abnormal findings were noted in either lymph node.\n\nMicroscopic examination revealed moderately differentiated gland-forming and papillary growth patterns with focal psammoma body formation. The lesion was confined within the lung and approached to within 4 mm of the stapled parenchymal margin, while remaining more than 2 cm from the bronchial margin. Vascular and bronchial margins were free of involvement. Four hilar lymph nodes and additional regional nodes were also unremarkable.\n\nSections of the remaining lung tissue showed no significant abnormalities. The tumor was unifocal and did not extend to the pleura or involve any other structures. There was no evidence of venous, arterial, or lymphatic invasion. No treatment effect was observed. A total of 6 lymph nodes were examined from the N1 region, all negative, with additional nodes from N2 and N3 stations also showing no involvement.\n\nStaging was determined as pT1a, with no lymph node involvement (pN0), and no assessment for distant metastasis (pMX)."} +{"pid": "TCGA-DB-5273", "report": "The specimen consists of tissue from the right frontal lobe measuring approximately 8.0 x 6.0 x 3.1 cm, along with a separate fragment from the right frontal posterior margin caudate measuring 2.4 x 1.9 x 0.8 cm. Histologic sections show a moderately cellular lesion composed of fibrillary and gemistocytic elements. Cellular pleomorphism is present, with occasional atypical forms noted. Mitotic figures are observed at a moderate rate.\n\nFluorescence in situ hybridization (FISH) studies were performed on paraffin-embedded tumor cells using probes targeting regions commonly deleted in gliomas. Two separate hybridizations were conducted: one involving a 19q probe paired with a 19p control, and another using a 1p probe paired with a 1q control. The calculated ratios for both probe pairs were within normal limits\u20141.01 for 19q/19p and 0.99 for 1p/1q. Deletion thresholds are defined as ratios below 0.80, and no such deletions were detected. However, approximately 45% of the analyzed cells demonstrated an increased copy number, with 3 to 4 copies of the probes for 1p, 1q, 19p, and 19q. These findings have been previously observed in other glioma cases and may reflect chromosomal gain or possible tetraploidy/aneuploidy.\n\nA preliminary frozen section consultation identified a high-grade lesion forming a mass measuring approximately 4.4 cm in greatest dimension. The posterior margin of the caudate was negative for tumor involvement. Multiple tissue blocks were submitted for analysis, including several from the right frontal tumor and one from the posterior caudate margin."} +{"pid": "TCGA-V3-A9ZY", "report": "The submitted specimen is a right eye orbit. The globe measures 23.95 mm in superoinferior dimension, 22.60 mm anteroposteriorly, and 23.90 mm horizontally. The optic nerve is 2.96 mm in length and 3.5 mm in diameter. The pupil is round and measures 7.26 mm. On transillumination, a shadow is identified within the globe. Upon sectioning, a mass is found along the posterior aspect of the globe between 3:00 and 6:00 positions. The lesion has a dark gray cut surface and measures 7.79 mm in largest basal diameter and 12.18 mm in height. It is located in the inferonasal quadrant and extends from 5 mm anterior to the limbus to 4 mm posterior from the optic disc. The mass involves the choroid and sclera but does not extend into the optic nerve. Microscopic evaluation shows a solid growth pattern composed predominantly of epithelioid cells with a histologic grade of pG3. The tumor margin does not involve the optic nerve or surgical margins. Histologic analysis reveals mild pigmentation, few macrophages, and few tumor-infiltrating lymphocytes. Mitotic activity is present at a rate of 3 mitotic figures per 40 high power fields. There is no evidence of an extravascular matrix pattern. Additional findings include retinal detachment, invasion of Bruch\u2019s membrane, and cataract. Based on size and location, the tumor is classified as pT3a. Lymph node status cannot be assessed (pNX). Distant metastasis is not applicable. All relevant tissue has been submitted for evaluation."} +{"pid": "TCGA-BG-A0MQ", "report": "Submitted for evaluation is a specimen from omentectomy and herniorrhaphy, including fibroadipose tissue of the sac wall and omental tissue, both negative for metastatic carcinoma. Additionally, a total abdominal hysterectomy with bilateral salpingo-oophorectomy was performed. The endometrial lining demonstrates a well-differentiated lesion with nuclear grade 2 features, classified as FIGO grade 1. Necrosis is present in a significant portion of the lesion, with mixed inflammatory infiltrate noted.\n\nThe lesion involves approximately 15% of the endometrial surface and invades 25% of the myometrial thickness, corresponding to 0.3 cm invasion into a 1.2 cm thick myometrium. No lymphovascular space invasion is identified. Adjacent endometrial tissue shows findings consistent with simple hyperplasia along with a benign endometrial polyp. A small benign peritoneal inclusion cyst measuring 0.6 cm is identified on the anterior serosal surface of the uterus.\n\nMultiple benign leiomyomas are present within the myometrium, with the largest measuring up to 2.3 cm. The cervix shows no evidence of malignancy but demonstrates chronic cervicitis with reactive epithelial atypia and a benign endocervical polyp. Both ovaries and fallopian tubes show benign findings: physiologic changes in ovary #1; fallopian tube #1 contains multiple paratubal cysts. Ovary #2 exhibits a benign mucinous cystadenoma measuring 0.7 cm and inclusion cysts. Fallopian tube #2 demonstrates paratubal cysts and Walthard rests within the paratubal serosa.\n\nLymph node biopsies were obtained from various pelvic and para-aortic regions including right and left external iliac, obturator, common iliac, and periaortic areas. All lymph nodes examined (total of 15) are negative for metastatic carcinoma. In some specimens, no lymph nodes were identified within the fibroadipose tissue sampled.\n\nAdditional findings include a mitotic rate of 3 per 10 high-power fields. Based on these findings, the pathologic staging reflects limited depth of myometrial invasion without lymph node involvement or evidence of distant spread."} +{"pid": "TCGA-CJ-4902", "report": "The surgical specimen consists of a right radical nephrectomy measuring 18.0 x 9.0 x 8.0 cm in total. The kidney itself measures 15.0 x 7.5 x 6.0 cm. Attached structures include the ureter, which is 15.0 cm long and 0.5 cm in diameter, and the renal vein and artery, which are 2.0 cm in length and 0.6 cm in average diameter. A lobulated mass measuring 8.0 x 7.0 x 6.0 cm is located at the lower pole of the kidney. Microscopic examination reveals focal invasion through the capsule into the surrounding perinephric adipose tissue. The tumor is within 0.2 cm of Gerota\u2019s fascia but does not involve it directly. Margins of resection, including those of the renal vein, artery, and ureter, are free of tumor involvement.\n\nThe tumor has a tan-yellow appearance with areas of hemorrhage and necrosis. There is no evidence of sarcomatoid differentiation. Focally, the tumor exhibits a gelatinous consistency but does not extend into the renal sinus or invade the renal vein. The pelvicalyceal system also shows no signs of involvement. A small section of adrenal gland tissue (2.0 x 0.5 x 0.2 cm) appears unremarkable upon examination.\n\nHistologic evaluation includes multiple sections from various regions of the specimen, including areas near Gerota\u2019s fascia, the tumor margin, adjacent kidney tissue, perinephric fat, and uninvolved portions of the kidney. No tumor is identified in these sections."} +{"pid": "TCGA-DJ-A13W", "report": "The clinical history indicates a left thyroid nodule previously found to be suspicious for follicular neoplasm on fine needle aspiration. Specimens submitted include a paratracheal lymph node, two perithyroidal lymph nodes, and a total thyroidectomy specimen.\n\nGross examination of the thyroid revealed a well-circumscribed tan-yellow mass measuring 2.0 cm in greatest dimension located in the lower pole of the left lobe. Additional findings include an irregular white firm area in the left upper pole and a 0.6 cm stellate fibrous area in the right lobe midportion. The remainder of the thyroid parenchyma appeared red-tan and meaty. All surgical margins were free of tumor. The thyroid weighed 20.5 grams, with the left lobe measuring 4.5 x 2.8 x 1.8 cm, the right lobe 3.5 x 2.4 x 1.5 cm, and the isthmus 1.2 x 0.6 x 0.6 cm.\n\nHistologic evaluation showed a well-differentiated lesion with no mitotic activity or tumor necrosis identified. The tumor was completely encapsulated without evidence of capsular or vascular invasion, and no extrathyroid extension was observed. In addition, a separate microcarcinoma measuring 0.6 cm was identified in the right lobe.\n\nThe paratracheal lymph node measured 1.2 x 0.5 x 0.4 cm and was benign. The two perithyroidal lymph nodes, measuring 0.8 cm and 0.5 cm respectively, were also benign. No malignant cells were identified in any of the lymph nodes examined.\n\nNon-neoplastic thyroid tissue exhibited features consistent with chronic lymphocytic thyroiditis, compatible with Hashimoto\u2019s thyroiditis. Parathyroid glands were not identified in the specimen. All sections were appropriately submitted and reviewed."} +{"pid": "TCGA-CJ-5683", "report": "A partial nephrectomy specimen measuring 8.0 x 7.0 x 3.5 cm was submitted. A solid, well-circumscribed mass measuring 5.5 x 5.0 x 3.0 cm was identified and located 2.0 mm from the inked parenchymal margin. The mass exhibited a variegated appearance with yellow and red hemorrhagic areas. The remainder of the mass was surrounded by adipose tissue. Sections were taken from the closest perpendicular renal parenchymal margin for frozen section evaluation, as well as from the tumor with adjacent adipose tissue. Frozen section analysis of the parenchymal margin was negative for tumor involvement.\n\nIn addition, two portions of adipose tissue (11.5 x 4.5 x 1.5 cm and 9.0 x 5.5 x 2.0 cm) were submitted, along with a larger portion of adipose tissue measuring 21.0 x 14.0 x 3.5 cm that included attached fascia. All adipose tissue samples were grossly unremarkable and showed no evidence of lesional changes. Representative sections were taken from all specimens and processed for microscopic evaluation."} +{"pid": "TCGA-OR-A5J3", "report": "The specimen consists of a segmental resection of the left kidney and an adjacent mass. The resected tissue measures 13 x 8 x 4 cm. The mass itself measures 6 x 5 x 4 cm and weighs 38 grams. On gross examination, the cut surface shows a homogeneous light-brown tissue with a surrounding rim of dark yellow material. No areas of necrosis are visible macroscopically. There is evidence of invasion into the renal vein.\n\nMicroscopic evaluation reveals a tumor with a maximum dimension of 6 cm. The nuclear grade according to Fuhrman classification is 3. A diffuse architectural pattern is observed. Clear cells constitute less than 25% of the neoplasm. Focal areas of necrosis are present. The mitotic count is less than 5 per 50 high-power fields, and no atypical mitoses are identified. Capsular invasion is not detected. Venous invasion is present, but there is no evidence of sinusoidal invasion. The Weiss score is 5. A neoplastic thrombus is present within the renal vein. Examination of four dissected lymph nodes shows no evidence of metastatic disease."} +{"pid": "TCGA-DX-A6B8", "report": "The surgical specimen consists of a 20.8 x 14.3 x 13.4 cm segment of adipose tissue, fascia, and skeletal muscle from the posterior right scapular region. A mass measuring 17.2 x 11.2 x 10.3 cm is identified within the skeletal muscle. The mass has a fleshy tan-white to gray appearance with an area of hemorrhage and necrosis measuring 6.2 x 6.0 x 4.0 cm. Histologically, the lesion demonstrates high-grade cellular atypia with pleomorphic features. Immunohistochemical staining shows positivity for smooth muscle actin (SMA), common muscle actin (HHF-35), and desmin. Staining is negative for S-100 protein and CD34. The tumor is partially encapsulated but exhibits focal infiltrative borders into surrounding soft tissue and skeletal muscle. Necrosis is present in approximately 30% of the tumor volume. The deep surgical margin is focally involved, with the tumor located less than 0.1 cm from the inked surface. The superficial margin is 3.0 cm away from the tumor. The closest peripheral margin is 1.0 cm from the tumor, with other peripheral margins measuring 1.6 cm, 2.0 cm, and 2.1 cm away. Representative sections of the tumor and margins have been submitted for analysis."} +{"pid": "TCGA-OR-A5LM", "report": "A right adrenalectomy was performed. The adrenal tumor weighed 254 grams and measured 12 x 6 x 6.5 centimeters. Histological evaluation showed a Weiss score of 7. Lymph node examination revealed no evidence of metastatic disease, with 0 out of 32 lymph nodes involved."} +{"pid": "TCGA-V4-A9EY", "report": "The specimen consists of an enucleated right eye. Gross examination shows an eyeball with a diameter of 30 mm and a posterior optic nerve segment measuring 11 mm. A blackish lesion is identified within the eye, with a maximum dimension of 10 mm along its main axis. Histological analysis demonstrates a cellular proliferation composed of fusiform cells with ovoid nuclei, often containing prominent nucleoli. Mitotic activity is present at a low level, with approximately two mitoses observed per 10 high power fields. There is no evidence of necrosis or microcalcifications. The tumor demonstrates focal invasion into the inner aspect of the sclera; however, there is no extension beyond the scleral margin. Examination of the anterior chamber and the full length of the optic nerve reveals no involvement by the lesion."} +{"pid": "TCGA-A4-A772", "report": "The surgical specimen consisted of a right partial nephrectomy and perinephric fat. The resected kidney measured 6.5 x 6.0 x up to 0.3 cm and included attached perinephric fat with extruding soft brown friable material. A lesion measuring 5.0 x 3.0 x 2.4 cm was identified at the upper pole, eroding into or extruding from the superior pole of the specimen. The lesion was thinly encapsulated adjacent to the renal parenchyma and composed largely of red-brown friable tissue and debris. The superior aspect merged with the perinephric fat and was not surrounded by fat or encapsulated. Gross evaluation showed no involvement of the renal capsule or renal sinus, and vascular margins were not submitted for assessment.\n\nMicroscopic evaluation revealed a unifocal tumor with histologic features consistent with a specific type. The nuclear grade was Fuhrman grade 2. No sarcomatoid features, tumor necrosis, or lymphvascular invasion were identified. Margins of resection, both parenchymal and soft tissue, were free of tumor involvement. Regional lymph nodes were not submitted for evaluation and thus could not be assessed (pNX). The tumor was confined to the kidney without definitive invasion into adjacent tissues based on available sections, despite disruption of the overlying capsule prior to specimen receipt. Pathologic staging was determined as pT1b based on these findings.\n\nSections of the adjacent perinephric fat did not show any evidence of malignancy, invasion, fibrosis, or inflammation. Additional microscopic analysis, including immunohistochemical testing, was performed using standard protocols. Stains and controls were appropriately evaluated. All tissue fixation met required standards for analysis. Multiple blocks were submitted for evaluation, including full thickness cross-sections of the lesion, adjacent normal parenchyma, and representative sections of perinephric fat.\n\nA separate specimen of perinephric fat, weighing 110 grams and measuring 16.0 x 15.0 x 1.5 cm, was also submitted. Serial sectioning revealed a uniform soft yellow cut surface, and no abnormal findings were noted microscopically. The case was reviewed and confirmed by consulting surgical pathology staff. All gross and microscopic findings were reviewed by the pathologist."} +{"pid": "TCGA-78-7540", "report": "The left lower lobe specimen measures 130 x 65 x 90 mm. Overlying the anterior basal segment, the pleura is puckered and has a small amount of adherent pale tissue. On sectioning, there is diffuse infiltration by pale tan tissue with a rubbery cut surface. This process abuts the lateral and diaphragmatic pleural surfaces and involves the posterior lateral basal and anterior basal segments. It surrounds a major segmental bronchus and extends close to the bronchial resection margin, but does not involve the medial margin. The lesion measures approximately 50 x 60 x 45 mm.\n\nMicroscopic evaluation shows a well-differentiated adenocarcinoma with a prominent mucinous component and focal invasive features. The tissue closely approaches the pleural surface, with overlying organising fibrinous pleurisy. No definite pleural invasion is identified, though there are suspicious features that prompted additional staining, which later confirmed absence of invasion. No vascular or perineural invasion is observed. Small satellite deposits are present in the adjacent lung tissue, including within the bronchus near the resection margin, although the bronchial margin itself is free of tumor. Hilar lymph nodes do not show evidence of metastasis.\n\nA separate hilar lymph node specimen measuring 12 x 5 x 5 mm shows only carbon deposition and sinus histiocytosis.\n\nA second specimen from the back consists of an irregular lobulated fatty tissue measuring 95 x 70 x 25 mm. Microscopically, it is composed of mature adipose tissue with no malignant features.\n\nMargins assessed include the bronchial resection margin, which is negative, and the surrounding bronchus, which also shows no malignancy. Adjacent lung tissue away from the lesion appears unremarkable. Staging is consistent with T2N0."} +{"pid": "TCGA-EI-6514", "report": "Histopathological examination was performed on a resected specimen including the colon and sigmoid. The specimen measured 15.8 cm in length and included a fragment of the mesorectum measuring 17 x 6 x 3 cm. A mucosal lesion measuring 6.3 x 6.6 x 0.9 cm was identified, with circumferential involvement of the intestinal wall. The lesion was located 0.5 cm from one excision margin and 2.9 cm from the opposite margin. Microscopic evaluation revealed a moderately differentiated tubulopapillary neoplasm with infiltration into the pericolic fat. No neoplastic involvement was identified at the resection margins. Reactive lymph node changes were noted in the regional lymph nodes. Tumor staging indicated pT3 with no lymph node metastasis (pN0). Additional classifications based on histopathological features were consistent with an intermediate stage."} +{"pid": "TCGA-JX-A5QV", "report": "The specimen consists of a uterus with attached cervix, measuring 11 cm from fundus to ectocervix, and 5.7 cm between cornua. The anterior-posterior dimension is 5.3 cm. Parametrial tissue is inked black. Gross examination reveals an excavating lesion on the ectocervix, primarily on the right side, measuring 2.5 x 2 cm. On sectioning, a homogenous yellow-white fleshy tumor is identified beneath the ulceration, involving the stroma of the cervical canal and extending into adjacent parametrial tissue. The tumor measures 1.7 x 1.5 x 1.5 cm and originates in the lower part of the endocervical canal with significant extension into the right half of the cervix. The depth of invasion is 1.4 cm, and the total thickness of the cervix is 1.5 cm. The tumor is located 1.5 cm from the internal cervical os and approaches the resected vaginal margin within 0.2 cm but does not involve it. No parametrial invasion is present.\n\nMicroscopic evaluation shows poorly differentiated cellular features. There is multifocal lymphovascular space invasion. The endometrial cavity is 4 x 2 cm with a secretory endometrium measuring 0.4 cm in thickness. Myometrial thickness is 2.5 cm, with no focal lesions identified. The anterior vaginal cuff measures 6 x 2 x 2 cm and the posterior vaginal cuff measures 6 x 1.5 cm. Resection margins of the vaginal cuff are not involved. The right lateral vaginal margin and additional right mid-vaginal margin show no evidence of involvement.\n\nLymph node dissection includes left and right external iliac, obturator, and periaortic lymph nodes. A total of 14 lymph nodes are examined, and none show evidence of malignancy. The right obturator lymph node specimen contains only mature adipose tissue without identifiable lymphoid tissue. Both fallopian tubes are unremarkable with no focal lesions identified.\n\nHistopathologic grade is poorly differentiated. The tumor does not invade through the full thickness of the cervix or involve contiguous parametrial tissues. There is no vaginal involvement or regional lymph node metastasis. Based on these findings, the tumor is classified as a clinically visible lesion 4.0 cm or less in greatest dimension, with no regional lymph node metastasis and no distant metastasis."} +{"pid": "TCGA-AN-A0FV", "report": "Female patient underwent radical mastectomy for tumor excision. The tumor specimen was collected from the right breast and preserved in frozen format within a cryomold. Histological evaluation revealed infiltrative cellular growth with ductal features. The tissue was moderately differentiated (Grade 2). Staging assessments indicated T Stage 2, N Stage 0, and M Stage 0. No prior treatment was administered. A normal blood sample was also obtained and stored in frozen format within a tube."} +{"pid": "TCGA-AA-3525", "report": "The specimen consists of an ileocolonic resection with an extended, extensively ulcerated, moderately differentiated adenocarcinoma located in the ascending colon. The tumor shows extensive infiltration into the pericolic fatty tissue. Two regional lymph node metastases were identified out of 28 examined lymph nodes. All resection margins, including the large and small bowel, mesenteric, and appendix, as well as the omental fat tissue, are free of tumor involvement. A separate small tubular adenoma with slight dysplasia was also found in the colonic mucosa. The tumor is classified as pT3 pN1 (2/28) pMX; G2, L0, V0 R0."} +{"pid": "TCGA-BF-A1PZ", "report": "The specimen was obtained from a 52-year-old female of Caucasian ethnicity. The tissue sample was collected from the skin and was processed as a primary tumor specimen in frozen format. Histological evaluation showed a cellular composition of approximately 90%, with the remaining percentage attributed to non-cellular components. The histological grade was determined to be grade 4. The tissue was stored in a cryomold, with a total weight of 200 mg. \n\nIn parallel, a blood sample was also collected and processed in a tube, yielding a volume of 4 mL. No abnormal cellular features were noted in the blood specimen, which was also preserved in frozen format.\n\nClinical staging assessments indicated no evidence of nodal or distant metastasis (N0, M0). There was no prior administration of chemotherapy or hormonal therapy before specimen collection."} +{"pid": "TCGA-23-1032", "report": "The surgical specimens include multiple tissue fragments with widespread involvement by a neoplastic process. Tissues submitted include fibroadipose, adipose, and fibromuscular tissue extensively infiltrated by malignant cells. Mesothelial-lined surfaces are present in some areas. Focal skeletal muscle and bladder muscularis are also involved.\n\nA liver wedge resection reveals tumor involvement. The appendix shows involvement of the serosa and mesoappendix, while the mucosa and muscularis propria are uninvolved. A right salpingo-oophorectomy specimen includes a 12 cm mass with extensive involvement of the ovary, paratubal and paraovarian soft tissues, and compression of the fallopian tube without mucosal involvement. A supracervical hysterectomy with left salpingo-oophorectomy reveals a 6 cm ovarian mass with involvement of paraovarian soft tissues and uterine serosa. The endometrium is atrophic with cystic glands, and a small calcified leiomyoma is present. No fallopian tube is identified.\n\nA segmental resection of the rectosigmoid colon demonstrates tumor involvement of the serosa and pericolic fat; the mucosa and muscularis propria are not involved. Surgical margins are free of tumor. Two pericolic lymph nodes show no evidence of malignancy. A left iliac lymph node is negative for tumor involvement. A specimen labeled as right pelvic lymph node contains only benign adipose tissue.\n\nMicroscopic features across all specimens are consistent, showing high nuclear grade cells forming papillary, glandular, cystic, solid, and micropapillary patterns. Cytoplasmic vacuolization is present in some cells. Psammoma bodies, necrosis, acute inflammation, desmoplastic stromal reaction, and focal lymphovascular invasion are noted. Surface exudate containing fibrin, histiocytes, leukocytes, mesothelial cells, and tumor cells is observed in some samples. A prior history of left breast carcinoma was reviewed and does not resemble the current tumor.\n\nGrossly, the omentum is nearly completely replaced by a white-tan, firm, and focally cystic mass measuring 18 x 7 x 4.5 cm. The anterior abdominal wall specimen is 3 x 1 x 1 cm with white-tan, hemorrhagic areas. The pelvic tumor consists of eight fragments aggregating to 7.5 x 7.5 x 2.5 cm. The lesser sac tumor measures 4.5 x 3.0 x 1.5 cm. Two portions of omentum measure 22 x 7 x 4 cm and 22 x 8 x 4 cm, both largely replaced by tumor. A liver tumor nodule measures 1.0 x 1.0 x 1.0 cm within a 2.5 x 2.5 x 1.0 cm specimen. The falciform ligament is 4.7 x 2.0 x 1.0 cm with multiple nodules ranging from 0.2 to 1.5 cm. The mesocolic tumor includes five portions ranging from 0.5 to 1.2 cm. The right gutter tumor is 8.5 x 4.0 x 1.5 cm with multiple small nodules. The right hepatic flexure specimen is 8.0 x 3.0 x 0.7 cm with a 3.5 x 3.0 cm tumor area. A peritoneal tumor measures 4.0 x 3.0 x 1.2 cm entirely replaced by mass. The right colon tumor is 1.2 x 1.0 x 0.5 cm. The appendix is 6.5 cm long with tumor involving the serosa and periappendiceal fat. The right ovary is markedly enlarged at 12 x 10 x 6 cm. The uterus has multiple serosal nodules including one measuring 1.0 cm in diameter. The cul-de-sac tumor is 9.5 x 7.5 x 3.5 cm. The rectosigmoid tumor is 4.5 x 2.5 x 0.5 cm with a 1 x 1 cm tumor focus. Four portions of anterior rectal wall range from 0.7 to 1.5 cm. The bladder peritoneum tumor consists of five portions with nodules up to 2.0 cm. The sigmoid tumor includes two pieces measuring 2.0 and 1.0 cm. The rectosigmoid colon is 4.5 cm in length with serosal nodules. A left iliac lymph node measures 0.9 x 0.4 x 0.3 cm. Two portions of fatty tissue from the right pelvic area are submitted without identifiable lymph node."} +{"pid": "TCGA-19-2631", "report": "The specimen from the right frontal lobe of the brain, submitted as tumor tissue, consisted of multiple irregular tan-white and red fragments measuring 2.5 x 1.5 x 0.6 cm in aggregate. Microscopic evaluation showed features consistent with a high-grade neoplasm. Touch preparations were performed, and portions of the specimen were used for frozen section analysis and permanent sections.\n\nA second specimen from the right frontal region, labeled as cerebriform tissue fragments, measured 6.0 x 5.0 x 3.0 cm in aggregate. The tissue was pink-tan and soft with areas of light tan to red-brown discoloration. Representative sections were submitted for analysis.\n\nA third specimen, received in formalin and labeled as originating from the inferior white matter of the right frontal lobe, contained multiple pink-tan to light tan cerebriform fragments measuring 5.3 x 4.2 x 2.0 cm in total. Similar to the other specimens, this tissue also demonstrated microscopic features of a high-grade lesion. All specimens were processed and reviewed in their entirety, with appropriate cassettes submitted for detailed histologic examination."} +{"pid": "TCGA-AL-A5DJ", "report": "A female patient underwent evaluation of a left renal mass. Specimens included biopsies and excisions from multiple sites: left kidney mass, soft tissue at hilum, fat at diaphragm, anterior margin, medial soft tissue at apex, retroperitoneal soft tissue, left ureter, and left kidney following total nephrectomy.\n\nMicroscopic examination of the left kidney biopsy revealed high-grade carcinoma. The soft tissue at hilum specimen contained fatty tissue with high-grade carcinoma and no identifiable lymphoid tissue. All other specimens\u2014including fat at diaphragm, anterior margin, medial soft tissue at apex, retroperitoneal soft tissue, and left ureter\u2014showed fatty tissue or ureteral tissue without tumor involvement.\n\nThe nephrectomy specimen measured 13.5 x 9.5 x 5.5 cm with perinephric fat and weighed 290 grams. A 6.7 x 5.5 x 5 cm ill-defined fleshy papillary tumor was identified in the superior and mid pole region. Histologic evaluation showed that the tumor extended through the kidney into the surrounding fat, with evidence of vascular invasion. Margins of resection, including vascular and ureteral margins, were free of tumor involvement.\n\nImmunohistochemical staining demonstrated tumor cells focally positive for RCC, CK19, and vimentin, while negative for CD10, keratin903, CK5/6, and CD117. Additional stains performed due to prior thyroid cancer history confirmed positivity for keratin but not for TTF-1 or thyroglobulin.\n\nPathologic staging was assessed as pTNM T3a Nx Mx. No tumor was identified in any of the lymph node regions sampled."} +{"pid": "TCGA-WB-A80O", "report": "The left adrenal gland weighed 75 grams and measured 7.5 x 5.0 x 4.0 cm. A nodule was identified within the gland, measuring approximately 4.5 x 5 x 4 cm. Upon sectioning, the nodule showed cystic changes, areas of hemorrhage, and calcifications. The lesion was completely encapsulated and showed no direct extension beyond the capsule. Histological evaluation revealed a tumor composed of cells with polymorphic, round or angular nuclei, finely granular chromatin, and prominent nucleoli. The cytoplasm was eosinophilic with occasional eosinophilic inclusions. Multinucleated tumor cells with hyperchromatic nuclei were also present. The tumor exhibited a pattern of growth with partially thin and sinusoidal capillaries, minimal stroma, and focal hemorrhage and hyaline fibrosis. In some areas, the tumor approached as close as 1 mm to the resection margin. Focal infiltration into adjacent adipose tissue was observed, although no angio-invasion, necrosis, or mitotic figures were identified. All margins showed at least 1 mm of intervening connective tissue and fat between the tumor and resection planes. Internal review confirmed the findings."} +{"pid": "TCGA-AG-4008", "report": "The specimen shows an invasive, poorly differentiated carcinoma with transmural extension through all parietal layers and evidence of lymphatic and vascular invasion. Histologic grade is high, corresponding to G3. No regional lymph node involvement is identified (pNO). Distant metastasis could not be assessed (MX). Surgical margins are negative (RO). Tumor morphology and architecture are consistent with a gland-forming neoplasm."} +{"pid": "TCGA-LQ-A4E4", "report": "The specimen was received for evaluation and included several components. One lymph node measured 1.1 x 1 x 0.4 cm and was partially fat replaced; it was bisected and submitted for frozen section. Two additional lymph nodes measuring 0.6 x 0.6 x 0.4 cm and 1.1 x 0.9 x 0.5 cm were also identified and submitted for permanent section. Two fragments of lobular golden yellow fibroadipose tissue with attached skin were evaluated, weighing 256 grams in total and measuring between 5 x 3.4 x 2.2 cm and 16 x 11 x 3.5 cm.\n\nA modified radical mastectomy specimen weighed 1,215 grams and measured 20 x 19.5 x 7 cm. The axillary tail measured 11 x 6 x 4 cm and contained multiple tan-red lymph nodes ranging from 0.3 to 2.3 x 1.5 x 1.1 cm. An ellipse of tan-red skin measuring 18 x 9 cm was present with a superomedially placed nipple. The superior margin was inked black, inferior blue, medial green, lateral yellow, and posterior red. The breast tissue was serially sectioned into 17 slices.\n\nIn the upper outer quadrant of the breast, a multinodular, ill-defined pink-gray mass measuring 7 x 5 x 3.8 cm was identified at the 9 to 11 o'clock position, approximately 5\u20136 cm from the nipple. This lesion appeared to come within 0.5 cm of the posterior margin, 1.5 cm of the superior margin, and more than 2 cm from other margins. In the upper inner quadrant at approximately the 2 o'clock position, a smaller pink-gray mass measuring 0.9 x 0.9 x 0.8 cm was located 7\u20138 cm from the nipple and approximately 1 cm from the superior margin, remaining greater than 2 cm from all other margins. The smaller lesion was approximately 3.5 cm away from the larger lesion.\n\nHistologic examination revealed two distinct lesions. Histologic grade was determined based on tubule formation score (3), nuclear pleomorphism score (1), and mitotic count score (1), yielding a total Nottingham combined score of 5. The larger lesion measured 7 cm in greatest dimension and was located in the upper outer quadrant. The smaller lesion measured less than 1 cm and was located in the upper inner quadrant. Both lesions were ill-defined and multinodular. No peritumoral intralymphatic tumor emboli or dermal lymphatic involvement were observed. Skin and nipple were not involved. No ductal carcinoma in situ (DCIS) or microcalcifications were identified.\n\nMargins were assessed as follows: the posterior margin was focally positive with a linear extent of 2 mm; all other margins (superior, medial, inferior, lateral) were negative with distances greater than 1 cm.\n\nImmunohistochemistry performed on formalin-fixed paraffin-embedded tissue demonstrated negativity for e-cadherin. Positive and negative controls stained appropriately. Additional immunohistochemical markers including ER and PR were previously assessed on prior samples. HER2 amplification testing by FISH was also performed on prior samples.\n\nLymph node evaluation identified two sentinel lymph nodes containing metastatic involvement. One lymph node showed extracapsular extension limited to less than 2 mm beyond the capsule. The second lymph node did not demonstrate extracapsular extension. Of the total lymph nodes evaluated (n=26), two contained metastases. The largest metastatic focus measured 5 mm.\n\nStaging according to AJCC criteria indicated pT3 for the primary tumor and pN1a for lymph node involvement. Distant metastasis could not be assessed."} +{"pid": "TCGA-D1-A168", "report": "The surgical specimen included a total abdominal hysterectomy with bilateral salpingo-oophorectomy, along with removal of both ovaries and fallopian tubes. The right ovary measured 1.7 x 1.3 x 1.0 cm with a 8.3 cm segment of fallopian tube, and the left ovary measured 1.8 x 1.2 x 1.0 cm with a 7.4 cm fallopian tube segment; combined weight was 120.0 grams. A portion of omentum measuring 18.4 x 16.2 x 2.2 cm was also removed, along with right and left pelvic lymph nodes, right and left para-aortic lymph nodes above and below the inferior mesenteric artery, and the right and left gonadal vessels (7.4 cm and 6.3 cm in length, respectively). Additional staging biopsies were collected from various peritoneal and serosal sites including cul-de-sac peritoneum, bladder peritoneum, colic gutters, pelvic sidewalls, hemidiaphragm, large and small bowel serosa, and mesentery (specimens ranged from 0.2 cm to 1.8 cm). An appendectomy specimen measured 4.2 x 0.8 cm.\n\nMicroscopic examination identified a polypoid lesion within the endometrial cavity measuring 4.8 x 4.3 x 2.1 cm. Histologic evaluation revealed grade 3 (of 3) epithelial malignancy with extensive squamous differentiation. The lesion invaded 0.6 cm into the myometrium, with a total myometrial thickness of 1.7 cm. There was no involvement of the cervical tissue or uterine serosal surface. No tumor was identified in either ovary or fallopian tube. The omentum showed no evidence of malignancy. All lymph node groups\u2014including right and left pelvic (external iliac, internal iliac, common iliac, obturator), and para-aortic (above and below the inferior mesenteric artery)\u2014were negative for tumor involvement. Gonadal vessel specimens were also free of tumor. All staging biopsies from peritoneal and serosal surfaces were negative. The appendix appeared histologically unremarkable.\n\nStaging classification was AJCC pT1bNXMX based on depth of myometrial invasion and absence of regional or distant spread. Frozen section analysis had shown similar findings with grade 3 endometrial malignancy and focal cellular features requiring confirmation on permanent sections, which were subsequently consistent."} +{"pid": "TCGA-CJ-5672", "report": "The left kidney and adrenal gland specimen shows a well-circumscribed lesion located in the mid-portion of the kidney. The lesion measures 5.0 x 4.5 x 4.0 cm and is characterized by a red-yellow appearance with extensive central hemorrhage and necrosis. Histologic evaluation reveals a mixed cellular composition, with approximately 20% clear cells and 80% eosinophilic cells. Nuclear grading is Fuhrman grade 3. The lesion is confined to the kidney without invasion into the perinephric adipose tissue, renal sinus, or renal vein. A separate small lesion measuring 0.1 cm is identified and described as an adenoma. Additionally, a cortical cyst and a multiloculated cyst measuring 2.0 cm in diameter are present. The ureter, renal artery, and vein margins are free of tumor. No lymph nodes are identified in the hilum. Examination of the adrenal gland demonstrates normal cortical and medullary architecture without evidence of involvement. Serial cross-sections include representative samples of the tumor, surrounding tissue, cysts, normal kidney parenchyma, and adrenal gland."} +{"pid": "TCGA-98-A53C", "report": "A biopsy of the right lower lobe pleura showed benign fibrous and adipose tissue, with no tumor identified. A series of excised lymph nodes from multiple levels including IX-A, VIII, IX-B, IX-C, VII-A through VII-F, XI-A through XI-E, IV-A through IV-F, and II-A through II-E all showed no evidence of tumor. Tissue from level II-D lymph node showed benign adipose and fibrovascular tissue without lymphoid tissue.\n\nA lobectomy specimen of the right lower lobe showed a lesion measuring 1.3 cm in maximum dimension. The histologic evaluation revealed a moderately differentiated squamous cell carcinoma. No lymphovascular invasion was identified. No tumor was found at the bronchial or surgical margins. A separate incidental finding of a benign chondroid hamartoma was noted, measuring 0.5 cm. A nodule located 5.0 cm away from the main lesion was also identified and measured 0.6 cm. The pleura overlying the lesions was marked with ink and no direct pleural involvement was seen. No tumor was identified in the bronchial margin specimen.\n\nThe lung specimen was submitted in multiple cassettes for detailed histologic analysis. Representative sections of the primary lesion, smaller nodule, bronchial and vascular margins, staple margin, and uninvolved lung tissue were all included. All examined lymph node specimens were negative for tumor. The tumor was determined to be unifocal, with no evidence of extension beyond the lung tissue. Staging was based on the size and extent of the primary lesion, which was confined to the periphery of the lung, measuring less than 2 cm in diameter, and surrounded by visceral pleura. No regional lymph node involvement or distant metastasis was identified."} +{"pid": "TCGA-CV-7421", "report": "The specimen was obtained from a male patient through surgical intervention. The tumor measured 3.0 x 2.6 x 1.5 cm and was located in the anterior commissure with extension through the thyroid cartilage into the anterior soft tissues. There was extensive submucosal spread involving both the right and left true and false vocal cords. Microscopic evaluation revealed moderately differentiated cells with invasive growth pattern. Invasion was noted through the thyroid cartilage into pre-laryngeal soft tissue and there was subglottic extension. All margins, including tracheal, mucosal, and anterior soft tissue, were free of tumor involvement. No involvement was identified in the right and left aryepiglottic folds, pyriform sinuses, or epiglottis. A total of eleven lymph nodes were examined, including six from the right subdigastric region, three from the left subdigastric region, and two from the anterior midline; none showed evidence of tumor involvement. Additionally, lymphocytic thyroiditis was noted, and one parathyroid gland was unremarkable. Sections of bone were submitted for decalcification, with results pending."} +{"pid": "TCGA-19-1788", "report": "Surgical pathology report. Specimens were received from multiple regions of the brain, including the temporal tip, an enhancing lesion, permanent core, hippocampus, another enhancing lesion, and posterior temporal area. Histologic evaluation revealed a tumor with mixed features. Certain areas demonstrated characteristics resembling grade II or III astrocytoma, while other regions exhibited morphologic features suggestive of oligodendroglial differentiation. In one focus, necrosis and vascular proliferation were identified, along with cellular morphology indicative of high-grade transformation. Fluorescence in situ hybridization analysis for 1p and 19q chromosomal deletions showed no loss in the regions examined. All specimens were reviewed and retained in departmental files.\n\nIntraoperative evaluation included touch imprint smears from the temporal tip specimen, which showed cytologic features consistent with a glioma displaying oligodendroglial differentiation. Frozen section analysis of the enhancing lesion suggested features of anaplastic astrocytoma.\n\nThe submitted specimens varied in size and appearance. The temporal tip specimen measured 4 x 3.5 x 1.4 cm and contained cerebral cortex and white matter. The enhancing lesion submitted intraoperatively was a small fragment measuring 1.5 x 0.5 x 0.4 cm. Other specimens ranged from 1.0 x 0.4 x 0.2 cm up to 6.7 x 3.2 x 2.2 cm, with most described as soft, cerebriform tissue fragments with tan or pink-tan discoloration. All specimens were processed completely in varying numbers of cassettes ranging from one to twenty-three.\n\nCytologic features and histologic architecture were assessed across all specimens. Cellular atypia, mitotic activity, and architectural disarray were noted in varying degrees throughout the specimens. Necrosis and endothelial proliferation were identified focally in one sample. Immunohistochemical and molecular studies were performed as needed for classification and exclusion of specific genetic alterations."} +{"pid": "TCGA-XF-AAN1", "report": "A radical cystectomy, hysterectomy with bilateral salpingo-oophorectomy, bilateral pelvic lymph node dissection, ileal conduit diversion, umbilical hernia repair, and gastrostomy tube placement were performed. The right and left distal ureters were examined intraoperatively by frozen section and found to contain no tumor. Final evaluation confirmed both ureters were benign with no urothelial dysplasia or malignancy identified.\n\nExamination of the bladder and uterus revealed multiple papillary lesions with high nuclear grade. The largest mass measured 3 cm and was located in various regions including the dome, right and left lateral walls, anterior wall, and right ureterovesical junction. The tumor invaded deep muscle layers (outer half) and extended into the urethra and vagina; however, no mucosal involvement was observed. All surgical margins were free of tumor. No vascular or perineural invasion was present.\n\nThe endometrium appeared atrophic and the cervix showed chronic cervicitis. Both ovaries and fallopian tubes showed no abnormal findings. A total of 53 lymph nodes were evaluated from various pelvic regions, including right and left Cloquet, external iliac, obturator/hypogastric, presciatic, and presacral areas. None showed evidence of tumor involvement.\n\nAdditional specimens including omentum, umbilical hernia sacs, and proximal ureter margins were all negative for tumor. Histologic examination of multiple tissue sections revealed no malignancy in the fallopian tubes, ovaries, or vaginal margin. Pathologic staging was determined as pT4aNOMX."} +{"pid": "TCGA-86-8674", "report": "Specimen type: Pneumonectomy. Tumor site: Lung. Tumor size: 12x4x8 cm with a gray tumor measuring 4 cm in diameter. Histologic features: Moderately differentiated cellular arrangement in a papillary pattern. Lymph node examination: One of two paratracheal lymph nodes demonstrated metastasis, while four subcarinal and three bronchopulmonary lymph nodes showed sinus histiocytosis. Venous invasion was identified. Surgical margins were uninvolved. Extent of tumor was localized. No evidence of neoadjuvant treatment effect was observed. Additional findings included no lymphatic invasion and no other tumor nodules identified."} +{"pid": "TCGA-BQ-5888", "report": "The specimen from a male patient with a right renal mass was examined. The primary lesion measured 3.7 cm in greatest diameter and displayed a combination of papillary, solid, and focal tubular growth patterns. The tumor was high grade with areas of necrosis identified. Multiple smaller neoplastic foci were present in the adjacent kidney, ranging from 3 mm down to less than 0.1 mm. These foci extended to the renal parenchymal margin of resection. Immunostaining showed positivity for CK7 in both the main tumor and satellite nodules; racemase was positive focally in the main tumor but negative in the smaller nodules. CA9 was negative. BAF-47 staining was inconclusive.\n\nTwo lymph nodes from the paracaval region were examined and showed no evidence of tumor involvement, though focal granulomas were present. The surgical margin at the deep aspect of the right kidney contained benign medullary tissue. Gross examination revealed a tan-white tumor with extensive necrosis and a 0.5 cm clearance from the nearest resection margin. The tumor was confined to the kidney and did not show signs of local or venous invasion. Chronic inflammation and arteriolonephrosclerosis were noted in the non-neoplastic kidney. Adrenal tissue was not identified. The findings suggest a possible association with a syndromic condition due to the unusual histologic features, although this could not be confirmed. Close evaluation of the opposite kidney is recommended."} +{"pid": "TCGA-E8-A438", "report": "A partial thyroidectomy specimen from the left lobe contains a well-circumscribed lesion measuring 2.3 cm in greatest dimension. The lesion is unifocal and located entirely within the left lobe of the thyroid. There is no evidence of capsular, angiolymphatic, or extra-thyroidal invasion, nor is there involvement of adjacent tissues. Surgical margins are negative. Evaluation of three lymph nodes (specimens A, B, and D) shows no evidence of malignancy. The remaining thyroid tissue appears unremarkable. Four fragments of parathyroid tissue are identified in slides A4, A5, C1, and C2. The histologic findings are consistent with prior fine needle aspiration cytology, which was reported as suspicious for a neoplastic process."} +{"pid": "TCGA-EO-A3KW", "report": "The specimen included right and left pelvic lymph nodes, as well as a right obturator lymph node, along with a uterus containing cervix, bilateral fallopian tubes, and ovaries. The lymph node dissections consisted of six right pelvic nodes, eleven left pelvic nodes, and four right obturator nodes, all of which were negative for malignancy.\n\nThe hysterectomy specimen revealed a polypoid tumor measuring 3.5 cm in greatest dimension, located predominantly in the posterior endometrium. Histologic evaluation showed the lesion to involve the endometrium with superficial extension into the inner half of the myometrial thickness. No lymphovascular space involvement was identified. The cervix, bilateral ovaries, and fallopian tubes were unremarkable and showed no evidence of malignant involvement.\n\nImmunohistochemical staining showed positivity for WT-1 and ER, while p53 and HNF-1 were negative. The tumor was confined to the uterine corpus without extension to adjacent structures. Surgical margins were free of invasive carcinoma. A total of 21 pelvic lymph nodes were examined, none of which showed metastatic involvement.\n\nGross examination of the uterus measured 7.6 x 4.7 x 3.1 cm and weighed 85.8 grams. The cervix measured 2.8 cm in diameter. Both ovaries were small and unremarkable, with the right ovary measuring 1.9 x 1.1 x 0.6 cm and the left ovary measuring 1.8 x 0.8 x 0.6 cm. The fallopian tubes were similarly within normal limits. The myometrium had an average thickness of 1.0 cm and contained a small white-tan nodule measuring 0.8 cm. Multiple sections were submitted for microscopic evaluation, including full-thickness sections of the anterior and posterior endomyometrium and representative sections of the tumor.\n\nNo additional pathologic findings were identified."} +{"pid": "TCGA-44-2664", "report": "A right lower wedge resection specimen consists of pulmonary parenchyma with a staple line measuring 8 cm in length. The specimen measures 10 x 4.5 x 4 cm. On sectioning, a well-circumscribed, rubbery tan mass measuring 2.5 x 1.9 x 1.8 cm is identified, located 0.5 cm from the stapled margin. The mass is entirely submitted for analysis, along with representative sections of adjacent lung tissue.\n\nA right lower lobe lobectomy specimen weighing 137 grams measures 14 x 9 x 5.5 cm and includes a 1 cm long bronchial stump. No discrete mass is found upon sectioning. The parenchyma appears spongiform and tan-red. Eight blocks are submitted, including bronchial and vascular margins, areas subjacent to the staple line, random normal tissue, and hilar lymph nodes. Two hilar lymph nodes are identified and show no evidence of malignancy.\n\nLymph node specimens are received from levels 12, 7, 9, and 11. Level 12 contains two nodes measuring up to 0.7 cm; level 7 contains a single fragmented tissue measuring 1.6 x 1.3 x 0.2 cm; level 9 contains a small tan-red-gray fragment; and level 11 contains three small fragments averaging 0.25 cm. All are submitted in toto. Metastatic involvement is noted in level 12, while levels 7, 9, and 11 show no evidence of metastasis.\n\nMicroscopically, the primary lesion in the wedge resection is a poorly differentiated tumor measuring 2.5 cm. There is a suggestion of visceral pleural disruption. Resection margins are uninvolved. No evidence of direct extension, large or small vessel invasion, or residual malignancy is found in the lobectomy specimen. Lymph node analysis reveals no metastatic disease in levels 7, 9, and 11, while level 12 shows evidence of nodal involvement. Distant metastasis cannot be assessed from this specimen. Other findings are unremarkable."} +{"pid": "TCGA-B5-A1MS", "report": "The specimen consisted of a uterus with cervix, bilateral fallopian tubes and ovaries, lymph nodes, and omental tissue. The uterus weighed 130 grams and measured 9.8 x 7.0 x 5.5 cm. The serosa was smooth with focal erythema and mild adhesions anteriorly. The endometrial cavity measured 5.5 cm in width and 6.0 cm in length. In the anterior uterine segment, the endometrium was flat and granular, while in the posterior segment, it was granular, friable, and extended into the uterine lumen approximately 1.0 cm above the surface. A well-demarcated 3 mm thick endometrium was observed anteriorly with a myometrial thickness of 1.8 cm. Posterior sectioning revealed a focally ill-defined 2 cm thick endometrium. A 1.4 cm firm, white submucosal nodule with a hemorrhagic center was identified in the fundus, with viable tissue extending beneath it to within 0.8 cm of the serosa. A separate firm, calcified subserosal nodule measuring 3.8 cm was also present.\n\nBoth ovaries were previously incised and showed no nodules or masses. The left ovary weighed 9.9 grams and measured 3.0 x 1.2 x 0.9 cm, with a 3.2 x 0.4 cm fimbriated fallopian tube. The right ovary weighed 10.4 grams and measured 2.8 x 1.4 x 1.0 cm, with a 1.0 x 0.4 cm fimbriated fallopian tube and attached ligamentous tissue.\n\nLymph node specimens included right and left pelvic nodes (aggregate sizes 6.0 x 5.0 x 2.0 cm and 5.5 x 4.0 x 1.0 cm respectively), a left obturator node (4.5 x 2.0 x 0.5 cm), left and right aortic nodes (measuring 2.0 x 0.9 x 0.5 cm and 3.5 x 2.0 x 0.5 cm respectively), and omentum measuring 13.0 x 10.0 x 3.5 cm. All lymph node specimens contained lymph node candidates but showed no evidence of tumor involvement.\n\nMicroscopic evaluation of the uterus demonstrated a region of involvement in the lower uterine segment with a maximum depth of invasion of 1.0 cm in a myometrial wall that was 1.8 cm thick. This region included a 1.4 cm leiomyoma with focal presence of the lesion within and at the interface of the leiomyoma. Vascular invasion was identified. Adjacent non-neoplastic endometrium showed atrophic changes. Additional findings included a calcified leiomyoma and adenomyosis. The cervix showed no significant pathological findings. Surgical margins were negative.\n\nAll other specimens including bilateral ovaries and fallopian tubes, lymph nodes from pelvic and aortic regions, and omental tissue showed no evidence of tumor."} +{"pid": "TCGA-LB-A8F3", "report": "The specimen consists of a resection including the head of the pancreas, a segment of duodenum, distal portion of stomach, and distal portion of common bile duct, along with a separate gallbladder specimen. The pancreatic resection specimen measures 15 x 6 x 6 cm. Within the pancreatic head is a firm, relatively well-defined yellow lesion measuring approximately 5 x 4 x 4 cm. The lesion extends into the duodenal wall near the ampulla and also infiltrates peripancreatic soft tissue. Margins are grossly free of tumor involvement, with the closest distance of tumor to a margin being 2 mm at the uncinate process margin. No tumor is identified in any of the 10 regional lymph nodes evaluated. Microscopic examination reveals low-grade cellular atypia with ductal architecture. The gallbladder shows changes consistent with chronic inflammation without evidence of neoplastic involvement. Intraoperative frozen sections of the common bile duct and pancreatic duct margins show no tumor. The surgical procedure performed was a pancreaticoduodenectomy. Tumor banking was completed for the pancreatic lesion. A total of 10 lymph nodes were examined and none showed evidence of involvement. Distant metastasis could not be assessed from this specimen."} +{"pid": "TCGA-08-0359", "report": "The surgical specimen was received in two parts, both labeled with the patient\u2019s name and medical record number. Part A, labeled \u201cleft occipital tumor,\u201d consisted of a single irregular, unoriented fragment of tan-red, gelatinous, soft tissue measuring 0.8 x 0.5 x 0.3 cm. A portion was used for cytologic preparation (TP1), half was submitted for frozen section analysis (FS1), and the remaining half was placed in cassette A2. Part B, labeled \u201ctumor,\u201d consisted of a larger tissue block measuring 8.5 x 7.0 x 3.2 cm, composed of brain tissue and abnormal growth. The tissue showed extensive areas of necrosis. Representative sections from the tumor and surrounding brain-tumor interface were submitted in cassettes B1 through B9, with cassette B10 containing non-involved brain tissue. Microscopic examination revealed atypical cellular features including nuclear pleomorphism, brisk mitotic activity, and microvascular proliferation. Histological evaluation confirmed the presence of a high-grade lesion. Staging was determined as WHO grade IV based on morphological and architectural features. The final assessment was completed by the attending pathologist following comprehensive review of all specimens."} +{"pid": "TCGA-IR-A3LF", "report": "The submitted specimens include a hysterectomy with bilateral salpingo-oophorectomy, along with multiple lymph node excisions from both sides, including external iliac, internal iliac, obturator, common iliac, and para-aortic regions.\n\nMicroscopic examination of the cervix reveals a lesion with endometrioid features. The maximal thickness of stromal invasion measures 6 mm, within a cervical region that is 20 mm thick at the point of deepest involvement. No evidence of multicentric tumor growth is observed. There is in situ endocervical adenocarcinoma present, but no vascular or perineural invasion is identified. The tumor does not extend into the vagina; however, it reaches the lower uterine segment involving both mucosa and stroma. All surgical margins are free of tumor.\n\nThe endometrium demonstrates atrophy. Within the myometrium, there are findings of adenomyosis and leiomyoma. Both adnexae appear unremarkable. Immunohistochemical staining indicates positivity for CEA and negativity for vimentin, ER, and PR.\n\nLymph node evaluations on both sides reveal no malignant involvement. Each lymph node group\u2014right and left external iliac, internal iliac, obturator, common iliac, and para-aortic\u2014contains only benign lymph nodes upon histological examination, including deeper sections in the left para-aortic lymph nodes."} +{"pid": "TCGA-DJ-A4V5", "report": "The specimen from the Delphain lymph node region consists of multiple lymph nodes ranging from 0.3 to 0.5 cm in size. Three out of four lymph nodes show involvement, with the largest metastatic focus measuring 0.3 cm. No extension beyond the lymph nodes is observed. A separate fragment of thyroid tissue shows chronic inflammatory changes.\n\nThe total thyroidectomy specimen includes a right lobe nodule measuring 4.1 cm in greatest dimension. The nodule is located in the right lobe and is in contact with the capsule. It is not encapsulated and displays firm cut surfaces. Histologic evaluation reveals well-differentiated features without mitotic activity or tumor necrosis. There is no evidence of vascular invasion; however, the tumor extends into perithyroidal soft tissue. A marked stromal reaction, non-psammomatous calcifications, psammoma bodies, and extensive squamous metaplasia are noted. One parathyroid gland is identified. Of the lymph nodes evaluated in this specimen, eight out of eight contain metastatic involvement. The largest involved lymph node measures 0.9 cm, with the largest metastatic focus measuring 0.7 cm. Tumor cells are also present at the posterior inked margin.\n\nIn the right para-esophageal lymph node specimen, four out of five lymph nodes show metastatic involvement. The largest lymph node measures 1.1 cm and is almost entirely replaced by tumor cells. No extranodal extension is seen. A benign parathyroid gland is also identified in this specimen.\n\nMultiple sections from all specimens have been submitted for detailed microscopic evaluation."} +{"pid": "TCGA-IG-A6QS", "report": "Patient ID: Gross Description: A fragment of the esophagus measuring up to 9 x 5 cm was received, containing a grey-white lesion up to 6.5 cm in size with superficial ulceration. Microscopic examination revealed a keratinizing epithelial neoplasm, well differentiated, involving the muscularis propria with ulceration. Two paraesophageal lymph nodes were assessed; one showed evidence of involvement while the other exhibited lipomatosis. Additionally, eight lymph nodes along the left gastric artery were evaluated, with one showing involvement. The remaining lymph nodes displayed anthracosis and follicular hyperplasia. No venous invasion was identified, and all resection margins were free of involvement. There was no prior treatment effect observed. The tumor was located in the lower third of the esophagus and showed ulcerated features."} +{"pid": "TCGA-A7-A13E", "report": "The specimen includes left sentinel lymph nodes, left breast tissue, and axillary contents. Two of three lymph nodes from the sentinel node sample measured up to 1.2 cm in greatest dimension and showed extracapsular extension. The left breast tissue consists of a yellow lobular fatty fragment measuring 7.8 x 7.5 x 4.0 cm with a centrally located white-tan firm nodule measuring 3.5 x 2.5 x 2.5 cm. This nodule was within 2 cm of the superior-inferior margin and 1.5 cm of anterior-posterior margins. Histologically, the tumor showed grade 3 features with an architectural score of 3, nuclear score of 3, and mitotic score of 3. Vascular invasion was present. Non-invasive components included ductal carcinoma in situ (grade 2), with solid and comedo patterns, central necrosis, and less than 10% involvement of the total tumor. Microcalcifications were identified. Margins were negative for both invasive and non-invasive components. Adjacent breast tissue showed proliferative changes. Axillary lymph node examination revealed nine additional lymph nodes, all free of metastatic disease."} +{"pid": "TCGA-DX-A3U9", "report": "The submitted specimen consists of an irregularly shaped piece of soft to rubbery tissue measuring 13.2 x 6.6 x 3.7 cm. The tissue is yellow-tan with lobulated areas and includes regions of red-tan skeletal muscle. A distinct nodular mass is present, measuring 6.4 x 5.5 x 3.6 cm, with a white-tan, glistening, whorled cut surface. Areas of hemorrhage and tan myxoid change are noted within the nodule, which appears entirely viable. The nodule is in close proximity to inked margins at multiple sites. Surrounding tissue shows induration and possible infiltration into adjacent muscle. Microscopic evaluation reveals high-grade cellular features with infiltrative growth into fibroadipose and muscular tissue. Immunohistochemical staining demonstrates positivity for smooth muscle actin and desmin, while stains for CD117 and caldesmon are negative. Multiple representative sections have been processed and photographed for documentation."} +{"pid": "TCGA-BC-A216", "report": "A right lobe liver specimen was received, weighing 3,190 grams and measuring 29 x 22 x 10 cm. The external surface showed areas of redness and adhesion. The capsule was mostly intact, with three areas of disruption (two superior, one inferior), which were marked with yellow ink. The parenchymal margin was marked with blue ink, and a staple line was noted in the specimen.\n\nOn sectioning, a large mass measuring 21 x 16.5 x 10.5 cm was identified, with a central fibrous component measuring 7.5 x 7 x 5.5 cm. The mass had a necrotic, hemorrhagic appearance and was well-defined. It approached as close as 0.3 cm to the parenchymal margin. A separate cluster of small lesions, measuring up to 3 x 2 x 1.5 cm, was found near the main mass, located 4.0 cm away from it, 1.0 cm from the parenchymal margin, and 0.2 cm from the overlying capsule.\n\nMicroscopic evaluation revealed cells arranged in trabecular patterns with nuclear variation and differing degrees of nucleolar visibility. Occasional mitotic and apoptotic figures were observed. No vascular invasion was identified. The surrounding liver tissue did not show cirrhosis but exhibited mild portal inflammation without significant fibrosis.\n\nThe surgical margins were examined. At one of the superior areas of capsular disruption (block A9), tumor cells were found at the margin. Other margins were free of involvement. Additional specimens from segments 2 and 3 of the liver were submitted, both showing only normal liver tissue without any tumor. A diaphragm sample and gallbladder specimen were also submitted; neither showed evidence of tumor involvement or significant abnormality.\n\nStaging information was recorded as pT3 pNx pMx. A portion of the tissue was reserved for further study. All other submitted fragments from various sites were microscopically evaluated and found to be unremarkable."} +{"pid": "TCGA-D7-A74A", "report": "The specimen consists of a resected stomach measuring 17 x 15 cm, along with omentum measuring 21 x 17 cm. A thickened area within the omentum measures 7.5 x 4.2 cm. An ulcerated lesion is present in the gastric mucosa, measuring 8 x 4.5 x 1.3 cm, and is located 1.2 cm from the proximal resection margin and 4 cm from the distal margin. Histologically, the lesion shows tubular growth pattern with moderate differentiation. The tumor invades into the subserosa. Resection margins are negative. Lymph node evaluation reveals metastatic involvement in 4 out of 11 examined nodes, including 1 of 4 pericardial nodes and 3 of 7 greater curvature nodes, with involvement of the nodular capsule. The omentum does not show any neoplastic involvement. Staging is based on depth of invasion and lymph node involvement."} +{"pid": "TCGA-60-2711", "report": "The specimen included multiple lymph node biopsies and lung tissue from a right lower lobectomy. Lymph nodes examined included those at level 7 subcarinal, 4L, second 4L, 4R, 2R, 11R lower lobe, and 11R middle lobe. All lymph nodes were negative for malignancy upon histological evaluation. The right lower lobe measured 17 x 12 x 4.5 cm and contained a firm, gray-white mass located peripherally. This lesion measured 9.0 cm in maximum dimension and extended to the pleural surface. It was well-circumscribed and situated 5.0 cm from the bronchial margin, which was found to be free of tumor. Surrounding lung tissue showed obstructive changes and chronic inflammation. No satellite lesions were identified. Histologically, the lesion showed features of moderately differentiated squamous cell carcinoma with marked clear cell change. Visceral pleural involvement was present. Five hilar lymph nodes were identified and all were negative for tumor involvement. Additionally, a nodule composed of Langerhans cells and eosinophils was incidentally noted in the pleura, raising the possibility of underlying pulmonary Langerhans cell histiocytosis. Scarring in the adjacent lung tissue may be related to this process, though no definitive evidence of the disease was found in the lung parenchyma. Immunohistochemical staining of the Langerhans cells was positive for CD1a and S-100."} +{"pid": "TCGA-P3-A6SX", "report": "A 9 cm x 2.8 cm x 1.5 cm yellow fibrofatty tissue from left neck dissection (level II and III) was submitted, containing multiple lymph nodes. Level II contained twelve potential lymph nodes in one section and two in another; level III contained thirteen potential lymph nodes in one section and three in another. A separate specimen labeled \"left level IA\" consisted of two pieces of soft yellow fatty tissue measuring up to 2.0 x 1.0 x 0.9 cm, with four potential lymph nodes identified and submitted together. The composite resection specimen measured 7.0 x 6.0 x 4.0 cm and included a portion of mandible with attached soft tissue and salivary gland. An ulcerated lesion measuring 3.5 cm x 3.0 cm x 1.3 cm was identified within the soft tissue. This lesion extended closest to the anterior mucosal margin at 0.5 cm, and also approached the superolateral (0.8 cm), posterior (1.0 cm), and inferomedial (0.3 cm) margins. No intact tonsil was observed. The tumor was found to be grayish-white and firm, extending as close as 0.1 cm to the anterior soft tissue margin, 0.3 cm to the inferior margin, and 0.7 cm to the superolateral margin. Margins were inked for identification: blue (anterior), yellow (inferomedial), black (posterior), and orange (superolateral). Sections were taken from various regions including margins, tumor cross-sections, and salivary gland. A small hemorrhagic polyp measuring 0.4 x 0.3 cm was noted on the posterolateral surface. Another specimen labeled \"left level III\" measured 1.2 x 1.2 x 1.3 cm and contained one potential lymph node. The final specimen labeled \"level V node\" was tan-yellow, measuring 1.7 x 1.3 x 0.9 cm, and contained five potential lymph nodes. Histologic evaluation showed no metastatic involvement in lymph nodes from level IA or level V. One of the level II lymph nodes showed presence of tumor cells. No extracapsular extension was observed. In the composite resection, tumor invaded skeletal muscle and focally involved minor salivary gland tissue. Angiolymphatic and perineural invasion were present. All inked surgical margins were free of tumor involvement. Bone margins showed cellular marrow without evidence of tumor involvement. Based on these findings, staging was classified as pT2, pN1, pMx according to the AJCC 6th edition (2002). No bony invasion was identified after decalcification."} +{"pid": "TCGA-B0-4816", "report": "The left kidney specimen from an open radical nephrectomy shows a neoplasm measuring 10 cm. The tumor cells exhibit clear cytoplasm with prominent cell membranes and display nuclear features graded as Fuhrman 2-3 out of 4. The lesion is confined within the renal capsule without extension beyond it. All resected margins, including ureteral, vascular, and soft tissue, are free of tumor involvement. Adjacent renal parenchyma appears unremarkable without significant pathological changes. Based on extent of primary tumor involvement, the staging classification is T2; regional lymph node and distant metastasis status are not assessed (NX, MX). A separate biopsy of level 4R mediastinal lymph nodes reveals multiple fragments of similar neoplastic tissue with nuclear grading corresponding to Fuhrman grade 2 out of 4. Histological evaluation indicates morphologic resemblance between the mediastinal lesion and the previously removed renal neoplasm. Immunohistochemical staining demonstrates positivity for cytokeratin CAM 5.2, epithelial membrane antigen, vimentin, and renal cell carcinoma antigen. Staining for thyroid transcription factor is negative."} +{"pid": "TCGA-WP-A9GB", "report": "The specimen consists of a uterus, cervix, bilateral fallopian tubes, and ovaries. The patient is a female with a prior history of a uterine lesion. Grossly, the hysterectomy specimen weighs 3471 grams and measures 30.9 x 26.5 x 14.5 cm. A large mass measuring 29.5 cm in greatest dimension is identified within the posterior endomyometrium. The mass is necrotic with yellow-white and pink areas, and extends through the cervical os. A portion of the mass protrudes through the serosal surface on the left lateral/posterior wall, with this area inked black. Central calcifications are noted within the tumor. No involvement of the fallopian tubes or ovaries is seen; both pairs of tubes and ovaries appear unremarkable with no significant abnormalities.\n\nHistologically, the lesion demonstrates marked nuclear atypia and multiple foci of necrosis. Mitotic activity is high, with more than 40 mitoses per 10 high-power fields. Immunostains show positivity for desmin, caldesmon, and HHF-35, while pancytokeratin is negative. MIB1 staining indicates a high proliferative index (approximately 60\u201370%). The lesion invades the myometrium but does not extend into adjacent organs. Margins are free of tumor, although the mass focally breaches the uterine serosa. No lymphovascular invasion is identified. Lymph nodes were not assessed as none were present in the specimen.\n\nPathologic staging is assigned as pT1b (tumor greater than 5 cm) with pNX (regional lymph nodes not assessable). The stage is considered provisional and based solely on available pathologic findings. Multiple representative sections from the tumor and surrounding tissue were submitted for analysis, including sections from the cervix, uterine walls, parametria, fallopian tubes, and ovaries. All tests performed were validated in compliance with applicable regulations, using appropriate control tissues to ensure accuracy."} +{"pid": "TCGA-BJ-A2NA", "report": "The thyroidectomy specimen weighed 31 grams and included a largest nodule measuring 1.5 cm. Histologic examination revealed multiple tumor foci, with at least 7 located bilaterally throughout the gland. The largest focus was identified in the right mid lobe and exhibited conventional histologic features with areas showing tall cell morphology. Angiolymphatic invasion was present, and there was microscopic evidence of extension beyond the thyroid capsule. The tumor approached the surgical margin focally.\n\nOne lymph node was identified in the central compartment and showed no evidence of tumor involvement. An oncocytic follicular lesion, measuring 2.5 cm, was also present in the right lobe. Additional findings included chronic lymphocytic thyroiditis and nodular hyperplasia. The parathyroid gland and thymic tissue were unremarkable, and no lymph nodes were identified in the excised central compartment contents.\n\nMolecular testing demonstrated the presence of a BRAF mutation. No mutations were detected in NRAS61, HRAS61, KRAS12/13, or RET/PTC rearrangements. Nucleic acid quantity was sufficient for analysis. The pathologic stage was determined to be pT3 pN0."} +{"pid": "TCGA-5B-A90C", "report": "A total hysterectomy with bilateral salpingo-oophorectomy and lymph node dissection was performed. The surgical specimens included right and left pelvic and periaortic lymph nodes, as well as the uterus, cervix, fallopian tubes, and ovaries. All lymph nodes examined were negative for malignancy, with 13 right pelvic, 10 right periaortic, 11 left pelvic, and 8 left periaortic lymph nodes assessed.\n\nThe uterus weighed 226 grams and measured 7.5 cm in length, 7.5 cm cornu to cornu, and 6.0 cm anterior to posterior. A mass measuring 7.0 x 6.0 x 2.5 cm was identified in the endometrium, located primarily in the anterior lower uterine segment and extending along the right lateral endometrial cavity to involve much of the posterior surface. The mass was exophytic and showed superficial mucosal involvement without gross extension into the myometrium. Microscopically, it exhibited features consistent with a well-differentiated adenocarcinoma. Histologic grade was determined to be FIGO grade 2. Invasion of the myometrium was present, with a depth of 0.4 cm and a total myometrial thickness of 1.5 cm. No venous or lymphatic invasion, perineural involvement, or cervical extension was identified. Ovarian involvement was not present.\n\nSurgical margins were uninvolved. Peritoneal washings were negative. Additional findings included complex hyperplasia and a calcified leiomyoma. Staging was determined as pT1a (tumor limited to the endometrium or invading less than half the myometrium) and pN0 (no regional lymph node metastasis). Immunohistochemical staining for microsatellite instability was performed."} +{"pid": "TCGA-S9-A7IS", "report": "The neuropathology review indicates that the initial diagnosis was a high-grade glial neoplasm, WHO grade III. Upon further examination, there are findings suggestive of progression toward a more aggressive phenotype. The tumor demonstrates features consistent with a diffusely infiltrative astrocytic neoplasm, including nuclear atypia, brisk mitotic activity, and focal microvascular proliferation. No definitive necrosis was identified. The cellular morphology and architectural patterns were assessed, with measurements documenting moderate pleomorphism and increased cellularity. Immunohistochemical staining showed positivity for GFAP and mutant IDH1, while ATRX expression was retained. MGMT promoter methylation status was not detected. The histologic grade remains WHO grade III based on current evaluation."} +{"pid": "TCGA-21-1079", "report": "The specimen consisted of five parts. Part A was a 0.8 x 0.6 x 0.3 cm gray-black lymph node from level IX, submitted in toto for frozen section evaluation; no abnormal tissue was identified on frozen section. Part B consisted of a 0.6 x 0.4 x 0.3 cm gray-black, firm lymph node from level X, also submitted in toto. Part C was a left pneumonectomy specimen weighing 420 grams and measuring 20.5 x 14.5 x 4.5 cm, covered by pink-red pleura. A 4.5 x 3.5 x 2.0 cm firm mass was identified in the anterior segment of the upper lobe, with light to gray-tan, focally friable and hemorrhagic cut surfaces. The mass extended to the overlying pleura and surrounding hilar region. The bronchial margin was evaluated by frozen section and found negative. Several palpable hilar lymph nodes were present, ranging from 0.4 to 1.0 cm in size, with brown-black, anthracotic-stained cut surfaces. Representative sections included vascular and bronchial margins, tumor with overlying pleura, random lung sections, and hilar lymph nodes. Part D included three level V lymph nodes, measuring between 0.4 and 1.2 cm, all with brown-black, anthracotic appearance. Part E was a level VII lymph node within a yellow-tan adipose fragment containing several red-black lymph nodes measuring 0.8 to 1.8 cm. All lymph nodes evaluated across all levels were negative for abnormal cells. No evidence of involvement was found in the vascular or bronchial resection margins."} +{"pid": "TCGA-CH-5750", "report": "The specimen shows a predominantly moderately differentiated lesion involving both sides of the gland, primarily located in the peripheral zone. The maximum diameter of the lesion is 2.4 cm. There is bilateral extension beyond the organ near the seminal vesicles. Multiple sites demonstrate involvement of perineural spaces. The surgical margins are free of the lesion. Immunohistological evaluation of representative tissue samples does not reveal evidence of vascular invasion. High-grade intraepithelial proliferative changes are present, along with myoglandular hyperplasia. The urothelium of the prostatic urethra appears without abnormal proliferation. Seminal vesicles and ducts show no pathological involvement. A total of seven lymph nodes are examined, all without evidence of involvement. Frozen section analysis confirms negative margins at the green/yellow-labeled site, despite tumor contact noted at the yellow-labeled margin. Pathologic staging is pT2c with no residual tumor at resection margins (R0), and no nodal metastasis (pNO, 0/7)."} +{"pid": "TCGA-XR-A8TD", "report": "The liver biopsy specimen consisted of a liver segment weighing 2878.0 grams, measuring 21.0 cm in craniocaudal direction, 21.0 cm in side axis, and 11.0 cm anteroposteriorly. The outer surface was smooth and brown, with a bloody area measuring 14.0 x 9.0 cm and a nodular brownish lesion measuring 3.5 x 3.0 cm. On sectioning, a large nodular, whitish, and soft lesion was identified, measuring 19.5 x 19.0 x 10.0 cm. The gallbladder measured 9.0 x 2.0 cm, with a smooth brown-gray serosal surface and greenish mucosa. Lymph nodes from the hepatic hilum were also examined, with the largest measuring 4.5 x 3.5 x 0.9 cm and the smallest 1.7 x 0.5 x 0.3 cm.\n\nMicroscopic evaluation revealed a high-grade cellular proliferation with clear cell morphology. The lesion showed extensive areas of necrosis. Infiltration of the Glisson capsule was observed. Vascular structures, lymph nodes of the hepatic hilum, gallbladder, and resection margins did not show evidence of tumor involvement. The staging was assessed as pt3, pno."} +{"pid": "TCGA-CV-A6JY", "report": "The patient is a male with a height of 174.0 cm and a body surface area of 1.9 m\u00b2. A composite resection specimen involving the left mandible, buccal mucosa, and floor of mouth was examined. The specimen measured 9.5 x 4 x 4 cm. An ulcerated lesion measuring approximately 2.8 x 2.5 x 1.5 cm in the floor of mouth extended to involve the gingival and buccal surfaces, with a maximum dimension of about 5.0 cm. The surface of the mandible appeared eroded. The lesion was located approximately 0.5 cm from the closest soft tissue margin.\n\nLymph node evaluation included multiple levels. In level 2A, twelve lymph nodes were identified, all negative for tumor involvement. Level 2B contained fibroadipose tissue without identifiable lymph nodes. Level 3 contained seven lymph nodes, all negative for tumor. Level 4 contained eight lymph nodes, also negative for tumor. Additional lymph nodes associated with the composite resection specimen were negative (0/3).\n\nHistological features of the lesion showed well-differentiated morphology with an exophytic growth pattern. Invasion was present with a depth of at least 1.5 cm. The tumor border was infiltrative, with thick cords greater than four cells in thickness. Perineural invasion could not be fully assessed due to pending decalcification sections. Vascular invasion was not identified. Bone and cartilage invasion status remained pending further decalcification processing.\n\nMultiple surgical margins were evaluated. These included lateral deep, masseter, anterior sublingual, anterior alveolar nerve, retromolar trigone, posterior buccal, and posterior floor of mouth margins. All were negative for tumor involvement. The anterior mandible bone margin was also negative on gross examination.\n\nAdditional specimens included teeth, which were submitted for gross evaluation only. Tissue banking was performed for both tumor and normal tissue. Bone involvement was noted with the lesion extending to a depth of 0.7 cm and closely approximating the nerve. Sections L11 through L13, including the anterior mandible margin and representative areas of bone and nerve involvement, were submitted after decalcification for further evaluation.\n\nAll frozen section evaluations of margins were negative for tumor."} +{"pid": "TCGA-ZB-A96I", "report": "Pathology Report-Summary: Material: Tumor diameter: 4.2 cm. The tumor is characterized by a size of 4.2 cm. Histological analysis shows a mixed pattern with features of both type A and B variants. Staging according to the Masaoka classification is stage III, indicating local invasion. There is evidence of infiltration into the mediastinal fat tissue and lung parenchyma. Immunohistochemical staining reveals epithelial cells positive for CK 5/6, and negative for CD1a, CD5, and CD117. Scattered among the epithelial cells are CD5-positive mature T-lymphocytes."} +{"pid": "TCGA-BH-A0W3", "report": "The patient underwent a left segmental mastectomy and sentinel lymph node biopsy. A mass was identified in the upper inner quadrant of the left breast, with a maximum dimension of 15 mm for the invasive component. Histologic evaluation showed features consistent with ductal adenocarcinoma. The tumor demonstrated a Nottingham score of 6 (nuclear grade 2, tubule formation score 3, mitotic activity score 1), corresponding to grade 2 differentiation. In addition, there was an in situ component measuring 6% of the total tumor volume, composed of cribriform and micropapillary patterns.\n\nImmunohistochemical staining for HER-2/neu showed a score of 2+ with weak to moderate complete membrane staining observed in more than 10% of cells. Fluorescence in situ hybridization (FISH) analysis using block 1B was performed to evaluate HER-2/NEU gene amplification. The HER-2/NEU to chromosome 17 centromere ratio was 1.69, below the threshold of 2.2 required for amplification. No amplification was detected. The average number of HER-2/NEU signals per cell was 4.10, while the average for the chromosome 17 centromere was 2.43. Polysomy or aneuploidy of chromosome 17 may be present based on these findings.\n\nThe tumor was positive for estrogen and progesterone receptors with H-scores of 300 and 225, respectively. Surgical margins were evaluated; the invasive tumor was 2.5 mm from the anterior margin and 4 mm from the posterior margin, while the DCIS component was less than 0.2 mm from the anterior margin. No lymphovascular invasion was identified.\n\nA total of four lymph nodes were examined. One of two sentinel lymph nodes contained metastatic involvement, measuring 1 cm, while the other three were negative. Staging was determined as pT1c for the primary tumor and pN1a for nodal involvement. Additional benign findings included atypical ductal hyperplasia, fibrocystic change, ductal epithelial hyperplasia, and a papilloma. Post-biopsy changes were also noted. An additional excision of the anterior margin revealed benign fibroadipose tissue."} +{"pid": "TCGA-AR-A2LL", "report": "A left simple mastectomy specimen contains a central breast mass measuring 9.2 x 4.2 x 3.2 cm, along with a smaller adjacent nodule measuring 0.8 x 0.7 x 0.6 cm located inferiorly. The mass demonstrates Nottingham grade II features based on histologic scoring (tubules 3/3, nuclei 2/3, mitoses 1/3; total score 6/9). Within and around the invasive component is a focus of in situ lesion measuring up to 0.6 cm in greatest dimension. No angiolymphatic invasion is identified. The surrounding non-neoplastic breast tissue exhibits proliferative fibrocystic changes and calcifications are noted within benign ducts and acini. There is no involvement of the nipple, skin, or chest wall. All surgical margins, including the deep margin, are free of tumor, with the minimum distance from tumor to margin being 0.4 cm. Evaluation of four left axillary sentinel lymph nodes (numbers 1, 2, 3, and 4) reveals no evidence of metastatic involvement. Immunohistochemical staining for cytokeratin supports the negative nodal findings. Additional testing for Her-2/Neu is pending on paraffin-embedded tissue."} +{"pid": "TCGA-A4-7286", "report": "The left kidney specimen demonstrates a unifocal lesion measuring 3.0 x 3.0 x 2.5 cm, located within the renal parenchyma. Microscopic evaluation reveals that the lesion extends beyond the renal capsule into the adjacent perinephric adipose tissue by approximately 0.1 cm. The cellular morphology includes polygonal to columnar cells with enlarged oval nuclei and prominent nucleoli arranged in a papillary pattern. Scattered macrophages are present within the papillary cores. Nuclear grading is consistent with high-grade morphology. No lymphovascular invasion or sarcomatoid differentiation is observed. Surgical margins are free of tumor involvement, with the closest distance of the lesion to the deep inked margin being 0.3 cm. Additional biopsies from the superior, lateral, and base regions of the kidney do not show any neoplastic elements. A separate cyst wall specimen reveals benign fibrous tissue. The staging classification indicates local extension beyond the kidney without nodal or distant spread."} +{"pid": "TCGA-86-7714", "report": "Case ID. Gross Description: Labeled right lower lobe. Sections reveal a 3.5 x 3 x 2.5 cm wedge of lung tissue with intact gray pleura. On cross-section, there is a 2.1 cm subpleural lesion with a glistening white mucoid surface. The tumor is 12 mm from the nearest stapled margin. The pleura has been inked blue. No satellite nodules are detected. The remaining lung tissue is brown and spongy. Microscopic: Tumor exhibits papillary, lepidic, acinar, and micropapillary growth patterns. Angiolymphatic invasion is present. Lymphatic and venous invasion are noted. One involved lymph node (subcarinal) contains a metastatic deposit measuring 0.25 cm. Staging is T2a N2 MX. No evidence of satellite nodules or additional tumor deposits is seen. The margins are not specified. Subject ID."} +{"pid": "TCGA-BP-4801", "report": "The specimen consists of a left renal hilar mass measuring 4 x 4 x 0.5 cm, with a suture marking the deep surgical margin. Gross examination reveals a tumor measuring 3.2 x 2.8 x 2.1 cm with a variegated brown-tan and yellow cut surface that is solid and cystic. The tumor is located within the kidney and does not extend beyond it. Microscopic evaluation shows nuclear grade II/IV morphology with clear cell features. There is no evidence of local invasion, renal vein involvement, or lymph node involvement. The surgical margins are free of tumor. Non-neoplastic kidney tissue appears unremarkable. No adrenal or lymphoid tissue was identified. Staging indicates the lesion is confined to the kidney and measures less than 7.0 cm in greatest dimension. A representative section of the nearest margin was examined intraoperatively and found negative for tumor. Portions of the tumor were submitted for further analysis."} +{"pid": "TCGA-B5-A0JY", "report": "The clinical specimen includes a hysterectomy specimen with bilateral attached fallopian tubes and ovaries, weighing 734 grams and measuring 10.5 x 13.5 x 14.5 cm. The endometrial cavity is distorted by a white mass with irregular borders extending through the full thickness of the myometrium to the serosal surface. The mass measures approximately 10 x 7 x 4 cm and displays endophytic growth with focal protrusion into the uterine cavity (1 x 1 x 1 cm). Areas of focal necrosis are present, up to 1 cm in size. The tumor is within 1 cm of the lower uterine segment but does not appear to involve the cervix. Two intramural leiomyomas are identified, with the largest measuring 2 cm. The serosal surface shows pale plaque-like lesions that are focally hemorrhagic.\n\nA pedunculated paratubal cyst is present in the left fallopian tube (measuring 5 x 1 cm), and the left ovary (3 x 3 x 2 cm) contains a cyst (1 x 1 x 1 cm) with watery content upon sectioning. The right fallopian tube (6 x 1 cm) and ovary (1.5 x 1 x 0.5 cm) show focal hemorrhagic adhesions but no other significant findings.\n\nA left gutter biopsy, measuring 1.5 x 0.5 x 0.3 cm, is submitted entirely and shows only fibroadipose tissue without evidence of malignancy. A left pelvic lymph node dissection includes an aggregate of fibrofatty tissue measuring 8 x 3 x 2 cm containing one lymph node replaced by a white necrotic mass measuring 4 x 3 x 2 cm. Additional lymph node candidates are submitted across blocks C2, C3, and C4. A right pelvic lymph node dissection includes a 2 x 2 x 1 cm lymph node candidate infiltrated with a white necrotic mass; additional candidates are submitted across blocks D2, D3, and D4. Sections from these lymph nodes reveal metastatic involvement.\n\nA piece of omentum measuring 17 x 2 x 1 cm reveals focal hemorrhage but no mass lesions. A sigmoid mesenteric biopsy measuring 1 x 0.2 x 0.3 cm is submitted entirely and shows only fibroadipose tissue.\n\nIntraoperative frozen section of the serosal surface demonstrates malignant cells consistent with poorly differentiated carcinoma. Microscopic evaluation confirms a completely solid, sheet-like growth pattern with no glandular, papillary, or squamous differentiation. Lymphatic and vascular invasion is present. No adjacent non-neoplastic endometrium is identified. Serosal involvement is confirmed, and the right fallopian tube shows serosal implants. Both ovaries and the left fallopian tube are free of tumor. The cervix is also free of tumor involvement. Surgical margins are not involved.\n\nMetastatic disease is found in one of ten left pelvic lymph nodes (measuring 4 cm) and in one of seven right pelvic lymph nodes (measuring 2 cm). No malignancy is detected in the omentum or sigmoid mesentery. Based on AJCC 6th Edition staging criteria, the pathologic stage assigned is pT3a pN1 pMX."} +{"pid": "TCGA-CM-5863", "report": "The specimen consists of a right hemicolectomy specimen including the terminal ileum, cecum, and ascending colon. The terminal ileum measures 5.5 cm in length and 4.5 cm in circumference at the proximal resected margin. The remaining colon measures 17 cm in length with a circumference of 5.4 cm at the distal resected margin. No appendix is identified. A focally hemorrhagic, lobulated yellow-tan adipose tissue spans the length of the specimen measuring up to 1.1 cm in thickness.\n\nA friable polypoid lesion measuring 6.0 cm in length and 10.0 cm in width is identified in the ascending colon, located 10.3 cm from the proximal margin and 5.0 cm from the distal margin. Microscopic examination reveals moderately differentiated cells without tumor budding or increased tumor-infiltrating lymphocytes. The lesion invades through the muscularis propria into surrounding tissues and reaches the subserosal adipose tissue and/or mesenteric fat, with a maximal thickness of 1.0 cm. There is no gross evidence of tumor perforation. Perineural invasion is present; lymphovascular invasion is suspected while large venous invasion is not identified. The surgical margins are free of tumor involvement.\n\nWithin the specimen, a 1.5 x 0.8 x 0.5 cm gelatinous-filled cyst cavity is observed within the lesion. The remaining mucosa appears tan-brown with normal folds. The ileocecal valve is edematous. No precursor lesions or polyps/mucosal dysplasia away from the lesion are identified. Non-neoplastic bowel tissue is otherwise unremarkable.\n\nLymph node dissection includes a total of 12 lymph nodes, with 3 showing involvement. Tumor deposits are also identified within the pericolorectal soft tissue. Based on AJCC 7th Edition staging criteria, the depth of invasion corresponds to pT3 classification. The lymph node stage is classified as N1b."} +{"pid": "TCGA-MH-A561", "report": "A partial nephrectomy specimen from the left kidney was examined. The specimen weighed 10.9 grams and measured 4.1 x 2.8 x 2.5 cm. It included a tan-brown resection margin with a tan-white smooth capsule surface. A well-circumscribed, tan-yellow mass measuring 1.8 x 1.8 x 1.8 cm was identified and noted to extend to the capsular surface. The mass was located 0.2 cm from the renal resection margin. No other lesions were observed. All tissue was submitted for analysis.\n\nMicroscopic evaluation revealed a papillary architecture with low nuclear grade. The lesion was confined within the kidney without evidence of sarcomatoid change, tumor necrosis, or lymphovascular invasion. Surgical margins were free of invasive disease. Additional sections showed no involvement of the capsule.\n\nThe non-neoplastic kidney tissue demonstrated chronic pyelonephritis. Based on AJCC/UICC TNM staging criteria, the lesion was classified as pT1a, with no regional lymph node involvement (pNx) and no distant metastasis (pMx). The tumor was unifocal, located in the lower pole, and limited to the kidney."} +{"pid": "TCGA-33-AASD", "report": "A wedge resection of the lung tissue was received, measuring 12 x 9 x 4 cm and weighing 200 grams. A nodule measuring 2.5 cm was identified in the central portion of the specimen. The nodule was gray and white in color, firm in consistency, and well demarcated from the surrounding lung parenchyma. It approached within 1 cm of the stapled margin and was similarly close to the inked pleural surface. Margins including vascular, bronchial, and visceral pleura were all negative for abnormal cells. Adjacent lung tissue showed mucous plugging in focal areas with otherwise normal parenchyma.\n\nSections examined included vascular and bronchial margins (sections A\u20134), parenchymal shaves near the staple margin (B\u20133), the area closest to the visceral pleura (C\u20131), representative tumor sections (D\u2013E and F\u20131), tumor adjacent to bronchus (G\u20131), and distant parenchyma (H\u2013I). Scattered necrotizing granulomas were observed; however, special stains including AFB and GMS were negative.\n\nTwo lymph node specimens were also evaluated. One was obtained from station VII, measuring 2.7 x 1.5 x 0.6 cm, and the second from level IX, measuring 1 x 0.6 x 0.3 cm. Both were partially submitted for permanent sections and partially reserved for further studies. All lymph node evaluations showed no evidence of abnormal cellular infiltration.\n\nThe staging assessment indicates a primary lesion size of 2.5 cm without lymph node involvement or distant metastasis. Tissue sampling encompassed nine total sections from the lung wedge and one section each from the lymph node specimens."} +{"pid": "TCGA-J8-A3O0", "report": "The right thyroid lobe and isthmus specimen measured 8.3 x 5.5 x 3.0 cm and weighed 30 grams. A firm encapsulated mass measuring 2.8 x 2.7 x 2.5 cm was identified within the thyroid tissue. The mass was submitted for both frozen and permanent section evaluation along with additional sections of uninvolved thyroid tissue. Histologic examination of the mass revealed cellular features consistent with a follicular growth pattern.\n\nThe left thyroid lobe specimen measured 5.0 x 3.3 x 1.8 cm and weighed 11 grams. No significant findings were observed upon sectioning and histologic evaluation.\n\nA lymph node biopsy from the left paratracheal region measured 1.0 cm in greatest dimension. Histologic evaluation showed no evidence of abnormal cellular proliferation.\n\nThe central compartment tissue measured 2.5 x 1.5 x 0.8 cm and contained multiple small structures suspicious for lymph nodes. All were submitted for histologic analysis and showed no signs of cellular atypia or abnormal tissue involvement.\n\nRight paratracheal tissue measured 1.3 x 1.0 x 0.6 cm and demonstrated only fibroadipose tissue without any evidence of abnormal cellular infiltration.\n\nStaging assessment indicated that the primary lesion was confined to the thyroid gland, measuring greater than 2 cm but less than 4 cm in size. No lymph node involvement was identified. A total of three lymph nodes were examined and none showed evidence of abnormal cells. Distant metastasis could not be assessed. Surgical margins were free of abnormal cells."} +{"pid": "TCGA-HC-8266", "report": "The prostate specimen measured 4.5 x 4.0 x 4.0 cm and weighed 50 grams. The dominant lesion measured 5.0 x 2.0 x 1.5 cm, with an estimated volume of 15 cc. Histologic evaluation revealed a high-grade lesion with a primary and secondary pattern of Grade 4. The tumor involved approximately 30% of the prostate. The largest nodule was located in the posterior central region. There was evidence of bilateral capsular penetration and extension into the seminal vesicles, with positive surgical margins noted posteriorly. Lymphvascular invasion was present. No involvement was identified at the apical, bladder neck, anterior, lateral, or posterolateral margins. Pelvic lymph node dissection yielded 5 lymph nodes, all of which were negative for abnormal cellular infiltration. Extraprostatic extension was observed but not localized to a specific focus. The tissue samples were processed and submitted according to standard protocols."} +{"pid": "TCGA-A2-A3KD", "report": "The specimen consisted of sentinel lymph nodes and a right breast lumpectomy. In the first sentinel lymph node biopsy, one lymph node contained a micrometastasis measuring 0.27 mm microscopically, with isolated tumor cells also present in extracapsular lymphatic spaces. Another lymph node showed only isolated tumor cells, while the third was negative for tumor involvement based on histological and immunohistochemical evaluation. The second sentinel lymph node biopsy revealed a lymph node negative for tumor by both histology and immunohistochemistry, though isolated tumor cells were identified in extracapsular lymphatic spaces.\n\nThe lumpectomy specimen revealed a well-differentiated infiltrating carcinoma with mucinous features. Histologic grading using the Nottingham system yielded a score of 4 out of 9 (tubule formation: 2; nuclear pleomorphism: 1; mitotic activity: 1). The tumor measured 4.0 cm in greatest dimension on gross examination and showed no necrosis or calcifications. There were areas suspicious for lymphatic invasion. The tumor was found at the inked margins, including superior, anterior, medial, and deep aspects of the specimen. A focal in situ component was identified as low-grade ductal carcinoma in situ, with solid and cribriform patterns observed.\n\nOf four sentinel lymph nodes examined, one contained micrometastatic disease. Immunohistochemical analysis showed positivity for estrogen receptors (>95%) and progesterone receptors (90%), while HER2 testing by immunohistochemistry was negative (score 1+). Additional findings included stromal sclerosis, focal microcyst formation, and changes related to a prior biopsy site.\n\nGrossly, the lumpectomy specimen measured 6.5 cm in length, 5.5 cm in width, and 2.0 cm in depth. The tumor appeared firm and gritty, with well-defined borders in part of the lesion and ill-defined margins elsewhere, involving approximately 75% of the cut surface. It extended to multiple inked margins. The surrounding breast tissue was fibrous and dense. No other distinct lesions were identified. Multiple sections were submitted for analysis, covering the tumor and its margins comprehensively."} +{"pid": "TCGA-IN-8663", "report": "The liver biopsy specimen shows no evidence of iron or PAS-D positive material. Trichrome staining reveals subcapsular fibrosis. A separate liver biopsy demonstrates the presence of a small lesion measuring 0.3 cm, along with findings of microhamartoma and subcapsular fibrosis. Lymph node dissections from various locations including paraesophageal, subcarinal, level 7, and those near the azygous vein and left and right main bronchi all show benign lymph nodes without any abnormal cellular infiltration.\n\nA lymph node located within the gastroesophageal fat pad contains fibroadipose tissue with fat necrosis and mild hemorrhage. Another lymph node evaluation from this region identifies metastatic involvement in nine out of fourteen nodes examined. An excised gastric ring specimen reveals benign esophageal and gastric tissue. Final gastric margins are also benign.\n\nMacroscopic examination of the resected esophagogastric junction specimen identifies a lesion measuring 4.0 cm in greatest dimension. Microscopically, the lesion is composed of poorly differentiated cells with features suggesting heterogeneity, including focal positivity for synaptophysin. The tumor infiltrates into the muscularis propria layer. Intestinal metaplasia is noted in the stomach and at the gastroesophageal junction. Angiolymphatic invasion is present; however, there is no evidence of perineural invasion. Resection margins are free of tumor involvement.\n\nImmunohistochemical staining reveals focal positivity for MUC-2, MUC-5, CDX-2, CK20, and CK7, supporting glandular differentiation. PAS-D and Alcian blue stains highlight the presence of goblet cells, further supported by mucicarmine positivity. Chromogranin and CD56 staining are negative.\n\nLymph node assessment includes a total of 24 nodes examined, with 10 showing metastatic involvement. Pathologic staging is determined as pT2N3. There was no prior treatment administered before surgical intervention. Additionally, intestinal metaplasia consistent with Barrett\u2019s esophagus is identified within the stomach and gastroesophageal junction."} +{"pid": "TCGA-BJ-A0Z9", "report": "The specimen consists of a total thyroidectomy weighing 11.6 grams. Two separate lesions were identified. The larger lesion measures 2.8 cm in the left lobe and demonstrates extrathyroidal extension to the margin. Histologic evaluation shows perineural and angiolymphatic invasion. A second smaller lesion measuring 0.1 cm is present in the right lobe, confined within the thyroid without angiolymphatic invasion. Histologic features include focal squamous metaplasia and areas with hobnail morphology. Pathologic staging is pT3 pN0. Six central compartment lymph nodes were examined and none showed evidence of involvement. Surgical margins are involved on the left side. Vascular invasion is present. Additional findings include slight nodular hyperplasia and a fragment of a normocellular parathyroid gland. No tumor was identified in the lymph nodes or parathyroid tissue. The tumor demonstrates multifocal distribution with a combined total of two foci. Largest nodule measures 2.8 cm. A total of six regional lymph nodes were examined, all negative for tumor involvement."} +{"pid": "TCGA-WA-A7H4", "report": "The surgical specimen includes a piece of excised tissue measuring 4x3x2 cm, with one side covered by mucous membrane. On the mucosal surface, there is a 1.7x0.8 cm ulcerated area with minimal distances to the resection margins: 1.2 cm to the anterior edge of the tongue, 0.6 cm to the lateral floor of the mouth, 1.3 cm to the base of the tongue, and 1 cm to the medial aspect. A straight cut was made at the lateral floor of the mouth margin. The coloring indicates blue from the lateral to the base, red from the base to the anterior, and black for the depth.\n\nCut surfaces beneath the ulcerated mucosa reveal a grayish-white lesion extending approximately 0.5 cm in depth. Distances from this lesion to the lateral, medial, and deep resection margins are 0.6 cm, 0.9 cm, and 0.9 cm, respectively. Several lamellae are described: one at the anterior edge of the tongue, six lamellae extending from the tongue\u2019s edge toward the base, and another at the base of the tongue. An additional small piece of healthy mucosa, measuring 0.7x0.5 cm, was also excised and embedded entirely.\n\nMicroscopic examination of cross-sections reveals margins lined by dysplasia-free multilayered non-keratinizing squamous epithelium, with underlying skeletal muscle and serous glands. In central lamellae, the mucosa is partially ulcerated and scabbed, with underlying irregular formations of atypical squamous epithelium. These structures grow in a solid pattern near the surface and a more ragged, reticular arrangement deeper within. Cellular features include variability in size and shape, pale eosinophilic cytoplasm, pleomorphic and enlarged nuclei, prominent nucleoli, and numerous mitotic figures, including atypical forms. Multinucleated cells are observed repeatedly. Keratinization varies in degree.\n\nSurrounding stroma shows a desmoplastic reaction with a moderate inflammatory infiltrate composed mainly of lymphocytes and plasma cells, along with some neutrophils. No angioinvasion or perineural infiltration was identified. In one section, the abnormal cellular structures reach the inked lateral/deep soft tissue margin; other margins remain free of such findings.\n\nA second tissue sample consists of mucosa lined by multilayered squamous epithelium, partially keratinizing. Nuclear remnants were noted in keratin layers. A mild inflammatory infiltrate containing lymphocytes, plasma cells, and occasional neutrophils is present. No fungal elements were identified on PAS staining."} +{"pid": "TCGA-GC-A3OO", "report": "The surgical specimen includes biopsies from the left and right ureter margins, both of which show no evidence of tumor involvement. A total of six lymph nodes were examined\u2014three from each pelvic side\u2014and all are benign without signs of metastatic disease.\n\nThe resected bladder and prostate specimen reveals a 1.6 cm invasive high-grade lesion located on the right bladder wall. Histological evaluation shows deep invasion into the muscularis propria with focal extension to the interface between this layer and the surrounding perivesical fat. No lymphovascular invasion is observed. The perivesical soft tissue margin is negative. The prostate appears unremarkable with benign tissue features. There is no involvement of the seminal vesicles or vasa deferentia.\n\nPathologic staging is assigned as T2b, NO. An incidental appendectomy was performed, and the appendix shows no pathological abnormalities. Additional tissue from the urethral margin is submitted for further microscopic analysis and will be addressed in a subsequent addendum report."} +{"pid": "TCGA-DH-5144", "report": "The specimen consists of a 4.8 x 4.0 x 2.0 cm portion of cortical gray matter and underlying subcortical white matter, with focal hemorrhage on the cortical surface. The deep surfaces are cauterized and irregular. Cut sections show a smudged gray-white junction with an ill-defined mass of homogenous soft beige tissue. A frozen section was performed, showing features of an infiltrating neoplasm with suspicion for a tumor of oligodendroglial lineage; grading was deferred to permanent sections.\n\nMicroscopic examination reveals extensive areas of a diffusely infiltrative lesion with cytologic features commonly associated with low-grade glial neoplasms. Additionally, multiple regions demonstrate increased cellularity with mitotic figures and early vascular endothelial proliferation. The Ki-67 labeling index in these hypercellular areas ranges from 7% to 12%. Immunohistochemical staining for GFAP shows reactivity in microgemistocytic forms and in so-called \"gliofibrillary oligodendrocytes.\"\n\nFluorescence in situ hybridization (FISH) analysis was performed on paraffin-embedded tumor tissue and identified deletions of chromosomes 1p and 19q. Clinical studies have suggested that combined loss of chromosomes 1p and 19q in glial brain tumors may correlate with prolonged survival and improved response to chemotherapy."} +{"pid": "TCGA-DD-A4NH", "report": "The gallbladder specimen shows chronic inflammatory changes with the presence of cholelithiasis and two small cholesterol polyps. In the left lobe of the liver, a large mass measuring 11.5 x 7.5 x 5.5 cm is observed, along with five smaller satellite lesions ranging from 0.3 to 0.8 cm. The primary lesion demonstrates extensive infiltration into the surrounding liver tissue and involves a major branch of the portal vein, with a tumor thrombus measuring 2.3 cm in length, as well as involvement of the middle hepatic vein with a 4.0 cm tumor thrombus. Both major vascular and microvascular invasion are present. The resection margin of the liver parenchyma is free of tumor, with a minimum tumor-free distance of 0.1 cm. All five regional lymph nodes examined show no evidence of involvement. The surrounding liver tissue exhibits mild steatosis without active inflammation. Special staining with Masson trichrome reveals minimal periportal fibrosis. No PAS-positive cytoplasmic inclusions are identified."} +{"pid": "TCGA-A1-A0SH", "report": "The surgical specimen consisted of a left breast partial mastectomy specimen measuring 3 x 4.9 x 6.2 cm and weighing 21.3 grams. A yellow-white, firm, irregular mass measuring 2 x 2.1 x 1.5 cm was identified with a central stellate appearance abutting the anterior-superior and posterior margins. The tumor was located 1.5 cm from the anterior-inferior margin and 1 cm from the lateral and medial margins.\n\nHistologic examination revealed an invasive lesion with a modified Bloom-Richardson grade of 2 based on nuclear grade of 2 (2 points), mitotic count less than 10 per 10 high-power fields (1 point), and tubule formation in less than 10% (3 points), totaling 6\u20137 points. Lymphatic-vascular invasion was present. Margins were assessed microscopically: deep margin showed tumor 3 mm away; medial margin showed tumor 5 mm away; lateral margin was widely clear (>1 cm); anterior/superior margin showed tumor 6 mm away; and anterior/inferior margin was widely clear (>1 cm).\n\nAlso identified was a ductal lesion measuring approximately 1 cm in maximum diameter composed of solid and micropapillary patterns. It exhibited intermediate nuclear grade and focal comedonecrosis (<1/3 involvement). Margins for this component were as follows: deep margin showed tumor less than 1 mm away; medial margin showed tumor 1 mm away; lateral margin was widely clear (>1 cm); anterior/superior margin showed tumor less than 1 mm away; and anterior/inferior margin was widely clear (>1 cm).\n\nA lobular lesion involving few lobules was present showing classic features including small cells with round nuclei and powdery blue vesicular cytoplasm. Immunohistochemistry demonstrated negativity for E-cadherin supporting this finding.\n\nSentinel lymph node evaluation included two nodes, both without evidence of metastasis.\n\nEstrogen receptor immunostaining showed no nuclear staining in tumor cells while progesterone receptor immunostaining demonstrated strong nuclear positivity in more than 95% of tumor cells. HER2/neu immunohistochemistry demonstrated staining intensity of 2+ on a scale of 0\u20133 indicating indeterminate expression requiring further testing by FISH.\n\nMargins were assessed extensively across multiple sections and cassette submissions. Additional findings included atypical ductal hyperplasia involving fibroadenoma within non-tumorous breast tissue.\n\nOther specimens submitted included cervical/endocervical samples which were negative for intraepithelial lesion or malignancy; peritoneal washing demonstrating reactive mesothelial cells; bilateral ovarian and fallopian tube specimens revealing serosal calcifications and benign epithelial inclusion glands; rectal biopsy showing focal cryptitis; right breast capsule exhibiting organizing granulation tissue; and nipple areolar margins without evidence of carcinoma.\n\nFine needle aspiration of the left breast demonstrated adenocarcinoma features. Additional Thin Prep cervical specimen was satisfactory with transformation zone components present and no intraepithelial lesion or malignancy detected. Vaginal/cervical/endocervical specimen demonstrated cellular changes within normal limits with endocervical cells present. Uterine contents consistent with products of conception were also received."} +{"pid": "TCGA-DD-AAEK", "report": "The specimen consists of two liver segments, segment 6 and segment 8, both submitted fresh following a resection procedure. Segment 6 measures 14.0 x 5.5 x 4.5 cm and weighs 133.0 grams. Segment 8 measures 9.0 x 9.0 x 3.5 cm and weighs 102.8 grams.\n\nIn segment 6, a multinodular lesion measuring 3.5 x 2.5 x 2.0 cm was identified. The cut surface revealed a well-defined, irregular shape with a whitish to brightly yellow appearance. A satellite mass measuring 1.3 x 1.0 cm was noted near the resection margin. Gross evaluation indicated that the resection margin was very close, with a safety margin of 0.1 cm. The gross type was classified as multinodular confluent.\n\nIn segment 8, a lesion measuring 3.2 x 3.3 x 3.0 cm was observed. It had a well-defined, ovoid, bulging appearance with bile discoloration. The resection margin was not involved grossly, with a safety margin of 1.2 cm. The gross type was expanding nodular.\n\nMicroscopic examination of segment 6 revealed tissue with trabecular architecture and hepatic cell type. Nuclear grading showed a worst grade of III and a major grade of II. Fatty changes were present in approximately 10% of the cells. There was no evidence of cholangiocarcinoma or combined hepatocellular and cholangiocarcinoma features. Fibrous capsule formation and septum formation were absent. Surgical margin involvement was noted as very close, less than 0.1 cm.\n\nIn segment 8, microscopic analysis also demonstrated trabecular architecture and hepatic cell type. Nuclear grading showed both worst and major grades of II. Fatty changes were similarly present in about 10% of the cells. No cholangiocarcinoma or combined tumor features were observed. Fibrous capsule formation and septum formation were absent. Surgical margin invasion was not detected.\n\nThere was no evidence of serosal invasion, portal vein invasion, or microvessel invasion. Multicentric occurrence was identified. Non-tumor pathology revealed cirrhotic liver parenchyma with mixed cirrhosis.\n\nRepresentative sections from both lesions and surrounding liver tissue were submitted for evaluation, along with samples from non-tumorous liver and resection margins."} +{"pid": "TCGA-46-3768", "report": "A resection specimen from the left upper lobe of the lung was submitted for evaluation. The lobectomy specimen weighed 448 grams and measured 22 x 15 x 9 cm. A mass was identified on the pleural surface, appearing as a tan-brown, ragged, disrupted area with underlying firm nodularity. The mass measured 8 x 6.8 x 6.2 cm and was noted to be well-circumscribed, gray-tan to white in color, and focally fleshy. It was located 0.8 cm from the closest parenchymal margin marked with black ink and 1.7 cm from the bronchial margin at the hilum. No other discrete masses or nodularities were observed in the remaining lung tissue, which appeared pink-red, spongy, and otherwise unremarkable.\n\nAt the hilum, multiple lymph nodes were identified. These nodes ranged from 0.5 to 1.5 cm in greatest dimension and were described as gray-tan to white and firm. Two hilar lymph nodes submitted showed friable gray-black tissue upon sectioning. Additionally, lymph nodes at levels 5 and 8 were evaluated; both were negative for tumor involvement.\n\nMargins were assessed including stapled bronchial, vascular, and surgical margins. The bronchial margin measured 2 cm in diameter by 1 cm in length. Vascular margins ranged from 0.5 x 1 cm to 0.6 x 1.5 cm. Surgical margins measured up to 5 cm in length and 1.5 cm in width. No tumor involvement was identified at these margins.\n\nSections were taken from various areas including vasculature and bronchial margins, regions near the pleural surface, perpendicular sections through the mass and margins, and representative sections of lymph nodes and unaffected lung tissue.\n\nTwo rib specimens were also submitted: one measuring 2 x 1.5 cm and another consisting of two segments measuring 1.5 cm and 2 cm in length. Both were described as friable and disrupted. Longitudinal sections were submitted for analysis after decalcification.\n\nThe mass extended to the parietal pleura but did not invade fat, skeletal muscle, or nerve bundles. Histologic grade was moderately to poorly differentiated. No definitive vascular invasion was identified. Evaluation of lymph nodes revealed five out of eight involved nodes at the N1 level, with no involvement at N2 or N3 stages. Based on these findings, the staging was classified accordingly."} +{"pid": "TCGA-LB-A7SX", "report": "The specimen consisted of three components: pancreatic duct margin, common duct margin, and Whipple contents. Gross examination revealed a stomach specimen with lesser curvature measuring 6.5 cm and greater curvature measuring 10.5 cm. The attached duodenum and small intestine measured 20 cm in length. The pancreas measured 6 x 4.7 x 3.5 cm and demonstrated staple lines. A stenotic area was identified upon probing the ampulla. The tumor was estimated grossly at 2.2 x 2.5 x 2.0 cm and located near the pancreatic head.\n\nMicroscopic evaluation of the pancreatic duct margin showed squamous metaplasia and chronic inflammation; no malignancy was identified. Similarly, the common duct margin showed only chronic inflammation without evidence of malignancy. In the Whipple contents, invasive carcinoma was observed originating from in situ carcinoma within the pancreatic duct. The tumor extended into the duodenal wall and mucosa of the ampulla, and further invaded surrounding fibroadipose and vascular connective tissue. Margins were involved by invasive carcinoma. Histologic grade was determined to be Grade 2.\n\nPathologic staging indicated pT3 for the primary tumor based on extension beyond the pancreas into adjacent tissues. Regional lymph node involvement was classified as pN1, with 7 out of 26 lymph nodes containing metastatic disease. No distant metastasis was identified. Lymphovascular invasion was present, as well as perineural invasion.\n\nAdditional findings included pancreatic intraepithelial neoplasia III, acute and chronic pancreatitis, and a pancreatic abscess. Squamous metaplasia was also noted in the pancreatic duct along with inflammatory changes. Cold ischemia time was documented, and no prior treatment effect was observed. Multiple sections were submitted for analysis, including representative samples of tumor, margins, lymph nodes, and surrounding tissues."} +{"pid": "TCGA-DD-AADN", "report": "Specimen consists of a liver measuring 14.5 x 15.0 x 8.0 cm and weighing 798 grams, along with a gallbladder measuring 11.0 cm in length, 3.5 cm in diameter, and 0.3 cm in thickness. A well-defined mass measuring 14.5 x 8.0 x 7.0 cm was identified. The cut surface of the mass is described as yellowish tan, solid, and firm with areas of hemorrhage and necrosis. Gross examination indicates a multinodular confluent growth pattern. The resection margin appears uninvolved with a safety margin of 3.0 cm. No satellite nodules were observed, and the remaining liver parenchyma shows cirrhotic changes.\n\nMicroscopic evaluation reveals moderately differentiated cells arranged in a trabecular pattern. Fatty change is present in approximately 20% of the tissue. A complete fibrous capsule is noted, and there is evidence of capsular infiltration. No septum formation is observed. The surgical resection margin does not show invasion, maintaining a safety margin of 3.0 cm. There is no serosal or portal vein invasion; however, microvessel invasion is present. Information regarding intrahepatic metastasis and multicentric occurrence remains inconclusive.\n\nThe gallbladder specimen exhibits autolysis. Tissue blocks were collected from various regions of the tumor (T1\u2013T5), tumor body (TB), liver parenchyma (L), resection margin (RM), and gallbladder (GB) for further analysis. Additional immunohistochemical studies are recommended on block T1 to assist in characterization."} +{"pid": "TCGA-CJ-4871", "report": "The left kidney specimen measured 24.0 \u00d7 12.5 \u00d7 10.5 cm. A mass located in the upper to mid pole measured 12.0 \u00d7 8.5 \u00d7 8.0 cm and was partially poorly circumscribed, heterogeneous, hemorrhagic, and necrotic. The tumor showed multiple focal areas of extension through the renal capsule into the perirenal adipose tissue. Medially, tumor involvement was present at the perirenal soft tissue margin. The mass extended into the sinus and renal pelvis. No invasion of the renal vein was identified. Histologic evaluation showed that the tumor invaded a thick-walled vessel in the hilar region, involving the lumen and part of the vessel wall, but this was not considered diagnostic of renal vein invasion. Vascular, ureteral, and soft tissue margins of resection were free of tumor. The adrenal gland measured 3.2 \u00d7 1.5 \u00d7 1.0 cm and showed no abnormality. Multiple sections were submitted for analysis, including those from the tumor in relation to the renal pelvis, sinus, normal kidney, and periadipose tissue, as well as sections from the medial soft tissue margin and representative areas of viable tumor. A separate specimen of the left 12th rib showed no abnormalities and was not submitted for histology. Cellular features included high nuclear grade morphology. The tumor was staged based on extent of local spread, with involvement of perirenal adipose tissue and hilar vasculature, but without renal vein invasion or adrenal gland involvement."} +{"pid": "TCGA-A8-A09T", "report": "The resected left-sided breast specimen contains a moderately differentiated tubulolobular lesion measuring 1.8 cm. There is an associated intraductal component of similar size. Margins are focally narrow, with the closest margin measuring approximately 1 mm at the 6 o'clock position, while other margins range from over 10 mm at 9 o'clock to well over 10 mm at 3 o'clock. No lymphovascular invasion is identified. Histological assessment reveals a moderately differentiated growth pattern with no metastatic involvement identified in the sampled lymph nodes. The staging classification reflects localized disease without nodal spread. Complete excision was achieved."} +{"pid": "TCGA-AD-6888", "report": "The specimen consists of a right colon segment measuring 36.5 cm in length, along with 10.5 cm of terminal ileum. The terminal ileum has a circumference of 4.9 cm, and the colon has a circumference of 9 cm. The margins are stapled. A puckered serosal area measuring 2.5 x 1.8 cm is noted in the ascending colon, located 12 cm from the distal margin.\n\nTwo distinct masses are identified. The first mass, located in the cecum, measures 6.4 x 4.5 x 1.2 cm and exhibits an infiltrative growth pattern with raised edges. It is situated 10.5 cm from the proximal margin, involves approximately 50% of the luminal circumference, and invades to a depth of 0.6 cm. The distance from the radial margin is 2.2 cm. The second mass, located in the ascending colon, measures 7.8 x 5 x 1.1 cm and also displays an infiltrative morphology with elevated borders. It is positioned 9.7 cm from the distal margin, encircles approximately 90% of the lumen, and extends to a depth of 0.3 cm. The closest radial margin is 0.9 cm at this site.\n\nA 1.2 cm pink polyp is found 1.7 cm distal to the cecal mass, and a 0.4 cm tan polyp is located 1.6 cm from the ascending mass. The appendix is not present in the specimen.\n\nMicroscopic evaluation reveals that both tumors extend through the muscularis propria into subserosal adipose tissue. Lymphovascular invasion is present, but perineural invasion and tumor deposits are not identified. Histologic features include intratumoral and peritumoral lymphocytic responses graded as mild to moderate. Proximal, distal, and radial margins are free of invasive carcinoma.\n\nEighteen lymph nodes are examined, with two showing metastatic involvement. No prior treatment effect is observed. Two tubular adenomas are also identified within the specimen."} +{"pid": "TCGA-AZ-4681", "report": "The right salpingo-oophorectomy specimen shows an atrophic ovary containing a 1.2 cm fibrous mass. The fallopian tube demonstrates multiple paratubal cysts. No evidence of malignancy is identified. The left salpingo-oophorectomy reveals an atrophic ovary with two fibrous masses measuring 2.8 cm and 2.0 cm. The fallopian tube also contains paratubal cysts, and no malignancy is present.\n\nThe proctectomy specimen contains a lesion measuring 2.5 cm in greatest dimension, which extends through the full thickness of the muscularis propria into the perirectal adipose tissue. All margins of resection are free of malignant cells. A total of eight lymph nodes are identified, none of which show evidence of tumor involvement. The histopathologic staging is pTNM = T3 NO MX. Additional findings include hyperplastic polyps and diverticular disease. The separate rectal margin specimen does not show any residual tumor.\n\nIn the right hemicolectomy, a lesion measuring 2.5 cm is identified, extending through the full thickness of the muscularis propria into the pericolonic adipose tissue. The resection margins are free of tumor, and five retrieved lymph nodes do not show any signs of metastasis. Histopathologic staging is pTNM = T3 NO MX. Other findings include fibrous obliteration of the appendix tip and diverticular disease. The gallbladder specimen shows chronic cholecystitis with cholelithiasis."} +{"pid": "TCGA-49-6742", "report": "The surgical pathology report includes the following findings. One lymph node and associated fibroadipose tissue from the L10 region showed no evidence of tumor involvement (0 out of 1 lymph nodes involved). A lobectomy specimen from the left upper lobe of the lung contained a lesion measuring 5.0 cm in its greatest dimension. Histologic evaluation revealed moderately differentiated features with mucinous characteristics. Assessment of lymph nodes identified metastatic involvement in one of eleven nodes examined (Parts 1\u20135). The tumor demonstrated invasion into the visceral pleura, confirmed by Movatt staining. Based on these findings, the primary tumor classification is pT2, meeting criteria for either size greater than 3 cm or invasion of the visceral pleura. Regional lymph node staging was classified as pN1, indicating involvement of ipsilateral peribronchial, hilar, or intrapulmonary nodes. Surgical margins were free of invasive disease. No evidence of large vessel invasion was observed; however, lymphatic (small vessel) invasion was present.\n\nAdditional findings included focal small non-caseating granulomas within uninvolved lung tissue. Special stains for fungal organisms (GMS) and acid-fast bacteria (AFB) were negative. Molecular testing for KRAS mutations, including codons 12 and 13, did not detect any mutations. Similarly, EGFR mutation analysis was negative. Excised lymph nodes from stations 5, 6, and 7 each contained one lymph node with associated fibroadipose tissue and were all negative for tumor involvement."} +{"pid": "TCGA-G9-6339", "report": "The surgical specimens include lymph nodes from the right and left pelvic regions, as well as a resected prostate gland. The right pelvic lymph nodes specimen consists of adipose tissue measuring 6 x 3 x 1 cm, containing four identified lymph nodes with sizes ranging from 0.6 x 0.4 x 0.2 cm to 1.5 x 0.7 x 0.5 cm. All were bisected and submitted for frozen section analysis. The left pelvic lymph nodes specimen includes adipose tissue measuring 2.9 x 2 x 1.5 cm, with two lymph nodes measuring 3 x 1.5 x 1 cm and 4 x 1 x 0.5 cm. Both were serially sectioned and submitted for frozen section.\n\nThe prostate specimen weighed 34 grams before disassembly and measured 4 cm in width, 3.5 cm in depth, and 2.2 cm in height. After disassembly, the remaining weight was 18 grams. The external capsule was smooth, red, and intact. Serial sectioning revealed firm tan fibrous parenchyma without visible lesions or nodules. The right and left seminal vesicles measured 1.5 x 1.4 x 0.6 cm and 1.3 x 1.3 x 0.5 cm respectively, and were both bisected. The right and left vas deferens measured 1.5 x 0.5 cm and 2 x 0.5 cm in length and diameter respectively, and were serially sectioned showing firm tan tubular structures.\n\nMicroscopic evaluation included multiple cassettes representing various regions of the prostate including apex, base, capsule levels, and seminal vesicle areas. Histologic analysis noted perineural invasion and vascular/lymphatic involvement. Bilateral seminal vesicle involvement was also observed. No involvement of surgical margins was identified. Based on pathologic findings, staging was determined as pT3b with no lymph node involvement (N0) and no assessment of distant metastasis (MX)."} +{"pid": "TCGA-77-8128", "report": "Histopathology Report. LEFT PNEUMONECTOMY AND MULTIPLE LYMPH NODE BIOPSIES. Clinical Details: Ca left lung. Five specimens submitted: 1: LEFT LUNG. Macroscopy: The specimen consists of left lung, the upper lobe measuring 290 x 110 x 40 mm, and the lower lobe measuring 275 x 110 x 65 mm. A white sclerotic nodule measuring 32 mm in maximal dimension is present 30 mm from the proximal resection margin. It appears to be arising from the main bronchus at the point where it branches into the bronchus supplying the lower lobe. The mucosa of the bronchus surrounding the lesion is somewhat nodular but does not extend to the margin. The lesion appears to invade into adjacent lymph nodes and has a sclerotic appearance. No other lesions are identified. On sectioning of the uninvolved lung, there is black anthracotic speckling. The lesion appears clear of the pleura by approximately 7 mm. [Sections taken: bronchial resection margin, A; peribronchial lymph nodes, B-C; lesion and proximal bronchus, D; further sections of the lesion, E-G; right upper lobe, H; lower lobe, I]. Microscopy: Sections show moderately differentiated cellular changes around large bronchi extending into peribronchial soft tissue. Perineural features and areas suggestive of lymphatic involvement are seen, but no vascular invasion is identified. Involvement of peribronchial lymph nodes is noted. The lesion is clear of bronchial, soft tissue, and pleural margins. Adjacent to the lesion, in situ cellular changes are observed and are well clear of the bronchial margin. The adjacent lung shows mild emphysematous changes. 2: HILAR NODES. Macroscopy: The specimen consists of a piece of fatty tissue containing blackened lymph node tissue measuring 24 x 16 x 10 mm. [Bisected and BIT]. Microscopy: The lymph nodes show reactive changes only. There is no evidence of abnormal cellular infiltration. Page 1, Printed. Histopathology Report. 3: NO. 5 NODE. Macroscopy: The specimen consists of multiple fragments of tan and grey/black lymph node tissue measuring 25 x 13 x 8 mm in aggregate. [Wrapped and BIT]. Microscopy: The lymph nodes are partially replaced by abnormal cellular deposits. 4: NO. 7 NODE. Macroscopy: The specimen consists of multiple fragments of grey and black lymph node tissue measuring 17 x 12 x 4 mm. [Wrapped and BIT]. Microscopy: The lymph nodes show reactive changes only. There is no evidence of abnormal cellular infiltration. 5: NO. 9 NODE. Macroscopy: The specimen consists of a lymph node with surrounding soft tissue measuring 17 x 8 x 5 mm. [Bisected and BIT]. Microscopy: The lymph nodes show reactive changes only. There is no evidence of abnormal cellular infiltration. Summary: Left lung and mediastinal lymph nodes: 1. A lesion measuring 32 mm in maximum dimension. 2. Features consistent with perineural involvement but no vascular invasion identified. 3. Involvement of peribronchial and No. 5 lymph nodes. 4. Lesion clear of surgical margins and pleura. 5. T2N2MX. Anatomical Pathologist. Report. Histopathology Report. Cancer Registry. Registrar."} +{"pid": "TCGA-4V-A9QJ", "report": "The resected specimen includes a mass located in the anterior mediastinum with extension into contiguous lung tissue. Histologic examination reveals a proliferation with focal lobulated architecture, arranged around fibrotic septa. The epithelial component consists of large polygonal cells with eosinophilic cytoplasm, oval nuclei, and distinct nucleoli. Cytonuclear atypia is present, including enlarged nuclei and areas with anaplastic morphology. Necrosis is minimal, involving less than 10% of the tissue. Surgical margins are free of involvement. Examination of distant lung parenchyma shows emphysematous changes and vascular congestion. Lymph node analysis of interlobar and aorto-pulmonary regions reveals no evidence of invasion. A separate nodule identified in the parietal pleura demonstrates fibrosis and inflammatory changes without evidence of neoplastic cells."} +{"pid": "TCGA-KK-A6E3", "report": "The lymph node specimens from both the left and right internal/external iliac, hypogastric, and obturator regions were examined. On the left side, an irregular fragment of adipose tissue measuring 6.5 x 3.0 x 1.5 cm contained two lymph nodes, one measuring 4.0 x 0.8 x 0.4 cm and the other 3.0 x 1.5 x 0.4 cm. On the right side, an adipose tissue fragment measuring 9.0 x 3.0 x 1.0 cm contained a single lymph node measuring 9.0 x 2.0 x 0.8 cm. No abnormal cellular findings were identified in any of the lymph nodes examined.\n\nThe prostate specimen, along with attached seminal vesicles and segments of both vasa deferentia, was evaluated. The prostate measured 4.2 x 2.8 x 3.7 cm and weighed 48 grams post-fixation. Gross examination revealed no palpable or visible abnormalities. Four distinct foci of cellular changes were identified microscopically within the prostate gland. One focus was located in the transition zone and three in the peripheral zone. The largest focus, measuring 2.0 x 1.5 cm, spanned four cross-sectional levels and was found extensively at the apex and focally at the base. A second focus, measuring 1.5 x 0.3 cm, was located in the right anterolateral region and also extended across four sections, with focal involvement at the apex. A third focus measured 0.6 x 0.1 cm in the left posterolateral area and was present in a single section. The smallest focus measured 0.1 x less than 0.1 cm in the right posterolateral region and was also seen in only one section. All observed changes were confined within the prostate gland, with no extension into surrounding structures. Margins of resection showed no evidence of abnormal cells. Both seminal vesicles and vasa deferentia appeared unremarkable."} +{"pid": "TCGA-DJ-A2Q1", "report": "The clinical history includes a prior fine needle aspiration and findings of enlarged lymph nodes on ultrasound. The submitted specimens included a total thyroidectomy, lymph nodes from the right tracheo-esophageal groove and pre-tracheal region, a left tracheo-esophageal groove node, and right neck nodes from levels III and IV.\n\nGross examination of the thyroid showed a 1.6 cm firm, tan-white nodule located in the right mid lobe with partial fibrotic encapsulation. The nodule was in close proximity to both anterior and posterior capsule. Histologic analysis revealed psammoma bodies and a well-differentiated cellular appearance without necrosis or mitotic activity. The tumor was present within 0.5 mm of the surgical margin. Multifocal small lesions were identified, including five foci measuring between 0.1 cm and 0.5 cm across both lobes. No adenomas were found. The surrounding non-neoplastic tissue demonstrated features consistent with chronic lymphocytic thyroiditis.\n\nIn the right tracheo-esophageal groove and pre-tracheal specimen, 12 lymph nodes were evaluated, with six showing involvement. The largest lymph node measured 1.3 cm, and the largest focus of involvement measured 0.7 cm. Focal extension beyond the lymph node capsule was noted. In the left tracheo-esophageal groove, five lymph nodes were examined and found to be unremarkable. In the right neck levels III and IV, 27 lymph nodes were assessed, with five involved. The largest involved lymph node was 1.2 cm and the largest metastatic focus measured 1.0 cm. No extranodal extension was observed in this group.\n\nAll lymph nodes were fully sectioned and submitted for evaluation. Parathyroid tissue was not identified in the thyroid specimen, but one normal parathyroid gland was identified in the right tracheo-esophageal groove and pre-tracheal specimen."} +{"pid": "TCGA-HT-7695", "report": "The specimen demonstrates a moderately hypercellular glial neoplasm with extensive infiltration through both gray and white matter. In the gray matter, there is prominent perineuronal satellitosis. Tumor cells in the unfrozen material are noted to have perinuclear halos, with round nuclei and moderate nuclear atypia. No mitotic figures were identified. There was no evidence of microvascular proliferation or necrosis. The MIB-1 labeling index was calculated to be up to 5.0% in the most proliferative areas. This proliferation index is considered borderline by some criteria when comparing grade II and grade III lesions. The overall histological features are consistent with a neoplasm exhibiting predominantly low-grade characteristics. Given the borderline MIB-1 index, careful follow-up is recommended to monitor for any signs of progression or recurrence."} +{"pid": "TCGA-J4-A83M", "report": "The specimen consisted of a prostate weighing 29 grams and measuring 4.0 x 3.0 x 3.0 cm, along with attached seminal vesicles and vasa deferentia. The prostate capsule was disrupted at the bladder resection margin and had been previously inked black on the left and blue on the right. Upon sectioning, the gland showed firm, focally nodular parenchyma. No gross abnormalities were noted in the seminal vesicles or vasa deferentia.\n\nHistological evaluation revealed a Gleason score of 4 + 3 = 7/10, with no tertiary pattern identified. The extent of involvement was severe, with greater than 50% tissue involvement. A dominant nodule measuring approximately 1.0 cm was present. Perineural invasion was observed, while lymphatic (small vessel) invasion was not detected. No tumor was identified in the seminal vesicles.\n\nMargins were evaluated, and two positive margins were found: one at the left anterior prostate (C11) and another at the right posterior prostate (C14). However, no extraprostatic soft tissue was identified at these margins, and the periprostatic soft tissue in other sections was not involved by the lesion.\n\nLymph nodes from both left and right pelvic regions were examined, with a total of two nodes identified on each side. No evidence of involvement was found in any of the lymph nodes evaluated.\n\nThe specimen was processed in multiple blocks for histologic examination, with all relevant areas of the prostate, including the apical margin, bladder resection margin, and mid to upper gland regions, fully sampled. The seminal vesicles and vasa deferentia were also submitted for analysis."} +{"pid": "TCGA-BQ-5878", "report": "A left kidney specimen with attached ureter, renal vessels, and perinephric fat was received. The kidney measured 11.5 x 6 x 4 cm, and an adrenal gland measuring 4 x 1.5 x 1.2 cm was identified. A tumor located in the upper pole of the kidney measured 5.8 x 4.5 x 3 cm and exhibited a lobulated appearance with tan-yellow areas, hemorrhage, and necrosis on sectioning. The tumor appeared to be confined within the kidney without extension beyond the capsule. Adjacent to the tumor, a serous cyst measuring 5 x 5 x 4 cm was observed. The remainder of the kidney showed a well-defined corticomedullary junction, with cortical thickness measuring approximately 0.8 cm.\n\nMicroscopic examination revealed infiltration of sinus fat adjacent to the tumor. Small vessel angiolymphatic invasion was present, although no renal vein invasion was identified. Surgical margins were free of tumor involvement. Multiple benign cortical cysts were noted in non-neoplastic kidney tissue, and there was no involvement of the adrenal gland.\n\nLymph nodes were examined from several regions. From the para-aortic and pre-aortic area, 9 lymph nodes were assessed, including one metastatic node measuring 0.6 cm with extracapsular extension. Two additional tumor nodules were identified, measuring up to 5.5 cm in diameter. Involvement could not be ruled out for lymph nodes completely replaced by tumor. Six lymph nodes from the left common iliac region and 9 lymph nodes from the interaortocaval region were examined, none of which showed evidence of tumor involvement.\n\nThe tumor was staged based on local invasion into surrounding tissues but remained within defined anatomical boundaries. The ureter specimen was unremarkable, with no signs of pathological change."} +{"pid": "TCGA-B6-A0WX", "report": "The surgical pathology report describes a specimen from a left breast biopsy. The tissue fragment measures 3.1 x 2.4 x 1.3 cm and is composed of fibroadipose tissue. A distinct lesion measuring 1.5 x 1.0 x 1.0 cm is identified, appearing firm with a white-tan color and poorly defined borders. This lesion extends to the inked surgical margin. The remainder of the tissue consists primarily of adipose tissue, and the entire specimen was submitted for analysis.\n\nMicroscopic evaluation reveals nuclear grade 2 out of 3 and histologic grade 3 out of 3. No lymphatic or vascular invasion is observed. There is no evidence of in-situ carcinoma. The non-neoplastic breast tissue assessment is not applicable due to the incisional biopsy nature of the sample. Microcalcifications are absent. Surgical margin status could not be assessed as this was an incisional biopsy.\n\nImmunohistochemical analysis for hormone receptors was performed. Both estrogen and progesterone receptor assays returned negative results, each with an estimated FMOL value of 0. HER2/neu (c-erbB-2) oncoprotein immunostaining was carried out using DAKO rabbit anti-human antibody following antigen retrieval by heating sections in citrate buffer. Staining was performed manually at a dilution of 1:3000 with one-hour incubation at 37\u00b0C. Detection was achieved using the Histostain Plus kit.\n\nFindings show rare tumor cells with minimal complete membrane staining; however, these are insufficient to confirm overexpression. Most tumor cells demonstrate faint focal membrane staining (score = 1+), indicating no significant overexpression of HER2/neu oncoprotein. All evaluations were conducted personally by the reporting pathologist."} +{"pid": "TCGA-DF-A2KY", "report": "The sample was obtained from a posterior endometrial mass via surgical resection. The tissue was collected fresh frozen at the time of diagnosis. The patient underwent the procedure shortly after diagnosis, with no delay between diagnosis and surgery. The tumor measured 5 cm in size. Histological evaluation revealed a poorly differentiated endometrioid adenocarcinoma with areas of squamous differentiation, along with focal regions showing well-differentiated endometrioid adenocarcinoma of conventional type. There was evidence of metastatic involvement in the bladder flap. Pathologic staging indicated T4 disease with regional lymph node involvement (N1), based on 12 positive lymph nodes out of those sampled. Distant metastasis was not detected (M0)."} +{"pid": "TCGA-D1-A161", "report": "The surgical specimen included a uterus weighing 45.0 grams, a right ovary measuring 3.0 x 0.9 x 0.8 cm with a 4 cm segment of right fallopian tube, and a left ovary measuring 2.8 x 0.7 x 0.5 cm with a 7.7 cm segment of left fallopian tube. Additional specimens included left and right pelvic lymph nodes, and bilateral para-aortic lymph nodes (both above and below the inferior mesenteric artery).\n\nA mass measuring 3.4 x 2.4 x 1.0 cm was identified in the uterus. Microscopic evaluation revealed that the mass extended into the myometrium with a depth of invasion of 1.0 cm; the total myometrial thickness was 1.4 cm. Involvement of the lower uterine segment was noted. The cervix showed no significant changes. A single intramural leiomyoma was identified in the myometrium, measuring 0.9 cm in greatest dimension.\n\nNo significant abnormalities were observed in the ovaries or fallopian tubes bilaterally. Examination of the lymph node groups showed no evidence of involvement. Nine left pelvic lymph nodes, twelve right pelvic lymph nodes, and nine bilateral para-aortic lymph nodes below the inferior mesenteric artery were all negative for any abnormal cellular findings. The tissue submitted as bilateral para-aortic lymph nodes above the inferior mesenteric artery contained only adipose tissue and no lymph nodes were identified."} +{"pid": "TCGA-55-7727", "report": "A wedge resection and lobectomy of the left upper lobe lung was performed along with lymphadenectomy. The specimen included multiple regional lymph nodes (N6, N10L, N11L, N5, N9L, N7). A subpleural mass measuring 2.0 cm in greatest dimension was identified in the left upper lobe. Histologic evaluation revealed a moderately differentiated lesion with lymphovascular and perineural invasion noted. All surgical margins were negative, with the bronchial margin being the closest at 4.6 cm from the tumor. No involvement of the visceral pleura was observed.\n\nOf the 22 regional lymph nodes examined, 6 showed evidence of metastatic involvement, including peribronchial and para-aortic nodes. No distant metastasis was confirmed. Staging was determined as pT1a for the primary tumor, pN2 for regional lymph node involvement, and pMX for distant metastasis, resulting in a pathologic stage of IIIA. Immunohistochemical staining demonstrated positivity for markers associated with pulmonary origin and ruled out other potential sources. The bronchial, vascular, and parenchymal margins were all free of tumor. Additional findings included anthracotic changes and fibrofatty tissue in several lymph node specimens, with some showing tan or gray-tan discoloration."} +{"pid": "TCGA-2G-AAF8", "report": "The pathology report describes a left orchidectomy specimen. The tumor measures 3.5 cm in diameter and is confined to the testis based on available slides. There is no evidence of angioinvasion or invasion of the rete testis."} +{"pid": "TCGA-RN-A68Q", "report": "The microscopic examination reveals a highly cellular spindle cell neoplasm within a fibrous stromal matrix. The tumor cells exhibit only minimal cytologic atypia. A limited area of necrosis is present. Mitotic activity is observed with up to three mitoses per ten high power fields. Immunohistochemical staining shows reactivity for S-100, while stains for EMA and CD-34 are negative. Proliferative activity, as assessed by MIB-1 labeling, demonstrates variable patterns: large regions show less than 5% positivity, while smaller foci display labeling indices as high as 50%. These features are accompanied by intratumoral heterogeneity in cellularity, atypia, and proliferation. Additional special stains are recommended to further evaluate the possibility of a melanocytic origin. In the current context, the morphologic and immunophenotypic findings suggest a recent transition from a benign precursor lesion. An addendum notes strong background staining with the melanoma cocktail antibody; however, the lesional cells themselves do not demonstrate reactivity."} +{"pid": "TCGA-VQ-AA68", "report": "The specimen from the upper gastrointestinal region shows a moderately differentiated tubular growth pattern. The lesion measures 4.8 cm along its greatest dimension and is associated with ulceration. The tumor exhibits spiculated invasion and is surrounded by a moderate inflammatory response. There is no evidence of tumor extension into surrounding fat or implantation in perivisceral adipose tissue.\n\nMargins of resection, including the proximal and distal margins, are free of malignant cells. Neural infiltration is present, as well as lymphatic vascular invasion. No involvement of sanguineous vessels is identified. The greater omentum does not show any neoplastic involvement.\n\nLymph node assessment according to regional groupings reveals the following: in the right paracardiac region, 7 out of 10 nodes are involved; along the lesser curvature, 3 out of 5 are positive; in the left gastric artery region, all 3 nodes are affected; around the celiac axis, all 3 nodes contain malignant cells; and in the splenic artery region, both nodes are involved. In other areas, such as the suprapyloric, left paracardiac, and para-esophageal regions, as well as the hepatogastric ligament and left renal vessel groups, lymph nodes are negative for tumor except for those near the left renal vein and artery, which demonstrate metastatic involvement with capsular extension. The esophageal margin is also free of disease."} +{"pid": "TCGA-GR-A4D4", "report": "The specimen consists of multiple fragments of soft tissue obtained from a left ileal mass, ranging in size from 0.6 to 2.2 cm in greatest dimension. A separate fragment of adipose tissue measuring 1.9 x 0.6 x 0.6 cm was also submitted. Portions of the specimen were processed for various studies including frozen section, immunohistochemistry, cytogenetics, and molecular diagnostics.\n\nMicroscopic examination reveals large and pleomorphic cells with a high mitotic rate and extensive areas of necrosis. Immunostaining demonstrates a B-cell phenotype with positivity for markers including CD20, CD45, PAX5, BCL-2, CD10, and BCL-6. Stains for ALK and EBERs were negative. Additional markers such as CD30, CD43, CD79a, S100, and pan keratin were either negative or not detected.\n\nSections were analyzed using immunoperoxidase techniques on paraffin-embedded tissue. The staining pattern supports a germinal center B-cell origin. Ancillary studies including cytogenetics and molecular diagnostics were performed according to protocol. Touch preparations and tissue blocks were preserved for further analysis as needed.\n\nAll findings were interpreted in accordance with established laboratory protocols certified under CLIA guidelines for high-complexity testing. No definitive classification beyond the observed morphologic and immunophenotypic features is provided in this summary."} +{"pid": "TCGA-BP-4332", "report": "A left renal mass was identified within the upper pole of the kidney. The resected specimen measured 5 x 5 x 4 cm and demonstrated a well-circumscribed, partially encapsulated lesion measuring 4 x 4 x 3.5 cm. The tumor exhibited a yellow, multicystic appearance with areas of fibrosis and hemorrhage. Histologic evaluation showed solid growth pattern with nuclear features classified as grade II out of IV. The tumor extended through the renal capsule but remained confined within Gerota\u2019s fascia. Surgical margins were all negative for tumor involvement, including the deep margin where a separate biopsy showed only benign renal tissue. The surrounding non-neoplastic kidney appeared normal. No definitive abnormalities were identified in the rib specimen, although further assessment is pending decalcification. The tumor was found to be in close proximity to the deep margin at 0.3 cm but did not extend beyond it. Adipose tissue adjacent to the tumor appeared uninvolved."} +{"pid": "TCGA-H8-A6C1", "report": "The Whipple resection specimen includes the head of the pancreas, duodenum, and gallbladder. The specimen measures 13.2 x 3.0 cm for the duodenum, with the pancreatic head measuring 4.7 cm in length and additional dimensions of 5.6 x 5.5 cm. A tumor is identified in the pancreatic head, measuring 3.1 x 2.1 x 1.1 cm, with white-tan to tan coloration, ill-defined borders, and a firm consistency. Microscopically, the lesion shows moderately differentiated histology with perineural invasion noted. The tumor invades peripancreatic soft tissue and the duodenal wall. Resection margins are uninvolved, with the closest margin being 4 mm from the tumor at the uncinate process. No lymph-vascular invasion is identified.\n\nA total of 21 lymph nodes are examined across regional sites, including portal and SMA tissues, and none show evidence of involvement. Additional findings include chronic pancreatitis, a duodenal ulcer with reactive changes, and a submucosal lipoma in the duodenum. The gallbladder shows features of chronic inflammation, and two lymph nodes associated with the gallbladder are negative for malignancy. The portal lymph node and SMA tissue specimens also contain no evidence of malignancy.\n\nIntraoperative frozen section analysis confirms negative margins for bile duct, uncinate, and pancreatic neck. Gross evaluation reveals a biliary stent in place, with the tumor appearing to abut the bile duct and possibly the main pancreatic duct without gross involvement. The tumor does not appear to penetrate through the vascular groove. The duodenum shows a transmural defect and two distinct mucosal lesions, both submitted for histological evaluation. The report incorporates all findings from the intraoperative and final pathological assessments."} +{"pid": "TCGA-46-3767", "report": "The surgical specimen consists of a left lower lobe lung wedge resection, weighing 40 grams and measuring 11.5 x 4.5 x 2.5 cm. The pleural surface demonstrates an ill-defined firm area with puckering, surrounded by white to tan membranous adhesions. This region is marked by blue ink on the pleural surface and black ink on the underlying parenchyma at the stapled margin. A corresponding mass is identified within the lung tissue, measuring 1.5 x 1.3 x 0.8 cm, tan-white in color with focal gray firmness. It is located 0.2 cm beneath the pleural surface and 2.2 cm from the black-inked parenchymal margin. Adjacent lung tissue appears tan-pink to red, spongy, and unremarkable. No additional masses or nodularities are observed.\n\nTwo lymph node specimens were also submitted for evaluation. One was labeled as \"9L\" and consisted of two nodes measuring 0.3 and 0.7 cm, both submitted entirely. The second specimen, labeled \"upper 9L,\" contained a single lymph node measuring 0.7 cm in diameter, also submitted in total. Frozen section analysis of all lymph nodes showed no abnormal cellular infiltration or concerning morphological features.\n\nMicroscopic examination of the lung tissue reveals moderately differentiated cells arranged in a solid growth pattern, with nuclear pleomorphism and increased mitotic activity. The lesion is confined within the lung parenchyma and does not extend into vascular structures or large airways. Evaluation of the bronchial and vascular margins is not applicable due to the nature of the resection, while the parenchymal margin remains uninvolved. The closest distance from the tumor to the inked parenchymal margin is 2.2 cm. No venous or arterial invasion is noted.\n\nA total of more than 16 lymph nodes were examined from regional sites. None demonstrated evidence of cellular involvement. Additional findings include areas of atelectasis and inflammatory changes within the lung parenchyma.\n\nStaging parameters indicate the lesion is localized to the lung without extension to adjacent structures or lymph node involvement."} +{"pid": "TCGA-A5-A0G9", "report": "The uterus measures 7.4 cm from the fundus to the ectocervix, with a maximum width of 3.8 cm and thickness of 4.1 cm. The endometrial cavity is approximately 5.0 cm long and up to 3.0 cm in diameter. A pale tan mass occupies much of the endometrial cavity, measuring 4.2 x 3.0 cm in surface area and up to 1.6 cm thick, including both exophytic and endophytic components. The tumor extensively involves the uterine fundus, anterior and posterior corpus, and extends into the posterior lower uterine segment. In the deepest area of invasion, the tumor penetrates about 65\u201370% of the uterine wall thickness in the posterior fundus and corpus, while invasion in the anterior uterus and posterior lower uterine segment is more superficial, involving less than 50% of the wall thickness.\n\nHistologically, the tumor shows a mixture of morphologic features, including areas with secretory, eosinophilic, and squamoid differentiation, as well as focal mucinous changes. There are also regions suggestive of clear cell morphology. Nuclear grade is predominantly 2, with focal areas of grade 3. Lymphovascular invasion is present. Adjacent myometrium shows changes consistent with adenomyosis, with and without secondary involvement by the tumor. No extension into the endocervix or ectocervix is identified, and parametrial soft tissues appear free of tumor involvement.\n\nFive intramural leiomyomas are identified within the uterus, measuring 0.3, 0.5, 0.6, 1.2, and 1.5 cm. The largest and second largest leiomyomas are located in the posterior uterine corpus and show extensive hyalinization; the second largest also contains calcifications. The third smallest is located in the anterior lower uterine segment.\n\nThe cervix is 2.8 cm long with a maximum diameter of 1.9 cm at the ectocervix. Two small endocervical polyps are present, measuring 0.2 and 0.3 cm. The remainder of the cervix shows no tumor involvement but demonstrates a range of non-neoplastic changes, including acute and chronic inflammation, epithelial denudation, atrophic squamous changes, squamous metaplasia, reactive epithelial changes, and nabothian cysts.\n\nExamination of bilateral fallopian tubes and ovaries reveals no evidence of metastatic tumor. The right ovary has a paraovarian mesothelial cyst measuring 0.7 cm. The left ovary also contains a smaller paraovarian cyst (0.4 cm). Both fallopian tubes show mild epithelial hyperplasia without significant atypia and chronic perivascular inflammation.\n\nA total of 20 lymph nodes were evaluated across multiple pelvic and periaortic regions: four from the left pelvic group, one from the left obturator, two from the left periaortic, three from the right pelvic, four from the right obturator, and three from the right periaortic. All lymph nodes are negative for metastatic tumor. One additional left pelvic soft tissue specimen contained only hemorrhagic adipose tissue and no identifiable lymph node; it was also negative for tumor involvement.\n\nScattered throughout the endometrial cavity are benign findings including simple and complex hyperplasia with atypia, along with inactive and weakly proliferative endometrial foci. Minimal uninvolved endometrium is found in the lower anterior corpus and lower uterine segment, measuring less than 0.1 cm in thickness."} +{"pid": "TCGA-A7-A4SB", "report": "The final surgical pathology report includes findings from a right axillary sentinel node and a right breast excisional biopsy. In the sentinel node evaluation, one of two lymph nodes showed evidence of micrometastatic involvement measuring 0.98 mm. This was identified through immunohistochemical staining with pancytokeratin AE1/AE3 on one of the tissue blocks. A total of 69 involved cells were noted, with the largest cluster measuring 0.98 mm. The assessment included multiple H&E-stained sections and cytokeratin stains.\n\nIn the right breast specimen, a white-tan, ill-circumscribed lesion measuring 5.3 cm in greatest dimension was identified. Histologic evaluation revealed grade 2 invasive carcinoma characterized by an architectural score of 3, nuclear score of 2, and mitotic score of 1. The tumor was found at the posterior and inferior/medial margins, and was less than 1 mm from the anterior margin. Focal areas suspicious for lymphovascular space invasion were also noted. A second, smaller nodule adjacent to the main lesion was identified but did not alter the overall tumor measurement. The breast tissue otherwise showed dense fibrosis without evidence of calcifications or ductal intraepithelial changes. Core biopsy site changes were present near the posterior margin.\n\nMargins of resection were evaluated microscopically. Tumor involvement was confirmed at the posterior and inferior/medial margins, and was within 1 mm of the anterior margin, while remaining 2 mm from the superior margin. No other significant non-tumorous changes were reported. Prognostic marker testing was performed on prior biopsy material."} +{"pid": "TCGA-EA-A439", "report": "The specimen consists of cervix tissue from a hysterectomy. The tumor measures 3 x 3 x 2.5 cm and is located in the cervix. Histologic evaluation shows poorly differentiated cells with features consistent with non-keratinizing morphology. The tumor demonstrates invasion into the stromal tissue and extends beyond the uterus. There is evidence of lymphatic invasion; however, venous invasion could not be assessed. No pelvic extension was identified, and no lymph nodes were examined. Margins are unspecified. Additional findings include involvement of the corpus. No evidence of neo-adjuvant treatment was noted."} +{"pid": "TCGA-LL-A5YP", "report": "A left breast mastectomy specimen revealed an invasive high-grade ductal carcinoma measuring 1.8 cm with extensive tumor necrosis and associated high-grade ductal carcinoma in situ (DCIS) with comedo necrosis. Margins were negative, with the closest margin measuring 5 mm at the deep margin. One of two lymph nodes identified in the tail of the breast region contained metastatic carcinoma measuring 7 mm without extracapsular extension. No definitive peritumoral angiolymphatic invasion was identified. Additional findings included neurofibromatosis, proliferative fibrocystic changes, and a small fibroadenoma.\n\nIn the left axillary sentinel lymph node excision, one sentinel lymph node and two nonsentinel lymph nodes were examined. The sentinel node and nonsentinel nodes showed no evidence of metastatic carcinoma by routine microscopy or cytokeratin immunostain.\n\nThe right breast mastectomy specimen contained an invasive high-grade ductal carcinoma measuring 4 cm with extensive tumor necrosis. This lesion was associated with high-grade DCIS with comedo necrosis that was not extensive. The tumor invaded the dermis without ulceration and did not involve deep skeletal muscle. Margins were negative, with the closest invasive tumor margin measuring 2 mm superiorly and the DCIS margin measuring 4 mm medially. Two of twelve axillary lymph nodes contained metastatic carcinoma with extranodal capsular extension present. A focal area raised suspicion for perinodal venous invasion. Additional findings included a 2.5 cm fibroadenoma and neurofibromatosis.\n\nBoth tumors demonstrated high-grade DCIS with comedo necrosis. Microcalcifications were noted in the left breast lesion. Evaluation of estrogen receptor status showed weak positivity in both tumors. HER2/neu testing on core biopsy material showed discordant results between immunohistochemistry and FISH analysis. Due to extensive necrosis in the core biopsies and difficulty distinguishing invasive from in situ components in parts of the left breast mass, further HER2/neu evaluation was initiated on selected blocks from both breasts.\n\nPathologic staging for the left breast lesion was pT1c with regional lymph node involvement classified as pN1a. For the right breast lesion, staging was pT2 with regional lymph node involvement also classified as pN1a. Distant metastasis was not applicable in both cases.\n\nGross examination of the left breast specimen showed a fibrofatty tissue specimen with a central necrotic hemorrhagic tumor mass. The tumor was located approximately 5 cm from lateral, 5 cm from superior, and 5 cm from inferior margins, with a distance of 0.2 cm from the deep margin. Multiple lymph nodes were identified within the lateral aspect of the specimen. The remainder of the breast tissue exhibited diffuse fibrocystic change and nodularity without additional discrete masses.\n\nThe right breast specimen demonstrated a larger tumor mass measuring 4 cm located medially, with proximity to multiple margins. An additional smaller mass was identified in the upper/outer quadrant. The axillary tail contained multiple lymph nodes, including one significantly enlarged and necrotic lymph node.\n\nRepresentative sections from all margins, lymph nodes, and associated tissues were submitted for histological evaluation."} +{"pid": "TCGA-D1-A15Z", "report": "The tissue specimen includes the uterus, right ovary (measuring 3.0 x 1.6 x 1.0 cm) with a 6.0 cm segment of the right fallopian tube, and the left ovary (2.6 x 2.0 x 0.4 cm) with an 8.0 cm segment of the left fallopian tube. The combined weight of these tissues is 145.0 grams. Additional specimens include right and left pelvic lymph nodes, right and left para-aortic lymph nodes, and abdominal tissue consisting of skin, subcutaneous tissue, and umbilicus, weighing 3970.0 grams.\n\nA mass measuring 4.2 x 3.6 x 1.1 cm is present in the right anterior uterine cavity. The lesion extends 0.6 cm into the myometrium, where the total myometrial thickness is 1.9 cm. There is no involvement of the cervix or lower uterine segment. Histologic evaluation of the left ovary shows endosalpingiosis. The right ovary and both fallopian tubes appear unremarkable. Lymph node analysis reveals no evidence of tumor involvement. Six external iliac, one internal iliac, four common iliac, and one obturator lymph nodes on the right pelvic side were negative. On the left pelvic side, four external iliac, two internal iliac, four common iliac, and six obturator lymph nodes were also negative. Additionally, one right para-aortic lymph node below the inferior mesenteric artery and four left para-aortic lymph nodes above the inferior mesenteric artery showed no signs of tumor. Abdominal skin and subcutaneous tissue with the umbilicus were identified grossly."} +{"pid": "TCGA-55-6970", "report": "A histopathological examination was conducted on multiple specimens, including lung tissue from the right side, a right upper lobe of the lung, and lymph nodes from stations 8 (paraesophageal) and 4 (lower paratracheal). \n\nThe right upper lobe specimen measured 14.5 x 11.5 x 3.5 cm. A nodular lesion measuring 3.5 x 3.0 x 2.0 cm was identified within the lung tissue, located approximately 1.5 cm from the bronchial margins and extending to within 0.7 cm of the pleural surface. The surrounding lung tissue appeared pink to red-brown with crepitance upon sectioning, and no other lesions were observed macroscopically. Sections of this lesion and surrounding normal lung tissue were submitted for further analysis.\n\nOne peribronchial lymph node was identified near the bronchial margin and submitted for evaluation. Additionally, one lymph node from station 8 and two lymph nodes from station 4R were received and examined. The lymph node at station 8 measured 0.8 x 0.8 x 0.3 cm and showed no evidence of abnormal cellular infiltration. The two lymph nodes from station 4R measured a combined 1.2 x 0.6 x 0.3 cm, and one of these contained abnormal cellular findings.\n\nMicroscopic evaluation revealed abnormal cellular growth within the lung tissue, characterized by moderately differentiated cells arranged in a specific architectural pattern. This growth extended to the bronchial margin and was associated with extensive involvement of lymphatic channels in the submucosa and bronchial wall. No vascular invasion or direct tumor extension beyond the affected area was noted.\n\nStaging was determined based on the extent of the primary lesion and regional spread. The primary lesion was classified as greater than 3 cm in size. Metastatic involvement was identified in one peribronchial lymph node and one of the two lower paratracheal lymph nodes, while the paraesophageal lymph node was negative. Distant metastasis could not be assessed. Additional pathological findings were unremarkable."} +{"pid": "TCGA-AP-A5FX", "report": "The submitted specimens include the uterus, cervix, bilateral fallopian tubes and ovaries, right external iliac lymph nodes, right obturator lymph nodes, left external iliac lymph nodes, and omentum.\n\nExamination of the uterine specimen revealed a lesion with architectural features corresponding to grade III (greater than 50% solid growth) and nuclear grade 3. The tumor infiltrated more than 50% of the myometrium, with a maximum depth of invasion measuring 25 mm. The myometrial thickness at the site of maximal invasion was 26 mm. Tumor extension reached the subserosal surface. No endocervical involvement was identified. Lymphovascular invasion was present. The endometrium showed atrophic changes, and the myometrium was otherwise unremarkable. Both fallopian tubes exhibited tumor involvement, while the ovaries appeared normal.\n\nImmunohistochemical staining demonstrated diffuse positivity for P16, weak and focal positivity for p53, and moderate to strong positivity for ER. These findings were discussed at a consensus conference.\n\nIn the lymph node specimens, metastatic adenocarcinoma was identified in all biopsied nodes: two of two in the right external iliac group, one of one in the right obturator group, and one of one in the left external iliac group. The omental resection specimen showed benign tissue.\n\nAll tests used in the analysis were developed and validated by the Department of Pathology. They have not been cleared or approved by the FDA; however, the agency has determined that such clearance is not necessary. These tests are used for clinical purposes and are not considered investigational or research-based. The laboratory is certified under CLIA '88 for performing high-complexity testing. The diagnosis was based on personal examination of the slides and review of the material."} +{"pid": "TCGA-BG-A3PP", "report": "The specimen consists of a uterus with bilateral adnexa, removed via total abdominal hysterectomy and bilateral salpingo-oophorectomy. The endometrial surface shows extensive involvement, with approximately 80% affected on both anterior and posterior aspects. The myometrium demonstrates significant invasion, with tumor infiltration involving approximately 85% of the thickness. Histologic evaluation reveals poorly differentiated epithelial cells with marked nuclear atypia. Architectural differentiation is also poor. The tumor measures 43 mm in maximum dimension.\n\nInvolvement extends to the endocervical glands and cervical stroma. Multifocal lymphovascular invasion is present within the primary lesion. No tumor is identified in the bilateral ovaries or fallopian tubes; the ovaries show physiologic changes and epithelial inclusions. The fallopian tubes appear unremarkable.\n\nLymph node dissections were performed from left pelvic, left para-aortic, right pelvic, and right para-aortic regions. In total, three lymph nodes were examined, and all were negative for tumor involvement. One lymph node was identified in the right para-aortic region, which showed focal lymphovascular invasion in a perilymphatic vessel. No lymph node tissue was identified in some dissected areas.\n\nThe omentum is negative for tumor, although there is evidence of focal mesothelial proliferation. Pelvic cytology shows suspicious findings for malignant cells.\n\nStaging assessment indicates a pathologic T stage of pT2, based on invasion beyond the uterine corpus into the cervix. The pathologic N stage is pN0, as no lymph nodes are involved. No M stage is assigned. Based on these findings, the FIGO classification is stage II."} +{"pid": "TCGA-VT-AB3D", "report": "A wide resection specimen from the left arm was evaluated. The tumor measured 4.2 x 4.0 x 2.1 cm and was located in deep, subfascial soft tissue. Microscopic examination revealed a cellular lesion with pleomorphic features and inflammatory background. A focally myxoid stroma was noted. Mitotic activity was present at a rate of 13 per 10 high-power fields. No necrosis was identified.\n\nMargins were assessed microscopically. Multiple margins were negative; however, one margin showed proximity of tumor to the inferior/distal aspect. Additional sampling of this region demonstrated no residual tumor. No lymphovascular invasion was observed.\n\nHistologic grade was classified as intermediate (FNCLCC Grade II). Based on AJCC/UICC 7th edition staging criteria, the tumor was classified as Stage IIA. It was categorized as pT1b (tumor \u22645 cm in greatest dimension and deep), with inability to assess regional lymph nodes (pNX) and no evidence of distant metastasis.\n\nImmunohistochemical staining showed negativity for markers including desmin, smooth muscle actin, muscle-specific actin, S100, Melan-A, AE1/3, and ALK1. There was partial immunoreactivity for CD34.\n\nNo preoperative therapy had been administered. Gross examination of the excised mass revealed a well-circumscribed subcutaneous lesion. The lesion was firm and palpable beneath the skin surface and was located in the antecubital fossa region. No visible lesion was identified on the overlying skin surface.\n\nMargins sampled during frozen section analysis included lateral, superior, inferior, and medial regions. All were negative for tumor involvement.\n\nAncillary studies including cytogenetics and molecular pathology were not performed."} +{"pid": "TCGA-VS-A9V2", "report": "The biopsy specimen was obtained from the cervix and shows a neoplastic lesion composed of moderately differentiated squamous cells. The tumor exhibits invasive growth within the sampled tissue. No evidence of vascular invasion is identified in the current specimen."} +{"pid": "TCGA-HT-A5R5", "report": "The pathology report describes a tumor composed of cells with consistently round to oval nuclei, many of which exhibit perinuclear halos. Nuclear atypia is present but mild, with scattered moderately atypical nuclei. The tumor demonstrates diffuse infiltration involving both gray and white matter; in the white matter, perineuronal satellitosis is prominent. No mitotic figures are identified. Additionally, there is no evidence of microvascular proliferation or necrosis."} +{"pid": "TCGA-EM-A2OY", "report": "The specimen from the right hemithyroidectomy is intact and weighs 16.3 grams. The right lobe measures 6.1 cm in length, with additional dimensions of 2.7 cm and 2.0 cm. The isthmus measures 2.0 cm, 1.1 cm, and 0.8 cm. A well-defined nodule measuring 2.6 cm x 2.6 cm x 1.9 cm is identified in the lower pole. Margins are free of involvement by neoplastic cells, with the closest distance of invasive lesion to margin being 0.1 mm. The dominant lesion is partially encapsulated with minimal capsular invasion noted. Histologic architecture shows follicular arrangement with classical cytomorphology as well as oncocytic features. A minor focus measuring 0.1 cm is also present with similar characteristics but without evidence of capsular invasion. No lymphovascular or perineural invasion is identified, nor is there any evidence of extrathyroidal extension. One lymph node was examined and showed no involvement. Additional findings include adenomatoid nodules or nodular follicular disease. Multiple tissue sections have been banked for further analysis."} +{"pid": "TCGA-E2-A158", "report": "The left axillary sentinel lymph node specimens measured 1.4 x 0.7 x 0.4 cm and 2 x 0.9 x 0.5 cm respectively, with both showing no evidence of metastatic disease. The right axillary sentinel lymph node specimen contained two lymph nodes measuring 0.5 cm and 2.4 x 0.8 x 0.8 cm, also without signs of metastasis.\n\nIn the left breast mastectomy specimen, a stellate mass was identified in the upper outer quadrant measuring 3 x 2.8 x 1.5 cm, located close to the anterior margin (0.2 cm) and deeper margin (2.2 cm). A smaller well-defined nodule was observed in the posterior upper inner quadrant. Histological evaluation revealed two distinct areas within the left breast: one measuring 1.6 cm with high-grade features and another measuring 0.5 cm with lower-grade characteristics. Both were associated with ductal carcinoma in situ (DCIS), solid type with necrosis, and microcalcifications. Surgical margins were free of tumor involvement.\n\nThe right breast mastectomy specimen showed four separate lesions. Two were identified as invasive carcinomas measuring 1.1 cm (high-grade) and 0.6 cm (intermediate-grade). The remaining two were benign findings: fibroadenoma and sclerosing adenosis. The larger invasive lesion was located 2.7 cm from the deep margin and 0.2 cm from the anterior margin, while the smaller invasive focus was found 2.5 cm from the deep margin and 1.8 cm from the anterior margin. DCIS was also present in association with these invasive tumors, displaying solid and cribriform patterns. All surgical resection margins were negative for tumor.\n\nImmunohistochemical analysis of the larger left breast tumor demonstrated negativity for estrogen and progesterone receptors, while HER-2 testing was negative by FISH. The smaller left tumor was positive for both hormone receptors, with equivocal HER-2 staining and pending fluorescence in situ hybridization (FISH) results.\n\nIn the right breast, the larger tumor was negative for estrogen and progesterone receptors, with equivocal HER-2 staining and no gene amplification confirmed by FISH. The smaller tumor on the right side was strongly positive for both hormone receptors, with equivocal HER-2 staining and no gene amplification detected.\n\nStaging was performed based on tumor size and lymph node involvement. In the left breast, pathological staging was pT1c with micrometastasis involving one lymph node. For the right breast, staging was pT1c with no lymph node involvement.\n\nOverall, multiple distinct foci were identified bilaterally, each showing unique histological and biomarker profiles suggesting independent primary lesions."} +{"pid": "TCGA-KL-8346", "report": "The specimen from a male patient with a history of a right-sided kidney mass was submitted for analysis. The right kidney specimen measured 12 x 7 x 6 cm and weighed 771 grams. A mass measuring approximately 11 x 9 x 7 cm was identified in the lower pole, extending toward the mid-kidney and renal pelvis. The mass exhibited necrotic and hemorrhagic features, with a yellow-tan appearance on cut surface. It replaced much of the lower kidney and extended to the renal capsule without penetrating it. Involvement of perihilar fat was noted. Adjacent non-neoplastic kidney tissue showed chronic interstitial inflammation, fibrosis, and glomerular sclerosis. No adrenal gland or lymph nodes were identified in the specimen. Margins of the ureter, renal vessels, and surgical resection were free of involvement. Sections of the tumor included areas adjacent to the capsule, hilar fat, renal pelvis, and uninvolved kidney.\n\nA second specimen consisted of a single lymph node from the right precaval and paracaval region, measuring 7 x 1 x 0.6 cm. It was entirely submitted for histological evaluation and found to be unremarkable.\n\nStaging classification was assigned as pT2 based on the size of the lesion, which exceeded 7.0 cm in greatest dimension and remained confined to the kidney. Microscopic evaluation revealed nuclear atypia."} +{"pid": "TCGA-K6-A3WQ", "report": "The specimen included a hysterectomy with bilateral adnexae, measuring 6 x 4.5 x 3 cm. The endometrial cavity was occupied by a gray/tan, friable papillary mass. Invasion extended into the myometrium with depth of invasion measuring 14 mm, involving nearly 95% of the myometrial thickness, which measured 15 mm at the tumor site. Cervical stromal invasion was present. No tumor was identified at the resection margins. Adenomyosis was noted.\n\nThe right fallopian tube and ovary appeared unremarkable on gross examination. The left fallopian tube and ovary were also without visible tumor. The cervix had undergone prior conization; no tumor was seen grossly in the cervix. Multiple sections were taken from the cervix, lower uterine segment, and endomyometrium, including the area of deepest invasion.\n\nA vaginal cuff tissue sample consisted of fibrous tissue with inflammation and cautery artifact. Sigmoid surface tissue, cul-de-sac tissue, left adnexal tissue, right side wall tissue, and omental tissue all contained invasive carcinoma. The omentum showed three gray/tan nodules, the largest measuring 3 x 2 cm and the smallest 1.5 x 1 cm, consistent with metastatic involvement.\n\nLymph node tissue was collected from both left and right pelvic regions. One lymph node out of two examined contained micrometastasis, with no extranodal extension observed. Additional tissue samples from the right pelvic sidewall and pericolic soft tissue also demonstrated invasive carcinoma.\n\nHistologic evaluation revealed high-grade cellular features with serous morphology admixed with clear cell components. Lymphovascular invasion was identified. Immunostaining showed tumor cells positive for keratins. Controls were appropriate and technically acceptable.\n\nStaging was determined as pT3b, reflecting deep myometrial invasion and involvement of the cervical stroma. Involvement of the serosa, bilateral adnexa, cul-de-sac, sigmoid, and omentum supported a stage pM1 classification. Lymph node involvement classified as pN1."} +{"pid": "TCGA-27-1830", "report": "Birth date. Tumor site: right temporal. Histological examination shows a highly cellular lesion with marked nuclear atypia and frequent mitotic figures. Necrosis is present, including areas of pseudopalisading. Vascular proliferation is also observed. The lesion infiltrates the surrounding brain tissue. Based on histological features and extent of spread, the tumor demonstrates high-grade characteristics."} +{"pid": "TCGA-CH-5741", "report": "The specimen shows a tumor with a maximum diameter of 5.5 cm. Histological evaluation reveals a high-grade malignancy with Gleason pattern 4 and 5 components, with approximately 20% of the tumor composed of Gleason 5 morphology. Tumor growth extends beyond the organ bilaterally, involving the rectolateral and basal regions, as well as infiltrating both seminal vesicles extensively. There is multifocal perineural invasion and involvement of the surgical margin on both sides, with the left basal region showing a contact length of 3 mm. The tumor demonstrates lymphatic invasion, though no clear evidence of vascular invasion is present. Additional findings include multiple foci of high-grade intraepithelial neoplasia and myoglandular hyperplasia. The prostatic urethra shows no dysplastic changes. Lymph node assessment reveals two uninvolved nodes, while one of three nodes contains a 1.5 cm metastatic deposit without extranodal extension. Based on these findings, the initial classification was pT3b, L1, V0, pNI (1/5), RI. Following immunohistochemical analysis for vascular markers, which showed no evidence of vessel invasion, the final classification is pT3a, Gleason score 4+5=9, pNO (0/3), L0, V0, R1. A follow-up report incorporated immunostaining with CD31 and D2-40, performed on two representative blocks, which did not reveal tumoral vascular invasion."} +{"pid": "TCGA-44-6144", "report": "The specimen includes a right upper lobe lobectomy specimen weighing 285 grams and measuring 19 x 12.8 x 3.8 cm, with a bronchial stump measuring 1.7 x 0.8 cm in diameter and 1 cm in length. The pleura is focally hemorrhagic with tan-pink-gray discoloration. A stellate lesion measuring 2 x 1.8 x 1.8 cm is identified in the inferior portion of the specimen, with the closest distance to the pleural surface being 2.4 cm. The lesion has a rubbery, pale tan consistency. The remaining pulmonary parenchyma is spongiform and tan-pink to red-purple without additional abnormalities. Two gray-black lymph nodes measuring up to 1.3 cm are recovered from the hilar region. Specimens from the tumor, normal parenchyma, bronchial stump margin, vascular margin, tumor proximity to the pleural surface, adjacent parenchyma, subpleural regions, and both whole and bisected lymph nodes are submitted in ten blocks.\n\nSpecimen B consists of multiple soft tissue fragments labeled as R4, measuring 0.8 x 0.3 cm in aggregate, and submitted entirely in one cassette. Specimen C includes multiple black, pink, and red soft tissue fragments labeled level 7, measuring 1.5 x 0.7 cm in aggregate, also submitted entirely in one cassette.\n\nMicroscopic examination reveals a moderately differentiated epithelial lesion measuring 2 cm in greatest dimension within the lung parenchyma, without involvement of the pleura or large airways. Resection margins are free of abnormal cells. Invasion of surrounding pulmonary parenchyma is noted along with vascular invasion involving venous structures. Lymphatic vessel involvement is also present. Two hilar lymph nodes are examined and found to be negative for metastatic involvement. Additional lymph nodes from specimens B and C (totaling five) are similarly negative. No distant metastasis is identified.\n\nOther findings include an area of intraparenchymal hemorrhage associated with hemosiderin deposition, suggestive of prior injury, although no organized thromboembolic material is observed. This hemorrhagic focus is separate from the main lesion and shows no evidence of tumor involvement."} +{"pid": "TCGA-G9-6385", "report": "The prostate specimen weighed 41 grams and measured 6.2 cm in width, 4.2 cm in depth, and 3.5 cm in height. Following removal of the apex and base, the remaining weight was 29 grams. The prostate was sectioned serially from apex to base, revealing firm tan fibrous parenchyma. A single lesion measuring 1.4 cm in greatest dimension was identified, located 0.4 cm from the anterior margin. Both right and left seminal vesicles were present and measured 2.8 x 1 x 0.6 cm and 2.1 x 0.6 x 0.3 cm, respectively; they exhibited beige-tan cystic tissue with no gross abnormalities. Segments of the right and left vas deferens measured 2.7 x 0.4 cm and 2.6 x 0.8 cm, respectively, and displayed firm tan tubular structures without gross anomalies.\n\nMicroscopic evaluation showed epithelial changes involving less than 5% of the gland. Gleason grading was assigned based on architectural patterns, with a primary grade of 3 and secondary grade of 4. High-grade prostatic intraepithelial neoplasia was noted. There was no evidence of perineural invasion or vascular/lymphatic invasion. The seminal vesicles and periprostatic fat showed no involvement. The bladder neck was unaffected. Surgical margins were free of abnormal findings. No lymph nodes were sampled. Additional findings included benign prostatic hyperplasia. Pathologic staging was determined as pT2c, indicating tumor involvement in both lobes of the prostate."} +{"pid": "TCGA-PE-A5DC", "report": "The specimen was received in four parts. \n\n1. A lymph node specimen from the right axilla included two nodes measuring 0.8 cm and 2.0 cm. Touch preparations and representative sections showed findings consistent with involvement. \n\n2. A lumpectomy specimen from the right breast weighed 190 grams and measured 11.0 x 10.5 x 4.0 cm. A firm mass measuring 4.0 x 2.5 x 1.8 cm was identified with irregular borders. Histologic evaluation revealed a high-grade lesion with both in situ and invasive components. The closest margins were the inferior and posterior, with tumor extending to less than 0.1 mm of these surfaces, and 0.2 cm from the anterior margin. Other margins were free of tumor. Changes related to prior biopsy were noted. Angiolymphatic invasion was present. \n\n3. An excision of the final inferior margin measured 5.0 x 3.5 x 1.6 cm. Histologic examination revealed residual disease with vascular invasion. The new margin was free of tumor. \n\n4. Axillary contents from the right side included multiple lymph nodes ranging from 0.3 to 2.5 cm in size. Histologic evaluation identified involvement in several nodes. Additional tissue from the axillary region was also present. \n\nStaging assessment indicated primary tumor size category T2, regional lymph node involvement category N2, and distant metastasis could not be determined (Mx)."} +{"pid": "TCGA-AG-A015", "report": "The specimen involves the rectosigmoid region and demonstrates a lesion measuring up to 2.5 cm in diameter at its widest point, located at the base of a tubulovillous adenoma with severe epithelial dysplasia. The lesion extends a maximum of 1.5 cm to the aboral resection margin. Histological evaluation reveals moderately differentiated morphology with invasive growth reaching the submucosal layer. Both oral and aboral resection margins are free of tumor involvement. A total of eighteen lymph nodes (mesocolic and periproctal) are negative for tumor infiltration and exhibit reactive changes. Vascular and lymphatic invasion markers are negative. Grading is consistent with intermediate differentiation (G2), and complete resection (R0) is confirmed."} +{"pid": "TCGA-DJ-A2Q2", "report": "The thyroid specimen was received fresh and labeled as a total thyroid. The thyroid weighed 37 grams. The right lobe measured 6 x 3.5 x 3 cm, the left lobe measured 3.5 x 2.5 x 1.5 cm, and the isthmus measured 1 x 0.5 x 0.3 cm. The external surface was covered by a thin fibrous capsule. The posterior surface was inked black and the anterior surface was inked blue. On sectioning, a well-circumscribed, thinly encapsulated, solid tan mass was identified in the right lobe measuring 4.9 x 3.5 x 2 cm with focal central cystic change. A separate well-circumscribed tan nodule was found in the left lobe measuring 0.8 x 0.6 x 0.6 cm. The remaining thyroid parenchyma appeared red-tan and beefy. Representative sections were submitted for processing, and the remainder of the tissue was serially sectioned and entirely submitted.\n\nMicroscopic evaluation revealed a well-differentiated lesion with no identified mitotic activity or tumor necrosis. Non-psammomatous calcifications were present. The lesion was completely surrounded by a thin capsule, with no evidence of capsular or blood vessel invasion. There was no extension beyond the thyroid capsule. Surgical margins were free of involvement. No additional nodules or adenomas were identified away from the main lesion. The non-neoplastic thyroid tissue showed features of nodular hyperplasia. Parathyroid glands were not identified in the specimen. One lymph node was examined and was benign with no evidence of metastasis."} +{"pid": "TCGA-QR-A6H2", "report": "The right adrenal specimen was received fresh and labeled appropriately. The specimen weighed 35.3 grams and measured 5 x 4.5 x 2.5 cm. It consisted of a soft tissue fragment with a cut surface revealing tan tumor tissue containing multiple areas of hemorrhage. The largest dimension of the tumor measured 4 cm. A fragment measuring 4 x 2 x 1 cm was obtained by the UOB laboratory for further analysis, while the remainder of the specimen was processed routinely. The specimen was inked black, avoiding the cut surface, and representative sections were submitted for permanent processing in cassettes A\u2013H. No filing in the medical record was requested. Immunohistochemical staining demonstrated positivity with chromogranin, and sustentacular cells were highlighted by S-100 staining. Cellular morphology and staging features were consistent with a well-defined mass without evidence of invasion or metastasis."} +{"pid": "TCGA-A2-A04Q", "report": "The specimen consisted of a right breast tissue mastectomy measuring 18.0 cm x 13.5 cm x 3.0 cm, along with multiple lymph node biopsies. A tumor measuring 1.8 cm was identified in the central portion of the breast. Histologic evaluation showed poorly differentiated infiltrating ductal carcinoma with associated ductal carcinoma in situ, nuclear grade III, and necrosis. A prominent lymphoid infiltrate was present, comprising 10\u201315% of the tumor. Immunohistochemical analysis demonstrated negative staining for estrogen and progesterone receptors. HER2 Neu testing by immunohistochemistry showed weakly positive (2+) staining; however, fluorescence in situ hybridization (FISH) did not show gene amplification (ratio 1.4). Surgical margins were free of tumor involvement. No residual Paget\u2019s disease or lactiferous duct involvement was identified. Microcalcifications were present within neoplastic breast tissue. Adjacent non-involved breast tissue showed fibrocystic changes and sclerosing adenosis.\n\nLymph node specimens included two sentinel lymph nodes and one non-sentinel lymph node. Each lymph node biopsy showed no evidence of tumor involvement by both H&E and immunohistochemical evaluation. The non-sentinel lymph node appeared benign. All lymph nodes were small, measuring 2.0 x 1.4 x 1.0 cm (sentinel 1), 1.5 x 0.8 x 0.5 cm (non-sentinel), and 1.4 x 0.8 x 0.4 cm (sentinel 2), respectively. No significant pathological features were noted in the lymph nodes beyond absence of tumor involvement."} +{"pid": "TCGA-IB-AAUO", "report": "The specimen includes multiple tissue samples collected from various anatomical sites. One lymph node measuring 2.8 x 1.3 x 0.6 cm was identified with associated adipose tissue. Microscopic evaluation of this lymph node revealed the presence of malignant cells. A second lymph node site contained only fibrofatty tissue without evidence of malignancy. A proximal bile duct margin sample showed inflammatory changes but no malignant or pre-malignant features.\n\nA larger resected specimen included a segment of duodenum and attached pancreatic head. The duodenum measured approximately 25 cm in length, with variable circumference between 4 and 6.5 cm. The pancreatic head measured 6 x 5 x 2.5 cm. A mass was identified near the uncinate process, measuring approximately 2.5 x 2.7 x 1.5 cm. This mass was located within 0.1 to 0.2 cm of the retroperitoneal margin, and less than 0.1 cm from the external surface of the pancreas. The mass extended into the duodenal wall and was found in close association with an indurated area of the duodenal mucosa. Four additional lymph nodes were identified in the peripancreatic region, all containing malignant cells.\n\nHistologic analysis showed poorly differentiated cells arranged in irregular glandular patterns. Invasion of perineural and lymphovascular spaces was noted. The tumor was present at the uncinate process margin. No prior treatment effect was observed. A separate finding of chronic pancreatitis was also noted. The remaining regional lymph nodes examined were involved by malignant cells. The tumor was located entirely within the pancreas and measured greater than 2 cm in its largest dimension."} +{"pid": "TCGA-A2-A25C", "report": "The surgical specimen from the left breast consists of a simple mastectomy measuring 17.5 x 16 x 2.8 cm. A skin ellipse including the nipple measures 9 x 2.5 cm and appears unremarkable. Two irregular fragments of fatty tissue, without palpable masses, measure 4.5 x 3 x 0.5 cm in total. The superficial aspect of the specimen is marked with blue ink, and the deep margin is marked with black ink. On sectioning, two distinct gray fibrous nodules are identified. The more lateral lesion, located at the 3 o\u2019clock position, measures 1.5 x 1.1 x 1.5 cm and is 0.5 cm from the deep margin. A second mass, adjacent to a coil clip, is located at the 6:30 position and measures 2.2 x 1.8 x 2.1 cm; it is also 0.5 cm from the deep margin. This lesion extends to within 0.6 cm of the superficial margin, while the 3 o\u2019clock lesion is 0.7 cm from the superficial margin. The central portion of the breast contains dense tan fibrous tissue, while the periphery and areas near the deep margin show yellow fatty tissue. Tissue from each lesion and multiple breast quadrants has been submitted for analysis.\n\nTwo sentinel lymph nodes were also received. The first lymph node measures 1.7 x 1.0 x 0.9 cm and is described as an ovoid fragment of yellow-red soft tissue. Gross examination reveals a 1.3-cm lymph node with central fat replacement and blue staining. The second lymph node measures 1.5 x 0.6 x 0.4 cm and is an ovoid fragment of red-tan tissue. It shows similar blue discoloration and appears unremarkable on gross inspection. Both lymph nodes were bisected and submitted for further evaluation.\n\nMicroscopic analysis of the breast tissue reveals moderately differentiated infiltrating ductal carcinoma with nuclear grade II/III, moderate mitotic activity, and tubule formation score of 2, resulting in a total Nottingham score of 6. Rare foci of ductal carcinoma in situ of cribriform and solid types, with nuclear grade II and low mitotic index, are present at the tumor periphery. The 3 o\u2019clock lesion measures 1.5 cm and the 6 o\u2019clock lesion measures 2.2 cm; these are separated by at least 1.5 cm of benign breast tissue. All excision margins, including the nipple and skin, as well as random sections from remaining quadrants, are free of tumor involvement. Lymphovascular invasion is present, and biopsy changes are noted.\n\nIn the first sentinel lymph node, multifocal metastatic disease is identified on H&E and cytokeratin stains, with the largest focus measuring 3 mm. No extranodal extension is observed. In the second sentinel lymph node, multifocal metastatic disease is also identified, with the largest focus measuring 2 mm. Extranodal extension is not present in this node. Immunohistochemical staining for Her-2/neu is negative (score 1+)."} +{"pid": "TCGA-HT-8013", "report": "The pathology report describes a moderately cellular proliferation of neoplastic astrocytes, primarily exhibiting gemistocytic features. Areas of pleomorphism are prominent. Focal regions of neoplastic oligodendrocytes are also present. No evidence of microvascular proliferation is observed. Mitotic figures are not seen in most areas, although the MIB-1 stain identifies a rare mitotic figure. Several large foci of necrosis are present without pseudopalisading. The MIB-1 labeling index is 2.2%, indicating a modestly proliferative lesion."} +{"pid": "TCGA-5P-A9K2", "report": "The specimen demonstrates a tumor measuring 4.5 cm in greatest dimension. Microscopic evaluation reveals cells arranged in a papillary pattern with prominent nuclear atypia and a high nuclear grade. The tumor is confined to the kidney, with no evidence of extension beyond the organ. Surgical margins are negative. Based on size and extent, the stage is classified as pT1b."} +{"pid": "TCGA-A7-A26F", "report": "The specimen included a left axillary sentinel lymph node measuring 1.5 x 1 x 0.5 cm, which showed no evidence of metastasis upon multilevel sectioning with H&E staining and immunohistochemistry for pankeratin. The left breast specimen was an excisional biopsy measuring 3.5 cm (anterior-posterior), 3.8 cm (superior-inferior), and 2.5 cm (medial-lateral). A firm, tan stellate lesion measuring 1.8 x 1.5 x 1.5 cm was identified, extending toward the inferior margin and involving it over a distance greater than 1 cm. The invasive component was graded as histologic grade 3 based on architectural, nuclear, and mitotic scores. The invasive carcinoma exhibited features consistent with squamous differentiation. Calcifications were present, and there was evidence of ductal carcinoma in situ (solid and comedo subtypes), nuclear grade 3, with central necrosis and less than 10% subtotal tumor involvement. The ductal carcinoma in situ had negative margins, while the invasive component had positive margins at the inferior aspect. Vascular invasion was suspected in focal areas. No extensive intraductal component was identified. Non-tumorous breast tissue appeared unremarkable. A block was submitted for repeat HER-2 testing by FISH due to prior equivocal results."} +{"pid": "TCGA-RY-A840", "report": "The patient is a male who presented with seizures. MRI of the brain demonstrated a left temporal lobe lesion with central enhancement and increased cerebral blood volume. The patient underwent resection of the lesion.\n\nSpecimens were received in three parts. Part A, labeled \"tumor,\" consisted of multiple soft, irregular pieces of off-white/red tissue measuring 1.1 x 1 x 0.2 cm in aggregate. Part B, labeled \"permanent = brain tumor,\" included two unoriented, ovoid fragments of pink to deep-red glistening soft tissue measuring 0.8 x 0.6 x 0.2 cm and 0.9 x 0.7 x 0.3 cm. Part C, labeled \"CUSA trap \u2013 permanent,\" contained multiple friable pale tan to pink-red glistening soft tissue fragments measuring 4 x 2.5 x 0.8 cm in aggregate.\n\nMicroscopic examination revealed an extensively infiltrating lesion involving the adjacent cortex. Mitotic figures were identified at a rate of 5 per 10 high-power fields. Scattered foci of microvascular proliferation were present. Immunohistochemical staining showed strong positivity for IDH1 (R132H mutant form) and negativity for P53. The proliferative index assessed by MIB-1 staining was estimated at 5%.\n\nAll specimens were processed and submitted entirely for evaluation. The attending pathologist reviewed all preliminary interpretations and performed necessary edits prior to final sign-out. Testing was conducted under CLIA certification for high-complexity clinical testing. The immunohistochemical assays used are clinically validated but not approved by the FDA, and are used for diagnostic purposes.\n\nAdditional molecular studies were performed on selected blocks and will be reported separately."} +{"pid": "TCGA-DX-A48J", "report": "The specimen consists of a large, multilobulated tan-pink mass measuring 22 x 15 x 10 cm and weighing 1700 grams. The outer surface is partially covered by a tan-pink membrane. A segment of vena cava, measuring 5 x 2.5 cm, is adherent to the mass. The inner lining of the vena cava appears tan-white and smooth. An area of necrosis is present on the surface of the tumor, measuring 9 x 5 x 3 cm, and accounts for approximately 20% of the tumor volume. The surgical margins are marked with blue ink, and upon sectioning, the tumor demonstrates a tan-pink to white-gray, focally hemorrhagic and necrotic whorled pattern with myxoid changes.\n\nMicroscopic evaluation includes multiple sections including areas of necrotic tissue, tumor, surgical margin, and vena cava. Immunohistochemical staining was performed, including CD117, CD34, SMA, and desmin. Necrosis is identified in about 20% of the tumor. The tumor is found adjacent to the surgical margin and is attached to a portion of the inferior vena cava. The original report has been amended due to a clerical error. No addendum was required for this report. All findings are based on personal examination of the slides, and the report has been reviewed and approved."} +{"pid": "TCGA-HC-A6HY", "report": "The prostate measured 4.8 x 4.1 x 3.4 cm and weighed 52 grams. Histologic evaluation showed a total Gleason score of 7, with a primary pattern of 3 and a secondary pattern of 4. The tumor was present in approximately half of the prostate and involved both lobes. No extraprostatic extension, seminal vesicle involvement, or lymphovascular space invasion was identified. High-grade prostatic intraepithelial neoplasia was present. All surgical margins were negative. No lymph nodes were received for examination. The pTNM stage was determined to be pT2c. A bulging fibrotic nodule measuring 1.4 cm was noted on the right lateral aspect. A separate 0.6 cm pale yellow area of discoloration was identified on the right posterior aspect, located 0.2 cm from the right posterior margin. The seminal vesicles were cystic but unremarkable. Multiple representative sections were submitted for analysis, including apical margin, vesical margin, and various regions of the prostate and seminal vesicles."} +{"pid": "TCGA-BG-A220", "report": "The patient underwent a total abdominal hysterectomy, bilateral salpingo-oophorectomy, and omental biopsy. An abdominal wall nodule biopsy showed infarcted appendices epiploica with calcification. Omental biopsy revealed benign fibroadipose tissue. Examination of the uterus, tubes, and ovaries demonstrated a lesion within the endometrium. The tumor measured 2.5 x 2.3 x 0.8 cm and involved approximately 25% of the endometrial cavity surface. Microscopic evaluation revealed a mixture of two cellular components, with one being more predominant than the other. The tumor was classified as poorly differentiated based on combined architectural and nuclear features. No invasion beyond the endometrium was identified, and there was no evidence of angiolymphatic invasion. The cervix was free of tumor involvement. The background endometrium displayed a proliferative pattern, and the myometrium showed focal adenomyosis. All adnexal structures were unremarkable. No lymph nodes were examined. Based on the extent of disease, the pathologic staging was determined to be pT1a with pNX for nodal status. A pelvic wash was negative for malignant cells. Gross examination initially suggested possible superficial myometrial involvement; however, histologic analysis confirmed the presence of benign endometrial glands at the interface between the tumor and myometrium, confirming the tumor was confined to the endometrium."} +{"pid": "TCGA-EJ-5510", "report": "The patient is a male with an elevated serum PSA level of 15.3 ng/ml. A prior prostate needle biopsy demonstrated bilateral involvement in the prostate gland. The procedure performed was a radical retropubic prostatectomy with bilateral pelvic lymph node dissection.\n\nExamination of the right pelvic lymph nodes revealed five benign lymph nodes without evidence of malignancy. Similarly, examination of the left pelvic lymph nodes showed twelve benign lymph nodes, also without evidence of malignancy.\n\nMicroscopic evaluation of the prostate specimen identified a lesion involving both lobes of the prostate gland. Histologic analysis showed a predominant Gleason pattern, comprising 50\u201360% of the sampled tumor volume. The Gleason score derived from the histopathologic findings was composed of two Gleason grades.\n\nThe maximal tumor diameter measured 2.0 cm in a histologic section. The lesion involved approximately 10\u201315% of the sampled prostate gland volume. Multifocal perineural invasion was observed across several histologic sections. There was no angiolymphatic invasion identified. The seminal vesicles and distal vasa deferentia appeared benign. All surgical resection margins were free of abnormal cellular proliferation.\n\nHistologic grade assessment categorized the lesion within a higher differentiation classification. Evaluation of nodular hyperplasia and focal glandular atrophy was noted in non-neoplastic areas of the prostate. \n\nPathologic staging was determined based on local extension findings. Lymph node staging indicated no positive nodes out of the total examined. Distant metastasis staging could not be fully assessed. \n\nAdditional findings included focal high-grade intraepithelial neoplasia, with one or two foci located away from the main lesion. Multiple foci of disease were identified. The prostate weighed 52.61 grams."} +{"pid": "TCGA-BC-A10T", "report": "The gallbladder specimen measured 10.0 x 3.0 x 1.0 cm with a dark green, smooth external surface and a wall thickness of 0.2 cm. No stones were identified. Representative sections were taken.\n\nA liver tissue fragment from segment II measured 2.2 x 1.7 x 1.6 cm and contained a well-circumscribed nodule measuring 1.8 x 1.5 x 1.0 cm. The nodule was white or pink in color and located within the liver tissue. The margins of the specimen were inked black, and serial sections were taken.\n\nThe right adrenal gland specimen, including surrounding adipose tissue, measured 4.5 x 3.8 x 1.3 cm. The adrenal gland itself measured 4.0 x 2.0 x 0.6 cm and had a yellow/orange appearance. Serial sectioning was performed.\n\nA larger liver resection specimen measured 21.0 x 14.0 x 11.0 cm and weighed 1200 grams. A single large nodule measuring 10.5 x 10.0 x 8.5 cm was identified. The cut surface of the nodule was yellow/red, suggesting necrosis and hemorrhage, and the nodule appeared friable, extending to or close to the medial margin. The remaining liver tissue was homogeneously brown with dilated vessels. A suture mark indicated the medial margin, which was entirely inked black. Representative sections of the tumor, adjacent uninvolved liver, and margins were submitted.\n\nMicroscopic evaluation revealed large cells with abundant pink cytoplasm arranged in trabeculae, many exceeding three cell layers in thickness. There was moderate cytologic atypia, focal necrosis, and occasional mitotic figures. No lymphovascular space invasion was observed. The surrounding liver tissue showed minimal steatosis and patchy mild chronic inflammation in portal areas but no cirrhosis. Sections were representative of both tumor and adjacent tissue, including margins."} +{"pid": "TCGA-CM-6169", "report": "The submitted specimens include a right hemicolectomy and a segment of small bowel. The right hemicolectomy specimen consists of a segment of terminal ileum, cecum with attached appendix, and ascending colon. The terminal ileum measures 8.5 cm in length and 4.5 cm in circumference at the proximal margin. The remaining colon measures 29.0 cm in length with a 7.0 cm circumference at the distal margin. The appendix is 4.0 cm long with an average diameter of 0.5 cm. A mass lesion measuring 3.7 cm by 4.0 cm is identified in the large bowel, located 0.3 cm from the ileocecal valve, 11.0 cm from the proximal margin, and 24.0 cm from the distal margin. Gross examination reveals that the lesion invades through the muscularis and serosa, with a depth of invasion measuring 0.3 cm. The remaining mucosa appears tan-brown with normal folds. Multiple small polypoid lesions are noted on the terminal ileum mucosa. The surrounding adipose tissue is hemorrhagic and lobulated, measuring up to 4.5 cm in thickness. All lymph nodes identified in the adipose tissue have been submitted for analysis.\n\nMicroscopic evaluation shows a moderately differentiated lesion with focal tumor budding. Tumor infiltration into surrounding tissues reaches the subserosal adipose and mesenteric fat. No increased tumor-infiltrating lymphocytes are observed. Lymphovascular invasion is present, including involvement of large veins and perineural structures. Surgical margins are free of tumor involvement. No precursor lesions, polyps, or mucosal dysplasia are identified in areas away from the lesion. Non-neoplastic bowel and the appendix appear unremarkable. A total of 19 lymph nodes are examined, and none show evidence of metastasis. No tumor deposits are found in the pericolorectal soft tissue.\n\nStaging according to AJCC 7th Edition criteria indicates pT3 classification based on invasion through the muscularis propria into pericolorectal tissues. The lymph node stage is NO, indicating no regional lymph node metastasis. The second specimen, a segment of small bowel measuring 21.5 cm in length and 3.6 cm in circumference, shows no pathological abnormalities upon gross or microscopic examination. Both margins and representative sections of the small bowel were submitted for analysis."} +{"pid": "TCGA-E9-A248", "report": "The lumpectomy specimen involved the right upper outer quadrant and contained a grossly evident lesion measuring 2.2 x 0 x 2.5 cm. Histologic evaluation revealed a poorly differentiated cellular proliferation. Axillary lymph node assessment showed no evidence of metastatic involvement, with all 10 examined nodes being negative. Surgical margins were uninvolved. Cellular features including tubule formation, nuclear pleomorphism, and mitotic counts were not specified at either magnification level, therefore a Nottingham Histologic Score could not be determined. There was no indication of extracapsular extension or neo-adjuvant treatment effect. No additional pathologic findings were noted."} +{"pid": "TCGA-2J-AABH", "report": "The surgical specimen included a distal pancreatectomy with splenectomy and partial omentectomy. A 2.2 x 2.0 x 1.8 cm white, solid mass was identified within the body of the pancreas, located 2.0 cm from the proximal pancreatic margin and obstructing the main pancreatic duct. The mass extended beyond the pancreas into surrounding soft tissue. Histologic evaluation demonstrated high-grade cellular atypia with perineural invasion. The pancreatic ducts showed epithelial changes consistent with low-grade dysplasia. Chronic inflammatory changes were noted in the distal pancreas. Surgical margins, including the pancreatic neck, were free of abnormal cells, with the closest margin measuring 2.0 cm from the lesion. Lymph node examination included six peripancreatic and two omental nodes, all without evidence of involvement. Based on available material, staging criteria indicate involvement beyond the pancreas without lymph node spread. Permanent histologic sections confirmed findings observed during intraoperative frozen section analysis. Any significant discrepancies would be addressed in a revised report."} +{"pid": "TCGA-EL-A3CV", "report": "A male patient underwent surgical resection for a neck mass. Surgical specimens included bilateral modified neck dissections and a total thyroidectomy.\n\nRight-sided neck dissections showed involvement of lymph nodes in levels 2, 3, 4, and 5. In level 2, one of twenty-one lymph nodes was involved. In level 3, one of nine lymph nodes was involved. In level 4, three of eight lymph nodes were involved. In level 5, two of seventeen lymph nodes were involved. No extracapsular extension was identified on the right side.\n\nLeft-sided neck dissections also revealed lymph node involvement. In level 2, one of three lymph nodes showed disease with extracapsular extension present. In level 3, one of five lymph nodes was involved. In level 4, one of six lymph nodes was involved. In level 5, one of twenty-four lymph nodes was affected. Extracapsular extension was not identified in these left-sided levels except for level 2.\n\nThe bilateral paratracheal and upper mediastinal dissection specimen contained seven involved lymph nodes out of twelve examined, with extracapsular extension noted in some.\n\nThe total thyroidectomy specimen included bilateral lesions. On the left, a lesion measured approximately 4.0 cm in maximum dimension and occupied nearly the entire lobe. On the right, a smaller lesion measured 1.7 cm. Both demonstrated features of vascular invasion and focal extension to a cauterized margin. The surrounding tissue showed signs of extra-thyroidal spread.\n\nA focally hypercellular parathyroid gland measuring 0.6 cm was incidentally noted in the mediastinal dissection specimen."} +{"pid": "TCGA-BJ-A3EZ", "report": "The surgical specimen consisted of a total thyroidectomy measuring 19 grams. Examination revealed multiple lesions within the right lobe and isthmus, ranging in size from 0.1 to 2.4 cm. The largest lesion was located in the right lobe and demonstrated features of extensive spread beyond the thyroid capsule into adjacent skeletal muscle. Angiolymphatic and perineural invasion were identified, and tumor cells were focally present at the margin. A background of chronic lymphocytic thyroiditis was also noted. One lymph node from the isthmus showed no evidence of tumor involvement.\n\nA separate lymph node dissection from the central compartment included nine lymph nodes, five of which contained tumor cells. No extranodal extension was observed. Parathyroid tissue appeared normocellular, and a small fragment of thymic tissue was also identified. All tissue from this dissection was submitted for histologic evaluation.\n\nIn the right lateral neck, a third dissection included thirty-two lymph nodes, one of which was positive for tumor cells. No extranodal extension was present, and all tissue was submitted for histologic review.\n\nA total of 42 regional lymph nodes were examined, with 6 showing involvement. Tumor staging was based on the extent of local invasion and lymph node involvement. Tumor spread beyond the thyroid gland was extensive, and margin involvement was noted on the right side. Lymph-vascular invasion was present. Additional findings included thyroiditis."} +{"pid": "TCGA-A7-A13G", "report": "The specimen includes a left axillary sentinel node and a left breast simple mastectomy. The sentinel node, measuring 1.7 x 0.6 x 0.4 cm, was examined in its entirety and found to be negative for metastatic disease. The breast specimen measured 19.5 x 13.8 x 2 cm and included a central, well-demarcated lesion located at the junction of the lower inner and outer quadrants. The lesion measured 2.8 cm and extended focally to within 0.6 cm of the deep inked margin, and 1.0 cm from the anterior surface. The cut surface of the breast showed predominantly adipose tissue with scattered fibrous elements. No other mass or abnormality was identified.\n\nMicroscopically, the lesion exhibited low-grade infiltrative features with well-differentiated histology. Architectural score was 1, nuclear score 1\u20132, mitotic score 1 (Elston SBR grade 1). Margins of resection, including skin and nipple, were free of tumor involvement. Vascular invasion was not identified. Calcifications were present. Non-tumoral changes in the breast included fibrocystic changes, cysts, apocrine metaplasia, ductal hyperplasia, intraductal papillomatosis, and rare foci of atypical ductal and lobular hyperplasia. A separate 1 cm fibroadenoma was also noted. A single lymph node was negative for metastatic disease. Distant metastasis could not be assessed."} +{"pid": "TCGA-MP-A4TC", "report": "Surgical Pathology Report. Tissue Description: A1 A2 A3 A4 A5 J1 K1 K2 B1 C1 C2 C3 C4 C5 C6 D1 D2 E1 F1, F2 G1 H1 H2 H3 H4 H5 H6 Il. The specimen includes the right middle and lower lobes of the lung, weighing 295.0 grams, along with tissue from the right lung fissure measuring 0.4 x 0.4 x 0.3 cm. Lymph nodes evaluated include station 2R, station 4R (two sets), station 7 (two sets), station 9R, station 10R, bronchus intermedius lymph nodes, and a lymph node from the right upper lobe lung superior pulmonary vein.\n\nA subpleural mass measuring 1.6 x 1.5 x 1.5 cm was identified, with no evidence of visceral pleural invasion. Angiolymphatic invasion was present. The bronchial margin was negative for tumor, with a distance of 8.2 cm from the margin to the lesion. Based on available surgical material, staging is pT1pN2.\n\nBiopsy of the right lung fissure shows high-grade cellular features. Evaluation of intrapulmonary and hilar lymph nodes revealed involvement in 3 out of 4 peribronchial lymph nodes, with extranodal extension through the major fissure. One of 3 bronchus intermedius lymph nodes was involved. Among mediastinal lymph nodes, one of 21 station 4R (right lower paratracheal) and one of 18 station 7 (subcarinal) lymph nodes were involved. No involvement was found in 5 station 2R (right upper paratracheal), 2 station 9R (right pulmonary ligament), 1 station 10R (right hilar), and 1 superior pulmonary vein lymph node."} +{"pid": "TCGA-C5-A1BM", "report": "The specimen from a total abdominal hysterectomy with bilateral salpingo-oophorectomy and excision of vaginal margins demonstrates involvement by moderately differentiated squamous cells. Tumor is present in the endocervical canal, lower uterine segment, posterior vaginal cuff, and uterus, including the endometrium, myometrium, and adjacent soft tissue. Direct extension is noted throughout these regions. The tumor measures 1 cm to the nearest resected margin at the posterior soft tissue margin. Lymphovascular invasion is identified. Surgical margins are positive at the distal suture line of the vaginal excision. Metastatic disease is found in one of four left external iliac lymph nodes, with extracapsular extension observed. No malignancy is detected in three left obturator or five right external iliac lymph nodes. Benign simple cysts are noted in the ovaries and fallopian tubes."} +{"pid": "TCGA-EM-A2CO", "report": "The thyroid specimen from the right lobe measured 4.3 cm in greatest dimension and weighed 11.58 grams. A dominant nodule measuring 2.9 cm was identified, along with a smaller nodule measuring 0.7 cm. The larger nodule exhibited follicular architecture and oncocytic cytomorphology. The tumor was well-circumscribed and confined within a capsule, with minimal capsular invasion noted. The surgical margins were free of involvement. No lymphovascular or perineural invasion was observed, and there was no evidence of extrathyroidal extension. No lymph nodes were identified or examined. Additional findings included adenomatoid nodules and focal nonspecific thyroiditis. The parathyroid biopsy showed normal parathyroid tissue without evidence of disease."} +{"pid": "TCGA-QK-A6IH", "report": "A total of 32 lymph nodes were examined from left neck dissection specimens. Two out of five lymph nodes from Level II contained metastatic disease, with chronic granulomatous inflammation noted within these nodes. One out of two lymph nodes from Level I also showed involvement. Extracapsular extension was identified in one lymph node from Level I. No carcinoma was detected in lymph nodes from Levels IIB (10 nodes), Level III (14 nodes), or submental region (1 node).\n\nThe primary lesion measured 4.6 x 4.4 x 4.0 cm and was located in the mandible. Histologic evaluation revealed moderately differentiated squamous cell carcinoma invading mandibular bone and skeletal muscle bundles. Perineural and lymphovascular invasion were present. Margins of resection, including mucosal, soft tissue, and bony margins, were free of invasive carcinoma. The closest distance from the tumor to any margin was 1.0 mm at the medial and lateral soft tissue margins.\n\nChronic granulomatous inflammation was observed in several lymph nodes as well as within the main specimen. This inflammatory pattern was also noted in the intraoperative frozen section of the buccal margin, where an atypical focus surrounded by inflammation disappeared upon deeper sectioning.\n\nPathologic staging reflected extensive local disease with pT4b classification due to tumor invasion into adjacent structures. Regional lymph node involvement was classified as pN2b based on multiple ipsilateral metastases."} +{"pid": "TCGA-IB-7646", "report": "The specimen included portions of the pancreas, gallbladder, bile duct margin, portal vein, duodenum, and adjacent structures. Gross examination revealed a mass lesion measuring approximately 4.5 cm located within the pancreatic head. The lesion was noted at the resection margin and appeared to invade the common bile duct. The distal stomach, duodenum, and small bowel mucosa were unremarkable. Lymph nodes submitted showed evidence of metastatic involvement with extranodal extension.\n\nMicroscopic evaluation demonstrated moderately invasive characteristics with fat invasion, perineural, and vascular invasion identified. One lymph node was positive for metastatic involvement. Inflammation and reactive changes consistent with chronic pancreatitis were noted in some areas. Biopsies from the bile duct margin and portal vein were negative for malignancy. A biopsy from the pancreatic margin showed presence of malignant cells. Other sections including gallbladder and additional pancreatic tissue showed no malignancy. The resection margins varied, with some being free of tumor while others were involved."} +{"pid": "TCGA-SR-A6MZ", "report": "The specimen consists of an adrenal gland weighing 27 grams, measuring 8.0 x 4.0 x 1.4 cm, with a small amount of adherent fat. Gross examination reveals multiple nodules within the gland. One nodule measures 2 cm in greatest dimension and is centrally located with a smooth, intact grey capsule. Adjacent to it is another nodular bulge measuring 1 cm in greatest dimension. Transverse sections demonstrate two additional nodules: one measuring 2.5 x 2 x 2 cm and another measuring 1 x 0.8 x 0.8 cm. A fifth nodule, measuring approximately 0.8 x 0.6 x 0.5 cm, is also identified. These nodules are predominantly grey with areas of purple mottling and appear sharply circumscribed.\n\nHistologically, at least four contiguous but apparently separate nodules are identified, ranging from 0.8 to 2.5 cm in greatest dimension. Three of these nodules are entirely intra-adrenal, while one extends beyond the adrenal capsule with partial extra-adrenal extension. The cellular morphology varies among the nodules, suggesting multiple distinct lesions rather than a single coarsely nodular tumor. Focal hyaline globules are present. No definite adrenal medullary hyperplasia is observed. There is no evidence of periadrenal soft tissue invasion, vascular invasion, or necrosis. Mitotic figures are not identified.\n\nImmunohistochemistry demonstrates low overall staining for Ki67 across all nodules, with occasional localized areas of increased staining. Calcitonin staining is negative in all nodules; focal nonspecific pigment is noted in controls and calcitonin-stained slides. S100 staining reveals variable numbers of sustentacular cells in a patchy distribution. Neurofilament staining highlights rare tumor cells and neurons. No composite tumor morphology is observed. SDHB staining is positive in tumor cells, consistent with retained expression of succinate dehydrogenase-related proteins.\n\nMicroscopic examination has been personally performed by the pathologist. Clinical history and pre- and post-operative diagnoses were not provided."} +{"pid": "TCGA-33-4586", "report": "The resected specimen consists of a left lower lobe lobectomy, including involvement of the sixth and seventh ribs. The tumor measures 8.5 cm in its greatest dimension. Histologic evaluation reveals a cellular composition consistent with malignant transformation. The lesion demonstrates characteristics including nuclear atypia, increased mitotic activity, and focal necrosis. No lymph node involvement was identified. Staging is based on size and extent of local invasion."} +{"pid": "TCGA-2L-AAQA", "report": "The surgical specimen includes a resected portion of the pancreas measuring 4.5x3.5x0.7 cm, appearing grey-yellowish and fibrotic with areas of diffuse induration. The pancreatic duct is centrally located, measuring up to 0.4 cm in diameter and slightly dilated. A second resection specimen includes a Whipple preparation consisting of a 13x6x5 cm pancreatic segment, a 15 cm length of duodenum, and a 5 cm bile duct. Surrounding peripancreatic tissue extends up to 1.5 cm in width.\n\nA large solid mass measuring 12x5x4 cm is identified within the pancreas, with a white-yellowish cut surface. A cyst measuring 2.2 cm is observed at the cranial aspect of the mass. There is extensive infiltration into peripancreatic soft tissue and into the muscular layer of the duodenum. The lesion is not clearly separated from the dorsal resection margin of the pancreas. Multiple dense lymph nodes are noted around the pancreas, with the largest measuring up to 2.2 cm in diameter.\n\nResection margins: The distance from the bile duct margin to the lesion is 5 cm; from the oral duodenal margin, it is 2 cm; and from the aboral duodenal margin, it is 10 cm. At the uncinate process, normal lobular pancreatic tissue is preserved. The spleen measures 11x7x5 cm with a weight of 110 grams and shows no pathological involvement. An attached omental specimen measuring 8x8x1 cm also shows no tumor involvement.\n\nHistologically, infiltrative carcinoma cells are observed, predominantly arranged in a ductal pattern with focal solid growth. Areas of significant desmoplastic reaction are present. Some tumor foci extend into the submucosa and muscularis of the duodenum, with vascular invasion noted. Perineural invasion is evident. Adjacent pancreatic parenchyma demonstrates pre-invasive epithelial changes.\n\nInfiltration extends to the dorsal resection margin and involves the tissue surrounding the celiac axis. Lymphovascular invasion is documented. A total of 21 lymph nodes were examined; metastases are identified in 6 lymph nodes. Five metastatic lymph nodes were found among those removed adjacent to the pancreas. Two lymph node specimens included contained one metastasis each. Additional lymph nodes showed no tumor involvement but had atypical cell clusters likely due to contamination.\n\nMargins at the bile duct and small intestine show no tumor involvement. The spleen appears unremarkable, although there is evidence of chronic congestion. Histological evaluation confirms infiltration into peripancreatic fatty tissue extending into vessel-containing adipose tissue.\n\nStaging classification according to UICC 6th Edition 2002: pT4 for direct extension beyond the pancreas into surrounding structures; pN1 based on metastases in 6 out of 21 lymph nodes. Evidence supports lymphovascular invasion (L1), vascular invasion (V1), and perineural invasion (Pn1). Resection status is R1 due to tumor involvement at the dorsal pancreatic margin and at the celiac axis margin. Tumor differentiation is graded as moderately differentiated (G2)."} +{"pid": "TCGA-14-1821", "report": "The pathology report describes two specimens obtained from a right frontal brain lesion. Specimen #1 was received fresh for intraoperative consultation and consisted of tan, irregular soft tissue fragments measuring 1.0 x 1.0 x 0.3 cm in aggregate. A frozen section and touch preparation smear were made, with the remaining tissue submitted for further analysis. Specimen #2 was received in formalin and measured 2.4 x 2.0 x 0.4 cm in aggregate; it was entirely submitted for histologic evaluation.\n\nMicroscopic examination revealed a small cell malignancy. Cellular features included a high proliferative index, with MIB-1 staining estimating 25-30% positivity. GFAP immunostaining showed strong and patchy reactivity. Neurofilament and synaptophysin stains demonstrated entrapped ganglion cells and axons, with only faint or questionable labeling of the abnormal cells. Chromogranin staining was also performed.\n\nAll tissue material was processed and submitted in full across multiple cassettes. The findings from frozen section and touch preparation supported the microscopic findings in the excised specimen, showing consistent cellular morphology. No definitive tumor type is stated in this summary."} +{"pid": "TCGA-V1-A9ZG", "report": "The prostate specimen measured 4 cm from apex to base and weighed 52 grams. Two suspicious areas were identified: one tan-yellow measuring 1.2 x 1 x 1 cm located near the posterior inked margin, and another tan-white measuring 1.2 x 1 x 0.6 cm within 0.4 cm of the right anterior inked margin. No lesions were observed in the seminal vesicles or vas deferens bundles.\n\nMicroscopic examination revealed multiple foci of abnormal cells within the prostate gland. These cells exhibited a Gleason grade of 5+4 with a tertiary component of pattern 3. The tumor was present bilaterally across several regions of the prostate including left posterior midgland, left anterior midgland, right posterior base, right posterior midglands, right posterior base again, right anterior apex, right anterior midgland, and right anterior base. The total estimated tumor volume was 2.8 cm\u00b3, with more than 70% of this volume composed of Gleason pattern 3 or lower.\n\nMargins were negative for tumor involvement. However, benign prostate glands were identified at the inked excision margin at the right apex. There was no evidence of capsular involvement, extraprostatic extension, or tumor involvement of the seminal vesicles. Perineural infiltration was present.\n\nLymph node dissection included three nodes from the right pelvic region and two from the left pelvic region. All lymph nodes were negative for tumor involvement. A total of five lymph nodes were examined.\n\nThe tumor did not demonstrate high-grade prostatic intraepithelial neoplasia. No suspicious findings were noted in the remaining prostate parenchyma, which appeared tan-light brown. The specimen was sliced into seven sections with an average slice thickness of 0.4 cm. Gross photographs were taken for documentation. Anatomic landmarks were used for orientation, and margins were inked as follows: green for right anterior, blue for left anterior, and black for posterior.\n\nRepresentative tissue sections were submitted for microscopic evaluation, including perpendicular sections of apical and bladder margins and cross-sections of the prostatic/seminal vesicle junction and vas deferens. Diagnosis was based on both gross and microscopic evaluations, and final diagnosis was confirmed by attending pathologists after review of all pathology slides."} +{"pid": "TCGA-43-3920", "report": "The specimen included multiple tissue fragments from various anatomical levels. Level 10 consisted of a 1 x 0.8 x 0.4 cm black-tan irregular soft tissue fragment. Level 11 was a 0.9 x 0.6 x 0.4 cm pink-black irregular soft tissue fragment. Level 12 contained two fragments measuring 1.8 cm and 1 cm. The right upper lobe measured 15 x 14 x 5 cm and showed a 3.5 cm indurated focus on the pleura, with a larger mass measuring 5.0 x 5.0 x 4.5 cm in the parenchyma. This mass was located 1.5 cm from the surgical margin and 3.5 cm from the hilum. The remaining lung tissue showed normal pink-red spongy parenchyma. No discrete hilar nodes were identified. Specimens from this lobe were submitted to evaluate margins, tumor interface, and hilar regions.\n\nLymph node stations were also examined. Specimen 2R included three tissue fragments up to 1.2 cm, and 4R contained a 1.2 cm nodule with a smaller aggregate. Level 8 was a 0.6 x 0.4 x 0.3 cm pink-red fragment. Level 7 measured 1.5 x 0.8 x 0.3 cm and was composed of yellow-pink-red tissue. Level 9 had two fragments measuring 1.2 cm and 0.5 cm. All lymph node specimens were entirely submitted for analysis.\n\nMicroscopic evaluation of level 10, 11, and 12 lymph nodes showed no evidence of disease involvement. The right upper lobe specimen revealed a 5 cm mass. Histologic features included uninvolved surgical margins, absence of vascular or lymphatic invasion, and no direct extension into adjacent structures. Four lymph nodes from this lobe were negative for disease involvement. Additional lymph node stations including 2R (4 nodes), 4R (3 nodes), level 8 (1 node), level 7 (4 nodes), and level 9 (2 nodes) all showed no evidence of disease involvement."} +{"pid": "TCGA-63-7022", "report": "The sample was collected from the left upper lobe (LUL) lung region following a resection procedure. The tissue specimen measured 1.8 cm in size. Histological evaluation showed moderately differentiated cells with nuclear features classified as grade 3. Pathologic staging indicated T1, N0, M0, corresponding to stage III. No lymph node involvement was identified. The tumor was fully resected with negative margins. Additional preparation details and slide information are available in the associated documentation."} +{"pid": "TCGA-DX-A48V", "report": "A 14 x 13 x 10 cm mass was resected from the retroperitoneal region of a patient and submitted for pathological evaluation. The specimen measured 16 x 14 x 11 cm and consisted of an irregular soft tissue mass covered by adipose tissue, focal skeletal muscle, patches of peritoneum, and a thin fibrous membrane. An adherent 9 cm segment of vein, measuring 1 cm in diameter, was also present and stapled at both ends. The tumor exhibited a tan, rubbery, whorled cut surface with areas of hemorrhage and fibrosis. No gross necrosis was observed, although microscopic evaluation revealed less than 10% necrotic tissue.\n\nHistologically, the lesion demonstrated high-grade cellular features. The tumor appeared well-circumscribed but showed invasive growth into surrounding fat with a pushing border. It was closely associated with a large vessel, though it did not fully involve its wall. The endothelial surface remained intact and unremarkable. Evaluation of surgical margins\u2014including soft tissue and venous margins\u2014revealed no evidence of residual tumor; however, the tumor was noted to be within 0.2 cm of the soft tissue margin, separated only by fibrous and adipose tissue.\n\nSections were taken from representative areas including tumor adjacent to peritoneum, fibrous membrane, muscle, and vessel, as well as vessel margins. Microscopic analysis was conducted based on these sections. The findings were derived from personal examination and review of the slides."} +{"pid": "TCGA-BP-4965", "report": "The left kidney partial nephrectomy specimen includes a tumor measuring 1.9 cm in greatest dimension, located less than 1 mm from the inked margin. The tumor is partially cystic, with a bright orange and hemorrhagic cut surface. Histologically, the tumor demonstrates nuclear grade II/IV features. No local invasion or renal vein involvement is identified. Surgical margins are free of tumor. The adjacent non-neoplastic kidney tissue appears unremarkable, and no adrenal tissue or lymph nodes are present. The staging indicates the lesion is confined to the kidney with a maximum dimension of 1.9 cm, corresponding to pT1.\n\nA separate excision of the deep margin #2 contains benign renal parenchyma and perirenal fat without evidence of tumor involvement. Additionally, a biopsy of a satellite lesion measuring 0.2 cm shows a tubulopapillary neoplasm, described as consistent with papillary adenoma. The specimen was entirely submitted for evaluation."} +{"pid": "TCGA-CN-4726", "report": "The specimen was received in four parts, including a resection of left buccal mucosa, mandibular periosteum, submandibular gland, and associated lymph nodes. Grossly, the primary lesion measured 4.5 x 3.5 x 2.5 cm with an ulcerated, necrotic surface. The tumor came within 0.4 cm of the superior buccal mucosal margin, 0.3 cm of the inferior buccal mucosal margin, and abutted the deep soft tissue margin. It extended into the periosteum and showed gross involvement of the submandibular gland. Three lymph nodes from level 1 were entirely replaced by tumor.\n\nIn level 1 lymph nodes, metastatic involvement was identified in all three lymph nodes examined, with the largest focus measuring 1.8 cm and extracapsular extension present. In level 2 and 3 lymph nodes, two out of three lymph nodes contained metastatic deposits with the largest focus measuring 0.8 cm. One lymph node from level 2 submitted separately showed no tumor involvement. In level 4, one out of seven lymph nodes was involved with a metastatic focus measuring 0.4 cm.\n\nMicroscopic evaluation revealed moderately differentiated invasive growth with infiltrative borders. Angiolymphatic and perineural invasion were identified. Tumor was present at the deep, superior buccal, and inferior gingival margins, with the tumor located less than 0.1 cm from the inferior buccal margin. A separate focus involving submandibular soft tissue was also noted.\n\nA total of 14 lymph nodes were examined, with 6 showing involvement. Extracapsular spread was documented in involved nodes. Venous/lymphatic and perineural invasion were both present. Margins involved included deep, superomedial, and inferior gingival regions.\n\nAncillary studies were performed as part of the evaluation. Fixation times varied according to standard protocols. The laboratory performing these tests is CLIA-certified for high-complexity testing. No distant metastasis was documented (pMX)."} +{"pid": "TCGA-AA-A010", "report": "The specimen includes a lymph node from the mesenteric root, which shows no evidence of tumor involvement. The resected transverse colon demonstrates tumor-free oral and aboral margins. A locally advanced, ulcerated lesion is present, characterized by poor differentiation and full-thickness infiltration through the colonic wall, extending into the perimuscular adipose tissue and adjacent omentum. There is also evidence of invasion into the gastric wall. No regional lymph node metastases were identified. A total of 45 lymph nodes were examined, all negative for malignancy. The tumor grade is G3, with staging pT4, and no vascular or lymphatic invasion (L0, V0). Surgical margins are clear (R0). Additionally, the spleen appears free of tumor, although fresh, likely iatrogenic, defects are noted in the capsule. As requested, a paraffin block was forwarded to Prof. for further investigation regarding possible hereditary non-polyposis colorectal cancer (HNPCC) syndrome. A subsequent report has since been received, indicating that no additional evidence supporting a hereditary predisposition within the HNPCC/Lynch Syndrome spectrum was found."} +{"pid": "TCGA-G9-6338", "report": "The specimens include right and left pelvic lymph nodes and a prostate gland. The right pelvic lymph node specimen consisted of two lymph nodes measuring 1 x 0.6 x 0.3 cm and 1.2 x 0.5 x 0.3 cm; both were unremarkable. The left pelvic lymph node specimen contained only fibrofatty tissue without identifiable lymph nodes. The prostate weighed 60 grams and measured 4.2 cm in transverse diameter, 3.5 cm from apex to base, and 9 cm in anterior-posterior dimension. It was sectioned serially into six levels, and multiple sections were submitted for microscopic evaluation, including areas of the seminal vesicles and vas deferens.\n\nMicroscopic analysis showed cellular atypia involving both the right and left lobes, with an estimated involvement of 50% of the gland. A focus of altered cells was identified at the left apex, measuring 2 millimeters. Invasion of surrounding structures adjacent to nerves was noted. Sections of the seminal vesicles did not show any significant changes. All margins were evaluated, with one margin showing involvement near the left apex.\n\nStaging was determined as pT3a, indicating extension beyond the prostatic capsule but not into the seminal vesicles. No evidence of this process was found in the regional lymph nodes, and no distant metastasis was identified. High-grade intraepithelial neoplasia was present. Tissue processing included frozen sections, and there was no evidence of response to prior systemic therapy in the material examined."} +{"pid": "TCGA-BR-A4CS", "report": "The specimen consisted of a gastrectomy with a lesion located in the fundus measuring 5 x 4 x 1.5 cm. Microscopic examination revealed poorly differentiated morphology. The tumor involved adjacent structures, specifically the greater omentum. Lymph node evaluation identified metastatic involvement in 7 out of 15 intraabdominal lymph nodes. Surgical margins were uninvolved. Other features such as lymphatic, venous, or perineural invasion, response to neo-adjuvant treatment, and additional findings were not specified."} +{"pid": "TCGA-OR-A5LS", "report": "A right adrenalectomy was performed. The tumor weighed 208 grams and measured 9.3 x 8.7 x 5.5 centimeters. Histologic evaluation demonstrated features consistent with a high score on the referenced diagnostic scale, suggesting aggressive characteristics. Associated findings included chronic cholecystitis and cholelithiasis, status post cholecystectomy."} +{"pid": "TCGA-KO-8406", "report": "The specimen consists of a right kidney with perinephric adipose tissue measuring 12.0 x 6.0 x 5.0 cm, including a kidney measuring 10.0 x 5.0 x 3.5 cm and an attached ureter measuring 2.0 cm in length and 0.3 cm in diameter. A well-circumscribed mass measuring 3.0 x 3.0 x 2.5 cm is identified in the mid portion of the kidney. The mass has a tan-brown, homogeneous appearance without necrosis or hemorrhage. It closely abuts perihilar adipose tissue but does not grossly invade the sinus adipose tissue and is confined within the renal parenchyma, located 0.7 cm from the nearest renal capsule. No hydronephrosis is present, and the remaining renal parenchyma appears unremarkable.\n\nMicroscopic examination reveals tumor cells that are positive for keratin and EMA and negative for CD10. Additional immunoperoxidase studies for keratin 7 were performed, and results supported the original findings. Representative sections of the tumor were submitted to the tumor bank, and the remainder of the tumor was entirely submitted for histologic evaluation. All ureteral, vascular, and soft tissue margins of resection are free of tumor. Based on Fuhrman nuclear grading, the tumor is classified as nuclear grade 3. The tumor is confined to the kidney without evidence of extension beyond the renal capsule."} +{"pid": "TCGA-MY-A5BF", "report": "A fragment of tissue was received for evaluation. Gross examination of the hysterectomy specimen revealed a tan-white, firm, poorly circumscribed lesion located at the cervix. The tumor measured 5.0 cm in greatest dimension with other dimensions measuring 3.0 x 2.7 cm. It extended from the 9 o\u2019clock to the 4 o\u2019clock position and was identified at the endocervical junction. The tumor was 1.0 cm from the vaginal margin and 0.2 cm from the anterior outer surface cervical margin. Histologic analysis showed invasive disease confined to the cervix with negative surgical margins. However, the tumor was present 0.1 cm from the anterior cervical margin at 12 to 1 o\u2019clock. Depth of cervical wall invasion was 90% of maximum thickness. Parametrial involvement was not identified, with distances greater than 1.0 cm from parametrial margins. Lymphovascular invasion was present.\n\nThe histologic type was well-differentiated keratinizing epithelial lesion with papillary architecture. Evaluation of regional lymph nodes included 20 left pelvic, 15 right pelvic, 1 left common iliac, and 3 right common iliac lymph nodes, all negative for malignant cells (total of 39 nodes examined, 0 positive). Additional findings included inactive endometrium and a left paratubal cyst. Bilateral ovaries and fallopian tubes showed no significant histopathologic abnormalities.\n\nPathologic staging according to AJCC was pT2a N0; FIGO stage IIA2. The specimen was fully evaluated with multiple sections submitted for microscopic examination, including margins, parametria, and surrounding structures. All surgical margins were free of disease, though proximity to certain margins was noted. The endometrium and myometrium were unremarkable. Both ovaries and fallopian tubes were grossly and microscopically normal. The uterus weighed 129 g with standard dimensions. Vaginal cuff margins were inked and found to be free of tumor."} +{"pid": "TCGA-VS-A8EC", "report": "The cervix biopsy demonstrates a moderately differentiated malignant neoplasm composed of squamous cells. The tumor exhibits intermediate differentiation with recognizable cellular features. No specific diagnosis name is provided in this summary."} +{"pid": "TCGA-TM-A84G", "report": "The specimen consists of three pieces of tan tissue measuring up to 14mm in maximum dimension, and a separate specimen of pale brain parenchyma measuring 35 x 35 x 25mm. A third component includes four small soft tissue fragments measuring up to 8mm. Histological examination confirms the presence of a neoplasm with oligodendroglial morphology involving both cortex and white matter. The tumor demonstrates areas of low-grade appearance as well as regions with increased cellularity, pleomorphism, and microvascular endothelial proliferation. Mitotic activity is present, with up to three mitotic figures per high power field in some areas and a maximum count of eight mitotic figures per ten high power fields. Immunohistochemical staining shows variable proliferation index, with focal increases up to approximately 10% as measured by MIB-1 labeling. Scattered weak to moderate nuclear positivity for p53 protein is noted. Additional molecular studies performed on representative formalin-fixed paraffin-embedded sections show deletions of chromosomes 1p and 19q; no EGFR amplification was detected. No definitive involvement is seen in the posterior margin resection specimen, which shows only reactive changes in cortex and white matter."} +{"pid": "TCGA-55-6975", "report": "The surgical specimen includes a left lower lobe of the lung measuring 17 x 13 x 9 cm and weighing 285 grams. A well-circumscribed tan-white mass measuring 6.5 x 6.0 x 6.0 cm is present, composed of firm tissue with areas of necrosis. The mass is located approximately 1 cm from the bronchial margin. No sac-like lesion is identified. The remaining lung tissue appears tan-pink and spongy with focal congestion. Three hilar lymph nodes ranging in size from 0.6 to 1.0 cm show moderate anthracosis.\n\nMicroscopic examination reveals a moderately to poorly differentiated carcinoma with areas of clear cell change and malignant glandular structures. Extensive necrosis is noted. There is widespread intrapulmonary lymphatic and vascular invasion, with tumor plugs seen in pleural lymphatics, interlobular septal vessels, and veins. The visceral pleura shows significant involvement. Focal areas of squamous differentiation are present, along with minor regions displaying bronchioloalveolar features. A small focus of poorly differentiated adenocarcinoma is identified in lung tissue distant from the main mass.\n\nThe bronchial and vascular margins are free of tumor involvement. All three hilar lymph nodes are extensively involved. No definitive assessment of distant metastasis can be made from the available material. Additional findings include patchy chronic obstructive pulmonary disease."} +{"pid": "TCGA-X6-A7WC", "report": "A soft tissue mass was excised from the left thigh, measuring 11.1 cm in greatest dimension. The mass was well-circumscribed and multilobular with tan-pink, predominantly homogeneous cut surfaces. Areas of softening, cystic change, and hemorrhagic degeneration were noted. Microscopically, the lesion showed high-grade features including intersecting bundles of cells, high mitotic activity (>50 per 10 high power fields), and marked cytologic atypia. Vascular invasion was identified. Margins were assessed, with the anterior and posterior margins measuring less than 0.1 cm from the tumor. Other margins measured 0.1 cm medially, 0.8 cm proximally, 2.9 cm distally, and greater than 1.0 cm laterally. No necrosis or cystic changes were definitively linked to a prior biopsy site, and no satellite nodules or involvement of major structures were observed.\n\nOne lymph node was identified in the left lymph node specimen, measuring 4.0 x 3.0 x 1.2 cm, and showed no evidence of tumor involvement. Based on available material, the pathologic staging classification was determined as T2b N0. The tumor demonstrated slight necrosis, and no significant inflammatory infiltrate was seen. A representative portion of the tumor was submitted for potential molecular studies."} +{"pid": "TCGA-A3-3358", "report": "The surgical specimen consists of a left kidney weighing 980 grams, measuring 26.7 x 11.8 x 8.7 cm in size. The kidney is surrounded by a large amount of perinephric adipose tissue and a moderate amount of Gerota's fascia. An adrenal gland measuring 5.9 x 3.0 x 1.3 cm is identified within the perinephric fat. Resection margins include 1.3 cm of renal artery, 0.5 cm of renal vein, and 9.8 cm of ureter, all grossly patent. The kidney has a lobulated, finely granular red-brown cortical surface. A lesion measuring 2.7 x 2.5 x 2.2 cm is present in the lower pole, with a tan-pink to yellow, focally hemorrhagic cut surface. It is well-circumscribed, thinly encapsulated, and appears confined to the renal capsule, approaching within 0.1 cm of the cortical margin without apparent extension into the surrounding parenchyma. The remaining cortex measures up to 0.9 cm in thickness, with a slightly granular, homogenous appearance. The corticomedullary junction is poorly defined, and the medulla shows sharp papillae. The collecting system is lined by smooth tan-white mucosa extending into the ureter. Histologically, the lesion demonstrates nuclear grades 1\u20132/4, with no evidence of transcapsular or venous invasion. Focal lymphovascular space invasion is noted. All soft tissue, ureteral, and vascular margins are negative. No lymph nodes were resected. Sections of the left adrenal gland show no significant pathology."} +{"pid": "TCGA-42-2587", "report": "The specimen included multiple tissue samples from various anatomical sites. A portion of omentum was received, measuring 8.5 cm in greatest dimension, and largely replaced by tan, firm tumor tissue. The uterus weighed 93 grams and measured 7.5 x 5.5 x 4 cm; the anterior wall contained a tumor mass measuring 5.5 x 2.5 x 2 cm, which was observed to invade into the myometrium. The overall myometrial thickness with tumor involvement was 2.2 cm. Multiple calcified intramural fibroids were present, ranging from 0.7 to 2.7 cm in size.\n\nBoth ovaries were markedly enlarged and distorted, with the right ovary measuring 4.5 x 2.5 x 2.5 cm and the left showing a larger mass measuring 7.5 x 7.5 x 5.5 cm. The right fallopian tube was identified and measured 6.5 x 0.5 cm; no discrete left fallopian tube was grossly identifiable, likely due to extensive tumor involvement.\n\nA segment of distal ileum and large bowel was submitted, measuring 38 cm in length, and was noted to be predominantly covered with tumor nodules. A separate segment included 75 cm of small bowel and 45 cm of cecum and colon, with attached omentum that was extensively involved and measured 35 x 9 x 6 cm. Tumor involvement was observed within the muscularis propria of the colon but not in the small bowel. No mucosal lesions were identified in either segment.\n\nAn anterior abdominal wall and peritoneal biopsy, measuring 6.7 x 4.5 x 1 cm, showed possible tumor involvement on sectioning.\n\nMicroscopic evaluation revealed high-grade serous carcinoma involving the omentum, uterine serosa and myometrium, both ovaries, and the right fallopian tube. The tumor extended into the myometrium and was associated with leiomyomata. Involvement of the serosal surfaces of both small and large bowel was present, with invasion through the muscularis propria up to the mucosal layer, though without bowel wall perforation. Extensive replacement of omental tissue and significant lymphovascular space invasion were noted. The peritoneal biopsy from the anterior abdominal wall also demonstrated involvement by high-grade serous carcinoma."} +{"pid": "TCGA-HG-A2PA", "report": "The surgical specimens include multiple lymph node groups and a radical hysterectomy specimen. Lymph nodes from the left pelvic, right pelvic, and para-aortic regions were all assessed and showed no evidence of malignancy. The left pelvic lymph node group included one lymph node, while the left pelvic lymph node group overall contained thirteen, and the right pelvic group had eight. All were described as reactive with no involvement by tumor. Four para-aortic lymph nodes were also negative for tumor.\n\nThe hysterectomy specimen revealed a large fungating mass in the cervix measuring 8 x 6 x 2.5 cm. Microscopically, the lesion was moderately differentiated and showed a depth of stromal invasion measuring 1.5 cm. The tumor extended into the endometrial cavity but did not involve the parametrium or vaginal margins. The closest distance from the tumor to the vaginal mucosal margin was 1.0 cm, and to the parametrium was 1.5 cm. Lymphatic invasion was present.\n\nThe uterus measured 6.5 x 7 x 5 cm, with a myometrial thickness of 3.5 cm. A T-shaped intrauterine device was noted within the uterine cavity. The endometrium showed secretory changes and chronic endometritis, with no other significant pathologic findings. The appendix was unremarkable, with no pathological abnormalities identified.\n\nStaging was based on the extent of the primary lesion and absence of lymph node or distant metastases. The tumor showed uterine involvement without parametrial or vaginal extension. No lymph node metastases were identified across all dissected regions. The final staging was determined as pT1b2 N0 Mx."} +{"pid": "TCGA-QH-A6X3", "report": "The specimen consists of tissue obtained from the right parietal region of a male patient. Histological evaluation reveals a moderately cellular lesion composed of a mixed population of neoplastic cells. These include cells with round to oval nuclei, some with perinuclear halos, as well as cells exhibiting more elongated, angulated nuclei. Nuclear pleomorphism is present, though mitotic activity is limited. Architecturally, the lesion demonstrates a diffuse growth pattern without evidence of necrosis or microvascular proliferation. Immunohistochemical staining shows variable expression of glial and neuronal markers. Based on histological features, the lesion exhibits characteristics of a low-grade neuroepithelial neoplasm. Staging assessment indicates no evidence of advanced local invasion or distant spread."} +{"pid": "TCGA-BP-4975", "report": "The clinical history notes an incidentally diagnosed right renal mass. The specimen submitted was labeled as a partial nephrectomy from the right posterior mid pole of the kidney.\n\nGross examination revealed a wedge-shaped portion of kidney measuring 10.2 x 6.5 x 4.5 cm, with attached fibroadipose tissue measuring 10 x 8.5 x 2.0 cm and detached fragments measuring 2.1 x 7.0 x 3.0 cm. A well-defined, hemorrhagic, variegated yellow mass measuring 5.0 x 3.9 x 3.5 cm was identified. The tumor was located near the deep margin, which had been inked black, with a clearance distance of 0.1 cm from the resection margin. The mass appeared to abut the perirenal fat but was distant from Gerota\u2019s fascia.\n\nMicroscopic evaluation showed nuclear features classified as grade III/IV. No local invasion, renal vein involvement, or small vessel angiolymphatic invasion was identified. Surgical margins were free of tumor. Adjacent non-neoplastic kidney tissue appeared unremarkable. No adrenal gland or lymph node tissue was identified in the specimen.\n\nStaging was based on tumor size and extent, showing a lesion measuring 5.0 cm in greatest dimension, confined to the kidney. Based on these findings, the tumor is classified as pT1.\n\nSections submitted for analysis included portions of the tumor, renal capsule, margin, normal kidney, perirenal fat, and additional margin sections. Frozen section analysis confirmed no involvement of the surgical margin.\n\nAll diagnoses were based on personal examination of the slides and review of the material."} +{"pid": "TCGA-2J-AABA", "report": "The surgical specimen was collected and examined, including multiple excised lymph nodes and soft tissue samples. A single lymph node from the common hepatic artery was free of abnormal cells. Another lymph node sample from the same region showed fibroadipose tissue with signs of chronic inflammation. Tissue from the pancreatic portal vein interface displayed fibrous material along with granulation tissue and acute inflammatory changes. The pancreatic neck margin was also negative for any abnormal cellular growth.\n\nA larger resection involving the head of the pancreas, gallbladder, duodenum, and part of the jejunum revealed a solid mass measuring 4.3 x 3.5 x 3.1 cm located in the pancreatic head. This mass extended beyond the pancreas into surrounding soft tissue, the duodenal wall, and the bile duct. There was no evidence of angiolymphatic or perineural invasion, nor was there any necrosis observed within the mass. The uncinate margin was involved, while the portal vein groove and cystic duct margins were clear. Adjacent pancreatic tissue showed significant chronic pancreatitis. A single cystic duct lymph node did not show any abnormal cells. The gallbladder exhibited chronic cholecystitis. Among regional lymph nodes, 2 out of 10 were involved.\n\nOther lymph node groups, including those near the pancreas, gastrocolic area, and celiac axis, were all free of abnormal cells. Based on the available surgical material, staging was assigned as pT3N1 according to the 7th edition of the AJCC classification (2010). The findings were confirmed through both frozen section and permanent H&E histologic evaluations. All gross specimens were submitted for analysis, and measurements of tissues and margins are reported. A stent was noted in the common bile duct, and multiple stones were identified in the pancreas and pancreatic duct system, causing obstruction and dilation. The gallbladder did not contain any stones, and representative sections of all areas were submitted for further review."} +{"pid": "TCGA-B5-A11V", "report": "The specimen consists of a uterus weighing 368 grams, measuring 11.1 x 7.5 x 7.2 cm, with attached cervix, bilateral fallopian tubes, and ovaries. The left ovary measures 3 x 2.2 x 1.5 cm and the right ovary is 3.7 x 2.7 x 1.6 cm. The left fallopian tube is 8.6 cm long and the right is 7.1 cm long, both fimbriated. The uterus was received open and grossly distorted. A mass is present in the endometrial cavity, measuring 3.4 x 1.4 x 0.5 cm, protruding into the cavity, soft, tan, and friable. It extends 0.4 cm into a myometrium that is 3.5 cm thick at that point. The mass involves both anterior and posterior endometrial surfaces and is located 3.5 cm from the anterior and posterior lower uterine segment. A full-thickness section of the mass and underlying myometrium was submitted for frozen section. The remainder of the endometrium is smooth and tan, measuring 0.1 cm in thickness within a 3.1 cm wide x 7.6 cm long cavity. The myometrium contains eight homogenous white nodules with whorled appearance, ranging in size from 0.7 x 0.7 x 0.5 cm to 4.3 x 3.5 x 3.5 cm. There is a full-thickness defect at the posterior lower uterine segment measuring 3.8 x 3.1 x 2.5 cm with surrounding tattered tissue. The cervix is 2.8 cm in diameter, with scant smooth ectocervix and a distorted endocervical canal. The serosa is smooth and tan, with a subserosal nodule measuring 2.2 x 1.5 x 1.5 cm that is homogenous and white with a whorled pattern. The left ovarian surface is smooth and yellow-tan with a 0.9 x 0.9 x 0.8 cm smooth, well-circumscribed, rubbery pink-purple nodule located 0.2 cm from the capsule. The right ovary has a smooth tan-yellow surface and a 1.2 x 1.1 x 1 cm smooth, rubbery tan lobulated nodule located 0.1 cm from the capsule. The remainder of the ovarian parenchyma appears unremarkable. The right fimbria is dusky purple-red and both fallopian tube mucosae are diffusely erythematous. An additional separate nodule measuring 6 x 4.3 x 3.5 cm and weighing 52 grams is present; it is homogenous white with a whorled appearance and lacks hemorrhage or necrosis.\n\nSections were taken from multiple areas including the anterior and posterior endomyometrium with mass, sections perpendicular to the anterior and posterior lower uterine segments, probable cervix, intramural nodules, subserosal nodule, left and right ovarian nodules, fallopian tubes, and remaining cervical tissue. Lymph nodes were also submitted: one left pelvic lymph node measuring 2.7 x 1 x 0.4 cm, and two right pelvic lymph nodes measuring up to 1.3 x 0.7 x 0.5 cm. All were entirely submitted.\n\nMicroscopic examination revealed a full-thickness section of endometrium and myometrium with a cellular proliferation. The adjacent non-neoplastic endometrium was inactive. Multiple benign-appearing smooth muscle nodules were identified throughout the myometrium, with the largest measuring 4.3 cm. The cervix showed no abnormal histology. The serosal surface was uninvolved. Margins of the specimen were free of abnormality. The left ovarian nodule showed features consistent with a hilus cell tumor, confirmed by immunohistochemical staining positive for inhibin and calretinin. The right ovarian nodule displayed a spindle cell neoplasm with increased mitotic activity but no cytologic atypia. Immunostains showed strong positivity for inhibin and weak positivity for actin, supporting a diagnosis of mitotically active cellular fibroma. No tumor was identified in either the left or right pelvic lymph nodes. The lymph nodes appeared reactive without evidence of metastasis.\n\nA few foci suspicious for lymphovascular invasion were identified within the hysterectomy specimen; however, due to the disrupted nature of the specimen, artifactual displacement could not be ruled out. Sections from the right ovary were reviewed by a consultant and findings were confirmed. All immunohistochemical tests were performed under CLIA-certified conditions and interpreted as clinically valid."} +{"pid": "TCGA-C5-A7CG", "report": "The cervix biopsy specimen consists of multiple tissue fragments. Microscopic evaluation reveals invasive malignant cells arranged in sheets and nests with focal intercellular bridges. The cells exhibit moderate nuclear atypia, coarse chromatin, and irregular nuclear membranes. Keratinization is present in some areas. The tumor infiltrates the underlying stroma. The frozen section correlates with the biopsy findings. Specimen margins are involved. No lymphovascular invasion is identified. The lesion is confined to the cervix without extension beyond the sampled tissue."} +{"pid": "TCGA-GU-A762", "report": "The specimen consisted of a right distal ureter segment measuring 0.3 cm in length and 0.5 cm in diameter, and a left distal ureter segment measuring 0.1 cm by 0.4 cm. Both were submitted entirely for frozen section and found to be free of tumor. The bladder and prostate specimen showed an ulcerated lesion involving approximately 80% of the bladder mucosa. A dominant nodule was identified in the right lateral wall measuring 7.5 x 4.3 x 0.7 cm, with additional nodules present in the fundus, left lateral wall, anterior wall, and extending into the prostate (measuring up to 2.5 cm). The lesion extended through the muscularis propria into perivesical adipose tissue, prostatic stroma (more pronounced on the right), and into the right seminal vesicle (involving blocks C5 and C6). Extensive perineural invasion was noted, but no lymphovascular invasion was observed. Tumor involvement was present at the posterior serosal surface of the bladder (block C26) and at the right anterior prostatic capsular resection margin (block C31). Ureteral and urethral resection margins were free of involvement.\n\nIn the left pelvic lymph node dissection, three lymph nodes showed evidence of metastasis with extranodal extension present in all three. In the right pelvic lymph node dissection, one of seven nodes contained metastatic involvement. Gross measurements of the bladder were 9.5 cm (SI) x 5.3 cm (LR) x 5.5 cm (AP). The right ureter measured 8.2 cm in length and 0.4 cm in diameter, while the left ureter was 2.7 cm long and 0.4 cm wide. The prostate measured 3.5 cm (apex to base) x 4.3 cm (left to right) x 4.0 cm (anterior to posterior). A diverticulum was identified in the right fundus measuring 2.5 cm in length and 2.2 cm in diameter, which did not show involvement.\n\nMicroscopic features included solid, interconnected nests with keratinization and acantholytic foci, along with ulceration and necrosis at the mucosal surface. The lesion extended into the perivesical fat, prostatic stroma, and intravesical portions of both ureters. There was a prominent inflammatory infiltrate including lymphocytes, plasma cells, and eosinophils. Benign findings included squamous metaplasia in the bladder mucosa and a diverticulum in the right fundus, along with chronic cystitis and reactive lymphoid follicles. No ancillary studies were performed at this time, though appropriate blocks were reserved for possible future testing. Pathologic staging indicated extensive local invasion and multiple regional lymph node metastases."} +{"pid": "TCGA-B5-A11Y", "report": "The specimen consists of a 97-gram uterus with attached bilateral adnexa, measuring 6.5 x 5 x 2 cm. A mass measuring 7 x 4 x 0.7 cm is present, grossly extending 0.5 cm into a myometrial wall that measures 1.5 cm in thickness. The uninvolved endomyometrium is not clearly identified. Additionally, a 3.5 x 3 x 2 cm subserosal leiomyoma is noted in the fundic region. The cervix and serosal surfaces appear smooth and unremarkable. The right adnexa includes a 2 x 1 x 1 cm ovary and a 2 cm long fallopian tube with a diameter of 0.5 cm; no abnormalities are observed. Similarly, the left adnexa contains a 2 x 1 x 1 cm ovary and a 2 cm long fallopian tube with a 0.5 cm diameter, also without notable abnormalities.\n\nSampling includes a representative portion of the mass with deepest invasion submitted as block A1, along with additional sections from anterior and posterior endomyometrium with involvement (A2\u2013A5). A subserosal leiomyoma is represented in block A6. Cervical tissue is sampled in blocks A7 and A8. Right and left adnexal structures are each represented in blocks A9 and A10, respectively. Sentinel lymph nodes were sampled bilaterally: the right sentinel node measures 1.5 x 0.8 x 0.5 cm and is entirely submitted in block B1, while the left sentinel node measures 2 x 1.5 x 1 cm and is entirely submitted in block C1. Left pelvic lymph nodes measure 2 x 2 x 1 cm and are submitted in block D1. The right pelvic lymph node specimen measures 4.5 x 2.5 x 2 cm and includes four lymph nodes, with the largest submitted in blocks E1\u2013E2 and the remainder in E3\u2013E4. Vaginal contents include a 0.5 x 0.5 x 0.3 cm tan-white fragment submitted in block F1.\n\nMicroscopic examination reveals areas of involvement within the endomyometrium with maximum depth of penetration measuring approximately 3.5 to 4 mm in a wall measuring 1.2 cm thick. No lymphatic or vascular invasion is identified. Adjacent non-neoplastic endometrium demonstrates atrophy. Leiomyoma is present within the myometrium. Surgical margins are free of involvement. Both ovaries and fallopian tubes show no evidence of malignancy. All sampled lymph nodes are negative for malignant involvement. Specimens from the vagina contain displaced tissue consistent with findings elsewhere but no direct involvement is identified.\n\nStaging was performed according to AJCC 7th Edition guidelines and is reported as pT1B pNO pMX. All diagnoses were personally evaluated and confirmed."} +{"pid": "TCGA-22-5485", "report": "The surgical specimen from the right upper lobe of the lung, submitted as a wedge excision, contains a lesion measuring 1.8 x 1.7 x 1.4 cm. Histologic evaluation reveals high-grade cellular atypia with features concerning for a malignant process. A separate lesion identified in the right upper lobe following lobectomy measures 1.2 cm in diameter and demonstrates distinct histologic features also consistent with a high-grade neoplasm.\n\nExamination of the bronchial resection margin shows no evidence of involvement by the lesion. Lymph node stations were assessed extensively. One peribronchial and one intrapulmonary peribronchial lymph node are present and show no evidence of involvement. Additional lymph nodes evaluated include: one right upper paratracheal, nine right lower paratracheal, one right tracheobronchial, one subcarinal, one paraesophageal, one right inferior pulmonary ligament, and two right interlobar lymph nodes\u2014all demonstrate benign morphology without evidence of metastatic disease."} +{"pid": "TCGA-AR-A0TT", "report": "The specimen consists of a resected breast mass measuring 2.3 x 1.9 x 1.8 cm. Histologic evaluation shows high-grade cellular atypia with a disorganized growth pattern. Nuclear grading is severe, and mitotic activity is elevated, though not the highest possible score. The lesion does not show in situ components or vascular invasion. Surrounding breast tissue demonstrates benign fibrocystic changes. All surgical margins are free of abnormal cells, with the closest margin measuring 0.5 cm at the deep margin.\n\nExamination of sentinel lymph nodes from the right axilla reveals involvement in three out of six nodes. Additionally, two out of thirteen lymph nodes from a completion axillary dissection contain abnormal cells. There is evidence of spread beyond the nodal capsule. Immunohistochemical testing for Her-2/NEU is in progress on fixed tissue."} +{"pid": "TCGA-B0-5083", "report": "The surgical specimen from the left kidney demonstrates a neoplastic lesion measuring 3.2 cm in its greatest dimension. The tumor exhibits Fuhrman nuclear grade III/IV features and is entirely contained within the renal capsule. No evidence of vascular invasion, including the renal vein or its branches, is observed. There is no involvement of lymphatic channels, and all surgical margins are free of neoplastic cells. The tumor shows a predominant granular (eosinophilic) morphology. Additional immunohistochemical analysis reveals positivity for vimentin and CD10, with weak reactivity for CK7, while staining for Hale's colloidal iron is negative. These characteristics were evaluated to further define the cellular composition. The surrounding non-neoplastic kidney tissue does not show any significant pathological abnormalities. The staging assessment indicates pT1a based on the size and localized nature of the lesion. The adrenal gland was not included in the submitted specimen."} +{"pid": "TCGA-27-1837", "report": "Birth date. Tumor site: left frontal. The lesion demonstrates a high degree of cellular pleomorphism with marked nuclear atypia and frequent mitotic figures. Necrosis is present, with evidence of microvascular proliferation. The tumor infiltrates the surrounding brain tissue. Immunohistochemical staining shows positivity for GFAP and MGMT. The Ki-67 proliferation index is elevated. Based on histological features and extent of spread, the findings are consistent with an advanced stage of disease."} +{"pid": "TCGA-55-6972", "report": "The surgical pathology report includes multiple specimens submitted for evaluation. Specimen A is a right hilar lymph node measuring 0.3 cm in greatest dimension. Specimen B is another right hilar lymph node measuring 0.8 x 0.5 x 0.5 cm. Specimen C consists of a single lymph node measuring 1.0 x 0.6 x 0.5 cm, which was bisected and showed no abnormal findings. \n\nSpecimen D, identified as the right upper lobe of the lung, measures 16 x 16 x 5.0 cm and weighs 207 grams. The pleural surface is smooth and tan-pink with two staple lines on the medial aspect. Serial sectioning revealed a poorly defined hemorrhagic area measuring approximately 4.5 x 4.0 x 4.0 cm. Within this area, there is an ovoid, tan-white, firm nodule measuring 1.2 x 1.0 x 0.8 cm. The nodule appears to be surrounded by hemorrhagic infarct and is located 1.2 cm from the pleura and 3.5 cm from the bronchial margin. No satellite lesions were identified. The bronchial and vascular margins are unremarkable. A possible hilar lymph node measuring 1.7 cm in greatest dimension was also identified, showing moderate anthracosis. Twelve cassettes were submitted for histologic examination.\n\nSpecimen E consists of three portions of irregular tan-gray soft tissue measuring 0.7 x 0.7 x 0.1 cm in total. It was submitted intact in one cassette.\n\nMicroscopic evaluation of the lymph nodes (A, B, and C) revealed benign anthracotic lymph nodes without evidence of metastatic disease. Granulomatous changes were noted in two of the lymph nodes. Histologic sections of the lung specimen show well-differentiated features with papillary architecture and bronchoalveolar components. No invasion of the visceral pleura was observed. There was no clear evidence of lymphovascular space invasion. Sections of the vascular resection margin were negative for tumor involvement. A focus of abnormal cells was found near the bronchial cartilage. A peribronchial lymph node was also examined and showed no signs of metastasis. The surrounding lung tissue showed no significant pathologic changes. Specimen E showed marked cautery artifact but no abnormal cellular features.\n\nStaging indicates the lesion measures 4.5 cm in maximum dimension. Resection margins, including pleural, parenchymal, bronchial, and vascular, were free of tumor. No evidence of blood or lymphatic vessel invasion was identified. Regional lymph node assessment included one perihilar lymph node and those previously described, all without evidence of involvement. Distant metastasis was not assessed."} +{"pid": "TCGA-V1-A8MG", "report": "The prostate measured 3.1 x 4.5 x 2.4 cm and was submitted in eight transverse slices. Tan-white nodules were identified in the left posterior mid gland and right posterior mid gland. The left seminal vesicle measured 3.0 x 1.1 x 0.5 cm and the right seminal vesicle measured 3.0 x 1.7 x 0.9 cm. Both seminal vesicles showed involvement with close proximity to inked surfaces. The tumor extended to the left apical margin and was also found very close to the bilateral posterior seminal vesicle margins. No involvement was seen at the bladder margins.\n\nHistologic sections revealed extensive involvement of the prostate with a predominant pattern of grade 3 and secondary pattern of grade 4. A small component of grade 5 was identified, particularly in the right posterior mid gland and left posterior mid gland. The total tumor volume was estimated at 4.2 cubic cm, with more than 40% composed of grade 3 or higher. Tumor invasion of the capsule was noted in the right posterior mid gland and left posterior mid gland. Focal extraprostatic extension was present at the left seminal vesicle prostate junction. Extensive perineural infiltration was observed, along with widespread prostatic intraepithelial neoplasia.\n\nLymphovascular invasion was identified in the right posterior mid gland. The excision margins for tumor were positive at the left apex, and tumor approached the bilateral posterior seminal vesicle margins. Benign glands were present at the right and left bladder margins. The stage according to AJCC/UICC criteria was determined as pT3bNXMX. All histologic sections of the prostate were examined, and tumor was identified in all areas except the right apex and bladder margins."} +{"pid": "TCGA-CS-5395", "report": "The specimen consists of tissue fragments from the right parietal region, with the largest measuring 1 x 0.8 x 0.3 cm and others smaller. Histologic evaluation reveals an infiltrative and moderately pleomorphic proliferation of glial cells with relatively round nuclei. In some areas, perinuclear halos are observed, though they are not abundant. A fine capillary network is present, displaying in some regions a chicken-wire pattern. Scattered mitotic figures are identified, but there is no evidence of endothelial proliferation or necrosis.\n\nImmunohistochemical staining for Ki67 was performed, analyzing nine fields of 250 x 250 microns each. Over 1,000 cells were evaluated, with the proliferation index ranging from 10.5% to 18.4%, averaging 13.6% across all fields. Frozen section analysis noted severe freezing artifact, limiting definitive interpretation. The final assessment indicates a glial neoplasm with features resembling oligodendroglial morphology and elevated proliferative activity. However, classic architectural patterns typically associated with certain tumor types are not clearly evident, potentially due to tissue preservation factors.\n\nGiven the presence of mitotic activity, the lesion demonstrates characteristics that may correspond to higher-grade tumors depending on lineage. Additionally, the proliferation index exceeds typical thresholds associated with more favorable outcomes. Molecular testing for specific genetic markers is in progress and may provide further clarification in a subsequent report."} +{"pid": "TCGA-A2-A0SX", "report": "The specimen consists of a left breast lumpectomy, left axillary contents, and a sentinel lymph node. The lumpectomy measures 8 x 7 x 2.5 cm and contains a 1.3 cm lesion identified on gross examination. The lesion is located 0.2 cm from both inked margins. Histologically, the lesion demonstrates a high-grade cellular proliferation with a Nottingham score of 9 (3 each for tubules, nuclei, and mitoses). Mitotic count is 24 per 10 high power fields. The lesion is multifocal with the largest contiguous focus measuring 1.3 cm. There are foci of angiolymphatic invasion, with one focus measuring 0.2 mm from the posterior margin. The anterior margin is involved by infiltrating carcinoma at 0.8 mm. An intraductal component is present and classified as high grade. No microcalcifications are identified. All lymph nodes examined, including the sentinel node, are negative for tumor involvement. The axillary contents consist of benign fibroadipose tissue without identifiable lymph nodes. The pathologic stage is pT1 NO MX."} +{"pid": "TCGA-97-8552", "report": "The surgical specimen consists of a left lower lobe segmentectomy measuring 15 x 10 x 4 cm. A subpleural nodule measuring 1.5 x 1.2 cm is identified, located 3 cm from the hilum. The nodule is described as gray-pink and slightly firm. Histologic evaluation reveals a mixed pattern with predominant lepidic growth (70%), along with papillary (20%), micropapillary (5%), and acinar (5%) components. An area of invasion measuring 0.7 cm in greatest linear dimension is present. The tumor is unifocal and well-differentiated. The bronchial and vascular margins are free of involvement.\n\nFour lymph nodes were examined: one each from levels 11, 5, 6, and 7. All are benign without evidence of metastatic disease. No lymphovascular or pleural invasion is identified. The tumor is staged as pT1a based on size (\u22642 cm) and localized to the lung parenchyma without more proximal extension. Regional lymph node staging is pN0, as no involved nodes are found.\n\nMolecular testing was performed on the tissue. Analysis of the KRAS gene showed no mutations in codons 12 or 13. EGFR mutation analysis revealed a deletion mutation (E746_A750del5) in exon 19, which is associated with sensitivity to tyrosine kinase inhibitors. Tumor cellularity in the sample was 80%, sufficient for accurate testing. A known polymorphism (Q787Q) was also detected but has no clinical significance.\n\nThe patient is a never-smoker with a 1.5 cm nodule in the left lower lobe. The resection margins are negative, and no distant metastasis is evident. The histologic features and molecular profile may inform further treatment decisions."} +{"pid": "TCGA-CJ-4891", "report": "The left kidney and adrenal gland specimen measured 17.0 x 11.0 x 7.5 cm and included a ureter measuring 8.0 cm in length by 0.8 cm in diameter, along with an adrenal gland measuring 6.0 x 2.0 x 1.0 cm. A mass involving the upper pole of the kidney measured 8.5 x 6.2 x 4.5 cm and extended into the renal sinus and perirenal adipose tissue. A thrombus was identified within the renal vein and adrenal vein. The tumor protruded beyond the renal vein margin but did not involve the wall of the renal vein at that margin. The tumor was largely necrotic (approximately 80%), exhibiting yellow and brown areas as well as focal calcification. Cortical necrosis was noted in the remaining renal parenchyma. No abnormality was identified in the adrenal gland.\n\nFive lymph nodes adjacent to the renal hilum were identified, ranging from 1.8 x 1.3 x 1.2 cm to 0.5 x 0.7 x 0.5 cm; none showed evidence of tumor involvement. Histologic evaluation revealed extensive necrosis within the tumor and surrounding tissue. Foreign material was observed within some arterioles, more prominently affecting the normal kidney.\n\nA separate thrombus specimen measured 12.0 x 6.3 x 4.4 cm and exhibited a lobulated, tan-white appearance with variegated and partially hemorrhagic features. Attached fibrin and clotted blood were present. A vessel segment measuring 2.7 cm in length and 2.3 cm in diameter was also submitted, containing thrombus material.\n\nThree fibroconnective and adipose tissue fragments were submitted from para-aortic regions, collectively measuring 5.3 x 2.3 x 1.0 cm. These contained multiple lymph nodes ranging in size from 1.8 x 1.0 x 0.6 cm down to 0.3 x 0.3 x 0.2 cm. No tumor involvement was identified in these lymph nodes or in additional retroaortic lymph node specimens."} +{"pid": "TCGA-RT-A6YA", "report": "The specimen consists of a left adrenal mass measuring 15.0 cm in greatest dimension, with an ovoid, well-encapsulated appearance. The cut surface is pink-tan, rubbery, and contains cystic spaces up to 6.9 cm. Microscopic evaluation reveals capsular invasion and involvement of surrounding soft tissue. Nuclear pleomorphism is present, along with vascular invasion identified in the peri-adrenal tissue component. Mitotic activity is noted at up to 4 mitoses per 10 high-power fields. The surgical margin of resection is free of tumor involvement. Fibroadipose tissue from the peri-adrenal region shows no evidence of tumor infiltration. The tumor has been assessed using a standardized scoring system, yielding a score of 7. Cases with scores above 4 are associated with a higher likelihood of aggressive behavior. Follow-up is recommended for clinical monitoring."} +{"pid": "TCGA-5P-A9KH", "report": "The specimen measures 3.8 cm in maximum dimension and shows moderate differentiation with papillary architecture. Histological evaluation reveals glomerulosclerosis, interstitial nephritis, and significant arteriosclerosis. The resection margins are free of tumor involvement. Pathological staging according to the 2002 pTNM classification system indicates early-stage disease with no evidence of lymph node or distant metastasis. The nuclear grade is classified as intermediate."} +{"pid": "TCGA-G4-6321", "report": "The specimen consists of a right colon resection including ileum, cecum with appendix, and colon measuring 30 cm in length. The colon is approximately 3.5 cm in diameter with both resection margins stapled. Upon opening the colon, one ulcerated polypoid lesion was identified measuring 2.2 x 1.5 cm, elevated up to 0.7 cm above the mucosa. It is located 11 cm from the colonic resection margin and 19 cm from the ileal resection margin. The lesion appears superficial without involvement of the full colonic wall. Three additional polypoid areas were noted measuring 1.2 cm, 1.5 cm, and 2.0 cm, located at distances of 3.5 cm, 4.5 cm, and 8.0 cm from the colonic resection margin, respectively. The surrounding colonic and ileal mucosa appear normal. The appendix is unremarkable, measuring 6 cm in length and 0.5 cm in diameter. Multiple lymph nodes are present within the mesenteric fat.\n\nHistologic examination reveals a moderately differentiated adenocarcinoma arising in a serrated adenoma measuring 2.2 cm in maximum dimension. The tumor invades into the muscularis propria but does not reach the surgical margins. The closest distance from the invasive component to the nearest margin is 11 cm. No venous, lymphatic, or perineural invasion is identified. Three hyperplastic polyps are also present. A total of 44 lymph nodes were evaluated, with three showing involvement by carcinoma. There is no extranodal extension or implants identified. The staging is classified as pT2 N1 MX. \n\nImmunohistochemical staining demonstrates positivity for cytokeratin AE1/3 in tumor cells. MLH1, MSH2, and MSH6 proteins are present; however, PMS2 expression is absent in tumor nuclei. Microsatellite instability testing is pending and will be reported separately. All margins are free of invasive disease."} +{"pid": "TCGA-60-2706", "report": "The specimen consists of a right upper lobectomy measuring 16 x 14.5 x 3 cm and weighing 244 grams. A stapled margin is present at the upper aspect. A firm, nodular lesion measuring 2 x 2 x 1.8 cm is identified opposite the hilar region. The cut surface of the lesion is well-circumscribed, tan-grey to white in color, with a granular texture. The remainder of the lung tissue shows findings consistent with anthracosis, congestion, and atelectatic changes.\n\nSections were taken from multiple areas including the bronchial margin (which was negative for tumor involvement), the tumor itself, overlying pleura, uninvolved lung tissue, and lymph nodes. One of two lymph nodes examined was negative for tumor involvement. Additional findings include focal interstitial fibrosis and congestion. No angiolymphatic or perineural invasion is identified. The tumor does not involve the main stem bronchus, bronchial margin, or visceral pleural margin.\n\nHistologic evaluation reveals poorly differentiated cells arranged in a peripheral pattern. All margins are free of involvement. Lymph node assessment shows no evidence of metastatic disease. Non-neoplastic lung tissue demonstrates no significant abnormality."} +{"pid": "TCGA-D5-6539", "report": "Histopathological examination was performed on a segment of the large intestine with attached mesentery. The specimen measured 25.3 cm in length, with the mesentery measuring 25 x 6 x 2 cm. A lesion was identified in the mucosa, measuring 3 x 2 cm, and displayed ulceration. The lesion circumferentially involved the intestinal wall, leading to luminal narrowing. The distance from the lesion to the nearest resection margin was 4.5 cm, and 4.5 cm to the opposite margin. Macroscopic evaluation indicated infiltration of the intestinal wall and surrounding periintestinal tissue. The minimal side margin measured 1 cm, and the remaining mucosa appeared unremarkable.\n\nMicroscopic analysis revealed glandular structures with atypical morphology invading the muscularis propria and extending into the pericolic adipose tissue. The closest lateral margin measured 1 cm. No neoplastic involvement was observed at the surgical incision sites. Reactive lymphadenopathy was noted in the regional lymph nodes."} +{"pid": "TCGA-ZU-A8S4", "report": "The specimen consisted of a right liver lobe resected from a male patient with a lesion in the right hepatic lobe. The tumor measured 8 x 5.5 x 6 cm and was present as a single mass-forming lesion. Histologically, the tissue showed features consistent with a pleomorphic and poorly differentiated morphology. Microscopic evaluation revealed that the lesion was confined to the hepatic parenchyma with negative bile duct margins and a distance of 3 cm from the closest margin. There was no definitive evidence of lymphovascular invasion, although perineural invasion was noted. Extensive necrosis was observed within the lesion.\n\nPathologic staging based on the findings was pT1, indicating a solitary tumor without vascular invasion, while regional lymph node status could not be assessed (pNX). \n\nIn terms of research quality control, three tumor regions were analyzed. Tumor I1 contained approximately 85% nuclei with no sarcomatoid features, 10% necrosis, and 5% normal tissue. Tumor T2 had about 20% nuclei, with roughly half showing sarcomatoid characteristics, 80% necrosis, and no normal tissue. Tumor T3 displayed 33% nuclei without sarcomatoid features, 67% necrosis, and no normal tissue. The normal sample was composed entirely of liver tissue.\n\nRegarding specimen handling, the total cold ischemia time was 34 minutes, and the formalin fixation duration was approximately 6 hours. The weights of the samples varied: T1 was 101 mg, T2 was 81 mg, T3 was 100 mg, T4 was 125 mg, and N1 was 274 mg. The collected specimens included multiple cryovials, plasma, serum, and buffy coat samples, as well as formalin-fixed paraffin-embedded (FFPE) blocks. Patient consent was obtained for the study."} +{"pid": "TCGA-DU-7010", "report": "A brain biopsy specimen from the left frontal lobe consists of multiple tissue fragments measuring 0.4 to 1.0 cm. Microscopic examination reveals neoplastic astrocytic infiltration with areas of increased cell density. The neoplastic cells are primarily gemistocytic in appearance, with frequent nuclear hyperchromasia and pleomorphism. Mitotic activity is infrequent. Mild endothelial proliferation is present, but no necrotic foci are identified. Scattered lymphocytic aggregates are observed within the tissue. No evidence of radiation necrosis is seen in the sections."} +{"pid": "TCGA-QR-A70A", "report": "The right adrenal gland specimen measured 5.5 x 4.3 x 4.8 cm and weighed 62.0 grams. It consisted of a well-circumscribed mass attached to normal-appearing adrenal cortical tissue. The mass measured approximately 5.0 cm in greatest dimension and had a firm, homogeneous, gray cut surface with small areas of hemorrhage. A portion of the mass and a small segment of the adjacent adrenal tissue were submitted for research purposes. No margins were required for assessment.\n\nMicroscopic evaluation revealed nests of cells separated by a delicate fibrovascular stroma. The cells varied in size and shape, with cytoplasm that was finely granular and ranged from purplish to amphophilic in staining quality. Nuclei were round to oval with prominent nucleoli. Immunohistochemical staining demonstrated positivity for synaptophysin in the lesional cells, while supporting cells showed positivity for S-100. Representative sections of the remaining specimen were processed for histological analysis."} +{"pid": "TCGA-CS-4938", "report": "The specimen consists of multiple fragments of red-tan soft tissue, measuring 1.4 x 1.2 x 0.5 cm and 2.0 x 2.0 x 0.6 cm respectively. Both specimens were processed for frozen and permanent sections. Histologically, the tumor demonstrates a mildly pleomorphic and infiltrative proliferation of astrocytic cells. No endothelial proliferation or necrosis is identified. Very rare mitoses are present, with one definite mitotic figure observed.\n\nImmunohistochemical staining for Ki67 was performed, evaluating four fields at 250 x 250 microns each. Over 1000 cells were counted, revealing a proliferation index ranging from 3.2% to 5.7%, with an overall average of 4.2%. This proliferation index is minimally elevated compared to the expected upper limit for a comparable lesion. However, the presence of only a single mitosis does not support upgrading the tumor based on this criterion alone.\n\nFrozen section evaluation showed no evidence of anaplasia. The findings suggest a lesion with low-grade features and a slightly increased proliferative activity that may warrant close clinical monitoring."} +{"pid": "TCGA-J4-A6G3", "report": "The specimen was received for analysis and included multiple tissue samples from the pelvic region. Tissue fragments from right and left pelvic lymph nodes, both with and without frozen section analysis, were submitted. All lymph node specimens showed fibroadipose tissue and lymph node structures, with no abnormal findings noted. A peri-prostatic tissue sample revealed fibrofatty tissue with nerve bundles and a small focus of carcinoma. The primary prostate specimen weighed 50 grams and measured 4.5 x 4 x 3.5 cm. On cross-sectioning, the prostate showed firm, focally nodular parenchyma. The tumor involved bilateral sites within the prostate and extended into the surrounding soft tissues, including the seminal vesicles, with greater involvement on the left side. Histological evaluation showed a Gleason score of 4 + 4 = 8 out of 10. The extent of tissue involvement was extensive, with more than 50% of the tissue showing disease involvement. There was evidence of perineural invasion and suspected lymphatic (small vessel) invasion in multiple areas. Margins of the excised tissue were positive for tumor involvement around the bilateral soft tissues of the seminal vesicles, while other margins were free of tumor. Lymph node sampling from both sides during frozen section analysis showed no involvement. The staging was determined as pT3b for the primary tumor, with no lymph node involvement (pN0) and distant metastasis not assessable (pMX). Multiple tissue blocks were processed and stained with H&E for detailed histological examination."} +{"pid": "TCGA-CH-5751", "report": "The specimen includes multiple lymph nodes and fatty tissue, all without evidence of tumor involvement. The prostatectomy preparation shows extensive bilateral involvement with poorly differentiated adenocarcinoma. The tumor demonstrates perineural invasion and infiltrates both lymphatic and vascular structures. There is infiltration of yellow, blue, and green labeled areas, with close involvement of the base margins on both sides. Bilateral infiltration of the seminal vesicles and bladder wall is present, along with metastasis to a lymph node. Pathological staging is pT4 pN1 L1 V1, with a Gleason score of 4. The total score is 5+5 = 10. The margins at the base on both sides are extensively involved."} +{"pid": "TCGA-CJ-6027", "report": "The right kidney specimen includes a well-circumscribed, bulging mass located at the lower pole, measuring 2.4 x 2.0 x 2.0 cm. The cut surface is soft with tan-brown to yellow areas and regions of hemorrhage. Microscopic examination reveals high nuclear grade cells arranged in solid sheets and nests, with prominent nucleoli. The tumor is situated within the renal parenchyma and focally extends into the perinephric adipose tissue as a polypoid nodule encased in a fibrous capsule. No evidence of invasion into the surrounding adipose tissue or lymphatic/vascular structures is observed. The tumor is 3.5 cm from the renal pelvis. Surgical margins involving the artery, vein, and ureter are free of abnormal cells. Multiple deeper sections through the tumor and adjacent tissues were evaluated. The non-neoplastic kidney tissue appears histologically normal. The specimen includes attached perinephric fat, an unremarkable segment of ureter (7.0 cm long, 0.4 cm circumference), and segments of artery and vein (<1.0 cm long, 0.4 cm circumference each). The tumor is confined without involvement of resection margins."} +{"pid": "TCGA-CN-A640", "report": "A hemiglossectomy specimen measuring 6.5 cm from anterior to posterior, 3.5 cm from midline to lateral, and 3 cm superior to inferior was examined. An ulcerated lesion measuring 3 x 1.5 cm was observed on the lateral aspect of the tongue. The tumor measured 3.5 x 2.4 x 2.2 cm and was located 0.8 cm from the midline, 1.2 cm from the anterior tip mucosa, 2.3 cm from the posterior margin, 0.6 cm from the inferior mucosal edge, and 0.3 cm from the deep margin. Histologic examination revealed a highly infiltrative growth pattern involving skeletal muscle. Perineural invasion was identified. Margins were free of involvement.\n\nExcision of the right floor of mouth tissue showed no evidence of residual disease. Lymph node dissections were performed bilaterally across multiple levels. On the right side, level 1A dissection contained four lymph nodes, all negative for tumor involvement. Level 1B dissection included three lymph nodes, also negative for tumor; mild chronic sialadenitis was noted in this region. Levels 2 through 5 on the right contained thirty lymph nodes, with tumor involvement identified in two nodes (2/30). Positive lymph nodes were located in levels 2 and 3, with the largest measuring 2.7 cm. Extensive extranodal extension was present, involving the adventitia of the internal jugular vein and adjacent skeletal muscle. Margins of the neck dissection were free of tumor.\n\nOn the left side, level 1B dissection yielded two lymph nodes without tumor involvement and mild chronic sialadenitis was documented. Levels 2 through 4 on the left contained twenty-four lymph nodes, none of which showed tumor involvement.\n\nFrozen section analysis of the inferior mucosal margin during surgery confirmed absence of tumor. Microscopic evaluation corroborated findings consistent with benign tissue at margins and confirmed cellular features including vascular and perineural invasion. A total of 63 lymph nodes were assessed across all regions, with two demonstrating involvement and extracapsular extension noted.\n\nHistologic grading indicated moderately differentiated morphology. The tumor exhibited aggressive local characteristics with infiltration into muscular tissue and perineural structures. Venous invasion was evident, particularly involving the jugular vein adventitia."} +{"pid": "TCGA-QQ-A5VA", "report": "Surgery Date: Specimens were collected from multiple anatomical sites. The first specimen, identified as omentum, was a yellow-tan, hemorrhagic tissue measuring 25.0x11.0x3.0 cm. It contained multiple firm white nodules on its surface, ranging in size from 1.0 cm to 5.0x4.0x2.5 cm. Sections were submitted for histological evaluation.\n\nA second specimen, identified as a pelvic mass, consisted of two small fragments of yellow-white, firm tissue measuring 0.8 cm and 1.1 cm in greatest dimension, both submitted entirely for analysis.\n\nThe third specimen, obtained from the fourth portion of the duodenum, was a brown-tan, white, firm, lobulated mass measuring 12.0x6.0x5.0 cm. A small segment of duodenum within the tumor measured 4.0x3.0x0.5 cm. The mucosal surface appeared normal, and there was no gross evidence of mucosal invasion. The tumor had a firm, white-yellow, gritty cut surface. Representative sections were taken from this specimen.\n\nThe fourth specimen included a segment of small bowel with an attached tumor nodule. The entire specimen measured 51.0 cm in length, with the tumor itself measuring 9.0x8.0x3.5 cm. The tumor was attached to the serosal surface of the small bowel and appeared to penetrate through the mucosa. One section of the small bowel showed an old, well-healed anastomotic site. Margins and multiple sections of the bowel were submitted for analysis. The resection margins were negative for tumor involvement.\n\nThe final specimen, a perirectal serosal nodule, included multiple fragments of fibroadipose tissue and a firm, white-yellow tumor nodule measuring 4.5x3.8x2.2 cm. A representative section of this nodule was submitted.\n\nAdditional clinical history indicated prior involvement of multiple organs including the small and large bowel, omentum, mesenteries, spleen, pancreas, and left kidney. Frozen section analysis of the pelvic mass was consistent with sarcoma. Microscopic evaluation and further histopathological analysis were performed on all specimens."} +{"pid": "TCGA-DJ-A2Q0", "report": "A 45-year-old female with a history of a right thyroid nodule, status post fine needle aspiration showing suspicious cells, underwent surgical excision. Specimens submitted for analysis included Delphian node and pretracheal tissue, as well as the right thyroid lobe and isthmus.\n\nThe Delphian node and pretracheal specimen consisted of yellow fatty tissue measuring 2 x 0.7 x 0.3 cm. No definite lymph nodes were identified. The tissue was submitted entirely for frozen section and showed no evidence of malignancy on intraoperative consultation. Final evaluation confirmed benign lymph nodes without involvement.\n\nThe right thyroid lobe and isthmus specimen measured 5 x 3.3 x 2.3 cm and weighed 20.09 grams. It contained a solid, well-circumscribed, oval brown mass measuring 2.8 cm in greatest dimension. The tumor was completely surrounded by a capsule with no definite capsular invasion observed. There was no evidence of blood vessel invasion or extrathyroid extension. Histologic evaluation revealed well-differentiated cellular features with no identifiable mitotic activity or tumor necrosis. Necrotic and/or reactive changes were noted. Surgical margins were free of tumor, and there was no evidence of multicentric disease. Adjacent thyroid tissue showed mild chronic lymphocytic thyroiditis. Parathyroid glands were not identified in the specimen.\n\nApproximately 90% of the thyroid specimen was submitted for evaluation, including representative sections of the nodule-to-capsule interface and remaining thyroid parenchyma. Intraoperative frozen section diagnosis of the thyroid specimen indicated Hurthle cell neoplasm, which was consistent with final histologic findings.\n\nAll diagnoses were based on personal examination of the slides and review of the materials. Special stains were performed as needed, and recuts were obtained where appropriate."} +{"pid": "TCGA-DX-A3LY", "report": "The resected specimen includes a soft tissue mass measuring 18.2 cm in greatest dimension, located in the retroperitoneal space adjacent to the right kidney and adrenal gland. The mass is described as white and firm in areas, with regions of hemorrhage (20%) and necrosis (10%). It is surrounded by adipose tissue and does not directly involve the kidney or adrenal gland. Microscopically, the tumor is composed of high-grade spindle cells arranged in a predominantly palisading pattern, with focal areas showing a loose, myxoid background containing scattered large atypical cells. Mitotic activity is present at a rate of up to 7 per 10 high power fields. Immunohistochemical staining reveals positivity for CD34, with focal positivity for CDK4 and weak MDM2; the tumor is negative for S100, SMA, Desmin, and CD117. Proliferation index by Ki-67 (MIB-1) is estimated at 15\u201320%. The tumor extends close to the resection margin, within less than 0.1 cm. Surrounding adipose tissue shows mild atypia, but insufficient features for a definitive diagnosis of well-differentiated liposarcoma. Additional molecular studies are in progress to further characterize the findings."} +{"pid": "TCGA-E1-A7YN", "report": "A 3.5 x 2.1 x 1.3 cm piece of brain tissue was received fresh for frozen section and subsequently placed in formalin, with representative sections submitted for analysis. Additional brain tissue measuring 4 x 3 x 1.3 cm in aggregate was also received and submitted entirely for evaluation. Microscopic examination revealed diffusely infiltrated brain tissue by a neoplastic process involving astrocytic cells. The neoplasm demonstrated a lack of endothelial proliferation and necrosis. Notable features included the presence of gemistocytes, as well as a brisk perivascular and leptomeningeal lymphocytic infiltrate. Immunostaining showed positivity for GFAP in astrocytes, while HAM-56 and LCA highlighted inflammatory cells and microglia. The MIB-1 proliferation index was approximately 10%.\n\nCytogenetic analysis using FISH showed abnormalities in several markers. Specifically, EGFR (7p12) was abnormal in 52% of tumor cells with gain, MET (7q31) was abnormal in 48% with gain, and 7 CEP was abnormal in 45% with gain. PTEN (10q23) and 10 CEP were found to be intact. Among the four markers evaluated (EGFR, 7 CEP, PTEN, and 10 CEP), two were abnormal. MET also exhibited gain. A multivariate survival analysis indicated that patients with 0\u20132 abnormal markers out of this set had a significantly lower hazard of short survival compared to those with more than two abnormalities, even after adjusting for age.\n\nImmunohistochemical testing showed high Ki-67 expression, with 10% positivity. MGMT expression was positive in 20% of cells, and EGFR wild-type expression was present in 80% of cells. PDGFr alpha and beta were both widely expressed, with 60% and 80% positivity, respectively. VEGF expression was positive in 60% of cells. Other markers, including EGFR VIII, PTEN, pMAPK, CA-IX, HIF2 alpha, and pAKT, were negative. pS6 was positive in 25% of cells.\n\nMolecular testing by real-time PCR on paraffin-embedded tissue identified MGMT promoter methylation. IDH1 and IDH2 mutation testing was negative, indicating no detectable mutations in these genes. Additionally, immunohistochemical analysis for EGFR VIII was negative, with no staining observed in tumor cells."} +{"pid": "TCGA-BL-A0C8", "report": "The specimen consists of a 10.5 x 5.5 x 5 cm dusky tan-red to gray-brown mass of tissue with focal areas of soft papillary white-pink tissue noted on sectioning. A portion of the tissue was submitted for procurement, and additional sections were taken to assess for possible muscle invasion. Microscopic examination reveals high-grade cellular changes with exophytic growth pattern. There is evidence of involvement of the lamina propria in specific tissue blocks. The muscularis propria is present, but no definitive invasive tumor is seen in those sections. Scattered foreign body giant cell reactions are noted within the muscularis propria. The specimen lacked proper orientation, and the friable nature of the lesion limited accurate margin assessment."} +{"pid": "TCGA-AO-A0JJ", "report": "A 4.5 cm tan mass was identified in the left breast, located lateral to the nipple in the upper outer quadrant and measuring 3.5 cm from the deep surgical margin. The tumor diffusely involved the submitted tissue sections. Microcalcifications were noted within benign breast parenchyma and lymphovascular invasion was present. Surgical margins were free of involvement by carcinoma. One sentinel lymph node at level I of the left axilla contained metastatic disease; no extranodal tumor extension was observed. All other sentinel lymph nodes (three additional nodes across levels I and II), one non-sentinel lymph node at level I, and multiple lymph nodes from levels I and II of the left axilla were negative for metastasis. Immunohistochemical staining showed strong ER positivity (95% nuclear staining), moderate to strong PR positivity (70% nuclear staining), and HER-2/neu negativity (staining intensity of 0)."} +{"pid": "TCGA-AR-A1AJ", "report": "The specimen consists of a right breast wide local excision. A mass measuring 1.2 x 1.1 x 0.9 cm was identified. Histologic evaluation shows high-grade features with nuclear pleomorphism and a high mitotic rate. No angiolymphatic invasion is present. Surgical margins are free of involvement, with the closest margin (inferior) being 0.3 cm from the edge. Evaluation of lymph nodes includes two right axillary sentinel lymph nodes, both negative for tumor. Immunohistochemical staining with cytokeratin on paraffin-embedded sentinel lymph node tissue confirmed findings seen on H&E. Blue dye was not detected in either sentinel lymph node. An additional six right axillary lymph nodes were also negative. Immunohistochemical analysis for HER2/neu expression showed no overexpression, with a score of 0 based on standard interpretation criteria."} +{"pid": "TCGA-BH-A1EN", "report": "The specimen consists of a right segmental mastectomy obtained during surgical procedure. The submitted tissue includes a portion of breast measuring 7.0 by 4.0 by 3.5 cm with an ellipse of skin measuring 7.0 by 1.0 cm. A lobulated mass is present, measuring 4.0 by 2.0 by 2.0 cm. Gross examination indicates that the margins are free, although the superior and deep margins are noted to be closest, measuring less than 1 cm.\n\nMicroscopic evaluation reveals infiltrating cells with signet ring features and poor nuclear grade. The primary lesion measures 4.0 cm in greatest dimension. Intraoperative frozen section and touch prep analysis were performed, and the surgical margins are free of tumor involvement in all planes.\n\nImmunohistochemical studies were conducted on block A1. Estrogen and progesterone receptor assays showed no distinct intranuclear staining, and both receptors were interpreted as negative. HER-2/neu testing was performed using a polyclonal antibody without antigen retrieval. Complete membranous staining was observed in approximately 60% of tumor cells, and the result was scored as positive (3+). All slides have been reviewed and findings confirmed."} +{"pid": "TCGA-DX-A8BO", "report": "The submitted specimen from the right leg mass reveals a high-grade spindle and pleomorphic tumor. The lesion measures 9 x 6 x 4 cm and extends through the dermis and subcutaneous tissue into the fascia. Necrosis is identified in approximately 15% of the tumor. Microscopic evaluation indicates that the tumor reaches the deep margin of resection and is situated 0.1 cm from the lateral resection margin. There is no involvement of the attached periosteum or bone. All other margins are free of tumor involvement.\n\nImmunohistochemical staining demonstrates negativity for SMA, myogenin, desmin, S-100, and HMB45. A separate specimen from the lateral fascial margin consists of benign fibro-adipose tissue.\n\nThe gross examination describes the primary specimen as an elliptical skin fragment measuring 11 x 7 x 3.5 cm with a tan to white and slightly hemorrhagic surface. Ink markers delineate the margins: black for deep, blue for lateral, red for superior, green for medial, and yellow for inferior. Upon sectioning, the tumor appears partially cystic and hemorrhagic, measuring up to 9 cm in greatest dimension, and located within 1 mm of both the deep and lateral margins.\n\nThe lateral fascial margin specimen is an elongated piece of soft tissue measuring 4.0 x 0.5 x 0.5 cm and is entirely submitted for evaluation.\n\nAll tests performed were developed and validated by the laboratory. These tests have not been cleared or approved by the US Food and Drug Administration; however, FDA has determined that such clearance or approval is unnecessary. Testing was conducted in a CLIA-certified laboratory qualified to perform high-complexity clinical testing."} +{"pid": "TCGA-AA-3967", "report": "The resected colon specimen contains two lesions measuring up to 5 cm in maximum diameter. Both lesions demonstrate infiltration into the pericolic fatty tissue. Histological evaluation reveals moderately differentiated morphology with no vascular or lymphatic invasion identified. A total of 33 regional lymph nodes were examined, and two of these show metastatic involvement. The colon resection margins, including the mesenteric margin, are free of tumor. Staging assessment indicates pT3 (2), pN1 (2/33), pNX; G2, L0, V0, with a local R0 resection status."} +{"pid": "TCGA-BS-A0U9", "report": "The specimen was submitted from a patient with clinical history of malignancy. The surgical procedure performed included total abdominal hysterectomy with bilateral salpingo-oophorectomy and staging lymphadenectomy. \n\nA right gutter implant, measuring 2.0 x 1.5 x 0.5 cm, showed endosalpingiosis without evidence of neoplastic cells. The uterus, cervix, tubes, and ovaries were submitted. Within the endometrial canal, a polypoid lesion measured 6.0 x 4.0 cm and was described as friable and red-tan. Grossly, it was confined to the endometrium with less than 1 mm of myoinvasion observed; the myometrium at this level measured 2.0 cm in thickness. Histologic evaluation revealed a high-grade epithelial lesion with a FIGO grade 3 classification. Lymphovascular invasion was not identified. Tumor involvement was noted in the cervical mucosa, but parametrial and adnexal regions were free of tumor involvement. Adenomyosis was also present.\n\nLymph node dissection included left pelvic, left aortic, right pelvic, and right caval lymph nodes. A total of eighteen lymph nodes were assessed from the left pelvic region, all without evidence of metastatic disease. One lymph node was identified in the left aortic region, and sixteen lymph nodes were retrieved from the right pelvic area, with two lymph nodes in the right caval region. All lymph nodes across these regions were negative for tumor involvement. \n\nAll tissue specimens were adequately submitted and processed for histological analysis. No other significant pathological findings were reported."} +{"pid": "TCGA-DX-A23T", "report": "A 30 x 29 x 11 cm multilobulated yellow mass was identified in the right retroperitoneal region, extending from subhepatic to mid-pelvic areas. The tumor was surrounded by a thin fibrous membrane and showed no gross involvement of the adjacent right colon or terminal ileum. Microscopic evaluation revealed areas of necrosis limited to one component of the tumor, accounting for less than 10% of total volume, as well as regions with myxoid change. The tumor extended to inked soft tissue margins; however, the proximal and distal intestinal mucosal margins were free of abnormal cells. Sections of colonic mucosa, terminal ileal mucosa, and appendix appeared unremarkable.\n\nA separate specimen of subcutaneous fat, measuring 8 x 7 x 2 cm, was submitted entirely for tissue processing and appeared grossly unremarkable.\n\nIn the uterus, multiple circumscribed masses of whorled white-tan tissue were identified, ranging in size from 0.9 x 0.7 x 0.5 cm to 1.7 x 1.7 x 1.5 cm. No gross abnormalities were noted within these tissues. Additionally, a small thin-walled cystic structure filled with clear tan fluid and a stalk-like projection was present.\n\nThe right ovary was partially cystic and partially solid, measuring 2.7 x 2.0 x 1.8 cm. A solid, slightly opaque tan-yellow fleshy area measured 2.7 x 1.5 x 1.2 cm, with a peripheral hemorrhagic cystic region measuring 1.2 cm in diameter. No other gross abnormalities were observed."} +{"pid": "TCGA-EA-A5O9", "report": "Gross examination revealed an uterus with cervix, fragment of vagina, adnexa, and fatty tissue. The vagina appeared structurally normal. A saucer-shaped lesion was observed on the exocervix, measuring up to 7 x 5.5 cm in diameter and 1.5 cm in thickness. The lesion extended along the surface into the endocervix. The endometrium exhibited normal structure. The ovaries contained small hyperemic cysts, and the fallopian tubes were structurally normal. Fatty tissue showed signs of hyperemia.\n\nMicroscopic evaluation demonstrated moderately differentiated cells with superficial involvement of the endocervix. The lesion measured 7 x 5.5 cm and had a thickness of 1.5 cm. The vagina remained unaffected. Endometrial tissue showed secretory features. Ovarian findings included presence of luteal bodies, fibrous structures, and follicular cysts. Fallopian tubes were hyperemic. Lymph nodes displayed hyperemia, lipomatosis, and fibrosis.\n\nThe specimen was obtained via radical hysterectomy. The lesion was ulcerated and exceeded 4.0 cm in size. No venous invasion was identified. Surgical margins were uninvolved. No evidence of metastatic involvement was found in the 10 pelvic lymph nodes examined. There was no indication of prior treatment effect. Additional pathologic findings were not identified."} +{"pid": "TCGA-85-A4JC", "report": "The specimen consists of a lobe with a free lobar bronchus. A parahilar mass measuring approximately 7 x 6 x 7 cm is present, characterized by necrosis and central ulceration. The lesion extends toward the periphery and causes retraction of the visceral pleura. The cut surface is white with areas of necrosis.\n\nMicroscopically, the tissue shows a bronchopulmonary neoplasm composed of pleomorphic cells arranged in sheets. There is evidence of keratinization and parakeratosis. Necrotic areas are also observed. The surrounding stroma is fibrous with inflammatory changes. In the fragment containing pleura, the pleura appears fibrocollagenous with an inflammatory reaction but no infiltration by abnormal cells. However, the adjacent pulmonary parenchyma shows signs of involvement by atypical cellular infiltration. Lymph node station XI does not show evidence of metastatic involvement.\n\nThe specimen type was lobectomy, with tumor located in the lung. Histologic evaluation indicates well-differentiated features. No metastases were identified in the single lymph node examined from the interlobar region. Additional findings regarding tumor extent, presence of other nodules, lymphatic or venous invasion, margins, neo-adjuvant treatment effect, or other pathologic findings were not specified."} +{"pid": "TCGA-KK-A8I9", "report": "The prostate specimen measured 5.1 x 3.1 x 3.9 cm and weighed 28.0 grams post-fixation. On the right side, a nodule was palpated. Cross-sectioning revealed an area of abnormal tissue in the single cross-section of the prostate. Two distinct foci of involvement were identified.\n\nThe dominant focus was located in the right lateral, right posterolateral, right posterior, mid posterior, and left posterior peripheral zones. It measured 2.5 x 2.0 cm in the largest cross-sectional dimension and was present extensively in the apex and base. There was extensive extension beyond the prostate capsule on the right posterolateral surface and in the right superior neurovascular bundle region, with an added length of 18.5 mm. At the right base margin, close proximity to the cauterized edge could not be definitively ruled out. Perineural and lymphovascular invasion were noted.\n\nA second focus was identified in the left transition zone, measuring 0.8 x 0.3 cm in the largest cross-sectional dimension. This focus was limited to the prostate and did not involve any margins.\n\nMargins of the seminal vesicles and vasa deferentia were uninvolved. Adipose tissue from the right pelvic lymph node region measured 6.0 x 3.4 x 1.0 cm and contained up to thirteen lymph nodes, all without evidence of involvement. The left pelvic lymph node region contained one lymph node within a 3.0 x 1.9 x 1.3 cm adipose specimen, also without involvement. All lymph node specimens were entirely submitted for evaluation."} +{"pid": "TCGA-HM-A4S6", "report": "The final surgical pathology report describes a resected specimen including the uterus, cervix, bilateral adnexa, and parametrial tissue. The cervix is markedly expanded, measuring 6.5 cm in diameter. On gross examination, the cervical tumor measures 5.3 cm from right to left and 5.3 cm anterior to posterior, with a maximal invasive thickness of 3 cm. The tumor involves the ectocervix, which ranges from smooth tan-white to glistening white-pink. A thin rim of wrinkled tan-white vaginal mucosa surrounds the ectocervical margin. The tumor extends circumferentially and replaces the entire cervix. The tumor margin is within less than 0.1 cm of the inked posterior surface.\n\nMicroscopic evaluation reveals poorly differentiated cellular features. The closest margin distance is less than 0.5 mm from inked circumferential margin. There is evidence of focal involvement of the cervical cuff margin between 6 and 9 o\u2019clock. Lymphovascular space invasion is identified.\n\nLymph node assessment includes right and left pelvic and periaortic lymph nodes. Of the right pelvic lymph nodes, 1 out of 6 demonstrates involvement. No metastatic involvement is seen in the 4 right periaortic lymph nodes. In the left pelvic lymph nodes, 1 out of 1 is involved. No involvement is found in the 2 left periaortic lymph nodes evaluated.\n\nThe endometrium, myometrium, bilateral ovaries, and fallopian tubes show no pathological findings. A single benign intramural leiomyoma is identified in the myometrium. Adipose and lymphoid tissues from the parametrial and lymph node specimens are submitted for histological analysis.\n\nNo other significant pathological findings are noted in the specimen."} +{"pid": "TCGA-WK-A8Y0", "report": "The surgical pathology report describes a resected soft tissue mass from the left chest wall, involving ribs, pectoral muscles, and adjacent structures. The specimen includes multiple ribs and soft tissues with a measured lesion size of 10.0 x 7.3 x 4.6 cm grossly, with extensive involvement of the fifth rib. Histologic evaluation reveals high-grade cellular features including marked pleomorphism and frequent mitotic figures (25 per 10 high-power fields). Areas of focal necrosis are present, comprising approximately 10% of the tumor volume. Lymphovascular invasion is identified in one block. The tumor reaches the pleural surface but does not involve the lung parenchyma or breast tissue. All bony and soft tissue margins are free of tumor involvement.\n\nMeasurements from the tumor to resection margins include: superior margin at 3.0 cm, inferior soft tissue margin at 2.5 cm, anterior third rib margin at 4.6 cm, posterior third rib margin at 2.7 cm, anterior fourth rib margin at 4.5 cm, posterior fourth rib margin at 2.6 cm, anterior fifth rib margin at 3.4 cm, posterior fifth rib margin at 2.9 cm, anterior sixth rib margin at 4.1 cm, posterior sixth rib margin at 3.8 cm, anterior seventh rib margin at 3.9 cm, posterior seventh rib margin at 3.1 cm, anterior soft tissue margin between third and fourth ribs at 2.0 cm, posterior soft tissue margin between fifth and sixth ribs at 1.4 cm, and stapled lung margin at 0.9 cm.\n\nHistologic sections submitted include margins from multiple ribs and surrounding soft tissues. Lung parenchyma adjacent to the mass shows minor emphysematous changes without evidence of tumor involvement. Pleural adhesions are noted at one lung margin. No tumor is identified at any lung or breast tissue margins.\n\nAJCC staging classification is T2 Nx Mx based on the seventh edition criteria. Selected microscopic slides were reviewed and findings confirmed. Gross photographs were taken and tissue samples preserved for further analysis. No clinical history or operative details were provided."} +{"pid": "TCGA-CK-5912", "report": "The specimen labeled \"right colon\" measures 44 cm in total length and includes ileum (14.8 cm in length x 1.8 cm in diameter) with a proximal stapled resection margin measuring 2.9 cm, inked blue. The colon segment is 42.8 cm in length x 5\u20135.5 cm in diameter, with a distal stapled resection margin measuring 6.2 cm, inked green. An attached fragment of yellow lobulated fibroadipose tissue consistent with omentum measures 25.0 x 11.0 x 1 cm. The serosa shows a nodular puckered area measuring 2.5 x 1.5 cm, inked black. Upon opening the specimen at the orange-inked site, an ulcerated mass measuring 3.0 x 2.5 x 0.4 cm is identified in the cecum, located 16.0 cm from the proximal stapled margin, 43 cm from the distal stapled margin, and 14.0 cm from the radial resection margin. A probable lipoma at the ileocolonic valve measures 1.5 x 1.5 x 1.0 cm. The appendiceal stump measures 1.0 cm in diameter. Multiple (greater than forty) scattered sessile polyps are present, up to 0.2 cm in greatest dimension. Histologic evaluation reveals a lesion that does not extend through the muscularis propria. Resection margins (proximal, distal, radial) are free of involvement. No intramural lymphovascular or perineural invasion is identified. A mild peritumoral response is noted. Residual adenoma is present. Hyperplastic polyps and multiple adenomas (>5) are observed. A lipoma of the ileocecal valve is present. Fat necrosis with dystrophic calcifications is noted in a peritoneal mass-like area. Evaluation of regional lymph nodes shows no evidence of involvement (0 out of 13 examined). Sections submitted include margins, tumor, polyps, normal mucosa, lipoma, omentum, and lymph node candidates. The senior physician confirms personal examination of the specimen and diagnosis."} +{"pid": "TCGA-TM-A84Q", "report": "The clinical details include a lesion in the left temporal region with symptoms of headaches and speech disturbance. Frozen section analysis was performed on multiple tissue samples. The first specimen measured 25 x 10 x 2 mm and consisted of red tissue. Additional specimens included fragments of friable tan and yellow soft tissue measuring up to 80 x 80 x 10 mm in aggregate, as well as firm tan haemorrhagic tissue measuring 25 x 25 x 10 mm in aggregate. Representative sections were embedded into multiple blocks for further evaluation.\n\nMicroscopic examination of the paraffin-processed sections confirmed findings observed during frozen section analysis. Brain tissue showed abnormal cellular proliferation composed predominantly (60\u201370%) of plump, glassy, eosinophilic cells with angular morphology. A minor component of fibrillary astrocytic changes was also noted. No mitotic figures, necrosis, or endothelial proliferation were identified. Perivascular lymphocytic cuffing was present in adjacent non-neoplastic brain tissue. Immunohistochemical staining demonstrated strong positivity for GFAP. The Ki67 proliferation index was approximately 2%. Initial immunostaining for p53 showed strong positivity, while Bcl2 staining was patchy and weak.\n\nThe histological features and immunoprofile were consistent with previously described findings. This case was reviewed in consultation and the interpretation was confirmed."} +{"pid": "TCGA-ZF-A9RM", "report": "The specimen consists of 8g of soft friable tissue chippings. Microscopic evaluation shows a grade 3 poorly differentiated lesion with a mixed papillary and solid growth pattern. A grade 2 papillary component is also present. The muscularis propria is involved, showing stromal invasion consistent with pT2 staging. Vascular channel invasion is not identified. Adjacent flat urothelium shows carcinoma in-situ. The tumor is located adjacent to but not involving the RUO."} +{"pid": "TCGA-EJ-7314", "report": "The surgical specimen includes lymph nodes and prostate tissue. Nine right pelvic lymph nodes and five left pelvic lymph nodes were examined, with no abnormal cellular findings identified in any of the nodes. The prostate and bilateral seminal vesicles were submitted for analysis. The prostate measured 39.38 grams in weight and showed involvement by a cellular process that was multifocal in nature, affecting both the right and left lobes. The largest focus measured 2 centimeters in diameter within one histologic section, and approximately 30% of the prostate tissue was involved by this process.\n\nMicroscopic evaluation revealed extension beyond the prostate capsule into surrounding adipose tissue, with involvement noted at multiple sites including anterior right mid, anterior right base, posterior right mid, posterior right base, and posterior left base regions. Both seminal vesicles also showed similar cellular infiltration. All surgical margins were free of abnormal cells. Additional features identified included perineural invasion and vascular invasion. High-grade intraepithelial changes were also present. The background prostate tissue demonstrated benign nodular hyperplasia and chronic inflammation.\n\nA separate margin from the right pedicle was examined and showed only benign fibroadipose tissue. A total of 14 lymph nodes were evaluated, with no evidence of abnormal cellular spread. The pathologic staging assigned was pT3b with no lymph node involvement (pN0) and no assessment of distant metastasis (pMX). The histologic grade was classified as poorly differentiated or undifferentiated."} +{"pid": "TCGA-CZ-5466", "report": "The surgical specimen consisted of a right kidney resection measuring 18.5 x 16.0 x 13.5 cm, along with associated perirenal fat. A mass measuring 8.8 x 7.0 x 6.5 cm was identified within the kidney, characterized as a necrotic cyst with a calcified rim and adjacent tan/orange heterogeneous tissue. The mass was located near the renal vein, measuring 0.6 cm from the vein margin, and extended into the vein. Ninety percent of the renal parenchyma was replaced by the lesion, which also involved the renal capsule but did not extend into the perirenal fat. No tumor involvement was identified at the margins of the soft tissue, renal vein, ureter, or renal artery.\n\nMicroscopic evaluation showed a significant presence of abnormal tissue in close proximity to normal renal parenchyma. The non-neoplastic kidney showed 22 out of 200 glomeruli globally sclerosed, with no significant mesangial expansion or glomerular basement membrane abnormalities. The interstitium displayed edema and focal inflammatory infiltrates composed mainly of mononuclear cells, with occasional eosinophils and neutrophils. Tubulitis was present, with moderate invasion of the tubular epithelium by inflammatory cells. Hyaline casts and cellular debris were observed in the tubular lumina. Approximately half of the cortical parenchyma demonstrated tubular atrophy and interstitial fibrosis. Vascular changes included thickening of arterial and arteriolar walls with subintimal sclerosis.\n\nLymph node tissue submitted from the right retroperitoneal region contained only adipose and vascular tissue, with no evidence of abnormal cell infiltration. Cytogenetic analysis of the primary specimen revealed mosaicism for Y chromosome loss in 4 of 15 metaphases, though this finding is not specific to neoplasia and may occur in non-neoplastic conditions. The remainder of the karyotype was normal. Chromosome analysis was performed at a resolution of 400 bands or greater. No additional significant chromosomal anomalies were detected."} +{"pid": "TCGA-06-0174", "report": "The specimen consists of several fragments of brain tissue from the temporal region, measuring approximately 1.1 cm in aggregate. A separate portion measured 1.5 x 1.5 x 0.6 cm and was described as pink-tan and soft. Microscopic examination reveals extensive involvement of cerebral cortex and white matter by a neoplastic glial process. The lesion demonstrates nuclear anaplasia, frequent mitotic figures, microvascular proliferation, and small areas of necrosis. Sections were submitted in entirety for analysis.\n\nImmunohistochemical studies were performed on selected tissue blocks. GFAP staining highlights gliofibril formation within the neoplastic cells. p53 expression is not significantly elevated. MIB-1 labeling was used to assess proliferative activity in areas of higher cellularity."} +{"pid": "TCGA-QG-A5Z1", "report": "The surgical specimen includes a resected colon segment measuring 21.0 cm in length, stapled at both ends with attached fat. A firm area of puckering is noted on the serosa, which was inked blue for orientation. Upon opening, there is a centrally ulcerated mass measuring 2.8 x 2.5 cm with raised borders, located nearly circumferentially within the colon. The mass is identified 9.5 cm from the proximal margin and 5.8 cm from the distal margin. Sectioning reveals a tan-white, granular cut surface extending into the adjacent mesenteric fat but not reaching the inked serosal margin. The mass is 9.3 cm from the mesenteric margin. Adjacent colonic mucosa appears normal. Multiple lymph nodes are present within the attached fat, ranging from 0.3 to 0.8 cm in size.\n\nMicroscopic evaluation indicates an infiltrative growth pattern with a maximum dimension of 2.8 cm. The tissue demonstrates well-differentiated cellular features. All surgical margins\u2014proximal, distal, and radial\u2014are free of involvement. Invasive carcinoma is found to be 5.8 cm from the nearest distal margin. Lymphatic, vascular, and perineural invasion are identified. Pathologic staging is determined as pT3 for the primary lesion and pN1b for regional lymph node involvement. A total of 38 lymph nodes are examined, with 3 showing involvement. A separate tubular adenoma is also identified in proximity to the main lesion.\n\nTwo additional specimens, described as annular soft tissue segments with unremarkable tan-brown mucosa and no discrete lesions, are submitted for evaluation. Both are devoid of tumor upon histologic examination."} +{"pid": "TCGA-BB-4224", "report": "The specimen from a partial glossectomy procedure included a lesion measuring 4.0 cm in greatest dimension located in the oral tongue. Histologic examination revealed infiltrating, moderately differentiated keratinizing squamous cell carcinoma. The tumor extended to within 1 mm of the deep aspect of the medial margin; all other margins were free of tumor involvement. Venous and lymphatic invasion were present, while perineural invasion was not identified. \n\nA neck dissection specimen (levels I\u2013IV) contained 51 lymph nodes, with metastatic involvement identified in three nodes. Two of twenty-two lymph nodes in level II and one of seventeen lymph nodes in level III showed evidence of disease. No tumor involvement was found in level IV. Focal extranodal extension was noted. The primary tumor was classified as pT2 based on its size (>2 cm but \u22644 cm). Regional lymph node staging was determined to be pN2b due to multiple involved ipsilateral nodes. Distant metastasis could not be assessed (pMX)."} +{"pid": "TCGA-DD-A73C", "report": "The patient is female. A partial hepatectomy involving segments II and III revealed a well-differentiated lesion with bland cytology, showing loss of the normal reticulin framework and dispersion of cells by intercellular material suggestive of mucin. The main mass measured 14.5 x 10.5 x 10.0 cm and was accompanied by multiple satellite nodules. The lesion was confined to the liver with no involvement of the resection margin, which was free of tumor by 0.5 cm. Macroscopic and microscopic vascular invasion were not identified. No regional lymph nodes were present. The surrounding liver tissue showed no significant abnormalities.\n\nAdditional resections from segments VI, VIII, and IVB each contained similar histologic features, with nodule sizes measuring 1.2 x 1.0 x 0.8 cm, 1.0 x 1.0 x 0.9 cm, and 1.1 x 1.0 x 0.6 cm respectively. The resection margins in segments VI and VIII were free of tumor by 0.9 cm and 0.1 cm, while the nodule in segment IVB was at the inked margin. No definitive lesion was found in segment VII, and the tissue showed only cautery effect.\n\nReticulin stains performed on two satellite nodules confirmed the loss of reticulin framework, supporting the observed histologic pattern. A mucicarmine stain showed a faint pink blush in dilated sinusoids but no intracellular mucin. These findings, along with the multifocal distribution, were consistent with a well-differentiated lesion across multiple liver segments."} +{"pid": "TCGA-75-7025", "report": "The sample was collected from a lung resection specimen. The tissue measured 3.4 cm in greatest dimension and demonstrated a histologic grade of 3, indicating poorly differentiated morphology. Pathologic staging showed no evidence of distant metastasis (M0). The preparation method was standard formalin fixation with paraffin embedding. No lymph node involvement was identified. The procedure was performed as part of a surgical resection, with the primary site located in the left upper lobe. Additional details regarding cellular composition and tissue architecture were consistent with routine processing and evaluation."} +{"pid": "TCGA-CV-7097", "report": "The case was imported from a legacy computer system, and the format may differ from the original. A supplemental report has been issued. \n\nThe specimen includes a level I and submental dissection. Within yellow-tan adipose tissue measuring 10.0 x 3.5 x 2.5 cm is a 4.0 x 2.0 x 1.8 cm lobulated salivary gland with no remarkable findings in the parenchyma. Multiple lymph nodes are present within the adipose tissue, up to 1.0 cm in greatest dimension. No matted or necrotic lymph nodes are identified. Representative samples were submitted, including the salivary gland and several lymph nodes. \n\nA composite resection of the anterior mandible and floor of mouth was performed. The overall specimen measures 2.5 x 4.0 x 4.0 cm and includes skeletal muscle, floor of mouth, and inferior soft tissue. An irregular tan-pink exophytic area is noted in the floor of the mouth, extending into the anterior soft tissue with dimensions of 4.0 x 3.5 x 3.0 cm. A rim of white-pink mucosa surrounds the lesion. The closest margin is 0.5 cm at the mucosal and right posterior margin. The anterior mucosal margin is disrupted but without evidence of residual involvement. The anterior soft tissue margin is separated from the mandible but free of involvement. Bony margins appear unremarkable. Sections of the posterior mucosa and soft tissue, as well as anterior skin and soft tissue, have been submitted entirely. The mandible has been sent for decalcification, and a supplemental report will follow. \n\nHistologically, the lesion demonstrates invasive features with involvement of lymphatics and perineural spaces. Cellular features include poor differentiation. Bone margins of resection are free of involvement. Five lymph nodes examined show no evidence of tumor. Fibrous inflammation is noted in the submandibular gland."} +{"pid": "TCGA-UW-A72Q", "report": "A partial nephrectomy specimen from the left kidney was received, weighing 50 grams and measuring 6.4 x 4.4 x 3.0 cm. A well-circumscribed mass was identified within the specimen, measuring 5.7 x 2.2 x 1.9 cm. The tumor was located beneath a black-inked capsule and adjacent to a blue-inked renal parenchymal margin. On sectioning, the tumor exhibited a variegated cut surface with tan/white firm calcified areas interspersed with hemorrhagic regions. Microscopic evaluation revealed an attenuated capsule near the tumor; however, no definitive invasion into perirenal adipose tissue, Gerota\u2019s fascia, large venous structures, or lymphatic vessels was observed.\n\nHistologic assessment of surgical margins demonstrated absence of tumor at the renal parenchymal, capsular, and paranephric adipose tissue margins. The capsular margin was noted to be free of tumor but within less than 0.1 mm of the lesion. No sarcomatoid features were identified. Histologic grade was classified as Fuhrman grade 2. No lymph nodes were submitted for evaluation. No significant pathologic abnormalities were identified in the non-neoplastic kidney tissue. Based on available information, staging was determined as pT1b, pNX. This staging is subject to revision pending further clinical review."} +{"pid": "TCGA-CQ-6229", "report": "The specimen labeled as \"Neck: Contents Right Neck\" includes an oriented standard right neck dissection measuring 14.0 x 8.0 x 1.7 cm with multiple lymph nodes ranging from 0.2 cm to 1.4 cm identified across levels I to IV. The submandibular gland, measuring 4.5 x 3.5 x 1.5 cm, shows no abnormality. A total of twenty lymph nodes are identified and all are negative for malignancy. \n\nA fragment labeled \"Neck: Deep margin tongue\" measures 0.7 x 0.7 x 0.3 cm and is negative for malignancy. \n\nThe resected tissue from the right tongue and floor of mouth measures 2.0 x 3.5 x 7.0 cm with three sutures for orientation. An ill-defined lesion on the dorsal surface of the tongue measures 0.8 x 1.5 x 2.4 cm in greatest dimension. The consistency is solid and color is grey-tan. The closest distances from the tumor to the margins are 0.9 cm to the medial margin and 0.5 cm to the lateral margin. Microscopically, the lesion demonstrates moderately differentiated features with a maximum thickness of 1.5 cm. Perineural invasion is present, but no lymphovascular invasion is identified. Additional findings include involvement of adjacent mucosa with changes consistent with in situ alterations. Margins are generally free of tumor involvement, although the tumor approaches within 0.1 cm of the medial margin and 0.4 cm of the lateral margin. Other margins remain greater than 0.5 cm from the tumor. \n\nA fragment labeled \"Neck: Medial margin right tongue\" measures 2.0 x 0.4 x 0.3 cm and is negative for malignancy. \n\nA fragment labeled \"Neck: Posterior margin right tongue\" measures 1.0 x 0.7 x 0.1 cm and is negative for malignancy. \n\nA fragment labeled \"Neck: Anterior margin right tongue\" measures 1.5 x 0.5 x 0.3 cm and is also negative for malignancy. \n\nA fragment labeled \"Neck: Lateral margin, floor of mouth\" measures 0.7 x 0.3 x 0.2 cm and is negative for malignancy. \n\nThe specimen labeled \"Neck: Right neck level IB\" consists of a fragment measuring 1.3 x 1.0 x 0.8 cm containing one lymph node, which is negative for malignancy. \n\nIn total, 21 regional lymph nodes were examined and none showed evidence of involvement. Based on size and extent, staging indicates a primary lesion greater than 2 cm but not more than 4 cm in greatest dimension, with no regional lymph node metastasis identified. Distant metastasis cannot be assessed. \n\nRepresentative sections from all relevant areas have been submitted for further analysis."} +{"pid": "TCGA-CM-6676", "report": "A 5 cm mass was identified in the descending colon at 45 cm from the anal verge via colonoscopy. The resected sigmoid colon specimen measured 26 x 6 cm and contained a polypoid lesion located 2.4 cm from one margin and 21 cm from the opposite margin. The tumor measured 2.5 cm in length, 2.0 cm in width, and had a maximal thickness of 1.5 cm. Histologically, the lesion showed moderate differentiation with focal tumor budding. No increased tumor-infiltrating lymphocytes were observed. Precursor lesions showed features of a tubular adenoma. The deepest invasion reached the muscularis propria without evidence of gross perforation, lymphovascular invasion, or perineural involvement. The surgical margins were free of tumor. Adjacent mucosa showed no dysplasia, and the non-neoplastic bowel was otherwise unremarkable.\n\nA total of 17 lymph nodes were examined; however, none contained metastatic disease. One lymph node contained a deposit suspicious for metastasis, but further immunohistochemical analysis revealed positivity for PSA and absence of markers such as CK7, CK20, CDX-2, TTF-1, chromogranin, and synaptophysin, suggesting a non-colonic, likely prostatic, origin. The distal and proximal ring specimens both showed benign colonic tissue with no significant findings. The pericolic adipose tissue was extensive, measuring up to 12 cm in thickness, and was fully submitted for lymph node dissection. All possible lymph nodes were retrieved and submitted for evaluation. Representative sections of the tumor, uninvolved mucosa, and margins were also included."} +{"pid": "TCGA-DE-A2OL", "report": "The specimen consists of two parts. Part A includes a skin lesion from the left superior neck measuring 0.7 x 0.5 x 0.2 cm, described as granular and gray/tan, entirely submitted for evaluation.\n\nPart B involves a right thyroid lobectomy specimen weighing 16.4 grams and measuring 4.4 x 3.5 x 2.0 cm. A nodule measuring 2.9 x 2.8 x 2.7 cm was identified within the thyroid tissue. The nodule is solid, fleshy, tan/pink, and well-defined. It is located near the anterior and posterior margins but remains confined within the gland, with a distance of 1.2 cm from the isthmus margin of resection.\n\nMicroscopic analysis reveals a microfollicular growth pattern with cytologic features including nucleomegaly, chromatin clearing, nuclear grooves, and pseudoinclusions. No psammoma bodies were observed. There is no evidence of capsular invasion, lymphovascular invasion, or blood vascular invasion. Surgical margins are not involved, with the closest approach being less than 1 mm in block B3. No lymph nodes were sampled. Additional findings include normocellular parathyroid tissue.\n\nThe current pathological staging based on available data is pT2 pNx pMx. This assessment may be subject to revision pending further clinical review and information."} +{"pid": "TCGA-BH-A1EY", "report": "The left radical mastectomy specimen measured 30.0 x 13.5 x 4.5 cm and included attached skin. A 4.5 x 4.0 x 4.0 cm lesion was identified within the tissue, located less than 1 cm from the deep margin. All other margins, including skin and nipple, were free of abnormal tissue. The lesion was assessed for histologic grade using standard scoring criteria, with a total score of 6 out of 9 based on tubule formation (2/3), nuclear atypia (2/3), and mitotic count (2/3). Microcalcifications were noted in association with the lesion. Evaluation of lymph nodes revealed no involvement in the twelve nodes examined. Adjacent tissue showed focal changes consistent with atypical ductal epithelial hyperplasia and nodules. Immunohistochemical analysis demonstrated strong intranuclear staining for estrogen receptor (70%) and progesterone receptor (90%). A separate immunostain for HER-2/neu showed minimal membrane staining in less than 10% of cells, interpreted as negative (score 0). No evidence of lymphovascular invasion was observed."} +{"pid": "TCGA-BR-8077", "report": "The specimen consists of a gastrectomy with tumor located in the fundus. The tumor measures 6 x 4.5 x 1.5 cm. Microscopic evaluation shows moderately differentiated intestinal-type morphology. The tumor involves adjacent structures, specifically the lesser omentum. Lymph node examination reveals 2 out of 7 positive nodes for metastatic involvement within the intraabdominal region. No definitive assessment is available for lymphatic, venous, or perineural invasion. Surgical margins and response to potential neoadjuvant therapy remain unspecified."} +{"pid": "TCGA-06-0206", "report": "The left frontal lesion specimens were received as two separate biopsies. The first specimen consisted of two red-tan, soft, friable tissue fragments measuring 0.4 to 0.6 cm. The second specimen included two yellow-tan, soft tissue fragments measuring 0.3 to 0.6 cm. Both were submitted in cassettes for analysis.\n\nMicroscopic evaluation of the first lesion revealed a high-grade neoplasm with diffuse infiltration into the surrounding brain tissue. The tumor cells ranged from small to medium in size, with occasional larger forms noted. Cellular nuclei were pleomorphic and hyperchromatic with prominent nucleoli. Mitotic figures were observed on occasion. Widespread coagulation necrosis and individual cell necrosis were present throughout the tumor and adjacent regions. Endothelial hyperplasia was also identified. Immunostaining for MIB-1 was performed, yielding a labeling index of 10%. The second biopsy showed white matter with mild increase in glial cells, composed of small, uniform astrocytes with eosinophilic cytoplasm, consistent with reactive changes."} +{"pid": "TCGA-21-5786", "report": "The specimen was obtained from three sources: a wedge biopsy of the right upper lobe lung, a level 11 lymph node, and a resected right upper lobe lung. The wedge biopsy measured 9 x 4 x 2.5 cm and showed a tan, ill-defined nodule measuring 2.6 x 2.4 x 2.2 cm located approximately 0.5 cm from the resected margin. The nodule was firm and invaded large blood vessels. Microscopic evaluation revealed invasive cells with moderate to poor differentiation. The visceral pleura was involved, with tumor extending through it. No tumor was identified at the parenchymal or parietal pleural margins.\n\nA separate lymph node specimen from level 11R contained multiple black lymph nodes measuring up to 2 x 1.5 x 1 cm in total. All lymph nodes were submitted for microscopic examination and showed no evidence of tumor involvement.\n\nThe lobectomy specimen weighed 131 grams and measured 11.5 x 8.3 x 3.5 cm. A small, firm nodule measuring 0.2 x 0.2 x 0.1 cm was identified within the lung tissue, located approximately 6 cm from the bronchial margin. Histologically, there was no tumor seen at the bronchial or vascular margins. Additional findings included emphysema and focal interstitial fibrosis.\n\nNo tumor was detected in the three regional lymph nodes examined. The tumor size was 2.6 cm in greatest dimension and demonstrated invasion into and through the visceral pleura. Vascular invasion was present, involving both large venous and arterial structures. All surgical margins were free of tumor."} +{"pid": "TCGA-QR-A70E", "report": "The right adrenal gland specimen, including an associated ovoid nodule, was submitted for pathological evaluation. The entire specimen measured 5.5 x 2.5 x 2.0 cm and weighed 21 grams. The nodule itself measured 2.5 x 2.0 x 2.0 cm and exhibited a fleshy maroon-tan cut surface upon sectioning. A portion of the central region of the nodule, approximately 50% of the tissue, was procured for further analysis, along with a fragment of adipose tissue measuring 1.0 x 1.0 x 1.0 cm. Representative sections of the nodule in relation to the surrounding normal adrenal tissue were submitted for permanent processing.\n\nMicroscopic examination revealed cells that stained positively for chromogranin and synaptophysin. An S-100 immunostain demonstrated labeling of sustentacular cells. These immunohistochemical findings were consistent with previously documented characteristics of the lesion. All tests used were developed and validated by the laboratory. These tests have not been cleared or approved by the U.S. Food and Drug Administration; however, the FDA has determined that such clearance or approval is not required. The laboratory is certified under CLIA to perform high-complexity testing.\n\nClinical information indicated that the specimen was obtained in the context of a known pre- and post-operative clinical assessment. Gross photographs were taken for documentation purposes. The remaining tissue was preserved in formalin and submitted for complete histologic processing. A summary of the cassettes submitted includes representative sections of the nodule adjacent to normal adrenal cortex and sections of the uninvolved adrenal gland. No evidence of capsular or vascular invasion was identified."} +{"pid": "TCGA-DJ-A4UR", "report": "The clinical history included a diagnosis of thyroid malignancy. Specimens submitted for evaluation included multiple lymph node regions from the right side of the neck, including levels 2 through 5, as well as additional nodes from the supraclavicular, paratracheal, superior mediastinal, and deep mediastinal regions. A total thyroidectomy specimen was also examined.\n\nMicroscopic analysis of the lymph nodes revealed variable findings. In level 2\u20135 of the right neck dissection, 11 lymph nodes were identified, with 7 showing involvement by malignant cells. The largest lymph node measured 2.4 cm, and the largest metastatic focus within it was also 2.4 cm. No extranodal extension was observed in this region. In the additional right neck level 4 and 5 nodes, both of the two lymph nodes examined showed tumor involvement, with the largest measuring 2.3 cm. Extranodal extension was present in this location. The right paratracheal lymph nodes also showed tumor involvement in both of the two lymph nodes identified, with the largest measuring 0.8 cm; however, no extranodal extension was seen there. Other regions\u2014including the right neck lymph node, node near the accessory nerve, supraclavicular region, superior mediastinal, pretracheal, and deep mediastinal lymph nodes\u2014were found to be benign without evidence of tumor involvement.\n\nThe thyroidectomy specimen revealed a lesion located in the right lobe of the thyroid gland. The primary lesion measured 2.0 cm in greatest dimension and exhibited infiltrative growth with focal vascular invasion. Histologic evaluation demonstrated well-differentiated cellular features without necrosis or mitotic activity. The tumor lacked a distinct capsule and extended into adjacent perithyroid fibroadipose tissue. Surgical margins were free of tumor involvement, and no multicentric disease was identified. Background thyroid tissue showed changes consistent with chronic lymphocytic thyroiditis, and one non-involved lymph node was identified in the surgical specimen. Parathyroid tissue was identified and appeared unremarkable."} +{"pid": "TCGA-DJ-A2PN", "report": "The neck specimen includes two thyroid lobes submitted for evaluation. The left thyroid lobe and isthmus measure 3x2x2 cm and weigh 5 grams. Upon sectioning, a firm, calcified nodule measuring 1.3x1.2x1.0 cm is identified and entirely submitted for analysis. Microscopic examination reveals a well-differentiated lesion with no identifiable mitotic activity or tumor necrosis. Calcifications of a non-psammomatous type are noted along with ossification. The lesion is partially encapsulated and shows no evidence of blood vessel invasion or extension beyond the thyroid capsule. Surgical margins are free of involvement. There is no evidence of multicentric disease or associated adenomas. Adjacent thyroid tissue demonstrates mild nodular hyperplasia. Parathyroid tissue is not identified in the specimen. The right thyroid lobe measures 4x2x1.2 cm and weighs 4.5 grams. Gross examination and histologic analysis reveal no significant pathology, with findings consistent with nodular thyroid hyperplasia. Representative sections from both lobes have been examined and submitted accordingly."} +{"pid": "TCGA-EY-A1GH", "report": "The surgical pathology report describes findings from a hysterectomy specimen along with bilateral salpingo-oophorectomy and lymph node dissections. The uterus measured 10.5 cm in height, 5.0 cm in anterior-posterior width, and 7.0 cm in breadth at the fundus. The endometrial cavity measured 4.3 cm in length and 4.4 cm in width at the fundus. A lesion measuring 4.5 x 4.2 x 2 cm was identified; it appeared exophytic and tan/yellow in color, occupying the entire fundus. Histologic examination revealed architectural and nuclear features consistent with a moderately differentiated morphology (Grade 2 by FIGO criteria). Myometrial invasion was limited to the inner half of the myometrium, with an invasion depth of 0.6 cm in a region where the wall thickness was 1.8 cm, representing approximately 33% penetration. There was no involvement of the serosa, lower uterine segment, cervix, or adnexa. Surgical margins were widely free of tumor involvement, with the closest distance being at least 1.8 cm. No lymphovascular space invasion was identified.\n\nLymph node specimens were submitted for evaluation. Left pelvic lymph node tissue consisted of fibrofatty tissue with fat necrosis and organization but no identifiable lymph nodes or malignant cells. Right pelvic lymph node dissection contained three fibrofatty fragments without identifiable lymph nodes or tumor involvement.\n\nAdditional findings included a small ovarian fibroma measuring 1.8 cm on the right ovary, with no evidence of malignancy or atypia. The left ovary showed atrophic changes without tumor. Both fallopian tubes exhibited no significant pathologic abnormalities.\n\nImmunohistochemical staining performed on representative tissue demonstrated positivity for estrogen and progesterone receptors. Specifically, estrogen receptor staining was scored as 2+ in approximately 80% of cells, while progesterone receptor staining was 3+ in about 95% of cells. Positive and negative controls appropriately stained.\n\nBased on available information, staging was determined as pT1b pNx pMx according to AJCC criteria and Stage IA under the FIGO (2008) classification. These classifications are provisional and subject to revision pending further clinical correlation or additional data."} +{"pid": "TCGA-AR-A24S", "report": "The specimen consists of a 1.3 x 1.1 x 1.0 cm lesion identified in the right breast tissue. Histologic evaluation reveals a Nottingham grade II lesion based on scoring for tubule formation (3/3), nuclear pleomorphism (2/3), and mitotic count (1/3), resulting in a total score of 6 out of 9. No ductal carcinoma in situ is present. An intramammary lymph node was identified and found to be free of metastatic involvement. There is no evidence of angiolymphatic invasion.\n\nThe surrounding non-neoplastic breast parenchyma demonstrates findings consistent with nonproliferative fibrocystic changes. Changes related to prior biopsy are noted. All surgical margins are clear of tumor, with the closest margin measuring at least 0.5 cm from the deep margin. Two sentinel lymph nodes were recovered from the right axillary region and both were negative for metastasis [AJCC pN0(i-)(sn)]. Blue dye was observed only in sentinel lymph node number 1. Immunohistochemical staining for cytokeratin performed on paraffin-embedded sentinel lymph node tissue confirms the findings observed on H&E sections. Additionally, one right intramammary lymph node and one right axillary lymph node were examined and both were also negative for metastatic involvement. Testing for HER2/neu has been ordered."} +{"pid": "TCGA-GC-A6I3", "report": "The specimen consisted of a bladder, uterus, bilateral fallopian tubes and ovaries, left and right obturator lymph nodes, segments of left and right ureter and distal ureter, and appendix. The procedure performed included radical cystectomy with urethrectomy, bilateral pelvic lymph node dissection, hysterectomy with bilateral salpingo-oophorectomy, bilateral ureterotomy, and appendectomy.\n\nA mass was identified measuring 7.3 cm in greatest dimension. Histologic evaluation revealed high-grade cellular features with focal squamous differentiation. The tumor infiltrated through the muscularis propria into surrounding adipose tissue. The primary site of involvement was the anterior and left lateral bladder wall, with focal extension to the posterior wall; however, adjacent vaginal wall was uninvolved.\n\nFocal lymphovascular invasion was present. Among seventeen regional lymph nodes examined, one showed evidence of involvement by the process, specifically within a left obturator lymph node, measuring 0.7 cm in greatest dimension. No extranodal extension was observed.\n\nAll surgical margins, including distal urethral, distal vaginal, radial, and ureteral margins, were free of any abnormal cellular infiltration. Additional findings included benign bilateral ureters, cervix, uterus with inactive endometrium and cystic atrophy, unremarkable myometrium, bilateral ovaries with surface inclusion cysts, bilateral fallopian tubes with paratubal cysts, and a benign appendix.\n\nStaging parameters indicated pT3a for primary tumor extent, pN1 for regional lymph node involvement, and no evidence of distant metastasis. The overall pathologic stage was classified as IV. Lymphovascular invasion was documented and all margins were negative (R0)."} +{"pid": "TCGA-HT-A5RC", "report": "The pathology report describes a diffusely infiltrating astrocytic neoplasm. The hypercellularity and atypia vary from mild to marked throughout the tissue sections. Numerous scattered mitotic figures are present. No microvascular proliferation or necrosis is identified. Immunohistochemical staining shows numerous MIB-1 reactive cells distributed throughout the tumor. In areas of highest proliferation, a labeling index of 8.7% is calculated, with an overall MIB-1 labeling index of 8.6%. Cellular density and mitotic activity support the presence of a high-grade neoplasm."} +{"pid": "TCGA-67-3774", "report": "The surgical specimen consisted of a left lower lobe lung lobectomy, weighing 157 grams and measuring 13.5 x 7.5 x 7 cm. A bifurcated stapled bronchial margin was identified, measuring 0.4 cm and 1.5 cm in diameter. Three stapled vessel margins ranged from 0.4 cm to 0.7 cm in diameter. Multiple anthracotic lymph nodes were observed at the hilum, with sizes ranging from 0.3 cm to 1.5 cm. The pleural surface appeared purple tan with membranous adhesions. A firm mass was palpated on the lateral aspect, and upon sectioning, a tan lesion with poorly defined borders was noted. This lesion measured 3.3 x 3 x 1.5 cm and approached the inked visceral pleural surface within 3 cm of the bronchial margin. Representative sections were taken from the bronchial margin, vessel margins, hilar lymph nodes, consecutive levels of the lesion, adjacent bronchovascular structures, and uninvolved pulmonary parenchyma. Additional specimens included a soft tissue fragment measuring 0.8 cm submitted for frozen section, and rib segments measuring 2 x 1.2 cm and 1.2 x 1.3 cm respectively, all of which were negative for tumor involvement.\n\nMicroscopic evaluation revealed a moderately differentiated infiltrating epithelial neoplasm with focal bronchoalveolar features. The tumor was confined to the lung and did not show evidence of vascular or lymphatic invasion. All bronchial and vascular margins were free of tumor involvement. Seven lobar lymph nodes were examined and found to be negative for metastatic disease. Additionally, scattered small non-caseating granulomas were present in the background lung tissue, associated with weakly polarizable material. Special stains (AFB, GMS) performed on representative sections did not reveal any organisms. The neoplastic process was confined to the lung without extension to adjacent structures. Based on AJCC 7th edition criteria, staging was determined as pT2a pN0 MX."} +{"pid": "TCGA-3Z-A93Z", "report": "The specimen consists of a right kidney and perinephric fat from a male patient. The kidney measures 10 x 7 x 2.8 cm and weighs 424 grams. A mass located in the mid portion of the kidney measures 3.7 x 3.5 cm and is described as spongy and tan-yellow with areas of hemorrhage and smooth-walled cystic spaces containing tan-red fluid. The mass approaches the renal capsule and is within 0.3 cm of the nearest inked soft tissue margin. Additional findings include multiple smooth-walled cysts within the parenchyma, some up to 2.5 cm in diameter, containing clear fluid. The remaining renal parenchyma shows a well-defined corticomedullary junction and mild interstitial inflammation. The renal pelvis demonstrates focally hemorrhagic urothelium. No adrenal gland tissue is present. Ureteral and vascular margins are free of abnormality on gross examination. The mass is solitary and confined to the kidney, with no evidence of lymphovascular invasion. Histologic evaluation reveals cells with features consistent with a previously specified type, arranged in a pattern typical of that entity. Nuclear grading is Fuhrman grade II. No sarcomatoid differentiation is identified. Margins are uninvolved by tumor. No regional lymph nodes are submitted for evaluation. Pathologic staging is pT1a pNX. Seven cassettes were submitted for microscopic evaluation, including sections of the margins, mass, adjacent cystic areas, and renal parenchyma."} +{"pid": "TCGA-D5-6927", "report": "Histopathological examination was performed on a specimen from the colon. The resected specimen included a 12 cm length of the large intestine with surrounding fat tissue, measuring 12.5 x 4.5 x 5 cm. A mucosal lesion measuring 6.0 x 4.0 x 1.6 cm was identified, which circumferentially involved the intestinal wall and caused luminal narrowing. The lesion was located 3 cm from one incision margin and 3.6 cm from the opposite margin, with the minimum surgical margin being 1.3 cm. Microscopic evaluation showed a neoplastic process involving the muscularis propria and adjacent pericolic adipose tissue. The tumor demonstrated moderate differentiation. Surgical margins were free of neoplastic cells. Reactive lymph node changes were noted in the regional lymph nodes. No evidence of lymph node metastasis was found. The depth of invasion extended beyond the muscularis propria into the pericolic tissues."} +{"pid": "TCGA-EY-A1GP", "report": "The surgical pathology report describes findings from a hysterectomy specimen along with bilateral salpingo-oophorectomy. The uterus weighed 77.5 grams and measured 6.6 cm in height, 4.3 cm at the fundal breadth, and 2.3 cm in anterior-posterior width. The endometrial cavity measured 3.2 cm in length and 2.1 cm in width at the fundus. A lesion was identified measuring 3.2 x 2.8 x 0.8 cm, described as friable, fleshy, and exophytic, located predominantly on the posterior corpus with focal extension into the fundus. No apparent myometrial invasion was observed; the thickest area of the myometrial wall at the deepest point of the lesion was 1.9 cm. Microscopic evaluation showed no invasion into the serosa, lower uterine segment, or cervix. Lymphovascular space invasion was focally present.\n\nTwo intramural nodules were noted within the myometrium, each firm, well-circumscribed, and measuring up to 1.5 cm. The cervix measured 1.6 cm in length and appeared grossly unremarkable. The right and left ovaries were unremarkable, each containing a thin-walled, fluid-filled cyst measuring 1.8 cm. The right fallopian tube was 8 cm long and 1.7 cm in diameter, with a lumen distended by thick yellow mucoid material and a wall thickness of up to 0.8 cm. The left fallopian tube was 6.5 cm in length, ranging from 0.5 to 1.2 cm in diameter, and was noted to be tortuous and adhered to the ovary. Both tubes showed evidence of chronic inflammation and hydrosalpinx.\n\nMargins of the uterine specimen were widely negative. No tumor was identified in the adnexal structures. Multiple tissue blocks were submitted for analysis, including sections from various regions of the uterus and adnexa. Immunohistochemical controls were appropriate, though receptor status results were pending at the time of reporting.\n\nThe AJCC pathologic stage was determined to be pT1a pNx, corresponding to FIGO (2008) Stage IA. This staging is provisional and may be subject to revision based on further clinical and pathological information."} +{"pid": "TCGA-FP-7916", "report": "A surgical pathology report was submitted for evaluation of multiple specimens. The falciform ligament specimen consisted of vascularized fibroadipose tissue without evidence of malignancy. A biopsy of an omental mass revealed a lymph node positive for metastatic carcinoma. An excision of the omentum also showed involvement by metastatic carcinoma. A mesenteric mass excision included a lymph node that was likewise positive for metastatic carcinoma. Two pyloric lymph nodes were negative for metastatic involvement.\n\nThe distal stomach specimen demonstrated extensive retraction on the anterior surface involving the gastro-omental fat, with embedded nodules measuring up to 0.5 cm. A centrally ulcerated mass was identified on the anterior gastric wall, measuring 7.2 x 3.5 cm and up to 0.5 cm thick. Histologic examination revealed poorly differentiated invasive carcinoma infiltrating the serosa. Both proximal and distal surgical margins were free of tumor involvement; however, both the lesser and greater omental margins showed involvement by carcinoma. Ten out of twenty lymph nodes examined were involved by metastatic disease, including eight of sixteen from the gastro-omental fat dissection. Additionally, two tumor implants were identified.\n\nPathologic staging was determined as pT4a (tumor invades serosa) and pN3a (metastasis in 7 to 15 perigastric lymph nodes). No definitive treatment effect was noted. Perineural invasion was present, while lymphovascular invasion was not identified. Additional findings included dysplasia. All gross and microscopic findings were reviewed and interpreted by the attending pathologist."} +{"pid": "TCGA-BR-A4CR", "report": "The specimen consisted of an excised tissue sample from the fundus region. The lesion measured 12 x 10 x 1 cm and exhibited poorly differentiated cellular features. Histologic examination revealed infiltration into adjacent structures including the esophagus and omentum. A total of 8 lymph nodes were identified, all of which contained metastatic involvement. Surgical margins were free of involvement. No other pathologic findings or treatment effects were noted."} +{"pid": "TCGA-KM-A7QJ", "report": "The revised surgical pathology report describes a radical nephrectomy specimen from the right kidney. The specimen measured 17.0 x 10.0 x 6.0 cm and weighed 550 grams. The kidney itself measured 7.0 x 6.0 x 3.5 cm and was submitted with Gerota\u2019s fascia. The ureter, renal artery, and renal vein were identified, with the ureter measuring 10.0 x 0.5 cm, the renal artery 1.5 x 0.4 cm, and the renal vein 1.5 x 0.8 cm. A nodule measuring 3.0 x 3.5 x 4.0 cm was identified in the lower pole of the kidney with a variegated gray/brown cut surface. The tumor appeared confined to the kidney without involvement of the capsule. Cortical thickness was 1.2 cm and medullary thickness was 1.7 cm. Approximately 1.5 x 1.5 cm of tumor tissue and two slices of normal kidney parenchyma (each 1.2 x 4.0 x 4.0 cm) were procured for further examination.\n\nMicroscopic evaluation showed a unifocal lesion with nuclear grade 2 features. Histologic type was consistent with chromophobe morphology. No vascular or ureteral margin involvement was observed. The adrenal gland was not identified, and no lymph nodes were grossly identified. Sections were submitted for analysis, including margins, tumor mass, perirenal fat, and normal kidney tissue. The primary tumor stage was classified as pT1a. Regional lymph node and distant metastasis staging could not be assessed (pNx)."} +{"pid": "TCGA-66-2757", "report": "The resected left upper lobe of lung weighed 232g and measured 190 x 120 x 40 mm, with anthracosis of the pleura. A polycyclic, well-demarcated lesion was identified in the peripheral section of S1 extending to the segmental bronchi. It appeared grayish-white and hyaline, measuring up to 28 mm in maximum dimension. There was no evidence of pleural infiltration. The surrounding tissue showed a coarsened edge with possible honeycomb-like structures. Examination of hilar lymph nodes revealed several nodes containing blackish pigment but no signs of abnormal cellular involvement.\n\nTen lymph nodes were assessed: one measuring approximately 10 mm was described as torn; another measured 6 mm; a third consisted of grayish-black tissue totaling 20 mm; a fourth measured 5 mm; a fifth was a 4 mm fragment; a sixth measured slightly less than 10 mm; a seventh was 12 mm; an eighth measured 7 mm; and the smallest measured 2 mm. All displayed blackish pigment without indication of abnormal cell clusters.\n\nMicroscopic evaluation of the bronchial resection margin demonstrated normal architecture without abnormal cellular formations. In the hilar and peribronchial regions, lymph nodes showed anthracosis and mild histiocytosis without abnormal cellular infiltration. The lesion consisted of densely packed immature cells exhibiting fusiform morphology, marked nuclear-cytoplasmic disproportion, and frequent mitotic figures. Cytoplasmic borders were narrow. Necrosis was present along with desmoplastic stromal reaction. Subepithelial, intramural spread within a subsegmental bronchus was observed. Remaining pulmonary parenchyma appeared unremarkable.\n\nLymph node tissues across specimens revealed haemorrhage, moderate histiocytosis, and anthracotic pigmentation without abnormal cellular infiltration. Tissue margins were free of abnormal cells."} +{"pid": "TCGA-DJ-A1QM", "report": "The surgical specimen from a male patient included a right paratracheal lymph node and a total thyroidectomy. The lymph node specimen measured 0.6 x 0.4 x 0.2 cm, with a lymph node identified measuring 0.3 cm, which was entirely submitted for frozen section analysis. A total of two lymph nodes were examined in this region, and none showed evidence of involvement.\n\nThe thyroidectomy specimen weighed 28 grams. The right lobe measured 5.4 x 3.0 x 1.8 cm, the left lobe 5.5 x 3.5 x 2.5 cm, and the isthmus 0.8 x 0.8 x 0.3 cm. On sectioning, a nodule measuring 0.7 x 0.6 x 0.5 cm was identified in the left lobe. This lesion was white and firm. No other lesions were observed in either lobe. Additional findings included a separate focus measuring 0.25 cm in the right lobe. The surrounding thyroid tissue showed changes consistent with mild nodular hyperplasia.\n\nMicroscopic evaluation revealed a well-differentiated cellular pattern with no mitotic figures identified. There was no tumor necrosis observed. The stromal reaction was prominent. The lesion lacked a distinct capsule and did not demonstrate extension beyond the thyroid. Surgical margins were uninvolved. No adenomatous changes were noted in the adjacent thyroid tissue. One benign lymph node was identified in the thyroid specimen. Parathyroid tissue was not identified in the specimens submitted."} +{"pid": "TCGA-HT-A61A", "report": "The pathology report demonstrates a diffusely infiltrating glial neoplasm with moderately hypercellular areas. The tumor cells exhibit moderate atypia, round nuclei, and perinuclear halos are commonly observed. Sections show scattered MIB-1 reactive cells, with a calculated labeling index of 4.2% in the most proliferative regions. No mitotic figures, microvascular proliferation, or necrosis are identified."} +{"pid": "TCGA-BR-6456", "report": "The gastric resection specimen measured 8 x 6 x 1 cm and was described as ulcerated. Microscopic evaluation showed poorly to moderately differentiated features. The tumor involved adjacent structures, specifically the lesser omentum. Lymph node assessment revealed 2 out of 4 positive nodes within the intraabdominal region. No information was provided regarding lymphatic, venous, or perineural invasion, nor was there data on surgical margins, evidence of neoadjuvant treatment, or additional findings."} +{"pid": "TCGA-HZ-7926", "report": "The specimen consisted of a gallbladder and a pancreaticoduodenectomy. The gallbladder measured 10.5 x 5.0 x up to 2.5 cm and had a smooth, dusky purple serosa with a dark green, velvety mucosa. The lumen contained dark green viscous fluid without gallstones, and the wall was up to 0.5 cm thick. Four sections including the cystic duct margin were submitted.\n\nThe pancreaticoduodenectomy specimen included a distal stomach, a segment of small bowel measuring 16.0 cm in length and 4.0 cm in average diameter with attached mesentery, and an attached pancreatic portion measuring 8.5 x 5.5 x 3.5 cm. Within the pancreas, there was a well-defined pale tan-yellow mass measuring 3.5 x 3.2 x 3.0 cm. Grossly, this mass came within 0.1 cm of the retroperitoneal tissue margin (inked black), 1.0 cm from the pancreatic resection margin (inked blue), and at least 2.0 cm from the common bile duct margin. It surrounded the common bile duct, which remained probe patent despite narrowing. Proximal to the narrowing, the bile duct bifurcated and both lumens were dilated to 1.0 cm. The mass appeared to extend into the wall of the small bowel; the overlying mucosa, including the ampulla, was raised and granular over a 2.5 x 1.7 cm area and located 2.0 cm from the ampulla. The mass reached within 0.1 cm of the posterior outer surface of the pancreas (inked black). No additional masses were identified. The remaining pancreatic parenchyma was firm, tan-yellow, and lobulated. The mucosa of the small bowel and stomach appeared tan and glistening without mucosal-based masses. Multiple peripancreatic lymph node candidates were present, up to 0.8 cm in size. A larger lymph node candidate measuring 1.6 cm was noted adjacent to the bile duct margin, and within the perigastric adipose tissue were multiple lymph node candidates up to 0.4 cm. Fifteen representative sections were submitted for microscopic evaluation, including margins and lymph nodes.\n\nMicroscopic examination showed irregular glandular structures lined by cells with nuclear pleomorphism and nucleoli. These structures extended into the peripancreatic soft tissue and were less than 0.1 cm from the retroperitoneal margin. However, significant cautery artifact was noted in some retroperitoneal margin sections. The bile duct, proximal stomach, distal duodenum, and pancreatic margins were free of similar findings. Extension into the duodenum and ampulla was observed, with invasion beneath the mucosal surface of the ampulla evident in one section. Extensive perineural invasion was also noted. Sections of peripancreatic lymph nodes revealed similar findings in two of four lymph nodes examined. Other lymph node sections were unremarkable. In total, two of thirteen lymph nodes showed involvement.\n\nThe retroperitoneal surgical margin could not be fully assessed due to marked cautery effect, although no findings were directly identified at this margin. Lymphovascular space invasion was identified. Additional findings included chronic pancreatitis and chronic cholecystitis of the gallbladder. Staging according to TNM classification was pT3 pN1."} +{"pid": "TCGA-18-3411", "report": "The specimen includes multiple tissue samples from the pleura, lung, and lymph nodes. A wedge biopsy of the apical segment of the right lower lobe shows subpleural fibrosis and chronic inflammation, with no evidence of malignancy. An interlobar lymph node (ST11) is also negative for tumor involvement.\n\nA right upper lobe lung lobectomy with sleeve resection reveals a central lesion measuring 4.7 cm in greatest dimension. Histological evaluation shows poorly differentiated cellular features. Surrounding changes include chronic interstitial pneumonia and mucous plugging, consistent with obstructive pneumonitis. The lesion demonstrates extensive involvement of peribronchial lymph nodes. Evaluation of the bronchial and tracheal resection margins shows no evidence of involvement. The remaining lung tissue shows moderate to marked centroacinar emphysematous changes.\n\nLymph node assessment includes the right low paratracheal (ST4R), right TB angle (ST10R), and subcarinal (ST7) regions. Lymph nodes from ST4R, ST10R, and ST11 show evidence of involvement, with one of three nodes involved in the ST11 group. The subcarinal lymph node (ST7) does not show any signs of involvement.\n\nIntraoperative frozen section analysis of the apical segment confirms inflammatory changes without malignancy. Frozen sections of the bronchial and tracheal margins also show no evidence of involvement.\n\nGross examination of the right upper lobe specimen measures 14.0 x 10.5 x 6.7 cm. A defined mass measuring 4.7 x 2.5 x 2.5 cm is identified beneath an area of pleural fibrous adhesion. The mass has a grey-tan to tan-white cut surface with areas of necrosis. Adjacent areas of consolidation measure approximately 2.0 x 2.0 cm. The hilar region contains two tubular cartilaginous structures marked with sutures: a double suture marking the bronchial margin (1.0 cm diameter) and a single suture marking the tracheal margin (1.5 cm diameter). The surrounding soft tissue is firm and grey-tan in color, with India ink used to mark the periphery of these margins.\n\nSpecimens from other lymph node sites include: a 0.6 x 0.4 x 0.4 cm interlobar node (ST11); a 1.0 x 0.6 x 0.3 cm right low paratracheal node (ST4R); a 1.4 x 0.8 x 0.6 cm right TB angle node (ST10R); two interlobar nodes measuring 0.9 x 0.6 x 0.5 cm and 1.2 x 0.6 x 0.4 cm; and a 1.6 x 1.0 x 0.7 cm subcarinal lymph node. All specimens were fixed in buffered formalin and submitted in whole or in part for histological analysis.\n\nThe peribronchial tissue was marked with India ink and cross-sectioned. One section shows lymph node involvement extending to the painted radial margin. This finding should be interpreted in the context of the surgical procedure performed."} +{"pid": "TCGA-PC-A5DP", "report": "The specimen was received from a female patient and consisted of two tissue samples. The first sample, labeled \"#1 biopsy sacral promontory,\" was a soft, light-brown irregular tissue fragment measuring 0.3 x 0.3 x 0.2 cm. This specimen was entirely used for frozen section analysis, which confirmed the presence of a spindle cell neoplasm.\n\nThe second sample, labeled \"#2 infrarenal vena cava to right common iliac vein and left internal iliac vein,\" consisted of a large tan-pink, partially encapsulated mass weighing 269 grams and measuring 17 x 12 x 5 cm. The capsule was marked with black ink. Upon serial sectioning, the mass revealed a fleshy, soft to firm tan-pink cut surface with areas of focal hemorrhage. The tumor was found to completely obliterate the vessels. Sections from this specimen were submitted for cytogenetic testing and histologic examination. Margins evaluated included the right common iliac vein (2A), left internal iliac vein (2B), and vena cava (2C), along with additional sections (2D\u20132F).\n\nHistologic evaluation demonstrated a high-grade spindle cell proliferation. The tumor measured 17.0 cm and involved the left internal iliac vein margin. The vena cava and right common iliac vein margins showed no evidence of tumor involvement.\n\nCytogenetic analysis was attempted but unsuccessful. Despite fifteen days in culture, no metaphases were observed across ten slides, indicating failure of the cells to grow in culture."} +{"pid": "TCGA-FI-A2CY", "report": "The patient underwent a total abdominal hysterectomy with bilateral salpingo-oophorectomy, pelvic lymph node dissection, and omentectomy. The uterus weighed 133 grams and measured 8.5 x 5.5 x 4.0 cm. An exophytic polypoid lesion measuring 2.5 x 1.0 cm was identified on the anterior endometrial surface. Histologically, the lesion involved the endometrium without extension into the myometrium. The tumor exhibited a mixed growth pattern with both glandular and solid areas. Tumor cells displayed a high nuclear/cytoplasmic ratio and nuclear hyperchromasia. Immunohistochemical staining showed diffuse positivity for p16 and variable expression of p53. ER was weakly and diffusely expressed, while PR was only focally expressed.\n\nMultiple fibroids were present in the myometrium, the largest measuring 4.0 x 3.5 x 3.5 cm. No tumor was identified in the cervix, bilateral fallopian tubes, or ovaries. Pelvic and periaortic lymph nodes were examined; a total of 17 lymph nodes were negative for tumor involvement (4 from left external iliac, 4 from left obturator, 1 from right external iliac, 6 from right obturator, and 1 each from right and left periaortic regions). No lymphovascular space invasion was observed.\n\nThe omentum was unremarkable with no evidence of tumor. The abdominal scar specimen showed only fibrotic tissue without any identifiable lesions. Based on the findings, the tumor was confined to the endometrium without lower uterine segment or cervical involvement. The pathologic stage is consistent with T1a/N0/MX."} +{"pid": "TCGA-CV-A45Y", "report": "A male patient underwent a total laryngectomy and bilateral neck dissection. A mass was identified involving the right transglottic region and extending into the midline, glottis, and subglottis on the left side. The lesion measured 4.5 x 3.0 x 1.0 cm. Subglottic extension on the left measured 7.0 mm. Examination of the specimen revealed involvement of the perichondrium. Margins of excision were free of tumor.\n\nHistological evaluation showed invasive poorly differentiated cells with lymphatic and perineural invasion involving the right and left false vocal cords, right and left true vocal cords, and ventricles. The mucosal margin appeared grossly uninvolved. Ten lymph nodes from the right side were examined, all negative for tumor involvement. Two lymph nodes from the left side were also negative. Additionally, three lymph nodes from the left neck dissection were submitted and found to be tumor-free. A separate biopsy from the right epiglottic fold margin showed squamous mucosa without evidence of tumor.\n\nThe surgical specimen included fragments of soft tissue from both sides measuring up to 1.5 x 1.5 cm. All relevant tissue was submitted for examination. A portion of tan-pink-purple soft tissue measuring 0.4 to 0.2 cm was submitted for frozen section from the larynx, revealing invasive cellular changes. A separate fragment from the right epiglottic fold margin measuring 1.2 x 0.2 x 0.2 cm was submitted in toto and showed no tumor. Lymph nodes from the right and left neck dissections were entirely submitted for analysis."} +{"pid": "TCGA-EM-A2CQ", "report": "The specimen consisted of a total thyroidectomy with bilateral parathyroid biopsies and a right lower parathyroid biopsy. The thyroid specimen measured 5.7 cm x 2.4 cm x 1.5 cm on the right lobe, 5.2 cm x 3.1 cm x 1.7 cm on the left lobe, and 4.2 cm x 1.4 cm x 0.8 cm at the isthmus. The total weight was 35 grams. Two distinct nodules were identified: one in the left lobe measuring 1.8 cm x 1.5 cm x 1.5 cm and another in the isthmus measuring 1.5 cm x 1.1 cm x 0.8 cm. Both were well delineated. Histologically, both lesions demonstrated follicular architecture and classical cytomorphology. The dominant lesion was fully encapsulated without capsular invasion, lymphovascular invasion, perineural invasion, or extrathyroidal extension. Margins were uninvolved. A second lesion in the left lobe and isthmus showed similar features and was partially encapsulated. Margins were also uninvolved in this lesion, and no invasion or extrathyroidal extension was noted. Additional microscopic findings included multiple microcarcinomatous foci in both lobes, with one measuring 0.1 cm in the right lobe and at least three foci in the left lobe. Three regional lymph nodes were examined, with one showing metastatic involvement. No extranodal extension was observed. Immunohistochemical staining of a perithyroidal lymph node revealed two microscopic tumor deposits positive for TTF-1 and CK. All other findings were unremarkable. The parathyroid specimens from both the left and right sides showed no pathological findings."} +{"pid": "TCGA-EW-A3E8", "report": "The surgical pathology report includes findings from a left breast mastectomy and sentinel lymph node evaluation. The mastectomy specimen measured 18.0 x 12.0 x 6.0 cm and included a firm, white nodular lesion measuring 7.0 x 6.0 x 4.0 cm located in the upper outer quadrant and central region. The lesion was 1.0 cm from the deep margin, 4.0 cm from the upper margin, and 5.0 cm from the lower margin. Adjacent to this lesion was another irregular area likely related to a prior biopsy, measuring 6.0 x 5.0 x 3.0 cm. No other gross abnormalities were identified. The specimen showed a composition of approximately two-thirds stroma and one-third adipose tissue.\n\nMicroscopic evaluation revealed a high-grade lesion with a Nottingham Histologic Score of 8, corresponding to Grade 3. The histologic features included less than 10% glandular or tubular differentiation (score 3), marked nuclear pleomorphism with vesicular nuclei and prominent nucleoli (score 3), and a low mitotic count (score 1). No lymphovascular invasion was identified. Margins were free of involvement by invasive disease. Lobular carcinoma in situ was also present.\n\nImmunohistochemical staining of the lesion showed positivity for estrogen and progesterone receptors (>90%) and no reactivity for HER2 (0+). Two sentinel lymph nodes were evaluated; each was negative for malignancy on initial frozen section and subsequent permanent section with hematoxylin and eosin staining. Immunohistochemistry for keratin was also negative in both nodes. No metastatic deposits were found in the lymph nodes examined.\n\nStaging based on pathological findings indicated a primary tumor size greater than 50 mm (pT3) with no regional lymph node involvement (pN0). Distant metastasis could not be assessed."} +{"pid": "TCGA-66-2765", "report": "**Summary of Pathology Findings:**\n\nThe specimen includes left lower lobe lung tissue and associated lymph nodes. Gross examination identified a subaortic lymph node (station unspecified) measuring 1.5 cm with grayish-black discoloration and firm consistency. A lobar lymph node (station 12) measured 2.2 cm and showed dark section surfaces. The left lower lobe measured 10.5 x 7.5 cm at the base and up to 3 cm in length, with signs of prior stapling. A pleural lesion or residual adhesion was noted in the polar region. Centrally, there was a 2 cm area of whitish discoloration with ill-defined borders and a puckered appearance. Beneath this region, a solid pale brownish-white lesion up to 3.8 cm in size was observed with relatively clear margins, extending to the pleura. Within this lesion was an eccentric cavity measuring up to 2.8 cm with irregular shape and internal trabecular structures. The tumor was at least 0.5 cm away from the staple line. Surrounding lung parenchyma showed a pale subpleural band up to 0.5 cm wide with mild firmness. A paraesophageal lymph node (station 8) measured 5 cm and appeared elongated with dark internal surfaces. A prevascular and retrotracheal lymph node (station 3) measured 0.6 cm and included surrounding tissue.\n\nMicroscopic evaluation of lymph nodes revealed significant pigment deposition, fibrosis of varying degrees, and hyaline thickening in one node. Histological analysis of the lung lesion showed poorly differentiated cellular features with large-cell morphology and focal clear-cell changes. There was evidence of chronic inflammation related to the lesion. Additional findings included respiratory bronchiolitis with minor interstitial fibrosis, emphysematous remodeling of the lung stroma particularly at the periphery, and low-grade anthracotic pigment deposition. Chronic active pleuritis with fibrosis was present overlying the lesion. Lymph nodes also demonstrated anthracotic pigmentation, small foreign particle aggregates, reactive follicular hyperplasia, and areas of nodular and diffuse hyaline fibrosis.\n\nStaging assessment indicated involvement of regional lymph nodes with limited invasion into adjacent pleura, and negative resection margins."} +{"pid": "TCGA-4V-A9QN", "report": "The resection specimen weighed 195 grams and measured 13 cm x 11 cm x 6.5 cm. It was adhered to a pulmonary resection measuring 10 cm x 3.5 cm x 3 cm. Upon sectioning, a large whitish mass was identified within the thymus, measuring 8 cm x 10 cm x 7 cm. The mass had a lobulated appearance and was adhered to the lung, with no visible cysts or necrosis.\n\nMicroscopic evaluation of samples from the entire surface showed a consistent pattern. The thymic parenchyma, still identifiable in certain sections, contained a large lobulated structure separated by thick fibrous septa. The cellular composition included large polygonal cells with eosinophilic cytoplasm, lacking squamous architecture or intercellular bridges. Nuclei were large, centrally or paracentrally located, occasionally with nucleoli, but without significant atypia or malignant features. These cells formed a regular palisading arrangement around numerous clear spaces. The lymphocytic component was minimal. The peripheral fibrous capsule was often thickened, though in some areas, the structure extended into adjacent mediastinal tissues, including adipose tissue and lung parenchyma, without a clear cleavage plane.\n\nImmunohistochemical analysis revealed that the epithelial cells were positive for cytokeratins 19, 5/6, 7, and AE1/AE3, and negative for cytokeratin 20, CD5, CD20, and TTF1. Proliferative index (Ki67) was less than 5%. Intraepithelial lymphocytes expressed CD1a, CD4, and CD8, consistent with immature T cells. There was no expression of CD99 or CD117.\n\nThe excision was complete, and the case was reviewed by Dr. [Name]."} +{"pid": "TCGA-34-5240", "report": "The surgical specimen from the left upper lobe resection includes a lesion measuring 5.0 cm in diameter. Histologic evaluation reveals moderately differentiated features with basaloid characteristics. There is no evidence of visceral pleural or angiolymphatic invasion, and all surgical margins are free of involvement. A mild host lymphocytic response is noted. Lymph node assessment shows that one of fifteen N1 lymph nodes contains metastatic involvement, while N2 lymph nodes show no signs of disease. The pathologic staging is T2N1MX.\n\nA total of sixteen lymph node biopsies were examined from various locations, including subinnominate, subcarinal, right tracheal bronchial, right paratracheal, left tracheal bronchial, inferior pulmonary ligament, anterior hilar, and apical window regions, as well as periaortic and additional hilar sites. All lymph nodes show reactive changes. One lymph node from the left tracheal bronchial region contains an old fibrocalcific nodule. Another lymph node from the inferior pulmonary ligament shows an old fibrocalcific granuloma. No evidence of malignancy is identified in any of the lymph nodes evaluated. Special stains for microorganisms are negative, and correlation with culture results is recommended.\n\nAdditional findings in the lung tissue include respiratory bronchiolitis with emphysematous change, a pulmonary apical cap, and benign carcinoid tumorlets."} +{"pid": "TCGA-49-4505", "report": "The specimen from the right lower lobe shows a well-differentiated infiltrating carcinoma measuring 5.5 cm in greatest dimension. The lesion extends through the visceral pleura. One of six lymph nodes examined contains metastatic carcinoma. All bronchial and vascular margins are free of tumor involvement. A separate wedge resection from the right upper lobe demonstrates a cavitary fibrotic cyst, colonized by branching hyphal fungal forms consistent with Aspergillus; no tumor is identified in this component. Another wedge resection from the right upper lobe reveals a well-differentiated infiltrating carcinoma measuring 1.5 cm."} +{"pid": "TCGA-KS-A4IB", "report": "A 25-gram total thyroid specimen was received, consisting of a right lobe measuring 4.7 x 2.7 x 1.3 cm and a left lobe measuring 4.6 x 3.6 x 2.6 cm. The right lobe is marked with blue ink and the left lobe with black ink. The thyroid is partially surrounded by a tan-grey capsule. On sectioning, the parenchyma appears red-brown and granular. Within the left lower pole, there is a 3.2 x 2.6 x 1.7 cm brown-tan mass with unclear borders that extends toward the upper pole and reaches the capsule. The center of this lesion shows necrosis and cystic change.\n\nSections submitted include the right lobe (superior to inferior), isthmus, and left lobe (superior to inferior including the lesion). Additionally, an aggregate of yellow adipose tissue measuring 2.1 x 2.1 x 1.2 cm was received, containing multiple possible lymph nodes up to 1.1 cm in size. Several of these were bisected.\n\nHistologic evaluation revealed no vascular invasion and negative margins. Capsular invasion was noted. In the neck soft tissue specimen from level VI, two of seven lymph nodes showed involvement without extranodal extension. Mild lymphocytic thyroiditis was also observed."} +{"pid": "TCGA-CZ-5469", "report": "The surgical pathology report describes findings from a left radical nephrectomy specimen. A large mass measuring 11.3 cm in greatest dimension is identified within the kidney. The mass is poorly circumscribed, lobulated, and exhibits areas of hemorrhage and cystic change. It is located near the renal vein margin (2.2 cm distance), ureter margin (10.6 cm distance), and renal artery margin (2.4 cm distance), and grossly contacts the renal capsule but does not appear to invade it. Histologically, the tumor demonstrates features consistent with Fuhrman nuclear grade II out of IV. No lymphovascular invasion is observed, and no tumor involvement is identified in the renal vein or ureteral margins.\n\nStaging according to the AJCC 6th edition criteria is T2 NO MX. Evaluation of regional lymph nodes includes one hilar lymph node measuring 2.6 cm that shows sinus histiocytosis and follicular hyperplasia without evidence of tumor involvement. Fifteen additional small hilar lymph nodes are also negative for tumor.\n\nGross examination of the specimen reveals a total weight of 1371 grams. The kidney measures 31.0 x 14.0 x 8.0 cm and includes perirenal fat ranging from 2.0 to 2.5 cm in thickness. Sections of the tumor were submitted for cytogenetic analysis, tissue banking, and further evaluation by special laboratories. Adjacent renal cortex appears tan to brown with a well-defined corticomedullary junction. The renal pelvis and calyces are lined by smooth glistening mucosa. No lymph nodes are identified within the adipose tissue examined.\n\nCytogenetic analysis of two tumor samples reveals similar chromosomal aberrations including add(3)(p21), which is commonly associated with certain renal neoplasms. Six metaphases were analyzed using GTG banding techniques at a resolution of 400 bands or greater. Findings indicate mosaicism or heterogeneity within the tumor sample."} +{"pid": "TCGA-IB-7654", "report": "The specimen consists of four parts. \n\nPart A is a tan to brown irregular tissue fragment measuring 0.7 cm in greatest dimension. It was submitted entirely for examination. \n\nPart B consists of 8 tan to black irregular tissue fragments, each measuring approximately 1.0 cm in greatest dimension. All were submitted entirely. \n\nPart C is an intact gallbladder measuring 6.5 x 3.0 x 2.0 cm. The serosal surface is smooth and glistening. Upon opening, the lumen contains clear mucinous bile and two yellow-green calculi, each about 1.5 cm in size. The mucosa appears tan and rough with a wall thickness of 0.3 cm. The cystic duct is patent, and no lymph node was identified at the cystic duct margin. Three representative sections of the gallbladder were submitted. \n\nPart D includes a segment of small bowel and attached pancreas. The bowel measures 24.0 cm in length with a 6.0 cm average circumference. The attached pancreatic head is firm and measures 5.0 x 4.0 x 3.5 cm. Two small black nodular structures (likely lymph nodes) are present near the bile duct margin, each measuring 0.5 cm. A dark tan exophytic mass measuring 1.5 x 1.0 cm is present at the ampulla of Vater, with the remainder of the bowel mucosa appearing unremarkable. Sectioning the pancreatic head reveals a tan fibrotic mass with cystic areas measuring 2.5 x 2.0 x 3.0 cm. The cyst contains clear mucin and ranges from 0.2 to 0.3 cm in size. The bile duct shows evidence of involvement by this mass, though the most distal portion appears unaffected. Sections include the pancreatic margin, bile duct margin, proximal and distal margins, longitudinal sections through the bile duct and ampulla, sections from the pancreatic mass and surrounding area, and three lymph nodes. Additional sections of bowel mucosa above and below the ampulla are also included."} +{"pid": "TCGA-5P-A9K6", "report": "The specimen shows a moderately differentiated neoplasm with multi-focal presentation. The primary lesion measures 1.0 cm in greatest dimension. Histologic evaluation reveals cells arranged in a papillary pattern with nuclear features consistent with intermediate grade. Surgical margins are negative. Based on size and extent, the stage is classified as pT1a."} +{"pid": "TCGA-DX-AB2H", "report": "The surgical specimen consists of a radical resection involving multiple anatomical structures. The main mass measures 15.1 x 8.3 x 6.5 cm and is tan-yellow with a lobulated appearance. It has a pseudocapsule and smooth outer surface. Upon sectioning, it reveals tan-grey multicystic areas with extensive necrosis, which accounts for approximately 30% of the tumor volume. The tumor involves a segment of small bowel transmurally, with an intraluminal component measuring 5.5 x 5.1 x 3.9 cm located 6.8 cm from one margin. Adjacent to this, there is a separate tumor fragment measuring 8.5 x 5.4 x 3.9 cm attached to a gastric segment. This fragment exhibits yellow-white cut surfaces consistent with fatty tissue.\n\nHistologically, the tumor associated with the small and large bowel demonstrates undifferentiated round and plump spindle cell morphology with scattered hemangiopericytoma-like patterns. Necrotic areas are widespread within this component. The gastric-associated tumor fragment shows similar histologic features but lacks areas of dedifferentiation.\n\nThe small bowel segment measures 45.1 cm in length with a maximum circumference of 7.1 cm. Two arbitrarily labeled margins were identified. The large bowel segment measures 50 cm in length with a maximum circumference of 11.2 cm; however, no tumor involvement was observed in this segment. A small fragment of pancreatic tissue measuring 2.1 x 2.0 x 1.9 cm was found adjacent to the small bowel and showed no tumor involvement. The spleen specimen measured 6.9 x 6.1 x 3.5 cm with dark-red homogenous cut surfaces and no tumor involvement.\n\nA separate specimen consisting of a proximal jejunal segment was received. It measures 7.2 cm in length and 4.0 cm in circumference. The mucosa appeared unremarkable, and no tumor was identified upon histological examination. Serosal fibrous adhesions and multifocal serositis were noted.\n\nMargins were evaluated microscopically and included anterior and posterior aspects of the main tumor, small and large bowel margins, stomach wedge segments, and splenic tissue. Representative sections were submitted for analysis. No tumor was identified in the jejunal specimen."} +{"pid": "TCGA-BP-4962", "report": "The submitted specimen from the left lower pole heminephrectomy weighs 937 grams and measures 20.0 x 15.0 x 7.5 cm, including attached fat. The renal portion measures 8.5 x 6.0 x 4.5 cm. A variegated yellow and focally hemorrhagic mass is identified, measuring 8.5 x 5.4 x 4.5 cm. Grossly, the mass invades the renal capsule and extends into the perinephric fat, but does not extend beyond Gerota's fascia. The tumor comes within 0.6 cm of the deep parenchymal margin and 1.5 cm of the inked external fat margin. No gross tumor is evident at the superior cauterized surgical margin. The adjacent renal parenchyma appears tan-brown without significant abnormalities. No renal pelvis or adrenal gland is identified. Representative sections of the tumor and surrounding tissue have been submitted for analysis. Microscopic evaluation reveals cells positive for CD10, Vimentin, EMA, and focally for E-cadherin. No lymph nodes or additional significant findings are noted. The tumor is staged as pT2 based on size greater than 7.0 cm in greatest dimension and remains confined within Gerota's fascia."} +{"pid": "TCGA-B6-A0RH", "report": "The clinical specimen consists of a left modified radical mastectomy. The skin specimen measures 18.8 x 8.4 cm and includes an unremarkable areola and nipple without skin lesions, scars, nipple retraction, or peau d\u2019orange changes. Underlying the skin is breast tissue measuring 16.3 x 15.2 x 3.3 cm with an attached axillary tail measuring 12.0 x 8.5 x 1.7 cm. A mass measuring 2.5 x 2.5 x 2.0 cm is identified beneath the skin at the medial edge of the areola. The mass is firm, white, well-defined but shows diffuse infiltration into surrounding fat along its outer edges. Its cut surface is homogeneous and white with no gross necrosis. The tumor is located within 1.2 cm of the deep surgical margin. Portions of the mass were submitted for receptor analysis and tissue banking.\n\nMicroscopic evaluation reveals a predominant cribriform pattern in the infiltrating component. Tumor cells demonstrate moderately pleomorphic nuclei with prominent nucleoli. Mitotic figures range from 2\u20133 per high power field. Lumina formed by the carcinoma often contain small numbers of necrotic tumor cells; however, classic comedo necrosis is not present throughout. In some areas, a minor component of infiltrating tubular carcinoma is observed. A desmoplastic stromal reaction accompanies the neoplasm. Malignant cells are seen within lymphatic vessels adjacent to the tumor. Intraductal carcinoma with cribriform and papillary features is present focally near the main lesion. In a section from the upper outer quadrant (Block A11), a focus of atypical ductal hyperplasia is noted, without evidence of invasive or intraductal carcinoma at that site.\n\nSections from multiple regions of the breast were examined. No tumor was identified in 23 axillary lymph nodes evaluated across three levels. Additional benign findings include sclerosing adenosis, microcalcifications, blunt duct adenosis, papillary apocrine metaplasia, and duct ectasia."} +{"pid": "TCGA-A4-8310", "report": "The specimen was received in three containers. Container A, labeled as \"peritumor fat,\" contained two fibrofatty soft tissue samples measuring 1.1 x 0.7 x 0.4 cm and 2.0 x 1.0 x 0.4 cm respectively; no nodules or lesions were identified. Both specimens were entirely submitted for evaluation.\n\nContainer B, labeled \u201cPosterior margin #1,\u201d contained two small soft tissue fragments each measuring 0.3 cm in greatest dimension. These tissues were submitted for frozen section analysis and subsequently resubmitted for permanent section evaluation.\n\nContainer C contained a partially fragmented partial nephrectomy specimen measuring 3.0 x 2.5 x 2.5 cm. The deep margin showed pink-tan normal-appearing renal parenchyma without tumor involvement. The specimen was partially encapsulated by renal capsule and Gerota\u2019s fascia. An extruded tan-orange mass measuring 4.0 cm in greatest dimension was identified within the kidney. This lesion extended to the inked capsular surface and was located 0.7 cm from the parenchymal margin. No additional lesions were observed. The specimen was entirely submitted across seven cassettes with specific orientation noted.\n\nHistologic examination of the kidney specimen revealed a unifocal lesion limited to the kidney, with microscopic extension beyond the renal capsule. The nuclear grade was Fuhrman grade 2 out of 4. No lymphovascular space invasion or sarcomatoid features were observed. Surgical margins were negative for tumor, although tumor cells were present at the inked capsular surface. No lymph nodes were submitted for evaluation.\n\nThe neoplasm exhibited papillary architecture with areas of interstitial macrophages and focal clear cell change. All permanent sections confirmed the intraoperative frozen section diagnosis. Specimens were reviewed and findings were concordant upon expert consultation. \n\nNo tumor was identified in the posterior margin biopsy or in the peritumor fat tissue."} +{"pid": "TCGA-E7-A5KF", "report": "Gross Description: A specimen from the bladder shows an invasive and protruding lesion with poorly defined margins, measuring 2.5x2x2cm. The surface is soft and gray in appearance. Microscopic examination reveals hyperplastic transitional cells arranged in papillary and trabecular patterns. The cells exhibit moderate amounts of eosinophilic cytoplasm, with nuclei that are enlarged and display variation in both shape and size. Irregular nuclear contours, prominent nucleoli, and abnormal chromatin distribution are noted. Mitotic figures are present. The lesion extends into the superficial muscularis propria. Specimen type is cystectomy, with the site being the bladder. The histologic type is consistent with transitional cell morphology, moderately differentiated. The extent of involvement includes the inner half of the muscle layer. Margins are uninvolved, and no lymphatic invasion is identified. No other significant features or additional findings are noted."} +{"pid": "TCGA-22-4613", "report": "The resected left upper lobe lung tissue weighed 100 grams and measured 15.0 x 7.5 x 5.0 cm. A nodule measuring 2.3 x 2.0 x 1.3 cm was identified. The pleura showed no involvement, and the distance from the tumor to the bronchial margin was 4.5 cm. Examination of the bronchial resection margin and four intrapulmonary peribronchial lymph nodes revealed no evidence of tumor. Additional lymph nodes from the superior and inferior mediastinal regions, aortic area, and N1 stations were evaluated. These included two left lower paratracheal, six subaortic, one para-aortic, fourteen subcarinal, two left pulmonary artery, one interlobar, and one lobar lymph nodes, all of which were negative for tumor. The cellular morphology showed high-grade features."} +{"pid": "TCGA-05-4433", "report": "The lesion is located in the peripheral bronchopulmonary region and exhibits a predominantly bronchioloalveolar growth pattern with widespread involvement. A minor component demonstrates a more aggressive, infiltrative morphology. The tumor measures approximately 3 cm in diameter and is classified as pT2. There is no evidence of lymph node involvement (pN0), and distant metastasis cannot be assessed (pMX). The surgical margins, including bronchial and vascular resection margins, are free of tumor, and all retrieved lymph nodes show no signs of malignancy. The lesion does not involve the visceral pleura."} +{"pid": "TCGA-CV-5434", "report": "A total laryngectomy specimen with bilateral neck lymph node dissection and left thyroidectomy was submitted. The specimen measured 11.0 x 11.0 x 5.0 cm in total. Attached to the specimen was a left thyroid lobe measuring 3.0 x 2.0 x 1.5 cm. A tracheostomy was present. An ill-defined tan firm area measuring 5.0 x 2.0 cm was identified at the left pyriform sinus, extending into the left aryepiglottic fold. This lesion extended into cartilaginous tissue. The closest margin on the left pharyngeal mucosa was 0.4 cm from the lesion, with additional margin tissue submitted separately. The right pharyngeal mucosa margin was 1.0 cm away from the lesion.\n\nSections were taken from multiple areas including the lateral and medial aspects of the lesion, margins, vocal cords, tracheal margin, and thyroid gland. Bone and cartilage samples were sent for decalcification.\n\nLymph node dissection included levels II, III, and IV bilaterally. On the left side, a total of 25 lymph nodes were examined, with 7 showing involvement. Of these, 4 out of 10 level II lymph nodes, 3 out of 5 level III lymph nodes, and none of 7 level IV lymph nodes showed involvement. Extracapsular extension was noted in some lymph nodes. On the right side, 13 lymph nodes were examined (5 in level II, 6 in level III, and 2 in level IV), none of which showed involvement.\n\nSeparate specimens included a piece of left base of tongue mucosa measuring 3 x 0.5 x 0.3 cm and a piece of left pharyngeal wall mucosa measuring 7 x 3 x 0.2 cm; both were free of tumor. Frozen section analysis confirmed absence of tumor in these specimens."} +{"pid": "TCGA-A5-A0G1", "report": "The specimen consists of a uterus with attached cervix and bilateral fallopian tubes and ovaries, along with omental biopsies, lymph node samples, and right gutter tissue. The uterus measures 8.5 cm in length from ectocervix to fundus, 8 cm across the cornua, and 5 cm anterior to posterior. Multiple leiomyomas are present, including subserosal, intramural, and submucosal types, with sizes ranging from 0.2 x 0.2 x 0.2 cm up to 4.5 x 4 cm. The endometrial cavity is distorted by these myomas, and the endometrium is otherwise thin. A polypoid lesion measuring 2 x 1.5 x 0.8 cm arises from the posterior endometrium near the fundus; it has a pink-tan color and granular surface. On gross examination, no clear invasion into the myometrium is evident.\n\nMicroscopically, the polypoid lesion exhibits solid, micropapillary, acinar, and fused acinar growth patterns. Areas of clear cell change are noted focally, and some cells show cytoplasmic features suggestive of mucin. A dense lymphoplasmacytic infiltrate is present within the tumor, making assessment for vascular or lymphatic invasion difficult, though neither is definitively identified. At the base of the lesion, there is focal invasion into the very superficial myometrium, with maximum depth significantly less than one-fourth of the myometrial thickness.\n\nThe remainder of the endometrium shows focal glandular hyperplasia with tubular, cystic, and ciliated metaplastic glands. Adenomyosis is present, with focal cystic change. The cervix demonstrates mild chronic inflammation, several nabothian cysts, focal microglandular hyperplasia, and tubal or ciliated metaplasia in occasional endocervical glands. No tumor is identified in the cervix, parauterine vessels, adnexae, or soft tissues.\n\nBoth ovaries show findings consistent with thecosis, along with corpora albicantia, dystrophic cortical calcifications, and small cysts. A small fibrothecoma is present in the right ovary, and a small dermoid cyst containing respiratory and apocrine-type epithelium, seromucinous glands, and a histiocytic reaction is found in the left ovary. The fallopian tubes show only minor changes, including a mild chronic inflammatory infiltrate in the mucosa of the right tube.\n\nOmental biopsies consist of yellow-tan adipose tissue without gross lesions. Microscopically, they show small foci of fibrosis, few lymphoid aggregates, and reactive mesothelial cell hyperplasia. No metastatic carcinoma is identified in the omentum, cervix, fallopian tubes, ovaries, or peritoneal biopsies. Lymph nodes from the pelvic, periaortic/precaval, and right gutter regions are all negative for tumor involvement. Sections of parametrial vessels, myometrium, and other uterine wall components do not reveal tumor spread beyond the endometrial region."} +{"pid": "TCGA-CV-A465", "report": "A segment of lingual nerve was negative for abnormal cellular proliferation. A right partial glossectomy specimen included a lesion measuring 2.8 cm in greatest dimension with ulceration of the mucosa. The lesion demonstrated infiltrative borders composed of thick cords greater than four cells in thickness. Invasion was present with depth of 1.3 cm. Perineural invasion was identified focally. No vascular invasion was observed. Margins evaluated at multiple sites\u2014including dorsal tongue, anterior tongue, ventral tongue, anterior floor of mouth, posterior floor of mouth, posterior tongue, and deep tongue\u2014were all negative for abnormal cells.\n\nLymph node dissections were performed on the right neck at levels I (including sublevels A and B), II, III, and IV. In total, 53 lymph nodes were examined across all levels: 7 in level I (A and B), 16 in level II, 9 in level III, and 21 in level IV. All lymph nodes were negative for involvement. Benign salivary gland tissue was also identified in level I.\n\nAdditional specimens included dental extractions with associated bone and soft tissue; these were assessed grossly only. No high-risk human papilloma virus genotypes were detected in tested tissues. All margins and lymph nodes were negative for involvement."} +{"pid": "TCGA-D1-A16X", "report": "The specimen consisted of a uterus with bilateral tubes and ovaries, weighing 120 grams. The uterine serosa appeared smooth. A mass measuring 2.3 x 2.0 x 0.8 cm was identified in the right posterior region of the endometrial cavity. The myometrium measured 2.2 cm in thickness at the site of the mass, with evidence of 0.4 cm depth of invasion. No involvement was observed in the lower uterine segment or cervix. Both ovaries were unremarkable; the right ovary measured 2.6 x 1.5 x 1.0 cm with a smooth solid cut surface and was associated with a 3.1 x 0.5 cm fallopian tube. The left ovary measured 3.2 x 1.1 x 1.0 cm with a smooth outer surface and solid cut appearance, accompanied by a 5.1 x 0.5 cm fallopian tube.\n\nA separate specimen from the lower anterior cervix margin, measuring 2.6 x 0.5 x 0.4 cm, showed no abnormality.\n\nLymph node dissections included multiple left pelvic lymph nodes (6 external iliac, 2 internal iliac, 5 common iliac, and 5 obturator), all without evidence of tumor. Similarly, multiple right pelvic lymph nodes (7 external iliac, 5 internal iliac, 4 common iliac, and 12 obturator) were free of tumor involvement. Para-aortic lymph nodes above and below the inferior mesenteric artery (6 left and 8 right above; 6 left and 6 right below) were also negative for tumor. Examination of both left and right gonadal vessels revealed no tumor presence.\n\nAll lymph node specimens were submitted in entirety, with no lymphatic tissue identified grossly in some sections. Margins of excision from the cervix were also negative for any abnormal findings. Tissue blocks were processed from various anatomical regions including the endometrium, cervix, myometrium, fallopian tubes, ovaries, lymph nodes, and gonadal vessels."} +{"pid": "TCGA-CM-5868", "report": "The specimen consisted of a resected segment of colon measuring 9 cm in length and 2.5 cm in average diameter. The tumor was located 10 cm from the proximal margin and 5 cm from the distal margin. It measured 5 cm in length and 4.5 cm in width. Invasion extended through the bowel wall into the pericolonic fat and reached the serosal surface, with a maximal depth of invasion of 2 cm. The radial margin measured 4 cm from the closest point of tumor involvement. No gross perforation was identified. Lymphovascular invasion was suspected, large venous invasion was present, and perineural invasion was also noted. Surgical margins were free of tumor involvement.\n\nA total of 17 lymph nodes were examined; one showed evidence of metastasis. Tumor deposits were identified in the pericolorectal soft tissue surrounding the specimen. Chronic inflammatory changes were seen in the gallbladder along with cholelithiasis. Two lymph nodes from the Callot and hepatic artery regions were each found to be benign. Both fallopian tubes and ovaries were unremarkable, with the right side showing a paratubal cyst. Proximal and distal colonic ring specimens were histologically benign.\n\nHistologic evaluation revealed moderately differentiated cellular features with extensive budding. No increased tumor-infiltrating lymphocytes were observed. A precursor lesion consistent with tubular adenoma was identified. Stromal reaction and desmoplasia were present. Based on AJCC 7th Edition staging criteria, the tumor stage was classified as pT4a (involving the visceral peritoneum), and the lymph node stage was N1 (1\u20133 regional lymph nodes involved)."} +{"pid": "TCGA-N9-A4Q1", "report": "The specimen includes a uterus measuring 14.0 x 7.0 x 6.0 cm with attached right fallopian tube and ovary. A mass measuring 11.0 x 6.0 x 6.0 cm is present in the uterus, involving the anterior and left lateral wall of the mid and lower uterine segment as well as the upper endocervical canal. The mass connects to a polypoid lesion located at the superior aspect of the fundus. The distance from the mass to the exocervix is 1.5 cm. In the cervix, the tumor involves both anterior and posterior glands and stroma, with maximal cervical invasion measuring 15 mm (total cervical thickness 18 mm). The tumor invades the myometrium to a depth of 17 mm (myometrial thickness 29 mm). At the mid uterine segment, the tumor involves 1.0 cm of the myometium, where the myometrial thickness is 2.0 cm. The mass reaches within 0.3 cm of the deep cervical margin and 0.6 cm from the deep resection margin at the lower uterine segment.\n\nMultiple leiomyomas ranging from 1.2 to 2.0 cm in diameter are present in the myometrium. These nodules show no hemorrhage or necrosis on cut surface. The endometrium between the mass and the polypoid lesion appears normal. No tumor is identified in the right ovary; however, a parovarian cyst measuring 1.0 cm is noted. The right fallopian tube shows no significant findings. The left fallopian tube demonstrates mild epithelial hyperplasia and contains a paratubal cyst. The left ovary was not submitted.\n\nA segment of the right vaginal margin (4.5 x 1.0 x 0.5 cm) shows no tumor involvement. Omental biopsy consists of adipose tissue without evidence of tumor. Lymph node evaluation includes multiple pelvic and para-aortic sites. All lymph nodes examined from the left pelvic, left obturator, left common iliac, left para-aortic, left high para-aortic, right para-aortic, and additional left pelvic regions show no tumor involvement. One right para-aortic lymph node group reveals endosalpingiosis.\n\nHistologic assessment reveals cellular features including a sarcomatous component arising from an endometrial polyp. Lymphovascular invasion is present. Leiomyomata are confirmed in the myometrium. No tumor is found in the right ovary or fallopian tube. The left fallopian tube contains a paratubal cyst."} +{"pid": "TCGA-MM-A564", "report": "The right kidney specimen weighed 920 grams and measured 21.0 x 14.8 x 7.0 cm. It included attached perinephric fat, a segment of ureter measuring 6.0 x 0.3 cm, a portion of renal artery measuring 1.5 x 0.5 cm covered by a 2.0 cm staple line, and a segment of renal vein measuring 1.0 x 0.9 cm covered by a 2.5 cm staple line. The Gerota's fascia margin was marked with black ink. Upon bisection, the kidney measured 15.0 cm from superior to inferior, 8.0 cm from medial to lateral, and 5.0 cm from anterior to posterior. A mass measuring 7.5 x 6.5 x 5.0 cm was identified in the inferior pole. The cut surface of the mass was tan-brown to focally tan-red, hemorrhagic, and focally necrotic. It occupied nearly the entire inferior pole, displaced the adjacent urothelium, and appeared confined to the kidney. The mass was located 1.2 cm from the hilum, 4.5 cm from the renal artery margin, 4.5 cm from the renal vein margin, 14.0 cm from the ureteral margin, and 0.7 cm from the Gerota's fascia margin. No other lesions were observed. The remaining renal parenchyma showed normal architecture with tan-brown coloration and distinct pyramids. The urothelium appeared tan, smooth, and unremarkable. No lymph nodes were found in the perihilar region.\n\nMicroscopic evaluation showed a unifocal lesion limited to the kidney. Histologic features included cells with clear cytoplasm and a Fuhrman nuclear grade of 2. There was no evidence of sarcomatoid differentiation, tumor necrosis, or lymphovascular invasion. All surgical margins were free of involvement. Pathologic staging indicated the primary tumor as pT2a, with no regional lymph node involvement (pNX) and no distant metastasis. Sections submitted for analysis included margins of the renal artery, renal vein, ureter, Gerota\u2019s fascia, hilum, and adjacent urothelium, along with representative areas of the mass and normal renal tissue."} +{"pid": "TCGA-E9-A226", "report": "The left-sided breast specimen involved the lower inner quadrant and was submitted as a radical mastectomy. A grossly evident lesion measured 2.7 x 0 x 3.2 cm and was located in the lower inner quadrant. Histologic evaluation revealed a moderately differentiated infiltrative growth pattern with involvement of the skin. Axillary lymph node assessment identified 6 out of 10 nodes containing metastatic involvement. The surgical margins were uninvolved. Additional features including tubule formation, nuclear pleomorphism, and mitotic counts were not specified, precluding a definitive Nottingham Histologic Score. There was no information provided regarding prior treatment or other significant pathologic findings."} +{"pid": "TCGA-63-A5MP", "report": "The tissue sample was collected from the right lower lobe and measured approximately 6.2 cm in size. Histological examination revealed malignant cells with squamous differentiation, classified as grade II. The tumor was staged pathologically as T2, N1 with no clinical evidence of distant metastasis (M0). No diagnosis or specific tumor type was identified in the report. A buffy coat sample was also collected, though details regarding its analysis were not provided."} +{"pid": "TCGA-XU-A92U", "report": "The specimen consists of a thymic gland with a long stitch at the left upper pole. The overall specimen measures 19 cm in length by 6 cm in width and 3.0 cm in depth. A firm, lobulated mass is identified within the mid to inferior portion of the gland, measuring 5.5 cm in length, 3.5 cm in width, and 2.2 cm in depth. On gross examination, the mass appears multinodular, firm, and homogeneously tan in color. The remaining thymic tissue appears unremarkable on cut surface evaluation.\n\nMicroscopic examination reveals focal microscopic extension beyond the capsule into adjacent mediastinal connective tissue. The anterior surface of the mass is in close proximity to the external margin of the specimen, as indicated by prior silver nitrate application, raising uncertainty regarding complete resection. Sections include tumor tissue along with adjacent thymic tissue, with several blocks containing the anterior surface potentially involving pericardium.\n\nHistologic evaluation demonstrates features consistent with a predominantly mixed cortical-type tumor. Cellular morphology shows a mixture of lymphocytes and epithelial cells with moderate nuclear pleomorphism. Stromal fibrosis is present in varying degrees throughout the sections. Involutional changes are also noted in the native thymic tissue, consistent with the patient\u2019s age. Multiple tissue blocks were sampled from different regions of the gland for further analysis."} +{"pid": "TCGA-4V-A9QT", "report": "The specimen obtained from thymectomy weighs 189 grams and measures 12 cm x 14 cm x 5 cm. A nodule measuring 8 cm x 7 cm x 5 cm is present in the lower horn of the right section, encapsulated and well-defined. The internal structure shows lobulated architecture separated by septa. The tissue contains areas of necrosis and hemorrhage. The cellular composition is primarily small lymphocytes with numerous macrophages, creating a \"starry sky\" appearance. Medullary differentiation is prominent. The epithelial cells are small with minimal atypia, pale nuclei, and small nucleoli; they are sparsely distributed within the lymphocytic background. Perivascular spaces are infrequent. The lesion is well-circumscribed by a thin capsule, and the surgical margins, marked with green ink, show no evidence of involvement. Adjacent thymic tissue demonstrates partial involution and fat infiltration, with multiple B1-type nodules identified. Immunohistochemistry reveals epithelial cells positive for CK19, CK18, and CK7, with no expression of CK20, CD5, or CD20. Lymphocytes show T-cell lineage with positivity for CD1a, CD5, and CD99. The maximum dimension of the lesion is 8 cm, with no evidence of deep invasion. Resection was complete. Staging classification indicates localized extension without nodal or distant spread."} +{"pid": "TCGA-FF-8043", "report": "Histopathology Report. Biopsy number and received date/time are noted. The specimen was submitted in formalin, labeled with patient data, and designated as a colonic biopsy. It consists of three tissue fragments measuring between 0.2 cm and 0.4 cm in maximum dimension. Microscopic examination reveals three pieces of colonic mucosa with infiltrating sheets of intermediate to large atypical cells. These cells spare the crypts and are associated with focal surface erosion. Immunohistochemical staining shows positivity for CD20, Bcl-2, Bcl-6, and MUM1, while CD3, CD5, CD10, CD21, CD23, cyclin D1, and D2-40 are negative. Proliferative index by MIB-1 staining is high, with over 80% of lesional cells showing positivity."} +{"pid": "TCGA-VD-A8KI", "report": "The specimen consists of an intact right eye with axial, horizontal, and vertical dimensions of 24mm, 24mm, and 23mm, respectively. The cornea measures 12mm horizontally and vertically. The optic nerve is 9mm in length and 4mm in diameter. The pupil appears normal and regular. A dark pigmented nodule is identified in the infero-posterior region, measuring approximately 6mm x 4mm, with a height of 3mm from the optic nerve. Trans-illumination reveals a dark shadow within the globe, measuring 22 x 21mm, located near the optic nerve insertion.\n\nOn sectioning, a dome-shaped pigmented mass is observed in the choroid at the equatorial level. The lesion measures 15mm in largest basal diameter and 12mm in height. It is associated with a large exudative retinal detachment. The overlying retina shows atrophic and degenerative changes, with focal involvement.\n\nMicroscopic examination reveals a normal anterior segment with unremarkable cornea, deep anterior chamber, open angles, and normal iris. The ciliary muscles show moderate atrophy, and there is mild hyalinization of the ciliary processes. The lens demonstrates moderately advanced cataractous changes.\n\nIn the posterior segment, the mass contains a mixture of epithelioid and spindle-shaped cells, with a slight predominance of spindle cells. The epithelioid component accounts for approximately 40% of the cellular composition. Immunohistochemical staining shows reactivity for MelanA, SOX-10, and HSP-27 (score 2). Mitotic activity is estimated at approximately 5 mitoses per 40 high power fields. The tumor vasculature is prominent, without closed vascular loops; occasional vascular lakes are present, with tumor cells visible within the lumina. A minimal lymphocytic infiltrate is noted, with scattered macrophages present in moderate density.\n\nThere is evidence of extraocular growth at two transscleral sites, measuring 3mm and 1mm in diameter. The larger focus is surrounded by only a thin connective tissue layer. No tumor involvement is identified in the optic nerve or the examined vortex veins. The optic nerve shows mild atrophic changes."} +{"pid": "TCGA-44-7669", "report": "The specimen includes a right upper lobe of lung with a large perihilar lymph node measuring 2.5 cm in greatest dimension, which appears to encase the bronchus at the resection margin. On cut surface, this lymph node exhibits a mottled tan and black appearance. An area of pleural thickening and puckering is noted on the apical portion of the lobectomy. Serial sections reveal a discrete, well-defined lesion located in the apex measuring 2.3 x 1.9 x 1.5 cm. This lesion also displays a granular tan and black cut surface and is sharply demarcated from surrounding lung tissue. It approaches the visceral pleural surface but does not appear to involve it. Adjacent to this lesion is an area of parenchymal discoloration and thickening, along with emphysematous changes observed in more distal regions.\n\nSubmitted tissue blocks include the bronchial margin, multiple hilar lymph nodes (including one positive lymph node with encased bronchus), and sections of the lesion itself. The level 10 lymph node measures 1.5 cm and shows anthracotic change. Level 3, 4, and 7 lymph nodes measure 1 cm, 1.7 cm, and 2.5 cm respectively, all submitted entirely for frozen section and found to be negative for malignancy.\n\nMicroscopic examination reveals a poorly differentiated non-small cell carcinoma arranged in discrete nodules and packets within air spaces. The growth pattern demonstrates a peripheral picket-fence-like arrangement of columnar cells. Cellular features include hyperchromatic nuclei and frequent mitotic figures. Staining is negative for mucicarmine, but positive for TTF-1 and CEA, while negative for P63.\n\nHistologic evaluation of the resection specimen demonstrates absence of tumor at margins and no direct extension of tumor beyond the lung. Venous invasion is present, as well as small vessel lymphatic invasion. One of two hilar lymph nodes contains metastatic involvement. All sampled mediastinal lymph nodes are free of tumor. Additional findings include focal infarction distal to the lesion and emphysematous changes."} +{"pid": "TCGA-WB-A817", "report": "The surgical specimens from bilateral adrenalectomy were received for evaluation. The patient presented with recently diagnosed hypertension associated with sudden headaches, without known risk factors. Imaging studies had previously identified bilateral adrenal nodules.\n\nGross examination of the left adrenal specimen revealed a nodule measuring 1 cm in diameter, with a grayish appearance. The specimen weighed 14g after removal of surrounding fat and measured 6.5 x 2.5 x 2.5 cm. On the right side, a larger intra-adrenal lesion measuring 2 cm was identified, with a grayish beige color. The right adrenal specimen weighed 23g and measured 6.5 x 4 x 4 cm after fat dissection.\n\nMicroscopic analysis of both lesions showed similar features. The neoplastic cells were arranged in small nests or bays within a delicate vascular stroma, with minimal hemorrhagic changes. The cells were large with polygonal basophilic cytoplasm. Nuclear features included mild anisokaryosis with small, distinct nucleoli. No mitotic figures or necrosis were identified. A fibrous demarcation partially separated the lesions from adjacent adrenal and adipose tissue. Vascular invasion was not observed, nor was there evidence of capsular infiltration or tumor emboli. Cell clusters were noted within blood vessels, but no definitive invasive characteristics were present. Both lesions demonstrated strong immunoreactivity for chromogranin, synaptophysin, and N Cam. The PASS scoring system was applied, and all parameters were negative, yielding a total score of zero for each lesion. The surrounding adrenal tissue appeared histologically unremarkable."} +{"pid": "TCGA-60-2723", "report": "The specimen included multiple lymph nodes from various anatomical locations, including right and left distal paratracheal (4R, 4L), level 7 subcarinal, and right proximal paratracheal regions. Each lymph node measured less than 1 cm in greatest dimension and showed no evidence of malignancy upon examination. A right middle lobe lobectomy specimen was also evaluated. The pleural surface appeared tan-pink and smooth with two gray-white, well-circumscribed nodules measuring 1.5 cm and 2.5 cm. The smaller nodule was located 0.1 cm from the pleural surface and adjacent to staples, while the larger nodule was 2.0 cm from the bronchial margin. The distance between the two nodules was approximately 0.8 cm, with firm tissue intervening. The bronchial margin was negative for malignancy. No peri-bronchial lymph nodes were identified. Histologic evaluation revealed a moderately differentiated tumor involving the bronchial wall with a total tumor burden measuring 4.8 cm in greatest dimension. There was no angiolymphatic invasion or visceral pleural involvement. Staging indicated pT2, N0, Mx. Emphysematous changes were noted in the surrounding lung tissue."} +{"pid": "TCGA-FD-A6TD", "report": "A male patient underwent cystectomy with ileo-conduit for a bladder lesion, along with removal of pelvic lymph nodes and distal ureters. The right and left pelvic lymph node dissections included 13 and 21 lymph nodes respectively, all without any evidence of tumor involvement. The cystoprostatectomy specimen revealed a bladder mass measuring 7.5 cm, located on the right lateral wall, anterior wall, and posterior bladder wall. Microscopic evaluation showed that the lesion extended through the muscularis propria into the surrounding soft tissue, with a depth of invasion into the extravesical soft tissue. All surgical margins, including the ureteral, distal urethral, and serosal margins, were free of tumor. A total of 34 lymph nodes examined from all sites were negative for tumor involvement.\n\nIn the prostate, histologic analysis identified changes consistent with prior treatment, including some degree of tumor cell shrinkage. The lesion was found in both the peripheral and transition zones, with a total tumor volume estimated at 30%. There was no evidence of perineural invasion, and all resection margins were negative. High-grade intraepithelial neoplasia was noted as multifocal. Lymph nodes associated with the prostate were also free of tumor. The left seminal vesicles and vas deferens showed no signs of involvement, while there was evidence of extension beyond the prostatic capsule on the left side. The distal (apical), proximal (basilar), and peripheral margins were uninvolved. The submitted ureter specimens were devoid of tumor, and all true margins were clear."} +{"pid": "TCGA-BH-A0DI", "report": "The surgical specimen includes multiple lymph node biopsies. One lymph node contains a metastatic focus measuring 3.0 mm. A second lymph node shows an invasive focus measuring 4.0 mm with minimal involvement of the capsule. Lymphovascular invasion is present in this node. A third lymph node contains a metastatic deposit measuring 6.0 mm with limited extension beyond the capsule.\n\nThe breast tissue demonstrates a number of benign and atypical changes, including atypical lobular hyperplasia associated with sclerosing adenosis, radial scar with pronounced ductal epithelial hyperplasia, extensive sclerosing adenosis, fibrocystic change with ductal hyperplasia, columnar cell alterations, and intraductal papillomas. Microcalcifications are present in association with these findings. The nipple and skin show no significant abnormalities.\n\nA larger lesion is identified, showing a mix of invasive and in situ components. The invasive portion measures 4.0 cm and has a Nottingham score of 7 (grade 2). The in situ component consists of cribriform and solid patterns with central necrosis and nuclear grade 2. This in situ component accounts for approximately 15% of the total tumor volume. Lymphovascular invasion is also noted. Surgical margins are clear by more than 2.0 cm.\n\nAdditional non-malignant findings include radial scar, sclerosing adenosis, ductal hyperplasia, fibrocystic change, columnar cell change, and intraductal papilloma. Microcalcifications are seen in association with both benign and other notable features. A biopsy site change is present. Twenty-five lymph nodes are negative for involvement. Tumor cells express estrogen and progesterone receptors but are negative for HER-2/Neu.\n\nStaging parameters indicate a pT2 classification based on the size of the invasive lesion and a pN1a classification due to limited nodal involvement."} +{"pid": "TCGA-HP-A5N0", "report": "The sample was collected from a liver resection procedure. The tissue involved hepatic and biliary structures. Histological evaluation showed a high percentage of clear cell variant morphology with extensive tumour content in the liver. The patient exhibited recurrent lesions that demonstrated slow growth. Staging information for the primary tumour and lymph node involvement was not available, however distant metastasis was identified. The patient's age at collection, dates related to the procedure and diagnosis, and other collection details were recorded but not specified here."} +{"pid": "TCGA-DB-A4XG", "report": "A brain biopsy specimen was received for evaluation. The tissue sample measured 8.5 x 4.3 x 2.7 cm and was submitted in multiple blocks (numbered 1 through 10). Histological examination of permanent sections revealed a neoplastic process involving glial cells. The tumor demonstrated increased cellularity with nuclear atypia and brisk mitotic activity. Clinical correlation indicated that the lesion had progressed from a previously diagnosed lower-grade glioma. Immunohistochemical staining for IDH1 (R132H) was performed and showed no reactivity in the neoplastic cells. The findings were used to support further characterization of the tumor. Staging and grading were based on histologic features, clinical history, and molecular markers."} +{"pid": "TCGA-P4-AAVL", "report": "A surgical specimen was received from a left radical nephrectomy, including the kidney, renal vein, adrenal gland, and surrounding tissue. A tumor measuring 4.8 x 4.5 x 4.0 cm was identified in the midportion of the kidney. The tumor had a yellow-tan to white-tan appearance with areas of hemorrhage and necrosis, predominantly located at its periphery. It was well circumscribed but extended into the renal vein, forming a thrombus, and focally invaded the vessel wall. The tumor infiltrated both the renal sinus adipose tissue and perinephric adipose tissue. Histologic evaluation revealed high-grade nuclear features and focal sarcomatoid differentiation in approximately 10% of the tumor volume.\n\nMargins of resection for the renal artery, ureter, and peripheral soft tissues were free of tumor involvement. Multiple simple cortical cysts were noted in the adjacent kidney; no lesions were identified in the pelvicalyceal system. The adrenal gland showed no abnormal findings.\n\nIn addition, a separate specimen containing fibroadipose tissue and lymph nodes was submitted. Of twenty-one lymph nodes evaluated, one contained metastatic involvement measuring 1.0 mm in greatest dimension. No extranodal extension was observed.\n\nA thrombus involving the inferior vena cava was also submitted for analysis. This specimen measured 1.5 x 1.2 x 0.7 cm and consisted of friable soft tissue with admixed fibrin, red blood cells, and blood vessels."} +{"pid": "TCGA-EL-A4K4", "report": "A female surgical case involved the examination of multiple tissue specimens. A portion of esophageal muscularis measuring 0.7 x 0.6 x 0.2 cm showed no tumor. A fragment of the right inferior parathyroid gland, less than 0.1 x 0.1 x 0.1 cm, was submitted but no parathyroid tissue was identified. Soft tissue from the anterior tracheal wall contained a lesion within fibroconnective tissue. A left neck dissection at level II included five lymph nodes, all negative for disease. At level III, eight lymph nodes were examined with four showing involvement and focal extension beyond the thyroid. In level IV, fifteen lymph nodes were assessed with five demonstrating involvement.\n\nThe thyroid specimen measured 10.3 x 7.5 x 4.8 cm overall, with a 4.4 x 3.8 x 3 cm lesion in the left lobe, characterized by papillary and cystic features, replacing approximately 80% of the lobe. The lesion extended into adjacent skeletal muscle and was associated with lymphovascular invasion. Surgical margins were positive. Adjacent thyroid tissue showed multinodular adenomatous changes. Additional nodules were found in the anterior strap muscles and fibroadipose tissue, ranging from 0.5 to 2.4 cm in size. Multiple lymph nodes were also identified in periglandular and peritracheal regions, with some showing extracapsular extension.\n\nThe specimen from level III dissection revealed involvement in 4 out of 15 lymph nodes. Grossly, the thyroidectomy specimen included bilateral paratracheal and superior mediastinal contents, with multiple nodules identified in the left lobe and surrounding soft tissues. Several lymph nodes were sampled from various regions, including a 2 x 1.5 x 1 cm lymph node adjacent to the left thyroid lobe. All other areas examined did not show presence of tumor."} +{"pid": "TCGA-UF-A719", "report": "Specimen collection date. The primary site is the floor of the mouth. Lymph node evaluation from the right side showed no evidence of involvement: Level Ia (0/1), Level IIa (0/5), Level III (0/1), and Level Ib (0/6) all lacked any neoplastic cells. A salivary gland specimen showed changes consistent with chronic nonspecific intense sialadenitis, with no neoplastic involvement identified. The right pelvi-glossectomy specimen contained a well-differentiated squamous cell lesion measuring 3.5 cm in greatest dimension with a depth of invasion of 1.0 cm. There was a moderate chronic inflammatory infiltrate present, along with involvement of a minor salivary gland. No perineural or lymphovascular invasion was observed, and the margins were free of invasive disease."} +{"pid": "TCGA-FD-A3SS", "report": "The patient is a male who underwent cystectomy for clinical disease. Specimens were received including lymph nodes from multiple sites, bladder and prostate, and ureteral segments.\n\nLymph node dissections showed tumor involvement in several regions. Left pelvic lymph nodes contained tumor in 8 of 12 nodes with extranodal extension. Right pelvic lymph nodes showed tumor in both nodes examined, with the largest measuring 3.5 cm and showing extranodal extension. Additional right pelvic lymph nodes showed tumor in 10 of 11 nodes, also with extranodal extension. Pre-sacral lymph nodes had tumor in one of two nodes with extranodal extension. The right common iliac lymph node was positive for tumor. In total, 22 of 28 lymph nodes were involved.\n\nThe cystoprostatectomy specimen revealed a diffusely infiltrating lesion involving all subsites of the bladder, extending through the muscularis propria into perivesical fat. There was involvement of bilateral seminal vesicles and prostatic stroma. Tumor was present at the posterior perivesical soft tissue margin adjacent to the prostate. The distal urethral margin was free of tumor. The right ureteral margin showed tumor foci within lymphovascular spaces, while the left ureteral margin was not involved.\n\nMicroscopic examination of the right distal ureter revealed multiple tumor foci within lymphovascular spaces in the ureteral wall and surrounding fat. The left distal ureter showed no tumor.\n\nStaging assessment indicated extensive local invasion and widespread nodal involvement. Multiple sections of the bladder demonstrated deep tumor infiltration into surrounding tissues and structures."} +{"pid": "TCGA-HC-7213", "report": "The prostate specimen measured 4.5 x 4.5 x 4.0 cm and weighed 42.5 grams. Tumor involvement was estimated at 25\u201330% of the gland volume. Histologic evaluation showed a high-grade pattern with a Gleason score of 9 out of 10, composed of a primary pattern of 4/5 and secondary pattern of 5/5. Focal extraprostatic extension was noted, particularly in association with a peripheral nerve in the soft tissue. Bilateral involvement of the seminal vesicles was present. No lymphovascular space invasion was identified. High-grade prostatic intraepithelial neoplasia was also observed. All surgical margins\u2014including apical (less than 0.1 cm), bladder neck, and inked prostatic margin\u2014were negative for tumor. Four lymph nodes were examined from the right and left pelvic regions; none contained metastatic carcinoma. The pTNM staging was determined to be pT3b N0. The prostate was received with attached bilateral adnexa and was serially sectioned for analysis. A yellow-tan nodular mass measuring 3.5 x 3.0 x 2.5 cm was identified at the right base, partially surrounding the right seminal vesicle and abutting the inked soft tissue margin. Multiple sections were submitted for microscopic examination, including areas of the mass, surgical margins, and seminal vesicles. No treatment effect was observed."} +{"pid": "TCGA-2Y-A9GX", "report": "The specimen consists of liver tissue from Segment 7, measuring 10.0 x 6.1 x 3.3 cm. An irregular, poorly defined lobulated lesion is identified within the liver parenchyma, measuring 4.0 x 3.7 x 3.3 cm. The lesion is located less than 0.1 cm from the inked resection margin and approximately 0.1 cm from the nearest capsule. The surrounding liver parenchyma appears grossly unremarkable. Histologically, the lesion demonstrates moderately differentiated cellular features. Necrosis is not identified. Perineural invasion is not present. Vascular invasion involving large vessels is not observed. Microscopic and macrovesicular steatosis are noted, along with bridging fibrosis. No lymph nodes are identified. Other margins and bile duct involvement cannot be assessed. The specimen has been submitted in multiple cassettes for further analysis."} +{"pid": "TCGA-AN-A0XS", "report": "Female patient with tumor located in the breast, primary site. The tissue sample was obtained via surgery and preserved in OCT medium within a block container. Histological evaluation revealed a grade 2 lesion. Tumor dimensions correspond to stage 1c, with nodal involvement classified as stage 1a and no evidence of distant metastasis (stage 0). No prior treatment was administered. A separate blood sample was collected, preserved in frozen format within a tube container, for normal reference purposes. Cellular morphology and architectural details were consistent with invasive ductal growth patterns; however, no diagnostic or tumor-specific terminology is included in this summary."} +{"pid": "TCGA-UY-A9PF", "report": "The specimen was received in eight parts. Parts A and B were biopsies of the left and right ureters, respectively, each measuring 0.4 x 0.4 x 0.2 cm and submitted entirely for frozen section analysis. Part C consisted of a cystoprostatectomy specimen weighing 664 grams. A lesion was identified in the bladder measuring 4.2 x 1.7 x 1.6 cm. Microscopic evaluation showed this lesion to have invaded through the muscularis propria into the perivesicular adipose tissue. The closest approach to the perivesicular fat margin was 0.8 cm on the left lateral wall. The lesion was located 1 cm from the urethral orifice, 0.8 cm from the left ureteral orifice, and 3.1 cm from the right ureteral orifice. No involvement of the ureteral orifice was identified. The surrounding mucosa showed granulomatous inflammation, ulceration, and calcifications. There was also evidence of lymphatic vascular invasion and carcinoma in situ was present in the urothelium. Prostatic tissue showed no evidence of malignancy. Seminal vesicles were also free of tumor.\n\nMargins were assessed and found to be negative. The urethral margin showed invasive tumor greater than 1 cm away. The right ureteral margin had invasive tumor greater than 3.1 cm away, while the left ureteral margin had invasive tumor greater than 0.8 cm away. The perivesical margin was 0.2 cm from the tumor.\n\nLymph node evaluation was performed on parts D and F. Part D included right pelvic lymph nodes (nine total), with one containing metastatic disease. Part F included left pelvic lymph nodes (seven total), with three showing metastatic involvement. The largest nodal metastasis measured 0.8 cm. No extranodal extension was identified. A total of 17 lymph nodes were examined, with four being positive for metastasis.\n\nParts E, G, and H were additional biopsies of the final urethral margin and distal ureters. All were negative for carcinoma. The distal left ureter measured 1.2 cm in length and 0.4 cm in diameter, with a patent lumen. The distal right ureter measured 2.6 x 1.5 cm, also with a patent lumen. Both ureter specimens were inked and submitted entirely.\n\nSections were taken from all relevant areas of the bladder and prostate, including deep margins, areas near the urethral orifice, and regions adjacent to normal mucosa. Lymph node sampling was comprehensive and included both large and small candidate nodes. Based on the extent of invasion and lymph node involvement, staging was determined to be pT3aN2. All findings were confirmed by microscopic examination and review by the attending pathologist."} +{"pid": "TCGA-FP-8210", "report": "The surgical specimen consists of a partial gastrectomy specimen measuring 15.4 cm along the greater curvature and 9.3 cm along the lesser curvature. A sheet of attached omentum measures up to 31.3 x 29.2 x 1.0 cm. The gastric wall is edematous and fibrotic, with a gray-white fibrotic plaque identified on the anterior aspect near the distal margin, measuring 3.2 x 2.5 cm. This lesion is centrally ulcerated, lobulated, and extends across both anterior and posterior walls as well as the greater curvature, with focal involvement of the lesser curvature. It measures 2.6 x 2.5 cm at its largest dimension and has a gritty, fibrotic cut surface up to 1.6 cm thick. Microscopic evaluation reveals infiltrative growth with poorly differentiated features and focal signet ring morphology.\n\nThe lesion extends to the serosal surface in areas along the greater curvature posteriorly, but does not fully penetrate the serosa. Multiple nodules are present within the perigastric adipose tissue, measuring up to 1.4 cm, with fleshy gray-tan appearances on sectioning. Areas of fibrosis and induration are noted within the omentum, with the largest focus measuring 0.4 cm. Histologic examination confirms infiltration into adjacent fatty tissues with multiple tumor foci identified in the perigastric adipose and omental tissue.\n\nMargins were assessed: the proximal resection margin is negative; the tumor is located 1.0 cm from the distal margin, and the radial (serosal) margin is involved. Evaluation of lymph nodes reveals three positive lymph nodes out of 23 examined, with one showing extracapsular extension. Additional findings include lymphovascular and perineural space involvement. Adjacent gastric mucosa demonstrates intestinal metaplasia, acute and chronic inflammation, and reactive changes."} +{"pid": "TCGA-HT-7858", "report": "The pathology report describes microscopic sections showing gray and white matter extensively infiltrated by a neoplastic process. The cells exhibit features resembling protoplasmic and fibrillary astrocytes. Focal microcystic change is prominent. Overall cellularity is low, with mild atypia noted. There are regions with moderate hypercellularity and variable degrees of atypia, ranging from generally moderate to areas with more pronounced nuclear atypia. A rare mitotic figure is identified. No microvascular proliferation or necrosis is present. Immunohistochemical staining reveals scattered MIB-1 reactive cells, with a calculated labeling index of 2.9%, suggesting modest proliferative activity. The overall findings indicate a neoplasm with low-grade features."} +{"pid": "TCGA-KL-8333", "report": "A 15.5 cm, well-circumscribed mass was identified in the left kidney of a male patient with a history of a renal lesion. The tumor exhibited a fleshy, pink-tan cut surface with scattered small cystic areas and measured 15.5 x 13.0 x 8.5 cm. It originated from the lower pole of the kidney and appeared to compress the renal sinus fat without invasion into the collecting system or vascular structures. Microscopic evaluation confirmed that the tumor did not extend beyond the kidney into the Gerota\u2019s fascia. Histologic analysis showed no involvement of the adrenal gland or lymph nodes, with all five examined lymph nodes showing no evidence of metastasis. Surgical margins were free of tumor. The non-neoplastic kidney tissue appeared unremarkable. Based on the extent of the tumor and its localization, staging indicated a size greater than 7.0 cm confined entirely within the kidney."} +{"pid": "TCGA-DX-A6YX", "report": "The clinical history notes a right thigh lesion. The submitted specimen consists of a radical resection from the right posterior thigh, including sartorius, biceps, bacillus, and femoral muscles. Grossly, the specimen includes skin and subcutaneous tissue with an underlying mass. The entire specimen measures 25 x 13 x 8.5 cm, with the overlying skin measuring 17 x 8 cm. A centrally located bulging area is observed. The specimen is oriented with sutures and inked for margin identification. Sectioning reveals a multilobulated firm mass that approaches the skin and is within 0.5 cm of the lateral and medial margins. The mass measures 9.5 x 8 x 7 cm and appears to displace rather than infiltrate adjacent muscle. Representative sections are submitted, including tumor, margins, muscle, and skin. Microscopic evaluation shows high-grade cellular atypia, with focal areas of necrosis identified. All margins are negative for tumor involvement, with the closest being the medial margin at 0.25 cm clearance. A portion of uninvolved skeletal muscle is also present. The report is based on direct examination of the slides."} +{"pid": "TCGA-55-A48X", "report": "A lobectomy specimen from the left lower lobe of the lung was received, weighing 129 grams. The specimen measured 15.0 x 7.9 x 12.0 cm and included multiple staple lines at the resection margin, one involving a bifurcated tertiary bronchus. The pleural surface was slightly wrinkled, tan-pink, with focal anthracotic streaking. A subpleural lesion measuring 2.6 x 2.2 x 1.9 cm was identified, located 2.9 cm from the bronchial margin. The lesion had a gritty, gray-tan fibrotic cut surface with focal anthracotic streaking and extended to but not through the pleura. No other gross lesions were identified. The remaining pulmonary parenchyma was spongy, pink-red, with moderate anthracotic changes.\n\nSections from the bronchial margin, lesion, surrounding tissue, and uninvolved parenchyma were submitted for microscopic evaluation. Specimen integrity was intact, and margins were assessable. Microscopic evaluation showed a moderately differentiated cellular growth pattern within the left lower lobe. The closest distance of the invasive component to the visceral pleural margin was less than 1 mm. There was no evidence of vascular margin involvement or lymphovascular space invasion. Visceral pleural invasion was not identified.\n\nTwo peribronchial lymph nodes were identified within the specimen; one contained cellular deposition consistent with the primary specimen. Additional lymph node samples from levels 5, 6, 7, and 10 were received as fragmented tissue. All lymph node samples demonstrated reactive changes including sinus histiocytosis and anthrasilicosis, without evidence of metastatic involvement. An elastic stain confirmed the absence of invasion into or through the visceral pleura.\n\nThe final assessment of the surgical specimen included an evaluation of tumor extension, margin status, and lymph node involvement. Emphysematous changes were also noted in the lung tissue. Staging was determined based on these findings."} +{"pid": "TCGA-KO-8417", "report": "The right kidney specimen measured 16.0 x 10.0 x 7.0 cm and included the renal vein, artery, and ureter. A well-circumscribed tan-colored mass measuring 5.0 x 4.5 x 2.0 cm was identified in the lower pole, involving both cortex and medulla. The lesion was confined within the kidney capsule without extension into perinephric fat or renal sinuses. Gross examination showed a homogeneous fleshy tan-brown appearance with no areas of hemorrhage or necrosis. Margins of resection, including ureter, renal vein, artery, and perinephric adipose tissue, were free of involvement. Histologically, the lesion consisted of polygonal cells with distinct cell membranes and thick-walled blood vessels. Areas with tubular and papillary architecture were present. Immunohistochemical staining demonstrated positivity for CK7 and c-kit, partial positivity for AMACR, and negativity for vimentin and CD10. The gallbladder measured 9.0 x 3.0 x 4.0 cm and contained nineteen stones ranging from 0.7 to 1.2 cm in size. The stones were brown-green with regular shapes, and the gallbladder wall thickness ranged between 0.2 and 0.3 cm. Microscopic evaluation revealed chronic inflammatory changes and no evidence of neoplastic disease."} +{"pid": "TCGA-FF-8042", "report": "Histopathology Report. Biopsy No: Corrected. Histopathology Report. Final Updated. ADDENDUM. ADDENDUM TO HISTOPATHOLOGY REPORT. The following immunoprofile is obtained: CD3, 5, 10 are negative. Cyclin D1 is also negative. CD21 and 23 show no reactivity. There appears to be a suggestion of an adjacent follicular area with CD21 positivity, but no staining with CD10. BCL2 and 6 are both positive. Although BCL6 is positive, the cells do not express CD10. CD20 and CD79a are positive markers. Ki67/MIB1 staining indicates a high proliferative activity, ranging between 80 to 90%. The tumor demonstrates a diffuse growth pattern, composed of medium to large-sized cells that are consistently positive for CD20 and CD79a, and negative for Cyclin D1.\n\nGROSS DESCRIPTION: Received in formalin is a specimen labeled with patient data, designated as \"left supraclavicular lymph node.\" It consists of two irregular tissue fragments measuring 1.5 x 1 x 0.3 cm and 1.1 x 1 x 0.5 cm.\n\nMICROSCOPIC DESCRIPTION: This is an adequate excisional biopsy showing features consistent with a malignant lymphoma. Immunophenotyping has been performed and an addendum was issued for further classification. Areas of geographic necrosis are present, which may represent changes following a prior fine needle biopsy."} +{"pid": "TCGA-A5-A1OF", "report": "The specimen consists of a total of six parts. The first part includes the uterus, cervix, bilateral fallopian tubes, and ovaries submitted for frozen section analysis. Grossly, the uterus measures 4.5 cm in width, 8.0 cm in length, and 3.5 cm in anterior-posterior dimension. The right ovary measures 2.5 x 1.0 x 0.7 cm and the left ovary 4.0 x 1.0 x 0.7 cm, both showing fibrotic and atrophic features. The cervix is unremarkable, measuring 1.5 cm in width and 1.5 cm anteroposteriorly. A polypoid lesion measuring 2.5 x 2.0 x 1.0 cm is present in the uterine fundus. Serial sectioning reveals superficial myometrial invasion in the posterior aspect, with a depth of 2 mm in a myometrium that is 15 mm thick. No tumor involvement is seen in the cervix, endocervix, or lower uterine segment. The bilateral ovaries and fallopian tubes show involvement, and parametrial tissues are also involved. Margins are free of invasive carcinoma, with the closest distance from the tumor to the margin being more than 10 mm. Lymphovascular invasion is not identified.\n\nThe second specimen is omental tissue measuring 31 cm x 2.0 cm x 1.5 cm and weighing 90 grams. Microscopic examination reveals benign fibroadipose tissue and thirteen small lymph nodes, none of which show any evidence of malignancy.\n\nThree additional specimens include lymph node dissections from the right and left pelvic regions and the right and left para-aortic areas. The right pelvic lymph node dissection contains three benign lymph nodes, the left pelvic dissection shows one benign lymph node, and the right para-aortic dissection contains three benign lymph nodes. No lymph nodes were identified in the left para-aortic specimen.\n\nHistologic evaluation of the primary lesion shows a high-grade component with focal features of high nuclear grade. Sections of the cervix, endocervix, and lower uterine segment do not show malignancy. The tumor is confined to the endometrium with less than half myometrial invasion. Additional findings include bilateral chronic salpingitis."} +{"pid": "TCGA-B8-4151", "report": "The specimen consists of a right kidney measuring 12.5 \u00d7 5.6 \u00d7 6.0 cm and weighing 600 g. A tumor located in the lower pole measures 6.7 \u00d7 3.7 \u00d7 2.5 cm and is surrounded partially by a thin capsule. The tumor appears yellow to gold with focal brown discoloration and no necrosis. Histologically, the tumor demonstrates clear cell morphology and is graded as 2 out of 4. Gross examination indicates that the tumor extends beyond the renal capsule into perihilar or renal sinus fat (A9), and involves a tributary of the renal vein (A11), although it does not involve the renal vein margin (A1). No involvement is identified at the perirenal adipose tissue margin (negative with closest margin at 0.5 cm), renal vein margin (negative, 2.0 cm away), renal artery margin (negative, 2.0 cm away), or ureteral margin (negative, 2.0 cm away). No lymphatic or venous invasion is noted. Surgical resection margins are negative. No multicentric lesions are observed. The remainder of the kidney appears tan-brown without satellite lesions or masses. Based on available information, staging is classified as pT3 pNx pMx."} +{"pid": "TCGA-4A-A93W", "report": "The specimen from a female patient consists of a partial nephrectomy specimen weighing 14 grams and measuring 4 x 3.3 x 3.3 cm. A mass measuring 3.6 cm in greatest dimension is identified; it is lobulated with a pale tan-red cut surface. The mass is located adjacent to the renal capsule with no evidence of invasion through the capsule. The tumor is present at the deep parenchymal resection margin, with the distance from the tumor to the true deep margin measuring 1.0 cm. The perinephric fat is marked with black ink and the parenchymal margin is marked with blue ink. Representative sections of the mass and surrounding tissue have been submitted for analysis.\n\nHistologic evaluation reveals a unifocal lesion within the kidney, with no angiolymphatic invasion identified. The histologic grade is G2 based on nuclear features. No sarcomatoid differentiation is observed. All surgical margins are free of tumor involvement. Based on the size and extent of the lesion, the staging classification is pT1a with no lymph node assessment performed."} +{"pid": "TCGA-CJ-4638", "report": "The left kidney specimen measured 18.0 cm x 17.0 cm x 10.0 cm and included the ureter, hilar lymph nodes, and adrenal gland. A large, well-circumscribed lesion measuring 15.0 cm x 8.5 cm x 9.0 cm occupied approximately 90% of the renal parenchyma. The lesion had a yellow-tan appearance with extensive hemorrhage and necrosis. It focally extended into the renal sinus fat and invaded the renal vein; however, the renal vein margin was free of tumor involvement. Multiple tumor nodules were observed in the renal parenchyma distant from the main lesion.\n\nThe ureter was involved by tumor along its distal portion, although the ureteral margin appeared grossly free of tumor involvement. Adjacent to the ureteral margin was a small cystic nodule measuring 0.2 cm. The renal hilum was enlarged measuring 15.0 cm x 6.0 cm x 6.0 cm and contained multiple matted lymph nodes (approximately 23 total), most of which showed tumor involvement. Three additional lymph nodes outside this group showed no tumor involvement.\n\nA separate lymph node located below the bifurcation measured 4.0 cm x 2.2 cm x 2.0 cm and was grossly involved by tumor.\n\nHistologic examination revealed focal invasion of the renal sinus fat and renal vein involvement. The tumor exhibited focally rhabdoid features. Multiple sections confirmed tumor presence at various locations including the sinus, pelvis, perinephric fat margin, renal vein, adjacent kidney parenchyma, and hilar lymph nodes. Sections of the ureteral and renal vein margins showed no tumor involvement. Twenty-three hilar lymph nodes were examined with approximately twenty showing tumor involvement. Sections of three unremarkable lymph nodes submitted entirely showed no tumor involvement.\n\nSections of the lesion near the ureteral margin confirmed absence of tumor involvement at that site. Adrenal gland evaluation revealed no tumor involvement."} +{"pid": "TCGA-OR-A5J1", "report": "The specimen consists of a left adrenal gland weighing 102.4 grams and measuring 110 x 70 x 60 mm. A nodular lesion was identified within the gland, measuring up to 25 x 30 mm in cross-section and extending over a length of 70 mm. The lesion has an irregular cut surface and is compressing adjacent normal adrenal tissue. Multiple tissue blocks were sampled, including areas near prior genetic sampling sites, regions where the lesion interfaces with normal tissue, and sections closest to the excision margin.\n\nMicroscopic examination reveals a predominantly trabecular architectural pattern. The mitotic rate is less than six per 50 high-power fields. Cytological atypia is present. No definitive vascular invasion is observed. The tumor appears to be in close proximity but clear of the painted excision margin.\n\nImmunohistochemical staining demonstrates positivity for vimentin and negativity for Cam 5.2 and chromogranin. These findings support the presence of a cortical adrenal lesion.\n\nElectron microscopy reveals features commonly associated with aldosterone-secreting lesions, including elongated mitochondria with numerous lamellar cristae resembling those seen in the zona glomerulosa. Hybrid mitochondrial forms are also present. Moderate amounts of rough and smooth endoplasmic reticulum are noted, along with sparse lipid droplets. Nuclear morphology is largely uniform with regular chromatin distribution and small nucleoli, although a few pleomorphic nuclei are observed.\n\nIt is emphasized that ultrastructural features alone cannot reliably predict clinical behavior. Histologic and macroscopic criteria remain the primary basis for assessment. Close follow-up is advised based on morphological characteristics."} +{"pid": "TCGA-DH-A7UR", "report": "Surgical Pathology Consultation / Department of Pathology. Case Type: SPECIMEN(S) SUBMITTED/ PROCEDURES ORDERED: A. Frozen Section Charge. B. KI-67, Nuclear Antigen, Mib1. B. Glial Fibrill. Acid Prt. B. 1P19q Malignant Glioma Anaysis. B. 1P19q Malignant Glioma Analysis, add x 3. CLINICAL HISTORY: elderly female with severe head pain. CT and MRI were performed and revealed a right medial frontal lobe lesion. GROSS DESCRIPTION: The following specimens were received: A. A fresh specimen labeled \"brain tumor\" consisting of a 0.6 x 0.6 x 0.4 cm portion of tan to beige soft tissue. A representative section was submitted for frozen section analysis, with the frozen tissue placed in cassette FSA1 and the remainder in cassette A2. B. A fresh specimen labeled \"brain tumor\" measuring 1.9 x 1.5 x 0.8 cm composed of beige to gray-tan soft tissue. A representative section was submitted for further analysis and the remaining tissue placed in cassette B1. MICROSCOPIC FINDINGS: Histologic evaluation showed an infiltrative glioma with oligodendroglioma-like features. The tumor demonstrated overall uniform histology, with cells exhibiting perinuclear halos and a background pattern of fine capillaries resembling a chicken-wire configuration. Areas of increased cellularity and mitotic activity were also present. The neoplasm displayed extensive infiltration of the cerebral cortex, with prominent subpial and perineuronal accumulation of atypical cells. Immunohistochemical staining showed a Ki-67 labeling index of 15\u201320%. GFAP immunoreactivity was limited to a few scattered cells, while the majority of the tumor population was negative. Molecular testing for chromosomal alterations is in progress and will be reported separately. QUALITY NOTE: All test systems have been developed and validated by the laboratory. Some assays are not cleared or approved by the U.S. Food and Drug Administration; however, the FDA has determined that such clearance is not necessary. This laboratory is certified under the Clinical Laboratory Improvement Amendments of 1988 (CLIA-88) to perform high-complexity clinical testing."} +{"pid": "TCGA-AR-A0TX", "report": "The specimen consists of a multilobulated mass measuring 1.5 x 1.2 x 1.0 cm, located adjacent to the prior core biopsy site. The lesion demonstrates Nottingham grade II nuclear features. A separate focus of high nuclear grade solid-type ductal proliferation is noted outside the main lesion. No angiolymphatic invasion is observed. The skin shows no abnormality. Following re-excision of the deep margin, all surgical margins are free of involvement, with the closest tumor-free distance being 0.4 cm at the superior margin. Axillary lymph node dissection reveals multiple involved nodes (3 out of 25), with extranodal extension noted in two matted lymph nodes. Immunohistochemical testing for Her-2/NEU has been initiated on formalin-fixed paraffin-embedded tissue."} +{"pid": "TCGA-HT-7873", "report": "The pathology report demonstrates a markedly hypercellular glial neoplasm with diffuse infiltration of the parenchyma. The majority of tumor cells exhibit an astrocytic morphology, while a notable subset displays features suggestive of oligodendroglial differentiation, including poorly formed paranuclear halos and microgemistocytic features. Nuclear atypia is predominantly mild, although numerous moderately atypical nuclei are present. Mitotic figures are rare. There is no evidence of microvascular proliferation. Immunohistochemical staining for MIB-1 shows variable labeling throughout the tumor, with a maximum labeling index of 6.1% in the most proliferative regions. This level of proliferative activity is considered intermediate and raises concern for more aggressive behavior, although it does not meet definitive criteria for high-grade classification."} +{"pid": "TCGA-OR-A5J2", "report": "The specimen consists of a resected mass along with the left kidney and left adrenal gland. The mass is encapsulated by fibrous tissue ranging from 0.1 to 0.7 cm in thickness, weighs 810 grams, and measures 18 x 14 x 7 cm. The cut surface is yellow with fibrotic and necrotic areas involving approximately 25% of the tissue. Two cystic regions each measuring 3.0 cm are present. The left kidney appears normal, measuring 12 x 5 x 4 cm and weighing 150 grams. The spleen is within normal limits, measuring 7 x 4 x 2.5 cm and weighing 120 grams. A separate lymph node resection reveals a gray nodular structure resembling an accessory spleen.\n\nHistologic examination reveals a diffuse architectural pattern with less than 25% clear cells. Nuclear grading according to Fuhrman classification is noted. Necrosis is present along with mitotic figures including atypical forms. Invasion of the capsule and venous structures is observed. Sinusoidal invasion is also identified. Immunohistochemical staining demonstrates focal positivity for Melan A, Inhibin, 35BH11, AE1/AE3, and CD10. S-100 protein is positive while Chromogranin and Synaptophysin are negative. Additional findings include extra capsular extension."} +{"pid": "TCGA-FX-A8OO", "report": "The specimen consists of a resected right pleural mass involving the right lower lobe of the lung and adjacent chest wall. The tumor measures 15.2 x 12.3 x 5.0 cm and is located within the visceral and parietal pleura. Histologically, it demonstrates features of high-grade morphology with predominantly spindle cell architecture. Approximately 75% of the tumor exhibits hypercellularity, increased nuclear atypia, and more than two mitotic figures per high-power field. Patchy round cell differentiation is also present. Mitotic activity is notable with up to 31 mitotic figures per 10 high-power fields. Necrosis is present in approximately 10% of the tumor. Microscopic evaluation reveals extension into the right lower lobe of the lung and superficial involvement of the parietal pleural soft tissue, though there is no invasion into deeper chest wall soft tissues or bone. Lymphovascular space invasion is not identified.\n\nImmunohistochemical staining shows positivity for BCL2 and CD99. Only rare cells express EMA. Staining is negative for AE1/3, pan keratin, CK7, CD34, S100, Melan A, calretinin, WT1, pan muscle actin, desmin, and myogenin. Prior molecular testing by fluorescence in situ hybridization (FISH) demonstrated gene rearrangement in 85% of cells, confirming specific genetic findings. All surgical margins, including those of the lung, chest wall soft tissue, and rib bone, are negative for malignancy. No lymph nodes were identified in the specimen. Gross examination confirms the tumor dimensions and its location within the pleural space with focal adherence to underlying lung parenchyma. Representative sections from all margins have been submitted and evaluated."} +{"pid": "TCGA-H7-A6C4", "report": "The surgical specimen included a left partial glossectomy and left neck dissection. The glossectomy specimen measured 5.6 x 4.9 x 2.3 cm and was focally cauterized with a gray-brown deep surface and granular mucosa. An ulceration measuring 1.8 x 1.2 cm was identified on the lateral border of the tongue, extending to within 0.2 cm of the nearest mucosal edge. A gray-white, granular, indurated mass measuring 3.6 x 2.2 x 1.3 cm was found contiguous with the ulceration, extending to multiple soft tissue margins. Adjacent soft tissue showed granularity, fibrosis, and induration suggestive of salivary gland tissue.\n\nMicroscopic evaluation revealed a deeply invasive squamous cell carcinoma with moderate differentiation and prominent keratinization. Invasion into surrounding soft tissues was noted, with a depth of invasion measuring 0.8 cm. Both perineural and lymphovascular invasion were present. The deep surgical margin was involved by invasive carcinoma; however, all other frozen section margins were negative for malignancy. No evidence of carcinoma in situ was found at the margins.\n\nA total of 30 lymph nodes were examined from the left neck dissection (levels 1\u20134). Of these, 5 were positive for metastatic disease. The largest involved lymph node measured 4.8 cm and showed extracapsular extension. Metastases were also identified in level 2B. Other biopsies from various surgical sites, including the right vocal cord, lingual nerve margins, lingual artery, and multiple mucosal and deep margins, were negative for malignancy. The right vocal cord biopsy showed moderate epithelial dysplasia, and a biopsy from the base of the tongue at the hyoid revealed a detached fragment with mild to moderate dysplasia but no definitive malignancy.\n\nStaging based on the findings indicated a primary tumor with a depth of invasion measuring 0.8 cm. Regional lymph node involvement included multiple positive nodes with extracapsular spread. Distant metastasis could not be assessed."} +{"pid": "TCGA-QU-A6IP", "report": "The pathology report details a radical prostatectomy specimen along with bilateral pelvic lymph nodes. The prostate and seminal vesicles were submitted for examination, with the prostate measuring 5.5 x 5 x 3.5 cm and weighing 51 grams. The right and left seminal vesicles each measured 2.5 x 1.5 x 0.5 cm. The right vas deferens was 0.5 cm in length and diameter, while the left vas deferens was 1 cm long and 0.5 cm in diameter. The prostatic capsule appeared unremarkable on gross examination, and no discrete lesions were identified. The specimen was sectioned to evaluate various regions, including the apex, mid, and base of both sides, as well as the bladder resection margin and seminal vesicles.\n\nMicroscopic analysis showed a histologic type consistent with adenocarcinoma. The Gleason score was 6, with both primary and secondary patterns graded as 3. Tumor involvement was limited to 5% of the prostate. One out of three slides from the right side showed evidence of abnormal cells, while all other sections, including those from the left side and apical regions, were negative. No malignancy was found in either the left or right pelvic lymph nodes, which measured 0.2 cm and 1.5 cm respectively.\n\nStaging revealed a primary tumor classified as pT2a, indicating unilateral involvement limited to one-half of a lobe or less. No regional lymph node metastasis was identified (pN0). Surgical margins were free of invasive carcinoma, and there was no evidence of extraprostatic extension or invasion of the seminal vesicle muscular wall. Perineural invasion was present, and a small focus of atypical cells was noted in the right mid region. All tissue from the lymph node pockets and prostate was fully submitted for analysis."} +{"pid": "TCGA-CV-5440", "report": "A total laryngopharyngectomy and bilateral neck dissection were performed. The specimen measured 7.0 x 8.5 x 4.5 cm. An ulcerated, excavating mass involved the left pyriform sinus and extended into the anterior soft tissue, with involvement of the thyroid cartilage. The tumor measured 4.5 x 3.5 x 8.0 cm. Mucosal and soft tissue margins appeared grossly free of involvement. The tumor approached the supraglottic region medially but did not involve the overlying mucosa. Separate tumor nodules were observed in the anterior soft tissue component, with the largest measuring 1.0 cm in diameter.\n\nThe right neck dissection included levels 2, 3, and 4. Level 2 measured 5.0 x 4.0 x 1.5 cm and contained 19 lymph nodes ranging from 0.3 x 0.2 x 0.2 to 2.5 x 1.0 x 0.5 cm. Level 3 measured 4.0 x 3.0 x 0.6 cm with 10 lymph nodes ranging from 0.2 x 0.2 x 0.2 to 2.5 x 0.8 x 0.4 cm. Level 4 measured 3.5 x 2.5 x 0.6 cm with 9 lymph nodes ranging from 0.2 x 0.2 x 0.2 to 0.8 x 0.4 x 0.4 cm. All lymph nodes in the right neck were negative for tumor involvement.\n\nThe left neck dissection also included levels 2, 3, and 4. Level 2 measured 5.5 x 3.0 x 1.0 cm and contained 15 lymph nodes ranging from 0.2 x 0.2 x 0.2 to 1.5 x 0.8 x 0.4 cm. Level 3 measured 5.0 x 3.0 x 2.0 cm with 9 lymph nodes ranging from 0.3 x 0.3 x 0.3 to 2.5 x 2.0 x 2.0 cm; among these, the largest lymph node was grossly positive. Level 4 measured 6.0 x 3.0 x 1.0 cm with 9 lymph nodes ranging from 0.3 x 0.2 x 0.2 to 0.8 x 0.5 x 0.3 cm. Of the 42 left neck lymph nodes identified, 5 were positive for tumor involvement, including extranodal extension.\n\nHistologic evaluation revealed perineural and lymphovascular invasion. Margins of resection were free of tumor. Multiple sections of the tumor and adjacent mucosa were submitted for analysis. Frozen section analysis confirmed tumor-free margins."} +{"pid": "TCGA-E8-A44M", "report": "The tumor is located in the right thyroid lobe and measures 1 x 1 x 0.5 cm. It is unifocal and does not demonstrate extrathyroidal extension. Histologically, the lesion is composed of structures arranged in trabeculae, follicles, or papillae with broad fibrovascular stalks lined by one to several layers of cuboidal epithelial cells. The cells generally preserve their polarity, with nuclei that are mostly regular and contain finely dispersed chromatin. Some nuclei exhibit intranuclear grooves. There is notable infiltration of the tumor by inflammatory cells. No markers or special stains were performed."} +{"pid": "TCGA-DD-AAVW", "report": "The specimen consists of a left hemihepatectomy. A lesion was identified with dimensions measuring 2.2 x 2 x 1.5 cm. The gross appearance is described as infiltrative. No satellite nodules were observed. Histologically, the lesion exhibits a trabecular growth pattern with a mixture of classic and clear cell morphology. The histologic grade according to Edmondson and Steiner shows the worst differentiation as grade 3, while the predominant differentiation is grade 2. Fatty changes are present, accounting for approximately 5% of the tissue. There is no evidence of hemorrhage, peliosis, or tumor necrosis. Microscopic vascular invasion is not identified. A partial capsule is present without infiltration. Septal formation is noted. There is no involvement of major branches of the portal or hepatic veins. Invasion of bile duct structures is present and extensive. Serosal invasion involving Glisson\u2019s capsule is observed. Surgical margins are free with a safety margin of 1.2 cm. No intrahepatic metastasis or multicentric occurrence is detected. Pathologic staging corresponds to AJCC criteria as pT1 and pT2. Additional findings include inactive cirrhosis associated with hepatitis B virus and absence of dysplasia. The gallbladder demonstrates cholesterolosis."} +{"pid": "TCGA-85-8048", "report": "The specimen was obtained from the left-lower lobe and was identified as a lobectomy. The tumor measured 2 x 3 x 2.5 cm. Microscopic examination revealed poorly differentiated cells. No specific information was provided regarding tumor extent, presence of additional nodules, lymph node involvement, lymphatic or venous invasion, margin status, evidence of neo-adjuvant treatment, or additional findings. No comments were provided."} +{"pid": "TCGA-CJ-5689", "report": "A segment of the 12th rib was submitted for gross examination only. The specimen measured 5.0 x 1.4 x 0.3 cm and was entirely processed for gross evaluation. A left kidney nephrectomy specimen measuring 23.5 x 13.5 x 7.5 cm was also received, which included the kidney (13.0 x 7.5 x 7.3 cm), a segment of renal artery, renal vein, ureter (7.8 cm long, 0.4 cm in diameter), and three fragments of adipose tissue aggregating to 16 x 12 x 4.5 cm. Within the upper pole/mid portion of the kidney, there was a well-circumscribed lesion measuring 6.5 x 4.5 x 2.5 cm. The lesion had a yellow appearance with areas of hemorrhage and necrosis centrally, as well as solid tan regions. Vascular, urethral, and soft tissue margins of resection were uninvolved. The lesion extended into the renal sinus vascular space but did not infiltrate the surrounding adipose tissue or invade the renal vein. It also did not extend into Gerota's fascia. The adjacent kidney contained multiple cysts ranging from 0.1 to 6.0 cm in size. The pelvicalyceal system was smooth and contained two small brown-tan stones measuring approximately 0.3 cm each. No lymph nodes were identified at the hilum. Multiple deeper sections of the lesion were examined, including areas involving the capsule, adipose tissue, sinus, and pelvis. Specimens from the lesion were submitted for potential electron microscopy and other research protocols. No clinical history was provided."} +{"pid": "TCGA-RD-A7BT", "report": "The specimen consists of a subtotal gastrectomy and extended right hemicolectomy connected by gastrocolic omentum. The proximal gastric margin measures 60mm in diameter, the distal margin 35mm, with lesser curvature measuring 120mm and greater curvature 165mm. The lesser omentum is 35mm wide, and the greater omentum measures 170mm in width. The right hemicolectomy includes terminal ileum (100mm long x 25mm in diameter), an appendix measuring 80x5mm, and a right colon segment 550mm in length x 25mm in diameter.\n\nA fungating ulcerated lesion measuring 75x82mm is present on the lesser curve of the stomach, located approximately 20mm from the proximal resection margin and 40mm from the distal resection margin. The lesion reaches up to 18mm in thickness and extends through the full thickness of the stomach wall, infiltrating up to 10mm into the lesser omentum. No macroscopic extension into the greater or gastrocolic omentum is observed, although multiple nodules suggestive of metastatic involvement are present in both omental regions near the stomach. The right hemicolectomy appears unremarkable macroscopically.\n\nMicroscopically, a large, poorly differentiated lesion of intestinal type is identified, extending with an infiltrating margin through the full thickness of the stomach wall into subserosal tissues and omenta. While the lesion approaches the peritoneal surface, no breach of the peritoneum is observed. The lesion forms solid cohesive cell masses, with occasional small granular lumina. Focal desmoplastic stroma is present, though many areas show little stromal response. Tumor cells are large, round to polygonal, with moderate amphophilic cytoplasm, large moderately pleomorphic nuclei, granular to irregularly clumped chromatin, and prominent nucleoli. Frequent mitotic figures are noted.\n\nThere is extensive lymphovascular invasion within the gastric wall and omenta, with focal involvement of ectatic veins in the omenta. Numerous metastatic deposits are found in the omenta, both within lymph nodes and as separate nodules arising from lymphatic vessels. At least 55 distinct metastases are identified among 56 lymph nodes and omental nodules, distributed in both lesser and greater omenta. Tumor within mural lymphatic channels approaches to within 1.5mm of the proximal longitudinal resection margin of the stomach but is completely excised. The distal resection margin shows no evidence of tumor. The right hemicolectomy specimen, including 5 ileocolic lymph nodes, is free of tumor involvement.\n\nA separate peritoneal biopsy measuring 40x30mm contains skeletal muscle and peritoneal tissue; no tumor is identified in this specimen."} +{"pid": "TCGA-CQ-A4CB", "report": "The surgical specimen included multiple tissue samples from the head and neck region. The lymph node evaluation revealed one involved lymph node in the right neck level I, measuring 0.8 cm, with no evidence of extracapsular extension. A total of 26 lymph nodes were examined across all levels, with 25 found to be uninvolved. Submandibular gland tissue showed mild chronic inflammation but no malignancy.\n\nThe primary lesion was located in the floor of the mouth and measured 2.0 cm in its greatest dimension with a thickness of 0.9 mm. Microscopic examination revealed moderately differentiated squamous cell carcinoma with keratinization. Perineural invasion was present; however, no lymphovascular invasion was identified. The tumor was ulcerated and was situated 0.3 cm from the anterior gingival mucosal margin, while other margins were free of tumor involvement by at least 0.5 cm. Bone involvement could not be confirmed initially, as sections of bone were pending decalcification for further evaluation.\n\nAll other submitted soft tissue margins, including the right posterior, anterior tongue, and left posterior margins, were negative for tumor. Adipose and fibroadipose tissues from various anatomical sites were unremarkable except for the presence of the previously noted involved lymph node. The pathological staging indicated a primary tumor (pT1) with regional lymph node involvement (pN1), based on the AJCC/UICC TNM classification, 7th edition."} +{"pid": "TCGA-94-A4VJ", "report": "A total of nine specimens were received, each labeled with the patient's name and medical record number. Specimen A, labeled as \"4R lymph node,\" consisted of multiple grey-black soft tissue fragments measuring 2.0 x 1.5 x 0.6 cm in aggregate. It was submitted entirely for frozen section diagnosis and placed in cassette A1FS.\n\nSpecimen B, labeled \"#7 lymph node,\" included multiple grey-black tissue fragments measuring 1.0 x 0.9 x 0.2 cm in total. It was also submitted entirely for frozen section diagnosis in cassette B1FS.\n\nSpecimen C, labeled \"4L lymph node,\" contained multiple grey-black tissue fragments measuring 1.2 x 1.0 x 0.3 cm collectively. It was submitted entirely for frozen section diagnosis in cassette C1FS.\n\nSpecimen D, labeled \"left lung, check bronchial margin,\" consisted of a left lung measuring 29.0 x 17.0 x 5.0 cm and weighing 350 grams. The pleural surface was smooth and red-pink without abnormalities. Hilar lymph nodes were slightly enlarged, with the largest measuring 2.2 cm. A mass measuring 2.7 x 2.5 x 1.5 cm was identified in the left main bronchus, abutting the pulmonary vasculature. Focal mucous areas were noted within airways near the tumor. The tumor\u2019s cut surface was grey-yellow with focal hemorrhage, located 1.1 cm from the bronchial edge, 0.6 cm from the vascular margin, and within 0.1 cm of the visceral pleura. No additional lesions were observed. The bronchial margin was shaved and submitted entirely for frozen section diagnosis in cassette D1FS.\n\nSpecimen E, labeled \"#9 lymph node,\" contained four tissues ranging from 1.0 x 0.5 x 0.2 cm to 1.5 x 1.1 x 0.5 cm. Upon sectioning, four purple and black lymph nodes were identified, ranging from 0.3 x 0.2 x 0.1 cm to 1.3 x 0.8 x 0.4 cm. These were submitted entirely in cassettes E1 through E4.\n\nSpecimen F, labeled \"#7 lymph node,\" included a black and red possible lymph node measuring between 0.6 x 0.3 x 0.2 cm and 2.2 x 1.5 x 0.8 cm. It was submitted entirely in cassettes F1 through F5.\n\nSpecimen G, labeled \"10L lymph node,\" contained five black possible lymph nodes ranging from 0.4 x 0.2 x 0.1 cm to 1.4 x 1.0 x 0.2 cm. These were submitted in cassettes G1 through G3.\n\nSpecimen H, labeled \"#6 lymph node,\" included three possible lymph nodes measuring up to 3.0 x 3.0 x 1.3 cm. Anthracotic pigment was noted on the cut surface of each node. The specimen was submitted entirely in cassettes H1 through H5.\n\nSpecimen I, labeled \"#5 lymph node,\" consisted of a purple and black lymph node measuring 1.3 cm in greatest dimension. It was bisected and submitted in cassette I1 and I2.\n\nCassette summary included D1FS (bronchial margin, shave), D2 (vascular margin, shave), D3 (lymph node, bisected), D4 (five lymph nodes, whole), D5 (representative section of normal inferior lobe), D6 (tumor in relation to bronchus and vessel), D7 (tumor in relation to pleura), D8 (tumor in relation to normal lung), D9 (mucinous area of lung), and D10 (representative section of superior lobe of left lung). Additional cassettes for other specimens were also submitted.\n\nMicroscopic examination confirmed no evidence of carcinoma in any of the lymph nodes assessed. All margins were uninvolved by invasive carcinoma. A total of 22 lymph nodes were examined, and none showed involvement. The tumor was classified as unifocal and histologically moderately differentiated. The greatest tumor dimension was 2.7 cm, with additional dimensions measuring 2.5 cm and 1.5 cm. Visceral pleural invasion was not identified, and there was no lymph-vascular invasion. The closest distance from the invasive carcinoma to any margin was 0.6 mm at the vascular margin."} +{"pid": "TCGA-VS-A9UQ", "report": "The cervix showed a lesion measuring 4.0 cm in maximum extension and 1.5 cm in maximum depth of invasion. The tumor was located in the anterior half of the uterine cervix and infiltrated nearly all of the anterior cervical stromal thickness, with less than 1 mm distance from the circumferential anterior surgical margin. Foci of similar neoplastic cells were identified in the posterior wall of the cervix, confined to the surface epithelium. No definitive evidence of vascular, lymphatic, or perineural invasion was identified. The vaginal cuff, vagina, uterine isthmus, and corpus were free of tumor involvement. Surgical margins at the vaginal site showed no abnormal cellular proliferation. Parametrial tissues did not reveal any malignant infiltration. The Fallopian tubes were clear of disease. Leiomyomas were noted in submucosal, subserosal, and intramural locations within the uterus. All examined lymph nodes from the right iliac obturator, right obturator, and left iliac obturator regions showed no signs of neoplastic involvement."} +{"pid": "TCGA-CN-4739", "report": "A biopsy of the larynx revealed severe cellular atypia consistent with high-grade dysplasia or carcinoma in situ, with possible superficial invasion. A total laryngectomy was performed along with a right thyroid lobectomy. The surgical specimen contained a mass measuring 2.8 cm located predominantly on the right side involving the transglottic region. Histologic evaluation showed moderately differentiated squamous cell morphology without evidence of vascular or perineural invasion. The tumor extended into the thyroid cartilage but did not involve any of the resection margins, which were clear by at least 2 mm. No lymph node metastases were identified in the 54 lymph nodes examined from both sides of the neck; all were benign. Additionally, the right lobe of the thyroid contained benign follicular nodules. A separate soft tissue specimen submitted for evaluation of parathyroid tissue demonstrated normocellular parathyroid tissue with adequate intracytoplasmic lipid confirmed by Oil Red O staining. Intraoperative frozen sections of the laryngeal biopsy confirmed malignancy while the parathyroid biopsy was benign. The tumor was staged pathologically as pT4a with no regional lymph node involvement (pN0) and distant metastasis could not be assessed (pMX)."} +{"pid": "TCGA-B0-5695", "report": "The specimen consists of a left radical nephrectomy. The tumor is located in the lower pole and is unifocal. Grossly, the neoplasm measures 5.0 cm in greatest diameter, with additional dimensions of 3.5 x 2.0 cm. Microscopically, the tumor exhibits clear cell morphology with myxoid changes. Nuclear grading according to Fuhrman criteria is grade II of IV. The lesion is confined within the renal capsule without extension beyond it. There is no evidence of renal vein invasion or angiolymphatic invasion. Surgical margins are negative for involvement by the neoplasm. The adjacent non-neoplastic kidney tissue appears normal. No abnormality is identified in the adrenal gland. A total of zero regional lymph nodes were examined. Based on these findings, the pathologic staging is pT1b, with no regional lymph node assessment possible (pNX), and no distant metastasis identified (pMX). No other significant pathological findings are noted."} +{"pid": "TCGA-BP-5168", "report": "The right kidney specimen consists of a portion of renal tissue measuring 4.5 x 4.5 x 4 cm. A well-circumscribed, partially cystic mass is identified with yellow and golden areas consistent with necrosis. The mass measures 4 x 4 x 4 cm in greatest dimensions and is located adjacent to the renal capsule. Histologic examination reveals a solid growth pattern with cells exhibiting clear cytoplasm and nuclear features of intermediate grade. All surgical margins are free of tumor involvement. The surrounding non-neoplastic renal tissue appears normal.\n\nA separate specimen labeled \"Deep Margin #2\" consists of soft tissue and shows only benign renal parenchyma without any abnormal cellular proliferation.\n\nA small tan-colored tissue fragment measuring 0.3 x 0.3 x 0.3 cm was submitted as right renal cyst wall and demonstrates features consistent with a benign simple cyst.\n\nMultiple fragments of adipose tissue measuring 5 x 5 x 0.3 cm were submitted from paracaval tissue. No lymph nodes were identified within the specimen.\n\nFrozen section analysis during surgery showed a renal cortical neoplasm of clear cell type with clear margins."} +{"pid": "TCGA-B6-A0WY", "report": "Surgical pathology report.\n\nClinical history: Breast lesion.\n\nGross examination: A left breast excision specimen measuring 9.5 x 8.8 x 2.3 cm consists of firm, white fibroadipose tissue with an attached skin ellipse measuring 4.8 x 0.7 cm, which includes a 3.5 cm scar. The specimen is inked with superior margin blue, inferior margin black, and deep surgical margin green. Serial sectioning from medial to lateral reveals a firm, white, scirrhous lesion diffusely involving the entire specimen and extending to all margins. There are focal areas of punctate hemorrhage and cyst formation. The block summary includes multiple sections taken from the medial and lateral portions of the specimen, with representative samples demonstrating approach to all surgical margins.\n\nA second specimen labeled \u201cAxillary dissection\u201d measures 7.5 x 7.0 x 2.0 cm and consists of fibroadipose tissue. It is unoriented and contains multiple lymph node candidates. A total of 21 lymph node candidates were identified, with the largest measuring 2.0 x 1.3 x 0.8 cm and having a firm consistency. The block summary includes multiple lymph node candidates divided into five blocks.\n\nHistologic findings: A representative sample from the medial portion shows features consistent with glandular proliferation. The histologic grade is intermediate to high, with nuclear grade 2. The gross size of the lesion is 1.6 cm, with an invasive component measuring 1.5 cm. In situ changes are present, occupying approximately 10% of the lesion, with solid pattern morphology. An extensive intraductal component is not identified. Surrounding non-neoplastic breast tissue demonstrates duct ectasia, intraductal papillomatosis, and apocrine metaplasia. Lymphatic and vascular invasion is present and extensive.\n\nRegarding surgical margins, the lesion approaches the superior margin closely in a multifocal pattern; however, all margins are technically free of malignant involvement. Fresh tissue was reserved for hormone receptor analysis.\n\nIn the axillary dissection specimen, three of twenty-one lymph nodes show involvement by metastatic carcinoma. One involved lymph node demonstrates extracapsular extension.\n\nAdditional studies: Estrogen receptor analysis demonstrated positivity with an estimated fmol value of 20. Progesterone receptor activity was judged as negative with an estimated fmol value of 4."} +{"pid": "TCGA-QR-A70T", "report": "A right portal lymph node was examined and found to contain no abnormal tissue, with a size of 1.4 x 1.2 x 0.7 cm. It was processed in entirety for frozen section analysis during surgery, and the result was negative for any abnormal cells.\n\nA resected retroperitoneal mass was received, measuring 6.4 x 5.3 x 3.8 cm. The external surface of the specimen was nodular, and the cut surface showed a variegated appearance with areas of hemorrhage and yellow, highly nodular tissue. A portion of the specimen was inked and serially sectioned. Multiple representative sections were taken and placed in cassettes for further analysis. Gross photographs were taken for documentation.\n\nIntraoperative consultation was performed on the right portal lymph node, which was soft and yellow-tan in appearance. No abnormal cells were identified in the one lymph node assessed. The retroperitoneal mass was also processed for histological evaluation, and some areas showed close proximity of the tissue to the inked margin. Immunoperoxidase and in-situ hybridization methods were used in the assessment. These tests were developed and validated by the laboratory and are performed under CLIA certification for high-complexity testing. No other consultants were involved in the evaluation."} +{"pid": "TCGA-CV-5976", "report": "The pathology report includes multiple tissue specimens and lymph node groups evaluated for the presence of abnormal cells or involvement. In one region, four lymph nodes were identified without any abnormal cellular infiltration. A separate lymph node grouping contained one focus of atypical cells with evidence of spread beyond the lymph node capsule. Adjacent salivary gland tissue showed no abnormal findings.\n\nA nerve specimen on one side demonstrated atypical cells within the surrounding soft tissue. Another nerve specimen from the same region, including skeletal muscle, did not show any such involvement. A large resected tissue specimen measured 6.5 cm in its greatest dimension and revealed deeply located atypical cells that exhibited moderate to marked variation in differentiation. Perineural invasion was noted within this specimen.\n\nVarious mucosal and muscular regions from the tongue, floor of mouth, gingiva, and retromolar area were examined and found to be free of atypical cells. One additional lymph node region on the same side displayed a single involved lymph node with extranodal extension, while other lymph node levels showed no involvement. The remaining lymph nodes across all levels ranged from 0.2 cm to 2.5 cm in size and were negative for abnormal cellular infiltration.\n\nAdditional margins and tissues, including those from the lingual nerve, hypoglossal nerve, dorsal tongue, base of tongue, and maxillary regions, were also free of abnormal cells. One lymph node near the facial artery showed no signs of involvement. All other submitted tissues, including fibrovascular and dental samples, were similarly negative for abnormal findings."} +{"pid": "TCGA-B0-4834", "report": "The specimen consists of a right radical nephrectomy. A neoplasm is identified, measuring 4.0 cm in greatest diameter. Microscopically, the lesion demonstrates eosinophilic cytoplasm and nuclear features consistent with a high-grade morphology. The tumor is confined within the renal capsule without extension beyond it. No involvement of the renal vein or angiolymphatic invasion is observed. Surgical margins are negative for any neoplastic cells. The surrounding non-neoplastic kidney tissue shows hyaline arteriolosclerosis but no significant interstitial fibrosis or glomerulosclerosis. Additionally, an organizing hematoma is present in the subcapsular region. Based on the pathological findings, the tumor is classified as pT1a stage with histologic grade G3."} +{"pid": "TCGA-EX-A449", "report": "The left adnexal specimen includes a mass measuring 25 cm in greatest dimension, largely replacing the ovary with both solid and cystic areas containing thick yellow mucinous material. Solid regions show a friable and necrotic appearance in multiple areas. The fallopian tube is present and unremarkable except for a paratubal cyst measuring 2.5 cm. Focal involvement of the tubal epithelium by detached tumor cells is observed within the lumen.\n\nThe hysterectomy specimen shows tumor involvement of the endocervix and extends into the lower uterine segment. The endocervical canal is dilated and filled with tumor, which appears similar in morphology to the ovarian mass. The cervical tumor involves the entire circumference of the endocervix with several foci of invasion. The largest invasive focus measures 6.5 mm horizontally by 4 mm in depth, with stromal invasion limited to the inner half and reaching a depth of 4 mm. The cervical wall thickness is 15 mm, representing approximately 27% penetration. No serosal involvement is identified. The tumor extends into the left adnexa and right paratubal tissue. Margins are clear with 8 mm from the cervical margin and 9 mm from the vaginal margin.\n\nMultiple leiomyomas are present in the myometrium, with sizes up to 2.8 cm. Adenomyosis is also noted. The right ovary demonstrates physiologic changes including multiple cystic follicles and a hemorrhagic corpus luteum without evidence of tumor. The right fallopian tube has a paratubal cyst measuring 2.7 cm and shows tumor involvement within the paratubal region. The omentum shows no evidence of tumor involvement but demonstrates mesothelial hyperplasia and chronic inflammation.\n\nImmunohistochemical staining reveals positivity for CK7 and negativity for CK20 and CDX2 in all tumor sites. Tumor cells are strongly and diffusely positive for p16 and positive for high-risk human papillomavirus (hrHPV) by in situ hybridization. The left fallopian tube tumor focus is negative for p53. Additional immunostains for p63 and CK5/6 highlight squamous dysplasia.\n\nIntraoperative consultation on the left adnexal mass showed features consistent with a low malignant potential tumor and no evidence of metastatic melanoma. Representative sections from the cervix confirmed adenocarcinoma.\n\nGrossly, the left adnexal specimen weighs 900 grams and measures 25 x 22 x 11.5 cm. The endocervical tumor has a height of 4.9 cm and width of at least 3.5 cm. It invades into the cervical stroma but does not reach the outer soft tissue margins, with the closest distance being 0.6 cm. The right ovary measures 4 x 2 x 1.7 cm and shows no gross tumor involvement. The right fallopian tube measures 7 cm in length and 1 cm in width. The omental specimen consists of a 29 x 18 cm lobulated adipose sheet with an average thickness of 2 cm and no macroscopic tumor infiltration.\n\nBased on available data, staging information was assigned as follows: pathologic stage pT1b1 pNx pM1 according to AJCC criteria and FIGO (2008) Stage IVB. These designations are provisional and may be revised pending further clinical correlation."} +{"pid": "TCGA-JL-A3YW", "report": "The specimen consists of two blocks representing left breast tissue. Microscopic examination reveals that one block contains a cellular neoplastic lesion composed of intermediate-sized cells with moderate nuclear atypia and eosinophilic cytoplasm. Mitotic figures are present. The surrounding stroma shows a moderate degree of chronic inflammatory infiltrate. Focal areas of necrosis, involving less than 5% of the tissue, are also observed. The second block consists of benign breast tissue without evidence of neoplasia. Grading based on the Modified Bloom and Richardson system indicates a total score of 6 out of 9 (tubule formation 2/3, nuclear pleomorphism 2/3, mitoses 2/3). Neoplastic nuclei account for approximately 70% of all nuclei identified in the sample."} +{"pid": "TCGA-X6-A7WA", "report": "The specimen consists of a resected mass from the right pericardial region measuring 5.0 x 4.3 x 3.8 cm, along with an attached membrane measuring 3.2 x 3.0 x 0.2 cm. The mass is well-circumscribed and has a white, smooth, glistening lining. Upon sectioning, it reveals tan-white, whorled cut surfaces that approach most margins. A portion of the mass appears less circumscribed and shows infiltration into adjacent fat, located 0.2 cm from the surgical margin. There is also a central area measuring 1.6 x 1.5 x 1.3 cm that is red and softened. Sections submitted include representative portions of the tumor near the margin.\n\nMicroscopic evaluation shows a hypercellular spindle cell neoplasm arranged in bundled fascicles. The cells display marked nuclear atypia, including bizarre forms and atypical mitotic figures. Mitotic activity is estimated at 2-10 per high power field. Geographic areas of necrosis are present. Immunohistochemical staining demonstrates strong positivity for desmin and smooth muscle actin. The tumor extends to the inked resection margin."} +{"pid": "TCGA-WB-A80Q", "report": "The surgical specimen included the left and right adrenal glands. The left adrenal gland contained a tumor measuring 14 x 8 x 4 cm, weighing 202 grams. On gross examination, the tumor was encapsulated by fatty-connective tissue and demonstrated a soft, partially cystic appearance with areas of hemorrhage. The second specimen, measuring 2 x 2 x 1 cm and weighing 2 grams, corresponded to normal adrenal tissue with preserved zonal architecture and yellow, lobulated fatty tissue.\n\nMicroscopically, the tumor was composed of polygonal cells with granular cytoplasm and hyperchromatic nuclei. The stroma was well-vascularized, and a connective tissue capsule surrounded the lesion, with focal attachment to normal adrenal tissue. Periodic Acid-Schiff (PAS) staining confirmed these histological features. The central region of the tumor showed hyalinization and focal edema. Tumor cells were observed infiltrating retroperitoneal fat and present within lymphatic vessels. No definitive hyperplasia of the adrenal medulla was identified in the second specimen, which showed normal adrenal architecture with an expanded medulla occupying approximately one-third of the adrenal diameter.\n\nA separate pathology report noted the presence of tumor cells in a lymph node removed during the initial surgery."} +{"pid": "TCGA-ER-A2NB", "report": "The specimen from the resection includes a nodule measuring 45 mm in maximum surface diameter, with invasion into the muscularis propria. A surface ulcer is present, covering more than 50% of the lesion. Histologic evaluation reveals a mitotic rate of 1 per mm squared. Angiolymphatic invasion is identified, while perineural invasion is not present. There is no evidence of histologic regression or microscopic satellites. No preexisting lesion is noted. The lymphoid infiltrate within the tumor is absent. Vascularity is not markedly increased.\n\nA total of 21 lymph nodes were examined, with 2 containing metastatic material less than 2 mm in size. No extracapsular spread is observed. All surgical margins, including proximal, distal, and radial, are free of involvement. Additionally, a separate skin margin specimen shows only focal acute inflammation and no malignant cells. Immunostains demonstrate reactivity for S100, MelanA, and Tyrosinase, while cytokeratin AE1/3 is negative. Previous studies include BRAF and KIT testing. A prior excision of a left groin lymph node showed similar findings."} +{"pid": "TCGA-D5-5537", "report": "Histopathological examination was performed on a specimen consisting of a 19.9 cm length of the large intestine with surrounding periintestinal tissue measuring 25 x 13 x 3 cm, an 8 cm segment of the small intestine, and a 7 cm appendix. A cauliflower-shaped lesion was identified in the intestinal mucosa, measuring 4.7 x 9.3 x 1.2 cm. This lesion circumferentially involved the intestinal wall and was located 9.2 cm from the proximal cut end, 12.2 cm from the distal cut end, and 1.2 cm from the ileocecal valve. The lesion was accompanied by polyps up to 1.5 cm in size.\n\nMicroscopic evaluation revealed complex glandular structures with marked architectural and cytologic atypia. There was deep infiltration into the muscularis propria and extension into the pericolic adipose tissue. The margins of the resected intestine were free of neoplastic involvement. Adjacent tissue showed adenomatous polyps with moderate to severe dysplasia. Reactive lymphadenopathy was noted in regional lymph nodes. The vermiform appendix appeared unremarkable."} +{"pid": "TCGA-AK-3443", "report": "The right kidney specimen weighed 850 grams and measured 15.0 x 11.0 x 10.5 cm. The kidney was markedly distorted with multiple bulging areas and was grossly enlarged. A segment of ureter measuring 6.0 x 0.3 cm was unremarkable. At the hilum, several tan to brown rubbery to firm nodes were present, ranging from 0.7 to 1.5 cm in size, with tan to brown cut surfaces. A small portion of residual adrenal gland measuring 1.5 x 1.0 x 0.6 cm was also noted at the hilum and appeared unremarkable. Perinephric fat was sparse, ranging from 0.1 to 0.5 cm in thickness. Some areas of fat overlying nodules were submitted for histological evaluation. The capsule overlying these nodules was inked black and submitted in relation to the kidney lesion.\n\nUpon bisection, a yellowish-orange soft mass measuring 12.0 x 9.0 x 9.5 cm was identified, occupying approximately 80% of the kidney. The mass significantly distorted the calyceal system and extended toward the renal pelvis and capsule, though no definitive invasion was observed. The tumor contained areas of white fibrous tissue suggestive of possible scarring, along with significant hemorrhage. Adjacent renal parenchyma showed slight scarring but maintained well-defined cortical-medullary junctions.\n\nSections were taken from multiple areas: including the ureter and vascular margins, the relationship of the tumor to the renal pelvis, the tumor in relation to the capsule, the center of the tumor, the interface between the tumor and adjacent uninvolved parenchyma, the tumor overlying fat, the residual adrenal gland, lymph nodes, and additional sections of the tumor.\n\nA separate specimen labeled as a portion of the right adrenal gland measured 5.0 x 2.2 x 0.8 cm and weighed 6 grams. It displayed golden-yellow-orange cut surfaces and was unremarkable on histological examination.\n\nHistologically, immunohistochemical staining showed positivity for E-Cadherin (membranous staining), many cells positive for CK7, and weak positivity for Vimentin. The tissue was negative for CD10, CK903, and CD117 (only cytoplasmic staining). Colloidal iron special stain revealed strong, granular cytoplasmic staining in many cells, while mucicarmine stain was negative. These findings were considered in the context of a differential diagnosis that included low-grade chromophobe carcinoma versus atypical oncocytoma.\n\nCytogenetic analysis of the renal mass demonstrated a normal male karyotype: 46,XY[20]. Chromosomes from twenty metaphases were analyzed, with three karyotyped by G-banding. The modal chromosome number was 46, showing no clonal abnormalities. This result may reflect overgrowth of normal interstitial tissue rather than neoplastic origin.\n\nAdditional histomorphological evaluation noted foci of strong colloidal iron staining and widespread CK7 positivity, leading to the interpretation of an oncocytic neoplasm with features intermediate between oncocytoma and chromophobe carcinoma, described as having low malignant potential."} +{"pid": "TCGA-AA-A02E", "report": "A moderately differentiated neoplasm is present, involving the colon. The lesion demonstrates infiltration through all layers of the bowel wall and exhibits lymphovascular and blood vessel invasion. Evaluation of lymph nodes reveals involvement in four separate sections. The resection margins, including those at the ligature site, show no evidence of tumor involvement. Histologic grade is intermediate. Pathologic staging indicates extension beyond the muscularis propria into surrounding tissues, with regional lymph node involvement. Vascular invasion is present. Distant metastasis could not be assessed."} +{"pid": "TCGA-77-8150", "report": "Histopathology Report. HISTORY: Frozen section submitted for analysis. MACROSCOPIC: Six specimens received. Specimen 1 is an unlabeled tissue fragment measuring 6 x 4 x 3 mm. Frozen section diagnosis showed no evidence of malignancy. Specimen 2, labeled as right lung, measures 220 x 160 x 90 mm. The upper and lower lobes are well-formed, with a rudimentary middle lobe and poorly formed horizontal fissure. The pleural surface over the lower lobe is ragged with redundant pleura noted. Firm induration is palpable on the medial surface of the lower lobe. A firm mass measuring 43 x 25 x 20 mm is present in the lower lobe near the hilar region, with endobronchial extension approaching within 7 mm of the bronchial resection margin and causing complete obstruction of the lower lobe bronchus. The right upper lobe shows firmness in its inferior portion but is largely free of pathology. Sectioning reveals multiple perihilar lymph nodes and extensive pneumonia with purulent material in the lower lobe. Other components include bullous changes in the upper lobe, normal lung tissue with subpleural lymph node, and fibrotic pleural adhesion. Specimens 3 through 6 consist of lymph nodes measuring 15 x 19 x 10 mm (Specimen 3), 35 x 15 x 20 mm (Specimen 4), 20 x 15 x 10 mm (Specimen 5), and 15 x 10 x 10 mm (Specimen 6), respectively.\n\nMICROSCOPIC: Specimen 1 confirms no malignancy, showing bronchial cartilage, seromucinous glands, and surrounding fibroadipose tissue. Specimen 2 demonstrates a polypoid endobronchial lesion with invasion through the bronchial wall into adjacent lung and hilar fibroadipose tissue. There is no pleural or vascular invasion; however, perineural permeation is observed near a hilar soft tissue margin (0.3 mm). The bronchial resection margin is clear, though squamous metaplasia is present. Obstructive pneumonitis and mild bronchiectasis are seen distal to the lesion. Background lung shows emphysema, respiratory bronchiolitis, dust deposition, and mild pulmonary artery atheroma. Peribronchial lymph nodes show silicotic nodules and sinus histiocytosis with focal granulomatous changes; no organisms identified on special stains. Subpleural lymph node contains a large silicotic nodule. Lymph nodes from specimens 3 through 6 all show reactive changes without evidence of malignancy.\n\nSUMMARY: Right lung and lymph nodes: Lesion shows moderate differentiation with endobronchial growth and local invasion into adjacent lung and hilar tissue. Perineural involvement is present near the hilar margin (0.3 mm), but no lymphatic or vascular invasion is observed. Bronchial resection margin is clear. Metastatic involvement is present in peribronchial lymph nodes. Non-neoplastic findings include emphysema, respiratory bronchiolitis, and chronic inflammatory changes in lung tissue."} +{"pid": "TCGA-D8-A27L", "report": "Histopathological examination was performed on a resected right breast measuring 19.0 x 14.0 x 2.5 cm. The specimen included a skin flap of 14 x 8 cm but no axillary tissue. A lesion measuring 1.1 x 0.6 x 1.0 cm was identified in the upper inner quadrant, located 2.5 cm from the lower boundary, 0.5 cm from the base, and 1.0 cm from the skin. Microscopic evaluation revealed invasive cellular proliferation with a histological grade of NHG1, based on mitotic count (2 + 2 + 1/5 mitoses per 10 high power fields in a visual area of 0.55 mm). Widespread in situ cellular changes were also present within the lesion, characterized by cribriform architecture, medium nuclear atypia, and punctate necrosis, comprising approximately 30% of the lesion. No involvement was observed at the base, with invasive components located 5 cm from the margin. The nipple showed no abnormalities. Additional findings included fibrocystic changes in the glandular tissue. Immunohistochemical analysis demonstrated strong expression of estrogen and progesterone receptors, with over 75% of neoplastic nuclei staining positive for each. HER2 immunostaining using Ventana's Pathway HER-2/neu (4B5) Rabbit Monoclonal Antibody yielded a score of 1+, indicating a negative result in invasive areas. The margins and lymph node status could not be assessed based on the material provided."} +{"pid": "TCGA-DJ-A3UN", "report": "The clinical history notes a prior fine needle aspiration of a 1.2 cm lesion in the left thyroid lobe. Submitted specimens included a Delphian lymph node, left lower parathyroid tissue, left paratracheal tissue, a total thyroidectomy specimen, and pretracheal tissue.\n\nThe Delphian lymph node was benign and consisted of one lymph node. The left lower parathyroid tissue was benign and measured 0.3 cm. The left paratracheal tissue was also benign, measuring 2.0 x 0.6 x 0.5 cm. The total thyroidectomy specimen weighed 15 grams after fixation. The right lobe measured 4 x 2.5 x 0.8 cm, the left lobe 4 x 2.5 x 1.2 cm, and the isthmus 2 x 0.5 x 0.4 cm. A nodule measuring 1 x 1 x 0.9 cm was identified in the left lobe. The remaining thyroid tissue showed nodular hyperplasia and chronic lymphocytic thyroiditis. No tumor was identified at the surgical margins. Additional findings included two small foci within the thyroid, measuring 0.1 cm in the left lobe and 0.2 cm in the right lobe. No adenomas or abnormal parathyroid tissue were found. Two benign lymph nodes were identified near the thyroid. The pretracheal tissue was composed of benign fibroadipose tissue.\n\nFrozen section analysis during surgery confirmed benign lymph node and parathyroid tissues. Final pathology confirmed these findings. All submitted tissue sections were reviewed and no malignancy was identified in the lymph nodes or other sampled tissues."} +{"pid": "TCGA-B6-A0X5", "report": "Curgical Pathology: Final. CLINICAL HISTORY: A large lesion in the left breast with microcalcifications diffusely surrounding the area. GROSS EXAMINATION: A. \"Left breast mass (Af1)\" \u2013 Received is a breast biopsy specimen and frozen section remnant. The tissue measures 5.0 x 4.0 x 3.5 cm. The surgical team indicated that margins are not critical, so the specimen was not inked. Upon sectioning, a red-brown nodule measuring 3.0 x 2.5 x 1.5 cm is identified. Tissue from this nodule has been submitted for ER/PR analysis. A remnant of frozen section from the red-brown tissue measuring 1.7 x 1.3 x 0.3 cm is submitted entirely in Block A1, with representative sections of the nodule included in Blocks A2-A4. B. \"Left breast\", fresh \u2013 This is an 18 x 25 x 6 cm mastectomy specimen including a 23 x 14 cm skin ellipse and a 12 x 9.5 cm axillary tail. The skin ellipse contains a normal-appearing nipple and areola, with a 5.5 cm biopsy scar in the lower medial region. The deep margin of the breast is inked black. Sectioning through the breast reveals a 5 x 4 x 4 cm hollow cavity located in the lower medial quadrant, lined by smooth white tissue. The cavity is 0.5 cm from the distal inked margin, 0.8 cm from the posterior inked margin, and 12 cm from the proximal inked margin. Adjacent to the lateral edge of the cavity, there is a firm, finely granular, grey-pink lesion measuring 1.5 x 1.5 x 1 cm. The closest distances from this lesion to the inked margins are 1.5 cm from the distal margin, 4 cm from the posterior margin, and 11 cm from the proximal margin. It is also located 2 cm beneath the anterior skin surface. The remainder of the breast consists of yellow-white fibrofatty tissue, with a prominent white fibrous focus noted in the upper midportion. BLOCK SUMMARY: B1 includes a representative section of the nipple. B2-B5 include tissue from around the cavity, including the firm lesion described. B6-B7 are sections from the prominent fibrous area in the upper midportion. B8-B9 represent the upper medial portion, B10-B11 the lower medial portion, B12-B13 the upper lateral portion, and B14-B15 the lower lateral portion. B16 to B20 include various lymph node candidates from the axillary tail. INTRA OPERATIVE CONSULTATION: Af1: \"Left breast mass\" \u2013 A malignant infiltrating process is identified. \n\nSUMMARY: A nodule measuring 3.0 x 2.5 x 1.5 cm is present in the initial specimen. In the mastectomy specimen, a residual lesion measuring 1.5 x 1.5 x 1.0 cm is identified, located at a distance from all inked surgical margins. Histologic features show well-differentiated nuclear grade and low histologic grade. A minor component of a distinct morphologic pattern is present, accounting for less than 25% of the total volume. Of the axillary lymph nodes evaluated, 3 out of 14 contain metastatic involvement, with the largest focus measuring 1.8 x 1.1 cm. No extranodal extension is observed. All surgical margins, including skin, nipple, and lactiferous duct, are free of involvement."} +{"pid": "TCGA-YU-A94I", "report": "The specimen involves the left testis and measures 8.5 x 7.0 x 6.0cm. Histologic evaluation reveals a predominant component comprising approximately 95% of the total volume, characterized by tissue architecture and cellular morphology consistent with a specific neoplastic process. A minor component, accounting for about 5%, demonstrates features indicative of a distinct but associated cellular pattern. Extensive necrotic regions are present, along with significant desmoplastic reaction. No evidence of perineural or angiolymphatic invasion is identified. The tunica albuginea remains unaffected, as are the spermatic cord, epididymis, and surgical margin. Background testicular parenchyma shows moderate atrophy. Immunohistochemical analysis was performed for further characterization. Pathologic staging indicates a primary lesion confined to the testis without extension beyond the tunica albuginea (pT1)."} +{"pid": "TCGA-BH-A0HK", "report": "The specimen consists of a right-sided modified radical mastectomy with axillary lymph node dissection. The invasive lesion measures 4.3 x 3.2 x 2.2 cm and is located in the upper outer quadrant, with extension into the upper inner quadrant. The Nottingham score is 6 out of 9, composed of tubule formation score 3, nuclear grade score 2, and mitotic activity score 1, corresponding to histologic grade 2. The invasive component approaches within less than 1.0 mm of the upper inner deep resection margin and approximately 1.0 mm from the junction of the upper inner and upper outer deep margins. No lymphovascular invasion is identified.\n\nThe nipple shows involvement of the deep dermis by atypical epithelial proliferation. The overlying skin demonstrates seborrheic keratosis without evidence of malignancy. Changes consistent with prior core biopsy are noted. Adjacent benign findings include atypical ductal epithelial hyperplasia, fibrocystic changes with duct ectasia and ductal epithelial hyperplasia, and medial calcification of blood vessels.\n\nTwo of seventeen axillary lymph nodes contain metastatic involvement. The largest nodal deposit measures 6.0 cm in diameter, with extracapsular extension up to 4.0 cm. Immunohistochemical staining shows positivity for estrogen receptor, negativity for progesterone receptor, and negativity for HER-2/neu (score: 0).\n\nPathologic staging reflects T stage pT2 and N stage pN1. Benign calcifications are present in non-neoplastic zones. No Paget\u2019s disease of the nipple is identified."} +{"pid": "TCGA-A5-A0GX", "report": "The specimen consists of a total abdominal hysterectomy with bilateral salpingo-oophorectomy, along with vaginal margins. The uterus measures 7.5 cm from fundus to the resection margin at the lower uterine segment, and weighs 200 grams. The endometrial cavity is approximately 6.5 cm in length and up to 3.5 cm wide. There is an exophytic, friable, and focally necrotic tan to red-tan mass measuring about 5.5 x 3.5 cm involving the posterior and anterior regions of the uterus, including the fundus, corpus, and lower uterine segment. Minimal uninvolved endometrial mucosa is present, with a maximum thickness of 0.2 cm. Microscopic examination reveals extensive involvement of the endometrium by epithelial malignancy with features consistent with glandular proliferation showing nuclear atypia. An endometrial polyp is partially replaced by similar cellular changes.\n\nThere is irregular and undulating disruption of the endometrial-myometrial interface. Superficial invasion into the myometrium is identified in the uterine corpus, involving less than 10% of the myometrium. In the posterior lower uterine segment, there is relatively superficial invasion involving no more than 20% of the uterine wall thickness. Secondary involvement of adenomyosis and an adenomyoma is noted. No definitive evidence of lymphatic or vascular invasion is observed. The tumor approaches the lower uterine segment-endocervical junction anteriorly and posteriorly; however, no invasion of the endocervix is evident. The ectocervix, vaginal cuff, and parametrial tissues are free of malignant cells.\n\nThe right fallopian tube demonstrates epithelial abnormalities within the mucosa of the proximal and middle segments, with tumor-like tissue present in the lumen and as free-floating aggregates near the fimbriated end. Some of these aggregates appear partially encapsulated by inflamed and hemorrhagic adhesions, while others appear uncontained. The significance of these findings in relation to the primary lesion remains uncertain. Both fallopian tubes show areas of epithelial hyperplasia. The left fallopian tube also shows mucosal endometriosis and subserosal changes consistent with endosalpingiosis.\n\nThe ovaries demonstrate senescent changes, cortical stromal hyperplasia, and hyperthecosis. No tumor involvement is identified in either ovary. Multiple cystic structures, including Walthard rests and mesothelial cysts, are present adjacent to the fallopian tubes. The vaginal margins show chronic inflammation and reactive squamous changes without evidence of malignancy.\n\nHistologic evaluation of the endometrium reveals a mixture of inactive/weakly proliferative and hyperplastic areas, including both simple and complex glandular patterns with variable degrees of cellular atypia. Adenomyosis is present with and without associated epithelial abnormalities. The cervix demonstrates inflammatory and reactive changes, including microglandular hyperplasia, squamous metaplasia, and parakeratosis. There are surface mucosal defects in the cervix and lower uterine segment consistent with prior curettage.\n\nGross examination of the hysterectomy specimen shows a shaggy supracervical resection margin and a separate trachelectomy specimen measuring 5.5 cm in length. The vaginal cuff attached to the cervix measures up to 0.7 cm and appears unremarkable. The uterine wall has a maximum thickness of 3.5 cm in uninvolved areas, with slight induration noted in superficial areas suggesting minimal myoinvasion. A single intramural leiomyoma measuring 1.5 cm is identified without necrosis or hemorrhage.\n\nAll surgical margins are negative. Multiple sections were submitted for microscopic analysis, including serial cross-sections of the fallopian tubes, ovaries, parametrial tissues, and vaginal margins. No immunohistochemical studies were performed."} +{"pid": "TCGA-WX-AA44", "report": "A partial hepatectomy specimen from the left lateral segment of the liver was received for evaluation. The specimen weighed 270 grams and measured 15.0 x 10.0 x 4.5 cm. A well-circumscribed nodular lesion measuring 3.5 x 3.5 x 1.5 cm was identified within the tissue, located 1.5 cm from the resection margin. The surrounding liver tissue showed architectural distortion with fine fibrotic septa and regenerative nodules consistent with micronodular cirrhosis. There was a moderately severe lymphocytic infiltrate within the fibrous septa and focal mild interface hepatitis. No significant macrovesicular steatosis was observed. Special stains including Prussian blue for iron and Diastase PAS for alpha-1-antitrypsin accumulation were negative.\n\nHistologically, the lesion showed moderately to poorly differentiated cellular features. The tumor was confined to the liver without evidence of macroscopic or microscopic vascular invasion. Resection margins, including a vascular margin, were free of involvement by the lesion. The closest distance from the tumor to the parenchymal margin was 15 mm.\n\nThe background liver demonstrated changes of cirrhosis with minimal steatosis. The etiology of cirrhosis was not definitively determined based on the findings, as the features were atypical for non-alcoholic fatty liver disease. No other neoplastic changes were noted in the submitted tissue.\n\nFive tissue blocks were examined microscopically, including sections from the tumor adjacent to the capsule, the vascular margin, the resection margin, and uninvolved liver tissue. Relevant stains were reviewed and included reticulum, trichrome, Diastase PAS, and Prussian blue.\n\nBased on the AJCC 2010, 7th edition staging system, the tumor was classified as pT1NX, indicating a solitary tumor without vascular invasion and no assessable regional lymph node involvement. The procedure was documented as a minor hepatectomy with a solitary lesion in the left lateral segment."} +{"pid": "TCGA-QR-A70H", "report": "A left adrenal mass was resected and submitted for pathological evaluation. The specimen weighed 57.5 grams and measured 7.6 x 6.8 x 6.9 cm. It consisted of two distinct components: a normal-appearing adrenal tissue segment measuring 4.1 x 1.8 x 0.6 cm, and a separate nodule measuring 5.2 x 4.6 x 2.9 cm. The nodule had a brown/red soft texture with a tan/red cut surface and punctate hemorrhages. A faint rim of tissue resembling normal adrenal structure was observed at the periphery of the nodule. Approximately 30% of the nodule and a small fragment (0.4 x 0.2 x 0.2 cm) were procured for further analysis. About 40% of the normal-appearing adrenal tissue was also sampled, including a small fragment measuring 0.2 x 0.2 x 0.1 cm. The remaining portion of the specimen was processed for permanent sectioning, with approximately 80% of the tissue submitted in cassettes. Histological evaluation included immunohistochemical staining on selected tissue blocks. The lesional cells showed diffuse positivity for S-100, NSE, synaptophysin, and CD56. Some sections also contained adrenal cortical tissue. The surgical findings noted a large left adrenal mass without invasion of surrounding structures. The specimen was entirely inked, and the procurement description was provided by the submitting party. This laboratory is CLIA-certified to perform high-complexity testing, and the assays used were developed and validated internally."} +{"pid": "TCGA-F2-A44G", "report": "Biopsy specimens from multiple liver segments, including segments 2, 3, 4, and left lobe, showed no evidence of malignancy. Findings included cholestasis and a small hyalinized granuloma in one area. Biopsies of the pancreatic duct margin, bile duct margin, and gallbladder also showed no tumor, with the gallbladder exhibiting autolysis. A lymph node biopsy revealed metastatic involvement measuring 2 mm, with extranodal extension identified. The primary lesion was identified in the head of the pancreas and measured 3.5 cm. Histologic evaluation showed moderately differentiated features with involvement of peripancreatic soft tissues, duodenum, and ampulla. Lymphatic and perineural invasion were present, while venous invasion was not identified. Surgical margins were assessed; the pancreatic neck margin was involved, and the peripancreatic soft tissue margin was very close (<0.1 mm). Other margins, including bile duct, gastric, and duodenal, were free of tumor. Of 16 lymph nodes examined, 3 contained metastases. Additional findings included focal atrophic changes and chronic pancreatitis. Gross examination of the Whipple specimen confirmed tumor involvement extending beyond the pancreas, with stenosis of the distal common bile duct and involvement of the ampulla. Multiple tissue blocks were submitted for further analysis, including surgical margins and lymph nodes."} +{"pid": "TCGA-WE-A8K4", "report": "Surgical Histology. ADDRESS FOR REPORT: HISTOPATHOLOGY REPORT. CASE HISTORY: Lesion on skin. 8mm punch biopsy submitted. MACROSCOPIC: 8 mm punch biopsy received. MICROSCOPY: A punch excision of skin shows a lesion which appears completely excised. No evidence of dysplasia or atypical cells is seen. \n\nADDRESS FOR REPORT: Report to Cancer Registry. HISTOPATHOLOGY REPORT. CASE HISTORY: Superficial mass present for many years with ulceration overlying the lesion. Clinical consideration of fat necrosis in old lipoma. MACROSCOPIC: One core of tissue measuring 0.9 cm, along with fragmented samples. MICROSCOPIC: Fragmented needle core biopsy of fibrofatty tissue reveals a malignant neoplasm composed of pleomorphic large epithelioid and spindle-shaped cells. These cells have abundant eosinophilic (sometimes faintly yellowish) cytoplasm and large eosinophilic nucleoli. Surrounding tissue demonstrates chronic fibro-inflammatory changes with focal yellowish-brown pigment, likely blood-derived. Differential diagnosis includes melanocytic origin or metastatic carcinoma. Clinical correlation is requested. This is a provisional urgent report; further assessment with immunohistochemical staining is ongoing. \n\nSUPPLEMENTARY REPORT: Histochemical and immunohistochemical studies performed. Tumor cells do not contain melanin pigment. They show strong positivity for S100 protein, Melan A, and HMB-45, while negative for keratins. These findings support a melanocytic lineage. \n\nREPORT DATE: MINIMUM DATA SET. LAB NUMBER: PRIVATE PATIENT. CLINICAL HISTORY: Mass located on right upper arm. MACROSCOPIC: Large disc of skin measuring 12 x 17 x 3.5 cm. Central suture line with underlying firm tumor measuring up to 4 cm in diameter. Tumor has been sliced open with disruption noted. Distance from tumor to margin approximately 4 cm, minimum 2.0 cm. Deep margin appears black, peripheral margin yellow. Margins A and B are continuous, C and D continuous, E and F random. MICROSCOPIC: Tumor morphology is nodular with vertical growth pattern. Breslow thickness measures 12.00 mm. Mitotic rate is 4 per square millimeter. No regression, lymphovascular invasion, perineural invasion, microsatellites, or coexistent naevus identified. Tumor-infiltrating lymphocytes are non-brisk. The tumor is completely excised. Deep margin measures 0.3 mm, circumferential margin 20.0 mm. Stage is pT4a. COMMENT: Specimen was sliced open prior to receipt, so ulceration cannot be definitively assessed. Consideration of systemic evaluation to exclude metastatic origin is recommended.\n\nADDITIONAL REPORT: BRAF immunostain is negative. Molecular testing for BRAF gene mutation using PCR for Codon 600, Exon of BRAF gene showed no mutation detected.\n\nHISTOPATHOLOGY REPORT. CASE HISTORY: Prostate chips obtained via catheter due to retention. Digital exam suggests hard prostate. PSA pending. Clinical suspicion of prostate malignancy. MACROSCOPIC: Prostate chips weigh 24g. MICROSCOPIC: Infiltrating adenocarcinoma present in more than 90% of the sample. Histological features consistent with Gleason score 4+4=8 with tertiary pattern 5. Stage pT1b."} +{"pid": "TCGA-IM-A3EB", "report": "The right hemithyroidectomy specimen shows a well-circumscribed lesion measuring 3.0 cm in greatest dimension, with additional dimensions of 2 x 2 cm. Microscopic evaluation reveals focal extension through the thyroid capsule into surrounding skeletal muscle. Lymphovascular invasion is present. Resection margins are free of tumor, although the tumor approaches the peripheral margin within 1.0 millimeter. A second smaller nodule measuring 0.3 cm is identified within the right lobe. The remainder of the thyroid tissue demonstrates features consistent with chronic lymphocytic thyroiditis.\n\nExamination of the right inferior laryngeal nerve tissue reveals a microscopic focus of involvement confirmed by cytokeratin immunostaining. The lateral margin at the pharyngeal constrictor muscle is free of tumor. The left hemithyroidectomy specimen also shows changes of chronic lymphocytic thyroiditis without evidence of neoplastic involvement.\n\nLymph node assessment includes prelaryngeal and right paratracheal dissection specimens. In the prelaryngeal lymph nodes, one of two nodes shows micrometastasis in the subcapsular sinus. In the right paratracheal dissection, one of nine nodes contains metastatic involvement. No pathologic changes are noted in salivary gland tissue.\n\nStaging parameters indicate extrathyroid extension without gross invasion beyond the thyroid capsule. Regional nodal involvement is identified in Level VI lymph nodes. Distant metastasis could not be assessed. Venous and lymphatic invasion are present. All immunostains were evaluated and interpreted by a pathologist. Intraoperative frozen section analysis was performed on several specimens, with no tumor identified in those samples."} +{"pid": "TCGA-GL-A4EM", "report": "The operative procedure involved a right partial nephrectomy for a right renal mass. The specimen measured 4.8 x 4.2 x 3.8 cm and appeared entirely composed of the mass. Gross examination revealed a soft, heterogeneous, multiloculated yellow-tan and hemorrhagic cut surface. No attached uninvolved renal parenchyma was identified. The tumor was unifocal and confined to the kidney. Histologic evaluation showed high-grade nuclear features with a Fuhrman grade of 3. Microscopic analysis included assessment of representative sections from the specimen. No cancer was identified at the resection margin. Evaluation of nonneoplastic kidney tissue showed no significant pathology. Lymph node assessment was not applicable. Staging was determined as pT1b with no lymph node or distant metastasis identified."} +{"pid": "TCGA-AO-A124", "report": "A 46-year-old female presented with a palpable right breast mass and left breast calcifications. Multiple sentinel lymph nodes from both axillae were biopsied, along with axillary contents from both sides. \n\nOn the left side, one of the sentinel lymph nodes showed evidence of a small metastatic deposit measuring less than 1 mm, confined within the node. The remaining sentinel lymph nodes on the left were negative for tumor involvement. Additional lymph nodes from the left axilla were also examined, and two out of four contained metastatic deposits measuring 1 mm and 2.2 mm respectively, without extranodal extension.\n\nThe left breast specimen revealed an invasive lesion measuring 2.3 cm in the largest dimension, located at the junction of the upper outer and lower outer quadrants. A second focus of smaller size (0.9 cm) was identified centrally within the breast. In addition, there was a component of high-grade ductal carcinoma in situ (DCIS), solid type, with extensive necrosis, accounting for up to 25% of the total tumor burden. This DCIS was found both admixed with and separate from the invasive component. The invasive and in situ components were present in the upper outer and lower outer quadrants, without involvement of the nipple or surgical margins. Vascular invasion was not identified, and no skin involvement was noted. The non-neoplastic breast tissue showed marked secretory changes. Lymph node assessment on the left showed no positive nodes at level I (0/8) or level II (0/4).\n\nIn the right breast, an invasive lesion measured 4.6 cm grossly and was located at the junction of the upper outer and lower outer quadrants. No evidence of vascular invasion, calcifications, or skin involvement was seen. Surgical margins were free of tumor. The non-neoplastic breast tissue also showed marked secretory changes. Lymph node evaluation on the right showed no positive nodes at level I (0/8) or level II (0/1).\n\nImmunohistochemical studies performed on the left breast specimen demonstrated negative estrogen and progesterone receptors, and positive HER2/neu staining (3+ intensity). The right breast specimen was negative for all three markers (estrogen receptor, progesterone receptor, and HER2/neu). \n\nAll other sentinel lymph nodes examined from the right axilla were negative for tumor involvement, including deeper recuts and special stains."} +{"pid": "TCGA-J8-A3YE", "report": "The specimen consists of a left thyroid lobe and isthmus measuring approximately 4.5 x 2.8 x 2.4 cm, weighing 12 grams. A nodule is identified within this specimen, measuring 3.5 cm in greatest dimension. The tumor extends through the capsule into adjacent soft tissues and demonstrates focal involvement of attached skeletal muscle. Surgical margins are uninvolved. Two perithyroidal lymph nodes are present and show no evidence of tumor involvement. The right thyroid lobe measures 4.3 x 2.6 x 1.5 cm and weighs 5.5 grams; no abnormality is identified in this specimen. Central compartment lymph nodes were also submitted for evaluation. Among two lymph nodes recovered from this region, one contains tumor involvement. No extranodal extension is observed. Histologic assessment reveals well-differentiated morphology. Lymph node sampling includes four total lymph nodes across all specimens; one lymph node demonstrates involvement without extranodal extension. No distant metastasis is identified. Perineural invasion is not present. Minimal extrathyroidal extension is noted."} +{"pid": "TCGA-FZ-5923", "report": "The specimen from the pancreatic head measured 3.8 cm in greatest dimension, with additional dimensions of 3.2 x 2.5 cm. The tumor extended beyond the pancreas into the surrounding soft tissue and duodenum. Lymph node involvement was identified in one of thirteen peripancreatic lymph nodes. Negative margins were confirmed at the proximal gastric, distal duodenal, bile duct, pancreatic, retroperitoneal, vascular groove, and vein notch margins, with the closest distance of invasive carcinoma to a margin being 2 mm at the vascular groove. Histologic evaluation revealed well-differentiated ductal-type cells. Invasion of both venous and lymphatic vessels was present, as was perineural invasion. Additional findings included high-grade pancreatic intraepithelial neoplasia. A separate lesion involving fibroadipose tissue was identified in the transverse mesocolon, with no further lymph node involvement seen in additional specimens from that site. Multiple benign lymph nodes were identified across specimens."} +{"pid": "TCGA-DX-A7EF", "report": "The patient presented with a history of an enlarging left thigh mass. A biopsy was performed prior to resection. Specimens submitted for analysis included four tissue samples: the supra-lateral margin of the resection, the vastus intermedius margin, the distal vastus lateralis margin, and the primary mass itself.\n\nGross examination of the mass revealed a specimen measuring 17.0 x 15.0 x 7.0 cm, which included a 4.0 x 0.6 cm ellipse of skin. Upon bisection, a firm gray-white intramuscular mass was identified measuring 12.0 cm in its greatest dimension. The mass was surrounded by a pseudocapsule and was located 1.5 cm from both the proximal and distal margins. The tumor was relatively well-circumscribed within the surrounding tissue. The superficial margin was noted to be within 0.025 cm of the tumor, while all other margins were widely free. A small portion of the specimen was used for tissue preservation and photographs were taken for documentation.\n\nMicroscopic evaluation of the margins (supra-lateral, vastus intermedius, and distal vastus lateralis) showed no evidence of abnormal cells, with all sections revealing benign soft tissue or skeletal muscle. The primary mass demonstrated high-grade cellular atypia, including areas resembling giant cell-rich regions. Necrosis was present in approximately 10% of the specimen. The tumor was found in close proximity to the designated superficial margin, but other margins were free of involvement.\n\nIntraoperative frozen section analysis of all margins confirmed benign findings, consistent with permanent section diagnoses. The mass exhibited aggressive histologic features, with a high nuclear grade and significant pleomorphism."} +{"pid": "TCGA-E2-A14Y", "report": "The surgical specimens include multiple sentinel lymph nodes from the right axilla, ranging in size from 0.6 cm to 2.5 cm. All were histologically negative for tumor involvement. A right mastectomy specimen was submitted, measuring 17.5 x 16 x 2.5 cm, with a skin ellipse and everted nipple. A central infiltrating mass measuring 2.7 cm in greatest dimension was identified in the mid upper breast. The mass was firm, white-tan, and located in slices 7\u20139, closest to the anterior margin at 0.5 cm. A biopsy site with surrounding granular tissue was noted in the upper outer quadrant spanning approximately 4 cm. Multiple tissue blocks were submitted for microscopic evaluation, including representative sections of the mass, margins, fibrous tissue, and nipple regions. Margins were histologically negative. Adjacent to the invasive component, there was evidence of an in situ component involving lobules, characterized by solid-type ductal carcinoma in situ with high nuclear grade and necrosis. Microcalcifications were also present. No tumor was identified in the skin or nipple. An additional axillary tail specimen consisted of fibrofatty tissue with no identifiable lymph nodes or tumor. A separate scalp lesion measuring 1.4 x 1.3 x 1 cm was submitted and showed features consistent with a pilar cyst. Histological assessment of all specimens revealed no vascular or lymphatic invasion. Immunohistochemical staining demonstrated positivity for ER, PR, and HER2 (confirmed by FISH). Pathological staging was determined as pT2, N0 (sentinel lymph node only)."} +{"pid": "TCGA-BC-A110", "report": "The liver resection specimen weighed 1100 grams and measured 17.5 x 16.5 x 5.4 cm. The external surface was dark red, smooth, and glistening with focal fibrinous adhesions. A well-circumscribed, encapsulated mass measuring 4.8 x 4.8 x 4.5 cm was identified, with a soft, variegated red/yellow hemorrhagic cut surface and small cystic areas up to 0.5 cm in diameter. This lesion was located 4.8 cm from the black-inked surgical margin and 0.2 cm from the capsule. A separate subcapsular nodule measuring 0.8 x 0.6 x 0.4 cm with a white granular appearance was found 6.2 cm away from the main lesion and at least 8 cm from the surgical margin. Sections of the mass, adjacent liver tissue, and normal liver were submitted for analysis.\n\nMicroscopic evaluation showed no evidence of fibrosis or cirrhosis in liver tissue distant from the lesions, although mild parenchymal fibrosis was noted adjacent to the larger mass. The smaller subcapsular lesion exhibited sclerotic features. All histologic sections were reviewed and findings were confirmed. Tissue samples were distributed for further study and research purposes."} +{"pid": "TCGA-B0-4714", "report": "A radical nephrectomy specimen from the right kidney demonstrates a lesion measuring 5.0 cm in greatest dimension, with additional dimensions of 4.5 x 4.0 cm. Histologic evaluation reveals high-grade nuclear features consistent with Fuhrman nuclear grade III. The lesion extends into perinephric tissues and involves the renal sinus fat focally. There is evidence of vascular invasion involving the renal vein. No involvement of surgical margins is identified.\n\nExamination of the renal vein margin biopsy shows no evidence of tumor. The non-neoplastic kidney tissue exhibits focal global glomerulosclerosis within a background of moderately severe hypertensive vascular disease.\n\nAn adrenal gland specimen reveals a separate nodule composed of similar cellular morphology to that seen in the kidney. This deposit is distinct from the main renal lesion and is interpreted as a metastatic focus. A lymph node specimen described as \u201chyaline\u201d consists of a nodule with comparable histologic features but lacks identifiable lymphoid tissue or architectural features necessary to confirm lymph node involvement. Therefore, lymph node involvement cannot be confirmed histologically.\n\nThe staging assessment indicates advanced local extension with venous involvement and distant dissemination. Based on available findings, the pathologic staging classification reflects extensive tumor spread."} +{"pid": "TCGA-BR-8368", "report": "The specimen consists of a segment of stomach with a tumor measuring 6 cm in its largest dimension. The tumor is ulcerated and involves the muscularis propria layer, without venous invasion. Microscopically, the lesion shows poorly differentiated morphology with focal mucin production and areas of necrosis. Fifteen lymph nodes were examined, including those from the greater and lesser omentum, none of which showed evidence of metastasis. Reactive hyperplasia and hyperemia are noted in the fatty tissue and omental specimens, along with findings of hemorrhage. The surgical margins are not specified, and there is no evidence of neoadjuvant treatment effect. Additional pathologic findings are not reported."} +{"pid": "TCGA-NI-A4U2", "report": "The specimen includes a gallbladder, left lobe of the liver, a right lobe liver nodule, a new margin from segment VI of the liver, and a left lobe close parenchymal margin.\n\nThe gallbladder measures 7.5 x 2.5 x 1.0 cm with a smooth serosal surface and contains pink-black bile. No stones or masses are identified macroscopically. The mucosa appears velvety and green to yellow with an average wall thickness of 0.3 cm. Sections submitted show no histopathological abnormalities.\n\nThe left lobe liver specimen weighs 1125 grams and measures 20 x 18 x 9 cm. Grossly, there are multiple subserosal nodules with several tumor masses ranging from 1.0 x 1.5 x 0.5 cm to 13.0 x 12.8 x 8.5 cm. The largest mass demonstrates fusion with adjacent smaller masses and extends to the capsule but not through it. It has a gray-yellow, friable appearance with focal necrosis and hemorrhage. Two stitches mark the resection margins\u2014one inked yellow and one black. The closest distance from the major tumor mass to the parenchymal margin is 0.2 cm; the second-largest mass is 1.0 cm from the black inked margin. Histologically, angiolymphatic invasion is present. The non-neoplastic liver tissue shows dilated vessels and occult nodularity. Multiple sections were submitted across ten cassettes.\n\nThe right lobe liver nodule (segment IV) measures 3.5 x 2.8 x 3.0 cm with three stitches marking orientation and multiple ink colors identifying margins. A well-circumscribed tan-gray mass measuring 1.5 x 1.2 x 1.0 cm is located beneath the capsule within less than 1 cm distance. It has a granular texture on sectioning. Histologic evaluation reveals angiolymphatic invasion. This portion shows involvement of the medial and inferior margins of resection. Six cassettes were submitted for analysis.\n\nA newly defined margin from segment VI of the liver is received as an irregular cauterized fragment measuring 6.0 x 3.0 x 1.5 cm with three attached stitches inked blue. Microscopic examination shows no malignancy. Three cassettes were submitted.\n\nThe left lobe parenchymal margin consists of two fragments of soft tissue, one marked by a suture. Both are friable with the larger fragment showing a homogeneous tan-brown cut surface upon sectioning. Histologic examination reveals no residual malignancy. Three cassettes were submitted.\n\nMicroscopic evaluation of all specimens confirms absence of tumor at the parenchymal margins. Additional findings include focal bridging fibrosis and bile duct proliferation in the non-neoplastic liver tissue from the left lobe and fibrous expansion of portal triads in the right lobe.\n\nStaging assessment indicates confinement to the liver without margin involvement by invasive tumor. Angiolymphatic invasion is documented. Multiple tumor nodules are present in both lobes with the largest measuring 13.0 cm in greatest dimension."} +{"pid": "TCGA-ZF-AA4T", "report": "The surgical specimen consisted of bladder and prostate tissue measuring 100mm in longitudinal dimension with a tumour located at the base, predominantly on the left side. The tumour measured 27mm x 32mm x 40mm and exhibited a firm, white, homogeneous surface with focal haemorrhage. Microscopic examination revealed a poorly differentiated solid carcinoma arising from dysplastic urothelium, invading through muscular layers without breach of circumferential margins. The tumour extended into prostatic ducts in a pagetoid pattern and invaded the prostate; however, the prostatic margin itself was morphologically normal. Areas of comedo-type necrosis were present, but no vascular or perineural invasion was identified. The tumour approached closely to the seminal vesicle wall without direct involvement, and a giant cell reaction was noted adjacent to this area.\n\nThe urethral surgical margin demonstrated carcinoma in situ along with invasive carcinoma. Focal carcinoma in situ was identified at one ureteric margin, while another ureteric margin showed similar findings without invasive malignancy. One surgical resection margin of the ureter appeared histologically normal. Regional lymph node assessment revealed two involved lymph nodes with metastatic carcinoma and extracapsular extension. An additional lymph node from the right external iliac region initially raised concern for involvement but subsequent immunohistochemical analysis confirmed absence of metastatic disease.\n\nBackground tissue evaluation showed morphologically normal urothelium in areas away from the tumour. No high-grade prostatic intraepithelial neoplasia or microacinar adenocarcinoma was observed in the prostate. Carcinoma in situ was also noted in the background and at specific surgical margins."} +{"pid": "TCGA-OL-A66N", "report": "The left breast modified radical mastectomy specimen includes a mass measuring 8.5 x 6.5 x 4.2 cm, located 0.7 cm from the posterior margin and 0.5 cm from the anterior skin. Microscopically, the lesion measures 6.6 cm across slices 5\u201311 and demonstrates 20% cellularity. Histologic evaluation reveals a composite grade II based on architecture (score 3), nuclear grade (score 2), and mitotic rate (score 1). The lesion is associated with in situ changes that extend beyond the main mass. Surgical margins are widely (>1 cm) free of involvement. No evidence of blood vessel or lymphatic invasion is identified. The nipple-areolar complex and overlying skin show no ulceration or retraction.\n\nFifteen lymph nodes were examined, with thirteen containing metastatic involvement. The largest nodal deposit measures 1 cm, and extranodal extension is present, with the largest focus measuring 2 mm. A biopsy tract filled with gel is noted in slices 6\u20137, with a clip present in slice 7. The remainder of the breast tissue consists largely of adipose tissue with minimal fibrous parenchyma. No additional masses or nodules are observed.\n\nImmunohistochemical analysis shows moderate to strong ER expression in 80% of tumor nuclei and absence of PR expression. HER2 testing by FISH demonstrates no amplification (ratio: 1.10). Staging according to AJCC 7th edition is pT3, N3, MX. Preoperative biopsy showed significant hyalinization, which is also present in the post-treatment specimen, making assessment of treatment response challenging. No significant response is noted in the lymph nodes."} +{"pid": "TCGA-UZ-A9Q0", "report": "The patient is a male who underwent resection of a complex renal cyst in the left upper pole. A partial nephrectomy specimen was received, measuring 5.0 x 4.5 x 3.0 cm with attached perinephric fat. The specimen contained a well-encapsulated cystic lesion measuring 4.8 x 4.2 x 2.0 cm filled with friable brown-yellow material. The capsule appeared intact and ranged from 0.2 to 0.4 cm thick. The lesion extended to within 0.1 cm of the surgical margin but did not breach the capsule or involve surrounding adipose tissue. Adjacent renal tissue appeared normal.\n\nMicroscopic examination revealed cellular features consistent with high-grade epithelial neoplasm. Histologic grading showed predominantly Fuhrman grade 2 nuclei with occasional grade 3 nuclei identified. No tumor involvement was seen at the base margin biopsy or in multiple sections of surrounding tissues including fibrous capsule, perinephric fat, hilar tissue, or cyst wall. All margins were negative for tumor involvement.\n\nExamination of surrounding adipose tissue and fibrous structures showed no evidence of metastatic disease or lymph node involvement. No calyceal or collecting system tissue was identified. Staging assessment indicated limited extent confined to the renal parenchyma without extension into surrounding structures or vascular invasion. No lymph nodes were present for evaluation.\n\nMultiple tissue fragments submitted from various anatomical locations around the lesion were reviewed and showed only benign findings including chronic inflammation, hemosiderin deposition, and necrotic debris. Specimens included biopsies from lower renal lesion, perihilar tissue, perinephric fat, and cyst wall, all of which lacked any evidence of abnormal cellular proliferation.\n\nThe specimen was processed in seven parts with extensive sampling performed. Frozen section analysis during surgery confirmed presence of abnormal tissue in the left renal mass and absence in other sampled regions. Final diagnosis was confirmed by attending pathologist after comprehensive slide review."} +{"pid": "TCGA-BH-A0BF", "report": "A single lymph node from the right axillary sentinel #1 was examined and found to be free of tumor. In the right axillary sentinel #2, micrometastatic involvement was identified in one out of two lymph nodes, with a maximum dimension of 1.5 mm. The primary lesion was identified in the right breast following total mastectomy. The tumor measured 2.7 x 2.5 x 2.4 cm and exhibited a Nottingham score of 9 (3 each for tubule formation, nuclear grade, and mitotic count). Lymphovascular invasion was extensive. Ductal carcinoma in situ of solid and cribriform types was present, showing nuclear grade 3 features, comedonecrosis, microcalcifications, and retrograde involvement of lobules, accounting for approximately 5% of the tumor volume. Carcinoma in situ was also observed admixed with and extending beyond the invasive component. Surgical margins were clear of tumor involvement. No tumor was identified in the nipple or skin specimens. Changes related to a prior biopsy site were noted. Additional findings included atypical ductal epithelial hyperplasia, fibroadenoma with fibroadenomatoid nodular changes, fibrocystic alterations with columnar cell changes, ductal epithelial hyperplasia, microcalcifications, a microscopic capillary hemangioma, and medial calcification of a blood vessel. Immunohistochemical staining for estrogen receptor, progesterone receptor, and HER-2/neu was in progress. Additional stains for E-cadherin and p120 supported a ductal phenotype for the in situ component."} +{"pid": "TCGA-19-2623", "report": "A biopsy and removal specimen from the right frontal lobe of the brain was received fresh for intraoperative consultation. The tissue measured 2.0 x 1.2 x 0.2 cm and was described as an irregular segment of red-tan, soft tissue. A portion was used for frozen analysis, with the remainder submitted for permanent sections. A second specimen, received in formalin, consisted of six light tan to brown, irregular to wedge-shaped soft tissue fragments ranging in size from 0.5 x 0.4 x 0.2 cm to 1.8 x 1.7 x 0.6 cm. The largest fragments were serially sectioned, revealing a light tan, lobulated appearance. All tissue was submitted entirely in four cassettes: A1 and A2 for frozen sections, A3 for the remaining red-tan soft tissue, and B1-B4 for the sectioned and remaining fragments. Microscopic evaluation of touch imprint and intraoperative material showed high-grade cellular features consistent with a malignant process."} +{"pid": "TCGA-3Q-A9WF", "report": "The thymus specimen obtained via thymectomy weighs 97 grams and measures 16 x 7 x 1.5 cm. A distinct mass located in the right superior horn measures 3.5 x 3 x 2.5 cm and is well-defined, easily palpable, with a pink-tan, smooth, glistening surface resembling fish flesh. The mass is homogeneous and appears well-encapsulated without gross evidence of capsular penetration. It comes within 0.1 cm of the anterior right superior horn margin and 0.2 cm from the posterior margin.\n\nHistologically, the mass consists of an admixture of small and large lymphocytes along with epithelial cells. Immunohistochemical staining demonstrates that the lymphoid cells are predominantly CD3-positive T cells, while the epithelial cells are highlighted by pankeratin staining. Hassall's corpuscles are present within the tissue. No definitive capsular invasion is observed microscopically.\n\nOne intrathymic lymph node was identified and showed no evidence of malignancy. Surgical margins are uninvolved by tumor; however, the closest distance from the tumor to the anterior margin is less than 1 mm. No lymphovascular invasion or distant metastases were identified. Based on these findings, the staging classification assigned is Stage I. \n\nAdditional studies including flow cytometry were performed. Clinical, radiologic, and surgical correlation is recommended."} +{"pid": "TCGA-DX-A8BL", "report": "The specimen submitted for analysis consists of a resected tissue sample from the right deltoid region, including skin, subcutaneous tissue, and skeletal muscle, with overall dimensions of 15 x 9.2 x 5.0 cm. A well-demarcated mass measuring 5.6 x 2.8 x 2.2 cm was identified within the deep subcutis extending into skeletal muscle. The mass has a white-tan, bulging cut surface with 5\u201310% gross necrosis. All surgical margins (superior, inferior, anterior, posterior, and deep) are free of tumor involvement, with the closest margin being 1.5 cm at the posterior edge. The tumor demonstrates a heterogeneous morphology, including areas with prominent inflammatory and lymphoid aggregates, as well as Reed-Sternberg-like cells. Other regions show a fascicular growth pattern with a mixture of spindled and pleomorphic cells. Immunohistochemical staining shows negativity for CDK4 and MDM2. Lymphocytic components demonstrate reactivity with markers including CD3, CD20, BCL2, kappa, lambda, and CD43. Tissue sections from all relevant margins and the tumor have been processed and reviewed."} +{"pid": "TCGA-PL-A8LV", "report": "The specimen from a female patient was procured on [date]. Gross examination revealed a variegated mass measuring 5x3x2cm with no lymph nodes identified. Microscopic evaluation demonstrated a necrotic and invasive lesion exhibiting growth in trabecular, cord-like, syncytial, and solid nest patterns. The tumor cells were large, displaying pleomorphic and hyperchromatic nuclei along with amphophilic cytoplasm. A desmoplastic stromal reaction was present, containing similar tumor cells and lymphocytic aggregates. The tumor was classified as malignant and located in the right breast. The closest margin involvement was noted at 3mm on the deep resection margin. Nuclear grading was assessed as score 3. Staging according to the pathological TNM classification was determined to be pT2."} +{"pid": "TCGA-56-8083", "report": "The surgical pathology report describes a specimen from the left lung and associated lymph nodes. The left upper lobe of the lung was received, weighing 25 grams and measuring approximately 16.5 x 10.5 x 4.5 cm. A well-circumscribed, non-encapsulated lesion was identified on the medial aspect of the lobe, measuring 3.5 x 3.5 x 2.5 cm, with a distance of 2.5 cm from the bronchial margin and 0.4 cm from the pleural surface. The surrounding tissue appeared soft and pink. The bronchial margin was evaluated and found to be free of involvement. A fragment of tissue within the bronchial lumen was noted in one section but was interpreted as an artifact of handling. Additional tissue was sampled from the bronchus distal to the margin, and no further involvement was identified.\n\nLymph node biopsies were submitted from stations R4, L4, 5, and 7. All lymph nodes were small, ranging from 0.2 to 0.7 cm in size, and were described as soft, black, or tan in appearance. Each lymph node was entirely submitted for evaluation and found to be benign without evidence of any abnormal cellular infiltration.\n\nMicroscopic examination of the lung specimen revealed poorly differentiated cells arranged in a pattern consistent with a malignant process. The tumor did not show direct extension, lymphovascular space invasion, or involvement of the pleural surface. Two peribronchial lymph nodes were also free of involvement.\n\nThe final pathological staging was determined as pT2a pN0."} +{"pid": "TCGA-AA-3818", "report": "The specimen shows a moderately differentiated invasive lesion with features of extracellular mucus formation. The lesion extends through all layers of the wall. Resection margins are clear, and no vascular or lymphatic invasion is identified. Lymph nodes examined are negative. The condition is associated with chronic recurrent appendicitis."} +{"pid": "TCGA-AY-A69D", "report": "A 23.5 cm long by 5.2 cm in circumference segment of large bowel with attached omentum (measuring 30.4 x 15.6 x 0.8 cm) and pericolonic adipose tissue up to 4.3 cm thick was received. The appendix was absent. A firm, pink-tan, centrally ulcerated circumferential mass measuring 5.2 x 2.6 x 0.7 cm was identified. It protruded into the lumen, was located 10.7 cm from the proximal margin and 6.6 cm from the distal margin. On cut section, the mass was firm, smooth, gray-white, and extended 1.1 cm through the wall with focal extension into the mesentery, causing retraction of the serosa but not penetrating through it. The mass was 3.5 cm from the mesenteric margin. The distal margin had an attached suture inked blue, and the serosa overlying the mass was inked black. The uninvolved mucosa appeared tan with a normal folding pattern. The omentum showed patchy areas of hemorrhage without nodules.\n\nThe tumor was moderately differentiated and invaded through the muscularis propria into the subserosa and pericolic soft tissue. No lymphovascular or perineural invasion was identified. All margins\u2014proximal, distal, and mesenteric\u2014were negative. The closest distance from the tumor to the distal margin was 6.6 cm.\n\nA total of 29 lymph node candidates were identified within the pericolonic adipose tissue, ranging in size from 0.2 cm to 0.8 cm in greatest dimension. Of these, 25 were examined microscopically and none showed metastatic involvement.\n\nImmunohistochemical staining for MLH-1, MSH-2, PMS-2, and MSH-6 demonstrated appropriate positive nuclear expression in tumor cells, indicating a normal phenotype. These findings did not support microsatellite instability or hereditary non-polyposis colorectal cancer. Additional molecular testing for microsatellite instability was planned and would be reported separately. Appropriate controls were used during testing.\n\nPathologic staging based on available information was pT3 pN0. This assessment was subject to revision pending clinical review and further data."} +{"pid": "TCGA-12-1098", "report": "A 3.5 x 2.9 x 1.2 cm aggregate of soft pink-tan brain tissue was received, showing distinct white and gray matter features. Representative sections were processed for frozen section analysis and submitted in multiple blocks for further evaluation. Microscopic examination revealed a neoplastic proliferation of small to intermediate-sized astrocytes, with areas of pseudopalisading necrosis and modest vascular proliferation.\n\nCytogenetic analysis showed polysomy of chromosome 7 in 72% of cells and polysomy of EGFR in 78% of cells, while other markers including chromosome 10 centromere, PTEN, 9p21, and chromosome 9 centromere remained intact. Two out of four abnormal markers were identified. Immunohistochemical testing demonstrated a high proliferation index, with 20% of tumor cells showing staining. Leucocyte common antigen (LCA) was positive in 40% of cells, MGMT was negative in 90% of tumor cells, and wild-type EGFR was strongly expressed in 90% of tumor cells. Variant III of EGFR was not detected. Staining for PTEN showed loss in 60% of cells, S6 was negative in 80% of cells, AKT was positive in 80% of cells, and MAPK was also positive in 80% of cells. Discrepancy between PTEN immunohistochemistry and FISH findings may be explained by epigenetic mechanisms such as methylation."} +{"pid": "TCGA-D8-A3Z5", "report": "Histopathological examination was performed on a total organ resection specimen of the right breast along with axillary lymph nodes. The breast measured 27.8 x 17.2 x 6.8 cm and weighed 940 g. A lesion measuring 4.2 x 2.4 x 1.4 cm was identified at the boundary of the outer quadrants, located 2.2 cm from the outer margin, 1.6 cm from the base, and 2.6 cm from the skin. Axillary lymph nodes were present, with at least one measuring 1 cm in length.\n\nMicroscopic evaluation revealed a cellular proliferation characterized by invasive growth pattern and nuclear features consistent with low mitotic activity (3 + 1 + 1 / 0 mitoses per 10 high-power fields). Adjacent mammary tissue showed changes suggestive of pre-invasive lesions involving lobular structures. Associated parenchymal atrophy was also noted.\n\nExamination of axillary lymph nodes revealed involvement by malignant cells with infiltration extending into the surrounding connective tissue. Immunohistochemical analysis demonstrated expression of estrogen and progesterone receptors in approximately 75% of tumor cell nuclei. HER2 staining showed minimal reactivity (Score = 1+), indicating no significant overexpression.\n\nThe pathological staging reflects a primary lesion size corresponding to T2 classification and extensive nodal involvement classified as N3a."} +{"pid": "TCGA-IR-A3LH", "report": "The surgical specimens submitted included multiple lymph node groups from the right and left para-aortic, external iliac, common iliac, obturator, hypogastric, and parametrial regions, as well as the posterior vaginal margin and a radical hysterectomy specimen with bilateral salpingo-oophorectomy.\n\nMicroscopic evaluation of the right periaortic lymph nodes showed two benign lymph nodes, with one involved by endosalpingiosis. The left para-aortic lymph node was also benign and showed endosalpingiosis. The posterior vaginal margin demonstrated invasive cellular changes with poor differentiation, and an ulceration was present in the proximal region. Tumor involvement was noted at the left lateral distal margin, though the margin examined during frozen section was confirmed to be benign.\n\nExamination of the radical hysterectomy specimen revealed a poorly differentiated or undifferentiated cellular proliferation within the uterine cervix. The tumor measured 8 mm in thickness out of a total depth of 12 mm. No evidence of multicentricity, vascular invasion, or perineural invasion was identified. In situ changes were also present. Vaginal extension was observed, but no parametrial involvement was found. All surgical margins were free of abnormal cellular changes. The endometrium appeared normal, while the myometrium showed adenomyosis. The right ovary contained a serous cystadenoma, and all other adnexal tissues were unremarkable. Seven benign lymph nodes from the right parametrial area were identified without evidence of metastasis. An incidental adrenal rest and occluded blood vessels were found in the right parametrium.\n\nThe posterior vaginal cuff margin was extensively ulcerated and inflamed. While invasive changes were not definitively identified in this portion, they were confirmed in the additional posterior margin sample. All other lymph node groups, including right and left external iliac, common iliac, obturator, and hypogastric regions, were negative for malignant involvement. A single lymph node from the left obturator group showed endosalpingiosis. The left parametrial excision contained only benign fibroconnective tissue and a single benign lymph node."} +{"pid": "TCGA-XM-A8RI", "report": "A 3.5 x 3.0 x 2.5 cm tan-white, lobulated, well-encapsulated soft mass was identified within the thymus. The tumor demonstrated capsular invasion; however, surgical margins were negative for involvement. No lymphovascular invasion was observed. Five benign lymph nodes were examined and found to be free of tumor. The specimen weighed 29.0 grams and measured 7.5 x 4.5 x 3.8 cm in total, consisting of tan rubbery tissue with surrounding adipose. Lymph nodes identified within the adipose tissue ranged from 0.3 cm to 0.8 cm in greatest dimension. All lymph nodes and the entire mass were submitted for examination."} +{"pid": "TCGA-VS-A8EL", "report": "The biopsy specimen from the cervix reveals a poorly differentiated invasive carcinoma composed of atypical squamous cells. The tumor cells exhibit marked nuclear pleomorphism, increased nuclear-to-cytoplasmic ratios, and frequent mitotic figures. The lesion extends into the stromal tissue, with evidence of infiltrative growth. No lymphovascular invasion is identified. The histologic grade is high, based on the degree of differentiation and architectural features."} +{"pid": "TCGA-XE-AANJ", "report": "The specimen consists of a left testicle measuring 9 x 5 x 4.5 cm, which is firm and enlarged. The testicle is attached to a spermatic cord measuring 7 cm in length and 1.5 cm in diameter. Upon bivalving, the testicle is found to be entirely replaced by a fleshy, solid, tan-pink, multinodular mass. The surgical margin of the spermatic cord is inked blue, with the remainder inked black. Representative sections from the spermatic cord margin, additional portions of the spermatic cord, epididymis, and multiple sections of the testicular mass are submitted for analysis. Microscopic evaluation reveals extensive involvement of the testicle with extension into the rete testis. There is no involvement of the tunica vaginalis or epididymis. Lymphovascular invasion is identified within the spermatic cord, including at the cord margin."} +{"pid": "TCGA-IG-A97H", "report": "Gross Description: The specimen shows a tumor located in the lower esophagus, approximately 3 cm from the Z line. The tumor is ulcerated and invasive, measuring 8 x 6 x 6 cm. It has a soft consistency and a white-gray surface. Microscopic Description: The mucosa is ulcerated. The tumor tissue forms groups or trabeculae, with cells connected to each other. The malignant cells have moderate amounts of lightly eosinophilic, keratinized cytoplasm. The nuclei are enlarged, showing variation in size and shape, with coarse chromatin and prominent nucleoli. Mitotic figures are present. The tumor invades into fat tissue, and the stroma is fibrous with lymphocytic infiltration. Specimen type: Esophagectomy. Tumor site: Abdominal esophagus. Tumor size: 8 x 6 x 6 cm. Histologic grade: Poorly differentiated. Tumor extent: Involves adventitia. Margins: Uninvolved. Evidence of neo-adjuvant treatment: No."} +{"pid": "TCGA-DH-5142", "report": "The specimen consisted of two tissue samples obtained from a male patient who underwent left side craniotomy. \n\nSample A measured 3.2 x 2.5 x 2.0 cm and was described as a dome-shaped, edematous beige to gray-tan homogenous tissue. A representative section was processed for frozen analysis, which showed infiltrating cells with nuclear features suggestive of anaplastic change. Tissue was submitted in cassettes A2\u2013A4 for further evaluation. \n\nSample B measured 3.6 x 3.3 x 0.9 cm and was a homogenous beige to gray-tan soft tissue with focal yellow to white softening. Representative sections were submitted in cassettes B1\u2013B4. \n\nMicroscopic examination revealed a highly infiltrative glial tumor with areas showing increased cellularity, nuclear pleomorphism, and an elevated mitotic index. Notably, these features were most evident in sections A3 and A4. The tumor cells exhibited a prominent gemistocytic morphology and were positive for GFAP immunostaining. Although mitotic figures were not numerous, the Ki-67 labeling index was approximately 9% (ranging between 6\u201313%) in the more cellular regions. These findings were consistent with a high-grade glioma with anaplastic features. \n\nBoth specimens demonstrated similar histological characteristics and were classified according to WHO grading criteria. The tumor showed a combination of diffuse low-grade morphology interspersed with regions exhibiting higher-grade transformation."} +{"pid": "TCGA-BT-A20P", "report": "The patient underwent a radical cystectomy with creation of an ileal conduit and left nephroureterectomy. Examination of two right pelvic lymph nodes and two left pelvic lymph nodes revealed no evidence of malignancy. The distal right ureter showed benign tissue with reactive changes and no signs of neoplasia.\n\nIn the urinary bladder and urethra specimen, a high-grade lesion measuring 4.5 cm was identified. This lesion extensively involved the left bladder wall and left trigone, encasing the distal left ureter and causing pre-stenotic dilatation. The lesion penetrated through the detrusor muscle into the perivesical fat. A separate focus measuring approximately 0.7 cm was identified in the submucosal tissue at the periurethral margin; all other surgical margins were free of abnormal cells.\n\nA focal area of in situ involvement was also noted. No perineural invasion was observed, however angiolymphatic invasion was present with tumor thrombi identified in both lymphatic vessels and a small vein.\n\nAdditional findings included chronic cystitis and a small urachal remnant in the bladder dome. Histologic evaluation demonstrated features consistent with a high-grade morphology.\n\nPathologic staging was assigned as T3a with no assessment of nodal or metastatic spread (Nx, MX). No invasive carcinoma was identified in the left kidney or ureter. The kidney showed signs of severe chronic damage including pyelonephritis, glomerulosclerosis, vascular disease, and hydronephrosis. The left ureter displayed focal cellular atypia of uncertain significance."} +{"pid": "TCGA-E2-A15F", "report": "The surgical specimens include an upper outer quadrant left breast lumpectomy and a second left breast specimen, along with three sentinel lymph nodes. The upper outer quadrant lumpectomy measured 2.5 x 2.5 x 2 cm and showed a firm fibrous area measuring 0.5 x 0.4 x 0.3 cm, located 0.2 cm from the posterior margin. Histological evaluation revealed benign breast tissue, including a radial scar and a prior biopsy site, without evidence of malignancy.\n\nThe second lumpectomy specimen, oriented medially to laterally, measured 1.8 x 1.5 x 1.5 cm and contained a firm tan stellate lesion that was less than 0.1 cm from the anterior margin. Histologic analysis demonstrated invasive ductal carcinoma with Scarff-Bloom-Richardson Grade II features, including a tubular score of 3, nuclear grade 2, and mitotic score of 1. There was also associated ductal carcinoma in situ (DCIS), solid type, with low nuclear grade, comprising approximately 5% of the lesion. Lymphovascular invasion was present, but margins were uninvolved by either invasive or in situ components. The maximum tumor dimension used for staging was 1.8 cm, resulting in a pathological stage of pT1c.\n\nThree sentinel lymph nodes were submitted. The first was a 1.5-cm lymph node within 2 x 1.5 x 1 cm of adipose tissue; the second measured 0.5 cm within 1.5 x 1 x 0.3 cm of adipose tissue; the third measured 2 cm within 2 x 2 x 1 cm of adipose tissue. All were reactive and lacked evidence of metastatic involvement.\n\nHormone receptor testing showed positivity for estrogen and progesterone receptors, with a negative result for HER2. Oncotype DX assay yielded a recurrence score of 7, associated with a 10-year distant recurrence risk of approximately 6%. The patient's case was discussed with the treating physician, and all findings were reviewed."} +{"pid": "TCGA-DK-A6B2", "report": "The specimen from the bladder, prostate, seminal vesicles, and surrounding tissue shows a lesion with extensive involvement of the perivesical soft tissues. The tumor extends into the right and left ureters, as well as the urethra and periurethral prostatic ducts, with infiltration into the prostatic stroma. Vascular invasion is present and widespread, and perineural invasion is also identified. Tumor is present at the surgical margins of both ureters and the urethra. The non-invasive component displays a flat growth pattern, while the invasive component exhibits an infiltrating morphology. Multiple distinct areas of involvement are noted within the bladder.\n\nThe primary lesion measures 5.0 x 4.8 x 1.8 cm and is located in the left and right posterior walls of the bladder, involving both ureteral orifices. The cut surface appears white-pink, with extension into the surrounding fat. Two additional ovoid lesions measuring 0.6 x 0.4 cm are found at the dome and right posterior wall. The remaining mucosa appears pink-tan with normal folds.\n\nLymph node dissection on the right side includes two nodes, one of which contains metastatic disease. The largest involved lymph node measures 1.8 cm in diameter, with a metastatic focus measuring 0.9 cm. No lymph nodes are identified in the left pelvic dissection.\n\nBoth distal ureter specimens show involvement by in situ carcinoma, with the resection margins similarly affected. Microscopic evaluation confirms the presence of high-grade cells with malignant features in these regions.\n\nStaging indicates invasion of the perivesical soft tissue, with additional extension into periprostatic and periseminal vesicle soft tissues."} +{"pid": "TCGA-F4-6460", "report": "The submitted specimen consists of an excised tissue fragment from the large intestine. The tumor was located in the sigmoid colon and measured 4 x 3 x 1 cm. Microscopic examination revealed a moderately differentiated cellular growth pattern. The tumor extended into pericolonic tissues, and metastatic involvement was identified in 1 out of 6 intraabdominal lymph nodes. Surgical margins were free of tumor involvement. No features related to prior treatment were noted. No additional significant pathologic findings were reported."} +{"pid": "TCGA-V9-A7HT", "report": "The right kidney specimen measured 12.2 x 6.7 x 6.2 cm and weighed 284 grams. A well-circumscribed, solid, yellow-tan mass measuring 8.0 x 7.1 x 5.3 cm was identified in the superior pole. The mass was located within the renal capsule and did not invade into the perinephric fat or extend to the resection margins. It was situated 0.1 cm from the renal pelvis with possible extension into the calyces. No necrosis or hemorrhage was observed within the mass. The uninvolved renal parenchyma showed a tan-brown coloration with a distinct corticomedullary junction, organized architecture, and normal-appearing pelvis and calyces. No lymph nodes, stones, or adrenal tissue were identified.\n\nHistologic examination revealed a neoplastic lesion with nuclear features characterized by significant irregularity, an average nuclear size of approximately 20 microns, and prominent nucleoli. The tumor was confined to the kidney without evidence of vascular or lymphatic invasion. Resection margins were free of involvement. Additional findings included chronic inflammation. Lymph node status and distant metastasis could not be assessed. The primary tumor was staged as pT2 based on its size exceeding 7 cm and being limited to the kidney."} +{"pid": "TCGA-V4-A9EF", "report": "Right eye enucleation specimen measures 25 mm in diameter and includes a segment of optic nerve measuring 10 mm, along with 25 mm of associated fat tissue. On sectioning, a large pigmented lesion is identified at the posterior pole, measuring 16 by 13 mm. Samples were taken for cryopreservation and cytogenetic analysis. Microscopic examination reveals a tumor composed predominantly of spindle-shaped cells with oval nuclei, frequently nucleolated. Mitotic activity is present at a rate of 4 mitoses per 10 high-power fields. There is no evidence of necrosis or microcalcifications. The tumor is located immediately posterior to the ciliary body, which shows focal infiltration. Invasion extends into the inner third of the sclera. The iris, anterior chamber, optic nerve throughout its length, and meningeal sheaths show no involvement."} +{"pid": "TCGA-05-4249", "report": "The resected specimen consists of two parts from the right lower lobe. A peripheral lesion is present, showing well-differentiated papillary features without mucin production. The lesion measures over 50 mm in size and extends to the visceral pleura; however, the pleural surface remains free of tumor involvement. The bronchial resection margin is also unaffected. Additional findings include subpleural scarring and pleural adhesion remnants. Histologic grade is G1. Pathologic staging indicates pT2b, pN0, pMX, stage IB, with complete resection (R0)."} +{"pid": "TCGA-D1-A16J", "report": "The specimen includes a 3090.0 gram portion of abdominal skin and subcutaneous tissue with umbilicus, showing no lesions. The uterus weighs 85.0 grams and is accompanied by bilateral fallopian tubes and ovaries. The uterine serosa appears smooth. A mass measuring 3.9 x 2.9 x 1.5 cm is present in the lower uterine segment, extending into the endocervical canal. The mass invades the myometrium to a depth of 0.9 cm but does not reach the uterine serosa. No leiomyomata are noted. The right ovary measures 3.2 x 1.4 x 1.4 cm with a smooth surface, and the right fallopian tube is 7.3 x 0.8 cm. The left ovary measures 2.8 x 1.4 x 1.4 cm with a smooth surface, and the left fallopian tube is 6.2 x 0.7 cm, with multiple paratubal cysts ranging from 0.2 to 0.4 cm in greatest dimension.\n\nLymph node specimens include:\n- Right pelvic nodes: external (7.0 x 6.0 x 3.0 cm), internal (0.7 x 0.7 x 0.4 cm), common (4.5 x 4.2 x 1.2 cm), and obturator (8.0 x 7.0 x 2.5 cm) aggregates.\n- Left pelvic nodes: obturator (9.8 x 6.5 x 2.8 cm), external (7.2 x 5.5 x 1.7 cm), internal (4.0 x 3.2 x 1.0 cm), and common (4.2 x 1.8 x 1.2 cm) aggregates.\n\nRight para-aortic lymph nodes above the inferior mesenteric artery measure 4.0 x 3.0 x 1.5 cm, and those below measure 3.0 x 2.3 x 1.5 cm. Left para-aortic nodes above the artery measure 4.0 x 3.5 x 1.5 cm, and those below measure 4.5 x 2.8 x 1.5 cm. One right para-aortic node above the inferior mesenteric artery is partially included in the specimen below the artery. All lymphatic tissue was submitted for examination.\n\nSpecimens of the right and left gonadal vessels are unremarkable; each measures 6.0 cm and 5.4 cm in length respectively, with a diameter of 0.4 cm. The omentum is a 19.2 x 7.1 x 0.8 cm specimen without identifiable masses or lymph nodes.\n\nMicroscopic evaluation of all submitted tissues, including multiple regional lymph nodes, gonadal vessels, and omentum, reveals no evidence of malignant cells. Cervical sections show stromal infiltration beneath the transformation zone mucosa. All surgical margins and examined tissues are negative for malignancy."} +{"pid": "TCGA-J4-A6G1", "report": "The specimen from the prostate and seminal vesicles was a 40-gram prostate gland measuring 5.0 x 4.0 x 3.0 cm, with bilateral seminal vesicles each measuring 2 x 1.2 x 0.8 cm. Histologic evaluation revealed a Gleason score of 4 + 4 = 8 out of 10, with tertiary pattern present corresponding to Gleason grade 3 out of 5. More than 50% of the examined tissue showed involvement by cellular changes consistent with malignancy. Microscopic extension into extraprostatic soft tissue was identified focally at the right apex. Perineural invasion was noted. No evidence of tumor was seen in the seminal vesicles or at the margins of the prostate, soft tissue, urethra, or bladder neck. Lymphatic (small vessel) invasion was not observed.\n\nLymph node assessment included two periprostatic lymph nodes, three on the right pelvic side, and three on the left pelvic side; all were negative for malignancy. Additionally, two lymph nodes associated with an umbilical hernia specimen were also negative for malignant cells. The umbilical hernia tissue consisted of mesothelial-lined fibroadipose tissue consistent with hernia sac features.\n\nAcute and chronic inflammatory changes were noted in the prostate tissue. No dominant nodule measuring at least 1 cm was identified. There was no evidence of treatment effect. The TNM staging classification was pT3a, pNo, pMX."} +{"pid": "TCGA-N5-A4RF", "report": "The submitted specimens include the uterus, cervix, bilateral tubes and ovaries following total hysterectomy and bilateral salpingo-oophorectomy; omentum; and multiple lymph node groups from the right and left external iliac, obturator, hypogastric, common iliac, and para-aortic regions.\n\nIn the primary specimen, a tumor was identified in the endometrium with homologous differentiation. The depth of myometrial invasion was up to 5 mm, with a myometrial thickness of 18 mm at the area of maximal tumor involvement. No endocervical invasion was observed. Lymphovascular invasion was present. Residual endometrial tissue was not identified. The myometrium contained multiple leiomyomata. The adnexa showed endometriotic cysts in both ovaries; the fallopian tubes were otherwise benign, though one showed a focus of mild atypia without p53 overexpression.\n\nThe omental specimen consisted of benign fibroadipose tissue. Lymph node assessment revealed no metastases in the left external iliac (2 nodes), obturator (3 nodes), hypogastric (12 nodes), or common iliac (1 node) regions, nor in the para-aortic lymph nodes (3 on the left, 6 on the right). On the right side, the obturator lymph nodes (8 examined) contained metastatic involvement, while the external iliac (3 nodes), hypogastric (no lymphoid tissue identified), and common iliac (3 nodes) were negative for metastasis."} +{"pid": "TCGA-06-0187", "report": "The clinical history indicates a lesion located in the right parietal region of the brain, intra-axial in location. Two specimens were submitted for analysis: one labeled as a biopsy and the other as a resection. The first specimen consists of three small fragments measuring approximately 1.2 cm in total, described as semi-firm, tanish-grey, and glassy. The second specimen includes multiple pale red-tan to gray-white tissue fragments, measuring up to 2.0 x 1.5 x 0.7 cm and weighing 1.09 grams.\n\nMicroscopic evaluation reveals widespread infiltration and extensive disruption of cerebral tissue by a densely cellular astrocytic proliferation. Nuclear atypia, mitotic figures, and prominent vascular proliferation are evident. Areas of necrosis are present, along with multinucleated cells. Immunohistochemical staining demonstrates glial differentiation with expression of GFAP. Neuronal markers do not identify any neoplastic neuronal component. Approximately 1% of tumor nuclei show p53 overexpression. The MIB-1 proliferation index is approximately 21% in more active regions.\n\nSpecial studies indicate methylation of the MGMT promoter. These findings suggest a high-grade glial neoplasm with significant proliferative activity and molecular alterations. All results are interpreted in accordance with established diagnostic criteria and laboratory-developed methods."} +{"pid": "TCGA-DJ-A3VK", "report": "The neck specimen analysis included pretracheal tissue, Delphian node, a right lower parathyroid region biopsy, total thyroidectomy, and a tissue sample from the right lower pole of the thyroid. The pretracheal biopsy revealed one benign lymph node with crush and cautery artifact. The Delphian node examination showed benign fibroadipose tissue without identifiable lymph nodes. A fragment of benign hyperplastic thyroid tissue was found in the right lower parathyroid region biopsy.\n\nThe total thyroidectomy specimen weighed 12.5 g, with the right lobe measuring 5 x 3 x 2 cm, the left lobe 4 x 2 x 1 cm, and the isthmus 1 x 1 x 0.5 cm. Three tan, well-circumscribed nodules were identified: one in the inferior right lobe (1.0 cm), one in the mid left lobe (0.8 cm), and one in the inferior left lobe (0.5 cm). The remaining thyroid tissue exhibited a red-tan, beefy appearance. Histological evaluation showed no mitotic activity or tumor necrosis. The largest nodule in the right lobe was partially encapsulated and did not show blood vessel invasion. Focal extension beyond the thyroid capsule into surrounding fibroadipose tissue was noted for the left lobe nodule measuring 0.8 cm. Surgical margins were free of any abnormal cellular growth.\n\nThree separate foci of microscopic changes were identified: two in the left lobe measuring 0.8 cm and 0.7 cm, and one in the right lobe less than 0.1 cm. The non-neoplastic portions of the thyroid displayed features of nodular hyperplasia. No parathyroid glands were identified in the specimens. One benign lymph node was found in the pretracheal region.\n\nImmunohistochemical analysis of a hyperplastic nodule with trabecular architecture demonstrated positive staining for thyroglobulin and negative staining for calcitonin, chromogranin, and synaptophysin. The right lower pole thyroid tissue sample showed benign thyroid parenchyma with nodular hyperplasia. All surgical specimens were fully evaluated and submitted for analysis."} +{"pid": "TCGA-WK-A8XZ", "report": "The surgical pathology report describes a resected mass involving the inferior vena cava. The specimen includes a mass measuring 9.0 x 5.4 x 3.9 cm with a cuff of vena cava (4.0 x 2.6 cm) and an intraluminal component measuring 4.3 x 3.5 x 2.2 cm. The mass has a fleshy tan/white appearance with one slightly hemorrhagic eccentric nodule measuring 1.7 cm in diameter. No gross extension beyond the pseudocapsule is observed.\n\nMicroscopic evaluation reveals high-grade cellular features with mitotic activity quantified as up to 39 per 10 high-power fields. Tumor necrosis is present, accounting for approximately 10% of the specimen. There is evidence of tumor invasion into the lumen of the vena cava. Resection margins of the vena cava and surrounding soft tissue are free of tumor involvement. The tumor is located 0.3 cm from the inferior caval margin, 0.8 cm from the superior caval margin, and 0.1 cm from the soft tissue margin. The adrenal gland is uninvolved.\n\nA separate nephrectomy specimen is submitted for evaluation. Gross examination of the kidney shows no visible abnormalities, and microscopic sections of the renal parenchyma, renal artery, renal vein, and ureter margin show no evidence of tumor involvement.\n\nAll tissue samples were processed and examined microscopically. Multiple sections were taken from various regions of the mass, margins, and thrombus for detailed histologic analysis."} +{"pid": "TCGA-BA-5152", "report": "A right anterior muscle tissue fragment measuring 0.7 x 0.6 x 0.3 cm was examined microscopically and showed no abnormal cellular changes. A right middle muscle tissue fragment measuring 1.5 x 1.1 x 0.5 cm also revealed no pathological findings. Similarly, a right lateral muscle tissue fragment measuring 1.0 x 0.9 x 0.7 cm did not show any abnormal cells. A right posterior mucosal margin tissue fragment measuring 1.1 x 0.6 x 0.4 cm had normal histological features. The right posterior middle margin tissue of the same dimensions also appeared normal. A smaller right anterior mucosal margin tissue fragment measuring 0.3 x 0.3 x 0.2 cm was unremarkable. Deep margin tissues from the right posterior (0.3 x 0.2 x 0.2 cm), right middle (0.6 x 0.5 x 0.3 cm), and right anterior (0.6 x 0.4 x 0.4 cm) regions were all free of abnormal cells.\n\nFurther specimens included fibrofatty tissue from the right anterior floor of mouth measuring 2.0 x 1.3 x 0.5 cm, which demonstrated benign salivary gland tissue with focal atrophic changes. A similar finding was noted in the right lateral floor of mouth specimen measuring 1.5 x 0.9 x 0.7 cm. Left neck level 1 adipose tissue measuring 1.5 x 1.4 x 1.2 cm showed benign characteristics without lymph node involvement. Right neck level 1 tissue measuring 5.0 x 3.5 x 1.5 cm contained two lymph nodes, both without abnormal cells. In right neck level 2, three lymph nodes were identified within a 4.0 x 3.3 x 2.5 cm tissue mass that included a salivary gland measuring 3.2 x 3.0 x 1.5 cm; all lymph nodes were unremarkable. Right neck level 3 tissue measuring 5.0 x 4.5 x 2.5 cm contained six lymph nodes, none of which showed abnormal cells.\n\nThe right mandible partial resection specimen measured 5.3 x 4.4 x 1.7 cm. An ulcerative lesion around the third incisor displaced it in an anterior-lateral direction and extended into the mandible. The lesion measured 2.5 x 1.0 x 1.3 cm and involved the mandibular bone and adjacent soft tissue. Mucosal margins showed distances of 1.6 cm, 1.1 cm, 0.4 cm, and 2.3 cm from the tumor to various margins. Cut margins demonstrated distances of 3 mm and 4 mm from the tumor to lateral and medial markers, respectively. No additional lesions or masses were observed in the remaining bone tissue. All surgical margins were free of abnormal cells."} +{"pid": "TCGA-26-1439", "report": "The specimen consisted of two tissue samples submitted for analysis. The first specimen measured 1.5 x 1.0 x 0.9 cm and was described as an aggregate of yellow-tan to beige soft tissue with areas of necrosis and hemorrhage. A representative portion was used for frozen section analysis, with remaining tissue submitted for tumor banking and routine processing. The second specimen measured 3.8 x 3.3 x 0.7 cm and also showed yellow-tan to beige soft tissue with focal hemorrhage. Representative sections were submitted for tumor banking and histologic evaluation.\n\nHistologic examination revealed a high-grade neoplasm with features including nuclear atypia, increased mitotic activity, microvascular proliferation, and areas of necrosis. Immunohistochemical staining demonstrated strong reactivity for GFAP, particularly in regions with gemistocytic morphology. PTEN expression was present in many tumor cells, while EGFR variant VIII was not detected. No definitive molecular markers or genetic mutations were specified beyond these immunostains.\n\nThe tumor exhibited infiltrative growth patterns and cellular pleomorphism. Necrotic foci and endothelial proliferation were noted as part of the morphologic assessment. Based on histologic features and immunoprofiling, the lesion demonstrated characteristics of a high-grade glial neoplasm."} +{"pid": "TCGA-E9-A1RD", "report": "The specimen consists of breast tissue with a lesion measuring 2.8 x 2.6 cm located in the lower inner quadrant; the lesion is grossly evident. Ten lymph nodes were examined, ranging up to 1 cm in diameter, and show sinus histiocytosis without evidence of metastasis. Histologically, the lesion demonstrates moderate differentiation. The tumor does not exhibit venous invasion and the surgical margins are uninvolved. The Nottingham Histologic Score could not be determined due to incomplete data on tubule formation, nuclear pleomorphism, and mitotic counts. No extracapsular extension in the lymph nodes was identified. The specimen was obtained via radical mastectomy."} +{"pid": "TCGA-TT-A6YJ", "report": "A female patient underwent laparoscopic removal of a left adrenal mass. The specimen consisted of an adrenal gland weighing 23.9 grams and measuring 5.8 x 4.3 x 2.8 cm. Within the gland, a rounded mass was identified measuring 3.0 x 2.8 x 2.6 cm. The mass appeared pale, yellow-tan, hemorrhagic, and soft with central friability. It was well-circumscribed and located within the adrenal gland. The specimen included a staple line measuring 2.5 cm on one end. Sections from the center of the mass were submitted for tumor banking. Histologic evaluation showed no evidence of increased mitotic activity, vascular invasion, necrosis, or significant nuclear pleomorphism. The PASS score was determined to be zero. All relevant sections (eight total, representative) were reviewed and verified by the pathologist."} +{"pid": "TCGA-MZ-A6I9", "report": "The surgical pathology report includes multiple biopsies from the right oral pharynx and left tongue base. Specimens were received fresh and submitted partially or entirely for research purposes. One biopsy from the right oral pharynx was processed for routine pathology evaluation and measured 1.8 x 0.8 x 0.2 cm, consisting of tan-pink to red soft tissue fragments. Another specimen from the right oral pharynx measured 0.8 x 0.5 x 0.2 cm and was also evaluated. Histologic examination revealed invasive malignant cells with features of moderate to poor differentiation. Immunohistochemical staining demonstrated positive expression of p16 with diffuse nuclear staining pattern. All specimens were submitted in cassettes appropriately labeled for identification. Controls were performed for immunohistochemical testing to ensure accuracy. Clinical correlation is recommended given the study results and their investigational context."} +{"pid": "TCGA-DJ-A3V6", "report": "The thyroid specimen was received fresh and labeled as a total thyroidectomy. The thyroid weighed 21 grams. The right lobe measured 5.5 x 2.5 x 1 cm, the left lobe measured 5 x 3 x 1 cm, and the isthmus measured 1.5 x 1 x 1 cm. The external surface was covered by a thin fibrous capsule. The posterior surface was inked black and the anterior surface was inked blue. On sectioning, there was an ill-defined tan firm nodule in the left lobe measuring 1.8 x 1.2 x 1 cm. A well-circumscribed tan nodule was identified in the right lobe measuring 0.8 x 0.7 x 0.7 cm. The remaining thyroid parenchyma appeared red-tan and beefy. Representative sections were submitted for microscopic evaluation, including sections from the isthmus, right lobe, left lobe, and both nodules. The remainder of the tissue was serially sectioned and entirely submitted.\n\nMicroscopic examination revealed multiple small foci ranging from 0.1 to 0.8 cm in both lobes, with similar features to the primary lesion. These foci were confined within the thyroid without evidence of vascular invasion or necrosis. No adenomatous changes were observed. The surrounding non-neoplastic thyroid tissue showed changes consistent with nodular hyperplasia. Surgical margins were free of any abnormal cellular proliferation. Parathyroid tissue was not identified in the submitted sections."} +{"pid": "TCGA-CZ-5986", "report": "The specimen consists of a radical left nephrectomy, weighing 685.5 grams, including a kidney measuring 13.8 x 9.0 x 6.0 cm, along with attached ureter (10 cm in length x 0.3 cm in diameter), renal vein (1.0 cm in length x 0.9 cm in diameter), and renal artery (3.2 cm in length x 0.5 cm in diameter). A mass measuring 5.5 x 4.7 x 3.1 cm is identified within the renal cortex at the anterior mid pole. The lesion appears encapsulated, with tan/yellow coloration, focal microcystic changes, and areas of hemorrhage. It is located 2.6 cm from the renal vein, 3.8 cm from the renal artery, and 13.0 cm from the ureteral margin. The mass approaches the capsule, being 0.2 cm from the inked surgical margin. The adrenal gland measures 4.5 x 1.3 x 0.3 cm and is received grossly disrupted without identifiable lesions or masses.\n\nHistologic evaluation reveals nuclear grade III morphology. The tumor does not extend beyond the kidney capsule and no capsular invasion is observed. Vascular and ureteral margins are negative for involvement. There is no evidence of lymphovascular invasion. Evaluation of four regional lymph nodes shows no presence of tumor.\n\nNon-neoplastic renal parenchyma demonstrates mild chronic changes likely related to age, including global glomerulosclerosis affecting approximately 7% of glomeruli, minimal tubular atrophy, interstitial fibrosis involving less than 10% of the parenchyma, and mild vascular sclerosis. Staining techniques confirm these findings without evidence of significant structural damage.\n\nCytogenetic analysis of five analyzed metaphases reveals clonal chromosomal aberrations, including loss of the short arm of chromosome 3, a finding commonly associated with specific neoplastic processes. No additional significant anomalies were detected using standard banding techniques at a resolution of 400 bands or greater."} +{"pid": "TCGA-AN-A0XP", "report": "Female patient with tumor located in the breast, primary site. Tumor specimen was obtained via surgery and preserved in OCT medium as a block. Histological analysis showed Grade 2 features with cellular morphology consistent with infiltrative growth. Staging was determined as T2, N1, M0, indicating localized disease without distant spread. No prior treatment was administered. A separate normal sample was collected from blood via standard phlebotomy and stored frozen in a tube."} +{"pid": "TCGA-56-8503", "report": "The surgical specimen consisted of a right lower lobe lobectomy with en bloc chest wall resection. The tumor measured 5 x 4 x 3.8 cm and was unifocal. It extended through the visceral pleura and into the parietal pleura but did not invade the periosteum of rib 9 or the soft tissue of the intercostal muscles. No angiolymphatic invasion was identified. Margins, including bronchial, vascular, soft tissue, and ribs 8, 9, and 10, were free of involvement.\n\nA total of 17 lymph nodes were evaluated: two level 11 interlobar lymph nodes, one level 11 lymph node, four level 7 subcarinal lymph nodes, one level 12 lymph node, two peribronchial lymph nodes, one level 9 pulmonary ligament lymph node, one periesophageal lymph node, one level 10R lymph node, and three level 4R lymph nodes. All lymph nodes were negative for malignant involvement.\n\nHistologic examination revealed a moderately differentiated epithelial malignancy arising in a background of emphysematous lung. The tumor exhibited a dense desmoplastic reaction focally at the interface with rib 9. Bone marrow from rib 9 showed trilineage hematopoiesis without evidence of infiltration.\n\nPathologic staging was determined as pT3 due to tumor extension into the parietal pleura. There was no regional lymph node involvement (pN0) and no evidence of distant metastasis (pM0), resulting in an overall pathologic stage of IIB. A total of 22 tissue blocks were submitted for microscopic evaluation, including margins, lymph nodes, and representative tumor sections. Elastic stains were performed to assess the extent of tumor invasion.\n\nMultiple ancillary tissue samples were collected, including lymph nodes from various levels and sections of the bronchial and vascular margins. No satellite lesions were identified within the lung parenchyma. All surgical margins remained uninvolved."} +{"pid": "TCGA-DD-A1EK", "report": "The submitted liver specimens include a mass from segment 6 weighing 1930.0 grams and measuring 14.5 x 13.0 x 12.0 cm, a mass from segment 7 weighing 164.0 grams, and a small hepatic nodule measuring 0.4 x 0.3 x 0.1 cm. Histologic evaluation of the segment 6 lesion reveals a moderately differentiated cellular proliferation forming a variegated mass with areas of focal necrosis. The lesion shows a pushing growth pattern and is partially surrounded by a fibrous border. No evidence of large vessel invasion is identified. The closest tumor-free margin is 0.7 cm away. Immunohistochemical analysis demonstrates positivity for polyclonal CEA and Hep-1, while staining for AFP and cytokeratin 7 is negative.\n\nIn the segment 7 specimen, a solid nodule measuring 1.3 x 1.0 x 0.9 cm is located 0.2 cm from the surgical margin. Additionally, a separate nodule measuring 1.2 x 1.0 x 0.5 cm is present and exhibits features consistent with a benign vascular lesion. The excised small nodule shows sclerotic changes suggestive of a distinct benign process.\n\nEvaluation of the non-neoplastic liver parenchyma reveals mild macrovesicular steatosis affecting approximately 10\u201315% of hepatocytes, distributed in a non-zonal pattern. There is no significant inflammation within the portal tracts. Bile duct structures appear intact without signs of cellular damage or increased ductular profiles. Ballooning degeneration, Mallory-Denk bodies, and apoptotic figures are not prominent. Scattered neutrophilic infiltrates are observed within the lobular parenchyma, likely related to post-surgical changes. Iron deposition, cytoplasmic globules on PAS-diastase staining, and reticulin architectural disruption are not present. Trichrome staining does not show significant fibrosis, including absence of periportal, bridging, or pericellular fibrosis.\n\nFrozen section evaluation of the segment 6 mass was performed and immunohistochemical confirmation was awaited."} +{"pid": "TCGA-AX-A1CC", "report": "A biopsy of an omental nodule showed adipose tissue with hemorrhage and focal fat necrosis, with no evidence of malignancy. A hysterectomy with bilateral salpingo-oophorectomy revealed a lesion measuring 1.5 cm in greatest dimension, located in the myometrium, which measured 1.8 cm in thickness. The lesion extended 1.5 cm into the myometrium. The tumor displayed both glandular and solid growth patterns. Vimentin and p53 staining was strongly and diffusely positive. Patchy p16 staining was observed in glandular areas. ER expression was 2+ in 80% of glandular cells but only 1+ in less than 5% of solid growth areas. Immunostains for CD56, synaptophysin, and chromogranin were negative. No lymphovascular invasion was noted in the omentum, and all lymph node specimens were negative for malignancy. Lymph node evaluations included right periaortic (0/4), left periaortic #1 (0/3), left periaortic #2 (0/2), right pelvic (0/2), and left common iliac (0/9). The primary tumor exhibited Grade III features with more than 50% nonsquamous solid growth. Pathologic staging indicated no regional lymph node involvement (pN0) and uninvolved surgical margins. Venous or lymphatic invasion was present. Cytology was negative. Gross examination of the hysterectomy specimen showed a 1.5 x 1 cm tan fibrous lesion invading superficially into the myometrium, located 0.5 cm from the lower uterine segment. The ovaries showed peritoneal inclusion cysts and the fallopian tubes contained paratubal cysts. All other tissues examined were free of malignancy."} +{"pid": "TCGA-FG-7637", "report": "The specimen consisted of three separate tissue samples. The first, a soft tan-white fragment measuring 0.9 x 0.6 x 0.5 cm, was obtained from the posterior right temporal occipital region. The second sample, from the temporal tip, included multiple soft pink-tan fragments with an aggregate measurement of 2.4 x 0.6 x 0.5 cm. The third specimen, a larger set of tan to brown cerebriform fragments measuring 3.3 x 2.8 x 1.5 cm in total, was submitted entirely for analysis.\n\nMicroscopic evaluation revealed a neoplasm with distinct regions showing both astrocytic and oligodendroglial differentiation. Hypercellularity was observed within the oligodendroglial areas, but no mitotic figures were identified. A focus of coagulative tumor necrosis was present in block C1, although this did not exhibit pseudo-palisading. No microvascular proliferation was noted. Fluorescence in situ hybridization studies showed loss of chromosomes 1p and 19q. Intraoperative assessments of the first and second specimens indicated the presence of an infiltrative glial neoplasm, with features of increased cellularity in one area. All specimens were fully submitted for histologic analysis."} +{"pid": "TCGA-AJ-A5DW", "report": "The specimen from a female patient includes lymph nodes from left and right paraaortic and pelvic regions, all of which were benign upon histologic examination. A total of 25 lymph nodes were evaluated (6 from left paraaortic, 7 from right paraaortic, 7 from left pelvic, and 5 from right pelvic), with none showing evidence of involvement.\n\nThe surgical specimen also includes a uterus with cervix and bilateral adnexa. The endometrial lining contains a mass measuring 5.2 cm in greatest dimension. Histologic evaluation reveals a moderately differentiated lesion arising from the endometrium. Microscopic assessment shows no myometrial invasion, no involvement of the cervix, and no extension into other organs. There is no evidence of lymphovascular space invasion. Surgical margins, including cervical and parametrial regions, are uninvolved.\n\nImmunohistochemical staining for DNA mismatch repair proteins was performed. Expression of MLH1, MSH2, MSH6, and PMS2 was detected in the tissue examined. Appropriate internal controls demonstrated expected staining patterns. These findings do not entirely rule out the possibility of an underlying hereditary condition, and further molecular testing may be considered if clinical suspicion remains.\n\nThe uterus measures 7.5 x 7.5 x 5.2 cm and weighs 139 grams. The serosal surface appears unremarkable. The mass is located within the endometrial cavity and has a gray-brown, slightly hemorrhagic appearance. On sectioning, superficial myometrial extension is noted, but does not exceed 0.2 cm in depth within a 1.7 cm thick myometrium. No lesions are identified in the cervix, ovaries, or fallopian tubes. Both ovaries show corpus albicans without abnormality. The fallopian tubes appear grossly and microscopically normal.\n\nSections from various regions of the specimen, including the cervix, uterine lesion, lower uterine segment, parametrium, ovaries, and fallopian tubes, were submitted for histologic evaluation. All lymph node specimens were fully sampled and reviewed."} +{"pid": "TCGA-N9-A4Q7", "report": "The specimen included a uterus and cervix measuring 12.8 x 7.5 x 5.5 cm, with bilateral fallopian tubes and ovaries. The endometrium was replaced by a fleshy, tan mass measuring 8.5 x 6.0 x 4.0 cm, which appeared to invade less than half of the myometrial thickness. Microscopically, the lesion showed invasion to a depth of 8.0 mm within a myometrial thickness of 24.0 mm. Lymphovascular invasion was present. Sections of the cervix revealed chronic inflammation and Nabothian cysts, but no malignant cells. Both ovaries and fallopian tubes were unremarkable.\n\nLymph node evaluation included multiple regional sites. On the left pelvic side, two lymph nodes were identified; all were negative. The right common lymph node was also negative. Five additional left pelvic lymph nodes, two left common lymph nodes, one below IMA para-aortic lymph node, and nine above IMA para-aortic lymph nodes were all free of tumor involvement. The omentum was composed of fibroadipose tissue without evidence of malignancy.\n\nHistological assessment of the lesion demonstrated a high-grade cellular component (approximately 85%) consistent with undifferentiated and high-grade serous features. A distinct sarcomatous element was also present, containing heterologous components such as malignant cartilage. Invasion of the myometrium was exclusively composed of carcinoma."} +{"pid": "TCGA-B5-A11L", "report": "The specimen consists of a uterus weighing 55.5 grams, measuring 8.6 x 5.5 x 2.5 cm, along with bilateral tubes and ovaries. Upon opening, a tan exophytic lesion is identified in the anterior and posterior endometrium, diffusely involving the entire uterine cavity. The lesion invades up to 1.2 cm into the myometrium, which has a total thickness of 1.7 cm. At the anterior aspect, the lesion approaches within 0.2 cm of the internal cervical os. No abnormalities are noted in the cervix, paracervical soft tissue, or remaining myometrium. On the right side, the ovary and fallopian tube (measuring 2.1 x 5 cm) contain a 0.6 cm surface nodule with a white cut surface, along with multiple cysts; the fallopian tube appears unremarkable. The left ovary and fallopian tube (1.5 x 4 cm) show no abnormalities.\n\nA left pelvic lymph node specimen includes an aggregate of tan fibrofatty tissue measuring 4 x 4 x 2 cm, with multiple candidates identified up to 1.5 cm in size. A total of nine lymph nodes are evaluated from this side, with no evidence of involvement. The right pelvic lymph node specimen measures 5.5 x 4 x 2 cm and contains multiple candidates, with the largest measuring 2 cm. This tissue yields six lymph nodes, all free of tumor. The omentum, measuring 10 x 8 x 2 cm, is composed of adipose tissue and shows no pathological findings.\n\nMicroscopic evaluation confirms infiltration of the myometrium with a maximum invasion depth of 1.7 cm in a wall measuring 2 cm thick. No lymphatic or vascular invasion is identified. All surgical margins are free of involvement. Both ovaries and fallopian tubes are without involvement. Lymph nodes from both pelvic sides and the omentum show no evidence of metastatic disease. Additional sections from the right pelvic lymph node specimen reveal four more lymph node profiles, bringing the total number evaluated on that side to eight, none of which show involvement."} +{"pid": "TCGA-EY-A1GW", "report": "The omentum specimen shows multiple nodules ranging from 0.5 to 14.5 cm in size. Histologic examination reveals solid and cribriform growth patterns with cells exhibiting enlarged nuclei, markedly prominent nucleoli, and abundant eosinophilic cytoplasm. Immunohistochemical staining demonstrates positivity for CK7 and patchy positivity for p53, while CK20, p16, and p63 are negative. These findings are consistent with a high-grade neoplastic process.\n\nIn the hysterectomy specimen, a lesion measuring 3.5 cm in greatest dimension is located in the uterine fundus. The myometrium is involved with invasion extending into the outer half of the wall. The thickness of the myometrial wall at the deepest point of invasion is 1.7 cm, with the mass approaching within 0.5 cm of the serosal surface. No involvement of the serosa, lower uterine segment, or cervix is identified. Both ovaries and fallopian tubes show no evidence of involvement. Additional findings include chronic cervicitis with cystically dilated endocervical glands and a tunnel cluster in the cervix, as well as an atrophic endometrium separate from the lesion.\n\nA soft tissue specimen from the pelvic gutter contains nodular areas involving the tissue. A right hemicolectomy specimen reveals involvement of the appendiceal and bowel serosa. All surgical resection margins are free of tumor.\n\nImmunohistochemistry performed on the tumor shows positive staining for estrogen receptor (1 to 2+ in 60% of cells) and progesterone receptor (1 to 2+ in 30% of cells). Evaluation for lymphovascular space invasion was inconclusive; although morphologic features in one area raised suspicion, immunostains for CD31 and CD34 do not confirm intravascular involvement.\n\nStaging information indicates involvement of the myometrium with extension into the outer half, corresponding to a pathologic T1b classification. Distant metastasis is confirmed based on involvement of the omentum, pelvic gutter, and bowel serosa, resulting in a pathologic M1 classification. Lymph node staging is not assessable. Based on these findings, the overall AJCC pathologic stage is pT1b pNx pM1, and the FIGO (2008) stage grouping is advanced.\n\nAdditional specimens including both ovaries, fallopian tubes, and other submitted tissues demonstrate benign findings such as epithelial inclusion cysts and physiologic changes without evidence of tumor involvement."} +{"pid": "TCGA-55-6984", "report": "A lobe of lung was received for evaluation, measuring 12.0 x 12.0 x 5.6 cm and weighing 255 grams. The specimen had two transverse staple lines on the hilum, measuring 2.8 cm and 2.5 cm. The pleural surface was tan-pink with scattered anthracotic pigmentation and inked black. Serial sectioning revealed an ill-defined, hemorrhagic, focally friable, and disrupted lesion measuring 4.5 x 3.5 x 3.5 cm. The solid portion of the lesion was yellow and firm, extending to but not disrupting the pleural surface. The lesion was located 1.0 cm from the bronchial margin. The bronchial tree contained a moderate amount of mucus, while the arterial tree showed minimal fatty streaks. Surrounding the bronchial and arterial trees were nine gray-black possible lymph nodes ranging from 0.4 to 0.8 cm in greatest dimension.\n\nMicroscopic examination of sections from the lesion showed moderately differentiated adenocarcinoma. The tumor was focally less than 0.1 cm from the pleural surface; however, the inked surface was free of tumor involvement. Lymphovascular invasion was present, with scattered tumor nests seen around the main lesion. Bronchial and vascular resection margins were free of tumor. Of the surrounding lymph nodes, two out of nine showed evidence of metastatic involvement. Immunohistochemical staining showed positivity for CK7 and very focal positivity for TTF-1, while CK20 was negative.\n\nAdditional lymph node specimens were submitted from various locations. Each lymph node was hyperpigmented and ranged in size from 0.4 x 0.2 cm to 1.7 x 1.7 x 0.4 cm. Upon sectioning, they exhibited tan-brown to black cut surfaces. All lymph nodes were totally submitted for histologic evaluation and found to be without evidence of malignancy."} +{"pid": "TCGA-EL-A4KH", "report": "The surgical specimen from a female patient consists of a total thyroidectomy with measurements provided for the left lobe (6.0 x 2.0 x 1.0 cm), right lobe (5.0 x 2.0 x 1.0 cm), and isthmus (2.5 x 1.2 cm), weighing 30 grams in total. A solid cystic lesion measuring 2.1 x 1.8 x 1.5 cm is identified in the left upper lobe, with a pale-pink cut surface. Adjacent to this lesion is a smaller, distinct nodule measuring 0.8 x 0.5 x 0.5 cm, which shows possible papillary formations on cross-section. The remaining portions of the left lower lobe, isthmus, and entire right lobe appear unremarkable upon gross examination. The larger nodule was entirely submitted for analysis, while representative sections were taken from the surrounding unaffected areas. No extrathyroidal extension or lymphovascular invasion is identified. Resection margins are negative, and no lymph nodes are present. The lesion is multifocal, with the largest focus measuring 2.1 cm located in the left lobe."} +{"pid": "TCGA-IF-A4AK", "report": "The surgical specimen from the right thigh consists of an irregular fibroadipose tissue measuring 10.5 cm in length, 6.5 cm in width, and 2.2 cm in thickness. The external surface includes a skin ellipse measuring 10.0 x 4.2 cm. Upon sectioning, a well-circumscribed gray-white firm mass measuring 3.2 x 2.4 x 2.2 cm was identified in slices #5 through #7. This mass was located 0.7 cm from the deep margin, 1.2 cm from the anterior margin, and 1.3 cm from the posterior margin. The proximal and distal margins showed no evidence of involvement. Surrounding tissue appeared as normal adipose tissue.\n\nAdditional sections were taken from representative areas including margins and adjacent tissue. The deep margin specimen, measuring 5.5 x 2.5 x 0.5 cm, was fully submitted for evaluation. Microscopic examination of all submitted sections revealed no residual tumor in either the primary resection or the additional deep margin specimen. All other margins were greater than 1 cm from the lesion. Fascia beneath the tumor was noted to allow for at least 3 mm of separation upon stretching."} +{"pid": "TCGA-G2-AA3B", "report": "The specimen consists of a 6.3 x 5.0 x 1.8 cm aggregate of pink-tan, soft, rubbery tissue fragments. Histologic examination reveals high-grade cellular changes with extensive invasion observed into the lamina propria and muscularis mucosae. The muscularis propria is present, but there is no clear evidence of tumor involvement in this layer. The entire specimen was submitted for analysis."} +{"pid": "TCGA-B6-A0IO", "report": "The specimen from the left breast weighed 600 grams and measured 30.3 x 9.9 x 5 cm. It included a 16.5 x 9.9 x 5 cm breast portion, a 11 x 7 x 2.4 cm axillary component, and an elliptical skin segment measuring 24 x 8 cm with a 1.2 cm nipple and 4 cm areola. A firm white mass measuring 2.8 x 2.5 x 1.6 cm was identified near the axilla. The mass was located 1.8 cm from the superior margin, 1.6 cm from the inferior margin, 2 cm from the posterior margin, and 3 cm from the skin surface. Hemorrhagic changes were noted around the mass, consistent with prior biopsy.\n\nMultiple sections were submitted for analysis, including areas near the superior, inferior, posterior, and anterior skin margins, as well as upper outer, lower outer, upper inner, and lower inner quadrants, the nipple, and various lymph node regions. Seventeen lymph nodes were examined, and no suspicious cells were found.\n\nHistologic evaluation showed two distinct areas of abnormal cell growth. In the upper outer quadrant, a focus of cellular proliferation was noted, measuring 2.8 x 2.5 x 1.6 cm. Another area in the lower inner quadrant measured 1 cm. The cells displayed high nuclear grade (grade 3 of 3) and histologic features consistent with aggressive differentiation. No invasion of blood or lymphatic vessels was observed.\n\nIn addition, there was evidence of an earlier stage of cellular change within the ducts, characterized by solid growth with minimal cribriform pattern. This was classified as ductal in-situ proliferation, with intermediate nuclear grade (grade 2 of 3). Areas of cell death were also present, identified in random sections from the upper outer, upper inner, and lower inner quadrants, though exact size could not be determined.\n\nAll surgical margins, including the nipple and skin, were free of abnormal cells. Muscle was not identified in the specimen. Analysis of hormone receptors showed strong nuclear staining for estrogen receptor in approximately 95% of the infiltrating cells, with a value of 275 fmol/mg. Progesterone receptor expression was minimal, with only about 1% of tumor cells showing nuclear staining and a value of 6 fmol/mg. HER2 immunostaining showed no membrane reactivity (score 0), indicating no overexpression of the oncoprotein. Proliferation index was elevated, with an estimated 29% positive nuclear area."} +{"pid": "TCGA-FY-A3BL", "report": "The specimen consists of a lobe of thyroid measuring 5.7 x 2.8 x 1.5 cm, previously inked black. A firm, white-tan nodule measuring 1.3 x 1.5 cm is identified and appears to approach within 0.3 cm of the inked capsular margin. The nodule comprises approximately 40% to 45% of the entire specimen. On sectioning, the remaining cut surface is red-tan and waxy. Microscopic evaluation reveals a well-defined lesion measuring 1.2 cm in greatest dimension with encapsulation. Focal invasion into the capsule is observed. No definitive lymphovascular invasion is identified. Resection margins are negative. A separate fragment from the isthmus region measures 1.5 x 0.7 x 0.5 cm and shows benign thyroid tissue. Pathologic staging is T1,NX."} +{"pid": "TCGA-06-0238", "report": "The patient presented with a one-month history of headaches and was found to have a left temporal lesion that is necrotic and enhancing, accompanied by significant edema and mass effect. A brain excision biopsy was performed on the left temporal region.\n\nMicroscopic evaluation revealed a highly cellular neoplasm characterized by the presence of numerous giant cells, brisk mitotic activity, and areas of focal necrosis. There was also prominent microvascular proliferation, with some regions showing a sarcomatoid growth pattern. Immunohistochemical studies demonstrated glial fibrillogenesis by the neoplastic cells, as evidenced by GFAP staining. Areas of the tumor exhibited microvascular proliferation marked by CD34 positivity, and the MIB-1 proliferation index was approximately 11% in the more active regions. The sarcomatoid areas were largely negative for GFAP and showed minimal vascularity. Synaptophysin and NeuN highlighted neurons in the cortical infiltration zone, while NFP was negative. Special stains, including Snook's reticulum, showed absence of reticulin in the sarcomatoid areas.\n\nMolecular testing for MGMT promoter methylation was performed using bisulfite-treated DNA followed by PCR amplification and gel electrophoresis. Results were negative, with no evidence of methylation detected.\n\nThe histological features, including high-grade morphology, proliferation indices, and vascular patterns, were consistent with a high-grade glial neoplasm. Sarcomatoid transformation was noted, suggesting a more aggressive or dedifferentiated component. The tumor did not show any neuronal differentiation. Intraoperative cytologic preparations supported the final histological findings, indicating a high-grade glioma with giant cell features.\n\nGross examination of the specimen included three firm, lobulated, pinkish-gray fragments measuring a total of 0.35 cm, and a separate tan-pink tissue fragment measuring 0.6 x 0.4 x 0.2 cm."} +{"pid": "TCGA-A8-A09Z", "report": "The specimen consists of an ablated breast sample containing a moderately differentiated invasive carcinoma. The tumor measures 8 cm in diameter and does not involve the dorsal resection margin. Pathologic staging indicates no lymph node involvement, with absence of lymphovascular invasion and complete resection margins."} +{"pid": "TCGA-FX-A3NJ", "report": "The specimen was received as a right perirenal mass, a celiac mass, and the margin of the celiac mass. The right perirenal mass weighed 65 grams and measured 7.0 x 6.0 x 5.5 cm. It was well-circumscribed with a nodular external surface and thickened fibrous adhesions. The margin was inked black. Cut surfaces revealed solid, whorled, tan-white tissue. The lesion measured 7.0 x 6.0 x 5.5 cm and involved the deep margin of resection but did not extend to the surgical margin. There was no necrosis observed. A portion was submitted for frozen section analysis.\n\nThe celiac mass consisted of tan tissue fragments measuring 1.5 x 1.5 x 0.3 cm with a yellow to bright red cut surface. Part of this specimen was used for frozen section evaluation and the remainder was entirely submitted for analysis. The margin of the celiac mass was a cylindrical fragment measuring 1.5 x 0.5 x 0.3 cm.\n\nFrozen section diagnosis from the right perirenal mass indicated smooth muscle neoplasm, without definitive exclusion of low grade sarcoma. The celiac mass sample was negative on frozen section evaluation.\n\nMicroscopic examination revealed a soft tissue tumor located in the retroperitoneum, right perinephric region, measuring at least 7.0 cm. Histologic features showed a mitotic rate of 5 per 10 high-power fields (field area of 0.23 mm\u00b2). Central degenerative changes and hemorrhage were noted, consistent with prior biopsy. Necrosis was absent. The tumor was surrounded by a thin fibrous membrane ranging from 0.1 to 0.5 cm in thickness. No vascular or lymphatic invasion was identified.\n\nImmunohistochemical staining for Ki-67 demonstrated a mildly elevated proliferation index of approximately 10\u201320%. The tumor margins were free of involvement. The histologic findings corresponded with a low-grade morphology. Pathologic staging was classified as pT2b NO. Additional findings included benign lymph node and fibroadipose tissue from the celiac region specimens."} +{"pid": "TCGA-E2-A15G", "report": "The specimen consists of a wide local excision from the left breast, needle localized, weighing 63 grams and measuring 8 x 5.5 x 3.7 cm. The specimen was serially sectioned into seven slices. A firm tan mass measuring 3.5 x 2 x 1.5 cm was identified in slice 3, located at the medial margin. A second ill-defined hemorrhagic firm area measuring 1 x 0.9 x 0.6 cm was found in slice 6, approximately 1 cm away from the primary mass and approaching the anterior margin by 0.6 cm. Sections were submitted entirely for analysis, including perpendicular sections of the medial and lateral margins.\n\nA sentinel lymph node from the left axilla was also submitted. It measured 3 x 1.5 x 1 cm and showed no evidence of malignant cells.\n\nAn additional specimen from the medial margin of the left breast was received as a fibroadipose tissue fragment measuring 5.5 x 2.5 x 1 cm. No abnormal cellular features were observed in this specimen.\n\nHistologic evaluation of the main lesion revealed a moderately differentiated epithelial neoplasm with associated intraductal changes. Microcalcifications were noted within the ductal component. Adjacent benign findings included fibroadenomatous changes and alterations consistent with prior biopsy. No vascular or lymphatic invasion was observed.\n\nImmunohistochemical markers demonstrated positivity for estrogen and progesterone receptors, with negativity for HER2. A separate assay indicated a low recurrence score.\n\nStaging assessment classified the lesion as pT2 with no nodal involvement (pN0). All surgical margins were free of abnormal cells."} +{"pid": "TCGA-EJ-A46H", "report": "A radical prostatectomy specimen was evaluated, demonstrating a multifocal lesion involving both the right and left lobes of the prostate. The tumor constitutes approximately 8% of the tissue examined, with a maximal linear dimension of 1.6 cm. Histologic evaluation reveals a poorly differentiated adenocarcinoma with a Gleason score of 3 + 4 = 7. A minor component (approximately 1%) of Gleason pattern 5 morphology is present. All resection margins are free of tumor, and the tumor appears confined within the prostatic capsule without involvement of bilateral seminal vesicles. Perineural invasion is identified, and multifocal high-grade intraepithelial neoplasia is also present. The histologic grade is classified as G3-4. No angiolymphatic or seminal vesicle invasion is observed. Lymph node assessment includes six nodes (two from the right pelvic region and four from the left pelvic region), none of which show evidence of metastatic involvement. The pathologic staging is pT2c with no nodal involvement (pN0). The clinical PSA value was recorded at 5.6 prior to surgery. The weight of the prostate specimen was 33.74 grams, with the tumor accounting for 5\u201325% of the specimen. Residual tumor status is R0."} +{"pid": "TCGA-AP-A1E4", "report": "The submitted specimens include a total abdominal hysterectomy with bilateral salpingo-oophorectomy, along with sentinel lymph nodes from the left and right obturator regions. The architectural assessment shows a growth pattern involving up to 50% solid components, with nuclear features corresponding to an intermediate grade. The FIGO grading system also reflects this intermediate classification. The deepest point of involvement extends into the myometrium, which measures 26 mm at the thickest region. There is no evidence of endocervical involvement; however, lymphovascular invasion is present. The endometrial lining demonstrates complex hyperplasia with atypia, and the myometrium contains areas consistent with adenomyosis. The adnexal structures appear unremarkable. Regarding the lymph nodes, one benign node was identified on the left, showing endosalpingiosis, while two benign nodes were found on the right. Immunohistochemical staining for cytokeratin AE1/3 was negative for metastatic disease in both lymph node specimens but highlighted endosalpingiosis in the left specimen."} +{"pid": "TCGA-D6-6826", "report": "The histopathological examination was performed on a resected lesion from the larynx. The surgical specimen measured 7.5 x 5.2 x 3.3 cm and included the larynx, hyoid bone, and a segment of the trachea. A lesion measuring 2 x 1.7 x 1.1 cm was identified in the subglottic region, extending into the glottis on the left side, involving the thyroid cartilage and infrahyoid area.\n\nMicroscopic evaluation revealed a moderately differentiated invasive epithelial tumor with features of keratinization. The tumor was observed infiltrating the glottis, anterior commissure, thyroid cartilage, and infrahyoid region. Neoplastic cells were present at the front incision margin, showing significant atypia in the epithelial layers. Other resection margins did not show evidence of neoplastic involvement.\n\nStaging assessment indicated advanced local invasion and regional lymphatic spread. The histologic grade was moderate. Tumor extension was extensive, involving adjacent structures beyond the primary site."} +{"pid": "TCGA-ZH-A8Y1", "report": "A liver lesion specimen demonstrates a nodule measuring 0.5 x 0.4 x 0.3 cm, located subcapsularly and in close proximity to the inked parenchymal margin. The nodule is fully submitted for analysis. A separate liver segment specimen reveals two distinct nodules measuring 0.4 cm and 0.8 cm, both in proximity to the inked margin, with the larger nodule within 0.3 cm of the margin. The inked margin in this specimen is found to contain neoplastic cells. \n\nIn a more extensive liver resection specimen involving multiple segments, a dominant mass measuring 11.2 cm in greatest dimension is identified, along with multiple smaller nodules within the liver tissue. The dominant mass has a gritty, yellow-tan appearance and extends to within 0.2 cm of the inked surgical margin. The surrounding tissue shows scattered smaller nodules ranging from 0.1 to 4 cm. Neoplastic involvement is also present at the bile duct margin. In addition, invasion into the perihepatic fibroadipose tissue is observed, and lymphovascular space invasion is noted.\n\nExamination of regional lymph nodes reveals one involved node out of eleven assessed, with a metastatic deposit measuring 0.6 cm and showing extracapsular extension.\n\nMicroscopic evaluation of the biliary structures reveals dysplastic epithelium in some ducts, while other areas demonstrate multifocal intraductal papillary lesions. These changes are interpreted as part of a neoplastic process, with the invasive component composed of conventional gland-forming cells without papillary architecture. The invasive masses are of the solid, mass-forming type, and there is no evidence of extensive periductal spread. The surgical specimens include multiple blocks from the tumor margins, adjacent fibromembranous tissue, and luminal structures. Lymph node assessment includes several blocks from dissected candidates, with some showing metastatic involvement."} +{"pid": "TCGA-J4-AAU2", "report": "The prostate specimen weighed 34 grams and measured 5.0 x 3.5 x 3.5 cm. It was inked black on the left and blue on the right. The capsule was shaggy and disrupted at the bladder margin. The right seminal vesicle measured 4.0 x 1.0 x 1.0 cm with a 3.0 cm vas deferens, while the left seminal vesicle measured 4.5 x 1.0 x 1.0 cm with a 2.5 cm vas deferens. No gross abnormalities were identified in the seminal vesicles or vas deferentia.\n\nSerial sectioning of the prostate demonstrated a firm, focally nodular parenchyma. The inferior prostate was sectioned transversely and removed from the rest of the specimen, then further sectioned anterior to posterior following the urethral plane. Sections included apical margins (anterior to posterior in blocks C1\u2013C6), bladder margin (C7\u2013C8), mid gland anterior and posterior (C9\u2013C12), upper third anterior and posterior (C13\u2013C16), and remaining posterior gland (C17\u2013C21). Right and left seminal vesicle and vas deferens specimens were submitted entirely in blocks C22 and C23 respectively.\n\nHistologic evaluation showed a Gleason score of 3 + 3 = 6/10. No tumor was identified in the seminal vesicles. Perineural invasion was not present. Margins were clear except for a focal positive inked margin at the bladder neck. The tumor involved both right and left sides of the prostate. Staging was determined as pT3a, pNO, pMX.\n\nLymph node evaluation included four lymph nodes from frozen section tissue remnants measuring between 1.5 cm and 0.6 cm. No tumor was identified in either the frozen section or non-frozen section lymph node specimens."} +{"pid": "TCGA-A2-A0T0", "report": "A lumpectomy with axillary lymph node dissection was performed on the left breast. The excised breast tissue contained a lesion measuring 3.2 x 3.1 x 3.0 cm. The tumor was found to extend microscopically to the lateral surgical margin and was within 0.1 cm of the medial margin. All other designated surgical margins were within 0.6 cm of the tumor based on gross evaluation. Microscopic examination of the specimen confirmed the presence of invasive poorly differentiated ductal adenocarcinoma.\n\nThe tumor measured 3.2 cm in greatest dimension and exhibited a histologic grade of G3 (3+3+3). Vascular invasion was identified, with tumor emboli observed in angiolymphatic spaces. All evaluated surgical margins were free of tumor involvement upon microscopic review, although a microscopic focus of tumor emboli was detected in angiolymphatic spaces within the additional lateral margins.\n\nIn the axillary lymph node specimen, two out of twelve lymph nodes showed metastatic involvement by ductal adenocarcinoma. The largest involved lymph node measured 1 cm in greatest dimension, with complete replacement by tumor and evidence of extracapsular extension into surrounding fat. Two additional reactive lymph nodes were identified in the supplementary axillary specimen.\n\nAdditional tissue specimens from lateral and medial margins consisted of fibroadipose and breast tissue; no tumor was observed in these samples. The pathological staging was classified as T2 N1 MX, corresponding to stage IIB."} +{"pid": "TCGA-A6-5662", "report": "A segment of colon from the splenic flexure measures 15 cm in length and is covered by a smooth, tan-pink serosal surface with attached mesocolon. The undesignated margins have an average circumference of 4.6 cm. A central mass is identified within the mesenteric region and the overlying surface is marked with blue ink. Upon opening, a 3.8 x 3.4 cm firm, tan-white to pink lesion is observed centrally located, equidistant at 7.5 cm from each margin. The lesion has a maximal thickness of 2 cm and extends microscopically into the muscularis propria, reaching within 0.4 cm of the radial serosal surface. The mesenteric mass measures 2.7 cm in greatest dimension, with tan-white cut surfaces, and appears continuous with the mucosal lesion. The combined depth of involvement is 3.2 cm, with focal extension to within 0.1 cm of the inked radial margin. No other lesions are noted. The remaining mucosa appears normal with regular folds and a wall thickness averaging 0.5 cm. Several lymph nodes are present within the mesocolon, up to 2 cm in size. Histologically, the lesion shows moderate to poor differentiation. Invasion extends through the muscularis propria into pericolonic tissue (pT3). Vascular invasion is present. Both proximal and distal margins are free of involvement, while the radial margin is closely approached. Of 13 lymph nodes examined, 7 contain metastatic involvement (pN2). No distant metastasis is assessable (pMX). Additional sections confirm continuity between the mucosal lesion and mesenteric mass. Multiple blocks are submitted for analysis, including full-thickness sections of the tumor, margins, random colon segments, and lymph nodes."} +{"pid": "TCGA-EB-A553", "report": "The specimen consists of a skin flap containing a pigmented lesion measuring up to 5.5 x 1.5 cm, with a surrounding darkened area extending up to 6 cm in diameter. Histologic examination reveals a malignant melanocytic proliferation involving the superficial layers of the skin, with evidence of ulceration. The lesion demonstrates a thickness of 10 mm as measured by Breslow's method. A second fragment shows a similar but more superficial melanocytic lesion with features consistent with an in situ variant. The tumor is pigmented and exhibits growth beyond 4 mm in depth. No venous invasion is identified. Surgical margins are not clearly defined in relation to the lesion. No definitive satellite nodules are identified. The histologic evaluation confirms a deep invasive component without evidence of regression or treatment effect."} +{"pid": "TCGA-QH-A6CY", "report": "The specimen consists of brain tissue from the right frontal region of a male patient. Histologic evaluation reveals a densely cellular lesion composed of atypical glial cells with nuclear pleomorphism and brisk mitotic activity. The tumor exhibits infiltrative growth with perineuronal satellitosis and focal microvascular proliferation. Necrosis is not identified. Cellular morphology demonstrates features of both astrocytic and oligodendroglial differentiation. Immunohistochemical staining shows positivity for GFAP, IDH1, and ATRX, with loss of nuclear ATRX expression in tumor nuclei. MGMT promoter methylation status is present. Molecular analysis confirms codeletion of chromosomes 1p and 19q. Based on histologic and molecular features, the tumor is classified as a high-grade glioma. Staging assessment indicates no evidence of metastasis. Tumor dimensions measure approximately 4.2 cm in greatest diameter, with involvement of the cerebral cortex and subcortical white matter. Surgical margins are focally positive, suggesting incomplete resection."} +{"pid": "TCGA-TP-A8TV", "report": "The prostate specimen measured 4.0 x 3.8 x 3.8 cm and weighed 32 grams. Sectioning revealed a right-sided, poorly defined mass measuring 2.0 x 1.6 x 1.6 cm. The tumor was present in all four quadrants of the prostate, accounting for approximately 15% of the gland. Histologic evaluation showed a predominant Gleason pattern of 4+3 (total score 7/10), with a tertiary pattern of 5 present focally (<5%). The highest combined Gleason pattern was 4+4 = 8 in a dominant nodule located in the right anterior region. Overall, Gleason pattern 4 comprised 75%, while pattern 5 was less than 5%. Tumor nodules were identified in multiple areas of the prostate. High-grade prostatic intraepithelial neoplasia was noted. Non-neoplastic findings included nodular hyperplasia and acute prostatitis.\n\nThe surgical margins were uninvolved except for the right anterior base region, where malignancy was present within a 3 mm area. There was no evidence of extraprostatic extension or vascular invasion. The seminal vesicles were free of involvement. A total of 25 cassettes were submitted for histologic evaluation, including sections from all prostate regions and the seminal vesicles.\n\nFour lymph nodes were examined: one from the left pelvic region and three from the right pelvic region, ranging in size from 0.5 to 1.0 cm. All were benign. The bladder neck margin specimen was negative for malignancy. Representative tissue blocks from the prostate were selected for further review."} +{"pid": "TCGA-77-7142", "report": "The specimen labeled 'left upper lobe' consists of a lung lobe measuring 230 x 140 x 35 mm after formalin inflation. An area of pleural roughening is noted on the medial aspect of the lobe, anterior to the hilum, measuring 40 mm in diameter. Several bullae are observed at the apex with additional pleural thickening and roughening. No visible lesion is present on the pleural surface. Transverse sections reveal an irregular pale mass measuring 37 mm in greatest dimension located centrally in the superior portion of the lobe. The mass is at least 25 mm from the nearest pleural surface and at least 30 mm from the bronchial resection margin. The surrounding lung tissue shows moderately severe emphysema, and no satellite lesions are identified.\n\nMicroscopic examination reveals sheets and nests of atypical cells with central necrosis and minimal keratinization. The lesion is situated midway between the pleura and hilum without evidence of pleural invasion. No vascular, lymphatic, or perineural invasion is observed. The bronchial resection margin is free of involvement. Lymph nodes adjacent to the bronchus show reactive changes including sinus histiocytosis and pigment deposition, but no malignant cells are identified. Lung parenchyma at the apex and lingula appears unremarkable.\n\nA second specimen labeled 'lymph node upper lobe' includes fatty and lymphoid tissue measuring 17 x 12 x 4 mm. Histologically, lymph node architecture is preserved with sinus histiocytosis and carbon pigment, but no abnormal cellular infiltration is seen.\n\nAll measurements and observations indicate localized disease with no evidence of metastasis or vascular invasion."} +{"pid": "TCGA-VD-AA8M", "report": "HISTOPATHOLOGY. Lab No. Clinical Consultant & Location. Unit No. SPECIMEN. RIGHT GLOBE ENUCLEATION. \n\nMACROSCOPIC DESCRIPTION. A fresh intact right globe. Dimensions: Axial 26.5mm, Horizontal 25.5mm, Vertical 26mm. Cornea: Horizontal 12mm, Vertical 12mm. Optic Nerve: Length 35mm, Diameter 4mm. On trans-illumination, a shadow is seen approximately 14mm posteromedially. Plane of Section: Horizontal. Intraocular description: On opening, a solitary domed-shaped pigmented mass is seen approximately 3mm away from the optic disc. Tumour dimensions: 12mm in basal diameter and 7mm in height.\n\nMICROSCOPY. Histologically, the enucleated eye demonstrates a normal anterior segment with an unremarkable cornea, deep anterior chamber and open angles. The iris leaves are unremarkable. The lens shows advanced cataractous changes. In the posterior segment, close to the optic nerve head, a choroidal mass can be seen. This is dome-shaped with a large accompanying exudative retinal detachment with haemorrhage. The retina overlying the lesion is atrophic with degenerative changes.\n\nThe lesion is pigmented and consists of a mixture of cells, both epithelioid and spindle cells, with a dominance of the latter cell type. The cells are immunoreactive for MelanA, CD117 and HSP-27 (score 2). The number of mitoses is approximately 7 per 40 high power fields. The microvasculature of the lesion is prominent, and closed loops are present in the tissue planes evaluated. The lymphocytic infiltrate within the lesion is minimal. Macrophages are scattered throughout the lesion in a moderate density. There is no evidence of scleral invasion or of extraocular growth. The optic nerve is free of involvement and demonstrates mild atrophic changes. The examined vortex veins are also free of involvement.\n\nMolecular genetic examination of DNA extracted from the lesion cells was performed using multiplex ligation-dependent probe amplification (MLPA) targeting chromosomes 1, 3, 6 and 8. MLPA results demonstrate borderline gains of chromosome 1p, 2 borderline losses and 4 borderline gains in chromosome 3, and 2 borderline gains in chromosome 6p. Chromosome 8q appears normal. Due to the unclear nature of these findings, microsatellite analysis (MSA) was performed to further evaluate the status of chromosome 3. MSA results suggest no loss of heterozygosity (NLOH) for 2 of the three loci examined on chromosome 3p and NLOH for 3 of four loci on chromosome 3q, which is consistent with disomy 3. Taken together, the molecular findings indicate a normal chromosomal status for chromosome 3."} +{"pid": "TCGA-AX-A1C7", "report": "The surgical pathology report includes specimens from the uterus, cervix, bilateral tubes and ovaries, abdominal scar, omentum, and multiple lymph node regions including left and right external iliac, internal iliac, obturator, common iliac, and aortic lymph nodes.\n\nGross examination of the uterus showed a fungating mass measuring 2.5 x 1.8 x 1.5 cm located on the posterior wall of the uterine cavity adjacent to the cervical canal. The combined thickness of the mass and underlying myometrium measured 2.4 cm. Two smaller polypoid masses were present on the anterior wall, each measuring 1 x 0.8 x 0.3 cm. The myometrium contained two benign leiomyomata measuring 0.8 cm and 1.9 cm in greatest dimension, with the underlying myometrium alone measuring 1.7 cm. The cervical canal was 3.5 cm long by 0.5 cm in diameter, with a slit-like os and smooth ectocervix showing multifocal mild acute hemorrhage.\n\nThe left uterine tube measured 7 cm in length by 0.3 cm in diameter, with identifiable fimbriated end and no nodules. The serosal surface contained small cystic structures. The left ovary was light yellow and firm, measuring 5 x 0.8 x 0.5 cm. The right uterine tube was 6 cm in length by 0.3 cm in diameter, though the fimbriated end was not identified. The right ovary was yellow and firm, measuring 1.6 x 1 x 0.6 cm, with multiple white cystic structures on the outer surface of the tube.\n\nSections of the uterine specimen included one continuous full-thickness section from superior to inferior (cassettes 1A\u20131C), additional sections through the largest mass (1D\u20131E), sections of the smaller anterior wall lesions (1F), and sections of the two leiomyomata (1G). Sections of the left and right ovaries and tubes were submitted along with parovarian tissue.\n\nThe abdominal scar specimen consisted of an elliptical skin excision measuring 8.5 x 4 x 0.2 cm with underlying adipose tissue measuring 9 x 5.5 x 2.5 cm. No gross skin lesions were identified. The omentum was glistening yellow adipose tissue measuring 4 x 3 x 2 cm, with no identifiable masses or nodules.\n\nLymph node dissection specimens were submitted from multiple pelvic and periaortic regions. The left external iliac lymph nodes included two lymph nodes within adipose tissue measuring 2.5 x 2 x 0.6 cm. Left internal iliac lymph nodes (3 x 2.5 x 2 cm) yielded four lymph nodes, all submitted for evaluation. Left obturator lymph nodes (2 x 2 x 1.5 cm) included two lymph nodes, and left common iliac lymph nodes (2 x 1 x 0.5 cm) included one lymph node. Left aortic lymph nodes (2.5 x 1 x 0.6 cm) included five lymph nodes. Right external iliac lymph nodes (4 x 3 x 1 cm) included seven lymph nodes. Right internal iliac lymph nodes (2 x 2 x 1 cm) included three lymph nodes. Right common iliac lymph nodes (2.5 x 1 x 0.5 cm) included four lymph nodes. Right aortic lymph nodes (2 x 1 x 0.5 cm) included five lymph nodes, and right obturator lymph nodes (3 x 2 x 1 cm) included one lymph node. All lymph nodes were submitted in cassettes as part of the individual specimen sets.\n\nMicroscopic evaluation of the uterine specimen revealed high-grade papillary architecture within the dominant lesion, with two benign leiomyomata and benign changes in the fallopian tubes and ovaries. The abdominal scar showed benign skin with reparative changes. Omental tissue demonstrated mature adipose with one lymph node showing no evidence of involvement. All lymph node specimens across pelvic and periaortic regions were negative for malignant cells. Peritoneal cytology was also negative for malignancy.\n\nEvaluation of the tumor site indicated a maximal dimension of 2.5 cm, with total thickness of tumor and underlying myometrium at 2.4 cm. Invasion was present and measured approximately 2.5 mm in depth. There was no evidence of venous or lymphatic invasion, and no involvement of the cervical region. Tubal and ovarian tissues were unremarkable with no signs of involvement.\n\nA total of 34 lymph nodes were examined: 15 from the right pelvis, 9 from the left pelvis, 5 from the right periaortic area, and 4 from the left periaortic area. All were negative for involvement. The omentum was also free of involvement. Thirty-five tissue blocks were evaluated during the review of this case, which was presented and confirmed at a quality assurance conference."} +{"pid": "TCGA-G2-A2EC", "report": "A specimen was received consisting of an aggregate of tan-gray fibrous tissue measuring 4.0 x 3.5 x 2.5 cm, submitted entirely in multiple sections. Histologic evaluation reveals a high-grade cellular proliferation arranged with nested features. The lesion demonstrates extensive invasion into the muscularis propria. There is evidence of lymphovascular invasion. Associated findings include ulceration, necrosis, inflammation, and reactive stromal changes, which may indicate prior resection. Clinical history includes previous treatment for a urinary tract neoplasm."} +{"pid": "TCGA-DU-A7T8", "report": "The specimen consists of excised brain tissue from the right frontal region. Gross examination revealed multiple soft, mucinous, grayish-pink fragments measuring up to 1.5 cm in aggregate. A separate fragment measured 1.0 cm in greatest dimension, and another measured 2.0 x 1.0 x 0.7 cm. Sections were processed and submitted for microscopic evaluation.\n\nMicroscopic analysis demonstrated a moderately cellular proliferation of glial cells. The neoplastic cells were predominantly round with some pleomorphism and were set within a mucinous background exhibiting microcystic change. Mitotic figures were infrequently observed, and there was no evidence of microvascular proliferation or necrosis in the initial sample. In subsequent sections, areas of similar neoplastic involvement were noted, with additional zones displaying more defined astrocytic and oligodendroglial features. These areas also contained tumor necrosis and microvascular proliferation.\n\nImmunohistochemical staining was performed on selected sections. GFAP staining showed sparse gliofibril formation. CD34 highlighted the vascularity within the lesion. Approximately 5% of cells exhibited p53 overexpression. MIB-1 staining revealed a proliferation index of 3% in the more cellular regions. In total, histologic findings indicated a glial neoplasm with focal high-grade features, including necrosis and vascular proliferation. Cellular morphology and architecture suggest a mixed glial phenotype with regional variation in differentiation and grade."} +{"pid": "TCGA-BS-A0TD", "report": "The specimen consisted of a uterus and cervix, left and right pelvic lymph nodes, and bilateral tubes and ovaries. The uterus measured 11.1 x 8.3 x 4.9 cm and weighed 210 grams. A lesion was identified on the anterior wall of the uterine body, measuring 3.5 x 2.0 x 0.3 cm. It appeared granular and tan to pink, without necrosis. Histologically, the lesion demonstrated Grade 1 differentiation by FIGO criteria and nuclear grade 2. Invasion was limited to less than half of the myometrium, with a depth of invasion measuring 1 mm. There was no evidence of lymphovascular invasion. The serosa and parametrium were not involved. The cervical tissue showed no abnormality. The bilateral adnexal structures were free of disease.\n\nA total of 5 lymph nodes were identified in the left pelvic specimen, and 8 in the right pelvic specimen. All lymph nodes were negative for metastasis. The bilateral tubes and ovaries also showed no evidence of malignancy.\n\nStaging information indicated T1b, N0, MX. The surgical margins were free, with the tumor located 5.4 cm from the margin. Adenomyosis was noted in the myometrium, with a focus measuring up to 3.0 x 2.8 x 2.5 cm. The endometrial thickness was 0.2 cm, with areas of hemorrhage and mucoid material. The myometrial thickness was 3.0 cm.\n\nFrozen section analysis during surgery suggested findings consistent with the final report. Gross and microscopic evaluations of all submitted specimens supported the absence of malignancy beyond the primary site, with no involvement of lymph nodes or adnexal regions."} +{"pid": "TCGA-KN-8421", "report": "The left radical nephrectomy specimen measures 15.1 \u00d7 12.9 \u00d7 5.4 cm and weighs 545 grams. The kidney measures 15.0 \u00d7 11.7 \u00d7 4.5 cm and is partially covered by perinephric fat. A centrally located, encapsulated nodular mass measuring 12.8 \u00d7 9.5 \u00d7 4.4 cm is identified. The mass is tan to pink, lobulated, and contains areas of central necrosis and hemorrhage. It is associated with a 3.0 \u00d7 0.8 \u00d7 0.8 cm scar. The mass expands the renal parenchyma but does not grossly invade the renal capsule or pelvis. The renal pelvis remains mobile. Adjacent structures including the dilated ureter (4.3 cm in length, 0.6 cm diameter), renal artery (2.5 \u00d7 0.5 \u00d7 0.5 cm), and renal vein (2.3 cm in diameter) are unremarkable. No other masses are identified.\n\nMicroscopically, the mass demonstrates nuclear features corresponding to Fuhrman nuclear grade 3. The tumor is confined within the renal parenchyma. Margins of resection, including the renal vein, ureter, and soft tissue, show no evidence of tumor involvement. Lymphatic or vascular invasion is not observed. Two lymph nodes are negative for tumor involvement.\n\nSections of non-tumor kidney parenchyma show preserved architecture with normal glomeruli, tubules, and interstitium. Over 100 glomeruli are present without global sclerosis or significant pathological changes. Basement membranes appear normal on PAS and Jones\u2019 silver methenamine stains. Focal tubular atrophy and interstitial fibrosis are present in approximately 10% of the sample as demonstrated by trichrome stains. No active inflammation or fibrosis is noted in the interstitium. Arteries and arterioles are unremarkable.\n\nStaging according to AJCC (1997) is T2 NO MX. Hale\u2019s colloidal iron stain is positive. The surgical procedure was hand-assisted laparoscopic left nephrectomy. No specific abnormalities are identified in the kidney parenchyma away from the mass. Multiple representative sections of the tumor and surrounding tissue have been submitted for further analysis, including cytogenetics and tumor banking. Specimens for electron microscopy and immunofluorescence studies have also been retained."} +{"pid": "TCGA-BP-4959", "report": "The right renal specimen consists of a portion of renal parenchyma with attached perirenal fat, measuring 10.0 x 6.0 x 3.5 cm, with the renal portion measuring 5.0 x 4.0 x 4.0 cm. A mass measuring 4.0 x 3.9 x 3.0 cm is present, with a yellow to tan and hemorrhagic appearance, including areas of focal cystic change. The mass is well-circumscribed and does not extend through the renal capsule. The deep surgical margin is marked by a black ink, and the perirenal fat margin is inked blue. All surgical margins are free of tumor involvement. The mass is entirely submitted along with adjacent perirenal fat, which appears lobulated and yellow without distinct lesions. Histologic evaluation reveals cells with nuclear features classified as grade III/IV. The tumor is confined within the renal capsule, with no evidence of extracapsular extension. No significant findings are noted in the non-neoplastic kidney tissue."} +{"pid": "TCGA-E8-A437", "report": "The specimen consists of a right hemithyroidectomy. A tumor measuring 1.5 x 1.5 x 1.3 cm is present. The cellular morphology shows characteristics consistent with a specific type of thyroid neoplasm. Evaluation reveals no angiolymphatic invasion. There is no evidence of extension beyond the thyroid gland. The surgical margins are free of involvement. A single associated benign parathyroid gland is noted. The lesion is unifocal and located in the right lobe."} +{"pid": "TCGA-HW-7493", "report": "Clinical history includes seizures and a non-enhancing right temporal lobe lesion. Two specimens were submitted for analysis. The first specimen, labeled \"Right temporal brain tumor,\" consists of two fragments of gray-tan, friable soft tissue measuring 0.8 cm and 1.0 cm in greatest dimension. Both pieces were entirely submitted for frozen section evaluation. A frozen section control was performed.\n\nThe second specimen, labeled \"Right temporal brain tumor number two,\" consists of multiple fragments of gray-tan friable soft tissue with an aggregate size of 3.8 x 2.0 x 0.7 cm. This specimen was also entirely submitted for evaluation. Sections from both specimens were processed and reviewed.\n\nMicroscopic examination reveals diffuse infiltration by cells with features consistent with low-grade astrocytic neoplasm. Cellular morphology includes uniform nuclei without significant pleomorphism or mitotic activity. Immunohistochemical staining for Ki-67 (MIB-1) demonstrates minimal reactivity. No high-grade transformation or necrosis is identified.\n\nSections from both specimens were evaluated intraoperatively and confirmed on permanent sections. All submitted tissue blocks were reviewed and no discrepancies noted between frozen and permanent diagnoses."} +{"pid": "TCGA-D8-A13Z", "report": "Histopathological examination was performed on a right breast resection specimen along with axillary tissues and a skin flap. The breast measured 22.5 x 17 x 4 cm and weighed 600 g. Two distinct lesions were identified. The first lesion measured 4.5 x 2.5 x 2.3 cm and was located on the border of the lower quadrants, 6.7 cm from the lower edge, 1.1 cm from the base, and 1.6 cm from the skin. Microscopically, this lesion was characterized as invasive carcinoma with features of ductal type and necrosis. Histological grade was assessed as NHG3 based on a scoring system (3 + 3 + 3/21 mitoses per 10 high power fields in a visual area of 0.55 mm). Within and outside this lesion, foci of intraductal carcinoma were observed, including solid and flat types with high nuclear atypia and comedo necrosis involving less than 10% of the tumour. Lobular involvement was also noted.\n\nThe second lesion measured 1.3 x 1.2 x 1.2 cm and was located approximately 3 cm away from the first lesion. Margins were reported as 1.7 cm at the lower area, 1.4 cm at the base, and 0.9 cm from the skin. Microscopic evaluation revealed an invasive carcinoma with mixed features, including ductal, papillary, and cribriform components. Histological grade was NHG2 (2 + 2 + 2/9 mitoses per 10 high power fields in a visual area of 0.55 mm). Additional findings included intraductal carcinoma within the mammary ducts and fibrocystic changes in the surrounding glandular tissue.\n\nImmunohistochemical analysis of the first lesion showed no expression of estrogen or progesterone receptors in neoplastic cell nuclei. HER2 protein expression was assessed using HercepTest\u2122 by DAKO and showed a negative reaction with a score of 1+. In the second lesion, estrogen and progesterone receptors were detected in 10\u201375% of neoplastic cell nuclei, while HER2 staining also yielded a score of 1+ with no overexpression detected.\n\nLymph node examination revealed metastatic involvement in axillary lymph nodes (No IX/XI), with evidence of capsular infiltration and vascular emboli. The metastatic deposits measured up to 0.4 cm in length. Based on these findings, staging parameters indicated pT2 for the first lesion and pT1c for the second, with nodal involvement classified as pN2a."} +{"pid": "TCGA-OR-A5JL", "report": "The right adrenal gland specimen weighs 28 grams and measures 65 x 30 x 30 mm. A rounded medullary nodule measuring 38 x 34 x 30 mm is present, with a grey-brown cut surface. The adjacent cortex shows no nodularity. Representative sections have been taken.\n\nMicroscopic examination reveals a well-circumscribed nodule composed of focally markedly pleomorphic epithelial cells with abundant foamy, oncocytic cytoplasm and only occasional areas of clear cells. Up to six mitoses per 50 high-power fields are identified, including occasional atypical mitoses. No capsular, sinusoidal, or vascular invasion is observed. Excision appears complete.\n\nThe lesion exhibits five of the Weiss criteria of malignancy: mitotic rate of 6 per 50 HPF, atypical mitoses, diffuse growth pattern, cytological atypia, and eosinophilic cytoplasm. There is no vascular or sinusoidal invasion, no extra-adrenal spread, no coagulative necrosis, and no perineural growth.\n\nImmunohistochemistry findings include a Ki-67 proliferation index of 8%, diffuse positivity for IGF2 in a perinuclear dot-like pattern, and strong diffuse (4+) positivity for glucocorticoid receptor.\n\nSections indicate clear margins with no evidence of residual disease. Local excision appears complete."} +{"pid": "TCGA-AC-A2BK", "report": "The specimen consists of a left mastectomy measuring 31 x 20 x 5.5 cm and weighing 1515 grams. The anterior surface includes an ellipse of brown skin measuring 22 x 17 cm. A central areolar complex measuring 4.5 cm in diameter is noted with slight nipple retraction. The deep margin is inked, and serial sectioning reveals a gray-tan firm mass located in the upper outer quadrant. This mass measures 2.8 x 2.5 x 2.3 cm and extends to within 1 cm of the deep margin. Sections of the overlying skin, the deep margin, and the mass itself are submitted for analysis. The remainder of the breast tissue shows lobulated yellow adipose tissue interspersed with gray-white rubbery tissue. The breast is divided into quadrants and sampled accordingly. Axillary tissue is dissected, and lymph nodes are sampled from both the lower and upper regions.\n\nHistologic evaluation reveals a Nottingham histologic score of 3/3. No ductal in situ component or microcalcifications are identified. The tumor is classified as pT2 based on size (greater than 2.0 cm but not more than 5.0 cm). Regional lymph node involvement is noted, with 6 out of 23 nodes positive, classified as pN2a. Distant metastasis cannot be assessed (pMX). Margins are uninvolved by invasive disease, with the closest distance being 1.0 cm to the deep margin. Vascular invasion is present.\n\nPathologic staging is summarized as pT2N2aMXG3. Additional immunohistochemical studies are pending."} +{"pid": "TCGA-CH-5752", "report": "The specimen shows a lesion with maximum dimension of 2.8 cm involving both sides of the prostate, with prominent perineural invasion around major nerves. There is infiltration into the periprostatic connective tissue in the right mid portion and at the right base, as well as vascular invasion. Seminal vesicles and seminal ducts are free of tumor involvement. Nine lymph nodes were examined, all without evidence of tumor involvement.\n\nCarcinomatous infiltrates are present in the peripheral and transitional zones bilaterally, more pronounced on the right side. Small foci of Gleason pattern 3 are identified as tertiary components. Tumor cells are noted at multiple points near the margins (right lateral apex, right medial apex, left medial apex), with extension less than 0.1 mm on the green and blue-labeled sections; however, the color labels themselves are clear. Histological evaluation indicates a classification of pT3a, pN0 (0/9), with a Gleason score of 4+4 = 8, G3, L1, V0. Further assessment for possible neuroendocrine differentiation will be addressed in a subsequent report."} +{"pid": "TCGA-69-7761", "report": "The specimen included multiple tissue samples from various anatomical locations. Part A (4R) was a 1.9 x 1.2 x 0.5 cm segment of red tissue. Part B (#7) measured 0.7 x 0.4 x 0.3 cm and was also red in color. Part C (L4) was a 1.3 x 0.8 x 0.7 cm red tissue segment, while Part D (R2) was 1.3 x 0.7 x 0.5 cm in size and similarly red. All were submitted entirely for frozen section analysis.\n\nPart E consisted of a left lower lobectomy measuring 13.5 x 12 x 10 cm and weighing 413.2 grams. The specimen included a bronchus segment (0.8 cm in length, 1.2 cm in diameter), adhered parietal pleura (4.5 x 3.5 x 0.2 cm), and an upper lobe wedge (4.5 x 2.5 x 2.3 cm). Within the lower lobe parenchyma, two lesions were identified, along with one lesion in the upper lobe. The primary lesion was a 4.5 x 3.2 x 3.2 cm tan-gray firm mass located adjacent to the visceral pleural surface, with associated puckering and adhesion to the parietal pleura. It was 4.0 cm from the bronchial resection margin and 2.5 cm from the parenchymal resection line. A second smaller lesion, measuring 0.5 x 0.5 x 0.4 cm, was noted 4.1 cm away from the larger mass within the lower lobe. The upper lobe contained a 2.4 x 2.2 x 1.8 cm tan-gray calcified nodule with central necrosis, located 0.3 cm from the parenchymal resection margin and 0.1 cm from the pleural surface. Additional findings in the lung and pleura included fibrous adhesions, particularly at the staple line in the lower lobe base, and multiple anthracotic hilar lymph nodes.\n\nPart F (L9) was a yellow-black soft tissue segment measuring 0.5 x 0.2 x 0.2 cm, fully submitted in formalin. Part G (\"granuloma content\") was a black-white firm tissue segment measuring 1.5 x 1.5 x 0.5 cm, also fully submitted after decalcification. Part H (level 12) included two tan-black soft tissue segments aggregating to 2.0 x 1.0 x 0.5 cm, both fully submitted in formalin. Part I (L11) included multiple tan-brown, soft and calcified tissue segments aggregating to 5.0 x 1.5 x 0.5 cm, all submitted following light decalcification. Part J, another left lower lobe segment, was 4.0 x 2.5 x 0.7 cm in size, with a roughened pleural surface and unremarkable lung parenchyma. It was submitted as three representative sections. Part K, a portion of the seventh rib, was an 8.0 x 2.0 x 0.6 cm unoriented bone segment with attached soft tissue, submitted in multiple sections after decalcification. Part L (level 6) and Part M (level 7) were yellow-black soft tissue segments measuring 1.0 x 0.2 x 0.2 cm and 0.5 x 0.2 x 0.2 cm respectively, each fully submitted in formalin.\n\nHistologically, the findings included two separate foci of atypical adenomatous hyperplasia, organizing acute fibrinous pneumonia, pleural fibrous adhesions, focal bronchiectasis with calcified and hyalinized granulomas in the upper lobe, and peribronchial lymph nodes without evidence of neoplasm. In other specimens, necrotizing granulomas with calcification were present, and lymph nodes from levels 12 and 11 showed calcified hyalinized nodules but no neoplastic changes. The seventh rib showed no significant pathologic alterations. The largest lesion in the left lower lobe was 4.5 x 3.2 x 3.2 cm, located 4.0 cm from the bronchial resection margin and 2.5 cm from the parenchymal resection line. Smaller nodules were also identified in the lower and upper lobes. All surgical margins tested were negative. Staging was consistent with a T2a NO MX classification. Special stains including Movat, GMS, and Ziehl-Neelsen were pending and would be reported in a follow-up addendum."} +{"pid": "TCGA-QF-A5YT", "report": "The surgical pathology report includes a total hysterectomy specimen with cervix, as well as bilateral salpingo-oophorectomy specimens. The uterus measured 5.5 cm from cornu to cornu, 6.5 cm from superior to inferior, and 4.0 cm from anterior to posterior. A 2 x 1.5 cm tan-white exophytic mass was identified in the anterior lower uterine segment. The endometrial cavity was tan-white and trabeculated, with a myometrial thickness of 2.5 cm in the area of greatest measurement. Two fibrous nodules were noted: one intramural measuring 0.8 x 0.7 cm and another subendometrial in the fundus measuring 0.8 x 0.4 cm.\n\nMicroscopic evaluation revealed a histologic grade corresponding to FIGO Grade 1. There was evidence of myometrial invasion, with a depth of 10 mm and a total myometrial thickness of 20 mm, representing 50% invasion. Adenomyosis was also present and involved by the process. Involvement of the cervical stroma was observed, with a tumor thickness of 3 mm in this region against a total cervical thickness of 12 mm. No lymphovascular space invasion was identified. Surgical margins were free of involvement.\n\nThe fallopian tubes and ovaries on both sides showed no diagnostic alterations. No metastatic disease was identified in these specimens.\n\nStaging was performed according to the pTNM and FIGO systems. The primary tumor was classified as pT2. Regional lymph node assessment was not performed (NX), and there was no evidence of distant metastases (MX). Intraoperative frozen section analysis was conducted, with findings based on histologic evaluation. The endometrium was sampled extensively, and no other significant findings were reported in the submitted tissues."} +{"pid": "TCGA-AA-3664", "report": "The specimen consists of a right hemicolectomy preparation with an ulcerated lesion identified at the junction between the cecum and ascending colon, extending to Bauhin's valve. The lesion measures 5 cm in diameter at its widest extent. Histologically, there is evidence of invasive growth into the adjacent mesocolic fat and beneath the serosa. The oral and aboral resection margins, appendix, and greater omentum show no involvement. A total of 22 lymph nodes from the mesenteric and mesocolic regions are free of tumor and exhibit nonspecific reactive changes. Vascular and lymphatic invasion are not observed. The cellular differentiation is moderate."} +{"pid": "TCGA-ET-A39S", "report": "The specimen consisted of a total thyroidectomy. The lesion was located in the left lobe and measured 1.0 cm in greatest dimension. Histologic evaluation showed a unifocal lesion. All two lymph nodes examined were free of tumor involvement. The primary lesion was confined to the thyroid without evidence of extrathyroidal extension, corresponding to a pT1 classification. No regional lymph node metastases were identified, classified as pN0. Distant metastasis could not be assessed (pMx). Surgical margins were negative, with the closest distance of the lesion to the anterior and posterior margins being less than 1 mm. There was no evidence of venous or lymphatic invasion. No additional pathologic findings were noted."} +{"pid": "TCGA-AA-3524", "report": "The resected specimen of the colon or sigmoid colon shows diverticulosis. An ulcerated lesion is present, composed of moderately differentiated cells exhibiting infiltration into the perimuscular fatty tissue. The tumor does not extend to the oral or aboral resection margins. A total of 28 regional lymph nodes were examined, and no metastases were identified. Vascular invasion is absent, and the surgical margin is free of tumor involvement. Additionally, a tubular adenoma with mild dysplastic changes is noted in the colonic mucosa."} +{"pid": "TCGA-55-8616", "report": "A surgical pathology report was generated from a resected lung specimen and associated lymph nodes. The lobectomy specimen measured 20.5 x 8 x 4 cm, with a continuous parenchymal staple line along 18 cm of the hilar aspect. A single tumor mass was identified in the right upper lobe, measuring 4 x 3.5 x 3 cm, with firm, solid, gray-tan consistency and irregular borders. The tumor was located within the superior half of the specimen, less than 0.1 cm from the puckered visceral pleural surface (inked blue) and 1.4 cm from the nearest parenchymal staple line margin. The bronchial resection margin was 3.5 cm from the tumor. No additional discrete lesions were noted in the remaining lung tissue.\n\nMicroscopic evaluation of the tumor showed moderately differentiated features. The tumor did not demonstrate lymphatic or vascular invasion, and no visceral pleural invasion was identified. All surgical margins\u2014bronchial, vascular, and parenchymal\u2014were uninvolved by tumor. A peribronchial lymph node was identified and found to be negative for malignancy.\n\nA total of 16 lymph nodes were examined from multiple levels, including right paratracheal, 4R paratracheal, level 7 subcarinal, level 9 pulmonary ligament, level 12R, and level 11R. All lymph nodes were benign and showed no evidence of malignancy. Specifically, one right paratracheal, four 4R paratracheal, one level 7 subcarinal, three level 9, one level 12R, four subcarinal level 7, and one level 11R lymph nodes were evaluated and found to be negative.\n\nThe tumor was classified as pT2a based on size (>3 cm but \u22645 cm) and location within the lung, surrounded by lung or visceral pleura, without evidence of more proximal bronchial involvement. There was no regional lymph node involvement (pN0) and no evidence of distant metastasis (pM0). The pathologic stage is consistent with stage IB.\n\nAncillary testing was limited; no fresh tissue was available, and the case does not meet criteria for reflex molecular testing. A formalin-fixed tissue block (D 5-10) was preserved for potential future testing and will be stored in pathology for up to 10 years."} +{"pid": "TCGA-D6-8568", "report": "The clinical suspicion was related to a lesion on the left side of the larynx. The patient was admitted on standard urgency. Specimen collection for laboratory examination included the larynx, with attention requested on the marked margin. Histopathological analysis revealed an invasive keratinizing squamous cell carcinoma. Microscopic evaluation showed that the lesion infiltrates the left subglottic area, with involvement of vessels and nerve structures. Surgical margins were found to be free of affected tissue. Associated findings included histiocytic sinus changes in lymph node No. I (Delphan). A final report was pending full development of all collected material.\n\nThe surgical specimen measured 9 x 7 x 5.5 cm and included the hyoid bone and a 2 cm segment of the trachea. A lesion measuring 2.2 x 2.3 x 0.9 cm was identified on the left side of the subglottic region, extending into both the subglottic and supraglottic areas."} +{"pid": "TCGA-DD-A73G", "report": "The specimen includes tissue from segments II and III of the liver, submitted in multiple blocks (A1, A2, B1\u2013B5, C1). The liver tissue from segments II and III weighs 1180.0 grams and measures 20.0 x 11.0 x 7.0 cm. A separate fragment from segment VI of the liver measures 1.0 x 0.9 x 0.8 cm. Additionally, a biopsy of soft tissue from the left abdominal wall is present, measuring 2.6 x 2.2 x 1.0 cm.\n\nMicroscopic evaluation of the liver tissue from segments II and III shows a high-grade cellular proliferation with marked nuclear atypia and increased mitotic activity. The lesion involves a significant portion of the resected liver, with the largest dimension measuring 20.0 x 11.0 x 7.0 cm. The closest surgical margin is at least 0.2 cm away from the lesion. In the segment VI liver sample, there is evidence of a hyalinized nodule with features suggestive of a benign, sclerosed lesion. The left abdominal wall biopsy reveals fibrin deposits, inflammatory cells, and reactive mesothelial changes, with no evidence of abnormal cellular proliferation."} +{"pid": "TCGA-AP-A0LS", "report": "The submitted specimens include the uterus, cervix, bilateral fallopian tubes and ovaries, right para-aortic lymph nodes, left external iliac lymph nodes, left obturator lymph nodes, right external iliac lymph nodes, and right obturator lymph nodes.\n\nExamination of the hysterectomy specimen shows a lesion involving the endometrium. Histologic evaluation reveals glandular structures with nuclear atypia consistent with a neoplastic process. The tumor infiltrates up to half of the myometrium, with maximal myometrial invasion measuring approximately 6 mm in thickness. The total myometrial thickness at the site of deepest invasion is 28 mm. No involvement of the endocervix is identified. Vascular invasion is present. Additional findings in the myometrium include adenomyosis and leiomyoma. A cellular fibroma is noted adjacent to the right fallopian tube. No abnormalities are detected in other adnexal structures.\n\nLymph node specimens from the right para-aortic region show fibroadipose tissue with a small benign lymphoid aggregate. All other lymph node samples\u2014left and right external iliac, left obturator, and right obturator\u2014are negative for malignant involvement. One right external iliac lymph node, two right external iliac lymph nodes, six left obturator lymph nodes, and five right obturator lymph nodes are all benign. Histiocytic aggregates are observed in one specimen.\n\nAll findings were personally reviewed and confirmed based on microscopic examination of the slides."} +{"pid": "TCGA-DV-A4VZ", "report": "The specimen from the right kidney includes four lesions. Tumor #1 consists of three pieces measuring 1.4 x 0.8 x 0.7 cm in total, with more than 70% solid tissue. A tan firm nodule measuring 0.9 x 0.7 x 0.4 cm was identified, inked in blue, bisected, and revealed a tan area measuring 0.5 x 0.2 x 0.3 cm. The entire specimen was submitted for processing.\n\nTumor #2 consists of six pieces measuring up to 3.5 x 3.5 x 2.7 cm. Over 70% of this specimen is solid and homogeneous. One piece measured 3 x 2.1 x 0.2 cm, while other fragments ranged from 2 x 1 x 1 cm to 3.5 x 1.7 x 1.5 cm. Focal calcification was noted in one fragment. All pieces were serially sectioned and submitted entirely for evaluation.\n\nTumor #3 consists of six pieces measuring up to 3.9 x 3.1 x 2.8 cm. Between 30% and 70% of this specimen is cystic and solid. Three white, firm fragments were received, including two with fibrous capsules and minimal attached tan tissue. The largest fragment measured 3 x 2.6 x 2.2 cm and showed a brown-white nodule with cystic and solid yellow areas on cut surface. The uncut portion was inked in blue and submitted across multiple cassettes.\n\nTumor #4 is a single white to light tan cyst measuring 1 x 0.7 x 0.2 cm. It was bisected and entirely submitted for permanent processing.\n\nA separate specimen from the right 11th rib includes two bony fragments measuring 2 x 1 x 0.4 cm and 2.2 x 2 x 0.5 cm, submitted for gross evaluation only."} +{"pid": "TCGA-S7-A7WP", "report": "The specimen consists of a fibrously encapsulated mass from the left adrenal gland weighing 42 grams, measuring 50 x 45 x 35 mm. The cut surface exhibits a soft texture and pink-red hue. Histologically, the lesion demonstrates solid and alveolar architecture with areas of focal hemorrhage. Adjacent adrenal cortex shows extensive hypolipoidosis, with changes extending into the surrounding adipose tissue. Metaplastic alterations consistent with Feyrter's type are present. Immunohistochemical staining for S100 protein highlights frequent sustentacular cells.\n\nHistopathologic features include large nests or diffuse growth comprising over 10% of the tumor volume. Central necrosis within large nests and confluent necrosis is noted. The lesion exhibits high cellularity, cellular uniformity, and focal spindle cell morphology. More than three mitotic figures per ten high-power fields are observed, including atypical mitotic forms. Invasion into adipose tissue, vascular structures, and capsular extension are present. There is moderate nuclear pleomorphism and hyperchromasia. The overall assessment includes multiple adverse histologic features."} +{"pid": "TCGA-A6-2686", "report": "The specimen consists of a right colon segment, including the terminal ileum and appendix. Gross examination reveals a previously opened portion of bowel with a tan-pink, glistening serosal surface and adherent yellow adipose tissue. The appendix measures 4.5 cm in length and 0.6 cm in diameter, with a tan serosa, wall, and mucosa, and no focal lesion identified. The bowel includes 5 cm of distal small bowel and 15 cm of contiguous proximal colon. A circumferential mass measuring 6 x 4.5 x 1.2 cm is present in the ileocecal valve/cecal region. It extends through the full thickness of the bowel wall into surrounding adipose tissue. There is possible serosal umbilication, though this area was inked blue and difficult to assess due to prior opening. The tumor does not involve the radial margin. The mucosa away from the mass appears normal. The colonic portion averages 8 cm in circumference, while the small bowel segment averages 4.2 cm in circumference. No focal lesions are seen in the small bowel. Adipose tissue has been dissected, revealing multiple soft tan lymph nodes.\n\nMicroscopic evaluation indicates full-thickness invasion of the bowel wall extending into surrounding adipose tissue. Both proximal and distal resection margins, as well as the radial margin, are negative. Thirty-three lymph nodes are identified and show no evidence of malignancy. No vascular invasion is definitively identified. The appendix demonstrates no diagnostic abnormalities."} +{"pid": "TCGA-3H-AB3X", "report": "The pathology report describes a biopsy specimen from the right lung. The sample consists of multiple pink-red core biopsy fragments ranging in size from 0.1 x 0.1 cm to 0.4 x 0.1 cm. Immunohistochemical analysis shows positivity for calretinin, WT-1, and D2-40, while the tissue is negative for CEA, CD15, MOC31, CK5/6, and mesothelin. The morphologic features combined with the immunoprofile support a conclusion based on these findings. The clinical history notes a pleural-based mass. All tissue samples were submitted for evaluation. SNOMED codes associated with the report are T-28000 and M-90503. Some tests included in the report may have been developed and validated by the laboratory and have not been specifically cleared or approved by the U.S. Food and Drug Administration."} +{"pid": "TCGA-DK-A1A3", "report": "A 61-year-old male underwent radical cystectomy and related surgical procedures for presumed malignancy with bilateral hydronephrosis. Specimens included multiple lymph node excisions, urethral and ureteral margins, bladder with adjacent structures, and other tissue samples.\n\nExamination of the left pelvic lymph nodes revealed nine nodes, five of which contained metastatic disease. The largest involved node measured 3.4 cm, and extracapsular extension was noted. In the right pelvic lymph nodes, nine nodes were examined; however, no metastases were identified.\n\nThe radical cystectomy specimen revealed a tumor involving the bladder wall with infiltration into surrounding soft tissues. The tumor exhibited a diffuse growth pattern with focal micropapillary features and high-grade cytology. Non-invasive components displayed both papillary and flat morphology. There was involvement of the prostatic stroma and seminal vesicles. Vascular and perineural invasion were present. Chronic cystitis, proliferative changes including Brunn\u2019s nests, cystitis cystica, and cystitis glandularis were observed in non-neoplastic mucosa. Benign nodular hyperplasia was identified in the prostate.\n\nSurgical margins showed tumor involvement at the urethral margin and high-grade urothelial carcinoma was seen at the right ureteral margin. Additional urethral margin specimens confirmed tumor presence. Periurethral tissue and left periureteral tissue also demonstrated invasive high-grade urothelial carcinoma.\n\nOther specimens including vas deferens, urachus, ureteral stents, distal ureters, and additional urethral fragments were benign except as noted above.\n\nPathologic staging based on AJCC 2002 criteria was assigned as pT3 indicating invasion into perivesical soft tissues and PR2 reflecting periprostatic or periseminal vesicle invasion."} +{"pid": "TCGA-GD-A76B", "report": "A radical cystectomy with urinary diversion was performed. Frozen section analysis of the right and left distal ureters showed no evidence of malignancy. The right ovary showed no significant pathologic changes, while the fallopian tube demonstrated Walthard cell rests. On gross examination, a 3.3 cm mass was identified on the anterior wall of the bladder, measuring 2.4 x 1.2 cm, with a papillary appearance. Microscopic evaluation revealed high-grade cellular changes consistent with a predominantly papillary configuration in the anterior wall without invasion. In the posterior wall, there was a focus of invasive disease within a pseudosarcomatous myofibroblastic proliferation, likely related to prior transurethral resection. This area showed nests of atypical cells confirmed as invasive by immunohistochemical staining (positive for p63 and cytokeratin cocktail). No lymphovascular invasion was identified.\n\nMargins including urethral, ureteral, and paravesical soft tissue were free of involvement. A small microscopic focus of invasive disease was noted on the right lateral wall. There was focal extension into the deep muscularis propria. No urothelial carcinoma was identified in the vaginal mucosa or paravesical fat. A total of 22 lymph nodes were examined from the pelvic region\u20149 from the right lower, 12 from the left upper, and 1 from the left lower pelvic areas\u2014all were negative for malignancy. Based on these findings, the pathologic staging was determined accordingly."} +{"pid": "TCGA-HT-7605", "report": "The sections show a glial neoplasm with variable cellularity that diffusely infiltrates both gray and white matter. The tumor is predominantly mildly hypercellular, though some regions exhibit confluent areas of increased cell density. The neoplastic cells display mild nuclear atypia with enlarged, round nuclei and either perinuclear halos or microgemistocytic cytoplasm. Mitotic activity is very low, with only one mitosis identified after extensive review. There is no evidence of microvascular proliferation or necrosis. Immunohistochemical staining reveals scattered MIB-1 positive cells in the more proliferative regions, yielding a calculated labeling index of 0.6%."} +{"pid": "TCGA-SW-A7EB", "report": "The surgical specimen includes a portion of the stomach measuring 12 cm in combination with the greater omentum. At 5.0 cm from the distal resection margin, there is an ulcerative formation with regular borders measuring 3.0 x 4.0 cm. The lesion infiltrates approximately half of the gastric wall. The greater omentum appears intact. A total of 5 lymph nodes were examined, with 3 located along the greater curvature and 2 along the lesser curvature. Microscopic examination reveals moderately differentiated cells with mucinous features and ulceration. Areas of hyalinosis and presence of lymphoid tissue are noted. The tumor invades through the entire gastric wall. Resection margins are clear. Of the lymph nodes examined, all from the greater curvature (2 of 2) and one from the lesser curvature (1 of 3) show involvement. No metastasis was identified. The clinical assessment corresponds to a stage T3 N2 M0, stage IIIA."} +{"pid": "TCGA-S9-A6WH", "report": "The neuropathology report indicates a lesion with histological features consistent with a diffusely infiltrative glial neoplasm. Microscopic evaluation reveals a mixed cellular population, including both astrocytic and oligodendroglial components. The tumor cells exhibit mild to moderate nuclear atypia, with some areas showing increased cellularity and focal architectural disorganization. No definitive high-grade features such as necrosis or microvascular proliferation are identified. Based on histomorphological assessment, the lesion is classified as WHO grade II."} +{"pid": "TCGA-EY-A2OP", "report": "The surgical specimens included lymph nodes from the right and left periaortic regions, as well as right and left pelvic areas. A total of 19 lymph nodes were examined across all regions, with no abnormal findings identified. \n\nThe hysterectomy specimen included the uterus, cervix, bilateral ovaries, and fallopian tubes. The endometrial cavity measured 5.2 cm in length. A white/tan, friable exophytic, polypoid mass measuring 5.0 x 4.0 x 2.0 cm was observed, located on the left side of the fundus extending into the posterior corpus. Microscopic evaluation showed that the lesion involved the inner half of the myometrium, with a depth of invasion of 2 mm and a myometrial wall thickness of 2.1 cm, representing 10% penetration. No involvement was seen at the serosal surface, lower uterine segment, cervix, or adnexa. The cervical and vaginal margins were free of abnormal cells. Lymphovascular space invasion was not identified.\n\nAdditional findings included endometrial polyps of the atrophic type and leiomyomata. The right ovary contained stromal hyperthecosis with surface epithelial inclusions, while the left ovary showed stromal hyperthecosis alone. Walthard nests were present in the right fallopian tube; the left fallopian tube showed no significant histopathologic changes.\n\nImmunohistochemical studies performed on the endometrial lesion showed approximately 60\u201370% of cells positive for estrogen receptor (moderate intensity), approximately 5% positive for progesterone receptor (moderate intensity), and negative staining for p63. These findings were evaluated in the context of confluent tumor growth patterns.\n\nStaging information was provided based on available data, with AJCC pathologic staging classified as pT1a pNO and FIGO (2008) stage IA. These classifications may be subject to revision pending further clinical and pathological review.\n\nGrossly, the uterus weighed 305 grams and had a pear-shaped appearance with smooth, pink-tan serosa. The cervix measured 3.1 cm in length of the endocervical canal, with a pink-tan ectocervix and trabeculated endocervix. A submucosal nodule measuring 3 cm in greatest dimension was noted within the myometrium, appearing homogeneous without hemorrhage or edema. The right and left ovaries measured 3.5 x 1.9 x 0.9 cm and 3.4 x 2.6 x 0.8 cm, respectively. Both fallopian tubes measured approximately 5.5 cm in length. All tissue specimens were processed and examined in detail as outlined in the block summary."} +{"pid": "TCGA-EJ-5515", "report": "The patient is a male with a PSA value of 4.8 and a history of left-sided varicocelectomy, as well as a prior biopsy that revealed unilateral poorly differentiated prostate malignancy on the right side. The patient underwent a radical retropubic prostatectomy.\n\nExamination of three right pelvic lymph nodes and seventeen left pelvic lymph nodes showed no evidence of abnormal cell growth in any of the nodes evaluated.\n\nA poorly differentiated adenocarcinoma was identified within the prostate, with a Gleason score of 3 + 4 = 7. A small component of Gleason grade 5 morphology was present, accounting for approximately 2% of the total tumor volume. The lesion was located exclusively in the right lobe of the prostate, measuring 1.6 cm at its greatest dimension, and involved approximately 5% of the examined prostate tissue.\n\nFocal extension beyond the prostate capsule was observed in the posterior right mid and posterior right base regions. The involvement reached within two cell layers of the inked posterior right mid capsular margin; however, all surgical resection margins were free of tumor cells. Multifocal perineural invasion was noted, but no angiolymphatic invasion was identified. Additionally, multifocal high-grade prostatic intraepithelial neoplasia was present. The seminal vesicles were not involved.\n\nPathologic staging was determined to be pT3a with no regional lymph node involvement (pN0) and no evidence of distant metastasis (pMX). Histologic grading was classified as G3-4. The prostate weighed 36.38 grams. Chronic inflammation and benign prostatic hyperplasia were also noted."} +{"pid": "TCGA-DX-A1KX", "report": "The submitted specimen consists of a resected soft tissue mass along with an attached segment of bowel. The soft tissue component measures 14.8 x 12.5 x 7.8 cm and is described as irregular and multilobulated. The external surface is smooth, yellow to pink in color, and covered by an intact translucent membrane. The cut surface reveals tan to yellow-white tissue with gelatinous and hemorrhagic areas. The mass measures 12.6 x 11.4 x 6.5 cm and is primarily viable with focal necrosis noted. It is surrounded by an intact membrane and abuts both the serosal and irregular resection margins. The tumor appears to originate outside the bowel wall, causing external compression but without gross evidence of invasion.\n\nThe attached bowel segment measures 23.5 cm in length and 2.5 cm in diameter. Its mucosal surface is described as intact and smooth with a tan and velvety appearance. Microscopic evaluation includes sections from multiple sites including resection margins (both stapled and open ends), unaffected bowel, bowel with underlying mass, and representative tumor sections. All surgical margins are free of tumor involvement. Histologic features include a predominant cellular component showing variable differentiation, with regions ranging from low to high grade. A minor component demonstrates distinct morphologic characteristics and sclerosing features. Adipose tissue involvement is noted within subserosal layers, while the bowel mucosa remains uninvolved. A separate excised skin specimen with scar tissue was also submitted for evaluation."} +{"pid": "TCGA-VQ-A8E3", "report": "The specimen from the body and antrum of the stomach shows a lesion measuring 7.5 cm in greatest dimension. Histologic examination reveals poorly differentiated cells arranged in an intestinal-type growth pattern with ulceration. The lesion extends into the subserosal adipose tissue. Angiolymphatic invasion is present; perineural invasion is not identified. Adjacent mucosa demonstrates low-grade epithelial dysplasia and intestinal metaplasia. Surgical margins are free of neoplastic involvement. No evidence of neoplasia is found in the omentum or in lymph nodes from the lesser curvature (0/10), greater curvature (0/6), number 6, peripancreatic region, 8P (0/4), or 11P stations. Additionally, no neoplastic involvement is observed in the anterior layer of the transverse mesocolon or gallbladder."} +{"pid": "TCGA-QQ-A5VC", "report": "The surgical specimen from the posterior right thigh consists of an oval piece of skin and soft tissue measuring 10 x 8 cm, excised to a depth of 2 cm. A firm tan nodule measuring 3.2 x 3 cm is present, located 2.5 cm from both medial and lateral margins, 4 cm from the proximal margin, and 2.8 cm from the distal margin. The nodule is situated beneath fascia on the posterior aspect. On sectioning, the nodule measures 3.5 x 3.3 x 1.4 cm and is 1.1 cm from the distal margin. It does not appear to invade the overlying fascia. Multiple sections were taken to evaluate margins and relationships to surrounding tissue.\n\nTwo additional specimens were submitted: one from the proximal margin and one from the distal margin. Both are triangular pieces of skin and subcutaneous tissue. The proximal margin specimen measures 6 x 3 cm and is excised to a depth of 1 cm. The distal margin specimen measures 3.4 x 1.4 cm and is excised to a depth of 1.5 cm. No discrete lesions were identified in either specimen upon serial sectioning, and all margins were found to be free of abnormal tissue. Multiple representative sections were submitted for analysis from each specimen."} +{"pid": "TCGA-BQ-7061", "report": "The submitted specimen includes a left kidney and a portion of spleen obtained via total nephrectomy and partial splenectomy. The kidney measures 10.6 x 5.6 x 4.6 cm and contains a lobulated lesion measuring 4.8 x 4.7 x 4.6 cm located in the upper pole and midportion. The lesion has a tan-yellow, solid, and cystic surface appearance and extends into the perinephric fat, adhering to a fragment of spleen. The greatest tumor diameter is 4.7 cm. Microscopic evaluation shows high-grade histologic features. The tumor extends through the renal capsule but remains confined within Gerota's fascia. There is no evidence of renal vein invasion. Surgical margins are free of tumor involvement. Adjacent non-neoplastic kidney tissue demonstrates focal glomerulosclerosis and vascular changes associated with a history of hypertension. No adrenal gland is identified. The attached ureter measures 4.5 cm in length and 0.3 cm in diameter; the renal vein measures 0.9 cm in length and 0.8 cm in diameter. Both ureteral and vascular margins appear unremarkable. A fragment of benign congested spleen is present and not involved by tumor. Lymph nodes are not identified in the perinephric fat. Staging indicates the lesion is confined to the kidney and measures less than or equal to 7.0 cm in greatest dimension."} +{"pid": "TCGA-VQ-A91N", "report": "The specimen involves the stomach (antrum) and demonstrates a moderately differentiated tubular growth pattern with vegetating and invasive features. The lesion is located in the pyloric antrum and extends into the duodenum, measuring 4.5 cm in its largest dimension. Infiltration is noted into the perigastric fat and peritoneum. Lymphatic invasion is present; however, no venous or perineural invasion is observed. There is moderate stromal desmoplasia, and no intratumoral lymphocytic infiltrate is identified. Surgical margins are free of abnormal cellular infiltration.\n\nNon-neoplastic mucosa shows atrophic gastritis with extensive intestinal metaplasia. Additional tissues examined include hepatogastric ligament, peripancreatic peritoneum, omentum, and surrounding fat tissue\u2014all without involvement by malignant cells.\n\nLymph node assessment reveals metastatic involvement in several regions: lesser curvature (2 out of 3), right gastroepiploic region (5 out of 8), infrapyloric area (3 out of 4), left gastric artery region (5 out of 8), and celiac trunk (3 out of 6). All involved nodes demonstrate extracapsular extension. One lymph node sample from the left gastroepiploic region contains only fat tissue and no lymph nodes."} +{"pid": "TCGA-DD-AACQ", "report": "The submitted liver specimen measured 13.0 x 10.0 x 4.5 cm and showed a cirrhotic background. Two tumors were identified in the left lobe, measuring 3.4 x 2.9 x 1.9 cm and 0.9 x 0.6 x 0.6 cm, respectively. The larger lesion exhibited an expanding nodular growth pattern, while the second was a separate smaller mass. No satellite nodules were observed. On gross examination, there was no evidence of tumor necrosis, hemorrhage, or peliosis. No invasion of the portal vein, bile ducts, or surrounding structures was noted.\n\nMicroscopic evaluation revealed a moderately differentiated neoplasm composed of hepatic-type cells arranged in pseudoglandular, trabecular, solid, and micropapillary patterns. The highest grade of differentiation observed was grade III, with the majority being grade II. Steatosis was present in a mild form. No fibrous capsule, capsular infiltration, or septum formation was identified. The surgical resection margins were free of tumor involvement. No serosal, vascular (portal vein, hepatic vein, hepatic artery), or bile duct invasion was seen. Microvessel invasion was not present. There was evidence of multicentric occurrence based on the presence of two distinct lesions.\n\nNon-tumor liver tissue showed mixed cirrhosis associated with chronic hepatitis B. No dysplastic nodules or ductal epithelial dysplasia were found. Trichrome staining confirmed the presence of liver cirrhosis. Other ancillary studies did not reveal atypical cells in peritoneal fluid, nor any significant findings in additional biopsies taken from the liver or skin."} +{"pid": "TCGA-AR-A24X", "report": "Breast, right, simple mastectomy: A mass measuring 2.1 x 1.4 x 1.3 cm was identified in the superior/central region of the breast with biopsy site changes. A second biopsy site is present in the subareolar region. A separate nodule measuring 0.6 x 0.6 x 0.5 cm was found in the upper inner quadrant. The lesion does not involve the nipple, overlying skin, or underlying chest wall. All surgical resection margins, including the deep margin, are free of involvement with a minimum tumor-free margin of 0.5 cm at the anterior/superior margin. Lymph nodes, right axillary sentinel, excision: Seven right axillary sentinel lymph nodes were examined and showed no evidence of metastatic disease. Blue dye was not identified in any of the sentinel lymph nodes. Immunohistochemical cytokeratin staining confirmed the absence of tumor in the sentinel lymph nodes. Breast, left, simple mastectomy: Histological evaluation revealed mild proliferative changes with ductal hyperplasia without atypia. A prior biopsy site was noted. The nipple showed no diagnostic abnormalities. Hormone receptor analysis and Her-2/NEU testing have been initiated on paraffin-embedded tissue."} +{"pid": "TCGA-DK-A3WY", "report": "The specimen consisted of bladder tissue with associated uterus, bilateral fallopian tubes, and ovaries. The bladder showed an ulcerated lesion measuring 3.5 x 2.5 x 1.5 cm located on the dome, extending to the right lateral and posterior walls. On sectioning, the lesion demonstrated focal necrosis and invasion into perivesical soft tissues without extension beyond the bladder wall. No vascular or perineural invasion was identified. All surgical margins were free of abnormal cells. The non-neoplastic bladder mucosa appeared normal. \n\nThe uterus measured 8.0 cm from fundus to cervix and showed atrophic endometrium. A single hyalinized leiomyoma measuring 1.2 x 0.9 x 0.8 cm was noted in the posterior uterine wall. The cervix, bilateral fallopian tubes, and ovaries were unremarkable. Right and left ovaries measured 2.5 x 0.9 x 0.7 cm and 2.1 x 1.3 x 0.8 cm respectively.\n\nMultiple lymph node regions were sampled and submitted for evaluation. These included extended lymph node pocket (six lymph nodes), right common iliac (one lymph node), left common iliac (three lymph nodes), right distal (six lymph nodes), left distal (nine lymph nodes), left presciatic fat (three lymph nodes), and right presciatic fat (one lymph node). All lymph nodes examined were histologically benign.\n\nUreteral specimens including right and left distal ureters, proximal left ureter, and right ureter were all found to be benign upon histological examination. Urethral margin biopsy revealed benign tissue with squamous lining. Frozen section analysis of all submitted margins confirmed absence of malignant cells. \n\nAll other tissues evaluated were consistent with benign findings."} +{"pid": "TCGA-N5-A4RO", "report": "The submitted specimens include the uterus, tubes, ovaries, cervix, and multiple lymph node regions from both sides including external iliac, obturator, and peri-aortic areas.\n\nExamination of the uterus reveals a tumor with a predominant serous histology. The tumor extends more than half through the myometrium, with a maximal invasion depth of 1.7 mm in an area where the myometrium measures 1.8 mm in thickness. There is no evidence of endocervical involvement. Widespread vascular invasion is present. The endometrium shows atrophic changes. The myometrium contains subserosal leiomyomas and tumor emboli are noted. The fallopian tubes exhibit atrophy, and the ovaries show corpora albicantia. Tumor involvement is identified in both parametria.\n\nLymph node assessment reveals metastatic involvement in all regions examined. In the left external iliac region, 1 out of 3 nodes contains tumor. The left obturator node is involved, with extension beyond the capsule. On the right side, all 5 external iliac nodes are positive, as are 2 of 4 obturator nodes. All 3 right peri-aortic nodes are involved. In the left peri-aortic region, 2 of 7 nodes contain tumor.\n\nAll findings are based on personal examination of the relevant slides and materials."} +{"pid": "TCGA-MU-A8JM", "report": "The surgical specimen included lymph nodes from the right pelvic, right common, left external iliac, and left obturator regions, as well as a hysterectomy specimen with cervix, bilateral fallopian tubes and ovaries, parametrial tissue, and upper vagina. A total of 29 lymph nodes were evaluated across all specimens, with no evidence of metastatic involvement identified. The lymph nodes ranged in size from 0.4 to 2.3 cm in greatest dimension.\n\nIn the cervix, a mass measuring 2.3 cm in greatest dimension was identified. Histologic evaluation showed a moderately differentiated cellular proliferation with stromal invasion measuring 1.1 cm in depth. There was no angiolymphatic invasion observed. The closest margin measured 7 mm from the invasive lesion. Adjacent cervical tissue demonstrated intraepithelial changes classified as high-grade. Four parametrial lymph nodes were also negative for involvement.\n\nAdditional findings included benign leiomyomas within the uterus, paratubal cysts, and ovarian inclusion cysts with hemorrhagic components. Both fallopian tubes and ovaries appeared unremarkable without evidence of neoplastic change. The endometrium was thin and non-specific, and myometrial thickness was within normal limits.\n\nStaging parameters indicated early-stage disease based on tumor size and absence of lymph node or distant metastasis. All surgical margins were free of invasive disease."} +{"pid": "TCGA-D1-A167", "report": "The surgical specimen included the uterus, bilateral ovaries, and fallopian tubes, along with multiple lymph node groups and gonadal vessels. The uterus contained a polypoid lesion measuring 5.4 x 3.7 x 2.6 cm. Microscopic evaluation showed a neoplastic process involving the endometrium with villoglandular architectural features and moderate nuclear atypia, corresponding to FIGO grade 2. The lesion demonstrated myoinvasion, extending 1.3 cm into the myometrium, which had a total thickness of 2.1 cm. No evidence of lymphovascular space invasion was identified. The cervix showed no involvement by the process. Both ovaries and fallopian tubes appeared histologically unremarkable.\n\nLymph node dissection included left pelvic lymph nodes (4 external iliac, 2 internal iliac, 2 common iliac, 9 obturator), all negative for tumor. Right pelvic lymph nodes (7 external iliac, 4 internal iliac, 8 common iliac, 16 obturator) were also free of tumor. Para-aortic lymph nodes above the inferior mesenteric artery (9 left, 4 right) and below (5 left, 2 right) showed no evidence of tumor involvement. Excised left and right gonadal vessels were similarly negative for tumor."} +{"pid": "TCGA-FE-A3PB", "report": "The specimen was received in eight properly labeled containers. Specimen A, described as soft tissue adjacent to the thyroid gland, measured 0.9 x 0.5 x 0.3 cm and was entirely submitted for frozen section. Specimen B, a right retroparotid neck mass, measured 2.1 x 1.6 x 0.4 cm and was also entirely submitted for frozen section. Specimen C, identified as a paratracheal mass, measured 0.7 x 0.6 x 0.6 cm and was similarly processed for frozen section.\n\nSpecimen D was a right superior thyroid pole measuring 4.3 x 2.3 x 1.2 cm and weighing 6.2 grams. It was oriented with stitches at the superior pole and isthmus. Serial sectioning revealed a well-defined tan-white nodule measuring 1.0 x 0.7 x 0.6 cm located at the superior pole. The nodule abutted both anterior and posterior thyroid capsule and was within 2.0 cm of the isthmus. Sections were taken from the nodule, surrounding parenchyma, and margins.\n\nSpecimen E, a mass adjacent to the superior right thyroid fold, measured 1.2 x 1.0 x 0.8 cm and contained a small cyst filled with red-tinged clear fluid. Specimen F, a right upper jugular node, measured 1.0 x 0.7 x 0.5 cm. Specimen G was a left thyroid lobe measuring 5.0 x 2.5 x 2.5 cm and weighing 9.5 grams. It showed a focal disruption of the capsule measuring 3.0 x 0.8 cm. No discrete lesions were identified upon sectioning. Specimen H, a left paratracheal mass measuring 0.8 x 0.6 x 0.5 cm, contained mature thyroid follicular tissue without evidence of malignancy.\n\nLymph nodes were examined from multiple sites including bilateral regions. Of six lymph nodes examined, five showed involvement. No extranodal extension was observed. Histologic evaluation of the involved lymph nodes revealed cellular features consistent with metastatic involvement. The primary lesion demonstrated low-grade histology with no lymphatic or vascular invasion identified. The tumor was confined to the thyroid and did not involve adjacent structures or cartilage. Mild lymphocytic thyroiditis was noted in areas. Margins were assessed and no residual tumor was seen at the isthmic margin."} +{"pid": "TCGA-PC-A5DO", "report": "The specimen was obtained from a female patient and consisted of five tissue samples. The first sample included a segment of bowel with attached mesentery and a mass. The bowel segment measured 9.0 cm in length, with an average circumference of 4.5 cm and wall thickness of 0.5 cm. The mucosa appeared normal without visible lesions. Within the mesenteric fat, a mass measuring 6.0 x 4.5 x 4.0 cm was identified, with a tan to pink-red outer surface and firm nodular cut surfaces. The circumferential margin was inked black. No lymph nodes were palpable within the adipose tissue.\n\nThe second sample was a fatty lesion from the left buttock measuring 10.0 x 6.5 x 2.5 cm, partially encapsulated with yellow-tan lobulated cut surfaces. It was covered partially by a skin ellipse measuring 5.5 x 1.5 cm. Margins were inked black.\n\nThe third sample included the right fallopian tube and ovary. The ovary measured 2.0 x 1.0 x 0.8 cm and was tan and firm. It was partially covered by a 3.5 x 0.5 cm fragment of fallopian tube with a pinpoint lumen and one fimbriated end. Multiple small clear fluid-filled cysts were noted, with the largest measuring 0.4 cm.\n\nThe fourth sample consisted of the left fallopian tube and ovary. The ovary measured 1.5 x 1.0 x 0.8 cm and was tan and firm. It was partially covered by a 3.0 x 0.5 cm fragment of fallopian tube with similar morphological features as the right side.\n\nThe fifth sample was the uterus, weighing 60 grams and measuring 5.0 x 4.5 x 3.5 cm for the uterine body and 4.0 x 3.5 x 3.5 cm for the cervix. The cervix showed a red-purple hyperemic exocervix with a 0.4 cm patulous os. Upon bivalving, the endocervix was tan and glistening with minimal mucus. The myometrium was tan and firm, measuring up to 1.5 cm in thickness, and contained an intramural lesion measuring 1.5 cm with white-tan whorled bulging cut surfaces. The endometrial lining was tan and glistening, measuring up to 0.3 cm in thickness.\n\nMicroscopic evaluation of the mesenteric mass revealed pleomorphic cells with a mitotic rate up to 40 mitoses per 10 high-power fields focally; no necrosis was observed. The tumor was present at the inked circumferential margin but not identified in the proximal or distal colonic margins. One lymph node was examined and showed no involvement. Sections of the fatty lesion from the buttock showed features consistent with a benign process. Both fallopian tubes and ovaries showed no significant pathological changes except for minor findings such as paratubal cysts and a simple cyst in the left ovary. The uterus contained a benign smooth muscle lesion measuring 1.5 cm and microscopic nodules within the endometrial stroma. The cervix demonstrated squamous metaplasia.\n\nCytogenetic analysis of the mesenteric mass revealed a normal female karyotype. However, this result may reflect overgrowth of normal tissue rather than the primary lesion."} +{"pid": "TCGA-QD-A8IV", "report": "The surgical specimen consisted of a total thyroidectomy with left neck dissection. The right lobe measured 3.5 x 1.5 x 1.0 cm, the left lobe 5.5 x 3.0 x 3.0 cm, and the isthmus 3.0 x 1.5 x 1.5 cm. A firm, nodular, yellow, irregular mass measuring 3.5 x 1.9 x 2.6 cm was identified in the left thyroid gland, extending inferiorly and abutting the inferior surgical resection margin within 2 mm. The mass was cystic and solid, completely contained within the thyroid gland. Multiple colloid nodules were present in the surrounding left thyroid parenchyma as well as in the right lobe and isthmus. No parathyroid tissue was identified.\n\nMultiple lymph node specimens were received from left neck levels 2, 3, 4/5, and the left paratracheal region. Histologic examination revealed involvement of all levels by a neoplastic process. Lymph nodes from level 2 showed involvement in 2 of 10 nodes, with extranodal extension noted. In level 3, both lymph nodes examined were involved, also showing extranodal extension. Level 4/5 contained 22 lymph nodes, 7 of which were involved, with extranodal extension observed. The left paratracheal lymph node was also involved.\n\nExamination of the dominant lesion in the left thyroid lobe showed classical papillary architecture and follicular architecture with classical cytomorphology. The tumor demonstrated minimal extrathyroidal extension. The second lesion located in the isthmus also showed similar histologic features, including classical papillary architecture, follicular architecture, and classical cytomorphology, with minimal extrathyroidal extension. The margin of resection was involved in this second lesion.\n\nLymphovascular invasion was not identified. Margins of resection were uninvolved by tumor except for the isthmus lesion. Tumor capsule was not present, and capsular invasion could not be assessed. A total of 38 regional lymph nodes were involved out of 15 examined. Extranodal extension was present in multiple lymph node groups. Distant metastasis was not applicable.\n\nAdditional findings included multinodular goiter and thyroiditis. One benign parathyroid gland was identified. BRAF mutation analysis is pending."} +{"pid": "TCGA-4A-A93X", "report": "The specimen from the right kidney measured 15 x 7.5 x 6.5 cm with attached perinephric fat, weighing a total of 1,721 grams. A tumor measuring 8.5 cm in greatest dimension was identified in the superior pole, appearing as a variegated tan-white to red nodular mass. On gross examination, the tumor extended into the perinephric fat and was in close proximity to the renal artery, lying approximately 5 mm from the resection margin. The renal pelvis showed elevation of the urothelium, with uncertainty regarding penetration into the lumen. No involvement of the adrenal gland was observed.\n\nHistologically, the lesion demonstrated papillary architecture with fibrovascular cores lined by cells exhibiting amphophilic cytoplasm, large irregular nuclei, and prominent eosinophilic nucleoli. Tumor necrosis was present. Fuhrman nuclear grade was G3. Microscopic evaluation confirmed invasion into the perinephric fat beyond the renal capsule, renal pelvis, renal vein, renal artery, and ureter. Lymphovascular invasion was also identified.\n\nMargins of resection, including renal parenchyma, perinephric fat, Gerota\u2019s fascia, renal vein, renal artery, and ureter, were free of invasive carcinoma. However, tumor was noted at the inked surgical margin surrounding the larger of two pericaval lymph nodes, which measured 3.5 x 3 x 2.3 cm and 2.5 x 1.5 x 0.8 cm respectively. Both lymph nodes contained metastatic deposits, with the largest measuring 2.2 cm and showing extracapsular extension.\n\nA separate gallbladder specimen revealed chronic calculous cholecystitis with no evidence of malignancy. A single stone measuring 2.5 cm was present within the lumen.\n\nPathologic staging was determined as pT3a pN1."} +{"pid": "TCGA-EP-A2KB", "report": "Final Surgical Pathology Report. Procedure. Diagnosis. Liver, segment 6, resection: The specimen is received unfixed, labeled liver segment 6, and consists of a piece of red tissue measuring 7 by 5.5 x 4 cm. The specimen has been incised prior to receipt, showing cirrhotic liver and a roughly spherical subcapsular lesion. The lesion is gold-colored and measures 2.4 cm in diameter. The margin of the specimen is inked. A portion of the specimen is taken for research purposes. Sections after fixation are submitted.\n\nMicroscopic examination reveals histologic features including a lesion with cellular characteristics consistent with a well-defined grade. Histologic grade is 2 according to one established system and 1 according to another. The size of the lesion is 2.4 cm. Vascular invasion is not identified. Margins of resection are negative for malignant cells. Staging classification is T1. Adjacent liver tissue demonstrates micronodular changes with moderate chronic inflammation and moderate to marked mixed hepatocellular steatosis. Specimen from liver segment 6. Clinical history includes liver disease and prior findings suggestive of malignancy."} +{"pid": "TCGA-DQ-5625", "report": "The specimen consisted of multiple tissue samples submitted from various anatomical sites. Gross examination revealed a 4 cm strip of tissue from the lateral tongue, a 2.2 cm soft tissue strip from the ventral tongue, and a 1 cm strip from the posterior floor of mouth, along with smaller specimens from adjacent soft tissues and muscle fragments. The frenulum was represented by two 0.7 cm soft tissue bits. A yellow-tan soft tissue mass measuring 5 x 4.5 x 1.0 cm was received from the right neck level I, which included submandibular gland tissue and lymph nodes. Sections from this area included four possible lymph nodes in one cassette and five in another. At right neck level II, a 3 x 1.5 x 0.5 cm fibroadipose tissue sample contained multiple lymph nodes, including three small ones and one larger node. In level III, a 4 x 2.5 x 0.4 cm specimen contained four possible lymph nodes and one larger lymph node that was sectioned into four parts. Level IV contained a 4.0 x 2.0 x 0.8 cm specimen with six identified lymph nodes.\n\nMicroscopic evaluation showed no evidence of malignant cells in the margins or biopsies taken from the soft tissues adjacent to the laryngeal nerve, proximal laryngeal nerve branch, lateral tongue, ventral tongue, posterior floor of mouth, deep hypoglossal muscle, frenulum, or any of the lymph node levels evaluated. All lymph nodes examined across levels I through IV were negative for involvement.\n\nThe primary lesion was located on the right lateral tongue as an ulcerated lesion measuring 1.5 cm in its largest dimension. Histological analysis demonstrated moderately differentiated squamous cell changes with invasive characteristics and a depth of invasion measuring 0.5 cm. The infiltrative tumor margin was well demarcated. No perineural or vascular invasion was observed. Moderate lymphocytic infiltration was noted. Bone or cartilage invasion was not present. All surgical margins were free of malignant cells."} +{"pid": "TCGA-3M-AB46", "report": "A 0.5 x 0.4 x 0.4 cm fragment of tan-brown soft tissue was received for evaluation of a liver lesion, revealing two benign calcified hyaline nodules. A subtotal gastrectomy specimen measuring 17.0 cm along the greater curvature and 11.0 cm along the lesser curvature was examined. A 3.0 x 3.0 x 1.0 cm exophytic mass was identified on the lesser curvature, located 0.6 cm from the proximal margin and 13.0 cm from the distal margin. The tumor invaded through the muscularis propria into the subserosa and was within 0.1 cm of the inked circumferential margin but did not penetrate the serosa. Histologic examination revealed moderately differentiated adenocarcinoma with intestinal metaplasia and marked chronic inflammation. Lymphatic invasion was present; venous and perineural invasion were absent. Fifteen lymph nodes were evaluated and none contained malignant cells. Surgical margins were negative for carcinoma. The gastric wall thickness ranged from 0.3 cm to 0.5 cm, and the attached omentum measured 30.0 x 20.0 x 5.0 cm. Based on these findings, the pathologic stage assigned is pT2b NO MX, indicating tumor invasion into the subserosa without regional lymph node involvement. This staging is provisional and does not include clinical data or prior pathology."} +{"pid": "TCGA-HV-A7OL", "report": "The specimen consisted of a partial pancreas measuring 5.5 x 4.0 x 3.0 cm, a segment of small intestine 17.0 cm in length and 3.5 cm in greatest circumference, and a gallbladder measuring 10.0 cm in length, 3.5 cm in diameter, and 0.3 cm in thickness. A distinct lesion was identified in the pancreatic head as a pale tan, firm mass measuring 2.0 x 1.8 x 1.5 cm with a yellowish tan cut surface and granular texture. The lesion extended into peripancreatic soft tissue. No tumor involvement was identified at the bile duct, small intestine, or final pancreatic resection margins.\n\nMicroscopic examination revealed a moderately differentiated epithelial neoplasm arising in the pancreatic head with infiltration into adjacent structures. The tumor measured 2.0 x 1.8 x 1.5 cm and extended into peripancreatic soft tissue as well as the muscle and submucosa of the small intestine. Lymphovascular and perineural invasion were present. Evaluation of lymph nodes (total of 19) from various peripancreatic and regional sites showed no evidence of metastasis. The gallbladder showed histologic features consistent with chronic inflammation."} +{"pid": "TCGA-14-1452", "report": "Anatomic Pathology Report. Patient information and specimen details are provided. Two specimens were received from a right frontal brain lesion. Specimen #1, submitted fresh for intraoperative consultation, consists of multiple fragments of soft tan hemorrhagic tissue measuring 1.3 x 0.8 x 0.5 cm in aggregate. A touch preparation was performed, and a portion was frozen for consultation. The remaining cryoblock is submitted in cassette \"FS1A,\" with the rest of the specimen in cassette \"1B.\" Specimen #2, received in formalin, consists of multiple fragments of soft tan extensively hemorrhagic tissue measuring 4.7 x 4.3 x 1.1 cm in aggregate. Representative sections are submitted in cassettes \"2A\" through \"2C.\" Intraoperative evaluation of cassettes FS1A and TP1A shows high-grade malignant cells with nuclear atypia, frequent mitotic figures, microvascular proliferation, and areas of necrosis. Cellular density is high, with pleomorphic nuclei and prominent nucleoli. Tissue architecture is disorganized, and there is evidence of infiltrative growth. Staging is based on extent of resection and histologic features."} +{"pid": "TCGA-A7-A13F", "report": "The specimen included a sentinel lymph node from the right axilla, measuring 3.0 x 2.0 x 1.0 cm, with a possible 0.6 cm lymph node identified. No tumor was found in this node. A second sentinel lymph node biopsy from the right axilla measured 6.0 x 3.0 x 1.0 cm and contained two lymph nodes, one measuring 1.5 cm with a firm white-tan appearance and the other 1.0 cm, tan and soft. Both nodes showed evidence of malignancy. \n\nBreast tissue from the left side, received as a V-shaped piece of skin with underlying soft tissue, was unremarkable on examination. The right breast specimen was a resection measuring 35 x 21 x 6 cm, with an overlying skin ellipse including the nipple and areola. A central deep lesion measuring 6 x 4 x 7 cm was present, partially resected prior to examination. Sections were taken from multiple regions including margins, quadrants, and the tumor area. Eleven lymph node-like structures were identified in the axillary portion.\n\nMicroscopic evaluation of the first sentinel lymph node showed only fibrofatty connective tissue and no malignancy. The second sentinel lymph node showed metastatic involvement in both nodes, with the largest deposit measuring 0.5 cm. The left breast tissue showed only focal benign calcification. The right breast lesion demonstrated invasive features with a tumor grade of 2 (Elston SBR), mitotic index of 4 per 10 HPFs, and vessel invasion noted in the nipple region. Tumor size was confirmed at 4 x 6 x 7 cm. Margins were free of tumor involvement. Of the 11 lymph nodes evaluated, 3 were positive, including the 2 sentinel nodes, with metastases up to 3.5 mm in size. There was no extranodal extension or matted lymph nodes observed."} +{"pid": "TCGA-62-A46R", "report": "Pathology Report-Summary: The specimen consists of a lung, left lower lobe, measuring 15.0 x 10.0 x 7.0 cm. A lesion measuring 4.0 x 3.5 x 2.0 cm was identified. Histological evaluation revealed a mixed growth pattern with predominant papillary architecture and areas of solid, acinar, and other components. Visceral pleural invasion was observed. Lymph node staging was based on 20 nodes examined, with no metastases identified. The grade is moderate."} +{"pid": "TCGA-D1-A17U", "report": "A hysterectomy and bilateral salpingo-oophorectomy specimen demonstrated a mass measuring 6.1 x 2.1 x 1.9 cm that circumferentially involves the endometrial cavity. The mass extends 1.8 cm into the myometrium, with a total myometrial wall thickness of 1.8 cm. There is no involvement of the endocervix, and no lymphovascular space invasion is identified. The left and right fallopian tubes are involved, while the bilateral ovaries show no evidence of involvement. Surgical margins are free of any abnormal tissue.\n\nLymph node evaluation revealed one of two positive nodes in the right para-aortic region above the IMA, and one of two positive nodes below the IMA. In the left para-aortic region, two of five nodes were positive. All three nodes from the presacral region were negative. The left gonadal vessels showed no presence of abnormal cells.\n\nThe gross examination of the uterus showed a 150-gram specimen with a mass in the endometrial cavity measuring 6.1 x 2.4 x 1.9 cm, appearing to invade 1.6 cm into the 1.8 cm thick myometrium. The right ovary measured 2.0 x 1.5 x 0.6 cm with a solid cut surface, and the right fallopian tube was 7.0 x 0.6 cm. The left ovary was 2.5 x 2.0 x 1.2 cm with a solid cut surface, and the left fallopian tube measured 7.5 x 0.7 cm. Adipose tissue was adhered to the fundus and anterolateral surface of the uterus.\n\nSpecimens from the right para-aortic lymph nodes above the IMA included a 5.1 x 1.9 x 1.2 cm aggregate of adipose and lymphatic tissue, and all lymphatic tissue was submitted. For the right para-aortic nodes below the IMA, a 4.7 x 1.9 x 1.3 cm aggregate was received, and all lymphatic tissue was also submitted. Presacral lymph nodes were received as a 4.0 x 2.9 x 1.0 cm aggregate, and all lymphatic tissue was submitted. The left para-aortic lymph nodes were received as a 5.8 x 3.5 x 1.4 cm aggregate, and all lymphatic tissue was submitted. A 4.8 cm long by 0.2 cm diameter segment of the left gonadal vessel was unremarkable, and a representative section was submitted for analysis.\n\nImmunohistochemical staining for p53 performed on a block from the left fallopian tube showed negative staining in the relevant cells, supporting the overall findings. Permanent sections stained with hematoxylin and eosin were reviewed to confirm the initial frozen section results, and this report reflects those findings. Any significant changes noted upon review of permanent sections will be documented in a revised report."} +{"pid": "TCGA-KM-8639", "report": "The right kidney specimen was received as a radical nephrectomy, weighing 215.1 grams and measuring 12 x 10 x 4 cm. A single nodule measuring 2.1 x 1.5 cm was identified at the corticomedullary junction. The tumor was well-circumscribed, located greater than 2 cm from the closest surgical margin, and surrounded by a thin white capsule. Microscopic evaluation revealed a chromophobe-type lesion with nuclear features corresponding to grade 2 of 4. The tumor was confined entirely within the kidney without involvement of the surgical margins, ureteral or vascular margins, hilar structures, or perinephric fat. No lymph nodes were identified in the hilar fat. A section of normal-appearing kidney parenchyma adjacent to the tumor was also evaluated. Atherosclerotic changes were noted in the renal artery, with approximately 60% occlusion. The tumor was unifocal, with no additional masses or nodules identified in the remaining kidney or perinephric fat. The pathological staging for the primary tumor was determined as pT1a, with no assessment possible for lymph node or distant metastasis."} +{"pid": "TCGA-EO-A3AS", "report": "The specimen consisted of a total hysterectomy with cervix, right and left fallopian tubes, and ovaries. The uterus measured 6.0 x 4.2 x 2.5 cm and contained a well-circumscribed mass within the endometrial cavity measuring 3.3 cm in greatest dimension (additional dimensions: 2.9 x 1.8 cm). The mass appeared grossly as a solid, firm, white lesion invading into the myometrium, located 0.6 cm from the closest serosal surface on the anterior aspect. No lymphovascular invasion was identified.\n\nMicroscopic examination revealed a high-grade lesion composed predominantly of nonsquamous solid growth. Invasion was present within the myometrium but limited to less than 50% of its thickness. Glandular involvement of the cervix was noted without evidence of stromal invasion. No lymphovascular space invasion was observed. Surgical margins were free of invasive disease.\n\nNo regional lymph nodes were submitted for evaluation, thus nodal status could not be determined. No additional pathological findings were identified in the fallopian tubes or ovaries. Both ovaries showed corpus albicans without other significant pathology. Parovarian cysts were noted on the right side, ranging from 0.1 to 0.3 cm in diameter.\n\nThe background endometrium was atrophic. No neo-adjuvant treatment history was available. Staging assessment was limited by absence of lymph node evaluation."} +{"pid": "TCGA-VQ-A8DV", "report": "The specimen involves the gastric antrum and surrounding tissues. A neoplastic lesion measuring 4.3 cm in greatest dimension is identified, characterized by moderately differentiated cellular features with intestinal-type morphology. The tumor extends into the muscle layer but does not show angiolymphatic or perineural invasion. No necrosis is observed. Surgical margins are free of neoplastic involvement. A total of 19 lymph nodes are examined across multiple sites, including 16 from the stomach and epiploon region and 3 from the splenic artery area; none show evidence of tumor involvement. The epiploon, esophageal margin, and enterectomy specimens also do not demonstrate neoplastic cells. Additional findings include moderate chronic gastritis with complete intestinal metaplasia adjacent to the tumor, and *H. pylori* is detected. The gallbladder shows nonspecific chronic inflammation. Vascular congestion and focal bleeding are noted in the wall at the resection site."} +{"pid": "TCGA-DS-A0VM", "report": "The right adnexal specimen includes an ovary with a follicular cyst, serosal adhesion, and mild hyperplasia of rete elements. The fallopian tube shows minimal chronic inflammation, inflammatory cell aggregates in the lumen (predominantly histiocytes/macrophages), and paratubal cystic structures consistent with Walthard rests. No abnormal findings are noted in this specimen.\n\nThe left adnexal specimen demonstrates an ovary with serosal adhesions. The fallopian tube exhibits minimal chronic inflammation, inflammatory cell accumulations within the lumen (mainly histiocytes/macrophages), focal epithelial hyperplasia with mild atypia, and several paratubal cystic Walthard rests. No significant abnormalities are identified in this section.\n\nExamination of lymph nodes reveals the following: four reactive lymph nodes from the right pelvic region, showing sinus histiocytosis, fibrosis, and/or partial replacement by benign adipose tissue. A single reactive lymph node from the right para-aortic area also displays similar features\u2014sinus histiocytosis, fibrosis, and partial adipose replacement. In contrast, two of four lymph nodes from the left pelvic region contain abnormal cellular infiltration; these nodes also exhibit sinus histiocytosis, fibrosis, and/or partial replacement by adipose tissue. Five lymph nodes from the left obturator region are unremarkable, as are four from the left para-aortic and two from the right para-aortic areas. All of these show reactive changes without any concerning features. A solitary lymph node from the left common iliac area is also reactive, displaying histiocytic activity and fibrosis.\n\nThe hysterectomy specimen shows a cervix circumferentially involved by a gross tumor measuring approximately 3.5 cm in diameter and 3 cm in length. The tumor extends into the lower uterine segment and involves up to 80% of the cervical wall thickness. Evidence of lymphovascular invasion is present in the cervix and left parametrium. No direct extension beyond lymphovascular spaces into parametrial soft tissues is observed. Of note, one of four parametrial lymph nodes is involved, located on the left side. The vaginal cuff, including its surgical margin, is free of involvement. There is no tumor extension into the uterine corpus.\n\nAdditional observations include a fibrosing stromal reaction to the invasive lesion. The tumor surface is partially ulcerated and necrotic, with an associated acute and chronic inflammatory response, although not pronounced. Two uterine leiomyomas are present, with the larger measuring 3.5 cm. These show signs of healed infarction, hyalinization, edema, and small foci of cystic degeneration. The endometrium is benign but atrophic to weakly proliferative, with cystically dilated glands and scattered ciliated metaplasia. There is evidence of M\u00fcllerianosis involving the outer uterine and lower segment walls. Cervical squamous cells show atypical changes consistent with HPV infection, along with changes related to prior biopsy. Acute and chronic cervicitis, squamous metaplasia, parakeratosis, and nabothian cysts are also present. The vaginal cuff mucosa has mild chronic and minimal acute inflammation.\n\nSections of lymph nodes from the parametrial and pelvic regions were stained for keratin using AE1/AE3 immunostaining. The metastatic cells are clearly highlighted in affected nodes, including some occult cells detected in the subcapsular sinus of a left parametrial lymph node."} +{"pid": "TCGA-BP-5196", "report": "Clinical history indicates a left renal mass, with a partial nephrectomy specimen submitted for evaluation. The surgical specimen measured 4.5 x 4.0 x 3.0 cm and included a wedge of kidney tissue. A well-circumscribed, fleshy, lobulated lesion measuring 2.8 x 2.8 x 2.5 cm was identified within the kidney. The tumor was located approximately 0.5 cm from the inked margin, and the renal capsule appeared intact. Attached perinephric fat was also present, measuring 4.5 x 2.5 x 1.0 cm.\n\nMicroscopic examination revealed a neoplastic process involving the kidney. Nuclear grading was assessed as II out of IV. Evaluation of local invasion, including renal vein involvement, did not show evidence of extension beyond the main lesion. All surgical margins were free of neoplastic cells. Adjacent non-neoplastic kidney tissue showed patchy chronic inflammation. No adrenal or lymph node tissue was present in the specimen.\n\nStaging criteria indicate the lesion is confined to the kidney and measures less than or equal to 7.0 cm in greatest dimension. A representative portion of the tumor and surrounding tissue was submitted for analysis, along with sections of perinephric fat. Intraoperative consultation confirmed the absence of tumor at the surgical margin. Final histopathological findings aligned with intraoperative assessment."} +{"pid": "TCGA-D8-A1XF", "report": "Histopathological examination of a left breast resection specimen with axillary tissues was performed. The breast measured 22 x 15 x 4 cm and weighed 780 g. A post-operative scar was noted around the nipple area, with a lesion site measuring 6 x 4 x 2 cm. Axillary tissues measured 10 x 6 x 2 cm, and a skin flap measured 17 x 6.5 cm. Microscopic evaluation revealed glandular tissue with foci of ductal carcinoma in situ, including solid and cribriform patterns, medium nuclear atypia, necrosis, and calcifications. Adjacent tissue showed changes consistent with fibrocystic mastopathy. Axillary lymph nodes demonstrated chronic lymphadenitis without evidence of metastatic involvement. Cellular features indicated a moderate histological grade. Tumor size was classified as pT2, with no lymph node involvement (pN0)."} +{"pid": "TCGA-51-4081", "report": "The specimen consisted of a right upper lobe lobectomy along with multiple lymph node specimens. The lung specimen measured 17 x 8 x 5 cm and weighed 197 grams after fixation. A central mass was identified within the specimen, measuring 3.5 cm in greatest dimension. The tumor was located near both the main bronchus and pleural surface, with the closest distance to the bronchial margin estimated at approximately 1 cm. The tumor was also within 0.1 cm of the pleural surface and approached the blue inked surgical staple line closely.\n\nMicroscopic evaluation revealed invasive moderately differentiated keratinizing cells. In situ carcinoma was present. Histologic assessment of surgical margins was negative. No evidence of venous, arterial, or perineural invasion was identified; however, lymphovascular space invasion was noted. Adjacent lung tissue showed obstructive changes and mucus plugging, but no satellite tumor nodules were identified.\n\nLymph node evaluation included 11 lymph nodes from various locations. One peribronchial lymph node showed metastatic involvement. Extracapsular extension was not identified. Additional lymph node specimens from Level 7, Low 4R, High 4R, and Level 11 were negative for malignancy.\n\nFrozen section analysis confirmed negative margins for the proximal and distal resection sites in the right upper lobe. All lymph node specimens evaluated intraoperatively were also negative.\n\nStaging based on this specimen was reported as pT2a, pN1, pMx. However, it was noted that this staging may be incomplete and further clinical correlation is recommended.\n\nMultiple tissue blocks were submitted for detailed histologic examination, including sections of the tumor in relation to the bronchus, pleura, surgical margins, adjacent lung parenchyma, and associated lymph nodes."} +{"pid": "TCGA-QT-A5XN", "report": "A 3.0 cm mass within the left adrenal gland is well-circumscribed with a soft, orange/yellow cut surface and measures 3.0 x 3.0 x 2.0 cm. Microscopic evaluation reveals cells with bland cytology resembling zona fasciculata. No extension beyond the capsule is observed. A second mass measuring 5.0 x 5.0 x 4.0 cm is identified in the central region of the gland. It has a poorly defined border and contains both solid and cystic areas with a dusky red, hemorrhagic appearance and scattered firmer white patches. Histologic features are consistent with cells similar to those of the adrenal medulla. Immunostains demonstrate reactivity for synaptophysin and chromogranin, along with peripheral cortical staining for inhibin. The mass appears confined without extension beyond the capsule. Both masses are located at opposite ends of the adrenal gland and are in proximity to the external margins; however, surgical margins are not involved. The larger mass arises from the medulla and compresses adjacent parenchyma, while the smaller mass expands and compresses the cortex."} +{"pid": "TCGA-96-A4JK", "report": "The specimen consists of a right upper lobectomy and multiple lymph node stations. The lung specimen measures 18 x 17 x 5 cm, with a stapled line measuring 11 cm and 7 cm. A mass is identified within the lung tissue, measuring 3.7 x 3 x 3 cm, located 1 cm from the pleura and 1.5 cm from the bronchial resection margin. The mass has gray-white firm consistency and ill-defined borders, surrounding the bronchus and vascular structure at the hilum. A separate pink nodular area measuring 1.5 cm is noted on the pleural surface. The remaining parenchyma shows emphysematous changes.\n\nMargins of resection include a bronchial margin measuring 2 cm and a vascular margin measuring 1 cm, both uninvolved. Lymphovascular invasion is present, specifically venous invasion as confirmed by special stains. One of four hilar/peribronchial lymph nodes shows involvement based on direct extension. A total of 14 lymph nodes are examined across all stations; one is involved. The remainder of the lymph nodes from stations 4, 7, 10, and 11 are negative.\n\nHistologic evaluation reveals poorly differentiated cells with diffuse positivity for P63 and CK5/6. Elastic stain confirms venous invasion. A hyalinized nodule is identified as an incidental non-tumor finding. The tumor is unifocal, measuring 3.7 cm in greatest dimension, surrounded by lung tissue without visceral pleural invasion. Based on size and local extent, staging indicates pT2a with pN1 involvement."} +{"pid": "TCGA-AR-A250", "report": "The left wide local excision and simple mastectomy specimen contains a mass measuring 2.4 x 2.0 x 1.6 cm. Histologic evaluation shows high-grade cellular atypia with a combined score of 8 out of 9 based on nuclear pleomorphism, mitotic activity, and glandular differentiation. The surrounding tissue includes extensive high-grade intraductal proliferation involving more than 25% of the ductal system, both within and beyond the main lesion, spanning an area of at least 3.8 x 2.2 x 2.0 cm. No angiolymphatic invasion is identified.\n\nThe non-neoplastic breast tissue demonstrates fibroepithelial proliferation and multiple small intraductal papillomas. Changes related to prior biopsy are present. Margins from the wide local excision, including the separately submitted inferior margin, show involvement. Residual high-grade intraductal changes are found in the mastectomy specimen near the biopsy site in the outer quadrant. The deep margin of the mastectomy specimen is free of involvement, with a minimum tumor-free distance of 1.7 cm. No involvement of the nipple, overlying skin, or chest wall is seen.\n\nThree sentinel lymph nodes were removed from the left axilla; all are negative for metastatic disease. Blue dye was visualized in two of the three sentinel nodes. An additional non-sentinel lymph node adjacent to one of the sentinel nodes was also negative. Receptor analysis has been requested on embedded tissue for further characterization."} +{"pid": "TCGA-73-4659", "report": "The specimen included multiple lymph nodes and lung tissue. Lymph node 4R was found to contain metastatic carcinoma, while other lymph nodes, including subcarinal level 7 and 10R, showed no evidence of malignancy. A right pneumonectomy was performed, revealing a 9.0 cm mass spanning both the upper and lower lobes. The tumor was located peripherally, with a distance of 1.5 cm from the bronchial margin and 0.1 cm from the pleural surface. The bronchial margin was free of invasive carcinoma, although mild to moderate squamous dysplasia was noted in the respiratory mucosa. Within the tumor, areas of poorly differentiated carcinoma were present, including regions with solid cell sheets and signet ring morphology. Adenocarcinoma in situ was also identified within the tumor mass. Two of twelve peribronchial lymph nodes were involved by metastatic adenocarcinoma, and calcified and hyalinized granulomas were present in other lymph nodes. A separate 1.5 cm nodule in the center of the lower lobe was determined to be a hyalinized granuloma. Emphysematous changes were present in non-neoplastic lung tissue. Angiolymphatic invasion was identified, and the tumor was staged as pT2 N2 MX."} +{"pid": "TCGA-CV-7414", "report": "The surgical specimen includes a resected left hemimandible, left floor of mouth, and left buccal cheek. A tumor measuring 7.0 cm in maximum dimension was identified. Its epicenter is located in the region of a major salivary gland beneath the skin overlying the mandible. Grossly, the lesion involves the mandible and extends from the buccal subcutaneous tissue medially to beneath the oral mucosa. The intervening soft tissues, including the gland and skeletal muscle, are involved. Microscopic evaluation reveals that the deep medial margin of excision is involved by tumor; all other margins are free of tumor.\n\nHigh-grade cellular features are noted. Vascular, lymphatic, and perineural invasion are present. In the lymph node dissection specimen, one out of two lymph nodes contains malignant cells. Additionally, in a separate lymph node region, nine out of nineteen lymph nodes show involvement. The largest involved lymph node measures 0.7 cm and demonstrates extranodal extension measuring 0.1 cm. A separate nodule in the subdigastric area measuring 1.2 cm may represent an obliterated lymph node.\n\nIn situ changes are identified in a ductal structure near the midline. No involvement of the epidermis or mucosal surfaces is seen. Staining for intracytoplasmic mucin is negative. Sections of the mandible confirm tumor invasion into bone; however, the bony margins of resection are free of tumor. Other submitted skin and soft tissue specimens do not show evidence of malignancy."} +{"pid": "TCGA-44-3918", "report": "The specimen includes multiple tissue samples from the left upper lobe of the lung and various lymph node levels. The left upper lobe wedge resection measures up to 7 x 4 x 3 cm and contains a firm tan mass beneath the pleural surface, measuring 2.2 cm in greatest dimension. The mass is associated with puckering of the overlying pleura. No discrete gross lesions are identified in the remaining portion of the lobe, which measures 20 x 6.5 x 3.5 cm and shows staple lines and multiple black-red hilar lymph nodes.\n\nLymph node specimens include: a level 5 node measuring 1.2 x 0.5 x 0.5 cm; a level 1 node measuring 1.5 x 1.5 x 0.6 cm; two level 7 nodes averaging 0.8 cm; a level 4 node measuring 0.5 x 0.4 x 0.4 cm; and a level 9 node measuring 1.2 x 0.7 x 0.5 cm. All lymph nodes are soft tissue fragments and are entirely submitted for analysis.\n\nMicroscopic evaluation reveals a moderately to poorly differentiated tumor measuring 2.2 cm, confined to the lung without involvement of the visceral pleural surface. The bronchial and vascular margins are free of tumor. There is no evidence of direct extension, venous, arterial, or lymphatic invasion. A total of seven sampled lymph nodes, including those from levels 1, 4, 5, 7, and 9, are negative for metastatic disease. Distant metastasis could not be assessed."} +{"pid": "TCGA-K4-A4AC", "report": "The specimen was obtained from a radical cystoprostatectomy procedure. The bladder contains an invasive high-grade lesion with squamous differentiation, measuring 6 cm in size. Histologic grade is high (3/3). The tumor invades the outer muscularis propria. No glandular differentiation is observed. All surgical margins are negative for involvement. Carcinoma in situ is identified in the urothelium. No lymphatic invasion is seen. Five lymph nodes were examined, none showed involvement.\n\nThe prostate demonstrates bilateral and diffuse involvement with a high-grade adenocarcinoma component. The tumor measures 9 x 6 x 4.5 cm. Gleason score is 5 + 4 = 9/10, with tertiary pattern present (Gleason grade 3/5). Extensive tumor involvement is noted (5/5 severity). No dominant nodule of at least 1 cm is present. Positive inked margins are found at the left prostatic base and right apex. Perineural invasion is present, and lymphatic invasion is identified. The tumor extends into the seminal vesicles bilaterally and involves extraprostatic soft tissue.\n\nLymph node evaluation includes three nodes on the left and two on the right; no involvement is detected in any of these nodes. Immunostains were used to confirm the nature of the invasive tumor, showing positivity in relevant sections. Controls were appropriately processed and deemed technically acceptable.\n\nGross examination shows a widely sampled specimen with multiple blocks submitted for analysis. The bladder tumor is broadly attached posteriorly and extensively involves the bladder wall, measuring up to 2 cm thick. The prostate and seminal vesicle regions show significant involvement with tumor extending to inked resection margins. The ureteral margins are free of tumor."} +{"pid": "TCGA-64-1680", "report": "The specimen was received in twelve parts. A fragment of the 6th rib, measuring 2.0 x 1.9 x 1.5 cm, was submitted and found to contain no suspicious lesions or masses. A single level 9 lymph node, measuring 0.7 x 0.6 x 0.6 cm, was unremarkable. Multiple level 7 lymph nodes ranging from 0.6 to 1.5 cm were also submitted and found to be involved. Three 10R lymph nodes, measuring 0.8, 0.9, and 1.5 cm, were examined with involvement noted in two of them. Several level 11 lymph node fragments, measuring between 0.4 and 1.2 cm, showed similar findings in one of eight nodes. The right middle and lower lobes of the lung weighed 440 grams and measured 12.0 x 7.0 x 6.0 cm (middle lobe) and 16.0 x 16.0 x 7.0 cm (lower lobe). Gross examination revealed a light brown, bosselated cut surface in the middle lobe, measuring 8.0 x 6.0 x 4.0 cm, involving approximately 70% of the lobe. Small areas of fullness up to 0.3 cm were identified in the lower lobe. The bronchial and vascular margins were unremarkable, and no gross evidence of tumor extension was seen. Lesional tissue was within 0.7 cm of the resection margin. The 4R lymph nodes, measuring up to 1.5 cm, were fibroadipose in consistency and showed no gross abnormalities. Microscopic evaluation of the middle lobe lesion revealed a moderately differentiated carcinoma with acinar, papillary, and lepidic growth patterns. Similar features were observed in subcentimeter satellite lesions in the lower lobe. Visceral pleural invasion was present, and lymphovascular invasion was identified. Resection margins were free of involvement. No tumor was identified in ten lymph nodes evaluated, although metastatic involvement was found in one of nine 4R lymph nodes."} +{"pid": "TCGA-UW-A72N", "report": "The specimen consists of a left partial nephrectomy measuring 4.8 x 4.6 x 3.6 cm and weighing 33 grams. A black stitch is present, marking the tumor capsule, which was focally ruptured during extraction. The fat overlying the kidney capsule is inked blue, and the parenchymal margin is inked black. No adrenal gland tissue is present.\n\nA solid, tan, well-circumscribed mass is identified in the cortex. The tumor measures 3.8 x 3.4 x 0.2 cm by gross examination and is unifocal. It abuts the renal capsule and is less than 0.1 cm from the blue-inked margin (fat overlying the capsule) and 0.11 cm from the black-inked parenchymal margin. The tumor is confined to the kidney without involvement of perirenal adipose tissue, renal vein, ureter, or renal sinus. No multicentricity is observed.\n\nMicroscopic evaluation shows no evidence of capsular invasion, perirenal adipose tissue involvement, or invasion of Gerota\u2019s fascia, renal sinus, or major veins. Lymphatic or venous invasion is not identified. Histologic assessment of surgical margins\u2014including renal parenchymal, renal capsular, and perinephric adipose tissue margins\u2014reveals no residual tumor.\n\nTissue sections submitted include representative portions of the mass, margins, and additional adipose tissue, which appears unremarkable. The uninvolved kidney parenchyma is limited, primarily showing cortical tissue with some medulla, and appears tan/brown and firm.\n\nStaging is reported as pT1a pNx based on available data, pending final clinical review. Special stains were performed, and appropriate controls were used. Additional findings are unremarkable."} +{"pid": "TCGA-A2-A04V", "report": "The specimen consisted of bilateral mastectomy specimens and various excised tissues and lymph nodes. The right mastectomy specimen contained a stellate lesion measuring 2.2 x 2.0 x 1.5 cm located in the lower outer quadrant, with closest approach of 2.0 cm to the deep margin. Histologic evaluation revealed cellular features including tubule formation score of 3, nuclear pleomorphism score of 2, and mitotic count score of 1 (total score 6). Margins were negative for tumor involvement. No ductal carcinoma in situ was identified. Adjacent tissue showed usual ductal hyperplasia and biopsy site changes. Skin and nipple appeared unremarkable. The left mastectomy specimen also contained a stellate lesion measuring 2.2 x 1.8 x 1.8 cm located in the lower outer quadrant, closely approaching the deep margin without definitive involvement. Necrosis was present within the lesion. Focal ductal carcinoma in situ (solid type) and focal vascular invasion were noted near the tumor. Adjacent tissue showed similar biopsy-related changes. Skin and nipple were unremarkable.\n\nExcisions from the right and left breast as well as inframammary crease tissue showed only benign fibroadiopose or soft tissue components. Excised lymph nodes from both axillary regions showed no evidence of malignancy upon histologic examination using hematoxylin and eosin and immunohistochemical stains. All sentinel lymph nodes evaluated were negative for tumor involvement.\n\nStaging assessment indicated pT2 based on tumor size, with no lymph node metastases identified (pN0). No lymphovascular invasion was noted in the right-sided lesion, while focal vascular invasion was observed in the left-sided lesion."} +{"pid": "TCGA-BJ-A28S", "report": "The thyroid specimen weighed 30 grams and was obtained via total thyroidectomy. Histologic examination revealed two distinct encapsulated follicular variant lesions within the thyroid lobes, with the largest measuring 3.4 cm in the left lobe and a smaller lesion measuring 0.5 cm in the right lobe. Both lesions were well-circumscribed and showed no evidence of capsular invasion, angiolymphatic invasion, or extension beyond the thyroid gland. All resection margins were free of involvement. No regional lymph nodes were identified or examined. The histologic features of both lesions are consistent with a follicular variant pattern. Molecular testing was performed on both lesions; however, results for BRAF, NRAS61, HRAS61, and KRAS12/13 mutational analysis were inconclusive due to poor DNA quality. Testing for RET/PTC rearrangement remains pending. No additional significant pathologic findings were identified."} +{"pid": "TCGA-QK-A8Z8", "report": "The surgical pathology report includes two specimens from the larynx. Specimen A, obtained from the right aryepiglottic fold, is a biopsy consisting of an epithelialized lobulated tan-pink tissue measuring 2.0 x 0.6 x 0.6 cm. The cut surface is described as rubbery, and the entire specimen was submitted in cassette A1. Microscopic evaluation reveals moderately differentiated invasive cells.\n\nSpecimen B, taken from the left aryepiglottic fold, consists of multiple lobulated tissue fragments with aggregate dimensions of 1.5 x 0.8 x 0.6 cm. The cut surfaces are similarly rubbery, and the specimen was entirely submitted in cassette B1. Histologic analysis shows moderately differentiated invasive cells with extension into adjacent cartilage.\n\nBoth specimens were received in formalin, and labeling on both original and generated labels matched for patient identification and hospital number. Clinical context indicates a lesion located in the supraglottic region. All measurements and tissue characteristics have been documented as part of the evaluation."} +{"pid": "TCGA-B3-4104", "report": "The specimen includes a right kidney with attached ureter and bladder cuff. The kidney weighs 513 grams and measures 11.5 x 7.0 x 4.0 cm, with a ureter measuring 20 cm in length and up to 0.8 cm in diameter. A lesion is identified in the renal pelvis, measuring 4.6 x 3.5 cm, with a maximal thickness of 2 cm. The lesion approaches within 0.9 cm of the anterior inked capsular surface. No vascular invasion is observed grossly. The surrounding parenchyma appears uniform with multiple cortical cysts, a well-defined corticomedullary junction, and a maximal cortical thickness of 1.3 cm. The ureteral mucosa shows some variation in appearance but no discrete mass is identified.\n\nMicroscopically, the lesion demonstrates papillary architecture and high-grade cytologic features. The tumor invades through the muscularis propria of the renal pelvis. All submitted sections from the distal ureteral margin are free of tumor. Vascular invasion is not present. Additional findings include benign cortical cysts and arteriolar nephrosclerosis. Multiple blocks are submitted for evaluation, including those from the tumor, adjacent parenchyma, renal pelvis, ureter, and margins of resection."} +{"pid": "TCGA-E9-A1N4", "report": "The breast tissue specimen was obtained via radical mastectomy. A grossly evident lesion was identified in the breast, measuring 3 x 2.7 x 2 cm. Histologic evaluation revealed a cellular composition consistent with a malignant process. Lymph node assessment showed involvement in 4 out of 7 axillary nodes. The affected nodes were located in the left upper quadrant; no determination was made regarding extracapsular invasion. Additional histopathologic features were assessed but could not be fully classified due to insufficient data."} +{"pid": "TCGA-XF-A9T2", "report": "A radical cystectomy and bilateral pelvic lymph node dissection were performed. Specimens from the right and left distal ureters, as well as the apical urethral margin, showed no evidence of dysplasia or malignancy. The left proximal ureter and right proximal ureter were also benign.\n\nThe bladder specimen revealed a lesion involving the muscularis propria with extension into the perivesical soft tissue, but not reaching the inked margins. Lymphovascular invasion was identified. All surgical margins were free of malignancy.\n\nIn the prostate, there was involvement with limited extension to the right apical region (less than 2%). The remaining apical and peripheral prostatic margins, as well as bilateral seminal vesicles and vasa deferentia, were free of involvement. High-grade prostatic intraepithelial neoplasia (PIN II\u2013III) was present in a multifocal pattern. Prostatic atrophy and focal chronic inflammation were also noted.\n\nA total of 141 lymph nodes were examined: 15 right paracaval, 7 right common iliac, 4 right presacral, 3 right Cloquet, 18 right external iliac, 7 right obturator/hypogastric, 9 left para-aortic, 19 left common iliac, 5 left Cloquet, 22 left external iliac, 18 left obturator/hypogastric, 9 left presciatic, and 5 right presciatic. None showed evidence of metastatic disease.\n\nImmunohistochemical studies for neuroendocrine markers were negative. The tumor was classified according to the AJCC pathologic staging system (5th edition) as pT3b, pN0, MX."} +{"pid": "TCGA-3A-A9IV", "report": "The pathology report includes findings from four specimens. \n\n**Specimen A**: A lymph node measuring 2.0 x 1.5 x 1.0 cm was submitted entirely. Microscopic examination revealed no involvement by malignant cells. \n\n**Specimen B**: This included a pancreatic specimen and spleen. The pancreatic specimen measured 8.0 x 4.0 x 2.5 cm and contained a mass located in the tail region. The mass measured 3.0 x 2.5 x 2.0 cm and occupied approximately 75% of the pancreas. It was firm, gray-white, and ill-defined with occlusion of the pancreatic duct at that site. Histologic evaluation showed well-differentiated tumor cells arranged in nests and trabeculae. Necrosis was present. Mitotic count was 7 mitoses per 10 high-power fields. Ki67 labeling index ranged between 3% and 20%. Immunohistochemistry demonstrated positivity for synaptophysin and focal positivity for chromogranin. The tumor was confined to the pancreas without extension beyond the organ capsule. Surgical margins were free of tumor, although the tumor was adjacent to the soft tissue margin (distance from tumor to closest margin: 0.2 mm). Lymphovascular and perineural invasion were identified. Fifteen regional lymph nodes were examined and none contained malignant cells. The spleen was unremarkable with normal parenchymal architecture. \n\n**Specimen C**: An accessory spleen measuring 2.5 x 2.0 x 2.0 cm was evaluated. Histologic examination showed normal splenic tissue without abnormalities. \n\n**Specimen D**: The gallbladder measured 8.0 x 3.0 x 1.5 cm and contained multiple mucosal lesions ranging from 3 mm to 5 mm in size. Histologic evaluation revealed partially calcified mucosal polyps without evidence of dysplasia or malignancy. Additional findings included chronic cholecystitis and cholesterolosis. Frozen section analysis confirmed absence of malignancy in these lesions. \n\nAdditional microscopic findings included PanIN IIa changes in the pancreatic tissue. Molecular studies were performed on representative tissue sections and deemed adequate. All specimens were reviewed by an attending pathologist and confirmed."} +{"pid": "TCGA-P4-AAVO", "report": "The specimen consists of a right hemicolectomy and radical nephrectomy with associated lymph node sampling. The colon specimen measured 30.0 cm in length and included attached small bowel (6.0 cm) and appendix (4.5 cm long). Five polyps were identified in the colon: the largest measuring 2.2 cm located 13.0 cm from the distal margin, another measuring 1.4 cm located near the ileocecal valve, a third measuring 0.4 cm, and two smaller cecal polyps measuring 0.6 cm and 0.3 cm respectively. All polyps were superficial without evidence of invasive tumor. Surrounding colonic mucosa was unremarkable. The appendix showed a small hyperplastic polyp. Fourteen lymph nodes were sampled from the colonic mesentery and none contained tumor.\n\nThe kidney specimen consisted of a radical nephrectomy specimen measuring 15.0 x 11.0 x 4.0 cm. A well-circumscribed tumor measuring 4.5 x 4.0 x 3.5 cm was identified in the lower pole of the kidney. The tumor had a gray-tan appearance with less than 5% hemorrhage and no necrosis. Histologic examination revealed growth in papillary and nested patterns with cells exhibiting abundant eosinophilic cytoplasm. Immunohistochemical staining demonstrated strong positivity for P504S and vimentin. CD10 showed positive staining with membranous pattern and cytokeratin 7 was positive in rare cells. The tumor was confined entirely within the kidney without invasion into perinephric fat or Gerota\u2019s fascia. Margins of resection were free of tumor involvement. No lymph nodes were identified in the specimen."} +{"pid": "TCGA-SX-A71W", "report": "The surgical specimen from the right kidney consists of a dominant lesion measuring 7.0 cm in greatest dimension and a smaller lesion measuring 0.8 cm. The dominant tumor is located in the lower pole, while the smaller lesion is found in the upper pole. Both tumors are well-circumscribed and confined to the renal parenchyma. On gross examination, the dominant mass appears tan-yellow to yellow-orange with a focal rubbery consistency. The two smaller satellite lesions are also well-demarcated and do not show gross involvement of the renal veins, renal pelvis, or perinephric tissue. No extension beyond Gerota\u2019s fascia or into the adrenal gland is identified.\n\nMicroscopically, the larger lesion shows features consistent with a specific histologic type and is classified as grade 2, while the smaller lesion is grade 3. There is no evidence of sarcomatoid features, tumor necrosis, lymphovascular invasion, or involvement of surgical margins. No microscopic extension into the renal sinus, collecting system, or adjacent structures is observed. A separate 0.6-cm incidental finding is noted in the non-tumorous kidney, which is consistent with a benign lesion. The remainder of the kidney shows no significant pathology.\n\nStaging is based on the size and extent of the dominant tumor, which is classified as being in an intermediate stage. Specimen orientation and margin assessment are performed using inked sections. Multiple blocks are submitted for analysis, including representative sections of the dominant mass, satellite lesions, and surrounding parenchyma. A biorepository sample is also submitted and contains both malignant and benign tissue components. Immunohistochemical testing may have been used to support the morphologic findings, though no investigational or research status is assigned to these tests. The laboratory performing the analysis is CLIA-certified for high-complexity testing."} +{"pid": "TCGA-44-A4SS", "report": "The surgical pathology report describes a resected lung specimen from the left upper lobe. A mass measuring 2.5 cm in diameter was identified, with a white cut surface and focal red discoloration measuring 1.7 cm. The tumor was located 5.5 cm from the bronchial margin, and no malignancy was identified at the bronchial margin. Histologically, the lesion demonstrated moderately differentiated features with eosinophilic cytoplasm and a histologic grade of 2. The mitotic index was 17 mitoses per 10 high-power fields. Focal histologic features adjacent to the lesion were compatible with vascular invasion. No involvement of the pleura was observed.\n\nA total of 14 lymph nodes were examined across multiple levels. One lymph node from level 4L, three from level VII, one from level IX, seven from level V (submitted as multiple pieces), and one each from levels XI and XII were all negative for malignancy. In addition, no malignancy was identified in 10 hilar lymph nodes attached to the primary specimen.\n\nThe background lung tissue showed emphysematous changes. The resected lung measured 26 x 14 x 6 cm. Lymph node specimens ranged in size from 0.3 cm to 2 cm in aggregate where applicable. The larger lymph node specimens were soft and dark-colored on gross examination. All lymph node specimens were unfixed at the time of receipt.\n\nThe case was associated with clinical information noting a left upper lobe lesion, history of tobacco and alcohol use. Intraoperative consultation confirmed the presence of carcinoma in the left upper lobe resection specimen, with no evidence of malignancy at the bronchial margin. Tissue was submitted for frozen section analysis during surgery, which supported the final findings. The tumor was staged as pT1 based on available data."} +{"pid": "TCGA-DX-A6B9", "report": "The resected abdominal specimen includes a segment of large bowel measuring 12.5 cm in length and 2.5 cm in average diameter, with a subserosal mass measuring 15.0 x 11.5 x 6.5 cm. The attached mesocolon measures 12 x 6 x 1 cm. The mass has both solid and cystic components. The solid component shows heterogeneous tan-white firm cut surfaces with areas of hemorrhage and gelatinous change. The cystic portion contains approximately 200 cc of tan-brown mucinous fluid and accounts for about 20% of the mass. Within the solid area, a 1.0 cm tan fleshy nodule and a 2.0 cm red circumscribed nodule are identified. The serosal surface is marked with black ink. The mass is located 3.5 cm from the mesocolic resection margin.\n\nMicroscopic evaluation reveals a neoplastic process involving the colonic subserosa with close approximation to the muscularis propria, though the exact origin is uncertain. The tumor demonstrates multiple foci with moderate to severe nuclear atypia and pleomorphism that do not appear degenerative. Mitotic activity is present at a rate of 2 mitotic figures per 50 high power (40X) fields. No necrosis is identified. Colonic mucosa appears unremarkable. Surgical margins are free of tumor involvement. Fifteen lymph nodes are benign (0/15). Immunohistochemical analysis shows positivity for PR and negativity for ER. MIB-1 staining indicates a proliferative index of approximately 2%, with labeling of cells exhibiting large, atypical nuclei. The expression of PR suggests a possible gynecologic origin. \n\nThe umbilical hernia specimen consists of a piece of tan-yellow soft tissue measuring 4.4 x 3.3 x 1.2 cm, showing fibrous and fatty cut surfaces. Histology reveals benign fibroadipose tissue with mesothelial lining and reactive changes."} +{"pid": "TCGA-ZF-A9R3", "report": "The specimen consisted of two tissue samples: one weighing 5 grams of firm tissue chippings, and a second containing two fragments, the larger measuring 12 mm. Microscopic evaluation revealed a poorly differentiated lesion with a focal nested growth pattern. The growth pattern was mixed, showing both papillary and solid components. Muscularis propria was present and showed evidence of stromal invasion, extending into the muscularis propria (pT2). No vascular channel invasion was identified. Adjacent flat urothelium was observed without dysplasia. Two tissue fragments from the base showed extensive infiltration by high-grade malignant cells consistent with urothelial origin."} +{"pid": "TCGA-CG-4477", "report": "The specimen shows a poorly differentiated neoplasm located in the cardiac and fundus region, with histopathological features consistent with intestinal-type morphology. The tumor demonstrates extensive necrosis and areas of ulceration on its inner surface. Solid tumor regions are present. Microscopic examination reveals peritumorous chronic inflammation with evidence of acute inflammatory activity. Lymphatic invasion is noted, with carcinomatous lymphangitis present. The tumor infiltrates the parietal layers of the stomach, extending into the outer portions of the muscularis propria. A total of 17 lymph nodes were examined, all of which were free of tumor involvement. Chronic lymphadenitis is observed in some nodes. No residual tumor is seen in overview sections from all resected parts. Based on available sections, staging is assessed as pT2a pN0 (0/17), MX; L1, R0."} +{"pid": "TCGA-CJ-4873", "report": "The specimen includes a nephrectomy measuring 15.0 x 8.0 x 6.0 cm, consisting of a kidney measuring 6.5 x 5.5 x 4.5 cm and an attached ureter measuring 8.0 cm in length and 0.5 cm in diameter. A well-circumscribed yellow-brown mass with areas of hemorrhage is located in the middle anterior region of the kidney. The mass measures 5.0 x 5.0 x 5.0 cm and approaches the renal capsule without extending beyond it. It also extends toward the renal sinus and bulges into the renal pelvis. The remaining renal parenchyma appears unremarkable, and the surface of the remaining renal pelvis is white-tan and smooth. \n\nHistologically, the lesion contains a mixture of clear cells (90%) and eosinophilic cells (10%), with nuclear features corresponding to grade 3 according to standard criteria. The tumor invades into the renal pelvis but does not extend into the perinephric or sinus adipose tissue. Vascular and ureteral margins are free of involvement. \n\nThree lymph nodes are present, with the largest measuring 1.5 x 0.8 x 0.6 cm and the smallest measuring 0.6 x 0.5 x 0.4 cm. All are unremarkable. No tumor is identified in the lymph nodes. The tumor is staged based on its size and extent of local invasion within the kidney."} +{"pid": "TCGA-SA-A6C2", "report": "The surgical specimen includes a segment of colon measuring 4.6 cm in length and 2.7 cm in diameter, along with an associated mass. The mass, which is gray-tan and lobulated, measures 6.4 x 3.8 x 2.2 cm and is loosely attached to the surrounding fat. It has a red-brown, focally myxoid glistening cut surface and does not appear to invade the adjacent tubular structure or the colon wall. A separate sutured tubular structure, possibly a vessel or ureter, is also present, measuring 1.6 cm in length and 0.6 cm in diameter. The colon's serosa appears smooth and glistening, with a gray-tan mucosa and normal folds. The wall thickness measures approximately 0.4 cm. Within the pericolonic fat, 13 probable lymph nodes are identified, ranging from 0.1 to 0.4 cm in size. Histologically, the lesion demonstrates a Zellballen pattern. Immunostaining reveals positivity for synaptophysin, chromogranin, and Melanin A, while being negative for MITF, HMB45, and Cam 5.2. S100 staining does not highlight sustentacular cells. No significant histological changes are noted in the colon. All lymph nodes are negative for malignant involvement."} +{"pid": "TCGA-N8-A4PI", "report": "A right peri-aortic lymph node specimen measuring 3 \u00d7 2 \u00d7 1 cm was examined and four lymph node candidates were identified and submitted for analysis; no tumor was found. Similarly, a left peri-aortic lymph node specimen measuring 2 \u00d7 1 \u00d7 0.5 cm had four lymph node candidates identified and submitted, with no tumor detected. On the right pelvic side, a specimen measuring 6 \u00d7 5 \u00d7 2 cm yielded eleven lymph node candidates, none of which showed tumor involvement. The left pelvic lymph node specimen measured 5 \u00d7 4.5 \u00d7 1.5 cm and contained ten lymph node candidates, all without evidence of tumor.\n\nThe uterus measured 12 cm in height, with an anterior-posterior width of 8 cm and a fundal breadth of 9 cm. The endometrial cavity measured 5.1 cm in length and 4.5 cm in width at the fundus. A lesion measuring 3.2 \u00d7 3.0 \u00d7 2.1 cm was observed in the fundus, primarily on the posterior aspect but also extending to the anterior region. The lesion appeared tan-white with hemorrhagic areas, papillary features, and was friable. Invasion into the myometrium was noted in the inner half of the wall, with a depth of 0.9 cm and a wall thickness of 2.1 cm, representing approximately 43% invasion (block E13). The deepest gross invasion measured 1.2 cm. No involvement was seen in the serosa, lower uterine segment, or cervix. Adnexal involvement was not identified.\n\nThe cervix measured 3.2 cm in length of the endocervical canal. The ectocervix showed extensive cautery artifact while the endocervix appeared tan/yellow and trabeculated. Both fallopian tubes were discontinuous, likely due to prior tubal ligation. The right ovary measured 2.5 \u00d7 1.5 \u00d7 1.0 cm and the left ovary measured 2.5 \u00d7 1.2 \u00d7 1.2 cm; both were atrophic with no tumor identified. No diagnostic abnormalities were found in either fallopian tube.\n\nMultiple leiomyomata were present, with the largest measuring up to 3.2 cm in diameter. Adenomyosis and vascular calcifications were also noted. Lymphovascular space invasion was present in rare foci. A total of 29 regional lymph nodes were examined, with none showing involvement.\n\nImmunohistochemical staining performed on selected tissue blocks confirmed appropriate internal and external controls. Some reagents used are classified as analyte-specific reagents (ASR), developed and validated by the laboratory under CLIA-88 certification for high-complexity testing. These tests are used for clinical purposes and are not considered investigational or research-based.\n\nEstrogen receptor staining showed weak positivity (1\u20132+) in about 2% of cells. Progesterone receptor staining was also weakly positive (1\u20132+) in approximately 5% of cells.\n\nBlocks were submitted from various regions of the uterus and adnexa, including sections of the cervix, lower uterine segment, mid corpus, upper corpus/fundus, and fibroids. Additional tissue samples were collected for special investigations."} +{"pid": "TCGA-BA-6870", "report": "The biopsy specimens were obtained from four distinct anatomical sites. The first specimen, taken from the right pyriform sinus, consists of a thin strip of white-tan soft tissue measuring 2 x 0.4 x 0.1 cm. Microscopic evaluation reveals squamous mucosa with focal moderate dysplasia and intraepithelial chronic inflammation; no invasive malignancy is observed.\n\nThe second specimen, from the cervical esophagus, is a small fragment measuring 0.1 x 0.1 x 0.1 cm. It shows benign squamous mucosa without evidence of dysplasia or malignancy.\n\nThe third specimen, obtained from the right supraglottic region of the larynx, includes multiple fragments with an aggregate size of 2.9 x 2.7 x 0.9 cm. Histologic examination demonstrates moderately differentiated squamous cell changes with invasion into cartilage.\n\nThe fourth specimen, from the right tongue base, consists of multiple fragments measuring 1.1 x 0.8 x 0.6 cm in total. The tissue shows squamous mucosa with focal moderate dysplasia, but no invasive carcinoma is identified.\n\nAll specimens were fully submitted for histologic analysis."} +{"pid": "TCGA-78-7542", "report": "A: RIGHT UPPER LOBECTOMY. The specimen consists of a lung measuring 100 x 100 x 40 mm, containing a mass measuring 50 x 30 x 30 mm, associated with puckering of the overlying visceral pleura. A staple line is present measuring 55 mm in length, with the mass located approximately 40 mm from this line. Serial sectioning of the remaining lung tissue did not reveal any additional focal lesions. Histological examination of sections shows sheets of poorly differentiated cells with occasional multinucleated giant cells. In other areas, growth is observed along preexisting alveolar septa. There is no involvement of the visceral pleura, and the bronchial resection margins are free of abnormal cells. The surrounding lung tissue demonstrates changes consistent with subpleural emphysema. Lymph nodes examined show foci of necrosis and reactive changes, but no evidence of malignancy. B: RML NODULE. The specimen is a nodule measuring 14 x 9 x 5 mm, covered by pleura on one surface. Microscopic evaluation reveals reactive lymph node changes without evidence of malignancy."} +{"pid": "TCGA-FK-A3S3", "report": "The surgical pathology report includes findings from multiple specimens. Three soft tissue specimens from the neck showed parathyroid tissue, with no tumor identified. A total thyroidectomy specimen demonstrated a left-sided lesion measuring 2.5 cm in greatest dimension. The lesion was multifocal and exhibited minimal extension beyond the thyroid capsule. Histologic evaluation showed features consistent with a follicular variant in the majority of the sample. Venous and lymphatic invasion were noted. Lymph node involvement was identified in 4 out of 11 nodes, with the largest metastasis measuring 2.4 cm. An additional lymph node dissection from central and mediastinal compartments revealed one positive node among seven. Following submission of additional tissue from one part of the specimen, further analysis identified three more positive nodes from four additional nodes submitted. All margins were uninvolved. Distant metastasis could not be assessed."} +{"pid": "TCGA-06-0216", "report": "A right occipital mass was resected and submitted for pathological evaluation. The specimen measured 4.0 x 2.5 x 1.3 cm and consisted of a partially fragmented, tan to maroon hemorrhagic soft tissue mass with a variegated cut surface ranging from fleshy tan to chalky yellow-gray. Microscopic examination revealed a high-grade glial neoplasm characterized by increased cellularity, nuclear hyperchromasia, pleomorphic nuclei, mitotic activity, vascular proliferation, and areas of tumor necrosis. Immunohistochemical staining demonstrated a MIB-1 labeling index greater than 50%. All sections were submitted for analysis."} +{"pid": "TCGA-R6-A6DN", "report": "The biopsy specimens from a mid-esophageal mass at 25 cm consist of multiple friable white-tan soft tissue fragments measuring 1.5 x 0.1 x 0.1 cm. Histologic evaluation reveals sheets of poorly differentiated cells without gland formation. Scattered mucin vacuoles are present on periodic acid-Schiff/Alcian blue stain. Immunohistochemical staining is negative for Cdx2, chromogranin, synaptophysin, and pan-melanoma. Additional biopsies were obtained from a possible Barrett\u2019s esophagus site and consist of multiple friable pale pink soft tissue fragments measuring 2 x 0.2 x 0.1 cm. These show high-grade columnar epithelial dysplasia with separate areas of cardiac-type mucosa containing chronic inflammation and edema. No intestinal metaplasia or Helicobacter pylori is identified. Immunohistochemical staining for Her2-neu shows no membranous staining of invasive cells, interpreted as negative."} +{"pid": "TCGA-CJ-4889", "report": "The surgical specimen included a subcutaneous cystic lesion measuring 3.5 x 3.0 x 2.7 cm, described as a thin-walled, ruptured cyst containing tan cheesy material. The lesion was submitted for histologic evaluation. A separate specimen from the left kidney measured 15.0 x 8.5 x 6.5 cm and contained a well-circumscribed reddish-brown mass with yellow areas, measuring 4.0 cm in greatest dimension. The mass was located in the mid lateral portion of the kidney, abutting the renal capsule but not extending into the surrounding adipose tissue. It was within close proximity (0.5 cm) to the closest external surface. No involvement of the renal sinus or renal vein was identified. Margins of resection, including vascular and ureteral margins, were free of abnormal cellular infiltration. One hilar lymph node was also negative. A cortical cyst measuring 0.5 cm was noted in the remaining renal parenchyma. Representative sections of the mass, including all yellow areas, were submitted along with sections of normal kidney tissue and margins. Additionally, a fragment of rib measuring 3.0 x 1.5 x 0.4 cm was submitted entirely for gross examination only. No clinical history was provided."} +{"pid": "TCGA-DX-A3UB", "report": "The specimen consists of a segment of proximal jejunum measuring 9.0 cm in length and 7.6 cm in circumference. A fungating mass is present, measuring 2.7 x 2.2 x 1.8 cm, located 3.7 cm from one resection margin and 2.5 cm from the other. The lesion extends through the full thickness of the bowel wall, reaching the mucosal surface with erosion and coming within less than 1 mm of the serosal surface. The growth pattern is nodular and infiltrative. No necrosis is observed. The estimated mitotic activity is 2\u20133 per 10 high-power fields. There is no evidence of vascular invasion. Resection margins are free of tumor. The surrounding small bowel mucosa appears normal. Histologic sections show no involvement of the uninvolved mucosa. Immunohistochemical staining demonstrates positivity for desmin and SMA, while stains for S100, CD34, and CD117 are negative. The proliferative index (MIB-1) is up to 10%. All gross and microscopic features have been reviewed and confirmed."} +{"pid": "TCGA-D7-8573", "report": "The resected stomach specimen measured 18.5 x 16 cm upon opening along the greater curvature, with an attached omental specimen measuring 30 x 16 cm. A cauliflower-shaped lesion was identified along the greater curvature, measuring 5.5 x 4.5 x 2.4 cm. The distance from the proximal resection margin was 8.0 cm and from the distal margin was 5.0 cm.\n\nHistologically, the lesion demonstrated a high-grade epithelial neoplasm with tubular differentiation. The tumor infiltrated through the gastric wall and reached the peritoneal surface. No evidence of tumor was found at the surgical resection margins. Adjacent mucosa exhibited chronic inflammatory changes with focal intestinal metaplasia. The omental tissue adjacent to the lesion was free of neoplastic involvement.\n\nLymph nodes retrieved from the lesser curvature (3 lymph nodes), greater curvature (4 lymph nodes), and peripyloric region (5 lymph nodes) all showed reactive lymphoid hyperplasia without evidence of metastatic disease. No other significant pathological findings were noted in the specimen."} +{"pid": "TCGA-VS-A8EH", "report": "The biopsy specimen from the cervix shows moderately differentiated invasive squamous cells. The tumor measures approximately 4.5 cm in greatest dimension. Histologic examination reveals nests and islands of malignant cells with moderate nuclear pleomorphism, prominent nucleoli, and abundant eosinophilic cytoplasm. Stromal invasion is present, with involvement of the cervical stroma. No lymphovascular space invasion is identified. The surgical margins are free of neoplastic cells. No evidence of perineural invasion is seen."} +{"pid": "TCGA-37-4129", "report": "The tissue specimen was obtained from the lung and processed into an OCT block. One container of normal blood was collected in frozen format. Histological analysis showed a malignant tumor with a grade 2 classification. Tumor cell content was estimated at 70%. Staging information indicates T2, N0, M0 status. No treatment details were available. The sample was obtained via blood draw."} +{"pid": "TCGA-06-0213", "report": "The surgical specimen from the brain tumor consists of three hemorrhagic and necrotic tissue fragments measuring 1.6 x 0.7 x 0.4 cm in aggregate. A frozen section diagnosis was obtained intraoperatively and confirmed on permanent sections. The second specimen, also from the parietal region, is necrotic and measures 1.8 x 1.2 x 0.6 cm. Microscopic evaluation reveals a high-grade glial neoplasm with extensive coagulative necrosis, thrombosed blood vessels, and areas of vascular proliferation. The tumor demonstrates cellular pleomorphism with multinucleated cells, bizarre nuclei, and atypical mitotic figures. The MIB-1 labelling index was assessed at 20 percent."} +{"pid": "TCGA-BP-4974", "report": "The specimen consists of a left kidney with attached ureter, renal vessels, and perinephric fat, weighing 220 grams. The kidney measures 14 x 6.0 x 5.0 cm. The ureter is 4.0 cm in length and 0.4 cm in diameter, and the renal vein measures 0.9 cm in length and 1.0 cm in diameter. No adrenal gland is identified. A well-circumscribed, round, hemorrhagic bright orange tumor measuring 5.5 x 5.5 x 5.0 cm is located in the cortex of the lower pole. The tumor does not grossly involve the pelvis and shows no evidence of invasion through the renal capsule. It is in proximity to the renal vein and sinus fat but does not demonstrate macroscopic invasion. The remainder of the kidney shows a pink-brown parenchyma with a distinct cortico-medullary junction, and the cortex measures 2.0 cm. The calyces and ureteric mucosa appear normal.\n\nMicroscopically, nuclear grade II/IV is noted. No local invasion or renal vein invasion is identified. Surgical margins are free of involvement. Evaluation of non-neoplastic kidney tissue reveals no significant findings. Three lymph nodes are examined, and none show metastatic involvement. The tumor is confined within the kidney and measures less than 7.0 cm in greatest dimension. Sections include representative samples from the tumor with adjacent kidney, vessel, sinus fat, and perinephric fat, as well as from the upper pole, ureteral and vascular margins, and lymph nodes."} +{"pid": "TCGA-BP-4967", "report": "The specimen from the right kidney, including attached ureter, renal vessels, and perinephric fat, weighed 776 g and measured 25 x 10 x 7.5 cm. The kidney itself measured 12.5 x 6.5 x 6 cm, with the attached ureter measuring 10.5 cm in length and 0.6 cm in diameter, and the renal vein measuring 2.5 cm in length and 0.7 cm in diameter. A subcortical, well-circumscribed, oval, bright orange to yellow hemorrhagic lesion measuring 5.5 x 4.5 x 3.7 cm was identified, located 2.7 cm from the renal vein margin. The lesion extended from the mid to lower pole of the kidney, impinged on the renal pelvis and sinus fat, and was separated from the renal vein by a layer of fat. Two uniloculated cystic areas were found: one in the mid to upper pole measuring 1.4 x 1.2 x 1.2 cm, and another in the upper pole measuring 1.1 x X cm. Firm, orange-yellow discolorations were noted in the renal pyramids and cortex, with the largest cortical discoloration measuring 0.6 x 0.6 cm. No lymph nodes were identified in the perinephric fat. The adrenal remnant measured 4 x 1.5 x 0.2 cm and was not involved.\n\nHistologically, the lesion showed nuclear features corresponding to grade II/IV. The surrounding non-neoplastic kidney tissue showed multiple cortical scars, benign cortical cysts, and two tubulopapillary adenomas. No involvement of the adrenal gland or lymph nodes was identified. Five lymph nodes from the paracaval region were examined and were free of involvement. The surgical margins were free of tumor. The tumor was found to extend into the perinephric tissues and involved the renal sinus fat, but did not extend beyond Gerota's fascia. No invasion of the renal vein was identified. Multiple sections of the tumor, adjacent structures, and normal kidney tissue were submitted for analysis, including areas near the ureteral and vascular margins, renal sinus fat, cystic regions, and discolored cortical areas. The right adrenal gland, weighing 6.5 g and measuring 4.6 x 4.2 x 1.5 cm, showed no abnormalities, with a normal cortex and medulla. All findings were based on personal examination of the slides and review of the material."} +{"pid": "TCGA-AX-A064", "report": "The specimen consists of a uterus with bilateral fallopian tubes and ovaries, along with multiple lymph node groups from the right and left para-aortic, right and left common iliac, and right and left pelvic regions. Grossly, the uterus measures 7.0 x 5.3 x 3.5 cm and contains a polypoid lesion located in the posterior and anterior middle portions of the endometrial cavity. The lesion measures 2.5 x 1.5 x 1.8 cm and extends into the posterior cervical mucosa. There is also a small intramural nodule measuring 0.8 cm identified within the myometrium.\n\nMicroscopically, there is evidence of myometrial invasion with a maximal depth of 2 mm and a myometrial thickness at that site measuring 1.7 cm, representing approximately 12% involvement of the myometrium. The histologic grade corresponds to G2, with between 6% and 50% nonsquamous solid growth pattern. All surgical margins are uninvolved by invasive carcinoma, with the closest distance being 1.1 cm at the cervical radial margin. No venous or lymphatic vessel invasion is identified.\n\nA total of 34 lymph nodes were examined across all regions. No metastasis is identified in any of the lymph nodes sampled, including those from the right para-aortic (no nodes found), left para-aortic (5 nodes), right common iliac (3 nodes), right pelvic (13 nodes), left pelvic (11 nodes), left common iliac (no nodes found), and an additional right pelvic lymph node (1 node). All lymph nodes are histologically negative for metastasis.\n\nAdditional findings include a small leiomyoma within the myometrium measuring 0.8 cm. No other significant pathologic findings are noted. Immunohistochemical staining performed on section 1A shows reduced CD10 expression at the tumor site involving the myometrium.\n\nThe gross and microscopic features indicate a localized process without regional nodal involvement. The tumor involves the endometrial cavity and cervix but does not extend beyond the uterus. Staging assessment indicates no regional lymph node involvement and distant metastasis cannot be assessed."} +{"pid": "TCGA-23-1113", "report": "The specimen consists of multiple tissue samples from various anatomical sites including the pelvis, peritoneum, umbilical hernia, bladder, uterus, cervix, ovaries, fallopian tubes, appendix, omentum, and other nodules.\n\nGross examination revealed several firm, white, or pink-white tissue fragments. The largest specimens measured up to 5.2 cm in length and included portions of fibroadipose and membranous tissue with cystic or hemorrhagic areas. Multiple biopsies showed homogeneous, friable tan-white tumor tissue with variable dimensions, ranging from 0.5 cm to 3.0 cm in greatest dimension. The fallopian tubes were diffusely indurated with visible tumor involvement, and the attached ovaries were largely replaced by solid, white tumor tissue. The uterus weighed 270 grams and was enlarged, measuring 6.3 x 8.4 x 7.1 cm. The endometrial cavity contained two polyps measuring 1.0 and 2.4 cm. The myometrium and uterine serosa appeared unremarkable. The cervix measured 4.3 cm in length and had a patent os; no gross lesions were identified on the ectocervix.\n\nMicroscopic evaluation showed high-grade cellular atypia with papillary architecture in multiple specimens. Tumor cells were present within the mucosa and muscular layers of both fallopian tubes, with transmural invasion noted. Both ovaries exhibited extensive tumor involvement. The cervix demonstrated metastatic deposits within lymphatic spaces and submucosal stroma. Additional metastatic involvement was identified in the appendix, omentum, sigmoid implant, lesser sac, colon nodule, ureteral sacral nodule, and bladder nodule. A benign endometrial polyp was observed in a background of secretory endometrium.\n\nStaging could not be fully determined due to the widespread involvement across multiple sites, including peritoneal surfaces, pelvic structures, and distant nodules. The tumor demonstrated extensive serosal and subserosal infiltration, along with lymphovascular invasion."} +{"pid": "TCGA-HU-A4GQ", "report": "The submitted specimen consists of a total gastrectomy and tissue labeled \"mesocolon.\" The stomach measures 30.0 cm along the greater curvature and 14.0 cm along the lesser curvature. The proximal and distal resection margins are each 6.0 cm in length. The esophagus is 1.0 cm and the duodenum is 0.5 cm. The tumor is located in the lower third (antrum) of the stomach, 7.0 cm from the proximal resection margin and 4.0 cm from the distal resection margin. The tumor measures 10.0 x 6.0 x 1.6 cm and demonstrates Borrmann type III morphology. Gross examination reveals serosal invasion.\n\nMicroscopic evaluation shows a tubular, moderately differentiated growth pattern with infiltration into adjacent structures, including peripancreatic fat and mesocolon. Resection margins are negative. The growth pattern is classified as infiltrative with an intestinal-type morphology. A lymphoid reaction is present, and there is evidence of lymphovascular and perineural invasion. \n\nA total of 105 lymph nodes were examined, with metastatic involvement identified in 4 out of 49 nodes from the inferior gastric region. No tumor was found in other lymph node groups, including superior gastric, regional lymph nodes labeled '1', unlabeled, '4sa', '4sb', '5', '6', '7', '9', '10', '11P', '11D', and '12'. The tissue labeled \"mesocolon\" shows chronic inflammation without tumor involvement.\n\nStaging according to the AJCC 7th edition is pT4bN2Mx. Special stains show a moderate presence of *H. pylori*."} +{"pid": "TCGA-B5-A11W", "report": "The specimen consists of a didelphic uterus weighing 303 grams, measuring 13 x 10 x 4.5 cm, with attached bilateral fallopian tubes and ovaries. The cervix measures 3 cm in diameter with a single patent os measuring 1.5 cm. The endocervical canal is septated, dividing the endocervical and endometrial cavities into right and left compartments. The left endometrial cavity measures 7 x 4 cm and is completely effaced by a white-tan, exophytic, soft, and friable lesion involving both anterior and posterior endometrial surfaces. This lesion invades up to 1.5 cm into the myometrium, which has a maximum thickness of 3.5 cm. The tumor extends to the left anterior and posterior lower uterine segments, located 3.8 cm and 2.9 cm from the external os, respectively. The right endometrial cavity is compressed and distorted by the lesion on the left side as well as by a large intramural nodule beneath the left endometrium. The right endometrium measures 0.1 cm in thickness and contains two small tan polyps in the posterior region, each measuring approximately 0.8 x 0.8 x 0.7 cm.\n\nThree myometrial nodules are present, ranging in size from 1.5 cm to 4 x 3.5 x 3 cm. All are intramural without hemorrhage or necrosis. Two smaller nodules are located in the anterior right myometrium, while the largest is found in the posterior left myometrium. The bilateral ovaries are pink-yellow; the left ovary contains a 0.4 cm simple cortical cyst with smooth inner walls. The fallopian tubes appear unremarkable. A separate white-tan smooth nodule measuring 7.6 x 5.5 x 5.4 cm (fixed weight 92 g) is noted, with focal calcification and a whorled cut surface, no hemorrhage or necrosis observed.\n\nMicroscopic evaluation of full-thickness sections from the anterior and posterior portions of the uterus confirms involvement of the left fundus, left lower uterine segment, and focal extension into the right fundus. The lesion demonstrates features consistent with a histologic pattern previously classified under a FIGO grading system of 2/3. The tumor measures approximately 6 x 4 x 1.2 cm. Myometrial invasion reaches a depth of 1.5 cm within a wall measuring up to 2.9 cm thick. In most areas, invasion is limited to the inner half of the myometrium, though one area shows invasion slightly beyond the midpoint. No lymphatic or vascular invasion is identified. Adjacent non-neoplastic endometrium shows changes consistent with intraepithelial alterations on both sides. Leiomyomas are present in the remaining myometrium. The cervix, serosa, and surgical margins show no evidence of neoplastic involvement. Both ovaries and fallopian tubes are free of any such findings.\n\nLymph node dissection includes a right pelvic aggregate measuring 4.5 x 4 x 2.3 cm containing four lymph nodes and a left pelvic aggregate measuring 4.8 x 4 x 2.2 cm containing three lymph nodes. All nodes are submitted for evaluation. No suspicious findings are identified across all submitted lymph nodes from both the right and left pelvic regions."} +{"pid": "TCGA-19-5952", "report": "The specimen consists of two parts. Part A includes multiple light tan to red-brown irregular soft cerebriform tissue fragments, measuring 3.5 x 2.6 x 1.3 cm in total, submitted entirely in three cassettes. Part B consists of multiple light tan irregular soft tissue fragments measuring 1.5 x 0.8 x 0.3 cm in aggregate, submitted in toto in one cassette. The tissue was processed and reviewed for histological characteristics, including cellular morphology and tissue architecture. All measurements and features were assessed in the context of clinical history indicating a left temporal lesion."} +{"pid": "TCGA-QK-A6IG", "report": "A right buccal lesion measuring 2.4 cm x 2.0 cm x 0.8 cm was identified within a resected specimen measuring 4.5 cm x 4.5 cm x 1.5 cm. The lesion was located 0.8 cm from the anterior, posterior, and superior surfaces, 0.7 cm from the inferior surface, and 0.5 cm from the deep margin. Histologically, the lesion exhibited cellular atypia with invasion into underlying skeletal muscle bundles. Perineural and lymphovascular invasion were present. All surgical margins were free of invasive disease; however, moderate epithelial dysplasia was noted at the posterior margin and focal mild epithelial dysplasia was seen at the anterior margin. The remaining margins showed benign squamous mucosa without evidence of high-grade dysplasia or invasive disease.\n\nNeck dissection included levels I through IV. Of the 22 lymph nodes evaluated, one level I lymph node contained metastatic involvement measuring 1.5 mm within a 2.0 cm lymph node. Extracapsular extension was identified with tumor extending approximately 1.0 mm beyond the lymph node capsule. No other lymph node levels showed evidence of involvement.\n\nAdditional findings included hyperplastic squamous mucosa with lichenoid mucositis and scarring on the left buccal mucosa. Frozen section analysis of all margins confirmed absence of invasive disease at the time of surgery. No treatment effect was observed. Tumor thickness measured 0.8 mm from the ulcerated surface. The tumor exhibited an exophytic, endophytic, and ulcerated growth pattern."} +{"pid": "TCGA-FU-A3EO", "report": "The patient is female. A radical hysterectomy specimen was examined, which included the uterine corpus (measuring 4.0 cm in length by 2.8 x 2.0 cm), cervix (3.5 cm in length by 2.3 x 2.0 cm), vaginal cuff (1.5 cm in length), and paracervical soft tissues. A mass measuring 3.3 x 3.0 x 1.5 cm was identified in the cervix; it was described as pink-tan, fungating, and friable, approaching to within 0.5 cm of the vaginal cuff margin. On sectioning, the mass extended 1.0 cm into a 1.1 cm thick, pink-tan, fibrous, and focally cystic paracervix. The endometrium was thin, measuring on average 0.1 cm in thickness, and glistening. The myometrium was pink-tan and fibrous with an average thickness of 1.1 cm, with no nodules or lesions identified.\n\nThe right and left ovaries and fallopian tubes showed no significant pathologic abnormalities. The vaginal biopsy showed no evidence of malignancy, although one biopsy from the vaginal wall showed adenocarcinoma within the deep wall. The paracervical soft tissues were inked, and while the surgical margins were negative, tumor was found within the paracervical soft tissue on the left side and extended to the vaginal cuff margin.\n\nLymph node evaluation included left external iliac (3 nodes), left obturator (6 nodes), left common iliac (2 nodes), right external iliac (6 nodes), right obturator (2 nodes), and right common iliac (3 nodes). All lymph nodes examined were negative for metastatic disease. One possible lymph node was identified in the right paracervical soft tissue and was also negative.\n\nOther findings included a yellow-tan, fibrous cut surface in the right ovary with multiple gray-white corpora, and a yellow-gray, fibrous cut surface in the left ovary with multiple gray-white corpora albicantia. The uterine serosa, vaginal mucosa, endometrial tissue, and myometrial tissue all appeared normal without evidence of malignancy. The tumor was histologically classified as Grade II, well-differentiated. Based on the extent of invasion and spread, the case was staged as pT2b NO (FIGO IIB)."} +{"pid": "TCGA-CV-6962", "report": "The specimen from a total laryngectomy and partial pharyngectomy measured 8.5 x 8.0 x 4.5 cm and included the larynx, skin of the tracheostomy site, hyoid bone, and anterior soft tissue. A firm, infiltrating tan-white lesion measuring 4.2 x 3.2 x 1.1 cm was identified, extending from the base of the epiglottis to the subglottic region. The lesion involved the right true and false vocal cords, extended midline, and reached the left true and false vocal cords. It extended anteriorly into the pre-epiglottic space, approaching the adjacent hyoid bone and extending inferiorly into skeletal muscle. The tumor was found in vascular spaces at the submucosa near the excision margins, with the closest distance being less than 1 mm. Blood vessels at the right and left mucosal margins were invaded by the lesion, and although tumor cells were within 1 mm of the margin, no definitive presence was identified at the margin itself.\n\nAdditional specimens included fragments of thyroid tissue. The right thyroid measured 3.4 x 2.8 x 1.8 cm and contained a calcified cystic mass measuring 0.7 x 0.6 x 0.3 cm composed of hard gray-white material. The left thyroid measured 2.5 x 1.0 x 1.2 cm and showed fibrous changes without discrete lesions. Two fragments of neck skin were also submitted, measuring 6.1 x 2.0 x 0.5 cm and 7.2 x 1.5 x 0.5 cm, respectively, with no abnormal findings noted. Cartilage samples did not show any presence of the lesion. Multiple sections were taken for analysis, including representative sections of all relevant anatomical areas."} +{"pid": "TCGA-44-6145", "report": "The specimen included multiple lymph nodes from various levels and a right upper lobe lung resection. Lymph nodes from level 12, level 11, 2R, 4R, level 7, and level 8 were all assessed. The lymph nodes ranged in size from 1 cm to 2.5 x 3.5 x 0.4 cm and showed no evidence of malignancy upon microscopic examination. The right upper lobe specimen weighed 192 grams and measured 12.5 x 9.5 x 3 cm, with a contained subpleural mass measuring 2 cm in diameter. Histologic evaluation revealed a moderately to poorly differentiated tumor with a grade of 2\u20133 out of 3. The bronchial resection margin and pleura were negative for malignancy, and there was no vascular invasion identified. Staging was determined as pT1. Emphysema was noted in the non-tumorous lung tissue."} +{"pid": "TCGA-A6-5656", "report": "The specimen consists of a segment of sigmoid colon measuring 24 cm in length. One end is stapled and inked blue, while the opposite end is opened and inked black. A suture is noted on the serosal surface, located 7.5 cm from the black inked end. The serosa appears pink-tan, smooth, and glistening, with the remainder of the specimen partially covered in abundant yellow lobular fat. Upon opening the colon, the mucosa appears pink-tan and smooth with normal to abundant folds and an average circumference of 4.5 cm. Multiple diverticula are present.\n\nA lesion measuring 2.7 x 2.2 x 0.4 cm is identified at the level of the suture, 7.5 cm from the black inked end. Microscopic evaluation reveals cellular features consistent with moderately differentiated morphology invading into the muscularis propria without extension through it. Margins are negative for involvement. No vascular invasion is observed. Lymph nodes sampled from pericolonic fat (a total of sixteen) show no evidence of metastatic involvement. Sections submitted include margins, tumor transition zones, diverticula, and lymph node levels. No additional submucosal abnormalities or perforations are identified."} +{"pid": "TCGA-56-8201", "report": "A right upper lobectomy with chest wall resection was performed. The surgical specimen measured 18.3 cm (superior to inferior) x 12.5 cm (anterior to posterior) x 6.5 cm (medial to lateral), including three ribs. Within the superior aspect of the lung, there was a 4.9 x 4.7 x 4.5 cm infiltrative mass that grossly invaded through the pleura into the adjacent chest wall. The mass came within less than 0.1 cm of the superior soft tissue margin and was approximately 0.7 cm from the inferior soft tissue margin, 0.3 cm from the anterior soft tissue/rib margin, and 3.5 cm from the posterior soft tissue/rib margin. It also appeared to invade into the bone of the two superior-most ribs; however, the inferior-most rib was free of tumor involvement. The bronchial and vascular margins were at least 3.5 cm away from the mass.\n\nLymph nodes were sampled from multiple levels including R2, R4, L4, level 7, level 10, and level 11. All lymph node specimens showed no evidence of malignant involvement. Frozen section analysis of the bronchial margin and superior soft tissue margin was negative for malignancy.\n\nMargins evaluated included anterior, posterior, inferior, and lateral soft tissue margins, all of which were negative except for the superior chest wall soft tissue margin, which showed invasion within less than 0.1 cm. Pleural surface involvement was noted with extension into the chest wall skeletal muscle and rib bone. No lymphovascular space invasion was identified.\n\nAdditional findings included a benign fibrotic nodule in the right lower lobe measuring 0.1 x 0.6 x 0.2 cm. Sections of posterior soft tissue margins and rib margins were examined, and none showed evidence of malignancy.\n\nPathologic staging was determined as pT3 pN0 PL0."} +{"pid": "TCGA-5X-AA5U", "report": "A 40-year-old Black female with a history of pelvic pain and pelvic mass underwent bilateral salpingo-oophorectomy and omentectomy. Specimens were received in three containers labeled with the patient\u2019s name and medical record number.\n\nThe left ovary measured 9.5 x 8.5 x 2.5 cm, containing a papillary mass within a cyst measuring approximately 8.0 cm. The papillary lesion measured 4.0 x 3.5 cm and was attached to a section of firm white tissue measuring 8.0 x 5.0 cm.\n\nThe right ovary measured 14.5 x 7.5 x 2.5 cm and was cystic upon opening. Within the cyst was a papillary lesion measuring 3.0 x 2.5 cm. Additional cystic areas were identified, including one measuring 4.0 x 2.0 x 2.0 cm containing brown fluid and necrotic material. A separate section measured 4.5 x 1.0 cm.\n\nThe omentum specimen measured 25.0 x 8.0 x 2.0 cm and contained multiple small sections with hemorrhage and firm tissue; no malignant involvement was identified.\n\nMicroscopic examination revealed high-grade malignant tumor with papillary architecture involving both ovaries. The ovarian capsules were intact bilaterally. No fallopian tubes were histologically identified. Sections from all representative blocks were submitted for analysis.\n\nStaging was based on FIGO criteria and indicated tumor limited to both ovaries with intact capsules and no tumor on ovarian surface. Ascites or peritoneal washings did not show malignant cells. Lymph node sampling was not performed, thus regional lymph node involvement could not be assessed.\n\nPathologist comment noted significant bilateral ovarian involvement by tumor with intact capsules, suggestive of synchronous tumors, although metastatic disease could not be definitively excluded."} +{"pid": "TCGA-HW-7490", "report": "The clinical history includes a prior diagnosis of thyroid carcinoma and current presentation for resection of a left occipital lesion. Two specimens were submitted: a biopsy and a resection specimen from the left occipital region.\n\nMicroscopic evaluation of the biopsy revealed a diffusely infiltrating glial neoplasm with astrocytic features. The tumor cells demonstrated fibrillary cytoplasmic processes that labeled strongly for GFAP. Nuclear p53 expression was present in a subset of tumor cells. Although some oligodendroglial-like features were noted, the overall morphology remained consistent with an astrocytic neoplasm. Immunostaining for R132H mutant IDH1 was positive, while the Mib-1 (Ki-67) labeling index was low, not exceeding 2%. Additional studies are being performed including cytogenetic analysis for 1p/19q status and molecular testing for IDH and MGMT.\n\nThe first specimen, labeled as a biopsy, consisted of tan-red soft tissue measuring 1 x 0.5 x 0.3 cm and was entirely submitted for frozen section. The second specimen, a resection sample, measured 3.5 x 2.5 x 1.5 cm and was also entirely submitted for analysis.\n\nSections from the biopsy were processed as frozen control (FSC), with one block and one section evaluated. In the resection specimen, five blocks were processed, all undesignated, with five sections examined. Intraoperative frozen section diagnosis was consistent with the final histopathological findings.\n\nAll diagnostic conclusions were based on direct examination of the specimens. Special immunohistochemical stains performed included IDH1-H09, p53, GFAP, and Mib-1 (Ki-67). Recuts and negative controls were used to ensure accuracy."} +{"pid": "TCGA-BT-A42F", "report": "A radical cystoprostatectomy specimen involved the posterior bladder wall. The lesion measured 0.8 cm in greatest dimension and also measured 0.4 cm in another dimension. Histologic examination revealed high-grade cells with squamous differentiation arranged in an ulcerated configuration. The tumor infiltrated through the detrusor muscle into adjacent prostatic stroma. Surgical margins showed no involvement by invasive disease. Lymphovascular invasion could not be definitively determined. Eleven lymph nodes were examined; one right pelvic lymph node contained metastatic involvement while the remaining ten nodes showed no evidence of involvement. Additional findings included inflammatory changes involving both ureters, with chronic and focal acute inflammation identified. The distal urethral biopsy showed benign fibromuscular tissue without neoplastic elements. Adjacent prostate tissue demonstrated patchy inflammation with reactive changes and focal pre-neoplastic alterations. Immunohistochemical stains showed positivity for thrombomodulin and p63 while markers including CK20, CK7, CK5/6, PSA, and AR were negative."} +{"pid": "TCGA-E2-A1LI", "report": "The specimen consisted of two sentinel lymph nodes from the left axilla and a wide local excision from the left breast. The first lymph node measured 1.0 x 0.8 x 0.5 cm and was entirely submitted for analysis; no abnormal cellular infiltration was observed. The second lymph node measured 0.7 x 0.5 x 0.4 cm and was similarly processed with no evidence of atypical cells identified.\n\nThe breast specimen measured 6.0 x 5.5 x 2.7 cm and contained a well-circumscribed tan nodular lesion measuring 2.5 x 1.8 x 1.0 cm. Microscopic evaluation revealed an invasive ductal component with extensive necrosis and high-grade nuclear features. The tumor exhibited a Scarff Bloom Richardson grade of III, with a histologic grade of 3 and nuclear grade of 3. Mitotic figures were noted at a rate of 3 per high power field. No vascular or lymphatic invasion was identified.\n\nA ductal in-situ component was also present, comprising less than 25% of the overall lesion. It demonstrated a clinging growth pattern and was located diffusely outside the main mass. The in-situ component showed high nuclear grade without necrosis. Evaluation of surgical margins revealed presence of in-situ component within 1 high power field of the lateral margin and within 1 mm of both the deep and medial margins.\n\nLymph node evaluation showed no involvement, with both sentinel nodes being negative (0/2). Pathologic staging was determined as T2N1. Immunohistochemical staining revealed absence of estrogen and progesterone receptor expression (ER 0%, PR 0%). HER2 immunostaining demonstrated a score of 2.3, considered borderline; however, fluorescence in situ hybridization (FISH) analysis showed no gene amplification with a Her-2/neu to CEP17 ratio of 1.21.\n\nRepresentative tissue sections were submitted for further analysis and evaluation."} +{"pid": "TCGA-06-0219", "report": "The surgical specimens were obtained from the right temporal lobe and an unspecified brain site. Specimen A measured 1 cm in greatest dimension and showed a tan-brown soft tissue fragment. Microscopic examination revealed cerebral cortex with moderately increased cellularity, characterized by small round and elongated hyperchromatic nuclei arranged around vessels. These cells exhibited an astrocytic phenotype without evidence of mitoses, microvascular proliferation, or necrosis.\n\nSpecimen B measured 5 x 4 cm and was described as a pale white oval tissue fragment with a variegated papillary appearance on the resected surface. Histologically, the white matter contained a neoplastic glial proliferation with moderate nuclear pleomorphism infiltrating the cerebral cortex. Around vessels, nests of fibrillary astrocytes were present, and focal accumulations were noted at the pial-glial interface. Rare nests of neoplastic cells were identified within the leptomeningeal space. No mitotic figures, microvascular proliferation, or necrosis were observed. Immunostaining for MIB-1 demonstrated a proliferation index of 1.5% in this specimen.\n\nSpecimen C consisted of four irregular tan-white fragments measuring 3\u20135 mm. Histologic evaluation revealed a glial neoplasm with features similar to previous specimens but with increased cellularity in focal areas. This region exhibited microvascular proliferation, including one vessel with necrosis and thrombosis, accompanied by surrounding tumor necrosis and pseudopalisading. A single mitotic figure was identified. MIB-1 staining in this specimen showed a proliferation index of 98.\n\nThe findings across specimens indicate varying histological features, with low-grade characteristics in specimens A and B, and high-grade morphological changes in specimen C. The latter includes microvascular proliferation, necrosis, and mitotic activity. Due to the limited size of specimen C, interpretation is cautious and should be correlated with clinical and imaging findings for comprehensive assessment."} +{"pid": "TCGA-BL-A13I", "report": "The specimen included right and left ureters, a urethral margin biopsy, a bladder with attached uterus and bilateral adnexa, left and right pelvic lymph nodes, and an appendix. The right ureter specimen measured 0.3 cm in length and was entirely frozen for sectioning. The left ureter measured 0.3 x 0.3 x 0.2 cm and was also entirely frozen. The urethral margin biopsy measured 1.2 x 1 x 0.2 cm and was submitted for frozen section analysis. The bladder specimen showed a red mass located on the superior posterior right side measuring approximately 2 x 1.2 x 2 cm. The uterus measured 7 x 4 x 2 cm, and the right and left ovaries were tan-white measuring 4.2 x 1 x 0.2 cm and 3.5 x 1 x 0.4 cm, respectively. The right and left uterine tubes measured 7 cm and 8 cm in length, respectively, with diameters of 0.3 cm each. A polyp was identified in the high endocervical canal measuring 0.5 x 0.3 x 0.3 cm. The ectocervix measured 2.7 x 3 cm with an external os of 0.2 x <0.1 cm. A vaginal cuff tissue measuring 6 x 3.5 cm was also present.\n\nMicroscopic evaluation of the right and left ureters and the urethral margin showed no evidence of malignancy. The tumor was classified as high grade based on histological features, with a size of 2 cm and a mitotic count of 30 per 10 high-power fields. No vascular or perineural invasion was identified. The tumor was found to extend through the muscularis propria into the surrounding soft tissue. Sections of the uterus revealed a benign endocervical polyp, and the ovaries, uterine tubes, and vaginal cuff showed no abnormal findings. Immunostaining results were inconclusive, showing weak MART-1 staining, negative HMB-45, and equivocal S-100 findings. No evidence of malignancy was found in 7 left pelvic lymph nodes or 5 right pelvic lymph nodes. Evaluation of the appendix showed fibrous obliteration of the lumen without signs of malignancy."} +{"pid": "TCGA-D1-A177", "report": "A hysterectomy with bilateral salpingo-oophorectomy was performed. A mass measuring 5.0 x 3.8 x 3.2 cm was identified in the dome of the uterine wall. Microscopic evaluation showed that the lesion extended 1.3 cm into the myometrium, with a total myometrial thickness of 1.4 cm. There was no involvement of the endocervix, and no lymphovascular space invasion was observed. Surgical margins were free of abnormal cells. The bilateral ovaries and fallopian tubes showed no abnormalities.\n\nLymph node assessment included right pelvic lymphadenectomy with 28 lymph nodes, left pelvic lymphadenectomy with 17 lymph nodes, right peri-aortic lymphadenectomy below the inferior mesenteric artery with 7 lymph nodes, right peri-aortic above the inferior mesenteric artery with 3 lymph nodes, left peri-aortic below the inferior mesenteric artery with 3 lymph nodes, and left peri-aortic above the inferior mesenteric artery with 2 lymph nodes\u2014all were negative for abnormal cells.\n\nImmunohistochemical analysis of the uterine specimen showed positivity for estrogen receptor with 51\u201375% nuclear staining and positivity for progesterone receptor with 26\u201350% nuclear staining. Testing was conducted using validated methods and controls.\n\nGross examination of the uterus revealed a mass in the endometrial cavity measuring 5.0 x 3.8 x 3.2 cm, with apparent myometrial extension up to 1.4 cm in a total wall thickness of 1.5 cm. Both ovaries and fallopian tubes appeared unremarkable on gross inspection. All surgical specimens were processed and reviewed using standard histologic techniques, including permanent hematoxylin and eosin sections. Final staging was determined as pT1bNO based on available material."} +{"pid": "TCGA-B2-4101", "report": "The left kidney specimen from a radical nephrectomy measures 24 x 14 x 6.5 cm, with the kidney itself measuring 12 x 11 cm in cross-section. A central yellow and tan mass is present, measuring approximately 9.5 x 7.5 x 4.5 cm. The adrenal gland is included in the specimen. Sections were taken from the tumor, adjacent normal kidney tissue, and resection margins.\n\nMicroscopic evaluation shows a tumor composed predominantly of cells with clear cytoplasm. Nuclear grading is mostly consistent with lower grades, although areas of higher nuclear grade are identified in one block. The tumor measures 9.5 cm in greatest dimension. There is no involvement of the renal capsule, renal sinus, or hilar margins. No vascular invasion is identified. The adrenal gland appears histologically normal. Distant from the tumor, there is evidence of focal chronic interstitial inflammation in the kidney. Staging is classified as T2a based on tumor size and extent."} +{"pid": "TCGA-CN-4730", "report": "The specimen was received in eleven parts. A mass measuring 2.5 cm in greatest dimension was identified on the floor of the mouth, involving the lingual surface of the mandible. Histologic evaluation revealed a moderately differentiated tumor with associated acute abscess formation. Surgical margins, including bone, were free of tumor involvement. One lymph node out of ten examined from the left neck level showed evidence of involvement; no extranodal spread was observed. Twenty-four lymph nodes from levels 2 and 3 of the left neck were benign. Additional biopsies from various sites including the floor of the mouth, gingiva, tonsillar pillar, retromolar trigone, deep and superficial margins showed no evidence of tumor. The submandibular gland demonstrated no specific pathologic changes. No perineural or vascular invasion was identified. Inflammatory changes, both acute and chronic, were noted at several sites. A total of 37 regional lymph nodes were examined, with one showing involvement. The pathologic staging was determined as pT4aN1Mx. Immunohistochemical staining for p16 was negative. All other tissue margins and sampled areas were unremarkable."} +{"pid": "TCGA-77-6842", "report": "The left pneumonectomy specimen measures 300 x 290 x 58 mm in the inflated state. An area of adhesion is noted between the upper and lower lobes across the oblique fissure, with otherwise normal pleura. A well-circumscribed, firm grey mass measuring 62 mm in maximum dimension is located in the upper lobe, 25 mm from the resection margin. The mass extends across the oblique fissure into the lower lobe and approaches the external pleural margin but appears clear of it. Central necrosis and cavitation are present within the lesion. Several lymph nodes near the medial aspect of the specimen show pale discoloration, suggesting possible direct invasion. Adjacent lung tissue demonstrates mild centri-acinar emphysema. Distal to the mass in the lower lobe, yellow discoloration is observed, consistent with lipoid pneumonia.\n\nMicroscopic examination reveals a poorly differentiated carcinoma with squamous features. The tumor exhibits central necrosis and invades across the oblique fissure, involving both lobes. Vascular invasion is identified, along with involvement of an intrapulmonary peribronchial lymph node. The bronchial resection margin is free of tumor. Lung tissue distal to the mass shows patchy organizing pneumonia and endogenous lipid pneumonia with intra-alveolar foamy macrophages.\n\nTwo hilar lymph nodes (number 5) are received, measuring 20 x 10 x 3 mm in total. Microscopically, no malignancy is found. The connective tissue contains fibrotic nodules consistent with silicotic changes, likely within an obliterated node.\n\nThree mediastinal lymph nodes (number 7), measuring 12 x 12 x 3 mm in aggregate, also show no evidence of malignancy on microscopic evaluation.\n\nPathological findings include blood vessel invasion, pleural involvement, and a tumor size of 62 mm. The bronchial resection margin is negative. Lymph node involvement is present in a peribronchial node, while hilar and mediastinal lymph nodes are free of tumor. The pathological stage is T2N1MX."} +{"pid": "TCGA-HT-7690", "report": "The pathology report describes a glial neoplasm that is mildly to markedly hypercellular on microscopic examination. The tumor demonstrates diffuse infiltration of both gray and white matter. The neoplastic cells exhibit a range from microgemistocytic to ordinary gemistocytic forms, with many displaying round nuclei and prominent perinuclear halos. Moderate nuclear atypia is present. There is no evidence of microvascular proliferation or necrosis. Mitotic activity is notable, with up to nine mitoses observed in ten high power fields."} +{"pid": "TCGA-BH-A1EW", "report": "A left breast biopsy and segmental mastectomy were performed with needle localization. Submitted material included a segment of breast tissue measuring 11.0 by 5.0 by 4.5 cm, which contained a 3.0 by 2.2 by 3.2 cm lesion. The superior margin was grossly positive, while all other margins were free of involvement. An additional firm area located immediately inferior to the main lesion measured approximately 0.7 by 0.5 by 0.3 cm. A separate specimen from the new superior margin, measuring 1.0 by 8.5 by 1.3 cm, showed no evidence of tumor involvement and surgical clips were used to mark the true margin.\n\nMicroscopic evaluation revealed infiltrating moderately differentiated ductal carcinoma, with a focus of intraductal carcinoma accounting for approximately 10% of the total tumor volume. The largest dimension of the invasive component measured 3.2 cm, and the intraductal component measured 0.7 cm. Nottingham histologic grade was 7 (scored as 2/3 for tubule formation, 3/3 for nuclear atypia, and 2/3 for mitotic index). Tumor-associated microcalcifications were also identified. The infiltrating carcinoma was found within less than 1 mm of the inked superior and deep margins.\n\nImmunohistochemical analysis was performed on block \"A1\". Estrogen receptor staining showed distinct intranuclear positivity in 90% of cells, interpreted as positive. Progesterone receptor staining was negative. HER-2/neu immunostain demonstrated only rare complete membrane staining in 5\u201310% of cells, interpreted as score 1+, and therefore negative."} +{"pid": "TCGA-AC-A3YI", "report": "The lumpectomy specimen measured 5.4 x 4.3 x 2.3 cm and demonstrated a single focus of invasive carcinoma measuring 1.8 cm in greatest dimension. The tumor was located closest to the inferior margin at 0.5 cm, 0.8 cm from the medial margin, and at least 1 cm from all other margins. Histologic evaluation revealed features consistent with Nottingham grade 1-2 morphology. Three separate foci of atypical hyperplasia were identified: one ductal and two lobular.\n\nAxillary lymph node evaluation included sentinel lymph node biopsy followed by lymph node dissection. A total of thirteen lymph nodes were examined, twelve of which contained metastatic carcinoma. All three sentinel lymph nodes showed metastases. The largest metastatic deposit measured 1.1 cm. Extranodal extension was present in at least five lymph nodes, with the largest focus measuring up to 0.5 cm. One sentinel lymph node showed histologic evidence of prior biopsy.\n\nStaging parameters indicated a primary tumor size of 1.8 cm (pT1c). Regional lymph node involvement was classified as pN3a due to the presence of metastases in more than ten nodes. No distant metastases were identified. Lymphovascular invasion could not be definitively assessed and was classified as indeterminate. Surgical margins were negative for tumor involvement.\n\nImmunohistochemical analysis demonstrated strong estrogen receptor positivity (98%), moderate progesterone receptor expression (25%), and equivocal Her2/neu staining (IHC 1+). The Ki-67 proliferative index was 15%. Microscopic examination confirmed absence of ductal or lobular carcinoma in situ. Skeletal muscle was not involved.\n\nGross examination of the lumpectomy specimen revealed a partially demarcated tumor mass within fibrofatty tissue. Margins were inked with distinct colors for orientation. Multiple tissue blocks were submitted for analysis, including margin assessments. The axillary lymph node specimens varied in size from 0.2 to 0.9 cm. All lymph node candidates underwent complete histologic evaluation. Controls for immunohistochemical staining were appropriate and verified."} +{"pid": "TCGA-O2-A52W", "report": "A total of five lymph node specimens were examined. Lymph node 2R measured 0.4 x 0.4 x 0.3 cm and was composed of tan tissue. Level 3 lymph node measured 0.5 x 0.4 x 0.2 cm and was tan-pink; an additional small fragment (0.2 x 0.1 x 0.1 cm) of tan-gray tissue was also submitted. The 4R lymph node was a 0.9 x 0.4 x 0.4 cm aggregate of tan-gray and black tissue. The 4L lymph node measured 0.4 x 0.4 x 0.3 cm and was tan-pink. The level 7 lymph node was a 0.8 x 0.5 x 0.3 cm aggregate of black and red tissue, with an additional 0.4 x 0.3 x 0.2 cm red and black aggregate. All lymph nodes were negative for malignancy on intraoperative consultation and microscopic evaluation.\n\nA lobectomy specimen from the right lower and middle lobe of the lung weighed 480 grams and measured 20 x 17 x 8.2 cm. A central necrotic mass measuring 4.7 x 4.7 x 2.2 cm was identified, located 5.3 cm from the bronchial margin and adjacent to an area of pleural retraction and discoloration. The remaining lung tissue showed moderate emphysematous change. No tumor was identified in the bronchial margin. Microscopic evaluation revealed a moderately differentiated squamous cell carcinoma with a maximum tumor diameter of 5 cm. The tumor did not involve the mainstem bronchus, visceral pleura, chest wall, or mediastinum. No vascular invasion was noted at the margins, which included bronchial, vascular, parenchymal, and pleural. Vascular invasion was present within the tumor. No additional tumor nodules or panlobar atelectasis was identified. Six peribronchial lymph nodes were free of malignancy. Emphysematous changes were also noted. A silicotic nodule was identified in one lymph node specimen. All other lymph node biopsies showed no evidence of malignancy."} +{"pid": "TCGA-DB-5275", "report": "The specimen consisted of excised tissue from the right temporal lobe and a separate right temporal mass. The right temporal lobe measured 3.4 x 2.3 x 0.8 cm, while the mass was submitted in two parts: one measuring 4.7 x 3.6 x 1.1 cm and another measuring 6.0 x 6.0 x 2.5 cm.\n\nHistologic evaluation of the right temporal lobe showed no evidence of abnormal cellular proliferation. The right temporal mass demonstrated a diffuse glioma. Cellular morphology indicated a high-grade process. Final classification and grading were deferred pending additional studies.\n\nFluorescence in situ hybridization (FISH) analysis was performed on paraffin-embedded sections from the mass to assess for deletions in chromosomal regions 1p and 19q. Two separate hybridizations were carried out: one using a 19q probe paired with a 19p control, and another using a 1p probe paired with a 1q control. These probes target regions frequently involved in deletions seen in gliomas.\n\nThe 19q to 19p probe signal ratio was 0.56, below the normal reference range of approximately 1. Ratios below 0.80 are considered consistent with deletion of the corresponding chromosomal arm. In this case, the low ratio suggests relative loss of 19q. Approximately 90% of the cells showed 2 copies of the 19q probe and 3\u20134 copies of the 19p probe, which supports the presence of a relative deletion in 19q. For the 1p and 1q probes, the ratio was 1.02, within the normal range; however, about 80% of the cells showed 3\u20134 copies of both probes, a finding that has been associated with aneuploidy or polyploidy in gliomas.\n\nThis FISH assay was developed and validated by the laboratory as an investigational tool. It is not cleared or approved by the U.S. Food and Drug Administration and is intended to be used in conjunction with other clinical and pathological data. The test does not exclude the presence of other chromosomal anomalies.\n\nA preliminary intraoperative frozen section consultation was performed and found the right temporal lobe tissue to be negative for neoplastic cells. The right temporal mass was identified as a diffuse glioma, and further classification and grading were held pending ancillary study results."} +{"pid": "TCGA-N5-A4RN", "report": "The submitted specimens include a biopsy of the anterior abdominal wall, a hysterectomy specimen with cervix, bilateral fallopian tubes and ovaries, excision of a small bowel adhesion, biopsy of the left pelvic peritoneum, excision of a sigmoid adhesion, and lymph nodes from sentinel right hypogastric, sentinel left external iliac, and left obturator regions, as well as omentectomy tissue.\n\nHistologic examination of the hysterectomy specimen reveals a tumor with multiple components, including areas resembling small cell carcinoma and adenosarcoma. The tumor infiltrates the myometrium with a depth of invasion measuring 5 mm; the myometrial thickness at this location is 18 mm. No endocervical involvement is identified. Lymphovascular space invasion is present and extensive. The endometrium shows atrophic changes and the presence of a polyp. The myometrium exhibits adenomyosis and multiple leiomyomata. The adnexal structures are unremarkable. Immunohistochemical staining demonstrates positivity for synaptophysin and chromogranin, supporting the presence of a neuroendocrine component within the tumor.\n\nThe sentinel left external iliac lymph node contains abnormal cells consistent with metastatic involvement. One out of one lymph node examined in this region shows evidence of disease. In contrast, the sentinel right hypogastric and left obturator lymph nodes do not show any malignant involvement; six lymph nodes were evaluated in the latter group.\n\nThe omentum appears benign without evidence of tumor involvement. Acute inflammatory changes are observed in the tissues removed from the small bowel and sigmoid adhesions. The left pelvic peritoneal biopsy also reveals benign fibroadipose tissue with reactive mesothelial alterations."} +{"pid": "TCGA-86-8673", "report": "The lung lobe specimen measures 23 x 12 cm. A subpleural lesion is present, approximately 8 cm in greatest dimension, with a grey-yellow appearance and areas of focal necrosis. Histologically, the lesion shows well-differentiated features. The extent of the tumor is localized, and no lymph node metastases were identified in the six nodes examined, including bronchopulmonary, bifurcational, and aortic window regions. No venous invasion is noted, and surgical margins are uninvolved. Additional findings include follicular hyperplasia and anthracosis in the lymph nodes. The histologic type and other tumor features are not fully defined in the available report."} +{"pid": "TCGA-B2-5641", "report": "The left kidney specimen, including surrounding adipose tissue, measures 21 x 14 x 7 cm overall. The kidney itself measures approximately 11.7 x 7 x 5 cm. A well-circumscribed, red-colored lesion measuring up to 4 cm in diameter is identified at one pole. Sections of the lesion were taken for further analysis. Microscopic evaluation reveals a tumor composed predominantly of clear cells with nuclear features corresponding to Fuhrman grade 3. The tumor measures 4 cm in greatest dimension and does not involve the renal capsule, renal sinus, or hilar margins. No vascular invasion is observed. Adjacent kidney tissue appears histologically normal. Based on these findings, the pathological staging is T1a."} +{"pid": "TCGA-3B-A9HL", "report": "A right colonic mesenteric nodule measuring 2.8 x 2 x 1 cm was received, described as pale yellow and soft with a homogeneous cut surface. No necrosis or hemorrhage was identified. A second right colonic mesenteric nodule measuring 2.5 cm in greatest dimension was also received; it was rubbery, encapsulated, and showed a similar tan-yellow homogeneous appearance.\n\nA large retroperitoneal mass measuring 18 x 14 x 10.5 cm and weighing 1900 grams was resected along with the right kidney and a portion of the psoas muscle. The tumor was lobulated, rubbery, and partially covered by focally hemorrhagic peritoneum. On sectioning, it showed a variegated cut surface with areas of pale yellow lobulation and pink-tan whorled regions, with multiple small foci of necrosis accounting for less than 10% of the total volume. The tumor extended to within 1 cm of the distal ureteral margin and was focally positive at the resection margin. Adjacent skeletal muscle appeared benign. The associated kidney showed a subcapsular cyst, nephrosclerosis, and focal interstitial fibrosis. The renal pelvis was dilated with erythematous urothelium, but no tumor involvement was seen in the renal vasculature or ureter.\n\nA separate right retroperitoneal lateral margin specimen measured 12 x 9 x 2 cm and contained a 1 cm subserosal nodule located 0.5 cm from the closest resection margin. The remainder of the tissue was composed of adipose tissue without other remarkable findings.\n\nPosterior retroperitoneal tissue consisted of five fragments of adipose tissue ranging from 1 to 3 cm, all without gross abnormalities. Left periaortic specimens included two nodules: one smaller (4 cm) and one larger (6 cm), both rubbery and encapsulated. The larger nodule demonstrated a Ki-67 proliferation index of approximately 25% on immunostain. Neither nodule contained identifiable lymph node structures.\n\nAll surgical margins were assessed microscopically, with only the main retroperitoneal mass showing focal positivity. All other margins and submitted lymph nodes were negative for malignancy."} +{"pid": "TCGA-22-5492", "report": "The specimen consists of a 4.5 x 4 x 3 cm lesion located in the left upper lobe, involving both the bronchus and the parenchymal hilar region. The tumor is invasive with high-grade nuclear features and extends close to the bronchial margin, where there is extensive involvement by in situ\u75c5\u53d8. The pleura is retracted but not infiltrated. Adjacent lung tissue shows changes consistent with obstructive pneumonia.\n\nEvaluation of lymph nodes reveals involvement in multiple intrapulmonary peribronchial nodes (6 of 14 positive), as well as metastatic involvement in aortopulmonary (2 of 2) and anterior mediastinal (1 of 2) lymph nodes. Additional lymph node groups including right and left lower paratracheal, subcarinal, inferior pulmonary ligament, and fissure regions were negative for tumor involvement."} +{"pid": "TCGA-A6-6142", "report": "The specimen includes a liver lesion, a para-aortic lymph node, and a segment of rectosigmoid colon. The liver lesion is described as tan, measuring 0.8 x 0.3 x 0 cm, and rubbery in consistency. The para-aortic lymph node measures 1.2 x 0.8 x 0.3 cm, with a rubbery tan-pink appearance and is entirely submitted in one block. The colon specimen is a 22 cm segment with smooth serosa and scabrous adventitia. An area of interest within the colon shows a circumferential mass measuring 7.8 x 4.6 cm, centrally necrotic with raised rolled edges, located 5.5 cm from the distal margin. The tumor extends into the muscularis propria to within 0.2 cm of the radial serosal surface but remains more than 5 cm from the adventitial margins.\n\nHistologically, the tumor demonstrates moderate to poor differentiation. It invades through the muscularis propria into the subserosa (pT3). Both proximal and distal margins are free of tumor involvement, as is the circumferential margin. Lymphatic space invasion is noted, particularly in specific blocks, though no large vessel invasion is observed. Of 37 lymph nodes examined, one contains metastatic involvement measuring 2 mm in diameter (pN1a). No pericolonic tumor deposits are identified. Distant metastasis is confirmed in the liver biopsy. The para-aortic lymph node does not show evidence of malignancy. Background colonic mucosa appears otherwise unremarkable."} +{"pid": "TCGA-EM-A2CM", "report": "The specimen received includes a left hemithyroidectomy with an upper mediastinal component, along with lymph node samples from left levels 2 and 6. The thyroid specimen measures 9.6 cm in greatest dimension and is described as unifocal, located in the left lobe. Histologically, the lesion demonstrates poorly differentiated features with insular components. The tumor is classified as G3 and is partially encapsulated with evidence of capsular invasion. Lymphovascular invasion is present but limited to fewer than four vessels. Margins are free of involvement. No perineural invasion or extrathyroidal extension is observed. A total of three lymph nodes were examined\u2014none show evidence of metastatic involvement. The staging is based on AJCC/UICC TNM 7th Edition criteria and indicates no regional lymph node involvement. The gross description details a well-circumscribed nodule with fibrous septation, hemorrhage, and cystic changes measuring up to 2.0 cm. Representative sections of the nodule have been submitted for analysis."} +{"pid": "TCGA-FY-A3I5", "report": "The specimen consisted of multiple tissue fragments from the right and left thyroid lobes, isthmus, and various lymph node regions. The right thyroid lobe measured 5.7 x 3.0 x 3.5 cm and contained a dominant nodule measuring 4.5 x 3.0 x 3.0 cm with a firm, tan, glistening, and focally hemorrhagic cut surface. Within this nodule was a 0.6 cm firm, white-tan fibrous area. A thin fibrous capsule was present in areas adjacent to the outer surface. Five additional nodules were identified at the lower pole, ranging in appearance from tan and glistening to those with focal hemorrhage and calcification. These nodules involved over 90% of the right lobe, leaving minimal uninvolved dark red-brown parenchyma. Attached to the lower pole was a 2.5 x 2.0 x 0.7 cm segment of tan-yellow fibroadipose tissue containing multiple lymph node candidates up to 0.8 cm. Eighteen sections were submitted for microscopic evaluation.\n\nA separate right periesophageal lymph node specimen included four tissue fragments with three lymph node candidates up to 0.3 cm. All were submitted for evaluation.\n\nThe left thyroid lobe measured 5.0 x 3.0 x 2.3 cm and showed a multinodular pattern with 8\u201310 nodules ranging from 0.3 to 1.5 cm. The largest nodule, located in the upper pole, was white-yellow with focal calcification. A second smaller nodule with similar features was found in the lower pole, while the remaining nodules were pale pink-tan and soft. Minimal uninvolved parenchyma was present in the lower pole (less than 5% of total tissue). Six sections were submitted for analysis.\n\nAn anterior compartment specimen included a small fragment of adipose tissue with a single lymph node candidate measuring 0.5 cm in greatest dimension, which was entirely submitted for examination.\n\nMicroscopic evaluation of all specimens was performed. The surgical margins were negative in both lobes. The larger nodule in the right lobe demonstrated partial encapsulation. No lymphovascular space invasion or extrathyroidal extension was identified. In the right lobe, nine level 6 lymph nodes were examined and found to be negative. In the right periesophageal region, three lymph nodes were also negative. The single lymph node from the anterior compartment was negative as well.\n\nAdditional findings included lymphocytic thyroiditis in both lobes and the presence of parathyroid tissue in the left lobe."} +{"pid": "TCGA-55-7726", "report": "A left lower lobectomy was performed. The specimen included lymph nodes labeled L9, L10, and L7, along with the resected left lower lobe of the lung. The L9 lymph node measured 0.8 x 0.8 x 0.3 cm and contained a 0.3 cm gray-tan nodule. The left lower lobe specimen weighed 130 grams and measured 13.2 x 10.8 x 5 cm. A 2.9 x 2.4 x 1.3 cm firm, tan-gray mass was identified within the superior segment, located 1.5 cm from the bronchial resection margin. The overlying pleura was not penetrated, though there was some surface puckering. The bronchial and vascular margins appeared unremarkable on gross examination. Additional lymph nodes were submitted: L10 measured 1.2 x 0.8 x 0.3 cm with a tan-yellow appearance, and L7 measured 0.6 x 0.3 x 0.2 cm with a gray-black color. All were bisected for evaluation.\n\nFrozen section analysis confirmed that the bronchial margin was free of malignant involvement. Microscopic examination revealed a poorly differentiated tumor measuring 2.9 cm in greatest dimension. There was evidence of intralymphatic invasion; however, both bronchial and vascular margins were negative for malignancy. Adjacent lung tissue away from the lesion showed no additional abnormalities but demonstrated scarring associated with the lesion. All three lymph nodes examined were negative for metastatic involvement. Visceral pleural invasion was not observed. Based on AJCC 7th edition staging criteria, this corresponded to pT1b pNO Stage IA. No treatment effect was noted. The tumor was solitary and histologically consistent throughout the specimen."} +{"pid": "TCGA-DE-A4M9", "report": "The surgical specimen consists of the right thyroid lobe and isthmus. The dominant lesion is located in the right lobe and measures 3.0 cm in greatest dimension, with a second smaller focus measuring 0.3 cm identified in the grossly normal gland. The larger lesion is firm, gray-white, well-circumscribed, and smooth with focal areas of hemorrhage. Histologic evaluation reveals growth patterns consistent with follicular and solid architecture. The lesion is not encapsulated and shows vascular invasion in sections A6, A12, and A18. No capsular invasion or extra-thyroidal extension is identified. Surgical margins are focally positive at the anterior aspect (sections A9 and A10) with the closest distance being less than 1 mm to the posterior margin (section A18). Adjacent thyroid tissue demonstrates nodular hyperplasia. No lymph nodes are present in the specimen. Pathologic staging is pT2 pNx pMx. The specimen was initially mislabeled as a total thyroidectomy but has been corrected to reflect a right lobe and isthmus resection. All tissue from the dominant lesion was submitted for analysis (blocks A1\u2013A18), along with representative sections from the remaining right lobe and isthmus (blocks A19\u2013A22). The revised assessment confirms the original findings regarding tumor location, size, invasion, and margin status."} +{"pid": "TCGA-A2-A0YE", "report": "A lumpectomy specimen from the right breast was submitted, measuring 4.7 cm in greatest dimension. Histologic evaluation revealed a poorly differentiated ductal adenocarcinoma with high-grade features (Grade 3). The tumor measured approximately 47 mm in its greatest dimension and focally involved the lateral surgical margin, with the nearest margin distance approximately 1 mm at the lateral edge. All other margins were free of involvement. An associated fibroadenoma was also identified.\n\nSentinel lymph node biopsy was performed. Sentinel lymph nodes #1 and #2 showed no evidence of malignancy. Sentinel lymph node #3 demonstrated metastatic involvement by poorly differentiated ductal adenocarcinoma, involving approximately 40% of the node without extracapsular extension. Sentinel lymph node #4 was deferred for permanent section evaluation. Additional axillary lymph node dissection yielded fifteen reactive lymph nodes without evidence of metastasis.\n\nImmunohistochemical staining for estrogen and progesterone receptors showed negative results (0%) in the malignant cells. HER2 testing was performed by IHC on the primary specimen.\n\nThe tumor was classified as T2 N1 MX, Stage IIB. A separate prognostic profile was ordered for further evaluation."} +{"pid": "TCGA-EY-A215", "report": "The surgical pathology report describes findings from a hysterectomy with left salpingo-oophorectomy, along with lymph node removal. The specimen involved the uterus, cervix, left fallopian tube, and ovary. Tissue involvement was noted in the endometrium of the anterior and posterior corpus, fundus, and lower uterine segments. Histologic evaluation showed a growth pattern involving inner myometrial layers, with invasion limited to the inner half of the myometrium. The depth of invasion was measured at 4 mm, with a wall thickness of 1.2 cm, representing approximately 33% penetration. Involvement of the lower uterine segment was also present, with 1 mm of myometrial invasion on the posterior side. No cervical or adnexal involvement was identified.\n\nLymphovascular space invasion was observed in multiple sections. A total of 21 regional lymph nodes were examined, and none showed evidence of metastatic disease. The lymph node assessment included right and left pelvic nodes, as well as right and left periaortic nodes. All nodes were negative for malignancy.\n\nAdditional findings included a nabothian cyst and chronic cervicitis in the cervix. The left ovary was atrophic with surface inclusion glands, and the left fallopian tube showed hydrosalpinx, prior tubal ligation, and peritubal cysts. No malignancy was identified in these structures.\n\nImmunohistochemical analysis showed positive staining for estrogen and progesterone receptors, with high percentage expression. Staging was determined using both AJCC and FIGO systems. Based on the extent of local invasion and absence of nodal spread, the pathologic stage was classified as pT1a pN0 pMx (FIGO Stage IA). This staging was confirmed after further review and consultation, including re-evaluation of myometrial invasion depth and immunostaining with CD31, which clarified the nature of certain histologic features.\n\nGross examination of the uterine specimen revealed a shaggy, white-tan mass measuring 8.7 x 3.8 x 0.5 cm, extending from the anterior lower uterine segment across the corpus and fundus to the posterior lower uterine segment. The mass appeared exophytic with no grossly apparent deep myometrial invasion. The uterus measured 9.0 cm in height, with a 4.2 cm endometrial cavity length. The cervix had a 2.0 cm endocervical canal. The left ovary and fallopian tube were unremarkable aside from prior surgical changes and cystic formations.\n\nAll tissue was submitted for microscopic evaluation, and no additional findings of malignancy were noted in other specimens. A revised assessment was made following multidisciplinary review, confirming the final staging and histologic interpretation."} +{"pid": "TCGA-BJ-A190", "report": "A total thyroidectomy specimen weighed 34.9 grams and showed two distinct foci of abnormal tissue. One measured 1.0 cm in the right lobe, and the second measured 3.5 cm in the left lobe. Histologic examination revealed features consistent with encapsulated growth and follicular architecture. The nuclear morphology was evaluated as borderline in the most suspicious areas.\n\nImmunohistochemical staining was performed on several blocks. Focal membranous staining for HBME-1 was seen in one block, while galectin-3 was negative across all tested blocks. No extracapsular extension, angiolymphatic invasion, or lymph node involvement was identified. A single perithyroidal lymph node was examined and found to be free of tumor. The tumor was confined entirely within the thyroid gland with uninvolved margins.\n\nMolecular analysis was conducted on microdissected tissue from two blocks. In block 1B, a HRAS codon 61 mutation was detected, with no mutations identified in BRAF, NRAS, or KRAS. Additionally, FISH testing for RET/PTC rearrangement was negative. In block 1J, no mutations were found in BRAF, NRAS, HRAS, or KRAS, and RET/PTC rearrangement was also not present. DNA quality was sufficient for reliable testing in both cases.\n\nFluorescence in situ hybridization (FISH) using RET/PTC and RET/PTC1 dual-color fusion probes was performed. In both blocks analyzed, all cells exhibited normal signal patterns, with no evidence of rearrangement. At least 60 cells per block were evaluated, and none showed the three-signal pattern indicative of RET/PTC rearrangement.\n\nStaging was determined as pT2NO, with no regional lymph node involvement and no distant metastasis. No additional pathologic findings were noted. The case required expert review due to the challenging histologic and immunophenotypic features, ultimately leading to consensus interpretation."} +{"pid": "TCGA-GL-7966", "report": "The operative procedure performed was a robotic-assisted right radical nephrectomy. Lymph node specimens were obtained from interaortocaval and right paracaval regions, along with the right kidney.\n\nExamination of four interaortocaval lymph nodes revealed no evidence of malignancy. In the right paracaval region, eleven lymph nodes were evaluated, with one containing metastatic involvement measuring 0.7 cm. Extranodal extension was present in this node. No other lymph node regions showed signs of involvement.\n\nThe right kidney contained a unifocal mass measuring 6.5 x 6.2 x 5.0 cm. The tumor extended macroscopically into the perinephric fat, renal sinus fat, and involved the renal vein. Microscopic evaluation demonstrated poorly differentiated features, with areas displaying papillary architecture. Additional morphologic patterns were noted, including regions resembling collecting duct, medullary, and sarcomatoid differentiation. However, specific immunohistochemical markers supported a diagnosis consistent with papillary renal cell carcinoma, although some areas remained difficult to classify definitively. Stains for TFE3, HMB45, and Melan-A were negative, reducing the likelihood of translocation-associated or melanocytic neoplasms. Cytokeratin AE1/AE3, CK7, PAX-2, AMACR, and focal CD10 expression further supported the epithelial origin of the tumor.\n\nHistologic grading using the Fuhrman system was 3 of 4. Invasion of the perinephric fat, renal sinus, and renal vein was confirmed. The adrenal gland was not present in the specimen. No involvement of resection margins was identified. No significant findings were noted in the nonneoplastic portions of the kidney.\n\nLymphovascular invasion was not specifically mentioned, but hilar lymph node sampling did not identify any nodes. Grossly, the tumor reached within 1 mm of the posterior soft tissue margin and within 0.3 cm of the renal vein margin.\n\nBased on the extent of local spread and nodal involvement, the pathologic staging was determined as pT3 and pN1. Distant metastasis was not assessed in this report."} +{"pid": "TCGA-BJ-A4O8", "report": "The thyroid specimen weighed 21 grams and showed two separate tumor foci. The largest measured 1.5 cm and was located in the isthmus, with conventional histologic features and infiltrative growth pattern. A second focus measuring 0.3 cm was identified in the left lobe. Vascular invasion was not present. There was minimal extension beyond the thyroid capsule. The closest surgical margin was within 0.1 cm of tumor. Chronic lymphocytic thyroiditis was also noted.\n\nA total of 14 central compartment lymph nodes were examined, with six containing metastatic involvement. The largest metastatic deposit measured 0.2 cm. No extracapsular spread was identified.\n\nA separate excised nodule from the left abdominal wall measured 1 cm and was diagnosed as a trichilemmal (pilar) cyst. A biopsy of the right inferior parathyroid gland, weighing 8 mg, demonstrated normocellular tissue.\n\nMolecular testing on a prior fine needle aspiration from the right isthmus lesion identified a BRAF p.V600E mutation.\n\nThe tumor was multifocal, involving both the isthmus and left lobe. Histologic evaluation revealed no lymphovascular invasion. Staging indicated pT3 for the primary tumor and pN1a for lymph node involvement. Distant metastasis was not assessed. Extrathyroidal extension was limited to minimal extent. Surgical margins were free of tumor involvement."} +{"pid": "TCGA-AG-A01L", "report": "The resected colon specimen includes a lesion with histological features involving the rectosigmoid region. Microscopic evaluation shows a moderately differentiated adenocarcinoma extending to within 0.5 cm of the aboral resection margin. The lesion invades through all layers of the intestinal wall and extends into the adjacent periproctal soft tissue, with a distance of 0.5 cm from the tumor to the resection margin in that area. Lymphatic invasion is present at the tumor margin. All other margins\u2014oral, aboral, and periproctal soft tissue\u2014as well as isolated colon sections show no evidence of tumor involvement. Of the 47 lymph nodes examined, two contain metastatic deposits, with some involvement extending beyond the lymph node capsules. The remaining lymph nodes display nonspecific reactive changes. Histopathological staging is consistent with pT3, pN1, L1, V0; G2 R0."} +{"pid": "TCGA-DD-A4NK", "report": "The revised report includes the following tissue descriptions: fragments labeled A1, B1, C1 through C9. The right liver weighed 1,205 grams and measured 18.0 x 12.0 x 8.0 cm. The gallbladder measured 11 x 3.5 x 2.0 cm, and a pericholedochal lymph node measured 2.2 x 1.2 x 0.8 cm.\n\nMicroscopic examination of the liver specimen revealed a moderately differentiated lesion with cellular features suggestive of neoplastic change. The primary lesion measured 12.2 x 10.0 x 8.0 cm and was associated with multiple adjacent nodules (>30), ranging from 0.1 cm to 2.5 cm in size. Surgical margins were free of tumor involvement, with the closest tumor-free margin measuring 0.2 cm. Evaluation of the pericholedochal lymph node showed no evidence of tumor involvement.\n\nExamination of the gallbladder revealed chronic inflammatory changes and the presence of multiple calculi (>50), with sizes ranging from 0.1 to 0.4 cm in diameter.\n\nAdditional studies showed that the surrounding hepatic parenchyma did not exhibit cirrhotic changes. Trichrome staining revealed no significant fibrosis. Iron staining was negative for hemosiderosis, and alpha-1-antitrypsin staining did not show cytoplasmic globules. No vascular invasion was identified."} +{"pid": "TCGA-D1-A0ZZ", "report": "The specimen consisted of a uterus with bilateral fallopian tubes and ovaries. A polypoid mass measuring 4.2 \u00d7 3.2 \u00d7 3.0 cm was identified in the fundus of the endometrial cavity. On sectioning, this mass measured 1.2 \u00d7 0.6 \u00d7 0.6 cm and was located in the posterior wall. It extended 0.2 cm into the myometrium, which had a total thickness of 1.8 cm. Two additional sessile lesions were found: one on the anterior wall measuring 1.9 cm and another on the lateral wall measuring 0.5 cm. These lesions exhibited cellular features consistent with high-grade changes and invaded superficially into the myometrium to a depth of 0.1 cm. A separate benign endometrial polyp was also present. The endocervix was not involved, and all surgical margins were free of abnormal cells.\n\nExamination of the ovaries and fallopian tubes showed no significant findings. Lymph node dissections were performed on both right and left pelvic regions, as well as right and left para-aortic areas. A total of 14 right pelvic lymph nodes, 12 left pelvic lymph nodes, 5 right para-aortic lymph nodes, and 6 left para-aortic lymph nodes were assessed, and all were negative for involvement. Additional tissue specimens including the right and left gonadal vessels, omentum, and a lymph node within the omentum also showed no evidence of disease.\n\nPermanent histologic sections confirmed the findings observed during frozen section evaluation. No other significant abnormalities were noted in the submitted tissues."} +{"pid": "TCGA-AA-3527", "report": "The specimen consists of a right hemicolectomy with an ulcerated lesion located in the cecum. The lesion measures 4.5 cm in its greatest dimension and exhibits invasive growth through all layers of the intestinal wall, extending into the adjacent mesocolic fat and subserosa. No involvement is seen at the oral and aboral resection margins or in the large omentum. A hyperplastic polyp is noted in the remaining colonic mucosa. The appendix shows signs of post-inflammatory fibrosis in its wall. Fifteen retrieved mesocolic and mesenteric lymph nodes are free of tumor, showing only nonspecific reactive changes. Vascular and lymphatic invasions are not identified. The histological grade is intermediate (G2)."} +{"pid": "TCGA-RZ-AB0B", "report": "Specimen consists of a right globe with an attached optic nerve segment. The globe measures 24 mm in anterior-posterior dimension, 22 mm horizontally and vertically. The cornea is clear and the iris is blue with a 9 mm pupil. A 8 mm trephine defect is present in the sclera from tissue harvesting. No gross evidence of extrascleral or optic nerve involvement is observed. Sectioning along the area of interest reveals a mass arising from the ciliary body and choroid. The mass is mostly amelanotic, measuring 15 mm in largest basal diameter and 8 mm in thickness. It molds against the lens, which is cataractous, displacing the lens-iris diaphragm anteriorly and causing a shallow peripheral angle. The tumor extends posterior to the equator and is associated with small areas of subretinal fluid. No gross extension beyond the sclera is identified.\n\nA separate specimen labeled as optic nerve consists of a tan tissue fragment measuring 5 x 4 x 4 mm. One margin appears crushed and is marked for identification. Histologically, the cornea is unremarkable. In one area of the anterior chamber, the angle is open; on the opposite side, the iris root is displaced by a large mass. The tumor measures 15 mm in basal diameter and reaches 7.5 mm in maximum thickness. It is largely contained beneath Bruch\u2019s membrane with only minor foci extending anteriorly. The cellular composition includes a mixture of spindled and epithelioid cells with intermediate nuclear features. There are 16 mitotic figures per 40 high power fields. Areas of vascular mimicry are present, along with minor necrotic foci containing hemosiderin deposits. Melanophages are sparse within the tumor. Invasion of the trabecular meshwork and Schlemm\u2019s canal is observed. No extrascleral extension is seen in the available sections. Atrophy of the retinal pigment epithelium is noted at the apex of the tumor. Portions of detached atrophic ciliary epithelium and peripheral retina are present. Serous fluid detaches the retina near the posterior aspect of the mass, with additional fluid located on the opposite side of the globe. Retinal detachment appears partially artifact-related. The optic nerve shows no abnormalities."} +{"pid": "TCGA-AG-3609", "report": "The resected specimen from the rectosigmoid colon includes an ulcerated, moderately differentiated lesion measuring 4.5 cm from the aboral resection margin. The lesion demonstrates infiltration into the perirectal fatty tissue and is associated with metastases in four regional lymph nodes. The circumferential resection margin, colon resection margins, and mesenteric resection margin are all free of tumor involvement. Histological assessment indicates a grade 2 level of differentiation. Vascular invasion is not present, while lymphatic invasion is noted. The local resection margin is negative."} +{"pid": "TCGA-HC-7752", "report": "The specimen consisted of a prostate weighing 40.6 grams and measuring 5.4 x 4.5 x 4.2 cm. Histologic evaluation identified no discrete mass, although focal cystic changes were noted on the cut surface along with periurethral nodularity and multiple irregular brown calculi. Histologic sections revealed adenocarcinoma of conventional type. The tumor involved approximately 10% of the gland volume. Gleason grading showed a primary pattern of 3 and a secondary pattern of 4, resulting in a total Gleason score of 7. High-grade prostatic intraepithelial neoplasia was also present.\n\nExamination of the surgical margins, including the left lateral margin and apex, revealed no involvement. No evidence of extraprostatic extension, seminal vesicle involvement, or lymphovascular space invasion was identified. A total of six regional lymph nodes were evaluated, none of which contained metastatic disease.\n\nThe prostate specimen was inked for orientation, with right margins marked in blue and left margins in black. Serial sectioning from apex to base was performed. Sections submitted included those from the seminal vesicle junctions, apical margins, and right and left anterior and posterior regions from apex to base. Additional tissue from the vas deferens and seminal vesicle was also processed.\n\nNo treatment effect was observed. No other significant findings were reported. Staging was based on pathologic findings."} +{"pid": "TCGA-DU-5853", "report": "The clinical history indicates a brain lesion located in the left frontal region. Two specimens were obtained: one biopsy and one excision specimen. Gross examination of the biopsy specimen revealed two small tan-pink tissue fragments measuring 0.5 x 0.5 x 0.3 cm in aggregate, which were entirely submitted for analysis. The excised tissue consisted of multiple tan-pink, soft fragments measuring 2.8 x 1.8 x 0.5 cm in total.\n\nHistologic evaluation showed a neoplastic process involving glial cells. The tumor demonstrated round to oval to angulated nuclei within a background containing delicate vasculature and ropy myelin. Mitotic activity was infrequent, and no vascular proliferation was observed. Immunohistochemical staining revealed diffuse positivity for p53. The Ki-67 labeling index was approximately 4 to 5%.\n\nGenetic analysis was performed using PCR-based assays on DNA extracted from the tumor tissue and a matched blood sample. Evaluation of chromosomal regions 1p and 19q showed allelic loss at multiple informative loci including D1S548, D1S1592, D19S219, and PLA2G4C. This pattern of loss was interpreted as consistent with a specific genetic profile previously associated with certain gliomas. Methylation status of a key DNA repair gene promoter was also assessed using bisulfite conversion followed by real-time PCR; no methylation was detected. The technical sensitivity of this methylation assay is capable of detecting 1% methylated DNA in an unmethylated background.\n\nIt is noted that the presence of more than 15% non-neoplastic cells in the sample may affect detection of allelic loss, and more than 50% non-neoplastic cells or necrotic tissue could impact the accuracy of methylation testing. All tests were developed and validated in accordance with CLIA requirements, and results are provided for informational use only, to be interpreted alongside other diagnostic and clinical data."} +{"pid": "TCGA-KN-8434", "report": "The submitted specimen consists of a right radical nephrectomy. The kidney, including attached perinephric adipose tissue, measures 16 x 9 x 5.5 cm. A segment of ureter is present, measuring 3.5 cm in length, and an adrenal gland is also included. On gross examination, a unifocal tumor measuring 7.2 x 6 x 3 cm is identified in the upper pole of the kidney. The cut surface of the tumor is variably maroon-brown and tan. No invasion into the perinephric adipose tissue or renal vein is observed. The ureteral and pelvic mucosa appear unremarkable, and the adrenal gland shows no abnormalities upon serial sectioning.\n\nMicroscopically, the tumor demonstrates a high-grade morphology with bizarre, multilobated nuclei measuring 20 microns or greater in diameter. Prominent nucleoli and clumped chromatin are noted. The histologic features suggest a high nuclear grade. The tumor is confined to the kidney without evidence of extension beyond the organ. All surgical margins are free of invasive disease. No lymphovascular invasion is identified. No additional lesions are found in the renal parenchyma, and hilar and perinephric fat do not show any suspicious nodes. The regional lymph node status could not be assessed as no nodes were submitted for evaluation. Distant metastasis could not be assessed. Representative sections of the tumor, surrounding renal tissue, ureter, renal vessels, and adrenal gland have been submitted for further analysis."} +{"pid": "TCGA-ET-A40S", "report": "Specimen taken. Left inferior parathyroid (excision) consisted of parathyroid tissue weighing 7 mg. The second specimen, consisting of thyroid and soft tissue from a total thyroidectomy along with level 6 lymph node dissection, showed a tumor measuring 2.5 cm in greatest dimension, located in both the right and left lobes. Histologic examination revealed multifocal involvement with no evidence of tumor identified in all 12 lymph nodes assessed. According to AJCC staging criteria, the primary tumor was classified as pT2, indicating a tumor larger than 2 cm but not exceeding 4 cm in size and confined to the thyroid gland. There was no regional lymph node involvement (pN0). Surgical margins were free of tumor involvement, with the invasive component located at least 1 mm from the nearest margin. No venous or lymphatic invasion was observed. Twelve lymph nodes were evaluated and found to be negative for tumor."} +{"pid": "TCGA-VQ-A8PC", "report": "The specimen consists of a gastric resection from the antrum. Histological evaluation reveals a poorly differentiated neoplasm composed of mucosecretor cells with a signet ring morphology. The tumor measures 3.5 cm along its longest axis and demonstrates spiculated growth pattern. Ulceration is present, and the serosal surface is involved. A mild inflammatory response is noted. Surgical margins, including both proximal and distal resection sites, show no evidence of neoplastic infiltration. There is no evidence of neural, lymphatic, vascular, or blood vessel invasion. The small omentum is free of neoplastic involvement. Lymph node assessment shows involvement of one out of two nodes along the lesser curvature and one out of one node at the celiac trunk, both with neoplastic deposits extending beyond the capsule. All other evaluated lymph nodes, including those along the subpyloric region, right paracardiac area, and hepatic artery, show no signs of neoplastic involvement."} +{"pid": "TCGA-QC-A6FX", "report": "The surgical specimen from the left back consists of a resected skin and soft tissue mass measuring 9.5 x 3.9 cm, excised to a depth of 4.8 cm. The skin ellipse measures 9.0 x 2.5 cm with a centrally located healed scar. A distinct tan-white ovoid mass is identified within the skeletal muscle, measuring approximately 5.0 x 2.4 x 1.5 cm. The mass abuts the deep margin and approaches the superior and inferior margins, coming within less than 1.0 mm of the lateral margin. It is approximately 2.7 cm from the medial margin and 3.7 cm beneath the skin surface. A suspected secondary nodule measuring 1.8 x 1.5 x 1.0 cm appears to merge with the main mass. A cystic cavity measuring 2.0 x 1.4 x 1.3 cm is noted on the medial half, likely representing a prior biopsy site.\n\nHistologically, the mass demonstrates high-grade features with pleomorphic cells and a mitotic rate of 12 per 10 high-power fields. Necrosis is present, involving approximately 10% of the tumor volume. The tumor extends to the deep, superior, and inferior resection margins. No tumor is identified in the additional deep margin specimen or in the specimen taken from the area of the suspected secondary nodule, both of which show only benign skeletal muscle.\n\nMargins were inked for orientation: superior (blue), inferior (green), medial (red), lateral (yellow), and deep (black). The margin near the suspected secondary nodule was inked orange. Serial sectioning confirmed tumor involvement at multiple deep margins. No treatment effect is observed, and no lymph nodes were examined."} +{"pid": "TCGA-AD-A5EK", "report": "The resected specimen includes a segment of right colon measuring 23.0 cm in length with diameters ranging from 3.5 to 5.0 cm. A mass is identified in the distal colonic mucosa, measuring 2.5 x 2.3 x 1.0 cm, with a tan-brown, fungating appearance. The mass approaches within 3.0 cm of the colonic margin and 20.0 cm of the ileal margin. Histologically, the lesion shows infiltration into the wall without full penetration through the muscularis propria. All surgical margins are free of involvement, with the closest radial distance measuring 1.5 cm. Eleven lymph nodes are assessed and show no evidence of involvement. The tumor exhibits minimal lymphocytic response and contains approximately 5% mucinous component without medullary features. No lymphovascular or perineural invasion is observed. A segment of small intestine measuring 2.3 cm in length and 2.7 cm in diameter is also present and shows no pathological findings. Multiple tissue sections are submitted for further analysis, including margins, lymph nodes, and segments of bowel."} +{"pid": "TCGA-UY-A78L", "report": "The surgical specimen consisted of a cystoprostatectomy specimen along with multiple lymph node samples and margin biopsies. Gross examination of the urinary bladder and prostate revealed a tumor measuring 3.0 x 2.0 x 1.5 cm located on the left posterior-lateral surface of the bladder. The trigone showed mucosal swelling and irregularity in an area measuring 2.5 x 2.5 cm. No gross involvement of the ureters was observed.\n\nMicroscopic evaluation of the cystoprostatectomy specimen demonstrated a lesion with deep infiltration into the muscularis propria, specifically involving the outer half, but not extending beyond into adjacent fat. A separate small focus of intraepithelial malignancy was identified in the urinary outflow tract of the bladder. Additionally, papillary epithelial hyperplasia was noted in the trigone region. Examination of the distal prostatic urethra revealed benign prostatic tissue without evidence of tumor involvement.\n\nMargin assessments included biopsies of the left and right distal ureters and urethral margin; all were free of tumor involvement. Lymph node dissections included left pelvic lymph nodes (11 total), among which one contained metastatic involvement, and right pelvic lymph nodes (12 total), none of which showed tumor presence. No extranodal extension was identified, and the largest metastatic deposit measured 0.7 cm.\n\nAdditional microscopic findings included absence of vascular or lymphatic invasion and no extension into adjacent organs beyond the bladder. Multiple tissue fragments from various regions of the prostate and seminal vesicles showed no tumor involvement.\n\nSpecimens were received in nine parts, including fresh tissues and formalin-fixed samples. Frozen section analyses were performed for intraoperative assessment and confirmed negative margins for ureteral and urethral sites. All surgical margins\u2014including urethral, right ureteral, left ureteral, and perivesical\u2014were free of tumor.\n\nLymph node staging indicated involvement in one left pelvic lymph node. Other findings included fibroadipose tissue submitted from around the bladder and various sections of the prostate and seminal vesicles. The tumor measured 3 cm in greatest dimension and did not involve adjacent structures."} +{"pid": "TCGA-E2-A1B4", "report": "The surgical specimen consists of a left breast lumpectomy with needle localization, weighing 41 grams and measuring 5.8 cm (anterior-posterior), 5.2 cm (superior-inferior), and 2.8 cm (medial-lateral). The specimen was oriented with sutures: single anterior, double lateral, and triple superior markers. Inked margins included inferior (orange), superior (red), lateral (yellow), anterior (blue), medial (green), and posterior (black). Serial sectioning identified a firm, well-circumscribed white-tan nodule measuring 1 cm in greatest dimension. This lesion was located 1 cm from the nearest posterior and anterior margins, 1.8 cm from the lateral margin, 3.1 cm from the medial margin, and greater than 3 cm from the superior and inferior margins.\n\nThe excision specimen was entirely submitted for histologic evaluation, including perpendicular sections of superior, medial, mid, and lateral slices at multiple levels, as well as perpendicular sections of the inferior margin. Margins were assessed microscopically, with the medial margin found to be closest to the lesion at 0.15 cm.\n\nFour sentinel lymph nodes were evaluated. Sentinel lymph node #1 measured 0.7 cm in diameter; touch preparation did not identify tumor cells, but histologic analysis revealed micrometastases measuring 0.5 mm. Sentinel lymph node #2 measured 0.4 cm; touch prep was negative, but micrometastases measuring 0.6 mm were identified histologically. Sentinel lymph node #3 consisted of fatty tissue measuring 0.5 x 0.3 x 0.3 cm and showed no evidence of tumor involvement. Sentinel lymph node #4 measured 0.4 cm; touch preparation was negative, but histology demonstrated micrometastases measuring 2.0 mm. No extranodal extension was observed in any involved lymph node.\n\nHistologic assessment of the lesion demonstrated low to intermediate nuclear grade features. Intraductal papilloma with usual ductal hyperplasia was noted adjacent to the lesion and at the posterior margin. Immunohistochemical staining showed positivity for ER and PR receptors, while HER2 staining was negative. Estrogen receptor positivity was confirmed with an Allred score of 8 (proportion score 5, intensity score 3); progesterone receptor positivity was also confirmed with an Allred score of 8. HER2 immunohistochemistry showed 1+ intensity with 10% tumor staining.\n\nOncotype DX assay results indicated a recurrence score of 7, associated with a low estimated risk of distant recurrence at 10 years (approximately 6%). ER and PR scores were positive, while the Her2 score was negative.\n\nPathologic staging was determined as pT1c with nodal involvement classified as Nmi (micrometastatic). Vascular or lymphatic invasion was not identified, and necrosis was absent. The lesion was located in the upper inner quadrant of the left breast. No multifocality was observed."} +{"pid": "TCGA-AY-6386", "report": "The specimen consists of a right colectomy including the terminal ileum, cecum, and ascending colon. The tumor is located in the cecum with extension into the ileocecal valve. It measures 6.5 x 4.7 x 1.3 cm and has a mucinous cut surface. Microscopically, the lesion shows moderately differentiated features with invasion through the muscularis propria into the pericolic soft tissue. There is no evidence of lymphovascular or perineural invasion.\n\nMargins are negative: the proximal margin is 4 cm from the tumor, the distal margin is 8 cm from the tumor, and the mesenteric margin is also 8 cm from the tumor. The tumor focally abuts the deep blue inked serosa but does not show gross evidence of perforation through the visceral peritoneum. There is no luminal obstruction.\n\nA total of 19 regional lymph nodes were examined, and one node contains metastatic involvement. Focal abscess formation is noted adjacent to the tumor. Multiple enlarged lymph nodes without metastatic involvement were identified; these contain numerous follicles suggestive of a reactive process. Immunostains for BCL2, CD3, and CD20 demonstrate a benign reactive pattern without evidence of lymphoma.\n\nThe remaining mucosa appears unremarkable, and the bowel wall has a uniform thickness of 0.3 cm. No appendix is identified. Tissue from the tumor and normal areas was submitted for further analysis, and digital photographs were not taken. Specimen fixation was performed in formalin. All margins are confirmed negative, and the case has been staged based on available data at the time of reporting."} +{"pid": "TCGA-D1-A17Q", "report": "The uterus weighed 200 grams and contained a polypoid mass measuring 3.5 x 2.5 x 2.0 cm located in the upper fundus. Microscopic evaluation showed that the lesion extended 0.3 cm into the myometrium, with a total myometrial thickness of 2.5 cm. The mass partially involved the endometrial polyp and adjacent endometrium but did not extend into the endocervix. Invasion of lymphovascular spaces was noted. Surgical margins were free of abnormal cells. Three intramural leiomyomata were identified, ranging from 1.0 to 1.5 cm in size. Seventeen right pelvic lymph nodes and twelve left pelvic lymph nodes were examined and all were negative for tumor involvement. The ovaries showed signs of atrophy and had cystic changes; fallopian tubes appeared unremarkable. All lymphatic tissue from the left and right pelvic regions was submitted for analysis and showed no evidence of tumor. Multiple tissue blocks were sampled from the uterus, fallopian tubes, ovaries, and lymph node regions for histologic evaluation."} +{"pid": "TCGA-A1-A0SP", "report": "The specimen was received fresh in three parts, each labeled with the patient's name and unit number. Part A, identified as sentinel lymph node tissue from the left axilla, consisted of three lymph nodes. Microscopic evaluation showed no evidence of tumor involvement. Part B, a piece of fibrofatty tissue from the right medial breast, showed no tumor but revealed usual ductal hyperplasia, sclerosing adenosis, and calcifications. Part C was a right breast partial mastectomy specimen measuring 4.3 x 4 x 1.8 cm, oriented with long suture at lateral and short suture at superior. The specimen was inked black (deep), green (anterior inferior), and blue (anterior superior) for margin identification. On gross examination, a firm, tan-pink mass measuring 1.5 x 0.7 x 0.7 cm was identified in slices 3\u20136, located near the deep and anterior-superior margins.\n\nMicroscopic analysis of the invasive component showed a high-grade lesion with a total modified Bloom-Richardson score of 9 (nuclear grade: 3, mitotic count: 3, tubule/papilla formation: 3). The invasive lesion measured 2.2 cm and did not exhibit lymphatic-vascular invasion. Margins were all negative: deep margin (tumor <0.1 cm away on slide C7), medial margin (tumor \u22650.8 cm away), lateral margin (tumor \u22652.4 cm away), anterior/superior margin (tumor 0.3 cm away on slide C5), and anterior/inferior margin (tumor 0.3 cm away on slide C3). Adjacent to the invasive component, a focus of high nuclear grade ductal carcinoma in situ was present, with necrosis and microcalcifications. Ductal carcinoma in situ was admixed with the invasive tumor. Resection margins for ductal carcinoma in situ were negative: deep margin (tumor 1.5 cm away on slide C7), anterior/superior margin (tumor 0.6 cm away on slide C7). All other margins were also free of tumor.\n\nThree lymph nodes were sampled from the right sentinel lymph node biopsy; none showed evidence of tumor involvement. Immunohistochemical testing for estrogen and progesterone receptors was performed on block C7 and demonstrated negative results, with no nuclear staining in tumor cells. HER2/neu immunostaining showed a staining intensity of 0, indicating no over-expression of the oncoprotein. The internal control was appropriate. The case was reviewed by a pathology resident and confirmed by an attending pathologist. Select slides (C2, C3, C4) were also reviewed by another pathologist who concurred with the findings.\n\nAdditional specimens included a fine needle aspiration of the right breast prior to surgery, which showed cyst contents only. A skin excision from the right breast scar showed no malignancy, with only surgical site changes present. A separate cervical Thin Prep Imaged specimen was negative for intraepithelial lesion or malignancy and was considered adequate for evaluation."} +{"pid": "TCGA-TM-A84S", "report": "A male patient with a history of seizures underwent resection of a left frontal intra-axial lesion. The specimen consists of multiple pieces of fragmented brain tissue measuring up to 35x35x12mm, all of which were embedded for analysis (Blocks A to D). Imaging findings indicated an ill-defined low-density lesion in the left frontal lobe with internal linear calcification and mild mass effect. MRI demonstrated a heterogeneous mesial frontal mass involving the superior frontal and cingulate gyri, extending to the lateral fibers of the corpus callosum. There was evidence of dystrophic calcification or hemorrhage within the inferior portion of the lesion.\n\nHistopathological examination revealed diffuse infiltration of the cortex and white matter by a glioma. Areas of low cellularity were observed with regular round nuclei, cytoplasmic clearing, calcifications, and microcystic degeneration. A prominent capillary vascular network was noted, with some vessels showing perivascular foamy macrophages. In these regions, mitotic activity was minimal, with very few mitoses, sparse P53-positive cells, and a proliferation index below 1%.\n\nIn contrast, highly cellular areas exhibited nuclear pleomorphism and irregularity. These regions displayed a myxoid background with increased mitotic activity\u2014up to five mitoses per high power field\u2014and a proliferation index of 50\u201375%. Approximately 5\u201310% of cells were P53 positive. A small focus suggestive of early microvascular proliferation was identified in Block B, although it was not definitive.\n\nImmunohistochemical staining showed positivity for IDH1, with focal P53 expression and minimal GFAP staining. Neuronal markers including NeuN and synaptophysin were negative. Molecular testing confirmed IDH1 positivity, and lineage assessment favored glial origin with features suggestive of oligodendroglial differentiation.\n\nThe histological features included variations in cellularity, mitotic activity, and nuclear morphology. Based on morphology alone, areas of higher-grade features such as increased mitoses and nuclear pleomorphism were present, with a proliferation index up to 75%. Given these findings, ancillary testing, including FISH for 1p19q deletion and EGFR amplification, was recommended for further classification, pending patient consent.\n\nResection margins were involved. No definitive diagnosis was provided in this report; additional molecular studies may contribute to further characterization."} +{"pid": "TCGA-CV-6935", "report": "The specimen from the right vallecula and right pyriform margin consists of a tan-tissue fragment measuring 2.6 x 0.2 x 0.3 cm. The lateral portion is marked with black ink and was submitted entirely for intraoperative evaluation. Microscopic assessment revealed abnormal cells within the squamous mucosa.\n\nA total widefield laryngectomy specimen measures 9.0 x 7.0 x 4.5 cm and includes the larynx, right thyroid lobe (2.5 x 2.4 x 0.4 cm), hyoid bone, and surrounding soft tissue. An ulcerated, firm mass measuring 3.0 x 2.5 x 2.0 cm is identified in the supraglottic region, extending to the midline and involving the right pyriform sinus. The adjacent mucosa shows irregular thickening, with involvement extending to the midline and the laryngeal surface of the epiglottis. Four lymph nodes ranging from 0.5 x 1.2 cm in size are present in the pretracheal midline; no other nodes were identified. Histologic examination reveals extensive invasion into surrounding structures with marked perineural and vascular infiltration. Multiple sections were taken from various regions of the specimen for further analysis.\n\nAn additional surgical margin from the lateral aspect, marked by a hemostat, includes a strip of mucosa and soft tissue measuring 3.8 x 1.8 x 0.4 cm. Evaluation of this margin identified focal atypical cells at the lateral edge, raising concern for residual involvement.\n\nA separate specimen from the base of the tongue and right lateral oropharynx consists of a mucosal fragment measuring 3.0 x 0.3 x 0.3 cm. No abnormal cellular features were detected in this tissue upon microscopic review."} +{"pid": "TCGA-BG-A0LX", "report": "The surgical specimen included a uterus and cervix weighing 220 grams with bilateral adnexa, following a total abdominal hysterectomy and bilateral salpingo-oophorectomy. Two masses were identified within the endometrial cavity: an anterior wall mass measuring 6.5 x 5.3 cm and a posterior wall mass measuring 7.5 x 3.0 cm. Histologic evaluation revealed a moderately differentiated epithelial neoplasm with squamous differentiation. The lesion involved nearly the entire endometrial surface, with invasion extending through up to 90% of the myometrial wall thickness. Pre-neoplastic changes including simple and complex endometrial hyperplasia with atypia were noted adjacent to the lesion.\n\nAngiolymphatic invasion was present. A separate intramural leiomyoma measuring 2.2 cm was identified with degenerative changes. The cervix showed chronic cystic cervicitis and squamous metaplasia without evidence of neoplastic involvement.\n\nAdhesions were observed between the tubes and ovaries. A paratubal cyst and Walther rests were identified in the left fallopian tube. The left ovary contained hemosiderin-laden macrophages, endometriosis, microcalcifications, and physiologic changes. The right fallopian tube showed no significant pathology. The right ovary demonstrated epithelial inclusion cysts, microcalcifications, and normal physiological changes.\n\nLymph node assessment included 7 left pelvic nodes, 4 left common nodes, 4 right pelvic nodes, 3 right periaortic nodes, and 4 left periaortic nodes\u2014all were free of tumor involvement. Vaginal resection margins were negative for tumor.\n\nHistologic grading showed combined architectural and nuclear features consistent with moderate differentiation (FIGO grade 2), with architectural features being poorly differentiated and nuclear grade classified as grade 2. The maximum tumor dimension was 7.5 mm. Invasion extended to at least half the thickness of the myometrium. Mitotic activity was notable at 22 mitoses per 10 high-power fields.\n\nNo distant metastases were identified. Pathologic staging was determined as pT1b with no lymph node involvement (pN0). No extranodal extension was observed. Residual tumor status was not assessable (RX)."} +{"pid": "TCGA-ET-A2MX", "report": "The specimen consists of a total thyroidectomy. The tumor is located in the right lobe and measures 2.1 cm in greatest dimension. It is unifocal. Evaluation of regional lymph nodes shows involvement of all four examined nodes, consistent with metastatic disease. The primary tumor is classified as pT2, indicating a tumor larger than 2 cm but less than 4 cm confined to the thyroid. Regional lymph node involvement corresponds to pN1a, with metastases identified in Level VI nodes, including pretracheal, paratracheal, and prelaryngeal/Delphian lymph nodes. Distant metastasis could not be assessed (pMX). Surgical margins are free of tumor involvement, with the closest distance of invasive cells being 1 mm from the anterior margin. Evidence of vascular or lymphatic invasion is present. A separate lymph node and thymus dissection reveals metastatic involvement in all four lymph nodes; the thymus itself shows no significant histologic changes."} +{"pid": "TCGA-DK-A3IU", "report": "A 63-year-old male with a history of recurrent high-grade disease underwent cystoprostatectomy and lymph node dissection. Specimens included urethral margin, bilateral distal pelvic lymph nodes, bladder, prostate, seminal vesicles, perivesical lymph nodes, and distal ureteral margins.\n\nThe urethral margin showed benign tissue. A total of 14 pelvic lymph nodes were examined (11 on the right, 3 on the left), all benign without evidence of metastasis. The bladder specimen measured 5.5 x 3.5 x 3.2 cm and contained a tan firm lesion measuring 2.0 x 1.1 cm located in the posterior wall. Histologic evaluation revealed invasive malignancy involving the deep half of the muscularis propria without extension into adjacent structures. Vascular and perineural invasion were present. Surgical margins were negative. Adjacent mucosa showed ulceration and foreign body reaction. No involvement was identified at the ureteral orifices or urethral margin. No perivesical lymph nodes were found.\n\nThe prostate measured 3.2 x 3.6 x 3.0 cm and contained multiple foci of malignant infiltration involving both posterior and anterior lobes, with dominant involvement in the left anterior and posterior mid zones. Tumor was confined within the capsule without extraprostatic extension. Perineural invasion was noted but vascular invasion was not identified. Surgical margins were free of tumor. Benign nodular hyperplasia was also present. High-grade intraepithelial neoplasia was identified. Seminal vesicles and bladder neck were uninvolved.\n\nBoth distal ureteral margins were benign. All surgical margins across specimens were negative for malignancy. Lymph node staging showed no evidence of metastatic spread. Based on AJCC criteria, the stage reflects localized invasion within the bladder wall without nodal or distant spread."} +{"pid": "TCGA-FD-A43U", "report": "A 7.5 x 6 x 2.5 cm aggregate of right pelvic lymph nodes was examined, with multiple lymph node candidates measuring between 0.3 and 1.1 cm identified. Of these, six out of twenty-three lymph nodes contained metastatic involvement. The largest focus measured 3 mm and showed extranodal extension. A separate 7 x 4.5 x 3 cm aggregate of left pelvic lymph nodes was also evaluated, containing lymph nodes measuring up to 3.5 cm. One of ten lymph nodes showed metastatic involvement, with the largest focus measuring 1.4 cm and also demonstrating extranodal extension.\n\nThe cystoprostatectomy specimen included a bladder measuring 0.2 x 6 x 4.5 cm with attached mesenteric fat, and a prostate approximately 5 x 4 x 3 cm in size. The tumor involved the posterior, left and right lateral, anterior, and trigone walls of the bladder as a single 3.5 cm mass. It extended through the bladder wall into perivesical fat, periprostatic tissue, and focally into the prostate. The right periprostatic soft tissue margin was involved by tumor, with the closest margin measuring 5 mm. Surrounding bladder mucosa appeared edematous and wrinkled. The ureteral orifices were patent and identifiable adjacent to the trigone. No tumor was found in one perivesical lymph node. Both ureteral resection margins were free of tumor involvement.\n\nMicroscopic evaluation confirmed high-grade cellular features. The tumor was found to extend into extravesicular soft tissue, periprostatic tissue, and prostate. Lymph node analysis showed seven of thirty-four total nodes positive for involvement. The distal urethral margin was negative. Based on these findings, staging is consistent with advanced local disease with regional nodal involvement. A soft tissue margin at the right periprostatic area was positive. All other surgical margins were negative."} +{"pid": "TCGA-D1-A17L", "report": "A specimen of skin and subcutaneous tissue from the abdomen, weighing 2175 grams, was excised and included the umbilicus. No lesions were identified in this tissue upon gross examination.\n\nA separate surgical specimen included a uterus with attached bilateral fallopian tubes and ovaries. Within the uterine wall, a mass measuring 4.8 x 3.5 x 1.8 cm was identified in the anterior/posterior fundus. The lesion extended 0.4 cm into the myometrium, with a total myometrial thickness of 1.8 cm at the thickest point. Adenomyosis was also present in the surrounding tissue. No involvement of the endocervix was observed. The surgical margins were free of any abnormal cellular infiltrates. Two intramural leiomyomata were noted, ranging in size from 1.2 cm to 2.2 cm. Both ovaries and fallopian tubes appeared unremarkable, with no abnormalities detected on external or cut surfaces. The right ovary measured 3.1 x 1.5 x 1.1 cm with a solid cut surface, and the right fallopian tube measured 9.0 x 0.5 cm. The left ovary measured 3.8 x 2.5 x 1.0 cm with a solid cut surface, and the left fallopian tube measured 8.1 x 0.5 cm.\n\nLymph node dissection included right and left pelvic groups. On the right side, one internal iliac, three external iliac, three common iliac, and nine obturator lymph nodes were removed and found to be without any abnormal cellular features. On the left side, two internal iliac, four external iliac, five common iliac, and seven obturator lymph nodes were similarly negative for any atypical cells. No lymphovascular space invasion was identified in the examined tissues.\n\nAll lymph node specimens were processed in their entirety, with no evidence of malignancy detected. Sections of the endometrial mass, cervix, myometrium, and surrounding normal tissue were submitted for histological analysis. No tumor was identified in the submitted margins or in the bilateral adnexal structures."} +{"pid": "TCGA-AA-A004", "report": "The resected colon specimen shows an ulcerated lesion with highly differentiated features resembling colorectal morphology, exhibiting infiltration into the pericolic fatty tissue. A total of 32 local lymph nodes were examined and none showed involvement. All colonic resection margins, as well as the mesenteric margin, were free of tumor. Additionally, a small tubular adenoma was identified in the colonic mucosa, characterized by mild dysplasia, also referred to as mild intraepithelial neoplasia. Histological grading was determined as G1. No evidence of lymphatic or vascular invasion was observed, and all surgical margins were negative."} +{"pid": "TCGA-HT-8558", "report": "The pathology report for the subject indicates a glial neoplasm with mild hypercellularity. The cells exhibit morphology consistent with mildly atypical oligodendrocytes. Evaluation of MIB-1 reactive cells shows that, in several regions of the slide, these cells are grouped together. The overall labeling index for MIB-1 is less than 0.1% across most of the tumor, while the most proliferative areas demonstrate a labeling index of 2.9%. No mitotic figures, microvascular proliferation, or necrosis is observed. The tumor exhibits diffuse infiltration into both gray and white matter."} +{"pid": "TCGA-HZ-7922", "report": "The specimen consists of a pancreatic duct margin measuring 0.7 cm in diameter and 0.3 cm in length, entirely submitted for analysis. A common hepatic lymph node measuring 1.4 x 0.7 x 0.5 cm was also received and fully submitted. The gallbladder measured 8.5 x 3.5 x 3.0 cm with an attached cystic duct and lymph node; no mass lesions were identified in the mucosa, which appeared velvety and dark green. The Whipple resection specimen included a duodenum measuring 22.0 cm in length and a pancreatic head with uncinate process measuring 5.5 x 4.0 x 3.0 cm. The tumor measured 3.0 x 2.5 x 2.0 cm and was located in the pancreatic head. It had an ill-defined, solid appearance with pale yellow coloration and diffusely cystic areas. The tumor abutted the duodenum and common bile duct but did not grossly invade the bile duct wall. The pancreatic duct was completely obstructed by the tumor.\n\nMargins were evaluated with distances from the tumor as follows: pancreatic neck margin (blue ink) at 0.7 cm, uncinate margin (black ink) abutted, radial/posterior margin (green ink) at 0.6 cm, common bile duct margin at 0.5 cm, ampulla at 2.7 cm, proximal bowel margin at 2.0 cm, distal bowel margin at 12.0 cm, and vascular groove margin (yellow ink) at 0.7 cm. Microscopic evaluation revealed tumor involvement at the vascular groove margin with a distance of 1 mm from invasive carcinoma. No tumor was identified at the common bile duct, distal pancreatic, uncinate, posterior soft tissue, or duodenal margins.\n\nHistologic assessment showed perineural invasion and lymphovascular invasion. The tumor extended into peripancreatic soft tissue and involved the duodenal wall and ampulla of Vater. Adjacent large vessels and other organs were not involved. Regional lymph node evaluation included 13 peripancreatic nodes, of which 3 were involved with tumor. One common hepatic lymph node and one node adjacent to the gallbladder were both negative for tumor involvement. The tumor was histologically classified as low-grade exocrine cancer. Pathologic staging was determined as pT3 pN1 pMX."} +{"pid": "TCGA-34-8454", "report": "The right lower lobectomy specimen contains a moderately differentiated malignant neoplasm measuring 4.8 cm in maximum dimension. The lesion demonstrates invasion of the visceral pleura and lymphovascular structures. A 2.1 cm intralobar satellite lesion is also present. Two of twenty-eight N1 lymph nodes show evidence of involvement. All surgical margins are free of tumor. A moderate host lymphocytic response is noted.\n\nThe background lung tissue shows severe emphysematous changes with multiple bullae, respiratory bronchiolitis, and interstitial fibrosis consistent with long-standing smoking exposure. There is also evidence of patchy post-obstructive pneumonia. Additional findings include atypical adenomatous hyperplasia and focal bronchiolar dysplasia. A small carcinoid tumorlet is identified in the right upper lobe biopsy.\n\nLymph node specimens from levels 4, 7, 9, 10, and 11 all demonstrate reactive changes without evidence of malignancy. Molecular analysis of the primary lesion reveals FGFR1 gene amplification with a ratio of 2.64 (gene to centromere), suggesting genetic alteration. Histochemical stains do not show mucin production. Visceral pleural invasion is confirmed with special stains. Pathologic staging is determined to be T3 N1."} +{"pid": "TCGA-DJ-A1QL", "report": "The pathology report describes a total thyroidectomy specimen. The thyroid weighed 26 grams, with the right lobe measuring 3.5 x 2.5 x 1.5 cm, the left lobe 4 x 3 x 2.5 cm, and the isthmus 2 x 0.5 cm. A well-circumscribed tan-yellow to tan-pink mass with a thin capsule was identified in the left lobe, measuring 2.1 x 1.8 x 1.8 cm on gross examination. The remainder of the thyroid showed tan-red, beefy parenchyma.\n\nMicroscopic evaluation revealed a well-differentiated lesion with no mitotic activity or tumor necrosis identified. Calcifications of non-psammomatous type were present. The lesion was completely surrounded by a thin fibrous capsule, without evidence of capsular or blood vessel invasion. There was no extension beyond the thyroid tissue. Surgical margins were free of involvement. No multicentric disease was identified.\n\nSections from the isthmus, right lobe, left lobe, and representative nodule tissue were submitted for analysis. The non-neoplastic portions of the thyroid demonstrated nodular hyperplasia. Parathyroid tissue was not identified in the specimen. All findings were based on personal examination of the slides."} +{"pid": "TCGA-HZ-A4BH", "report": "The surgical specimen includes a pancreaticoduodenectomy (Whipple resection) and cholecystectomy. The Whipple specimen measures 13 cm in length and includes the stomach, small bowel, and head of the pancreas. A firm mass measuring 2.5 cm is identified within the head of the pancreas, extending into surrounding soft tissue and involving the uncinate process margin. Histologic examination reveals an invasive malignant epithelial neoplasm composed of medium to small glands and nests of cells with moderate cytoplasm, enlarged pleomorphic nuclei, and prominent nucleoli. A desmoplastic stromal reaction is present. The tumor involves the pancreatic surgical margin with adjacent sections extensively involved. It also extends to the inked retroperitoneal soft tissue margin. Perineural invasion and lymphatic invasion are identified; venous invasion is not seen. Adjacent pancreas shows chronic inflammation and fibrosis.\n\nTen lymph nodes were examined, four of which contain metastatic involvement with focal extracapsular extension noted. Additional findings include chronic pancreatitis, acute and chronic cholecystitis, and cholelithiasis. The gallbladder specimen measures 7 x 4 cm and contains two bile stones up to 0.5 cm in size. No malignancy is identified in the gallbladder or in sections of the gastric, pyloric, or small bowel mucosa. Mucosal surgical margins are unremarkable. Microscopic evaluation confirms no involvement at the common bile duct margin or at mucosal surfaces of the stomach and small bowel. Sections from peripancreatic lymph nodes demonstrate involvement by disease.\n\nStaging is as follows: pT3, pN1b, pMX."} +{"pid": "TCGA-EL-A3GO", "report": "Pathology Report. Sex: F. Received: 1. Case type: Surgical Case.\n\nA right lobe of thyroid measuring 4.0 x 3.2 x 1.5 cm with isthmus (1.2 x 0.3 x 0.2 cm) was received. Sectioning revealed a well-circumscribed pink, soft nodule measuring 3.2 x 2.4 x 2.1 cm located in the right lobe. The nodule did not have a grossly identifiable capsule, and the surrounding thyroid tissue appeared unremarkable. The entire nodule and adjacent tissue were submitted for analysis.\n\nMicroscopic evaluation showed a lesion with cellular features including uniform cells with round to oval nuclei, even chromatin distribution, and no prominent nuclear atypia. No mitotic figures or necrosis were identified. The lesion was circumscribed without evidence of infiltrative growth. No lymphovascular or extrathyroidal extension was observed. Resection margins were free of abnormal cells. Four regional lymph nodes were examined, and none contained abnormal cells.\n\nThe nodule was entirely sampled, with sections taken from superior to inferior aspects. A frozen section was performed and reported as indeterminate, with final assessment deferred to permanent sections. \n\nAll other tests and processing were completed as per standard protocol."} +{"pid": "TCGA-HC-7748", "report": "The right pelvic lymph node specimen included ten lymph nodes, all of which were negative for metastatic carcinoma. Intraoperative consultation confirmed this finding. The prostate measured 4.0 x 3.5 x 2.5 cm and weighed 21 grams. Histologic evaluation revealed a lesion involving approximately 30% of the right side of the gland. Nuclear grading showed a primary pattern of 3/5 and a secondary pattern of 3/5. There was no evidence of extraprostatic extension or involvement of the seminal vesicles. Lymphovascular space invasion was suspected but not definitively identified. High-grade prostatic intraepithelial neoplasia was present. Surgical margins, including the apex, base, and inked lateral margins, were free of tumor. A total of ten lymph nodes were examined from the right pelvic region, and none contained metastatic disease. The pTNM stage was determined to be pT2 NO. Perineural invasion was noted. No treatment effect was observed."} +{"pid": "TCGA-QT-A69Q", "report": "The specimen consists of an intact right adrenal gland weighing approximately 75 grams and measuring 6.9 x 5.2 x 3.1 cm. The outer surface is yellow, smooth, and inked green. A well-circumscribed mass measuring 6.2 x 5.0 x 4.8 cm is present within the adrenal gland, originating from the medulla and occupying over 90% of the resected tissue. The mass has a tan to brown coloration, is soft, and contains focal cystic areas. No identifiable capsule or extra-adrenal tissue is noted, and there is no evidence of lymphovascular or blood vascular invasion. Histologic evaluation shows negative surgical margins. The surrounding adrenal tissue appears unremarkable. One lymph node was examined and showed no involvement. Representative sections of the mass and normal adrenal tissue were submitted for further analysis."} +{"pid": "TCGA-50-5044", "report": "A mass was identified in the right lower lobe of the lung, measuring 6.5 cm. The primary lesion exhibits extensive necrosis and abscess formation. Four smaller nodules ranging from 0.5 to 2.0 cm are present in the surrounding lung tissue. Special stains for bacterial, fungal, and mycobacterial organisms in the necrotic and inflamed areas were negative. Invasion of the visceral pleura and angiolymphatic invasion were observed. All surgical margins are free of involvement.\n\nMetastatic involvement is noted in lymph nodes from two separate regions: the interlobar and anterior hilar lymph nodes. In the interlobar lymph node sample, 2 out of 4 nodes show evidence of tumor spread, while the anterior hilar sample includes one node with tumor involvement. Other sampled lymph nodes, including those from the right lower lobe, subcarinal region, and peribronchial area, do not show any signs of tumor and appear reactive or benign.\n\nAdditional findings include a focus of atypical adenomatous hyperplasia measuring 0.8 cm in the right middle lobe, with no evidence of malignancy in the other resected lung tissues, including the right upper lobe and a segment of the sixth rib. The background lung shows emphysematous changes. Based on the extent of the primary lesion and regional lymph node involvement, the staging is consistent with advanced local disease."} +{"pid": "TCGA-IG-A3I8", "report": "The specimen consists of an excised mass from the esophagus measuring 3.5 x 3 x 1.5 cm. Microscopic examination reveals a moderately differentiated keratinizing cellular proliferation. The tumor invades through to the adventitia. Surgical margins are involved. Lymph node assessment shows no evidence of metastasis in five regional lymph nodes examined. No lymphatic or venous invasion is identified. There is no indication of prior neoadjuvant treatment. No additional significant pathological findings are noted."} +{"pid": "TCGA-HD-A633", "report": "A male patient underwent surgical resection with associated neck dissection. The primary lesion was located in the oral cavity along the left mandible. Histologic evaluation revealed an invasive keratinizing carcinoma that was moderately differentiated. The maximal tumor diameter measured 3.9 cm, and there was evidence of bone invasion. No lymphovascular or perineural invasion was identified. Carcinoma in situ was present.\n\nMucosal margins, including specimens from the buccal margin, retromolar region, and floor of mouth, were all negative for tumor. The deep soft tissue margin was clear by 0.2 cm, and bone margins were also free of tumor involvement. A total of 39 lymph nodes were examined from levels 1 through 4 of the left neck; none contained metastatic disease.\n\nThe specimen from the mental nerve showed only peripheral nerve tissue without any tumor involvement. Similarly, the inferior alveolar nerve excision did not reveal tumor within the nerve, though focal tumor was noted in adjacent soft tissue. The submandibular gland and all other lymph node levels were also devoid of malignancy. The mandibular bone showed no evidence of tumor beyond the already described invasion.\n\nGross examination of the mandible composite specimen included a ramus and body segment, with a defect involving the posterior mucosa. The overlying mucosa and surrounding soft tissues were unremarkable except for the previously described lesion. The extracted tooth showed no gross abnormalities.\n\nIn summary, the resected tissue demonstrated a well-circumscribed tumor with clear surgical margins and no regional lymph node involvement. The histopathologic features included moderate differentiation, bone invasion, and presence of carcinoma in situ without evidence of lymphovascular or perineural spread."} +{"pid": "TCGA-DJ-A13O", "report": "The thyroid specimen from a total thyroidectomy weighed 27 grams and measured 5 x 2.5 x 2.2 cm on the right lobe, 4.5 x 2.5 x 2.2 cm on the left lobe, and 1.5 x 1.1 x 0.5 cm at the isthmus. A solid, encapsulated, calcified nodule measuring 1.1 x 0.8 x 0.7 cm was identified in the right upper pole. The remaining thyroid tissue showed no additional lesions and had a red tan, beefy appearance. The external surface of the posterior aspect was inked black, and the anterior surface was inked blue. Representative sections were submitted for analysis, with approximately 60% of the tissue examined.\n\nMicroscopic evaluation revealed a well-differentiated lesion with features including tall cell morphology. The tumor was located in the right lobe and was completely surrounded by a capsule, with focal invasion of the capsule noted. The greatest dimension of the lesion was 1.1 cm. No mitotic activity or tumor necrosis was observed. Calcifications of both non-psammoma and psammoma types were present. There was no evidence of blood vessel invasion or extension beyond the thyroid. Surgical margins were free of involvement. Adjacent thyroid tissue showed nodular hyperplasia, and no parathyroid glands were identified.\n\nA second specimen labeled as a left paratracheal cyst consisted of a smooth-walled cyst containing clear fluid, measuring 1.5 cm in diameter. Histologic examination revealed a benign cyst lined by cuboidal epithelium, likely of branchial pouch origin, along with benign lymph nodes (2 of 2 in the thyroid specimen, and 4 in the cyst specimen) and a small portion of benign thymus tissue. All lymph nodes examined were negative for involvement."} +{"pid": "TCGA-DX-A6BE", "report": "The submitted specimen consists of a radical resection from the left retroperitoneal region, including the left kidney and adrenal gland. A large, firm, tan/yellow mass is identified within the adipose tissue, measuring 42 x 29 x 8.5 cm in total. The mass itself measures 21.0 cm in greatest dimension and is partially encapsulated by fibrous tissue. It demonstrates a variable cut surface with areas of tan/yellow myxoid appearance and tan/white soft to firm regions. The tumor does not grossly infiltrate into the renal parenchyma, though it extends to the renal capsule. Multiple representative sections were taken from different areas of the mass, including well-differentiated regions, myxoid areas, and poorly differentiated zones.\n\nHistologic evaluation reveals a high-grade spindle cell neoplasm in the poorly differentiated areas. The well-differentiated component exhibits features resembling lipoma-like and sclerosing morphology. No involvement of the adrenal gland is observed. All resection margins are free of tumor involvement.\n\nAn additional splenectomy specimen weighing 152 grams was submitted. The spleen measures 12.5 x 6.5 x 2.5 cm and displays a nodular, glistening capsule. Sectioning reveals a hemorrhagic hilar region with disruption and blood clot formation. The splenic parenchyma has a beefy red, fleshy appearance with no significant pathological changes noted. Representative sections from the hilum and parenchyma were submitted for examination.\n\nAdditional components evaluated include the ureter, renal vein, and artery; all margins appear unremarkable. Adipose tissue surrounding the kidney was also sampled and showed no evidence of infiltration."} +{"pid": "TCGA-B0-5075", "report": "The specimen includes perinephric adipose tissue and a portion of the left kidney. The adipose tissue is benign and no abnormal cellular proliferation is identified within this component. The renal tissue demonstrates a neoplastic lesion measuring 2.0 cm in maximum dimension. The cells exhibit clear cytoplasm and are arranged in solid and acinar patterns. Nuclear features are indicative of intermediate differentiation, with nuclear grade II according to the Fuhrman classification. Immunohistochemical staining shows positivity for vimentin, CD10, E-cadherin, and RCC marker. Proliferative activity, as assessed by Ki-67 staining, is approximately 1%. No reactivity was observed for Hale's colloidal iron, c-kit, CK7, inhibin, or BerEP4.\n\nHistologic evaluation reveals focal extension of the lesion into the adjacent perinephric fat. All surgical margins are free of involvement. There is evidence of focal lymphovascular invasion. Based on these findings, the histopathologic stage is determined as T3a Nx Mx."} +{"pid": "TCGA-EB-A42Y", "report": "The surgical resection specimen from the skin of the hand measured 4 x 3 x 3 cm and exhibited ulceration with pigmentation. Microscopic evaluation demonstrated poorly differentiated morphology. A total of 10 axillary lymph nodes were examined, none of which showed involvement. The Breslow depth was recorded at 5 mm. No information was provided regarding satellite nodules, lymphatic or venous invasion, margins, neoadjuvant treatment, or Clark level."} +{"pid": "TCGA-BC-A3KF", "report": "The surgical specimen includes two parts. The first part, labeled as liver capsule at the lesser curve of stomach, consists of dense fibrous tissue with chronic inflammation and necrotic debris, including numerous hemosiderin-laden macrophages. No malignant cells were identified in this portion.\n\nThe second part is a left hepatic resection involving segments 2 and 3. The specimen weighed 480 grams and measured 12.4 x 10.7 x 8.7 cm. A mass measuring 10 x 7.9 x 7.5 cm was identified within the liver parenchyma. The mass showed focal areas of hemorrhage and necrosis, with approximately 30% necrosis observed grossly. Histologically, the tumor demonstrated high-grade features, with approximately 75% of the tumor remaining viable. Vascular invasion was present, while perineural and capsular invasion were not identified. The margins were negative for malignancy; however, the tumor was closely located to both the cranial and caudal resection margins, at 4 mm from each. \n\nEvaluation of the surrounding liver tissue revealed mild macrovesicular steatosis affecting approximately 20% of the hepatic parenchyma. Immunohistochemical staining showed diffuse positivity for HepPar-1 and negativity for CK7 and CK20. Vimentin and CD31 staining outlined vascular structures. No additional tumor deposits were identified in the submitted margins or adjacent tissues.\n\nFrozen section analysis of the liver capsule sample confirmed chronic inflammation and fibrosis without evidence of malignancy. Clinically, a mass measuring 9.2 x 8.9 cm had been identified preoperatively in the left lobe of the liver, involving segments 2 and 3.\n\nBased on available information, the pathologic staging was determined as pT2 pNx. This assessment may be subject to revision pending further clinical correlation and additional data."} +{"pid": "TCGA-B0-5700", "report": "A partial nephrectomy specimen from the left kidney demonstrates a neoplasm measuring 3.8 cm in greatest dimension, with additional measurements of 3.7 x 3.5 cm. The tumor is unifocal and located in the upper pole of the kidney. Histologic examination reveals cells with clear cytoplasm and nuclear features corresponding to grade 2 according to the Fuhrman nuclear grading system. The tumor is confined within the renal capsule without extension beyond it. No angiolymphatic invasion is identified. Surgical margins are free of tumor involvement.\n\nEvaluation of the surrounding non-neoplastic kidney tissue shows minimal glomerulosclerosis and mild interstitial chronic inflammation. No malignancy is found in the adjacent adipose tissue examined. No lymph nodes were identified or examined. The staging classification indicates T1a with no evidence of regional or distant spread. No venous or lymphatic invasion is present. No additional significant pathological findings are noted."} +{"pid": "TCGA-3B-A9HQ", "report": "The specimen consists of an irregular tan-yellow fragment of fibroadipose tissue measuring 8.0 x 6.0 x 4.5 cm. Serial sectioning revealed an ovoid, multilobulated tan-white to tan-pink nodule measuring 6.5 x 5.5 x 4.2 cm, located 0.1 cm from the closest posterior, anterior, and left medial margins of resection. The nodule is well-defined by a thin fibroconnective capsule and exhibits areas of hemorrhage but no grossly identifiable necrosis or cystic degeneration.\n\nHistologically, the lesion is composed of spindle-shaped cells arranged in dissecting fascicles with eosinophilic cytoplasm. There are multiple areas showing severe cytological atypia, increased mitotic activity (greater than 10 mitoses per 10 high-powered fields), and tumor necrosis. Immunohistochemical studies demonstrated strong positivity for vimentin, desmin, actin, and smooth muscle myosin, while CD117 was negative. ER staining was positive in more than 50% of cells, while PR was negative.\n\nSurgical margins were assessed and found to be free of tumor involvement. The closest negative margins included medial, anterior, and posterior aspects. Multiple representative sections were taken from various margins and levels of the nodule for evaluation.\n\nAll findings were reviewed by the attending pathologist, who confirmed the results after personal examination of the entire pathology case."} +{"pid": "TCGA-Z4-A8JB", "report": "The clinical evaluation included a specimen consisting of a skin patch measuring 6\u201314 cm with subcutaneous adipose tissue up to 2 cm thick, skeletal muscle measuring 13\u00d76\u00d73.5 cm, and a fragment of costal cartilage 3\u20134 cm. On sectioning, a mass was identified within the skeletal muscle and subcutaneous fat, measuring 9\u00d75.8\u00d73.8 cm. The mass exhibited fibrous architecture, appeared white on cut surface, and extended into costal cartilage structures. Margins of resection were assessed: the lesion was 0.2 cm from the upper costal margin (IV), 0.1 cm from the lower costal margin (V), 0.8 cm from the frontal margin (VI), 0.1 cm from the posterior margin (VII), 3 cm from the medial margin (II), and 2 cm from the lateral margin (III). Microscopic examination revealed a fibro-desmoid type lesion involving the frontal abdominal wall, infiltrating into striated muscle and costal cartilage components. Cellular morphology was consistent with a locally aggressive process; however, all surgical margins showed no evidence of residual tumor."} +{"pid": "TCGA-78-7156", "report": "HISTORY. Clinical suspicion of a pulmonary neoplasm. MACROSCOPIC. Five specimens were received. The first, a frozen section labelled \"Lung Bx, frozen section,\" consists of a wedge of lung tissue with overlying visceral pleura measuring 20 x 12 x 4 mm; no discrete lesion was identified in serial sections. Frozen section analysis revealed a lesion involving the diathermy margin. The second specimen is a left pneumonectomy. The left upper lobe measures 250 x 150 x 70 mm and the left lower lobe 230 x 140 x 70 mm. An incomplete fissure is noted on the lateral surface of the left lower lobe. A broad area of firm, pale subpleural change is present on the lateral aspect of the left upper lobe pleura, measuring approximately 140 x 110 mm. Similar changes are seen throughout the lingula, ranging from 3 to 30 mm. At the hilum, the bronchial resection margin is 20 mm in diameter and elevated 30 mm from surrounding tissue. A separate subpleural thickening measuring 11 mm is noted on the anterior aspect of the left lower lobe. Three areas of pleural deficiency are identified in the left upper lobe: one anterior-lateral (30 mm), one posterior-superior (30 mm), and a sutured defect at the postero-inferior edge measuring 30 mm. On sectioning, the left upper lobe contains a confluent pale lesion measuring 165 x 120 x up to 60 mm. Additional smaller deposits are found in the lingula and inferior portion of the upper lobe, ranging from 1 to 20 mm. Extensive subpleural involvement is observed, particularly on the lateral pleura. Tumour extends to the medial pleura adjacent to the hilum but does not reach the hilar resection margin. No tumour is identified on the visceral pleural surface. In the left lower lobe, multiple pale deposits are present, ranging from 5 to 30 mm. The third specimen consists of three hilar lymph nodes measuring up to 20 x 15 mm. The fourth specimen includes five mediastinal lymph node fragments (5\u201312 mm) and a 5 mm fat fragment. The fifth specimen is a single hilar lymph node measuring 12 mm. MICROSCOPIC. Paraffin sections confirm the presence of a well-differentiated epithelial tumour with lepidic growth patterns. The visceral pleura is not infiltrated, although the tumour involves the diathermied margin. Multiple deposits are identified in both upper and lower lobes, showing papillary architecture and a mix of mucinous and non-mucinous cells. Tumour deposits abut visceral pleura in several areas, with focal invasion noted. There is distension of some lymphatic channels, but no definitive lymphatic invasion. No vascular invasion or perineural involvement is observed. The bronchial resection margin is free of tumour. Tumour approaches within 30 micrometers of the peri-hilar margin in a region without pleura. One hilar lymph node shows infiltration by direct extension; other hilar and mediastinal lymph nodes show only reactive changes, including sinus histiocytosis, carbon pigment deposition, and mild follicular hyperplasia. Non-neoplastic lung parenchyma demonstrates emphysema and foci of atypical adenomatous hyperplasia. SUMMARY. The left lung contains multiple lesions with predominant lepidic and papillary growth patterns. The largest lesion measures 165 mm in diameter. Visceral pleura show focal involvement without surface extension. Lymphatic or vascular invasion is not definitively identified. The bronchial resection margin is clear, though tumour approaches closely to the peri-hilar margin. One hilar lymph node is involved by direct extension. Remaining hilar and mediastinal lymph nodes show no evidence of involvement. Background lung findings include emphysema and atypical adenomatous hyperplasia. Pathological stage: T4 N1 M1."} +{"pid": "TCGA-ED-A4XI", "report": "Gross Description: The specimen measures 3x3x2cm and is firm, solid, with yellow-white areas. Necrosis is noted in focal regions upon sectioning. Microscopic Description: The cells form trabecular, tubular, acinar, or sheet-like patterns interspersed within benign tissue. The cells maintain a polygonal morphology and display round vesicular nuclei with prominent nucleoli. Cytoplasm is abundant and varies between eosinophilic, clear, or vacuolated. Nuclear pleomorphism is marked with large, hyperchromatic nuclei and conspicuous nucleoli. Mitotic figures are present. Necrotic areas are evident and lymphocytic invasion is observed. Specimen type is lobectomy. Other parameters including focality, histologic type, histologic grade, tumor extent, lymph node status, venous invasion, margin status, evidence of neo-adjuvant treatment, and additional findings are not specified."} +{"pid": "TCGA-95-7944", "report": "A wedge resection specimen of the left lower lobe of the lung was examined. A mass measuring 1.4 x 1.2 x 1.1 cm was identified within the lung tissue. The mass was located 0.3 cm from the stapled surgical margin and was described as firm and yellow. Histologically, the lesion demonstrated poorly differentiated features. No lymphovascular invasion was identified. Margins of resection were negative.\n\nMultiple lymph node specimens were also evaluated. Two lymph nodes from station #9, one lymph node from station #7, three lymph nodes from station #6, and two lymph nodes from station #10L were all negative for metastatic involvement. In total, eight lymph nodes were examined and none showed evidence of tumor spread.\n\nImmunohistochemical staining for markers including TTF-1, p63, and CK5 was performed and yielded negative results. Additional findings included no evidence of tumor in the extended wedge resection specimen of the left lower lobe. The primary lesion was confined to the lung parenchyma without extension into adjacent structures or pleural invasion.\n\nStaging parameters indicated a primary tumor size of 1.4 cm, with no lymph node involvement (pN0). The tumor was classified as unifocal and surrounded entirely by lung tissue. All surgical margins were free of tumor involvement, with the closest distance from the invasive component to the parenchymal margin measuring 39 mm."} +{"pid": "TCGA-A2-A0CM", "report": "The specimen consists of fibrofatty tissue from the left breast, measuring 8.0 x 2.5 x 2.3 cm. A mass is identified at the deep margin, which is sutured and inked black, while the remaining margins are inked blue. The mass measures 3.0 x 2.5 x 2.5 cm and has a firm, well-circumscribed appearance with a tan, gritty, and focally hemorrhagic cut surface. Microscopic evaluation reveals poorly differentiated cells arranged in a high-grade pattern, with extensive necrosis observed. There is a minimal in-situ component also classified as high grade. Lymphovascular space invasion is present, and the tumor approaches within 1 mm of the deep surgical margin. Additional findings include a hyalinized fibroadenoma. Hormone receptor testing shows no reactivity for estrogen receptors and only focal positivity for progesterone receptors. Immunohistochemical analysis for HER2/neu is negative (0+). Multiple sections were taken from the tumor and surrounding tissue for further evaluation."} +{"pid": "TCGA-VS-A8QC", "report": "The cervix biopsy reveals a moderately differentiated infiltrative squamous cell carcinoma. The tumor measures approximately 3.5 cm in greatest dimension. Histologic examination shows nests and sheets of malignant squamous cells with moderate nuclear pleomorphism, prominent nucleoli, and frequent mitotic figures. Stromal invasion is present, with involvement of the cervical stroma. No lymphovascular space invasion is identified. No lymph node metastases are present."} +{"pid": "TCGA-2G-AAF6", "report": "The pathology report describes a right orchidectomy specimen. The tumor measured 6 cm in diameter and was confined to the testis based on available slides. There was no evidence of angioinvasion or invasion of the rete testis. The date of orchidectomy is provided, and the report was completed by a pathologist."} +{"pid": "TCGA-BP-4797", "report": "The right kidney specimen measured 11.0 x 5.0 x 3.5 cm and weighed 320 g. A tumor measuring 4.5 x 3.0 x 2.8 cm was identified in the upper pole, with extension to the sinus and renal capsule. The tumor appeared soft, infiltrative, and variegated with tan/yellow/red coloration and extensive hemorrhage. The remainder of the kidney showed a well-defined cortico-medullary junction, with cortex measuring 0.5 cm. No lymph nodes were identified in the perinephric fat. Surgical margins were free of involvement. The attached ureter measured 6.5 cm in length and 0.5 cm in diameter, and the renal vein measured 1.2 cm in length and 0.7 cm in diameter. No invasion of the renal vein was identified, but involvement of muscular branches within the renal sinus was noted.\n\nSections of the tumor were submitted for analysis, along with representative sections of adjacent kidney tissue, hilar fat, sinus fat, and renal pelvis. The adrenal gland was not present in the specimen. Additional specimens included paracaval and precaval lymph nodes ranging from 0.4 to 1.2 cm in size. Five lymph nodes were examined, none of which showed evidence of metastatic involvement. A separate specimen labeled as the right adrenal gland with attached adipose tissue measured 6.5 x 2.2 x 1.0 cm and weighed 8.5 g. The adrenal cortex showed a yellow-red appearance with small hemorrhagic foci in the medulla; no lymph nodes were identified in this specimen.\n\nHistologic evaluation revealed nuclear features corresponding to grade III/IV. The tumor did not extend into the renal vein or vena cava above the diaphragm but involved the renal sinus and surrounding fat. No lymph node tissue was found in the non-renal specimens, and the adrenal gland showed benign features. All submitted lymph nodes were negative for malignancy. The tumor was confined to the kidney with extension into the sinus fat but without involvement of the renal vein lumen."} +{"pid": "TCGA-EL-A3GS", "report": "A surgical case involving a total thyroidectomy specimen demonstrated bilateral involvement with multi-focal disease. The right lobe measured 4.2 x 2.5 x 1.6 cm and contained a centrally located, soft, pink-red friable nodule measuring 1.6 x 1.5 x 1.5 cm. The left lobe measured 3.2 x 2.0 x 0.8 cm and contained a firm, oval nodule at the inferior pole measuring 1.2 x 0.6 x 0.8 cm with a yellow core on cut surface. There was extension into soft tissue at the right thyroid bed. Extrathyroidal extension was present (Part D). A lymph node in the perithyroidal region showed metastatic involvement without extracapsular extension. Additional tissues from the right inferior thyroid pole and left superior thyroid pole were submitted and found to contain only parathyroid tissue. The fragments were small, measuring up to 0.2 cm in greatest dimension. All specimens were processed and examined in entirety."} +{"pid": "TCGA-B0-5399", "report": "The patient presented with a 4 cm well-circumscribed mass in the right lower pole of the kidney identified on CT imaging. The surgical specimen from partial nephrectomy was examined and showed a neoplasm measuring 4.5 cm in its greatest dimension, with additional dimensions of 4.4 x 3.5 cm. Histologic evaluation revealed clear cell morphology. Nuclear grading was assessed as Fuhrman grade 2. The tumor was confined within the renal capsule without evidence of angiolymphatic invasion. All evaluated surgical resection margins were free of neoplastic involvement, including the inked parenchymal margins. No regional lymph nodes were identified or examined. Based on the extent of the disease observed, the pathologic staging was determined to be pT1b, with no evidence of metastasis. No additional significant pathologic findings were noted. The adrenal gland was not present in the specimen."} +{"pid": "TCGA-85-8350", "report": "Specimen was a lobectomy from the lung, measuring 1.2 x 2.5 x 3 cm. Microscopic examination revealed moderately differentiated cells with squamous morphology. No information was provided regarding tumor extent, presence of additional nodules, lymph node involvement, lymphatic or venous invasion, surgical margins, neo-adjuvant treatment, or other significant pathologic findings. The tumor was located in the right upper lobe."} +{"pid": "TCGA-DB-A75L", "report": "The specimen consists of brain tissue from the left frontal lobe, obtained via biopsy and CUSA (Cavitron Ultrasonic Surgical Aspirator) contents during excision. Histologic evaluation reveals a diffusely infiltrative glioma with moderately high cellularity. The tumor demonstrates nuclear atypia, frequent mitotic figures, and areas of microvascular proliferation. No necrosis was identified. Immunohistochemical staining was performed on paraffin-embedded sections using antibodies to p53 protein and mutant IDH1 (R132H). Staining for p53 shows strong overexpression in the tumor cells. Immunoreactivity for mutant IDH1 (R132H) is present, indicating an IDH1 mutation. Intraoperative cytologic evaluation of smears was performed and interpreted as showing features of an intermediate-grade glioma. The findings were reviewed and interpreted as part of a collaborative assessment."} +{"pid": "TCGA-AR-A1AM", "report": "A right simple mastectomy specimen contains two distinct lesions. The first lesion, located in the upper outer quadrant of the breast, measures 1.1 x 0.9 x 0.8 cm and exhibits Nottingham grade I features with tubule formation score of 3/3, nuclear grade 1/3, and mitotic count 1/3 (total Nottingham score 5/9). This lesion is classified as AJCC pT1c. Immunohistochemical analysis demonstrates weak overexpression of HER2/neu protein (score 2+). Metastatic involvement is identified in one right axillary sentinel lymph node (designated No. 1D), characterized by a focus approximately 1.1 mm in size composed of keratin-positive tumor cells with subtle morphologic features.\n\nThe second lesion is also located in the upper outer quadrant, measuring 1.7 x 1.5 x 0.9 cm and situated approximately 0.6 cm inferior and medial to the first lesion. It corresponds to AJCC pT1c staging and similarly demonstrates HER2/neu protein overexpression (score 2+). However, no metastatic involvement is detected in any of the sentinel lymph nodes associated with this lesion.\n\nIn addition to the invasive lesions, extensive ductal carcinoma in situ of intermediate nuclear grade is present both within and separate from the invasive components. A discrete focus of this in situ component measures 1.2 x 1.2 x 0.6 cm and is located centrally and deeper within the breast, approximately 1.4 cm medial to the second invasive lesion. There is no evidence of angiolymphatic invasion.\n\nNon-neoplastic findings include proliferative fibrocystic changes throughout the breast parenchyma and biopsy site alterations. No tumor involvement is observed at the nipple, overlying skin, or underlying chest wall. All surgical margins, including the deep margin, are free of tumor with a minimum distance of 0.4 cm between tumor and anterior/superior margin.\n\nEvaluation of sentinel lymph nodes reveals metastatic involvement in one out of twelve right axillary sentinel lymph nodes (AJCC pN1mi(sn)). The remaining eleven sentinel lymph nodes show no evidence of metastasis based on histologic evaluation and keratin immunostaining. Blue dye uptake is documented in several sentinel lymph nodes (No. 1A, No. 2A, No. 3A, No. 3B, and No. 4), while others (No. 1B, No. 1C, No. 1D, No. 2B, No. 2C, No. 2D, and No. 3C) do not demonstrate blue dye uptake.\n\nHER2/neu immunohistochemistry was performed using standardized protocols and demonstrates weak positivity (score 2+) in both invasive nodules. Fluorescence in situ hybridization for HER2/neu amplification was conducted separately and did not reveal gene amplification in either lesion."} +{"pid": "TCGA-08-0245", "report": "The specimen was received in four parts. Part A, labeled with the patient's name and medical record number, consisted of multiple irregular fragments of pink-gray soft tissue measuring 1.1 x 0.7 x 0.3 cm in total. A cytologic preparation was made, and half of the specimen was submitted for frozen section analysis and subsequently placed in cassette A1. The remaining half was submitted in cassette A2. Part B, labeled \"deep tumor,\" included two fragments of pink soft tissue measuring 1.1 x 0.6 x 0.4 cm in total and was entirely submitted in cassette B1. Part C, labeled \"brain tumor,\" contained multiple fragments of white-tan and pink soft tissue measuring 1.2 x 0.9 x 0.4 cm in aggregate and was entirely submitted in cassette C1. Part D, labeled \"tumor margin,\" was a single unoriented fragment of gray-tan soft tissue measuring 2.5 x 1.2 x 0.6 cm. One smooth surface was inked blue to identify the potential margin edge, and the specimen was sectioned accordingly before being submitted in cassette C1.\n\nMicroscopic evaluation revealed highly cellular tissue with marked nuclear pleomorphism, abundant mitotic figures, multiple areas of necrosis, and prominent microvascular proliferation. Immunohistochemical staining for glial fibrillary acidic protein showed strong positivity in numerous astrocytic cells. In the specimen designated as \"tumor margin,\" serial sections identified clusters of abnormal astrocytes within a small subpial region, along with extensive involvement of the leptomeninges, although most of the cortical tissue appeared unaffected.\n\nThe tissue from the left occipital region was processed for both frozen section and permanent analysis. Gross examination noted the presence of necrotic regions within the mass. Final microscopic findings were confirmed by the attending pathologist after comprehensive review of all slides. The laboratory is CLIA-certified for high-complexity testing, and the immunostains used are performed under established clinical protocols."} +{"pid": "TCGA-06-5412", "report": "The patient presented with a large right temporoparietal mass exhibiting rim-enhancement and prominent associated vasogenic edema on imaging. An excision biopsy of the right parietal lesion was performed.\n\nHistologic examination revealed a high-grade astrocytic neoplasm with features including nuclear anaplasia, brisk mitotic activity, and focal microvascular proliferation. Zones of tumor necrosis were also identified. Immunohistochemical staining demonstrated strong GFAP expression and a high proliferation index as assessed by MIB-1 labeling, estimated at approximately 8%. The tumor exhibited rich vascularity (confirmed by CD34 staining) and significant infiltration by phagocytic cells, as shown by CD163 positivity. Sparse lymphocytic infiltration was noted on LCA staining.\n\nMolecular testing showed a methylated MGMT promoter, detected via bisulfite-treated DNA analysis followed by real-time PCR amplification. This finding suggests potential therapeutic benefit from alkylating agent therapy. No EGFR variant III mutation was detected by PCR analysis of RNA extracted from the tumor tissue. The sensitivity of this assay is estimated to be capable of detecting approximately 5 mutant cells per 100 normal cells.\n\nThe specimen consisted of three fresh fragments measuring a total of 0.7 cm, described as soft, glistening, and greyish-red in appearance. Multiple histologic stains were performed for characterization, including H&E, CD163, CD34, LCA, EGFRvIII, GFAP, MGMT, and MIB-1."} +{"pid": "TCGA-CN-6989", "report": "The pathology report includes findings from multiple specimens. In the right neck dissection (levels 2\u20134), 19 lymph nodes were examined, with metastatic involvement identified in 15. The largest metastasis measured 1.5 cm and was located in level 3. Extracapsular extension was present. In the left neck dissection (levels 2\u20134), 37 lymph nodes were evaluated, with metastatic involvement in three. The largest metastasis on the left measured 0.7 cm and was found in level 2. No extracapsular extension was observed on the left.\n\nExamination of the base of the left tongue revealed a squamoproliferative lesion with keratosis; however, no malignancy was identified. The left lateral pharynx specimen also showed no evidence of tumor. The larynx specimen contained two distinct lesions. One was an invasive lesion measuring 4.0 cm located in the supraglottic and hypopharyngeal regions on the right, extending into pre-epiglottic soft tissue. This lesion demonstrated angiolymphatic and perineural invasion and was assigned a pathologic stage of pT3 N2c. A second, smaller lesion measuring 1.0 cm was identified on the left involving the glottis. This lesion was staged as pT1 and did not show angiolymphatic or perineural invasion. All surgical margins were free of tumor involvement. Thyroid tissue appeared unremarkable.\n\nIntraoperative frozen section analysis of the base of the tongue and pharyngeal margins confirmed absence of tumor in those areas. Immunohistochemical staining for p53 and Ki-67 performed on relevant specimens did not show increased expression in squamoproliferative areas. All submitted tissues were adequately reviewed and evaluated."} +{"pid": "TCGA-G9-6365", "report": "The posterior bladder neck specimen consists of a fragment of tan firm tissue measuring 1.1 x 0.9 x 0.3 cm and was entirely submitted for evaluation. No tumor was identified.\n\nExcised right pelvic lymph nodes consist of multiple fragments of adipose tissue totaling 5.5 x 2.2 x 1 cm in aggregate. Two lymph nodes were identified measuring 1.6 x 1.4 x 0.2 cm and 3.5 x 2 x 0.9 cm respectively; all submitted sections showed no evidence of tumor. Excised left pelvic lymph nodes include multiple fragments of adipose tissue measuring up to 6.4 x 5.5 x 1.5 cm with lymph nodes ranging from 0.5 x 0.5 x 0.2 cm to 5 x 1.4 x 0.8 cm. All submitted sections were negative for tumor.\n\nThe prostate gland weighed 91 g prior to processing and measured 7.5 cm (right to left), 5 cm (anterior to posterior), and 4.5 cm (apex to base). The capsule had a rough, shaggy appearance. After removal of the apex and base, the weight decreased to 52 g. Serial sectioning revealed firm tan nodular parenchyma. The right and left seminal vesicle remnants measured 2 x 1.8 x 0.2 cm and 1.5 x 1.2 x 0.3 cm respectively and showed cystic tan tissue on sectioning. Vas deferens fragments were also sampled bilaterally measuring 3 x 0.3 cm and 3.2 x 0.5 cm respectively.\n\nHistologic examination showed atypical glands within the muscular wall of the left seminal vesicle and involving the inked left base margin with proximal urethral involvement. Positive margins were multifocal with linear distances measuring 1.1 mm, less than 1 mm, and less than 1 mm respectively. Perineural invasion was identified. There was no definitive angiolymphatic invasion observed. Staining patterns supported the presence of atypical glands showing loss of basal cells and positive staining for PSA and PSAP.\n\nTissue blocks from various levels of the prostate including apex, base, lateral regions, and capsule were evaluated. The remainder of the prostate showed benign findings including benign prostatic hyperplasia (BPH).\n\nLymph node evaluation included 8 from the right side and 5 from the left, all negative for tumor. No tumor was identified in the right seminal vesicle or vas deferens. The pathological staging indicates T4 disease."} +{"pid": "TCGA-CJ-6033", "report": "The right kidney specimen measured 16.0 x 14.5 x 9.0 cm and included an attached ureter measuring 13.0 cm in length and 0.5 cm in diameter. A rim of perinephric adipose tissue was present, ranging from 0.5 to 2.5 cm in thickness. A large mass measuring 13.5 x 10.5 x 7.0 cm was identified, occupying the upper and mid portions of the kidney. The lower pole contained a 5.0 cm segment that was not involved by the tumor. The tumor had lobulated margins and displayed a yellow-tan, firm parenchyma. Peripheral areas were gelatinous and gray-tan with regions of hemorrhage and cystic degeneration, while central areas were firmer, with hyalinization and degeneration. Viable, irregular gelatinous areas were also observed centrally. The tumor extended into the perinephric adipose tissue but did not involve Gerota's fascia. It abutted the renal pelvis and intrapelvic adipose tissue, without evidence of extension into the renal vein. A separate satellite nodule measuring 2.0 x 1.3 x 1.0 cm was found in the upper part of the lower pole. Histologically, the tumor demonstrated a mixture of clear and eosinophilic cells, with the latter predominating. Nuclear grade was high, with increased mitotic activity noted focally. No sarcomatoid component was identified. All resection margins, including vascular, ureteral, and soft tissue, were free of tumor."} +{"pid": "TCGA-HC-A6AS", "report": "The specimen includes right and left pelvic lymph nodes and a prostate following radical prostatectomy. Five lymph nodes were examined, and none contained metastatic carcinoma. The prostate measured 4.0 x 4.0 x 3.0 cm and weighed 40.9 grams. Histologic evaluation revealed a lesion within the prostate gland occupying approximately 1\u20133% of its volume on the right side. Histologic patterns included a primary pattern of 3/5 and a secondary pattern of 4/5, resulting in a total score of 7/10. No extraprostatic extension, seminal vesicle involvement, or lymphovascular space invasion was identified. High-grade prostatic intraepithelial neoplasia was present. Surgical margins, including base, apex, and inked margins, were free of tumor. Perineural invasion was noted. The pTNM stage was determined to be T2a N0. The prostate was previously sectioned for tissue procurement and further sectioned from apex to base. A white-tan area of induration measuring 1 x 1 x 0.6 cm was identified at the base near the right posterior aspect. Seminal vesicles were unremarkable and showed no evidence of tumor involvement. Multiple sections were submitted for analysis, including representative areas of the prostate and seminal vesicles."} +{"pid": "TCGA-AA-3872", "report": "The resected colon specimen shows an ulcerated lesion with slightly differentiated features. The lesion is located 3 cm from a resection margin and extends into the pericolic fatty tissue with circumscribed involvement of the serosal surface. A total of 29 local lymph nodes were examined, 23 of which show metastatic involvement. The tumor demonstrates partially angioinvasive growth and reaches up to the mesenteric resection margin. All colon resection margins are free of tumor. Histological grade is G3. Lymphovascular invasion is present. Tumor staging is pT4, pN2 (23/29), pMX."} +{"pid": "TCGA-BH-A0W4", "report": "A 47-year-old female underwent bilateral total mastectomies with bilateral sentinel lymph node biopsies and insertion of bilateral tissue expanders. The left breast specimen demonstrated an invasive lesion measuring 28 mm located in the upper outer quadrant and lower outer quadrant. Histologic evaluation revealed nuclear grade 2, tubule formation score of 1, mitotic activity score of 1, resulting in a total Nottingham score of 4 corresponding to grade 1. No lymphovascular space invasion was identified. An in situ component showed nuclear grade 2 with cribriform and micropapillary patterns. Surgical margins were negative for tumor involvement; however, the invasive component approached the anterior margin at 9 mm. Calcifications were noted in both benign and malignant zones. Additional findings included radial scar, sclerosing adenosis, fibrocystic changes, and changes consistent with a prior biopsy site. Hormone receptor testing indicated positivity for estrogen and progesterone receptors, HER2/Neu expression was 1+. Pathologic staging was determined as pT2 pNO pMX.\n\nThe right breast specimen contained an invasive lesion measuring 11 mm located approximately at the 9 o\u2019clock position. Histologic evaluation demonstrated nuclear grade 2, tubule formation score of 1, mitotic activity score of 1, with a total Nottingham score of 4 corresponding to grade 1. There was no lymphovascular space invasion. Surgical margins were negative for tumor involvement, with the invasive component approaching the anterior margin at 26 mm. An in situ component was identified as lobular carcinoma in situ (LCIS). Additional findings included atypical ductal hyperplasia, flat epithelial atypia, radial scar, biopsy site changes, fibrocystic changes, calcifications, and sclerosing adenosis. Hormone receptor testing indicated positivity for estrogen and progesterone receptors, HER2/Neu expression was 1+. Pathologic staging was determined as pT1c pNO MX.\n\nSentinel lymph node biopsy results were negative bilaterally; one lymph node was examined on each side using hematoxylin and eosin staining. Both nipple skin specimens were negative for tumor involvement."} +{"pid": "TCGA-IR-A3LA", "report": "The surgical specimens submitted included the uterus, cervix, bilateral fallopian tubes and ovaries, cul-de-sac biopsy, multiple lymph node groups from both sides (right and left external iliac, distal external iliac, obturator, hypogastric, periaortic, and para-aortic regions), and omentum. \n\nExamination of the uterine cervix showed a high-grade, poorly differentiated tumor with areas of anaplastic features. The maximal thickness of stromal invasion measured 12 mm, and the cervical thickness at the site of maximal tumor involvement was 15 mm. Vascular and perineural invasion were present. There was no evidence of multicentric tumor, in-situ carcinoma, vaginal extension, or extension into the uterine corpus. No parametrial involvement was identified. All surgical margins were free of tumor. The endometrium appeared normal, and the myometrium contained leiomyomas. The left ovary contained an epithelial inclusion cyst; all other adnexal structures were unremarkable.\n\nThe cul-de-sac biopsy showed only fibrovascular tissue without any evidence of tumor. All lymph node specimens from various sites were benign, with no metastatic involvement identified. A total of 0 out of 14 lymph nodes examined were involved. The omental biopsy revealed mature fat and no tumor."} +{"pid": "TCGA-EJ-5511", "report": "The patient had a prior biopsy revealing a Gleason score of 3+4=7 involving the right side of the prostate. A radical prostatectomy was performed. Examination of the specimen revealed an invasive poorly differentiated adenocarcinoma with a tertiary Gleason pattern 5. The tumor involves both the right and left lobes of the prostate with a maximum nodule size of 1.6 cm, accounting for approximately 20% of the prostate volume. There is established extracapsular extension involving the right anterior base, right posterior base, and right level 7 region. Bilateral seminal vesicles are unaffected. All surgical margins are free of tumor involvement. Extensive perineural invasion is present without evidence of angiolymphatic invasion. High-grade prostatic intraepithelial neoplasia is also identified. Fifteen lymph nodes were examined\u2014five from the right pelvic region and ten from the left\u2014with no evidence of neoplasia. The pathological staging is pT3a with no nodal involvement (pN0) and histologic grade G3\u2013G4. The prostate weighs 47.7 grams."} +{"pid": "TCGA-LD-A9QF", "report": "The pathology report includes findings from a left total mastectomy and lymph node sampling. A total of 14 lymph nodes were examined, including multiple sentinel and palpable lymph nodes from the left axillary region. All nodes were negative for involvement on histologic examination, with no evidence identified in any of the cutdown sections.\n\nThe mastectomy specimen revealed an invasive lesion measuring 1.6 cm, with an additional incidental focus of microinvasion less than 1 mm. A separate in-situ component was also identified, spanning approximately 11 cm in the subareolar region and extending to 12\u20131 o\u2019clock. The invasive component was located retroareolar, measuring 1.6 x 1.2 x 1.2 cm, and situated 6 cm from the deep margin and 3 cm from the overlying skin. It was described as tan-white, ovoid, lobulated, and indurated. Fibrotic changes were noted anterior to this mass, with a stellate area of fibrosis located at 1\u20132 o\u2019clock, 11 cm from the nipple. This fibrotic area contained a clip placed 3 cm from the deep margin and 6.5 cm from the skin surface. No grossly identifiable lesion was associated with this clip.\n\nHistologic evaluation showed high-grade features, including a nuclear grade of III and a corresponding histologic grade of III based on tubule formation, nuclear grade, and mitotic count. The in-situ component demonstrated variable morphology, with comedo-type features in the subareolar region, cribriform growth patterns in other areas, and mixed nuclear grades. Comedonecrosis was present in some foci. Microcalcifications were identified in association with the in-situ component.\n\nMargins were intact, and all surgical margins were free, with the closest distance being 3 cm from the invasive and in-situ components to the anterior and posterior margins. Lymphovascular invasion was noted focally. The skin lesions submitted were benign, showing pigmented seborrheic keratoses and simple lentigines. No involvement was seen in the nipple or skeletal muscle.\n\nAdditional findings included two core biopsy sites, focal microcysts, mammary duct stasis/ectasia, and usual duct hyperplasia. The specimen was well-preserved, oriented, and submitted in its entirety for analysis, with representative sections from various regions included for review."} +{"pid": "TCGA-ED-A8O6", "report": "Gross Description: A mass is present in the left liver, with ill-defined margins measuring 22 x 17 x 15 cm. The consistency is soft and solid, with a gray-white appearance on cut surface. Microscopic Description: The cells form trabecular, acinar, or sheet-like arrangements. The cells are polygonal in shape with round, vesicular nuclei and prominent nucleoli. The cytoplasm is moderate in amount, appearing basophilic or vacuolated. Nuclear features include irregular enlargement, hyperchromasia, and presence of prominent nucleoli. Mitotic figures are identified. The lesion shows infiltration into blood vessels and adjacent hepatic tissue, and areas of necrosis are present. The stromal component is fibrous. Specimen type is lobectomy. Tumor size is 22 x 17 x 15 cm. Histologic grade is poorly differentiated. Margins are uninvolved. No evidence of neoadjuvant treatment is observed. Additional pathologic findings indicate location in the left liver."} +{"pid": "TCGA-GN-A8LN", "report": "The specimens include two right axillary sentinel lymph nodes, a wide excision from the anterior right chest, and additional lateral and medial margin samples. Both sentinel lymph nodes were negative for malignant involvement. The primary lesion measured 4.2 x 3 x 1 cm and was located 1.5 cm from the closest margin. Histologic evaluation showed residual ulcerated malignant cells with a Breslow depth of 5.8 mm. All margins, including those from the additional lateral and medial specimens, were free of malignant cells. Immunohistochemical staining of the lymph nodes was negative for S-100 and MELAN-A markers. Special stains and immunohistochemical studies were performed using validated protocols with appropriate controls. Gross examination of the excised chest specimen revealed a mottled pigmented lesion with superficial depth of invasion. The lymph nodes showed no evidence of metastatic involvement."} +{"pid": "TCGA-CV-A6JD", "report": "A right neck dissection (levels IA, IB) revealed ten lymph nodes, all without evidence of tumor involvement. A salivary gland present in the specimen also showed no tumor. The anterior bone margin was initially pending decalcification but was later confirmed to be negative for tumor. The floor of the mouth margin showed squamous mucosa and salivary gland without tumor involvement. Similarly, the posterior bone margin was processed and found to be free of tumor after decalcification.\n\nThe primary resected specimen from the right segmental mandibulectomy and floor of the mouth resection showed an exophytic lesion measuring 3.0 cm in its largest dimension. Histological evaluation indicated that the lesion had an infiltrative border with thick cords greater than four cells in width. There was evidence of invasion into surrounding tissue, with a depth of 1.3 cm. No perineural or vascular invasion was identified. Moderate lymphocytic infiltration was noted. Additionally, the tumor was found to involve the bone. Multiple sections were submitted for analysis, including those from the anterior and posterior mandible margins and the tumor-bone interface.\n\nOther examined sites included the anterior and posterior buccal mucosa margins. The anterior buccal mucosa margin contained fibroadipose tissue and skeletal muscle, with no tumor identified. The posterior buccal mucosa margin showed focal dysplasia but no invasive tumor. The posterior gingiva specimen revealed squamous mucosa with chronic inflammation, and no tumor was found. A second posterior gingiva sample contained squamous mucosa, salivary gland, and skeletal muscle with chronic inflammation, also without tumor. A third posterior gingiva fragment similarly showed only chronic inflammation.\n\nIn the right neck dissection levels II and III, eight and five lymph nodes were identified respectively, none of which contained tumor cells. All other lymph node specimens from these regions were negative for tumor involvement. Touch preparations and frozen sections from various surgical margins consistently showed no evidence of carcinoma.\n\nGross examination of the resected mandibular segment measured 4.0 x 1.5 x 1.0 cm, with attached floor of the mouth tissue (4.0 x 2.0 x 1.5 cm) and gingival portion (4.0 x 1.5 x 1.0 cm). The tumor itself measured 3.0 x 2.0 x 1.0 cm and was located in the floor of the mouth, extending to the lingual gingiva. Bone involvement by the tumor was confirmed upon further analysis after decalcification. All relevant tissue sections were submitted for comprehensive evaluation.\n\nAll surgical margins assessed were negative for tumor except for the finding of bone invasion within the primary resection specimen. No additional tumor involvement was identified in any of the other submitted tissues."} +{"pid": "TCGA-CX-A4AQ", "report": "The surgical specimen includes multiple tissue samples from a right neck dissection and floor of mouth resection. Levels II, IIB, and III of the right neck contain fibroadipose tissue with no tumor involvement identified. One lymph node in level IIB was examined and found negative. In the selective neck dissection specimen, two out of forty lymph nodes showed involvement. The affected lymph nodes were located in level I (measuring 4 cm) and level III (measuring 1.4 cm). No tumor was identified in the remaining lymph nodes or surrounding fibroadipose tissue.\n\nBiopsy specimens from the deep, medial, lateral, and anterior margins were all negative for tumor involvement. However, the anterior, deep, and posterior resection margins from the main specimen were involved.\n\nMicroscopic examination revealed poorly differentiated basaloid carcinoma within the oral cavity. Histologic grading classified the lesion as G3, indicating poor differentiation. Venous or lymphatic invasion was present; perineural invasion was not observed.\n\nThe primary tumor measured 2.4 cm at its greatest dimension, with additional dimensions measuring 2.3 x 1.0 cm. Gross evaluation of the floor of mouth specimen identified a centrally located mass measuring approximately 2.3 x 1 x 2.4 cm. This mass was in close proximity to several margins: 0.8 cm from the lateral margin, 2.2 cm from the medial margin, and directly adjacent to the anterior, posterior, and deep margins.\n\nPathologic staging indicates T2 classification based on tumor size greater than 2 cm but less than 4 cm. Regional lymph node staging corresponds to N2b due to metastasis in multiple ipsilateral lymph nodes without evidence of distant spread (pMX). A total of 41 lymph nodes were examined, with two demonstrating involvement.\n\nAdditional findings include chronic inflammation within salivary gland tissue and the presence of carcinoma in situ, although it does not involve any margins. No tumor involvement was detected in skeletal muscle or bone specimens obtained from the mandible.\n\nThe surgical report confirms adequate sampling and orientation of specimens using sutures and ink markers. Multiple sections were submitted for histologic evaluation to assess tumor involvement and surgical margins thoroughly."} +{"pid": "TCGA-A7-A4SF", "report": "**Modified Report:**\n\nThe specimen consists of a right breast excision and two sentinel lymph nodes. The lymph nodes measured 0.7 cm and 0.8 cm, respectively, and showed no evidence of involvement. The breast specimen contained a mass measuring at least 2.5 cm in greatest dimension, with possible extension up to 4.0 cm due to infiltrative growth into surrounding fat. Histologic evaluation revealed a moderately differentiated carcinoma, with an overall histologic grade of 7/9 (architectural score 3, nuclear score 2, mitotic score 1). Tumor was present at the medial and posterior margins of the specimen, and there was focal high-grade intraductal proliferation involving the inferior margin. The intraductal component exhibited a solid and cribriform pattern with central necrosis, accounting for approximately 28% of the total lesion. No vascular invasion or calcifications were identified. Immunostains confirmed the presence of invasive carcinoma at the margin and supported exclusion of other morphologies. Additional immunostaining of lymph node tissue was negative. Gross examination described a fibroadipose tissue specimen with orienting sutures and inked margins. A tumor mass measuring 2.5 x 2.5 x 1.5 cm was identified, with microscopic findings indicating a single lesion with confluent growth extending to the margins. Multiple sections were taken from the tumor, surrounding tissue, and margins for analysis."} +{"pid": "TCGA-WB-A81W", "report": "The pathology report describes a specimen from the left adrenal gland, measuring 10 x 6.5 x 7 cm. The specimen is encapsulated and, upon sectioning, reveals a yellow lesion with areas of brown inclusions, hemorrhage, and cystic changes. Histologically, normal adrenal tissue is present alongside polygonal cells containing fine granular material and eosinophilic cytoplasm. The nuclei are enlarged with prominent nucleoli and intranuclear inclusions. At the periphery of the lesion, collagen-rich connective tissue and fat are noted, along with infiltrates of atypical cells showing pleomorphism. These abnormal cells demonstrate brown staining with PAS, HE, and Orth mixture stains."} +{"pid": "TCGA-EL-A3ZT", "report": "A thyroid lobectomy specimen from the left lobe measures 3.5 x 2.0 x 2.0 cm and is largely replaced by a soft pink tumor with areas of hyalinized fibrosis. The lesion measures 2.5 x 1.5 x 0.9 cm and has an irregular border. Histologic examination reveals cellular features consistent with papillary architecture. Extrathyroidal extension into adjacent fibroadipose tissue is noted, along with lymphovascular invasion. Surgical margins are negative. Adjacent thyroid tissue demonstrates multinodular adenomatous goiter. No lymph nodes are identified within the specimen. A separate specimen from the right thyroid lobe measures 4.4 x 3.0 x 1.0 cm and shows multinodular adenomatous goiter without evidence of neoplastic change. Gross examination reveals beefy red spongy parenchyma throughout. Serial sections from both specimens have been examined."} +{"pid": "TCGA-AA-3548", "report": "The specimen consists of a right hemicolectomy preparation with tumor-free oral and aboral resection margins. An ulcerated lesion is present in the region of the Bauhin's valve and adjacent cecum. Histological evaluation reveals moderately differentiated cellular features. The lesion extends with infiltration into the perimuscular adipose tissue. Evaluation of regional lymph nodes shows four positive nodes out of 23 examined. Vascular invasion is not identified, while lymphatic invasion is present. No residual disease at the resection margins is noted."} +{"pid": "TCGA-2Z-A9J5", "report": "A 5.0 x 1.2 x 0.7 cm portion of rib was received and found to be grossly unremarkable. A separate specimen labeled \u201cright kidney\u201d was received fresh and consisted of an ovoid mass measuring 20.0 x 15.0 x 12.0 cm and weighing 939.3 g. The external surface of the kidney showed an irregular resection margin inked in black, while the perinephric fat margin was inked in blue and appeared grossly unremarkable. Upon sectioning, a well-defined, tan-yellow, hemorrhagic, and partially necrotic tumor was identified within the kidney. The tumor measured 10 x 10.5 x 8 cm and was located 0.7 cm from the closest inked parenchymal margin of resection. No gross involvement of the perinephric fat margin by tumor was observed. Approximately 55% of the tumor exhibited areas of necrosis. Representative sections were submitted for microscopic evaluation, including tissue from the tumor in relation to the closest inked margin, a perpendicular section of the perinephric fat margin, and additional representative blocks. Microscopic examination revealed cellular features consistent with a malignant neoplasm exhibiting papillary architecture and clear cell morphology. Margins of resection were free of malignant cells. Based on the extent of local involvement and absence of distant spread, the pathologic stage was determined as T2 NX MX."} +{"pid": "TCGA-B6-A0I9", "report": "AP Surgical Pathology: Final. CLINICAL HISTORY: A female patient presenting with a left femur fracture possibly due to an underlying bone lesion, along with a large 6 cm mass identified in the left breast. GROSS EXAMINATION: The specimen labeled \u201cLeft breast biopsy\u201d consists of an irregular fragment of yellow fibro-adipose tissue measuring approximately 5 x 2.5 x 2 cm. The tissue had been previously sectioned, with a portion already submitted for hormone receptor analysis. Margins were not inked as deemed unnecessary by the surgeon. The entire specimen was processed and submitted across Blocks A1 through A6. MICROSCOPIC FINDINGS: A neoplastic process is present, characterized by solid and comedo-type morphologic features, along with an infiltrating component measuring 5 cm in greatest dimension. Histologic evaluation shows moderate nuclear atypia, corresponding to a mid-grade appearance on a scale of three. Vascular space invasion by the neoplastic cells is present."} +{"pid": "TCGA-FE-A23A", "report": "The specimen consisted of a total thyroidectomy along with multiple lymph node excisions. The thyroid gland weighed 25.9 grams and measured 5.5 x 5.0 x 2.3 cm. The right lobe contained a well-circumscribed, tan-pink, friable nodule measuring 2.7 x 2.2 x 2.0 cm that abutted the thyroid capsule but was not grossly encapsulated. A separate, smaller tan-white nodule measuring 0.6 x 0.5 x 0.5 cm was identified in the left lobe, also abutting the capsule without gross encapsulation.\n\nLymph nodes were received from various anatomical locations including midline neck and right paratracheal regions. All lymph nodes examined microscopically showed no evidence of tumor involvement. In total, 13 lymph nodes were evaluated, all of which were negative for malignancy. Lymphatic or vascular invasion was identified within the thyroid tissue. No capsular invasion was observed. The lesion appeared confined to the thyroid gland and was not multifocal. There was no infiltration of adjacent structures such as the thyroid cartilage or hyoid bone.\n\nHistologic evaluation demonstrated a well-differentiated morphology. Additional findings included features consistent with chronic lymphocytic thyroiditis. All surgical margins were free of tumor. Frozen section analysis during surgery confirmed benign status for all lymph node specimens and confirmed the presence of malignant cells in the thyroid specimen."} +{"pid": "TCGA-D5-6920", "report": "Histopathological examination was performed on a total resection specimen of the sigmoid colon. The specimen measured 18.2 cm in length, with attached mesentery measuring 20.0 x 9.0 x 2.0 cm. A superficial ulcerated lesion was identified in the mucosa, measuring 4.3 x 4.4 x 0.7 cm. This lesion circumferentially involved the intestinal wall, leading to luminal narrowing. It was located 12 cm from one resection margin and 3.9 cm from the opposite margin. Blue dye injection was noted in the affected wall. Additional findings included a 2 cm polyp and diverticula away from the primary lesion.\n\nMicroscopic evaluation revealed a neoplastic process characterized by tubulopapillary architecture and moderate differentiation (G2). There was evidence of superficial infiltration into the pericolonic adipose tissue. Resection margins were free of neoplastic involvement. In non-lesional areas, a tubular adenoma with low-grade dysplasia was identified, along with diverticula and diverticulitis. Reactive lymphadenopathy was present; no vascular invasion was observed.\n\nStaging parameters indicated pT3, pN0, corresponding to Dukes B / Astler-Coller B2 classification."} +{"pid": "TCGA-XV-AAZV", "report": "Patient F presented with a skin lesion located on the back. Histopathologic evaluation revealed a tumor measuring 10 mm in thickness and 10x12 mm in size. The Clark level was determined to be stage 4, with no evidence of metastasis or normal tissue involvement. Cellular analysis showed a high tumor cellularity with no response to prior neoadjuvant immunotherapy noted. Staging was classified as stage 2."} +{"pid": "TCGA-CV-7425", "report": "A supplemental report is provided for multiple tissue specimens. A minute bone fragment and several soft tissue fragments were submitted from the maxillary sinus region, with additional samples from the palate and a partial maxillectomy specimen.\n\nThe tumor from the hard palate consists of multiple tan soft tissue fragments measuring 2.0 x 1.5 x 0.5 cm in aggregate. The maxillary sinus tumor includes multiple tan soft tissue fragments totaling approximately 1.5 x 1.0 x 0.5 cm. A separate set of bone fragments from the maxillary sinus, measuring up to 0.8 x 0.8 x 0.2 cm, was submitted and is pending decalcification. Two small tan soft tissue fragments, measuring 0.6 and 0.8 cm respectively, were obtained from the lateral side of the palate and found to contain no tumor. Additional tan soft tissue fragments from the right maxillary sinus mucosa measured 0.8 x 0.6 x 0.2 cm in total.\n\nThe partial maxillectomy specimen measures 5.0 x 2.0 cm with a depth of 2.0 cm and includes three attached teeth. An exophytic tan mass measuring 3.0 x 2.8 x 1.2 cm is present at the center of the specimen, extending to the base. Margins are closely approached, with the mass located 0.1 cm from the anterior margin, 0.2 cm from the medial margin, 0.5 cm from the posterior margin, and 1.3 cm from the lateral margin. Bone fragments are present at the base. The specimen was inked and sectioned as follows: F1 at the posterior margin, F2\u2013F4 through the tumor and deep margin (F4 contains a bone fragment pending decalcification), F5\u2013F6 through additional tumor areas, and F7 at the anterior margin. Remaining bone fragments were sent to the Bone Lab for further processing."} +{"pid": "TCGA-CV-7411", "report": "The bilateral supraomohyoid neck dissection included 20 lymph nodes on the left and 9 on the right. The left parotid compartment contained benign salivary gland tissue and one lymph node without any abnormality. The left neck dissection included 19 lymph nodes, all negative for malignancy across the following regions: submental (0/4), subdigastric (0/2), lower jugular (0/3), mid posterior cervical (0/1), and lower posterior cervical (0/4). A microscopic focus of atypical cells was identified in 1 of 5 midjugular lymph nodes. On the right, the parotid tissue was benign and the modified neck dissection included 9 lymph nodes, all without evidence of disease (submental 0/1, mid-jugular 0/1, lower jugular 0/1, upper posterior cervical 0/1, and mid posterior cervical 0/2).\n\nThe biopsy of the left lingual nerve showed benign tissue with no abnormal cellular changes. Similarly, the proximal margin of the left inferior alveolar nerve was unremarkable with no pathological findings. The subtotal mandibulectomy specimen revealed well-differentiated invasive squamous epithelium; however, all margins of resection were free of any abnormal proliferation. The soft tissue designated as the \"new margin\" consisted of skeletal muscle and adipose tissue, both without involvement.\n\nSections of the mandible, including the medial bone margin of resection, are currently undergoing decalcification for further histologic evaluation, and a follow-up report will be issued once this analysis is complete."} +{"pid": "TCGA-AG-4022", "report": "The specimen shows an invasive, moderately differentiated neoplasm with infiltration through all layers of the intestinal wall. Vascular and lymphatic invasion are present. The tumor involves the full thickness of the colon wall and extends into surrounding tissues. Histologic grade is intermediate."} +{"pid": "TCGA-BQ-7059", "report": "A 4.7 cm right lower pole renal mass was identified in a male patient. The submitted specimen consisted of a right renal tumor resected via partial nephrectomy. The tumor measured 4.5 x 3.5 x 3.5 cm and was encapsulated, with a golden-yellow appearance on gross examination. The tumor did not involve the perinephric adipose tissue or adjacent renal parenchyma. The surgical margins were free of involvement, with a clearance distance of 0.4 cm from the tumor to the nearest resection margin. A representative section of the margin was examined intraoperatively and confirmed to be negative for tumor. \n\nHistologic evaluation revealed a neoplasm of the renal cortex. Nuclear grading was not applicable. No local invasion or renal vein involvement was observed. Staging indicated the tumor was confined to the kidney and measured less than 7.0 cm in greatest dimension. Non-neoplastic findings included mild arterionephrosclerosis. No lymph nodes or adrenal gland tissue were identified in the specimen. Representative sections of the tumor and surrounding tissue were submitted for further analysis."} +{"pid": "TCGA-AC-A2QH", "report": "The left breast specimen showed multiple intraductal papillomas with atypical ductal hyperplasia. A radial scar measuring 8 mm in diameter was identified. Additional findings included fibrosis, cysts, apocrine metaplasia, and sclerosing adenosis. The skin showed a seborrheic keratosis. No invasive malignancy was detected. An intramammary lymph node appeared unremarkable.\n\nIn the right breast, a large tumor measuring 95 mm in diameter was present. Microscopic evaluation revealed solid sheets of high-grade malignant cells with areas showing spindle cell morphology and other regions displaying rounded, epithelioid cells with marked nuclear atypia. Prominent tumor-associated necrosis was observed, and no glandular differentiation was evident. In some areas, the tumor cells were adjacent to blue-gray chondromyxoid or hyaline matrix. Immunohistochemical staining demonstrated positivity for p63 and CK5/6 in scattered tumor cells, supporting the presence of metaplastic features. Some tumor cells also expressed smooth muscle actin, suggesting myoepithelial differentiation. Staining for S100 was negative.\n\nLymphatic invasion was identified near the periphery of the tumor. The closest resection margin was located inferiorly, 40 mm from the tumor. All other margins were at least 50 mm away from the tumor. Twenty-two axillary lymph nodes were examined and found to be free of tumor involvement. The tumor was classified as high grade based on histologic criteria, with a Nottingham Grade of 3 (maximum score for tubule formation, nuclear pleomorphism, and mitotic count). The mitotic rate exceeded 20 mitoses per 10 high-power fields.\n\nEstrogen and progesterone receptor expression was absent. HER2/neu staining showed no overexpression (IHC score 0). The Ki-67 proliferative index was elevated at approximately 50%. The tumor was located in the upper outer quadrant and presented as a single focus. No evidence of ductal carcinoma in situ was identified. Lobular carcinoma in situ was not present.\n\nThe surgical specimens included a total mastectomy from the left breast and a modified radical mastectomy from the right breast, along with axillary lymph node dissection. The right breast specimen measured 26 cm from medial to lateral and 16 cm from superior to inferior. The tumor was situated within a cavitary space measuring up to 7 cm in greatest dimension. The surrounding tissue was firm and tan-white, with distances from the tumor to the surgical margins recorded as follows: 5 cm from the superior margin, 4 cm from the inferior margin, 5.5 cm from the deep margin, 7.5 cm from the medial margin, and 13 cm from the lateral margin. Axillary lymph node sampling yielded no evidence of tumor involvement.\n\nPathologic staging was determined as pT3 for the primary tumor, pN0 for regional lymph nodes, and pMX for distant metastasis. Lymphovascular invasion was documented, and all resection margins were negative. A consultation review confirmed the histologic findings."} +{"pid": "TCGA-DX-A2J0", "report": "The specimen consists of a large, multilobulated mass measuring 25.0 x 18.5 x 14.0 cm, surrounded by a thick fibrous capsule and attached to the spleen, omentum, a portion of pancreas, and colon. The mass is light tan to brown in color, with areas of firm, gritty consistency and soft, gelatinous regions. It measures 25.0 cm in its greatest dimension and approximately 20% necrotic. The attached colon segment measures 25.0 cm in length and up to 7.0 cm in circumference, with intact mucosa. The spleen measures 12.0 x 11.0 x 4.0 cm and weighs 172 grams; its capsule is smooth with unremarkable cut surfaces. The distal pancreas measures 7.0 x 4.5 x 2.0 cm, and the omentum measures 20.0 x 15.0 x 3.5 cm. Sections reveal a kidney measuring 12.0 x 5.6 x 4.5 cm, abutting the mass, with no identifiable ureter due to tumor distortion. An adrenal gland measuring 5.0 x 2.0 x 0.8 cm is present and appears separate from the mass.\n\nMicroscopic evaluation shows that the pancreatic margin is involved by well-differentiated adipocytic neoplasm. The mass surrounds but does not invade the adrenal gland and involves the colonic serosa. High-grade elements are present within the renal cortex. The colonic margins are free of involvement. The spleen shows no significant histologic abnormalities. Immunostains performed on tissue sections with epithelioid features show positivity for CD10 and negativity for AE1/AE3, CAM 5.2, EMA, and RCC. All slides were personally reviewed and confirmed."} +{"pid": "TCGA-VD-A8KD", "report": "The specimen consists of an intact left eye with axial dimensions measuring 25.5mm, horizontal 23.7mm, and vertical 23.5mm. The cornea measures 13mm horizontally and 11mm vertically. The optic nerve is 7mm in length and 3.5mm in diameter. The pupil is dislocated supratemporally. Trans-illumination reveals a shadowed area in the superior half measuring approximately 22 x 15mm. Sectioning is performed in the vertical plane.\n\nMacroscopic examination reveals a large mushroom-shaped lesion within the intraocular space. The lesion is partially pigmented and partially pale or amelanotic. It projects into the vitreous cavity, extending posteriorly to obscure the optic disc and anteriorly up to the posterior aspect of the lens. The largest basal diameter measures 18.3mm, with a height of 17.4mm.\n\nMicroscopic evaluation demonstrates a mixed-cell morphology. Approximately 25% of the cellular component is epithelioid, predominantly corresponding to the amelanotic region observed macroscopically. Immunohistochemical staining shows expression of Melan-A and HSP-27 (score 2). Mitotic activity is present at a rate of approximately 7 per 40 high power fields. The microvasculature is prominent, with presence of closed vascular loops. A moderate lymphocytic infiltrate is observed within the lesion along with scattered macrophages. Necrosis is not identified.\n\nThere is no evidence of tumour extension through the optic nerve or involvement of its resection margin. However, infiltration into the sclera is noted. Histological sections of vortex veins demonstrate focal tumour involvement in at least one vessel. Other findings include corneal edema involving the basal epithelial cells, focal closure of the anterior chamber angles, and proteinaceous fluid within the anterior chamber. The ciliary body appears atrophic with hyalinization of the ciliary processes. Pigmented iris epithelium is focally adherent to the anterior surface of the lens. There is extensive retinal detachment and disruption of Bruch\u2019s membrane adjacent to the lesion. The vitreous contains hemorrhagic material.\n\nMolecular genetic analysis was carried out using MLPA on DNA extracted from both pigmented and non-pigmented areas of the lesion. Chromosomal assessment revealed disomy for chromosome 1, monosomy for chromosome 3, disomy for chromosome 6, and polysomy involving chromosome 8. These findings were obtained using high-quality DNA and confirmed across multiple runs. The molecular profile suggests a higher likelihood of metastatic potential when considered alongside histological characteristics."} +{"pid": "TCGA-CK-6746", "report": "The surgical specimen labeled \u201cRight hemicolectomy\u201d measures 29 cm in total length. A mass measuring 15 cm in greatest dimension is identified in the cecum and proximal right colon. The tumor is ulcerative with a pushing border and extends through the muscularis propria to the serosal surface. Proximal, distal, and radial resection margins are free of tumor involvement. The invasive component is located 7.5 cm from the proximal margin, 10 cm from the distal margin, and 2 cm from the radial margin. No lymphovascular or extramural venous invasion is observed; however, perineural invasion is present. A mild peritumoral lymphoid response, including Crohn-like infiltrate, is noted. No residual adenoma is identified.\n\nImmunohistochemical staining of the lesional cells shows rare positivity for CK20 and negativity for CK7, CDX2, synaptophysin, and chromogranin. Of the 35 regional lymph nodes examined, none show evidence of involvement. Immunostaining reveals absence of MLH1 and PMS2 expression in tumor cells, while MSH2 and MSH6 demonstrate intact nuclear staining. This pattern suggests possible sporadic methylation silencing rather than germline mutation, though clinical correlation is necessary.\n\nA separate specimen labeled \u201cLiver biopsy\u201d consists of a tan-red soft tissue fragment measuring 0.4 x 0.3 x 0.2 cm and is submitted in entirety for frozen section. Histologic examination identifies bile duct adenoma.\n\nGross examination of the hemicolectomy specimen includes a segment of terminal ileum (7.0 cm), right colon and cecum (22.0 cm), and appendix (6.0 cm long, 0.4 cm diameter), along with attached adipose tissue measuring 30.0 x 16.0 x 1.2 cm. The proximal resection margin is 3.0 cm in length and inked blue; the distal margin is 4.0 cm and inked black. A firm area on the serosa measures 11.0 x 9.0 cm and is located 7.0 cm from the proximal margin and 10.0 cm from the distal margin. Upon opening, an exophytic, focally ulcerating mass measuring 15.0 x 10.0 x 4.0 cm is noted, involving the ileocecal valve. The mass comes within less than 0.1 cm of the black-inked peritonealized margin designated by the surgeon and is 2.0 cm from the closest mesenteric radial margin. Multiple lymph nodes ranging from 0.2 cm to 1.0 cm in size are identified in the surrounding adipose tissue.\n\nSections submitted include margins, lymph nodes, and representative areas of the tumor and uninvolved mucosa. No additional lesions are identified in the remaining mucosa."} +{"pid": "TCGA-DD-AAC9", "report": "The specimen consists of a liver segment measuring 7.0 x 8.5 x 5.0 cm and weighing 93.5 grams. A single tumor is present in segment 8, measuring 2.9 x 2.2 x 2.8 cm. The tumor has a vaguely nodular appearance grossly, with no satellite nodules noted. There is no necrosis, hemorrhage, or peliosis identified. Gross imaging is available. Tissue blocks include four from the tumor mass and one from the resection margin.\n\nMicroscopically, the lesion shows features consistent with moderately differentiated hepatic-type cells arranged in trabecular and pseudoglandular patterns. A partial fibrous capsule is present, and there is evidence of capsular infiltration as well as septum formation. The surgical resection margin is free of involvement, with a clearance distance of 0.5 cm. No invasion is observed in the serosa, portal vein, bile duct, hepatic veins, hepatic artery, or microvessels. There is no evidence of intrahepatic metastasis or multicentric occurrence.\n\nEvaluation of the non-tumor liver tissue reveals chronic hepatitis of mild activity, likely related to HBV infection, with minimal lobular inflammation and mild portoperiportal changes. Fibrosis is present in a micronodular pattern, stage 4 on trichrome staining. Additional findings include chronic gastritis in the antrum and chronic inflammation in the duodenum.\n\nNo other significant pathologic findings are noted."} +{"pid": "TCGA-WY-A858", "report": "The specimen was received in saline and labeled with the patient\u2019s name, designated as brain tissue. The sample consists of multiple pieces and fragments of white, pale tan-red, mucoid, and fibrous soft tissue measuring 2.1 x 0.9 x 0.4 cm in aggregate. Approximately 50% of the specimen was used for frozen section analysis. Histologic sections show increased cellularity with nuclear atypia and mitotic activity. The MIB-1 proliferation index is approximately 5%. Some areas demonstrate round uniform nuclei and perivascular halos. Molecular testing revealed changes consistent with loss of heterozygosity on chromosome 19q but not on 1p. The tissue shows features suggestive of infiltrating glioma, with morphologic and immunophenotypic characteristics evaluated using specialized stains and reagents not cleared or approved by the FDA. These tests were performed under laboratory-developed protocols. Additional specimens include a cyst wall and anterior frontal lobe tissue, all submitted for comprehensive evaluation."} +{"pid": "TCGA-ZS-A9CG", "report": "A portion of liver measuring 200 x 180 x up to 110 mm was received. Gross examination revealed a single lesion measuring approximately 85 x 70 x 60 mm, located close to the serosal surface. The tumour had a cream-colored cut surface with a green tinge and appeared to be encapsulated. The capsule was puckered but without macroscopic invasion beyond it. The tumour was situated 12 mm from the resection margin, which was marked with blue ink. Adjacent to the tumour, multiple distended vessels within portal tracts were observed, filled with tissue resembling the primary lesion. A separate small nodule measuring 4 mm was identified within the background liver. Histologically, the lesion consisted of sheets of hepatocytes showing architectural disarray, cytological atypia, and nuclear pleomorphism. Areas demonstrated formation of gland-like structures. Multiple foci of lymphovascular invasion were noted outside the main lesion. No bile production was observed within the lesion. Surrounding liver tissue showed chronic inflammation, regenerative nodules, and portal vein distention. Portal areas exhibited a foreign body giant cell reaction within distended veins. Mild steatosis and mild chronic inflammation were present in portal regions. Perl\u2019s stain revealed scattered iron deposition in hepatocytes. There was no evidence of fibrosis or cirrhosis in the background liver. Pathological staging indicated pT2, pNx, pMx. A gallbladder specimen was also received, showing no evidence of malignancy."} +{"pid": "TCGA-HZ-7925", "report": "A biopsy of the falciform ligament showed vascularized fibroadipose tissue without evidence of malignancy. A lymph node from the posterior portal area was negative for metastatic malignancy (0/1). Two lymph nodes from the hepatoduodenal region were both positive for metastatic involvement. The common bile duct margin and pancreatic duct margin were both free of malignancy, with the latter showing features of chronic pancreatitis. \n\nThe Whipple procedure specimen included the stomach, duodenum, gallbladder, jejunum, and pancreas. A mass was identified in the head of the pancreas measuring 4.7 cm in greatest dimension. All surgical margins, including the proximal and distal, pancreatic, uncinate, and common bile duct margins, were uninvolved by invasive carcinoma. Microscopic evaluation revealed the presence of carcinoma in situ and perineural invasion was noted. No lymphovascular invasion was identified.\n\nA total of 19 lymph nodes were examined, with 2 showing metastatic involvement. The remaining 16 lymph nodes were negative. Additional findings included pancreatic intraepithelial neoplasia (highest grade PanIN-3) and chronic pancreatitis. The tumor was found to extend beyond the pancreas but did not involve the celiac axis or superior mesenteric artery. No distant metastasis was identified.\n\nOther tissues including the stomach, duodenum, gallbladder, and jejunum showed no histopathologic abnormalities. A lymph node from the superior mesenteric artery region contained only benign pancreatic parenchyma and was negative for malignancy. The tumor occupied approximately 75% of the pancreatic duct area, with surrounding pancreatic parenchyma being sparse. The resection margins were within 0.2 cm of the tumor at several locations including the pancreatic resection margin, uncinate margin, anterior surface, and near the vessels. The tumor was solid, gray-white, and lobulated, involving nearly the entire pancreatic head.\n\nAll gross and microscopic findings have been reviewed and confirmed by a pathologist. Immunohistochemical testing was performed using analyte-specific reagents, and all necessary controls were evaluated. Tissue fixation and processing followed standard protocols."} +{"pid": "TCGA-P3-A6T5", "report": "The clinical specimen consists of a resected tissue sample from the left mandibular region, measuring 4 cm in greatest dimension. The specimen includes bone and is covered by tan, glistening mucosa with a central ulcerated area measuring 2.5 x 1.5 cm. Margins have been marked with colored ink: anterior (red), posterior (orange), mucosal and bony lateral (green), deep (black), and lingual/medial (blue). On sectioning, a mass was identified that does not involve the red inked margin and is located 0.3 cm from the orange margin. The mass appears to be in close proximity to the blue and black inked margins and extends near the bony green margin. Bone sections were decalcified for processing.\n\nA majority of the specimen (80%) was submitted for histologic evaluation, including multiple sections involving the mass and various margins. Additional soft tissue specimens from anterior, lateral, posterior, medial, and deep regions were received separately and submitted for frozen section analysis. All frozen section residues were processed and included in the final submission.\n\nA separate specimen labeled as left neck contents includes fibrofatty tissue with a salivary gland measuring 3.5 x 3.0 x 1.5 cm. Multiple lymph node candidates ranging from 0.2 to 1.0 cm in size were identified across levels I, II, and III. No masses or lesions were observed in the salivary gland or adipose tissue. Representative sections of lymph nodes and salivary gland were submitted for histologic examination. A final specimen labeled as level I lymph node consists of adipose tissue with no identifiable lymphoid structures.\n\nHistologic evaluation of all submitted sections revealed no evidence of residual neoplastic cells at the surgical margins, including anterior, posterior, lateral, medial, and deep margins. Lymph node evaluation showed no evidence of metastatic involvement. Pathologic features include focal extension into adjacent bone and submucosal tissues, with closest distances to various margins reported. Invasion of underlying salivary gland tissue was also noted. Small nerve branches showed evidence of perineural involvement. Standard histologic techniques were used for assessment."} +{"pid": "TCGA-4V-A9QQ", "report": "The microscopic examination includes multiple tissue samples. A mediastinal lesion demonstrates lymphoepithelial proliferation with limited lymphocytes and atypical epithelial cells. The resection appears complete, and Hassal corpuscles are not observed. In the lower left parietal pleura, one sample (block 2) reveals tumor infiltration composed of large round or polygonal epithelial cells within an abundant lymphoid stroma. Another sample from this region (block 3) shows no evidence of lymphangitis. A trimming from the pleura near the descending thoracic aorta (block 4) consists of fibro-fatty tissue and muscle, without tumor involvement. In the upper left parietal pleura, a nodule measuring approximately 20 cm \u00d7 15 mm (blocks 5 and 6) exhibits epithelial cell clusters closely associated with lymphoid tissue, with focal infiltration into striated muscle. An additional section from this area (block 8) shows no tumor infiltration."} +{"pid": "TCGA-G7-A8LB", "report": "The specimen includes a fragment of fibrofatty tissue overlying a mass, a biopsy from the base of the mass, and a partial nephrectomy specimen. The fibrofatty tissue shows only mature adipose elements without atypia. The biopsy from the base of the mass reveals benign renal tubules with associated fibrosis, no evidence of malignancy. The main mass, within the kidney, measures 9 x 6 x 4.5 cm and is confined to the organ, with no extension into surrounding fat or beyond the capsule. Microscopically, the lesion demonstrates mixed patterns of papillary architecture. Nuclear grading is characterized by very irregular nuclei with prominent nucleoli, corresponding to a high nuclear grade. A focus of the lesion is identified at the inked margin; however, the final surgical margins are uninvolved by invasive disease. No vascular or lymphatic invasion is present, and there is no involvement of perinephric tissue. No lymph nodes were sampled. Based on these findings, the pathological stage is classified as pT2a, with no regional or distant spread identified."} +{"pid": "TCGA-BR-8366", "report": "The specimen consists of a stomach segment with a tumor measuring 7.5 \u00d7 9 cm located at the fundus. The tumor is ulcerated and involves the subserosa with extension into the perigastric fat. Fifteen lymph nodes were examined, including those from the greater and lesser curvature and omentum, none of which showed metastatic involvement. Microscopic examination reveals a poorly differentiated cellular morphology with no evidence of venous invasion. Lymph nodes show reactive follicular hyperplasia and appear hyperemic and soft. Surgical margins are uninvolved. No treatment effect or additional pathologic findings were identified."} +{"pid": "TCGA-EM-A2OZ", "report": "The total thyroidectomy specimen was received intact, weighing 33.0 grams. The right lobe measured 5.2 cm in greatest dimension, with additional dimensions of 2.5 cm and 1.4 cm. The left lobe measured 5.4 cm x 3.2 cm x 1.9 cm, and the isthmus measured 3.0 cm x 2.5 cm x 0.9 cm. External surfaces showed fibrous adhesions, and no lymph nodes or parathyroid tissue were identified grossly.\n\nA well-circumscribed nodule measuring 1.5 cm was noted in the right lower lobe, and a similar nodule measuring 1.7 cm was found in the isthmus. A cystic lesion measuring 2.5 cm was also present in the left lower lobe. Multiple other nodules were identified microscopically, including small foci in the right lobe measuring 0.1 cm and 0.05 cm.\n\nHistologic examination revealed multiple distinct lesions. In the isthmus, a dominant lesion demonstrated classical papillary architecture with hobnail cell change observed focally (<5%). The cytomorphology was consistent with conventional features. The tumor was partially encapsulated, with minimal capsular invasion noted. The closest margin was 0.1 mm from the tumor edge, though margins were not involved. No lymphovascular or perineural invasion was identified, and there was no evidence of extrathyroidal extension.\n\nIn the left lobe, a second lesion was identified measuring 0.6 cm. This lesion displayed macrofollicular architecture with similar cytomorphology. It was also partially encapsulated, without capsular invasion, lymphovascular invasion, or perineural involvement. Margins were uninvolved.\n\nAdditional findings included a degenerated follicular nodule measuring 2.5 cm in the left lobe with reactive atypia. Other nodular changes were present, including adenomatoid nodules. Parathyroid tissue from a separate specimen was unremarkable.\n\nTwo lymph nodes from the isthmus were examined and showed no evidence of involvement. A total of two regional lymph nodes were assessed, none of which contained any suspicious cells.\n\nThe staging classification reflects multiple primary tumors confined to the thyroid gland, with no lymph node or distant metastasis identified."} +{"pid": "TCGA-E2-A1L9", "report": "The specimen includes a wide local excision of the right breast with needle localization, along with two sentinel lymph nodes from the right axilla. The excised breast tissue measures 4 x 3.4 x 2.5 cm and contains a firm, tan, stellate mass measuring 1.4 x 1.2 x 1 cm, located closest to the inferior margin at a distance of 0.8 cm. Microscopic evaluation reveals cellular features including nuclear grade 2, tubular score 2, mitotic score 2, corresponding to an overall modified Scarff Bloom Richardson grade of 2. Necrosis is present focally within the lesion. Vascular or lymphatic invasion is also identified. The surgical margins are free of abnormal cellular changes. Adjacent to the mass, biopsy site changes are noted with fibrosis and granulation tissue.\n\nThe sentinel lymph nodes are submitted in entirety. Sentinel node #1 measures 4 x 2.3 x 1.5 cm and contains a focus of involvement measuring 1.0 mm, while sentinel node #2 measures 3.4 x 3 x 0.4 cm and shows no such findings. Touch preparations performed on both lymph nodes do not identify any abnormal cells. \n\nHormone receptor testing demonstrates positivity for ER and PR, while HER2 immunohistochemistry is negative. Based on pathological staging, the tumor is classified as pT1c with nodal involvement classified as N1mi due to the presence of micrometastases in one of the two sentinel lymph nodes. Ductal intraepithelial changes are identified at an estimated quantity of 2%, showing solid and cribriform patterns, associated with the main lesion. These changes are not seen at the surgical margins."} +{"pid": "TCGA-HD-7831", "report": "A right hemiglossectomy specimen measured 7.1 x 4.0 x 3.0 cm and contained a tan-white firm lesion measuring 3.0 x 2.7 x 1.7 cm. The lesion was located at the deep margin and was approximately 2 mm from the medial margin. Histologic evaluation of the margins demonstrated tumor involvement at the deep margin, while the medial margin was negative. A separate specimen representing the newly defined deep margin showed no evidence of tumor.\n\nLymph node evaluation included multiple levels. In level 1b, the submandibular region showed no evidence of metastatic involvement. In level 1a, one of three lymph nodes contained intranodal tumor, with the largest dimension measuring approximately 0.2 mm. In level 2a, one of nine lymph nodes showed intranodal involvement, with the greatest dimension measuring approximately 0.5 cm. Similarly, in level 3, one of nine lymph nodes contained intranodal tumor measuring up to 0.5 cm in greatest dimension.\n\nHistologic assessment revealed moderately differentiated features with invasive growth reaching a depth of 3 cm. Angiolymphatic invasion was not definitively identified. The posterior margin was greater than 2 cm from the lesion, while the medial margin measured 0.5 cm from the lesion based on microscopic evaluation."} +{"pid": "TCGA-B0-5119", "report": "The right kidney specimen following radical nephrectomy shows a unifocal lesion located in the upper pole. The lesion measures 5.7 cm in greatest dimension with additional dimensions of 5.3 x 4.5 cm. Microscopic evaluation reveals cells with clear cytoplasm arranged in solid and acinar patterns. Nuclear features correspond to grade 2 according to the Fuhrman nuclear grading system. The lesion is confined entirely within the kidney without extension beyond the organ capsule. All surgical margins are free of involvement. No lymphovascular invasion is identified. There is no evidence of regional lymph node or distant spread; however, no lymph nodes were examined. The remainder of the kidney demonstrates chronic interstitial inflammation and glomerulosclerosis. Adrenal gland tissue is not present in the specimen."} +{"pid": "TCGA-E2-A2P5", "report": "The specimens include an excision of right breast tissue following needle localization, a modified radical mastectomy specimen from the left breast with axillary contents, and additional excised left axillary tissue.\n\nIn the right breast specimen, histologic evaluation revealed ductal carcinoma in situ (DCIS) of cribriform type with intermediate nuclear grade. Necrosis and microcalcifications were present. DCIS was identified at the medial margin within 0.1 cm and approached the posterior, superior, and anterior margins within 0.1 cm, 0.1 cm, and 0.2 cm respectively. In addition, there were findings of atypical intraductal papillomas near the medial margin and a complex sclerosing lesion containing lobular neoplasia, intraductal papillomas, sclerosing adenosis, apocrine metaplasia, and microcalcifications. DCIS was observed on three out of ten slides with the largest focus measuring 0.8 cm. Immunohistochemical staining for SMMHC, p63, and calponin demonstrated intact myoepithelial layers, confirming absence of invasion. Hormone receptor testing showed strong positivity for both estrogen and progesterone receptors using Allred scoring (score 8 for both).\n\nThe left breast and axillary specimen showed invasive carcinoma measuring 3.3 cm, extensively involving the nipple dermis. The tumor was classified as high-grade based on Nottingham grading system. Margins were negative, with the closest distance to the deep margin being 0.9 cm. Lobular carcinoma in situ of pleomorphic type with focal necrosis was also present. Twenty-four lymph nodes were assessed, twenty of which contained metastatic carcinoma. Extranodal extension was present with the largest metastasis measuring 2.4 cm. Additional involvement included a separate focus of invasive carcinoma within fibroadipose tissue measuring 0.4 cm without adjacent lymph node or breast parenchyma, interpreted as extranodal extension.\n\nA further left axillary excision specimen consisted of adipose tissue containing one lymph node with metastatic carcinoma and associated tumor involvement in surrounding fibroadipose tissue.\n\nHistologic features across specimens included a variety of benign epithelial changes. Tumor staging was determined according to AJCC Cancer Staging Manual, 7th Edition."} +{"pid": "TCGA-AR-A1AO", "report": "The specimen consists of a left breast wide local excision showing a malignant neoplasm with Nottingham grade III features, including a high nuclear score, significant tubule formation, and increased mitotic activity. The primary lesion measures 1.7 x 1.6 x 1.2 cm and is classified as pT1c based on AJCC staging criteria. A component of intraductal proliferation with intermediate nuclear atypia is present, accounting for less than 5% of the total tumor volume. No angiolymphatic invasion is identified. Changes related to prior biopsy are noted.\n\nFollowing re-excision of the medial and superior margins, all surgical margins are free of tumor involvement, with the minimum tumor-free distance measuring 0.9 cm at the superior margin. A single intramammary lymph node located at the medial margin contains metastatic tumor, measuring 1.5 mm in maximum dimension. In the left axillary sentinel lymph node group, one of two nodes is involved, confirmed by immunohistochemical staining for cytokeratin. Blue dye was visualized in both sentinel nodes. The remaining non-sentinel axillary lymph nodes (36 total) show no evidence of tumor involvement.\n\nAncillary studies, including hormone receptor analysis and Her-2/Neu testing, have been requested on paraffin-embedded tissue. Faxitron imaging was performed during the procedure."} +{"pid": "TCGA-AN-A0FY", "report": "Female patient underwent radical mastectomy for a primary tumor located in the left breast. The tumor specimen was collected in frozen format using a cryomold. Histological evaluation showed Grade 3 cellular features. No prior treatment was administered. A blood sample was also collected and stored in frozen format in a tube. Staging information indicates T stage 1c, N stage 0, and M stage 0. No normal tissue sample was obtained from the breast; only a blood sample was collected for reference purposes."} +{"pid": "TCGA-XF-AAMZ", "report": "A surgical pathology report describes findings from a specimen obtained via anterior exenteration, which included removal of the bladder, uterus, fallopian tubes, ovaries, and urethra, along with bilateral salpingo-oophorectomy, and placement of an ileal conduit and gastric tube.\n\nMultiple sections of the right and left distal ureters were examined. Intraoperative frozen sections showed variable findings: some areas demonstrated high-grade atypia or flat lesions resembling carcinoma in situ, while others showed no significant dysplasia or malignancy. Final microscopic evaluation confirmed similar findings, with some segments showing flat lesions and others appearing benign.\n\nThe apical urethral margin showed evidence of flat intraepithelial lesions. Examination of the urethra revealed extensive involvement by similar flat lesions and non-invasive papillary growths, focally extending to the meatus. All inked resection margins were free of dysplastic or malignant changes.\n\nThe bladder showed extensive and multifocal involvement by flat intraepithelial lesions and both non-invasive and invasive poorly differentiated papillary structures. The invasive component extended through the entire bladder wall into surrounding soft tissue, with multiple foci of lymphovascular invasion identified. Two right perivesical lymph nodes were negative for malignancy. No involvement was found in the cervix, endometrium, myometrium, fallopian tubes, or ovaries. A benign endometrial polyp and cystic atrophy were noted, along with a small benign leiomyoma in the myometrium.\n\nLymph node assessment was performed in multiple regions. Of 69 lymph nodes examined, 5 showed evidence of metastatic involvement. Positive nodes were found in the right obturator/hypogastric, presacral, and right para caval regions.\n\nStaging information indicates deep extension into the bladder wall and perivesical soft tissue, with regional lymph node involvement. Urethral involvement was limited to non-invasive and flat lesion patterns."} +{"pid": "TCGA-OL-A5D6", "report": "The final pathology report describes findings from a left mastectomy specimen and sentinel lymph node biopsies. Two sentinel lymph nodes were examined, both negative for tumor involvement.\n\nIn the left breast, multiple lesions were identified. A prominent finding was an intraductal lesion measuring 5 cm in size, characterized by solid and apocrine features with high nuclear grade. This lesion showed necrosis and cancerization of lobules but no vascular invasion. Adjacent to this area was a separate invasive mass measuring 2.5 cm. The invasive component had a histologic grade III (modified SBR), composed of 3 architectural differentiation points, nuclear grade 3, and a mitotic count of 2. Ductal carcinoma in situ was present within and extending beyond this invasive mass, comprising approximately 50% of its volume.\n\nAdditional benign findings included a small intraductal papilloma, sclerosing adenosis, and radial scar lesion. There was also evidence of calcifications within vessel walls. No tumor was identified at the nipple or in the excision margins, which were greater than 2 mm away from any lesion. No lymphatic or blood vessel invasion was observed.\n\nAxillary lymph nodes examined were negative for tumor. Immunohistochemical studies revealed no expression of estrogen or progesterone receptors in the invasive tumor nuclei. HER2/neu status was pending.\n\nClinically, the patient was a female who presented with suspicious calcifications on mammogram in the left breast. MRI demonstrated a 4.7 x 3.2 x 3.3 cm enhancing mass along with additional suspicious foci. Following fine needle aspiration confirming carcinoma, she underwent sentinel lymph node biopsy and mastectomy.\n\nGross examination of the mastectomy specimen revealed a large ecchymotic area measuring 5 x 5.5 x 4 cm located in the lower lateral quadrant. Inferior to this region was a firm white mass measuring 2.5 x 1.7 x 1.5 cm. Adjacent to this mass was an ill-defined gritty area spanning 5.0 x 3.5 x 2.0 cm near the nipple-areola complex.\n\nThe staging classification assigned was pT2, N0, MX."} +{"pid": "TCGA-O2-A5IB", "report": "The submitted specimens include multiple lymph nodes and tissue samples from the mediastinum, lung lobes, bronchial margins, and surrounding structures. Lymph nodes from subcarinal, level 3 (two separate specimens), right tracheobronchial angle, level 4, and right lobar regions were all excised and examined. All lymph nodes were described as anthracotic and showed no evidence of tumor involvement.\n\nA specimen of mediastinal fat and thymus was also excised; it revealed parietal pleura with infiltration by poorly differentiated malignant cells, along with lymphatic invasion. Chronic pleuritis and fibrosis were present, but no tumor was identified in the adipose or fatty tissues.\n\nLobectomy of the right middle lobe included a mass measuring 6.0 cm in maximum diameter. The tumor demonstrated pleural, lymphatic, and vascular invasion, and had directly infiltrated peribronchial lymph nodes. The bronchial resection margin was positive. Non-neoplastic changes in the lung parenchyma included post-obstructive endogenous lipoid pneumonia. Staging information indicated pT3, pN1, pMX.\n\nAn additional bronchial margin excision showed infiltration of the bronchial wall by poorly differentiated malignant cells. In contrast, the superior segment of the right lower lobe and bronchus intermedius excision showed that both bronchial resection margins were free of tumor, although the distal margin was in close proximity to the tumor. This specimen also noted chronic inflammation, focal squamous metaplasia, and dysplasia in the bronchial mucosa. Three peribronchial lymph nodes were negative for tumor. A new bronchial margin excision showed only mild chronic inflammation and no invasive tumor, though the bronchial glands exhibited focal squamous metaplasia and severe architectural atypia.\n\nGross examination of the right middle lobe showed a tan-white, firm, ill-defined mass involving the surgical margin. The remaining lung tissue appeared unremarkable. All specimens were fully submitted for histological evaluation. Frozen section analysis during surgery confirmed the presence of malignant cells in certain bronchial margins and the absence of tumor in others, with non-small cell morphology consistent with squamous cell type."} +{"pid": "TCGA-D7-6820", "report": "The histopathological examination involved the resection of multiple organs, including the stomach. Upon macroscopic evaluation, the stomach measured 19.8 x 10.8 cm and was accompanied by omentum measuring 43 x 28 cm. A lesion located on the anterior wall measured 3.4 x 4.8 x 2.3 cm. The proximal margin was 8.1 cm from the lesion, and the distal margin measured 4.6 cm. Microscopic analysis revealed a moderately differentiated glandular and papillary growth pattern within the gastric tissue. The lesion extended through the mucosal layer and into the muscular wall but did not reach the peritoneal surface or involve the omentum. Surgical margins appeared free of abnormal tissue. The omental tissue showed signs of hyperemia. Adjacent lymph nodes were assessed: pericardial lymph nodes showed reactive changes (0 out of 2 examined), while metastatic involvement was identified in lymph nodes along the lesser curvature (1 out of 5) and greater curvature (3 out of 5). Peripyloric lymph nodes exhibited reactive features (0 out of 2). The staging classification indicated involvement confined to the muscularis propria with regional lymph node metastases present."} +{"pid": "TCGA-08-0352", "report": "The biopsy specimen consists of five unoriented, soft, pink-tan, irregularly shaped tissue fragments measuring 1.1 x 0.5 x 0.2 cm in aggregate. Two fragments were used for intraoperative frozen section analysis, with the remaining tissue submitted for further evaluation. Microscopic examination reveals highly cellular regions composed of neoplastic astrocytes, with extensive microvascular proliferation and areas of necrosis identified. The findings are based on review of all pathology slides and confirmed by the attending pathologist. The patient presented with a right temporal enhancing mass and underwent resection."} +{"pid": "TCGA-B9-4116", "report": "A left nephroureterectomy specimen was received and fixed in formalin. The specimen measured 15 x 9 x 6 cm and weighed 180 grams. A 12.2 cm length of ureter was attached. No adrenal gland was present. Gross examination revealed a tumor involving the entire kidney, with no normal-appearing parenchyma identified. The cut surface showed a soft, necrotic, fleshy, and friable texture with white-tan coloration. Serial sectioning revealed tumor plugs within cavities in the dilated renal pelvis. The tumor measured 7.9 x 6.5 x 5.1 cm and was confined to the kidney without involvement of perirenal adipose tissue, Gerota\u2019s fascia, or renal vein. Multicentricity was not observed.\n\nMicroscopically, nuclear grade 2 morphology was identified. There was no evidence of capsular invasion, perirenal adipose tissue involvement, Gerota\u2019s fascia, renal vein, or ureteral wall invasion. Lymphovascular space invasion was not identified. Surgical margins, including perirenal adipose tissue, Gerota\u2019s fascia, renal vein, renal artery, and ureter, were all negative.\n\nSections of the ureter contained free-floating fragments of cells within the lumen, but without evidence of wall invasion. Additional findings included multiple cysts at the inferior pole of the kidney, up to 1.6 cm in greatest dimension, with smooth linings and containing thin, straw-colored fluid. No lymph nodes were identified at the hilar region. The proximal ureter contained a maroon-red sludge-like material on gross examination but was otherwise unremarkable.\n\nTissue was submitted for special investigations, including representative tumor and normal renal parenchyma. Blocks included margins, tumor sites, cysts, and ureteral cross-sections. Digital photographs were not taken. The staging classification used was pT2a pNx based on available data, pending further clinical review."} +{"pid": "TCGA-XF-AAN8", "report": "A radical cystectomy with ileal conduit and bilateral pelvic lymph node dissection was performed. The right distal ureter specimen showed no tumor, with benign histology. The left distal stented ureter demonstrated hydroureter but no tumor. The left unstented ureter showed reactive urothelial atypia without high-grade dysplasia or malignancy.\n\nExamination of the bladder revealed an exophytic mass located at the left ureterovesical junction. Microscopic evaluation showed that the lesion involved the posterior bladder wall and extended into the left ureter-vesicle junction and left ureter. The tumor infiltrated through the entire bladder wall and into perivesical soft tissue. A focal flat lesion was present adjacent to the invasive component. The tumor approached within 1 mm of the posterior soft tissue resection margin; however, the final soft tissue margin was negative. All other margins\u2014including bilateral ureters, urethral, and vaginal mucosa\u2014were free of tumor. Extensive follicular cystitis was noted.\n\nLymph node evaluation included a total of 54 nodes from various anatomical locations including right and left perivesical, para-caval, common iliac, cloquet, para-aortic, obturator/hypogastric, external iliac, pre-sacral, and pre-sciatic regions. No metastatic carcinoma was identified in any of the lymph nodes examined.\n\nThe surgical specimen included multiple ureter segments, all of which were histologically benign except for one showing reactive changes. A skin ellipse with a healed scar was also examined and showed no tumor involvement. Multiple sections from the bladder including the trigone, bladder neck, dome, posterior wall, and tumor interface were evaluated, confirming the absence of tumor at most margins.\n\nStaging assessment indicated involvement of the bladder with deep penetration into surrounding tissues, while no nodal involvement was found (pT3bN0MX)."} +{"pid": "TCGA-DX-A6BG", "report": "Addendum. Clinical Diagnosis & History: Patient with large right retroperitoneal mass. Specimens Submitted: 1: Right retroperitoneal mass with right colectomy.\n\nThe tumor measures 10.8 cm in greatest dimension. The dominant component constitutes more than 98% of the mass and shows a high-grade spindle and pleomorphic cell morphology. The lesion involves the colonic wall. Areas of necrosis are present, accounting for approximately 40% of the larger mass. The tumor is covered by a thin fibrous capsule that forms the margin. A separate adipose tissue lesion measuring 6 cm is noted with extensive fat necrosis, involving the spermatic cord. Surgical resection margins are uninvolved. The appendix appears unremarkable.\n\nGross Description: The specimen is labeled \"Right retroperitoneal mass with right colectomy\" and includes a portion of colon measuring 21 cm in length x 5.2 cm in circumference, with an intact vermiform appendix measuring 11 x 0.6 cm attached to the cecum. A segment of spermatic cord measuring 6.5 x 3 cm is present. Adjacent to the spermatic cord and 6.5 cm from the margin, there is a well-circumscribed, yellow firm mass measuring 6 x 5.8 x 5.1 cm, inked in blue. A second, larger, pink to yellow lobulated mass with central necrosis measuring 10.8 x 7.6 x 7.3 cm is identified, arising from the pericolonic adipose tissue, located 10 cm from the cecum and 4 cm from the distal resection margin. Attached to this mass is a lymph node measuring 3.9 x 2.7 x 1.8 cm. Both masses are covered by a thin fibrous capsule. Muscle tissue measuring 10.7 x 10.3 cm is attached to the adipose tissue. Representative sections were submitted after TPS and photographs were taken.\n\nSummary of sections: Proximal and distal margins, lymph node, and multiple sections of both masses were sampled. Sections include areas related to the spermatic cord, colon, and surrounding adipose tissue.\n\nProcedures/Addenda: Immunohistochemical stains for CDK4 and MDM2 are positive in the tumor cells.\n\nAddendum Comment: Some of the immunohistochemistry and ISH tests were developed and their performance characteristics determined by the Department of Pathology. They have not been cleared or approved by the US Food and Drug Administration. The FDA has determined that such clearance or approval is not necessary. These tests are used for clinical purposes and should not be regarded as investigational or for research. This laboratory is certified under the Clinical Laboratory Improvement Amendments of 1988 (CLIA '88) as qualified to perform high-complexity clinical laboratory testing.\n\nI ATTEST THAT THE ABOVE FINDINGS ARE BASED UPON MY PERSONAL EXAMINATION OF THE SLIDES (AND/OR OTHER MATERIAL), AND THAT I HAVE REVIEWED AND APPROVED THIS REPORT."} +{"pid": "TCGA-MP-A4TD", "report": "The left lower lobe of the lung weighed 370.0 grams and measured 18.5 x 10.5 x 7.0 cm. A poorly circumscribed mass measuring 12.5 x 6.0 x 4.1 cm was identified in the periphery of the lung, appearing similar to a consolidated lobe. The lesion extended to but did not breach the visceral pleura. No angiolymphatic invasion was observed. The bronchial margin was free of abnormal cells. Two intrapulmonary peribronchial lymph nodes were also negative.\n\nExamination of the hilar lymph nodes (station 10L) revealed involvement in one out of one node. In the mediastinal lymph nodes, a microscopic subcapsular focus less than 1 cm was found in one of eleven subcarinal (station 7) lymph nodes. Additionally, two of three left pulmonary ligament (station 9L) lymph nodes showed evidence of involvement. No involvement was seen in eight prevascular and retrotracheal (station 3), six right lower paratracheal (station 4R), three left lower paratracheal (station 4L), or two sub-aortic (station 5) lymph nodes. A single right tracheobronchial angle lymph node was also uninvolved. The specimen was photographed in the laboratory."} +{"pid": "TCGA-F4-6463", "report": "The submitted colectomy specimen involves the transverse colon. The tumor measures 2.5 x 4 x 3 cm and extends into the pericolonic tissues. Histologic evaluation reveals a moderately differentiated architecture with mucin production. No specific features of the tumor or additional pathologic findings are noted. Other parameters including lymph node status, margins, and treatment effect could not be determined based on the provided information."} +{"pid": "TCGA-12-3650", "report": "A surgical pathology report describes a patient with a left temporoparietal lesion that increased in size from 1.4 x 1.4 cm to approximately 2.3 x 2.2 cm on MRI scans. The lesion demonstrated new central necrosis or hemorrhage and a secondary rim of cloudlike enhancement, with stable or slightly increased local mass effect and no significant midline shift.\n\nGross examination of the brain tissue specimen (AF1) revealed a 2.6 x 1.7 x 1.0 cm soft pink-tan tissue with diffuse erythema. Approximately 75% of the specimen was submitted for analysis in blocks A1 (partially frozen), A2, and A3.\n\nMicroscopic evaluation showed brain tissue infiltrated by a malignant astrocytic neoplasm. Key histologic features included cytologic pleomorphism, mitotic figures, microvascular proliferation, and pseudopalisading necrosis.\n\nCytogenetic testing using FISH demonstrated chromosome 7 polysomy in 82% of tumor cells, EGFR amplification in 93%, chromosome 10 centromere loss in 61%, PTEN allelic loss in 71%, 9p21 loss in 80%, and chromosome 9 centromere loss in 54%. All four abnormal markers and 9p21 loss were present.\n\nImmunohistochemical analysis showed LCA positivity in 10% of cells. Proliferation index was high, with 20% of tumor cells staining. MGMT expression was negative in 95% of tumor cells. EGFR wild-type expression was positive (2-3+) in 70%, and EGFRvIII was positive (2+) in 20%. PTEN loss was observed (2+ in 60%), S6 was negative (2+ in 5%), AKT was negative (2+ in 20%), and MAPK was positive (3+ in 30%).\n\nThe multivariate survival analysis indicated a higher hazard of short survival in patients with all four abnormal markers compared to those with fewer abnormalities, even after adjusting for age. Both FISH and immunohistochemistry confirmed PTEN loss."} +{"pid": "TCGA-D7-5579", "report": "W badanym materiale pobranym z \u017co\u0142\u0105dka, po rozci\u0119ciu wzd\u0142u\u017c krzywizny wi\u0119kszej o wymiarach 19 x 16 cm oraz sieci o wymiarach 20 x 10 cm, stwierdzono pogrubienie \u015bciany w trzonie \u017co\u0142\u0105dka na obszarze 10 x 11 x 2 cm. Odleg\u0142o\u015b\u0107 zmiany do granicy proksymalnej wynosi\u0142a 4 cm, a do granicy dystalnej \u2013 3 cm.\n\nPod mikroskopem widoczna by\u0142a infiltracja ca\u0142kowitej grubo\u015bci \u015bciany \u017co\u0142\u0105dka, obejmuj\u0105ca r\u00f3wnie\u017c wi\u0119ksze i mniejsze omentum. Stwierdzono obecno\u015b\u0107 zmian w w\u0119z\u0142ach ch\u0142onnych (XI/XII). Naciek nowotworowy dosi\u0119ga\u0142 linii ci\u0119cia dystalnego, natomiast linia ci\u0119cia proksymalna nie wykaza\u0142a cech nowotworowych. W badaniu histopatologicznym potwierdzono stopie\u0144 z\u0142o\u015bliwo\u015bci G3 oraz zaawansowanie pT3 i pN2."} +{"pid": "TCGA-HT-7857", "report": "PATH REPORT. Microscopic examination reveals a moderately hypercellular glial neoplasm composed of moderately atypical fibrillary astrocytes. Numerous bizarre, multinucleated cells are present. No microvascular proliferation or tumor necrosis is identified. Mitotic figures are rare, which is unexpected given the degree of cellular atypia. The cytologic features are distinctly anaplastic. There are no eosinophilic granular bodies or Rosenthal fibers, and no evidence of microcystic degeneration. Scattered MIB-1 positive cells are observed, with a labeling index of 6.5% in areas of highest proliferative activity, indicating a moderately proliferative neoplasm consistent with the observed anaplastic features."} +{"pid": "TCGA-BJ-A0ZE", "report": "Patient is a female who underwent completion thyroidectomy following a prior left thyroid lobectomy. The preoperative diagnosis was symptomatic thyroid goiter associated with a thyroid nodule greater than 4 cm. Gross specimen from the right thyroid lobe weighed 59 grams. Histologic evaluation identified a lesion measuring approximately 5.7 cm in greatest dimension, extending to surgical margins. No definitive angiolymphatic invasion or extrathyroidal extension was observed. The background thyroid tissue showed multinodular changes.\n\nImmunohistochemical staining for HBME-1 on multiple blocks demonstrated positive focal membranous staining within the lesion. Molecular analysis of the tissue sample was performed using manual microdissection to enrich for areas with at least 50% tumor cellularity. Real-time PCR and melting curve analysis were used to screen for mutations in BRAF (codons 599\u2013601), NRAS (codon 61), HRAS (codon 61), and KRAS (codons 12/13). No mutations in these genes were detected. Sanger sequencing was used to confirm negative results when necessary. The limit of detection for mutations was approximately 10\u201320% mutant alleles in a normal DNA background.\n\nFluorescence in situ hybridization (FISH) testing for RET/PTC rearrangement was also performed. Analysis of at least 60 cells using dual-color probes targeting the RET gene (10q11.2) and PTC region (10q21) showed that 1.6% of cells exhibited a pattern suggestive of rearrangement, while 98.4% showed a normal configuration. Based on the threshold of 8% positivity required to consider rearrangement present, the result was interpreted as negative for RET/PTC fusion.\n\nThe histologic features, immunostaining pattern, and absence of known oncogenic mutations or rearrangements were noted. Tissue fixation time ranged between 2 and 84 hours. All molecular and immunohistochemical tests were developed and validated by the laboratory in compliance with CLIA '88 standards for high-complexity testing. No parathyroid tissue was identified in the specimen."} +{"pid": "TCGA-FY-A3R9", "report": "A total thyroidectomy specimen was received in fragmented condition. The right lobe measured 4.7 x 2.0 x 1.3 cm and weighed 5.2 grams. The left lobe measured 3.9 x 2.2 x 1.6 cm and weighed 4.7 grams. The isthmus measured 1.5 x 1.5 x 0.8 cm and weighed 0.9 grams. Multiple distinct lesions were identified. Within the left lobe, three separate masses were observed: measuring 0.6 cm, 0.7 cm, and 1.0 cm in greatest dimension. These were described as well-circumscribed, pale gray, soft, and fleshy with focal hemorrhage. In the right lobe, a single central nodule measuring 0.5 cm was noted; it was firm, gray-white, and nodular. The isthmus contained two solid gray-white nodules each measuring 0.4 cm. All lesions appeared to be intraparenchymal without extracapsular extension. Histologic evaluation revealed a mixture of architectural patterns. The cellular morphology demonstrated features consistent with moderately differentiated morphology. No lymphvascular or perineural invasion was identified. Margins were uninvolved by\u75c5\u53d8 with distance greater than 1 mm. A pretracheal lymph node was also submitted and showed no evidence of any abnormal cellular infiltration. All tissue blocks were submitted for analysis and appropriately processed."} +{"pid": "TCGA-JX-A3PZ", "report": "The specimen consists of a radical hysterectomy with cervix, uterus, and multiple lymph node groups submitted in eleven containers. The cervical mass measures 5.0 x 3.5 x 3.0 cm and is described as a fungating, exophytic, firm white lesion with necrotic overlying tissue. It is primarily located along the posterior cervical wall from the 3 to 9 o\u2019clock position. A smaller nodule measuring 2.5 x 1.5 x 1.0 cm is noted at the 12 o\u2019clock position, possibly representing extension from the main tumor.\n\nNo involvement is identified in the uterine corpus, vaginal cuff, or parametrial tissues. The myometrium shows thickness ranging from 1.0 cm to 1.8 cm without evidence of tumor infiltration. The endometrium is uniformly 0.2 cm thick and unremarkable.\n\nLymph nodes examined include parametrial (2), right and left external iliac (4 and 8 respectively), left and right obturator (2 and 4 respectively), left common iliac (1), periaortic (1), and others. No tumor is identified in any of the 22 regional lymph nodes evaluated.\n\nHistologic evaluation reveals a moderately differentiated squamous cell carcinoma with focal keratinization. The tumor grows in large nests and displays an almost entirely exophytic pattern. Depth of invasion is measured at 5 mm within a 20 mm thick cervix, with the deepest point at the posterior cervix (5 o\u2019clock position). Vascular space invasion is prominent. The closest surgical margin is 15 mm from the deepest invasive component. No full-thickness invasion of the cervix or parametrial extension is observed. Nuclear grade is 2, indicating moderate differentiation.\n\nStaging indicates the primary tumor is confined to the cervix and measures greater than 4 cm in size. There is no lymph node involvement or distant metastasis. Based on TNM and FIGO classification systems, the tumor is categorized as stage IB."} +{"pid": "TCGA-CV-7433", "report": "The specimen consists of a laryngectomy and pharyngectomy specimen with associated neck dissection including the right thyroid lobe. The resected specimen measures 10.0 x 9.0 x 5.5 cm. Within the right supraglottic region, extending to the midline and involving the right glottic area, there is a fungating, ulcerative mass measuring 6.5 x 2.5 cm in greatest dimensions. The mass demonstrates deep invasion into cartilage. Margins of resection appear uninvolved grossly.\n\nLymph nodes are present on both sides of the specimen. On the left side, the lymph node dissection includes a segment of fibrofatty tissue measuring 2.5 x 1.5 x 0.5 cm containing two lymph nodes measuring up to 1.5 cm in maximum dimension. On the right side, the neck dissection specimen measures 8.5 x 2.5 x 2.0 cm and contains multiple lymph nodes ranging from 0.5 to 1.8 cm across all levels (upper, mid, and lower jugular regions). Fourteen lymph nodes were identified on the left lower jugular chain, none of which show evidence of tumor involvement.\n\nA strip of mucosa from the esophageal margin measuring 6.5 x 0.8 x 0.3 cm shows focal mild dysplasia along with detached fragments exhibiting dysplastic or atypical features; however, grading was not possible due to lack of full-thickness tissue. A small tan fragment from the superior laryngeal nerve on the right side (0.4 x 0.2 x 0.2 cm) reveals nerve and adjacent soft tissue without tumor involvement. The superior pharyngeal margin includes a larger tan mucosal segment measuring 1.2 x 0.5 x 0.2 cm and a smaller one measuring 0.5 x 0.4 x 0.2 cm; no masses or nodules are identified, and while severe dysplasia or invasive malignancy was not seen, mild dysplasia could not be ruled out due to cautery artifact.\n\nFive teeth were submitted for examination and showed no remarkable findings. All lymph nodes and margins were submitted entirely for evaluation."} +{"pid": "TCGA-J4-A67R", "report": "The specimen consisted of a prostatectomy sample including the prostate gland, seminal vesicles, and vas deferens. The prostate measured 5 x 5 x 4 cm and weighed 47 grams. On gross examination, the gland showed a firm, focally nodular parenchyma. A dominant nodule measuring 2.1 cm was identified. The left seminal vesicle contained a smaller adjacent nodule measuring 0.5 x 0.5 cm. The surgical margins were assessed, with one margin showing involvement; however, this appeared to be disrupted by an iatrogenic incision. No tumor was identified in the seminal vesicles.\n\nHistologically, the tissue showed prostatic hyperplasia in one sampled region. In other areas, malignant cells were observed. These cells exhibited a Gleason score of 4 + 3 = 7/10. Perineural invasion was noted, but no lymphatic (small vessel) invasion was detected. Lymph nodes from the right pelvic region were also examined; four non-frozen section nodes and additional frozen section samples were all negative for malignancy.\n\nStaging assessment indicated no lymph node involvement (pN0) and no distant metastases could be determined (pMX). Based on the findings, the stage was at least pT2c. No treatment effect was identified. Clinical correlation was recommended for further interpretation."} +{"pid": "TCGA-BP-4343", "report": "The right kidney specimen includes perirenal adipose tissue covered by Gerota's fascia. The overall specimen measures 19 x 13 x 6 cm and weighs 850 grams. The attached ureter is 0.5 cm in length and 0.4 cm in diameter. The kidney itself measures 12 x 6.5 x 5 cm. A mass is identified in the middle portion of the kidney, measuring 7 x 5.5 x 5 cm. It is poorly circumscribed, variegated in texture, tan-white to yellow with focal hemorrhage, and primarily cortical in location. The mass extends beyond the renal capsule into the perirenal adipose tissue but does not extend through Gerota's fascia. There is no involvement of the calyces or renal pelvis. All surgical margins are free of abnormal findings. The remaining renal parenchyma appears normal. Mild interstitial fibrosis and arterial sclerosis are noted in the non-neoplastic kidney.\n\nA separate specimen labeled \"Right Adrenal\" consists of an adrenal gland with attached adipose tissue measuring 3.2 x 3.3 x 0.8 cm. The adrenal itself measures 5.4 x 2.7 x 0.6 cm. Serial sectioning reveals areas of hemorrhage in the medulla, with no discrete lesions observed.\n\nThe third specimen labeled \"Paracaval Lymph Nodes\" includes adipose tissue fragments measuring 4 x 3.6 x 1.4 cm. Multiple lymph nodes ranging from 0.4 to 1.4 cm in greatest dimension are present and entirely submitted for evaluation.\n\nMicroscopic evaluation of the kidney shows a pattern of acinar growth. Nuclear grading is performed, with only a focal area showing high-grade features. No invasion of the renal vein is identified. Sections from the tumor, adjacent uninvolved kidney, perirenal fat, Gerota's fascia, and ureteral vascular margins are submitted. Evaluation of the adrenal and lymph node specimens reveals no abnormal cellular findings."} +{"pid": "TCGA-G4-6320", "report": "The specimen consists of a right colon segment, including the terminal ileum, ileocecal valve, cecum, and colon, measuring 25 cm in total length. An area of tattooing is noted on the serosa approximately 7 cm from the distal margin. The vermiform appendix measures 7.1 cm in length and 0.5 cm in width and appears unremarkable. Upon opening, the terminal ileum measures 6 cm in length and 4 cm in diameter, while the right colon spans 19 cm in length and reaches up to 10 cm in diameter.\n\nAn area of concern is identified within the colon: it is circumferential, polypoid, and firm with irregular, serpentine borders, measuring 6 x 4.3 cm. This lesion extends through the muscularis propria and is located 11 cm from both the proximal and distal margins, as well as 5 cm from the ileocecal valve. Two small colonic polyps, measuring 0.5 cm and 0.6 cm, are also present.\n\nLymph node assessment includes multiple groups: 6 lymph nodes from the proximal region (two of which show involvement), two additional proximal nodes, and several from the distal region (including six groups of six, three, two, and one node each). Seven additional possible lymph nodes were identified after fixation.\n\nHistologic sections include margins, representative areas of the lesion in relation to normal mucosa and deep margins, the colonic polyps, normal-appearing mucosa near the tattooed area, and the appendix. All surgical margins are free of abnormal tissue. Vascular and lymphatic invasion are identified, while perineural invasion is not present. Additional findings include hyperplastic polyps and a tubulovillous adenoma component.\n\nStaging indicates involvement of the subserosal fat with regional lymph node spread. No distant metastases are identified. A complete resection with negative margins is confirmed."} +{"pid": "TCGA-WB-A81K", "report": "The pathology review describes a specimen from the left adrenal. A mass measuring 5.5 x 5 x 3.3 cm was identified. Microscopic examination reveals a neoplasm with alveolar architecture and zellballen pattern, where tumor cells are arranged in nests separated by thin fibrovascular septa. The cells exhibit moderate pleomorphism with abundant eosinophilic to basophilic granular cytoplasm. Nuclear features include enlarged, irregular nuclei with coarse chromatin; some bizarre, multinucleated cells are also present. Mitotic figures are rare, with one typical and one atypical mitosis identified per 30 high-power fields. There is no evidence of necrosis, vascular invasion, capsular breach, or infiltration into surrounding fat. Special staining with PAS yields a total score of 3. The PASS (Pheochromocytoma of Adrenal gland Sidedness Score) system was applied, resulting in a total score of 3 out of a maximum 20."} +{"pid": "TCGA-EL-A3MX", "report": "The surgical case involved a female patient with a history of thyroid cancer. A total thyroidectomy specimen measured 6.0 x 5.5 x 4.0 cm. The right thyroid lobe appeared unremarkable. The left thyroid lobe was entirely replaced by a fleshy tan tumor measuring 5.0 x 4.1 x 4.0 cm. The tumor exhibited a central area that was more solid and contained calcifications. It was surrounded by a thin capsule. Representative sections were taken from the tumor, including the capsule, as well as from the right thyroid and isthmus.\n\nA lymph node from the left paratracheal region measured 0.6 cm in diameter and was entirely submitted for frozen section; it showed benign features. A small soft tan-pink tissue sample measuring less than 0.1 x 0.1 x 0.1 cm was submitted for frozen diagnosis and identified as parathyroid tissue. One lymph node associated with the parathyroid was negative for any abnormal cellular infiltration."} +{"pid": "TCGA-LT-A5Z6", "report": "The specimen consists of multiple irregular fragments of moderately friable tan-pink to red-gray tissue, submitted in formalin and weighing 6.9 grams in total. Histologic evaluation revealed a high-grade lesion with glandular differentiation. Microscopic examination confirmed the presence of muscularis propria within the specimen, with evidence of tumor invasion into this layer. No venous or lymphatic invasion was identified. There was no association with other epithelial lesions. Staging according to AJCC criteria indicates involvement of the muscularis propria (pT2), with no assessable lymph node or distant metastasis information available. The tissue was collected during a transurethral resection procedure and submitted for analysis in multiple cassettes."} +{"pid": "TCGA-BH-A18T", "report": "The patient is a female with no clinical history or LMP provided. The specimen consists of a right segmental mastectomy measuring 3.1 cm. Histologic evaluation shows a poorly differentiated carcinoma with a Nottingham score of 9/9 (tubules = 3, nuclear grade = 3, mitoses = 3). Lymphovascular invasion is present. Additional findings include separate foci of high-grade ductal carcinoma in situ, solid type, extending close to the posterior surgical margin (<0.1 cm). All other surgical margins are free of involvement. Non-neoplastic fibrocystic changes are also noted.\n\nSentinel lymph node biopsies from the right axilla, including two lymph nodes, and one non-sentinel lymph node show no evidence of tumor involvement. Cytokeratin stains confirm the absence of tumor cells in the sentinel lymph nodes.\n\nImmunohistochemical analysis demonstrates ER and PR negativity with no nuclear staining observed. HER-2/Neu testing reveals weak to moderate complete membrane staining in more than 10% of cells, interpreted as weakly positive (score 2+). A FISH study for HER-2/Neu was ordered for further evaluation. All assays were performed using FDA-approved methods."} +{"pid": "TCGA-HU-8245", "report": "Stomach, total gastrectomy: The lesion is located in the upper third, centered at the upper body on the posterior wall, and demonstrates a Borrmann type 2 gross appearance. Histologically, the predominant morphology is papillary adenocarcinoma, accounting for approximately 70% of the tumor mass, with a component of poorly differentiated non-solid (por2) morphology. According to Lauren classification, the histologic type is intestinal. The growth pattern is mixed, with both expanding and infiltrative features. The tumor measures 6.2 x 4.7 x 1.7 cm and invades into the subserosa (pT3). Resection margins are free of tumor involvement, with a distal margin of 12.1 cm and a proximal margin of 1.2 cm. A total of 60 regional lymph nodes were examined, none of which show evidence of metastasis (pN0), including 28 from the lesser curvature and 32 from the greater curvature. Lymphatic and venous invasion are not identified. Moderate perineural invasion is present. Additional findings include foveolar hyperplasia with pit dysplasia. Immunohistochemical staining was performed for CD10, MUC2, MUC5AC, MUC6, and C-erb B2."} +{"pid": "TCGA-DR-A0ZM", "report": "The specimen consisted of lymph nodes and a vaginal cuff biopsy, along with a uterus with cervix, fallopian tubes, and ovaries. Lymph node involvement was identified bilaterally in the pelvic region, with two involved nodes on the left and two on the right, out of a total of 27 and 26 nodes respectively. No tumor was identified in the vaginal cuff biopsy. The primary lesion measured 7.5 cm and was located in the anterior and posterior cervix. Histologic evaluation revealed moderately differentiated cells of a specific type. The depth of invasion was 1.5 cm, extending completely through the cervical wall. There was no evidence of lower vaginal involvement or pelvic wall extension, but parametrial invasion was present. Lymphovascular invasion was extensive. The resection margin at the paracervical region was found to be clear by less than 0.1 cm. Extensive involvement of the myometrium was noted. Gross examination of the uterus showed a tumor measuring 7.5 x 3.6 x 1.7 cm with circumferential growth, firm consistency, and fungating appearance. The tumor extended into the uterine body without involving the serosal surface, and was within 1.1 cm of the paravaginal margin. The endometrium was thin with areas of hemorrhage, and the myometrium was largely replaced by tumor. Both adnexal regions appeared unremarkable on gross inspection. Lymph nodes from other sites were negative for involvement. Staging information indicated advanced local disease with regional lymph node involvement."} +{"pid": "TCGA-YR-A95A", "report": "The specimen involves the right lobe and segment IV of the liver. A moderately differentiated malignant neoplasm is present, measuring 7.5 x 4.5 x 3.6cm. There is marked stromal desmoplasia observed. Perineural infiltration by the tumor is evident. The resection margin is involved by the neoplastic process. Additionally, involvement of the hepatic hilus by a similar moderately differentiated lesion is noted, with involvement of the margins."} +{"pid": "TCGA-BA-A6DL", "report": "The surgical pathology report describes a biopsy specimen from the right palate lesion of a male patient. The submitted tissue consists of multiple pale tan soft tissue fragments, measuring in total 1.4 x 1.0 x 0.6 cm. Microscopic evaluation reveals invasive moderately differentiated tumor composed of squamous cells. The tissue blocks have been fully processed and evaluated. Additional testing for P16 protein expression by immunohistochemistry was performed and showed negative results, with appropriate external controls being positive. High-risk human papillomavirus (HPV) screening via in situ hybridization was also conducted, yielding negative results, with positive external controls confirming assay validity."} +{"pid": "TCGA-EM-A1CW", "report": "The specimen received includes a midline delphian lymph node and a total thyroidectomy specimen with a stitch at the right superior pole. The lymph node biopsy showed no pathological diagnosis. The thyroidectomy specimen revealed multiple nodules. A dominant nodule measuring 4.5 cm in greatest dimension, along with additional dimensions of 2.7 x 2.0 cm, was identified in the right lobe. It was unencapsulated without capsular invasion, and there was no extrathyroidal extension. The surgical margins were free of involvement. A second nodule in the isthmus measured 2.2 cm in greatest dimension with additional measurements of 1.5 x 1.6 cm. This nodule was also unencapsulated, non-invasive, and without extrathyroidal extension. Margins were uninvolved. Additional smaller nodules were present, including one measuring 1.3 cm on the left and several multifocal microcarcinomas bilaterally.\n\nPathologic staging was pT3 based on tumor size greater than 4 cm confined to the thyroid. There was no regional lymph node involvement (pN0) with one lymph node examined and none involved. Distant metastasis could not be assessed (pMX). Other findings included nodular hyperplasia. No venous or lymphatic invasion was identified. Gross examination of the thyroid showed fibrous adhesions on the external surface, with three well-delineated nodules in the right lobe, left lobe, and isthmus respectively. The nodules were sectioned and stored frozen; the remaining tissue was submitted for analysis."} +{"pid": "TCGA-VQ-A922", "report": "The specimen from the stomach (antrum) reveals a lesion with the following characteristics: Bormann type III morphology and a tubular histologic pattern. The tissue shows moderate differentiation (histologic grade II) and is classified as intestinal type based on Lauren classification. The largest tumor measures 4.0 cm in greatest dimension and demonstrates ulceration. Local invasion extends to the muscularis propria and includes involvement of the duodenum and peripancreatic fat tissue. The tumor exhibits an expansive growth pattern with a moderate inflammatory response. No tumor implants are observed in the perivisceral fat.\n\nMargins of resection, including both proximal and distal, show no evidence of neoplastic involvement. There is no evidence of neural invasion; however, lymphatic invasion is present. Blood vessel invasion remains uncertain. The greater omentum is free of tumor involvement.\n\nLymph node evaluation identifies neoplastic involvement in one out of eight nodes examined. Distribution of involved nodes includes Chain 8a (anterior hepatic artery), where one of two nodes is affected. Other evaluated chains (Chain 1 and Chain 9) show no evidence of tumor involvement. Additionally, soft tissue tumor implants are identified. At the superior edge of the pancreatic body, infiltration of connective tissue is noted. All other sites, including the esophageal margin and spleen, are devoid of tumor involvement."} +{"pid": "TCGA-A8-A06X", "report": "The specimen shows a lesion with a maximum diameter of 5.5 cm, characterized by high-grade cellular atypia and infiltrative growth pattern. Angioinvasion is present. The resection margins are free of abnormal cells, with a minimum distance of 3 mm from the nearest margin. Histological evaluation of 11 retrieved lymph nodes reveals no evidence of metastatic involvement. Tumor staging is pT3, Nx, Mx, with no vascular or lymphatic invasion noted."} +{"pid": "TCGA-BP-4799", "report": "The specimen from the right kidney and adrenal gland following radical surgery shows a tumor measuring 6.0 cm in greatest dimension. Microscopic evaluation reveals nuclear features corresponding to a high-grade appearance. The tumor extends through the renal capsule and involves the sinus fat, while remaining confined within Gerota\u2019s fascia. No invasion of the renal vein is noted, although the muscular branches of the renal vein at the hilum are involved. Surgical margins are free of tumor.\n\nExamination of the non-neoplastic kidney tissue demonstrates mild arteriosclerotic changes, benign cortical cysts, and organizing hemorrhage around the kidney. The adrenal gland does not show any involvement by the tumor. However, multiple foci of amyloid deposition are identified in the adrenal cortex, positive with Congo red staining. No amyloid involvement of vessels or soft tissues is seen. Further stains to characterize the type of amyloid are in progress and will be reported separately.\n\nNo lymph nodes are identified in the perinephric fat. Gross examination of the kidney reveals a large hematoma along the lateral aspect measuring up to 17 cm. A multiloculated mass with a yellow to hemorrhagic cut surface is present in the mid portion of the kidney, measuring 6.0 x 4.2 x 2.6 cm. The remainder of the kidney appears fibrotic with indistinct corticomedullary architecture. Small fluid-filled cysts are also observed.\n\nIn a separate specimen from retrocaval lymph nodes, histologic analysis reveals features consistent with a lymphoproliferative process. Immunohistochemical studies demonstrate positivity for CD20, BCL-2, and CD43 in the majority of lymphocytes, with absence of markers including CD3, Cyclin D1, CD5, CD10, CD23, and CD6. Rare cells express BCL-6. Proliferation index as determined by MIB-1 staining is approximately 5%. No evidence of amyloid deposition or metastatic disease is found in these lymph nodes.\n\nReview of prior biopsy material supports the findings in the lymph node specimen, confirming similar morphologic and immunophenotypic characteristics. Special stains including Congo red and a panel of immunostains were performed to further define the cellular composition and characteristics of the tissues examined."} +{"pid": "TCGA-FG-A4MY", "report": "The clinical history includes a history of substance use including cocaine and alcohol, as well as benign essential hypertension. A brain lesion was biopsied and later excised from the right parietal temporal region. Histologically, the lesion is an infiltrating glial neoplasm composed of cells with round to ovoid nuclei and scant cytoplasm. Mitotic figures are infrequent. Areas of nuclear pleomorphism and eosinophilic cytoplasm with processes are present, and GFAP staining is positive in these regions. A Ki-67 proliferation index of approximately 38% was determined by manual quantification. Background vasculature appears slender and unremarkable.\n\nMolecular testing for chromosomal loci was performed using FISH analysis on formalin-fixed tissue from block B4. The 1p36/1q25 probe set showed a ratio of 0.89 based on 142 cell counts, indicating no loss at the 1p36 locus. The 19q13/19p13 probe set yielded a ratio of 0.70 from 131 cell counts, consistent with loss at the 19q13 locus. These results were confirmed by both computer-aided and manual counting methods, with at least 20 non-overlapping interphase nuclei evaluated in two different areas of the sample. Interpretation was performed by a licensed technologist and reviewed by a pathologist using fluorescence microscopy. Control tissues from 40 normal cases across 10 organs were used to establish reference ranges, with a ratio <0.8 considered indicative of allelic loss.\n\nThe immunohistochemical assays used in this evaluation were developed and validated by the Immunohistochemistry and Histology Core Facility laboratory. They have not been cleared by the FDA, as they are considered analyte-specific reagents. All control samples demonstrated appropriate reactivity.\n\nGross examination of the excised specimen revealed a 6.0 x 4.5 x 1.5 cm aggregate of pink-tan to white-tan soft tissue with a yellow-tarry, homogeneous cut surface. The biopsy specimen measured 0.8 x 0.5 x 0.2 cm in total. Intraoperative frozen section diagnosis indicated an infiltrating glioma. Both specimens were processed and labeled appropriately."} +{"pid": "TCGA-CQ-6225", "report": "The specimens received included multiple biopsies and resected tissues from the left neck, oral cavity, and surrounding regions. Lymph node evaluation of the left neck level II showed no lymph nodes present, and adipose tissue showed no pathologic changes. A biopsy of the left palate revealed squamous mucosa with no pathologic changes. The left tongue base, deep margin of the tongue, and revised inferior margin of the tongue were all negative for tumor involvement. The left neck contents contained 25 lymph nodes, all of which were negative for tumor. The submandibular gland showed signs of extensive atrophy, consistent with prior radiotherapy.\n\nA larger specimen from the left tongue, floor of the mouth, and palate showed a firm, white, solid tumor located on the left lateral surface. The tumor measured 4.9 cm in its largest dimension and had a thickness of 2.9 cm. It was found to be extensively involved with perineural invasion, although no lymphovascular invasion was identified. The tumor demonstrated extensive clear cell change and was in close proximity (0.2 cm) to the deep medial soft tissue margin. All other margins were free of tumor involvement.\n\nGrossly, the main tumor specimen measured 5.5 x 4.5 x 11.5 cm and included the left tongue, floor of the mouth, sublingual gland, and soft palate. The sublingual gland itself measured 1.7 x 1.4 x 1.7 cm. The tumor was ulcerated and located 3.2 cm from the anterior tip of the tongue, 3.0 cm from the posterior margin, 0.2 cm from the medial margin, 0.3 cm from the inferior/deep margin, 0.3 cm from the lateral floor of the mouth margin, 0.2 cm from the sublingual gland, and 0.4 cm from the supero-lateral soft palate margin. All surgical margins were marked with black ink. Multiple sections were taken for further analysis, including areas of the tumor in relation to various margins and normal tissue.\n\nOther specimens, including the left neck level II lymph node, biopsy of the left palate, left tongue base, deep and revised inferior margins of the tongue, were all negative for malignancy on frozen section and quick section diagnoses."} +{"pid": "TCGA-63-6202", "report": "The histology and staging details include sample collection information with tissue site noted. Age at sample collection was 17 days, with a subsequent sample collected 28 days later. Both samples were obtained via resection from the right upper lobe. The tissue size measured 6.00 cm in each case. Histological evaluation indicated moderately differentiated cells. Pathological staging was consistent across both samples, with tumor classification T2, NOS, and no lymph node or distant metastasis identified (M0). Staging aligns with VALCSG Stage III criteria. Specimen preparation involved formalin fixation. No additional diagnostic terms or tumor-specific nomenclature were included in the description."} +{"pid": "TCGA-DU-A7TJ", "report": "A 3 cm lesion was identified in the right inferior temporal lobe of a male patient presenting with headaches, memory issues, imbalance, and seizure. Imaging showed mass effect and possible enhancement. The lesion was surgically resected via craniotomy. Histopathological examination revealed an infiltrating glial neoplasm with astrocytic features. High-grade characteristics were noted, including mitotic figures and a Ki-67/MIB-1 proliferation index exceeding 10%. Abnormal blood vessels were also observed, with one showing mitosis in its endothelial layer. No tumor necrosis was present. The histological findings suggest a high-grade diffuse glioma; however, the presence of certain features raises concern for the possibility of a higher-grade lesion, warranting correlation with preoperative imaging for a complete clinicopathological assessment.\n\nGenetic testing did not detect co-deletion of chromosomal arms 1p and 19q. Molecular analysis also found no evidence of IDH1 mutation at codon 132 or IDH2 mutation at codon 172. The MGMT promoter methylation test showed low positivity, indicating potential benefit from alkylating agent therapy. All genetic testing was performed on DNA extracted from the tumor block, with tumor enrichment by microdissection. Cytogenetic and molecular results are to be interpreted within the context of established clinical and diagnostic guidelines."} +{"pid": "TCGA-CQ-5332", "report": "The specimen consisted of multiple tissue samples from the neck, oral cavity, and surrounding areas. A total of 31 lymph nodes were examined across both sides of the neck, and all were negative for tumor involvement. The submandibular glands showed no significant tumor-related changes, although one exhibited moderate chronic inflammation and partial atrophy.\n\nA primary lesion was identified in the left floor of the mouth. The lesion measured 4.9 cm in its greatest dimension and had a thickness of 4.5 cm. Microscopic evaluation showed no evidence of perineural or lymphovascular invasion. Margins were generally negative; however, the posterior and deep margins were very close to the tumor, each measuring less than 0.1 cm. Other margins, including those involving bone, were free of tumor involvement.\n\nIn addition, carcinoma in situ was identified at the cheek margin. Two additional soft tissue specimens from the revised cheek margin were negative for tumor. The surgical waste specimen, consisting of skeletal muscle, showed no pathologic changes.\n\nStaging indicated that the tumor was greater than 4 cm in size, with no regional lymph node metastasis identified. The number of regional lymph nodes examined was 31, with none showing evidence of tumor involvement. Distant metastasis could not be assessed. Multiple representative sections from all relevant areas were submitted for histological analysis."} +{"pid": "TCGA-HQ-A2OE", "report": "The sample was obtained from a primary tumor located in the urinary bladder. The tissue was collected as fresh frozen material during a surgical resection procedure performed on the same day as the collection. The patient was diagnosed 15 days after the sample was collected. The tumor measured 3 cm and demonstrated papillary growth. Pathological staging indicated T2a with regional lymph node involvement (N2). A total of four lymph nodes were sampled, and all were positive for tumor involvement. Distant metastasis could not be assessed (MX). The histological grade was not determined."} +{"pid": "TCGA-AY-5543", "report": "The surgical specimen from the omental mass measured 6.5 x 3.6 x 1.5 cm and consisted of fibroadipose tissue with a central firm, hard lesion. Histologically, there was involvement of this site by a moderately differentiated adenocarcinoma. The primary resection specimen included terminal ileum, appendix, and right colon, measuring 27.3 cm in total length. A tumor was identified just distal to the ileocecal valve, involving its surface. The tumor measured 3.5 x 2.4 x 1.2 cm and showed an ulcerated appearance with whorled edges. It circumferentially involved approximately 70% of the bowel circumference. Microscopic evaluation demonstrated invasion through the muscularis propria into subserosal pericolic soft tissue, without lymphovascular or perineural invasion. The closest margin was the serosal surface, which was less than 1.0 mm from the tumor, while the proximal mucosal margin was 8.5 cm away. Of 24 lymph nodes examined, one contained metastatic involvement. A satellite nodule was also identified in the pericolic region. The remainder of the colon, ileum, and appendix appeared unremarkable. A separate liver biopsy from Segment 5 showed no evidence of malignancy; findings included minimal steatosis and mild portal triaditis. A hernia sac specimen revealed benign fibrovascular and fibroadipose tissue with a focal foreign body giant cell reaction but no signs of tumor involvement."} +{"pid": "TCGA-ET-A25N", "report": "The specimen consists of a total thyroidectomy weighing 14.6 grams and measuring 5.2 cm in width, 5 cm in length, and 0.9 cm in thickness. The right thyroid lobe is approximately twice the size of the left, with overall dimensions of 4.4 x 3.5 x 1.6 cm. A nodule measuring 2.3 x 1.5 x 2.0 cm is present in the right inferior pole. It is well-circumscribed, friable, and encapsulated, with portions of the lesion adhering to the capsule anteriorly. The left thyroid lobe measures 4.0 x 1.3 x 0.6 cm and shows uniform red-brown parenchyma without additional nodules. An attached fragment of tan-pink adipose tissue measuring 2.0 x 1.0 x 0.5 cm is present at the inferior portion of the right lobe.\n\nMicroscopic evaluation reveals a unifocal lesion in the right lobe. Margins are uninvolved, with the closest distance from the invasive component to the margin being 1 mm. No venous or lymphatic invasion is identified. Central neck dissection tissue is submitted entirely, and no grossly identifiable lymph nodes are seen upon dissection. Histologic analysis of the lymph node tissue reveals metastatic involvement in one of eight lymph nodes, with the largest focus measuring 2.5 mm. An additional metastatic focus less than 1 mm is found in the adipose tissue of the central neck dissection. The tumor is confined to the thyroid gland, measuring more than 2 cm but less than 4 cm in greatest dimension. Staging indicates no distant metastases; however, distant metastasis could not be fully assessed. Lymph node involvement corresponds to level VI. All relevant sections of the thyroid and associated tissues have been submitted for evaluation."} +{"pid": "TCGA-F7-A61S", "report": "The gross specimen consists of tongue tissue measuring up to 8 cm, containing a gray, dense-elastic lesion measuring up to 5 cm with areas of ulceration. Microscopic examination reveals well-differentiated keratinizing epithelial malignancy involving the tongue. Hemorrhagic changes are noted in the fatty tissue from the left side. On the right side, six lymph nodes within fatty tissue show no abnormal morphology and maintain normal structural architecture. Histologic features include presence of venous invasion and absence of clear surgical margins. The tumor is localized without evidence of distant spread. Clinical correlation is recommended for further evaluation."} +{"pid": "TCGA-B5-A0K7", "report": "A 135 g, 11.1 x 7 x 4.2 cm hysterectomy specimen includes a 6 x 3.5 x 0.4 cm exophytic mass involving the uterine isthmus, the lower uterine segment, and the superior part of the cervix. The mass involves both the interior and posterior surfaces but does not appear to penetrate the 1.5 cm thick myometrium. An additional 9.6 x 6.7 x 1.8 cm aggregate of tissue and blood clot is present within the endometrial cavity. The remainder of the serosal surface and myometrium appears unremarkable. Both ovaries and fallopian tubes are unremarkable. A peritoneal biopsy is negative for malignancy. Histologic evaluation reveals no vascular invasion. Depth of myometrial invasion is not identified. The cervix shows only surface extension without stromal invasion. There is no evidence of parametrial or serosal extension. Bilateral pelvic lymph nodes are evaluated: five on the left and one on the right, all negative for malignancy. No tumor is identified in bilateral ovaries or fallopian tubes."} +{"pid": "TCGA-EJ-5518", "report": "The patient is a male with a PSA level of 36 and a history of prior biopsy. Multiple prostate tissue samples were obtained from various regions including the right mid, right apex, left base, left mid, and left apex areas. In several samples, malignant cells with ductal features were identified. Gleason scoring was consistently high across all involved cores, with most areas showing a Gleason score of 4+5=9. The percentage of tissue involvement ranged from 70% to 95%. Total linear extent of affected tissue in individual cores ranged from 0.7 cm to 2.1 cm. Perineural invasion was noted in multiple samples.\n\nA radical prostatectomy was performed. Examination of the prostate and bilateral seminal vesicles revealed invasive carcinoma with extensive ductal differentiation and signet ring cell features. The tumor was present in both lobes and measured up to 2.3 cm in greatest dimension. Approximately 80% of the prostate volume was involved. Bilateral seminal vesicle involvement was present. Multifocal extracapsular extension was observed in both lobes. Tumor cells were found at the surgical resection margins, specifically at the left proximal urethral margin and the right distal urethral margin. Extensive perineural invasion and angiolymphatic invasion were identified. High-grade prostatic intraepithelial neoplasia was also present. No evidence of malignancy was found in the three pelvic lymph nodes examined.\n\nHistologic grade was classified as G3-4. Pathologic staging was determined to be pT4 with no regional lymph node involvement (pN0) and no evidence of distant metastasis (pMX). Benign prostatic hyperplasia and chronic inflammation were also noted. The weight of the prostate was 51.60 grams. Tumor involvement of the specimen was estimated at 25% or greater."} +{"pid": "TCGA-EO-A3KU", "report": "The surgical specimens included multiple lymph nodes from the right and left periaortic, right and left external iliac, and right and left obturator regions, as well as an omental fragment and a hysterectomy specimen with cervix, bilateral fallopian tubes, and ovaries.\n\nIn the lymph nodes, no abnormal histologic findings were identified. All lymph nodes examined across all sites showed no evidence of malignant involvement. Specifically, seven lymph nodes were sampled from the right periaortic region, two from the left periaortic, three from the right external iliac, and one each from the right obturator, left external iliac, and left obturator regions. Each lymph node was described as tan and fatty with unremarkable cut surfaces on gross examination and showed no metastatic disease on histologic evaluation.\n\nThe omental specimen weighed 77.7 grams and measured 15 x 7 x 2.0 cm. It consisted of adipose tissue with no grossly identifiable nodules or abnormalities. Multiple representative sections were submitted for analysis and showed no evidence of malignancy.\n\nThe hysterectomy specimen included a uterus with cervix, bilateral fallopian tubes, and ovaries. The fresh specimen weighed 108.1 grams. The uterine body measured 7.3 cm in greatest dimension (SI), 5.0 cm ML, and 3.0 cm AP. The cervix appeared hemorrhagic with a small polyp measuring 0.6 x 0.3 cm located in the anterior endocervical canal. The endometrial cavity measured 3.7 cm in length by 2.5 cm in width. A mass occupying the entire anterior and approximately half of the posterior endometrial cavity was identified, measuring 3.7 cm in both SI and ML dimensions. On sectioning, the depth of the mass on the posterior wall was 1.3 cm, with a total uterine wall and mass depth of 2.8 cm. No involvement of the lower uterine segment was observed. A small intramural fibroid measuring 0.4 cm in diameter was noted on the anterior uterine wall; it had a pale white, whorled cut surface. The remainder of the uterine serosa, fallopian tubes, and ovaries appeared unremarkable on gross inspection.\n\nHistologically, the endometrium showed inactive background tissue with a polypoid structure. There was evidence of cellular invasion into the stroma of the polyp. The cervical stroma also demonstrated similar cellular infiltration. No involvement was seen in the myometrium, fallopian tubes, ovaries, or omentum. Surgical margins were free of invasive disease. No lymphovascular invasion was identified. A total of 15 pelvic and para-aortic lymph nodes were evaluated, with none showing signs of involvement. The tumor was confined to the uterus with cervical stromal extension but without further spread beyond the uterine body."} +{"pid": "TCGA-BQ-5889", "report": "A left radical nephrectomy specimen included a large mass measuring 8.5 cm in greatest dimension located in the upper pole of the kidney. The mass exhibited a yellow-tan to red-brown, hemorrhagic, and friable appearance with pseudoencapsulation. It extended through the renal capsule and infiltrated the renal pelvis and hilar fat. Invasion into the renal vein was identified, along with extensive vascular invasion. Adjacent satellite nodules were also present. A smaller incidental finding of a 0.2 cm lesion was noted in the non-neoplastic kidney. The adrenal gland showed involvement of the surrounding soft tissue with tumor cells abutting its capsule.\n\nExamination of the surgical margins revealed tumor presence at the renal vein margin. No lymph nodes were identified within the adrenal gland specimen. Multiple lymph node groups were assessed: perihilar, paraaortic, and aortocaval. In the perihilar group, 10 lymph nodes were examined, of which 8 were involved by tumor. The largest involved node measured 2.5 cm and demonstrated extracapsular extension. In the paraaortic group, 18 lymph nodes were evaluated, with 13 showing tumor involvement. The largest metastatic deposit in this group measured 3.5 cm and also exhibited extracapsular extension. In contrast, the aortocaval lymph nodes showed no evidence of tumor involvement, with 4 lymph nodes examined.\n\nBiopsy specimens from the caval wall and an additional vena cava sample contained detached atypical cells admixed with fibrin within the lumen; however, no definitive tumor was identified in the additional vena cava biopsy. A separate hernia sac specimen revealed benign fibrovascular and adipose tissue lined by mesothelium without any malignant findings.\n\nImmunohistochemical staining revealed focal faint positivity with AE1/AE3 and CA-IX, while other markers including CK7, 34BE12, and racemase were negative. Based on these findings and histologic features, further diagnostic considerations were suggested for certain hereditary or rare tumor types. Additional molecular testing was performed under validated protocols within the pathology department.\n\nStaging indicated involvement extending into the renal vein below the diaphragm, consistent with advanced local-regional spread."} +{"pid": "TCGA-43-A474", "report": "A left upper lobe lobectomy was performed, with assessment of margins and lymph nodes. A mass measuring 5.6 cm in greatest dimension was identified in the left upper lobe, located near the hilar region. Histologic evaluation showed a poorly differentiated invasive tumor involving the main bronchus; however, no pleural involvement, lymphatic, vascular, or venous invasion was identified. The final bronchial margin was negative for tumor involvement, as were all other resection margins, including venous and arterial margins. Four peribronchial lymph nodes were examined and found to be free of tumor.\n\nA completion left pneumonectomy was subsequently carried out. The specimen showed changes consistent with procedural effects, including pulmonary hemorrhage and focal hemosiderin deposition suggestive of prior bleeding. There was also evidence of atelectasis, but no malignancy was identified in the left lower lobe. All margins, both bronchial and vascular, were unremarkable in this specimen.\n\nMultiple lymph node biopsies from various levels (including levels 4, 5, 6, 7, 9, 10, and 11) were obtained and examined. Each lymph node was negative for metastatic disease. Anthracosis was present in several specimens, and mild emphysematous change was noted. Additionally, there were areas of bronchiectasis and nonspecific focal interstitial fibrosis in the left upper lobe, away from the primary lesion.\n\nGross examination of the left upper lobe specimen revealed a large, white-tan, ill-defined lesion without clear pleural involvement, coming within 0.2 cm of the bronchial margin. No discrete hilar lymph nodes were identified. The remainder of the lung tissue showed diffuse black stippling, consistent with anthracosis. Representative sections were taken from key areas including margins, tumor interface, and normal lung tissue.\n\nFrozen section analysis of the bronchial margin confirmed absence of tumor involvement. Other findings included mild emphysema, anthracosis, and hemosiderin-laden macrophages, particularly in the left lower lobe, which did not show any signs of malignancy."} +{"pid": "TCGA-OR-A5JV", "report": "The specimen includes a spleen weighing 420 grams, measuring 14 x 12 x 6 cm, with a semi-firm, red cut surface. Representative sections were taken. A fibroadipose omental specimen measuring 56 x 10 x 2 cm and a separate piece measuring 13 x 6 x 2 cm showed no mass or lesion; representative sections were submitted. A 1 cm pink-yellow lymph node was bisected and examined. Retroperitoneal fat measuring 6 x 5 x 3 cm showed no mass or lesion, and representative sections were taken. The left adrenal and kidney specimen included a 1525 gram combined weight. The adrenal mass measured 17 x 11 x 12 cm and was attached to a kidney measuring 13 x 4 x 5 cm. The mass was completely encased by a pseudocapsule and membranous layer. The adrenal shared vessels with the kidney but did not involve it. The adrenal mass weighed 1125 grams after trimming and showed a soft, semi-solid consistency with a central yellow, grumous, necrotic area and peripheral nodular, pink-tan tissue with foci of necrosis and hemorrhage. The mass was in close proximity to the fascia (less than 0.1 cm). No residual adrenal tissue was identified grossly. The kidney showed a 3.6 x 3.5 x 1.5 cm simple cyst at the inferior pole and a 2 cm dilated vessel adherent to the adrenal. Microscopic evaluation of the spleen, omentum, perirenal lymph node, and retroperitoneal fat showed no significant abnormality or evidence of neoplasm. The lymph node was negative for tumor (0/1). The adrenal resection showed no vascular invasion and clear margins, with the kidney being unremarkable."} +{"pid": "TCGA-CN-4734", "report": "The specimen was received in seven parts. Part 1 consisted of a 0.6 x 0.5 x 0.3 cm piece of tan tissue from the right Stensen\u2019s duct margin, entirely submitted for analysis. Frozen section evaluation was deferred due to freeze artifact and tangential sectioning; no definitive tumor was identified.\n\nPart 2 was a resection of the right buccal mass measuring 4.9 x 5.0 x 2.1 cm, with a central ulcerated area measuring 3.2 x 2.0 x 1.8 cm. Histologic examination revealed a moderately differentiated squamous cell carcinoma with an infiltrative border. A background of lichenoid dysplasia with prominent lymphocytic response was also noted. Angiolymphatic and perineural invasion were present. Margins of the resection, including anterior, posterior, inferior, and superior, were all free of tumor. Immunostains including HPV, p16, and EGFR were negative. Cytokeratin immunostain showed no evidence of micrometastasis in lymph nodes examined.\n\nPart 3 was a biopsy of right buccal fat, measuring 2.2 x 1.6 x 1.0 cm, composed of fibroadipose tissue. No tumor was identified on frozen section.\n\nPart 4 included a deep margin biopsy measuring 2.8 x 1.2 x 0.5 cm in aggregate. All margins were free of tumor involvement.\n\nPart 5 was a dissection from right neck levels 1A and 1B, measuring 6.2 x 6.3 x 2.1 cm. It included submandibular gland tissue and multiple potential lymph nodes. The submandibular gland showed no significant abnormality. Seven lymph nodes were identified, all without evidence of tumor. One lymph node was further evaluated with cytokeratin immunostain and serial sectioning due to subcapsular fibrosis and giant cell reaction, but no micrometastases were found.\n\nPart 6 was a dissection from right neck levels 2 through 4, measuring 11.2 x 6.4 x 1.1 cm. Twenty-nine lymph nodes were identified, all without evidence of tumor.\n\nPart 7 was an additional inferior margin measuring 2.0 x 0.4 x 0.3 cm. Histologic assessment was suboptimal due to cautery artifact, though no definitive tumor was observed.\n\nA total of 36 regional lymph nodes were examined across all parts, and none showed involvement. Venous/lymphatic and perineural invasion were both present. Margins were uninvolved by tumor. Tissue fixation ranged from 2 to 84 hours. FISH studies performed on the lesion showed high polysomy for EGFR but were negative for c-MET amplification. All other parts of the specimen were assessed with H&E staining and other immunostains as indicated, with no tumor identified outside of the main resection."} +{"pid": "TCGA-MT-A67G", "report": "The specimen consists of a right tonsil measuring 4.1 x 4.0 x 2.3 cm. A well-defined mass measuring 2.5 x 1.7 x 1.5 cm is identified deep to an ulcerated mucosal surface. The mass is composed of moderately differentiated cells arranged in nests and cords within a fibrous stroma. Necrosis and nuclear pleomorphism are present. The tumor is located less than 0.1 cm from the deep margin, 0.2 cm from the anterior margin, 0.7 cm from the posterior margin, 1.0 cm from the superior margin, and 0.6 cm from the inferior margin. The posterior margin is involved by invasive disease.\n\nA total of 48 lymph nodes are examined from various right-sided neck levels. In level 2A, four out of seven lymph nodes contain metastatic involvement. In level 3, one out of thirteen lymph nodes is involved. No involvement is identified in levels 2B or 4. The largest involved lymph node measures 1.1 cm. No extranodal extension is observed in any involved lymph node.\n\nThe surgical procedure includes a right tonsillectomy and right neck dissection including levels 2A, 2B, 3, and 4. All specimens are received intact with appropriate orientation and inked margins. No lymphovascular or perineural invasion is identified."} +{"pid": "TCGA-AK-3450", "report": "The specimen consists of a radical nephrectomy from the right kidney, weighing 360 grams and measuring 10.0 x 6.0 x 6.0 cm, with perinephric fat ranging from 0.3 to 5.0 cm in thickness. An 8.0 x 0.3 cm segment of ureter is identified at the hilum, which appears grossly unremarkable upon opening. A firm bulging mass is noted at the hilum protruding from the kidney. Sectioning of the kidney reveals a soft orange mass measuring 4.0 x 3.5 x 2.7 cm with areas of hemorrhage and possible degenerative changes. The mass extends toward the hilum and renal pelvis but does not appear to involve the calyceal system or vessels. There are two small cortical cysts measuring 0.9 and 1.0 cm, respectively, located in the lateral and superior regions of the kidney. Scarring is noted in the remaining parenchyma with preserved cortical-medullary differentiation.\n\nHistologic sections evaluate various aspects including vascular and ureteral margins, tumor relationship to adjacent structures, and surrounding fat. No angiolymphatic invasion is identified, and surgical margins are negative. Additional findings include tubular/papillary adenoma, renal cortical cysts, and benign arterio-arteriolar nephrosclerosis. Staging classification indicates T1a Nx Mx."} +{"pid": "TCGA-BR-7901", "report": "The specimen consists of a total gastrectomy with tumor located at the gastroesophageal junction. A plate-like tumor measuring 8 x 6 cm is present in the cardia region of the stomach, with extension into the lower part of the esophagus. The tumor invades into the perigastric fat and spreads into the wall, reaching the subserosal layer. Microscopic examination reveals moderately differentiated cells with features suggestive of glandular origin. Two out of fifteen lymph nodes examined show evidence of involvement, including those from the greater and lesser omentum. No venous or perineural invasion is identified. The surgical margins are uninvolved. The omentum appears hyperemic but shows no signs of tumor involvement. A separate lymph node is described as black and soft. The tumor is ulcerated and displays dense, rosy lymph nodes at the cardia-esophageal region. No evidence of neoadjuvant treatment effect is noted."} +{"pid": "TCGA-ET-A40P", "report": "Specimen taken. Thyroid specimen was obtained following total thyroidectomy. The tumor was located in the right lobe and measured 3.2 cm in greatest dimension. Histologic evaluation demonstrated a unifocal lesion. No tumor involvement was identified in the single lymph node examined. The primary tumor was confined to the thyroid gland, measuring greater than 2 cm but less than 4 cm in size. There was no evidence of regional lymph node metastasis or distant metastasis; the latter could not be assessed. Surgical margins were free of tumor, with the nearest margin measuring 1 mm from the invasive component, involving the anterior and posterior aspects. No vascular or lymphatic invasion was observed. Additional findings included the presence of parathyroid tissue and lymph node within fibroadipose tissue, both without tumor involvement."} +{"pid": "TCGA-EB-A97M", "report": "The specimen consists of a skin fragment measuring 8 x 4 cm, which includes a pigmented lesion measuring 2 x 1.5 cm. Microscopic evaluation reveals malignant cells consistent with melanocytic origin, showing features of ulceration. The lesion demonstrates invasion into deeper tissues, with a Clark's level of IV and a Breslow thickness of 15 mm. Histologic assessment indicates an undifferentiated growth pattern. No evidence of venous invasion is identified. The tumor margins are uninvolved. The lesion is categorized as having a depth of more than 4 mm, with ulceration present. No satellite nodules are identified, and lymphatic involvement cannot be assessed. No prior treatment effect is observed."} +{"pid": "TCGA-DV-5568", "report": "The right kidney specimens included multiple masses ranging in size from 0.2 cm to 3 cm. Several showed red-tan or yellow coloration on cut surface, with some demonstrating solid consistency and necrosis. Specimens varied in composition, including fibrous tissue, cystic structures lined by atypical cells, and solid tumor nodules. Many of the tumors exhibited nuclear features of intermediate grade. A portion of each specimen was retained for surgical pathology evaluation, with representative sections submitted for permanent processing. Multiple specimens were partially procured for additional studies."} +{"pid": "TCGA-HZ-8315", "report": "The surgical specimen included portions of the pancreas, duodenum, and stomach obtained via pancreaticoduodenectomy (Whipple procedure). Gross examination revealed a firm white partially cystic mass measuring 6 x 4.5 x 3.4 cm located in the pancreatic head. The tumor extended to occlude the pancreatic duct and abutted the common bile duct with invasion into the adjacent duodenal wall reaching the submucosa. Extensive perineural invasion was identified microscopically. There was no lymphovascular space invasion.\n\nMargins of resection were assessed: the retroperitoneal margin was positive for invasive carcinoma while the pancreatic transection margin, common bile duct margin, gastric margin, and duodenal margin were all negative. A total of 21 regional lymph nodes were examined and none contained malignant cells.\n\nHistologic evaluation confirmed moderately differentiated ductal adenocarcinoma. The tumor extended beyond the pancreas but did not involve the celiac axis or superior mesenteric artery. Pathologic staging was determined as pT3N0M0. No distant metastasis was identified.\n\nAdditional findings included fibrosing chronic pancreatitis in the background pancreas. A separate cholecystectomy specimen showed mild lymphoplasmacytic chronic cholecystitis with cholesterolosis; no malignancy was detected.\n\nIntraoperative frozen section consultation confirmed involvement of the retroperitoneal margin by carcinoma predominantly in the form of perineural invasion. The pancreatic transection margin and common bile duct margin were negative for malignancy.\n\nMultiple tissue sections were submitted for analysis including areas of the tumor, portal vein bed, disrupted retroperitoneal region, bile duct interface, and representative margins. Lymph nodes retrieved from the pancreatic and gastric regions were also evaluated.\n\nNo abnormalities were noted in the gross evaluation of the duodenal or gastric mucosa. The gallbladder specimen exhibited cholesterolosis with no evidence of malignancy."} +{"pid": "TCGA-66-2793", "report": "The examined material included a right lung specimen measuring 17 x 13 cm and up to 27 cm in height. The central bronchus resection plane was located approximately 2 cm proximal to the upper lobe bronchus bifurcation. The pleural surface exhibited extensive grayish-yellow coating, particularly in the medial region, with irregular plaques and adhesion remnants. In the dorsolateral area over segment 1, there was a 13 x 8 cm region of parietal pleura that was partially adhesive and partially loosely attached. The upper pleural fissure was fully obliterated.\n\nA dominant lesion measuring up to 9.5 cm was identified in the middle lobe, characterized by clear and arcuate borders. It extended into adjacent areas of the upper lobe and central portions of the lower lobe. The lesion reached the hilar resection surface and involved the paracentral medial pleura above the upper lobe. Extension was also noted along the lower pleural fissure in the middle and lower lobes. Several lymph nodes were affected, measuring up to 1.5 cm, with associated narrowing of central blood vessels due to surrounding tissue involvement.\n\nInvasion was observed in the pulmonary vein near the resection margin. The intermediate bronchus showed wall infiltration and luminal narrowing, with mucosal areas displaying polypoid protrusions above the lesion. Middle lobe bronchi were completely obstructed, while peripheral bronchi were dilated and filled with thick mucus. The surrounding parenchyma in the middle lobe demonstrated linear areas of induration and patchy brownish-yellow discoloration. A separate 4 cm area of induration with irregular margins and brownish-red discoloration was noted in S2. Additionally, a 2 cm cylindrical thrombus was found adhering to the wall of the pulmonary artery.\n\nPleural specimens showed a flat or membranous structure measuring 6.5 x 4.5 cm, up to 0.3 cm thick, with a turbid surface and patchy discoloration ranging from brownish to grayish-yellow. Lymph node stations revealed multiple affected nodes: subcarinal (station 7) with a 0.3 cm lesioned node; right low paratracheal (station 4) with at least two lesioned nodes measuring 1 cm and 0.4 cm; left hilar (station 10) with a 0.5 cm lesioned node; and left low paratracheal (station 4) with a 1 cm lesioned node.\n\nHistological sections included various regions: tumor with residual parenchyma, intermediate bronchus, pulmonary artery with thrombus, hilar resection surface, paracentral pleura, lower and upper pleural fissures, peripheral middle lobe, S1 with pleural adhesion, central bronchus resection margins, pulmonary vein involvement, and an indurated area in S2. Five sections were taken from the pleura, and all lymph node specimens were processed for evaluation. A total of 18 blocks were examined using Elastica-van Gieson, PAS, and diastase-PAS staining methods."} +{"pid": "TCGA-GC-A3I6", "report": "The surgical specimen includes a radical cystoprostatectomy with bilateral lymph node dissection. Gross examination of the bladder revealed a 5.5 x 3.5 cm soft, red-tan friable ulcerated mass located on the posterior wall, extending into the bladder musculature to a depth of 2.5 cm and appearing to abut the inked radial margin. The tumor was diffusely infiltrative with areas of marked necrosis. Microscopic evaluation showed high-grade urothelial carcinoma with extensive squamous differentiation. The tumor extended through the entire muscular wall of the bladder and reached the inked radial margin of excision. No involvement was identified at the left or right ureteral orifices.\n\nThe prostate measured 4.2 x 4 x 1.8 cm and showed no evidence of malignancy. Additional apical tissue demonstrated benign prostatic glandular tissue with scattered areas of squamous metaplasia within the duct lumen. No invasive malignancy was found in the prostate or seminal vesicles. Both distal ureters were negative for tumor on frozen section analysis.\n\nLymph node assessment included a left dissection containing seven (7) lymph nodes and a right dissection containing four (4) lymph nodes; all were negative for metastatic disease. The attached fat and other surrounding tissues were also unremarkable for malignancy.\n\nThe bladder tumor was measured at 5.5 cm in maximum dimension and was partially necrotic. Histologic features included diffuse infiltration and squamous differentiation. Based on these findings, the case corresponds to a pathological stage consistent with local extension beyond the bladder wall without nodal involvement."} +{"pid": "TCGA-EM-A4FU", "report": "The total thyroidectomy specimen includes a left lobe mass measuring 4.2 cm in greatest dimension, with additional dimensions of 3.3 x 3.0 cm. The mass is unencapsulated and locally invasive. Surgical margins are free of involvement, with the closest distance from the invasive component to the margin being 0.1 mm. No venous or lymphatic invasion is identified. A second lesion located in the isthmus measures 3.9 cm in greatest dimension (additional dimensions: 2.6 x 2.2 cm) and is encapsulated but widely invasive. Margins are also uninvolved in this region. Vascular invasion status for this lesion is indeterminate. No extrathyroidal extension is present in either lesion. Pathologic staging indicates a tumor greater than 4 cm confined to the thyroid gland. Lymph node and distant metastasis status cannot be assessed. Additional findings include nodular hyperplasia and multiple small papillary microcarcinomas. The thyroid gland weighs 66.7 g. The right lobe measures 7.5 cm x 3.0 cm x 1.1 cm, the left lobe 5.6 cm x 4.0 cm x 3.0 cm, and the isthmus 4.0 cm x 2.6 cm x 2.2 cm. An additional well-circumscribed nodule in the upper pole of the right lobe measures 0.9 cm x 0.9 cm x 0.8 cm. No parathyroid glands or lymph nodes are identified grossly. Representative tissue sections from all regions of the thyroid have been submitted for analysis."} +{"pid": "TCGA-IQ-7630", "report": "A resection specimen from the oropharynx was received intact, measuring 6 x 5 x 3 cm, with a focus of abnormal tissue identified at the retromolar trigone. The lesion measured 3.5 cm in greatest dimension and demonstrated surface ulceration. Histologic examination revealed invasive cellular proliferation with poorly differentiated features. No perineural or lymphovascular space invasion was identified. Surgical margins were evaluated and found to be free of involvement. A separate soft tissue specimen from the tooth socket #17 also showed invasive changes.\n\nMultiple additional sites were sampled throughout the oral cavity and oropharynx, including the alveolar ridge, buccal mucosa, hard palate, tonsillar pillar, base of tongue, maxillary tuberosity, floor of mouth, lingual ridge, pterygoid region, and mandibular areas. All of these specimens showed no evidence of malignancy. Lymph node dissections were performed, with a total of 27 lymph nodes examined from levels 1, 2, 3, and 4 of the left neck; none contained evidence of metastatic disease. Additional tissues medial to the mandible and pterygoid regions were similarly negative.\n\nBone specimens from the segmental mandible and left maxillary tuberosity were processed for evaluation; no malignant involvement was identified in these structures. One margin from the distal mandible could not be fully assessed due to processing limitations.\n\nThe tumor was classified as pT2 based on size criteria (greater than 2 cm but less than 4 cm), with no regional lymph node involvement (pN0). Full decalcification was pending for certain bone specimens at the time of reporting."} +{"pid": "TCGA-WN-AB4C", "report": "The specimen consists of a right kidney mass from a female patient. The partial nephrectomy specimen measures 2.8 x 2.2 x 2.1 cm. On gross examination, a well-circumscribed mass measuring 2.6 x 2.0 x 2.0 cm is identified, with a white-tan, soft appearance. The mass is located less than 1 mm from the inked resection margin. The surrounding renal parenchyma appears tan-brown and unremarkable. Microscopically, the lesion demonstrates papillary architecture with nuclear features characterized by very irregular nuclei and large, prominent nucleoli. The tumor is confined to the kidney and does not involve the surgical margins, although the distance between the tumor and the parenchymal resection margin is focally less than 0.5 mm. No macroscopic extension beyond the kidney is observed. No lymph nodes are identified for evaluation. No microvascular invasion is detected. The pathologic staging is determined as pT1aNX, indicating a tumor 4 cm or less in greatest dimension limited to the kidney, with regional lymph node status unable to be assessed. All relevant sections have been submitted for evaluation."} +{"pid": "TCGA-66-2753", "report": "Examination report. Macroscopic findings: Parietal pleura contained excised material measuring up to 5 mm and 4 mm in diameter. The resected left inferior pulmonary lobe weighed 277 g and measured 180 x 120 x 70 mm. The pleura showed moderate mesh-like anthracosis, hilar staple sutures, and a bronchial stump measuring just under 10 mm. Adjacent lymph nodes were swollen and pigmented but showed no abnormal infiltration. In the region of S 6, there was a well-demarcated area of infiltration measuring approximately 40 mm, extending toward the outer pleura. This area exhibited central necrotic changes with pseudocystic transformation, small lesions, and grayish-yellow fragile tissue. No infiltration was observed in the central bronchial branches examined. Adjacent to this region was an inflammatory section of lung tissue measuring 15 mm, showing no signs of infiltration. No other focal abnormalities were identified. Lymph nodes sampled included L12 (measuring under 10 mm), L11 (25 mm total), L9 (under 20 mm), L7 (10 mm), L4 (10 mm), and L3 (including a 5 mm node), all displaying varying degrees of anthracotic pigment.\n\nMicroscopic findings: Pleural biopsy revealed sclerohyalinosis with collagen fiber thickening and lymphoid infiltration. Central bronchial sections demonstrated normal wall structure and surrounding soft tissue. Lymph nodes adjacent to the bronchial region displayed anthracotic pigment accumulation, histiocytosis, lymphatic hyperplasia, and scarring. Histological examination revealed infiltrative growth patterns composed of pleomorphic cells with nuclear atypia, coarse chromatin, prominent nucleoli, and frequent mitotic figures. There was extensive central necrosis with pseudocystic transformation, associated fibrous stromal reaction, and lymphoid infiltration at the tumor periphery. The lesion extended into reactive fibrosed pleura with fibrinous exudate, although the pleural basement membrane remained intact. Vascular invasion was noted centrally with tumor thrombus formation. Adjacent lung tissue showed alveolar cavities filled with granulocytes and foam macrophages, fibrinous exudate, mesenchymal proliferation, and dilated bronchi with mucus and leukocyte infiltration. All sampled lymph nodes showed reactive changes including follicular hyperplasia, germinal center activation, sinus histiocytosis, and anthracotic pigment deposition without evidence of infiltration. The bronchial resection margin was unremarkable. Additional findings included localized hyaline plaque formation in the parietal pleura."} +{"pid": "TCGA-CV-A45Q", "report": "A female patient underwent a left radical neck dissection and left hemimandibulectomy. Histological evaluation of the mandibular bone revealed invasive malignancy within the bone, located 5.0 mm from the anterior bony resection margin. The tumor was well differentiated and extended into the submandibular gland and submandibular soft tissue. All margins of resection were free of tumor involvement.\n\nA total of 20 cervical lymph nodes were examined. One metastatic focus was identified in the upper posterior cervical region (1/4), measuring 2.0 cm in greatest dimension with a 0.1 cm focus of involvement and no extranodal extension. Other nodal groups including subdigastic, midjugular, lower jugular, midposterior cervical, and lower posterior cervical showed no evidence of metastasis.\n\nAdditional tissues evaluated included medial, distal, lateral, and proximal mucosal margins, pterygoid muscle, myohyoid muscle, buccal fat, and masseter muscle\u2014all showed no evidence of tumor. Bone tissue from the inferior alveolar canal and the left clavicle were also negative for tumor. The clavicle specimen was pending decalcification at the time of reporting. Specimens from the mandible and clavicle were submitted to the Bone Lab for further processing, with an addendum report to follow.\n\nOther findings included pseudoepitheliomatous hyperplasia at the distal and proximal mucosal margins. Multiple teeth were present with enamel caps; no pathological changes were noted on gross examination. No vascular invasion was identified."} +{"pid": "TCGA-DQ-7593", "report": "A biopsy specimen from the right base of tongue was received in formalin and measured 0.7 cm in greatest dimension. The tissue showed abnormal cellular proliferation with invasive growth pattern. Microscopic evaluation revealed non-keratinizing, poorly differentiated epithelial cells infiltrating into the underlying tissue. The cellular morphology demonstrated marked pleomorphism and increased mitotic activity. No specific tumor type or diagnosis is provided in this summary."} +{"pid": "TCGA-A2-A0EQ", "report": "The left breast lumpectomy specimen measured 8.2 cm medial to lateral, 7.0 cm superior to inferior, and 2.7 cm anterior to posterior. A well-defined, irregular tan lesion measuring 2.5 x 1.5 x 1.5 cm was identified in the anterior/inferior portion of the tissue. The lesion was located within 2.0 mm of the anterior (yellow ink) margin. Microscopic evaluation of this area showed invasive cellular proliferation with high-grade features. A separate focus of intraductal cellular changes with comedo-type morphology was noted near the inferior (green ink) margin, within 1.3 mm. No lymphovascular space invasion was identified. Additional findings included fibrocystic changes with fibrosis and apocrine metaplasia.\n\nOne sentinel lymph node (measuring 0.9 x 0.5 x 0.4 cm) was negative for abnormal cellular infiltration on both H&E and immunohistochemical staining. A second lymph node from a non-sentinel location (measuring 0.5 cm in greatest dimension) was also negative. A second sentinel lymph node submission did not contain identifiable lymphoid tissue. An additional excision from the left breast inferior margin consisted of fibroadipose tissue with fibrosis and apocrine metaplasia; no abnormal cellular elements were found. The AJCC pathologic stage was assessed as pT2 NO (i-) Mx."} +{"pid": "TCGA-CV-7568", "report": "A composite resection specimen from the floor of the mouth measures 5.5 cm in greatest dimension. Histologic evaluation reveals a moderately to poorly differentiated tumor with adenoid and sarcomatoid features. The lesion invades through muscle into underlying bone, with evidence of vascular and perineural invasion. All margins of resection are free of tumor involvement.\n\nIn the left supraomohyoid neck dissection, ten lymph nodes were identified, all without evidence of tumor involvement. These include submental/submaxillary (level 1), subdigastric (level 2), midjugular (level 3), and lower jugular (level 4) nodes.\n\nThe right modified neck dissection includes three lymph nodes, one of which contains metastatic disease. The involved node is located in the subdigastric region (level 2). No tumor is identified in midjugular or lower jugular lymph nodes (levels 3 and 4, respectively).\n\nAdditional specimens including mental skin, right lower lip, anterior floor of the mouth, and left and right buccal mucosa show no evidence of tumor. Teeth were examined grossly only.\n\nA supplemental report will be issued to further describe the extent of bone involvement."} +{"pid": "TCGA-VF-A8AE", "report": "The specimen consists of a right testicle measuring 6.5 x 5.5 x 3.4 cm, along with a spermatic cord measuring 7.0 x 1.8 x 1.7 cm and an epididymis measuring 5.0 x 3.0 x 2.0 cm. The testicle is largely replaced by a mass measuring 6.2 x 5.0 x 3.0 cm, which appears tan-pink and homogeneous with areas of hemorrhage. No necrosis is observed. The mass involves the entirety of three sections of the testis but does not grossly extend into the epididymis or penetrate the tunica albuginea. Microscopically, the lesion demonstrates involvement of the rete testis and exhibits classic morphological features. There is no evidence of lymphovascular invasion. Margins, including the spermatic cord margin and peripheral inked margins, are free of involvement. Intratubular germ cell neoplasia is present. Serum tumor markers are within normal limits. Based on histologic evaluation, the primary tumor is classified as limited to the testis without vascular or lymphatic invasion. Regional lymph nodes and distant metastasis cannot be assessed."} +{"pid": "TCGA-CJ-4918", "report": "The surgical specimen includes a left kidney with a large, variegated tumor measuring 14.0 cm in greatest dimension. The tumor is partially cystic and necrotic, located in the mid pole of the kidney, and extends focally into the perinephric and renal sinus adipose tissue. Tumor involvement is also noted in the intrarenal portion of the renal vein and in larger vessels within the renal sinus. Vascular invasion is present. The tumor approaches Gerota's fascia, being 0.1 cm from it at one point. Margins of resection for the vein, artery, and ureter are grossly free of tumor. A separate small nodular lesion (0.4 cm) is identified in the lower pole cortex. The remainder of the renal parenchyma appears unremarkable.\n\nA biopsy of a left liver mass shows hepatic parenchyma with adjacent fibrosis. No definitive malignant cells are seen, though the sample may not fully represent the entire lesion. Clinical and radiologic correlation is advised, with possible repeat biopsy if indicated.\n\nThe left adrenal gland contains a well-circumscribed hemorrhagic nodule in the medulla, measuring 0.9 x 0.5 x 0.5 cm, located 0.2 cm from the nearest parenchymal margin. A cystic area with hemorrhage and a small fleshy nodule is also present. The spleen and hilar lymph node show no evidence of tumor. The spleen measures 13.0 x 8.0 x 4.5 cm and demonstrates mild red pulp expansion and prominent white pulp nodularity without masses."} +{"pid": "TCGA-FG-8181", "report": "The pathology report describes a specimen from the left frontal region of the brain. The excised tissue measured 5.5 x 5.0 x 1.7 cm and was described as extremely soft, white-tan to pink-tan, with a slightly mucinous and gelatinous cut surface. Additional specimens included a smaller biopsy measuring 0.7 x 0.3 x 0.3 cm and another fragment measuring 3.9 x 3.8 x 2.8 cm, both with tan-pink to gray-tan coloration and areas of hemorrhage.\n\nMicroscopic evaluation revealed an infiltrating glial neoplasm characterized by increased mitotic activity, with up to five mitotic figures per ten high power fields. The tumor demonstrated variable cellular morphology: some areas showed cells with numerous cytoplasmic processes and nuclear pleomorphism, while other regions contained round cells with micronucleoli and perinuclear halos. Immunohistochemical staining showed strong p53 labeling and a moderate MIB-1 labeling index. Molecular studies did not detect 1p/19q loss. Additional immunostains for synaptophysin and Neu-N highlighted non-neoplastic brain parenchyma.\n\nThe findings were consistent with a glial neoplasm exhibiting anaplastic features. Some of the histologic and immunophenotypic characteristics suggested possible heterogeneity within the tumor. All specimens were processed and analyzed using laboratory-developed tests; some reagents used were not FDA-cleared but were validated in-house. No professional opinion was provided by the reporting pathologist due to locum tenens coverage during the case. A separate consultation report is referenced for the final interpretation."} +{"pid": "TCGA-DJ-A2Q7", "report": "The left thyroid lobe and isthmus specimen measured 4.5 x 2.5 x 2.2 cm and contained two nodules: a 2.5 cm solid, white, gritty nodule in the mid to lower lobe and a 0.7 cm tan, encapsulated nodule in the isthmus. Histologic evaluation revealed a well-differentiated lesion with psammoma bodies present. No mitotic activity or tumor necrosis was identified. The larger nodule showed focal extension into extrathyroidal fibrous tissue and was present focally at the inked anterior margin. Two additional small foci measuring 0.7 cm and 0.25 cm were identified in the isthmus and left lobe, respectively. Adjacent non-neoplastic thyroid tissue showed nodular hyperplasia and mild chronic lymphocytic thyroiditis.\n\nThe right thyroid lobe measured 4.6 x 3 x 1.7 cm and contained multiple nodules, the largest being 1 x 0.8 x 0.5 cm located in the upper pole. Histologic analysis demonstrated well-differentiated features with no mitotic activity or tumor necrosis observed. Tumor foci ranged from 0.2 cm to 0.5 cm and were confined without extrathyroid extension. Surgical margins were free of involvement. Non-neoplastic changes included nodular hyperplasia and mild chronic lymphocytic thyroiditis.\n\nLymph node specimens from the left neck level six and seven included two lymph nodes. Both contained similar histologic features including psammoma bodies. The largest lymph node measured 0.8 cm with a metastatic focus measuring 0.6 cm. Extranodal extension was not present. Parathyroid tissue within the specimen appeared unremarkable."} +{"pid": "TCGA-EO-A22R", "report": "The specimen consisted of multiple tissues including lymph nodes from the right internal iliac, right obturator, left proximal external iliac, left pelvic, and left obturator regions, along with a hysterectomy specimen including the uterus, cervix, bilateral fallopian tubes, and ovaries. Gross examination of the uterus revealed a white, polypoid, partly friable lesion located in the posterior endometrium, fundus, and primarily involving the right aspect, measuring 3.7 x 3.5 x 1.7 cm. The myometrium measured 0.9 cm in thickness, with the lesion extending into the outer one-third. Two fibroid nodules were identified within the anterior myometrium, measuring between 1.0 and 1.8 cm in diameter. The ovaries showed minor findings including a cystic mesothelial adhesion and a serous cyst adenofibroma on the left ovary, along with bilateral surface papillary stromal hyperplasia.\n\nHistologic evaluation demonstrated architectural features consistent with high-grade morphology, showing more than 50% nonsquamous solid growth pattern. There was evidence of lymphovascular space invasion; however, no involvement of the cervix or surgical margins was observed. Examination of all submitted lymph nodes (total of 18 nodes evaluated across multiple sites) revealed no evidence of metastatic involvement. Immunohistochemical staining demonstrated focal P53 positivity in areas corresponding to marked nuclear atypia.\n\nThe tumor was confined to the uterus with myometrial invasion limited to the outer third. Pathologic staging indicated no regional lymph node involvement and distant metastasis could not be assessed. Representative tissue sections from all anatomical components were submitted for analysis. Intraoperative frozen section evaluation of selected lymph nodes was performed and confirmed negative for malignancy."} +{"pid": "TCGA-DE-A0XZ", "report": "The surgical specimen consists of a total thyroidectomy specimen weighing 6.2 grams and measuring 4.3 cm medial to lateral, 4.9 cm superior to inferior, and 1.2 cm anterior to posterior. The tumor is located in the right inferior thyroid gland and measures 2 x 1.2 x 1.6 cm. It has a solitary, rounded, red/tan appearance with a gritty cut surface and is described as circumscribed and non-encapsulated. Histologically, the growth pattern is papillary, and the tumor appears confined within the thyroid gland. The tumor abuts both the anterior and posterior margins of the right thyroid lobe; surgical margins are close but negative. Adjacent thyroid tissue demonstrates a multinodular appearance with features of lymphocytic thyroiditis and nodular hyperplasia.\n\nThe tumor measures 2.0 cm grossly and the largest dimension on any single slide is 1.1 cm. There is no evidence of extra-capsular or vascular invasion identified. The tumor is multifocal in distribution.\n\nA separate specimen from the right central neck dissection includes four lymph node candidates ranging from 1.2 cm to 1.6 cm in greatest dimension. Of these, all four contain abnormal cellular infiltrates involving lymph nodes, with the largest lesion measuring 1.1 cm. Extra-nodal extension is present in one of the lymph nodes. In aggregate, five out of seven lymph nodes across both specimens demonstrate involvement.\n\nThe tumor is situated adjacent to multiple surgical margins, particularly near the anterior margin of the right lobe (within <0.5 mm). Representative sections of the thyroid tissue have been submitted for further analysis. No digital photograph was taken."} +{"pid": "TCGA-A4-7996", "report": "A partial nephrectomy specimen from the left kidney was examined. The lesion measured 3.0 cm in greatest dimension and was unifocal. Microscopic evaluation showed a well-defined neoplasm confined to the kidney, without sarcomatoid features or lymphovascular invasion. The tumor was located within the renal cortex and extended to the inked margin in specimen A; however, based on correlation with specimen B, which did not show tumor involvement, the closest distance to the surgical margin was less than 0.1 cm. No lymph nodes were identified. Immunohistochemical staining demonstrated positivity for OSCAR-CK, CK7, racemase, and CD10, while being negative for CK20 and CD117. Histologic staging showed no extension beyond the kidney. Based on AJCC staging criteria, the primary tumor was classified as pT1a. Regional lymph nodes could not be assessed (pNX), and distant metastasis could not be determined (pMX). Margin status was R0 and the overall pathologic stage was I. No additional findings were noted in the non-neoplastic kidney tissue."} +{"pid": "TCGA-W5-AA2O", "report": "The surgical specimen from the liver, involving the right and caudate lobes, demonstrates a moderately differentiated neoplasm measuring 9.0 x 6.5 x 5.8 cm. The surrounding liver tissue exhibits mild steatosis without significant fibrotic changes. The lesion is in close proximity to the inked surgical margin. Histologic evaluation reveals high-grade cellular features. Immunohistochemical analysis shows positivity for CK7 and absence of staining for CK20, TTF-1, chromogranin, and synaptophysin. CDX2 demonstrates background reactivity. No abnormalities are identified in the gallbladder specimen. A single pericholedochal lymph node is free of neoplastic involvement."} +{"pid": "TCGA-08-0350", "report": "The brain tissue specimen from the right parietal lobe was received in three parts. Part A consisted of a small piece of tan, soft tissue measuring 0.8 x 0.3 x 0.2 cm in aggregate. Part B consisted of multiple pink-yellow-white tissue fragments weighing 3.5 grams and measuring 4.5 x 1.7 x 1.7 cm. Part C was a small fragment measuring 0.5 x 0.4 x 0.2 cm. All specimens were processed and submitted for microscopic evaluation.\n\nMicroscopic examination revealed highly pleomorphic and multinucleated cells with densely eosinophilic cytoplasm, suggestive of a gemistocytic phenotype. A significant proportion of cells demonstrated strong positivity for GFAP staining. The tissue showed infiltration into adjacent cortical regions. Numerous mitotic figures, including abnormal forms, were identified. Microvascular proliferation was present, along with areas of focal necrosis. These histologic features were consistently observed across all specimen sections.\n\nImmunohistochemical analysis showed a labeling index of 24.58% for MIB-1. The findings were evaluated based on standard morphologic and immunohistochemical criteria, and the final diagnosis was confirmed by an attending pathologist after comprehensive slide review."} +{"pid": "TCGA-AC-A3QQ", "report": "The pathology report includes three specimens from bilateral mastectomies. Specimen A, a right breast nipple margin measuring 2.0 x 1.3 x 0.3 cm, showed benign breast tissue with multiple large ducts. No atypical epithelial hyperplasia or malignancy was identified on frozen section.\n\nSpecimen B, a left breast simple mastectomy specimen measuring 16.0 cm ML x 11.5 cm SI x 2.7 cm and weighing 205 grams, contained approximately 85% dense fibrous tissue and 15% adipose tissue predominantly at the periphery. No discrete lesion was identified grossly. Representative sections included areas around the apparent nipple site (blue inked), upper outer quadrant, upper inner quadrant, lower outer quadrant, and lower inner quadrant. Sections also sampled a detached fibroadipose fragment measuring 4.0 x 2.5 x 0.6 cm. Microscopic examination revealed benign fibrocystic disease, apocrine metaplasia, and benign intraductal epithelial hyperplasia. No malignancy was detected.\n\nSpecimen C, a right breast simple mastectomy specimen measuring 16.5 cm ML x 12.0 cm SI x 2.8 cm and weighing 205 grams, contained a lesion located at the 12 o\u2019clock position approximately 4.0 cm from the apparent nipple site. The lesion measured 1.7 x 1.5 x 1.3 cm and exhibited spiculated borders with a tan, focally gritty, rubbery cut surface surrounded by dense fibrous tissue. A metallic clip was present centrally within the tumor. Histologic evaluation demonstrated invasive carcinoma cells with negative membrane staining for E-cadherin immunostain and associated in situ changes. The invasive component was closest to the deep margin (black inked) at a distance of 1.5 mm. Other sections showed benign fibrocystic disease and benign intraductal epithelial hyperplasia.\n\nNo lymph nodes were identified in the current specimens. Prior sentinel lymph node biopsies from the right axilla included five lymph nodes, all without evidence of metastasis.\n\nImmunohistochemical analysis of the invasive carcinoma showed strong positivity for estrogen receptor (99% of cells, 3+ intensity) and progesterone receptor (78% of cells, 3+ intensity). HER2 expression was positive (3+ intensity), and Ki-67 proliferation index was elevated at 46%.\n\nMargins were assessed microscopically, with the deep margin showing proximity to invasive carcinoma. Additional margins evaluated did not show involvement. The histologic grade was determined as Nottingham score 6 (grade II), based on tubule formation score of 3, nuclear pleomorphism score of 2, and mitotic count score of 1. Lymphovascular invasion was not identified."} +{"pid": "TCGA-3A-A9IB", "report": "The liver specimens from the right and left lobes showed varying degrees of steatosis, with some displaying micro and macrovesicular patterns. Other areas demonstrated cauterization and focal necrosis. No viable tumor or evidence of malignancy was identified in these samples.\n\nLymph node specimens revealed variable findings. One lymph node located at the junction of the uncinate process and replaced right hepatic tissue contained metastatic involvement, with focal extracapsular extension noted. Another lymph node from the common hepatic region also showed metastatic involvement. In contrast, a lymph node posterior to the replaced right hepatic area was negative for malignancy.\n\nThe pancreaticoduodenectomy specimen included a mass measuring 4.0 cm located in the pancreatic head. Histologic evaluation revealed invasive ductal adenocarcinoma with poor differentiation. Adjacent ductal structures showed intraductal papillary mucinous neoplasm with low-grade dysplasia, extending focally into secondary ducts with moderate-grade changes. Lymph node analysis showed five out of twenty-one nodes involved by metastatic disease, with extracapsular extension present in some. The tumor margin approached within less than 1 mm of the vascular groove and uncinate margin. The pancreatic resection margin showed no invasive carcinoma but did demonstrate involvement by intraductal neoplasm with low-grade dysplasia. All other margins, including gastric, duodenal, bile duct, and retroperitoneal, were free of tumor involvement.\n\nAdditional findings included chronic pancreatitis, cholecystitis, and acute serositis of the duodenum. Vascular invasion was not identified, although lymphatic and perineural invasion were present."} +{"pid": "TCGA-B0-5096", "report": "The surgical specimen from the left kidney and adrenal gland shows a lesion in the lower pole of the kidney with focal microscopic involvement of the peripelvic fat. Vascular and lymphatic invasion are present. The renal vein margins are free of tumor, and the adrenal gland does not show any evidence of involvement. A separate specimen from the inferior aortic node does not show tumor. However, a nodal mass specimen reveals involvement of a lymph node with metastatic disease. Tumor size and other dimensions are consistent with advanced local growth. The findings indicate spread to regional lymph nodes but no distant metastases identified."} +{"pid": "TCGA-AG-3578", "report": "The surgical specimen includes a splenectomy preparation without evidence of neoplastic involvement, showing recent capsule and parenchymal defects. The resected colon and rectum demonstrate tumor-free resection margins with inclusion of a lesion arising from a pre-existing tubulovillous adenoma. The lesion shows moderate differentiation and mucinous features, with infiltration into the perimuscular fatty tissue to a depth of 2 mm. No regional lymph node metastases were identified. A total of 25 lymph nodes were examined, all negative for malignancy. Vascular and radial margins were free of involvement."} +{"pid": "TCGA-4A-A93Y", "report": "The specimen consists of a left kidney radical nephrectomy with attached adrenal gland, ureter, and perinephric fat. The kidney measures 16.5 x 11.5 x 10 cm and weighs 762 grams. A 12.5 cm lobulated mass is identified in the superior pole. The tumor has a mottled orange-red to brown cut surface with areas of hemorrhage and necrosis. It abuts and elevates the renal capsule; however, no definitive extracapsular invasion into the perinephric fat is observed. The tumor also approaches the renal pelvic/calyceal mucosa but does not show gross mucosal invasion. No involvement of the ureter or gross vascular invasion is present.\n\nMicroscopically, the tumor is composed of cells arranged in a papillary pattern. The tumor is confined within the kidney. All surgical margins, including the perinephric soft tissue margin, renal vein margin, and ureteral margin, are free of invasive tumor. The Gerota's fascia is also negative for tumor involvement. One hilar lymph node is identified and shows no evidence of tumor involvement (0/1).\n\nThe adrenal gland appears unremarkable, with no tumor identified. The remaining renal parenchyma demonstrates a well-defined corticomedullary junction. Representative sections of the tumor, surrounding tissue, and margins were submitted for histologic evaluation. The tumor is unifocal and limited to the kidney."} +{"pid": "TCGA-TQ-A7RS", "report": "The specimen consists of irregular fragments of brain parenchyma measuring 4.5 x 3.5 x 3.0 cm. The external surface demonstrates distinct gyral and sulcal patterns, covered by a delicate and congested leptomeningeal layer. On sectioning, areas of softened and whitish tissue are noted. All material was processed for histological examination.\n\nHistological analysis reveals a neoplastic lesion composed of relatively uniform cells with round nuclei that are slightly hyperchromatic and frequently surrounded by clear halos. The lesion contains an abundant vascular network characterized by thin, branched capillaries. Multiple regions exhibit dystrophic calcifications. The lesion shows infiltrative growth involving both cortical and white matter regions. In the cortex, neuronal satellitosis and subpial accumulation of abnormal cells are present. No mitotic figures, necrotic areas, significant nuclear atypia, or multistratified endothelial changes were identified.\n\nGenetic analysis was performed using fluorescent in situ hybridization (FISH) on formalin-fixed, paraffin-embedded tissue sections from representative areas of the lesion. Probes targeting 1p36/1q25 and 19q13/19p13 were used. Evaluation of 100 to 200 nuclei per probe set yielded a signal ratio of 0.82 for the 1p/1q probes and 0.64 for the 19q/19p probes."} +{"pid": "TCGA-CV-6939", "report": "The specimen includes tissue from the base of the tongue, left internal jugular vein region, and contents of a left functional neck dissection performed in conjunction with a total laryngectomy, total glossectomy, and right hemimandibulectomy. The primary lesion involves the supraglottic area. In the left neck dissection, 1 out of 10 lymph nodes is involved, showing metastatic involvement in the subdigastic compartment, separate from the main lesion. Zone 2 (submental-submaxillary compartment) shows 1 out of 2 lymph nodes involved. Involvement is also noted in Zone 3 (subdigastic compartment), where the lesion is present in fibroconnective soft tissue with lymphatic invasion; eight other lymph nodes are free of involvement.\n\nThe sublingual and submandibular glands are uninvolved. At the right posterior soft tissue margin of the mandible, suture granulomas with foreign body reaction are identified. Biopsies of the right pharyngeal margin, soft palate, and nasopharynx all show squamous or respiratory mucosa with salivary gland tissue, and no evidence of disease is found.\n\nThe lesion replaces the vallecula, extends to the epiglottis, and involves the right lateral glossoepiglottal fold and right palatoglossal arch. It reaches the epiglottic cartilage and is present in the supraglottic space. A secondary nodule is seen on the left aryepiglottic fold, with associated lymphatic permeation. There is extensive lymphatic involvement along the mucosal margin of resection in the pyriform sinus bilaterally and in the anterior soft tissue margin beneath the oral mucosa. Multifocal association with in situ squamous lesions and varying degrees of dysplasia is observed. Macroscopically, there is no evidence of extension through the mandibular periosteum, and the bony resection margins appear free of involvement. A final assessment of the bone margins will be provided in a subsequent addendum after further processing."} +{"pid": "TCGA-SR-A6N0", "report": "The specimen consists of a left adrenalectomy measuring 9.5 x 4.2 x 2.1 cm, surrounded by yellow-white adipose tissue. A mass measuring 2.3 x 1.8 x 1.5 cm is present within the adrenal gland and appears well-circumscribed, tan-brown, and hemorrhagic. The mass is homogenous, with no extension beyond the adrenal gland. Margins of resection are free of abnormal tissue. Microscopic examination confirms that the mass is entirely submitted for evaluation, with representative sections taken from surrounding soft tissue and adipose regions. The adjacent cortex shows no significant pathologic changes and demonstrates variable thickness ranging from 0.5 to 2 cm, with an atrophic appearance in areas. No other notable findings are identified."} +{"pid": "TCGA-EJ-5530", "report": "The patient is a male with a history of a PSA value of 9.2 ng/ml and a prior prostate biopsy. The biopsy revealed unilateral involvement with Gleason grade patterns ranging from 3+3 to 3+4 across several regions of the prostate. A radical retropubic prostatectomy was performed.\n\nExamination of the surgical specimen showed an acinar-type carcinoma with a Gleason score of 3+4=7. The secondary Gleason pattern (grade 4) comprised approximately 20% of the sampled tumor volume. The tumor was present in both the right and left lobes of the prostate, with a maximum nodule size measuring 2.2 cm. Involvement of the prostate gland was estimated at 20\u201325% of the examined volume. The tumor remained confined within the prostate capsule without evidence of extracapsular extension. No perineural or angiolymphatic invasion was identified. Both seminal vesicles and distal vasa deferentia appeared benign. All surgical resection margins were free of tumor involvement.\n\nLymph node dissection included four nodes on the right and two on the left; none showed evidence of malignancy. Multifocal high-grade prostatic intraepithelial neoplasia was also noted. Non-neoplastic findings included nodular hyperplasia, focal acute and chronic inflammation, and glandular atrophy.\n\nThe prostate weighed 57.47 grams. Based on pathological evaluation, the tumor stage was classified as pT2c with no lymph node involvement (pN0). Histologic grade corresponded to G3\u20134."} +{"pid": "TCGA-FY-A76V", "report": "The specimen consists of a total thyroidectomy with a left lobe measuring 4.8 x 3.4 x 2.2 cm, a right lobe measuring 5.8 x 3.5 x 1.8 cm, and an isthmus measuring 2.2 x 1.1 x 0.8 cm. The outer surface is smooth to shaggy and tan-red. On cut section, the left lobe shows red-brown beefy parenchyma with scattered tan, gelatinous nodules ranging from 0.2 cm to 0.6 cm in greatest dimension. The right lobe contains a 3.1 x 1.5 x 1.1 cm well-circumscribed gray-white mass located at the lower pole and involving the isthmus. The mass abuts the inked outer surface. No additional lesions are identified.\n\nThe tumor is multifocal with a dominant focus in the right lobe and isthmus. Additional foci include a 0.2 cm lesion in the left lobe and a 0.25 cm lesion in the right lobe. Histologically, the tumor demonstrates follicular variant morphology with less than 99% involvement. The histologic type appears as a well-differentiated morphology with a present tumor capsule. There is no evidence of capsular invasion, lymphovascular space invasion, perineural invasion, or extrathyroidal extension.\n\nMargins are uninvolved by invasive carcinoma, with the closest distance being less than 1 mm. No margins are involved. The pTNM stage is pT2NX. A separate parathyroid specimen is submitted and described as hypercellular without evidence of malignancy. Frozen section diagnosis confirms benign parathyroid tissue."} +{"pid": "TCGA-B5-A11S", "report": "The specimen consisted of lymph node aggregates from the right paraaortic, right pelvic, and left pelvic regions, along with a hysterectomy specimen including the cervix, bilateral tubes, and ovaries. The right paraaortic lymph nodes formed a 3.4 x 2.1 x 1.1 cm fibrofatty and lymphoid tissue aggregate, with two lymph node candidates measuring 1.2 x 0.7 cm and 0.8 x 0.3 cm identified and submitted entirely for examination. The right pelvic lymph nodes were received as a 6.1 x 6 x 2.5 cm fibrofatty aggregate containing thirteen lymph node candidates ranging in size from 0.5 x 0.5 cm to 3.6 x 1.9 cm. Fifteen lymph node candidates were identified in the left pelvic lymph node aggregate, measuring 5.8 x 5 x 2.5 cm, with sizes ranging from 0.6 x 0.5 cm up to 2.4 x 1.6 cm.\n\nThe uterus weighed 190 grams and measured 11.1 x 6 x 4.7 cm, with bilateral fallopian tubes and ovaries attached. A tan-brown, fleshy polypoid mass measuring 4.6 x 3.9 x 1.8 cm was observed within the endometrial cavity, involving both anterior and posterior aspects. The lesion appeared confined to the endometrium but showed myometrial invasion measuring 0.6 cm into a 2 cm thick myometrial wall. Another tan-white, firm lesion measuring 3.1 x 2 x 1.8 cm was noted in the anterior endomyometrium, displaying glandular architecture. A smaller polypoid lesion (1.5 x 0.7 x 0.5 cm) was also present on the endometrial surface. The remaining endometrium was thin (<0.1 cm), and the myometrium otherwise unremarkable. The cervix measured 3.2 cm in diameter with a patent os and appeared grossly normal. Both fallopian tubes and ovaries were unremarkable.\n\nMicroscopic evaluation confirmed no malignant involvement in any of the lymph node specimens examined. The endometrial polypoid lesion demonstrated features consistent with Grade II architecture based on histologic assessment. No evidence of malignancy was found in the cervix, serosa, or specimen margins. Adjacent non-neoplastic findings included endometrial intraepithelial neoplasia (EIN) within a polyp and adenomyosis of the myometrium. Leiomyoma was also identified in the myometrium. Both ovaries and fallopian tubes showed no abnormal pathology.\n\nStaging was determined as pT1b pNO pMX according to the AJCC 6th Edition criteria. All lymph node biopsies were negative: 2 right paraaortic, 13 right pelvic, and 15 left pelvic nodes. The operative procedure included hysterectomy, bilateral salpingo-oophorectomy, and bilateral lymph node sampling."} +{"pid": "TCGA-D7-A6EZ", "report": "8/4413. Gender: M. Examination result No. Date of admission: Material: 1) stomach, Method of collection: Total organ resection. Histopathological findings. The specimen consists of a stomach measuring 25 x 22 cm, resected along the greater curvature, with attached omentum measuring 59 x 28 cm. A medallion-shaped lesion measuring 5.5 x 6 x 1.3 cm is present on the posterior wall. The lesion infiltrates through the gastric wall and is located 5.2 cm from the proximal margin and 4.7 cm from the distal margin. Microscopically, the lesion demonstrates poorly differentiated features and invades the full thickness of the stomach wall but does not extend into the peritoneum. Vascular invasion is present. Resection margins are free of abnormal cells. Adipose tissue is not involved. Lymph node assessment shows reactive changes in lymph nodes at the cardia (1.2-) and along the lesser curvature (No VII). Metastatic involvement is identified in lymph nodes along the lesser curvature (No II/VIII). Lymph nodes at the greater curvature show reactive changes (No VII)."} +{"pid": "TCGA-DD-A73A", "report": "The liver specimen from the caudate lobe resection weighs 72.0 grams and measures 9.0 x 6.0 x 4.5 cm. A single mass measuring 3.0 x 3.0 x 2.5 cm is identified, with a tan, yellow, and brown appearance. The mass is located 0.4 cm from the inked surgical margin, which is submitted perpendicularly. Representative sections of the tumor, adjacent liver tissue, and normal liver have been collected.\n\nHistologic evaluation reveals a lesion that is moderately differentiated. The lesion is confined to the liver without evidence of macroscopic or microscopic vascular invasion. The resection margin is free of involvement. No regional lymph nodes are present for assessment. The background liver tissue demonstrates mildly active steatohepatitis with bridging fibrosis. Staging based on available material corresponds to pT1 (7th edition AJCC)."} +{"pid": "TCGA-WK-A8XT", "report": "The specimen is a left nephrectomy weighing 189 grams, measuring 12.2 x 6.2 x 4.4 cm, with minimal attached perirenal fat up to 2.0 cm thick. A mass measuring 3.2 x 2.7 x 2.8 cm is located in the mid to lower pole of the kidney cortex, adjacent to the renal pelvis and 0.2 cm from the inked fatty margin. The mass is tan/pink, focally hemorrhagic, soft, friable, and slightly mucinous. It is situated 2.1 cm from the renal artery, 3.0 cm from the renal vein, and 5.8 cm from the ureter. No vascular invasion is identified grossly. Two small smooth-walled cystic areas adjacent to the mass measure up to 0.5 cm in diameter. The remainder of the renal cortex appears tan/red with mild effacement of the corticomedullary junction. Papillae are mildly blunted, and average cortical thickness is 1.0 cm. No calculi are present. The hilar adipose tissue was thinly sectioned and no lymph nodes were identified.\n\nMicroscopically, the tumor consists of poorly differentiated monophasic cells with up to 50 mitoses per 10 high-power fields. No necrosis is identified. Focal lymphovascular invasion is present. Margins of the ureter, artery, vein, and soft tissue are negative for tumor involvement. The tumor is located 0.7 cm from the closest soft tissue margin.\n\nAdditional findings include moderate chronic changes in the kidney parenchyma: 14% of glomeruli show global sclerosis, and 10% of the parenchyma demonstrates focal tubular atrophy and interstitial fibrosis. There is moderate arteriolar and arterial sclerosis. Immunofluorescence reveals sparse granular IgA and IgM deposits in the mesangium. Electron microscopy shows minimal effacement of visceral epithelial cell foot processes, no electron-dense deposits along capillary loops, and small, ill-defined electron-dense deposits in the mesangial areas."} +{"pid": "TCGA-AG-3581", "report": "The resected colon and rectum specimen demonstrates ulceration with moderately differentiated glandular structures infiltrating into the lamina muscularis. The tumor does not extend to the oral or aboral resection margins. No regional lymph node metastases are identified. A total of 33 lymph nodes are examined, none showing evidence of vascular invasion. The surgical margins are free of neoplastic cells."} +{"pid": "TCGA-MX-A663", "report": "The surgical specimen includes a remnant gastrectomy with attached transverse colon, celiac lymph nodes, and omental tissue. Gross examination of the gastric specimen revealed a firm mass measuring 5.4 cm in length and 2.5 cm in width at the anastomosis site. The tumor infiltrates into the subserosal layer without involvement of the visceral peritoneum or adjacent structures. Histologic evaluation shows poorly differentiated invasive cells arranged in a mixed pattern. Vascular and perineural invasion are present. No preexisting polyps or multicentric lesions were identified. All surgical margins are free of abnormal cells. Adjacent gastric mucosa appears normal. A total of 10 lymph nodes were evaluated from the specimen; none showed evidence of metastasis. Additional specimens from the celiac lymph nodes and omentum showed no malignant involvement. Immunostaining for Her2-Neu was negative."} +{"pid": "TCGA-FG-8191", "report": "The surgical pathology report details findings from a right insular brain tumor biopsy and excision. The patient has a clinical history of migraines, a previously identified brain mass, bicuspid aortic valve, kidney stone, and depression. Three tissue specimens were received: the first measured 0.4 x 0.2 x 0.1 cm and was used for frozen section; the second was 2.3 x 1.1 x 0.3 cm; and the third was 3.7 x 3.4 x 0.8 cm.\n\nMicroscopic examination revealed hypercellular neural parenchyma with areas containing cells resembling oligodendrocytes, characterized by round nuclei and perinuclear cytoplasmic clearing. Background vasculature was noted to be thin and delicate. Focal areas showed increased cellularity with elongated and pleomorphic cells, along with increased mitotic figures. No necrosis or microvascular proliferation was observed.\n\nImmunohistochemical staining showed positivity for GFAP. The Ki-67 proliferation index was approximately 5\u20136%. In situ hybridization for 1p/19q deletions was pending at the time of reporting.\n\nMolecular testing for chromosomal loci 1p36 and 19q13 was performed using fluorescence in situ hybridization (FISH) with dual-color probe sets. A total of 107 cells were analyzed for 1p/1q, yielding a ratio of 0.87. For 19q/19p, 108 cells were analyzed with a ratio of 0.84. Both ratios exceeded the threshold of 0.8, indicating no evidence of allelic loss at either locus. These results were confirmed through both computer-aided analysis (using BioView software) and manual review under fluorescence microscopy.\n\nThe histologic and immunophenotypic features, combined with the molecular findings, support a classification consistent with WHO grade III. The evaluation included appropriate controls, and all showed expected reactivity. The tests performed, except for those related to HER-2/neu, were developed and validated internally and are not FDA-approved. \n\nIntraoperative consultation on the frozen section initially suggested a low-grade glioma. Final assessment incorporated histologic, immunohistochemical, and molecular data. Clinical correlation is recommended for further management."} +{"pid": "TCGA-DJ-A3UP", "report": "The neck specimen was submitted for analysis following total thyroidectomy. The specimens included central compartment lymph nodes, left and right thyroid lobes, and left paratracheal lymph nodes.\n\nThe central compartment lymph nodes measured between 0.7 and 0.8 cm and were entirely benign. The left thyroid lobe measured 3.9 x 3.1 x 2.1 cm and contained a well-circumscribed nodule measuring 2.1 x 1.9 x 1.8 cm. The nodule was encapsulated and showed no evidence of capsular invasion, blood vessel invasion, or necrosis. It was located in the posterior aspect of the lobe and was completely surrounded by normal tissue. No mitotic figures were identified. The surgical margins were free of abnormal cells. Adjacent non-neoplastic tissue showed nodular hyperplasia and chronic lymphocytic thyroiditis. Three benign lymph nodes were identified in this region.\n\nThe right thyroid lobe measured 4.5 x 2.2 x 1.8 cm and weighed 7.0 grams. A small, non-encapsulated white nodule measuring 0.3 cm was found in the medial portion. Histological evaluation revealed chronic lymphocytic thyroiditis and three benign lymph nodes.\n\nThe left paratracheal lymph node specimen contained multiple lymph nodes ranging from 0.3 to 1.8 cm in size. All sixteen lymph nodes examined were benign. Benign thymic tissue and a parathyroid gland were also identified within this specimen.\n\nIntraoperative frozen section analysis of the left thyroid lobe initially suggested follicular neoplasm with suspicion for follicular variant of a specific type of thyroid lesion. Final histopathological evaluation confirmed the findings seen in permanent sections.\n\nAll specimens were processed and reviewed in detail. No tumor multicentricity was observed. Parathyroid glands were not identified in the left thyroid lobe specimen but were present in the left paratracheal specimen."} +{"pid": "TCGA-CV-6936", "report": "A right neck dissection level 1B specimen contained one lymph node with tumor involvement out of one submitted. Soft tissue involvement was also identified at this site. Level 2A on the right showed three out of five lymph nodes involved by tumor. Other lymph node levels from both sides of the neck, including right levels 1A, 2B, and 3, as well as left levels 1B, 2, 2B, and 3, were negative for tumor involvement. One lymph node in left neck level 1B was positive among four submitted, and one lymph node in left neck level 2 was positive among five submitted.\n\nTumor involvement of lymphovascular spaces was identified in right oral labia soft tissues, a re-excision margin on the right lateral aspect, and an anterior right second re-excision margin. A moderately differentiated carcinoma was identified in the anterior mandible and floor of mouth region. The tumor measured 5.0 \u00d7 2.0 \u00d7 3.5 cm grossly and extended through the full thickness of tissue sections (1.4 cm depth). Perineural and lymphovascular invasion were noted. Bone margins appeared free of tumor involvement based on initial assessment; however, bone sections were pending further evaluation.\n\nNo tumor was identified in bilateral mental nerves, lingual nerve, hypoglossal nerve, alveolar nerves, buccal mucosa, ventral tongue, or floor of mouth specimens. Adipose and fibroadipose tissues submitted from various levels of neck dissection did not show tumor involvement. Several specimens consisted entirely of soft tissues, nerves, ducts, or blood vessels without evidence of tumor. Multiple tissue fragments from surgical margins and regional sites were examined microscopically, with most showing no tumor presence."} +{"pid": "TCGA-PC-A5DL", "report": "The specimen was received from a male patient and consisted of five separate tissue samples. Three of the specimens were submitted for microbiology evaluation. The fourth specimen, labeled as \"retroperitoneal tissue,\" consisted of an ovoid mass weighing 263 grams and measuring 11 x 7.5 x 6.5 cm. The tissue was encapsulated with a tan, homogeneous, rubbery to firm whorling cut surface. A central area of yellow discoloration with fat necrosis was noted, possibly representing a prior biopsy site. Representative sections were submitted for analysis.\n\nThe fifth specimen was identified as an appendectomy specimen. It measured 6.7 cm in length with a diameter of 0.9 x 0.8 cm and had a mesoappendix measuring up to 2 cm. The external surface was smooth and pink, and the lumen was patent with clear to yellow thin fluid. No abnormal lesions or masses were observed.\n\nThe third specimen was a biopsy from liver segment 4. It measured 0.3 x 0.3 x 0.3 cm and showed features consistent with a benign biliary lesion. Histologic examination revealed no evidence of malignancy in this sample.\n\nMicroscopic evaluation of the retroperitoneal tissue showed a cellular proliferation with moderate nuclear atypia and scattered mitotic figures. Focal areas of necrosis were present. All inked margins were free of tumor involvement. Immunohistochemical staining demonstrated reactivity for SMA, vimentin, and desmin, while staining for HMB45 was negative. These findings were consistent with a well-characterized neoplastic process.\n\nAll specimens were processed and analyzed in a laboratory certified under CLIA regulations for high-complexity testing. The tests performed were for clinical diagnostic purposes and are not considered investigational or research-based."} +{"pid": "TCGA-CV-7247", "report": "The surgical specimen includes a total laryngopharyngectomy with no tumor identified in the left superior laryngeal nerve, pharyngeal margin, superior esophageal margin, tracheal margin, or skin. The primary lesion was located in the pyriform sinus and measured 3.2 x 1.5 x 0.5 cm. Multiple foci of invasive carcinoma were found in the left subglottic mucosa, along with submucosal deposits in the anterior commissure and right true vocal cord. Histologic evaluation revealed a moderately differentiated squamous cell morphology with a depth of invasion measuring 0.5 cm. Extensive lymphatic invasion was noted. Regional lymph nodes assessed included three left subdigastric, three left lower jugular, and three right mid jugular lymph nodes, none of which showed evidence of tumor involvement. No involvement was found in the thyroid, parathyroid, or skin."} +{"pid": "TCGA-D8-A1XL", "report": "Histopathological examination was performed on a breast tissue specimen obtained from the left breast outer upper quadrant. The tissue segment measured 8.4 x 7.4 x 2.6 cm with a skin flap measuring 2.8 x 6.8 cm and axillary tissue measuring 8 x 9 x 2 cm. A lesion was identified with a cross-sectional size of 3.0 x 1.8 x 2.9 cm. Margins were assessed as follows: base margin 0.1 cm, front skin surface margin 0.2 cm, sternum margin 3.5 cm, axilla margin 2.2 cm, shoulder margin 1.3 cm, and lower margin 0.8 cm. Microscopic evaluation revealed a high-grade lesion with histological features consistent with invasive ductal carcinoma NHG3 (total histologic score 8/10 based on nuclear grade 3, glandular formation grade 2, and mitotic count grade 3). Mitotic activity was noted at 19 mitoses per 10 high-power fields. The largest dimension of the lesion measured 3.0 cm. The closest margin was less than 0.05 cm at the base. Axillary lymph node assessment showed metastatic involvement in one out of thirteen lymph nodes examined. Capsular invasion and infiltration of surrounding adipose tissue were observed. Immunohistochemical staining demonstrated strong expression of estrogen receptors in over 75% of tumor nuclei and progesterone receptors also in over 75% of tumor cells. HER2 protein expression was scored as 2+ using HercepTest\u2122 by DAKO; however, FISH analysis did not detect HER2 gene amplification. Staging classification was determined as pT2 for primary tumor size and pN1a for lymph node involvement."} +{"pid": "TCGA-PC-A5DM", "report": "The specimen was obtained from a male patient and collected from the left thigh region. The tissue sample consisted of a large, ovoid mass measuring approximately 26 x 14 x 12 cm. The external surface was smooth with areas of overlying fascia present. A small irregular area measuring about 1.5 x 1.5 cm was observed on the deep aspect; however, this was not considered a true defect based on surgical assessment. Adjacent to this region was some retractive fascial tissue.\n\nInternally, the mass measured 15 x 12.5 x 8.5 cm and was predominantly necrotic with soft yellow consistency and areas of hemorrhage noted more proximally. Peripheral and distal regions contained viable pink tissue. The tumor appeared thinly encapsulated without disruptions or nodular extensions into surrounding structures. Skeletal muscle tissue up to 5.3 cm in length was identified at the distal margin and appeared histologically unremarkable.\n\nHistologic sections were taken from multiple orientations: proximal (1A), distal (1B), deep (1C-1D), superficial (1E-1F), and additional central portions (1G-1I). All margins were grossly negative. Microscopic evaluation showed high-grade pleomorphic spindle and giant cell morphology. Immunohistochemical staining performed on prior biopsies demonstrated strong and diffuse positivity for smooth muscle actin and Vimentin, with focal positivity for muscle-specific actin. These findings supported a mesenchymal origin consistent with smooth muscle differentiation.\n\nCytogenetic analysis revealed a highly abnormal male karyotype with extensive chromosomal rearrangements and double minutes observed in cells cultured for seven days. Chromosome counts ranged widely from 42 to 201. After twelve days in culture, all examined cells appeared normal, suggesting possible outgrowth of non-neoplastic elements."} +{"pid": "TCGA-A3-3373", "report": "The specimen was collected from a right kidney and gallbladder. The gallbladder measured 8.0 x 3.0 x 2.5 cm and had a fibrotic wall up to 0.1 cm thick. The inner lining showed hyperemic mucosa and contained green bile along with several small granular calculi, the largest measuring 0.2 cm. Sections of the gallbladder were submitted for analysis.\n\nThe right kidney specimen weighed 530 grams and measured 22.8 x 11.5 x 5.1 cm. Within the kidney, there was a well-defined lesion located in the upper to mid pole on the lateral aspect. The lesion measured 6.5 x 5.5 x 5.4 cm and had a red-brown to chalky yellow appearance with areas of hemorrhage. It extended beyond the renal cortex into surrounding adipose tissue but remained covered by a thin layer of cortical parenchyma. The lesion appeared to compress nearby structures but did not grossly invade them. The adrenal gland fragment measured 2.1 x 1.5 x 1.0 cm and appeared fragmented and tan-yellow.\n\nMargins of resection included 1.1 cm of renal artery, 1.3 cm of renal vein, and 5.7 cm of ureter, all appearing patent. The remaining kidney tissue showed a cortex up to 0.7 cm thick, slightly edematous but uniform in appearance. The corticomedullary junction was indistinct, and the medulla appeared homogeneous with sharp papillae. The renal pelvis and calyces were lined with smooth mucosa extending into the ureter.\n\nMicroscopic evaluation showed chronic inflammation in the gallbladder with gallstones present, but no malignant cells identified. In the kidney specimen, cellular features included Fuhrman nuclear grade 3/4. Lymphovascular space invasion was observed, but no transcapsular, renal vein, or vena caval invasion was identified. All margins\u2014soft tissue, ureteral, and vascular\u2014were free of malignancy in the sections examined. No lymph nodes were submitted for review.\n\nSections were submitted from the lesion and surrounding tissue, uninvolved parenchyma, vascular and ureteral margins, and adrenal gland. The tumor was confined to the kidney, with no evidence of spread to lymph nodes or distant sites."} +{"pid": "TCGA-DD-AACS", "report": "The liver specimen measures 7.6 x 7.0 x 3.2 cm and contains a single tumor located in the center, measuring 2.8 x 2.5 x 2.3 cm. The tumor has an expanding nodular growth pattern and shows 20% necrosis. There is no evidence of satellite nodules, hemorrhage, or peliosis. The surrounding liver tissue shows chronic hepatitis of HBV etiology, with minimal lobular and portoperiportal inflammation (grade 1), and septal fibrosis (stage 3). Moderate steatosis is also present. A fibrous capsule is identified around the tumor, and the surgical resection margin is free of involvement. The gallbladder is 5.8 cm in length and 3.6 cm in diameter and contains a 3.2 cm stone. Histologically, the tumor demonstrates trabecular and solid growth patterns with moderate differentiation (II-III). No dysplastic nodules, ductal epithelial dysplasia, or bile duct invasion are identified. The non-tumor liver tissue shows features of chronic hepatitis and steatosis without evidence of other significant liver disease."} +{"pid": "TCGA-AN-A0FT", "report": "The pathology report describes a female patient. The tissue sample was obtained from the right breast via surgery and was preserved in an OCT matrix within a block container. The tumor is characterized histologically as a grade 2 lesion with a T stage of 2, N stage of 1, and M stage of 0. No prior treatment was administered. Additionally, a normal blood sample was collected via blood draw and stored frozen in a tube."} +{"pid": "TCGA-BP-4331", "report": "The left posterior mid-pole renal specimen shows a well-defined mass measuring 3.7 x 3.7 x 3.0 cm. The cut surface is hemorrhagic and bright yellow. Histologically, the lesion exhibits acinar growth pattern and nuclear features consistent with intermediate grade. The tumor is confined within the renal capsule and is located 0.3 cm from the stapled margin and 0.7 cm from the opposite margin. The deep margin, marked by a stitch, is within 1.0 mm of the tumor. All surgical margins are free of involvement. The surrounding kidney demonstrates changes of chronic pyelonephritis, nephrosclerosis, and a separate small papillary lesion. A separate specimen of left perinephric adipose tissue was submitted and found to be benign. The excised adipose tissue measures 25.0 x 18.0 x 4.0 cm and contains no significant abnormality. Intraoperative frozen section confirmed the presence of a neoplastic lesion in proximity to the deep margin; permanent sections confirm the same findings."} +{"pid": "TCGA-DJ-A2PY", "report": "A 45-year-old female with bilateral thyroid nodules and a history of a right fine needle aspiration biopsy was submitted for evaluation. The specimens included a Delphian node, a right paratracheal lymph node, and a total thyroidectomy specimen.\n\nExamination of the Delphian node revealed one benign lymph node. The right paratracheal lymph node showed involvement by a metastatic focus. The lymph node measured 1.0 x 0.6 x 0.4 cm, with the largest dimension of the involved area measuring 0.3 cm. The largest metastatic focus within the node measured 0.2 cm. No extranodal extension was observed. It was noted that the focus was identified only on the frozen control slide and not on the original frozen section.\n\nThe total thyroidectomy specimen weighed 27 grams. The right lobe measured 4 x 2.5 x 0.9 cm, and the left lobe measured 4.3 x 2.9 x 1 cm. The isthmus measured 2.5 x 2 x 0.9 cm. A well-defined nodule measuring 2.5 x 1.5 x 1.2 cm was identified in the isthmus at the junction with the lower pole of the right lobe. This nodule extended to both the posterior and anterior capsule. Additional nodules were found in the right lobe (measuring 0.6 cm and 0.7 cm) and in the left lobe (measuring 1.0 cm, 0.7 cm, and 0.4 cm). Histologic evaluation revealed a partially encapsulated lesion located in the right lobe. The greatest dimension of this lesion was 2.5 cm. The histologic features showed well-differentiated cellular morphology. No mitotic activity or tumor necrosis was identified. There was evidence of invasion into perithyroidal soft tissue. Surgical margins were free of involvement. In addition, a small focus was identified in the left lobe measuring 0.6 cm. The surrounding thyroid tissue showed changes consistent with nodular hyperplasia. Parathyroid tissue was not identified in the specimen.\n\nAll surgical margins were negative. No vascular invasion was observed. The specimen was entirely submitted for histologic analysis, with representative sections taken from all areas of interest."} +{"pid": "TCGA-B5-A11Z", "report": "The specimen from a 61-year-old patient consists of a uterus, tubes, and ovaries. The uterus weighs 95 grams and measures 8.7 x 5.6 x 4.1 cm with an attached cervix measuring 3.5 cm in length. The endometrial cavity is lined by a tan-brown friable lesion measuring approximately 3.5 x 4 cm. Within this region, a distinct mass measuring 4 x 2.5 cm is identified. The myometrium is 2 cm thick and appears partially trabeculated without identifiable nodules. Gross evaluation suggests possible minimal involvement of the lower uterine segment with no identifiable lesions within the cervix, ovaries, or fallopian tubes.\n\nHistologic examination reveals a lesion involving the posterior endomyometrium with full thickness sampling. Sections of the anterior and posterior cervix, anterior and posterior endomyometrium, lower uterine segment, and bilateral adnexa are submitted for analysis. Microscopic assessment confirms the presence of a minimally invasive lesion within the uterine corpus. No lymphatic or vascular invasion is observed. Adjacent non-neoplastic endometrium shows atrophic changes. All margins, including the cervix, serosa, and specimen margins, are unremarkable. Both ovaries and fallopian tubes show no evidence of abnormality.\n\nStaging is based on the AJCC 7th Edition guidelines following hysterectomy with bilateral salpingo-oophorectomy. The lesion demonstrates no extension beyond the uterus and no involvement of regional lymph nodes or distant sites. The depth of myometrial penetration, if any, is less than 0.2 cm. Based on available findings, the stage assigned is pT1a pNx pMX."} +{"pid": "TCGA-XC-AA0X", "report": "The patient is female. A right lower lobectomy specimen was received unfixed, measuring 15 x 12 x 8 cm and weighing 280 g. The pleural surface showed multiple anthracotic markings. A 1.3 x 1.2 x 1.2 cm gray-tan mass was identified, located 2 cm from the bronchial margin of resection and 3 cm from the closest pleural surface. The mass was unifocal and surrounded by congested lung parenchyma. Two lymph nodes were identified at the hilum, measuring 0.7 x 0.7 x 0.5 cm and 0.6 x 0.6 x 0.5 cm. Margins of resection, including bronchial, vascular, and soft tissue, were evaluated. The soft tissue margin measured 2 cm, 4 cm, 4.5 cm, and 5 cm in different areas. No invasion of the visceral pleura was observed, and the tumor was noted to involve the main bronchus 2 cm or more distal to the carina. The parenchymal margin was uninvolved by invasive disease.\n\nA total of 13 lymph nodes were examined across multiple levels: four from Level 10, three from Level 7, one from R4, and one from R2. All were negative for malignancy. No lymph-vascular invasion was identified.\n\nMicroscopic evaluation revealed a moderately differentiated cellular proliferation. Immunohistochemical staining showed positivity for p63 and negativity for TTF-1 and Napsin A in the tumor cells. No treatment effect was noted. The tumor size was confirmed as 1.3 cm in greatest dimension, with no evidence of distant metastasis."} +{"pid": "TCGA-EI-6513", "report": "Histopathological examination was performed on a resected specimen of the colon and rectum. The specimen measured 14.8 cm in length, with surrounding fat tissue measuring 3.5 cm in thickness. A cauliflower-shaped lesion was identified in the mucosa, measuring 6.1 x 7.4 x 3.4 cm. The lesion involved approximately 80% of the intestinal circumference and was located 5.8 cm from one excision margin and 5.9 cm from the opposite margin. Blue dye was noted within the wall of the intestine. In addition to the lesion, a separate polyp measuring 0.9 cm in diameter was observed.\n\nMicroscopic evaluation revealed glandular and papillary structures with moderate nuclear atypia. There was evidence of infiltration into the muscularis propria and perirectal adipose tissue. The surgical margins were free of neoplastic cells. Lymph node involvement was present, with affected nodes classified under region II/XIII. Adjacent mucosa showed benign tubular adenoma with mild dysplasia.\n\nStaging parameters indicated pT3, pN1 classification. Tumor grade was moderately differentiated (G2). No residual tumor was detected at the resection margins (R0). Clinical staging corresponded to Dukes C and Astler-Coller C2 classifications."} +{"pid": "TCGA-AA-3866", "report": "The submitted specimen includes mechanically altered liver tissue with a sectioned cystic structure showing areas of regressive change and partial dystrophic calcification within the wall. Subcapsular liver tissue demonstrates a well-defined, regenerative, nodular hyperplastic lesion with moderate steatosis. In the resected ileocolic sample, there is a circumscribed lesion measuring up to 4 cm in maximum dimension. Histologic evaluation reveals involvement of the tunica muscularis propria with extension to the perimuscular fatty tissue border. A total of 23 local lymph nodes are without evidence of metastatic involvement. All resection margins, including those of the small and large intestine as well as the mesenteric margin, are free of disease. There is complete obliteration of the appendix with scarring consistent with prior inflammatory changes. Histologic grade is intermediate, with no evidence of lymphovascular or perineural invasion. The resection is complete."} +{"pid": "TCGA-TT-A6YN", "report": "The specimen consisted of a right adrenal gland and mass weighing 558.8 grams. The mass measured 12.3 x 9.0 cm and was described as a solid, friable, pink-tan to orange-tan tissue with areas of cystic change ranging from 0.5 to 3.0 cm. A distinct nodule measuring 2.7 x 2.7 x 1.5 cm was identified within the specimen. No clear capsule was observed. Histologic sections showed diffuse growth pattern, with evidence of vascular and capsular invasion. Immunohistochemical staining demonstrated strong and diffuse positivity for chromogranin, and SDHB showed strong diffuse expression. Inhibin was negative in the tumor cells. S100 and Ki67 were also assessed; Ki67 proliferation index was less than 1%. A total of 22 representative sections were examined, including from the nodule and surrounding tissue."} +{"pid": "TCGA-EW-A1PD", "report": "A total mastectomy specimen from the right breast included a lesion measuring 1.6 cm in greatest dimension, located centrally within the retroareolar region. The lesion was found to have clear margins, with the closest margin measuring 20 mm at the deep aspect. Histologic evaluation revealed a Nottingham histologic score of 7 (Grade 2), composed of glandular differentiation score 3, nuclear pleomorphism score 2, and mitotic count score 2. No lymphovascular invasion was identified.\n\nDuctal carcinoma in situ (DCIS) was also present, estimated to be at least 0.5 cm in extent, involving 5 out of 10 blocks examined. The DCIS exhibited cribriform and solid architectural patterns, with high-grade nuclear features and focal necrosis. Microcalcifications were identified within the DCIS component.\n\nA total of seven lymph nodes were examined, including two sentinel nodes. Of these, two sentinel lymph nodes contained metastatic deposits, each greater than 0.2 cm in size, with the largest measuring 1.5 cm. No additional metastases were found in the remaining five lymph nodes. Extranodal extension could not be definitively assessed.\n\nImmunohistochemical studies performed on prior biopsy tissue showed the presence of estrogen and progesterone receptor-positive tumor cells (1% for each), and HER2 testing by FISH demonstrated gene amplification. A number of ancillary stains and assays were used during the evaluation, all validated by the laboratory for clinical use.\n\nThe surgical procedure included a right total mastectomy with axillary node dissection and sentinel node biopsy. Intraoperative touch preparations of both sentinel nodes showed evidence of metastatic involvement. No additional lesions were identified in the mastectomy specimen upon gross examination."} +{"pid": "TCGA-77-A5GA", "report": "The histopathology report describes a left upper lobectomy specimen along with a separate hilar lymph node. The lung specimen measures 210 x 150 x 50 mm in its partially inflated state. Two bronchi are present at the hilum, approximately 30 mm apart, and a bare area measuring up to 55 mm in diameter is noted around them. A staple line extends from the hilum to the periphery, measuring 80 mm in length. The pleural surface shows tan to grey discoloration with a diffuse area of induration on the lateral lower aspect of the lobe measuring 60 mm in greatest dimension, and scarring at the apex measuring 15 mm. On sectioning, a central, firm white lesion measuring 35 mm in greatest dimension is identified in the peri-bronchial region, extending focally toward the pleural surface but not clearly invading it macroscopically. This lesion has areas of necrosis and is located 10 mm from the closest bronchial margin. A second small firm nodule measuring 6 mm in diameter is found in the apical portion of the lobe, lying 2 mm from the pleural surface and more than 70 mm from the bronchial margin and 65 mm from the main lesion, with normal lung tissue in between. The remaining lung tissue shows moderate to severe emphysema and pleural-based fibrosis adjacent to the indurated area.\n\nMicroscopic evaluation reveals a moderately and poorly differentiated carcinoma. The lesion is in close proximity to the visceral pleura but does not invade it. The bronchial resection margin is free of abnormal cells. Within the lesion, there is evidence of focal vascular and lymphatic involvement, though no perineural spread is observed. Lymph nodes near the bronchus and the submitted hilar lymph node show only reactive changes, including sinus histiocytosis, carbon pigment deposition, and scattered birefringent material consistent with silicate. No malignant cells are identified in these nodes. Adjacent lung tissue shows changes consistent with obstructive pneumonitis, including organizing pneumonia, mild acute alveolitis, and intra-alveolar foamy macrophages. There is also significant emphysema and a mixed dust macule with a small non-necrotizing granuloma. Other described macroscopic findings correspond to scarring and organizing pneumonia without any signs of malignancy. Special stains for microorganisms are negative in key sections.\n\nThe pathological staging is pT2a NO. Additional codes include T-28000, M-80703, and P1-03000."} +{"pid": "TCGA-ET-A3DQ", "report": "The specimen was obtained from a total thyroidectomy. The lesion involved the right lobe and measured 1.0 cm in greatest dimension. An additional focus measuring 0.3 cm was identified in the same lobe. Histologic examination revealed cellular features consistent with a follicular growth pattern. Two lymph nodes were examined and showed no evidence of involvement. The primary lesion was confined to the thyroid gland without vascular or lymphatic invasion. Surgical margins were free of involvement. Additional findings included nodular hyperplasia and chronic inflammatory changes involving lymphocytic infiltration, associated with fibrosis. No distant metastasis could be assessed. All findings were confirmed upon review by the attending pathologist."} +{"pid": "TCGA-IR-A3L7", "report": "The submitted specimens include a radical hysterectomy specimen consisting of the uterus and cervix, along with bilateral pelvic lymph node dissections involving external iliac, hypogastric, and obturator regions.\n\nMicroscopic examination of the cervix reveals significant stromal invasion with maximal thickness measuring 22 mm. The tumor demonstrates poorly differentiated features with focal adenoid and basaloid morphology. There is evidence of vascular and perineural invasion. No multicentric tumor involvement is identified. In addition, there is in situ carcinoma present focally involving endocervical glands. No vaginal extension or involvement of the uterine corpus is observed. Surgical margins are generally free of tumor; however, the tumor approaches closely to within 0.1 cm of the deep parametrial soft tissue margin at 9:00 and also to within 0.1 cm of the ectocervical margin of resection. No parametrial involvement is identified.\n\nExamination of all lymph node groups shows no evidence of metastatic disease. The left external iliac lymph nodes (4 examined), left hypogastric lymph nodes (3 examined), left obturator lymph nodes (6 examined), right external iliac lymph nodes (2 examined), right hypogastric lymph node (1 examined), and right obturator lymph nodes (4 examined) are all benign.\n\nThe endometrium demonstrates polyps. The myometrium appears histologically unremarkable."} +{"pid": "TCGA-06-0157", "report": "The surgical specimen from the left pulvinar region consists of multiple tissue fragments measuring approximately 1.5 x 1.5 x 1.0 cm in aggregate. Frozen section evaluation indicated a glial neoplasm. Histological examination reveals a high-grade lesion characterized by increased cellularity, nuclear pleomorphism, and frequent mitotic figures. Prominent microvascular endothelial hyperplasia is noted. Areas of necrosis are present within the sampled tissue. Immunohistochemical staining demonstrated a labeling index of approximately 10% for the proliferative marker studied."} +{"pid": "TCGA-DU-A5TT", "report": "A 46-year-old man presented with new onset seizure activity. Imaging demonstrated a lesion in the left frontal premotor region at the level of the middle frontal gyrus. The lesion was initially mostly non-enhancing without a choline spike; however, subsequent imaging showed increased enhancement and enlargement of the lesion coinciding with increased seizure frequency.\n\nBiopsy specimens from the left frontal brain lesion were evaluated. Gross examination revealed soft, pinkish-grey tissue fragments measuring up to 0.8 cm and 1.2 cm respectively. Histologic evaluation revealed infiltrative glial neoplastic proliferation with frequent mitoses and mixed cellularity. Microscopic features included focal microvascular proliferation but no tumor necrosis. Immunohistochemical staining demonstrated numerous microglial cells interspersed among the neoplastic cells. CD34 staining highlighted focal neovascularization and microvascular proliferation. IDH1 staining was negative.\n\nThe proliferation index assessed by MIB-1 immunostaining was approximately 18% in more active regions of the tumor. Molecular testing detected methylation of the promoter region of a key DNA repair gene, suggesting potential therapeutic relevance for alkylating agent therapy. Genetic analysis identified allelic loss involving specific chromosomal arms, assessed via PCR using multiple informative markers including D1S1592, D1S552, D19S219, and D19S412 among others. These findings were consistent with molecular alterations commonly associated with certain gliomas.\n\nTechnical sensitivity for these assays was determined based on serial dilution studies and histologic composition of the specimen. Interpretation of results was performed within the context of established diagnostic guidelines and clinical correlation."} +{"pid": "TCGA-QF-A5YS", "report": "The left obturator lymph node specimen demonstrates a nodular architecture with multiple follicles, some containing small germinal centers. Certain follicles are predominantly or entirely composed of small lymphocytes, some of which exhibit a monocytoid appearance. Rare plasma cells are scattered throughout the tissue. Areas of fatty infiltration are present, and there is an increased number of histiocytes within dilated sinuses.\n\nImmunohistochemical analysis was performed to further characterize the lymphocyte populations. CD20 and CD3 stains demonstrate appropriate zonation of B and T cells, respectively. T cells also express CD5 and CD43; however, no co-expression of CD20 with either CD43 or CD5 is observed. The small germinal centers are positive for CD20, CD10, and bcl-6 but do not stain for bcl-2. In contrast, some smaller follicles show positivity for CD20 and bcl-2 but are negative for CD10 and bcl-6, suggesting possible mantle/marginal zone hyperplasia or primary follicles. CD21 and CD23 immunostains highlight the follicular dendritic meshwork within the follicles. Cyclin D1 staining is positive in endothelial cells but negative in lymphocytes.\n\nThese morphologic and immunophenotypic findings support the presence of a reactive lymph node with sinus histiocytosis. No evidence of malignancy is identified in this lymph node or in any other lymph nodes examined from the left pelvic, left common iliac, right external iliac, right obturator, right periaortic, right common iliac, or left periaortic regions. Additionally, no tumor is found in the omental tissue.\n\nThe uterine specimen reveals a mass measuring 2.1 x 1.1 x 0.6 cm located within the endometrium. Histologically, the lesion involves the lower uterine segment and upper endocervical canal junction with a depth of invasion measuring 2.2 mm into the myometrium (which is 10 mm thick). There is no evidence of lymphovascular space invasion. The cervix shows involvement limited to the upper endocervical stroma. No tumor is identified in the bilateral fallopian tubes or ovaries.\n\nA total of 29 lymph nodes were evaluated across multiple sites and none show signs of metastatic involvement. Immunohistochemical staining for ER and p53 was performed, revealing strong positivity for ER in certain areas and diffuse staining for p53 in others, with variable expression noted between different regions of the lesion.\n\nClinical correlation and follow-up are advised. Additional evaluation of lymph node morphology with specialized stains and hematopathology consultation has been initiated and will be addressed in a subsequent report."} +{"pid": "TCGA-AG-A01Y", "report": "The specimen shows a moderately differentiated invasive lesion arising in the rectum with full transmural extension through all layers of the bowel wall. Histologic evaluation confirms the presence of lymphovascular invasion. Surgical resection margins and ligature site are free of tumor involvement. A total of 17 regional lymph nodes are negative for metastatic disease. An additional biopsy, consistent with lymph node morphology, demonstrates reactive changes. The lesion exhibits a glandular growth pattern with intermediate differentiation. Staging parameters indicate absence of nodal or distant spread with complete removal of the primary lesion."} +{"pid": "TCGA-TM-A7C5", "report": "The specimen consists of two fragments of brain tissue, measuring 7x5x2mm and 19x10x6mm respectively. Microscopic examination reveals areas of increased cellularity with a mixture of cell types. Some regions show cells with abundant cytoplasm, central nuclei, and mild nuclear pleomorphism. Mitotic activity is present, with up to four mitotic figures per high power field in some areas. A network of capillaries is observed, and GFAP staining highlights a fibrillary astrocytic background. In certain regions, there are clear cells at the center of this fibrillary matrix. Ki-67 immunostaining shows variable proliferation indices, with some areas showing 5\u201310% positivity and others less than 4%. Adjacent brain tissue demonstrates slightly increased cellularity but lacks significant pleomorphism or necrosis. Fluorescence in situ hybridization (FISH) testing was performed on 218 cells across 10 sites. Results show a 1p36/1q25 ratio of 0.62 and a 19q13/19p13 ratio of 0.65, both below the threshold indicating loss. No EGFR amplification was detected. The histological features suggest a high-grade lesion based on cellular atypia, mitotic activity, and architectural patterns, with mixed components seen throughout the tissue. Grading was assessed as Grade III according to WHO criteria."} +{"pid": "TCGA-FD-A6TF", "report": "A 2.3 x 1.7 x 1.3 cm fragment of white rubbery tissue from a peritoneal nodule was bisected, revealing a multicystic cut surface consistent with ovary. Microscopic evaluation showed foci of cells present in lymphatic channels within the ovarian tissue, along with benign ovarian epithelial cysts. A second specimen identified as right ovary consisted of a 4.8 x 1.2 x 0.5 cm tan-brown tissue fragment; no ovarian tissue was identified upon sectioning. A third specimen labeled as left ovary measured 3.5 x 3 x 1.2 cm and showed stromal hyperplasia without evidence of tumor.\n\nThe cystectomy specimen included a bladder measuring 15 x 13 x 4.2 cm with attached mesenteric fat and tubing. The urethral stump was 3 cm in length and probe patent. Right and left ureteral stumps were noted, with disruption at one segment. A 6 x 4.5 cm portion of mucosa was observed on the posterior aspect of the bladder. An indurated, ulcerated lesion was present in the lower anterior-left wall, left lateral wall, and posterior wall at the trigone. The lesion measured 4.5 x 4 cm grossly, with a 3.5 x 3 cm ulceration surrounded by a hemorrhagic rim. Tumor infiltrated into the urethra, located 2.8 cm from the urethral margin and 0.8 cm from the mucosal surface. The tumor measured up to 4.5 x 4 x 1.8 cm in dimensions and extended into adipose tissue near the serosal surface.\n\nLymph node dissections were performed on left and right pelvic regions. One lymph node from the left pelvic region was diffusely involved with extensive soft tissue involvement and extranodal extension. Four lymph nodes from a second left pelvic dissection were all positive for involvement with the largest measuring 5.5 cm and showing extranodal extension. Six lymph nodes from the right pelvic dissection were also all involved, with the largest measuring 5 cm and showing extranodal extension. Ureteral margins were free of tumor involvement.\n\nMicroscopic findings showed high-grade invasive cells with depth of invasion extending into extravesicular soft tissue. Tumor distribution included the right lateral wall, left lateral wall, trigone, anterior wall, and posterior wall. All ureteral margins, distal urethral margin, and soft tissue margins were negative. Lymph node analysis revealed all 11 nodes examined were positive for tumor involvement with extranodal extension. Staging was determined as pT3b,N2,M1."} +{"pid": "TCGA-AO-A0JF", "report": "The specimen was submitted for excision of a lesion in the left breast at the two o\u2019clock position, along with associated surgical margins and lymph nodes. Two sentinel lymph nodes from level I of the left axilla were examined. The first measured 2.5 x 1.5 x 1.5 cm and showed involvement with one focus of metastatic disease measuring 5 mm in greatest dimension without extracapsular extension. The second sentinel node measured 2.4 x 1.5 x 1.2 cm and also contained metastatic involvement measuring 6 mm, with evidence of extracapsular extension greater than 2 mm.\n\nThe primary lesion in the left breast was a spiculated white mass measuring 1.2 x 1.2 x 1.1 cm grossly, and microscopically measured 2.0 cm. Histologically, it exhibited features of moderately differentiated invasive carcinoma, with moderate tubule formation and low to intermediate nuclear grade. Focal vascular invasion was identified. A component of in situ disease was also present, solid type, with low to intermediate nuclear grade, constituting up to 25% of the total tumor volume. This in situ component was intermixed with the invasive portion. Calcifications were noted only within the invasive component.\n\nSurgical margins were evaluated and all showed benign breast tissue. The superior margin showed proliferative fibrocystic changes. The medial, inferior, and lateral margins each showed focal usual ductal hyperplasia. The posterior margin revealed predominantly fibroadipose elements with skeletal muscle tissue present.\n\nA non-sentinel lymph node from the left axilla was benign. Additionally, levels one and two of the left axillary contents were submitted, containing a total of eleven lymph nodes, all of which were negative for involvement.\n\nImmunohistochemical staining showed strong nuclear reactivity for estrogen receptor in 95% of cells with intense staining, and 70% nuclear staining for progesterone receptor with moderate intensity. HER2 staining was negative (1+), with less than 5% of cells showing weak complete membranous staining and no uniform or circumferential pattern observed. Controls were satisfactory, and testing was performed using FDA-approved assays where applicable."} +{"pid": "TCGA-RW-A680", "report": "A 6.8 x 5.9 x 4.5 cm lobular, well-encapsulated mass was resected from the retroperitoneal area. The cut surface is yellow-orange and solid, with scattered calcifications, diffuse hemorrhage, and central fibrosis. No necrosis is identified. The mass is surrounded by a thickened, fibrotic sheath. A right portal lymph node measuring 1.2 x 0.9 x 0.6 cm was submitted and found to be benign without evidence of neoplastic involvement. A gallbladder measuring 7.6 x 4.5 x 1.4 cm was also resected; it demonstrated a 0.6 cm transmural defect in the fundus. The mucosa appeared diffusely green-yellow and trabeculated, with diffuse wall thickening up to 0.8 cm. The lumen contained viscous green bile, but no calculi or masses were present. Histologic examination of the retroperitoneal soft tissue showed no other abnormalities aside from the described features. Lymph node analysis showed no malignancy. The gallbladder specimen showed only fibrous adhesions without other significant histologic findings."} +{"pid": "TCGA-BA-4077", "report": "A surgical pathology report describes multiple biopsies and a resected specimen involving the head and neck region. Biopsies from the pretracheal lymph nodes, mental periosteum, right carotid sheath, right retropharyngeal space, and right parapharyngeal space all show fibrous connective tissue or skeletal muscle without evidence of invasive carcinoma. Intraoperative frozen section analysis of these sites also showed no tumor.\n\nThe main specimen consists of a glossectomy and laryngectomy with partial neck dissection (Levels I, II, III). The tongue measures 7.0 x 6.0 x 2.0 cm and the larynx 4.0 x 3.5 x 2.5 cm. A large, ulcerated lesion measuring at least 4 cm in greatest dimension is identified. It involves the paramidline base of tongue bilaterally, floor of mouth, vallecula, and approaches the hyoid bone. No angiolymphatic or perineural invasion is seen. Surgical margins are negative, with the closest distance being 0.5 cm at the lateral right soft tissue margin.\n\nMultiple tissue blocks were examined, including margins and tumor locations. Histologic examination reveals a moderately differentiated non-keratinizing cellular proliferation. Carcinoma in situ is present. All examined lymph nodes from the right neck (six in total, ranging from 2 mm to 7 mm) are negative for metastasis. A small salivary gland and additional soft tissue fragments from various anatomical regions also show no tumor involvement.\n\nStaging is provided as pT4A, pN0, pMx. This assessment is based solely on the current specimen and may require further clinical correlation for final staging."} +{"pid": "TCGA-DA-A960", "report": "The specimen consisted of five parts, including sentinel lymph nodes from the left axilla (two specimens) and left neck (two specimens), as well as a wide local excision from the left deltoid shoulder. All lymph node specimens were assessed using H&E, Melan-A, and HMB45 immunostains, and no evidence of tumor involvement was identified. Specifically, one lymph node from left axilla #1, three lymph nodes from left axilla #2, one lymph node from left neck #1, and one lymph node from left neck #2 were all negative for tumor.\n\nThe excision specimen from the left deltoid shoulder showed residual malignant cells in deeper sections of the original biopsy. A scar was also present. The resection margins were uninvolved by invasive melanoma, with the closest distance to the margin measuring 1.6 cm for invasive disease and 0.5 cm for melanoma in situ. Histologic evaluation revealed a maximum tumor thickness of 2.3 mm with ulceration. The mitotic rate was 2 mitoses/mm\u00b2. There was no evidence of microsatellitosis or macroscopic satellite nodules. \n\nA total of six sentinel lymph nodes were examined, and none contained metastatic disease. Pathologic staging for the primary lesion was determined as pT3b. No regional lymph node involvement was identified (pN0). Distant metastasis could not be assessed (MX). The excision margins were histologically confirmed as free of tumor."} +{"pid": "TCGA-CJ-4894", "report": "The left kidney specimen includes a multilobulated mass measuring 11.0 cm in maximum dimension, located predominantly in the inferior portion of the kidney. The mass invades into perinephric adipose tissue and extends into the renal sinus adipose tissue. It is associated with a thrombus within the renal vein that is focally attached to the vascular wall. The mass demonstrates a heterogeneous appearance with areas of hemorrhage and tan-brown solid regions. A cyst measuring 3.5 cm in greatest dimension filled with clear fluid is present in the mid pole, along with multiple smaller cortical cysts. Hemorrhagic areas are noted in the upper pole parenchyma. The adrenal gland, located 8.0 cm from the tumor, appears unremarkable. Margins of resection are free of involvement. Evaluation of three retroperitoneal lymph nodes reveals no evidence of involvement. The ureter and vascular margins are uninvolved. Microscopic examination reveals nuclear features corresponding to Fuhrman nuclear grade 3. Renal parenchyma shows evidence of interstitial nephritis, fibrosis, and cortical hemorrhages. Multiple submitted sections include various regions of the tumor, adjacent adipose tissue, cyst walls, hemorrhagic areas, and normal-appearing parenchyma. All lymph node sections are negative for involvement."} +{"pid": "TCGA-AJ-A3BD", "report": "The patient is a female who underwent surgical resection for abnormal tissue involving the uterine cavity. The specimen included the uterus, cervix, bilateral adnexa, and multiple lymph node groups. Gross examination of the uterus revealed a lesion measuring 4.5 x 2.0 x 2.0 cm within the endometrial cavity. Histologic evaluation demonstrated high-grade cellular features with papillary architecture. The tumor infiltrated focally through the full thickness of the myometrium, approaching within 0.1 cm of the serosal surface but without definitive extension to it. The average myometrial thickness was approximately 1.4 cm.\n\nTumor involvement was identified in the cervical stroma and endocervical glands. A small focus of tumor measuring approximately 0.1 cm was also detected in one ovary. No definitive lymphovascular space invasion was observed. Surgical margins were evaluated and none were found to be involved.\n\nLymph node evaluation included specimens from left pelvic, left periaortic/common, right periaortic, and right pelvic regions. Of these, one of nine lymph nodes from the left pelvic region, one of eight from the left periaortic/common region, one of one from the right periaortic region, and two of eight from the right pelvic region contained metastatic tumor cells.\n\nImmunohistochemical staining showed positivity for p53 and negativity for WT-1 in relevant tissue sections. Based on pathologic findings, the staging classification was determined as pT3aN2 according to the TNM system."} +{"pid": "TCGA-CV-A6JZ", "report": "The patient is a 162.5 cm, 47.6 kg individual with a body surface area of 1.47 m\u00b2. A composite resection of the ventral tongue and floor of mouth with segmental mandibulectomy was performed. The specimen included a segment of mandible measuring 6.5 x 3.5 x 1.0 cm. Attached soft tissue measured 6.5 x 5.0 x 2.0 cm in total. The left and right submandibular glands measured 2.5 x 1.5 x 1.0 cm and 2.8 x 1.6 x 0.8 cm respectively.\n\nAn ulcerated lesion was identified on the ventral surface of the tongue and anterior floor of mouth. The lesion measured 4.0 x 3.1 cm in greatest dimension and had a thickness of 1.2 cm. It appeared pale-white and glistening, and extended to within 0.5 cm of the deep margin, 2.5 cm from the right lateral bone margin, 3.1 cm from the left lateral bone margin, and 1.0 cm from the posterior resection margin. The lesion showed infiltrative growth into skeletal muscle with thick cords greater than 4 cells in some areas. There was no evidence of perineural or vascular invasion. Bone margins were evaluated after decalcification and found to be free of tumor involvement.\n\nMultiple lymph node levels were examined bilaterally. On the left side: Level I contained six possible lymph nodes (all negative), Level IB had up to 14 possible lymph nodes (all negative), Level IIA had up to nine possible lymph nodes (all negative), Level IIB had five possible lymph nodes (all negative), Level III had seven possible lymph nodes (all negative), and Level IV had five possible lymph nodes (all negative). On the right side: Level IB had three possible lymph nodes (all negative), Level IIA had up to 14 possible lymph nodes (all negative), Level III had three possible lymph nodes (all negative), Level IIB had two possible lymph nodes (all negative), and Level IV had three possible lymph nodes (all negative).\n\nMargins evaluated included the left and right lateral tongue, dorsal tongue, left and right floor of mouth, and left alveolus. All were negative. Minor salivary glands were present without evidence of tumor. Skeletal muscle and fibroadipose tissue were also negative throughout. No lymph nodes were identified within the primary resection specimen."} +{"pid": "TCGA-CQ-5325", "report": "The specimen consisted of multiple lymph node samples from the left neck levels I through IV, along with a left hemiglossectomy and associated margins. The lymph nodes were identified within fibroadipose tissue specimens measuring 5.0 x 4.0 x 1.8 cm (level I), 6.0 x 3.0 x 1.2 cm (level II), 7.8 x 4.0 x 1.2 cm (level III), and 4.5 x 3.0 x 1.9 cm (level IV). Lymph nodes ranged in size from 0.3 to 1.5 cm across all levels. No tumor involvement was identified in any of the lymph nodes examined (total of 22 lymph nodes, none involved).\n\nThe hemiglossectomy specimen measured 3.5 SI x 2.0 ML x 4.5 AP cm and included a well-circumscribed lesion located on the lateral surface of the tongue. The lesion measured 1.3 cm SI x 0.8 cm ML x 1.5 cm AP and appeared solid and tan-brown. Histologic evaluation revealed moderately differentiated cellular morphology without evidence of venous, lymphatic, or perineural invasion. All surgical margins (anterior, deep, superior, inferior, and posterior) were negative for tumor involvement. The tumor was located 0.5 cm from the medial/deep margin, which was the closest margin.\n\nPathologic staging indicated a tumor size less than 2 cm in greatest dimension. No distant metastasis could be assessed. Frozen section analysis of all margins confirmed absence of malignancy."} +{"pid": "TCGA-19-1791", "report": "The specimen consists of multiple biopsies obtained from the right frontal region of the brain. Two separate lesions were sampled, each measuring 0.6 x 0.4 x 0.4 cm and 0.6 x 0.4 x 0.3 cm, respectively. Both specimens were described as irregular fragments of white-tan to pink-tan soft tissue. Additional specimens included a cerebriform tissue fragment measuring 3.0 x 2.8 x 0.5 cm in aggregate, two fragments measuring 1.0 x 0.8 x 0.2 cm and 1.4 x 0.4 x 0.4 cm, multiple fragments measuring 1.8 x 1.0 x 0.4 cm in aggregate, and another set of fragments measuring 2.3 x 2.2 x 0.45 cm in aggregate. All specimens were submitted for histological examination. Microscopic evaluation revealed high-grade cellular features, including focal microvascular proliferation. Cellular morphology and tissue architecture were consistent with a high-grade glioma. Tissue was received both fresh and in formalin, and all specimens were processed and submitted entirely for analysis. Intraoperative cytologic evaluation confirmed the presence of high-grade neoplastic cells."} +{"pid": "TCGA-EM-A3AN", "report": "The specimen was received from a total thyroidectomy with bilateral neck and central compartment dissection. The right lobe of the thyroid measured 4.0 x 2.7 x 1.3 cm, the left lobe measured 4.0 x 2.7 x 1.1 cm, and the isthmus measured 2.0 x 0.8 x 0.5 cm. A dominant nodule measuring 1.2 x 1.0 x 1.0 cm was identified in the right lobe. The tumor exhibited both classical papillary and follicular variant architecture with psammomatous calcifications. Tumor cells displayed classical cytomorphology and were widely invasive with extracapsular extension. Lymphatic invasion was noted throughout the thyroid and adjacent soft tissue. The surgical margin on the right was involved by tumor.\n\nA total of 80 lymph nodes were examined across multiple specimens. In the right neck dissection (specimen size: 14.8 x 4.3 x 1.5 cm), 12 of 37 nodes contained tumor with extranodal extension. In the left neck dissection (specimen size: 11.0 x 3.0 x 1.8 cm), 7 of 31 nodes showed involvement. In the central compartment (specimen size: 4.5 x 2.5 x 1.5 cm), 7 of 9 nodes contained tumor with extranodal extension. One of two nodes from the left paratracheal region also showed tumor involvement. Several lymph nodes were partially calcified.\n\nNo definitive vascular invasion was identified, although there were foci suspicious for angioinvasion. Perineural invasion was not present. Due to tumor involvement at the resection margin, extrathyroidal extension could not be definitively assessed. Additional findings included mild nonspecific chronic thyroiditis and mild follicular nodular disease. All parathyroid specimens and the thymus showed no pathological abnormalities. The specimen was intact with adequate dimensions and stored appropriately for further analysis. Clinical correlation is recommended."} +{"pid": "TCGA-QK-A8Z7", "report": "The surgical pathology report includes multiple specimens from a composite resection and neck dissections. The composite resection specimen measured 7.0 x 4.8 x 3.4 cm and contained a white firm lesion measuring 2.7 x 2.0 x 2.0 cm. The lesion was found to involve the mandible and adjacent muscle tissue, with the closest deep margin measuring 0.6 cm from the right posterior aspect. All other mucosal margins were free of involvement. Histologic evaluation showed a basaloid growth pattern in the lesion.\n\nA total of 96 lymph nodes were examined across various neck levels. Of these, 5 lymph nodes showed evidence of involvement. In the left neck level 3 dissection, 3 out of 12 lymph nodes were involved, with the largest measuring 3.0 cm. In the left neck level 1 dissection, 1 out of the lymph nodes evaluated was involved. Similarly, in the right neck level 1 dissection, 1 out of 3 lymph nodes was involved. No extranodal extension was identified. The remaining lymph nodes from all other levels, including left facial, left neck levels 1A, 4, 5, 2, and right neck levels 2, 3, 4, and 5, were negative for involvement.\n\nAdditional specimens, including the anterior gingiva, myohyoid muscle, and mandibular margins, were all negative for involvement. A salivary gland specimen showed chronic sialadenitis without evidence of a mass. The anterior mandible specimen had clear margins after decalcification.\n\nGross examination of the composite resection confirmed a firm white lesion involving the mandible and surrounding soft tissues. The tumor was unifocal and measured 2.6 cm at its greatest dimension. No lymphovascular or perineural invasion was identified. The surgical procedure included a partial mandibulectomy, bilateral neck dissection, and additional reconstructive measures."} +{"pid": "TCGA-85-8666", "report": "The specimen consists of lung tissue from a pneumonectomy. The tumor is located in the upper lobe and measures 4 cm in greatest dimension. It is a moderately differentiated epithelial tumor arising in the bronchus. The tumor appears grey-pinkish on gross examination. Surgical margins are uninvolved. Six lymph nodes were examined, including those from the aortic window, bifurcational, and bronchopulmonary regions; none show evidence of metastasis. There is no venous invasion identified. Additional findings include anthracosis. Other features such as lymphatic invasion, presence of additional tumor nodules, and response to neoadjuvant treatment were not specified."} +{"pid": "TCGA-A7-A26H", "report": "The pathology report includes multiple specimens from bilateral axillary sentinel lymph nodes and breast tissue. \n\n**Specimen A (Left Axillary Sentinel Node):** A lymph node measuring 1.2 cm in greatest dimension was identified within a soft tissue specimen measuring 2.5 x 2 x 0.8 cm. Histologic evaluation revealed the presence of metastatic cells within this lymph node, with the largest deposit measuring 0.7 cm. No extranodal extension was observed. \n\n**Specimen B (Left Breast):** The resected breast specimen measured 19.5 x 18.5 x 3.0 cm and included an overlying skin ellipse measuring 16 x 9.3 cm. A central areola and nipple were present. Gross examination identified an area of induration at the superior edge of the areola, measuring 1.5 x 0.7 cm, possibly representing a biopsy scar. A firm red area measuring approximately 1.5 cm was noted centrally and inferiorly, with another firm area measuring about 1.2 x 1.5 cm located beneath the indurated skin. Microscopic analysis showed invasive cellular proliferation consistent with infiltrating ductal morphology. The tumor measured 1.5 cm and was classified as grade 1 (Elston SBR grading system; A/N/M = 2/2/1) with a mitotic index of 3 mitoses per 10 high-power fields. No vascular invasion or calcifications were identified. Margins were negative. Adjacent benign findings included scar tissue, cyst formation, columnar metaplasia, benign calcifications, usual ductal hyperplasia, and focal atypical ductal hyperplasia. Staging was determined as pT1 pN1a. \n\n**Specimen C (Right Axillary Sentinel Node):** Two pieces of soft tissue measuring 2 x 1.8 x 0.7 cm and 2.5 x 2.5 x 0.7 cm contained a single lymph node measuring 1 cm in diameter. Histologic evaluation showed no evidence of malignant involvement. \n\n**Specimen D (Right Axillary Sentinel Node #2):** A soft tissue specimen measuring 5.5 x 3 x 0.6 cm included a partially blue-stained lymph node measuring 2.3 cm in greatest dimension. Histologic examination revealed no signs of malignancy. \n\n**Specimen E (Right Breast):** The right breast resection measured 27 x 19 x 4.5 cm with an overlying skin ellipse measuring 16.5 x 9 cm. Central firmness consistent with a distinct lesion was identified. Microscopic evaluation demonstrated invasive cellular infiltration with features of infiltrating ductal morphology. The tumor measured 1.2 cm and was graded as 2 (Elston SBR grading system; A/N/M = 3/2/1), with a mitotic index of 3 mitoses per 10 high-power fields. No vascular invasion or calcifications were seen. The tumor exhibited a central fibrotic focus. Sections away from the primary lesion showed columnar metaplasia, usual ductal hyperplasia, cyst formation, apocrine metaplasia, and an atypical area positive for p63 staining. Staging was determined as pT1. \n\n**Specimen F (Left Axillary Contents):** A soft tissue specimen measuring 12 x 8 x 2 cm contained four lymph nodes. Histologic evaluation showed no evidence of malignant involvement in any of these nodes. \n\nAll measurements, histologic features, and staging details have been summarized without reference to specific diagnostic terminology."} +{"pid": "TCGA-GV-A6ZA", "report": "The submitted specimen included multiple tissue samples from the left and right distal ureters, right pelvic wall, urethral margin, pelvic lymph nodes, bladder, and prostate. Microscopic examination of the left distal ureter showed markedly denuded mucosa with no evidence of neoplasm. The right distal ureter was similarly negative for dysplasia or neoplastic changes. A biopsy of the right pelvic wall revealed benign fibromuscular tissue with myxoid changes. The urethral margin showed no signs of dysplasia or neoplasia. Twelve pelvic lymph nodes were examined, and none contained any evidence of malignant cells.\n\nA radical cystoprostatectomy specimen revealed invasive high-grade papillary epithelial changes in the bladder with focal glandular features. The tumor measured 3.5 cm in greatest dimension and extended into the muscularis propria (detrusor muscle) but did not reach the margins of resection. Cystitis cystica et glandularis with mucinous metaplasia was also noted. All resection margins, including those of the ureter, urethra, and soft tissues, were free of involvement.\n\nIn the prostate specimen, there was a small focus of cellular changes consistent with acinar-type differentiation, with a Gleason score of 3+3=6. The affected area was unifocal, measuring less than 1% of the prostate volume, with a maximum dimension of 1 mm. This lesion was confined to the prostate without evidence of extraprostatic extension or seminal vesicle involvement. Surgical margins were negative, and no lymphovascular invasion was identified. Additional findings in the prostate included benign prostatic hyperplasia, multifocal atrophy with inflammation, and atherosclerotic changes in periprostatic vessels.\n\nLymph node analysis showed no metastatic involvement. Immunohistochemical staining supported the absence of normal basal cell layers in certain atypical glands, reinforcing the presence of altered cellular architecture in the bladder and prostate regions examined."} +{"pid": "TCGA-A8-A090", "report": "The specimen consists of an ablated breast sample containing a moderately differentiated invasive component. The lesion measures 2.7 cm in greatest dimension. The dorsal resection margin is free of tumor involvement. Histologic evaluation shows no evidence of lymphovascular invasion. Lymph node examination reveals no metastatic disease."} +{"pid": "TCGA-QR-A70N", "report": "The left adrenal specimen measures 8 x 5 x 4.5 cm and weighs 108 grams. The cut surface is nodular and tan to brown in color, with the largest nodule measuring 4.0 cm in diameter. No distinct normal adrenal gland structure is apparent, though small yellow foci are observed near the periphery of the largest nodule. A central section of the largest nodule, measuring 2.2 x 1.8 x 1.0 cm, was selected for further analysis. Histologically, the tissue shows cellular features consistent with a well-defined lesion. Immunohistochemical staining demonstrates variable positivity in scattered ganglion-like cells. Adjacent cortical tissue reveals areas of micronodular change suggestive of hyperplasia. All margins are free of involvement. No other significant pathological findings are identified."} +{"pid": "TCGA-3B-A9HV", "report": "The specimen consists of a supracervical uterus with attached bilateral tubes and ovaries, weighing 1319 grams. The uterus is markedly distorted, measuring 17.2 x 9.8 x 13.4 cm. The serosal surface is focally shaggy and congested on the right lateral wall and fundus. Upon opening, there is a submucosal polyp distorting the endometrial cavity. A lobulated, focally congested, glistening tan-gray tumor measuring 14.9 x 9.8 cm is present, with approximately 15% necrosis. The tumor extends to the disrupted serosa at the right cornu. The endometrial lining is glistening and tan, measuring 0.1 cm in thickness. The myometrium is dense and tan-gray, measuring 3.2 cm in thickness, and contains three intramural nodules with a maximum size of 5.0 cm. \n\nSections show a hypercellular tumor with marked cellular atypia, areas of necrosis, and increased mitotic activity. Tumor emboli are identified within vascular spaces in the right paratubal soft tissue. Tumor involvement is also noted in the right parametrial tissue. The right fallopian tube measures 6.5 cm, is edematous and purple-gray; it has a patent lumen. The right ovary, measuring 2.5 x 1.8 x 1.1 cm, is smooth and lobulated with dense tan-gray stroma. The left fallopian tube, previously transected and measuring 6.5 cm, is smooth to shaggy and purple-gray, with a dilated lumen containing tan-yellow material. The left ovary, measuring 2.7 x 2.5 x 1.6 cm, has a smooth to shaggy surface, purple-gray in color, with a 1.5 cm hemorrhagic subcortical cyst and dense purple-gray stroma.\n\nMicroscopic evaluation includes representative sections from various regions including full-thickness tumor extending to disrupted serosa, tumor adjacent to endometrium, tumor at the fundal serosa, and involvement of the myometrium. Additional sections include right and left adnexal structures and parametrial tissues. Pathologic staging is determined as T2 Nx Mx. All slides were personally reviewed by the attending pathologist, who rendered the final assessment."} +{"pid": "TCGA-VQ-A91Y", "report": "The specimen involves the stomach, specifically the body and antrum. The lesion measures 9.0 cm as the largest dimension and is associated with ulceration. Histologic evaluation reveals a tubular growth pattern with poor differentiation (Grade III). The tumor invades through to the serosa and approaches the distal surgical margin, where neoplastic glands are identified at a distance of 1 mm from the margin. The proximal margin is free of involvement. Vascular invasion is present, including lymphatic and blood vessel invasion. Neural invasion is also observed.\n\nExamination of regional lymph nodes demonstrates involvement in multiple chains. Involved nodes include those along the lesser curvature (16 out of 18), left gastroepiploic vessels (2 out of 4), right gastroepiploic vessels (7 out of 7), hepatoduodenal ligament (hepatic artery) (1 out of 1), suprapyloric region (1 out of 1), infrapyloric region (11 out of 11), left gastric artery (4 out of 4), anterior hepatic artery (3 out of 3), celiac trunk (4 out of 4), proximal splenic artery (1 out of 1), and hepatoduodenal ligament behind the portal vein (4 out of 4). Capsular transposition is noted in some involved nodes. Additional lymph node groups evaluated include right paracardic (0 out of 2), left paracardic (0 out of 3), short gastric vessels (0 out of 1), and mesenteric lymph node (0 out of 1), all of which are uninvolved.\n\nOther examined tissues including the esophageal margin, peritoneum from the cardia, hepatogastric ligament, and greater omentum show no evidence of involvement."} +{"pid": "TCGA-2Y-A9H2", "report": "The liver specimen from segments 4B and 5 includes a solitary lesion measuring 3.4 cm in maximum dimension. Histologic evaluation reveals a poorly differentiated cellular proliferation arranged in trabeculae with focal sclerotic stromal reaction. The tumor extends into the subserosal layer of the adjacent gallbladder but does not involve the gallbladder wall. Perineural invasion is present; no evidence of lymphatic or vascular invasion is identified. The hepatic parenchymal margin is free of invasive disease. One periportal lymph node examined shows no involvement by malignant cells. No additional significant pathological findings are noted. Gross examination confirms the tumor's location and its proximity to surrounding structures, with the closest parenchymal margin measuring 1.1 cm from the tumor. The gallbladder lumen contains bile and demonstrates a granular mucosal surface without direct tumor extension. Multiple representative tissue sections have been submitted for further analysis."} +{"pid": "TCGA-CZ-4859", "report": "The specimen consists of a right kidney measuring 11.0 x 6.5 x 4.3 cm and weighing 313.5 grams. The kidney includes a ureter measuring 8.8 x 0.3 cm, a stapled renal vein of 2.1 x 1.2 cm, and a renal artery of 3.5 x 0.3 cm. A well-circumscribed tan/yellow, focally cystic mass measuring 5.0 x 4.3 x 2.5 cm is identified. The mass is located approximately 9.0 cm from the ureter, 2.0 cm from the vein, and 1.8 cm from the renal artery. Grossly, the tumor does not appear to involve the renal vein and appears confined to the kidney.\n\nMicroscopic evaluation confirms that the tumor is limited to the kidney. Vascular and ureteral margins are free of tumor involvement, and no lymphovascular invasion is identified. Representative sections of the tumor were submitted for analysis, including additional fragments for cytogenetic, electron microscopy, and tissue banking purposes. Sections of normal kidney tissue were also submitted for similar studies.\n\nStaging according to the AJCC 6th edition classification system indicates a T1 NO MX status. No metaphases were available for karyotyping, and therefore, cytogenetic analysis could not be completed.\n\nEvaluation of the non-neoplastic kidney tissue reveals minimal chronic changes, including focal global glomerulosclerosis in 2.0% of glomeruli, minimal tubular atrophy, and interstitial fibrosis affecting less than 10% of the parenchyma. Mild arterial sclerosis is also present. These findings are considered within expected age-related ranges."} +{"pid": "TCGA-EW-A2FV", "report": "The left mastectomy specimen contains a lesion measuring 7.5 cm in greatest dimension, with involvement of 13 out of 14 tissue blocks, comprising approximately 80% of the sampled tissue. Microscopic evaluation reveals poorly differentiated features with Nottingham Histologic Grade 3 (score of 9 based on tubule formation, nuclear pleomorphism, and mitotic count). The invasive component is present within close proximity to both anterior and posterior margins (<0.1 cm). Extensive lymphovascular invasion is noted across multiple blocks.\n\nA focus of high-grade intraductal proliferation with micropapillary architecture is identified in one block. Dermal lymphovascular invasion is also present. Skeletal muscle is present but shows no evidence of tumor involvement.\n\nLymph node dissection reveals metastatic involvement in all sampled regions. In the intra-mammary lymph nodes, all five nodes show metastases with extranodal extension. In the axillary dissection, 17 out of 20 nodes are positive for metastasis, with the largest deposit measuring 2.9 cm. Two level III lymph nodes and five lymph nodes above the brachial plexus are all involved, with largest deposits measuring 2.2 cm and 1.8 cm respectively. Overall, 29 out of 32 lymph nodes contain macrometastases.\n\nPathologic staging indicates a primary tumor larger than 50 mm (pT3) and regional lymph node metastases involving 10 or more axillary nodes with at least one deposit greater than 2 cm (pN3a). No distant metastasis is identified.\n\nMargins are free of invasive carcinoma and ductal carcinoma in situ. There is no known prior neoadjuvant treatment. Immunohistochemical staining for hormone receptors and HER2 is pending. A separate fibroadipose tissue specimen from the breast is negative for malignancy.\n\nGrossly, the mastectomy specimen weighs 190 grams and measures 16.0 x 11.0 x 1.0 cm. A tan, ill-defined mass measuring 7.5 x 6.0 x 2.0 cm is located retro-areolarly and extends near the deep margin. Multiple sections were submitted for analysis from various quadrants and margins. Lymph node specimens submitted vary in size and number, with extensive involvement by metastatic disease observed microscopically."} +{"pid": "TCGA-R6-A6KZ", "report": "A biopsy of tissue from the esophagogastic junction at 37 to 48 centimeters shows infiltrating poorly differentiated and mucinous adenocarcinoma with scattered signet ring cells. The sample also contains areas of overlying squamous epithelium, which displays balloon cells and nonspecific reactive changes. Bacterial colonies are present. Villiform columnar-lined mucosa is noted, along with high-grade columnar epithelial dysplasia and intramucosal adenocarcinoma.\n\nGrossly, the specimen consists of multiple red-tan soft tissue fragments measuring a total of 1.0 x 0.3 x 0.2 cm, all of which were submitted for analysis.\n\nImmunohistochemical staining was performed on a representative section. HER2 staining showed 10% positivity in invasive tumor cells with complete membrane staining. The staining pattern was not uniform but exhibited a homogeneous, dark circumferential appearance. According to established criteria, cases with uniform, intense, and complete membrane staining in more than 30% of invasive tumor cells are considered positive (Score 3+). Cases with no staining or weak, incomplete membrane staining in any proportion of cells are considered negative (Score 0 or 1+). Equivocal cases show strong staining in \u226430% of cells or non-uniform or weak complete membrane staining in at least 10% of tumor cells (Score 2+). Based on this system, the HER2 staining in this case is classified as Score 1+."} +{"pid": "TCGA-GL-A59T", "report": "The operative procedure involved a left laparoscopic radical nephrectomy. The specimen consisted of a left kidney with overall dimensions of 23.4 x 8.7 x 5.2 cm. Attached fat was present, and the renal parenchyma measured 14.2 x 6.4 x 3.8 cm. An adrenal gland was not identified. Multiple nodules and masses were observed throughout the kidney, with a total of approximately 12 identified. The largest mass measured 6.7 x 5.9 x 4.4 cm and was located in the lower pole. Additional smaller foci ranged from 0.2 x 0.2 x 0.2 cm to 1.7 cm. These lesions varied in color from yellow-orange to red-brown, with granular to variegated and occasionally hemorrhagic appearances. Some of the nodules extended to the renal capsule but did not extend beyond it. Renal sinus fat and perinephric fat showed no gross invasion. The renal vein was not involved and appeared negative at the margin.\n\nMicroscopic evaluation revealed multiple distinct lesions. One dominant lesion and several smaller ones were identified, varying in size and location. Histologic features included a combination of cellular patterns. Cellular grading was assessed as Fuhrman grade 2 of 4. Sarcomatoid features were not identified. No cancer was found at the resection margins. A search of hilar lymph nodes, including palpation and chemical clearing, revealed none. Additional findings included the presence of cysts ranging from minute to 1.2 cm in size, containing serous fluid. The renal cortex exhibited granular texture and contained multiple ill-defined yellow-orange foci similar in appearance to the nodules. Hemorrhagic papillary tips were also noted. Histologic blocks submitted included those from the dominant mass, smaller nodules, cystic areas, hemorrhagic regions, and normal renal parenchyma. Numerous small benign-appearing lesions were identified in the nonneoplastic kidney. The pathologic staging was determined to be pT1b with no lymph node involvement (pNX) and no distant metastasis."} +{"pid": "TCGA-WC-A87W", "report": "The specimen consists of an intact enucleation specimen of the left globe measuring 22 x 22 x 23 mm, with an attached optic nerve measuring 9 mm in length. The anterior chamber is formed, with a blue-gray iris measuring 10 x 11 mm surrounding a round 6 mm pupil. The external appearance of the eye and sclera is unremarkable. A shadow is noted 12 mm from the limbus, located from 2 to 4 o\u2019clock, approaching the optic nerve. On cut section, this corresponds to a lesion in the choroid region measuring 1 cm at its base and 5 mm in height. The ciliary body appears uninvolved, and the underlying sclera remains intact. Histologically, the lesion demonstrates a cellular composition primarily composed of spindle-shaped cells. The tumor extends through the majority of the sclera in a perivascular pattern. No evidence of extraocular extension is identified. Vortex veins and optic nerve are free of involvement. Sections include regions of the vortex veins (superior nasal, superior temporal, inferior temporal, inferior nasal), a pupil-optic nerve section, calottes (with A7 harvested), and the optic nerve margin."} +{"pid": "TCGA-B3-3925", "report": "The specimen consists of a partial nephrectomy with loosely attached perinephric fat, labeled as \"left renal mass.\" The renal cortical tissue measures 3.9 x 4 cm at its base. On the surface of the specimen is a protruding dome-shaped lesion measuring 1.5 cm above the surrounding renal tissue. Upon sectioning, this corresponds to a soft tan-yellow lesion measuring 3.1 x 3.1 cm and appears in close proximity to the deep resection margin, although the margin itself is free of tumor involvement. Peripheral margins are unaffected. No tumor nodules are identified within the attached perinephric fat.\n\nHistologically, the lesion demonstrates features consistent with a nuclear grade of 2 according to Fuhrman grading. The lesion measures 3.1 cm in maximum dimension and extends through the renal capsule with minimal involvement of surrounding fat. All surgical margins are negative for tumor. Lymph node and distant metastasis status cannot be assessed. There is no evidence of vascular invasion or significant pathology in the non-neoplastic kidney tissue."} +{"pid": "TCGA-IB-A6UF", "report": "The specimen was received for evaluation of a mass located in the head of the pancreas. The resection included a portion of the pancreas, duodenum, gastric pylorus, and common bile duct. The pancreatic tissue measured 6.5 x 5.5 x 3.0 cm. A firm, ill-defined mass measuring 3.3 cm in greatest dimension was identified in the pancreatic head. The mass appeared whitish and homogenous on cut surface, with no necrosis, hemorrhage, or cystic changes noted. Tumor involvement was observed in the peripancreatic soft tissues and fat, with extensive perineural invasion and presence of lymphatic invasion. No angiovascular invasion was identified.\n\nMargins were assessed: the vascular bed margin was involved by tumor, as was the uncinate process margin. The pancreatic distal transection margin was 0.3 cm away from the tumor. A total of 17 peripancreatic lymph nodes were examined, with 7 showing metastatic involvement. Additionally, 5 periduodenal lymph nodes were evaluated and found to be free of metastasis. The duodenal mucosa did not show tumor involvement.\n\nAdditional specimens included omental fat, which showed no malignancy; a gallbladder specimen with cholelithiasis and mild chronic cholecystitis, along with two reactive cystic duct lymph nodes; and a portal lymph node that was reactive and without malignancy.\n\nGross examination of the Whipple specimen revealed a narrowed middle portion of the common bile duct measuring 0.5 cm in diameter, with surrounding fibrotic tissue. The proximal bile duct mucosa was denuded. Multiple cross sections of the tumor and margins were submitted for analysis, including areas near the resection, vascular, and uncinate margins. Lymph nodes retrieved from the peripancreatic and periduodenal regions were also sampled extensively.\n\nStaging assessment indicated pT3 based on tumor extension beyond the pancreas but without involvement of major vessels such as the celiac axis or superior mesenteric artery. Regional lymph node involvement was classified as pN1 due to the presence of metastases in peripancreatic nodes. Distant metastasis could not be determined (Mx)."} +{"pid": "TCGA-FD-A3B6", "report": "The surgical specimens were received and processed as follows: right and left pelvic lymph nodes, segments of the left and right distal ureters, and a cystoprostatectomy specimen including the bladder, prostate, seminal vesicles, and vas deferens.\n\nLymph node dissection included five right pelvic lymph nodes and ten left pelvic lymph nodes; all were negative for tumor involvement. Both distal ureter specimens were also negative for tumor.\n\nThe cystoprostatectomy specimen showed a mass in the bladder measuring 4.1 cm in greatest dimension, located at the right lateral and posterior walls. The mass extended into the muscularis propria and perivesicular fat. The surrounding mucosa appeared unremarkable. Proximal, distal, and soft tissue margins were all free of tumor involvement. No evidence of tumor was found in the seminal vesicles or vas deferens.\n\nHistologic evaluation revealed invasive high-grade papillary features with poorly differentiated pleomorphic areas and focal glandular differentiation. The tumor was multifocal and confined to the bladder without lymph node involvement (pT2b, N0, MX). Staging was based on the 7th edition TNM classification system.\n\nIn the prostate, histologic findings included a Gleason score of 3+3=6 and perineural invasion. Tumor volume was estimated at 5% within the peripheral zone bilaterally. High-grade prostatic intraepithelial neoplasia was noted multifocally. All surgical margins\u2014apical, basilar, and peripheral\u2014were negative for tumor involvement. Lymph nodes associated with the prostate were also negative for tumor (0/15).\n\nNo extraprostatic extension was identified. The prostate capsule was intact, and no tumor involvement was seen in the seminal vesicles."} +{"pid": "TCGA-06-0237", "report": "The patient presented with a recent onset of seizures and was found to have a right frontal mass as well as a right temporal intra-axial enhancing lesion. Two brain tumor specimens were obtained for analysis.\n\nThe excisional biopsies from the right temporal region reveal a neoplastic process characterized by astrocytic proliferation that diffusely infiltrates and focally disrupts the surrounding brain tissue. Nuclear anaplasia is present, along with frequent multinucleated cells, mitotic figures, and microvascular proliferation.\n\nImmunohistochemical analysis demonstrates sparse glial fibrillary acidic protein (GFAP) expression, indicating limited astrocytic differentiation. Synaptophysin and neurofilament protein (NFP) staining show a faint positive background, supporting the infiltrative nature of the neoplasm. Neu N staining highlights scattered small neurons entrapped within the tumor. Over 50% of the neoplastic cells show p53 overexpression, and the MIB-1 labeling index is 28%, indicating a high proliferation rate.\n\nGross examination of specimen A shows several semi-firm, tan-yellow, glistening fragments measuring 0.6 cm in aggregate. Specimen B consists of multiple irregular red-gray-tan tissue fragments measuring 4 x 1.0 x 0.8 cm and weighing 0.32 grams.\n\nHistological evaluation included various stains and blocks for both specimens. Special studies are ongoing and will be reported separately."} +{"pid": "TCGA-X6-A8C3", "report": "The surgical specimen consists of an excised mass from the right leg, submitted with orientation markers indicating proximal (12 o\u2019clock) and anterior (3 o\u2019clock) margins. The overall specimen measures 8.0 x 7.5 x 3.0 cm and includes skin, subcutaneous tissue, and superficial tendinous muscle and fascia. A central vertical linear defect is noted on the skin surface measuring 2.1 x 2.5 cm, with a red-tan necrotic mass protruding from its center. Measurements of the defect in relation to orientation markers are as follows: 2.8 cm from the 12 o\u2019clock aspect, 2.4 cm from the 3 o\u2019clock, 2.0 cm from both the 6 and 9 o\u2019clock aspects.\n\nUpon sectioning, a well-circumscribed ovoid mass is identified within the subcutaneous tissue, measuring 4.0 x 3.0 x 2.3 cm. It has a tan-red-white gelatinous appearance with focal necrosis, which accounts for approximately 30% of the tumor volume. The tumor appears to bulge slightly upon cutting and measures 4.0 x 3.0 x 2.6 cm in size. The tumor is confined to the subcutaneous layer, with focal extension into the underlying fibroconnective fascia; skeletal muscle is not involved. No vascular invasion or lymph node involvement is identified.\n\nMargins are assessed with respect to the tumor. The tumor extends to within less than 0.1 cm of the deep margin, 0.4 cm from the distal margin, and 0.5 cm from the posterior margin. Other margins show greater distances: 1.0 cm at the anterior (3 o\u2019clock), 2.2 cm at the 9 o\u2019clock, 1.3 cm at the 6 o\u2019clock, and 2.8 cm at the 12 o\u2019clock margin. The tumor involves the anterior soft tissue margin.\n\nMicroscopic evaluation confirms high-grade morphology with a mitotic count of 40 per 10 high-power fields. The tumor exhibits myxoid features with focal necrosis and no evidence of vascular invasion or inflammatory infiltrate. The maximal dimension of the tumor is 4.0 cm. There is no evidence of pre-existing benign lesion or satellite nodules.\n\nBased on available material, the pathologic staging assessment indicates a deep-seated tumor measuring 5 cm or less in greatest dimension with no regional lymph node metastasis identified (pT1b pNx). Block A1 is recommended for molecular studies."} +{"pid": "TCGA-EJ-7123", "report": "The surgical specimen included a prostate weighing 61.5 grams with bilateral seminal vesicles. A nodule was identified with a maximum dimension of 1.3 cm, involving both the right and left lobes. The lesion demonstrated poorly differentiated histology and exhibited a Gleason score pattern. Approximately 15% of the prostate volume was involved by the lesion. Microscopic evaluation revealed capsular invasion; however, no extracapsular extension was observed. Both seminal vesicles were uninvolved. All surgical resection margins were free of abnormal cells, although perineural invasion was noted on specific slides. No angiolymphatic invasion was present. High-grade intraepithelial changes were also identified in multiple areas. Lymph node assessment included 22 pelvic nodes (9 from the right side and 13 from the left), all of which showed no evidence of involvement. Based on these findings, the pathologic staging classification was assigned as pT2c with no nodal involvement. The histologic grade was consistent with a poorly differentiated morphology. Additional findings included benign prostatic hyperplasia and chronic active inflammation. A minor proximity of less than 0.1 mm was noted between the lesion and the left anterior apex margin, though the margin itself showed no presence of abnormal cells."} +{"pid": "TCGA-DU-A76L", "report": "The specimen consists of two fresh tissue fragments measuring 1.1 cm in aggregate, described as soft, focally hemorrhagic, and glistening. A second specimen from the right temporal region measures 2.0 x 1.8 x 0.2 cm and consists of fragmented tan-red soft tissue with scant blood clot. All sections were submitted for analysis.\n\nMicroscopic examination reveals a highly cellular neoplasm involving the brain tissue. The neoplastic cells are glial in origin and display round or ovoid nuclei with marked anaplastic features. The tumor demonstrates a fibrillary background with prominent microvascular proliferation. Frequent mitotic figures are observed, along with individual cell necrosis and geographic areas of tumor necrosis. At the tumor periphery, some neoplastic cells exhibit perinuclear halos, suggesting a possible oligodendroglial morphology. In certain regions, the neoplasm shows distinct zones with features of high-grade transformation.\n\nImmunostaining with GFAP highlights the fibrillary nature of the tumor and confirms the presence of microvascular proliferation. Using MIB-1 immunostain, a labelling index of 37% was determined, indicating a high proliferation rate.\n\nThe histological features include significant nuclear atypia, active mitotic activity, vascular proliferation, and extensive necrosis, contributing to a high histological grade."} +{"pid": "TCGA-HT-A4DS", "report": "The specimen consists of multiple biopsies obtained from the brain. The first three specimens were received fresh for frozen section analysis and measured 0.7 x 0.4 x 0.3 cm, 0.9 x 0.7 x 0.3 cm, and 0.8 x 0.7 x 0.3 cm respectively. Each consisted of soft tissue fragments ranging in color from tan-white to pink or red-tan. Smear preparations were made from each sample and examined. Portions of these specimens were submitted for frozen section with remaining tissue placed in permanent cassettes. The fourth specimen was received in formalin and measured 2.0 x 2.0 x 0.3 cm; it was entirely submitted for histologic evaluation.\n\nMicroscopic examination revealed a markedly hypercellular astrocytic neoplasm infiltrating both gray and white matter. Cellular atypia ranged from moderate to marked, with mitotic activity varying from rare to numerous. Specimens from the enhancing portions showed greater atypia and mitotic activity compared to others. No definitive microvascular proliferation or tumor necrosis was identified."} +{"pid": "TCGA-X6-A8C7", "report": "The surgical specimen from the left foot includes a resected mass measuring 6.7 x 3.3 x 2.7 cm, composed of skin with underlying yellow, lobular fibroadipose tissue. A suture at one tip marks the proximal margin. A portion of sesamoid bone is identified at the deep/lateral aspect. The skin surface shows a linear defect consistent with a prior incision, located close to several margins. The lesion measures 1.6 x 1.5 x 1.3 cm and is pink-tan to red-brown, variegated, firm, and well-circumscribed, located near multiple margins and in proximity to the sesamoid bone. The skin defect extends to the lesion, with surrounding hemorrhage and necrosis. A thin capsule is noted. No other lesions are found.\n\nMicroscopic evaluation reveals a mitotic count of 15 per 10 high-power fields. No significant tumor necrosis is observed. Surgical margins are negative. All relevant sections of the lesion and surrounding tissue have been submitted for analysis."} +{"pid": "TCGA-BR-8483", "report": "The specimen consists of a subtotal gastrectomy. The tumor is located in the antrum and presents as ulcerated. It measures up to 9.5 cm in greatest dimension. Histologic examination reveals moderately differentiated cells arranged in glandular structures. The tumor extends to the subserosa with invasion into perigastric fatty tissue. Venous invasion is not identified. Lymph node evaluation shows 4 out of 15 nodes positive for metastatic involvement, including those from the greater and lesser curvatures. Margins are uninvolved. There is no evidence of treatment effect. No lymphatic or perineural invasion is noted. Additional findings are not specified."} +{"pid": "TCGA-EB-A24D", "report": "The excised lesion from the skin of the shoulder measured 4.1 x 3.6 x 5.2 cm and was pigmented. Microscopic evaluation showed malignant cells. Examination of regional lymph nodes revealed 3 out of 10 were positive for metastatic involvement. No venous invasion was identified. The surgical margins were free of tumor. No other significant pathologic findings were noted."} +{"pid": "TCGA-CI-6622", "report": "The patient presented with rectal bleeding, diverticulosis, and a rectal mass. A colonoscopy with biopsy was performed. The biopsy specimen involved tissue from the rectum. Histologic evaluation revealed invasive malignant cells. The tumor exhibited well-to-moderately differentiated morphology. No specific prior malignancy, chemotherapy, radiation treatment, organ transplant, immunosuppression, or other significant medical history was provided. The specimen was assessed for staging; however, no further clinical correlation or diagnostic follow-up information was included in the report."} +{"pid": "TCGA-J4-A67S", "report": "The specimen consists of a prostatectomy sample along with lymph node fragments. The prostate, seminal vesicles, and vas deferens were submitted for analysis. The prostate gland weighs 40 grams and measures 4.0 x 3.5 x 3.0 cm. The capsule appears shaggy and is disrupted at the bladder resection margin. The right seminal vesicle measures 3.5 x 1.5 cm, and the left seminal vesicle measures 3.0 x 1.0 cm. Both vasa deferentia appear within expected size limits.\n\nHistological evaluation reveals a Gleason score of 3 + 4 = 7 out of 10. The tumor involvement in the tissue is assessed as 4 out of 5, indicating a significant portion of the tissue is affected. There is no dominant nodule identified measuring over 1 cm. No treatment effect was observed.\n\nLymph node assessment includes one intraoperative frozen section fragment measuring 1.3 x 0.6 cm and two non-frozen section lymph node fragments measuring 0.7 x 0.4 cm and 0.5 x 0.2 cm. No abnormal cellular infiltration is seen in these lymph node samples.\n\nMargins are mostly clear except for the left prostate margin, which is involved. There is no evidence of tumor extension into the seminal vesicles. Lymphatic or small vessel invasion is not observed, nor is there perineural invasion present. The specimen was staged as pT3a, with no regional lymph node involvement (pNo), and distant metastasis could not be assessed (pMX)."} +{"pid": "TCGA-FU-A3YQ", "report": "The patient is female. A right ovary and fallopian tube specimen showed surface excrescences measuring up to 0.5 cm and a corpus luteum measuring 1.5 x 1 cm. The fallopian tube was unremarkable. Additional cystic follicles were present. The left ovary and fallopian tube showed multiple cysts containing clear or hemorrhagic fluid, with sizes up to 3.5 x 1.5 cm and 1.5 cm, respectively. A corpus luteum measuring up to 0.5 cm was also noted. A paratubal cyst measuring 3 cm was identified. The fallopian tube showed no significant findings.\n\nA radical hysterectomy specimen included a cervical lesion measuring 1.7 x 1.7 cm. Microscopic evaluation showed the tumor extended 0.8 cm into a cervical wall that measured 1.8 cm in thickness. Lymphovascular space invasion was focally present. All surgical margins, including the vaginal mucosal and deep margins, were negative. The endometrium and myometrium showed no evidence of malignancy. Lymph node dissection included left and right common iliac, external iliac, and obturator regions, as well as right aortic lymph nodes. A total of 24 lymph nodes were examined: five from the left common iliac, four from the left external iliac, two from the left obturator, three from the right aortic/common iliac, seven from the right external iliac, and three from the right obturator. All were negative for metastatic disease. A vaginal biopsy was also negative for malignancy.\n\nGross examination of the right ovary and tube showed an ovarian size of 4 x 2 x 1 cm with attached cysts. The fallopian tube measured 4 cm in length and 0.5 cm in diameter. The left ovary measured 3 x 1.5 cm and contained multiple cysts. The fallopian tube measured approximately 3 cm in length. The radical hysterectomy specimen measured 7 x 6.8 x 6 cm and weighed 143 grams. The cervix measured 4 cm in length. The vaginal margin was inked and showed no lesion. The myometrium measured up to 2.8 cm in greatest dimension. The vaginal biopsy measured 0.9 x 0.5 x 0.2 cm. Lymph node specimens ranged in size from 0.4 to 2.6 cm and were embedded in fibroadipose tissue. All lymph nodes were fully submitted for histologic analysis and found to be free of metastatic disease."} +{"pid": "TCGA-NJ-A7XG", "report": "The specimen from the left lung, obtained following pneumonectomy, demonstrates a 10 x 4 x 2.5 cm white-tan mass located in the upper lobe with areas of necrosis. The mass invades through the pleura and is present 1 cm from the bronchial margin and 1 cm from the vascular margins. Multiple small nodules, ranging from 2 to 8 mm, are identified throughout the left lower lobe, with confluent nodules in the superior portion. No normal lung tissue is found in this lobe. The hilar region contains multiple lymph nodes measuring between 0.5 and 2 cm.\n\nHistologic evaluation reveals moderately differentiated features, with grade 2 histology. Lymphovascular invasion is extensive, and invasion of the parietal pleura is noted. Margins of resection, including bronchial and vascular, are uninvolved. Ten of 21 peribronchial lymph nodes show involvement. The tumor is multifocal, with separate nodules identified in different lobes. No treatment effect is observed. Non-neoplastic pathology is not present.\n\nLymph node specimens from levels 4R, AP window level 5, and level 6 are all negative for malignant involvement. Intraoperative frozen section analysis of the level 4R lymph node and the surgical margin of the left lung both show no evidence of malignancy. Elastic stain findings support the described characteristics.\n\nStaging is based on tumor size, local extension, and lymph node involvement, with the TNM classification determined as pT4N1."} +{"pid": "TCGA-N1-A6IA", "report": "The surgical pathology report describes a hysterectomy specimen including the cervix, bilateral ovaries, and fallopian tubes. A mass was identified in the endometrial cavity measuring 5.0 x 4.0 x 2.5 cm with a tan-gray to tan-brown exophytic appearance. The mass extends into the myometrium, predominantly in the posterior fundus, with deep invasion observed (92% myometrial invasion, depth of 2.4 cm). The tumor approaches within 0.5 cm of the cervical os on the posterior aspect and is located close to the uterine serosa, with focal extension to within 0.2 cm of the posterior uterine serosa. A suspicious focus for lymphovascular invasion is noted.\n\nHistologic evaluation reveals high-grade morphology with poor differentiation. Immunohistochemical staining demonstrates patchy positivity for muscle markers including caldesmon, desmin, and smooth muscle actin (SMA), along with positivity for P16 and CD10. Cytokeratin shows patchy staining as well. Additional findings include a benign intramural nodule in the anterior fundus measuring 1.0 cm. The remainder of the endometrium shows proliferative changes with endometritis. Acute and chronic cervicitis are also present.\n\nThe right ovary contains a hemorrhagic corpus luteum cyst measuring 1.3 cm, and the right fallopian tube demonstrates paratubal cysts. No significant histopathologic findings are identified in the left ovary or fallopian tube. The omentum biopsy reveals fibroadipose tissue with extensive acute inflammation and reactive changes. No tumor involvement is identified in the bilateral ovaries, fallopian tubes, or omentum.\n\nLymph node assessment includes six lymph nodes from the left pelvic region, all negative for tumor involvement. In the right pelvic region, no discrete lymph nodes were identified; the specimen consists of fibroadipose tissue with extensive acute inflammation and cautery artifact.\n\nStaging is based on pathologic findings. According to AJCC classification, the staging is pT1a. Based on FIGO criteria, the tumor appears confined to the uterus with deep myometrial invasion but without cervical stromal involvement. Regional lymph node metastasis could not be fully assessed due to limited sampling, and distant metastasis cannot be determined at this time.\n\nAncillary studies including ER, PR, and several immunohistochemical markers are performed, though some results remain pending. Multiple immunostains support the presence of at least focal muscle differentiation within a high-grade spindle cell neoplasm with fascicular morphology.\n\nAdditional gross findings include a cervix lined by mucosa with a patent os, and a uterus measuring 15.0 cm from fundus to ectocervix. The attached adnexal structures show no other significant abnormalities aside from those previously described. All specimens were processed and submitted according to standard protocols, with appropriate controls used for immunohistochemical testing."} +{"pid": "TCGA-BR-7958", "report": "The specimen consisted of excised tissue from the fundus measuring 3.5 x 3 x 1 cm. Microscopic examination revealed poorly differentiated cells arranged in a disorganized growth pattern. The lesion extended into adjacent structures, specifically involving the lesser omentum. No lymph node metastases were identified among the four regional lymph nodes examined. There was no evidence of involvement at the surgical margins. Other features such as lymphatic, venous, or perineural invasion were not specified. No additional pathologic findings or comments were noted."} +{"pid": "TCGA-PJ-A5Z9", "report": "The pathology report describes a left partial nephrectomy specimen. A solitary mass was identified within the specimen, measuring 6 cm in greatest dimension. Microscopic evaluation demonstrated cells with nuclear features corresponding to Grade 3 according to the Fuhrman histologic grading system. The tumor did not show direct extension beyond the kidney and there was no sarcomatoid component identified. No lymphovascular invasion was observed outside of the renal vein; however, renal vein involvement could not be assessed. No significant pathologic findings were noted in the non-neoplastic portions of the kidney, and adrenal tissue was not present in the specimen.\n\nAll surgical margins were free of malignant cells. Lymph nodes were not assessable. Based on AJCC staging criteria, the primary tumor was classified as pT1b. No lymph node involvement was determined (pNX), and distant metastasis was not applicable. Gross examination revealed a soft, nodular, red-gray mass measuring approximately 6 cm in size. The mass appeared close to the inked surgical margin, coming within 0.1 cm, but did not grossly invade through the renal capsule. Surrounding the tumor was a rim of normal-appearing renal parenchyma. Representative sections including the surgical margin and tumor periphery were submitted for further analysis."} +{"pid": "TCGA-06-0126", "report": "The pathology report describes a brain biopsy specimen from the left posterior frontal region. The tissue fragment measured 1 x 0.9 x 0.2 cm and was described as pink-tan, rubbery, and soft. All three sections submitted for analysis showed a high-grade glial tumor characterized by increased cellularity, presence of mitotic figures, and prominent endothelial hyperplasia. One section also contained an area of necrosis. Immunostaining with MIB-1 demonstrated a proliferation index of approximately 25%."} +{"pid": "TCGA-2Z-A9JS", "report": "The partial nephrectomy specimen from the left kidney measures 2.5 x 2.0 x 2.0 cm and contains a well-defined tan-yellow mass with areas of hemorrhage and necrosis. The mass measures 2.2 x 1.5 x 1.0 cm and is located 0.1 cm from the nearest inked parenchymal margin. Histologic evaluation reveals a neoplasm composed of papillary structures with nuclear features ranging from grade II to III, predominantly grade III. No sarcomatoid differentiation, tumor necrosis, perineural invasion, or angiolymphatic invasion is identified. The tumor is confined to the kidney without extension beyond the organ capsule. Surgical margins are negative for malignant cells. Regional lymph node assessment was not possible. Distant metastasis could not be evaluated. Frozen section analysis of the deep margin showed no evidence of malignancy. All slides were personally reviewed by the attending pathologist."} +{"pid": "TCGA-BP-4981", "report": "The right kidney specimen, along with renal vessels, ureter, and parinephric fat, weighs 667.5 g. The kidney measures 12.6 x 7.5 x 6.0 cm. A well-defined, yellow to light tan, lobulated mass measuring 8.6 x 7.5 x 6.0 cm is present in the superior portion of the kidney. The mass appears confined within the renal capsule and compresses the renal pelvis without perforation. A tumor thrombus is identified within the renal vein. The remainder of the kidney shows a pink-brown parenchyma with a distinct cortico-medullary junction. The adrenal gland measures 3.3 x 1.7 x 0.7 cm and is unremarkable. The ureter measures 9.5 cm in length and 0.4 cm in diameter; the renal vein measures 0.3 cm in length and 0.7 cm in diameter. All surgical margins are free of tumor involvement. Histologically, nuclear features are consistent with high-grade morphology. No lymph nodes are identified. The tumor extends into the renal vein or vena cava below the diaphragm.\n\nA separate specimen from the falciform ligament consists of fibrotic and adipose tissue without significant pathological findings."} +{"pid": "TCGA-KN-8426", "report": "The specimen consists of a left kidney removed via hand-assisted laparoscopic nephrectomy. The kidney weighed 659.5 grams and measured 19.0 x 12.5 x 7.8 cm. The ureter was 11.0 cm in length and 0.7 cm in diameter, the renal artery measured 2.0 cm in length and 1.0 cm in diameter, and the vein was 1.1 cm in both length and diameter. A heterogeneous mass measuring 11.5 x 10.5 x 5.3 cm was identified in the lower pole, abutting the kidney capsule. The mass was located 1.3 cm from the vein, several centimeters from the artery, and 12.5 cm from the ureter. It had areas of cystic degeneration and hemorrhage, with some golden yellow regions noted. A tan/red/yellow blood clot was found within the renal pelvis.\n\nMicroscopic evaluation revealed extensive necrosis and calcification within the mass. Frequent mitotic figures were observed. Invasion into adipose tissue at the hilum and into the renal pelvis was present. The lesion was confined by the capsule, and lymphovascular invasion was identified. Margins of the renal artery, vein, and ureter showed no evidence of involvement.\n\nSections of normal renal parenchyma were examined using special stains, including immunofluorescence and electron microscopy. Glomeruli showed signs of hypertrophy and mild mesangial expansion, suggestive of early diffuse changes. There was minimal chronic damage to the renal parenchyma, including focal global glomerulosclerosis involving approximately 4% of glomeruli, and less than 5% of the cortex showed tubular atrophy and interstitial fibrosis. Arterial and arteriolar sclerosis was moderate. No significant glomerular basement membrane abnormalities were seen on PAS or Jones\u2019 silver stain. Distal tubules contained PAS-positive hyaline casts, and there was focal interstitial inflammation associated with areas of atrophy."} +{"pid": "TCGA-QH-A65V", "report": "The specimen was received from a female patient and originated from the frontal lobe. Gross examination revealed a well-circumscribed lesion with a grayish-white cut surface. Microscopic evaluation demonstrated a neoplastic process characterized by a monomorphic population of cells with round to oval nuclei, perinuclear halos, and a delicate fibrillary background. Calcifications were present, and a branching capillary network was observed. Mitotic activity was low. No necrosis or microvascular proliferation was identified. The tumor cells were diffusely positive for IDH1 immunostain, and molecular analysis showed 1p/19q co-deletion. Based on histological and molecular features, the lesion is classified as a low-grade glioma."} +{"pid": "TCGA-BJ-A0Z3", "report": "A total thyroidectomy specimen weighed 29 grams and revealed two tumor foci in the left lobe measuring 1.3 cm and 0.8 cm. Both lesions were confined to the thyroid gland and showed follicular variant morphology. No angiolymphatic invasion was identified. A chronic lymphocytic thyroiditis was present. One perithyroidal lymph node from the isthmus showed no evidence of tumor involvement. Additionally, two central compartment lymph nodes were examined and did not contain tumor. Pathologic staging was determined as pT1 N0. Surgical margins were free of tumor involvement. Molecular testing identified a BRAF V600E mutation at low level within the tumor cells. This finding was confirmed by direct sequencing; however, only a small fraction of tumor cells demonstrated this mutation despite a high purity of epithelial cells based on GAPDH and KRT7 controls. Testing for mutations in NRAS codon 61, HRAS codon 61, KRAS codons 12/13, and rearrangements involving RET/PTC1, RET/PTC3, and PAX8/PPAR\u03b3 was negative. Amplification of control genes was adequate and nucleic acid quantity was sufficient for analysis. The limit of detection for mutations was approximately 10% mutant alleles in a background of normal DNA. BRAF mutations are often associated with aggressive clinical behavior when present at high levels, but the significance of low-level positivity remains uncertain. RAS mutations and gene rearrangements such as RET/PTC or PAX8/PPAR\u03b3 have been linked to malignancy in a significant proportion of thyroid nodules, though these were not detected in this case. Given that molecular findings may correlate highly with malignancy, interpretation should be integrated with clinical findings, imaging, and cytology. False-positive BRAF mutation results have rarely been reported and must be considered in context."} +{"pid": "TCGA-AA-3941", "report": "The specimen consists of a right hemicolectomy preparation with tumor-free oral and aboral resection margins. The colon shows an ulcerated lesion in the ascending colon, which is moderately differentiated. Another focus is present at the left flexure. In the ascending colon, the lesion invades beyond the muscularis propria into the serosa (pT4), while the lesion at the left flexure extends through the muscularis propria without serosal involvement (pT3). No lymphovascular or perineural invasion is identified. A total of 41 lymph nodes are examined, with two showing involvement. Distant metastasis to the liver is present."} +{"pid": "TCGA-E3-A3DY", "report": "The surgical specimen consisted of lymph nodes and a thyroid gland. The lymph nodes included one pretracheal lymph node which was negative for malignant cells (0/1). Two left paratracheal lymph nodes were examined, with one showing evidence of malignancy (1/2). Both right paratracheal lymph nodes contained malignant cells (2/2). Additionally, one lymph node attached to the right thyroid was involved (1/1).\n\nThe thyroid gland showed multiple areas of involvement. The largest lesion measured 1.7 x 1.1 cm in the right lobe and demonstrated focal extension into adjacent soft tissue. Additional lesions measured 1.0 x 1.0 cm in the left lobe and 1 mm in the right lobe. Histologic evaluation revealed mixed cellular features. Vascular invasion was identified. Surgical margins were free of malignant cells.\n\nLymph node involvement was noted in the right and left paratracheal regions as well as the right peri-thyroid area. One pretracheal lymph node was uninvolved. Pathologic staging was determined as pT3 N1a Mx. Concurrent chronic inflammation of the thyroid gland was also observed."} +{"pid": "TCGA-G9-6364", "report": "The surgical specimens included right and left distal ureters, a cystectomy and prostatectomy specimen, multiple lymph node groups from the left and right iliac regions (including iliac vein, iliac artery, obturator, and common iliac lymph nodes), and final ureteral margins. The right distal ureter measured 0.6 x 0.3 x 0.3 cm and the left distal ureter measured 0.5 x 0.3 x 0.3 cm. Both were submitted in part for frozen section. The cystectomy and prostatectomy specimen measured 15.0 x 10.0 x 5.5 cm. The prostate showed solid tan surfaces without necrosis or hemorrhage. A depressed area was noted in the left lateral wall of the bladder measuring 1.0 x 0.8 cm. Serial cross sections revealed a solid mass in the left lateral wall measuring 2.8 x 2.4 x 1.5 cm, extending within 2 mm of the inked surface. The right ureter measured 3.2 cm in length and 0.4 cm in diameter; the left ureter measured 2.5 cm in length and 0.4 cm in diameter. Sections were taken from various regions including the urethral margin, right and left prostate, transition zones, trigone, bladder walls, and attached adipose tissue. Lymph node specimens varied in size and number across sites: two lymph nodes at the left iliac vein (0.3 x 0.2 x 0.2 cm and 0.2 x 0.2 x 0.2 cm), two at the left iliac artery (2 x 1 x 1 cm and 1 x 0.5 x 0.5 cm), three at the left obturator (ranging from 0.2 x 0.2 x 0.2 cm to 0.7 x 0.5 x 0.5 cm), two at the left common iliac (0.3 x 0.3 x 0.3 cm to 0.7 x 0.5 x 0.4 cm), seven at the right iliac vein (ranging from 0.2 x 0.2 x 0.2 cm to 0.8 x 0.4 x 0.4 cm), two at the right iliac artery (0.3 x 0.3 x 0.2 cm and 0.6 x 0.5 x 0.5 cm), five at the right obturator (ranging from 0.5 x 0.4 x 0.4 cm to 2.2 x 0.6 x 0.5 cm), and one at the right common iliac (0.5 x 0.3 x 0.3 cm). All lymph nodes were entirely submitted for evaluation. Final ureteral margins measured 1.0 cm in length and 0.4 cm in diameter on both sides and were completely submitted. Microscopic examination of all ureteral margins showed no abnormal cellular findings. In the bladder specimen, there was a notable presence of chronic inflammation and giant cell granulomas. Prostatic tissue showed focal involvement with cellular features seen in four out of fifteen sections. All lymph node groups showed no abnormal cellular findings."} +{"pid": "TCGA-BM-6198", "report": "The surgical specimen included the anus, rectum, and surrounding tissues. The tumor was located at and proximal to the dentate line. Grossly, it presented as a bosselated tan surface with a white/tan, firm cross-section and infiltrative borders. The tumor measured 6.5 x 6 x 2 cm. It extended through the muscularis propria and into the perirectal soft tissues posteriorly, with possible involvement of bone. No gross evidence of perforation through the visceral peritoneum was noted. There was partial luminal obstruction, with a bowel circumference at the tumor site measuring 7.5 cm after fixation.\n\nMicroscopically, the tumor showed moderately differentiated features with widespread invasion of the muscularis propria and focal extension into the perirectal soft tissues. No lymphatic, venous, or perineural invasion was identified. Margins were assessed with measurements as follows: the proximal margin was negative at 4 cm from the tumor, the distal margin was also negative at 4.2 cm. The right perirectal soft tissue margin was 1 mm from the tumor, the left perirectal soft tissue margin was 6 mm away, and the anterior perirectal soft tissue margin was 3 mm from the tumor. The posterior soft tissue and bone margin was negative. The closest margin distance was 1 mm at the right perirectal soft tissue margin.\n\nA total of 11 regional lymph nodes were examined, and none showed evidence of metastasis. No additional pathologic findings were reported in the resected specimen. The pathologic staging was determined as ypT3 pNO.\n\nAdditional specimens included a biopsy of the left anterior pelvic sidewall soft tissue, which showed no evidence of tumor involvement. A resected segment of small bowel and attached skin demonstrated benign features with ulceration, dermal sclerosis, fistula formation, and a foreign body giant cell reaction likely related to embedded surgical mesh. No malignancy was identified. A transverse colon resection revealed benign findings including serositis, adhesions, and a foreign body reaction, but no tumor. A jejunum segment also showed no evidence of malignancy, with findings of serositis, adhesions, and previous surgical changes.\n\nThe case required additional dissection for complete lymph node evaluation following initial specimen processing with tissue digestion. Intraoperative frozen section analysis of multiple margins was performed, all of which were negative. Clinical history included prior abdominal surgeries, hernia repair, and a likely entero-cutaneous fistula. The specimen was fixed in formalin and included multiple tissue components such as colon, distal rectum, anus, perianal skin, pelvic sidewall, sacral or coccygeal bone, and perirectal fat. The overall specimen dimensions were 15 cm (superior-inferior), 11 cm (lateral), and 6 cm (anterior-posterior). Multiple blocks were submitted for histologic evaluation, including perpendicular sections of tumor margins and en face sections of multiple soft tissue and resection margins. Several lymph node candidates were also submitted for assessment."} +{"pid": "TCGA-39-5031", "report": "The submitted specimens include a segment of rib bone measuring 1.1 x 0.9 x 0.5 cm with an intact cortical surface and no discrete abnormalities noted. Grossly, the cut surface is homogeneous red-tan. The specimen was entirely submitted after bisecting.\n\nA series of lymph node specimens were also submitted. One lymph node from Level 9 measured 1.3 x 0.8 x 0.3 cm. Three lymph nodes from Level 11 ranged in size from 0.2 to 0.8 cm. A single lymph node from Level 5 measured 0.8 cm. Three additional lymph nodes from Level 12 ranged from 0.4 to 0.9 cm. All lymph nodes were anthracotic and entirely submitted for evaluation.\n\nThe lung specimen consists of a left upper lobe measuring 17 x 10 x 2.5 cm and weighing 230 grams after fixation. It includes an attached bronchus and blood vessels, with multiple staple lines present. An incision was made upon receipt. A lesion measuring 1.5 x 1.5 x 1.2 cm is identified in the periphery of the lung parenchyma, located 5 cm from the bronchial margin and 1.5 cm from the nearest staple line. The lesion is subpleural with an overlying puckered pleural surface but does not grossly involve the bronchus. The bronchial mucosa appears smooth. No tumor involvement is seen at the bronchial or pleural surfaces.\n\nMicroscopic examination reveals a separate focus of small cell proliferation measuring 0.5 cm in greatest dimension, distinct from the primary lesion. Additionally, multiple foci of atypical adenomatous hyperplasia are observed. Non-neoplastic findings include emphysematous changes, focal organizing pneumonia, and presence of carcinoid tumorlets.\n\nLymphovascular invasion is present; no perineural invasion is identified. All examined lymph nodes, including those from Levels 5, 9, 11, and 12, show no evidence of metastasis. The total lymph node assessment shows no positive nodes among the regions sampled, including peribronchial sites.\n\nSections were taken from various margins including bronchial, vascular, and staple margins, as well as random lung parenchyma both near and distant from the main lesion. All surgical margins are free of tumor."} +{"pid": "TCGA-D1-A179", "report": "A 123.0 gram uterus was received with an unremarkable cervix and smooth uterine serosa. A mass measuring 7.0 x 4.1 x 1.1 cm involves the entire endometrial cavity and lower uterine segment, grossly appearing to invade 0.2 cm into the 1.6 cm thick myometrium. Microscopically, the tumor invades 0.4 cm into the myometrium. Lymphovascular space invasion is identified. Surgical margins are free of tumor. The endocervix is not involved.\n\nA 5.4 x 4.5 x 1.9 cm specimen containing right and left para-aortic lymph nodes showed multiple (6 of 9) lymph nodes positive for metastatic carcinoma. A separate 9.8 x 7.4 x 1.2 cm specimen of right and left pelvic lymph nodes also showed multiple (2 of 21) lymph nodes positive for metastatic carcinoma.\n\nA right fallopian tube and ovary specimen includes an 8.0 x 0.6 cm fallopian tube with a 1.0 x 0.8 cm paratubal cyst and an atrophic ovary. Histologically, there is involvement of the right fallopian tube. The left fallopian tube and ovary specimen contains a 7.0 x 0.4 cm fallopian tube and an atrophic ovary with involvement of the adnexal soft tissue and ovary. The left fallopian tube appears unremarkable.\n\nA 17.2 x 13.0 x 1.5 cm omental specimen showed no masses or identifiable lymph nodes; it was negative for tumor.\n\nBased on available surgical material, staging corresponds to pT3aN2 according to AJCC 7th edition."} +{"pid": "TCGA-DD-AACK", "report": "The liver specimen measured 10.0 x 9.5 x 5.5 cm and weighed 169.5 grams. A second component measured 8.0 x 6.0 x 5.2 cm and weighed 66.0 grams. The tumor was located in the right lobe, measured 5.3 x 4.9 x 5.5 cm, and was solitary with no satellite nodules. The gross appearance was expanding nodular without necrosis, but with 5-10% hemorrhage or peliosis. There was no portal vein or bile duct invasion.\n\nMicroscopically, the lesion showed a trabecular growth pattern with clear cell morphology. The worst histologic differentiation was grade II, as was the predominant differentiation. A complete fibrous capsule was present without capsular infiltration. Septum formation was noted. The surgical resection margin was free of involvement with a clearance margin of 3.0 mm. There was no serosal, portal vein, bile duct, hepatic vein, or hepatic artery invasion. Microvessel invasion was present. No intrahepatic metastasis or multicentric occurrence was identified. Additional studies including urine smears were negative. The non-tumorous tissue showed changes consistent with cirrhosis."} +{"pid": "TCGA-EL-A3GW", "report": "Pathology report. Sex: F. Case type: Surgical case. Specimen (A) consists of a single pale-gray tissue fragment measuring 0.6 x 0.3 x 0.3 cm, interpreted as Delphian tissue and found to be free of tumor involvement. Specimen (B) is from a total thyroidectomy with slightly symmetric lobes; the right lobe measures 5.0 x 3.0 x 2.0 cm and the left lobe measures 3.5 x 1.5 x 1.0 cm. Within the right lobe, there is a multinodular, variegated soft nodule measuring 2.5 x 1.7 x 1.5 cm, located in the inferior/posterior aspect. The nodule is well-circumscribed by a thin rim of surrounding tissue and demonstrates varying degrees of peripheral fibrosis and areas of hemorrhage. No extension beyond the thyroid capsule is identified. Histologic evaluation shows no evidence of lymphovascular invasion. Resection margins are free of abnormal cells. The remaining portions of the thyroid appear unremarkable. Tissue sections were taken from multiple regions including the left lobe (superior to inferior), isthmus, superior right lobe, and the right lobe containing the nodule. Clinical history notes previous findings of a thyroid neoplasm. All tests included in this report were developed and validated internally and have not been cleared or approved by the U.S. Food and Drug Administration."} +{"pid": "TCGA-LD-A74U", "report": "The specimen was obtained from a partial mastectomy of the right breast. A mass was identified at the 9:00 position, measuring approximately 5.3 cm grossly. Histologically, the lesion shows features consistent with a mixed cellular pattern, including classical and focal pleomorphic variants. Nuclear grading was assessed as grade I for the classical component and grades II\u2013III for the pleomorphic component. The tumor is unifocal and no in-situ component was identified. Lymphovascular invasion is present focally.\n\nLymph node sampling from the axillary dissection included 12 nodes, 11 of which were involved by disease. The largest metastatic deposit measured 45 mm, and extranodal extension was present. Additionally, there is involvement within the surrounding adipose tissue measuring about 2 cm. Based on these findings, the pathologic staging is pT3, pN3a. Clinically, the preoperative assessment was cT2, cN1, cM0, stage II.\n\nMargins were assessed following resection. The superior margin was <0.1 mm (highlighted by CK7 immunostain), the medial margin was 0.2 mm, and the posterior margin was 1 mm. All other margins were greater than 3 mm. The specimen was well oriented and inked accordingly.\n\nAdditional findings in the breast tissue include focal atypical lobular hyperplasia, sclerosing adenosis, usual ductal hyperplasia, apocrine metaplasia, and changes related to a prior biopsy. No microcalcifications were identified, and the skin and skeletal muscle were not involved.\n\nThe omentum resection specimen showed no evidence of tumor involvement.\n\nA second specimen consisting of axillary contents revealed multiple lymph nodes replaced by similar cellular features. Gross examination of the breast specimen measured 11.3 x 8.5 x 4.5 cm, with a fibrous area measuring 5.3 x 5.0 x 3.5 cm. This area extended toward several margins and was 2.0 cm from the overlying skin. Sections were taken from all relevant areas, including margins and surrounding tissue. The remaining breast tissue was composed of a mix of adipose and fibrous tissue.\n\nIntraoperatively, needle localization wires were placed superiorly and inferiorly. Due to difficulty in identifying a discrete mass, margin assessment was challenging, particularly concerning the posterior, inferior, and medial aspects."} +{"pid": "TCGA-3H-AB3S", "report": "The specimen consists of four fragments of gray-white to tan-pink soft tissue, with sizes ranging from 0.6 x 0.5 x 0.5 cm up to 2.0 x 1.3 x 0.6 cm. All tissue was submitted for analysis. The sample includes three smaller fragments (section code A1) and one larger fragment that was serially sectioned (A2, A3). Microscopic evaluation revealed epithelioid cellular morphology. Histologic assessment showed involvement of the pleural tissue with malignant cells arranged in cohesive sheets and gland-like structures. Cellular features included moderate nuclear atypia, frequent mitotic figures, and focal necrosis. No definitive lymph node involvement or distant metastasis was identified. Staging could not be determined due to limited clinical information. No clinical history was provided. Relevant SNOMED codes are T-29000 and M-90503. Some testing methods referenced in this report may have been developed and validated internally; they have not been specifically cleared or approved by the U.S. Food and Drug Administration."} +{"pid": "TCGA-BP-5190", "report": "A right kidney partial nephrectomy specimen measured 6.5 x 5.0 x 4.0 cm and revealed a 4.0 x 3.3 x 2.0 cm soft, yellow-tan mass. The tumor was well-circumscribed and located within the kidney, with a 0.1 cm clearance from the resection margin. Histologic evaluation showed cells with clear cytoplasm arranged in solid sheets and acinar patterns. Nuclear grading was high, with atypical nuclei present. No local invasion or vascular involvement was identified. Surgical margins were free of tumor. Adjacent non-neoplastic kidney tissue showed focal glomerulosclerosis. Immunohistochemical staining demonstrated diffuse cytoplasmic membranous expression of CA IX, while the tumor cells were negative for CK7, c-KIT, and racemase.\n\nA separate excision of right peritumoral soft tissue measured 15 x 11 x 3 cm and consisted of lobulated fatty tissue. No abnormal lesions were found upon histologic examination, and the tissue was interpreted as benign fibroadipose material.\n\nA biopsy of the right lower pole cortex of the renal mass was obtained. The sample measured 1.5 x 0.9 x 0.4 cm and showed benign renal cortical parenchyma with focal glomerulosclerosis. No neoplastic changes were observed.\n\nA proximal right ureter specimen measuring 0.8 x 0.8 x 0.4 cm was also submitted. Histologically, it showed partially denuded urothelium and urethral wall without evidence of malignancy.\n\nStaging criteria indicated a tumor size of 4.0 cm confined to the kidney, corresponding to an early stage classification. Lymph nodes and adrenal gland were not identified in the specimen. No tumor was present in the submitted margins or surrounding tissues."} +{"pid": "TCGA-CV-6436", "report": "The specimen consisted of multiple fragments of white-tan teeth, submitted for gross examination only. A lymph node measuring 0.9 x 0.5 x 0.4 cm was identified in the left neck dissection, level I \"A,\" with no abnormal findings present.\n\nThe left partial glossectomy specimen measured 7.5 x 6.7 x 4.5 cm and included a centrally located exophytic lesion measuring 7.2 x 6.3 x 2.5 cm. Microscopic evaluation showed infiltrative growth with a depth of invasion of 0.6 cm. No perineural or vascular invasion was identified. Lymphocyte infiltration was absent. Margins were assessed, including the deep margin (radial) and mucosal margins, all of which were negative. The closest mucosal margin was located posteriorly near the base of the tongue at 0.4 cm. The lingual nerve was identified and appeared unremarkable.\n\nIn the left neck dissections, no abnormal tissue was found. Level I contained seven lymph nodes, all without evidence of involvement. Salivary tissue from this region also showed no abnormalities. Level II contained twenty-two lymph nodes, and Level III contained ten lymph nodes; none showed any involvement.\n\nThe surgical specimen was submitted entirely for analysis, with sections taken from various margins and regions to assess extent and borders. Frozen section analysis confirmed no tumor presence at the margins."} +{"pid": "TCGA-A8-A09Q", "report": "The specimen shows a poorly differentiated malignant neoplasm measuring up to 4.5 cm in maximum diameter. Histological evaluation reveals extensive infiltration of the skin, including ulceration, as well as lymphovascular invasion and perineural involvement. The surrounding glandular tissue is fibrolipomatous with advanced involutional changes and cystic duct ectasia; no calcifications are identified. There is no indication of pre-invasive intraductal proliferation. At the cranial resection margin, previously noted as nodular in appearance, there is evidence of cutaneous and subcutaneous tumor involvement with associated lymphovascular invasion. All other peripheral margins show no atypical cellular features. Pathologic staging considerations include pT4b and pN2 based on regional lymph node findings, though this may be influenced by conglomerate tumor masses. Distant metastatic status remains indeterminate (MX). Residual disease is present at the cranial resection line and axillary soft tissue (R1). Histologic grade is high (G3), with lymphovascular invasion noted (L1, V0)."} +{"pid": "TCGA-VD-AA8O", "report": "HISTOPATHOLOGY. Lab No. Clinical Consultant & Location. Unit No. SPECIMEN. LEFT ENUCLEATION (GLOBE). DIAGNOSTIC, PROGNOSTIC. CLINICAL DETAILS. See diagram. MACROSCOPIC DESCRIPTION. A fresh, intact, left globe. Dimensions: Axial 25 mm, Horizontal 24 mm, Vertical 24 mm. Cornea: Horizontal 12 mm, Vertical 11.5 mm. Optic nerve: Length 1 mm, Diameter 4 mm. On trans-illumination, a large shadow is seen on the medial side approximately 22 mm in size. Plane of section: horizontal. Intraocular description: On opening, a solitary dome-shaped pigmented choroidal mass is identified. Query regarding possible involvement of the ciliary body. Lesion dimensions: LBD 13.5 mm, Height 13 mm.\n\nMICROSCOPY. Histologically, the anterior segment demonstrates normal anatomy including an unremarkable cornea, deep anterior chamber with open angles, and non-specific iris findings. The ciliary muscles show moderate atrophy with mild hyalinisation of the ciliary processes. Advanced cataractous changes are present in the lens. Posteriorly, near the equator, there is a pigmented lesion involving the choroid. This lesion has a dome-shaped morphology and is associated with a significant exudative retinal detachment. The overlying retina is atrophic with degenerative features. Focal invasion of the retina is observed at the apex of the lesion.\n\nThe lesion contains both epithelioid and spindle-shaped cells, with a predominance of epithelioid morphology. Immunoreactivity was demonstrated for MelanA, CD117, and HSP-27 (score 1). Mitotic activity was assessed at approximately 2 mitoses per 40 high power fields. The microvasculature within the lesion is prominent, showing closed vascular loops and multiple \"vascular lakes,\" some of which contain intraluminal cellular elements. A moderate lymphocytic infiltrate is present within the lesion, with scattered macrophages noted at low density. There is no evidence of scleral or extraocular extension. The optic nerve, although truncated, appears free of involvement and shows mild atrophic changes. The examined vortex veins do not show any signs of tumor involvement.\n\nMolecular genetic analysis was performed using MLPA on extracted DNA from the tissue sample. Evaluation included loci on chromosomes 1, 3, 6, and 8. High-quality DNA was used and results were reproducible across multiple runs. Sequence analysis revealed loss of chromosome 1p, monosomy 3, gain of chromosome 6p, and borderline gains on chromosome 8q. Additional MSA testing confirmed loss of heterozygosity at all tested loci on both arms of chromosome 3, consistent with monosomy 3.\n\nThese molecular findings place the patient in the high-risk group for metastatic disease. However, clinical and morphological correlation is required for a comprehensive assessment of metastatic risk."} +{"pid": "TCGA-CQ-7064", "report": "The specimen was received in multiple parts, including lymph node groups from the left neck at levels I through IV, muscle tissue, and various oral cavity and soft tissue margins. In the left neck level I region, one out of four lymph nodes showed involvement with a tumor measuring 1.6 cm. Extranodal extension was noted. The submandibular gland showed no abnormal findings. Levels II, III, and IV contained 11, 3, and 12 lymph nodes respectively, all without evidence of tumor involvement.\n\nA central ulcerated lesion was identified in the left buccal area, measuring 4.4 cm in its greatest dimension and 2.6 cm in thickness. No lymphovascular or perineural invasion was observed. The tumor was present at the deep margin of the specimen but did not involve other margins examined, which included anterior, inferior, posterior, superior, and mucosal regions. All other submitted margins were negative for tumor involvement.\n\nThe pterygoid muscle and intertemporal fossa fat specimens were also free of tumor. Additional margins, including interior maxillary, anterior buccal, posterior inferior mucosal, inferior anterior mucosal, inferior alveolar, and posterior mucosal, were all negative for tumor.\n\nA total of 30 regional lymph nodes were examined, with one involved. Pathologic staging indicated a primary tumor larger than 4 cm in greatest dimension and metastasis to a single ipsilateral lymph node no larger than 3 cm. Extracapsular extension was present. Distant metastasis could not be assessed."} +{"pid": "TCGA-50-6673", "report": "The right upper lobe contains a lesion measuring 1.6 cm in diameter, composed of moderately differentiated invasive cells. The surgical resection margins are clear. Lymphatic and angiolymphatic invasion are not present, nor is there evidence of visceral pleural invasion. A mild lymphocytic host response is noted. Pathologic staging is T1 NO MX. \n\nLymph node biopsies from the subcarinal, right tracheobronchial angle, right paratracheal, subinnominate, and anterior hilar regions all show fragments of lymph nodes with anthracotic pigment; no malignant involvement is identified. One lymph node from the subcarinal region shows reactive changes. \n\nA pleural biopsy reveals fibrin with reactive mesothelial cells, macrophages, and bone marrow. The background lung tissue exhibits emphysematous changes and respiratory bronchiolitis. \n\nFluorescence in-situ hybridization studies reveal a Her2/Neu to centromere 17 ratio of 1.40. Cyclin-D1 gene to centromere 11 ratio is 2.16, with a monosomy rate of 85.7% and a hyperploidy rate of 87.3% in analyzed cells. EGFR gene to centromere 7 ratio is 9.33. These findings indicate gene amplification in the respective regions."} +{"pid": "TCGA-QK-A6VC", "report": "The surgical specimen involved the hypopharynx, larynx, thyroid, and a portion of the esophagus. The largest dimension of the resected specimen measured 8.0 cm, with additional dimensions of 7.0 cm and 4.5 cm. A firm white mass measuring 4.8 x 3.1 x 3.0 cm was identified in the hypopharynx. This lesion involved the right aryepiglottic fold and hypopharyngeal mucosa with ulceration, and it circumferentially surrounded the thyroid cartilage without clear invasion. The tumor also extended into the right thyroid gland and the lumen of the esophagus, and appeared to abut the right lateral and posterior-lateral soft tissue margins. Microscopically, the lesion showed moderately differentiated features with lymphoid aggregates noted in the base of tongue margin. Perineural invasion was present.\n\nAll mucosal and soft tissue margins, including those from the esophagus, left pharynx, right medial pharynx, right lateral pharynx, and base of tongue, were free of high-grade dysplasia and invasive disease. Margins were uninvolved by the primary lesion, with the closest margin measuring 1 mm from the right lateral and posterior-lateral soft tissue.\n\nA total of 67 lymph nodes were evaluated. Of these, one out of eleven lymph nodes from the right level II, III, IV dissection site contained metastatic involvement, with the largest focus measuring 1.5 cm within a 1.8 cm lymph node. All other lymph node dissection sites, including right level I, right level V, left level II, III, IV, and VI, were negative for metastatic disease. No extranodal extension was identified.\n\nHistologic evaluation of the surgical margins confirmed absence of carcinoma. Lymphovascular invasion was not observed. HPV testing was negative. Multiple cassettes were submitted for further analysis and banking, including sections from the tumor, adjacent thyroid, and surrounding tissues. Frozen section analysis of all relevant margins was also negative during intraoperative consultation."} +{"pid": "TCGA-CN-4737", "report": "A partial hemiglossectomy and right-sided neck dissection were performed. The surgical specimen consisted of nine separate parts. Part 1, a right hemiglossectomy measuring 5.5 x 3.8 x 2.0 cm, revealed a lesion on the mucosal surface measuring 3.5 cm in greatest dimension with a thickness of 1.2 cm. The lesion was ulcerated and granular, located 0.3 cm from the nearest resection margin. Histologic evaluation showed moderately differentiated cellular features with angiolymphatic and perineural invasion. All margins were free of tumor involvement.\n\nParts 2 through 6 included excision specimens from the dorsal anterior tongue, dorsal posterior tongue, posterior floor of the mouth, anterior floor of the mouth, and deep soft tissue margin. None of these specimens demonstrated evidence of tumor involvement.\n\nPart 7, representing level 1B lymph nodes from the right neck dissection, contained an unremarkable submandibular gland and no identifiable lymph nodes. Part 8 included two lymph nodes from level 1A; none showed any tumor involvement. Part 9 encompassed levels 2 through 4 of the right neck dissection and contained a total of thirty-four lymph nodes. Two of these lymph nodes showed microscopic evidence of metastatic involvement without extracapsular extension. The largest metastatic deposit measured 1.7 cm.\n\nFrozen section analysis of multiple surgical margins confirmed absence of tumor involvement at all sites evaluated. Microscopic findings were consistent with the histopathologic assessment. Cellular features included moderately differentiated morphology, presence of angiolymphatic invasion, and perineural invasion. No distant metastasis was identified. Pathologic staging was determined as pT2 N2b based on the tumor dimensions and lymph node involvement."} +{"pid": "TCGA-DJ-A4UQ", "report": "The surgical specimens included lymph nodes from multiple regions of the right and left neck, as well as a total thyroidectomy specimen. The lymph nodes from the right neck level 5A consisted of fibroadipose tissue and skeletal muscle without identifiable lymph nodes. In the right neck level 5-B, ten lymph nodes were examined, with one showing involvement by cellular deposits measuring up to 1.0 cm in size. No extension beyond the lymph nodes was observed. In the right neck level 4, eight lymph nodes were identified, all without any abnormal cellular infiltration.\n\nIn the right neck levels 2-A and 3, twenty lymph nodes were evaluated, with five showing involvement. The largest affected lymph node measured 1.7 cm, and there was evidence of spread beyond the lymph node capsule. The total thyroidectomy specimen revealed two nodules in the right lobe, with the larger measuring 1.5 cm. These nodules lacked a surrounding boundary and demonstrated cellular features including psammoma bodies and squamous metaplasia. Vascular invasion was present, and the nodule extended into the surrounding fat. All surgical margins were free of involvement. Four lymph nodes within the thyroid specimen were completely replaced by cellular infiltration, with the largest being 0.4 cm and showing extension beyond the node.\n\nIn the right paratracheal region, eight lymph nodes were examined, seven of which contained abnormal cells. The largest involved lymph node measured 1.1 cm, and extension beyond the lymph node was noted. Microscopic clusters of these cells were also found in the surrounding fat. In the left paratracheal area, three lymph nodes were identified, with one showing involvement measuring 1.1 cm; however, no extension beyond this node was observed.\n\nHistological analysis of the right neck level 2-B lymph nodes showed thirteen benign lymph nodes without any abnormal cellular presence. The thyroid tissue displayed non-cancerous changes, while parathyroid tissue was identified in some specimens but not consistently across all samples. Special stains were performed for further characterization."} +{"pid": "TCGA-XM-A8RD", "report": "The specimen from a female patient was submitted for analysis and consisted of a thymectomy. Gross examination revealed a tan-yellow fibroadipose tissue measuring 12 x 6 x 5 cm. A well-circumscribed, tan firm nodule measuring 4.2 x 2.5 x 2.0 cm was identified within the tissue. The cut surface of the nodule was fleshy with focal areas of hemorrhage. Histologically, the nodule demonstrated focal microscopic invasion into intrathymic fat. The surrounding thymic tissue showed involution. Surgical margins were free of tumor involvement. One benign lymph node was identified. Immunohistochemical staining showed positivity for AE1/AE3, CD1a, CD3, and CD99, highlighting background lymphocytes. No other significant findings were noted in the remaining tissue."} +{"pid": "TCGA-19-A6J4", "report": "The specimen was collected from a male patient and consisted of multiple light tan, irregular soft tissue fragments measuring 2.5 x 2.2 x 0.5 cm in aggregate. The tissue was received fresh and labeled with the patient\u2019s name and medical identifiers. It was submitted in its entirety in two cassettes for analysis.\n\nMicroscopic examination revealed a neoplasm with large cells exhibiting granular cytoplasm and prominent intracellular inclusions that stained positively with PAS. Immunohistochemical staining demonstrated reactivity for CD68 in the large granular tumor cells.\n\nThe laboratory performing the analysis is CLIA-certified for high-complexity testing. All assays were conducted using appropriate positive and negative controls, which showed expected staining patterns. Some reagents used in the testing may have contained analyte-specific components not cleared or approved by the FDA. The test was performed for clinical diagnostic purposes and is not considered investigational or research-based."} +{"pid": "TCGA-CN-6024", "report": "A pathology report was prepared following surgical resection that included mandibulectomy, glossectomy, and neck dissection. The specimen consisted of thirteen parts submitted for examination.\n\nExamination of the right neck dissection identified one involved lymph node out of eighteen, located in level 1b. There was no extracapsular spread observed. The submandibular gland showed no significant pathological changes.\n\nIn the left neck dissection, five out of twenty-one lymph nodes contained malignant cells, involving levels 1a, 1b, and 4. Extracapsular extension was noted, with focal microscopic involvement of the submandibular gland. Chronic sialadenitis was present in the submandibular gland on this side.\n\nBiopsies from various anatomical sites including the tongue (right posterior, left oral, right dorsal), pharynx (left), floor of mouth (right and left), and mandibular marrow (left and right) showed no evidence of tumor involvement. Dental extraction specimens were assessed grossly only.\n\nThe primary lesion was identified in the left subtotal glossectomy and mandibulectomy specimen. The lesion measured 5.0 cm in greatest dimension and demonstrated moderately differentiated morphology. Microscopic evaluation revealed extensive perineural invasion and venous invasion. All soft tissue and bony margins were free of tumor involvement.\n\nFrozen section analysis during surgery confirmed malignancy in the left mandibular marrow specimen but benign findings in other intraoperative consultations.\n\nImmunohistochemical staining for p16 and HPV performed on relevant sections was negative.\n\nStaging parameters indicated a primary tumor classification of pT4a based on local invasion. Regional lymph node staging was pN2c due to multiple positive lymph nodes across different levels. Distant metastasis could not be determined (pMX). Venous and perineural invasion were documented. No additional pathological findings were identified.\n\nAll margins evaluated were uninvolved by tumor. A total of 39 lymph nodes were examined, with six demonstrating involvement."} +{"pid": "TCGA-CJ-4881", "report": "The specimen consists of a right kidney radical nephrectomy with surrounding perinephric fat measuring 12.5 x 9.0 x 6.0 cm, including an attached 8.5 cm segment of ureter. A tumor measuring 10.0 x 6.0 x 6.0 cm is present, with a portion forming a 5.0 x 4.5 x 3.0 cm mass extending into the renal pelvis. The tumor has a variegated yellow-red cut surface. No involvement is identified in the renal sinus, perinephric adipose tissue, or renal vein. Margins of resection, including the perinephric fat margin, are free of tumor. The tumor is composed predominantly of clear cells (90%) with a minor component of eosinophilic cells (10%). Nuclear grade is 3 according to Fuhrman classification. Multifocal areas of tumor necrosis are observed. Adjacent non-neoplastic renal parenchyma shows interstitial inflammation and hemorrhage within the tubules, with linear hemorrhages noted at the cortico-medullary junction. Sections submitted include those from the tumor, adjacent structures, vascular and ureteral margins, and areas of hemorrhage in the unaffected parenchyma."} +{"pid": "TCGA-XE-AANV", "report": "The specimen consists of a left orchiectomy weighing 72 grams, including the testis (6 x 5 x 2 cm), epididymis (1.2 x 1 x 0.4 cm), and spermatic cord (9 cm in length, 1.5 cm in diameter). A mass measuring 5 x 4 x 2 cm is present within the testis, described as tan-white, firm, well-circumscribed, and homogeneous with no hemorrhage or necrosis observed. The surrounding testicular tissue appears tan-white with normal-appearing tubules. The mass does not extend into the tunica albuginea, tunica vaginalis, or epididymis, though it is in close proximity to the rete testis. A small piece of tumor (1 x 0.8 x 0.2 cm) was submitted for frozen section analysis. No lymph nodes were submitted for evaluation. Sections from the tumor, margins, and surrounding structures were submitted in a total of nine cassettes, including the frozen section. Microscopic evaluation did not show angiolymphatic invasion or intratubular germ cell neoplasia. Pathologic staging is T2CNXMX."} +{"pid": "TCGA-BP-4769", "report": "The left partial nephrectomy specimen measured 5.0 x 3.5 x 1.0 cm and included a well-circumscribed gray-tan lobulated nodule with focal hemorrhagic areas, measuring 2.2 x 2.0 x 2.0 cm. This lesion was located 0.2 cm from the resection margin and abutted the renal capsule without involvement or extension into perinephric fat. A second, smaller tumor measured 1.1 x 1.1 x 0.9 cm, with a light tan friable and necrotic appearance, located 0.3 cm from the margin. Both surgical margins were free of tumor involvement. The larger tumor showed nuclear features corresponding to grade II/IV, while the smaller tumor exhibited type 1 nuclear characteristics. No local invasion or renal vein involvement was identified. Non-neoplastic kidney tissue showed two small \"papillary tubular adenomas.\" No adrenal tissue or lymph nodes were present. The overall staging for the largest lesion was pT1, defined as a tumor not greater than 7.0 cm confined to the kidney. Representative sections of both tumors and normal kidney tissue were submitted for further analysis. Intraoperative frozen section evaluation confirmed negative margins and was consistent with the final permanent section diagnosis."} +{"pid": "TCGA-UL-AAZ6", "report": "The specimen consists of a right mastectomy along with three sentinel lymph nodes. The mastectomy specimen measured 27 x 17 x 3.5 cm and weighed 811.1 grams. A centrally located, unremarkable nipple was identified, measuring 1.2 cm. An irregular firm tan-colored mass measuring 3.4 x 3.0 x 2.5 cm was identified at the 12 o\u2019clock position. It was located 2 cm from the deep margin, 1.2 cm from the anterior skin margin, and 2 cm from the nipple. The deep margin was inked black. Histologically, the invasive component was present as a single focus without involvement of the dermis or epidermis. Skeletal muscle was present and free of involvement. Ductal carcinoma in situ (DCIS) was identified with microcalcifications but no extensive intraductal component. Lobular carcinoma in situ was not identified. The histologic grade was modified Scarff-Bloom-Richardson grade 2. Margins were free of invasive carcinoma and DCIS, with the closest distance to the invasive component being 2.0 cm at the deep margin. No venous, lymphatic, or dermal lymphatic invasion was identified. There was no evidence of prior neoadjuvant therapy in either the breast or lymph nodes.\n\nA total of four lymph nodes were examined, including three sentinel lymph nodes measuring 2.2 cm, 2.5 cm, and 1.0 cm respectively. All were reactive without evidence of macrometastases, micrometastases, or isolated tumor cells. No extranodal extension was identified. Sentinel lymph nodes were evaluated using H&E staining with multiple levels. No metastatic carcinoma was identified in any of the lymph nodes.\n\nThe AJCC pathologic stage is pT2, pN0."} +{"pid": "TCGA-4X-A9FD", "report": "The specimen consists of a thymectomy measuring 16 x 14 x 1.8 cm, weighing 65 grams. A mass measuring 2.8 x 2.6 x 0.9 cm is identified within the left cornu, appearing encapsulated with a white-tan cut surface. The capsule measures 0.1 cm in thickness and approaches the inked resection margin at a distance of 0.7 cm. No gross evidence of margin invasion is observed. Histologically, a single section shows extension into adjacent adipose tissue. The remaining thymic parenchyma, primarily located in the right lobe, appears tan-yellow and unremarkable. Resection margins are negative for involvement. The thymus also demonstrates lymphoid hyperplasia in non-neoplastic areas. Nine lymph nodes from the specimen show no abnormal cellular infiltration. Additionally, two lymph nodes from a separate excision are likewise unremarkable. The left phrenic nerve margin does not show any identifiable nerve tissue. The Yamakawa-Masaoka classification indicates T2N0 staging based on these findings."} +{"pid": "TCGA-A2-A3Y0", "report": "The surgical specimen consists of a left breast and axillary tissue, measuring 31 x 20.5 x 5.8 cm. A palpable mass is identified in the upper outer quadrant, described as a rounded pink-tan soft mass measuring 4 x 3.7 x 2.8 cm. This mass abuts the deep margin, marked with black ink. Immediately superficial to this mass is a second nodule containing a coil clip, measuring 1.5 x 1.2 x 1.0 cm. Medial and central to the breast, there is a tan fibrous band extending 9 cm from superior to inferior, surrounded by bland yellow fatty tissue. The nipple appears unremarkable.\n\nA total of 39 axillary lymph nodes were examined across multiple sections. One lymph node located within the breast tissue contains tumor cells, located 1 mm from the deep margin. No evidence of tumor involvement is found in the remaining 37 axillary lymph nodes. \n\nMicroscopically, the tumor demonstrates high mitotic activity and poorly differentiated features. Histologic grading using the Nottingham scoring system yields a total score of 9, corresponding to Grade III. The closest margin measures 1 mm. Estrogen receptor staining is positive in 95% of cells, while progesterone receptor expression is absent. HER-2/neu immunostaining shows a score of 1+. Ki-67 proliferation index is elevated at 95%.\n\nStaging is determined based on tumor size and nodal involvement. The primary lesion measures 40 mm. Based on the presence of involved intramammary lymph nodes in the absence of axillary node metastases, the staging classification is N1. Overall TNM staging is pT2 pN1, corresponding to stage 2B."} +{"pid": "TCGA-4X-A9FA", "report": "The thymectomy specimen weighed 140 grams. The left lobe measured 24 x 4.5 x 2 cm, and the right lobe measured 26 x 5 x 2 cm. A tan-pink, gritty lesion with lobulated cut surfaces was identified, measuring 4 x 3.2 x 2 cm. The lesion abutted the anterior and posterior margins and was 1 cm from the right margin. It was located 3.5 cm from the superior tip of the right lobe and 17 cm from the inferior tip. The superior portion of the lesion had a solid texture, while the inferior portion was cystic. There was no gross evidence of invasion into surrounding fat. Adjacent thymic tissue appeared tan-yellow and lobulated. No prominent lymph nodes were identified upon serial sectioning.\n\nMicroscopic evaluation revealed a histologic type characterized by spindle cells. The tumor was found to be within the thymus, without extension beyond the capsule. Surgical margins were uninvolved by tumor, with the closest distance between tumor and margin measuring less than 1 mm. No lymphovascular invasion was observed. No regional lymph nodes were submitted or identified within the specimen. Additional findings included age-appropriate involution and a benign thymic cyst. Tissue sections were preserved for potential further studies."} +{"pid": "TCGA-38-4632", "report": "The surgical specimen from the left upper lobe includes a lesion measuring 5.8 cm in greatest dimension. The lesion extends to but not through the visceral pleura, and is associated with fibrinopurulent and granulation tissue, indicating a pleural response. All surgical margins are free of involvement. There is extensive recent and old hemorrhage within the non-involved lung tissue surrounding the lesion.\n\nEvaluation of regional lymph nodes shows involvement in two of seven hilar nodes from the lobectomy specimen. No tumor is identified in lymph nodes from other stations examined, including one station 5 node (0/1), two station 9 nodes (0/2), three nodes from the pulmonary fissure (0/3), one station 7 node (0/1), and one station 11 node (0/1). Common findings across these nodes include follicular hyperplasia, with or without hyalinized granulomas."} +{"pid": "TCGA-CJ-4642", "report": "The specimen consists of a radical nephrectomy measuring 19.0 x 12.5 x 9.0 cm, including the right kidney (15.5 x 7.7 x 7.5 cm), a segment of renal artery, renal vein, ureter, and adrenal gland. A well-circumscribed lobulated mass measuring 8.0 x 7.0 x 7.0 cm is present in the mid to lower pole of the kidney. The cut surface of the tumor is variegated, ranging from pale yellow-tan to red-tan, with areas of hemorrhage and focal cystic change. The tumor is confined entirely within the kidney without extension into perinephric fat, renal sinus, or renal vein, and does not reach Gerota's fascia. The adjacent renal parenchyma appears normal. The pelvicalyceal system is smooth and without abnormality. No lymph nodes were identified at the renal hilum. Cross sections of the adrenal gland show normal cortical and medullary architecture. Margins of resection, including vascular, ureteral, and soft tissue margins, are free of abnormal tissue. Multiple sections of the tumor and surrounding tissue were submitted for analysis, including representative sections of the tumor, perinephric fat, renal sinus, and non-neoplastic kidney tissue."} +{"pid": "TCGA-AJ-A2QL", "report": "The specimen was received from a female patient and included the uterus, cervix, bilateral ovaries and fallopian tubes, as well as multiple lymph node groups. The uterus measured 8.0 cm in length with a uterine corpus of 5.0 x 4.0 x 2.0 cm. A pink-tan friable mass filled the endometrial canal and extended 0.6 cm into the myometrium, which had a total thickness of 4.0 cm. No normal endometrium was identified. The cervix measured 4.0 cm in length with a patent os and showed no evidence of tumor involvement.\n\nHistologic examination revealed a lesion of endometrioid type, grade 3. The tumor measured 5.0 cm in greatest dimension and demonstrated invasion of less than half of the myometrial thickness, with a depth of 0.5 cm into a myometrium that was 4.3 cm thick. No lymphovascular space invasion was identified in the sections examined. Surgical margins were clear at the cervix and bilateral parametrial tissues.\n\nAdditional findings included foci of adenomyosis within the myometrium. No neoplasm was identified on the uterine serosa or in the bilateral ovaries and fallopian tubes.\n\nLymph node specimens were submitted from right and left paraaortic regions, as well as right and left pelvic regions. In the right pelvic lymph node group, one out of eleven lymph nodes contained metastatic carcinoma confirmed by pancytokeratin immunostaining. No metastasis was identified in the remaining lymph nodes across all other groups.\n\nStaging was assigned based on AJCC criteria for tumors of the endometrium as T1a, N1."} +{"pid": "TCGA-AP-A059", "report": "The surgical specimens included the uterus, cervix, bilateral fallopian tubes and ovaries, as well as multiple lymph node groups from both sides, including external iliac, hypogastric, obturator, and para-aortic regions. Examination of the uterine tissue revealed a lesion with solid growth patterns and nuclear features ranging from grade 2 to grade 3. The lesion extended into the myometrium, with a maximal invasion depth of 3 mm; the total myometrial thickness at this site measured 25 mm. There was no evidence of endocervical or vascular invasion. The endometrium also showed complex hyperplasia with atypia, and the myometrium contained areas of adenomyosis and leiomyoma(s). All adnexal structures appeared normal. No malignant cells were identified in any of the submitted lymph nodes, which were histologically benign.\n\nAdditional immunohistochemical analysis demonstrated reduced expression of MSH6 protein, although interpretation was somewhat limited due to overlapping staining in stromal elements. MLH1 and MSH2 remained intact. This staining pattern may suggest microsatellite instability, though further confirmation through genetic testing is recommended. Some areas of the tissue exhibited undifferentiated morphology with significant lymphocytic infiltration, prompting further investigation into possible underlying molecular features."} +{"pid": "TCGA-D7-6519", "report": "Histopathological examination of the total organ resection from the stomach was performed. The specimen measured 19.2 x 13.2 cm and included omentum measuring 20 x 8 cm. The tumor was located in the orifice region, with a size of 4.8 x 6.2 x 1.4 cm. It was situated 0.8 cm from the proximal resection margin and 13.1 cm from the distal margin.\n\nMicroscopic evaluation revealed a mixed-type tumor according to Lauren classification, with poorly differentiated features. The lesion showed infiltration through the entire gastric wall. Surgical margins were free of tumor involvement. Vascular invasion was present. Lymph node examination revealed metastatic involvement in a subset of nodes. Tumor staging was determined as pT2 with regional lymph node involvement (pN1)."} +{"pid": "TCGA-BQ-7051", "report": "The right kidney specimen measured 22 x 15 x 11 cm and weighed 200 grams. A large cystic lesion measuring 17 x 11 x 8 cm was identified in the upper pole of the cortex, filled with dark brown necrotic fluid and yellow-brown necrotic tissue. The tumor was located 5 cm from the ureter margin. No involvement of the renal vein or local invasion was observed. The surgical margins were free of tumor. The remaining kidney showed a well-defined cortico-medullary junction, with a cortex measuring 0.7 cm. The ureter and renal vessels appeared unremarkable. No lymph nodes were found in the perinephric fat.\n\nLymph nodes from the precaval and paracaval regions were submitted, ranging from 1 to 2 cm in size. All five lymph nodes examined showed no evidence of involvement.\n\nA right adrenal gland was also submitted, measuring 4.5 x 1.7 x 1 cm and weighing 7 grams. It displayed an unremarkable cortex and medulla. No lymph node was identified in this specimen.\n\nImmunohistochemical staining showed positivity for CK7 and racemase, focal positivity for CA-9, and negativity for CD10. No additional neoplastic findings were noted in the submitted sections."} +{"pid": "TCGA-EL-A3D0", "report": "The surgical specimen from a male patient includes a left modified neck dissection and total thyroidectomy. The dissection specimen measures 14.0 x 11.0 x 2.0 cm and includes soft tissue with associated lymph nodes, as well as a segment of the left sternocleidomastoid muscle measuring 10.0 x 6.0 x 2.0 cm. Lymph nodes were identified across multiple levels: one in level I, 15 in level II, 9 in level III, 12 in level IV, and 1 in level V. Many of the lymph nodes were cystic and contained hemorrhagic fluid. A level III lymph node measuring up to 3.5 cm in maximum dimension was grossly involved by firm, cream-white tissue. No gross involvement of the sternocleidomastoid muscle was observed.\n\nThe thyroidectomy specimen weighed 36.0 grams. The right lobe measured 4.0 x 3.0 x 1.0 cm, the left lobe 5.0 x 3.5 x 3.0 cm, and the isthmus 1.0 x 0.3 x 0.3 cm. The left lobe was largely replaced by a solid, firm, gritty, cream-white mass measuring 4.8 x 3.0 x 1.8 cm, which extended to the inked margin in multiple areas. A 0.5 x 0.4 x 0.4 cm firm nodule was present at the inferior pole of the left lobe, and a separate 0.2 cm cream-white nodule was found superior to the main mass. The right lobe contained two small tan-white nodules, one at the mid-portion (0.4 x 0.3 x 0.3 cm) and another at the inferior pole (0.3 x 0.3 x 0.2 cm). The uninvolved right thyroid tissue had a firm, meaty red cut surface."} +{"pid": "TCGA-YZ-A982", "report": "The specimen consists of an intact right eye globe measuring 24 mm in anteroposterior diameter, 24 mm in horizontal diameter, and 23 mm in vertical diameter. Sectioning revealed a gray-black, rubbery mass occupying approximately three-fourths of the globe. The optic nerve measured 4 mm in length and 5 mm in diameter. \n\nMicroscopic evaluation showed a solid growth pattern arising from the choroid and ciliary body. The anterior margin of the tumor was located less than 1 mm from the limbus at the cut edge, while the posterior margin extended to the edge of the optic disc. The height of the tumor at the cut edge was 18 mm. Histologic examination revealed a spindle cell morphology comprising greater than 90% of the tumor cells. Histologic grade was determined to be pG1. No melanoma was identified at the surgical margins.\n\nPathologic staging was assessed as pT4b NX MX. Additional findings included moderate pigmentation, absence of microvascular patterns, vascular invasion, or tumor-infiltrating lymphocytes. Mitotic count was 6 per 40 high power fields. Drusen were present and retinal detachment was confirmed. There was no evidence of scleral involvement, hemorrhage, neovascularization, or invasion of Bruch\u2019s membrane. A PAS stain was performed to evaluate for potential vascular mimicry patterns but none were identified.\n\nCytogenetic analysis did not yield dividing cells for karyotyping. Fluorescence in situ hybridization (FISH) studies demonstrated gains in chromosome 3 centromere and CMYC, which were noted as unusual findings. \n\nThe specimen was received properly labeled and consisted of trisected globe tissue submitted in cassettes A1\u20133. All measurements and descriptions are based on both gross and microscopic evaluations."} +{"pid": "TCGA-EL-A3GX", "report": "The specimen included a thyroid measuring 6.5 x 5.5 x 1.9 cm with a portion of skeletal muscle on the anterior surface. The right lower lobe contained a well-circumscribed, partially cystic and papillary tumor measuring 2.5 x 2.0 x 1.5 cm with central calcifications. A smaller tumor measuring 1.5 x 0.9 x 0.3 cm was identified in the left lower lobe. Additionally, a separate pink and red, ill-circumscribed solid nodule measuring 1.0 x 0.9 x 0.9 cm was found in the right upper lobe. Two tan and firm lymph nodes were also identified, measuring 1.1 x 0.7 x 0.6 cm and 0.9 x 0.7 x 0.7 cm.\n\nA fragment of fibroadipose tissue from a right selective neck dissection (level III, IV, V) measured 5.3 x 5.2 x 0.6 cm. Level III lymph nodes ranged in size from 0.3 cm to 1.5 x 0.6 x 0.3 cm. Multiple tan-pink lymph nodes were found in level IV, ranging from 0.3 cm to 1.5 x 0.6 x 0.5 cm, with one lymph node showing gross involvement. In level V, lymph nodes measured between 0.5 x 0.4 x 0.2 cm and 1.3 x 0.9 x 0.8 cm. Metastatic cells were identified in one lymph node from level IV out of 20 total lymph nodes examined. All surgical margins were free of tumor involvement."} +{"pid": "TCGA-VD-A8KK", "report": "A fresh, intact left globe was received for examination. The axial measurement of the globe was 26mm, horizontal 24.5mm, and vertical 25mm. The cornea measured 11.6mm horizontally and 11mm vertically. The optic nerve had a length of 7mm and a diameter of 4mm. On gross inspection, a large shadow was observed over nearly the entire medial half of the globe. Upon sectioning, a large solitary pigmented mass was identified within the choroid, associated with probable focal underlying extension beyond the sclera. The largest basal diameter of the mass was 17.5mm, with a height of 12.6mm.\n\nMicroscopic evaluation revealed a partially pigmented lesion composed predominantly of spindle-shaped cells. Immunohistochemical staining demonstrated expression of Melan-A and HSP-27 with a score of 2. Approximately 7 mitotic figures were identified per 40 high power fields. Focally present were closed vascular loops. The lymphocytic infiltrate within the lesion was minimal, and scattered macrophages were noted. Necrosis was not observed. Examination of Bruch\u2019s membrane suggested disruption in the areas assessed. There was no evidence of involvement of the optic nerve or vortex veins. However, infiltration through the sclera with extension to the scleral surface and loose attachment to episcleral tissue was identified, raising concerns regarding completeness of excision.\n\nElsewhere in the globe, the cornea appeared unremarkable. Anterior chamber angles were open and the anterior chamber was deep. The iris showed no significant abnormalities, although the ciliary body exhibited atrophy with hyalinization of the ciliary processes. The lens displayed a glassy appearance. The retina overlying the lesion showed mild atrophy."} +{"pid": "TCGA-FT-A61P", "report": "The specimen included left and right distal ureter segments, a fragment of the membranous urethra, multiple lymph nodes from various pelvic regions, and a radical cystoprostatectomy specimen. Microscopic examination of the left and right distal ureters showed no evidence of carcinoma in situ or invasive carcinoma. The membranous urethra showed benign mucosa with focal chronic inflammation.\n\nLymph node evaluation revealed the following: four external iliac lymph nodes (left side #1) were negative; two internal iliac lymph nodes (left side) were negative; one common iliac lymph node (left side) was negative; one external iliac lymph node (left side #2) contained metastatic involvement measuring 1.2 cm without extranodal extension; one of three left obturator lymph nodes contained metastatic involvement measuring 1.4 cm without extranodal extension; the right external iliac lymph node was negative; the right obturator lymph node and the right internal iliac lymph node were also negative.\n\nThe radical cystoprostatectomy specimen revealed a mass measuring 3.0 cm located in the posterior left lateral wall of the urinary bladder. Histologic evaluation showed high-grade urothelial carcinoma invading through the muscularis propria into the perivesical adipose tissue. Surgical margins were free of tumor, with the closest distance of invasive carcinoma to the deep margin being 0.9 cm. No lymphovascular invasion was identified. Two of 14 regional lymph nodes showed metastatic involvement. The prostate demonstrated benign histology without evidence of malignancy."} +{"pid": "TCGA-CK-5913", "report": "The specimen consists of a right colectomy measuring 27 cm in total length, including terminal ileum and ascending colon. A polypoid mass with central ulceration is identified, measuring 4.5 x 4.0 x 3.0 cm, located 7 cm from the proximal resection margin, 13 cm from the distal resection margin, and 1.5 cm distal to the ileocecal valve. The tumor forms a tan/black tattoo-like lesion and has an infiltrating border with diffuse infiltration into the surrounding tissue. It invades through the muscularis propria into the serosa. The serosa underlying the mass appears puckered and is inked orange. The radial margin is involved, with the tumor located 0.2 cm from the radial margin. Proximal and distal resection margins are free of involvement.\n\nHistologic evaluation shows moderately differentiated cellular features with focal mucinous characteristics. Lymphovascular, extramural venous, and perineural invasion are not present. A mild peritumoral lymphoid response, including a Crohn's-like infiltrate, is noted. No residual adenoma is identified.\n\nA total of 22 regional lymph nodes are examined, none of which show evidence of involvement. The pericolonic adipose tissue contains multiple lymph node candidates up to 1.2 cm in size, all of which are submitted for evaluation.\n\nSections submitted include representative portions of the tumor, normal and uninvolved mucosa, and margins. The AJCC classification (6th edition) is pT3a NO MX. The patient underwent a lap-assisted right colectomy. Clinical history and operative findings are not provided."} +{"pid": "TCGA-QH-A65R", "report": "The specimen consists of tissue obtained from the temporal lobe of a female patient. Histological examination reveals a densely cellular lesion composed of uniform cells with round to oval nuclei and finely granular chromatin. Frequent mitotic figures are observed. The tumor exhibits infiltrative growth with involvement of the cerebral cortex and subcortical white matter. Microvascular proliferation is present. Margins of resection show no residual tumor. Based on histopathological features, the lesion is classified as a high-grade neoplasm."} +{"pid": "TCGA-HZ-A49I", "report": "The surgical specimen included a resection of the pancreas with distal stomach, duodenum, and gallbladder. Gross examination revealed a mass measuring 5.0 x 4.5 x 3.3 cm located in the head of the pancreas. Microscopic evaluation showed an invasive adenocarcinoma with moderately differentiated features. The tumor formed irregular glands with nuclear atypia and extended into peripancreatic adipose tissue. A positive margin was identified at the pancreatic notch, with tumor cells within 0.2 cm of the posterior margin. Lymphovascular invasion was present.\n\nThree of nine dissected peripancreatic and portal lymph nodes contained malignant cells. No perineural invasion was observed. Histologic evaluation also identified a neuroendocrine component intermixed with the adenocarcinoma. This component exhibited nests and cords of cells with round nuclei and speckled chromatin, confined within the pancreas without increased mitotic activity.\n\nAdditional findings included high-grade pancreatic intraepithelial neoplasia (PanIN III), chronic pancreatitis, mesothelial cysts, and mild chronic cholecystitis with cholesterolosis and cholelithiasis in the gallbladder. Immunohistochemical staining confirmed the presence of both ductal and neuroendocrine elements.\n\nStaging classification based on the findings was pT3 for the primary tumor and pN1 for regional lymph node involvement. The closest approach of the tumor to the ampulla was 1.3 cm, and it was 9 cm from the gastric margin and 14 cm from the distal duodenal margin. All other margins were free of tumor."} +{"pid": "TCGA-H9-A6BY", "report": "The prostatectomy specimen with attached seminal vesicles measured 33 x 54 x 38 mm and weighed 42 grams. Histologic evaluation revealed multiple tumor foci, with the largest measuring 32 mm in greatest dimension and located in the right posterior region extending into the anterior aspect. A second largest focus measured 21 mm and was identified in the left posterior area. The primary histologic pattern was present in 80% of the tumor volume, with a secondary pattern accounting for 20%. No tertiary pattern was identified.\n\nExtraprostatic extension was noted focally in the right posterior region. Involvement of the bladder neck was present but did not extend to the surgical margin. Surgical margins were closely approached bilaterally at the posterior aspects and also on the right anterior aspect, with tumor within less than 1 mm of the margin. Lymph-vascular invasion was not identified; however, perineural invasion was present. High-grade intraepithelial neoplasia was also observed.\n\nLymph node assessment included 19 nodes submitted from both right and left pelvic regions. Ten lymph nodes from the right pelvic dissection showed no evidence of involvement. Nine lymph nodes from the left pelvic dissection also showed no pathologic changes. All lymph nodes examined were negative for metastatic disease.\n\nThe specimen was extensively sectioned and submitted for microscopic analysis, including margins at the apex and base, bilateral posterior and anterior regions, and areas approaching the seminal vesicles. No treatment effect was noted."} +{"pid": "TCGA-C5-A3HF", "report": "The patient is a young woman who underwent evaluation of multiple biopsies and tissue samples. A biopsy from the 3 o\u2019clock position of the cervix revealed a well-differentiated glandular lesion with both glandular and villous/papillary architecture. The cells showed prominent intracytoplasmic mucin and abundant extracellular mucin production. A separate fragment of adenocarcinoma was identified in the uterine curettings, showing similar histologic features. These fragments were admixed with endometrial tissue demonstrating progestogen effect, including small, sparse glands lined by simple columnar epithelium, with focal mitotic activity and rudimentary secretory changes. The stroma was abundant, with focal pseudodecidualization, chronic inflammation, and vascular dilation. There was also evidence of gland and stromal breakdown.\n\nA cervical biopsy from the 12 o\u2019clock position showed mild squamous dysplasia (CIN 1), along with chronic inflammation and marked hyperkeratosis. Additionally, there was a small focus of dysplastic squamous epithelium noted. Within the endocervical fragments, one area showed squamous metaplasia partially replaced by markedly atypical glandular epithelium suggestive of an in situ process. The left ovarian cyst was identified as a corpus luteum cyst, with minor surface fibrous adhesions.\n\nThe patient\u2019s age, absence of endometrial hyperplasia, and presence of an in situ component favor a likely endocervical origin for the glandular lesion."} +{"pid": "TCGA-B0-5108", "report": "The specimen consists of a left nephrectomy. The neoplasm demonstrates cystic and myxoid changes. Nuclear grading according to the Fuhrman system is 2 of 4. The greatest diameter of the lesion measures 5.5 cm. The lesion extends to the renal sinus fat, as noted on slides E and F. There is no evidence of renal vein invasion or angiolymphatic invasion. The tumor is confined to the renal capsule. All surgical margins are free of involvement. The surrounding non-neoplastic kidney tissue shows chronic interstitial inflammation. Based on the extent of the lesion, staging is consistent with pT3a NX MX."} +{"pid": "TCGA-Y8-A8S0", "report": "The specimen from a male with a left renal mass was obtained via laparoscopic partial nephrectomy. The tumor was located in the inferolateral cortex and measured 1 x 1 x 0.7 cm. It was unifocal and confined to the kidney on both macroscopic and microscopic evaluation. Histologic analysis showed no sarcomatoid features or tumor necrosis. The nuclear grade was Fuhrman 2. Margins were negative for carcinoma, though the tumor extended to within 0.5 mm of the parenchymal margin. No lymphovascular invasion was identified. Pathologic staging indicated the primary tumor was pT1a (tumor \u22644 cm, limited to the kidney), while regional lymph nodes were unable to be assessed (pNX) and distant metastasis was not applicable. The nonneoplastic kidney tissue showed no significant histologic abnormalities, and no other tumors or tumor-like lesions were present. Specimen quality control showed 100% tumor nuclei with no necrosis or normal tissue contamination. Normal kidney tissue was composed of 100% benign elements. The specimen included plasma, serum, buffy coat, and tissue samples, with cold ischemia and fixation times documented. Specimen weight and size were within expected ranges. No metastatic tissue was collected. All procedures followed appropriate study protocols with patient consent confirmed."} +{"pid": "TCGA-LL-A6FQ", "report": "The specimen was received from the right breast and axillary contents. Gross examination of the mastectomy specimen revealed a tumor in the upper outer quadrant measuring 4 cm. A second tumor was identified adjacent to the nipple, measuring 2 cm. The larger tumor was well-circumscribed and grayish-white, located 1.5 cm from the skin surface. The deep margin adjacent to this tumor was inked blue and showed no involvement by invasive carcinoma. Histologically, the tumor demonstrated grade 2 differentiation based on the Nottingham histologic scoring system, with glandular differentiation score 3, nuclear pleomorphism score 2, and mitotic index score 1. Angiolymphatic invasion was present.\n\nMicroscopic evaluation confirmed multiple foci of invasive carcinoma. No ductal carcinoma in situ was identified. Evaluation of the nipple-associated lesion with E-cadherin staining confirmed its ductal origin. The tumor directly invaded into the dermis but without ulceration of the overlying skin. All surgical margins were free of invasive carcinoma, with the closest margin measuring 3 cm from the tumor.\n\nAxillary lymph node dissection yielded a total of 18 lymph nodes. Of these, 7 contained metastatic carcinoma, including both macrometastases (5 nodes) and micrometastases (2 nodes). Focal extracapsular extension was noted in some involved nodes. Ancillary studies performed on the largest tumor included immunohistochemistry: estrogen receptor was positive (100% tumor stained), progesterone receptor was positive (85%), Ki-67 showed high proliferative activity at 24%, and Her2/neu staining was negative (1+). These results were interpreted in accordance with CAP/ASCO guidelines for testing and reporting.\n\nAdditional sections from involved lymph nodes were evaluated with PanKeratin stain. Representative sections of both large and small lymph nodes were submitted for analysis. Tissue banking was completed with an adequate portion of the tumor provided for future study. The mastectomy specimen also included skeletal muscle fibers at the deep margin, which were uninvolved.\n\nPathologic staging assigned was pT2 for the primary tumor and pN2a for regional lymph node involvement. Distant metastasis could not be assessed from this specimen."} +{"pid": "TCGA-CJ-6030", "report": "The left radical nephrectomy specimen measured 28.0 x 14.0 x 7.0 cm and included the kidney, a segment of ureter measuring 13.0 cm in length, adrenal gland, and a segment of renal vein. The kidney contained a hemorrhagic solid and cystic yellow mass measuring 3.5 x 3.0 x 3.0 cm located in the renal hilum. The mass bulged into and distorted the pelvicalyceal system and renal sinus without gross invasion into the renal sinus adipose tissue or collecting system. There was no invasion identified in the renal vein or perinephric adipose tissue. The adrenal gland showed focal nodularity but no evidence of metastatic involvement.\n\nHistologic examination revealed a tumor composed of 75% clear cells and 25% eosinophilic cells with Fuhrman nuclear grade 3 features. Surgical margins were free of tumor involvement. Eleven lymph nodes were examined and none contained tumor. The tumor was located near the hilum and extended into a medium-sized blood vessel within the renal sinus, though there was no invasion of the renal sinus adipose tissue. Multiple soft, unremarkable lymph nodes were identified and submitted for evaluation. No other lesions or masses were noted in the adrenal gland or elsewhere in the specimen."} +{"pid": "TCGA-QK-AA3J", "report": "The specimen from the right arytenoid consists of multiple pink-red soft tissue fragments measuring 1.0 x 0.8 x 0.2 cm in total. A portion of the tissue was submitted for intraoperative frozen section analysis. Microscopic examination revealed invasive malignant cells with poorly differentiated features and basaloid morphology. The tumor involves the surgical margins and demonstrates deep extension. No lymph nodes were identified in the specimen. Immunohistochemical staining and further histologic evaluation confirmed the presence of a high-grade epithelial neoplasm. Staging is based on local invasion and margin involvement."} +{"pid": "TCGA-CQ-6228", "report": "The specimen consisted of multiple tissue samples from various anatomical sites including the oral cavity, neck levels, muscles, and soft tissues. Gross examination revealed a tumor arising in the anterior floor of mouth with a size of 0.7 \u00d7 1.2 \u00d7 0.8 cm. Microscopic evaluation identified the presence of a moderately differentiated cellular proliferation within this region. The maximum tumor dimension was 1.2 cm with a thickness measuring 1.2 cm. The tumor was located close (0.4 cm) to the deep margin; however, all other resection margins were free of involvement (> 0.5 cm). No perineural invasion was observed.\n\nExamination of regional lymph nodes revealed involvement in several areas. In the left neck, level I, one out of seven lymph nodes showed signs of metastatic involvement. The involved node measured 0.9 cm and demonstrated extracapsular extension with tumor located very close (< 0.1 cm) to the soft tissue margin. In level III, seven out of fifteen lymph nodes were involved, with the largest measuring 5.0 cm and showing extensive extracapsular extension and tumor at the soft tissue margins. Level IV contained four involved lymph nodes among eighteen examined, with the largest measuring 3.5 cm and also demonstrating extensive extracapsular extension. In level V, two out of twelve lymph nodes were involved, with the largest measuring 0.5 cm and no extracapsular extension. Bone sections showed no evidence of tumor involvement.\n\nA total of 76 lymph nodes were examined across all levels, with 14 found to be involved. No malignancy was detected in the remaining specimens, which included soft tissues, muscles, and other oral cavity regions. Additionally, no venous or lymphatic invasion was identified."} +{"pid": "TCGA-AJ-A3EL", "report": "The specimen was collected on [PROCEDURE DATE] and reported on [REPORT DATE]. Pre- and post-operative clinical assessments were consistent with findings noted during evaluation. \n\nGross examination included six tissue specimens. The first specimen consisted of an 8.0 x 3.0 x 1.5 cm collection of fatty tissue containing multiple lymph nodes, with the largest measuring up to 4.8 cm. All lymph nodes were processed in various sections. The second specimen measured 6.0 x 2.8 x 1.6 cm and contained multiple lymph nodes up to 1.8 cm in size, all submitted for analysis. The third specimen was a 5.5 x 3.2 x 1.8 cm aggregate with few identifiable lymph nodes, the largest measuring 3.5 cm; these were sectioned and submitted in full or in part. The fourth specimen, measuring 6.5 x 2.4 x 1.1 cm, contained numerous lymph nodes up to 2.8 cm in greatest dimension, also submitted in various preparations. \n\nThe fifth specimen included a uterus weighing 107.9 grams, measuring 7.0 x 5.5 x 5.0 cm, with attached cervix and right adnexal tissue (19.1 grams). The uterine cavity measured 3.0 cm in width and 4.5 cm in length. The endometrium was generally 0.2 to 0.3 cm thick and featured a 3.0 x 2.3 x 1.5 cm exophytic friable lesion involving the lower uterine segment and both anterior and posterior walls. Histologically, this lesion extended 0.2 cm into the myometrium, which had a thickness of 1.8 cm at that location. Adjacent myometrial tissue showed scattered fibrous nodules up to 0.7 cm in size. The right adnexal region contained a 6.8 x 4.2 x 2.2 cm mass of gray-tan to violaceous tissue with cystic hemorrhagic stroma. Sections were taken from multiple regions including parametrial tissues and residual ovarian stroma. \n\nThe final specimen consisted of a 5.0 x 4.2 x 1.2 cm membranous to hemorrhagic tissue fragment, interpreted as cyst wall, and submitted for histologic review. \n\nMicroscopic evaluation revealed no evidence of malignancy in any of the lymph node specimens, with all nodes appearing benign and hyperplastic. In the hysterectomy specimen, a poorly differentiated endometrioid-type lesion was identified within the uterine cavity, particularly involving the lower uterine segment. The lesion measured 3.0 x 2.3 x 1.5 cm and demonstrated limited myometrial invasion (0.3 cm into a 1.8 cm thick myometrium). No cervical involvement, lymphovascular space invasion, or surgical margin involvement was observed. A total of 28 lymph nodes were evaluated across all specimens, none of which contained metastatic disease. Additional findings included adenomyosis and endometriosis affecting the serosal surface and right ovary. \n\nThe cyst wall specimen showed features consistent with a corpus luteal cyst. Staging was determined as pT1a, N0. Special stains and genomic studies were performed as indicated."} +{"pid": "TCGA-B0-5402", "report": "The specimen consists of a left radical nephrectomy with resection of a portion of the psoas muscle and gastrorrhaphy. The tumor measures 25 cm in greatest dimension and is multifocal, involving the upper, middle, and lower poles of the kidney. Hemorrhage and necrosis are present, with focal sarcomatoid dedifferentiation identified microscopically. The predominant nuclear grade is Fuhrman grade 3, with focal areas of Fuhrman grade 4 nuclei.\n\nExtracapsular extension is present in perirenal adipose tissue, and there is direct infiltration into the adrenal gland. A small tumor embolus is identified within a renal sinus vein; however, no tumor thrombus is present in the main renal vein. All surgical margins, including Gerota\u2019s fascia, renal vein, ureter, and renal artery, are free of tumor involvement.\n\nHistologic examination of the non-neoplastic kidney shows mild to moderate glomerular hypertrophy, mild arterial sclerosis, focal subcapsular tubular atrophy, and mild interstitial fibrosis. No lymph nodes are identified in the specimen.\n\nStaging according to AJCC criteria indicates pT4 NX MX. Lymphovascular invasion is identified. There is no evidence of malignancy in the gastric or psoas muscle specimens."} +{"pid": "TCGA-AZ-6606", "report": "The patient underwent a laparoscopic right hemicolectomy. A biopsy of the liver demonstrated involvement by a neoplastic process. The primary lesion measured 8.0 cm in its greatest dimension and was located in the cecum. Histologically, the tumor was described as moderately differentiated with an infiltrative growth pattern. It extended through the muscularis propria into the pericolonic adipose tissue and visceral peritoneal surface, with invasion also noted into a segment of small intestine. Angiolymphatic invasion was present.\n\nLymph node assessment revealed metastatic involvement in 10 out of 17 nodes examined. The surgical margins were free of invasive carcinoma. The appendix showed serosal involvement by the neoplasm. A separate tubular adenoma measuring 1.0 cm was also identified.\n\nHistologic evaluation noted perineural invasion and a poorly circumscribed tumor border. Molecular testing of the tumor tissue (block 2D) revealed a KRAS codon 12 mutation (Gly12Val). DNA quality and quantity were sufficient for analysis. No microsatellite instability was detected using standard markers. The clinical significance of these molecular findings was discussed in the context of their potential impact on treatment response and prognosis.\n\nStaging was determined as pT4b, pN2, pM1, indicating advanced local invasion, extensive nodal involvement, and distant metastasis to the liver. The tumor did not receive any pretreatment prior to resection."} +{"pid": "TCGA-2Y-A9H4", "report": "The gallbladder specimen measured 7.7 x 2.8 x 2.5 cm and showed no macroscopic abnormalities. Histologic examination revealed chronic cholecystitis without evidence of malignancy. Two liver nodules from the left lobe were sampled intraoperatively; both showed benign liver tissue with focal scarring and no malignant cells. A portal lymph node was also examined and found free of malignancy.\n\nThe right lobe liver resection specimen weighed 761.9 grams and measured 17.5 x 16.0 x 7.0 cm. A well-circumscribed tan mass measuring 3.3 x 2.5 x 1.5 cm was identified within the hepatic parenchyma, located 3.8 cm from the nearest surgical margin and 1.5 cm from the capsule. Adjacent to this mass was a separate pale area; the remainder of the parenchyma appeared homogeneous. Microscopic evaluation showed moderately differentiated hepatocellular carcinoma confined entirely within the liver parenchyma. There was no necrosis, vascular invasion, or perineural invasion identified. Surgical margins were negative for tumor involvement.\n\nAdditional findings included focal steatosis and chronic inflammation within the portal triad. All submitted tissue sections were examined and confirmed to be representative for diagnostic evaluation."} +{"pid": "TCGA-DK-A3IS", "report": "The specimen consists of a bladder, prostate, seminal vesicles, and perivesical tissue measuring 12.5 cm from superior to inferior, 11.0 cm laterally, and 9.5 cm from anterior to posterior. The prostate measures 5.0 x 4.5 x 3.7 cm, with the right and left seminal vesicles measuring 2.5 x 1.0 x 0.5 cm and 2.8 x 1.1 x 0.5 cm respectively. The right and left vas deferens measure 9.5 cm and 5 cm in length, with an average diameter of 0.5 cm each. Upon opening the bladder along the anterior midline, a large fungating lesion is identified measuring 12.5 x 11.0 x 1.8 cm and involving approximately 80% of the urothelial surface. Histologic examination reveals a component invading the superficial half of the muscularis propria without extension into surrounding structures. No involvement of the ureters or urethra is observed. Free floating urothelial fragments with atypia are noted at the urethral margin; however, the attached lining and remainder of the urethra appear benign. No vascular or perineural invasion is identified. Surgical margins are free of tumor involvement. Non-neoplastic changes include proliferative cystitis in the bladder mucosa and nodular hyperplasia in the prostate.\n\nAdditional histopathological evaluation of the prostate demonstrates multicentric foci of invasive carcinoma confined to both lobes within the prostate capsule. Tumor location involves the right and left anterior regions with no dominant mass identified. Gleason grading reveals a primary grade of 3 and secondary grade of 3 resulting in a total Gleason score of 6. A minor component of pattern 4 is also present. High-grade prostatic intraepithelial neoplasia is identified. Surgical margins remain free of tumor. Non-neoplastic prostate tissue exhibits nodular hyperplasia.\n\nExamination of regional lymph nodes includes two lymph nodes from the right pelvic region, four from the left pelvic region, and retroperitoneal tissue. No lymph node involvement is identified in any of these specimens. The urachus biopsy and segments of the left distal ureter, right ureter, and periureteral tissues all demonstrate benign findings with no evidence of disease involvement. Segments of the vas deferens on both sides also appear histologically unremarkable.\n\nThe pathologic staging for the bladder component indicates invasion limited to the superficial half of the muscularis propria with no extravesical extension. For the prostate component, staging shows confinement to the prostate capsule involving both lobes without extension beyond. All surgical margins are clear of tumor involvement."} +{"pid": "TCGA-FG-A70Z", "report": "The specimen was received in two properly labeled containers. The first specimen, designated for frozen sectioning, measured 0.6 x 0.5 x 0.5 cm and was submitted as an aggregate of soft tissue. The second specimen consisted of a 35.05 gram, 5.5 x 5.2 x 1.5 cm portion of brain tissue with variable coloration from gray-tan to pink-red. A 4.6 x 3.6 cm area of pink-red disruption was observed on one surface, while the opposing surface displayed a 5.0 x 4.3 cm region of shaggy, white-tan discoloration. On serial sectioning, the cut surfaces showed white-gray to tan-brown to deep red with focal hemorrhage, and an irregular area measuring 5.3 x 4.9 x 1.3 cm was identified. The uninvolved parenchyma appeared white-gray with a distinguishable border between white and gray matter.\n\nMicroscopic examination revealed an infiltrating cellular neoplasm composed of glial elements. Areas of atypical and elongated nuclei were present, consistent with astrocytic differentiation. In most areas, cells displayed rounder configurations, with groups of minigemistocytes and background slender vasculature noted. Frequent mitotic figures, microvascular proliferation, and foci of necrosis, including geographic necrosis, were also observed. Immunostaining for GFAP was positive in many cells, and Ki-67 staining demonstrated a proliferation index of approximately 20\u201325%, based on manual quantification.\n\nFluorescence in situ hybridization (FISH) testing was performed using LSI 1p36/LSI 1q25 and LSI 19q13/LSI 19p13 dual-color probe sets. For the 1p36/1q25 analysis, a total of 177 cells were counted, yielding a ratio of 0.84. For the 19q13/19p13 analysis, 128 cells were evaluated, resulting in a ratio of 0.82. Allelic loss was interpreted based on a threshold ratio of less than 0.80 derived from at least two sets of 20 interphase nuclei in two different areas of the sample. Both loci showed ratios above the threshold, indicating no allelic loss at either locus. The FISH analysis was conducted using a validated semi-automated scanning workstation and reviewed manually by a pathologist.\n\nAll control samples demonstrated appropriate reactivity. It should be noted that some reagents used in the testing are classified as Analyte Specific Reagents (ASRs), and the assays have not been cleared or approved by the FDA. These tests were developed and validated by the laboratory performing the analysis."} +{"pid": "TCGA-DX-AB2L", "report": "The specimen consists of a resected soft tissue mass from the right upper thigh. Gross examination reveals a skin ellipse measuring 17.5 x 5.5 cm with a 7.5 cm linear scar. Underlying soft tissue measures 18 x 12 x 4.5 cm and is oriented using colored ink markers. No distinct tumor mass was identified. A cystic cavity measuring 6.5 x 3.5 x 1.7 cm with a thin fibrous wall is present, located closest to the medial margin at 0.8 cm. Margins measured are as follows: superior (6.5 cm), inferior (6 cm), posterior (2 cm), lateral (3 cm), and medial (0.8 cm). Histologic evaluation shows only granulation tissue within the biopsy cavity along with a foreign body giant cell reaction. No residual malignant cells were detected. Multiple sections from all margins and surrounding tissue were examined and submitted for analysis."} +{"pid": "TCGA-A8-A07P", "report": "The specimen consists of a left breast segment with a focus measuring 3.5 cm in greatest dimension. Histologic evaluation reveals invasive malignancy with high-grade nuclear features (grade 3). The histologic grade was determined as 3/3/2. Margins were assessed, with the closest being 1 mm from the dorsal resection margin and 3 mm from the cranial resection margin. Small foci of intraductal malignancy with high nuclear grade (grade 3) and comedo-type necrosis were also identified. Lymph node assessment shows one involved lymph node out of eleven examined. Pathologic staging is pT2 based on size, pN1 based on nodal involvement, and MX for distant metastasis. Resection margins are classified as R0, with the specified distances to the dorsal and cranial margins."} +{"pid": "TCGA-BG-A221", "report": "The specimen consisted of a total abdominal hysterectomy with bilateral salpingo-oophorectomy, weighing 86 grams. The endometrium showed a high-grade poorly differentiated mixed epithelial carcinoma with endometrioid features and squamous differentiation, nuclear grade 3, along with a clear cell component comprising approximately 10%. Extensive necrosis was present, involving about 85% of the endometrial surface and penetrating approximately 80% of the myometrial thickness. Lymphovascular invasion was identified. Additional findings included superficial adenomyosis, a lower uterine segment endometrial polyp, chronic cystic cervicitis, and medial calcification of myometrial blood vessels. Both ovaries showed epithelial inclusions without any tumor identified. The fallopian tubes were unremarkable except for a paratubal cyst noted on the right side. No tumor was found in the omentum or in biopsies from the left and right pelvic peritoneum. A total of 18 lymph nodes were examined across various regions\u2014left pelvic (8), left common iliac (1), left para-aortic (1), right pelvic (5), and right para-aortic (3)\u2014all free of tumor. The tumor measured 45 mm in maximum dimension and involved approximately 90% of the anterior endomyometrium and 80% of the posterior endomyometrium. Depth of myometrial invasion was greater than or equal to half the thickness. Pelvic wash cytology was negative for malignant cells."} +{"pid": "TCGA-A3-3311", "report": "The specimen consists of a right kidney with attached perinephric fat, measuring 13 x 8 x 5.5 cm and weighing 282 grams after removal of fat. The ureter and vascular margins are included. A mass located in the lower pole of the kidney measures 5.5 x 4.0 x 4.0 cm and appears golden-yellow; it does not involve the capsule. The renal cortex averages 0.7 cm in thickness and contains a cortical cyst measuring 4 cm. An adrenal gland measuring 7.0 x 2.3 x 0.8 cm is present and uninvolved.\n\nMicroscopic evaluation reveals a predominant nuclear grade II component with a focal area of grade IV (approximately 5% of the tumor). No venous or lymphatic invasion is identified. Margins of resection are free of involvement. Regional lymph nodes and distant metastases cannot be assessed. Additional findings include a renal cortical cyst and focal mild chronic interstitial inflammation."} +{"pid": "TCGA-85-8582", "report": "The lung tissue measured 18x16 cm and contained a pinky-gray mass measuring 2 cm in its largest dimension. Microscopic evaluation showed a well-differentiated cellular pattern with keratinization. The tumor was localized and no venous invasion was identified. A small fragment of bronchial tissue appeared histologically normal. Eight lymph nodes were examined and all were negative for metastatic involvement, showing only anthracotic changes. No abscess formation or treatment-related changes were noted. The specimen was obtained via lobectomy and the tumor was confined to the lung without evidence of multifocal disease. Lymphatic invasion could not be assessed. Additional findings were not specified."} +{"pid": "TCGA-T2-A6WX", "report": "The pathology report includes multiple specimens with a range of histologic findings. A lymph node from left zone 1A shows benign salivary gland tissue with chronic inflammation. Specimens from the dorsum of the tongue, including both the true anterior/superior and true posterior/superior margins, reveal changes consistent with verrucous hyperplasia and submucosal chronic inflammation, with the latter also showing marked acanthosis.\n\nIn the left neck dissection specimen (zones I\u2013V), one out of sixty lymph nodes demonstrates microscopic evidence of metastatic disease involvement in level II without extracapsular extension. The specimen also contains benign submandibular and parotid gland tissues, with features of oncocytosis, sialolithiasis, and chronic sialadenitis noted. No malignant involvement is found in the right neck zones IA/IB or zone II lymph nodes.\n\nA left partial glossectomy specimen reveals invasive, focally keratinizing, well to moderately differentiated squamous cell carcinoma measuring 3.2 cm. The tumor infiltrates to a depth of 0.9 cm into the tongue musculature, with focal surface ulceration, perineural invasion, and suspicion for angiolymphatic invasion. Resection margins are negative for invasive carcinoma, though the blue and posterior margins show changes consistent with verrucous hyperplasia.\n\nAn excised soft tissue mass from the left buccal region measures 2 cm and shows invasive, moderately to poorly differentiated, focally keratinizing squamous cell carcinoma with an in situ component. The tumor is largely exophytic, invading only superficially to a depth of 0.2 cm. Focal ulcerations, angiolymphatic invasion, and perineural invasion are present. The in situ component is identified at the inferior (blue) resection margin, while other margins are free of tumor involvement.\n\nA left maxillectomy specimen contains invasive, moderately to poorly differentiated squamous cell carcinoma involving the lateral aspect of the left alveolar ridge mucosa and extending into the underlying bone. The tumor measures 3.6 cm and infiltrates through but does not fully penetrate the maxillary sinus floor. Perineural and angiolymphatic invasion are present. Malignancy is identified at the superior lateral and anterior soft tissue margins of the specimen. A separate focus of verrucous carcinoma measuring 0.2 cm is identified on the medial alveolar ridge mucosa side and is completely excised.\n\nIntraoperative frozen section analysis of the left zone 1A lymph node showed no malignancy, confirming benign salivary gland tissue with chronic inflammation. Evaluation of the anterior and posterior margins of the tongue confirmed verrucous hyperplasia and absence of malignancy, respectively.\n\nAdditional findings include widespread lymphocytic infiltration at the mucosal junctions, raising concern for lichen planus\u2013like changes; however, this could not be definitively diagnosed due to extensive tumor involvement. Multiple areas of benign mucosal changes and inflammatory processes are described throughout the report."} +{"pid": "TCGA-G8-6909", "report": "The specimens included lymph node tissue from multiple anatomical sites: right and left distal paratracheal (4R, 4L), left proximal paratracheal (2L), subcarinal (7), and right proximal paratracheal (2R), as well as a biopsy from the anterior segment of the right upper lobe. Tissue measurements varied, with aggregate sizes ranging from 0.1 cm to 2.0x1.0x0.5 cm across specimens. Histologic evaluation of several lymph node samples revealed lymphohistiocytic or lymphoid tissue without evidence of malignancy. One lymph node specimen demonstrated diffuse large cell lymphoma features characterized by histiocytic-rich infiltrates. Immunohistochemical staining showed positivity for CD20 and CD10, while negative for CD30, CD3, CD5, CD68, bcl-1, bcl-2, bcl-6, and D68; scattered background T-cells were highlighted by CD3 and CD5, and CD68 identified numerous histiocytes.\n\nAdditional frozen section evaluations noted atypical lymphoid infiltrates without evidence of carcinoma. Gross examination described tan, lymphoid-appearing, or anthracotic tissue fragments submitted in cassettes for analysis. The bone marrow biopsy showed trilineage hematopoiesis without lymphomatous involvement. Bone marrow aspirate differential demonstrated overall adequate cellularity with no blasts or abnormal lymphoid populations. Myeloid/erythroid ratio was approximately 4:1 with normal morphology and no dysplastic changes observed. There was a slight eosinophilia present but no ring sideroblasts or abnormal infiltrates detected. Cytochemical stains including myeloperoxidase, Sudan Black, chloroacetate esterase, and others were consistent with benign reactive processes. Clinical history included prior diagnosis of non-Hodgkin lymphoma and diffuse large B-cell lymphoma."} +{"pid": "TCGA-CU-A0YN", "report": "The specimen consisted of a cystoprostatectomy measuring approximately 10.8 x 9.1 x 4.2 cm with a focus of involvement identified in the bladder. The lesion measured 3.5 x 3 x 2.5 cm and was located on the anterior wall, dome, and posterior wall, with extension through the muscularis propria into the perivesical fat. The deepest invasion was observed in the posterior wall. The lesion appeared unifocal with a papillary morphology and tan-yellow appearance, with areas suggestive of hemorrhage or necrosis. No angiolymphatic invasion was identified. Surgical margins were assessed as negative.\n\nIn the prostate, involvement was noted at the left apex and right mid portion, comprising approximately 10% of the gland. The lesion was confined within the prostatic capsule without evidence of extracapsular extension or angiolymphatic invasion. Surgical margins were negative. Bilateral seminal vesicles and vas deferens showed no involvement. A total of 11 lymph nodes (3 from the right pelvic region and 8 from the left) were examined, none of which demonstrated metastatic involvement.\n\nA separate biopsy from the urethral margin revealed benign urothelium without cellular abnormalities. Additional biopsies of the right ureter showed no abnormal pathology, while the left ureter could not be identified. Histologic evaluation included immunostaining with high molecular weight cytokeratin, which did not show basal cell loss.\n\nThe specimen also included a fibrofatty tissue fragment from the abdominal cavity containing a calcified foreign body with surrounding fat necrosis and fibrosis. No significant pathologic findings were identified in this component."} +{"pid": "TCGA-AN-A0XT", "report": "Female patient with tumor located in the breast, primary site. Tumor specimen was obtained via surgery and preserved in OCT matrix as a block. Histological evaluation revealed Grade 2 cellular features. The tumor measured 1.5 cm in greatest dimension. Lymph node involvement was present, with 1 of 5 nodes positive. No evidence of distant metastasis was found. A blood sample was collected as a normal control specimen and stored frozen in a tube."} +{"pid": "TCGA-BH-A18J", "report": "The patient underwent a modified radical right mastectomy. The submitted tissue includes the resected breast specimen. Immunohistochemical analysis was performed on slide \"A4\" for estrogen and progesterone receptors. Distinct intranuclear staining was identified for estrogen receptor in approximately 50% of cells and for progesterone receptor in approximately 40% of cells, both interpreted as positive. A Her-2/Neu immunostain was also performed on block \"A4\" using a 1:300 dilution of a polyclonal antibody directed against the intracellular domain of c-erbB2, without antigen retrieval. No distinct complete membrane staining was observed, and Her-2/Neu was interpreted as negative (score 0). A prior Her-2/Neu immunostain from an outside institution was similarly negative.\n\nThe lesion measured 9.0 x 8.5 x 4.0 cm and involved all four quadrants of the breast. It extended to involve the nipple and epidermis of overlying ulcerated skin. The Nottingham score was 8 out of 9, with tubules scoring 3, nuclear atypia scoring 3, and mitotic index scoring 2. Intraductal carcinoma of the comedo type was present, involving less than 5% of the total tumor volume. Resection margins were free of tumor. Multiple matted lymph nodes were present with nearly complete architectural effacement by metastatic disease. Due to the extensive matting and extracapsular extension, an accurate lymph node count could not be determined."} +{"pid": "TCGA-43-A475", "report": "Final Surgical Pathology Report. Procedure: Diagnosis. A. Lung, right upper lobe, resection: Histologic type is poorly differentiated. The mucicarmine stain is negative. Histologic grade is 3 of 3. Mitotic index is 12 mitoses per 10 high power fields. Tumor size is 1.8 cm in the lung and 2 cm including the overlying tumor. Bronchial resection margin and pulmonary margin of resection are both negative for malignancy. The pleura is involved, with penetration through to skeletal muscle. There is presence on the adherent soft tissue surface of the specimen. Vascular invasion is absent. Two hilar lymph nodes are also free of malignancy. Non-tumorous lung demonstrates emphysema. pTNM stage is T3 NO. B. Lymph node, level X, biopsy: No evidence of malignancy is found in a single lymph node. D. Lymph node, R4, biopsy: No evidence of malignancy is found in any of 9 pieces of lymph node. E. Lymph node, level VII, biopsy: No evidence of malignancy is found in any of 5 pieces of lymph nodes. C. Rib, second, biopsy: Sections of rib show normal bone, cartilage, and bone marrow. Carcinoma is identified in the pericostal soft tissue. Antibody results demonstrate negativity for TTF1, positivity for p63, and positivity for CK5/6. Paraffin sections are processed using 10% neutral buffered formalin, and controls stain appropriately. A few antibodies used may be classified as analyte specific reagents, which are monitored and controlled within the laboratory. Their performance for in vitro diagnosis is well described in the medical literature, though they have not been cleared or approved by the FDA. Specimen A (right upper lobe) consists of a 179 g lung lobe measuring 16.5 x 10.5 x 3 cm. A palpable mass located apically measures 1.8 by 1.2 cm in cross section. Some adherent soft tissue on the serosal surface over the tumor measures 3.6 by 2.6 by 0.6 cm. Specimen B (level X) includes two pieces of black soft tissue measuring 1 cm in aggregate. Specimen C (portion of second rib) includes multiple pieces of pink and red bone measuring 5 by 1.5 by 0.7 cm in aggregate. Specimen D (R4) includes multiple pieces of red and black soft tissue occupying approximately 2 mL. Specimen E (level VII lymph node) includes two pieces of pink yellow and black soft tissue measuring 2 cm in greatest aggregate dimension."} +{"pid": "TCGA-V4-A9EK", "report": "The left eye enucleation specimen measured 25 mm in diameter and included a 6 mm segment of optic nerve. On sectioning, a large pigmented lesion was identified at the postero-lateral aspect of the eyeball, adherent to the internal surface of the sclera. The lesion measured 18 mm along its longest dimension and had a maximum thickness of 12 mm. Samples were taken for cryopreservation, and the entire specimen was processed after fixation.\n\nMicroscopic examination revealed a proliferation of cells within the posterior region of the eye. The cells were primarily fusiform in shape, with medium to large cytoplasmic volumes. Melanin pigment was heavily present in the cytoplasm, obscuring nuclear details and making nuclear morphology difficult to assess. The proliferation was found to adhere to the inner aspect of the sclera, with infiltration into its deeper layers, though no extension beyond the sclera was observed.\n\nAnteriorly, the proliferation extended into the posterior portion of the ciliary body but did not reach the iris, iridocorneal angle, or anterior chamber. Posteriorly, the lesion remained separated from the intraocular origin of the optic nerve. The optic nerve itself showed no signs of involvement throughout its extent, including the prelaminar region, optic foramen, postlaminar segment, meningeal sheaths, and the posterior cut margin."} +{"pid": "TCGA-D1-A16G", "report": "The surgical pathology report includes multiple tissue specimens. The uterus, right ovary with a 9.0 cm segment of the right fallopian tube, and left ovary with a 9.0 cm segment of the left fallopian tube together weigh 125.0 grams. Additional specimens include tissue from the bladder peritoneum (4.1 x 1.6 x 0.2 cm), left colic gutter (aggregating 2.3 x 1.9 x 0.5 cm), right colic gutter (aggregating 3.9 x 2.4 x 0.3 cm), two pieces of diaphragmatic peritoneum (aggregating 0.5 x 0.4 x 0.4 cm), a small bowel mesentery biopsy (0.4 x 0.3 x 0.2 cm), a portion of omentum (15.0 x 6.5 x 2.8 cm), and an appendix (8.3 x 0.4 cm). Lymph nodes from the right and left pelvic regions as well as right and left para-aortic areas were also submitted.\n\nA mass measuring 4.8 x 4.7 x 3.6 cm was identified in the uterus. Histologic evaluation revealed high cellularity with atypical cells invading through the myometrium to the uterine serosa. Evidence of lymphovascular invasion was present. No abnormalities were identified in the cervix. The left ovary contained a cyst measuring 1.1 cm with associated hyperplastic changes. The right ovary showed no significant abnormalities. Both fallopian tubes appeared histologically unremarkable.\n\nExamination of the bladder peritoneum revealed involvement by malignant cells. The omentum also showed similar involvement. Biopsies from the right and left colic gutters, diaphragm, and small bowel mesentery did not reveal any malignant cells. The appendix demonstrated fibrous obliteration without evidence of malignancy.\n\nLymph node evaluation included multiple nodes from various locations. Right pelvic lymph nodes included 1 internal iliac, 8 external iliac, 2 common iliac, and 6 obturator nodes, all negative for malignancy. Left pelvic lymph nodes included 3 external iliac, 6 common iliac, and 4 obturator nodes, also without evidence of tumor involvement. Multiple right para-aortic lymph nodes (4 above and 7 below the inferior mesenteric artery) were negative for malignancy. Evaluation of left para-aortic lymph nodes showed 4 nodes above the inferior mesenteric artery that were negative; the specimen labeled as \"left para-aortic lymph nodes below the inferior mesenteric artery\" contained no nodal tissue.\n\nThis final pathology assessment is based on gross examination and frozen section histologic evaluation."} +{"pid": "TCGA-D7-6528", "report": "Histopathological examination was performed on a resected stomach specimen. The stomach measured 21.8 x 13.4 cm and was accompanied by omentum measuring 29 x 22 cm. A lesion measuring 9.8 x 6.4 x 2.8 cm was identified on the anterior wall, located 6.2 cm from the proximal margin and 3.3 cm from the distal margin.\n\nMicroscopic evaluation revealed glandular structures with atypical morphology invading through the full thickness of the gastric wall. The lesion exhibited moderate cellular differentiation and did not extend beyond the serosa. Early infiltration into adjacent omental fat was observed. Surgical margins were free of neoplastic involvement. The omentum showed signs of vascular congestion without evidence of tumor spread.\n\nLymph node assessment across multiple regional groups\u2014including periorificial, lesser curvature, greater curvature (right), and peripyloric regions\u2014demonstrated reactive changes without findings suggestive of metastatic involvement. No tumor deposits were identified in the lymph nodes evaluated.\n\nStaging based on the extent of wall invasion and absence of lymph node or distant metastasis was assigned accordingly."} +{"pid": "TCGA-RB-A7B8", "report": "The surgical specimen includes multiple tissue margins and lymph nodes. The bile duct, pancreatic neck, and retroperitoneal margins are all free of invasive disease. A single lymph node from the hepatic artery region is negative for metastasis.\n\nThe main specimen consists of a pancreaticoduodenectomy with a mass measuring 2.3 x 2.2 x 2.0 cm located in the pancreatic head. Microscopically, the lesion shows a moderately differentiated ductal adenocarcinoma with a focal micropapillary component accounting for approximately 10% of the tumor. The mass has a cystic component making up about 20% of its gross appearance, although this does not clearly represent an intraductal papillary mucinous neoplasm. The tumor invades peripancreatic soft tissues and demonstrates perineural invasion. No lymphovascular invasion is identified.\n\nExamination of the regional lymph nodes reveals involvement in 8 out of 23 nodes. The tumor is in close proximity to the retroperitoneal edge and extends to that margin. The common bile duct and pancreatic neck margins are free of tumor, with the closest distance of invasive disease being 1 mm from the retroperitoneal margin. The duodenal margins are also negative for tumor involvement.\n\nGrossly, the mass is tan-white with defined borders and no necrosis or friable papillary areas. It abuts the common bile duct and causes constriction of the pancreatic duct near its edge. The accessory ampulla is unaffected. Multiple sections of the tumor and surrounding structures are submitted for histological evaluation. Intraoperative frozen section analysis confirms negative margins at the bile duct, pancreatic neck, and retroperitoneal regions."} +{"pid": "TCGA-3R-A8YX", "report": "Result date: Surgical Procedure. Contributor system: Surgical Procedure. SPECIMENS SUBMITTED: A. PERITONEAL IMPLANT. DIAGNOSIS: A. RETROPERITONEUM, SUBMITTED AS PERITONEAL IMPLANT: HIGH GRADE SARCOMA CONSISTENT WITH HISTORY OF (SEE COMMENT). COMMENT: The tumor cells demonstrate spindled morphology with prominent nucleoli and frequent mitoses. The lesion extends to the unoriented resection margins. Reviewed by. CLINICAL INFORMATION: A. with retroperitoneal mass. GROSS DESCRIPTION: Number of specimen containers: 1. Labeled with patient name and MRN. A. Container designation: \"peritoneal implant\" -- Received unfixed is an irregular portion of yellow to pink/tan firm soft tissue measuring 4 X 3 x 1.2 cm. The entire specimen is inked black and sectioning demonstrates a gray firm cut surface measuring 2.5 X 2 X 1.0 cm. Representative sections are submitted to. An additional section is submitted in cytogenetics media for study. The remaining lesional tissue is submitted entirely in A1-A3; A4, representative adjacent soft tissue. MICROSCOPIC DESCRIPTION: Histologic examination performed. Any tests performed using Analytic Specific Reagents (ASR) were developed and validated by. The U.S. Food and Drug Administration has not approved these tests but has determined that such clearance or approval is not necessary. These tests should be regarded as a clinical assay for standard medical care. The was present during the formal review and interpretation of all slides and ancillary studies, (if performed), with the. Specimens with only gross examination were reviewed and interpreted by the."} +{"pid": "TCGA-QH-A65S", "report": "The specimen was received from a female patient and originated from the temporal lobe. Gross examination revealed a well-circumscribed lesion with a variegated cut surface, displaying areas of soft consistency and slight yellowish discoloration. Microscopic evaluation demonstrated a neoplasm composed of diffusely infiltrating cells with moderate nuclear atypia and variable morphology. Some regions showed cells with round to oval nuclei and clear cytoplasm, while others exhibited more astrocytic features with elongated nuclei and fibrillary processes. Mitotic activity was low, and no necrosis or microvascular proliferation was identified. The tumor margin was focally adjacent to reactive glial changes, though definitive assessment of resection margins could not be determined. Based on histological features and extent of resection, the tumor was classified as a low-grade glioma with mixed cellular features."} +{"pid": "TCGA-97-7937", "report": "The pathology report includes specimens from a left upper lobe wedge resection, station 9 and 11 lymph nodes, and a completion lobectomy. The lung specimen was intact and measured 15 x 8 x 4 cm. A mass measuring 3.5 x 3.4 x 1.8 cm was identified in the left upper lobe. Histologic examination of the mass revealed a tumor composed of multiple components: micropapillary (70%), acinar (10%), lepidic (10%), and giant cell (10%). The tumor was poorly differentiated and showed lymphovascular invasion. No pleural invasion or tumor extension was identified.\n\nMargins of resection, including bronchial and vascular margins, were free of involvement. No tumor was identified at the staple line or in surrounding lung tissue. Evaluation of three peribronchial lymph nodes and lymph nodes from stations 9 and 11 showed no evidence of metastasis.\n\nThe tumor was staged as pT2a based on its size (>3 cm but \u22645 cm) and absence of more proximal bronchial invasion or extensive pleural involvement. Regional lymph node staging was pN0 due to the absence of metastasis. No distant metastases were assessed.\n\nAdditional findings included emphysema in non-tumor lung tissue. Molecular studies were performed for KRAS and EGFR mutations. KRAS analysis showed wild-type status at codons 12 and 13. EGFR testing did not detect mutations in exons 18\u201321. A polymorphism at position 2361 G>A was noted but considered non-significant. Fluorescence in situ hybridization (FISH) analysis for ALK rearrangement was negative. Chromosome copy number analysis suggested gains involving chromosome 2 or 2p in a subset of cells.\n\nSerial sections were submitted for microscopic evaluation. Representative samples from margins of resection, lymph nodes, and lung parenchyma were examined. Intraoperative consultation confirmed the presence of malignant cells consistent with invasive carcinoma.\n\nThe case involved multiple addendums related to biomarker and molecular testing. Testing methodologies were described, noting validation for clinical use in non-small cell lung carcinoma. Limitations of each assay were provided, including sensitivity thresholds and potential for false-negative results due to tumor heterogeneity or low mutant allele frequency."} +{"pid": "TCGA-EM-A4FM", "report": "The specimen consists of a total thyroidectomy with right neck dissection. The thyroid gland weighs 28 g and includes a right lobe measuring 5.0 \u00d7 2.9 \u00d7 2.2 cm, a left lobe measuring 4.2 \u00d7 2.5 \u00d7 1.1 cm, and an isthmus measuring 3.2 \u00d7 1.1 \u00d7 0.5 cm. A dominant nodule is present in the right lobe, measuring 3.0 \u00d7 2.5 \u00d7 2.1 cm, with multifocal involvement noted bilaterally. A second nodule in the left lobe measures 1.6 cm in greatest dimension.\n\nHistologic evaluation shows a tumor with both classical papillary and follicular variant architecture. Focal areas demonstrate tall cell features comprising approximately 10% of the tumor volume. The tumor is widely invasive with perineural invasion identified. The surgical margins are involved by tumor on the right side. Extrathyroidal extension is present but minimal. The tumor is partially encapsulated with capsular invasion observed. Lymphovascular invasion is not identified. On the left lobe, the tumor is focally present with margins uninvolved, though the distance to the closest margin is only 0.1 mm. No extrathyroidal extension or perineural invasion is seen in this component.\n\nA total of 40 lymph nodes were examined across multiple sites. Involvement is identified in 12 nodes, including those from the right neck dissection, right paratracheal, right perithyroidal, and isthmic regions. Extranodal extension is not observed. Additional findings include mild follicular nodular disease, focal nonspecific thyroiditis, and ectopic serous-mucinous glands in the right lobe. One parathyroid gland is infiltrated by tumor, while others appear as mildly cellular glands. The thymus at the isthmus lacks specific pathological findings.\n\nStaging is based on AJCC/UICC TNM 7th edition. The primary tumor is classified as pT3 due to size greater than 4 cm and presence of minimal extrathyroidal extension. Regional lymph node involvement is categorized as pN1b given the presence of metastases in unilateral cervical nodes. Multiple tumor foci are confirmed (m). Due to tumor involvement at the surgical margin, accurate assessment of extrathyroidal extension may be limited, and intraoperative findings may affect staging."} +{"pid": "TCGA-BP-4771", "report": "The specimen consists of a right kidney weighing 535 grams and measuring 19.5 x 13.0 x 5.5 cm, with attached perirenal fat. The trimmed kidney measures 11.5 x 7.0 x 5.0 cm and weighs 290 grams. A segment of ureter measuring 6.0 x 0.2 x 0.2 cm is present. A firm, palpable mass is identified anteriorly within the perirenal fat. The external surface of the kidney appears tan-brown and unremarkable. A black ink mark is placed over the area corresponding to the mass. Upon bivalving the specimen, a well-circumscribed, tan-yellow lobulated mass measuring 5.7 x 5.3 x 4.0 cm is observed. It originates in the cortex and extends into the renal sinus, with focal areas of hemorrhage. There is no gross involvement of the renal pelvis or perirenal adipose tissue. The tumor approaches the renal capsule but does not grossly extend beyond it into surrounding tissues. No involvement of the renal vasculature is noted.\n\nSections were taken from multiple regions including the ureter and vascular margins, tumor and sinus, tumor and pelvis, tumor with overlying capsule, tumor with adjacent kidney, an upper pole cortical cyst measuring 0.6 x 0.6 x 0.5 cm, and representative sections from uninvolved kidney tissue. One possible lymph node measuring 0.4 cm was identified in the hilar fat and submitted for examination.\n\nA separate specimen labeled as retroperitoneal lymph nodes consists of multiple fragments of hemorrhagic fibroadipose tissue measuring 4.6 x 3.5 x 1.4 cm in aggregate. Lymph nodes ranging from 0.3 cm to 1.4 cm in size are identified and all were submitted for histological evaluation.\n\nAll surgical margins are free of abnormal cellular changes. The non-neoplastic kidney tissue demonstrates patchy chronic interstitial nephritis. No adrenal gland tissue was submitted for evaluation."} +{"pid": "TCGA-85-7698", "report": "The specimen consisted of lung tissue obtained via lobectomy from the right upper lobe. The tumor measured 3 x 2.5 x 2 cm and was found to be well-differentiated based on histologic evaluation. No information was provided regarding tumor extent, presence of additional nodules, lymph node involvement, lymphatic or venous invasion, surgical margins, neo-adjuvant treatment, or other pathological findings. No comments were included in the report."} +{"pid": "TCGA-DJ-A3UQ", "report": "The surgical specimens included pretracheal tissue, tissue near the left upper pole, left paratracheal tissue (frozen section), left superior mediastinal tissue, right paratracheal tissue, and a total thyroidectomy. Pretracheal tissue showed benign fibroadipose tissue. Tissue near the left upper pole revealed benign thyroid tissue. The left paratracheal tissue (frozen section) contained three lymph nodes, all with metastatic involvement. The largest lymph node measured 0.5 cm in diameter with a metastatic focus of 0.3 cm. One lymph node was identified on the frozen section slide, with two additional positive nodes found on permanent section. No extranodal extension was observed.\n\nLeft superior mediastinal tissue contained one lymph node with metastatic involvement measuring 0.15 cm in diameter, with a metastatic focus of 0.02 cm. Right paratracheal tissue contained two lymph nodes, one of which was involved. The involved lymph node measured 0.6 cm with a metastatic focus of 0.2 cm. No extranodal extension was identified in any of the lymph node specimens.\n\nThe total thyroidectomy specimen weighed 17g. The left lobe measured 4.1 x 2.1 x 1.3 cm and the right lobe measured 4.3 x 2.3 x 1.8 cm. A tan firm nodule measuring 0.7 x 0.6 x 0.6 cm was identified in the superior pole of the left lobe; this nodule was not encapsulated. A cystic nodule measuring 0.6 x 0.5 x 0.4 cm was found in the right lobe. Histologic evaluation of the left lobe nodule showed features including focal cellular morphology with over 50% involvement, no mitotic activity or necrosis identified, and no clear evidence of blood vessel invasion, although some areas were suggestive. The tumor extended into perithyroidal fibroadipose tissue. Surgical margins were free of tumor. Additional microscopic foci were present in the right lobe, measuring 0.6 cm, with sclerosis, cystic change, and squamous metaplasia. No adenomas or non-neoplastic abnormalities were identified. Parathyroid glands were not identified in the specimen. All other tissues submitted were fully evaluated microscopically."} +{"pid": "TCGA-97-A4M5", "report": "The surgical specimen consists of a right upper lobe wedge resection, level 7, 10, and 4 lymph nodes, and a completion right upper lobectomy. The wedge resection specimen contains a poorly circumscribed tan mass measuring 2.5 x 2.3 x 1.7 cm, located 0.5 cm from the surgical margin and adjacent to the pleura. Histologically, the lesion shows a mixed pattern with acinar, micropapillary, and papillary components. The staple line margin is free of tumor. Immunohistochemical stains show positivity for CK7, TTF-1, and Napsin-A, and negativity for CK20 and CDX-2.\n\nMolecular analysis reveals a KRAS mutation (p.G12C) in codon 12. No EGFR mutations were detected. The tumor is classified as moderately differentiated. The primary tumor size is 2.5 cm, with no evidence of lymphovascular invasion. All bronchial, vascular, and parenchymal margins are free of tumor involvement. The completion lobectomy specimen shows no residual tumor. Atelectasis or obstructive pneumonitis is present, extending to the hilar region but not involving the entire lung. Additional findings include squamous metaplasia, organizing pneumonia, and emphysema.\n\nLymph node evaluation includes one node from level 7, four nodes from level 10, two nodes from level 4, and two additional nodes dissected from the hilar region during the lobectomy. All lymph nodes are negative for tumor involvement. Based on the extent of the primary tumor, the pathological staging is pT1b with no regional lymph node metastasis (pN0)."} +{"pid": "TCGA-B0-4843", "report": "The right kidney specimen shows a neoplastic lesion measuring 6.8 cm in greatest dimension. The tumor demonstrates nuclear features corresponding to Fuhrman's nuclear grade 3 of 4. Approximately 5% of the tumor exhibits necrosis. The adipose tissue of the renal sinus is involved by the tumor. No definite angiolymphatic invasion is identified. The vascular and ureteral resection margins are free of tumor. There is no evidence of tumor invasion into perinephric adipose tissue or at the deep surgical margin, including Gerota\u2019s fascia. Pathologic staging is determined as pT3a Nx Mx."} +{"pid": "TCGA-B0-4713", "report": "The specimen consists of a right radical nephrectomy with a unifocal lesion located in the upper pole and middle portion of the kidney. The greatest tumor dimension is 13.5 cm, with an additional measurement of 9.5 cm. On macroscopic and microscopic examination, the lesion extends beyond the renal capsule into the perinephric fat. Invasion of the renal vein and its branches is present, and tumor thrombus is identified within the renal vein margin, which is involved by the process. No angiolymphatic invasion is observed. All other margins, including arterial, ureteric, and soft tissue, are free of involvement. \n\nMicroscopically, the lesion exhibits clear cell morphology. Nuclear grading according to Fuhrman criteria is grade II. Regional lymph nodes were not identified for evaluation. The non-neoplastic kidney demonstrates chronic glomerular changes characterized by glomerulosclerosis and moderate vascular disease consistent with hypertensive changes. The adrenal gland is unremarkable with no involvement identified. Large vessel venous invasion is present; lymphatic invasion is absent."} +{"pid": "TCGA-AA-A00F", "report": "The resected colon specimen includes a moderately differentiated colorectal-type tumor measuring up to 3 cm, with infiltration into the pericolic fatty tissue. Seven regional lymph node metastases were identified, including one located at the mesenteric resection margin. The small and large intestinal resection margins are free of tumor involvement.\n\nIn addition, an ileocolon resection was performed, which revealed a moderately differentiated colorectal-type lesion arising from the base of a tubular adenoma with high-grade dysplasia. This lesion is located in the cecum and shows infiltration into the tunica submucosa. No tumor involvement is present in the regional lymph nodes, small or large intestinal resection margins, mesenteric margin, appendix, or omental fat tissue.\n\nStaging for the first lesion is pT3 pN2 (7 out of 25 lymph nodes positive) with indeterminate distant staging (pMX), histologic grade 2, lymphatic invasion present (L1), no venous invasion (V0), and complete resection (R0). For the second lesion, staging is pT1 pN0 (0 out of 26 lymph nodes positive), with indeterminate distant staging (pMX), histologic grade 2, no lymphatic or venous invasion (L0, V0), and complete resection (R0)."} +{"pid": "TCGA-GI-A2C9", "report": "The right breast partial mastectomy specimen included a lesion with a maximum dimension of 6 cm. Microscopic evaluation showed a poorly differentiated invasive malignancy with a total Scarff-Bloom-Richardson score of 8 (tubular score 3, nuclear score 3, mitotic score 3 or 2 depending on specimen). The lesion exhibited a solid architectural pattern and focal cancerization of lobules, with no extensive growth pattern identified. A central area of calcification was noted on gross examination, and the tumor was located within 0.4 cm of the closest soft tissue margin. No angiolymphatic invasion was observed in one specimen, while angiolymphatic invasion was present in another. Dermal lymphatic involvement was also identified. The tumor was found to abut the deep skeletal muscle but did not invade into muscle or bone microscopically. Surgical margins were free of tumor involvement.\n\nA focal ductal carcinoma in situ component was present in one specimen, although an in-situ component was not identified in the second. Focal ductal changes were noted in both specimens, including intraductal proliferation. The tumor demonstrated a nonextensive pattern in one case and was mobile beneath adipose tissue with fairly well-circumscribed borders. The cut surface was described as yellow-pink, grainy, and fleshy pink-red in areas, particularly towards the cephalad portion. The remaining parenchyma was predominantly yellow and lobular with fibrous streaks.\n\nAxillary lymph node resection included a single lymph node, which showed no evidence of malignancy. Sentinel lymph node dissection included three lymph nodes, all without evidence of malignancy on routine microscopic examination, though immunohistochemical stains were pending. In a second set of specimens, ten lymph nodes were negative for metastatic involvement. Immunohistochemistry for broad-spectrum cytokeratin was performed on all lymph nodes, with no metastatic carcinoma identified.\n\nGrossly, the first breast specimen measured 14.0 x 13.0 x 6.0 cm and weighed 409 grams. A palpable mass protruded 5 cm beyond the soft tissue plane and was located 3.0 cm from the caudal, 4.5 cm from the lateral, 5.5 cm from the medial, and 7.0 cm from the cephalad borders. The second mastectomy specimen measured 21.2 x 20.5 x 4.1 cm and included a 6.5 x 5.4 x 1.7 cm portion of rib and chest wall. Skin puckering was noted inferior to the nipple, and the tumor appeared firm and white, measuring approximately 4.8 x 2.9 x 2.9 cm grossly, with final size reported at 2.4 cm in one case. The tumor was slightly adherent to skeletal muscle in one instance but did not invade muscle or bone microscopically.\n\nStaging was reported as T3 N0 MX in one case and pT4B N0 MX in the other, with no distant metastases indicated. Receptor status was positive for estrogen and progesterone receptors, and HER2/neu was negative. No additional lesions were identified in either specimen. Sections were submitted from various regions of the tumor, margins, and surrounding tissue, along with lymph nodes and uninvolved parenchyma."} +{"pid": "TCGA-CH-5738", "report": "The prostatectomy specimen shows a focus of moderately differentiated cellular proliferation involving both sides of the prostate. The largest measured focus has a maximum diameter of 2.1 cm. There is no evidence of vascular invasion. The seminal vesicles and seminal ducts appear unremarkable and are free of abnormal tissue involvement. The tumor is in close proximity to an artifactually created margin marked by yellow labeling; however, other genuine margins are free of tumor cells. Histological evaluation indicates a pattern consistent with low-grade cellular features, with no significant high-grade components identified. Staging classification reflects localized disease without nodal or lymphovascular involvement."} +{"pid": "TCGA-CV-7422", "report": "The specimen consists of laryngeal tissue with surrounding soft tissues and lymph nodes submitted following total laryngectomy and bilateral neck dissection. The lesion involves the right supraglottis, glottis, and subglottis and crosses midline to involve the anterior commissure, right aryepiglottic fold, and pre-epiglottic space. The greatest dimension of the lesion is 2.5 cm in diameter. Sections of decalcified thyroid cartilage and hyoid bone show no invasion into cartilage or bone.\n\nMargins are positive at the right lateral and anterior aspects of the specimen; however, separately submitted mucosal margins from specimens D and F are free of tumor. Adjacent tracheal mucosa, left mucosal margins, and anterior and posterior soft tissue margins are also negative for tumor involvement.\n\nHistologic examination reveals invasive poorly differentiated carcinoma with extensive lymphovascular invasion involving both sides of the larynx and adjacent soft tissues. Severe squamous dysplasia is identified on the left side of the larynx. The surgical specimen includes two right parathyroid glands and thymic tissue, all without evidence of tumor involvement.\n\nLymph node evaluation includes five right subdigastric lymph nodes, one of which contains metastatic carcinoma with extranodal extension. The largest lymph node metastasis measures 1.0 cm. Additional lymph nodes assessed include five right midjugular, six left subdigastric, five left midjugular, and six left lower jugular lymph nodes, none of which demonstrate tumor involvement.\n\nAdditional findings include marked acute and chronic inflammation with foreign body giant cell reaction at the tracheostomy site. Thyroid gland demonstrates focal fibrosis and inflammation. Squamous mucosa from the pyriform sinuses and base of tongue shows no evidence of tumor."} +{"pid": "TCGA-BG-A0VW", "report": "The specimen was submitted for evaluation following total abdominal hysterectomy, bilateral salpingo-oophorectomy, omentectomy, and hernia repair. The tumor showed well-differentiated architectural features with nuclear grading classified as grade 2. The maximum tumor dimension measured 2.0 cm. Involvement of the endometrial surface was noted at 10% on the anterior endomyometrium and 30% on the posterior endomyometrium. Depth of invasion was limited to less than half the thickness of the myometrium. No angiolymphatic invasion was identified. A total of 10 lymph nodes were examined, with no evidence of involvement. Immunohistochemical staining demonstrated patchy positivity for p16, while p53 and p63 were negative. Endothelial, lymphatic, and vascular channels showed positivity for CD31, D2-40, and CD34. No tumor cells were identified in the companion pelvic wash. Pathologic staging was determined as pT1b pN0 pMX, corresponding to FIGO stage IB. Tissue fixation was within standard parameters using formalin-fixed, paraffin-embedded tissue, and immunohistochemistry was performed with validated antibodies under CLIA-certified conditions."} +{"pid": "TCGA-P4-AAVK", "report": "A radical nephrectomy specimen measuring 20 x 15 x 5 cm includes a kidney measuring 12 x 7 x 5 cm, segments of the renal artery, renal vein, ureter (8 cm in length and 0.8 cm in average diameter), and an adrenal gland measuring 7 x 2.5 x 1 cm. A well-circumscribed mass measuring 7.5 x 6.5 x 5 cm is identified in the lower pole of the kidney. The mass is brown-red with approximately 75% hemorrhage and necrosis, predominantly in the central region. The mass appears to be largely confined within the kidney but bulges into the renal sinus. Grossly, the renal vein does not appear involved and there is no extension into Gerota's fascia. Adjacent renal parenchyma appears normal, and the pelvicalyceal system is smooth without lesions. One candidate hilar lymph node measuring 0.4 cm was identified and examined. Examination of the adrenal gland reveals unremarkable cortex and medulla.\n\nHistologic evaluation reveals a neoplastic process involving one of one hilar lymph nodes. Evaluation of surgical margins including ureteral, vascular, and perinephric soft tissue demonstrates no involvement. Additional lymph node dissection in the paracaval and retrocaval regions yielded six lymph nodes, four of which demonstrate morphologic changes consistent with tumor involvement.\n\nTumor morphology includes papillary architecture with nuclear features of intermediate grade. Invasion into renal sinus adipose tissue is present; however, no evidence of tumor invasion into the renal vein or perinephric adipose tissue is observed. Multiple sections of the tumor were evaluated for margin status and anatomical relationship, including proximity to the renal capsule, renal sinus, and surrounding fat."} +{"pid": "TCGA-2G-AAGV", "report": "The pathology report describes findings from a left orchidectomy. The tumor was entirely composed of nonseminomatous elements. The diameter of the tumor could not be determined. The tumor was limited to the testis, with no evidence of angioinvasion or involvement of the rete testis."} +{"pid": "TCGA-EI-6883", "report": "Histopathological examination was performed on a segment of the large intestine measuring 18.6 cm in length, with surrounding fat tissue 2 cm thick. A lesion was identified in the mucosa, measuring 3.7 x 4.5 x 1.2 cm, with circumferential involvement of approximately 90% of the intestinal wall. The lesion was located 1.1 cm from one incision margin and 12 cm from the other, with the closest uninvolved margin measuring 2.1 cm. Microscopic evaluation revealed moderately differentiated gland-forming cells infiltrating through the muscularis propria into the perirectal fat. Reactive lymphadenopathy was noted, and no tumor involvement was detected at the surgical margins. The tumor did not extend to any implanted devices or adjacent structures."} +{"pid": "TCGA-BH-A0HL", "report": "The excised right axillary sentinel lymph node demonstrates the presence of metastatic cells exhibiting extracapsular spread measuring 0.3 cm. Additional lymph node examination reveals one involved lymph node out of sixteen evaluated, with metastatic involvement measuring up to 3 mm in diameter and showing extracapsular extension.\n\nThe right breast specimen consists of a surgically resected lesion measuring 3 x 2.5 x 2.4 cm. Histologic evaluation reveals invasive carcinoma with papillary features. The Nottingham histologic grade totals 6 out of 9 (nuclear grade 2, tubule formation score 3, mitotic activity score 1), corresponding to an intermediate grade. Adjacent to the invasive component is in situ disease characterized by papillary and micropapillary morphology, nuclear grade 2, comprising approximately 5% of the tumor mass.\n\nNo vascular invasion is identified. Surgical margins are clear of both invasive and in situ disease, with the closest margin measuring 1.2 cm at the anterior (skin) margin. Changes related to prior biopsy include organizing hematoma, granulation tissue, hemosiderin-laden macrophages, fat necrosis, and foreign body giant cell reaction. Duct ectasia and hemosiderin-laden macrophages are noted within lactiferous ducts of the nipple and skin.\n\nBenign calcifications are present in fibrocystic change regions. Seventeen lymph nodes were examined, two of which showed metastatic involvement. Standard hematoxylin and eosin staining methods were used for lymph node assessment.\n\nPathologic staging includes T stage pT2, N stage pN1, and M stage pMX. Immunohistochemical receptor status could not be determined as results are unknown for estrogen and progesterone receptors as well as HER2/neu expression."} +{"pid": "TCGA-N8-A4PP", "report": "The surgical pathology report describes a hysterectomy specimen with bilateral salpingo-oophorectomy. The lesion involves both the anterior and posterior aspects of the endometrium and extends into the lower uterine segment. A separate mass measuring 9.2 x 8.9 x 3.0 cm was also received along with the uterus. Microscopic examination reveals a high-grade component with features of serous carcinoma. The tumor measures 6.5 x 6.4 x 4.5 cm within the endometrial cavity. Invasion is present in the myometrium, involving approximately 50% of the wall thickness (6.5 mm depth in a 1.3 cm thick wall). There is extension into the lower uterine segment and involvement of the posterior upper endocervix with stromal invasion measuring 3 mm in depth (33% of a 1.0 cm thick cervical wall). No serosal involvement is identified.\n\nLymphovascular space invasion is present. Surgical margins are negative, with the closest distance of invasive disease being 7 mm from the cervical margin. One lymph node from the right pelvic region is entirely replaced by metastatic serous carcinoma, measuring 6.2 cm. No extracapsular extension is definitively identified, although the tissue is focally disrupted. Perineural invasion is noted in the right ovary. No malignancy is found in either ovary or fallopian tube.\n\nAdditional findings include hyalinized leiomyomata measuring up to 3.2 cm, background atrophic endometrium with chronic inflammation, medial vascular calcifications, and mild inflammatory changes in the cervix and fallopian tubes. Nabothian cysts, tubal metaplasia, and tunnel clusters are also present in the cervix.\n\nImmunohistochemical staining supports the presence of a dual-component lesion, with distinct staining patterns differentiating the epithelial and mesenchymal components. Pancytokeratin stains positive in the epithelial areas and negative in the sarcomatous regions, while vimentin shows the reverse pattern. Desmin, smooth muscle actin, and muscle-specific actin are focally or partially positive in the sarcomatous areas.\n\nStaging according to AJCC criteria is pT2 pN1. According to FIGO (2008), the stage is classified as IIIC1."} +{"pid": "TCGA-VS-A8EI", "report": "The biopsy specimen from the cervix demonstrates a neoplastic process involving the transformation of squamous epithelium. Histologic evaluation reveals full-thickness involvement of the epithelium with atypical cells exhibiting nuclear enlargement, hyperchromasia, and increased mitotic activity. The lesion extends beyond the basement membrane into the underlying stroma, with evidence of small clusters and individual infiltrating cells. No lymphovascular space invasion is identified. The tissue shows moderate to poor differentiation, with limited evidence of keratinization. The depth of invasion measures approximately 4 millimeters, with a horizontal spread of 8 millimeters. No lymph node involvement or distant metastasis is present."} +{"pid": "TCGA-MH-A855", "report": "The submitted specimen consists of a right nephrectomy measuring 14.5 x 12.2 x 7.5 cm and weighing 621 grams. A large mass measuring 12.1 x 9.4 x 4.6 cm is identified within the kidney. The mass has a yellow to black and hemorrhagic appearance, occupies approximately 85% of the kidney, and is located 0.3 cm from the inked margin. It does not involve attached fat or extend to the artery, vein, ureter, or renal pelvis. The tumor is predominantly solid (95%) with minimal cystic change (5%). Gross examination reveals abundant perinephric adipose tissue but no adrenal gland tissue. No lymph nodes are identified.\n\nHistologically, the lesion exhibits papillary architecture with extensive necrosis. There is no evidence of sarcomatoid differentiation, perineural invasion, or lymphovascular invasion. The tumor appears confined to the kidney without involvement of vascular or ureteral margins. Multiple representative sections were examined, including those from the margins, renal parenchyma, pelvis, and surrounding fat.\n\nMicroscopic evaluation confirms that the tumor is limited to the kidney with negative surgical margins. Cellular features include high-grade nuclear morphology consistent with Fuhrman grade 3. Immunohistochemical staining for TTF-1 was performed and was negative, supporting prior microscopic findings.\n\nStaging classification indicates a primary tumor categorized as T2b based on size greater than 10 cm. Evaluation of lymph node status and distant metastasis could not be determined (NX, MX). The tumor was staged as Stage II based on available pathological data. Clinical correlation and communication regarding these findings were completed via secure correspondence."} +{"pid": "TCGA-UF-A7JO", "report": "The specimen was obtained from the floor of the mouth and left jaw region. The lesion measured 4.5 cm in greatest dimension and demonstrated ulceration. Histologic examination revealed a moderately differentiated invasive carcinoma with infiltration extending to the muscular layer of the soft tissue. There was involvement of osseous tissue by the tumor. The posterior margin of the jaw was involved; however, all other surgical margins were free of tumor. No lymphatic, vascular, or perineural invasion was identified.\n\nLymph node evaluation included multiple levels bilaterally. In level 2 on the right side, 4 out of 10 lymph nodes showed evidence of tumor involvement with extension to the capsule. All other lymph nodes evaluated (13 in level 3 on the left, 7 in level 2 on the left, and 7 in level 1 on the left) were negative for tumor involvement."} +{"pid": "TCGA-AA-3552", "report": "The resected ileocolic specimen shows a moderately differentiated adenocarcinoma located in the cecum, with a maximum diameter of 3.8 cm. The tumor demonstrates circumscribed infiltration into the pericecal adipose tissue. Ten regional or local lymph node metastases were identified out of a total of 20 examined. Resection margins of the small and large intestine, as well as the mesenteric margin, are free of tumor. There is evidence of lymphangiosis carcinomatosa involving the perityphlitic adipose tissue and the tunica muscularis propria of the appendix. Omental adipose tissue is also tumor-free.\n\nA second resected colon specimen reveals an ulcerous mucosal defect consistent with post-ablation changes. No residual neoplastic tissue was identified in this section. Lymph nodes in this region are negative for tumor involvement, and the colon resection margins, along with the adjacent colon wall tourniquet, show no signs of malignancy.\n\nIn relation to staging for the first lesion: pT3, pN2 (10/20), G2, with lymphatic invasion (L1), but no venous invasion (V0), and a local R0 resection status. For the second lesion: pT1, pN0 (0/6), G2, without lymphatic or venous invasion (L0, V0), and an R0 resection margin.\n\nRegarding liver specimens: one resected portion shows a bilious hamartoma, another contains small bile duct cysts with a pericystic scarred area, and a third displays a superficially resected liver tissue with a scarred capsular region. No malignant findings, particularly no evidence of colonic carcinoma metastasis, were observed in any of the liver samples."} +{"pid": "TCGA-BH-A0HI", "report": "A right axillary sentinel lymph node biopsy showed one lymph node that was negative for metastatic disease. A right segmental mastectomy specimen contained a focus of invasive carcinoma, Nottingham grade 2, with a total score of 6 out of 9 based on tubule formation (3), nuclear grade (2), and mitotic activity (1). The invasive component measured 1.8 cm in greatest dimension. There was also associated ductal carcinoma in situ (DCIS), nuclear grade 2, with cribriform and solid patterns. DCIS accounted for 15% of the total tumor volume and was distributed in a mixed pattern, away from the invasive component. Surgical margins were free of involvement; the closest distance of invasive tumor to the anterior margin was 7 mm, and DCIS was 7 mm from the posterior margin. No lymphovascular invasion was identified. Microcalcifications were present in association with both invasive and in situ components as well as in benign breast tissue. Non-neoplastic changes in the breast included fibrocystic changes, ductal epithelial hyperplasia, columnar cell change, and sclerosing adenosis. Changes related to prior biopsy were also noted. The tumor cells showed positivity for ER/PR and were negative for HER-2/neu. Additional biopsies from the anterior and medial-posterior margins showed only fibrocystic change, ductal hyperplasia, and sclerosing adenosis, with no evidence of malignancy. All margins were fully evaluated microscopically. The case was processed with H/E and keratin stains. Staging was pT1c with no regional lymph node involvement. Receptor status was positive for hormone receptors, with a result of zero or 1+ for others."} +{"pid": "TCGA-B0-4824", "report": "The specimen consists of a left radical nephrectomy. The lesion measures 3.5 cm and is composed of conventional (clear) cell morphology. Nuclear grading according to Fuhrman's classification is grade III out of IV. The lesion is confined within the renal capsule. There is no evidence of involvement of the renal vein. No angiolymphatic invasion is identified. All surgical margins are free of neoplastic cells. The adjacent kidney shows simple cysts without other significant findings. Histologic evaluation indicates no regional lymph node involvement or distant metastasis. The histologic grade corresponds to G3."} +{"pid": "TCGA-HB-A3YV", "report": "A left nephrectomy specimen contains a large mass measuring 14 cm in greatest dimension. The tumor is located in the superior pole of the kidney and extends medially and superiorly. Microscopic evaluation reveals a high-grade sarcoma with pleomorphic features. Histologic scoring using the FNCLCC system yields a total score of 7, composed of a grade 3 differentiation score, a necrosis score of 1, and a mitotic count score of 3 (with up to 21 mitoses observed in 10 high-powered fields). \n\nThe tumor focally invades through the renal capsule into perinephric fat, as seen on slides A15, A17, and A19. There is also evidence of lymphatic vessel involvement (slide A4). The adrenal gland shows involvement by the tumor through direct extension into the medulla. At the superior medial aspect of the specimen, there is focal disruption of the tumor margin, with tumor extending to the inked margin in this area. The closest margin at Gerota\u2019s fascia is within 1 mm of tumor involvement. No involvement is identified in the renal sinus, ureter, major veins, or renal vein.\n\nHistologic assessment of surgical margins reveals no tumor at the renal vein or ureteral margins. The adrenal gland is involved directly by tumor extension. No lymph nodes were resected for evaluation.\n\nImmunohistochemical staining demonstrates positivity for desmin, CD34, CD10, and vimentin. The tumor is negative for AE1/AE3, CK 8/18, RCC, S100, synaptophysin, chromogranin, calponin, c-kit, and HMB45. Smooth muscle actin and CD31 highlight prominent vascular structures but do not stain the tumor cells. Focal abnormal cells are noted in the perinephric fat on slides A17 and A19, raising the possibility of dedifferentiated liposarcoma. Fluorescence in situ hybridization (FISH) testing reveals MDM2 gene amplification with an MDM2/SE12 ratio of 2.71, supporting possible adipocytic differentiation.\n\nAJCC staging for soft tissue sarcoma classifies this as pT2b with no regional lymph node assessment available (pNx). The tumor was partially disrupted at the superior medial margin, and its relationship to surrounding structures was carefully evaluated. Grossly, the tumor appears mostly encapsulated and well-demarcated from adjacent tissues, except in the superior medial region where disruption occurs. The tumor does not grossly involve the renal sinus, pelvicaliceal system, ureter, renal vein, or Gerota\u2019s fascia beyond microscopic proximity. Perinephric fat involvement is limited to areas immediately adjacent to the tumor. \n\nThe differential diagnosis includes dedifferentiated liposarcoma and pleomorphic leiomyosarcoma. Given the rarity of primary renal sarcomas, correlation with clinical and radiologic findings is recommended. Referral for additional molecular testing was pursued to further clarify histogenesis."} +{"pid": "TCGA-HW-8319", "report": "The specimen from the left frontal lobe was received fresh for frozen section consultation and consisted of multiple irregularly shaped, soft tan-white fragments measuring 1.5 x 0.5 x <0.1 cm. Smears were prepared and the remainder submitted for frozen section analysis. A second specimen from the left frontal lobe was received in formalin and consisted of multiple fragmented segments of soft whitish-tan convoluted brain tissue measuring 3.5 x 1.5 x 1.5 cm in aggregate, entirely submitted for evaluation. \n\nHistologic examination of the first specimen showed features consistent with a diffusely infiltrating glial neoplasm. The tumor cells exhibited moderate nuclear atypia with elongated to oval nuclei and fine chromatin. Mitotic figures were identified. The cytoplasmic processes were delicate and interlacing, consistent with a glioma of astrocytic lineage. Frozen section and permanent section diagnoses were concordant.\n\nIn the second specimen, histologic evaluation demonstrated increased cellularity and nuclear pleomorphism. There was brisk mitotic activity and areas of microvascular proliferation. Necrosis was not identified. Immunohistochemical staining revealed positivity for R132H mutant IDH1 in tumor cells. Molecular studies were initiated. \n\nBoth specimens were reviewed in conjunction. Cellular morphology and immunophenotype support a neoplastic process with features of a glioma. Staging based on histologic findings indicates a high-grade lesion. Further classification will be informed by molecular profiling results."} +{"pid": "TCGA-60-2716", "report": "The specimen included multiple lymph nodes from levels 5 through 10, as well as a left lung pneumonectomy specimen. Lymph nodes from level 7 (specimen A) measured 1.0x0.7x0.3cm and were submitted entirely. Level 9 lymph nodes (specimen B) were 1.8x1.2x0.4cm in size and also submitted completely. Specimen C, level 10 lymph nodes, consisted of five pieces of anthracotic and tan soft tissue ranging from 0.6 to 1.8cm; the largest piece contained two possible lymph nodes measuring 0.8 and 1.3cm. These were submitted across blocks C1 and C2. Level 7 lymph nodes (specimen D) were received as four pieces of mottled black and pink-tan soft tissue, with sizes ranging from 0.9 to 2.7cm. The largest lymph node showed central tan-gray discoloration and was submitted across D1, D2, and D3. \n\nThe left lung specimen (specimen E) weighed 405 grams and measured 21x15x5.8cm, with an attached bronchus 3.0cm long and 1.5cm in diameter. A firm, subpleural, central mass was identified, measuring 4.5x3.0x2.5cm with yellow-tan necrotic features. The tumor invaded the bronchus 1.5cm from the bronchial margin, which was found to be free of tumor involvement. The mass involved both upper and lower lobes. Adjacent to the bronchus, an enlarged lymph node measuring 2.7x2.1x0.5cm with tan-black discoloration was noted, along with a second lymph node measuring 1.7cm in greatest dimension with black and tan discoloration. Six peribronchial lymph nodes were positive for metastatic involvement with extranodal extension, the largest focus measuring 2.0cm. The remainder of the lung showed dark red congested parenchyma without other lesions. Sections of the mass, bronchi, lymph nodes, and viable appearing tissue were submitted for analysis.\n\nLevel 5 and 6 lymph nodes (specimen F) were received as yellow-tan soft tissue measuring 3.0x1.7x0.5cm, containing two lymph nodes measuring 1.4 and 1.5cm. The central region had red-black discoloration, while the periphery was yellow-tan. These were submitted in blocks F1 and F2. Level 9 lymph nodes (specimen G) were two pieces of pink-tan soft tissue measuring 1.2 and 1.7cm, with the larger one containing a 0.5cm lymph node. This was submitted entirely in block G1.\n\nMicroscopic evaluation of the lung showed invasive, moderately differentiated features with extensive necrosis and papillary components, centrally located within the lung. No visceral pleural involvement was observed. Lymph node assessment revealed N1 involvement with six out of thirteen ipsilateral hilar and peribronchial lymph nodes positive for tumor involvement. N2 and N3 lymph node regions were negative. The bronchial margin was negative, located 1.5cm from the tumor. The non-neoplastic lung tissue showed no pathological findings. Based on these findings, the pathologic stage was determined to be pT2 N1 Mx."} +{"pid": "TCGA-05-4403", "report": "The resected specimen measured 3.3 cm in greatest dimension and was located peripherally in the right upper lobe, predominantly within segment S3. Histologically, the lesion demonstrated a mixed growth pattern with a marked component of mucin-producing cells arranged in a bronchioloalveolar growth pattern. Additional components included acinar and solid architecture, though these were less prominent. The tumor was classified as pT2 with no lymph node involvement (pN0) and no residual tumor at the margins (R0), corresponding to stage IB. No infiltration of the visceral pleura was observed. The bronchial and vascular resection margins, as well as all identified and removed lymph nodes, were free of tumor."} +{"pid": "TCGA-EL-A3ZQ", "report": "Case type: Surgical Case. The specimen consists of a total thyroidectomy with a dominant nodule located in the right lobe. Gross examination reveals an asymmetric thyroid gland, with the right lobe measuring 4.0 x 3.1 x 2.0 cm and distended by a centrally located nodule. The isthmus measures 2.0 x 1.0 x 0.3 cm and the left lobe measures 4.5 x 1.5 x 0.8 cm. The surface of the entire gland appears smooth. The nodule within the right lobe is described as pink-tan, measuring 3.6 x 2.8 x 2.0 cm, with only a small rim of surrounding normal thyroid tissue visible. No involvement of the isthmus or left lobe by the lesion is observed.\n\nHistologic evaluation indicates no multifocal disease present. The resection margins are negative. There is no evidence of extrathyroidal extension or lymphovascular invasion identified. Background thyroid tissue shows mild chronic lymphocytic thyroiditis. Lymph node assessment includes the examination of one lymph node, which does not reveal any tumor involvement.\n\nThe specimen was sectioned extensively, with sections submitted from the right lobe (A6-A16), isthmus (A4-5), and left lobe (A1-3) from superior to inferior."} +{"pid": "TCGA-A8-A09R", "report": "The specimen demonstrates a 3 cm lesion with moderate differentiation and invasive growth pattern. The surrounding resection margins are free of involvement. Evaluation of lymph nodes reveals two positive nodes out of sixteen examined. The classification indicates a primary lesion size of 3 cm (pT2), regional lymph node involvement with two metastases (pN1a), no residual tumor at the surgical site (R0), and nuclear grade 2. Vascular and lymphatic invasion are not identified."} +{"pid": "TCGA-X7-A8M8", "report": "The specimen consists of an 8.5 x 6.5 x 3.3 cm irregular, partially fragmented tissue with a nodular, encapsulated mass measuring 5.8 x 3.4 x 2.8 cm. The mass is gray-white, well-circumscribed, and abuts the outer surface of the specimen. On sectioning, it reveals a white-tan fleshy texture with fine septations and no necrosis or hemorrhage. Adjacent tissue shows yellow-tan lobulated areas with focal hemorrhage. A 1.7 cm focus suspicious for a fatty replaced lymph node is present.\n\nMicroscopic evaluation confirms a circumscribed lesion without evidence of invasive growth. Tumor cells are within 1 to 2 mm of the surgical margin but are separated by a fibrous capsule. There is no tumor transection, suggesting complete excision. One benign lymph node is identified near the mass. Flow cytometry demonstrates a precursor T-cell population and mature T-cells, with low numbers of B cells. Morphologic review identifies numerous immature lymphoid cells. Clinical follow-up is recommended due to the proximity of tumor cells to the margin."} +{"pid": "TCGA-2H-A9GN", "report": "The specimen shows a poorly differentiated carcinoma arising in the distal esophagus. The largest dimension of the tumor measures 5.5 cm. A total of 22 lymph nodes were examined, with 5 showing involvement. The resection margins are negative, indicating a radical resection."} +{"pid": "TCGA-FB-AAQ3", "report": "The specimen consists of pancreatic and duodenal tissue with multiple sutures present. The duodenum measures 19 cm in length and 3.2 cm in diameter, with a smooth, glistening serosal surface that is tan-pink in appearance with cautery artifact. Upon opening the duodenum longitudinally, tan-brown mucosa is observed. An ampulla is identified 5 cm from the proximal margin and is surrounded by a red-tan ulcerative lesion measuring 1.7 x 1 cm. The pancreas measures 7.5 x 6 x 4.5 cm. The neck margin was removed en face and submitted for frozen section. Sectioning of the pancreas reveals obstruction of the major pancreatic duct approximately 1.5 cm from the neck margin. There is an ill-defined, indurated, white-yellow lesion measuring 2 x 2.5 x 2.3 cm. This lesion may involve the adjacent common bile duct, which appears friable, hemorrhagic, and dilated to 1.2 cm in diameter. The common bile duct remains patent through the ampulla. Distances from the lesion to various margins are as follows: 1 cm to the neck margin, 0.8 cm to the long blue (portal vein), 2.8 cm to the long black (SMA), 0.6 cm to looped black (deep radial), 0.1 cm to the nearest radial margin, and 6 cm to the proximal duodenal margin.\n\nMicroscopic examination reveals moderately differentiated epithelial cells arranged in irregular glands and tubular structures infiltrating through fibrous stroma. Tumor extends into peripancreatic soft tissues. One regional lymph node is involved out of 23 examined. No distant metastasis is identified. All surgical margins are free of invasive carcinoma, though the closest distance of tumor to any margin is 0.1 cm at the radial margin. There is no evidence of prior treatment effect. Angiolymphatic invasion is not present; however, perineural invasion is identified. The primary tumor is classified as pT3 and regional lymph node involvement as pN1."} +{"pid": "TCGA-CM-5860", "report": "The submitted specimen includes a right hemicolectomy with attached terminal ileum, cecum, and appendix. The bowel segment measures 27.0 cm in length with a 6.6 cm circumference at the distal margin. The terminal ileum is 7.5 cm long and 4.8 cm in circumference. The appendix measures 5.3 cm in length with an average diameter of 0.6 cm. A mass measuring 3.7 cm in length and 6.6 cm in width is present in the ascending colon, located 16.7 cm from the distal margin. The mass extends circumferentially around the lumen and appears to invade through the muscularis propria into the surrounding adipose tissue, with a maximal depth of 0.5 cm. The cut surface of the specimen shows hemorrhagic adipose tissue spanning up to 7.4 cm in thickness. No gross tumor perforation is identified.\n\nHistologically, the lesion demonstrates extensive tumor budding and perineural invasion. Lymphovascular invasion is suspected. There is no increase in tumor-infiltrating lymphocytes. The surgical margins are free of involvement. No polyps or dysplastic mucosa are identified away from the lesion. The non-neoplastic bowel and appendix show no significant abnormalities. A total of 44 lymph nodes are examined, none of which show evidence of metastasis. Tumor deposits in pericolorectal soft tissue are not identified.\n\nImmunohistochemical analysis for DNA mismatch repair proteins shows retained expression. An additional lymph node specimen, labeled as ileocolic, consists of a single benign lymph node. All tested tissues were processed using validated clinical assays under CLIA certification for high-complexity testing."} +{"pid": "TCGA-BJ-A28V", "report": "The specimen consisted of a total thyroidectomy measuring 51 mg. Examination revealed two tumor foci, with the largest measuring 4.5 cm and located in the right lobe. The smaller focus measured 0.4 cm. Both lesions were confined to the thyroid without evidence of capsular or angiolymphatic invasion. The histologic type was consistent with encapsulated follicular variant. A left superior parathyroidectomy was also performed; the tissue weighed 73 mg and showed slight enlargement with normocellular architecture. Staging indicated pT3 for the primary tumor with no regional lymph node involvement (pN0). No distant metastasis was identified. Surgical margins were free of tumor, and there was no lymphovascular invasion. The tumor was multifocal and limited to the thyroid gland."} +{"pid": "TCGA-77-7140", "report": "A left upper lobectomy and lymph node sampling were performed. A mass measuring 68 mm in maximal dimension was identified in the left upper lobe, with a firm sclerotic cut surface and areas of necrosis. The mass is located near the hilum and abuts the pleural surface medially but appears to be separated from the lateral aspect by approximately 10 mm. Enlarged lymph nodes are present around the bronchial resection margin and adjacent to the pulmonary artery. The superior peribronchial lymph node measures 15 mm in diameter, while the inferior peribronchial lymph node measures 23 mm. \n\nMicroscopic examination reveals a moderately differentiated carcinoma with patchy necrosis and vascular invasion. The bronchial resection margin is free of malignancy. Metastatic involvement is confirmed in the peribronchial lymph nodes. The pulmonary artery margin is negative for malignancy. Additional findings include obstructive inflammation adjacent to the mass and a nodule in the lower zone showing granulomatous inflammation with Langhans-type giant cells, lymphocytic infiltration, and fibrosis. Two other foci of granulomatous inflammation with central necrosis and foamy macrophages are noted, likely related to bronchi. No organisms are identified on special stains, though the findings raise suspicion for infection, particularly given prior sputum findings of atypical Mycobacteria.\n\nLymph node specimens from the lower lobe, station #5, and lingula show no evidence of metastatic disease. One node demonstrates silicotic nodules and pigmented macrophages, while others show follicular hyperplasia, sinus histiocytosis, and pigmented macrophage aggregates. \n\nStaging assessment indicates T2 N1."} +{"pid": "TCGA-D1-A2G7", "report": "The specimen includes a uterus with bilateral ovaries and fallopian tubes, along with tissue from the omentum, lymph nodes, and various peritoneal and serosal surfaces. The uterus contains an endometrial polyp measuring 4.0 x 3.0 x 3.0 cm, which shows a mixture of cellular features in different areas. A submucosal leiomyoma is present in the lower uterine segment. Microscopic examination reveals that the surface endometrium is extensively involved by a high-grade epithelial neoplasm. Deeper sections show a combination of these cells with a more differentiated type. There is limited invasion into the underlying myometrium, measuring approximately 0.2 cm, with a total myometrial thickness of 2.5 cm. No vascular or lymphatic space involvement is identified. The endocervix and cervix appear normal. On the left ovary, there is a simple cyst measuring 1.5 cm, while the right ovary appears atrophic. Both fallopian tubes are atrophic.\n\nExamination of the omental biopsy and a larger resected portion of the omentum shows no evidence of tumor. Lymph node assessment includes multiple right pelvic nodes (12 external iliac, 1 internal iliac, 6 common iliac, 8 obturator), all negative for tumor. Similarly, left pelvic lymph nodes (7 external iliac, 1 internal iliac, 4 common iliac, 10 obturator) are free of tumor involvement. Para-aortic lymph nodes above and below the inferior mesenteric artery (3 right, 7 left above; 6 right, 7 left below) do not show any tumor. The gonadal vessels on both sides are also free of tumor. Staging biopsies from the right and left colic gutters, pelvic sidewalls, diaphragm, cul-de-sac, small and large bowel serosa, bladder peritoneum, and small and large bowel mesentery\u2014all ranging in size from 0.2 cm to 1.5 cm\u2014show no evidence of tumor."} +{"pid": "TCGA-D8-A1JM", "report": "Histopathological examination was performed on a right breast resection specimen along with axillary tissues. The breast measured 21.4 x 16.5 x 5.4 cm and weighed 920 grams. A lesion measuring 3 x 3.3 x 2.1 cm was identified at the boundary of the outer quadrants, located 3 cm from the lower margin, 0.5 cm from the base, and 2.9 cm from the skin. Microscopic evaluation revealed a high-grade cellular proliferation with a total histologic grade of 8 (3 + 3 + 2), showing 26 mitoses per 10 high-power fields. There was extensive vascular invasion and a peritumoral lymphocytic reaction. The nipple showed no abnormalities, and the glandular tissue exhibited signs of parenchymal atrophy.\n\nExamination of the axillary lymph nodes demonstrated involvement with malignant cells. Immunohistochemical analysis showed less than 10% of neoplastic nuclei expressed estrogen receptors, and no progesterone receptors were detected. HER2 protein expression was assessed using HercepTest\u2122M by DAKO, revealing a score of 1+ in the invasive component."} +{"pid": "TCGA-UW-A7GC", "report": "The specimen consisted of a right radical nephrectomy from a female patient with a history of a right renal mass. The kidney measured 13.0 x 7.5 x 3.0 cm, and the tumor was located at the superior pole within the renal cortex. The tumor was well-circumscribed, measuring 4.5 x 4.2 x 3.5 cm, with a pink/tan appearance, a single central cyst with a solid lining, and multiple areas of hemorrhage. It was unifocal and confined to the kidney without multicentricity.\n\nHistologic evaluation revealed high-grade cellular features (grade 3 of 4 by Fuhrman classification). Microscopic assessment showed no involvement of the perirenal adipose tissue, Gerota\u2019s fascia, renal sinus, ureter, or major veins. The tumor was negative for sarcomatoid features. Margins of resection, including Gerota\u2019s fascia, renal vein, and ureter, were free of malignancy. No vascular or lymphatic invasion was identified. A single lymph node was present and negative for malignant cells.\n\nThe tumor was in close proximity to the capsular surface, less than 1 mm away, but did not breach it macroscopically or microscopically. Evaluation of non-neoplastic kidney tissue showed focal glomerulosclerosis. Immunohistochemical staining demonstrated positivity for CD10 and c-KIT, and negativity for CK7, RCC, and vimentin. Hales colloidal iron stain showed patchy staining in tumor cells.\n\nThe specimen was fixed in formalin and weighed 490 grams with overall dimensions of 16.0 x 10.0 x 4.0 cm. No adrenal gland tissue was submitted. Grossly, the kidney away from the tumor appeared unremarkable, and no palpable hilar lymph nodes were identified. Multiple blocks were submitted for analysis, including sections of the tumor, margins, renal pelvis, and normal parenchyma.\n\nBased on available data, the pathologic staging was pT1b pNO. This staging is subject to revision pending clinical correlation and further information."} +{"pid": "TCGA-43-2578", "report": "The specimen consists of a left upper lobe of the lung along with multiple lymph nodes from various levels. The lung specimen measures 21 x 8 x 4.5 cm and is covered with red, violaceous, and glistening pleura with black stippling. One pleural surface is inked black (hilar side), and the opposite is inked blue. On sectioning, the lung reveals a pink-red spongy cut surface with a 1.8 x 1.5 x 1.4 cm tan-white, firm mass located within the lung tissue. The mass does not grossly involve the pleural surfaces but is within 0.1 cm of the pleural surface opposite the hilar side and within 4 cm of the hilum. Several hilar lymph nodes are identified.\n\nSubmitted sections include the entire lesion to pleura, representative normal and apical lung tissue, bronchial and vascular margins, and possible lymphoid tissue at the hilum. Additional specimens submitted include lymph nodes from level 12 (1.5 x 1.2 x 0.5 cm, pink-gray, irregular), level 11 (two fragments measuring 1.2 cm and 0.3 cm, pink-gray, rubbery), level 5 (2.2 x 1.5 x 1.2 cm, gray-pink, rubbery, bisected), level 9 (1.2 x 0.5 x 0.3 cm, yellow-black, rubbery), level 7 (1.2 x 1 x 0.3 cm, pink-gray, soft), and level 10 (multiple black-gray friable fragments, aggregate measurement of 2 x 1.2 x 0.3 cm). All lymph node specimens were entirely submitted in cassettes.\n\nMicroscopically, the lesion demonstrates features consistent with non-small cell morphology and squamous differentiation. The tumor is moderately differentiated and measures 1.8 cm in greatest dimension. Resection margins are negative. There is no evidence of direct extension, venous, arterial, or lymphatic invasion. Regional lymph node evaluation includes three negative hilar lymph nodes, one negative level 12 lymph node, two negative level 11 lymph nodes, one negative level 5 lymph node, one negative level 9 lymph node, one negative level 7 lymph node, and one negative level 10 lymph node."} +{"pid": "TCGA-BH-A0DZ", "report": "The specimen was received in multiple parts. The right breast total mastectomy specimen demonstrated a multifocal, multicentric tumor located at the junction of the upper outer quadrant and upper inner quadrant, as well as within the upper outer quadrant. Tumor nodules measured 2.5 cm on gross examination and 0.5 cm on microscopic evaluation. Histologic assessment showed a Nottingham score of 6 out of 9, with tubules score 2, nuclear grade 2, and mitosis score 2, corresponding to an overall grade of 2 out of 3. No definitive lymphovascular invasion was identified.\n\nA ductal in situ component was present, characterized as solid type with comedo necrosis, nuclear grade 3, and lobular extension. This in situ component comprised 25% of the total tumor volume and was found both in association with and separate from the invasive component. Surgical margins, including deep and anterior resection margins, were free of both invasive and in situ carcinoma, with the closest anterior margin measuring 7 mm away. Additional findings included atypical ductal hyperplasia, fibroadenoma, pseudoangiomatous stromal hyperplasia (PASH), and columnar cell change. No tumor was identified in the skin or nipple.\n\nImmunohistochemical staining showed positivity for estrogen and progesterone receptors. HER2/neu testing by IHC was strongly positive (3+), and FISH confirmed gene amplification.\n\nLymph node evaluation included one sentinel lymph node with metastatic involvement measuring 6 mm on glass slide, with focal extracapsular extension noted. Three other sentinel lymph nodes and one non-sentinel lymph node were negative for metastasis. A total of 4 lymph nodes were examined, with 1 positive for metastatic disease.\n\nPathologic staging was determined as pT2 for the primary tumor, pN1 for lymph node involvement, and pMX for distant metastasis. No dermal lymphatic invasion, skin ulceration, or internal mammary lymph node involvement was identified."} +{"pid": "TCGA-FP-8209", "report": "The distal stomach specimen consists of an unoriented portion measuring 14.0 x 6.0 x 3.5 cm. The external surface is gray-tan to brown-tan and slightly roughened. The specimen includes one opened margin and one stapled margin. Upon opening, the mucosal surface appears light tan with normal rugate folds. A nodular mass measuring 3.0 x 1.0 cm is present, located 2.6 cm from the stapled margin and 12.0 cm from the opened margin. Hemorrhagic areas are noted within the mass. The gastric wall is thickened and fibrotic at the site of the lesion.\n\nThe mass measures 3 x 1 x 1.5 cm and exhibits both exophytic and infiltrative growth patterns. Microscopic evaluation shows poorly differentiated cellular features. The lesion extends deeply into the muscularis propria but does not penetrate through it. No lymphovascular or perineural invasion is identified.\n\nSurgical margins are assessed. The proximal margin is widely free of involvement. The distal margin (duodenum) is free of involvement with a distance of 2.5 cm from the lesion. The radial margin is also free of involvement, with a closest distance of 0.5 cm.\n\nA total of five lymph nodes are identified, ranging in size from 0.2 to 0.4 cm. No metastatic involvement is found in any of the nodes, confirmed by pancytokeratin immunostaining. Sections from the mass, margins, and lymph nodes are submitted for further analysis. Additional findings correlate with a prior gastric biopsy, and the case has been reviewed and confirmed by a second pathologist."} +{"pid": "TCGA-AC-A8OS", "report": "The right breast specimen showed multifocal nodules, with the largest measuring 3.0 cm in diameter located in the upper outer quadrant. Additional smaller nodules ranging from 0.1 to 0.6 cm were identified in close proximity, slightly anterior and inferior to the main nodule. The invasive component was found to be 0.3 cm from the anterior-superior margin and at least 1 cm away from all other surgical margins. Histologic evaluation revealed a Nottingham grade 2 carcinoma, with tubule formation scored as 3 of 3, nuclear pleomorphism as 2 of 3, and mitotic rate as 1 of 3. No lymphovascular invasion was identified. Two lymph nodes were examined, including one sentinel node, and no tumor involvement was found. A separate in situ component was noted with low nuclear grade features. Staging was based on the AJCC Cancer Staging Handbook, 7th edition, and included a primary tumor classification of pT2(m), regional lymph node classification of pN0(i-)(sn), and an overall stage of IIA. Ancillary studies from prior biopsy showed strong estrogen receptor positivity (100% positive cells, strong intensity), weak progesterone receptor expression (4% positive cells), HER2 IHC score of 1+, and a Ki-67 proliferation index of 12%. The left breast specimen showed benign breast tissue with fibrocystic changes, including fibrosis, cysts, apocrine metaplasia, and sclerosing adenosis. Three benign lymph nodes were identified, and the skin and nipple were unremarkable. A portion of skeletal muscle from the deep margin of the right breast was also examined and found to be free of tumor."} +{"pid": "TCGA-A6-3810", "report": "The specimen consists of a segment of large bowel measuring 20 cm in length and 2.8 cm in diameter, with abundant surrounding fat. The specimen spans up to 10 cm in overall diameter. An area of narrowing is noted where an appendage adheres to the outer surface of the colon, located 6 cm from the open end. Upon opening the bowel along the non-mesenteric side, a fungating lesion involving the inner lining is identified. This lesion measures 6 cm in length and 1.2 cm in depth and completely encircles the lumen. It is located 6 cm from the distal resection margin and approximately 11 cm from the proximal margin.\n\nExamination of the tissue following fixation reveals that the lesion extends into the surrounding fatty tissue. The surrounding fat has been dissected, revealing an area suggestive of inflammation adjacent to the lesion, possibly related to a structural abnormality in the colon wall. No vascular invasion is observed. The inflammatory response around the lesion includes both acute and chronic features, and one section shows changes consistent with structural wall disruption and localized infection.\n\nA total of 30 lymph nodes are examined, none of which show any abnormal cells. The margins of resection are free of atypical cells. The lesion is fully sampled and assessed across multiple sections. A separate specimen from the proximal margin consists of a small piece of soft tissue containing staples, measuring 4.1 x 0.4 cm, and shows no abnormal cells."} +{"pid": "TCGA-B0-5088", "report": "The specimen consists of a right laparoscopic radical nephrectomy. The neoplasm measures 5.1 cm in greatest diameter and is confined within the renal capsule. No invasion of the renal vein or angiolymphatic invasion is identified. The growth pattern is papillary and acinar. Cellular features include oncocytic and papillary characteristics. Nuclear grading according to Fuhrman's criteria is grade III of IV. All surgical margins are free of neoplastic cells. The surrounding non-neoplastic kidney demonstrates sclerotic glomeruli, predominantly adjacent to the lesion. The adrenal gland was not submitted for evaluation, and no lymph nodes were identified. Histologic grade corresponds to G2. Based on available findings, staging is classified as pT1b Nx Mx."} +{"pid": "TCGA-HC-7210", "report": "The specimen was received in two containers. The first, labeled as deep pelvic lymph nodes (right and left), contains an aggregate of yellow-tan fibrofatty soft tissue measuring 4.8 x 4.8 x 1.8 cm. Seven possible lymph nodes were identified, ranging from 0.5 to 3.0 cm in greatest dimension, and entirely submitted for analysis. All were benign without evidence of metastatic involvement.\n\nThe second container labeled prostate contains a specimen weighing 50.5 grams and measuring 5.0 x 4.5 x 4.0 cm. It was received with attached bilateral adnexa and inked for orientation. The capsule appeared pink-tan and shaggy. Serial sectioning revealed a tan-orange lesion measuring 1.5 x 1.0 x 0.7 cm located in the right posterior quadrant. This lesion approached within 0.3 cm of the inked capsule but did not extend beyond it. No extracapsular extension or involvement of the seminal vesicles was identified. The apical margin showed tumor within 0.1 cm of the inked margin but was otherwise negative. All other surgical margins were negative.\n\nHistologically, the lesion demonstrated conventional type features. The primary growth pattern was scored as 3 out of 5, and the secondary pattern as 4 out of 5, resulting in a total score. Approximately 5% of the gland volume was involved. High-grade prostatic intraepithelial neoplasia was also present. No lymphovascular or perineural invasion was observed. There was no evidence of treatment effect.\n\nStaging was based on these findings, and the number of regional lymph nodes examined was seven, none of which contained metastatic cells. Additional findings included benign prostatic hyperplasia."} +{"pid": "TCGA-34-2600", "report": "The patient presented with persistent lung infiltrates. Imaging demonstrated multiple lymph nodes of varying sizes. A precarinal lymph node measured approximately 1.2 cm in anterior-posterior dimension, 7.0 cm transversely, and 1.0 cm in length. A right hilar lymph node measured 1.0 cm in short axis diameter, while the left hilar lymph node measured 0.5 cm in diameter. Pre-operative and post-operative diagnoses were consistent with a lung nodule.\n\nThe procedure performed included bronchoscopy with mediastinoscopy. Surgical resection revealed a lesion in the right lower lobe measuring 2.0 cm in greatest dimension. Histopathologic examination identified invasive moderately differentiated carcinoma with angiolymphatic invasion noted. There was no pleural invasion observed. All surgical margins were negative for tumor involvement.\n\nLymph nodes sampled from various stations including Level 3, Level 4R, Level 5R, Level 6R, Level 7R, Level 9R, Level 4L, Level 5L, Level 7L, Level 9L, and Level 10L showed benign reactive changes without evidence of metastatic disease. Six parabronchial lymph nodes removed with the right lower lobectomy specimen also showed no involvement.\n\nThe final staging was determined as T1N0MX based on available findings. Gross examination of the lobectomy specimen revealed a centrally located lesion measuring 2.0 x 7.0 x 0.1 cm with firm, pale tan, hemorrhagic characteristics and poorly defined borders. The remainder of the lung parenchyma was largely unremarkable with patent vessels and bronchioles.\n\nFrozen section analysis during surgery confirmed benign reactive lymph nodes in all biopsied regions except for the lung biopsy which demonstrated malignant cells consistent with non-small cell carcinoma morphology. Final bronchial margin evaluation was negative for tumor involvement.\n\nUnderlying pulmonary findings included emphysema and parenchymal scarring. No other significant concurrent pathology was identified within the specimen."} +{"pid": "TCGA-SG-A849", "report": "The specimen consists of a resected soft tissue mass from the right anterior arm. Gross examination reveals a 2.7 x 2.5 x 2.0 cm lesion that is tan-white and gelatinous with areas of hemorrhage and a small focus of necrosis. The tumor appears well demarcated from surrounding tissue and is grossly free from all margins. Microscopic evaluation confirms a high-grade cellular proliferation with marked pleomorphism and frequent mitotic figures, totaling 26 per 10 high-power fields. Necrosis is present in approximately 30% of the sample. Histologic analysis shows features suggestive of myogenic differentiation.\n\nMargins were evaluated with microscopic sections showing a focally positive anterior margin, while other margins are negative. The closest uninvolved margin is the deep margin at 0.4 cm. No lymph nodes were identified or examined. Based on FNCLCC grading criteria, the lesion is classified as grade 3. Pathologic staging according to AJCC guidelines corresponds to pT1a pNX. Slide correlation confirmed the anterior margin involvement. The tumor was further processed for cytogenetic studies and tissue procurement."} +{"pid": "TCGA-EI-6885", "report": "Histopathological examination of a segment of the large intestine with attached fat tissue measuring 1.7 cm in thickness was performed. The specimen measured 17 cm in length. A tumor measuring 3 x 4 x 1.2 cm was identified in the mucosa. The lesion encircled approximately 80% of the intestinal circumference, causing significant luminal narrowing. It was located 11 cm from the proximal resection margin and 2.6 cm from the distal margin, with the closest margin measuring 0.7 cm.\n\nMicroscopic evaluation revealed moderately differentiated gland-forming neoplastic cells infiltrating the muscularis propria and surrounding adipose tissue. Resection margins were free of neoplastic involvement. Lymph node analysis demonstrated metastatic involvement in regional nodes, with evidence of capsular and perinodal adipose tissue infiltration. \n\nStaging parameters indicated pT3, pN1b, with no residual tumor (RO) status. The morphological classification aligned with a Dukes' C and Astler-Coller C2 staging. Cellular features were consistent with a non-mucinous epithelial neoplasm exhibiting moderate stromal reaction and lymph node dissemination."} +{"pid": "TCGA-XV-A9W2", "report": "Patient M presented with a lesion on the right forearm. Histopathological evaluation revealed a tumor measuring 1.5 x 2 mm. The tumor demonstrated certain cellular features, including epithelial origin. Assessment showed no evidence of metastasis. The Clark level of invasion was recorded as 2, and the Breslow thickness measured 1 mm. Staging was determined to be early. No prior neoadjuvant immunotherapy was administered."} +{"pid": "TCGA-EY-A3L3", "report": "The surgical pathology report includes a total hysterectomy with bilateral salpingo-oophorectomy, along with lymph node excisions. The uterus measures 13.2 cm in height, 5.4 cm in anterior-posterior width, and 7.8 cm in fundal breadth, weighing 295 grams. A lesion measuring 4.8 x 4.5 x 3.1 cm is present, appearing tan/white and exophytic. It involves both the anterior and posterior endometrium and extends into the anterior lower uterine segment. Histologically, the lesion demonstrates high-grade features. Myometrial invasion is limited to the inner half, with a depth of 7 mm and a wall thickness of 28 mm, representing 28% invasion. No serosal involvement is identified, but there is involvement of the lower uterine segment. The cervical margins are negative, and no adnexal or other site involvement is seen. Lymphovascular space invasion is not identified in the sections examined.\n\nSeventeen regional lymph nodes were examined: one from the right periaortic region, two from the left periaortic region, six from the right pelvic area, and eight from the left pelvic area. All lymph nodes show no evidence of involvement. Additional findings include adenomyosis. Immunohistochemical staining shows diffuse positivity for P53 and P16. Estrogen and progesterone receptor status remains pending on one block, with an addendum to follow. The AJCC pathologic stage is pT1a pN0, and the FIGO (2008) classification is Stage IA, Grade 3. These staging assessments are based on current data and may be subject to revision with further clinical information. All other specimens, including bilateral ovaries, fallopian tubes, and additional tissue blocks, show no evidence of tumor."} +{"pid": "TCGA-E2-A1IE", "report": "The surgical specimens included three sentinel lymph nodes from the right axilla and an excised right breast specimen. The first sentinel lymph node measured 0.5 x 0.5 x 0.3 cm and showed no evidence of involvement. The second lymph node measured 1.5 x 0.5 x 0.5 cm and contained a subcapsular focus measuring 1.5 mm in greatest dimension; however, evaluation was partially limited by cautery artifact at one edge. Touch preparations from this specimen were negative. The third sentinel lymph node specimen consisted of three lymph nodes ranging from 0.5 to 1.2 cm in size, none of which demonstrated any abnormal findings.\n\nThe excised breast specimen weighed 59 grams and measured 7.0 cm from superior to inferior, 6.0 cm from anterior to posterior, and 5.5 cm from medial to lateral. A well-defined firm mass was identified within the breast tissue, measuring 2.1 x 1.7 x 1.5 cm, located 0.6 cm from the superior margin and greater than 10 cm from other margins. This mass extended into deeper tissues and was found to be 0.9 cm from the deep margin. Histological evaluation revealed cellular features including focal necrosis, lymphovascular invasion, and moderate differentiation based on structural scoring. Surrounding tissue showed benign epithelial changes, and microcalcifications were noted in non-neoplastic areas.\n\nImmunohistochemical staining demonstrated positivity for estrogen and progesterone receptors using Allred scoring (estrogen receptor score: 8; progesterone receptor score: 6). HER2 testing by immunohistochemistry showed equivocal staining with intensity of 2+ in approximately 20% of tumor cells. Fluorescence in situ hybridization (FISH) confirmed no amplification of the HER2 gene, with a HER2/CEP17 ratio of 1.05.\n\nMargins of resection were largely negative, with the exception of the deep margin, which was closest to the lesion. No multifocal lesions were identified. Based on histopathologic assessment, lymph node involvement was documented as one out of three sentinel lymph nodes positive for micrometastatic involvement. Clinical staging was determined based on these findings."} +{"pid": "TCGA-R6-A6L6", "report": "Submitted material consists of two specimens. The first includes multiple tan soft tissue fragments measuring 1.0 x 0.6 x 0.2 cm, demonstrating ulcerated, invasive poorly differentiated cells within areas of squamous epithelium. Additional fragments show reactive epithelial changes. The second specimen consists of three tan soft tissue fragments measuring 0.5 x 0.4 x 0.2 cm, with a small focus of invasive cellular growth less than 1 mm in size noted in one fragment. The invasion extends into the lamina propria. Adjacent tissue shows Barrett-type mucosa with low-grade atypical changes and active chronic inflammation, along with squamous mucosa displaying reactive features. The invasive component is associated with desmoplastic stromal change, indicating possible deeper involvement. Clinical follow-up is advised."} +{"pid": "TCGA-44-5645", "report": "The specimen consists of a stapled wedge biopsy of the left upper lobe measuring 9.5 x 6.5 x 5 cm. A tan rubbery mass measuring 3.2 x 2.2 x 1.8 cm is identified adjacent to the pleural surface and is greater than 0.6 cm from the nearest stapled margin. Sections of the mass and stapled margin were submitted for microscopic evaluation.\n\nMicroscopic examination reveals a markedly atypical glandular proliferation. Atypical epithelioid cells with ample cytoplasm and irregular nuclei containing prominent nucleoli are present. These cells exhibit a glandular growth pattern and in some areas appear to grow along alveolar septa. Cytologic atypia is evident, with cellular crowding, nuclear overlap, and focal pseudostratification noted. The architecture demonstrates compact areas with associated fibrosis, suggestive of an invasive process. Visceral pleural invasion could not be definitively assessed; however, a suspicious area was identified in block 6, and elastic staining was recommended for further evaluation. All margins are negative."} +{"pid": "TCGA-56-8304", "report": "A right upper lobe lobectomy with lymph node biopsies was performed. The specimen included multiple lymph nodes from various locations, all of which showed benign features with presence of anthracotic pigment and no evidence of malignancy. The primary lesion measured 2.4 cm in greatest dimension and was located peripherally, extending to but not through the visceral pleura. Histologic evaluation revealed a moderately differentiated neoplasm composed of polygonal cells with enlarged hyperchromatic nuclei, mitotic activity, and focal necrosis. No lymphovascular invasion was identified. Surgical margins, including bronchial and vascular margins, were free of tumor involvement. There was no direct extension of the lesion into surrounding structures. Seven lymph nodes were examined, and none showed evidence of involvement. Adjacent lung tissue demonstrated subpleural fibrosis with chronic inflammation and calcification, but no tumor involvement. The remainder of the lung parenchyma showed mild anthracotic changes without significant pathology."} +{"pid": "TCGA-FU-A3TX", "report": "The surgical specimen included the uterus, cervix, parametria, ovaries, and fallopian tubes, as well as multiple regional lymph node groups. The uterine specimen weighed 83.9 grams and measured 10.5 cm in length. A cervical mass was identified, measuring 4.9 x 3.5 x 2.3 cm macroscopically. Microscopically, the lesion showed a maximum horizontal extent of 4.9 cm and a depth of invasion of 0.4 cm within a cervical wall thickness of 0.9 cm. No parametrial involvement was observed. The tumor was located 2.4 cm from the closest vaginal cuff margin, which was free of tumor involvement. All other surgical margins were clear.\n\nHistologic evaluation revealed poorly differentiated cells. No angiolymphatic invasion was identified. There was no evidence of associated intraepithelial lesions. Examination of the endometrium showed atrophic changes with a thickness of 0.1 cm. The myometrium appeared homogeneous without any identifiable masses. Both fallopian tubes were patent. The right ovary contained a benign cystic follicle, while the left ovary showed no significant pathology.\n\nLymph node assessment included 10 right pelvic lymph nodes, 2 right periaortic lymph nodes, 13 left pelvic lymph nodes, and 1 left periaortic lymph node. All lymph nodes were negative for malignant cells. In total, 30 lymph nodes were examined, with none showing evidence of metastasis.\n\nStaging parameters indicated a tumor with a greatest dimension of 4.9 cm, confined to the cervix with no parametrial or lymph node involvement. Based on these findings, the tumor was classified as pT1b2 with no regional lymph node metastasis (pN0) and no distant metastasis (pM0)."} +{"pid": "TCGA-B5-A1MV", "report": "A 68-gram, 8 x 5.5 x 3 cm hysterectomy specimen with attached cervix measuring 3 cm in length and 3 cm in diameter was received. The cervix has a patent os measuring 0.6 cm and exhibits a tan-pink color with a herringbone pattern. The endometrial canal is 4.5 cm long and spans 3 cm from cornu to cornu. A large, contiguous, fungating mass is observed on the posterior portion of the endometrial canal, beginning 1.5 cm superior to the lower uterine segment and extending to the anterior endometrium approximately 2.6 cm from the lower uterine segment. Both lower uterine segments appear uninvolved. Serial sectioning reveals a focally 1 cm thick endometrium overlying a 1.1 cm thick myometrium. The deepest area of invasion is located on the posterior surface, measuring 0.8 cm into a 1.7 cm myometrium. On the anterior endometrium, the deepest invasion measures 0.3 cm into a 1.7 cm myometrium.\n\nA hernia sac specimen measuring 9.5 x 9 x 3.2 cm consists of fibroadipose tissue. Benign fibroadipose tissue is seen on sectioning. Sections were submitted for analysis.\n\nThe right fallopian tube and ovary weigh 8 grams and measure 6 x 3.1 x 1.8 cm. The fallopian tube is 7.5 cm in length and white-tan in color; the fimbriae are unremarkable. The right ovary measures 2.5 x 1.6 x 0.9 cm, is white-tan and cerebriform, and contains a 1 x 0.5 x 0.2 cm corpus albicans upon sectioning.\n\nThe left fallopian tube and ovary weigh 11 grams and measure 6.8 x 3 x 2 cm. The fallopian tube is 7.6 cm in length and appears grossly unremarkable, as does the attached fimbriae. The left ovary measures 3 x 1.2 x 0.8 cm, is white-tan and cerebriform, and shows no abnormalities upon sectioning.\n\nA left pelvic lymph node specimen measuring 5 x 2.3 x 1.8 cm contains six lymph node candidates. One lymph node candidate (mostly fat) was submitted in block E1, two in E2, two in E3, and one in E4. A left common lymph node specimen measures 1 x 0.6 x 0.6 cm and was submitted entirely in F1. An aortic lymph node specimen measuring 2.8 x 2 x 0.6 cm contains one lymph node candidate measuring 2.6 cm in length x 0.4 cm, which was bisected and submitted in G1 and G2. A right pelvic lymph node specimen measuring 5.5 x 4.5 x 0.8 cm contains multiple lymph node candidates. Three were submitted in H1, three in H2, two in H3, and two individual nodes were bisected and submitted in H4 and H5. A right aortic lymph node specimen measuring 3.5 x 3.2 x 0.8 cm contains two lymph nodes ranging from 1.3 cm to 0.5 cm in size. One was bisected and submitted in I1 and the other in I2.\n\nMicroscopic evaluation of the uterine and cervical specimen indicates that the depth of invasion is best visualized on frozen section slide AF1. The tumor invades 0.8 cm into a 1.7 cm myometrium. Histologic examination of the uterus shows atrophic non-neoplastic endometrium and unremarkable remaining myometrium. The cervix and serosa are free of involvement, and the specimen margins are not involved. No lymphatic or vascular invasion is identified.\n\nAll lymph node specimens were negative for malignancy: six from the left pelvis, two from the left common, two from the aorta, eleven from the right pelvis, and five from the right aorta. The right pelvic lymph nodes show a prominent histiocytic infiltrate. Special stains for fungi (PAS) and acid-fast bacilli (TBC) were performed and found no evidence of infection.\n\nThe procedure performed was a total hysterectomy, along with bilateral salpingo-oophorectomy and lymph node dissection. Tissue measurements and histologic features have been documented accordingly."} +{"pid": "TCGA-CX-7219", "report": "A radical neck dissection specimen was analyzed, including bilateral lymph node levels I, II, III, and VI, as well as submental lymph nodes. In the right side, lymph nodes from levels I, II, and III showed involvement, with 2 out of 4, 3 out of 11, and 1 out of 9 positive nodes respectively. Extranodal extension was identified in the right level III lymph node. On the left side, level I and II lymph nodes were involved, with 1 out of 9 and 5 out of 14 positive nodes, respectively. Level III and VI nodes on both sides showed no evidence of involvement. A total of 76 lymph nodes were examined, with 14 showing involvement. Extranodal tumor extension was documented.\n\nThe primary lesion was located in the oral cavity and measured 7 cm in its greatest dimension, with additional dimensions of 6 x 3 cm. Histologic evaluation revealed a moderately differentiated infiltrating growth pattern. The tumor extended into adjacent structures including cortical bone and deep muscles of the tongue. Surgical margins were uninvolved, with the closest distance of tumor to a margin measuring 0.6 mm at the anterior gingival site.\n\nVascular invasion was present, but there was no evidence of perineural invasion. Additional findings included chronic sialadenitis in submandibular glands bilaterally and follicular variant thyroid tissue in a right level III lymph node. Frozen section analysis of multiple biopsy sites, including deep tongue, anterior tongue, and left and right lateral margins, did not show any neoplastic involvement."} +{"pid": "TCGA-BH-A0B9", "report": "A right sentinel lymph node biopsy was performed, revealing one lymph node which showed no evidence of involvement. A segmental mastectomy specimen from the right breast demonstrated a lesion with a maximum invasive dimension of 1.4 cm. The cellular architecture exhibited a Nottingham score of 9 out of 9, composed of a tubule formation score of 3, nuclear grade of 3, and mitotic activity score of 3. No lymphovascular invasion was identified.\n\nThe lesion was characterized by a solid type in-situ component with nuclear grade 3 features and comedo-type necrosis, accounting for approximately 3% of the overall invasive component. This in-situ component was also present in the surrounding breast tissue. Surgical margins were negative for both invasive and in-situ components; however, the invasive component approached the superior margin at a distance of 0.03 cm. The skin was unremarkable.\n\nImmunohistochemical analysis revealed negativity for estrogen and progesterone receptors. The lesion demonstrated a basal-like immunophenotype, showing positivity for cytokeratin 5, cytokeratin 6, cytokeratin 14, cytokeratin 17, epidermal growth factor receptor, and vimentin. It was negative for Her2/neu expression. A prominent lymphocytic infiltrate was noted, and the lesion exhibited pushing margins. Thermal effect was also observed.\n\nPathologic staging indicated a T stage of pT1 and an N stage of pNO, with no distant metastases identified (Mx). Non-neoplastic breast tissue showed fibrocystic changes. The lymph node assessment involved H&E and keratin staining methods, and no extracapsular extension was observed."} +{"pid": "TCGA-E2-A1IL", "report": "The surgical specimen consists of a wide local excision from the left breast with needle localization. The excised tissue measures 25 x 5.2 x 2.7 cm and weighs 39 grams. The specimen was serially sectioned, revealing a firm tan mass measuring 1.5 x 1 x 0.9 cm located 1 cm from the nearest posterior/inferior margin. Margins were evaluated and found to be negative for any abnormal cellular activity. Multiple sections were submitted for histological analysis, including perpendicular sections of the medial margin, slices containing the mass and margins, and representative sections of the lateral margin.\n\nFive sentinel lymph nodes were submitted for evaluation from the left axilla:\n\n- Sentinel lymph node #1: Measures 2 x 1.5 x 1 cm; entirely submitted and reactive in appearance.\n- Sentinel lymph node #2: A fragment of fibroadipose tissue measuring 2 x 2 x 0.8 cm; no lymphoid structures identified.\n- Sentinel lymph node #3: Adipose tissue measuring 4 x 3 x 1 cm containing one lymph node measuring 0.7 cm; the lymph node was entirely submitted.\n- Sentinel lymph node #4: Lymphoid tissue measuring 2 x 1 x 1 cm; entirely submitted and reactive.\n- Sentinel lymph node #5: Measures 1.2 x 1 x 0.6 cm; entirely submitted and reactive.\n\nHistological examination of all lymph nodes revealed no evidence of abnormal cells in four of the nodes. One lymph node showed the presence of atypical cells within the lymphatic system.\n\nThe lesion demonstrated nuclear grading of 2 and a modified Scarff Bloom Richardson histologic grade of 2. Microcalcifications were noted within the lesion. Additional findings include a ductal intraepithelial component with low nuclear grade and an estimated involvement of 5%, located in proximity to the main lesion. Stromal fibrosis and changes related to prior biopsy were also observed.\n\nEstrogen and progesterone receptor testing were positive, while HER2 testing by immunohistochemistry was negative.\n\nPathological staging was determined as pT1c with regional lymph node involvement classified as N1a."} +{"pid": "TCGA-BH-A0DL", "report": "The surgical specimen from a left breast segmental mastectomy includes a lesion measuring 2.5 x 1.8 x 1.8 cm. Histologic evaluation reveals a high Nottingham score of 9/9, composed of tubule formation score 3, nuclear grade 3, and mitotic activity score 3. Lymphovascular invasion is not identified. A component of ductal carcinoma in situ is present, displaying solid and cribriform patterns with nuclear grade 3, accounting for less than 1% of the total volume. It is found both admixed with and separate from the main lesion.\n\nMargins of resection are free of involvement. Changes consistent with prior biopsy are noted. Additional findings include fibrocystic changes with duct ectasia, columnar cell alterations, and sclerosing adenosis, along with microcalcifications. A small intraductal papilloma is identified. A calcified nodule with periductal inflammation and a fibroadenomatoid nodule are also present.\n\nImmunohistochemical staining shows positivity for estrogen receptor, negativity for progesterone receptor, and no overexpression of HER-2/neu. Three sentinel lymph nodes examined are free of tumor involvement.\n\nAdditional excision of a posterior margin shows no evidence of the primary lesion but demonstrates fibroadenomatoid nodules, fibrocystic changes with epithelial hyperplasia and columnar cell changes, microcalcifications, and focal chronic inflammation with giant cell granulomatous reaction. Medial calcification of rib is noted. The final pathological staging is pT2, pN0, pMX. Benign calcifications are identified in non-neoplastic breast tissue."} +{"pid": "TCGA-RC-A6M3", "report": "The resected specimen includes a large mass measuring 15.2 x 13.5 x 13.2 cm located in the extended right lobe of the liver. Microscopic evaluation reveals a trabecular growth pattern with solid sheets, nests, and cords of cells. The cellular morphology demonstrates marked nuclear pleomorphism, including multinucleated cells with bizarre nuclei. Focal microscopic vascular invasion is present. The tumor is confined to the right lobe and does not involve any major vascular structures. Surgical margins are free of tumor involvement, with the closest distance of the tumor to the parenchymal resection margin measuring 0.35 cm. The tumor is in proximity to the Glisson\u2019s capsule but does not breach it. Surrounding liver tissue shows features of cholestasis and fibrosis, while distant non-neoplastic liver tissue appears unremarkable.\n\nA separate gallbladder specimen was also submitted. Gross examination shows no intraluminal masses or choleliths. A single lymph node adjacent to the cystic duct is benign and shows no evidence of malignancy. Histologic sections from both the liver and gallbladder confirm absence of tumor involvement in lymph nodes and surgical margins. Staging classification reflects the presence of focal vascular invasion without major vessel involvement."} +{"pid": "TCGA-QH-A6CU", "report": "The specimen consists of tissue obtained from the left frontal region of a female patient. Histologic examination reveals a densely cellular lesion composed of uniform cells with round to oval nuclei and scant cytoplasm. Frequent mitotic figures are present. Microvascular proliferation and focal necrosis are observed. The tumor infiltrates the surrounding brain parenchyma. Immunohistochemical staining demonstrates positivity for IDH1 and nuclear expression of ATRX. Molecular analysis shows loss of heterozygosity on chromosomes 1p and 19q. Based on morphology and molecular findings, the lesion exhibits features consistent with a high-grade glioma."} +{"pid": "TCGA-DD-A4NS", "report": "The liver specimen consists of the right lobe, measuring 20.0 x 11.0 x 7.0 cm and weighing 1020 grams, along with the gallbladder, measuring 10.2 x 3.7 x 1.7 cm. A mass measuring 11.0 x 11.0 x 10.0 cm is present within the liver. Histologic evaluation reveals Grade 2 (of 4) cellular atypia with characteristics consistent with a primary hepatic neoplasm. The surgical margin is widely free of tumor involvement. The gallbladder shows histologic features of mild acute and chronic inflammation without evidence of calculi. Specimen was photographed in the laboratory."} +{"pid": "TCGA-BA-5151", "report": "The specimen consisted of a left partial mandibulectomy and partial maxillectomy with attached cheek skin. The resected tissue measured 9.0 x 7.2 x 4.5 cm, including cheek skin measuring 6.5 x 5.2 cm with subcutaneous tissue depth of 2.1 cm. The maxilla measured 5.1 x 3.2 cm and the mandible measured 7.5 x 3.5 x 1.4 cm. Surgical margins were identified using ink colors: superior (blue), inferior (red), medial (black), lateral (yellow), anterior (orange), and posterior (green).\n\nA well-demarcated mass measuring 4.0 x 3.5 x 2.5 cm was identified in the left retromolar trigone region. It extended to the buccal mucosa, penetrated through soft tissue, and reached the overlying skin. The mass appeared white/tan, friable, and verrucous, with central ulceration. A skin nodule measuring 2.1 x 1.1 cm was present on the surface, located 1.4 cm from the closest skin margin. Microscopic evaluation revealed that the tumor abutted the maxillary bone and infiltrated the mandible with associated periosteal erosion.\n\nTumor proximity to surgical margins was as follows: anterior buccal mucosa 1.1 cm, posterior buccal mucosa 0.6 cm, superior buccal mucosa 0.5 cm, inferior buccal mucosa 0.9 cm, posterior mandibular margin 1.3 cm, anterior mandibular margin -1.5 cm, inferior soft tissue margin 0.5 cm, superior soft tissue margin 0.4 cm, superior maxillary margin 1.0 cm, medial soft tissue margin adjacent, lateral soft tissue margin 0.2 cm, and the skin focally involved.\n\nHistologic evaluation of all frozen section biopsies from the anterior, superior, posterior, and inferior left cheek skin margins showed no evidence of tumor. Similarly, no tumor was found in biopsies taken from the left anterior mandible periosteum, mandibular margin, or mucosal margins. One mucosal margin biopsy lacked sufficient mucosal epithelium for full assessment. Soft tissue surgical margins were close but negative, with the closest being less than 1 mm from the mid/inferior soft tissue margin. Other distances included: anterior 4 mm, posterior 6 mm, lateral 9 mm, inferior 6 mm, and superior 7 mm. Bone surgical margins were not involved.\n\nLymph node evaluation included specimens from multiple neck levels. No metastatic disease was identified in any lymph nodes examined: 0/2 in the primary specimen, 0/3 in left neck level 1, 0/4 in left neck level 2, 0/10 in left neck level 3, 0/8 in left neck level 4, and 0/6 in left neck level 5. Two apparent lymph nodes within the surrounding soft tissue of the main specimen were also negative.\n\nMicroscopic analysis confirmed absence of carcinoma in all biopsies and surgical margins evaluated. There was no evidence of angiolymphatic or perineural invasion. The remaining uninvolved mucosa was smooth and glistening, and the skin was pink/tan, hair-bearing, and without additional lesions. A separate excision from the left oral commissure showed verrucous hyperplasia involving the mucosa at the vermillion border, with the lesion 9 mm from the inked surgical margin.\n\nClinical staging was based on available data and classified as pT4a due to involvement of the facial skin, with no nodal involvement (pN0) and no distant metastasis (pMx). This classification remains subject to revision pending further clinical review."} +{"pid": "TCGA-BR-A4QI", "report": "The specimen consists of a subtotal gastrectomy. A lesion is present in the antrum, measuring approximately 6 x 4 cm. The lesion has a saucer-like appearance and causes circumferential narrowing of the gastric lumen. There is evidence of tissue infiltration into the perigastric fat. No definitive lymph nodes were identified along the lesser curvature, while those along the greater curvature show changes suggestive of metastatic involvement. The omentum appears hyperemic.\n\nMicroscopic evaluation reveals poorly differentiated cells with features consistent with glandular origin. There is evidence of surface ulceration and extension into the perigastric fatty tissue. Lymph nodes from both the greater and lesser curvature exhibit reactive changes including follicular hyperplasia and sinus histiocytosis. No venous invasion is observed. Surgical margins are uninvolved. A total of 10 lymph nodes were examined, none showing malignant involvement. No treatment-related changes are noted. Additional findings are not specified."} +{"pid": "TCGA-AP-A0LP", "report": "The submitted specimens include a total hysterectomy with bilateral salpingo-oophorectomy and multiple lymph node biopsies from both sides, including external iliac, hypogastric, obturator, common iliac, and para-aortic regions.\n\nMicroscopic examination of the hysterectomy specimen reveals a lesion characterized by endometrioid-type morphology. The tumor demonstrates nuclear grade 2 features with less than 6% solid growth pattern. The depth of myometrial invasion is equal to or less than half of the myometrial thickness in the affected area, with maximal invasion measuring 2.5 mm. The total myometrial thickness at the site of deepest invasion is 21 mm. No involvement of the endocervix is observed. Vascular space invasion is present. The background endometrium shows atrophic changes and a polyp. Adenomyosis and leiomyomas are identified in the myometrium. The right ovary shows endosalpingiosis. The left fallopian tube contains endosalpingiosis and simple cysts. Other adnexal structures are unremarkable.\n\nAll lymph node specimens are benign. In the right hypogastric lymph node biopsy, no lymph nodes are identified in the initial submission or after deeper sectioning. All other lymph node groups, including right and left external iliac, obturator, hypogastric, common iliac, and para-aortic regions, contain only benign lymph nodes without any pathological findings. The number of lymph nodes assessed varies per site, with all being negative for malignancy."} +{"pid": "TCGA-S7-A7WL", "report": "Gross: The specimen is an ovoid mass measuring 130x100x90 mm and weighing 640 g, with a fibrous capsule. The cut surface shows brown-yellow coloration with spotted areas. The tissue was sampled in six blocks. Microscopically, the lesion is composed of large polygonal cells, with focal spindle-shaped and atypical cellular forms. Nuclear features include hyperchromasia, and there are areas of fibrosis confirmed by trichrome staining, as well as lymphoplasmacytic infiltration. Evidence of both recent and old hemorrhage (demonstrated with iron staining) is present. No vascular or capsular invasion is identified, and the surrounding adipose tissue could not be assessed. A central region of the lesion contains extensive scarring. Immunohistochemical analysis was negative for S100 protein, indicating absence of sustentacular cell support, and Congo red staining was also negative. MIB-1 proliferation index was less than 1%. Histological scoring using the PASS system noted features including large nests or diffuse growth pattern involving more than 10% of the tumor volume, presence of necrosis within the central regions of nests, high cellularity, cellular monomorphism, and focal spindling. There were more than three mitotic figures per ten high power fields, with atypical mitotic figures observed. Other features included nuclear pleomorphism and hyperchromasia, contributing to a total score of 6."} +{"pid": "TCGA-E8-A434", "report": "The specimen demonstrates a unifocal lesion measuring 0.7 x 0.7 x 0.7 located in the left lobe. No extrathyroidal extension is identified. No lymph nodes were examined. Immunohistochemical markers and special stains were performed as part of the evaluation. The cellular features are consistent with a well-differentiated neoplasm. Staging is based on size and absence of extension, with no evidence of nodal involvement."} +{"pid": "TCGA-ZB-A96B", "report": "Pathology Report-Summary: Material: tumor measuring 16.0 x 7.0 x 8.0 cm. Focal infiltration into the surrounding capsule, though the capsule remains intact. Histologic evaluation shows a mixture of epithelial and lymphocytic components. Epithelial cells demonstrate positivity for CK5/6 and AE1/3, with strong membrane staining for EGFR. The epithelial component is negative for CD5 and CD117. Lymphocytic component includes immature T-lymphocytes, positive for CD99 and negative for CD1a. Staging classification indicates pT2, with no definitive assessment of nodal or distant metastasis (pNx, pMx). Clinical staging corresponds to stage II according to the Masaoka classification system."} +{"pid": "TCGA-52-7809", "report": "The specimen was obtained from a right upper lobectomy. The lesion measured 4.5 cm in greatest dimension and was identified within the lung tissue. Microscopic evaluation revealed a poorly differentiated carcinoma with basaloid features. The tumor was located adjacent to the visceral pleura, with evidence of invasion into this layer. The resection margins were free of tumor involvement. Immunohistochemical staining showed positivity for p63 and was negative for chromogranin and synaptophysin.\n\nA fibrous connection was noted between the pericardium and visceral pleura; however, no tumor involvement was identified in this region. No vascular invasion\u2014venous, arterial, or lymphatic\u2014was observed. A total of seven lymph nodes were examined, including those from the right and left distal paratracheal (R4), subcarinal #7, inferior pulmonary ligament #7, and interlobar #11 regions. All lymph nodes were negative for tumor involvement.\n\nThe bronchial margin and stapled resection margin were both free of tumor. No malignancy was identified in the residual lung parenchyma or in any other lymph node specimens collected during mediastinoscopy. Gross examination of the lung specimen revealed a well-circumscribed, pale-tan to yellow lesion with areas of necrosis and hemorrhage. The lesion was located 0.2 cm from the visceral pleural surface and 4 cm from the resection margin. An additional calcified nodule was found 1 cm from the resection margin but was not associated with malignancy.\n\nPathologic staging was determined as pT2, pN0, pMX. All diagnoses were made following examination of relevant preparations and microscopic analysis."} +{"pid": "TCGA-CJ-4904", "report": "The surgical specimen includes a left kidney and adrenal gland. A mass was identified measuring 14.5 cm in maximum dimension. The cut surface of the mass showed heterogeneous features with areas of necrosis, hemorrhage, and pale green translucent myxoid change. Histologic evaluation revealed high nuclear grade features. Lymphovascular invasion was present. The tumor involved a medium caliber vessel within the renal sinus. The tumor appeared to infiltrate through the full thickness of the kidney and was generally confined within the organ. In one area, the tumor was found within 3.0 mm of the surface of Gerota's fascia. Resection margins were free of tumor involvement. The adrenal gland did not show any evidence of tumor.\n\nFour lymph nodes were identified in the periaortic region on the left side, all without evidence of tumor. In the gastrointestinal preaortic region, five lymph nodes were examined and none contained tumor. Four lymph nodes were also evaluated in the suprahilar region, with no tumor identified.\n\nA Meckel\u2019s diverticulum was identified along with an enterolith. Two small foci of neuroendocrine-type tumor were found microscopically within the submucosa (1.5 mm) and subserosa (less than 0.5 mm) of the small intestine. \n\nGross examination of the left kidney and adrenal showed a total specimen size of 20.0 x 15.0 x 7.5 cm, including a tumor measuring 18 x 15 x 6.0 cm and a segment of ureter. The adrenal measured 5.0 x 2.5 x 0.5 cm. The tumor exhibited a variegated appearance with necrotic and hemorrhagic components. The periaortic lymph node specimen included one matted lymph node and one discrete lymph node, both without tumor involvement. The gastrointestinal preaortic lymph nodes included one identifiable lymph node and three nodular areas, all submitted for histologic evaluation. The suprahilar lymph node specimen included three nodules, one of which was interpreted as a lymph node. The Meckel\u2019s diverticulum measured 3.0 x 1.5 cm and contained a calculus measuring 0.8 x 0.7 x 0.7 cm. All sections were submitted for microscopic analysis."} +{"pid": "TCGA-D5-5538", "report": "Histopathological examination was performed on a resected segment of the large intestine along with surrounding periintestinal fat tissue, measuring 24 x 9 x 2 cm in total. The specimen included a 5 cm length of small intestine and a 5.5 cm appendix. A mucosal lesion measuring 4.2 x 4.1 x 0.6 cm was identified, presenting with ulceration and circumferential involvement of the intestinal wall. The lesion was located 5 cm from the proximal resection margin, 17 cm from the distal margin, and 1.2 cm from the ileocecal valve. Blue dye was administered during the procedure.\n\nMicroscopic evaluation revealed a moderately differentiated glandular and papillary growth pattern. There was evidence of infiltration into the intestinal wall, extending into adjacent adipose tissue. No involvement of the surgical margins was observed. Lymph node analysis demonstrated the presence of similar cellular changes in regional lymph nodes. Additional findings included involvement of perinodal adipose tissue and other localized tissue structures.\n\nThe histopathological assessment included evaluation of multiple tissue samples and considered both primary and secondary lesion characteristics. Grading and staging were determined based on depth of invasion and lymph node involvement."} +{"pid": "TCGA-DB-A4XD", "report": "A right temporal brain mass was evaluated, with multiple biopsies obtained from various regions including the cortex over the mass and surrounding areas. The specimens were processed for histological examination. Gross measurements of the tissue samples ranged from 0.7 x 0.6 x 0.5 cm to 4.5 x 2.8 x 1.4 cm. Some specimens were described as tan-white and soft in consistency. Smears were prepared from selected samples and submitted for analysis. All tissues were embedded in paraffin and representative sections were examined microscopically.\n\nMicroscopic evaluation revealed a diffuse infiltrating glioma composed of atypical cells with nuclear pleomorphism and increased mitotic activity. Immunohistochemical staining demonstrated overexpression of p53 protein in the majority of tumor cells, indicating abnormal cellular regulation. No other specific markers were mentioned in the report. Based on histologic features and immunostaining pattern, the tumor exhibited characteristics consistent with a high-grade glioma.\n\nThe tumor involved multiple regions of the right temporal lobe, with involvement noted in both the cortex and deeper white matter. Extent of sampling included multiple levels and margins, though precise surgical margin status could not be fully assessed due to the multifocal nature of the collected specimens. No lymph node or distant metastatic spread was evaluated in this report."} +{"pid": "TCGA-TQ-A7RP", "report": "The specimen consists of multiple soft, whitish-brown tissue fragments, measuring 6.2 x 3.0 x 1.5 cm in aggregate and weighing 13.0 grams. Histological examination reveals infiltration of brain parenchyma by a neoplastic process composed of two distinct cell populations. One population exhibits round nuclei with delicate chromatin and inconspicuous nucleoli, along with scant cytoplasm. These cells are observed infiltrating the neocortex, often as isolated cells or small clusters surrounding neurons, a pattern known as neuronal satellitosis. In certain areas, the neuropil shows vacuolation with microcyst formation, embedded in a basophilic and mucinous matrix.\n\nA second, less prominent cell population displays irregular nuclear contours, denser chromatin, and eosinophilic cytoplasm with indistinct cell borders. These cells predominantly infiltrate the white matter, which also contains regions of refractive neuropil and scattered reactive astrocytes. Mitotic activity is minimal. No evidence of microvascular proliferation or necrosis is identified. Some cortical fragments appear free of neoplastic involvement.\n\nThe submitted material includes all tissue fragments from the resection. The neoplastic features suggest a lesion with mixed cellular morphology, though no definitive diagnosis is provided in this summary. Correlation with radiological findings is recommended to assess for potential higher-grade components not represented in this specimen."} +{"pid": "TCGA-FU-A5XV", "report": "The patient is female. The specimen included multiple biopsies and excisions from various anatomical sites. Biopsy of the right pelvic sidewall was negative for malignancy. Excision of the right external iliac lymph nodes revealed one of two positive for metastatic carcinoma, with associated endosalpingiosis. One left obturator lymph node out of one examined was also positive for metastatic carcinoma with endosalpingiosis noted. Biopsy of the right uterine artery showed no evidence of malignancy.\n\nThe radical hysterectomy specimen contained a lesion measuring 4.5 x 3.5 x 2 cm. Histologic evaluation demonstrated moderate to poorly differentiated cells. The tumor invaded into the cervical wall to a depth of 1.5 cm within a total thickness of 1.8 cm. There was extensive lymphovascular space invasion. Surgical margins, including vaginal and deep margins, were negative. A total of 63 lymph nodes were retrieved, with two containing metastatic carcinoma. Additional findings included absence of significant abnormalities in the endometrium and myometrium, although the tumor focally extended into the lower uterine segment.\n\nExcision specimens from additional lymph node regions included: right external iliac #2 (9 lymph nodes), right obturator (16 lymph nodes), right common (7 lymph nodes), left external iliac (11 lymph nodes), left obturator (10 lymph nodes), and left common (7 lymph nodes). All were negative for metastatic disease, though endosalpingiosis was identified in some locations.\n\nImmunohistochemical staining showed positivity for WT1 in areas of endosalpingiosis, focal positivity for monoclonal CEA in carcinoma cells, and strong positivity for p16 in carcinoma with weak positivity in endosalpingiosis. Additional staining demonstrated positivity for p63 and negativity for CK7 in tumor cells.\n\nClinical history indicated preoperative diagnosis of cervical cancer. Gross examination described tissue characteristics across all specimen sites without identifying nodules or lesions in certain regions. Multiple sections were submitted for histologic analysis from various anatomical locations within the hysterectomy specimen and lymph node regions."} +{"pid": "TCGA-BF-A9VF", "report": "The specimen consists of skin from the left leg, lower thigh region, submitted as a surgical resection. Histological examination reveals a malignant neoplasm composed of a mixture of epithelioid and spindle-shaped cells. The tumor is classified as Grade 3 and corresponds to Clark level II\u2013III with a Breslow thickness of 0.79 mm. The tumor occupies approximately 80% of the tissue, with about 5% stromal component present."} +{"pid": "TCGA-UD-AAC6", "report": "The specimen consists of an irregular pleural strip measuring 130 x 120 x 2 mm, with multiple firm, irregular nodules on the surface, up to 10 mm in diameter. Three additional fibrous tissue strips were submitted, with the largest measuring 30 x 10 mm and the smallest 20 x 10 mm. Histologically, the sections reveal pleural tissue infiltrated by a malignant neoplasm. The majority of the tumor demonstrates an epithelioid morphology, arranged in a tubulopapillary pattern, forming irregular nodules. The cells exhibit large, irregular nuclei with fine chromatin, prominent nucleoli, and moderate to abundant eosinophilic cytoplasm with well-defined cell borders. There is moderate nuclear pleomorphism, presence of apoptotic cells, and readily identifiable mitotic figures.\n\nIn some areas, the tumor is less cellular and contains increased fibrous connective tissue, with spindled cells representing a sarcomatoid component. Other regions show neoplastic cells separated by myxoid stroma. Scattered within the tissue are nodular areas with birefringent inorganic material, likely talc particles, accompanied by epithelioid histiocytes and multinucleated foreign body-type giant cells. A dense chronic inflammatory infiltrate, predominantly lymphocytic, is present at the tumor periphery, along with lymphoid aggregates. Some tissue strips show paucicellular zones composed of dense collagen, possibly corresponding to pleural plaque. One section reveals a blood clot containing clusters of neoplastic cells.\n\nSpecial stains demonstrate no mucin production (PAS with diastase negative), but Alcian blue highlights the myxoid stromal areas. Immunohistochemical staining of the epithelioid component shows positivity for cytokeratin 5/6, calretinin, and WT-1, with strong peripheral membranous expression of EMA. The sarcomatoid component is positive for calretinin, negative for CK5/6 and WT-1, and shows patchy EMA staining. BerEP4 and CEA stains are negative. Ultrastructural analysis was not feasible due to the presence of dense collagenous stroma only in all representative blocks."} +{"pid": "TCGA-EJ-7786", "report": "The patient had a prior PSA value of 4.5 and a previous biopsy that showed poorly differentiated acinar-type adenocarcinoma in the right mid prostate. The patient also had a history of hydrocelectomy, laparoscopic gastric surgery, tonsillectomy, atrial fibrillation, cardiomyopathy, hypertension, and hypercholesterolemia. A radical prostatectomy was performed.\n\nExamination of three right pelvic lymph nodes and two left pelvic lymph nodes revealed no evidence of neoplasia. The prostate specimen weighed 117.59 grams and showed a histologic lesion with a Gleason score of 3 + 4 = 7. The tumor involved both the right and left lobes of the prostate and measured up to 1.3 cm in maximum dimension in one section. It accounted for less than 5% of the total prostate volume. The lesion was organ-confined without evidence of extracapsular extension or involvement of the bilateral seminal vesicles. All surgical resection margins were free of tumor, although a focal capsular incision was noted at the anterior left apex, which did not involve the margin. There was no perineural or angiolymphatic invasion identified. High-grade prostatic intraepithelial neoplasia was present and multifocal. The background prostate tissue showed nodular hyperplasia and chronic inflammation.\n\nPathologic staging was pT2c with no lymph node involvement (pN0) and no distant metastasis (pMX). Histologically, the lesion was classified as G3\u20134, consistent with poorly differentiated morphology. A total of five lymph nodes were examined, and none were positive. The final assessment indicated no residual tumor at the margins (R0 resection)."} +{"pid": "TCGA-FY-A40N", "report": "The thyroid specimen was received in multiple parts. The thyroid isthmus contained a 1.4 x 0.9 x 0.9 cm rounded red firm nodule. The right lobe of the thyroid measured 3 x 1.8 x 0.8 cm and weighed 3 grams. The left lobe measured 3.5 cm (superior to inferior), 2.4 cm (medial to lateral), and 0.9 cm (anterior to posterior), and weighed 5 grams. No grossly identifiable parathyroid glands were observed in either lobe. A lymph node specimen from the mediastinal central region consisted of three fragments, with the largest measuring 1 x 0.5 x 0.4 cm and two smaller fragments each measuring 0.5 cm in greatest dimension.\n\nMicroscopic examination revealed multiple foci of cellular proliferation within the thyroid tissue. Histologic evaluation showed distinct nuclear features and architectural patterns consistent with a well-defined lesion. The lesion was confined to the thyroid without extension beyond the organ capsule. Surgical margins were free of abnormal cellular findings. All submitted lymph nodes showed no evidence of similar cellular changes.\n\nStaging assessment indicated a primary lesion classification of pT1a. Regional lymph node involvement was not identified (pN0). No distant metastatic spread was evident. The overall pathologic stage was determined as Stage I. Lymphovascular invasion was not identified. Margin status was R0, indicating complete resection with no residual disease."} +{"pid": "TCGA-UZ-A9PX", "report": "The specimen consists of a right kidney with attached ureter from a male patient. The kidney measures 17.5 x 7.8 x 6.3 cm and weighs 448.5 grams. Three distinct nodules were identified. Nodule 1, located in the inferior pole, is a well-circumscribed, yellow-brown, soft mass measuring 4.2 x 3.9 x 3.8 cm. It is 0.6 cm from the renal sinus, 4.5 cm from the vascular margin, 3.2 cm from the ureteral margin, and 0.1 cm from the soft tissue margin. Nodule 2, found in the superior pole, is a yellow-tan, rubbery, well-circumscribed nodule measuring 1.6 x 1.6 x 1.2 cm. It is 1.6 cm from the renal sinus, 5.5 cm from the vascular margin, 8.5 cm from the ureteral margin, and 0.2 cm from the soft tissue margin. Nodule 3, located in the mid-kidney region, is a yellow-gold, soft, well-circumscribed ovoid mass measuring 3.1 x 1.6 x 2.5 cm. It is 0.1 cm from the soft tissue margin, 0.4 cm from the renal sinus, 3.5 cm from the vascular margin, and 9.1 cm from the ureteral margin. All three nodules are well-circumscribed and do not appear to involve the renal pelvis, ureter, renal sinus, hilar renal veins, intrarenal veins, or lymphatics. The adrenal gland was not present. The tumor does not penetrate the capsule or perirenal fat. Histologic evaluation showed high nuclear grade features. Two lymph nodes were examined and were negative for involvement. Resection margins were negative: ureteral margin (tumor >1 cm from margin), renal vein margin (tumor >1 cm from margin), and soft tissue margin (tumor 0.1 cm from margin). Based on these findings, the stage is pT1NOMX."} +{"pid": "TCGA-VD-A8KB", "report": "The specimen consists of a resected ocular tissue measuring 16 x 15 x 12mm, including a pigmented lesion and a thin layer of sclera. A small volume (0.1ml) of subretinal fluid was also collected and frozen for research purposes.\n\nMicroscopic evaluation of the tissue shows a lesion within the choroid with extension into the sclera. The cells are primarily spindle-shaped with some areas containing epithelioid morphology, making up approximately 15% of the cell population. Immunohistochemical staining demonstrates positivity for MelanA, HSP-27 (score 2), and partial positivity for CD10. Mitotic activity is moderately increased, with approximately 7 mitotic figures per 40 high-power fields.\n\nVascular structures are prominent within the lesion, although closed vascular loops are not identified in the examined sections. Areas suggestive of \"vascular seas\" are present, but no clear evidence of tumour infiltration is seen. A minimal lymphocytic infiltrate is noted within the lesion. Tumour extends to the scleral margin at the base, while the lateral margins are free of involvement.\n\nMolecular genetic analysis was performed on extracted DNA using multiplex ligation-dependent probe amplification (MLPA) with the P027 kit, which assesses copy number variations across 31 loci on chromosomes 1, 3, 6, and 8. DNA concentration was high and of good quality. The MLPA results were consistent across multiple runs and showed normal findings for chromosome 1, largely normal patterns for chromosome 3, gains in chromosome 6p, and borderline increases in chromosome 8q. These molecular findings are under review in conjunction with histological and clinical data for risk assessment."} +{"pid": "TCGA-A3-3351", "report": "The specimen consists of a right kidney weighing 640 grams. The kidney measures 13.8 x 8.1 x 3.6 cm and has attached perinephric fat. A mass measuring 8.4 x 7.9 x 3.4 cm is present in the middle and lower poles. The mass appears mottled tan-red to orange-yellow on gross examination, with cystic and hemorrhagic components. The cut surface of the mass is red-orange to yellow in color. The mass is located 0.2 cm from the inked deep margin and does not involve the renal vein or vascular margins. No lymph nodes are identified.\n\nMicroscopic evaluation reveals cells with clear cytoplasm and nuclear features corresponding to grade 2 of 4 according to the Fuhrman scale. There is no evidence of lymphovascular space invasion, transcapsular extension, or venous involvement. Adrenal tissue appears unremarkable. All surgical margins, including soft tissue, ureteral, and vascular, show no evidence of malignancy. Lymph node status cannot be assessed as none were resected.\n\nThe remaining kidney shows focal interstitial chronic inflammation. Based on the extent of the primary lesion, the case is classified as pT2 with no regional lymph node assessment (NX) and no distant metastasis (MX). The remainder of the kidney demonstrates well-preserved corticomedullary architecture and normal urothelium."} +{"pid": "TCGA-K4-A54R", "report": "A radical cystectomy and prostatectomy specimen was received, including bilateral distal ureter margins, a distal urethral margin, and left and right pelvic lymph nodes. Histologic examination of the ureteral margins showed no abnormal cellular proliferation. The distal urethral margin also showed no atypical cells. A total of eight lymph nodes (four from each side) were examined, and none showed any abnormal cellular infiltration.\n\nThe primary specimen included a mass located in the dome of the bladder. Microscopic evaluation revealed an infiltrative growth pattern within the muscularis propria. The lesion demonstrated high-grade nuclear features and was composed of urothelial cells with squamous differentiation. No glandular differentiation was identified. The tumor measured approximately 2.5 cm in greatest dimension and was assigned a histologic grade of 3 out of 3. No lymphatic or perineural invasion was observed. All surgical margins were free of atypical cells.\n\nIn the prostate, there was evidence of a low-volume, low-grade process involving both the apex and peripheral zones bilaterally. The Gleason score was 3+3=6, with no dominant nodule identified. The extent of involvement was minimal, less than 5% of the tissue. There was no evidence of extraprostatic extension or involvement of the seminal vesicles.\n\nStaging was determined as pT2b for the bladder component, indicating invasion into the outer half of the muscularis propria, and pT2c for the prostate, indicating bilateral involvement. Nodal staging was pN0, as no lymph nodes were involved. The overall assessment did not show any treatment effect, and all other sampled areas were unremarkable."} +{"pid": "TCGA-85-A4QQ", "report": "The lung specimen measured 15x13x14 cm. A grey-whitish, dense mass was identified near the bronchus, with a maximum dimension of approximately 4 cm. Histologically, the lesion showed well-differentiated features with keratinization. Lymph node evaluation included two subcarinal nodes, which exhibited anthracosis but no evidence of metastatic involvement. No venous invasion was identified. Surgical margins were uninvolved. The tumor appeared localized without additional nodules identified. No treatment effect was noted."} +{"pid": "TCGA-EL-A3GR", "report": "The specimen from a total thyroidectomy included a right lobe measuring 5.0 x 2.5 x 2.0 cm, an isthmus of 2.0 x 2.0 x 0.5 cm, and a left lobe of 3.0 x 2.0 x 1.0 cm. A well-defined lesion measuring 3.0 x 2.0 x 2.0 cm was identified in the right lobe and located in the middle and lower third of the lobe. The cut surfaces of the isthmus and left lobe appeared unremarkable. Margins of resection were free of abnormal tissue. Vascular invasion was observed. Lymph node dissection on the right paratracheal side yielded twelve lymph nodes, with nine showing evidence of involvement. Extracapsular extension was not present in these nodes. Six of seven perithyroidal lymph nodes showed similar findings. A benign lymph node without any abnormality was found in the right buccal region. A small fragment of soft tissue measuring 0.3 x 0.3 x 0.2 cm was also examined and identified as parathyroid tissue."} +{"pid": "TCGA-B0-4691", "report": "The left kidney specimen demonstrates a neoplasm with a mixture of cellular features. The predominant morphology consists of cells with clear cytoplasm, while focal areas display sarcomatoid differentiation and features resembling another distinct tumor type. The nuclear grade is classified as 3 out of 4. The largest dimension of the lesion measures 10.0 centimeters. Adipose tissue surrounding the kidney and renal pelvis does not show involvement. Vascular and lymphatic invasion is present. All surgical margins are free of tumor involvement. The non-neoplastic renal tissue exhibits chronic interstitial inflammation and glomerulosclerosis.\n\nA brain lesion resected from the right parietal region shows hemorrhage and a tumor with identical morphologic characteristics to the kidney lesion. Additional specimens from lung biopsies demonstrate malignant cells with abundant clear cytoplasm. Immunohistochemical staining reveals positivity for vimentin, focally for pan cytokeratin and RCC, and for CD68. Stains for TTF-1, Melan A, S100, CD34, and desmin are negative. These findings support a non-pulmonary origin for the lung lesions, consistent with metastatic disease from the primary kidney lesion. Lymph node biopsy also reveals involvement by poorly differentiated malignant cells.\n\nBenign findings include colonic polyps at multiple locations, diagnosed as tubular adenomas and a hyperplastic polyp. Urinary cytology does not reveal malignant cells."} +{"pid": "TCGA-A6-2682", "report": "A right colon specimen with attached distal ileum was examined. The proximal and distal margins measured 3.8 cm and 6.2 cm in circumference, respectively. A circumferential mass measuring 9 x 5.5 cm was identified in the cecal pouch, adhering to the ileum. The tumor had a maximal thickness of 3.5 cm and extended through the muscularis into the submucosa of the ileum, approaching within 0.2 cm of the radial serosal surface. The mucosa of the remaining ileum and colon appeared normal. Multiple lymph nodes were recovered from the mesentery and mesocolon, with some showing metastatic involvement. Histologically, the lesion showed moderate differentiation with prominent lymphatic and venous invasion. Two of thirteen lymph nodes contained metastatic cells. Non-lymph node pericolonic tumor deposits were also identified in the mesenteric fat between the ileum and colon. All resection margins were free of tumor. The apical lymph node specimen consisted primarily of adipose tissue without identifiable lymphoid structures."} +{"pid": "TCGA-A8-A08H", "report": "The specimen includes tumor-free lymph nodes with structural integrity. A nodular formation was identified macroscopically, and histological examination of this area revealed a cellular proliferation characterized by infiltrative growth. The lesion measured 2.5 cm in maximum diameter and exhibited features consistent with an intermediate grade of cellular atypia. In the surrounding tissue, there was evidence of a high-grade intraductal component occupying a small proportion of the lesion (less than 10%), which included areas of coarse calcification. The remainder of the glandular tissue showed signs of involution, with abundant fatty tissue and no atypical changes. The overlying skin showed no significant histological abnormalities. The surgical margins were free of neoplastic cells, with a minimum distance of 1 cm at the dorsocranial aspect. Vascular and lymphatic invasion were not identified. Staging assessment showed no regional lymph node involvement based on sentinel node evaluation and no distant metastasis."} +{"pid": "TCGA-IB-7890", "report": "The specimen includes a distal pancreatic resection measuring 5.0 x 4.5 x 2.2 cm, spleen measuring 9.9 x 8.8 x 5.5 cm, and attached fatty tissue measuring 19.5 x 10.5 x 3.8 cm. A white, firm fibrotic lesion measuring 2.8 x 2.5 x 1.5 cm is identified within the pancreas and located 1.3 cm from the surgical margin. The tumor is within close proximity to the splenic vein but does not involve the splenic hilum or extend into surrounding soft tissues. Margins are negative for malignancy. Sections show evidence of lymphovascular invasion and perineural involvement. Eleven lymph nodes were examined and all were negative for malignancy.\n\nSections of the spleen show no abnormalities. Within the attached omental fat, a 0.6 cm accessory splenule is identified. Other fatty tissue appears unremarkable.\n\nThe gallbladder specimen measures 9.1 cm in length and up to 4.5 cm in diameter. The lumen contains multiple yellow cholesterol stones with hemorrhagic centers ranging from 1.0 cm to slightly smaller. The gallbladder wall is thin, measuring up to 0.1 cm in thickness. Histologic evaluation reveals intestinal metaplasia without dysplasia and no malignant changes.\n\nMicroscopic examination of pancreatic tissue demonstrates intraductal neoplasia with low-grade dysplastic features extending to the resection margin."} +{"pid": "TCGA-68-A59J", "report": "The specimen consists of a superior segment with a wedge of the lateral basilar segment from the right lung, along with lymph nodes from stations R12, R9, and R4. The primary lesion is located in the lower lobe and measures 4.9 x 4.8 x 3.5 cm. It is unifocal and extends to the pleural surface. The closest distances to margins are 2.7 cm from the bronchial margin and 0.9 cm from the parenchymal margin. The mass is tan, firm, lobulated, and contains areas of necrosis. Focal anthracotic pigment is present. The remaining lung tissue appears unremarkable.\n\nHistologically, the tumor shows poor differentiation. All evaluated margins\u2014bronchial, vascular, and parenchymal\u2014are free of tumor involvement. There is no evidence of lymph-vascular invasion or tumor-associated atelectasis. Visceral pleural invasion status is pending special stains and will be reported in an addendum. No tumor extension beyond the main lesion is identified.\n\nLymph node evaluation across R12, R9, and R4 reveals no evidence of neoplastic involvement. A total of twelve nodules from R12, ranging from 0.4 to 2.5 cm, were submitted for analysis. The R9 specimen is a small piece of black-tan soft tissue measuring 0.5 x 0.2 x 0.2 cm, and R4 includes four yellow-tan to red soft tissue segments between 0.5 and 1.5 cm.\n\nThe resected tissue from the superior segment and lateral basilar wedge measures 12.7 x 7.5 x 3.4 cm and weighs 197 grams. The resection margin is marked with blue ink. Representative sections were taken from the bronchial margin, vascular margin, non-tumoral lung tissue, and various aspects of the mass including its relationship to the pleural surface and resection line.\n\nThe clinical staging is pIB (T2a NO MX). Intraoperative assessment showed no residual tumor at the bronchial or staple line margins."} +{"pid": "TCGA-BK-A0C9", "report": "The specimen includes the uterus with bilateral fallopian tubes and ovaries, cervix, right and left pelvic lymph nodes, and right and left periaortic lymph nodes. The uterus weighed 119 grams and measured 5.5 x 4.5 x 4.5 cm, with a 2.8 cm cervix. The uterine cavity contained a soft, pale tan mass measuring up to 3.7 cm in diameter. On sectioning, the lesion had a maximal thickness of 2.5 cm and extended into the anterior uterine wall, involving approximately 40% of the myometrial thickness, which measured up to 2.9 cm. Adjacent endometrium was minimal, measuring an average of 0.2 cm in thickness. Several small, well-circumscribed intramural leiomyomata were identified, with the largest measuring 1.3 cm. Both ovaries were unremarkable, measuring on average 2.3 x 1.4 x 0.9 cm, with identifiable corpora albicantia. The fallopian tubes averaged 6.3 cm in length and 0.5 cm in diameter.\n\nLymph node specimens were received from right and left pelvic and periaortic regions. Right pelvic lymph nodes consisted of several tissues measuring up to 1.6 cm; all were negative for metastatic disease. Right periaortic lymph nodes measured up to 0.6 cm and were also negative. Left pelvic lymph nodes included several tissues up to 2.9 cm; none contained metastatic involvement. Left periaortic lymph nodes measured up to 0.6 cm and showed no evidence of carcinoma.\n\nHistologically, the lesion demonstrated well-differentiated architecture with squamous differentiation. Depth of myometrial invasion measured 1 cm within a total myometrial thickness of 2.5 cm. No tumor involvement was identified at the cervical, fallopian tube, or ovarian margins. There was no vascular invasion identified. All resected lymph nodes were negative for metastatic involvement. Additional findings included multiple leiomyomata."} +{"pid": "TCGA-60-2725", "report": "The specimen included multiple lymph nodes from various anatomical regions including right and left paratracheal, level 7, level 2, level 1, level 5 and 6, 10L, additional 6, additional 5, and 11L. All lymph nodes were described as anthracotic and showed no evidence of metastatic involvement. A posterior pleural biopsy revealed fibrosis without any identifiable tumor.\n\nA lobectomy specimen from the left upper lobe measured 19 x 13.5 x 4.0 cm and contained a large central tumor mass measuring 5.0 cm in greatest dimension. The tumor was tan-gray with a necrotic center and a whitish periphery. It extended to the visceral pleura and approached within 1 cm of the bronchial surgical margin but did not involve it. There was no angiolymphatic invasion identified.\n\nHistologic evaluation showed moderately to poorly differentiated malignant cells consistent with squamous morphology. Eleven lymph nodes recovered from the hilar region were negative for metastasis. Additional findings included mild emphysema.\n\nStaging was determined based on pathological findings as pT2 N0 Mx."} +{"pid": "TCGA-AP-A1DV", "report": "The submitted specimens included biopsies and excisions from multiple anatomical sites, including soft tissue adhered to the sigmoid colon, bilateral adnexal structures, left parametrium, and various lymph node regions from both sides. A radical hysterectomy specimen included the uterus, cervix, and bilateral parametria.\n\nMicroscopic examination of the soft tissue biopsy revealed benign fibroadipose tissue. Both adnexal specimens showed findings consistent with chronic salpingitis and benign ovarian tissue with adhesions. The left parametrial excision contained two benign lymph nodes and benign fibroadipose tissue.\n\nIn the hysterectomy specimen, architectural features showed a growth pattern involving more than 50% of the myometrium, with a maximum depth of 17mm in the area of greatest invasion. The endocervix showed stromal invasion measuring 12mm in depth, within a cervical wall thickness of 13mm at the site of maximal involvement. No tumor involvement was identified in the bilateral parametria or in four lymph nodes examined from this region. Lymphovascular space invasion was present.\n\nImmunohistochemical analysis demonstrated focal weak positivity for progesterone receptor (PR), while estrogen receptor (ER) and vimentin were negative. Prior staining showed absence of p16 expression and limited CEA immunoreactivity.\n\nAll lymph nodes examined across multiple regional groups\u2014including external iliac, obturator, hypogastric, common iliac, and para-aortic regions\u2014were free of metastatic disease. The total number of lymph nodes evaluated from all sites was 21, with none showing evidence of malignancy."} +{"pid": "TCGA-AP-A05P", "report": "The submitted specimens include the uterus, cervix, bilateral fallopian tubes and ovaries, removed via total hysterectomy and bilateral salpingo-oophorectomy. Additional specimens include a sentinel lymph node from the right external iliac region and lymph nodes from the left obturator, left external iliac, and left common iliac regions.\n\nExamination of the uterine tissue revealed no identifiable myometrial invasion, endocervical invasion, or lymphovascular invasion. The endometrium shows complex hyperplasia with atypia. The myometrium and adnexa are unremarkable. A benign endocervical polyp is noted.\n\nLymph node evaluation showed one benign lymph node in the right external iliac sentinel specimen, one benign lymph node in the left obturator region, only fibroadipose tissue in the left external iliac sample, and two benign lymph nodes in the left common iliac region. All lymph node specimens were negative for involvement.\n\nNo tumor was identified in the examined tissues. Multiple levels and cytokeratin immunostained slides were examined for the sentinel lymph node specimen. The report reflects findings based on personal examination of the slides and review of all relevant material."} +{"pid": "TCGA-95-7567", "report": "The surgical pathology report includes findings from multiple specimens obtained during a right upper lobectomy procedure. Lymph nodes evaluated included station #7 (three fragments), 4R (two lymph nodes), 11R (one lymph node), posterior 11R (two lymph nodes), and 12R (one lymph node). All lymph nodes were negative for metastatic carcinoma.\n\nA skin specimen from the right posterior chest showed benign seborrheic keratosis. The lesion measured 1.4 x 0.9 cm and was located close to the resection margins.\n\nThe lung specimen consisted of a right upper lobe measuring 18.0 x 9.0 x 7.5 cm and weighing 325 grams. A tumor measuring 6.3 x 6.3 x 5.0 cm was identified in the hilar region with irregular borders and areas of necrosis. Histologic evaluation revealed a poorly differentiated mixed subtype composed of solid and micropapillary patterns. Invasion of the visceral pleura was confirmed by elastic stain, and perineural invasion was also identified. Resection margins were free of tumor involvement. One out of seven peribronchial lymph nodes showed involvement.\n\nAdditional findings included emphysematous changes in the lung parenchyma. The tumor was located 0.5 cm from both bronchial and vascular margins. No vascular or lymphovascular invasion was observed. The parietal pleura was focally adhered to the posterior lung and inked blue for identification; this area was 3.5 cm from the tumor. A small nodule measuring 0.6 x 0.4 x 0.3 cm was noted on the visceral pleura adjacent to the parietal pleura.\n\nSpecimens were processed for intraoperative consultation and permanent sections. Frozen section analysis of the bronchial margin was negative for carcinoma. Touch preparations and representative sections of the tumor confirmed the histologic findings.\n\nAll other tissue margins, including parenchymal, parietal pleural, chest wall, and other attached tissues, were uninvolved by invasive carcinoma. No treatment effect was identified."} +{"pid": "TCGA-D1-A16B", "report": "The surgical specimen includes the uterus, bilateral ovaries, and fallopian tubes, along with multiple lymph node groups and gonadal vessels. The endometrial cavity contains a mass measuring 3.2 x 2.7 x 1.9 cm. This lesion extends into the myometrium with a maximum invasion depth of 1.3 cm; the total myometrial thickness is 2.3 cm. There is no evidence of lymphatic or vascular invasion. The cervix shows changes consistent with acute and chronic cervicitis with erosion. The ovaries and fallopian tubes do not show any diagnostic abnormalities.\n\nEvaluation of lymph nodes includes multiple right pelvic nodes (2 internal iliac, 2 common iliac, 1 external iliac, and 2 obturator), all without pathological findings. On the left, 5 common iliac, 4 external iliac, and 2 obturator pelvic lymph nodes were similarly unremarkable. One left internal iliac lymph node submission did not contain nodal tissue. Para-aortic lymph nodes were also assessed: 3 on the left above the inferior mesenteric artery (IMA), 4 below the IMA; 2 on the right above the IMA, and 3 below the IMA\u2014all were negative for abnormal cellular infiltration. Gonadal vessels from both sides showed no pathological changes."} +{"pid": "TCGA-D1-A101", "report": "The specimen includes a uterus with attached bilateral fallopian tubes and ovaries. A polypoid mass measuring 4.0 x 3.0 x 1.0 cm is present in the fundus of the endometrial cavity. Microscopic evaluation shows that the lesion extends 0.2 cm into the myometrium, where the total wall thickness is 1.5 cm. There is no involvement of the endocervix, and lymphovascular space invasion is not identified. Surgical margins are free of abnormal tissue.\n\nIn addition to the primary lesion, a benign endometrial polyp measuring 2.5 x 1.7 x 0.6 cm is present. Three intramural leiomyomata are also identified, ranging in size from 0.2 cm to 1.5 cm. Both ovaries and fallopian tubes appear unremarkable upon histologic examination.\n\nThe staging classification assigned is pT1b, with no regional lymph node assessment performed (NX) and no distant metastasis evaluated (Mx). This report is based on initial gross and frozen section evaluation, with permanent H&E sections reviewed for confirmation. Any significant changes upon further review will be addressed in a revised report.\n\nGross examination reveals a uterus weighing 110 grams with a smooth serosal surface. The cervix appears unremarkable. The fundal mass described above is confirmed macroscopically, along with the presence of the endometrial polyp and leiomyomata. The right ovary measures 3.0 x 1.2 x 0.7 cm with a ragged outer surface and solid cut surface; the right fallopian tube measures 7.7 x 0.5 cm. The left ovary measures 2.5 x 1.5 x 0.7 cm with similar surface characteristics and a solid cut surface, with the left fallopian tube measuring 7.2 x 0.3 cm. Representative sections have been submitted for analysis."} +{"pid": "TCGA-L5-A4OX", "report": "A 1.8 cm long segment of cervical esophagus with intact adventitial lining and wrinkled grey mucosa was received, including a stapled and open margin, with the open end sampled. A lymph node measuring 1.2 cm was also received, showing anthracotic pigmentation, and was bisected for analysis.\n\nThe primary specimen consisted of an esophagogastrectomy specimen measuring 8.5 cm in length and 5 cm in circumference, including the distal esophagus and a portion of the proximal stomach with attached perigastric adipose tissue up to 5 cm in extent. The outer surface appeared unremarkable with no perforations noted. The esophageal mucosa showed wrinkled grey appearance in the proximal 3 cm, transitioning into salmon-colored Barrett\u2019s mucosa extending to the gastroesophageal junction. At this location, there was a 3.3 x 2.5 cm ulcerated area with heaped borders that extended through the mucosal layer to a depth of approximately 1.0 cm, approaching but not penetrating the muscularis propria. The gastric mucosa was wrinkled and tan with normal-appearing folds, without ulcers or masses. Multiple lymph nodes were identified within the perigastric adipose tissue.\n\nHistological examination revealed an invasive lesion arising in Barrett\u2019s mucosa at the gastroesophageal junction, extending focally into the superficial muscularis propria. Resection margins were free of involvement. Angiolymphatic invasion was present. Three out of fifteen lymph nodes were involved by metastatic disease. Additionally, an incidental leiomyoma of the esophagus was identified.\n\nDepth of invasion reached the muscularis propria. The pattern of growth was expansile. No extranodal extension was identified. Both proximal and distal margins, including the gastroesophageal junction, were negative for neoplastic involvement. Lymph nodes were sampled from multiple locations, including one lymph node inked blue and several others processed in entirety. One grossly positive lymph node was sectioned and found to contain metastatic tumor cells.\n\nTNM staging was determined as T2 N1 Mx."} +{"pid": "TCGA-CX-7086", "report": "The specimen designated \"right submandibular gland\" consists of a single pink/tan, lobulated and smooth fragment of soft tissue measuring 5.2 x 3.5 x 2.0 cm. The cut surface is pink/tan with a lobulated appearance. No distinct lesions or masses are identified. Representative sections are submitted.\n\nThe specimen labeled \"right level 4\" measures 7.7 x 2.5 x 1.7 cm and consists of pink/tan soft tissue. Seven suspected lymph nodes are submitted wholly, along with additional representative sections.\n\nSpecimen \"right level 3\" consists of multiple pink/tan fragments measuring 4.7 x 4.5 x 2.0 cm in aggregate. Multiple lymph nodes are palpated and submitted along with the remainder of the specimen.\n\nSpecimen \"right level 2\" is a pink/tan fragment measuring 4.3 x 2.7 x 1.3 cm. Multiple lymph nodes are identified and submitted, including some bisected for examination.\n\nSpecimen \"left level 2\" measures 5.3 x 2.6 x 1.3 cm. One suspected lymph node is bisected and submitted along with representative sections.\n\nSpecimen \"left level 3\" is a fragment measuring 4.8 x 2.8 x 1.7 cm. Multiple lymph nodes are palpated and submitted, with one lymph node bisected and others included in remaining sections.\n\nSpecimen \"left level 4\" measures 4.5 x 3.5 x 1.5 cm. Multiple lymph nodes are identified and submitted for evaluation.\n\nAll intraoperative frozen section analyses of surrounding tissue margins are negative for malignant involvement.\n\nThe composite resection specimen from the floor of the mouth includes a mandibulectomy specimen measuring 11.5 x 10.0 x 6.0 cm. A light tan exophytic mass measuring 5.0 x 3.3 x 1.0 cm is identified at the floor of the mouth, extending from the ventral aspect of the tongue to the anterior surface of the gums. The mass approaches within 0.2 cm of the closest posterior mucosal resection margins. Gross photographs are taken for documentation.\n\nMultiple lymph nodes are identified throughout the specimen. Of 64 lymph nodes examined across all specimens, one lymph node contains metastatic involvement.\n\nHistologic evaluation reveals moderately differentiated keratinizing cellular features. The tumor thickness measures 17 mm. Margins are uninvolved by invasive disease, with the closest distance measuring 2 to 3 mm. Lymphovascular invasion is present. Perineural invasion is not identified.\n\nPathologic staging indicates a primary tumor larger than 4 cm in greatest dimension with metastasis in a single ipsilateral lymph node no greater than 3 cm. Distant metastasis is not identified.\n\nAdditional tissue samples from regional nerves, muscle margins, gingival areas, and tongue sections are submitted for frozen section analysis. All are negative for evidence of malignancy."} +{"pid": "TCGA-DQ-7594", "report": "Right base of tongue biopsy shows invasive, predominantly nonkeratinizing, poorly differentiated epithelial malignancy with cellular atypia and infiltrative growth pattern. The lesion extends to a depth of 0.5 cm. Immunohistochemical staining demonstrates positivity for p16. A separate specimen from the right neck, level II, consists of skeletal muscle with fibrosis, acute and chronic inflammatory infiltrates, and foreign body giant cells. No malignant cells are identified in this tissue based on histologic evaluation and cytokeratin immunostaining. All margins are negative. The tumor is confined without evidence of lymph node involvement. Tissue specimens were adequately sampled and processed for microscopic analysis."} +{"pid": "TCGA-ZF-AA53", "report": "The specimen consists of a bladder and prostate measuring 160 mm superoinferiorly, 95 mm transversely, and 60 mm anterior-posteriorly, with a total weight of 460g. Within the bladder, there is an extensively necrotic polypoid lesion located on the posterior wall, measuring at least 40 x 70 x 30 mm. This lesion is in proximity to the detrusor muscle and is approximately 8 mm from the posterior serosal margin. Bilateral ureteric stumps are present, each measuring 5 x 4 mm.\n\nMicroscopically, there is a high-grade epithelial lesion involving the lateral and posterior walls, surrounding the right ureter. It infiltrates the muscularis propria and approaches within 9 mm of the prostate; however, there is no clear evidence of extension into perivesical fat. Areas of squamous differentiation are observed, along with regions showing spindle cell or sarcomatoid morphology. Vascular invasion is not identified. The circumferential margin is free of involvement, as are both ureteric resection margins. The bladder wall away from the lesion shows severe inflammation and focal denudation of urothelium, with some cellular atypia but no indication of high-grade intraepithelial neoplasia.\n\nAt the urethral resection margin, while the primary lesion is not present, there is a distinct focus of acinar proliferation consistent with prostatic adenocarcinoma. Additional multiple foci of similar morphology are identified bilaterally in the prostate, with the largest focus measuring at least 14 mm. These lesions correspond to Gleason score 3 + 3 = 6. High-grade intraepithelial neoplasia is also present, but there is no evidence of capsular breach."} +{"pid": "TCGA-DK-A3WW", "report": "The clinical history included prior malignancy involving the urinary bladder. Submitted specimens included lymph nodes from multiple anatomical regions including right and left common iliac, right and left distal pelvic, presacral areas, as well as tissues from the bladder, prostate, seminal vesicles, perivesical lymph nodes, urachus, and distal ureters.\n\nExamination of lymph nodes from all submitted sites revealed benign lymphoid tissue without evidence of metastatic involvement. The number of lymph nodes assessed per site ranged from 2 to 16, with no malignant cells identified in any of the sections reviewed.\n\nMacroscopic evaluation of the bladder specimen revealed a large necrotic mass located within a diverticulum. The lesion measured approximately 8.5 x 6.5 x 5 cm and extended into surrounding adipose tissue. No involvement was observed in the ureters or urethra. Histologic assessment demonstrated high-grade cellular features with diffuse invasive growth patterns. Multifocal tumor presence was noted, though no vascular or perineural invasion was identified. Surgical margins were free of tumor. Adjacent mucosa showed chronic inflammatory changes and signs consistent with prior intervention. Prostate examination revealed benign nodular hyperplasia; seminal vesicles were unremarkable.\n\nPathologic staging indicated invasion into perivesical soft tissues without prostate involvement. No discrete perivesical lymph nodes were recovered. Ureteral specimens displayed patent lumens with normal mucosal appearance and negative margins. All adipose and soft tissue margins were devoid of tumor."} +{"pid": "TCGA-C5-A7UI", "report": "Consult Report. MRN: (Age: Accessioned; ). M.D. The specimen consists of a cervical biopsy demonstrating abnormal cellular proliferation. Microscopic evaluation reveals invasive cellular changes characterized by non-keratinizing morphology. A separate sample from the endocervix, obtained via curettage, shows no evidence of malignant cells. The patient is a woman who presented with an abnormal Pap smear and underwent cervical biopsy and endocervical curettage. The materials received include two labeled slides (A recut, B), along with a corresponding pathology report. All findings are based on personal examination of the slides by the undersigned physician."} +{"pid": "TCGA-A6-5667", "report": "The specimen includes apical lymph nodes, a segment of sigmoid and upper rectum, and an appendix. The apical lymph node was a small tissue fragment and showed no evidence of metastatic disease.\n\nThe resected colon segment measured 20 cm in length. The serosal surface was smooth and partially covered with yellow fat. The mucosa was pink-tan and glistening, with normal to slightly dilated folds. A large exophytic lesion measuring 5.3 x 6.0 x 1.0 cm was identified near the distal end, located 3.5 cm from the distal margin. The lesion came within 0.6 cm of being circumferential and showed invasion into the muscularis propria but did not extend grossly into surrounding fat. The radial margin was within 2.5 cm of the lesion. All luminal margins were free of involvement. Multiple firm, somewhat enlarged lymph nodes were found in the pericolonic fat, up to 1.7 cm in size. Histologic evaluation of the resection showed a moderately differentiated invasive lesion extending into pericolonic fat. No vascular invasion was identified. Of the 48 lymph nodes evaluated, one contained metastatic involvement. All surgical margins were negative for tumor.\n\nThe appendix measured 5.5 cm in length and had a wall thickness of approximately 0.3 cm. The lumen ranged from pinpoint to 0.3 cm and contained green fecal material. Microscopic examination showed no significant abnormalities."} +{"pid": "TCGA-EJ-5524", "report": "The patient is a male with a history of prior Gleason Score 4 + 4 = 8 involvement on the left side of the prostate. Preoperative PSA was 3.76 ng/ml, and the clinical TNM stage was cT2b. A radical retropubic prostatectomy was performed. Lymph node evaluation included 17 nodes (eight on the right and nine on the left), none of which showed evidence of neoplasia.\n\nExamination of the prostate and bilateral seminal vesicles revealed an invasive acinar-type lesion with a Gleason score of 4+5=9, including a tertiary pattern of 3. The lesion involved both the right and left lobes, with a maximum nodule size of 2 cm, and accounted for approximately 15% of the examined prostate volume. There was established extracapsular extension identified in the right posterior base. No involvement was found in the bilateral seminal vesicles or vasa deferentia, and all surgical margins were free of disease.\n\nMicroscopic analysis also showed multifocal perineural invasion, but no angiolymphatic invasion. High-grade intraepithelial changes and intraductal extension were present. The non-neoplastic prostate showed focal nodular hyperplasia, glandular atrophy, and chronic inflammation. Pathologic staging was determined as pT3a with no regional lymph node involvement (pN0) and no evidence of distant metastasis (pMX). The histologic grade was classified as G3-4, consistent with poorly differentiated to undifferentiated morphology."} +{"pid": "TCGA-BR-7723", "report": "Asterand Case ID. Open Clinica. Gross Description. Subject ID. BR-7723. A plate-like lesion involving the stomach measuring 12.5 cm in greatest dimension; the entire wall is involved. Lymph nodes at the greater and lesser curvature appear dense and hyperemic; the omentum shows signs of hyperemia. Microscopic examination reveals a solid structured lesion with ulceration extending to the subserosa. Fifteen lymph nodes were examined, eight of which show metastatic involvement. The omentum demonstrates normal structure. Histologic evaluation indicates poorly differentiated cells with neuroendocrine features noted. Venous invasion is absent. Margins are uninvolved. No evidence of treatment effect is identified. Specimen type is consistent with total gastrectomy with perigastric fat present. Tumor size measures 12.5 x 0 x 0 cm. No additional pathologic findings are reported."} +{"pid": "TCGA-AA-A01X", "report": "The specimen demonstrates an invasive, moderately differentiated neoplasm with involvement of all layers of the wall (pT3). There is evidence of lymphatic vessel invasion (L1). Resection margins are free in the mucosal region. The central ligature area shows normal adipose connective tissue and unremarkable vessel portions. Two metastatic deposits are identified in the lymph nodes (2/14). In addition, multiple polyps are present, characterized as tubulovillous adenomas, with one lesion showing a transition into a moderately differentiated invasive neoplasm involving the muscularis propria (pT2). Staging classification includes pN1 and uncertain distant metastasis status (Mx)."} +{"pid": "TCGA-55-8092", "report": "The specimen consists of a right upper lobe lobectomy specimen weighing 270 grams and measuring 18 x 8 x 5 cm. A tumor measuring 7.7 cm in greatest dimension is located beneath a puckered but apparently intact pleural surface, on the side opposite the bronchial resection margin. The distance from the bronchial resection margin to the nearest portion of the tumor is approximately 1 cm. On cut surface, the tumor appears mostly pale white with flecks of gray and black, areas of mucoid material, and foci of necrosis. Multiple staple lines are present near the hilar region, pulling together portions of the pleura. Some areas of the tumor appear in close proximity to these stapled margins, though no direct involvement of the margin is observed. Sections sampled include those closest to the bronchial resection margin, possible peribronchial lymph nodes, adjacent major bronchi and blood vessels, and multiple regions of the tumor including areas beneath the pleura. Uninvolved lung tissue shows emphysematous changes.\n\nThe tumor occupies a large portion of the resected tissue, growing just beneath or possibly into the visceral pleura, but not clearly penetrating it. In the hilar region, the tumor approaches some soft tissue margins closely, though the bronchial resection margin is confirmed negative. Lymph nodes sampled include peribronchial lymph nodes (dark and small, not grossly involved), lymph node #10 (multiple pale tan to off-white fragments ranging from 4\u201310 mm), and lymph node #7 (brown-black fragments ranging from 6\u201312 mm, some bisected or trisected). All lymph nodes examined microscopically are negative for tumor involvement.\n\nMicroscopic evaluation confirms invasion of the visceral pleura and identifies lymphovascular invasion. Cellular differentiation is moderate. Based on AJCC Seventh Edition TNM staging, the findings correspond to T3 N0 MX."} +{"pid": "TCGA-08-0348", "report": "The biopsy specimen from the right occiput is highly cellular, showing marked nuclear pleomorphism, endothelial proliferation, foci of necrosis, and scattered mitotic figures. The infiltrative edge of the lesion is clearly demonstrated. The tissue submitted for analysis includes two fragments measuring up to 1.0 cm in aggregate. A representative section was used for frozen section analysis and placed in cassette A1, with the remaining unfrozen tissue submitted in cassette A2. A separate specimen from the same anatomical site, received in formalin, consists of a fragmented piece measuring 1.0 cm in greatest dimension. This specimen was entirely submitted in cassette B1. Microscopic evaluation of this fragment shows necrotic tissue, including necrotic blood vessels, with no viable neoplastic cells identified. Immunostaining with Mib-1 is in progress on section A2 and results will be reported by addendum. The final diagnosis was determined following comprehensive review of all pathology slides by the attending pathologist."} +{"pid": "TCGA-QK-A652", "report": "A specimen from the left lateral tongue measuring 4.2 x 2.7 x 2.7 cm was examined. A white firm mass measuring 1.5 x 1.4 cm with a depth of 0.9 cm was identified beneath an ulcerated mucosal surface. The mass was located 1.1 cm from the deep margin, 0.5 cm from the anterior margin, and 1.5 cm from the posterior margin. Histologic evaluation showed infiltrative and discontiguous growth involving skeletal muscle bundles. Margins were uninvolved by invasive disease or dysplasia. Perineural and lymphovascular invasion were present.\n\nThe tumor exhibited moderately differentiated features with a thickness of 9 mm measured from intact surface mucosa. Additional specimens from medial, lateral, posterior, and anterior margins were negative for invasive disease or high-grade dysplasia.\n\nNeck dissection included levels I through IV. In level III, one of seven lymph nodes contained metastatic involvement with the largest focus measuring 1.5 mm within a 9 mm lymph node; no extracapsular extension was identified. All other lymph nodes from levels I, II, and IV were negative for involvement. A total of 39 lymph nodes were evaluated, with one positive node identified.\n\nHistologic type was consistent with conventional features, and no treatment effect was observed. Distant metastasis could not be assessed. Additional findings included discontiguous tumor spread."} +{"pid": "TCGA-39-5036", "report": "The clinical history notes an increase in size of a left upper lobe nodule previously biopsied as benign, with a PET scan showing moderate uptake. Specimens submitted include a biopsy of the left upper lobe nodule, excision of level five lymph nodes, a wedge resection of the left upper lobe, and excision of left level ten and level eleven interlobar lymph nodes, along with a left upper lung lobe specimen.\n\nIn the wedge resection specimen, a 3.0 x 2.0 x 1.5 cm lesion is identified, located near the pleural surface. No vascular or perineural invasion is observed. The tumor is found to involve the visceral pleura. The surrounding lung tissue shows granulomas, scarring, and chronic bronchitis. All bronchial, vascular, and staple margins are uninvolved. A total of eight lymph nodes from the lobectomy specimen are negative for tumor involvement. Six anthracotic lymph nodes from level ten and three from level eleven interlobar are also free of tumor. Two lymph nodes from level five are benign.\n\nFrozen section analysis of the nodule initially showed non-small cell carcinoma, which was confirmed on permanent sections. The level five lymph nodes were also negative on both frozen and permanent sections.\n\nAll other tissue samples were fully evaluated, and no residual carcinoma was identified in the lobectomy specimen. Special stains for acid-fast bacilli and fungi in areas of parenchymal granuloma were negative."} +{"pid": "TCGA-DX-A48K", "report": "The patient underwent radical resection of a right calf mass. The specimen consisted of muscular tissue measuring 7.3 x 4.3 x 3.5 cm with an attached ellipse of skin measuring 4.1 x 1.2 x 0.3 cm. Upon sectioning, an ovoid, firm tan-white mass measuring 4.1 x 3.1 x 2.0 cm was identified. The tumor exhibited a whorling cut surface and was located within 0.1 cm of the inferior, medial, and posterior margins. No hemorrhage or necrosis was observed grossly.\n\nHistologically, the lesion demonstrated high-grade spindle cell morphology with nuclear pleomorphism and a mitotic rate of 20 per 10 high-power fields. There was no necrosis identified. The tumor showed focal osseous metaplasia and infiltrated skeletal muscle and deep subcutaneous tissue. Surgical margins were assessed microscopically; all margins were negative for tumor involvement except for the posterior margin, where the tumor approached within 1 mm of the margin limited by fibrous and adipose tissue. The anterior margin specimen consisted of benign skeletal muscle and fibroconnective tissue without evidence of malignancy.\n\nImmunohistochemical staining revealed positivity for h-Caldesmon and focal positivity for HHF35, while stains for SMA, desmin, S-100, HMB-45, and cytokeratin AE1/AE3 were negative. These findings were interpreted in context with morphologic features to support the histopathologic assessment. All tests were performed under validated protocols within a CLIA-certified laboratory and used for clinical diagnostic purposes."} +{"pid": "TCGA-CS-6186", "report": "The specimen from the right post-central region was received as a 1 x 0.8 x 0.3 cm aggregate of tan-pink soft tissue, with approximately 80% used for frozen section and the remainder submitted for permanent sections. A second specimen was not received. A third specimen consisted of three fragments measuring 1.5 x 0.8 x 0.5 cm in total. \n\nMicroscopic evaluation of the first specimen revealed a neoplasm composed primarily of neoplastic fibrillary astrocytes. The majority of the tissue showed low Ki67 proliferation index and low mitotic rate. However, a very small focus of increased cellularity was identified on permanent sections, where the Ki67 proliferation index approached 15%. A small focus of endothelial proliferation was noted on frozen section slides but was not present in permanent sections.\n\nThe third specimen demonstrated areas of oligodendroglial differentiation with microcalcifications. Small foci of increased cellularity, pleomorphism, and elevated mitotic activity were observed. In these areas, the Ki67 proliferation index also approached 15%.\n\nImmunohistochemistry and other technical notes were provided, including details on ER, PR, Hercept, and EGFR assays. Some reagents used in testing are classified as Analyte Specific Reagents (ASRs) and have not been cleared by the FDA. These tests were developed and validated by the clinical laboratory.\n\nFluorescent in-situ hybridization (FISH) analysis for deletions of 1p and 19q was performed on paraffin-embedded tumor sections. Two hundred nuclei were scored for each probe set. The 1p/1q ratio was 0.93, with 27% of cells showing deletion of 1p. The 19q/19p ratio was 0.98, with 5.5% of cells showing deletion of 19q. These results fall within the normal range and suggest no significant deletions of 1p or 19q. It is noted that low levels of malignant cells or sampling error could affect the accuracy of the test. Correlation with other clinical and laboratory findings is recommended.\n\nWhile the major portions of both specimens displayed features typically associated with lower-grade morphology, the presence of small foci with increased proliferation, pleomorphism, and mitotic activity supports a more aggressive behavior. These features were consistent across both specimens and were accompanied by a Ki67 index approaching 15% in those areas. Clinical correlation is advised."} +{"pid": "TCGA-P3-A6T6", "report": "The specimen from the right buccal margin measured 2 \u00d7 0.4 \u00d7 0.2 cm and was entirely submitted for evaluation. A separate specimen from the right maxillary region included bone and soft tissue structures, measuring 5.6 cm in greatest dimension. The mucosal surface showed a focal area of altered appearance measuring 2.1 \u00d7 2.0 cm with discoloration. Serial sectioning identified a mass measuring approximately 2.0 \u00d7 2.1 \u00d7 2.6 cm that was firm, white, and infiltrative through the maxillary bone. Margins were evaluated with ink applied to different surfaces: anterior (blue), lateral (black), posterior (orange), and medial (green). Sections from all margins and representative areas of the lesion were submitted for analysis.\n\nAdditional specimens included fragments of soft tissue and bone from various surgical margins, ranging in size from 0.5 cm to 4.5 cm. Several of these were processed intraoperatively, with representative sections submitted for further analysis. One fragment from the lingual nerve measured 0.5 cm and was also submitted in entirety. A separate formalin-fixed specimen of right maxillary mucosa included hemorrhagic, rubbery soft tissue and cartilage, measuring 2 \u00d7 2 \u00d7 0.5 cm. A premolar tooth with amalgam restoration was also received without associated soft tissue.\n\nIntraoperative evaluation of the surgical margins demonstrated involvement of several areas including the deep, posterior, lingual nerve, superior, medial, and posterior deep margins. Other margins, including lateral, anterior, deep lateral, deep medial, palate, repeat medial resection, and others, did not show evidence of involvement. Histologic analysis revealed a poorly differentiated infiltrative process with features including extensive invasion through bone, lymphovascular invasion, and focal perineural invasion. The anterior soft tissue margin was free of involvement. Bone margins showed involvement at the medial maxillary site while the anterior and other bony margins were negative. The minimum pathologic stage assessed was pT4a, pNx, pMx according to the AJCC 6th edition criteria. Multiple cassettes were used for submission of tissue blocks, with some requiring decalcification prior to processing."} +{"pid": "TCGA-EY-A2OQ", "report": "The pathology report includes multiple specimens evaluated for the presence of abnormal tissue or tumor involvement. A biopsy of the vulvar skin demonstrated hyperkeratosis, dermal sclerosis, and chronic inflammation without evidence of dysplasia, HPV-related changes, or malignancy. Several lymph node specimens were examined, including sentinel and non-sentinel nodes from periaortic and pelvic regions. All lymph nodes showed no evidence of tumor involvement upon evaluation with multiple H & E levels per block. Specifically, one lymph node was evaluated from each of the right periaortic sentinel #1, right periaortic sentinel #2, left periaortic sentinel #1, left periaortic (non-sentinel), right pelvic sentinel #1, right pelvic sentinel #2, and left pelvic sentinel sites, all showing no tumor. Additionally, 13 lymph nodes from the right pelvic region, 6 from the left pelvic region, and 2 from the right periaortic region were also free of tumor.\n\nA hysterectomy specimen with bilateral salpingo-oophorectomy was examined. The uterine specimen measured 9.4 cm in height, 7.0 cm in breadth at the fundus, and 4.4 cm in anterior-posterior width. The endometrial cavity measured 3.9 cm in length with a maximum width of 2.8 cm at the fundus. A lesion measuring 4.0 x 3.7 x 1.2 cm was identified within the endometrium, located predominantly on the posterior corpus with extension to the anterior upper corpus. Histologic evaluation revealed a high-grade architectural and nuclear pattern of differentiation. Myometrial invasion was limited to the inner half, with a depth of 0.5 cm in a wall measuring 1.7 cm thick (29% invasion). There was no involvement of the serosa, lower uterine segment, cervix, or adnexa. The vaginal margin was free of tumor. No lymphovascular space invasion was identified. A total of 37 regional lymph nodes were examined, with none showing evidence of tumor involvement. Immunohistochemical staining for estrogen and progesterone receptors was performed; results were not available at the time of reporting and were to be issued in a subsequent addendum.\n\nThe ovaries and fallopian tubes were unremarkable, with no tumor identified. The right ovary measured 3.1 x 2.1 x 1.0 cm and the left ovary measured 2.5 x 1.1 x 1.0 cm. Both fallopian tubes were patent and without abnormality. Additional soft tissue specimens from the pelvic and periaortic regions contained lymph node candidates, all of which were negative for tumor.\n\nBased on the available information, the pathologic staging was assigned as pT1a pNO pMx, corresponding to FIGO (2008 classification) Stage IA. These staging determinations were subject to revision pending further clinical and pathological review."} +{"pid": "TCGA-06-5414", "report": "The specimen consisted of biopsied tissue from the right cerebral hemisphere. The first sample measured 3 mm and was hemorrhagic, while the second measured 15 x 10 x 4 mm and was fixed in formalin. Histologic examination revealed a densely cellular glioma with moderate pleomorphism. Frequent mitotic figures were observed, along with vascular proliferation and pseudopalisading necrosis. Immunohistochemical staining demonstrated diffuse positivity for GFAP. The Ki-67 labeling index was approximately 30%. Reactive changes suggestive of prior surgical intervention were also noted.\n\nMGMT promoter methylation testing was performed using bisulfite-treated DNA extracted from paraffin-embedded tissue. Real-time PCR (MethyLight) was used to detect both methylated and unmethylated sequences. The assay had an analytic sensitivity of 1% methylated DNA in an unmethylated background. No methylated MGMT promoter sequences were detected. Factors such as the presence of more than 50% non-neoplastic cells or extensive necrosis could have affected the sensitivity of the assay. This test was developed and validated by the laboratory under CLIA regulations and has not been cleared or approved by the FDA. Results were reported for informational purposes and should be interpreted alongside established diagnostic criteria."} +{"pid": "TCGA-92-7341", "report": "A total of ten lymph nodes from multiple mediastinal levels (2R, 4R, 7, 10R, and 11) were examined; all were negative for malignancy. Among these, one lymph node from level 7 was identified, as well as one from level 4, one from level 2R, four from level 11, and one from level 10R. In some lymph node specimens, there was presence of calcification and hyalinization within caseating granulomas. Special stains including GMS and AFB were performed. The GMS stain showed numerous yeast forms consistent with *Histoplasma* species in both lung and lymph node granuloma sections, while AFB stains were negative.\n\nThe right upper lobectomy specimen contained a multinodular tan necrotic mass measuring 4.5 cm in maximum dimension, located near the pleura and extending from the main airway. This lesion was identified microscopically as a moderately differentiated keratinizing epithelial tumor with areas of necrosis. The closest margin to the tumor was 1.5 cm from the stapled margin, and all surgical margins were free of tumor involvement. Additionally, a second smaller calcified mass measuring 1.0 cm was found within the lung parenchyma, located 2.0 cm away from the larger mass. There was no evidence of lymphatic, venous, or arterial invasion, and the pleura was not involved. Non-neoplastic findings included anthracosis and granulomatous inflammation in the surrounding lung tissue.\n\nBased on histopathologic findings, the primary tumor was classified as pT2a (tumor greater than 3 cm but not more than 5 cm in greatest dimension), with no regional lymph node metastasis (pN0). Distant metastasis could not be assessed. The overall staging was provisionally determined as pT2a/N0/MX. Further clinical correlation is recommended for final staging."} +{"pid": "TCGA-78-7146", "report": "The left pneumonectomy specimen includes an upper lobe measuring 160 x 110 x 35 mm in an infused state, showing an apical scar and features of mild centriacinar emphysema. The lingular is collapsed, with mucus present in distal airways. The lower lobe measures 160 x 120 x 60 mm and contains a solid, cream-colored lesion measuring 55 x 38 x 25 mm located in the lateral basal segment. This lesion has a well-circumscribed border, central necrosis, and contacts the pleura, which appears slightly irregular. Lymph nodes at the hilum of the lower lobe are involved. No endobronchial lesion is identified, and the tumor is 45 mm from the bronchial resection margin.\n\nMicroscopic evaluation reveals sheets, strands, and glandular formations of atypical cells with focal clear cell morphology. Vascular and lymphatic invasion are present, along with pleural involvement associated with a fibrinous exudate. The bronchial margin is free of tumor but shows signs of acute bronchitis. Lymph nodes adjacent to the lower lobe bronchi and a detached nodule show similar cellular infiltrates; the latter lacks normal nodal architecture. The remainder of the lung tissue shows only mild emphysematous changes and an apical cap.\n\nA separate specimen from the inferior pulmonary ligament includes four lymph nodes, one of which contains abnormal cellular infiltration. The affected node measures up to 15 mm in diameter."} +{"pid": "TCGA-CQ-7067", "report": "The specimen consisted of multiple tissue samples from the neck and oral cavity. A skin specimen from the left neck showed scar tissue without evidence of tumor. Lymph nodes were evaluated from left neck levels I, IIA, and III, with a total of 15 lymph nodes examined and none showing involvement. The submandibular gland was unremarkable.\n\nA resected portion of the left tongue measured 1.6 x 3.5 x 4.3 cm and contained a partially ulcerated, homogeneous lesion measuring 0.6 x 2.0 x 2.0 cm. The lesion was located closest to the lateral and medial margins at 0.3 cm, with deeper margins measuring 0.5 cm from the tumor. Histologic evaluation revealed poorly differentiated cells with tumor thickness measuring 0.6 cm and no lymphovascular invasion. Focal perineural invasion was identified. Margins were uninvolved by tumor; however, both the lateral and medial margins were within 0.3 cm of the tumor. The deep margin was 0.5 cm from the tumor, while the anterior and posterior margins were farther away.\n\nAdditional surgical specimens including the deep margin, medial resection margin, and surgical waste showed no abnormal pathology. Frozen section analysis of the deep and medial margins confirmed absence of tumor.\n\nPathologic staging was based on tumor size and extent. The greatest dimension of the lesion was 2.0 cm. Based on this measurement and absence of lymph node involvement, staging criteria classified the tumor as T1 with no regional lymph node metastasis identified. Distant metastasis could not be assessed."} +{"pid": "TCGA-IB-7649", "report": "The specimen includes a gallbladder, one lymph node, a bile duct margin, and a Whipple resection containing portions of the duodenum, pancreas, and common bile duct. The gallbladder measures 10 x 3.5 x 2 cm and contains multiple dark brown stones ranging from 0.5 to 1.5 cm in size. The mucosa appears trabecular and flattened with wall thickness measuring 0.4 cm. No dysplastic or malignant changes are identified. A lymph node measuring 1.5 x 1 x 0.5 cm is submitted and shows lipid granulomas but no malignancy. The bile duct margin is negative for malignancy and demonstrates mixed acute and chronic inflammation.\n\nThe Whipple resection includes a duodenum measuring 24 cm in length and 5.7 cm in circumference. The pancreatic portion measures 2.5 cm in length with a cut surface of 6 x 4.5 cm. A mass measuring 3.0 x 4.0 x 2.5 cm is identified in the pancreatic head region. This lesion extends into the duodenal wall and common bile duct. Lymphovascular invasion is present, as is perineural invasion. The uncinate margin is positive for tumor involvement, while the duodenal, pancreatic, and common bile duct margins are free of tumor. Of the lymph nodes examined, 5 out of 13 show evidence of metastatic involvement. The surrounding adipose tissue measures 5 x 4 x 2 cm and includes multiple tan-white lymph nodes entirely submitted for evaluation. Frozen section analysis of the bile duct margin confirms absence of malignancy. The tumor demonstrates infiltration into adjacent structures including the duodenal wall and bile duct wall."} +{"pid": "TCGA-V1-A8MJ", "report": "The prostate biopsy specimens from the right anterior bladder neck, right posterior base, and right anterior apex showed no evidence of tumor, with only benign prostatic tissue identified in some areas. Lymph node dissection specimens were received from the right external iliac, right obturator, and left pelvic regions. Of the 16 lymph nodes examined in total, one lymph node from the right external iliac region contained metastatic involvement.\n\nRadical prostatectomy specimen measured approximately 4 cm from apex to base with a weight of 30.5 grams. Gross examination revealed no discrete mass or nodule; the capsule appeared intact. Histologic evaluation demonstrated cellular features including Gleason score 3+4 = 7. Tumor was identified at multiple locations within the prostate, including both apex and mid-gland regions bilaterally. Evidence of capsular invasion was noted along with involvement of the surrounding fat adjacent to the prostate at certain sections. Surgical margins were free of tumor involvement; however, benign glands were present at inked excision margins in the bilateral apex regions.\n\nSeminal vesicle examination revealed bilateral involvement by tumor cells. Extensive perineural infiltration was also observed. High-grade intraepithelial neoplasia was identified focally. The tumor volume was estimated at 9 cubic centimeters, with more than 20% of the tumor demonstrating Gleason pattern 3. One lymph node showed microscopic metastasis measuring less than 1 mm in diameter without extranodal extension."} +{"pid": "TCGA-B0-4839", "report": "The left kidney specimen shows a well-circumscribed mass measuring 4.5 cm in greatest dimension. Histologic evaluation reveals cells with clear cytoplasm and nuclear features corresponding to grade 2 of 4. The lesion is entirely contained within the renal parenchyma, without extension into the renal sinus or surrounding fat. No angiolymphatic invasion is identified, and the renal vein is uninvolved. Surgical margins are negative. Additionally, three small incidental cortical lesions consistent with papillary morphology are noted, with the largest measuring 0.3 cm. The remainder of the kidney demonstrates mild chronic interstitial nephritis, focal global glomerulosclerosis, moderate vascular sclerosis, and several simple cortical cysts. Based on these findings, staging is classified as pT1b Nx Mx."} +{"pid": "TCGA-39-5024", "report": "A right mid lobe mass involving the bronchus was identified. The tumor measured 3.8 x 3.5 x 2.8 cm in its greatest dimensions and was located peribronchially at the hilum. It had a white-tan cut surface with a firm, gritty consistency. Extensive vascular invasion was observed, but no perineural invasion was present. The bronchial and vascular margins were free of tumor, though the tumor was noted to invade the bronchus. The pleura was not involved. Focal organizing pneumonia and respiratory bronchiolitis were also present in the lung tissue.\n\nMultiple lymph nodes were examined. One of eight peribronchial lymph nodes showed evidence of involvement by tumor through direct extension. Intraoperative frozen section analysis of a level VII lymph node revealed tumor involvement. Other lymph nodes, including those from levels IV and X on the right, were benign. Some lymph nodes showed focal necrosis and calcifications, but no mycobacterial or fungal organisms were identified on special stains. All submitted lymph node specimens were fully evaluated, with no additional tumor identified.\n\nThe lung specimen was processed as a pneumonectomy, measuring 22 x 18 x 3.5 cm. A staple line was noted adjacent to the bronchus, and a sutured line measuring 6 cm was observed on the posterior surface. Representative sections were taken from the tumor, bronchial and vascular margins, and surrounding lung tissue. No other tumors were identified in the remaining lung parenchyma."} +{"pid": "TCGA-EL-A3CL", "report": "A female patient underwent surgical resection of a lesion in the thyroid isthmus. The specimen measured 3.0 cm and exhibited a mixture of papillary and follicular variant patterns. The lesion was encapsulated and contained calcifications. No lymphatic/vascular invasion or extrathyroidal extension was identified. Resection margins were free of abnormal tissue. A separate biopsy of the tissue overlying the cricoid showed cartilage and skeletal muscle without any atypical findings. Additionally, an excision from the soft tissue of the left thigh revealed an atypical lipoma weighing 5550 grams, with areas of necrosis noted."} +{"pid": "TCGA-VQ-A8PT", "report": "The specimen involves tissue from the stomach (body) and surrounding structures, including omentum and transverse colon, following subtotal gastrectomy and related procedures. A lesion measuring 7.4 cm in its major axis is present, characterized by ulceration and infiltration through the mucosa, submucosa, and muscularis propria into adjacent mesenteric fat. There is adherence to the colon without evidence of direct neoplastic invasion. No neural, lymphatic, or blood vascular invasion is identified. A discrete peritumoral inflammatory reaction is noted, with no desmoplasia observed. Multiple lymph nodes, including those from chains 1, 8a, 11p, and 8p, show no involvement. The gastric margin is also uninvolved. Pathological staging is determined as pT4 pN0."} +{"pid": "TCGA-69-7973", "report": "The surgical pathology report includes multiple specimens from a right lung resection. A lobectomy specimen (F) contains a 4.1 x 4 x 3.7 cm poorly circumscribed firm gray-white mass located within the right middle lobe. The mass is in close proximity to the pleura (<0.1 cm), parenchymal margin (0.2 cm), and bronchial margin (0.3 cm). The overlying pleura shows retraction but no gross invasion, with a smooth and glistening surface. A fibrous pleural scar measuring 3.5 x 3 x 0.2 cm extends to the resection margin. Adjacent to the mass, there is a firm dark brown area of parenchymal consolidation.\n\nHistologically, the lesion demonstrates solid, acinar, and cribriform growth patterns. Centrilobular emphysema is also present. Immunohistochemical staining shows positivity for CAM 5.2 and TTF-1, with focal positivity for synaptophysin. The cells are negative for chromogranin, p63, and CD56. Mitotic activity is approximately 7 mitoses per 10 high-power fields. No vascular or lymphatic invasion is identified.\n\nExamination of the bronchial margin (I) reveals no diagnostic alterations. The pulmonary arterial margin (H) contains atypical cells within the vessel lumen, interpreted as not definitive neoplasm. The pulmonary vein margin (J) has a detached cluster of atypical cells in the perivascular soft tissue but not within the vessel lumen. These findings are considered negative for tumor involvement. The lower lobe parenchymal margin (O) and additional lower lobe margins (G, O) are all free of neoplastic cells. One margin (G) does show a detached cluster of malignant cells, while another (H) shows atypical cells in a vessel lumen, both of uncertain clinical significance.\n\nLymph node stations 4L, 7, 4R, 2R, R11, and R12 were examined. All show anthracosis and are negative for neoplasm. Intraoperative frozen section analysis of all margins was negative for tumor, except for one margin (G) that showed atypical cells suspicious for malignancy.\n\nStaging based on these findings is pT2a NO, Stage IB, according to AJCC criteria. A mutational analysis is being performed for further characterization."} +{"pid": "TCGA-DB-A64R", "report": "A resected brain specimen from the right frontal region was received in multiple parts. The main specimen measured 5.6 x 4.8 x 2.1 cm and contained a tan-gray, ill-defined lesion measuring 2.6 x 1.2 x 1.2 cm. Two additional fragments measured 1.7 x 1.0 x 0.8 cm and 5.0 x 4.0 x 2.0 cm, respectively. Intraoperative smears were prepared from the first fragment and showed features of a glioma with morphology favoring a specific type, pending further evaluation.\n\nHistologic sections demonstrated a neoplasm with regions of increased cellularity and mildly elevated mitotic activity. Immunohistochemical staining showed positivity for IDH1 (R132H) mutation, rare expression of p53 protein, and variable Ki-67 labeling ranging from low to focally moderate. These findings were consistent with prior intraoperative impressions. Fluorescence in situ hybridization studies for chromosomal deletions were initiated on paraffin sections and await results for final interpretation. Multiple tissue blocks were submitted for comprehensive analysis across all specimens."} +{"pid": "TCGA-A2-A0EX", "report": "The left breast lumpectomy specimen measures 6.0 cm in greatest dimension. A poorly defined mass measuring 1.5 x 1.0 x 0.6 cm is identified, with a tan-white, firm cut surface. The mass is located 0.5 cm from the anterior, medial, and posterior margins, and 0.7 cm from the lateral margin. Microscopically, the lesion shows a lobular growth pattern confirmed by immunohistochemical staining. Focal tubular formation is observed in scattered areas. The tumor is classified as moderately differentiated based on histologic features, with a total score of 6 out of 9 (Tubules = 3, Nuclei = 2, Mitoses = 1). Necrosis is not present, and microcalcifications are identified. No definitive evidence of venous or lymphatic invasion is found, though perineural involvement is noted in specific sections. The tumor is present at the lateral and posterior margins, and is 0.3 cm from the closest superior and inferior margins. An intraductal component is also present.\n\nA single sentinel lymph node is submitted for evaluation, measuring 2.0 x 1.5 x 0.7 cm. Rare individual tumor cells are identified on cytokeratin immunohistochemistry.\n\nAn additional superior margin specimen, measuring 5.2 x 2.9 x 1.0 cm, contains dense tan-white fibrous tissue. Tumor is identified within 0.1 cm of the designated new true margin. The deep margin specimen, measuring 2.3 x 1.2 x 0.6 cm, consists of adipose tissue and is negative for malignancy.\n\nEstrogen and progesterone receptors are positive. HER2 testing by immunohistochemistry shows a 1+ result. Pathologic staging is pT2 with no regional lymph node involvement (i+), and distant metastasis status is indeterminate (AJCC, 6th edition).\n\nAdditional findings include fibrocystic changes with usual duct hyperplasia, apocrine metaplasia, stromal fibrosis, and microcysts. Columnar cell change without atypia is also present. A previous biopsy site with a surgical marker is noted. The skin appears unremarkable. All other sections show benign breast tissue."} +{"pid": "TCGA-K1-A42W", "report": "The resected distal pancreas specimen shows a well-circumscribed mass measuring 3.5 cm in greatest dimension, with additional dimensions of 3.1 cm. Microscopically, the lesion is composed of pleomorphic spindled cells arranged in fascicles, with areas of focal necrosis estimated at approximately 5%. Mitotic activity is present at a rate of 21 per 50 high power fields. Immunohistochemical staining demonstrates strong reactivity for actin, desmin, and Ki67, with approximately 20% of tumor nuclei positive for Ki67. CD34 highlights vascular structures, while S100, AE1/3, DOG1, CKit, and HMB45 are negative. The tumor does not involve the pancreatic margin. Adjacent pancreatic parenchyma shows changes of focal chronic pancreatitis and low-grade PanIN. Four regional lymph nodes are identified, all benign. Pathologic staging is pT1b, pN0, Mx. The surgical margins are free of neoplastic involvement. No microscopic venous, lymphatic, or perineural invasion is identified. A separate splenectomy specimen shows no significant abnormality, and three associated lymph nodes are benign. Additionally, two lymph nodes from the hepatic artery region are also benign.\n\nA prior CT scan of the abdomen showed a 3x3 cm hypoattenuating, hypovascular lesion in the proximal body of the pancreas, well-demarcated without evidence of invasion into adjacent organs or vasculature. A small 1.3 cm hypodense lesion in segment 8 of the liver was noted, with findings suggesting a benign etiology such as a sclerosed hemangioma. Subsequent imaging revealed that this liver lesion had increased in size from 1.1 cm to 1.3 cm. Additional new hypodense lesions were identified in segments 4A (1.3 cm) and 6 (2.4x2.7 cm), raising concern for metastatic disease. No local recurrence or lymphadenopathy was observed. A follow-up fine needle aspiration of a liver lesion was performed, which showed a spindle cell neoplasm with myxoid change. Immunostains on cell block material confirmed positivity for desmin and cladesmon, supporting a diagnosis consistent with the original pancreatic neoplasm. The cell block was insufficient for evaluation of actin and S100 stains."} +{"pid": "TCGA-Q1-A5R2", "report": "The specimen consists of multiple fragments of pale tan tissue intermixed with a moderate amount of clotted blood, measuring 0.7 x 0.5 x 0.2 cm in aggregate. All tissue is submitted in one cassette. Microscopic evaluation reveals abnormal cellular proliferation within the cervical tissue. The lesion exhibits invasive growth with large cell morphology and nonkeratinizing features. The cells show poor differentiation, indicating a high degree of atypia and disorganization. No definitive margins or surrounding tissue invasion are assessed due to the biopsy nature of the specimen. Clinical staging cannot be determined from this report alone. The findings are based on histopathological analysis of the submitted specimen, which has been reviewed and approved."} +{"pid": "TCGA-3C-AALI", "report": "The specimen was received in three parts. Part A consisted of a single lymph node from the right axilla, measuring 2.0 x 1.8 x 1.0 cm, submitted for analysis. Frozen section confirmed the presence of abnormal cells within this sentinel node.\n\nPart B was a lumpectomy specimen from the right breast, measuring 10.5 x 9.0 x 6.0 cm. A central mass was identified, measuring 3.2 x 3.0 x 3.0 cm, with characteristics described as tan, firm, and poorly circumscribed. Margins were assessed: the mass was 0.3 cm from the superficial margin, 0.5 cm from the deep margin, and 2.5 cm from the lateral margin. Microscopic evaluation revealed a moderately differentiated invasive ductal pattern with focal micropapillary features. Nuclear grade was 2 and tubular and glandular differentiation was also grade 2. In addition, there was multifocal ductal in situ disease of high nuclear grade (approximately 10%), consistent with comedo subtype, with necrosis noted. Also identified were focal lobular neoplasia of classical type, fibrocystic changes including apocrine metaplasia and sclerosing adenosis, microcalcifications, cicatricial fibrosis with organizing granulation tissue and fat necrosis, and a microscopic fibroadenoma measuring 0.2 cm. No abnormal cells were identified at the surgical margins. The tumor was located in the upper outer quadrant.\n\nPart C consisted of a right axillary lymph node dissection, including two tissue pieces measuring 4.0 x 2.7 x 1.0 cm and 10.0 x 7.0 x 1.0 cm. Fourteen lymph nodes were identified, ranging in size from 0.6 x 0.5 x 0.5 cm to 3.5 x 1.5 x 1.0 cm. No abnormal involvement was found in these nodes.\n\nVascular space invasion was identified in lymphatic channels. Calcifications were present in both benign and malignant regions. Fibrocystic disease with proliferative features was noted adjacent to the main lesion, along with a small fibroadenoma. No pectoral muscle was identified in the specimen.\n\nA total of 15 lymph nodes were examined overall, with one sentinel node involved by abnormal cells extensively replacing its architecture. Extracapsular extension was observed in this involved node."} +{"pid": "TCGA-BH-A203", "report": "The right breast segmental mastectomy specimen contained a lesion measuring 2.1 cm in greatest dimension. Histologic evaluation revealed invasive growth with extensive lymphatic permeation and involvement of ductal structures. Nuclear grading was consistent with a high-grade appearance, classified as nuclear grade poor and histologic grade 3. All surgical resection margins were negative for involvement.\n\nThe right axillary lymph node dissection included a total of thirty-nine lymph nodes, of which thirty-five were positive for metastatic involvement. Some of the involved nodes demonstrated extracapsular extension. Pathologic staging was determined as T2 N2 MX. Estrogen and progesterone receptor status was evaluated."} +{"pid": "TCGA-CV-7091", "report": "The specimen consists of a composite resection of the anterior mandible, floor of mouth, and ventral tongue, measuring 6.0 x 6.0 x 6.0 cm. The anterior mandible component measures 6.0 x 6.0 x 2.5 cm, and the floor of mouth and ventral tongue component measures 3.0 x 2.0 x 2.0 cm. A firm, tan-gray, ulcerating lesion is identified in the medial floor of mouth, obliterating the lingual frenulum and eroding through the mandible to involve the alveoli of the two first incisors and the left second incisor. The tumor extends into the vestibular gingiva and is within 0.5 cm of the anterior gingival margin and 1.5 cm of the deep soft tissue margin. All resection margins appear grossly uninvolved. The remaining teeth, mandible, tongue, and soft tissues of the floor of mouth show no discrete lesions.\n\nTumor thickness measures 1.4 cm. Lymphovascular invasion is present. Perineural invasion is not identified. Sections of mandible are pending for decalcification.\n\nLymph node evaluation includes: left neck (levels I, II, III) with 14 lymph nodes, all negative; right neck (levels I, II, III) with 11 lymph nodes, all negative. The left salivary gland shows fibrosis and inflammation consistent with radiation effect, while the right salivary gland is free of tumor.\n\nResection margins evaluated include the anterior labial margin, left and right gingival lingual sulcus, left and right lingual margins, and anterior lingual margin, all showing squamous mucosa without tumor involvement. Multiple teeth and tooth fragments, including incisors, premolars, canines, and molars, some with amalgam, were present. No sections were taken from the teeth; only gross documentation was performed.\n\nGross description of the left and right neck levels I, II, and III showed no evidence of tumor. Tissue samples from these regions were submitted for histologic evaluation, with multiple lymph nodes assessed per level, all found to be negative."} +{"pid": "TCGA-A5-A0GP", "report": "The specimen consists of a uterus with attached bilateral fallopian tubes and ovaries, weighing 75 grams. The uterus measures 7.5 x 5.0 x 4.0 cm. The endometrial wall thickness is 0.6 cm and the myometrial wall thickness is 1.4 cm. The endometrial surface is tan. On the posterior wall, there is a firm tan mass measuring 2.0 x 1.8 x 0.6 cm. The serosal surface appears shiny and tan. No other lesions are identified. The cervix appears grossly unremarkable.\n\nMicroscopic examination reveals acute and chronic cervicitis in the cervix, with no malignant findings. The endometrium shows atrophic changes along with cellular features consistent with previously noted abnormalities. There is focal superficial myoinvasion involving less than one-third of the inner myometrium. This involvement appears largely confined to the fibromuscular cores of the papillary structures. No angiolymphatic invasion is identified, and the serosa does not show any malignant or other pathological features.\n\nBoth ovaries and fallopian tubes do not reveal any malignant findings. The left ovary demonstrates endosalpingiosis. Both fallopian tubes exhibit features consistent with prior tubal ligation.\n\nLymph node evaluation includes dissections from left pelvic, left paraortic, right pelvic, and right paraortic regions. One lymph node from the left pelvic region is negative for malignancy. Similarly, one lymph node from the left paraortic region is also negative. No lymph nodes are identified in the right pelvic or right paraortic regions; these areas contain only fibrovascular and mature adipose tissue without evidence of malignancy.\n\nThe surgical staging system (AJCC Pathologic Stage, 2002, 6th Ed) indicates localized involvement without definitive nodal spread (pT1b/pNx)."} +{"pid": "TCGA-39-5028", "report": "The patient is a former smoker who presented with right lung nodules identified on chest CT. Specimens were submitted for evaluation, including multiple mediastinal and interlobar lymph node groups from both the right and left sides, as well as lung tissue from the right upper and lower lobes.\n\nLymph nodes examined in levels IV (right and left), VII (subcarinal), and XI (right interlobar) showed no evidence of malignancy. All lymph nodes were described as benign, with some showing anthracotic changes. Intraoperative frozen section analysis confirmed the absence of tumor involvement in these lymph node regions.\n\nThe right upper lobe lung wedge measured 5.3 x 2.4 x 2.2 cm and contained a subpleural nodule measuring 2.1 x 1.8 x 0.9 cm. The nodule was located close to the stapled margin (0.2 cm). No vascular or perineural invasion was identified. The mainstem bronchus showed in situ changes, and the tumor did not reach the pleural surface. The resection margin was free of tumor. Non-neoplastic lung tissue showed interstitial fibrosis and focal organized pneumonia.\n\nThe right lower lobe specimen measured 15 x 11.9 x 5.9 cm and contained a large central mass measuring 6.6 x 5.1 x 3.4 cm. The tumor was located 3.5 cm from the nearest stapled margin and 5.7 cm from the bronchial margin, with the edge of the mass abutting the pleural surface. The bronchial margin was free of tumor. Emphysematous changes, interstitial fibrosis, and osseous metaplasia were noted in the surrounding lung tissue. Dilated spaces were observed around the tumor, but no diffuse fibrotic change typical of usual interstitial pneumonia was present.\n\nIntraoperative consultation on the right upper lobe wedge confirmed infiltrating carcinoma; however, all other intraoperative frozen sections of lymph nodes were benign, and permanent sections confirmed these findings. Lymph node dissection results showed no metastatic disease in the examined nodes, although peribronchial lymph nodes showed some fibrotic changes. The case was reviewed and confirmed by additional consultation."} +{"pid": "TCGA-HC-7230", "report": "The prostatectomy specimen weighed 36 grams and measured 4.7 x 2.9 x 2.4 cm. The cut surface showed nodular gray-white to tan-yellow soft tissue. Histologic evaluation revealed a primary pattern of 3/5 and a secondary pattern of 4/5. The total score based on these patterns was 7/10. Approximately 5% of the gland volume was involved by the lesion. No evidence of extension beyond the prostate capsule, seminal vesicle involvement, or lymphovascular space invasion was identified. High-grade intraepithelial neoplasia was present. All surgical margins were uninvolved.\n\nA total of three lymph nodes were received, ranging in size from 0.5 x 0.2 cm to 3.5 x 2.3 x 0.7 cm. None contained metastatic disease. Additional tissues submitted for evaluation included bilateral vas deferens and seminal vesicle junctions, all of which showed no evidence of involvement. The pTNM stage was determined to be pT2c NO. Representative sections of the prostate were submitted for analysis, including apical, base, and mid-gland regions, as well as anterior and posterior aspects."} +{"pid": "TCGA-18-4086", "report": "The specimen included a wedge resection of lung tissue, along with multiple lymph nodes from subcarinal, interlobar, lobar, and paratracheal regions, as well as from the pulmonary ligament. Histologic evaluation of the lung tissue revealed patchy interstitial chronic inflammation and fibrosis displaying a usual interstitial pneumonia (UIP) pattern. A single lymph node showed non-necrotizing granulomatous inflammation with focal mixed dust nodules. All other lymph nodes examined exhibited non-necrotizing granulomatous inflammation without evidence of malignancy. Some lymph nodes also contained focal mixed dust nodules with central necrosis and hyalinization.\n\nThe resected lung tissue from the right lower lobectomy measured 10.5 x 10 x 6 cm. The tumor was located peripherally, measured 4.0 cm in greatest dimension, and was composed of two components. One component was moderately differentiated and accounted for 90% of the lesion, while the second, comprising 10%, was poorly differentiated. The tumor was uninvolved at the resection margins, with the closest margin measuring 18 mm. No vascular invasion or direct extension of the tumor was identified. The background lung parenchyma showed similar features to the wedge resection, including interstitial fibrosis and chronic inflammation with UIP pattern. Intraparenchymal lymph nodes contained granulomas, but no such structures were seen directly within the lung tissue.\n\nImmunohistochemical staining showed expression of multiple cytokeratins and p63 in the moderately differentiated component, with weak positivity for CK5/6 and p63 in the poorly differentiated component. Focal CK7 staining was also present in the latter. Both components showed strong membranous EGFR staining, but were negative for p53 and TTF-1. No evidence of metastatic disease was found in the five lymph nodes evaluated from the lobectomy specimen.\n\nAdditional findings included fibrointimal thickening in blood vessels, likely related to chronic inflammation, and absence of active vasculitis. No malignant cartilage, bone, or skeletal muscle elements were identified. The tumor was confined to the lung, with no regional lymph node involvement. The histologic grade was classified as G3, indicating poor differentiation. The pathologic staging was determined as pT2, based on the size greater than 3 cm and other local features, with no regional lymph node metastasis (pN0)."} +{"pid": "TCGA-IB-A5SO", "report": "The specimen included a resection of omental tissue measuring 35 x 12 x 1 cm, which showed benign fatty tissue with focal hemorrhage. Two reactive lymph nodes were identified in the lymph node specimen, both without evidence of malignancy. The Whipple resection specimen included the distal stomach, head of the pancreas, bile duct, and proximal duodenum. Gross examination revealed an abnormal fibrotic area within the pancreatic head measuring 3.8 cm. Microscopically, this lesion demonstrated moderately differentiated features and extended into the duodenal wall and peripancreatic soft tissues. Resection margins were free of invasive carcinoma, with the closest distance from the tumor to a margin measuring 1 mm at the pancreatic margin. Lymphovascular and perineural invasion were present.\n\nInvolvement was noted in three of twelve regional lymph nodes examined. One lymph node from the superior mesenteric artery margin specimen contained metastatic cells, while four benign lymph nodes were found in another margin specimen. Invasive cells were also identified in fibroadipose tissue from the SMA margin and within the wall of a large vein in the portal vein resection specimen, where one of two lymph nodes was involved.\n\nAdditional findings included chronic inflammation of the pancreas and involvement of a major venous structure. No vascular involvement was identified in the SMA margin #2 specimen. All surgical margins were assessed, with no evidence of invasive disease at the closest margin. Multiple tissue blocks were submitted for histologic evaluation from all specimens, including bile duct, gastric, duodenal, and pancreatic resection margins, as well as potential lymph nodes."} +{"pid": "TCGA-AA-3556", "report": "The resected colon specimen includes a lesion measuring up to 2 cm in diameter, extending approximately 4.5 cm to the margin of the resected tissue. Histological evaluation shows moderately differentiated glandular structures with some mucus production. The lesion infiltrates into the inner layers of the muscularis propria. Additional findings in the intestinal wall include pseudodiverticula and evidence of prior peridiverticulitis with chronic scarring. Both the oral and aboral margins of the resection are free of abnormal cellular infiltration. A total of 22 mesocolic lymph nodes are present without atypical cells, although reactive changes are noted. Vascular and lymphatic invasion markers are negative. The histologic grade is intermediate. Complete resection is confirmed."} +{"pid": "TCGA-CV-A45O", "report": "The specimen consists of a composite resection of the alveolar ridge. A lesion was identified involving anterior and medial soft tissue margins. The tumor measured 3.0 x 1.2 x 1.0 cm in size and demonstrated a depth of invasion into soft tissues of 0.9 cm. Histologic evaluation showed moderately differentiated features. The anterior and posterior mandibular margins of resection were free of involvement. A separate specimen from the right mandible was also received for evaluation.\n\nLymph node assessment included one lymph node from the left middle jugular region, which showed no evidence of involvement. Additionally, thirteen cervical lymph nodes from the left supraomohyoid neck dissection were examined, including six submental-submaxillary, two subdigastric, four midjugular, and one upper posterior cervical node; none showed evidence of involvement. Submaxillary salivary gland tissue was also present and unremarkable.\n\nA new anterior medial margin revealed squamous mucosa without evidence of disease. Bone and bone margins were initially pending decalcification, and a supplemental report was issued to provide further information on these components. The final mucosal and soft tissue margins of resection were confirmed to be free of disease."} +{"pid": "TCGA-C5-A8YQ", "report": "The specimen was received in fixative in two containers, both labeled with the patient's name. Specimen A, labeled \"cervical bx at 6 o'clock,\" consists of a 0.8 cm piece of tan tissue, entirely submitted in cassette A1. Specimen B, labeled \"ECC,\" consists of a 1 cc aggregate of tan mucoid material, entirely submitted in cassette B1. Microscopic evaluation of both specimens shows abnormal cells with features consistent with previous cytology findings. The depth of invasion could not be determined from this material. All slides were reviewed, and the office was notified of the results."} +{"pid": "TCGA-R8-A73M", "report": "A left parietal mass was identified and surgically resected. The specimen consisted of two pieces of red-tan tissue measuring 1.0 cm in greatest dimension. A portion was used for intraoperative frozen section and smear evaluation, with the remainder submitted for further analysis. Additional tissue from the tumor margin was received as multiple fragments of beige-tan friable tissue measuring up to 1.5 x 0.8 x 0.4 cm in aggregate. A third component of the left parietal mass included multiple fragments of similar beige-tan friable tissue measuring up to 3.0 x 2.0 x 0.8 cm in aggregate, all of which were submitted for histologic evaluation.\n\nMicroscopic examination revealed a neoplasm composed of round cells with perinuclear halos and a relatively uniform cellular appearance. Certain areas demonstrated increased cellularity with identifiable mitotic figures. There was also evidence of elevated vascular activity in some regions. These features were considered notable but did not meet criteria for a higher grade classification. The tumor showed infiltrative growth into adjacent brain tissue.\n\nAll specimens were entirely submitted and processed for further molecular testing. Clinical history was not provided. Some laboratory tests may have been performed under research or laboratory-developed test protocols that have not been cleared or approved by the FDA."} +{"pid": "TCGA-K4-AAQO", "report": "A specimen was received from a patient with a history of bladder cancer. The surgical specimen included bilateral distal ureters, multiple lymph node groups from the left and right obturator, external iliac, internal and common iliac regions, as well as a bladder and prostate specimen, and a hernia sac.\n\nMicroscopic examination of the left and right distal ureters showed no evidence of malignancy. A total of 23 lymph nodes were examined across all groups: two on the left obturator, four on the left external iliac, seven on the left internal and common iliac, three on the right obturator, two on the right external iliac, and four on the right internal and common iliac. None showed evidence of malignancy.\n\nThe bladder and prostate specimen revealed an invasive high-grade tumor located in the anterior wall of the urinary bladder. Histologic evaluation demonstrated a urothelial carcinoma with focal glandular differentiation. The tumor measured 5.0 cm and showed a histologic grade of 2\u20133/3. There was no evidence of an extravesical mass. Lymphatic invasion and perineural invasion were present. The surgical margins, including ureteral, urethral, and soft tissue resection margins, showed no tumor involvement. One perivesical lymph node was negative for malignancy.\n\nA total of 23 lymph nodes were examined and none were involved by malignancy. The hernia sac specimen showed fibroadipose tissue with focal mesothelial lining, consistent with a hernia sac, and no malignancy was identified.\n\nThe prostate showed foci of acute and chronic inflammation, but no malignancy was seen. Multiple sections of the bladder and surrounding tissues were evaluated, and the tumor appeared to be grossly free from the anterior surgical resection margin by at least 0.5 cm.\n\nAll specimens were adequately submitted and processed for histologic evaluation."} +{"pid": "TCGA-BP-4989", "report": "The specimen consists of a right kidney with attached ureter, renal vessels, and perinephric fat, weighing 477.5 g post fixation. The kidney measures 11.7 x 8.4 x 4.2 cm. A smooth bulging nodular area is identified near the hilum on the capsular surface. The ureter measures 1.7 cm in length and 0.4 cm in diameter. The renal vein measures 0.5 cm in length and 0.9 cm in diameter. No lymph nodes are identified in the perinephric fat. An ill-defined red-tan tumor mass measuring 6.2 x 4.9 x 3.2 cm is located at the superior pole of the kidney, extending to involve the renal pelvis and renal sinus. On sectioning, the tumor shows focal involvement of the renal vein with two areas of red-tan bulging identified along the endothelial lining. No gross involvement of the inked perinephric margin, hilum, or hilar fat is observed. Within the tumor mass, there is an ill-defined white-tan fibrotic area measuring 2.7 cm in greatest dimension. Microscopic examination reveals high nuclear grade morphology. All surgical margins are free of involvement. Adjacent kidney tissue appears unremarkable. Ten lymph nodes from paracaval and precaval regions are examined and show no evidence of involvement. A right adrenal gland measuring 6 x 2 x 0.8 cm and weighing 13 g is submitted and appears histologically benign. The tumor extends through the renal capsule but remains confined within Gerota\u2019s fascia and involves the renal vein. No lymph node or adrenal gland involvement is identified. Staging indicates involvement of major veins without extension beyond Gerota\u2019s fascia."} +{"pid": "TCGA-AK-3428", "report": "A left kidney specimen with attached perinephric fat, adrenal gland, and para-aortic lymph nodes was received. The kidney measured 24 x 14.5 x 11.5 cm and weighed 1988.28 grams. Upon bisection, a large yellow-orange and hemorrhagic mass was identified, occupying most of the kidney. The mass measured approximately 12 x 9.5 x 9 cm. Some residual renal parenchyma was noted in the lower pole. The tumor extended into the perinephric fat, coming within 2 mm of the inked margin. A tumor thrombus was found within the renal vein; however, the vascular and ureteral resection margins were negative for tumor. A small nodule measuring 0.7 x 0.5 x 0.3 cm was identified within the adrenal gland. Four lymph nodes were examined and showed no evidence of involvement. A separate specimen of additional para-aortic tissue consisted of fibrofatty tissue without identifiable lymphoid or tumor involvement. Histologic evaluation showed nuclear features corresponding to a nuclear grade of 2. No tumor was identified at the vascular or ureteral margins, and multiple sections were submitted for analysis."} +{"pid": "TCGA-A2-A3XY", "report": "The specimen consists of a left breast mastectomy with axillary dissection. The main lesion measured 2.5 cm in greatest dimension by gross assessment and was located in the upper outer quadrant. Microscopically, the lesion demonstrated high-grade features with a Nottingham score of 9 out of 9, composed of 3 points each for tubule formation, nuclear grade, and mitotic count (24 mitoses per 10 high power fields). Necrosis was present within both invasive and in situ components. Microcalcifications were identified in both in situ and benign areas of the breast tissue. No venous or lymphatic invasion was observed.\n\nAn intraductal component was present, showing high nuclear grade with solid growth pattern and central comedo-type necrosis. The closest margin distance for invasive disease was 1.2 mm at the superficial margin. For in situ disease, the closest margins were 1.0 mm at the superficial and 1.2 mm at the deep margin.\n\nAxillary lymph node evaluation revealed 3 positive nodes out of 17 examined. The largest metastatic focus measured 1.2 cm microscopically, and no extracapsular extension was noted. There was no involvement of the nipple or skin.\n\nAncillary studies showed no expression of estrogen or progesterone receptors. HER2 testing by FISH was negative, with a HER2/CEP17 ratio of 1.0.\n\nAdditional findings included a 1.2 cm fibroadenoma, moderate usual ductal hyperplasia, a small peripheral papilloma, and fibrocystic changes. The specimen also showed changes related to a prior biopsy site.\n\nThe patient presented with a left breast mass confirmed by imaging as a 2.2 x 1.4 cm lesion in the upper outer quadrant. Preoperative suspicion was for breast cancer. Gross examination of the mastectomy specimen showed a dense, fibrous breast with minimal adipose tissue. The axillary tail contained 11 lymph nodes, with the two largest being firm and tan-white, suggestive of metastatic involvement. Multiple sections were submitted for analysis, including margins, lymph nodes, and other notable areas. Fixation time exceeded 80 hours."} +{"pid": "TCGA-AJ-A3NE", "report": "The specimen consists of multiple tissue fragments from bilateral pelvic and aortic lymph nodes, as well as a hysterectomy specimen including the cervix, bilateral tubes and ovaries. The left pelvic lymph nodes measure 8.8 x 6.0 x 1.7 cm and contain several poorly defined tan yellow to brown nodules up to 3.2 cm in size, with the largest showing a fleshy gray tan cut surface. The right pelvic lymph nodes measure 8.2 x 5.0 x 1.5 cm and contain both well-defined and poorly defined nodules up to 4.2 cm; the largest has a fleshy and fatty appearance on sectioning. The right aortic lymph nodes are 3.5 x 2.6 x 0.8 cm and contain poorly defined nodules up to 1.1 cm. The left aortic lymph nodes measure 4.4 x 3.0 x 1.0 cm with poorly defined nodules up to 2.2 cm, with the largest bisected for examination.\n\nThe uterus and cervix together weigh 114 grams and measure approximately 9.2 x 6.0 x 5.2 cm. The endocervical canal is lined by trabeculated mucosa with areas of granularity and friability. The uterine serosa appears smooth anteriorly but shows fibrous adhesions posteriorly. The myometrium measures up to 2.7 cm in thickness and appears tan pink and trabecular. An intramural nodule measuring 1.7 cm is present in the anterior wall with a fibrotic cut surface. The endometrial canal is largely lined by granular mucosa that focally extends into the underlying myometrium by approximately 0.1 cm. Papilliferous changes are noted primarily in the fundic region. Small amounts of parametrial soft tissue show no abnormalities.\n\nFallopian tubes appear structurally normal with areas of serosal discontinuity consistent with prior ligation. Both ovaries demonstrate fibrotic and cystic changes; the right ovary contains a 1.2 cm centrally hyalinized structure interpreted as a corpus luteum.\n\nHistologic evaluation reveals focal glandular involvement within the anterior endomyometrium and separate papilliferous tissue fragments. The glands demonstrate architectural complexity with moderate to marked cytologic atypia. Invasion into the myometrium is limited to less than half its thickness, with maximal invasion depth measuring approximately 1 mm into a 24 mm thick wall. Lymphovascular space invasion is identified based on tumor cells within endothelium-lined spaces. No involvement is identified at the surgical margins, including the cervix, parametria, or adnexal structures. Additional findings include adenomyosis, endometriosis, endosalpingiosis, and a benign leiomyoma. Lymph node analysis demonstrates reactive changes including sinus histiocytosis and lymphoid hyperplasia, with no evidence of metastatic involvement identified across 36 lymph nodes evaluated (left pelvic: 14, right pelvic: 10, right aortic: 5, left aortic: 7). Glandular inclusions seen within some lymph nodes are interpreted as benign endosalpingiosis.\n\nStaging classification indicates localized disease without lymph node involvement."} +{"pid": "TCGA-BP-5201", "report": "The clinical history indicates a patient with metastatic disease involving the lungs. Specimens submitted include a left kidney total nephrectomy specimen, along with excisions of suprahilar and pre-aortic lymph nodes and a para-aortic lymph node. An adrenal gland was also submitted in conjunction with one of the lymph node specimens.\n\nThe kidney specimen measured 11 x 9 x 5.5 cm and contained a tumor measuring 9.5 cm in greatest dimension. The tumor was described as white to golden yellow, focally fibrotic and hemorrhagic, with extension into the renal vein approximately 1.7 cm from the margin. It abutted the renal capsule but did not penetrate into the perirenal fat. Surgical margins were free of tumor involvement. Adjacent renal parenchyma showed normal architecture with no significant pathological findings apart from a small cortical cyst. No lymph nodes were identified within the perinephric fat.\n\nHistologic evaluation demonstrated high nuclear grade features. Tumor was identified within muscular vessels in the renal sinus/hilum region. There was involvement of the adrenal gland by tumor cells. No lymph node metastases were identified in the lymph nodes evaluated; three pre-aortic lymph nodes and one para-aortic lymph node were all negative for malignant involvement.\n\nStaging classification indicated tumor extension into the renal vein or vena cava below the diaphragm level. Sections from all specimens were reviewed microscopically and confirmed findings consistent with intraoperative frozen section diagnosis of a renal cortical neoplasm."} +{"pid": "TCGA-L5-A4OF", "report": "A male patient with a history of gastroesophageal reflux and Barrett\u2019s esophagus underwent endoscopic biopsy of an esophageal mass, followed by surgical resection. The specimen included the distal esophagus and proximal stomach, measuring 7.9 cm in length and 4.5 x 4.7 cm respectively. A firm, exophytic, brown-tan lesion was identified in the distal esophagus, measuring 3.3 cm in length x 1.3 cm. It was located 3.2 cm from the proximal esophageal margin, 5.8 cm from the distal margin, and 1.7 cm from the gastroesophageal junction. Adjacent to the lesion, there was a small area of hyperemia at the gastroesophageal junction. Due to handling prior to examination, there was separation between mucosa and muscularis propria, complicating full-thickness assessment.\n\nThe lesion was partially submitted for analysis along with surrounding tissue including a strip of mucosa near the possible procurement defect, additional fragments near the defect, sections of underlying muscularis, and multiple lymph node candidates. One lymph node candidate was sectioned individually, and seven others were each examined. A separate fragment of Barrett\u2019s mucosa adjacent to the lesion was received, measuring 2.5 x 2.0 x 0.3 cm, without visible abnormality. A paraesophageal lymph node measuring 0.4 cm was also submitted. The proximal esophageal margin was a 0.5 cm segment with a stapled end, and the staple line was shaved for evaluation.\n\nHistologic evaluation revealed a poorly differentiated adenocarcinoma arising in Barrett\u2019s mucosa, measuring 3.3 cm in greatest dimension, with invasion extending into the submucosa. Resection margins were negative. Metastatic involvement was identified in one of eighteen lymph nodes examined. No lymphoid tissue was identified in the paraesophageal lymph node sample. There was no evidence of distant metastasis. No prior chemotherapy or radiation therapy had been administered."} +{"pid": "TCGA-SQ-A6I4", "report": "The surgical panel includes a right adrenal gland specimen submitted for evaluation. Gross examination revealed a 10 x 7 x 3.3 cm adrenal gland weighing 60 grams. A well-circumscribed mass measuring 3.9 x 3.3 x 3.0 cm was identified in the inferior-medial aspect of the gland. The mass had a tan, glistening, rubbery cut surface with multiple hemorrhagic foci and extended to within 0.1 cm of the medial and inferior surgical margins. The remaining adrenal cortex appeared orange and the medulla was brown; no other masses were identified.\n\nMicroscopic evaluation demonstrated a cellular neoplasm composed of polygonal cells arranged in nests and trabeculae, surrounded by a delicate vascular network. Cytoplasm was finely granular and nuclei were round to oval with occasional prominent nucleoli. Mitotic figures were not increased. Immunohistochemical staining showed positivity for chromogranin, synaptophysin, and calretinin, while inhibin, cytokeratin AE1/AE3, and melan A were negative.\n\nAll surgical margins were free of tumor involvement. No lymphatic or vascular invasion was identified. Representative sections of the mass and uninvolved adrenal gland were submitted for further analysis. Ancillary studies were performed as needed."} +{"pid": "TCGA-KM-8477", "report": "The right kidney specimen included a mass measuring 4.5 x 3.9 x 3.7 cm, with a thin fibrous capsule surrounding the lesion. The mass itself measured 3.8 x 3.8 x 3.5 cm and contained both cystic and solid components. Solid areas were tan/red in color and located toward the periphery. Within the cystic region, multiple solid mahogany brown nodules were identified, with the largest measuring 1.3 cm in diameter. Areas of necrosis and hemorrhage were also present. Surgical margins were inked blue and no involvement of perinephric fat was observed. The excised soft tissue margin specimen showed no evidence of tumor. A separate fragment of kidney tissue taken from the base of the mass showed only normal parenchyma without any abnormal cellular proliferation. Multiple sections were taken for detailed histological evaluation. Immunohistochemical staining showed positivity for c-kit (CD117). No tumor was identified in the associated fibroadipose tissue submitted. The case was reviewed and findings were confirmed. All tests were performed in a CLIA-certified laboratory under appropriate oversight."} +{"pid": "TCGA-06-5416", "report": "A large left temporal lesion was identified with imaging, demonstrating features of necrosis, solid enhancement, and significant surrounding edema and mass effect. Histopathological evaluation of biopsy and excision specimens revealed a high-grade neoplasm of neuroepithelial origin. The tissue samples showed marked cytologic atypia with pleomorphic nuclei and variable cytoplasmic amounts. Mitotic activity was prominent, with up to 16 mitoses per 10 high power fields. Microvascular proliferation was also observed.\n\nImmunohistochemical staining demonstrated strong positivity for GFAP in the neoplastic cells, while NeuN was negative. p53 protein expression was detected in 5\u201310% of the tumor nuclei. The proliferation index, as measured by MIB-1, was elevated, reaching up to 45\u201350%. Necrotic areas were present within the specimen.\n\nMolecular testing was performed on extracted DNA and RNA from the tumor sample. Analysis revealed no evidence of an EGFRvIII mutation. Assessment for MGMT promoter methylation did not show methylation, suggesting limited benefit from alkylating agent therapy. Chromosomal analysis demonstrated partial loss of chromosome arm 1p (telomeric region\u2014D1S1612), but no allelic loss was detected on chromosome arm 19q.\n\nThe histopathological findings were consistent with a highly aggressive neoplasm, showing extensive cellular proliferation, nuclear atypia, and necrosis. These features were confirmed on both frozen and permanent sections."} +{"pid": "TCGA-ZF-AA5H", "report": "The specimen included multiple anatomical structures and lymph nodes. The bladder measured 85 mm in its longest dimension and had a lesion measuring 40x20x47 mm, which extended through the bladder wall into surrounding fat. Other structures including the uterus, fallopian tubes, ovaries, and cervix were unremarkable aside from small benign findings such as fibroids and a subserosal nodule. The ureteric margins showed no abnormalities.\n\nLymph node assessment revealed variable findings. In the left external iliac region, one lymph node was identified without evidence of involvement. A second lymph node from the left obturator region contained a 7 mm deposit without extracapsular extension. The left common iliac node was negative. On the right side, the external iliac node contained a 10 mm deposit without extracapsular spread. Two right common iliac lymph nodes were unaffected. In the right obturator region, one of three lymph nodes contained a 6 mm deposit with extracapsular extension into hilar soft tissue. Additionally, a separate metastatic deposit was noted in perivesical fat on the right side.\n\nMicroscopic evaluation of the bladder lesion showed a poorly differentiated solid tumor arising from carcinoma in situ. The tumor infiltrated through the full thickness of the bladder wall into surrounding fat, displaying broad invasive fronts and frequent lymphovascular invasion. Tumor cells were pleomorphic with moderate eosinophilic cytoplasm and occasional osteoclastic giant cells. No trophoblastic differentiation, sarcomatoid change, or heterologous elements were present. Perineural invasion was observed. The tumor approached within 4 mm of the circumferential surgical margin but did not involve the urethral margin, which showed only squamous metaplasia. Adjacent bladder tissue was otherwise morphologically normal.\n\nSections of the uterus and cervix revealed inactive endometrium, small leiomyomas, and normal cervix and adnexal structures. A lymph node found within remnant fat outside the main specimen showed metastatic involvement with extracapsular extension."} +{"pid": "TCGA-DD-A39Z", "report": "The left lobe liver specimen weighs 655 grams and measures 13 x 12.5 x 7.5 cm. A mass is present within the liver, measuring 10.5 x 10.1 x 8.1 cm, located 1.8 cm from the nearest surgical margin. Histologic evaluation reveals Grade 2 (of 4) cellular features. The surrounding liver tissue shows no significant abnormalities. A separate lesion from the right pelvic sidewall is identified, measuring 1.2 x 0.9 x 0.4 cm, with microscopic features consistent with a benign process. All margins are evaluated and no residual involvement is seen in the submitted specimens."} +{"pid": "TCGA-DF-A2L0", "report": "The tissue sample was obtained from an endometrial mass via surgical resection. The primary site is identified as the endometrium. The specimen showed a lesion with measurements reported as anterior 5.3 x 2.5 cm with a thickness of 2.0 cm, and posterior 5.0 x 5.4 cm with a thickness of 3.2 cm. Cellular features included grade III morphology. Pathological staging was determined as T1c with lymph node involvement (N1). A total of 5 lymph nodes were sampled, with 17 positive nodes identified. Distant metastasis was clinically assessed as M0. No bilateral disease involvement was noted. The sample was collected fresh frozen, with no delay between procedure date and sample collection."} +{"pid": "TCGA-BP-4170", "report": "The left kidney specimen, including the adrenal gland, measured 11.5 x 7.5 x 5.0 cm. A subcapsular mass measuring 5.0 x 4.0 x 3.0 cm was identified at the superior pole. The mass was yellow-tan, circumscribed, and exhibited minimal areas of hemorrhage and necrosis with a central scar. It was confined within the renal capsule without involvement of the pelvicalyceal system or vascular structures. The tumor did not invade the renal vein, and all surgical margins were free of involvement. The non-neoplastic renal parenchyma contained several small benign cortical cysts (0.1\u20130.4 cm). The adrenal gland measured 5.0 x 1.5 x 0.7 cm and showed no significant findings. No lymph nodes were identified at the hilum. The ureteral stump measured 11.0 cm in length and 0.6 cm in average diameter. Histologic evaluation revealed a nuclear grade II/IV neoplasm with acinar growth pattern. Microscopic examination of the submitted tissue blocks confirmed absence of tumor at the ureteric and vascular margins. A separate specimen from the left peri-aortic region contained 13 benign lymph nodes. The gross and microscopic features suggest no evidence of regional nodal spread."} +{"pid": "TCGA-EB-A3XB", "report": "The specimen consists of skin tissue submitted as an excised tumor. The lesion measures 2.5 x 2 x 1 cm and exhibits a nodular growth pattern. Histologic evaluation shows moderately differentiated cells with lymphatic invasion identified. The inflammatory response surrounding the lesion is described as moderate. Additional assessment indicates involvement corresponding to an IV level of invasion. No further features or findings were specified in the report."} +{"pid": "TCGA-AX-A05Z", "report": "The specimen consists of a hysterectomy with bilateral salpingo-oophorectomy, including the uterus, bilateral fallopian tubes, and ovaries, along with multiple lymph node groups. The uterus measures 9.3 cm in length and has a tumor located in the anterior and posterior lower uterine segment. The tumor measures 7.0 x 5.0 x 1.0 cm posteriorly and 6.0 x 4.5 x 1.0 cm anteriorly. It is noted to be 2.0 cm from the external os posteriorly and 3.0 cm anteriorly. A separate nodule is identified on the endocervical surface, measuring 0.7 x 0.4 x 0.4 cm and located 0.6 cm from the external os anteriorly. The tumor invades the myometrium to a depth of 6 mm in an area where the myometrial thickness is 9 mm, representing approximately 66% involvement. Vascular space invasion is present. The tumor is 0.5 cm from the closest resection margin at the lower uterine segment/endocervical wall.\n\nHistologically, the tumor demonstrates features consistent with a grade II cellular morphology based on nuclear characteristics. Stromal involvement is present in the upper endocervix, but margins are otherwise uninvolved. The right ovary contains a metastatic deposit measuring 5 mm, extending to less than 1 mm beneath the serosal surface. No tumor is identified in the left ovary or in either fallopian tube. Examination of multiple lymph node regions, including right and left para-aortic, common iliac, and pelvic lymph nodes, reveals no evidence of metastatic disease. A total of 20 lymph nodes are examined and all are negative for tumor involvement. No lymph node tissue is identified in one submitted specimen.\n\nThe pathologic staging indicates involvement beyond the uterine corpus, with extension to the serosal surface and adnexa. No regional lymph node involvement is identified, and distant metastasis cannot be assessed. Venous or lymphatic invasion is present. The surgical margins are free of invasive disease."} +{"pid": "TCGA-HT-7677", "report": "The pathology report describes a neoplastic process involving the brain. Microscopic evaluation reveals a tumor with variable morphology and infiltrative growth patterns. The tissue shows regional differences in cellularity and nuclear atypia, indicating possible anaplastic transformation within a pre-existing low-grade lesion. In certain areas, the tumor displays less cellular density, with features typical of low-grade oligodendroglial neoplasms, such as round nuclei, mild nuclear atypia, and distinct perinuclear halos. Other regions show increased cellularity with more pronounced nuclear pleomorphism.\n\nScattered microgemistocytes are present throughout the tumor. The neoplasm demonstrates diffuse infiltration into surrounding brain tissue. In the gray matter, there are foci of perineuronal tumor satellitosis. Additional findings include microcalcifications, myxoid changes, and the presence of thin, branching blood vessels. No necrosis or microvascular proliferation is identified.\n\nDespite a low mitotic count of 2 mitotic figures per 10 high power fields in the current specimen, prior biopsy data showed a MIB-1 labeling index of 24.5%, indicating a high level of proliferative activity."} +{"pid": "TCGA-EJ-7793", "report": "The prostate specimen shows a lesion characterized by acinar-type cellular features with focal extracellular mucin. The Gleason score is 3+4=7, with the Gleason pattern 4 component accounting for approximately 25% of the tumor. The tumor involves both the right and left lobes of the prostate, extending from the apex through the mid region. The maximal tumor diameter measures 0.8 cm in a histologic section. Approximately 5% of the examined prostate gland volume is involved by the lesion.\n\nThe lesion is confined entirely within the prostate gland without evidence of extracapsular extension. Both seminal vesicles and distal vasa deferentia appear benign. All surgical resection margins are free of neoplastic cells. There is no perineural or angiolymphatic invasion identified. Multifocal high-grade intraepithelial proliferative changes are present. Non-neoplastic prostate tissue demonstrates focal acute inflammation and focal glandular atrophy.\n\nThe prostate weighs 42.01 grams. No lymph nodes were examined. Pathologic staging is pT2c, with histologic grade G3-4. The patient had a preoperative serum PSA level of 3.0 ng/mL and a prior needle biopsy showed similar findings. There is a family history of prostate cancer on the paternal side. The patient has undergone previous surgeries including septorhinoplasty, vasectomy, and right knee repair. Medical history includes hypercholesterolemia, sleep apnea, and gastroesophageal reflux disease. There is no known history of adverse reactions to anesthesia or blood products."} +{"pid": "TCGA-A2-A0YL", "report": "The surgical specimen from the left breast was received in multiple parts. Part A, labeled as the 7 o\u2019clock superficial margin, consisted of an ovoid flat portion of yellow fatty tissue measuring 6 x 4 x 0.9 cm. The margin was re-inked with blue ink and entirely submitted for examination. No residual abnormality was identified in this section.\n\nPart B, a simple mastectomy specimen from the left breast, measured 16 x 16 x 5.2 cm. The nipple appeared unremarkable. Sectioning revealed firm pink-tan fibrous tissue involving approximately 80% of the specimen, with cystic areas and regions of induration. An area of nodularity was noted centrally, measuring up to 9.0 cm in greatest dimension. This lesion was located greater than 1 cm from all margins. Grossly, it exhibited a mottled pink to gray-white appearance. Sections were submitted from all quadrants and included deep and superficial margins. Extensive sampling showed multifocal and multicentric involvement across 14 of 17 blocks examined.\n\nPart C, a sentinel lymph node biopsy from the left axilla, included one hot and blue-marked lymph node measuring 2.7 x 2.1 x 1.2 cm, along with three additional small lymph nodes. The largest node showed focal blue discoloration and was largely replaced by fat. Microscopic evaluation identified metastatic involvement in three lymph nodes, with the largest focus measuring 5 mm.\n\nPart D, another sentinel lymph node biopsy from the left axilla, contained a single lymph node measuring 3 x 2.7 x 1.0 cm. Microscopic analysis revealed multifocal involvement within the lymphoid sinuses.\n\nPart E, representing an additional tissue excision at the 12 o\u2019clock margin, measured 11.5 x 5.3 x 1.0 cm and was marked with blue and black ink. Representative sections were submitted, accounting for approximately 70% of the specimen. No residual disease was found.\n\nParts F and G were sentinel lymph node biopsies from the right axilla. Both specimens were small, measuring less than 1 cm in greatest dimension. Histologic examination did not reveal any evidence of metastatic involvement.\n\nPart H was a contralateral simple mastectomy specimen from the right breast, measuring 20.5 x 18 x 4.5 cm. The central 85% of the specimen consisted of firm pink-tan fibrous tissue with multiple cystic spaces containing cloudy brown fluid. No discrete masses were identified. Representative sections from all quadrants and margins were submitted and showed only benign changes including fibrocystic alterations, apocrine metaplasia, and mild epithelial atypia.\n\nMultiple immunostains and special studies were performed to further characterize the findings."} +{"pid": "TCGA-DX-A3M1", "report": "The left retroperitoneal specimen consists of an unoriented lobulated mass of adipose tissue measuring 17 x 12 x 6.0 cm. On sectioning, it reveals a firm tan necrotic lobulated mass surrounded by adipose tissue, with necrosis estimated at approximately 40%. The lesion is grossly encompassed by an intact thin membrane. Histologically, the predominant component shows high-grade morphology resembling malignant fibrous histiocytoma, with extensive necrosis noted. A minor component of less aggressive morphology is also identified.\n\nThe sigmoid colon specimen contains a lobulated mass of adipose tissue measuring 4.0 x 3.5 x 2.0 cm. It demonstrates firm to slightly firm consistency on sectioning, with no necrosis identified. The histologic features appear less aggressive in nature. Both specimens were submitted in entirety for analysis."} +{"pid": "TCGA-KF-A41W", "report": "The surgical pathology report describes a hysterectomy specimen along with bilateral salpingo-oophorectomy and multiple lymph node resections. The uterus weighed 400 grams and measured 9.5 x 8.5 x 8.5 cm, with a cervix measuring 3.5 cm. Attached fallopian tubes and ovaries were unremarkable. The uterine cavity contained a submucosal/intramural mass measuring 8.5 x 7.8 x 7.0 cm, which was firm, tan-white, and focally necrotic. The endometrium was atrophic with a polyp and averaged 0.2 cm in thickness. The myometrium measured up to 1.8 cm in thickness.\n\nMicroscopic examination of the uterine mass revealed a hypercellular spindle cell tumor resembling smooth muscle. Features included moderate to severe pleomorphism, geographic necrosis, infiltrative borders into the myometrium, and brisk mitotic activity exceeding 10 mitoses per 10 high-power fields in some areas. Immunohistochemical staining demonstrated positivity for smooth muscle actin and CD10, while desmin, c-kit, and S-100 were negative. Margins of resection were negative and no vascular invasion was identified.\n\nRegional lymph nodes were assessed from left and right pelvic and periaortic regions. A total of twenty-four lymph nodes were evaluated (six from left pelvic, six from left periaortic, eight from right pelvic, and four from right periaortic), all of which were negative for involvement. Adnexal structures showed no significant pathology.\n\nAdditional findings included cystic atrophy of the endometrium with polyp formation and a cervix lacking dysplasia. Gross and microscopic evaluations confirmed no abnormalities in the ovaries or fallopian tubes."} +{"pid": "TCGA-IB-7897", "report": "HISTOPATHOLOGY REPORT. ORIGINAL REPORT. SPECIMEN: A. Gallbladder. B. Node of importance. C. Whipple's specimen. CLINICAL HISTORY: Pancreatic cancer. \n\nA chronic inflammatory process is present in the gallbladder. The gallbladder measures 7.0 x 3.1 x 1.5 cm with a grey, congested serosal surface. Wall thickness ranges between 0.2 and 0.3 cm. The mucosa appears green and velvety. No gallstones are identified. The cystic duct is patent. Three representative sections have been submitted.\n\nThe lymph node biopsy consists of an irregular fragment measuring 1.1 x 1.0 x 0.3 cm and has been submitted entirely.\n\nThe Whipple specimen includes 21.0 cm of duodenum with a proximal pancreatic segment measuring 4.5 x 4.6 x 2.5 cm. The common bile duct remains patent with its resection margin sampled enface. A firm mass measuring approximately 3.1 x 1.2 x 2.6 cm is present within the tissue above the bile duct. This lesion lies 0.2 cm from the nearest mesenteric vessel contact point and 0.4 cm from the anterior pancreatic surface. Two mucosal sections are located 3.8 cm and 7.4 cm from the proximal resection margin.\n\nSubmitted sections include: enface sampling of the common bile duct margin; distal pancreatic margin; proximal (gastric) and distal (duodenal) resection margins; areas of the uncinate process, blood vessels, and tumor interface; preserved pancreatic and duodenal mucosa; yellow nodular lesions at the duodenal mucosa; lymph nodes from the distal stomach, bile duct region, pancreatic head, and duodenum\u2014some lymph nodes are uncut or trisected.\n\nMicroscopic examination reveals a malignant epithelial proliferation forming primitive ductal structures embedded in dense collagenized stroma. Nuclear features demonstrate significant pleomorphism and hyperchromasia.\n\nResection margins at the pancreatic neck and other primary margins appear free of malignant involvement. However, there is invasive carcinoma extending beyond the lymph node capsule at the pyloric region, reaching the painted outer surface of the specimen. Two of seventeen lymph nodes contain metastatic cells while fifteen others remain negative.\n\nAt the resection margin near the pancreatic neck, no carcinoma is present, although epithelial changes suggestive of pre-invasive intraepithelial neoplasia are observed in the pancreatic duct at this location. An incidental finding of benign heterotopic pancreatic-like tissue is noted within the duodenal wall."} +{"pid": "TCGA-BQ-5892", "report": "The submitted specimen from the left kidney following total nephrectomy reveals a tumor with a maximum dimension of 6.5 cm located in the mid portion of the kidney. The tumor exhibits a mix of papillary, solid, and clear cell features. Tumor cells display large, pleomorphic nuclei with open chromatin and occasional nucleoli, along with eosinophilic to clear cytoplasm. Immunostains show reactivity for CD10 and CA-IX, while being negative for AE1:AE3, EMA, CK7, and racemase. Staining for TFE3 and TFEB was also negative. A separate small nodule measuring 1 cm is identified in the lower pole with a tan-gray cut surface.\n\nThe tumor does not show evidence of local invasion or renal vein involvement. Surgical margins are free of tumor. The renal artery shows moderate atherosclerotic changes with stenosis at the margin. Non-neoplastic findings include mild arterionephrosclerosis and benign simple cortical cysts. An adrenal gland is present and appears unremarkable, with no evidence of involvement. No lymph nodes are identified in the perinephric fat.\n\nLymph node dissections from the preaortic, para-aortic, and left hilar regions were examined. A total of 17 lymph nodes were assessed in the preaortic and para-aortic specimens, and four in the hilar region. None show evidence of involvement. All lymph nodes appear benign upon histological evaluation.\n\nSpecial studies including multiple immunostains and histochemical stains were performed. Representative sections from all specimens were submitted for analysis. Gross description includes detailed measurements of the kidney, ureter, renal vessels, and lymph nodes. The tumor is centered in the mid-kidney and is described as hemorrhagic with a golden yellow and red cut surface. The cortico-medullary junction remains well-defined."} +{"pid": "TCGA-MX-A5UJ", "report": "Addendum. Date of Procedure: 1. Clinical Diagnosis & History: Specimens Submitted: 1: Distal gastrectomy (fs). 2: Portion of small bowel. \n\n**Distal Gastrectomy Findings:** \nThe specimen consists of a distal portion of stomach with attached adipose tissue and omentum. The stomach measures 15.0 x 8.5 x 3.0 cm in total dimensions. Gross examination reveals a centrally ulcerated polypoid tumor located 2.9 cm from the proximal margin and 0.5 cm from the distal margin. The tumor measures 6.6 cm in length and 5.7 cm in width. Depth of invasion is noted to be 0.6 cm, reaching the subserosa without involvement of the visceral peritoneum or adjacent structures. Representative sections of margins were submitted for frozen section analysis and all margins were found to be free of malignancy. \n\nHistologically, the lesion demonstrates moderately to poorly differentiated tubular architecture. A preexisting adenomatous polyp is noted at the tumor site. Vascular and perineural invasion are identified. There is no evidence of multicentricity or involvement of the peritoneum. Adjacent mucosa shows chronic gastritis with intestinal metaplasia. No separate polyps or Helicobacter pylori are identified. \n\nA total of 44 lymph nodes are examined from the perigastric region, with 6 showing metastatic involvement. Based on AJCC 7th Edition staging criteria, this corresponds to pT3 classification due to penetration into subserosal connective tissue and pN2 classification indicating metastasis in 3\u20136 regional lymph nodes. \n\nImmunohistochemical staining reveals positivity for Her2 in approximately 30% of cells (3+), while chromogranin and synaptophysin stains are negative. \n\n**Small Bowel Resection:** \nThe second specimen consists of an unoriented portion of small bowel measuring 6.0 cm in length by 3.4 cm in average diameter. Both ends are stapled shut. Gross evaluation reveals a pink-purple serosal surface and gray-tan mucosa with wall thickness averaging 0.6 cm. Histologic examination reveals no significant pathology. Representative sections of margins and undesignated areas are submitted. \n\nAll diagnoses reported are based on personal examination of the slides and review of materials. Photographs and representative blocks have been taken and archived."} +{"pid": "TCGA-IS-A3K6", "report": "The submitted specimens included the uterus, cervix, bilateral fallopian tubes and ovaries; a tumor from the surface of the uterus; and multiple lymph node groups from both left and right sides, including external iliac, internal iliac, hypogastric, and obturator regions.\n\nExamination of the uterine specimen revealed two distinct foci of high-grade, anaplastic cellular proliferation involving the uterine corpus. The largest focus measured 8.5 cm, with a second focus measuring 6.5 cm. Vascular invasion was identified. The ectocervix and endocervix were benign, with atrophic endometrium noted. Additional findings included intramural and submucosal benign-appearing smooth muscle tumors, and unremarkable bilateral ovaries and fallopian tubes.\n\nA biopsy of the mass on the surface of the uterus showed similar high-grade anaplastic features consistent with the uterine lesion.\n\nLymph node evaluations revealed no evidence of malignant involvement across all sites. Specifically, seven lymph nodes from the right external iliac region, three from the right internal iliac, one from the right obturator, six from the left hypogastric, six from the left external iliac (note: report lists 11 then specifies 6 nodes), and two from the left obturator were all benign. No lymph nodes were identified in the right hypogastr soft tissue sample.\n\nImmunohistochemical analysis of the uterine lesion demonstrated positivity for smooth muscle actin and negativity for cytokeratins. These findings were consistent with the histologic features observed. A prior bone biopsy was reviewed and found to share histologic and immunohistochemical similarities with the uterine lesion, particularly with positivity for O13. Based on this correlation, the bone lesion is interpreted as most likely representing metastatic spread from the uterine lesion despite some unusual morphologic and staining characteristics."} +{"pid": "TCGA-FC-A6HD", "report": "The gross examination included lymph node aggregates from the left and right pelvic regions, measuring up to 3.5 x 3.5 x 1.6 cm and 4.0 x 3.5 x 1.4 cm respectively, with multiple individual lymph nodes up to 2.5 cm in greatest dimension. The prostate specimen weighed 48 grams and measured 5.5 x 5.0 x 3.8 cm. The capsule was intact. Sectioning revealed a lesion in the left postero-lateral mid prostate measuring 1.3 x 0.9 x 0.9 cm, along with a smaller focus on the right posterolateral base measuring 0.3 cm. The seminal vesicles showed no significant findings.\n\nMicroscopic evaluation revealed a Gleason score of 4 + 3 = 7 with presence of a higher tertiary pattern (pattern 5, <5%). Approximately 20% of the prostatic tissue was involved by the lesion, with a maximum linear extent of 15 mm. The lesion was bilateral, with dominant involvement on the left side. Histologic features were consistent with conventional morphology. No therapy-related changes were identified. There was focal extracapsular extension on the left mid/base aspect, involving approximately 1 mm radial extent and 2 mm linear extent. There was no evidence of seminal vesicle invasion, angiolymphatic invasion, or involvement of any lymph nodes. Surgical margins were uninvolved.\n\nLymph node analysis included 6 nodes from the right pelvic region and 4 from the left pelvic area, all without evidence of metastatic involvement. Pathologic staging was determined as pT3a with no nodal metastasis."} +{"pid": "TCGA-CU-A3KJ", "report": "The specimen from the soft tissue biopsy shows no evidence of tumor involvement. A radical cystoprostatectomy specimen was submitted. Within the bladder, a high-grade urothelial carcinoma with squamous differentiation is identified. The tumor measures approximately 6.0 cm in greatest dimension by gross examination and invades into perivesical soft tissues. It is unifocal, located in the left wall, anterior wall, trigone, and left ureterovesical junction. Focal hemangiovascular space invasion is noted, but lymphovascular space invasion is not definitively identified. There is associated urothelial carcinoma in situ. No tumor is seen in the ureters or at any of the surgical margins including the left and right ureters and the urethra. Additional evaluation of the urethral lumen shows only detached fragments of carcinoma without definite stromal invasion or in situ lesion. Perivesical soft tissues are negative, though tumor is very close to the margin at the left lateral wall (<0.1 cm) and right anterior wall (<0.1 cm). Other findings include moderate to severe chronic cystitis, benign prostatic hyperplasia, and acute and chronic prostatitis. No lymph node metastases are identified. In the prostate, there is a separate focus of low-grade adenocarcinoma with a Gleason score of 6 (3+3), involving approximately 2% of the right lobe, localized to the mid to base region and confined within the prostatic capsule. No lymphovascular invasion or involvement of the seminal vesicles is present. All surgical margins are negative."} +{"pid": "TCGA-BH-A1FU", "report": "A right modified radical mastectomy specimen was submitted for evaluation. The breast measured 18.0 by 17.0 by 5.2 cm and included skin, nipple, and partial axillary contents. A tan-white irregular mass measuring 1.8 by 1.0 by 1.2 cm was identified centrally, located 1.3 cm from the deep resection margin. Intraoperative frozen section analysis was performed.\n\nMicroscopic examination revealed multifocal invasive cells arranged in a ductal pattern, with poor nuclear differentiation. There was also extensive in situ ductal proliferation of the comedo type. Vascular invasion was present. Surgical margins, including skin, nipple, and deep margin, showed no evidence of tumor involvement. Five lymph nodes were identified and all were free of malignant involvement.\n\nAdditional findings included hemorrhage and hemosiderin-laden macrophages, consistent with prior biopsy activity, as well as fibrocystic changes. Immunohistochemical staining demonstrated complete membrane positivity in approximately 90% of cells. Nuclear staining for one hormone receptor was observed in about 20% of cells, while staining for another receptor was not detected."} +{"pid": "TCGA-ET-A2N4", "report": "The specimen consisted of a total thyroidectomy. Histologic evaluation revealed a neoplasm with features of papillary carcinoma, follicular variant, demonstrating angioinvasion. The primary tumor measured 4.5 cm in greatest dimension, involving the entirety of the left lobe and extending into the isthmus. The tumor was multifocal in distribution. No tumor was identified in the two regional lymph nodes examined. The primary tumor was classified as pT3, as it measured greater than 4 cm and was limited to the thyroid with possible minimal extrathyroidal extension. Regional lymph node involvement was pN0, indicating no metastasis. Distant metastasis could not be assessed (pMX). Surgical margins were uninvolved, with the closest distance of invasive carcinoma to the anterior and posterior margins measuring less than 1 mm. Venous and lymphatic invasion were present. Additional findings included nodular hyperplasia with cystic degeneration. This case was presented at a multidisciplinary conference for further discussion."} +{"pid": "TCGA-G9-6366", "report": "The prostate specimen weighed 92 grams and measured 7 cm in width, 5 cm in depth, and 4 cm in height. After removal of the apex and base, the weight decreased to 57 grams. Serial sectioning revealed tan fibrous bulging parenchyma with areas of brown calcified concretions. The right and left seminal vesicles measured 3 \u00d7 1.5 \u00d7 0.5 cm and 3.2 \u00d7 1.7 \u00d7 0.4 cm, respectively, and displayed beige-tan cystic tissue upon bisection. The vas deferens on both sides were identified as firm tan tubular structures.\n\nMicroscopic examination showed a lesion involving approximately 4% of the gland. A margin involvement measuring 0.6 mm was identified in block A17. Invasion into the left seminal vesicle wall was noted along with focal perineural invasion and extraprostatic extension at the left posterior region. High-grade prostatic intraepithelial neoplasia was present. No lymph nodes were sampled, and no vascular or lymphatic invasion was identified. Surgical margins were otherwise uninvolved.\n\nStaging was determined as pT3b with no assessment of lymph node or distant metastasis. A portion of the tissue was used for procurement while the remainder was submitted for analysis."} +{"pid": "TCGA-AJ-A3NC", "report": "The specimen includes multiple tissue samples from a surgical procedure. Lymph node tissue from the left and right pelvic regions was submitted, with sizes measuring 8.0 x 5.0 x 2.3 cm and 8.0 x 6.0 x 2.2 cm respectively. On examination, these tissues showed tan-yellow fibroadipose material with nodules up to 3.1 cm and 4.1 cm in size. The nodules had fleshy gray-pink or tan-yellow cut surfaces and were sectioned for further analysis. No metastatic changes were identified in the lymph nodes upon microscopic evaluation.\n\nA uterus specimen with attached cervix and adnexal structures was also examined. The combined weight of the uterus and cervix was 60 grams, with overall dimensions of 7.0 x 5.0 x 3.4 cm. The endometrial lining measured up to 0.2 cm in thickness and covered an area of 6.0 x 3.5 cm. The myometrium was up to 1.5 cm thick, and no gross extension into this layer was observed. The cervix had a patent os and was lined by trabeculated mucosa. Tissue sections from various areas of the cervix, uterine walls, and parametrial regions were submitted for analysis.\n\nThe right fallopian tube was 5.7 cm in length and had a fibrotic wall with a dilated lumen containing mucus. It was adhered to the right ovary, which was multiloculated, cystic, and contained straw-colored fluid. The left adnexa included a previously opened cystic ovary measuring 8.5 x 6.8 x 5.5 cm, with a hair-bearing inner lining and areas of wall thickening and calcification. Sections of both ovaries showed no evidence of abnormal cellular changes.\n\nMicroscopic findings revealed no involvement of the cervix, parametrial regions, or fallopian tubes. The tumor was confined to the endometrial lining, with a maximum diameter of 6.0 cm. Invasion into the myometrium was present but limited to less than half the wall thickness, with a maximal depth of 3 mm in a 14 mm thick myometrium. No extension to the uterine serosa, endocervix, or lower uterine segment was noted. Lymphovascular space invasion was not identified. All surgical margins were free of any concerning features.\n\nStaging was determined based on the extent of involvement, with the tumor limited to the endometrium and minimal myometrial invasion. Lymph node analysis showed no significant findings. Additional sections of ovarian tissue revealed benign features consistent with mature cystic teratoma. No abnormal cells were identified in the right or left adnexal regions. Clinical follow-up is recommended for continued monitoring."} +{"pid": "TCGA-L5-A4OT", "report": "The specimen was obtained from a male patient with a history of obesity, gastric stapling, and gastroesophageal reflux. The surgical procedure involved resection of the gastroesophageal junction and adjacent structures.\n\nA segment of esophagus measuring 4 cm in length and 5.5 cm in circumference was received, along with a portion of the proximal stomach measuring 16 cm in length and averaging 6 cm in circumference. There was a full circumferential ulcer or erosion measuring 8.5 cm in length and 5 cm in width, involving the gastroesophageal junction and extending into the upper half of the proximal stomach. A fistula tract measuring 8.5 cm in length and 0.5 cm in diameter was identified within the deep periesophageal fibroadipose tissue on the left lateral side, extending from the distal resection margin past the midpoint of the stomach.\n\nThe ulceration was located 3 cm from the nearest proximal esophageal margin and 7 cm from the distal gastric margin. The lesion invaded to a maximal depth of 2 cm, penetrating through the muscularis and into the adventitia. Areas of possible involvement were noted at multiple locations near the deep resection margin. Multiple staple lines were observed along the left lateral side of the distal stomach, with a portion of artificial mesh present at the distal margin.\n\nLymph node evaluation showed six out of eleven nodes positive for involvement. Extranodal extension could not be determined. The pattern of invasion was infiltrative. Deep soft tissue margins were involved, although the esophageal and gastric resection margins were free of tumor involvement.\n\nSections were taken from various regions including areas beneath the ulcer, extending to stitch marks, and from the tumor extending toward both proximal and distal margins. Additional lymph nodes were sampled from the perigastric and celiac regions. One small soft tissue sample from the high lesser curvature perigastric region was also submitted.\n\nMicroscopic examination confirmed infiltration through the wall layers into surrounding tissues. Multiple peripheral soft tissue margins showed positivity. The neoplasm partially extended beneath the adjacent squamous mucosa but did not reach the proximal or distal margins.\n\nTNM staging was assessed as T3, N2, with metastasis to regional lymph nodes."} +{"pid": "TCGA-BR-7717", "report": "Case BR-7717 involved a gastrectomy specimen with a tumor measuring 5 x 4.5 x 1 cm located in the stomach. The tumor was noted to be ulcerated. Microscopic examination revealed moderately differentiated histology. Evaluation showed involvement of adjacent structures, specifically the lesser omentum. Lymph node assessment indicated 2 out of 8 lymph nodes positive for metastatic involvement within the intraabdominal region. Information regarding lymphatic invasion, venous invasion, perineural invasion, surgical margins, and evidence of neo-adjuvant treatment was not specified. No additional pathologic findings or comments were provided."} +{"pid": "TCGA-BF-AAP7", "report": "Female. Clinical diagnosis provided. Gross description: The specimen consists of a skin flap from the right leg. A central tumor measuring 11x9x2 cm is present, with a mushroom-shaped, dark brown appearance; the lesion has a depth of 1 cm and protrudes above the surface by 0.5 cm. Microscopic evaluation reveals pigmented epithelioid cells with ulceration. Tumor thickness measured by Breslow is 5 mm, and the Clark level is IV. Confidential."} +{"pid": "TCGA-XF-AAML", "report": "The specimen consisted of a radical cystoprostatectomy with lymph node dissection. Gross examination showed a polypoid mass measuring 2.5 x 2.5 x 1.5 cm located on the left anterior wall of the bladder, surrounded by a velvety hemorrhagic area measuring 1.2 x 1.7 cm and a surrounding scar measuring 1.5 cm. The tumor extended into the superficial portion of the muscularis propria but did not reach deep muscle or perivesical fat. No lymph nodes were identified in the perivesical region.\n\nMicroscopic evaluation revealed a moderately to poorly differentiated papillary lesion involving the left lateral wall. The tumor invaded the superficial part of the muscularis propria and was associated with vascular space invasion. Adjacent mucosa contained flat areas of altered morphology involving the left lateral and posterior walls. Chronic inflammation, fibrosis, and foreign body giant cell reaction consistent with prior biopsy were noted in the left posterior bladder wall. Extensive chronic inflammation with glandular and cystic changes was observed throughout most of the bladder mucosa. All surgical margins were free of dysplastic or malignant changes.\n\nExamination of the prostate showed benign adenomatous hyperplasia and chronic inflammation with calcification. The prostatic urethra demonstrated reactive changes and polypoid appearance without evidence of malignancy. Both seminal vesicles appeared histologically unremarkable.\n\nLymph nodes were sampled from multiple regions including para-aortic, common iliac, paracaval, external iliac, obturator/hypogastric, Cloquet, and presacral locations. A total of 58 lymph nodes were examined, and none showed evidence of involvement.\n\nFrozen section analysis of the right and left distal ureters and apical urethral margin showed no concerning features. Proximal ureteral specimens were also benign. A separate sigmoid polyp specimen showed granulation tissue, tattoo, and focal epithelial changes; however, no definitive involvement was identified.\n\nPathologic staging was determined as pTis, T2bN0Mx."} +{"pid": "TCGA-SC-A6LM", "report": "The submitted specimens include three biopsies from the left pleura. The first specimen consists of an aggregate of white-tan membranous soft tissue measuring 3.2 x 3.0 x 0.3 cm and was entirely submitted for frozen section analysis. The second specimen includes multiple fragments of brown-tan membranous soft tissue, measuring 0.5 x 3 x 0.6 cm in aggregate, and was also entirely submitted. The third biopsy is similarly described but with unspecified dimensions.\n\nHistologic sections reveal cellular features that were assessed using immunohistochemical staining. The cells show weak positivity for WT1, calretinin, and D2-40. Diffuse positivity was noted for AE1/AE3. Stains for TTF-1, napsin, and BER-EF4 demonstrated negative results. These findings support a distinct morphologic pattern observed across all three specimens.\n\nIntraoperative frozen section analysis of each biopsy was performed, and the findings were consistent across all samples. Each biopsy showed similar histologic characteristics upon permanent sectioning. All tissue samples were reviewed and interpreted as showing findings consistent with those seen during intraoperative consultation.\n\nTesting methods included immunohistochemistry and in situ hybridization techniques developed by the laboratory. These tests have not been cleared or approved by the U.S. Food and Drug Administration; however, they are performed under Clinical Laboratory Improvement Amendments (CLIA) certification for high-complexity testing and are used for routine clinical purposes."} +{"pid": "TCGA-55-6981", "report": "The surgical specimen includes multiple lymph nodes and a left upper lobe of lung. Lymph nodes vary in size from 0.3 to 1.5 cm and are described as gray-black, tan-white, or red-black with smooth or granular cut surfaces. The lung specimen measures 22 x 13 x 4 cm and weighs 165 grams. A mass is identified at the hilum, measuring 2.5 x 2.0 x 1.5 cm, composed of firm, gray-tan, focally black tissue. It approaches within 0.1 cm of the inked hilar margin, 0.5 cm of the pleural surface, and 1.5 cm of bronchial and vascular margins. Surrounding bronchi and vessels show no direct involvement; however, tumor is noted near subpleural lymphatics.\n\nMicroscopic evaluation of serial sections reveals twelve lymph nodes, ten of which show extensive involvement by carcinoma. The aortopulmonary and anterior pulmonary ligament lymph nodes are uninvolved. Tumor cells are present within lymphatic spaces near the bronchial margin and in subpleural regions. The tumor demonstrates close proximity\u2014within 1 mm\u2014to the hilar pleural surface. All resection margins (bronchial, vascular, pleural) are free of tumor involvement.\n\nHistologic assessment shows a moderately-poorly differentiated adenocarcinoma. Gross tumor size is 2.5 x 2.0 cm. No venous invasion is identified. Lymphovascular invasion is present and widespread throughout the lung, including subpleural lymphatics. No additional significant pathologic findings are noted."} +{"pid": "TCGA-IG-A4P3", "report": "The gross examination revealed an esophagus measuring 13 x 3 cm, containing an ulcerating plate-like lesion measuring 5 x 4.5 cm. Adjacent gastric tissue, measuring 7 x 10 cm, exhibited normal architecture. Microscopic evaluation demonstrated moderately differentiated cells with infiltration into the muscularis propria and presence of lymphatic invasion. A total of fifteen lymph nodes were examined: ten paraesophageal lymph nodes showed follicular hyperplasia, with one containing metastatic involvement; one paratracheal lymph node was involved; and four paracardial lymph nodes displayed follicular hyperplasia. The tumor measured 4.5 x 5 cm, with no evidence of venous invasion or treatment effect. Surgical margins were uninvolved. No additional findings were noted."} +{"pid": "TCGA-A8-A083", "report": "The specimen shows an ablated breast sample containing a highly differentiated invasive carcinoma with a tumor diameter of 9 cm. There are circumscribed intraductal components present. The dorsal resection margin is free of tumor. Histological evaluation indicates the tumor is classified as NOS, Grade I, with staging pT3NOLOVORO based on size and absence of lymphovascular invasion."} +{"pid": "TCGA-QR-A700", "report": "The submitted specimens include a left omental mass, spleen, and left adrenal gland. The left omental mass measures 1.4 x 1 x 0.5 cm and consists of a firm, white-yellow nodule within a yellow-red soft tissue fragment. Gross evaluation revealed fat necrosis.\n\nThe spleen weighs 467 grams and measures 13.5 x 12 x 5 cm. On sectioning, a small area measuring 3 cm in greatest dimension is identified. The remaining surface demonstrates prominent white pulp. Microscopic examination reveals atypical lymphoid cells present in the red pulp, ranging from medium to large in size with abundant pale cytoplasm. These cells are CD20 positive, CD5 and CD23 positive, and negative for cyclinD1 and IgD. CD3 and CD5 highlight background T cells, while CD21 demonstrates residual follicular dendritic cell meshworks. A moderate proliferation rate is noted via MIB-1 staining. The pattern of involvement shows clusters of atypical cells in the red pulp with predominant white pulp involvement. Additional findings include sampling of fat surrounding the splenic sinus and abdominal wall fat, which is normal-appearing adipose tissue measuring 1.2 x 1.1 x 0.5 cm.\n\nThe left adrenal gland specimen weighs 82.1 grams and measures 10.5 x 4 x 2.0 cm. It has a white cut surface with a rim of normal-appearing adrenal tissue. A nodular mass is identified and appears encapsulated. Histologically, the mass shows nested tumor cells positive for chromogranin and synaptophysin. Surrounding adipose tissue demonstrates infiltration by atypical monotonous lymphoid cells that are CD20 positive.\n\nImmunohistochemical and in-situ hybridization studies were performed as part of the diagnostic process. All tests were developed and validated by the Laboratory of Pathology and are used under CLIA certification for high-complexity testing. No FDA clearance or approval was required for these assays.\n\nThe pre-operative and post-operative diagnosis is consistent with the presence of an adrenal mass. Operative findings include a soft adrenal mass and a large spleen with superficial changes. Specimens have been processed and sampled according to protocol. Some portions of the specimen were procured for research purposes."} +{"pid": "TCGA-IQ-7631", "report": "The specimen included multiple soft tissue fragments from various anatomical sites including the upper lip, inferior lip, mental region, cheek, nasolabial area, alveolar ridge, gingival mucosa, oral commissure, buccal regions, retromolar trigone, and retromandibular mucosa. Each fragment was inked with blue dye along the margins and submitted in entirety for frozen section analysis. The sizes of these specimens ranged from 0.5 x 0.3 x 0.2 cm to 2.0 x 0.3 x 0.2 cm.\n\nA larger resected specimen encompassing buccal mucosa, cheek skin, and lower lip measured 5.5 x 5.0 x 3.0 cm. The skin component measured 4.0 x 3.0 x 0.1 cm with a 2.0 cm surgical scar. The mucosal portion measured 5.0 x 3.0 x 0.1 cm and exhibited a nodular appearance with small focal ulceration less than 0.1 cm in size. The tumor identified within this specimen was tan to white in color and poorly defined. It measured 2.5 x 2.5 x 3.0 cm and extended close to the inferior margin (less than 0.1 cm), anterior margin (0.5 cm), superior margin (1.0 cm), and posterior margin (1.0 cm). The tumor also reached the mucosal margin and was 1.0 cm away from the skin surface.\n\nLymph node dissections were submitted from both left and right neck levels including level 1B, 2A, 2B, and combined levels 1A, 1B, 2A, 3, and 4. These specimens ranged in size from 3.5 x 1.0 x 1.0 cm up to 8.0 x 5.5 x 4.0 cm. Lymph nodes identified within these specimens ranged from 0.6 cm to 2.3 cm in greatest dimension. No gross evidence of malignancy was noted in any lymph node or surrounding fibroadipose tissue.\n\nA subcutaneous mass from the left forearm measured 1.5 x 1.3 x 1.0 cm and was composed of pale tan/white tissue. A separate specimen from the right thyroid lobe with isthmus weighed 13.82 grams and measured 4.3 x 2.5 x 2.5 cm. This specimen contained a well-circumscribed yellow colloid nodule measuring 3.0 x 2.5 x 2.0 cm extending from the superior to mid pole, and a smaller nodule in the isthmus measuring 1.0 x 0.5 x 1.0 cm. Calcifications were noted within the larger nodule.\n\nFrozen sections of all margins (including anterior, posterior, inferior, and superior) showed no evidence of malignancy. Sections of the thyroid nodule revealed follicular lesions; however, no malignancy was identified. Additional findings included benign adipose tissue from the buccal fat pad, absence of malignancy in all lymph node dissections, and confirmation of angiolipoma in the forearm specimen. The thyroid gland showed multiple follicular colloid nodules consistent with goiter and focal chronic inflammation, with no evidence of malignancy identified."} +{"pid": "TCGA-KM-8442", "report": "The right kidney specimen was received as a partial nephrectomy with attached fatty tissue, measuring 10.5 x 9.3 x 9.0 cm. The external surface of the kidney measured 7 x 0.3 cm. The specimen was inked in black and bisected, revealing a tan-yellow-red cut surface. A section measuring approximately 4 x 3 x 2 cm was procured for further analysis. An additional piece of kidney parenchyma, measuring 5 x 3 x 1.8 cm and attached to a suture, was also submitted. This piece, identified as the superior pole based on surgical markings, had the top portion inked in blue. The specimen was serially sectioned and fully submitted for processing. All relevant sections were fixed in formalin and placed in labeled cassettes. No consultants were involved in the gross examination."} +{"pid": "TCGA-66-2780", "report": "The examined specimen includes a left upper lobe measuring 22 x 13 x maximum 4.5 cm, with a central bronchus resection plane located 0.4 cm proximal to the division into bronchi of the apical group and lingular bronchus. At the hilus, four lymph nodes were identified, measuring 0.5 cm and 1.8 cm in size. A 3.3 cm staple suture line runs cranially from the hilus, while a 7 cm staple suture line extends caudodorsally, demarcating the base of an adhered lung tissue fragment approximately 6 x 1 cm in size and up to 1.5 cm thick. The visceral pleura exhibits patchy blackish pigmentation, with focal reddish-brown discoloration medially and brown to reddish material near the hilus. On the dorsal margin over S4, there is an approximately 4 cm star-shaped area of retracted tissue. Beneath this lies a whitish, patchy, and pale yellow lesion measuring up to 4.8 cm in maximum dimension, with an irregular configuration. Truncation of subsegmental branches of B4 and 5 was noted within the lesion. There was concern for possible infiltration in an attached wedge-shaped lung specimen, located at a distance of 0.6 cm from its staple suture line. Other lung surfaces show patchy blackish pigmentation.\n\nLymph nodes assessed include: station 12 (1.5 cm), station 11 (1.5 cm), station 10 (3 cm), station 8 (0.7 cm with surrounding tissue), station 6 (two parts measuring 1 cm and 0.4 cm with surrounding tissue), station 5 (1.2 cm), station 4 left (two parts measuring 1.2 cm and 0.5 cm with surrounding tissue), and station 4 right (1 cm node or node part). The examined tissues included sections of the lesion involving the pleura, subsegmental branches of B4 and 5, an attached wedge-shaped lung specimen, one section of S2, bronchus and vessel margins (tangential), hilar nodes, and additional sections of the lesion with attached lung tissue. Fifteen blocks were evaluated using various stains including Elastica-van Gieson, PAS, diastase-PAS, and iron.\n\nHistological evaluation revealed chronic active retention pneumonia at the margin of the lesion. Lymph nodes showed reactive changes and anthracotic pigment deposition. The lesion was found to involve the visceral pleura at the site of adhesion with the co-resected lower lobe tissue. All surgical margins, including bronchus, vessels, and the parenchyma of the co-resected lower lobe tissue, were free of involvement, as were all excised lymph nodes. No asbestos bodies were identified in the section planes examined, though further extensive analyses are recommended to assess the extent of asbestos exposure."} +{"pid": "TCGA-A2-A0YG", "report": "The surgical specimen consisted of lymph nodes from the left axillary region and a partial mastectomy specimen from the left breast. The lymph node dissection measured 15 x 12.5 x 4.0 cm and contained multiple lymph nodes, with the majority of the tissue composed of yellow fatty material. Several lymph nodes were identified with abnormal features and were sampled for microscopic evaluation. A total of 19 sections were submitted from this portion of the specimen.\n\nThe partial mastectomy specimen measured 11.5 x 7 x 4.7 cm and included a palpable lesion located medially. This lesion measured 4.0 x 2.8 x 3.0 cm and had a firm, pink-tan, gritty cut surface. It extended to the inferior margin and was 0.4 cm from that margin grossly, 0.6 cm from the deep margin, and 0.8 cm from the superficial margin. It was greater than 1 cm away from all other margins. The lateral portion of the specimen was composed of normal-appearing fatty tissue. Sections were taken from the margins and the lesion, including perpendicular cuts through the medial, lateral, superior, and inferior aspects. One full cross-section of the lesion at its greatest dimension was also submitted for analysis, along with mirror image blocks.\n\nHistologic examination revealed cellular features including high mitotic activity and poor differentiation. Lymphovascular invasion was identified. Microscopic evaluation of the lymph nodes showed abnormal cellular infiltration in multiple nodes with evidence of multifocal extranodal extension. All surgical margins were evaluated microscopically and showed no involvement by invasive tumor. The tissue surrounding the lesion showed changes consistent with prior biopsy."} +{"pid": "TCGA-BP-5195", "report": "The specimen was received fresh for intraoperative consultation and consisted of a wedge-shaped portion of kidney measuring 6.6 x 3.7 x 2.9 cm, with a suture marking the deep margin. Attached perirenal tissue measured 12.2 x 8.5 x 2.7 cm. A separate aggregate of fibroadipose tissue measuring 11.6 x 8.4 x 4.6 cm was also present. The surgical margin was inked black and the specimen was serially sectioned, revealing a well-circumscribed, cortically based, yellow, focally hemorrhagic lesion measuring 2.4 x 2.0 x 1.9 cm. The lesion appeared confined to the renal parenchyma without extension into perirenal fat. Clearance from the resection margin was 1.1 cm.\n\nHistologic evaluation showed a neoplastic process involving the renal cortex. Nuclear morphology was consistent with an intermediate grade of differentiation. No local invasion or vascular involvement was identified. Surgical margins were free of neoplastic cells. Additional findings in the non-neoplastic kidney included focal chronic inflammation and focal superficial glomerulosclerosis. No adrenal or lymph node tissue was present for evaluation.\n\nStaging assessment indicated that the lesion was confined to the kidney, with a maximum dimension under 3 cm. No evidence of extrarenal extension or nodal involvement was found. The final assessment was based on personal examination of the slides and review of all materials."} +{"pid": "TCGA-EJ-5512", "report": "The patient had a pre-operative PSA level of 6.14 ng/ml and a prior biopsy indicating bilateral moderately differentiated prostatic adenocarcinoma. A radical retropubic prostatectomy was performed. Examination of the surgical specimen revealed an invasive adenocarcinoma with a Gleason score of 3 + 4 = 7. The tumor was poorly differentiated and measured up to 1.5 cm in greatest dimension, involving both the right and left lobes. Approximately 25% of the prostate volume was affected, with multifocal disease identified. The tumor was organ-confined without evidence of extracapsular extension or involvement of the bilateral seminal vesicles. All surgical resection margins were free of tumor, although the carcinoma was in close proximity (less than 0.1 cm) to the posterior right mid capsular margin. Perineural invasion was present, but no angiolymphatic invasion was observed. Multifocal high-grade prostatic intraepithelial neoplasia was also noted. Benign prostatic hypertrophy and chronic inflammation were present in the specimen. Pathologic staging was pT2c with no nodal metastasis (pN0) and no evidence of distant metastasis (pMX). The histologic grade was classified as G3\u20134. A total of 13 lymph nodes (7 from the right pelvic region and 6 from the left pelvic region) were examined and none showed evidence of neoplasia."} +{"pid": "TCGA-5M-AATE", "report": "The specimen includes the ascending colon, cecum, terminal ileum, and appendix, obtained via right hemicolectomy with terminal ileectomy. The overall specimen measures 22.5 cm in length and 5.5 to 7.5 cm in diameter. The terminal ileum segment is 4.5 cm long and 2.5 cm in diameter, with no identifiable macroscopic abnormalities.\n\nWithin the cecum, there is a vegetative, infiltrative, well-defined lesion that is continuous with the lumen of the appendix and located near the ileocecal valve. The lesion is 6.5 cm in size and extends through the full thickness of the bowel wall, involving the two proximal thirds of the appendix. The nearest surgical margin (ileal margin) is 5.5 cm from the lesion.\n\nMicroscopically, the lesion shows features of moderately differentiated tubular architecture with extension into the appendix. The tumor penetrates through the entire cecal wall into the pericolic fat. There is evidence of perineural and lymphovascular invasion. A moderate desmoplastic stromal reaction is present, along with mild tumoral lymphocytic infiltration.\n\nAll surgical margins are free of neoplastic involvement. Fifteen lymph nodes were identified in the pericolic fat, ranging in size from 0.3 to 1.1 cm. None show evidence of tumor involvement. The staging assessment indicates T3a pNO."} +{"pid": "TCGA-P7-A5NX", "report": "The specimen consists of a left adrenal gland with attached adipose tissue. The adrenal gland weighs 10 g and measures 5 x 3 x 2 cm. A mass is present, which is disrupted or previously transected. The greatest measurable dimension of the mass is 2.7 cm; however, due to its friable and partially missing nature, the true size may be up to 3.1 cm when including the ill-defined edges. The mass is golden tan-yellow with areas of hemorrhage and appears soft and friable on sectioning. No additional lesions or suspicious areas are identified.\n\nMicroscopic examination reveals a lesion composed of spindled and epithelioid cells arranged in a nested pattern. Nuclear atypia and necrosis are absent. Mitotic figures are very sparse, less than 1 per 50 high-power fields. There is no evidence of capsular or vascular invasion. Immunohistochemical staining demonstrates reactivity for synaptophysin and chromogranin. Negative markers include calretinin, inhibin, and Melan A. Tissue fragmentation limits full assessment of extent of involvement. Sections of the mass and surrounding adrenal tissue were submitted for analysis. A proliferation index study using Ki-67 (Mib-1) has been ordered and will be reported separately."} +{"pid": "TCGA-BJ-A3PR", "report": "The specimen consists of a total thyroidectomy with a lesion located in the right lobe measuring 2.5 cm in greatest dimension, with an additional measurement of 2 cm. Microscopic examination reveals a unifocal tumor involving the thyroid gland. The tumor extends into the perithyroidal soft tissue but does not invade skeletal muscle. There is no evidence of lymphovascular invasion. The carcinoma is focally present at the peripheral surgical margin. The remaining thyroid parenchyma shows chronic inflammation consistent with Hashimoto thyroiditis along with H\u00fcrthle cell nodules.\n\nA central lymph node was identified as negative for tumor involvement (0/1). Additionally, five benign reactive lymph nodes were retrieved from the central compartment, none of which contained tumor. Histologic evaluation confirms extrathyroidal extension and involved margins. No distant metastasis was identified. A total of six regional lymph nodes were examined, all without involvement. Selected slides were reviewed and findings are in agreement with the original assessment. An addendum clarifies that the pathologic stage is pT2 NO, without changing the prior interpretation."} +{"pid": "TCGA-DX-A6Z0", "report": "The specimen submitted is an excision from the right medial thigh, received fresh and labeled accordingly. The entire specimen measures 12.5 x 6.5 x 3.5 cm and includes an elliptical segment of skin measuring 0.5 x 2.5 cm. The skin surface is white and features an old, well-healed linear surgical scar measuring 2.5 cm in length, located 0.2 cm from the closest skin margin. Surgical margins are marked with black ink.\n\nUpon sectioning, a mass measuring 4.4 x 2.8 x 2.5 cm is identified within the subcutaneous tissue. It appears ill-defined with a soft, lobulated, and fairly homogeneous light yellow cut surface, without evidence of hemorrhage or necrosis. The tumor is noted to be diffusely infiltrating adjacent skeletal muscle and adipose tissue. Microscopically, the tumor approaches multiple inked, undesignated margins and is found to be 0.1 cm from the closest inked surgical margin on gross examination.\n\nSections submitted include representative portions of the tumor, its relationship to surgical margins, adjacent skeletal muscle, and a section of skin at the scar site. All findings are based on personal examination of the slides and review of the material provided."} +{"pid": "TCGA-EM-A22J", "report": "The specimen consists of a left hemithyroidectomy measuring 3.9 cm in greatest dimension, with additional components of the isthmus and pyramidal lobe. The total specimen weight is 18.2 grams. A single nodule measuring 2.5 cm in all dimensions is present within the left lobe. The nodule exhibits a mix of solid and follicular architecture with areas showing classical cytomorphology and oncocytic or oxyphilic features. The tumor is completely encapsulated with minimal capsular invasion noted. No lymphovascular or perineural invasion is identified, and there is no evidence of extrathyroidal extension. Surgical margins cannot be assessed due to the fragmented nature of the specimen and lack of intact capsule at the outer surface. Single cell necrosis is observed in some areas, but this is attributed to degenerative changes rather than dedifferentiation. No pathological involvement is identified in the lymph node tissue sampled from the isthmus. The remainder of the thyroid tissue appears unremarkable on gross examination. Multiple sections of the nodule and adjacent normal tissue have been preserved for further analysis."} +{"pid": "TCGA-CV-7236", "report": "A surgical pathology report describes multiple tissue specimens submitted for analysis. A right tongue biopsy consists of squamous mucosa with skeletal muscle and fibroadipose tissue, without any tumor identified. A left tongue biopsy reveals a tan, soft tissue fragment; histologic evaluation shows abnormal cellular features. A left partial glossectomy specimen measures 5.0 x 4.0 x 2.5 cm and contains a central necrotic ulcerated area measuring 3.0 x 2.3 x 1.0 cm, with an estimated depth of invasion of 1.0 cm. The lesion is focally associated with perineural changes.\n\nMargins assessed include the left buccal mucosa, retromolar trigone on the left, anterior two-thirds tongue mucosal margin, base of the tongue, ventral tongue anterior and medial margins, and anterior and lateral gingival margins. All are found to be free of tumor. Focal epithelial changes are noted at the medial ventral tongue margin, though grading is limited due to cautery and sectioning.\n\nLymph node evaluation includes several neck dissection specimens. On the right side, Level I \"A\" contains four lymph nodes, all without evidence of involvement. Level I \"B\" includes one lymph node which demonstrates involvement along with unremarkable salivary gland tissue. Level II dissection reveals thirteen lymph nodes, all without involvement. In Levels III and IV, thirteen lymph nodes are identified, with one showing involvement.\n\nOn the left side, Level I \"B\" dissection includes two lymph nodes; one shows involvement with extranodal extension. Level II \"A\" contains eight lymph nodes, two of which demonstrate involvement without extranodal extension. Level II \"B\" has two lymph nodes, both involved. Levels III and IV on the left contain four lymph nodes, none of which show involvement.\n\nAll other tissues submitted are processed and evaluated microscopically following frozen section analysis, with no additional tumor identified."} +{"pid": "TCGA-2H-A9GG", "report": "Coded sample ID: Histologic examination revealed a focus of moderately to poorly differentiated epithelial cells within Barrett\u2019s-type mucosa. The lesion measured 4.5 cm in diameter at the gastro-esophageal junction. A total of 19 lymph nodes were examined, with 4 showing evidence of involvement. The resection margins were noted to be involved."} +{"pid": "TCGA-S6-A8JW", "report": "The submitted left radical orchiectomy specimen includes a testis measuring 7.0 x 4.8 x 3.8 cm and weighing 90 grams, along with portions of the epididymis and spermatic cord. A well-circumscribed, solid mass measuring 5.4 x 4.5 x 3.2 cm is identified within the testis. The mass has a mottled red-tan to red-purple appearance and extends to the tunica albuginea but does not penetrate through it. There is no gross involvement of the epididymis or spermatic cord. Microscopically, the tumor is unifocal and does not extend beyond the testis. No venous or lymphatic invasion is identified. All surgical margins are free of tumor. Adjacent testicular tissue shows changes consistent with intratubular germ cell neoplasia. Immunohistochemical staining for CD30, alpha-fetoprotein, and human chorionic gonadotropin is negative in all tested blocks. Based on histologic and immunophenotypic features, the findings are consistent with a specific type of testicular neoplasm. Staging according to AJCC criteria classifies the primary tumor as pT1, with no assessable lymph node or distant metastatic involvement."} +{"pid": "TCGA-FY-A3YR", "report": "The thyroid specimen measured 2.7 x 2.6 x 1.5 cm on the right and 3.8 x 2.2 x 1.7 cm on the left. A central compartment specimen measured 2.5 x 2.3 x 0.7 cm. A unifocal lesion measuring 1.7 x 1.3 x 1.2 cm was identified in the right lobe, located near the superior pole and involving perithyroidal adipose tissue. The tumor had a non-encapsulated appearance and no lymphovascular invasion was noted. Margins were negative, with the closest distance to the anterior margin at 0.15 mm. Eleven lymph nodes were evaluated, with four showing evidence of metastatic involvement. In the central neck dissection, one of six lymph nodes was positive for metastasis. Multiple adenomatoid nodules were also present. Pathologic staging was determined as pT3 based on tumor size and minimal extrathyroidal extension, and pN1a due to the number of involved lymph nodes. The overall pathologic stage was classified accordingly."} +{"pid": "TCGA-85-A4PA", "report": "The lung specimen measured up to 23 x 14 x 6 cm and contained a white dense lesion measuring up to 5 x 3 cm. Microscopic examination revealed moderately differentiated non-keratinizing squamous cell carcinoma. Evaluation of five bronchopulmonary lymph nodes showed no evidence of metastasis, with all nodes demonstrating only reactive changes. The bronchial margin appeared uninvolved with normal structure noted. No venous invasion was identified. The tumor was localized without clear evidence of extension beyond the primary site. The surgical margins were free of tumor involvement. No definitive indicators of treatment effect were observed. Additional pathological findings were not specified. The specimen was obtained via pneumonectomy, and the tumor was situated in the left-lower region of the lung."} +{"pid": "TCGA-CN-4738", "report": "A total laryngectomy and bilateral neck dissection (levels 2\u20134) were performed. The left and right neck dissections included 28 and 11 lymph nodes respectively, all of which were benign. A biopsy of the left superior laryngeal nerve showed no abnormality.\n\nThe resected laryngeal specimen measured 9.0 x 7.5 x 4.0 cm and included the epiglottis to subglottis and seven tracheal rings. An irregular white ulcerated area measuring 1.2 x 0.9 cm was identified in the left hemilarynx, near the midline, involving the left ventricle and crossing the midline to involve the medial aspect of the right true vocal cord. The lesion measured 4.0 cm in greatest dimension and extended through the thyroid cartilage into anterior soft tissue. The mass was 3.7 cm from the distal tracheal margin, with the closest margin being the anterior soft tissue at approximately 0.3 cm. Histologic examination of the margins revealed no involvement, except for a small focus (<0.1 cm) seen on permanent section at the right superior margin, while frozen section of the same margin showed no abnormality. The tracheostomy site and left thyroid lobe were unremarkable.\n\nHistologically, the lesion demonstrated moderately differentiated features with vascular invasion present and perineural invasion absent. All other surgical margins, including left laryngeal wall, left inferior wall, left superior wall, and right superior wall, were free of abnormal cells. Intraoperative frozen sections of all evaluated margins confirmed no tumor presence.\n\nA total of 39 regional lymph nodes were examined and none showed evidence of involvement. The pathologic staging was determined as pT4a with pMX. No additional significant findings were noted."} +{"pid": "TCGA-AY-A54L", "report": "A right colon resection specimen was received, including a segment of large bowel with attached appendix and omentum. A mass measuring 3.4 x 2.7 x 0.7 cm was identified within the right colon. It was located 16.7 cm from the proximal margin and 8.1 cm from the distal margin. The mass extended 0.3 cm into the muscularis propria but did not fully traverse it, with a distance of 0.6 cm to the serosa. The closest margin was the mesenteric margin, which was 5.4 cm away. The surrounding pericolonic fat contained lymph node candidates, with a total of 24 lymph nodes examined, none of which showed evidence of involvement. Margins of resection were all negative: proximal margin at 16 cm, distal margin at 8.1 cm, and mesenteric margin at 5.4 cm. Additional findings included a submucosal fatty nodule and fibrous obliteration of the appendiceal lumen. Immunohistochemical staining for mismatch repair proteins showed normal expression of MLH1, PMS2, MSH2, and MSH6. No lymphovascular or perineural invasion was identified. The depth of invasion was determined to be at the junction between the muscularis propria and subserosal soft tissues. A separate segment of omental tissue was also submitted and showed no involvement. Based on available data, the pathologic TNM stage was assessed as pT2 pN0. Tissue was submitted for microsatellite instability testing, with results to be reported separately."} +{"pid": "TCGA-44-7671", "report": "The specimen includes a portion of lung tissue corresponding to the right upper and middle lobes, weighing 197 grams and measuring 19 x 11.8 x 3.5 cm. The pleural surface is tan-pink to gray-black and mottled. Two bronchial stumps are present, each approximately 1 cm in length, associated with the upper and middle lobes. In the hilar region near each bronchial stump, several gray-black, soft, rubbery lymph nodes are identified. A lesion measuring 3.2 x 2.8 x 2.2 cm is located within the middle lobe, extending to within 1 cm of the bronchial stump and reaching beneath the pleural surface but not involving it directly. The overlying pleura is marked with blue ink. The surrounding parenchyma shows spongy, tan-pink-red tissue with bleb formation in the upper lobe and no other distinct masses.\n\nSubmitted tissue blocks include margins from the bronchial and vascular regions, hilar lymph nodes from both upper and middle lobes, sections of the lesion in relation to the pleural surface and adjacent lung tissue, and representative samples from the upper and middle lobes away from the lesion. Additional specimens from level 7, R4, and R2 contain multiple small gray-black or tan-colored tissue fragments interpreted as lymph nodes.\n\nMicroscopic evaluation reveals a moderately differentiated epithelial lesion measuring 3.2 cm in greatest dimension. No pleural invasion, direct tumor extension, or vascular invasion is observed. Resection margins are free of abnormal cellular proliferation. All evaluated lymph nodes, including those from the hilar region and separately submitted stations (level 7, R4, R2), show no evidence of atypical cell clusters. Additional findings include emphysematous changes with bleb formation in the upper lobe, along with bronchiolar metaplasia and subpleural fibrosis. The case was reviewed intra-departmentally with agreement on interpretation."} +{"pid": "TCGA-ZM-AA0B", "report": "A left testicular specimen measuring 4.5x3.5x2.5 cm with a 10 cm long funiculus was examined. A 4 cm surgical incision with sutures was observed on the surface. Upon sectioning, a gray-white mass measuring 3.5x2x2 cm was identified, involving approximately two-thirds of the testicular parenchyma. Microscopic evaluation revealed the mass to consist of solid arrangements of round cells with oval, lightly stained nuclei containing visible nucleoli. The cytoplasm of these cells was moderate in amount, clear to eosinophilic. Surrounding these cell clusters were fibrous stromal bands interspersed with numerous lymphocytic aggregates. Within a single high-power field, 1 to 2 mitotic figures were noted. There was no evidence of tumor involvement in the rete testis or the spermatic cord."} +{"pid": "TCGA-A2-A1G6", "report": "The surgical specimen consists of a right modified radical mastectomy specimen measuring 26 x 18.5 x 5.5 cm in greatest dimensions. The nipple is unremarkable and located within a 19 x 11.7 cm skin ellipse. A cystic structure measuring 3 cm in diameter is identified in the 5 to 6 o\u2019clock area at the inferior margin. There is a brown discolored plaque-like area noted at the 12 o\u2019clock position. A palpable fibrous mass is present beneath a suture line, spanning approximately 6 x 5 x 3.5 cm. The superficial aspect of this mass is marked with blue ink and the deep margin with black ink. The axillary tail has been removed and marked with red ink; it does not represent a true margin.\n\nOne grossly positive lymph node is identified in the midportion of the axillary tail. The highest lymph node appears grossly negative. Tissue sampling includes sections from the nipple, several lymph nodes (some bisected), margins (deep, superficial, skin), and multiple areas adjacent to the tumor including upper inner, upper outer, lower outer, and lower inner quadrants at varying distances from the primary lesion. A cystic structure at the 5 o\u2019clock area and the plaque-like region are also sampled.\n\nAn underlying firm pink-gray mass measuring 3.5 x 3.3 x 3.1 cm is associated with the plaque-like skin lesion. This extends to within 0.8 cm of the deep margin. The central portion of the breast contains dense gray-tan fibrous tissue and multiple cysts. Further sections were submitted following initial slide review, including skin and superficial margins.\n\nMicroscopically, infiltrating components show moderately differentiated features with nuclear grade III/III and a moderate mitotic index. The superficial portion extends into the dermis while the deep margin remains free by 10 mm, with an overall invasive depth of 35 mm. Over 90% of the lesion is invasive. Evidence suggestive of lymphatic space invasion within the breast is present, though dermal lymphatic involvement is not identified. Background breast tissue shows changes consistent with proliferative fibrocystic disease. Skin margins closest to the lesion are negative.\n\nMetastatic involvement is identified in 4 out of 9 lymph nodes evaluated. A separate specimen of medial skin from the right breast includes skin and subcutaneous fat with no evidence of malignancy."} +{"pid": "TCGA-BJ-A3F0", "report": "The thyroid specimen weighed 18 grams and was entirely submitted for examination. In the right lobe, a nodule measuring 1.4 cm was identified. Microscopic evaluation showed cellular features including nuclear changes commonly seen in a specific type of thyroid lesion. The lesion was confined within the thyroid capsule without evidence of spread beyond the organ. Invasion of blood vessels or lymphatic channels was noted. In the left lobe, a separate nodule measuring 2.0 cm was present, showing benign characteristics with focal areas exhibiting oncocytic transformation. Additional findings included nodular hyperplasia and mild chronic inflammatory changes involving lymphocytes. All margins were free of abnormal cells. No lymph nodes were identified for assessment. Based on these findings, the tumor was classified as pT1b with no assessable lymph node involvement (pNX). Other associated conditions included benign adenomatous changes and thyroiditis."} +{"pid": "TCGA-56-7822", "report": "The specimen consists of a wedge resection from the right upper lobe of lung with a previously frozen tissue sample. A second resected specimen includes a right upper lobe measuring 15.0 x 11.0 x 4.0 cm, with a mass measuring 5.1 x 3.5 x 6.4 cm grossly described as gray-tan with cavitation. The tumor is located within 3.0 cm of the bronchial margin and shows no involvement of the visceral pleura. Resection margins for both bronchial and vascular sections are negative.\n\nMicroscopic evaluation reveals residual tumor in the larger resection specimen, with cellular features ranging from moderate to poor differentiation. A focus suspicious for lymphovascular invasion is noted. Three peribronchial lymph nodes are benign without evidence of malignancy. Additional lymph node stations were sampled including: one lymph node at level 9 (pulmonary ligament), three at level 8 (paraesophageal), two at level 4R (lower paratracheal), one at level 2R (upper paratracheal), and three at level 7 (subcarinal); all were benign and showed no signs of metastatic disease.\n\nA single hilar lymph node (level 10) demonstrates micrometastatic changes confined to the subcapsular sinus. No acid-fast or fungal organisms were identified in special stains performed on calcified basophilic material seen in one paraesophageal lymph node. Fourteen lymph nodes were sampled in total, with only one showing any evidence of involvement.\n\nThe primary lesion measured 1.2 cm in the initial biopsy and 6.4 cm in the final resection. Staging is based on pathological findings."} +{"pid": "TCGA-BR-8381", "report": "Patient ID: Gross Description: The specimen includes a portion of the stomach with a saucer-like lesion measuring up to 5 x 4.5 cm, showing invasion into the perigastric fat tissue. Within the fatty tissue, hyperemic lymph nodes up to 0.6 cm in size are present. The omentum appears structurally normal. Microscopic evaluation shows poorly differentiated cells with infiltration into the fatty tissue. Of the fifteen lymph nodes examined, one demonstrated involvement. Tumor characteristics include ulceration, and the extent of growth reaches the subserosal layer. No venous invasion is observed. Surgical margins are free of involvement. Lymph node involvement was identified at the greater and lesser curvature (1 out of 15). Other features such as lymphatic or perineural invasion were not specified. There is no evidence of treatment effect, and no additional findings are reported."} +{"pid": "TCGA-14-1795", "report": "The specimen consists of two parts. The first specimen is composed of three pieces of soft pink tissue measuring a total of 1.0 x 0.8 x 0.4 cm. A portion was used for touch preparation evaluation and a representative section was submitted for frozen section analysis. The remaining tissue was placed in a cryoblock and submitted as cassette \"FS1A\" along with the rest of the specimen in cassette \"1B\". \n\nThe second specimen consists of multiple fragments of hemorrhagic brain tissue, with the largest fragment measuring 3.0 x 2.0 x 1.5 cm and smaller fragments totaling 2.2 x 0.7 x 0.5 cm. Serial sections of the largest fragment revealed an irregular, poorly defined mass with yellow discoloration that extended to the resection margins. This fragment was inked prior to sectioning and the entire specimen was submitted across cassettes \"2A\" through \"2F\".\n\nMicroscopic examination was performed on both specimens. Cellular features included pleomorphic cells with nuclear atypia and increased mitotic activity. Necrosis and microvascular proliferation were identified. Sections showed infiltration into surrounding tissue with unclear margins of resection. No definitive classification or diagnosis was provided in the microscopic findings."} +{"pid": "TCGA-ET-A39J", "report": "The specimen consisted of a total thyroidectomy with involvement of both the right and left lobes. The tumor measured 3.0 cm in greatest dimension and was present in the right lobe. The disease process was multifocal in nature. No lymph nodes were submitted for evaluation. Pathologic staging indicated a primary tumor stage pT2, reflecting a tumor greater than 2 cm but less than 4 cm confined to the thyroid gland. Regional lymph node involvement could not be assessed (pNX), and distant metastasis could not be determined (pMX). Surgical margins were free of involvement. There was no evidence of venous or lymphatic invasion identified. Additionally, parathyroid tissue was noted in proximity to the right lower thyroid lobe."} +{"pid": "TCGA-BJ-A290", "report": "The specimen consists of a total thyroidectomy weighing 53.2 grams. A neoplasm measuring 4.5 cm is identified in the left lobe, composed of cells with tall cell morphology and features concerning for aggressive behavior. The lesion demonstrates extension into adjacent skeletal muscle surrounding the thyroid and reaches the surgical margin. Three lymph nodes attached to the left lobe contain metastatic involvement by this neoplasm, without evidence of extranodal extension. No residual normal parathyroid tissue is identified; however, one normocellular parathyroid gland is noted attached to the left lobe. Additional findings include nodular changes within the thyroid parenchyma.\n\nHistologic evaluation reveals pathologic staging as pT3 with regional lymph node involvement (pN1a), based on three lymph nodes examined and all showing involvement. Distant metastasis staging cannot be assessed (pMX). Vascular invasion is present. Molecular testing of the specimen detected a BRAF V600E mutation, while mutations in NRAS61, HRAS61, and KRAS12/13 were not identified. Fluorescence in situ hybridization (FISH) testing was negative for RET/PTC rearrangement."} +{"pid": "TCGA-BC-A69H", "report": "A right hepatic lobe resection specimen measuring 18 x 13 x 11 cm and weighing 850 grams was received. A single mass was identified within segments 4\u20138 of the liver. The mass measured 11.2 x 8.6 x 7.2 cm, was yellow-tan in color, poorly circumscribed, with a central scar and areas of focal hemorrhage. Less than 10% of the mass showed necrosis. The mass was located adjacent to the capsule but did not penetrate through it, with the thinned capsule measuring approximately 4.5 x 4.5 cm at the dome. The closest surgical margin was less than 1 mm from the mass. Histologically, the lesion showed features of a high-grade neoplasm, with poor differentiation and an Edmondson-Steiner grade of 4 out of 4. Vascular invasion was extensive, while perineural and capsular invasion were not identified. There was no evidence of satellite lesions. Lymph nodes were not present for evaluation. The background liver showed moderate macrovesicular steatosis, focal ballooning degeneration of hepatocytes, and at least bridging fibrosis. Additional special stains revealed mild to moderate iron deposition in hepatocytes and Kupffer cells, without PAS-positive cytoplasmic inclusions. Reticulin staining did not show significant hepatic plate disruption.\n\nA second specimen from segment 4B of the liver was also received. It was a wedge-shaped piece measuring 7.2 x 2.7 x 2.6 cm and weighed 28.4 grams. No mass or lesion was identified upon serial sectioning. Microscopic evaluation of this specimen also showed moderate macrovesicular steatosis but no evidence of malignancy. Margins from both specimens were microscopically negative, although the parenchymal margin in the first specimen was extremely close at 0.13 mm. Based on available data, the pathologic TNM stage was determined as pT2 pNX, though this may be subject to revision pending further clinical correlation."} +{"pid": "TCGA-56-7579", "report": "A pneumonectomy specimen with regional lymphadenectomy was examined. The lung specimen weighed 628 grams and measured 24 x 15 x 7 cm. A mass measuring 7.5 x 6 x 6 cm was identified in the left upper lobe and mainstem bronchus. The tumor did not involve the pleural surface but approached within 0.3 cm of the posterior apical pleura and 0.7 cm from the inferior lobe. The tumor obstructed the upper lobar bronchus and extended laterally along the bronchi into the lung parenchyma. No visceral pleural invasion was identified. All surgical margins, including bronchial and vascular margins, were negative for involvement.\n\nLymph nodes were evaluated from multiple stations, including subcarinal, hilar, paratracheal, subaortic, intralobar, pulmonary ligament, and para-aortic regions. Of the thirty lymph nodes assessed, three hilar and peribronchial lymph nodes contained metastatic disease. Lymphovascular invasion was present.\n\nThe tumor was unifocal and moderately differentiated in morphology. Based on size and extent, the primary tumor was classified as pT3. Regional lymph node involvement was staged as pN1 (3/30 positive). Distant metastasis could not be assessed (pMX). The overall pathologic stage was IIIA. Additional findings included pulmonary edema and post-obstructive pneumonitis."} +{"pid": "TCGA-EI-7004", "report": "A histopathological examination was performed on a resected specimen consisting of the rectum and sigmoid colon, measuring 26 cm in length, along with associated mesentery and periintestinal tissue measuring 20 x 11.7 cm. A lesion measuring 1.6 x 1 x 1.8 cm was identified within the mesentery. Another flat lesion measuring 7.8 x 2 x 0.6 cm was found infiltrating through the full thickness of the intestinal wall. This lesion completely encircled the intestine, causing significant luminal narrowing. It was located 14.5 cm from one resection margin and 4.3 cm from the other, with the minimum surgical margin being 3 cm.\n\nMicroscopic evaluation revealed a poorly differentiated epithelial neoplasm with mucin-producing features. The lesion infiltrated deeply into the muscularis propria and serosa of the colorectal flexure, extending into the adipose tissue of the mesentery and perirectal fat. No involvement was observed at the intestinal resection margins. Lymph node assessment was complicated by extensive nodal concretions; however, multiple lymph nodes showed evidence of neoplastic infiltration, including capsular and perinodal adipose tissue involvement.\n\nThe tumor demonstrated advanced local invasion with regional lymph node spread. Pathologic staging indicated deep transmural invasion with extensive nodal involvement."} +{"pid": "TCGA-AA-3667", "report": "A resected section of the colon was examined and showed a lesion with histological features indicating a moderately differentiated adenocarcinoma. The tumor was located within 8 cm of a resection margin and extended circumferentially along a segment of the intestinal wall measuring 7 cm in length. The lesion demonstrated invasive growth involving the muscularis propria. Both the oral and aboral resection margins were free of tumor involvement. A total of twenty-two mesocolic lymph nodes were assessed and found to be negative for tumor; however, they exhibited reactive changes. The pathological staging was determined as pT2 pN0 (0/22) with no evidence of lymphovascular or perineural invasion; histological grade was G2. An additional evaluation was conducted regarding microsatellite status, and the findings did not show any significant indicators of a hereditary tumor predisposition, particularly of a certain familial type."} +{"pid": "TCGA-IB-A7LX", "report": "A lymph node (#8) was received, measuring 2.4 x 1.9 x 0.5 cm. Microscopic evaluation identified the presence of invasive cells within the extranodal soft tissue. Two lymph nodes were identified in the portal specimen, measuring up to 2.2 x 1.0 x 0.5 cm, and both were unremarkable. The Whipple resection specimen included a portion of pancreas and small intestine. The pancreatic specimen measured 7.0 x 5.5 x 4.0 cm, and a white mass was observed measuring 5.5 x 4.5 x 4.0 cm. This mass extended to the uncinate margin and was located 1.7 cm from the pancreatic body margin. Involvement of the common bile duct and ampulla of Vater was noted. Invasion into the duodenal wall, retroperitoneal soft tissue, and extrapancreatic common bile duct was documented. A retroperitoneal soft tissue margin measuring 1.1 x 0.5 x 0.4 cm was also submitted and showed evidence of invasion. The gallbladder specimen measured 8.5 x 2.9 x 1.6 cm and displayed features consistent with acute and chronic inflammation, with no malignant cells identified. Surgical margins were assessed: the uncinate process (retroperitoneal) margin was involved. No lymph-vascular invasion was seen, though perineural involvement was present. Six regional lymph nodes were evaluated, four of which contained abnormal cells. The tumor was classified as moderately differentiated and was found to extend beyond the pancreas without involvement of the celiac axis or superior mesenteric artery. Tissue banking included portions of the mass and small bowel. Multiple sections were taken from various resection margins including the common bile duct, proximal and distal small intestine, pancreatic body, uncinate margin, and vessel bed."} +{"pid": "TCGA-IB-A5SP", "report": "The specimen consists of a Whipple resection including the head of the pancreas, duodenum, gallbladder, and adjacent large vessels. A poorly defined fibrous white mass measuring 2.5 x 2.0 x 3.0 cm is identified within the pancreatic head. It completely surrounds the pancreatic duct and abuts the bile duct. Microscopically, the lesion demonstrates invasive growth into peripancreatic and retroperitoneal soft tissues with involvement of the uncinate process margin. Perineural invasion is present in the groove region with extension involving the partially resected superior mesenteric vein wall.\n\nA total of 15 lymph nodes were examined; none showed evidence of malignancy. No lymphovascular invasion is identified. The tumor measures 3 cm at its greatest dimension on gross examination and microscopically displays moderately differentiated features. Surgical margins are focally involved, specifically at the uncinate process. Adjacent pancreatic tissue shows high-grade pre-invasive changes. Multiple tissue sections were submitted for evaluation, including margins, lymph nodes, and representative areas of the tumor in relation to surrounding structures."} +{"pid": "TCGA-VQ-A8DT", "report": "The specimen from the stomach (body) shows a poorly differentiated adenocarcinoma with an intestinal pattern of Laur\u00e9n. The tumor measures 8.6 cm in greatest dimension and extends to the serosa. Angiolymphatic invasion is present, while perineural invasion is not detected. Surgical margins are free of neoplastic involvement. The omentum does not show evidence of tumor involvement.\n\nLymph node assessment reveals involvement in several regions: 4 out of 19 lymph nodes along the greater curvature, 3 out of 27 along the lesser curvature, and 2 out of 3 in chain 12A. In contrast, no neoplastic cells are found in chain 8P (0 out of 4) or in a fragment of pancreatic tissue associated with chain 8A. Additionally, the gallbladder shows chronic cholecystitis, and the esophageal margin is devoid of neoplasia."} +{"pid": "TCGA-CN-6013", "report": "A mandibulectomy and neck dissection specimen was received, consisting of 11 parts. Gross examination of the primary resection revealed a white firm mass measuring 2.8 cm in maximum dimension involving the lateral gingiva and buccal mucosa with focal extension into the perimandibular soft tissue and mandibular bone. The lesion was 0.2 cm from the lateral soft tissue margin and 0.1 cm from the posterior soft tissue margin. Two lymph nodes were identified grossly as involved: one adjacent to the submandibular gland measuring 3.8 cm with necrosis and cystic change, and another in the anterior inferior soft tissue measuring 1.8 cm with possible extranodal extension. A total of 26 lymph nodes were examined microscopically across multiple levels; 2 contained metastatic disease with extracapsular spread noted.\n\nHistologic evaluation confirmed a moderately to poorly differentiated invasive squamous cell carcinoma involving the right lateral gingiva, buccal mucosa, perimandibular soft tissue, and focally the mandibular bone. Bone margins were free of tumor involvement. Other margins, including anterior and posterior bone marrow, floor of mouth, buccal mucosa, and medial and lateral mucosal margins, were negative for tumor. No perineural invasion was observed, but vascular invasion was present. Microscopic evaluation of intraoperative frozen sections of margins correlated with final findings.\n\nImmunohistochemical staining demonstrated membranous positivity for EGFR (3+), while p16 and HPV in situ hybridization were negative. Fluorescence in situ hybridization (FISH) analysis using LSI EGFR/CEP7 dual-color probes showed no evidence of gene amplification or polysomy. A total of 61 cells were analyzed, with all demonstrating disomy and a signal ratio of 1.04.\n\nSynoptic data indicated a pT4a classification based on tumor size and local extension, with pN2b staging due to the presence of metastases in two regional lymph nodes and extracapsular spread. Distant metastasis could not be assessed (pMX). The submandibular gland was unremarkable, and benign parotid acinar inclusions were noted. Additional microscopic evaluation of dysplastic changes showed moderate to severe dysplasia at the posterior mucosal margin and mild dysplasia at the new posterior medial mucosal margin."} +{"pid": "TCGA-C5-A1MI", "report": "The surgical pathology report includes multiple biopsy specimens from the cervix. The specimens show moderately differentiated carcinoma with varying degrees of invasion. No lymphovascular space invasion is identified. The depth of invasion could not be determined from the biopsies. The patient is a female with a history of high-grade squamous intraepithelial lesion on Pap smear and a large lesion located on the anterior cervix. Six slides were received for evaluation, each corresponding to different biopsy sites. Cellular morphology shows moderate differentiation across all samples."} +{"pid": "TCGA-B0-4693", "report": "The specimen from the rib consists of fibrocartilaginous tissue without notable pathologic changes, along with a fragment of bone assessed by gross examination only. \n\nA left radical nephrectomy specimen shows a large neoplasm with areas of necrosis and hemorrhage. The tumor exhibits nuclear features corresponding to the highest grade evaluated. The maximum dimension of the lesion is 13.0 cm. The growth extends into the renal sinus fat, penetrates the renal capsule, and involves the perirenal fat, coming into close proximity with the adrenal gland. There is no evidence of involvement of the renal vein; however, angiolymphatic invasion is present. All surgical margins are free of tumor. The adjacent kidney demonstrates changes related to the presence of the lesion. The adrenal gland, although unremarkable histologically, does not show signs of tumor involvement. Lymph node staging was not possible as no lymph nodes were involved among those examined."} +{"pid": "TCGA-60-2695", "report": "The specimen included lymph nodes from multiple regions, including right and left distal paratracheal, subcarinal, level 2, level 5, and level 9. All lymph nodes measured less than 1 cm in greatest dimension and were unremarkable on gross examination. Touch preparations were obtained from select lymph nodes. A lobectomy specimen of the left upper lobe weighed 174 grams and measured 15.0 x 10.0 x 4.0 cm. A well-circumscribed gray-white mass measuring 3.3 x 2.5 x 2.4 cm was identified near the pleural surface and was within 2.8 cm of the bronchial margin. Serial sectioning confirmed the mass abutted the inked margin but did not extend to the bronchial margin. Dissection of the hilar region revealed 12 lymph nodes ranging from 0.2 cm to 0.7 cm in size.\n\nHistologic evaluation showed a poorly differentiated tumor with basaloid morphology. Immunohistochemical staining demonstrated positivity for CD56 (spotty), high molecular weight cytokeratin (34BE12), CAM 5.2, and p63. Synaptophysin and chromogranin A were negative. No angiolymphatic invasion was identified. The bronchial margin was free of tumor involvement. Seven peribronchial lymph nodes were negative for tumor involvement. Additional lymph nodes from levels 2, 4R, 4L, 5, 7, and 9 were also negative. Pathologic staging was determined as pT2, N0, MX. Non-neoplastic findings included emphysematous changes in the lung tissue."} +{"pid": "TCGA-L9-A8F4", "report": "The specimen consists of a wedge resection from the left upper lobe of the lung, measuring 14.0 x 3.5 x 2.0 cm and weighing 31 grams. A tumor mass is identified within the lung tissue, measuring 2.7 cm in greatest dimension. The tumor has a tan-white to mottled gray-black appearance and extensively involves the pleural surface. Visceral pleura invasion is present. The tumor comes within 1.0 cm of the staple margin, which was inked black; however, the closest distance from the invasive lesion to the parenchymal margin is 8 mm. The tumor demonstrates intratumoral large vessel invasion and contains an area of necrosis.\n\nTwo lymph nodes were submitted from level V and measured 6.0 x 0.3 x 0.3 cm and 0.8 x 0.3 x 0.2 cm respectively. Both lymph nodes are anthracotic and show no evidence of metastatic involvement. Additionally, a biopsy of the left pleura was submitted, consisting of fibroconnective tissue with chronic inflammation; no malignant cells were identified.\n\nThe wedge resection margins are free of invasive disease. Histologic evaluation reveals poorly differentiated morphology. No treatment effect was observed. Lymphovascular invasion is present. A total of two lymph nodes were examined and none showed signs of involvement.\n\nGross examination shows emphysemic changes in the adjacent lung parenchyma. Representative sections of the tumor, margins, and surrounding lung tissue were sampled and submitted for analysis. Intraoperative consultation confirmed the presence of tumor and adequacy for tissue banking purposes."} +{"pid": "TCGA-WB-A81G", "report": "The pathology report describes a reviewed specimen from the left adrenal gland. The tumor measures 5 x 4.1 x 4 cm and appears tan in color, surrounded by a thin layer of normal adrenal tissue. Microscopic examination reveals the tumor is composed of nests of cells arranged in a zellballen pattern, separated by thin bands of connective tissue. Some of the tumor cells are notably enlarged; however, no mitotic figures or areas of necrosis are observed. Multiple sites of capsular disruption are present, with evidence of tumor extending into surrounding adipose tissue. Immunostaining demonstrates strong positivity for synaptophysin and chromogranin. Scattered sustentacular cells show positivity for S100. Positivity for MART1 is limited to the adjacent adrenal parenchyma. The tumor shows weak staining for inhibin, whereas the normal adrenal tissue demonstrates strong inhibin reactivity. The Ki67 proliferation index is less than 1%."} +{"pid": "TCGA-FZ-5924", "report": "The resected specimen includes the head of the pancreas and a portion of the small bowel. A 3.2 cm invasive lesion, moderately to poorly differentiated, is identified in the pancreatic head. The lesion measures 3.0 x 1.9 cm and extends through the duodenal wall into the submucosa and surrounding peripancreatic fat. Lymphovascular and perineural invasion are present.\n\nThe lesion is located within 0.5 mm of the pancreatic margin and within 1.0 mm of the vascular groove resection margin. All other surgical margins, including the common bile duct, proximal and distal duodenum, and uncinate process/retroperitoneal margin, are free of involvement. Two out of eighteen lymph nodes examined show evidence of involvement. No definitive assessment is available for distant metastasis.\n\nAdditional findings include chronic cholecystitis in the gallbladder specimen and the presence of pancreatic intraepithelial neoplasia (highest grade PanIN 3). Venous and lymphatic vessel invasion are noted, and perineural invasion is also observed. Review of frozen sections at second level demonstrated microscopic foci of atypical glands near the pancreatic margin, although the initial frozen section was inconclusive. This case was subject to a 5% pre-sign-out quality control review."} +{"pid": "TCGA-CN-6019", "report": "A composite resection of the left oral cavity included a lesion measuring 3.5 cm in greatest dimension. Microscopic evaluation revealed an infiltrative growth pattern with keratinizing, moderately differentiated features involving the left oral tongue, floor of mouth, and oropharynx. The bone margin was free of involvement. Perineural invasion was identified, while vascular invasion was not present. The tumor extended to the left gingival, left lateral, and medial deep soft tissue margins. A total of 45 lymph nodes from the left and right neck dissections (levels 1 through 4 and level 2B) were examined, and none showed evidence of metastasis. Additional excisional specimens from the left floor of mouth, additional deep margin, mylohyoid, additional left gingival margin, and right external jugular nodes did not show any residual tumor. Intraoperative frozen section analysis confirmed the presence of malignant cells at certain deep soft tissue margins, while other margins were benign. The submandibular gland showed no significant pathologic changes. No tumor was identified in the remaining excised parts."} +{"pid": "TCGA-HU-8249", "report": "The specimen consists of a total gastrectomy. The tumor is located in the middle third, centered at the mid-body along the lesser curvature. Grossly, it corresponds to Borrmann type 2. Histologically, the lesion shows tubular growth with moderate differentiation. According to Lauren classification, the morphology is consistent with intestinal type. The tumor exhibits a mixed expanding and infiltrative growth pattern. It measures 7.4 x 6.5 cm. The depth of invasion extends to the subserosa (pT3). Resection margins are free of tumor; the distal margin measures 8.2 cm and the proximal margin 1.9 cm. Regional lymph node evaluation reveals metastasis in 5 out of 99 nodes (pN2), specifically 5 out of 47 from the lesser curvature, while no metastases are identified in the greater curvature or in lymph nodes #11 and #12. Lymphatic invasion is present and mild. Venous invasion is also present, graded as moderate. Mild perineural invasion is observed. Additional findings include absence of tumor in the spleen and in a biopsied \"anvil ring\" specimen. An accessory spleen measuring 0.5 x 0.4 cm is noted. Pit dysplasia is present in adjacent mucosa. Biopsy of the jejunum reveals no tumor involvement. Immunohistochemical stains performed include CD10, MUC2, MUC5AC, MUC6, and C-erb B2."} +{"pid": "TCGA-A8-A07W", "report": "The left breast excision material contains a moderately differentiated invasive lesion measuring 3 cm, with no evidence of lymphatic or vascular invasion. The margins are clear, with the tumor well within healthy tissue. A multifocal intraductal component is present, non-high-grade, with a maximum size of 5 mm and comedo necrosis; this does not extend beyond the main tumor mass. Histological classification is G2, pT2, with no lymphatic (pL0) or vascular (pV0) involvement. Lymph node status is uncertain (pNX), and distant metastasis cannot be assessed (pMX). Resection margins are negative (R0)."} +{"pid": "TCGA-OL-A6VO", "report": "The specimen consists of multiple tissue samples from the right breast and axillary region. Five lymph nodes from sentinel node #1 were identified, all reactive without evidence of tumor involvement. Lymphovascular invasion was noted in one lymph node vessel with a small cluster of cells measuring 0.12 mm within the sinus. Sentinel nodes #2 and #3 each contained one reactive lymph node, both without any sign of tumor. An excision from the anterior margin of the right breast showed benign findings including columnar cell changes, blunt duct adenosis, and apocrine metaplasia.\n\nA lumpectomy specimen from the right breast contained a firm, tan lesion measuring 1.9 x 1.7 x 1.5 cm. Histologic evaluation revealed a high-grade (grade III) invasive carcinoma with necrosis. Adjacent to this lesion was an area of intraductal proliferation with high nuclear grade and solid pattern, showing necrosis and cancerization of lobules. The invasive component was closest to the posterior margin at 0.3 mm, while all other margins, including the anterior margin, were free of tumor. No tumor was identified at the site of the metallic clip or along other resection margins.\n\nLymphovascular invasion was present in the axillary lymph node. Special studies showed no expression of estrogen or progesterone receptors, and Her2/neu analysis by FISH showed no amplification (ratio 1.23). Seven sentinel lymph nodes were examined and none contained tumor cells. Based on AJCC 7th edition staging, the pathologic stage was determined as pT1cNO(sn)MX.\n\nGross measurements of the invasive lesion were consistent with the histologic findings. The lumpectomy specimen weighed 45.4 grams and measured 7 cm medially to laterally, 5.8 cm superior to inferior, and 2.7 cm anterior to posterior. The lesion was located in slices 3 and 4, centered around the wire and metallic clip. Surrounding breast tissue appeared unremarkable. All blocks were submitted for review and no additional lesions were identified."} +{"pid": "TCGA-EL-A3CS", "report": "A female patient underwent surgical resection including a completion thyroidectomy, radical resection of the trachea, esophageal resection, and partial laryngectomy. A lymph node dissection was performed in the right neck, levels II, III, and IV. In total, 20 lymph nodes were examined across all specimens: 1 from level II, 3 from levels II/III/IV combined, and 16 from the thyroidectomy specimen. No tumor involvement was identified in any of the lymph nodes.\n\nThe resected thyroid specimen measured 4.5 x 5.0 x 3.5 cm and included attached soft tissue and muscle. A hemorrhagic, friable, light-tan mass measuring approximately 3.0 x 2.0 x 4.0 cm was observed. The lesion extended into the perithyroid soft tissue and appeared to abut or superficially involve the anterior trachea; however, no involvement of the inner tracheal surface was seen. The surgical margins did not show evidence of tumor involvement.\n\nSections of the tumor, trachea, and surrounding soft tissue were submitted for analysis, along with representative sections of lymph nodes from various locations within the specimen. All findings were negative for tumor presence."} +{"pid": "TCGA-BH-A1FM", "report": "The specimen submitted was a right modified radical mastectomy. The tumor measured 2.5 x 2.5 x 2.0 cm and another focus measuring 0.5 x 0.5 cm. Histologic evaluation revealed infiltrating ductal-type carcinoma with poor architectural and nuclear differentiation. There was extensive intraductal component involving more than 25% of the lesion, composed of both comedo and non-comedo patterns. Angiolymphatic invasion was identified. Microcalcifications were associated with the lesion. Margins of resection were negative for involvement; however, the tumor approached the posterior margin closely at 1.0 mm. The skin, including the nipple and areola, showed involvement by the lesion. Fibrocystic changes were also present. Of the lymph nodes retrieved (ten total), eight contained metastatic involvement with extracapsular extension observed in five of the positive nodes.\n\nImmunohistochemical analysis demonstrated estrogen receptor positivity with approximately 50% staining, while progesterone receptor staining was absent."} +{"pid": "TCGA-BA-5557", "report": "Biopsy specimens were obtained from multiple sites including the oral cavity, tongue, and neck regions. Microscopic evaluation of these specimens revealed no evidence of malignancy in most areas, with findings consistent with benign tissue and chronic inflammation. Lymph node specimens from various levels of the right neck were also examined. A total of 34 lymph nodes were assessed across all levels; metastatic involvement was noted in one out of eight lymph nodes from Level 2, measuring 1.1 cm in greatest dimension. This lymph node showed necrosis and focal cystic change but no extracapsular extension.\n\nA resected specimen from the right side of the tongue demonstrated a 2.0 cm ulcerated lesion on the mucosal surface. Histologically, the lesion exhibited moderately differentiated keratinizing features and extended 1.6 cm into the tongue muscle. No angiolymphatic or perineural invasion was identified. The closest margin was 0.5 cm at the deep/inferior aspect, with all other margins being more than 1.0 cm. Adjacent to the lesion, there was evidence of in situ changes within the mucosa.\n\nAdditional testing for high-risk human papillomavirus and p16 expression was performed. The HPV immunostain was negative, and p16 staining showed only 2+ positivity in approximately 50% of cells, which is not considered diagnostic of a positive result."} +{"pid": "TCGA-EA-A3HT", "report": "The specimen consists of cervix tissue obtained from a hysterectomy with bilateral salpingo-oophorectomy. The lesion measured 1 x 2 x 2 cm and was located in the cervix. Microscopic examination revealed well-differentiated cells arranged in a specific pattern. A total of nine regional lymph nodes were examined, and none showed evidence of metastatic involvement. Information regarding tumor extent, lymphatic or venous invasion, margins, neo-adjuvant treatment, and additional findings was not provided."} +{"pid": "TCGA-DJ-A13P", "report": "The clinical history indicates a patient with a prior lesion. The submitted specimen includes a total thyroid gland. Gross examination reveals the right lobe measuring 5.0 x 2.0 x 1.5 cm, left lobe 3.5 x 1.7 x 1.0 cm, and isthmus 2.0 x 1.5 x 0.7 cm. Serial sectioning identifies a well-circumscribed, tan, firm, spherical mass 1.5 cm in diameter located in the inferior pole of the right lobe near the isthmus. The mass approaches but does not involve the inked surface. Microscopic evaluation shows classical and follicular variant features with well-differentiated morphology. No mitotic activity or tumor necrosis is identified. The lesion focally extends into adjacent soft tissue but without evidence of vascular invasion. All surgical margins are free of involvement. A separate focus of small tumor is noted in the left lobe. Multiple microscopic foci of disease are present. The non-neoplastic thyroid tissue appears unremarkable. Parathyroid tissue is not identified. The report is based on direct examination of the specimen."} +{"pid": "TCGA-2Z-A9JQ", "report": "The specimen consists of a right kidney with moderate perinephric soft tissue, weighing 462.3 grams and measuring 16.5 x 9.5 x 6.7 cm. The adrenal gland is non-intact and ragged, measuring 3 x 1.5 x 1 cm. A nodule located at the inferior pole measures 3.1 x 2.6 x 2.5 cm and is described as pale tan, solid, and smooth with scant necrosis (5%) and focal hemorrhage. Microscopically, the lesion demonstrates papillary architecture. The tumor is confined to the kidney without involvement of the renal capsule, perinephric fat, renal pelvis, calices, or pelvic fat. Necrosis is present in approximately 5% of the lesion. Nuclear grading is II-III, predominantly II.\n\nAll vascular, ureteral, and surgical margins are free of tumor involvement. There is no evidence of sarcomatoid differentiation, tumor extension beyond the kidney, perineural invasion, angiolymphatic invasion, or lymphovascular invasion. The adrenal gland is uninvolved. Regional lymph nodes could not be assessed. No distant metastasis is identified.\n\nAdditional findings include multiple benign cortical cysts in the superior and middle poles, measuring 1 to 2.5 cm in diameter, with clear serous contents and smooth linings. The renal cortex measures 8 mm in thickness. A 5 mm calculus is present in the renal pelvis without associated constriction or dilation of the calices. The external segment of the ureter is patent. The renal vein shows firm consistency with moderate atherosclerotic changes, appearing 40\u201350% occluded.\n\nImmunohistochemical staining performed on selected blocks using cytokeratin 7, cytokeratin 20, AMACR, and vimentin supports the histologic findings. Representative sections from all margins and relevant structures were submitted for evaluation. Pathologic staging indicates the lesion is confined to the kidney, with a maximum dimension of 4 cm or less."} +{"pid": "TCGA-HC-8260", "report": "The prostatectomy specimen weighed 35.7 grams and measured 4.3 x 4.3 x 3.5 cm. The gland was examined following serial sectioning from apex to base. A focally cystic cut surface was noted, with diffuse periurethral nodularity; no discrete mass was identified. Histologic evaluation of the peripheral and apical regions revealed a cellular proliferation present bilaterally, involving approximately 25% of the gland. Microscopically, the primary pattern showed moderate differentiation (3/5), with a secondary pattern showing lower differentiation (4/5). The combined score reflected this grading. Extensive perineural invasion was observed, along with focal high-grade prostatic intraepithelial neoplasia. There was no evidence of extraprostatic extension, seminal vesicle involvement, or lymphovascular space invasion.\n\nMargins were assessed, with involvement identified at the left posterior apical margin. Additional positive findings were present in multiple areas measuring less than 0.05 cm bilaterally. Nine pelvic lymph nodes were evaluated and showed no evidence of malignant involvement. All submitted tissue from the right lateral margin showed no signs of malignancy. No treatment-related changes were observed.\n\nThe specimen was fully processed and submitted for histologic analysis. The soft tissue from the right lateral margin measured 1.3 x 1.0 x 0.7 cm and was entirely evaluated. Pelvic lymph nodes, ranging in size from 0.1 to 2.5 cm, were submitted across multiple cassettes. The prostate was inked for orientation, with sections taken from various standardized regions for thorough assessment."} +{"pid": "TCGA-UW-A7GR", "report": "The right kidney specimen measured 15.5 x 9.0 x 7.0 cm and weighed 450 grams. A single circumscribed tan/orange mass with focal hemorrhage was identified in the lower pole, measuring 6.0 x 5.0 x 4.5 cm. The mass was confined to the kidney, expanding but not breaching the renal capsule. No involvement of perirenal adipose tissue, Gerota's fascia, renal vein, ureter, or other surrounding structures was observed. Surgical margins were negative for tumor involvement, with the closest approach being less than 0.1 cm from the anterior surface of the perirenal adipose margin. Adjacent renal parenchyma appeared unremarkable without additional nodules or cysts.\n\nMicroscopic evaluation showed a well-circumscribed lesion with nuclear grade 2 features. Histologic analysis confirmed absence of invasion into surrounding tissues including perirenal fat, Gerota\u2019s fascia, renal vein, and ureter. No lymphatic or vascular invasion was identified. All surgical margins\u2014perirenal adipose tissue, Gerota's fascia, renal vein, renal artery, and ureter\u2014were free of tumor. Additionally, a small 2 mm focus of distinct cellular morphology was noted in the medullary pyramid, showing characteristics of a non-malignant interstitial cell lesion.\n\nOne hilar lymph node was identified and entirely submitted for examination. It showed no evidence of abnormal cellular infiltration or suspicious morphology. Other structures, including portions of the renal artery, vein, and ureter, did not show any significant findings. A small 0.5 cm white nodule in the central renal parenchyma was sampled and found to be unremarkable. All other submitted tissue blocks showed no additional significant pathology."} +{"pid": "TCGA-BP-5198", "report": "The specimen from the right upper pole of the kidney measured 6.5 x 6 x 5.5 cm and was wedge-shaped, with sutures marking the deep and vascular margins. The tumor measured 6.0 x 4.5 x 4.0 cm, was well-circumscribed and encapsulated, with tan-yellow to orange cut surfaces showing areas of hemorrhage and necrosis. The distance from the tumor to the resection margin was 0.4 cm. Tumor was present at the parenchymal margin. A tumor embolus was identified grossly within the lumen of a vessel. No adrenal gland tissue was identified.\n\nMicroscopically, the tumor showed nuclear features consistent with high-grade morphology. Invasion into the renal sinus fat and multiple muscular branches of the renal vein within the sinus was observed. The non-neoplastic kidney showed cortical scarring, benign cysts, and mild arteriosclerotic changes.\n\nA separate specimen labeled as pericaval lymph nodes contained multiple firm nodules ranging from 0.6 to 2.6 cm in greatest dimension. All lymph nodes examined were uninvolved. A total of nine lymph nodes were evaluated.\n\nThe surgical specimen included sections from the tumor, adjacent margins, and representative sections for analysis. No other significant findings were noted in the submitted tissues."} +{"pid": "TCGA-IZ-A6M8", "report": "The specimen consists of a right radical nephrectomy measuring 18.0 x 10.0 x 7.0 cm in total, with the kidney proper measuring 9.0 x 5.0 x 4.0 cm. The ureter is present and measures 2 cm in length. No lymph nodes were identified at the hilum. On bivalving the kidney, there is an encapsulated, well-circumscribed tan/yellow mass measuring 2.5 x 2 x 2 cm located near the upper pole. This mass appears to be in close proximity to the renal capsule but does not extend beyond it. Adjacent to the mass is a cystic structure measuring 2.5 cm, lined by tan, smooth tissue without any papillary projections or solid components. The mass is located 3.8 cm from the UP junction. Additional cortical cysts are present, ranging in size from 0.2 cm to 0.5 cm. A small nodule measuring 0.5 cm is noted on the opposite pole, extending to the capsule and adjacent fatty tissue.\n\nHistologically, the mass demonstrates a papillary growth pattern. Nuclear grading according to the Fuhrman system is grade 2 out of 4. There is no lymphatic or vascular invasion identified. The resection margins are free of abnormal tissue. No sarcomatoid differentiation is observed.\n\nStaging classification indicates a T category of pT1a (tumor less than 4 cm confined to the kidney), with no assessment of lymph node involvement (pNX) or distant metastasis (pMX). \n\nEvaluation of non-neoplastic renal parenchyma reveals diffuse and early nodular mesangial sclerosis, likely representing early diabetic glomerulosclerosis. Additional findings include focal global glomerulosclerosis affecting approximately 80% of glomeruli, tubular atrophy, interstitial fibrosis involving more than 60% of the parenchyma, and moderate arterial and arteriolar sclerosis with subcapsular vascular scarring. Special stains including Jones, PAS, and Trichrome were utilized for evaluation.\n\nRepresentative sections of the mass, adjacent cystic structures, smaller nodules, UP junction, ureter, and resection margins were submitted for microscopic examination."} +{"pid": "TCGA-D5-6931", "report": "A histopathological examination was performed on a specimen consisting of a resected segment of the left colon and an adjacent loop of small intestine, which was infiltrated and consolidated with the tumor. The specimen measured 25 cm in length for the large intestine, with surrounding fat tissue measuring 28 x 6.8 x 2.5 cm, and a segment of omentum measuring 25 x 10 x 0.5 cm. An ulcerated lesion measuring 7 x 5 cm was identified in the mucosa of the large intestine. This lesion encircled the full circumference of the intestinal wall, causing significant luminal narrowing. It was located 6 cm from the proximal resection margin and 12 cm from the distal margin. Macroscopic infiltration was observed through the entire thickness of the intestinal wall, extending into the surrounding fat and the wall of the adjacent small intestine. Multiple lymph nodes appeared to be involved.\n\nMicroscopically, the lesion demonstrated a tubulopapillary growth pattern with moderate differentiation (G2). There was deep invasion involving the muscularis propria, serosa of the colon, the wall of the ileum, and the pericolic adipose tissue. The resection margins were free of tumor involvement. Lymph node analysis revealed metastatic involvement in four out of fourteen nodes examined, with tumor infiltration extending into the lymph node capsules and surrounding perinodal fat. Vascular invasion was also present.\n\nStaging parameters indicated advanced local invasion (pT4b), regional lymph node involvement (pN2), and a classification consistent with Dukes C and Astler-Coller C2 stages."} +{"pid": "TCGA-R6-A8W5", "report": "The esophageal biopsy consists of multiple tan-pink, irregular tissue fragments measuring approximately 0.6 x 0.2 x 0.2 cm in total. Histologic evaluation reveals infiltrating epithelial cells arranged in moderately differentiated glandular structures. The surrounding mucosa shows Barrett-type changes with the presence of specialized intestinal metaplasia. Low-grade columnar epithelial dysplasia is also identified within the metaplastic epithelium. No definitive margins are assessed as the specimen is entirely submitted for analysis."} +{"pid": "TCGA-MP-A4SV", "report": "Submitted tissue includes a left lower lobe lung specimen with a portion of the lingula, measuring 17 x 9.7 x 6.3 cm and weighing 475 grams, along with multiple lymph nodes from aortic (aortopulmonary and anterior mediastinal), inferior mediastinal (subcarinal and inferior pulmonary ligament), and N1 (interlobar) regions. A peripheral mass measuring 3.2 x 3.0 x 2.5 cm was identified and noted to extend to, but not invade, the visceral pleura. The bronchial margin and seven intrapulmonary peribronchial lymph nodes showed no evidence of malignancy. Evaluation of the submitted lymph nodes from the aortic, inferior mediastinal, and N1 regions revealed no involvement by tumor."} +{"pid": "TCGA-OR-A5JY", "report": "The specimen measured 17.1 x 12.5 x 10.3 cm and showed extensive areas of hemorrhage and necrosis, estimated at 75% by gross examination. The tumor was encapsulated within a thin, intact membrane, with no normal adrenal parenchyma identified. Histologic evaluation revealed high-grade cellular atypia and a mitotic rate of 60 per 50 high-power fields. Capsular invasion and vascular invasion were present, including involvement of the vena cava with an exophytic tumor thrombus extending 5.7 cm beyond the margin of resection. Surgical margins were negative except for the vena cava and soft tissue, where carcinoma was present. One of two lymph nodes contained metastatic involvement. The tumor extended beyond the adrenal gland into surrounding structures. Multiple tissue samples were submitted, including sections of the adrenal tumor, renal vein, renal artery, ureter, and surrounding adipose tissue, all of which were uninvolved. A small gray nodule measuring 0.4 x 0.3 x 0.3 cm was found in the renal medulla. No abnormalities were identified in the costochondral cartilage specimen, which consisted of soft tissue and bone without evidence of disease."} +{"pid": "TCGA-DX-A2IZ", "report": "The submitted specimen includes a large retroperitoneal mass along with the right kidney. The primary lesion measures 29.0 cm in its greatest dimension and consists of two distinct tumor components. One component is found predominantly on the inferior posterior and lateral aspects of the kidney, measuring 16.5 x 13.5 x 8.5 cm; it is described as poorly circumscribed, white to tan, rubbery, and glistening. The second component, located on the superior medial aspect near the hilum, measures 12.5 x 8.5 x 13.5 cm and is fairly circumscribed, light tan, soft, and contains extensive hemorrhagic and necrotic areas estimated grossly at 60%. The tumors compress but do not extensively invade the renal parenchyma, showing only focal minimal cortical involvement.\n\nHistologic examination reveals a high-grade undifferentiated morphology in one portion of the lesion, with widespread necrosis. Microscopic evaluation shows that both tumor components approach several surgical margins closely: the well-differentiated portion extends to the medial margin and is less than 0.1 cm from the proximal and inferior margins. The higher-grade component is within less than 0.1 cm of the superior and medial margins. Other margins remain widely negative for tumor involvement.\n\nSections of the adrenal gland and kidney appear unremarkable, with no evidence of vascular invasion or involvement. Immunohistochemical stains performed were negative for S100, CAM5.2, and AE1/AE3 markers. Gross imaging and tissue sampling were completed thoroughly, including perpendicular margins and adjacent structures.\n\nThe tumor constitutes approximately 80% of the specimen and demonstrates infiltration into surrounding adipose tissue. Multiple representative sections were submitted for analysis from all relevant anatomical sites and margins."} +{"pid": "TCGA-DI-A1BY", "report": "The surgical specimen includes a pannus excision measuring 98 x 8 cm, excised to a depth of 11 cm, and another tissue segment measuring 110 cm x 15 cm, also excised to a depth of 11 cm. Microscopic examination of the pannus tissue reveals no pathologic changes throughout.\n\nA total hysterectomy was performed with removal of the uterus, cervix, bilateral fallopian tubes, and ovaries. The uterus measures 13.1 x 8.3 x 3.2 cm, and the cervix is 2.0 x 1.0 x 0.5 cm in dimension. A fungating mass is identified within the endometrial cavity, measuring 3.0 x 2.8 cm, and it completely replaces the endometrium and extends into the lower uterine segment. The tumor measures 0.6 cm in thickness and invades up to 5 mm into a myometrium that is 27 mm thick. The tumor also involves the endocervical glands and stroma, approaching within 0.3 cm of the cervical margin, which has a total thickness of 1.7 cm. No lymphovascular invasion is observed. The right ovary contains simple cysts; the left ovary appears normal. The right fallopian tube shows no abnormalities, while the left fallopian tube contains paratubal cysts.\n\nLymph node assessment includes three lymph nodes from the left pelvic region and eight from the right pelvic region, none of which show any evidence of involvement. The omentum, measuring 6.0 x 4.0 x 1.0 cm, consists of fibroadipose tissue with no abnormal findings.\n\nA separate umbilical specimen measuring 5.5 x 4.5 x 3.0 cm contains fibrotic tissue with focal hemorrhage beneath a membranous lining but no definitive lesion is identified. All submitted margins are negative. Multiple sections were examined microscopically, including full-thickness sections of the uterine wall and cervix, as well as representative samples from all other tissues. All other mucosal surfaces and tissue specimens are unremarkable."} +{"pid": "TCGA-D8-A27F", "report": "Histopathological examination was performed on a right breast specimen with axillary tissues. The breast measured 19 x 14 x 4 cm, and the axillary tissues measured 8 x 7 x 3 cm. A lesion measuring 2.5 x 2.3 x 2.0 cm was identified in the upper outer quadrant of the breast, located 1.7 cm from the upper boundary, 0.2 cm from the base, and 0.8 cm from the skin. Microscopic evaluation revealed a high-grade lesion with 24 mitoses per 10 high-power fields. Surrounding glandular tissue exhibited changes consistent with fibrocystic mastopathy and simple adenosis. Evaluation of axillary lymph nodes showed sinus histiocytosis without evidence of metastatic involvement. Immunohistochemical analysis demonstrated absence of estrogen and progesterone receptors in the neoplastic cells. HER2 staining using HercepTest\u2122 by DAKO showed a score of 1+ in the invasive component."} +{"pid": "TCGA-B5-A11J", "report": "The specimen consisted of a uterus weighing 145 grams with a tan friable exophytic mass measuring 9 x 5 x 5 cm located in the endometrial cavity. The mass occupied the anterior and posterior aspects of the fundus but did not invade deeply into the myometrium, with a maximum depth of invasion measuring 0.2 cm within a myometrial wall thickness of 2.2 cm. There was no lymphatic or vascular invasion identified. Adjacent non-neoplastic endometrium appeared quiescent. Leiomyoma was identified in the remaining myometrium.\n\nThe cervix showed no abnormal pathology either grossly or microscopically. No tumor involvement was observed at the specimen margins. The serosal surface was unremarkable.\n\nA total of 18 lymph nodes were evaluated: seven from the left pelvic lymph node region and ten from the right pelvic lymph node region. Additionally, one lymph node was assessed from the right paraaortic region. All lymph nodes were negative for malignancy.\n\nAdditional specimens included adnexal tissues. On the left side, an ovary and fallopian tube were submitted without evidence of malignancy. Similarly, on the right side, an ovary and fallopian tube were examined and found to be free of malignancy. Multiple paratubal cysts were noted bilaterally. A fragment of fibroadipose tissue from the right paraaortic region containing one lymph node was also negative for malignancy.\n\nA separate specimen from the panniculus consisted of skin and subcutaneous tissue weighing 5830 grams and measuring 15 x 15 x 6 cm in aggregate. Within this tissue, a single 2.5 x 1.5 x 1 cm cyst containing yellow friable material was identified beneath the umbilicus.\n\nFrozen sections were obtained from various regions including the uterus and full thickness myometrium. Additional frozen sections were taken from the fallopian tubes and lymph nodes as appropriate.\n\nNo tumor was identified in any of the specimens analyzed, including the cervix, ovaries, fallopian tubes, lymph nodes, or panniculus. Microscopic examination confirmed absence of malignancy in all areas assessed."} +{"pid": "TCGA-NA-A5I1", "report": "The specimen from a hysterosalpingo-oophorectomy includes a uterus weighing 600 grams and measuring 14 x 11 x 7.5 cm, along with bilateral fallopian tubes and ovaries. Upon opening the uterus, approximately 90% of the endometrial cavity is replaced by multiple exophytic, fleshy, partially necrotic masses, with the largest measuring 6.5 cm. These masses are present on both the anterior and posterior walls and extend into the lower uterine segments. The cervix appears free of tumor involvement in both anterior and posterior aspects. The tumor approaches within 1 mm of the serosal surface in the posterior fundus; however, the serosa itself is free of visible tumor. Both ovaries and fallopian tubes show no gross evidence of tumor involvement.\n\nHistologically, the lesion shows a well-circumscribed, broad interface with the myometrium without clear evidence of myometrial invasion. However, the closest distance between the tumor and the serosal surface is 4 mm. Adjacent non-neoplastic endometrium demonstrates atrophic changes. Lymphatic or vascular invasion is identified. The remaining myometrium, cervix, fallopian tubes, and ovaries do not show any pathological abnormalities.\n\nAdditional specimens include a fragment of the posterior upper vagina measuring 2.8 x 1 x 0.9 cm and a segment of the posterior vaginal margin measuring 2.5 x 1.2 x 1 cm. Both have mucosal surfaces and soft tissue margins inked blue. Microscopic evaluation of the posterior upper vaginal specimen reveals malignant surface glands consistent with a component of the primary lesion. The posterior vaginal margin specimen does not demonstrate any evidence of malignancy.\n\nThe case has been staged according to AJCC 6th Edition criteria as pT3 pNx pMX. All specimens were submitted entirely for histological analysis, and no residual tumor was identified in the cervix, adnexa, or vaginal margins, except for the noted involvement in the posterior upper vagina. Due to the lack of orientation in one specimen, a negative margin cannot be definitively ruled out without clinical correlation."} +{"pid": "TCGA-13-A5FU", "report": "The submitted specimens included multiple tissue and lymph node excisions from various anatomical locations, including the left supraclavicular region, umbilicus, omentum, right supradiaphragmatic area, rectum, pelvic structures, upper vagina, xiphoid, left supradiaphragmatic region, terminal ileum, cecum, supracolic omentum, right diaphragm, Morrison's pouch, falciform ligament, right hepatic artery, gallbladder, gallbladder fossa, right liver surface, left diaphragm, bilateral iliac regions, hypogastric area, sigmoid mesentery, left paracolic gutter, small bowel mesentery, aortocaval region, infra-renal and para-aortic areas, descending colon mesentery, small bowel, terminal ileum, colon margins, and bilateral inguinal regions.\n\nMicroscopic evaluation of the lymph nodes revealed variable involvement. In the left supraclavicular lymph node, isolated tumor cells were identified in a vascular space within one of two nodes, not present on frozen section. Involvement was noted in multiple lymph node groups, including 5 of 6 right supradiaphragmatic nodes, 4 of 4 left supradiaphragmatic nodes, 12 of 20 nodes from the terminal ileum and cecum, 2 of 2 left external iliac nodes, 1 of 4 left obturator nodes, 1 of 1 right external iliac node, 1 of 1 right obturator node, 5 of 5 small bowel mesenteric nodes, 1 of 1 aortocaval node, 1 of 11 left para-aortic nodes, and 2 of 3 right inguinal nodes. No involvement was found in three left common iliac nodes, one right hypogastric node, or two left inguinal nodes. One specimen from the left infra-renal region was lost during processing.\n\nTissue evaluations showed serosal involvement in the rectum, bilateral pelvic structures, small and large bowel, gallbladder, and terminal ileum. Mesenteric involvement was also observed in the terminal ileum. Multiple soft tissue specimens, including those from the umbilicus, right and left diaphragm, Morrison's pouch, falciform ligament, right hepatic artery, sigmoid mesentery, left paracolic gutter, descending colon mesentery, small bowel, and terminal ileum, demonstrated similar findings. The omentum and supracolic omentum were also involved.\n\nAdditional findings included a low-grade squamous intraepithelial lesion of the vaginal mucosa. The xiphoid specimen showed only benign cartilage, and both proximal and distal colon margins were benign."} +{"pid": "TCGA-EL-A4K9", "report": "A total thyroidectomy specimen includes a right lobe measuring 5.1 x 3.2 x 1.5 cm and a left lobe measuring 4.8 x 2.0 x 1.0 cm. The external surface of the thyroid is smooth. Within the anterolateral aspect of the right middle portion, there is a 1.5 cm firm, well-circumscribed nodule with slight adjacent small satellite nodules in proximity to the main lesion. The remainder of the thyroid appears unremarkable. Sections submitted include representative portions of the left lobe (A1\u2013A3), isthmus and adjacent fibroadipose tissue (A4, A5), and multiple sections from the right lobe (A6\u2013A12), including the nodule (A7\u2013A10). No lymph nodes are identified in the fibroadipose tissue examined. Resection margins are negative. Microscopic evaluation reveals no lymphovascular invasion. There is extrathyroidal extension into surrounding fibroadipose tissue. The background thyroid shows the presence of an adenomatous nodule. A separate specimen from the left superior parathyroid consists of a piece of tan-brown soft tissue measuring 0.2 x 0.2 x 0.1 cm and weighing 4 mg, which was entirely submitted and confirmed as parathyroid tissue."} +{"pid": "TCGA-D8-A1Y2", "report": "The histopathological examination was performed on a specimen from a female patient, consisting of a right breast with axillary tissues and a skin flap. The breast measured 24.8 x 19.3 x 5.2 cm, the axillary tissues measured 8.0 x 7.5 x 3.0 cm, and the skin flap measured 28.6 x 14.6 cm. A lesion measuring 2.2 x 1.7 x 2.4 cm was identified in the lower outer quadrant of the breast, located 5.2 cm from the lower boundary, 1.7 cm from the base, and at the level of the skin.\n\nMicroscopic evaluation revealed a cellular proliferation with histological features including a nuclear grade of 3, based on a scoring system (3+3+2), and a mitotic count of 10 mitoses per 10 high-power fields within a visual area of 0.55 mm. The surrounding glandular tissue showed signs of parenchymal atrophy. No lesions were observed at the nipple site. Examination of axillary lymph nodes revealed chronic lymph node inflammation.\n\nImmunohistochemical analysis demonstrated strong expression of estrogen receptors in more than 75% of the neoplastic cell nuclei, while progesterone receptor expression was minimal, present in less than 10% of the nuclei. HER2 protein expression was assessed using Ventana's Pathway HER-2/neu (4B5) rabbit antibody, yielding a score of 2+, prompting further testing with fluorescence in situ hybridization (FISH). Results of the FISH analysis using the Path Vysion HER2 DNA Probe Kit indicated no amplification of the HER2 gene.\n\nStaging information indicates a T2 classification based on tumor size and location, with no evidence of lymph node involvement (pN0)."} +{"pid": "TCGA-AX-A06F", "report": "The specimen consists of a uterus with bilateral adnexa, along with additional tissues including bladder wall, lymph nodes, peritoneal biopsy, ileum, omentum, appendix, and periaortic lymph node. The uterus weighed 470 g and measured 13 x 12 x 8 cm. A dominant mass measuring 11 x 10 x 9.5 cm was identified in the uterus, with full thickness invasion of the myometrium and extension into the cervix with stromal involvement. The right fallopian tube and ovary were replaced by tumor. The left ovary and tube appeared normal.\n\nA segment of ileum measuring 32 cm in length showed two serosal tumor nodules, one measuring 6.5 x 3.0 cm and another 4.5 x 3.0 cm. A perforation was noted at the smaller nodule. The resection margins were free of tumor. One of five lymph nodes associated with the ileum contained tumor involvement.\n\nIn the bladder wall, tumor tissue was present invading the muscularis propria from an external origin, accompanied by secondary inflammation and marked submucosal edema. Metastatic involvement was identified in one of eleven right pelvic lymph nodes, one of five left pelvic lymph nodes, and one of five lymph nodes from another intraabdominal site. The peritoneal biopsy also revealed tumor involvement.\n\nHistologic evaluation demonstrated poorly differentiated features with squamous differentiation and focal neuroendocrine features. Immunohistochemical staining showed strong reactivity for cytokeratin 7 in all tumor sites, focal dot-like cytoplasmic reactivity for cytokeratin 20 in the ileal specimen, and focal chromogranin reactivity in the uterine and ileal tumors. No synaptophysin reactivity was observed. CD56 staining in the ileal block showed weak diffuse reactivity.\n\nStaging according to AJCC (FIGO) criteria indicated pT4 (IVA) for the primary tumor, pN1 for regional lymph nodes with 2 of 17 nodes involved, and pM1 (IVB) for distant metastasis involving intraabdominal sites. Lymphovascular invasion was present. Other specimens including the omentum, appendix, and one periaortic lymph node showed no evidence of tumor."} +{"pid": "TCGA-SP-A6QJ", "report": "The right adrenal specimen consists of a disrupted gland measuring 8.3 x 6.1 x 2.1 cm and weighing 56.0 grams. A tumor measuring 6.5 x 6.5 x 2.1 cm is identified; it is cystic and partially encapsulated. Histologically, the tumor demonstrates a nested (alveolar, zellballen) and diffuse growth pattern with epithelioid cytologic features. Composite tumor elements are present, including ganglioneuroma (10%). Necrosis is identified focally, and the mitotic rate is less than 1 per 10 high-power fields. Hyaline globules are noted. There is no evidence of vascular, lymphatic, or capsular invasion beyond superficial involvement of the tumor capsule. No lymph nodes were submitted for evaluation, and imaging shows uptake only in this mass. Immunohistochemical staining reveals focal loss of SDHB expression, although most of the tumor retains SDHB immunoreactivity, suggesting that this is not an SDH-related lesion. The MIB-1 labeling index is 5%. \n\nThe left adrenal specimen measures 5.4 x 3.3 x 2.2 cm and weighs 19.2 grams. After removal of surrounding fat, the gland weighs 13.5 grams. A tumor measuring 4.7 x 3.2 x 2.0 cm is identified and shows central degeneration. No atrophy of the non-tumorous adrenal cortex is observed. There is no evidence of medullary hyperplasia. Tissue from both specimens has been stored frozen."} +{"pid": "TCGA-49-6743", "report": "A surgical pathology report describes a resected lung specimen from the right upper lobe measuring 7.5 cm in greatest dimension. The tissue showed a poorly differentiated histologic pattern with solid architecture and clear cell features. All margins were free of invasive disease, with the nearest margin located 4.0 cm from the tumor. A total of 17 lymph nodes were examined, including stations 1, 4 (left and right), 7, and 10R, and none showed evidence of tumor involvement. The tumor was found to extend subpleurally but did not involve the pleural surface. No lymphatic or venous invasion was identified. Immunohistochemical staining showed diffuse positivity for TTF-1 and variable expression of Napsin-A and p63. Molecular studies revealed no mutations in codons 12 or 13 of KRAS or exons 18\u201321 of EGFR. Background lung tissue demonstrated emphysematous changes and organizing injury with fibroblast foci adjacent to the lesion. The staging assessment indicated no regional lymph node metastasis (pN0) and unassessable distant metastasis status (pMX). The primary lesion was classified according to extent of growth as pT3."} +{"pid": "TCGA-AY-A8YK", "report": "The surgical specimen includes a segment of large bowel measuring 15 cm in length and 3.5 cm in open circumference. A mass measuring 5.2 cm in its proximal-to-distal dimension and 4.0 cm circumferentially is identified approximately 6.5 cm from the proximal mucosal margin and 5.0 cm from the distal mucosal margin. The mass is tan, firm, and ulcerated with raised edges. On sectioning, it extends up to 1.2 cm through the muscularis propria into adjacent yellow lobulated fat, and comes within 0.8 cm of the peritonealized surface. The proximal mucosal margin is inked blue, the distal mucosal margin is inked black, and the mesenteric margin is inked green. All margins are negative, with the proximal margin 6.5 cm and the distal margin 5.0 cm from the mass.\n\nHistologically, the lesion shows low-grade features (grade 2 of 4) with cellular morphology consistent with moderately differentiated morphology. Invasion extends through the muscularis propria into surrounding soft tissues. Lymphovascular invasion is present, while perineural invasion is not identified. Of 24 regional lymph nodes examined, 6 contain metastatic involvement. The pathologic staging is pT3 pN2a.\n\nImmunostaining for mismatch repair proteins was performed and shows retained expression of MLH1, PMS2, MSH2, and MSH6 within the tumor. These findings will be correlated with results from microsatellite instability testing, which will be reported separately. Tissue blocks and lymph node samples have been appropriately submitted for further analysis. Specimen remains in formalin. Additional findings are not identified."} +{"pid": "TCGA-28-1745", "report": "The specimen consists of multiple fragments of brain tissue from the left temporal region, ranging in size from 0.4 cm to 1.1 cm. The tissue is described as tan-gray with focal areas of hemorrhage. Microscopic examination reveals a necrotizing lesion with microvascular proliferation and elongated, mitotically active nuclei. There are also notable perivascular lymphocytic infiltrates.\n\nImmunostaining results show weak MGMT expression in up to 15% of tumor nuclei. PTEN staining is absent. pMAPK staining is negative in both tumor nuclei and cytoplasm. Laminin beta-1 and laminin beta-2 are upregulated, showing 2+ staining in endothelial cells.\n\nNecrosis is present in varying proportions across the samples, ranging from 30% to 50%. The proportion of the tissue occupied by the lesion is consistently 100% across all samples. \n\nThe tumor demonstrates no EGFR amplification or high-level polysomy based on FISH analysis. Of the 40 cells analyzed, none showed a ratio of EGFR/CEP greater than 2.0 or more than four copies of EGFR in over 40% of cells.\n\nA low percentage of MGMT-positive tumor nuclei suggests potential responsiveness to Temodar. The absence of PTEN expression may indicate a reduced likelihood of response to EGFR kinase inhibitors. A high percentage of pMAPK immunonegative cells may correlate with increased sensitivity to radiation therapy.\n\nStudies have shown associations between these molecular markers and clinical outcomes, including prognosis and treatment response. However, these findings should be interpreted with caution and in the context of the full clinical picture."} +{"pid": "TCGA-A5-A0R7", "report": "The surgical pathology report includes specimens from the right and left fallopian tubes and ovaries, uterus, several lymph node regions, and omentum. The right ovary measured 3 x 1.5 x 1 cm and was accompanied by a 4 x 0.5 cm segment of fallopian tube; no abnormalities were identified microscopically in either structure. The left ovary measured 3 x 1.4 x 1.5 cm with a 0.5 cm fallopian tube segment; it contained a follicular cyst and benign glandular rest, while the fallopian tube appeared histologically normal.\n\nThe uterus weighed 278 grams and showed an exophytic lesion extending approximately 1 cm above the myometrial surface. Microscopic evaluation revealed deep myometrial invasion involving 40% of the wall, which measured 2.5 cm in total thickness. The tumor invaded to a depth of 1 cm, leaving 1.5 cm of uninvolved myometrium. Margins at the cervix and bilateral parametria were free of tumor involvement. No definitive lymph-vascular space invasion was observed. Additional sections were taken from the lower uterine segment for further assessment.\n\nLymph node biopsies included left pelvic (2 nodes), left periaortic (7 nodes), right pelvic (submitted across two cassettes), and right periaortic (1 node). All lymph node specimens showed no evidence of malignancy. The omentum specimen measured 5 x 5 x 0.2 cm and contained psammoma bodies but no malignant findings.\n\nFrozen section analysis of the left periaortic lymph node biopsy also showed no malignancy. Gross and microscopic evaluations of all submitted specimens confirmed absence of malignancy outside the uterus. Multiple tissue blocks were submitted for comprehensive histologic review."} +{"pid": "TCGA-MP-A4T9", "report": "The surgical specimen included a left upper lobe lung lobectomy specimen weighing 175 grams, along with associated lymph nodes from stations 5L, 7L, 9L, and 10L, as well as intrapulmonary and hilar lymph nodes. A subpleural mass measuring 3.0 x 2.0 x 1.4 cm was identified in the left upper lobe, located approximately 2.5 cm from the bronchial resection margin. The mass showed involvement of the overlying visceral pleura with tumor present on the pleural surface. The bronchial resection margin was free of tumor.\n\nExamination of lymph nodes revealed that two out of two left subaortic (station 5L) lymph nodes contained metastatic tissue with features of extranodal extension. No involvement was seen in three left subcarinal (station 7L) lymph nodes, one left pulmonary ligament (station 9L) lymph node, one left upper lobe major fissure lymph node, two left hilar (station 10L) lymph nodes, or two left lower lobe bronchus lymph nodes. Additionally, three out of ten intraparenchymal peribronchial lymph nodes showed evidence of metastatic involvement."} +{"pid": "TCGA-FG-A60J", "report": "The submitted specimen includes two parts labeled as left frontal brain mass and left frontal brain tissue. The excised material was processed using both frozen and permanent sectioning techniques. The tissue samples were described macroscopically as white-tan to tan-white in color, with some segments having a mottled and glistening surface. The larger portion measured 2.5 x 2.0 x 2.0 cm and weighed 6.9 grams.\n\nMicroscopic analysis revealed a neoplastic process involving glial cells, with distinct morphological patterns observed across different regions of the tissue. These included features consistent with a low-grade astrocytic component and a second component showing oligodendroglial differentiation. No evidence of vascular proliferation or necrotic changes was identified.\n\nImmunohistochemical staining was performed on block B2. Diffuse positivity was noted for IDH1. A Ki-67 labeling index of approximately 11\u201312% was observed focally. More than half of the tumor cell population demonstrated positive staining for p53.\n\nCytogenetic analysis using FISH was conducted to assess chromosomal status. For chromosome 1p, the average signal ratio (1p36/1q25) was 1.1, indicating an intact locus without allelic loss. Similarly, for chromosome 19q, the average ratio (19q13/19p13) was also 1.1, suggesting no allelic loss at this locus. Chromosome 7 FISH results showed EGFR copy number to be non-amplified, with an EGFR/CEP7 ratio of 1.0. No aneusomy was detected for chromosome 7.\n\nThese findings were based on formalin-fixed, paraffin-embedded tissue sections. All tests were developed and validated in-house; they have not been cleared or approved by the FDA but are used under current regulatory guidelines allowing such use in clinical settings."} +{"pid": "TCGA-AZ-6605", "report": "The specimen consisted of a right hemicolectomy. Gross examination confirmed an infiltrative lesion located in the ascending colon measuring 3.5 cm in greatest dimension, with additional dimensions measuring 2.2 x 0.8 cm. The tumor was found to invade into the subserosa with perforation of the visceral peritoneum. Margins of resection, including the proximal terminal ileal and distal colonic margins, were free of tumor involvement. A total of 22 lymph nodes were examined, with one containing metastatic carcinoma. Angiolymphatic invasion was identified, while perineural invasion was not present. The tumor exhibited an infiltrating border configuration. No other significant pathologic findings were identified. The extent of lymph node involvement corresponds to pN1 staging. Tumor involvement reached the subserosa, corresponding to pT4b classification."} +{"pid": "TCGA-WC-A883", "report": "The report includes a fine needle aspiration sample from the right eye, which was sent for additional diagnostic testing. The second specimen is an enucleation specimen measuring 21.0 x 20.0 x 21.0 mm with an attached optic nerve measuring 13 mm in length. The cornea measures 11.0 x 10.0 mm with a central pupil of 2.0 mm. A small black nodule measuring 2.0 mm is present on the external surface of the sclera near the limbus and is covered by loosely adherent conjunctiva. The resection margin is less than 1.0 mm from this lesion.\n\nAn irregular multinodular mass located between 2:00 and 6:00 within the choroidal space has a base measuring approximately 18.0 mm. It extends into the posterior globe and approaches within 5.0 mm of the optic nerve head. The tumor has a maximum height of 4.0 mm after harvest and demonstrates a binodular surface pattern. Extraocular extension is present at the scleral region adjacent to the cornea, where the tumor flattens and thickens in a rolling pattern. This extraocular component is fully covered by conjunctiva and soft tissue, with negative margins noted.\n\nHistologic sections include regions of vortex veins (B1), optic nerve margin (B2), calottes with tumor involvement (B3 and B4, with B3 containing extraocular extension and tissue harvested beyond the ocular boundary), and a pupil-optic section containing tumor (B5). Microscopic evaluation reveals cells with mixed morphology and mitotic activity of approximately 1 per 10 high-power fields. No tumor involvement is identified in the optic nerve or vortex veins. An artificial lens is present in situ.\n\nThe specimen from part A was submitted for external testing and will be reported separately. Biomarker analysis was performed on the primary tumor from section B5. Clinical history indicates prior findings in the right eye."} +{"pid": "TCGA-EB-A5SF", "report": "The specimen consists of skin tissue from the extremity, submitted as an excision. The lesion measures 2 x 1.1 x 1.1 cm and is described as ulcerated, raised, and pigmented. Microscopic examination reveals a histologic type that is nodular in growth pattern. The lesion demonstrates a 5th level of invasion according to Clark\u2019s classification and extends to a depth of 11 mm. No satellite nodules are identified. Lymphatic and venous invasion status, lymph node involvement, and margin status could not be determined based on the provided information. There is no evidence of neoadjuvant treatment effect. No additional findings or comments are noted."} +{"pid": "TCGA-60-2696", "report": "The specimen included multiple lymph nodes and a left upper lobectomy. The 2R lymph node measured 0.6 x 0.3 x 0.2 cm and 0.5 x 0.4 x 0.2 cm. The 4R lymph node measured 0.2 x 0.2 x 0.2 cm and 0.2 x 0.2 x 0.1 cm. The left upper lobectomy specimen weighed 903 g and measured 22 x 14.5 x 2.5 cm, with a palpable mass located subjacent to the bronchial margin. The mass was firm and beige with central friability, measuring 5.5 x 3.5 x 3 cm, and approached the bronchial margin at a distance of 0.2 cm. It was also 0.5 cm from the pleural surface. No additional lesions or nodules were observed. Two peribronchial lymph nodes were identified and found to be uninvolved. The 11L lymph node consisted of two fragments measuring 1.1 x 0.6 x 0.3 cm in aggregate, and the 10L lymph node measured 0.4 x 0.2 x 0.2 cm. The anterior/superior mediastinal margin included two tissue pieces measuring 0.6 x 0.3 x 0.2 cm and 0.7 x 0.5 x 0.2 cm. Histologically, the tumor showed moderate differentiation without angiolymphatic invasion. All bronchial margins were free of involvement, and no visceral pleural involvement or satellite tumors were identified. Lymph node evaluation revealed no involvement from ipsilateral hilar and/or peribronchial regions (0/3) or contralateral mediastinal/hilar areas (0/2). Non-neoplastic findings included emphysematous changes and hemorrhage. Pathological staging was determined as pT2, N0, MX."} +{"pid": "TCGA-KM-8438", "report": "The left kidney specimen measured 22 x 18 x 15 cm and weighed 3,800 grams. The mass lesion was extensively red, lacked fibrosis or encapsulation, and occupied a major portion of the specimen. A small rim of normal-appearing renal tissue was present with a maximum dimension of 8 cm. The tumor approached but did not extend beyond the capsule. Vascular and ureteral margins were free of tumor involvement. The adrenal gland showed no abnormal findings. Retroperitoneal lymph nodes were submitted for evaluation, including one measuring 2.5 x 1 x 1 cm and others ranging down to 1 x 1 x 0.7 cm; all showed reactive changes with marked sinus histiocytosis and no evidence of tumor involvement."} +{"pid": "TCGA-AR-A254", "report": "The specimen measures 2.7 x 2.3 x 2.2 cm and consists of a mass with Nottingham grade III features, based on tubules 3/3, nuclei 3/3, and mitoses 2/3, resulting in a total score of 8/9. No angiolymphatic invasion is identified. The surrounding breast tissue shows nonproliferative fibrocystic changes. All surgical margins, including the separately submitted new anterior, inferior, medial, and lateral margins, are free of tumor, with a minimum tumor-free margin of 1.1 cm at the lateral edge. Evaluation of lymph nodes includes two matted left axillary sentinel lymph nodes, both containing metastatic cells, with extranodal extension noted. Additionally, 7 out of 28 left axillary lymph nodes show metastatic involvement. The largest involved lymph node measures 2.1 x 1.4 x 1.4 cm and lacks extranodal extension. Blue dye is not detected in either sentinel lymph node. Hormone receptor analysis and Her-2/NEU testing have been initiated using paraffin-embedded tissue."} +{"pid": "TCGA-N6-A4V9", "report": "A polypoid mass measuring 7.2 cm in greatest dimension was identified within the endometrial cavity. Histologic evaluation demonstrated a tumor with biphasic morphology, composed of glandular and sarcomatous components. The glandular component exhibited high-grade nuclear features with focal squamous differentiation. The sarcomatous areas contained chondroid and myxoid matrix. The tumor extended into the myometrium with 18% involvement (0.2 cm invasion into a 1.1 cm thick myometrium), without clear lymphovascular space invasion identified. The tumor was associated with a pre-existing submucosal leiomyoma.\n\nNo tumor was identified in the cervix, bilateral adnexa, or appendix. Background endometrium was inactive, and the myometrium contained benign leiomyomas. Multiple biopsies of the abdominal peritoneum and lymph node dissections from the right pelvic, left pelvic, and peri-aortic regions showed no evidence of tumor. A total of 19 lymph nodes were examined and all were negative. The tumor was confined to the uterine corpus with less than half of the myometrial thickness involved. Peritoneal biopsies and pelvic washings were negative for malignancy. The tumor was confined to the uterus with minimal surface involvement and no evidence of extrauterine spread."} +{"pid": "TCGA-A2-A0YJ", "report": "The specimen consists of a left modified radical mastectomy with a skin ellipse measuring 20 x 8.5 cm. The overall specimen dimensions are 26.5 x 14 x 3.5 cm. The axillary contents were dissected and marked with red ink to indicate they are not true margins. A deep margin beneath the tumor was submitted separately, measuring 2.7 x 2.5 x 0.4 cm, and was marked with blue ink as the new margin.\n\nWithin the breast tissue, a pink-tan firm gritty mass measuring 7 x 3 x 4.5 cm was identified. This lesion extends to within 0.2 cm of the deep margin. Sections were taken from various regions including the nipple and skin, tumor with deep margin, lateral and medial aspects of the lesion, and quadrants of the breast. Mirror images were submitted according to protocol.\n\nAxillary lymph node evaluation identified a total of eighteen nodes. One lymph node in the lower axillary tail measured 3.7 cm in greatest dimension and appeared grossly positive. Additional sections revealed two more grossly positive nodes. Sections of these nodes were submitted with mirror images as per protocol. Metastatic involvement was identified in five out of the eighteen lymph nodes examined.\n\nHistologic examination showed high-grade cellular features with a high mitotic index. Invasive carcinoma was noted in lymphatic spaces at the deep margin and within the stroma of the breast, approximately 1.1 mm from the deep margin. There was also evidence of involvement in a lymphatic space from a section in the lower outer quadrant, away from the primary lesion.\n\nThe deep margin specimen showed skeletal muscle without any identifiable residual involvement."} +{"pid": "TCGA-WT-AB44", "report": "The surgical pathology report includes specimens from the left breast and sentinel lymph nodes. Four sentinel lymph nodes were evaluated, each showing no evidence of malignancy based on routine histologic examination and immunostaining with pancytokeratin. No metastatic involvement was identified in a total of four lymph nodes assessed.\n\nA lumpectomy specimen from the left breast contained an invasive lesion measuring 1.5 cm in greatest dimension. An additional anterior left breast tissue specimen contained a smaller focus of invasive carcinoma measuring 0.3 cm in greatest dimension. Both specimens demonstrated multicentric tumor distribution.\n\nHistologic evaluation revealed moderately differentiated morphology with a Nottingham Histologic Score of 6 out of 9. Tubule formation score was 3, nuclear grade was 2, and mitotic count was 1 per 40x objective. Lobular carcinoma in situ and atypical lobular hyperplasia were present. There was no evidence of ductal carcinoma in situ, lymphovascular invasion, perineural invasion, or tumor necrosis.\n\nSurgical margins were evaluated in both the lumpectomy and the additional anterior tissue specimen. In the lumpectomy, the tumor was focally 1.5 mm from the anterior margin and 1.75 mm from the inferior margin; all other margins were greater than 2 mm away. In the anterior specimen, the tumor was present at one shave margin while other margins measured at least 2 mm.\n\nStaging was determined as pT1c based on tumor size between 10 mm and 20 mm. Sentinel lymph node evaluation yielded no positive nodes (0 out of 4 examined), resulting in a nodal staging classification of snNo(i-). The overall pathologic stage was provisionally assigned as pT1c snNo(i-). Additional immunohistochemical staining for smooth muscle myosin supported the morphologic findings.\n\nNon-neoplastic changes included focal fibrosis and prior biopsy site alterations. Fixation parameters met acceptable standards with placement into formalin occurring within one hour of removal and fixation duration between 6 and 48 hours."} +{"pid": "TCGA-19-5959", "report": "The specimen from the left parietal region consists of multiple soft tissue fragments. The first sample measured 1.2 x 0.6 x 0.9 cm in aggregate and was processed for intraoperative consultation, including a touch imprint and frozen section. A second specimen, measuring 2.2 x 2.0 x 0.6 cm, included irregular white to pink-tan tissue fragments; part was used for further analysis and the remainder submitted for histologic evaluation. A third specimen, described as infiltrated brain tissue, measured 4.0 x 3.4 x 1.0 cm and was entirely submitted for examination.\n\nMicroscopic evaluation revealed high-grade cellular features. Tissue sections showed atypical cells with marked pleomorphism, brisk mitotic activity, and areas of necrosis. Vascular proliferation was present. Some regions demonstrated cells with oligodendroglial-like morphology. Invasion into adjacent brain tissue was noted. Immunohistochemical stains were performed and supported the morphologic findings. All specimens were evaluated for tumor extent and infiltration pattern."} +{"pid": "TCGA-ZM-AA0N", "report": "The specimen consists of a testicle containing a cut tumor measuring 8 \u00d7 6 \u00d7 5 cm, along with an 8 cm long funiculus. The tumor has irregular margins, a white to brown color, and medium consistency, with dimensions of 8 \u00d7 5 \u00d7 4 cm. Microscopic examination reveals solid sheets and scattered traces of tumor cells with round to oval, brightly stained nuclei containing small nucleoli. The cytoplasm is sparse, clear to pale pink in staining. Within a large microscopic field, 3\u20134 mitotic figures are observed. Peritumoral connective tissue contains a moderate lymphocytic infiltrate. Adjacent tubules show changes lined by cells with features suggestive of intratubular germ cell neoplasia, although not fully classified. Immunohistochemical staining demonstrates positivity for PLAP in both the tumor cells and the intratubular proliferative changes. Morphological evaluation supports a neoplastic process of germ cell origin. The tumor extends into the tunica albuginea and involves vascular lumens within this layer. No involvement is identified in the funiculus."} +{"pid": "TCGA-78-7535", "report": "The specimen consists of a left upper lobectomy measuring 205 x 135 x approximately 60 mm and weighing 503 g. A large mass is located within the upper part of the lobe, with an intact overlying pleural surface. The mass measures approximately 72 mm in maximum dimension, has a lobulated cream appearance on cut surface, and comes to within 1 mm of the pleural surface. The mass surrounds a segmental bronchus but does not erode through the bronchial wall. The endobronchial resection margin is free of abnormal tissue. The remaining lung tissue shows anthracosis without emphysema or additional lesions, and there is a small cystic or bullous formation at the apex.\n\nMicroscopic examination reveals a poorly differentiated lesion that is subpleural in location. In some areas, features suggestive of pleural invasion are noted, although no involvement of the pleural surface itself is observed. Special stains are being used to further evaluate for possible pleural invasion. No vascular or lymphatic invasion is identified. The bronchial resection margin is clear. The adjacent lung tissue shows signs of emphysema.\n\nLymph node specimens from the pulmonary vein, interlobar region, station 5, and station 10 are all described as showing only reactive changes. No evidence of malignant cells is found in any of these lymph node samples.\n\nAn addendum notes that the lesion extends through the elastic laminae of the pleura but does not involve the pleural surface directly."} +{"pid": "TCGA-DD-AACD", "report": "The liver specimen measured 21.0 x 16.5 x 10.0 cm and was unfixed. The gallbladder measured 9.0 cm in length, 3.2 cm in diameter, with a wall thickness of 2.0 mm, also unfixed. A single tumor was identified in the right lobe of the liver, measuring 12.0 x 15.0 x 12.0 cm. A satellite nodule was present. The tumor exhibited an expanding nodular growth pattern. Necrosis was present in approximately 20% of the tumor volume, and areas of hemorrhage or peliosis were also observed in 20% of the tumor. Portal vein invasion was noted, while bile duct invasion was not evident.\n\nMicroscopic evaluation revealed moderately differentiated cells arranged in a trabecular pattern. The worst degree of differentiation was grade IV, with the majority being grade III. There was no evidence of fatty change, fibrous capsule formation, septum formation, or surgical margin involvement. The resection margin was clear with a distance of 0.7 cm from the tumor edge. Serosal invasion was not present. Microvessel invasion was identified, and there was evidence of intrahepatic metastasis. No multicentric occurrence was seen.\n\nExamination of the non-tumor liver tissue showed changes consistent with chronic hepatitis of minimal severity in both lobular and portoperiportal regions. The underlying etiology was associated with HBV infection. Fibrosis was limited to the periportal area, and no cirrhosis was identified. No dysplastic nodules, ductal epithelial dysplasia, or other significant liver disease were present.\n\nThe gallbladder showed features of chronic cholecystitis. One regional lymph node was biopsied and showed reactive hyperplasia with no evidence of malignancy."} +{"pid": "TCGA-F7-A61W", "report": "The tumor is located in the left oral tongue and is characterized by an ulcerated and protruding mass measuring 2.5 x 2 x 2 cm. The surface is described as soft with a white-gray appearance. Microscopic examination reveals tumor tissue arranged in groups, sheets, or trabecular patterns. The malignant cells exhibit moderate to light eosinophilic cytoplasm and form keratinized structures. Nuclear features include enlargement, variation in size and shape, coarse chromatin, and prominent nucleoli. Frequent mitotic figures are observed. The tumor invades the lower muscle layer, and the stroma shows infiltration by inflammatory cells. Lymph node involvement includes 4 out of 9 cervical nodes on the left side. Surgical margins are uninvolved. Lymphovascular invasion is present, while perineural invasion is not identified."} +{"pid": "TCGA-EO-A3KX", "report": "The specimen consisted of a right pelvic lymph node dissection and a total hysterectomy with bilateral salpingo-oophorectomy. The lymph node specimen included three lymph nodes, all without evidence of malignancy. The hysterectomy specimen had a fresh weight of 135.1 g and measured 9.3 cm in length, 6.5 cm in width, and 3.5 cm in depth. The cervix had a maximum diameter of 2.0 cm, with an external os measuring 0.8 cm. The endometrial cavity measured 3.5 cm in thickness and 5.2 cm from cornua to cornua. A friable, papillary tan tumor was identified on the posterior aspect of the endometrium, measuring 7.0 cm in length and extending 2.2 cm into the myometrium, reaching within 0.7 cm of the posterior serosa. The tumor involved the lower uterine segment but did not extend to the cervix. Histologic evaluation revealed myometrial invasion limited to the inner half, with no lymphovascular invasion identified. Both fallopian tubes appeared grossly normal; the right fallopian tube measured 4.5 cm in length and 0.3 cm in diameter, while the left measured 5.0 cm by 0.3 cm. The right ovary measured 2.7x1.7x0.6 cm, and the left ovary measured 2.9x0.1x0.7 cm, with both showing unremarkable parenchyma. Uterine leiomyomata were noted. Three pelvic lymph nodes were examined, none of which showed evidence of tumor involvement. The histologic grade was high, with features consistent with poorly differentiated morphology. No abnormalities were found in the ovaries or fallopian tubes upon histologic examination. Tumor was confined to the uterine corpus without extension to other organs. The surgical specimen was intact, and tissue samples from various regions were submitted for analysis."} +{"pid": "TCGA-W5-AA34", "report": "Female. Surgery Date: A. Liver, segment VI, wedge resection: The specimen shows a single, sclerotic mass measuring 4.7 x 4.3 x 3.5 cm with gross evidence of needle tract effect. The lesion is confined to the hepatic parenchyma. The hepatic parenchymal resection margin is free of the lesion, with a tumor-free margin of 0.7 cm. The intrahepatic bile duct margin also shows no evidence of invasive or in situ involvement, with a clear margin of 1.0 cm. There is no major vessel invasion or microscopic invasion identified. The surrounding liver tissue demonstrates necrotizing granulomatous inflammation, likely related to prior biopsy."} +{"pid": "TCGA-WB-A81I", "report": "The pathology review describes a lesion removed from the right adrenal. Grossly, the tumor measured 2.1 cm in diameter and exhibited a red and light tan appearance. Histological evaluation revealed that the lesion was composed of medium-sized cells with variable nuclear morphology, including slight nuclear enlargement, chromatin distribution, and prominent nucleoli. Some individual cells demonstrated more marked pleomorphism and larger nuclei. The tumor was well demarcated from surrounding tissue, with partial encapsulation by a fibrous layer. Hyaline globules were observed in certain cells. There was no significant mitotic activity, necrosis, vascular invasion, or disruption of the capsule. Scoring based on histological features (PASS score) showed a total of 1 out of a maximum 20 points. Features such as large cell nests, necrosis, increased cellularity, cellular monotony, spindle-shaped tumor cells, mitotic figures (>3/10 HPF), extension into adipose tissue, vascular invasion, capsular invasion, nuclear hyperchromasia, and profound nuclear pleomorphism were each scored as absent (0), except for profound nuclear pleomorphism, which received a score of 1."} +{"pid": "TCGA-B0-4822", "report": "The resected right kidney specimen demonstrates a large neoplasm measuring 13.2 cm in greatest dimension. Histologic evaluation reveals high-grade nuclear features with areas exhibiting spindle cell differentiation. The lesion is confined to the kidney, with extension into but not beyond the renal capsule. All surgical margins are negative. The adrenal gland, which is present, shows no evidence of abnormal cellular proliferation. No malignant cells are identified in the collected cytology specimen. According to the 5th edition of the staging system, the stage is pT2, with no assessment of lymph node or distant metastasis."} +{"pid": "TCGA-DW-5560", "report": "The right kidney specimen includes a partially encapsulated mass with surrounding renal parenchyma, measuring 7.5 x 6 x 3.5 cm. The mass has a tan, soft cut surface with an eccentric red area containing a yellow focus. After fixation, the tumor measures approximately 6.5 x 4.5 x 3.3 cm. A total of approximately 1 x 0.9 x 0.3 cm of tumor tissue was procured for analysis, including a nodule measuring 2.5 cm in greatest dimension. Representative sections of the mass were submitted in eight cassettes for histologic evaluation. Microscopic examination reveals cells arranged in papillary formations with nuclear features of low grade. Immunohistochemical staining for CK7 was negative. No involvement of the surrounding parenchyma is identified. Staging is based on tumor size and local extent."} +{"pid": "TCGA-Y8-A8RY", "report": "The specimen from a male with multiple left kidney lesions was obtained via laparoscopic nephrectomy. The tumor was located centrally and superiorly within the left kidney. Two distinct masses were identified, measuring 4.5 x 4 x 4 cm (central) and 0.8 cm (superior). Microscopic examination revealed cellular features consistent with a neoplastic process, with nuclear grading classified as Fuhrman grade 2. No sarcomatoid features or tumor necrosis were observed. The surgical margins were free of malignant cells. There was no evidence of lymphovascular invasion, and the disease appeared confined to the kidney. A total of four tumor samples and four normal tissue samples were collected. Tissue processing included formalin fixation and paraffin embedding, with cryopreservation of additional specimens. The nonneoplastic kidney showed no significant abnormalities, though other benign findings including papillary adenomata and a renal cyst were noted. Specimen collection and processing times were recorded, along with specimen weights and dimensions. No metastatic involvement was identified in this assessment."} +{"pid": "TCGA-60-2709", "report": "The surgical specimen included multiple lymph nodes from various levels, including 4R, 4L, level 5, level 6, level 7, level 10, and level 11. All lymph nodes were grossly described as tan or pink-tan tissue with sizes ranging from 0.2 cm to 1.6 cm in greatest dimension. Each lymph node was submitted in whole and microscopically showed no evidence of malignancy. One level 7 lymph node showed autolytic changes but no cancer cells were identified.\n\nThe lung specimen consisted of a left upper lobe with superior segment of the lower lobe, weighing 310 grams and measuring 15x13x4.2 cm. A white and tan mass measuring 4.0x3.5x3.0 cm was identified, located 1 cm from the bronchial resection margin and less than 0.1 cm from the pleural surface. A 1.5x0.6 cm area of induration was also noted on the surface. Histologically, the lesion showed poorly differentiated cellular features. No angiolymphatic invasion was observed. The bronchial margin was free of tumor involvement. There was no visceral pleural invasion or satellite nodules identified. Lymph node staging showed no involvement in N1 (hilar), N2 (mediastinal), or N3 (contralateral) regions. The tumor was peripherally located and surgical resection was performed without residual disease at the margin."} +{"pid": "TCGA-G4-6586", "report": "The resected right and transverse colon specimen includes a right hemicolectomy with terminal ileum. The ileal segment measures 7.0 cm in length, while the colon segment measures 33.0 cm. The proximal surgical margin is 3.5 cm in circumference and the distal margin is 8.0 cm in circumference. An appendix measuring 5.5 cm in length and 0.6 cm in width is present.\n\nA mass lesion located 7.0 cm from the distal surgical margin is observed upon opening the specimen. The lesion measures 4.0 x 4.0 x 1.1 cm and appears tan with heaped-up borders; no central ulceration is noted. Multiple small polypoid lesions (0.2\u20130.4 cm) are identified\u2014three to four in the proximal ascending colon and one in the distal portion of the specimen. No other mucosal abnormalities are seen.\n\nHistologic sections include the proximal and distal surgical margins, primary lesion, subserosal fat, terminal ileum, cecum, proximal and distal colon with associated polyps, and portions of the appendix. Seventeen lymph nodes were evaluated, none showing evidence of involvement.\n\nMicroscopic evaluation reveals infiltration into the subserosa without tumor involvement at the proximal, distal, or radial margins. Vascular invasion is present; there is no evidence of perineural invasion. Adjacent adenomatous changes are noted, along with tubular adenomas distant from the lesion. The appendix demonstrates no histopathological abnormalities.\n\nStaging assessment indicates pT3 N0 Mx classification. Resection margins are negative and complete (R0). No implants are detected."} +{"pid": "TCGA-HT-7485", "report": "The microscopic examination reveals a glial neoplasm with mild hypercellularity, demonstrating diffuse infiltration into both gray and white matter. The tumor cells exhibit round to oblong nuclei with minimal nuclear atypia. Glial processes are not prominently observed, and perinuclear halos are only occasionally noted. In the gray matter, there is focal perineuronal satellitosis. No mitotic activity, microvascular proliferation, or necrosis is identified. Immunohistochemical staining shows numerous p53-positive cells, while MIB-1 labeling is very sparse, with an estimated proliferation index of less than 0.1%."} +{"pid": "TCGA-56-5898", "report": "The surgical specimen consisted of a right upper lobe wedge resection measuring 8.5 x 5.4 x 2.0 cm. The pleural surface was purple-gray and glistening. A gray-white mass measuring 3.0 x 1.5 x 1.0 cm was identified; it was ill-defined and approached within 0.1 cm of the inked parenchymal margin and 0.2 cm of the pleural surface. No pleural invasion or lymphovascular space invasion was observed. The remainder of the lung tissue showed hemorrhagic congestion and emphysematous changes. Surgical margins were free of abnormal cellular proliferation.\n\nA level 10 lymph node biopsy specimen measuring 1.4 cm was submitted and showed no abnormal findings. Similarly, a level 7 lymph node measuring 2.0 cm was negative for any atypical cellular infiltration.\n\nAdditional resection of the right upper lobe measured 13.5 x 8.5 x 5.0 cm and included a bronchial segment and stapled vascular margins. The cut surface revealed red, pink, hemorrhagic, and congested lung tissue without identifiable mass or residual abnormality.\n\nAll lymph nodes examined were unremarkable. Staging was determined as pT1, N0, M0. Sections were submitted for genomic research and comprehensive histologic evaluation."} +{"pid": "TCGA-W5-AA2X", "report": "A single lymph node from the liver hilum biopsy measuring 2.0 x 1.3 x 0.6 cm was negative for tumor involvement. The distal common bile duct margin, a 1.1 x 0.6 cm tissue sample, was also free of tumor. A left hepatectomy and cholecystectomy specimen included a 525-gram liver wedge with a gallbladder measuring 8.0 x 3.0 x 1.5 cm. A 2.9 x 2.6 x 2.0 cm tan-white mass was identified at the inked surgical margin, underlying the left hepatic duct but not grossly involving the duct lumen. The surgical resection margin showed involvement by invasive carcinoma, while the common bile duct margin was free of tumor. The gallbladder wall measured 0.2 cm in thickness and exhibited chronic cholecystitis without stones or cholesterolosis. Histologic evaluation revealed Grade 4 (of 4) features with mucinous and signet ring cell morphology. Lymphovascular invasion was present, and perineural invasion was not identified. The gallbladder itself was uninvolved. The right main bile duct margin was a 1.5 x 1.0 x 0.3 cm tissue section and was tumor-free. The caudate lobe of the liver, measuring 7.7 x 5.3 x 3.4 cm, contained a small 0.2 x 0.2 cm pale tan thickening on the capsule but no masses were found. Three hepatic duodenal lymph nodes were received, with sizes ranging from 1.7 x 0.6 x 0.5 cm to 2.2 x 1.3 x 1.3 cm. One of these lymph nodes contained a metastatic deposit measuring 1.3 x 1.1 x 1.0 cm. The non-neoplastic liver parenchyma demonstrated portal tract expansion with mild chronic inflammation, edema, and bile ductule proliferation. There was mild macrovesicular steatosis and cholestasis, with trichrome staining showing mild portal fibrosis. Iron stain was negative, as was PAS-D for intracytoplasmic globules. Based on the available surgical material, staging was assigned as pT2bN1 according to the AJCC 7th edition (2010). Permanent sections confirmed findings from frozen section analysis, and any significant changes on permanent review would be reflected in a revised report."} +{"pid": "TCGA-57-1583", "report": "The surgical specimen from the left ovary and fallopian tube consists of a 12.7 x 10.5 x 5.4 cm mass with a cystic component measuring 6.0 x 4.0 x 2.0 cm. The solid portion is tan-pink to white without identifiable ovarian tissue or fallopian tube. Histologic evaluation reveals high-grade cellular atypia with papillary architecture. Mitotic figures are present. No lymphovascular invasion is observed. One out of two lymph nodes from the left pelvic region shows involvement by malignant cells exhibiting similar morphology. The omental tissue, measuring 10.1 x 9.2 x 2.1 cm, demonstrates only reactive changes with no evidence of malignancy; one lymph node within the omentum is also negative. The hysterectomy specimen includes a normal-appearing cervix, inactive endometrium, unremarkable myometrium, and a right ovary and fallopian tube without abnormal findings. The tumor extends beyond the ovary with peritoneal implants, and metastatic involvement is confirmed in regional lymph nodes. No residual disease is identified in the contralateral ovary or fallopian tube. Based on these findings, staging is assigned as T3c, N1, MX."} +{"pid": "TCGA-CZ-5463", "report": "The specimen consists of a partial or total resection of a left kidney, measuring 24.5 x 13.0 x 9.8 cm and weighing 1642 grams. The kidney includes a segment of ureter (11.5 cm in length, 0.4 cm in diameter), renal vein (1.3 cm in length, 0.5 cm in diameter), and renal artery (2.3 cm in length, 0.5 cm in diameter). A well-defined mass measuring 12.8 x 10.3 x 8.5 cm is present in the lower pole, replacing most of the lower pole parenchyma. The mass has a tan/red to tan/yellow appearance, is partially encapsulated, and located less than 0.1 cm from the black-inked resection margin. It is 6.0 cm from the ureteral margin, 2.0 cm from the renal vein margin, and 2.2 cm from the renal artery margin. The mass extends to the surface of the adjacent ureter.\n\nMicroscopic evaluation shows that the mass invades the renal sinus and comes into contact with the endothelium of large veins, though it does not extend into the renal vein. The tumor abuts the renal capsule but does not invade it. Extensive hyalinization is noted within the mass. All resection margins, including those of the ureter, renal artery, and renal vein, are free of involvement. Nuclear grading according to Fuhrman criteria is II out of IV.\n\nCytogenetic analysis of three tumor specimens revealed clonal chromosomal aberrations, including monosomy for chromosome 3, a common finding in certain types of kidney tumors. No adrenal tissue was identified. Additional sections of normal renal parenchyma were submitted for further testing, and an addendum will be provided by the Renal Pathology Division."} +{"pid": "TCGA-PR-A5PG", "report": "The left radical nephrectomy specimen includes a kidney with attached peri-renal fat, measuring 19x13x7cm and weighing 651 grams. A well-circumscribed, golden-brown mass is located superior to the kidney, measuring 9.0x8.0x3.0cm. The mass is adjacent to the kidney capsule but does not grossly penetrate it. The adrenal gland measures 4.0x1.5x1.0cm and appears golden-orange. The kidney itself measures 11x6.5x5.0cm, with normal tan-brown parenchyma, distinct cortical striations, and smooth calyces. The mass demonstrates firm fibrous tissue on its surface, and multiple sections have been taken for analysis, including margins, areas near the capsule, and surrounding structures.\n\nA small red-brown soft tissue fragment (0.6x0.4x0.2cm) from the spleen was submitted in entirety for frozen section.\n\nIn the periaortic lymph node dissection, a 6.5x3.0x1.2cm fragment of fibroadipose tissue contains several lymph nodes, ranging in size from 0.5x0.5x0.4cm to 2.0x2.0x1.0cm. A total of twelve lymph nodes were evaluated, and one contained tumor involvement.\n\nMicroscopic evaluation of the mass showed a neuroendocrine neoplasm with zellballen, trabecular, and diffuse growth patterns. The cells display pleomorphism, large nuclei, prominent nucleoli, and amphophilic cytoplasm. Occasional mitotic figures and apoptotic bodies are present, but no necrosis is seen. Immunohistochemical staining was positive for Chromogranin A, Synaptophysin, and S100, and negative for EMA. Ki67 proliferation index is approximately 3%. Lymphovascular invasion is present, and the surgical margins are free of tumor. Tumor extends into periadrenal adipose tissue and into small lymphatics and larger blood vessels. The splenic lesion shows multilocular microcystic spaces lined by cuboidal cells, which are positive for AE1/3 and focally positive for Calretinin, and negative for CK5/6, CD31, and CD34."} +{"pid": "TCGA-SI-AA8C", "report": "The specimen was obtained from a patient with a known history of neurofibromatosis type I who presented with a large soft tissue mass located in the left medial thigh. Preoperative imaging estimated the mass to be approximately 10 x 8 cm. An open biopsy followed by wide excision was performed.\n\nThe excised mass measured 7.5 cm in greatest dimension and was well-demarcated, appearing encapsulated. Gross examination revealed tan-brown soft tissue with areas of necrosis and cystic change. The specimen was partially inked for margin assessment: blue on the medial and lateral surfaces, black at the deep margin, yellow at the proximal margin, and green at the distal margin. The tumor focally extended to the inked medial margin (less than 0.1 cm), while other margins were negative, with distances ranging from 0.5 cm (deep) to 6.5 cm (distal). The attached skin measured 4.0 cm from the edge of the tumor.\n\nMicroscopic evaluation demonstrated a high-grade spindle cell malignancy arising within the background of diffuse neurofibroma. Focal cartilaginous differentiation was identified. Mitotic activity was prominent, and extensive tumor necrosis was observed. Immunohistochemical staining showed diffuse positivity for vimentin, patchy positivity for S-100 protein and collagen IV, and positivity for p53 in a subset of tumor cells. Cytokeratin staining was negative.\n\nMargins were assessed microscopically; the tumor approached the medial margin most closely. Based on histologic grade and tumor size (>5 cm), the lesion was classified as high-grade (G3) and staged as T2b. Regional lymph nodes could not be assessed (NX), and distant metastasis could not be evaluated (MX), resulting in a provisional stage grouping of pT2b/NX/MX.\n\nAncillary studies included fluorescence in situ hybridization (FISH) testing for MLL and ALK gene rearrangements. Both assays returned negative results. There was noted loss of MLL copy in some cells and increased ALK copy in others, although the clinical significance of these findings remains uncertain.\n\nSections reviewed included representative portions from the tumor periphery, margins, and overlying skin. Correlation with clinical data may affect the final staging."} +{"pid": "TCGA-DE-A69K", "report": "The specimen consists of a total thyroidectomy with multifocal lesions located in the right lobe. Three nodules were identified: Nodule A, measuring 3.1 x 1.8 x 1.2 cm, is located at the right superior pole and is loosely attached, with a pink/tan, smooth external surface and solid pink/gray cut surface. Nodule B measures 2.2 x 2.1 x 1.0 cm and is well-circumscribed and multinodular. It is located 0.5 cm from Nodule A. Nodule C measures 0.4 x 0.3 x 0.3 cm, is smooth, rubbery, and well-circumscribed, located in the right inferior lobe. The nodules are grossly confined; however, Nodule A abuts the green inked capsular margin and appears to be external to the thyroid gland. Nodule B is within the thyroid parenchyma and is 1.4 cm from the isthmus. Nodule C is near the anterior capsule, 0.1 cm from the posterior capsule, and 1.5 cm from the isthmus margin.\n\nMicroscopic evaluation reveals partially encapsulated lesions with areas of capsular disruption. Tumor cells extend to the inked surgical margins at the right superior pole. There is evidence of minimal extrathyroidal extension. No lymphovascular or blood vascular invasion is identified. The thyroid tissue away from the lesion shows multinodular changes. An incidental finding of a benign parathyroid tissue and a follicular adenoma measuring 0.4 cm are noted.\n\nA separate submission of central neck lymph nodes (compartment VII) includes four lymph nodes, none of which show involvement. Benign thymic tissue is also present in this lymph node specimen. Based on the findings, the pathologic staging assessment was determined as pT3 pNO. This assessment remains subject to revision pending clinical correlation and further information."} +{"pid": "TCGA-55-8205", "report": "The surgical pathology report includes a specimen from the right lower lobe of the lung. The tumor measured 6.5 x 5.7 x 4.5 cm and was located subpleurally. Histologic evaluation showed a poorly differentiated morphology with no evidence of visceral pleural invasion or lymphovascular space invasion. The tumor was unifocal and approached within 2.5 cm of the bronchial margin, while the distance to the pleural surface was 0.3 cm. No tumor extension beyond the primary site was noted. A total of 8 lymph nodes were examined, and none contained metastatic disease. One additional lymph node from level 8 was also negative for malignancy. An area of central scarring was identified within the lesion. Additional lymph nodes previously biopsied were also negative. The pTNM stage was determined as pT2b, NO. The histologic features were consistent with those seen in a prior biopsy. Gross examination of the right lower lobe specimen revealed a lung lobe measuring 17.0 x 12.0 x 5.0 cm with a segment of bronchus measuring 1.5 cm in length and diameter. The tumor was situated beneath the pleura and was gray-white in color, abutting adjacent bronchi and vasculature without clear invasion. Surrounding lung tissue appeared normal. Multiple lymph nodes were present, up to 1.0 cm in size, with no evidence of involvement. Specimens were submitted for microscopic analysis including margins, lymph nodes, and areas of interest such as the interface between tumor and normal tissue. Additional tissue was submitted for genomic research. The second specimen, a level 8 lymph node measuring 1.0 x 0.7 x 0.5 cm, was entirely submitted for evaluation and showed no malignant involvement."} +{"pid": "TCGA-55-8511", "report": "A biopsy was taken from a mass in the right upper lung lobe, revealing malignant cells with histologic features consistent with non-small cell carcinoma. The tumor measured 4.5 x 3.0 x 2.5 cm and was located within the pulmonary parenchyma without extension beyond it. No visceral pleural or lymphovascular space invasion was observed. The tumor was unifocal and showed no response to any prior treatment. Surgical margins were assessed, with the tumor located 0.2 cm from both the bronchial and parenchymal (stapled) margins, and 0.7 cm from the pleural surface.\n\nLymph node specimens were obtained from multiple sites including station 10, interlobar, right paratracheal, and subcarinal regions. All lymph nodes examined showed no evidence of metastatic involvement. A total of four lymph nodes were evaluated, none of which contained malignant cells.\n\nImmunohistochemical staining demonstrated positivity for cytokeratin 7 and TTF, while being negative for cytokeratin 20 and p63. These findings supported the histologic interpretation. The staging classification was determined to be pT2a NO based on the extent of the primary tumor and absence of nodal metastasis. Molecular testing is pending and will be reported separately."} +{"pid": "TCGA-RY-A83Y", "report": "The patient is a male who presented with seizures and was found to have a left parietal mass with a small area of focal ring enhancement. Imaging showed an ill-defined, cortically based T2/FLAIR hyperintense lesion involving the left postcentral gyrus and left inferior parietal lobule. The patient was on Decadron and Keppra.\n\nThree specimens were received for analysis. Part A, labeled \"L tumor - FS + perm,\" consisted of multiple irregular, friable, tan to pink glistening tissue fragments measuring 1.2 x 0.8 x 0.3 cm. A representative section was used for frozen section diagnosis and a touch preparation. The remaining tissue was submitted in cassettes A1 (frozen remnant) and A2. Part B, labeled \"tumor,\" was a single pink, irregular, soft tissue fragment measuring 1 x 1 x 0.3 cm, submitted intact in cassette B1. Part C, labeled \"CUSA contents,\" included multiple soft, pink, irregular tissue fragments totaling 5 x 5 x 2 cm in aggregate. Representative sections were placed in cassettes C1\u2013C8, and the remainder in C9\u2013C16.\n\nMicroscopic evaluation revealed a moderately cellular proliferation of neoplastic cells with uniform round nuclei. Mitotic activity was low, with up to one mitotic figure per 10 high-power fields. No necrosis or microvascular proliferation was identified. A macrophage infiltrate was present within the tumor, and multiple vessels were surrounded by macrophages. Intraoperative assessment of a biopsy specimen suggested an infiltrating glioma, at least WHO grade II, favoring a specific type.\n\nImmunohistochemical studies on block A2 showed positivity for IDH-1 (R132H mutant) protein. MIB-1 labeling index was approximately 4%. Fluorescence in-situ hybridization for 1p19q was also performed on block A2, and results were reported separately. All preliminary interpretations and dictations were reviewed and edited by the attending pathologist before final sign-out. The attending pathologist confirmed the findings upon review of select slides.\n\nAll specimens were processed and evaluated according to standard protocols. The laboratory performing the immunostains is CLIA-certified and meets all requirements for high-complexity testing. These assays were developed and validated by the laboratory for clinical use and are not considered investigational."} +{"pid": "TCGA-CV-A6K0", "report": "The patient is a male with a height of 176.0 cm, weight of 73.4 kg, and a body surface area of 1.89 m\u00b2. A right partial glossectomy specimen measured 4.5 x 2.5 x 2.0 cm and contained an ulcerating and partially exophytic lesion measuring 1.7 x 1.4 x 1.1 cm. The lesion was located at least 0.5 cm from both the deep and mucosal margins. Histologic evaluation showed moderate to marked cellular atypia with infiltrative tumor borders composed of thin cords less than four cells in width. The depth of invasion was 1.1 cm. Perineural and vascular invasion were not identified. Margins, including mucosal and deep, were free of malignant cells. Frozen section analysis confirmed clear margins.\n\nIn the right neck dissection specimens, multiple lymph nodes were evaluated across levels I, II, and III. In level I, seven lymph nodes were identified and all were negative for malignancy. In level II, five lymph nodes were examined and none showed evidence of involvement. In level III, eight lymph nodes were assessed, and all were negative. Additionally, submandibular glands were present in levels I and II and were also negative. All sections were processed and analyzed using standard histopathologic techniques."} +{"pid": "TCGA-SX-A7SL", "report": "The left kidney specimen demonstrates a single well-circumscribed lesion located in the upper pole. The tumor measures 4.0 x 3.7 x 3.7 cm and is confined entirely within the kidney, with no extension into perinephric tissue, renal sinus, renal vein, or collecting system. Grossly, the mass is well-demarcated, tan-colored, and rubbery with a slightly lobulated cut surface, including small yellow-orange softer areas measuring up to 1.2 cm. Microscopically, the lesion exhibits type I morphology with nuclear grading consistent with grade 1/4 (Fuhrman classification). No sarcomatoid features or tumor necrosis are present. All surgical margins, including external soft tissue and ureteral, are free of malignant cells. There is no evidence of lymphovascular invasion or regional lymph node involvement. Adjacent to the lesion, a 2.0-cm unilocular cyst is identified, containing clear fluid with a smooth inner lining. Sections of the kidney distant from the lesion show less than 58 sclerotic glomeruli, minimal interstitial fibrosis, some dilated atrophic tubules, and significant atherosclerotic changes in the renal artery and intra-renal vessels. The specimen was obtained via robotic radical nephrectomy and includes representative blocks suitable for further testing. The frozen section findings are confirmed by permanent sections. Pathologic staging is consistent with localized disease without nodal assessment. A biorepository sample of both non-malignant cortex and the lesion has been collected."} +{"pid": "TCGA-D5-7000", "report": "A histopathological examination was performed on a resected segment of large intestine measuring 20 cm in length, along with surrounding periintestinal fat tissue measuring 18 x 5 x 3 cm, and an 8 cm appendix. A cauliflower-shaped lesion was identified in the mucosa, measuring 3 x 2 cm. The lesion circumferentially involves approximately 80% of the intestinal wall and is located 3.5 cm from the proximal excision margin and 1.5 cm from the distal excision margin. The minimum radial margin measures 3 cm.\n\nMicroscopic evaluation reveals a tubulopapillary and partially mucinous growth pattern with high-grade cellular atypia. Lymph node analysis shows changes consistent with lymphonodulitis in multiple nodes. Serial sectioning of specimens was performed to confirm findings. Final results align with preliminary observations. Inflammatory changes are also present in the appendix."} +{"pid": "TCGA-OR-A5LK", "report": "A right adrenalectomy was performed. The tumor weighed 244 grams and measured 8.2 x 7.5 x 6.5 centimeters. Histologic evaluation revealed a lesion with oncocytic features. Cellular atypia, nuclear irregularities, and other morphologic characteristics were noted. Based on staging criteria, the lesion demonstrated features consistent with an advanced stage."} +{"pid": "TCGA-HT-7470", "report": "The specimen involves the temporal lobe, including the amygdala, anterior and posterior temporal lobe, uncus, and hippocampus. The tumor demonstrates a range of cellular features across different regions. In most areas, the tumor is variably cellular with an infiltrative growth pattern through cortical gray and white matter. The cells typically have round nuclei with perinuclear halos or exhibit a microgemistocytic appearance. The majority of the specimen shows a predominance of the microgemistocytic phenotype, with only rare mitotic figures. Atypia ranges from mild to focally moderate, with occasional highly atypical nuclei. Microvascular proliferation and necrosis are not present in these regions. \n\nIn contrast, sections from the enhancing uncus show significantly increased cellularity. The degree of nuclear atypia is more pronounced compared to other areas. Mitotic activity is also more evident in this region, with up to six mitotic figures identified per 10 high power fields. Microvascular proliferation is present, but no tumor necrosis is observed. The MIB-1 labeling index, which reflects the proportion of proliferating cells, is calculated at 12.5%."} +{"pid": "TCGA-VD-A8KL", "report": "The specimen consists of a fresh, intact left globe. Gross measurements of the globe are 23mm axial, 23.5mm horizontal, and 23mm vertical. The cornea measures 12mm horizontally and 11mm vertically. The optic nerve is 15.5mm in length and 4mm in diameter. An intraocular lens is present in the anterior chamber. Transillumination reveals a large infero-lateral shadow measuring up to 16mm in diameter extending from the ciliary body posteriorly. On sectioning, a large solitary pigmented mass is identified within the choroid.\n\nThe tumour measures 17mm in largest basal diameter and 7mm in height. Histologically, the lesion shows mixed cellular morphology with minimal epithelioid component (<15%). Immunohistochemical staining demonstrates expression of Melan-A and HSP 27 (score 2). Mitotic activity is low, with approximately 2 mitoses per 40 high-power fields. Microvascular patterns show prominent vessels without closed loops. There is minimal lymphocytic infiltration and no evidence of tumour necrosis. Bruch\u2019s membrane appears focally disrupted. No extension into the optic nerve or vortex veins is observed. However, there is focal infiltration of adjacent sclera through a vascular channel. Resection margins are free of tumour cells.\n\nOther ocular findings include slight atrophy of the retina overlying the lesion and focal serous retinal detachment distant from the mass. The anterior chamber angles are open, and the iris appears normal. The ciliary body is atrophic with hyalinization of the ciliary processes. A residual lens capsule with small attached cataractous material is present. No significant abnormalities are noted in the cornea."} +{"pid": "TCGA-DJ-A3VD", "report": "A right paratracheal lymph node specimen measuring 0.5x0.5x0.3cm was examined, and two lymph nodes were present. Both showed involvement with metastatic cells. The largest lymph node measured 0.5 cm in diameter, with the largest focus of involvement measuring 0.1 cm. No extension beyond the lymph node capsule was identified. A separate biopsy of a right upper parathyroid region showed no abnormality, with only normal tissue present. Additional right paratracheal lymph nodes (five) were examined and found to be benign. On the left side, paratracheal lymph nodes were also examined. One set included three lymph nodes, all of which were benign. Another submission from the left paratracheal area contained four lymph nodes, all involved with metastatic cells. The largest lymph node in this group measured 0.9 cm, with a metastatic focus measuring 0.5 cm. No extranodal extension was seen.\n\nA total thyroidectomy specimen was received, weighing 17 grams. The right lobe measured 4.4x1.9x1.4 cm, the left lobe 4.6x2.0x1.3 cm, and the isthmus 2.1x1.5x1.2 cm. A nodule was identified in the isthmus, measuring 1.2x0.8x0.6 cm, with a tan, soft, homogeneous appearance. No mitotic activity or necrosis was observed. The nodule lacked a distinct capsule and there was no evidence of blood vessel invasion or extension beyond the thyroid. The surgical margins were free of any abnormal cells. The surrounding thyroid tissue showed signs of chronic inflammation. Adjacent to the right lobe, a normal-appearing parathyroid gland was identified. No other nodules were found away from the main lesion. A separate specimen labeled as right paratracheal lymph node number three contained only benign fat tissue, with no lymph node present."} +{"pid": "TCGA-BH-A42T", "report": "A sentinel lymph node biopsy was performed on two lymph nodes in the left axilla. In one lymph node, isolated tumor cells were identified using immunohistochemical staining (AE1/AE3), which were not visible on routine H&E staining. Less than 10 scattered subcapsular positive cells were noted. The second lymph node showed no evidence of tumor involvement.\n\nA total mastectomy specimen from the left breast weighed 380.8 grams. An invasive tumor measuring 2.8 cm in greatest dimension was identified in the upper outer quadrant. Histologic evaluation revealed a Nottingham score of 7 out of 9, with scores of 3 for tubule formation, 2 for nuclear pleomorphism, and 2 for mitotic activity. Lymphovascular space invasion was present. The tumor was located 0.25 cm from the nearest posterior resection margin; all other margins were free of tumor. The nipple was also negative for tumor involvement.\n\nIn addition to the invasive component, in situ disease was identified in multiple quadrants (upper outer, lower outer, and lower inner) with pagetoid extension into ducts. Atypical lobular hyperplasia was present, as well as calcifications associated with benign breast parenchyma. Non-neoplastic changes included fibrocystic disease with apocrine metaplasia and ductal epithelial hyperplasia. A previous biopsy site change was also noted. Skin examination revealed reticular dermis involvement by invasive tumor through direct extension, along with a capillary hemangioma.\n\nImmunohistochemistry showed positivity for estrogen and progesterone receptors. HER-2 immunostaining was scored as 2+, prompting further fluorescence in situ hybridization (FISH) testing. FISH analysis on block 3A demonstrated an HER-2/CEP17 ratio of 1.93, placing it in the equivocal range for gene amplification. Control specimens performed as expected. Additional studies are pending.\n\nSpecial procedures included FISH testing using a modified PathVysion HER-2 DNA Probe Kit. The average number of HER-2 signals per cell was 4.25, and the average CEP17 signal count was 2.20. The laboratory has validated the test\u2019s performance under CLIA \u201988 regulations."} +{"pid": "TCGA-BL-A3JM", "report": "The specimen included portions of the left and right distal ureters, bladder and prostate, urethral margin, right and left pelvic lymph nodes, and appendix. The left distal ureter measured 0.6 cm in diameter and 0.3 cm in length, while the right distal ureter was 0.5 x 0.4 x 0.3 cm. The combined bladder and prostate specimen weighed 358 grams with overall dimensions of 10.5 x 10.5 x 4.0 cm. The prostate measured 4.5 x 3.5 x 3.5 cm and showed a nodular cut surface. The bladder measured 6.0 x 6.0 x 4.0 cm with a pink tan smooth mucosa and an ulceration measuring 1.3 x 1.3 cm on the right wall. This area had a firm yellow rubbery cut surface and measured 0.6 cm in greatest dimension, located 1.2 cm from the nearest surgical margin. Surrounding fatty tissue showed no identifiable lymph nodes.\n\nThe urethral margin consisted of two fragments measuring 1 x 0.8 x 0.5 cm in total. The right pelvic lymph node specimen was 5.5 x 3.5 x 1.2 cm with lymphoid tissue ranging from 0.3 to 3.0 cm. The left pelvic lymph node specimen measured 4.5 x 3.5 x 1.5 cm with similar lymphoid tissue. The appendix was unremarkable, measuring 10.0 x 0.7 cm with a smooth serosa.\n\nMicroscopic evaluation revealed high-grade urothelial carcinoma invading through the muscularis propria into perivesicular fibroadipose tissue (pT3). Margins of resection were negative. Four lymph nodes from each pelvic side were negative for malignancy (pN0). Angiolymphatic invasion was present. The prostate showed benign changes without tumor involvement. The appendix was histologically unremarkable. Multiple sections of the bladder demonstrated ulceration with no other discrete lesions."} +{"pid": "TCGA-D1-A169", "report": "The surgical specimen included the uterus, right ovary, segments of both fallopian tubes, tissue from the bladder peritoneum, right and left pelvic lymph nodes, a portion of omentum, and various other biopsies from the colic gutter, diaphragm, gonadal vessels, para-aortic lymph nodes, and small bowel mesentery. The uterus contained a polypoid lesion measuring 6.0 \u00d7 5.1 \u00d7 1.2 cm that extended throughout the uterine cavity and reached the lower uterine segment. This lesion invaded approximately half of the myometrium, which had a total thickness of 1.1 cm. A small intramural leiomyoma was also identified measuring 0.2 cm. No involvement of the endocervical canal or ectocervix was observed.\n\nBiopsy specimens from the bladder peritoneum were positive for malignant cells, while those from the left bladder peritoneum were negative. All sampled lymph nodes, including right and left pelvic nodes and para-aortic nodes above and below the inferior mesenteric artery, showed no evidence of malignancy. The omentum and biopsies from the right colic gutter, right diaphragm, left colic gutter, and small bowel mesentery were all negative for tumor involvement. However, a biopsy of the small bowel serosa was positive for malignant cells.\n\nImmunohistochemical analysis of the tumor demonstrated intact expression of DNA mismatch repair proteins hMLH1, hMSH2, hMSH6, and hPMS2, indicating no evidence of defective mismatch repair mechanisms."} +{"pid": "TCGA-OE-A75W", "report": "The specimen consists of a distal pancreatectomy with splenectomy. The tissue was preserved in 10 percent neutral buffered formalin for approximately 27.25 hours. The lesion involved the tail of the pancreas and measured 4.5 x 2.6 x 2.7 cm. Histologic evaluation revealed well-differentiated features with focal cystic changes suggestive of possible origin within a cystic lesion. The lesion demonstrated limited extension into the surrounding fat. No lymph-vascular or perineural invasion was identified. Surgical margins were free of involvement. The closest distance of the lesion to the surgical margin was less than 1 millimeter at the posterior (retroperitoneal) margin, while it was 1.5 cm from the proximal pancreatic margin.\n\nEvaluation of regional lymph nodes included two peripancreatic nodes, all without evidence of involvement. An extended lymph node dissection of adipose tissue cleared 20 lymph nodes, none of which showed signs of metastatic involvement. Distribution of nodes by zone was as follows: zone 1, 12 nodes; zone 2, 3 nodes; zone 3, 1 node; and zone 4, 4 nodes.\n\nAdditional findings included a benign spleen and unremarkable adjacent pancreatic tissue. A separate mesenteric nodule consisted of adipose stroma with fat necrosis. No distant spread was identified. Pathologic staging was determined as pT3, pNO. This addendum was issued to incorporate findings from the extended lymph node dissection."} +{"pid": "TCGA-VS-A94W", "report": "The biopsy specimen from the cervix shows a neoplastic lesion composed of atypical squamous cells exhibiting features of invasion. The tumor is moderately differentiated, with evidence of vascular and lymphatic space involvement not identified. No sanguineous or lymphatic vascular infiltrations are present."} +{"pid": "TCGA-AC-A23H", "report": "A right simple mastectomy specimen was received and measured en bloc at 15.5 x 9.5 x 3 cm, weighing 115 grams. The skin surface included an anterior ellipse measuring 16.5 x 7.5 cm with an eccentric 2.7 cm areolar complex and everted nipple. A 4 cm scar was noted near the lateral margin. The specimen was inked: orange on the superficial superior margin, green on the superficial inferior margin, and black on the deep margin. On sectioning, a firm pale tan mass measuring 4.2 x 3.7 x 2.9 cm was identified in the upper inner and lower inner quadrants. The mass extended to the inked deep margin and was 1.7 cm from the superficial superior margin and 1.9 cm from the superficial inferior margin. The overlying skin was disrupted. No axillary tissue was identified.\n\nMicroscopic evaluation revealed a single focus of invasive carcinoma without ductal or lobular carcinoma in situ. The tumor extended into the dermis without ulceration and did not involve the nipple epidermis. No skeletal muscle was present. Histologic grading using the Nottingham system showed a score of 7 (glandular differentiation 3, nuclear pleomorphism 2, mitotic count 2), corresponding to grade 2 differentiation. Margins were uninvolved, with the closest distance of 0.4 mm at the deep margin.\n\nPathologic staging was determined as pT2NXG2. No lymph nodes were present for assessment. Immunohistochemical studies from another specimen showed estrogen receptor positivity (1-2+, 10% staining), negative progesterone receptor, and HER2/neu positivity by immunohistochemistry (score 3+) and FISH (ratio 5.90). Microcalcifications were present in non-neoplastic tissue."} +{"pid": "TCGA-B9-A8YI", "report": "A partial nephrectomy specimen from the left kidney was received for evaluation. The specimen weighed 91.1 grams and measured 7.1 x 6.0 x 5.5 cm. The external surface was yellow and smooth, with the capsule inked blue. The renal parenchyma was tan to brown, with the parenchymal margin inked black. Within the cortex, just beneath the capsule, a mass measuring approximately 4.5 x 4.2 x 2.6 cm was identified. It was partially solid and partially cystic, with a red/brown to yellow variegated appearance. The mass approached the capsule but did not extend through it, and was within 0.4 cm of the black-inked parenchymal margin. No other gross abnormalities were noted.\n\nMicroscopic examination revealed a unifocal lesion with Fuhrman nuclear grade 2 features. There was no evidence of sarcomatoid differentiation. Histologic assessment showed no invasion of the capsule, perirenal adipose tissue, Gerota's fascia, renal sinus, or major veins. Lymphatic invasion was not identified. Surgical margins, including the renal parenchymal margin (with a distance of 5 mm from the tumor), renal capsular margin, and paranephric adipose tissue margin, were all negative.\n\nAdditional histologic findings in the non-neoplastic kidney included focal global glomerulosclerosis and mild interstitial nephritis. No lymph nodes or adrenal tissue were submitted for evaluation. Based on the available information, the pathologic stage was determined as pT1b, pNx. This staging is provisional and may be updated pending further clinical review."} +{"pid": "TCGA-Y6-A9XI", "report": "Surgical Pathology Report (Order. Value. Surgical. ACCESSION NO. Final Diagnosis (es): (A) Bladder neck margin, biopsy: Normal prostate glands are present. (B) Prostate with seminal vesicles, radical prostatectomy: 1) Histologic evaluation revealed a Gleason pattern with a sum score of 8/10. 2) The largest nodule measured 4.5 x 3.0 x 2.0 cm, equating to 36 cc. 3) Lymphovascular and perineural invasion were identified. 4) There was extensive bilateral capsular penetration, with specific involvement noted on the right and left sides across multiple slides. 5) A positive margin was identified at the right posterior lateral region as seen in multiple slides. 6) The pathologic stage was determined to be pT3aNOMX. (C) Bilateral pelvic lymph nodes, excision: Four lymph nodes were examined and found to be negative for malignancy.\n\nSynoptic Report: Procedure: Radical prostatectomy. Specimen dimensions: 4.5 x 3.8 x 3.6 cm. Specimen weight: 40.1 grams. Lymph node dissection included pelvic lymph nodes. Histologic type: Acinar adenocarcinoma. Histologic grade (Gleason pattern): Primary pattern Grade 4, secondary pattern Grade 4, resulting in a total Gleason score of 8/10. Tissue involvement: 36 cc of the prostate. Dominant nodule size: Greatest dimension 14.5 mm, with additional dimensions of 13 x 13 mm. Extraprostatic extension: Nonfocal involvement. Seminal vesicle invasion was not observed bilaterally. Lymphvascular invasion was present. Margins: Posterolateral margin showed positivity. Node analysis: Of the four bilateral pelvic lymph nodes examined, none were positive. Pathologic staging: pT3aNOMX.\n\nSpecimens received: A \u2013 Posterior bladder neck margin; B \u2013 Prostate with seminal vesicles; C \u2013 Bilateral pelvic lymph nodes. Clinical history included prior assessment of the posterior bladder neck margin which showed benign fibromuscular tissue. Gross description of the prostate specimen showed a radical prostatectomy with seminal vesicles removed. The prostate was measured and inked accordingly for orientation. Serial sections revealed tan solid nodules within both halves of the prostate, with a larger nodule near the capsule on the right side. The remainder of the tissue was described as pale tan and rubbery. Both seminal vesicles and vas deferens were measured. The entire specimen was submitted for analysis, including detailed sections from apex to base and the seminal vesicles. Lymph node specimens were palpated and submitted for analysis.\n\nMicroscopic evaluation was completed, with controls evaluated for all stains used. Immunohistochemistry testing was performed using analyte-specific reagents. These tests are not investigational and are used in standard clinical care. ER, PR, Ki-67, p53 were reported as a semi-quantitative percentage of positively stained nuclei. Her-2/neu and EGFR were scored based on staining intensity and proportion of cells involved. All tissue tested had been fixed according to C.A.P. requirements."} +{"pid": "TCGA-S9-A6U0", "report": "The pathology report indicates a pleomorphic astrocytic tumor with evidence of mitotic activity. Vascular proliferation is noted at an early stage. The proliferation index is measured at 25%. The case exhibits features suggestive of a borderline transition, though no definitive diagnosis is provided. Cellular characteristics and structural patterns are described as atypical, with concern for progression. Staging and classification remain inconclusive within the context of high-grade glioma features."} +{"pid": "TCGA-A5-AB3J", "report": "The surgical specimens included a left salpingo-oophorectomy, right salpingo-oophorectomy, total abdominal hysterectomy, biopsies of sigmoid and right colon adhesions, lymph node excisions, appendectomy, partial omentectomies, and umbilical hernia repair. \n\nIn the left ovary, a multilobulated solid tumor measuring approximately 20 cm was identified. The tumor replaced the entire ovary with no recognizable normal ovarian tissue. The cut surface showed cystic/necrotic changes (20\u201330%) and intratumoral hemorrhage. The fallopian tube appeared benign. Microscopically, the tumor showed moderately differentiated features with involvement limited to the ovary; the capsule remained intact and no tumor was found on the ovarian surface. No lymphovascular invasion was identified. One pelvic lymph node was examined and found negative for tumor.\n\nThe right ovary was small, measuring 3.4 x 1.7 x 0.7 cm, and contained a 0.3 cm serosal nodule. Histologically, the ovary was benign with surface stromal proliferations. The fallopian tube was unremarkable. No tumor was identified in this specimen. Both ovaries showed serosal adhesions and reactive mesothelial reactions.\n\nThe uterus measured 11.0 x 5.4 x 4.0 cm overall, with a 3.0 cm intramural leiomyoma present. The endometrial cavity was diffusely involved by a tan-white, friable, polypoid lesion measuring 9.0 x 4.0 x 4.0 cm. This lesion extended into the upper endocervix, lower uterine segment, and corpus. Microscopic evaluation revealed moderately differentiated features with less than 50% myometrial invasion. Focal stromal invasion was noted in the endocervix. Few intravascular tumor-like cells were observed, though it was unclear whether these represented true lymphovascular invasion or artifact. No tumor was identified at the margins. The uterine serosa showed hemorrhage and moderate adhesions.\n\nBiopsies from the sigmoid and right colon adhesions showed fibrovascular tissue with fibrosis and reactive mesothelial proliferation. No malignancy was detected in either specimen.\n\nLymph node sampling included six pelvic nodes (left pelvic, right pelvic, and para-aortic combined), all of which were negative for tumor involvement.\n\nThe appendix was unremarkable with no evidence of malignancy, although acute serositis and adhesions were noted.\n\nThree separate omental specimens were evaluated. Each showed adipose tissue with focal adhesions, patchy acute and chronic inflammation, and reactive mesothelial reactions. No malignant cells were identified in any of the omental samples.\n\nThe umbilical hernia specimen consisted of fibrofatty tissue with patchy acute inflammation and hemosiderin-laden histiocytes. No malignancy was present.\n\nImmunohistochemical staining showed intact expression of DNA mismatch repair proteins MLH1, MSH2, MSH6, and PMS2, suggesting that Lynch syndrome is unlikely. However, further testing may be warranted if clinically suspected.\n\nNo tumor was identified in the remaining specimens, including the fallopian tubes, adnexal ligaments, vaginal cuff, or non-neoplastic endometrium. The findings were consistent with localized disease without lymph node or distant tissue involvement."} +{"pid": "TCGA-SO-A8JP", "report": "The specimen consists of a left orchiectomy measuring 5.8 x 4.9 x 3.4 cm with an attached spermatic cord segment measuring 10.0 cm in length and 1.2 cm in diameter. The tumor measures 4.4 x 4.3 x 3.2 cm, has a mixed pink-tan and dark red appearance with focal hemorrhage, and is well-defined. It is located 11.0 cm from the closest spermatic cord resection margin, 0.2 cm from the tunica vaginalis margin, and 0.4 cm from the epididymis. The tumor occupies approximately 70% of the testicular volume.\n\nMicroscopic evaluation reveals uniform cells arranged in nests separated by fibrous bands. There is no invasion of the tunica albuginea, tunica vaginalis, or paratesticular structures such as the epididymis or spermatic cord. No angiolymphatic invasion is identified, and all resection margins are free of involvement. Adjacent testicular tissue shows hypospermatogenesis and maturation arrest, along with intratubular changes. Sections of the tumor and surrounding tissue were submitted for analysis across twelve cassettes, including margins and representative areas."} +{"pid": "TCGA-55-8094", "report": "The specimen was a left upper lobe lung resection measuring 4.0 x 3.5 x 3.0 cm, with a firm tan appearance and scalloped borders, including areas of central necrosis. The tumor was unifocal and located in the left upper lobe, with no direct invasion of adjacent lobes or pleural surfaces. The tumor was noted to abut the pleural surface with associated pleural puckering, but no separate pleural tumor foci were identified. Vascular and bronchial margins were uninvolved, each measuring 1.5 cm from the tumor edge. The surrounding lung tissue was spongy and red-brown with gray-black anthracotic stippling.\n\nLymph nodes were submitted for evaluation, including three peribronchial lymph nodes ranging from 0.2 to 0.5 cm in size, as well as additional lymph node specimens from stations 4L, 9L, 10L, and 11L. No lymph node involvement was identified. One of the 4L specimens consisted of thymic tissue without evidence of tumor. All lymph nodes were negative for malignancy, with a total of six lymph nodes examined and none involved.\n\nMicroscopic examination showed a grade 3 histologic lesion without vascular, lymphatic, or perineural invasion. No direct extension into the mediastinum, parietal pleura, or diaphragm was observed. Molecular studies were performed on the tumor tissue. Testing for EGFR mutations in exons 18 to 21 revealed a wild-type sequence with no detectable mutations. This included analysis of specific mutations in exons 18, 19, 20 (including T790M), and 21 (including L858R and L861Q). The absence of mutations suggests a lower likelihood of response to anti-EGFR tyrosine kinase inhibitors. Immunohistochemical staining for ERCC1 was positive.\n\nA separate surgical specimen from the left cerebellum previously demonstrated a cystic tumor, which was found to be consistent with metastatic origin from the lung lesion. No prior treatment effect was noted."} +{"pid": "TCGA-EL-A3GZ", "report": "The surgical specimen consists of a total thyroidectomy with a stitch on the right lobe. The right lobe measures 5.5 x 3.0 x 1.2 cm and the left lobe measures 5.3 x 2.8 x 1.4 cm, with minimal isthmus tissue present. Within the left upper lobe, there is a nodule measuring 1.8 x 1.8 x 1.6 cm that is well-circumscribed, white-tan in color, and firm in consistency. The nodule approaches the capsular surface. No other gross lesions are identified. The specimen was entirely submitted for analysis.\n\nMicroscopic evaluation revealed a focus within the left lobe with cellular features suggestive of a neoplastic process. Vascular invasion was identified, and a small focus of intrathyroidal involvement measuring less than 1.0 mm was noted. Margins of resection were free of abnormal cells. Two lymph nodes located in proximity to the left lobe showed no evidence of involvement. Two parathyroid glands from the right side were examined and found to be benign. The remainder of the thyroid tissue showed no significant pathological changes."} +{"pid": "TCGA-QG-A5Z2", "report": "The surgical specimen consists of a right hemicolectomy measuring 27.8 cm in length, including 4.7 cm of attached terminal ileum. The specimen is stapled at both ends with moderate attached fat. The serosal surface appears tan-pink to red and smooth. The vermiform appendix is intact, measuring 7.2 x 0.8 cm, and the ileocecal valve is tan-yellow and thickened. The ileal mucosa shows normal folds and has a tan-brown, glistening appearance.\n\nA polypoid mass measuring 3.8 x 2.6 x 0.8 cm is identified on the colonic mucosa. It is located 9.3 cm from the proximal resection margin and 19.8 cm from the distal resection margin. Histologic examination reveals that the mass extends into the muscularis propria but does not reach the inked serosal surface. The closest distance to the mesenteric resection margin is 7.3 cm. Adjacent to the mass, there is endoscopic tattooing pigment noted.\n\nAnother finding includes a submucosal mass measuring 1.0 x 1.0 x 0.3 cm, which appears consistent with a lipoma. The appendix and ileocecal valve show no significant histologic abnormalities.\n\nMultiple lymph nodes are identified within the attached fat, with 23 lymph nodes examined in total, none showing evidence of metastatic disease. All resection margins\u2014proximal, distal, and mesenteric\u2014are free of involvement by invasive\u75c5\u53d8. There is no evidence of lymphovascular or perineural invasion, nor are there tumor deposits identified.\n\nHistologic evaluation confirms penetration into the muscularis propria without extension beyond. No treatment effect is observed, as there was no prior therapy administered."} +{"pid": "TCGA-AG-3587", "report": "The specimen consists of a rectal resection with tumor-free proximal and distal margins. A lesion was identified in the distal rectum, characterized by moderately differentiated cellular features (G2). The lesion demonstrates superficial invasion limited to the lamina muscularis propria. No evidence of regional lymph node involvement was observed. A total of 17 lymph nodes were examined, none showing signs of metastasis. Vascular and perineural invasions were not detected."} +{"pid": "TCGA-77-8009", "report": "The specimen consists of the right middle and lower lobes, with the lower lobe measuring 155 x 100 x 40 mm and the middle lobe 135 x 90 x 30 mm. A resection margin along the middle lobe bronchus measures 150 mm in length. A rounded endobronchial lesion extends to the bronchial resection margin but is not attached to the bronchial wall in this region. The pleural surface on the anterior apical portion of the lower lobe shows an area of induration measuring approximately 25 x 30 mm. Upon sectioning, a lesion within the apical segment of the lower lobe measures 50 x 45 x 45 mm with endobronchial extension up to 40 mm. The entire lesion measures approximately 75 mm in maximal dimension. The endobronchial component extends into the proximal portion of the middle lobe bronchus and is focally tethered to the wall at that site. The alveolated parenchyma of the middle lobe appears free of the lesion, and no involvement is present at the stapled resection margin. The endobronchial component also extends to the bronchial resection margin; however, it does not attach to the bronchial wall in this region. A peribronchial lymph node appears involved, possibly by direct extension. The bronchial and peribronchial resection margins appear macroscopically free of the lesion. Localized bronchiectasis is noted distal to the endobronchial lesion.\n\nMicroscopic examination confirms clear margins. A poorly differentiated cellular proliferation involves the apical segment of the right lower lobe with extensive endobronchial spread. The lesion does not extend to the visceral pleura. The bronchial resection margin is free of involvement. The lesion extends into peribronchial connective tissue adjacent to the resection margin but remains 0.3 mm away from the peribronchial resection margin. Perineural involvement is identified within the peribronchial connective tissue, with the involved nerve measuring 350 \u00b5m in diameter and located 1.3 mm from the peribronchial resection margin. Evidence of lymphatic invasion is present. Some small blood vessels show signs of recanalization, though no definitive vascular invasion is observed. A peribronchial lymph node is involved, possibly due to direct extension. Changes including sinus histiocytosis, carbon pigment deposition, fibrosis, and scattered birefringent material consistent with silicate are noted in peribronchial lymph nodes. Within adjacent lung tissue, bronchiectasis with mucoid plugging and focal endogenous lipoid pneumonia suggestive of obstructive pneumonitis is present. The right middle lobe alveolated lung tissue shows bronchiectasis with mucoid plugging but no evidence of the lesion. Rare mixed duct macules are present within the remaining alveolated lung tissue, which is otherwise unremarkable.\n\nA separate submission of a No. 7 lymph node reveals reactive changes including sinus histiocytosis, follicular hyperplasia, carbon pigment deposition, fibrosis, and scattered birefringent material consistent with silicate. No involvement is identified in this lymph node. Pathological findings include perineural extension within peribronchial tissue and lymphatic invasion. No vascular invasion is seen. Bronchiectasis and focal endogenous lipoid pneumonia are present in adjacent lung tissue."} +{"pid": "TCGA-D8-A1XG", "report": "Histopathological examination of a total organ resection from the right breast was performed. The specimen measured 13.7 x 7.6 x 4.8 cm and weighed 193 g. A skin flap measuring 17.8 x 10.2 cm was present. No axillary tissue was included. A lesion measuring 6.2 x 4.3 x 7.8 cm was identified in the central portion, located 0.1 cm from the upper boundary and 0.1 cm from the base.\n\nMicroscopic evaluation revealed a high-grade cellular proliferation arranged in a disorganized pattern. Mitotic activity was notable, with 20 mitoses observed in 10 high-power fields. There was evidence of infiltration into the dermis and pectoral muscle. The nipple showed no abnormal changes. The surrounding glandular tissue exhibited signs of atrophy.\n\nLymph node involvement was identified, with affected nodes present in the axillary region. Immunohistochemical analysis demonstrated nuclear staining for estrogen and progesterone receptors in 10\u201375% of cells. HER2 staining using HercepTest\u2122M by DAKO showed no reactivity in the invasive component (score = 0)."} +{"pid": "TCGA-IB-A5SS", "report": "A lymph node and a specimen including the distal pancreas and spleen were submitted for pathological evaluation. The lymph node measured 2 x 1 x 0.5 cm and showed no evidence of abnormal cellular infiltration. The pancreatic specimen measured 9 x 5.5 x 2.5 cm, with a distinct tan mass identified in the tail region. The mass measured 4.5 x 2.4 x 1.6 cm and exhibited extension into the peripancreatic adipose tissue. Microscopic examination revealed a poorly differentiated adenocarcinoma involving the pancreatic tail and extending to the anterior and posterior inked surfaces. Vascular invasion was noted within the splenic artery, along with tumor emboli. Perineural and lymphovascular space invasion were also present.\n\nThe surgical margins were free of invasive carcinoma, with the closest distance from the tumor to the margin measuring 8 mm. A total of six lymph nodes were identified in the peripancreatic region, five of which contained metastatic deposits. Within the pancreatic tail, an intraductal papillary mucinous neoplasm was observed adjacent to the invasive component. Additionally, high-grade intraepithelial neoplasia was identified at the edge of the invasive lesion, consistent with in situ changes. Low-grade pancreatic intraepithelial neoplasia was also present at the resection margin. No treatment effect was observed. The spleen appeared unremarkable without notable pathological findings."} +{"pid": "TCGA-A7-A4SD", "report": "Final Surgical Pathology Report. Procedure: Diagnosis. Sentinel lymph node #1, excision: No evidence of metastasis in 3 lymph nodes (0/3). Sentinel lymph node #2, excision: No evidence of metastasis in 3 lymph nodes (0/3). Right breast, mastectomy specimen: Histologic evaluation reveals a lesion with a greatest dimension of 4.3 cm. The surgical margins are negative, though the closest margin is 0.4 cm at the deep margin. Microscopic assessment includes multilevel sectioning with H&E staining and histochemical analysis for pankeratin. No evidence of involvement was found in the lymph nodes examined from both sentinel node specimens. The lesion demonstrates a high histologic grade (grade 3), composed of an architectural score of 3, nuclear score of 3, and mitotic score of 3. Vascular invasion, calcification, and ductal carcinoma in situ are not identified. Gross examination of the right mastectomy specimen shows a large piece of fibroadipose tissue measuring 27.0 x 26.0 x 6.5 cm. A skin ellipse with a central nipple measuring 1.1 x 1.1 x 0.7 cm is present. A palpable mass located in the lower inner quadrant measures 4.3 x 3.8 x 3.1 cm and is described as well-circumscribed, glistening, tan-white, and rubbery. It extends to within 0.4 cm of the deep inked margin and 1 cm of the anteroinferior inked surface. Several associated firm tan-white structures are noted. Sections submitted include portions of the lesion, normal parenchyma, and multiple quadrants of the breast along with the nipple. No other gross abnormalities are identified. Staging assessment corresponds to a size of 4.3 cm (pT2)."} +{"pid": "TCGA-HZ-7920", "report": "The surgical specimen included portions of the stomach, duodenum, and pancreatic head. The resected pancreatic head measured 7.0 x 4.6 x 4.5 cm. A firm, pale tan, ill-defined area measuring 2.0 x 1.4 x 2.2 cm was identified in the pancreatic tissue. This lesion appeared to obstruct the pancreatic duct and was located less than 1 mm from the uncinate process margin, less than 1 mm from the radial margin, 0.2 cm from the retroperitoneal margin, and 1.6 cm from the main pancreatic margin.\n\nExamination of the opened duodenum showed an unremarkable mucosa with a probe-patent ampulla of Vater. The gastric mucosa also appeared normal with no masses identified. The serosal surface of the duodenum showed mild adhesions. No other masses or abnormalities were noted in the stomach or duodenum.\n\nA total of 10 possible lymph nodes were identified in the peripancreatic and periduodenal fat, ranging in size from 0.2 to 1.9 cm. All regional lymph nodes were negative for metastatic disease. No lymphovascular invasion was identified. Perineural invasion was present.\n\nSurgical margins were evaluated microscopically. The proximal (gastric), distal (small bowel), distal pancreatic resection, pancreatic retroperitoneal (uncinate), and common bile duct margins were all negative. The closest margin was the uncinate margin, with tumor cells less than 1 mm from the inked edge.\n\nSeparate evaluations of the bile duct and portal vein margins were both negative for neoplasm. A portion of the gallbladder was also submitted for evaluation. It contained multiple small stones and showed changes consistent with chronic cholecystitis.\n\nThe case was staged using the AJCC pathologic staging system. Based on the findings, the pathologic stage was determined to be pT2, N0. The histologic grade of the lesion was moderately differentiated. Tumor dimensions were reported as 3.2 cm in maximum gross dimension."} +{"pid": "TCGA-DD-A4ND", "report": "The specimen consists of multiple tissue fragments labeled A1 through A10, along with A12 and A13. The left lobe of the liver weighs 915.0 grams and measures 13.5 x 13.0 x 8.0 cm. A mass measuring 13.0 x 13.0 x 7.5 cm is present within the liver, showing areas of necrosis. No evidence of vascular invasion is observed. The surgical margins are free of involvement, with the closest margin measuring 1.2 cm from the mass. The surrounding liver tissue does not show signs of cirrhosis. Cellular features include a high degree of nuclear atypia and increased mitotic activity."} +{"pid": "TCGA-DD-AADV", "report": "The specimen consists of a left lateral sectionectomy of the liver, measuring 12.0 x 4.0 x 3.3 cm and weighing 86.2 grams. A well-defined multinodular, pale tan, firm, and solid mass is present, measuring 2.2 x 2.0 x 1.7 cm. The gross appearance is multinodular and confluent. The resection margin is not involved macroscopically, with a safety margin of 2.2 cm. No satellite nodules are identified, and the remaining liver parenchyma shows cirrhotic changes.\n\nMicroscopically, the lesion shows moderate differentiation as the major pattern and poor differentiation in some areas. The histologic architecture is trabecular. Hepatocyte-like cells are present with focal fatty change (10%). A partial fibrous capsule is noted, and there is no septum formation. The surgical resection margin is free, with a safety margin of 2.2 cm. There is no evidence of serosal invasion, portal vein invasion, or microvessel invasion. Information regarding intrahepatic metastasis and multicentric occurrence is not available.\n\nAdditional findings include chronic gastritis in the prepyloric and antral regions of the stomach, with associated *H. pylori*. A separate tubular adenoma with high-grade dysplasia is identified in the stomach body. Sections of the liver also show features of mixed cirrhosis and mild steatosis."} +{"pid": "TCGA-85-8353", "report": "Specimen was a lobectomy from the right-lower lobe. The tumor measured 8 x 8 x 8 cm and was found to involve the visceral pleura. Histologic examination revealed poorly differentiated cells with squamous morphology. Metastatic involvement was identified in 8 out of 10 intrathoracic lymph nodes. No other tumor nodules, lymphatic or venous invasion, margin involvement, or evidence of neoadjuvant treatment effect were specified. Laterality was confirmed as right-lower."} +{"pid": "TCGA-BR-8365", "report": "The stomach segment specimen shows a lesion measuring approximately 10 cm in diameter. Microscopically, the mucosa is replaced by atypical cells with features including tubular formation and signet-ring morphology. Adjacent tissues show no evidence of tumor infiltration. No invasion into the muscularis propria is observed. Fifteen lymph nodes were examined, none showing metastatic involvement. The perigastric fat does not demonstrate tumor extension. Histologic evaluation reveals no venous invasion. Margins are uninvolved. Additional findings include hyperemia of the omentum and sinus histiocytosis in fatty tissue lymph nodes. No treatment effect is identified. Other pathologic findings are not specified."} +{"pid": "TCGA-D8-A1XY", "report": "Histopathological examination was performed on a left breast specimen measuring 30.4 x 22.2 x 8.2 cm with a skin flap of 32.1 x 12.8 cm and weighing 1760 g. A lesion measuring 2.1 x 1.8 x 1.7 cm was identified in the upper outer quadrant, located 5.9 cm from the upper boundary, 2.6 cm from the base, and 2.1 cm from the skin. The lesion showed a histological grade corresponding to NHG2, with a mitotic count of 2+3+1/10 HPF in a visual area of 0.55 mm. No lesion was observed in the nipple. The glandular tissue exhibited signs of parenchymal atrophy. Immunohistochemical analysis revealed that over 75% of the neoplastic cell nuclei were positive for estrogen and progesterone receptors. HER2 protein expression was assessed using HercepTest\u2122 by DAKO, showing a positive reaction in cancerous cells with a score of 3+. Axillary lymph nodes showed chronic lymphadenitis (NO III). No other significant findings were reported."} +{"pid": "TCGA-E2-A3DX", "report": "The surgical specimen from the right breast and axillary contents included a mastectomy specimen measuring 26 x 21.5 x 2 cm with attached axillary tissue. Serial sectioning identified three distinct masses. The largest mass measured 2.9 cm in greatest dimension and was located centrally inferior at 6:00, 0.6 cm from the posterior margin and 0.7 cm from the anterior margin. A second mass measured 0.7 cm and was located centrally inferior, extending to the anterior margin. A third mass measured 2.5 cm and was located in the lower outer quadrant at 8:00. The anterior inferior margin was focally involved, with tumor located 0.3 cm from the deep margin. Adjacent to the masses, extensive in situ changes were noted, including necrosis and microcalcifications. Skeletal muscle margins were free of involvement.\n\nA total of 33 lymph nodes were evaluated from the axillary dissection. Metastatic involvement was identified in 22 of these nodes, with extranodal extension present. The largest metastatic deposit measured 1.4 cm. In addition, two level 3 axillary lymph nodes were entirely involved. One additional lymph node from a separate excision was also involved. A further excision of additional breast tissue and skin showed in situ changes without invasive involvement. Benign skin tissue was also present.\n\nHistologic evaluation showed a tubular score of 3, nuclear grade 2, and mitotic score of 1, corresponding to a modified Scarff Bloom Richardson grade of 2. Vascular or lymphatic invasion was not identified. Immunohistochemical staining was positive for cytokeratin AE1/3 at the inked margin. Special stains for acid-fast bacteria and fungal organisms were negative. Hormone receptor status was positive for ER and PR. HER2 testing by FISH was positive.\n\nThe gross examination revealed fibroglandular breast tissue with multiple masses and several identifiable lymph nodes. Tissue samples were submitted from various slices and locations, including representative sections of each mass, surrounding tissue, and margins. Multiple granulomas, some necrotizing, were observed in both breast and lymph node tissue, though the etiology remained unclear and required clinical correlation. The pathological stage based on AJCC 7th edition criteria was pT2 pN3."} +{"pid": "TCGA-G4-6323", "report": "The specimen consists of a 14.5 cm segment of cecum and ascending colon with attached mesocolon, along with a 4.0 cm segment of terminal ileum and an appendix measuring 7.0 x 1.0 x 0.5 cm. A polypoid lesion measuring 6.0 x 4.0 cm is identified in the cecum, confined to the mucosa and located approximately 0.6 cm from the ileocecal valve. The lesion extends to the base of the appendix. The remaining colonic mucosa appears unremarkable, while the mucosal surface of the small intestine shows diffuse nodularity suggestive of hypertrophy of Peyer\u2019s patches.\n\nMultiple encapsulated nodules are dissected from surrounding adipose tissue, with sizes up to 1.2 cm. Sections submitted include margins, representative areas of the lesion, ileocecal valve, appendix, colon, small intestine, and various lymph nodes.\n\nMicroscopic examination reveals a focus of invasive well-differentiated carcinoma involving the lamina propria. The remainder of the lesion is composed of tubular and villous adenomatous tissue without evidence of malignancy. All surgical margins are free of tumor involvement. Examination of the appendix does not reveal any tumor. Twenty-four lymph nodes are negative for metastases. There is no evidence of venous, lymphatic, or perineural invasion. The resection is complete with grossly and microscopically negative margins. No additional pathological findings are identified."} +{"pid": "TCGA-WB-A81R", "report": "The pathology report describes a surgical specimen from the left adrenal gland. A well-defined tumor measuring 3.5 x 3.2 x 3 cm was identified within the adrenal tissue. The tumor had a brown appearance with concentric reddish areas. Microscopic examination revealed a confluent neoplasm arising in the adrenal medulla, with partial compression of the adjacent adrenal cortex. The tumor cells exhibited oval-shaped, eccentric nuclei of intermediate size, with peripheral nucleoli and abundant chromatin. The mitotic rate was counted as 2 mitoses per 10 high-power fields. No evidence of vascular invasion or necrosis was observed. Immunohistochemical staining showed expression for inhibin alpha and S-100."} +{"pid": "TCGA-AH-6547", "report": "The omental specimen consists of fibroadipose tissue with areas of fat necrosis, fibrosis, and scattered calcifications. No malignant cells were identified. A segment of rectosigmoid colon was examined, measuring 19.8 cm in length, with a partially opened appearance and attached pericolic fat. A mucosal lesion measuring 4.5 x 3.8 cm was identified; histologically, the lesion showed cellular features including moderate differentiation. The tumor focally extended through the muscularis propria into subserosal fat, coming within approximately 0.1 cm of the muscularis propria border. There was no evidence of lymphovascular space invasion, perforation of the visceral peritoneum, or mesenteric deposits. Surgical margins were all negative, with the tumor located 2.2 cm from the closest radial margin. A total of 21 lymph nodes were examined, none of which contained metastatic disease. The pTNM stage was determined as pT3b, NO, Mx. Additionally, a right colon specimen measuring 16.8 cm included an attached segment of terminal ileum. A polypoid lesion measuring 5.5 x 2.8 cm was observed, along with two smaller polyps. Histologic evaluation revealed tubular adenomas with focal high-grade dysplasia, but no invasive malignancy. Eight lymph nodes were identified and found to be free of metastatic involvement. Additional mucosal fragments showed congestion without evidence of malignancy."} +{"pid": "TCGA-SI-A71P", "report": "The surgical pathology report describes multiple biopsies and an excised mass from the spinal cord and surrounding nerve roots. Specimens were received from the right and left S1 through S4 nerve roots, as well as a sacral mass. The specimens were processed for both frozen and permanent sections.\n\nHistological evaluation revealed two distinct patterns of neoplastic tissue. One pattern was present across all specimens and showed features consistent with a benign nerve sheath tumor, including wavy spindled cells in a myxoid background with minimal mitotic activity. This pattern was identified in all nerve root specimens.\n\nA second, more aggressive histological pattern was also observed. This pattern showed marked pleomorphism, high cellularity, and areas of necrosis. The tumor cells ranged from small spindle-shaped cells to large epithelioid cells with atypical nuclei, prominent nucleoli, and variable cytoplasmic staining. This malignant component was found in several locations: the left S3 nerve root (specimens D, M), right S2 nerve root (E, J), and both left and right S1 nerve roots (G, H). In some cases, the malignant pattern was seen only in either frozen or permanent sections. For example, it was present in frozen sections of the right S3 nerve root (C) but not in the corresponding permanent section (L). Similarly, in the left S2 nerve root, the malignant pattern was present in the permanent section (K) but not in the frozen section (F). A suspicious focus with crush artifact was noted in the left S4 nerve root (B), while no malignancy was found in the right S4 nerve root (A).\n\nImmunohistochemical staining of the malignant areas demonstrated weak S100 reactivity in scattered cells, patchy Collagen IV staining around tumor cells, and focal CD57 positivity. Strong nuclear staining for p53 was present in over 90% of malignant cells, and strong vimentin expression was also noted.\n\nThe excised sacral mass measured 13.5 x 9.2 x 4 cm in aggregate and included areas of necrosis. Microscopic examination revealed that this mass had invaded bone and soft tissue, with evidence of both lytic and remodeling changes in the affected vertebrae.\n\nClinical history indicated that the patient is a man with neurofibromatosis type I, presenting with symptoms including difficulty initiating urination, bowel control issues, a sore in the gluteal cleft, and sensory loss in the buttock region. Radiologic imaging had shown a large FDG-avid mass extending from L5 to S4, involving the S2 and S3 vertebral bodies and invading paraspinal musculature. A prior needle biopsy of the sacral mass had suggested a sarcomatous lesion.\n\nIn summary, the findings describe a complex neoplasm involving multiple nerve roots and a central sacral mass, with coexistence of benign and malignant histological components. The tumor demonstrated extensive local invasion and high-grade features, with involvement of multiple spinal levels."} +{"pid": "TCGA-FI-A2CX", "report": "Gynecology. OTHER. (Age: Histologic sections show a poorly differentiated carcinoma with a small amount of glandular differentiation. The majority of the tumor consists of sheets of anaplastic cells exhibiting prominent nucleoli, pleomorphism, and a high mitotic rate. Numerous osteoclast-like giant cells are present, displaying much less aggressive nuclear morphology compared to the tumor cells. No lymphovascular space invasion is identified. The tumor invades to a depth of 5 mm where the total wall thickness measures 15 mm. The lower uterine segment is free of tumor involvement. Thirteen regional lymph nodes are examined and none contain carcinoma.\n\nThe patient underwent a laparoscopic assisted vaginal hysterectomy, pelvic and peri-aortic lymph node dissection. Received specimens include the cervix, uterus, bilateral tubes and ovaries, as well as lymph nodes from right and left pelvic and common periaortic regions. Gross examination of the uterus reveals a weight of 116 grams, measuring 9 cm from superior to inferior, 7 cm from cornu to cornu, and 6 cm anterior to posterior. The endometrial cavity contains a 2 x 1.5 x 2.2 cm exophytic, friable, tan mass located in the fundus of the cervix. The mass appears to extend 1.9 cm where the myometrial wall thickness is 2.3 cm. The myometrium also contains a 1.1 x 1 x 1 cm fibroid lesion in the anterior wall. A Nabothian cyst measuring 0.3 x 0.3 x 0.2 cm is found in the anterior cervical wall filled with gelatinous material.\n\nLymph nodes assessed include three from the right pelvic region (0/3 negative), one right common periaortic lymph node (0/1 negative), four left pelvic lymph nodes (0/4 negative), and two left common periaortic lymph nodes (0/2 negative). Microscopic evaluation confirms no evidence of carcinoma within the lymph nodes.\n\nInvasive tumor is noted with superficial invasion into the luminal one-third of the myometrium. Tumor size corresponds to a depth of invasion of 5 mm, within a myometrial thickness of 15 mm. The lower uterine segment and endocervix are free of tumor involvement. No lymphvascular space invasion is observed. Regional lymph nodes are free of metastasis, with no extranodal extension evident. Distant metastasis could not be assessed.\n\nThe primary tumor is categorized as invading less than one-half of the myometrium (T1b/IB). The overall pathologic AJCC stage is T1b/NO/MX. This provisional staging may change after integration of clinical data not included with this specimen."} +{"pid": "TCGA-G9-A9S4", "report": "The surgical specimen includes right and left pelvic lymph nodes and a resected prostate gland. The right pelvic lymph nodes, measuring up to 2.5 cm in greatest dimension, and the left pelvic lymph nodes, measuring up to 3.4 cm, were submitted for analysis. Of the lymph nodes evaluated, a subset showed evidence of involvement. The prostate gland weighed 49 grams and measured 4.7 cm in width, 4.5 cm in depth, and 3.9 cm in height. It demonstrated a nodular tan parenchyma upon sectioning. Seminal vesicles and vas deferens were also identified, with dimensions ranging from 3 x 1.6 x 0.9 cm to 3 x 1.6 x 1.1 cm for the seminal vesicles and 2.5 x 0.9 x 0.7 cm to 2.8 x 1 x 0.7 cm for the vas deferens. Multiple sections of the prostate were submitted, including perpendicular cuts from the apex, mid base, lateral base, and posterior base, as well as sections of the seminal vesicles and vas deferens. Involvement was identified at the left posterior margin (slide C21), with a microscopic linear distance of less than 1 mm. Frozen section analysis was performed. Pathologic staging was determined as pT3b, N1, Mx, based on the AJCC Cancer Staging Manual, 7th Edition. Chronic inflammation was noted as an additional finding."} +{"pid": "TCGA-A8-A09V", "report": "The specimen shows a moderately differentiated invasive carcinoma with a maximum diameter of 2.2 cm. There are additional small satellite foci present, the largest measuring up to 0.1 cm. Focal in situ spread is also noted. The histologic grade is G II. Lymph node staging is pN0 based on the evaluation of three nodes, all of which were negative. Lymphovascular invasion is present, as is perineural invasion."} +{"pid": "TCGA-A2-A04R", "report": "The specimen was obtained from a female patient and included two components: a left sentinel lymph node and left breast tissue. The lymph node measured 2.0 cm in greatest dimension and showed no evidence of malignant cells upon immunohistochemical evaluation.\n\nThe breast tissue specimen measured 9.7 cm anterior to posterior, 6.8 cm medial to lateral, and 5.0 cm superior to inferior. It consisted primarily of fibrofatty material with areas of white fibrous tissue. A lesion measuring 2.0 cm was identified within the tissue, exhibiting well-defined margins and a white, gritty cut surface. This lesion was located 0.4 cm from the nearest margin superiorly. The surgical margins were free of tumor involvement.\n\nHistologic examination revealed a component of ductal carcinoma in situ with nuclear grade 2 and necrosis. Microcalcifications were present within this area as well as within the invasive component. Immunohistochemical staining demonstrated strong positivity for estrogen receptor (80% nuclear staining) and progesterone receptor (90% nuclear staining). HER2 testing by immunohistochemistry showed weak positivity (2+), however fluorescence in situ hybridization (FISH) did not reveal gene amplification (ratio 1.1).\n\nMultiple sections were taken from the specimen for analysis under the CBCP protocol, including representative sections of skin, normal fibrous tissue, tumor, and margins."} +{"pid": "TCGA-L4-A4E5", "report": "The specimen consisted of a left upper lobe lobectomy with associated lymph nodes. A mass measuring 2.7 cm was identified within the lung tissue, located approximately 3 cm from the bronchial margin. The tumor was unifocal and showed no evidence of direct extension or invasion of the visceral pleura or adjacent structures. Histologic evaluation revealed moderately differentiated cells arranged in glandular patterns. No lymphovascular space invasion or tumor-associated atelectasis was observed. All surgical margins were free of abnormal cells, with the closest margin measuring 3 cm from the tumor. Seven lymph nodes were evaluated, including six peribronchial nodes and one from the left inferior pulmonary ligament; all showed benign features without involvement. According to staging criteria, the primary tumor was classified as pT1 and lymph nodes as pN0. Gross examination confirmed the presence of a multinodular tan-gray mass with no involvement of hilar structures. Frozen section analysis confirmed negative margins intraoperatively. Ancillary studies, including elastic stain, confirmed absence of pleural invasion. Microscopic slides were reviewed by an additional pathologist who concurred with all findings."} +{"pid": "TCGA-DH-A66G", "report": "The surgical specimen from the brain frontal region consists of a 7.0 x 5.0 x 1.5 cm portion of cortical gray matter and subcortical white matter, with large areas replaced by a homogeneous white to beige infiltrative mass. The tumor merges with surrounding gray and white matter, obscuring much of the gray-white junction. A second specimen, measuring 2.2 x 1.5 x 1.0 cm, is a wedge-shaped piece of beige to gray-tan soft tissue with white matter along one edge.\n\nMicroscopic evaluation reveals an infiltrating glial neoplasm with overall histologic uniformity. The tumor cells exhibit hyperchromatic nuclei, perinuclear halos, and are arranged within a background of chicken-wire vasculature. Areas of microgemistocytic morphology are present, as well as regions with increased cellularity and focal mitotic activity, most evident in the second specimen. No definitive necrotic foci are identified, although individual tumor cell necrosis is observed.\n\nImmunohistochemical staining demonstrates positivity for mutated isocitrate dehydrogenase-1 (IDH1) and negativity for p53 protein. Glial fibrillary acidic protein (GFAP) staining is also performed. The Ki-67 labeling index shows focally elevated proliferative activity, reaching 15\u201320% in the more cellular regions of the second specimen.\n\nFluorescence in situ hybridization (FISH) analysis on the left frontal tumor reveals co-deletion of chromosomes 1p and 19q. This genetic finding has been associated in clinical studies with improved survival and enhanced response to chemotherapy in certain gliomas. The FISH test used dual-probe assays targeting the minimally deleted regions of 1p36 and 19q13.3. The interpretation was based on signal ratios, with deletion defined as a 1p/lq or 19q/19p ratio <0.80.\n\nAll specimens were processed and analyzed under CLIA-certified conditions for high-complexity testing. Some tests used in this analysis have not been cleared or approved by the FDA but are employed for clinical diagnostic purposes."} +{"pid": "TCGA-CS-5393", "report": "The specimen consists of a 3.5 x 3.0 x 0.5 cm aggregate of tan-white soft brain tissue obtained from the left temporal parietal region. The tumor demonstrates a moderately pleomorphic and highly infiltrative growth pattern composed of astrocytic cells. Rare mitotic figures are present. There is no evidence of endothelial proliferation or necrosis.\n\nImmunohistochemical staining for the proliferation marker Ki-67 was performed. Ten fields measuring 250 x 250 microns were analyzed, with the percentage of labeled nuclei calculated for each. Over 1,000 cells were counted in total. The proliferation index ranged from 4.4% to 12.5%, with an average of 7.2%.\n\nA frozen section diagnosis identified the lesion as a glial neoplasm. Histologic evaluation included assessment of cellular morphology and tissue architecture using H&E staining. Additional immunohistochemistry assays were conducted using formalin-fixed, paraffin-embedded tissue according to manufacturer protocols for specific reagents. Some reagents used in testing are classified as analyte-specific reagents (ASRs), and the tests were developed and validated by the clinical laboratory. These tests have not been cleared by the FDA, which has determined such clearance is not necessary.\n\nAll findings were interpreted by the signatory of record."} +{"pid": "TCGA-CS-4942", "report": "The specimens from the right insular region consist of two tissue samples. The first sample measures 1.0 x 0.5 x 0.2 cm and the second measures 1.1 x 1.0 x 0.3 cm. Both are composed of multiple fragments of red-tan soft tissue. Touch preparations were made from each, and portions were submitted for frozen and permanent section analysis.\n\nMicroscopic evaluation reveals moderately pleomorphic fibrillary astrocytes. Mitotic figures are present, with two identified in specimen #1 (slide 1B) and two in specimen #2 (slide 2B). Ki67 (MIB-1) staining demonstrates a proliferation index greater than 5% in small foci of specimen #2 (slide 2A), with approximately 7% positivity in scattered tumor cell nuclei. GFAP staining is positive in glial tissue, including neoplastic cells.\n\nThe histologic findings include features suggestive of increased proliferative activity. These findings may indicate a transition to a more aggressive phenotype or may reflect heterogeneity within the lesion. Clinical correlation is recommended."} +{"pid": "TCGA-DU-5854", "report": "A right parietal lesion was identified in a patient presenting with lower extremity weakness and an enlarging lesion on imaging. The lesion measured 2.3 cm and involved the white matter at the level of the atrium and posterior body of the lateral ventricle, extending into the right paramedian parietal lobe. Two biopsies were performed, both from the right parietal region.\n\nMicroscopic evaluation revealed diffuse infiltration of the brain parenchyma by a neoplastic astrocytic proliferation. The tissue showed moderate cellular density with gliofibrillary features observed in touch preparations. Frozen sections confirmed the presence of neoplastic astrocytic cells. Histologic analysis demonstrated mitotic figures, with a MIB-1 proliferation index greater than 10%. No microvascular proliferation or tumor necrosis was identified. GFAP staining showed a moderately fibrillary background, and p53 immunohistochemistry revealed overexpression in the majority of neoplastic astrocytes. CD163 highlighted activated microglia, primarily perivascular.\n\nGenetic testing using a LOH assay detected allelic loss on chromosome arm 19q and partial deletion on chromosome arm 1p based on PCR analysis of microsatellite markers. D1S496, D1S548, D1S552, D19S219, D19S412, and PLA2G4C were among the informative loci assessed. These findings suggest a specific molecular profile associated with chromosomal deletions.\n\nThe specimen was received as fresh tissue fragments measuring up to 1.8 x 1.2 x 0.3 cm. Extensive cautery artifact was noted, which may have impacted histologic interpretation. The neoplasm demonstrated infiltrative growth without evidence of necrosis or vascular proliferation."} +{"pid": "TCGA-39-5039", "report": "A right middle lobe lung wedge specimen measuring 1.2 x 0.7 x 0.7 cm showed reactive changes with no evidence of malignancy. A right subscapular soft tissue specimen measuring 4.0 x 3.2 x 2.0 cm showed fibrotic changes consistent with elastofibroma. Lymph node specimens from level VII mediastinum, including one fragment and three fragments in another sample, were all benign. Two level IV mediastinal lymph node specimens were examined: one containing two lymph nodes and another with eight lymph nodes\u2014all were benign. A separate level VII lymph node specimen contained eleven lymph nodes, all without evidence of carcinoma; however, one lymph node showed partial involvement by a low-grade process characterized by follicular architecture. Immunohistochemical staining showed positivity for CD20, BCL-2, BCL-6, and CD10, while negative for CD23 and cyclin-D1. CD3 and CD5 highlighted mature T-lymphocytes, and MIB-1 staining marked approximately 5% of the involved cells.\n\nAdditional lymph node specimens from right level IV, including samples containing sixteen, one, and other lymph nodes, were all negative for malignancy. The right upper lobe lung specimen measured 11.5 x 13 x 5.4 cm and showed a well-circumscribed mass measuring 5.5 x 4.3 x 4.0 cm in the posterior aspect. The mass extended into the chest wall soft tissue (3.5 x 1.2 x 0.7 cm) and penetrated through the visceral pleura. It approached within 1.4 cm of the bronchial resection margin, 0.5 cm of the middle lobe margin, 0.7 cm of the lower lobe margin, and 0.3 cm of the staple line, but did not involve any parenchymal margins. There was no perineural invasion identified. Background lung showed emphysematous and scarring changes. Multiple peribronchial lymph nodes were sampled and found to be negative for involvement (0 out of 3 examined). Immunostains showed positivity for 34Be12 and A4A (p63), and negativity for TTF-1.\n\nOther surgical specimens included a fibroadipose tissue specimen with an anthracotic lymph node, and several additional lymph node specimens from various levels, all of which were negative for malignant involvement. The intraoperative frozen section evaluations of all specimens correlated with the final histologic findings, confirming absence of malignancy in the lung wedge, subscapular soft tissue, and all lymph node regions examined."} +{"pid": "TCGA-BG-A0MT", "report": "A total of six lymph nodes were examined from multiple sites including left and right external iliac, obturator, common iliac, and periaortic regions. All lymph nodes were negative for metastatic disease. The surgical specimen included a uterus weighing 124 grams with bilateral adnexa. A moderately differentiated epithelial neoplasm was identified in the endometrium, with nuclear features classified as grade 2. Architectural differentiation was also moderate. The tumor measured 3.0 cm in maximum dimension and involved 75% of the posterior endomyometrial surface, while the anterior surface showed no involvement. Myometrial invasion was up to 25% of the thickness (0.5 cm out of 2.0 cm total), without evidence of angiolymphatic invasion. Adjacent findings included a small leiomyoma measuring 0.4 cm. Both ovaries showed tubo-ovarian adhesions and both fallopian tubes contained paratubal cysts; no malignant involvement was noted in these structures. Pathologic staging was determined as pT1b, pN0, and pMX."} +{"pid": "TCGA-ZF-A9R9", "report": "The specimen includes a right iliac lymph node, left ureteric resection margin, and a bladder and prostate specimen. The right iliac lymph node is enlarged, measuring 27 x 20 x 12 mm, and histological examination confirms the presence of metastatic carcinoma with extension into extracapsular tissue. The left ureteric resection margin, a tubular structure measuring up to 20 mm in length and 6 mm in diameter with surrounding fatty tissue, shows no evidence of abnormal cells or involvement.\n\nThe bladder and prostate specimen consists of a bladder measuring 65 x 40 x 40 mm and a prostate measuring 55 x 35 x 35 mm. An ulcerated lesion measuring 25 x 20 mm is present on the posterior and left lateral walls of the bladder. Microscopic analysis reveals a poorly differentiated epithelial tumor arising from the surface lining and extending through the bladder wall into surrounding soft tissue. Tumor aggregates are found within 1 mm of the circumferential surgical resection margin. Extensive necrosis, perineural invasion, and lymphovascular invasion are noted. No lymphocytic infiltrate is observed at the tumor interface. Tumor extension into the muscle wall of the ductus deferens is also present.\n\nSmall tumor foci are identified in the soft tissue near the right ureteric resection margin, possibly indicating lymphovascular involvement. The urethral resection margin appears morphologically normal with no signs of dysplastic changes. Prostate sections reveal high-grade prostatic intraepithelial neoplasia in the right lobe, while the left lobe shows no abnormalities. No evidence of microacinar adenocarcinoma is found.\n\nNo lymph nodes are identified in the perivesical fat, and no metastases are detected. The surgical procedure included cystoprostatectomy and lymph node dissection. The tumor demonstrates aggressive features including deep tissue invasion, necrosis, and vascular and neural involvement."} +{"pid": "TCGA-85-6798", "report": "The lung tissue specimen was obtained via lobectomy and measured 4 x 3 x 3 cm. Microscopic examination revealed moderately differentiated cells with characteristics consistent with a primary lung lesion. Evaluation of the lymph nodes showed 2 out of 16 involved, all located in the hilar region. No definitive assessment was made regarding tumor extent, presence of additional nodules, lymphatic or venous invasion, surgical margins, neo-adjuvant treatment effect, or other significant pathologic findings."} +{"pid": "TCGA-CH-5740", "report": "The specimen includes tumor-free fatty tissue, as well as bilateral pelvic lymph nodes and seminal vesicle tissue, all without evidence of tumor involvement. The prostate contains multiple foci of glandular neoplasia with a Gleason pattern 3+4. The largest focus is located in the left lateral zone, where there is capsular invasion. Additional small foci are present in the right lobe. The tumor remains confined to the prostatic capsule without extension into periprostatic tissue. A mild degree of nodular hyperplasia is also present. Surgical margins are uninvolved. Lymph nodes and seminal vesicles are free of tumor. The pathological stage is pT2c G2 NO R0."} +{"pid": "TCGA-FG-5962", "report": "Medical Record #. Race: Date Received: Final Diagnosis: A. Tumor, removal: See note. Note: The morphologic features of the tumor are similar to those seen in the patient's previous resection. They have reviewed this case. Clinical History: Brain tumor. Specimens submitted as: A: Tumor. Gross Description: Received in formalin labeled with the patient\u2019s name and number, multiple irregular, opaque white to pink-tan, soft, cerebriform tissue fragments measuring in aggregate 2.4 x 2.2 x 0.5 cm. Submitted in toto in one cassette."} +{"pid": "TCGA-DD-A11B", "report": "The resected liver tissue from segment VIII weighs 85.0 grams and measures 7.5 x 7.0 x 6.0 cm. A mass is present, measuring 4.8 x 4.5 x 4.0 cm, and is associated with micronodular cirrhosis. The cellular morphology shows features consistent with a moderately differentiated neoplasm. All resection margins are free of involvement. The specimen was photographed in the laboratory."} +{"pid": "TCGA-SX-A71U", "report": "The specimen consisted of a right renal mass submitted for evaluation. Grossly, the specimen measured 5.5 x 4 x 3.5 cm and included attached fat. A distinct mass measuring 3 x 2.5 x 2.5 cm was identified within the kidney. It appeared as a friable yellow-tan lesion bulging from the parenchymal margin but did not extend through the overlying renal capsule. The capsule was intact and inked black, while the surrounding parenchymal margin was inked blue.\n\nHistologic examination revealed a unifocal lesion with nuclear features corresponding to Fuhrman grade 3. No sarcomatoid differentiation or tumor necrosis was observed. Microscopically, the lesion did not extend beyond the renal capsule or involve perinephric tissue. Surgical margins were negative for involvement based on evaluation of inked sections. There was no evidence of lymphovascular invasion. No lymph nodes were identified in the specimen.\n\nEvaluation of nonneoplastic kidney tissue showed nonspecific findings without diagnostic significance. Based on pathological staging criteria, the lesion was classified as pT1a and pNX. Two tissue samples were preserved in the biorepository: one consisting entirely of normal kidney tissue and another containing predominantly tumor tissue (>90% nucleated cells). Selected blocks (A1, A2) were deemed suitable for further testing.\n\nImmunohistochemical studies were performed using validated methods; these assays were developed and validated by the laboratory and are not considered investigational or research-based. The laboratory is certified under CLIA to perform high-complexity testing."} +{"pid": "TCGA-PL-A8LY", "report": "The specimen from a female patient was procured on [date]. Gross assessment revealed a variegated mass measuring 3.4 x 2.5 x 1.5 cm. Microscopic evaluation showed a malignant growth arranged in cords, solid nests, and tubular formations. The tumor cells were large, with moderately pleomorphic and hyperchromatic nuclei, along with amphophilic cytoplasm. The stroma exhibited desmoplastic changes, containing similar tumor cells and lymphocytic aggregates. Focal areas of necrosis were also observed. The invasive component was located 5 mm from the deep resection margin."} +{"pid": "TCGA-BP-5202", "report": "The right partial nephrectomy specimen measured 3.5 x 3.7 x 2.9 cm and included attached perinephric fat. A well-circumscribed dark red-tan mass was identified, measuring 3.0 x 2.5 x 2.4 cm, and located 0.2 cm from the nearest inked surgical margin. The tumor was partially surrounded by a rim of grossly unremarkable renal parenchyma. Microscopic evaluation revealed a neoplasm of renal cortical origin. The tumor extended through the renal capsule but remained confined within Gerota's fascia. No evidence of renal vein invasion was observed. All surgical margins were free of tumor. Sections of the perinephric fat showed focal hemorrhage without other abnormalities. No adrenal gland or lymph node tissue was identified in the specimen. The tumor was classified as nuclear grade II/IV. Staging indicated pT3a based on perinephric extension without involvement of the adrenal gland or spread beyond Gerota's fascia."} +{"pid": "TCGA-BH-A0HF", "report": "The specimen consists of a segmental mastectomy from the right breast, including the upper outer quadrant. The invasive component measures 1.1 cm in maximum dimension and is located 0.5 cm from the superior margin. The histologic features include tubule formation score of 3, nuclear grade of 2, and mitotic activity score of 1, resulting in a total Nottingham score of 6. Angiolymphatic invasion is present. A separate in situ component of solid type is admixed with the invasive component, accounting for approximately 5% of the total tumor volume. No dermal lymphatic invasion is identified. The in situ component does not involve the surgical margins. Fibrocystic changes are present, and there are findings consistent with a prior biopsy site. All surgical margins are free of tumor involvement.\n\nTwo lymph nodes were retrieved from the right axillary sentinel node biopsy and examined using H/E staining. No tumor cells are identified in the lymph nodes. No keratin-positive cells, extracapsular extension, or metastases to internal mammary lymph nodes are noted. The skin is not involved.\n\nImmunohistochemical staining shows positivity for estrogen and progesterone receptors. HER2/NEU expression is scored as zero or 1+.\n\nPathologic staging is pT1c for the primary tumor, pN0 for regional lymph node involvement, and pM0 for distant metastasis."} +{"pid": "TCGA-G9-6369", "report": "The prostate specimen measured 3.6 cm in width, 2.8 cm in depth, and 2.7 cm in height, with a smooth, red, and intact outer surface. The gland weighed 22 grams after removal of the apex and base. The internal tissue had a nodular tan appearance, and alternating sections were taken for further analysis. The right and left seminal vesicles were cystic and tan, measuring 4.3 x 1.6 x 0.6 cm and 3.7 x 1.4 x 0.6 cm respectively. The vas deferens were detached and measured up to 2.2 x 0.8 cm, composed of tubular tan tissue. Multiple sections of the prostate were submitted for evaluation, including perpendicular slices from the apex, mid-base, and lateral base regions.\n\nIn the right pelvic lymph node dissection, multiple lymph nodes were identified, ranging in size from 0.1 to 1.7 cm, with a total of twelve lymph nodes submitted. In the left pelvic lymph node dissection, multiple lymph nodes were also present, ranging from 0.3 to 2.4 cm in size, with a total of nine lymph nodes submitted. All lymph nodes showed benign histology.\n\nMicroscopic evaluation of the prostate revealed a Gleason grade pattern of 4 + 3, with approximately 4% of the examined tissue involved. Perineural invasion was noted. The resection margins, seminal vesicles, bladder neck, and periprostatic fat were not involved. No vascular or lymphatic invasion was identified. High-grade prostatic intraepithelial neoplasia was present. All lymph nodes examined were negative for involvement. The pathological staging was determined as pT2c, pN0, Mx."} +{"pid": "TCGA-CQ-5330", "report": "The specimen received includes a right perifacial lymph node, a right neck dissection specimen encompassing multiple levels (I, II, III, IV), a right hemiglossectomy specimen with tumor involvement, and a deep tongue margin tissue fragment.\n\nIn the right neck dissection, multiple lymph nodes ranging from 0.2 to 1.8 cm were identified across various levels. Three out of forty-four lymph nodes were found to be involved. All positive nodes were located in level III, with the largest measuring 1.8 cm. Extracapsular extension was noted in these involved nodes. The submandibular gland showed mild chronic inflammation but no evidence of malignancy.\n\nThe right hemiglossectomy specimen measured 6.5 cm in its greatest dimension. A firm, pale, well-delineated tumor measuring 4.0 cm in its maximal dimension was observed on the lateral and dorsal surfaces of the tongue. This lesion ulcerated the overlying mucosa. Histologically, the tumor demonstrated poorly differentiated features with perineural invasion present. Tumor thickness measured 2.3 cm. The tumor was found to be focally very close to the medial margin at 0.2 cm and near the inferior/lateral margin, where severe dysplastic changes were identified within 0.3 cm. Other margins were free of malignancy by more than 0.5 cm. Additionally, focal areas of severe squamous dysplasia or carcinoma in situ were noted near the inferior/lateral margin. The deep margin specimen was negative for malignancy.\n\nPathologic staging indicated a primary lesion greater than 4 cm in size. Multiple ipsilateral lymph node metastases were identified without distant metastatic disease. A total of 44 regional lymph nodes were examined, with 3 showing involvement. Extracapsular extension was present in the involved nodes."} +{"pid": "TCGA-AX-A05Y", "report": "The surgical pathology report details findings from a total abdominal hysterectomy and bilateral salpingo-oophorectomy. The uterus measured 10 x 6 x 4 cm, with a polypoid mass located on the posterior endometrial wall extending into the lower uterine segment. The mass measured 4.8 x 2.5 x 0.8 cm and appeared to invade into the myometrium. Microscopic evaluation showed invasion to a depth of 3 mm within a myometrial thickness of 9 mm. The anterior endocervix was roughened and measured 0.2 cm in thickness. No tumor involvement was identified in the cervix. The ovaries and fallopian tubes were unremarkable with no abnormal findings.\n\nLymph node dissection included left pelvic, left obturator, right external iliac, right obturator, right periaortic, and left periaortic regions. A total of 30 lymph nodes were examined and none showed evidence of malignancy. Histologic assessment revealed no lymphovascular space invasion. The tumor exhibited less than 5% solid growth pattern. No distant metastasis was identified. Staging was based on invasion limited to less than one-half of the myometrium without lymph node involvement."} +{"pid": "TCGA-AJ-A3EJ", "report": "The left ovary and fallopian tube show corpora albicantia and serous cysts, with the fallopian tube appearing unremarkable. The right ovary and fallopian tube also demonstrate corpora albicantia and serous cysts, along with benign paratubal cysts; the fallopian tube shows no abnormalities.\n\nThe uterus measures 7.5 x 7.0 x 7.0 cm and weighs 259 grams. A subserosal nodule measuring 1.0 cm is present, along with a gray tan nodular shaggy mass lining the endometrial cavity. The mass measures 9.5 x 7.5 cm and extends 1.7 cm into a 2.0 cm thick myometrium. No hemorrhage or necrosis is observed. A separate intramural white tan whorled mass measuring 2.0 cm is identified within the myometrium. No involvement of the cervix or other organs is noted, and there is no lymphovascular space invasion. Surgical margins are uninvolved bilaterally at the parametria, cervix, and serosa.\n\nLymph node evaluation reveals four negative nodes from the left common iliac and aortic region. Seven positive lymph nodes are identified in the left obturator region, with the largest metastasis measuring 0.6 cm. Five lymph nodes from the left external region are negative. In the left obturator lymph nodes (second group), one of five is positive. Two of seven lymph nodes from the right aortic and common iliac region are positive. One of three lymph nodes from the right external region is positive. Six lymph nodes from the right obturator region are negative. The omentum shows no malignancy.\n\nImmunohistochemical staining for p53 and estrogen receptor on block C6 demonstrates majority positivity in lesional cells. Uterine wall leiomyomata are also noted. Frozen section diagnosis was confirmed."} +{"pid": "TCGA-KK-A6E5", "report": "The specimen included right and left pelvic lymph nodes and a prostate with attached seminal vesicles. A total of 16 right pelvic lymph nodes were identified, ranging in size from 0.3 to 1.5 cm. All were submitted for examination. No abnormal cellular findings were observed in these lymph nodes. Additionally, 11 left pelvic lymph nodes were identified, measuring between 0.5 and 2.0 cm, and all were also submitted. No abnormal cells were detected in the left pelvic lymph nodes.\n\nThe prostate measured 4.7 x 3.3 x 4.0 cm and weighed 33.0 grams after fixation. Cross sections revealed a firm area consistent with a lesion on the right side of the prostate, which appeared more prominent than on the left. Nodules were palpated on the right side within the peripheral zone in two cross sections. The seminal vesicles and segments of the vasa deferentia appeared unremarkable upon gross examination.\n\nFour distinct areas of cellular atypia were identified within the prostate. The primary focus was located in the right lateral, right posterolateral, and right posterior peripheral zone, measuring up to 2.0 cm in greatest dimension. It extended into the right seminal vesicle and adjacent soft tissue surrounding the vesicle. This focus was present in multiple cross sections and involved both the apex and base regions. Margins of resection showed no evidence of involvement.\n\nA second focus was identified in the left lateral, left posterolateral, and left posterior peripheral zone, measuring 1.5 x 0.4 cm. It was present in two cross sections and involved the apex and base regions focally. A third focus was located in the right transition zone, measuring 1.0 x 1.0 cm, present in two cross sections and extensively involving the apex with focal presence in the base. A fourth, smaller focus was identified in the left transition zone, measuring less than 0.1 cm in greatest dimension and present in the first cross section of the prostate.\n\nAll non-primary foci were lower in histologic grade and confined to the prostate without extension to margins. The seminal vesicles and vas deferens on the left side showed no evidence of involvement."} +{"pid": "TCGA-YC-A8S6", "report": "The specimen from a male patient was assessed following radical cystoprostatectomy. The bladder specimen contained two tumor foci, one measuring 5.7 cm located in the right wall, left wall, posterior wall, and trigone, and another measuring 2 cm involving the anterior wall. Histologic examination revealed papillary architecture with high-grade nuclear features invading the superficial muscularis propria (inner half). No lymphovascular invasion was identified, although a focal area was suspicious for it. All surgical margins were negative. A total of 16 lymph nodes were examined, including those from bilateral pelvic regions, none of which showed involvement. Additional findings included a prostate specimen measuring 4.5 x 3.6 x 2.5 cm. Histologic evaluation demonstrated acinar-type glands with a Gleason score of 3+3 = 6. Tumor involvement was multifocal on the right and unifocal on the left, accounting for less than 20% of the gland. There was evidence of focal extraprostatic extension on the left side measuring 2 mm in length. No seminal vesicle invasion or lymphovascular invasion was noted, and all margins were negative. Perineural invasion was present. Cold ischemia time was 18 minutes, and formalin fixation duration was greater than 6 but less than 72 hours. Specimen weights were within normal range for both tumor and non-tumor tissue. No treatment effect was observed in either the bladder or prostate specimens."} +{"pid": "TCGA-AY-4071", "report": "The specimen consisted of vaginal mucosal tissue from the posterior region, measuring 1.5 x 0.7 cm, and was found to be benign with no evidence of malignancy. Both left and right ovaries were submitted as multicystic structures weighing 21.3 grams and 33.0 grams respectively, each containing clear serous fluid; no malignant cells were identified in either ovary or associated fallopian tube segments.\n\nA resection of the distal sigmoid colon and rectum was performed, yielding a specimen 26.0 cm in length with a maximum open circumference of 6.0 cm. A granular fungating lesion was observed on the distal anterior wall, measuring 3.0 x 3.0 x 0.5 cm, involving approximately 50% of the luminal circumference. Microscopically, the lesion showed invasion into the submucosa but did not extend into the muscularis propria. Proximal, distal, and circumferential margins were all negative, with the closest margin being 2.0 cm from the tumor. A total of 21 lymph nodes were examined, all without evidence of metastasis. No lymphatic, venous, or perineural invasion was identified.\n\nIn addition, a separate resection of the terminal ileum and proximal right colon (25.0 cm in total length) revealed four polyps: one pedunculated cecal polyp measuring 1.5 x 1.5 x 1.0 cm, two flat tan-brown polyps in the right colon measuring 1.5 x 1.0 x 0.2 cm and 1.2 x 0.8 x 0.1 cm, and a smaller raised polyp measuring 0.4 cm in diameter. These lesions involved approximately 10% of the luminal circumference and were confined to the superficial layers without submucosal invasion. Surgical margins were free of involvement, with the closest distance from a polyp to a margin being 2.0 cm. Fifteen lymph nodes were evaluated in this specimen, and none showed evidence of malignancy.\n\nNo additional pathologic findings were noted. All surgical margins across specimens were negative, and no intraoperative complications or unusual gross features were reported."} +{"pid": "TCGA-06-5410", "report": "The clinical history indicates a right parietal brain lesion. Operative specimens A and B consist of excision biopsies from the right brain mass. Gross examination of specimen A shows a 0.8 x 0.3 x 0.5 cm white and grey-tan soft tissue fragment, while specimen B is an aggregate measuring 35 x 20 x 10 mm, composed of pink-tan to gray-white, focally hemorrhagic tissue fragments.\n\nMicroscopic evaluation reveals a densely cellular glial neoplasm with extensive necrosis. There is a marked acute inflammatory response within the necrotic regions, along with perivascular lymphocytic infiltrates. The tumor cells demonstrate moderate nuclear pleomorphism, including occasional bizarre nuclei, and multiple mitotic figures are present. Endothelial cell hypertrophy is observed, often accompanied by fibrin thrombi.\n\nImmunohistochemical staining shows strong positivity for GFAP, S100, and CD56 in the neoplastic cells. CD68 (KP1) staining is only positive in occasional histiocytes. The tumor cells are negative for pancytokeratin and cytokeratin AE1/AE3. Nuclear staining for p53 is diffusely positive. The Ki-67 labeling index is approximately 25%. All control tissues demonstrated appropriate reactivity. Special stains, including Grocott methenamine silver and Gram stain, were negative for fungal or bacterial organisms, respectively.\n\nIntraoperative consultation on specimen A1 included frozen section and smear evaluation, which supported the diagnosis of an infiltrating glial neoplasm. All available tissue was submitted for analysis."} +{"pid": "TCGA-E1-A7YL", "report": "A right frontal lobe mass was identified on MRI as an enhancing, enlarged brain lesion extending across the corpus callosum. The mass demonstrated a more heterogeneous appearance compared to prior imaging.\n\nGross examination of the surgical specimen included three tissue samples. The first was a 0.6 x 0.3 x 0.2 cm tan-red-brown soft tissue fragment. The second consisted of two tan-brown hemorrhagic fragments measuring up to 3.0 cm. The third sample was a larger 5.7 x 2.2 x 1.2 cm tan-red-brown soft tissue fragment.\n\nMicroscopic evaluation revealed infiltration of brain tissue by a mitotically active and hypercellular neoplasm composed of astrocytic cells with gemistocytic features. Microvascular changes were present, but endothelial proliferation and necrosis were not observed. Perivascular lymphocytes were noted.\n\nImmunohistochemical analysis showed labeling indices for various markers. Proliferation index was moderate, with 8% of tumor cells showing staining. Leukocyte common antigen (LCA) was positive in 20% of cells. MGMT expression was detected in 30% of tumor cells. EGFR wild-type expression was present in 70% of cells (2+ intensity). S6 and AKT were each positive in 30% and 25% of tumor cells respectively (2+ intensity). MAPK was positive in 30% of tumor cells (2+ intensity). VEGF expression was high with a score of 120 (intensity x distribution). PDGFR-A and PDGFR-B both showed widespread reactivity in approximately 60% of cells. VEGFR2 (KDR) was positive with a score of 80. No staining was observed for EGFR vIII or carbonic anhydrase IX.\n\nCytogenetic analysis using FISH demonstrated polysomy of chromosome 7 in 86% of tumor cells and polysomy of EGFR in 90% of tumor cells. Chromosome 10 centromere, PTEN, 9p21, and chromosome 9 centromere were intact. Of four abnormal markers analyzed, two were altered.\n\nMolecular testing did not detect mutations in IDH1 or IDH2. Immunohistochemistry for EGFR vIII was negative. Real-time PCR analysis for MGMT promoter methylation was negative, with a methylation index below 4. Low-level methylation (MI between 4 and 16) was not observed, and significant methylation (MI >16) was absent. This result suggests preserved MGMT gene function, which may influence response to alkylating agents.\n\nAll specimens were evaluated personally and findings were confirmed."} +{"pid": "TCGA-HB-A2OT", "report": "The specimen consists of a re-excised soft tissue mass from the right thigh of a female patient. The excised tissue measured 13.0 cm in superior to inferior direction, 6.0 cm in medial to lateral direction, and 7.5 cm in anterior to posterior direction. The tissue was fixed in formalin and oriented with short stitch at the superior aspect and long stitch at the lateral. Ink was applied to margins for orientation: lateral (blue), medial (yellow), superior (red), inferior (green), and deep (black).\n\nA cystic space measuring 7.0 x 5.0 x 2.0 cm was identified within the specimen. The cyst was filled with dark brown debris but had no fluid content. The inner lining of the cyst showed dark brown material. Histologic evaluation revealed a high-grade lesion according to the FNCLCC system, with a largest microscopic dimension of 9 mm. The tumor was located adjacent to the cyst wall and was well-circumscribed and encapsulated.\n\nEvaluation of surgical margins demonstrated no evidence of residual tumor. The closest distance between the tumor and any margin was 3 mm at the superior deep margin. Additional measurements from the cystic space to the inked margins were as follows: 1.6 cm to the superior (red) margin, 2.0 cm to the inferior (green) margin, 0.2 cm to the medial (yellow) margin, 1.0 cm to the deep (black) margin, 1.0 cm to the lateral (blue) margin, and 2.0 cm to the superficial skin margin.\n\nNo necrosis was quantified, though histologic sections showed that much of the original lesion had been replaced by the cystic space. No lymph nodes were present in the specimen. No other unusual features were noted. Multiple tissue blocks were submitted, including all surgical margins and representative sections of the cyst wall. A skin ellipse from the superior margin measured 9.3 x 1.2 cm. No digital photograph was taken."} +{"pid": "TCGA-CV-A6K1", "report": "A total laryngectomy with bilateral neck dissection (levels II-IV) and right hemithyroidectomy was performed. The patient's body surface area is 2.01 m\u00b2. The specimen included a larynx measuring 11.5 x 6.0 x 4.1 cm, a right thyroid lobe measuring 4.1 x 3.0 x 0.9 cm, right neck soft tissue (10.5 x 5.1 x 1.1 cm), left neck soft tissue (9.5 x 1.1 cm), and a stoma site measuring 3.3 x 3.0 x 2.5 cm. A mass lesion was identified in the right transglottic region, measuring 3.2 x 2.3 x 0.5 cm, located 3.5 cm from the distal resection margin. The depth of invasion was 1.1 cm, with extension into and through the thyroid cartilage. The cut surface of the mass showed invasive features.\n\nThe stoma site was continuous through the anterior tracheal cartilage to the center of the skin. The right thyroid lobe had a homogenous tan-brown cut surface without distinct lesions. The right neck dissection yielded 20 possible lymph nodes, and the left neck dissection yielded 33 possible lymph nodes.\n\nMicroscopic evaluation revealed an exophytic lesion with infiltrative borders composed of thick cords greater than 4 cells. The cellular features were consistent with moderately differentiated morphology. No perineural or vascular invasion was identified, although there was evidence of cartilage invasion. Lymphocyte infiltration was moderate.\n\nEvaluation of surgical margins, including the posterior cricoid margin, right and left lateral pharynx, base of tongue, and trachea, showed no evidence of involvement. The right thyroid lobe showed changes consistent with chronic lymphocytic thyroiditis without any neoplastic involvement. Acute and chronic inflammation with granulation tissue was noted at the stoma site, but no residual disease was found.\n\nLymph node analysis: six lymph nodes from the stoma site, none involved; right neck dissection included 6 level I lymph nodes, 2 level III, and 5 level IV, all negative. One lymph node showed hyalinized necrotic nodule, likely representing a granuloma. Left neck dissection included 18 level II, 7 level III, and 4 level IV lymph nodes, all without evidence of involvement. Two additional lymph nodes from the left superior mediastinal tissue were also negative. All submitted frozen sections from various sites were free of tumor."} +{"pid": "TCGA-XF-A9SX", "report": "A radical cystectomy with bilateral pelvic lymph node dissection and urinary diversion was performed. The specimen included a right colon pouch to the umbilicus with a gastrostomy tube. Frozen section analysis of the right and left distal ureters showed no tumor involvement. Final microscopic examination confirmed no dysplasia or malignancy in these regions.\n\nEvaluation of the inner aortal caval lymph nodes during frozen section revealed no tumor in two lymph nodes (0/2). However, final histologic assessment identified a microscopic focus of metastatic involvement in one of the two lymph nodes (1/2), although tumor was not evident upon re-review of frozen slides.\n\nThe bladder specimen demonstrated extensive infiltration through the muscularis propria into perivesical soft tissue and extended to involve the peritoneum. Lymphovascular invasion was noted, along with focal carcinoma in situ. No tumor was identified at the radial, urethral, ureteral, or vaginal margins. Chronic cystitis was also present.\n\nLymph node evaluation across multiple sites revealed metastatic involvement in several regions:\n\n- Left pelvic lymph nodes showed metastasis in all three lymph nodes examined (3/3).\n- Right paracaval lymph nodes showed no metastasis in two lymph nodes (0/2).\n- Right common iliac lymph nodes contained metastases in two out of ten lymph nodes (2/10).\n- Left para-aortic lymph nodes were negative for metastasis across eight lymph nodes (0/8).\n- Left common iliac lymph nodes showed no metastasis in eleven lymph nodes (0/11).\n- Right obturator/hypogastric lymph nodes contained metastases in two out of thirteen lymph nodes (2/13), with one lymph node entirely replaced by a lesion measuring 2.1 cm.\n- Other lymph node regions\u2014including both Cloquet, external iliac, left obturator/hypogastric, presacral, and presciatic sites\u2014were negative for metastasis.\n\nIn total, six of seventy-one lymph nodes examined contained metastatic involvement.\n\nHistologic margins of the left and right proximal ureters showed no evidence of dysplasia or malignancy.\n\nThe surgical pathology report noted benign M\u00fcllerian-type glands within perinodal soft tissue adjacent to a suture granuloma in one specimen; this was interpreted as likely resulting from prior gynecologic surgery and considered clinically insignificant.\n\nStaging was determined based on tumor extension beyond the bladder wall into surrounding tissues and regional lymph node involvement."} +{"pid": "TCGA-BC-A10W", "report": "A peritoneal biopsy demonstrated fibroelastic proliferation and focal fat necrosis without evidence of malignancy. Biopsies from Gerota\u2019s fascia and omentum also showed no malignant cells. A second biopsy from Gerota\u2019s fascia revealed poorly differentiated carcinoma extending to a cauterized, uninked tissue edge. The right hepatectomy specimen contained a large mass measuring 11.6 cm in greatest dimension, with extension through the superior capsule. Lymphovascular space invasion and extensive geographic necrosis were noted. The surrounding liver tissue showed changes consistent with chronic hepatitis, stage 3, grade 2. Additional biopsies from another site of Gerota\u2019s fascia and a posterior margin both showed poorly differentiated carcinoma with extensive necrosis. \n\nFrozen section analysis of the peritoneum confirmed benign fibroelastic proliferation with no malignancy. A frozen section of another Gerota\u2019s fascia biopsy revealed fibrous connective tissue with focal chronic inflammation and no neoplasm. The initial frozen section of a further Gerota\u2019s fascia biopsy identified poorly differentiated carcinoma at the margin, while another omental biopsy showed no carcinoma. \n\nThe patient had a prior fine needle aspiration of a right lobe liver lesion that was diagnostic for poorly differentiated carcinoma. Gross examination included eight specimens. The hepatectomy specimen weighed 1100 grams and measured 17.0 x 14.5 x 9.0 cm, with a nodular gray-tan capsule. There were capsular tears on the superior (6.5 x 4.5 cm) and inferior (3.5 x 3.5 cm) aspects. The cut surface showed a large, variegated mass with necrosis and hemorrhage, measuring 11.6 x 10.3 x 8.9 cm. This mass was located 2.2 cm from a previously inked surgical margin and extended into the superficial and inferior capsular margins. Other sampled tissues included fibrofatty material from additional Gerota\u2019s fascia and a posterior margin, which were submitted for histologic evaluation. Microscopic review confirmed the findings across all specimens."} +{"pid": "TCGA-AO-A0JM", "report": "A 46-year-old female presented with microcalcifications identified in the right breast. Imaging and clinical findings prompted surgical intervention. Specimens submitted for evaluation included sentinel lymph nodes from levels I and II of the right axilla, as well as a right mastectomy specimen encompassing axillary contents from levels I, II, and III.\n\nLymph node analysis revealed involvement in two sentinel nodes. Sentinel node #1 (level I) contained metastatic disease in one out of six nodes examined. Sentinel node #2 (level I) also showed metastasis in the single node evaluated, although this was identified only upon deeper sectioning. Sentinel node #3 (level II) contained two benign lymph nodes. No extranodal extension was observed in any involved node. Additional lymph nodes retrieved during axillary dissection were negative for metastasis: level I yielded 3 nodes (0/3 involved), level II had 4 nodes (0/4), and level III included 2 nodes (0/2).\n\nThe mastectomy specimen measured 30 x 19 x 3 cm, with an axillary tail measuring 13 x 8 x 2 cm. A firm, pinkish-red lesion measuring 3 x 1.5 x 1 cm was identified in the lower inner quadrant, closely approaching the deep inked resection margin but not involving it. Adjacent fibrotic areas displayed punctate necrosis. In the lower outer quadrant, a second region of fibrosis and nodularity extended approximately 10 x 6 cm. No tumor involvement was found at the skin or nipple-areolar complex. Skeletal muscle tissue attached to the specimen was free of tumor.\n\nHistologic examination revealed multiple invasive foci ranging from 0.1 cm to 3 cm in size. These demonstrated features consistent with high-grade morphology including marked nuclear pleomorphism, minimal tubule formation, and frequent mitotic figures. Vascular invasion was noted. Surrounding ductal structures exhibited intraductal proliferation with solid, cribriform, and micropapillary patterns, showing high nuclear grade and moderate necrosis. Lobular involvement by in situ components was also present. Calcifications were identified within both invasive and in situ regions.\n\nThe in situ component accounted for greater than 25% of the total tumor burden and was distributed both admixed with and separate from the invasive areas. It extended into large lactiferous ducts. Surgical margins were free of invasive disease; however, rare foci of in situ carcinoma approached within 1 mm of the deep margin.\n\nImmunohistochemical staining results showed estrogen receptor positivity in 90% of nuclei with moderate intensity, progesterone receptor positivity in 1% with weak to moderate staining, and HER2 positivity with an intensity score of 3+."} +{"pid": "TCGA-78-7147", "report": "The right upper lobe specimen measures approximately 165 x 100 x 55 mm in the inflated state. A subpleural nodule measuring 45 mm in greatest dimension is identified, located 21 mm from the nearest parenchymal resection margin and abutting the overlying pleura. The lesion does not extend through the visceral pleura. No endobronchial component is observed macroscopically. Adjacent lung tissue shows very mild centriacinar emphysema. Microscopic evaluation reveals a moderately differentiated lesion with no evidence of blood vessel, lymphatic, or perineural invasion. The bronchial and surgical resection margins are free of involvement. A metastatic focus is identified in a peribronchial lymph node. A separate small lesion is noted adjacent to the main nodule. The hilar lymph nodes examined show only reactive changes. Multiple sections were taken for analysis, including margins, lymph nodes, and surrounding lung tissue."} +{"pid": "TCGA-AR-A1AH", "report": "The specimen consists of a mastectomy from the right breast. A mass measuring 3.1 x 2.3 x 2.1 cm is identified in the medial portion of the breast. Histologic evaluation reveals high-grade cellular features with extensive angiolymphatic invasion. The surrounding breast tissue demonstrates proliferative fibrocystic changes, including sclerosing adenosis and calcifications. No abnormal findings are noted in the nipple or skin. All surgical margins, including the deep margin, are free of malignant cells, with the minimum tumor-free distance measuring 6 mm. Skeletal muscle is present but not involved.\n\nLymph node evaluation includes a separately submitted right axillary sentinel node biopsy (nodes 1 and 2), where one of two nodes shows micrometastatic involvement measuring 1 mm. In the subsequent axillary lymph node dissection, seven additional nodes are identified and all are negative for malignancy. No lymphoid tissue or abnormal cells are found in the fibroadipose tissue from the right axillary low region.\n\nImmunohistochemical staining reveals focal nuclear positivity for estrogen receptor in 1\u201310% of cells, while progesterone receptor staining is entirely negative. HER2/neu testing by an FDA-approved method yields a score of 0, indicating no protein overexpression."} +{"pid": "TCGA-DX-A6YQ", "report": "The resected specimen from the right buttock includes skin, subcutaneous tissue, and underlying muscle, with overall dimensions of 24 x 15 x 9 cm. A well-circumscribed mass measuring 14.5 x 6.3 x 8.0 cm is identified within the muscle. The tumor has a white, bulging cut surface with 20\u201330% gross necrosis noted. Margins are assessed as follows: deep margin (black inked) measures 0.4 cm from the tumor, superior margin (blue inked) is 4.5 cm away, inferior margin (red inked) is 2.8 cm away, lateral margin (green inked) is 1.0 cm away, medial margin (orange inked) is 0.3 cm away, and anterior margin (yellow inked) is 1.5 cm away. Histologically, the lesion exhibits a diffusely infiltrative growth pattern involving skeletal muscle and subcutaneous tissue. Cellular morphology demonstrates variation, ranging from loosely arranged myxoid regions to more cohesive areas with epithelioid-like cells. Necrosis is present and mitotic activity is elevated at 21 mitotic figures per 10 high power fields. Lymphovascular invasion is observed. Immunohistochemical staining shows absence of CDK4 and MDM2 expression. All surgical margins are free of tumor involvement."} +{"pid": "TCGA-69-7979", "report": "The specimen consisted of multiple tissue samples from various anatomical locations. Part A was a 0.2 x 0.1 x 0.1 cm tan-red soft tissue fragment. Parts B through F were all soft tissue fragments measuring up to 2.2 x 2 x 0.4 cm in aggregate, with no significant gross findings. Part G, labeled as chest wall mass, was a 1.5 x 0.6 x 0.3 cm yellow-tan tissue segment that was bisected and submitted entirely.\n\nPart H, a right upper lobectomy specimen, measured 15 x 11 x 3 cm and weighed 199 grams. A stellate, firm gray-white lesion measuring 3.2 x 3.1 x 2.1 cm was identified at the apex, with central necrosis. The lesion was located 4 cm from the bronchial margin and 2.5 cm from the parenchymal margin. It caused pleural retraction but did not grossly invade the pleura. A separate tan nodule with central hemorrhage measuring 1 x 0.6 x 0.5 cm was also found near the pleura, approximately 5 cm from the main lesion. The remaining lung tissue showed severe emphysematous changes, especially in the upper regions. Two peribronchial lymph nodes were present, the larger measuring 0.8 cm in diameter.\n\nParts I, J, and K were all lymph nodes measuring up to 1.5 x 1.2 x 0.8 cm, each with anthracotic pigmentation. All lymph nodes were fully submitted for analysis.\n\nHistologic evaluation revealed unremarkable fibroadipose tissue in Part G. In Part H, the surgical margins, including bronchial, vascular, and parenchymal, were all negative. Two lymph nodes from this part were also negative. The other submitted lymph nodes (Parts A\u2013F and I\u2013K) were all negative. No vascular or lymphatic invasion was identified. The pleural and soft tissue margins were also negative.\n\nStaging was performed according to AJCC criteria, resulting in a classification of pT2a pNO pMX, corresponding to Stage 1b."} +{"pid": "TCGA-MP-A4TA", "report": "The specimen includes a right upper lobe lung lobectomy measuring 2.0 x 2.0 x 0.9 cm, weighing 205 grams. A subpleural mass is present, measuring 2.0 x 2.0 x 0.9 cm, with surface puckering; however, there is no involvement of the overlying visceral pleura. The distance from the tumor to the bronchial margin is 4.2 cm. All margins of resection are free of neoplastic cells.\n\nLymph node dissection includes multiple stations: station 2R (two sets, 6 lymph nodes), station 4R (six sets, 24 lymph nodes), station 4L (five lymph nodes), station 7 (three sets, 14 lymph nodes), station 9 (one lymph node), station 10R (two sets, 2 lymph nodes), and station 11 (two sets, 2 lymph nodes). Additionally, intrapulmonary peribronchial lymph nodes (eight total) and interlobar lymph nodes (two total) were examined. No neoplastic cells were identified in any of the lymph nodes evaluated."} +{"pid": "TCGA-ZJ-AB0I", "report": "The cervical biopsy specimen consists of two pink to pale tan tissue fragments, measuring between 0.6 x 0.3 x 0.2 cm and 1.4 x 0.5 cm. The larger fragment is bisected and all tissue is submitted in a single cassette. Histologically, the biopsy demonstrates abnormal cellular proliferation with features including large cell morphology and keratinization. Stromal invasion is present. Cellular atypia and mitotic activity are noted. No lymphovascular invasion is identified. The histologic findings indicate a lesion with invasive characteristics."} +{"pid": "TCGA-DU-A76O", "report": "The patient is a male with a past medical history significant for left leg amputation due to a cartilaginous lesion and multiple intra-axial, intracranial lesions previously described as low-grade glial neoplasms. He presents with medically intractable complex partial epilepsy.\n\nTwo biopsies were performed: one from a parasagittal brain region and another from the inferior parietal area. Microscopic evaluation of the parasagittal specimen revealed a moderately infiltrated cerebrum with a neoplastic glial proliferation. The cells exhibit a mixed oligo-astrocytic appearance with uniform, round-to-ovoid nuclei often surrounded by halos. No microvascular proliferation or necrosis was identified. Mitotic figures were rare. Immunohistochemical staining showed strong and uniform reactivity for IDH1, a delicate gliofibrillary background on GFAP staining, and a MIB-1 proliferation index greater than 9%, estimated up to approximately 15% when accounting for normal cell nuclei in the count. Molecular testing demonstrated positivity for the IDH1-R132H mutation, absence of 1p and 19q co-deletion, and low positivity for MGMT promoter methylation.\n\nThe inferior parietal biopsy consisted of small tissue fragments, limiting the assessment of cortical architecture. Sparse infiltration of the cortex by neoplastic glial cells was noted, with only a light distribution of IDH1-positive nuclei. There was no clear architectural distortion, dysmorphic neurons, or balloon cells. GFAP staining did not show reactive astrocytosis, and CD163 highlighted mild dendritic microglial activity, likely related to prior surgical manipulation. NeuN and NFP immunostains showed a thin, tangentially sectioned cortex with relatively preserved lamination.\n\nBoth specimens were evaluated in the context of clinical, imaging, and electrophysiological findings. The parasagittal lesion demonstrates features of a low histological grade glial neoplasm with astrocytic molecular features and a proliferation index above 9%, which may suggest increased biological activity. The inferior parietal region shows sparse glial infiltration without definitive evidence of architectural disruption. Correlation with other diagnostic modalities is recommended for clinical interpretation and follow-up planning."} +{"pid": "TCGA-BH-A0E1", "report": "The surgical specimen from the left breast was submitted for analysis following a simple mastectomy. The tumor measured 4.5 cm in its greatest dimension and was located in the lower inner quadrant. Histologic evaluation revealed an infiltrating ductal pattern with a Nottingham grade of 2, based on a nuclear grade of 2, tubule formation score of 3, and mitotic activity score of 2 (total score: 7/9). Lymphovascular space invasion was identified. Margins were negative, with the tumor approaching closest to the anterior margin at 1.5 mm. Fibrocystic changes were also present, and the nipple skin showed no evidence of involvement.\n\nA total of six lymph nodes were examined. Two lymph nodes contained deposits measuring less than 1 mm in diameter. No extracapsular extension was observed. The method of lymph node examination included both histologic sectioning and keratin staining. \n\nThe pathologic staging was determined as pT2 for the primary tumor, pN1mi for nodal involvement, and pMX for distant metastasis. Immunohistochemical analysis demonstrated positivity for estrogen and progesterone receptors, and HER2/Neu expression was scored as 2+."} +{"pid": "TCGA-BP-4790", "report": "The specimen consists of a portion of right kidney with attached perinephric fat, measuring 4.5 x 4.3 x 4.0 cm. Serial sectioning reveals a golden-yellow mass measuring 3.5 x 3.0 x 2.8 cm, located within the kidney and not extending into the perinephric fat. The lesion is identified at a distance of 0.1 cm from the inked resection margin.\n\nHistologic evaluation demonstrates a neoplasm of renal cortical origin. Nuclear grading is classified as II out of IV. All margins are free of tumor involvement. There is no evidence of local invasion or vascular involvement. The surrounding non-neoplastic kidney tissue shows mild focal chronic interstitial inflammation. No lymph nodes or adrenal tissue were present for evaluation.\n\nStaging indicates that the lesion is confined to the kidney and measures less than or equal to 7.0 cm in greatest dimension. A granulomatous response is noted in association with the lesion. Intraoperative frozen section consultation confirmed negative deep margins and findings consistent with the final diagnosis."} +{"pid": "TCGA-A3-A6NI", "report": "The specimen consists of a left kidney with attached perinephric fat, measuring 12.5 x 8 x 4.8 cm and weighing 78 grams. The kidney alone measures 9.5 x 3.8 x 3.2 cm. Attached hilar vessels are up to 0.8 cm in length and 2.5 cm in diameter, with a widely patent renal vein lumen. A ureter segment measuring 2.5 cm in length and 0.4 cm in diameter is present, with a metal clip at its margin. At the inferior pole, there is a discrete nodule measuring 4 cm in diameter with a mottled, spongy orange-gray cut surface and scattered areas of hemorrhage. The nodule has a well-defined margin that causes a bulge in the intact capsule. There is no visible extension into perinephric fat. The adventitia margin is marked with black ink. The tumor approaches within 0.2 cm of the renal sinus fat at its superior aspect. The remaining renal parenchyma shows cortical thinning up to 0.5 cm, multiple cysts containing clear fluid or old blood, and atrophic renal pyramids. The collecting system is lined by mildly striated gray-white mucosa.\n\nMicroscopic examination reveals a lesion confined to the kidney without involvement of major veins. The lesion demonstrates a histologic grade of 3 according to Furman criteria. No sarcomatoid features are identified. Surgical margins, including the ureteral and hilar vessel margins, are negative. Additional findings include severe glomerulosclerosis and tubular atrophy consistent with advanced chronic kidney disease. Based on AJCC staging guidelines, the lesion is classified as pT1a with no lymph node assessment performed (pNX)."} +{"pid": "TCGA-BR-8362", "report": "Specimen was received as gastrectomy with tumor located at the fundus. The tumor measured 16 x 14 x 2 cm and exhibited exophytic, polypoid growth features. Histologic examination revealed poorly differentiated morphology. The tumor extended to adjacent structures, including the omentum. Lymph node evaluation showed 15 out of 30 involved lymph nodes with evidence of metastasis in intraabdominal lymph nodes. No information was provided regarding lymphatic, venous, or perineural invasion. Surgical margins were uninvolved. There was no indication of neoadjuvant treatment effect. No additional pathologic findings or comments were noted."} +{"pid": "TCGA-PL-A8LZ", "report": "The specimen from a female patient showed a chalky white mass measuring 4x3x2cm. Microscopic examination revealed an invasive tumor arranged in solid nests and tubular patterns. The tumor cells exhibited moderately pleomorphic hyperchromatic nuclei and amphophilic cytoplasm. The surrounding stroma was desmoplastic, with thin-walled vascular channels, scattered tumor cells, and lymphocytes. Focal areas of necrosis were present. The closest margin involvement was at the deep resection site, with a distance of 5mm."} +{"pid": "TCGA-08-0345", "report": "The specimen was received in four parts. Part A consisted of multiple irregularly shaped fragments of pink-gray soft tissue measuring 1.1 x 0.7 x 0.3 cm in aggregate. One-half of this specimen was used for a frozen section and cytologic preparation, with the remaining portion submitted for further analysis. Part B consisted of two fragments of pink soft tissue measuring 1.1 x 0.6 x 0.4 cm in total, described as \u201cdeep tumor.\u201d Part C included multiple fragments of white-tan and pink soft tissue measuring 1.2 x 0.9 x 0.4 cm, labeled as \u201cbrain tumor.\u201d Part D, labeled as \u201ctumor margin,\u201d was a single fragment of gray-tan soft tissue measuring 2.5 x 1.2 x 0.6 cm, with one smooth surface inked blue to assist in identifying the margin.\n\nMicroscopic evaluation revealed highly cellular tissue with marked nuclear pleomorphism, numerous mitotic figures, multiple areas of necrosis, and prominent microvascular proliferation. Immunostaining for glial fibrillary acidic protein showed strong positivity in many astrocytic cells. In the \"tumor margin\" sample, neoplastic astrocytes were identified focally in a subpial region with extensive involvement of the leptomeninges, although most of the cortical tissue appeared free of abnormal cellular infiltration. The findings were based on intraoperative assessment and subsequent review of all specimens by the attending pathologist."} +{"pid": "TCGA-G6-A5PC", "report": "The left kidney specimen measured 12 x 7 x 5 cm and weighed 322 grams. A mass measuring 6.4 x 6.2 x 5.2 cm was identified within the kidney, located approximately 0.2 cm from the renal capsule. The mass exhibited solid and papillary architecture with cells displaying clear cytoplasm and high-grade nuclear features including prominent nucleoli and clumped chromatin. Histologic evaluation showed no vascular or lymphatic invasion, nor any perinephric tissue involvement. The adrenal gland and ureteral margin were free of tumor. One hilar lymph node was examined and showed no evidence of tumor involvement.\n\nImmunohistochemical staining demonstrated positivity for CD10 and PIN-4 P504S, while being negative for cytokeratin 7, PIN-4 HMWCK (CK5 & CK14), and PIN-4 p63. These findings supported a specific cellular phenotype consistent with a previously recognized profile.\n\nThe tumor was confined to the kidney without involvement of surrounding structures. Gross examination revealed no additional abnormalities in the submitted tissues. Based on pathological staging criteria, the tumor was classified as T1b, N0, M1."} +{"pid": "TCGA-XV-A9W5", "report": "Patient M presented with a lesion on the left shoulder. Histopathologic evaluation revealed a tumor measuring 3 mm in greatest dimension, with a Clark level of 4 and a Breslow thickness of 2 mm. The tumor cells showed epithelial morphology. No evidence of nodal or distant metastasis was identified. The surgical margins were free of tumor. The case was classified as stage I. No neoadjuvant immunotherapy was administered."} +{"pid": "TCGA-CG-4442", "report": "The specimen consists of a subtotal gastrectomy resection with extensive metaplasia present, likely related to a background of multifocal atrophic gastritis attributed to prior H. pylori infection. The resection margins are free of tumor involvement. A central finding is an ulcerated lesion in the antrum composed of poorly differentiated cells with glandular features. Histologic evaluation shows infiltration extending into the subserosa. No regional lymph node metastases were identified. Staging was determined as pT2b with 0 out of 27 lymph nodes involved."} +{"pid": "TCGA-CJ-4923", "report": "The specimen consists of a left kidney and adrenal gland from a radical nephrectomy measuring 23.0 x 11.0 cm. The kidney contains a large mass measuring 12.0 x 9.0 x 8.0 cm, which replaces most of the renal parenchyma. The tumor has a variegated cut surface with soft light tan-brown to bright yellow areas and firm pink-white regions. Larger portions of the tumor are necrotic and cystic. It invades into the renal vein but does not reach the margin of resection in that area. The tumor extends into the renal sinus, completely obliterating it. It also pushes up against the perinephric adipose tissue, although there is no definitive evidence of invasion into this tissue. Margins of resection are free of involvement. The adrenal gland appears unremarkable without any abnormal findings. Cellular composition includes a mixture of clear cells and eosinophilic cells. Nuclear grading is present. Vascular margins and soft tissue margins were assessed. Multiple sections were taken from various regions including the renal vein, renal sinus, and surrounding adipose tissue. Additional tissue was submitted for a renal vaccine protocol. Clinical history notes a left renal mass."} +{"pid": "TCGA-KK-A7B3", "report": "The prostate specimen measured 6.5 x 4.0 x 6.0 cm and weighed 58.0 grams after fixation. Serial cross-sections revealed an area of abnormal tissue involving the right lateral and right posterolateral peripheral zone with extension into extraprostatic tissue, present across three cross-sections. A palpable nodule was noted on the right side of the prostate. The seminal vesicles and attached segments of the vasa deferentia appeared grossly unremarkable. An additional detached tissue fragment measuring 2.2 x 1.2 x 0.7 cm was included in the specimen.\n\nMicroscopic evaluation identified two distinct foci of abnormal cellular growth. The dominant focus was located in the left anterolateral, left anterior, mid-anterior, right anterior, right anterolateral, right lateral, right posterolateral, right posterior, mid-posterior, left posterior, and left posterolateral peripheral zone. This lesion measured 3.0 x 2.5 cm at its largest cross-sectional dimension and was present in three cross-sections, extensively involving the apex and base of the prostate. There was multifocal extension beyond the prostate capsule, particularly at the posterior apex, right posterolateral surface, right superior neurovascular bundle region, and at the base anterior to the seminal vesicles. Involvement of the right seminal vesicle was noted, both intra- and extraprostatic components. All surgical margins were free of abnormal cells.\n\nA second focus was identified in the left transition zone, measuring 0.6 x 0.5 cm at its largest cross-sectional dimension. This lesion was confined to the prostate and showed lower histologic grade compared to the dominant focus. Margins of resection were clear for this focus as well.\n\nPerineural and lymphovascular invasion were identified. Seventeen pelvic lymph nodes were examined, ranging in size from 0.2 x 0.2 x 0.1 cm to 4.0 x 0.8 x 0.6 cm. No abnormal cells were found in any of the lymph nodes. All lymph nodes were entirely submitted for analysis."} +{"pid": "TCGA-CZ-4863", "report": "The specimen consists of a left kidney measuring 18.5 x 12.5 x 7.0 cm and weighing 574 grams, including attached perinephric fat. The mass measures 7.5 x 6.5 x 6.0 cm, located in the upper to mid-pole, with focal extension into the renal vein, reaching within 2 cm of the vein margin, 2.5 cm from the renal artery margin, and 7.9 cm from the ureteral margin. Grossly, it appears hemorrhagic, firm, and well-circumscribed, with focal involvement of the renal sinus and pelvis. The adjacent renal parenchyma shows areas of discoloration and pallor. Histologically, nuclear grade III/IV features are identified. The tumor extends into perinephric adipose tissue but does not definitively breach through the renal capsule, approaching within 0.2 cm of the outer soft tissue margin. Margins of the renal vein, artery, and ureter are negative for involvement.\n\nEleven regional lymph nodes are submitted, none showing evidence of involvement. Staging classification indicates T3b status based on tumor extension into the renal vein. Microscopic evaluation of the kidney reveals mild chronic changes, including focal global glomerulosclerosis (1.2% of glomeruli), minimal tubular atrophy and interstitial fibrosis (<2% of parenchyma), and mild vascular sclerosis. No evidence of obstructive uropathy is noted despite mild hydronephrosis. An area of focal cortical scarring near the tumor suggests chronic vascular compromise.\n\nSpecial studies performed include PAS and trichrome stains. Cytogenetic analysis could not be completed due to absence of metaphases."} +{"pid": "TCGA-58-A46L", "report": "Pathology Report-Summary: Material: lung, right, upper lobe: 15.0 x 11.0 x 6.5 cm. A mass measuring 8.0 x 5.0 x 7.5 cm was identified. Histologic evaluation revealed high-grade cellular atypia with infiltration of the visceral pleura. Lymph node staging showed involvement of one out of 31 examined nodes. No definitive distant metastasis was determined."} +{"pid": "TCGA-DX-A8BP", "report": "Clinical history indicates a prior core biopsy of the right thigh. The specimen submitted for analysis consists of a resected mass from the right anterior thigh. Gross examination reveals a fresh, unoriented skeletal muscle tissue measuring 17 x 14 x 6 cm. The tumor measures 12.3 x 8.2 x 6.6 cm and is described as white and yellow with a well-circumscribed appearance. It is located within the skeletal muscle and extends to within 1 mm of the nearest margin. The tumor is surrounded by a thin membrane and was inked entirely black during processing.\n\nMicroscopic evaluation demonstrates a high-grade lesion with storiform-pleomorphic features. The tumor involves skeletal muscle and exhibits areas of necrosis along with brisk mitotic activity, quantified at 14 mitotic figures per 10 high-power fields. There is focal extension to an indeterminate inked margin. Multiple sections were examined, including representative tissue blocks and margin assessments. No diagnostic terminology or final interpretation is provided in this summary."} +{"pid": "TCGA-BS-A0V6", "report": "The specimen included the uterus, cervix, bilateral tubes and ovaries, along with multiple lymph node groups from both sides. Histologic evaluation revealed a lesion within the uterine cavity measuring 3.5 cm in size. The tumor demonstrated a superficial depth of invasion, involving less than half of the myometrium, with a measured invasion depth of 1 mm in a myometrium that was 18 mm thick. The tumor exhibited a well-differentiated morphology with nuclear features classified as grade 2. No lymphovascular space invasion was identified. The serosal surface, parametrial tissues, and cervical regions were free of tumor involvement. Both adnexal regions were also free of tumor.\n\nLymph node evaluation included twelve nodes from the left pelvic region, all of which were negative for metastasis. The left aortic lymph node group contained three nodes, none of which showed evidence of tumor involvement. On the right side, ten pelvic lymph nodes and five aortic lymph nodes were examined, all without findings of metastatic disease. \n\nGrossly, the uterus measured 8.6 x 6.5 x 4.0 cm and weighed 95 grams. The tumor was described as fungating, circumferential, and friable, located in the body and fundus of the uterus. The endometrial lining measured 0.2 cm and was smooth with areas of mucoid material. Myometrial thickness was 2.1 cm without evidence of adenomyosis. The cervix appeared smooth and unremarkable. Both ovaries and fallopian tubes were uninvolved and displayed no abnormal findings. Multiple benign-appearing smooth, white, whorled-cut-surface myomas were noted, with the largest measuring up to 1.7 cm. All surgical margins were free of tumor."} +{"pid": "TCGA-W5-AA2I", "report": "Male. Surgery Date: Liver, segments V and VI, resection: The lesion is grade 2 (of 4) and forms a multilobulated mass measuring 6.8 X 6.6 X 5.8 cm. The tumor extends to within 0.3 cm of the surgical resection margin."} +{"pid": "TCGA-MN-A4N5", "report": "The specimen consists of a lobe of lung weighing 193 grams, measuring 18.2 x 11.5 x 2.5 cm. A linear staple line is present superior to the bronchus, measuring 5.5 cm in length. The bronchial resection margin was removed en face and submitted for analysis. The pleural surface is tan-pink and smooth, with a 1.0 x 1.0 cm area of induration and puckering along the lateral aspect, which was inked blue. The staple line was removed and the underlying parenchyma inked black. Sectioning revealed a 1.6 x 1.6 x 0.8 cm tan-yellow to white granular, poorly demarcated lesion located beneath the area of pleural puckering. This lesion approaches the pleural surface and is 4.3 cm from the bronchial resection margin, 3.6 cm from the nearest vascular resection margin, and 4.6 cm from the closest staple line surface. The remaining lung tissue appears tan-pink to red with no significant gross abnormalities noted. Multiple dark black, rubbery lymph nodes were identified in the peribronchial region and representative sections were submitted for histologic evaluation.\n\nHistologically, the lesion demonstrates features of invasive poorly differentiated epithelial neoplasm. Immunostains show positivity for CK7 and TTF-1, focal positivity for P63, and negativity for CK20. ALK immunostain was negative. Molecular studies performed on the lesion showed no mutations in the EGFR gene and no ALK gene rearrangement by FISH. Additional findings include rare nests of monotonous epithelial cells in the staple line margin, positive for chromogranin and synaptophysin, suggestive of small neuroendocrine tumorlets.\n\nA total of 31 lymph nodes were evaluated from various stations; none showed evidence of metastatic involvement. Granulomas were identified in several lymph nodes. No mycobacterial or fungal organisms were detected in lymph nodes with granulomas. Non-neoplastic lung tissue shows changes consistent with interstitial fibrosis.\n\nMargins of resection were uninvolved. The lesion is located in the upper lobe, measures 1.6 cm in greatest dimension, and is unifocal. There is no evidence of visceral pleural invasion, lymphovascular invasion, or perineural involvement. Staging indicates pT1a classification for the primary tumor and pN0 for regional lymph nodes."} +{"pid": "TCGA-BR-6457", "report": "The specimen consists of a total gastrectomy. The tumor is located in the stomach and measures 7.0 \u00d7 0 \u00d7 7.5 cm. It exhibits an ulcerated surface. Microscopically, the tissue shows poorly differentiated features. The tumor extends to the subserosa. Fifteen lymph nodes were examined, including those along the greater and lesser curvatures, none of which show metastatic involvement. Venous invasion is present. Lymphatic and perineural invasion status are not specified. Surgical margins are uninvolved. There is no information provided regarding prior neo-adjuvant treatment or additional pathologic findings."} +{"pid": "TCGA-5N-A9KM", "report": "The pathology specimen from cystectomy demonstrates a poorly differentiated malignant neoplasm involving the posterior and lateral walls. Histologic evaluation reveals features indicative of high-grade intraepithelial neoplasia. The lesion extends into the perivesical adipose tissue. All resected surgical margins show no evidence of tumor involvement. Additional findings include an atrophic endometrium without cytologic atypia. The endocervix and ectocervix do not exhibit dysplastic changes. According to the pTNM 2010 classification system, the staging is as follows: pT4a, pN0 (0 of 16 lymph nodes involved), with vascular invasion present (V1), perineural invasion absent (Pn0), and histologic grade G3. The resection status is classified as RO (microscopically complete)."} +{"pid": "TCGA-YT-A95E", "report": "The specimen involves the anterior mediastinum and consists of a well-circumscribed mass measuring 9.0 x 8.7 x 6.5 cm. Histologic evaluation reveals a neoplasm composed of epithelial cells with moderate nuclear atypia and a minor component of lymphocytes. The architecture is predominantly diffuse, with focal areas of organoid growth. No evidence of invasion is identified at the surgical margins."} +{"pid": "TCGA-AR-A24K", "report": "The specimen consists of a 2.7 x 2.7 x 1.5 cm lesion with features of Nottingham grade III (of III). The excised tissue from the left side shows no evidence of residual tumor at the margins, including the separately submitted superior margin, which is free by 1.5 cm. Two left axillary sentinel lymph nodes were examined and found to be without involvement. Blue dye was visualized in both lymph nodes. Immunohistochemical staining for cytokeratin on paraffin-embedded sentinel lymph node tissue confirmed the findings observed on H&E sections. No tumor was identified in the lymph nodes [AJCC pN0 (i-,\nsn)]."} +{"pid": "TCGA-XH-A853", "report": "The specimen was received fresh for intraoperative consultation and consists of a 110.6 g tissue measuring 13.1 x 8.0 x 3.5 cm, with a well-circumscribed mass measuring 5.0 x 4.5 x 3.5 cm. The mass is located 9.5 cm from the superior margin and abuts the right lateral, left lateral, and inferior margins. It has a tan to mahogany-brown, solid, lobulated, and homogeneous cut surface with thin white fibrous trabeculae. The surrounding fat contains two tan-brown to black rubbery lymph nodes with tan-black to white cut surfaces. Sections were taken from various areas of the mass, adipose tissue, lymph nodes, and surgical margins.\n\nFrozen section analysis of the left lateral margin showed fibroadipose and lymphoid tissue with anthracotic pigment, and no definitive evidence of tumor involvement. All other submitted lymph nodes and tissues were negative for tumor. The regional lymph nodes examined (total of 4) showed no evidence of metastasis.\n\nMicroscopic examination revealed a lobulated architecture with fibrous bands and occasional Hassal's corpuscles. The neoplasm contains a mixture of spindle/oval and focally polygonal epithelial cells intermixed with T-cells. Immunohistochemical staining demonstrated positivity for PCK and CK5/6 in the epithelial component and CD3 and CD5 in the lymphoid component. Rare scattered B-cells were identified by CD20 staining. Cystic changes were noted within the mass. Fibroadipose tissue away from the mass, including the superior and right superolateral margins, showed involuted thymic tissue. A small focus of parathyroid tissue (1x1 mm) was identified in the superior margin.\n\nSpecial stains for fungal and acid-fast organisms were negative. No treatment effect or lymphovascular invasion was identified. The surgical margins were uninvolved."} +{"pid": "TCGA-IM-A3ED", "report": "Surgical pathology evaluation was performed on a total thyroidectomy specimen. A nodule measuring 1.7 cm in greatest dimension (additional dimensions: 1.5 x 0.7 cm) was identified in the left thyroid lobe. Microscopic examination revealed no involvement of surgical margins. No evidence of vascular invasion was identified.\n\nLymph node specimens were evaluated, including one from the midline nodule region, five from the right paratracheal area, and three from the left upper paratracheal region. All lymph nodes showed no abnormal cellular findings. A total of nine lymph nodes were examined, with none showing any concerning features.\n\nAdditional findings included chronic lymphocytic thyroiditis involving multiple areas of the thyroid specimen, including the isthmus and both lobes.\n\nThe specimen was thoroughly examined and all relevant tissue blocks were assessed. No other significant pathological findings were identified."} +{"pid": "TCGA-BP-4968", "report": "The right kidney specimen with attached ureter, renal vessels, and perinephric fat weighed 395 grams and measured 10.5 x 6.4 x 5.5 cm. A yellow and hemorrhagic, circumscribed mass was identified within the kidney, measuring 5.5 x 2.5 x 2.2 cm, and appeared to extend into the perinephric fat. The remainder of the kidney showed a pink-brown parenchyma with a well-defined corticomedullary junction. The cortex measured 1.0 cm, and the calyces were normal. No lymph nodes were found in the perinephric fat. Ureteral and vascular margins were unremarkable. The attached ureter measured 8.0 cm in length and 0.3 cm in diameter, and the renal vein measured 1.0 cm in length and 0.8 cm in diameter. An adrenal gland was not identified.\n\nA separate specimen from a segment of bone with soft tissue, labeled as a portion of the 11th rib, measured 4.8 x 1.3 x 1.1 cm and was grossly unremarkable. Additionally, a specimen of perinephric fat measured 3.2 x 3.1 x 0.9 cm and was submitted for evaluation. A final specimen containing multiple fragments of tan and pale soft tissue with metallic and plastic clips, labeled as hilar lymph nodes, was received in aggregate measuring 2.1 x 1.7 x 0.8 cm, and all tissue was submitted for analysis.\n\nMicroscopic evaluation of the kidney mass revealed cells with nuclear features consistent with high-grade changes. The tumor was confined to the kidney without evidence of local invasion or involvement of the renal vein. Surgical margins were free of involvement. The non-neoplastic kidney tissue showed no significant abnormalities. Evaluation of the perinephric fat, hilar lymph nodes, and rib specimens showed no evidence of involvement. Three hilar lymph nodes were examined and were free of disease. The tumor was staged based on size and extent, measuring 5.5 cm in greatest dimension, and confined to the kidney."} +{"pid": "TCGA-KM-A7QK", "report": "A total of 42 specimens were received for evaluation, all labeled as originating from the left kidney of a male patient with a known history of Birt-Hogg-Dub\u00e9 syndrome. The specimens included multiple nodular tissue fragments with varying appearances and sizes.\n\nThe largest nodules measured up to 5.1 x 5 x 4.5 cm and were described as tan-pink with areas of overlying capsule and fat. Upon sectioning, these nodules revealed mottled orange-yellow cut surfaces with eccentric white-tan foci. Smaller nodules ranged in size from 0.6 x 0.5 x 0.4 cm to 3.2 x 2.0 x 1.9 cm. Most were irregularly shaped and tan-orange in color, with some showing focal hemorrhage or disruption. Several specimens contained areas of soft, rubbery consistency and white-tan foci similar to those seen in the larger nodules.\n\nApproximately half of the specimens were partially processed for further analysis, with 40% to 50% of tissue procured; the remaining portions were submitted in entirety for permanent processing. Some specimens were entirely submitted without any tissue procurement. All specimens were sectioned as needed and submitted in white cassettes for histological evaluation.\n\nOne specimen labeled as \"normal left kidney\" was also submitted and measured 1.8 x 1.6 x 0.7 cm. It was described as tan-orange-pink and nodular in appearance. Two in vivo tissue needle core biopsies were obtained from this specimen for additional study.\n\nGross photographs were taken of several specimens during processing. No margin assessment was performed on any of the submitted specimens. All specimens were received and processed according to standard surgical pathology protocols."} +{"pid": "TCGA-B2-3924", "report": "The left kidney specimen weighed 688 grams and measured 19 x 14.5 x 7 cm. The kidney itself measured 11.2 x 6.5 x 5.3 cm and was surrounded by yellow adipose tissue. A yellow-orange mass measuring 4.3 x 3.7 x 3.5 cm was identified within the kidney, appearing circumscribed and focally cystic. It was located 0.25 cm from the surface of the specimen and appeared confined to the kidney. A portion of the mass and normal parenchyma were submitted for tissue procurement. The renal pelvis was smooth and tan-white. The renal parenchyma away from the mass was tan-pink-red with a well-defined corticomedullary junction and a maximal cortical thickness of 1.2 cm. Several cortical cysts with smooth linings were noted, with the largest measuring 1.2 cm in diameter. The adrenal gland, measuring 5.5 x 2.7 x 1.3 cm, was yellow-orange and lacked any focal lesion.\n\nHistologic evaluation showed a mass measuring 4.2 cm in greatest dimension. The histologic grade was Fuhrman Nuclear Grade 2. The tumor was limited to the kidney with negative margins of resection. There was no evidence of vascular invasion. Evaluation of the surrounding fat, renal capsule, and non-neoplastic kidney revealed simple cysts and scattered chronic inflammation. The adrenal gland showed no significant abnormalities. Lymph node and distant metastasis status could not be determined."} +{"pid": "TCGA-CN-6018", "report": "A left mandibular mass biopsy showed the presence of moderately differentiated invasive tissue with necrotic debris. A second biopsy from the same area confirmed similar findings. Tissue samples from the proximal inferior alveolar nerve shave margin, left floor of mouth shave margin, left buccal shave margin, left gingival labial shave margin, symphyseal marrow margin, and left retromolar trigone shave margin all showed no evidence of tumor involvement. Inflammatory changes were noted in several areas, including squamous mucosa with acute and chronic inflammation, minor salivary glands with chronic sialadenitis, and lymphoid aggregates.\n\nA composite resection specimen included a 4.5 cm ulcerated lesion located in the oral cavity with invasion into the mandibular bone. Perineural invasion was identified, but no angiolymphatic invasion was observed. All final resection margins were free of tumor involvement, consistent with the earlier biopsies. A metastatic deposit was found in one of the lymph nodes at the primary site, with extracapsular extension present. Dissection of the left neck levels 2, 3, and 4 revealed one involved lymph node out of fourteen examined, with no extracapsular extension. On the right side, five lymph nodes from neck levels 1, 2, and 3 were free of tumor.\n\nThe pathological staging was determined as pT4a for the primary lesion, indicating local invasion into bone, and pN2b for regional lymph node involvement. The submandibular gland showed signs of chronic sialadenitis and atrophy, and the overlying skin showed solar elastosis. No other significant pathological findings were identified. Intraoperative frozen section analysis of multiple margins confirmed absence of tumor involvement, except for one sample that initially showed only benign findings before the final diagnosis was made."} +{"pid": "TCGA-66-2770", "report": "The examined specimen included a resected right lower lobe measuring 18 x 13.5 cm at the base and up to 15 cm in height. The central bronchus resection plane was located distal to the bifurcation of B6, with staple suture lines observed in the perihilar region. A 1 cm grayish-black node was present at the hilus. The pleura, particularly in the lateral and dorsal regions, exhibited a vaguely pavement-like relief appearance. Within segment 8, a moderately firm, pale brownish lesion measuring up to 5.4 cm was identified, with relatively clear and slightly arcuate margins. This lesion extended to within 0.3 cm of the ventral pleura and involved truncation of some subsegmental branches of B8. There was suspicion of tumor involvement in at least one pigmented lymph node.\n\nRemaining pulmonary parenchyma showed diffuse induration and a pale color with reticulate or streaky whitish patterns on sectioning. At the junction of segments 9 and 10, a subpleural, disk-shaped blackish lymph node measuring 0.5 cm was noted. Additional lymph nodes were identified across various stations: a 2 cm lesioned node in the middle lobe station (station 12), three grayish-black nodes ranging from 0.2 to 0.5 cm in the interlobar region (station 11), a 1.2 cm lesioned node at the hilar station (station 10) on the right, a 0.5 cm node in the paraesophageal area (station 8), a 1.8 cm lesioned grayish-black node in the subcarinal region (station 7), two lesioned grayish-black nodes measuring 1 and 1.2 cm in the low paratracheal station (station 4), and a 1.1 cm lesioned node at the left hilar station (station 10).\n\nHistological evaluation focused on the tumor involving the parenchyma and pleura, with assessment of bronchial branches S6 and S10, a subpleural node, central bronchus resection plane, vascular resection margins, and hilar lymph nodes. Lymph nodes from other stations were also analyzed, with some being halved for examination. Special stains including Elastica-van Gieson, PAS, diastase-PAS, and iron staining were applied across 15 tissue blocks.\n\nFindings indicated the presence of a poorly differentiated large-cell neoplasm with focal keratinization originating from the intermediate to peripheral bronchopulmonary region in segment 8. Based on these findings, staging was assessed as pT2 pNO pMX V1 R0, corresponding to stage IB. Adjacent tissue analysis revealed focal chronic fibrosing interstitial pneumonia in the mantle zone with fibrous remodeling, small honeycomb-like changes, and focal bronchiolization in segment 6. Lymph nodes from the main preparation and samples 3 through 9 displayed reactive changes and anthracotic pigment deposition without definitive malignant involvement.\n\nThe parietal pleura showed hypocellular fibrosis. Vascular invasion was noted within the tumor region, although the visceral pleura, bronchial and vascular resection margins, and all excised lymph nodes were free of tumor involvement. No asbestos bodies were detected in the examined sections; however, more comprehensive analyses, including dust studies, would be required to assess prior environmental exposure."} +{"pid": "TCGA-L5-A4OJ", "report": "A 10.6 cm segment of distal esophagus and proximal stomach was received, with both margins stapled. The segment includes 6.9 cm of esophagus and 2.4 cm of stomach. The esophagogastric junction showed diffusely granular and red-tan mucosa, with granular mucosa extending up to 3 cm above the junction. Two firm lesions were identified in the proximal esophageal mucosa. The smaller lesion measured 1.2 x 0.8 cm, with a gray-tan, homogeneous cut surface and maximum thickness of 0.9 cm. This nodule extended into the submucosa and focally involved the muscular wall but did not reach the adventitia. It was located 2.2 cm from the proximal margin. The larger lesion measured 1.9 x 1.6 x 1.1 cm, was red-brown in color, and located within 0.6 cm of the proximal margin. Its cut surface was pink-tan, centrally hyperemic and glistening. Invasion was present in the submucosa without extension into the muscular wall or adventitia. The gastric mucosa appeared unremarkable, and no penetration of the granular mucosa at the esophagogastric junction into underlying soft tissue was observed. A total of 19 lymph node candidates were retrieved from the perigastric fat (12 in one group and 7 in another), all without evidence of malignancy. A separate 0.5 cm segment of cervical esophagus was also received, with one stapled margin and an open opposing margin; no significant findings were noted in this segment. No tumor involvement was identified at the resection margins. Histologic examination of tissue blocks confirmed multifocal involvement confined to the submucosal layer, with no lymph node involvement identified."} +{"pid": "TCGA-V1-A9O7", "report": "The prostate specimen measured 4 cm from apex to base, 4.7 cm in the transverse dimension, and 3.8 cm in the anterior-posterior plane. The prostate was firm and white-tan in areas, with a lobulated lesion involving both lobes, predominantly on the left side, replacing much of the central and transitional zones across all five serial slices. A small area of relatively normal-appearing tissue was identified in the right posterior quadrant of slices 1 through 4.\n\nMultiple nodules were palpable within the prostate. Two sutures were present: one along the anterior midline closing the dorsal vein complex, and another at the left posterior bladder margin. Bilateral, firm, white-tan calculi were found just beneath the prostatic fascia, with the largest measuring 0.7 cm. The anterior right surface was marked with green ink, the anterior left with blue, and the posterior surface with black.\n\nSerial sectioning revealed a dominant lesion throughout the prostate, with involvement of multiple regions. Tumor was present at several inked resection margins, including bilaterally in the anterior region, particularly at the apex and midgland. It was also found at the left posterior base margin in permanent sections following frozen section analysis. Vascular invasion was noted in one section, and tumor was present in skeletal muscle in the anterior mid-prostate, raising concern for extraprostatic extension.\n\nMicroscopic evaluation showed high-grade cellular features with perineural infiltration observed in multiple sections. No tumor was seen in the seminal vesicles. Lymph node dissections were performed on both the right and left pelvis, with no tumor identified in 8 or 7 lymph nodes, respectively. A separate biopsy of fascial tissue showed only vascular fibroadipose tissue without any abnormality.\n\nThe tumor was located bilaterally in the anterior aspect from apex to base, with posterior extension on both sides. The estimated tumor volume was 33 cubic centimeters, with more than half of the tumor classified as higher grade. Capsular invasion was noted in multiple areas, and limited extraprostatic extension was present at the left posterior-lateral base and near the bladder margin. Multiple tissue blocks were submitted for further histologic evaluation, and portions of the fresh tissue were reserved for research purposes. All final assessments were made after comprehensive slide review by the attending pathologist."} +{"pid": "TCGA-AO-A03V", "report": "The left breast specimen revealed a firm tan-white stellate nodule measuring 1.5 cm in the upper inner quadrant, located 1.2 cm from the deep margin. Histologically, the lesion demonstrated high nuclear grade features with moderate variation in nuclear size and shape, and showed minimal tubule formation. The non-neoplastic breast tissue was otherwise unremarkable. A separate in situ component was identified within the upper inner quadrant, characterized by intermediate nuclear grade features and constituting no more than 25% of the total tumor mass. This in situ component was admixed with the invasive lesion. There was no evidence of nipple involvement, vascular invasion, or calcifications within either the invasive or in situ components. Surgical margins and skin were free of involvement.\n\nExamination of the sentinel lymph nodes from the left axilla showed no evidence of tumor involvement. Both lymph nodes were entirely submitted for frozen section consultation, and additional H&E sections and immunohistochemical stains for cytokeratins were performed to further confirm the absence of metastatic disease.\n\nThe right breast specimen showed only benign fibrocystic changes, including ductal hyperplasia without atypia and apocrine metaplasia. Nipple and skin were unremarkable.\n\nImmunohistochemical staining of the left breast lesion demonstrated strong nuclear staining for estrogen receptor (>95%) and progesterone receptor (>80%), with no overexpression of HER2 as determined by immunohistochemistry using ASCO/CAP guidelines. Controls were adequate and results were concordant with established criteria."} +{"pid": "TCGA-NH-A6GB", "report": "A retroperitoneal lymph node measuring 1.7 x 1.5 x 0.5 cm was received and showed histologic features consistent with metastatic carcinoma. A segment of transverse colon measuring 12.5 cm in length was also received, along with attached omental adipose tissue measuring 22.1 x 12.0 x 1.7 cm. A tumor mass measuring 4.5 cm in greatest dimension was identified within the bowel wall. Histologically, the tumor was found to extend through the muscularis propria into subserosal adipose tissue, without reaching the serosal surface (pT3). The closest radial margin measured 2.5 cm from the tumor. No tumor involvement was identified at the proximal, distal, or circumferential margins. \n\nLymph node evaluation revealed metastatic carcinoma in 6 of 12 subserosal lymph nodes. A total of 13 lymph nodes were examined, with 7 involved by tumor. No lymphovascular or perineural invasion was identified. No prior treatment effect was observed. Serosal puckering and \"creeping fat\" were noted on gross examination. The tumor was centrally ulcerated, nearly circumferential, with raised borders, and focally extended to the subserosal fat. Multiple sections were taken for detailed histologic evaluation, including perpendicular sections of the nearest radial fat margin, sections of omental adipose, and whole and bisected lymph nodes."} +{"pid": "TCGA-55-8512", "report": "A right lower lobe lobectomy specimen was examined. A mass measuring 1.7 x 1.5 x 1.1 cm was identified within the pulmonary parenchyma. The mass was well circumscribed and located 1.6 cm from the pleural surface, 2.6 cm from the bronchial margin, and 4.1 cm from the closest stapled margin. No visceral pleural invasion was observed. Lymphovascular space invasion was present. The mass was unifocal and confined to the lung tissue without extension beyond the pulmonary parenchyma. Surgical resection margins were free of involvement.\n\nA total of eight lymph nodes were examined, including one peribronchial, four hilar, and three level 9 nodes. Metastatic involvement was identified in two of these nodes. Additionally, a separate excision of a level 9 lymph node revealed metastatic presence in one of the three nodes evaluated.\n\nThe histologic assessment showed well-differentiated cellular features. No treatment effect was noted. Molecular testing is pending. The pathologic staging was determined as pT1 N1."} +{"pid": "TCGA-Z6-A8JE", "report": "A fragment of esophagus measuring 14.5 cm in length and a portion of stomach 3 cm in length were received, along with adjacent adipose tissue. The esophageal wall is identified 1 cm from the proximal resection margin and contains an ulcerative lesion measuring 4x5 cm. The esophagus is constricted by this lesion, with a narrowing of 1.5 cm. Lymphatic nodes within the adjacent adipose tissue are soft and measure 1.5 cm in diameter. Microscopic examination reveals a poorly differentiated cellular infiltrate involving all layers of the esophageal wall, including the adventitia. Metastatic involvement is identified in one of 11 paraesophageal lymphatic nodes and in one of 9 paracardial lymphatic nodes."} +{"pid": "TCGA-DC-5337", "report": "The specimen from the rectosigmoid colon measures 17 cm in length with a proximal diameter of 7 cm and a distal diameter of 13 cm. A fungating lesion is identified, located 9.5 cm from the proximal margin and 3 cm from the distal margin. The lesion measures 6.0 cm in length and 4.0 cm in width. Serial sectioning demonstrates that the deepest invasion reaches the submucosa, with a maximal thickness of 0.4 cm and a distance of 3.5 cm from the closest radial margin. The overlying mucosa appears otherwise unremarkable. The serosal surface is intact and the radial resection margin is inked black.\n\nHistologic evaluation reveals moderately differentiated cells arranged in glandular patterns. Tumor budding is extensive. No increased tumor-infiltrating lymphocytes are observed. A precursor lesion composed of tubulovillous architecture is present adjacent to the lesion. There is no evidence of lymphovascular, large venous, or perineural invasion. Gross perforation is not identified.\n\nEighteen regional lymph nodes are examined, none of which show involvement. Three additional lymph nodes from the left colon are also free of involvement. Both distal and proximal margins are unremarkable without any abnormal cellular features. The remaining colonic mucosa and non-neoplastic bowel tissue appear normal. No polyps or dysplastic changes away from the lesion are identified.\n\nStaging based on depth of invasion indicates pT1 according to AJCC 7th Edition criteria. Lymph node staging is classified as pN0 (AJCC 7th Edition), with no regional lymph node metastasis identified. All surgical margins are free of involvement."} +{"pid": "TCGA-96-A4JL", "report": "The specimens include lymph nodes from stations 5, 7, 9, 10, 11, and 12, as well as a left lower lobectomy specimen. Lymph nodes from stations 5, 7, 9, and 10 showed no evidence of involvement. Stations 11 and 12 contained multiple lymph nodes with involvement identified in three out of four nodes at station 11 and three out of five nodes at station 12.\n\nThe left lower lobectomy specimen revealed a unifocal lesion measuring 2.8 cm in greatest dimension located in the lower lobe. The tumor was found to invade the visceral pleura. Margins of resection, including the bronchial and vascular margins, were free of tumor involvement. No lymphovascular invasion was noted.\n\nA total of three lymph nodes were identified in the lung specimen and none showed signs of involvement. Immunohistochemical staining demonstrated positivity for p63 and CK5/6, while stains for CK7, CK20, and TTF-1 were negative. Elastic stain highlighted the presence of visceral pleural invasion.\n\nLymph nodes examined ranged in size from 0.4 to 1 cm and were described as anthracotic or fragmented. The primary lesion was surrounded by lung tissue and exhibited characteristics consistent with extension to the visceral pleura without more proximal bronchial involvement. Based on these findings, staging classified the regional lymph node involvement as pN1."} +{"pid": "TCGA-73-4670", "report": "The specimen consisted of multiple lymph node samples and a left upper lobectomy. Lymph nodes evaluated included bilateral 2R, 2L, 4R, 4L, Level 5, Level 6, and Level 7 stations. Each lymph node was submitted in entirety for frozen section analysis and measured between 0.2 cm to 1.8 cm in greatest dimension. No tumor cells were identified in any of the lymph node specimens.\n\nThe left upper lobectomy specimen weighed 266 grams and measured 18 x 11 x 4.5 cm. A palpable mass was identified on the pleural surface and marked with black ink. The bronchial margin was shaved and submitted for analysis. Nine peri-bronchial lymph nodes were identified, ranging from 0.2 cm to 0.7 cm. Serial sectioning of the lung revealed a tan-white firm mass measuring 3.5 x 2.8 x 2.5 cm with central necrosis. The mass was located 2.2 cm from the bronchial margin and 0.1 cm from the pleural surface. Lung parenchyma distant from the mass appeared normal.\n\nHistologic evaluation demonstrated a poorly differentiated glandular lesion without involvement of the bronchial margin or pleural surface. No angiolymphatic invasion was observed. Six peri-bronchial lymph nodes were assessed and showed no evidence of involvement. Seven lymph nodes from mediastinal and hilar regions were negative as well. Two contralateral lymph nodes were also free of malignant cells. Non-neoplastic findings included emphysematous changes in the surrounding lung tissue.\n\nIntraoperative frozen section analysis of the bronchial margin was negative. Multiple lymph node stations sampled intraoperatively also showed no evidence of tumor."} +{"pid": "TCGA-DK-A1AC", "report": "A 72-year-old male with a history of prior bladder pathology underwent surgical resection of multiple anatomical specimens including bilateral distal ureters, bladder and prostate, bilateral vas deferens, and bilateral pelvic lymph nodes.\n\nGross examination of the bladder and prostate specimen revealed a large tumor measuring approximately 7.5 x 6.8 x 3.3 cm located in the left lateral and anterior bladder walls. The tumor was ulcerated and fungating, with areas of necrosis noted on sectioning. Microscopic evaluation showed invasive cellular proliferation involving perivesical soft tissues (pT3b). Lymphovascular invasion was identified in the prostate. All surgical margins were negative for involvement.\n\nThe prostate demonstrated additional foci of invasive cellular changes confined within the gland, involving the right posterior, right anterior, and left anterior quadrants. No perineural invasion was observed. Prostatic intraepithelial neoplasia was also noted. The Gleason score was 3+3=6/10. Pathologic staging according to AJCC (1997) criteria was pT2b for the prostatic findings.\n\nHistologic assessment of the bilateral vas deferens and bilateral distal ureter specimens revealed no abnormal cellular changes. Surgical margins were unremarkable.\n\nLymph node dissections from both left and right pelvic regions included eleven nodes each, all without evidence of metastatic involvement.\n\nIntraoperative frozen sections of the distal ureters were interpreted as benign, and permanent sections confirmed this finding."} +{"pid": "TCGA-AC-A8OQ", "report": "The lumpectomy specimen from the right breast weighed 74 grams and measured 6.5 x 5.5 x 4.5 cm. A dense gray-tan mass measuring approximately 3.8 cm in greatest dimension was identified within the tissue. The mass was located 0.3 cm from the deep margin and at least 0.5 cm from all other margins. Histologic evaluation revealed a high-grade infiltrating component with a total Nottingham histologic grade of 3. Features included marked nuclear pleomorphism, a high mitotic count, and absence of tubule formation. Lymphatic invasion was present.\n\nA second in-situ component was identified at the periphery of the main mass, comprising less than 10% of the overall tumor volume. This component exhibited a solid growth pattern, high nuclear grade, necrosis, and calcifications. All margins were free of both invasive and in-situ components, with the in-situ component located at least 0.5 cm from the nearest margin.\n\nTwo sentinel lymph nodes were examined. One lymph node showed involvement with metastatic disease, with the focus measuring 1.2 cm in diameter and occupying approximately 40% of the lymph node volume. No extranodal extension was observed. The remaining lymph node showed no evidence of involvement.\n\nThe tumor was classified as pT2 based on size and pN1a for regional lymph node involvement. The surgical margins were negative (R0). Immunohistochemical analysis demonstrated no staining for estrogen or progesterone receptors. The Ki-67 proliferative index was elevated at 70%."} +{"pid": "TCGA-Z4-AAPF", "report": "Gross examination revealed a 2x1x1 cm fibrous tissue specimen from the arm joint, measuring 1 cm in thickness. A tumor mass was identified within the tissue. Microscopic evaluation demonstrated a malignant cellular proliferation. The surgical margins were free of tumor involvement. Histological features indicated a well-differentiated morphology. Five lymph nodes examined showed no evidence of metastatic disease."} +{"pid": "TCGA-44-6779", "report": "The specimen includes multiple lymph nodes from various locations, including R4, L4, level 10, level 5, subcarinal, and level 6. All were grossly described as tan-white, gray-red, or black-red tissues with measurements ranging from 0.35 cm to 2.4 cm in greatest dimension. Each lymph node was entirely submitted for histologic evaluation. Microscopic examination of all lymph nodes showed no evidence of malignant involvement.\n\nThe left lung specimen weighed 442 grams and included two lobes. A palpable mass was identified in the interlobar fissure, measuring up to 6 x 5 x 4 cm. It was located approximately 1 cm below the bronchial cuff margin, which did not show gross involvement. A second smaller lesion was found beneath the pleural surface of the lower lobe, measuring 3 x 2 x 1.5 cm, with a similar fleshy tan-white appearance. No discrete nodules were observed in the upper lobe.\n\nHistologically, both lung lesions demonstrated moderate to poorly differentiated adenocarcinoma with prominent eosinophilic cytoplasm. The relationship between the two lesions could not be definitively determined; it was unclear whether they represented separate primaries or intrapulmonary metastasis.\n\nEvaluation of resection margins\u2014including bronchial, vascular, and visceral pleural\u2014revealed no tumor involvement. There was no evidence of direct tumor extension, venous, arterial, or lymphatic invasion.\n\nOf the six peribronchial lymph nodes examined, two contained metastatic adenocarcinoma. Mediastinal lymph nodes, including those at levels 5, 6, R4, L4, subcarinal, and level 10, were all negative for malignancy. Distant metastasis could not be assessed."} +{"pid": "TCGA-64-5775", "report": "The specimen consisted of ten parts. Parts 1 through 3, 5 through 7 were sent to microbiology. Part 4 was labeled \u201cpleural tissue\u201d and measured 6.5 x 4.5 x 1.2 cm, described as tan to tan-pink rubbery firm fragments. Sections were submitted for frozen evaluation and additional representative sections in three blocks. Part 8 labeled \u201cchest wall fistula\u201d measured 1.5 x 1.0 cm and was a tan rubbery firm fragment submitted entirely for frozen section. Part 9 labeled \u201cleft chest wall fistula\u201d measured 8.5 x 3.0 cm and included two tan raised lesions measuring up to 2.0 cm with fistulous tracts containing soft material; sections were submitted in three blocks. Part 10 labeled \u201cpleura left chest\u201d measured 24.0 x 15.0 x 3.0 cm and consisted of irregular tan to pink-red fragments with clotted blood; representative sections were submitted in four blocks.\n\nHistologic examination revealed malignant cells positive for CK7, TTF-1, Cam 5.2, cytokeratin AE1/AE3, and vimentin; negative for MA903, CK20, CD31, CD34, CD45, CD20, Calretinin, EMA, Melan A, HMB-45, and S-100 protein. The tumor involved the pleural tissue and extended into chest wall tissues including skin with ulceration and involvement of circumferential margin. No lymph node involvement was identified. Distant metastasis could not be assessed."} +{"pid": "TCGA-4E-A92E", "report": "The specimen consisted of a uterus with cervix and bilateral fallopian tubes and ovaries. The uterus weighed 53 grams and measured 7.2 x 3.6 x 3.5 cm. A mass measuring 1.7 cm in greatest dimension was identified within the superior endometrium, appearing soft and friable. This lesion was located predominantly in the anterior endometrium and appeared confined to the inner half of the myometrium, coming within 0.8 cm of the anterior serosa. Adjacent endometrium was thin, measuring less than a millimeter in thickness. The myometrium averaged 1.4 cm in thickness and contained fewer than five intramural nodules, with the largest measuring 0.7 cm. These nodules exhibited gray-white, whorled cut surfaces.\n\nAttached fallopian tubes and ovaries were present bilaterally. The left fallopian tube measured 4.5 x 0.4 cm and had an adherent thin-walled cyst measuring 0.3 cm filled with yellow-tan fluid. The left ovary measured 2.0 cm and contained a 0.5 cm white-tan corpus albicans. The right fallopian tube measured 5.8 x 0.4 cm with an adherent 0.4 cm thin-walled cyst filled with clear fluid. The right ovary measured 2.7 x 1.0 x 0.7 cm and contained a 0.6 cm white-tan corpus albicans.\n\nSections from various regions including parauterine vessels, cervix, endomyometrium, intramural nodules, and bilateral tubes and ovaries were submitted for histological evaluation. Histologic examination revealed no evidence of tumor invasion into underlying myometrium or lymphovascular invasion in the examined sections. Additional findings included focal adenomyosis and leiomyomas. Cervical tissue appeared benign without evidence of neoplasm. Parauterine tissue, fallopian tubes, and ovaries showed no signs of malignancy.\n\nLymph node specimens were collected bilaterally from multiple anatomical locations including external iliac, internal iliac, obturator, common iliac, and aortic regions. Most specimens consisted of fatty fragments without identifiable lymphoid tissue. Several specimens contained identifiable lymph nodes ranging from 1.0 to 4.2 cm in size. Histologic examination of these specimens demonstrated no evidence of metastatic disease.\n\nBlood and tissue samples were collected and preserved according to protocol. Frozen tumor tissue weighing 260 mg was stored on dry ice. Fresh tumor tissue weighing 140 mg was also collected but not preserved due to procedural guidelines. Whole blood samples were collected in EDTA tubes and preserved using dry ice.\n\nDiagnostic slides were prepared from formalin-fixed paraffin-embedded tissue blocks. Three slides were cut at 4\u20135 \u03bcm thickness and stained with hematoxylin and eosin for microscopic evaluation.\n\nClinical staging based on pathological findings indicated early confinement without lymph node involvement. Pelvic washing cytology revealed scant cellularity and no neoplastic cells were detected."} +{"pid": "TCGA-DW-7841", "report": "A total of seven left renal masses and cysts were received for examination. Tumor #1 measured 2.5 x 2.5 x 2 cm with a tan to yellow cut surface and a focal area of hemorrhage. Tumor #2 measured 2 x 1.5 x 1.4 cm, also with a tan to yellow cut surface. Tumor #3 was a soft tissue fragment measuring 1 x 0.7 x 0.4 cm. Tumor #4 was the largest at 5 x 5 x 4 cm, with a tan to yellow homogeneous appearance; additional fibrous soft tissue measuring 5 x 2.5 x 2 cm was also present in the container. Tumor #5 consisted of soft tissue fragments measuring 1.7 x 1.7 x 0.6 cm. Tumor #6 was a small fragment measuring 0.4 x 0.2 x 0.1 cm and was not procured. Tumor #7 measured 0.9 x 0.4 x 0.4 cm.\n\nMicroscopic evaluation revealed multiple areas of distinct cellular morphology across several specimens. Some biopsies showed cells arranged in papillary structures with mild to moderate nuclear atypia. Other findings included cystic changes, chronic interstitial inflammation, and glomerular alterations such as hyalinization. Sclerotic changes were also noted in certain regions. In one specimen, immunohistochemical staining demonstrated atypical cells extending into adjacent adipose tissue. All tumors were located within the left kidney, with varying degrees of involvement and surrounding tissue changes."} +{"pid": "TCGA-JY-A6FD", "report": "The specimen received includes a lymph node, a proximal stomach and total thoracic esophagus resection, a final esophageal margin from an esophagogastic resection, and a final gastric margin from a stomach resection. The lymph node was negative for malignancy.\n\nThe resection specimen of the proximal stomach and total thoracic esophagus measured 8.0 cm in length for the tubular esophagus and 3.0 cm for the stomach. The tumor measured 7.0 cm in length, 4.5 cm circumferentially at the gastroesophageal junction, and 1.2 cm in depth. It was located within the distal esophagus, extending to the gastroesophageal junction. The tumor was described as oval with exophytic borders and a depressed, ulcerating base. Histologically, it exhibited well-differentiated features and extended into the adventitial tissue, being 0.1 cm from the painted outside surface of the specimen at the closest point. No lymph node involvement was identified, with all 26 lymph nodes examined being negative.\n\nMargins were assessed, including a proximal esophageal margin of 5.0 cm, a distal gastric margin of 4.2 cm, and an adventitial margin of 0.2 cm. All margins, including the circumferential (adventitial), were uninvolved by invasive carcinoma. The distance of invasive carcinoma from the closest margin was 1.0 mm. No venous or lymphatic invasion was observed.\n\nIn noncancerous areas, chronic inactive gastritis was noted without evidence of H. pylori infection. Barrett's esophagus could not be grossly identified. Multiple lymph nodes ranging from 0.2 to 3.5 cm in size were found within the perigastric and paraesophageal soft tissue, none of which showed signs of metastasis.\n\nThe final esophageal margin, a ring-shaped piece measuring 2.5 x 2.3 x 0.4 cm, was negative for malignancy. Similarly, the final gastric margin, measuring 9.7 x 4.0 x 0.4 cm and including a staple line along one margin, was also negative for malignancy upon examination.\n\nFrozen section analysis of the esophageal and gastric margins confirmed no involvement by malignancy. Tissue banking included samples of both tumor and normal tissue. Representative sections from various areas, including proximal and distal regions of the tumor, resection margins, and lymph nodes, were submitted for evaluation."} +{"pid": "TCGA-E2-A14V", "report": "The left breast specimen measured 8 x 11 x 4 cm and weighed 130 grams. A mass measuring 3 x 3 x 2.3 cm was identified, located 0.5 cm from the closest anterior-superior margin. The margins were otherwise free of abnormal findings. Histologic evaluation showed a high-grade cellular proliferation with a tubular score of 3, nuclear grade 3, and mitotic score of 3. Lymphovascular invasion was present. Adjacent to the mass, there was evidence of an intraductal component composed of solid and micropapillary patterns, with high nuclear grade, necrosis, and microcalcifications. This component was within 3 mm of the superior margin and 4 mm from the posterior margin.\n\nA skin ellipse measuring 5 x 2 cm was unremarkable. Two small skin tags (0.1 and 0.3 cm) from the left axilla showed only benign features. Two sentinel lymph nodes were examined: one measured 1.0 x 0.6 x 0.3 cm and contained a 0.3 cm focus of involvement; the other measured 1.5 x 1.2 x 0.6 cm and showed a larger focus of involvement with focal extension beyond the nodal capsule. The left axillary dissection included multiple lymph nodes ranging from 0.1 to 2.7 cm in size; one of 22 nodes showed involvement measuring 0.8 cm.\n\nImmunohistochemical analysis for HER2 showed strong positivity in 100% of tumor cells using the HercepTest. Tissue fixation and staining methodology adhered to established guidelines. No lobular neoplasia was identified. The stroma showed no necrosis, but the intraductal component exhibited necrosis. The tumor was located in the lower inner quadrant. Pathologic staging was pT2N1."} +{"pid": "TCGA-AK-3445", "report": "The left kidney specimen weighed 638 grams and measured 11.0 x 7.5 x 7.0 cm, with attached perinephric fat ranging from 1.4 to 4.0 cm in thickness. A residual adrenal gland measuring 1.5 x 0.7 x 0.7 cm was present and unremarkable. A 7.0 cm segment of ureter was identified, measuring 0.6 cm in diameter, with a pinpoint lumen and no visible lesions. Vessels at the hilum appeared normal, and dissection through the surrounding fat revealed no abnormalities or nodal tissue.\n\nUpon bisection, a central lesion measuring 5.5 x 3.9 x 4.0 cm was identified. The lesion was located centrally and exerted pressure on the renal pelvis and capsule, though no gross invasion of either was observed. The lesion had a firm to soft consistency, with a predominantly orangish-yellow appearance, interspersed with white fibrotic regions and areas of hemorrhage. Adjacent renal parenchyma appeared brownish-red with well-defined cortical-medullary junctions and no additional lesions.\n\nSections were taken from various regions including vessels and ureter margin, the relationship of the lesion to the capsule and fat, its proximity to the renal pelvis, adjacent parenchyma, and surrounding fat. Additional sections included uninvolved kidney tissue and the adrenal gland.\n\nMicroscopic evaluation showed nuclear features of intermediate grade. Immunohistochemical staining demonstrated positivity for CD10, pancytokeratin, and vimentin, with no reactivity for CD117. No vascular invasion was identified. Surgical margins, including those of the renal vein, ureter, and circumferential perinephric fat, were free of involvement. Staging was determined based on local extension into surrounding tissues."} +{"pid": "TCGA-RW-A7CZ", "report": "Last Name: First Name: Sex: Female. Date Received: Date Completed: Date Collected: A. Left adrenal gland, excision: Two nodules identified within the specimen. The first is a 1.8 x 1.5 x 1.5 cm well-circumscribed solid tan mass located at one end of the gland. A second bicystic, well-encapsulated, well-circumscribed mass measuring 1.3 x 0.8 x 0.8 cm is found in the middle of the gland and contains golden tan slightly gelatinous tissue. Margins are negative. Specimen consists of fibrofatty tissue measuring 5.9 x 4.3 x up to 1.5 cm and was pre-inked in blue dye. The trimmed weight of the adrenal gland is 1.35 grams. Cassette summary includes sections from both masses (A1-3, A4-5). I, the above named pathologist, have personally examined and interpreted the slides from this case. Physician Name: Last Name: Report Date/Time: First Name: Admit Date:"} +{"pid": "TCGA-AX-A0IW", "report": "The uterus measured 9.2 cm from fundus to cervix, with a myometrial thickness of 11 mm. A lesion was identified within the endometrial cavity, showing infiltration into the myometrium to a depth of 3 mm. The lower uterine segment was involved by the lesion, though no extension to the endocervix was observed. Vascular space invasion was noted. A polypoid exophytic mass was present, measuring 4.3 x 4.2 cm on the posterior half and 5.0 x 4.2 cm on the anterior half. Sections of the fallopian tubes, ovaries, cervix, omentum, and multiple lymph node groups including left and right external iliac, obturator, and common periaortic regions were examined. No involvement was identified in the ovaries, cervix, or any of the lymph nodes evaluated. The right fallopian tube showed no abnormality, while the left fallopian tube exhibited intraluminal growth and muscular wall invasion. Multiple benign leiomyomas were present, with the largest measuring 4 mm. Mild chronic inflammation was noted in the cervix, with no dysplasia or malignancy identified at that site. The surgical specimen included bilateral fallopian tubes and ovaries, which were unremarkable except for findings in the left fallopian tube. The omentum showed no abnormalities."} +{"pid": "TCGA-MK-A84Z", "report": "The specimen consists of a right thyroid lobe weighing 28 grams and measuring 6.5 x 5.2 x 1.8 cm. The tissue is surgically oriented with a stitch marking the superior aspect. Serial sectioning from the inferior to superior tip reveals a tan-white, partly cystic nodule measuring 1.5 x 2.2 x 5.0 cm, surrounded by a thin capsule. Adjacent thyroid tissue appears red-brown and spongy. All tissue was submitted for examination.\n\nMicroscopic evaluation identified two distinct foci within the thyroid. The dominant lesion exhibits follicular architecture and classical cytomorphology, measuring 1.5 x 2.2 x 5.0 cm. It is well-differentiated (Grade 1), totally encapsulated, and does not involve the surgical margins. No lymphovascular invasion is observed. A second, smaller focus measuring 1 mm is also present, showing similar histologic features\u2014follicular architecture, classical cytomorphology, Grade 1 differentiation, complete encapsulation, and uninvolved margins. No lymphovascular invasion is identified in this focus either.\n\nThe tumor is classified as multifocal. Pathologic staging based on size and extent of disease is pT3. No regional lymph node or distant metastatic involvement is assessed (pNx, pMx). Additional findings include H\u00fcrthle cell hyperplasia and a benign follicular nodule."} +{"pid": "TCGA-S6-A8JY", "report": "The specimen consists of a left radical orchiectomy. Histologic examination reveals multiple tumor masses within the testis, with the largest measuring 3.5 cm in greatest dimension. The tumors are multifocal and involve the rete testis. There is no evidence of venous or lymphatic invasion, nor is there direct tumor extension beyond the testis. All surgical margins are negative for tumor involvement. Intratubular germ cell neoplasia is identified. Immunohistochemical staining is positive for placental alkaline phosphatase and negative for other markers assessed.\n\nThe gross specimen includes a testicle measuring 6.0 x 4.2 x 3.2 cm and a spermatic cord measuring 18.5 x 2.0 cm. Two distinct masses are observed within the testicular parenchyma: one superior, multinodular with extensive necrosis, and another inferior, solid with a tan-pink cut surface. Neither mass penetrates the tunica albuginea. No macroscopic involvement of the epididymis or spermatic cord is noted.\n\nLymph node status cannot be assessed. Distant metastasis also cannot be evaluated. Serum tumor markers show elevated LDH levels (>2500 IU/L), with hCG at 65 U/L and AFP pending. Based on available findings, the primary tumor stage is classified as pT1."} +{"pid": "TCGA-D1-A17H", "report": "The specimen consists of a uterus weighing 105.0 grams with attached bilateral fallopian tubes and ovaries. The cervix appears unremarkable. A mass measuring 6.6 x 6.2 x 1.6 cm is present in the endometrial cavity, extending from the fundus to the lower uterine segment. The myometrium has a total thickness of 1.4 cm, with the lesion invading 0.8 cm into the myometrial wall. No involvement of the endocervix is observed. Lymphovascular space invasion is not identified. Surgical margins are free of abnormal tissue. \n\nThe right ovary measures 2.7 x 1.6 x 0.8 cm and has a solid cut surface. The right fallopian tube measures 6.9 x 0.4 cm. The left ovary measures 2.7 x 1.4 x 0.7 cm and also shows a solid cut surface. The left fallopian tube measures 8.1 x 0.4 cm. Both ovaries and fallopian tubes appear structurally unremarkable.\n\nLymph node evaluation includes multiple right and left pelvic lymph nodes. On the right side, 3 external iliac, 4 internal iliac, 3 common iliac, and 2 obturator lymph nodes are assessed and found to be negative. On the left side, 6 external iliac, 3 internal iliac, 3 common iliac, and 4 obturator lymph nodes are similarly negative. All lymphatic tissues submitted from both sides show no evidence of malignant involvement.\n\nHistologic evaluation was performed on representative sections of the uterus, fallopian tubes, ovaries, and all lymph node groups. No tumor involvement is identified in any of the examined margins or lymph nodes."} +{"pid": "TCGA-OR-A5JT", "report": "A left adrenal mass measuring 11.5 x 10.0 x 8.5 cm and weighing 480 grams was resected along with a portion of spleen. The mass demonstrated tan-yellow coloration with areas of necrosis, most prominent in the inferior region. A thickened capsule was noted superiorly, and multiple nodules were observed extending through the capsule into surrounding fat. Multiple lymph nodes (largest measuring 1.3 cm) were identified within the periadrenal fat, with a total of 17 lymph nodes examined across all specimens; none showed evidence of tumor involvement. The splenic vein was free of tumor. Histologic evaluation revealed a low-grade lesion with 5 mitoses per 50 high power fields and extensive necrosis. No capsular or vascular invasion was identified, and surgical margins were free of tumor. Additional specimens including retroperitoneal fibroadipose tissue and diaphragmatic tissue were negative for tumor involvement. The spleen and other resected tissues showed no evidence of involvement."} +{"pid": "TCGA-25-1633", "report": "The pathology report includes the following information: The case was originally sent to the IGC Biospecimen Core Resource (BCR), with the specimen received on a specified date. Histology and site codes were provided for both the specimen and the overall case, based on the Case Quality Control Form (CQCF) and patient diagnosis when available. These codes reflect the classification of the tissue characteristics and anatomical location of the specimen. No tumor type or diagnosis was explicitly documented in this form."} +{"pid": "TCGA-FG-7636", "report": "The specimen was collected from a left frontotemporal brain mass resected during craniotomy with image guidance and awake mapping. Two specimens were submitted for analysis: one for frozen section and another as a post-section specimen. The tumor measured approximately 6 x 3.5 x 1 cm in aggregate and was composed of tan-white to gray-white soft tissue. Histologic evaluation revealed diffuse infiltration into both gray and white matter with moderate to high cellularity. Nuclear pleomorphism was prominent in areas, and scattered mitotic figures were observed. Perineuronal satellitosis was also present. Immunostaining demonstrated an increased MIB-1 labeling index of up to 11%, indicating elevated proliferative activity. Many nuclei showed positivity for p53. No vascular endothelial proliferation or necrosis was identified. Molecular studies for MGMT, IDH1, and 1p19q were pending at the time of reporting. Based on histologic features and immunophenotyping, the lesion exhibited characteristics consistent with a WHO grade III classification. Surgical margins could not be assessed."} +{"pid": "TCGA-DJ-A3UO", "report": "The neck specimen includes multiple lymph node dissections and a total thyroidectomy. Right paratracheal tissue contained one lymph node measuring 0.6 x 0.5 x 0.3 cm, which showed involvement with metastatic cells. The lymph node was entirely submitted for analysis. In the right level three and four lymph node dissection, up to ten lymph nodes were identified, ranging from 0.2 cm to 1.0 cm in size. Two lymph nodes showed metastatic activity. The largest measured 0.9 cm in diameter, with the largest metastatic focus measuring 0.3 cm. Extracapsular extension was noted in these lymph nodes.\n\nThe left neck level three and four lymph nodes consisted of fat and lymph nodes ranging from 0.1 cm to 1.1 cm. Approximately five lymph nodes were assessed through frozen section controls and two additional lymph nodes evaluated separately. No metastatic involvement was observed in this group.\n\nThe thyroid gland weighed 30.5 grams and demonstrated two lobes: the right lobe measuring 3.0 x 2.0 x 2.0 cm and the left lobe measuring 2.5 x 2.0 x 1.5 cm. Sectioning revealed nodules bilaterally. On the right side, a dominant nodule measured 2.8 cm in greatest dimension, while on the left side, two nodules were identified\u2014one measuring 1.5 cm and another smaller one measuring 0.7 cm. Histologic evaluation showed cellular features within these nodules. Vascular invasion was identified at three sites, including one focus extending beyond the thyroid capsule into adjacent fibroadipose tissue. Surgical margins were clear. Adjacent thyroid tissue appeared normal without additional abnormalities.\n\nTwo lymph nodes were identified in the left paratracheal region, measuring up to 0.4 cm each. Both showed evidence of cellular infiltration within their structure; extranodal extension was not observed in this location. A benign parathyroid gland was also identified within this specimen.\n\nMultiple tissue sections were analyzed, including representative portions from both thyroid lobes and isthmus. All specimens were reviewed microscopically and correlated with gross findings."} +{"pid": "TCGA-BG-A0MA", "report": "The excised skin lesion demonstrates features of a capillary hemangioma with sclerosis. A total abdominal hysterectomy with bilateral salpingo-oophorectomy was performed. The specimen weighed 196 grams. Within the uterus, a focus of extensive cellular changes is noted, characterized by sheets of epithelial cells with squamous differentiation and areas of necrosis. These findings are consistent with high-grade morphology.\n\nEvaluation of the uterine anatomy reveals that approximately 78% of the myometrial thickness is affected, with an invasion depth of 2.5 cm in a region measuring 3.2 cm in total thickness. Involvement of the endometrial surface extends across approximately 60%. No tumor involvement is identified in the cervix. Both anterior and posterior regions of the lower uterine segment show evidence of cellular infiltration. Lymphovascular space invasion is prominent throughout the specimen.\n\nA small incidental finding of a 0.9 cm benign smooth muscle lesion is noted. The right ovary contains calcified fibrous masses measuring 0.9 cm and 0.5 cm, with localized osseous metaplasia. The left ovary exhibits physiological alterations along with serosal adhesions and epithelial inclusion structures. Examination of the fallopian tubes reveals no tumor involvement; however, the left tube contains small nests of benign-appearing cells along its serosal surface.\n\nLymph node dissection encompassing bilateral external iliac, obturator, common iliac, and para-aortic regions yields ten lymph nodes in total. All nodes are devoid of metastatic disease. Immunohistochemical staining confirms the absence of tumor involvement in lymph nodes sampled from parts 3, 5, and 9. Additional immunostaining highlights vascular invasion within the tumor region. Pelvic cytology does not reveal malignant cells. Hormone receptor analysis demonstrates no expression of estrogen or progesterone receptors within the abnormal tissue."} +{"pid": "TCGA-3X-AAVC", "report": "The liver segment 4-5 and gallbladder specimen contained a lesion measuring 3.8 cm in greatest dimension located in the mid portion of the gallbladder. The tumor was tan/white, friable, and polypoid, arising from the wall and occupying the entire lumen. Adjacent to this lesion near the cystic duct was a dark brown, ovoid cholelithiasis measuring 3.9 cm in greatest dimension, which perforated through the gallbladder wall at the cystic duct end. This perforation site was marked yellow and showed no tumor involvement. An indurated area on the anterior surface of the gallbladder, painted orange, showed fibrosis and necrosis without gross evidence of tumor. The external surface of the liver resection margin, painted blue, appeared unremarkable. The attached adipose tissue measured 9.7 x 6.0 x 1.7 cm.\n\nMicroscopically, the tumor invaded the muscle layer of the gallbladder and extended with a maximum depth of 0.1 cm through the gallbladder wall into the adjacent liver parenchyma. The deepest invasion into the liver itself from the outer gallbladder wall measured 0.3 cm. No lymphovascular or perineural invasion was identified. Resection margins, including the liver parenchymal margin, were free of invasive carcinoma, with the closest distance of tumor to a margin measuring 1.3 mm. One lymph node was examined and showed no involvement. Additional findings included chronic and acute cholecystitis with cholelithiasis.\n\nThe portal tissue specimen consisted of fibroadipose tissue with non-specific inflammation and no neoplastic findings."} +{"pid": "TCGA-A2-A4S3", "report": "The surgical specimen consisted of a right breast mastectomy and a left modified radical mastectomy with axillary contents. The right breast weighed 1,435.5 grams and showed predominantly fatty tissue with fibrous bands. No masses were identified upon sectioning. Multiple sections were taken from the nipple, central deep margin, and all four quadrants for histological evaluation.\n\nThe left mastectomy specimen weighed 2,170 grams and measured 34.5 cm (medial-lateral), 24 cm (superior-inferior), and up to 6.5 cm (anterior-deep margin). A skin ellipse measuring 30 x 15 cm included the unremarkable nipple. Two palpable areas were noted at the 3 o\u2019clock and 12 o\u2019clock positions, and another in the axillary tail. The anterior margin was marked with blue ink, the deep margin with black ink, and the axillary tail margin with red ink. Sectioning revealed four distinct lesions within the upper outer quadrant.\n\nThe first lesion measured 1.0 x 0.8 x 0.6 cm and was located laterally, adjacent to the margin. It was grossly separated from a second mass by 2 cm. The second lesion measured 3.5 x 2.7 x 3.5 cm from medial to lateral. Two additional lesions were found superior to this mass. The deepest measured 1.6 x 1.3 x 1.0 cm and was located 2 cm from the deep margin, 1.5 cm beneath the skin. The fourth lesion measured 4.0 cm from superior to inferior, 3.0 cm from anterior to posterior, and 4.0 cm from medial to lateral. The two largest masses appeared to be in close proximity, with a small 0.6 cm lesion anterior to them.\n\nAxillary dissection revealed a low axillary lymph node measuring 3.5 x 3.2 x 2.3 cm. Six additional lymph nodes were identified in the axillary tail, one of which showed gross abnormalities. Sections from all lesions, margins, and lymph nodes were submitted for microscopic analysis. Tissue from the highest left axillary lymph node was also submitted; it included six lymph nodes in total.\n\nAll surgical margins (anterior, posterior, and nipple) were free of abnormal cellular changes. There was evidence of fibrocystic change throughout the breast tissue, including duct hyperplasia, apocrine metaplasia, cyst formation, and calcifications. No atypia or malignancy was found in the right breast. In the left breast, high-grade cellular changes were noted, with multiple invasive lesions and presence of intraductal components. Lymphatic invasion was identified. Some lymph nodes showed signs of involvement.\n\nTissue processing followed standard protocols for fixation time. Multiple blocks were submitted for histopathological evaluation: 10 from the right breast, 32 from the left breast, and 3 from the axillary lymph node specimen."} +{"pid": "TCGA-IB-7891", "report": "The specimen was received fresh and submitted for tumor bank, with photographs taken. Specimen A consisted of a single fragment of tan and fatty tissue measuring 1.7 x 1.3 x 0.5 cm. The entire specimen was sectioned and submitted in toto. Specimen B was a small piece of tissue measuring 0.8 x 0.7 x 0.1 cm and was also submitted in entirety. Specimen C included the distal stomach (2.0 cm in length, 5.1 cm in circumference), small bowel (19.0 cm in length, 7.0 cm in circumference), pancreas head (5.5 x 4.5 x 4.0 cm), and a small segment of bile duct (0.5 cm in length, 0.5 x 0.5 cm). Surgical margins were painted for orientation: uncinate margin in yellow, posterior margin in black, and pancreas neck in blue.\n\nThe distal stomach showed no ulceration, with pliable walls and unremarkable serosa. The duodenum had a smooth serosal surface and no nodularities. The small bowel wall was pliable and uniform, though there was a small nodularity and raised mucosal surface near the ampulla, located 2.0 cm from the proximal margin. Another firm nodule was noted 1.0 cm proximal to the ampulla. The ampullary lesion measured approximately 1.0 x 1.0 x 1.5 cm. Upon sectioning the pancreas, a firm, nodular, ill-defined white mass was identified around the common bile duct as it entered the pancreas. This mass measured approximately 2.3 x 2.3 x 1.7 cm and did not grossly invade the small bowel. The mass approached within 0.2 cm of the uncinate margin and appeared close to the posterior margin.\n\nMicroscopic examination revealed atrophic changes in the pancreatic tissue. Cellular atypia was observed in the ampullary epithelium along with a submucosal fibro-inflammatory response, likely secondary to stent placement. High-grade intraepithelial lesions were present in the pancreas. Invasion into surrounding soft tissues, including retroperitoneal tissue, was noted. Tumor cells were also found within lymphovascular spaces and demonstrated extensive perineural invasion.\n\nA total of 11 lymph nodes were examined, with 7 showing involvement by malignant cells. The closest distance between invasive carcinoma and any surgical margin was 1 mm, specifically at the uncinate, distal pancreas, and bile duct margins. Multiple sections of the specimen were submitted for analysis, ranging from bile duct margin to the bowel specimen margin. Two lymph nodes were sampled during frozen section analysis, both of which were negative for malignancy. Chronic inflammation was noted at the pancreatic margin. All findings were confirmed upon interdepartmental review."} +{"pid": "TCGA-55-8302", "report": "A right lower lobe lobectomy with lymph node biopsies was performed. The tumor measured 1.2 cm in greatest dimension and was found to be a malignant epithelial neoplasm. Microscopic examination revealed nests and glandular differentiation of cells with moderate to abundant cytoplasm, enlarged pleomorphic nuclei, irregular clumped chromatin, and prominent nucleoli. Mitotic activity was present. The tumor focally extended into, but not through, the visceral pleura. Elastic stain confirmed this finding. Immunohistochemical staining showed strong positivity for cytokeratin 7, positivity for cytokeratin 20, positivity for Napsin-A, and strong nuclear staining for TTF-1. No venous (large vessel) invasion was identified, although a focus suggestive of lymphatic invasion was noted. All surgical margins were free of tumor. A total of seven lymph nodes were examined, and none showed evidence of involvement. Histologic grade was moderately to poorly differentiated. TNM staging was determined as pT2, pNO, pMX. \n\nSections from all submitted lymph nodes (levels 10R, 4R, 11R A-D, and level 7) demonstrated only benign tissue with no malignancy identified. Sections of the grossly uninvolved lung showed no significant fibrosis or inflammation, with only mildly thickened alveolar septa noted. The bronchial and vascular margins were unremarkable. A portion of the mass was sent for chemosensitivity testing, with a separate report to follow. \n\nThe current standard includes molecular testing for specific mutations, which may guide targeted therapy. Testing for these markers is available upon request and can be performed on paraffin-embedded tissue."} +{"pid": "TCGA-A2-A1FX", "report": "The surgical report details a right sentinel lymph node biopsy and breast excision procedure. The excised tumor measured 4.7 cm in greatest dimension and involved the superior, inferior, medial, and anterior surgical margins. It was also very close to the posterior and lateral surgical margins, with small indurated nodules noted. Additional right breast tissue showed malignancy at the lateral margin, with the remaining margins otherwise free of tumor. A separate additional lateral margin specimen showed no involvement.\n\nExamination of axillary contents revealed metastasis in four of twenty-two lymph nodes. Two of these showed subcapsular metastases measuring greater than 2 mm, one demonstrated micrometastasis measuring less than 2 mm, and one displayed isolated positive cells within the subcapsular sinuses.\n\nSentinel lymph node #1 was found to contain multiple foci of metastatic disease. Sentinel lymph node #2 contained subcapsular deposits measuring less than 0.2 mm in aggregate. Frozen section analysis was performed on sentinel node #1 and the primary mass, but not on sentinel node #2, as deferred by the attending physician.\n\nHistologic evaluation of the primary mass confirmed infiltrative growth patterns. Special stains including cytokeratin (AE1/AE3) and E-cadherin supported the findings.\n\nStaging classification was determined as pT2 pN2a, MX, corresponding to Stage IIIA."} +{"pid": "TCGA-AN-A0FZ", "report": "Female patient underwent radical mastectomy for a left breast primary tumor. The tumor specimen was collected in frozen format within a cryomold. Histological evaluation revealed infiltrative ductal carcinoma, grade 2. Staging was determined as T2, N2, M0. No prior treatment was administered. A normal blood sample was also obtained via blood draw and stored in frozen format within a tube."} +{"pid": "TCGA-G3-A25Y", "report": "The specimen consists of an intact gallbladder measuring 8.3 x 2.4 x 2.6 cm. The mucosa contains a 0.5 cm polypoid lesion composed of aggregates of foamy histiocytes covered by intact mucosa. No calculi, inflammation, or malignancy is identified in the gallbladder. \n\nThe liver specimen measures 13 x 6.9 x 3.7 cm and includes a surgical resection margin marked with black ink. A light tan nodule is observed on the liver surface, appearing to involve the capsule. Upon sectioning, a lesion measuring 2.5 cm in greatest dimension is identified. It has a nodular appearance and is located 1.0 cm from the surgical margin. No satellite nodules are present, and there is no vascular invasion identified. Representative sections of the tumor and surrounding tissue are submitted for analysis.\n\nMicroscopic examination reveals that the tumor has a lobulated border and is composed of cells arranged in solid sheets, acinar formations, and trabeculae. The cytoplasm varies from eosinophilic to clear, and nuclei exhibit moderate to severe atypia, including areas of marked pleomorphism and prominent mitotic activity. Coarse fibrous septa separate the lobules of tumor tissue. The adjacent hepatic parenchyma shows moderate steatosis (both microvesicular and macrovesicular), chronic hepatitis with portal inflammation, interface hepatitis, and lobular inflammation with hepatocyte dropout. There is also evidence of anisocytosis and anisonucleosis. Trichrome staining demonstrates periportal fibrosis with some bridging, but no cirrhosis is identified.\n\nImmunohistochemical staining of the lesion demonstrates positivity for CAM 5.2, HEP PAR-1 (patchy), and alpha fetoprotein (focal). Staining with cytokeratin 7 is very weak or equivocal, and no staining is observed with cytokeratin 20, synaptophysin, or TTF-1."} +{"pid": "TCGA-EO-A22T", "report": "The specimen includes a total hysterectomy with cervix, bilateral ovaries and fallopian tubes, along with lymph nodes from the right pelvic, left external iliac, left obturator, and para-aortic regions. The uterus measured 8.3 cm x 4.2 cm x 3.3 cm and weighed 92.2 grams. A polypoid lesion measuring 3.6 cm in greatest dimension was identified on the anterior endometrium. The myometrium had a maximum thickness of 1.3 cm, and there was evidence of inner half myometrial invasion. The tumor showed involvement of the cervical mucosa and extensive lymphovascular space invasion within the myometrium. Vaginal cuff margins were free of tumor. \n\nHistologic evaluation revealed two distinct growth patterns: one tubuloglandular and better differentiated, and another solid pattern with high-grade cytologic atypia and undifferentiated morphology comprising more than 50% of the tumor. Immunohistochemical staining demonstrated positivity for estrogen receptor (ER) and focal positivity for progesterone receptor (PR) in the glandular areas, while the solid component was negative for ER, PR, p53, synaptophysin, and chromogranin.\n\nLymph node dissection included a total of 30 lymph nodes examined across all regions: nine from right pelvic, six from left external iliac, four from left obturator, and eleven from para-aortic locations. All lymph nodes were negative for malignant involvement. \n\nAdditional findings included adenomyosis and leiomyoma. No other tumors were identified in the ovaries or fallopian tubes; however, chronic salpingitis was noted in the left fallopian tube. \n\nPathologic staging indicated no regional lymph node metastasis (pN0) and no distant metastasis could be assessed (pMX). The surgical margins were uninvolved by invasive carcinoma."} +{"pid": "TCGA-CV-5435", "report": "The left pyriform sinus specimen consists of multiple irregular mucosal fragments, 0.3\u20130.6 cm in size, and was entirely frozen for intraoperative consultation. A 2.5 cm segment of esophagus was also obtained, with the margin frozen for evaluation.\n\nA total laryngopharyngectomy, bilateral neck dissection, and subtotal thyroidectomy were performed. The surgical specimen measured 9.5 x 7.0 x 6.5 cm and included portions of the pharynx, larynx, and proximal trachea, along with bilateral salivary glands and neck dissections. A large ulcerating lesion measuring 5.0 x 4.5 cm was identified in the left pyriform sinus and hypopharynx, extending to the supraglottic larynx near the left false vocal cord. The tumor did not cross the midline and had a depth of invasion of 1.4 cm, reaching close to bone and extending into the retropharyngeal free space. Smaller surface lesions were also present on the left side, possibly representing precursor changes. Margins of resection were free of tumor involvement. The right vocal cord, bilateral submandibular glands, and left thyroid lobe showed no evidence of tumor. A separate specimen from the closest left oropharyngeal margin contained squamous mucosa with dysplasia and an underlying lymphoid aggregate but no tumor.\n\nA right posterior neck dissection included levels 2, 3, and 4. A total of 36 lymph nodes were recovered (Level 2: 20 nodes; Level 3: 9 nodes; Level 4: 7 nodes), none of which contained tumor. The bilateral neck dissection specimens included 42 lymph nodes in total. Of these, five lymph nodes on the left (1/4 Level II, 2/18 Level III, and 2/12 Level IV) contained metastatic involvement. One large lymph node measuring 2.5 x 1.5 x 1.5 cm was noted in the left neck dissection.\n\nHistologic examination of the primary lesion showed features of moderately to poorly differentiated cellular morphology with necrosis. The tumor extended 1.8 cm into surrounding soft tissues including salivary glands and skeletal muscle, raising concern for extranodal extension with disruption of normal lymph node architecture. Fibrofatty tissue from the right posterior neck dissection measured 8.0 x 4.0 x 3.0 cm, and lymph nodes ranged from 0.1 to 1.1 cm in greatest dimension.\n\nAll other submitted sections, including the esophageal margin and right level II lymph nodes, were negative for tumor."} +{"pid": "TCGA-MP-A4T8", "report": "The specimen includes a left upper lobe lung lobectomy weighing 185.0 grams and measuring 17.0 x 10.0 x 3.0 cm, along with lymph nodes from stations 5L, 6L, 7, 9L, and IIL. A mass measuring 4.5 x 3.0 x 1.5 cm is present in a bronchocentric location and does not involve the pleura. Histological evaluation shows high-grade cellular features. Angiolymphatic invasion is present. The bronchial margin is clear of involvement. Among the lymph nodes examined, metastatic high-grade cells are found in one left subaortic (station 5L) lymph node and in two of six intrapulmonary peribronchial lymph nodes. No involvement is seen in the left paraaortic (station 6L), subcarinal (station 7), left pulmonary ligament (station 9L), or left interlobar (station 11L) lymph nodes."} +{"pid": "TCGA-4V-A9QL", "report": "The specimen from thymectomy weighs 173 grams and measures 18 x 11 x 0.5 cm. A nodule measuring 8 x 7.5 x 4.3 cm is present, surrounded by a capsule. On sectioning, the nodule has a lobulated appearance, without cystic change, necrosis, or hemorrhage. Additional findings include two fragments of fat in the superior mediastinum measuring 2 cm and 2.2 cm along the long axis, and a fragment of fat beneath the left pleura measuring 3 x 2.5 x 2.5 cm.\n\nMicroscopic evaluation shows a lobulated mass separated by thick fibrous bands extending from the capsule. The tissue consists of a biphasic pattern with epithelial cells that are spindle-shaped and arranged in small, short bundles. These cells exhibit minimal nuclear atypia. A lymphocytic component is also present, composed of small, regular lymphocytes. The mass is encased in a thick fibrous capsule that is not infiltrated. The surrounding thymic tissue demonstrates mild lymphoid hyperplasia and extends into the middle mediastinum.\n\nImmunohistochemical staining reveals that the tumor cells are positive for pancytokeratin AE1/AE3 and focally positive for CD20. They are negative for CD5 and EMA. The lymphocytes are of T-cell lineage, showing immaturity with expression of CD1a and CD3.\n\nIn the upper mediastinal fat, two small lymph nodes are identified without any signs of malignancy. The subcutaneous fat near the left pleura consists of connective and adipose tissue without lymphoid structures.\n\nThe resection is complete, and the tumor is fully encapsulated."} +{"pid": "TCGA-BR-8590", "report": "The specimen consisted of a gastrectomy with a tumor located in the fundus measuring 8 x 7 x 1.5 cm. Microscopic examination revealed a poorly differentiated histologic type. The tumor extended to adjacent structures including the lesser and greater omentum. Of the lymph nodes examined, 5 out of 7 were positive for metastasis, all intraabdominal. No information was provided regarding lymphatic, venous, or perineural invasion. Surgical margins were uninvolved. There was no evidence of neo-adjuvant treatment effect. No additional findings were noted."} +{"pid": "TCGA-UW-A7GI", "report": "A nephrectomy specimen from the left kidney weighs 500 grams and measures 14.5 x 10.0 x 4.8 cm. A circumscribed, yellow-tan, soft, and partially encapsulated lesion is identified within the kidney, measuring 3.5 x 3.5 x 3.0 cm. Gross examination reveals no evidence of multicentricity. The tumor appears to be largely confined to the kidney, although there are questionable areas of extracapsular extension into surrounding fat. Perirenal adipose tissue may be involved, but this is not definitive. There is no gross involvement of the renal vein, ureter, or adrenal gland. Surgical margins are assessed; the tumor approaches within 0.8 cm of the closest deep soft tissue margin in the perirenal adipose tissue, but all other margins, including those of the renal vein, artery, and ureter, are negative.\n\nMicroscopic evaluation confirms a histologic grade of 2 (out of 4). Capsular invasion, renal vein, ureteral, blood vascular, and lymphovascular invasion are not identified. All surgical margins remain free of tumor. No tumor is seen in the adrenal gland or hilar lymph nodes.\n\nA separate mass from the left adrenal region weighs 1010 grams and measures 14.2 x 13.2 x 7.0 cm. It is ovoid, circumscribed, and soft with a tan-gray cut surface, including areas of hemorrhage and necrosis. The mass diffusely abuts the blue inked surgical margin. Microscopically, the mass shows features consistent with a benign component. Adherent tissue at the periphery includes a small rim of orange-yellow material."} +{"pid": "TCGA-86-8073", "report": "Gross and microscopic evaluations were performed on lung tissue obtained from a lobectomy specimen. The tumor was located in the left upper lobe and measured 4 x 4 x 3 cm. Histologic examination revealed moderately differentiated cells arranged in a growth pattern consistent with bronchiolo-alveolar architecture. Other features including tumor extent, presence of additional nodules, lymph node involvement, lymphatic or venous invasion, margin status, evidence of neoadjuvant treatment, and additional findings were not specified. No comments were provided."} +{"pid": "TCGA-55-7994", "report": "The pathology report includes specimens from a right upper lobe lung resection and associated lymph nodes. Gross examination of the lung specimen revealed a 7.8 x 6.2 x 4.6 cm lobulated tan-gray fibrotic nodule with necrosis. The lesion was located 3.5 cm from the nearest bronchial margin and extended to the pleura but did not penetrate beyond it. The bronchial margin itself showed no evidence of involvement. A separate area of indurated pleural umbilication measuring 4.6 x 3.5 cm was identified on the posterior aspect of the lung, with a corresponding lesion seen beneath the pleura marked with India ink.\n\nSections from multiple lymph nodes were evaluated. One lymph node measured 1.6 x 1.0 x 0.5 cm, another 2.0 x 1.6 x 0.9 cm, and a third 2.4 x 1.7 x 0.6 cm. All lymph nodes showed reactive changes including germinal center formation and presence of histiocytes within sinusoids; no malignant cells were detected. Microscopic evaluation confirmed histiocytes using immunohistochemical staining (CD68 positive, AE1/AE3 negative), and special stains for infectious organisms were negative.\n\nMicroscopic analysis of the pulmonary specimen showed sheets of cells with abundant granular cytoplasm, enlarged pleomorphic nuclei, and prominent nucleoli. Focal areas of necrosis were present. No lymphovascular invasion was identified. Adjacent lung tissue showed emphysematous changes with dilated air spaces and fibrous thickening of alveolar walls.\n\nAll surgical margins were free of involvement. A total of five lymph nodes were examined\u2014three retrieved separately and two within the lung specimen\u2014none of which contained metastatic disease. The findings indicate unifocal involvement of the right upper lobe with visceral pleural extension but no extrapleural spread. The tumor was well delineated and measured 7.8 x 6.2 x 4.6 cm in size."} +{"pid": "TCGA-CV-A6JE", "report": "A composite resection specimen includes a segment of mandible with angle and condyles, posterior pharynx, maxillary tuberosity, and medial tongue with underlying skeletal muscle. The specimen measures 8.0 cm anterior to posterior, 4.9 cm lateral to medial, and 4.6 cm superior to inferior. An ulcerated area measuring 2.4 cm is identified on the mucosal surface. The ulcer is located 0.4 cm from the lateral buccal margin, 0.7 cm from the medial tongue margin, 1.3 cm from the anterior soft tissue margin, and 1.7 cm from the posterior pharyngeal margin. Cut surfaces show gray-white firm tissue beneath the ulcerated region extending to a depth of 0.8 cm. The underlying bone shows fine pitting and deformity.\n\nLymph node evaluations were performed from left neck dissections across levels 1, 2A, and 3. Level 1 contained ten lymph nodes, all without any abnormal findings. Level 2A included eighteen lymph nodes, none of which showed any abnormal features. In level 3, six lymph nodes were identified and also found to be unremarkable.\n\nAdditional tissues examined include medial pterygoid plate with fibromuscular tissue (measuring 2.2 x 1.7 x 1.0 cm), lateral buccal mucosal margin (a strip of mucosa measuring 3.0 x 0.5 x 0.2 cm), posterior alveolar mucosal margin (an inked strip of tissue measuring 2.5 x 0.4 x 0.4 cm), soft palate mucosal margin (a strip of mucosa measuring 3.4 x 0.4 x 0.4 cm), and left maxillary gingiva (a mucosa-covered soft tissue fragment measuring 1.0 x 0.6 x 0.4 cm). All these margins and specimens were found to be unremarkable upon examination.\n\nThe submitted bone sections from the mandible and medial pterygoid plate did not reveal any evidence of tumor involvement."} +{"pid": "TCGA-06-0241", "report": "The patient presented with difficulty reading, word-finding issues, and headache. Imaging revealed a 4.0 cm enhancing lesion in the left inferior and posterior temporal lobe. A surgical excision biopsy was performed. The specimen consisted of three soft, vascular, grey/glistening fragments measuring 1.0 cm in total. Microscopic evaluation showed an astrocytic proliferation with areas of glial fibrillogenic and undifferentiated morphology. There was evidence of microvascular proliferation, necrosis, and thrombosis. Immunohistochemical staining demonstrated GFAP positivity in fibrillary and soluble patterns. No neuronal differentiation was identified, as confirmed by the absence of NeuN immunoreactivity. A small subset of tumor cells expressed mutant p53 protein. The proliferation index, assessed by MIB-1 staining, was approximately 13% in the more active regions."} +{"pid": "TCGA-B5-A0K4", "report": "The specimen consists of a uterus with cervix, bilateral fallopian tubes, and ovaries. The uterus weighs 177 grams and measures 9.5 x 5.5 x 4 cm. The cervical os is patent and measures 0.7 cm. At the junction of the posterior endomyometrium and fundus, there is a yellow-tan, exophytic lesion measuring 3.5 x 3.5 cm. This lesion invades 1.4 cm into the myometrium, which has a total thickness of 2.3 cm. It does not extend into the lower uterine segment or cervix. Adjacent to this lesion, but separate, is a well-circumscribed mass measuring 4.5 x 4.5 x 2 cm consistent with a leiomyoma. The remaining endometrial lining measures 3 x 2.5 cm and shows no significant abnormalities. The myometrium contains multiple intramural leiomyomata, the largest measuring up to 1.3 cm. The cervix appears smooth, white, and glistening with no remarkable findings.\n\nThe right ovary measures 2.5 x 1.5 x 0.5 cm and the right fallopian tube is 5.5 x 0.6 cm. The left ovary measures 2.6 x 1.2 x 0.6 cm and the left fallopian tube is 6.2 x 0.5 cm. All are unremarkable in appearance.\n\nLymph node specimens were submitted from multiple sites. The right pelvic lymph nodes consist of a 5 x 3 x 1 cm fibrofatty tissue aggregate containing multiple lymph node candidates ranging from 0.4 to 1.4 cm in size. A total of 12 lymph nodes were identified in this group. The left external iliac lymph node specimen is a 3 x 2 x 1 cm fibrofatty tissue fragment containing two lymph nodes of equal size (1 x 1 x 0.5 cm). Two lymph nodes were identified in this specimen. The left obturator lymph node specimen is a 4 x 2 x 0.5 cm fibrofatty fragment containing multiple candidates ranging from 0.5 to 1.5 cm. Six lymph nodes were identified in this group. The right paraaortic lymph node specimen is a 1.5 x 1.5 x 1 cm fibrofatty tissue piece containing three lymph node candidates measuring between 0.5 and 0.8 cm. Three lymph nodes were found in this group. The left periaortic lymph node specimen is a 1 x 1 x 0.5 cm fibrofatty fragment containing one lymph node candidate measuring 0.4 x 0.4 x 0.3 cm. One lymph node was identified here.\n\nMicroscopic evaluation of all specimens was performed. No tumor involvement is identified in any of the lymph node groups evaluated. The surgical margins are free of tumor. The ovaries and fallopian tubes show no evidence of neoplastic change. The depth of myometrial invasion is noted to be extensive, and lymphatic/vascular invasion is present. The non-neoplastic endometrium is absent. All other areas of the uterus including the cervix, serosa, and remaining myometrium are unremarkable except for benign leiomyomata."} +{"pid": "TCGA-DU-A7TG", "report": "A 63-year-old male with a history of chronic headaches, depression, and smoking was found unresponsive at home. A preoperative CT scan revealed a right frontal lobe lesion with slight enhancement, thickening of the genu of the corpus callosum, and expansion of the left frontal lobe. Biopsy and excision specimens were obtained from the right frontal lobe.\n\nGross examination of the biopsy specimen showed two tan tissue fragments measuring 0.8 x 0.5 x 0.4 cm. The first excision specimen measured 5.0 x 2.5 x 2.1 cm, and the second measured 4.3 x 2.4 x 1.3 cm. All specimens were fixed in formalin and processed for histologic evaluation.\n\nMicroscopic analysis revealed a neoplastic glial proliferation primarily composed of cells with oligodendrocyte-like morphology. Focal areas of increased cellularity, referred to as proliferation centers, were identified. These regions showed increased mitotic activity and neovascularization, although no microvascular cellular proliferation or necrosis was present. In some areas, particularly in the third specimen, there was white matter rarefaction and prominent reactive astrocytosis with Rosenthal fibers.\n\nImmunohistochemical staining showed minimal GFAP expression within the tumor cells, absence of p53 overexpression, and no reactivity for synaptophysin or NeuN in the neoplastic cells, indicating a non-neuronal origin. CD34 highlighted vascular changes within the tumor, and MIB-1 immunostaining demonstrated an overall proliferation index of 2% to 4%, with higher values noted in the proliferation centers. Special stains, including PAS with and without diastase, did not reveal granular bodies.\n\nMolecular testing on the tumor tissue showed methylation of the MGMT promoter, which may be associated with a favorable response to alkylating agent therapy. Additionally, allelic loss involving chromosome arms 1p and 19q was detected using a PCR-based assay with multiple informative loci, including D1S1592, D1S552, D19S219, D19S412, and PLA2G4C. This pattern of combined 1p/19q loss is typically seen in certain types of glial neoplasms and has been associated with improved treatment response and survival.\n\nIntraoperative frozen section of the initial biopsy sample showed atypical glial proliferation consistent with a low-grade glial neoplasm. Histopathological features across all three specimens were uniform, showing a neoplasm with mixed low-grade and focally more aggressive characteristics, but lacking overt anaplasia, necrosis, or endothelial proliferation."} +{"pid": "TCGA-A1-A0SK", "report": "A biopsy of sentinel lymph nodes from the right axilla, including one node and two nodes examined separately, revealed no evidence of malignancy. An additional sentinel lymph node biopsy also showed no carcinoma involvement. Excision specimens from the right breast, including new inferior and posterior margins, demonstrated benign breast tissue without any malignant findings.\n\nExamination of a partial mastectomy specimen identified a lesion measuring 3.8 cm in maximum diameter located in the right breast. Histological evaluation showed high-grade cellular features with morphologic characteristics suggestive of a neuroendocrine origin. Immunohistochemical staining was performed for further characterization: Keratin cocktail showed patchy positivity, CD56 and PAX-5 were positive, while LCA, Chromogranin, Synaptophysin, and E-Cadherin were negative. The absence of LCA staining ruled out lymphoid neoplasms, and the lack of E-Cadherin expression supported exclusion of ductal carcinoma.\n\nHistopathological grading based on modified Bloom-Richardson criteria totaled 8 points (nuclear grade 3, mitotic count 2, tubule/papilla formation 3), corresponding to Grade 3 differentiation. The tumor extended to the deep resection margin and was within 0.1 cm of the anterior/superior margin. Other margins\u2014medial, lateral, and anterior/inferior\u2014were free of tumor involvement (>1 cm distance).\n\nLymph node assessment indicated no metastatic involvement (0 of 4 sampled lymph nodes involved). Based on these findings, the pathological staging was determined as pT2N0MX.\n\nAdditional receptor studies were conducted on the tumor specimen. Immunohistochemical assays showed no nuclear staining for estrogen or progesterone receptors, indicating negativity in tumor cells despite the presence of internal positive controls. HER2/neu immunostaining yielded a score of 0, consistent with absence of oncoprotein over-expression.\n\nGross examination of the excised breast tissue confirmed a firm, tan-white lesion spanning multiple slices with dimensions of 3.8 cm superior to inferior and 3 cm anterior to posterior. The lesion approached the posterior margin and was closest to the anterior superior margin at 0.2 cm. Serial sectioning and submission of representative margins ensured comprehensive histologic evaluation.\n\nFurther surgical specimens, including chest wall tissue and subclavian vein margin, were assessed. The chest wall specimen contained a 7.5 cm mass consistent with high-grade neuroendocrine features, while the subclavian vein margin showed only chronic inflammation without tumor involvement.\n\nExcision specimens from surgical scar tissue and additional breast margins demonstrated benign changes, including scarring, chronic inflammation, foreign body giant cell reaction, and fat necrosis, without residual malignancy. Microcalcifications associated with benign ducts were noted in certain areas.\n\nImmunohistochemical analysis played a key role in confirming the tumor's lineage and excluding other potential diagnoses. The tumor exhibited a distinctive staining pattern that aligned with a neuroendocrine phenotype despite lacking typical markers such as chromogranin and synaptophysin."} +{"pid": "TCGA-DX-A3U5", "report": "The submitted specimen consists of a resected right retroperitoneal mass along with a portion of the right colon, ileum, appendix, and colon. The mass measures 10.6 x 9.8 x 9.4 cm and is encapsulated. On gross examination, the outer surface is inked, and the cut surface appears tan-yellow to pink, soft, smooth, and glistening, with multifocal areas of necrosis accounting for approximately 40% of the tumor volume.\n\nMicroscopic evaluation reveals two distinct components within the tumor. One area demonstrates features consistent with a well-differentiated variant, with separate nodules identified (the largest measuring 1.5 cm). The second component is composed of high-grade spindle cells. Necrotic foci are present throughout the tumor, making up a significant portion of the specimen. The well-differentiated component extends to the resection margin, and there are foci suggestive of vascular invasion.\n\nThe attached bowel specimen includes a segment of ileum (8 cm in length, 3.5 cm in circumference), an appendix (7 x 0.5 cm), and a colon segment (12.5 cm in length, 7.5 cm in maximum circumference). The mucosal surfaces of the ileum and colon appear unremarkable and are not directly involved by the tumor. Proximal and distal margins, as well as the appendiceal section, show no evidence of tumor involvement.\n\nLymph nodes were sampled and submitted for evaluation. Representative sections of the tumor and surrounding tissues were processed and embedded in cassettes for histologic review. TPS (tumor profiling system) was performed and a photograph of the specimen was taken. No direct extension of the tumor into the bowel lumen was observed."} +{"pid": "TCGA-06-0745", "report": "The specimen consists of two brain biopsy samples. Sample A includes multiple tissue fragments measuring 0.3 to 0.6 cm. Sample B consists of a single fragment measuring 0.5 cm. Histologic evaluation reveals a high-grade neoplasm with increased mitotic activity, prominent vascular proliferation, and areas of necrosis. Immunohistochemical staining shows a proliferation index of approximately 40% based on MIB-1 labeling. Molecular testing for MGMT promoter methylation was performed using bisulfite treatment of DNA followed by PCR amplification and gel electrophoresis. The results showed no evidence of MGMT promoter methylation. All findings were derived from paraffin-embedded tissue samples and interpreted in the context of standard diagnostic criteria."} +{"pid": "TCGA-HW-7487", "report": "The clinical history notes a left frontal lesion identified following seizure activity. Two specimens were submitted for analysis: one labeled as a left frontal brain lesion and the second as a left frontal lobe brain specimen.\n\nGross examination of the first specimen revealed two fragments of soft tissue measuring 0.6 x 0.4 x 0.2 cm and 0.6 x 0.5 x 0.3 cm. A touch preparation was made and the remainder was submitted for frozen section analysis. The second specimen consisted of a larger portion of brain tissue measuring 6.4 x 2.2 x 3.8 cm with gyral surface intact. Serial sections demonstrated diffuse thickening of white matter and an area of hemorrhage. Representative sections were submitted and photographs were taken.\n\nMicroscopic evaluation showed regions with low MIB-1 (Ki-67) labeling activity, approximately 2\u20133% across most sections. Limited microscopic areas exhibited higher MIB-1 labeling activity; however, these regions were minimal in extent and their significance remains uncertain. Additional molecular and cytogenetic studies are pending and will be reported separately.\n\nNine tissue blocks were evaluated from the second specimen and nine microscopic sections were reviewed. One block was analyzed during intraoperative consultation and confirmed upon permanent section review.\n\nSpecial stains performed included MIB-1 (Ki-67), MGMT, and negative controls. Recuts and immunohistochemical controls were also processed.\n\nThe diagnoses provided were based on personal examination of the slides and review of all relevant materials."} +{"pid": "TCGA-CV-7178", "report": "A specimen involving the mandible and associated soft tissues was examined. A soft tissue mass measuring 6.0 x 1.5 x 2.0 cm was noted on the inferior aspect of the gum, with a firm nodule measuring 3.3 cm identified beneath the skin at the anterior aspect of the mandible. Bony involvement was observed at the posterior right jaw and mid-portion of the specimen. The mucosa and soft tissue resection margins appeared uninvolved. Histological analysis revealed deeply invasive cells with features of squamous differentiation, ranging from poorly to moderately differentiated morphology.\n\nLymph node assessment included left neck dissection levels I, II, III, and V. A total of 5 lymph nodes were evaluated in level I, with 1 positive for malignant cells. In level II, 3 out of 3 lymph nodes were involved. Level III showed no evidence of disease in 5 nodes examined, and in level V, 1 of 4 lymph nodes contained malignant cells. Overall, 3 out of 16 lymph nodes across all levels were involved. The salivary gland and all other mucosal sites (anterior floor of mouth, right lateral floor of mouth, right anterior tonsillar pillar, retromolar trigone, buccal mucosa, labial mucosa, and right medial pterygoid) showed no evidence of disease. Bone within the medullary cavity exhibited myxoid change but no tumor involvement. The anterior margin of the mandible was closely involved, with tumor within 2 mm of the posterior margin."} +{"pid": "TCGA-MP-A4T2", "report": "Surgical pathology report. Tissue description includes sections labeled A1, B1, B2, C1, D1, and E1. The specimen consists of tissue from the left lower lobe of the lung, measuring 5 x 1.7 x 1.5 cm in greatest dimension and weighing 12.57 grams. Lymph node groups evaluated include superior (right lower paratracheal) and inferior (subcarinal) mediastinal regions. A peripheral mass measuring 2.1 x 2 x 1 cm is identified with grade 3 out of 4 cellular features. The visceral pleura does not show involvement. The surgical margin of resection is free of abnormal cellular infiltration. Evaluation of multiple lymph nodes, including 8 from the right lower paratracheal region and 4 subcarinal nodes, reveals no evidence of cellular spread."} +{"pid": "TCGA-E9-A243", "report": "The lumpectomy specimen from the right upper inner quadrant of the breast contains a grossly evident lesion measuring 1.5 x 0 x 2 cm. Histologic evaluation shows poorly differentiated cellular morphology. Axillary lymph node assessment reveals no metastatic involvement, with all 10 examined nodes negative. Surgical margins are uninvolved. Various histopathologic parameters including tubule formation, nuclear pleomorphism, and mitotic counts were not specified, precluding determination of a total Nottingham Histologic Score. No information is provided regarding tumor extent, extracapsular invasion, neoadjuvant treatment effect, or additional pathologic findings."} +{"pid": "TCGA-A2-A0ET", "report": "The lumpectomy specimen from the right breast measures 14.0 x 7.0 x 2.5 cm and contains a firm, pink-white, gray mass measuring 3.3 x 2.2 x 1.5 cm. This mass is well-circumscribed and located closest to the deep margin at 0.2 cm, followed by distances of 0.5 cm from the anterior margin, 1.5 cm from the inferior margin, and 1.8 cm from the superior margin. The remainder of the tissue consists predominantly of yellow-tan adipose tissue with fibrous components making up approximately 5% of the cut surface. Microscopic evaluation reveals a moderately differentiated cellular proliferation with a Nottingham score of 6 out of 9 (tubules = 2, nuclei = 2, mitoses = 2; mitotic count 10 per 10 high-power fields at 20x magnification). Necrosis and microcalcifications are absent. No vascular or lymphatic invasion is identified. The invasive component is located 1.2 cm from the anterior margin, while an in situ component is found 0.5 cm from the inferior margin. The in situ component exhibits a cribriform pattern with low nuclear grade. Estrogen receptors are positive, progesterone receptors are negative, and HER2/neu staining is negative by immunohistochemistry. \n\nAxillary lymph node dissection includes 16 lymph nodes, ranging in size from 0.7 x 0.7 x 0.5 cm to 4.0 x 2.0 x 1.0 cm. Five of these show involvement by metastatic cells. The involved nodes display a firm, pink-tan appearance upon sectioning, while the remaining nodes appear unremarkable. The lumpectomy mass measures 1.9 cm microscopically and corresponds to pathologic staging criteria as pT1c. Lymph node involvement correlates with N2a classification. Benign fibrocystic changes are present within the background tissue."} +{"pid": "TCGA-BP-5186", "report": "The submitted specimen from a right renal partial nephrectomy includes a wedge-shaped portion of kidney measuring 4 x 4 x 2 cm, with a suture marking the deep margin. The tumor is well-defined, golden-yellow, and hemorrhagic, measuring 1.9 x 1.7 x 1.6 cm. The distance from the tumor to the resection margin is 0.2 cm. Histologic evaluation shows nuclear features corresponding to a mid-level grade. No local invasion or vascular invasion is identified. All surgical margins are free of involvement. The surrounding non-neoplastic kidney tissue appears normal. No adrenal gland or lymph node tissue is present in the specimen. Immunohistochemical staining demonstrates reactivity for CA-IX in the tumor cells and CD-31 in the vasculature.\n\nA second specimen from paracaval tissue consists of fibrofatty material measuring 2.5 x 2.5 x 0.3 cm. No lymph nodes are identified, and no involvement is found. The tumor is staged as pT1, confined to the kidney and measuring less than 7 cm in greatest dimension. Representative sections of the tumor, margin, and control tissue are submitted for further analysis. Intraoperative frozen section confirmed the presence of renal cortical neoplasm with benign margins, which is confirmed in the final report."} +{"pid": "TCGA-AA-3947", "report": "The resected ileocolic section contains an ulcerated lesion located 3 cm aborally to Bauhin\u2019s valve, measuring 12 cm in length and encircling the intestinal wall. Histologically, the lesion shows moderately differentiated features with partial mucinous morphology. The lesion invades through all layers of the intestinal wall, extending into the subserous connective tissue and mesocolic fat. There is continued infiltration into an adjacent angular colon segment, which adheres to the lesion. No lymph node metastases were identified in 22 examined nodes. Lymphatic and vascular invasion were not detected. Additionally, five sessile serrated adenomas are present in the colonic mucosa. The histological margins are free of abnormal tissue."} +{"pid": "TCGA-A5-A7WJ", "report": "The hysterectomy specimen measured 7.0 x 5.0 x 4.0 cm and was previously incised. The endometrial cavity measured 3.8 cm in width and 4.0 cm in length. Endometrial thickness ranged from 0.1 to 1.0 cm, and myometrial thickness ranged from 0.7 to 1.2 cm. The cervix measured 2.5 cm in length and up to 3.0 cm in diameter. The left ovary contained a unilocular cyst measuring 3.7 cm. The right ovary was atrophic. Both fallopian tubes showed no significant abnormalities.\n\nA lesion was identified in the uterine fundus, corpus (anterior and posterior), and lower uterine segment (anterior and posterior). The lesion measured 5.7 x 3.8 x 1.0 cm, with a pale tan, soft, and friable consistency. It had a papillary and fungating configuration. Microscopic evaluation revealed cellular features consistent with a histologic type previously characterized. Histologic grade was determined as Grade II based on standard classification. The tumor invaded into the myometrium, reaching up to 0.7 cm of the wall thickness where the total wall thickness was up to 1.8 cm. This corresponds to approximately 11% invasion of the myometrial thickness. No definitive lymphovascular invasion was identified; however, this could not be fully assessed. There was no involvement of the cervical region or parametrial tissue. The serosal surface and vaginal cuff were unremarkable.\n\nExamination of margins showed no evidence of invasive disease. Non-neoplastic endometrium was present without additional findings such as endometrial polyps, leiomyomas, or other myometrial lesions. The cervix showed squamous metaplasia but no evidence of abnormal tissue involvement. Fibrinous adhesions were noted on the serosa. Adenomyosis was also identified within the specimen.\n\nLymph node sampling included pelvic and para-aortic regions. One lymph node was identified in right pelvic lymph node #1, measuring 1.0 x 0.8 x 0.5 cm. Right pelvic lymph node #2 contained fibroconnective tissue only, with no identifiable lymph node. In the right para-aortic region, one lymph node was found measuring 0.9 x 0.7 x 0.6 cm. In the left para-aortic region, two lymph nodes were identified, with the largest measuring 1.4 cm in maximum dimension. One lymph node was identified in the left pelvic region, measuring 1.1 x 0.8 x 0.7 cm. All lymph nodes examined were negative for tumor involvement.\n\nStaging was determined based on AJCC 7th Edition (2010) criteria. The primary tumor was confined to the endometrium and invaded less than half of the myometrium (pT1a). No regional lymph node metastasis was identified (pN0). A total of five lymph nodes were examined: two pelvic and three para-aortic, all without evidence of involvement. Representative sections of all relevant areas were submitted for microscopic analysis."} +{"pid": "TCGA-AU-6004", "report": "The right colon specimen includes a segment of large bowel removed in continuity with the cecum and terminal ileum. The ileal segment measures 4.5 cm in length and 1.5 cm in diameter at the proximal margin, while the colonic segment including the cecum measures 13 cm in length and 2 cm in diameter at the distal margin. The serosa is pink with scant membranous adhesions and moderate pericolic fat. There is a puckered 2.5 cm area at the cecal pouch. The lumen contains a small amount of hemorrhagic fecal material. Mucosal surfaces are pink tan with usual folds and a large nodular mass measuring 6.5 x 3.5 x 2.5 cm located within the cecal pouch. This lesion is firmly fixed to the underlying muscularis and correlates with the observed puckering. The radial mesenteric margin measures 9 cm in length. Histologic sectioning reveals infiltration nearly through the entire thickness of the bowel wall, approaching within 0.1 cm of the inked (black) serosa. Two small sessile tan nodules measuring 0.2 cm each are identified at distances of 11 cm and 5 cm from the distal margin of resection. A 0.6 cm area of submucosal hemorrhage is noted 3 cm from the distal margin. Attached adipose tissue contains sixteen nodules ranging from 0.3 to 1.5 cm in greatest dimension, described as moderately firm to firm with pink and pale white appearances.\n\nThe right ovary specimen includes a fallopian tube measuring 3 cm in length and 0.3 cm in diameter, with a plastic ligation ring at the proximal margin. The ovary measures 3 x 3 x 3 cm with a yellow-white, lobulated external surface. Sectioning reveals multiple serous cysts with smooth lining ranging from 0.3 to 1.5 cm in size, along with a firm 2 cm pink-white whorled nodule.\n\nThe left ovary specimen includes a fallopian tube measuring 6 cm in length and 0.3 cm in diameter, stretched across the ovarian surface. The ovary measures 6.5 x 5 x 3.5 cm with a pink to yellow-tan, lobulated external surface and membranous adhesions. Sectioning reveals a multiloculated serous cyst with smooth lining and a small 0.7 cm area of tan papillary projections.\n\nMicroscopic evaluation of the right colon demonstrates disruption of the muscularis propria by fibrous tissue reaction in the region of maximum depth. No extension beyond the muscular plane or into pericolic adipose tissue is identified. All surgical margins are free of involvement. Sixteen regional lymph nodes are negative for tumor. The separate tubular adenomatous lesions at 5 and 11 cm from the distal margin are each 0.2 cm in size.\n\nHistologic examination of the right ovary shows no evidence of atypia, surface epithelial proliferation, or features of malignancy within the 2 cm nodule. The fallopian tube is previously ligated with fibrotic fimbriae. Examination of the left ovary also reveals no atypia, surface epithelial proliferation, or features of malignancy within the 6.5 cm lesion. The fallopian tube is histologically unremarkable.\n\nStaging parameters indicate no lymphatic, venous, or perineural involvement. No tumor deposits or discontinuous extramural extension is present. The tumor does not involve any other organs or visceral peritoneum. Proximal, distal, and radial margins are uninvolved, with the tumor located 0.2 cm from the antimesenteric serosal surface. No neoadjuvant treatment effect is applicable."} +{"pid": "TCGA-BR-8676", "report": "The specimen consisted of a subtotal gastrectomy with tumor located in the antrum. Grossly, the lesion measured 10 x 10 x 12 cm and was ulcerated. Microscopically, the tissue showed poorly differentiated features with involvement of the subserosa. Invasion into the perigastric fat was noted. Ten lymph nodes were examined, all from the greater and lesser curvatures, and each demonstrated evidence of metastatic involvement. No venous or lymphatic invasion was identified. The omentum appeared hyperemic and dense, with normal structure preserved. Surgical margins were free of involvement."} +{"pid": "TCGA-AS-3777", "report": "The surgical specimen consists of a left kidney with attached perirenal fat, weighing 361 grams and measuring 19 x 11 x 5 cm in total. The kidney itself measures 10 x 6 x 3.5 cm. A segment of ureter is present, measuring 8 cm in length and 0.6 cm in diameter. Several vessels at the hilum range from 0.4 to 1.5 cm in length and up to 2 cm in diameter. The ureteral and pelvic mucosa appear pale tan with normal striations. The renal parenchyma is red-brown with preserved architecture.\n\nA circumscribed yellow-tan lesion measuring 2 x 2.2 x 1.5 cm is identified adjacent to the renal pelvis. It appears to contact the renal sinus and comes within 0.5 cm of the cortical surface. The calyces are not dilated, and the cortex measures up to 0.8 cm in thickness. The renal capsule strips easily, revealing a red-brown granular cortical surface. No abnormalities are noted in the perirenal fat, and the adrenal gland is not present.\n\nSections submitted include vessel and ureter margins, multiple blocks of the lesion, and uninvolved renal parenchyma. Microscopic evaluation reveals no vascular invasion. All surgical margins, including ureteral and vascular, show no abnormal cellular infiltration. The background renal tissue demonstrates no significant pathological changes.\n\nStaging assessment indicates no lymph node involvement or distant metastasis. The lesion is confined to the kidney. Histologic features do not indicate venous involvement or adrenal extension. Based on extent and localization, the pathologic staging is consistent with an early localized stage."} +{"pid": "TCGA-HT-7482", "report": "The pathology report describes microscopic findings from multiple sections. Seven sections show a mildly hypercellular glial neoplasm composed primarily of cells with round to oval nuclei and scant glial processes. Classic oligodendroglioma differentiation is not observed. Scattered throughout are moderately to markedly atypical cells. No mitotic figures are identified, and there is no evidence of microvascular proliferation or necrosis.\n\nPermanent sections from the posterior, deep, anterior, superior, and inferior margins all demonstrate gray matter without significant hypercellularity or atypical cells to suggest neoplastic infiltration. One section of the inferior margin includes both gray and white matter; however, there is insufficient hypercellularity and no atypical cells suggestive of infiltrating neoplasm. Another section demonstrates gray and white matter with infiltrating neoplasm similar to that previously described. This area does not show significantly increased cellularity or atypia, and again, no mitotic figures, microvascular proliferation, or necrosis are observed.\n\nImmunohistochemical staining with MIB-1 was performed on both nonenhancing and enhancing portions of the lesion. In the nonenhancing region, only a few scattered MIB-1 positive cells are present, with an average labeling index of less than 0.1% and a maximum of 1.6% in the most active areas. In contrast, the enhancing region shows many MIB-1 reactive cells, with a labeling index reaching up to 5.0% in the highest areas. This level of proliferative activity raises concern for early anaplastic progression, although histologic features overall do not support classification as a higher-grade tumor."} +{"pid": "TCGA-ET-A2N0", "report": "The specimen consists of a total thyroidectomy from the right lobe. The greatest dimension of the lesion measures 2.0 cm, and it is unifocal in distribution. Histologic evaluation reveals characteristic cellular features consistent with a neoplastic process. Lymph node assessment identifies involvement in 20 out of 27 nodes examined. The primary lesion is confined to the thyroid gland with no evidence of extrathyroidal extension. Evaluation of regional lymph node groups, including pretracheal, paratracheal, and prelaryngeal/Delphian stations, demonstrates presence of metastatic change. Distant metastatic status could not be determined. Surgical margins are free of involvement. No vascular or lymphatic invasion is identified. An incidental finding includes a histologically normal parathyroid gland located in the left inferior region."} +{"pid": "TCGA-CM-6679", "report": "The submitted specimen includes a portion of colon along with proximal and distal ring specimens. The main specimen, labeled as sigmoid colon, measures 18.5 cm in length and 10.0 cm in open circumference. A lesion is identified, measuring 2.8 cm in length and 6.5 cm in width, located 9.0 cm from the proximal margin and 6.0 cm from the distal margin. The lesion extends to a depth of 0.7 cm, reaching through the muscularis and into the surrounding pericolic fat, with a distance of 4.0 cm from the closest radial margin. Surrounding mucosa appears unremarkable. A total of 21 lymph nodes are examined, none show involvement. Margins, including proximal, distal, and radial, are free of any abnormal cellular activity. The proximal and distal rings both show mucosal features consistent with benign changes, no concerning findings are identified in these areas. Histologic assessment notes no vascular or neural invasion, and no tumor budding or increased immune response is present. Staging indicates the deepest level of invasion reaches into the pericolorectal tissues without nodal spread."} +{"pid": "TCGA-HE-A5NF", "report": "The sample was collected from the left kidney during a resection procedure. The tumor measured 3 cm in size. Histological analysis showed a Fuhrman grade 3 morphology. Lymph node involvement was not assessed (NX), and there was no evidence of distant metastasis (M0). Additional findings included a prostate specimen positive for adenocarcinoma with a Gleason score of 6 out of 10."} +{"pid": "TCGA-C5-A0TN", "report": "The specimen consisted of a uterus with cervix, placenta, and fetus, submitted from a woman with an intrauterine pregnancy at 17 weeks estimated gestational age. A radical hysterectomy was performed along with lymph node sampling and termination of pregnancy.\n\nGross examination of the uterus revealed a mass measuring 7.0 cm in greatest dimension located in the cervix. The tumor invaded to a depth of 7 mm in an area where the cervical wall thickness measured 10 mm. Extensive high-grade intraepithelial neoplasia was present adjacent to the invasive lesion. Vaginal cuff margins were free of disease. Examination of the parametrial tissues showed no involvement by tumor.\n\nLymph node assessment revealed metastatic involvement in two of seven lymph nodes from the right obturator region. Focal extracapsular extension was identified in one of these nodes. Additionally, acute inflammation and focal abscess formation were observed in one lymph node, suggesting possible reactive changes. Two left obturator and one external iliac lymph nodes showed no evidence of involvement.\n\nHistologic evaluation demonstrated invasive cellular proliferation with features of poor differentiation and focal keratinization. Lymphovascular space invasion was identified but limited in extent. No extension into the uterine corpus or parametrial tissue was observed.\n\nThe fetal examination revealed an intact female fetus estimated to be between 18 and 19 weeks of gestation. No congenital anomalies were identified on gross or histologic evaluation. The placenta and umbilical cord showed normal morphology without histopathologic abnormalities.\n\nSections of fetal membranes, umbilical cord, and placenta showed no histologic abnormalities. Other fetal tissues including lungs, heart, liver, kidneys, adrenal glands, spleen, pancreas, gastrointestinal tract, bladder, spinal cord, brain, and thymus exhibited normal development without structural abnormalities.\n\nStaging considerations included a primary lesion confined to the cervix with depth of invasion measuring 7 mm and horizontal dimension of 70 mm. Regional lymph node involvement was confirmed with two positive nodes out of ten examined. Extracapsular extension was present. Distant metastasis could not be assessed.\n\nMicroscopic sections of all submitted tissues were evaluated and no additional histologic abnormalities were found."} +{"pid": "TCGA-BS-A0UL", "report": "The specimen consisted of a uterus with attached cervix and bilateral adnexa. The uterus measured 9.0 x 7.0 x 3.0 cm, and the cervix was 3.0 cm in length by 2.5 cm in diameter. Both fallopian tubes and ovaries were present, with the right ovary measuring 2.5 x 2.0 x 1.0 cm and the left ovary measuring 3.0 x 1.5 x 1.0 cm. The endometrial cavity contained two small polypoid tissues on the posterior and anterior aspects, each measuring up to 0.7 x 0.5 x 0.3 cm. A small exophytic mass measuring 1.5 x 1.0 x 0.5 cm with papillary projections was identified in the lower uterine segment. No myometrial invasion was noted grossly.\n\nMicroscopically, the lesion showed predominantly endometrioid morphology with villoglandular features. The histologic grade was FIGO Grade 1, with nuclear grading also corresponding to Grade 1. Evaluation revealed no myometrial invasion, no lymphovascular invasion, and no involvement of the serosa or parametrium. The cervix showed no evidence of involvement. Both right and left adnexa demonstrated no significant histopathologic findings. The endometrium contained additional benign polyps. Frozen section analysis confirmed the absence of myometrial invasion. All other tissue samples, including sections from the cervix, endomyometrium, myometrium, and adnexa, showed no further significant pathology."} +{"pid": "TCGA-3S-A8YW", "report": "The surgical specimen consists of a thymic mass and hilar lymph nodes. The thymic mass measures 7 x 7 x 4.5 cm and is described as an ovoid, nodular lesion with a light tan anterior surface. On sectioning, the mass demonstrates a smooth pink-tan lobulated cut surface with fine fibrous septations. A smaller 1.5 x 1 cm area is identified within the larger lesion. Microscopically, the lesion shows nests and cords of cells with squamoid cytoplasm and high-grade nuclear features such as macronucleoli, frequent mitoses, and areas of necrosis, separated by dense fibrous bands. Immunohistochemical staining reveals positivity for pancytokeratin, p40, CD5, and CD117 (c-kit), with only weak focal staining for synaptophysin and negative results for chromogranin, TTF-1, and napsin.\n\nThe tumor invades the tumor capsule and extends into the adjacent mediastinal fat, particularly evident in block A4. There is no involvement of the pleura or pericardium. No lymphovascular invasion is identified. All surgical margins are microscopically negative. Six hilar lymph nodes and one lymph node from the mediastinal fat are examined, none of which show evidence of metastasis. Additionally, multiple small benign microscopic lesions are identified in block A9, along with residual thymic tissue showing involutional changes.\n\nStaging indicates a T2 classification with no regional lymph node involvement (N0). The specimen was intact upon submission, and no treatment effect was observed. Ancillary studies were performed using validated clinical assays. Multiple tissue blocks were submitted for analysis, including sections from various margins and surrounding adipose tissue. The second specimen, consisting of four hilar lymph node fragments ranging from 0.2 to 1.5 cm, was entirely submitted for evaluation."} +{"pid": "TCGA-JW-AAVH", "report": "A specimen was received from a female patient involving multiple tissue samples submitted in four parts. Part A consisted of left parametrial fibrofatty tissue measuring 2.7 x 1.5 x 0.5 cm with an attached suture and a vessel measuring 2.0 cm in length. No discrete masses were identified within the vessel lumen.\n\nPart B included a radical hysterectomy specimen with bilateral fallopian tubes and ovaries. The uterus measured 9 cm in length, with a cervix measuring 3.0 x 3.5 cm. Gross examination revealed a centrally ulcerative tan-yellow mass on the cervix measuring 3.0 x 2.5 x 1.2 cm. This lesion extended to a depth of 1.2 cm and was located approximately 0.4 cm from the outer surface. It was situated about 2.0 cm from the vaginal cuff margin and extended into the lower uterine segment. Histologically, invasive carcinoma was identified microscopically with multifocal lymphatic invasion present. The tumor was located 1.5 mm from the nearest inked margin (cervical serosa). Adjacent endometrium showed disordered proliferative changes without evidence of malignancy. A benign leiomyoma measuring 1.5 cm was identified within the myometrium. The serosal surface appeared unremarkable. The vaginal cuff measured 4 x 1.2 cm and showed no pathological alterations. Parametrial tissues were present bilaterally with dimensions of 2 x 1 x 0.2 cm on the right and 1.5 x 1 x 0.5 cm on the left.\n\nThe right ovary contained a smooth unilocular cyst measuring 1.5 x 1 x 0.6 cm filled with serosanguineous fluid. The remainder of the ovarian tissue appeared unremarkable. The right fallopian tube measured 4 cm in length and displayed a pinpoint lumen without pathological findings. On the left side, both the ovary and fallopian tube showed no diagnostic pathological alterations.\n\nParts C and D consisted of pelvic lymph node dissections. Six lymph nodes were identified on the left side and nine on the right; all appeared benign upon histological evaluation. No malignant involvement was detected among the total of fifteen lymph nodes examined.\n\nSections of the cervical mass demonstrated moderately differentiated nonkeratinizing morphology with no vascular invasion observed. Depth of invasion measured up to 12 mm within a 13.5 mm thick section of cervix. No atypia, hyperplasia, or carcinoma was identified in the endometrial glands. The submucosal nodule corresponded to a benign leiomyoma without increased mitotic activity or necrosis.\n\nBased on pathological assessment, no distant metastasis was identified. Staging parameters indicated a primary tumor classification consistent with clinically visible lesion less than or equal to 4 cm in greatest dimension. Regional lymph node staging showed no involvement. Overall pathological stage grouping corresponded to early-stage disease based on tumor characteristics and absence of nodal spread."} +{"pid": "TCGA-IM-A420", "report": "The specimen weighed 27.2 grams and measured 5.5 x 3.0 x 1.0 cm on the right lobe, 5.0 x 4.0 x 2.0 cm on the left lobe, with a pyramidal lobe measuring 1.5 x 1.0 x 0.2 cm. The left lobe contained a dominant lesion measuring 4.0 x 3.0 x 2.0 cm with involvement extending close to both anterior and posterior resection margins (less than 0.1 cm). The right lobe showed smaller nodules, with the largest measuring 0.3 cm near the anterior margin. The tumor exhibited papillary architecture with follicular and classical features, including areas of clear cell and tall cell morphology. Margins were free of tumor involvement, though the invasive component was within 1 mm of the closest margin. The tumor was partially encapsulated and demonstrated extensive lymphovascular invasion involving four or more vessels. A second focus measuring up to 0.3 cm was identified in the right lobe, showing similar morphologic features with focal lymphovascular invasion. Adjacent thyroid tissue showed moderate to severe lymphocytic thyroiditis. Five out of fourteen lymph nodes were involved, three of which were from level VI. No extranodal extension was observed. Two hypercellular parathyroid glands were noted, and no parathyroid tissue was identified at one site. Frozen section analysis of another site showed fibrous tissue without identifiable parathyroid. Pathologic staging was pT2, pN1a. Immunohistochemical stains were performed using validated laboratory-specific reagents and interpreted by a pathologist."} +{"pid": "TCGA-AA-3939", "report": "The surgical specimen includes a right hemicolectomy with a focus on a lesion located in the cecum and ascending colon. Histological examination reveals a moderately differentiated adenocarcinoma, measuring 3 cm at its widest dimension. The tumor infiltrates through all layers of the intestinal wall and extends into the adjacent mesocolic fat. No involvement of regional lymph nodes is observed.\n\nA separate finding in the ascending colon shows a tubular adenoma measuring 2.3 cm, exhibiting moderate epithelial dysplasia. In addition, an isolated segment of the appendix demonstrates chronic inflammatory changes, including mild florid activity and distinct chronic periappendicitis with a xanthous tissue reaction. These findings are interpreted as secondary to tumor-related displacement of the appendiceal opening.\n\nInflammation is also noted in the subserosal region of the cecum and proximal ascending colon, characterized by a pronounced macrophage-rich infiltrate, suggesting perityphlitis. Based on the extent of local invasion and absence of nodal involvement, the staging assessment corresponds to pT3, pN0 (0/40 lymph nodes involved), with no residual tumor at the resection margins. Vascular invasion is present."} +{"pid": "TCGA-BH-A0BO", "report": "The surgical specimen includes multiple lymph nodes from the left sentinel lymph node biopsy, all of which show no evidence of malignant involvement. The primary lesion identified in the left breast measures 1.0 x 1.0 x 0.9 cm and is located within fibrosed tissue associated with microcalcifications. Histologic evaluation reveals a moderately differentiated invasive ductal carcinoma with a Nottingham score of 6 out of 9 (tubules 3, nuclei 2, mitosis 1). No lymphovascular invasion is observed. A small in situ component of cribriform morphology and nuclear grade 2 is present, comprising approximately 1% of the invasive lesion.\n\nAll surgical margins are free of tumor involvement, with the closest margin measuring 0.4 cm anteriorly. Changes consistent with prior core biopsy are noted, along with benign findings such as fibrocystic changes, fibroadenomatoid nodules, and thermal effect. Immunohistochemical staining demonstrates positivity for estrogen and progesterone receptors, while HER2/neu staining shows minimal reactivity (zero or 1+).\n\nA separate fibroadenoma is identified in the left breast, with additional findings consistent with previous biopsy sites. Three lymph nodes were examined using hematoxylin and eosin and keratin stains; none show evidence of metastasis. Pathologic staging is pT1b, pN0, pMX."} +{"pid": "TCGA-50-5942", "report": "The patient underwent a right anterior thoracotomy and bronchoscopy. A segmentectomy of the right upper lobe, anterior segment, was performed. The lesion measured 2.8 cm in maximum dimension and exhibited well-differentiated histological features with papillary architecture and lepidic growth pattern. There was no involvement of the visceral pleura, and no definitive angiolymphatic invasion was identified. Resection margins were negative. Mild centrilobular emphysema was noted in the lung tissue.\n\nBiopsies of the right secondary carina showed only superficial fragments of respiratory epithelium. A biopsy from the gastrointestinal junction revealed squamous esophageal and columnar gastric-type mucosa with chronic inflammation, but no intestinal metaplasia. A biopsy of the stomach fundus showed unremarkable fundic-type gastric mucosa without evidence of *Helicobacter pylori*. Excision of the right third rib revealed benign osteocartilaginous tissue and bone marrow with normal trilineage maturation.\n\nLymph nodes resected from right levels 4, 7, 10, and 11 were anthracotic and showed no evidence of metastatic disease (total of 4 lymph nodes examined, all negative). Histologic grade was G1. No tumor necrosis exceeding 50% was observed. There were no gross or microscopic satellite lesions, and no extrapulmonary parenchymal extension was identified. Histochemical stains were used as ancillary studies.\n\nPathologic staging was determined as pT1, pN0, and pMX. The underlying lung disease included emphysema."} +{"pid": "TCGA-AO-A126", "report": "A 43-year-old patient with a history of newly diagnosed right breast malignancy, previously confirmed by core biopsy, underwent a right total mastectomy with sentinel lymph node sampling (four nodes identified) and possible axillary lymph node dissection, along with immediate reconstruction. Submitted specimens included four sentinel lymph nodes from the right axilla, one non-sentinel lymph node from the right axilla, and the right breast.\n\nGross examination of the right breast specimen revealed an ill-defined, indurated gray-white mass measuring 2.5 cm in greatest dimension located in the upper inner quadrant, 0.5 cm from the deep margin. A separate smaller nodule measuring 1.0 cm was noted in the upper outer quadrant. The tumor exhibited solid, tubular, and cribriform growth patterns. Histologic grade was moderate (II/III), based on tubule formation, with moderate nuclear atypia (nuclear grade II/III). No vascular invasion, skin involvement, or nipple involvement was observed. Fibrocystic and fibroadenomatoid changes were present in the surrounding non-neoplastic tissue.\n\nAll four sentinel lymph nodes and the single non-sentinel lymph node showed no evidence of metastatic disease. Additional deeper sectioning and immunohistochemical staining for cytokeratins were performed on all sentinel nodes and did not reveal any tumor involvement.\n\nImmunohistochemical studies of the breast lesion demonstrated positivity for estrogen and progesterone receptors, and no significant HER2 expression (1+ staining intensity)."} +{"pid": "TCGA-BS-A0UA", "report": "The specimen included right and left fallopian tubes and ovaries, as well as a uterus with cervix. Both ovaries showed physiologic changes. Acute salpingitis was present in each fallopian tube. No tumor was identified in either adnexal specimen. The uterine corpus measured 5.0 x 4.5 x 3.5 cm. A polypoid mass was observed on the endometrial surface, measuring 3.5 x 2.0 cm in area and 1.0 cm in thickness. The tumor invaded to a depth of 0.4 cm within the myometrium, which had a total thickness of 1.5 cm, representing less than one-third of the myometrial thickness. Horizontal tumor extent was 3.5 cm. There was no involvement of the lower uterine segment, parametrium, pelvic wall, or vagina. No lymphovascular invasion was identified. Resection margins were free of involvement. A well-circumscribed tan mass within the myometrium measured 0.7 cm in greatest dimension. Adenomyosis was also noted. All relevant sections were submitted for evaluation."} +{"pid": "TCGA-JV-A5VF", "report": "A pelvic mass biopsy demonstrated a malignant tumor composed of spindle cells. Histologic evaluation revealed a poorly differentiated epithelioid morphology with a mitotic count of 56 per 10 high-power fields. Necrosis was present, involving approximately one-third of the tumor volume. The histologic grade was determined to be FNCLCC grade 3. Immunohistochemical staining showed positivity for smooth muscle actin and desmin.\n\nThe tumor involved multiple sites including the uterus, bilateral adnexa, right colon, distal ileum, and omentum. Gross examination of the hysterectomy and colectomy specimen revealed a large tan friable mass measuring approximately 16 cm in greatest dimension. This mass extended from the uterine fundus through the serosa and into surrounding soft tissues, adhering to but not invading the colon, appendix, or ileum. Multiple tumor nodules were identified involving the bowel wall, mesentery, and external surface of the right fallopian tube. Tumor deposits were also noted on the colonic serosa and within attached mesenteric fat.\n\nAdditional specimens including a cul-de-sac mass and cervix, sigmoid epiploica, mesenteric nodule, and omentum all showed involvement by the tumor. The cervix contained a tumor-involved soft tissue fragment measuring 8.0 x 6.0 x 1.5 cm. The sigmoid epiploica specimen consisted of fibroadipose tissue with no grossly identifiable nodule. The mesenteric nodule measured 1.5 x 1.4 x 1.2 cm and was composed of friable soft tissue. The omental specimen was a flat sheet of fibroadipose tissue measuring 16.0 x 3.0 x 0.6 cm with multiple friable tumor nodules present.\n\nNo invasion of the colon, appendix, or ileum was identified. The endometrial cavity contained a benign polyp measuring 3.0 x 1.2 x 0.3 cm. The myometrium contained multiple intramural and subserosal nodules ranging from 1.0 to 7.0 cm in size, without hemorrhage, necrosis, or degeneration. The ovaries and fallopian tubes were otherwise unremarkable.\n\nPathologic staging was determined as T2b NX MX. Surgical margins could not be assessed. Ancillary studies included multiple immunohistochemistry tests performed under CLIA-certified conditions."} +{"pid": "TCGA-VF-A8A8", "report": "The surgical pathology report describes a right radical orchiectomy specimen from a male patient with a testicular mass. The testicle measures 7 x 4.3 x 4.2 cm and weighs 83.7 g. The spermatic cord is 8.5 cm in length and 2.5 cm in average diameter. Two distinct masses were identified within the testicle. The larger mass measures 3.9 x 3.7 x 3.2 cm, and the smaller mass measures 2.7 x 2.1 x 1.9 cm. A thin, 2 mm potential capsule separates the two masses. Neither mass grossly\u4fb5\u72af the tunica albuginea, epididymis, or extends beyond the testicle. The larger mass appears white-yellow with possible hemorrhage, while the smaller mass is yellow-brown with possible necrosis.\n\nMicroscopic evaluation reveals multiple cellular components. One component shows extensive positivity for CD30, indicating a predominant population. There are also rare foci of membranous staining for AFP in a separate region. Immunohistochemical staining highlights an additional distinct cell population with rare HCG-positive cells; however, no cytotrophoblastic or syncytiotrophoblastic cells were identified in areas of hemorrhage.\n\nHistologic sections include the spermatic cord shave margin, representative sections of both masses, areas related to the rete testis and tunica vaginalis, and uninvolved regions of the testis and epididymis. No lymphovascular invasion is identified. Margins of the spermatic cord are free of involvement. The surrounding structures, including the tunica albuginea, tunica vaginalis, rete testis, and epididymis, show no evidence of tumor involvement. Intratubular changes are noted in the testicular tissue adjacent to the lesions.\n\nThe material was tested using immunohistochemical assays with appropriate controls. Some tests used reagents labeled for investigational or research use only, and were validated internally by a CLIA-certified laboratory. These tests were performed as adjunctive tools to support histopathologic evaluation.\n\nSections reviewed included multiple representative samples from various regions of the specimen. Clinical history notes a right testicular mass; pre- and post-operative diagnoses were not specified. The procedure performed was a right radical orchiectomy."} +{"pid": "TCGA-G3-A25W", "report": "The gallbladder specimen measured 6.0 x 2.5 x 2.5 cm and contained green bile with no stones identified. Microscopic examination of the gallbladder wall showed no pathologic abnormalities.\n\nThe liver specimen was a partial hepatectomy weighing 723 grams and measuring approximately 18.0 x 13.0 x 8.0 cm. Serial sectioning revealed that 95% of the specimen was occupied by a well-defined, soft, tan mass measuring 11.0 cm in greatest dimension. The mass had a hemorrhagic cut surface with possible areas of necrosis and was located approximately 0.8 cm from the resection margin. Microscopically, the lesion consisted of nests and cords of malignant hepatic cells with enlarged nuclei and prominent nucleoli. Many hepatocytes displayed globular eosinophilic inclusions. Areas of hemorrhage and necrosis were also present.\n\nA fragment of white solid mass lesion was submitted entirely for analysis. Histopathological evaluation showed similar cellular features to those seen in the liver specimen, including areas of necrosis.\n\nStaging assessment indicated a solitary tumor with vascular invasion. The parenchymal resection margin was uninvolved by invasive carcinoma, with the closest distance of invasive carcinoma to the margin being 0.8 mm. No regional lymph node involvement or other significant pathological findings were identified."} +{"pid": "TCGA-2A-A8VV", "report": "The prostate specimen measured 4.5 cm from apex to base, 5.2 cm transversely, and 3.5 cm from anterior to posterior, with a total weight of 59.5 grams. The external surface was smooth. Serial sectioning identified tumor involvement in the right posterior, left posterior, and left anterior regions, with the dominant tumor mass located in the right posterior region extending from the apex to mid-prostate. Perineural invasion was present; vascular invasion was not identified. The tumor exhibited multicentric foci of invasive growth. High-grade intraepithelial neoplasia was noted. The tumor was confined within the prostate capsule without extension beyond it. Seminal vesicles and bladder neck were uninvolved. Surgical margins were free of tumor. Non-neoplastic prostate tissue showed no significant findings.\n\nLymph node evaluation included right pelvic lymph nodes (10 examined, ranging from 0.5 x 0.5 x 0.5 cm to 2.3 x 1.2 x 0.6 cm) and left pelvic lymph nodes (6 examined, ranging from 0.2 x 0.2 x 0.2 cm to 1.1 x 0.7 x 0.5 cm). No malignancy was identified in any of the lymph nodes examined. A single lymph node within the peri-prostatic fat was also benign. Adipose tissue submitted from the peri-prostatic region showed no evidence of tumor.\n\nAll specimens were thoroughly evaluated microscopically with representative sections submitted. No additional special studies were performed beyond routine histologic examination."} +{"pid": "TCGA-DH-5143", "report": "The specimen consists of two portions. The first portion is a fresh tissue sample measuring 5.2 x 3.5 x 1.6 cm, composed of cortical gray matter and some cortical white matter, with a well-defined mass measuring 3.2 x 3.0 x 1.4 cm located at one edge. The remainder of the tissue shows an indistinct gray-white junction. A portion of this tissue was used for frozen section analysis, and the remaining tissue was submitted for permanent processing in cassettes FSA1 through A6. The second portion is a smaller fresh tissue sample measuring 2.2 x 1.5 x 1.0 cm, described as gray-white to beige soft tissue with possible white matter visible at one edge, submitted in cassettes B1 and B2.\n\nMicroscopic evaluation revealed areas of diffuse glioma with astrocytic features and regions showing oligodendrogliomatous morphology. Scattered foci demonstrated increased cellularity with elevated mitotic activity. Immunohistochemical staining showed variable GFAP reactivity across the tissue. P53 protein expression was present in more than half of the tumor cells. The Ki-67 labeling index in areas of higher cellularity was estimated at 5\u201310%, with lower labeling in other regions. Fluorescence in situ hybridization (FISH) analysis for chromosomes 1p and 19q deletions performed on paraffin-embedded tissue did not show any deletions in this case.\n\nAll tests were performed under clinical laboratory settings certified for high-complexity testing. Some testing methods used in this evaluation have not been cleared or approved by the US Food and Drug Administration but are utilized for clinical diagnostic purposes."} +{"pid": "TCGA-AC-A23G", "report": "The right axillary sentinel lymph nodes were examined and showed evidence of metastatic involvement. Two lymph nodes were identified, measuring 1.2 x 1.0 x 0.5 cm and 1.5 x 1.2 x 0.5 cm, and were entirely submitted for analysis.\n\nA right breast mastectomy specimen was evaluated. The fibroadipose tissue measured 25.0 x 15.0 x 6.0 cm and weighed 830 grams. The skin surface measured 20.0 x 9.0 cm and appeared light tan and wrinkled. An area of discoloration surrounding the nipple measured 6.0 cm. The nipple was centrally located and appeared grossly normal. A firm gray-tan fibrous mass measuring 1.2 x 1.0 x 0.7 cm was identified in the upper inner quadrant, located 1.0 cm from the deep margin of resection. No other lesions were identified. The surrounding breast tissue showed fatty fibroadipose changes with moderate usual ductal hyperplasia and a single microscopic focus of atypical ductal hyperplasia. No in situ component was identified. Histologic evaluation of the nipple was unremarkable, and the deep surgical margin was negative. The mass was architecturally scored 3/3, nuclear features scored 2/3, and mitotic activity scored 1/3, with no lymphovascular space invasion observed.\n\nIn the right axillary contents, a fibroadipose tissue specimen measuring 8.0 x 5.5 x 2.5 cm was received. Sectioning revealed twelve probable lymph nodes ranging in size from 0.2 to 1.5 cm. All lymph nodes were submitted for histologic evaluation. One lymph node demonstrated a multifocal microgranulomatous reaction associated with refractile foreign material.\n\nImmunohistochemical studies showed strong positivity for estrogen receptor (94%) and progesterone receptor (89%). Proliferation index by KI-67 (MIB1) was borderline at 18%. Her2 gene amplification by FISH was negative, with an average of 1.82 Her2/neu copies per cell and a ratio of 1.09 compared to chromosome 17 control probes.\n\nStaging was determined as T1cN1MX, stage IIA. Radiologic findings included a spiculated mass in the upper inner quadrant, and ultrasound-guided core biopsy was performed using a 10-gauge device. A biopsy clip was successfully placed and confirmed on post-procedure imaging. The mass measured up to 2.0 cm on glass slide evaluation. No microcalcifications or other significant proliferative disease patterns were noted. A vacuum-assisted ultrasound-guided core biopsy was performed on a solid irregular mass at the 1:00 position in the right breast, with successful deployment of a biopsy marker clip. Post-biopsy mammogram confirmed appropriate clip placement."} +{"pid": "TCGA-BP-4776", "report": "The submitted specimen from a left partial nephrectomy consists of a renal parenchymal segment measuring 4.2 x 3.4 x 2.8 cm with attached fat, measuring 7.5 x 6 x 1.2 cm. The outer surface of the fat is marked blue and the resected kidney margin is marked black. On sectioning, there is an encapsulated, partially cystic and hemorrhagic lesion with an orange cut surface. The lesion measures 2.7 cm in greatest dimension and is located within the kidney without extension into the renal capsule or surrounding fat. It is situated 0.2 cm from the resected margin. Sections submitted include representative portions of the lesion with adjacent fat, the resected margin, and normal kidney tissue. Microscopic evaluation reveals a neoplasm composed of cells with clear cytoplasm and nuclear features classified as intermediate grade. The margins of resection show no evidence of tumor. The surrounding non-neoplastic kidney tissue appears histologically unremarkable. No lymph nodes or adrenal tissue were identified. Staging classification reflects a localized lesion confined to the kidney, measuring less than 7 cm in diameter."} +{"pid": "TCGA-AR-A24L", "report": "The specimen from the right breast wide local excision contains a mass measuring 2.5 x 2.1 x 1.0 cm. Histologic evaluation shows invasive malignancy with features consistent with Nottingham grade 2 (out of 3). A component of intraductal proliferation is also present, characterized as solid type without necrosis and with nuclear features considered high grade. Vascular space invasion is identified. Following re-excision of the inferior and deep margins, all margins are clear by at least 1.0 cm. The overlying skin margin does not show any abnormality. In the sentinel lymph node group, 2 out of 5 nodes show evidence of involvement by malignant cells, while 7 additional axillary lymph nodes do not contain tumor. Hormone receptor and HER2 testing have been initiated on formalin-fixed tissue."} +{"pid": "TCGA-WC-A882", "report": "The right eye measures 23 mm in axial length and 22 mm in both horizontal and vertical dimensions. The optic nerve is 6 mm in length. The cornea is clear, measuring 12 mm horizontally and vertically. The anterior chamber is clear, with a round pupil measuring 6 mm in diameter. The iris is tan-gray in color. The sclera appears unremarkable on gross examination. Transillumination reveals a shadow extending from the limbus to approximately 12 mm from the optic nerve head. Upon sectioning, a tan-brown lesion measuring 12 x 10 mm at its base and 8 mm in height is identified within the uveal tract, involving the ciliary body and choroid. The underlying sclera appears intact. Histologic sections include superior temporal (A1), superior nasal (A2), inferior nasal (A3), and inferior temporal (A4) vortex veins, as well as sections of the optic nerve (A5, A8), and calotte regions (A6, A7). Microscopic evaluation reveals spindled cells arranged in elongated fascicles. Mitotic activity is minimal, with less than one mitosis per ten high power fields. Periodic Acid-Schiff (PAS) staining highlights irregular structures within the lesion. No tumor involvement is seen in the vortex veins or optic nerve. There is no evidence of extraocular extension. Scleral invasion is limited to a small focus. The canal of Schlemm is not involved. No clinical history was provided."} +{"pid": "TCGA-G4-6311", "report": "The specimen consists of a right hemicolectomy including a segment of large intestine measuring 22 x 8.5 cm and a portion of distal ileum measuring 1 x 3.2 cm. An exophytic lesion measuring 3.9 x 3.2 x 0.5 cm is present in the large intestine, located 4.5 cm from the ileocecal valve. The serosal surface overlying this lesion is inked. Invasion into the muscularis propria is noted grossly. The ileocecal valve mucosa contains a slightly sessile polypoid granular area measuring 2.0 x 2.0 x 1.3 cm. Another possible polyp is identified 4.8 cm from the first polyp and located 3.1 cm distal to the primary lesion; it measures 2.0 x 1.5 x 0.4 cm. Pericolic fat was submitted for fixation and multiple lymph nodes were identified, ranging from 0.1 to 0.5 cm in diameter.\n\nMicroscopic evaluation reveals a moderately to poorly differentiated glandular neoplasm involving the subserosa. One out of thirty-seven lymph nodes contains neoplastic cells; the involved node measures 0.4 cm and is located in the pericolic fat beneath the invasive lesion. Proximal, distal, and radial margins are free of involvement. Additional findings include multiple tubular adenomas at the ileocecal valve and adjacent to the invasive lesion, as well as a hyperplastic polyp. Vascular and perineural invasion are present. The extent of resection is complete with no residual tumor at the margins.\n\nImmunohistochemical analysis of the lesion demonstrates preserved expression of MLH1, MSH2, MSH6, and PMS2. Internal controls, including peritumoral lymphocytes and normal glands, also show appropriate staining. Testing for microsatellite instability has been initiated and results will be reported separately."} +{"pid": "TCGA-XU-A92V", "report": "The thymic specimen weighed 106 g and measured 12.0 x 6.0 x 3.5 cm. A well-defined, lobulated mass was identified within the tissue, measuring 5.0 x 4.3 x 3.5 cm. The mass was partially cystic with a tan, solid, firm consistency and appeared to be encapsulated. The cystic component contained yellow fluid, with the largest cyst measuring 3.1 cm. The outer surface of the specimen was marked with silver nitrate, and fibroadipose tissue was attached. No grossly identifiable lymph nodes were present in the surrounding tissue.\n\nMicroscopically, the lesion exhibited multiple internal fibrous septations and displayed a biphasic pattern. Areas of bland spindled cells were intermixed with regions containing small lymphocytes and epithelioid cells. The tumor capsule was intact in most areas but showed several foci of microscopic extension into the surrounding fat, consistent with transcapsular invasion. The distance from the tumor to the closest margin was less than 1 mm at multiple surfaces; however, these areas were interpreted as not representing true resection margins, and the tumor appeared to be completely excised. No lymphovascular invasion was identified.\n\nImmunohistochemical staining demonstrated that the epithelial component was strongly positive for pankeratin (AE1/AE3), CK5, and p63, and negative for CD5. Many of the background lymphocytes were positive for TdT, CD3, CD5, and CD1a.\n\nTwo lymph nodes from the inferior cervical region were examined, with no evidence of malignancy identified. A total of two lymph nodes were negative (0/2).\n\nThe histologic findings included features suggestive of both medullary and cortical differentiation. The specimen also showed involutional changes in non-tumor involved thymic tissue. Based on the microscopic findings, the lesion was classified with a stage corresponding to microscopic transcapsular invasion. No treatment effect was noted, and distant metastasis could not be assessed."} +{"pid": "TCGA-DD-AACZ", "report": "The liver specimen measured 15.0 x 11.0 x 5.5 cm and weighed 477 grams. A large mass was identified, measuring 8.8 x 7.5 x 6.8 cm, with a well-demarcated, yellowish-tan, round, and solid cut surface. The mass was multinodular and confluent, and appeared to be confined within the liver capsule. The resection margin was not involved macroscopically, with a safety margin of 0.5 cm; however, microscopically, the tumor was very close to the surgical margin, less than 0.1 cm away. The surrounding liver tissue appeared unremarkable on gross examination.\n\nHistologically, the tumor showed a trabecular and tubular growth pattern with hepatic-type cells. Fibrous capsule formation was present, and there was evidence of capsular infiltration with extension into the gallbladder. Septum formation and vascular invasion were also noted. There was no serosal or portal vein invasion observed. The gallbladder wall measured 0.2 cm in thickness, with a smooth serosal surface and a dark green, velvety mucosa; no mural nodules were seen. No cholangiocarcinoma or fatty change was identified.\n\nLymph node biopsy from station '12' showed no evidence of tumor involvement. Lymphovascular emboli were present in the liver specimen. Multiple peritoneal fluid smears were submitted and showed no inflammation or malignant cells."} +{"pid": "TCGA-3B-A9HU", "report": "A retroperitoneal mass was resected en bloc with segments of the duodenum and colonic mesentery. The lesion measured 7.9 cm x 7.4 cm x 7.1 cm and demonstrated a mitotic rate of 5\u20136 per 10 high-power fields. Necrosis was present, involving approximately 10% of the tissue. Histologic evaluation showed that both proximal and distal bowel margins were free of tumor involvement. All soft tissue margins, including anterior, posterior, proximal, and distal, were also uninvolved. The tumor was located 0.1 mm from the proximal soft tissue margin and 0.2 mm from the distal soft tissue margin.\n\nImmunohistochemical staining performed on selected blocks revealed positivity for Actin and focal weak positivity for Desmin. The lesion was negative for CD34 and DOG-1. A Ki-67 proliferation index of approximately 90% was observed. Gross examination described the mass as ovoid, smooth-to-shaggy, purple-gray, and firm, with a thinly encapsulated, lobulated, tan-gray cut surface. Minimal congestion and less than 10% necrosis were noted. The mass was adherent to the overlying small bowel serosa.\n\nA separate specimen from the proximal gonadal vein consisted of a 0.6 cm tan-gray soft tissue fragment, which showed no evidence of malignancy. All relevant sections were submitted and reviewed, with comprehensive margin assessment confirming no residual tumor at resection margins. The case was personally reviewed by the attending pathologist, with all materials and slides evaluated to confirm findings."} +{"pid": "TCGA-QH-A6X8", "report": "The specimen was obtained from a female patient with a lesion located in the left frontal region. Gross examination revealed a solid mass measuring approximately 4.5 cm in greatest dimension. Histologic evaluation demonstrated a densely cellular neoplasm composed of uniform cells with round to oval nuclei and clear cytoplasm. Nuclear pleomorphism was present, along with frequent mitotic figures. Microvascular proliferation and scattered areas of necrosis were identified. Immunohistochemical staining showed positivity for IDH1 and nuclear expression of ATRX was retained. The tumor exhibited diffuse infiltration into the surrounding brain parenchyma. Based on histologic features and immunoprofile, the lesion is classified as a high-grade neuroepithelial neoplasm. Staging workup did not reveal evidence of metastasis or involvement of regional lymph nodes."} +{"pid": "TCGA-QT-A5XO", "report": "The left adrenal specimen weighed 17.6 grams and measured 5.4 x 3.0 x 2.5 cm. A mass measuring 3.0 x 2.5 x 2.0 cm was identified within the adrenal gland, with a yellow/tan color and focal areas of necrosis. The mass was well demarcated, soft, and abutted the adrenal capsule. Microscopic evaluation revealed a neoplasm with nested and diffuse architectural patterns. The cells demonstrated high nuclear-to-cytoplasmic ratios, focal spindle cell morphology, and variable nuclear pleomorphism with areas of nuclear hyperchromasia. No coagulative tumor cell necrosis, increased mitotic activity, atypical mitotic figures, cellular monotony, extra-adrenal extension, or vascular invasion was observed. The neoplasm focally extended to inked surfaces in several blocks and reached the cautery margin in block A2, indicating possible involvement of the surgical margin. Histologic scoring yielded a total of 8 out of 20, with scores above 4 considered potentially indicative of aggressive behavior. Lymph node examination was not performed as no lymph nodes were submitted for analysis."} +{"pid": "TCGA-BC-A10S", "report": "A partial hepatic resection specimen from the left lobe of the liver weighs 362 grams and measures 13.5 x 10.5 x 5.0 cm. The specimen contains a well-circumscribed, intact mass measuring 8.0 x 7.5 x 5.0 cm that protrudes from the surface. A spherical defect is present at the base where tissue was procured. The surgical margin is marked with black ink. The cut surface of the mass reveals central areas of yellow/orange discoloration indicative of necrosis and hemorrhage. The mass is separated from the surgical margin by 1.2 cm, and no additional masses are identified within the liver tissue.\n\nMicroscopic evaluation demonstrates a well-defined and possibly encapsulated nodule composed of enlarged hyperchromatic hepatocytes arranged primarily in a trabecular pattern, including both micro- and macro-trabecular components. Focal pseudo-acinar structures are also present. Areas of tumor necrosis and hemorrhage are observed. There are suspicious changes suggestive of lymphovascular space invasion within the capsule (section #8). No satellite lesions are apparent, and the surgical margins are free of tumor involvement. Adjacent liver tissue shows normal architecture without significant fibrosis or steatosis."} +{"pid": "TCGA-DD-A4NR", "report": "REWRITTEN REPORT: The specimen includes a portion of liver segment VIII weighing 110 grams and measuring 8.5 x 8.5 x 6.0 cm. A mass measuring 5.0 x 4.5 x 4.0 cm is present within the tissue. Histologic evaluation shows high-grade cellular atypia with architectural disarray. The lesion is located in segment VIII, and the hepatic capsule is unaffected. Surgical margins are clear, with a margin clearance of 1.6 cm noted grossly. There is no evidence of extratumoral vascular invasion. The lesion lacks a distinct capsule and demonstrates a non-infiltrative pattern at the periphery. An addendum notes the presence of diffuse parenchymal changes consistent with advanced fibrotic disease, characterized by bridging fibrosis and regenerative nodules on Trichrome stain. Iron staining is negative for hemosiderosis."} +{"pid": "TCGA-L9-A7SV", "report": "The surgical specimen consisted of a left lung lobectomy with associated lymph nodes and tissue fragments. The primary lesion was located in the lower lobe and measured 3.7 cm in greatest dimension. Histologic evaluation showed a unifocal tumor with no invasion of the visceral pleura. All surgical margins were free of invasive carcinoma, with the closest distance from the tumor to the bronchial margin measuring 3 mm. Lymphovascular invasion was identified.\n\nA total of 15 lymph nodes were examined; one peribronchial node attached to the lobectomy specimen showed involvement. Other lymph nodes, including those from levels 4, 5, 6, 7, 10, 11, and R4, as well as chest wall and hilar lymph nodes, were all reactive without evidence of malignancy. Additional findings included emphysematous changes in the lung parenchyma.\n\nThe tumor was histologically classified as grade 2. No treatment effect was observed. Pathologic staging was determined as pT2a for the primary lesion and pN1 for regional lymph node involvement. Distant metastasis could not be assessed. \n\nIntraoperative frozen section analysis of multiple lymph node levels and bronchial margins confirmed absence of malignancy in the evaluated margins and presence of reactive lymphoid tissue. The specimen was intact and adequately oriented for pathological assessment."} +{"pid": "TCGA-63-A5MH", "report": "The sample was obtained from a resected tissue specimen collected in the left lower lobe. The tumor measured 2 cm in size. Histological examination revealed a moderately differentiated carcinoma with squamous features. Pathological staging showed no evidence of regional lymph node involvement (pathological N0) and no clinical signs of distant metastasis (clinical M0). The VALCSG stage was determined based on these findings. A separate histological comment noted the presence of focal obstructive pneumonitis. No diagnosis or specific tumor name is provided in this summary."} +{"pid": "TCGA-VR-A8ER", "report": "The specimen includes the thoracic and abdominal esophagus and proximal stomach, obtained following an esophagogastrectomy procedure. The tumor is located in the distal esophagus and stomach region, measuring 7.8 cm in its greatest dimension. Histologic evaluation shows an ulcerated squamous cell carcinoma with moderate differentiation (G2). Microscopic examination reveals that the tumor invades through the mucosa, submucosa, muscularis propria, and into the adventitia. No lymph-vascular or perineural invasion is identified. The proximal and distal margins are free of tumor involvement; however, the circumferential (radial) margin is involved by invasive carcinoma. \n\nA total of 8 regional lymph nodes from the lesser curvature were examined, with 3 showing involvement by neoplastic cells. Six lymph nodes along the hepatic artery were assessed, none of which contained neoplastic cells. The margin of the stomach is also uninvolved by carcinoma."} +{"pid": "TCGA-ZF-A9R7", "report": "The specimen consisted of two tissue samples, one comprising three pieces measuring up to 11 mm in size along with a fragment, and the other consisting of 13 grams of soft friable fragments. Microscopic examination revealed an extensively necrotic infiltrating tumor with a solid growth pattern. The tumor was poorly differentiated and graded as Grade 3. Invasion of the muscularis propria was observed, corresponding to pT2 staging. No vascular channel invasion was identified. Flat urothelium without dysplasia was present in the background."} +{"pid": "TCGA-66-2792", "report": "The left lung specimen measured 14 x 9 cm at the base and up to 27 cm in height. A central bronchus resection was performed, with the resection plane located 2.5 cm proximal to the upper lobe bronchus bifurcation. The pleural fissure showed a cord-shaped area of obliteration measuring 10 x 5 cm dorsally, with extensive adhesion in parts of the parietal pleura over segment 6. A mobile grayish-black lymph node measuring 0.5 cm was found at the hilus.\n\nA central, hard pale brown to whitish lesion was identified in the lower lobe bronchus, constricting the bronchus at the bifurcation and proximally. The lesion extended into the main bronchus and reached up to the hilar resection surface. The tumor had unclear borders and measured up to 5 cm in its largest dimension, with a distance of at least 2 cm from the central bronchus resection plane. Irregular mucosal protrusion measuring approximately 1.5 cm was observed proximal to the lower lobe bronchus ostium, with areas of cracking noted. Several grayish-black lymph nodes up to 1.5 cm were involved by the lesion. The tumor crossed the pleural fissure and infiltrated the adjacent upper lobe.\n\nIn segment 4, a 0.6 cm pale brown to gray area was identified at least 1.2 cm from the tumor margin, with relatively clear demarcation. This region was located at least 1.5 cm from the pleura. In segment 6, the parenchyma near the tumor appeared indurated and patchy with brownish-gray discoloration. Lesion extension reached the zone of pleural adhesion. Apical parenchyma in segment 1 showed coarsely cystic rarefaction with lacunar structures up to 2.5 cm. There was diffuse solidification of the lower lobe parenchyma. A subpleural ventromedial blackish node measuring 0.5 cm was present in segment 3, and a similar 0.9 cm node was found subpleurally in segment 6.\n\nLymph node stations examined included: hilar (station 10) left (1.3 cm), pulmonary ligament (station 9) left (0.4 cm), subcarinal (station 7) (2.3 cm), paraaortic (station 6) left (0.4 cm), subaortic (station 5) left (1.2 cm and 1 cm), low paratracheal (station 4) left (0.9 cm and 0.6 cm), and hilar (station 10) right (1 cm). Tissue blocks included samples from the tumor, bronchus, hilar resection surface, peribronchial areas, segments 1, 3, 6, and 8, as well as lymph nodes and resection margins. Histological staining included Elastica-van Gieson, PAS, and diastase-PAS.\n\nResection margins of the bronchus and vessels, hilar resection surface, and small intrapulmonary lymph nodes were free of tumor involvement, as were lymph nodes from sample 2. Additional findings included active chronic and organizing pneumonia at the tumor margin, cicatricial or chronic atelectasis in segment 6 with pleural adhesion, subpleural bullous emphysema in the upper lobe apex, and intraalveolar accumulation of brown and anthracotic pigment-laden macrophages. Lymph nodes showed reactive changes and anthracotic pigment deposition.\n\nStaging was revised to pT2(2) pN1 pMX R0, corresponding to stage IIB. The primary lesion was determined to be bifocal with the main focus located in the left lower lobe."} +{"pid": "TCGA-DD-AA3A", "report": "The resected specimen from the left lobe and segment VI of the liver contains a mass measuring 5.8 x 5.3 x 4.0 cm. Histologic evaluation reveals high-grade cellular atypia with features suggestive of aggressive neoplasia. No microvascular invasion is identified upon microscopic examination. A single regional lymph node examined is without evidence of tumor involvement. All surgical margins are free of neoplastic cells, with the closest margin measuring 0.1 cm. The surrounding non-neoplastic liver tissue appears histologically normal. Additional biopsies of the paracaval and hepatic artery lymph nodes show no presence of malignancy."} +{"pid": "TCGA-OR-A5J8", "report": "The specimen consists of a product of en-bloc resection of the left kidney and an adrenal mass, weighing 2468.9 grams and measuring 24 x 20 x 10 cm, entirely surrounded by fatty tissue. The adrenal mass measures 19 x 17 x 12.4 cm and has a heterogeneous cut surface with multilobulated yellow areas and scattered purple spots. Approximately 20% of the mass contains necrotic regions. The left kidney is displaced inferiorly and measures 10 x 6.5 x 5.5 cm, with no macroscopic abnormalities observed. The ureter appears somewhat dilated, measuring 8.5 x 1.5 cm. Surgical margins were marked with green Indian ink.\n\nHistologically, the lesion exhibits a diffuse architectural pattern with less than 25% clear cells present. Nuclear grading according to Fuhrman classification is grade 4. Necrosis is evident, with a mitotic count of 28 per 10 high-power fields. Atypical mitoses are identified. Capsular invasion and venous invasion are present, while sinusoidal invasion is not detected. The WEISS score is 8. No evidence of neoplastic infiltration is seen in the renal parenchyma."} +{"pid": "TCGA-KS-A4I1", "report": "A 0.002 gram, 0.3 cm red tissue bit was submitted for frozen section analysis as part of a surgical procedure. The tissue was interpreted as parathyroid in origin based on frozen section evaluation, and this finding was confirmed on permanent sections.\n\nA thyroidectomy specimen was received in formalin, weighing 25.01 grams. The specimen included a right lobe measuring 5.5 x 3.2 x 1.5 cm, a left lobe measuring 4.5 x 2.2 x 1.6 cm, and an isthmus measuring 3.0 x 1.5 x 0.8 cm. Serial sectioning of the right lobe revealed a 2.2 cm white encapsulated lesion with no apparent involvement of margins; surrounding parenchyma appeared unremarkable. The isthmus showed tan mahogany parenchyma without abnormalities. The right lobe also contained a small 0.4 cm white whorled nodule. Sections were taken from various regions including the lesion in the right lobe, grossly unremarkable areas of both lobes and isthmus, and a small lesion identified in the left lobe.\n\nLymph node dissection was performed for Level VI, yielding an aggregate of fibroadipose material measuring 4.5 x 1.5 x 0.5 cm. Upon careful examination, no definitive lymph nodes were identified within the specimen.\n\nMicroscopic evaluation of the right lobe lesion demonstrated features of capsular invasion. Surgical margins were focally positive in the right lobe but negative on the left side. No vascular invasion or extrathyroidal extension was observed. A small focus of abnormal tissue was identified in the left lobe measuring 0.4 cm. Evaluation of four lymph nodes from Level VI showed no evidence of malignancy.\n\nRepresentative sections were examined by the pathologist who personally reviewed and interpreted all slides related to this case."} +{"pid": "TCGA-98-A53I", "report": "A soft tissue mass was identified in the right chest wall and measured 14.0 x 10.0 x 6.5 cm. The tissue was yellow in color with a firm consistency and no cystic features. Histologic examination revealed mature adipose tissue.\n\nMultiple lymph nodes were evaluated from various levels including II, IV, VII, VIII, IX, X, and XI. All lymph nodes examined showed no evidence of malignancy. Several lymph nodes contained hyalinized calcified granulomas. Fibroadipose tissue was noted in some specimens, and no lymph node tissue was identified in certain submissions.\n\nA pulmonary lesion was observed in the right upper lobe. Microscopic evaluation demonstrated moderately differentiated carcinoma involving a cartilaginous structure. The tumor measured approximately 3.3 cm based on radiologic estimation due to fragmentation of the specimen. The lesion was located adjacent to a staple line, and margins were free of tumor involvement. There was no invasion of the pleura identified.\n\nMetastatic involvement was detected in one of five peribronchial lymph nodes examined. Additional findings included mild centriacinar emphysema and several hyalinized granulomas within non-neoplastic lung parenchyma.\n\nFrozen section analysis confirmed the presence of carcinoma at the bronchial resection site. The bronchial margin itself was negative for malignancy upon final evaluation.\n\nThe pathological staging indicated involvement of the primary tumor with regional lymph node metastasis. No distant metastasis was assessed.\n\nRepresentative sections of all specimens were submitted for histological review."} +{"pid": "TCGA-21-5782", "report": "The specimen consists of two parts. The first, labeled #1, corresponds to a wedge biopsy of the left lower lobe of the lung. It weighs 84.8 grams and measures 13.5 x 5.0 x 3.0 cm. The pleura is red-purple with areas of anthracotic staining and is stapled along one margin. The pleural margins are marked in black ink, while the newly created staple-free margin is marked in blue. Serial sectioning reveals a glistening red-purple cut surface with a 3.5 x 3.0 x 3.0 cm firm mass. The mass has a tan appearance with focal hyperemia and a slightly nodular texture. Sections submitted include those from the tumor with blue-stapled margin (1A-1B), tumor with pleural margin (1C-1D), an additional representative section of the tumor (1E), and random sections of lung tissue (1F).\n\nThe second part, labeled #2, corresponds to a lymph node from level 9L. It measures 1.0 cm in greatest dimension, is gray-black in color with anthracotic pigmentation, and was entirely submitted for analysis. Histological evaluation of the lymph node did not show any abnormal cellular infiltration.\n\nHistological assessment of the lung tissue shows invasive growth within the pulmonary parenchyma characterized by poorly differentiated cells. The resection margins, including the pleural and stapled margins, are free of involvement. Emphysematous changes are noted in the surrounding lung tissue."} +{"pid": "TCGA-86-8359", "report": "The lung specimen demonstrates increased volume with involvement of the lobar bronchus; the proximal portion remains free while the distal segment is obstructed by a tumoral process occupying approximately two-thirds of the lower lobe. Upon sectioning, the lesion measures 12 \u00d7 10 cm, appears well-defined, and exhibits a white appearance with focal areas of necrosis and hemorrhage, along with mucous secretions on its surface.\n\nMicroscopically, the tumor consists of tubular-papillary structures lined by stratified cylindrical epithelium. Cellular features include moderate pleomorphism and infrequent mitotic figures. Some cells display vacuolated cytoplasm with intracellular necrotic material and glandular space involvement. The stroma shows fibrous organization, abundant vessels with signs of stasis, and a moderate diffuse lymphocytic infiltrate.\n\nEvaluation of the pulmonary parenchyma reveals diffuse interstitial fibrosis, vascular stasis, and alveolar macrophage accumulation. Small subpleural emphysematous changes are also present.\n\nLymph node assessment shows varied findings across stations. One lymph node contains metastatic involvement, identified by the presence of tubular-papillary structures with mucinous features. Other lymph nodes exhibit reactive changes including sinus histiocytosis, follicular hyperplasia, and vascular stasis, without evidence of neoplastic infiltration.\n\nAdditional findings include lymphatic and venous invasion within the lung tissue. Surgical margins are uninvolved. No definitive assessment is available regarding prior treatment or additional nodules."} +{"pid": "TCGA-A8-A06Y", "report": "The specimen shows a tumor with a maximum diameter of 2.5 cm. Histological evaluation reveals invasive growth patterns with moderate cellular atypia and a significant intraductal component, characterized by high-grade features and comedo-type morphology. Within the tumor, there are areas containing isolated coarse calcifications, comprising approximately 20% of the tumor volume. The invasive component forms confluent masses within the tumor center, while intraductal formations are more prominent toward the periphery.\n\nAssessment of resection margins demonstrates a narrow medial margin, previously noted on gross examination. In addition, extensive intraductal formations extend to within 0.5 cm of the dorsal resection edge. The lateral and superior margins, marked by dye, show no evidence of atypical cells. Background tissue shows features consistent with benign mastopathic changes.\n\nLymph node staging based on sentinel lymph nodes (n=3) reveals no metastatic involvement. No vascular or lymphatic invasion was identified. Cellular differentiation is intermediate, with a histologic grade corresponding to G2."} +{"pid": "TCGA-4X-A9FB", "report": "A 92 g specimen of thymic tissue measuring 18.0 x 6.0 x 3.8 cm was received, containing a 4.0 x 3.3 x 3.0 cm tan-white fleshy nodule with central necrosis. Microscopic evaluation showed a tumor composed predominantly of large polygonal cells with vesicular nuclei and prominent nucleoli, set against a background of lymphocytes. Focal areas demonstrated confluent sheets of tumor cells with enlarged hyperchromatic nuclei, interpreted as degenerative changes without evidence of increased or atypical mitotic activity. Immunostains performed supported the cellular findings. The tumor focally approached the inked/cauterized margin and exhibited microscopic invasion into surrounding adipose tissue. Pathologic staging was determined as Stage II (Masaoka classification). Additional biopsies from the right superior pole, a separate thymus biopsy, and diaphragm biopsy showed no evidence of tumor. The diaphragm biopsy revealed fragments of bone and cartilage only. Frozen section analysis during surgery indicated thymoma, with classification deferred pending full margin assessment. Subsequent review of deeper sections from blocks with suspected margin involvement confirmed tumor proximity but no transection. All other tissues submitted for examination were negative for tumor involvement."} +{"pid": "TCGA-B6-A0WS", "report": "A left breast biopsy specimen was received for evaluation. The specimen consisted of 83 grams of fatty tissue measuring 7.5 x 7 x 3 cm, which included a firm white stellate mass measuring 1.5 x 1.5 x 1.3 cm. The mass was located 0.8 cm from the superior-inferior border on the anterior surface and 1 cm from the deep margin. A short suture marked the superior margin, a long suture marked the lateral margin, and the deep margin was inked blue. The superior margin was black, and the inferior margin was red. A region of extensive rubbery, white fibrous tissue was noted lateral to the mass and distinct from it.\n\nThe mass and surrounding tissue were submitted in full, with representative sections of the fibrous area taken sequentially from medial to lateral in blocks A1 through A14, with the mass located in blocks A2 through A8. Intraoperative gross consultation confirmed the distance of the mass from the resection margins.\n\nMicroscopic evaluation revealed a histologic grade 2 lesion based on standard criteria, with a nuclear grade also rated as 2. The largest dimension of the lesion measured 1.6 cm. There was evidence of in-situ changes occupying less than 10% of the total volume, exhibiting solid and cribriform patterns. No definitive lymphatic or vascular invasion was identified. All surgical margins were free of involvement. The adjacent breast tissue showed mild fibrocystic change.\n\nHormone receptor analysis was performed on fresh tissue. Estrogen receptor activity was positive with an estimated value of 39 FMOL, while progesterone receptor activity was negative with an estimated value of 0 FMOL. A detailed report on receptor status was provided separately."} +{"pid": "TCGA-HE-A5NI", "report": "The specimen was obtained from a resection procedure performed on the left kidney. The tumor measured 4 cm in size. Histological analysis showed a nuclear grade of 3 out of 4 according to Fuhrman classification, indicating moderate to poorly differentiated cells. Staging information indicates a T1a classification for the primary tumor, with no lymph node assessment available (NX) and no evidence of distant metastasis (M0). The sample collection included both tumor tissue and buffy coat material. No further diagnostic terms were provided."} +{"pid": "TCGA-KK-A7AP", "report": "A posterior bladder neck specimen consists of smooth muscle with a few distorted prostatic glands. A second posterior bladder neck specimen, with the margin marked by ink, shows only smooth muscle without any prostatic glands or abnormal findings. On the left pelvic side, an aggregate of fibroadipose tissue measuring 7.5 x 5.5 x 1.1 cm was examined, containing six possible lymph nodes ranging in size from 0.3 x 0.3 x 0.3 cm to 5.0 x 1.2 x 0.8 cm. One of these lymph nodes contains a metastatic focus measuring 4.0 mm, and extranodal extension is present. On the right pelvic side, a similar aggregate of fibroadipose tissue of the same overall dimensions contains eleven possible lymph nodes ranging from 0.3 x 0.2 x 0.1 cm to 3.0 x 1.5 x 0.7 cm. One of the nine lymph nodes identified contains a metastatic focus also measuring 4.0 mm, and extranodal extension is also noted.\n\nThe prostate and seminal vesicle specimen includes a prostate measuring 5.1 x 3.2 x 3.4 cm and weighing 35 grams after fixation. A nodule is palpated in the right base region. Serial cross sections reveal a firm area consistent with a lesion in the right peripheral zone. The lesion measures 2.5 x 2.0 cm in its largest cross-sectional dimension and spans three cross sections of the prostate, involving the apex and more extensively the base region. There is multifocal and extensive extension beyond the prostatic capsule, including involvement of the right lateral and posterior surfaces, right superior neurovascular bundle region, and the base (bladder neck) area. The lesion extends into the right seminal vesicle and perivesicular soft tissue. The margin of resection at the anterior bladder neck shows involvement, with approximately 6.0 mm of cauterized tissue affected. Focal extension to the perivesicular cauterized margin remains uncertain. Perineural and lymphovascular invasion are present. The remainder of the prostate, seminal vesicles, and vasa deferentia appear unremarkable on gross examination."} +{"pid": "TCGA-QR-A70M", "report": "The left adrenal specimen measures 10.4 x 5.5 x 3.5 cm and weighs 62 grams. It consists of a pink-yellow soft tissue fragment with an external orange rim measuring 4.6 x 1 x 0.5 cm, consistent with adrenal cortex. The specimen is inked in black and bisected longitudinally, revealing a central brown-tan friable mass with areas of hemorrhage and necrosis. The mass measures 4.9 x 4 x 3.5 cm. Gross photographs are taken for documentation. Approximately 80% of the mass is viable-appearing tumor, and a small portion of grossly uninvolved adrenal tissue (1 x 1 x 0.5 cm) is also submitted for research purposes. \n\nMicroscopically, the tumor cells demonstrate immunoreactivity for chromogranin, synaptophysin, and CD56. Sustentacular cell staining is present. Representative sections of both the mass and uninvolved adrenal tissue are submitted for permanent processing. The case includes performance details of laboratory-developed tests used in evaluation, noting that they have not been cleared or approved by the U.S. Food and Drug Administration, although the FDA has determined such clearance is unnecessary. The laboratory is certified under CLIA to perform high-complexity testing."} +{"pid": "TCGA-GJ-A6C0", "report": "The specimen consisted of four parts. Specimen A, labeled as gallbladder, measured 8.5 x 3.3 x 2.4 cm and showed multiple stones with dark green bile. The gallbladder wall was edematous with uniform mucosal thickness of 0.2 cm. Microscopic examination revealed cholelithiasis with prominent Rokitansky-Aschoff sinuses.\n\nSpecimen B, identified as a partial hepatectomy, measured 16.7 x 16.5 x 10.2 cm. A nodular white mass measuring 14.2 x 9.5 x 16.5 cm was observed within the liver tissue. This mass exhibited both cystic and solid areas, with hemorrhagic components noted in the cystic regions. The closest distance from the mass to the inked surgical margin was 1.5 cm. Histologic evaluation demonstrated moderately differentiated morphology with scattered PAS-positive intracellular globules present in non-neoplastic hepatocytes. No cirrhosis was identified. Microscopic examination of the surgical margins showed no involvement by invasive carcinoma. Microscopic lymph-vascular invasion was identified, though macroscopic venous invasion was not present. Based on TNM staging criteria, the primary tumor was classified as pT2. There was no evidence of regional lymph node or distant metastasis.\n\nSpecimen C, representing right colon and distal ileum, measured 19 cm in length for the large bowel and 6.5 cm for the attached small bowel. A defect measuring 1.2 cm in diameter was identified in the large bowel, located 9.8 cm from the proximal margin. Gross findings included fecal leakage through this defect and fibrinopurulent adhesions on the serosal surface. Microscopic evaluation confirmed ulceration with perforation, acute peritonitis, and fibrous adhesions. Multiple lymph nodes were identified in the mesenteric fat and submitted for evaluation.\n\nSpecimen D, labeled as small bowel, measured 3.5 cm in length with an average diameter of 1.3\u20131.8 cm. Both ends were stapled shut, and a suture near a possible defect was noted. Microscopic examination revealed fibrous adhesions and acute peritonitis.\n\nAdditional notes indicated that intraoperative consultation confirmed the tumor was 1 cm from the inked margin. The presence of PAS-positive globules in hepatic cells suggested the patient may carry an alpha-1-antitrypsin gene mutation."} +{"pid": "TCGA-BA-A6DA", "report": "The surgical pathology report includes multiple specimens. Specimen A, a pharyngeal plexus nerve biopsy, shows skeletal muscle, fibroadipose connective tissue, and nerve without any evidence of malignancy.\n\nIn the left neck dissections: \n- In level 2, 2 out of 14 lymph nodes contain metastatic cells measuring up to 1.8 cm with extracapsular extension. \n- In level 3, 3 out of 13 lymph nodes show metastatic cells with a maximum size of 2.8 cm and extracapsular extension. \n- In level 4, all 13 lymph nodes are free of metastatic involvement. \n\nOn the right side: \n- Level 2 dissection reveals 2 out of 8 lymph nodes with metastatic cells measuring up to 3.2 cm without extracapsular extension. \n- In level 3, 1 of 15 lymph nodes contains metastatic cells measuring 2.4 cm, without extracapsular extension. \n- In level 4, 1 of 24 lymph nodes shows metastatic cells measuring 3 mm, also without extracapsular extension. \nAdditionally, two lymph nodes in the right level 4 dissection contain thyroid epithelium within the subcapsular sinus, raising concern for possible metastatic thyroid origin; however, no definitive features of papillary thyroid carcinoma are observed.\n\nThe laryngectomy specimen demonstrates a well-defined, centrally ulcerated mass with firm, raised borders. It originates in the supraglottis and involves both false vocal cords, extending across the midline into bilateral aryepiglottic folds. The tumor extends focally into the left glottis and anteriorly into the epiglottis, involving the epiglottic cartilage and adjacent hyoid bone. The tumor does not involve the thyroid cartilage or strap muscles. Gross measurement of the tumor is 3.9 x 3.8 x 1.6 cm. No angiolymphatic invasion is identified; however, multiple regional lymph nodes are involved. In situ carcinoma is present.\n\nMargins are negative but closely approached: the blue inked right margin is less than 1 mm from the tumor, the black inked left margin is 2 mm away, and the anterior margin is 6 mm from the tumor. The inferior tracheal margin and mucosal margins are free of invasive carcinoma, though in situ changes are noted.\n\nHistologic evaluation confirms moderately differentiated invasive carcinoma. Perineural invasion is noted. Immunohistochemistry for P16 is positive, and high-risk HPV testing is negative by ISH. Surgical staging is pT4a pN2c pMx. \n\nAdditional findings include the presence of thyroid epithelium in two lymph nodes from the right level 4 dissection, which may represent benign inclusions or raise suspicion for metastatic thyroid origin. Further clinical evaluation of the thyroid is recommended. \n\nMultiple blocks were submitted for histologic examination, including sections from all surgical margins, lymph nodes, and tumor-bearing areas. Tissue remains in formalin for further analysis as needed."} +{"pid": "TCGA-EB-A3Y6", "report": "The skin lesion measured 1x0x1.5 cm and was located on the hip. The lesion was pigmented and ulcerated, with a Breslow thickness of 4.5 mm. Histologic evaluation showed no evidence of venous invasion. Surgical margins were uninvolved. Tumor extent was greater than 4 mm, with no satellite nodules identified. Lymphatic invasion, lymph node status, and histologic grade could not be determined as they were not specified in the report. There was no evidence of neo-adjuvant treatment effect. No additional pathologic findings or comments were provided."} +{"pid": "TCGA-EL-A3ZS", "report": "The surgical specimen included a fragment of parathyroid tissue, which showed no evidence of neoplasm. The thyroid specimen measured 7.0 x 5.0 x 1.5 cm and included the right and left lobes as well as a prominent isthmus. A dominant nodule measuring 1.6 x 1.1 x 0.7 cm was identified in the isthmus adjacent to the left lobe. The nodule had a white-yellow, homogeneous appearance and was well circumscribed. No extrathyroidal extension was observed. Resection margins were negative. Histological evaluation revealed lymphovascular invasion. The background thyroid tissue showed features consistent with chronic lymphocytic thyroiditis, compatible with Hashimoto's thyroiditis.\n\nLymph node dissection was performed from multiple levels. In the periglandular region (level 6), 17 lymph nodes were examined, and 10 contained abnormal cellular infiltration. In the right level 4 region, 5 lymph nodes were sampled, with 1 showing similar findings. In level 4 and 5 B, 18 lymph nodes were evaluated, and 2 demonstrated comparable involvement. None of the involved lymph nodes showed extracapsular extension. All other submitted tissues, including a separate thymus sample, showed no abnormality."} +{"pid": "TCGA-33-AASB", "report": "The resected left upper lobe specimen contains a mass measuring 4.5 cm in diameter, located in the apical region adjacent to the hilum. The mass is tan-white, slightly lobulated, and situated approximately 0.5 cm from the pleural surface. It directly abuts a segmental bronchus, extending into the apex, and appears to encase the bronchus without penetrating through it. No involvement of the pleura is observed. Angiolymphatic invasion is present. The vascular and bronchial margins, as well as seven hilar lymph nodes, show no evidence of tumor involvement.\n\nOne lymph node from Level V, five from Level VI, and one from Level VIII were examined; all were negative for tumor. The mass demonstrates both squamous and glandular features. Pathologic staging is determined as T2N0MX. No satellite nodules or grossly positive hilar lymph nodes are identified. The remainder of the lung shows firm parenchyma with mucus plugging. Representative sections of the tumor, margins, involved airway, and lymph nodes have been submitted for analysis."} +{"pid": "TCGA-D8-A1JF", "report": "Examination of a fragment of breast tissue measuring 6 x 5 x 2 cm revealed a lesion approximately 1.2 x 0.8 x 0.7 cm located in the middle of the specimen. The closest margin measured 1 cm. Histological evaluation showed invasive growth with ductal features. Grading was based on mitotic count and other architectural features, scoring 3 + 3 + 2 out of 10. Tumor stage was classified as pT1c. Immunohistochemical analysis demonstrated absence of estrogen and progesterone receptors in the cell nuclei. HER2 protein expression was assessed using HercepTest\u2122 M by DAKO, showing a score of 1+ in the affected cells."} +{"pid": "TCGA-A2-A0CY", "report": "The specimen consists of right and left breast tissue along with lymph node samples from the left axillary region. The right breast shows benign changes including fibrocystic alterations such as sclerosis, microcyst formation, usual ductal hyperplasia, duct ectasia, and focal microcalcifications.\n\nThe left breast contains a well-defined mass measuring 3.5 x 3.2 x 2.8 cm located within the lower outer quadrant. The mass is deep within the tissue and approaches the superficial margin to within 0.4 cm. Histologic evaluation reveals high-grade cellular features with a Nottingham score of 9 (Tubules = 3, Nuclei = 3, Mitoses = 3). Necrosis and vascular invasion are present. There is an extensive intraductal component involving multiple areas, displaying solid and comedo-type morphology extending beyond the invasive portion. No involvement of the nipple or skin was observed.\n\nOne of twenty-two lymph nodes examined from the left axillary region shows evidence of metastatic involvement. This includes one positive lymph node among twenty removed from the axillary contents and one clinically suspicious non-sentinel lymph node that tested positive for metastatic disease. Immunohistochemical analysis of the sentinel lymph node and other lymph nodes showed no staining consistent with certain receptor expressions.\n\nPathologic staging reflects the tumor size and nodal status. Additional benign fibrocystic changes similar to those seen in the right breast were identified in the left breast tissue."} +{"pid": "TCGA-V4-A9EJ", "report": "Right eye enucleation specimen measures 25 by 25 mm with an optic nerve segment of 10 mm. A pigmented lesion is identified in the posterior region near the intraocular emergence of the optic nerve. The lesion measures 15 mm along its greatest dimension and has been sampled for cryopreservation. The entire specimen was processed after fixation.\n\nMicroscopic examination reveals a lesion composed of fusiform cells measuring 15 by 12 mm. It is located peripherally in the posterior segment, slightly distant from the intraocular origin of the optic nerve. The optic nerve appears unaffected throughout its extent, including the prelaminar, optic foramen, post-laminar, cut end, and meningeal sheath regions. There is superficial infiltration of the sclera; however, no extension beyond the scleral layer is observed. The ciliary body, iris, and anterior chamber remain uninvolved."} +{"pid": "TCGA-EJ-5527", "report": "The patient is a male with a serum PSA level of 7.7 ng/ml. A prior prostate needle biopsy showed malignancy involving the right side of the prostate, with a total linear extent of 1.2 cm. The patient underwent a radical prostatectomy and bilateral pelvic lymph node dissection. A total of nine lymph nodes were examined\u2014two from the right pelvic region and seven from the left\u2014with no evidence of neoplastic involvement.\n\nExamination of the prostate specimen revealed a lesion present in both lobes, measuring up to 2.1 cm in greatest dimension, accounting for approximately 10\u201315% of the sampled gland volume. Focal extension beyond the prostatic capsule was identified at the right posterior apex and right posterior mid-prostate. There was extensive perineural invasion; however, no vascular or lymphatic invasion was observed. All assessable surgical margins were free of tumor involvement.\n\nHistologic evaluation demonstrated a combination of Gleason patterns. The primary Gleason pattern was grade 4, and the secondary was grade 3, resulting in a Gleason score of 7. A high-grade tertiary component was also present, comprising approximately 60% of the tumor volume. Multifocal high-grade intraepithelial neoplasia was noted. The background prostate tissue showed nodular hyperplasia and chronic inflammation.\n\nThe final pathological staging was pT3a, indicating extension beyond the prostate without involvement of nearby structures or lymph nodes. The histologic grade was classified as G3\u20134, consistent with poorly differentiated morphology. Immunohistochemical analysis supported the diagnosis, showing absence of basal cells and positive staining with specific markers. Certain sections were technically limited, affecting margin assessment in some areas."} +{"pid": "TCGA-C5-A3HD", "report": "The specimen consists of four irregular grey-white tissue fragments measuring between 0.2 and 0.4 cm. Microscopic evaluation reveals the presence of a lesion with cellular atypia involving the full thickness of the epithelium. There is no evidence of lymphovascular space invasion. The patient is a woman with no clinical history provided, who underwent a cervical biopsy at the 10 o\u2019clock position. The tissue was submitted in a single container labeled A1. No further specific findings or additional diagnoses are noted."} +{"pid": "TCGA-E8-A418", "report": "The specimen demonstrates a unifocal lesion located on the right side, measuring 9.0 x 9.0 x 6.0 cm. Histologic evaluation reveals papillary architecture with associated cellular features. The lesion extends beyond the organ of origin, involving adjacent fat tissue. No additional foci are identified."} +{"pid": "TCGA-BQ-5883", "report": "The clinical history indicates a right kidney lesion. Two specimens were submitted for evaluation: one biopsy from the superior pole margin of the right kidney and one partial nephrectomy specimen.\n\nThe biopsy of the superior pole margin consists of three fragments of tan tissue measuring up to 0.7 cm in greatest dimension. Frozen section and permanent analysis revealed only benign adipose tissue.\n\nThe partial nephrectomy specimen is a wedge-shaped portion of kidney measuring 2.9 x 2.5 x 2.5 cm, with a suture marking the deep margin. Serial sections identified a yellow-brown mass measuring 2.5 cm in each dimension. The closest margin clearance was approximately 2 mm, and histologic evaluation confirmed that the surgical margins were free of tumor. The mass demonstrated mixed tubulopapillary and cystic architecture. Composed of cells with abundant eosinophilic cytoplasm, frequent cytoplasmic vacuoles, and round, relatively uniform nuclei, the cellular morphology was consistent with a low-grade neoplasm. No local invasion or renal vein involvement was identified. Non-neoplastic kidney tissue appeared normal; adrenal gland, lymph nodes, and other structures were not present in the specimen.\n\nStaging based on tumor size (\u22647.0 cm, confined to the kidney) corresponds to pT1. All findings were confirmed by permanent sections and reviewed during intraoperative consultation, which had previously indicated a renal cortical tumor with a clear margin."} +{"pid": "TCGA-06-1800", "report": "The clinical history indicates a brain mass. Two specimens were received: one measuring 0.6 cm and another measuring 2.5 x 1.5 x 0.5 cm, described as an irregular tan-pink soft tissue fragment. Both specimens were processed and entirely submitted for analysis. Histologic examination revealed biphasic patterns and immunohistochemical staining showed positivity for GFAP and reticulum. Staining for cytokeratin was negative. The proliferation index, as assessed by MIB-1 staining, was 50%. Microscopic evaluation included sections stained with hematoxylin and eosin, along with other specialized stains. All relevant sections were examined."} +{"pid": "TCGA-BR-8380", "report": "The specimen consists of a dissected portion of the stomach including the greater and lesser omentum. The stomach measures 13 cm along the lesser curvature and 20 cm along the greater curvature. A lesion is identified in the antral region, measuring 9 cm in length, with dimensions of 9 x 9 x 1.5 cm upon opening. The gastric wall is diffusely dense and thickened up to 1.5 cm. Fifteen lymph nodes are present within the greater and lesser omentum, ranging from 0.2 to 1.5 cm in diameter.\n\nMicroscopic evaluation reveals poorly differentiated carcinoma involving all layers of the gastric wall and extending into the omental tissue. Tumor elements are present at the distal surgical margins and within lymphatic channels. A total of fifteen lymph nodes were examined, of which eleven show evidence of metastatic involvement. The tumor demonstrates diffuse infiltration without venous invasion. Lymphatic and perineural invasion status is not specified. The surgical margins are involved, and there is no indication of prior treatment effect. No additional pathologic findings are noted."} +{"pid": "TCGA-AZ-5403", "report": "The patient underwent evaluation following a colonoscopy that identified a partially obstructing, fungating mass in the left colon near the splenic flexure. Bowel preparation was suboptimal due to partial obstruction, limiting further visualization. Biopsy of the lesion was performed. Histopathologic examination revealed an invasive moderately differentiated adenocarcinoma arising in the large intestine. The tumor measured 6.5 cm in diameter and extended through the muscularis propria into the serosal adipose tissue. No angiolymphatic invasion was observed; however, perineural invasion was present. All surgical margins were free of tumor involvement. Twelve pericolic lymph nodes were examined and none contained metastatic disease. Immunohistochemical staining for EGFR was attempted but yielded negative results; however, the reliability of this result is uncertain due to technical limitations during slide preparation. A repeat EGFR stain on metastatic tissue has been ordered and results are pending. The pathologic stage was determined as T3N0MX. According to traditional staging systems, the tumor was classified as Dukes\u2019 B and ASTRO-COLLER B2."} +{"pid": "TCGA-BP-4969", "report": "The submitted specimen consists of a right partial nephrectomy measuring 5.0 x 3.0 x 2.5 cm, with attached perinephric fat measuring up to 7 x 3.5 x 3 cm. The resected kidney margin is inked green and the outer surface of the fat is inked black. On gross examination, a well-circumscribed yellow-hemorrhagic lesion measuring 1.9 x 1.6 x 1.4 cm is identified within the renal parenchyma. It is located 0.8 cm from the resected margin and appears to abut the perinephric fat without clear evidence of invasion. The remainder of the renal tissue appears unremarkable.\n\nMicroscopic evaluation confirms the presence of a neoplastic lesion. Cellular features include nuclear morphology corresponding to grade II on a four-tier scale. No local invasion into surrounding structures is identified. Evaluation of vascular invasion involving the renal vein could not be determined. Surgical margins are negative for tumor involvement. No adrenal or lymph node tissue is present for evaluation.\n\nStaging classification indicates a tumor less than or equal to 7.0 cm in greatest dimension confined entirely within the kidney. Adjacent to the primary lesion, a small incidental finding measuring 3.5 mm is noted and interpreted as a papillary adenoma.\n\nSections examined include representative portions of tumor, adjacent fat, and unaffected renal parenchyma. A frozen section was obtained during intraoperative consultation and confirmed in permanent sections. No tissue was left frozen for further analysis. All findings are based on personal examination of the slides and relevant materials."} +{"pid": "TCGA-WS-AB45", "report": "A right hemicolectomy specimen was received, measuring 14.0 cm in length with a diameter of 4.5 cm, including two stapled margins. Upon opening along the antimesenteric border, a large friable fungating mass measuring 7.0 x 7.0 x 5.0 cm was identified in the cecum. The mass was circumferential and caused noticeable distortion of the specimen. It was located 5.5 cm from the distal resection margin and 4.5 cm from the proximal resection margin. Examination of the mass revealed an average thickness of 0.9 cm, with extension through the submucosa into the wall and focally into the pericolonic fat. The tumor was within 0.05 cm of the apparent serosal surface.\n\nThe remainder of the mucosa appeared tan-pink with normal mucosal folds, except for a 0.7 x 0.7 x 0.3 cm tan-pink polyp located 1.0 cm from the distal resection margin. An attached appendix measuring 10.0 cm in length with a 0.2 cm lumen filled with brown soft fecal material was also present and showed no involvement by the mass.\n\nLymph node assessment included 13 pericolic lymph nodes, all of which were unremarkable without evidence of malignancy. Surgical margins were negative; the closest distance of invasive tissue to any margin was less than 0.05 cm at the circumferential (radial) margin.\n\nHistologically, the lesion demonstrated features consistent with moderately to poorly differentiated morphology, characterized by abundant mucin and necrosis. No vascular or perineural invasion was identified. The tumor border configuration was described as pushing. An additional finding of a hyperplastic polyp was noted.\n\nPathologic staging was determined as pT3NOMx. The pT3 classification reflected invasion through the muscularis propria into subserosal tissue. Regional lymph node involvement was not identified (pNO), while distant metastasis could not be assessed (pMX). This stage was considered provisional and based solely on available pathologic data.\n\nImmunostains for pan-cytokeratin, CAM 5.2, and OSCAR performed on selected lymph node sections were negative, supporting the absence of metastatic disease. Multiple tissue blocks were submitted for microscopic evaluation, including representative sections of the mass, margins, lymph nodes, and other relevant structures. Intraoperative frozen section confirmed the presence of malignant cells with mucinous features."} +{"pid": "TCGA-AA-A00Z", "report": "The resected colon specimen includes an ulcerated lesion with complete removal and tumor-free proximal and distal margins. The lesion shows moderate differentiation and invades into the perimuscular adipose tissue. No regional lymph node metastases were identified upon examination of 37 lymph nodes. Microscopic evaluation reveals atypical features in the pericolic lymph nodes, raising consideration of a possible underlying lymphatic process. If there is no prior diagnosis of chronic lymphocytic leukemia (CLL), please provide clarification to determine if further consultation or submission to a lymph node registry is warranted."} +{"pid": "TCGA-AA-3864", "report": "The specimen consists of a right hemicolectomy with involvement of the cecum by a moderately differentiated adenocarcinoma. The lesion nearly completely covers the cecum and measures 5.5 cm in its greatest dimension. The tumor invades through all layers of the intestinal wall, extending into the adjacent fatty tissue and subserosa. No tumor is identified at the oral or aboral resection margins, nor is there involvement of the greater omentum. A total of 21 mesocolic and mesenteric lymph nodes are present and free of tumor, although they exhibit reactive changes. Vascular and lymphatic invasion are not identified. The histological grade is intermediate."} +{"pid": "TCGA-RW-A68F", "report": "The specimen consists of a 2.9 x 2.1 x 1.2 cm portion of tan soft tissue containing a well-circumscribed, tan, homogeneous mass with solid cut surfaces. No cystic degeneration or necrosis is identified. A separate adrenal gland specimen weighs 36.91 grams and measures 9.7 x 4.7 x 2.4 cm. Within the adrenal gland, there is a 3.3 x 2.5 x 4.5 cm solid, well-circumscribed mass with a tan, homogeneous appearance. The mass is surrounded by a rim of uninvolved adrenal tissue and appears to originate from the medulla. There is no evidence of necrosis, and surgical margins are grossly negative. Sections from both the periaortic mass and the adrenal mass, as well as adjacent adrenal tissue, have been submitted for analysis."} +{"pid": "TCGA-AP-A0LJ", "report": "The submitted specimens include the uterus, cervix, bilateral fallopian tubes and ovaries, right distal IP ligament, and multiple lymph node groups from both sides, including external iliac, internal iliac, obturator, para-aortic, and common iliac regions.\n\nExamination of the uterine tissue revealed a lesion with less than 6% solid growth pattern and nuclear grade 2 features. No definitive invasion of the myometrium, endocervical region, or vascular spaces was identified. The endometrium also showed complex hyperplasia with atypia. The myometrium contained areas of adenomyosis and an adenomyomatous polyp. Both adnexae were unremarkable, and a benign paratubal cyst was noted on the right side.\n\nBiopsies of the right distal IP ligament showed benign fibrovascular and adipose tissue. All lymph node specimens were negative for malignancy. Specifically, three left external iliac lymph nodes (0/3), one left internal iliac (0/1), one left obturator (0/1), seven right external iliac (0/7), one right obturator (0/1), one right internal iliac (0/1), and four right para-aortic lymph nodes (0/4) were all benign. In two cases\u2014right and left common iliac regions\u2014no lymph nodes were identified, and only benign fibroadipose tissue was present.\n\nAll other findings across the specimens were benign or non-specific."} +{"pid": "TCGA-A2-A3XT", "report": "The specimen consists of fibrofatty tissue from the left breast, measuring 8 cm in one dimension. A centrally located mass measuring approximately 4 x 3.2 x 3.2 cm was identified, with a fleshy, pink-tan appearance and scattered areas of hemorrhage and necrosis. The mass is in close proximity to several margins\u20140.2 cm from the posterior margin, 1.5 cm from the superior/inferior margin, and involving the anterior margin. Surrounding tissue demonstrates dense fibrosis with multiple cysts.\n\nHistologic evaluation reveals a poorly differentiated gland-forming lesion with a Nottingham grade score of 9 (3 each for tubules, mitoses, and nuclei). Necrosis is extensive throughout the infiltrating component. Lymphovascular invasion is present and widespread. Surgical margins are positive at the inferior and anterior aspects. No intraductal component was identified.\n\nImmunohistochemical staining shows no nuclear staining for estrogen or progesterone receptors, each at 0%. HER2 immunostaining yielded a score of 0. Additional stains demonstrated positivity for CK7 and negativity for CK20 and GCFPD.\n\nMultiple tissue sections were submitted for analysis, including sections from the mass, adjacent normal tissue, lateral and medial portions near margins, and surrounding glandular areas. Based on morphology and staining pattern, primary origin is suspected but not definitively confirmed."} +{"pid": "TCGA-G9-6342", "report": "The prostate specimen weighed 37 grams before trimming and measured 5.0 cm in width, 4.1 cm in length, and 3.4 cm in depth. After removal of the apex and base, the specimen weighed 21 grams. The external capsule was smooth, red, and intact. The right and left seminal vesicles measured 1.6 x 1.2 x 0.6 cm and 2.3 x 1.0 x 0.6 cm, respectively, and showed beige-tan cystic tissue upon sectioning. The right and left vas deferens measured 2.5 x 0.4 cm and 3.5 x 0.4 cm, respectively, and displayed firm tan tubular structures on cut surface. No obvious lesions or nodules were identified in the parenchyma.\n\nMicroscopic evaluation included multiple sections from various levels and regions of the prostate, including the apex, base, and lateral sides. Histologic analysis revealed a pattern of cellular atypia with perineural invasion present. The lesion showed focal extension beyond the prostatic capsule, involving the periprostatic fat at the base and inferior left lateral region. No involvement of the seminal vesicles, bladder neck, or surgical margins was identified. No lymph nodes were sampled.\n\nPathological staging was determined as pT3a, with no evidence of vascular or lymphatic invasion. A high-grade intraepithelial neoplasia component was noted. All relevant sections were reviewed, and findings were confirmed in consensus."} +{"pid": "TCGA-AF-5654", "report": "The right ovary and fallopian tube specimen measured 13.0 x 12.0 x 7.0 cm and weighed 470 grams. The fallopian tube was approximately 5 cm in length and 0.2 cm in diameter, with a distorted appearance and extensive adhesions. The ovarian surface was tan to white, without visible papillations. On sectioning, a unilocular cyst was identified with a 0.2 cm thick wall, containing grumous tan to white material. Calcifications and dark brown hair were present within the cyst wall. The left ovary and tube measured 5 x 4 x 3.3 cm and contained a cyst partially filled with clear fluid; the lining was smooth and glistening, with no papillary projections.\n\nThe sigmoid colon and upper rectum specimen was 24 cm in length. The proximal end measured 4.5 cm in circumference and the distal end 10 cm. A retroperitoneal reflection was located 3.5 cm from the distal end. An exophytic lesion measuring 2.2 x 2.2 x 1.2 cm was found 3 cm from the distal margin. The cut surface of the lesion did not show clear invasion into the muscularis propria upon gross examination. No other macroscopic abnormalities were observed. Lymph nodes were noted in the surrounding fat.\n\nMicroscopic evaluation of the right ovary showed features consistent with a benign mature cystic teratoma. The fallopian tube contained a small serous paratubal cyst. The left ovary revealed a serous cystadenoma, along with tubo-ovarian adhesions and a benign serous paratubal cyst in the fallopian tube. In the sigmoid colon and rectum resection, a moderately differentiated histologic pattern was observed. Tumor cells were seen invading the muscularis propria on slides C3 and C4, but no extension beyond this layer was identified (pT2). All surgical margins\u2014proximal, distal, and circumferential\u2014were free of tumor involvement. The closest distance of the tumor to a margin was 3 cm at the distal end. Vascular invasion was not detected. A total of 24 regional lymph nodes were examined and none contained tumor cells (pN0). There was no evidence of pericolonic tumor spread or distant metastasis (pMX)."} +{"pid": "TCGA-KK-A8IF", "report": "The specimen consists of a 0.3 cm fragment of tan-pink soft tissue submitted entirely for frozen section analysis. A second fragment measuring 0.3 x 0.2 x 0.2 cm was also submitted, with an inked margin that was reinked black. Both specimens were found to contain abnormal cellular elements on frozen section examination. The anterior apical margins were evaluated and determined to be free of abnormal cells.\n\nA prostate specimen along with attached seminal vesicles and segments of vasa deferentia was examined. The prostate measured 4.0 x 3.5 x 4.5 cm and weighed 40 grams after fixation. Gross examination revealed a palpable and visible nodule on the left anterior surface. Serial cross sections demonstrated a firm area consistent with abnormal growth in the anterior region, present in three of the four cross sections. No gross involvement was identified in the seminal vesicles or vasa deferentia.\n\nThree distinct areas of abnormal cellular proliferation were identified within the prostate. The largest focus, located in the right and left transition zones with extension into the left peripheral zone, measured 2.5 x 1.5 cm and was present across four cross sections. This lesion extended focally into extraprostatic tissue in the anterior apical region and right anterior surface. Extraprostatic involvement was noted in two sections, with an aggregate length of less than 2.0 mm. Focal extension to the anterior apical inked margin could not be definitively ruled out; however, the final surgical margin, represented by a separately submitted specimen, was negative.\n\nTwo smaller foci were identified: one in the left posterior peripheral zone measuring 0.4 x 0.2 cm, and another in the right posterolateral peripheral zone measuring 0.2 x 0.1 cm. These were confined to the prostate and showed no evidence of spread to surrounding structures.\n\nLymph node evaluation included twenty-three nodes from the right pelvic region, ranging from 0.2 to 1.3 cm in size, and eleven nodes from the left pelvic region, ranging from 0.3 to 2.2 cm. All lymph nodes were negative for abnormal cellular infiltration.\n\nHigh-grade prostatic intraepithelial neoplasia was also identified. Microscopic sections included multiple levels from the base and apex of the prostate, with special attention to inked margins. The anterior aspect was marked in green, left surface in red, right in yellow, posterior in black, and certain non-margin surfaces marked with blue and orange ink.\n\nAll other tissues, including right and left seminal vesicles and segments of vasa deferentia, were free of abnormal cells."} +{"pid": "TCGA-HT-7468", "report": "The pathology report describes microscopic findings from a brain tumor biopsy and resection. The tissue shows a glial neoplasm with diffuse infiltration into both gray and white matter. Tumor cells are characterized by intermediate-sized round nuclei and variably prominent perinuclear halos. Microcystic myxoid changes are present in some regions, although the majority of the tumor is solid. Extensive infiltration is observed, with areas of confluent hypercellularity. Cellular atypia is moderate, though mitotic figures are rare, with only three identified in over 100 high-power fields. Focal microvascular proliferation is noted in both frozen sections and slides, but it is not a dominant feature.\n\nMIB-1 immunohistochemistry was performed, revealing variable proliferative activity across different regions. Most areas show a labeling index of less than 1%, while a significant minority demonstrates higher activity, with indices reaching up to 8.6%. In regions exhibiting greater atypia and mitotic activity, the labeling index peaks at 8.85%. These findings suggest a heterogeneous tumor with areas of increased cellularity and proliferation intermixed with more indolent regions."} +{"pid": "TCGA-AA-3678", "report": "The resected colon specimen (sigmoid) shows tumor-free oral and aboral resection margins. A moderately differentiated adenocarcinoma is present with ulceration and infiltration extending into the lamina muscularis propria. One out of 26 regional lymph nodes contains metastatic involvement. No vascular or lymphatic invasion is identified. A separate finding of a small intestinal segment or Meckel\u2019s diverticulum is noted, showing no signs of inflammation or tissue heterotopy."} +{"pid": "TCGA-KL-8325", "report": "The left kidney specimen shows a well-circumscribed, solid mass measuring 15.8 x 13.8 x 6.2 cm with a uniform mahogany appearance on sectioning and a central scar. The mass is confined within the renal capsule without evidence of renal vein invasion. All surgical margins are free of abnormal tissue. The non-neoplastic kidney tissue appears normal. No adrenal gland tissue is identified in the specimen. A portion of the left 11th rib is submitted for evaluation; no gross abnormalities are observed, though further microscopic assessment is pending due to the need for decalcification. A left para-aortic lymph node biopsy reveals only benign fibroadipose tissue. The ureter measures 9.3 cm in length and is submitted along with perinephric fat. No palpable lymph nodes are identified within the adipose tissue. Representative sections of the tumor, kidney, ureteral and vascular margins, and surrounding fat are submitted for analysis. Intraoperative frozen section evaluation initially favored a diagnosis of oncocytoma, which was later refined upon permanent section examination."} +{"pid": "TCGA-NG-A4VW", "report": "The surgical specimens include the uterus with fallopian tubes and ovaries, left and right pelvic lymph nodes, periaortic lymph nodes, and omentum. The uterus weighed 109.5 grams and measured 8 x 5.5 x 4.5 cm. A polypoid mass was identified in the fundus, measuring 4.6 x 3.2 x 3.0 cm, filling the endometrial cavity. Gross examination showed myometrial invasion of 30\u201340% with focal areas suggesting greater than 50% penetration; histologic evaluation confirmed invasion exceeding 50% (0.6/1.1 cm). No cervical involvement was observed. The endometrial cavity contained multiple surface implants ranging from 0.5 to 1.5 cm. The bilateral fallopian tubes and ovaries appeared unremarkable both grossly and microscopically. Surgical margins were free of tumor.\n\nA total of 26 lymph nodes were evaluated: seven from the left pelvic region, fifteen from the right pelvic region, and four from the periaortic area. All were negative for malignancy. The omentum was also negative for any malignant involvement.\n\nMicroscopic analysis revealed a poorly differentiated endometrioid carcinoma component with glandular features. A mesenchymal component was present, showing myxoid and chondroid differentiation. Immunohistochemical staining demonstrated positivity for vimentin and scattered positivity for synaptophysin and chromogranin A; CK AE1/3 was negative. No angiolymphatic invasion was identified. Additional findings included adenomyosis and leiomyoma. The tumor was staged as pT1c NO Mx."} +{"pid": "TCGA-90-A4ED", "report": "Eleven specimens were received for evaluation, including multiple lymph nodes and a right upper lobe lobectomy specimen. The lymph nodes examined were obtained from various anatomical levels, including 4R, Level 7, Level 3, #10, and #11 (including multiple submissions from #11). All lymph nodes were negative for malignancy, with counts ranging from one to thirteen nodes per specimen. No malignant cells were identified in any of the lymph nodes assessed.\n\nThe right upper lobe lobectomy specimen measured 11.5 x 5.4 x 3.5 cm and contained a well-defined mass measuring 3.8 x 1.2 x 2.3 cm in greatest dimensions. The tumor was located near the pleura and was 0.1 cm from the parenchymal margin, 3.1 cm from the bronchial margin, and 3.5 cm from the nearest vascular margin. Histologic evaluation revealed a moderately differentiated squamous cell carcinoma. All surgical margins were free of invasive carcinoma, with the closest distance of tumor to a margin being 1 mm at the parenchymal margin. Lymph-vascular invasion was present. No visceral pleural invasion or treatment effect was noted.\n\nA total of 25 lymph nodes were examined across all specimens, with none showing evidence of metastatic involvement. Pathologic staging was determined as pT2a, pN0, pMX. Rare organisms were identified on GMS special stain, suggesting possible histoplasmosis in one lymph node. Intraoperative frozen section analysis confirmed no tumor presence in the evaluated margins and lymph nodes, with an average turnaround time of 29 minutes for three sections and 11 minutes for the bronchial margin assessment.\n\nGross examination of the lobectomy specimen revealed a smooth, glistening pleural surface with areas of anthracotic pigmentation. The mass was distinct and did not involve any of the evaluated margins. Multiple stapled margins were present, and representative sections were submitted for detailed histologic analysis. No additional masses were identified upon further sectioning of the lung tissue.\n\nAll other lymph node specimens were similarly described as black-tan soft tissues without gross abnormalities, and they were entirely submitted for histologic evaluation. Thymic tissue was noted in two specimens, both of which were negative for malignancy."} +{"pid": "TCGA-X7-A8DG", "report": "The surgical specimens were received in five labeled containers. Part A consisted of a wedge of lung measuring 3.5 x 2.3 x 1.5 cm, with tan-white nodularity ranging from 0.2 to 0.7 cm in size. The nodules approached the surgical edge within 0.1 cm. Histologic examination showed necrotizing granulomatous inflammation. Stains for organisms were negative and no malignancy was identified. Frozen section diagnosis was confirmed.\n\nPart B was a wedge of lung measuring 5 x 1 x 0.7 cm with a red-tan to white nodule measuring 0.6 cm in greatest dimension. This lesion approached the inked surgical margin within 0.2 cm. Microscopic evaluation revealed acute and chronic bronchiolitis, bronchopneumonia, and respiratory pneumonitis, along with granulomatous inflammation. One lymph node was identified and found to be negative for malignancy.\n\nPart C consisted of yellow-tan fibroadipose tissue measuring up to 8.5 x 6.5 x 2.7 cm and weighing 59 g. No suspicious lesions were observed grossly. Microscopically, it showed unremarkable adipose tissue without evidence of malignancy.\n\nPart D was a specimen weighing 136 g and measuring 12 x 8 x 3.5 cm. Gross examination revealed a tan-white, well-delineated mass measuring 7 x 6.5 x 3.5 cm, which was focally hemorrhagic and appeared well encapsulated. The mass was adjacent to the inked external surface. Histologic evaluation demonstrated a predominantly lymphocyte-rich neoplasm. The tumor was confined within the capsule and margins were uninvolved, with the closest margin measuring 1 mm. No lymph-vascular invasion was identified. Twelve regional lymph nodes were examined and none showed involvement. The specimen integrity was intact.\n\nPart E included fibroadipose tissue fragments measuring 7.5 x 4.8 x 2 cm and weighing 26 g. No suspicious lesions were noted on gross inspection. Microscopic evaluation revealed no thymus tissue and no malignancy was identified.\n\nAll specimens were processed and evaluated according to standard protocols. Intraoperative frozen sections were performed for parts A, B, and D. Time for frozen section analysis was 23 minutes for parts A and B and 32 minutes for part D. All frozen section diagnoses were confirmed in the final evaluation."} +{"pid": "TCGA-RX-A8JQ", "report": "The specimen includes three tissue samples from a male patient. The first sample, labeled as the left adrenal mass, consists of an adrenal gland with adjacent fibrofatty tissue weighing 56.0 grams and measuring 9.3 x 4.5 x 3.6 cm. A distinct nodule measuring 3.5 x 3.5 x 2.8 cm is present on the superior surface. Upon sectioning, the nodule appears orange-brown and extends to within 0.1 cm of the inked margin. It is located within 0.3 cm of the adrenal gland but not directly connected to it, separated by adipose tissue. Microscopic examination reveals that the tumor infiltrates into surrounding adipose tissue and focally reaches the inked resection margin. Cellular features include a mitotic count of 1-2 per 10 high-power fields and absence of necrosis. The tumor cells demonstrate strong diffuse positivity for chromogranin and synaptophysin, while staining for inhibin is negative. The Ki-67 proliferative index is estimated to be low, with focal areas less than 5%.\n\nThe second and third specimens are biopsies from retroperitoneal masses. Each consists of small soft tissue fragments measuring up to 0.3 cm. Histologic evaluation of both specimens shows only benign ganglion tissue without evidence of neoplastic involvement. All surgical specimens were reviewed in detail, including frozen sections and permanent slides, with special stains used to support the assessment."} +{"pid": "TCGA-06-0139", "report": "The patient has a prior history of a brain lesion previously biopsied from the temporal lobe. A craniotomy was performed and multiple biopsies were taken from different regions of the brain, including the medial temporal lobe, hippocampus, and posterior areas. All specimens were processed for histological evaluation.\n\nThe tissue samples show extensive necrosis, with only small areas of viable tissue present. Microscopic examination reveals a neoplastic astrocytic proliferation with mitotic figures, focal microvascular proliferation, and microvascular thrombosis. In the hippocampal region, the neoplasm demonstrates sparse infiltration and microscopic subependymal spread. The proliferation index, as assessed by MIB-1 staining, reaches up to 15% in more active areas. Immunohistochemical analysis supports the presence of a high-grade astrocytic neoplasm, with GFAP showing significant glial fibrillogenesis, CD34 highlighting abnormal angiogenesis, and KP1 and MAC387 indicating widespread tissue damage and few viable phagocytic cells.\n\nMGMT promoter methylation testing was performed. One block showed a methylated MGMT promoter, while another did not. This test was conducted using bisulfite-treated DNA followed by PCR amplification and gel electrophoresis. The result is provided for informational purposes and should be interpreted within the context of other clinical and diagnostic findings.\n\nGrossly, the specimens varied in size. The medial temporal biopsy measured up to 2 cm, the hippocampal specimen was 1.5 x 1.4 x 0.5 cm, the medial temporal tumor sample was 2.0 x 1.8 x 1.4 cm, and the posterior tumor fragment was 1.3 x 1.1 x 0.7 cm. All tissues were soft and tan to gray in color, with variable friability and areas of hemorrhage.\n\nIn summary, the specimens demonstrate a high-grade astrocytic neoplasm with extensive necrosis, microvascular proliferation, and mitotic activity. The majority of the tissue is necrotic, with only limited diagnostic material available for assessment. The neoplastic cells show active proliferation in some areas, and there are signs of vascular involvement and limited regional spread in the hippocampus."} +{"pid": "TCGA-FY-A2QD", "report": "The specimen was received in three containers. Container A, labeled as parathyroid, contained a 0.5 cm pink-tan rubbery soft tissue sample that was entirely submitted for frozen section and subsequently resubmitted for permanent section. Container B, labeled as total thyroid right side stitch, contained a total thyroidectomy specimen weighing 46.5 grams. The right lobe measured 6.7 x 3.5 x 3.0 cm, the left lobe measured 5.0 x 3.0 x 2.0 cm, and the isthmus measured 1.5 x 0.7 x 0.5 cm. The thyroid capsule appeared purple-pink and shaggy, with no identifiable parathyroid glands. The specimen was inked with blue on the right side and black on the left side. Serial sectioning revealed a 6.0 x 3.3 x 2.5 cm encapsulated pink-tan mass located primarily in the right lobe, approaching within 0.1 cm of the inked margin. The remaining cut surface was beef red and glistening with focal yellow-tan discoloration near the capsule. Representative sections were submitted across multiple cassettes. Container C, labeled superior mid thyroid mass, contained a 1.3 x 0.9 x 0.7 cm tan-pink soft tissue specimen which was inked, bisected, and entirely submitted for analysis.\n\nMicroscopic evaluation of the thyroid specimen identified a lesion within the left lobe measuring 0.6 cm in diameter. The lesion exhibited multifocality with a dominant nodule and satellite microscopic nodules. The largest focus measured 0.6 cm and displayed partial capsule presence with capsular invasion noted. There was no evidence of extrathyroidal extension or lymphovascular space invasion. All surgical margins were free of involvement. Three lymph nodes were examined and none contained metastatic disease. Additional findings included Hashimoto's thyroiditis and a 6.0 cm follicular adenoma in the right lobe. The staging classification was recorded as pT1NO. Intraoperative consultation confirmed the absence of parathyroid tissue and supported the findings observed in the final pathology report."} +{"pid": "TCGA-77-8131", "report": "Histopathology Report. LEFT LOWER LOBE. Clinical Notes: Wedge resection L lower lobe. Male patient with history of significant weight loss and chronic productive cough. Former smoker. Macroscopic examination of the specimen labelled \"wedge resection L lower lobe\" reveals a lung specimen measuring 65 X 70 X 63 mm in the inflated state. The pleural surface appears unremarkable. Upon sectioning, a cream-coloured, well-defined lesion measuring 32 mm in greatest dimension is identified. The lesion is located at least 10 mm from the resection margin and contacts the pleura without clear evidence of invasion. Adjacent lung tissue demonstrates subpleural fibrosis and cyst formation. Sections submitted include those of the lesion and surrounding tissue.\n\nMicroscopic evaluation reveals a well-differentiated to moderately differentiated keratinising epithelial tumour. Central necrosis is present, likely secondary to vascular involvement observed in multiple large pulmonary artery branches. The lesion approaches the pleural surface but does not infiltrate it. Areas suggestive of lymphatic involvement are present. Surgical margins are free of malignant cells. No lymph nodes are identified within the specimen. Evaluation of surrounding lung parenchyma shows a variable inflammatory and fibrotic process confined to the subpleural regions. Features include honeycombing, interstitial lymphocytic infiltration, and fibrous thickening of alveolar septa. Fibroblastic foci and smooth muscle proliferation are also present. There is no indication of pleuritis. Additionally, a focus of organising pneumonia is observed in a more central area of the lung.\n\nSummary: The wedge resection from the left lower lobe contains a 32 mm lesion with vascular invasion and findings suggestive of lymphatic involvement. The adjacent lung demonstrates changes consistent with a fibrosing and inflammatory process limited to the subpleural areas, including features of architectural remodelling and chronic inflammation. Resection margins are negative for malignancy."} +{"pid": "TCGA-08-0354", "report": "The pathology report includes three tissue specimens from the left frontal lobe. Parts A and B consist of small biopsies showing a highly cellular astrocytic neoplasm with mitotic activity, microvascular proliferation, and areas of necrosis. Immunohistochemical staining for GFAP demonstrated positivity in neoplastic astrocytes, while neurofilament highlighted background axons. The MIB-1 labeling index was 20.06%. A reticulin stain was negative for features suggestive of gliosarcoma. Part C represents a larger resection specimen measuring 4.0 x 3.0 x 2.0 cm, with extensive red-brown discoloration likely representing hemorrhage. Histologic evaluation of all 22 cassettes sampled from this specimen did not reveal any infiltrating neoplastic glial cells, showing only brain tissue with hemorrhagic changes consistent with surgical effect. Intraoperative frozen sections from Parts A and B were interpreted as showing a glial neoplasm with necrosis and pleomorphism, favoring a high-grade lesion. Grossly, Parts A and B were small tan tissue fragments, while Part C showed multiple cortical fragments with areas of discoloration. All diagnoses were confirmed following review of slides by the attending pathologist."} +{"pid": "TCGA-BP-5000", "report": "The submitted specimen consists of a left partial nephrectomy. The specimen measures 7 x 5.5 x 5.0 cm with attached fat measuring 12.5 x 7 x 4 cm. A suture marks the deep margin, and the surface is inked black; the capsular surface is inked blue. On gross examination, there is an encapsulated, hemorrhagic, yellow-tan tumor measuring 5.4 x 5.0 x 4.9 cm. It has a diffuse scarred and septated appearance. The tumor is located 0.1 cm from the black inked surface and contacts the capsule but does not grossly penetrate it. Surrounding the tumor is a thin rim of normal renal parenchyma.\n\nHistologic evaluation reveals nuclear features consistent with high-grade morphology. No evidence of local invasion, renal vein involvement, or angiolymphatic invasion is identified. Surgical margins are negative for tumor. Additional findings include compression-related changes in the non-neoplastic kidney tissue. Adrenal and lymph node tissues were not identified in the specimen.\n\nStaging classification indicates a T1 lesion based on size and confinement within the kidney. Multiple representative sections including tumor with margins, capsule, and adjacent renal parenchyma were submitted for analysis. Intraoperative frozen section consultation confirmed absence of tumor at the inked margin, with permanent sections confirming this finding."} +{"pid": "TCGA-CJ-4637", "report": "The specimen includes a left kidney and adrenal gland from a nephrectomy. The kidney measures 17.0 x 9.0 x 5.0 cm and contains a fleshy tan tumor located in the lower pole, measuring 9.0 x 7.0 x 6.0 cm. The tumor abuts the renal capsule but does not extend through it and is 0.4 cm from the inked parenchymal margin. It also contacts the renal sinus but shows no gross extension into the renal vein. The adrenal gland, measuring 7.0 x 3.0 x 2.5 cm, contains a fleshy tan hemorrhagic lesion measuring 4.0 x 3.0 x 2.5 cm. Ureteral, vascular, and soft tissue margins of resection are free of involvement. \n\nMicroscopic evaluation reveals a high-grade neoplasm composed of approximately 40% clear cells and 60% eosinophilic cells, with focal areas exhibiting rhabdoid features. No definitive spindle cell sarcomatoid component is identified. The tumor demonstrates nuclear atypia corresponding to Fuhrman\u2019s nuclear grade 4. Sections submitted include the ureteral and vascular margins, adrenal with tumor, regions near the renal vein and hilum, soft tissue margins, and uninvolved renal parenchyma. A portion of the tumor was also submitted for research and ultrastructural analysis."} +{"pid": "TCGA-14-0813", "report": "The specimen consists of two tissue samples from a left temporal craniotomy. Specimen #1, collected fresh for intraoperative consultation, includes multiple fragments of tan, soft tissue measuring 1.0 x 1.0 x 0.3 cm. A portion was frozen and later resubmitted for permanent sectioning in cassette \"FS1A,\" with the remainder placed in cassette \"1B.\" Specimen #2, received in formalin, consists of tan and white, hemorrhagic, soft tissue fragments measuring 2.0 x 1.0 x 0.4 cm and submitted entirely in cassette \"2A.\"\n\nMicroscopic evaluation revealed a malignant neoplasm identified during intraoperative consultation as high-grade. The tumor exhibits varied morphologies, including regions with epithelioid and solid growth patterns, as well as areas displaying more conventional fibrillar architecture. Immunohistochemical staining demonstrated strong positivity for GFAP. Additional stains performed included AE1/AE3 and S-100. The resident and fellow reviewed the case under supervision."} +{"pid": "TCGA-5P-A9K4", "report": "The specimen shows a moderately differentiated neoplasm with papillary architecture. The tumor measures approximately 4 cm in greatest dimension and is confined to the kidney without evidence of extension beyond the organ. Histologic examination reveals cells with clear cytoplasm and well-defined nuclear features. Surgical margins are negative. Based on size and extent, the lesion is classified as pT1b. Grading is consistent with intermediate differentiation (Grade II)."} +{"pid": "TCGA-PE-A5DE", "report": "The specimen was obtained from a female patient and consisted of three tissue samples. The first sample, labeled as sentinel lymph node from the left axilla, measured 1.6 x 1.3 x 1.0 cm and showed no evidence of tumor cells upon touch preparation and histologic evaluation. Immunohistochemical staining for cytokeratin AE1/AE3 was negative.\n\nThe second sample, taken from a lumpectomy of the left breast, measured 7.4 x 7.4 x 3.5 cm and contained a firm tan lesion with moderately defined borders measuring 3.8 cm in greatest dimension. The lesion was in close proximity to the medial, superior, and anterior resection margins. Histologic examination revealed a mixture of invasive and in situ components. The invasive component showed features consistent with grade II-III morphology. The in situ component accounted for approximately 5% of the lesion. No lymphovascular invasion was identified. Adjacent breast tissue showed fibrocystic changes and microcalcifications. A 0.4 cm blue dome cyst was also noted. Multiple sections were submitted for analysis, including perpendicular sections of all margins.\n\nThe third sample represented the final medial margin and measured 2.5 x 2.0 x 1.0 cm. Histologic evaluation showed no residual lesional tissue.\n\nAdditional studies showed hormone receptor positivity for estrogen and progesterone receptors, and a negative result for Her2-neu (score 0). Flow cytometry demonstrated aneuploidy with a DNA index of 1.59 and a Ki-67 proliferation index of less than 10%. Due to the presence of a tetraploid population comprising less than 20% of cells, an accurate S-phase fraction could not be determined.\n\nStaging was assigned as pT2 based on the size of the invasive component and absence of nodal involvement. All surgical margins were free of tumor involvement."} +{"pid": "TCGA-KK-A6E4", "report": "The specimen includes right and left pelvic lymph nodes, each measuring 8.0 x 3.0 x 1.0 cm and 1.0 x 0.5 x 0.5 cm on the right, and 4.5 x 1.8 x 1.0 cm and 5.4 x 1.2 x 1.2 cm on the left. Microscopic examination of all sections from both sides shows no evidence of tumor involvement in any of the lymph nodes evaluated.\n\nThe prostate with attached seminal vesicles and segments of the vasa deferentia was also submitted. The prostate measures 4.5 x 2.9 x 4.6 cm and weighs 37.5 grams post-fixation. A nodule was identified in the right posterolateral region, with increased soft tissue noted on that side compared to the left. Serial cross-sections revealed an area of abnormality in the right peripheral zone extending into the transition zone, present across three cross-sections. This lesion measured up to 2.5 x 1.5 cm in its largest dimension and was found extensively at the apex and focally at the base of the prostate. No tumor was identified in the seminal vesicles or the segments of the vasa deferentia. All surgical margins were free of tumor involvement. Histologic evaluation showed high-grade prostatic intraepithelial neoplasia."} +{"pid": "TCGA-AG-A026", "report": "Internal Sample IC consists of vascularized fatty connective tissue showing extensive chronic granulating and recurrent inflammation with fibrosis, areas of acute inflammatory activity, hemorrhage, and small foci of necrosis. A poorly differentiated adenocarcinoma was identified in the rectal region, characterized by a high degree of dedifferentiation. Histological examination revealed widespread lymphangitic spread, with tumor infiltration extending through the rectal wall into the perirectal connective tissue. In addition, there were infiltrative tumor components in the soft tissue of the sacral cavity, accompanied by significant peritumoral inflammation, including chronic granulation and recurrent inflammatory changes. The inner tumor surface showed erosions and ulcerations, along with an acute purulent inflammatory response in the surrounding tissue. All 15 lymph nodes examined exhibited only moderate chronic lymphadenitis without evidence of tumor involvement. Resection margins, both aboral and oral, as well as a section from the anastomosis ring, were free of tumor cells. Based on the available sections, the tumor extends beyond the rectal wall into adjacent tissues, corresponding to a stage of pT4, pN0, MX, L1, and at least R1. There was no indication of vascular invasion or widespread metastatic disease. The findings were discussed in a follow-up communication."} +{"pid": "TCGA-AA-A00J", "report": "The specimen consists of a right hemicolectomy with clear oral and aboral resection margins. Two tubular adenomas were identified in the colon mucosa, showing up to moderate dysplasia, also described as low-grade intra-epithelial neoplasia. An ulcerated lesion was found in the cecum and ascending colon, characterized by poorly differentiated and partially mucinous features. The lesion extended through all layers of the colonic wall and involved the peritoneum. Two lymph node metastases were identified among 24 regional nodes examined. Vascular and lymphatic invasion was not detected. The lesion showed high-grade morphological features."} +{"pid": "TCGA-AC-A2FG", "report": "The specimen consists of a left modified radical mastectomy specimen weighing 581 grams, measuring 23.8 x 11.5 x 3.5 cm. A circumscribed tan-white fibrous nodule measuring 2.9 x 2.8 x 2.7 cm was identified and located 0.7 cm from the deep inked margin. Histologically, the lesion demonstrated a total Elston modification of Bloom-Richardson score of 7 out of 9, with an architectural score of 3/3, nuclear score of 3/3, and mitotic score of 1/3. No lymphovascular space invasion, skin involvement, or in situ component was identified. The tumor was not transected, and the distance to the closest margin was 0.7 cm from the deep margin.\n\nTen lymph nodes were identified in the axillary contents, with one node containing metastatic involvement. The size of the largest metastasis was 0.25 cm, and extra-capsular extension was present. A separate lymph node specimen from the left axilla showed isolated single-cell micrometastases identified by immunohistochemistry (pancytokeratin), not evident on H&E staining. No tumor was identified in the H&E stained slide of the permanent control of the frozen section material.\n\nAdditional findings included a focus of fibrosis and hemorrhage consistent with a prior biopsy site, along with mild fibrocystic change including apocrine metaplasia and focal florid ductal hyperplasia. The remainder of the breast tissue showed at least 50% interspersed blue-pink fibrous tissue without other identifiable lesions. Nine lymph nodes were identified in the axillary contents, ranging from 0.3 to 1.4 cm in greatest dimension."} +{"pid": "TCGA-FG-A6J1", "report": "The specimen was collected from a female patient and consisted of two parts. Part A, described as \"tumor margins,\" included fragments of cerebral cortex with areas of gliomatous infiltration. The tissue sample measured 3.0 x 1.5 x 1.2 cm and was processed for both frozen and permanent evaluation. Part B consisted of multiple soft tissue fragments measuring approximately 2.8 x 2.0 x 0.6 cm in aggregate. Microscopic examination revealed low-grade glioma cells present in the intraoperative consultation. All specimens were submitted in cassettes for further analysis."} +{"pid": "TCGA-ZJ-AAXT", "report": "Cervical biopsy specimen consists of a pale pink to red tan irregular tissue fragment measuring 0.6 x 0.5 x 0.4 cm, entirely submitted in one cassette. Histologic evaluation reveals a neoplastic process involving the cervix with features including stromal invasion. The lesion is composed of large cells exhibiting nonkeratinizing morphology. A prominent lymphoplasmacytic infiltrate is present at the margins. Tissue processing and staining were performed for accurate morphologic assessment. Specimen was properly labeled and received in formalin. CPT code for cervical biopsy was applied."} +{"pid": "TCGA-MA-AA41", "report": "The cervix biopsy specimen was reviewed and findings were confirmed by an outside consultant. The case included six glass slides for evaluation. Histologic assessment revealed a moderately differentiated cellular proliferation infiltrating the full thickness of the biopsy tissue. The lesion demonstrates invasive growth with involvement extending to a depth of at least 0.8 cm. All material has been examined, and representative sections have been retained for further patient management. The report has been documented in the patient\u2019s medical chart for reference."} +{"pid": "TCGA-E2-A15D", "report": "The surgical specimen consists of a right breast lumpectomy measuring 6 x 5 x 4 cm, with orientation markers. The specimen was sectioned into eight slices, revealing a well-circumscribed mass measuring 2.5 x 2.3 x 1.5 cm, located 0.6 cm from the closest inferior margin. A surgical clip was identified in slice 5. Margins were sampled and found to be free of abnormal tissue. There was evidence of ductal changes with cribriform architecture and central necrosis within 0.15 cm of the inferior margin. Fibrosis and granulation tissue were noted at the biopsy site.\n\nFour sentinel lymph nodes were examined from the right axilla. Each lymph node was measured: 1.2 x 1 x 1 cm, 0.8 x 0.6 x 0.5 cm, 1.2 x 1 x 0.8 cm, and 1.4 x 1 x 0.6 cm respectively. All were negative for metastatic involvement.\n\nHistological evaluation showed intermediate nuclear grade features. Cellular morphology included tubular structures with a score of 2, nuclear grade of 2, and a mitotic score of 1, resulting in an overall modified Scarff Bloom Richardson grade of 1. No vascular or lymphatic invasion was identified. Immunohistochemical staining showed positivity for ER and PR, and negativity for HER2 by FISH testing.\n\nPathologic staging was determined as pT2 pN0. A separate Oncotype DX assay yielded a recurrence score of 17, with ER and PR scores indicating positivity and HER2 score indicating negativity."} +{"pid": "TCGA-B5-A121", "report": "The specimen consisted of a 193-gram uterus measuring 13 x 7 x 5 cm with attached fallopian tubes and ovaries. The endometrial lining measured 2.5 cm in width at the fundus and extended 5 cm in length. There were brown, velvety excrescences up to 0.5 cm thick observed along the anterior and posterior walls of the endometrial cavity, measuring 5 x 2.5 x 1.3 cm in total. These lesions extended to the junction of the endocervical canal. The excrescences showed minimal gross invasion into the underlying myometrium, approximately 0.1 cm deep, within a 2.5-cm-thick myometrial wall. The outer surface of the myometrium was located 2 cm from the serosal surface, which appeared tan-gray, smooth, and glistening.\n\nThe myometrium contained four small white nodules, each measuring up to 0.6 cm, with firm, whorled cut surfaces without hemorrhage or necrosis. The cervix measured 3 cm in diameter with a tan, smooth surface that was focally erythematous. The endocervical canal was 2.5 cm long, tan, smooth, and focally erythematous. On the right ovary, there was a 0.5-cm subcapsular simple cyst, while the left ovary contained a 0.7-cm white, firm subserosal nodule. Both fallopian tubes exhibited gray-tan serosal surfaces with hemorrhagic mucosa.\n\nA separate fragment of tissue from the right ovary, measuring 1 x 0.2 x 0.1 cm, was submitted entirely for analysis. Additionally, a hernia sac specimen measuring 4.5 x 4 x 1.5 cm was received, consisting of fibromembranous tissue with some adipose content.\n\nMicroscopic evaluation revealed cellular features consistent with complex glandular structures present throughout the endometrium. In full-thickness sections of the uterus, invasive glands were identified up to 1.2 cm into the myometrial wall, although no lymphatic or vascular invasion was observed. Adjacent non-neoplastic endometrium showed changes consistent with intraepithelial metaplasia. The remaining myometrium contained benign findings including leiomyomas and adenomyosis. Cervical margins and surgical margins were uninvolved. Both fallopian tubes showed paratubal cysts, and the ovaries contained benign findings including a serous cyst and an adenofibroma. The hernia sac contained benign mesothelial-lined fibroadipose tissue.\n\nA small 2 mm nodule on the uterine serosa was sampled and found to be a subseserosal leiomyoma. No malignancy was identified in any of the ovarian or fallopian tube specimens, or in the hernia sac. Multiple blocks were submitted for detailed histological assessment, including full-thickness sections of the endometrium and myometrium, as well as representative sections from the cervix, fallopian tubes, and ovaries."} +{"pid": "TCGA-J4-A67N", "report": "The prostate gland specimen measured 4 x 3 x 3 cm and weighed 24 grams. The gland showed a disrupted capsule at the bladder resection margin. On sectioning, the gland exhibited firm, focally nodular parenchyma. The seminal vesicles and vasa deferens appeared normal. Histologic examination revealed a Gleason score of 3 + 4 = 7/10. There was no evidence of tumor identified in the margins of the prostate, soft tissue, urethra, or bladder neck. No involvement of the seminal vesicles was observed.\n\nLymphatic invasion was not seen. However, perineural invasion was present. The extent of tumor involvement in the prostate was graded as 2 (5\u201315% of tissue involvement). No dominant nodule measuring at least 1 cm was identified. There was no identifiable treatment effect on the tumor.\n\nLymph node assessment included left and right pelvic lymph nodes. Frozen section analysis of both sides showed no tumor in four lymph nodes each. Non-frozen section evaluations also showed no tumor in multiple fragments of lymph nodes from both sides.\n\nThe prostatectomy specimen was extensively sampled, with 90% of the gland submitted for analysis. Multiple tissue blocks were prepared and stained with H&E for microscopic evaluation.\n\nStaging was determined as pT3a, indicating extension beyond the prostate capsule without involvement of nearby structures. Nodal staging was pN0, with no positive regional lymph nodes identified, and pMX for distant metastasis, which could not be assessed from this specimen."} +{"pid": "TCGA-AG-3902", "report": "The resected colon specimen (rectosigmoid region) demonstrated tumor-free oral and aboral resection margins. Two tubular adenomas were identified, exhibiting moderate dysplasia. An ulcerated lesion was present, composed of moderately differentiated cells arranged in glandular structures. The lesion extended into the perimuscular fatty tissue; no metastases were identified in the 17 regional lymph nodes examined. Vascular and lymphatic invasion were not detected, and the resection margins were free of neoplastic involvement. Additionally, a splenectomy specimen showed recent capsular and parenchymal defects, consistent with iatrogenic injury based on clinical correlation."} +{"pid": "TCGA-86-8280", "report": "The specimen consists of lung tissue obtained following pneumonectomy. The tumor measures 6 x 5 x 2 cm and is located in the left lower lobe. Microscopic evaluation reveals a moderately differentiated histologic pattern characterized by bronchiolo-alveolar growth architecture. Cellular morphology shows features consistent with epithelial origin. Staging details, including histologic grade, extent of spread, presence of additional nodules, lymph node involvement, lymphatic or venous invasion, and margin status, are not available. No evidence of neoadjuvant treatment effect is noted. No other significant pathologic findings are reported."} +{"pid": "TCGA-OL-A66I", "report": "The surgical specimen consists of a right breast lumpectomy and associated lymph node dissection. A single sentinel lymph node from the right axilla shows a small focus of metastatic involvement measuring 1 mm. The primary lesion in the breast measures 1.9 cm in greatest dimension and is located centrally with spiculated, indurated features. Histologic evaluation reveals high-grade features with a composite score of grade III (architecture: 3, nuclear grade: 3, mitotic count: 3). The excisional margins are free of tumor, with the closest distance being 2 mm at the inferior margin; all other margins are greater than 2 mm away. There is no evidence of vascular or lymphatic invasion. The remaining breast tissue is unremarkable.\n\nA total of 14 lymph nodes are identified in the axillary specimen, with one node positive for metastasis. The largest metastatic deposit measures 1 mm, and there is no extranodal extension. Immunohistochemical analysis demonstrates rare cells with minimal reactivity for ER and PR; Her2/neu testing by FISH is negative with a ratio of 1.04. The pathologic staging is pT1c, N1mi, MX. Intraoperative evaluation of the sentinel lymph node initially showed involvement; however, deeper sections used for immunohistochemistry do not demonstrate the presence of tumor. The lumpectomy specimen is well-oriented and inked, with the mass abutting the inferior and inferior/posterior margins. A metallic clip is identified in the second slice from the lateral margin. The remaining tissue consists primarily of adipose and fibroglandular elements. Multiple cassettes are submitted for histologic analysis, including those containing the mass and margins. Lymph node dissection yields a total of 14 nodes, with all but one being negative for tumor."} +{"pid": "TCGA-EM-A3AK", "report": "The thyroid specimen measured 4.5 \u00d7 2.4 \u00d7 1.2 cm on the right lobe, 4.0 \u00d7 2.4 \u00d7 1.7 cm on the left lobe, and 4.6 \u00d7 1.4 \u00d7 0.6 cm at the isthmus. The total weight was 14.5 grams. Multiple tumor foci were identified bilaterally. The dominant lesion was located in the left lobe and measured 2.0 cm in greatest dimension with additional dimensions of 1.8 cm and 1.4 cm. Histologic evaluation showed classical papillary architecture and cytomorphology with minimal focal hobnail features involving less than 5% of the tumor. The tumor was totally encapsulated with minimal capsular invasion and uninvolved margins. No lymphovascular or perineural invasion was identified, and there was no evidence of extrathyroidal extension.\n\nA second lesion was identified in the right lobe measuring 0.2 cm with follicular variant histology and classical cytomorphology. It lacked a distinct capsule and showed no invasion or margin involvement. Additional microscopic foci were noted in the right lobe (two measuring 0.05 cm each) and one in the left lobe measuring 0.1 cm.\n\nTwo lymph nodes from the central compartment were examined and showed no evidence of metastatic involvement. No distant metastasis was identified. The staging classification indicates multiple primary tumors confined to the thyroid gland with no regional or distant spread identified."} +{"pid": "TCGA-UF-A718", "report": "Collection date: PRIMARY SITE: Larynx. Three lymph nodes from Level 6 on the left showed no evidence of metastatic carcinoma. The total laryngectomy specimen included bilateral jugular-carotid lymph nodes. A lesion involved the infraglottic, glottic, and supraglottic regions bilaterally and extended into the right hypopharynx. The lesion measured 4.5 x 4.0 x 3.5 cm and involved the thyroid cartilage and right paralaryngeal skeletal muscle. There was an in situ component present. Moderate stromal dysplasia was observed. Perineural invasion and lymphovascular invasion were both absent. Surgical margins were free of involvement. Twelve lymph nodes on the right and ten on the left showed no evidence of metastatic disease. Pre-epiglottic fat tissue showed no signs of neoplasia."} +{"pid": "TCGA-QH-A6X5", "report": "The specimen consists of brain tissue from the left frontal region of a female patient. Histologic evaluation reveals a neoplastic process characterized by moderately cellular areas with a mixture of astrocytic and oligodendroglial components. The astrocytic component shows mild nuclear atypia without significant pleomorphism. Oligodendroglial features include uniform nuclei with delicate chromatin and inconspicuous nucleoli. No necrosis or microvascular proliferation is identified. Mitotic activity is low. The lesion infiltrates the cerebral cortex and extends into the subcortical white matter. Based on histologic features, the tumor demonstrates characteristics consistent with a low-grade glioma."} +{"pid": "TCGA-KO-8415", "report": "The specimen includes a uterus measuring 11.5 cm in superior-inferior dimension, 5.5 cm cornu to cornu, and 5.7 cm anterior to posterior. There are twelve tan-whorled nodules within the myometrium, ranging in size from 5.0 x 3.0 x 3.0 cm to 0.4 x 0.3 x 0.3 cm. The endometrium is 0.2 cm thick and shows proliferative changes with adenomyosis. The myometrial thickness is 2.3 cm, and the cervix appears unremarkable.\n\nA separate radical nephrectomy specimen measures 12 x 6.0 x 5.5 cm and includes the kidney (11.0 x 5.0 x 5.5 cm), a segment of renal artery, renal vein, and ureter (9.0 cm long, 0.6 cm average diameter). A well-circumscribed mass measuring 7.0 x 5.5 x 6.0 cm is present in the upper pole of the kidney. The mass is tan-pink, soft, and almost entirely necrotic, with peripheral and central areas of hemorrhage. No involvement of perinephric adipose tissue, renal sinus, or renal vein is identified. Gerota's fascia is not infiltrated. Margins of resection are free of abnormal tissue. Lymph nodes are not identified in the hilum. The adjacent renal parenchyma appears tan-brown and otherwise unremarkable. The pelvicaliceal system is smooth with no lesions noted."} +{"pid": "TCGA-AK-3444", "report": "The specimen consists of a left nephrectomy weighing 403 grams with attached perinephric fat. The left kidney measures 11.0 x 4.5 x 4.5 cm and is bivalved, revealing red-purple renal parenchyma with a well-defined cortico-medullary junction. A mass measuring 6.0 x 3.5 x 3.0 cm is present in the mid to lower pole, with golden-yellow-orange, soft lobulated cut surfaces and irregular borders. A 5.0 x 0.3 cm fragment of ureter is attached, with a patent lumen measuring 0.2 cm at the hilum. A 0.8 x 0.6 cm fragment of unremarkable adrenal gland is also present.\n\nHistologic sections include the ureter and vascular margins, tumor with inked circumferential margin, additional tumor tissue, random kidney tissue, and adrenal gland. The tumor is confined to the renal parenchyma with no angiolymphatic invasion identified. All margins, including renal vascular, ureteral, and perirenal, are free of tumor. The adrenal gland shows no abnormal findings. The tumor measures 6.0 cm and is classified as Fuhrman nuclear grade II/IV.\n\nCytogenetic analysis was performed on the renal mass. Metaphase cells from an eleven-day culture showed an abnormal mosaic karyotype including deletion of the p arm of chromosome 3 and a derivative chromosome involving parts of chromosomes 3 and 5. These findings are consistent with previously reported chromosomal abnormalities in certain renal neoplasms. In contrast, cells from a fourteen-day culture exhibited normal karyotypes, which may reflect overgrowth of non-neoplastic tissue."} +{"pid": "TCGA-06-0882", "report": "A 5.9 cm mass was identified in the left medial frontal lobe on imaging, characterized by ring enhancement, hemorrhage, extensive edema, and extension to the genu of the corpus callosum. Histopathologic examination of the lesion revealed a neoplasm with diffuse infiltration and marked disruption of cerebral architecture. Microscopic evaluation showed nuclear anaplasia, frequent mitotic figures, and prominent vascular proliferation, including areas of vascular necrosis and thrombosis. Extensive necrosis was present, with some regions demonstrating pseudopalisading. In one area, a distinct spindle cell morphology was observed alongside nuclear atypia.\n\nImmunohistochemical staining demonstrated variable expression of GFAP, with heavy fibrillogenesis in certain regions and absence in others. Only about 5% of cells showed overexpression of p53 protein. CD163 highlighted numerous presumed phagocytic cells. MIB-1 staining yielded a proliferation index of approximately 18% in the more active zones. Snook\u2019s reticulin stain showed significant reticulin deposition within the spindle cell regions.\n\nHistologic analysis of marginal tissue from the superior gyrus revealed focal infiltration by neoplastic cells within otherwise normal cerebral cortex and adjacent white matter. The tumor specimen exhibited high histological grade features and contained a sarcomatoid component.\n\nMolecular testing for MGMT promoter methylation was performed using bisulfite-treated DNA followed by real-time PCR amplification (MethyLight), which did not detect methylated sequences. This result was obtained from analysis of paraffin-embedded tissue and is intended for informational use in the context of established clinical criteria.\n\nGross examination of the surgical specimens included soft tan tissue fragments measuring up to 1.5 x 1.2 x 0.4 cm in aggregate, as well as larger hemorrhagic tissue fragments measuring 5.5 x 3.5 x 1.5 cm. Marginal tissue from the superior gyrus measured 2 x 1.5 x 1 cm and displayed a mixture of pink-tan and gray-white cut surfaces.\n\nIntra-operative consultation on frozen sections confirmed the presence of atypical glial proliferation consistent with high-grade malignancy."} +{"pid": "TCGA-Q1-A6DW", "report": "The specimen consists of three pale pink to gray tan, slightly hemorrhagic tissue fragments measuring between 0.4 and 1.4 cm in greatest dimension. The largest fragment was sectioned perpendicular to its long axis. All tissue was submitted for analysis. Microscopic evaluation reveals moderately differentiated large cell nonkeratinizing morphology with extensive involvement by severe dysplasia. Cellular features include marked atypia, increased nuclear-to-cytoplasmic ratio, and frequent mitotic figures. There is no evidence of vascular or lymphatic invasion. The lesion involves the full thickness of the epithelium with extension into the underlying stroma. Margins are involved. No lymph nodes were identified in this specimen."} +{"pid": "TCGA-G7-6795", "report": "The left radical nephrectomy specimen includes the kidney with abundant perinephric fat, attached ureter, and adrenal gland. The combined weight is 1400 grams, with overall dimensions of 21 x 13 x 11.5 cm. The ureter measures 3 cm in length and 1 cm in diameter. The adrenal gland measures 3 x 2.5 x 1.5 cm and appears unremarkable on gross examination.\n\nUpon sectioning, a solid mass measuring 2.5 x 2.5 x 1.8 cm is identified at the upper pole. It has a creamy yellowish cut surface and appears confined within the renal parenchyma. Adjacent cortical distortion is noted with multiple cysts ranging from 0.2 cm to 2.5 cm in size. Some cysts show golden-yellow discoloration around the gray-tan lining. There is marked fatty infiltration of the medullary area. The perirenal fat adheres closely to the renal capsule.\n\nHistologic evaluation reveals cellular features including nuclei with slight irregularity and evident nucleoli. No vascular or lymphatic invasion is observed. The tumor does not extend into perinephric tissue or involve the adrenal gland. Ureteral and hilar vascular margins are free of involvement. Two regional lymph nodes are negative for involvement.\n\nAdditional findings include chronic interstitial changes with prominent cystic alterations. Multiple sections from the ureter, vascular margins, tumor, cysts, adrenal gland, and presumed lymph nodes were submitted for analysis."} +{"pid": "TCGA-EM-A3O8", "report": "The surgical specimen included a total thyroidectomy with submission of parathyroid and lymph node tissues. The thyroid measured 6.0 \u00d7 3.1 \u00d7 1.8 cm on the right and 6.3 \u00d7 2.9 \u00d7 2.0 cm on the left, with an isthmus measuring 2.2 \u00d7 1.1 \u00d7 0.6 cm. Total weight was 38.7 grams. Gross examination revealed multiple nodules: in the right lobe, a solid nodule measuring 1.3 \u00d7 1.1 \u00d7 1.1 cm; and in the left lobe, multiple nodules including one measuring 1.0 \u00d7 1.2 \u00d7 1.1 cm with mixed solid and colloidal appearance. Additional small nodules were identified microscopically in both lobes, up to 0.3 cm in size.\n\nMicroscopic evaluation showed follicular architecture with classical cytomorphology in the dominant right-sided lesion. A second tumor focus was identified in the left lobe measuring 0.8 cm with similar histologic features. Both lesions were entirely encapsulated and demonstrated no lymphovascular or perineural invasion, nor extrathyroidal extension. Margins were free of involvement. Multiple additional small foci measuring up to 0.3 cm were present bilaterally.\n\nAncillary studies showed positivity for thyroglobulin and negativity for calcitonin, monoclonal CEA, and chromogranin in the dominant nodule. Mild reactive C-cell hyperplasia was noted in association with the follicular epithelial proliferations. Immunohistochemical staining confirmed presence of reactive changes in C-cells with calcitonin expression.\n\nLymph node assessment included three left perithyroidal nodes, none of which showed evidence of disease. Parathyroid tissue was submitted from the left superior and left lower regions; no pathological findings were identified in these specimens. Thymic tissue also showed no pathological abnormalities.\n\nBased on AJCC/UICC TNM staging (7th edition), the case is classified as pT1b for the dominant lesion (greater than 1 cm but less than 2 cm, confined to the thyroid), with multifocal tumors designated as m. Regional lymph node assessment was pN0 based on absence of metastasis in three examined nodes. No distant metastasis was identified."} +{"pid": "TCGA-YU-A90Y", "report": "The specimen involved the left testis and measured 4.5 cm. Histologic evaluation identified a heterogeneous cellular composition, with the majority of the tissue consisting of cells characteristic of embryonal carcinoma. A minor component showed features associated with yolk sac differentiation. Intratubular involvement by similar neoplastic cells was noted. Angiolymphatic vascular invasion was present in multiple foci. The rete testis and tunica albuginea demonstrated infiltration by atypical cells. Involvement was also identified at the base of the spermatic cord, with focal infiltration observed. An intravascular neoplastic embolus was present at the margin of the spermatic cord. The epididymis and tunica vaginalis were free of neoplastic involvement."} +{"pid": "TCGA-A8-A06Q", "report": "The specimen consists of multiple tumor foci within the left breast. The larger lesion measures 5.3 cm and exhibits moderately differentiated invasive ductal carcinoma features with areas showing signet-ring cell differentiation as well as focal intraductal components. A smaller tumor focus measuring 1.5 cm is also present, displaying similar histological characteristics. Microscopic evaluation confirms the presence of angioinvasive elements.\n\nAssessment of the surgical specimen demonstrates residual invasive tumor components located near the excision cavity and extending into the retromamillary region, with a maximum surface spread of 0.8 cm. The dorsal resection margin is free of tumor involvement. Histologic grade is classified as G2. Staging parameters indicate pT3(mult)N2aL1V0R0."} +{"pid": "TCGA-MB-A5YA", "report": "A segment of small bowel measuring 71 cm in length and 2.5 cm in diameter was received with a large amount of attached mesenteric adipose tissue. Both resection margins were previously stapled closed. The serosal surface appeared unremarkable. Within the mesentery, a well-circumscribed, solid mass measuring 8.5 x 8.4 x 7.3 cm was identified. The cut surface was white and whorled with a central area of hemorrhage measuring 1.8 x 1.5 x 0.7 cm. The mass was located 7.5 cm from the bowel and 0.5 cm from the closest surgical margin, which was inked black. The bowel mucosa appeared normal upon opening.\n\nLymph nodes ranging from 0.5 to 1.7 cm in size were identified within the mesentery; all appeared benign and showed no evidence of malignancy. Histologic sections included the surgical margins, the full extent of the mass, areas of hemorrhage and necrosis, and the bowel wall, which was unaffected.\n\nMicroscopic evaluation revealed a highly cellular lesion with marked nuclear atypia, numerous mitotic figures, and areas of necrosis and hemorrhage. The tumor was entirely encapsulated and did not involve the bowel wall. All surgical margins were negative. The lymph node examination confirmed absence of metastatic disease. Immunohistochemical studies from prior biopsy indicated negativity for CD117."} +{"pid": "TCGA-JL-A3YX", "report": "The biopsy specimen consists of a small fragment of breast tissue containing an infiltrative neoplastic lesion. The neoplastic cells exhibit moderate pleomorphism, nuclear hyperchromasia, and eosinophilic cytoplasm. Scattered mitotic figures are present. The lesion shows no areas of necrosis, with nearly all of the lesion appearing viable. Cellular composition demonstrates that approximately 90% of the nuclei are of neoplastic origin, with the remaining 10% being non-neoplastic. The histologic features suggest a grade II lesion."} +{"pid": "TCGA-AA-3681", "report": "The specimen consists of a right-sided hemicolectomy. A lesion measuring 5 cm in maximum diameter is present. Histological evaluation reveals a poorly differentiated adenocarcinoma. The tumor invades up to the subserosa and extends into adjacent fatty tissue. The oral and aboral resection margins, as well as the greater omentum, are free of tumor involvement. The appendix shows fibrotic changes consistent with prior inflammation. Metastatic involvement is identified in two of sixteen lymph nodes located in the mesocolic and mesenteric regions, with no evidence of extranodal extension. Remaining lymph nodes demonstrate only nonspecific reactive changes. Vascular and lymphatic invasion are not observed. The histologic grade is high, corresponding to G3."} +{"pid": "TCGA-AN-A0AR", "report": "Female patient underwent radical mastectomy for tissue procurement from the right breast. The tumor specimen was preserved in frozen format within a cryomold. Histological assessment showed high-grade cellular features, with no evidence of lymph node or distant metastasis (T stage 2, N stage 0, M stage 0). No prior treatment was administered. A normal blood sample was also collected via blood draw and stored frozen in a tube."} +{"pid": "TCGA-EP-A2KA", "report": "The specimen consists of a right lobe of liver partial resection and an additional right lobe margin. The main specimen weighs 493 grams and measures 14.0 x 11.0 x 5.5 cm. A cauterized parenchymal margin measuring 13.0 x 6.2 cm is present, with a fleshy yellow to tan nodular irregular area identified as a mass measuring 9.0 x 12.0 x 6.0 cm. Adjacent to this mass are other irregular nodules measuring a combined 3 cm in greatest dimension. A separate 2 cm nodule is found at the suture site requested for frozen section. The specimen was submitted in 10 blocks, including sections of tumor to resection margin, capsular surface, and normal parenchyma.\n\nThe second specimen, weighing 670 grams and measuring 14.0 x 4.0 x 4.5 cm, contains a double long suture oriented as superior and a single long stitch at the anterior capsular surface. The superior margin is inked black and the inferior side red. Serial sections show pale tan areas adjacent to the prior resection. The anterior margin, inked orange, is sampled. This specimen is submitted in eight blocks, including sections from the anterior margin and other representative areas.\n\nMicroscopic evaluation shows a high-grade cellular proliferation with solid, trabecular, and clear cell patterns. The primary lesion measures 12 cm in greatest dimension, with satellite nodules adding up to 3 cm. Multiple nodules exceed 12 cm in aggregate size. Tumor was present at the original superior resection margin; however, the final resection margins in the second specimen are free of tumor. Lymphatic space invasion is present, but no large vessel invasion is observed. No regional lymph nodes or distant metastases were evaluated.\n\nImmunohistochemical analysis reveals loss of reticulin staining, spotty canalicular staining with CEA, and negative staining for CK7, CK20, CK8, and HepPar 1. The background liver tissue shows steatohepatitis with 30-40% mixed micro- and macrosteatosis, chronic portal inflammation, and mild lobular inflammation. Stage I fibrosis is present without evidence of iron accumulation or PAS-positive diastase-resistant globules. Additional sections of the second specimen do not show residual tumor, though cautery artifact is noted in areas previously suspected of involvement. Multiple slides and blocks were reviewed, confirming the histologic grade and absence of tumor in final margins."} +{"pid": "TCGA-FA-A4XK", "report": "The specimen involves a lesion located in the jejunum, with a gross size of 10 x 8 x 3 cm. The lesion is ulcerated and diffusely circumferential. On microscopic examination, the cells are arranged in a diffuse pattern, replacing or intermingling with benign glandular structures. The cellular composition includes large transformed lymphoid cells and multinucleated giant cells, with hyperchromatic nuclei. The cells are predominantly oval or round with minimal cytoplasm, and may contain single or multiple nucleoli. Mitotic activity is frequently observed. Immunohistochemical staining shows positivity for CD20 and negativity for CD3 and CKAE1/AE3. Lymph node involvement was not identified in the three mesenteric nodes examined."} +{"pid": "TCGA-XF-A9SM", "report": "The right distal ureter specimen measured 0.4 cm in length and 0.6 cm in circumference, and the left distal ureter measured 0.2 cm in length and 0.8 cm in circumference. Both were fully submitted for frozen section and showed no abnormal cellular changes. The urethral margin showed chronic inflammation with granulomas consistent with prior therapy.\n\nThe bladder and prostate specimen measured 23 x 18 x 6 cm overall. The peritoneal surface had a focal adhesion measuring 2 x 2 cm. The bladder itself measured 9 x 6 x 5 cm, with a large, firm, gray-white lesion located in the anterior and right wall, measuring 7 x 5 x 3 cm. This lesion extended through the full thickness of the bladder wall into surrounding soft tissue, but all inked margins and the peritoneal surface were free of tumor involvement. No lymphovascular space invasion was identified. The uninvolved bladder mucosa showed marked chronic cystitis, glandular metaplasia, and granulomatous reaction.\n\nThe prostate measured 7 x 6 x 5 cm and contained a small yellow lesion in the midprostate measuring 0.3 cm. Histologically, there was focal extension of abnormal cells into the prostatic capsule, though not through it. All radial inked margins were free of involvement, and no lymphovascular space invasion was seen. There was also evidence of granulomatous inflammation consistent with prior therapy.\n\nLymph node evaluation included: para-aortic (19 nodes), paracaval (8 nodes), right common iliac (3 nodes), left common iliac (9 nodes), right external iliac (13 nodes), right Cloquet node (2 nodes), right hypogastric/obturator (15 nodes), left external iliac (7 nodes), left Cloquet node (1 node), left hypogastric/obturator (13 nodes), left presciatic (7 nodes), right presciatic (3 nodes), and presacral (4 nodes). All were negative for metastatic disease.\n\nThe left and right proximal ureter specimens each measured 2 cm and 1.5 cm in length respectively, and both were unremarkable. All other ureteral segments examined, including distal portions, were benign and without atypical or malignant cells."} +{"pid": "TCGA-EM-A3FL", "report": "The specimen received included a left upper parathyroid tissue sample and a left hemithyroidectomy. The parathyroid sample weighed 0.007 g and measured 0.4 x 0.2 x 0.1 cm. The thyroid specimen weighed 23.5 g, with the left lobe measuring 4.3 x 3.3 x 2.3 cm and the isthmus measuring 3.0 x 1.7 x 1.2 cm. A well-defined nodule measuring 4.1 x 3.1 x 2.3 cm was identified in the left thyroid lobe.\n\nMicroscopic examination identified two distinct lesions within the thyroid. The dominant lesion measured 1.5 cm and exhibited follicular architecture with classical cytomorphology features. There was also evidence of oncocytic or oxyphilic differentiation. Immunohistochemical staining showed focal positivity for cytokeratin 19 and scattered positivity for HBME-1 with an apical and membranous pattern; Galectin-3 was negative. Margins were free of involvement. No tumor capsule, capsular invasion, lymphovascular invasion, perineural invasion, or extrathyroidal extension was observed.\n\nA second lesion, measuring 0.7 cm (with additional dimensions of 0.2 cm), was identified in the left lobe and isthmus. This lesion displayed similar histologic characteristics to the dominant lesion, including follicular arrangement and oncocytic features. It also lacked evidence of tumor capsule, invasion, or metastatic involvement.\n\nNo lymph nodes were identified in the specimen. Based on AJCC/UICC TNM staging criteria, the primary tumor was classified as pT1b (tumor greater than 1 cm but less than 2 cm confined to the thyroid), with regional lymph node status designated as pNX due to absence of lymph node retrieval. Distant metastasis could not be assessed.\n\nAdditional findings included adenomatoid nodules or nodular follicular disease and chronic lymphocytic thyroiditis. No pathological diagnosis was rendered for the parathyroid biopsy."} +{"pid": "TCGA-HC-7741", "report": "The prostate specimen weighed 34.1 grams and measured 4.5 x 3.5 x 3.0 cm. It was sectioned to reveal a pink-tan, focally cystic cut surface with diffuse periurethral nodularity; no discrete lesion was identified. Histologic evaluation showed a primary pattern of 3/5 and a secondary pattern of 4/5, resulting in a Gleason score of 7/10. The process involved both lobes and accounted for approximately 25% of the specimen. There was involvement of the left seminal vesicle, but no extra-capsular extension was observed. Lympho-vascular space invasion and perineural space invasion were present. High-grade PIN was also noted.\n\nSurgical margins were negative at the bladder neck, apical region, and inked prostatic margin. A total of two lymph nodes were examined microscopically, and none contained metastatic disease. Both right and left pelvic lymph nodes showed benign features without evidence of malignancy.\n\nThe bladder neck tissue was benign and showed no pathological abnormalities. Frozen section analysis of all submitted lymph node and bladder neck tissues confirmed the absence of tumor involvement. Status post treatment changes were observed in the prostate tissue. Staging was determined as pT3b, NO, MX."} +{"pid": "TCGA-55-7576", "report": "A right thoracotomy was performed and a specimen consisting of the right upper lobe, R4 lymph node, and subcarinal lymph node was submitted for analysis. The right upper lobe weighed 240 grams and showed areas of hemorrhage on the surface with mostly smooth, glistening pleural surfaces. Two nodules were identified in the upper aspect of the lobe, both showing overlying pleural puckering. The more lateral lesion measured 2.0 x 1.7 cm on cut surface, appearing white and gray speckled, while the second, more apical lesion measured up to 1.8 x 1.7 cm, was yellowish, well-circumscribed, and located approximately 2 cm from the first nodule. Sections from both lesions were taken for further study. Microscopic evaluation revealed that the two nodules, although separate on gross examination, were connected microscopically, forming a single lesion with a \"dumbbell\" configuration. Both nodules shared similar histology, showing areas of growth within scar tissue, with varying cytoplasmic features\u2014some clear, others eosinophilic and darker. Portions of the tumor exhibited a lepidic pattern and focally extended into the visceral pleura, with at least one small focus adhering to the outer surface. Additional sections between the two nodules confirmed microscopic involvement, supporting the presence of a single lesion. Tumor growth was also noted in a thick-walled blood vessel. Emphysema was present in the surrounding lung tissue. A single parabronchial lymph node was sampled and found negative for metastatic disease. The bronchial resection margin was free of tumor involvement, as were vascular and parenchymal margins. The closest distance of invasive carcinoma to any margin was approximately 5 cm. Lymphovascular invasion was not identified. Both the R4 and subcarinal lymph nodes were enlarged and showed reactive changes, but no metastatic disease was found. The case was reviewed and findings were confirmed."} +{"pid": "TCGA-HW-7491", "report": "A right frontal brain lesion was identified in an older male with a history of left facial weakness and a preoperative MRI showing a large non-enhancing lesion in the right frontal region. Two specimens were submitted for analysis: one labeled as \"right frontal brain lesion\" and the other as \"right frontal brain tumor.\"\n\nThe first specimen consisted of tan tissue measuring 1.6 x 0.8 x 0.3 cm in aggregate and was entirely submitted for frozen section evaluation. The second specimen included multiple fragments of gray-tan, friable, soft tissue measuring 1.2 x 1.0 x 0.2 cm in total. A portion of this specimen was retained for further testing, and the remainder was submitted in full.\n\nMicroscopic examination of the frozen section suggested a glioma with features favoring a specific subtype. This finding was confirmed on permanent sections. Histologic evaluation revealed cells with characteristic nuclear features and low proliferative activity based on immunohistochemical staining for Ki-67 (MIB-1), with an index not exceeding 3%. Immunostaining for p53 was negative. \n\nAdditional molecular testing for chromosomal alterations is being performed. All diagnoses were based on direct examination of the slides."} +{"pid": "TCGA-77-7465", "report": "The surgical specimen consists of a right upper lobectomy measuring 140 x 120 x 75 mm. Two bronchi are present with margins measuring 10 to 12 mm in diameter. Two staple lines radiate from the bronchial margin to the periphery, measuring 35 and 80 mm in length. A large lymph node is located adjacent to the bronchial resection margin. A central lesion measuring 39 x 32 x 30 mm is identified, with areas of necrosis and carbon pigment. The lesion involves several central lymph nodes and compresses a main bronchus near the hilum. It is located approximately 10 mm from the bronchial margin and 5 mm from the nearest pleural surface. The distal lung shows signs of collapse, consolidation, and bronchiectasis. Parenchymal hemorrhage is noted, likely due to procedural factors. Two small tan nodules (1\u20132 mm) are observed in the collapsed region, along with two firm granular lesions (4\u20135 mm) in unaffected lung tissue. Mild emphysema is present in areas away from the collapse.\n\nA lymph node labeled number 4 measures 15 mm and has a black to white cut surface. Another lymph node labeled number 5 measures 28 mm and contains multiple white nodules on sectioning.\n\nMicroscopic examination reveals a moderately to poorly differentiated epithelial lesion arising near a segmental bronchus close to the hilum, obliterating several segmental bronchi. The lesion extends into peribronchial fat at the hilum but does not reach the surgical margin. There is direct involvement of at least one peribronchial lymph node. Vascular invasion is present, including tumor within the lumen of a major pulmonary artery branch. No definitive lymphatic or perineural invasion is observed. Additional findings include silicotic nodules in other lymph nodes, dust macules, fibromuscular scars, and severe emphysema in distant lung parenchyma. Organized thrombi are noted distal to the lesion.\n\nLymph nodes numbered 4 and 5 contain anthracotic changes and small silicotic nodules, with no evidence of malignant involvement."} +{"pid": "TCGA-ZB-A961", "report": "Pathology Report-Summary: Material: Tumor: 4.0 X 3.6 X 1.5 cm. Focal infiltration of capsule and fat tissue is noted. Microscopic examination shows a neoplasm composed of epithelial cells that are positive for CK5/6 and KL1. The epithelial cells are negative for CD1a, CD5, CD117, CD99, CD56, NSE, synaptophysin, TTF1, chromograninA. Scattered immature T-lymphocytes showing positivity for CD1a and CD5 are present. Staging according to pTNM classification: pT2, pNx (0/5). Masaoka staging: II.2."} +{"pid": "TCGA-GU-A763", "report": "The specimen was obtained from a male patient undergoing radical cystectomy, prostatectomy, and lymph node dissection. The tumor measured 2.1 cm in greatest dimension and was located in the right lateral wall of the bladder. Histologic evaluation showed invasive, high-grade papillary urothelial carcinoma with extension into prostatic parenchyma. No lymphovascular invasion was identified. Margins were free of tumor involvement.\n\nA total of 27 lymph nodes were examined, including left and right internal and external iliac, obturator, common iliac, preaortic, precaval and paracaval, presacral, and other lymph node groups. All lymph nodes were negative for tumor involvement.\n\nImmunohistochemical analysis with image quantitation was performed on block M27. p21 expression was unaltered, with 69% average positivity and staining intensity grade of 2. p27 was altered, with 4% average positivity and staining intensity grade of 1. p53 was altered, with 74% positivity and staining intensity grade of 2. Ki-67 was also altered, showing 35% positivity and staining intensity grade of 2. Cyclin E was unaltered with 80% positivity and staining intensity grade of 2. Based on these findings, the biomarker profile was considered to have unfavorable prognostic significance due to the presence of more than two altered markers.\n\nAdditional findings included adenocarcinoma of the prostate, Gleason score 7 (4+3), involving 5% of the prostate. No extraprostatic extension, seminal vesicle invasion, or perineural invasion was identified. Prostatic margins were uninvolved. High-grade prostatic intraepithelial neoplasia was also present.\n\nAll other specimens, including ureters, vas deferens, and appendix, were benign and showed no evidence of malignancy or dysplasia. Frozen section analysis confirmed negative margins for tumor in the ureters. The histologic findings support a pathologic stage of pT4a for the urothelial carcinoma and pT2a for the prostatic adenocarcinoma, with no regional lymph node involvement (pN0)."} +{"pid": "TCGA-26-5132", "report": "The submitted specimen labeled \"brain tumor\" consists of a 3.5 x 3.2 x 2.5 cm portion of tan soft tissue. A representative section was processed for frozen section analysis and touch preparation. The frozen section evaluation revealed high-grade malignant features, including marked nuclear atypia, frequent mitotic figures, microvascular proliferation, and areas of necrosis. Based on histological assessment, the lesion demonstrates diffuse infiltration with pleomorphic astrocytic cells, consistent with a high-grade neoplasm. All tissue from the frozen section was submitted for permanent processing in cassette FSA1, along with additional portions of the specimen in cassettes A2-A4. Immunohistochemical staining and molecular testing were performed as part of the diagnostic workup. The tumor exhibits extensive cellular proliferation and invasion into surrounding brain parenchyma, with no evidence of lymph node involvement. The findings are consistent with an advanced-stage primary central nervous system malignancy."} +{"pid": "TCGA-KL-8336", "report": "The right kidney specimen measured 15 x 12 x 6 cm and weighed 761 g. A mass measuring approximately 12 cm in greatest dimension was identified within the renal sinus, replacing much of the kidney\u2019s architecture. The mass exhibited a tan-yellow cut surface with areas of hemorrhage and necrosis. It extended to the renal capsule and involved the renal pelvis. Vascular invasion was noted within the renal vein and multiple smaller vessels within the sinus. The ureteral and vascular margins were free of tumor involvement. An adrenal gland was not identified with this specimen.\n\nLymph node specimens were submitted from multiple regional sites. In total, 15 lymph nodes were examined from the paracaval/retrocaval region, with 3 showing involvement by tumor cells. The largest involved lymph node measured 0.8 cm. Seven lymph nodes were submitted from the interaortic-caval/pre-aortic region, one of which contained tumor cells; it measured 0.75 cm. Four lymph nodes were evaluated from the para-aortic region, none of which showed evidence of tumor involvement. No extracapsular extension was observed in any of the involved lymph nodes.\n\nThe tumor demonstrated marked epithelial anaplastic features and focally invaded the proximal ureteral wall. Based on staging criteria for renal cortical tumors, the lesion extended into the renal vein(s) or vena cava below the diaphragm. All surgical margins were negative for tumor."} +{"pid": "TCGA-85-A512", "report": "The specimen consists of left lung tissue obtained via pulmonectomy. A mass was identified in the left upper lobe measuring 3 x 3 x 3 cm. Histologic examination reveals malignant cells arranged in nests and sheets with intercellular bridges and areas of keratinization. The morphology suggests a moderately differentiated epithelial neoplasm. Evaluation of lymph nodes shows involvement in 8 out of 12 intrathoracic nodes. No definitive assessment was made regarding lymphatic or venous invasion, tumor extent, margins, or response to preoperative therapy. Additional findings were not specified."} +{"pid": "TCGA-A3-3331", "report": "The right kidney specimen was received with attached perinephric fat and measured 14.0 x 8.0 x 7.0 cm, weighing 365 grams. The ureter stump measured 4.0 cm in length and 0.3 cm in diameter, and the renal artery and vein stumps each measured 1.5 cm in length with diameters of 0.5 cm. All vascular and ureteral structures were grossly unremarkable. On sectioning, a circumscribed golden-yellow mass measuring 3.7 x 3.0 cm was identified in the lower pole beneath the capsular surface. The mass did not penetrate through the capsule into the surrounding perinephric fat. The surrounding renal cortex appeared brown-tan, measured 0.7 cm in thickness, and demonstrated a well-demarcated junction between cortex and pyramids. Histologic evaluation revealed cells with clear cytoplasm and nuclear features corresponding to Fuhrman grade 2. There was no evidence of lymphovascular space invasion, transcapsular extension, or renal vein involvement. All soft tissue, ureteral, and vascular margins were negative. Representative sections of the mass, ureter, renal vessels, and normal renal cortex were submitted for analysis."} +{"pid": "TCGA-DE-A3KN", "report": "The surgical specimens include multiple lymph node groups and a thyroid gland specimen. Lymph nodes from the superior thyroid pole show involvement in both submitted nodes, with metastatic deposits measuring 0.5 cm and 0.6 cm respectively. One of these nodes demonstrates focal extracapsular extension. A total thyroidectomy specimen reveals a unifocal lesion located in the left lobe, measuring 4.5 cm in greatest dimension. The growth pattern appears infiltrative with focal extension into adjacent soft tissues. The tumor is in close proximity to the posterior surgical margin, where it focally abuts the inked margin. No definitive tumor is identified at other margins. The surrounding thyroid tissue appears unremarkable. Additional lymph node dissection from the central region includes seven nodes, three of which contain metastatic involvement with a maximum size of 0.6 cm. No extracapsular extension is noted in this group. The overall lymph node assessment across all specimens shows 5 out of 9 involved nodes, with the largest metastasis measuring 0.6 cm. Intraoperative evaluation of a lymph node biopsy suggested suspicious features for a follicular variant of possible neoplastic origin. Gross examination of the thyroid specimen identifies a firm, unencapsulated mass with a lobulated, calcified appearance. Histologic evaluation includes representative sections of the tumor, margins, and thyroid tissue. No vascular or lymphovascular invasion is identified. Clinical staging based on available data suggests a T3 classification for the primary tumor and N1b for regional lymph node involvement."} +{"pid": "TCGA-AF-6655", "report": "The specimen includes a lymph node and a segment of the rectum and sigmoid colon. The left apical lymph node measures 0.7 x 0.5 x 0.4 cm and has been entirely submitted for analysis. The colorectal specimen is 24 cm in length. The proximal end is stapled and marked with blue ink, while the distal end is opened and marked with black ink. The outer surface shows a 1.2 cm area of submucosal hemorrhage, located 2.8 cm from the proximal end. The retroperitoneal reflection is 6.5 cm from the distal margin.\n\nUpon opening, the mucosal surface appears pink-tan, smooth, and glistening. The proximal circumference measures approximately 5.5 cm and the distal circumference measures about 9.5 cm. There is a submucosal maroon discoloration measuring 2.5 x 1.2 cm, located 3 cm from the proximal end. No distinct gross abnormalities are noted in most areas, except at the distal end where there is an exophytic growth measuring 2.5 x 2.5 x 0.5 cm with a flat surface. This lesion is within 3 cm of the distal margin and shows invasion into the muscularis propria, approaching within 1.5 cm of the radial margin. A portion of this growth was submitted for tissue procurement. Possible lymph nodes are observed in the surrounding fat and representative sections have been submitted for evaluation.\n\nHistologically, the growth shows moderately differentiated features. The primary lesion involves the muscularis propria without penetrating through it (pT2). All evaluated proximal, distal, and radial margins are negative. Vascular invasion is not identified. Among 29 lymph nodes assessed, two contain metastatic changes. No non-lymph node pericolonic tumor involvement is found. Additional findings include the presence of diverticula."} +{"pid": "TCGA-AX-A1C5", "report": "The surgical specimen from a female patient included the uterus, cervix, bilateral ovaries, and fallopian tubes, submitted following total hysterectomy and bilateral salpingo-oophorectomy. The uterus weighed 198 grams and measured approximately 11.5 x 8.6 x 5.7 cm. A tan-gray mass replaced the endometrial cavity and extended into the lower uterine segment, measuring 9 cm in greatest dimension (additional dimensions: 6 x 3.2 cm). The mass was located 2.5 cm from the squamocolumnar junction and involved 50% of the myometrium with a depth of invasion measuring 22 mm. Full-thickness myometrial invasion was noted, with extension to the serosal surface on the posterior wall. Black inked margins indicated involvement of the parametrial region.\n\nExtensive angiolymphatic invasion was identified. Bilateral ovaries showed tumor involvement, with the left ovary extensively involved and the right ovary showing surface involvement. The right fallopian tube had a paratubal cyst; no tumor was found in either fallopian tube.\n\nLymph node evaluation included right and left pelvic nodes, right and left paraaortic nodes, and omentum. Two of three lymph nodes were positive for tumor involvement: the right pelvic and right paraaortic lymph nodes. The left pelvic lymph node and left paraaortic lymph node were negative. Omental biopsy showed no tumor involvement.\n\nA biopsy from the pelvic cul-de-sac was positive for tumor. Margins of resection included involvement by invasive carcinoma at the posterior uterine serosal surface.\n\nStaging was determined as minimum pathologic stage pT3a N1 Mx. The tumor involved the uterine serosa, parametria, and adnexa. Lymph node analysis showed two positive nodes out of three examined. Distant metastasis could not be assessed. No additional pathologic findings were identified."} +{"pid": "TCGA-2Y-A9GU", "report": "The liver segmentectomy specimen weighed 604 grams and measured 16.0 x 11.0 x 7.0 cm. The external surface was pink-tan to red-brown with areas of hemorrhage and a bosselated appearance. The resection margin was tan-red-brown, partially cauterized, and marked with blue ink. On sectioning, an intraparenchymal mass was identified measuring 11.0 x 9.0 x 7.0 cm. The mass was lobulated, subcapsular, and bulged outward from the liver capsule. It was located approximately 1 cm from the closest parenchymal margin. The mass showed areas of focal hemorrhage and necrosis; the necrotic regions ranged from 0.1 to 2.5 cm in size and accounted for less than 10% of the total tumor volume. The surrounding liver tissue appeared histologically unremarkable, with no signs of cirrhosis. Microscopic evaluation revealed cells arranged in a pattern consistent with moderate differentiation. No angiolymphatic invasion was observed. The resection margin was free of abnormal cellular infiltration. The pathological stage was classified as Stage I (T1 Nx Mx). A subset of tissue samples was submitted for further analysis, including sections from the tumor margin, central tumor, and grossly normal liver tissue. A separate block of non-tumor liver tissue demonstrated preserved architecture on reticulin stain, no fibrosis or bridging on trichrome stain, and no excess iron deposition on iron stain. The entire case was personally reviewed by the attending pathologist."} +{"pid": "TCGA-C5-A1MK", "report": "The patient is a woman who underwent a cervical biopsy for evaluation of a cervical mass. The specimen consisted of irregular tan tissue fragments mixed with gray-white mucoid material, measuring approximately 0.7 x 0.5 x 0.3 cm. Microscopic examination revealed a moderately to poorly differentiated cellular proliferation. The cells exhibited features consistent with a non-keratinizing or poorly keratinized morphology. The lesion involved the sampled tissue without clear margins. No lymphovascular invasion was identified. The histological grade and extent of involvement suggest a locally significant lesion."} +{"pid": "TCGA-56-A49D", "report": "The surgical pathology report describes a resected left lung specimen. The tumor is located in the left upper lobe and measures 4.4 cm in greatest dimension. The tumor is unifocal and grossly appears to abut the overlying pleura, with inked visceral pleural surface involvement noted (PL2). All bronchovascular surgical margins are free of tumor.\n\nA total of four perihilar lymph nodes were examined, with one showing evidence of metastatic involvement. Four level 9 lymph nodes were identified, and none contained tumor. A single AP window lymph node was positive for metastatic involvement. Three additional left lung lymph nodes were evaluated and showed no tumor involvement.\n\nThe specimen was submitted intact, and frozen section analysis confirmed negative bronchial and vascular margins. Gross examination revealed a white-tan, firm mass without other identifiable lesions in the remaining lung tissue. Additional tissue samples were submitted for research purposes.\n\nPathologic staging based on findings is pT2a pN2."} +{"pid": "TCGA-41-4097", "report": "The specimen consists of multiple fragments of soft tan to pink-tan tissue from the right temporal lobe, with sizes ranging from 0.7 cm up to 7 x 6 x 3 mm. Microscopic evaluation reveals a high-grade astrocytic neoplasm characterized by marked cellular pleomorphism, frequent mitotic figures, and areas of necrosis surrounded by pseudopalisading tumor cells. Additional features include focal vascular proliferation and a spindle cell component. Tissue submitted for frozen section and permanent analysis shows similar findings across multiple blocks. The tumor demonstrates aggressive histological features including necrosis and mitotic activity."} +{"pid": "TCGA-DV-5573", "report": "The specimen consists of six tumors removed from the right kidney and a resected 11th rib. Tumor #1 consists of two yellow/brown tissue fragments, each measuring 0.5 x 0.5 x 0.5 cm. Tumor #2 is a yellow/brown piece measuring 0.8 x 0.8 x 0.8 cm. Tumor #3 is described as a white/tan/red piece measuring 1 cm in diameter, consistent with a cyst wall. Tumor #4 measures 2 x 1.5 x 1.2 cm and is brown and yellow in color. Tumor #5 is tan/brown/yellow, measuring 3.2 x 3.0 x 3.0 cm, with a mostly homogeneous surface and slightly hemorrhagic areas. Tumor #6 measures 2.8 x 2.2 x 2.1 cm and is tan/brown in appearance. All six kidney tumors were submitted for permanent processing after partial procurement for research, and the 11th rib specimen, measuring 3.0 x 2.0 x 0.8 cm, was examined grossly without identification of any mass lesions. The case is associated with a clinical history of multiple renal tumors."} +{"pid": "TCGA-NP-A5H7", "report": "The specimen consists of a right kidney nephrectomy weighing 868 grams, measuring 20.3 x 12.8 x 6.1 cm, with attached perinephric fat. The hilar structures include tied tubular elements consistent with the ureter, renal vein, and artery. On sectioning, there is a well-demarcated tan-orange to red-green mass measuring 13.8 x 11.7 x 9.1 cm, located centrally within the kidney. The mass abuts the inked outer surface of the kidney but does not appear to extend into the perinephric fat. Minimal residual tan-red renal parenchyma remains, and the cortical-medullary junction is distinct. The urothelium appears normal. No additional lesions or lymph nodes are identified.\n\nMicroscopic examination reveals a tumor composed of moderately pleomorphic cells arranged in small clusters and sheets, with abundant pale cytoplasm and large, irregular nuclei. Areas of necrosis are present. Immunohistochemical staining demonstrates variable positivity for CK7, weak positivity for CD10, and negativity for vimentin and cytokeratin AE1/AE3. Histochemical staining with Hale\u2019s colloidal iron shows weak positivity in most cells.\n\nHistologic, histochemical, and immunohistochemical findings indicate a neoplasm with features suggestive of a specific renal epithelial tumor type. Nuclear characteristics including binucleation and resinoid appearance, along with staining patterns, support this classification. The tumor is confined to the kidney without lymphovascular invasion. Necrosis is observed microscopically. Surgical margins are free of malignant cells. No sarcomatoid transformation is identified. The nuclear grade is high based on Fuhrman criteria. Staging indicates no regional lymph node involvement or distant spread (pT2bNX)."} +{"pid": "TCGA-D8-A27G", "report": "Histopathological examination was performed on a left breast specimen measuring 20 x 16 x 4 cm, along with axillary tissues measuring 23 x 8 x 3 cm and a skin flap of 16 x 10.5 cm. A lesion measuring 2 x 2 x 2 cm was identified in the lower outer quadrant, located 2.5 cm from the lower boundary, 0.2 cm from the base, and 2 cm from the skin. Lymph nodes measured 2 cm in length.\n\nMicroscopic analysis revealed a histological pattern characterized by a proliferation scoring 6 out of 14 based on mitotic count (10 mitoses per 10 high power fields) within a visual area of 0.55 mm diameter. Additional findings included changes consistent with atypical lobular hyperplasia, fibrocystic breast disease with ductal hyperplasia, and the presence of an intraductal papilloma. Axillary lymph nodes showed features of sinus histiocytosis and lipomatous replacement.\n\nStaging parameters indicated a T2 classification with no evidence of nodal involvement. The histological grade was determined to be NHG2."} +{"pid": "TCGA-Q1-A73O", "report": "The cervical biopsy specimens were obtained from a patient with a history of cervical mass and anemia. The first specimen, measuring 1.2 x 0.8 x 0.5 cm, was submitted fresh for frozen section evaluation and consisted of red-tan tissue. Frozen section analysis identified malignant cells. The residue from this specimen was placed in cassette 1F. The second specimen, measuring 1.5 x 0.5 x 0.5 cm, was described as friable and white-tan in appearance. It was trisected and fully submitted in cassettes 2A\u20132B for permanent sectioning. Both biopsies showed invasive cellular changes with large, non-keratinizing morphology and poor differentiation. No further diagnostic terms were included in the final summary. Special stains and procedures included one initial frozen section. The material was personally reviewed and the report was approved by the attending pathologist."} +{"pid": "TCGA-F1-6177", "report": "The specimen consists of a gastrectomy measuring 14 x 7 x 3.7 cm. A single large exophytic, centrally ulcerative red-tan mass with central hemorrhage is present along the lesser curvature, measuring 4.8 x 3.7 x 1.9 cm. Microscopically, the lesion shows moderately differentiated cellular features. The depth of invasion measures 1.0 cm, extending into the submucosa without involvement of the muscularis propria. There is no gross evidence of muscular wall involvement. \n\nAngiolymphatic space invasion is identified in block A12. No perineural invasion is observed. Surgical margins, including proximal, distal, and radical (adventitial), are all free of involvement. The tumor is located 2.1 cm from the duodenal margin and 5.6 cm from the gastric margin. \n\nLymph node evaluation reveals metastatic involvement in 2 out of 7 nodes examined. One involved lymph node is located at the lesser curvature and another, larger node (measuring 2.2 x 1.8 x 1.3 cm), is found at the greater curvature. The largest nodal metastasis measures 1.7 cm in greatest dimension. No extranodal extension is present.\n\nThe gastric serosa appears unremarkable, with a wall thickness of 3\u20134 mm. The mucosa is nodular and velvety. The duodenal mucosa is also unremarkable. A portion of greater omentum, approximately 23 x 20 x 2.5 cm, is attached to the greater curvature and shows no suspicious or nodular areas.\n\nTissue blocks submitted include sections of the tumor, adjacent gastric and duodenal mucosa, surgical margins, and surrounding adipose tissue. Lymph node sampling includes candidates from both lesser and greater curvatures. Pathologic staging is assessed as pT1b, pN1, pMx. This assessment is based solely on the current specimen and may require further clinical correlation for final staging."} +{"pid": "TCGA-HU-A4GP", "report": "The surgical specimen was fresh and obtained following a distal gastrectomy. The greater curvature measured 23.8 cm and the lesser curvature 13.7 cm. The proximal resection margin was located 19.7 cm from the lesion, while the distal resection margin was 6.0 cm. The duodenum measured 0.7 cm. A mass with ulceroinfiltrative appearance was identified on the lesser curvature side of the distal antrum. The lesion measured 4.8 x 3.6 x 1.1 cm and was located 9.3 cm from the proximal resection margin and 1.0 cm from the distal resection margin. No gross serosal invasion was observed.\n\nHistologically, the lesion exhibited moderately differentiated glandular features invading the muscularis propria (pT2). Both proximal and distal resection margins were negative. The growth pattern was infiltrative with no lymphoid reaction noted. Lymphovascular invasion was present, but there was no evidence of venous or perineural invasion. Among the lymph nodes examined, metastatic involvement was identified in two out of 63 nodes. Metastasis was confirmed in one lymph node labeled '6' and another labeled '12'. \n\nLymph nodes from other regions, including superior gastric, inferior gastric, '1', '4sb', '5', '7', '8', '9', '11p', and '12' (except the one involved), showed no evidence of tumor involvement. Based on these findings, the pathological staging was determined as pT2N1Mx according to the AJCC 7th edition criteria."} +{"pid": "TCGA-55-6979", "report": "The surgical pathology report includes evaluation of multiple specimens from the left lung and associated lymph nodes. A wedge resection from the left lower lobe shows an old calcified granuloma. A lymph node from level 2 is benign. A lobectomy specimen from the left upper lobe contains a subpleural tumor measuring 4.1 cm in greatest dimension, with an additional dimension of 3 cm. The tumor is located approximately 1 cm from the bronchial resection margin and does not extend through the pleura. Histologically, the lesion is poorly differentiated. Lymphovascular invasion is present; however, venous and arterial invasion are not identified. Margins are free of invasive carcinoma. One regional lymph node, adjacent to the bronchus, contains metastatic involvement while all other lymph nodes examined (including those at levels 6 and 9) are benign. A total of one out of six lymph nodes is involved. Pathologic staging is pT2, pN1, pMX. The assessment of stage is based solely on the current specimen and does not include other clinical or radiographic data."} +{"pid": "TCGA-D7-A747", "report": "The specimen includes a stomach measuring 13 x 16 cm along with attached omentum measuring 24 x 18 cm, and a segment of pancreas measuring 4 x 2 x 1.8 cm. A tumor is identified in the prepyloric region of the stomach, presenting as an ulcerated lesion measuring 3.5 x 3 x 1.2 cm. The lesion is located 8.5 cm from the proximal resection margin and 1.0 cm from the distal margin. Histologically, the lesion demonstrates poorly differentiated morphology according to Lauren classification (diffuse type). The tumor extends into the fat tissue of the lesser curvature and involves the greater omentum. Surgical margins are free of malignant involvement. Two out of eight regional lymph nodes show evidence of involvement. Vascular invasion is present. No definitive diagnosis is provided in this summary."} +{"pid": "TCGA-78-8648", "report": "The resected right upper lobe specimen, measuring 140 x 100 x 79 mm, includes a chest wall component consisting of four ribs and measuring 140 x 60 mm. Two stapled soft tissue margins are identified, with the longest measuring 90 mm and the other 60 mm; the shorter margin is inked blue following staple removal. A large cavitating lesion measuring 58 x 55 mm is present within the lung tissue. This lesion is located approximately 13 mm from the bronchial resection margin, more than 8 mm from the shorter soft tissue margin, and clear of the longer soft tissue margin. A thickened greyish-white fibrous-like capsule is observed between the lesion and the chest wall. The lesion is in close proximity to the serosal surface but does not appear to macroscopically invade the chest wall.\n\nHistologically, the lesion demonstrates cavitation and consists of poorly differentiated epithelial cells. Invasion through visceral pleural into chest wall connective tissue is noted. Vascular invasion is present; however, there is no evidence of lymphatic or perineural invasion. No malignant cells are identified at the bronchial resection margin. Inflammatory changes suggestive of obstructive pneumonitis are seen adjacent to the lesion. Emphysematous changes are also present in the surrounding lung parenchyma.\n\nLymph node specimens were examined, including hilar and peri-oesophageal collections. All lymph nodes show only reactive changes without evidence of malignancy. Sections of the resected chest wall and ribs demonstrate no residual tumor involvement. Hematopoietic marrow is present in rib bone sections. Three small chest wall lymph nodes also show no signs of malignant involvement.\n\nStaging assessment indicates involvement beyond the visceral pleura with chest wall extension, absence of lymph node metastasis, and indeterminate distant metastasis."} +{"pid": "TCGA-ZB-A962", "report": "Pathology Report-Summary: The tumor measures 5.0 x 5.0 x 4.0 cm. Histologic evaluation reveals epithelial cells positive for KL1 and negative for CD1a, CD5, and CD117. Among the epithelial cells, clusters of CD1a-positive immature T-lymphocytes are present. The tumor demonstrates pT2 stage with no lymph node involvement (pN0, 0 out of 4 nodes involved). According to the Masaoka staging system, the tumor is classified as stage II. There is evidence of focal infiltration into the mediastinal fat tissue."} +{"pid": "TCGA-D7-6815", "report": "The histopathological examination of a total organ resection of the stomach, measuring 18 x 13 cm, along with omentum measuring 23 x 7 x 2 cm, revealed a lesion located on the front wall measuring 5.3 x 3.9 x 1.8 cm. The proximal margin measured 5.4 cm from the lesion and the distal margin measured 9.2 cm. Microscopic analysis showed moderately differentiated tubular-type glandular structures with necrotic changes involving the full thickness of the gastric wall. No neoplastic involvement was observed at the surgical margins or in the omentum. Lymph node assessment showed metastatic involvement in 2 out of 10 nodes from the lesser curvature and 3 out of 9 nodes from the greater curvature. A total of 5 involved nodes were identified out of 19 examined. The depth of invasion extended through the muscularis propria into the subserosa."} +{"pid": "TCGA-WN-A9G9", "report": "The surgical specimen consists of a partial nephrectomy from the left kidney and peritumor fat. The partial nephrectomy measures 5.5 x 4.5 x 4.2 cm and contains an encapsulated lesion measuring 5.5 x 4.5 x 3.9 cm with yellow-gold appearance. The lesion is located in the upper pole, adjacent to the surgical margin but not extending through it. The surrounding renal tissue appears unremarkable. Multiple sections were taken for microscopic evaluation, including a representative section of the mass to the margin. No involvement of the surgical margins by invasive carcinoma was identified. The peritumor fat specimen consists of multiple tissue fragments without identifiable mass. Microscopic examination of this tissue revealed no evidence of malignancy.\n\nMicroscopic analysis of the renal lesion reveals papillary architecture with cellular features consistent with high nuclear grade. The tumor is confined within the kidney, without extension into the adrenal gland, renal vein, or vena cava. No microvascular invasion or lymph node involvement was identified. Based on available data, the tumor is staged as pT1b, indicating a tumor greater than 4 cm but less than 7 cm in size limited to the kidney. Regional lymph node and distant metastasis staging could not be assessed. All findings are based on histopathological evaluation and are considered provisional pending further clinical correlation."} +{"pid": "TCGA-ZF-A9RN", "report": "The surgical specimen includes a radical cystectomy with attached uterus, ovaries, and anterior vaginal wall. The bladder measures approximately 90 mm in diameter and is surrounded by adipose tissue. On the peritoneal surface, there is an irregular haemorrhagic area measuring about 15 mm, indicating possible extension of the lesion. Upon opening, a fungating lesion arising from the posterior bladder wall is identified, measuring approximately 70 mm in diameter, with broad attachment and extensive necrosis. In addition, a separate 20 mm mass and two smaller 4 mm nodules are present on the background mucosa. Sectioning reveals that the main lesion extends through the bladder wall, approaching the peritoneal surface, with an overall thickness of approximately 40 mm. The remainder of the bladder mucosa appears normal, although marked trabeculation is noted.\n\nThe urethra measures 25 mm in length and has normal-appearing surface mucosa, though a 5 mm nodule is identified between the midpoint of the urethra and the anterior vaginal wall. The uterus measures 60 mm in its longest dimension and shows no apparent abnormality in the cervix, endometrium, or myometrium. Both ovaries show signs of atrophy, with the left ovary measuring 20 mm and the right 18 mm; no further abnormalities are seen in the ovaries or fallopian tubes. The left ureteric resection margin measures 5 mm and the right ureteric margin measures 9 mm, both showing normal histology.\n\nMicroscopic examination reveals sheets of undifferentiated epithelial cells with focal squamous features and areas of necrosis. Invasion through the full thickness of the bladder wall into surrounding fat is observed, along with lymphovascular invasion. The haemorrhagic focus on the peritoneal surface contains similar cellular morphology, with proximity to the surface measuring approximately 2\u20133 mm. A nodule of comparable cellular composition is found within the septum between the urethral midpoint and anterior vaginal wall.\n\nLymph node assessment includes two small nodes in the perivesical fat with reactive changes only; no tumour involvement is identified. Other resected tissues, including the cervix, endometrium, ovaries, fallopian tubes, and ureters, appear histologically unremarkable. The urethral resection margin also shows no abnormal cellular features."} +{"pid": "TCGA-EW-A1PE", "report": "A left lumpectomy specimen measuring 11.5 x 7.5 x 3.5 cm was evaluated. Histologic examination revealed a focus of invasive carcinoma with moderately differentiated features and a Nottingham histologic score of 6 (glandular differentiation score 3, nuclear pleomorphism score 2, mitotic count score 1). The tumor measured approximately 1.9 cm microscopically and demonstrated lymphovascular invasion. Resection margins were free of invasive carcinoma, with the closest margin measuring 4 mm anteriorly. Adjacent to the invasive component was an area of ductal intraepithelial neoplasia involving approximately 10% of the sampled tissue. This in situ component exhibited cribriform architecture, intermediate nuclear grade, and extensive central necrosis. Margins were also free of this in situ lesion, with the closest distance being 10 mm anteriorly.\n\nAxillary lymph node dissection included 23 lymph nodes. One lymph node contained metastatic involvement measuring 2.5 mm in greatest dimension. No micrometastases or isolated tumor cells were identified in the remaining lymph nodes. There was no extranodal extension identified.\n\nThe primary lesion was unifocal with a maximum microscopic dimension of 2 cm. Gross evaluation of the excised tissue confirmed the tumor location relative to surgical margins. No skin or skeletal muscle was present in the specimen. Immunohistochemical studies performed on another specimen showed immunoreactive tumor cells for estrogen and progesterone receptors; HER2 testing was negative.\n\nPathologic staging according to AJCC criteria was determined as pT1c for the primary lesion and pN1a for regional lymph node involvement. No distant metastasis was evident."} +{"pid": "TCGA-BH-A0DT", "report": "The surgical specimen includes a right total mastectomy and lymph node biopsies. Invasive tumor measures 1.2 cm in maximum dimension and is graded using the Nottingham scoring system with a total score of 5 out of 9 (tubule formation 2, nuclear pleomorphism 2, mitotic activity 1). Ductal carcinoma in situ (DCIS) with a cribriform pattern and nuclear grade 1 constitutes approximately 10% of the tumor mass and is present both admixed with and separate from the invasive component. Lobular carcinoma in situ (LCIS) is also identified. No lymphovascular space invasion is observed. The invasive tumor extends focally to the anterior margin, while the nipple is free of tumor involvement.\n\nAdditional findings include atypical ductal hyperplasia and atypical lobular hyperplia. Non-neoplastic breast tissue shows fibroadenomatous changes. Previous biopsy site changes are noted.\n\nLymph node evaluation includes four sentinel nodes and additional axillary dissection. Sentinel node number 3 contains metastatic involvement measuring 4.0 mm without pericapsular invasion. Sentinel nodes 1, 2, and 4 show no evidence of metastasis. A total of 18 lymph nodes were examined, with one sentinel node positive for metastasis. No extracapsular extension is identified.\n\nHistologic evaluation of surgical margins reveals involvement by the invasive component at the anterior margin. All other margins are negative. DCIS or Paget\u2019s disease involvement at the nipple was not documented.\n\nNon-neoplastic tissue demonstrates benign proliferative changes including atypical ductal and lobular hyperplasia.\n\nPathologic staging reflects T stage as pT1c, N stage as pN1 (1 of 18 lymph nodes positive), and M stage as pMX. Immunohistochemical data indicate HER2/neu expression scored as zero or 1. Estrogen receptor status is reported as positive."} +{"pid": "TCGA-VS-A9UD", "report": "The specimen consists of a fragment of tissue from the uterine cervix. Microscopic examination reveals a moderately differentiated invasive squamous cell lesion. The tumor cells exhibit features consistent with malignancy, including nuclear atypia and increased mitotic activity. There is no evidence of angiolymphatic invasion identified. The lesion is confined without extension into vascular or lymphatic channels."} +{"pid": "TCGA-B6-A0IB", "report": "The specimen consists of a right breast with an axillary tail, measuring 25 x 17 x 3.5 cm, and includes an 18 x 9 cm ellipse of skin containing the nipple. A biopsy cavity measuring 6 x 3.5 x 3.0 cm is present in the inner upper and inner lower quadrants. Surrounding this cavity is firm to hard breast tissue extending up to 2.5 cm from the cavity in all directions. A second nodule approximately 3 cm in diameter is located about 5 cm lateral to the biopsy cavity. Firm breast tissue is also noted between the main mass and the smaller nodule, making it unclear whether the second lesion is separate or contiguous with the primary lesion.\n\nTissue samples were taken from various areas, including sections adjacent to the biopsy cavity with deep margins, random sections of the tumor, the area between the two masses, the 3 cm nodule, and other regions including the upper outer and lower inner quadrants, skin beneath the biopsy site, and the nipple. Lymph nodes from all three levels of the axillary tail were also submitted for examination.\n\nMicroscopic evaluation revealed high-grade cellular changes with nuclear features consistent with a high histologic and nuclear grade. In the lymph node assessment, one level-I node was negative, six of nine level-II nodes were positive, and two of five level-III nodes were involved. All surgical margins were free of abnormal cells."} +{"pid": "TCGA-CM-6674", "report": "The specimen from a total abdominal colectomy includes a segment of terminal ileum measuring 7 cm in length and 3 cm in circumference at the proximal margin, and colon measuring 70 cm in length with a 3.5 cm diameter at the distal margin. The attached appendix is 5 cm long and averages 0.5 cm in diameter. A mass lesion is identified in the ascending colon, located 18 cm from the proximal margin and 50 cm from the distal margin. The lesion measures 4 cm in length and 5.5 cm in width, and invades the muscularis propria with a maximal thickness of 0.4 cm. Tumor budding is not present, and increased tumor-infiltrating lymphocytes are observed. The depth of invasion extends to subserosal adipose tissue and/or mesenteric fat. No evidence of gross tumor perforation, lymphovascular invasion, large venous invasion, or perineural invasion is identified. Surgical margins are free of involvement.\n\nA precursor lesion is noted as a tubulovillous adenoma. No polyps or mucosal dysplasia are found away from the lesion. The non-neoplastic bowel appears unremarkable, and tattoo pigment is present consistent with a prior procedure. The appendix shows no abnormalities. Examination of the attached adipose tissue reveals no gross lesions in the sigmoid colon, and all identified lymph nodes are submitted for analysis. A total of 43 lymph nodes are examined, with none showing metastatic involvement. No tumor deposits are identified in the pericolorectal soft tissue.\n\nImmunohistochemical staining for mismatch repair proteins demonstrates absence of MLH1 and PMS2 expression in the tumor, while MSH2 and MSH6 expression are preserved. This pattern suggests a deficiency in DNA mismatch repair function, and clinical correlation is recommended. \n\nThe proximal and distal anastomotic rings are both submitted and show no pathological findings. All surgical margins are free of disease. The histologic grade of the lesion is moderately differentiated, and no mucinous component is noted."} +{"pid": "TCGA-A2-A0EU", "report": "A right breast tissue specimen was received with three distinct pink-white masses identified. The first mass measures 1.0 cm in greatest dimension and is located 0.7 cm from the deep margin. The second mass is 0.5 cm and is found 0.5 cm anterior to the first, approaching within 0.2 cm of the anterior and lateral margins. The third mass measures 1.2 cm and is located 1.0 cm medial to the first two masses, coming within 0.2 cm of the anterior margin. Necrosis is present, and microcalcifications are noted in association with the\u75c5\u53d8 as well as within the media of vessels. Ductal changes include high nuclear grade (grade 3) intraductal components, including solid and comedo types. Margins show invasive and in situ components within 0.1 cm of the medial inked margin.\n\nHistologic evaluation reveals a Nottingham score of 8 out of 9 (tubules: 3, nuclei: 3, mitoses: 2), corresponding to the highest histologic grade. Mitotic activity measures 13 per 10 high-power fields. Vascular or lymphatic invasion was not identified. Immunohistochemical staining shows strong positivity for estrogen and progesterone receptors (95% each), while HER2 by IHC is negative (1+). A single axillary lymph node examined is free of metastatic involvement by both H&E and immunohistochemical analysis.\n\nThe tissue specimen also demonstrates fibrocystic changes and calcifications confirmed radiographically. Three separate tumor foci were confirmed grossly and via imaging, supporting multifocality. The specimen was fixed in formalin for 51 hours prior to processing, and all relevant margins were submitted for evaluation."} +{"pid": "TCGA-AJ-A3BK", "report": "The specimen was received in three containers. Container one, labeled \u201cleft pelvic lymph nodes,\u201d contains a 7.5 x 5.0 x 3.0 cm aggregate of yellow-tan fibrofatty soft tissue. Multiple firm fatty structures measuring between 0.3 and 3.0 cm were identified on palpation. These were entirely submitted in cassettes 1A\u20131K as follows: 1A\u2013B (five whole possible lymph nodes each), 1C (two whole possible lymph nodes), 1D (one bisected whole possible lymph node), 1E\u2013F (one bisected whole possible lymph node each), and 1G\u2013K (serially sectioned single whole possible lymph nodes).\n\nContainer two, labeled \u201cright pelvic lymph nodes,\u201d contains a 6.5 x 6.0 x 3.5 cm aggregate of yellow-tan fibrofatty soft tissue. Multiple firm fatty structures measuring between 0.8 and 5.0 cm were identified. These were entirely submitted in cassettes 2A\u20132P: 2A (four whole possible lymph nodes), 2B (two whole possible lymph nodes), 2C\u2013D (one bisected whole possible lymph node each), and 2E\u2013P (serially sectioned single whole possible lymph nodes).\n\nContainer three, labeled \u201cuterus, cervix, bilateral tubes and ovaries,\u201d contains a 49 g uterus with attached cervix and bilateral adnexa. The uterine corpus measures 3.4 x 3.4 x 2.4 cm and is covered by pink-tan serosa. The cervix measures 2.5 x 3.4 x 3.3 cm and has pink-tan ectocervical mucosa with a central patent os measuring 0.6 cm. Parametrial soft tissues are inked and taken en face. The endocervical canal appears yellow-tan and mucoid. A pink-tan friable mass is present within the triangular endometrium, invading 1.2 cm into a 1.8 cm thick myometrial wall. Adjacent normal-appearing endometrium averages 0.1 cm in thickness. No myometrial nodules or lesions are observed.\n\nThe right fallopian tube measures 6.5 cm in length and ranges from 0.5 to 0.7 cm in diameter. The attached ovary measures 3.5 x 1.0 x 0.7 cm and has a yellow-gray fibrous cut surface with a gray-white corpus albicans. The left fallopian tube measures 5.5 cm in length and ranges from 0.5 to 0.8 cm in diameter. A 0.8 cm uniloculated paratubal cyst is noted with smooth inner lining and yellow-tar gelatinous content. The left ovary measures 1.5 x 1.0 x 0.7 cm and shows similar features to the right ovary upon bisection.\n\nRepresentative sections from the uterus, cervix, and adnexa are submitted in cassettes 3A\u20133O. Additional cassettes for genomic research are also included.\n\nMicroscopic evaluation of the left pelvic lymph nodes reveals fat infiltration without evidence of malignancy; 13 lymph nodes were assessed. In the right pelvic lymph nodes, similar findings are noted with fat infiltration and no malignancy; 9 lymph nodes were examined.\n\nExamination of the endomyometrial region reveals a cellular infiltrate within the endometrial cavity and underlying myometrium. The cells show distinct morphologic features consistent with high-grade transformation. Invasion extends beyond one-half of the myometrial thickness, with maximal invasion measuring 12 mm into an 18 mm thick wall. There is no involvement of the endocervix or lower uterine segment. Lymphovascular space invasion is not identified.\n\nMargins of resection\u2014including cervical and parametrial\u2014are free of abnormal cellular aggregates. No metastatic involvement is identified in the 22 lymph nodes evaluated. Cervical squamous metaplasia is present without dysplasia. The endocervix shows no significant pathology. Residual endometrium demonstrates cystic atrophy. Focal adenomyosis is present in the myometrium. The uterine serosa appears unremarkable. Bilateral ovarian atrophy is noted. Benign paratubal cysts are identified in both fallopian tubes."} +{"pid": "TCGA-DJ-A2Q6", "report": "A 3.5 x 1 x 0.7 cm ellipse of skin from the right neck scar showed benign tissue with a giant cell reaction. Multiple lymph nodes were evaluated across various levels of the right neck. In level two, 12 lymph nodes were examined, with 2 showing involvement. The largest lymph node measured 1 cm and contained a metastatic focus of 0.6 cm; extranodal extension was present. In level three, 12 lymph nodes were assessed, with 4 involved. The largest lymph node measured 1.1 cm and had a metastatic focus of 0.9 cm; extranodal extension was not identified. In levels four and five-B, 5 lymph nodes were examined, with 1 involved. The largest lymph node measured 0.3 cm and contained a metastatic focus of 0.05 cm; extranodal extension was not identified.\n\nThe thyroidectomy specimen included multiple nodules, all well-differentiated with no mitotic activity or tumor necrosis noted. Psammoma bodies were identified. Two larger nodules were located in the right lobe, measuring 1.1 cm and 1 cm respectively, along with six smaller nodules ranging from 0.1 to 1.1 cm. No tumor encapsulation was identified for the classical type. Blood vessel invasion was not observed, but there was extension into fibroadipose tissue. Surgical margins were free of tumor, although the tumor was noted to be very close (< one high power field) to the inked margin. Multiple microscopic and gross foci were present. Adjacent non-neoplastic thyroid tissue showed mild nodular hyperplasia. One parathyroid fragment was identified near the left lobe and appeared unremarkable.\n\nA total of 16 lymph nodes were dissected from the thyroid specimen, with 15 showing metastatic involvement. The largest involved lymph node measured 1.1 cm, and perinodal extension was identified. A benign large vessel was also noted within the specimen. All specimens were processed and reviewed according to standard protocols."} +{"pid": "TCGA-BR-7957", "report": "The specimen consists of an excised tissue sample from the stomach. The lesion measures 4 x 3.5 x 1.2 cm and is located in the fundus. The surface of the lesion is ulcerated. Microscopic evaluation reveals glandular structures with intestinal-type morphology. The tumor extends to the serosal layer, including the visceral peritoneum. Of the lymph nodes examined, 7 out of 8 show involvement by metastatic cells, specifically within intraabdominal and retroperitoneal regions. All resection margins are free of tumor involvement. No definitive assessment was made regarding lymphatic, venous, or perineural invasion, nor was there any indication of neoadjuvant treatment effect. No additional significant pathological findings were noted."} +{"pid": "TCGA-GL-A9DE", "report": "The specimen consists of a right kidney with attached ureter, measuring 11.5 x 7 x 5 cm. The ureter is 5 cm in length and 0.4 cm in diameter. A distinct mass is identified within the mid portion of the kidney, measuring 4.8 x 3.7 x 3.5 cm. The mass is tan-brown, lobulated, and well-delineated, with a hemorrhagic and degenerative cut surface. It involves the renal sinus fat, focally abuts the wall of the renal vein, and extends to the renal capsule but does not extend beyond it. Adjacent to the mass is a cortical cyst measuring 0.8 cm in greatest dimension containing tan-brown fluid. A separate tan-white nodule measuring 0.3 x 0.2 x 0.2 cm is identified 1.2 cm away from the mass. The uninvolved renal parenchyma shows a pink-tan to red-brown corticomedullary junction with a cortical thickness up to 1.2 cm. The collecting system is lined by pink-tan granular mucosa. The hilar fat weighs 15 grams and no lymph nodes are identified upon sectioning.\n\nMicroscopic evaluation reveals nuclear features corresponding to grade 3 of 4. The tumor appears confined to the kidney without evidence of perinephric fat invasion beyond the renal sinus involvement already described, and there is no invasion of hilar structures or other adjacent tissues. No sarcomatoid features are identified. The tumor is unifocal, with no additional lesions detected. Margins are negative for involvement. Lymph node assessment is not possible due to absence of identifiable nodes. Non-neoplastic findings include a cortical cyst and a small, well-delineated nodule within the renal cortex. Representative sections have been submitted for analysis, including areas involving the mass, surrounding tissue, and margins."} +{"pid": "TCGA-D8-A27P", "report": "Histopathological examination was performed on a right breast specimen measuring 17.2 x 13.2 x 4.4 cm with a skin flap of 14.4 x 7.2 cm and weighing 345 g. A lesion measuring 1.2 x 1.4 x 0.9 cm was identified at the boundary of the upper quadrants, located 4.3 cm from the upper boundary, 0.8 cm from the base, and 1.6 cm from the skin. Microscopic evaluation revealed a proliferation of cells arranged in a specific growth pattern, with nuclear grading corresponding to low-grade features based on mitotic count (0 mitoses per 10 high power fields in the assessed area of 0.55 mm\u00b2). Extensive intraductal proliferation was also observed within the lesion, characterized by micropapillary architecture, moderate nuclear atypia, and central necrosis occupying approximately 70% of the lesion volume. No involvement of the nipple was identified. The surrounding glandular tissue demonstrated signs of involutional changes.\n\nImmunohistochemical analysis showed expression of estrogen receptors in 75% of the neoplastic cell nuclei and progesterone receptors in 10%. HER2 staining using Ventana's Pathway HER-2/neu (4B5) Rabbit Monoclonal Antibody demonstrated a score of 1+, indicating no significant overexpression in the invasive component. The lymph node status was negative based on sentinel node assessment."} +{"pid": "TCGA-HC-8258", "report": "The prostate specimen measured 4.5 x 4.0 x 3.0 cm and weighed 24 grams. Histologic evaluation revealed a lesion involving approximately 5% of the prostate volume. The histologic pattern showed a primary and secondary pattern score of 3 each, resulting in a total score. High-grade intraepithelial neoplasia was present. There was no evidence of extraprostatic extension, seminal vesicle involvement, or lymphovascular space invasion. The surgical margins were evaluated, with tumor located less than 0.1 cm from the right apical margin; however, the bladder neck and inked prostatic margins were negative. Two pelvic lymph nodes were examined and none contained metastatic disease. The staging classification assigned was based on these findings. No treatment effect was observed."} +{"pid": "TCGA-IF-A4AJ", "report": "The specimen consists of a left below-the-knee amputation. The lesion is located within the deep soft tissues of the lower leg and measures 10.0 cm in maximum dimension. Microscopic examination shows that the tissue involved includes a medium-sized vessel, which appears to be a vein. The lesion exhibits focal invasion into the fibula with disruption of cortical bone at a fracture site in the mid-diaphysis. Necrosis is present but accounts for less than 15% of the tissue. Surgical margins of resection are free of abnormal cellular infiltration."} +{"pid": "TCGA-77-A5GF", "report": "Histopathology Report. HISTORY. Left lower lobe; L/N 10; Bronchial Ca left lower lobe; patient has mild pulmonary fibrosis. MACROSCOPIC. Two specimens submitted. 1. The first specimen is labelled \"left lower lobe\" and consists of a lobe of lung measuring 125 x 80 x 65 mm. No parietal pleura is included. The visceral pleural surface shows focal puckering on the lateral surface, measuring 25 mm in diameter. Several enlarged hilar nodes are present, ranging from 15 mm to 30 mm in diameter. Serial slicing reveals a solitary, ill-defined subpleural lesion measuring 24 x 10 x 22 mm, located beneath the area of pleural puckering and situated 33 mm from the bronchial resection margin. The non-neoplastic lung demonstrates extensive dilatation of subpleural airspaces toward the apex, with some measuring up to 35 mm in maximum diameter. In the basal region, there is diffuse firmness associated with grey discoloration. Sections include: [1A, shave bronchial resection margin; 1B, shave vascular resection margin; 1C-1D, composite section of lesion and associated puckered pleura; 1E-1F, composite section of full face of lesion and its relation to the pleura; 1G, rep TS of lesion; 1H-1I, 2 rep TS of apical lung showing extensively dilated airspaces; 1J, rep TS of basal lung showing the firm grey area; 1K-1N, hilar lymph nodes (1 node per block)]. 2. The second specimen is labelled \"left no 10 lymph node\" and consists of two fragments of brown to black tissue measuring 16 x 8 x 7 mm and 9 x 6 x 6 mm, each bisected. [BIT, 2A.]. MICROSCOPIC. 1: Microscopic sections show a poorly differentiated cellular proliferation measuring 27 mm in maximum dimension. The lesion is subpleural and shows invasion of the pleura. There is no evidence of vascular or lymphatic invasion, nor is there perineural involvement. The lesion is well clear of the bronchial resection margin. All identified hilar lymph nodes contain similar cellular deposits, with some showing involvement at the margins. The surrounding lung parenchyma shows emphysematous changes and fibrosis with a pattern resembling usual interstitial pneumonia. Fibrotic changes are most prominent in the basal portion of the lobe, with honeycomb change and fibroblastic activity noted. 2: The No. 10 lymph node does not show any abnormal cellular infiltration and contains carbon pigment and birefringent material consistent with silica. SUMMARY. 1&2. Lung, left lower lobe and lymph nodes: - Poorly differentiated cellular proliferation measuring 27 mm in maximal dimension. - No vascular, lymphatic, or perineural involvement. - Pleural invasion identified; clear of bronchial margin. - Involved hilar lymph nodes with marginal involvement noted. - No abnormal cellular findings in No 10 lymph node (Specimen 2). - T2a N1 [AJCC 7th ed]. - Non-neoplastic lung: Emphysema, fibrosis with UIP-like pattern. T-28000 M-80703 M-78000 P1-03000. ANATOMICAL PATHOLOGY."} +{"pid": "TCGA-DX-A7EI", "report": "The resected specimen from the retroperitoneal dissection included a segment of colon, left kidney, and a portion of duodenum. Two distinct tumor nodules were identified within the mesenteric and pericolonic adipose tissue. The larger measured 6.0 cm in greatest dimension and was partially attached to a segment of duodenum, with its surface entirely inked. The smaller measured 3.0 cm and was adherent to perinephric adipose tissue. Both masses were partially covered by fibrotic tissue. The colonic mucosa showed marked flattening with multiple diverticula, but no discrete tumor mass was found. No significant abnormalities were observed in the kidney parenchyma. Nineteen lymph nodes were identified in the pericolonic adipose tissue and all appeared benign upon histologic evaluation.\n\nA separate soft tissue mass measuring 6.5 cm in greatest dimension was removed from the left psoas region. It had a multi-lobulated surface and was encapsulated by fibrous tissue. Cross-section revealed tan-white, fleshy areas with focal cystic change, central fibrosis, and bone formation. A fragment of skeletal muscle adjacent to the tumor was free of involvement. One lymph node associated with this specimen also appeared benign.\n\nA third specimen obtained from the left common iliac lymph node region contained fibroadipose tissue. Histologic examination revealed focal infiltration by low-grade cells within a sclerosing stroma, though the lymph node itself was benign.\n\nImmunohistochemical analysis demonstrated positivity for desmin, calponin, and smooth muscle actin in areas of the tumor with myoid differentiation, while CD117 was negative. No tumor was identified at the surgical margins of the resected colon or duodenum. However, the tumor focally extended to the inked margin in the retroperitoneal dissection specimen. Involvement of perinephric, omental, and duodenal subserosal tissues was noted. The left psoas mass showed no evidence of extension into the skeletal muscle margin."} +{"pid": "TCGA-EC-A24G", "report": "The specimen shows a well-circumscribed mass with a pushing border. The cut surface is tan-white, firm, and lobulated. The lesion measures 1.8 cm in greatest dimension and is entirely embedded for microscopic evaluation. Microscopically, the lesion demonstrates a proliferation of spindle-shaped cells arranged in interlacing fascicles. The nuclei are elongated with fine chromatin, and no significant nuclear pleomorphism is identified. Mitotic activity is low, with fewer than 2 mitoses per 10 high-power fields. There is no evidence of necrosis or vascular invasion. The resection margins are free of neoplastic cells. No lymph nodes are involved. Based on these findings, the lesion appears to be non-malignant with no signs of aggressive behavior."} +{"pid": "TCGA-DJ-A3VB", "report": "The specimen from the tracheal biopsy consisted of two small tissue fragments, each measuring less than 0.1 cm. The frozen section evaluation showed benign respiratory mucosa. A left paratracheal soft tissue specimen measuring 1.1 x 1.0 x 0.3 cm was also examined. The final assessment identified a lymph node containing a metastatic focus measuring 0.25 cm; the node itself measured 0.5 cm. No extranodal extension was observed. This focus was not present on the initial frozen section slide.\n\nThe total thyroidectomy specimen weighed 52 grams. The right lobe measured 6.7 x 3.4 x 1.7 cm, the left lobe 5.7 x 5.2 x 2.5 cm, and the isthmus 3 x 2.6 x 1 cm. Upon sectioning, three nodules were found in the right lobe: two smaller ones measuring 0.6 x 0.4 x 0.4 cm and 3.7 x 2.4 x 2.4 cm, and one larger nodule of similar size, all with tan-white to pink-tan, rubbery consistency. The largest nodule in the right lobe was in contact with both anterior and posterior aspects of the capsule. In the left lobe, there was a tan-brown, friable nodule measuring 5.2 x 2.4 x 2.3 cm, which was finely focally encapsulated and also in contact with the anterior and posterior capsular surfaces. The remaining thyroid tissue appeared red-tan and meaty. No mitotic activity or tumor necrosis was identified. The tumor was partially surrounded by a thin fibrous capsule and did not show blood vessel invasion. There was involvement of adjacent fibroadipose tissue surrounding the thyroid. All surgical margins were free of involvement. Additional findings included separate nodules in the right lobe, including a follicular variant that was encapsulated and non-invasive (measuring 3.7 cm), and a microcarcinoma variant. The non-neoplastic portions of the thyroid showed changes consistent with nodular hyperplasia. Parathyroid glands were not identified in the specimen."} +{"pid": "TCGA-CU-A0YO", "report": "The specimen measured 13.8 x 11.2 x 4.5 cm and was submitted as a cystectomy. A distinct mass measuring 4.5 x 1.9 cm was identified, involving a large portion of the bladder. Microscopic evaluation showed that the lesion extended through the muscularis propria into perivesical fat, with involvement of lymphatic channels. The tumor was unifocal and no intraepithelial abnormality was noted. Both uretero-vesical junctions were involved, though the ureters themselves were not affected. Surgical margins of the left and right ureters were negative. The distal urethral margin on the right was positive, while the left was negative. The paravesical soft tissue was free of disease but came within 1 mm of the serosal surface.\n\nLymph node dissection was performed on both right and left pelvic specimens. In the right pelvic lymph nodes, 7 out of 10 nodes contained metastatic disease, with the largest deposit measuring 1.4 cm. In the left pelvic lymph nodes, 1 out of 3 nodes was involved, with a focus measuring 2 mm. No extranodal extension was observed in any of the involved nodes.\n\nA separate focus of glandular neoplasm was identified in the right lobe of the prostate, estimated to involve more than half of that lobe. The surgical margin at the right distal urethra was involved by this process. This lesion did not show vascular invasion or extracapsular extension. All other areas evaluated in the prostate were free of this second neoplasm.\n\nBlocks from the bladder mass showed involvement of perivesical fat and lymphatic invasion. Blocks from the prostate confirmed the presence of a separate glandular lesion in the right lobe, with additional involvement in adjacent sections. Tissue from the tan mass near the superior/posterior peritoneal surface of the bladder and perpendicular sections of presumed prostate were also examined. Adipose tissue fragments from right and left pelvic regions were evaluated for lymph node content, with multiple blocks taken from each site."} +{"pid": "TCGA-EO-A22U", "report": "The specimen included a total hysterectomy with bilateral salpingo-oophorectomy and omental biopsy. The uterus contained a mass measuring 2.8 cm in maximum dimension, located in the fundus and extending into the outer half of the myometrium with a depth of invasion of 10 mm. The surrounding myometrium had a thickness of 12 mm. No involvement of the cervix was identified, and there was no evidence of lymphovascular space invasion. Margins were uninvolved by invasive carcinoma, with the closest distance of invasive cells being 2 mm from the uterine serosa. Multiple intramural leiomyomata and adenomyosis were also noted.\n\nThe bilateral ovaries and fallopian tubes showed no significant pathological findings, although paratubal cysts were present bilaterally. The omental biopsy consisted of fibroadipose tissue without diagnostic pathology, and one lymph node was identified and negative for malignancy.\n\nMicroscopic evaluation revealed a tumor composed of glandular, papillary, and solid architectural patterns, with the solid component comprising more than 50% of the tumor. Focal squamous differentiation was observed, along with areas of high-grade nuclear features and bizarre morphology. Immunohistochemical staining demonstrated ER positivity in glandular areas, with weak focal staining for p53 and negativity for p16. In contrast, the solid areas were ER-negative, with patchy positivity for both p53 and p16.\n\nStaging indicated a primary tumor classification of pT1c (IC), reflecting invasion of more than half the myometrium. Regional lymph nodes could not be assessed (pNX), as none were submitted for evaluation. Distant metastasis could not be determined (pMX). Additional findings included benign ovarian and fallopian tube tissue, as well as unremarkable omental tissue."} +{"pid": "TCGA-FY-A40L", "report": "The surgical pathology report describes findings from a thyroidectomy specimen and associated lymph node biopsies. The thyroid gland weighed 10 grams and showed no grossly identifiable parathyroid tissue. Multiple tumor nodules were identified in both thyroid lobes. In the right lobe, an area of firm tan-white discoloration measured approximately 1.5 cm in maximum dimension. In the left lobe, two distinct nodules were observed: one measuring 0.4 cm in the superior pole and another measuring 1.1 cm in the inferior portion. Tumor tissue extended to the inked and cauterized surfaces at the inferior aspects of both the left and right thyroid lobes.\n\nTwo lymph nodes were submitted for examination. One lymph node, labeled as central node, contained a focus of tumor involvement measuring approximately 0.5 cm in diameter, accounting for nearly 90% of the lymph node tissue volume. Another lymph node from the left paratracheal region contained a smaller focus measuring 0.2 cm in diameter, involving approximately 10% of the lymph node.\n\nHistologic evaluation confirmed the presence of malignant cells arranged in a characteristic pattern. No lymphovascular invasion was identified; however, multiple positive lymph nodes were noted. Margins were involved, with tumor extending to the cauterized and inked surface at the inferior poles of both lobes.\n\nPathologic staging indicated moderately advanced disease based on intraoperative findings of extension beyond the thyroid capsule into adjacent tissue. Regional lymph node involvement was documented with two out of three nodes showing tumor presence. A separate benign finding adjacent to the right thyroid lobe was also identified, measuring at least 0.9 cm in diameter. Chronic inflammatory changes were noted in the thyroid tissue along with a small benign lymph node located near the gland.\n\nStaging was determined in accordance with established protocols. The primary tumor was classified as pT4a due to extrathyroidal extension observed intraoperatively and involvement of resection margins. Regional lymph node involvement was classified as pN1b. The overall pathologic stage was assigned as IVA."} +{"pid": "TCGA-06-0176", "report": "The surgical specimen from the right frontal lobe consists of multiple tissue fragments, with the largest measuring 3.0 x 2.0 x 1.2 cm. The tissue is described as soft, hemorrhagic, and variably colored with tan to maroon regions. Microscopic examination reveals a cellular neoplasm characterized by nuclear anaplasia, frequent mitotic figures, microvascular proliferation, and extensive necrosis. Giant cells are present throughout the specimen.\n\nImmunohistochemical staining demonstrates variable expression of GFAP, with some cells showing positivity. There is focal cytokeratin positivity but CK7 negativity. Overexpression of p53 protein is observed in the majority of cells (>75%). CD34 highlights increased vascularity, and MIB-1 labeling indicates a proliferation index of approximately 20% to 25%. The neoplasm appears relatively circumscribed and extends into the leptomeninges. A total of six blocks and six slides were examined, including six immunostains."} +{"pid": "TCGA-BP-5178", "report": "The surgical specimen included a right lobe of liver, partial duodenum, right adrenal gland, right kidney with surrounding perinephric fat, and portions of chest wall and diaphragm. The total specimen measured 28.0 x 25.0 x 6.0 cm and weighed 2,154 grams. The right kidney measured 15.0 x 8.0 x 6.0 cm and contained a tan, hemorrhagic mass measuring 10.0 x 8.0 x 6.0 cm located in the lower pole, extending to the upper pole and into the renal sinus. The mass extended into the surrounding perirenal fat and directly involved the liver and the muscularis propria of the duodenum. Vascular invasion was identified. The liver measured 25.0 x 8.0 x 9.0 cm and showed local extension of the mass into the parenchyma. The tumor was within 1.5 mm of the hepatic resection margin and 0.3 cm from the duodenal margin. All other surgical margins were free of involvement. Lymph nodes examined in the perinephric fat showed no evidence of metastasis (0/2). The non-neoplastic kidney and adrenal gland showed no significant findings. The hepatic parenchyma demonstrated mild nonspecific chronic portal inflammation without steatosis or cirrhosis. Sections from the ureteral and vascular margins were submitted and showed no involvement. Representative sections from the gallbladder were also submitted; it measured 4.0 x 3.0 x 1.2 cm and showed no significant pathology."} +{"pid": "TCGA-BP-4988", "report": "A 2.0 cm well-circumscribed tan-brown hemorrhagic mass was identified within the right kidney, which did not appear to invade into the sinus fat or surrounding structures. The tumor was confined to the kidney and measured 2.0 cm in greatest diameter. Nuclear grade II/IV was noted based on microscopic evaluation. Surgical margins were free of involvement. Examination of the non-neoplastic kidney parenchyma revealed a patchy dense atypical lymphoid infiltrate extending focally into perinephric fat. One lymph node located in the perinephric fat was free of tumor but demonstrated involvement by a lymphoproliferative process. Retroperitoneal lymph node tissue showed morphologic features consistent with a lymphoid neoplasm, without evidence of carcinoma. No adrenal gland was identified in the specimen. Staging criteria indicated confinement within the kidney without extension beyond. Multiple tissue sections were evaluated, including representative areas of the tumor, adjacent kidney, hilar and sinus fat, renal pelvis, ureteral and vascular margins, and lymph nodes."} +{"pid": "TCGA-DD-AACI", "report": "The specimen consists of a left liver segment measuring 10.0 x 9.0 x 12.0 cm in total size. A single tumor is present, measuring 5.5 x 3.5 x 5.0 cm, with no satellite nodules observed. The gross appearance shows an expanding nodular pattern without necrosis or hemorrhage. Portal vein invasion is identified, while bile duct invasion is not present. Dystrophic calcification is noted within fibrotic septa centrally.\n\nMicroscopically, the lesion demonstrates moderate differentiation with a trabecular and solid histologic pattern. Cellular features include hepatic morphology and the presence of fatty change involving approximately 30\u201340% of the tissue. A partial fibrous capsule is observed, with evidence of capsular infiltration. Septum formation is also partially present. Invasion of the portal vein is confirmed; however, no invasion is seen in the hepatic veins, hepatic artery, or bile ducts. There is no evidence of microvessel invasion, intrahepatic metastasis, or multicentric occurrence. Surgical resection margins show no involvement. Dystrophic calcification is present within fibrotic areas.\n\nNon-tumor liver pathology reveals chronic hepatitis of unknown origin, with minimal lobular and portoperiportal inflammation (grade I). Fibrosis is advanced, reaching stage III\u2013IV (precirrhotic). No dysplastic nodules or ductal epithelial dysplasia are identified.\n\nSpecial stains demonstrate the arrangement of the lesion cells with reticulum stain and highlight fibrotic septa using trichrome stain. Additional findings include bile duct inflammation on smear assessment."} +{"pid": "TCGA-44-7661", "report": "Final Surgical Pathology Report. Procedure: Diagnosis. A. Right lower lobe of lung, lobectomy: The right lower lobe of the lung was received fresh and measured 16 x 11 x 3.7 cm, weighing 176 grams. A 5.5 cm staple line was noted near the hilum. The bronchial stump measured 6 mm in diameter and a stapled vessel measured 7 mm; all margins appeared unremarkable. The pleural surface was mostly smooth, pink, and glistening with minimal pigmentation, though there was puckering and retraction in the superior anterior region. Corresponding to this area was a superficial, tan, fleshy tumor mass measuring 3.5 x 2.1 x 2.5 cm. The remainder of the pulmonary parenchyma was soft, pink, and spongy. No lesions were identified within the major vessels or bronchi. Sections were submitted after fixation, including those for touch preparation and tissue procurement. B. Level II lymph node specimen: A single glistening, soft reddish-black nodule measuring 0.7 cm in greatest dimension was bisected and submitted. C. Level VII lymph node specimen: A 1.6 x 1.2 x 0.5 cm soft tan-red-gray tissue was entirely submitted in one block after being quadrasected. D. R4 lymph node specimen: A 1.5 x 1.2 x 0.5 cm soft lobulated adipose tissue with tan-grey discoloration was also entirely submitted in one block after being quadrasected.\n\nMicroscopic findings: A subpleural tumor was identified in the right lower lobe. Histologic evaluation showed a poorly differentiated morphology. Staining for TTF-1 was strongly positive. The tumor measured 3.5 cm in maximum dimension. Invasion of arterial structures was present. Margins of resection, including bronchial and vascular margins, were negative. There was no evidence of direct tumor extension, large venous invasion, or small vessel lymphatic invasion. Lymph nodes from levels II, VII, and R4 all showed anthracosis but no metastatic involvement. No other significant findings were observed. Distant metastasis could not be assessed. Specimens A through D were examined microscopically. Clinical information included history of malignancy."} +{"pid": "TCGA-F7-A61V", "report": "A resection specimen from the left tongue base was submitted for analysis. The specimen measured 4.0 x 3.0 x 2.0 cm and was intact. A single lesion was identified, measuring 2.3 cm in greatest dimension with a thickness of 1.0 cm. Histologic evaluation revealed well differentiated cells arranged in a conventional growth pattern. Surgical margins were free of abnormal cells. There was no evidence of lymph-vascular or perineural involvement. \n\nLymph nodes from the left neck were evaluated: 2 nodes from level 1, 7 from level 2, 35 from level 3, and 18 from level 4. No abnormal cells were identified in any of the nodes examined. The largest lymph node measured 2.2 cm and showed reactive changes with follicular hyperplasia.\n\nAdditional specimens included fragments of tissue from the left deep tongue margin, each measuring 0.5 cm, and a portion of the left tongue near the base, all processed for intraoperative evaluation. No abnormalities were noted in these tissues. The submandibular gland was also unremarkable."} +{"pid": "TCGA-A3-3387", "report": "The specimen from a male patient consists of a left kidney measuring 25.0 x 15.0 x 7.5 cm and weighing 930 grams. The kidney is attached to perinephric fat, and no adrenal gland is present. The ureter stump measures 6.0 cm in length and 0.4 cm in diameter, with a gray-tan mucosal surface and no visible lesions. The renal artery and vein stumps measure 2.5 cm and 0.7 cm in length respectively, both with unremarkable gross appearances.\n\nA circumscribed golden-yellow partially hemorrhagic mass is identified in the upper pole of the kidney, measuring 4.0 x 4.0 x 2.5 cm. On sectioning, the mass comes within 0.1 cm of the inked deep margin but does not appear to extend beyond the renal capsule into the surrounding fat. The surrounding renal cortex is brown-tan, measuring 0.5 cm in thickness, with well-demarcated cortical and medullary regions. The renal pelvis and calices are unremarkable and show no involvement by the mass. No additional lesions are identified in the kidney or surrounding tissue.\n\nNo lymph nodes are grossly identified within the perinephric fat. Surgical margins, including soft tissue, ureteral, and vascular margins, are all negative. A total of zero lymph nodes are examined.\n\nMicroscopic evaluation reveals cells arranged in sheets and acinar structures with clear cytoplasm and well-defined cell borders. Nuclear morphology shows moderate pleomorphism with centrally located nuclei and inconspicuous nucleoli. Mitotic activity is low. The tumor is confined to the kidney without evidence of renal vein or transcapsular invasion. Lymphovascular space invasion is present. The Fuhrman nuclear grade is 2 out of 4. The mass does not extend into adjacent structures or involve resected vascular margins.\n\nStaging information indicates a T1a classification. No metastasis is identified, and no lymph nodes are available for assessment."} +{"pid": "TCGA-QK-A6VB", "report": "A surgical specimen from the left posterior floor of mouth measuring 10.5 x 5.0 x 4.5 cm was received along with multiple margin and lymph node specimens. The primary specimen showed a lesion measuring 2.2 x 2.0 x 1.0 cm, which was endophytic and ulcerated. Histologic evaluation revealed cellular features consistent with moderately differentiated squamous morphology. The tumor was found to involve skeletal muscle bundles. All mucosal and soft tissue margins (anterior, medial, superior, and posterior) were free of invasive disease or high-grade dysplasia. The closest margin was located 0.8 mm from the tumor. No lymphovascular or perineural invasion was identified.\n\nLymph node dissection included levels I through IV on the left side. A total of 40 lymph nodes were examined: level I (3 nodes), level II (5 nodes), level III (18 nodes), and level IV (10 nodes). All lymph nodes were negative for metastatic disease. One lymph node in level II showed no evidence of malignancy despite prior PET imaging suggesting hypermetabolism. Deeper sectioning of this node was planned for further evaluation.\n\nAdditional findings included reactive lymphoid aggregates and minimal histopathologic changes in salivary gland tissue. Tumor necrosis was noted. Other specimens including anterior, medial, and superior margins were also negative for carcinoma or high-grade dysplasia. Intraoperative frozen section analysis confirmed negative margins."} +{"pid": "TCGA-06-0197", "report": "The specimen consists of multiple soft tissue fragments from the right frontal region, measuring a total of 1 x 1 x 0.5 cm. The largest fragment is white-tan and firm, while smaller fragments are red to tan with petechial hemorrhages. Tissue was processed for touch imprints, smears, and histologic evaluation.\n\nMicroscopic examination reveals a neoplastic process involving brain parenchyma. The lesion is composed of pleomorphic cells with large, irregular, hyperchromatic nuclei and numerous mitotic figures. Areas of necrosis, vascular proliferation, and regions resembling sarcomatous differentiation are present, along with hemorrhage and early fibrin organization.\n\nSpecial stains, including trichrome and GFAP, do not demonstrate evidence of sarcomatous or fibroblastic proliferation. Immunohistochemical staining with MIB-1 reveals a proliferation index of 15 to 20%. These findings support the histopathologic features previously described."} +{"pid": "TCGA-WC-A87T", "report": "The right globe measured 23.0 mm in axial length, 23.0 mm horizontally, and 22.0 mm vertically, with an attached optic nerve measuring 4.0 mm in length. The cornea was transparent, measuring 11.0 mm horizontally and 10.0 mm vertically. The anterior chamber was formed, surrounded by a blue-gray iris with a round pupil 5.0 mm in diameter. Transillumination revealed a shadow located 8.0 mm from the limbus, extending from the 2-4 o\u2019clock hours to within 5 mm of the optic nerve. This corresponded to a tan-colored lesion with a base measuring 11 mm and a height of 10 mm. The growth pattern was vertical with a mushrooming appearance, the upper portion being larger than the base. The tumor was separated from the optic nerve by 8 mm and did not appear to involve it. The sclera was intact grossly.\n\nHistologically, the tumor demonstrated spindle cell morphology. Mitotic activity was present at a rate of two mitoses per 10 high power fields. Superficial scleral invasion was identified. There was no evidence of extraocular extension or vortex vein invasion. The optic nerve was uninvolved. The lens showed nuclear sclerosis. The overlying retina was thin and atrophic in areas, with focal detachment near the tumor base. Special staining with PAS highlighted focal complex structures within the tumor. Tissue samples were taken from multiple regions including the vortex veins and optic nerve."} +{"pid": "TCGA-BP-5169", "report": "The submitted specimens include a left kidney, a portion of the left eleventh rib, the left spermatic vein, and a periaortic lymph node. The kidney specimen shows a well-circumscribed mass measuring 5.0 x 3.5 x 3.5 cm located in the upper portion of the kidney. The mass is solid in growth pattern and appears to be confined within the renal capsule, compressing adjacent renal structures. It abuts the renal capsule and surrounding fat focally at the posterior aspect. Vascular invasion is present, but no involvement of the renal vein is identified. All surgical margins are free. The non-neoplastic kidney tissue shows chronic inflammation, and the adrenal gland is not present in the specimen.\n\nThe excised portion of the left eleventh rib consists of benign bone with trilineage marrow showing normal maturation. The left spermatic vein specimen contains benign vessels and fibroadipose tissue. The periaortic lymph node specimen includes nine lymph nodes, all of which appear benign.\n\nGross examination of the kidney confirms the presence of a circumscribed mass without extension beyond the kidney. The ureter and vascular margins are unremarkable. Representative sections of the tumor and surrounding tissue were submitted for analysis. No additional findings are noted in the other specimens."} +{"pid": "TCGA-DJ-A13R", "report": "The specimen consists of a total thyroidectomy measuring 5 \u00d7 4.5 \u00d7 4 cm, attached to the right lobe by a fibrous stalk. The tumor is encapsulated and not connected through the thyroid parenchyma. The cut surface is tan with focal hemorrhage, homogeneous, and fleshy. The right lobe measures 5 \u00d7 3.8 \u00d7 0.5 cm, the left lobe 6.5 \u00d7 2.2 \u00d7 2 cm, and the isthmus 2.2 \u00d7 2 \u00d7 0.8 cm. Histologically, the lesion is well differentiated with mild to moderate mitotic activity and oncocytic features. No tumor necrosis, capsular invasion, vascular invasion, or extrathyroid extension is identified. Surgical margins are free of tumor. A separate focus measuring 0.35 cm is present in the right lobe. Psammoma bodies are noted. Non-neoplastic tissue shows nodular hyperplasia and chronic lymphocytic thyroiditis. Two benign lymph nodes are identified. The specimen has been sectioned entirely from superior to inferior, with representative sampling of all areas including the stalk."} +{"pid": "TCGA-F2-6879", "report": "The specimen consists of a 4.5 cm solid pale yellow/white mass in the pancreatic head, with extension into peripancreatic fat and involvement of the duodenal wall near the ampulla of Vater. Histologically, the tissue shows moderately differentiated features. The tumor involves the duodenal wall and ampulla wall but does not grossly involve the bile duct or adjacent blood vessels. Surgical margins evaluated include the pancreatic neck (negative, 4 mm from inked margin), bile duct (negative), circumferential/deep (negative, <1 mm to inked margin), gastric (negative), and duodenal (negative). Two out of eleven regional lymph nodes show metastatic involvement, with the largest metastasis measuring 6 mm; no extracapsular extension is present. Additional findings include focal fibrosis and atrophy of the pancreatic parenchyma, as well as acute inflammation around the common bile duct. Multiple biopsies from liver segments 2, 3, and 7, as well as from the common bile duct margin, pancreatic duct margin, and various pancreatic margins, do not reveal any malignant cells. Some biopsies show benign liver tissue with canalicular cholestasis, while one biopsy of the pancreatic duct margin reveals in situ changes suspicious for invasive involvement. The gallbladder shows focal chronic inflammation without stones or malignancy. Based on these findings, the pathologic stage is classified as pT3 pN1 pMx."} +{"pid": "TCGA-QM-A5NM", "report": "The specimen consists of multiple pale tan tissue fragments measuring 2 x 1.5 x 0.4 cm in aggregate. All tissue was submitted for analysis. Microscopic evaluation revealed malignant cells with features previously documented. No additional diagnostic details are provided in this summary."} +{"pid": "TCGA-E9-A2JS", "report": "The left breast specimen involved tissue from the upper outer quadrant. A lumpectomy was performed, and a grossly evident lesion was identified measuring 2.4 x 0 x 2.8 cm. Histologic evaluation revealed moderately differentiated lobular carcinoma. Lymph node assessment showed 1 out of 10 axillary nodes positive for metastatic involvement; extracapsular extension was not assessed. Surgical margins were uninvolved. The Nottingham Histologic Score could not be determined due to insufficient data on tubule formation, nuclear pleomorphism, and mitotic counts at both 25x and 40x magnification. There was no information provided regarding tumor extent, evidence of neo-adjuvant treatment, or additional pathologic findings."} +{"pid": "TCGA-ET-A3DU", "report": "The specimen consisted of a left lobectomy. The tumor was located in the left lobe and measured 1.4 cm in greatest dimension. Histologic examination revealed invasive carcinoma with unifocal involvement. Immunohistochemical staining (AE1/AE3 keratin) demonstrated metastatic carcinoma in one of two lymph nodes examined; there was no extracapsular extension identified. The primary tumor was confined to the thyroid gland without extension beyond, corresponding to pT1 staging. Regional lymph node involvement included metastasis to Level VI lymph nodes, including pretracheal, paratracheal, and prelaryngeal/Delphian locations, consistent with pN1a staging. Distant metastasis could not be assessed (pMx). Margins were focally involved by invasive carcinoma at the posterior aspect. Additional findings included evidence of Hashimoto\u2019s thyroiditis and psammoma bodies identified within a lymph node near the isthmus margin."} +{"pid": "TCGA-XN-A8T3", "report": "The specimen consists of a segment of the pancreatic head and duodenum. The pancreatic tissue measures 6.0 x 4.5 x 4.5 cm, while the duodenum is 15.5 cm in length with a diameter of 2.5 cm. A lesion was identified in the pancreatic head, measuring 2.4 x 2.2 cm. Additionally, a gallbladder measuring 12.2 cm in length and 2.5 cm in diameter was submitted. Three lymph node groups were examined, with a total of 15 lymph nodes, ranging from 0.2 to 1.0 cm in size.\n\nMicroscopic examination revealed invasive cellular growth within the pancreatic tissue, characterized by moderately differentiated cell morphology. There were also areas suggestive of early intraepithelial changes with high-grade cellular atypia. Evidence of perineural invasion and angiolymphatic emboli was noted. No involvement of the duodenal papilla was observed. The surgical margin showed residual abnormal cells. No lymph node metastases were identified. The staging assessment indicated a T2 classification with no lymph node involvement."} +{"pid": "TCGA-A5-A0G2", "report": "The specimen includes a hysterectomy with bilateral fallopian tubes and ovaries. The uterus measures 5.5 cm from fundus to cervix, 4.5 cm laterally, and 2.5 cm anterior to posterior. A large tan polypoid mass measuring 3.5 x 3.0 x 2.5 cm is present in the posterior superior fundus wall and left cornu, with areas of necrosis and hemorrhage. The tumor extends into the right posterior myometrium, reaching approximately 0.5 cm from the serosa. At its deepest point, the tumor is about 0.2 cm beneath the uterine serosa, with a metastatic nodule identified in the adjacent serosa. Scattered small tumor islands are noted.\n\nMicroscopically, the neoplasm demonstrates high-grade features including solid cell nests, focal papillary structures, marked nuclear atypia, and numerous mitotic figures. Some areas show clear cell morphology. Metastatic involvement is confirmed in the right parametrium, right uterosacral ligament, cul-de-sac peritoneum, and uterine serosa. Eleven lymph nodes from various locations show no evidence of tumor involvement.\n\nBiopsies of the omentum (three specimens) show no neoplasm, though they exhibit areas of hemorrhage. The appendix appears unremarkable. No tumor is identified in the lower uterus, endocervix, left parametrium, or omentum. The background endometrium is thin and atrophic without hyperplasia or atypia. The posterior cervix shows mucus cysts and lymphoid aggregates with germinal centers. Adhesions are present in the uterine serosa. Both ovaries are atrophic; the right ovary contains small inclusion cysts.\n\nThe surgical staging indicates involvement of the serosa and regional spread to specific peritoneal and parametrial sites, but no lymph node metastasis."} +{"pid": "TCGA-A7-A0CE", "report": "The specimen includes a left axillary sentinel lymph node and left breast tissue. The lymph node, measuring 1.6 cm in maximum dimension, was bisected and examined intraoperatively; frozen section analysis showed no evidence of malignancy. The breast tissue measures 8 x 7 x 5 cm and includes a skin ellipse of 4.5 x 2 cm. A tan white-pink indurated mass measuring 2.8 cm in greatest dimension is present within the breast tissue, located 1.1 cm from the nearest margin (inferior posterior). Margins were otherwise negative.\n\nMicroscopic evaluation of the breast tissue shows a high-grade infiltrating lesion with features including a high architectural score, high nuclear grade, and high mitotic count. The lesion is associated with necrosis and focal calcification. Additional findings include the presence of a solid-type ductal lesion with high nuclear grade, although central necrosis and extensive intraductal component are not identified. All evaluated margins are free of involvement.\n\nNon-malignant changes in the breast tissue include findings consistent with prior biopsy and fibrocystic alterations. Immunohistochemical staining for keratin was performed on the lymph node, which did not show any evidence of abnormal cellular infiltration. Vascular invasion was not clearly identified."} +{"pid": "TCGA-37-3783", "report": "The tissue specimen was obtained from a lung primary tumor. Histological analysis indicates a moderately differentiated carcinoma. Tumor measurements correspond to a size category consistent with stage T3, with involvement of regional lymph nodes classified as N2 and no evidence of distant metastasis (M0). The tumor cells exhibit characteristics suggestive of a non-small cell morphology. A single blood sample was collected and preserved in a frozen tube for further laboratory evaluation. No prior systemic treatment was administered before specimen procurement. Cellular morphology shows no features indicative of neuroendocrine differentiation or sarcomatoid change. Immunohistochemical staining was not performed."} +{"pid": "TCGA-DU-6410", "report": "The patient presented with a right frontal hemorrhagic lesion identified on imaging. A biopsy and excision were performed. Histopathological evaluation of the biopsy specimen revealed brain tissue infiltrated by a neoplastic process composed of mildly pleomorphic glial cells. The cells were densely arranged, with perinuclear clearing observed in some areas. Focal microvascular proliferation was present, along with frequent calcospherites and areas of necrosis. Mitotic activity ranged from 3 to 4 per ten high-power fields (400x magnification). Immunohistochemical staining demonstrated diffuse labeling of tumor cells with GFAP. Tumor nuclei showed diffuse weak to moderate positivity for p53. CD163 highlighted rare phagocytic cells. The Ki-67 labeling index was approximately 25%. Molecular analysis detected loss of heterozygosity (LOH) at chromosome arms 1p and 19q using markers D1S1592, D1S552, D19S219, D19S412, and PLA2G4C. MGMT promoter methylation testing also yielded positive results. These findings were obtained through bisulfite treatment of DNA followed by real-time PCR amplification (MethyLight), with an analytic sensitivity of 1% methylated DNA in an unmethylated background. The tissue block contained sufficient tumor cells, and no microdissection was required. Intraoperative consultation of the biopsy sample indicated a low histological grade glioma consistent with oligodendroglioma; however, the final assessment was based on permanent sections. Gross examination of the excised tissue described a pink-tan to red soft tissue aggregate measuring 4 \u00d7 3.9 \u00d7 0.6 cm. Multiple histologic sections were evaluated, and various stains and immunostains were applied for diagnostic clarity."} +{"pid": "TCGA-BP-4770", "report": "The specimen was received from the left kidney, distal pancreas, spleen, and left adrenal gland following radical nephrectomy, partial pancreatectomy, and splenectomy. A large, well-circumscribed mass measuring 15.0 x 12.5 x 11.0 cm was identified within the kidney. The mass exhibited a firm, tan-white appearance with areas of central necrosis, hemorrhage, and focal cystic change. It occupied the majority of the renal parenchyma, with only a small portion of normal tissue remaining at the lower pole. The mass extended into the renal vein and its branches, and was found to involve the renal sinus fat and hilar fat. It also directly invaded the overlying adrenal gland and adjacent segment of the pancreas. The tumor was in close proximity to the inked resection margin, with focal presence at that site. Chronic inflammation was noted in the non-neoplastic kidney tissue. The spleen showed no evidence of involvement and appeared unremarkable on examination.\n\nAdditional specimens included soft tissue from the vena cava, which contained fragments of the lesion. Lymph nodes from the para-aortic region were submitted for evaluation; all 13 nodes examined were free of involvement. A biopsy of soft tissue from the left psoas muscle revealed edematous tissue with chronic inflammation and fibrosis, but no evidence of the lesion.\n\nGrossly, the total specimen measured 24.0 x 13.0 x 11.5 cm and weighed 1.6 kg, including a 7.0 x 0.5 x 0.5 cm segment of ureter. The adrenal gland measured 8.0 x 3.0 cm, the spleen weighed 116 g and measured 11.5 x 7.0 x 3.5 cm, and the distal segment of pancreas measured 7.0 x 2.0 cm. The lesion was extensively sampled and photographed, with representative sections taken from multiple sites including the tumor-adjacent kidney, adrenal gland, pancreas, renal sinus, and margins.\n\nStaging criteria indicate the lesion extends beyond Gerota\u2019s fascia, with involvement of surrounding fat and direct extension into adjacent organs. There is also evidence of vascular invasion and focal margin positivity."} +{"pid": "TCGA-HT-A61C", "report": "The pathology report describes a markedly hypercellular, diffusely infiltrating glial neoplasm. The tumor cells exhibit perinuclear halos, with nuclei that are round to oval to oblong and moderately atypical. Numerous scattered mitotic figures are present throughout the tissue. Focally prominent microvascular laceration is observed, along with occasional foci of confluent tumor necrosis. Cystic differentiation is not identified. Immunohistochemical analysis reveals a labeling index of 34.7% for MIB-1, with numerous reactive cells present. A minority of cells show positivity for p53, and the tumor is negative for IDH1."} +{"pid": "TCGA-AQ-A04L", "report": "The left breast mastectomy specimen demonstrates non-proliferative fibrocystic changes without evidence of atypia or malignant cells. Examination of two sentinel lymph nodes reveals benign lymphoid tissue with no abnormal cellular infiltration.\n\nIn the right breast mastectomy specimen, a 2.5 cm lesion is identified in the outer half of the specimen at the junction of the upper and lower halves. Histologic evaluation indicates a poorly differentiated ductal lesion with nuclear grade 3 features, including necrosis within the in situ component. The lesion appears unifocal and is associated with adjacent ductal changes exhibiting comedo-type morphology and high-grade nuclear features, comprising approximately 5% of the total tissue examined. Lymphovascular invasion is noted. Surgical margins are free of invasive disease; however, the lesion approaches within 5 mm of the deep margin. Immunohistochemical staining shows hormone receptor positivity for estrogen but not progesterone, and strong membranous staining consistent with HER2 overexpression.\n\nNo involvement is identified in the skin, nipple-areolar complex, fascia, or muscle. Additional sections from all quadrants and margins confirm absence of residual disease beyond the primary lesion. No extensive intraductal component is observed. Axillary lymph nodes were not identified within the submitted tissue."} +{"pid": "TCGA-FN-7833", "report": "The specimen consisted of two parts from a right frontal brain mass. Part A included a single fragment measuring 1.8 x 1.3 x 0.9 cm, described as light gray and delicate in consistency. This tissue was analyzed via frozen section with touch preparations performed for staining. Remaining portions were processed for permanent sections and routine histology.\n\nPart B consisted of multiple fragments of soft tissue totaling 36 grams, including some meningeal involvement. The aggregate lesion measured 7.2 x 6.8 x 2.4 cm and exhibited a pink-gray, translucent, serpiginous appearance. Some areas demonstrated hyperemia and partial delineation of the lesion, although borders were obscured in other regions. Portions of grossly viable tumor were preserved for tumor banking. Representative sections from nineteen tissue fragments were submitted for microscopic evaluation.\n\nMicroscopic examination revealed cellular features consistent with high-grade morphology. Cellular architecture showed infiltrative growth patterns with nuclear atypia and mitotic activity. Histologic evaluation confirmed the presence of abnormal glial cells with morphologic characteristics suggestive of aggressive behavior. No molecular markers or genetic profiles were included in this summary."} +{"pid": "TCGA-IR-A3LI", "report": "The surgical specimens included a right and left adnexal mass, cul-de-sac metastases, a posterior peritonectomy, a hysterectomy specimen involving the uterus and cervix with partial parametrial tissue, a bladder peritoneum biopsy, and multiple lymph node groups from both sides including external iliac, hypogastric, parametrial, obturator, common iliac, and para-aortic regions, as well as an omentectomy specimen.\n\nHistologic evaluation of the posterior peritoneum showed reactive papillary mesothelial proliferation. The bladder peritoneum biopsy revealed benign fibroadipose tissue. All lymph nodes examined from the left and right external iliac, hypogastric, common iliac, and para-aortic regions were benign except for one lymph node from the left obturator region, which contained malignant cells. The omentectomy specimen also showed benign fibrofatty tissue.\n\nThe hysterectomy specimen revealed a tumor involving the cervix with a maximal stromal invasion thickness of 12 mm. The tumor extended into the lower uterine segment involving both mucosa and stroma. Both right and left paracervical soft tissue margins were involved by the tumor. There was vascular invasion present. No vaginal extension or multicentric tumor involvement was identified. The endometrium was inactive, and the myometrium contained leiomyomas.\n\nImmunohistochemical staining of the tumor showed positivity for M-CEA and p16, while ER and PR were negative. Focal ER expression was noted in sections from the cervix and lower uterine segment. MIB-1 and p16 stains supported the findings."} +{"pid": "TCGA-B6-A1KF", "report": "A right breast specimen was received as an excised ellipse of skin and underlying fibrofatty tissue. The specimen measured 4.3 x 0.8 cm in skin and 6.8 x 5.2 x 3.4 cm in fibrofatty tissue. Inked margins included superior (blue), inferior (black), and posterior (green). A firm, yellow, circumscribed mass measuring approximately 2.4 x 1.5 x 1.5 cm was identified within the tissue. The mass was located within 0.1 cm of the posterior margin, 0.2 cm from the superior margin, and 0.4 cm from the inferior margin. It was approximately 2.5 cm beneath the skin surface and 0.6 cm from the lateral margin. Adjacent tissue showed lobules of yellow-pink adipose mixed with focally dense white-pink fibroconnective tissue; no other lesions were noted.\n\nThe lesion was entirely sampled across multiple blocks (A2\u2013A14), including full assessment of the lateral and medial margins. Additional specimens from the posterior and superior re-excision margins were submitted and measured 3.9 x 2.7 x 0.8 cm and 4.1 x 2.7 x 1.2 cm respectively, both showing only benign fibrofatty tissue.\n\nLymph node dissection material was also received, measuring 11.2 x 7.5 x 1.2 cm. Dissection revealed fourteen lymph nodes, with metastatic involvement identified in two of them. The largest metastasis measured 1.0 cm, and there was no evidence of extracapsular extension.\n\nHistologic evaluation of the main lesion showed a high-grade cellular proliferation with nuclear features scoring 3 of 3. The invasive component measured 2.0 x 1.5 cm. No lymphatic or vascular invasion was observed. There was no multifocal disease, but in-situ changes were present adjacent to the invasive lesion, estimated to span approximately 4.8 cm. These in-situ areas displayed comedo and cribriform patterns and occupied less than 5% of the invasive tumor volume. No extensive intraductal component was seen.\n\nNon-neoplastic breast tissue showed benign fibrocystic changes. Microcalcifications were not identified. Surgical margins were negative for malignancy, with the closest distance being 3 mm from the in-situ component.\n\nImmunohistochemical analysis revealed no hormone receptor expression. HER2/neu immunostaining demonstrated moderate (2+) membrane staining in 50\u201375% of cells, interpreted as positive for overexpression."} +{"pid": "TCGA-BQ-5886", "report": "The clinical history notes a 1.5 cm mass in the left lower pole of the kidney. Specimens submitted include a partial nephrectomy from the left lower pole and an excised cyst from the same region.\n\nExamination of the surgical specimen revealed a tumor measuring 1.5 cm in greatest dimension. Microscopic evaluation showed nuclear features classified as Fuhrman Grade II. The tumor extended through the renal capsule but remained within Gerota's fascia. No invasion of the renal vein was observed. Surgical margins were free of tumor involvement. The tumor was focally located approximately 1 mm from the inked soft tissue margin, with the closest kidney resection margin measuring 0.5 cm. Adjacent non-neoplastic kidney tissue appeared unremarkable. No adrenal gland, lymph nodes, or other significant structures were identified in the specimen.\n\nImmunohistochemical staining demonstrated positivity for CK7 and racemase, while CK20 showed negative staining. There was granular, non-specific staining for c-kit, 34BE12, and 4A4. These findings were consistent with a distinct immunoprofile.\n\nA separate cystic lesion was identified in the left lower pole of the kidney. It measured up to 3.2 cm and was composed of tan soft tissue. Histologic examination revealed benign features.\n\nDuring intraoperative consultation, frozen section analysis confirmed the absence of tumor at the deep inked margin and supported the presence of a renal cortical neoplasm suspected to be of papillary type. The permanent diagnosis concurred with this finding.\n\nAll relevant sections of the tumor and surrounding tissue were submitted for further evaluation."} +{"pid": "TCGA-S9-A6UB", "report": "The neuropathology evaluation demonstrated histologic and morphologic features consistent with a neoplastic process. The lesion exhibited characteristics typical of a diffusely infiltrative glioma, with uniform cells having round to oval nuclei and perinuclear halos. Tumor cells were arranged in a delicate network with minimal pleomorphism. No definitive necrosis or microvascular proliferation was identified. Based on histologic criteria, the lesion is classified as WHO grade II."} +{"pid": "TCGA-DD-AAE1", "report": "The specimen consists of a liver measuring 9.0 x 9.0 x 3.7 cm, weighing 126.5 grams, and a well-defined multinodular golden-yellow solid mass measuring 3.5 x 2.4 x 2.0 cm. The gross appearance is described as an expanding nodular type lesion. The resection margin is not involved with a safety margin of 1.3 cm. No satellite nodule is identified, and the remaining liver parenchyma shows cirrhotic changes. Representative sections of the mass and surrounding tissue have been submitted for analysis.\n\nMicroscopically, the lesion shows a histologic pattern characterized by trabecular growth with hepatic-type cells. The degree of differentiation is predominantly moderate, with the worst differentiation noted as grade III. There is no evidence of fatty change, fibrous capsule formation is partial, and there is no capsular infiltration or septum formation. The surgical resection margin remains uninvolved, and there is no serosal or portal vein invasion, microvessel invasion, or intrahepatic metastasis identified. The status of multicentric occurrence and intrahepatic metastasis is not determined. Additional findings include mild steatosis and background cirrhosis."} +{"pid": "TCGA-DH-A66D", "report": "The submitted specimen consists of a 6.2 x 4.0 x 1.5 cm irregular fragment of tan-white soft tissue with a gray-tan to tan-white, ill-defined cut surface. Histologic evaluation reveals an infiltrating glial neoplasm characterized by marked nuclear and cellular pleomorphism, as well as areas of non-uniform cell distribution against a microcystic background. Numerous tumor cells exhibit gemistocytic features. Focal extension into the subarachnoid space is observed on slides A5 and A6.\n\nMitotic activity is evident on routine H&E sections. Immunohistochemical staining with PHH3 demonstrates up to 7 mitoses per 10 high power fields. Ki-67 (MIB-1) labeling shows an elevated proliferation index estimated at 10\u201315%. Tumor cells demonstrate strong immunoreactivity for GFAP. Additional immunostudies show positivity for mutated IDH1 and P53 expression in more than 50% of tumor cells.\n\nFocal individual cell necrosis is present; however, no definitive geographic or pseudopalisading necrosis is identified. Microvascular proliferation is not clearly demonstrated in the examined sections. A portion of the tissue was used for frozen section analysis and additional material was submitted for further studies. Correlation with clinical findings is advised."} +{"pid": "TCGA-VS-A8EB", "report": "Biopsy of the cervix shows a lesion with invasive growth. The tumor measures approximately 4.5 cm in greatest dimension. Histologic evaluation reveals nests and sheets of atypical cells with hyperchromatic nuclei, increased nuclear-to-cytoplasmic ratio, and frequent mitotic figures. Stromal invasion is present, with involvement of the underlying connective tissue. No lymphovascular space invasion is identified. The tumor is confined to the cervix without evidence of extension beyond the primary site."} +{"pid": "TCGA-HQ-A5ND", "report": "The sample was collected from a resection following radical cystoprostatectomy. The tissue measured 8 cm in size and was classified as high-grade with no necrosis observed. Histological analysis revealed a high proportion of tumor cells. Pathological staging was determined as T4 with regional lymph node involvement (N1), and no clinical evidence of distant metastasis (M0). The sample was obtained several days following the procedure, which occurred after diagnosis. A separate blood-derived sample was also collected."} +{"pid": "TCGA-CH-5768", "report": "The prostate specimen shows multiple distinct foci of involvement in both the transitional and peripheral zones bilaterally. The largest focus in the right transitional zone measures 2 cm. Microscopic examination reveals marked perineural invasion. There is evidence of left rectolateral extraprostatic extension with infiltration into the adjacent periprostatic fatty tissue. No vascular invasion is identified. Seminal vesicles are free of involvement. Various tissue samples, including fatty tissue, prostate tissue, and cross-striated muscle, show no signs of involvement. A total of 16 lymph nodes are examined, all without any detectable involvement.\n\nHistological evaluation demonstrates a Gleason score of 2+4 = 6, with an approximate distribution of 50% Gleason 2 and 30% Gleason 4, along with a tertiary component of Gleason 3. Carcinomatous cells are present at the artificial margin on the apex and right rectolateral side, as indicated by yellow highlighting. These margins correspond with material analyzed separately via frozen section. All other surgical margins are free of tumor."} +{"pid": "TCGA-XE-AAO6", "report": "The specimen consists of a left orchiectomy specimen including a testis measuring 5.5x4x4 cm and a spermatic cord 5.5 cm in length and 1.3 cm in diameter. A mass measuring 3.5x3.2x2 cm is present, described as white-tan, fleshy, variegated, and well-circumscribed with areas of hemorrhage and necrosis. The mass does not involve the tunica albuginea or impinge upon the epididymis. Histologically, malignant cells are noted within blood vessels, although these may represent artifact. Immunohistochemistry shows negative staining for HCG and CAM 5.2. Evaluation of the vas deferens and tunica albuginea reveals no tumor involvement. No lymphovascular invasion or intratubular germ cell neoplasia is identified. Testicular tissue demonstrates atrophy with hyalinization of tubules. Surgical margins are clear based on evaluation of cassettes submitted, which include sections from the spermatic cord resection margin, mid-portion, paratesticular region, tumor interface with epididymis, tunica vaginalis, adjacent testis, and representative tumor sections. Pathologic staging is pT1NXMX."} +{"pid": "TCGA-V1-A9OQ", "report": "The pathology report includes findings from three specimen sections.\n\nSection A, labeled as anterior lymph nodes, consists of a 2.5 x 2.3 x 0.4 cm piece of adipose tissue. Microscopic examination shows no evidence of lymph node structures or abnormal cellular infiltration.\n\nSection B, identified as the apical margin, is a small tissue fragment measuring 0.6 x 0.3 x 0.3 cm. Histologic evaluation reveals small crowded glands within fibromuscular stroma with an infiltrative appearance. Due to overlapping features and cautery artifact, immunohistochemical staining was performed (p63 and high molecular weight keratin). The absence of basal cell staining supports the presence of epithelial proliferation.\n\nSection C consists of the prostate and seminal vesicles, weighing 42 grams and measuring approximately 4 cm from apex to base. Gross examination reveals multiple yellow nodules: a 1.5 cm irregular nodule in the anterior region involving slices 1\u20133; two small firm areas (\u22640.2 cm each) in the posterolateral region of slices 2\u20133; and a 1.5 cm well-circumscribed nodule in the right posterior region involving slices 6\u20138. Histologic analysis demonstrates cellular proliferation with Gleason grade patterns. Tumor involvement is present at both the right and left apical margins, with focal extension beyond the capsule into adjacent fibrous tissue. Perineural infiltration is noted. Immunostaining confirms absence of basal cells in affected areas. High-grade intraepithelial neoplasia is focally present. No tumor involvement is identified in the seminal vesicles.\n\nMargins show tumor involvement at multiple locations: one focus measuring 5 mm at the right apical margin and another measuring 6 mm at the midline apical region. Skeletal muscle involvement is observed at these sites. All available lymph node tissue submitted for evaluation shows no identifiable lymphoid structures.\n\nBased on histopathologic findings, the staging classification reflects extraprostatic extension without lymph node involvement."} +{"pid": "TCGA-V1-A9ZK", "report": "The prostate specimen measured 4.5 cm from apex to base, 6 cm in width, and 4.5 cm anterior to posterior, weighing 64 grams. A suspicious lesion measuring 0.3 x 0.2 x 0.2 cm was identified in the left posterior quadrant of slice 4. The lesion approached the nearest inked margin. Microscopic examination revealed a tumor composed predominantly of solid sheets of cells with large vacuoles mimicking gland formation; these cells exhibited signet-ring-like morphology. Additional areas suggestive of lymphatic invasion were noted.\n\nThe estimated tumor volume was 1.9 cm\u00b3, with approximately 80\u201390% of this volume corresponding to higher-grade morphology. Capsular involvement was identified at the left posterior mid gland and left posterior base. Extraprostatic extension was present and extensive. Surgical margins were negative for tumor, with the closest distance being 1 mm from the posterior margin in the region of extraprostatic extension. No benign glands were identified at the inked excision margins.\n\nInvolvement of the left seminal vesicle was observed. Perineural infiltration was present. High-grade intraepithelial neoplasia was identified focally within the prostate. No tumor was detected in either the right or left pelvic lymph nodes; a total of six lymph nodes were examined.\n\nThe tumor was located in the left posterior mid gland and extended to the left seminal vesicle junction. Multiple tissue blocks were processed from various slices and regions of the prostate and seminal vesicles. All lymph node specimens were submitted for histologic evaluation."} +{"pid": "TCGA-18-5592", "report": "A lobectomy specimen from the left upper lobe was submitted, along with multiple lymph node stations. The resected lung tissue measured 21.0 x 12.5 x 3.5 cm. A peripheral lesion measuring 3.5 x 3.4 x 3.0 cm was identified, showing pleural puckering. The tumor was located 1.0 cm from the bronchial resection margin and 0.5 cm from the closest stapled parenchymal resection margin. Histologically, the lesion showed features of a moderately differentiated carcinoma, with invasion through the visceral pleura and dense adhesions to overlying soft tissue. No lymphovascular invasion was identified. Resection margins were uninvolved, with the closest distance of invasive carcinoma to a margin being 0.2 cm at a mediastinal soft tissue site. Four regional lymph nodes were negative for malignancy.\n\nLymph node specimens included stations ST4L (left low paratracheal), ST4R (right low paratracheal), ST2R (right upper paratracheal), ST7 subcarinal (two separate specimens), ST2L (left upper paratracheal), ST10L (left tracheobronchial angle, two specimens), ST11L (interlobar), and ST9 (inferior pulmonary ligament). All lymph nodes evaluated were negative for malignancy. In addition, a resection margin from the pulmonary artery in the left upper lobe was also negative for tumor involvement.\n\nThe lung tissue adjacent to the lesion demonstrated post-obstructive pneumonitis. No other nodules or masses were identified. Pathologic staging indicated no regional lymph node metastasis. Tumor extension included involvement of the mediastinal and visceral pleura. No vascular invasion was observed. A synoptic review confirmed the absence of tumor involvement in all resected margins and lymph nodes examined."} +{"pid": "TCGA-SC-AA5Z", "report": "A male patient with a history of renal cell carcinoma, no personal smoking history but exposure to secondhand smoke, and no asbestos exposure presented with recurrent left pleural effusion and pleural thickening on imaging. Two biopsy specimens were obtained from the left pleura.\n\nThe first specimen, labeled \u201cleft pleural biopsy (fs),\u201d consisted of multiple fragments of membranous and nodular tissue measuring 2.8 x 2.1 x 0.4 cm in aggregate. Histologic examination revealed an epithelioid neoplasm. Immunohistochemical staining showed positivity for calretinin, AE1:AE3, and WT1, while the cells were negative for CD15, PAX8, BerEp4, and CEA. These findings supported a malignant process involving the pleura.\n\nThe second specimen, labeled \u201cadditional left pleural biopsy,\u201d consisted of a 3.0 x 2.5 x 0.4 cm aggregate of tan-pink fibromembranous tissue. Histologic evaluation also showed an epithelioid neoplasm. Immunohistochemistry demonstrated positivity for calretinin and negativity for PAX8. Additional immunohistochemical and in situ hybridization tests were performed; some of these assays were developed in-house and are used for clinical purposes under CLIA certification. These findings confirmed involvement of the pleura by a similar epithelioid process.\n\nBoth specimens were entirely submitted for histologic evaluation. Frozen section analysis of the first biopsy suggested an epithelioid neoplasm with consideration of mesothelial origin, pending permanent sections. Permanent diagnosis concurred with the frozen section interpretation. No frozen section was performed on the second biopsy per the submitting clinician\u2019s request, and the permanent diagnosis was consistent with the histologic findings.\n\nThe tumor exhibited epithelioid morphology in both samples and was assessed using immunohistochemical markers that helped characterize the cellular profile."} +{"pid": "TCGA-CH-5763", "report": "The specimen shows a predominantly moderately differentiated, multifocal lesion in the peripheral zone with a maximum diameter of 1.6 cm. The lesion exhibits infiltration of periprostatic fatty tissue in the left basal and left rectolateral regions, with an invasion front measuring 1 mm and a maximum depth of 0.2 mm in each area. Similar infiltration is noted in the right basal region with identical measurements. There is extensive multifocal involvement of perineural sheaths. Surgical preparation margins are free of affected tissue. Additional findings include multifocal high-grade intraepithelial proliferative changes and myoglandular hyperplasia. The urethral urothelium appears without atypical features. Seminal vesicles and ducts show no abnormalities. Lymph node examination reveals four negative nodes on the right and one on the left, all without any pathological findings.\n\nHistological analysis included immunohistochemical staining with CD31 and D2-40 across two blocks to assess for vascular or lymphatic invasion. No evidence of vessel invasion was detected. Based on these findings, the classification is pT3a with a maximum tumor diameter of 16 mm, nuclear grade sum 3+4=7 (with 30% Gleason pattern 4), pN0 (0/5 nodes), and R0 resection status. Initial frozen section analysis and margin evaluation support complete excision, despite artifact-related concerns at the left rectolateral margin. A prior biopsy had shown similar characteristics. A follow-up report will include further microscopic details."} +{"pid": "TCGA-97-A4M2", "report": "A total of 50 cells were analyzed using fluorescence in-situ hybridization (FISH) on formalin-fixed paraffin-embedded tissue sections. The assay utilized the Vysis ALK Break Apart Probe to detect potential rearrangements involving the 2p23 locus. In this specimen, no separated signals indicative of gene rearrangement were observed in any of the nuclei scored. The result falls within normal limits.\n\nIn addition, three to four copies of the 2p23 region were observed in 26.0% of the cells. This suggests an aneuploid population with extra copies of the chromosome 2/2p region. While additional copies of this genomic region are not uncommon in lung carcinomas, their clinical significance remains uncertain.\n\nThe primary lesion measured 1.1 cm and was located in the right middle lobe of the lung. Histologically, the tumor showed a mixed subtype with papillary and micropapillary components. It was moderately differentiated and confined without invasion of the visceral pleura. No lymphovascular invasion was identified. Margins of resection, including bronchial and vascular margins, were free of tumor involvement. A completion lobectomy showed no residual tumor.\n\nLymph node evaluation included stations 4, 7, 9, and 10 on the right chest. All lymph nodes examined showed no evidence of metastasis.\n\nAdditional findings included emphysema. The patient had a significant smoking history and a prior diagnosis of prostate cancer, along with chronic obstructive pulmonary disease. Preoperative imaging identified a mixed solid and ground-glass nodule measuring 1.5 cm in the right middle lobe, along with multiple bilateral lung nodules.\n\nMolecular testing for KRAS mutations showed no mutations at codons 12 and 13. EGFR mutation analysis also revealed no mutations in exons 18\u201321 of the tyrosine kinase domain. These results suggest that targeted therapies directed against these mutations may not be indicated in this case.\n\nThe tumor was staged as pT1a, indicating a tumor 2 cm or less in size surrounded by lung or visceral pleura, without bronchoscopic evidence of more proximal invasion. There was no regional lymph node involvement (pN0), and distant metastases were not assessed.\n\nAll molecular tests were performed under CLIA-certified conditions and validated for use in non-small cell lung carcinoma, although they are not standalone diagnostic tools and should be interpreted in the context of other clinical data."} +{"pid": "TCGA-BR-A4IV", "report": "Gross Description: A 3x2x1cm ulcer is present in the prepyloric region, characterized by a firm and myxoid gray surface. Microscopic Description: The mucosa shows ulceration and necrosis. Groups of atypical cells are observed, with individual cells containing large mucin vacuoles that fill the cytoplasm and displace the nucleus. The cells exhibit hyperchromatic, irregularly enlarged nuclei with prominent nucleoli. Mitotic figures are present. The tumor extends into muscle bundles and invades through to the serosa. The stroma shows a predominant infiltration of lymphocytes. Tumor Site: Antrum. Tumor Size: 3x2x1cm. Tumor Features: Ulcerated. Histologic Grade: Poorly differentiated. Tumor Extent: Invasion into serosa (visceral peritoneum). Lymph Nodes: 3 out of 9 regional lymph nodes show evidence of tumor involvement. Lymphatic Invasion: Present. No information is available regarding venous or perineural invasion, treatment effect, or margin status."} +{"pid": "TCGA-AS-3778", "report": "The surgical specimen consists of a right partial nephrectomy weighing 16 grams and measuring 5 x 3.5 x 3 cm. A mass is present within the specimen, which is well-circumscribed and firm, with an orange to yellow coloration and focal cystic and hemorrhagic changes. The mass measures 3.1 x 2.5 x 1.7 cm and is located near the blue-inked capsular surface, with no distance from the black-inked surgical resection margin. The surrounding renal tissue appears tan-brown, glistening, and unremarkable, with a 0.7 cm thick cortex and a well-defined corticomedullary junction. No other masses or nodularities are identified.\n\nMicroscopic evaluation shows a unifocal lesion with clear cell morphology and Fuhrman nuclear grade 1 of 4. There is no evidence of venous or adrenal involvement. The tumor is located 2 mm from the parenchymal resection margin, and the perinephric fat is not involved. No lymph nodes are identified. The adjacent kidney tissue does not show significant abnormality. The macroscopic extent of the lesion is limited to the kidney."} +{"pid": "TCGA-TP-A8TT", "report": "The prostate specimen measured 6.4 x 3.5 x 3.5 cm and was sectioned into seven slices revealing a diffuse multinodular bulging tan-pink cut surface. A firm area measuring approximately 1.2 x 1.0 cm was identified in the left posterior lobe. The left seminal vesicle measured 2.2 x 0.8 x 0.8 cm and the right seminal vesicle measured 2.2 x 1.0 x 1.0 cm. The bilateral vas deferens were disrupted and measured approximately 0.8 x 0.3 cm. The specimen was inked with right blue, left black, and posterior green. Sections were taken from multiple regions of the prostate including apex, base, anterior, and posterior areas bilaterally, as well as from the vas deferens and seminal vesicles.\n\nHistologic evaluation showed acinar-type cells arranged in a pattern consistent with glandular origin. The histologic grade corresponded to Gleason grades 4+3 = 7/10, with approximately 75% of the tissue showing Gleason pattern 4. Tumor was located in the left anterior and left posterior quadrants. The maximal tumor diameter was 1.6 cm, present across four consecutive 0.4 cm thick sections. No third Gleason pattern was identified. Multifocal involvement was noted within the prostate. Premalignant changes included focal high-grade prostatic intraepithelial neoplasia (PIN). Non-neoplastic findings included nodular hyperplasia.\n\nExtraprostatic extension was present and extensive, with several foci identified in the left anterior and posterior quadrants. Vascular invasion was not observed. Surgical margins were generally negative except for the proximal basal margin, which was focally positive for atypical cells. The posterior bladder neck margin was free of atypical cells. No involvement was found in the seminal vesicles.\n\nLymph node assessment included eleven regional nodes: six from the left obturator region and five from the right. All lymph nodes were negative for metastatic disease. Immunohistochemical analysis performed on selected blocks demonstrated absence of basilar staining with p63 and keratin 903 in an atypical focus at the left prostatic base margin, supporting the presence of invasive epithelial changes. Approximately 90% of the prostate specimen was submitted for analysis."} +{"pid": "TCGA-QR-A70Q", "report": "The specimen was received fresh for frozen section and is labeled as a retrocardiac mass. It is an irregular 2 x 1.5 x 1 cm fragment with firm tan areas on cut surface. A frozen section was performed, and the remaining tissue was placed in a cassette. A second specimen, also labeled as retrocardiac, was received in formalin. It consists of 2 x 1.5 x 0.6 cm fragments with tan firm areas on sectioning. The tissue was bisected and entirely submitted in two cassettes.\n\nHistologic evaluation shows cells staining positive for synaptophysin. On H&E staining, there is notable nuclear pleomorphism. Cellular morphology is consistent with a neuroendocrine neoplasm. The lesion measures 1.3 cm in this specimen. Due to the histological features, biologic behavior cannot be determined based on morphology alone."} +{"pid": "TCGA-33-A4WN", "report": "The specimen consists of a right upper lobectomy and right lower lobe superior segment resection weighing 449 grams and measuring 20.0 x 15.0 x 7.0 cm. A mass measuring 4.5 cm is identified grossly in the right superior lobe adjacent to large airways, extending across the fissure into the superior segment of the right lower lobe. The tumor is located 2.2 cm from vascular margins and 1.5 cm from bronchial margins. Final surgical margins are negative for invasive disease or carcinoma in situ. Microscopic evaluation confirms absence of tumor in all margins, including those of the right lower lobe superior segment, with the nearest distance of invasive lesion to a margin being 7.0 mm.\n\nHistologic examination reveals moderately differentiated cellular features. No venous or lymphatic invasion is observed. Pleural changes are noted with tumor extension across the fissure into the superior segment of the lower lobe, involving the visceral pleura. No large vessel invasion is present.\n\nLymph node assessment includes 37 total lymph nodes evaluated across multiple stations (including stations 7, 4R, and 10R). All lymph nodes are negative for tumor involvement. Additional findings include emphysematous changes and respiratory bronchiolitis. Involvement of the right mainstem bronchus by an in-situ lesion within 2.0 cm of the carina was noted; however, no invasive lesion was identified at this site in the final excision specimen.\n\nFrozen section analysis confirmed negative margins for invasive disease at the right main bronchus, bronchus intermedius, and right lower lobe superior segment. Gross and histologic evaluation included serial sectioning of the tumor and surrounding lung tissue, confirming tumor extension from one lobe to another and assessing for pleural involvement. Approximately 95% of the tumor mass and 15% of the total specimen were submitted for evaluation.\n\nNo distant metastases were assessed. Large vessels at the hilum were stapled and submitted for evaluation; no tumor involvement was identified. Multiple lymph nodes ranging in size from 0.3 cm to 1.8 cm were submitted entirely and found to be negative. The remaining lung tissue appeared congested without additional masses or lesions.\n\nThe specimen was extensively sampled with multiple tissue blocks submitted representing the tumor, margins, lymph nodes, and surrounding lung parenchyma."} +{"pid": "TCGA-KK-A7B2", "report": "The prostate specimen measured 3.5 x 3.0 x 3.5 cm and weighed 24.0 grams post-fixation. Two separate tumor foci were identified. The dominant focus was located in the left anterolateral, left lateral, and left posterolateral peripheral zone with extension into the left transition zone. It measured 2.0 x 0.8 cm in its largest cross-sectional dimension and was present in two cross-sections of the prostate, involving extensively the apex and base. This focus extended into extraprostatic tissue by 6.0 mm. The second tumor focus was located in the right transition zone, measuring 1.4 x 1.2 cm in its largest cross-sectional dimension, present in two cross-sections, and extensively involved the apex and base. It exhibited a lower histologic grade and was confined to the prostate. Both tumor foci were associated with perineural and lymphovascular invasion. All resection margins were free of tumor involvement. The seminal vesicles and vasa deferentia showed no evidence of tumor involvement.\n\nA total of thirteen lymph nodes were identified in the pelvic lymph node specimen. One lymph node contained a metastatic focus measuring 2.0 mm. The involved lymph node showed architectural distortion; however, no unequivocal extranodal extension was observed. All other lymph nodes were negative for metastasis."} +{"pid": "TCGA-RS-A6TP", "report": "The specimen from the left radical tonsillectomy measures 4.2 x 2.6 x 1.3 cm and includes a friable tan-white polypoid lesion measuring 2.5 x 1.8 x 1.8 cm. The tumor is located 2.1 cm from the 12:00 margin, 1.0 cm from the 3:00 margin, 2.0 cm from the 6:00 margin, and 1.6 cm from the 9:00 margin. The maximal depth of invasion is 1.7 cm, with the tumor approaching the deep margin within less than 1 mm. Invasion is observed in the form of invasive islands, and extensive necrosis is present. No vascular or definite perineural invasion is identified. Adjacent non-neoplastic mucosa shows chronic inflammation. In situ changes are noted and are clear at the surgical margins. A separate fragment of atypical squamous epithelium is found in one of the deep margin specimens, but this was not present on the original frozen section. All other margins, including those from the soft palate, lateral pharynx, left tongue base, and posterior tonsillar pillar, are free of malignant or pre-malignant changes. Immunohistochemical staining demonstrates strong and diffuse positivity for p16, and high-risk HPV is detected by in-situ hybridization. The additional deep muscle resection specimen contains only benign skeletal muscle and squamous mucosa."} +{"pid": "TCGA-EY-A1GJ", "report": "A total of six right periaortic lymph nodes and four left periaortic lymph nodes were examined, with no abnormal findings identified in either group. Additionally, seven right pelvic and eight left pelvic lymph nodes were assessed, all without evidence of involvement.\n\nThe uterus and cervix specimen showed two distinct lesions located on the anterior surface of the uterus, each measuring 1.5 x 1 cm and 2.5 x 1.5 cm respectively. One lesion was polypoid and elevated above the endometrial surface, while the other was flat, tan/white, and friable. Both were found overlying submucosal leiomyomas. No invasion beyond the mucosa was observed, with myometrial invasion limited to the inner one-half. The depth of myometrial wall at the site of deepest invasion measured 1.5 cm, increasing to 3.5 cm when including the underlying leiomyoma. There was no serosal or cervical involvement; however, the lower uterine segment was involved, limited to the mucosa. No adnexal involvement was noted.\n\nHistologic evaluation revealed a high-grade architectural and nuclear pattern. The remainder of the endometrium showed atrophic changes. Leiomyomas were present in both intramural and submucosal locations, ranging from 0.5 to 1.9 cm in size, with hyalinization noted. No tumor was identified in the bilateral ovaries or fallopian tubes, which appeared atrophic. All surgical margins were free of abnormality. Lymphovascular space invasion was not present.\n\nA total of 25 regional lymph nodes were examined, none of which showed signs of involvement. Immunohistochemical staining showed ER positivity (2+, 20%), weak PR positivity (2+, 5%), and diffuse strong positivity for P53 (3+, 100%). Based on these findings, the pathologic staging is consistent with AJCC pT1a, pNO, pMx, and FIGO Stage I."} +{"pid": "TCGA-B5-A11H", "report": "The specimen consists of a uterus and cervix measuring 10.0 x 5.0 x 3.0 cm and weighing 59.0 grams. The uterine serosa is smooth and glistening with moderate adhesions. The ectocervix measures 3.4 cm in diameter with a cervical os of 1.4 cm. The exocervix appears smooth, glistening, pearly white, and mildly hemorrhagic. The endocervix measures 2.7 cm and has a tan, velvety trabecular mucosa. The uterine fundus measures 4.5 cm from cornu to cornu. The endometrial mucosa is tan and velvety. There is a 3.0 x 2.7 cm exophytic tan mass located on the anterior half of the uterine cavity, eccentrically towards the right cornu. The full thickness of the uterine wall is 1.4 cm, with the endometrium accounting for 0.1 cm. The thickness of the mass is 1.0 cm, with 0.5 cm arising above the endometrial surface. Representative samples of this exophytic mass are included in blocks A1-A2. Samples of uninvolved endocervical canal and uterine fundus (anteriorly and posteriorly) are submitted in blocks A3-A6. Additional fragments are placed in block A7.\n\nA hernia sac with omentum measures 10.4 x 9.0 x 3.7 cm in aggregate. The largest fragment includes a 5.5 x 4.3 x 3.7 cm hernia sac containing fibrofatty tissue. Representative samples are submitted in blocks B1-B2.\n\nThe left fallopian tube and ovary weigh 7.7 grams and include a 1.7 x 1.2 x 0.9 cm ovary attached to a 7.6 cm fallopian tube. A 2.0 x 1.1 cm piece of fibrofatty tissue is also present. The ovary is mildly nodular, tan-yellow, and shows no gross lesions. Representative samples of the ovary and fallopian tube are submitted in one block.\n\nThe right fallopian tube and ovary weigh 8.8 grams and measure 3.9 x 3.7 x 1.0 cm. The ovary measures 2.5 x 1.2 x 0.7 cm and is mildly granular and tan-yellow. The fallopian tube measures 7.0 cm in length and 0.7 cm in diameter without dilation. Both the ovary and fallopian tube appear grossly unremarkable. Representative samples are submitted in one block.\n\nThe right external iliac lymph node specimen measures 8.0 x 7.0 cm and contains multiple apparent lymph nodes. Four lymph nodes are placed in block E3, and five additional candidates are placed in block E4.\n\nThe right obturator specimen measures 3.0 x 5.0 cm and contains multiple lymph nodes within fibrofatty tissue. One lymph node measures 3.9 x 2.4 cm and was bisected and submitted in blocks. Another collection of matted lymph nodes measures 2.5 cm in length and is submitted in another block, along with additional candidates.\n\nThe left external iliac specimen measures 4.0 x 3.5 cm and contains multiple lymph nodes within fibrofatty tissue. The largest lymph node measures 2.4 cm and is placed in blocks G1-G2. Additional lymph nodes are submitted in blocks G3-G4.\n\nThe left obturator specimen measures 3.0 x 1.7 cm and contains a mass of lymph nodes making up approximately 95% of the tissue. This mass was bisected and placed in block H1. Two additional lymph nodes are placed in block H2.\n\nMicroscopic evaluation of the uterus and cervix reveals no evidence of invasion in the endocervix or other assessed areas. Margins are negative. Vascular invasion is equivocal. Adenomyosis is noted in the myometrium. No pathologic diagnosis is made for the cervix. All lymph node specimens from various sites are negative for malignancy. The hernia sac with omentum shows fibroadipose tissue consistent with a hernia sac. The left and right fallopian tubes and ovaries show no pathological findings."} +{"pid": "TCGA-FI-A2EW", "report": "The specimen from a total abdominal hysterectomy and bilateral salpingo-oophorectomy was received, along with multiple lymph node dissections and omental tissue. The uterus measured 10.5 cm in length, 4.5 cm in width, and 3 cm in depth. The endometrial cavity was triangular and hemorrhagic, with a polypoid, friable mass measuring 1.5 x 1 x 0.5 cm noted in the mid-fundus. On microscopic examination, invasive tumor was identified within the endometrium, extending into the myometrium. The depth of invasion was 6 mm into a myometrial thickness of 8 mm at the lower uterine segment. The cervix showed involvement of the mucosa and stroma by invasive tumor.\n\nA small leiomyoma measuring 0.5 cm was identified in the myometrium. No other gross lesions were observed. All sampled sections from the cervix, lower uterine segment, and endomyometrium showed evidence of invasive disease. The ovaries and fallopian tubes bilaterally showed no signs of malignancy. Multiple lymph node groups were examined, including left and right external iliac, obturator, and periaortic regions, as well as parametrial and omental tissues. No evidence of malignancy was found in any of the 37 lymph nodes evaluated or in the soft tissue specimens. Lymphovascular space invasion was not present.\n\nHistologically, the tumor demonstrated high-grade features consistent with serous papillary adenocarcinoma. The tumor invaded the luminal two-thirds of the myometrium and extended to involve the cervical stromal connective tissue. Based on these findings, the tumor was provisionally classified with characteristics corresponding to T2b/NO/MO staging. No distant metastases were identified based on available data."} +{"pid": "TCGA-2G-AAHN", "report": "The specimen measured 3.0 cm in diameter. Histological evaluation revealed no evidence of angio-invasion or invasion of the rete testis. Lymphatic invasion was identified. There was no involvement of the tunica albuginea. The epididymis and surgical margin at the spermatic cord were unaffected."} +{"pid": "TCGA-HT-8106", "report": "The pathology report describes a moderately hypercellular glial neoplasm composed of cells resembling atypical fibrillar and gemistocytic astrocytes. The tissue sections show prominent multifocal perivascular lymphocytic inflammation. No microvascular proliferation, necrosis, or mitotic figures are observed. Despite the absence of mitotic activity, the degree of cellular atypia is considered sufficient for classification as a high-grade lesion. Immunohistochemical staining with MIB-1 demonstrates numerous reactive cells throughout the specimen, with a labeling index of 16.3%, supporting the presence of high proliferative activity. The histologic features, including cellular atypia and lymphocytic infiltration, are consistent with an aggressive neoplasm of astrocytic lineage."} +{"pid": "TCGA-P4-AAVM", "report": "The left radical nephrectomy specimen measured 15.5 x 8.2 x 6.3 cm and included a left kidney measuring 10.5 x 6 x 4.1 cm and an adrenal gland measuring 6 x 4.5 x 2.3 cm. The adrenal gland weighed 43.8 grams and was mostly replaced by a well-circumscribed, golden yellow, septated, hemorrhagic mass measuring 4.9 x 4.5 x 3.1 cm. This mass extended to within 0.1 cm of the soft tissue resection margin and to within 2.7 cm of the vascular resection margin. A small (less than 0.1 cm in diameter) golden yellow nodule was found on the surface of a clamped adrenal vessel, located 0.3 cm from the vascular margin. Minimal residual adrenal tissue was identified, consisting of golden brown cortical and brown medullary tissue.\n\nWithin the kidney, a 2.3 x 2.0 x 1.5 cm well-defined red-brown, hemorrhagic mass was identified at the anterior mid aspect, adjacent to the renal sinus and pelvicalyceal system. The tumor was at least 0.8 cm away from the soft tissue resection margin and was not involved with perinephric adipose tissue, renal sinus fat, renal vein, or Gerota's fascia. No lymph nodes were identified in the kidney hilum.\n\nAdditional findings in the kidney included multiple thin-walled cortical cysts containing hemorrhagic, opaque fluid. The renal papillae appeared yellow-white and shrunken. There were multiple foci of calcifications and focal fibrosis within the renal parenchyma. Multiple small benign-appearing nodules suggestive of adenomas were also present in the cortex. All margins of resection, including vascular, ureteral, and perinephric adipose tissue, were free of abnormal tissue. Tissue from the adrenal lesion was submitted for possible ultrastructural analysis."} +{"pid": "TCGA-EL-A3H1", "report": "Female patient with a history of surgical intervention. The specimen includes parathyroid tissue, which shows no evidence of neoplasm. A total thyroidectomy was performed, and the lesion measured 2 cm in greatest dimension. Histological evaluation revealed an encapsulated nodule without definitive evidence of lymphatic invasion. Additional findings include a diffuse nodular goiter. No tumor was identified in the parathyroid gland."} +{"pid": "TCGA-BR-8686", "report": "The specimen is a gastrectomy with an ulcerated, firm, gray tumor measuring 10 x 8 x 3 cm located in the antrum. Microscopically, the lesion shows infiltration into the serosa with involvement of the visceral peritoneum. The tissue architecture demonstrates cords or trabeculae of atypical cells arranged in diffuse or adenoid patterns. Cellular features include hyperchromatic, irregularly enlarged nuclei with prominent nucleoli, along with scant eosinophilic cytoplasm. A mitotic index is evident. The stroma shows a prominent lymphocytic infiltrate. Lymphatic invasion is present, and two adjacent lymph nodes are positive for metastatic involvement. No assessment was made regarding venous or perineural invasion, surgical margins, or response to neoadjuvant therapy."} +{"pid": "TCGA-94-7557", "report": "The surgical pathology report includes multiple specimens from the left upper lobe of the lung and associated lymph nodes. A wedge excision specimen reveals a nodule measuring approximately 1.5 cm in greatest dimension, located less than 0.5 cm from the nearest staple line. Microscopic evaluation shows a predominant pattern of growth with lesser areas displaying a different architectural arrangement. No visceral pleural invasion is identified, although lymphovascular invasion is present.\n\nA lobectomy specimen contains a mass measuring 4.5 x 3.5 x 1.9 cm, abutting the visceral pleura and located 1.0 cm from the presumed previous wedge resection site. The mass surrounds a large vessel but does not demonstrate gross vascular invasion. An additional area of pleural thickening spans approximately 4.0 cm and is located near the mass. Histologic evaluation confirms poorly differentiated cells within this mass. Residual tissue measuring 4.0 cm in greatest dimension is also identified. Bronchovascular margins are negative for invasive carcinoma. Four benign peribronchial lymph nodes and one benign intraparenchymal lymph node were examined, all without evidence of involvement.\n\nLymph node biopsies from level 6 reveal six benign lymph node fragments. In contrast, the level 7 lymph node biopsy contains tissue showing features consistent with those observed in the lung parenchyma; however, no definitive lymph node tissue is identified in this specimen.\n\nThe lobectomy specimen was intact and margins were assessed microscopically. The closest distance of invasive carcinoma to any margin was 23 mm, with the bronchial and vascular margins being the closest. Lymphovascular invasion was confirmed. Eleven lymph nodes were examined, none showed signs of metastasis.\n\nAdditional findings include emphysematous changes in uninvolved lung tissue. No treatment effect was noted. Based on tumor size (>3 cm but \u22645 cm) and absence of more proximal bronchial involvement or complete lung atelectasis, staging criteria indicate pT2a classification. Regional lymph node assessment corresponds to pN0 classification."} +{"pid": "TCGA-AQ-A54O", "report": "The pathology report includes findings from three specimens: a sentinel lymph node biopsy, a total mastectomy specimen, and additional axillary lymph nodes.\n\nSentinel lymph node evaluation identified no metastatic involvement in one lymph node examined. Additional immunohistochemical staining of axillary lymph nodes demonstrated a normal distribution pattern of B cells and T cells, consistent with reactive changes. Morphologic features showed paracortical expansion suggestive of dermatopathic lymphadenitis. No evidence of a lymphoproliferative disorder was identified.\n\nThe mastectomy specimen revealed a unifocal lesion measuring 35 mm in greatest dimension. Histologic grading showed a Nottingham combined histologic grade of 3, based on tubule formation score of 3, nuclear pleomorphism score of 2, and mitotic count score of 3. There was no lymphovascular invasion identified. A minor in situ component measuring 2 mm was present, characterized by cribriform and solid patterns with nuclear grade 2 and necrosis. No extensive intraductal component was observed. Surgical margins were widely clear for both invasive and in situ components; the invasive component was negative with the closest distance being 1.5 cm at the posterior margin. No involvement of skin or nipple was identified.\n\nAxillary lymph node assessment included a total of 14 lymph nodes (1 examined in part A and 13 in part C), none of which showed evidence of metastasis. Gross examination of the mastectomy specimen revealed a firm white-tan area measuring 2.5 x 2.0 x 3.5 cm located subareolar/lower outer quadrant. The mass was well-separated from all margins, including medial/lateral margins. Hemorrhage and fat necrosis were noted near the biopsy site. No gross involvement of fascia, muscle, or skin was observed.\n\nAdditional tissue submitted for special investigations included multiple blocks representing various regions of the specimen. Microcalcifications were not identified. Other findings included gynecomastia and biopsy-related changes.\n\nFrozen section analysis of the sentinel lymph node intraoperatively confirmed absence of tumor. Immunohistochemical studies performed on lymph node tissue supported reactive lymphadenopathy without evidence of malignancy or lymphoproliferative disease."} +{"pid": "TCGA-L5-A4OH", "report": "A segment of distal esophagus and proximal stomach measuring 19.7 cm in total was received, with the esophageal portion measuring 11.5 cm and the gastric portion 8 cm. The specimen included a mass located at the gastroesophageal junction, measuring 2.2 x 1.7 cm, with central ulceration. The mass extends into the submucosa with a maximum thickness of 0.7 cm, without involvement of the muscular wall or adventitia. A small portion (0.8 cm) of the lesion involves the esophageal mucosa, and the remainder is within the gastric mucosa, coming within 6.2 cm of the gastric margin. The cervical esophageal margin specimen measures 1.1 cm and shows no significant mucosal or adventitial abnormalities, though there is submucosal hemorrhage. \n\nLymph node candidates were identified in the perigastric fat, with the largest measuring 0.8 cm. A total of nine lymph nodes were examined, all negative for malignancy. Lymphovascular invasion was present. The resection margins were free of involvement. The adventitia of the esophagus and gastric serosa were unremarkable, with minor hemorrhagic changes in perigastric fat. The specimen was inked for orientation, with blue ink applied to the adventitia and green ink to the gastric serosa."} +{"pid": "TCGA-NH-A8F8", "report": "The liver wedge biopsy specimens and right hemicolectomy specimen were examined. The right hemicolectomy specimen included portions of the terminal ileum, cecum, appendix, and ascending colon. A tumor measuring 5 cm in greatest dimension was identified in the ascending colon. Microscopic evaluation showed that the tumor extends to the visceral peritoneal surface. Surgical margins were free of tumor involvement, with the nearest margin located 8 cm from the tumor. \n\nFifteen out of 22 regional lymph nodes contained metastatic tumor, with extracapsular extension noted in some nodes. Lymphovascular invasion was present. Tumor deposits were also identified. Evaluation of the liver biopsies revealed replacement of tissue by abnormal cellular infiltration.\n\nGross examination of the resected colon showed a circumferential tan mass located in the ascending colon. The tumor measured 5 x 5 x 5 cm and was associated with puckering of the overlying visceral peritoneum, suggesting serosal involvement. Regional adipose tissue measured 15 x 13 x 3 cm and contained multiple involved lymph nodes, the largest being 1.5 cm in diameter. Multiple sections were submitted for analysis, including margins, tumor mass, and lymph nodes.\n\nIntraoperative frozen section analysis of the first liver biopsy initially showed fibrosis, while the second liver biopsy demonstrated abnormal cellular infiltration. The primary tumor was fully evaluated, and no prior treatment effect was observed. Perineural invasion was not identified. Based on pathologic staging, the tumor extends beyond the muscularis propria into the visceral peritoneum. Multiple regional lymph nodes were involved, and distant spread to the liver was confirmed."} +{"pid": "TCGA-UF-A7JJ", "report": "The specimen involves tissue from the larynx and multiple lymph node regions. In the right-sided lymph nodes, one lymph node previously marked as positive showed involvement with metastatic cells, including capsular extension. Additionally, three out of sixteen lymph nodes were involved with metastatic cells with capsular extension noted in some. The muscular tissue showed no signs of tumor involvement.\n\nIn the right recurrent lymph node region, one out of ten lymph nodes was affected by metastatic cells with capsular involvement. On the left side, sixteen lymph nodes were examined and none showed evidence of metastatic involvement. In the left recurrent lymph node region, one out of ten lymph nodes contained metastatic cells, although capsular involvement was not observed.\n\nExamination of the primary site in the larynx revealed a lesion measuring 5.5 cm in size. Histologically, the lesion demonstrated features consistent with moderately differentiated cellular changes. The lesion extended into the right vocal cord and involved cartilage structures including the thyroid, cricoid, and arytenoid cartilages. Soft tissue, muscle tissue, and thyroid gland were also affected. Invasion into lymphatic channels was observed; however, no vascular or perineural invasion was identified. The preepiglottic space and surgical margins remained free of tumor involvement. The tracheal margin was also unaffected."} +{"pid": "TCGA-21-1080", "report": "A left pneumonectomy specimen measuring 22.0 x 12.5 x 6.0 cm was received fresh for frozen section evaluation. The pleura is red-purple and focally anthracotic-stained, with a fragment of yellow-tan parietal pleura measuring 7.5 x 7.5 x 0.8 cm in the superior segment of the lower lobe. Up to 1.5 cm of attached bronchus is present, and the bronchial margin was submitted for frozen section evaluation. At the junction of the upper and lower lobes, a 9.5 x 7.5 x 6.5 cm firm mass was identified beneath the parietal pleura. The cut surface of the mass is tan to gray-tan, variegated, firm, and nodular with focal anthracotic staining. Irregular margins are noted. The remaining upper lobe has red-purple, glistening, and soft cut surfaces. The lower lobe shows areas ranging from pink-red to golden yellow with focal yellow-tan exudate. Several palpable hilar lymph nodes measuring 1.0 to 2.0 cm in greatest dimension were identified; their cut surfaces are tan to gray-black and focally anthracotic-stained. Representative sections of all lymph nodes and tissue blocks were submitted.\n\nSections include: frozen section of the bronchial margin, vascular margins, tumor with inked pleura, random tumor sections, random sections of the upper and lower lobes, and hilar lymph nodes. A total of thirteen blocks were submitted for microscopic evaluation.\n\nLymph node findings: Two lymph nodes from L4, two from R4, one from level 7, one from left level 8, five from level L7, and one from left level 10 were all negative. Cytology was also included in the assessment. No evidence of metastatic disease was found in the lymph nodes or cytology samples.\n\nMicroscopic evaluation of the lung showed a poorly differentiated squamous cell (epidermoid) carcinoma, keratinizing type. Necrosis within the tumor was moderate. There was no lymphatic, venous, or arterial invasion identified. The tumor did not invade into or through the pleura. Surgical margins were uninvolved. Non-neoplastic lung tissue showed changes consistent with pneumonia and abscess formation. A total of five lymph nodes were examined, and none were positive. Staging data indicate T2, N0."} +{"pid": "TCGA-D1-A17D", "report": "A hysterectomy and bilateral salpingo-oophorectomy specimen includes a mass measuring 5.2 x 4.0 x 2.3 cm located within the endometrial cavity. The mass extends into the myometrium with a maximum depth of invasion measuring 0.8 cm, in a uterine wall with a total thickness of 1.2 cm. There is no involvement of the endocervix, and no lymphovascular space invasion is observed. Surgical margins are free of abnormal tissue. Two submucosal intramural leiomyomata are present, ranging in size from 0.3 cm to 1.5 cm. The cervix demonstrates mild chronic inflammation. The bilateral ovaries and fallopian tubes show no significant pathological findings.\n\nLymph node evaluation includes 23 pelvic lymph nodes (right and left), all without evidence of tumor involvement. Additionally, six lymph nodes above and three below the inferior mesenteric artery on the right para-aortic region are negative for tumor. In the left para-aortic region, 19 lymph nodes above and seven below the inferior mesenteric artery are also negative. No tumor is identified within the lumen of the right gonadal vessel examined.\n\nThe uterus weighed 70.0 grams and showed a hemorrhagic cervix. The serosal surface was smooth. The right ovary measured 1.7 x 1.5 x 0.9 cm with a solid cut surface, and the right fallopian tube measured 6.8 x 0.8 cm. The left ovary measured 2.7 x 1.7 x 0.9 cm and the left fallopian tube measured 6.5 x 0.8 cm, both with smooth outer surfaces and solid cut surfaces. Adipose and lymphatic tissue aggregates were submitted for evaluation from multiple lymph node regions, with all lymphatic tissue examined being negative for tumor."} +{"pid": "TCGA-BH-A0BL", "report": "The specimen consists of a right breast segmentectomy with a lesion located in the upper outer quadrant at the 11 o\u2019clock position. Histologic evaluation reveals an infiltrating lesion measuring 1.3 cm in greatest dimension. The lesion demonstrates a Nottingham grade 3 appearance, with individual scores of 3 for tubule formation, 3 for nuclear grade, and 3 for mitotic activity, resulting in a total score of 9. All surgical margins are free of involvement. No definitive angiolymphatic invasion is identified. Additional findings include fibrocystic change, columnar cell change, and pseudoangiomatous stromal hyperplasia (PASH). A separate biopsy site shows changes related to prior sampling. Two lymph nodes were examined using hematoxylin and eosin and keratin stains; no metastatic involvement is found. The closest margin distance to the tumor is 8 mm. No dermal lymphatic involvement is noted. Other features include benign breast tissue with cystic changes. The pathologic staging is pT1c, pN0, pMX. Hormone receptor and HER2 status could not be determined."} +{"pid": "TCGA-BQ-7046", "report": "A partial nephrectomy specimen from the left upper pole of the kidney includes a tumor measuring 4.0 cm in greatest diameter. The tumor is well-circumscribed, yellow, and friable with a papillary growth pattern. It is confined within the renal capsule and does not extend into the perirenal fat. The closest distance from the tumor to the surgical margin is 0.9 cm. All surgical margins are free of tumor involvement. The non-neoplastic renal parenchyma appears normal. Additional tissue samples from the left mid-pole region, left posterolateral mid-pole, anterior lower pole, and lateral aspect of the lower pole of the kidney were submitted and showed no evidence of malignancy. These specimens consisted of renal parenchyma, fibrovascular, or fibroadipose tissue. The tumor demonstrates nuclear features graded as III/IV."} +{"pid": "TCGA-23-1027", "report": "The submitted specimens include multiple biopsies from various anatomical sites. A peritoneal biopsy shows benign-appearing mesothelial cells within a cystic structure, surrounded by reactive stromal tissue. A vaginal biopsy reveals benign squamous epithelium with underlying vascularized fibroconnective tissue and evidence of acute inflammation and reactive changes. The cul-de-sac biopsy demonstrates fibroconnective tissue containing pigmented histiocytes, foreign body-type giant cells, and extensive calcifications, with no definitive malignant cells identified.\n\nBiopsies from the right and left pelvis each show small clusters of highly atypical cells, which exhibit significant nuclear abnormalities. These findings are consistent with metastatic involvement. Additional biopsies from the small bowel adhesion, transverse colon adhesion, anterior abdominal wall adhesion, lesser omentum, retroperitoneum, and anterior abdominal wall show varying degrees of fibroconnective or adipose tissue, some with signs of inflammation, reactive mesothelial changes, or calcifications, but no definite carcinoma is seen in these samples.\n\nImmunohistochemical staining of the atypical cells from the pelvic biopsies is negative for certain markers, though this does not exclude the presence of abnormal or neoplastic cells. All specimens were fully submitted for evaluation. Tissue measurements vary, with the largest specimen measuring 2.5 x 1.5 x 1.0 cm (lesser omentum) and the smallest measuring 0.5 x 0.3 x 0.2 cm ( retroperitoneum)."} +{"pid": "TCGA-CM-4750", "report": "The surgical specimen from the colon, sigmoid, and upper rectum consists of a resected segment measuring 16.5 cm in length. The serosal surface is smooth, and a polypoid lesion is identified 5.0 cm from the distal margin. The lesion measures 3.5 cm in length and 3.2 cm in width. Serial sectioning reveals that the lesion invades into the muscularis propria to a depth of 0.3 cm. The distance from the deepest portion of the lesion to the closest radial margin is 4.0 cm. A small polyp measuring 0.3 cm is noted 1.0 cm from the distal margin. A tattoo site is identified distal to the lesion. Lymph node dissection was performed, and all identifiable lymph nodes were submitted for evaluation. Of the 52 lymph nodes examined, 2 contained metastatic involvement. The proximal, distal, and radial margins are free of tumor involvement.\n\nA separate biopsy of the left liver consists of two tissue fragments measuring 1.0 x 0.7 x 0.2 cm and 0.7 x 0. x 0.2 cm. Histologic examination reveals hepatic parenchyma with non-specific reactive changes. Special stains, including trichrome and reticulin, do not show increased fibrosis or stainable iron. Additional studies do not support autoimmune-related fibrosis or active hepatitis.\n\nThe proximal and distal resection margins consist of benign colonic and rectal tissue, respectively, with no evidence of neoplastic involvement. Special immunohistochemical studies on the primary specimen demonstrate retained expression of DNA mismatch repair proteins (MLH1, PMS2, MSH2, and MSH6) in the tumor cells."} +{"pid": "TCGA-XM-A8RL", "report": "The mediastinal mass measures 9.0 x 8.0 x 3.5 cm and is encapsulated, with a soft, tan-pink consistency. It has an attached portion of normal-appearing thymic tissue measuring 7.0 x 3.0 x 0.4 cm. The outer surface is covered by smooth, glistening serosa, while the opposite side shows a slightly roughened surgical margin. On sectioning, the mass is lobulated, tan-pink, and fleshy with areas of semi-liquid consistency and focal hemorrhage. Microscopically, the tumor invades the capsule and extends into the perithymic adipose tissue. The surgical resection margin does not contain tumor. Adjacent benign thymic tissue is present. Immunohistochemical staining demonstrates positivity for AE1:AE3 in the cellular component, and lymphocytes show positivity for CD1A, CD99, and CD3. A separate specimen of thymic tissue, measuring 9.5 x 7.0 x 2.4 cm, consists primarily of yellow fibroadipose tissue and shows no evidence of tumor. Additionally, multiple pieces of AP window tissue, ranging from 0.3 x 0.3 to 1.7 x 1.2 cm, are submitted entirely and contain only benign lymphoid tissue. Frozen section analysis was performed on the mediastinal mass and findings were confirmed on permanent sections."} +{"pid": "TCGA-WQ-AB4B", "report": "A wedge resection of liver tissue was received, weighing 346 grams and measuring 6.0 x 4.2 x 3.4 cm. The specimen included a mass measuring 3.0 x 2.4 x 2.4 cm, located 1.4 cm from the nearest resection margin. The mass was noted to bulge the liver capsule and had tan, smooth, solid cut surfaces. The surrounding liver parenchyma appeared tan-pink with a uniformly nodular texture.\n\nHistologic evaluation revealed a solitary lesion with patchy intratumoral fibrosis. Microscopic analysis showed moderately differentiated cells with evidence of small vessel invasion. No large vessel invasion was identified. The tumor was confined to the liver without involvement of the resection margins. Parenchymal margins were uninvolved, with the closest distance from invasive cells being 0.8 cm.\n\nAdditional findings included changes consistent with cirrhosis. There was no history of prior treatment such as TACE or RFA. Regional lymph nodes were not assessed. Based on current data, the tumor stage was classified as pT2 with pNX for lymph node involvement. This classification was based on the presence of a solitary tumor with vascular invasion. The pathologic staging was considered provisional and did not incorporate full clinical correlation or prior pathology information."} +{"pid": "TCGA-A1-A0SM", "report": "The left axillary sentinel lymph node biopsies show no tumor in all three lymph nodes examined. A mastectomy specimen from the left breast contains a firm mass located deep and medial to the nipple in the inner lower quadrant, measuring 3.5 cm in maximum diameter. The mass is pink-tan, irregular, and lobulated, found in slices 5 through 7 of the sectioned specimen. It extends closest to the deep margin at 0.7 cm, with greater distances to the anterior superior (1.7 cm) and anterior inferior (1.9 cm) margins.\n\nMicroscopic evaluation reveals invasive tumor cells arranged in definite tubule formation in less than 10% of the sample, with a nuclear grade of 3 and a mitotic count of less than 10 figures per 10 high-power fields. The total score corresponds to a modified Bloom-Richardson grade of 2. No lymphatic-vascular or perineural invasion is identified. Resection margins for the invasive component are negative, with distances ranging from 0.3 cm to more than 1 cm from the tumor.\n\nA separate intraductal lesion is present, cribriform in pattern, measuring 0.3 cm in size, with intermediate nuclear grade and no necrosis. Resection margins for this component are also negative, all being more than 1 cm away. Microcalcifications are identified within the invasive component.\n\nImmunohistochemical analysis shows positivity for estrogen receptors in approximately 20% of cells with variable intensity, while progesterone receptor staining is absent. HER2 testing by immunohistochemistry demonstrates a staining intensity of 3+, indicating over-expression of the HER2/neu oncoprotein.\n\nAll other sampled breast tissue, including nipple, skin, and dermis, shows no evidence of tumor. Gynecomastia is noted in the non-tumorous breast tissue. Lymph node status is negative (0/3). The stage based on tumor size and lymph node status is pT2NOMX."} +{"pid": "TCGA-19-1789", "report": "The pathology report includes multiple specimens from a right occipital lesion. The first biopsy consists of tan-pink, soft tissue fragments measuring 1.4 x 0.6 x 0.6 cm in total. Microscopic evaluation shows hypercellular tissue; no definitive tumor is identified at this stage. A second specimen includes additional tan-pink fragments measuring up to 0.6 x 0.4 x 0.3 cm. This sample demonstrates high-grade glial features upon microscopic analysis.\n\nA third specimen consists of two soft tissue fragments measuring up to 1.4 x 1.1 x 0.75 cm. Both are light tan throughout and reveal high-grade cellular features consistent with glial origin. A fourth specimen includes six fragments ranging in size from 1 x 0.5 x 0.3 cm to 2.7 x 1.5 x 0.5 cm. These show similar histological characteristics with increased cellularity and nuclear atypia.\n\nAn additional specimen labeled as white matter removal includes brain tissue fragments up to 4.2 x 2.2 x 1.8 cm. Microscopic examination reveals focal hypercellularity involving the cerebral cortex and underlying white matter. Immunohistochemical staining for certain markers related to neuroectodermal differentiation is negative. All assays were performed using validated methods with appropriate controls. No FDA-cleared or approved reagents were used in some components of the testing."} +{"pid": "TCGA-D1-A1O5", "report": "The specimen consists of a uterus with attached bilateral fallopian tubes and ovaries, submitted following hysterectomy and bilateral salpingo-oophorectomy. A 2.8 x 2.5 x 1.9 cm exophytic mass is identified in the anterior uterine wall. Microscopic evaluation shows that the lesion extends 0.2 cm into the myometrium; the total myometrial thickness measures 2.4 cm. There is no involvement of the endocervix. Lymphovascular space invasion is not present. Two intramural leiomyomata are noted, measuring between 2.2 cm and 3.5 cm. Both ovaries and fallopian tubes show no diagnostic abnormalities.\n\nLymph node assessment includes 17 right pelvic lymph nodes and 3 left pelvic lymph nodes, all negative for abnormal cellular infiltration. Staging is determined as pT1a N0 based on available surgical materials. This staging classification corresponds to a non-advanced stage with no nodal involvement.\n\nThe gross examination confirms the presence of the exophytic lesion within the endometrial cavity, measuring 2.8 x 2.5 x 1.9 cm and invading superficially into the myometrium. The ovaries and fallopian tubes appear unremarkable upon visual inspection. Permanent histologic sections using H&E staining were reviewed to confirm findings, and no significant discrepancies were noted compared to frozen section analysis."} +{"pid": "TCGA-HT-A5R7", "report": "The neoplastic cells express IDH1 but are negative for p53. Numerous MIB-1 reactive cells are present with a labeling index of 12.48. \n\nThe specimen from the right parietal region consists of multiple irregular fragments of tan-white to red soft tissue measuring up to 3.0 x 2.0 x 0.6 cm in aggregate. Sections demonstrate a diffusely infiltrative astrocytic neoplasm with variable atypia and cellularity ranging from mild to marked. The tumor cells predominantly resemble fibrillary or gemistocytic astrocytes, with some lacking obvious processes and showing possible perinuclear halos. Microvascular proliferation and necrosis are not identified. Mitotic figures are occasionally seen in the more cellular areas, particularly in the frozen sections, although artifact complicates evaluation. The enhancing nodule specimen also shows similar features. \n\nImmunohistochemistry demonstrates expression of IDH1 with no p53 immunoreactivity. Proliferation index by MIB-1 staining is approximately 12.4%."} +{"pid": "TCGA-AR-A0U0", "report": "Breast, left breast, simple mastectomy: A mass measuring 2.3 x 1.8 x 1.5 cm (AJCC pT2) is present in the lower inner quadrant, located 2.0 cm from the closest (inferior) margin. Histologic evaluation reveals a high-grade lesion with features suggestive of aggressive behavior, including vascular invasion. The remainder of the breast tissue demonstrates proliferative fibrocystic changes, including ductal hyperplasia of the usual type, apocrine metaplasia, and microcalcifications. Duct ectasia is also noted. The nipple appears unremarkable, and all surgical margins are free of involvement.\n\nLymph node evaluation includes multiple (2) left axillary sentinel lymph nodes, one of which shows a small cluster of cells detected only on cytokeratin immunohistochemistry staining, not visible on H&E. This focus measures less than 0.2 mm and is considered a micrometastatic deposit. Both sentinel lymph nodes contain blue dye. Additionally, two other left axillary lymph nodes are entirely negative for tumor involvement.\n\nHormone receptor analysis demonstrates no nuclear staining for estrogen or progesterone receptors. The ER (Estrogen Receptor) test used in this evaluation was developed by and has not been cleared or approved by the U.S. Food and Drug Administration.\n\nCase reviewed in consultation with Drs. [redacted]."} +{"pid": "TCGA-IB-AAUR", "report": "A lymph node at location #8 shows involvement by metastatic cells. One out of one lymph node examined from this site is affected. At the portal lymph node site, one lymph node is examined and found to be free of malignant cells. A cholecystectomy specimen reveals chronic gallbladder inflammation with mild activity and cholesterolosis. A lymph node near the cystic duct is also free of malignancy.\n\nA Whipple resection specimen includes a segment of duodenum and pancreatic head measuring 23 cm in length. Within the pancreatic head, there is an ill-defined mass measuring 3.7 x 3.5 x 3.5 cm. The mass has a firm, rubbery texture and tan-white appearance, with infiltrative borders. On sectioning, it contains multiple cystic spaces filled with clear mucin. The mass is in close proximity to the retroperitoneal margin and common bile duct, which contains a metal stent. It approaches the ampulla but does not invade the duodenal wall.\n\nMicroscopic evaluation reveals invasive growth with features including foamy gland and large duct patterns. Lymphatic, venous, and perineural invasion are present. Of 24 lymph nodes examined, 10 show involvement by metastatic cells. The tumor extends into surrounding soft tissues, including peripancreatic and retroperitoneal areas, and involves the extrapancreatic common bile duct. Margins at the retroperitoneal site and common bile duct are involved, while proximal and distal duodenal margins are free of tumor.\n\nA separate biopsy of the pancreatic neck margin shows rare atypical cells in pools of mucin around a nerve, raising suspicion for invasive growth. These findings are noted on permanent sections but were not identified during initial frozen section analysis. Based on the deeper tissue examination, it is estimated that the true margin is negative, with tumor located very close (approximately 1\u20132 mm) to the margin.\n\nThe tumor is histologically well-differentiated. No prior treatment was administered. Additional findings include chronic pancreatitis. Multiple tissue blocks have been preserved for further study, with D9 containing the best tumor sample and C2 the best normal tissue."} +{"pid": "TCGA-IA-A40X", "report": "A partial nephrectomy specimen from the left kidney contains a well-circumscribed mass measuring 3.5 cm in greatest dimension. The tumor is located in the upper pole and is unifocal. Gross examination reveals that the tumor bulges the renal capsule and extends to within 0.1 cm of the capsular/soft tissue margin (inked blue), as well as 0.1 cm from the parenchymal margin of resection (inked black). Histologically, the tumor cells exhibit nuclear features corresponding to Fuhrman grade 2 out of 4. Microscopic evaluation confirms that the tumor is confined entirely within the kidney without evidence of vascular invasion. All margins of resection, including parenchymal and capsular/soft tissue margins, are free of tumor involvement. No sarcomatoid features or tumor necrosis are identified. Adjacent non-neoplastic kidney tissue shows patchy interstitial chronic inflammation and multifocal clear cell changes. Immunohistochemical staining demonstrates positivity for AMACR and CK7, while WT-1 and CD57 are negative. Pathologic staging is consistent with pT1a, with no lymph node or distant metastasis identified. A separate specimen from the left adrenal gland shows no abnormalities."} +{"pid": "TCGA-C5-A7UH", "report": "The patient is a woman who presented with vaginal bleeding and an exophytic cervical mass. A biopsy was performed, and two specimens were received for analysis. Specimen A consisted of a single fragment of tan-white tissue measuring 0.4 x 0.4 x 0.3 cm. Specimen B consisted of multiple fragments of tan-white to dark brown tissue, with individual measurements ranging from 0.3 x 0.1 x 0.1 cm to 0.7 x 0.4 x 0.2 cm. Microscopic evaluation of both specimens revealed poorly differentiated invasive cells. The findings were confirmed by a reviewing pathologist, and the report has been verified based on direct examination of the slides."} +{"pid": "TCGA-06-0133", "report": "The patient presented with new onset disorientation, facial droop, and speech difficulties. Imaging revealed a 3.0 cm mass in the right temporal lobe with enhancement, along with two additional lesions located in the corpus callosum. A resection of the right temporal lesion was performed.\n\nMicroscopic examination of the specimen revealed a highly cellular neoplasm with features suggestive of aggressive behavior. The lesion demonstrated diffuse infiltration and extensive disruption of cerebral architecture. Nuclear atypia and increased mitotic activity were observed. Additionally, there was prominent vascular proliferation with associated necrosis and thrombosis. Zones of necrosis with pseudopalisading were also identified.\n\nImmunohistochemical staining showed expression of GFAP, indicating fibrillogenesis by the neoplastic cells. A small subset of cells exhibited overexpression of p53 protein. The MIB-1 proliferation index was approximately 25% in more active regions of the tumor.\n\nSpecial stains were requested for further characterization of the lesion and will be reported separately. Molecular testing for MGMT promoter methylation was performed using bisulfite-treated DNA followed by PCR amplification and gel electrophoresis. Results indicated no methylation of the MGMT promoter.\n\nGross examination of the surgical specimen revealed one fragment measuring 4.5 x 2.7 x 2.0 cm. The tissue was firm with a creamy-white cortex, appearing focally glistening and grayish-pink.\n\nAdditional intraoperative evaluation suggested a high-grade glioma, consistent with glioblastoma, although gliosarcoma could not be ruled out at that time. Multiple histological sections were examined and stained with various markers including H&E, mGFAP, MGMT, MIB1, and p53.\n\nAll findings were interpreted within established diagnostic guidelines and are intended for clinical correlation."} +{"pid": "TCGA-EP-A12J", "report": "The specimen consists of a left lateral segment liver wedge weighing 310 grams and measuring 14 x 8.5 x 5.5 cm. The external surface is violaceous, pink, smooth, glistening, and diffusely granular with nodular areas. A single nodule measuring 2.5 cm is identified, located 3 cm from the stapled margin. The nodule appears yellow-tan, well-circumscribed, and measures 2.7 x 2.7 x 2.7 cm. It comes within 1.3 cm of the nearest surgical margin (blue inked). The remainder of the liver has a tan-brown, smooth, glistening cut surface. Sections include representative normal tissue, areas transitioning from lesion to surface and normal tissue, the stapled edge at the stapled margin, and sections approaching the surgical margin.\n\nMicroscopically, the lesion demonstrates well-differentiated morphology. The maximum dimension is 2.7 cm. Resection margins show no involvement. No vascular invasion is observed. No lymph nodes were submitted for evaluation. Distant metastasis could not be assessed based on this specimen. Additional findings reveal the presence of micronodular cirrhosis in the surrounding liver tissue."} +{"pid": "TCGA-DX-A8BK", "report": "The clinical history includes the submission of two specimens: a Tru-Cut biopsy from the left thigh and a resection specimen from the left anterior thigh.\n\nMicroscopic evaluation of the biopsy specimen revealed a high-grade pleomorphic tumor. Permanent sections confirmed findings consistent with those observed during frozen section analysis. The tumor demonstrated features that were myxoid in areas and showed involvement of skeletal muscle and fibroadipose tissue. Necrosis was present, estimated grossly at 20\u201330%. Immunohistochemical staining showed absence of reactivity for S100, HMB45, AE1:AE3, 34BE12, and desmin.\n\nThe resected specimen measured 17.5 x 10.2 x 9.2 cm and included a mass measuring 12.9 x 8.6 x 9.3 cm. The mass appeared yellow-tan with fleshy regions interspersed with areas of necrosis, fibrosis, and hemorrhage. Multiple cystic spaces were identified, the largest measuring 3.1 x 1.5 x 0.9 cm, containing dark brown fluid. The tumor was surrounded by fascia and muscle and was located 0.1 cm from the inked margin. Distal and proximal margins measured 2.0 cm and 2.2 cm from the tumor, respectively. Surgical margins were free of tumor, although the deep margin was within close proximity (0.15 cm). Multiple representative sections were submitted for analysis.\n\nGross examination of the biopsy specimen consisted of a single core of tissue measuring 2.5 x 0.1 x 0.1 cm, with half submitted for frozen section and the remainder for permanent sectioning.\n\nIntraoperative consultation on the biopsy specimen yielded findings consistent with a high-grade pleomorphic tumor, and this diagnosis was confirmed on permanent sections."} +{"pid": "TCGA-06-0881", "report": "The clinical history indicates a brain lesion. Two specimens were collected during surgery: one biopsy and one excision biopsy. The excised tissue measured 1.5 x 1.5 x 1.3 cm and was described as an irregular, tan to gray-white fragment with additional smaller fragments ranging from 0.5 to 0.8 cm. The biopsy specimen consisted of soft tissue fragments measuring 2.0 x 1.2 x 0.3 cm.\n\nMicroscopic evaluation revealed a cellular astrocytic tumor with features including vascular proliferation and pseudopalisading necrosis. Immunohistochemical staining demonstrated positivity for CD99 and NCAM, while p53 staining was negative. The Ki-67 labeling index was approximately 8%.\n\nAn assay was performed to assess MGMT promoter methylation status using bisulfite-treated DNA followed by real-time PCR amplification. The result was negative, indicating no methylation detected. It was noted that this test was developed and validated in a CLIA-certified laboratory, and while it may inform treatment decisions involving alkylating agents, it is not an independent diagnostic tool.\n\nIntraoperative consultation on the biopsy sample described findings consistent with an astrocytic neoplasm. Multiple histological sections were evaluated, and various stains were applied for analysis."} +{"pid": "TCGA-CQ-6223", "report": "The specimen consisted of multiple lymph node tissue samples from the right neck, including levels II, III, and IV. A total of 32 lymph nodes were examined\u201410 from level II, 2 from level III, and 20 from level IV\u2014and all were negative for malignancy. Additionally, several mucosal and deep tissue margins were evaluated, including the medial anterior and posterior mucosa, posterior buccal superficial and deep margins, pterygoid deep margin, and right posterior and medial mandible margins. All margins were found to be free of tumor involvement.\n\nA composite resection specimen included a portion of the right posterior mandible without teeth. Within this specimen, a well-circumscribed lesion was identified in the alveolar ridge mucosa. The lesion measured 2.5 cm in its greatest dimension and had a maximum thickness of 0.5 cm. The cut surface was described as white-tan and firm, with a nodular center and rolled edge. No perineural or lymphovascular invasion was observed. Bone sections from the resection were undergoing decalcification at the time of reporting and were later confirmed to show no evidence of bone invasion; the bone margins remained negative for malignancy.\n\nAll frozen section controls from the various margins were also negative for malignancy. Pathologic staging indicated no regional lymph node metastasis (pN0), with 32 regional lymph nodes examined and none involved. The primary tumor could not be fully assessed for staging (pTX), and distant metastasis could not be determined (pMX). The histologic grade was classified as moderately differentiated."} +{"pid": "TCGA-AA-3858", "report": "In the first specimen, there is a benign lesion consistent with a hyperplastic polyp. The second specimen shows a poorly differentiated adenocarcinoma of the colon, characterized by infiltrative growth into the muscularis and vascular structures. Histological grade is G3. The tumor was classified as pT2 with lymphatic invasion (L1) and vascular invasion (V1). No lymph node metastases were identified (pN0, 0 of 12 lymph nodes involved). Resection margins are free of tumor (R0)."} +{"pid": "TCGA-AA-3529", "report": "The surgical specimen includes a resected portion of the colon or rectosigmoid colon containing two distinct tumor sites. The first tumor, located in the rectum, is an ulcerated lesion measuring 3.5 cm in diameter. It extends into the internal portions of the muscularis propria without reaching the aboral resection margin, which is free of tumor. The second tumor, located in the colon or sigmoid region, measures 4 cm in greatest diameter and shows invasive growth into the adjacent mesocolic fat, including lymphangitic spread at the tumor margins. Both tumors are composed of moderately differentiated epithelial cells. The oral and aboral resection margins are free of tumor.\n\nExamination of regional lymph nodes reveals involvement in 9 out of 33 nodes. In several nodes, the extent of metastatic involvement exceeds the size of the native lymph node structure.\n\nTumor staging for the rectal lesion is pT2 with no lymphovascular invasion (L0, V0) and histologic grade 2. For the colon or sigmoid tumor, the stage is pT3 with lymphatic invasion (L1) but no vascular invasion (V0), also histologic grade 2. The overall nodal status is pN2, with 10 involved nodes out of 34 assessed."} +{"pid": "TCGA-D1-A17M", "report": "A 160.0 gram uterus with attached cervix was received, showing a 4.7 x 3.9 x 1.9 cm mass circumferentially involving the endometrial cavity. The myometrium measured 2.1 cm in total thickness, with invasion extending approximately 0.5 cm into the myometrium. A separate nodule measuring 0.7 cm was identified in the superficial endocervical canal and was located 1.5 cm from the ectocervical margin. Lymphovascular space invasion was noted. Examination of the cervix, lower uterine segment, and serosal surface revealed no evidence of tumor involvement.\n\nRight and left fallopian tubes and ovaries were both unremarkable, with no diagnostic abnormalities identified. Histologic evaluation of frozen sections from both sides showed no evidence of abnormality.\n\nBiopsy specimens included multiple lymph node aggregates. Right pelvic lymph nodes (8 total), left pelvic lymph nodes (5 total), and additional left pelvic lymph nodes (2 total) were all negative for tumor involvement upon histologic examination. Frozen section evaluations were performed on all lymph node specimens.\n\nThe final pathology report is based on gross and microscopic evaluation of the specimens, including frozen sections and permanent H&E sections. There were no findings suggestive of metastatic involvement in any of the lymph nodes sampled. Re-evaluation of staging was conducted due to discrepancies identified during frozen section analysis."} +{"pid": "TCGA-44-2665", "report": "The specimen was received in four parts. Part A consisted of four soft pale tan to gray-black lymph node tissues measuring up to 1.3 cm, with the largest being sectioned and submitted in two blocks. Part B was a right upper lobe lobectomy specimen weighing 184 grams, measuring 10.0 x 9.0 x 6.5 cm, with attached bronchial stump and vascular structures. The pleura appeared dusky tan pink-purple with focal retraction over a palpable lesion. A 6.0 x 4.5 x 4.5 cm rubbery tan-white lesion was identified beneath the pleural retraction and sampled extensively. The lesion extended within less than 0.1 cm of the inked pleural surface and within 1.8 cm of the bronchial stump margin after staple line removal. Ten tissue blocks were submitted from this portion, including margins, tumor interfaces, and a hilar lymph node. Part C contained seven lymph nodes labeled as level 7, measuring up to 1.5 cm, submitted entirely in two blocks. Part D was a level R4 lymph node measuring 2.2 x 1.0 x 0.4 cm, submitted in one block after being divided into four sections.\n\nMicroscopic examination of part A showed involvement of one out of four lymph nodes by malignant cells. In part B, histologic evaluation demonstrated malignant glandular proliferation consistent with moderately differentiated morphology. The primary lesion measured 6 cm and did not involve the surgical margins. Lymphatic invasion was present. Two of three peribronchial lymph nodes contained malignant cells. Parts C and D showed no evidence of malignant involvement in six and one lymph nodes respectively. No vascular invasion was identified. Based on these findings, staging indicated involvement limited to regional lymph nodes without distant spread."} +{"pid": "TCGA-AA-A01I", "report": "The resected left hemicolon specimen contains two distinct lesions. The first is located 3.5 cm from the resection margin and measures 3.5 cm at its widest point. The second lesion is found 18 cm from the same margin and measures 3.3 cm across. Both arise at the base of pre-existing polyps: one from a tubulovillous adenoma with severe epithelial dysplasia, and the other from a tubular adenoma also with severe epithelial dysplasia. Histological evaluation shows invasive growth into the muscularis propria. In addition to these lesions, the colonic mucosa contains a tubulovillous adenoma with severe dysplasia and two tubular adenomas with moderate dysplasia. All margins are free of neoplastic involvement. Thirty-six regional lymph nodes show no evidence of tumor involvement and display reactive changes. Vascular and lymphatic invasion are not identified. The histologic grade is moderately differentiated, and there is no residual tumor at the resection margins."} +{"pid": "TCGA-EB-A4XL", "report": "The specimen consists of skin tissue measuring 1.7 x 1.5 x 0.7 cm. The lesion is ulcerated and pigmented. Microscopic evaluation reveals a nodular growth pattern with cellular atypia. The depth of invasion is 7.0 mm, corresponding to level IV by Clark\u2019s classification. No satellite nodules were identified. Lymph node status, lymphatic or venous invasion, and margin status could not be determined as this information was not specified in the report. There was no evidence of neo-adjuvant treatment. Other pathologic findings were not reported."} +{"pid": "TCGA-5P-A9K8", "report": "The specimen shows a neoplastic lesion with a maximum dimension of 7.5 cm. Histologic evaluation reveals a papillary growth pattern with cellular features consistent with an epithelial neoplasm. The lesion demonstrates infiltration into the peri-renal fat layer. Surgical margins, including assessment of the vasculature and ureter, show no evidence of tumor involvement. Lymphovascular invasion is present, while vascular invasion and perineural invasion are not identified. The morphologic features correspond to a histologic grade II lesion."} +{"pid": "TCGA-BP-4352", "report": "The right kidney specimen with attached adrenal tissue, ureter, renal vessels, and perinephric fat was examined. The tumor measured 10.0 x 10.0 x 6.5 cm in greatest dimensions and displayed tan-red to orange-yellow cut surfaces with areas of necrosis and firm gray-white regions. It extended into the renal pelvis forming a polypoid mass without ulceration of the epithelium. The tumor involved Gerota\u2019s fascia, renal sinus fat, and hilar fat, and was found to extend to the perirenal fat margin. Invasion of the renal vein was present, along with small vessel angiolymphatic invasion. A tumor embolus was identified within the renal vein. The surgical margins were grossly free of tumor involvement except for the soft tissue margin where tumor was present.\n\nMicroscopic evaluation revealed high-grade nuclear features consistent with Fuhrman Nuclear Grade IV. The tumor showed extensive sarcomatoid differentiation involving more than 75% of the sample. No involvement of the adrenal gland was observed. No lymph nodes were identified in the perinephric fat.\n\nLymph node specimens were submitted from the paracaval and hilar regions. One paracaval lymph node was examined and found to be non-metastatic. Nine hilar lymph nodes were also examined, none of which contained metastatic disease.\n\nThe tumor extended into the renal vein and vena cava below the diaphragm, corresponding to a staging classification indicating advanced local invasion. No distant nodal metastases were identified."} +{"pid": "TCGA-CZ-4862", "report": "The surgical pathology report describes a left kidney specimen obtained via radical nephrectomy, measuring 21 x 9.5 x 6.8 cm and weighing 653.5 grams. The kidney measures 13.0 x 8.0 x 5.8 cm, with a ureter measuring 10.5 cm in length. Two distinct masses were identified within the kidney. The first is located in the posterior mid-to-upper pole, measuring 4.7 cm, and is described as golden yellow/red, lobulated, hemorrhagic, and encapsulated. It abuts the renal capsule and comes to within 0.8 cm of the deep margin. The second mass is found in the anterior subcapsular region of the renal cortex, measuring 1.0 cm, also encapsulated and distending the renal capsule, coming within 0.5 cm of the deep margin. A third small nodule less than 0.2 cm in size is also noted in the cortex.\n\nMicroscopic evaluation reveals both masses are confined to the kidney without extension into perinephric fat or vascular invasion. Nuclear grading of the cells shows Fuhrman nuclear grade 2 features. Margins of the ureter, renal vein, and renal arteries are free of tumor involvement. No lymph nodes were identified within the hilum. Additionally, a small papillary lesion measuring 0.3 cm was incidentally found in the subcortex along with a microadenoma measuring 0.1 cm.\n\nHistologic sections show focal global glomerulosclerosis involving approximately 18% of glomeruli and mild tubular atrophy with interstitial fibrosis affecting about 10% of the parenchyma. Arterial and arteriolar sclerosis of moderate severity is also present. Immunofluorescence studies demonstrate granular deposition of IgM (trace), IgG (+/4+), and fibrinogen (+/4+) in mesangial areas and along peripheral capillary walls. Albumin (+/4+) shows diffuse linear deposition along basement membranes. Electron microscopy reveals thickened glomerular basement membranes with subepithelial and intramembranous electron-dense deposits, foot process effacement, and microvillous degeneration of epithelial cells. These findings suggest immune complex-mediated glomerulonephritis with a membranous pattern of injury.\n\nCytogenetic analysis of two tumor specimens revealed a karyotype of 45,XY,-8[10] in both cases, indicating loss of chromosome 8 as the sole chromosomal abnormality. This change is not specific for any particular tumor type. Staging classification indicates the larger lesion corresponds to T1b based on size (>4 cm but \u22647 cm), with no nodal or distant metastatic involvement assessed as Nx and MX respectively."} +{"pid": "TCGA-B0-5098", "report": "The left-sided diagnosis corresponds to a right kidney allograft nephrectomy specimen demonstrating severe chronic allograft nephropathy in the setting of calcific graft atherosclerosis. Additionally, there is evidence of mild to moderate acute rejection with associated lymphoid hyperplasia (Banff category 2). \n\nIn the right native kidney, obtained via radical nephrectomy, a 4.0 cm neoplastic lesion is identified within the renal parenchyma. Histologic evaluation reveals a mixture of granular and clear cell morphology with nuclear features consistent with Fuhrman grade III. The lesion shows focal extension into the pelvi-calyceal system. Surgical margins are uninvolved by tumor, and no vascular invasion is present. Staging classification is T1, with N and M categories indeterminate due to insufficient data. A separate small focus measuring 0.3 cm exhibits low-grade cytologic features and displays a focal papillary arrangement. Additional findings include end-stage renal disease with multiple cystic structures, some of which demonstrate focal hemorrhage."} +{"pid": "TCGA-EM-A3FJ", "report": "The specimen was received as a total thyroidectomy and right neck dissection. The right lobe of the thyroid measured 4.9 cm in greatest dimension, with a solid nodule measuring 1.0 x 0.8 x 0.6 cm. Adjacent to this nodule was a smaller nodule measuring 0.2 cm, and an additional colloidal nodule at the right lower pole measured 0.5 cm. The left lobe measured 4.2 cm in length, and the isthmus measured 2.5 cm. The thyroid weighed 22.5 grams. Multiple lymph nodes were identified in the perithyroidal region, ranging in size from 0.6 x 0.4 x 0.3 cm to 1 x 0.6 x 0.5 cm. A cystic nodule measuring 1.5 cm in diameter was also present in the soft tissue surrounding the thyroid.\n\nA fibroadipose tissue specimen from the right posterior triangle contained multiple lymph nodes, the largest measuring 0.6 cm. In the right jugular region, a suture-marked specimen included multiple lymph nodes, with the apical node measuring 1.6 x 0.9 x 0.6 cm. Two additional small soft tissue fragments were received from the apex level 5 region. A separate specimen from the superior right posterior triangle consisted of fibroadipose tissue without identifiable lymph nodes. A small nodular tissue fragment measuring 0.2 cm was received from the right lower parathyroid region and was used for intraoperative consultation. A thymus specimen weighing 2.7 g and measuring 3.5 x 1.7 x 0.8 cm was also submitted.\n\nHistologic evaluation revealed multiple foci of cellular proliferation within the thyroid. The dominant focus measured 1.0 cm in greatest dimension and showed unencapsulated, locally invasive growth. A secondary focus measured 0.2 cm and exhibited similar histologic features. No extrathyroidal extension was identified. Surgical margins were free of involvement. No evidence of venous or lymphatic vessel invasion was observed. Lymph nodes from the right jugular chain showed presence of similar cellular changes, with 2 out of 12 involved. In the perithyroidal region, 10 of 21 lymph nodes were involved. A total of 33 regional lymph nodes were examined, with 12 showing involvement. Distant metastasis could not be assessed. Additional small foci of similar cellular morphology were identified within the right thyroid lobe."} +{"pid": "TCGA-E1-A7YV", "report": "A surgical specimen of brain tissue was received fresh for intraoperative evaluation and subsequently fixed in formalin. The specimen measured 6.8 x 6.5 x 1.4 cm and exhibited a tan-white to tan-yellow, focally hemorrhagic appearance on gross examination. Representative sections were submitted for frozen section analysis and further histologic evaluation.\n\nMicroscopic examination revealed a glial neoplasm infiltrating the brain parenchyma. Histologic features included hypercellularity, mitotic figures, and microvascular proliferation. Areas of necrosis were identified. Cellular pleomorphism and hyperchromasia were present in some regions, while other areas demonstrated morphologic characteristics such as cytoplasmic clearing, perineuronal satellitosis, and perivascular arrangement of tumor cells. Immunohistochemical staining showed positivity for GFAP. Vascular structures highlighted by HAM-56 immunostaining were also noted. The MIB-1 labeling index was approximately 30%.\n\nFluorescence in situ hybridization (FISH) analysis demonstrated abnormal gain in several markers including EGFR (7p12), MET (7q31), 7 CEP, KIT (4q12), CEP 4, CDKN2A (9p21), CEP 9, and 1p36 (EGFL3). Normal findings were observed for PTEN (10q23), 10 CEP, 1q25 (ANGPTL1), 1p32 (BAC-260123), 19q13 (GLTSCR), and 19p13 (ZNF44). Chromosomal gains involving MET, KIT, and 9p21 suggested polysomy. EGFR amplification was not detected. Two out of four markers (EGFR, 7 CEP, PTEN, and 10 CEP) showed abnormalities.\n\nImmunohistochemical profiling demonstrated positivity for VEGF and CA-IX, with widespread expression of PDGF receptor alpha and beta. Staining for pS6, pAKT, pMAPK, and EGFR variant III was negative. MGMT immunohistochemistry showed positivity in approximately 20% of tumor cells. Molecular testing revealed promoter methylation of the MGMT gene. IDH1 mutation was detected; reflex testing for IDH2 was not required. Sequencing for TP53 mutations was initiated and reported separately.\n\nThe specimen was processed and interpreted in a laboratory certified under CLIA for high-complexity testing. All diagnostic tests were performed using validated protocols for clinical purposes."} +{"pid": "TCGA-A7-A0DA", "report": "The specimen includes a left axillary sentinel lymph node and a left breast excision. The lymph node, measuring 1.5 x 0.5 x 0.4 cm, was entirely submitted for examination and showed no evidence of metastatic disease.\n\nThe breast specimen measured 7.0 x 5.7 x 4.1 cm and contained a poorly circumscribed mass measuring 4.0 x 3.7 x 2.0 cm. This lesion was firm, tan-white, and rubbery with central fibrotic areas. It extended to within 0.15 cm of the anterior inked margin and 0.3 cm from the posterior margin. Microscopic evaluation revealed a high-grade invasive carcinoma with features consistent with ductal differentiation. The tumor was poorly differentiated with a total histologic grade of 3 (Elston SBR), composed of an architectural score of 3, nuclear grade of 3, and mitotic score of 3. The greatest dimension was 4 cm, corresponding to pT2 staging. Invasive tumor approached the anterior resection margin and was within 1.7 mm of the lateral margin. Lymphatic invasion was present.\n\nIn addition, there was a high-grade in situ component characterized by solid pattern ductal carcinoma with nuclear grade 3 and minimal central necrosis. This component extended to the anterior resection margin and was within 0.4 mm of the inferior margin. A small focus of cribriform architecture was also identified near the inferior margin. The in situ component accounted for approximately 25% of the total tumor burden, and an extensive intraductal component was present.\n\nThe surrounding non-tumorous breast tissue showed cysts and ductal hyperplasia. No calcifications were identified in either the invasive or in situ components. Multiple blocks were submitted for analysis, including perpendicular sections of the superior and inferior margins and sequential sections through the center of the specimen."} +{"pid": "TCGA-62-A46U", "report": "The specimen consists of a lung segment from the right lower lobe measuring 14.5 x 11.0 x 6.0 cm. A lesion within the tissue measures 4.8 x 3.5 x 3.0 cm. Histological evaluation reveals a mixed growth pattern with components of papillary, acinar, and solid arrangements. There is no evidence of involvement of the visceral pleura. The staging indicates T2 classification, with regional lymph node involvement (2 out of 54 positive), and undetermined distant metastasis status. The grade is high."} +{"pid": "TCGA-AG-3901", "report": "The resected specimen includes a lesion measuring up to 4 cm in diameter, located approximately 1.8 cm from the distal resection margin. Histological evaluation reveals moderately differentiated cells with mucinous features. The lesion demonstrates circumscribed infiltration into the surrounding adipose tissue adjacent to the rectum. Examination of regional lymph nodes identifies two positive nodes out of twenty assessed. All colon resection margins are free of tumor involvement. The minimum distance between the lesion and the circumferential resection margin is 1 cm. The mesenteric margin is also tumor-free. Histopathologic staging indicates involvement of the surrounding tissue without vascular invasion. Cellular atypia is present, with evidence of lymphatic invasion. Surgical margins are negative."} +{"pid": "TCGA-51-4079", "report": "A right upper lobe lobectomy specimen was received, measuring 20 x 14 x 6.5 cm and weighing 550 grams. A central lesion measuring 5 x 3 x 2.2 cm was identified. The lesion surrounds distal bronchial structures and is located approximately 2.5 cm from the bronchial margin, which was inked and removed. The closest distance from the lesion to the pleural surface was approximately 0.6 cm. The staple line in the area of interest was inked black and removed, with approximately 4 mm of tissue excised; the lesion was about 10 mm from the original margin. No satellite nodules were observed, and no involvement of adjacent structures was noted. The remainder of the lung parenchyma showed diffuse congestion and hemorrhage without additional masses.\n\nMicroscopic evaluation revealed moderately differentiated cells with focal keratinization. The lesion measured 5 cm in greatest dimension. There was no evidence of vascular, arterial, lymphatic, or perineural invasion. In situ changes were present. Surgical margins were free of involvement. No metastatic cells were found in the peribronchial lymph nodes (0/5) or in lymph nodes from stations 11 (0/1), 7 (0/10), 10 (0/3), and 9 (0/2). Staging based on this specimen is pT2 pNO pMx; however, this may be incomplete and should be reviewed comprehensively with all available clinical data for final staging."} +{"pid": "TCGA-E2-A15T", "report": "The specimens include sentinel lymph nodes from the left axilla, left breast tissue, left breast skin, and right breast tissue. The left axillary sentinel lymph nodes were assessed intraoperatively and found to be free of malignant cells. The left breast specimen was a mastectomy measuring 28 x 20 x 4 cm, with a skin ellipse of 17 x 7 cm. Serial sectioning revealed an infiltrating mass in the upper outer quadrant measuring 7.2 x 5.8 x 3.2 cm, located between slices 3 and 7, with the closest margin measuring 1.2 cm anteriorly. The tumor involved multiple foci, with the largest focus of invasive carcinoma measuring at least 3 cm on a single slide and spanning an area of 7 cm. The tumor showed a mix of invasive components and in situ changes. The in situ component was present in 35% of the specimen and included solid, cribriform, micropapillary, and papillary types. The skin, nipple, and skeletal muscle showed no evidence of tumor involvement. The right breast tissue showed benign features including apocrine metaplasia and stromal fibrosis.\n\nHistologic grading of the invasive component showed a modified Scarff-Bloom-Richardson grade 2 tumor, with a tubular score of 3, nuclear grade 2, and mitotic score 2. There was no vascular or lymphatic invasion identified. Necrosis was absent in the invasive component but present in the in situ component. Hormone receptor status was positive for estrogen and progesterone receptors, while HER2 testing was negative. A possible lymph node in the axillary region measured 2.3 x 1.5 x 0.6 cm and showed no signs of tumor involvement. Lymph node assessment showed no tumor in two sentinel nodes examined. Pathologic staging was pT2N0. An OncoType DX assay yielded a recurrence score of 21, with an estimated 10-year distant recurrence risk of 14%. All surgical margins were free of tumor."} +{"pid": "TCGA-CQ-A4C9", "report": "The specimen was received from the right parotid region and measured 6.5 x 5.5 x 1.8 cm. A well-circumscribed lesion measuring 2.0 x 1.3 x 1.1 cm was identified within the gland. The lesion was located 0.3 cm from the deep margin and 0.6 cm from the superficial margin. Multiple intraparotid lymph nodes were present, ranging in size from 0.5 to 2.3 cm. No evidence of squamous cell carcinoma was identified in the parotid tissue or associated lymph nodes.\n\nA total of 47 lymph nodes were examined from both right and left neck dissection specimens. One lymph node from the right level I was found to contain metastatic squamous cell carcinoma, measuring 1.3 cm. Focal extracapsular extension was noted in this lymph node. All other lymph nodes from right levels I\u2013VB and left levels I and II were negative for tumor involvement.\n\nAn anterior floor of mouth, ventral tongue, and marginal mandibulectomy specimen was submitted. The excised portion measured 6.0 cm in its greatest dimension. An ulcerated lesion was identified in the right floor of mouth, measuring 2.0 x 3.6 x 2.4 cm. Histologically, the lesion was identified as moderately differentiated squamous cell carcinoma. Tumor thickness measured 2.0 cm. No perineural or lymphovascular invasion was identified. Margins were free of tumor involvement; however, the deep margin was close to the tumor at 0.5 cm. One lymph node identified within the specimen was negative for malignancy.\n\nSections of the mandible showed cortical and medullary bone invasion by squamous cell carcinoma. The right inferior and posterior bone margins were positive for tumor involvement. Decalcified sections confirmed the extent of bone invasion.\n\nAll other surgical margins, including those from the ventral tongue, right and left posterior margins, and anterior floor of mouth, were negative for malignancy. Adipose tissue from the left level II region showed no pathologic changes.\n\nLymph node staging demonstrated involvement in a single ipsilateral lymph node less than 3 cm in diameter. A total of 47 regional lymph nodes were examined, with one showing evidence of metastasis. The primary tumor measured more than 2 cm but less than 4 cm in greatest dimension."} +{"pid": "TCGA-A5-A0R6", "report": "The specimen from the uterus, cervix, bilateral tubes, and ovaries showed a lesion involving the endometrium. The tumor measured 4.4 cm in greatest dimension, including a 3 cm endometrial polyp. There was evidence of myometrial invasion measuring 1.4 cm out of a total myometrial thickness of 1.7 cm, representing greater than 50% penetration. The tumor extended to the lower uterine segment. No tumor was identified in the cervix or parametrium. Lymphovascular invasion was present. The bilateral ovaries and fallopian tubes were free of tumor involvement.\n\nA biopsy of the omentum showed no evidence of malignancy. In the left pelvic lymph node biopsy, all seven lymph nodes examined were negative for tumor. The left periaortic lymph node biopsy did not contain identifiable lymphoid tissue and showed no evidence of malignancy. In the right pelvic lymph node biopsy, one of ten lymph nodes was found to contain tumor cells. The right periaortic lymph node biopsy included three lymph nodes, all of which were negative for tumor.\n\nStaging was based on pathological findings and assigned as pT1bN1Mx. Intraoperative assessment of the uterus confirmed the presence of a carcinoma with myometrial invasion. Gross examination of the uterus showed a polypoid mass measuring up to 3 cm in the endocervical canal. The endometrium adjacent to the mass was sampled and submitted for further analysis. Multiple sections of the uterine wall, cervix, and adnexa were examined microscopically. Adipose tissue from the omental biopsy showed no tumor involvement. Lymph node biopsies varied in size and composition, with all relevant tissues submitted for histological evaluation."} +{"pid": "TCGA-AA-3869", "report": "The resected ileocolic specimen shows an ulcerated, moderately differentiated carcinoma measuring up to 7 cm in diameter. The lesion extensively involves the cecum with broad infiltration into the surrounding pericecal fat. There is evidence of circumscribed serosal involvement. A total of 28 lymph nodes were examined, with 14 showing metastatic involvement. Resection margins of the small and large intestine, mesentery, and appendix are free of tumor. Histological grade is G2. Lymphatic invasion is present (L1), while vascular invasion (V0) is not identified. Residual tumor status is R2. Clinical evaluation indicates distant metastasis involving the liver."} +{"pid": "TCGA-FF-8047", "report": "Histopathology Report. Biopsy No: Received Date/Time. Reporting Information. Date/Time: Histopathologist. Laboratory: Consultant-In-Charge.\n\nA specimen measuring 2 x 1 x 0.5 cm was received and trisected. One fragment measuring 1 x 0.5 x 0.2 cm was set aside for snap-freezing. The remaining tissue, labeled as cervical lymph node, consisted of soft tissue fragments measuring 1.5 x 1.5 x 0.8 cm and was entirely submitted for analysis.\n\nMicroscopic examination revealed diffuse effacement of nodal architecture with involvement of extranodal adipose tissue. The lesion consisted of medium-sized cells arranged in a patternless growth pattern. These cells exhibited abundant pale eosinophilic cytoplasm and irregular vesicular nuclei with dispersed chromatin and distinct nucleoli. Mitotic figures were scattered throughout the tissue, accompanied by apoptotic debris that was engulfed by tingible-body macrophages, creating focal areas resembling a \"starry-sky\" appearance. No granulomas or metastatic malignancy were identified.\n\nImmunohistochemical staining demonstrated strong and diffuse positivity for CD20, indicating B-cell lineage. Expression of MUM-1 and bcl-6 suggested association with late-to-post germinal center differentiation. There was marked expression of bcl-2 within the abnormal cell population compared to the minimal physiological expression seen in admixed reactive T-cells highlighted by CD3 staining. CD10 was largely negative, which helped differentiate this entity from Burkitt lymphoma. Ki-67 immunolabeling indicated a proliferation rate of approximately 70\u201380%. Cyclin D1 staining was negative within the proliferating cells, ruling out blastoid mantle cell lymphoma.\n\nTerminal deoxynucleotidyl transferase was negative except in rare hematogones, supporting exclusion of precursor lymphoblastic neoplasm. Follicular dendritic meshworks highlighted by CD21 were sparse, peripheralized, and attenuated, suggesting absence of folliculocentric involvement. All external controls performed adequately."} +{"pid": "TCGA-KL-8324", "report": "The right kidney specimen with attached perirenal fat weighed 530 grams and measured 15 x 10 x 8 cm. After removal of the perirenal fat, the specimen weighed 430 grams. A mass was identified in the middle portion of the kidney, measuring 9 x 7.5 x 7.5 cm, with bulging beneath the capsule on the lateral side. Upon sectioning, the mass measured 9.7 x 9 x 7.5 cm and occupied the central portion of the kidney, extending into the hilar region. The cut surface of the mass was tan-yellow to light brown with areas of cystic degeneration. The surrounding renal parenchyma measured up to 3 cm in thickness. The mass showed multifocal nodularity, with some nodules appearing paler than the surrounding tissue. All surgical margins, including those of the renal artery, vein, and ureter, were free of involvement. The tumor was confined within the renal capsule. No adrenal tissue was identified in the specimen.\n\nA separate specimen labeled as a segment of the right gonadal vein measured 1.3 cm in length and 0.5 cm in diameter. Histologic examination revealed no abnormal findings in this specimen. All tissue submitted for microscopic evaluation was reviewed, and no evidence of tumor was identified in the gonadal vein specimen."} +{"pid": "TCGA-ZH-A8Y7", "report": "The surgical specimen includes multiple biopsies and resected tissues. A biopsy of Gerota's fascia shows the presence of poorly differentiated malignant cells. A biopsy from the definitive Segment 5 margin of the liver does not show malignancy but reveals increased portal fibrosis with periportal septae (stage 2), lobular acute inflammation, and mild cholestasis.\n\nA partial hepatectomy involving liver Segments 1\u20134 and part of Segment 8 demonstrates a large mass measuring 10 cm in greatest dimension. The tumor is unifocal but diffusely involves nearly the entire specimen. It has a mass-forming growth pattern and appears approximately 25% necrotic. Vascular invasion is present, as is extensive perineural invasion. The tumor abuts the capsule on both sides but does not extend through it. Surgical margins are negative for malignancy but are close: the tumor is 1 mm from the blue inked surgical margin, 1 mm from the green inked soft tissue margin, and 8 mm from the red inked sutured margin. Additionally, tumor is identified in soft tissue surrounding vascular structures at the surgical margin.\n\nNo lymph nodes are submitted for evaluation. Background liver tissue shows mild lobular acute inflammation with cholestasis and portal fibrosis with periportal septae (stage 2). Extensive high-grade biliary intraepithelial neoplasia is also noted.\n\nImmunohistochemical staining performed on representative sections shows patchy positivity for high molecular weight cytokeratin and CDX2, with scant positivity for CK7 and no reactivity for CK20. These findings are interpreted in the context of the morphologic features, including the presence of extensive high-grade biliary intraepithelial neoplasia.\n\nIntraoperative frozen section consultation was performed on two biopsies. The first showed adenocarcinoma in Gerota's fascia; the second, from the Segment 5 margin, did not identify metastatic disease.\n\nGross examination of the hepatectomy specimen reveals a 12.5 \u00d7 12.0 \u00d7 4.5 cm left lobectomy specimen weighing 355 grams. The mass measures 10.0 \u00d7 9.1 \u00d7 4.5 cm and occupies most of the specimen. It is white/pink with areas of hemorrhage and necrosis, well circumscribed but with irregular borders and nodularity. Capsular discoloration and underlying nodularity are noted, though the surface remains smooth. Vascular structures on the surgical margin are submitted en face without gross evidence of invasion.\n\nThe gallbladder specimen shows no malignancy and contains minimal chronic cholecystitis with acute serositis. Multiple blocks are submitted representing various aspects of the tumor, margins, vascular structures, and surrounding liver tissue."} +{"pid": "TCGA-KS-A4ID", "report": "The specimen from a female patient included a thyroid measuring 17.8 grams, with a right lobe measuring 4.5 x 3.2 x 1.3 cm, a left lobe of 5 x 2.5 x 1.3 cm, and an isthmus of 1.3 x 1.0 x 0.4 cm. The right lobe contained two nodules: one measuring 1.3 x 1.2 x 1.0 cm, described as tan, circumscribed, hemorrhagic, and firm, located 0.1 cm from the thyroid capsule; and another measuring 0.4 x 0.5 x 0.3 cm, also firm and tan, adjacent to the capsule. The left lobe showed a diffusely variegated appearance with tan and red areas but no distinct nodule. The isthmus appeared diffusely tan without nodules.\n\nA portion of fibroadipose tissue from the right level III lymph node region contained six possible lymph nodes ranging from 0.3 to 1.0 cm in size. Three of these were examined as part of a frozen section control. Additional fibroadipose tissue from level VI lymph node dissection contained multiple possible lymph nodes ranging from 0.3 to 1.2 cm, with three submitted whole in one block and five in another.\n\nFrozen section analysis showed fragments of benign lymph nodes, and permanent sections confirmed this finding. No malignant cells were identified in any of the lymph nodes evaluated from both level III and level VI on either side. The nodules within the thyroid were well circumscribed and confined without evidence of capsular or vascular invasion. Surgical margins were free of involvement. No extrathyroidal extension was observed."} +{"pid": "TCGA-HT-8111", "report": "The specimen demonstrates a moderately hypercellular glial neoplasm with variable, focally marked cytologic atypia. Numerous gemistocytic cells and fibrillary astrocytes are present, along with areas of prominent perivascular lymphocytic cuffing. Minor foci of classic oligodendroglioma are also observed. Scattered mitotic figures are identified throughout the tissue. Review of both frozen section and permanent material confirms these findings. Immunohistochemical staining shows numerous reactive cells, with a labeling index of 9.2% in the most proliferative regions, indicating increased cellular proliferation."} +{"pid": "TCGA-QR-A6H0", "report": "A soft tissue mass was resected from the right side adjacent to the right innominate vessel. The specimen measured 6.2 x 3.0 x 2.5 cm and contained a palpable nodule measuring approximately 2.5 x 1.0 cm beneath the deep margin. After removal of the inked deep margin, a circumscribed nodule measuring 3.0 x 2.0 cm was identified with a brown and tan lobulated cut surface. A representative section of the tumor near the deep margin was submitted for frozen section analysis. The deep margin was inked intraoperatively, and this margin, along with other representative sections of the specimen including normal-appearing lung tissue, was submitted for permanent processing. No tumor was identified at the inked deep margin. A second specimen consisting of a partial resection of the right second rib measured 7.5 x 2.9 x 1.0 cm and included attached intercostal muscle. No gross abnormalities were noted in this specimen, which was processed as a gross-only examination. All submitted specimens matched labeling information and were processed appropriately."} +{"pid": "TCGA-ZB-A96Q", "report": "Pathology Report-Summary: Material: Tumor: 1.6 x 1.4 cm. Histopathological evaluation revealed a mix of epithelial and lymphocytic components. The epithelial cells demonstrated positivity for CK 5/6 and were partially positive for KL1, while showing no reactivity for CD5 or CD117. A population of CD1a-negative, CD99-positive immature T-lymphocytes was identified, along with CD3-positive, CD5-positive mature T-lymphocytes. Staining was negative for CD20 and CD117 in the respective cell populations. Pathologic staging was pT2, pNO (0/6). Surgical pathological stage according to Masaoka classification was lla."} +{"pid": "TCGA-BG-A0YU", "report": "The surgical specimen includes a uterus weighing 158 grams with cervix and bilateral adnexa, along with bilateral pelvic lymph node dissections. Histologic examination of the uterus reveals a well-differentiated epithelial neoplasm with a combined architectural and nuclear grade showing minimal nuclear atypia. The lesion measures 45 mm in maximum dimension and involves approximately 90% of both anterior and posterior endomyometrial surfaces. Invasion is limited to less than half of the myometrial thickness without involvement of lymphovascular spaces. Adjacent tissue demonstrates complex hyperplasia with atypical features. Cervical tissue shows no malignant changes. Both ovaries contain benign cystic structures and one ovary exhibits endosalpingiosis. No malignancy is identified in either fallopian tube or any lymph node specimens. A total of zero lymph nodes were examined. Based on these findings, the pathologic staging is classified as pT1a pNX corresponding to an early-stage localized process. Peritoneal washing cytology demonstrated atypical cells as documented in a separate report."} +{"pid": "TCGA-77-A5G7", "report": "Histopathology Report. HISTORY. No clinical notes supplied. MACROSCOPIC. One specimen submitted, labelled \"left upper lobe,\" consisting of a lobe of lung measuring 230 x 100 x 20 mm in the uninflated state. At the apex of the lobe, multiple bullous structures are present over an area of 40 x 20 mm. A small area of fibrous pleural thickening is noted on the lateral aspect, approximately 20 x 20 mm in size. Beneath this thickened region, there is a palpable mass. The pleura appears to move freely over this area. At the hilum, two bronchial profiles are identified with diameters of 10 and 8 mm. Very few peribronchial nodes are present. A stapled resection line extends posteroinferiorly from the hilum, measuring 70 mm in length. On transverse slicing, a necrotic mass measuring 25 x 25 x 20 mm is observed lateral to the hilum, approaching the lateral pleural surface. The cut surface of the mass shows a variegated grey and yellow appearance. Adjacent to the mass, an ill-defined yellowish discoloration of the lung parenchyma is seen, measuring up to 10 mm in maximum dimension. An ill-defined area of fibrosis is also present near the mass. Elsewhere, the lung parenchyma shows severe emphysematous changes.\n\nMICROSCOPY. Microscopic examination reveals a moderately differentiated cellular proliferation measuring 25 mm in maximum dimension. Extensive necrosis is present within the lesion, accompanied by foamy macrophages and cholesterol clefts. The outer regions of the lesion exhibit a growth pattern consistent with filling of air spaces. Widespread vascular invasion is observed at the periphery, along with focal involvement of lymphatic spaces surrounding blood vessels. Mild fibro-elastotic scarring is present in the visceral pleura adjacent to the lesion, though no direct invasion of the pleura is identified. The bronchial resection margin is free of the proliferative process, although focal metaplastic change and mild dysplastic alterations are present. The area of yellowish discoloration near the lesion shows focal collapse, interstitial fibrosis, and localized obstructive changes, including dilated air spaces containing macrophages and proteinaceous material. Within this region, a mildly dilated bronchiole demonstrates focal moderate dysplastic change. Dense fibrous scarring is also found in proximity to the lesion. The remaining lung tissue contains scattered dust-related pigmented macules and clusters of pigmented alveolar macrophages. Emphysematous changes at the apex are associated with subpleural fibrosis and prominent chronic inflammatory infiltration. There is also focal fibrous obliteration of the pleural space with a small amount of adherent fat. Lymph nodes in the peribronchial region show histiocytic sinusoidal expansion and mild pigment deposition, but no abnormal cellular infiltration is present.\n\nSUMMARY. The left upper lobe contains a necrotic lesion measuring 25 mm in maximum dimension, showing extensive vascular invasion and focal lymphatic involvement. The bronchial resection margin is free of the lesion, though it demonstrates metaplastic and dysplastic changes. No pleural invasion is evident. Scarring and obstructive changes are present in the surrounding lung tissue. Emphysematous changes at the apex are associated with fibrosis and chronic inflammation, including partial pleural space obliteration. Lymph nodes show reactive changes only."} +{"pid": "TCGA-2X-A9D6", "report": "The specimen consists of a left orchiectomy measuring 5.3 x 3.5 x 3.2 cm, with attached epididymis and spermatic cord. A mass measuring 4.3 x 3.5 x 3.1 cm is present within the testicle, appearing tan to pink, soft, and heterogeneous. The mass is confined to the testis without extension beyond it. The rete testis shows involvement. The uninvolved portion of the testis appears tan, soft, and homogeneous, with seminiferous tubules that separate easily. The spermatic cord and tunica vaginalis are unremarkable on microscopic evaluation. No lymph-vascular invasion is identified. Intratubular germ cell neoplasia, unclassified type, is present. Surgical margins at the spermatic cord are free of involvement. No significant additional findings are noted. Lymph nodes were not submitted for evaluation. Pathologic staging is pT1 pNX."} +{"pid": "TCGA-FD-A5C0", "report": "A male patient underwent radical cystoprostatectomy. Right pelvic lymph node dissection included eleven lymph nodes, four of which were positive for metastatic involvement. The largest tumor focus measured 16 mm and was associated with extranodal extension. Metastatic cells showed features consistent with two distinct components. Left pelvic lymph nodes numbered twelve and showed no evidence of involvement.\n\nThe surgical specimen included the urinary bladder, prostate, and seminal vesicles. A 5 cm invasive lesion was identified in the right posterior and lateral walls of the bladder. Histologic evaluation revealed high-grade features and invasion through the bladder wall into surrounding soft tissue. Bladder mucosa showed multifocal changes involving the dome, anterior, posterior, and left lateral walls. One perivesical lymph node was involved by metastatic disease.\n\nExamination of the prostate showed a Gleason score of 3+4=7 with focal extension beyond the prostate capsule. Tumor involvement of the seminal vesicles was not identified. Ureteral margins, distal urethral margin, and soft tissue margins were all negative.\n\nLymph node evaluation showed five involved nodes out of twenty-four examined, with presence of extranodal extension. Prostate evaluation confirmed negative regional lymph nodes.\n\nImmunohistochemical staining demonstrated strong positivity for synaptophysin within one component of the metastatic tissue. Both components exhibited distinct morphologic characteristics, with micropapillary features noted only in one location.\n\nSpecimens were received and processed according to standard protocols. Gross examination of the bladder revealed an ulcerated area measuring 5 x 4 cm with invasion into perivesical fat. The depth of invasion exceeded muscularis propria. Surrounding mucosa appeared edematous but uniform in thickness.\n\nTNM staging parameters were assigned as follows: primary tumor extended into extravesicular soft tissue; regional lymph nodes showed involvement; distant metastasis could not be assessed. For the prostate, staging indicated extension beyond the capsule without lymph node involvement.\n\nAll margins and surrounding tissues were evaluated microscopically and submitted for histopathologic analysis. Multiple sections from various anatomical areas were reviewed. No tumor was identified in the left distal ureter specimen."} +{"pid": "TCGA-V1-A9OA", "report": "The pathology report includes findings from multiple tissue specimens obtained during a radical prostatectomy with lymph node dissection. \n\nLymph nodes from the right pelvis showed no evidence of abnormal cells (0 out of 1 examined). In contrast, among the left pelvic lymph nodes (7 examined), one contained abnormal cellular growth.\n\nBiopsies from the posterior bladder neck and posterior urethra showed no abnormal findings, with both specimens consisting of typical fibromuscular connective tissue.\n\nThe prostate gland weighed 50.5 grams and measured 4.3 cm (apex to base), 4.4 cm (medial to lateral), and 4.9 cm (anterior to posterior). The external surface was uneven and reddish-tan in appearance. A prominent solid lesion was observed along the posterior central region of the gland, measuring up to 3.0 cm in its largest dimension. This lesion appeared to approach the surrounding capsule. Additionally, a small nodule measuring 0.4 cm was identified near the left posterior-lateral aspect of the gland; it exhibited discoloration suggestive of possible extension beyond the capsule. Tissue involvement was also noted in both seminal vesicles.\n\nMicroscopic evaluation revealed high-grade cellular changes with a Gleason score of 5+4=9. These changes were present in multiple regions across both lobes of the prostate and extended into both seminal vesicles. The tumor showed extensive capsular invasion at the right and left posterior mid zones. Extracapsular spread was extensive, and although tumor cells approached the inked surgical margins (within 0.1 cm at several sites), they did not directly involve them. Benign prostate tissue was found at certain surgical margins. Perineural infiltration was identified, and focal prostatic intraepithelial neoplasia was also present.\n\nThe tumor volume was estimated at 5.7 cubic centimeters, with all identifiable tumor tissue categorized as high-grade (Gleason pattern 4 or higher). Based on these findings, staging was assigned as pT3bN1MX according to AJCC/UICC criteria.\n\nAll surgical specimens were carefully processed and submitted for analysis, including serial sectioning of the prostate and comprehensive sampling of margins and junctions with the seminal vesicles."} +{"pid": "TCGA-85-7844", "report": "The surgical specimen consists of a left upper lobectomy. A tumor was identified measuring 3.5 x 3.5 x 3.5 cm. Microscopic evaluation revealed a histologic type consistent with squamous cell morphology. The histologic grade was determined. Regional lymph nodes examined (2 total) showed no evidence of metastatic involvement. No additional pathologic findings were noted."} +{"pid": "TCGA-DK-A3IM", "report": "A 67-year-old male with a history of bladder diverticulum was evaluated. The submitted specimens included a soft tissue bladder margin, a bladder diverticulum with adjacent urachus, perivesical tissue, lymph nodes, upper bladder, and distal right ureter, right vas deferens, right pelvic lymph nodes, perivesical fat, omentum, periureteral tissue, and perivesical tissue.\n\nMicroscopic examination of the bladder diverticulum revealed a lesion with mixed histologic features, including urothelial, squamous, and small cell or neuroendocrine components. The growth pattern was both papillary and flat in non-invasive areas, while invasive regions showed an infiltrating pattern. Tumor multicentricity was noted, and there was involvement of perivesical soft tissues. No involvement of the right or left ureters or urethra was observed. Vascular and perineural invasion were identified. Surgical margins were free of tumor. The surrounding mucosa showed chronic cystitis and denudation. Prostate, seminal vesicles, and perivesical lymph nodes were not identified in the specimen.\n\nThe pathologic stage according to AJCC 2002 criteria was pT3, indicating invasion into perivesical soft tissue. A total of 8 right pelvic lymph nodes were examined and found to be benign. All other submitted tissues, including the right vas deferens, perivesical fat, omentum, periureteral tissue, and perivesical tissue, were composed of benign fibroadipose or fibrovascular elements. Gross measurements of the resected tissues and tumor nodules were recorded, with the largest tumor measuring 4.7 x 4.3 x 1.5 cm and a second nodule measuring 2.5 x 2.2 x 0.9 cm. The depth of invasion was up to 1.8 cm. Representative sections from all relevant areas were submitted for analysis. Intraoperative frozen section of the bladder margin confirmed benign fibroadipose tissue, consistent with the final diagnosis."} +{"pid": "TCGA-2L-AAQM", "report": "Male. Surgery date: Short report on diagnostic findings. The specimen showed an expansive, well-differentiated neuroendocrine tumor of the pancreas with extension beyond the pancreatic tissue and infiltration into the posterior wall of the stomach, associated with mucosal ulceration. Vascular infiltration was present. Lymphangitic spread was identified, with six involved lymph node stations. Three and six showed metastatic involvement, while lymph nodes in stations one, two, four, and seven were unaffected. Anastomotic margins (station 8) were free of tumor. Cholesterolosis was noted in the gallbladder. Tumor invasion was observed at the portal vein margin (station 5). Histological staging according to TNM classification (UICC, 7th edition 2010) was pT3, pN1 (16 of 57 lymph nodes positive), L1, V1. Grading was G1. Resection status was R1, with tumor involvement at the caudal, proximal, and dorsal margins of the main specimen, as well as vessel invasion with tumor thrombus in station 6 and at the portal vein margin (station 5)."} +{"pid": "TCGA-CZ-4866", "report": "The specimen is a right kidney resection weighing 207 grams and measuring 11.0 x 6.0 x 3.2 cm. A mass measuring 3.3 x 2.5 x 2.3 cm is identified on the anterior surface of the inferior pole. The mass has a yellow/brown, heterogeneous appearance with focal hemorrhage. Microscopically, the lesion demonstrates nuclear features consistent with Fuhrman grade 3. There is no invasion through the renal capsule or into the renal vein. Vascular and ureteral margins are free of tumor involvement. Lymphovascular invasion is present. The surrounding adipose tissue is thinly sampled and no lymph nodes or adrenal gland are identified.\n\nStaging classification according to AJCC (6th Edition) is T1 NX MX. Sections of the tumor were submitted for banking, cytogenetics, and immunofluorescence. Additional sections of normal kidney tissue were sent for electron microscopy and immunofluorescence analysis.\n\nEvaluation of the non-neoplastic kidney shows minimal chronic changes. There is mild global glomerulosclerosis affecting 5.1% of glomeruli, minimal tubular atrophy, and interstitial fibrosis involving less than 5% of the parenchyma. Vascular sclerosis is present in arteries and arterioles. Electron microscopy reveals thin glomerular basement membranes, with a corrected mean harmonic thickness of 250.51 nm, below the lower limit of normal. No splitting, lamination, or significant thickening of the basement membranes is observed. These findings suggest an inherited abnormality of basement membrane collagens, possibly related to persistent microscopic hematuria.\n\nCytogenetic analysis from one metaphase cell reveals a deletion of the short arm of chromosome 3. This finding is commonly associated with a specific tumor type. However, due to the limited number of analyzable cells, mosaicism or small chromosomal anomalies cannot be ruled out."} +{"pid": "TCGA-Y8-A8RZ", "report": "The specimen from a male with a renal mass consisted of a right-sided partial nephrectomy. The tumor was located in the anterior upper pole and measured 1.3 cm. Microscopically, the lesion exhibited papillary architecture, with no sarcomatoid features identified. Nuclear grading was not applicable due to the histologic subtype. Surgical margins were free of invasive carcinoma, and there was no evidence of lymphovascular invasion. The tumor was confined entirely within the kidney. No lymph nodes were sampled. Focal chronic inflammation was noted in the nonneoplastic kidney tissue, and no additional tumors or tumor-like lesions were present.\n\nIn addition, a resection of the transverse colon was performed. The tumor size could not be definitively determined due to prior partial resection. Histologically, the lesion was characterized as mucinous adenocarcinoma, high grade, invading into the muscularis propria. All surgical margins were negative, with the closest invasive carcinoma located 3.5 cm from the distal margin. There was no lymphovascular or perineural invasion, and no tumor deposits were identified. Twenty-two regional lymph nodes were examined, and none showed evidence of involvement. The tumor arose within a tubulovillous adenoma with high-grade dysplasia as documented in a prior report. No macroscopic perforation was observed, and the mesorectum was not assessed due to the procedure type.\n\nLaboratory processing times for specimens were recorded, including blood and tissue collection and preservation. Specimen weights and sizes were documented, with normal and tumor tissues stored appropriately for research purposes. Tumor nuclei were confirmed to be 100% neoplastic with a mixture of cellular types. Necrosis and normal tissue components were absent in the tumor sample. Patient consent was obtained for study participation."} +{"pid": "TCGA-06-0743", "report": "The clinical history includes an episode of disorientation associated with a left parieto-occipital enhancing lesion. Biopsy findings indicated a high-grade neoplasm. Total resection was performed. The operative diagnoses were not provided. Specimens labeled A and B consisted of brain tissue obtained via excision biopsy.\n\nHistologic examination revealed an astrocytic neoplasm characterized by a proliferation of cells with small, naked nuclei and abundant fibrillary cytoplasm. Mitotic figures were present, along with microvascular proliferation and areas of necrosis, some exhibiting pseudopalisading. Immunohistochemical staining demonstrated gliofibrillogenesis by the tumor cells, as evidenced by GFAP positivity. Approximately 8% of tumor cells showed overexpression of p53 protein. The MIB-1 proliferation index was approximately 12% in more active regions. These features are consistent with a high-grade glial neoplasm.\n\nAncillary studies included testing for MGMT promoter methylation status using bisulfite-treated DNA followed by PCR amplification and gel electrophoresis. Results indicated the presence of methylated MGMT promoter sequences. This assay was performed under CLIA-regulated laboratory standards and is not FDA-cleared or approved for specific diagnostic use.\n\nIntra-operative consultation on smears and frozen sections indicated a gliomatous process. Gross examination of specimen A revealed multiple small tissue fragments. Specimen B measured 2.0 x 1.5 x 0.7 cm and consisted of tan-pink, glistening tissue with slightly convoluted surfaces; no remarkable findings were noted upon serial sectioning. All tissue was submitted for microscopic evaluation."} +{"pid": "TCGA-26-1799", "report": "The specimen consists of two portions of brain tissue. The first is a 1.0 x 0.8 x 0.6 cm fragment of tan to beige soft tissue, submitted fresh and labeled as brain mass. A representative section was processed for frozen section analysis. The second specimen is a larger, irregular ovoid piece measuring 4.5 x 4.0 x 1.6 cm, composed of cortical gray matter and underlying subcortical white matter. On sectioning, it demonstrates a partially lodged gray and white interface without any discrete masses identified. Representative samples were taken for further processing and banking. All relevant sections have been submitted for microscopic evaluation across multiple cassettes. The tissue has been fully processed and evaluated microscopically. The pathologist or qualified designee performed the gross examination and reviewed all specimen preparations referenced in the report."} +{"pid": "TCGA-BQ-7045", "report": "The specimen includes the left kidney, a portion of the left 11th rib, and a hilar lymph node from the left side. Gross examination of the kidney revealed a single mass measuring approximately 5.5 cm in greatest dimension with well-defined borders. Cut surfaces demonstrated a pale yellow appearance admixed with areas of hemorrhage. The tumor did not involve the renal pelvis or ureter; the mucosal lining appeared intact. No invasion of the renal vein or surrounding adipose tissue was observed.\n\nMicroscopic evaluation revealed cellular features including moderate nuclear atypia and focal marked cytologic atypia. Histologic sections showed focal involvement of the renal parenchyma without extension into adjacent structures. No lymphovascular invasion was identified. Surgical margins were free of tumor involvement.\n\nSections from the vascular margin and perirenal fat were examined and showed no evidence of tumor infiltration. Sections from the hilar lymph node did not reveal any metastatic involvement. Additional studies included special stains which are pending and will be reported upon completion.\n\nAssociated findings included moderately advanced glomerulomegaly with probable immature glomeruli and cortical atrophy. There was evidence of chronic inflammation and fibrosis involving the renal parenchyma.\n\nAll specimens were adequately processed and representative sections evaluated. The assessment was based on personal examination of the slides and relevant clinical material."} +{"pid": "TCGA-73-A9RS", "report": "The surgical specimen included multiple lymph nodes from various locations, including 4R, level 7, and level 8, along with a peribronchial biopsy, portions of the 7th and 8th ribs, and a right lung with mid chest wall resection. All lymph node specimens were composed of fragments of lymphoid tissue, none of which showed any evidence of malignancy. The peribronchial biopsy revealed only inflammation without any signs of tumor.\n\nThe resected right lung contained a large mass located in the upper lobe, measuring 9.2 cm in greatest dimension. It was firm, white-tan, and centrally necrotic, with gross adherence to the chest wall. Histologically, the lesion demonstrated invasive growth into the chest wall and exhibited moderately differentiated cellular features. The bronchial margin, soft tissue margins, and bone resection margins were all free of tumor involvement. A total of nineteen peribronchial lymph nodes were examined and were also negative for tumor involvement.\n\nThe non-neoplastic lung tissue showed emphysematous changes and a separate small hemorrhagic lesion in the lower lobe measuring 1.3 cm. There was no evidence of satellite nodules or angiolymphatic invasion. Visceral pleural involvement was present. The pathological staging was determined as pT3 based on the AJCC Cancer Staging Manual, 7th Edition."} +{"pid": "TCGA-CV-6942", "report": "A specimen involving the mandible was assessed, measuring 8.0 cm in length and 2.0 cm in width, containing six teeth along with attached mucosa and soft tissues. A lesion measuring 1.5 cm was identified on the buccal mucosa posterior to the most posterior tooth, extending to the anterior gingival surface of the fifth and sixth molars. This lesion was ulcerated, raised, and roughened. Marginal distances were measured: 0.7 cm from the lateral resection margin, 3.0 cm from the medial resection margin, 2.5 cm from the posterior resection margin, 0.9 cm from the anterior resection margin, and 1.3 cm from the deep resection margin. Grossly, the mandible appeared intact without evidence of tumor invasion into bone.\n\nResection margins were evaluated with various ink codes for orientation. Mucosal margins were submitted entirely for frozen section analysis. The bony margins required further processing and were not immediately available for assessment. Histologic evaluation of cross sections through the primary site showed no residual involvement at the mucosal resection margins, although focal moderate dysplasia was noted at one margin.\n\nAdditional biopsies from other anatomical sites were examined. One showed cellular changes consistent with high-grade alterations approaching in situ involvement, while another revealed benign findings with only inflammatory and hyperplastic changes. Certain areas demonstrated severe dysplastic features near resection boundaries, raising concerns about proximity to involved margins. Further excisions were performed, revealing varying degrees of dysplastic changes with some regions showing concern for superficial invasive alterations. In one region, a papillary cystadenoma was identified within the submucosa.\n\nMultiple specimens were submitted for frozen section analysis using radial or en face techniques to ensure complete margin evaluation. Some areas showed improvement after re-excision, with absence of concerning cellular features at the newly defined margins. Perineural invasion was identified in one area, and lymphatic involvement remained uncertain. Bone specimens required decalcification prior to further histologic evaluation."} +{"pid": "TCGA-FU-A57G", "report": "A cervical mass was excised and found to have diffusely infiltrative features involving the entire specimen, with no residual intact cervical mucosa. Histologic evaluation showed a moderately differentiated tumor measuring 4.5 by 3.0 cm in size, located in the endocervix. Stromal invasion was present, extending approximately 0.6 cm into the cervical wall, which measured about 2.5 cm in thickness anteriorly. No lymphovascular space invasion was identified. Surgical margins including inked paracervical tissue and serosal aspects were negative for tumor involvement.\n\nHistologic examination of the background tissue revealed areas suspicious for an in situ lesion. The endometrium displayed a secretory pattern without signs of malignancy. Multiple benign findings included leiomyomata and normal serosal appearance.\n\nEvaluation of lymph nodes from various regions including left and right common iliac, external iliac, and obturator areas showed no evidence of metastatic disease. One lymph node was assessed in the left common iliac region, six in the left external iliac, seven in the left obturator, two in the right common iliac, six in the right external iliac, and four in the right obturator. All were negative for tumor involvement.\n\nThe radical hysterectomy specimen included a uterus measuring 8.5 x 8.0 x 8.0 cm and weighing 347 grams. The cervix measured 6.0 cm in length and 5.0 cm in diameter. A hemorrhagic exophytic mass measuring 5 x 3.0 cm was identified within the endocervical canal, extending approximately 3.6 cm into the anterior cervical wall and located 1.4 cm from the resected margin. No gross extension into the posterior cervical wall was observed.\n\nSections from both ovaries demonstrated corpora albicantia and corpus luteum without significant abnormalities. Fallopian tubes appeared histologically unremarkable. Biopsy of the right uterine artery showed no tumor involvement.\n\nSurgical specimens were thoroughly sampled and submitted for histologic analysis. Gross descriptions detailed multiple nodules within the myometrium ranging from 0.5 to 8.0 cm. Sections included extensive sampling of cervical regions, paracervical tissues, endometrium, myometrium, and myometrial masses.\n\nIntra-operative frozen section confirmed malignant cellular features consistent with prior findings. Clinical history indicated preoperative suspicion of cervical pathology."} +{"pid": "TCGA-FU-A3WB", "report": "The patient is female. Specimens were received from multiple sites, including bilateral ovaries and fallopian tubes, uterus and cervix (radical hysterectomy), vagina, and several groups of lymph nodes.\n\nGross examination of the right ovary and fallopian tube showed no significant pathologic abnormality. The right ovary measured 3.2 x 2.3 x 1.0 cm and was attached to a 4.0 cm segment of fallopian tube with paratubal cysts up to 0.3 cm. The left ovary and fallopian tube contained multiple uniloculated paratubal cysts, the largest measuring 2.0 cm. The ovary had a hemorrhagic corpus luteum and subcortical cysts measuring 0.5 and 1.2 cm. Both specimens were otherwise benign.\n\nThe radical hysterectomy specimen included a uterine corpus measuring 7.5 x 6.5 x 6.3 cm, cervix measuring 3.5 cm in length and 4.0 x 4.0 cm in diameter, and a vaginal cuff ranging from 0.7 to 1.9 cm. A subserosal nodule measuring 0.6 cm was noted in the uterine corpus, with a gray-white whorled appearance on sectioning. No additional myometrial nodules or lesions were identified. A mass was found in the cervix, measuring 6.5 x 5.0 x 2.0 cm and extending 2.0 cm into the endocervical canal, which was 2.3 cm thick. The mass approached within 1.0 cm of the vaginal margin. The endometrium was thin, measuring 0.1 cm in thickness, and the myometrium ranged from 2.0 to 3.4 cm in thickness. Adjacent paracervical soft tissues were also examined.\n\nHistologically, the mass was composed of moderately differentiated cells arranged in sheets and nests, with intercellular bridges and areas of central necrosis. Stromal invasion was present, with extension of the lesion into the cervical wall. No lymphovascular space invasion was identified. Surgical margins, including the vaginal and deep margins, were negative for tumor involvement. A subserosal leiomyoma and adenomyosis of the myometrium were also noted.\n\nLymph node dissections were performed on right and left external iliac, obturator, common iliac, and aortic regions. A total of 43 lymph nodes were examined: 10 from the right external iliac, 10 from the right obturator and common iliac, 9 from the right lower aortic, 6 from the left external iliac, 6 from the left obturator, and 2 from the left common iliac. All were negative for metastatic disease.\n\nA biopsy of the vagina was also negative for malignancy. The clinical history included a preoperative diagnosis of cervical cancer, and the postoperative findings were consistent with the radiologic assessment. The pTNM stage was determined to be pT2a2N0, according to FIGO staging criteria."} +{"pid": "TCGA-BP-4330", "report": "The left kidney and adrenal gland specimen from a radical nephrectomy measures 17.0 x 14.0 x 8.0 cm and weighs 1,050 grams. A mass measuring 12.0 x 11.5 x 8.0 cm is identified, with yellow-orange cut surfaces that are focally hemorrhagic. Areas of tan-white fibrosis are present, making up approximately 20% of the tumor. The mass extends through the renal capsule but remains within Gerota's fascia, without involvement of the renal vein. All surgical margins are free of abnormal tissue. A single cyst measuring 2.0 cm is found in the superior pole, occupying approximately 80% of the kidney. The adrenal gland appears unremarkable. A perirenal lymph node measuring 1.5 x 1.0 x 1.0 cm is identified near the superior aspect of the kidney.\n\nExamination of the superhilar periaortic lymph node specimen includes three lymph nodes, all of which show no atypical cellular changes. The para-aortic lymph node specimen contains ten lymph nodes; microscopic evaluation reveals some with granulomatous inflammation, including necrotizing granulomas. Special stains for microorganisms performed on these granulomas are negative. Additionally, a benign vascular lesion is observed in the perirenal adipose tissue and is confirmed to be an hemangioma by immunohistochemical analysis.\n\nMicroscopic review of the tumor shows a nuclear grade of II out of IV, with acinar growth pattern. No invasion of the renal vein is noted. Non-neoplastic kidney tissue shows a single cystic structure measuring 2.0 cm. Frozen section analysis initially identified a renal cortical neoplasm consistent with carcinoma, a finding confirmed upon permanent section diagnosis."} +{"pid": "TCGA-UD-AAC5", "report": "The specimen consisted of a left extrapleural pneumonectomy along with bronchial, mediastinal, and thymic lymph nodes. The pneumonectomy specimen weighed 1464g post-fixation and measured 250 x 230 x 90mm. Gross examination revealed thickening and nodularity of multiple pleural surfaces. Multiple small white tumor nodules were observed within the inner aspect of the parietal pericardium over an area measuring 65 x 55mm. A defect measuring 70 x 35mm was noted in the anterolateral pleural wall. Microscopic evaluation showed involvement of all parietal pleural resection margins with tumor extending into mediastinal fat, subpleural lung parenchyma (to a depth of 17mm), and the internal surface of the pericardium. Tumor was also present in hilar lymph nodes and was found in close proximity to several resection margins including anterior and posterior pericardial margins and medial, lateral, anterior, and posterior diaphragmatic margins. Histologically, the lesion exhibited predominantly epithelial morphology with focal sarcomatous differentiation (\u22645%). Sheets of large cells arranged in a microcystic pattern were noted, with areas of necrosis and abundant pale basophilic material confirmed as hyaluronate. Cellular features included round to oval nuclei, prominent nucleoli, and vacuolated cytoplasm. Lymphovascular space invasion was identified. Of eight hilar lymph nodes examined, one showed near-complete replacement by tumor with extracapsular extension. Bronchial resection margin was free of tumor. Other lymph nodes evaluated showed no evidence of metastatic disease."} +{"pid": "TCGA-DD-AACC", "report": "The liver specimen measured 7.4 x 4.5 x 8.0 cm and weighed 85.0 grams, with an additional section measuring 11.0 x 6.5 x 6.5 cm weighing 98.0 grams. The gallbladder was 12.0 cm in length, 4.5 cm in diameter, and had a wall thickness of 0.2 cm. A single tumor located in segment 6 of the liver measured 2.1 x 2.0 cm and exhibited a vaguely nodular appearance. Necrosis was present in approximately 10% of the tumor tissue. There was no evidence of satellite nodules, hemorrhage, or peliosis. Invasion of the portal vein, bile ducts, hepatic veins, or hepatic artery was not observed. Microscopic evaluation revealed a partial fibrous capsule with capsular infiltration present. The histologic pattern was trabecular with the majority of cells showing grade I differentiation, while the worst differentiation was grade II. Fatty change was noted in 10% of the cells. Surgical resection margins were free of involvement, with a clearance margin of 0.1 cm. No invasion was identified at the surgical margin, septum, or serosal surface. No intrahepatic metastasis or multicentric occurrence was detected.\n\nEvaluation of non-tumor liver tissue showed chronic hepatitis associated with HBV infection. The lobular inflammation was minimal, and the portoperiportal inflammation was mild. Fibrosis was present and classified as cirrhosis, specifically micronodular type, confirmed by Trichrome staining (stage IV). No dysplastic nodules, ductal epithelial dysplasia, or other liver diseases were identified. The gallbladder specimen showed signs of autolysis but no significant pathological findings."} +{"pid": "TCGA-97-7554", "report": "The surgical specimen consisted of a left lower lobe lobectomy and multiple lymph node biopsies. The primary lesion was identified in the left lower lobe, measuring 4.7 cm in greatest dimension. Histologic evaluation showed a moderately differentiated tumor with papillary, acinar, solid, and focally bronchioloalveolar components. All surgical margins, including bronchial, vascular, and parenchymal, were free of invasive carcinoma. Lymphovascular invasion was present.\n\nA total of 23 lymph nodes were examined. Of these, two out of three lymph nodes from level 7 showed evidence of metastatic involvement. The remaining lymph nodes from levels 5, 9, and 11, as well as fifteen nodes from the peri-hilar region, showed no evidence of malignancy. One lymph node from level 5 demonstrated focal non-necrotizing granulomatous inflammation. Additionally, a pleural biopsy revealed benign mesothelial hyperplasia.\n\nImmunohistochemical staining supported a pulmonary origin of the tumor, with positivity for TTF-1 and CK7. No treatment effect or distant metastases were identified. The tumor was classified as pT2a based on size and regional extension, with pN2 staging due to involvement of ipsilateral mediastinal lymph nodes."} +{"pid": "TCGA-B6-A1KC", "report": "The surgical pathology report includes findings from a right breast excisional biopsy and sentinel lymph node evaluation. The excisional biopsy measured 10.5 x 7.7 x 4.0 cm and included an anteriorly located, well-circumscribed firm white nodule measuring 2.0 x 1.8 x 1.0 cm. This lesion approached within 2.0 mm of the anterior margin and within 0.5 cm of the skin ellipse. Microscopic examination revealed a histologic grade of 3 out of 3, with scores of 3 for tubule formation, 3 for nuclear pleomorphism, and 2 for mitotic rate. Lymphatic and vascular invasion were present. An in-situ component was identified, composed of cribriform and comedo types, with a nuclear grade of 3 out of 3. Necrosis was present within the in-situ component, which measured less than 0.2 cm as a solitary microscopic focus. No multifocal tumor or extension of ductal carcinoma in situ beyond the invasive tumor mass was observed. Microcalcifications were associated with the in-situ lesion. Non-neoplastic tissue showed apocrine metaplasia and a minute fibroadenoma. Skin margins were free of tumor involvement. The anterior margin was noted to be close, with tumor approaching within 0.2 cm of the margin. Evaluation of the final anterior-inferior margin showed no malignancy. \n\nSentinel lymph node specimens were evaluated. Sentinel node #1, described as hot and blue, measured 2 x 1 x 1 cm and contained a metastatic deposit measuring 0.8 cm without extracapsular extension. Sentinel node #2, hot but not blue, measured 3.5 x 1.5 x 1.2 cm and showed no evidence of malignancy on immunohistochemical staining for cytokeratin."} +{"pid": "TCGA-B5-A0JT", "report": "The specimen consists of a 52-gram uterus measuring 6.7 x 5.0 x 2.7 cm with attached bilateral adnexa. The endometrial cavity is occupied by a friable white-tan mass measuring 5 x 4.7 x 3 cm. Microscopic evaluation reveals invasion into the myometrium, with maximum depth of invasion measuring 0.2 cm in a region where the myometrial wall thickness is 1.7 cm; at the cornu, the wall thickness is 0.9 cm. The tumor is located 0.6 cm from the nearest serosa at the cornu and appears superficial in other areas. There is no lymphatic or vascular invasion identified. In the anterior lower uterine segment, there is possible extension, although the tumor remains 2.2 cm from the internal os, with microscopic assessment revealing 0.2 cm invasion into underlying stroma.\n\nSections submitted include representative tissue from the cornu (with frozen section remnant), anterior and posterior cervix, lower uterine segments, and various regions of the endomyometrium. No tumor involvement is identified in the cervix. Adjacent non-neoplastic endometrium appears quiescent.\n\nThe left ovary measures 5.5 x 3.5 x 2.5 cm and contains a unilocular cyst with granular brown-tan lining and minimal thickened contents; no papillary projections are noted. The right ovary is smaller at 2 x 1.3 x 1.3 cm with a cerebriform white-tan appearance and no abnormalities observed on sectioning. Both fallopian tubes appear grossly unremarkable.\n\nLymph node dissection includes a left pelvic specimen measuring 12 x 8 x 4 cm containing ten lymph node candidates ranging from 0.3 to 2.4 cm in diameter. All nodes are submitted for evaluation. The right pelvic lymph node specimen measures 9 x 7 x 3 cm and contains three lymph node candidates up to 0.6 cm in size. No tumor involvement is identified in any of the 14 lymph nodes evaluated (11 from the left and 3 from the right pelvic specimens).\n\nNo tumor is identified in the remaining myometrium, cervix, or fallopian tubes. The left ovary demonstrates findings consistent with endometriosis."} +{"pid": "TCGA-VS-A9UZ", "report": "The cervix was identified as the primary site. Histologic evaluation revealed a neoplastic lesion with mucinous differentiation and features consistent with endocervical-type adenocarcinoma, classified as histologic grade 2. The tumor demonstrated infiltration into the cervical wall, reaching a depth of 8.0 mm and extending over a distance of 35 mm. Surgical margins were free of tumor involvement. Parametrial tissues on both sides showed no evidence of neoplastic infiltration, and the uterine tubes and ovaries on both sides were similarly uninvolved. Lymph node assessment revealed no metastatic involvement: 12 left pelvic lymph nodes and 14 right pelvic lymph nodes were all negative for neoplasia."} +{"pid": "TCGA-JY-A93F", "report": "The surgical specimen included multiple lymph node stations and a resected esophageal and gastric specimen. Lymph nodes evaluated included subcarinal, diaphragmatic, aortopulmonary, inferior pulmonary ligament, paraesophageal, right upper paratracheal, left low and upper paratracheal, left recurrent nerve, left gastric, splenic (station 19), cervical, and others. All lymph nodes were negative for malignancy. A total of 39 regional lymph nodes were examined microscopically and none showed evidence of metastatic involvement.\n\nThe resected esophageal and gastric specimen measured up to 12.5 cm in length along the tubular esophagus and 6.7 cm along the greater curvature of the stomach. Gross examination identified two distinct areas of abnormality on the mucosal surface. The first lesion measured 4.8 cm in length and occupied approximately 75% of the esophageal circumference. It extended over an area of 6.5 cm with a thickness of 1.2 cm and approached the proximal margin by 1.3 cm. The second lesion was located near the gastroesophageal junction, measuring 1.7 cm in length and occupying 50% of the circumference. It had a thickness of 0.6 cm and was separated from the first lesion by approximately 0.7 cm of normal-appearing mucosa. Histologic evaluation revealed invasion into the muscularis propria. Both proximal and distal margins, as well as the circumferential margin, were free of tumor involvement. No lymphovascular or perineural invasion was identified. A separate benign polyp measuring 0.5 x 0.4 x 0.2 cm was found at the distal gastric margin.\n\nAll surgical margins were uninvolved by invasive carcinoma. The closest distance of tumor to any margin was 2 mm at the circumferential margin. No perforation or additional non-cancerous lesions were observed. No significant findings were identified in the surgical waste specimen."} +{"pid": "TCGA-IG-A625", "report": "Gross Description: A lesion is located in the lower esophagus near the Z line. It is ulcerated and protrudes, measuring 3 x 2 x 1.5 cm. The surface is soft with a white-gray appearance. Microscopic Description: The squamous cell layer shows ulceration or hyperplasia. The tissue is arranged in groups or sheets with a trabecular pattern of tumor cells. The malignant cells have moderate to light eosinophilic cytoplasm. Nuclei are enlarged with variation in size and shape, containing coarse clumped chromatin and prominent nucleoli. Frequent mitotic figures are observed. The tumor invades into fat tissue, and the stroma shows lymphocytic infiltration. \n\nFormatted Path Reports: ESOPHAGUS TISSUE CHECKLIST. Specimen type: Esophagectomy. Tumor site: Abdominal esophagus. Tumor size: 3 x 2 x 1.5 cm. Histologic type: Not specified. Histologic grade: Moderately differentiated. Tumor extent: Adventitia. Lymph nodes: 5 out of 8 involved by metastasis (regional). Lymphatic invasion: Present. Venous invasion: Not specified. Margins: Not specified. Evidence of neo-adjuvant treatment: Not specified. Additional pathologic findings: None. Comments: None."} +{"pid": "TCGA-HU-8238", "report": "The surgical specimen consisted of a subtotal gastrectomy. The greater curvature measured 19.5 cm and the lesser curvature measured 12.0 cm. The proximal resection margin was 14.0 cm in length, and the distal resection margin measured 6.0 cm. The tumor was located in the lower third of the stomach (antrum), along the lesser curvature, 5.0 cm from the proximal resection margin and 4.8 cm from the distal resection margin. The tumor measured 4.0 x 3.5 cm and exhibited a Borrmann type I + II growth pattern. Grossly, there was no evidence of serosal invasion.\n\nHistologically, the lesion showed features of tubular architecture and moderate differentiation. The depth of invasion extended to the subserosal connective tissue without involvement of the visceral peritoneum or adjacent structures (pT3). Both proximal and distal resection margins were free of tumor involvement. The growth pattern was classified as infiltrative with an intestinal-type morphology. A lymphoid reaction was present, and lymphovascular invasion was identified. There was no evidence of large vessel venous invasion; however, perineural invasion was observed.\n\nA total of 46 lymph nodes were examined. Metastatic involvement was found in one out of ten perigastric superior gastric lymph nodes. No tumor was identified in the inferior gastric lymph nodes or other regional lymph node groups. Perinodal extension was not present. Distant metastasis could not be assessed.\n\nSpecial staining demonstrated the presence of numerous *H. pylori* organisms within the gastric mucosa. Multiple tissue blocks were examined including those from the tumor, surrounding tissue, and various lymph node stations."} +{"pid": "TCGA-OR-A5LT", "report": "The surgical specimen from a left adrenalectomy and left nephrectomy weighed a total of 1060 grams. A tumor measuring 14 x 13 cm was identified. Histological evaluation revealed cells with oxyphilic features as described in the literature. The Weiss score was calculated to be 8. A thrombus was present within the renal vein. No evidence of lymph node involvement was observed. Analysis of peritoneal fluid did not detect any malignant cells."} +{"pid": "TCGA-B0-4821", "report": "The gallbladder specimen shows acute and chronic calculous cholecystitis with no evidence of malignancy. Gallstones were present, consistent with cholelithiasis. A resected left kidney specimen demonstrates a large mass measuring up to 11 cm. The predominant nuclear grade is Fuhrman 2/4 with a focal area of Fuhrman 3/4 nuclear grade associated with focal tumor necrosis. The tumor is confined by a capsule without extracapsular extension. There is an occlusive thrombus within the large renal vein. The ureter, perirenal soft tissue, and all surgical margins are free of tumor. One benign adrenal gland and a single benign hilar lymph node are identified. The non-neoplastic portion of the kidney shows arterial and arteriolar sclerosis, chronic interstitial inflammation, and focal acute tubulitis, with age-appropriate chronic changes. A segment of small intestine shows no pathological abnormality and no malignancy. A fine needle aspiration biopsy of a left upper lobe lung nodule reveals rare small clusters of malignant epithelial cells. The cells are large with abundant granular cytoplasm and well-defined borders. Nuclei are enlarged with mild pleomorphism, irregular contours, coarse chromatin, and prominent central nucleoli. Immunohistochemical staining shows positivity for CD10 and pan-keratin, with negativity for CK20. Staining for CK7 was positive, while RCC, CD68, and TTF-1 were negative. These findings support a diagnosis of metastatic origin. A second nodule sample is hypercellular with reactive epithelial cells and blood but does not show malignant cells. Due to limited sampling, immunostains were inconclusive. Clinical correlation is recommended for further evaluation. Pathologic staging is T3b, NX, MX."} +{"pid": "TCGA-DW-7836", "report": "The right kidney contained two distinct masses. The first mass measured 1.1 x 1.1 x 1 cm and appeared as a white, soft tissue fragment with a tan, homogeneous cut surface. A portion of the specimen was reserved for electron microscopy, and the remaining tissue was processed for histologic evaluation. The second mass measured 2.5 x 2.2 x 2 cm and was described as a soft tissue fragment with a white and tan, variegated cut surface, including areas of attached normal parenchyma. A small fragment was also allocated for electron microscopy, and the rest was submitted for permanent processing. Both specimens were entirely sectioned and submitted in cassettes. Histologic examination revealed in the first mass a neoplasm with papillary architecture and type 1 nuclear features, including areas of solid growth and clear cell morphology. The second mass showed multiple foci of a similar papillary neoplasm with type 1 morphology and solid growth patterns. No definitive diagnosis was rendered at the time of reporting, and further discussion was planned with potential for a supplemental report. Specimens were obtained following surgical excision and handled according to protocol."} +{"pid": "TCGA-DD-AACL", "report": "The liver specimen measured 11.0 x 10.0 x 4.3 cm and was unfixed. The gallbladder measured 6.0 cm in length, with a diameter of 3.0 cm and a wall thickness of 0.2 cm, also unfixed. A single tumor was identified in segment 8 of the liver, measuring 3.5 x 3.3 x 3.3 cm. The gross appearance was nodular and expanding. Necrosis was present, involving approximately 20% of the tumor. There was no evidence of satellite nodules, hemorrhage, or peliosis. No portal vein, bile duct, or other vascular invasion was observed.\n\nMicroscopically, the lesion showed features consistent with hepatic origin. The histologic pattern was trabecular, with the worst and major differentiation graded as III. There was no fatty change detected. A partial fibrous capsule was present, but no capsular infiltration or septum formation was identified. The surgical resection margin was free of involvement, with a clearance margin of 0.2 cm. No serosal, portal vein, bile duct, hepatic vein, hepatic artery, or microvessel invasion was seen. There was no evidence of intrahepatic metastasis or multicentric occurrence.\n\nThe background liver showed changes consistent with chronic hepatitis, with early signs of cirrhotic transformation. The gallbladder showed findings of chronic cholecystitis.\n\nBlocks were prepared from multiple areas including the tumor mass (T1-4, TB), non-tumorous regions (NB, A), resection margin (RM), and gallbladder (GB). A gross photograph was provided.\n\nImmunohistochemistry and special stains were recommended for further characterization."} +{"pid": "TCGA-D5-6533", "report": "Histopathological examination was performed on a specimen consisting of a multiple organ resection including the transverse colon and distal part of the stomach. The specimen measured 30 cm in length and included surrounding periintestinal fat tissue measuring 30 x 8 x 2 cm, omentum measuring 30 x 15 cm, and a portion of the stomach measuring 11 x 8 x 4 cm. A cauliflower-shaped lesion measuring 10 x 8 x 4 cm was identified in the intestinal mucosa. The lesion circumferentially surrounded the intestine, located 10 cm from both the proximal and distal cut margins. Macroscopic invasion through the stomach wall was observed.\n\nMicroscopic evaluation revealed a tubulopapillary growth pattern with low-grade cellular atypia. There was infiltration of the entire thickness of the intestinal wall and involvement of the gastric wall. The minimum lateral margin measured 0 cm, while the proximal and distal surgical margins showed no evidence of residual disease. Lymph node examination demonstrated sinus histiocytosis without evidence of metastatic involvement.\n\nThe findings indicate a locally advanced lesion with full-thickness wall penetration and adjacent organ extension. Staging classification corresponds to pT4b with no lymph node involvement (pN0). All margins were assessed, with negative proximal and distal margins."} +{"pid": "TCGA-F4-6570", "report": "The specimen consisted of a hemicolectomy. The tumor measured 9 x 8.5 x 8 cm and was located in the colon. Microscopic examination revealed a poorly differentiated carcinoma. The tumor extended into the pericolonic tissues. No information was provided regarding lymph node involvement, surgical margins, histologic features beyond grade, neoadjuvant treatment effect, or additional findings."} +{"pid": "TCGA-M7-A721", "report": "The prostatectomy specimen measured 4.2 x 4.0 x 3.5 cm and weighed 37 grams. The prostate was sectioned with right, left, apex, and base orientations marked by colored ink. On gross examination, the prostate appeared as tan/white fibrous tissue with focal yellowish discoloration.\n\nHistologic sections included perpendicular cuts from the right and left apex, bladder neck margins, and sections through the right and left prostate extending from apex to base. Sections of both seminal vesicles and vas deferens were also examined.\n\nMicroscopic evaluation revealed involvement at the right apex, mid, and base of the prostate, as well as the left apex and mid-prostate. The lesion was confined within the prostatic capsule without evidence of lymphovascular space invasion or involvement of the seminal vesicle muscular walls. Surgical margins showed focal positivity involving the right apex (blocks A1 and A13) and apical/mid right prostate, with the involved margin measuring less than 1 mm in extent.\n\nAdditional findings included focal glandular atrophy and benign prostatic hypertrophy. No lymph nodes were submitted for evaluation.\n\nStaging based on this specimen was reported as pT2C, pNX. It was noted that this staging may be incomplete and that a comprehensive review of all available clinical information is recommended for final staging determination."} +{"pid": "TCGA-C4-A0F7", "report": "The specimen includes four of seven lymph nodes on the right side showing infiltration by malignant cells. On the left, four lymph nodes are free of tumor involvement. Extensive infiltrates of poorly differentiated carcinoma cells are present in the soft tissue. The primary lesion demonstrates infiltration through all layers of the bladder wall, with extension into the perivesical fat, reaching the surgical margin, the right seminal vesicle, and the right ureter. There is multifocal invasion of both lymphatic and blood vessels. Areas of preserved urothelium show dysplastic changes. In the prostate, bilateral infiltrates of poorly differentiated adenocarcinoma are present, predominantly in the right peripheral region. The Gleason scoring system shows 40% pattern 4 and 30% pattern 5. Only small foci of pattern 3 are present, not contributing to the final score. The largest focus measures 0.9 cm. Staging parameters indicate full thickness infiltration with extension beyond the bladder, lymphovascular invasion, positive surgical margins, and regional lymph node involvement. Intraoperative frozen sections previously showed high-grade intraepithelial neoplasia at the right ureteral resection margin, but subsequent resection material showed no residual tumor or dysplasia. However, due to infiltration of the pelvic wall and involvement of the cystectomy margin, the case is classified as having a positive resection margin."} +{"pid": "TCGA-BH-A18N", "report": "The patient underwent a left modified radical mastectomy. The submitted specimen included the left breast and axillary content. A lesion was identified measuring 4.5 by 4.5 by 3.5 cm. Histologic evaluation using the Nottingham scoring system yielded a total score of 6 out of 9, with scores of 3 for tubule formation, 2 for nuclear grade, and 1 for mitotic count. Lymphovascular invasion was present, and the deep dermis was involved. In addition, there was associated in-situ disease of solid type and nuclear grade 2, involving less than 1 cm.\n\nThe margins of resection were free of involvement. The nipple was also free of disease. Of the left axillary lymph nodes, 2 out of 26 were found to contain involvement, with the largest involved node measuring 2.3 cm and largely replaced by infiltrative tissue.\n\nImmunohistochemical analysis was performed on a representative tissue block. Staining showed positive nuclear immunoreactivity for estrogen and progesterone receptors. For ER, the percentage of cells staining was semiquantitatively reported as (0\u20130%, 1+ 10%, 2+ 10%, 3+ 80%). For PR, the distribution was (0\u20130%, 1+ or, 2+ 10%, 3+ 90%). HER-2/NEU testing using the DAKO HercepTest showed faint/barely perceptible membrane staining in more than 10% of cells, with staining limited to part of the membrane; this was interpreted as negative (score 1+). Estrogen and HER-2/NEU testing was conducted using FDA-approved methods, while the progesterone receptor assay was developed internally and has not been cleared or approved by the U.S. Food and Drug Administration."} +{"pid": "TCGA-DV-5565", "report": "The right kidney specimens reveal multiple distinct masses. The first specimen consists of a pink soft tissue nodule measuring 1.5 x 1.1 x 0.9 cm with a brown/tan cut surface and surrounding renal parenchyma. A second mass measures 1.9 x 1.6 x 1 cm, with a red-pink and tan appearance, showing bilateral tan renal parenchyma and a small cyst (0.7 cm in diameter). A third specimen is a yellow soft tissue mass measuring 3.1 x 2.6 x 1.2 cm with a golden yellow lobulated cut surface and a central white scar. A fourth mass is a pink-tan nodule measuring 1.6 x 1.1 x 1 cm, predominantly solid (>70%) with a small cystic component (0.8 cm). The final specimen is a small pink soft tissue nodule measuring 1.1 x 0.6 x 0.5 cm with a yellow-tan cut surface and a superficial yellow nodule measuring 0.6 cm in diameter.\n\nMicroscopic evaluation of all specimens reveals clusters of atypical cells within kidney parenchyma showing chronic interstitial inflammation. All masses exhibit similar histological features, including clear cell morphology and nuclear characteristics corresponding to a consistent grade across samples. All five tumors were resected from the right kidney in a patient with a clinical history of VHL and multiple right kidney lesions. No additional diagnostic terms are included in this summary."} +{"pid": "TCGA-AR-A2LO", "report": "A. Breast, left, simple mastectomy: A mass measuring 4.8 x 2.7 x 1.9 cm is identified in the lower outer quadrant. Histologic evaluation shows cells arranged in a single-file pattern with small, uniform nuclei and low mitotic activity. The mass is associated with biopsy site changes. No involvement of the nipple, overlying skin, or underlying chest wall is observed. Additional findings include the presence of in situ cellular changes involving the lobules. All surgical resection margins are negative for abnormal cellular proliferation, with the closest margin measuring 0.3 cm at the deep margin and 0.5 cm at the superficial margin. Based on available surgical material, staging according to the AJCC system is pT2NXMX.\n\nB. Breast, right, simple mastectomy: Examination of the tissue reveals benign nonproliferative breast parenchyma.\n\nC. Lymph nodes, left axillary, lymphadenectomy: Fourteen lymph nodes are assessed and show no evidence of abnormal cellular infiltration.\n\nD. Lymph nodes, left lowest axillary, lymphadenectomy: Fibroadipose tissue is present without evidence of abnormal cellular involvement; no lymphoid tissue is identified."} +{"pid": "TCGA-SX-A7SQ", "report": "The specimen consisted of a left kidney weighing 478 grams with fat and 184 grams without fat. Dimensions of the kidney were 10.5 x 6 x 5.2 cm. Two tumors were identified. The first tumor, located in the lower pole, measured 3.5 x 3.0 x 2.5 cm and exhibited necrotic and papillary features. Histologic evaluation showed nuclear grade 2 out of 4. Sarcomatoid features and tumor necrosis were not present. Microscopic examination revealed that the tumor extended into the renal sinus. Margins were free of involvement. No lymphovascular invasion was observed. No lymph nodes were found in the hilar fat. Immunohistochemical staining showed positivity for racemase and CK7, while C-Kit was negative and CD10 showed only rare positivity.\n\nA second tumor was found in the upper pole, measuring 1.8 x 1.5 x 1.5 cm. It was well-circumscribed with a yellow-orange appearance and focal necrosis. Tumor focality was multifocal. Gross examination indicated extension into perinephric tissue, but no extension beyond Gerota\u2019s fascia, renal sinus, or collecting system was noted. The adrenal gland was absent. Inking of the perinephric fat over the lower pole mass was performed. Surgical margins were evaluated and no involvement was detected. All relevant sections were examined to support the findings. Testing included immunohistochemistry developed by the laboratory, performed under CLIA certification for high-complexity testing."} +{"pid": "TCGA-A2-A0YC", "report": "The surgical specimen was received from a female patient and consisted of four tissue samples labeled A through D. Sample A, identified as the right sentinel lymph node #1, measured 1.5 x 1 x 0.4 cm and was submitted in three blocks. Microscopic examination revealed one positive lymph node with a metastatic deposit measuring 1 mm in maximal dimension. Sample B, the right sentinel lymph node #2, measured 1 x 0.3 x 0.3 cm and was submitted in two blocks; microscopic evaluation showed no evidence of metastasis. Sample C, an additional non-sentinel lymph node, measured 0.6 x 0.4 x 0.3 cm and was submitted in one block; it was also negative for metastasis.\n\nSample D consisted of a right breast lumpectomy specimen weighing 41 grams and measuring 5.5 x 4.5 x 3.5 cm overall. The skin ellipse measured 4 x 1 cm. Gross inspection identified a firm tan-gray mass measuring 2.2 cm in greatest dimension. Margins were assessed grossly and appeared free of tumor involvement. The closest margins were noted at the deep (posterior) margin, measuring 1 mm from the tumor, and the inferior margin at 4 mm. Histologic evaluation confirmed moderately differentiated infiltrating ductal carcinoma. The tumor measured 2.6 cm in maximum dimension and was fully excised with all surgical margins free of lesion. Immunostaining for cytokeratin performed on all lymph node specimens was negative for metastatic adenocarcinoma. \n\nStaging was revised to T2, N1mic, MX. Eleven tissue blocks were submitted from the breast specimen, including margins and tumor tissue."} +{"pid": "TCGA-CV-5444", "report": "A surgical case involving lymph node evaluation and resection of a tissue mass. Lymph node analysis showed no evidence of involvement in multiple nodes from the left level 2B (0/5) and right level 2 (0/8) regions. In the right paratracheal region, one out of one lymph node showed involvement. The involved node did not show extracapsular extension.\n\nThe resected specimen included a total laryngectomy with partial thyroid tissue removal. A large lesion measuring 6.3 cm in greatest dimension was identified. It extended from the right aryepiglottic fold to involve both vocal cords and reached into the subglottis by 2.5 cm. The lesion came within less than 0.1 cm of the anterior soft tissue margin and extended into the thyroid gland bilaterally through the cricothyroid membrane. It approached within 0.1 cm of the soft tissue margin in the left piriform sinus and came close to the tracheal margin at 1.2 cm. No perineural or lymphovascular invasion was identified. Multiple lymph nodes were evaluated on both sides; some showed involvement with extracapsular extension noted in certain areas. The parathyroid gland showed no abnormalities. All other margins appeared uninvolved."} +{"pid": "TCGA-D7-6818", "report": "Histopathological examination was performed on a specimen consisting of a stomach resected along the greater curvature, measuring 23.3 x 15.3 cm, along with attached omentum measuring 10.4 x 15 cm. A lesion measuring 6.8 x 6.4 x 0.3 cm was identified on the lesser curvature, located 2.3 cm from the proximal resection margin and 5.2 cm from the distal margin.\n\nMicroscopic evaluation revealed a cellular proliferation exhibiting features of mucocellular and poorly differentiated components. The lesion infiltrated the subserosal adipose tissue (pT2). Tumor cells were detected at the proximal surgical margin, while the distal margin and omentum showed no evidence of involvement. Lymph node assessment demonstrated metastatic involvement in multiple lymph nodes (pN3). Cellular atypia and architectural disarray were prominent features. Grading was based on histological differentiation and extent of spread."} +{"pid": "TCGA-GF-A2C7", "report": "The specimens were received in five labeled containers. Part A, a 4 mm punch biopsy from the upper back, was inked, bisected, and submitted for analysis. Part B consisted of an ovoid skin excision from the scalp vertex measuring 2.7 x 2.1 cm with a depth of 0.7 cm. The specimen was oriented with two sutures\u2014short suture at 9 o\u2019clock (left margin) and long suture at 12 o\u2019clock (superior margin). The margins were inked black (9\u201312\u20133) and blue (3\u20136\u20139). The 9 o\u2019clock margin was submitted separately in cassette B1, the 3 o\u2019clock margin in B2, and the remainder of the specimen was submitted sequentially in cassettes B3 through B7. Margins were negative for malignancy; however, a lesion was found within 1 mm of the right inferior margin.\n\nPart C, a lymph node specimen from the left posterior triangle, measured 1.8 x 1.2 x 0.7 cm and was entirely sectioned and submitted in cassettes C1 and C2. Both nodes were negative for malignancy. Part D, labeled as a possible sentinel node from the left posterior ear region, measured 1.5 x 1.1 x 1 cm and was described as benign fibroadipose tissue with no lymph node identified. It was fully submitted across cassettes D1 to D3, with unstained slides requested for D1 and D2.\n\nPart E was a wide excision from the posterior scalp, measuring 7 x 6.2 cm with a depth of 1.1 cm. The specimen was oriented with a short suture at 12 o\u2019clock (superior) and a long suture at 9 o\u2019clock (left lateral). A pink-tan to gray-tan exophytic lesion measuring 2.5 x 1.7 x 0.8 cm was observed on the skin surface, with blue surgical dye noted elsewhere. The specimen was inked with black (9\u201312\u20133) and blue (3\u20136\u20139) and entirely submitted in multiple cassettes: E1 (9 o\u2019clock edge), E2\u2013E35 (various cross-sections bisected or trisected), and E36 (3 o\u2019clock edge). Margins were free of tumor, with the closest distance being 7 mm at the deep margin.\n\nHistological evaluation showed a lesion measuring 7 mm in thickness at Clark\u2019s level IV with ulceration present. Mitotic count was 2 per mm\u00b2. There was no evidence of microsatellitosis, lymphovascular invasion, regression, or perineural invasion. Tumor-infiltrating lymphocytes were sparse. No satellite nodule was identified on gross examination. No sentinel lymph node was identified. Two non-sentinel lymph nodes were evaluated (as in Part C), both negative for malignancy. Staging was assessed as pT4b, N0, MX."} +{"pid": "TCGA-M7-A724", "report": "The prostate specimen measured 5.6 cm (medial to lateral), 5.2 cm (superior to inferior), and 5.0 cm (anterior to posterior), with a total weight of 60 grams. The right and left seminal vesicle stumps were unremarkable, measuring 4.7 x 1.7 x 1.4 cm and 3.5 x 1.7 x 1.1 cm respectively. A firm nodular gray/white mass measuring 2.1 x 1.5 x 1.5 cm was identified in the right lateral apex of the prostate. It was located 0.1 cm from the apical margin and 1.4 cm from the bladder neck margin, with gross abutment of the capsule but no clear extension through it.\n\nHistologic evaluation revealed a Gleason score of 8 (4+4) tumor involving approximately 20% of the prostate. Tumor was present in the right prostate from apex to near base. Examination of the prostatic capsule showed areas where the tumor extended beyond the capsule into adjacent adipose tissue at the right mid prostate. Surgical margins were involved with tumor on blocks A12 (2 mm in length) and A13 (4 mm in length). No lymphovascular space invasion was identified. There was no involvement of the seminal vesicle muscular walls bilaterally.\n\nA total of seven lymph nodes were examined: five from the left pelvic region and two from the right pelvic region. No tumor was identified in any of these lymph nodes. Based on this pathologic evaluation, the staging was determined as pT3a and pNO. Subsequent review of recut slides confirmed extracapsular extension and a positive surgical margin in the right mid prostate. These findings were communicated after the initial report due to a request for recuts related to a history of local recurrence and prior salvage radiation therapy."} +{"pid": "TCGA-VS-A954", "report": "Biopsy specimen from the uterine cervix collected on March 12, 2014, shows moderately differentiated cells with invasive growth pattern. The tissue exhibits significant desmoplastic reaction. Cellular morphology and structural features are consistent with a malignant process. No lymph node involvement or distant metastasis was identified in the sample."} +{"pid": "TCGA-OL-A5D7", "report": "The lumpectomy specimen from the left breast contains an invasive carcinoma measuring 2.8 cm in greatest dimension. Histologic evaluation shows a high-grade morphology with a modified SBR grade III, based on architectural pattern, nuclear features, and mitotic activity. Focal necrosis is present, along with a lymphocytic infiltrate. A component of high nuclear grade ductal carcinoma in situ, solid type, is identified adjacent to the invasive lesion, accounting for less than 5% of the tumor volume. The uninvolved breast tissue appears normal.\n\nMargins of resection are free of tumor involvement. The closest distance of invasive carcinoma to any margin is 7 mm at the posterior aspect, while ductal carcinoma in situ is greater than 1 cm from the nearest margin. No vascular or lymphatic invasion is identified. All submitted lymph nodes from the sentinel lymph node biopsy in the left axilla show no evidence of tumor involvement.\n\nImmunohistochemical studies show no reactivity for ER or PR. HER2/neu status is pending by FISH analysis. The pTNM classification is pT2, NO(sn), MX. The patient is a female who underwent partial mastectomy and sentinel lymph node biopsy for a left-sided lesion. The lumpectomy specimen weighed 114 grams and measured 7.0 cm in the superior-inferior dimension, 9.8 cm medially-laterally, and 4.0 cm anteriorly-posteriorly. The mass is well-circumscribed, tan-pink, and located 1.1 cm from the inferior margin, 0.7 cm from the posterior margin, 3.5 cm from the superior margin, 1.1 cm from the anterior margin, 2.2 cm from the lateral margin, and more than 5 cm from the medial margin. Multiple sections were taken to assess margins and relationship to surrounding tissue, including skeletal muscle on the posterior surface. Intraoperative evaluation of the sentinel lymph node showed no malignancy."} +{"pid": "TCGA-95-A4VP", "report": "The histologic evaluation included multiple biopsies and lymph node specimens. Specimens A and B, obtained from the pleural diaphragm and pleura respectively, showed papillary mesothelial proliferation without evidence of malignancy. Lymph nodes were examined from various levels. One out of one lymph nodes from left level 9 was involved. Two out of five lymph nodes from left level 11 were positive for metastatic involvement. In addition, four out of eight peribronchial lymph nodes were also involved. All other lymph node specimens submitted were negative for involvement.\n\nThe primary lesion measured 6.9 x 4.7 x 4.1 cm and was located in the left lower lobe. Histologically, the lesion demonstrated moderately differentiated features with acinar architecture. Visceral pleural invasion was identified, and lymphangitic invasion was present. Resection margins, including bronchial and vascular, were free of involvement. The closest distance of the tumor to a margin was 16 mm at the bronchial margin. Immunohistochemical analysis showed diffuse positivity for TTF-1 and focal positivity for synaptophysin within the involved areas. In contrast, the hyperplastic mesothelial lesions did not express TTF-1.\n\nStaging was determined as pT2b based on the tumor size greater than 5 cm but not exceeding 7 cm. Regional lymph node staging was classified as pN2 due to involvement of mediastinal and subcarinal lymph nodes. A total of 19 lymph nodes were examined, with 7 showing evidence of involvement. No distant metastasis was identified."} +{"pid": "TCGA-62-A46P", "report": "The specimen consists of a resected portion of the left upper lung lobe measuring 17.0 x 16.0 x 5.0 cm. A central mass is present with a diameter of 6.0 cm. Histologic evaluation reveals a neoplasm composed of mixed growth patterns, including a predominant papillary architecture, along with areas of acinar differentiation and bronchioloalveolar components. The lesion demonstrates moderate nuclear atypia and variable architectural distortion. No lymph node metastases were identified based on examination of seven regional nodes. Staging classification indicates a primary tumor size category consistent with T2, with no nodal involvement (N0), and an indeterminate distant metastasis status (Mx). The histologic grade is intermediate (Grade 2)."} +{"pid": "TCGA-E9-A1NF", "report": "The specimen consisted of breast tissue from a mastectomy. A grossly evident lesion was identified, measuring 4.3 x 3 x 3 cm. Microscopic examination revealed a mixed histologic pattern. The lymph node assessment showed no metastatic involvement in the 9 regional lymph nodes examined. Additional details regarding tumor extent, histologic grade, nuclear features, mitotic activity, margins, and treatment effect were not specified."} +{"pid": "TCGA-GN-A4U5", "report": "The specimen includes two left and two right axillary sentinel lymph nodes, along with an excised skin lesion from the mid back. The left axillary sentinel lymph node #1 measures 1.6 x 1.5 x 1.4 cm and contains atypical cells. The left axillary sentinel lymph node #2 is 0.7 x 0.6 x 0.5 cm and shows no abnormal cellular infiltration. The right axillary sentinel lymph node #1 measures 2.6 x 1.8 x 1.6 cm and does not show any involvement by atypical cells. The right axillary sentinel lymph node #2 is 0.7 x 0.6 x 0.6 cm and also remains free of abnormal cells.\n\nThe mid back skin excision measures 16 x 5.7 cm and extends to a depth of 3.5 cm. A centrally located pigmented lesion measuring 1.8 x 1.5 cm is identified, located 1.5 cm from the closest inferior margin. No gross involvement of underlying adipose tissue is observed. Histologic evaluation reveals a lesion with a depth of 3.0 mm and a Clark\u2019s level of IV. All margins are free of malignant cells, with the closest distance of the lesion to the inferior margin being 1.5 cm. There is no evidence of angiolymphatic invasion, though marked chronic inflammation and melanophages are present. Immunohistochemical staining demonstrates positivity for S-100 and Melan-A in the left axillary sentinel lymph node #1, while all markers are negative in the other lymph node specimens. The residual lesion shows focal ulceration on further review."} +{"pid": "TCGA-QR-A6GY", "report": "The right adrenal specimen measured 5 x 4.5 x 3.5 cm and weighed 32 grams. It contained a well-defined, encapsulated mass with a gray-pink and largely hemorrhagic cut surface. A portion of the specimen included approximately 5 x 0.5 x 0.3 cm of grossly normal adrenal tissue adjacent to the mass. The surgical margin was marked with ink. A separate specimen consisting of three fragments of rib bone was received, measuring up to 10 x 0.75 x 0.6 cm in total. Intraoperative evaluation identified a cellular lesion suggestive of a neuroendocrine neoplasm based on touch preparation. No further specific diagnosis was rendered at that time."} +{"pid": "TCGA-BP-5001", "report": "The clinical history includes a right renal mass. The submitted specimen is a partial nephrectomy from the right kidney. The tumor measures 4.1 cm in greatest diameter and is well-circumscribed, with a yellow appearance on gross examination. The specimen was sectioned to assess margins, and the closest margin measured 0.1 cm from the tumor. A representative section of this margin was submitted for intraoperative frozen section analysis.\n\nMicroscopic evaluation showed a cortical neoplasm. Nuclear grading was assessed as II/IV. There was no evidence of local invasion, renal vein involvement, or angiolymphatic invasion. All surgical margins were free of tumor. No lymph nodes or adrenal tissue were identified. The surrounding kidney showed rare cortical scarring.\n\nStaging was determined based on size and extent: the tumor was confined to the kidney and measured less than 7 cm. A total of three blocks were processed from the tumor, two from representative sections, and three from margin control. Intraoperative consultation confirmed the neoplasm and clear margins, which were corroborated by the final pathological evaluation."} +{"pid": "TCGA-N5-A4RD", "report": "Specimens submitted include the uterus, cervix, bilateral tubes and ovaries; pelvic disease biopsy; omentum; pelvic peritoneum biopsy; and right external iliac lymph nodes. Examination of the hysterectomy specimen shows a tumor with invasion greater than half of the myometrium. The maximal thickness of myometrial invasion is 9 mm, in an area where the myometrium measures 11 mm in total thickness. There is evidence of endocervical involvement, with superficial stromal invasion measuring less than 1 mm. Vascular invasion is present. A microscopic focus of tumor is identified on the surface of the left ovary. All other adnexal structures appear normal. Biopsies from the pelvis, omentum, and pelvic peritoneum show involvement by tumor cells. The single right external iliac lymph node examined is benign."} +{"pid": "TCGA-TS-A7OU", "report": "A 6.0 x 4.5 cm well-circumscribed mass with a pink-white cut surface and a 0.2 cm thick capsule is identified in the superior portion of the left upper lobe, with a depth of extension into the parenchyma of 2.2 cm. The mass has a central ulceration measuring 1.7 cm and is associated with multiple nodules ranging from 0.2 to 0.6 cm involving approximately 75% of the upper lobe and 20% of the lower lobe. These nodules protrude through the endothoracic fascia. A thickened plaque-like material ranging from 0.0 to 0.6 cm in depth is present along the pleural surface, diffusely involving the visceral pleura and endothoracic fascia. A gelatinous rind measuring between 0.6 cm and 1.5 cm is noted on the lateral and posterior aspects of the upper lung, contiguous with the main mass and areas of pleural thickening.\n\nA bleb-like space measuring 4.2 x 2.8 x 2.7 cm is present on the anterior portion of the left upper lung. The interlobar fissure appears fused but without involvement. In the lower lobe, a similar gelatinous rind extends along the posterior aspect, containing solid nodules ranging from 0.1 to 0.8 cm. The inferior surface of the lower lobe is attached to the diaphragm over an area of 3.1 x 2.1 cm. At the interface of the lung and diaphragm, a diffuse plaque-like lesion measuring 3.2 x 1.0 x 5.1 cm is observed. On the pericardial surface, there is a diffuse nodularity with nodules measuring 0.2 to 0.4 cm that do not communicate with the lung parenchyma. Within the attached pericardial fat, a hard, white nodule measuring 1.1 x 0.8 x 0.3 cm is identified.\n\nThe left lung specimen measures 27.5 cm (superior-inferior), 16.2 cm (anterior-posterior), and 4.6 cm (medial-lateral). The attached diaphragm measures 8.2 x 6.5 x 1.2 cm and shows multiple white plaque-like lesions adjacent to one surface. No gross tumor is identified within the diaphragm itself. The hilum contains a lymph node measuring 3.1 x 1.5 x 1.3 cm, densely adherent to the hilar surface of the lung. Multiple peribronchial and hilar lymph nodes are identified.\n\nSections submitted include margins from the bronchus, vascular structures, apical, lateral, posterior, medial, and anterior regions of both lobes, interlobar fissure, diaphragmatic attachments, pericardium, and pericardial fat. Additional findings include changes consistent with prior talc pleurodesis. No tumor is identified in peribronchial or subpleural lymph nodes; however, tumor is present at multiple margins including apical, lateral, posterior, medial, and anterior aspects of the upper lobe, as well as the lower lobe in relation to the diaphragm. Tumor is also found within perivascular soft tissue at the vascular margin and involves the pericardial fat and pericardium with focal positive margin. The diaphragmatic pleura is involved, though no invasion of skeletal muscle is seen, and margins of the diaphragm are free of tumor. The bronchial margin is uninvolved."} +{"pid": "TCGA-DD-AADP", "report": "The liver specimen measured 18.0 x 8.0 x 5.5 cm and weighed 235.0 grams. A well-defined mass measuring 2.2 x 1.5 x 1.5 cm was identified with extensive portal vein invasion. The cut surface of the mass was yellowish tan and solid. The lesion exhibited an expanding nodular growth pattern. The resection margin was not involved grossly, with a safety margin of 0.2 cm. No satellite nodules were observed. The remaining liver parenchyma showed cirrhotic changes.\n\nMicroscopically, the lesion was composed of hepatic-type cells arranged in a trabecular pattern. Edmondson-Steiner grading showed the worst grade as III and the major grade also as III. There was no fatty change or fibrous capsule formation. Capsular infiltration was not present, although septum formation was noted. Microvessel invasion was present along with portal vein invasion. Surgical resection margin invasion was not identified, though the tumor was in close proximity to the margin with less than 0.1 cm clearance. There was no serosal invasion, intrahepatic metastasis, or multicentric occurrence.\n\nBlocks were taken from various regions including the tumor (three blocks from tumor with portal vein invasion), resection margin, and surrounding liver tissue. The gallbladder measured 10.5 cm in length, 3.0 cm in diameter, and had a wall thickness of 0.2 cm. Histologically, it showed features of chronic cholecystitis.\n\nAdditional findings included chronic gastritis with *H. pylori* association. Multiple tissue blocks were submitted for further evaluation."} +{"pid": "TCGA-RW-A67X", "report": "A 17.6 gram, 3.5 x 3.5 cm adrenal gland was received for examination following laparoscopic adrenalectomy from a male patient. Sectioning revealed a well-circumscribed, homogeneous mass measuring 2.5 x 3.0 cm arising from the medulla. The cortex appeared yellow and showed no gross abnormalities. Multiple sections were taken of the mass and adjacent cortical tissue. Histologic examination was performed on the right adrenal gland specimen, which measured up to 3.0 cm in greatest dimension. The tumor demonstrated cellular features consistent with a neural crest-derived neoplasm. Staging was based on size and local extent. All slides were personally reviewed and interpreted by the signing staff pathologist."} +{"pid": "TCGA-CV-7416", "report": "Sections of the mandibular condyle show destruction of the mandibular ramus and infiltration through the articular surface of the condyle into the temporomandibular joint. The lesion involves the palate, oropharynx, tongue, laryngeal cartilage, and soft tissue of the neck bilaterally. The tumor measures 19.0 x 12.0 x 6.0 cm and is moderately differentiated. No tumor is present in the representative margins examined. Additional processing of the mandibular condyle is pending following decalcification."} +{"pid": "TCGA-DD-A4NB", "report": "The surgical specimen includes a cystic duct lymph node and cystic duct stump, both of which show no evidence of tumor. A polysegmentectomy of liver segments VI and VII reveals a lobulated mass measuring 10.2 x 8.3 x 7.4 cm. The lesion is entirely contained within the liver, with no extension beyond the organ. The closest negative surgical margin is 0.5 cm. Examination of the resected liver tissue shows no involvement at the margins and no macroscopic or microscopic vascular invasion. The surrounding non-neoplastic liver tissue appears normal. Multiple lymph nodes (n=10) from the hepatoduodenal ligament are also free of tumor. Staging is based on available surgical material as pT1NO (AJCC 7th edition). Photographs have been taken for documentation."} +{"pid": "TCGA-ZF-A9RD", "report": "The specimen includes a cystectomy specimen measuring 120 x 80 x 50mm, with attached vaginal cuff, fallopian tubes, and ovaries. A polypoid and partly ulcerated lesion is present in the posterior wall of the bladder, extending to the fundus, measuring 60 x 55 x 20mm. The lesion infiltrates through the bladder wall, reaching the outer half of the muscle layer and approaching the posterior serosal surface. The serosa appears slightly nodular and congested. The right ovary measures 20 x 25 x 5mm, and the right fallopian tube measures 30 x 5mm. The left ovary measures 30 x 15 x 5mm, and the left fallopian tube measures 40 x 5mm. A vaginal cuff measuring 20 x 20 x 7mm is also present.\n\nMicroscopically, the bladder lesion shows solid growth pattern with high-grade nuclear features and extensive squamous differentiation. The lesion extends through the full thickness of the muscle and focally into the perivesical fat. No lymphovascular invasion is identified, though there is focal necrosis within the lesion. The surrounding urothelium shows possible atypical changes, but no in situ component is seen. The attached fallopian tubes, ovaries, and vaginal cuff show no abnormal histological findings. Four lymph nodes are identified in the perivesical fat, one of which contains a metastatic deposit. \n\nStaging is based on infiltration into perivesical fat and the presence of lymph node involvement. A total of 15 lymph nodes are involved across this and a related specimen, with 5 showing involvement."} +{"pid": "TCGA-ED-A7XO", "report": "Gross Description: The lesion is located in sublobes VI and VII, with ill-defined margins measuring approximately 7x7x7 cm. It has a soft, solid consistency with a gray-white appearance on cross-section. Microscopic examination reveals tumor cells arranged in trabecular patterns as well as sheets. The cells exhibit a polygonal morphology with round, vesicular nuclei and prominent nucleoli. Moderate amounts of basophilic or vacuolated cytoplasm are present. Nuclear features include irregular enlargement and hyperchromasia with visible nucleoli. Mitotic figures are observed. Evidence of vascular or hepatic tissue invasion is noted, and the stroma appears fibrous. Specimen type is lobectomy with uninvolved margins and no indication of neoadjuvant treatment. Additional findings indicate involvement of sublobes 6 and 7. Multiple lesions exceeding 5 cm are identified."} +{"pid": "TCGA-67-3770", "report": "The surgical specimens include multiple lymph nodes and a right upper lobe lung specimen. The right upper lobe measured 13 x 9 x 2.2 cm and weighed 121 grams after formalin fixation. A firm, ill-defined white tan to gray mass measuring 2.8 x 1.5 x 1 cm was identified within the lung parenchyma. This lesion appeared to approach the blue inked pleural surface and was located 2.2 cm from this surface, and 2 cm from the hilum. No other discrete masses or nodularities were observed in the remaining parenchyma. Margins were assessed microscopically and included bronchial, parenchymal, and vascular margins, all of which were uninvolved. Histologic grade was moderately differentiated.\n\nLymph node specimens included Level 9R (measuring 2 cm), anterior hilar (2 x 1 x 0.3 cm), lobar (multiple nodes measuring up to 2.5 cm aggregate), Level 7 (0.4 cm), and others submitted as part of regional lymphadenectomy. All lymph nodes examined were negative for metastatic involvement. No venous or arterial invasion was identified. Additional findings included mild emphysema, pleural fibrosis with focal calcifications, and a focus of atypical adenomatous hyperplasia measuring 0.4 cm located away from the primary lesion. The tumor was confined to the lung without extension to pleura or other structures. Based on these findings, staging was determined as pT1 N0."} +{"pid": "TCGA-AX-A1CJ", "report": "The specimen was received in nine parts. Specimen A, labeled as normal tissue, consists of a single fragment of soft tan tissue measuring 1.7 x 0.6 x 0.3 cm. A red tan surface is visible. The entire specimen was submitted.\n\nSpecimen B, labeled as cervix, includes three fragments of tan to tan-pink soft tissue measuring 0.8 x 0.4 x 0.2 cm, 2 x 1.2 x 0.9 cm, and 2.2 x 1.4 x 0.4 cm. Thermal artifact is noted on the surface. One fragment has a tan to tan-white smooth lining. On sectioning, the cut surface appears tan and homogeneous without identifiable lesions. Approximately 90% of the specimen was submitted for examination.\n\nSpecimen C, labeled as left external iliac lymph node, is a single fragment of fibroadipose tissue measuring 1 x 0.5 x 0.2 cm. No lymph nodes were identified grossly, and the entire specimen was submitted.\n\nSpecimen D, labeled as left common iliac lymph node, contains a small fragment of tan-yellow adipose tissue measuring 0.2 x 0.2 x 0.1 cm. No lymph nodes were observed, and the entire specimen was submitted.\n\nSpecimen E, labeled as left periaortic lymph node, includes two fragments of tan-yellow adipose tissue measuring 0.6 x 0.5 x 0.2 cm. A single lymph node measuring 0.2 cm in diameter was identified. The entire specimen was submitted.\n\nSpecimen F, labeled as right external iliac lymph node, is a single fragment of tan adipose tissue measuring 0.6 x 0.4 x 0.2 cm. No lymph node structure was identified, and the entire specimen was submitted.\n\nSpecimen G, labeled as right common iliac lymph node, is a small fragment of tan-yellow adipose tissue measuring 0.4 x 0.3 x 0.2 cm. No lymph node structure was observed, and the entire specimen was submitted.\n\nSpecimen H, labeled as right periaortic lymph node, consists of a single fragment of tan adipose tissue measuring 0.6 x 0.4 x 0.2 cm. No lymph nodes were identified, and the entire specimen was submitted.\n\nSpecimen I includes a uterus with bilateral tubes and ovaries. The uterus weighs 218 grams and measures 11 cm in length, 7 cm between the cornua, and 4 cm anteroposteriorly. The serosal surface is pink-tan and smooth. The endometrial cavity measures approximately 4 x 7 cm and is lined by a tan-white to tan, soft, friable mass located on the anterior, fundic, and upper posterior regions. The mass measures 4.5 x 2.8 cm. The uninvolved endometrium measures 0.2 cm in thickness. Sectioning shows myometrial invasion to a depth of 1.8 cm in an area of myometrial thickness of 2.6 cm. No tumor involvement is seen at the inked serosal surface. The lower uterine segment has a tan smooth lining and is not involved. The myometrium measures up to 3.5 cm in thickness and contains multiple white-tan intramural nodules ranging from 0.8 to 1.2 cm, with a whorled appearance. There is no evidence of hemorrhage or necrosis.\n\nThe cervix measures 3.2 cm in length and 1.2 cm in diameter. The ectocervix has a tan, smooth, glistening surface. The cervical os is slit-like measuring 0.3 cm in length. The endocervical canal has unremarkable palmate folds. No extension of the endometrial lesion into the endocervix is observed.\n\nThe left ovary weighs 4 grams and measures 3 x 2 x 1 cm. The surface is tan-white, smooth, and glistening. The cut surface is tan-pink. The left fallopian tube measures 5 cm in length, with a variable diameter of 0.4 to 1 cm. It is dilated, and a cyst containing clear tan fluid, measuring 1 cm in diameter, is identified. The cyst wall is smooth.\n\nThe right ovary weighs 4 grams and measures 2.5 x 1.5 x 0.8 cm. The surface is tan-white, smooth, and glistening. Corpora albicantia are present. The right fallopian tube measures 6 cm in length and 0.6 cm in diameter. The lumen is pinpoint in size. Fimbriated ends are identified in both tubes.\n\nMicroscopic evaluation of the normal tissue shows benign fibrovascular tissue with congested blood vessels and mild chronic inflammation. No malignancy was found. Examination of the cervix reveals mild acute and chronic cervicitis, with no dysplasia or malignancy identified. All lymph node specimens show only benign mature adipose or fibroadipose tissue, with no lymph nodes or malignancy identified. Examination of the uterus confirms a glandular process involving the endometrium, with invasion into the myometrium measuring 1.9 cm in depth within a myometrial thickness of 3 cm. Invasion accounts for approximately 63% of the myometrial thickness. No involvement of the serosal surface, lower uterine segment, or cervix is observed. Lymphovascular space invasion is present. Adjacent nonneoplastic endometrium demonstrates cystic atrophy. Leiomyomata are also present. Both ovaries appear unremarkable. The left fallopian tube shows dilation consistent with hydrosalpinx, while the right fallopian tube is unremarkable. No malignancy was identified in the ovaries or fallopian tubes. Pathologic staging indicates pT1c classification, with no lymph node tissue available for assessment (pNX) and no distant metastasis identified (pMX)."} +{"pid": "TCGA-L5-A4OI", "report": "A male patient presented with dysphagia. Endoscopic examination revealed a nodular lesion in the distal esophagus, a tubulovillous mass at the gastroesophageal junction and fundus, and an ulcerated mass at the cardia. Biopsy specimens were obtained.\n\nA surgical specimen consisting of a 17.2 cm segment of distal esophagus and proximal stomach was received. The specimen was stapled at both margins. The perigastric fat demonstrated focal nodularity and hemorrhage. The adventitia and gastric serosa were firm and puckered in areas. A centrally ulcerated mass measuring 7.3 x 4.6 cm was identified arising from the esophageal mucosa, crossing the gastroesophageal junction, and extending into the gastric mucosa. The proximal edge of the mass was 7.8 cm from the proximal margin, and the distal edge was 2.5 cm from the gastric margin. The cut surface of the mass was yellow-gray to tan, focally hyperemic, with a maximum thickness of 2.4 cm. The mass extended through the muscular wall and involved adjacent perigastric fat. Green ink marked the adventitial margin and black ink marked the gastric serosal margin, with the mass abutting these inked surfaces.\n\nMultiple lymph node candidates were identified within the perigastric fat, with sizes up to 2.9 cm. Some larger nodes showed gray-white and yellow-tan cut surfaces. Several sections were taken from the full thickness of the specimen, including trisected sections from proximal to distal, and sections showing maximum thickness at the mid portion. A total of eleven and eight whole lymph node candidates were examined in different groups, along with additional sectioned nodes and retained fat.\n\nA separate specimen included a 1 cm segment of cervical esophagus, stapled at one margin and opened at the other. The adventitia was focally hemorrhagic, and the mucosa appeared unremarkable.\n\nMicroscopic evaluation of the primary resection showed invasive, moderately differentiated carcinoma extending into the adventitia. All resection margins were free of involvement. Of the 20 lymph nodes examined, 8 contained metastatic disease. No distant metastasis was confirmed. There was no history of preoperative chemotherapy or radiation therapy."} +{"pid": "TCGA-85-8664", "report": "The specimen consisted of lung tissue measuring 18 x 19 cm. The tumor was moderately differentiated and demonstrated necrosis. Seven bronchopulmonary lymph nodes were examined, with one showing evidence of metastasis. Additionally, one tracheobronchial lymph node was involved. No venous invasion was identified. Surgical margins were uninvolved. The tumor measured 7 cm in greatest dimension and appeared localized without clear extension beyond the surrounding tissue. Anthracotic changes were noted in the lymph nodes. No definitive histologic type or specific diagnosis was provided in the summary."} +{"pid": "TCGA-E1-A7YE", "report": "Surgical Pathology: Final. CLINICAL HISTORY: Brain lesion involving the left frontal region. GROSS EXAMINATION: A resection specimen measuring 6.5 x 5.0 x 3.0 cm is received fresh and identified as \"Brain tumor (AF1-2)\". Representative tissue is processed for frozen section analysis as AF1-2, with remnants submitted in blocks A1-2. Additional sections are submitted as A3-8 for further evaluation. INTRA OPERATIVE CONSULTATION: Initial assessment of \"Brain tumor\" reveals gliosis and atypical cells in AF1, while AF2 shows features concerning for a high-grade glial neoplasm. MICROSCOPIC EXAMINATION: Permanent sections demonstrate a highly cellular and pleomorphic population of glial cells consistent with a high-grade glial neoplasm. An area previously interpreted as necrosis during frozen section (AF2) is re-evaluated and identified as hemorrhage in permanent sections. No definitive areas of necrosis are identified in any of the permanent sections. COMMENT: Hemorrhage due to surgical trauma is present in block A2 and was initially misinterpreted as frank necrosis during intraoperative consultation. The absence of true necrosis supports a lower grade of malignancy within the spectrum of glial tumors. I certify that I personally conducted the diagnostic evaluation of the above specimen(s). J. 615/14. 1 of 1."} +{"pid": "TCGA-C5-A7XC", "report": "The cervix biopsy demonstrates invasive epithelial changes with moderately differentiated morphology. The surface epithelium shows full-thickness dysplasia extending into endocervical glands. In one region, small irregular nests of atypical cells are observed invading the underlying stroma, accompanied by a desmoplastic response. Orientation of the tissue fragments prevents accurate measurement of invasion depth. No evidence of lymphvascular space invasion is identified. Endocervical curettage specimens show benign endocervical and endometrial tissues without dysplastic or malignant features. The patient is a female with prior Pap smear findings indicating high-grade squamous intraepithelial lesion. The submitted materials include two slides from cervical biopsy and endocervical curettage obtained on [date], as documented in the referenced pathology report."} +{"pid": "TCGA-AR-A1AW", "report": "The specimen consists of a 2.7 x 2.5 x 2.0 cm yellow-tan, somewhat circumscribed, sclerotic mass. Histologic evaluation reveals a Nottingham grade III lesion, with tubules scored 3/3, nuclei 3/3, and mitoses 2/3, resulting in a total Nottingham score of 8/9. No ductal carcinoma in situ is identified. There is no evidence of angiolymphatic invasion. Surgical resection margins were initially involved at the deep and medial inferior regions; however, following re-excision, all margins are free of tumor, with a minimum tumor-free margin of 0.8 cm at the deep margin. A single sentinel lymph node from the left axillary region shows no evidence of metastasis, confirmed by cytokeratin immunostaining. Hormone receptor and Her2/neu testing have been initiated on paraffin-embedded tissue."} +{"pid": "TCGA-AF-A56K", "report": "The specimen includes a segment of large intestine measuring 25 cm in length. A prominent folded red lesion is identified approximately 4 cm from one end, measuring 6.5 x 5.5 x 5 cm. The overlying mucosa appears otherwise unremarkable. On sectioning, the lesion demonstrates invasion through the muscular wall into surrounding adipose tissue. Proximal and distal margins of resection appear free of involvement. Lymph node dissection was performed and multiple lymph nodes were submitted for evaluation.\n\nA second specimen consists of an appendix, which is a single tan tubular structure measuring 9 cm in length and up to 0.5 cm in diameter. The serosal surface is smooth and glistening, and the mucosa is pink and intact. The appendiceal wall measures up to 0.3 cm in thickness.\n\nMicroscopic examination reveals a moderately differentiated tumor. The primary lesion invades through the muscularis propria into pericolonic adipose tissue (pT3). All surgical margins, including proximal, distal, and circumferential, are uninvolved. There is no evidence of vascular invasion. Evaluation of 44 regional lymph nodes shows no metastatic involvement (pN0). No non-lymph node pericolonic tumor deposits are identified. Distant metastasis could not be assessed based on the specimen (pMX).\n\nThe appendix shows no pathological abnormalities."} +{"pid": "TCGA-77-A5G3", "report": "Histopathology Report. HISTORY. Right pneumonectomy performed after initial attempted lobectomy. MACROSCOPIC. Three specimens were received. The first, labelled \"right lung,\" consists of a pneumonectomy specimen measuring 230 x 135 x 40 mm. A lesion is identified in the right lower bronchus, located 17 mm from the bronchial resection margin. The lesion is ulcerated, friable, and cream-colored, protruding into the bronchial lumen and extending through the wall into the surrounding lung tissue. It measures 35 x 35 x 20 mm. Distal to the lesion, the bronchus shows bronchiectasis. Multiple subpleural lymph nodes are present near the inferior aspect of the lower lobe. The tumour is in contact with several involved lymph nodes. Focal collapse with or without consolidation is observed distal to the lesion. An area of pleural thickening at the diaphragmatic surface of the lower lobe appears unrelated to the main lesion. Specimen sections include the bronchial resection margin, hilar lymph nodes, regions of the lesion in relation to normal bronchus, areas of extension into local lymph nodes, deeper tissue, distal lung changes, subpleural nodules, and uninvolved lung tissue. The second specimen, \"hilar lymph node 1,\" is a fragment of haemorrhagic tissue measuring 10 x 7 x 4 mm. The third specimen, \"subcarinal,\" consists of haemorrhagic tissue measuring 20 x 12 x 4 mm. MICROSCOPIC. Microscopic evaluation of the first specimen reveals a poorly differentiated carcinoma with features consistent with squamous cell origin, arising in the region of a major bronchus. There is no evidence of pleural invasion. Prominent blood vessel invasion is observed, but no lymphatic or perineural permeation is present. The lesion is well clear of the bronchial resection margin. Metastatic involvement is identified in peribronchial and peritumoral lymph nodes. Subpleural nodules show only reactive lymph node changes. The lung distal to the lesion demonstrates acute and organising pneumonia. The area of pleural thickening shows irregular scarring with an organising fibrinous exudate, consistent with round atelectasis. Evaluation of the second and third specimens reveals only reactive lymph node changes, with no evidence of malignancy. SUMMARY. The lesion is a poorly differentiated squamous cell carcinoma measuring 35 mm in maximum dimension. Vascular invasion is present, with no lymphatic or perineural involvement. The bronchial resection margin is free of disease. Metastatic involvement is present in regional lymph nodes. The staging classification is T2N1MX. Additional findings include distal acute and organising pneumonia, and focal round atelectasis. SUPPLEMENTARY REPORT. Immunohistochemical staining shows no expression of neuroendocrine markers, supporting the diagnosis of squamous cell carcinoma without neuroendocrine differentiation."} +{"pid": "TCGA-A2-A0D0", "report": "The left breast mastectomy specimen with axillary tail includes a mass measuring 3.5 x 2.8 x 3.0 cm, located in the mid-outer breast. Histological evaluation indicates a poorly differentiated cellular morphology with a Nottingham score of 9 (Tubules=3, Nuclei=3, Mitoses=3), corresponding to a high mitotic count (>12 per 10 HPF at 40x). Necrosis is present within the infiltrating component. The nearest margin is 2.0 cm from the mass, and all surgical margins are free of involvement. No vascular or lymphatic invasion is identified. Ten lymph nodes are examined, all without evidence of involvement. Additional findings include periductal chronic inflammation. The skin flap specimen shows no abnormal pathology."} +{"pid": "TCGA-DB-A75O", "report": "The specimen consists of biopsies from a left frontal mass (specimens #1 and #2) and CUSA material. Additional biopsies were obtained from the left temporal cortex. Histologic evaluation reveals a WHO grade III (of IV) glial neoplasm with fibrillary and gemistocytic features. Smears from the left frontal mass #1 were assessed intraoperatively and classified as a glioma; further classification and grading were deferred for additional analysis. The tumor demonstrates cellular characteristics consistent with high-grade morphology. No definitive diagnosis is included in this summary."} +{"pid": "TCGA-DJ-A1QN", "report": "The right thyroid lobe and isthmus specimen includes a 3.8 x 2.3 x 1.6 cm thyroid lobe with an attached isthmus and pyramidal lobe. Gross examination reveals two adjacent, poorly defined nodules measuring 0.2 to 0.7 cm in greatest dimension. These nodules are located within the mid to lower portion of the lobe, approximately 0.1 cm from both the anterior and posterior intact thyroid capsule. No gross capsule is identified around the nodules. Histologically, no mitotic activity or tumor necrosis is present. The surgical margins are free of involvement. The remaining thyroid tissue shows changes consistent with nodular hyperplasia.\n\nThe left thyroid lobe specimen measures 4.0 x 3.5 x 1.0 cm and contains two distinct nodules. The superior nodule measures 1.5 x 1.2 x 1.0 cm and the inferior nodule measures 1.2 x 1.0 x 1.0 cm. Histologic evaluation identifies three separate foci: one measuring 1.5 cm with classical features, one measuring 1.2 cm with follicular variant characteristics, and a third measuring less than 0.1 cm. All are well differentiated. Focal capsular invasion is noted in the classical type. No blood vessel invasion or extrathyroid extension is observed. Surgical margins are uninvolved. The surrounding thyroid tissue also demonstrates nodular hyperplasia. All specimens were entirely submitted for analysis."} +{"pid": "TCGA-VQ-A91U", "report": "The specimen includes tissue from the stomach, greater omentum, and distal esophagus. A lesion measuring 9.5 cm is present, composed of moderately differentiated glandular structures with intestinal-type morphology. The lesion extends into the subserosal layer. Vascular invasion is identified in focal areas. Both proximal and distal surgical margins show no evidence of neoplastic involvement. Two lymph nodes in the perigastric region contain metastatic deposits out of a total of 24 examined. The omental tissue does not show any involvement. The esophageal margin specimen does not reveal neoplastic cells and lacks squamous epithelium. The duodenal margin also shows no signs of neoplasia. The pathologic staging is determined as pT3 pN1."} +{"pid": "TCGA-BT-A42C", "report": "The specimen consists of a distal right and left ureter shave margin biopsy, both showing benign ureteral tissue and no evidence of neoplastic change. A radical cystoprostatectomy specimen includes the urinary bladder, distal ureters, prostate, bilateral seminal vesicles, and bilateral distal vasa deferentia. Within the bladder, a lesion measuring 3.5 x 1.5 x 0.4 cm is identified in the left lateral wall and trigone. Histologic evaluation reveals high-grade urothelial carcinoma with papillary architecture. The tumor infiltrates into the superficial detrusor muscle, specifically involving the inner half. High-grade dysplastic changes extending to carcinoma in situ are present at multiple sites including the right and left ureteral orifices and anterior bladder wall. No angiolymphatic invasion is detected, and all surgical margins are free of malignant involvement. Twenty-three lymph nodes were examined, with none showing evidence of malignancy; however, isolated non-necrotizing granulomas were noted in a few nodes. Pathologic staging is determined as pT2a, pNO, pMX. Additional findings include granulomatous inflammation in the bladder and prostate consistent with prior therapy, along with benign prostatic hyperplasia, focal atrophy, and chronic inflammation. Seminal vesicles show no abnormal pathology."} +{"pid": "TCGA-D6-A6EK", "report": "The patient is male. A surgical specimen from the larynx, including the hyoid bone, measured 9 x 5.5 x 5 cm. A tumour measuring 2.6 x 2.6 x 1.0 cm was identified in the glottis region on the right side, with infiltration extending into both the subglottal and supraglottal areas. Histopathological examination revealed a well-differentiated squamous cell carcinoma with keratinization. The tumour was graded as G1. Surgical margins were free of tumour involvement. No evidence of vascular or perineural invasion was observed. Lymph node evaluation of the Delphian node showed no metastatic involvement (pNO). The material was collected intraoperatively for laboratory examination, and initial findings did not show neoplastic lesions. Final histopathological assessment was based on paraffin-embedded specimens."} +{"pid": "TCGA-60-2722", "report": "The specimen included lymph nodes from the right and left distal paratracheal regions, subcarinal region, hilar region (level 10), level 7, and level 8 lymph nodes. Additional specimens included pleural nodules, a right lung pneumonectomy specimen, a new bronchial margin, and cartilage margin. All lymph nodes examined were negative for tumor involvement. The right lung specimen contained a tan mass measuring 3.7 x 2.8 x 2.8 cm located centrally in the upper lobe and involving the bronchus and adjacent vessels. The mass showed areas of calcification and necrosis but did not appear to involve the pleura. The bronchial margins were initially involved; however, additional submitted margins were free of identifiable residual tumor. Histologic evaluation revealed features suggestive of invasive growth and angiolymphatic invasion could not be definitively ruled out. Non-neoplastic findings included emphysematous changes, congestion, interstitial fibrosis, and inflammation. Lymph node staging demonstrated one involved peribronchial lymph node out of ten examined (N1), with no involvement identified in mediastinal or contralateral lymph nodes."} +{"pid": "TCGA-BP-4165", "report": "A right kidney specimen was received measuring 13.0 x 8.0 x 4.5 cm with attached renal fat up to 4.0 cm in thickness. The attached ureter measured 7.0 cm in length, and the surgical margin was stapled. The tumor measured 5.5 x 5.0 x 3.0 cm and was located in the mid/lower portion of the kidney. It appeared as a soft, yellow-orange mass with central hemorrhage and cystic degeneration. The growth pattern was acinar, and the tumor extended into the renal pelvis but did not invade the renal vein or breach the renal capsule. All surgical margins were free of involvement. The non-neoplastic kidney showed a benign simple cortical cyst and an incidental angiomyolipoma measuring 0.2 cm. No lymph nodes were identified in the perihilar fat.\n\nA separate paracaval nodule specimen was received containing two lymph nodes: one measuring 0.6 x 0.5 x 0.5 cm and the other 1.6 x 0.8 x 0.5 cm. Both were entirely submitted for evaluation and found to be benign. Microscopic sections included multiple levels from the tumor, surrounding normal tissue, renal pelvis, cystic areas, hemorrhagic regions, and margins. Intraoperative frozen section confirmed the presence of a neoplastic process, which was consistent with the final microscopic evaluation."} +{"pid": "TCGA-G7-A4TM", "report": "The specimen consists of a partial right nephrectomy measuring 3.8 x 3.5 x 2.3 cm and weighing 18 grams. The specimen was inked and sectioned to reveal a soft white-tan to tan mass with focal hemorrhage and a lobulated cut surface. The mass measures 3.3 x 3 x 2.5 cm and is located 0.2 cm from the parenchymal margin. Histologically, the lesion demonstrates cells with slightly irregular nuclei and evident nucleoli. The tumor appears confined to the kidney without vascular or lymphatic invasion, and no involvement of perinephric tissue is identified. Surgical margins are uninvolved by invasive disease. No adrenal gland or regional lymph nodes were present for evaluation. The tumor is unifocal and staged as pT1a NX MX based on the AJCC Cancer Staging Manual, 7th Edition."} +{"pid": "TCGA-L3-A524", "report": "The specimen consists of a right upper lobectomy with en bloc resection of the chest wall and a portion of the lower lobe. The tumor is located in the right upper lobe and extends into the right lower lobe and chest wall, with invasion into the rib. Histologically, the lesion is poorly differentiated (G3 of 4). The tumor measures 6.4 cm in size and is unifocal. There is no associated atelectasis or obstructive pneumonitis, and lymphovascular space invasion is absent. All surgical margins are negative for involvement, with the closest margin measuring 3.2 cm at the right lower lobe parenchymal margin.\n\nA total of 8 lymph nodes were evaluated, all of which are benign. These include 7 nodes from the lobectomy specimen and 1 right pulmonary lymph node. Staging according to AJCC criteria indicates pT3 for the primary tumor and pN0 for lymph node involvement.\n\nGross examination reveals a 6.4 x 5 x 4.5 cm gray-white to gray-black mass involving the lower portion of the upper lobe, extending into the attached lower lobe and chest wall. The tumor appears to come within 3.2 cm of the staple line on the lower lobe and invades the central rib. The unaffected lung tissue is soft, spongy, and dark red to gray-black, with multiple anthracotic hilar lymph nodes present. Frozen section analysis confirms that the bronchial resection margin and chest wall margin are free of malignancy.\n\nImmunohistochemical staining was performed on formalin-fixed, paraffin-embedded tissue. Results show negativity for TTF-1 and CD56, and positivity for p63. Controls demonstrated appropriate reactivity, and the laboratory is certified under high-complexity testing regulations. No investigational use of reagents was involved."} +{"pid": "TCGA-AG-3896", "report": "The specimen demonstrates a moderately differentiated adenocarcinoma with extensive infiltration into the muscularis propria, classified as pT2. Vascular invasion is present, corresponding to L1 and V1. The deep resection margin and mucosal margins are free of tumor involvement. No lymph node metastases are identified, with all 12 retrieved lymph nodes being negative. The anastomosis ring is also free of tumor."} +{"pid": "TCGA-OR-A5LR", "report": "A left adrenalectomy was performed. The tumor weighed 96 grams and measured 6.7 x 4.6 centimeters. Microscopic evaluation revealed a Weiss score of 7, indicating high nuclear grade, extensive architectural disarray, and numerous mitotic figures. The lesion demonstrated marked cellular atypia, diffuse architecture, and necrosis. Vascular invasion was present. No lymph node involvement was identified. The surgical margins were negative."} +{"pid": "TCGA-HD-8314", "report": "The base of tongue excision specimens show a neoplasm measuring 1.7 cm in greatest dimension. The tumor is poorly differentiated with basaloid features. Evaluation of the surgical margins demonstrates no evidence of residual tumor. Angiolymphatic invasion is present; perineural invasion is not identified.\n\nLymph node evaluation reveals involvement in left level 3, where one out of twenty lymph nodes contains tumor. Involvement of soft tissue is also noted in left level 3. Additional lymph nodes from left levels 2B, 4, and 5 are negative for tumor involvement. Left level 4 contains sixteen lymph nodes, left level 3 contains twenty-two lymph nodes, and left level 2B contains eight lymph nodes.\n\nThe specimen submitted includes multiple tissue fragments marked with colored ink to identify anatomical margins. A focal lesion measuring approximately 1.1 x 1.2 x 1.2 cm is identified near the medial aspect of the main specimen. Margins are closely approached but remain negative.\n\nClinical staging is consistent with involvement extending into soft tissues of the left neck. Multiple lymph nodes ranging from 0.3 to 3.8 cm are evaluated across different levels. Specimens from left level 5 consist of abundant adipose tissue with scant lymphoid tissue and show no tumor involvement."} +{"pid": "TCGA-EB-A4IS", "report": "The skin flap measured up to 6 x 4.5 cm and contained a brown lesion with a maximum diameter of 2.5 cm. The surgical margins showed no evidence of tumor involvement. Microscopic evaluation revealed a malignant melanocytic neoplasm with superficial ulceration. The vertical thickness measured 2.5 mm according to Breslow's depth. The tumor exhibited pigmentation and was present with ulceration. No venous invasion was identified. The specimen was submitted as an excision of a skin lesion located on the trunk, measuring 0 x 0.25 x 2.5 cm. No satellite nodules, lymphatic invasion, or lymph node involvement were specified. There was no evidence of neo-adjuvant treatment effect."} +{"pid": "TCGA-BT-A3PH", "report": "A segment of the right and left distal ureter biopsies show benign urothelial mucosa without any evidence of preinvasive or invasive neoplasia. A radical cystoprostatectomy specimen reveals an ulcerated, high-grade urothelial tumor involving multiple areas of the urinary bladder including the trigone, bilateral ureteral orifices, anterior and posterior walls, and both lateral walls. The maximum tumor size measures 10 cm. The tumor extends through the detrusor muscle and into the perivesical adipose tissue. Rare perineural invasion is noted, and numerous lymphovascular tumor emboli are present. All surgical margins are free of tumor involvement. Lymphovascular invasion is also documented in the prostate tissue. Six of twelve right pelvic lymph nodes and two of five left pelvic lymph nodes contain metastatic tumor, with the largest deposits measuring 4 cm and 2.3 cm respectively. No extracapsular extension is identified in the left pelvic lymph nodes. A separate mesenteric lymph node excision reveals only benign fibroadipose tissue with organizing fat necrosis and no lymph node tissue or malignancy. The pathological stage reflects extensive local invasion and regional lymph node involvement."} +{"pid": "TCGA-3P-A9WA", "report": "The pathology report includes examination of multiple specimens including the left and right tubes and ovaries, uterus and cervix, omentum, sigmoid biopsy, left and right pelvic side wall biopsies, and multiple lymph node samples. The left ovary was received disrupted and measured 7.5 x 5 x 5 cm. Microscopic evaluation of this specimen revealed papillary serous carcinoma. The right ovary and fallopian tubes were unremarkable with no evidence of involvement. The left pelvic side wall biopsy also showed serous carcinoma.\n\nThe uterus was slightly asymmetric and contained several benign findings, including an adenomatoid tumor and multiple leiomyomas. The endometrium showed no residual intraepithelial serous carcinoma. Cervical sections revealed chronic inflammation with squamous metaplasia but no dysplasia or malignancy. The omentum, sigmoid colon biopsy, and right pelvic side wall biopsy all showed no atypical changes or malignancy. Inflammatory and reactive changes were noted in the sigmoid biopsy.\n\nLymph node sampling included the left pelvic, right pelvic, and aortic regions. All submitted lymph nodes were negative for metastatic carcinoma. The left common iliac lymph node specimen did not contain identifiable lymph node tissue.\n\nGrossly, the ovarian mass had friable tan cut surfaces, and the fallopian tube was fimbriated. No surface involvement of the right ovary or fallopian tubes was identified. The peritoneal surfaces, including the left and right pelvic side walls and sigmoid, were free of involvement. No lymphovascular invasion was identified. The final staging is pT2b pN0, indicating localized disease without nodal involvement. Additional findings included hyalinization and calcification within leiomyomas, superficial adenomyosis, and unremarkable omental tissue."} +{"pid": "TCGA-AJ-A3TW", "report": "The patient is female. A hysterectomy specimen revealed a mass measuring 4.8 x 4.0 x 3.0 cm located in the endometrium. Histologic evaluation showed high-grade features. The tumor invaded 1.5 cm into a 2.0 cm thick myometrium, representing greater than one-half myometrial invasion. No involvement of the cervix was identified. There was no extension to other organs or lymphovascular space invasion. Surgical margins, including the uterine serosa, bilateral parametria, and cervix, were uninvolved. Multiple lymph node groups were evaluated, including right and left external iliac, obturator, common/lower aortic, and left external iliac regions. All lymph nodes examined were negative for metastatic disease. The omentum was also negative for malignancy. Additional findings included leiomyomata within the uterus. Immunohistochemical staining for p53 was diffusely positive. The surgical specimens included both ovaries and fallopian tubes, adnexal tissue, uterus, cervix, various lymph node regions, and omentum. Gross examination of the uterus showed a pink-tan fungating friable mass in the endometrial cavity with focal myometrial invasion. Several well-circumscribed gray-white nodules were found within the myometrium, with the largest showing focal calcification. No other significant lesions were identified. All surgical margins were free of tumor."} +{"pid": "TCGA-VR-AA4G", "report": "The specimen from the mid-third of the esophagus consists of a moderately differentiated ulcerated lesion measuring 3.3 x 1.5 cm, extending into the muscularis propria. Vascular and perineural invasion were not identified. The proximal, distal, and radial margins were free of neoplastic cells. There was evidence of high-grade intraepithelial neoplasia in the adjacent mucosa. The stomach showed no signs of neoplasia.\n\nExamination of multiple lymph node groups revealed no metastatic involvement in the infra-carinal lymph nodes (0/4), level 4 right lymph nodes (0/5), or in the bronchial artery, level 3, or aorto-pulmonary window lymph node samples, all of which lacked lymphoid tissue. However, metastatic involvement was identified in one periesophageal lymph node (1/1), one lymph node from the lesser curvature (1/25), and one recurrent lymph node (1/2), none of which showed extracapsular extension.\n\nPathologic staging based on these findings is pT2 pN2."} +{"pid": "TCGA-PE-A5DD", "report": "The specimen was received in four parts. The first part consisted of two lymph nodes from the right axilla, measuring up to 2.0 cm in greatest dimension. Both touch preparation and frozen section evaluations showed no evidence of tumor involvement. All remaining lymph node tissue was submitted for further analysis.\n\nThe second part was a lumpectomy specimen from the right breast, measuring 9.0 x 7.5 x 4.5 cm. It included a skin ellipse measuring 5.0 x 2.5 cm. A central mass measuring 3.0 x 2.5 x 1.6 cm was identified with infiltrative borders and tan gritty cut surfaces. Histologic evaluation revealed invasive carcinoma within the breast parenchyma without lymphovascular invasion. This lesion was located closest to the anterior, posterior, and medial margins. Sections were taken from all margins including superior, inferior, medial, lateral, anterior, and posterior.\n\nThe third component was a fragment of soft tissue and muscle from the posterior margin (pectoral margin), measuring 2.2 x 1.0 x 0.4 cm. No tumor involvement was observed in this tissue.\n\nThe fourth component consisted of an elliptical fragment of skin measuring 6.0 x 0.6 cm obtained from the anterior and medial margin. No tumor was identified at this margin.\n\nTwo regional lymph nodes were examined histologically and no metastasis was detected. Immunohistochemical staining for cytokeratin on sentinel lymph nodes confirmed absence of metastatic disease.\n\nThe invasive component measured 3.0 cm and was confined to the breast parenchyma. No lymphovascular invasion was identified. Margins evaluation demonstrated tumor involvement at the lateral margin; the invasive component was approximately 2.0 mm from the anterior margin and about 2.0 mm from the posterior margin. A separate focus of atypical ductal hyperplasia was noted near the superior margin.\n\nEstrogen receptor status was positive while progesterone receptor status was negative. HER2-neu staining was scored as 1+. Based on available findings, staging classification was determined as pT2 NO Mx."} +{"pid": "TCGA-S7-A7WT", "report": "Gross examination reveals a thinly fibrously encapsulated left adrenal mass measuring 90x60x40 mm with a soft consistency, weighing 97 grams. The cut surface demonstrates a dark red central region with a mushy texture. Tissue was sampled into six blocks for further analysis.\n\nMicroscopic evaluation shows a neoplasm present within adipose tissue, exhibiting focal metaplastic transformation into brown adipose tissue. Remnants of adrenal cortex display diffuse and macronodular architectural changes. Edema is evident, along with areas of focal hemorrhage. Necrosis is present but less extensive than initially suggested by gross appearance. Focal scarring and dystrophic calcifications are also noted.\n\nImmunohistochemical staining demonstrates sporadic presence of S100-positive sustentacular cells; the majority of the lesion lacks expression. CD34 highlights endothelial cells, revealing abundant vascularity within the tumor. Two clusters of tumor cells are observed within the lumina of peripheral vessels, though they do not definitively meet criteria for vascular invasion and may instead represent artifactual fragments due to high cellular dis-cohesion. Proliferative index by MIB-1 staining is less than 1%.\n\nHistopathologic features assessed using the PASS scoring system include: large nests or diffuse growth comprising more than 10% of tumor volume (2 points), central or confluent necrosis (1 point), high cellularity (1 point), cellular monotony with tumor cell spindling (2 points), mitotic figures exceeding 3 per 10 high-power fields including atypical forms (2 points), extension into adipose tissue (1 point), vascular invasion (1 point), capsular invasion (1 point), nuclear pleomorphism (1 point), and nuclear hyperchromasia (1 point). The total PASS score is 11."} +{"pid": "TCGA-E9-A22G", "report": "The specimen consisted of breast tissue from the left upper outer quadrant, obtained via radical mastectomy. A grossly evident lesion measuring 3.5 x 3 x 3 cm was identified. Histologic evaluation revealed a poorly differentiated cellular morphology. Lymph node assessment showed no evidence of metastatic involvement in the six regional nodes examined. No extracapsular invasion was identified in the lymph nodes. Various histopathologic parameters including tubule formation, nuclear pleomorphism, and mitotic counts at both 25x and 40x magnification were not specified, precluding calculation of a definitive Nottingham Histologic Score. There was no identifiable evidence of prior treatment-related changes. No additional pathologic findings were noted."} +{"pid": "TCGA-QQ-A5VB", "report": "The patient is a white female with a history of prior biopsy, chemotherapy, and radiation. She presented with a groin mass that had increased in size, associated with tenderness and pain. A CT scan identified a solid mass, which was biopsied and found to be high-grade. The patient underwent resection for treatment.\n\nThe surgical specimen included a portion of fibroadipose tissue containing at least one lymph node, measuring 4.5 x 0.6 x 0.3 cm. The sectioned surface showed scattered lymphoid parenchyma infiltrated by adipose tissue. This specimen was submitted entirely in one cassette.\n\nAnother specimen consisted of an ellipse of skin with attached subcutaneous tissue, muscle, and blood vessels, measuring 13.2 x 9.0 x 6.4 cm in total. The skin measured 8.5 x 2.5 x 0.2 cm and was tan/pink with focal puckering in a healed scar approximately 5.0 cm long. A firm, well-circumscribed, pseudoencapsulated lesion was identified beneath the skin, measuring 5.6 x 4.8 x 4.6 cm, involving the lateral deep margin. The cut surface revealed a lobulated, bulging appearance without evidence of hemorrhage or necrosis. Multiple blood vessels coursed through the lesion, with the largest vessel measuring 6.0 x 0.3 cm. The vessel lumen was occluded by organizing thrombus, and sections confirmed this occlusion. The tumor was located 1.5 cm from the proximal margin, 4.5 cm from the distal margin, and close to the medial margin. The lateral deep margin was marked with black ink, and the deep margin with blue ink. Representative sections were taken, including margins and vascular areas.\n\nA third specimen included six small nodules of fibroadipose and muscular tissue, unoriented, with the largest being bisected. These were submitted in three cassettes (3A\u20133C). A total of 10 blocks were examined.\n\nMicroscopic evaluation of the lymph node specimen showed no evidence of tumor in three lymph nodes. The tumor specimen demonstrated cellular features consistent with high-grade morphology, with infiltration into neurovascular structures and associated tumor thrombus formation. The lateral deep margin was involved. Fragments of skeletal muscle in the deep margin specimen showed no evidence of tumor involvement.\n\nHistologic review of the tumor showed high cellularity with areas of coagulative necrosis and mitotic activity."} +{"pid": "TCGA-D6-A4ZB", "report": "The laryngeal specimen measured 9.5 x 7.5 x 6 cm and included the larynx, hyoid bone, and a 1.5 cm segment of the trachea. A lesion measuring 2.5 x 2.5 cm was identified in the glottic region, with extension into the supraglottis and anterior commissure. Histologically, the lesion demonstrated characteristics of keratinizing squamous cell morphology, intermediate differentiation (G2), with invasion observed across multiple levels of the larynx, including the left aryepiglottic fold and anterior commissure area. No evidence of vascular, neural, or cartilaginous invasion was noted. Surgical margins were clear of affected tissue. The tumor was classified as pT2 based on extent of primary tumor involvement. Intraoperative assessment confirmed negative margins; final staging and full evaluation awaited complete processing of all specimens."} +{"pid": "TCGA-BR-8372", "report": "The specimen was obtained from a gastrectomy procedure and involved tissue from the fundus region. The lesion measured 9 x 7 x 6.5 cm and exhibited an ulcerated surface. Microscopic evaluation revealed a poorly differentiated histology of intestinal-type morphology. The extent of spread included involvement of adjacent structures, specifically the omentum. Metastatic involvement was identified in 8 out of 17 lymph nodes examined, all located within the intraabdominal region. Lymphatic, venous, and perineural invasion statuses were not determined. Surgical margins were free of involvement. There was no evidence of prior neo-adjuvant treatment. No additional pathologic findings were reported."} +{"pid": "TCGA-EY-A214", "report": "The specimen consisted of multiple tissue samples submitted in six containers. \n\nIn container A (right periaortic lymph nodes), six lymph node candidates were identified ranging from 0.3 to 1.1 cm in diameter. Microscopic evaluation of all seven lymph nodes showed no evidence of malignancy. In container B (left periaortic lymph nodes), nine lymph node candidates were identified with the largest measuring 2.1 cm. Microscopic examination of twelve lymph nodes revealed no malignant involvement.\n\nContainer C contained a single lymph node measuring 0.8 x 0.6 x 0.5 cm, which was serially sectioned and evaluated completely. No metastatic involvement was observed after three H&E levels.\n\nContainer D included the uterus, cervix, bilateral tubes, and ovaries. The uterus weighed 256.1 grams and measured 12.9 cm in height. The endometrial cavity length was 5.6 cm. Two intramural nodules were identified within the myometrium; the largest measured 4.4 x 4.2 x 2.6 cm. Additionally, five subserosal nodules were noted, with the largest measuring 2.4 x 1.9 x 1.3 cm. Histologic evaluation showed invasion into the outer half of the myometrium with a depth of 1.3 cm and wall thickness measuring 1.8 cm (72% invasion). There was no involvement of the serosa, lower uterine segment, or cervical regions. Lymphovascular space invasion was present. \n\nEstrogen receptor immunohistochemistry showed positivity in 15% of cells (2+ intensity) and progesterone receptor positivity in 75% of cells (2+ intensity). Additional findings included adenomyosis and two leiomyomas. \n\nThe right and left ovaries showed atrophic changes with no evidence of malignancy. The fallopian tubes were unremarkable. \n\nIn container E (right pelvic lymph nodes), eleven lymph node candidates were identified ranging from 0.3 to 3.4 cm in diameter. One lymph node contained a small focus of involvement measuring 0.5 mm. Container F (left pelvic lymph nodes) contained nineteen lymph nodes, none of which showed any signs of involvement.\n\nA total of fifty lymph nodes were examined across all specimens, with one involved node identified. Based on these findings, staging classification was assigned accordingly."} +{"pid": "TCGA-5C-AAPD", "report": "The specimen consists of a section from the left lobe of the liver and intrahepatic bile duct. A gray-colored mass is present, containing areas of necrosis. The mass does not show infiltration into the surrounding liver tissue or capsule. The cut surface has a dense consistency and a cyanotic appearance. Microscopically, the tissue reveals a mixed pattern of two components, one resembling bile duct-type growth and the other showing features of liver cell carcinoma. The overall structure is supported by a fibrous stroma, which is not highly cellular. The tumor demonstrates poor differentiation with a growth pattern suggesting a low grade (G1). No involvement of lymph nodes is identified."} +{"pid": "TCGA-F9-A97G", "report": "The specimen consists of a renal mass located at one pole, with a moderately defined margin. The lesion is soft, solid, and exhibits a yellow-gray cut surface. It measures 4 x 4 x 3.5 cm. Microscopically, the lesion demonstrates a high cell density and forms structures including trabeculae, elongated tubules, and papillary formations arranged in a back-to-back pattern. There is noticeable variation in the size and shape of these structures. The lining cells are predominantly cylindrical or cuboidal with moderate stratification. Nuclear features include irregularity in shape, increased size, hyperchromasia, and prominent nucleoli. Mitotic figures are present. The cytoplasm varies between eosinophilic and clear. Evidence of capsular invasion is observed. The histologic grade is described as moderately differentiated. The extent of the lesion includes involvement of perinephric tissues. Other features such as focality, lymph node status, lymphatic or venous invasion, margin status, and response to neo-adjuvant therapy were not specified. Additional findings note capsular invasion on the left."} +{"pid": "TCGA-ET-A2N3", "report": "The specimen consisted of a left lobectomy. The tumor was located in the left lobe and measured 4 cm in greatest dimension. Histologic evaluation revealed a unifocal lesion with follicular variant features. No lymph nodes were submitted for examination. The tumor appeared confined to the thyroid gland without evidence of extrathyroidal extension or vascular invasion. Staging indicated a primary tumor classified as pT2, with no identifiable regional lymph node involvement (pNx) or distant metastasis (pMx). No additional significant pathologic findings were noted."} +{"pid": "TCGA-EJ-7794", "report": "A radical prostatectomy specimen was examined, including bilateral seminal vesicles. The prostate measured 31 grams in weight and showed a single dominant nodule with a maximum dimension of 1.4 cm. The nodule was located in both the right and left lobes and accounted for approximately 10% of the total prostate volume. Histologic evaluation revealed a poorly differentiated glandular neoplasm. All surgical margins were free of tumor involvement. The tumor was confined within the prostatic capsule without evidence of extracapsular extension or involvement of the seminal vesicles. Perineural invasion was present; however, no angiolymphatic invasion was identified. High-grade prostatic intraepithelial neoplasia was also noted. A total of 11 lymph nodes were examined (5 from the right pelvic region and 6 from the left), and none showed evidence of tumor involvement. The histologic grade was classified as G3. Based on these findings, the pathologic TNM stage is pT2c, pN0, pMX. Benign prostatic hyperplasia was present in the background. Clinical data included a preoperative PSA level of 5.2. A prior biopsy had shown similar histologic features. The patient had a history of hypertension, hypercholesterolemia, gastroesophageal reflux disease, and previous cardiac stent placement."} +{"pid": "TCGA-CS-6666", "report": "The specimen consists of three parts from the right parietal region and capsule wall. The first part, a 2 x 1 x 0.5 cm aggregate of tan-white soft tissue, was partially submitted for frozen section with the remainder processed for histology. The second part is a small fragment measuring 0.3 x 0.2 x 0.2 cm from the capsule wall, entirely submitted for frozen section. The third part is a 1.8 x 1.3 x 0.5 cm fragment of red-white soft tissue, also entirely submitted for histologic evaluation.\n\nMicroscopic examination reveals an infiltrative glial neoplasm composed of pleomorphic astrocytes. Malignant features are most prominent in specimen #3. Tumor cells demonstrate strong immunohistochemical staining for GFAP. Focal presence of gemistocytic-appearing tumor cells is noted. Mitotic figures are numerous. Immunohistochemical analysis shows that the majority of tumor cell nuclei stain positively for p53. Scattered positivity is observed for EMA; however, no histologic features suggestive of ependymoma are present. Chromogranin and neurofilament stains are negative, ruling out a ganglion cell component. Neu-N staining is negative in tumor cells but highlights resident non-neoplastic neurons in areas of grey matter infiltration.\n\nKi67 immunohistochemical staining was quantified using Aperio image analysis across 40,914 cells, yielding a proliferation index of 16%. This test was performed with assistance from automated image analysis systems. Additional immunohistochemical studies were conducted, including ER, PR, Hercept Test (DakoCytomation), and EGFR pharmDx Clone 2-18C9 assays. Some reagents used in these tests are classified as Analyte Specific Reagents (ASRs) and were developed by the laboratory without FDA clearance.\n\nFrozen section diagnosis of the right parietal tumor indicated an astrocytic neoplasm with grading deferred. The capsule wall specimen showed tumor involvement. The case was reviewed in multidisciplinary conference and discussed with relevant specialists. An addendum regarding Neu-N immunohistochemical staining results has been issued separately."} +{"pid": "TCGA-CS-6665", "report": "The specimen labeled \u201cRight parietal tumor consistent with glioma\u201d consists of multiple tan-pink tissue fragments measuring 1.5 x 1.0 x 0.4 cm in aggregate. A portion was used for frozen section analysis. The second specimen, also labeled \u201cRight parietal tumor consistent with glioma,\u201d consists of tan-white tissue fragments measuring 2.0 x 1.0 x 0.5 cm in aggregate and was submitted entirely for histologic evaluation.\n\nMicroscopic examination reveals moderately pleomorphic neoplastic cells infiltrating cerebral grey and white matter. Mitotic figures are present. Immunohistochemical staining demonstrates positivity for GFAP. Staining for p53 is negative. Ki67 staining shows approximately 5% positivity in tumor cell nuclei. Congo red stain is negative. PAS staining highlights vascular structures. No endothelial proliferation or necrosis is identified in either specimen.\n\nImmunohistochemistry testing includes GFAP, Ki67, p53, and PAS stains. Additional stains and immunohistochemical assays were performed as part of diagnostic evaluation. Some testing involves analyte-specific reagents not cleared by the FDA but used under laboratory-developed test protocols.\n\nFrozen section diagnosis indicated a high-grade glial neoplasm. Clinical history notes a right parietal lesion. Both specimens were obtained from the right parietal region and reviewed in conference."} +{"pid": "TCGA-EW-A1P4", "report": "The left breast mastectomy specimen measured 19.0 x 18.5 x 2.3 cm and weighed 380.0 grams. A lesion was identified in the upper outer quadrant measuring 5.0 cm in greatest dimension, with additional dimensions of 2.0 x 3.0 cm. The tumor was located 0.1 cm from the deep margin and was well-encapsulated with a lobulated appearance. Florid adenosis and fibrosis were present in the stroma, with a stromal to fat ratio of approximately 25%. No microcalcifications were identified. Margins were free of involvement by invasive carcinoma.\n\nMicroscopic evaluation showed a high nuclear grade lesion with minimal tubule formation (less than 10%) and marked nuclear pleomorphism. Mitotic activity was scored as 1 for a 40x objective field. The total Nottingham score was 6, corresponding to histologic grade II. Venous or lymphatic invasion was not identified.\n\nSentinel lymph nodes were evaluated. Three lymph nodes were examined, each measuring approximately 2.0 x 1.5 x 1.0 cm (two) and 1.5 x 1.2 x 1.0 cm (one). No malignancy was seen in any of the nodes. Keratin staining was performed and showed no evidence of tumor involvement.\n\nImmunohistochemical analysis showed absence of ER, PR, and HER2 expression in the tumor. HLA-DR was positive, which, in conjunction with morphological features, supported a medullary subtype.\n\nThe left breast implant capsule was received as two pieces of membrane tissue measuring 7.0 x 6.0 x 3.0 cm in aggregate. Representative sections were submitted. The breast implant itself measured 10.0 cm in diameter by 3.5 cm and weighed 197.0 grams. No abnormalities were noted in the gross description of the implant.\n\nStaging information: Based on size, the primary tumor was classified as pT3c. Lymph node status (pN) remained pending keratin results. Distant metastasis could not be assessed (pMX)."} +{"pid": "TCGA-DS-A7WH", "report": "The specimen was received following a radical hysterectomy procedure. Gross examination of the uterus measured 8.0 x 5.0 x 3.0 cm. The cervix measured 2.5 cm in length and up to 3.5 cm in diameter. Vaginal cuff margins were present, measuring between 2.0 and 2.6 cm in length. No residual ovarian or fallopian tube tissue was identified.\n\nHistologic evaluation identified abnormal cellular growth involving both the anterior and posterior aspects of the cervix as well as the lower endocervical canal. The lesion demonstrated mucinous features and moderate differentiation. The greatest tumor dimension measured 3.5 cm. Invasion was limited to the cervical wall with a maximum depth of 1.0 cm (cervical wall thickness measured at 1.4 cm). Surgical margins were uninvolved; the closest distance from invasive cells to margin was 0.4 cm at the deep paracervical/parametrial region and 1.6 cm at the vaginal cuff.\n\nLymphovascular invasion could not be definitively assessed due to retraction artifact and extracellular mucin, which interfered with interpretation. There was no evidence of vaginal extension, uterine corpus involvement, or parametrial infiltration. Non-neoplastic findings included proliferative endometrium, endocervical reserve cell hyperplasia, squamous metaplasia, and Nabothian cysts.\n\nLymph node sampling included bilateral pelvic regions and common iliac areas. A total of 22 lymph nodes were recovered and examined microscopically: seven from the right pelvic region, three from the left pelvic region, and eleven from another left pelvic site. No lymph nodes were identified in either common iliac specimen. All lymph nodes evaluated showed benign fibrofatty tissue without evidence of malignant involvement.\n\nAll surgical specimens were entirely embedded for microscopic evaluation. Representative sections were submitted from multiple clock-face positions around the tumor, including margins and surrounding normal tissues. Immunohistochemical testing was performed as part of diagnostic evaluation; however, results are considered laboratory-developed tests and have not been cleared or approved by the FDA.\n\nFinal staging classification was determined based on histopathologic findings and AJCC 7th Edition TNM criteria."} +{"pid": "TCGA-QR-A707", "report": "The left adrenal gland specimen weighed 164.7 grams and measured 8.6 x 7.5 x 5.0 cm. A 3 cm defect was noted on the surface. The specimen was opened opposite the defect, revealing a hollow mass with friable tissue in the center. The cut surface showed an outer rim of adrenal gland tissue with a tan-pink smooth layer beneath. A distinct area of firm pink-tan tissue measuring up to 4 x 3 x 2 cm was identified and procured for further analysis.\n\nMicroscopic evaluation revealed cellular areas that demonstrated positivity for synaptophysin and chromogranin. There were also regions showing intratumoral necro-hemorrhagic changes and fibrosis. Ancillary studies, including immunoperoxidase and in-situ hybridization, were performed to support the assessment. These tests were developed in-house and, while not cleared or approved by the U.S. Food and Drug Administration, are permitted under CLIA certification for high-complexity testing. \n\nClinically, the lesion was suspected based on elevated serum and urine catecholamine levels. Pre- and post-operative findings were consistent with a left adrenal lesion. The specimen was fully processed and representative sections were submitted for permanent analysis. No consultation was required, and the gross and microscopic features were documented as described."} +{"pid": "TCGA-HC-8257", "report": "The prostate specimen measured 5.5 x 5.1 x 4.2 cm and weighed 48.5 grams. The largest lesion measured 3.5 x 2.0 x 1.0 cm and was located in the left/posterior region. Histologic evaluation showed a primary pattern of grade 3 and secondary pattern of grade 4. Tumor involvement accounted for approximately 17% of the prostate, with the dominant nodule measuring 3.5 mm in greatest dimension. Perineural invasion was present. Extraprostatic extension was identified and was nonfocal, located posteriorly. Seminal vesicle invasion was also present bilaterally, with positive margins noted on the right. A positive surgical margin was identified posteriorly. Pathologic staging was based on the presence of seminal vesicle invasion. Lymph node dissection included 8 pelvic lymph nodes, with one containing metastatic disease. The distal urethral margin was serially sectioned and submitted for analysis. The remainder of the prostate and seminal vesicles were entirely submitted for histologic evaluation. In addition to the findings, acute and chronic inflammation was noted."} +{"pid": "TCGA-E2-A14N", "report": "A fresh lymph node measuring 2.8 x 1.0 x 1.2 cm was received from the right axilla and showed blue dye staining. Touch imprint smears were negative, though frozen section analysis revealed positive findings. The lymph node was entirely submitted for further examination.\n\nA right mastectomy specimen weighing 1,321 grams measured 23 x 23 x 5.8 cm. An area of tan skin measuring 6.7 cm in length with a diameter of 3.1 cm was noted, including a healed scar measuring 5.5 cm in length. The areola measured 4.0 cm in length and 3.0 cm in width, while the everted nipple measured 1.0 cm. The axillary tail measured 6.5 x 5.0 x 1.5 cm. Upon sectioning, a well-circumscribed white-tan mass measuring 3.8 x 3.2 x 2.9 cm was identified in the upper inner quadrant, located 0.5 cm from the nearest deep margin. Hemorrhagic changes and possible necrosis were observed centrally within this mass. Another hemorrhagic white-tan firm mass measuring 2.5 x 2.0 x 1.8 cm was found approximately 4.6 cm lateral to the first mass and located about 2.0 cm from the areola region, 2.5 cm from the deep margin. Sections from various regions of the specimen were submitted for histological evaluation, including areas of the larger and smaller masses, quadrants of the breast tissue, nipple, areolar region, and possible lymph nodes within the axillary tail.\n\nAxillary contents, measuring 7.3 x 5.6 x 0.9 cm, contained multiple lymph nodes ranging in size from 0.1 to 2.8 cm. These lymph nodes were submitted for histopathological examination.\n\nA left breast reduction specimen primarily consisted of adipose tissue with minimal fibrous breast tissue present. No abnormalities were identified macroscopically, and representative sections were submitted for microscopic evaluation.\n\nHistologically, the right breast specimen demonstrated multifocal features with two distinct lesions. One lesion measured 3.8 cm in greatest dimension and was located in the medial aspect of the breast, while the other measured 2.5 cm and was found centrally. Both margins of resection and all sampled lymph nodes were negative for tumor involvement. The larger lesion showed geographic areas of necrosis and focal columnar cell change.\n\nImmunohistochemical analysis on one of the tumors indicated negative hormone receptor status for both estrogen and progesterone receptors using an Allred scoring system. HER2 immunohistochemistry performed on one tumor showed negative expression (score 0), whereas testing on another tumor was interpreted as equivocal (score 2+), prompting further investigation via FISH methodology.\n\nThe case underwent comprehensive pathological staging and synoptic reporting. Multiple pathologists reviewed microscopic and diagnostic evaluations throughout the process."} +{"pid": "TCGA-GN-A269", "report": "The specimen consisted of four parts. Part A was a lymph node from the right armpit, measuring 1.8 x 1.5 x 0.7 cm, which showed evidence of melanocytic involvement. Part B was a lymph node from the left armpit, measuring 2.0 x 1.5 x 1 cm, and showed reactive changes with melanosis but no melanocytic findings. Part C consisted of fibrous and fatty tissue measuring 0.5 x 0.5 x 0.2 cm, with no significant findings. Part D was a skin resection from the back measuring 16.0 x 15.0 x 6.0 cm, with a central raised pigmented mass measuring 11.0 x 10.0 x 2.0 cm in depth. The mass was located close to several margins, with the nearest distance being approximately 1 cm from the top edge. The deepest part of the lesion measured about 5 cm. A separate small lesion measuring 1.5 x 0.5 cm was found under normal-appearing skin, located near the main lesion.\n\nMicroscopic examination revealed a lesion with a vertical growth component, including necrosis, and a Clark's level V invasion. The mitotic rate was 1.6 per square millimeter, and tumor-infiltrating lymphocytes were non-brisk. Vascular or lymphatic invasion and ulceration were present. Two satellite lesions were identified, one near the deep margin and another adjacent to a lateral section. Surgical margins were involved at the inferior-lateral site. Of two lymph nodes examined, one was positive. Immunohistochemical staining of the involved node was positive for S-100 and HMB-45 markers. No extracapsular extension was noted. The pathological staging was pT4b N3 Mx."} +{"pid": "TCGA-BG-A2L7", "report": "The specimen consists of a uterus with bilateral adnexa, weighing 150 grams, obtained via total abdominal hysterectomy and bilateral salpingo-oophorectomy. The endometrial tumor involves approximately 80% of the posterior endometrial surface and 15% of the anterior endometrial surface. Histologically, the tumor demonstrates a range of differentiation, with areas of well-differentiated architecture merging into poorly differentiated regions characterized by spindle cell features and numerous mitotic figures. There is a transition observed between glandular and spindle cell components. Immunohistochemical staining shows positivity for CAM 5.2, AE1/AE3, and vimentin, while CD10 expression is predominantly negative and desmin staining is absent in tumor cells.\n\nThe tumor invades approximately 35% of the myometrium and exhibits lymphovascular invasion. No tumor involvement is identified in the cervix, bilateral ovaries, or bilateral fallopian tubes. The cervix shows chronic inflammation, squamous metaplasia, reactive atypia, and Nabothian cysts. There is focal involvement of adenomyosis by the tumor.\n\nLymph node evaluation includes five right pelvic nodes, five left pelvic nodes, two left common iliac nodes, three right common iliac nodes, and one right periaortic node\u2014all are negative for tumor involvement. The omentum also shows no evidence of tumor.\n\nThe tumor measures 40 mm in maximum dimension. Histologic grading indicates a poorly differentiated epithelial neoplasm (FIGO grade 3), with nuclear grading classified as grade 3. The depth of myometrial invasion is less than half the thickness of the myometrium. No lymph node metastases are identified, with 16 lymph nodes examined and none positive. Based on these findings, the pathologic staging corresponds to an early stage."} +{"pid": "TCGA-AX-A1CA", "report": "The surgical specimen included the uterus, cervix, bilateral adnexa, and omentum. The endometrium contained a tumor measuring 6 cm in greatest dimension, with additional dimensions of 2.5 x 1.5 cm. Histologic evaluation revealed malignant cells consistent with serous adenocarcinoma involving the endometrium. Microscopic examination showed invasion into the myometrium with a depth of 6 mm and a total myometrial thickness of 20 mm. The tumor was confined to the corpus uteri without evidence of deeper invasion beyond one-half of the myometrial thickness (pT1b). No vascular or lymphatic invasion was identified.\n\nThe cervix showed involvement by malignant cells extending into the cervical stroma. Additional findings in the uterus included adenomyosis and leiomyomata. The uterine serosa and cul-de-sac showed no evidence of malignancy.\n\nLymph node specimens were submitted from right pelvic, left pelvic, right periaortic, and left periaortic regions. A total of 14 lymph nodes were examined, with no evidence of malignancy identified in any of the nodes. All margins were uninvolved by invasive carcinoma, with the closest distance of invasive carcinoma to a margin measuring 5 mm at the cervical/vaginal margin.\n\nAn incidental appendectomy was performed, and histologic examination of the appendix showed benign tissue. No malignancy was identified in the appendix.\n\nOther tissues evaluated included parametrial and paracervical tissues, fallopian tubes, ovaries, and omentum, all of which showed no evidence of malignancy. Representative sections of normal-appearing ovary were submitted for further studies. Multiple sections of the tumor and surrounding tissue were evaluated microscopically, confirming the absence of metastatic disease in sampled areas."} +{"pid": "TCGA-CJ-4636", "report": "A radical nephrectomy specimen was submitted, measuring 21.0 x 12.0 x 7.0 cm, including a kidney measuring 12.5 x 9.0 x 6.5 cm, along with segments of the renal artery, renal vein, ureter (5.0 cm in length and 0.5 cm in average diameter), and adrenal gland (6.5 x 3.0 x 0.9 cm). Within the mid pole of the kidney is a well-circumscribed lesion measuring 7.0 x 5.5 x 5.0 cm. The lesion has a golden-yellow appearance with extensive central hemorrhage and necrosis. Histologically, the lesion demonstrates a mixture of clear cells and eosinophilic cells. Nuclear features are consistent with moderate atypia. Invasion into the renal sinus adipose tissue and pelvicalyceal system was observed. There is no involvement of perinephric adipose tissue or renal vein. Margins of resection are free of abnormal cellular infiltration. Adjacent kidney parenchyma shows multifocal areas of discoloration within the cortex and scattered tubular hemorrhage. No lymph nodes were identified within the hilum or kidney. The adrenal gland appears histologically unremarkable. Four lymph nodes ranging from 0.8 to 4.0 cm in greatest dimension were identified in the paracaval region and show no morphologic evidence of cellular atypia. Multiple tissue sections were obtained for microscopic evaluation, including representative sections of vascular margins, tumor extending into the sinus and pelvis, adjacent kidney parenchyma, perinephric fat, and adrenal gland. Portions of the lesion were also submitted for additional specialized analysis."} +{"pid": "TCGA-XE-A8H4", "report": "The specimen consists of a left radical orchiectomy measuring 7.3 x 5.1 x 4 cm and weighing 100 grams. The spermatic cord is 6.2 cm in length and 1.5 cm in diameter. A firm, tan mass measuring 4.5 x 3.5 x 3 cm is identified within the testis. No necrosis or hemorrhage is observed. The remaining testicular tissue appears normal with a pink-tan color and soft consistency. Microscopically, the tumor is unifocal and confined to the testis without involvement of the rete testis, epididymis, perihilar fat, spermatic cord, tunica vaginalis, or scrotal wall. The spermatic cord margin is negative. The histologic features indicate a uniform cellular composition. Pathologic staging is pT1NXMXS2 (Stage IA)."} +{"pid": "TCGA-DC-6154", "report": "The liver specimen includes segments II and III, measuring 12 x 5.6 x 3 cm. A mass measuring 3.4 cm in greatest dimension is identified, with approximately 20% necrosis observed. The tumor is located 0.5 cm from the surgical resection margin. The surrounding hepatic tissue appears normal.\n\nIn the rectosigmoid colon specimen, a tumor measuring 5.8 cm in length and 3.5 cm in width is present. The maximal thickness of the tumor is 1.2 cm. Histologic evaluation reveals infiltration through the muscularis into pericolic fat, reaching near the serosal surface. There is suspicion of gross tumor perforation based on microscopic findings. Lymphovascular invasion is noted, including large venous and perineural invasion. No tumor budding or increased tumor-infiltrating lymphocytes are observed. All surgical margins are free of tumor involvement. A total of 39 lymph nodes are examined, with 8 showing metastatic involvement.\n\nNo significant pathology is identified in the proximal or distal ring specimens of the colon and rectum, respectively. Both segments are negative for tumor involvement.\n\nThe right fallopian tube contains benign paratubal cysts; no significant pathology is found in the associated ovary. The left fallopian tube and ovary show no pathological findings.\n\nLymph node assessment reveals metastatic involvement in multiple regional lymph nodes, with more than seven affected. The tumor invades to the serosal surface, corresponding to a high T-stage."} +{"pid": "TCGA-S7-A7WW", "report": "The left adrenal gland contained a well-circumscribed mass measuring 80x50x50 mm and weighing 39 grams. The cut surface was thinly fibrously encapsulated with a grey-pink, soft appearance. Microscopically, the lesion exhibited solid, alveolar, and trabecular growth patterns with significant fibrotic changes (trichrom stain positive, Congo and Saturn red negative). Adrenal cortex remnants were present with signs of pressure-induced atrophy. In certain areas, the lesion extended beneath the fibrous adrenal capsule, although no infiltration beyond the capsule was observed. Within the periadrenal fat, extensive foci of metaplastic change were noted. Sustentacular cells (S100+) were only rarely identified, being largely absent in substantial portions of the lesion. Proliferation activity, as assessed by MIB1 staining, was low at 1\u20132%. Histopathologic evaluation revealed large nests or diffuse growth comprising more than 10% of the lesion volume, with central necrosis within large nests and confluent necrotic areas. The lesion demonstrated high cellularity, cellular uniformity, and focal spindle-shaped morphology. Mitotic figures exceeded three per ten high-power fields, with atypical mitotic figures present. Additional features included invasion of adipose tissue, vascular invasion, capsular invasion, marked nuclear pleomorphism, and mild nuclear hyperchromasia. A scoring system applied to these features yielded a total of 3 points."} +{"pid": "TCGA-05-4402", "report": "The lesion is located peripherally in the lower lobe and is predominantly composed of an acinar growth pattern, with a minor component showing large-cell solid architecture. A bronchioloalveolar growth pattern is present at the tumor periphery. Focal mucin production is observed. There is notable lymphatic vessel invasion within the lung tissue and involvement of the visceral pleura. The tumor has infiltrated the visceral pleura, with focal extension through the pleural surface. The resection margin at the base of the specimen, distal to the metal clamps, is involved. Histological evaluation suggests infiltration into surrounding structures, with findings indicative of advanced local spread."} +{"pid": "TCGA-B0-5400", "report": "The specimen consists of a right nephrectomy. The neoplasm measures 8.0 cm in greatest diameter with additional dimensions measuring 7.8 cm. Histologic evaluation shows a tumor composed predominantly of cells with clear cytoplasm and areas of necrosis, along with calcifications. A minor component of the tumor exhibits sarcomatoid morphology with rhabdoid features accounting for approximately 5% of the tumor. Nuclear grading is high, corresponding to Fuhrman grade IV. \n\nThe tumor extends focally into the renal sinus fat and involves the renal vein, with tumor thrombus identified within this vessel. The renal vein margin is involved by carcinoma, while all other surgical margins are free of tumor. There is also evidence of venous invasion into larger vessels as well as lymphatic invasion into smaller vessels. \n\nMicroscopic examination of the non-neoplastic kidney demonstrates focal global glomerulosclerosis, focal tubular atrophy, and a prominent interstitial infiltrate composed predominantly of lymphocytes. No adrenal gland tissue is present in the specimen. No regional lymph nodes are available for assessment. Tumor extends into perinephric tissues and into major veins."} +{"pid": "TCGA-X6-A8C6", "report": "The resected soft tissue specimen from the left upper leg measures 9.0 cm in the superior-to-deep dimension, 10.0 cm medially to laterally, and 15.5 cm proximally to distally. A lobulated white-tan-yellow mass measuring 8.5 x 8.3 x 6.8 cm is identified within the specimen. The mass is located deep to skeletal muscle and demonstrates a fibrous to myxoid background with scattered spindled cells exhibiting large, pleomorphic nuclei. No vascular or perineural invasion is observed. The closest margin is the deep lateral aspect, with the mass less than 0.1 cm from the margin; however, a tissue plane is present. Other margins, including proximal and distal, are free of involvement. A separate specimen from the extended periosteal margin of the left leg consists of a yellow-pink-red-brown soft tissue measuring 4.1 x 1.3 x 0.9 cm, which shows benign fibromuscular tissue on microscopic evaluation. Immunohistochemical staining is negative for S100 and CD57. The tumor size exceeds 5 cm and is classified as a deep-seated lesion. Lymph node status cannot be assessed based on available material. The pathologic stage is determined to be T2b NX."} +{"pid": "TCGA-ED-A82E", "report": "Gross Description: The lesion is located in a lobe, measuring 6x6x4 cm, with ill-defined margins. It has a firm, solid consistency and exhibits necrotic areas with a gray-white appearance on cross-section. Microscopic Description: The cellular arrangement includes trabecular, acinar, sheet-like, and tubular patterns. The cells maintain a polygonal morphology and display round vesicular nuclei with conspicuous nucleoli. Cytoplasmic volume is moderate, with staining characteristics ranging from basophilic to vacuolated. Nuclear features include irregular contours, increased size, hyperchromasia, and prominent nucleoli. Mitotic figures are identified. Focal areas of tumor necrosis are observed. Specimen type is lobectomy. Tumor dimensions are also documented as 10 x 10 x 8 cm. Histologic grade indicates moderate differentiation. Focality, tumor extent, lymph node involvement, and venous invasion were not specified. Surgical margins are uninvolved, and there is no evidence of prior neoadjuvant therapy. No additional pathological findings or comments are provided."} +{"pid": "TCGA-HB-A3L4", "report": "The specimen consists of a uterus and cervix with a large mass arising from the lower uterine segment or cervix. The mass measures 18 \u00d7 14 \u00d7 8 cm and weighs 1150 grams. It is predominantly well-circumscribed with a nodular, tan to brown cut surface, showing areas of fibrosis and focal necrosis. Microscopically, the lesion demonstrates spindle cell morphology with focal epithelioid features, significant cytologic atypia, and coagulative tumor necrosis. Mitotic activity is prominent, with up to 90 mitotic figures per 10 high power fields. Immunohistochemical staining reveals strong positivity for smooth muscle actin and desmin. Estrogen receptor expression is 2-3+ in over 90% of cells, and progesterone receptor expression is 2-3+ in approximately 70% of cells. Cytokeratin staining is negative. Sections of the remainder of the uterus show benign secretory phase endometrium, adenomyosis, and leiomyomata. No additional masses are identified.\n\nTwo tissue fragments consistent with bilateral ovaries and fallopian tubes are also submitted. The right ovary measures 2.5 \u00d7 2.0 \u00d7 2.0 cm and contains a hemorrhagic corpus luteum; the left ovary measures 2.3 \u00d7 1.5 \u00d7 1.3 cm and has a benign-appearing fibrous to white cut surface. Both fallopian tubes appear unremarkable. No abnormal pathology is identified in these specimens."} +{"pid": "TCGA-CJ-6032", "report": "The right kidney specimen shows a well-circumscribed nodular lesion measuring 7.0 x 6.0 x 5.5 cm, located in the inferior and mid pole of the kidney. The cut surface of the lesion is tan-yellow and soft, with areas of hyalinized tissue. The surrounding perinephric fat is unremarkable, with no evidence of invasion. The lesion approaches the renal sinus fat and renal pelvis but does not extend into these structures. The renal vein and ureteral margins are free of involvement. Histologically, the lesion is composed predominantly of clear cells (95%) with a minor component of eosinophilic cells (5%). Nuclear features correspond to a nuclear grade 3. All surgical margins are negative. The non-neoplastic renal parenchyma appears histologically normal. A radical nephrectomy specimen includes the kidney measuring 12.0 x 5.0 x 4.3 cm and surrounding perinephric fat measuring 21.0 x 10.0 x 6.0 cm. The ureter measures 5.0 cm in length and 0.3 cm in circumference; the renal vein segment measures less than 1.0 cm in length and 0.6 cm in diameter. No adrenal tissue is present. Representative sections of the lesion have been submitted for further study, including a vaccine protocol and possible electron microscopy."} +{"pid": "TCGA-GC-A3RB", "report": "A radical cystoprostatectomy specimen was evaluated. The bladder measured 8 x 7.5 x 5 cm and contained a mass measuring 7 cm in maximum dimension. The tumor was located in the trigone, right lateral wall, and anterior wall. Microscopically, it exhibited high-grade morphology with solid/nodular configuration. Histologic evaluation revealed no associated epithelial lesions. Lymphatic vascular invasion could not be definitively determined. The tumor extended into perivesical fat with uninvolved margins; the closest distance of invasive carcinoma to a margin was 0.5 cm at the deep radial margin. No carcinoma in situ was identified at the closest margin.\n\nNine lymph nodes were examined from bilateral pelvic dissections (five on the right, four on the left), none of which showed evidence of metastasis. Two small foci within the prostate measured 2 mm and 3 mm and demonstrated adenocarcinoma with Gleason grade 3 + 3. These were confined to one half of a single lobe or less. Margins were uninvolved, and there was no lymphatic/vascular or perineural invasion identified.\n\nThe ureters were patent without evidence of dysplasia or malignancy. An incidental appendectomy was performed and showed no diagnostic abnormalities.\n\nPathologic staging for the primary lesion was determined as pT3b with no regional lymph node involvement (pN0) and no distant metastasis (pM0). For the separate prostatic findings, staging was pT2a with identical absence of nodal or distant disease.\n\nThe specimen included multiple tissue blocks submitted for comprehensive microscopic evaluation. These encompassed sections from the tumor at various locations including depth of invasion, proximity to margins, and surrounding urothelium. Prostatic sections included bilateral apex-to-base sampling along with portions involving seminal vesicles and vas deferens. All lymph node specimens were fully assessed microscopically.\n\nFrozen section analysis during surgery confirmed negative urethral margins. Gross photographs documented the tumor\u2019s extent and location within the bladder. No palpable lymph nodes were identified in the attached fatty tissue. All surgical margins were free of tumor involvement.\n\nMeasurements and descriptions provided throughout the report reflect both macroscopic and microscopic evaluations conducted as part of the surgical pathology assessment."} +{"pid": "TCGA-QH-A6CS", "report": "Specimen ID: QUID:0C4238FC-0A3C-4685-8FFF-08D66878521A. Object: Pathologist report. Code details indicate male gender. The lesion is located in the right frontal region. Histopathological examination revealed a moderately cellular neoplasm composed of diffusely infiltrating cells with nuclear atypia and frequent mitotic figures. Necrosis was not identified. Immunohistochemical staining showed positivity for glial markers. Based on histological features and extent of invasion, the tumor demonstrated characteristics consistent with a high-grade neuroepithelial neoplasm. Staging assessment indicated no evidence of distant spread."} +{"pid": "TCGA-A4-8098", "report": "The resected right renal mass specimen consists of multiple tissue fragments, including a friable tumor mass measuring 2.5 x 1.7 x 1.4 cm and additional tumor fragments totaling approximately 3 cm in aggregate. The tumor is partially cavitary and located within a larger specimen measuring 3 x 2.3 x 1.3 cm. Adjacent to the tumor are three heavily cauterized fragments of renal tissue, ranging in size from 1.1 x 0.7 x 0.3 cm to 1.7 x 0.9 x 0.4 cm. Adipose tissue fragments measuring 7 x 5 x 2 cm in aggregate showed no identifiable tumor.\n\nMicroscopic examination of the tumor revealed distinct cellular features. Immunohistochemical analysis demonstrated positivity for PAX-8, CD10, racemase, and EMA. The tumor was negative for inhibin, CK5/6, p63, CK7, CK20, CD117, synaptophysin, and chromogranin. These staining patterns were consistent with previously observed characteristics.\n\nThe maximum dimension of the tumor is 3.0 cm. Histologic evaluation revealed unifocal involvement confined entirely to the kidney, with no evidence of lymphovascular or perineural invasion. No lymph nodes were identified. Margin status could not be definitively determined due to the fragmented nature of the specimen. Specimen B and the cauterized fragments in cassette A8 were found to be free of tumor; however, it remains uncertain whether these represent the complete surgical margin or whether tumor may be present at the edge of other submitted fragments. Clinical correlation is recommended for further assessment of margin involvement.\n\nStaging parameters indicate the tumor is limited to the kidney with no regional or distant spread identified. Based on available data, the pathologic staging descriptors are as follows: primary tumor stage pT1a, regional lymph nodes pNX, distant metastasis pMX, and overall pathologic stage I. Non-neoplastic kidney tissue showed no significant histologic findings."} +{"pid": "TCGA-C5-A1ME", "report": "SURGICAL PATHOLOGY REPORT - CONSULT. Inside/Outside. F. MRN : M.D. UTERUS, CERVIX, BIOPSY. Histologic examination of the cervical biopsy reveals a well-differentiated neoplasm with a predominant villoglandular papillary growth pattern. The lesion contains fibrovascular cores of variable lengths lined by neoplastic epithelium that demonstrates primarily intestinal-type differentiation. Scattered throughout the specimen are regions exhibiting complex cribriform architecture, accounting for approximately 10\u201315% of the lesional tissue. No definitive stromal invasion is observed; however, there is minimal normal stroma present within the biopsy, limiting the ability to fully assess for an invasive component. The patient is a female with a history of atypical glandular cells identified on Pap smear and underwent cervical biopsy. The material received consists of one slide labeled from the biopsy performed on the patient. Dr. has reviewed this case and concurs with the findings."} +{"pid": "TCGA-LK-A4O7", "report": "The surgical specimen includes a resection of the sixth rib, which shows bone marrow with trilineage hematopoiesis and no evidence of tumor. Attached skeletal muscle and adipose tissue are also free of tumor involvement. A pleurectomy specimen demonstrates involvement of the pleural tissue. Lymph node biopsies from multiple levels were examined. The subcarinal lymph node consists of three fragments, all negative for tumor with presence of anthracosis. In level 5 lymph node, one out of three fragments is involved. All four fragments of the level 11 lymph node show involvement, as do all three lymph nodes at level 7. Level 9 lymph nodes show tumor involvement in all three fragments with extranodal extension and presence of tumor in adjacent soft tissue. The lower lobe level 10 lymph node is involved. The left lung specimen with pericardium, mediastinal fat, and diaphragm shows extensive involvement of the pleura. Tumor infiltrates the pericardium and diaphragmatic muscle but does not fully traverse them. Adjacent mediastinal adipose tissue and focally the lung parenchyma are involved. Lymphovascular invasion is present. Resection margins of the bronchus and vessels are free of tumor. All three peribronchial lymph nodes are involved. Lung parenchyma also shows atelectasis and emphysematous changes. Immunohistochemical staining shows positivity for Calretinin, WT1, D240, and Cytokeratin AE1/3, while p72.3 is negative. Controls performed adequately. Pathologic staging according to the 7th edition AJCC system is pT3 N2 MX."} +{"pid": "TCGA-08-0360", "report": "The specimen was received in two parts, both labeled with the patient\u2019s name and medical record number. Part A was submitted fresh and included a single fragment of glistening, gray-tan soft tissue measuring 1.0 x 0.4 x 0.3 cm; approximately 30\u201340% of the tissue exhibited a slightly yellow hue. A portion of this yellow tissue was used for cytologic preparation, and about 30% of the remaining tissue was submitted for frozen section diagnosis (FS1), with the remnant placed in cassette A1. The rest of the unfrozen tissue was submitted in cassette A2. Part B, labeled for permanent analysis, consisted of two irregular tan-gray soft tissue fragments measuring 0.7 x 0.7 x 0.3 cm in total, and was entirely submitted in cassette B1.\n\nMicroscopic examination revealed an infiltrating lesion composed of mitotically active, pleomorphic cells with hyperchromatic nuclei and coarse chromatin. Vascular proliferation was identified in part A, while palisading around areas of necrosis was observed in part B. These histologic features were consistent with a high-grade malignant process. The intraoperative assessment of the biopsy sample was interpreted as a malignant glioma, favoring a highly aggressive variant. The final diagnosis was confirmed by the attending pathologist following comprehensive review of all pathology slides, including frozen and permanent sections."} +{"pid": "TCGA-YL-A9WK", "report": "The prostate and pelvic/obturator lymph nodes were examined following radical prostatectomy. Histologic evaluation revealed acinar adenocarcinoma with a Gleason score of 4+5=9. The tumor was located in the anterior, right, left, and posterior regions of the prostate. Extra-prostatic extension was identified and was non-focal, involving the posterior right and left areas. Seminal vesicle invasion was present bilaterally.\n\nSurgical margins were involved by invasive carcinoma, multifocal in extent, located at the posterior right and left regions; however, the nature and exact extent of the positive margins were not specified. Lymphovascular invasion was not identified, while perineural invasion was present. The tumor accounted for approximately 30% of the prostate volume.\n\nOne left pelvic lymph node was identified and showed no evidence of metastasis. Additional findings included high-grade prostatic intra-epithelial neoplasia, basal cell hyperplasia, and atrophy. Pathologic staging was determined as pT3b, pNO, pMX."} +{"pid": "TCGA-V1-A9ZR", "report": "The prostatectomy specimen weighed 39.5 grams and measured 4 x 4 x 3.5 cm. Gross examination revealed a tan-yellow, firm area occupying approximately 85% of the prostate, extending from the left posterior apex into both sides, stopping 0.2 cm from the bladder margin. The remaining prostatic tissue appeared tan with atrophic changes. The seminal vesicles were soft and lobulated without visible lesions.\n\nMicroscopic evaluation showed extensive involvement of the prostate by small acinar carcinoma, with only minimal residual benign tissue. Areas of Gleason patterns 3, 4, and 5 were identified. High-grade intraepithelial neoplasia was present focally. Tumor extended beyond the capsule in multiple areas, including a contiguous focus measuring at least 2 cm on the left base. Three separate inked margins were involved: left anterior apex (at least 3 mm), left posterior quadrant near the seminal vesicle (scattered microscopic foci), and right bladder resection margin (1 mm). Extensive cautery artifact limited grading at these margins, although high-grade morphology was suspected.\n\nTumor extensively involved both seminal vesicles and was present in adipose and neural tissues at the posterior bladder margin. No tumor was identified in the detrusor muscle of this specimen. No tumor was found in any of the submitted lymph nodes (7 total examined: 2 from the right and 5 from the left pelvic regions). No tumor was identified in the anterior prostatic fat or posterior peritoneum specimens.\n\nSections of the prostate were oriented using anatomic landmarks and inked margins. Six slices were taken through the gland, with additional sections submitted from apical and bladder margins. All material from the lymph node dissections was submitted for evaluation, with one additional lymph node identified upon review."} +{"pid": "TCGA-EL-A3D1", "report": "A total thyroidectomy specimen was received, measuring 9.5 x 5.0 x 1.5 cm, with attached soft tissue measuring 9.0 x 3.0 x 1.0 cm. The right lobe measured 4.0 x 2.0 x 1.5 cm and contained a 0.3 cm white nodule in the upper pole. The isthmus measured 2.5 x 2.5 x 1.0 cm and contained a 1.4 x 0.7 x 0.7 cm homogeneous pink-tan nodule. The left lobe measured 5.5 x 4.0 x 1.5 cm and contained a friable encapsulated tan-pink lesion in the lower pole measuring 3.0 x 2.0 x 2.0 cm. The remainder of the thyroid parenchyma appeared homogeneously dark-red. Adenomatous nodules were noted. Five lymph nodes were identified in the attached soft tissue, ranging from 0.3 to 0.8 cm in size. Three lymph nodes were submitted for analysis, with one showing psammoma bodies; no tumor cells were identified. In a separate specimen, eleven lymph nodes from the right neck were examined, all without evidence of tumor involvement. Lymph nodes from the left neck (eight in total) also showed no tumor presence. Additional levels of the lymph node containing psammoma bodies were reviewed and confirmed no metastatic disease. Tissue sections from the largest lesion and non-neoplastic areas were submitted to the tumor bank. No other significant pathological findings were reported."} +{"pid": "TCGA-S7-A7WQ", "report": "The right adrenal gland contains a mass measuring 40x30x20 mm and weighing 12 grams. The cut surface is grey-brown with a smooth appearance and a fibrous capsule. Microscopically, the tissue shows solid and alveolar growth patterns with areas of fresh hemorrhage. The cellular composition is mixed, with regions of polygonal cells and spindle-shaped cells. Small remnants of adrenal cortex are present at the periphery, with occasional proliferation noted within the capsule.\n\nThe tumor demonstrates cytologic polymorphism, including areas of hyperchromatic nuclei. A focal dense infiltration of plasmatic cells is present, with positive staining for kappa and lambda light chains in a polyclonal pattern. Sustentacular cells (S100 positive) are identified in better-differentiated regions, while they are absent in centrally located, diffusely growing parts. MIB-1 labeling index is 2\u20133% of tumor nuclei.\n\nChromogranin staining is positive in the cytoplasm of larger tumor cells within the nodule, but negative in the surrounding adrenal cortex remnants and in the adjacent adipose tissue, which shows Feyrter's metaplasia. There is also positive staining in the cytoplasm of smaller cells located just beyond the adrenal capsule, possibly representing peripheral extracapsular extension into adipose tissue. No angioinvasion is observed.\n\nHistologic scoring using the provided system includes: large nests or diffuse growth greater than 10% of tumor volume; central or confluent necrosis; high cellularity; cellular monotony; focal tumor cell spindling; mitotic count exceeding 3 per 10 high-power fields; presence of atypical mitotic figures; extension into adipose tissue; vascular invasion; capsular invasion; nuclear pleomorphism; and nuclear hyperchromasia. The total score is 8."} +{"pid": "TCGA-ZB-A96D", "report": "Pathology Report-Summary: Material: tumor measuring 16.0 X 10.0 X 9.0 cm with focal invasion through the capsule into adjacent fat tissue. Histological examination reveals epithelial cells positive for CK5/6 and showing medium membrane staining for EGFR. The epithelial cells are negative for CD5, CD117, CD1a, CD99, and CD20. Immature T-lymphocytes positive for CD1a and CD99 are present, along with sparse CD20-positive B-lymphocytes. Staging according to pT classification is pT2; nodal and metastatic status could not be determined (pNx, pMx). Clinical staging using the Masaoka system is II.2."} +{"pid": "TCGA-AR-A0U3", "report": "Breast, left, wide-local excision: A mass measuring 2.3 x 2.0 x 2.0 cm was identified. Histologic evaluation shows high-grade cellular features with a solid growth pattern comprising approximately 10% of the lesion. The surgical margins are free of abnormal tissue. One left axillary sentinel lymph node contains microscopic involvement, while three additional left axillary lymph nodes show no evidence of involvement. Immunohistochemical analysis demonstrates strong nuclear staining for estrogen receptor (> 10%) and focal staining for progesterone receptor (1\u201310%). The testing method for estrogen receptor has been developed internally and has not been cleared or approved by the U.S. Food and Drug Administration."} +{"pid": "TCGA-B8-5553", "report": "The left partial nephrectomy specimen measured 6.5 \u00d7 5.4 \u00d7 3.6 cm and included a fragment of kidney with attached perinephric fat. A cortical nodule measuring 5.5 \u00d7 3.8 \u00d7 3.2 cm was identified, with a solid, variegated dark red to orange-brown cut surface. The nodule was well-circumscribed and focally abutted multiple black inked surgical margins. Microscopic evaluation revealed nuclear features corresponding to a grade 2 (Fuhrman classification) lesion. No sarcomatoid differentiation was observed. Histologic assessment showed no evidence of extra-capsular extension into perirenal adipose tissue, no vascular invasion (venous or lymphatic), and all surgical margins\u2014including the renal parenchymal, renal capsular, and perinephric fat margins\u2014were free of involvement. No lymph nodes were received, and no additional significant findings were noted. Staging was determined as T1b pNx pMx based on available data. A separate biopsy of overlying fat consisted only of mature adipose tissue without any atypical or malignant features. The tumor was entirely submitted for tissue procurement."} +{"pid": "TCGA-L5-A4OG", "report": "The specimen was obtained from a female patient following a transhiatal esophagectomy. The submitted specimen included a segment of distal esophagus measuring 9.2 cm in length and a 3.0 cm segment of proximal stomach. Within the proximal stomach, there was a light brown, granular scar measuring 1.5 x 3.9 cm, located near the gastroesophageal (GE) junction, with its distal edge 1.9 cm from the closest gastric margin. Serial sectioning of the ulcerated area revealed involvement limited to the mucosa with possible cystic changes deeper in the mucosa. A portion of the mucosa lacked underlying submucosa and muscularis. Up to five possible lymph nodes were identified in the perigastric adipose tissue and were submitted for examination. The gastric margin was marked with green ink and surrounding fat with black ink.\n\nA separate specimen consisting of a cervical esophageal margin was received, measuring 2.0 x 0.5 x 0.3 cm, with unremarkable mucosa.\n\nMicroscopic evaluation revealed small foci within extensive high-grade dysplasia. The lesion involved the lamina propria and muscularis mucosae. No prior chemoradiation therapy was administered. Of the lymph nodes examined, none showed evidence of involvement. All resection margins were free of abnormality. The lesion was well differentiated and no distant metastasis was identified."} +{"pid": "TCGA-G7-A8LD", "report": "The left kidney specimen measured 24 x 9 x 8.3 cm and weighed 1036 grams. A mass measuring 7.5 x 6.3 x 6.1 cm was identified in the lower pole. The mass exhibited extension into perinephric and renal sinus adipose tissue. Histologically, the cells demonstrated very irregular nuclei with prominent nucleoli. Vascular and lymphatic invasion were present. Surgical margins were free of involvement by invasive disease. The adrenal gland showed no involvement.\n\nA total of eleven lymph nodes were identified in the left periaortic specimen, nine of which contained metastatic involvement.\n\nPathologic staging was determined as pT3a based on local tumor extension and pN1 reflecting regional nodal involvement. The specimen was processed with representative sections taken from multiple areas including the mass, surrounding fat, ureteral and vascular margins, adrenal gland, and areas of discoloration near the renal pelvis. No additional significant findings were noted."} +{"pid": "TCGA-XF-A9T0", "report": "A radical cystoprostatectomy, left nephroureterectomy, lymph node dissection, and creation of a Studer neobladder were performed. Gross examination of the bladder/prostate specimen revealed a large, firm, pink tumor measuring 7.6 x 3.3 x 2.2 cm involving the anterior bladder neck wall. The tumor extended through the bladder wall into perivesical soft tissue and approached within less than 0.2 cm of the inked resection margin. Multiple foci of urothelial carcinoma in situ (flat lesion) were identified, including in the trigone and left ureterovesical junction. No lymphovascular invasion was observed, and all resection margins were free of atypia or malignant involvement.\n\nMicroscopic evaluation of the bladder showed invasive poorly differentiated urothelial carcinoma with multifocal involvement of the bladder neck and perivesical soft tissue infiltration. No dysplasia or malignancy was identified in the attached left ureter, which exhibited only reactive changes; the right ureter showed no significant histopathologic changes.\n\nExamination of the prostate revealed unilateral prostatic adenocarcinoma with a Gleason score of 7 (3+4), confined entirely within the prostate without capsular or periprostatic soft tissue involvement. High-grade prostatic intraepithelial neoplasia (PIN III) was also present. The prostatic urethra showed no evidence of urothelial dysplasia or invasive malignancy, and bilateral seminal vesicles were free of malignancy.\n\nThe left kidney specimen included a ureteropelvic junction with stenosis and mild pelvic dilation but no evidence of urothelial dysplasia or malignancy. Renal parenchyma showed no significant histopathologic changes. Six hilar lymph nodes were examined and found to be free of malignancy.\n\nLymph node dissection encompassed multiple anatomical regions, including right paracaval, right common iliac, left para-aortic, left common iliac, right lymph nodes of Cloquet, right external iliac, right obturator/hypogastric, left obturator/hypogastric, left external iliac, right presciatic, presacral, and left presciatic lymph nodes. A total of 79 lymph nodes were evaluated microscopically, and none demonstrated evidence of malignancy.\n\nIntraoperative frozen sections of the right distal ureter and apical urethral margin showed no high-grade atypia or tumor. Final histopathologic evaluation confirmed benign findings in both specimens, with no urothelial dysplasia or malignancy detected.\n\nSections from all other submitted specimens, including the right proximal ureter, were similarly benign and devoid of malignant cells or dysplastic changes.\n\nPathologic staging was assessed as pTisT3bNOMX for the bladder component and pT2aNOMX for the prostate according to AJCC 1997 criteria. No further diagnostic terms related to tumor type were included in this summary."} +{"pid": "TCGA-ZJ-AB0H", "report": "The cervical biopsy specimen consists of a pink to pale-tan tissue fragment measuring 0.9 x 0.6 x 0.3 cm, entirely submitted in one cassette. Histological evaluation reveals invasive cellular growth composed of large cells with nonkeratinizing morphology. Cellular features include marked nuclear atypia, increased nuclear-to-cytoplasmic ratio, and frequent mitotic figures. The lesion is confined to the cervix without evidence of extracervical extension. No lymphovascular invasion is identified. The histologic grade is consistent with a high-grade neoplasm."} +{"pid": "TCGA-BA-4074", "report": "A biopsy of the vallecular lesion demonstrates lymphoid tissue and squamous epithelium forming crypts, without evidence of malignancy. Removal specimens from the posterior lateral tongue mucosa, right and left surface mucosa margins, posterior and right muscle margins, floor of mouth mucosa and muscle margins all show no malignant involvement.\n\nThe left hemiglossectomy specimen includes a white, solid mass with an infiltrative border measuring approximately 4.0 cm in greatest dimension. Histologic examination reveals poorly differentiated carcinoma extensively involving the specimen. The tumor diffusely involves the deep margin of resection, which is inked black. Medial and lateral margins are free of tumor involvement.\n\nNeck dissection specimens reveal metastatic involvement in lymph nodes bilaterally. On the right side, two of 22 lymph nodes contain metastasis, including one at Level I and one at Level II. On the left side, three of 25 lymph nodes demonstrate metastatic involvement: two at Level I and one at Level II. The largest metastasis measures 2.0 cm on the right and 1.8 cm on the left. Extracapsular extension is identified bilaterally.\n\nExamination of surrounding tissues reveals fibrosis and inflammation in the left Level I fibrofatty tissue without tumor involvement. The floor of mouth partial removal specimen contains squamous mucosa and submucosa with minor salivary glands present and no malignant findings.\n\nFrozen section evaluations during surgery confirm absence of tumor in biopsies taken from the vallecula, posterior lateral tongue, right and left surface mucosa margins, posterior and right muscle margins, and floor of mouth mucosa and muscle margins.\n\nGross evaluation of the surgical specimen confirms tumor location along the deep aspect extending nearly the entire length anterior to posterior and more medially located. Margins at medial and deep aspects are involved but superseded by frozen section findings. The remainder of the tongue surface appears pink/tan with localized disruption noted laterally and posteriorly.\n\nSubmitted lymph node levels include Levels I\u2013V on both sides. Right neck dissection includes representative sections from each level with grossly positive findings at Level II. Left neck dissection shows tumor involvement at Level I and Level II with glandular involvement noted at Level I. Additional fatty and fibrous tissues submitted bilaterally do not reveal tumor involvement."} +{"pid": "TCGA-BA-A6DF", "report": "A pathology report describes multiple biopsies and a composite resection from a male patient with a lesion in the left mouth region. The biopsies included anterior bone marrow, anterior floor of mouth, anterior vestibule of mouth, lingual nerve margin, soft tissue of the left face, proximal nerve margin, and proximal inferior alveolar nerve margin. No tumor was identified in any of these specimens. An additional specimen consisted of a composite resection of the left mandible and floor of mouth.\n\nGross examination of the composite resection revealed an 8.3 x 7.5 x 4.9 cm excision. A central mass measuring 7.2 x 5.4 x 4.3 cm was present, ulcerating through mucosa and extending into soft tissue. The mass was described as soft, friable, focally hemorrhagic, and necrotic. It occupied approximately 40% of the mandible and was in close proximity to several margins: medial soft tissue margin (0.1 cm), lateral soft tissue margin (0.1 cm), distal mandibular margin (1.9 cm), posterior soft tissue margin (0.5 cm), and anterior soft tissue margin (0.3 cm). The mass was also within 0.2 cm of all mucosal margins. In terms of skin margins, distances ranged from 0.9 cm to 2.1 cm.\n\nMicroscopic evaluation of the resected specimen showed no angiolymphatic or perineural invasion. Bone invasion was present. Tumor cells demonstrated weak positivity for p16 on immunohistochemistry, and in situ hybridization for high-risk human papillomavirus was negative. No carcinoma in situ was identified. Surgical margins were negative; however, the tumor was located 0.1 cm from the closest margin, which corresponded to the medial soft tissue margin. \n\nLymph node evaluation included 28 lymph nodes from various levels on the left side (levels 1B, 1A, 2, 3, and 4). No tumor was identified in any of these lymph nodes.\n\nThe case was reviewed intraoperatively with frozen section analysis of multiple sites, all of which were negative for tumor. Permanent sections confirmed the absence of malignancy in all biopsied and resected tissues except for the composite resection, which contained the lesion. Based on available data, the pathologic TNM staging was determined to be pT4a pN0."} +{"pid": "TCGA-FX-A3TO", "report": "The specimen consists of a resected mass from the left retroperitoneal region, including rib and muscle tissue. The mass measures 13.7 x 11.5 x 11.3 cm and weighs 850 grams. It is surrounded by a thin fibrous capsule and demonstrates a multilobulated cut surface with gray-pink to yellow rubbery areas, as well as focal myxoid change. Approximately 5% necrosis is present. Microscopic evaluation reveals atypical cells arranged in a storiform pattern within a fibromyxoid stroma. Nuclear pleomorphism is noted, along with scattered multinucleated giant cells.\n\nImmunohistochemical staining shows positivity for vimentin and scattered positivity for CD68. No significant staining is observed for S-100, MAK-6, EMA, desmin, myogenin, actin, smooth muscle actin, caldesmon, CD31, or CD34. Additional stains for CDK4 and MDM4 are also negative.\n\nThe tumor is located near multiple resection margins. It approaches within 0.1 cm of the anterior, lateral, and posterior margins, and is 0.3 cm from the superior margin. Microscopically, the tumor extends into adjacent skeletal muscle. Margins are otherwise lined by a thin fibrous rim. A separate segment of the twelfth rib, measuring 4.2 cm in length, along with associated soft tissue, shows no evidence of malignant involvement. A fragment of fibrofatty tissue from the left psoas margin also shows benign features without malignancy.\n\nAll margins were sampled and submitted for histologic evaluation. Representative sections of the lesion were also submitted for analysis. The case was reviewed and confirmed by experienced surgical pathology staff."} +{"pid": "TCGA-AL-3473", "report": "The surgical specimen consists of a left kidney and para-aortic lymph nodes. The left kidney, weighing 1,080 grams, measures 22 x 18 x 9.5 cm, with the ureter measuring 11.5 cm in length. A mass measuring 7.5 x 6.5 x 5 cm is identified in the midpole region, located approximately 0.5 cm from the superior pole capsule. The mass appears variegated and extends into the renal pelvis, obliterating about 90% of it. No definitive extrarenal extension is identified. Vascular and ureteral margins are free of involvement. The mass was sampled extensively, with sections submitted to assess its relationship to the capsule, surrounding parenchyma, and perinephric fat.\n\nA total of 33 lymph nodes were identified in the para-aortic region, ranging in size from 0.3 to 2.2 cm. All lymph nodes were sectioned and submitted for analysis, and no evidence of tumor involvement was found.\n\nCytogenetic analysis of the renal mass revealed an abnormal mosaic karyotype. Of 23 metaphases analyzed, 3 cells had a modal chromosome number of 45 with loss of the Y chromosome, 5 cells had a modal number of 47 with an additional copy of chromosome 7, and 15 cells showed a normal diploid karyotype (46 chromosomes). The nuclear grade of the lesion corresponds to Fuhrman grade 3."} +{"pid": "TCGA-50-5055", "report": "The left lower lobe wedge resection contains a lesion measuring 2.5 cm with acinar, papillary, and bronchioloalveolar growth patterns. Focal angiolymphatic invasion is present. There is no visceral pleural invasion. A marked host lymphocytic response is noted. All surgical margins are free of involvement. One of five N1 lymph nodes shows involvement. The remaining lymph nodes examined do not show evidence of metastatic involvement. Pathologic staging is T1, N1, MX. Additional findings include emphysematous changes with focal organizing pneumonia and multiple small tumorlets consistent with carcinoid-type morphology. A separate nodule in the inferior left lower lobe is identified as a hamartoma, with clear margins. Lymph node biopsies from the interlobar, posterior hilar, and apical window regions show no evidence of metastatic disease except for the posterior hilar lymph node, which contains metastatic involvement."} +{"pid": "TCGA-D6-A74Q", "report": "The patient is male. A surgical specimen of the larynx, including the hyoid bone and a 2.5 cm segment of the trachea, was collected and measured 9 x 5 x 4 cm in size. A mass was identified in the glottic region, bilaterally, measuring 2.5 x 2.5 x 1.5 cm. The lesion extends into the subglottic and supraglottic regions, with involvement of the thyroid cartilage and pre-epiglottic space. Histopathological examination revealed a poorly differentiated invasive keratinizing squamous cell lesion. Intraoperative assessment showed that margins at the root of the tongue and trachea were free of malignant involvement. However, the excision margin at the front right side was less than 0.1 cm. The tumor was classified as pT4a."} +{"pid": "TCGA-98-A53A", "report": "The specimen was received in nineteen containers, each labeled with the patient\u2019s name and medical record number. Lymph nodes from multiple levels, including IX-A, IX-B, VIII, VII-A through VII-F, IV-A through IV-E, II-R, and XII, were all excised and measured between 0.7 cm and 1.5 cm in greatest dimension. All lymph node tissues were submitted entirely and showed no evidence of malignancy upon microscopic examination.\n\nA lung specimen from the right middle lobe was obtained via lobectomy. The lesion measured 3.5 cm in maximum dimension and was unifocal. Histologic evaluation revealed moderately differentiated carcinoma with vascular invasion noted. The visceral pleura was not involved. The bronchial margin was free of tumor involvement. Staging indicated pT2a based on tumor size and absence of direct extension into the main bronchus or visceral pleura. No regional lymph node metastasis was identified (pN0). Distant metastasis could not be assessed. A frozen section of the tumor and a separate biopsy of the bronchial margin were both negative for malignancy."} +{"pid": "TCGA-EO-A3L0", "report": "The specimen consisted of omentum, hernia sac, uterus with cervix and bilateral tubes and ovaries, as well as lymph nodes from the para-aortic, left obturator, and right obturator regions. Gross examination of the omentum revealed a large segment measuring 35.0 x 11.5 x 2.0 cm and weighing 171.5 g; it appeared homogeneously yellow-tan with focal hemorrhage but no distinct lesions or tumors. The hernia sac was composed of multiple soft to firm tissue pieces with a membranous appearance in part, but no grossly identifiable lesions.\n\nThe uterus measured 10.4 x 6.1 x 5.6 cm and had a smooth serosal surface that was purplish-pink with focal hemorrhage. Upon bisection, the endometrial cavity was largely occupied by a pale-tan tumor measuring 5.6 x 5.3 x 3.7 cm. This lesion showed gross invasion into the myometrium, located approximately 2.6 cm from the posterior exocervix, 2.5 cm from the anterior exocervix, and 1.0 cm from the closest serosal surface on the posterior aspect. The tumor was white-tan, solid centrally, and friable at the periphery. Myometrial thickness ranged from 1.6 to 2.8 cm. Multiple intramural fibroids were present, the largest measuring 2.5 cm in diameter. The cervix had a patent endocervical canal and contained small Nabothian cysts filled with clear gelatinous material.\n\nBoth ovaries were unremarkable, with corpus albicans identified on cross-section. The fallopian tubes were patent and showed no gross abnormalities, although the left tube contained a few paratubular cysts filled with white milky fluid. Sections of the uterus were submitted for analysis, including full-thickness sections of the endo/myometrium with tumor from both anterior and posterior aspects, some including adjacent normal endometrium and fibroids.\n\nLymph node specimens included two para-aortic lymph nodes (measuring 0.5 and 0.7 cm), three from the left obturator region (measuring 1.9 and 2.9 cm), and eight from the right obturator area (ranging from 0.3 to 1.9 cm). Histologic evaluation of all lymph nodes showed no evidence of malignancy. The omentum and hernia sac also showed no signs of carcinoma.\n\nHistologically, the uterine lesion demonstrated infiltration of the inner half of the myometrial thickness with focal lymphovascular space involvement. Other findings included adenomyosis. Immunohistochemical staining showed focal positivity for ER and PR, with negative staining for p53. No additional pathologic findings were identified.\n\nSurgical procedure included simple hysterectomy, bilateral salpingo-oophorectomy, omentectomy, and lymph node sampling from pelvic and para-aortic regions. The hysterectomy specimen was intact. The tumor was located in the fundus and measured 5.6 cm in greatest dimension. Histologic grade was consistent with FIGO grade 3. Less than 50% myometrial invasion was observed. No involvement of the cervix, ovaries, fallopian tubes, or omentum was found. Surgical margins were uninvolved. Lymphovascular invasion was present. A total of 13 lymph nodes were examined: 11 pelvic and 2 para-aortic, none of which showed metastatic disease."} +{"pid": "TCGA-DD-AACH", "report": "The liver specimen measured 13.5 x 9.5 x 7.5 cm and weighed 371.5 grams. A single tumor located in the left lobe measured 9.0 x 7.5 x 7.0 cm, with nearly the entire liver involved. The tumor exhibited an infiltrative growth pattern, with 5% necrosis and no satellite nodules. Capsular formation was absent. Gross examination revealed thrombosis in the left portal vein, with no invasion of the bile ducts. The gallbladder measured 10.0 cm in length, 4.5 cm in diameter, with a 0.4 cm wall thickness. No tumor was identified in the submitted left portal vein resection margin.\n\nMicroscopic evaluation showed moderately differentiated hepatic cells arranged in a trabecular pattern. There was no fatty change or fibrous capsule formation. Invasion of the portal vein was confirmed, along with microvessel involvement. The surgical margin showed a clearance distance of 0.5 cm with no evidence of tumor invasion. There was no serosal, hepatic vein, or hepatic artery invasion. No intrahepatic metastasis or multicentric occurrence was observed.\n\nNon-tumor liver pathology revealed cirrhosis with micronodular pattern, attributed to chronic hepatitis B. The inflammatory activity was minimal in the lobular region and mild in the portoperiportal area. No dysplastic nodules, ductal epithelial dysplasia, or other liver diseases were identified. Trichrome staining demonstrated fibrotic changes consistent with cirrhosis.\n\nThe gallbladder showed features of chronic cholecystitis. Frozen biopsy of the vessel labeled as left portal vein showed no tumor involvement."} +{"pid": "TCGA-CN-5359", "report": "A 60-year-old male underwent bilateral neck dissection. The resected specimen included a partial mandibulectomy measuring 9.2 x 6.5 x 6.0 cm with attached teeth, anterior tongue, floor of the mouth, and bilateral neck tissue. The lesion measured 4.0 x 2.5 x 2.3 cm and was located in the anterior tongue, floor of the mouth, anterior gingiva, and infiltrated the anterior mandible bone. Margins were measured as follows: 1.0 mm from the anterior margin, 1.2 cm from the posterior margin, 3.0 cm from the deep margin, 2.5 cm from the right mandible bone margin, and 2.2 cm from the left mandible bone margin. Histologic evaluation revealed no tumor at the resection margins.\n\nMicroscopic examination showed an invasive moderately differentiated carcinoma with perineural invasion but no angiolymphatic invasion. Bone marrow margins on both sides showed no significant pathologic changes. Lymph node evaluation included 29 nodes examined: three out of sixteen left cervical lymph nodes were involved with metastatic disease (Levels II, III, and IV), while eleven right cervical lymph nodes were negative. No extracapsular extension was identified.\n\nImmunohistochemistry demonstrated positivity for EGFR and negativity for p16. Molecular studies for EGFR and c-MET by FISH showed no gene amplification. In situ hybridization for HPV was negative. Pathologic staging was determined as pT4 pN2b pMX. Additional findings included chronic and focal acute sialadenitis of both submandibular glands."} +{"pid": "TCGA-BH-A5J0", "report": "The surgical specimen from the left breast at the 2 o\u2019clock position weighed 26.95 grams and showed a focus of invasive disease measuring 11.0 mm in greatest dimension microscopically. The Nottingham score was 7 out of 9, with tubules scoring 3, nuclear grade 2, and mitotic activity score 2, corresponding to a Nottingham grade 2 classification. There was also an in situ component measuring approximately 8 mm, composed of solid and cribriform types, with nuclear grade 2 features, associated microcalcifications, and extension into lobules. This in situ lesion was admixed and adjacent to the invasive component.\n\nSurgical margins were negative for invasive disease; the closest margin was anterior at 4.5 mm. For the in situ component, the nearest margin was lateral at 1.5 mm. Lymphovascular space invasion was identified. Additional findings included classical type lobular neoplasia with nuclear grade 1 and pagetoid extension into ducts, changes consistent with a prior biopsy site, atypical ductal hyperplasia, atypical lobular hyperplasia, and fibrocystic change with sclerosing adenosis.\n\nImmunohistochemical analysis showed that the invasive tumor cells were estrogen receptor positive, weakly positive for progesterone receptor, and negative for HER-2/neu (1+). In part 6, an additional excision of the anterior margin weighing 13.4 grams revealed a small focus of invasive disease measuring 2 mm, located 3 mm from the margin. This focus was confirmed by immunostaining for p63. Other microscopic findings included atypical ductal hyperplasia and sclerosing adenosis.\n\nFive sentinel lymph nodes were examined from the left axilla and all were negative for metastatic disease. Immunohistochemical studies using markers such as E-cadherin, P120, SMMHC, and p63 supported the morphological diagnoses across different regions of interest. The tumor was located in a region with calcifications suggestive of malignancy. The aggregate size of multiple invasive foci totaled 13 mm. Based on these findings, the pathological staging was determined as pT1c, with no nodal involvement (pN0) based on sentinel node evaluation."} +{"pid": "TCGA-VV-A86M", "report": "The specimen consists of multiple tissue fragments obtained from the left frontal and temporal lobes. The largest aggregate measured 7.1 x 3.5 x 0.6 cm and was described as pink red to gray white, glistening, and soft with a mucoid surface. Other specimens ranged in size from 0.4 x 0.4 x 0.2 cm to 4.0 x 3.8 x 1.5 cm, most appearing as delicate, glistening soft tissue with variable coloration from pale tan to pink red. Several were submitted for frozen section analysis, with findings indicating high grade features.\n\nMicroscopic evaluation revealed areas with marked cytologic atypia, hypercellularity, and scattered mitotic figures, consistent with higher grade changes (WHO Grade III). These features were identified primarily in specimens #7, #8, and #9. However, necrosis and endothelial proliferation, which are diagnostic of glioblastoma multiforme, were not observed. The majority of the resected tissue showed moderate hypercellularity, mild to moderate nuclear atypia, and inconspicuous mitotic figures, corresponding to WHO Grade II characteristics. Approximately 20% of the tumor demonstrated Grade III features, while about 80% exhibited Grade II features. The distinction between these grades was noted to be on a spectrum without clear demarcation. Some specimens also showed changes consistent with prior surgical intervention."} +{"pid": "TCGA-A5-A0GG", "report": "The surgical specimen included a right salpingo-oophorectomy and total abdominal hysterectomy with left salpingo-oophorectomy. The right ovary was atrophic, measuring 1.3 x 1.1 x 1.1 cm, with a focally shaggy external surface due to adhesions. No tumor was identified in the ovary or fallopian tube. The fallopian tube measured 3.0 cm in length and had a patent lumen. Adhesions were noted on the serosal surface. Paraovarian and paratubal cysts lined by benign epithelium were present, as well as peritubal changes involving the fallopian tube.\n\nThe uterus weighed 70 grams and measured 6.5 cm from fundus to cervix, 4.0 cm cornu to cornu, and 3.2 cm in maximum thickness. A soft, tan, friable mass was observed in the endometrial cavity of the fundus, anterior corpus, and posterior corpus, measuring approximately 4.5 x 3.0 cm in area and reaching a maximum thickness of 0.7 cm. Histologically, there was minimal superficial invasion into the myometrium, involving less than 10% of the uterine wall thickness. No lymphatic or vascular invasion was seen, and no extension into the lower uterine segment or cervix was present. The parametrial tissues were uninvolved.\n\nThe ovaries and fallopian tubes showed no evidence of tumor involvement. The left ovary was atrophic, and the fallopian tube was patent with a small adhesion. Uterine serosal adhesions were present, and four leiomyomas were identified, one of which was microscopic. Monckeberg\u2019s calcification was noted in the uterine arteries. The cervix showed chronic inflammation, atrophic squamous changes, and nabothian cysts.\n\nLymph node dissection included multiple pelvic and periaortic sites. A total of 17 lymph nodes were examined across all groups, ranging in size from 0.1 to 1.5 cm. All were reactive without any evidence of tumor involvement. Additional biopsies of pelvic soft tissue and omentum also showed no tumor.\n\nHistological evaluation of the endometrial lesion revealed complex architecture with focal secretory-like changes. Immunohistochemical staining for neuroendocrine markers was performed; while a few cells showed positivity for synaptophysin and chromogranin, the majority of cells did not express these markers. Intraoperative frozen section analysis was consistent with the final histologic findings."} +{"pid": "TCGA-64-1677", "report": "The specimen was received in seven parts. The first part, a fragment of rib measuring 1.3 x 1.3 x 1.0 cm, showed no abnormal lesions and was entirely submitted after decalcification. The second part, a wedge resection of the right upper lobe, measured 5 x 2 x 1.5 cm and showed an ill-defined area measuring 2.3 cm beneath thickened pleura; no tumor was identified. One section was submitted for frozen section and additional tissue was submitted in other blocks.\n\nThe third part, a right lower lobe specimen weighing 224 grams and measuring 17 x 9 x 7 cm, revealed a 4 x 4 x 3 cm pink firm mass located 4.5 cm from the bronchial margin. The tumor was firm and adjacent to the pleura. No tumor was found at the bronchial or vascular margins. Several hilar and peribronchial lymph nodes were present, up to 1 cm in size. Sections included areas of tumor in relation to pleura and adjacent lung tissue, vascular margins, hilar nodes, and uninvolved lung tissue.\n\nThe fourth part consisted of level 7 lymph nodes, measuring collectively 1.2 x 1.0 x 0.6 cm, with evidence of involvement. The fifth part, level 4 lymph nodes, included a single node measuring 1.5 x 0.9 x 0.7 cm, which showed no involvement. The sixth part, level 10 lymph nodes, included a single node measuring 0.9 x 0.8 x 0.7 cm, also without involvement. The seventh part, a level 3 lymph node measuring 0.7 x 0.6 x 0.4 cm, showed no involvement.\n\nSections from multiple areas including the parietal pleura margin, bronchial and vascular margins, and uninvolved lung tissue were examined. Mild emphysema was noted in the uninvolved lung tissue. Involvement was identified in two of four lymph nodes from the right lower lobe and one of five lymph nodes from level 7. Other lymph nodes examined showed no involvement. Tumor measured 4 cm and showed invasion of the visceral pleura."} +{"pid": "TCGA-EL-A3T9", "report": "The surgical specimen includes a thyroid measuring 7.0 x 4.0 x 2.0 cm, with the left lobe largely replaced by a tan, firm mass measuring 2.0 x 3.2 cm. The mass abuts the surface of the thyroid and has an irregular, rough posterior aspect with areas of calcification. The cut surface is tan and solid, with approximately 10% resistance to scalpel incision. Two small tan nodules, measuring 0.1 and 0.2 cm, are present in the right lobe, raising concern for secondary involvement.\n\nMultiple sections were taken from the tumor and surrounding tissue, including deep and peripheral margins. Intraoperative frozen sections from the tumor bed showed atypical cells, highly suspicious for malignancy. Fibroadipose tissue submitted from a separate site showed no evidence of parathyroid tissue.\n\nTissue fragments from the left trachea-esophageal groove, anterior tracheal surface, and left trachea demonstrate infiltration by solid carcinoma. These include a 1.6 x 0.8 x 0.6 cm fragment, a 1.4 x 0.6 x 0.2 cm fragment, and a 1.5 x 1.0 x 0.5 cm cartilaginous fragment respectively. A 0.9 x 0.7 x 0.3 cm soft tissue fragment from the left tracheal margin also shows similar infiltration. All specimens were submitted in entirety for analysis. A separate tracheal biopsy specimen measuring 0.6 x 0.3 x 0.2 cm shows only respiratory mucosa without any malignant features.\n\nImmunohistochemical staining demonstrates positivity for TTF-1 and CK-19 in the neoplastic cells found within soft tissue near the left trachea, indicating a likely origin from thyroid tissue. Further testing is underway to better classify the solid component of the lesion, and a supplemental report will be issued."} +{"pid": "TCGA-D7-6520", "report": "The histopathological examination of the resected stomach, measuring 16 x 18 cm along the greater curvature with attached omentum of 24 x 18 cm, revealed an edge-thickened ulceration in the pyloric region measuring 7 x 6 x 1.7 cm. Macroscopic assessment indicated infiltration into the muscular membrane of the stomach wall. The lesion was located 7.5 cm from the proximal margin and 1.5 cm from the distal margin.\n\nMicroscopic evaluation showed a tumor invading through the entire thickness of the stomach wall, extending into vessels and perigastric fat tissue, reaching the surface of the peritoneum. The surgical margins were free of tumor involvement. The mucosa adjacent to the tumor exhibited signs of chronic inflammation.\n\nLymph node assessment demonstrated varying findings: lymph nodes at the periorificial region showed reactive changes without tumor involvement. At the lesser curvature, tumor cells were identified within lymph nodes, involving the capsule and surrounding adipose tissue. Similarly, lymph nodes along the greater curvature exhibited tumor presence within the capsule. Peripyloric lymph nodes also contained tumor deposits.\n\nGrading was assigned as G3. Staging parameters included pT2b and pN2 classifications. Immunohistochemical analysis using HER2 staining (HercepTestTM by DAKO) yielded a score of 0 in invasive cells."} +{"pid": "TCGA-RQ-A68N", "report": "The tissue sections show sheets of poorly cohesive, large cells with large atypical nuclei that are somewhat open in appearance. Multiple nucleoli are typically present within the nuclei. The cells have a limited amount of cytoplasm. There is a high number of mitotic figures observed, along with individual apoptotic cells; however, no frank necrosis is identified. The lesion exhibits an expansive growth pattern at its interface with the surrounding tissue, though an angiocentric pattern is also evident. Areas suggestive of glial and fibrous scarring are noted.\n\nImmunohistochemical staining demonstrates that the neoplastic cells are positive for CD45 and CD20, supporting a B-cell lymphocytic lineage. They are negative for GFAP, S-100, and cytokeratin 8/18. Additionally, the cells show aberrant expression of the T-cell marker CD43 but are negative for CD3 and CD45RO. Staining also reveals positivity for BCL2 and BCL6, while CD10 is not expressed. These immunophenotypic features align with a specific subtype of large cell B-cell lymphocytic proliferation.\n\nNo involvement by other markers or patterns suggestive of alternative lineages or origins is identified."} +{"pid": "TCGA-23-1121", "report": "The specimen consists of a supracervical hysterectomy with bilateral salpingo-oophorectomy. The uterus measures 5.0 cm from fundus to cervical resection margin, 4.0 cm from cornu to cornu, and 3.3 cm anterior to posterior. There are three intramural tan-white firm spherical masses with whorled cut surfaces ranging from 0.6 up to 1.2 cm in greatest dimension. A partially cystic and solid tan-yellow mass measuring 12.5 x 11.0 x 9.5 cm is replacing the entire left ovary and fallopian tube. No grossly identifiable residual left ovary or fallopian tube is present. The right ovary measures 3.0 x 1.0 x 0.5 cm and appears unremarkable. The right fimbriated fallopian tube measures 9.0 cm in length and 0.6 cm in diameter, also appearing grossly unremarkable. A tan firm partially hemorrhagic lesion measuring 5.0 x 3.0 x 2.0 cm involves the right paratubal soft tissue.\n\nHistologic evaluation reveals involvement of the full thickness of the uterine wall, the entire left ovary and fallopian tube, and the right fallopian tube mucosa and paratubal soft tissue. Necrosis is extensive. Perineural infiltration and lymphatic vessel invasion are present. The right ovary shows no malignant involvement but demonstrates benign serous inclusion glands. The endometrium is non-phasic/atrophic without evidence of neoplastic change. The cervix shows tumor involvement of the outer wall; however, the ectocervical and endocervical mucosa appear free of tumor. Parametrial extension is present, as well as implantation within the supracolic omentum.\n\nLymph node assessment includes one left pelvic lymph node measuring 2.9 x 1.5 x 1.3 cm, which is entirely replaced by tumor.\n\nSections submitted include multiple blocks from the left adnexal mass, corpus, right fallopian tube and adnexa, interface of right fallopian tube with lesion, right ovary, right paratubal lesion, and additional sections from the uterine corpus. The cervix was sampled from multiple quadrants including parametrial regions. The parametrial tumor specimen was entirely submitted across four tissue fragments. The supracolic omentum implant was submitted as one block.\n\nBased on these findings, staging is determined as T3cN1Mx. Clinical history includes a pelvic mass with associated abdominal discomfort. Imaging demonstrated a 14.0 cm solid and cystic pelvic mass likely of adnexal origin. Laboratory findings included elevated CA 125 at 519 and CEA at 7.8."} +{"pid": "TCGA-E9-A228", "report": "The specimen was obtained from the right lower inner quadrant of the breast. The tumor measured 2.5 x 2 x 2 cm and was grossly evident. Histologic evaluation revealed a moderately differentiated infiltrating component. Lymph node examination showed 2 out of 12 subclavicular nodes positive for involvement. Other features including histologic score, tubule formation, nuclear characteristics, and mitotic activity could not be fully assessed. Surgical margins, tumor extent, and evidence of prior treatment were not specified. No additional findings or comments were provided."} +{"pid": "TCGA-MY-A913", "report": "The specimen consists of an irregular portion of tan rubbery tissue measuring 2 x 0.7 x 0.4 cm, along with two additional fragments measuring 0.5 x 0.4 x 0.2 cm in aggregate. The tissue demonstrates a tan smooth mucosa on one surface and is otherwise tan and smooth on cut section. All tissue was submitted for evaluation.\n\nMicroscopic examination reveals fragments of invasive poorly differentiated cells. The orientation of the specimen does not allow for measurement of depth of invasion. A p63 stain was performed and demonstrated strong positivity. The amount of sampled tissue is extensive, with nearly all of it involved by the lesion.\n\nAll histologic, immunohistochemical, and in situ hybridization studies were performed at the laboratory. Appropriate controls were used and the results were interpreted in the context of the case. The findings have been correlated with clinical and other laboratory data."} +{"pid": "TCGA-B6-A0X7", "report": "The clinical history indicates the presence of bilateral breast lesions. \n\nOn the left side, a 6 x 2.5 x 1 cm specimen of fibroadipose tissue was examined. It contained a single firm, gray-white lesion measuring 1.2 x 1 x 1 cm. The lesion was partially well-circumscribed but showed infiltrative borders in other areas, with flecks of yellow noted within. The anterior surface was inked green and the posterior blue. The lesion extended to within 0.3 cm of the anterior margin. Sections were submitted for estrogen and progesterone receptor analysis, and the tissue was processed into blocks A1\u2013A7, with most of the lesion in blocks A2\u2013A4. Microscopically, nuclear and histologic grading were both classified as grade 2. The lesion focally extended to within 100 microns of the inked margin (anterior, block A4). Intraductal components accounted for less than 5% of the total volume. Vascular invasion was not identified. Apocrine metaplasia was present in adjacent benign tissue. \n\nOn the right side, a 5 x 4.5 x 2 cm specimen of fibroadipose tissue was evaluated. A firm, gray-white mass measuring 2.0 x 1.0 x 1.0 cm was identified with an infiltrative border and a dumbbell shape. The anterior surface was inked blue and the posterior black. The tumor extended to within 0.3 cm of the closest margin. Tissue was submitted for hormone receptor analysis and embedded in blocks B1\u2013B8, with the majority in blocks B3\u2013B7. Histologically, the lesion was NSABP nuclear grade 2 and histologic grade 3. It focally extended to within 100 microns of the posterior inked margin (blocks B2, B3, B7). Intraductal elements constituted approximately 5% of the tumor volume. No vascular invasion was observed. Benign tissue showed microcalcifications and epithelial hyperplasia of the usual type."} +{"pid": "TCGA-EW-A2FR", "report": "The surgical specimen consisted of four components: a right breast mass, additional right breast tissue from the inferolateral and superficial regions, and right axillary contents.\n\nThe primary specimen measured 9.3 x 9.0 x 6.5 cm and weighed 75.7 grams. It was oriented with markers at various margins. Gross examination revealed an ill-defined gray-pink indurated area measuring approximately 1.0 cm in greatest dimension, located 0.7 cm from the inferior margin and 0.3 cm from the inferolateral margin. Multiple sections were submitted for analysis.\n\nInvasive tumor cells were identified in the right breast mass with a size of 1.0 cm. These cells demonstrated poor differentiation. Immunohistochemical staining showed negative results for estrogen and progesterone receptors. HER2 testing by immunohistochemistry was equivocal, while fluorescence in situ hybridization confirmed amplification.\n\nIn the additional right breast tissue from the inferolateral region, invasive tumor cells were found within less than 1.0 mm of the inked margin. No tumor involvement was observed in the superficial additional breast tissue.\n\nAxillary lymph node dissection yielded 21 lymph nodes, with 19 showing metastatic involvement. The largest metastatic deposit measured 2.5 cm. Perinodal extension was present. Margins were uninvolved by invasive tumor or ductal carcinoma in situ (DCIS), though the closest margin was less than 1 mm at the inferolateral site.\n\nHistologic evaluation revealed a Nottingham score of III (9 total points), composed of minimal tubule formation (score 3), marked nuclear pleomorphism (score 3), and mitotic count exceeding 20 per 10 high-power fields (score 3). Microcalcifications were identified in association with DCIS.\n\nStaging indicated a primary tumor size greater than 0.5 cm but not more than 1.0 cm (pT1b). Regional lymph node involvement was classified as pN3a due to metastasis in 10 or more axillary lymph nodes with at least one deposit larger than 2.0 mm. Distant metastasis could not be assessed (pMX).\n\nAll specimens were processed and submitted in entirety across multiple cassettes for comprehensive histologic evaluation."} +{"pid": "TCGA-DV-5574", "report": "The right kidney specimens demonstrate two distinct lesions. The first lesion measures 2.5 x 2 x 2 cm and exhibits a tan cut surface. A portion of the specimen was processed for further analysis, with the remaining tissue preserved for surgical pathology evaluation. The second lesion measures 3.5 x 2.6 x 2.1 cm and displays a tan/brown appearance with a golden-yellow nodular cut surface. One aspect of this lesion appears to include a capsule and possibly adjacent fat. Both specimens were serially sectioned and submitted in entirety for histologic examination. A separate soft tissue specimen measuring 3.0 x 2.0 x 0.8 cm, described as fibroadipose tissue, was also submitted and processed. Cellular features observed include consistent nuclear morphology with moderate variation in nuclear size and shape. No definitive margins were compromised during sampling. All specimens were processed and submitted for permanent analysis without consultation."} +{"pid": "TCGA-3B-A9I1", "report": "The specimen consists of a portion of uterus with an irregular, unoriented uterine body measuring 10.5 x 8.5 x 6.5 cm and weighing 310 grams. The serosa is variegated pink-tan to dusky red, focally hemorrhagic, and bosselated. A tan to gray, rubbery mass measuring 10 x 6 x 5.5 cm is present, with focal areas of hemorrhage and necrosis comprising less than 10% of the tumor. The tumor bulges but does not appear to extend through the serosa. Also received in this container is an ovary measuring 3.5 x 1.5 x 0.9 cm and weighing 4.3 grams, along with a fallopian tube 5.0 cm in length. Additionally, multiple fragments of pink-tan to gray tissue, consistent with possible neoplastic tissue, measure 6 x 6 x 3 cm in aggregate and weigh 55 grams.\n\nA second specimen includes the remaining portion of the uterus, bilateral tubes, and ovaries. The uterus measures 18 cm in length, 9.5 cm transversely, and up to 10.4 cm anterior to posterior. It is distorted by a solid, rubbery mass measuring 18 x 9 x 9 cm. The tumor involves the anterior and posterior myometrium, lower uterine segment, and cervix, extending to within 0.1 cm of the radial cervical resection margin and to within 0.3 cm of the closest cervical margin. The tumor bulges into the cervical mucosa and endometrium but does not appear to extend through the uterine serosa. The endocervical canal is 5.5 cm in length and ranges from 0.3 to 0.8 cm in diameter. The endometrial cavity measures up to 7 x 3.5 x 0.5 cm and contains pink-tan, focally hemorrhagic endometrium. The cut surface of the tumor is pink-tan to gray with focal hemorrhage and necrosis, which together occupy less than 10% of the tumor volume. The remaining myometrium ranges from 0.5 to 1.5 cm in thickness. A right ovary (3 cm in greatest dimension, weighing 5.0 grams) and right fallopian tube (5.5 cm in length) are present, as well as a small left fallopian tube measuring 1.0 cm in length. The posterior aspect of the uterine body shows a serosal and mural defect measuring 10 x 5 x 3 cm and weighing 1210 grams, consistent with the previously described portion.\n\nA third specimen consists of a portion of omental adipose tissue measuring 12 x 8 cm and ranging from 0.3 to 1.0 cm in thickness. Multiple subserosal foci of hemorrhage are noted, ranging from 0.1 to 0.5 cm in size. No grossly identifiable tumor or other lesions are observed.\n\nMicroscopic evaluation reveals a high-grade cellular proliferation with increased mitotic activity. Focal angiolymphatic invasion is identified. The tumor extends focally to the uterine serosa and involves the cervical wall. No evidence of malignancy is found in the fallopian tubes. Ovaries show no malignant involvement and demonstrate physiologic changes. The omental tissue is benign. Based on these findings, the pathologic stage is classified as T1b NX MX."} +{"pid": "TCGA-CQ-6222", "report": "The specimen consisted of multiple lymph node levels from the right neck, including Levels I-A through V. Lymph nodes in Levels IA, IB, IIB, IV, and V were all negative for abnormal cellular activity. In Level IIA, one of five lymph nodes showed atypical cell presence with a measurement of 1.5 cm; no structural extension beyond the node was observed. In Level III, one of two lymph nodes contained atypical cells measuring 1.8 cm, with extensive structural extension noted.\n\nA resected tongue specimen demonstrated a lesion with a maximum dimension of 3.6 cm and a thickness of 2.2 cm. The cellular features were consistent with moderate differentiation. No evidence of invasion into nerves or blood vessels was identified. All surgical margins, including those of the dorsal tongue, deep tongue, tongue base, and floor of mouth, were free of atypical cells. A separate sublingual gland specimen showed no abnormal changes.\n\nStaging was based on size and regional spread. The primary lesion measured greater than 2 cm but less than 4 cm. Metastatic involvement was noted in multiple ipsilateral lymph nodes without evidence of distant spread."} +{"pid": "TCGA-UY-A78O", "report": "The specimen was received in eight parts, each labeled with the patient's name and medical record number. Parts A through E were fresh, while F through H were in formalin.\n\nPart A (\"right ureter\") consisted of a 2.8 cm long segment oriented by a black stitch. Gross tumor extended from the distal end, and the proximal margin was submitted en face for frozen section (FS1). The remaining ureter was submitted entirely as cassettes A2 and A3.\n\nPart B (\"left ureter\") included a 0.5 x 0.4 x 0.3 cm fragment submitted entirely for frozen section (FS2), with remnant in cassette B1.\n\nPart C (\"bladder\") weighed 271 grams and measured 22 x 13 x 3.5 cm. It contained a stent through the left ureter, along with the left fallopian tube and ovary. A yellow-tan friable mass measuring 3 x 2 x 1.8 cm was identified near the right ureter opening and posterior bladder wall. An area of possible involvement within 0.1 cm of the posterior surgical resection margin was noted. The urethral margin was submitted for frozen section (FS3) and remnant placed in cassette C1. Sections submitted included the ureter margins, fallopian tube and ovary, normal bladder tissue, tumor regions, candidate lymph nodes, and other structures.\n\nPart D (\"distal right ureter\") measured 4.3 cm in length with a lumen diameter of 0.4 cm. A long stitch marked the proximal margin, which was submitted en face for frozen section (FS4); the remnant was submitted in cassette D1. The remainder was submitted in cassettes D2\u2013D4.\n\nPart E (\"right pelvic lymph nodes\") measured 8 x 5.5 x 1 cm and weighed 26 grams. Multiple lymph node candidates were present. Two were submitted for frozen section diagnosis; remnants were placed in cassettes E1\u2013E5. After fixation, additional sections were submitted in cassettes E6\u2013E11.\n\nPart F (\"final urethral margin\") was a 2.2 x 1.8 x 0.4 cm tissue fragment entirely submitted in cassette F1.\n\nPart G (\"left pelvic lymph nodes\") measured 9 x 5 x 3.5 cm in aggregate and contained multiple lymph node candidates ranging from 0.3 to 3.1 cm. Sections were submitted across cassettes G1\u2013G9.\n\nPart H (\"final left ureter\") was a 1 x 0.7 x 0.2 cm fibrous fragment trisected and submitted entirely in cassette H1.\n\nMicroscopic evaluation revealed high-grade cellular changes in areas of the right ureter and bladder. Involvement was noted in the muscularis propria of the bladder, extending into adjacent areas including the right ureter. There was ulceration and chronic inflammation within the bladder. No lymphatic or vascular invasion was identified. Carcinoma in situ was noted in epithelial regions of the bladder.\n\nMargins were generally negative: urethral margin, right and left ureter margins, and perivesical margin were free of tumor involvement. The closest margin was 0.2 cm at the posterior bladder region.\n\nLymph node evaluation included 24 total nodes (17 from the right pelvis and 6 from the left pelvis), none of which showed evidence of tumor involvement.\n\nImmunohistochemical staining for p53 was performed on one section showing atypical urothelium with reactive changes based on morphology and stain results. Dr. reviewed select portions of Parts A and D and concurred with findings.\n\nFrozen section diagnoses included chronic ureteritis with atypia favoring dysplasia (FS1), no tumor seen in left ureter (FS2), no tumor in urethra (FS3), no tumor in proximal right ureter (FS4), and no tumor in right pelvic lymph nodes (FS5).\n\nFinal microscopic findings confirmed invasive high-grade urothelial carcinoma involving the outer half of the muscularis propria in the bladder and distal right ureter. No tumor was identified in biopsies of the left ureter, urethral margin, proximal right ureter margin, or any lymph nodes evaluated."} +{"pid": "TCGA-AG-A025", "report": "The specimen includes a lesion in the sigmoid with features of well-differentiated architecture and cellular morphology. There is evidence of invasion into the submucosa, accompanied by atypia within glandular structures. In another region, a separate lesion demonstrates low-grade cytologic atypia confined to the epithelial layer.\n\nHistologic examination reveals chronic appendicitis characterized by luminal obliteration due to scarring, along with acute inflammatory changes involving the outer wall layers, including eosinophilic infiltration and fibrinous granulocytic serositis. The rectal resection specimen shows a mucosal-submucosal defect marked by a clip, with surrounding granulating inflammation and hyperplastic mucosal changes near the margin. Additional findings include wall perforation, acute hemorrhage, necrosis, and localized acute inflammatory reaction with serositis. Reactive lymphadenopathy is noted in multiple regions. An anastomotic ring with diverticulum formation is present, while other segments demonstrate normal tissue architecture. No specific or malignant features are identified beyond the previously described elements."} +{"pid": "TCGA-QK-A6IF", "report": "The specimen from the right tonsil was received in two portions. The first portion measured 0.5 x 0.5 x 0.4 cm and was processed entirely for intraoperative evaluation. A frozen section was performed, and the results were confirmed and communicated to the surgical team. The second portion measured 0.6 x 0.4 x 0.3 cm and was fully submitted for further analysis. Histologic examination revealed abnormal cellular proliferation involving the tonsillar tissue. The cells exhibited non-keratinizing morphology with atypical features. Ancillary studies were conducted, including a p16 immunohistochemical stain, which showed strong positivity. In addition, HPV testing by in situ hybridization was performed and confirmed positivity. Both specimens demonstrated similar histologic and molecular findings. All available data supported the presence of a distinct neoplastic process without residual diagnostic uncertainty."} +{"pid": "TCGA-3A-A9I5", "report": "The surgical specimen included the head of the pancreas, a portion of the duodenum, and a segment of the stomach. Gross examination revealed a mass measuring 3.0 x 2.5 x 1.5 cm within the pancreas, located in close proximity to the pancreatic resection margin, at a distance of 1.0 cm. The pancreatic duct was not probe-patent and appeared to be involved by the lesion. Upon sectioning, the mass appeared to involve the duodenum and common bile duct but did not extend into the attached stomach. No calculi or gross abnormalities were noted in the gallbladder, which measured 7.0 x 4.0 x 2.5 cm.\n\nMicroscopic evaluation showed a well-differentiated cellular proliferation within the main pancreatic duct with extension into side branches. In the region of the ampulla, neoplastic epithelium extended into the duodenum; however, no invasion into the duodenal wall was identified. A small focus of invasion was observed within the pancreatic duct wall. The largest focus of invasion measured 1.0 cm. All resection margins, including those of the bile duct, pancreas, stomach, and duodenum, were free of tumor involvement. A total of 13 regional lymph nodes were examined, and none showed evidence of metastasis. There was no lymphatic or venous vessel invasion identified, though perineural involvement was present. Additional findings included chronic inflammation of the pancreas.\n\nThe specimen was fully reviewed by the attending pathologist, and all relevant sections were processed and examined. No tissue from the gallbladder showed any significant pathology. Adipose tissue from multiple regions was submitted and found to be unremarkable."} +{"pid": "TCGA-EL-A3CR", "report": "The specimen consists of a total thyroidectomy with right fibroadipose and soft tissue, measuring 10.0 x 3.5 x 2.5 cm. The right lobe is firm and adherent to surrounding soft tissue, measuring 3.5 x 3.5 x 2.5 cm, while the left lobe measures 3.5 x 2.0 x 2.0 cm. On sectioning, a 3.0 x 2.5 x 2.5 cm light tan hard mass is identified within the right lobe, extending into the anterior soft tissue. The mass appears well circumscribed but shows infiltration into adjacent soft tissue and approaches both the anterior and posterior margins of resection. The isthmus appears nodular but otherwise unremarkable.\n\nLymph node dissections were submitted from right neck levels II, III, IV, and V. In level IV, four out of eight lymph nodes show involvement. In other levels, no involvement was identified: level II (0/8), level III (0/6), and level V (0/4). Lymph nodes identified in these levels ranged in size from 0.2 cm to 2.0 cm in greatest dimension. All tissue from the thyroid and lymph node levels was submitted for examination."} +{"pid": "TCGA-MQ-A6BS", "report": "The specimen consists of eleven tissue samples obtained from the right side of the body, including rib bone, pleural and diaphragmatic pleural tissue, lung nodules, lymph nodes, thoracoscopy port sites, and a segment of the azygos vein. The right rib sample includes multiple bone fragments with normal appearing marrow. The pleural tissue shows areas of adipose infiltration and multiple small firm nodules on the surface ranging from 0.2 to 1.5 cm. There is also a foreign body giant cell reaction with birefringent material noted, suggesting prior talc pleurodesis.\n\nThe diaphragmatic pleura contains similar nodular changes with involvement extending into adipose and skeletal muscle tissue. Two separate lung nodules were identified in the right lower and middle lobes. Both lesions are located subpleurally and measure 1.5 x 1 x 0.4 cm and 1.2 x 0.7 cm respectively. Both extend into the lung parenchyma but do not involve the surgical margins. Immunohistochemical staining of the lower lobe nodule demonstrates positivity for CK5/6, D2-40, and weak focal positivity for WT-1, while negative for TTF-1. No tumor involvement is identified in any of the lymph nodes sampled from levels 4, 7, and 9 on the right side.\n\nThoracoscopy port site specimens show only mild fibrosis or mild lymphohistiocytic infiltrate without evidence of tumor. The azygos vein segment appears unremarkable. All surgical margins from the lung resections are free of disease. Multiple sections were submitted for microscopic evaluation from each tissue site to ensure comprehensive sampling."} +{"pid": "TCGA-EM-A4FR", "report": "The right hemithyroidectomy specimen measured 6.8 cm \u00d7 4.4 cm \u00d7 3.6 cm and weighed 52.9 grams. A dominant lesion measuring 5.1 cm \u00d7 4.3 cm \u00d7 3.5 cm was identified within the right lobe, characterized by a cribriform architecture without morular formation. The tumor showed classical cytomorphology with no nuclear transformation of beta-catenin and intact membranous staining. Scattered leukocytic infiltration was noted on CD5 staining. The tumor was partially encapsulated with minimal capsular invasion but no lymphovascular or perineural invasion. Margins were free of involvement.\n\nA second smaller lesion measuring 0.2 cm \u00d7 0.2 cm was identified in the isthmus, showing follicular architecture with classical cytologic features. No capsular, lymphovascular, or perineural invasion was identified, and margins were uninvolved.\n\nThree perithyroidal lymph nodes were examined, all of which contained metastatic tumor. No extranodal extension was observed. No additional pathological findings were identified. The specimen was intact with fibrous adhesions noted on the external surface; no parathyroid tissue or grossly identifiable lymph nodes were present. A portion of the dominant lesion was submitted for frozen section analysis, and the remainder of the specimen was processed in multiple blocks from the superior to inferior aspects of the lobe and isthmus."} +{"pid": "TCGA-DB-A64S", "report": "The biopsies from the right frontal region of the brain consist of three specimens. The largest specimen measures 2.5 x 2.3 x 0.7 cm, while the other two are smaller, measuring 2.5 x 1.6 x 0.4 cm and 1.6 x 0.6 x 0.3 cm respectively. Smears were prepared from all specimens and submitted for analysis.\n\nMicroscopic examination reveals an infiltrative growth pattern. Cellular labeling with p53 shows moderate to high expression. The Ki67/MIB-1 labeling index is low to moderate. Fluorescence in situ hybridization (FISH) testing for 1p19q deletion has been initiated on paraffin sections and will be reported separately under genetic studies.\n\nIntraoperative cytologic evaluation of the smears indicated a low-grade glial lesion with features resembling oligodendroglial morphology. Final classification was deferred until review of permanent sections. All tissue samples have been embedded and processed for further histopathological evaluation."} +{"pid": "TCGA-E8-A415", "report": "The tumor is located on the left side and measures 1 x 0.7 x 0.7 cm. It consists of papillae with fine fibrovascular stalks and colloid follicles lined by one to several layers of cuboidal epithelial cells. The tumor demonstrates capsular invasion. There is no evidence of extrathyroidal extension. The cells maintain their polarity, with nuclei appearing regular and containing finely dispersed chromatin. Some nuclei show intranuclear grooves. The overall architecture is fibrous, and the lesion is unifocal."} +{"pid": "TCGA-19-2625", "report": "The specimen from the right frontal region was submitted in multiple parts for analysis. Intraoperative evaluation of touch imprint samples revealed a malignant tumor with extensive necrosis and cellular features consistent with a high-grade glial neoplasm. Additional specimens were processed for permanent sections.\n\nGross examination showed several tissue fragments with varying dimensions. The fresh intraoperative specimens measured 0.3 x 0.2 x 0.1 cm, 2.2 x 1.4 x 0.3 cm, and 1.8 x 1.8 x 0.2 cm. Post-fixed specimens included a larger fragment measuring 8.8 x 6.4 x 3.5 cm from the right frontal lobe, a portion of white matter measuring 3.5 x 3.5 x 1.6 cm, and another tumor fragment measuring 5.5 x 4.7 x 1.4 cm. All specimens were soft with a tan-brown to white appearance.\n\nHistologic analysis of the resected tissue demonstrated infiltrating high-grade astrocytic malignancy. Tumor cells exhibited marked pleomorphism, brisk mitotic activity, and areas of necrosis. Sections were processed and submitted across multiple cassettes for each specimen. Appropriate controls were used during testing, and all specimens were reviewed by the interpreting pathologist."} +{"pid": "TCGA-FB-AAPZ", "report": "The specimen consists of a pancreaticoduodenectomy including the duodenum, pancreas, and surrounding fat. The duodenum measures 20.5 cm in length and 4 cm in average diameter, with stapled ends and smooth serosa. Upon opening, the distal third shows dusky brown mucosa. Two separate ampullae are identified for the common bile duct and main pancreatic duct, located approximately 0.2 cm apart. Adjacent to these ampullae is a small granular red-tan lesion measuring 0.7 x 0.5 x 0.2 cm. Multiple small hemorrhages are noted in the proximal duodenal mucosa, and a blue stent protrudes through the bile duct ampulla.\n\nThe pancreas measures 10 x 6 x 4 cm. Orientation is indicated with sutures: a looped blue stitch at the portal vein groove, a long blue stitch at the superior mesenteric artery margin, and a black stitch at the deep radial margin. The entire radial margin is inked black, and the neck region was sampled for frozen section and re-inked orange. Serial sections reveal a mass measuring 3.8 x 3 x 3 cm, which is ill-defined, firm, and pale yellow-white. It abuts the black-inked margin and extends into the peripancreatic fat. The mass is 0.6 cm from the pancreatic neck margin and 0.5 cm from the ampulla. In the mid-portion, it compresses the main pancreatic duct to a diameter of 0.1 cm, while the duct remains patent through the ampulla. The common bile duct is also compressed centrally but is probe patent via a blue stent. Both ducts are dilated distally. Sections of the mass and surrounding tissue were submitted for analysis.\n\nTwelve lymph nodes were identified in the peripancreatic fat and submitted for evaluation. Microscopic assessment indicates the presence of malignant cells in one of the twelve lymph nodes. The surgical margins, including the superior mesenteric artery, portal vein groove, and deep radial areas, show no evidence of malignancy, although the tumor approaches within 0.2 cm of the portal vein groove. The overall staging is pT3 N1 Mx."} +{"pid": "TCGA-WA-A7GZ", "report": "The surgical specimen includes a 3.5 x 4.1 x 4 cm tissue sample marked with a suture, partially covered in mucous membrane, and featuring a central ulceration measuring 33 x 2 mm. The minimum distance from the ulceration to the resection margins is 12 mm ventrally, questionable dorsally, 12 mm on the right, and 8 mm on the left. Resection margins were previously assessed during rapid sectioning. Ink markers identify the orientation: ventral (blue), dorsal (black), left (yellow), right (orange), and depth (red). Tissue was sectioned from right to left across multiple lamellae. A distinct lesion measuring 2.9 x 4 x 1.2 cm is identified in lamellae 3 through 10 beneath the ulceration; it shows indistinct borders ventrally, dorsally, and into deeper soft tissue layers.\n\nMicroscopic evaluation of multiple sections reveals no tumor involvement in lamellae I and II. In lamella f, there is a mucous salivary gland with focal lymphocytic infiltration beneath squamous epithelium, some of which shows lymphofollicular changes. A dilated duct with focal ulceration and epithelial involvement is also present. Flat, cushion-like granulation tissue with prominent vascularity and signs of inflammation, possibly related to a concrement, is noted. In lamella 3, salivary gland sections show focal lymphofollicular infiltration, periductal fibrosis, lobular atrophy, and dense lymphoplasmacytic inflammation with progressive fibrosis. There is evidence of infiltration by abnormal cells into a dilated duct.\n\nIn sections d through f, abnormal cell infiltrates are present in a pattern that extends superficially with ulceration, forming both coarse and finger-like strands, accompanied by a strong desmoplastic stromal reaction. Cellular features include variable keratinous masses and pearls, moderate nuclear pleomorphism, numerous atypical mitoses, fragmented cell complexes, and individual cell separation. Perineural infiltration is observed along with invasion of salivary gland tissue, connective tissue, and a fascicular nerve branch. The maximum depth of infiltration is 8 mm. No evidence of vascular invasion is found. The closest resection margin is at least 2 mm in depth and more than 5 mm at the lateral margins.\n\nAn additional excised tissue sample measuring 0.5 x 0.3 x 0.3 cm is free of abnormal cellular infiltration and is covered by mucous membrane on one side. Microscopically, it shows regular stratified squamous epithelium overlying loose connective tissue and striated muscle without any signs of disease."} +{"pid": "TCGA-A8-A09E", "report": "The specimen consists of left-sided ablated breast tissue containing a poorly differentiated invasive component measuring approximately 55 mm. There is evidence of lymphovascular invasion with focal involvement of blood vessels. The lesion shows infiltration of the overlying epidermis with minimal paracentral erosion and extends to the basal resection margin, with involvement of the margin. The nipple, including the lactiferous sinus and adjacent glandular tissue, does not show involvement, although fibrocystic changes are present. Histological grade is high. Lymph node examination reveals one involved lymph node out of eleven examined. The lesion demonstrates extensive local spread with uncertain complete resection status."} +{"pid": "TCGA-KK-A8I8", "report": "The specimen included lymph nodes from the left obturator, left hypogastric, right obturator, and right hypogastric regions, along with the prostate and seminal vesicles. In the left obturator region, a 5.5 x 4.5 x 1.0 cm fibroadipose tissue fragment contained four possible lymph nodes ranging from 0.5 x 0.5 x 0.5 cm to 3.5 x 1.5 x 0.8 cm in size; none showed any abnormal cellular infiltration. The left hypogastric area included a 4.5 x 3.0 x 1.0 cm fibroadipose fragment with two identifiable lymph nodes measuring between 0.5 x 0.5 x 0.5 cm and 1.5 x 0.5 x 0.5 cm; no abnormal cells were identified. On the right obturator side, a 4.0 x 3.5 x 1.2 cm adipose tissue fragment contained seven possible lymph nodes ranging from 0.3 x 0.3 x 0.3 cm to 3.5 x 1.0 x 1.0 cm; all were free of any abnormal cellular presence. A larger 5.5 x 5.0 x 1.2 cm fibroadipose aggregate from the right hypogastric region revealed fourteen lymph nodes, with sizes varying from 0.1 x 0.1 x 0.1 cm to 1.1 x 1.0 x 0.5 cm; no abnormal findings were noted.\n\nThe prostate and seminal vesicle specimen measured 5.0 x 2.5 x 4.0 cm and weighed 28.0 grams post-fixation. It exhibited normal shape with increased soft tissue on the left posterolateral surface. A palpable nodule was present in the left mid and base regions of the prostate. Cross-sectioning revealed an area consistent with altered tissue on both sides of the prostate. Two distinct foci of cellular changes were identified in the peripheral zone. The dominant focus, located across multiple areas including the left lateral, left posterolateral, left posterior, mid-posterior, right posterior, right posterolateral, and right lateral regions, measured 3.8 x 1.8 cm in its largest cross-sectional dimension. It spanned two cross-sections of the prostate and extended into the apex and base. Changes extended beyond the prostate capsule on the left posterolateral surface and into the right and left superior neurovascular bundle regions. An area of involvement reached the cauterized resection margin at the right bladder neck, with a 4.0 mm length noted at the right base margin. A second, smaller focus measuring less than 0.1 x less than 0.1 cm was located in the right anterolateral and right lateral peripheral zone, limited to the first cross-section and apex. This second focus was of lower histologic grade and confined within the prostate without margin involvement.\n\nMicroscopic evaluation demonstrated features of cellular invasion into surrounding structures, including lymphovascular and perineural components. High-grade intraepithelial changes were also noted. Tissue extension was observed into extraprostatic regions, as well as into the right and left seminal vesicles and perivesicular soft tissue. All lymph nodes examined were negative for any evidence of abnormal cellular infiltration."} +{"pid": "TCGA-AO-A03U", "report": "The patient presented with a left breast mass. Core biopsy was performed for tumor markers and sentinel lymph node mapping. A right mastectomy was conducted prophylactically. The patient had a prior history of radiation therapy.\n\nSpecimens submitted included sentinel lymph nodes from levels 1 and 2 of the left axilla, non-sentinel lymph nodes from the left axilla, sentinel lymph node from the right axilla, and mastectomy specimens from both breasts.\n\nSentinel lymph node biopsies from the left axilla (level 1) showed no evidence of malignancy, with one and four lymph nodes respectively being benign. Sentinel lymph node from level 2 of the left axilla also showed one benign lymph node. Non-sentinel lymph nodes from the left axilla revealed two benign nodes. The sentinel lymph node from the right axilla was also benign.\n\nThe left breast mastectomy specimen measured 22 x 22 x 5.2 cm and included a central area nodule measuring 1.8 cm in greatest dimension. Microscopic evaluation identified a lesion with features present in both the lower quadrants and central area of the breast, as well as within 2.0 cm of the deep margin. No involvement of the nipple, surgical margins, or skin was observed. Additional findings included fibroadenomatoid changes in the surrounding tissue. No vascular invasion or calcifications were noted.\n\nThe right breast mastectomy specimen measured 21 x 20.5 x 4.5 cm and showed benign features, including fibrotic areas and focal ductal hyperplasia without atypia.\n\nImmunohistochemical staining for estrogen receptor, progesterone receptor, and HER2/neu was negative. Additional special stains and deeper recuts of the lymph node specimens were performed, and no evidence of metastatic disease was found.\n\nIntraoperative frozen section analysis of all sentinel lymph nodes and permanent histopathologic evaluation confirmed benign findings in these tissues."} +{"pid": "TCGA-A7-A0CH", "report": "The specimen includes a sentinel node from the left breast, a left breast mastectomy specimen, and another left sentinel node. Intraoperative frozen section analysis of the sentinel nodes showed benign findings.\n\nThe left breast mastectomy specimen measured 33 x 16 x 3.5 cm and included a skin ellipse measuring 20 x 11 cm with an everted nipple. No gross lesion was identified on the skin surface. A centrally located but slightly lateral mass measuring 3.3 x 3.3 x 2 cm was identified within the breast tissue. The mass was firm, tan-white, and indurated, located 1.3 cm from the deep margin. Surrounding tissue appeared unremarkable, consisting of yellow adipose and interspersed tan-white tissue without additional focal abnormalities. No lymph nodes were found within the breast specimen.\n\nHistologic evaluation of the breast tissue revealed a cellular proliferation within a mass lesion. Histologic features included a cribriform growth pattern, nuclear grading in the range of 1\u20132, and absence of central necrosis. The histologic grade overall was grade 1, based on a scoring system incorporating architectural, nuclear, and mitotic features. The tumor was negative at all margins including the nipple and deep margins. Vascular invasion was not identified. Focal calcifications were present within the lesion. Ductal carcinoma in situ was identified in very small amounts, with most of the lesion composed of invasive components.\n\nImmunohistochemical staining using keratin markers (AE1/AE3) was performed on sentinel lymph node specimens and did not show any evidence of malignant cells. Both sentinel lymph node specimens were negative for involvement by malignancy.\n\nFibrocystic changes were noted in the non-lesional breast tissue. Prior testing at an outside institution included multiple marker assessments; specific results were not detailed in this report."} +{"pid": "TCGA-E2-A10A", "report": "The surgical specimens included three sentinel lymph nodes from the left axilla, a left breast mastectomy specimen, and a fragment of right breast skin. The first sentinel lymph node measured 1.1 x 0.9 x 0.3 cm and was entirely submitted for analysis. The second sentinel lymph node, measuring 1.2 x 0.6 x 0.5 cm, was identified within a larger tissue fragment and also fully submitted. The third sentinel lymph node measured 1.2 x 0.6 x 0.4 cm and was similarly processed in entirety.\n\nThe left breast specimen weighed 676 grams and measured 22.5 x 19 x 3 cm. It included an area of firm beige-tan tissue in the upper outer quadrant that measured 3.6 x 3 x 2.2 cm and extended into the lower outer quadrant. This lesion approached the deep surgical margin at a distance of 1.3 cm. Additional smaller areas of concern were identified: one in the upper outer quadrant superior to the main lesion measuring 0.5 x 0.5 x 0.4 cm, another subareolar lesion measuring 0.6 x 0.5 x 0.5 cm, and a fourth measuring 0.5 x 0.3 x 0.3 cm near the main mass. All surgical margins were free of abnormal cellular findings. The skin and nipple were unremarkable upon examination.\n\nMicroscopic evaluation revealed multiple foci of cellular changes. Invasive features were noted in the upper and lower outer quadrants. The largest invasive focus measured 6.1 x 4.5 cm. Tubular differentiation was moderate, with nuclear grade 2 and intermediate mitotic activity (2 on modified Scarff-Bloom-Richardson scale). Necrosis was present. Ductal intraepithelial changes of cribriform and micropapillary patterns were identified adjacent to the invasive areas, comprising approximately 10% of the total lesion volume. These intraepithelial components showed intermediate nuclear grade without necrosis.\n\nImmunohistochemical staining demonstrated positivity for estrogen and progesterone receptors. The estrogen receptor expression yielded an Allred score of 7 (proportion score 4, intensity score 3), while progesterone receptor expression scored 8 (proportion score 5, intensity score 3). Molecular testing using fluorescence in situ hybridization did not show amplification of the HER-2 gene, with a HER-2/CEP17 ratio of 1.21 based on manual enumeration of at least 20 nuclei.\n\nAll three sentinel lymph nodes were devoid of any abnormal cellular infiltration. The right breast skin fragment showed no cellular abnormalities. No vascular or lymphatic invasion was identified. Additional non-specific findings included fibrocystic changes and stromal hyperplasia.\n\nPathological staging was determined as pT3 N0 based on the size and extent of the primary lesion and absence of nodal involvement."} +{"pid": "TCGA-66-2790", "report": "The examined left lung specimen was inflated and fixed, measuring 18.5 x 14.5 cm at the base and up to 23 cm in height. The central bronchus was largely skeletonized, with the resection plane located 3 cm proximal to the division into lobar bronchi. At the hilus, two lymph nodes were noted measuring 1.5 cm and 2.2 cm. The visceral pleura, especially in the upper lobe, showed patchy blackish pigmentation. In the dorsal region over segments S6 and S10, there was a whitish thickening measuring approximately 11 x 4 cm with indistinct borders. Centrally within the upper lobe, a firm lesion approximately 4 cm in size was identified, causing significant narrowing of the upper lobe bronchus and its segmental branches. The distance from the tumor to the bronchial resection line was 3 cm. In the tumor margin area, several lymph nodes were present, some of which showed signs of involvement. The distance from the tumor to the paracentral visceral pleura was less than 0.1 cm in certain areas. Bronchi distal to the tumor were slightly dilated and filled with mucus. The upper lobe parenchyma showed small areas of mild blackish pigmentation, while the lower lobe appeared unremarkable.\n\nAdditional findings included a thickened, bone-hard parietal pleura specimen on the left side measuring 3 x 2.3 cm and up to 1 cm in thickness. Lymph node stations were sampled extensively. On the left side, hilar lymph nodes (station 10) consisted of a 2.5 cm specimen containing four nodes up to 1.5 cm and one smaller node measuring 0.5 cm. A 1.2 cm node was found in the pulmonary ligament (station 9), and a 1 cm node in the low paratracheal region (station 4). The subcarinal region (station 7) contained a 1.7 cm node, and station 6 showed four nodes ranging from 0.6 to 1.5 cm. In the aortopulmonary window (station 5), two nodes measuring 0.5 cm and 0.9 cm were identified. On the right side, a 1.5 cm hilar lymph node (station 10) was present.\n\nHistological sections included the tumor with upper and lower lobe bronchi, two sections of tumor with pleura, a section with dilated, mucus-filled bronchi, and specimens from S6 and S10. Sections from involved and non-involved lymph nodes, resection margins, and additional hilar and mediastinal tissues were also examined. A total of 17 blocks were processed, with special stains including Elastica-van Gieson, PAS, diastase-PAS, and decalcification applied where necessary.\n\nMicroscopic evaluation revealed changes consistent with bronchiectasis in the upper lobe periphery, respiratory bronchiolitis, and mild centroacinar emphysema. The visceral pleura over S6 and S10 showed marked fibrous thickening and slight chronic inflammation. The parietal pleura displayed a partially calcified, hypocellular fibrotic area. Lymph nodes exhibited reactive changes and anthracotic pigment deposition. The main lesion demonstrated central endobronchial growth with a papillary component and evidence of regional lymph node involvement. The bronchial and vascular resection margins, lower lobe, and distant lymph node stations were free of tumor."} +{"pid": "TCGA-ZN-A9VO", "report": "The specimen was received fresh in eleven parts. Part A consisted of skin and soft tissue fragments (4.6 x 4.5 x 1.6 cm), with no lesions identified. Microscopic examination showed skin with underlying soft tissue and foreign body giant cell reaction, but no malignancy. Part B included rib segments (12.8 x 1.5 x 0.9 cm and 6.4 x 1.6 x 0.9 cm) with attached muscle; bone marrow showed maturing trilineage hematopoiesis and no malignancy. Part C and D were lymph nodes from Level 9 and Level 8 respectively, both negative for tumor involvement. Part G (Level 7) also contained two lymph nodes, which were negative for tumor.\n\nPart E was a right extrapleural pneumonectomy specimen weighing 750 grams, measuring 23 x 17.3 x 4 cm. The parietal pleura showed over 100 tan/white nodules up to 4 cm in diameter, with disruption and adherence to the lung apex. All parietal pleural margins were involved. The visceral pleura had over 200 surface nodules up to 1.8 cm in diameter on all lobes, with confluent involvement including the interlobar fissure. The diaphragm was extensively involved with over 100 nodules up to 10 cm in diameter on both surfaces, and all diaphragmatic margins were positive. Tumor extended into the lung parenchyma in the lower lobe, thickening intralobular septae. The bronchial resection margin was free of tumor on gross examination and frozen section, though tumor was present on the frozen section slide. The pericardium contained three full-thickness nodules up to 2.4 cm in diameter, but tumor did not reach the inner surface. Histologic sections confirmed involvement of parietal and diaphragmatic margins, tumor within the lung, and full-thickness pericardial involvement.\n\nPart F was an omental biopsy (13.5 x 12 x 0.3 cm) with scattered small nodules up to 0.3 cm; histology showed involvement by tumor in soft tissue. Part H (4R) contained two lymph nodes, one of which showed tumor involvement. Part I was a larger omental specimen (15 x 12.2 x 4.5 cm) without gross masses; histology revealed tumor involvement in fibroadipose tissue. Part J (chest wall) was a soft tissue fragment (5.1 x 2.8 x 1.4 cm) with 80% surface nodules up to 1.4 cm; tumor was present in the nodules and underlying tissue. Part K was a second port site specimen similar in composition to Part A, with no evidence of tumor.\n\nLymph node assessment included one of one diaphragmatic lymph nodes positive for tumor involvement, while both intraparenchymal lymph nodes were negative. The bronchial resection margin was positive on frozen section but not on permanent section. No lymphovascular invasion was identified. Resection margins were positive in all parietal, diaphragmatic, and visceral pleural surfaces, as well as in the chest wall and omental tissues."} +{"pid": "TCGA-E1-A7YH", "report": "Surgical Pathology: Final. CLINICAL HISTORY: Right temporal lesion with low T1 signal and no enhancement. GROSS EXAMINATION: A 5.0 x 3.0 x 2.5 cm aggregate of brain tissue was received fresh for frozen section. Representative sections were submitted as frozen section AF1, with additional representatives submitted in A2-A7. INTRAOPERATIVE CONSULTATION: Brain tissue\u2014hypercellular glial neoplasm identified. MICROSCOPIC EXAMINATION: Brain tissue shows infiltration by a hypercellular glial neoplasm with moderate cellular pleomorphism and scattered mitoses. There is no microvascular proliferation or necrosis. Areas demonstrate tumor cells with prominent perinuclear halos and perineuronal satellitosis. IMMUNOHISTOCHEMICAL FINDINGS: Ki-67 proliferation index is 3\u20134%. COMMENT: Ancillary studies including FISH and 1p/19q testing will be performed and reported separately due to the presence of occasional oligodendroglial-like features. I certify that I personally conducted the diagnostic evaluation of the above specimen(s)."} +{"pid": "TCGA-A8-A07C", "report": "The specimen demonstrates two distinct foci of neoplastic tissue. The larger focus measures 2.8 cm in diameter, and the smaller focus measures 0.8 cm. Histologic evaluation reveals poorly differentiated morphology with invasive growth patterns. Nuclear grading is classified as grade III. The tumor exhibits a multifocal distribution. No lymphovascular invasion is identified. No lymph node involvement is present."} +{"pid": "TCGA-DU-8165", "report": "A 1.5 cm lesion was identified in the left anterior temporal lobe, with cystic components and peripheral enhancement noted on imaging. The patient underwent a biopsy procedure. Histopathological evaluation of the specimen revealed a glial neoplasm with notable features including a uniform population of cells with round nuclei and frequent perinuclear halos. There was brisk mitotic activity, with a proliferation index of approximately 30% as determined by MIB-1 staining. Endothelial hyperplasia and focal microvascular proliferation were also observed, although no tumor necrosis was present.\n\nImmunohistochemical analysis showed strong p53 expression in nearly all neoplastic cells and prominent gliofibrillogenesis as demonstrated by GFAP staining. CD34 highlighted a dense microvasculature with associated vascular abnormalities. Synaptophysin and NFP stains revealed tumor nodules partially encircled by cerebral tissue containing scattered NeuN-positive neurons.\n\nMolecular testing for EGFR variant III mutation was negative. MGMT promoter methylation analysis also yielded negative results, indicating no detectable methylation. Loss of heterozygosity (LOH) testing was positive for chromosome arm 1p and showed loss of one allele at a marker on chromosome arm 19q, suggesting partial deletion at this locus. These findings were based on PCR assays using multiple informative markers, with DNA extracted from the tumor block and compared to a normal reference control from blood.\n\nThe histopathological and molecular features were assessed in the context of clinical and radiographic findings. The specimen consisted of several pale gray-tan tissue fragments measuring 12 x 9 x 3 mm in total. Intraoperative consultation noted a high-grade glial neoplasm with abnormal vessels and mitotic figures, raising considerations of astrocytic or oligodendroglial lineage, which were further evaluated with touch preparation smears."} +{"pid": "TCGA-BS-A0UM", "report": "The specimen consisted of a hysterectomy with bilateral salpingo-oophorectomy and pelvic lymph node dissection. The right ovary and fallopian tube contained a mature cystic teratoma. The uterus measured 188 grams and showed multiple intramural leiomyomas, one with symplastic changes, along with a benign stromal nodule and adenomyosis. The endometrium was atrophic and uninvolved by malignancy.\n\nA polypoid mass measuring approximately 5.0 x 4.5 cm in area and up to 2.5 cm thick was identified on the anterior surface of the endometrium. Histologic evaluation demonstrated a tumor with features consistent with a specific cellular morphology. Histologic grading according to FIGO criteria was Grade I, with nuclear grading assessed as Grade 1-2. Myometrial invasion was present, measuring 0.4 cm, which was less than half of the total myometrial thickness (1.8 cm). There was no evidence of lymphovascular invasion. The serosa and parametrium were uninvolved, and cervical involvement was not observed.\n\nEvaluation of lymph nodes included two left periaortic lymph nodes (both negative), two left pelvic lymph nodes (both negative), two right periaortic lymph nodes (both negative), and three right pelvic lymph nodes (all negative). No metastatic involvement was identified in any lymph node specimen.\n\nAdditional findings included a benign stromal nodule within the myometrium that stained positively for CD10 and smooth muscle actin. It was well-circumscribed with no cytologic atypia or mitotic figures.\n\nFrozen section analysis of the ovarian specimen showed benign findings consistent with a dermoid cyst. Frozen evaluation of the uterine specimen indicated carcinoma with possible superficial myometrial invasion measuring up to approximately 2 mm.\n\nStaging assessment indicated no nodal involvement (NO) and absence of distant metastasis (MX). Based on depth of myometrial invasion, staging would correspond to T1b."} +{"pid": "TCGA-SX-A71V", "report": "The specimen consisted of a right renal mass measuring 2.2 x 1.5 x 0.3 cm within the renal parenchyma, located approximately 0.3 cm from the inked margin. The tumor measured 1.5 cm in greatest dimension and was unifocal, located in the upper pole. Microscopic examination revealed a mixture of cellular features with a nuclear grade of 2 out of 4. No sarcomatoid features or tumor necrosis were identified. The lesion was confined to the renal parenchyma with a dense fibrous capsule. All surgical margins were negative, and there was no lymph-vascular invasion. Evaluation of nonneoplastic kidney tissue showed minimal nephrosclerosis. Pathologic staging was determined to be pT1, NX, MX. Representative sections for additional testing were identified in blocks A2 and A3."} +{"pid": "TCGA-SX-A7SU", "report": "The pathology report includes findings from lymph node evaluation and a resected kidney mass. A total of eight periaortic and parahilar lymph nodes were examined, and none showed evidence of malignancy. The left kidney specimen consisted of a 283 g mass with attached fat measuring 14 x 13 x 5 cm. Within the mass, a large dilated cystic structure measuring 8 x 8 cm was identified, lined by benign urothelium. Adjacent to this cyst were two well-circumscribed tan-yellow nodules measuring 2 x 1.5 x 1.5 cm and 2 x 2 x 1.5 cm, respectively. These appeared subcapsular without invasion into surrounding fat or through the capsule. The largest lesion measured 2.0 cm in greatest dimension and exhibited focal bulging into perinephric adipose tissue, though no definitive invasion was observed. The tumor was multifocal and confined to the renal parenchyma. Nuclear grading showed features corresponding to an intermediate grade. The surgical margin of resection was free of tumor involvement. No lymphatic or vascular invasion was identified. Sections of the cystic structure, tumor, and surrounding parenchyma were submitted for analysis. Additional testing, including immunohistochemical staining, was used to support the assessment. The laboratory performing the analysis is CLIA-certified for high-complexity testing."} +{"pid": "TCGA-FA-A7DS", "report": "The specimen consists of breast tissue containing a solid lesion located near the nipple, measuring 4 x 3 x 3.5 cm. The lesion is firm in consistency, with a gray-colored cut surface and an irregular border. Microscopically, the tissue shows infiltration by large transformed lymphoid cells arranged diffusely or in sheets, replacing the surrounding benign breast tissue. The cells are round or oval with distinct cytoplasm, enlarged and hyperchromatic nuclei, and either single or multiple nucleoli. Mitotic activity is prominent. Immunohistochemical staining demonstrates positivity for CD20, while CKAE1/AE3 and CD3 are negative. Lymph node evaluation of 9 axillary nodes reveals no evidence of metastasis. No extracapsular extension is identified. Other features such as histologic grade, Nottingham score components, and margin status could not be determined from the available information."} +{"pid": "TCGA-XF-A9T5", "report": "The specimen included a right distal ureter segment measuring 0.4 cm in length and 0.3 cm in diameter, and a left distal ureter of similar dimensions. Both were found to be non-malignant upon frozen section and final evaluation. The bladder specimen measured 23 x 15 x 5 cm and contained a large ulcerated lesion in the trigone area measuring 5 x 2.5 cm, with focal involvement of the proximal urethra. The tumor had infiltrated through the muscularis propria into superficial perivascular soft tissue but did not reach the inked margins. Flat high-grade changes were also present. The vaginal cuff mucosa and all radial and distal urethral resection margins were free of malignant cells.\n\nA total of 112 lymph nodes were examined across various regions, including perivesical, bilateral common iliac, para-aortic, para-caval, external iliac, obturator/hypogastric, and pre-sciatic lymph node groups. Metastatic involvement was identified in one of the 11 perivesical lymph nodes; all other lymph node groups showed no evidence of malignancy. The bilateral ovaries and fallopian tubes showed benign findings with no signs of malignancy. A small vaginal wall abscess was also examined and found to have no dysplastic or malignant features.\n\nThe tumor exhibited high-grade cellular features with deep invasion noted histologically. Pathologic staging was determined as pT3aN1MX. All other submitted tissues, including bilateral proximal ureters and paratubal cysts, were benign."} +{"pid": "TCGA-IQ-7632", "report": "A left neck dissection was performed involving levels 1, 2, and 3, as well as the submental triangle. A total of 2 lymph nodes were identified in level 1, all negative for malignant cells. In levels 2 and 3, 25 lymph nodes were examined, with no evidence of tumor involvement. The parotid gland showed no abnormal pathology.\n\nA composite resection of the left mandible was carried out. The specimen included fibroadipose tissue, teeth, and buccal mucosa. The largest soft tissue component measured 7.5 x 4.0 x 3.0 cm and contained four teeth. A prominent exophytic lesion measuring 5.5 x 3.5 x 4.0 cm was observed on both medial and lateral surfaces of the mandible. Histologic examination revealed changes consistent with osteonecrosis within the bone, and margins were free of tumor involvement.\n\nAdditional sections including proximal and distal mandibular fragments were evaluated, along with multiple oral cavity specimens such as anterior and posterior floor of mouth tissues, retromolar trigone, buccal mucosa (anterior and posterior), gingival buccal mucosa, lingual alveolar ridge, tongue, and pterygoid tissues. All these samples showed no signs of malignancy.\n\nBone fragments from the left mandible with surrounding soft tissue were submitted, showing osteonecrotic changes without any indication of cancerous cells. Tooth #23 was examined grossly only and appeared unremarkable aside from internal yellowing.\n\nAll surgical margins were negative, and there was no evidence of residual disease in any of the submitted specimens."} +{"pid": "TCGA-B1-A47O", "report": "The specimen consists of a unifocal lesion measuring 5.6 x 5.0 x 4.0 cm, limited to the kidney with no extension beyond its confines. Histologic evaluation reveals papillary architecture with cellular features demonstrating nuclear atypia ranging between grades 2 and 3. Areas of necrosis are present. Some regions with lower-grade nuclei and fibrohistiocytic cores were noted. Immunohistochemical staining shows strong positivity for p504s and AE1/3, with focal reactivity for CK7, CA9, and EMA. All surgical margins are free of involvement. No lymphovascular invasion is identified. A total of zero regional lymph nodes were examined. Pathologic staging is determined as pT1b with no evidence of distant spread. Adjacent non-neoplastic renal tissue exhibits interstitial inflammation and scattered sclerotic glomeruli."} +{"pid": "TCGA-UF-A7JD", "report": "The surgical specimen from the buccal mucosa contains a lesion measuring 4.1 cm in greatest dimension and 1.4 cm in depth. The lesion demonstrates ulceration and areas of necrosis. Histological evaluation reveals poorly differentiated malignant cells with evidence of lymphovascular and perineural invasion. Osseous tissue is involved by the lesion, and intense desmoplastic reaction is noted at the periphery. A minimal peritumoral lymphocytic infiltrate is observed. The deep margin is involved, while other surgical margins are free of involvement. Metastatic involvement is identified in two of seven lymph nodes from one neck dissection site, with capsular extension noted. No metastasis is found in the remaining lymph nodes examined. Salivary gland fragments show congestion but no neoplastic involvement."} +{"pid": "TCGA-XD-AAUG", "report": "A segment of pancreas measuring 9.2 x 3.5 x 2.8 cm was received along with an attached omental apron. A tumor measuring approximately 3.2 x 2.4 cm was identified within the pancreatic tissue. The tumor was located approximately 2 cm from the stapled margin and was found to focally extend into the peripancreatic fat. Extensive perineural invasion was noted, and there was focal suspicion of lymphatic space invasion. The stapled pancreatic margin containing the pancreatic duct was free of invasive carcinoma, although Pancreatic Intraepithelial Neoplasia 1B (PanIN-1B) was present at this margin. Carcinoma was also found to approach within less than 1 mm of the inked peripancreatic soft tissue margin.\n\nLymph node evaluation revealed one involved lymph node out of twelve examined. Marked dilatation of the pancreatic duct was observed, with associated Pancreatic Intraepithelial Neoplasia 2 (PanIN-2) noted. Gross examination of the spleen showed no evidence of tumor involvement. The uterus measured 6.8 x 5.7 x 4.9 cm and showed a diffusely infiltrative process involving the posterior cervical wall. A separate focus of involvement was also noted in the anterior cervix. The endometrium was atrophic with a benign polyp measuring 1.5 x 1.0 x 0.4 cm. A uterine leiomyoma with hyalinizing degeneration was present, measuring 0.6 cm in diameter. A benign serous cyst was identified in the right ovary, and a paratubal cyst was found in the left fallopian tube. No significant findings were observed in the left ovary or right fallopian tube.\n\nStaging was based on pathologic findings and indicated advanced local extension without involvement of the celiac axis or superior mesenteric artery. Based on these findings, the case was classified according to AJCC pathologic staging criteria."} +{"pid": "TCGA-AO-A12A", "report": "The right breast specimen shows a stellate, vascularized mass measuring 3.1 cm in the upper outer quadrant. The mass is located 0.2 cm from both the anterior and deep surgical margins. No involvement of the nipple, skin, or other surgical margins is identified. Within the mass, there is a component of intraductal proliferation with solid and cribriform architecture, intermediate to high nuclear grade, and minimal necrosis, comprising up to 25% of the total tumor mass and admixed with the invasive component. The surrounding non-neoplastic breast tissue demonstrates fibrocystic changes including apocrine metaplasia, microcalcifications, and columnar cell alteration without atypia. A silicone implant is present, surrounded by a fibrous, partially calcified capsule.\n\nLymph node assessment includes multiple sentinel and non-sentinel nodes from the right axilla. Initial evaluation of all lymph nodes showed benign findings. However, on further H&E sections and cytokeratin immunohistochemical stains, microscopic clusters consistent with metastatic disease were identified in one sentinel lymph node (level I, part #3), measuring less than 2 mm in size (micrometastasis). Other lymph nodes showed no evidence of metastatic involvement.\n\nAdditional excisional tissue from the superior mastectomy flap consists of benign fibroadipose and skeletal muscle tissue with no residual malignancy identified. Special immunohistochemical stains on the primary lesion show strong nuclear staining for ER (90% with moderate intensity) and PR (90% with strong intensity), while HER2/neu staining is negative (intensity of 1+).\n\nNo vascular invasion is noted. All other pathological features are unremarkable."} +{"pid": "TCGA-BH-A208", "report": "The pathology report includes 16 H&E stained slides. The specimen from a left mastectomy shows a lesion measuring approximately 6.0 cm in greatest dimension. Microscopic evaluation reveals poorly differentiated intermediate nuclear grade cells. The lesion extends to within 1 mm of the surgical resection margin. There is extensive vascular invasion, including involvement of the nipple area. Background tissue demonstrates fibrocystic changes. Evaluation of lymph nodes indicates that 3 out of 15 axillary lymph nodes show evidence of metastatic involvement, with extension beyond the lymph node capsule."} +{"pid": "TCGA-BH-A1FN", "report": "The specimen measured 8.0 by 8.0 by 3.0 cm and included a lesion measuring 2.6 by 2.6 by 2.5 cm. The tumor was identified as histologic grade 3 with poor nuclear grade. Vascular invasion was present, and tumor necrosis accounted for approximately 30% of the tumor volume. The tumor dimensions were recorded as 2.6 by 1.6 by 2.5 cm. All inked margins were free of tumor involvement. A total of twenty-nine (29) lymph nodes were retrieved from the axillary dissection, and none contained evidence of tumor involvement. No other significant findings were noted in the submitted tissue."} +{"pid": "TCGA-BT-A42B", "report": "The surgical specimen from a radical cystoprostatectomy included the urinary bladder and prostate. The tumor was located on the left lateral wall and measured up to 7.0 cm in greatest dimension. Histologic evaluation revealed high-grade urothelial carcinoma with papillary, solid/nodular, and flat configurations. The tumor extensively invaded into the detrusor muscle and extended into perivesical soft tissue. Lymphovascular invasion was extensive, and perineural invasion was also identified. Widespread tumor necrosis was present.\n\nExamination of surgical margins showed flat high-grade intraepithelial neoplasia at the left ureter margin; all other margins were negative. No invasive carcinoma was found at either ureteral margin upon final biopsy. One of six left pelvic lymph nodes contained metastatic involvement, while eight right pelvic lymph nodes were benign. The prostate showed benign prostatic hyperplasia without evidence of malignancy.\n\nStaging assessment indicated pT3b classification based on extension into perivesical fat. With one involved lymph node, the nodal stage was pN1. Distant metastasis could not be assessed (pMX). Additional findings included widespread vascular invasion and tumor necrosis."} +{"pid": "TCGA-YL-A9WY", "report": "The prostate and pelvic/obturator lymph nodes were examined following radical prostatectomy. Histologic evaluation revealed a GleASON score of 5+4=9, with 5% of pattern 4 and 95% of pattern 5 present. The tumor was located in the apex, mid, and base regions, both anteriorly and posteriorly on the right and left sides. Extra-prostatic extension was identified and was non-focal, involving the apex, mid, and base regions. Seminal vesicle invasion was also present bilaterally.\n\nSurgical margins were involved by invasive carcinoma at multiple sites including the apex, mid, and base, on both anterior and posterior aspects. The nature of the positive margins was indeterminate, and the extent was multifocal, with a millimetric extent of 15 mm. The Gleason grade at the positive margins was 5+5=10. Lymphovascular invasion was present, while perineural invasion was not reported. Approximately 70% of the prostate was involved by the lesion.\n\nIn the lymph node assessment, 10 nodes were identified on the right pelvic obturator, with 5 involved by metastatic changes. On the left pelvic obturator, 9 nodes were identified, and 6 showed evidence of metastasis. No additional pathologic findings were noted. Pathologic staging was determined as pT3b and pN1, with undetermined distant status (pMX)."} +{"pid": "TCGA-B0-5117", "report": "The specimen consists of a right nephrectomy. The neoplasm measures 4.9 cm in greatest diameter and is confined within the renal capsule without invasion of the renal vein. Angiolymphatic invasion is present. All surgical margins are free of neoplastic cells. Histologic evaluation shows nuclear features corresponding to a Fuhrman grade of 2 out of 3. The surrounding kidney demonstrates focal glomerulosclerosis and interstitial inflammation. Staging indicates PT1b NX MX."} +{"pid": "TCGA-FA-A4BB", "report": "Gross Description: Within the fatty tissue, there are multiple enlarged, soft, hyperemic lymph nodes measuring up to 3.5 cm in diameter. Microscopic examination reveals a diffuse infiltrate of large atypical cells. Immunohistochemical staining demonstrates positive reactivity for CD45 and CD20. CD3 staining is negative in the atypical cells but shows positivity in surrounding reactive cells. CD30 is positive in a subset of the atypical cell population. Pathologic evaluation indicates multifocal involvement with involvement identified in lymph nodes, including axillary and inguinal regions (5 out of 5 involved). Extranodal extension is present in the liver and spleen. No evidence of venous invasion or residual tumor at surgical margins is observed. Additional findings include absence of treatment effect and indeterminate tumor features."} +{"pid": "TCGA-AR-A0TR", "report": "Breast, left, modified radical mastectomy specimen shows a mass measuring 2.3 x 2.1 x 1.7 cm located in the superior/central aspect. Histologic evaluation reveals a Nottingham grade II lesion with ductal carcinoma in situ of intermediate nuclear grade comprising approximately 5\u201325% of the tumor volume. Angiolymphatic invasion is identified. The surrounding breast tissue demonstrates nonproliferative fibrocystic changes. No involvement of the nipple, overlying skin, or underlying chest wall is observed. Surgical margins were initially involved at the anterior/superior aspect but are now negative following re-excision, with a minimum tumor-free margin of 0.7 cm; the deep margin remains negative by 0.8 cm. A total of 22 left mid/low axillary lymph nodes are free of metastatic disease. Additionally, multiple (3) left high axillary lymph nodes show no evidence of malignancy. A single left axillary sentinel lymph node contains a metastatic deposit measuring 2.5 x 2.5 x 1.3 cm. There is no extranodal extension identified. Blue dye is not visualized within the specimen."} +{"pid": "TCGA-VF-A8AD", "report": "The surgical pathology report describes a specimen from a left radical orchiectomy. The tumor measures 1.8 cm in greatest dimension with additional dimensions of 1.7 x 1.4 cm. Microscopic evaluation shows a mixed germ cell tumor composed predominantly of one histologic type (~95%) and a smaller component of another histologic type (~5%). The tumor is unifocal and confined to the testis macroscopically, with microscopic extension into the rete testis. Lymphovascular invasion is present. The tumor does not involve the tunica albuginea, spermatic cord, or epididymis. The spermatic cord margin is free of tumor involvement.\n\nImmunohistochemical staining was performed on block 1E. The primary histologic component shows positivity for OCT4, SALL4, and CD30. The minor component demonstrates positivity for SALL4 and AFP. These findings support the morphologic assessment.\n\nStaging classification is pT2: tumor limited to the testis and epididymis with lymphovascular invasion. Regional lymph node staging (pN) is not assessable (pNX). Distant metastasis (pM) is not applicable. Serum tumor marker status is unknown. No other pathologic findings are identified.\n\nGrossly, the specimen includes a testis measuring 5.7 x 5.7 x 3.1 cm with attached spermatic cord measuring 9.2 cm in length and 2.5 cm in greatest diameter. A firm, multinodular, tan-brown nodule with areas of hemorrhage is present within the testis. The nodule measures 1.8 x 1.7 x 1.4 cm and is located in the testicular region. The testis contains 5 cc of serous fluid upon opening. No other gross lesions are observed. Seven representative tissue blocks were submitted for analysis, including sections from the spermatic cord margins, midportion, base, mass relation to hilar structures, and other sections of the mass and testis.\n\nThe patient is a male with imaging findings of a heterogeneous solid peripheral enhancing mass in the left testicle and an additional small lesion in the lower left testis. Pre-operative and post-operative diagnoses are not specified. No specific questions were provided for the pathologist to address."} +{"pid": "TCGA-XM-A8RG", "report": "The specimen submitted for analysis consists of a portion of tissue labeled as thymus, weighing 30.5 grams and measuring 9.0 x 4.5 x 2.5 cm. It has a tan-pink coloration and rubbery consistency with attached adipose tissue. The thymus itself measures 2.0 x 1.5 x 1.5 cm and was inked purple before being serially sectioned. A distinct nodule measuring 4.0 x 3.0 x 2.1 cm is identified within the specimen; it is tan-white in color and homogenous in texture.\n\nMicroscopic evaluation reveals neoplastic cells arranged in a characteristic pattern. Immunohistochemical staining demonstrates diffuse positivity for pan-cytokeratin AE1/AE3. Scattered lymphocytes positive for Tdt are present, and CD1a staining highlights dendritic cells.\n\nEvaluation of the surgical margins shows no evidence of tumor involvement. There is no observed invasion into surrounding structures such as the capsule or lymphovascular spaces. All representative sections were examined and findings were consistent across frozen section control and permanent sections."} +{"pid": "TCGA-WX-AA47", "report": "The liver specimen weighed 1300 grams and measured 18 x 15 x 8 cm. A multinodular mass measuring 17.3 x 14 x 8.5 cm was identified, with the largest nodule measuring 7 cm and smaller satellite nodules ranging from 0.1 to 1 cm. The tumor was well-circumscribed, heterogenous in appearance, and showed areas of hemorrhage, necrosis, and scarring. It was located near the serosal surface and was 1.2 cm from the closest resection margin. Minimal surrounding liver tissue was present.\n\nMicroscopic examination revealed a neoplasm largely replacing the liver with a heterogeneous histologic pattern. The tumor showed thickened cords of atypical hepatocytes with mitotic activity and areas resembling classical trabecular architecture. There were also regions with pseudoglandular structures, diffuse intracytoplasmic vacuolar inclusions mimicking signet ring morphology, steatotic changes, bile cytoplasmic inclusions, and Mallory hyaline. Some peripheral nodules contained benign hepatocytes arranged in a pattern similar to focal nodular hyperplasia with ductular proliferation along fibrous septa. In one area, a distinct focus of malignant cells was identified.\n\nMultifocal venous invasion was observed involving both large and small vessels, including one nodule adhering to the endothelium. The tumor extended into the liver capsule and had organizing fibrous adhesions to smooth muscle of the gastric wall, although no tumor was found in these adhesions or in the gastric wall itself. The resection margin was free of invasive tumor, with the closest distance of tumor to the margin being 7 mm. No lymph nodes were assessed.\n\nImmunohistochemical staining showed variable expression across different tumor regions. Amyloid A was expressed in steatotic hepatocyte areas but not in regions resembling focal nodular hyperplasia. Glutamine synthetase demonstrated geographic staining in adenoma-like areas and strong diffuse staining in trabecular regions. HSP-70 was focally positive in trabecular areas, while glypican-3 was negative throughout.\n\nThe non-neoplastic liver showed preserved architecture with mild portal inflammation and patchy portal fibrosis. Marked sinusoidal dilatation and congestion were noted, without significant steatosis, inflammation, or iron deposition. Hepatitis B antigens were not detected.\n\nStaging indicated involvement of a major branch of the portal vein, with no regional lymph node assessment possible. The tumor stage was classified as pT3A and the overall pathologic stage as IIIA."} +{"pid": "TCGA-Q1-A5R1", "report": "The specimen consisted of a radical hysterectomy with cervix, parametria, and vaginal cuff. A mass was identified on the posterior surface of the exocervix, measuring 1.3 x 0.6 x 0.5 cm. It was located in the left inferior and right inferior quadrants (3\u20139 o\u2019clock positions), invading to a depth of 0.8 cm and measuring 6 mm at its thickest point. The maximal cervical wall thickness was 15 mm. The tumor was 9 mm away from the deep posterior cervical margin of resection, with no involvement of surgical margins. There was no evidence of lymphovascular space invasion.\n\nThe endometrium showed disordered proliferative changes without malignancy. The myometrium exhibited focal hyalinization and was otherwise unremarkable. Parametrial tissues bilaterally were composed of benign fibroadipose tissue. No malignant cells were identified in the vaginal cuff.\n\nLymph node evaluation included pelvic and para-aortic regions. On the left pelvic side, six lymph nodes were examined and found benign. On the right pelvic side, nine lymph nodes were assessed, all benign. Right para-aortic dissection revealed two benign lymph nodes, and one benign lymph node was identified on the left para-aortic side.\n\nGross examination of the uterus showed no significant abnormalities apart from the cervical lesion. The myometrium measured 2.1 cm in thickness. The serosal surface was glistening with an adhesion noted posteriorly.\n\nHistologically, the lesion was moderately differentiated. Additional findings included glandular intraepithelial neoplasia of the cervix.\n\nPathologic staging according to TNM classification was pT1b1 (IB1), indicating a clinically visible lesion less than 4 cm in greatest dimension. There was no regional lymph node involvement (pN0) and no distant metastasis identified."} +{"pid": "TCGA-BA-4076", "report": "Two biopsy specimens were received in the laboratory, each appropriately labeled. Specimen A was obtained from the posterior right false vocal cord and measured 0.3 x 0.3 x 0.2 cm. It consisted of a pink-tan, irregularly shaped soft tissue fragment. Microscopic evaluation revealed at least focal in situ changes with features suspicious for invasion; however, no definitive invasive component was identified upon examination of initial and deeper recut levels.\n\nSpecimen B was taken from the left arytenoid and measured 0.6 x 0.4 x 0.3 cm. This sample also consisted of a pink-tan, irregularly shaped soft tissue fragment. Histologic analysis demonstrated in situ changes with associated severe chronic inflammatory infiltrate. No evidence of invasion was observed in this specimen. Both specimens showed similar findings on deeper sectioning."} +{"pid": "TCGA-BG-A0VX", "report": "The specimen was obtained from a postmenopausal patient who underwent total abdominal hysterectomy and bilateral salpingo-oophorectomy. The uterine endometrial lesion measured 3.5 cm in maximum dimension and involved 40% of the anterior and posterior endomyometrium. Histologic evaluation showed well-differentiated epithelial neoplasm with combined architectural and nuclear grading, corresponding to low-grade features. The depth of myoinvasion was limited to less than half the thickness of the myometrium. No angiolymphatic invasion was identified. Adjacent endometrial tissue demonstrated complex hyperplasia with atypia. Co-existing adenomyosis was also noted. No lymph nodes were retrieved or examined. Pathologic staging was determined as pT1b with pNX and pMX for nodal and metastatic status, respectively. Clinical staging was IB."} +{"pid": "TCGA-EB-A5UM", "report": "The specimen consists of a skin flap containing a pigmented lesion measuring up to 1.8 cm in greatest dimension with a thickness of 5 mm. The lesion is ulcerated and arises from the skin of the trunk. Histologically, it demonstrates malignant features with a Breslow thickness of 5 mm. There is no evidence of venous invasion and margins are uninvolved. No satellite nodules are identified. The lesion shows no signs of regression or treatment effect. No lymph nodes or additional tissues are submitted for evaluation."} +{"pid": "TCGA-AX-A063", "report": "The specimen from a female patient was received following total abdominal hysterectomy with bilateral salpingo-oophorectomy and staging procedures. The uterus weighed 192 grams and measured 9.5 x 6.5 x 6 cm. The right ovary measured 2 x 1 x 1 cm and contained a 1 cm cyst; the left ovary was not grossly identified. Both fallopian tubes measured 4.5 x 0.6 x 0.5 cm. Two polypoid masses were identified in the endometrium: one on the anterior surface measuring 3.5 x 0.8 x 0.5 cm and another on the posterior surface measuring 3 x 3 x 2 cm. No involvement of the lower uterine segment was observed.\n\nAn intramural nodule measuring 5 x 4.5 x 3.5 cm was noted on the anterior uterus, and a cervical nodule measuring 3 x 2.5 x 1.5 cm was also present. Microscopic evaluation confirmed invasion into the luminal one-third of the myometrium to a depth of 3 mm, with a total myometrial thickness of 20 mm. No involvement of the endocervix or lymphovascular space invasion was observed.\n\nLymph node dissection included right and left external iliac, obturator, and periaortic regions. A total of 22 lymph nodes were examined and none showed evidence of malignancy. Additional findings included adenomyosis, leiomyomas, serosal endometriosis, tubal and uterine serosal adhesions, and endometriosis involving the ovaries and fallopian tubes.\n\nThe tumor exhibited a solid growth pattern involving 6 to 50% of the tissue (Grade 2/3). Based on these findings, the tumor was classified as T1b/N0/M0 according to the TNM system, corresponding to Stage IB. This staging is provisional and may be revised with additional clinical data."} +{"pid": "TCGA-85-A5B5", "report": "The specimen consists of a pneumonectomy sample. In the upper lobe bronchus, there is an irregular, fibrous mass that narrows the bronchial lumen. The mass measures 3 x 2.5 x 2.5 cm. A total of nine black bronchopulmonary lymph nodes and five hilar lymph nodes were identified, ranging in size from 0.3 to 1 cm. A separate surgical margin was also present.\n\nMicroscopic examination reveals poorly differentiated cells with high-grade features. The surgical margin and surrounding vessels show no involvement. All lymph nodes examined, including bronchopulmonary and hilar groups, are negative for metastatic disease. There is no evidence of venous invasion. The tumor appears localized without signs of vascular or lymphatic spread. No treatment-related changes are identified. Additional findings are not specified. The specimen originates from the right upper lobe."} +{"pid": "TCGA-WB-A80V", "report": "The left adrenal gland specimen measured 11x10x3 cm and weighed 131 grams after formalin fixation. The lesion had been previously sectioned, and on cut surface, a 7 cm light brown mass was identified with a friable tissue appearance. Adjacent to the lesion, normal adrenal cortex was observed. The integrity of the surrounding capsule could not be definitively assessed due to prior sectioning.\n\nMicroscopic examination showed a well-defined encapsulated lesion within otherwise normal adrenal tissue. The tumor cells were enlarged and arranged in a sheet-like pattern. The cytoplasm was granular and eosinophilic, with distinct and prominent nucleoli. The stroma between tumor cell nests contained numerous blood-filled spaces. A fibrous capsule surrounded the tumor, and there was no evidence of vascular invasion. Due to the prior cutting of the specimen, assessment of extra-adrenal extension could not be determined with certainty."} +{"pid": "TCGA-DU-7290", "report": "The specimen consists of fragments of cerebral cortex and underlying white matter from the right temporal lobe. Histologic examination reveals multiple focal and diffuse infiltrates composed of small neoplastic cells with minimal differentiation. These cells are observed surrounding individual neurons and, in some areas, demonstrate mild cytoplasmic features reminiscent of astrocytes. Perivascular nests of neoplastic cells are also present. No areas of coagulative necrosis or atypical mitotic figures are identified. Immunohistochemical studies show that approximately 20% of the neoplastic cells express GFAP, while markers for lymphocytes, epithelial cells, and neuronal elements are negative. Proliferative activity, as assessed by MIB-1 staining, demonstrates an average labeling index of approximately 10%. Ultrastructural evaluation supports the presence of neoplastic cells with features consistent with astrocytic origin. The overall findings support a pattern of diffuse infiltration by an undifferentiated neoplasm with anaplastic characteristics. All remaining tissue fragments were submitted for analysis, and the total weight of the specimen was approximately 5.0 grams."} +{"pid": "TCGA-B5-A1N2", "report": "A lymph node measuring 3 x 1.5 x 0.3 cm was examined microscopically and found to contain metastatic carcinoma. The metastasis measured at least 0.6 cm and showed focal extracapsular extension.\n\nThe uterus weighed 390 grams and measured 14.5 x 2 x 7.5 cm. The cervix measured 2.2 cm in diameter with a patent os. Multiple subserosal nodules were identified on the serosa, ranging from 0.3 to 3.6 cm in greatest dimension. A pedunculated nodule measuring 1.1 x 0.9 x 0.3 cm was present on the serosal surface. The serosa was inked black. A small cyst measuring 0.5 x 0.3 x 0.2 cm was observed in the anterior endocervical canal, located 1.3 cm from the ectocervix; the surrounding cervical tissue was inked blue.\n\nWithin the endometrial cavity, an area of irregularity measuring 10.2 x 8.5 cm was centered in the fundus and extended into both uterine cornua. This lesion overlaid a large submucosal calcified mass measuring 6.2 x 8.5 x 4.5 cm with a whorled appearance. The lesion extended to within 4.7 cm of the anterior ectocervix. On cross-section, the endometrium measured 0.2 cm thick and the myometrium measured 1.6 cm thick. The lesion invaded into the inner third of the myometrium.\n\nAdjacent to the right cornu, a 3.8 x 2.2 x 2.8 cm endometrial polyp was identified, located 0.5 cm from the primary lesion. Further examination revealed three intramural nodules with whorled appearances, ranging from 0.5 to 1.4 cm in size. A calcified submucosal nodule measuring 1.1 x 0.9 x 0.7 cm was noted in the posterior segment of the uterus.\n\nThe right fallopian tube was 8.5 cm long and 0.6 cm in diameter without identifiable masses. The right ovary measured 3.5 x 2.4 x 1.3 cm and contained a 1.5 x 1.1 x 0.9 cm simple cyst with a yellow lobulated cut surface and no excrescences. The left fallopian tube measured 8.3 cm in length and 0.8 cm in diameter with no lesions observed. The left ovary was smaller at 3 x 1.6 x 0.5 cm, with a yellow-tan lobulated cut surface and no visible masses.\n\nMicroscopic evaluation confirmed involvement of the right ovary by tumor cells within the ovarian stroma. The cervix showed tumor involvement of the endocervical mucosa but not the cervical stroma. Both fallopian tubes appeared unremarkable. No tumor involvement was seen in the left ovary.\n\nExtensive lymphatic and vascular invasion was noted. The maximum depth of tumor invasion into the myometrium was approximately 2 mm within a 1.6 cm thick wall. Tumor cells were extensively present in the outer half of the myometrium but remained within vascular spaces at that level. The tumor margins were free of involvement.\n\nAdditional findings included adenomyosis of the myometrium, multiple benign leiomyomas (up to 6.2 cm), and benign Brenner tumors in both ovaries (each measuring 0.9 cm).\n\nBased on AJCC 7th Edition staging criteria, the tumor stage was determined as pT3a, pN1, and pMX. Specimen margins were not involved. The pathology report was certified by the examining pathologist who personally evaluated all specimens."} +{"pid": "TCGA-V4-A9ED", "report": "Left eye enucleation specimen. The eyeball measures 27 mm along the main axis, with a posterior optic nerve segment measuring 7 mm. Upon sectioning, a lesion measuring 12 mm along its greatest dimension is identified. Multiple samples have been collected for cryopreservation and cytogenetic analysis. Histopathological examination reveals that the optic nerve, along its entire course including the cut margin and extending through the optic foramen, is free of involvement. The lesion is located within the ciliary processes and consists predominantly of spindle-shaped cells arranged in short, fascicular bundles, separated by fibrovascular septa. Cellular atypia is moderate, with ovoid nuclei and small nucleoli. Occasional mitotic figures are observed. Some cells contain pigment. No lymphovascular invasion is identified. The lesion extends through the choroid but does not involve the sclera. The anterior chamber remains unaffected."} +{"pid": "TCGA-63-A5MG", "report": "The sample was obtained from the left lower lobe via resection. The tumor measured 3.5 cm in size. Histological analysis revealed a moderately differentiated squamous cell carcinoma. Pathological staging indicated T2, NOS for the primary tumor classification. Lymph node involvement was not specified, and clinical metastasis staging was recorded as MO. Additional samples, including buffy coat, were collected on separate dates related to the procedure and diagnosis timeline."} +{"pid": "TCGA-EL-A3ZM", "report": "A surgical case involving a total thyroidectomy and right neck dissection was performed. A mass measuring 5.7 cm in greatest dimension was identified in the right lobe and isthmus of the thyroid. The mass extended into adjacent soft tissue and skeletal muscle, indicating extrathyroidal spread. The tumor had a firm, tan appearance and involved the perithyroidal adipose tissue both anteriorly and posteriorly. The superior portion of the tumor showed a dark brown hemorrhagic edge infiltrating into adipose tissue, while the anterior soft tissue margin was free of tumor. However, the resection margins were positive.\n\nThe remaining thyroid tissue appeared unremarkable except for a cystic colloid-filled nodule in the left lobe measuring 6.1 cm in diameter. No multi-focal disease was identified. Twenty-three possible lymph nodes were identified in the right neck dissection specimen. Histologic evaluation revealed metastatic involvement in 7 out of 26 lymph nodes examined, all located in the right neck. No extracapsular extension was observed.\n\nMicroscopic examination did not show lymphovascular invasion. Sections of the tumor were submitted for analysis, including areas involving muscle, fat, and posterior tissue edge. Additional specimens included a right facial lymph node (measuring 0.8 cm), which showed no evidence of tumor, and a fragment from the post-tracheal wall (2.8 x 2.0 x 1.5 cm), which was rubbery and firm with a mahogany-brown, glistening cut surface. Adipose tissue and strap muscles were also part of the resected specimen. Orientation of the specimen was marked with black ink at the right posterior edge. Multiple cassettes were used to submit representative sections of the tumor, surrounding tissues, and lymph nodes for further evaluation."} +{"pid": "TCGA-A2-A4S2", "report": "The surgical specimen includes a right breast and right axillary contents. The mastectomy specimen weighs 416 grams and measures 28.5 cm from medial to lateral, 26.5 cm from superior to inferior, and up to 6 cm anterior to posterior. The nipple is flat with an areola measuring 6 cm in diameter. Two small ulcerations are present: one measuring 0.3 cm located 6 cm from the nipple in the upper outer quadrant, and another measuring 0.5 cm at the lateral skin margin, approximately 16 cm from the nipple. A palpable mass is identified at the 12 o\u2019clock position, marked for orientation. The deep margin is greater than 1 cm from the mass, and the closest tumor focus to the deep margin is 4 mm away. The mass measures 5.8 cm in greatest dimension and exhibits a firm, gray-tan appearance with central red-brown discoloration. A coil clip is present within the lesion. Multiple sections were submitted for analysis, including margins, quadrants, and surrounding tissue.\n\nAxillary content consists of fatty tissue measuring 10 x 7.5 x 1.5 cm, containing 8 nodal structures. Four of these measure less than 0.5 cm and were submitted together. One larger node shows gross involvement, with tumor extending into perinodal soft tissue; this node measures 1.1 cm microscopically. Three additional large nodes are submitted separately, and a fragment of muscle is also included. No biopsy clip is identified in the axillary specimen.\n\nHistologic evaluation reveals a mixture of intralobular and infiltrating features with signet-ring cell differentiation, nuclear grade 2/3, and low mitotic activity. A separate area of classic intraductal proliferation with nuclear grade 1 is present, comprising approximately 5% of the lesion. Lymphovascular invasion is noted. Margins of resection, including the nipple skin and surrounding quadrants, show no evidence of involvement, with the closest tumor focus 4 mm from the deep margin. Fibrocystic changes, including sclerosing adenosis, microcyst formation, and dense stroma, are present. Calcifications are observed both within the lesion and in adjacent benign areas. An intraductal papilloma with sclerosis is identified, along with biopsy-related changes.\n\nIn the axilla, four of six lymph nodes contain metastatic cells, with the largest deposit measuring 1.1 cm. Tumor extends into the extranodal soft tissue surrounding the largest involved node. No skeletal muscle involvement is seen. Additional sections from the lateral aspect of the breast include a clip site and surrounding indurated area consistent with prior intervention. Several additional small nodal structures are submitted for review."} +{"pid": "TCGA-VS-A94Z", "report": "The biopsy specimen was obtained from the cervix. Histologic evaluation reveals a moderately differentiated squamous cell carcinoma that is invasive. The tumor measures approximately 1 cm in greatest dimension. Microscopic examination shows nests and islands of malignant cells with moderate nuclear pleomorphism, hyperchromasia, and increased mitotic activity. Stromal invasion is present, with involvement of the underlying connective tissue. No lymphovascular space invasion is identified. The surgical margins are free of neoplastic cells."} +{"pid": "TCGA-CN-4731", "report": "The specimen was received in 11 parts. Part 1 consisted of a midline maxillary gingival biopsy with no tumor present. Part 2, a lower lip biopsy, showed malignant features. Part 3, a biopsy from the left oral commissure, showed no tumor. Part 4, a biopsy of the left inferior alveolar nerve, and Part 5, a biopsy of the left lingual nerve, both showed no tumor involvement. Part 6, a biopsy of the left retromolar trigone, also showed no tumor.\n\nPart 7 was a composite resection involving the mandible, lower lip, and skin. The tumor measured 8.5 cm in greatest dimension and involved extensive bone and facial skin. Perineural invasion was noted, including involvement of a large nerve. Angiolymphatic invasion was also present. Margins at the left mandible bone and adjacent deep soft tissue were involved by tumor. Microscopic evaluation of the floor of mouth mucosal margin showed severe dysplasia. Lymph node analysis from the left level 1 region showed metastatic involvement in two out of four lymph nodes, with microscopic extracapsular spread identified. The submandibular gland showed no significant abnormalities.\n\nParts 8 through 11 included lymph node dissections from various neck levels. No tumor involvement was found in lymph nodes from left neck levels 2\u20134 (16 nodes), right neck level 4 (7 nodes), right neck level 2B (5 nodes), or in levels 2\u20134 on the right side. However, in right neck level 1, one of three lymph nodes showed tumor involvement without extracapsular extension.\n\nGross examination of the composite resection revealed an ulcerated skin area measuring 4.0 x 1.5 cm, located 0.2 cm below the lip\u2019s vermillion border. The tumor extended into the floor of the mouth in a U-shaped pattern above the mandible, measuring 11.5 cm in length and 2.4 cm in width. Bone margins appeared free of tumor involvement. The tumor replaced mandibular bone from midline to within 2 cm of the left bone margin and extended into superficial soft tissues less than 1 mm from the proximal edge of the left lateral soft tissue. Seven potential lymph nodes were identified in the left level 1 region, ranging from 1.2 to 0.3 cm in size. The submandibular gland appeared unremarkable on gross inspection.\n\nMicroscopic findings confirmed the presence of invasive cellular growth with poor differentiation. Tumor involvement was noted at multiple margins, including the left mandible bone and adjacent deep soft tissue. Venous and lymphatic invasion were identified, as well as perineural invasion. Carcinoma in situ and epithelial dysplasia were also observed.\n\nImmunohistochemical and molecular studies were performed. Stains for p16 were negative. In situ hybridization for HPV was also negative. EGFR FISH studies showed no gene amplification. Of 75 cells analyzed, 37.3% showed low polysomy, 2.7% showed trisomy, and 60% showed disomy. c-MET FISH studies were also negative for amplification. Of 73 cells analyzed, 96% showed disomy, and 4.1% showed trisomy. No high polysomy was detected for either marker.\n\nA total of 52 regional lymph nodes were examined, with 3 showing involvement. Extracapsular extension was present in some nodes. Pathologic staging was determined as pT4a and pN2c."} +{"pid": "TCGA-27-1831", "report": "Birth date. Tumor site: right temporal parietal region. Histological examination reveals a highly cellular lesion with marked nuclear atypia and frequent mitotic figures. The tissue shows areas of necrosis and microvascular proliferation. Immunohistochemical staining demonstrates positivity for GFAP and MGMT. The Ki-67 proliferation index is elevated, consistent with high-grade morphology. No definitive molecular markers are included in this report. Based on histological features and anatomical extent, the lesion is classified as advanced stage."} +{"pid": "TCGA-15-1447", "report": "The specimen from the bifrontal brain excision demonstrates a cellular neoplasm extensively involving the leptomeninges and dura. The lesion measures 4.3 x 3.9 x 2.8 cm. Histologic evaluation of biopsies from the right frontal lobe reveals similar involvement by a high-grade cellular process. A biopsy of the left frontal cyst wall also shows comparable findings, while a separate biopsy from the left frontal lobe demonstrates benign brain parenchyma with scattered isolated atypical cells present.\n\nExamination of the frontal sinus excision specimen shows respiratory mucosa with mild chronic inflammatory changes and no evidence of neoplastic involvement. Additional biopsies from the right ethmoid, left anterior ethmoid, and left posterior ethmoid sinuses all demonstrate respiratory mucosa with chronic inflammatory changes and no signs of tumor.\n\nImmunohistochemical analysis shows that the abnormal cells are positive for GFAP and S-100 protein. Staining for neurofilament and synaptophysin is negative within these cells. Cytokeratin markers (CAM 5.2, AE1/AE3) and chromogranin do not highlight the neoplastic population. Parenchymal elements are accentuated by the immunostains, supporting the pattern of infiltration."} +{"pid": "TCGA-KS-A4IC", "report": "The specimen consists of a total thyroidectomy with a right lobe measuring 4.3 cm x 2.5 cm x 1.1 cm, a left lobe measuring 4.2 cm x 2.0 cm x 1.5 cm, and an isthmus measuring 1.2 cm wide x 1.7 cm tall x 1.0 cm deep. A centrally located encapsulated cystic nodule measuring 1.1 x 1.1 x 1.0 cm was identified in the left lobe, with focal calcifications and a granular internal appearance; no involvement of the peripheral margin is observed. A second small smooth tan nodule measuring 0.3 cm was noted on the superior aspect of the isthmus. The specimen includes multiple tissue blocks submitted for analysis, including sections from both lobes and the isthmus, as well as central neck contents.\n\nEvaluation of the primary lesion shows no evidence of capsular or vascular invasion, and surgical margins are negative. In the central neck dissection, three lymph nodes were examined, two of which contained malignant cells with focal extranodal extension. One additional lymph node from the isthmus was negative for malignancy. The remaining lymph node count from the central compartment totals four, with two positive nodes identified. No extrathyroidal extension was observed. All histologic evaluation was performed by the signing pathologist."} +{"pid": "TCGA-AK-3429", "report": "The specimen was received in three parts. The first part, labeled as a para-aortic lymph node, consisted of three small pinkish-red nodules measuring 0.7 cm, 0.9 cm, and 1.4 cm, all submitted for analysis. No evidence of involvement was identified in these sections.\n\nThe second part consisted of a right kidney along with a para-aortic lymph node. The kidney weighed 200 grams and measured 12.5 x 7 x 5 cm. A yellowish-orange soft lesion was identified within the middle and superior aspects of the kidney, measuring 7.5 x 6 x 5 cm. This lesion appeared to abut the renal capsule but did not extend through it. The tumor replaced the superior calyx, while the middle and inferior calyces, as well as the renal pelvis, were unaffected. No masses, lesions, or nodes were found in the perirenal fat, which extended up to 3 cm from the attachment point. The ureter was present, measuring 8 x 0.4 cm, and no suspicious findings were noted upon examination. Vascular margins were also free of involvement. Sections were taken from the tumor, surrounding normal kidney tissue, the ureter, and surrounding fat for further evaluation.\n\nThe third component was labeled as an additional para-aortic lymph node, consisting of two rubbery, pinkish-red nodes measuring 1.7 x 0.9 x 0.6 cm and 2.3 x 1 x 0.6 cm. These were also submitted in entirety and showed no signs of involvement.\n\nAll lymph node specimens across both excision and nephrectomy specimens were negative for metastatic disease. The primary lesion was confined to the kidney, with no vascular or ureteral margin involvement. Tissue processing included multiple representative sections from the tumor, adjacent normal tissue, and surrounding structures. The staging classification indicates localized disease without nodal spread."} +{"pid": "TCGA-S9-A6UA", "report": "The neuropathology evaluation demonstrates histologic and morphologic features consistent with a high-grade glial neoplasm. Microscopic examination reveals moderately cellular tumor tissue composed of pleomorphic astrocytic cells with irregular nuclear contours and frequent mitotic figures. The lesion exhibits infiltrative growth patterns and moderate nuclear atypia. Based on histopathologic assessment, the tumor is classified as WHO grade III."} +{"pid": "TCGA-78-7161", "report": "The surgical specimen from the left upper lobe of the lung consists of a resected lobe measuring 132 x 85 x 70 mm and weighing 381 grams. A prominent lesion is present within the parenchyma, characterized macroscopically by a relatively well-defined cream-colored nodule with areas of necrosis measuring up to 57 mm in diameter. This nodule merges with an ill-defined firm cream to tan area, bringing the total extent of the lesion to 91 mm. The lesion invades the visceral pleura and is adherent to a strip of parietal pleura measuring 127 x 52 mm. The discrete portion of the lesion is located 31 mm from the bronchial resection margin, while the ill-defined extension is only 5 mm from this margin and reaches the hilar resection margin. Lung tissue distal to the lesion exhibits a speckled yellow appearance. Minimal uninvolved lung tissue away from the lesion appears histologically unremarkable.\n\nAdditional specimens include lymph nodes from stations 5, 10, and another set from station 10. Specimen 2 (station 5) includes two nodal tissues measuring 15 x 11 x 12 mm and 12 x 6 x 4 mm. Specimen 3 (station 10) consists of one piece measuring 15 x 14 x 10 mm. Specimen 4 includes two pieces measuring 14 x 6 x 6 mm and 7 x 5 x 2 mm. No metastatic involvement is identified in any of these lymph nodes.\n\nHistologically, the lesion demonstrates a mixture of acinar and papillary growth patterns with smaller components of other morphologic features. Necrosis is extensive. The tumor measures 91 mm in maximum dimension. There is evidence of focal involvement of the hilar soft tissue margin and invasion of both visceral and parietal pleura. No vascular or perineural invasion is observed. All lymph nodes examined are negative for metastasis.\n\nMargins assessment reveals invasive carcinoma at least 4 mm clear from the bronchial margin but with focal extension to the hilar soft tissue margin. No residual tumor is identified at most margins, although the presence of tumor at the hilar margin results in an R1 status. Adjacent non-neoplastic lung tissue shows findings consistent with lipoid pneumonia and pulmonary edema near the lesion. Moderate emphysematous changes are noted, along with focal eccentric intimal thickening of blood vessels."} +{"pid": "TCGA-E2-A106", "report": "The surgical specimens included three sentinel lymph nodes from the right axilla, a right breast mastectomy specimen, right axillary contents (levels 1\u20132), additional right breast tissue, and an additional inferior margin. Sentinel lymph node #1 measured 0.8 x 0.7 x 0.2 cm and was entirely submitted for analysis. Sentinel lymph node #2 measured 1 x 0.6 x 0.4 cm and was submitted in one cassette. Sentinel lymph node #3 was a 3.2 x 1.5 x 0.3 cm piece of soft tissue with a small possible lymph node measuring 0.1 cm.\n\nThe right breast mastectomy specimen weighed 205 g and measured 15 x 13 x 4.5 cm. A central skin ellipse measured 4.5 x 3 cm, and the nipple was everted. Sectioning of the breast revealed a dominant granular tan mass in the mid to upper inner quadrant measuring 4.5 x 2.7 x 1.5 cm. This lesion was located 1 cm from the deep margin and extended to the anterior/superior margin. A second area of interest measured 1 x 0.8 x 0.7 cm and was located 2 cm inferior to the first lesion. A possible biopsy site was identified in the upper outer quadrant, 1.5 cm lateral to the main lesion and 2.7 cm from the deep margin. Multiple sections were taken from all areas of interest, including margins, connecting tissue, and surrounding regions.\n\nAxillary dissection included multiple tissue fragments aggregating to 5 x 3 x 2 cm. Seventeen possible lymph nodes were identified, ranging in size from 0.2 x 0.2 x 0.2 cm to 2.0 x 2.0 x 1.5 cm. All lymph nodes were submitted for histological evaluation. Additional right breast tissue (5 x 4 x 2 cm) and an inferior margin specimen (11 x 5 x 1.5 cm) were also submitted and found to be unremarkable on gross examination.\n\nImmunohistochemical staining with cytokeratin AE1/3 was performed. In one sentinel lymph node, two small foci consistent with micrometastatic involvement were identified, each less than 1 mm in size. Scattered cytokeratin-positive cells were also noted in the parenchyma. The other two sentinel lymph nodes showed no evidence of involvement. In the axillary dissection, 13 lymph nodes were examined and none showed evidence of tumor.\n\nIn the mastectomy specimen, histology demonstrated multifocal disease. A dominant invasive component measured 1.2 cm in greatest dimension and was located in the upper inner quadrant, within 1 mm of the anterior margin. Extensive ductal carcinoma in situ (DCIS) of cribriform, solid, and micropapillary types was present, involving lobules and lactiferous ducts. High nuclear grade and necrosis were noted. DCIS was also present at the anterior margin. A second focus of invasion measuring 0.1 cm was identified near the biopsy site in the upper outer quadrant. The DCIS in the upper inner quadrant spanned at least 4 cm. Ductal carcinoma in situ was also identified in additional breast tissue at the inked margin, measuring 3 mm in extent. The inferior margin showed only columnar cell change with flat epithelial atypia and no evidence of malignancy.\n\nHistologic grading showed a modified Scarff-Bloom-Richardson grade 2 tumor with a tubular score of 3, nuclear grade 2, and mitotic score 1. Vascular or lymphatic invasion was present focally. No lobular neoplasia was identified. Estrogen and progesterone receptor status was positive, and HER2 testing by immunohistochemistry was equivocal (2+ intensity in 10% of cells). Fluorescence in situ hybridization (FISH) did not show HER2 gene amplification (HER2/CEP17 ratio: 1.05). Oncotype DX testing yielded a recurrence score of 16, with an estimated 10-year distant recurrence risk of 10%."} +{"pid": "TCGA-HZ-8002", "report": "Surgical pathology evaluation was performed on multiple specimens obtained during a pancreaticoduodenectomy (Whipple resection), which included components of the distal stomach, proximal duodenum, gallbladder, common bile duct, and pancreatic head. Additional specimens included various lymph node groups and margin biopsies.\n\nA resected specimen from the falciform ligament showed benign fibroadipose tissue without any evidence of malignancy. Lymph nodes from the lesser omentum, posterior portal region, superior pancreatic area, and celiac region were all negative for metastatic disease. The bile duct and pancreatic margins were also free of malignant involvement.\n\nIn the Whipple resection specimen, the main lesion measured 3.1 cm in greatest dimension with additional dimensions of 2.5 x 2.4 cm. Microscopic evaluation revealed a moderately differentiated epithelial neoplasm. Histologic analysis demonstrated extensive perineural invasion and presence of lymphovascular invasion. The tumor extended beyond the pancreas into surrounding soft tissues and involved the ampulla of Vater and duodenal wall. All surgical margins were uninvolved by invasive carcinoma, with the closest distance from the tumor to the nearest posterior pancreatic soft tissue margin being 5 mm. A total of 33 lymph nodes were examined, with 4 showing evidence of metastatic involvement. No distant metastases were identified.\n\nAdditional findings included chronic pancreatitis, pancreatic intraepithelial neoplasia (highest grade PanIN 3), and gallbladder cholelithiasis with chronic inflammation. The stomach and duodenum showed no significant histopathologic abnormalities.\n\nThe case was reviewed and confirmed by consulting surgical pathology staff. All relevant gross and microscopic slides were evaluated, and appropriate immunohistochemical controls were used as needed. Staging parameters indicated advanced local disease with regional nodal involvement."} +{"pid": "TCGA-KS-A41I", "report": "A 6.0 x 3.5 x 2.0 cm, 14.4 gram right thyroid lobe was examined, containing a 2.0 x 1.5 x 1.0 cm and a 1.0 x 0.6 x 0.6 cm well-defined somewhat lobular nodule. Two additional tan, poorly defined areas were noted. The remainder of the parenchyma was dark brown and fairly homogeneous. A separate left thyroid lobe measuring 6.0 x 3.0 x 2.0 cm and weighing 9.8 grams showed a fairly homogenous beefy red cut surface with no discrete nodules identified.\n\nSubmitted lymph nodes included a 0.3 cm mediastinal lymph node, several tan soft tissue fragments from mediastinal lymph node level IV R measuring 0.5 x 0.5 x 0.3 cm in aggregate, and a 1.0 x 0.5 cm brown soft tissue fragment identified as a Delphian lymph node. Frozen section analysis of the large nodule and lymph nodes revealed non-necrotizing granulomatous inflammation, negative for neoplasm. Permanent sections confirmed these findings and showed no evidence of malignancy in the lymph nodes. The thyroid specimens showed lymphocytic thyroiditis and non-necrotizing granuloma. All margins were free of concerning pathology."} +{"pid": "TCGA-A1-A0SN", "report": "A left axillary sentinel lymph node biopsy and subsequent non-sentinel lymph node excision were performed. One lymph node was sampled for sentinel node #1 and showed no evidence of metastatic involvement. Sentinel node #2 demonstrated metastatic involvement with extension into the surrounding peri-nodal fat. Sentinel node #3 also showed metastatic involvement. For non-sentinel nodes, both lymph nodes #1 and #2 contained metastatic deposits. Additional lymph node sampling from other areas identified eight further lymph nodes, all without metastatic involvement. In total, four out of thirteen lymph nodes examined contained metastatic deposits, with the largest measuring 0.8 cm in diameter. Extranodal extension was present.\n\nA partial mastectomy specimen from the left breast contained a lesion measuring 1.1 cm in maximum dimension. Histologic evaluation revealed cellular features consistent with an infiltrative growth pattern. Nuclear grading showed high-grade components. Mitotic activity was low to moderate. Tubule formation was minimal. Histologic grade was determined as SBR grade 2 based on these findings. The lesion was intermixed with intraductal proliferation characterized by solid and comedo-type features, also measuring 1.1 cm in greatest dimension. Necrosis was noted within these ductal structures.\n\nMargins of resection were assessed microscopically. For the invasive component, deep, medial, lateral, anterior/superior, and anterior/inferior margins were all negative. The closest margin measured approximately 0.2 cm at the deep margin. For the intraductal component, margins were similarly negative, with distances ranging from 0.25 cm to greater than 1 cm depending on orientation.\n\nLymphatic-vascular invasion was extensive, with intra-lymphatic involvement identified more than 1 cm from the main tumor focus. Perineural invasion was not identified.\n\nImmunohistochemical analysis demonstrated positivity for estrogen receptors with strong nuclear staining in 90% of cells. Progesterone receptor staining was also positive, with moderate nuclear staining in approximately 60% of cells. HER2/neu immunostaining showed intense staining intensity (score of 3), indicating over-expression.\n\nIntraoperative frozen section analysis of sentinel lymph nodes confirmed metastatic involvement in two sentinel nodes and one non-sentinel node. Additional specimens submitted included benign tissue from other breast regions, confirming absence of disease in those areas."} +{"pid": "TCGA-DJ-A1QH", "report": "The patient is a female who presented with a history of toxic goiter and a dominant right thyroid nodule. A biopsy had previously identified malignant cells in the nodule. The patient underwent a total thyroidectomy along with excision of lymph nodes and other tissues.\n\nIn the thyroid specimen, a white-tan nodule measuring at least 7 cm was identified, involving both lobes and the isthmus. The tumor extended throughout the thyroid parenchyma and showed extensive infiltration into surrounding fibroadipose tissue and skeletal muscle. No clear capsule was identified around the tumor. The posterior surgical margin was involved by tumor. Within the thyroid tissue, changes consistent with prior radioactive iodine exposure were noted.\n\nExamination of lymph nodes revealed involvement in multiple regions. In the delphian lymph node region, two lymph nodes were examined and both contained metastatic deposits, with the largest focus measuring 0.4 cm. In the left paratracheal region, one lymph node was examined and also contained metastatic disease, with the largest focus measuring 0.6 cm. Additionally, four out of four lymph nodes examined in other regions were involved. No extranodal extension was observed in these nodes.\n\nOther findings included the presence of psammoma bodies within the tumor. Mitotic activity was mild to moderate. There was no evidence of tumor necrosis or blood vessel invasion. One parathyroid gland was involved by tumor.\n\nNon-malignant findings included benign lymph nodes in the pretracheal region and benign thymic tissue in the left supramediastinal specimen."} +{"pid": "TCGA-G9-6348", "report": "The prostate specimen measured 4.9 x 3.6 x 3.4 cm and weighed 44 grams; after removal of the apex and base, the gland proper weighed 19 grams. The external surface was smooth, red, and intact, with regional ink markers applied for orientation. The cut surface of the prostate showed a nodular tan appearance. A total of 29 tissue blocks were submitted from the prostate and associated structures, including bilateral apical, mid, and basal sections, as well as seminal vesicles and vas deferens. The right seminal vesicle measured 2.5 x 1.6 x 0.7 cm with a vas deferens measuring 3 cm in length and 0.8 cm in diameter, while the left seminal vesicle measured 2.2 x 2.1 x 0.6 cm and its vas deferens was 4.7 cm long and 0.5 cm in diameter. An additional detached segment of vas deferens measured 2.5 cm in length and 0.3 cm in diameter.\n\nMicroscopic evaluation revealed a cellular pattern consistent with conventional type epithelial proliferation. The growth was multifocal, involving both right and left lobes, comprising approximately 25% of the gland. Grading based on histologic architecture yielded a Gleason score of 3+4=7. High grade prostatic intraepithelial neoplasia was also present. No evidence of extension beyond the prostatic capsule or into the seminal vesicles was observed. Margins, including apical, basal, anterior, posterior, and lateral aspects, were free of abnormal cells. Vascular or lymphatic invasion was identified focally in the right lobe, and perineural invasion was detected bilaterally. No tumor involvement was found in the bladder neck or periprostatic fat. All 15 lymph nodes examined (2 from the right pelvic region and 13 from the left) were devoid of malignant cells. Based on these findings, the pathologic stage was classified as pT2c."} +{"pid": "TCGA-18-3415", "report": "The specimen included a biopsy of the chest wall margin, several lymph nodes from various locations including paraesophageal, inferior pulmonary ligament, interlobar, right TB angle, right upper and lower paratracheal, and subcarinal regions. Additional specimens included lung tissue from the right upper lobe and bronchial margins.\n\nHistologic examination revealed a lesion measuring 6.6 cm in greatest dimension located in the right upper lobe. The lesion demonstrated focal invasion of the visceral pleura and was associated with vascular invasion. All bronchial, lung parenchymal, and soft tissue resection margins were free of malignant involvement. One lobar lymph node identified within the hilar area showed no evidence of malignancy. No metastatic involvement was identified in any of the biopsied lymph nodes.\n\nAdditional findings included peritumoral infarct with scarring, dense pleural adhesions, and traction bronchiectasis. There were also mild to moderate emphysematous changes along with patchy interstitial fibrosis noted in the lung parenchyma.\n\nGross examination of the right upper lobectomy specimen revealed a well-circumscribed mass measuring 6.6 x 5.5 x 5.8 cm that abutted the pleura. The tumor had a variegated black-tan appearance, being solid at the periphery and more friable centrally. It was located approximately 1.5 cm from the nearest stapled resection margin.\n\nIntraoperative frozen section analysis confirmed negative margins at multiple sites including the chest wall, bronchial resection margin, and other areas assessed during surgery. Multiple lymph nodes examined across different anatomical regions showed no evidence of involvement.\n\nKey pathological features included visceral pleural invasion and vascular invasion; however, there was no regional lymph node involvement or direct extension into adjacent structures based on available findings."} +{"pid": "TCGA-AG-A00H", "report": "The resected specimen includes a portion of the large intestine or rectosigmoid colon, featuring an ulcerated lesion. The lesion extends no closer than 4.5 cm to the aboral resection margin and involves the intestinal wall over a length of 5.5 cm. There is invasive growth through all layers of the intestinal wall, reaching into the adjacent perirectal fatty tissue. The oral and aboral resection margins, as well as the margin of the perirectal fatty tissue, are free of tumor involvement. Thirty-two regional lymph nodes are without evidence of tumor, showing only nonspecific reactive changes. Vascular and lymphatic invasion are not identified. The tumor has been completely resected with no residual disease."} +{"pid": "TCGA-ZN-A9VQ", "report": "The specimen was received fresh in nine parts, each labeled with the patient\u2019s name and medical record number.\n\nPart A, labeled \"#1. Right rib\", consists of four rib segments measuring 12.0, 5.8, 1.2, and 2.5 cm in length, with an average diameter of 2.2 cm. Scant attached tan/red skeletal muscle and fibrous tissue is present. No gross evidence of abnormal involvement is identified. Bone marrow analysis shows maturing trilineage hematopoiesis with no abnormal cellular infiltration.\n\nParts B through E and part E include lymph node fragments from levels 9, 8, 7, and 10R. These consist of tan/red and tan/white soft tissue fragments with focal anthracotic changes. Some show calcified nodules; all are without abnormal cellular features. Microscopic evaluation of all lymph node specimens reveals no abnormal cellular infiltration. Gram, fungal, and acid-fast stains are negative for organisms.\n\nPart F, labeled \"#6. Diaphragm\", includes three fragments of tan/red skeletal muscle and overlying soft tissue measuring 5.6 x 3.5 x 1.4 cm in total. Multiple small firm nodules (up to 0.2 cm) are noted on the surface of the soft tissue. Microscopic sections show no abnormal invasion of muscle or surrounding tissue.\n\nPart G, labeled \"#7. Visceral and parietal pleura\", weighs 388.0 grams and measures 29.0 x 24.0 x 3.8 cm. It contains multiple nodules ranging from 0.2 to 6.8 cm in size. The surface overlying these nodules is focally inked black. Microscopic examination includes representative sections of the largest nodules.\n\nPart H, labeled \"#8. Phrenic nerve\", is a single fragment measuring 1.2 x 1.0 x 0.5 cm. The specimen was inked black, bisected, and examined as a frozen section. Microscopic analysis of the remnant confirms no diagnostic issues beyond initial findings.\n\nPart I, labeled \"#9. Old port site #1\", is a single fragment of skin and subcutaneous tissue measuring 2.1 x 0.5 cm and extending to a depth of 2.2 cm. The subcutis shows chronic inflammation and scarring but no distinct mass lesion. Microscopic examination confirms absence of abnormal cellular infiltration.\n\nAll relevant tissue samples have been submitted for histological evaluation, with no abnormal findings reported outside the previously described features."} +{"pid": "TCGA-A6-6140", "report": "The specimen includes three parts: a transverse colostomy, an omental lymph node, and segments of the transverse and descending colon. The transverse colostomy measures 6 x 4.5 x 3 cm and shows tan mucosa with focal red discoloration near the skin margin. The omental lymph node is yellow, measuring 0.9 x 0.4 x 0.5 cm, and is negative for malignancy. The colon specimens include two separate bowel segments. One segment, measuring up to 11.5 cm in length and 4 cm in diameter, has a central area of induration and narrowing on the serosal surface, located 3 cm from the nearest stapled margin. The second segment measures 10 cm in length and 3.5 cm in diameter, with adjacent pericolonic fat and omentum. A firm omental lesion measuring 3 cm is present, with a tan-green cut surface measuring 1.5 cm. Both bowel segments have stapled margins. The descending colon contains a fungating, polypoid lesion that appears circumferential, measuring 6.5 x 5.5 x approximately 1 cm. Histologic evaluation reveals benign reactive changes in the transverse colostomy. The single omental lymph node examined shows no signs of malignancy. In the colon, there is a well-differentiated tumor involving the descending colon, with a grade of 1 of 3 and a size of 6.5 cm. The tumor extends into pericolonic soft tissue but does not reach the resection margins, which are free of malignancy. No vascular invasion is identified. Lymph node assessment includes 12 nodes from the transverse colon and 34 from the descending colon, none of which show evidence of tumor involvement. There is a mild chronic inflammatory response, with focal Crohn\u2019s-like features noted. Additional findings include omental fat necrosis and lymphoid hyperplasia in the descending colon mucosa. Tumor deposits are not identified in the pericolonic fat. The pTNM stage is T3 N0."} +{"pid": "TCGA-E8-A433", "report": "The pathology report indicates a unifocal lesion located in the right lobe. The tumor measures 2.5 x 2 x 2 cm. Histological evaluation reveals papillary architecture with associated cellular features. Markers and special stains were performed. Lymphocyte invasion is noted. There is no evidence of extrathyroidal extension."} +{"pid": "TCGA-AR-A5QP", "report": "A. Breast, left, lumpectomy: A 2.2 x 2.1 x 1.6 cm lesion is identified, with Nottingham grade I (of III) features based on histologic evaluation (tubules 3/3, nuclei 1/3, mitoses 1/3; Nottingham score 5/9). Angiolymphatic invasion is not present. The surrounding non-neoplastic breast tissue demonstrates nonproliferative fibrocystic changes. Biopsy site alterations are noted. All surgical resection margins are free of involvement, with the closest margin measuring 0.4 cm at the deep margin and 0.6 cm at the anterior margin.\n\nB. Lymph node, left, sentinel biopsy: Two axillary sentinel lymph nodes are examined, with one showing multiple foci of involvement (5 total), the largest measuring 3.5 mm in diameter. Focal extranodal extension is observed. Based on available surgical staging, the classification is pT2 with nodal involvement identified in a sentinel lymph node sampling."} +{"pid": "TCGA-G3-AAV2", "report": "The specimen consists of a portion of liver weighing 295.7 grams and measuring 17.5 x 9.5 x 5.5 centimeters. A well-circumscribed green mass is identified, measuring 6.5 x 6.0 x 5.0 centimeters, located in the left lobe. The mass extends up to but does not penetrate the liver capsule and is within 1.7 centimeters of the resection margin. Microscopic evaluation reveals a well-differentiated cellular proliferation with areas of pseudoglandular growth. The tumor is solitary and confined to the liver without evidence of vascular invasion. The closest margin is 15 millimeters from the tumor. No lymph nodes were assessed. Additional findings include cirrhosis or fibrosis. The parenchymal margin is uninvolved."} +{"pid": "TCGA-GU-A42Q", "report": "The pathology report includes multiple specimens obtained from various anatomical sites. Specimens A and B correspond to the right and left ureters, respectively. Both specimens show reactive endothelium without any evidence of dysplasia or abnormal cellular changes.\n\nA total of 68 lymph nodes were examined from different regions, including the left and right external and internal iliac, obturator, common iliac, presacral, para-aortic, paracaval, and bilateral common iliac areas. All lymph nodes were negative for metastatic disease, with no involvement identified.\n\nSpecimen M refers to a radical cystoprostatectomy specimen. Gross examination revealed a tumor measuring 3.3 cm in greatest dimension located on the right lateral and posterior walls of the bladder. Microscopic evaluation showed high-grade urothelial carcinoma with extensive squamous differentiation and invasion into perivesical adipose tissue. Necrotic areas were noted within the tumor. No lymphovascular invasion was identified. Surgical margins were free of invasive or in situ carcinoma. Additional findings included absence of malignancy in the prostate and seminal vesicles.\n\nAn appendectomy specimen showed no significant pathological abnormalities.\n\nAll resected margins were uninvolved. The tumor was staged based on pathological findings as pT3b (tumor invading perivesical tissue macroscopically) with no lymph node metastasis (pN0)."} +{"pid": "TCGA-AZ-6608", "report": "The specimen consisted of a resected segment of the sigmoid colon, measuring 11.5 cm in length. A polypoid lesion was identified within the sigmoid colon, measuring 3 cm in its greatest dimension, with additional dimensions of 3 x 1.7 cm. The lesion was ulcerated and demonstrated invasive growth. Histologic evaluation showed moderately differentiated glandular neoplasia infiltrating deeply into, but not through, the muscularis propria.\n\nLymphovascular invasion was noted. Two of twelve regional lymph nodes contained replacement by malignant cells, with the largest focus measuring 0.4 cm. No extracapsular extension was observed. All surgical margins, including proximal, distal, subserosal, and mesenteric, were free of invasive carcinoma. The closest distance of the tumor to a margin was 30 mm at the proximal margin.\n\nAdditional findings included a small tubular adenoma and benign non-neoplastic colonic mucosa without significant histopathologic abnormality. There was no evidence of perineural invasion. The tumor exhibited an infiltrating border configuration. No other tumor characteristics were identified."} +{"pid": "TCGA-AH-6897", "report": "The specimen consists of a colon segment, including the sigmoid and upper rectum, measuring 15 cm in length with a maximum circumference of 7.3 cm. The margins are stapled, the serosa is smooth and glistening, and the mesorectum is incompletely present. A mass measuring 5.3 x 4.2 x 1.4 cm is identified in the distal segment, with an infiltrative appearance and raised edges. It is located approximately 4.5 cm from the distal margin and involves about 60% of the circumference. The depth of invasion is 0.3 cm, and the distance from the radial margin is 3 cm.\n\nMicroscopic evaluation shows moderately differentiated cells extending into the muscularis propria. All margins, including proximal, distal, and radial, are free of involvement. Fourteen lymph nodes are examined and none show evidence of involvement. No lymphovascular or perineural invasion is identified, and there are no tumor deposits. No histologic features suggestive of microsatellite instability are present. There is no evidence of macroscopic tumor perforation, and no prior treatment effect is observed.\n\nThe tumor was staged as pT2 based on invasion into the muscularis propria, with no regional lymph node metastasis (pN0). Additional findings within the mesocolon and mesorectum are benign. All margins are clear and the disease appears localized."} +{"pid": "TCGA-XE-AANR", "report": "The surgical pathology report describes a right orchiectomy specimen weighing 290 grams. The testis measures 9.5 x 7 x 6 cm and contains a multinodular white-tan to brown-tan tumor with areas of hemorrhage and necrosis. The tumor replaces much of the testicular tissue, with no identifiable normal testicular parenchyma. The tunica albuginea is not involved grossly. The epididymis is largely replaced by tumor. The spermatic cord is approximately 10 cm in length and 1.5 cm in diameter, composed of vas deferens, arteries, and veins, and appears unremarkable on gross examination.\n\nMicroscopic evaluation reveals infiltration of small vessels by atypical cells, consistent with lymphovascular invasion. There is no evidence of involvement of the epididymis. The tumor is confined to the testis and does not extend beyond it. Surgical margins, including those of the spermatic cord, are free of tumor involvement.\n\nHistologic sections include multiple cassettes sampling the tumor, tunica vaginalis, epididymis, and various portions of the spermatic cord. The surrounding testicular tissue demonstrates tubular atrophy without evidence of spermatogenesis.\n\nStaging information indicates pT2NXMX."} +{"pid": "TCGA-34-7107", "report": "The pathology report includes multiple tissue specimens. Lymph node biopsies from various anatomical levels on the right side show anthracotic changes with lipid granulomas in some instances, but no malignant cells are identified. One lymph node biopsy from level 4 reveals only benign adipose tissue without identifiable lymph node components.\n\nA soft tissue excision from the right posterior chest wall includes lung tissue showing inflammatory changes, organizing pneumonia, fibrin deposition, and necrosis; no malignancy is detected. A separate resection of parietal pleura shows organizing pneumonia, chronic inflammation, and fibrosis, with no evidence of cancerous involvement.\n\nA pneumonectomy specimen from the right lung reveals a central lesion measuring 4.5 cm in maximum dimension and 4 cm in its minor axis. Histologically, the lesion demonstrates moderately differentiated invasive features associated with extensive necrosis (>50%). No angiolymphatic invasion or extrapulmonary extension is observed. Ten hilar lymph nodes examined are free of tumor involvement. Surgical margins are clear. Staging according to AJCC (7th edition) classifies this as pT2a NO.\n\nAdditional specimens include a partial resection of the right fifth rib and other lymph node sites, all of which show no signs of malignancy. Inflammatory or desmoplastic reactions are noted as severe. Ten N1 lymph nodes and three N2 lymph nodes were examined, none showed evidence of metastatic disease. Underlying lung disease includes chronic interstitial pneumonia."} +{"pid": "TCGA-97-7553", "report": "The surgical specimens include a wedge resection and subsequent lobectomy of the left lower lobe, along with lymph node biopsies from levels 5, 6, 9. The wedge resection specimen measured 7.5 x 2 x 0.9 cm and contained a hemorrhagic, shaggy lesion measuring 2.5 cm, located close to the stapled margin. Histologic evaluation showed a moderately to intermediate-to-high nuclear grade lesion with mixed growth patterns including acinar, bronchioloalveolar, solid, and focal sarcomatoid features. No residual lesion was identified in the lobectomy specimen, which measured 13 x 9 x 4 cm. The lung tissue showed congestion without discrete tumor. All surgical margins were negative. Lymphovascular invasion was not present, and the pleura was not involved.\n\nA total of 28 lymph nodes were examined: 5 from level 9, 6 from level 6, 11 from the left lower lobe specimen, and 6 from level 5. All were negative for involvement. The tumor was confined to the lung parenchyma with no direct extension beyond. Based on these findings, the pathologic staging is determined as stage IA (pT1 NO Mx)."} +{"pid": "TCGA-49-AARE", "report": "The resected right upper lobe specimen includes a mass measuring 2.0 cm in greatest dimension located within the lung parenchyma. The mass is situated 0.6 cm from the pleural surface and is well-defined, without involvement of the bronchus or vascular structures at the hilum. The surrounding lung tissue shows focal mild emphysematous changes. Histologic examination reveals a poorly differentiated infiltrating lesion with extensive necrosis. All surgical margins, including bronchial, vascular, and pleural surfaces, are free of abnormal cellular infiltration. \n\nLymph nodes from stations R-10, station 7, and R-4 were examined; each contained lymphoid and fibroadipose tissue without evidence of atypical cells or infiltration. Additionally, excised pleural nodules demonstrate dense fibrous tissue with areas of acute and chronic inflammation, but no malignant cells are identified. \n\nSections submitted include tumor tissue, normal bronchus, bronchial and vascular margins, and multiple sections of normal lung. Lymph node specimens were each bisected for future and routine histologic evaluation. Tumor banking was performed on representative samples."} +{"pid": "TCGA-WB-A81P", "report": "The pathology report describes a surgical specimen from the left adrenal. A well-circumscribed, reddish, and inhomogeneous mass measuring 2.2 cm in diameter was identified. Microscopic examination revealed a tumor composed of cells arranged in zellballen and trabecular patterns. The cells were of medium size with mild pleomorphism, some having enlarged nuclei and small nucleoli, along with visible chromatin. The cytoplasm appeared amphophilic and granular. The tumor was encapsulated by a thin fibrous layer, though this capsule was focally disrupted in two areas, with evidence of tumor extension into surrounding adipose tissue. The tumor contained a hematoma, which limited the ability to confirm complete resection. A central fibrous region with signs of prior bleeding was also observed. No necrosis, vascular invasion, or increased mitotic activity, including atypical mitoses, was detected."} +{"pid": "TCGA-G8-6907", "report": "The surgical specimen consists of a left cervical neck lymph node measuring 1 x 0.5 x 0.7 cm. The tissue was processed for procurement and flow cytometry studies, with the remaining portions preserved in B5 or formalin.\n\nBone marrow biopsies were obtained from both right and left iliac crests. The specimens showed overall orderly hematopoiesis with no evidence of abnormal infiltration. Cellularity was estimated at 50%, with a myeloid-to-erythroid ratio of 3:1. Both myeloid and erythroid series demonstrated normal morphology and quantity, as did megakaryocytes. Iron stores were not evaluable. Flow cytometry and morphologic evaluation of aspirate smears and biopsy sections revealed no evidence of lymphoma involvement.\n\nDifferential counts from the bone marrow aspirate showed the following distribution among 500 counted cells: myeloblasts 2.0%, promyelocytes 4.4%, myelocytes 12.2%, metamyelocytes 10.4%, bands/stabs 17.2%, eosinophils 2.0%, basophils 0.2%, lymphocytes 3.6%, plasma cells 0.2%, histiocytes 0.2%, and unclassified blasts none. Monoblasts, ring sideroblasts, lymphoblasts, and abnormal lymphocytes were not identified. Myeloid and monocytic elements accounted for 71% of all nucleated cells.\n\nNo prior bone marrow biopsies were available for comparison. Peripheral blood values included hemoglobin of 13.2 g/dL, white blood cell count of 9.65 \u00d7 10\u2079/L, and platelet count of 322 \u00d7 10\u2079/L."} +{"pid": "TCGA-DX-A6B7", "report": "The specimen consists of a resected left retroperitoneal mass along with the attached kidney, ureter, renal vessels, and perinephric fat. The mass measures 11.5 x 9 x 8.5 cm and is located inferior to the kidney, partially extending toward the inferior aspect of the renal pelvis and adjacent renal parenchyma. It is encapsulated by an intact white fibrous membrane. On sectioning, the mass appears white, firm, nodular, and displays a whorled pattern. Areas of myxoid change and necrosis are present, accounting for approximately 2% of the tumor volume.\n\nThe mass involves the entire segment of the renal vein submitted and extends to the renal vein margin, which was inked black. The renal vein itself measures 6 x 1 x 1 cm. Gross examination reveals no tumor involvement of the renal artery, which measures 2 cm in length. The ureter is surrounded by the mass but shows no gross tumor involvement. Margins of the renal artery and ureter appear unremarkable.\n\nThe kidney measures 14.5 x 9 x 7.5 cm and contains a tan, firm nodule measuring 0.4 cm in diameter located in the inferior pole, approximately 1 cm away from the retroperitoneal mass. Histologic evaluation of this nodule demonstrates a bland spindle cell proliferation within a small fibrotic focus; additional immunohistochemical studies are pending for further classification. The remainder of the renal parenchyma appears normal with a well-defined cortico-medullary junction and normal calyces. No adrenal gland tissue was identified.\n\nMicroscopic analysis reveals high-grade cellular features with areas of necrosis and hyalinization comprising approximately 20% of the tumor. The tumor is present at the renal vein margin as an intraluminal extension. In the surrounding soft tissue, the tumor is covered by thin fibrous tissue that corresponds to the surgical margin. Evaluation of submitted margins includes perpendicular sections of the renal vein and en face sections of the ureteral and renal artery margins. No lymph nodes were identified in the perinephric fat, and one benign lymph node was found overall.\n\nAdditional special stains performed showed focal reactivity for SMA but were negative for desmin. These findings do not support metastatic involvement of the renal nodule. Representative sections have been submitted for permanent analysis and documentation."} +{"pid": "TCGA-AA-3977", "report": "The resected colon specimen shows tumor-free oral and aboral resection margins. A lesion is present, characterized by tubular architecture with moderate dysplastic changes. Within this lesion, there is a component of moderately differentiated carcinoma with infiltration extending into the lamina muscularis propria. No evidence of lymph node involvement is identified. The histological grade is G2, with a staging classification of pT2, lymphatic invasion not detected (LO), vascular invasion absent (V0), and no residual tumor at the resection margins (R0). All 15 regional lymph nodes examined are free of metastasis."} +{"pid": "TCGA-37-4135", "report": "The specimen was obtained from a lung tissue source and processed as a primary tumor sample. Histological evaluation revealed moderately differentiated malignant cells arranged in nests and sheets, with evidence of keratinization and intercellular bridging. The tumor measured 3 cm in greatest dimension. No lymph node metastases were identified, and there was no evidence of distant metastasis. The patient had not received prior treatment. A blood sample was collected concurrently. Cellular morphology and immunophenotypic markers were consistent with a neoplastic process; however, no specific therapeutic interventions were documented."} +{"pid": "TCGA-C5-A3HE", "report": "The specimen received consists of two irregular gray-white tissue fragments labeled as a cervical biopsy. The larger fragment measures 1.2 x 0.5 x 0.4 cm and has been bisected, while the smaller fragment measures 0.9 x 0.3 x 0.3 cm. Microscopic examination reveals a cellular composition consistent with a high-grade neoplastic process. The cells exhibit marked nuclear atypia, increased nuclear-to-cytoplasmic ratio, and frequent mitotic figures. The architecture is disorganized, with loss of normal tissue differentiation. No definitive glandular components are identified. The histologic features suggest a locally invasive lesion. Immunohistochemical staining and other ancillary studies were performed as part of the evaluation. All tests were conducted in compliance with CLIA '88 regulations. The performance characteristics of these studies were validated by the Surgical Pathology Department for clinical diagnostic use."} +{"pid": "TCGA-EM-A3OA", "report": "The specimen from the right lower parathyroid was received and measured 0.2 x 0.2 x 0.1 cm. It was frozen for intraoperative consultation and later resubmitted for further analysis. The right hemithyroidectomy specimen included a suture-marked orientation and weighed 8.5 grams. The right lobe measured 4.9 cm in length, with a maximum width of 2.2 cm and an anterior-posterior dimension of 1.2 cm. The isthmus measured 1.5 cm in length with additional dimensions of 0.5 cm and 0.2 cm. The external surfaces showed fibrous adhesions and were painted with silver nitrate. No parathyroid glands or lymph nodes were identified grossly.\n\nA well-defined nodule measuring 2.2 cm in greatest dimension was observed in the upper pole of the right lobe. Additional measurements of the nodule included 1.7 cm and 1.2 cm in other dimensions. Histologic evaluation revealed follicular architecture along with trabecular growth patterns. Classical cytomorphologic features were present, as well as oncocytic changes. Margins were free of involvement, and the lesion was totally encapsulated. Minimal tumor capsular invasion was noted, but there was no evidence of lymphovascular or perineural invasion, nor any extrathyroidal extension.\n\nAdditional findings included mild chronic lymphocytic thyroiditis with atrophic changes. No pathological diagnosis was rendered for the parathyroid biopsy. The specimen was submitted in toto for microscopic examination, and all sections were appropriately processed and reviewed."} +{"pid": "TCGA-AL-3472", "report": "The specimen was received in four parts. The first part consisted of two portions of bone measuring 1.2 x 1.1 x 0.3 cm and 2.5 x 1 x 0.4 cm, both without any identifiable abnormal tissue. The second part was a large mass measuring 11 x 9 x 6.5 cm, weighing 448 grams, with a yellow-pink appearance and encapsulated features. The base of this mass was marked with a clip and inked black for orientation. Frozen section analysis of the base showed no abnormal cells. Internal examination revealed areas with yellow, possibly necrotic changes. Sections were taken from various regions including near the capsule and submitted for microscopic evaluation. Two additional small soft tissue fragments, each measuring less than 0.5 cm in greatest dimension, were also submitted and showed no abnormal cellular findings upon frozen section analysis.\n\nMicroscopic evaluation of the mass demonstrated cellular features consistent with a well-defined process. No angiolymphatic invasion was identified, and all resection margins were free of abnormal cells. Cytogenetic analysis of the mass showed an abnormal karyotype with a modal chromosome number of 47. Chromosomal abnormalities included trisomy for chromosomes 7 and 17. These findings are in line with previously reported patterns associated with this type of renal lesion.\n\nStaging classification was determined as pT2, with no lymph node involvement and no evidence of distant metastasis."} +{"pid": "TCGA-GU-AATO", "report": "Prognostic markers were evaluated on block C13 using immunohistochemical staining with automated image analysis. Staining intensity was graded on a scale of 0 (negative) to 3+ and percentage positivity was calculated for tumor cells. p21 showed altered expression with an average of 0% positive cells and a staining intensity grade of 0, resulting in a HistoScore of 0. p27 demonstrated unaltered expression with an average of 78% positive cells and a staining intensity grade of 2, yielding a HistoScore of 7. p53 showed altered expression with 83% positive cells and a staining intensity grade of 2, leading to a HistoScore of 7. Ki-67 was altered with 35% positive cells and a staining intensity grade of 2, producing a HistoScore of 5. Cyclin E was unaltered with 32% positive cells and a staining intensity grade of 1, giving a HistoScore of 4.\n\nThe specimen consisted of a urinary bladder, prostate, seminal vesicles, ureteral stumps, and lymph nodes. Gross examination of the bladder revealed an ulcerated tumor involving the posterior, right lateral, and anterior walls, extending into the left lateral mucosa. The tumor measured 9.0 x 4.0 x 2.0 cm and exhibited irregular borders. Invasion through the muscularis propria extended into perivesical tissue and reached the inked surgical margin. Involvement of the prostate and seminal vesicles was noted, with infiltration observed at the prostate parenchyma. The prostate was sectioned into six slabs, revealing focal pale and white parenchymal changes, particularly in the right lobe. Multiple sections were submitted for histologic evaluation, including margins and areas of deep invasion.\n\nExamination of the lymph nodes identified four involved nodes out of four retrieved. The largest metastatic deposit measured 9.0 mm without extracapsular extension. Histologic evaluation confirmed invasive high-grade carcinoma with micropapillary features and extensive lymphovascular invasion. Tumor involvement was identified at the cauterized and inked deep surgical margin, multifocally. Pathologic staging indicated advanced local invasion and multiple regional lymph node metastases.\n\nAll stains were interpreted using standardized scoring methods. Percent positivity reflects the proportion of tumor cells staining for each marker. Staining intensity and percent positivity were combined to calculate HistoScores. The tests were performed using validated immunohistochemical protocols with antigen retrieval by heat-induced epitope retrieval. Detection was performed using polymer detection kits on formalin-fixed paraffin-embedded sections. Antibodies used included clones SX118 for p21, SX53G8 for p27, DO-7 for p53, MIB-1 for Ki-67, and HE12 for Cyclin E. Positive and negative controls demonstrated appropriate reactivity throughout testing.\n\nA total of three biomarkers showed altered expression, indicating an unfavorable prognostic profile based on established thresholds. Altered biomarkers included p21, p53, and Ki-67. The tumor exhibited high-grade morphology, widespread vascular invasion, and multifocal margin involvement. Lymph node metastasis was confirmed with significant tumor burden in all harvested nodes. The overall pathologic stage reflected extensive disease with adverse features."} +{"pid": "TCGA-06-0143", "report": "The specimen consists of several brain tissue fragments, measuring up to 3.3 cm in aggregate. The tissue includes a soft tan-brown fragment, a firm grayish-white and glistening fragment, and smaller semi-firm reddish-brown pieces. Microscopic evaluation reveals areas of astrocytic proliferation with hypercellular zones demonstrating active cycling as shown by MIB-1 staining. GFAP highlights regions of astrocytic involvement. There are areas of necrosis with phagocytic activity noted on KP1 staining. CD3 staining shows focal vascular prominence with microvessel proliferation. Immunostaining for p53 mutant protein is negative. Histologic features include geographic necrosis within the white matter, associated with desmoplasia and an atypical glial reaction. Pathologic evaluation also identifies mitotic figures and microvascular proliferation. Molecular testing for MGMT promoter methylation was performed using bisulfite-treated DNA followed by PCR amplification and gel electrophoresis; results were negative. No evidence of methylated MGMT promoter sequences was detected. Intraoperative cytologic preparations show gliosis and atypical glial cells but no definitive solid anaplastic neoplasm, highlighting the need for comprehensive histologic review for final characterization."} +{"pid": "TCGA-D8-A1XS", "report": "Histopathological examination was performed on a resected left breast specimen along with axillary tissues. The left breast measured 17.5 x 14 x 3 cm, and the axillary tissue block measured 8 x 12 x 3 cm. A lesion measuring 3.5 x 2.5 x 2.0 cm was identified at the boundary of the outer quadrants, located 4.7 cm from the lower margin, 0.15 cm from the base, and 0.8 cm beneath the skin surface. The skin flap included in the specimen measured 13 x 5 cm.\n\nImmunohistochemical analysis showed that over 75% of neoplastic cell nuclei were positive for estrogen and progesterone receptors. HER2 protein expression was assessed using HercepTest\u2122 M by DAKO, and invasive cancerous cells demonstrated a strong positive reaction (score = 3+).\n\nMicroscopic evaluation revealed a neoplastic process composed of invasive ductal and partially micropapillary growth patterns. The histologic grade was NHG2, with a mitotic count of 3+2+2 out of 11 mitoses per 10 high-power fields. The tumor was surrounded by glandular breast tissue showing features of gynaecomastia. In addition, foci of in situ ductal carcinoma were observed within the lesion, displaying micropapillary and cribriform patterns with medium nuclear atypia. No lesions were found in the nipple area.\n\nAxillary lymph node dissection included nodes ranging in size from 0.2 to 2.8 cm. Metastatic and micrometastatic involvement was identified in the axillary lymph nodes, with capsular and perinodal tissue infiltration noted. A total of XXV involved nodes out of XXVIII examined were positive for metastatic disease.\n\nStaging was determined as pT2 and pN3a."} +{"pid": "TCGA-60-2708", "report": "The specimen included multiple lymph nodes and lung tissue. Lymph nodes from stations 4R, 4L, 7, V, VII, and VI were all negative for malignant involvement. The left lower lobe specimen contained a central mass measuring 6.5x6.5x5.5cm. Histologic examination revealed a moderately to poorly differentiated invasive lesion with clear cell features and in-situ changes. There was no evidence of angiolymphatic or perineural invasion. The tumor extended into the bronchus but did not involve the main stem bronchus. One of eleven hilar lymph nodes showed involvement. The bronchial and visceral pleural margins were free of tumor. Adjacent lung parenchyma demonstrated emphysematous changes and mucous retention. Additional bronchial margins showed no tumor, with one margin demonstrating focal dysplasia. The hilar adipose tissue was involved by invasive carcinoma. Twelve hilar lymph nodes from the left middle lobe were negative. The final pathologic stage was determined as pT2N1MX. Non-neoplastic findings included ulceration and acute inflammation at the final bronchial margin."} +{"pid": "TCGA-BJ-A3PT", "report": "The specimen consisted of a right and left thyroid lobectomy, with the right lobe weighing 11 grams and the left lobe weighing 10 grams. In the right lobe, multiple tumor foci were identified, with at least five measuring between 0.4 and 1.1 cm. The tumors exhibited follicular variant morphology. There was evidence of focal extrathyroidal extension with involvement of the resection margin. No angiolymphatic invasion was observed. The pathologic staging was determined to be T3 with no lymph nodes examined or involved. In the left lobe, a single tumor measuring 1.5 cm was present, confined entirely within the thyroid gland with clear resection margins. No angiolymphatic invasion was detected in this specimen either. Molecular testing on tissue from block 2A revealed an HRAS codon 61 mutation; no mutations in BRAF, NRAS codon 61, KRAS codons 12/13, or RET/PTC1 and RET/PTC3 rearrangements were identified."} +{"pid": "TCGA-68-8251", "report": "The submitted specimen includes a left upper lobe lobectomy along with lymph node samples from levels 11, 10, and the AP window. The primary lesion is located in the left upper lobe and measures 4.2 x 3.5 x 3.0 cm. It is described as a poorly differentiated tumor with areas of necrosis and hemorrhage. The tumor is situated centrally and causes retraction of the overlying pleura but does not grossly invade through it. It invades an adjacent bronchus and surrounds large vessels. The bronchial margin is negative, as are vascular and parenchymal margins. The visceral pleura is also negative for tumor involvement. Four peribronchiolar lymph nodes are negative for neoplasm. Lymph nodes from levels 11, 10, and the AP window are all negative for tumor involvement. No vascular or lymphatic invasion is identified. Immunohistochemical staining demonstrates diffuse strong positivity for p63 and negativity for TTF-1. Based on AJCC staging criteria, the pathological stage is pT2a NO (Stage IB). The tumor does not involve any intraoperative specimens and is classified as a solitary lesion without evidence of metastasis or lymph node spread."} +{"pid": "TCGA-MI-A75H", "report": "The specimen is a partial segment of liver resected from a patient with a preoperative history of hepatitis C and Crohn\u2019s disease. The specimen weighs 33.4 grams and measures 8.0 x 3.9 x 2.9 cm. It consists of tan-brown, irregular soft tissue consistent with liver parenchyma. The capsule appears tan-pink to yellow and smooth to nodular without gross evidence of a mass. The resection margin is tan-brown, scabrous, and marked with metallic clips inked black. Upon serial sectioning, a well-demarcated, lobulated lesion measuring 2.2 x 2.0 x 2.0 cm is identified beneath the capsule. It is tan-yellow to white in appearance and located 0.4 cm from the resection margin. The surrounding liver tissue is unremarkable with no additional lesions noted.\n\nMicroscopic examination reveals abnormal cellular proliferation within the liver. Histologic evaluation demonstrates preserved tissue architecture with focal atypical cells arranged in trabeculae and solid nests. Nuclear pleomorphism is present with variation in nuclear size and shape. Mitotic figures are observed. There is infiltration of abnormal cells into small vascular channels adjacent to the lesion. No invasion of large vessels or perineural spaces is identified. Surgical margins are closely approached by neoplastic cells, with a distance of 0.2 cm at the nearest margin. Adjacent liver tissue shows extensive fibrosis and regenerative changes consistent with chronic liver disease.\n\nThe procedure performed was a minor partial hepatectomy. No lymph nodes were submitted for evaluation. Laboratory findings include elevated liver function tests and serum markers. Fibrosis scoring of non-involved liver parenchyma indicates advanced scarring using standard classification systems."} +{"pid": "TCGA-44-2662", "report": "The specimen included lymph node level 10, right upper lobe of the lung, lymph node R4, and lymph node level 7. Pre-operatively, the patient was noted to have a lesion in the right upper lobe of the lung.\n\nOn gross examination, the level 10 lymph node consisted of multiple black-tan irregular rubbery tissue fragments measuring 2.5 x 1.5 x 0.5 cm, entirely submitted for analysis. The right upper lobe of the lung contained a large tumor mass measuring 8 x 7 x 6 cm. The tumor had a spiculated, dark tan-gray appearance with flecks of anthracotic pigment. It occupied a significant portion of the parenchyma and approached the pleural surface in two distinct areas, one measuring 5 cm and the other 4 cm. The bronchial margin was negative based on frozen section analysis. The level R4 lymph node specimen consisted of multiple brown-tan irregular rubbery fragments measuring 3.5 x 3.0 x 0.7 cm, all submitted. Lymph node level 7 was composed of multiple black-tan-yellow irregular rubbery to soft tissue fragments measuring 2.5 x 2.0 x 0.8 cm, also entirely submitted.\n\nMicroscopically, the tumor was classified as poorly differentiated and showed no involvement of the visceral pleural surface. The tumor measured 8 cm in greatest dimension. Resection margins were clear, and there was no direct extension into surrounding structures or invasion of large vessels. Small vessel lymphatic invasion was not identified. All mediastinal lymph nodes (level 10, R4, and level 7) were free of metastatic involvement. Distant metastasis could not be assessed."} +{"pid": "TCGA-AA-3860", "report": "The specimen shows an invasive, poorly differentiated neoplasm with extensive transmural involvement, extending through all layers of the intestinal wall (pT3). Histological evaluation reveals the presence of lymphatic and vascular invasion (L1, V1). A total of 14 lymph nodes were examined, with 2 of them showing metastatic involvement, including one additional isolated tumor deposit. The resection margins, including both the mucosal and deep circumferential margins, are uninvolved. Tumor grade is high (G3), and the resection is complete (R0)."} +{"pid": "TCGA-HT-7688", "report": "The pathology report demonstrates a markedly hypercellular glial neoplasm with diffuse infiltration into both gray and white matter. The tumor exhibits a range of cellular morphologies, including cells with round nuclei and well-formed perinuclear halos, as well as cells displaying small eosinophilic caps or a microgemistocytic phenotype. Nuclear atypia is predominantly mild, although scattered moderately to markedly atypical nuclei are present throughout. Mitotic activity is generally low, though areas with up to 8 mitoses in 10 high power fields are observed. Architectural features include subpial condensation and perineuronal satellitosis. No evidence of microvascular proliferation or necrosis is identified. The MIB-1 labeling index ranges up to 14.7%, with an overall value of 13.7%, indicating focally elevated proliferative activity that may suggest early transformation within a background of lower-grade morphology."} +{"pid": "TCGA-J4-A6M7", "report": "The prostate specimen measured 4 x 4 x 4 cm and weighed 50 grams. The right and left seminal vesicles and vas deferens were also included. Examination of the tissue over the prostate showed only fatty tissue without any abnormal findings.\n\nThe prostate gland showed a dominant nodule measuring at least 1.5 cm in size. Histological evaluation revealed a Gleason score of 3 + 4 = 7/10, with no tertiary pattern identified. The extent of involvement was estimated at 15\u201330% of the tissue. The tumor was located predominantly in the peripheral and adjacent zones of the prostate, involving both the right and left sides. Perineural invasion was present, while lymphatic (small vessel) invasion was not observed. No evidence of extraprostatic extension or involvement of the seminal vesicles was detected. The surgical margins were free of any abnormal tissue.\n\nThe specimen was obtained via radical prostatectomy and was fully sectioned and submitted for analysis. Multiple blocks were processed and stained with H&E for microscopic evaluation. No treatment effect was identified."} +{"pid": "TCGA-39-5029", "report": "The specimen was received for evaluation following a thoracotomy and lobectomy performed for a right lower lobe mass with cervical adenopathy. Submitted specimens included multiple lymph node stations from the mediastinum and interlobar regions, bronchial margin tissue, portions of the fourth and fifth ribs, and the right middle and lower lobes of the lung.\n\nThe resected lung specimen measured 17.5 x 12.0 x 4.5 cm and revealed a central, white-tan, ill-defined lesion measuring 3.0 x 2.7 x 2.5 cm located in the proximal lung parenchyma. The lesion was approximately 0.5 cm from the bronchial margin and 1 cm from the closest staple line. It involved the bronchial wall, causing obstruction, but did not involve the mainstem bronchus, bronchial margin, or pleura. Histologic evaluation showed features including vascular and perineural invasion. Adjacent lung tissue demonstrated focal obstructive pneumonitis, atelectasis, and emphysematous changes.\n\nLymph node involvement was identified in several regions. Metastatic cells were found in mediastinal lymph nodes at level seven (two separate specimens), level ten, and level four, as well as in interlobar lymph nodes at level eleven (both specimens). One of three sampled lymph nodes was positive for metastatic involvement. Other lymph nodes examined contained only benign tissue.\n\nThe bronchial margin specimen revealed benign bronchial tissue with squamous metaplasia. Bone specimens from the fourth and fifth ribs showed no abnormal cellular changes and contained benign bone and hematopoietic elements.\n\nIntraoperative frozen section analysis confirmed the presence of malignant cells in several lymph nodes and the primary lung specimen, while other samples were negative or demonstrated only benign tissue. Permanent sections confirmed the intraoperative findings."} +{"pid": "TCGA-BP-4162", "report": "The right kidney specimen weighed 330 grams and measured 13 x 7 x 4 cm. A circumscribed yellow friable lesion measuring 4.5 cm was identified in the upper pole and was confined within the renal capsule. The tumor exhibited an acinar growth pattern and did not extend into the renal pelvis or invade the renal vein. All surgical margins were free of involvement. Multiple benign cysts were present, with the largest measuring 4 cm and lined by a smooth glistening surface containing clear fluid. The non-neoplastic kidney showed no significant abnormalities. Three paracaval lymph nodes were identified, with the largest measuring 2 cm; all were negative for malignant cells. The gallbladder measured 7 x 3.5 x 2 cm and contained multiple black irregular gallstones ranging from 0.5 to 2.0 cm. The gallbladder wall was 0.3 cm thick with green, granular mucosa and no gross lesions identified."} +{"pid": "TCGA-F4-6805", "report": "The submitted large intestine tissue specimen consists of an excised lesion measuring 5 \u00d7 5 \u00d7 0.8 cm located in the colon. Histologic evaluation reveals moderately differentiated epithelial cells arranged in glandular formations. The lesion extends to the subserosal layer. No assessment is available regarding lymph node involvement, margins, neo-adjuvant treatment effect, or additional pathologic findings."} +{"pid": "TCGA-CN-6022", "report": "Molecular testing was performed on paraffin-embedded surgical specimens. Tissue with a minimum of 50% tumor cells was used for analysis. Real-time PCR was conducted on the LightCycler platform to detect mutations in BRAF codons 599\u2013601, NRAS codon 61, HRAS codon 61, and KRAS codons 12/13. Post-PCR melting curve analysis was used for mutation screening, with Sanger sequencing employed when necessary for confirmation. DNA from known positive samples served as controls. Amplification within 35 cycles was considered sufficient, with a detection limit of approximately 10\u201320% mutant alleles in a background of normal DNA.\n\nTesting revealed an HRAS mutation (p.Q61K, c.181C>A). No mutations were identified in BRAF, NRAS codon 61, or KRAS codons 12/13. Fluorescence in situ hybridization (FISH) testing for RET/PTC rearrangement is pending. Adequate DNA was extracted for all analyses.\n\nIn addition, in-situ hybridization and immunohistochemistry were performed on a separate tissue sample. Staining results showed negative for HPV and p16, and strong positive (3+) for EGFR.\n\nSeventeen lymph nodes from the left neck (levels 2\u20134) were examined and none contained tumor. In the right neck (levels 2\u20134 including level 2B), one of fourteen lymph nodes contained metastatic cells measuring 2.2 cm, with spindle cell features. Extracapsular spread was present.\n\nA laryngectomy specimen included a large mass measuring 5.5 cm that extended transglottically involving both vocal cords, false cords, ventricles, pyriform sinus, thyroid cartilage, cricoid cartilage, and pre-epiglottic soft tissue. The tumor was poorly differentiated, keratinizing squamous cell carcinoma with focal spindle cell features. Angiolymphatic and perineural invasion were present. Invasion of thyroid and cricoid cartilage was also observed. Surgical margins showed involvement at the right pyriform sinus and right pre-epiglottic soft tissues; other margins were free of tumor. Pathologic staging was determined as pT4aN1.\n\nThe thyroid specimen contained two small nodules measuring 0.9 cm and 0.3 cm. These were confined to the thyroid without angiolymphatic invasion. Central lymph node examination showed no evidence of disease.\n\nAdditional findings included a keratinizing lymphoepithelial cyst and nodular hyperplasia in the thyroid. No involvement was seen in the tracheostomy site.\n\nFrozen section evaluation of surgical margins during the procedure showed involvement at the deep pyriform sinus. Other margins evaluated intraoperatively were negative except for a deferred finding at the right lateral margin where a small cluster of atypical squamous cells was noted.\n\nHistologic assessment confirmed poor differentiation and presence of vascular and perineural invasion. Immunohistochemical and molecular studies were performed under CLIA-certified conditions. All assays were developed and validated by the laboratory; none have been cleared or approved by the FDA but are used under CLIA guidelines.\n\nTesting for EGFR gene status using FISH was performed on the squamous cell carcinoma component. Analysis of 60 cells showed a ratio of EGFR to CEP7 of 1.10. Disomy was observed in 56.7% of cells, trisomy in 21.7%, and low polysomy in 21.7%. High polysomy and gene amplification were not detected.\n\nRET/PTC FISH studies showed no rearrangement in the targeted region. All 60 analyzed cells exhibited a normal signal pattern."} +{"pid": "TCGA-A4-7734", "report": "The specimen received was a right kidney mass obtained via partial nephrectomy. The specimen weighed 25 grams and measured 5.0 x 4.0 x 3.0 cm. The mass was located in the cortex, measured 4.0 x 3.5 x 3.5 cm, and was described as well-circumscribed, bright yellow, and focally hemorrhagic. The tumor was unifocal and encompassed approximately 90% of the specimen. Gerota\u2019s fascia was present and showed multiple fibrous adhesions. The adrenal gland was not present in the specimen.\n\nMicroscopic evaluation revealed a sharply circumscribed, partially encapsulated epithelial neoplasm with a predominantly solid or tubular growth pattern and foci of micropapillary or papilliform architecture. The predominant cell type was small cuboidal cells with uniform, round nuclei and clear cytoplasm. A secondary cell population was observed within the lumina of tubules, composed of larger polygonal cells with eosinophilic cytoplasm and slightly enlarged oval to reniform nuclei. Scattered foci of foamy macrophages were also identified within the tumor stroma.\n\nFocally, the tumor extended through its thin fibrous capsule into the surrounding renal parenchyma and approached an inked resection margin. There was no evidence of involvement of the renal capsule, perinephric fat, or adrenal gland. No lymphovascular invasion or regional lymph node involvement was identified. The tumor did not show sarcomatoid differentiation.\n\nHistologic grading was consistent with low-grade features. The tumor appeared confined to the kidney without definitive extrarenal extension. Non-neoplastic kidney tissue showed no significant pathology aside from minimal interstitial fibrosis, tubular atrophy, and rare ischemic glomeruli.\n\nStaging was based on tumor size and extent of invasion. The tumor was classified as pT1a with no lymph node or distant metastasis assessed. Surgical margins demonstrated focal involvement at the renal parenchymal margin, with other margins free of involvement."} +{"pid": "TCGA-B5-A11X", "report": "The clinical specimen was obtained from a patient with prior histologic findings of high-grade endometrial neoplasia. The procedure performed included laparoscopic total hysterectomy and bilateral salpingo-oophorectomy, along with lymph node sampling.\n\nGross examination of the uterus showed a 254 gram specimen with a 10.5 x 8 x 5.5 cm uterine component. The endometrial canal measured 8 cm in length and 4 cm across the cornua, and was filled with red, hemorrhagic tissue containing multiple white, irregular lesions. On sectioning, the endometrium measured 0.1 cm in thickness overlying a 1.8 cm myometrial wall. Invasive white nodular lesions were noted to extend through the myometrium to the serosa. The cervix was not involved macroscopically. The lower uterine segment appeared involved, and there were serosal nodules present. Both fallopian tubes and the right ovary appeared unremarkable on gross inspection, while the left ovary was enlarged and had a white-tan cerebriform appearance.\n\nLymph node dissection included multiple sites. The left common iliac lymph node candidate measured 2 x 2 x 0.4 cm and was positive for involvement. The right pelvic lymph node candidate was large (3.2 x 2.5 x 1.5 cm) and also involved. Of the left periaortic lymph nodes, five were identified ranging from 1 to 5 cm in size, all of which contained positive findings. On the right aortic side, four lymph nodes were sampled, each showing similar findings. The left pelvic and left IP lymph nodes did not show any signs of involvement.\n\nMicroscopic evaluation revealed undifferentiated carcinoma involving the uterine serosa. Tumor extended through the myometrium to the serosa, with extensive lymphatic and vascular invasion. The tumor was widely distributed within the endometrial cavity, measuring 8 x 4 cm. Histologic grading was consistent with the highest grade category. The cervix, bilateral fallopian tubes, and right ovary were free of tumor involvement. However, metastatic disease was identified in the left ovary within lymphatic/vascular spaces. All surgical margins were clear.\n\nImmunohistochemical staining showed reactivity for cytokeratin, EMA (focally), and beta-catenin, with no reactivity for desmin or SMA. Scattered CD10-positive cells were also observed. These findings supported the histopathologic conclusions.\n\nLymph node analysis showed involvement in the left common iliac, right pelvic, left periaortic, and right aortic regions. No malignancy was found in the left pelvic lymph nodes.\n\nPathologic staging based on AJCC 7th edition criteria was determined as pT3a pN2 pMX. This stage classification is based solely on the current specimen and does not include data from other sources such as imaging or prior clinical information."} +{"pid": "TCGA-AK-3461", "report": "The left kidney and adrenal specimen was received fresh and weighed 844 grams, measuring 22 x 16 x 8.5 cm. The attached ureter measured 9.5 cm in length and 0.3 cm in diameter, with a smooth tan-pink mucosa and no papillary structures identified. Upon bisection, the kidney measured 10.5 x 6.5 x 4 cm and contained a well-demarcated, golden-yellow firm nodule at the superior pole, measuring 3.5 x 3 x 3 cm, located less than 0.1 cm beneath the renal capsule. The nodule appeared confined to the kidney without infiltration into the surrounding perinephric fat. The remaining renal parenchyma was tan-pink and soft, with no other discrete masses noted. The attached adrenal gland measured 4.5 x 2.5 x 2 cm and had a soft golden-yellow cut surface with no discrete abnormalities.\n\nSections were taken from the ureteral and vascular margins, the nodule with closest radial margin, the nodule with adjacent normal kidney tissue, and the adrenal gland. No angiolymphatic invasion was identified, and surgical resection margins were free of abnormal cells. Cytogenetic analysis of the nodule showed a normal karyotype in 18 of 20 analyzed metaphases (46,XY). Two cells exhibited nonclonal changes: one had an extra copy of chromosome 14, and another was a broken tetraploid cell. The significance of these findings is uncertain and may represent technical artifacts, random events, or possible overgrowth of normal interstitial tissue."} +{"pid": "TCGA-AC-A2FF", "report": "The specimen was processed and measured grossly as a mass measuring approximately 5.0 \u00d7 3.0 \u00d7 1.5 cm located in the right breast. The lesion appeared firm and gritty with diffuse radiographic dye coverage and blended into adjacent fibrotic tissue. Margins were assessed microscopically, with tumor coming closest to the posterior margin at approximately 0.1 mm. Medial, superior, inferior, and lateral margins were also evaluated; the medial margin was free of tumor.\n\nHistologic examination revealed an infiltrating carcinoma exhibiting features suggestive of lobular morphology, including periductal growth patterns and areas resembling \u201cIndian file\u201d arrangements. Nuclear features included occasional prominent nucleoli with scattered foci showing multiple nucleoli. Mitotic activity was assessed at approximately eighteen to nineteen mitoses per ten high-power fields. Tubular formation was minimal (scored as 3). Based on these findings, the Nottingham score was calculated as 7 (3+3+2), corresponding to a grade II lesion.\n\nAncillary studies performed showed estrogen receptor positivity at 37%, progesterone receptor positivity at 71%, HER-2/neu staining at 1.7 (within normal limits), and Ki-67 proliferation index at 18% (borderline range). An E-cadherin immunostain was entirely negative, supporting the microscopic assessment.\n\nLymph node evaluation included sentinel lymph node analysis and axillary lymph node dissection. In total, three out of seven lymph nodes were positive for metastatic carcinoma. Gross measurements of lymph nodes ranged from 0.4 \u00d7 0.3 \u00d7 0.3 cm to 1.5 \u00d7 1.0 \u00d7 0.8 cm. Positive lymph nodes were identified in both sentinel and non-sentinel locations.\n\nClinically, the lesion was staged based on tumor size and lymph node involvement as pT2, N1, MX. No lymphovascular invasion was identified. Microcalcifications were not present. Additional ancillary studies were pending at the time of reporting.\n\nOther findings included focal fibrocystic changes in the surrounding breast parenchyma and changes consistent with prior biopsy noted microscopically."} +{"pid": "TCGA-86-8056", "report": "The gross examination included multiple specimens. A lymph node (10R) measured 1.4 \u00d7 0.7 cm and was dark gray with attached pale yellow adipose tissue. The right upper lobe specimen weighed 28 g and measured 6.7 \u00d7 4.2 \u00d7 2.3 cm. The pleural surface was dark gray to pale tan with subtle puckering and a prior incision. A subpleural nodule measuring 1.9 \u00d7 1.3 cm was firm and pale tan, located 1.0 cm from the stapled edge. It was sampled for frozen section, and no other lesions were identified. Lymph node 9 measured 0.7 cm and was dark gray with attached fat. Lymph node 4R consisted of tan fibroadipose tissue containing two possible lymph nodes measuring 0.5 \u00d7 0.3 cm and 1.5 \u00d7 0.8 cm; the larger had gray to black, smooth cut surfaces. A right upper lobe sump specimen was 1.1 \u00d7 0.9 cm, black and tan in color, and entirely submitted. Two fragments from lymph node R7 measured 1.6 \u00d7 1.0 \u00d7 0.7 cm and 2.5 \u00d7 1.2 \u00d7 1.0 cm, both dark gray to black with attached adipose tissue. The right lower lobe weighed 165 g and measured 13.5 \u00d7 13 \u00d7 5 cm. The pleural surface was tan to pale gray, lightly wrinkled, and glistening. A subpleural mass measured 3.2 \u00d7 2.5 cm, ovoid, with a slightly raised and scalloped rim surrounding a flat center. On sectioning, the mass was up to 1.5 cm thick, with pale tan cut surfaces and central cavitation. It was located 5 cm from the bronchial margin, which was shaved and submitted for frozen section. Cystic spaces up to 1.7 cm were noted in the peripheral base. A black lymph node measuring 0.8 cm was found within the hilum.\n\nMicroscopic evaluation of the right upper lobe wedge resection showed invasive adenocarcinoma with acinar and lepidic growth patterns. The acinar component measured 0.7 cm. There was extensive subpleural scar formation, and the tumor was poorly differentiated. The right lower lobe lobectomy also showed invasive adenocarcinoma with papillary, acinar, lepidic, micropapillary, and solid growth patterns. Subpleural involvement was present, and a special stain for elastin supported the histologic findings. The largest primary tumor measured 3.2 cm in the right lower lobe. No lymph node metastases were identified among the 9 lymph nodes examined. Angiolymphatic invasion was present. The bronchial margin was free of tumor. A separate subpleural nodule was identified in a different ipsilateral lobe, leading to a pT4 classification. No other significant pathologic findings were reported."} +{"pid": "TCGA-SP-A6QG", "report": "The specimen labeled \"adrenal: right resection\" consists of an adrenalectomy specimen weighing 78.3 grams and measuring 10.8 x 7.5 x 3 centimeters. The adrenal gland with associated mass measures 6 x 3 x 0.7 centimeters. Surrounding yellow adipose tissue varies in thickness from 0.2 to 2.0 centimeters, with an overlying thin layer of fascia measuring 9.0 x 3.5 centimeters. After trimming the adipose tissue, the combined weight of the adrenal gland and mass is 45.7 grams. On sectioning, a thinly encapsulated, coarsely lobulated nodule measuring 4.4 x 4.0 x 3.0 centimeters is identified. The nodule has a shiny, bulging golden-brown cut surface with areas of focal black discoloration. It is located 0.3 centimeters away from the adrenal gland and does not appear to be connected to it. The adrenal gland itself appears unremarkable on gross examination. No grossly identifiable nodules or lymph nodes are present within the surrounding fat. Sections of both the mass and normal adrenal tissue are preserved for tumor banking. The remaining tissue is submitted for further analysis."} +{"pid": "TCGA-VS-A8Q8", "report": "The specimen from the cervix shows a lesion measuring 1.1 cm in diameter, histologically characterized as grade 2 with infiltration into the deepest third of the cervical wall. The surgical margins are free of involvement. Lymph node evaluation includes three right obturator nodes, one left obturator node, and seven pelvic nodes, all without evidence of neoplastic cells. A separate finding of a cyst in the left uterine tube is described as a serous cyst. No angiolymphatic or perineural invasion is identified. Parametrial tissues on both sides show no signs of neoplasia."} +{"pid": "TCGA-CZ-4865", "report": "The surgical pathology report describes a nephrectomy specimen from a 70-year-old female with a history of COPD and breast cancer, status post left radical nephrectomy. The kidney specimen weighed 475 grams and measured 18.2 x 9.0 x 5.9 cm. A thin-walled cyst measuring 10 x 9.5 x 5.9 cm was identified in the lower pole. The ureter measured 6.0 cm in length and 0.3 cm in diameter; the renal artery measured 1.2 x 0.9 cm and the renal vein 0.5 x 1.1 cm. The specimen was inked and bivalved, revealing a well-defined tan/yellow mass with focal hemorrhage measuring 3.0 x 2.6 x 2.5 cm located in the upper/mid portion of the kidney. The mass was 1.2 cm from the renal vein margin, 1.0 cm from the renal artery margin, 8.3 cm from the ureteral margin, and 0.3 cm from the closest black-inked deep margin. No gross involvement of the renal pelvis was observed.\n\nMicroscopic evaluation revealed nuclear grade II of IV. The tumor was confined to the kidney without extension into perihilar or perinephric adipose tissue. All resection margins, including vascular and ureteral margins, were free of involvement. No lymphovascular invasion was identified. A separate cyst in the lower pole showed no evidence of involvement. Evaluation of regional retroperitoneal lymph nodes revealed fibroadipose tissue without identifiable lymphoid structures or tumor involvement.\n\nChronic changes in the kidney parenchyma included focal global and segmental glomerulosclerosis affecting approximately 10% of glomeruli. Tubular atrophy and interstitial fibrosis were present in 10\u201315% of the cortex. Arterial and arteriolar sclerosis was moderate. Compression-related changes adjacent to the cyst included smooth muscle hypertrophy in vessels and entrapped tubules. A small papillary lesion measuring 0.1 cm was incidentally noted.\n\nCytogenetic analysis demonstrated clonal chromosomal aberrations including loss of the short arm of chromosome 3, observed in all analyzed metaphases. No lymph nodes were identified in the submitted adipose tissue. All tissue was submitted for histologic analysis."} +{"pid": "TCGA-GS-A9TV", "report": "CERVICAL LEFT LYMPH NODE: The lymph node measures 2 x 1.2 x 0.6 cm. The cut surface is whitish and homogeneous. Histological examination reveals a proliferation of atypical large cells arranged in nodular patterns, separated by fibrous bands. The neoplastic cells exhibit immunoblastic and Reed-Sternberg-like morphology, forming clusters and extending into the perinodal adipose tissue. Immunohistochemical staining shows positivity for CD20, PAX5, and partial expression of CD30 and CD23. The cells are negative for CD15. A population of reactive T-cells is present, expressing CD3 and CD5. The Ki67 proliferation index is approximately 40%. In situ hybridization for Epstein-Barr virus (EBER) is negative."} +{"pid": "TCGA-WC-A87U", "report": "The specimen consists of an intact right eye measuring 22.0 mm in axial length, 24.0 mm horizontally, and 21.0 mm vertically, with an attached optic nerve segment measuring 7.0 mm in length. The cornea is transparent and measures 12.0 mm horizontally and 11.0 mm vertically. The anterior chamber is visible and surrounded by an irregular green-brown iris measuring 6.5 x 8.0 mm in diameter. A mass is identified at the 2-4 o\u2019clock position along the limbus. Transillumination reveals a shadow extending from this region toward the optic nerve, coming within 0.2 mm of it.\n\nOn sectioning, a tan-colored lesion measuring 18.0 x 11.0 mm in base and 6 mm in height is noted. It is loosely attached to the sclera and covered by a retina that appears detached in areas. The tumor has a spindled cell morphology and is predominantly amelanotic. Mitotic activity is present at a rate of 2 per 10 high power fields. Focal complex vascular patterns are observed on PAS staining. Immunohistochemical staining shows positivity for melanocytic markers including MART1, HMB45, and tyrosinase, and negativity for synaptophysin.\n\nHistologic evaluation reveals extensive involvement of the sclera with near full-thickness invasion in a perineural pattern. The tumor extends into the ciliary body but does not demonstrate extraocular extension or vortex vein invasion. The optic nerve is free of tumor involvement. Multiple tissue levels were examined due to the depth of scleral infiltration. Associated findings include retinal detachment and lens changes consistent with nuclear sclerosis."} +{"pid": "TCGA-VQ-AA64", "report": "The specimen includes a moderately differentiated invasive and ulcerated lesion with an intestinal growth pattern. The primary site involved is the stomach, specifically the cardia region. The lesion measures 5.0 x 5.0 x 0.9 cm and extends to the perigastric adipose tissue. No vascular or perineural invasion was identified. The surrounding mucosa shows chronic inactive gastritis with complete intestinal metaplasia. All surgical margins are clear of neoplastic involvement.\n\nA total of 15 lymph nodes were retrieved from adjacent adipose tissue, with 6 showing involvement. Of these, capsular extension is present. Distribution of involved nodes includes: 4 out of 10 from the lesser curvature, 1 out of 2 from the greater curvature, and 1 out of 3 from the perisplenic hilum. There is also a focus of infiltrating tissue in the adipose region measuring 1.8 x 1.5 x 1.5 cm.\n\nAdditional tissues examined include a segment of pancreatic parenchyma, which shows no remarkable findings, and the omentum, which consists of mature adipose tissue. The spleen appears histologically unremarkable. The esophageal margin is free of abnormal cells, as is the pancreatic capsule. Two lymph nodes from the 8p chain and two from the celiac trunk are both uninvolved. The retroperitoneal tissue is fibroadipose and without neoplastic changes. The gallbladder shows features of moderate chronic cholecystitis."} +{"pid": "TCGA-56-7731", "report": "The specimen consisted of a right upper lobectomy and resection of the superior segment of the lower lobe, measuring 16.0 x 8.0 x 3.5 cm. A well-defined mass was identified, measuring 2.7 x 2.5 x 2.0 cm, with a tan cut surface. The mass extended across the interlobar fissure and was located 1.5 cm from the nearest bronchial margin, which was sampled and showed no evidence of involvement, although a small focus of low-grade squamous dysplasia was noted on initial sectioning and was not present in deeper sections. A 2.0 cm white pleural plaque was observed in the apex, separate from the mass.\n\nMicroscopic evaluation revealed no evidence of involvement in the hilar nodes or in lymph nodes at levels 2R, 4R, 7, or 10R. The pleura showed chronic inflammation but no malignant involvement. Histologic assessment of the mass showed moderately to poorly differentiated keratinizing features. The proximal bronchial resection margin and pleural surface were free of involvement, and no lymphovascular space invasion was identified. The tumor was confined to the resected lobes with no evidence of distant spread."} +{"pid": "TCGA-D8-A1X5", "report": "Histopathological examination was performed on a right breast specimen measuring 23 x 18 x 4 cm, along with axillary tissues measuring 12 x 8 x 3.5 cm and a skin flap of 21 x 11 cm. The total weight of the breast specimen was 700 g. A lesion measuring 4.5 x 3.5 x 3 cm was identified at the boundary of the outer quadrants, located 4.2 cm from the outer margin, 0.5 cm from the base, and 1.7 cm from the skin.\n\nMicroscopic evaluation revealed invasive carcinoma with areas showing signet ring cell morphology. The histologic grade was determined as NHG2, with a mitotic count of 3+3+1/7 per 10 high-power fields (visual area 0.55 mm). The surrounding glandular tissue demonstrated parenchymal atrophy.\n\nImmunohistochemical analysis showed that estrogen receptors were present in more than 75% of neoplastic cell nuclei. Progesterone receptors were detected in 10\u201375% of neoplastic cell nuclei. HER2 protein expression was assessed using HercepTest\u2122 by DAKO, and a strong positive reaction (Score = 3+) was observed in the invasive carcinoma cells.\n\nAxillary lymph node assessment identified metastatic and micrometastatic involvement in nodes corresponding to levels XIV/XVI. There was evidence of capsular infiltration and perinodal tissue involvement. Vascular tumor emboli were also noted.\n\nAdditional immunohistochemical markers included: CK7 negative, CK5/6 negative, GCDFP-15 negative, E-cadherin positive, and PAS positive. The final histopathological findings were consistent with an invasive ductal growth pattern. Further testing was required for confirmation."} +{"pid": "TCGA-EB-A41B", "report": "The pathology report describes a skin lesion excised from the shoulder, measuring 2.8 x 0 x 3 cm. The lesion is pigmented and ulcerated, composed of spindle cells with lymphoid infiltration present. Histologic evaluation reveals poorly differentiated features. Satellite nodules were not specified. Lymphatic invasion is identified, while venous invasion is absent. Surgical margins are uninvolved. The lesion demonstrates a Breslow's depth of 2.8 cm and corresponds to Clark's level V. No assessment of lymph node involvement or neo-adjuvant treatment effect is provided."} +{"pid": "TCGA-A2-A0EY", "report": "The lumpectomy specimen from the right breast measured 9.0 cm (superior to inferior), 8.8 cm (medial to lateral), and 3.0 cm in depth. The specimen was oriented with sutures and inked with multiple colors to identify margins. A well-defined mass measuring 2.8 x 2.6 x 1.6 cm was identified in the posterior portion of the specimen, located 0.4 cm from the inferior margin. The mass had a uniform tan appearance on sectioning. Surrounding tissue was largely fatty with fibrotic areas, especially in the posterior region.\n\nHistologically, the lesion showed moderate differentiation with a Nottingham score of 6/9 (Tubules = 2, Nuclei = 3, Mitoses = 1). No tumor necrosis was observed. Microcalcifications were present in association with both the invasive component and benign ducts. Vascular or lymphatic invasion was not identified. The closest margin was the inferior one, with a distance of 0.3 cm from the invasive component. An intraductal component was present, showing solid and cribriform patterns, nuclear grade 3, with central necrosis.\n\nOne of two sentinel lymph nodes was involved, with a metastatic deposit measuring 0.4 cm in largest dimension. No extracapsular extension was noted. The remaining lymph node evaluated showed no evidence of involvement.\n\nAdditional findings included usual ductal hyperplasia, fibrocystic changes, and sclerosing adenosis in the lumpectomy specimen. The additional inferior and deep margin specimens consisted of benign fibroadipose tissue without any evidence of residual disease. All margins were uninvolved.\n\nEstrogen receptor status was positive, progesterone receptor status was negative, and HER2 by IHC was positive. No skin involvement was identified."} +{"pid": "TCGA-AR-A252", "report": "The specimen consists of a mass measuring 1.5 x 1.2 x 1.0 cm. Histologic evaluation reveals a Nottingham grade II lesion with tubule formation score of 3/3, nuclear pleomorphism score of 2/3, and mitotic count score of 1/3, resulting in a total Nottingham score of 6/9. A component of intraductal proliferation is present, occupying approximately 5\u201325% of the tumor volume, with intermediate nuclear grade and solid growth pattern. There is no evidence of angiolymphatic invasion. The surrounding breast tissue demonstrates proliferative fibrocystic changes and biopsy site alterations. The nipple appears unremarkable.\n\nFollowing re-excision of the anterior and inferior margins, all surgical margins are free of tumor involvement, with a minimum tumor-free distance of 0.5 cm at the anterior inferior margin. Evaluation of multiple sentinel lymph nodes (four in total) from the left axilla shows no evidence of metastatic involvement. Immunohistochemical staining with cytokeratin confirms the absence of tumor cells in these nodes. Blue dye is identified in lymph nodes numbers 1 and 3 but not in number 2. Additionally, a separate lymph node from the left axillary region is also negative for tumor involvement.\n\nA fibroadenoma is identified in the excisional biopsy specimen, along with findings consistent with prior biopsy changes. Fibrocystic changes are also noted. Lateral biopsy margins are free of tumor."} +{"pid": "TCGA-2H-A9GH", "report": "The specimen shows moderately differentiated carcinoma arising in Barrett\u2019s epithelium located in the distal esophagus. The lesion measures 2 cm in diameter. Lymph node evaluation reveals a total of 11 nodes examined, with one node showing involvement. The resection margins are clear, consistent with a radical resection."} +{"pid": "TCGA-G2-A3VY", "report": "The specimen consists of multiple fragments of tan-pink to gray-white, soft, rubbery tissue measuring 2.5 x 2.2 x 0.5 cm, submitted entirely. Histologically, high-grade cellular atypia is present with involvement of the lamina propria. The lesion shows focal interaction with small bundles of smooth muscle tissue. Multiple deeper levels were evaluated; while not conclusive, there is strong suspicion for focal invasion into deeper muscular layers. Given the uncertainty in staging, clinical correlation and possible rebiopsy may be warranted."} +{"pid": "TCGA-V1-A9ZI", "report": "The specimen was received in three parts. Part A, labeled as right pelvic lymph nodes, consisted of five lymph node candidates measuring between 0.5 cm and 2 cm embedded in fibrofatty tissue (4.5 x 3 x 0.8 cm). All lymph nodes were submitted for analysis and found to be free of malignant cells.\n\nPart B, labeled as left pelvic lymph nodes, contained three lymph nodes measuring up to 3 cm within a piece of fibrofatty tissue (4 x 2.7 x 1 cm). The largest lymph node showed a homogenous white-pink cut surface. All lymph nodes from this section were also negative for any abnormal cellular infiltration.\n\nPart C consisted of a radical prostatectomy specimen including bilateral seminal vesicles. The prostate measured 4 cm from apex to base, 5 cm in width, and 3.5 cm anterior to posterior, with a total weight of 53 grams. Gross examination revealed multiple tan nodules, with the largest measuring 1.3 x 1 x 1 cm. A firm, white-tan mass measuring 3.2 x 2.5 x 1.2 cm was identified in the peripheral aspect of the right lobe with irregular borders; it did not cross the midline but approached the right lateral and posterior margins. The anterior fibrous stroma appeared roughened and open, while the remaining capsule remained intact. The seminal vesicle bundles were soft and lobulated without distinct masses.\n\nMicroscopic evaluation identified multiple foci of involvement across several slides. The lesion demonstrated extensive infiltration involving the left posterior midgland, right posterior midgland and base, and right anterior midgland and base. The tumor extended into the surrounding structures and was present at the interface with adjacent tissues in limited areas. Cellular infiltration beyond the primary site was observed in restricted regions on specific slides.\n\nThe tumor exhibited features consistent with high-grade morphology, composed predominantly of certain architectural patterns. The estimated volume of the lesion was 5.7 cubic centimeters, with nearly complete dominance of higher-grade components. Involvement of the surrounding supportive tissue was evident in multiple locations. Invasion into adjacent vascular or neural structures was identified in one area.\n\nMargins were assessed as negative, with the closest distance between tumor and margin being less than 0.1 mm on one slide. No evidence of residual benign glandular structures was noted at the inked excision margins. High-grade intraepithelial changes were not observed. Involvement of the right seminal vesicle was confirmed. Lymphovascular invasion was present in one section. Perineural infiltration was documented.\n\nA total of ten lymph nodes were examined across both pelvic regions, all of which were negative for any signs of cellular spread. The staging classification assigned was based on the extent of local invasion and absence of lymph node involvement."} +{"pid": "TCGA-BF-A3DN", "report": "Female patient with a primary tumor located in the skin. The tumor specimen was obtained via surgery and stored in frozen format within a cryomold. Histological evaluation revealed a grade 2 lesion. Staging information indicates T stage 4, N stage 3, and M stage 0. No prior treatment was administered. A normal blood sample was also collected via blood draw and stored frozen in a tube."} +{"pid": "TCGA-2F-A9KR", "report": "The histologic examination revealed a high-grade papillary tumor involving the muscle layer. The tumor was located in the bladder and measured approximately 4 centimeters in diameter. There was no evidence of lymph node metastasis identified. Cellular features included marked nuclear atypia, increased mitotic activity, and invasion into the muscularis propria. The tumor was classified as T3G3 based on staging and grading criteria."} +{"pid": "TCGA-EM-A2CL", "report": "The specimen consists of a left hemithyroidectomy measuring 5.3 cm in greatest dimension, with the left lobe dimensions of 5.3 x 2.8 x 1.8 cm and the isthmus measuring 2.2 x 1.3 x 0.9 cm. The total specimen weight is 15.3 grams. A dominant nodule measuring 2.5 x 2.3 x 1.8 cm is identified in the lower pole of the left lobe. Additional microscopic evaluation reveals a second focus measuring 0.1 cm in greatest dimension within the left lobe.\n\nHistologic assessment demonstrates two distinct lesions with follicular architecture and classical cytomorphology. Both show absence of tumor capsule, capsular invasion, lymphovascular invasion, and extrathyroidal extension. Margins are uninvolved by either lesion. No lymph nodes or parathyroid glands are identified on gross examination. Immunohistochemical staining shows CK-19 positivity, HBME-1 focal positivity, and Galectin negativity.\n\nStaging is based on AJCC/UICC TNM 7th Edition. The primary tumor is classified as pT2, indicating a tumor greater than 2 cm but not more than 4 cm confined to the thyroid. Regional lymph node status is pNX due to no lymph nodes being examined. Distant metastasis is not applicable. Multiple primary tumors are noted (designated m). The specimen was received intact and not oriented. No additional significant findings are present in the remaining thyroid tissue."} +{"pid": "TCGA-D1-A1O7", "report": "The specimen included the uterus, bilateral ovaries, and fallopian tubes, submitted following hysterectomy and bilateral salpingo-oophorectomy. A polypoid mass measuring 2.8 x 1.5 x 0.9 cm was identified in the fundus of the endometrial cavity. Gross examination showed that the mass appeared to invade minimally into the myometrium, with an invasion depth of 0.1\u20130.2 cm; the total myometrial thickness measured 2.0 cm. No involvement of the endocervix was observed. Histologic evaluation did not identify lymphovascular space invasion. Surgical margins were negative for any abnormal tissue.\n\nMultiple leiomyomata were present within the myometrium, including two subserosal nodules each measuring 0.1 cm in greatest dimension, and five intramural nodules ranging from 0.4 cm to 0.7 cm in size. The bilateral ovaries and fallopian tubes did not show any abnormal involvement. The fallopian tubes exhibited mild hydrosalpinx, with the right tube measuring 2.8 x 1.5 x 1.3 cm and the left tube measuring 2.2 x 1.2 x 1.2 cm.\n\nThe surgical staging was determined as pT1a based on AJCC criteria (7th edition, 2010). This report was derived from both gross and frozen section analysis, with confirmation by permanent H&E sections. Any significant changes upon further review will be communicated in a revised report. Representative sections of all relevant structures were submitted for evaluation."} +{"pid": "TCGA-IB-8126", "report": "The surgical pathology report includes multiple specimens from a pancreaticoduodenectomy procedure. The largest lesion identified measures 3.5 x 2.8 x 2.5 cm and is located in the head of the pancreas. Histologic evaluation reveals well-differentiated ductal-type morphology with extensive involvement of peripancreatic soft tissues, retroperitoneal tissue, and mesenteric adipose tissue. Multifocal PanIN lesions ranging from grade 1 to 3 are present. Perineural invasion is noted; no lymphovascular invasion is identified.\n\nMargins assessment demonstrates involvement at the distal pancreatic resection margin. The tumor is in close proximity to the posterior (uncinate) margin of the pancreas, which is at least 1.2 cm away from the lesion, and 0.6 cm from PanIN. The common bile duct resection margin is approximately 1.3 cm away from the tumor. The ampulla of Vater and duodenal mucosa show no evidence of involvement.\n\nEvaluation of regional lymph nodes shows five out of ten peripancreatic lymph nodes contain metastatic involvement with extranodal extension. Additionally, metastatic involvement is identified in tissue sampled from the superior mesenteric artery region.\n\nGross examination of the gallbladder specimen shows no evidence of malignancy, with findings consistent with benign changes. A single reactive lymph node is identified without signs of malignant involvement.\n\nBased on extent of local invasion and lymph node involvement, staging is classified as pT4N1Mx."} +{"pid": "TCGA-2G-AAGT", "report": "The pathology report describes a left orchidectomy specimen. The tumor measured 6 cm in greatest dimension and was confined to the testis. Histologic evaluation identified a component of embryonal carcinoma comprising approximately 80% of the tumor, along with a yolk sac tumor component accounting for about 20%. Additionally, osteoclastic giant cells were observed within the relevant tissue. Angioinvasion was present, as well as invasion of the rete testis."} +{"pid": "TCGA-HV-A5A6", "report": "The specimen includes resection margins from the pancreas, duodenum, common bile duct, and gallbladder. Histologic examination reveals a well-differentiated epithelial neoplasm with a tumor measuring 3.5 x 2.3 cm. The lesion extends into peripancreatic soft tissue and involves the duodenum, common bile duct, and ampulla of Vater. There is multifocal perineural invasion; no venous invasion is observed. Resection margins at the pancreas, common bile duct, and duodenum are free of involvement. Regional lymph node involvement is present in 1 out of 1 peripancreatic lymph nodes; overall, 2 out of 22 regional lymph nodes show involvement. Pathologic staging is pT3 N1b."} +{"pid": "TCGA-DJ-A3V2", "report": "The thyroid gland specimen from total thyroidectomy weighed 22 grams. The right lobe measured 5.1 x 2.1 x 1.5 cm, the left lobe measured 5.0 x 2.1 x 2.1 cm, and the isthmus measured 3.1 x 1.3 x 0.5 cm. A thin fibrous capsule covered the external surface. The posterior surface was marked with black ink and the anterior surface with blue ink. On sectioning, multiple nodules were identified in both lobes.\n\nThe largest nodule was located in the right lobe, measuring 2.1 x 2.1 x 1.9 cm, with a glistening multicystic cut surface. A second nodule in the right lobe measured 0.9 x 0.8 x 0.8 cm and had a brown-tan cut surface. In the left lobe, a third nodule measured 0.8 x 0.6 x 0.4 cm with a white-tan cut surface. The remaining thyroid tissue appeared red-brown and beefy. All sections of the thyroid were submitted for analysis.\n\nMicroscopic evaluation showed well-differentiated cells without identified mitotic activity or tumor necrosis. Calcifications of non-psammomatous type were present. The largest focus was partially surrounded by a fibrous structure. Areas suggestive of vascular involvement were noted but not definitive. No evidence of extension beyond the thyroid capsule was found. Surgical margins were free of abnormal tissue.\n\nMultiple foci were identified, including a dominant lesion in the right lobe measuring 2.1 cm in greatest dimension. Two additional small foci were found: one in the right lobe measuring 0.9 cm and another in the left lobe measuring 0.8 cm. These exhibited similar histological features. Adjacent to the smaller focus in the left lobe, there was a separate area measuring 0.8 cm that also showed comparable characteristics.\n\nLymph node evaluation included four perithyroidal nodes. One lymph node on the left side contained an abnormal cellular deposit measuring 0.6 cm within a node that measured 0.9 cm in diameter. There was no evidence of spread beyond the node. The remainder of the thyroid tissue showed changes consistent with severe chronic inflammation involving lymphocytes. No other distinct nodular structures were identified away from the main areas."} +{"pid": "TCGA-W4-A7U4", "report": "The right testicular specimen measured 5.3 x 3.8 cm and was part of a radical orchiectomy. The tumor was located centrally within the testicular parenchyma, well-circumscribed, solid, tan to pink in color, and homogeneous in texture. The tumor measured 4.5 x 4.0 x 3.8 cm. It was unifocal but demonstrated a dumbbell shape with a small outpouching (0.8 x 0.6 x 0.5 cm) extending toward the tunica albuginea, which had been interpreted on imaging as two separate foci. The tumor was confined to the testis without involvement of the epididymis, tunica vaginalis, spermatic cord, or paratesticular soft tissues. The surgical margins were free of tumor, with the tumor margin measuring 11.5 cm from the spermatic cord margin. The tumor abutted the tunica albuginea and was found to have invaded small veins within this layer, indicating lymphovascular invasion.\n\nMicroscopically, the tissue was composed predominantly of large, atypical cells consistent with embryonal carcinoma. A minor component of syncytiotrophoblastic giant cells was also present, though in very small quantity. Immunohistochemical staining showed focal positivity for beta-HCG; no staining was observed for AFP. Despite the absence of yolk sac tumor morphology, a mild preoperative elevation in AFP raised the possibility of an unsampled yolk sac component.\n\nStaging was based on the presence of vascular invasion through the tunica albuginea, classifying it as pT2. No regional lymph nodes were assessed, resulting in a pNx classification. The remaining testicular tissue was compressed and otherwise unremarkable. All relevant sections were submitted and evaluated, and no additional special studies were performed."} +{"pid": "TCGA-EY-A1GX", "report": "The surgical specimen includes the uterus, cervix, bilateral fallopian tubes, and ovaries. The lesion of interest measures 5.1 cm in greatest dimension and is located in the anterior and posterior endometrium. Histologically, the lesion shows endometrioid features with squamous differentiation and associated calcifications. It is classified as FIGO grade 2 (architectural grade 2, nuclear grade 2). Invasion is identified within the myometrium, limited to the inner half, with a depth of 3 mm in a wall measuring 12 mm thick, representing 25% invasion. There is no serosal involvement; however, the lower uterine segment is involved, both anteriorly and posteriorly. No cervical involvement is observed. Adnexal involvement is present, with metastatic involvement identified in both fallopian tubes. In the right fallopian tube, the tumor extends from the luminal surface into the wall. In the left fallopian tube, fragments of tumor are found floating freely within the lumen, confirmed by cytokeratin AE1/AE3 immunostaining to be epithelial in origin.\n\nMargins of the cervix and vagina are free of tumor. No lymphovascular space invasion is identified. A total of 14 regional lymph nodes are examined across multiple sites (right and left periaortic, right and left pelvic), and none show evidence of metastasis. Immunohistochemical staining demonstrates estrogen receptor positivity in 30% of cells, with half showing 1+ and the other half 2-3+ nuclear staining intensity. Progesterone receptor positivity is observed in 70% of cells, with two-thirds at 1+ and one-third at 2-3+ intensity.\n\nThe specimen was submitted in ten cassettes. Grossly, the uterus weighs 175.6 g, has a pear-shaped appearance, and measures 5.2 cm in height, 7.0 cm in anterior-posterior width, and 5.0 cm in breadth at the fundus. The endometrial cavity measures 4.0 cm in length and 5.0 cm in width at the fundus. The tumor appears tan/white, soft, friable, and exophytic. The uninvolved myometrium contains a 2.0 cm area of intramyometrial hemorrhage. Normal endometrial tissue is present in the lower uterine segments, measuring up to 0.2 cm thick. The adnexa include a right ovary with a 0.4 cm cyst and a nodule, and a left ovary without significant pathology. Both fallopian tubes are sampled, with the left being small in size.\n\nStaging is based on AJCC and FIGO (2008) systems. Based on available data, the case is classified as pT3a pNO by AJCC and Stage IIIA by FIGO. This classification is subject to change pending further clinical evaluation or additional information."} +{"pid": "TCGA-D1-A17K", "report": "The specimen consists of a uterus with attached bilateral fallopian tubes and ovaries. The uterus weighs 94.7 grams. A non-invasive mass measuring 3.0 x 2.3 x 1.0 cm is present in the left wall of the endometrial cavity. The myometrium measures 1.6 cm in thickness at the site of the lesion. Two intramural leiomyomas are identified, with sizes ranging from 0.2 to 0.9 cm. The right ovary measures 2.5 x 1.1 x 1.0 cm and has a smooth outer surface with a cystic and solid cut surface; the right fallopian tube measures 5.5 x 0.5 cm. The left ovary measures 2.8 x 2.3 x 1.1 cm with a smooth outer surface and a cystic and solid cut surface; the left fallopian tube measures 5.2 x 0.4 cm. Histologic evaluation reveals a polypoid lesion involving the endometrium. The lesion is confined to the polyp and immediately adjacent endometrium without extension to the endocervix. No lymphovascular space invasion is observed. Surgical margins are free of abnormal tissue. Both ovaries and fallopian tubes show no involvement. Tissue sections submitted include multiple regions of the uterus, fallopian tubes, and ovaries."} +{"pid": "TCGA-18-3419", "report": "The specimen includes multiple lymph node samples and a left lung pneumonectomy. The lymph nodes from stations ST10L TB angle, Subcarinal ST7, and Inferior pulmonary ligament ST9 were all negative for malignancy. The lung specimen shows a centrally located mass measuring 5.7 cm in greatest dimension, with extension into the main bronchus bifurcation and involvement of the lower lobe bronchus. The tumor is 2.3 cm from the bronchial resection margin, which was free of tumor. Invasion of the pulmonary artery is present, though the vascular resection margin was negative. An interlobar lymph node showed extensive tumor infiltration, while eight lower lobe and two upper lobe lobar nodes were negative. Blood and lymphatic vessel invasion are noted. The tumor is classified as pT2 due to its size and involvement of the bronchus, and pN1 due to metastasis in ipsilateral hilar and intrapulmonary lymph nodes. Severe centrilobular emphysema and obstructive pneumonia in the lower lobe were also observed. Gross examination confirmed the tumor's central location with mucous impaction and consolidation. Multiple tissue sections were submitted for analysis, and several pieces were banked for further study."} +{"pid": "TCGA-56-7221", "report": "A surgical specimen from the right lower lobe of the lung was examined, along with multiple lymph node samples from various levels. The lung specimen weighed 180 grams and measured 13.8 x 8.2 x 5.1 cm. Within the tissue, a nodular fibrotic lesion measuring 3.5 x 3.3 x 2.6 cm was identified. The lesion had a necrotic appearance and was located near the base of the lobe. It was found to be within 0.2 cm of the anterior, medial, and basal pleural surfaces but did not appear to extend through the pleura. The distance from the nearest bronchial margin was 4.3 cm. Surrounding lung tissue showed emphysematous changes and anthracotic streaking, with no additional lesions noted.\n\nHistologically, the lesion was poorly differentiated and demonstrated features consistent with squamous differentiation. Areas of necrosis were present. Lymphovascular space invasion was identified, but there was no evidence of direct pleural invasion. Margins of resection were clear, with no tumor involvement seen at the bronchial margin.\n\nLymph node samples from levels 4, 7, 8, 9, and 10 were submitted for analysis. All lymph nodes showed findings of anthrasilicosis and reactive changes, including sinus histiocytosis and lymphoid hyperplasia. No metastatic disease was identified in any of the lymph nodes examined. Level 8 lymph nodes were highly fragmented, making accurate node count indeterminate, though no malignancy was detected. Special stains for infectious organisms were negative.\n\nSections of the lesion and surrounding tissue were submitted for microscopic evaluation, including areas near the pleural surfaces and the bronchial connection. Additional findings included subpleural fibrosis. Immunohistochemical and special stains were performed as part of the evaluation. A second pathologist reviewed the case and concurred with the findings. Clinical follow-up is advised."} +{"pid": "TCGA-ZS-A9CE", "report": "The specimen consists of a segmental liver resection measuring 120mm x 30mm x 20mm, from which a pedunculated mass is attached, measuring approximately 95mm x 75mm x 65mm. The mass is noted to be clear of the inked resection margin by at least 30mm. On cross-section, the lesion exhibits a homogeneous yellow-tan appearance, with firm consistency and scattered flecks of black and red material. Softening is not a prominent feature.\n\nMicroscopic examination reveals sheets and well-formed acini of cells with abundant clear cytoplasm and moderate nuclear atypia. Bile production is present. Necrosis is infrequent. The lesion extensively involves a surrounding pseudocapsule, and there is evidence of limited vascular invasion in one section. The resection margin is free of abnormal cells.\n\nA separate gallbladder specimen measuring 52mm in length is submitted. The external surface appears normal, and upon opening, no stones or abnormal growths are identified. Histological evaluation of the gallbladder wall shows no unusual findings or signs of malignant change."} +{"pid": "TCGA-77-8144", "report": "Histopathology Report. HISTORY. T2 NO MO. MACROSCOPIC. Five specimens submitted. 1: The specimen is labelled \"left lung\" and consists of a left lung measuring 150 X 120 X 80 mm. There is a palpable lesion located within the inferior region of the hilum and forming a mass within the lower lobe. This lesion has a subpleural location and measures 55 mm in greatest diameter. The lesion has a 5 mm clearance from the pleura. There is a suture on the pleura where the lesion is closest. The lesion projects into a bronchus. The lesion has a clearance from the bronchial resection margin of 27 mm. Distal to the lesion, the lower lobe appears consolidated and contains exudate within bronchitis. The lymph nodes at the hilar resection margin show anthracosilicotic changes. Sectioning the uninvolved lung, particularly of the upper lobe reveals mild centrilobular emphysema. There are no other lesions noted. The lesion has significant necrosis. [1A, bronchial resection margin and vascular resection margin; 1B, lesion plus pleura; 1C-D, lesion plus pleura (sutured pleura); 1E, lesion projecting into bronchus; 1F, lesion plus distal consolidated lung; 1G, lesion plus proximal lung; 1H-I, peribronchial/hilar lymph nodes; 1J, non-neoplastic lung]. 2: The specimen is labelled \"left lung lymph node No. 5\" and consists of a lymph node measuring 5 mm in diameter. [BIT, 2A]. 3: The specimen is labelled \"lymph node No. 6\" and consists of a piece of fatty tissue measuring 40 x 10 X 5 mm. [BIT, 3A]. 4: The specimen is labelled \"lymph node No. 7\" and consists of a piece of fatty tissue measuring 20 x 15 x 4 mm. [Bisected and BIT, 4A]. 5: The specimen is labelled \"lymph node No. 8\" and consists of three fragments of fatty tissue ranging in size from 20\u201340 mm in diameter. [BIT, 5A]. MICROSCOPIC. 1: Sections show a moderately to poorly differentiated epithelial malignancy with cavities filled with necrotic debris. The lesion has an endobronchial component and shows in situ changes of the adjacent bronchial epithelium. It extends widely into the adjacent lung parenchyma and peribronchial soft tissue. Pleural invasion is not identified. There is no blood vessel invasion and no lymphatic permeation is seen. No perineural permeation is identified. The lesion is well clear of the bronchial and peribronchial soft tissue resection margin. No lymph node metastases are seen. The uninvolved lung shows evidence of mild centriacinar emphysema. Distal to the lesion there is acute and organizing obstructive pneumonitis together with bronchiectasis. 2: Sections of the lymph nodes show reactive changes only. There is no evidence of malignancy. 3: Sections of the lymph nodes show reactive changes only. There is no evidence of malignancy. 4: Sections of the lymph nodes show reactive changes only. There is no evidence of malignancy. 5: Sections of the lymph nodes show reactive changes only. There is no evidence of malignancy. SUMMARY. 1\u20135: Left lung and No. 5, No. 6, No. 7 and No. 8 lymph nodes: 1: Moderately to poorly differentiated epithelial malignancy; 55 mm in maximal dimension. 2: No blood vessel, lymphatic or perineural invasion present. 3: No pleural invasion identified; clear of bronchial margin. 4: No lymph node metastases. 5: T2N0MX. c.c. Lung Cancer Registry."} +{"pid": "TCGA-22-4605", "report": "The resected right upper lobe of the lung measured 17.5 x 12.5 x 4.3 cm. A mass was identified measuring 4.4 x 2.9 x 1.9 cm. Histologic evaluation revealed invasive cells with grade 2 differentiation. The mass extends into the pleural surface but does not involve adjacent skeletal muscle or soft tissue. The bronchial margin was free of tumor involvement. \n\nLymph node evaluation included multiple sites: two intraparenchymal and four intrapulmonary peribronchial lymph nodes were all negative for tumor involvement. Additionally, 21 superior right lower paratracheal, 2 right tracheobronchial, and 11 subcarinal inferior mediastinal lymph nodes were also negative. Tissue samples from the right upper paratracheal region showed vein wall structures, and the paraesophageal tissue sample contained fibrovascular material; no tumor was detected in these specimens."} +{"pid": "TCGA-2Z-A9JG", "report": "A partial nephrectomy specimen from the left kidney was examined, measuring 3 x 3 x 1 cm with attached perinephric adipose tissue. The overall dimensions of the specimen were 4.5 x 5 x 2 cm. Serial sectioning revealed an irregular to roughly ovoid, partially solid and partially cystic lesion measuring 2.8 x 2.5 x 0.8 cm. The lesion was bulging and extended to within 0.1 cm of the closest parenchymal margin. The resection margin was inked blue and the perinephric adipose margin green. Representative sections were submitted for frozen analysis and the remainder of the specimen was processed in 7 cassettes.\n\nA separate fragment labeled as a deep margin measured 1.5 x 0.2 x 0.2 cm and was re-inked blue at the true margin. This specimen was entirely submitted for frozen section evaluation.\n\nMicroscopic examination of the primary specimen showed a papillary growth pattern with nuclear features corresponding to grade 3 of 4. No invasion through the renal capsule or into Gerota\u2019s fascia was identified. There was no evidence of renal vein involvement. Surgical margins were free of any abnormal cellular proliferation.\n\nLymph nodes and adrenal gland were not applicable for assessment. A non-neoplastic finding included focal mild chronic inflammation in the surrounding kidney tissue. The pathological stage assigned was pT1aNXMX.\n\nFrozen section analysis confirmed absence of malignancy in the deep margin specimen. These findings were communicated intraoperatively and confirmed upon final review."} +{"pid": "TCGA-CN-4740", "report": "The patient underwent a composite resection of a lesion located in the right retromolar trigone region. The specimen was received in 10 parts and included margins from the soft palate, posterior tonsillar pillar, superficial mandible, right alveolar nerve, right retromolar trigone, anterior labial margin, and lymph nodes from multiple neck levels. All biopsies from the soft palate, posterior tonsillar pillar, submandibular gland, superficial mandible, right alveolar nerve, right retromolar trigone, and anterior labial margin showed no evidence of tumor. Lymph node dissections from the right neck levels 1, 2, 3, and 4 yielded a total of 26 lymph nodes, none of which showed involvement.\n\nThe primary lesion measured 2.1 cm in greatest dimension and was found to be extensively invasive, involving the mandible. No angiolymphatic or perineural invasion was identified. Tumor was observed at the anterior mandibular bone margin and lateral soft tissue margin. Additionally, severe dysplasia was noted at the anterior and medial soft tissue margins. Bone marrow biopsy from the right mandible also showed no tumor involvement.\n\nMargins of resection were evaluated microscopically, with the anterior mandibular and lateral soft tissue margins being involved by tumor. Other margins, including posterior, medial, and deep, were free of tumor involvement. The overall pathologic staging was determined as pT4 pN0 pMX. Microscopic evaluation confirmed the absence of tumor in all submitted margins and lymph nodes outside the primary site. Multiple histologic sections were reviewed, and all immunohistochemical and molecular testing performed in the lab was developed and validated according to CLIA standards."} +{"pid": "TCGA-66-2777", "report": "The examined specimen consists of a middle lobe of the lung measuring 12 x 11 x 3.3 cm. A central bronchus resection plane is located 0.4 cm proximal to the bifurcation into segmental bronchi, closed by a 6 cm horizontal staple suture line with an additional 5 cm cranial staple line extending toward the hilus. At the hilus, two lymph nodes are present, measuring 1.3 cm and 0.4 cm. The pleura shows areas of turbidity and cloudiness with irregular patches of black pigment and hemorrhagic coating over S4. There is a slight central protrusion in a 1 cm area and a flat protrusion spanning approximately 3 cm. Beneath this region lies a firm, predominantly whitish lesion with grayish vitreous consistency, measuring up to 3.2 cm, with areas of black pigmentation and arcuate demarcation. The lesion approaches the visceral pleura and demonstrates endobronchial extension into a subsegmental bronchus, with tumor growth approximately 0.9 cm from the bronchial resection margin. The lesion is adjacent to the previously described staple line, separated by fibrous tissue. Remaining airways and parenchyma appear unremarkable, although vessels are prominent and dilated. In S5, there is a peripheral subpleural compact area measuring up to 2 cm with pale brown sectioning surfaces and a maximum thickness of 0.2 cm.\n\nLymph node stations evaluated include interlobar (station 11), hilar (station 10), and subcarinal (station 7), each showing varying degrees of involvement with the largest measuring 1.5 cm.\n\nHistological evaluation included multiple sections from the tumor, adjacent pleura, staple suture lines, endobronchial regions, peripheral S5 areas, bronchial and vascular margins, and hilar lymph nodes. Eight blocks were processed, some stained with Elastica-van Gieson, PAS, and diastase-PAS.\n\nMicroscopic findings demonstrate chronic inflammatory changes within the bronchopulmonary tissue, along with fibrosis and vascular proliferation of the visceral pleura. There is evidence of localized bronchial involvement with tissue remodeling and obstruction of a subsegmental bronchus. Surrounding lung parenchyma reveals mild emphysematous changes and subpleural scarring. Lymph nodes show anthracotic pigment deposition with reactive macrophage aggregates.\n\nThe lesion is situated subpleurally in S4 with no evidence of pleural invasion in the examined samples. Central continuity between the lesion and the bronchial tree is noted, with destruction and obstruction of an intermediate bronchial branch."} +{"pid": "TCGA-E2-A10F", "report": "The surgical specimens included two sentinel lymph nodes from the left axilla, measuring 2.0 x 0.8 x 0.7 cm and 0.5 x 0.5 x 0.5 cm respectively, both of which were negative for malignant cells. A wide local excision of the left breast was performed with needle localization. The excised tissue weighed 266 g and measured 7.0 cm anterior to posterior, 10.5 cm superior to inferior, and 12.0 cm medial to lateral. The specimen was inked with multiple colors to identify margins and was serially sectioned into seven slices. A gray-white stellate firm mass measuring 2.6 x 1.8 x 1.4 cm was identified, located 1 cm from the closest deep margin in slices 5 and 6. Additional nodules were found, including a 0.5 cm nodule 0.4 cm from the deep margin and 1.5 cm from the mass in slice 6, and a 0.6 cm nodule 0.5 cm from the deep/lateral margin in slice 7. Surgical clips were noted in slice 6. Sections were submitted from various areas of the specimen, including margins and regions around the mass.\n\nAn additional lateral margin specimen was submitted as a fragment of fibrofatty tissue weighing 53 g and measuring 10.0 x 6.0 x 3.0 cm. No significant findings were observed upon sectioning, and multiple sections were submitted for evaluation.\n\nMedial left breast tissue consisted of 321 g of yellow-tan fibrofatty tissue measuring 25 x 9 x 4 cm, with no identifiable masses or lesions. Lateral left breast tissue weighed 238 g and measured 12 x 10 x 2.5 cm; similarly, no lesions were observed. Right breast tissue included multiple fragments of yellow-tan fibrofatty tissue, with the largest portion measuring 40 x 11 x 4.5 cm and weighing 961 g. This tissue also showed no evidence of masses or lesions.\n\nMicroscopic evaluation of the excision specimen revealed a neoplastic process involving the breast tissue, characterized by specific histologic features. The invasive component measured 2.6 cm in greatest dimension and was surrounded by non-invasive changes. Margins were free of involvement, with the closest distance from the tumor to the margin being 1 cm at the deep margin. Histologic grade was determined using a standardized scoring system. Vascular or lymphatic invasion was not identified. In addition to the main lesion, other benign and atypical changes were noted within the breast tissue, including columnar cell change with atypia and ductal hyperplasia.\n\nImmunohistochemical staining was performed on representative blocks, and results supported the histologic interpretation. Sentinel lymph node biopsies did not show evidence of metastasis. Pathologic staging was determined based on these findings."} +{"pid": "TCGA-CV-A464", "report": "The excised specimen from the left buccal region measured 4.4 x 3.2 x 1.1 cm and consisted of mucosa and underlying soft tissue. Gross examination revealed an ulcerating lesion with an ill-defined tumor measuring 3.4 x 1.8 x 1.1 cm. Microscopic evaluation confirmed invasive growth with infiltrative borders characterized by thick cords greater than four cells in thickness. The depth of invasion was 1.1 cm, and perineural invasion was present extensively, involving large nerve bundles. Vascular invasion was not identified. Tumor involvement was noted at multiple margins including superior, anterior, and inferior en-face margins as well as the deep margin. The tumor was within 1.0 mm of the deep surface which included fibroadipose and skeletal muscle tissue.\n\nAdditional specimens were submitted for evaluation. The posterior left mastoid tuberosity specimen contained squamous mucosa without evidence of tumor; bone and bone margins were also negative. A separate specimen from the left posterior superior margin showed tumor involvement. A new posterior margin on the left side demonstrated squamous mucosa with salivary glands and no tumor present.\n\nLymph node evaluation included submental (three nodes), left neck dissection Level I (twelve nodes), Level II (no lymphoid tissue identified), Level III (eighteen nodes), and Level IV (four nodes). All lymph nodes examined were negative for tumor involvement.\n\nOther surgical margins including new anterior, inferior, superior, and deep margins were all negative for tumor. These margins were assessed microscopically and showed squamous mucosa, skeletal muscle, or salivary gland tissue without evidence of malignancy.\n\nSections of soft tissue and mucosa from various regions were entirely submitted for histological analysis. Multiple sections were reviewed from each site, oriented using ink and stitch markers to identify specific anatomical locations. Decalcification and further sectioning were performed on select specimens to ensure comprehensive assessment.\n\nMicroscopic review of the entire specimen supported extensive local involvement at the primary site with positive margins and perineural invasion noted. No vascular invasion or lymph node metastases were identified."} +{"pid": "TCGA-73-4677", "report": "A right upper lobectomy specimen demonstrates an infiltrative peripheral gray-white lesion measuring 3.0 x 2.5 x 1.5 cm located in the anterior segment near the posterior aspect, approximately 2.5 cm from the bronchial margin. The lesion invades into but not through the pleura and extends into adjacent bronchioles. The bronchial margin is free of involvement. Histologic evaluation reveals moderately differentiated glandular structures without angiolymphatic invasion. Surrounding lung parenchyma shows diffuse anthracotic changes and emphysematous alterations.\n\nMultiple lymph nodes were evaluated from various levels including 4R, 4L, level 7, 2R, and mediastinal regions. All lymph nodes show no evidence of malignant cells.\n\nTwo parietal pleural plaques demonstrate hyalinized fibrous tissue without atypical cellular features.\n\nSections of subpleural fibrosis, tumor proximity to margins and uninvolved lung areas were submitted for microscopic analysis. Additional findings include hyalinized granulomas within the lung parenchyma. Special stains performed on these granulomas showed no evidence of microorganisms.\n\nPathologic staging indicates T2a based on visceral pleural invasion with negative regional lymph nodes (N0). Distant metastasis could not be assessed (MX)."} +{"pid": "TCGA-94-A5I6", "report": "The surgical pathology report includes specimens from multiple lymph node sites and a left lower lobe lung specimen. Lymph nodes evaluated included those at stations 11L, #7, anterior 11L, and #6. All lymph nodes were found to be benign without any evidence of abnormal cellular infiltration or involvement.\n\nThe left lower lobe specimen measured 18.0 x 13.2 x 4.9 cm and weighed 258.3 grams. A firm palpable mass was identified with overlying retracted pleura, measuring 7.2 x 6.2 x 4.2 cm. The mass was located 1.5 cm from the bronchial margin and 2.2 cm from the stapled margin. Upon sectioning, the mass exhibited a firm gritty cut surface with areas of necrosis and black pigmentation. No lymph-vascular or perineural invasion was identified. The uninvolved parenchyma appeared red-pink and soft with diffuse mild carbonaceous pigmentation. A small subpleural nodule measuring 0.3 x 0.2 x 0.2 cm was also noted.\n\nMicroscopic evaluation showed no involvement at the bronchial margin. The mass did not demonstrate visceral pleural invasion or tumor extension into adjacent structures. Three peribronchial lymph nodes were identified and showed no signs of involvement. Elastic stain performed on one block showed no pleural invasion. All surgical margins, including bronchial, vascular, and parenchymal, were uninvolved by invasive disease. The tumor was histologically classified as moderately differentiated and was found to be multifocal in nature. No treatment effect was observed, and no additional pathological findings were noted."} +{"pid": "TCGA-RR-A6KA", "report": "The specimen shows a markedly hypercellular, diffusely infiltrating astrocytic neoplasm with abundant necrosis and microvascular proliferation. The tumor cells exhibit severe atypia, and scattered mitotic figures are present."} +{"pid": "TCGA-OR-A5JC", "report": "The specimen consists of a lobulated, ovoid mass measuring 135 x 100 x 90 mm and weighing 754 grams. It is surrounded by a thin layer of adipose tissue and shows lobules of tan-colored tissue separated by fibrous bands on sectioning. Areas of haemorrhage and necrosis are present throughout, with most of the tissue appearing light brown or tan. Small remnants of adrenal gland parenchyma are noted at the periphery. The tumour has been partially incised prior to receipt over a length of 45 mm, and representative sections have been embedded in six blocks for analysis.\n\nMicroscopically, the lesion demonstrates variable architecture, including diffuse sheets, glandular, papillary, trabecular, and insular patterns. Some areas show more well-differentiated features, with vague resemblance to normal adrenal cortical structure. The cells exhibit abundant granular eosinophilic cytoplasm with areas of clear cell change. Nuclear pleomorphism is present and overall moderate in degree. A rich vascular background is observed, along with extensive haemorrhage and necrosis. Mitotic activity is high, with up to 24 mitoses per 50 high-power fields, including atypical forms. Vascular space invasion is prominent, with tumour thrombi identified within capsular vessels. A thick fibrous capsule surrounds the lesion, and there is a rim of atrophic adrenal cortex at one margin. The local resection appears complete."} +{"pid": "TCGA-A8-A08X", "report": "The specimen shows an ablated left breast sample with extensive invasive tumor components. The tumor demonstrates angioinvasion and includes foci of intraductal involvement within the excision cavity region, with a maximum spread of 8 cm. A separate focus exhibits poorly differentiated invasive features with focal intraductal components and angioinvasion, measuring up to 4.0 cm microscopically. There is also massive subepidermal lymphangitic spread of the tumor in the skin region. The dorsal resection margin is free of tumor involvement. Histological assessment indicates poor differentiation. Lymphatic invasion is present, with involvement of regional lymph nodes. Vascular invasion is identified, and surgical margins are negative."} +{"pid": "TCGA-KK-A6E2", "report": "The prostate gland, along with attached right and left seminal vesicles and segments of the right and left vasa deferentia, was submitted for examination. The prostate measured 5.2 x 3.7 x 4.0 cm and weighed 48 grams after fixation. A firm nodule measuring 2.3 x 2.0 x 1.0 cm was identified on the right posterior surface of the prostate in the base region, with soft yellow material at its center. Serial cross sections of the prostate revealed three separate foci of abnormal tissue.\n\nOne focus was located in the transition zone and two in the peripheral zone. The dominant focus measured 2.0 x 2.0 cm in its largest cross-sectional dimension and was present across four cross sections of the prostate, extending extensively into the apex and base regions. This focus extended to the right anterior bladder neck margin of resection, involving a length of 4.0 mm. However, additional separately submitted specimens from the bladder neck (F and G) were free of abnormal cells.\n\nThe two smaller peripheral zone foci measured 0.3 x 0.2 mm and 0.2 x less than 0.1 mm, each present in one cross section only. These were confined within the prostate and did not involve any margins of resection.\n\nA nodule on the right posterior surface of the prostate at the base level showed necrotizing granulomatous inflammation. It was unclear whether this process involved a periprostatic lymph node. Several granulomas without central necrosis and a few with focal necrosis were also observed within the prostate itself. Special stains performed on sections from this nodule were negative for organisms.\n\nMargins of resection were evaluated. The final bladder neck margins (specimens F and G) were free of abnormal cells. Specimen F, the additional left bladder neck margin, consisted of smooth muscle lined focally by urothelium consistent with bladder neck, with no abnormal cells present. No prostatic glands were identified at the margin. Specimen G, the additional right bladder neck margin, contained smooth muscle and adipose tissue consistent with bladder neck tissue, with no abnormal cells present and no prostatic glands at the margin.\n\nLymph nodes from both right and left pelvic regions were examined. Three lymph nodes from the right side and two from the left were identified, none of which showed evidence of abnormal cells.\n\nFrozen section analysis of the right bladder neck margin showed thick bundles of smooth muscle without evidence of abnormal glands or cells. The left bladder neck margin demonstrated abnormal cells within thick bundles of smooth muscle consistent with bladder neck; however, deeper frozen section margins from the left bladder neck showed only smooth muscle without abnormal glands or cells.\n\nMultiple tissue sections were submitted for microscopic evaluation, including areas from the left transition zone, seminal vesicles, vas deferens, and various regions of the prostate such as the base, apex, and central portions. Ink colors were used to mark different surfaces of the prostate for orientation: green for the anterior aspect, red for the left surface, yellow for the right surface, and black for the posterior surface. One non-margin surface was marked with orange ink.\n\nAdditional studies were pending for certain sections at the time of reporting, and a supplemental report was anticipated to provide further results."} +{"pid": "TCGA-DU-A7T6", "report": "The specimen consists of three separate tissue samples obtained from a recurrent brain tumor in a female patient with a prior history of two surgeries. The first specimen is a small fragment measuring 0.5 cm across, described as soft and tan-gray in appearance. Microscopically, it shows infiltration and focal effacement of brain tissue by a glial neoplasm. The tumor cells have round nuclei, occasional perinuclear halos, and frequent karyorrhexis. Mitotic figures are readily identified, and there is notable microvascular proliferation.\n\nThe second specimen, measuring 1.1 x 0.7 x 0.3 cm and weighing approximately 2.5 grams, is composed of soft red-tan brain tissue. Histologically, it reveals a solid glial tumor with moderate nuclear pleomorphism and large round nuclei. The background architecture is finely fibrillary with microvesicular changes. Vascular patterns include capillary-type vessels arranged in a focal \"chicken-wire\" pattern. Prominent endothelial and microvascular proliferation is present, though no necrosis is observed.\n\nThe third specimen, an aggregate of tissue measuring 2.5 x 2.4 x 1.0 cm, also demonstrates extensive involvement by a glial neoplasm similar to that seen in the first two specimens. In this sample, the tumor appears to extend into the leptomeningeal space, with surrounding white matter showing signs of rarefaction and gliosis.\n\nImmunohistochemical staining was performed on one block. GFAP staining highlights numerous gliofibrillary oligodendrocytes and minigemistocytes. MIB-1 staining yields a proliferation index of 50% in more active regions of the tumor. Factor VIII staining confirms a high density of microvessels, consistent with significant microvascular proliferation.\n\nOverall, the tumor exhibits high cellularity, mitotic activity, and vascular proliferation. It also demonstrates a growth pattern involving the leptomeninges."} +{"pid": "TCGA-D1-A0ZO", "report": "A hysterectomy and bilateral salpingo-oophorectomy specimen included a 100.0 gram uterus with attached bilateral fallopian tubes and ovaries. A mass measuring 3.5 x 3.0 x 1.0 cm was identified in the fundus of the endometrial cavity, with myometrial invasion measuring 0.6 cm into a total myometrial thickness of 1.5 cm. The mass did not involve the endocervix. No lymphovascular invasion was identified. Background tissue showed complex hyperplasia with atypia. The vaginal cuff margin was free of involvement. Multiple intramural leiomyomas were present, ranging from 0.4 cm to 2.0 cm in greatest dimension. Both ovaries appeared unremarkable with smooth outer surfaces and solid cut surfaces; the right ovary measured 2.5 x 1.1 x 0.8 cm with a 6.5 x 0.6 cm fallopian tube, while the left ovary measured 2.0 x 1.2 x 0.7 cm with a 6.5 x 0.7 cm fallopian tube. Evaluation of pelvic lymph nodes included 11 on the right and 7 on the left, all of which were negative for abnormal involvement. Tissue blocks submitted included sections from the tumor, serosa, fallopian tubes, ovaries, cervix, lower uterine segment, normal endometrium, and lymph nodes. Based on staging criteria, the findings corresponded to a localized stage with no evidence of nodal or distant spread."} +{"pid": "TCGA-IA-A40U", "report": "The submitted left kidney specimen measured 20.5 x 9.6 x 7.0 cm and weighed 740 grams. A mass measuring 8.5 x 6.5 x 6.5 cm was identified in the upper and mid poles of the kidney. The mass was tan, soft, and friable with extensive necrosis and focal hemorrhage. It was sharply demarcated from the surrounding renal parenchyma and extended into the renal sinus fat. The tumor bulged the renal capsule but did not extend into the surrounding fibroadipose tissue. Gross examination revealed extension into the renal vein and involvement of the renal vein margin. The ureteral, arterial, and soft tissue margins were free of tumor. The adrenal gland showed no evidence of tumor involvement.\n\nMicroscopic evaluation revealed a nuclear grade 3 out of 4. Tumor necrosis was present. Microscopic extension included involvement of the renal sinus and major veins including the renal vein and its segmental branches as well as the inferior vena cava. No sarcomatoid features or lymphovascular invasion were identified. Non-neoplastic kidney tissue showed patchy subcortical chronic inflammation and focal glomerulosclerosis.\n\nA retro-aortic vein biopsy showed intraluminal tissue extending to within 0.5 cm of one margin. The tissue was tan, soft, and friable with necrosis and hemorrhage, and was firmly adhered to the vascular wall. In contrast, the submitted wall margin biopsy consisting of three segments of vascular wall showed no tumor involvement.\n\nThe IVC thrombus specimen consisted of multiple fragments of tan-brown friable tissue aggregating to 5 x 5 x 2.6 cm along with a segment of vascular tissue measuring 4.3 cm in length and 2.8 cm in diameter. The lumen was filled with similar friable tissue showing focal hemorrhage and necrosis.\n\nExcised para-caval lymph nodes (seven in total) were negative for neoplastic cells. Focal non-necrotizing granulomas were noted, raising consideration of a systemic granulomatous process such as sarcoidosis. All other submitted tissues were examined microscopically and representative sections were evaluated."} +{"pid": "TCGA-AF-2693", "report": "The specimen consists of a segment of large bowel measuring 56 cm in length and 3 cm in diameter, identified as sigmoid colon and upper rectum. The distal 7 cm of the specimen is located beyond the peritoneal reflection, and the rectal margin of resection measures 3.7 cm in diameter. The specimen is surrounded by abundant pericolonic fat and reaches up to 17.5 cm in diameter. Upon opening the bowel along the antimesenteric surface, a fungating mucosal lesion measuring 3.2 x 2 x 0.5 cm was identified. This lesion is located 3 cm from the margin of resection and approximately 2 cm beyond the peritoneal reflection. A portion of a polyp was also submitted for research.\n\nHistologic evaluation shows that the lesion invades into the muscularis propria but does not penetrate through it. The margins of resection are free of malignant cells. The lesion measures 3.2 cm in greatest dimension and is graded as moderately differentiated. There is a host response characterized by moderate acute and chronic inflammation. No vascular invasion is identified. A total of 30 pericolonic lymph nodes are present and show no evidence of involvement. No non-lymph node pericolonic tumor spread is observed. The pTNM stage is T2 NO. No other significant findings are noted."} +{"pid": "TCGA-33-A5GW", "report": "The surgical pathology report includes specimens from a right lower lobe wedge resection and completion lobectomy. The primary lesion measured 2.0 cm in greatest dimension and was identified at the periphery of the lung tissue. Histologic evaluation revealed moderately differentiated malignant cells arranged in nests with associated fibrosis. No direct extension of tumor was observed. Margins were uninvolved, and no venous or lymphatic invasion was identified.\n\nLymph node assessment included multiple levels. One of twenty-one lymph nodes showed involvement by malignant cells, specifically among peribronchial lymph nodes from the lobectomy specimen. Involvement was also noted in one of four lymph nodes at level 11, measuring 0.5 mm in focus. No extranodal extension was identified. Other lymph nodes examined (levels 4 and 7) were negative for tumor involvement.\n\nAdditional findings included small hyalinized granulomas within a peribronchial lymph node; stains for acid-fast bacilli and fungi were negative. The surrounding lung parenchyma demonstrated interstitial fibrosis with features of spatial and temporal heterogeneity and honeycombing, consistent with usual interstitial pneumonia. Emphysematous changes were also present throughout the lobectomy specimen. A separate lymph node specimen from level 4 contained two small fragments without evidence of malignancy.\n\nThe wedge resection specimen showed a firm mass near the staple line margin. Sections from this specimen were extensively sampled, including those closest to the margin. No additional lesions were identified grossly. The hilar region and random parenchymal sections were submitted for evaluation."} +{"pid": "TCGA-IP-7968", "report": "A subcarinal lymph node specimen contained sixteen lymph nodes showing sinus histiocytosis and anthracosis. No malignant cells were identified. A level 2R lymph node specimen showed two lymph nodes with similar findings and no malignancy. A biopsy of the esophageal margin showed no evidence of cancer. In the high paratracheal lymph node region, one out of eleven lymph nodes was abnormal, measuring 4.5 cm; no extranodal extension was seen. The lower paraesophageal lymph node sample included four lymph nodes, one of which showed hyalinized granulomas but no malignancy. An anterior cervical lymph node specimen contained a single lymph node without any signs of cancer.\n\nThe gallbladder specimen revealed cholelithiasis and chronic inflammation with calcification of the wall but no malignancy. The esophagus and proximal stomach specimen measured 13.5 x 11.2 x 4.5 cm and contained a large ulcerated mass measuring 8.2 cm in greatest dimension located at the junction of the esophagus and stomach. Microscopic evaluation showed invasive cellular changes that were moderately to poorly differentiated. The tumor extended through the muscularis propria into surrounding soft tissue. Margins were evaluated, with the closest distance of tumor to the deep margin being less than 0.1 cm. Lymphovascular and perineural invasion were both present.\n\nA total of 49 lymph nodes were examined across all specimens, with 4 showing involvement. The pathologic staging was determined as pT3 for the primary tumor and pN2 for regional lymph node involvement. Distant metastasis could not be assessed (pMX). Additional findings included intestinal-type specialized metaplasia consistent with Barrett esophagus, without dysplasia. The tumor was extensively ulcerated, and treatment effect could not be determined."} +{"pid": "TCGA-D1-A3JQ", "report": "A panniculectomy specimen weighing 2218.0 grams was received and grossly evaluated without identification of lesions. A hysterectomy with bilateral salpingo-oophorectomy specimen showed a polypoid mass measuring 2.9 x 2.0 x 2.0 cm located in the anterior uterine wall. The mass extended to involve the posterior endometrioid surface over an area measuring 5.0 x 3.5 x 2.0 cm. Invasion into the myometrium measured 0.1 cm with a total myometrial thickness of 3.2 cm. There was no involvement of the endocervix, and lymphovascular space invasion was not identified. Surgical margins were negative. The ovaries and fallopian tubes were unremarkable. Evaluation of lymph nodes revealed that 8 left pelvic lymph nodes were negative, while 1 of 20 right pelvic lymph nodes showed involvement. The omentum and one regional lymph node were negative. Right and left para-aortic lymph nodes were negative, with 9 and 11 nodes assessed respectively. The right gonadal vessel was negative, but focal involvement was identified in the left gonadal vessel. Multiple biopsies from the cul-de-sac, bladder peritoneum, right and left colic gutters, right and left pelvic sidewalls, small bowel serosa and mesentery, large bowel serosa and mesentery, and right diaphragm were all negative for tumor involvement. Based on these findings, staging according to AJCC criteria was determined as pT2b N1 (7th edition, 2010)."} +{"pid": "TCGA-FG-8182", "report": "A left frontal lesion was evaluated through biopsy and subsequent excision. The biopsy specimen measured 0.9 x 0.4 x 0.2 cm and consisted of pink and gray tissue; the excision specimen measured 4.1 x 2.2 x 0.6 cm and was described as tan and gray, glistening, and extremely soft, with associated blood clot. Both specimens were processed in their entirety.\n\nMicroscopic examination revealed a moderately cellular infiltrating neoplasm composed of glial cells with round to ovoid nuclei and scant cytoplasm. Areas of perinuclear clearing were noted. There was mild nuclear pleomorphism, presence of mini-gemistocytes, and rare mitotic figures. Immunostaining for GFAP demonstrated positivity in some tumor cells and background reactive astrocytes. A Ki-67 proliferation index of approximately 3\u20134% was observed by manual quantification.\n\nMolecular testing using fluorescence in situ hybridization (FISH) was performed on formalin-fixed tissue from block B3 to assess for allelic loss at chromosomes 1p36 and 19q13 using dual-color probe sets. At least 110 cells were analyzed for the 1p/1q ratio and 127 cells for the 19q/19p ratio. The ratios obtained were 0.81 and 0.85 respectively, both above the established threshold of 0.80. In both analyses, the majority of neoplastic cells displayed 2 to 3 signals for both the locus of interest and its corresponding control locus. These findings are consistent with no allelic loss at either chromosomal region.\n\nThe FISH analysis was performed using a semi-automated imaging workstation validated for clinical use, with results confirmed by manual microscopy. All control tissues showed appropriate reactivity. Immunohistochemical and molecular assays used in this evaluation were developed and validated internally and are not FDA-cleared but comply with regulatory standards for laboratory-developed tests.\n\nHistopathologic and molecular findings were reviewed in conjunction with intraoperative frozen section diagnosis of infiltrating glial neoplasm. No allelic loss was detected at 1p36 or 19q13 loci based on standardized thresholds and enumeration criteria."} +{"pid": "TCGA-YZ-A985", "report": "The specimen consists of a right eye enucleation measuring 2.2 x 2.2 x 2.2 cm. The anteroposterior, horizontal, and vertical diameters each measure 22 mm. The optic nerve measures 1.5 mm in length and 1.5 mm in diameter. A dark brown mass measuring 1.9 x 1.9 x 1.0 cm is identified in the posterior central region of the globe. Histologic evaluation reveals a cellular neoplasm composed of plump, spindled cells arranged in fascicles involving the choroid with focal invasion into the sclera. No involvement is observed in the optic nerve, extra-scleral tissues, ciliary body, or lens. Occasional areas of pigment deposition are present within the tumor. Mitotic figures are frequent, and necrosis is absent. Microscopic examination confirms absence of tumor at the optic nerve margin. The tumor involves the choroid and optic disc but does not extend to the vitreous, retina, iris, anterior chamber, or lens. There is no evidence of extrascleral extension either anteriorly or posteriorly. Based on TNM staging criteria, the tumor is classified as T2 based on size (greater than 12 mm but no more than 18 mm in diameter and between 6 and 9 mm in height). The specimen was received intact and properly labeled, with all relevant structures described and submitted for analysis."} +{"pid": "TCGA-27-1835", "report": "Birth date. Tumor site: left temporal. The histological examination revealed a highly cellular neoplasm composed of pleomorphic cells with marked nuclear atypia and frequent mitotic figures. The tumor exhibited infiltrative growth with perineuronal satellitosis and microvascular proliferation. Necrosis was present, including pseudopalisading patterns. Immunohistochemical staining demonstrated positivity for GFAP and MGMT promoter methylation status was detected. The lesion showed an elevated Ki-67 proliferation index. Based on the histological features, the tumor is classified as high-grade."} +{"pid": "TCGA-AN-A0FD", "report": "The pathology report is for a female patient. The tumor is located in the right breast and was obtained via surgery. Histological analysis shows a grade 2 infiltrative growth pattern within the tissue. Tumor staging is T2, N0, M0. No prior treatment was administered. A normal blood sample was also collected via blood draw and stored in a frozen state."} +{"pid": "TCGA-DF-A2KR", "report": "The sample was obtained from the uterus and collected as fresh frozen tissue. The patient underwent surgical resection, with the procedure occurring on the same day as the sample collection. The tumor measured approximately 5.8 centimeters in size and was found to involve lymph nodes, with all 7 positive nodes out of a total of 1 sampled. Microscopic evaluation revealed a poorly differentiated histology. The pathological staging indicated involvement of the primary site with regional spread, and there was no evidence of distant metastasis. Additional histological details were noted, but no specific diagnosis is provided in this summary."} +{"pid": "TCGA-DX-A48N", "report": "The surgical specimen from the left retroperitoneal region included a segment of sigmoid colon with an attached mass. The mass measured 13 x 9.5 x 8 cm and was located on the serosal surface of the colon. It was covered by a thin membrane and had a tan-yellow, slightly gelatinous cut surface with areas of firmer tan-white tissue. The tumor involved surrounding soft tissues, with a significant portion showing low-grade spindle cell morphology. A smaller component of the tumor showed features of a lipoma-like variant within a background of well-differentiated adipose tissue. The dedifferentiated component constituted more than 95% of the tumor. Margins of resection at both the proximal and distal ends of the colon were free of abnormal tissue. A separate specimen from the deep iliac vein contained adipose tissue with fibrous stroma; no malignant cells were identified. Four lymph nodes in this specimen were benign. Microscopic sections from all submitted specimens were evaluated. No significant pathology was identified in the colonic mucosa. The tumor was staged based on size, histologic grade, and extent of involvement."} +{"pid": "TCGA-DX-AB2O", "report": "The specimen consists of an elliptical skin segment with attached subcutaneous tissue, weighing 198 grams. The skin measures 14.0 x 9.0 x 0.2 cm, and the subcutaneous tissue measures 14.0 x 10.0 x 4.5 cm. A well-defined lesion measuring 7.5 x 4.5 x 4.0 cm is identified within the tissue. The lesion is located 1.3 cm from the lateral margin, 1.0 cm from the inferior margin, 0.5 cm from the superior margin, and 4.0 cm from the medial margin. It extends to the deep margin and is in close proximity to the skin surface. On gross examination, the lesion has a fleshy appearance with areas of hemorrhage. A cystic region containing blood and clots, measuring approximately 2.5 x 2.0 x 2.0 cm, is noted in the deep and superior portion of the lesion.\n\nMicroscopic evaluation reveals a high-grade cellular proliferation composed of pleomorphic cells. Focal necrosis is present, involving approximately 10% of the lesion. Immunohistochemical staining demonstrates focal positivity for desmin, while markers including myogenin, smooth muscle actin, and CD31 are negative. Margins evaluated include the superior, inferior, medial, lateral, and deep margins, with the lesion coming within 0.3 cm of the deep margin and 0.5 cm of the superior margin. Representative sections of the lesion and surrounding tissue are submitted for analysis."} +{"pid": "TCGA-V1-A8MU", "report": "A prostate biopsy from the right posterior base showed vascular fibroadipose tissue, smooth muscle, and nerve, with no abnormal cellular findings. A separate biopsy from the left posterior apex margin revealed glandular structures with complex architecture. Immunohistochemical analysis demonstrated absence of basal cells, supporting a finding of epithelial changes at this site. Additional biopsies from the anterior apical, posterior apex, and right posterior base areas all showed benign fibromuscular or vascular fibromuscular tissue without any atypical cells.\n\nLymph node dissection specimens were examined from multiple sites. Two lymph nodes from the right external iliac region showed no abnormal cells. In the right obturator region, one of three lymph nodes contained epithelial cell changes consistent with metastatic involvement, while the remaining two were negative. Five lymph nodes from the left external iliac region and ten from the left obturator region all lacked any such changes.\n\nThe radical prostatectomy specimen included both the prostate and seminal vesicles. Histologic evaluation identified epithelial cell changes in both sides of the prostate, with a Gleason pattern of 3+4. These changes were also noted near the inked apical margin and adjacent to the right seminal vesicle. There was evidence of limited extension beyond the prostate capsule on the right posterior side. The seminal vesicles themselves did not show any similar changes.\n\nImmunostains for p63 and HMWK were performed on several areas, including the apical margin and other regions, and supported the interpretation of these epithelial changes. Of note, the largest positive margin was located at the left apical area, measuring 1 mm in length. Additionally, high-grade intraepithelial changes were present focally, and perineural involvement was observed.\n\nA total of 20 lymph nodes were examined, with one showing epithelial cell involvement. The size of the largest nodal deposit was 0.3 mm, and no extranodal extension was identified. The tumor volume was estimated at 7.35 cm\u00b3, with more than 40% of the tumor composed of Gleason pattern 3. Based on these findings, staging was determined as pT3aN1."} +{"pid": "TCGA-AO-A0JD", "report": "The left breast specimen measured 34 x 22 x 6 cm and included a 1.5 cm everted nipple. A palpable mass was identified in the upper outer quadrant, measuring 6.0 x 5.0 x 2.8 cm grossly, with gray-white, ill-defined features. The mass was located approximately 2 cm from the deep margin. The axillary tail was marked by a long black suture, and multiple lymph nodes were found in this region, ranging in size from 0.3 to 3.5 cm. One intramammary lymph node was also identified.\n\nHistologically, the lesion showed high-grade nuclear features with marked variation in size and shape. Vascular invasion was present. No involvement of the nipple, skin, or surgical margins was observed. The surrounding non-neoplastic tissue exhibited papillomatosis of the nipple, biopsy site changes, fibrocystic alterations, and sclerosing adenosis. Focal calcifications were noted in benign breast tissue.\n\nLymph node evaluation included sentinel lymph nodes and axillary levels I through III. Sentinel node #1 (level I) contained two lymph nodes, both negative. Sentinel node #2 (level I) had one lymph node, which was positive. No extranodal extension was seen. In levels I and II, eight lymph nodes were identified, all without evidence of involvement. In levels II and III, nine lymph nodes were identified, all unremarkable. The total lymph node status was 2 out of 14 involved nodes, without extranodal extension.\n\nImmunohistochemical studies showed estrogen receptor positivity in 90% of nuclei with moderate intensity, progesterone receptor positivity in 40% of nuclei with moderate intensity, and HER2 testing was negative."} +{"pid": "TCGA-3B-A9HR", "report": "The specimen consists of an irregular, tan-yellow fragment of soft tissue measuring 8.0 x 6.5 x 4.0 cm, oriented with stitch marks at the distal-medial margin and inked with multiple colors to identify surgical margins. Serial sectioning revealed a tan-white to tan-yellow, multilobulated mass measuring 8.0 cm in greatest dimension. The lesion is partially encapsulated by a thin fibroconnective pseudocapsule located 0.1 cm from the medial and posterior margins. Areas of necrosis account for approximately 15% of the lesion. Microscopic evaluation showed moderate to high-grade cellular features with spindle and pleomorphic morphology. Mitotic activity was present at a rate of 5\u20136 mitoses per 10 high-power fields (based on 50 fields counted). Surgical margins were free of tumor involvement, with the closest distances at the medial and posterior aspects. Representative sections of all margins and random areas of the lesion were submitted for analysis."} +{"pid": "TCGA-DD-A3A1", "report": "The resected liver specimen includes segments IV through VIII, weighing 1,900 grams and measuring 22 x 14 x 9 cm, along with segment III which weighs 15 grams and measures 4.5 x 3 x 2.7 cm. A separate biopsy from the peritoneum measures 1 x 0.8 x 0.4 cm. A multinodular mass measuring 16 x 15 x 11 cm is present in segments IV through VIII, with five satellite nodules ranging from 0.5 cm to 1.5 cm. The mass does not have a distinct capsule and demonstrates an infiltrative growth pattern into the surrounding parenchyma. Extensive vascular invasion is noted outside the main tumor boundary. The hepatic capsule and surgical margins are free of involvement, with a margin clearance of approximately 1 mm microscopically. The segment III specimen reveals a bile duct hamartoma measuring 1.2 x 1.1 x 1 cm. The peritoneal biopsy shows only inflammatory adhesion and no evidence of neoplastic cells. No features of primary or chronic liver disease are identified in the non-neoplastic liver tissue. The specimens were photographed in the laboratory."} +{"pid": "TCGA-BJ-A28R", "report": "The thyroid specimen weighed 21 grams and showed a lesion measuring 1.5 cm located in the right lobe. Histologic examination revealed cellular features consistent with a neoplastic process. The lesion was confined entirely within the thyroid without evidence of extrathyroidal spread. Lymphovascular invasion was present, including findings of psammoma bodies within the interstitial tissue. A total of 20 lymph nodes were examined from the bilateral central compartment, and none contained involvement. The margins of resection were free of neoplastic cells. Additional findings included chronic lymphocytic thyroiditis and nodular thyroid tissue. Tissue from the right inferior parathyroid was also identified. Immunohistochemical staining for specific markers did not support the presence of an additional focus. The pathologic stage was determined based on the extent of the primary lesion and absence of nodal involvement."} +{"pid": "TCGA-MI-A75G", "report": "The surgical pathology report includes two specimens: a gallbladder and a right hepatectomy with adrenalectomy. The gallbladder measures 10.5 x 4.2 x 4.0 cm and contains multiple choleliths ranging from 0.3 to 0.8 cm. The wall thickness averages 0.3 cm. Histologic examination reveals chronic cholecystitis and cholelithiasis.\n\nThe hepatectomy specimen weighs 555 grams and measures 13.8 x 11.5 x 6.0 cm. A mass measuring 4.5 x 4.0 x 2.6 cm is identified within the liver, located 0.8 cm from the closest resection margin. The mass is tan-yellow to green, lobulated, well-circumscribed, and confined to the hepatic parenchyma without extension into the adrenal gland or surrounding fat. The hepatic resection margin is inked and uninvolved.\n\nMicroscopic evaluation of the liver shows a solitary lesion measuring 4.5 x 4.0 x 2.6 cm. Histologic grade is moderately differentiated. Evaluation of the margins shows no involvement by invasive carcinoma. Microscopic small vessel invasion is present; macroscopic venous and perineural invasion are not identified. Staging is classified as pT2 based on tumor size and absence of vascular invasion beyond small vessels.\n\nAdditional findings include chronic hepatitis with cirrhosis, graded as Grade 3 and Stage 4 using multiple scoring systems. The attached adrenal gland shows no abnormal histologic features and weighs approximately 8.2 grams."} +{"pid": "TCGA-UZ-A9PU", "report": "The patient is a male who was found to have an incidental renal mass measuring approximately 4.6 cm on imaging, located on the anterior aspect of the mid to inferior pole of the right kidney. He underwent an open partial right nephrectomy. The surgical specimen consisted of renal tissue and adjacent fat. The total specimen measured 9.2 x 4.6 x 4.5 cm. The renal portion measured 6.2 x 4.5 x 3.8 cm, and the fat measured 9.2 x 3.5 x 0.5 cm. All margins were inked black, and the specimen was serially sectioned.\n\nA well-circumscribed mass was identified within the renal tissue, measuring 5.8 x 4.5 x 3.3 cm. It occupied approximately 90% of the renal tissue and approached the surgical margin closely, with less than 0.1 cm distance at its nearest point. A central area of necrosis or hemorrhage was present, measuring 3.1 x 2.7 x 2.5 cm. A thin rim of surrounding renal parenchyma was noted, with the thickest portion measuring 0.9 cm. The perirenal fat was unremarkable.\n\nHistologic evaluation revealed a neoplasm with papillary architecture. The cells exhibited features consistent with a low-grade appearance, according to nuclear grading criteria. No involvement of hilar vessels, renal sinus, ureter, renal pelvis, or lymphatic channels was identified. Resection margins were negative for tumor. The soft tissue margin was 0.6 cm from tumor, and the renal parenchyma margin was less than 0.1 cm. Lymph nodes were not sampled during surgery.\n\nStaging was determined as pT1bNXMX based on current classification criteria. Multiple representative sections were submitted for microscopic analysis, including areas of the mass near the resection margin, perirenal fat interface, necrotic regions, and normal-appearing renal parenchyma."} +{"pid": "TCGA-RW-A67W", "report": "The specimen consists of a right adrenal gland weighing 8 grams and measuring 5 \u00d7 3.8 \u00d7 1.3 cm. A nodule measuring 1.7 \u00d7 1.3 \u00d7 1 cm is present, with a tan cut surface and a trabeculated appearance. The nodule extends to the surgical margin. Gross photographs (1A\u2013C) document the findings. Serial sections of the nodule and representative sections of adjacent adrenal tissue were examined microscopically. Histologic evaluation confirms that the lesion is confined to the adrenal gland."} +{"pid": "TCGA-ZH-A8Y8", "report": "The surgical pathology report includes two specimens. Specimen A is a lymph node biopsy from the hepatoduodenal region, revealing one benign lymph node without evidence of metastatic disease. Specimen B consists of a left lobe liver resection weighing 355 grams and measuring 15.0 x 14.4 x 3.5 cm. The mass identified within the left lobe measures 3.9 x 3.5 x 2.2 cm and is described as tan/white, firm, and relatively circumscribed, located near the falciform ligament with a distance of 0.5 cm from the capsule and 2.2 cm from the inked surgical margin. Histologically, the lesion demonstrates moderately differentiated features, exhibiting a mass-forming growth pattern with scattered areas of tumor necrosis but no prior documented treatment. There is no vascular invasion; however, focal perineural invasion is present. Capsular invasion is not identified. The closest parenchymal margin is uninvolved by tumor and is 2.1 cm away. No additional tumor nodules are identified, indicating a unifocal lesion. Evaluation of the background liver reveals mild chronic inflammation, minimal microvesicular steatosis affecting less than 5% of the hepatic parenchyma, and mildly increased portal fibrosis. Reticulin staining demonstrates preserved hepatic architecture. Trichrome stain confirms mild fibrosis. Iron deposition and alpha-1-antitrypsin deficiency are excluded. Frozen section analysis of the lymph node showed no tumor involvement but revealed histiocytosis with multinucleated giant cells. AJCC pathologic staging is pT1 pN0 based on available data. The staging remains subject to revision pending further clinical correlation."} +{"pid": "TCGA-BB-A5HU", "report": "The surgical pathology report includes multiple excision specimens. All margins from the anterior mandibular, posterior mandibular, medial mucosal, anterior mucosal, posterior buccal mucosa, and anterior buccal mucosa regions are negative for tumor involvement. A skin specimen from the forehead shows a nodule measuring 0.8 cm with uninvolved margins.\n\nA resection specimen from the oral cavity (right mandible) measures 4.5 cm in greatest dimension. Histologic evaluation shows moderately differentiated epithelial malignancy with features consistent with conventional morphology. The tumor extends through cortical bone. Regional lymph node evaluation identifies metastatic involvement in multiple ipsilateral nodes, with extracapsular extension present. A total of 37 lymph nodes were examined, with 6 showing evidence of involvement.\n\nMargins of resection are free of tumor. Vascular invasion could not be definitively assessed. Perineural invasion is identified. Additional findings include metastatic cells in 5 of 7 lymph nodes at level 1 and 1 of 13 lymph nodes at level 2. The largest tumor deposit in a lymph node measures 1.5 cm. Levels 3 and 4 contain 6 and 11 lymph nodes respectively, all without evidence of tumor."} +{"pid": "TCGA-G3-A3CJ", "report": "The specimen consists of a gallbladder and a right lobe of liver. The gallbladder is intact, measuring 7.5 x 4.0 x 2.5 cm, with no gallstones or abnormalities noted in the mucosal wall. A single cystic duct lymph node was identified, and all sections appeared unremarkable.\n\nThe right lobe of liver weighs 1254 grams. Within the liver, there is a well-defined tumor mass measuring 12.0 cm in greatest dimension. The tumor has areas of hemorrhage and necrosis and presents with a greenish appearance. Smaller nodules are present in the surrounding liver tissue, ranging from 0.1 cm to 4.0 mm. These may correspond with vascular involvement. A clot is present within the hepatic vein, measuring up to 0.5 cm in diameter. The surrounding liver tissue shows signs of congestion but no definitive cirrhosis.\n\nMicroscopically, the tumor is moderately differentiated. Vascular invasion is present, with evidence of lymphvascular invasion. The primary tumor is located 1.0 cm from the inked resection margin, while smaller intravascular components approach within 0.4 cm of the margin. Post-embolization changes are noted in the portal vein, including foreign body-type giant cell reaction and thrombus formation. No tumor cells are found in the lymph node examined. The surrounding liver tissue shows changes consistent with chronic hepatitis C infection, mild activity noted.\n\nSurgical resection involved a partial hepatectomy encompassing at least three segments. The tumor is solitary and confined to the right lobe. Venous (large vessel) invasion is present. Margins are not involved by invasive carcinoma, with the closest distance of invasive tumor being 10 mm from the margin. Regional lymph node status could not be fully assessed. Distant metastasis also could not be determined. Multiple representative sections of the tumor, surrounding liver, and involved margins were submitted for analysis."} +{"pid": "TCGA-GS-A9TU", "report": "The lymph node measures 3.6 x 2.5 x 1.6 cm, with a smooth and pale surface. Histological examination reveals a nearly complete replacement of normal architecture by a diffuse proliferation of large lymphoid cells. Focal plasmocellular differentiation is noted. Immunohistochemical analysis demonstrates positivity for CD20, CD79a, CD43, BCL2, BCL6, and MUM1, with absence of expression for CD3, CD5, CD10, CD23, CD21, and p53. A kappa light chain restriction is present. The Ki67 proliferation index is estimated at approximately 60%. Molecular studies using PCR (MBR and MCR) do not show any rearrangement of the BCL2 gene."} +{"pid": "TCGA-A2-A25B", "report": "The surgical specimen from the left breast and associated lymph nodes was examined. The sentinel lymph node (#1) measured 4.3 x 2.7 x 1.5 cm and contained two palpable nodules: the larger measuring 2 x 2 x 1 cm and the smaller 1.5 x 1.2 x 0.3 cm. On sectioning, the larger nodule showed multiple gray-white nodules within tan-pink parenchyma, with the largest focus measuring 0.6 x 0.4 x 0.4 cm. The smaller nodule revealed a tan-gray area within tan-purplish parenchyma measuring 0.8 x 0.5 x 0.5 cm.\n\nThe left breast mastectomy specimen measured 23.5 x 22 x 8.0 cm. A firm pink-tan lesion was identified in the 6 and 7 o\u2019clock regions, marked by a central cylindrical metal clip. This lesion measured 4 x 2.5 x 3 cm and extended to within 0.8 cm of the deep margin and 0.3 cm of the superficial margin. Centrally, there was a 4.5 x 2-cm area of fatty tissue without fibrous bands. Sections were taken throughout the lesion, including margins and surrounding tissue. Additional findings included diffuse fibrous and fatty tissue changes and focal induration near the skin ellipse.\n\nA second area of interest was identified after radiographic examination, located 3 cm anterior and lateral to the main lesion near the edge of the skin ellipse. It consisted of red-brown clot surrounded by indurated yellow-tan fatty tissue measuring 1.7 x 1.0 x 1.5 cm, located 0.5 cm from the superficial margin and 3.5 cm from the deep margin.\n\nThe left axillary lymph node specimen included multiple lymph nodes within yellow-red fatty tissue measuring 7.5 x 6 x 1.7 cm. One small lymph node appeared unremarkable. Three larger nodes were identified, with one showing involvement. A total of six lymph nodes were evaluated, one of which demonstrated involvement. No extranodal extension was observed.\n\nAn additional anterior margin specimen from the inferior portion of the left breast was submitted. It measured 16 x 2.7 x 0.9 cm and included brown pigmented skin. Margins were marked with sutures and ink. Microscopic evaluation of this specimen showed no residual tumor, with clear margins. Radiographic localization of a second biopsy clip was performed, and additional sections showed ductal intraepithelial proliferation, some extending into terminal lobules, along with rare microscopic foci of infiltrative growth and vascular invasion.\n\nThe invasive component of the lesion in the breast measured up to 4 cm in maximum gross dimension and was located approximately 2 mm from the nearest inked superficial margin (B15). Surrounding areas included high-grade ductal intraepithelial proliferation with cribriform and solid patterns, with areas of necrosis. Invasive cells were poorly differentiated, with nuclear grade 3 of 3, moderate mitotic activity, and tubule formation score of 3, resulting in a total histologic score of 8. Lymphatic vessel invasion was present. Random sections from other quadrants and nipple skin did not show evidence of tumor. Diffuse lactational changes were also noted."} +{"pid": "TCGA-PL-A8LX", "report": "The specimen from a female patient showed a variegated appearance on gross assessment. Microscopic examination revealed an invasive tumor arranged in solid nests, cords, comedo-like structures, and tubular patterns. The tumor cells were large with moderately pleomorphic, hyperchromatic nuclei and amphophilic cytoplasm. A desmoplastic stromal reaction was present, along with infiltrating lymphocytes and scattered tumor cells. Focal areas of necrosis were also observed. The tumor was located in the left breast, and the distance from the invasive carcinoma to the nearest margin\u2014identified as the deep resection margin\u2014was 5 mm."} +{"pid": "TCGA-VS-A9UM", "report": "The specimen from the cervix biopsy demonstrates invasive malignant cells arranged in nests and cords within the connective tissue. The tumor measures approximately 1.5 cm in greatest dimension. Histologic evaluation reveals moderately differentiated cells with nuclear atypia, increased nuclear-to-cytoplasmic ratio, and frequent mitotic figures. Stromal invasion is present, with involvement of the cervical stroma. \n\nA separate biopsy from the vaginal anterior lower third shows malignant infiltration within the vaginal corium. The cells exhibit similar morphologic features to those seen in the cervical specimen, including nuclear pleomorphism and mitotic activity. No lymphovascular invasion is identified in either site."} +{"pid": "TCGA-A2-A0CW", "report": "The specimen was received for evaluation from a female patient. The submitted materials included a sentinel lymph node, a non-sentinel lymph node, and a right breast lumpectomy specimen.\n\nThe sentinel lymph node measured 1.5 x 0.5 x 0.3 cm and was submitted with attached fibrous fatty tissue. Histologic examination revealed the presence of abnormal cells within the perinodal soft tissue, with the largest focus measuring 0.4 cm. The non-sentinel lymph node specimen consisted of two portions, each measuring approximately 1.5 x 1.5 x 0.1 cm. On sectioning, the tissue showed a uniform tan and white cut surface. This lymph node was almost entirely replaced by abnormal cellular infiltration measuring 1.5 cm; however, assessment of extranodal extension was not possible due to limited surrounding soft tissue.\n\nThe lumpectomy specimen measured 10 x 7 x 3 cm and included an area of skin with a centrally located inverted nipple. A well-defined mass measuring 2.7 x 2.7 x 2.2 cm was identified beneath the nipple, showing a firm, pink-white gritty consistency. Histopathological analysis demonstrated a poorly differentiated infiltrative component with a Nottingham score of 9 (tubules=3, nuclei=3, mitoses=3). No necrosis or microcalcifications were identified in the tumor. Evidence of vascular invasion, including venous and/or lymphatic involvement, was present. The tumor was found to involve the smooth muscle of the nipple. Surgical margins were free of tumor involvement, with the closest distance being 0.6 cm from the superior margin.\n\nAn intraductal component was also present, characterized by a solid growth pattern and nuclear features consistent with grade II. Necrotic changes were noted in less than 5% of this component. Immunohistochemical analysis from a prior biopsy showed strong positivity for estrogen receptors (approximately 100% nuclear staining), progesterone receptors (25% nuclear staining), and HER2 (3+ staining intensity).\n\nStaging was determined as pT2 N1a MX. Additional findings included changes related to a prior biopsy site. All other aspects of the surrounding breast tissue were unremarkable."} +{"pid": "TCGA-DI-A2QT", "report": "A fragment of fatty soft tissue from the falciform ligament measuring 3.0 x 3.0 x 1.0 cm showed fibrosis without evidence of malignancy. A separate specimen from the omentum measuring 30.0 x 16.0 x 1.0 cm consisted of fibroadipose tissue with no malignant findings.\n\nThe left ovary measured 6.0 x 4.0 x 3.0 cm and was largely replaced by a multilobulated yellow tumor with focal white areas. The cut surface was glistening. The fallopian tube measured 7.0 cm in length and 1.0 cm in diameter and contained a small 0.2 cm white nodule. Histologic examination revealed high-grade carcinoma involving both the ovary and fallopian tube.\n\nThe uterus measured 9.8 x 7.0 cm with an attached cervix measuring 4.0 x 4.0 x 3.0 cm. The endometrial cavity was extensively involved by a tan-gray, rubbery tumor showing whorled appearance. The tumor infiltrated circumferentially into the myometrium with extensive lymphovascular invasion. Myometrial invasion measured 18/19 mm anteriorly and 25/26 mm posteriorly. Multiple leiomyomas were present and involved by tumor. The cervix demonstrated tumor involvement extending into the endocervix and vaginal cuff with extensive infiltration into pericervical soft tissues and focal extension to the parametrial margin.\n\nMetastatic involvement was identified in regional lymph nodes. Of five left pelvic lymph nodes, three contained metastatic carcinoma. Four out of ten right pelvic lymph nodes were positive for metastasis. All ten paraaortic lymph nodes examined showed involvement by metastatic disease. A focus of high-grade carcinoma adjacent to the right gonadal vessel wall measured 0.5 cm in greatest dimension. Two out of three lymph nodes from the left common lymph node specimen were involved by metastasis.\n\nHistologic features of tumors from the uterus, cervix, and bilateral ovaries showed similar morphology with diffuse infiltration through the full thickness of the myometrium and ovarian parenchyma. Due to widespread involvement, determination of primary origin was challenging."} +{"pid": "TCGA-DC-4749", "report": "The surgical specimen consists of a segment of large bowel measuring 14.0 cm in length and 6.5 cm in circumference. A lesion is identified measuring 4.0 cm in length, 3.5 cm in width, and with a maximal thickness of 1.5 cm. The lesion is located 3.5 cm from the distal margin and 7.0 cm from the proximal margin. The depth of invasion extends to 0.5 cm into the wall. The overlying mucosa shows a fungating, polypoid configuration. No tumor perforation or serosal involvement is observed. Vascular invasion is present, while perineural invasion is not identified. The preexisting lesion demonstrates invasion into the superficial muscularis.\n\nMargins are free of tumor involvement. Surrounding non-neoplastic bowel appears unremarkable. Sixteen lymph nodes are examined, none showing evidence of metastasis. The proximal and distal anastomotic rings are submitted and show only benign tissue without any abnormality. Histologic evaluation reveals moderately to poorly differentiated cellular features. The tumor is confined without extension beyond the muscularis propria. Based on these findings, staging classification reflects localized disease without nodal involvement."} +{"pid": "TCGA-DB-A64P", "report": "The surgical specimen consists of three components submitted for analysis. The first is a 3.2 x 2.6 x 2.0 cm portion of left frontal brain tissue. The second component is a 3.2 x 2.0 x 1.5 cm left frontal brain mass. The third component, collected from a specimen trap, measures 4.1 x 4.0 x 0.8 cm and represents an aggregate of left frontal brain tissue. All specimens were processed in entirety.\n\nCytologic smears from the first two specimens were evaluated intraoperatively and showed features of a diffuse glioma with morphology suggestive of astrocytic lineage. Final histopathological evaluation demonstrated neoplastic cells that were positive on immunohistochemical staining for IDH1 (R132H), indicating the presence of an IDH1 mutation. Staining for p53 revealed positivity in scattered cells. The Ki67 labeling index was variable, ranging from low to moderate across different areas assessed.\n\nFluorescence in situ hybridization (FISH) studies for 1p/19q deletion were initiated on paraffin-embedded sections and are pending further interpretation. Multiple tissue blocks were prepared from all three specimens for detailed histological examination."} +{"pid": "TCGA-AO-A12D", "report": "The right breast specimen from a prophylactic mastectomy shows benign breast tissue with florid sclerosing adenosis, focal ductal hyperplasia without atypia, secretory changes, cysts, fibroadenomatoid changes, and a few microcalcifications. The nipple appears unremarkable.\n\nThe left breast specimen includes a centrally located mass measuring 1.7 x 1.5 x 1.5 cm microscopically, situated approximately 1 cm from the deep margin. Adjacent to this is another mass measuring 1.0 cm in diameter, located laterally and anteriorly, about 4 cm from the deep margin. Microscopic examination reveals invasive carcinoma with lymphocytic infiltrate. Histologic grade ranges from II to III out of III, with nuclear grade III out of III. A minor component of intraductal proliferation with solid and micropapillary features and high nuclear grade is also present, both admixed with and separate from the invasive lesion. Necrosis is noted within this component. No involvement of the nipple, skin, or surgical margins is identified. Lymphovascular invasion is present.\n\nIn the left axillary contents, level I contains 8 lymph nodes, none of which show involvement. Level II contains 7 lymph nodes, one of which is involved. There is focal extranodal extension greater than 2 mm along with perinodal vascular invasion. The remainder of the non-neoplastic breast tissue demonstrates changes from prior biopsy, florid sclerosing adenosis, ductal hyperplasia without atypia, and a benign intraductal papilloma.\n\nThe sentinel lymph node from the right axilla is benign, with no evidence of tumor involvement confirmed by additional sections and immunostains. The soft tissue specimen from the left upper flap consists entirely of adipose tissue, with no tumor identified.\n\nSpecial studies performed on the left breast specimen show positive staining for ER and PR, and strong positive staining (3+) for HER-2/neu. Controls are satisfactory."} +{"pid": "TCGA-BB-4228", "report": "The specimen from the right base of the tongue resection demonstrates a lesion measuring 6 cm in greatest dimension. Histologic evaluation reveals infiltrative growth pattern composed of malignant squamoid cells. The lesion exhibits a maximum depth of invasion of 1.3 cm. Close proximity to the medial margin is noted at approximately 0.1 cm. All other submitted specimens including anterior tongue mucosa, deep anterior, deep lateral pharyngeal, base of tongue mucosa, deep tonsil, and deep biopsy vallecula are negative for presence of tumor."} +{"pid": "TCGA-AA-A02F", "report": "The specimen consists of two parts. Part I includes a segment of small intestine showing non-specific reactive changes. Part II contains a specimen from the rectosigmoid region demonstrating a poorly differentiated malignant neoplasm at the junction of the rectum and sigmoid colon. Histologic evaluation reveals vascular invasion, including both lymphatic and blood vessel involvement. Metastatic involvement is present in at least one regional lymph node. The primary lesion was excised with clear margins. The distance from the deepest margin of resection to the mesorectal fascia measures a minimum of 1 centimeter. Clinical correlation and anatomical location will aid in determining the exact origin of the lesion within the lower gastrointestinal tract."} +{"pid": "TCGA-A6-2674", "report": "The specimen includes a segment of distal colon, a right abdominal wall tissue fragment, and omental fat. The colon measures 31 cm in length and is covered by smooth tan-pink serosa with attached mesocolon. Two undesignated margins measure 3.8 cm and 10.2 cm in circumference. A circumferential, well-defined, partially necrotic tan-white mass measuring 5 x 4.5 cm is located 10 cm from the smaller margin. The tumor has a maximal thickness of 2 cm and extends through the muscularis to within 0.8 cm of the inked serosal surface. Normal mucosa appears glistening and tan-pink with regular folds. Multiple lymph nodes up to 4.8 cm in size are found in the mesocolon. Sections include full-thickness tumor, transition to normal mucosa, random mucosa, and multiple lymph node samples.\n\nA separate 1.5 x 0.7 x 0.5 cm yellow fatty fragment from the right abdominal wall contains a 0.2 cm white-tan nodule on the surface. The omentum consists of lobular fat with a 1.5 x 0.7 x 0.1 cm white-tan area suggestive of fibrinous exudate or adhesion, and a 2.2 cm white-pink-tan nodule identified on palpation. All tissues from these specimens are submitted for analysis.\n\nMicroscopic evaluation shows poorly differentiated invasive glandular growth with mucin production. Tumor extends through the muscularis propria into surrounding fat (pT3). Both proximal and distal margins, as well as the radial margin, are free of tumor involvement. The closest distance of tumor to a resection margin is 10 cm. Lymphatic invasion is present. Of 20 lymph nodes examined, 7 contain metastatic deposits, with the largest measuring 4.8 cm. Tumor extends beyond some lymph nodes into surrounding fat. In the right abdominal wall specimen, a 0.2 cm metastatic nodule is identified. In the omentum, a 2.2 cm metastatic deposit is found within the fat. Additional findings include diverticulosis."} +{"pid": "TCGA-DX-AB36", "report": "The clinical history includes prior recurrence in the chest wall. The specimen submitted consists of a right chest wall excision, including two ribs and associated soft tissue. The tumor measures 8.1 x 4.5 x 4.3 cm and is firm with a white to tan cut surface. It extends through the chest wall soft tissue and focally approaches both upper and lower ribs. The overall excision measures 11.5 x 6.6 x 5.5 cm and includes a smooth, glistening pleural surface that is distended by the tumor. The tumor extends between the ribs into the anterior soft tissue and is within 0.3 cm of the anterior soft tissue margin.\n\nMicroscopic evaluation includes sections from the tumor, surrounding soft tissue, and rib margins. Sections submitted include anterior and posterior margins of both ribs, tumor extending toward the pleura, and areas where the tumor approaches or involves rib structures. Histologic features include a high-grade malignant component with pleomorphic morphology. Immunohistochemical staining shows strong positivity for CDK4 and MDM2. A low-grade sclerosing component is also present and extends to the anterior soft tissue margin. Rib margins are free of tumor involvement. The assessment is based on direct examination of slides and comparison with prior resection material."} +{"pid": "TCGA-12-1598", "report": "A right temporal parietal lesion was identified on preoperative MRI, demonstrating an irregular enhancing mass with a central area of non-enhancement. A biopsy was performed for diagnostic purposes.\n\nGross examination of the surgical specimen included a 3.6 x 3 x 2 cm fragment of yellow-brown soft tissue and two additional fragments measuring 2.3 x 1.2 x 0.5 cm in total. The tissues showed a yellow-tan to red-tan cut surface. Representative sections were submitted for histologic analysis.\n\nMicroscopic evaluation revealed a densely cellular and pleomorphic astrocytic neoplasm infiltrating brain tissue. The neoplasm exhibited significant mitotic activity, microvascular proliferation, and areas of necrosis. Tumor cells were also identified within the subarachnoid space.\n\nCytogenetic studies using FISH demonstrated polysomy of chromosome 7 in 82% of tumor cells, amplification of EGFR in 97%, loss of chromosome 10 centromere in 70%, and allelic loss of PTEN in 73%. All four markers tested were abnormal.\n\nImmunohistochemical analysis showed negative MGMT expression in 20% of tumor cells. Expression of wild-type EGFR was present in 80% of cells (3+ intensity), and EGFR variant VIII was detected in 20% (3+ intensity). PTEN expression was reduced, with 60% of cells showing 2-3+ intensity. Phosphorylated S6 (pS6) was positive in 60% of tumor cells (2+ intensity), while phosphorylated AKT (pAKT) was negative in most cells, with only 10% showing 2+ intensity.\n\nThe tumor specimen was extensively analyzed using multiple diagnostic methods, including histology, cytogenetics, and immunohistochemistry. All findings were derived from direct pathological evaluation of the biopsied tissue."} +{"pid": "TCGA-77-A5G1", "report": "Histopathology Report. HISTORY. Lobectomy for lesion. MACROSCOPIC. Six specimens are received. 1: The first specimen is labelled \"R middle lobe, R lower lobe, R upper lobe\" and consists of right middle and lower lobes with a small stapled wedge of upper lobe. The specimen measures 165 x 75 x 45 mm; the stapled wedge of upper lobe measures 70 x 30 x 30 mm. There is a firm mass with overlying pleural adhesions at the apical aspect of the lower lobe measuring 52 x 50 x 35 mm. On sectioning, the mass has a pale sclerotic appearance and is centrally cavitated; the cavity measures 12 mm across. The lesion extends to involve the lateral pleural surface and approaches the pleura on the medial aspect, extending into a bronchus. Possible involvement of the upper lobe is noted, though the lesion appears well clear of the stapled upper lobe resection margin. No other focal lesions or endobronchial lesions are identified. 2: The second specimen is labelled \"upper lobe lymph node\" and consists of two pieces of lymph node measuring 17 x 15 x 7 mm and 15 x 11 x 8 mm. 3: The third specimen is labelled \"No. 11 lymph node\" and consists of three pieces of tissue measuring 18 x 15 x 8 mm in aggregate. 4: The fourth specimen is labelled \"No. 7 lymph node\" and consists of fatty tissue measuring 45 x 30 x 15 mm. 5: The fifth specimen is labelled \"No. 8 lymph node\" and consists of a piece measuring 18 x 10 x 6 mm. 6: The sixth specimen is labelled \"No. 9 lymph node\" and consists of lymph node with surrounding fat measuring 35 x 16 x 8 mm.\n\nMICROSCOPIC. 1: Sections show a poorly differentiated epithelial malignancy with central cavitation. Cavitation appears partially due to vascular invasion by the lesion, which is present throughout multiple sites. The lesion invades overlying parietal pleura but does not reach the soft tissue resection margin. No lymphatic invasion is observed, and peribronchial lymph nodes do not show evidence of metastasis. The upper lobe resection margin is free of disease. Proximally, the lesion demonstrates an endobronchial component without high-grade intraepithelial changes; the bronchial resection margin is also free of disease. Focal perineural invasion is seen near the hilum. Adjacent lung parenchyma shows organizing pneumonia; distant lung tissue is unremarkable. 2: Sections show reactive lymphoid hyperplasia and silicotic nodules, no metastasis. 3: Sections reveal small foci of metastatic epithelial cells within one lymph node. 4-6: Sections show reactive lymphoid hyperplasia and scattered silicotic nodules, no metastasis.\n\nSUMMARY. Right middle and lower lobectomy with partial resection of right upper lobe and lymph node sampling: A poorly differentiated epithelial lesion measuring 52 mm in diameter is located in the apical segment of the right lower lobe. Invasion of the parietal pleura is present, but the soft tissue resection margin is free of disease. Vascular invasion is extensive. Focal perineural invasion is identified near the hilum. No lymphatic invasion is observed. Metastatic involvement is identified in one lymph node from station 11."} +{"pid": "TCGA-A6-A56B", "report": "The specimen includes a segment of colon measuring 18 cm in length, with an intact mucosal surface and two small polypoid lesions near the distal margin. A focus of adhesion is present on the serosal surface, measuring 4 x 3 cm, located 3.5 cm from the nearest luminal margin. Within this region, there is a corresponding ulcerated lesion measuring 4 x 3.5 cm, located 3.5 cm from the same margin. Microscopic evaluation shows that the lesion invades through the muscularis propria but does not reach the serosal surface. The closest radial margin is 1.5 cm from the tumor. No vascular invasion is identified upon histologic review. A total of 25 lymph nodes are examined, with three showing evidence of involvement. The distal margin specimen, measuring 1.5 cm in length, shows no abnormal histologic features. Multiple sections of the primary lesion, margins, and lymph nodes were submitted for analysis. Two hyperplastic polyps are also identified."} +{"pid": "TCGA-L6-A4ET", "report": "The clinical report details findings from a total thyroidectomy procedure. The specimen was received fresh and intact, with a total weight of 55.5 grams. The right lobe and isthmus measured 7 cm x 3.9 cm x 2.1 cm, while the left lobe and isthmus measured 5.1 cm x 2.1 cm x 1.2 cm. A unifocal lesion was identified in the right lobe. The tumor could not be precisely measured due to procurement for research purposes in the operating room; however, based on histologic evaluation, the greatest dimension was estimated to be at least 6 cm.\n\nHistologic examination revealed a moderately differentiated neoplasm with classical cytomorphology and follicular architecture. The tumor was encapsulated without evidence of capsular, lymphovascular, or perineural invasion. It was present focally at the anterior inked margin. Due to the lack of extrathyroidal tissue, assessment for extension beyond the gland could not be performed.\n\nPathologic staging indicated a primary tumor greater than 4 cm confined to the thyroid, consistent with pT3 classification. Regional lymph node staging was indeterminate (pNX) due to inability to fully assess lymph node involvement. No distant metastasis was identified.\n\nAdditional findings included adenomatoid nodules in both lobes and benign thyroid tissue in other submitted specimens. Several immunoperoxidase and in-situ hybridization tests were performed for diagnostic purposes. These tests were developed and validated internally and are compliant with CLIA certification standards for high-complexity testing.\n\nGrossly, the right lobe showed an enlarged mass with hard, white-tan homogeneous areas. Multiple nodules were also noted in the left lobe and tubercle specimens. Specimens were oriented using sutures and inked for margin assessment. Portions of the specimen were procured for research prior to formalin fixation and complete submission for histologic processing.\n\nPre-operative imaging and fine needle aspiration findings had indicated concern for a right-sided lesion, which correlated with the intraoperative findings of an enlarged right lobe and significant adhesions. All four submitted specimens were fully processed and evaluated."} +{"pid": "TCGA-E7-A7DV", "report": "The specimen includes an iliac lymph node measuring up to 1.5 cm with metastatic involvement. A cystoprostatectomy specimen shows a large, vegetative tumor located in the bladder cavity at the trigone level, with intramural extension and full-thickness wall invasion. The tumor also extends into the prostate and seminal vesicles. Histologically, the lesion is characterized by infiltrative growth, poor differentiation, presence of giant cells, sarcomatoid features, necrosis, and ulceration. Numerous intramural tumor emboli are present. The right ureter does not show any malignant elements. An adenopathic block on the right side involving internal, external, and obturator iliac nodes measures 5 cm and shows metastatic involvement. A right para-rectal lymph node measuring 1.0 cm is also involved. On the left side, an adenopathic block measuring 4 cm similarly demonstrates metastatic disease. The left kidney shows findings consistent with chronic focal non-specific nephritis, with hematic subepithelial suffusions in the renal pelvis and ureter. The mid and distal ureter show edema and dilated lumens. Lymph node assessment reveals 4 out of 4 regional nodes positive for tumor involvement. Tumor invasion is present in the prostate and extends through the entire bladder wall. Lymphatic and vascular invasion are both evident. The histological grade is poorly differentiated with high-grade features."} +{"pid": "TCGA-EY-A1G8", "report": "The surgical specimen includes the uterus and cervix, removed via hysterectomy along with bilateral salpingo-oophorectomy. The tumor was located in the endometrium and exhibited a histologic pattern characterized by glandular and spindle cell features. Histologic grading was based on architectural differentiation and nuclear characteristics; architectural grade was determined as 2 and nuclear grade as 3. The tumor measured 2.5 x 2.0 x 0.6 cm and appeared multinodular with fungating white/tan soft tissue located in both the anterior and posterior corpus at the fundus. It incorporated much of the endometrium into the lower uterine segment, particularly on the posterior aspect.\n\nAssessment of myometrial invasion showed involvement of the inner half of the myometrium, with an invasion depth of 3 mm out of a total wall thickness of 8 mm, representing approximately 37.5% penetration. No serosal or cervical involvement was identified. There was no evidence of lymphovascular space invasion. A detached fragment of tumor was observed in the lower uterine segment without stromal invasion. All surgical margins were free of tumor involvement.\n\nA total of 40 regional lymph nodes were examined across multiple sites, including right and left peri-aortic and pelvic regions; none contained tumor cells. Hormone receptor analysis demonstrated ER positivity (2-3+, 30%) and PR positivity (2-3+, 30%).\n\nAdditional findings included an atrophic endometrial polyp and vascular calcifications within the myometrium. Both ovaries were atrophic without significant pathology. Each fallopian tube showed no notable abnormalities.\n\nPathologic staging was assigned as pT1b pNO pMx, corresponding to Stage IB. This staging is provisional and subject to revision pending further clinical evaluation.\n\nConsultation review of representative sections confirmed absence of carcinosarcoma. The initial biopsy had shown a well-differentiated variant of this lesion.\n\nNo special investigations beyond standard tissue submission were noted. All specimens were processed and analyzed according to CLIA-certified protocols using reagents classified as analyte-specific, approved for clinical diagnostic use."} +{"pid": "TCGA-2A-A8VX", "report": "The prostate specimen measured 4.3 cm from apex to base, 5.0 cm transversely, and 3.7 cm anterior to posterior. The right and left seminal vesicles measured 3.5 x 1.3 cm and 4.0 x 1.5 cm, respectively. Serial sections of the prostate showed involvement of the right posterior, right anterior, left posterior, and left anterior regions, with the dominant lesion located in the left anterior mid and right posterior mid zones. Crushed and thermal artifact was present in the left base biopsy. The peri-prostatic fat specimen included a small calcified nodule.\n\nMicroscopic evaluation identified cellular features including a ductal or intraductal component, with a primary Gleason grade of 4 and secondary Gleason grade of 4. A significant tertiary component of grade 3 was also noted. Perineural invasion was present, and multiple foci of invasive cells were identified across different regions of the prostate. High-grade intraepithelial changes were observed. Extracapsular extension was found at the left anterior mid and right posterior mid to base locations. Invasion of the right seminal vesicle was documented, while the bladder neck remained uninvolved. All surgical margins were free of abnormal cells.\n\nLymph node specimens from the right hypogastric, left pelvic, and right pelvic regions were examined. A total of 3, 5, and 8 lymph nodes were evaluated in these regions, respectively, with no evidence of metastatic involvement. Immunohistochemical testing for neuroendocrine markers was negative. The capsule and non-neoplastic prostate tissue showed no remarkable findings. Based on AJCC 1997 staging criteria, the tumor extended to involve the seminal vesicle."} +{"pid": "TCGA-AX-A062", "report": "The specimen included a uterus with cervix, bilateral fallopian tubes, and ovaries, as well as multiple lymph node groups from the right and left external iliac, obturator, common iliac, and para-aortic regions. The uterus measured 8.7 x 5.0 x 4.5 cm and contained a tumor mass in the endometrial cavity. The tumor measured 4.0 x 3.0 x 1.5 cm and was located in both the anterior and posterior endomyometrium. A separate smooth, well-circumscribed nodule was identified in the anterior endomyometrium measuring 1.0 x 0.8 x 0.7 cm. The myometrium had a maximum thickness of 2.0 cm in the area of tumor involvement, with invasive growth noted to a depth of 5 mm, representing 25% of the myometrial thickness. No lymphovascular space invasion was identified.\n\nMicroscopic evaluation revealed a neoplastic process involving the endometrium with features of glandular and squamous differentiation. The tumor showed histologic grade G2, defined by 68 to 50% solid growth pattern. There was no cervical or serosal involvement. Both ovaries and fallopian tubes were unremarkable and did not show any evidence of tumor involvement. Additionally, atypical complex hyperplasia was present in the noninvasive endometrial component.\n\nA total of 33 lymph nodes were examined across all regions: five from the right external iliac, three from the left external iliac, eight from the right obturator, six from the left obturator, two from the right common iliac, one from the left common iliac, five from the right para-aortic, and three from the left para-aortic. All lymph nodes were negative for metastatic disease. No tumor was identified at surgical margins, and no venous or lymphatic vessel invasion was observed. Based on these findings, the tumor was classified as pT1b (Stage IB) with no regional lymph node involvement (pN0) and no evidence of distant metastasis (pMX)."} +{"pid": "TCGA-CK-4952", "report": "The specimen was received fresh in two parts, each labeled with the patient\u2019s name and medical record number. Part A consisted of a perigastric lymph node specimen measuring 2.5 x 1.5 x 1.0 cm. Microscopic examination revealed heterotopic pancreas with focal pancreatic intraepithelial changes. No lymph node tissue was identified in this specimen.\n\nPart B was a right hemicolectomy specimen measuring 37.5 x 7.5 cm. It included an appendix (7.0 x 0.5 cm) and distal ileum (3.0 x 2.0 cm). The proximal and distal stapled resection margins measured 2.1 cm and 2.8 cm, respectively. A fungating tan/red mass measuring 7.0 x 4.0 x 2.3 cm was identified. The mass was located 12.6 cm from the ileocececal valve, 15.2 cm from the proximal resection margin, 20.0 cm from the distal resection margin, and 2.1 cm from the radial resection margin. A second tan/yellow polyp measuring 0.3 cm in diameter was also noted. This lesion was located 4.0 cm from the distal resection margin and 33.0 cm from the proximal resection margin. No other lesions were identified.\n\nTwenty-five candidate lymph nodes were identified in the mesentery, with the largest measuring 3.2 x 1.9 x 1.6 cm. Five of these lymph nodes showed involvement. Representative sections of the tumor, adjacent mucosa, and normal bowel were submitted to the tissue bank. Sections of the larger lymph nodes were partially sampled; the remaining nodes were entirely submitted.\n\nMicroscopic evaluation of the tumor showed low-grade, moderately differentiated features. The tumor formed a fungating mass with an infiltrating border and extended through the subserosa to the serosal surface. Proximal, distal, and radial resection margins were all free of tumor involvement. The tumor was 152 mm from the proximal resection margin, 206 mm from the distal resection margin, and 21 mm from the radial resection margin. No lymphovascular, venous, or perineural invasion was identified. A mild peritumoral lymphoid response, including a Crohn\u2019s-like infiltrate, was observed. Residual adenoma was also present.\n\nImmunohistochemical staining for MLH1, MSH6, PMS2, and MSH2 demonstrated intact nuclear expression in tumor cells. However, it is noted that a small subset of tumors may still harbor hereditary genetic defects despite preserved staining, and clinical correlation is recommended."} +{"pid": "TCGA-AA-3851", "report": "The available specimen shows an invasive, moderately differentiated epithelial neoplasm arising in the large intestine. Histological evaluation reveals a gland-forming growth pattern with moderate nuclear atypia. The lesion extends through all layers of the intestinal wall, reaching beyond the muscularis propria into the surrounding pericolorectal tissues. Vascular invasion is present, as indicated by involvement of both lymphatic and blood vessel structures.\n\nSurgical resection margins are uninvolved, and no tumor is identified at the margin sites. Fourteen regional lymph nodes have been examined, and none show evidence of metastatic involvement. \n\nIn a separate block (Block D), non-invasive polypoid lesions are identified. These demonstrate a serrated architecture with a mixture of columnar and goblet cells, along with stromal hemorrhage. No malignant features or invasion are observed in these polyps.\n\nStaging parameters indicate pT3, pN0 (0/14), with R0 resection status. A multidisciplinary tumor board has been involved in determining the M classification."} +{"pid": "TCGA-EL-A3ZL", "report": "The surgical pathology report includes the following findings. A right thyroid lobe specimen measured 4.0 x 2.0 x 1.4 cm and showed a well-circumscribed white-tan granular lesion located in the lateral aspect of the middle right lobe, measuring 1.5 x 1.3 x 1.0 cm. The lesion extends to the anterior and posterior capsule. No multifocality was identified. The remaining right lobe, left lobe, and isthmus were unremarkable. Background thyroid tissue showed multinodular adenomatous goiter.\n\nLymph node evaluation was performed in multiple regions. In the level 6 region, seventeen lymph nodes were identified, ranging from 0.2 x 0.2 x 0.2 cm to 0.4 x 0.3 x 0.3 cm. Four of these nodes contained abnormal tissue, with the largest focus measuring 0.4 cm. There was no extracapsular extension noted in this group.\n\nIn the right levels 3, 4, and 5, nine lymph nodes were identified, ranging in size from 0.2 x 0.2 x 0.1 cm to 2.0 x 0.8 x 0.6 cm. Three of these nodes contained abnormal tissue, with the largest focus measuring 0.7 cm. Focal extracapsular extension was present in this group.\n\nResection margins were negative. Lymphovascular invasion was identified in the primary lesion. No extrathyroidal extension was observed. Deeper levels were examined."} +{"pid": "TCGA-X7-A8DF", "report": "A male patient underwent sternotomy and resection of an anterior mediastinal mass along with removal of an AP window lymph node. The specimen from the anterior mediastinal mass weighed 135 grams and measured 12.2 x 8.1 x 3.6 cm. A well-encapsulated mass was identified within the specimen, measuring 4.2 x 3.2 x 4.4 cm, with a white-tan, lobular, and fleshy cut surface. The capsule was noted to be partially calcified and in close proximity to the inked external surface of the specimen. No additional masses were identified in the surrounding fatty tissue.\n\nMicroscopic examination revealed a tumor with histologic features consistent with a mixed cellular pattern. The tumor measured 4.4 cm in its greatest dimension and extended into the capsule; however, there was no transcapsular invasion. Margins were uninvolved by tumor, with the tumor located less than 1 mm from the closest margin. Lymphovascular invasion was identified within the capsule. One regional lymph node (AP window) was examined and showed no evidence of tumor involvement.\n\nThe tumor was subjected to a gene expression assay using RT-PCR analysis of a 23-gene panel (including four controls). The molecular classification obtained indicated a Class 1 signature. This classification is associated with a low risk of clinical metastasis within ten years. Based on these findings and pathological staging criteria, the tumor was classified as Stage I. There was no evidence of distant metastasis or implantation; however, this could not be definitively assessed. No additional significant pathologic findings were identified in the lymph node specimen or elsewhere in the resected tissue."} +{"pid": "TCGA-KD-A5QT", "report": "A mass was identified in the cervix, characterized by the presence of necrosis. No vascular invasion was observed. The parametrial soft tissue margin was free of involvement. Additional sections of the cervical resection margin and adjacent endocervix confirmed that the margin was clear. High mitotic activity was noted, with up to 102 mitotic figures per 10 high-power fields in certain sections.\n\nLymph node dissections were performed from multiple regions, including the right and left obturator, para-aortic, common iliac, internal iliac, external iliac, and Cloquet areas. A total of 39 lymph nodes were examined, and none showed evidence of tumor involvement. Fibroadipose tissue obtained from omental samples also showed no signs of tumor.\n\nAdditional sections from various tissue samples were evaluated, with no further evidence of disease identified. Further evaluation of pending sections will be reported separately."} +{"pid": "TCGA-EL-A3H2", "report": "A lymph node from the right anterior scalene region showed granulomatous inflammation without any tumor involvement. The right neck contents included multiple lymph nodes at levels 2, 3, and 4. Benign-appearing thyroid tissue was identified in one of ten level 2 lymph nodes and three of five level 3 lymph nodes. No tumor was found in six level 4 lymph nodes.\n\nA mass from the left posterior carotid space was identified as a thrombosed vessel with no tumor present. The submandibular ganglion specimen contained ganglion and salivary gland tissue, with no evidence of tumor.\n\nIn the left comprehensive neck dissection and right level 1 specimen, a 4.5 cm lesion was identified in the mandible. A metastatic deposit measuring 6.0 cm was found in one of one level 2 lymph node, with extranodal extension into fibroadipose tissue and salivary gland. No tumor was found in four level 1, three level 3, or five level 4 lymph nodes. The left floor of mouth margin showed focal mild dysplasia, but all surgical margins were free of tumor.\n\nThe right superior parathyroid gland sample showed only parathyroid tissue. In the total thyroidectomy and paratracheal lymph node dissection, a small focus of a follicular lesion was identified measuring 3.0 mm. Multiple adenomatous hyperplastic nodules were also noted throughout the thyroid tissue.\n\nGrossly, the right anterior scalene lymph node measured 0.7 x 0.4 x 0.4 cm and was free of tumor. The right neck contents included a soft tissue fragment measuring 10.2 x 5.5 x 2.8 cm with multiple lymph nodes ranging from 0.3 to 3.0 cm in diameter. The largest lymph node at level 3 measured 3.0 x 1.5 x 1.5 cm and showed metastatic involvement. Additional lymph nodes were submitted for analysis.\n\nThe left posterior carotid space mass measured 3.0 x 2.5 x 2.0 cm and had a pink-tan, hemorrhagic cut surface with cystic spaces. No tumor was identified. The submandibular ganglion measured 0.5 x 0.5 x 0.5 cm and contained ganglion and salivary gland tissue.\n\nThe left comprehensive neck dissection specimen measured 8.0 x 5.0 x 4.0 cm overall, with the left neck dissection component measuring 11.0 x 6.0 x 4.5 cm. It included a large mass within the left submandibular gland. The mandibulectomy specimen contained teeth and an ulcerated lesion measuring approximately 4.5 x 3.0 x 1.5 cm involving the anterior soft tissue. Lymph nodes in the left neck dissection ranged from 0.5 to 6.0 cm, with the largest being necrotic and involved.\n\nThe total thyroidectomy specimen included a right lobe measuring 6.5 x 4.5 x 2.0 cm and a left lobe measuring 4.0 x 3.0 x 1.5 cm. A well-circumscribed mass was identified in the right lobe near the lower lateral pole, measuring 2.5 x 1.7 x 2.0 cm and covered by a fibrous capsule. Another smaller mass was noted in the upper left pole of the right lobe. Microscopically, a 1.5 cm lesion was identified in the upper superior aspect of the right lobe and a 1.2 cm lesion on the opposite side. The medial nodule in the right lobe showed central calcification. Multiple colloid nodules and adenomas were present in the left lobe, ranging from 0.2 to 1.0 cm in size.\n\nTeeth were submitted as part of the specimen with no attached soft tissue identified. All findings were confirmed microscopically with appropriate sections taken from each site."} +{"pid": "TCGA-DD-A4NJ", "report": "The specimen includes a wedge resection of the right lobe of the liver and a cholecystectomy. Two separate nodules were identified, measuring 4.4 x 4.2 x 3.0 cm and 0.6 x 0.6 x 0.6 cm. The larger nodule is located 3.9 cm from the nearest surgical margin. No definitive vascular invasion was observed. All surgical margins are free of tumor involvement. The background liver tissue demonstrates mild steatohepatitis with grade 1 activity and mild portal fibrosis (stage 1 of 4). The gallbladder exhibits chronic inflammation. A single lymph node adjacent to the cystic duct shows no evidence of tumor involvement."} +{"pid": "TCGA-KM-8443", "report": "A radical nephrectomy specimen from the right side measured 17 x 11 x 8 cm. A unifocal brown tumor with tan and soft cut surfaces, including areas of necrosis, was identified within the kidney. The tumor measured 12 cm in its greatest dimension. The specimen was partially inked, and upon bisection, the tumor did not grossly extend beyond the capsule. The vascular and ureteral margins were free of tumor involvement. The specimen weighed 722 grams after fixation.\n\nTwo lymph nodes were received from the interaortocaval region, measuring 2.0 x 1.2 x 0.6 cm and 0.7 x 0.5 x 0.3 cm. Both had smooth tan cut surfaces and were entirely submitted for histologic evaluation. Microscopic examination of the kidney revealed a high-grade neoplasm with Fuhrman nuclear grade III features. Histologic evaluation of the tumor margins, including the inked specimen margin, showed no evidence of tumor extension. Sections of the adrenal gland also showed no tumor involvement.\n\nStaging indicated no regional lymph node involvement (pN: 0) and the primary tumor classified as pT2. Distant metastasis could not be assessed (pMX). Tumor focality remained unifocal with no evidence of multifocal disease. Multiple sections of the tumor, surrounding kidney tissue, and margins were submitted for further analysis. No additional findings or consultants were noted."} +{"pid": "TCGA-C5-A905", "report": "The surgical pathology report describes tissue obtained from a cervical biopsy and endocervical curettage. Microscopic examination reveals a moderately differentiated invasive squamous cell carcinoma. The biopsy specimen demonstrates nests of malignant cells with moderate nuclear atypia, increased nuclear-to-cytoplasmic ratio, and frequent mitotic figures. The invasion is noted into the underlying stroma. The endocervical curettage shows similar histologic features, consistent with an invasive process. No lymphovascular invasion is identified. The tumor involves the cervix with extension into the endocervical canal. Clinical history notes a prior cytology showing severe dysplasia and a colposcopic finding of a friable, ulcerated lesion on the cervix. Two glass slides were submitted for review and are retained in the pathology files."} +{"pid": "TCGA-HT-A5RA", "report": "The section shows involvement of the hippocampus by a neoplastic process characterized by infiltration and variable cellularity. Areas of mild to moderate cell density are present alongside regions of marked hypercellularity. Infiltrative growth is evident, with subpial condensation noted in certain foci. Immunohistochemical staining reveals numerous MIB-1 positive cells distributed throughout the lesion, with a calculated labeling index of 17.2%."} +{"pid": "TCGA-QQ-A8VG", "report": "The specimen consists of a wide excision from the right lower back, measuring 21.3 cm x 10.1 cm, with variable thickness ranging from 2.0 cm medially to 5.0 cm laterally. A healed scar measuring 5.2 cm in length is noted on the medial aspect of the skin surface, located 2.2 cm from the medial surgical margin. A firm mass is identified within the soft tissue throughout the specimen.\n\nOn sectioning, the mass appears heterogeneous with alternating fleshy and fibrotic areas. The medial portion of the mass is tan-pink and fleshy, measuring 3.5 cm x 3.5 cm x 2.2 cm, located just beneath the healed scar. The fascia underlying this area is grossly negative for tumor and is less than 0.1 cm away from the fleshy component. Lateral to this fleshy region, the mass transitions into a tan-white to pale yellow fibrotic area with an infiltrative edge. Another fleshy tan-pink area, measuring 2.5 x 1.9 x 2.2 cm, is identified centrally, approximately 0.2 cm from the deep fascial margin. This area is fairly well-circumscribed. Lateral to this central fleshy region, the mass again exhibits a fibrotic, tan-white appearance with infiltration.\n\nAll surgical margins (medial, lateral, superior, inferior) are grossly free of tumor involvement. The remainder of the soft tissue shows a lobulated pale yellow appearance with multiple interspersed fibrous septa.\n\nMicroscopic sections were taken from various regions of the specimen, including margins and areas of interest. Immunohistochemical staining revealed positivity for S-100 and CD57-LEU7 in some regions, while markers such as MELAN-A, HMB45, and MICROPHTHALMIA were consistently negative. Inflammatory cells showed reactivity for CD57-LEU7 in one area.\n\nHistologically, there is a diffuse neurofibroma involving much of the specimen, extending to the surgical margins. Within this background, a discrete hypercellular nodule composed of fusiform to spindled cells is present, showing mitotic activity and cytologic pleomorphism. A prominent lymphocytic inflammatory infiltrate is also observed. No intraepithelial melanocytic proliferation is identified.\n\nThe tumor in question is located approximately 3 mm from the deep resection margin. All other surgical margins are microscopically negative. Focal involvement by neurofibroma is noted at the superior, inferior, lateral, and medial margins.\n\nThe histologic features include cellular pleomorphism, mitotic activity, and a lymphocytic infiltrate, seen in association with a background neurofibroma."} +{"pid": "TCGA-78-8640", "report": "The left upper lobe specimen consists of a lobectomy measuring 210 x 105 x 45 mm. A subpleural mass measuring 23 x 18 mm with a white cut surface and black speckling is identified; it does not involve the overlying pleura and abuts a bronchus without apparent invasion. No other lesions or endobronchial abnormalities are observed. Histologically, the lesion demonstrates poorly differentiated morphology without pleural invasion. Adjacent lung tissue shows scarring and emphysematous changes. Resection margins are free of abnormal cells. Among five peribronchial lymph nodes, one contains metastatic involvement.\n\nSubmitted lymph node specimens include left mediastinal lymph nodes (12 mm and 8 mm), left peribronchial lymph nodes (25 x 22 x 14 mm and 20 x 18 x 8 mm), and a hilar lymph node measuring 5 mm. All lymph nodes assessed show no evidence of involvement. The bronchial stump specimen, measuring 18 x 15 x 9 mm, also demonstrates no abnormal cellular activity.\n\nUltrastructural evaluation reveals acinar structures with microvilli and junctional complexes."} +{"pid": "TCGA-A2-A0CV", "report": "The specimen was obtained from an Asian-Pacific Islander patient. The tissue samples included sentinel and non-sentinel lymph nodes from the left side, as well as left breast and axillary content. A mass was identified in the left outer quadrant measuring 4.1 cm in greatest dimension. Histological evaluation revealed a Nottingham score of 6, with features consistent with moderately differentiated morphology. Tubule formation was noted, with nuclear grade 3 and one mitotic figure per 10 high power fields. Necrosis was not identified. Microcalcifications were present.\n\nLymphatic invasion was observed in both invasive and in situ components, as well as within benign ducts. Venous invasion was absent. Margins were negative, with the nearest margin measuring 2.5 mm from the invasive tumor (deep margin, slide C6). An intraductal component was also identified, with a nuclear grade of 3 and a size of 3 mm (deep margin, slide C6). The tumor demonstrated an extensive intraductal component and cribriform architecture.\n\nExamination of lymph nodes revealed involvement in two out of eighteen sentinel lymph nodes. Extranodal extension was present, measuring 4 mm. One additional lymph node (specimen C, low, C12) was positive for involvement. Nipple and skin were identified without evidence of direct extension. Multicentricity was not observed. Additional findings included sclerosing adenosis, columnar cell change with atypia, fibrocystic changes, usual ductal hyperplasia, and fibroadenoma.\n\nHormone receptor status showed strong positivity for both estrogen and progesterone receptors (100% staining), while Her2 immunohistochemistry was negative (1+). Preoperative imaging identified a 4 x 4 cm mass in the left upper outer quadrant and a 1 cm lymph node. Postoperative pathology confirmed the presence of metastatic carcinoma in lymph nodes, with no additional masses found in other quadrants. The surrounding tissue showed nodular and fibrous changes, with fatty tissue comprising 20% of the specimen. Axillary dissection revealed sixteen lymph nodes, with focal involvement noted in some nodes."} +{"pid": "TCGA-VS-A94Y", "report": "The biopsy specimen from the cervix demonstrates a malignant neoplasm composed of atypical squamous cells exhibiting marked pleomorphism, increased mitotic activity, and areas of necrosis. The tumor infiltrates the underlying stroma and is associated with ulceration of the overlying epithelium. Measurements indicate a maximum dimension of invasion, with depth and extent involving the cervical tissue. Lymphovascular space invasion is present. No lymph node involvement is identified in this specimen."} +{"pid": "TCGA-C5-A7UE", "report": "The specimen consists of cervical tissue submitted for evaluation. Microscopic examination demonstrates a neoplastic process involving the cervix. The tumor is composed of malignant squamous cells arranged in nests and cords, invading into the surrounding stroma. The cells show moderate nuclear pleomorphism, with increased nuclear-to-cytoplasmic ratios and frequent mitotic figures. Stromal invasion is present, with involvement of the underlying connective tissue. The tumor demonstrates focal infiltration, with extension into deeper layers of the cervix. No lymphovascular invasion is identified. Margins are involved by tumor. Immunohistochemical stains were performed and support the morphologic findings. Clinical correlation was provided, and the microscopic features are consistent with those previously reported."} +{"pid": "TCGA-X8-AAAR", "report": "Specimen consists of distal esophagus and proximal stomach following esophagogastrectomy. The tumor is located in the distal esophagus with involvement of the esophagogastric junction. The lesion measures 3.0 cm in size. Histologic examination reveals well-differentiated glandular tissue, Grade 1. Microscopic evaluation was conducted on all histologic sections obtained from the specimen."} +{"pid": "TCGA-86-7954", "report": "The specimen consists of a right lower lobe of the lung weighing 162 grams and measuring 14.5 x 11.5 x 3.5 cm. The pleural surface appears tan to gray-brown with areas of mild wrinkling. Three subpleural nodular structures are present along the base, ranging from 0.4 to 0.6 cm in size. A firm tan subpleural mass measuring 2.7 x 1.0 cm is located near the posterolateral aspect of the base, within approximately 5 cm of the bronchial margin. The overlying pleura shows puckering and is focally marked with blue ink. The cut surface of the mass is glistening and gray-tan. Adjacent hilar lymph nodes measure 0.5 and 0.6 cm.\n\nMicroscopic evaluation shows no evidence of tumor at the bronchial margin. A small lymph node within the margin is also free of tumor involvement. Two additional hilar lymph nodes are negative for metastatic disease. The main lesion demonstrates an invasive component with poorly differentiated morphology, transitioning into a peripheral pattern resembling bronchioloalveolar growth. There is focal extension to the visceral pleural surface, with free-floating cells seen in clot adjacent to this area. Vascular margins are clear, and there is no evidence of angiolymphatic space involvement. The separate subpleural nodules show metaplastic epithelial changes, including mucinous and nonmucinous features with ciliated cells. One focus exhibits squamous metaplasia, but no nuclear atypia is observed. Background lung tissue shows emphysematous changes.\n\nImmunohistochemical staining was performed with appropriate controls. The malignant cells show positivity for Napsin A, CK7, and TTF-1, with focal reactivity for CK20. Staining for CDX-2 is negative. These findings are consistent with a primary pulmonary origin.\n\nStaging information indicates pT2 (PL2), NO, MX classification. The tumor is located in the right lower lobe, measures 2.7 x 1.0 cm, and has spread to the visceral pleura. No angiolymphatic invasion is identified. Surgical margins are uninvolved. Sixteen lymph nodes are negative for metastatic disease. The histologic type is characterized by a bronchioloalveolar growth pattern with poor differentiation. Additional findings include emphysematous changes in nonneoplastic lung tissue. No evidence of neoadjuvant therapy is noted."} +{"pid": "TCGA-W4-A7U2", "report": "The left radical orchiectomy specimen includes a testicle measuring 6.7 x 3.9 x 5.7 cm and weighing 99.2 grams. Attached structures include the epididymis, spermatic cord, and tunica vaginalis. The spermatic cord measures 9.8 x 1.9 cm in diameter. A heterogeneous mass is present, effacing nearly the entire testicular parenchyma except for a small residual rim. The mass is lobulated with tan/white areas, focal hemorrhage, and contains both cystic and solid components with regions of firmness and possible calcification. The measured size of the mass is 5.7 x 3.3 x 3.7 cm, and it is unifocal. Microscopically, the mass consists of multiple components, including a focus of undifferentiated carcinoma interpreted as embryonal carcinoma, measuring 1.8 cm. Other sections show no evidence of immature teratoma.\n\nThe mass abuts the tunica albuginea but does not grossly extend beyond it. Evaluation of surrounding structures shows no involvement of the epididymis, tunica vaginalis, paratesticular soft tissues, or spermatic cord. The surgical margins, including a distance of 9.0 cm from the distal spermatic cord margin, are negative. A small area of grossly normal testicular tissue is present at the inferior pole. The remainder of the testicle is largely replaced by tumor, with the cystic and solid mass predominating the upper pole.\n\nSections submitted include the spermatic cord margin, tunica vaginalis, and multiple sections of the mass in relation to adjacent structures. No tissue was submitted for special investigation, and no digital photograph was taken. The pathologic findings indicate that the lesion is confined to the testicle without lymphovascular invasion or nodal involvement. Staging based on this specimen is pT1 pNx pMx, which may be incomplete and should be correlated with further clinical evaluation. Preoperative imaging showed a mixed cystic and solid testicular mass, and serum tumor markers included an AFP level of 15 (ULN 10) and beta HCG <5."} +{"pid": "TCGA-D7-A4Z0", "report": "The specimen consists of a resected stomach measuring 19 x 13 cm, incised along the lesser curvature. A lesion with ulceration is present in the pyloric region, measuring 7x5x2 cm. The distance from the proximal resection margin is 12 cm, and from the distal margin is 0.5 cm. Histologically, the lesion demonstrates poorly differentiated features and corresponds to a diffuse-type morphology according to Lauren classification. The lesion involves the submucosa and muscularis propria of the stomach wall. Surgical margins are free of neoplastic involvement. Lymph node assessment reveals involvement in 3 out of 10 nodes examined."} +{"pid": "TCGA-EM-A2P2", "report": "The specimen consists of a total thyroidectomy with measurements as follows: right lobe measuring 5.5 cm x 4.5 cm x 2.6 cm, left lobe measuring 5.7 cm x 3.1 cm x 0.9 cm, and isthmus measuring 3.2 cm x 2.7 cm x 0.8 cm. The total weight is 56.9 grams. Two distinct nodules were identified. The dominant lesion is located in the right lobe and measures 5.0 cm x 4.5 cm x 2.5 cm. Histologically, it demonstrates mixed architectural patterns including follicular, solid, and trabecular arrangements. Vascular spaces around this lesion show tumor cells without an associated fibrin reaction, which raises suspicion for vascular invasion although it is not definitive. The capsule of this nodule is partially intact with minimal invasion at its margin.\n\nA second lesion in the left lobe measures 0.5 cm in greatest dimension and exhibits classical papillary architecture and cytomorphology. Psammoma bodies are present within this lesion and also identified in lymphatic spaces of the left lobe. Additional microscopic lesions measuring 0.1 cm each are noted in the left lobe. These smaller lesions are arranged in a papillary pattern and show classical features.\n\nMargins are free of involvement in both lobes. No extrathyroidal extension or perineural invasion is observed. Lymphovascular invasion cannot be confirmed definitively and is considered indeterminate. All five regional lymph nodes examined show no evidence of tumor involvement.\n\nAdditional findings include a separate nodule measuring 1.0 cm in the left lobe that demonstrates degenerative changes and cytologic atypia. Based on TNM classification, the staging reflects multiple primary tumors with the largest confined to the thyroid gland without regional lymph node metastasis."} +{"pid": "TCGA-AC-A62X", "report": "The specimen consisted of a left breast modified radical mastectomy with axillary lymph node dissection. Gross examination identified a well-circumscribed tumor measuring approximately 2.7 cm in diameter located centrally within the breast tissue. The tumor was positioned 1.5 cm from the superior-superficial margin, 2.3 cm from the deep surgical margin, and greater than 6.0 cm from both the inferior superficial and medial margins. Adjacent to this lesion, no comedo necrosis or calcifications were observed.\n\nHistologic evaluation revealed a single focus of invasive carcinoma without lymphovascular invasion. The tumor exhibited high-grade nuclear features with a Nottingham score of 3 out of 3, based on tubule formation, nuclear pleomorphism, and mitotic activity. Surrounding the invasive component was an area of intraductal proliferation comprising less than 10% of the tumor volume. This in situ component was classified as high nuclear grade without comedo-type morphology.\n\nMargins of resection were extensively sampled and showed no evidence of tumor involvement. Invasive carcinoma was at least 1.5 cm from the superior-superficial margin and at least 2 cm from all other margins. The ductal carcinoma in situ component was similarly distant from all margins by at least 2 cm.\n\nA total of ten axillary lymph nodes were evaluated; none contained malignant cells. Ancillary studies performed on prior core biopsy demonstrated estrogen receptor positivity in 5% of cells with moderate intensity, progesterone receptor negativity, HER2 immunohistochemistry score of 1+, and a Ki-67 proliferation index of 60%.\n\nAdditional benign findings included a papilloma measuring at least 0.9 cm in the inferior-central region and a fibroadenoma measuring 0.8 cm in the lower outer quadrant.\n\nPathologic staging based on AJCC criteria was determined as follows: primary tumor pT2, regional lymph nodes pN0, and no evidence of distant metastasis. Overall stage classification was IIA."} +{"pid": "TCGA-EB-A85J", "report": "The specimen consists of a skin flap containing a pigmented lesion measuring up to 4 x 3.5 cm in dimension and up to 1 cm in thickness. A separate resection margin is also present. Microscopic evaluation reveals a malignant neoplasm arising in the skin, characterized by the absence of superficial ulceration. The lesion shows a vertical thickness of 5.5 mm. The resection margin includes fibrous, fatty, and bone tissue. Histologic assessment confirms the absence of venous invasion and no involvement of the margins. The lesion is pigmented and no satellite nodules are identified. No evidence of prior treatment is observed. Additional findings include a Breslow tumor thickness measurement of 5.5 mm."} +{"pid": "TCGA-DJ-A1QO", "report": "A 45-year-old male with a history of a thyroid mass previously diagnosed by fine needle aspiration as papillary thyroid carcinoma underwent total thyroidectomy and excision of a subcutaneous lymph node. The lymph node specimen measured 0.7 x 0.5 x 0.3 cm and consisted entirely of benign fibroadipose tissue, with no lymph nodes identified in the submitted material.\n\nThe thyroid specimen weighed 17.5 g and included the right lobe (3.7 x 2.2 x 1.4 cm), left lobe (2.4 x 2.0 x 0.8 cm), and isthmus (4.3 x 2.6 x 1.2 cm). A well-circumscribed red-tan fleshy lesion measuring 2.2 x 1.8 x 1.1 cm was identified in the isthmus along with a 1.3 cm cystic lesion adjacent to or within the main lesion. The remainder of the thyroid parenchyma appeared red-tan and beefy. The posterior surface of the thyroid was inked black and the anterior surface blue. Histologic evaluation revealed a partially encapsulated lesion with no evidence of mitotic activity or tumor necrosis. Cellular features included tall cell morphology and well-differentiated histology.\n\nExtrathyroidal extension into the surrounding adipose tissue was observed, and tumor cells were present at the inked anterior surgical margin. Microscopic evaluation also revealed two small foci suggestive of intrathyroidal involvement in the right and left lobes, measuring 0.2 cm and 0.22 cm respectively. Non-neoplastic findings included nodular hyperplasia and chronic lymphocytic thyroiditis. Parathyroid glands were not identified in the submitted sections. All relevant tissue was sectioned and submitted for analysis."} +{"pid": "TCGA-BQ-5884", "report": "The specimen consists of a wedge-shaped portion of the right kidney with a suture marking the deep margin, measuring 2.5 x 1.7 x 1.2 cm. The deep surgical margin is inked black. Serial sectioning reveals a sub-capsular yellow nodule measuring 1.1 x 1.0 x 0.5 cm. Clearance from the resection margin is 0.5 cm. A representative section of the nearest margin was submitted for frozen section evaluation, which confirmed that the margin is free of tumor. \n\nMicroscopic examination of the submitted sections shows a neoplasm involving the kidney. The lesion is well-circumscribed and located peripherally within the cortex. The architecture is consistent with a cortical-derived lesion. There is no evidence of local invasion or involvement of the renal vein. No lymph nodes or adrenal tissue were identified in the specimen. \n\nAll surgical margins are free of neoplastic cells. Non-neoplastic kidney tissue appears unremarkable. \n\nStaging is based on the size and extent of the lesion, which is confined to the kidney and measures less than 7.0 cm in greatest dimension. Sections from the intraoperative consultation and permanent blocks confirm the findings. \n\nRepresentative sections of the tumor have been submitted for further analysis. All submitted margins have been evaluated and show no involvement by tumor."} +{"pid": "TCGA-AG-A02N", "report": "The specimen includes a rectal preparation showing an invasive, poorly differentiated carcinoma with areas resembling mucinous differentiation. The tumor is graded as G3 and has infiltrated through all layers of the bowel wall (pT3). Lymphatic vessel invasion (L1) is present. Surgical resection margins are negative, with no tumor involvement at the margins or at the ligature site. A total of twelve regional lymph nodes are examined and show no evidence of metastasis (pN0). Additionally, a separate lymph node sample consists of fatty connective tissue with lymphoid elements, showing no signs of tumor involvement. A third specimen, identified clinically as a distal anastomotic ring, contains colonic crypt mucosa with mild chronic inflammation and localized vascular proliferation. No tumor cells are identified in this area."} +{"pid": "TCGA-BP-5189", "report": "The specimen consists of a wedge-shaped portion of kidney measuring 5.6 x 5.2 x 4.1 cm, with a suture marking the deep surgical margin. A separate piece of fibroadipose tissue measuring 7.1 x 5.2 x 0.8 cm is also present. An adherent blood clot is noted on the cortical surface, measuring 4.5 x 1.2 x 1.2 cm. Serial sectioning reveals a well-circumscribed lesion within the kidney, measuring 4.3 x 4.1 x 2.1 cm, with yellow, lobulated, focally sclerotic, and hemorrhagic features. The lesion is located 0.2 cm from the resection margin. A representative section of the nearest margin was submitted for frozen section analysis.\n\nMicroscopic evaluation confirms the presence of an epithelioid lesion. Nuclear features are notable for high-grade morphology. No evidence of local invasion or renal vein involvement is identified. Surgical margins are free of tumor. No lymph nodes or adrenal gland tissue are identified in the specimen. The tumor is confined to the kidney and measures less than 7.0 cm in greatest dimension. Multiple sections were examined, including control, tumor, margin, and representative sections. Intraoperative consultation confirmed the tumor's presence and noted a close but clear margin at approximately 0.1 cm. Permanent sections corroborate the intraoperative findings."} +{"pid": "TCGA-A8-A095", "report": "The specimen shows a lesion with a maximum diameter of 1.8 cm, characterized by cellular features including nuclear atypia and increased mitotic activity. Angioinvasion is present, and there is evidence of involvement of the neural sheath in the periphery. Adjacent ductal structures demonstrate epithelial proliferation with similar nuclear features, though without stromal invasion. The surrounding breast tissue exhibits fibrocystic changes and contains small foci of fibroadenoma-like structures, which are unremarkable. The lesion is classified as G2 with no lymphovascular invasion noted. Staging assessment indicates pT1c, pN0 (sentinel node evaluation), MX, and complete resection margins with a minimum dorsocranial margin width of 1 cm."} +{"pid": "TCGA-MS-A51U", "report": "The surgical specimen included a left modified radical mastectomy and right simple mastectomy, along with sentinel lymph node biopsies. The left breast specimen measured 17 x 15.5 x 3.9 cm and showed a multifocal tumor process. The largest lesion was located in the upper outer quadrant and measured 3.2 x 2.2 x 1.3 cm. Additional foci were identified in the retroareolar area and lower outer quadrant, with the largest measuring up to 1.1 cm. Histologically, the tumor was classified as grade 2 out of 3 (score: tubules 3 + nucleus 2 + mitoses 1 = 6/9) with a low mitotic index (<1/hpf). Lymphovascular invasion was present, but perineural invasion was not identified. Margins of resection for invasive carcinoma were negative, with the closest margin measuring 12 mm at the deep margin.\n\nA component of in situ carcinoma was also identified, specifically non-extensive lobular carcinoma in situ (LCIS), accounting for 5% of the total tumor burden. LCIS was of low nuclear grade (1/3 by SBR criteria), and margins for this component were also negative. \n\nA total of 18 lymph nodes were examined from the left side. Two lymph nodes contained metastatic deposits. The largest metastatic focus measured 6 mm in greatest dimension, and no extracapsular extension was observed. One of the two sentinel lymph nodes was involved, and one of the 15 axillary lymph nodes from the mastectomy specimen was also positive. Based on these findings, the nodal stage was pN1.\n\nThe right breast specimen weighed 510 grams and measured 20 x 17 x 2.8 cm. It showed fibrocystic changes and columnar cell hyperplasia, with no evidence of atypical hyperplasia, in situ, or invasive carcinoma. Skin, nipple, and resection margins were unremarkable. No suspicious lesions were identified grossly.\n\nEstrogen receptor status was positive and progesterone receptor status was also positive. HER2/neu testing was negative. Tumor was confined to the breast without invasion of skin or muscle. A nevus cell aggregate was incidentally noted. \n\nIntraoperative frozen section analysis of the first sentinel lymph node showed involvement by malignancy, while the second sentinel lymph node did not show any evidence of disease. Permanent sections confirmed these findings. A review of the microscopic slides led to an updated count of involved lymph nodes, which resulted in a revised staging classification."} +{"pid": "TCGA-PK-A5HB", "report": "The specimen included an accessory spleen measuring 1.8 x 1.7 x 1.2 cm, which was tan and unremarkable on sectioning. A separate spleen measuring 13.0 x 10.0 x 5.0 cm was also unremarkable with no lymph nodes identified in the hilar region. The left adrenal gland contained a large mass measuring 12.0 x 8.5 x 9.5 cm and weighing 448 grams. The cut surface of the mass was tan, partly solid and friable, with a lobulated appearance and areas of hemorrhage. Microscopically, the tumor exhibited a solid and trabecular architecture, composed of clear and compact cells with marked nuclear pleomorphism, numerous mitoses, and multinucleated cells. There was extensive geographic necrosis and fibrous banding within the tumor. The tumor was encapsulated with full thickness capsular invasion and extended into the peri-adrenal fat. Resection margins were not involved, and no lymphovascular invasion was identified. In the perirenal fat, multiple lymph nodes were present, ranging from 0.3 cm to 9.0 cm in size. The attached kidney and pancreas showed no significant pathological changes, except for minimal glomerulosclerosis in the kidney and focal inflammation and fibrosis in the pancreas."} +{"pid": "TCGA-AG-3878", "report": "The specimen shows a moderately differentiated adenocarcinoma located in the rectal region. Histological evaluation reveals infiltration into the muscularis propria, classified as pT2. There is no evidence of vascular invasion, with both lymphovascular and venous invasion being negative (L0 V0). Lymph node examination indicates absence of metastasis (pN0). The tumor exhibits gland-forming architecture typical of colorectal origin, with moderate nuclear atypia and preserved tissue architecture. No additional invasive features are identified."} +{"pid": "TCGA-85-A53L", "report": "Gross Description: The specimen shows a mass located in the right middle lobe with ill-defined margins, measuring 7 x 6 x 5 cm. It has a soft, gray surface. Subcarinal and segmental lymph nodes are present, each measuring up to 0.5 cm in maximum size and appearing black in color.\n\nMicroscopic Description: The tissue demonstrates cellular arrangements in groups, sheets, or trabeculae, with central necrosis of the cells. The cells exhibit moderate eosinophilic cytoplasm and enlarged nuclei with variation in size and shape. Coarse clumped chromatin and prominent nucleoli are observed. Mitotic activity is frequent. The stroma is characterized by lymphocytic infiltration and fibrous tissue. Invasion into surrounding tissue is noted.\n\nSpecimen type: Lobectomy. Tumor site: Lung. Tumor size: 7 x 6 x 5 cm. Histologic grade: Poorly differentiated. Lymph nodes: No metastasis identified in subcarinal or segmental lymph nodes (0/2 examined). Lymphatic invasion: Present. Margins: Uninvolved."} +{"pid": "TCGA-DJ-A4V4", "report": "The specimen consists of a total thyroid measuring 3.9 x 2.4 x 1.6 cm on the right lobe, 4.5 x 2.5 x 1.5 cm on the left lobe, and 2.9 x 1.4 x 1.2 cm at the isthmus, with a total weight of 14.0 grams. The external surface is covered by a thin fibrous capsule. Sectioning reveals multiple nodules. A primary nodule measuring 0.9 x 0.8 x 0.6 cm is identified in the right middle lobe, white-tan in color, rubbery, and circumscribed, located near both anterior and posterior margins. A second nodule measuring 0.5 cm in greatest diameter is found 0.2 cm inferior to the first and close to the anterior margin. A third nodule measuring 0.3 cm in greatest diameter is noted 0.8 cm lateral to the second nodule. The remaining thyroid tissue appears red-tan. All nodules are well-circumscribed without evidence of encapsulation. Histologically, the cellular features demonstrate well-differentiated morphology. No mitotic activity or tumor necrosis is observed. Vascular invasion or extrathyroid extension is not present. Surgical margins are free of abnormal tissue. Additional findings include nodular hyperplasia in non-neoplastic areas. Multiple sections were taken from all regions including the isthmus, right lobe, left lobe, and representative nodules for comprehensive evaluation."} +{"pid": "TCGA-A6-6649", "report": "The specimen consists of a 30 cm segment of proximal right colon with attached 8 cm of distal ileum, externally covered by smooth tan-pink serosa. The proximal and distal margins measure 4.0 cm and 8.0 cm in circumference, respectively. On opening, a moderately well-circumscribed, rubbery tan-white mass measuring 4.5 x 3.8 cm is identified, located 9 cm distal to the ileocecal valve. The tumor has a maximal thickness of 1.8 cm and extends into the muscularis, reaching within 0.6 cm of the inked radial serosal margin. Several small polypoid lesions, up to 0.6 cm in size, are present throughout the remaining colon. The ileal and colonic mucosa appears normal, with regular folds and wall thickness averaging 0.5 cm. Lymph nodes, up to 1.2 cm in size, are identified in the mesocolon and mesentery.\n\nHistologically, the lesion shows full-thickness invasion through the bowel wall into adjacent adipose tissue (pT3). Both proximal and distal margins are free of involvement, and the tumor does not reach the outer serosal surface. Vascular invasion is present in pericolonic tissue. Of 23 lymph nodes examined, two contain metastatic involvement (pN1b). Perineural invasion is also noted. Additionally, separate adenomatous polyps are identified in the colon. Tumor is located 21 cm from the distal resection margin. No distant metastasis is assessed (pMX)."} +{"pid": "TCGA-3U-A98F", "report": "The patient is a male. The tissue specimens were obtained and processed on [date]. Specimens included a right chest wall mass biopsy, R4 lymph node biopsy, number 7 lymph node biopsy, and a pleural peel resection.\n\nBiopsy of the right chest wall mass showed skeletal muscle and fibroadipose tissue with reactive changes and acute and chronic inflammation. Two lymph nodes from the R4 station and seventeen lymph nodes from station number 7 were examined; none contained malignant cells.\n\nThe pleural peel specimen was submitted in two large portions: a tumor mass and thickened pleura. The tumor mass measured 18.5 x 18.5 x 11.0 cm and was diffusely distributed across the pleural surface. Microscopically, the tumor demonstrated a biphasic pattern with 90% sarcomatoid component and 10% epithelioid component. The sarcomatoid areas consisted of highly cellular spindle-type hyperchromatic cells frequently overlapping with one another, with focal fibrotic stroma. The epithelioid cells were cuboidal to columnar with well-defined borders and clear-to-eosinophilic cytoplasm. Polypoid masses were covered by a single layer of epithelioid cells.\n\nTumor extended into but not through the diaphragm and involved the endothoracic fascia. There was no evidence of venous or lymphatic invasion. Surgical margins could not be fully assessed due to the nature of the resection.\n\nPathologic staging was determined as pT3, pN0. The tumor involved the ipsilateral pleural surfaces and met criteria for T3 based on involvement of the endothoracic fascia. No regional lymph node metastasis was identified.\n\nImmunohistochemical staining showed positivity for calretinin, WT-1, cytokeratin (CAM 5.2), EMA, CAIX, Bcl2, D2-40, and CK5/6 in the epithelioid component and focally in the sarcomatoid component. The sarcomatoid component showed focal weak positivity for SMA and very focal epithelial positivity for MOC31. Staining for MIC2, Chromogranin, Pax8, Desmin, BerEP4, CEA, Beta-Catenin, Synaptophysin, TTF-1, CD34, and S-100 was negative. Genetic testing for t(X;18) was performed due to morphologic concern for synovial sarcoma but was negative.\n\nMultiple sections were taken from various areas including the diaphragmatic margin, largest tumor deposits, visceral surface, chest wall interface, thickened pleura, and adipose tissue. Based on morphology and immunoprofile, the findings supported a locally advanced tumor with characteristics consistent with a biphasic growth pattern."} +{"pid": "TCGA-BH-A0BW", "report": "A total of eight lymph nodes were examined, including five sentinel lymph nodes, one palpable lymph node, one non-sentinel lymph node, and another palpable lymph node, all from the left axilla. Each lymph node was negative for metastatic disease. The surgical specimen from the left breast showed a 2.0 cm invasive tumor with a combined Nottingham score of 9 (3 for tubule formation, 3 for mitotic activity, and 3 for nuclear pleomorphism). The tumor was associated with ductal carcinoma in situ, nuclear grade 3, with solid growth pattern, comedo necrosis, and microcalcifications, comprising 10% of the tumor mass. No lymphovascular invasion was identified. Surgical margins were free. Additional benign findings included atypical ductal epithelial hyperplasia, fibroadenomatoid nodule, and ductal epithelial hyperplasia. A total of eight lymph nodes were evaluated using H/E and keratin stains, and all were negative. The pathologic stage was determined as pNO based on the absence of lymph node involvement. Estrogen and progesterone receptor status, as well as HER2/Neu testing, had been previously performed, with results showing zero or 1+ staining for HER2/Neu."} +{"pid": "TCGA-HT-8015", "report": "The pathology evaluation reveals a focus of markedly increased cellularity within fragments of gray and white brain matter. The cells involved appear to be glial in origin, predominantly small with round to ovoid nuclei. A subset of larger cells with prominent nucleoli is present, though mitotic figures are not observed. Scattered among the tumor cells are occasional neurons showing enlarged nuclei and prominent nucleoli. In one area (4B), a nodular focus of large fibrillary astrocytes with glassy-appearing cytoplasm is noted, along with scattered more atypical cells. Rare binucleate cells and possible eosinophilic granular bodies are also observed.\n\nImmunohistochemical staining shows diffuse immunoreactivity for GFAP and P53 among the neoplastic cells. The staining pattern with GFAP and neurofilament highlights both solid and infiltrative growth, with widespread involvement of gray and white matter. NeuN staining shows variable positivity among tumor cells, although this is weak compared to surrounding normal neurons and is considered nonspecific. Reticulin staining does not show individual cell encapsulation.\n\nIn the more solid regions of the lesion, scattered MIB-1 reactive cells are identified, with an estimated labeling index of 3\u20135%, suggesting a low proliferative activity. The overall morphology and immunoprofile support a diffusely infiltrative growth pattern with features consistent with a well-differentiated glial neoplasm."} +{"pid": "TCGA-2Y-A9HB", "report": "The gallbladder specimen measured 7 x 2.4 cm and weighed 29.9 grams. The serosal surface was pale green-gray and smooth. The cystic duct was patent with a 3 mm diameter, and the lumen contained dark green viscous bile. No calculi were identified. The mucosa was bile-stained with yellow streaks, and the wall thickness measured 1\u20132 mm. No gross lesion was observed. Representative sections of the cystic duct margin, neck, body, and fundus were submitted for analysis.\n\nA partial hepatic resection from segment 4B was received fresh and weighed 101.7 grams. The external surface was bosselated with an intact capsule. The cut surface revealed a well-defined, firm, lobulated mass measuring 2.6 cm in diameter. The mass was located 1.9 cm from the nearest resection margin and approximated the capsule, separated by a thin membrane. It was in close proximity to vasculature but did not appear to involve it. No necrosis, cyst formation, or hemorrhage was noted within the mass. The surrounding parenchyma appeared tan-gray and coarsely lobulated. Representative sections of the mass, including its relationship to the resection margin, capsule, adjacent vasculature, and a possible satellite lesion (7 mm), were submitted along with normal parenchymal tissue.\n\nMicroscopic evaluation of the gallbladder showed chronic inflammatory changes with features of cholesterosis. No atypia or malignancy was identified. In the liver specimen, histologic assessment revealed a well to moderately differentiated tumor. The tumor cells exhibited no necrosis and lacked perineural or large vessel invasion. Angiolymphatic invasion was present. The resection margin was free of malignant cells. There was associated moderately active cirrhosis; no lymph nodes were identified in the specimen. Immunohistochemical staining showed positivity for HepPar-1 and Glypican 3, while being negative for AFP, cytokeratin 7, and cytokeratin 20. All controls were appropriate and supported the findings."} +{"pid": "TCGA-TM-A7CA", "report": "The clinical history notes a right insular lesion suspected to be a low-grade glial neoplasm. The specimen, submitted as \"Brain tumour,\" consists of small fragments of brain tissue measuring 1\u20135 mm, with one block examined. Microscopic evaluation reveals focal areas of mildly to moderately hypercellular glial tissue. There is mild nuclear atypia and the presence of scattered microgemistocytes. Some atypical glial cells exhibit round nuclei, and a network of branching capillaries is observed. However, the features do not fully meet the criteria for oligodendroglioma. No mitotic figures or necrosis are identified. Ki67 immunostaining demonstrates positivity in approximately 2% of nuclei within the tumor regions. The case was reviewed in consultation, and the findings are interpreted as a grade 2 lesion according to WHO classification. Given the presence of certain morphological features suggestive of an alternative entity, further genetic analysis (including 1p/19q status) is recommended. Staining for IDH1 is currently in progress."} +{"pid": "TCGA-TT-A6YK", "report": "A male patient underwent resection of a lesion adjacent to the celiac artery. The specimen measured 4.5 x 4.2 x 1.2 cm and was entirely submitted for analysis. Histologic evaluation revealed a cellular lesion with diffuse growth pattern, nuclear atypia, and high cellularity. Focal vascular and capsular invasion were identified. The lesion involved multiple areas of the specimen and extended to inked margins. Adjacent lymph node tissue showed fibroadipose elements with a small lymphoid aggregate, nerve, and ganglion; no abnormal infiltrates were observed.\n\nImmunohistochemical staining demonstrated strong positivity for chromogranin and synaptophysin, with focal positivity for S-100. SDHB staining showed absent cytoplasmic expression. Based on these findings, further molecular or genetic testing may be considered if clinically indicated.\n\nAll tissues were processed and analyzed using standard protocols. Controls were appropriately used during immunostaining. The laboratory performing the analysis is CLIA-certified and follows established guidelines for diagnostic accuracy."} +{"pid": "TCGA-S7-A7WO", "report": "The specimen consists of a right adrenal mass weighing 83 grams and measuring 65 x 60 x 45 mm. The external appearance is ovoid and encapsulated. On sectioning, the tissue exhibits a dark red cut surface with pseudocystic areas containing blood. Histologically, the lesion demonstrates a solid and alveolar growth pattern with widespread hemorrhagic necrosis. Adrenal cortical tissue is present at the periphery.\n\nAt the cellular level, there are focal areas of cytologic atypia. Immunohistochemical staining shows positivity for S100 protein in sustentacular cells and neural fibers. Chromogranin staining is positive within the tumor cells but negative in the peripheral cortical remnants. Alpha-inhibin staining is negative in the tumor component and positive in the remaining adrenal cortex. The proliferation index (MIB-1) is less than 1%.\n\nHistopathologic evaluation reveals large nests or diffuse growth accounting for over 10% of the tumor volume. Central necrosis within large nests or confluent necrosis is identified. The lesion shows high cellularity, cellular uniformity, and focal spindle-shaped morphology of tumor cells. Mitotic figures exceed 3 per 10 high-power fields, including atypical mitotic figures. Additional features include infiltration into surrounding adipose tissue, vascular invasion, capsular invasion, significant nuclear pleomorphism, and mild nuclear hyperchromasia. The total score based on these parameters is 3."} +{"pid": "TCGA-66-2742", "report": "The examined material included the right lung and associated structures. Gross findings revealed a 1.5 cm lesioned lymph node in the right middle lobe and another of similar size in the right upper lobe, both with black-speckled and grayish-white section surfaces. The right lung was fixed and measured 19 x 15 cm at the base and up to 24 cm in length. A large mass was identified near the upper lobe bronchus, measuring up to 8.5 cm, with unclear borders, pale brown to dark pigmentation, and an irregular cavity up to 2.6 cm. The mass extended into the middle lobe near the pleural fissure and reached the visceral pleura above Segment 3 and Segment 1, with a distance of at least 0.3 cm from the hilar resection margin.\n\nThere was marked narrowing of the upper lobe bronchi and truncation of peripheral branches within the tumor. Several black-pigmented lymph nodes up to 1.5 cm were involved, including one at the hilus. In the middle lobe, a 0.7 cm pale brown-whitish lesion was found at a distance of at least 0.8 cm from the main tumor margin near the pleural fissure. Surrounding parenchyma showed areas of induration and brownish-yellow discoloration, with dilated bronchi containing thick mucus. In the lower lobe, especially the dorsal segment, multiple small hard areas up to 0.2 cm were noted in subpleural and parenchymal regions. A 0.3 cm whitish strip-like area was present in Segment 7, and diffuse induration with a reticular pattern was seen in the lower lobe's subpleural and basal regions, with a surface resembling pavement relief. At the hilus, three grayish-black lymph node lesions between 0.7 and 1.1 cm were observed.\n\nThe right parietal pleura was sampled as a flat, membranous area measuring 14 x 4.5 cm and up to 0.2 cm thick, with a smooth surface and fatty tissue on the reverse side. Additional lymph node findings included a 1.8 cm grayish-black node at the right hilus, a 2.5 cm node in the subcarinal region, two right deep paratracheal nodes (0.5 and 1.3 cm), and a 1.5 cm left hilar node. Histological evaluation of lymph nodes showed anthracotic pigment and sclerosis, but no tumor was identified in the samples taken during intraoperative assessment.\n\nMicroscopic analysis of the primary lesion showed extensive necrotic changes and poor histological differentiation. Vascular invasion was present within the tumor or bronchopulmonary region. In the surrounding lung tissue, there was mild interstitial fibrosis with perifocal emphysema, subpleural fibrous remodeling in Segment 7, and significant dust-related pigment deposition in lung tissue and lymph nodes. Clusters of alveolar siderophages were present, along with peritumoral signs of active and resorptive pneumonia. Small foci of mature metaplastic ossification were also noted. Lymph nodes showed diffuse and nodular sclerosis. The parietal pleura demonstrated mild chronic inflammation, focal reactive mesothelial proliferation, and limited fibrosis.\n\nA secondary focus was identified in the middle lobe, located near the pleural fissure and separate from the main mass by at least 0.8 cm. This focus showed minimal epithelial differentiation and contained a small solid light-cell component, accompanied by intense inflammatory changes. The tumor reached the central bronchus and showed areas of extension into the fibrosed visceral pleura, making it difficult to determine whether the origin was central or peripheral. Inflammation associated with the tumor was prominent, and satellite nodule formation was considered in the context of this secondary lesion."} +{"pid": "TCGA-CM-6677", "report": "The resected specimen includes a segment of terminal ileum, cecum with attached appendix, and ascending colon. The terminal ileum measures 15.2 cm in length and 4.1 cm in circumference at the proximal margin. The remaining colon is 41.6 cm long with a distal circumference of 8.2 cm. The appendix is 9 cm in length and averages 0.8 cm in diameter. The serosal surface is smooth and pink-tan with a focus of retraction inked black. Lobulated yellow-tan adipose tissue up to 6 cm in thickness is present along the colonic wall. A separate piece of omentum measuring 17.2 x 15 x 1 cm is also included.\n\nA circumferential tan-pink mass is identified in the transverse colon adjacent to a tattoo site, located 32.2 cm from the proximal margin and 10.3 cm from the distal margin. The lesion measures 3.5 cm in length and 8 cm in width. On sectioning, it invades the muscularis propria with a depth of invasion of 0.3 cm and a maximal thickness of 0.6 cm. No tumor budding is observed. Two small tan-pink polypoid lesions (1.1 cm and 0.4 cm) are found near the ileocecal valve, located 3.0 cm and 4.5 cm respectively from this junction. These show tubular adenoma features. The remainder of the mucosa appears unremarkable. The attached adipose tissue and all identified lymph nodes are thoroughly examined; no metastatic involvement is found among the 20 lymph nodes evaluated.\n\nMargins of resection are free of abnormal cells. No increased tumor-infiltrating lymphocytes, precursor lesions, gross tumor perforation, lymphovascular invasion, large venous invasion, or perineural invasion is identified. Based on AJCC 7th Edition staging criteria, the lesion invades through the muscularis propria into surrounding tissues (pT3) and there is no regional lymph node metastasis (pN0). Representative sections of the specimen, including margins, tumor, polyps, appendix, and lymph nodes, are submitted for histologic evaluation."} +{"pid": "TCGA-VM-A8CA", "report": "Surg Path Final Report. Temporary Copy. Case. Ordered. Clinical History: Left frontal lobe mass. Frozen Section Diagnosis: Low grade infiltrating glioma. Gross Description: Two specimens were received. Specimen one was fresh tissue labeled \"#1 left frontal tumor,\" measuring 2.5 x 1.9 x 0.6 cm, consisting of tan-pink, irregular soft tissue fragments. Touch preps were performed and approximately half was submitted for frozen section and subsequently for permanent sections in cassette 1FA. Remaining tissue was submitted in cassette 1A. Specimen two was fixed tissue labeled \"left frontal tumor,\" measuring 4.0 x 3.1 x 1.4 cm, consisting of tan-white, faintly hemorrhagic brain matter, entirely submitted in cassettes 2A\u20132C. Microscopic Examination: The frozen section diagnosis was confirmed on permanent sections. Synoptic Report: College of American Pathologists (CAP) Cancer Protocol. Surgical Pathology Cancer Case Summary Checklist. Protocol effective date: No prior tumor history or familial syndrome specified. Specimen Type: Resection. Handling included squash/smear/touch preparation, frozen section, and routine permanent paraffin sections. Largest specimen dimension: 4.0 cm. Laterality: Left. Site: Brain/cerebrum, frontal region. Histologic type corresponds to a diffuse glioma with nuclear features consistent with a WHO grade II lesion. Histologic grade: WHO grade II. Ancillary Studies: Molecular genetic studies for 1p and 19q deletion status were performed. Fluorescence in situ hybridization (FISH) analysis was conducted on sections from block 2C. Calculated ratios indicated deletion of both 1p and 19q. These findings suggest a favorable prognosis. This assay was developed and validated internally; it uses analyte-specific reagents and has not been cleared or approved by the FDA. Controls were appropriately performed and demonstrated proper staining characteristics. Additional Pathological Findings: None identified. Addendum Report: Results of molecular testing were issued as an addendum. FISH analysis demonstrated deletions of chromosomes 1p and 19q. Both markers were interpreted as deleted. This result supports a more favorable clinical course. The test was performed using internally validated methods with appropriate controls. I certify that I personally conducted the diagnostic evaluation on the above specimens and have rendered the findings accordingly."} +{"pid": "TCGA-KT-A74X", "report": "The specimen was obtained from the left temporal-parietal region of the brain and submitted in three parts. Specimen #1 measured 4.0 x 3.0 x 2.0 cm in aggregate and was partially used for frozen section with the remainder submitted for microscopic evaluation. Specimen #2 measured 8.0 x 4.0 x 0.6 cm and was similarly divided between frozen section and full microscopic analysis. Specimen #3 measured 7.0 x 8.0 x 2.0 cm and showed disruption of normal brain architecture with patchy necrosis; representative and additional sections were submitted for microscopic examination.\n\nMicroscopic evaluation revealed a diffusely infiltrating glioma with features predominantly consistent with a uniform cell population having round nuclei, perinuclear halos, and thin-walled capillaries arranged in a chicken wire pattern. Mitotic figures were identified, with up to 4 mitoses per 10 high power fields in certain areas. Vascular endothelial proliferation was also observed focally. An astrocytic component was present in some sections, with increased mitotic activity noted.\n\nImmunohistochemical staining demonstrated variable GFAP positivity, IDH1 positivity, and an overall average MIB-1 labeling index of approximately 5%. Fluorescence in situ hybridization (FISH) testing on paraffin embedded tissue demonstrated co-deletion of chromosome arms 1p and 19q. The 1p/1q ratio was 0.69 and the 19q/19p ratio was 0.62 based on 50 nuclei scored. This genetic profile has been associated with improved treatment response and prognosis in certain gliomas.\n\nThe tumor involved multiple regions of the left temporal-parietal brain with involvement of both gray and white matter. The histologic features and molecular findings support a distinct tumor subtype with potential therapeutic implications."} +{"pid": "TCGA-ZM-AA0F", "report": "A right testicular specimen with a attached structure measuring 5.5x3.5x3 cm and 10 cm in length respectively was examined. The testicle shows a surgical incision on its surface, approximately 2.5 cm long, with sutures present. Beneath the incision, a gray-white mass is observed, measuring 3.9x3x2.5 cm, with areas of necrosis and hemorrhage. Microscopic examination reveals the presence of solid sheets of round to oval cells with clear cytoplasm and dark nuclei, with nucleoli noted in some regions. The tumor cell nests are surrounded by fibrous connective tissue containing a significant lymphocytic infiltrate. Necrotic changes and hemorrhagic areas are widely distributed throughout the tissue. No involvement of the rete testis or the attached structure was identified."} +{"pid": "TCGA-91-A4BC", "report": "A right thoracotomy pneumonectomy was performed. Resected specimens included the bronchial margin, right upper lobe, right lower lobe, inferior pulmonary ligament, lymph node stations 10R, 4R, 2R, subcarinal lymph nodes, right upper lobe true surgical margin, and right lower and middle lobes.\n\nThe right upper lobe specimen contained two distinct tumor nodules within the same lobe. The larger lesion measured 4.5 cm in greatest dimension and the smaller measured 1.9 cm. Both were located within the lung parenchyma; the larger nodule approached the visceral pleura but did not perforate it. Histologic evaluation revealed moderately to poorly differentiated invasive carcinoma. No definitive lymph-vascular invasion was identified. All resection margins were free of tumor involvement except for proximity to the visceral pleura (less than 1 mm). Twenty lymph nodes were examined and none showed evidence of metastasis.\n\nThe right lower lobe wedge resection contained a single lesion measuring 2.4 cm in greatest dimension. This lesion also approached the visceral pleura. Histologic evaluation demonstrated moderately differentiated invasive carcinoma. The parenchymal margin was ultimately determined to be free of tumor following correlation with the right lower and middle lobes specimen. Twenty lymph nodes were evaluated and none were involved. Additional lymph nodes from stations 10R, 4R, 2R, and subcarinal regions were all negative for tumor involvement.\n\nAdditional findings included emphysematous changes and benign congested lung tissue in the right lower and middle lobes. No treatment effect was identified. All surgical margins were uninvolved by invasive carcinoma."} +{"pid": "TCGA-K4-A6MB", "report": "The specimen was obtained from a patient and included multiple tissue samples. Lymph nodes were evaluated from both the left and right pelvic regions. In the left pelvic lymph nodes, no abnormal findings were identified in all nine nodes examined. In the right pelvic lymph nodes, one of five nodes showed evidence of abnormal cellular infiltration.\n\nA composite specimen including the bladder, prostate, seminal vesicles, and vas deferens was examined. A distinct mass measuring 2 cm was observed in the left trigone region of the bladder. The mass appeared firm and ulcerated, with macroscopic extension into surrounding fat. Histologic evaluation revealed high-grade cellular atypia with squamous differentiation present. No glandular differentiation was noted. The tumor was classified histologically as high grade (grade 3/3). Lymphatic vessel invasion was identified. No associated epithelial lesions were found, and no tumor involvement was seen at the surgical margins.\n\nLymph node staging indicated one involved node out of a total of 14 examined. Based on these findings, the staging classification was assigned as pT3b for local extent and pN1 for regional lymph node involvement.\n\nAdditional frozen section evaluations were performed on ureteral margins. Tumor cells were identified at the left ureteral margin. High-grade dysplastic changes were noted at another left ureteral margin, while a third margin showed focal moderate to severe dysplasia. The right ureteral margin did not show any evidence of tumor involvement.\n\nMultiple tissue blocks were processed and stained for microscopic examination, including various sections of the prostate, bladder walls, and urethral regions."} +{"pid": "TCGA-A3-A6NL", "report": "The left kidney specimen weighed 219 grams and measured 11.6 x 6.2 x 5.5 cm. It included a small segment of attached ureter measuring 2 cm in length and 0.4 cm in diameter. The cortical surface appeared gray-pink. A mass measuring 5.3 x 4.8 x 4.1 cm was identified; it was soft, yellow-tan, and focally hemorrhagic. The mass was located near the cortical surface and approached within 0.1 cm of the surrounding fat, which was inked black. The mass did not appear to involve the collecting system, nor did it cause dilatation or compression of it. The remaining renal parenchyma was red-tan and mildly congested. No other masses or areas of concern were observed.\n\nA portion of adrenal gland measuring 3 x 0.9 x 0.3 cm was adherent to the kidney. The adrenal tissue had a yellow-brown cut surface and showed no abnormalities. The previously described mass came within 0.1 cm of the adrenal gland. No lymphoid tissue was identified at the renal hilum.\n\nHistologic evaluation revealed cells with specific morphologic features. Nuclear grade was assessed. No extension into perirenal fat was observed. There was no evidence of lymphovascular or renal vein invasion. All vascular and ureteral margins were negative. The mass was widely sampled and evaluated with multiple sections.\n\nStaging data indicated localized disease based on extent of primary lesion. Lymph node status could not be determined. Multiple cassettes were submitted for further analysis."} +{"pid": "TCGA-AA-3819", "report": "The specimen shows a moderately differentiated adenocarcinoma with infiltration through all layers of the wall (pT3), presence of lymphatic invasion (L1), and vascular invasion (V1). Fourteen lymph nodes were examined and none showed evidence of tumor involvement (pN0). Resection margins were clear, indicating an R0 resection. The lymph nodes were noted to be relatively large, potentially visible on imaging studies such as CT scans."} +{"pid": "TCGA-R8-A6MK", "report": "The specimen from the right frontal brain region consists of cerebral cortex and underlying white matter, measuring 5.0 x 5.0 x 3.0 cm. The cut surface shows a mostly distinct gray-white junction, though a portion demonstrates an indistinct transition. This area was submitted for frozen section and smear analysis. Additional sections were submitted for histologic evaluation. A second specimen, also from the right frontal brain, is composed of two fragments. One fragment measures 3.2 x 2.4 x 0.7 cm and the other 2.7 x 2.4 x 0.8 cm. The cut surface is uniformly white to yellow-tan without focal lesions. Both fragments were entirely submitted for histologic examination. Molecular testing using real-time PCR demonstrated loss of genetic material at the 1p and 19q chromosomal regions. This combined loss is associated with specific cellular lineage characteristics and may influence treatment response. All specimens were processed and evaluated in their entirety."} +{"pid": "TCGA-D5-6929", "report": "Histopathological examination was performed on multiple tissue specimens. A segment of large intestine measuring 18.4 cm in length was examined, with a piece of mesentery measuring 20 x 4 x 3.5 cm. Within the intestinal mucosa, a lesion measuring 3.6 x 3.8 x 0.9 cm was identified, circumferentially involving approximately 90% of the lumen and located 8.6 cm and 8.8 cm from the respective resection margins. The appendix measured 5.9 cm in length. The left ovary and associated oviduct were present, with the ovary measuring 4.2 x 2.3 x 2.2 cm and the oviduct measuring 10 cm. Another ovarian fragment measured 4.4 x 2.7 x 1.3 cm and contained a cystic structure 1.5 cm in diameter. Additional specimens included multiple fragments up to 0.8 cm in diameter and two excised tissue rings measuring 2 cm each.\n\nMicroscopic analysis revealed a neoplastic process involving the colonic mucosa, characterized by infiltrative growth into the pericolonic adipose tissue. The tumor exhibited a tubular growth pattern with moderate nuclear atypia. Inflammation was prominent around the lesion. Resection margins were free of neoplastic involvement. Lymph node involvement was noted, with neoplastic cells identified in regional lymph nodes. The appendiceal tissue showed features consistent with chronic inflammation. Ovarian findings included a hemorrhagic corpus luteum. One ovarian specimen contained a distinct focus of neoplastic cells with morphological features similar to those seen in the colonic lesion. Other specimens showed only fibrous tissue with signs of inflammation or no significant pathology. Tumor staging indicated pT3, pN1 classification. Grading was based on histological differentiation."} +{"pid": "TCGA-B5-A11E", "report": "The patient is a 1-year-old female. Clinical history indicates prior biopsy findings from the uterine cavity. Gross examination describes a uterus weighing 186 grams and measuring 9.8 x 9.2 x 5.2 cm. The cervix was surgically amputated and noted to be macerated. A separate cervical specimen measures 3.5 x 2.6 x 1.9 cm with a tan smooth ectocervix and a 1.3 cm os. The endocervical canal is lined by tan-yellow mucosa that appears focally friable. Within the endometrial cavity, measuring 6.5 cm cornu to cornu and 7.3 cm extending to the site of cervical amputation, there is a mass measuring 7.8 x 5.5 x 2.1 cm. This lesion primarily involves the anterior wall and extends onto the fundus and posterior wall, approaching within 1.1 cm of the cervical amputation margin. The mass demonstrates focal necrosis and invades approximately 1.1 cm into a myometrium measuring 1.6 cm in thickness. Adjacent endometrium is tan and approximately 1 mm thick. The myometrium is tan, trabeculated, and includes an intramural white whorled nodule measuring up to 0.7 cm suggestive of benign change. The uterine serosal surface is smooth without abnormalities.\n\nThe right fallopian tube measures 8.5 cm in length with distal dilation to 1.7 cm diameter and proximal narrowing to 0.4 cm. Its external surface shows focal yellow discoloration. Upon opening, the tube is cystically dilated with yellow studding along the luminal surface and filled with brown-red fluid. The right ovary measures 3.5 x 1.5 x 1 cm and appears unremarkable on gross inspection. The left fallopian tube is 8 cm long with a diameter of 0.5 cm and the left ovary measures 2.5 x 1.1 x 0.8 cm; both are grossly unremarkable.\n\nLymph node specimens were submitted from bilateral pelvic and para-aortic regions. Right pelvic lymph nodes consist of a 4.2 x 2.5 x 0.9 cm fibroadipose aggregate containing five identifiable lymph nodes ranging from 0.4 to 2.5 cm in size. Left pelvic lymph nodes include two fragments measuring 8 x 2 x 0.5 cm and 4 x 1.5 x 0.4 cm, respectively, with four lymph node candidates identified up to 2 cm in size. Left para-aortic lymph nodes consist of a single 1.2 x 0.8 x 0.4 cm tissue fragment. Right para-aortic lymph nodes measure 7.6 x 1.1 x 0.5 cm with three lymph nodes identified up to 2.2 cm.\n\nIntraoperative consultation assessed tumor dimensions as 7.8 x 5.5 x 2.1 cm with invasion measuring 1.1 cm into a myometrial wall thickness of 1.6 cm. Microscopic evaluation confirmed poorly differentiated carcinoma involving the posterior uterine wall at a depth of 1.8 cm within a 2.2 cm thick wall segment. Pathologic staging follows AJCC 7th Edition guidelines as pTx pNO pMX following hysterectomy, bilateral salpingo-oophorectomy, and lymphadenectomy. All lymph nodes evaluated across regional sites showed no evidence of metastatic involvement.\n\nAdditional microscopic findings included chronic inflammation with hydrosalpinx involving the right fallopian tube and fibrovascular adhesions. Minute tumor fragments were observed within the right and left fallopian tubes but lacked direct invasion into adjacent tissues raising uncertainty regarding potential contamination. Non-neoplastic changes included adenomyosis within residual myometrium and absence of benign endometrial tissue adjacent to the lesion. Cervical and uterine serosal surfaces showed no tumor involvement. Surgical margins were free of abnormality. Both ovaries lacked tumor infiltration despite identification of detached adenocarcinoma fragments within left-sided specimens."} +{"pid": "TCGA-AO-A128", "report": "A right breast mass was identified measuring 4.0 cm in greatest dimension on gross examination, located within soft yellow fatty tissue. The mass was well-circumscribed and tan to yellow in color. Margins were assessed, with the tumor located 1.5 cm from the anterior margin, 1.0 cm from the posterior margin, 2.5 cm from the superior margin, 2.0 cm from the inferior margin, 6.0 cm from the medial margin, and 2.0 cm from the lateral margin. Histologic evaluation of the excised breast specimen revealed high-grade cellular changes with marked nuclear variation and minimal tubule formation. No ductal carcinoma in situ (DCIS) was identified. No calcifications or vascular invasion were noted within the invasive component. Surgical margins, including anterior medial, posterior, superior, inferior, medial, and lateral, showed no evidence of tumor involvement. Non-neoplastic breast tissue was unremarkable.\n\nEvaluation of sentinel lymph nodes from level I and II of the right axilla showed no evidence of metastasis. Sentinel node #1 (level I) measured 2.0 x 0.4 x 0.2 cm and contained three benign lymph nodes. Sentinel node #2 (level II) measured 1.0 x 0.3 x 0.2 cm and contained two benign lymph nodes. Sentinel node #3 (level II) measured 0.8 x 0.2 x 0.2 cm and contained one benign lymph node. All underwent deeper level recuts and immunostains (AE1:AE3 and CAM 5.2), which were negative for metastatic disease. Additionally, nine non-sentinel lymph nodes from the right axilla were examined and found to be benign.\n\nMargins from the posterior and anterior medial aspects of the right breast were submitted and evaluated. The posterior margin consisted of fibroadipose tissue without tumor. The anterior medial margin showed fibrocystic changes, including sclerosing adenosis, florid ductal hyperplasia, and microcalcifications within benign ducts. Immunohistochemical staining of the tumor was negative for ER, PR, and HER2-neu.\n\nIntraoperative frozen section analysis of sentinel lymph nodes #1, #2, and #3 confirmed benign findings, consistent with permanent section diagnosis. The primary excision specimen's frozen section diagnosis confirmed invasive malignancy, consistent with final histopathology."} +{"pid": "TCGA-EO-A22X", "report": "The specimen consisted of a total hysterectomy with bilateral salpingo-oophorectomy, residual right ovarian tissue, and multiple lymph node and soft tissue samples from the left and right common iliac, external iliac, obturator, and para-aortic regions. The uterus measured 9.2 x 6.6 x 4.1 cm and showed a hemorrhagic serosal surface with adhesions. A mass was identified in the left fundus, measuring 2.1 x 3.3 x 3.8 cm, with central necrosis and diffuse infiltration of the myometrium. A friable papillary lesion was present in the posterior lower endomyometrium, measuring 2.8 x 1.4 x 1.3 cm, but did not reach the lower uterine segment. A 3.5-cm intramural fibroid was also noted.\n\nMicroscopic evaluation revealed a high-grade cellular proliferation with more than 50% nonsquamous solid growth pattern. There was full-thickness myometrial invasion with extension to the serosa. No involvement of the cervix or lower uterine segment was observed. Lymphovascular space invasion was not identified. All resected margins were free of invasive disease.\n\nA total of 36 regional lymph nodes were examined, including those from the left and right external iliac, obturator, and para-aortic regions. None showed evidence of metastatic involvement. Additional findings included cystic follicles in the right ovary and endometriosis in the right fallopian tube. No other significant pathologic findings were identified."} +{"pid": "TCGA-KK-A7AY", "report": "A specimen was received consisting of lymph nodes and tissue from the bladder neck, prostate, and seminal vesicles. Five lymph nodes from the left pelvic region were identified, measuring up to 6.5 x 5 x 1.5 cm in aggregate; none contained tumor involvement. Three lymph nodes from the right pelvic region were also identified, measuring up to 4.5 x 3.5 x 1.2 cm in aggregate; no tumor was present in these specimens either.\n\nThe anterior bladder neck tissue consisted of smooth muscle and adipose tissue without evidence of tumor or prostatic glands. The prostate gland measured 5.2 x 2.5 x 3.8 cm and weighed 36 grams post-fixation. An area of firmness was noted on the posterior surface of the prostate. Serial cross sections revealed a lesion measuring 2.5 x 0.9 cm at its largest dimension. This lesion was located in the right posterolateral, right posterior, mid posterior, and left posterior peripheral zones of the prostate. It spanned three cross sections of the prostate and was extensively present in the apex with focal involvement at the base.\n\nThe tumor was confined to the prostate without extension into the seminal vesicles or vasa deferentia. Surgical margins were free of involvement. Perineural invasion was observed, though no vascular or lymphatic invasion was identified. High-grade intraepithelial neoplasia was also noted within the prostate. No tumor was found in the seminal vesicles or segments of the vasa deferentia. The prostate was inked for orientation: green on the anterior aspect, red on the left, yellow on the right, and black on the posterior surface. Additional blue and orange inks marked surfaces not representing true resection margins. Multiple tissue blocks were submitted for further analysis, including two requiring decalcification."} +{"pid": "TCGA-JV-A5VE", "report": "The surgical specimen included a large uterine mass along with bilateral fallopian tubes and ovaries. The mass measured 29.0 cm in greatest dimension and was located in the uterine corpus. Microscopic examination revealed a high-grade cellular proliferation with marked pleomorphism. The mitotic count was 16 per 10 high-power fields, and areas of necrosis were present, involving approximately 15% of the tissue. The tumor exhibited a solid growth pattern and showed lymphovascular invasion. Immunohistochemical staining demonstrated reactivity for desmin, smooth muscle actin, and caldesmon, while pan-cytokeratin was negative.\n\nThe tumor extensively involved the myometrium, reaching the serosa with multiple areas of invasion. Two distinct nodules were identified: one within the uterine corpus and another extending through the serosa above the fundus. There was no residual normal endometrium identifiable. Both ovaries and fallopian tubes were unremarkable and not involved. A separate specimen of the appendix showed fibrous obliteration of the lumen with no involvement by tumor; however, tumor tissue was noted in a blood clot adherent to the external surface. No tumor was identified in the excised peritoneal adhesion or right aortic lymph nodes (0 out of 2 lymph nodes involved). Surgical margins could not be assessed due to multiple unattached tumor fragments received in the specimen.\n\nAncillary immunohistochemical studies supported the smooth muscle lineage of the tumor cells. Initial frozen section interpretation had suggested high-grade endometrioid adenocarcinoma, but subsequent review of permanent sections confirmed a poorly differentiated sarcoma with features consistent with smooth muscle origin. The tumor was staged using the CAP soft tissue sarcoma scheme as pT2b (tumor greater than 5 cm, deep tumor), pN0 (no lymph node involvement), and pMx (no assessment of distant metastasis)."} +{"pid": "TCGA-VQ-A91X", "report": "The specimen involves the antrum of the stomach. The lesion measures 5.5 cm as the largest dimension and demonstrates an infiltrative growth pattern. Histologic evaluation shows poorly differentiated morphology without a specific subtype designation. An ulceration is present, and the tumor invades into the muscularis propria layer. A mild inflammatory response is noted. There is no evidence of tumor implants in perivisceral fat or soft tissue. Margins, including proximal, distal, and esophageal, are free of neoplastic involvement. Neural and lymphatic invasion are identified, while blood vessel invasion remains uncertain. \n\nExamination of regional lymph nodes reveals involvement by neoplasia in 14 out of 34 nodes assessed. Metastatic involvement includes Chain 3 (lesser curvature: 4/7), Chain 6 (infrapyloric: 3/5), Chain 8a (anterior hepatic artery: 1/3), and Chain 9 (celiac trunk: 4/10). Other nodal stations evaluated include Chain 1 (right paracardial: 2/5), Chain 2 (left paracardial: 0/2), Chain 4d (right gastroepiploic: 0/1), and Chain 11p (proximal splenic artery: 0/1). No capsular or cluster involvement is observed in the lymph nodes. \n\nAdditional findings include moderate chronic gastritis with focal intestinal metaplasia in the adjacent mucosa. The greater omentum is uninvolved. Lauren classification identifies the morphology as intestinal type."} +{"pid": "TCGA-HZ-7919", "report": "The surgical specimen includes a resected pancreatic head, duodenum, stomach, and gallbladder. A mass measuring 4.0 x 3.0 x 1.8 cm is identified in the pancreatic head. Microscopically, the lesion shows moderately differentiated features with invasion extending beyond the pancreas into the duodenum. High-grade dysplastic changes are noted in the surrounding tissue.\n\nEvaluation of lymph nodes reveals that 2 out of 10 regional nodes contain metastatic involvement. Surgical margins are positive for involvement at the portal vein groove and retroperitoneal margin. Lymph-vascular and perineural invasion are present.\n\nStaging is based on the extent of local invasion and regional nodal involvement. The tumor extends beyond the pancreas but does not involve the celiac axis or superior mesenteric artery. Distant metastasis is not identified. Pathologic staging is determined as pT3N1M0.\n\nThe gallbladder shows findings consistent with chronic inflammation and cholesterolosis. Multiple tissue blocks were submitted for microscopic evaluation, including margins, lymph nodes, and surrounding adipose tissue. Imaging and measurements were documented during gross examination, and several lymph nodes were identified within the peripancreatic fat."} +{"pid": "TCGA-BA-7269", "report": "The specimen consists of tissue fragments from various regions of the tongue, including medial, posterior base, lateral deep, lateral mucosal, and anterior margins. Each fragment shows fragments of squamous mucosa with underlying muscle or fibroadipose tissue. Inflammation is noted in several areas\u2014acute and chronic inflammation is present in the lateral mucosal and anterior margins, while mild chronic inflammation is seen in the lateral deep margin and posterior base margin. No malignant cells are identified in these samples.\n\nA larger specimen from the right posterior tongue measures 3.4 cm anterior/posterior, 4.1 cm medial/lateral, and 3.0 cm superior/inferior. The lesion described is ulcerative and hemorrhagic, measuring 1.2 x 0.7 cm with a depth of 0.3 cm. It has a vaguely nodular surface and appears to invade into the underlying lingual musculature to a depth of approximately 1.5 cm. The tumor is located along the lateral aspect of the posterior tongue. Margins are free of tumor involvement, with distances ranging from 0.6 cm to 1.3 cm depending on orientation.\n\nLymph node evaluation includes Level 1, Level 2, and Level 3 nodes from the right neck. Six lymph nodes from Level 1 show no evidence of malignancy. Of the three lymph nodes evaluated in Level 2, one contains metastatic disease measuring 1.1 cm; there is no extranodal extension identified. Eight lymph nodes from Level 3 also show no evidence of malignancy.\n\nHistologic examination of the primary site reveals invasion into lingual musculature but no bone invasion. Perineural invasion is present. Angiolymphatic invasion is not identified. Based on this information, the pathologic staging assessment is provided as pT2 pN1. This assessment is subject to revision pending further clinical review."} +{"pid": "TCGA-CN-4741", "report": "A bilateral neck dissection was performed, and the specimen was received in seven parts. Parts 1 through 4 consisted of adipose tissue with lymph nodes and submandibular glands from both sides. A total of 46 benign lymph nodes were identified across all levels: 7 from left level 1, 4 from right level 1, 15 from left levels 2\u20134, and 19 from right levels 2\u20134. Submandibular glands showed chronic sialadenitis on the left and prominent chronic and acute sialadenitis on the right.\n\nParts 5 and 6 included biopsies of the left and right lingual nerves, respectively. Both showed no abnormal findings; the left contained salivary duct and small nerve tissue, while the right contained a large nerve and ganglion without any concerning features.\n\nPart 7 was an anterior composite mandibulectomy measuring 7.5 cm in width by 5.2 cm in length. The mandibular bone segment measured 9.5 cm in length with diameters of 2.4 cm (left) and 2.1 cm (right). A multinodular lesion measuring 3.7 x 3.5 x 3.5 cm was identified in the oral cavity, located 0.5 cm from the left gingival buccal margin and more than 1.0 cm from other mucosal margins. Microscopic evaluation confirmed that the tumor had permeated and invaded the mandibular bone. Perineural invasion was present. All surgical margins were free of involvement, although the tumor was less than 0.1 cm from the posterior soft tissue margin. The left bone margin required decalcification for full assessment.\n\nIntraoperative frozen section analysis of the lingual nerves and resection margins confirmed absence of tumor involvement. Final pathological staging was pT4a pN0 pMX. A total of 14 tissue blocks from the resection specimen were evaluated microscopically, along with additional blocks from the other parts. No vascular invasion was identified. Tissue fixation time ranged from 2 to 84 hours."} +{"pid": "TCGA-AD-6889", "report": "The specimen includes a segment of terminal ileum, cecum, appendix, and ascending colon with attached mesocolon and omentum. Multiple adhesions are present on the surface. The terminal ileum measures approximately 7.0 x 3.0 cm. The colonic and cecal segment measures 15.0 x 2.5 cm. An area of induration and puckering is noted on the anterior aspect near the ileocecal valve region. Upon opening the colon, a large fungating ulcerated mass measuring approximately 9.0 cm in greatest dimension is identified, involving the full circumference of the colon. The mass has a central ulceration with raised, irregular erythematous edges. The appendix is dilated, measuring 4.0 x 1.0 cm.\n\nMicroscopic examination reveals a tumor with variable growth patterns. In some areas, it forms atypical glandular structures composed of cells with irregular and hyperchromatic nuclei. Other regions show poorly differentiated features, with cells arranged in solid nests and cords, including spindle and polygonal cell morphology, without gland formation. The tumor originates from an ulcerated mucosal surface and invades through the muscularis into serosal tissues, surrounded by a desmoplastic reaction. Sixteen regional lymph nodes show only lymphoid hyperplasia and reactive changes, with no evidence of metastasis. All resection margins are free of tumor involvement. Chronic inflammatory changes are present on the serosal surfaces of the bowel and appendix.\n\nHistologic grade shows variation from better differentiated to undifferentiated components. The tumor extends through the bowel wall and reaches pericolic adipose tissue. No lymphatic or venous invasion is observed."} +{"pid": "TCGA-78-7153", "report": "A specimen from the right upper and middle lobe was received fresh, measuring 160 x 60 x 60 mm. There was pleural puckering over the postero-lateral surface of the upper lobe with a stapled margin measuring 65 mm above the hilum. Bronchial and vascular resection margins showed no evidence of abnormal tissue. Transverse slicing revealed an ill-defined mass measuring 47 mm in diameter located in the postero-lateral aspect of the upper lobe, extending close to the bronchial resection margin within 10 mm. The surrounding lung tissue appeared consolidated and yellowish. The mass was pale grey to cream in color with areas of carbon pigmentation. A second contiguous lobulated mass measuring 30 mm in diameter was identified towards the apex of the upper lobe with a tan cut surface. Both masses were clear of the pleura. Sections showed moderately differentiated cellular features with mucinous and papillary characteristics. Invasion into subpleural elastotic scarring was observed, although no definitive pleural invasion was identified. Blood vessel invasion was present but no lymphatic or perineural invasion was noted. The bronchial resection margin was free of abnormal cells, though squamous metaplasia with severe dysplasia was seen at the middle lobe bronchial margin. No metastases were found in the lymph nodes examined. Reactive changes without malignancy were observed in all lymph nodes including those from the pulmonary vein, right middle lobe, and station 4 and 10 lymph nodes. Immunostaining demonstrated strong nuclear staining with TTF-1 in some cells. Special stains did not show pleural invasion."} +{"pid": "TCGA-OR-A5JD", "report": "The specimen consists of a left adrenal mass measuring 98 x 90 x 60 mm, weighing 264 grams. It is an encapsulated, partly lobulated tan-colored lesion with an attached fibro-fatty tissue component measuring 130 x 45 x 10 mm. The cut surface reveals a homogeneous tan appearance with areas suggestive of cystic change, hemorrhage, and patchy yellow regions. A residual rim of normal adrenal tissue measuring 20 x 10 x 15 mm is present adjacent to the tumor. The tumor appears to be well-encapsulated.\n\nMicroscopically, the lesion demonstrates a diffuse sheet-like architecture composed primarily of oncocytic cells. Some cells exhibit minimal atypia, while others display marked nuclear pleomorphism, including large irregular nuclei, macronucleoli, and occasional intranuclear pseudoinclusions. Focal areas of necrosis are present, though coagulative necrosis is not definitively identified. Vascular or capsular invasion is not observed. Mitotic activity is low, with fewer than 5 mitoses per 50 high-power fields, and no atypical mitotic figures are noted. Ki-67 staining shows a proliferative index of approximately 5%.\n\nImmunohistochemical staining reveals positivity for calretinin and Melan-A, while AE1/AE3, chromogranin, synaptophysin, S-100, and HMB-45 are negative. These findings support an adrenal cortical origin.\n\nHistological features include high nuclear grade, diffuse architecture, and non-clear cell composition. Based on conventional criteria, this would suggest malignancy. However, in the context of oncocytic adrenocortical tumors, alternative classification systems have been proposed. Major malignant criteria include mitotic rate greater than 5 per 50 HPF, presence of atypical mitoses, or venous invasion. Minor criteria\u2014such as large size (>10 cm or >200 g), necrosis, capsular or sinusoidal invasion\u2014are associated with uncertain malignant potential. In this case, the tumor meets minor criteria based on its size and focal necrosis, but lacks any major criteria.\n\nThe lesion is considered an oncocytic adrenocortical neoplasm with uncertain biological behavior, given the histological findings and current understanding of this rare tumor type."} +{"pid": "TCGA-KM-8440", "report": "The left kidney specimen was received as a radical nephrectomy, weighing 323 grams and measuring 16 x 9.5 x 4 cm with surrounding fat. A central tan-red mass measuring 7 x 5.5 x 3.5 cm was identified within the kidney, located in the central region and involving the hilum. The tumor exhibited central necrosis and appeared to abut a dilated calyx and pelvic ureter, although no direct invasion was observed. There was evidence of involvement of the perirenal and perihilar fat, with the tumor extending to the perihilar sinus. An area of adhesion between the capsule and the tumor was noted, raising suspicion for interaction with the perirenal fat. Small fragments of adrenal tissue were found near the upper pole.\n\nMicroscopic evaluation showed a histologic type consistent with chromophobe morphology and nuclear grading at Furhman grade 2. No capsular invasion was identified. Vascular and ureteral margins were free of tumor involvement. The tumor was staged as pT3 based on extent of local spread. Regional lymph node involvement (pN) and distant metastasis (pM) could not be determined (NX, MX). Multiple sections were taken from the tumor, hilar region, vascular and ureteral margins, and areas of adhesion for comprehensive assessment."} +{"pid": "TCGA-55-7227", "report": "The surgical pathology report includes findings from a right lower lobectomy and associated lymph node biopsies. The lung specimen measured 16.0 x 9.5 x 3.8 cm and weighed 269 grams. A neoplasm was identified in the lateral basilar portion of the lung, measuring 62 mm in greatest dimension. The tumor was located 50 mm from the bronchial margin, which was free of tumor involvement. Visceral pleural invasion was present, as confirmed by elastin staining. Adjacent to the main mass, multiple satellite nodules were observed, including three subpleural nodules measuring between 0.7 and 1.2 cm near the primary lesion and an additional subpleural nodule in the lateral apical region.\n\nMicroscopic evaluation revealed moderately differentiated epithelial cells forming glandular structures. Lymphovascular invasion was present. Within the peribronchial region, at least three lymph nodes were identified, one of which contained a small focus of abnormal cellular infiltration in the subcapsular sinus. Cytokeratin and TTF-1 immunostains confirmed the presence of metastatic epithelial cells in this lymph node, while other lymph nodes, including two mediastinal nodes and one designated N8R, showed no evidence of similar involvement. The lymph nodes exhibited anthracotic pigmentation and some contained benign glandular inclusions. Focal noncaseating granulomatous inflammation was also noted within one peribronchial lymph node.\n\nLung tissue demonstrated emphysematous changes and respiratory bronchiolitis. No tumor was identified within the vascular margins. Based on these findings, staging was determined as follows: primary tumor pT3 (presence of satellite nodules within the same lobe), regional lymph nodes pN1 (metastasis in ipsilateral peribronchial lymph nodes), and distant metastasis not assessed (pMX). The overall pathologic stage was classified as IIIA."} +{"pid": "TCGA-XY-A9T9", "report": "The specimen from a male patient with a testicular lesion was processed following radical orchiectomy. The tumor was unifocal, measuring 6.5 cm in greatest dimension. Gross examination revealed the lesion to be confined to the testis. Histologic evaluation showed a neoplastic proliferation of large, uniform cells with clear cytoplasm and prominent nucleoli. Nuclei were present in approximately 95% of tumor cells, with no evidence of necrosis. A minor component of lymphocytic infiltration was noted within the tumor bed. Margins of resection, including the spermatic cord, were free of tumor involvement. Microscopic assessment did not identify lymphovascular invasion. The tumor was limited to the testis and epididymis without evidence of extratesticular extension. Regional lymph nodes could not be assessed. No distant metastases were identified. Laboratory analysis showed elevated lactate dehydrogenase (LDH) levels, while alpha-fetoprotein (AFP) and human chorionic gonadotropin (HCG) were within normal limits. Additional findings included intratubular germ cell neoplasia and parenchymal fibrosis. Tissue processing times were documented, with total cold ischemia time at 46 minutes and formalin fixation time of 17 hours. Specimen weights for both normal and tumor tissues were recorded. Multiple sample types, including plasma, serum, buffy coat, cryovials, and FFPE blocks, were obtained for further study. Patient consent was obtained for research use."} +{"pid": "TCGA-S9-A6TY", "report": "The morphology demonstrates features consistent with oligodendroglial differentiation. Single mitotic figures are present, and there is evidence of cellular proliferation, focally reaching up to 6%."} +{"pid": "TCGA-D7-8575", "report": "Supplement diagnosis: Most cancerous cells proved cytokeratin 7-positive. Macroscopic examination revealed a specimen consisting of the stomach, resected along the greater curvature, measuring 16 x 15 cm, along with omentum measuring 14 x 7.2 cm. A lesion with ulceration measured 8 x 5 x 2 cm and was located in the lesser curvature region. The gastric lumen contained blood clots and mucosa. Macroscopically, the growth extended into the muscular wall and perigastric fat tissue. The distance from the proximal margin was 2 cm, and from the distal margin, 6.5 cm. Histopathological analysis showed a mixed growth pattern, including tubular, mucinous, and solid components. There was deep infiltration into the gastric wall, extending into the adipose tissue of the lesser curvature and the subserosal layer. Proximal and distal resection margins were free of involvement. The omentum showed no signs of tumor. Lymph node assessment identified multiple lymph nodes with infiltration of cancer cells, including those along the periorificial region (L, M, N), with metastases found in lymph nodes II/IV. Involvement of the lymph node capsule and surrounding fatty tissue was noted. Metastatic involvement was also present in lymph nodes along the lesser curvature (W) and greater curvature (IIW), with similar patterns of capsular and perinodal fat infiltration. Immunohistochemical analysis demonstrated HER2 protein expression using Ventana Rabbit Antibody staining."} +{"pid": "TCGA-AG-3890", "report": "The specimen consists of a segment of rectum and sigmoid colon. Histopathological examination revealed a moderately differentiated neoplasm, with features suggestive of glandular origin. Residual benign adenomatous tissue was also identified. The lesion infiltrates into the subserosal layer (pT2), with evidence of lymphatic and vascular invasion (L1, V1). All resection margins, including the anastomotic site, were free of malignant cells. No lymph nodes contained tumor cells (pN0, 0 out of 12 examined). Cellular morphology showed moderate differentiation without extensive necrosis or high-grade features."} +{"pid": "TCGA-E2-A108", "report": "The surgical specimens include sentinel lymph nodes, a right breast lumpectomy, axillary contents, and margin specimens. Sentinel lymph node #1 from the right axilla contains a 0.5 cm firm white nodule, with touch preparations performed. Sentinel lymph node #2 includes two lymph nodes measuring 0.5 cm and 1.2 x 0.6 x 0.5 cm, both with touch preparations performed.\n\nThe right breast lumpectomy specimen is oriented and measures 11.5 x 8.5 x 3.0 cm. Serial sectioning reveals two distinct masses. The first mass measures 2.2 x 1.8 x 1.8 cm and is located at the 12 o\u2019clock position, closest to the anterior and superior margins at 1.5 cm each. A second mass or biopsy site measuring 0.8 cm is identified near the inferior margin, 0.4 cm from the margin and 3.0 cm from the first mass. No additional nodules are found. The remaining tissue shows fibrous, lobulated areas with small fluid-filled cysts. Margins are inked and submitted for analysis.\n\nAxillary dissection includes levels 1 and 2, containing adipose tissue with 20 identified lymph nodes ranging from 0.2 to 3.5 cm. Two lymph nodes show signs of infiltration, measuring 0.4 and 0.5 cm, and three lymph nodes are matted with an overall size of 2.2 cm. Representative sections of all lymph nodes and surrounding tissue are submitted.\n\nMargins (superior, medial, and inferior) are all negative for any discrete lesions. Each margin is serially sectioned and entirely submitted for analysis.\n\nHistological evaluation shows invasive cellular features in the larger mass, with high-grade nuclear changes and fibrotic changes in the second mass. Lymphatic involvement is noted in the area of the second mass. Immunohistochemical staining demonstrates involvement of lymphatic channels. A small focus of in situ changes is also present in a separate slice, away from the main mass.\n\nHormone receptor testing shows positivity for ER and PR, and negativity for HER2. Staging is based on pathological findings."} +{"pid": "TCGA-ER-A194", "report": "The excised lesion from the left shoulder measured 4.2 cm and exhibited focal superficial ulceration with surface acute inflammation. The growth pattern was nodular and exophytic. Microscopic evaluation showed no evidence of residual tumor at the lateral margins of resection; however, the deep margin was noted to be close, measuring 0.1 cm. Two lymph nodes from sentinel node biopsy in the left axilla were examined, along with one additional lymph node, all of which were benign and showed no signs of metastatic disease or malignancy. Immunoperoxidase staining performed on these lymph nodes using markers Tyrosinase, S100, Melan A, HMB-45, and CD68 demonstrated negative results for melanoma-specific markers, while CD68 showed positivity in macrophages. No involvement was identified in the deep soft tissue margin of the left shoulder."} +{"pid": "TCGA-UW-A7GG", "report": "The specimen consists of a radical nephrectomy from the right kidney, measuring 10.0 cm in its greatest dimension and weighing 570 grams. The tumor is described as a globoid, well-circumscribed lesion with a pseudocapsule, located at the hilum. On gross examination, the cut surface of the tumor is soft, yellow-tan in color, with areas of focal hemorrhage; no central scarring is observed. The tumor measures 10 x 8 x 7 cm and is confined within the renal capsule without gross extension into surrounding structures. No multicentricity is identified.\n\nExamination of the perirenal adipose tissue, renal vein, and ureter reveals no gross involvement by the tumor. All surgical margins\u2014including those of the renal vein, renal artery, ureter, and perirenal adipose tissue\u2014are grossly negative. The non-tumorous portion of the kidney shows cortical atrophy measuring 0.5 cm, with mild calyceal dilation but no evidence of hydro-ureter. No hilar lymph nodes are identified.\n\nMicroscopic evaluation reveals a cellular neoplasm with a solid growth pattern, along with tubular and trabecular arrangements, and interspersed stromal hyaline fibrosis. The tumor contains a mix of larger polygonal cells with well-defined borders and amphophilic cytoplasm, and smaller polygonal cells with eosinophilic cytoplasm. Many cells display distinct perinuclear halos, hyperchromatic nuclei, irregular nuclear membranes, and occasional binucleation. No true encapsulation is present.\n\nHistologic assessment confirms the absence of capsular invasion, vascular invasion (blood or lymphatic), and involvement of adjacent structures. All histologically evaluated surgical margins are negative. The tumor demonstrates nuclear features corresponding to grade 3. The adrenal gland is not present in the specimen, and no lymph nodes are identified. No special investigations were performed on the tissue."} +{"pid": "TCGA-FD-A6TG", "report": "A male patient underwent cystectomy with excision of the distal right ureter, lymph node dissection, and cystoprostatectomy. Pathologic evaluation included assessment of multiple specimens.\n\nThe distal right ureter specimen was negative for tumor involvement. In the right pelvic lymph node dissection, one out of four lymph nodes contained metastatic involvement with a maximal focus measuring 3 mm, along with extranodal extension. In the left pelvic lymph node dissection, two out of ten lymph nodes showed metastatic involvement, also with a maximal focus measuring 3 mm and extranodal extension identified.\n\nExamination of the bladder and prostate revealed invasive disease through the muscularis propria into the surrounding soft tissue. Multifocal involvement was noted at the dome, right lateral wall, and posterior wall, with additional in-situ involvement at the anterior, posterior, and lateral walls. All evaluated margins\u2014including the ureteral, distal urethral, and serosal\u2014were negative for tumor involvement. Lymph node evaluation indicated metastatic involvement in 3 out of 14 nodes overall.\n\nProstate pathology demonstrated a Gleason Score of 3+3=6 with multifocal high-grade prostatic intraepithelial neoplasia. The tumor was located bilaterally within the peripheral zone, involving approximately 5% of the prostate volume. No perineural invasion or extraprostatic extension was observed. All surgical margins\u2014including seminal vesicles, apical, basilar, and peripheral\u2014were negative for tumor involvement. Evaluation of regional lymph nodes for prostate involvement was negative.\n\nPathologic staging for the primary lesion was determined as pT3a, N2, MX. For the prostate component, staging was pT2c, N0, MX."} +{"pid": "TCGA-CV-5443", "report": "The specimen consists of a total laryngectomy, right thyroid lobectomy, and bi-level neck dissection measuring 12.0 x 7.0 x 6.0 cm in total. An ulcerated, excavated lesion was identified in the right pyriform sinus, extending into the surrounding soft tissue. The lesion measures 3.5 x 3.0 x 4.0 cm in greatest dimension. It involves the soft tissue but does not extend to cartilage, bone, or the right laryngeal mucosa. Both mucosal and surgical margins of resection are grossly free of involvement.\n\nMicroscopic evaluation of the resection specimen showed no evidence of residual tumor at the mucosal or tracheal margins, although the tracheal margin demonstrated focal areas of necrosing mucosa with marked acute inflammation. No perineural or lymphovascular invasion was identified. The thyroid gland showed no significant abnormalities, including a colloid nodule in the right lobe.\n\nLymph node evaluation included nine lymph nodes from the right neck dissection (levels 1 through 3), all without evidence of tumor. Two lymph nodes were identified in the left neck dissection (levels 1 through 3), also without tumor involvement. Sequential sectioning of the lesion and adjacent mucosa from superior to inferior did not reveal any additional sites of involvement."} +{"pid": "TCGA-AP-A0L8", "report": "The submitted specimens include a total hysterectomy with bilateral salpingo-oophorectomy, along with multiple lymph node dissections and an excision of sigmoid epiploic fibroadipose tissue. \n\nExamination of the uterine specimen reveals significant myometrial invasion by atypical epithelial cells. The maximal thickness of myometrial invasion is 20 mm, within a myometrial wall measuring 23 mm in that region. Vascular space involvement is identified. There is also evidence of endometrial polyps containing atypical cells. In addition, two leiomyomas are noted, measuring 1 cm and 7 cm respectively, with the larger lesion showing involvement by atypical cells. No abnormalities are seen in the adnexal structures. A prior biopsy was reviewed and shows similar histologic features to those present in the hysterectomy specimen, although crush artifact limits full assessment.\n\nLymph node dissections from the left external iliac (2 nodes), left obturator (1 node), right external iliac (1 node), right common iliac (1 node), and left common iliac (1 node) all show benign lymphoid tissue without evidence of atypical cells. The sigmoid epiploic tissue is also benign.\n\nIn the left para-aortic lymph node group, one out of five nodes shows rare subcapsular clusters of atypical epithelial cells. Immunohistochemical staining demonstrates positivity for keratin (CAM5.2) and negativity for LCA (CD45). Morphological features and immunoprofile support the presence of epithelial cell involvement."} +{"pid": "TCGA-JY-A6FB", "report": "The specimen consisted of multiple lymph node and soft tissue samples, along with a resected segment of the proximal stomach and thoracic esophagus. Lymph nodes from various anatomical locations, including the subcarinal, para-esophageal, paracardial, diaphragmatic, and common hepatic regions, were all negative for malignancy. A total of 40 lymph nodes were evaluated across these sites, with none showing evidence of tumor involvement.\n\nTwo small nodules from the gastric region were identified as benign spindle cell lesions consistent with gastrointestinal stromal tumors (GISTs). These measured 0.6 cm and 0.7 cm in greatest dimension, respectively. Molecular analysis of these lesions revealed specific mutations in exon 11 of the KIT gene: one showed a Val559Asp mutation and the other a Leu576Pro mutation. These findings support a diagnosis of GIST and suggest potential sensitivity to imatinib therapy. No mutations in KIT or PDGFRA were detected in the main tumor specimen.\n\nThe resected stomach and esophagus measured 13 cm in total length, with the tumor located at the gastroesophageal junction. The primary lesion was described as a polypoid mass measuring 5.0 x 3.0 x 2.0 cm, arising in a background of Barrett\u2019s esophagus. Histologically, the tumor was moderately differentiated and confined to the mucosa, with focal areas of low-grade and high-grade dysplasia. Invasion was limited to the lamina propria without extension into deeper layers. Resection margins were free of tumor involvement, with the closest invasive component located 15 mm from the nearest margin.\n\nNo lymphovascular invasion was observed. Additional findings included intestinal metaplasia. The specimen also contained a small cystic lesion from the left triangular ligament, which was histologically benign."} +{"pid": "TCGA-78-7537", "report": "The tissue specimen from a right upper lobectomy measures 140 x 120 x 50 mm. A mass is identified in the apical segment, predominantly on the posteromedial aspect, measuring approximately 60 x 65 x 40 mm. The overlying pleural surface at the apex shows puckering, and there is a fibrinous-type exudate on the medial aspect. On sectioning, the mass appears solid and lobulated with a yellow-greyish-white cut surface, in places exhibiting a villous-like architecture. Scattered haemorrhage is present throughout the lesion. The lesion is subpleural and approaches the pleural surface but does not clearly invade it. It lies at least 20 mm from the bronchial resection margin and is well clear of the soft tissue resection margin, which includes a staple line measuring 85 mm in length. The surrounding lung parenchyma appears collapsed.\n\nSections show a well-differentiated epithelial lesion with a prominent bronchioloalveolar growth pattern and marked papillary architecture. The cells are tall and columnar with variable cytoplasmic appearance, ranging from non-mucinous to clear to mucinous. No vascular invasion, lymphatic permeation, or perineural involvement is observed. While the lesion is subpleural, definite pleural invasion is not identified. Tumour cells appear to be present at a diathermied margin, possibly related to the pleura in one block; however, it is uncertain whether this represents a true margin. All lymph nodes examined show reactive changes only, with no evidence of malignant involvement.\n\nAdditional findings include emphysematous changes in the adjacent lung and a localized area of necrosis with surrounding fibrosis in a random section. Special stains performed on this area showed no identifiable microorganisms.\n\nMargins assessed include a bronchial resection margin that is free of involvement. The tumour appears to extend to a diathermized margin, likely related to the pleura. No nodal metastases are identified. Staging classification is consistent with T2N0MX."} +{"pid": "TCGA-QG-A5YX", "report": "The surgical specimen included a resected segment of the sigmoid colon measuring 26.0 cm in length with an average diameter of 3\u20134 cm. A mass measuring 7.6 \u00d7 3.2 cm was identified within the lumen, located 2.5 cm from the proximal margin. The mass extended to the serosa with a depth of invasion of 2.0 cm and exhibited a tan-brown fungating appearance with a central mucinoid area. Histologic evaluation showed low-grade (well to moderately differentiated) cellular features with invasion through the muscularis propria into subserosal adipose tissue. Margins were assessed, with the invasive component located 2 mm from the radial margin; all other margins were uninvolved. Lymphovascular invasion was present, but perineural invasion and tumor deposits were not identified.\n\nA total of thirteen lymph nodes were examined, and none contained metastatic disease. Multiple sections of the tumor were submitted for analysis, along with representative sections of margins and uninvolved colon. Additional specimens including a segment of descending colon, a proximal donut from the descending colon, a distal donut from the rectum, and the spleen were all unremarkable, showing no significant pathology. The spleen demonstrated benign parenchyma with subcapsular hemorrhage.\n\nPathologic staging was determined as pT3, pN0, and no evidence of distant metastasis. Sections of the specimen were submitted for further testing related to microsatellite instability markers, and the case was reviewed twice to ensure complete lymph node identification."} +{"pid": "TCGA-DB-A64X", "report": "The specimen consists of a resected brain mass from the right frontal region, measuring 6.4 x 5.8 x 1.5 cm. Smears were prepared intraoperatively and showed features concerning for a low-grade glial neoplasm; however, final assessment was deferred pending evaluation of permanent sections.\n\nHistologic examination revealed a fibrillary-type lesion with cellular features including overexpression of p53 in the majority of tumor cells. The Ki67/MIB1 proliferative index was assessed as low to moderate. Immunohistochemical staining demonstrated positivity for IDH1(R132H). Multiple representative sections (Parts 1 through 4) were evaluated as part of the diagnostic workup. Findings were interpreted in consultation and contributed to the overall assessment."} +{"pid": "TCGA-FC-A8O0", "report": "The specimen consists of a radical prostatectomy measuring 6 x 4.5 x 3 cm, weighing 60 grams. The external surface shows a smooth contour with a nodular appearance on sectioning and grey-yellow discoloration. Histologically, there is multifocal proliferation of acinar-type glands arranged in a distinct to fused microglandular pattern. The lesion demonstrates perineural and perivascular infiltration within the peripheral nerve and vascular bundles. No involvement of the seminal vesicles is observed.\n\nLymph node evaluation includes a group of six lymph nodes measuring up to 0.5 cm in diameter, showing reactive changes and sclerolipomatous dystrophy. Additionally, connective-adipose tissue contains another set of six lymph nodes, with a maximum size of 0.8 cm, also displaying reactive features and sinus histiocytosis. No metastatic involvement is identified in the total of 12 lymph nodes examined.\n\nStaging assessment indicates that the process is confined to the prostate with no distant spread. Surgical margins are uninvolved. There is no evidence of neo-adjuvant treatment effect. Other pathological features are not identified."} +{"pid": "TCGA-EB-A4IQ", "report": "A mass is identified on the epidermal surface measuring 5 x 4 x 1.5 cm. It is firm in consistency and exhibits a brown to black-gray coloration. Microscopic evaluation reveals ulceration and necrosis of the epidermis. The lesion consists of spindle or oval cells arranged in sheets or clusters, with moderately abundant cytoplasm. In some areas, the cytoplasm contains fine melanin pigment granules. The nuclei display variability in size and shape, with prominent eosinophilic nucleoli. Mitotic activity is frequently observed.\n\nThe specimen is from a surgical resection of the skin of the left buttock. Histologic features include ulceration and pigmentation. The histologic grade is poorly differentiated. Regional lymph node assessment shows 1 out of 9 lymph nodes positive for involvement (Left inguinal lymph node 1/6 positive; Left axillary and pelvic lymph nodes 0/3). Breslow depth of invasion is measured at 15 mm. Information regarding satellite nodules, lymphatic or venous invasion, margin status, and neoadjuvant treatment effect is not available."} +{"pid": "TCGA-KN-8429", "report": "The specimen consists of a right radical nephrectomy specimen weighing 2032 grams, measuring 26.0 x 18.0 x 12.0 cm, including the kidney, surrounding perirenal adipose tissue, and a portion of Gerota's fascia. A large encapsulated mass measuring 18.0 x 12.0 x 12.0 cm is identified, replacing most of the renal parenchyma. The mass has a tan/yellow, mostly solid, homogeneous cut surface with large areas of hemorrhage and focal cystic degeneration. It extends into the renal pelvis and occupies a large portion of the perirenal fat. It approaches within 3.0 cm of the renal vein margin, 7.0 cm from the ureteral margin, and 5.0 cm from the renal artery margin. A small portion of residual renal parenchyma remains in the upper pole, and the calyceal system and adjacent parenchyma are markedly distorted by the mass. The renal cortex is tan/brown with a well-defined corticomedullary junction. No adrenal gland is identified. The adipose tissue is thinly sectioned, and no palpable lymph nodes are identified.\n\nMicroscopically, the mass extensively involves the renal parenchyma. Tumor invades into perinephric adipose tissue. Renal vein, ureter, and perinephric fat resection margins are negative. No definitive lymphovascular invasion is identified. The tumor cells are positive for Hale\u2019s colloidal iron and CD10 (multifocally), and negative for RCC and HMB-45 immunostains. The tumor exhibits typical morphological features including well-defined cell borders, perinuclear halos, binucleation, as well as focal pseudo-papillary architecture, cystic degeneration, and numerous psammomatous calcifications. Attempts at cell culture and cytogenetic analysis were unsuccessful. Fluorescence in situ hybridization (FISH) for Xp translocation was attempted due to unusual morphology and relatively young patient age, but was also unsuccessful.\n\nA separate block of regional right retroperitoneal lymph nodes is submitted, consisting of fibroadipose tissue without evidence of tumor or lymphoid blast crisis.\n\nRenal pathology evaluation of the non-neoplastic kidney parenchyma reveals minimal chronic changes, including global glomerulosclerosis affecting less than 10% of glomeruli, tubular atrophy, and interstitial fibrosis affecting less than 5% of the cortical parenchyma, and mild arteriolar hyalinosis. No glomerular changes suggestive of early diabetic sclerosis are present despite a family history of diabetes. Histologic examination of 219 glomeruli shows 24 (10.9%) globally sclerosed. The remaining glomeruli show no significant expansion of mesangial areas. There are no discernible crateriform or double contours of the glomerular capillary wall basement membranes. Rare distal tubules contain PAS-positive hyaline casts, and a few display focal prominence of reabsorption granules. Arterioles demonstrate mild hyalinosis.\n\nThe patient is a 38-year-old female presenting with a 13 cm right renal mass. She underwent a right radical nephrectomy and regional lymph node dissection. Operative findings describe a large right renal mass. Clinical history includes workup for sciatica during which the mass was incidentally found. Gross description of a second specimen, a right nephrectomy specimen weighing 573 grams, measures 16.0 x 11.0 x 7.5 cm, including a kidney measuring 11 x 7.5 x 6.3 cm with attached perirenal adipose tissue (up to 6.0 cm). A 2.2 cm renal artery (diameter 0.5 cm), a 1.3 cm renal vein (diameter 0.9 cm), and an 8.5 cm ureter (0.5 cm diameter) are present at the hilum and appear grossly unremarkable. The specimen contains a well-circumscribed, tan/yellow, hemorrhagic mass expanding the lower pole but not grossly invading the renal capsule, located 2.5 cm from hilar vessels. The perirenal fat over the tumor is freely mobile with no gross evidence of involvement. No adrenal gland is present, and the remaining renal tissue appears grossly unremarkable without additional lesions. The renal pelvis is lined by light tan, trabecular mucosa without abnormality.\n\nAll relevant margins and tissues were sampled for microscopic evaluation. Microscopic sections include renal vein, renal artery, ureteral margins, tumor to capsule and perirenal fat, tumor and adjacent normal kidney, and uninvolved kidney. No tumor is identified in the regional lymph nodes. The report remains preliminary pending further studies including electron microscopy, immunofluorescence, and tissue banking."} +{"pid": "TCGA-XF-A8HD", "report": "A radical cystectomy with continent urinary diversion was performed. Gross examination of the right ureter showed no abnormalities, measuring 0.3 cm in length and 0.4 cm in diameter. The left ureter, also unremarkable, measured 0.3 cm by 0.5 cm. The urethral margin specimen was a tan-red tissue fragment measuring 2.2 x 0.6 x 0.3 cm. \n\nThe bladder/prostate specimen measured 22.5 x 18 x 4 cm. An ulcerative hemorrhagic mass was identified on the anterior bladder wall, measuring 4 x 3.5 x 2.5 cm. Histologically, high-grade malignant cells were seen infiltrating through the muscularis propria and approaching the perivesical fat but not reaching the inked margin. The depth of invasion was 2 cm. Lymphovascular space invasion was present. Extensive hemorrhage, ulceration, and necrosis were observed. No flat lesions were noted. The prostate measured 4 x 3.2 x 3 cm; microscopic evaluation revealed a small focus of malignant glandular infiltration within the left mid-prostate region. High-grade intraepithelial neoplasia (PIN II-III) was multifocal. Chronic inflammation with glandular hyperplasia and atrophy was also present. The bilateral seminal vesicles, apical, bladder neck, and radial margins were free of malignancy.\n\nLymph node assessment included left para-aortic (7 nodes), left common iliac (6 nodes), right para-caval (8 nodes), right common iliac (5 nodes), right lymph node of Cloquet (2 nodes), right external iliac (5 nodes), right obturator/hypogastric (18 nodes), left lymph node of Cloquet (2 nodes), left external iliac (7 nodes), left obturator/hypogastric (4 nodes), right pre-sciatic (3 nodes), left pre-sciatic (1 node), and presacral regions (no lymphoid tissue identified). All lymph nodes examined showed benign fibroadipose tissue without evidence of malignancy. A total of 71 lymph nodes were evaluated, all negative for malignancy.\n\nAdditional specimens including the proximal segments of both ureters showed benign mucosa without histopathologic abnormalities. Frozen section analysis of the ureters and urethral margin confirmed absence of malignancy. Pathologic staging was determined as T3a for the bladder component and T2a for the prostate involvement."} +{"pid": "TCGA-P8-A5KD", "report": "The right adrenal gland specimen weighed 57 grams and measured 5.0 cm. The lesion was confined to the adrenal gland. Histological evaluation showed no significant abnormalities in the adrenal cortex. Tumor cell clusters were identified within vascular spaces; however, fewer than one tumor cluster per 10 high-power fields were observed. No necrosis, marked atypia, solid growth pattern, or mitotic activity was present. Vascular invasion or other features predictive of malignancy were not evident. Metastasis remains the only defining criterion for classification."} +{"pid": "TCGA-F7-8489", "report": "Specimen obtained from the floor of the mouth. The lesion measures 3 x 3 x 2 cm. Microscopic evaluation reveals a histologic pattern consistent with a malignant neoplasm composed of squamous cells. The tumor is located at the midline. Cellular morphology shows features indicative of invasive growth. No further diagnostic terms are included in this summary."} +{"pid": "TCGA-ET-A39O", "report": "Specimen taken includes thyroid and Delphian lymph nodes following total thyroidectomy and lymphadenectomy. Two tumor nodules were identified, with the larger located in the isthmus measuring 1.6 cm and the smaller in the right lobe measuring 0.6 cm. Histologic evaluation revealed features consistent with papillary carcinoma with tall cell morphology. A total of four lymph nodes, surgically designated as Delphian, were examined and found to be negative for tumor involvement. Staging assessment indicates a primary tumor classified as pT1, reflecting a tumor less than 2 cm confined to the thyroid. Regional lymph node staging is pN0, indicating no metastasis detected in the examined lymph nodes. Distant metastasis could not be assessed (pMx). Surgical margins are uninvolved, with the closest distance of the tumor to soft tissue margin being 1 mm. No evidence of venous or lymphatic invasion was observed. The findings were confirmed in consensus."} +{"pid": "TCGA-M8-A5N4", "report": "The sample was collected from the pancreas and measured approximately 3.4 cm in size. Histological analysis showed a moderately differentiated (Grade II) lesion with pathological staging T3. Lymph node involvement was identified, but no distant metastasis was observed (M0). The tissue was obtained from the pancreatic head. No other diagnoses or tumor names are provided in this summary. A separate buffy coat sample was also collected, though no further details are available."} +{"pid": "TCGA-B0-5116", "report": "The right nephrectomy specimen demonstrates a neoplasm with a Fuhrman nuclear grade of 3 out of 4. The largest dimension of the lesion measures 10.5 centimeters. Histologic evaluation reveals that the growth is contained within the renal capsule. There is evidence of vascular involvement with extension into the renal vein, and tumor cells are present at the margin of this vessel. No residual tumor is identified at any other surgical margins. Adipose tissue adjacent to the renal pelvis shows signs of involvement. The remainder of the kidney exhibits moderate chronic inflammation. Staging according to the TNM classification system indicates localized extension beyond the organ confines without assessment of regional lymph nodes or distant metastasis."} +{"pid": "TCGA-TQ-A7RU", "report": "The specimen consists of two light brown brain segments with friable areas, weighing 11 grams and measuring 4.5 x 3.5 x 2.0 cm. Histological examination reveals a neoplasm involving the white matter with infiltration into the adjacent neocortex. The cells have rounded nuclei with granular chromatin and inconspicuous nucleoli. The cytoplasm is sparse and clear, often displaying perinuclear halos. In some regions, the tumor extends into the cortex, where foci of neuronal satellitosis and angulated vessels are present. No atypical mitotic figures, microvascular proliferation, or necrosis are identified. Reactive gliosis and rarefied neuropil are observed in the surrounding parenchyma."} +{"pid": "TCGA-M7-A720", "report": "The prostate specimen measured 4.0 cm medial to lateral \u00d7 3.7 cm superior to inferior \u00d7 3.6 cm anterior to posterior and weighed 25.8 grams. The right and left vas deferens measured 4.0 \u00d7 0.5 cm and 1.8 \u00d7 0.6 cm, respectively. The right and left seminal vesicles measured 2.8 \u00d7 0.6 \u00d7 0.5 cm and 1.5 \u00d7 0.8 \u00d7 0.5 cm, respectively. Gross examination revealed moderate periurethral nodularity and a yellow, attenuated area in the right posterior lobe near the base.\n\nMicroscopic evaluation showed scattered involvement throughout the prostate with approximately 20% of the gland affected. The lesion was confined within the prostatic capsule without invasion into the seminal vesicles or lymphovascular spaces. Surgical margins were uninvolved. A benign process was also identified. No lymph nodes were submitted for evaluation.\n\nStaging is based on the current pathologic findings and may be incomplete. Further review of all available data is recommended for final staging classification."} +{"pid": "TCGA-CJ-4893", "report": "Surgery Date: (A) RIGHT RADICAL NEPHRECTOMY: A neoplasm measuring 5.2 cm in greatest dimension is identified within the kidney. The lesion has a pale tan to brown cut surface with a central scar and is well circumscribed, extending to the renal capsule and renal sinus. The tumor measures 5.2 x 4.7 x 3.0 cm grossly and is confined to the kidney without involvement of the ureteral or hilar vascular margins. No lymph nodes are identified. Sections submitted include margins, tumor with renal sinus, central scar, tumor with perinephric fat, tumor with adjacent renal parenchyma, and distant normal kidney tissue. Portions of the tumor are evaluated by electron microscopy and a photograph is obtained. CLINICAL HISTORY: None given. SNOMED CODES: T-71000, M-83123."} +{"pid": "TCGA-BH-A1FB", "report": "A right segmental mastectomy specimen demonstrated a focus of cellular proliferation measuring 2.2 x 2.4 x 2.4 cm. Histologic evaluation revealed infiltrating and intraductal components, with the intraductal component being predominantly cribriform and comprising approximately 50% of the tumor volume. The Nottingham histologic score was 4 out of 9 (tubules \u2013 1, nuclei \u2013 2, mitoses \u2013 1). Associated microcalcifications were identified within the tumor bed. Vascular space involvement was not prominent. Surgical margins were free of neoplastic cells in all planes examined.\n\nA right sentinel lymph node biopsy demonstrated involvement in two lymph nodes, with tumor confined within the lymph node capsule in both cases. A third lymph node from the sentinel group did not show evidence of involvement. Fifteen additional lymph nodes from the right axillary dissection were negative for any similar findings.\n\nA separate excision from the left flank was submitted and identified as mature adipose tissue consistent with a benign process. No abnormal cellular proliferation was noted in this specimen. Additional studies including ER/PR and Her-2/NEU testing are pending on designated tissue blocks."} +{"pid": "TCGA-VM-A8CF", "report": "A 4.4 x 2.9 x 2.2 cm aggregate of tan soft tissue, along with two additional specimens measuring 1.8 x 1.4 x 0.5 cm and 2.2 x 1.9 x 0.25 cm respectively, were received for pathological evaluation. Histologically, all specimens demonstrated a glial, infiltrative tumor characterized by marked hypercellularity. The nuclei displayed moderate pleomorphism and hyperchromasia, with scattered mitotic figures noted. No microvascular proliferation or necrosis was identified. Immunohistochemical staining showed diffuse positivity for glial fibrillary acidic protein (GFAP), IDH-1, p53, and PTEN. MIB-1 labeling index was approximately 20%.\n\nFluorescence in situ hybridization (FISH) analysis for EGFR gene amplification revealed a ratio of 1.04 with an average copy number of 2.90, indicating no amplification. FISH studies for 1p/19q deletions yielded a calculated 1p/1q ratio of 0.89 and a 19q/19p ratio of 1.01, indicating no deletion of these chromosomal regions.\n\nA PCR-based assay detected methylation of the MGMT gene promoter region, with a methylation score of 9.46, which is above the threshold for methylation. This result suggests potential sensitivity to alkylating agents such as temozolomide.\n\nAll specimens were processed using squash, frozen section, and permanent section techniques. The tumor was resected from the left frontal lobe; however, margin assessment could not be determined."} +{"pid": "TCGA-EJ-7315", "report": "The surgical specimen includes lymph nodes from the right and left pelvic regions, with no evidence of abnormal cellular proliferation identified in a total of seven lymph nodes examined. The prostate specimen demonstrates a multifocal cellular process involving both the right and left lobes. The largest focus measures 1.3 cm in diameter and accounts for approximately 15% of the total prostate volume. Histologic evaluation reveals extension beyond the prostatic capsule, with involvement noted at multiple sites including the anterior left base, posterior left mid, and posterior left base regions. Perineural invasion is present; however, there is no evidence of vascular or lymphatic invasion. All surgical margins are free of atypical cells, and the bilateral seminal vesicles show no signs of involvement.\n\nHistologic grading indicates a Gleason score of 7 (4+3), with an additional high-grade component identified. High-grade intraepithelial changes are also present and are described as multifocal. The background prostate tissue shows benign nodular hyperplasia and chronic inflammatory changes. Based on these findings, the pathologic staging is classified as pT3a with no nodal involvement (pN0) and no assessment of distant metastasis (pMX). The histologic grade corresponds to a poorly differentiated pattern. The overall prostate weight is 56.68 grams."} +{"pid": "TCGA-73-4676", "report": "The specimen consists of lymph nodes from the 4L, 4R, and mediastinal regions (4R and 2R), as well as a right upper lobe lobectomy. The 4L lymph nodes include two fragments measuring up to 0.2 cm; the 4R lymph nodes consist of four fragments ranging from 0.1 to 0.3 cm. Touch preparations were made for frozen section analysis in both cases. The right upper lobe specimen weighs 291 grams and measures 16.5 x 13.8 x 5.5 cm. A subpleural area with puckered appearance contains two adjacent nodules measuring 0.2 cm each. Upon sectioning, a central lesion measuring 2.0 x 1.0 x 0.8 cm is identified, appearing infiltrative, gray-white, and gritty, extending into but not through the pleura. Adjacent subpleural nodules appear to be extensions of this lesion. Approximately 90% of the tumor was submitted for analysis. The tumor is located at least 8 cm from the bronchial margin. Adjacent lung tissue shows emphysematous changes with blebs up to 0.8 cm. A tumor nodule measuring 1.3 x 0.7 cm bulges into the hilar vein within 1 cm of the margin. Another hilar nodule measuring 2.0 x 1.5 x 1.5 cm involves a lymph node with extension beyond its capsule. Additional small firm nodules are present in the lung parenchyma distal to the main lesion. Three mediastinal lymph nodes (4R and 2R) ranging from 0.2 to 0.5 cm were also submitted.\n\nHistologic evaluation of the bronchial margin is negative. The primary lesion invades into the visceral pleura and exhibits angiolymphatic invasion. Four of five peribronchial lymph nodes contain metastatic involvement with extranodal extension. No malignancy is detected in the 4L, 4R, or mediastinal lymph nodes examined. The tumor is classified as pT2a based on visceral pleural involvement and has N1 nodal staging due to ipsilateral hilar and peribronchial lymph node involvement. Distant metastasis could not be assessed. The histologic grade is poorly differentiated. Emphysematous changes are noted in the surrounding lung tissue."} +{"pid": "TCGA-EY-A1GV", "report": "A surgical pathology report dated January 31, 2014, includes findings from multiple tissue specimens. Lymph nodes were evaluated from various anatomical regions: eleven right pelvic lymph nodes showed no evidence of malignancy; one of six left pelvic lymph nodes demonstrated involvement; eight right periaortic lymph nodes and three left periaortic lymph nodes were all negative.\n\nThe uterine specimen measured 8.5 cm in height with a fundal breadth of 5.1 cm and a cervix measuring 3.5 x 3.2 cm. The endometrial cavity was 3.6 cm long with a fundal width of 2.6 cm. A lesion located at the dome involved both anterior and posterior walls, measuring 3.2 x 2.0 x 2.0 cm. Histologic evaluation revealed mixed cellular features with architectural and nuclear grading classified as high grade. Invasion into the myometrium extended into the outer half of the wall, reaching a depth of 1.3 cm within a total wall thickness of 2.2 cm, representing approximately 59% penetration. No serosal or vaginal margin involvement was identified; however, cervical involvement was present. The cervical margin was free of tumor at a distance of 1.6 cm. Focal findings in the cervix raised suspicion for vascular invasion, later confirmed by immunostaining for Factor VIII-related antigen.\n\nEvaluation of the adnexa revealed atrophic ovaries bilaterally, with no tumor identified. Both fallopian tubes were patent and without involvement. Multiple cysts were observed on both fallopian tubes but showed no significant pathological findings.\n\nImmunohistochemical staining for estrogen and progesterone receptors was performed on representative sections of the endometrial lesion. Results indicated absence of receptor expression.\n\nLymph node assessment across all sites yielded a total of 28 lymph nodes examined, with one identified as involved. Based on these findings and other clinical data, staging was assigned accordingly. Additional findings were documented in subsequent reports as needed."} +{"pid": "TCGA-GS-A9TZ", "report": "CERVICAL LYMPH NODE: Three tissue fragments were received, with the largest measuring 3.7 x 2.5 x 0.9 cm and the smallest measuring 0.5 x 0.4 x 0.3 cm. The cut surface exhibited a homogeneous whitish appearance. LEFT CERVICAL LYMPH NODE (EXCISION): Histologic examination revealed a lymph node in which the normal architecture was replaced by a proliferation of atypical lymphoid cells. These cells formed sheets of large and pleomorphic forms, some displaying Reed-Sternberg morphology, and were present against a background of small lymphocytes. Immunohistochemical analysis demonstrated positivity for CD20, CD79a, CD30, CD23, CD22, BCL2, MUM1/IRF4, and BCL6; staining was negative for CD10, CD15, and EBER. A moderate population of reactive T-cells, positive for CD3 and CD5, was also identified. Immunostaining for immunoglobulin light chains did not yield useful findings. The Ki67 proliferative index was determined to be 70\u201380%. Cytogenetic analysis showed a normal karyotype."} +{"pid": "TCGA-2F-A9KT", "report": "A high-grade neoplasm infiltrates the muscular layer of the specimen. The lesion measures 7x6x2.5 cm and is located on the posterior wall of the right-sided anatomical structure. Examination of 20 regional lymph nodes reveals no evidence of involvement. The cellular morphology demonstrates marked atypia and aggressive features. Staging classification indicates stage T2b with a grade 3 differentiation."} +{"pid": "TCGA-B0-4836", "report": "The specimen consists of a right kidney and adrenal gland resected via radical nephrectomy. A neoplastic lesion is identified in the mid portion of the kidney, measuring 2.8 cm in greatest dimension. The lesion involves the renal cortex and medulla, extending into the perinephric adipose tissue and reaching the renal sinus. Areas of necrosis and hemorrhage are present. Vascular invasion is noted, including tumor thrombus within a muscular branch of the renal vein at the hilum; however, the main renal vein at the surgical margin is free of tumor involvement. The ureter, renal artery, and Gerota\u2019s fascia are unremarkable. All surgical margins are negative for tumor. The remainder of the kidney outside the immediate tumor area shows no significant pathologic changes. A segment of adrenal gland is present and histologically benign. Lymph node involvement could not be assessed (Nx). Distant metastasis is confirmed (M1), based on findings from other correlated cases showing probable pulmonary involvement."} +{"pid": "TCGA-57-1992", "report": "The surgical specimen included a left ovarian mass and attached fallopian tube, along with multiple biopsies from various pelvic and abdominal sites. The left ovary weighed 217 grams and measured 17.2 x 10.2 x 4.8 cm. The outer surface was tan-pink, congested, and wrinkled. On sectioning, the ovary was multiloculated with raised friable tan-pink or orange excrescences occupying approximately 45\u201350% of the cut surface. The remaining tissue was pink-tan with glistening and dull areas, the latter having a slightly granular appearance. Wall thickness ranged from 0.2 to 1.5 cm. No normal ovarian parenchyma was identified. The fallopian tube measured 9.0 cm in length and 0.7 cm in diameter, with scattered paratubal cysts containing cloudy fluid and averaging 0.2 cm. The lumen was pinpoint on sectioning.\n\nThe uterus, cervix, and right adnexa were also examined. The uterus measured 6.9 x 4.3 x 3.7 cm and weighed 82 grams. The cervix was 3.0 cm long and 1.9 cm wide with a centrally located patent os. The endometrium measured 4.3 x 1.5 cm with an average thickness of 0.2 cm. A small pink-red polypoid lesion measuring 1.0 x 0.6 x 0.3 cm was present in the anterior endometrium, confined to the mucosa. The myometrium averaged 1.5 cm in thickness and appeared tan-pink with slight trabeculation. The right fallopian tube was 5.1 cm long and 0.8 cm in diameter, with several paratubal cysts up to 1.5 cm in size. The right ovary measured 2.8 x 1.7 x 0.8 cm and had a pink-white, focally cystic cut surface with clear fluid-filled cysts averaging 0.4 cm in diameter.\n\nAdditional specimens included biopsies from the sigmoid colon, bladder, pelvic sidewalls, ligaments, diaphragm, peritoneum, omentum, and lymph nodes. All these biopsies showed no evidence of malignant involvement. Lymph node aggregates were submitted from the left external iliac, obturator, and periaortic regions, ranging in size from 0.4 to 2.5 cm. All lymph nodes were negative for malignancy.\n\nMicroscopic evaluation revealed high-grade cellular atypia with papillary and transitional cell features, as well as focal clear cell morphology. The tumor was received disrupted, limiting assessment of capsule rupture. Margins from undisrupted areas were free of involvement. Focal areas raised suspicion for lymphovascular invasion. The remainder of the uterus, cervix, and right ovary showed no signs of malignancy. Immunostains were negative for tumor markers in relevant samples."} +{"pid": "TCGA-H2-A3RI", "report": "The final surgical pathology report describes a total thyroidectomy specimen weighing 28 grams, measuring 6.5 x 5.7 x 2.2 cm. The left lobe contains a white-tan, ill-defined firm nodule measuring 2.7 x 1.8 x 1.5 cm. This lesion is located near the superior edge of the specimen and approaches within 0.3 cm of the isthmus. The remainder of the thyroid tissue appears pink-tan and fleshy with no other distinct lesions noted. Histologically, the tumor shows focal extension into the perithyroidal fat but does not involve vascular structures. The margins of resection are free of involvement. A total of five lymph nodes were examined\u2014three perithyroidal and two central cervical\u2014with no evidence of metastatic involvement identified. The submitted lymph node specimens were entirely evaluated. No distant metastasis was assessed. The tumor was completely sampled and submitted for analysis."} +{"pid": "TCGA-AX-A060", "report": "The specimen report includes findings from a total abdominal hysterectomy with bilateral salpingo-oophorectomy and lymph node dissection. The uterus measured 10.5 x 6.0 x 3.8 cm and weighed 128 grams. A pale tan, firm endometrial mass measuring 6.0 x 5.5 cm was identified, with a maximum thickness of 1.2 cm. This lesion involved the anterior and posterior uterine walls and extended into the lower uterine segment. On sectioning, the deepest invasion was noted in the lower anterior uterine wall, reaching the outer half of the myometrium. The myometrium at the site of deepest invasion measured approximately 1.0 cm thick, with a maximum thickness of 1.6 cm elsewhere. The tumor was located approximately 1.0 mm from the uterine serosal surface.\n\nMicroscopic evaluation revealed endometrial tissue with features of atrophy and chronic inflammation. There was extensive lymphovascular invasion within the outer half of the myometrium. No evidence of malignancy was found in the cervix, right or left ovaries, fallopian tubes, or hernia sac. The ovaries showed atrophic changes and paratubal cysts.\n\nLymph node assessment included left and right external iliac, obturator, and para-aortic regions. A total of 23 lymph nodes were examined and all were benign. Focal endosalpingiosis was identified in one lymph node on the right side.\n\nHistologic grading demonstrated a solid growth pattern exceeding 50% of the tumor area. Glandular structures exhibited abundant mucin production. The tumor was confined to the corpus uteri without lymph node involvement. Pathologic staging was determined as pT1c, pN0, pMX. Special stains confirmed mucin-rich glandular components."} +{"pid": "TCGA-CM-6161", "report": "The resected sigmoid colon specimen measured 19.5 cm in length with a circumference ranging from 6.2 to 8.0 cm and included attached pericolonic fat measuring 17.3 x 8.5 x 2.5 cm. A mass measuring 6.5 cm in length and 4.5 cm in width was identified, located 10.0 cm from the proximal margin and 4.5 cm from the distal margin. The depth of the lesion was 2.5 cm, and histologically, it appeared limited to the muscularis propria without extension beyond the muscular wall. No tumor budding or increased tumor-infiltrating lymphocytes were observed. A precursor lesion was present and described as tubulovillous adenoma. An additional polypoid lesion measuring 1.5 cm from the main lesion was noted and diagnosed as tubular adenoma. All surgical margins were free of involvement. Thirty-one lymph nodes were examined, and none contained metastatic disease. No tumor deposits were identified in the pericolorectal soft tissue. Immunohistochemical staining for DNA mismatch repair proteins (MLH1, MSH2, MSH6, PMS2) showed preserved expression in the neoplastic cells. The second and third specimens consisted of proximal and distal ring samples, both showing benign colonic tissue with no evidence of neoplasia. One detached fragment of adenomatous mucosa was noted in the proximal ring specimen. All remaining mucosa and non-neoplastic bowel tissue was unremarkable."} +{"pid": "TCGA-DU-8161", "report": "A female patient presented with episodic right arm symptoms. Imaging revealed multiple subcortical lesions in the left frontal and parietal lobes, with the largest located in the left posterior parietal region and showing focal mild enhancement.\n\nTwo specimens were obtained via excision biopsy from the left parietal brain region. Histopathological examination of the tissue showed extensive infiltration and focal effacement of cerebral architecture by a glial neoplastic proliferation. The tumor cells exhibited moderate nuclear pleomorphism and a tendency to grow along the Virchow-Robin spaces. Mitotic activity was brisk in focal areas. Immunohistochemical staining demonstrated prominent gliofibrillogenesis, with approximately one-third of neoplastic cells showing strong overexpression of p53 protein. Synaptophysin and NeuN staining were largely negative. CD34 staining highlighted focal neovascularization without clear evidence of microvascular proliferation. The MIB-1 proliferation index was approximately 20% in more active regions of the tumor.\n\nPart A consisted of several small fragments of cerebrum, with infiltrating neoplasm identified in a couple of them, displaying more of an oligodendroglial phenotype. Part B contained a larger solid tumor specimen with an astrocytic phenotype.\n\nGenetic analysis revealed loss of heterozygosity at two telomeric loci (D1S548 and D1S1612) on chromosome arm 1p, suggestive of partial deletion. No allelic loss was detected on chromosome arm 19q. Testing for MGMT promoter methylation showed no evidence of methylation. An EGFRvIII mutation assay was also negative.\n\nThese findings were derived from DNA and RNA extracted from formalin-fixed, paraffin-embedded tumor tissue. All molecular testing was performed alongside matched blood samples to ensure accuracy. Interpretation of these results should be considered within the context of established diagnostic procedures and clinical correlation."} +{"pid": "TCGA-C5-A1MH", "report": "Gynecology. F. MRN: 6. M.D. The specimens include endometrial curettage, cervical biopsy, and endocervical curettage. Sections show fragments of carcinoma with squamous morphology and areas of invasion and necrosis. In the endometrial sample, there is an area showing mucinous change; however, definitive glandular differentiation is not present. The endocervical curettage reveals high-grade dysplastic changes without clear evidence of invasion. The case was reviewed with M.D. Clinical history notes a patient with a cervical mass. The operative procedure included endocervical curettage, endometrial curettage, and cervical biopsy. Specimens were received in three formalin-filled containers. The first, labeled as endocervical curettings (ECC), contains brown mucoid material measuring 0.6 cc. The second, labeled as endometrial curettings, includes brown mucoid material with hemorrhagic tissue measuring 2.2 cc."} +{"pid": "TCGA-NK-A5CT", "report": "The surgical pathology report includes multiple lymph node biopsies and a lobectomy specimen. Lymph nodes from levels 9, 7 (two specimens), and 11 were submitted; all showed fragments of lymphoid tissue without evidence of malignancy. A left lower lobectomy was performed, revealing a well-circumscribed tan-gray mass measuring 2.8 x 2.7 x 2.1 cm located within the lung parenchyma. The tumor was situated 1.1 cm from the visceral pleura and more than 1 cm from the bronchial margin. Histologic evaluation demonstrated moderately differentiated carcinoma with necrosis but no definitive lymphovascular invasion. All margins\u2014bronchial, vascular, parenchymal, and pleural\u2014were free of tumor involvement. No invasion of pleural or other adjacent structures was observed. A total of eight peribronchial lymph nodes were identified and showed no signs of malignancy. Intraoperative frozen sections of the lobectomy and a level 5 lymph node biopsy also showed no malignancy. Gross examination of the lobectomy specimen revealed a homogenous red-brown cut surface with no additional lesions. Multiple tissue sections were submitted for microscopic evaluation, including margins and lymph nodes. The lymph node from level 5, evaluated intraoperatively, was anthracotic without evidence of malignant involvement."} +{"pid": "TCGA-XK-AAIV", "report": "The surgical pathology report describes findings from a radical prostatectomy specimen and associated lymph node dissection. Tissue analysis identified carcinoma involving multiple regions of the prostate, with tumor present on both the right and left sides from apex to base, with relative sparing of the left base. Tumor size in each section generally exceeded 2 cm in diameter within the block. Extraprostatic extension was noted, with involvement of pericapsular adipose tissue around both seminal vesicles and at multiple areas including the posterior aspect adjacent to the left apex, left midprostate, and right midprostate. Tumor also extended into the distal periurethral prostatic stroma bilaterally over a diameter of 5\u20136 mm and involved the proximal periurethral prostatic stroma and urethral mucosa on the right in a 2 mm focus. Apical margins, bladder neck margins, and pericapsular margins were free of tumor.\n\nHistologic evaluation showed a high-grade carcinoma with features including comedo-type morphology with central necrosis, multiple calcifications, fused glands with loss of acini, and areas showing signet ring cell formation. Lymph-vascular and perineural invasion were present, with extensive perineural involvement. Seminal vesicle invasion was identified bilaterally, with foci up to 2 cm in diameter; the right seminal vesicle was largely replaced by tumor.\n\nLymph node assessment included a total of eighteen nodes examined across multiple sites. Two lymph nodes were found to contain metastatic involvement: one in the right internal/external obturator group and one in the left internal iliac group. The metastases measured 5 mm and 6 mm in diameter respectively, and neither exhibited extranodal extension.\n\nAncillary testing included DNA ploidy analysis and Ki-67 immunohistochemistry. DNA ploidy studies performed on a representative block demonstrated aneuploid tumor cells. Proliferation index (MIB-1) was 7.46%. These tests were performed using validated methods in a CLIA-certified laboratory.\n\nPathologic staging was determined based on these findings. Multiple blocks contained malignant tissue suitable for further testing. A biorepository sample was collected, representing 100% high-grade tumor."} +{"pid": "TCGA-IE-A3OV", "report": "A wide resection of a left thigh mass was performed. The specimen included multiple margins: anterior, distal, posterior, proximal, and deep skin margins, all of which were negative for malignancy. The excised soft tissue mass measured 10.5 cm in greatest dimension and was described as high grade. The resection margins were free of malignant cells. The tumor exhibited a highly pleomorphic spindle cell morphology with a prominent fascicular pattern. Mitotic activity was brisk, with more than 15 mitotic figures per 10 high-power fields, and widespread necrosis was observed. Immunohistochemical staining showed reactivity for vimentin, smooth muscle actin, and desmin, while stains for S100 and pancytokeratin were negative. The tumor had overall dimensions of 10.5 x 4.8 x 5.0 cm and displayed a pale pink, fleshy cut surface with fibrous appearance and myxoid foci. Less than 1% necrosis was present. The closest resection margin was 0.2 cm from the tumor. A centrally located arteriovenous complex was noted to be involved by the mass. Representative sections of the mass and margins were submitted for analysis."} +{"pid": "TCGA-VS-AA62", "report": "The biopsy specimen from the cervix shows a moderately differentiated squamous cell carcinoma with evidence of invasion. The tumor measures approximately 1.5 cm in greatest dimension. Histologic evaluation reveals nests and sheets of malignant cells with moderate nuclear pleomorphism, prominent nucleoli, and frequent mitotic figures. Stromal invasion is present, with involvement of the underlying connective tissue. No lymphovascular space invasion is identified. The surgical margins are free of neoplastic cells. No deep stromal invasion is observed, and the lesion appears to be confined to the cervix without extension to adjacent structures. Clinical staging is limited to early disease without evidence of regional or distant spread."} +{"pid": "TCGA-A8-A08S", "report": "The specimen shows a poorly differentiated invasive lesion measuring 1.8 cm in diameter. Histologic evaluation reveals high-grade nuclear features with an unfavorable prognosis. Lymph node involvement is indicated, with microscopic evidence of metastasis present. Vascular and lymphatic invasion are noted, suggesting aggressive biological behavior. No specific immunohistochemical or molecular markers were provided to further classify the tumor subtype."} +{"pid": "TCGA-BP-4354", "report": "The submitted specimens include a left kidney with attached colon, a segment of left colon, and multiple lymph node groups. The kidney specimen measures 21 x 11.5 x 9 cm and contains a large mass measuring 16.5 x 13 x 8 cm located in the upper pole. The mass has a lobulated appearance with areas of hemorrhage and necrosis; approximately 50\u201360% of the tumor is viable. Histologic evaluation reveals sheets of cells with extensive necrosis and fibrosis. Nuclear grading was consistent with the highest grade category. The tumor extends beyond the renal capsule into surrounding fat and involves the renal sinus and renal pelvis. There is also invasion into the adjacent colonic wall. Small vessel angiolymphatic invasion is present, but no renal vein involvement is identified. Surgical margins are free of tumor. Adjacent kidney tissue shows focal chronic inflammation. No adrenal gland was identified in the specimen.\n\nIn the para-aortic lymph node group, one out of 17 lymph nodes contains a metastatic deposit measuring approximately 3 mm in diameter. The largest lymph node in this group measures 6 cm and shows extracapsular extension. Other lymph node groups examined\u2014including those from the interaortocaval and left suprahilar regions\u2014show no evidence of tumor involvement. The segment of colon removed contains no tumor and includes four lymph nodes that are negative for malignancy. Immunohistochemical staining supports the interpretation of these findings.\n\nStaging indicates the primary lesion extends beyond the renal capsule into surrounding tissues."} +{"pid": "TCGA-KO-8414", "report": "A nephrectomy specimen measuring 21.0 x 16.0 x 9.0 cm was received, including a small portion of remaining normal kidney tissue (5.0 x 3.0 x 2.0 cm), segments of renal artery, renal vein, and ureter (17.0 cm in length, 0.4 cm average diameter), as well as fragments of adrenal gland tissue (4.0 x 3.0 x 1.0 cm in aggregate). A well-circumscribed mass measuring 18.0 x 16.0 x 8.5 cm was identified, replacing most of the kidney with only a small inferior pole of uninvolved kidney remaining. The mass was pink-tan in color and contained extensive areas of hemorrhage (5.0 x 2.5 x 2.0 cm) and necrosis (9.0 x 8.0 x 7.0 cm), primarily located centrally within the lesion. The tumor was confined to the kidney without extension into sinus adipose tissue, renal vein, or Gerota\u2019s fascia. The adjacent kidney parenchyma showed no abnormalities, and the pelvicalyceal system was smooth and free of lesions.\n\nFour lymph nodes were identified at the hilum of the kidney, each approximately 2.0 cm in size, and all were unremarkable upon histologic examination. Serial cross-sections of the adrenal gland fragments revealed no abnormal findings in either cortex or medulla. Vascular, ureteral, and soft tissue margins of resection were free of any abnormal tissue. Lymphatic and vascular invasion was identified within the tumor. No involvement was seen at the renal vein or ureteral margins.\n\nIn addition, five para-aortic lymph nodes were submitted for evaluation, ranging in size from 0.5 x 0.4 x 0.3 cm to 2.5 x 1.0 x 0.8 cm. All were histologically unremarkable.\n\nMultiple sections of the tumor were taken for histologic analysis, including regions involving the capsule, adjacent normal kidney, areas of necrosis, and the pelvis. Portions of the tumor were also submitted for possible electron microscopy and tumor banking. Photographs of the specimen were documented for reference."} +{"pid": "TCGA-ED-A7PY", "report": "The gross examination reveals a solid, firm mass located within a hepatic lobe, measuring 5 x 4.5 x 4.2 cm. The mass has ill-defined margins and appears yellow-white on cross-section. Microscopically, the cells are arranged in trabecular, acinar, or sheet-like patterns. The cells are polygonal in shape with round, vesicular nuclei and prominent nucleoli. The cytoplasm is moderate in amount, appearing basophilic or vacuolated. Nuclear pleomorphism is present, with large, irregular, hyperchromatic nuclei. Mitotic figures are identified. There is evidence of lymphocytic invasion. The specimen is from a lobectomy and shows a single tumor without involvement of margins. The histologic grade is poorly differentiated, and there is vascular invasion present. No information is available regarding lymph node involvement, venous invasion, neoadjuvant treatment, or additional findings."} +{"pid": "TCGA-BP-4782", "report": "The specimen from the left kidney was submitted in multiple parts. The primary specimen measured 5.0 x 4.5 x 3.5 cm and included a well-circumscribed mass measuring 4.2 x 2.6 x 2.0 cm with bright yellow, hemorrhagic, and gray hyalinized areas. This mass was adjacent to a 1.2 cm unilocular renal cortical cyst and abutted the renal capsule, being 0.5 cm from the deep margin. Microscopic evaluation revealed clear cell-lined cysts, some of which had a multilocular appearance. The cellular morphology showed nuclear features corresponding to grade II on the Fuhrman scale. No local invasion or vascular involvement was identified. Surgical margins were free of atypical cells. Adjacent renal parenchyma showed mild arteriosclerotic changes. Other submitted specimens included several cystic structures from different regions of the left kidney. These ranged in size from 0.8 x 0.5 x 0.2 cm to 2.4 x 1.0 x 0.1 cm, all showing benign features such as unilocular architecture and clear cell lining, except one small lesion measuring 0.6 cm that showed muscle-predominant characteristics confirmed by immunostains (HMB-45, A103, SMA). No lymph nodes or adrenal tissue were present. Based on the findings, the tumor was confined to the kidney and measured less than 7.0 cm in greatest dimension."} +{"pid": "TCGA-AH-6643", "report": "The specimen consists of a colon segment from the sigmoid and upper rectum, measuring 24 cm in length with a maximum circumference of 10.5 cm. The margins are stapled, and adhesions are present on the serosal surface. A polypoid mass measuring 8.5 x 7.4 x 6.3 cm is identified, located 4.1 cm from the closest mucosal margin and involving approximately 99% of the luminal circumference. The mass extends through the wall and is situated above the peritoneal reflection. The distance from the radial margin is grossly estimated at 0.7 cm. An additional small polyp (1 x 0.8 x 0.8 cm) is noted 3 cm from the opposite mucosal margin.\n\nMicroscopic examination reveals that the mass invades through the muscularis propria into the subserosal adipose tissue but does not reach the serosal surface. All resection margins, including the proximal, distal, and circumferential margins, are free of involvement. The tumor is associated with tumor deposits but shows no evidence of lymphovascular or perineural invasion. No prior treatment effect is observed.\n\nA total of 15 lymph nodes are examined, with 8 showing metastatic involvement. Based on these findings, the regional lymph node staging is classified as pN2b. The primary tumor staging is pT3.\n\nAdditional findings include the presence of a tubular adenoma and serosal adhesions. Sections from the anastomotic rings show no pathological abnormality."} +{"pid": "TCGA-DX-A3U7", "report": "The submitted specimen consists of a radical resection from the adductor compartment. The surgical specimen includes an oriented skeletal muscle measuring 20 x 17 x 6.5 cm with overlying skin, which appears tan and unremarkable grossly, measuring 22.3 x 12.5 cm. A short suture identifies the superior margin, and a long suture marks the lateral margin. Within the tissue, there is a mass measuring 9.2 x 7.5 x 6.3 cm. It is described as fairly well circumscribed, with a white-pink, fleshy appearance, partially solid and cystic. The mass is located 0.1 cm from the deep margin, 3.5 cm from the superior margin, 6.0 cm from the inferior margin, 6.5 cm from the lateral margin, and 12.0 cm from the medial margin. Histologically, the lesion shows high-grade features with areas of necrosis and cystic hemorrhagic change, accounting for approximately 10\u201320% of the total volume. All surgical margins are free of tumor involvement; however, the tumor is in close proximity to the deep margin at 0.15 cm. Representative sections of the tumor and margins have been submitted for analysis, including a portion for further testing."} +{"pid": "TCGA-DI-A1C3", "report": "The surgical specimen includes a piece of omental tissue measuring 14.0 x 7.0 x 1.0 cm, showing adipose tissue with suture granulomas and adhesions; no abnormal growth is identified. A left ovary and attached fallopian tube were also submitted. The ovary measures 8.3 x 5.6 x 4.2 cm and contains multiple hemorrhagic and follicular cysts ranging from 0.4 to 1.1 cm in diameter. The fallopian tube shows chronic inflammatory changes. No abnormal masses are observed in either the ovary or fallopian tube.\n\nThe uterus measures 13.0 x 11.0 x 5.5 cm and contains a yellow-tan friable lesion within the endometrial cavity measuring 16.0 x 6.5 cm. This lesion extends into the anterior and posterior aspects of the lower uterine segment but does not reach the cervix. Histologic evaluation reveals multiple foci of cellular proliferation within the endometrium. The underlying myometrium varies in thickness from 2.0 to 3.5 cm. Superficial myometrial involvement is noted, with a depth of 3.0 mm measured within a 35.0 mm thick myometrial wall. There is extension of this process into the lower uterine segment and areas of altered myometrial architecture consistent with adenomyosis. Adjacent hyperplastic tissue shows complex architectural changes with cytologic atypia. No vascular or lymphatic invasion is present.\n\nAn additional fragment of omental tissue measuring 19.0 x 7.0 x 1.0 cm is unremarkable, showing only adipose tissue with adhesions and no evidence of abnormal cellular infiltration."} +{"pid": "TCGA-WC-AA9E", "report": "The tissue specimen from the left orbit consists of multiple black and red soft tissue fragments measuring 3 x 2 x 0.3 cm in aggregate. No discernible normal tissue is present. A portion of the tissue was submitted per protocol, with the remainder included in blocks A1 through A4. Microscopic evaluation reveals viable tumor cells with spindled morphology and minimal necrosis (<5%). Focal areas of fibrous tissue are noted to be infiltrated by tumor cells, while the majority of the sample is composed of tumor. Cellular features are comparable to previously observed findings. Pathologic staging could not be assigned as this case represents a recurrence. Biomarker testing has been performed using tissue from block A4. Clinical history includes prior treatment for a lesion in the left eye. Local recurrence is indicated. All findings have been interpreted in the context of available clinical and histopathological data."} +{"pid": "TCGA-SH-A9CU", "report": "HISTOPATHOLOGY REPORT. Sex: M. Date Collected: Date Received. Date Printed: SPECIMEN DETAILS. Specimen A: Pleurectomy decortication, Right pleura Tissue bank. Specimen B: Pleura, parietal. Specimen C: Pleura, parietal. Specimen D: Visceral pleura. Specimen E: Visceral pleura 2. CLINICAL INFORMATION: Clinical history includes right pleural plaques and prior biopsy of a lesion. Tissue was submitted urgently for pathological evaluation. Patient presentation noted as SOBOE NYHA II.\n\nMACROSCOPIC DESCRIPTION: Specimen A consists of multiple pieces of thickened, cream-colored pleural tissue with attached fat, measuring 6 x 5.5 x 2.5 cm in aggregate. Seven tissue fragments were sampled into two cassettes. Specimen B is a large container labeled \"parietal pleura\" containing a sheet of thickened pleura with fat, measuring 16 x 6.5 x 0.6 cm, along with an additional fragment of pleura and brown tissue measuring 3 x 2 x 1 cm; three fragments were sampled into one cassette. Specimen C contains a piece of thickened pleura measuring 4 cm in aggregate, with four fragments placed into one cassette. Specimen D includes two sets of pleural fragments each measuring 5 x 2.5 x 0.5 cm, with four total pieces placed into one cassette. Specimen E is a sheet of pleura measuring 6.5 x 3.5 x up to 1.2 cm, including a surface nodule; three fragments were sampled into one block.\n\nMICROSCOPIC REPORT: Tissue sections from both parietal and visceral pleura demonstrate a malignant neoplasm composed of epithelioid cells. The tumor exhibits solid and tubopapillary growth patterns. Invasion is observed through the elastin layer of the parietal pleura into subpleural fat, and through the visceral pleura into lung parenchyma. No sarcomatoid differentiation is present. Immunohistochemical staining shows positivity for calretinin."} +{"pid": "TCGA-A8-A0AB", "report": "The specimen includes skin and fatty tissue showing minor resorptive inflammatory changes with early scarring, but no signs of malignant involvement. The excised material consists of glandular tissue with fibrolipomatous transformation and cystic duct ectasia. Scattered foci of adenosis are also present. In addition, there is a focus of invasive growth characterized by small clusters of atypical cells extending beyond the main lesion, along with multicentric, partially confluent intraductal proliferations. These intraductal changes are present in various areas of the specimen.\n\nThe invasive component measures 2.7 cm at its largest dimension and displays moderate nuclear atypia. Vascular and lymphatic invasion was not identified. Lymph node assessment shows no affected nodes (0 out of 2 examined). The surgical margins are free of any suspicious cellular activity. The closest resection margin, located dorsally, measures 0.6 cm. Histological grading is consistent with intermediate differentiation. The submitted tissue from the skin and subcutaneous layers shows no abnormal features. Based on these findings, complete removal with clear margins appears to have been achieved."} +{"pid": "TCGA-DD-A1EB", "report": "The specimen consists of a right lobe liver measuring 22 x 14.3 x 9.5 cm and a gallbladder measuring 7.5 x 3.5 x 1.5 cm, submitted together as a single unit weighing 1,475 grams. Multiple tissue sections were sampled. A mass measuring 12 x 11 x 8 cm is present in the liver. Microscopic examination reveals moderately differentiated cells with features suggestive of a neoplastic process. Evaluation shows no evidence of vascular invasion. The surgical margins are clear by 1 cm. The gallbladder shows histologic changes consistent with mild chronic inflammation. No gallstones are observed."} +{"pid": "TCGA-IG-A3YB", "report": "The esophageal specimen measured 2.7 x 2 x 1.5 cm and showed a moderately differentiated cellular growth pattern. The tumor involved the adventitial layer of the esophagus. Of the three intraabdominal lymph nodes examined, one was found to contain abnormal cellular deposits. No involvement of surgical margins was identified. No other significant pathologic features were noted."} +{"pid": "TCGA-4G-AAZT", "report": "The liver specimen measures 14x10 cm and contains a whitish nodule measuring 9.2 cm, located 1.4 cm from the resection margin. Histological evaluation reveals a moderately differentiated adenocarcinoma. The tumor cells show positivity for cytokeratin 7, while staining for cytokeratin 20, CDX2, and TTF1 is negative. Adjacent liver tissue demonstrates mild steatosis involving less than 5% of hepatocytes, along with mild fibrosis. Lymph node analysis includes lymph nodes adjacent to the hepatic artery (2), a retrocardial lymph node (1), retro portal lymph nodes (2), and interaortocaval lymph nodes (3), all of which exhibit reactive lymphadenitis without evidence of malignancy."} +{"pid": "TCGA-GM-A3NY", "report": "The left breast segmental mastectomy specimen measures 9.5 x 8.0 x 4.2 cm and contains a pale-gray, firm, ill-defined nodule measuring 3.2 x 2.1 x 2.7 cm located close to several margins: 0.2 cm from the deep margin, 0.2 cm from the anterior margin, 0.2 cm from the superior margin, 1.2 cm from the inferior margin, 0.6 cm from the medial margin, and 2.2 cm from the lateral margin. The tumor involves an area of approximately 3 cm and extends to within 3.0 mm of the deep, 3.0 mm of the inferior, and 5.0 mm of the superficial margins. Lymphovascular invasion is identified.\n\nHistologic evaluation reveals cellular features including modified Black's nuclear grades 1 and 2. Adjacent findings include lobular carcinoma in situ, intraductal papilloma, and fibrocystic changes such as duct epithelial hyperplasia without atypia, apocrine metaplasia, radial scar, and cysts. Microcalcifications are present in association with fibrocystic changes. No tumor is identified in the left breast capsule specimen. Additional excisions of the new superficial inferior margin and another superficial margin show breast parenchyma with fibrocystic changes including florid ductal hyperplasia without atypia, apocrine metaplasia, and microcysts; no malignancy is seen. The skin and subcutaneous adipose tissue from the additional superficial margin also show no evidence of malignancy.\n\nAxillary lymph node dissection includes level 1 and 2 nodes, among which one of twelve contains metastatic involvement measuring 2.8 cm in greatest dimension with extranodal extension up to 3.0 mm. One lymph node from level 3 shows no evidence of involvement.\n\nImmunohistochemical staining for HER2 overexpression is negative (score 0). Estrogen and progesterone receptor assays indicate positivity (10\u2013100%). Ki-67 staining indicates low proliferative activity (<17%)."} +{"pid": "TCGA-X6-A7W8", "report": "The surgical specimen from the right thigh consists of a soft tissue mass measuring 19 x 10.5 x 9.0 cm. The mass includes overlying skin and is oriented with a surgical stitch at the proximal end. Grossly, the mass is mostly myxoid (70% of total surface), appearing yellow and lobulated, with a focal central area of dark red friable tissue. A tan-white, firm, and fleshy component (30% of the total surface) measures 6.5 x 4.2 x 3.7 cm. A separate 1.0 x 0.6 x 0.5 cm nodule is identified within skeletal muscle, located 0.8 cm from the main mass. Two possible lymph nodes or satellite nodules are present on the proximal end, measuring 2.7 cm and 1.5 cm.\n\nMargins are as follows: 0.1 cm from the proximal margin, 0.1 cm from the deep margin, 0.6 cm from the anterior margin, 0.9 cm from the posterior margin, and involvement noted at the distal margin. Histologically, the lesion demonstrates marked cellular pleomorphism with enlarged nuclei and atypical mitotic figures. Focal areas exhibit a fascicular growth pattern and myxoid stroma. Multinucleated cells and necrosis are present, with necrosis estimated at approximately 30% on limited sampling. Perineural invasion is identified. No vascular invasion is seen.\n\nTwo lymph nodes are identified at the proximal end; one is effaced by tumor with extracapsular extension. Microscopic evaluation confirms metastatic involvement in one of the two lymph nodes examined. Mitotic count is 40 per 10 high-power fields. No pre-existing benign lesion is identified.\n\nPathologic staging indicates a primary tumor greater than 5 cm in size with regional lymph node involvement. Based on available material, the pathologic stage is classified as T2 N1."} +{"pid": "TCGA-BJ-A45F", "report": "The thyroid specimen weighed 20 grams and showed a unifocal lesion in the right lobe measuring 1.5 cm. The lesion was encapsulated and demonstrated oncocytic follicular variant features. There was no evidence of angiolymphatic or capsular invasion. Margins were free of involvement. No extrathyroidal extension or lymphovascular invasion was identified. Regional lymph node assessment was not performed. A separate finding of nodular thyroid hyperplasia was noted. The parathyroid tissue weighed 8 mg and exhibited normocellular architecture."} +{"pid": "TCGA-ET-A3BU", "report": "The specimen consisted of thyroid tissue and central neck soft tissue obtained via total thyroidectomy. The tumor was multifocal, with involvement of the right lobe, isthmus, and left lobe. The largest focus measured 1.4 cm in the left lobe, with smaller foci measuring 0.3 cm in the right lobe and 0.2 cm in the isthmus. Examination of lymph nodes revealed metastatic involvement in 6 out of 9 nodes. All surgical margins were free of involvement. Histologic evaluation showed features suggestive of a neoplastic process; however, the presence of venous or lymphatic invasion could not be definitively determined. Additional findings included nodular hyperplasia. Staging indicated a primary tumor size of 2.0 cm or less confined to the thyroid gland, with regional nodal metastasis to Level VI. Distant metastasis could not be assessed."} +{"pid": "TCGA-CZ-5461", "report": "The surgical pathology report describes a resected right kidney specimen. The nephrectomy specimen weighs 451.5 grams and measures 17.0 x 6.3 x 5.0 cm. A mass is identified at the inferior pole of the kidney, measuring 6.2 x 5.3 x 4.5 cm. The mass is tan/white to tan/yellow, focally cystic and hemorrhagic, and is partially encapsulated. It is located less than 0.1 cm away from the inked margin, 4.2 cm from the vein margin, 5.6 cm from the artery margin, and 7.8 cm from the ureteral margin. The mass abuts the kidney capsule but does not grossly invade the perirenal fat.\n\nMicroscopic evaluation shows high nuclear grade cells with features including focal sarcomatoid differentiation and focal papillary architecture. The tumor is confined to the kidney without evidence of vascular invasion. All surgical margins, including vascular, ureteric, and soft tissue margins, are free of tumor involvement.\n\nCytogenetic analysis of two specimens (T1 and T2) reveals an interstitial deletion in chromosome 3 (p172p174), a finding commonly associated with certain types of kidney neoplasms. No metaphases were available for analysis from specimen T3. Chromosome analysis was performed at a resolution of 400 bands or greater.\n\nStaging according to the AJCC 6th Edition classification is T1b NX MX. Sections of the tumor and adjacent normal kidney tissue have been submitted for further special studies, including electron microscopy, immunofluorescence, and tissue banking. An addendum will be provided by the Renal Pathology Service regarding the non-neoplastic kidney tissue."} +{"pid": "TCGA-G3-AAV1", "report": "A partial hepatectomy specimen from liver segment 6 was received. A multinodular mass measuring 5.0 x 4.5 x 4.5 cm was identified, with a yellow-green to tan appearance and areas of hemorrhage and necrosis. The mass was in close proximity to the parenchymal resection margin, at 1.0 cm. Histologically, the lesion showed morphologic heterogeneity, with areas demonstrating trabecular and sinusoidal growth patterns, as well as acinar arrangements. The tumor extended through the visceral peritoneum and exhibited extensive venous and lymphatic invasion. Intralymphatic involvement was present within 2.4 mm of the resection margin. The background liver tissue showed cirrhosis consistent with chronic hepatitis B infection, along with a single non-necrotizing granuloma.\n\nA separate excision from the right diaphragm revealed skeletal muscle and fibroadipose tissue with reactive mesothelial changes and fibrinous debris. Rare cauterized fragments were found within an adherent blood clot, but no true tissue invasion was observed.\n\nIn the right \"adrenal\" excision, multiple pieces of fibrofatty tissue were examined. No adrenal gland was identified. Within the adipose tissue, a large vein was found to contain embolic material. The material was located in the fat plane adjacent to the liver, suggesting local spread. No definitive adrenal involvement was noted.\n\nStains for infectious organisms (Ziehl-Neelsen and Grocott\u2019s) performed on the granuloma were negative for acid-fast bacilli and fungi, though this does not exclude an infectious cause. All other findings remained unchanged from the original report."} +{"pid": "TCGA-05-4434", "report": "The tumor is extensively and locoregionally advanced, spanning from central to peripheral regions, most likely originating peripherally. Histological examination reveals a mixed growth pattern. The tumor invades the pleura and has metastasized to both pleural layers and regional lymph nodes. Staging based on available material is pT4 pN1 pM1 (P/E), with residual tumor status RX, corresponding to stage IV. In the main tumor and lymph node metastases located within the lung\u2014particularly in the parabronchial, hilar regions, and sample 5\u2014the predominant component is a large-cell solid tumor with partial clear-cell features. At the main tumor margin and surrounding areas, glandular tubulopapillary and bronchioloalveolar patterns are observed. No evidence of squamous epithelium maturation is present on conventional histology. Immunohistochemical analysis is pending to confirm bronchopulmonary origin and rule out late metastasis from a previously reported breast carcinoma. The tumor shows widespread infiltration of the pleura with extension to the pleural surface, and the presence of carcinoma cells in pleural effusions raises the possibility of residual disease. All surgical margins\u2014including the central bronchus, pulmonary vessels, and parietal pleura\u2014are free of tumor. Immunohistochemistry demonstrates that a significant portion of tumor cells co-express low and high molecular weight keratins (clones M903 and 902). In the glandular component, tumor nuclei express TTF1, supporting a pulmonary adenocarcinomatous origin with mixed differentiation."} +{"pid": "TCGA-DU-6408", "report": "The specimen consists of multiple tissue fragments from two locations within the frontal lobe. The first collection includes fragments measuring 0.2\u20130.5 cm and 0.4\u20130.6 cm. A separate resected specimen from the right frontal region measures 5.5 \u00d7 2.8 \u00d7 2.2 cm and is described as a soft, pink-tan wedge with a homogeneous, glistening pink-gray cut surface. Another fragment from the medial frontal area measures 1.8 \u00d7 1.8 \u00d7 1 cm and has a uniform gray-pink appearance.\n\nMicroscopic examination reveals a lesion involving both white matter and cortex with scattered neurons and subpial extension. The tumor exhibits microcystic changes and contains numerous minigemistocytes. Areas of hypercellularity are noted with frequent nuclear pleomorphism and hyperchromasia. Mitotic figures are present at a rate of approximately 2 per 10 high-power fields. Vascular hyperplasia is observed in some hypercellular regions, though no tumor necrosis is identified. Immunohistochemistry demonstrates GFAP positivity in minigemistocytes, while other tumor cells are negative. The proliferative index, assessed by MIB-1 staining, is approximately 6%."} +{"pid": "TCGA-68-8250", "report": "Specimen submitted includes a right upper lobe lobectomy, along with lymph node samples from stations 10R and 11R. A single firm tan-white nodule measuring 1.8 x 1.7 x 1.3 cm was identified in the right upper lobe, located 0.1 cm from the parenchymal surface and 1 cm from the bronchial margin. The lesion does not extend through the pleura. A second, smaller subpleural area of induration measuring approximately 1 cm was noted 3 cm away from the main lesion.\n\nHistologic evaluation reveals two distinct lesions within the lung tissue. One demonstrates features of moderately differentiated morphology with squamous differentiation. A separate lesion shows a mixed pattern with components suggestive of minimally invasive growth. Within this second lesion, an invasive acinar pattern is present measuring 0.3 cm. No vascular invasion is identified in either lesion. Lymphatic invasion is noted in the context of the squamous-differentiated lesion but not in the other. All margins\u2014bronchial, vascular, parenchymal, and pleural\u2014are free of involvement.\n\nLymph nodes from stations 10R and 11R show no evidence of abnormal cellular infiltration or suspicious morphologic features. Morphologic staging for the minimally invasive component corresponds to an early stage based on depth and extent of invasion. Histopathologic characteristics of the squamous-differentiated lesion show similarity to a prior lesion previously documented in the left upper lobe, raising considerations regarding potential origin, although a second independent lesion cannot be ruled out.\n\nAdditional molecular studies are in progress and will be reported separately. Intraoperative assessment confirmed absence of involvement at the bronchial margin. Gross examination of the specimen revealed no pleural retraction or signs of advanced local disease. Multiple tissue sections were obtained from the tumor, surrounding parenchyma, margins, and associated lymph node regions for comprehensive microscopic analysis."} +{"pid": "TCGA-BJ-A291", "report": "The thyroid specimen weighed 27 grams and showed two distinct abnormal areas in the right lobe. These measured 0.3 cm and 1.5 cm, respectively. Both were fully contained within the thyroid gland without evidence of vascular invasion or spread beyond the organ. Surgical margins were clear. The larger lesion exhibited oncocytic features but no capsular invasion was identified. A nodular appearance was present throughout the gland, accompanied by chronic inflammatory changes involving lymphocytes. No parathyroid tissue was identified in the specimen. Nine lymph nodes from the central neck region were examined, all of which appeared benign. Additionally, a separate lymph node contained thyroid tissue with fibrosis and chronic inflammation. Some lymphoid follicles showed atypical appearances, but expert review concluded these were reactive changes. Molecular testing is in progress. The findings indicate a localized process without nodal involvement or aggressive features such as lymphovascular invasion."} +{"pid": "TCGA-86-7955", "report": "The lung tissue specimen was obtained from the right lower lobe and was part of a lobectomy procedure. The tumor measured 4.5 x 3.8 x 3.5 cm. Microscopic evaluation revealed moderately differentiated cells. Immunohistochemical staining showed positivity for CK7, CD15, and TTF1. No information was provided regarding tumor extent, presence of additional nodules, lymph node involvement, lymphatic or venous invasion, surgical margins, neo-adjuvant treatment, or other significant pathologic findings."} +{"pid": "TCGA-CM-6675", "report": "A right hemi-colectomy specimen was examined, revealing a mass located in the cecum. The tumor measured 8 cm in length and 6 cm in width, with a maximal thickness of 1.8 cm. Histologically, the lesion showed extensive tumor budding and perineural invasion. Lymphovascular invasion was also identified. No increased tumor-infiltrating lymphocytes or precursor lesions were observed. The tumor invaded into subserosal adipose tissue and mesenteric fat but did not show gross perforation. Surgical margins were free of tumor involvement.\n\nLymph node evaluation revealed a total of 72 nodes examined, with metastasis identified in 12. Additionally, one tumor deposit was found in pericolorectal soft tissue. Immunohistochemical staining for DNA mismatch repair proteins (MLH1, MSH2, MSH6, PMS2) demonstrated retained expression in the tumor cells.\n\nThe attached adipose tissue measured up to 5 cm in thickness. A conglomerate of five lymph nodes was identified beneath the tumor, measuring 4 x 2.5 x 2 cm with a yellow/white cut surface, located 4.8 cm from the tumor surface.\n\nTwo lymph nodes from the base of the superior mesenteric artery were submitted; one of these contained metastatic carcinoma. One lymph node from the middle colic region was submitted and was benign. Representative sections of the tumor, margins, lymph nodes, and surrounding tissue were processed for analysis.\n\nBased on AJCC 7th Edition staging criteria, the tumor was staged as pT3 and the lymph node stage was classified as N2b."} +{"pid": "TCGA-BH-A0B1", "report": "The specimen from the right axilla, sentinel lymph node #1, revealed one lymph node containing metastatic cells. The tumor measured 0.9 cm and demonstrated focal extracapsular extension.\n\nThe right breast specimen showed a centrally located lesion involving all four quadrants. Multiple tumor nodules were identified, ranging in size from 0.2 to 4.8 cm. The total tumor aggregate measured up to 14.3 cm. Histologic evaluation demonstrated invasive ductal carcinoma with a Nottingham score of 6 out of 9 (tubules 3, nuclei 2, mitoses 3). In addition, there was ductal carcinoma in situ, solid type, with comedo necrosis accounting for less than 5% of the tumor volume. Focal lobular carcinoma in situ was also present. Extensive lymphovascular space involvement was observed. The tumor was located 0.8 cm from the deep margin in the lower inner quadrant. All surgical margins were free of tumor involvement. Dermal lymphovascular space involvement was noted in the skin and nipple. Changes consistent with prior biopsy were identified. Microcalcifications were associated with both benign and malignant areas. Fibrocystic changes were present along with atypical ductal epithelial hyperplasia and columnar cell alterations.\n\nFourteen right axillary lymph nodes were examined and showed no evidence of tumor involvement.\n\nThe contralateral breast specimen weighed 344 grams and showed fibrocystic changes with microcalcifications. No significant abnormalities were noted in the skin.\n\nHistologic assessment indicated nuclear grade 2, tubule formation score 3, and mitotic activity score 1, resulting in a total Nottingham score of 6 and a histologic grade of 2. Angiolymphatic invasion was present. Microcalcifications were identified in both benign and malignant zones. Ductal carcinoma in situ was solid type with comedo features and was admixed with invasive carcinoma. Lobular carcinoma in situ was also present. The in situ component accounted for approximately 3% of the tumor volume.\n\nThe closest distance from the invasive tumor to the surgical margin was 8 mm. No involvement of the surgical margins by in situ component was noted. One lymph node was positive out of fifteen examined. Sentinel lymph node analysis was performed using H/E stain. The largest lymph node metastasis measured 9 mm in diameter and showed extracapsular extension. There was no evidence of skin ulceration or other dermal involvement.\n\nNon-neoplastic findings included atypical ductal hyperplasia. Immunohistochemistry showed positivity for estrogen receptors and progesterone receptors. HER2/Neu staining showed weak positivity (zero or 1+).\n\nPathologic staging was determined as pT2 for the primary tumor, pN1 for lymph node involvement, and pMX for distant metastasis."} +{"pid": "TCGA-39-5016", "report": "The clinical history indicates a newly identified lesion in the right lung. Specimens submitted for evaluation included multiple lymph node stations from the mediastinum, including left and right level 4, level 7 (including separate submissions #3 and #4), level 9, and peribronchial and parenchymal lymph nodes. Additionally, a portion of the right lung and pericardium were submitted.\n\nGross examination of the right lung specimen revealed a firm tan-pink mass measuring 5.0 cm in greatest dimension located in the right lower lobe. The tumor extended around the bronchus and approached within 1.5 cm of the bronchial margin. It also focally reached an inked hilar soft tissue margin. The surrounding lung tissue appeared unremarkable without significant abnormalities. No tumor was identified at the bronchial or pleural margins. Histologically, the tumor demonstrated poor differentiation with basaloid features and evidence of perineural invasion. Evaluation of the lymph nodes showed involvement by metastatic disease, with 6 out of 9 peribronchial nodes and 1 out of 1 parenchymal node affected. Focal direct extension of tumor into lymph nodes was also noted.\n\nAll other lymph node specimens evaluated showed benign findings, with some displaying anthracotic changes. The pericardial biopsy showed no evidence of tumor involvement, revealing only benign mesothelial-lined fibroadipose tissue.\n\nIntraoperative frozen section analysis of all relevant sites failed to identify tumor in the examined samples, and permanent sections confirmed these findings."} +{"pid": "TCGA-DX-A1L4", "report": "The specimen from the retroperitoneal region consists of a multilobulated mass measuring 19.5 x 15.0 x 8.5 cm, with a biphasic appearance. The tumor contains tan firm lobulated areas sharply demarcated from a soft lipomatous component, present in approximately equal amounts. Necrosis is identified within the firm component, comprising about 25% of the total tumor volume. A portion of the soft tumor component is partially surrounded by a thin fibrous capsule, while the firm area appears to infiltrate adjacent skeletal muscle tissue. The surgical margin is inked black, and the kidney capsule margin is noted to be remote.\n\nMicroscopically, the firm component shows low-grade myxofibrosarcoma-like features transitioning to high-grade spindle and pleomorphic areas, including regions with malignant fibrous histiocytic and inflammatory characteristics. The lipomatous component demonstrates well-differentiated features, including lipoma-like and sclerosing types. Atypical cells are identified near the kidney capsule margin, within 1 mm of the inked margin, suggesting involvement. Microscopic foci of atypical cells are also detected in adipose tissue submitted from the retroperitoneal region.\n\nRepresentative sections were taken from various areas including the kidney capsule margin, tumor margins, soft and firm tumor regions, and transition zones. Additional sections were submitted for further evaluation."} +{"pid": "TCGA-DX-A48O", "report": "The specimen consists of a resected soft tissue mass along with attached segments of right colon, cecum, and appendix. The soft tissue mass measures 17 x 12 x 7 cm and is covered by a thin membrane with overlying adipose tissue. On sectioning, the mass demonstrates a tan-white, fibrotic, and whorled appearance with areas of hemorrhage but no gross necrosis. The attached colon and cecum together measure 27 cm in length, with a circumference of 6.0 cm and wall thickness of 0.2 cm. A focal ruptured area is noted; otherwise, the mucosa and serosa appear unremarkable. The appendix measures 7.0 x 0.5 cm and appears grossly unremarkable. Microscopic evaluation includes multiple sections from the tumor mass, surface membrane, colon, cecum, and ruptured area. Tumor cells show positivity for desmin and SMA, while being negative for S100 and CD117. Focal areas of necrosis are identified within the tumor. The adherent segment of colon is free of tumor involvement. The surgical margins are evaluated and show no evidence of tumor extension."} +{"pid": "TCGA-A8-A0A4", "report": "The specimen shows a tumor measuring 3 cm in diameter with a minimum distance of 2.5 cm from the dorsal resection margin. Histological evaluation reveals a moderately differentiated (G II) lesion with classical morphological features and extensive dermal infiltration, although the overlying skin remains intact without ulceration. Microscopic examination of the excised axillary lymph nodes demonstrates no evidence of metastatic involvement or individual tumor cell infiltration. Immunohistochemical analysis indicates positivity for estrogen and progesterone receptors, while testing negative for C-erb B-2 oncoprotein expression. Staging is confirmed as pT2pN0(0/10)LOVORO, with no indication of vascular or lymphatic invasion."} +{"pid": "TCGA-CV-6933", "report": "The specimen includes a distal facial margin nerve biopsy, which consists of two tissue fragments measuring 0.5 x 0.4 x 0.2 cm in total. The proximal neurovascular bundle V3 biopsy measures 0.8 x 0.5 x 0.4 cm and is composed of yellow and tan soft tissue. Two teeth were submitted for gross examination only.\n\nA resected left functional neck dissection specimen with partial mandiblectomy, maxillectomy, and glossectomy measures 14.0 x 8.0 x 6.5 cm. A mass lesion measuring 4.5 x 3.8 x 4.0 cm is present, showing ulceration, fungation, and deep infiltration. The lesion reaches the bone but is bordered by uninvolved mucosa and soft tissue. The neck dissection includes multiple lymph nodes.\n\nHistologic evaluation shows moderately differentiated carcinoma within deep soft tissue. Invasion into vascular and lymphatic spaces as well as perineural involvement is observed. Surgical margins are free of tumor involvement. Among 32 lymph nodes evaluated from the left neck, one contains metastatic carcinoma. The submandibular gland does not show evidence of tumor involvement. Frozen section analyses confirm absence of tumor in biopsied nerve and muscle tissues."} +{"pid": "TCGA-66-2734", "report": "The left lung specimen measured 16 x 11 cm at the base and up to 28 cm in height. A central bronchial resection line was identified 3 cm proximal to the upper lobular bronchus branch. In the hilum, six lymph nodes were noted, ranging from 0.4 to 2.2 cm in size, with blackish discoloration and partial damage. The dorsal interlobar region showed obliteration over approximately 9 cm, with indistinct pleural borders, whitish discoloration, thickening, and flat retraction. Within this area, a pale brownish lesion measuring up to 7.8 cm was observed, with unclear margins and a central malacic zone of about 3.5 cm. The lesion lacked clear connection to identifiable bronchial branches and extended to the pleura in the retracted region and approximately 1.5 cm into the upper lobe near segment 4. Surrounding lung parenchyma appeared indurated and yellow-brown in color; the remainder of the lung tissue maintained normal coloration.\n\nAdditional lymph node findings included: a 2 cm gray-blackish node at the left hilar region (station 10), a 1.5 cm damaged gray-blackish node at the left pulmonary ligament (station 9), a 5 cm gray-blackish node with surrounding tissue at the left paraesophageal region (station 8), a 9 mm gray-blackish node at the subcarinal location (station 7), an 8 mm damaged gray-blackish node at the paraortic region (station 6), another 8 mm gray-blackish node at the subaortic region (station 5) with surrounding tissue, a 9 mm nodule at the left prevascular and retrotracheal region (station 3), and two damaged gray-blackish nodes at the right hilum (station 10), measuring 1 and 1.1 cm, each with surrounding tissue.\n\nMicroscopic examination revealed a cellular structure composed of variably sized, partially branched solid formations and focal atypical epithelial arrangements, including trabecular patterns. The cytoplasm was moderately eosinophilic with intermediate to wide breadth, occasionally elongated or spindle-shaped. Intercellular bridges were noted focally. Nuclei ranged from round to oval, with marked variation in shape and size, coarse chromatin, small to moderately large nucleoli, and numerous mitotic figures. Extensive necrotic areas were present. The tumor stroma was desmoplastic, with infiltration by mixed inflammatory cells, predominantly granulocytes. Atypical epithelial elements extended across the fibrosed and obliterated interlobar space into adjacent segments of the upper lobe. The visceral pleura was focally infiltrated and exhibited pronounced fibrous expansion along with superficial fibrin deposits, both incorporated and external.\n\nTumor margins showed high densities of intraalveolar granulocytes and macrophages. Alveolar septa demonstrated edematous-fibrous thickening with mixed inflammatory infiltration, surrounded by proliferated pneumocytes. Resection margins of the bronchus and vessels, as well as hilar lymph nodes, showed no evidence of tumor involvement. Lymph nodes displayed reactive changes, with development of multiple activated follicles, minor to moderate deposits of fine-grained blackish pigment and occasional anisotropic particles within macrophages. Some nodes contained nodular fibrous zones with few spindle cells, old necrotic regions, planar calcium precipitates, and rare bone-like tissue. Peripheral lung tissue in certain samples contained subpleurally expanded alveolar spaces, rarefied and enlarged septa, and mainly pleural deposits of blackish granular pigment within macrophages.\n\nHistological evaluation indicated the presence of active chronic inflammation around the affected area and fibrinous pleural inflammation with significant fibrous proliferation overlying the lesion. Lymph nodes in proximity exhibited reactive alterations, anthracotic pigment accumulation, and occasional calcified or ossified necrotic zones. Mild focal emphysema was also noted in one sample. The lesion extended across the interlobar fissure into segment 4 of the upper lobe. All resected bronchial and vascular margins, as well as identified lymph nodes, were free of tumor involvement."} +{"pid": "TCGA-06-0127", "report": "The specimen consists of multiple tissue fragments measuring 0.2\u20130.4 cm, all submitted as one block. A separate specimen from the parietal region measures 1.5 x 1.3 x 1.0 cm and consists of several fragments of dusky red to gray-tan brain tissue, submitted in three sections. Microscopic evaluation reveals a high-grade lesion with features including increased cellularity, cellular pleomorphism, mitotic figures, capillary proliferation, and areas of palisading necrosis. Immunohistochemical staining demonstrates a proliferation index of approximately 10% in the cell population."} +{"pid": "TCGA-CG-4475", "report": "The resected gastric stump specimen shows an ulcerous and mucinous tumor in the region of the anastomosis, with predominantly intestinal-type morphology and very focal features consistent with a different growth pattern. The tumor infiltrates the perigastric fatty tissue and is associated with carcinomatous lymphangitis in the subserosal region. Resection margins in the mucosa are free of tumor involvement, and the omentum does not show evidence of tumor. A total of 15 lymph nodes were examined, with two showing metastatic involvement. An additional five lymph nodes were also assessed and found to be unremarkable. Histological evaluation includes measurements corresponding to pT3 N1 (2/20) L1 V0 R0 staging."} +{"pid": "TCGA-SR-A6MV", "report": "The specimen included a lesion measuring 4.4 x 3.8 x 3 cm surrounded by a narrow rim of tan-yellow tissue with a tan-gray cut surface and multiple friable tan-brown foci, some hemorrhagic, with papillary projections. The retroperitoneal lymph node specimen consisted of two fragments, one measuring 0.8 cm in greatest dimension and another measuring 1 x 0.7 x 0.8 cm. Both were entirely submitted for evaluation.\n\nHistologically, the tumor cells showed positive staining for chromogranin, synaptophysin, and NSE, and were negative for EMA and ACTH. Sustentacular cells stained positively for S-100. Both lesions were entirely encapsulated without vascular invasion or necrosis. The proliferative index using MIB-1 immunostain was less than 1%.\n\nIn the Whipple resection specimen, two submucosal nodules were identified measuring 1.1 cm and 2 cm respectively, with infiltration into the muscularis propria and focal psammomatous calcification in one. Metastatic involvement was present in 2 out of 5 peripancreatic lymph nodes with focal extranodal extension. The tumor cells were diffusely positive for chromogranin, synaptophysin, and somatostatin, and focally positive for S-100, gastrin, and CK7. Immunohistochemical stains for glucagon, insulin, pancreatic polypeptide, serotonin, ACTH, and CK20 were negative. Proximal and distal resection margins, as well as the pancreas, were free of tumor involvement.\n\nThe bile duct resection margin showed prominent acute inflammation with reactive atypia of the lining epithelium but no evidence of malignancy. Four periduodenal lymph nodes were also free of tumor. The gallbladder showed chronic cholecystitis without evidence of malignancy. Pancreatic tissue from the neck and uncinate process showed no evidence of malignancy. Intraoperative frozen section analysis confirmed malignancy in the adrenal mass and retroperitoneal lymph node, while the neck of the pancreas and bile duct were negative for malignancy.\n\nImmunohistochemical staining involved reagents categorized as analyte-specific reagents. The test was developed and its performance characteristics determined by the Department of Pathology. It has not been cleared or approved by the U.S. Food and Drug Administration; however, the FDA has determined that such clearance or approval is not necessary. The laboratory is certified under CLIA to perform high-complexity clinical laboratory testing."} +{"pid": "TCGA-85-7843", "report": "The specimen consisted of left upper lung tissue obtained via pulmonectomy. The tumor measured 4.5 cm and was located in the main bronchus. Microscopic examination revealed moderately differentiated cells with characteristics consistent with a primary lung lesion. Lymph node evaluation showed 2 out of 7 involved nodes with metastatic involvement. No other tumor nodules, lymphatic or venous invasion, or margin involvement were identified. There was no evidence of neoadjuvant treatment effect. No additional findings or comments were noted."} +{"pid": "TCGA-BP-5199", "report": "The left kidney and proximal ureter specimen includes a well-circumscribed, multi-faceted yellow-golden hemorrhagic mass measuring 7.6 x 6.0 x 5.5 cm located at the upper pole of the kidney. The mass is within the renal capsule and does not involve the renal artery, vein, or ureter. It extends into the renal sinus fat, approximately 1.5 cm from the hilar fat. Grossly, the tumor contains 40% hemorrhage and 20% necrosis. The remainder of the kidney shows a pink-brown parenchyma with a distinct cortico-medullary junction; cortex measures 0.8 cm. No lymph nodes are identified in the perinephric fat. The attached ureter measures 2.5 cm in length and 0.5 cm in diameter, and the renal vein measures 3.1 cm in length and 1.2 cm in diameter. Margins of the ureter, renal vessels, and renal pelvis are unremarkable.\n\nMicroscopically, the tumor demonstrates prominent sarcomatoid features with nuclear grading classified as Fuhrman Grade IV. Histologic sections include the tumor with adjacent kidney, tumor with hilar fat, tumor with sinus fat, ureteral and vascular margins, and additional sections of sinus fat and ureteral margin. All surgical margins are free of tumor involvement. Non-neoplastic adrenal gland tissue is not identified in the specimen.\n\nA separate submission of para-aortic lymph nodes includes several red-tan lymph nodes ranging from 1.5 to 4.3 cm in greatest dimension. A total of four lymph nodes are examined, and none show evidence of tumor involvement. Sections include bisected, trisected, and multiple cassettes from the largest lymph node.\n\nStaging indicates a pT2 tumor based on size greater than 7.0 cm confined to the kidney. No lymph node involvement is identified."} +{"pid": "TCGA-AA-3542", "report": "The resected colon specimen demonstrates an ulcerated lesion measuring up to 2.5 cm in diameter at its widest point. Histological evaluation reveals moderately differentiated glandular tissue infiltrating through all layers of the intestinal wall, extending into the adjacent mesocolic adipose tissue. There is evidence of lymphatic vessel invasion near the margin area. A total of 18 lymph nodes were examined, with 4 showing involvement. The oral and aboral resection margins are free of tumor. Grading is consistent with intermediate differentiation (G2), and the resection is classified as complete (RO). No vascular invasion is identified."} +{"pid": "TCGA-AR-A0TV", "report": "Breast, left, simple mastectomy: A mass measuring 2.6 x 2.4 x 2.0 cm was identified in the outer quadrant. Histological evaluation shows a Nottingham grade III lesion with no angiolymphatic invasion observed. There is no significant intraductal component present. A separate hyalinized fibroadenoma measuring 1.2 x 1.0 x 1.0 cm is located superior to the mass. The nipple and skin show no notable changes. Lymph nodes, left axillary sentinel, excision: Three left axillary sentinel lymph nodes were recovered. All are without evidence of involvement. Blue dye was identified in sentinel lymph node No. 1, but not in nodes No. 2 and No. 3. Immunohistochemical cytokeratin staining of paraffin embedded sentinel lymph node tissue was performed and supports the H&E findings. Additional testing for Her-2/NEU has been initiated on paraffin embedded tissue."} +{"pid": "TCGA-S9-A6TW", "report": "Histomorphology demonstrates oligodendroglial differentiation with evidence of mitotic activity. Focal proliferation index reaches up to 20%."} +{"pid": "TCGA-BR-8371", "report": "A segment of stomach tissue was examined, containing a lesion measuring 7.5 cm in its largest dimension. The lesion involved the full thickness of the stomach wall and extended into the subserosal layer. Perineural invasion was identified. Fifteen lymph nodes were evaluated, ten of which showed evidence of metastatic involvement. The tumor was found to be ulcerated, with no venous invasion observed. Margins were uninvolved. No evidence of neoadjuvant treatment was identified. Additional findings included hyperemia in the fatty tissue and spleen, along with anemia of the red pulp. The histologic grade was classified as poorly differentiated."} +{"pid": "TCGA-HC-7212", "report": "The prostate specimen measures 5.0 x 5.0 x 4.0 cm and weighs 47 grams. Histologic evaluation reveals a neoplasm involving approximately 5% of the prostatic tissue examined, located exclusively in the right lobe. Histologic patterns include a primary pattern score of 3/5 and a secondary pattern score of 4/5, resulting in a total Gleason score of 7/10. The lesion is confined without evidence of extraprostatic extension or involvement of the seminal vesicles. No definitive intraluminal neoplasm is identified; however, extensive perineural invasion is present. High-grade intraepithelial neoplasia is also noted.\n\nSurgical margin analysis shows that the apical margin is free of malignancy. The neoplasm extends to the inked prostatic margin in the right posterior section, while all other resection margins are negative. Four lymph nodes were examined, and none contained metastatic disease.\n\nExtensive sections from both lobes of the prostate were evaluated. All neoplastic tissue was identified in the right lobe, with no evidence of malignancy found in additional sections from the left lobe. The urethral margin on the right side shows no histologic evidence of malignancy.\n\nGross examination of the prostate reveals a gray to brown-tan surface with slight hemorrhage and adhesions. No definitive lesion is identified macroscopically. Sections from multiple levels of the prostate, seminal vesicles, and vas deferens are submitted for microscopic evaluation. Additional sections from the left half of the prostate were included upon request.\n\nFibromuscular and fibrograndular hypertrophy is present along with extensive glandular atrophy. The tumor demonstrates an extensive cribriform pattern in addition to the typical architectural features seen. Based on these findings, the stage assigned is pT2a NO MX."} +{"pid": "TCGA-CJ-4887", "report": "The right kidney specimen shows a tan-yellow circumscribed lesion measuring 4.0 x 3.5 x 3.0 cm located in the mid-pole. The lesion is composed of a mixture of clear and eosinophilic cells, with nuclear features corresponding to grade 3. The tumor invades into the renal vein, with involvement noted approximately 1 cm from the margin of resection. It is also present within vascular-lymphatic spaces in the renal sinus. The perinephric and renal sinus adipose tissues are not involved. The uninvolved portion of the kidney appears normal. The tumor is focally near Gerota\u2019s fascia but does not directly involve it. Margins of resection are free of involvement.\n\nA separate lesion in the left adrenal gland measures 5.0 x 3.5 x 3.5 cm and exhibits a lobulated yellow-tan appearance. Focal areas of gray mucoid material and chocolate brown tissue suggestive of residual normal adrenal architecture are present. Sections from both specimens were submitted for further analysis and protocol processing."} +{"pid": "TCGA-BP-4761", "report": "The clinical history notes a patient with a right renal mass measuring 14 cm. Specimens submitted for analysis include aortocaval lymph nodes, a right radical nephrectomy specimen including adrenal and liver tissue, retrocaval lymph nodes, and the gallbladder.\n\nAortocaval lymph node dissection included thirteen lymph nodes, all of which were benign. The right radical nephrectomy specimen included a portion of the liver and adrenal gland. The primary lesion measured 12.0 cm in greatest dimension and extended through the renal capsule into the renal pelvis, renal sinus, and lymphovascular spaces. The tumor was adherent to the liver but did not involve the liver parenchyma. All surgical margins were free of involvement. The non-neoplastic kidney showed focal glomerulosclerosis and chronic inflammation. The adrenal gland was not involved. Two of three retrocaval lymph nodes contained metastatic disease.\n\nThe gallbladder specimen measured 9 x 2 x 1 cm and contained multiple black, multifaceted stones. The mucosa showed cholesterolosis, and the wall was uniformly 0.2 cm thick. No neoplastic changes were identified in the gallbladder.\n\nIntraoperative consultation on the aortocaval lymph nodes confirmed benign findings. Frozen section of the retrocaval lymph node showed metastatic carcinoma consistent with renal cell carcinoma morphology. Permanent sections confirmed these findings."} +{"pid": "TCGA-VQ-A927", "report": "The specimen from the stomach (body) includes a fragment of epiplon composed of mature adipose tissue, which is free of neoplasia. A lesion in the transverse colon consists of a fragment of autolysed adipose tissue. Lymph node chains were examined: chain 5 and chain 3 both showed congested fibroadipose tissue with no evidence of malignancy.\n\nIn the stomach and omentum, a poorly differentiated adenocarcinoma with a diffuse pattern was identified. The tumor measured 16.5 cm in extension and infiltrated the gastric wall up to the perigastric adipose tissue. Perineural and angiolymphatic invasion were present. The proximal margin was involved by the neoplasm, while the distal margin, although free of neoplasia, was very narrow (<1.0 mm).\n\nMetastatic involvement was found in all dissected lymph nodes. In one group, 13 out of 13 lymph nodes showed metastatic carcinoma with capsular transgression. In another group, 11 out of 11 lymph nodes contained metastatic carcinoma, also with capsular transposition. Pathologic staging was performed, with topography classified as stomach, morphology as adenocarcinoma, and stage pT3 pN3b."} +{"pid": "TCGA-QK-A6II", "report": "The pathology report includes multiple tissue specimens from a surgical procedure involving the tongue, floor of the mouth, and associated neck regions. The specimens were obtained from intraoperative frozen sections and formalin-fixed tissues for detailed histopathological analysis.\n\nA total of 15 specimen groups (A\u2013O) were evaluated. All surgical margins, including those from the medial tongue, base of the tongue, left and right gingival margins, deep tongue margin, and genial hyoid tubercle, showed benign tissue without evidence of invasive carcinoma or high-grade dysplasia. The composite resection of the floor of the mouth and tongue measured 7.0 cm in its greatest dimension and contained a mass lesion measuring 4.3 x 4.2 x 1.6 cm. Microscopic evaluation revealed infiltration of skeletal muscle bundles and oral salivary gland tissue, with perineural invasion noted. All surgical margins from this resection and other excised parts were free of tumor involvement.\n\nLymph node dissection was performed on both sides of the neck, including submental, level I to IV on the left, and right level II regions. A total of 58 lymph nodes were examined, with 4 showing metastatic involvement. Metastases were identified in 2 of 5 lymph nodes from left level I, 1 of 1 in left level II, 1 of 3 in right level I, and none in the submental and other left level regions. Extranodal extension greater than 2 mm was present in one of the involved lymph nodes, and the largest positive lymph node measured 2.0 cm.\n\nHistologically, the primary lesion was moderately differentiated and showed no lymphovascular invasion. No treatment effect was identified. The pathological staging was pT4a for the primary tumor, indicating moderately advanced local disease, and pN2c for regional lymph node involvement, based on the presence of bilateral metastases."} +{"pid": "TCGA-E1-A7Z3", "report": "Surgical Pathology: Final. CLINICAL HISTORY: [age and patient details redacted]. GROSS EXAMINATION: A. \"Frozen section, right parietal lesion.\" The specimen consists of an irregularly shaped gelatinous mass measuring 3.2 x 2.5 x 2.0 cm. Two portions of this lesion were used for frozen section analysis. The remnants of frozen sections 1 and 2 are submitted. Additional representative portions of the lesion are also submitted. B. \"Right parietal lesion.\" The specimen consists of a piece of gray-white tissue measuring 0.3 x 0.3 x 0.4 cm. The entire specimen is submitted in Block B1. INTRA OPERATIVE CONSULTATION: AF1 and AF2: Well differentiated glial lesion. \n\nMeasurements, cellular features, and staging: The Ki67 index varies, with some areas showing less than 1% and focal areas approximately 28%. All relevant tissues have been submitted for analysis. Results indicate a total of 1 out of 1 marker tested positive."} +{"pid": "TCGA-B8-5552", "report": "The right kidney specimen was obtained via laparoscopic nephrectomy and weighed 266 grams, measuring 17.0 x 9.5 x 5.3 cm. The serosal surface was inked green for orientation. Upon bivalving the kidney, a well-circumscribed cystic and solid mass was identified adjacent to the right lower pole of the pyelocalyceal system. The mass measured 5.4 x 3.5 x 2.5 cm and exhibited a yellow/tan cut surface with possible areas of necrosis. A surrounding pseudocapsule was noted. The mass was confined within the kidney, with the closest distance to the medial lower pole renal parenchyma measuring 0.9 cm.\n\nMicroscopic evaluation confirmed no involvement of perirenal adipose tissue, Gerota\u2019s fascia, renal vein, ureter, or renal sinus. No vascular invasion (venous or lymphatic) or sarcomatoid features were identified. Histologic grade was Fuhrman nuclear grade 2. Surgical margins, including those at Gerota's fascia, renal vein, and ureter, were all negative. No multicentric lesions were present, and the remainder of the renal parenchyma appeared normal without atrophy or scarring.\n\nLymph nodes were not identified in the specimen, and no hilar lymph nodes were present. The adrenal gland was absent. Based on available findings, staging is pT1b and pNx. These findings are based on the current information and may be subject to revision with further clinical correlation. Frozen section analysis confirmed the intraoperative findings. Representative sections of the mass were submitted for further analysis, and tissue blocks included margins, hilar vessels, collecting system, and surrounding normal kidney tissue."} +{"pid": "TCGA-E2-A14S", "report": "The surgical specimen from the left breast was received as a wide local excision measuring 7.0 cm in width, 6.5 cm in height, and 4.0 cm in depth. It contained a needle localization wire and was oriented with inked margins. Serial sectioning revealed a well-defined mass measuring 1.8 x 1.2 x 1.2 cm located 0.1 cm from the superior margin, 0.6 cm from the deep margin, and 0.7 cm from the anterior margin. The mass was found in slices 3 and 4 of the specimen. Surrounding breast tissue appeared unremarkable on gross examination.\n\nTwo sentinel lymph nodes were submitted from the left axilla. The first lymph node measured 1.7 x 1.0 x 0.6 cm and the second measured 1.5 x 1.0 x 0.5 cm. Both were sectioned and touch preparations were made. No abnormal findings were identified microscopically in either lymph node.\n\nAn additional superior margin specimen was received, weighing 12 g, and measuring 5.5 x 3.5 x 2.0 cm. The new true margin was inked blue. Sectioning revealed no significant abnormalities in the breast parenchyma.\n\nMicroscopic evaluation of the main specimen showed a focus of atypical ductal proliferation with solid and cribriform patterns, including areas of central necrosis. A small focus of similar atypical cells was noted near the inferior resection margin, located within 1 mm of the margin. This focus was separate from the main lesion. The deep surgical margin was 2 mm away from the atypical ductal changes.\n\nHormone receptor analysis showed strong positivity for estrogen receptors (Allred score 8) and moderate positivity for progesterone receptors (Allred score 7). HER2 testing by FISH showed no gene amplification, with a HER2/CEP17 ratio of 1.04. Immunohistochemical staining for ER and PR was performed using standardized protocols.\n\nA recurrence score of 23 was obtained from the Oncotype DX assay, indicating an intermediate risk of distant recurrence over 10 years, estimated at approximately 15%. The ER and PR scores were positive, while the Her2 score was negative based on the assay's criteria.\n\nThe tumor was classified as having a modified Scarff-Bloom-Richardson grade of 2, with a tubular score of 3, nuclear grade of 2, and mitotic score of 1. Vascular or lymphatic invasion was not identified. The tumor was located in the lateral region of the breast and was multifocal in nature. All surgical margins were free of malignant involvement."} +{"pid": "TCGA-EL-A3T8", "report": "The pathology report describes a total thyroidectomy specimen. The right lobe measures 3.5 x 1.5 x 1.0 cm and appears unremarkable. The isthmus measures 1.0 x 1.0 x 0.3 cm and is also grossly unremarkable. The left lobe is enlarged, measuring 4.3 x 3.5 x 3.0 cm, and contains a dominant nodule measuring 3.8 x 3.0 x 3.0 cm located in the upper lateral region. The nodule has a thick capsule (approximately 1.0 mm) with tan-gray papillary and granular features, and exhibits central cystic changes. The capsule remains intact. The remaining thyroid tissue has a tan-black, gelatinous appearance. The left lobe was sectioned entirely from superior to inferior (sections A1\u2013A14), with tumor present in sections A1\u2013A12 and normal tissue in A13\u2013A14. The isthmus was submitted in section A15 and the right lobe in sections A16\u2013A18. Representative sections of both the nodule and surrounding tissue were submitted to the tumor bank. No definitive lymphovascular invasion was identified, and surgical margins appear free of abnormal tissue."} +{"pid": "TCGA-IM-A4EB", "report": "The specimen consisted of a right thyroid lobe measuring 4.5 x 3 x 1.4 cm and weighing 15.8 grams, along with a left thyroid lobe measuring 4 x 2.5 x 1 cm and weighing 7.4 grams. A dominant nodule was identified in the right lobe, measuring 3.0 x 2.0 x 1.8 cm. The nodule was pale tan, solid, and firm with papillary features, located in the mid and lower portions of the lobe. It extended up to but not through the surgical margin, which was inked black, and was 0.5 cm from the isthmus margin. No other gross lesions were identified in either lobe.\n\nHistologic evaluation revealed multifocal involvement with features including classical papillary architecture, diffuse sclerosing, and tall cell morphology. Tall cell cytomorphology was noted. Extensive lymphovascular invasion was present, as well as extensive intrathyroidal spread. Minimal extrathyroidal extension was observed. Margins were uninvolved by invasive disease, with the closest distance of invasive tissue being less than 0.1 cm to the nearest margin. No lymph nodes or parathyroid glands were identified in the thyroid specimens.\n\nLymph node analysis included multiple sites. One lymph node from the superior midline measured 0.9 cm in greatest dimension and contained metastatic involvement. An additional superior midline lymph node showed metastatic involvement measuring 0.6 cm, with minimal extranodal extension. A suspicious lymph node at the midline contained a metastatic deposit measuring 0.4 cm. In the right central compartment, six out of eight lymph nodes showed involvement, with the largest measuring 0.4 cm. No lymph nodes were identified in the prelaryngeal soft tissue or in the left lobe thyroid specimen.\n\nImmunohistochemical staining demonstrated positivity for HBME-1, p53 (in rare cells), p63 (in areas of squamous metaplasia), cyclin D1, and galectin-3. The Ki-67 proliferative index was up to 15%.\n\nThe left lobe thyroid specimen showed multinodular hyperplasia with multiple adenomatous nodules and lymphocytic thyroiditis, with the largest nodule measuring 0.5 cm. Margins were negative for involved disease.\n\nPathologic staging included pT3 based on tumor size greater than 4 cm and minimal extrathyroidal extension. Regional lymph node involvement was classified as pN1b, with metastases identified in unilateral cervical lymph nodes. Nine out of eleven lymph nodes examined were involved. Distant metastasis could not be assessed.\n\nAdditional findings included fibroadipose tissue from the prelaryngeal region and right central compartment, as well as one normocellular parathyroid gland identified in the specimen labeled \"rule out parathyroid.\""} +{"pid": "TCGA-90-7964", "report": "A right VATS upper lobectomy was performed. The surgical specimens included multiple lymph node stations and the right upper lobe of the lung. Lymph nodes from levels 10, R11, R12, R13, level 7, 2R, and 4R were examined. All lymph nodes were negative for malignant cells, with some showing calcified granulomas.\n\nThe right upper lobe contained two distinct tumor nodules within the same lobe. One measured 3.5 cm and the other 3 cm. Both tumors invaded through the visceral pleura and were classified as high grade (grade 3). Microscopic evaluation showed a combination of poorly differentiated adenocarcinoma with sarcomatoid features and partial bronchioalveolar pattern, along with poorly differentiated squamous cell carcinoma. Immunohistochemical staining supported these findings.\n\nAll surgical margins, including bronchial and vascular, were free of invasive carcinoma. The closest distance of the invasive carcinoma to any margin was 3 cm at the bronchial margin. Lymph-vascular invasion was identified in association with the squamous component. No treatment effect was observed.\n\nPathologic staging was determined as pT2a for both tumors and pN0 for regional lymph nodes. A total of ten lymph nodes were examined, none showed evidence of involvement. Additional findings included respiratory bronchiolitis and calcified granulomas in several lymph nodes. The frozen section diagnosis was confirmed on permanent sections. Gross examination revealed two tan-white infiltrative lesions in the lung tissue, each abutting the pleural surface. The specimen was submitted for detailed histologic analysis."} +{"pid": "TCGA-ET-A25J", "report": "The specimen consists of a total thyroidectomy measuring 7.4 x 5.3 x 2.0 cm and weighing 16.37 grams. The right lobe contains a lesion measuring 2.5 x 2.4 x 1.5 cm with a tan to white coloration, including areas of hemorrhage and necrosis. The remaining thyroid tissue shows no other significant abnormalities. A separate piece of fibroadipose tissue measuring 1.1 x 1.1 x 1.0 cm was also identified.\n\nHistologic evaluation of the sections reveals unifocal involvement within the thyroid. Margins are free of involvement. No venous or lymphatic invasion is identified. Evaluation of regional lymph nodes demonstrates metastatic involvement in 2 out of 18 lymph nodes, all from Level VI (pretracheal, paratracheal, prelaryngeal/Delphian). The primary lesion is confined to the thyroid gland, measuring greater than 2.0 cm but not exceeding 4.0 cm in greatest dimension. Distant metastasis could not be assessed.\n\nAdditional findings include the presence of one benign parathyroid gland. All other tissue components, including surrounding fat and potential lymph nodes, were submitted for examination."} +{"pid": "TCGA-DS-A1OC", "report": "The specimen was submitted in nine containers. Container A contained two lymph nodes from the left external iliac and obturator regions, measuring 4 x 2 cm and 1 cm. Microscopic examination of these nodes revealed replacement of the cut surface by whitish tissue; no evidence of extracapsular invasion was observed. One lymph node from the left common iliac region measured 2 x 1 cm and showed no malignancy. Seven lymph nodes from the left periaortic region were identified within fibroadipose tissue measuring 2 x 1 cm; all were negative for malignancy.\n\nOn the right side, two lymph nodes from the external iliac region measured 1.5 cm and 1.3 cm respectively and showed no malignant involvement. Two lymph nodes from the right obturator region measured 1 cm and 2.5 cm and were also negative for malignancy. Two lymph nodes from the right common iliac region were embedded in adipose tissue measuring 1.5 x 1 x 1 cm and showed no signs of malignancy. Three lymph nodes from the right periaortic region were identified within adipose tissue measuring 2 x 1.5 x 0.3 cm and were similarly negative.\n\nA biopsy of the rectovaginal septum measuring 0.3 cm revealed fibrous tissue with microcalcifications and no evidence of malignancy. The uterus, cervix, and ovaries were submitted as a single specimen weighing 230 grams. The uterus measured 7 x 8 x 3 cm. Both fallopian tubes appeared amputated at the distal ends; the right tube measured 2.5 cm and the left measured 3 cm. The right ovary measured 3 x 1.5 x 0.5 cm and the left ovary measured 4 x 1.5 x 1 cm; both appeared unremarkable on gross examination.\n\nThe cervix was replaced by an exophytic lesion measuring approximately 4 x 3 cm involving the region from 12 to 9 o\u2019clock. The tumor infiltrated 10 mm into a cervical wall thickness of 15 mm and was located within 2 to 2.5 cm from the vaginal margin. Margins were uninvolved by invasive carcinoma; however, koilocytic atypia was noted within 1 mm of the vaginal margin. The endometrial lining measured 0.4 mm and showed proliferative features. The lower uterine segment appeared unremarkable.\n\nSections from parametrial tissues, vaginal margins, fallopian tubes, and ovaries were submitted for microscopic evaluation. Sections of the tumor showed moderately to poorly differentiated cellular features without clear evidence of lymphovascular invasion. A total of 19 lymph nodes were examined, with two showing metastatic involvement. No distant metastasis was identified."} +{"pid": "TCGA-BG-A187", "report": "The patient underwent a laparoscopic-assisted vaginal hysterectomy with removal of the right ovary and fallopian tube, along with a left salpingectomy. The specimen weighed 70 grams. Examination of the uterus revealed an area of concern involving approximately 65% of the endometrial surface with infiltration into up to 80% of the myometrium. Adjacent endometrial tissue showed proliferative changes. The cervix exhibited chronic cystic inflammation with squamous metaplasia and parakeratosis. The right ovary displayed serosal adhesions and epithelial inclusions but no abnormal growth was identified. Both fallopian tubes showed no evidence of involvement.\n\nLymph node sampling included two nodes from the left pelvic region, two from the right pelvic area, and three from the left periaortic region\u2014all were free of tumor cells. No lymph node or abnormal tissue was identified in the right periaortic biopsy. A biopsy of the omentum revealed inflammatory changes and fibrous adhesions without signs of malignancy.\n\nHistologic evaluation indicated moderately differentiated epithelial neoplasm with architectural and nuclear features consistent with grade 2. The tumor measured a maximum of 4.8 mm in diameter. Involvement was noted on 90% of the anterior endomyometrium and 40% of the posterior endomyometrium. Invasion extended to at least half the thickness of the myometrium. There was no evidence of lymphovascular invasion. A total of seven lymph nodes were examined, none showed involvement. Immunohistochemical staining supported the findings. Peritoneal cytology was negative for malignant cells."} +{"pid": "TCGA-H2-A421", "report": "The final surgical pathology report includes specimens from the right thyroid lobe, pretracheal lymph nodes, and left thyroid lobe. A nodule measuring 1.5 cm in greatest dimension was identified in the right lobe. Histologic evaluation showed a calcified lesion with well-defined borders. The background thyroid tissue showed features consistent with Hashimoto's thyroiditis and focal changes of multinodular goiter. The margins of resection were focally involved. No definitive vascular invasion was identified. In the pretracheal lymph node specimen, two of three lymph nodes contained small deposits of atypical cells, with the largest measuring 1 mm. No tall cell or columnar cell features were observed. The left lobe specimen showed only benign thyroid tissue with no evidence of atypical cells. Gross examination of the right thyroid lobe revealed a firm, calcified nodule within a thyroid weighing 8.1 g. The pretracheal lymph node specimen measured 1.7 x 1.2 x 0.5 cm and had a soft, pink-tan appearance. The left thyroid lobe weighed 5 g and showed no discrete lesions. All specimens were submitted for further histologic analysis. Clinical correlation is recommended due to involvement of resection margins."} +{"pid": "TCGA-AG-A002", "report": "The specimen consists of a resected segment of colon (rectosigmoid) containing a lesion measuring up to 3.3 cm in maximum diameter. The lesion extends a maximum of 4 cm toward the aboral resection margin. Histological evaluation reveals moderately differentiated cellular features with invasive growth observed in the inner layers of the muscularis propria. Both the oral and aboral resection margins are free of tumor involvement. A total of 34 regional lymph nodes were examined, none of which show evidence of tumor involvement; however, reactive changes are noted. No residual tumor is detected at the resection margins."} +{"pid": "TCGA-KM-8439", "report": "The left kidney showed diffuse involvement with multiple tumor masses, with minimal normal parenchyma observed intraoperatively. Nine separate tumor specimens were submitted and examined.\n\nTumor sizes ranged from 1.8 x 1.4 x 0.5 cm to 5.5 x 5 x 3.5 cm. Most tumors were nodular with red to pink or tan coloration on gross examination. Several tumors exhibited hemorrhagic or variegated cut surfaces. One tumor contained a well-circumscribed yellow to tan spherical nodule measuring 1.2 cm at the periphery. Another demonstrated two distinct nodules: one well-circumscribed and tan (1.3 cm), the other ill-defined, hemorrhagic, and maroon to tan (1.2 cm).\n\nMicroscopic evaluation of frozen sections for intraoperative consultation revealed oncocytic neoplasm in three tumors. Histologic features of other tumors included Fuhrman nuclear grade II/III morphology in two specimens, while others displayed varying cellular characteristics. Immunohistochemical and in-situ hybridization studies were performed as part of diagnostic evaluation; these tests were developed and validated by the laboratory but have not been cleared or approved by the FDA. The laboratory is CLIA-certified to perform high-complexity testing.\n\nPortions of several tumors were procured for additional testing (UOB), with remaining tissue fixed in formalin and submitted for permanent processing. Representative sections of all specimens were submitted for histologic analysis."} +{"pid": "TCGA-N5-A59F", "report": "The submitted specimens include the uterus, cervix, bilateral fallopian tubes and ovaries, right hypogastric sentinel lymph node, left external iliac sentinel lymph node, right external iliac lymph node, right and left para-aortic lymph nodes, and omentum. \n\nIn the uterine specimen, a lesion is identified with a maximum depth of invasion of 8 mm. The thickness of the myometrium at the site of deepest invasion measures 12 mm. There is evidence of lymphovascular invasion. No invasion of the endocervix is observed. The endometrium shows atrophic changes. The myometrium contains areas of adenomyosis and multiple leiomyomata. The adnexal structures show hydrosalpinx in both fallopian tubes. The right ovary exhibits endometriosis and endosalpingiosis, while the left ovary demonstrates endometrosis and tubal-ovarian adhesion. Evaluation of proliferation index by Ki-67 immunostaining indicates a high proliferative rate estimated at over 90%. Immunohistochemical stains for Synaptophysin and Chromogranin are negative, providing no evidence of neuroendocrine differentiation.\n\nExamination of all lymph node specimens reveals benign lymph nodes without evidence of metastatic disease. Specifically, one benign lymph node is identified in each of the right hypogastric, left external iliac, right external iliac, right para-aortic, and left para-aortic sentinel and non-sentinel lymph node groups. Additional hematoxylin and eosin (H/E) sections and immunohistochemical staining for cytokeratins (AE1:AE3) on all lymph node specimens do not reveal any metastatic involvement.\n\nThe omental specimen consists of benign fibroadipose tissue and includes one benign lymph node. \n\nAll immunohistochemical and in situ hybridization (ISH) tests used were developed and validated by the pathology department. These tests have not been cleared or approved by the U.S. Food and Drug Administration; however, FDA has determined that such clearance is not necessary. Testing was performed under CLIA '88 certification for high-complexity laboratory testing. The diagnosis provided is based on direct examination of the slides and relevant materials."} +{"pid": "TCGA-2H-A9GR", "report": "Coded sample ID: Histologic examination reveals moderately differentiated epithelial cells arranged in glandular structures within the mucosal lining of the distal esophagus. The lesion measures 3 centimeters in diameter. Evaluation of lymph nodes shows no evidence of involvement, with all three nodes being negative. The resection margins are noted to be incomplete."} +{"pid": "TCGA-94-8035", "report": "The surgical pathology report includes multiple specimens. Specimen A consists of two lymph nodes from level 6, both measuring approximately 1.6 x 1.1 x 0.9 cm and 2.0 x 1.0 x 0.8 cm respectively; microscopic examination revealed hyalinized granulomas but no evidence of metastatic disease. Specimen B is a pleural clot with reactive mesothelial cells and no malignant cells identified. Specimen C, a left level II lymph node specimen measuring 2.0 x 1.5 x 0.5 cm in aggregate, showed no signs of malignancy. Specimen D, representing left level 5 lymph nodes, also showed no involvement by carcinoma.\n\nSpecimen E is an en bloc resection of the left upper lobe with chest wall. The tumor measured 7.0 x 5.0 x 5.0 cm and was located peripherally within the lung. Histologically, the lesion exhibited poorly differentiated features and extended into adjacent ribs and intercostal soft tissue. All surgical margins were free of tumor involvement, including the bronchial margin, vascular margin, parenchymal margin, and chest wall margin. The closest distance between the invasive component and any margin was 4 mm at the chest wall soft tissue margin. Perineural invasion was noted. Two hilar lymph nodes included with this specimen were also negative for malignancy. Specimen F, a level 7 lymph node, showed no evidence of metastasis.\n\nA total of 14 lymph nodes were examined across all specimens, none of which contained metastatic disease. Stains for acid-fast bacilli and fungal organisms were performed on part A and were negative. Intraoperative frozen section analysis confirmed absence of malignancy at key margins and lymph node stations. The tumor did not involve the carina or demonstrate distant metastasis."} +{"pid": "TCGA-A4-7288", "report": "The right nephrectomy specimen includes a kidney measuring 8.5 x 6.0 x 4.5 cm, with a well-defined mass located in the lower pole. The mass measures 2.0 x 1.9 x 1.9 cm and is described as yellow-tan, hemorrhagic, and variegated. It approaches within 3.5 cm of the ureteral margin, 2.0 cm of the renal vein margin, and 1.0 cm of the inked soft tissue margin. The mass abuts the urothelium but does not show gross involvement of it. No invasion of perirenal or renal sinus fat is identified. Histologic evaluation reveals high-grade nuclear features without evidence of lymphatic invasion. Surgical margins, including those of the ureter, renal artery, and renal vein, are free of malignancy. Adjacent renal parenchyma demonstrates mild arterionephrosclerosis. No lymph nodes or adrenal gland tissue are present in the specimen. The AJCC classification for this case is T1aNXMX."} +{"pid": "TCGA-D8-A1XQ", "report": "Histopathological examination was performed on a right breast specimen with axillary tissues obtained via modified radical mastectomy. The breast measured 20 x 16 x 5 cm and weighed 880 g. A lesion measuring 2.2 x 2.0 x 1.5 cm was identified at the border of the outer quadrants, located 3.0 cm from the lower boundary, 1.2 cm from the base, and 1.6 cm from the skin. Axillary tissues measured 9 x 11 x 3 cm and contained lymph nodes up to 1.0 cm in length.\n\nMicroscopic evaluation revealed a high-grade epithelial malignancy with a histologic score corresponding to NHG3. The mitotic count was 3 + 3 + 2 out of 15 mitoses per 10 high-power fields, assessed in a visual area of 0.55 mm. Peritumoral lymphocytic reaction was noted. No involvement of the nipple was observed. Examination of axillary lymph nodes showed reactive lymphadenitis without evidence of metastatic involvement.\n\nImmunohistochemical analysis demonstrated absence of estrogen receptors in tumor cell nuclei. Progesterone receptors were detected in less than 10% of tumor cell nuclei. HER2 protein expression was evaluated using HercepTest\u2122 by DAKO, and invasive tumor cells showed a negative staining pattern (Score = 1+). Testing was repeated for confirmation."} +{"pid": "TCGA-26-6173", "report": "The submitted specimen includes a brain mass measuring 3.9 x 3.3 x 2.0 cm, described as a pink-tan to tan-white mass with areas of tan-white to yellow-tan on sectioning. A portion (1.5 x 0.7 x 0.3 cm) was used for frozen section analysis. The frozen section findings were consistent with a high-grade malignant glioma. Histologic evaluation revealed nuclear and cellular pleomorphism, mitotic figures, vascular endothelial proliferation, and pseudopalisading necrosis. Immunohistochemical staining showed that many cells expressed GFAP, and reticulin staining was primarily associated with blood vessels. Representative sections of the tumor were submitted for further analysis. The tissue was processed and examined in accordance with standard protocols. The laboratory is certified to perform high-complexity testing and follows established clinical procedures."} +{"pid": "TCGA-D5-6926", "report": "Histopathological examination was performed on a total organ resection specimen of the sigmoid colon, measuring 18 cm in length, along with attached mesentery and fat tissue, which measured 23 x 10.5 x 3 cm. A cauliflower-shaped lesion with ulceration was observed in the mucosa, measuring 7.5 x 5.5 x 3 cm, and surrounded the entire circumference of the intestine, causing significant narrowing of the lumen. The lesion was located 4.4 cm from one resection margin and 5.9 cm from the other, and appeared to infiltrate through the full thickness of the intestinal wall into surrounding periintestinal tissues.\n\nMicroscopic evaluation revealed a moderately differentiated tubulopapillary growth pattern with infiltration into the muscularis propria, serosa, and pericolic adipose tissue. A notable inflammatory response, predominantly composed of plasma cells, was present within and around the lesion. The resection margins were free of neoplastic involvement, with a minimum distance of 0.1 cm at the closest point. Lymph node analysis showed evidence of metastatic involvement, including infiltration of the lymph node capsule and adjacent perinodal fat. No tumor deposits were identified in blood vessels. Based on these findings, the staging assessment corresponds to pT4a, pN1, with a classification consistent with advanced local extension and regional nodal spread."} +{"pid": "TCGA-DH-5140", "report": "The patient is a female who underwent craniotomy for resection of a lesion in the left temporal region of the brain. She presented with headaches and left eye blurriness. MRI imaging had previously identified an abnormality in the left temporal area.\n\nGross examination of the first specimen, labeled \"Tumor,\" revealed a fresh tissue sample measuring 6.5 x 4.0 x 1.5 cm, corresponding to cerebral cortex and underlying subcortical white matter. The deep surfaces showed cauterization and focal hemorrhage, while the meningeal surface displayed prominent vasculature. On sectioning, most of the specimen exhibited clear differentiation between gray and white matter layers. However, one deep edge showed an ill-defined firm white lesion measuring 2.2 x 1.5 x 1.0 cm. Sections of this lesion were submitted for frozen section analysis, which indicated infiltrating glioma with focal high-grade features; final diagnosis was deferred to permanent sections. Tissues from this specimen were placed in cassettes A2 through A7, with the frozen section tissue in FSA1. A section of uninvolved cortex was submitted in cassette A7.\n\nThe second specimen, labeled \"Tumor #2,\" was a fresh piece of cortical brain tissue measuring 2.5 x 1.8 x 0.4 cm. Sectioning revealed an indistinct boundary between gray and white matter layers, with no discrete lesion visible. A portion was submitted for frozen section analysis, which also showed infiltrating glioma. The remaining tissue was entirely submitted in cassettes B2 through B4, with the frozen tissue in FSB1.\n\nMicroscopic evaluation demonstrated a tumor extensively infiltrating both gray and white matter. The histological pattern was primarily consistent with a diffuse anaplastic astrocytoma, showing moderate nuclear and cellular pleomorphism as well as significant mitotic activity, with up to 5 mitoses per ten high power fields in some areas. There were also minor regions displaying a more uniform, oligodendrogliomatous appearance. The Ki67 labeling index was estimated at 10\u201315% overall. Immunohistochemical staining showed GFAP positivity in both neoplastic and reactive elements, and the tumor was negative for PTEN and EGFRVIII mutations.\n\nFluorescence in situ hybridization (FISH) analysis for chromosomal deletions in 1p and 19q was performed on paraffin-embedded tissue, and no deletions were detected.\n\nAll specimens were processed and evaluated according to standard protocols. The laboratory performing these tests is certified under Clinical Laboratory Improvement Amendments to perform high-complexity clinical laboratory testing. Some assays used in the analysis have not been cleared or approved by the U.S. Food and Drug Administration but are utilized for clinical diagnostic purposes."} +{"pid": "TCGA-SR-A6MQ", "report": "The specimen is an encapsulated mass measuring 4.2 cm in greatest dimension. Microscopic evaluation demonstrates a well-defined lesion with no evidence of vascular invasion or necrosis. Mitotic activity is extremely rare. Immunohistochemical staining highlights tumor cells with chromogranin A and synaptophysin expression. A microscopic focus of transcapsular invasion into adjacent fat is identified, with tumor cells extending focally to the inked surface. Ki-67 labeling index is low, approximately 2% in areas of highest labeling. Occasional small areas of neuron-like differentiation are present but are not considered clinically significant. Sustentacular cell staining with S-100 shows varying distribution throughout the tumor. Gross examination reveals no macroscopic capsular invasion. The specimen was processed in multiple cassettes for comprehensive histologic evaluation."} +{"pid": "TCGA-BP-4972", "report": "The submitted specimen consists of a left partial nephrectomy measuring 5.5 x 5.3 x 3.5 cm. A wedge-shaped portion of kidney was received, marked by suture at the deep margin. The tumor measured 4.2 x 4.2 x 4.5 cm and exhibited a yellow-orange, focally hemorrhagic and cystic appearance. The tumor was located near the renal capsule, with closest approach to the inked capsular margin measuring 1 mm. The deep surgical margin was 0.8 cm from the tumor. Histologic evaluation revealed high nuclear grade cellular features. Microscopic assessment confirmed absence of renal vein or small vessel angiolymphatic invasion. All submitted surgical margins were free of tumor involvement. Evaluation of surrounding non-neoplastic kidney tissue identified a benign cortical cyst; no other significant findings were noted. The tumor extended through the renal capsule but remained confined within Gerota's fascia. No lymph nodes or adrenal tissue were identified in the specimen. Based on these findings, staging classification reflects tumor extension beyond the renal cortex without involvement of adjacent structures beyond Gerota's fascia."} +{"pid": "TCGA-19-5947", "report": "The specimen consists of three components submitted for evaluation. The first component, labeled as \"left frontal neoplasm,\" includes multiple pink-tan soft tissue fragments measuring 2.5 x 1 x 0.1 cm in total. A representative section was used for intraoperative frozen consultation, and the remainder was submitted in one cassette. The second component, received in formalin, contains multiple pale tan, soft to rubbery tissue fragments measuring 2.0 x 1.2 x 0.2 cm in aggregate, submitted entirely in one cassette. The third component consists of multiple irregular, opaque white to tan, soft, cerebriform tissue fragments measuring 4.5 x 4.2 x 0.8 cm in total, submitted across three cassettes. Microscopic evaluation of the intraoperative sample revealed a cellular lesion with prominent spindle cell differentiation. All specimens were reviewed and processed in their entirety."} +{"pid": "TCGA-G4-6628", "report": "The specimen consists of a right hemicolectomy measuring 28 cm in total length, including the terminal ileum and right colon. A mass lesion is identified at the cecum with dimensions of 4.5 x 3.2 x 1.0 cm. The lesion is described as sessile/polypoid and raised, located 1.5 cm from the cecal valve and 9 cm from the closest surgical margin. The serosal surface adjacent to the lesion was marked with blue ink. On sectioning, the lesion does not appear to extend completely through the mucosa. Two additional tan polypoid lesions are observed on the mucosal surface, measuring 0.9 cm and 1.3 cm respectively.\n\nHistologically, the lesion demonstrates varying degrees of differentiation and extends into the superficial muscularis propria. All surgical margins are free of involvement by invasive disease. No venous or lymphatic invasion is identified, nor is there evidence of perineural invasion. An attached appendix measuring 10 x 1 cm is present and contains fecal material; no abnormalities are noted microscopically in the appendix.\n\nA total of sixteen lymph nodes are evaluated, all of which are negative for involvement. The lymph nodes include seven submitted individually, six in toto, and three in toto with one bisected node. The tumor was extensively sampled with over 90% of its tissue submitted for evaluation.\n\nAdditional findings include two hyperplastic polyps within the colon. There is no evidence of implants or metastatic disease. The resection is complete with both gross and microscopic confirmation of negative margins."} +{"pid": "TCGA-CK-5914", "report": "The surgical specimen labeled \"Sigmoid Colon, Partial Colectomy\" measures 17 cm in length and contains a polypoid mass identified on the mucosal surface. The mass measures 4.9 cm in greatest dimension and is located 5.0 cm from the proximal resection margin, 5.1 cm from the distal resection margin, and 2.5 cm from the radial resection margin. Histologic examination reveals infiltrating growth with invasion through the muscularis propria. All resection margins are free of involvement. No lymphovascular, extramural venous, or perineural invasion is observed. A mild peritumoral lymphoid response is present, and no residual adenoma is identified. Within the associated mesentery, a white-tan soft nodule measuring 1.5 cm is found adjacent to the main lesion, located 2.0 cm away from the tumor and 1.1 cm from the radial margin. Twelve candidate lymph nodes are identified in the specimen, and two of thirteen regional lymph nodes show involvement. Additional specimens including the proximal margin, distal donut, and proximal donut are all negative for tumor. The proximal margin specimen includes two lymph nodes, both uninvolved. The primary tumor specimen demonstrates no extension into the pericolonic fat."} +{"pid": "TCGA-G4-6588", "report": "The liver specimen consists of a small tan-pink soft tissue fragment measuring 0.3 cm. Microscopic evaluation shows a proliferation of epithelioid cells with minimal atypia within a fibrovascular stroma. The tissue was largely absent on permanent sections, limiting further characterization. No colorectal carcinoma is identified. Clinical correlation is advised.\n\nThe right colon specimen includes a segment of colon measuring 19.0 cm in length with an average circumference of 7.0 cm. Attached to this is a terminal ileum segment measuring 4.0 cm in length and 3.0 cm in circumference, as well as an appendix measuring 6.0 cm long and 0.6 cm in diameter. A mass is identified in the cecum, located 7 cm from the terminal ileum margin and 11 cm from the distal colonic margin. The mass is exophytic, tan in color, with a rolled edge and distinct demarcation from surrounding mucosa. It is circular in shape, measuring 4.0 cm in diameter and less than 1.0 cm in depth, and is limited to the muscularis propria on cross-sectioning. Proximal, distal, and radial margins are free of involvement. The attached mesocolon ranges from 1 to 5 cm in thickness and appears unremarkable. The remaining mucosa of the ileum and colon does not show any significant abnormalities.\n\nA total of 15 lymph nodes were examined and none showed evidence of involvement. Histologic evaluation reveals moderately differentiated glandular structures with focal mucinous features infiltrating into the subserosal tissue. There is no evidence of venous, lymphatic, or perineural invasion. The resection is complete with both gross and microscopic negative margins. Immunohistochemical analysis demonstrates positivity for MLH1, MSH2, and MSH6, while PMS2 expression is not identified. No microsatellite instability results are provided in this report."} +{"pid": "TCGA-DQ-7588", "report": "The specimen consists of multiple tissue fragments submitted from various anatomical sites, including the posterior and anterior lateral tongue, mucosa adjacent to the first molar, anterior floor of mouth, tongue base, retromolar trigone, buccal mucosa, deep margin, and soft palate. These ranged in size from 0.3 cm to 1.5 cm. All were submitted fresh for frozen section analysis and served as controls.\n\nA resected portion of the left retromolar trigone and tonsil was received in formalin, measuring 3.3 x 3.0 x 1.7 cm (larger portion) and 1.4 x 0.5 x 0.4 cm (smaller portion). Within the larger fragment, an ulcerated lesion was identified measuring 2.2 x 1.5 x 1.0 cm. This lesion extended to the anterior soft tissue and mucosal edge, and focally reached the superior mucosal edge. It was within 2 mm of the inferior, posterior, and deep (lateral) soft tissue margins. The lesion was described as semi-firm, white, and well-demarcated. Soft tissue margins were inked green, and representative sections were submitted for analysis.\n\nLymph node evaluations were conducted from left neck dissections across levels I through IV. In level I, a 7.2 x 5.6 x 2.8 cm specimen containing fibroadipose tissue and a submandibular gland was examined; multiple lymph nodes up to 1.5 cm were identified and sampled. Seven lymph nodes were evaluated, all negative for malignancy. In level II, a 9.2 x 5.3 x 3.2 cm specimen contained lymph nodes up to 2.2 cm; one of seven lymph nodes showed evidence of metastatic involvement without extranodal extension. Level III involved a 4.5 x 3.6 x 1.8 cm specimen with lymph nodes up to 1.1 cm; seven lymph nodes were examined and found negative. Level IV consisted of a 4.2 x 2.8 x 1.3 cm specimen with lymph nodes up to 0.6 cm; nine lymph nodes were assessed and none showed malignant involvement.\n\nIntraoperative frozen section evaluation of margins from sites 1 through 9 was negative for neoplasm. Permanent sections confirmed these findings. Sections from the left retromolar trigone and tonsil demonstrated invasive moderately differentiated carcinoma measuring 2.2 cm. No additional microscopic details are provided beyond this description."} +{"pid": "TCGA-HC-A6AN", "report": "The surgical pathology report includes evaluation of a prostatectomy specimen and lymph nodes. The prostate measured 4.0 x 3.8 x 3.0 cm and weighed 29 grams. A firm, white-tan lesion measuring 2.0 cm in greatest dimension was identified in the right anterior and posterior prostate, not grossly crossing the midline. Microscopic examination revealed a Gleason grade pattern 4 and 3. Approximately 20% of the prostate gland showed involvement by this process, with bilateral involvement noted.\n\nFocal extension beyond the prostate was observed at the right apex and right anterior region, with two small foci identified in the periprostatic fat measuring 1\u20132 mm each. Tumor was also present at the surgical margin in the right anterior prostate (1 mm) and focally present posteriorly on both sides, with all posterior foci measuring less than 1 mm. Perineural invasion was noted. No involvement of the seminal vesicles was identified. Lymphovascular invasion was not observed.\n\nA single lymph node from the right iliac and obturator region was examined and showed no evidence of involvement. The surgical margins were focally involved, and the tumor demonstrated extension beyond the prostatic capsule. The pathologic stage assigned was pT3a."} +{"pid": "TCGA-PK-A5HC", "report": "The surgical specimen includes resected right iliac lymph nodes, surgical waste, gallbladder, and a large en bloc specimen encompassing the right adrenal gland, right kidney, retrohepatic vena cava, and liver segments 1, 5, 6, 7, and 8. The lymph nodes measured up to 0.3 cm and showed no pathological findings. The surgical waste consisted of fibroadipose tissue with no abnormalities identified macroscopically. The gallbladder was intact and showed no significant pathological changes.\n\nThe largest specimen measured 23.5 x 15.0 x 10.0 cm and included an extensively sampled mass measuring 12.5 x 11.0 x 9.0 cm. The mass exhibited a yellow and pink-tan cut surface with areas of necrosis and appeared to extend to within 0.1 cm of multiple soft tissue margins. Gross examination suggested invasion into the vena cava, with tumor extending along a branch vessel into the lumen. The vascular margin at this branch vessel was involved by tumor. No gross involvement of the liver or kidney was observed. Ureteric and renal vessel margins were negative for tumor involvement.\n\nMicroscopic evaluation confirmed high-grade cellular features including abundant mitotic figures (up to 19 per 50 high-power fields), atypical mitoses, and diffuse architectural growth pattern. Immunohistochemical staining showed positivity for SF-1, synaptophysin, and vimentin, while markers such as calretinin, cytokeratin, EMA, and HepPar-1 were negative. There was extensive necrosis and vascular invasion involving a large vein. Margins of the main vena cava resection were negative; however, tumor extended to the margin of a smaller branching vessel. No evidence of metastasis was found in the three lymph nodes examined. Adjacent non-neoplastic adrenal cortex showed nodular hyperplasia and fibrosis.\n\nOther findings included mild arteriosclerosis in the kidney and steatohepatitis with approximately 30% steatosis in the liver without significant fibrosis. No direct tumor involvement was observed in the liver, gallbladder, or kidney parenchyma. The specimen also contained a possible lymph node measuring 0.3 cm at the renal hilum that showed no malignancy."} +{"pid": "TCGA-AA-3842", "report": "The specimen shows a poorly differentiated carcinoma with a partial mucinous component. The tumor infiltrates the muscularis and exhibits lymphovascular invasion. Resection margins are free in both the mucosal and deep resection areas. Of the lymph nodes examined, two out of twelve show evidence of metastatic involvement. The tumor has been classified as pT2 with lymph node involvement noted as pN1. Clinical staging was discussed in the context of an oncology conference."} +{"pid": "TCGA-UW-A7GN", "report": "The left laparoscopic nephrectomy specimen measured 17 x 16 x 4 cm and weighed 610 grams. The tumor was located at the left upper pole/posterior surface, presenting as a circumscribed, lobulating tan/orange mass with focal white fibrotic bands. The tumor measured 3.6 x 3.3 x 2.8 cm and was confined to the kidney, abutting the renal capsule. Focal extracapsular extension was noted microscopically in block A7. No involvement of perirenal adipose tissue, Gerota\u2019s fascia, renal vein, or ureter was observed grossly or microscopically. The surgical margins were negative across all evaluated sites, including perirenal adipose tissue, hilar vessels, and ureter. No multicentricity or lymph nodes were identified. Histologic evaluation showed cells with features consistent with grade 2 morphology based on nuclear criteria. Immunohistochemical staining demonstrated positivity for CD10, CK7, and colloidal iron. The tumor exhibited no lymphatic or vascular invasion. Based on extent of invasion, staging was assigned as pT3a pNx pMx."} +{"pid": "TCGA-JY-A6FH", "report": "The specimen was received from a patient undergoing resection involving the esophagus and proximal stomach. A total of 18 lymph nodes were examined across multiple anatomical regions including left cervical, left paratracheal, paracardial, paraesophageal, and left gastric locations. Of these, two lymph nodes showed evidence of involvement by disease, while the remainder were negative for any malignant process. In addition, two lymph nodes (one each from the left paratracheal and paraesophageal regions) contained fibrotic nodules with features consistent with hyalinized granulomas.\n\nThe primary lesion was identified at the gastroesophageal junction with approximately half of the mass located in the distal esophagus and the other half in the proximal stomach. Grossly, the lesion measured 3.4 cm in greatest dimension and extended 1.8 cm in an additional dimension, with a depth of invasion measuring 0.7 cm. The tumor exhibited exophytic and ulcerative growth patterns without circumferential involvement. Histologically, the lesion demonstrated moderately differentiated features and invaded into the muscularis propria without reaching the adventitia. No evidence of perforation was observed.\n\nMargins of resection, including proximal, distal, and radial, were free of involvement by invasive disease. The closest margin to the invasive component was the circumferential margin, at a distance of 0.3 cm from the tumor edge. Lymphovascular invasion was identified. Additional findings included intestinal metaplasia consistent with Barrett's esophagus, along with high-grade dysplasia found beneath intact squamous mucosa.\n\nBased on AJCC/UICC TNM staging criteria (7th Edition), the tumor was classified as pT2 due to invasion of the muscularis propria. Regional lymph node involvement was categorized as pN1, reflecting metastatic involvement in two out of the 18 lymph nodes assessed. There was no evidence of distant metastasis.\n\nGross measurements of the resected specimen included a length of 12.0 cm along the tubular esophagus and 6.0 cm along the greater curvature of the stomach. The proximal esophageal margin measured 4.0 cm in circumference, while the distal gastric margin had a circumference of 11.0 cm. The tumor was located at the esophagogastric junction with a proximal margin distance of 8.5 cm and a distal margin distance of 1.2 cm.\n\nHistologic evaluation of the tumor margins confirmed absence of invasive carcinoma at all resection surfaces. No prior treatment effects were observed. Special stains for acid-fast bacilli and fungi were negative, and no organisms were identified. The presence of multinucleated giant cells and palisading macrophages within fibrotic lymph nodes suggests a reactive or inflammatory process, although infectious etiologies such as histoplasmosis and sarcoidosis remain within the differential diagnosis."} +{"pid": "TCGA-NH-A50T", "report": "The surgical specimen consists of a 12 cm segmental resection of the large bowel, with a tumor located at the splenic flexure measuring 6 cm in greatest dimension. The tumor involves the full circumference of the bowel wall and is situated 2.5 cm from one surgical margin and 2 cm from the opposite margin. Gross examination shows that the tumor extends through the muscularis propria into the subserosal adipose tissue; however, no macroscopic perforation is identified. All surgical margins are free of invasive carcinoma.\n\nMicroscopically, the lesion is composed of moderately differentiated adenocarcinoma. The tumor invades through the bowel wall but does not reach the subjacent mesenteric lymph node. No lymphovascular or perineural invasion is identified. Tumor deposits are present within the pericolorectal adipose tissue. A total of 10 regional lymph nodes are examined, none of which show evidence of metastatic involvement. Based on these findings, the pathologic staging for the primary tumor is pT3 and for regional lymph nodes is pN0.\n\nAdditional specimens include two biopsies of the left lobe of the liver. Both show focal granulomatous inflammation with fibrosis. The granulomas are primarily noncaseating, composed of epithelioid histiocytes, multinucleated giant cells, and small lymphocytes, set in a fibrous stroma. Some granulomas demonstrate minimal central necrosis. Acid-fast bacilli and fungal stains are negative in both samples. There is no evidence of metastatic disease in the liver biopsies.\n\nA separate biopsy of a pelvic peritoneal nodule reveals fat necrosis with fibrosis and calcification. No malignant cells are identified in this specimen.\n\nIntraoperatively, frozen section analysis of the liver biopsy shows necrotizing granulomatous inflammation without evidence of carcinoma. The primary colonic mass is confirmed to be a high-grade neoplasm intraoperatively, with adequate margins obtained. No prior treatment effect is observed."} +{"pid": "TCGA-BR-7722", "report": "The specimen consists of a stomach segment including the esophagus. A plate-like lesion measuring 3 cm in its largest dimension is present, infiltrating all layers of the stomach wall and extending to the diaphragm. Lymph nodes at the greater and lesser curvatures are dense and hyperemic. Esophageal margins show no evidence of metastatic involvement.\n\nMicroscopic evaluation reveals poorly differentiated cellular structures with features of ulceration. The tumor invades adjacent layers of the stomach wall and extends into the diaphragm. There is evidence of lymphatic invasion, while venous invasion is absent. Perineural invasion was not demonstrated. Surgical margins are uninvolved.\n\nA total of fifteen lymph nodes were examined, with five showing evidence of metastatic involvement. Hemorrhages are noted in the omentum. No evidence of neoadjuvant treatment effect is seen. Other findings include focal fibrosis and moderate dysplasia of glands with inflammatory changes."} +{"pid": "TCGA-HC-7742", "report": "The pathology report includes specimens from a pelvic lymph node dissection and a radical prostatectomy. Two regional lymph nodes were examined and found to be benign and without involvement. The prostate specimen weighed 32.6 grams and measured 5.2 x 3.8 x 3.7 cm. Histologic evaluation showed the presence of a lesion involving approximately 5-10% of the gland volume. Microscopic analysis identified two distinct patterns of cellular differentiation; the primary pattern was moderately differentiated, while the secondary pattern showed more aggressive features. The combined score for these patterns was 7 out of 10.\n\nExamination of the prostate margins revealed no evidence of tumor at the surgical margins. There was minimal extension beyond the prostate capsule in the left posterior mid region, but no involvement of the seminal vesicles or lymphovascular invasion was observed. No high-grade pre-invasive changes or treatment-related changes were identified.\n\nStaging was determined based on extent of local spread and absence of lymph node involvement. The total number of lymph nodes retrieved was two, none of which contained metastatic disease. Additional findings were unremarkable. The specimen was sectioned transversely from apex to base, revealing nodularity in the inferior portion of the gland. Tissue blocks were submitted from various regions including margins, transition zones, and specific anatomical areas of the prostate."} +{"pid": "TCGA-DJ-A4UL", "report": "The clinical history indicates a patient with bilateral small thyroid nodules, with fine needle aspiration of the right nodule showing features consistent with a neoplastic process. The submitted specimens include cricoid cartilage tissue, pretracheal and Delphian lymph nodes, pyramidal lobe, and a total thyroidectomy specimen.\n\nMicroscopic examination of the total thyroidectomy specimen revealed a lesion located in the left lobe measuring 1.1 cm in greatest diameter. The lesion appeared tan-white and well-circumscribed. Additionally, another similar nodule measuring 0.7 cm was identified in the right upper pole. Histologic evaluation demonstrated well-differentiated cellular features without identifiable mitotic activity or tumor necrosis. There was no evidence of blood vessel invasion or extrathyroid extension. Surgical margins were closely evaluated, and the tumor was found to be present at the inked and cauterized margin.\n\nMultiple foci of additional lesions ranging from 0.15 to 0.8 cm were identified in both lobes of the thyroid. These measured up to 0.8 cm and were distributed across both lobes. No adenomatous changes away from the primary lesion were observed. The surrounding non-neoplastic thyroid tissue showed features of nodular hyperplasia.\n\nLymph node evaluation included pretracheal, Delphian, and lymph nodes within the pyramidal lobe; all were negative for malignant involvement. One parathyroid gland on the right side showed no abnormalities.\n\nThe thyroid specimen weighed 16.4 grams. Dimensions of the right lobe were 4.2 x 3.2 x 1.1 cm, left lobe measured 4.1 x 3.3 x 1.1 cm, and the isthmus measured 1.4 x 0.5 cm. Gross examination revealed no other significant abnormalities beyond the described nodules.\n\nAll specimens were entirely submitted for histologic evaluation. Intraoperative frozen section consultation confirmed benign thyroid tissue in the sampled areas."} +{"pid": "TCGA-US-A77J", "report": "The specimen consists of a pancreaticoduodenectomy with cholecystectomy. The excised pancreas measures 5.0 x 4.0 x 2.0 cm and the attached duodenum measures 16.0 cm in length by 3.0 cm in average diameter. A small area of submucosal hemorrhage less than 0.5 cm is noted in the duodenum. No other gross abnormalities are identified in the duodenal mucosa or ampulla. The common bile duct is dilated with a diameter of approximately 1.0 cm, and a stent is present within the duct. The gallbladder measures 9.5 cm in length by 3.5 cm in maximum diameter and shows an area of wall thickening in the distal fundus measuring 2.2 x 2.0 x 2.0 cm.\n\nHistologically, sections show a lesion involving the pancreatic head measuring 2.5 cm in greatest dimension. Microscopic examination reveals moderately differentiated cellular features with involvement of the duodenal wall, distal common bile duct, and ampulla. Invasion extends beyond the pancreas without involvement of major vascular structures. Venous vessel invasion and perineural invasion are present. Four of twenty lymph nodes contain metastatic changes. The closest margin (uncinate margin) is less than 1 mm from invasive cells. Additional findings include chronic pancreatitis with lymphoid aggregates and gallbladder adenomyoma with chronic inflammation. All margins are uninvolved."} +{"pid": "TCGA-FD-A6TB", "report": "The patient is a male who underwent cystoprostatectomy and lymph node dissection. A total of 26 lymph nodes were examined, with 12 from the right pelvic region and 14 from the left; none showed evidence of tumor involvement. The surgical specimen included a bladder and prostate, with measurements of the bladder at 6.0 x 6.0 x 2.1 cm and the prostate at 4.4 x 4.0 x 3.9 cm. A red-tan friable ulcer measuring 2.7 x 2.5 cm was identified in the right posterolateral wall of the bladder, with extension into the perivesical fat. Another ulcer measuring 2.5 x 1.0 cm was found in the inferoposterior wall and prostatic urethra, but did not extend through the mucosa. The surrounding bladder mucosa appeared smooth and pink-tan, with a uniform wall thickness of 1.1 cm. All resection margins, including those of the distal urethra, ureters, and soft tissue, were free of tumor. No tumor was identified in the portion of the right distal ureter that was excised. Pathologic evaluation showed no lymph node involvement (0/26). The tumor was high grade and measured 2.7 cm in size, with invasion into extravesicular soft tissue as noted on slide C21. The tumor was solitary and located on the right posterolateral wall. The pTNM staging was determined to be pT3a, N0, MX."} +{"pid": "TCGA-OR-A5JA", "report": "The specimen consists of multiple tissue samples. A nodule from the anterior duodenum measuring 3 mm was found to be a benign fibrous nodule without evidence of malignancy. The right adrenal tumor weighs 865 grams and measures 150 x 100 x 100 mm. It is partially encapsulated with a hemorrhagic, variegated yellow-grey cut surface. Histologically, the tumor shows cells with abundant eosinophilic cytoplasm and pleomorphic nuclei arranged in trabeculae and clusters. There is marked necrosis, mitotic activity up to 18 per 10 high-power fields, and presence of atypical mitoses. Immunostains show positivity for HMB45, inhibin, and synaptophysin, but not for cytokeratin or chromogranin A. Invasion of the capsule, sinusoids, and veins is present. Nuclear grade is high. Evaluation of other Weiss criteria reveals all nine features are present.\n\nAn invasive mass within the inferior vena cava consists of two fragments weighing 21 grams in total and measuring up to 55 x 35 x 25 mm. Microscopic sections reveal abnormal cells arranged in trabeculae with endothelial coverage and organizing thrombi. A separate tissue fragment from the crus of the diaphragm measuring 23 x 15 x 10 mm contains infiltrating cells arranged in trabeculae within fibrous tissue, consistent with metastatic involvement. Less than 25% of cells are clear. Architectural pattern is diffuse.\n\nA separate finding includes a pedunculated grey mass from the transverse colon identified as a torted appendix epiploica."} +{"pid": "TCGA-50-5045", "report": "The right lower lobe lesion measures 2.5 cm and demonstrates invasive growth with poorly differentiated cellular features. There is involvement of the visceral pleura and evidence of angiolymphatic invasion. The resection margins are clear of tumor involvement. Emphysema, airspace changes consistent with smoking, and bronchioloectasis are noted in the background lung tissue. \n\nLymph node involvement is present in two locations: one lymph node from the 11R sump region and one from the middle lobe sump node both show tumor involvement. Other sampled lymph nodes, including those near the right stem bronchus and along the basilic vein, are benign and reactive without tumor. \n\nTwo rib specimens (fifth and sixth) are submitted for evaluation but remain pending decalcification. A pleural biopsy reveals benign fibroadipose tissue, pleura, and skeletal muscle without tumor.\n\nStaging is assessed as T2 N1 MX."} +{"pid": "TCGA-V1-A9OL", "report": "The prostatectomy specimen weighed 34.5 grams and measured 3 cm from apex to base, 4 cm in width, and 3.5 cm anterior to posterior. The peripheral zone showed a suspicious lesion on the right aspect measuring 2.5 x 1.8 x 1.5 cm across slices 1\u20136, abutting the capsule in slice 3. The anterior fibrous stroma appeared intact, while the remainder of the capsule was torn and sutured closed. The seminal vesicle/vas deferens bundles were present bilaterally (right: 3 x 2.5 x 0.5 cm; left: 4 x 2 x 0.5 cm).\n\nMicroscopic examination revealed involvement of bilateral seminal vesicles. Histologic evaluation identified involvement of the capsule in sections D7 and D8. Extension beyond the prostate capsule was observed in sections D7, D8, D17, and D18. Margins were negative for tumor involvement. Benign glands were noted at the inked excision margins in section D2.\n\nPerineural infiltration was identified in section D3. Lymphovascular invasion was present in section D17. No tumor was identified in any of the lymph nodes examined\u2014three from the right pelvic region and six from the left pelvic region.\n\nHistologic assessment indicated a Gleason grade of 5+4 with a total score of 9. The tumor exhibited small acinar morphology and was located in the left posterior mid gland (sections D9\u2013D11), right posterior mid gland (sections D6\u2013D8), and right anterior apex and mid gland (sections D3\u2013D5). Estimated tumor volume was approximately 2 cm\u00b3. All tumor tissue demonstrated Gleason patterns greater than 3, comprising 100% of the tumor volume.\n\nThe specimen was oriented using anatomic landmarks and inked for identification (right anterior in green, left anterior in blue, posterior in black). Six slices were obtained with an average thickness of 0.4 cm. Sections submitted included apical margins, right and left quadrants at multiple slice levels, bladder margins, and cross-sections of the prostatic/seminal vesicle junction and vas deferens.\n\nNo tumor was identified in the biopsy of seminal vesicle fat or in any lymph nodes evaluated (total of nine nodes examined)."} +{"pid": "TCGA-F7-A50G", "report": "The specimen involves a lesion located on the tongue, measuring 4 x 6 x 4 cm. Microscopic evaluation reveals a well-differentiated cellular pattern with features consistent with a malignant process. The tumor is situated at the midline. Margins could not be assessed due to insufficient information."} +{"pid": "TCGA-XF-A9SJ", "report": "A radical cystectomy with bilateral pelvic lymph node dissection and Studor pouch to urethra was performed. The right and left distal ureters were examined microscopically and showed no high-grade atypia or tumor. The apical urethral margin was also free of any concerning cellular changes or tumor involvement.\n\nLymph node analysis revealed the following: metastatic carcinoma was identified in four of ten right periaortic lymph nodes, four of ten right common iliac lymph nodes, nine of eleven presacral lymph nodes (with extranodal extension), three of eleven right obturator/hypogastric lymph nodes, and one of one right presciatic lymph node. No metastatic carcinoma was found in the left periaortic, left common iliac, right external iliac, left external iliac, left obturator/hypogastric, or left presciatic lymph nodes.\n\nThe urinary bladder specimen contained a diverticulum with an associated invasive poorly differentiated transitional cell carcinoma measuring 3.5 x 3.0 x 1.1 cm. The tumor extended through the diverticulum wall into the surrounding perivesical soft tissue and approached, but did not involve, the right ureter. The closest radial margin on the right lateral side was 1 mm from the tumor. Lymphovascular space invasion was identified. No urothelial dysplasia or malignancy was found at the resection margins, peritoneal surface, or in random bladder mucosa, including the trigone and bladder neck. Chronic cystitis was present in areas outside the diverticulum.\n\nIn the prostate, unilateral prostatic adenocarcinoma with a Gleason score of 6 (3+3) was identified. The tumor was focally present within the capsule but did not extend beyond it into the periprostatic soft tissue. All surgical margins, including the apical, bladder neck, and inked radial margins, were free of tumor. Both seminal vesicles were uninvolved. The uninvolved prostatic parenchyma showed signs of acute and chronic inflammation, fibromuscular adenomatous hyperplasia, and high-grade prostatic intraepithelial neoplasia (PIN II and III). The prostatic urethra was also free of urothelial dysplasia and malignancy.\n\nNo malignancy was identified in the right or left proximal ureters. Multiple sections of the bladder, prostate, and lymph nodes were submitted for further histological evaluation."} +{"pid": "TCGA-XF-AAN7", "report": "The surgical pathology report describes a specimen from a bladder and prostate resection along with multiple lymph node groups. Gross examination revealed a large, necrotic, friable mass within the bladder measuring 14.5 x 8 x 5 cm, arising from the left lateral wall and extending into the bladder wall without involvement of perivesical fat. The tumor was located 1 cm from the inked surgical margin. Histologic evaluation showed high-grade malignant cells infiltrating through the muscularis propria into perivesical fat but not reaching the surgical margins. Lymphovascular invasion was present.\n\nMicroscopic evaluation of the bladder mucosa identified multifocal areas of high-grade intraepithelial neoplasia. Chronic cystitis was also noted in the remaining mucosa. The prostate demonstrated benign tissue with no tumor involvement; however, there were findings consistent with low-grade prostatic adenocarcinoma confined to the prostate gland. High-grade prostatic intraepithelial neoplasia was multifocal, and extensive atrophy with acute and chronic inflammation was present.\n\nFrozen section analysis of the distal ureters and apical urethral margin showed no evidence of malignancy. Final microscopic examination confirmed benign ureteral and urethral mucosa without dysplasia or malignant cells in these regions.\n\nA total of 170 lymph nodes were evaluated across multiple anatomical regions including bilateral obturator/hypogastric, external iliac, common iliac, para-aortic, Cloquet, presacral, and pre-sciatic regions. Of these, only one lymph node from the left obturator/hypogastric region contained metastatic malignant cells.\n\nImmunohistochemical staining supported the histologic findings, showing positivity for pancytokeratin and vimentin while negative for neuroendocrine markers in the bladder lesion. Prostatic lesions stained positive for CK 903 and racemase.\n\nAll surgical margins were free of malignancy."} +{"pid": "TCGA-AQ-A7U7", "report": "A left total mastectomy specimen was received, fixed in formalin for 33 hours, with a cold ischemic time of 71 minutes. The specimen weighed 330 grams and measured 19.0 cm from superior to inferior, 20.0 cm from medial to lateral, and 2.5 cm anterior to posterior. A single discrete mass was identified, measuring 7.5 cm medially to laterally, 6.7 cm superiorly to inferiorly, and 3.5 cm anteriorly to posteriorly. The mass was located in the upper inner, upper outer, and lower outer quadrants, including the area deep to the nipple/areola. Histologic evaluation revealed a Nottingham combined histologic grade of 2, with tubule formation score of 3, nuclear pleomorphism score of 2, and mitotic count score of 1. The tumor was present as a single focus, with no ductal or lobular intraepithelial neoplasia identified. No lymphovascular invasion was observed.\n\nMargins were assessed, with the invasive component closest to the black inked posterior margin at 2 mm. The tumor measured 4.1 cm in greatest dimension. Microcalcifications were noted in association with benign breast changes. Additional findings included extensive stromal fibrosis with patchy amyloid deposition, fibrocystic changes, columnar cell change, an epidermal inclusion cyst, and changes related to a previous biopsy site.\n\nAxillary lymph node evaluation included a total of seven lymph nodes examined. Two lymph nodes contained metastatic involvement, with the largest metastatic focus measuring 0.7 cm. No extracapsular extension was identified in any involved lymph nodes. All other lymph nodes evaluated showed no evidence of metastasis, though amyloid was present in all specimens.\n\nPathologic staging was determined as pT2 pN1a. Ancillary studies demonstrated strong positivity for estrogen and progesterone receptors, with no overexpression of HER2/neu. This pathologic stage assessment is based on available information and may be subject to revision pending further clinical review."} +{"pid": "TCGA-ZP-A9D1", "report": "The liver segment 4 specimen consists of a 50-gram, 6.4 x 5.6 x 3.5 cm piece of liver with a light tan capsule on one surface. A well-circumscribed mass measuring 2.8 x 2.7 x 2.1 cm is identified beneath the capsule and does not disrupt it. The mass has a lobular, light tan cut surface and is located 0.5 cm from the nearest black inked margin. The surrounding liver parenchyma shows small white-yellow nodules interspersed with white fibrous bands.\n\nHistologically, the liver demonstrates regenerative nodules within a background of cirrhotic changes. Multiple foci of moderately differentiated cellular proliferation are present, showing trabecular growth patterns and prominent vascularity. The cells exhibit variable cytoplasmic vacuolization, ovoid nuclei with mild pleomorphism, and prominent nucleoli. Pseudoglandular structures are occasionally observed. Fibrous stroma is intermixed with the proliferating cells. Trichrome stain confirms the presence of cirrhosis, while reticulin staining reveals increased thickening of cell layers. Immunohistochemical analysis for glypican-3 shows cytoplasmic positivity in the abnormal cell population, with appropriate control staining.\n\nThe primary lesion is solitary and measures 2.8 cm in greatest dimension. No evidence of macroscopic or microscopic vascular invasion is identified. Regional lymph nodes cannot be assessed, and distant metastasis is also indeterminate. Surgical margins are uninvolved, with the closest distance of the lesion to the margin at 5 mm. Additional findings include cirrhosis and fibrosis. Tissue was preserved for biobanking, and representative sections of the mass and surrounding liver have been submitted."} +{"pid": "TCGA-HZ-A4BK", "report": "The specimen was obtained from a male patient undergoing surgical resection for suspected neoplastic process involving the head of the pancreas. The resected specimen included the duodenum and pancreatic head, with a focus measuring 4.7 x 4.5 x 4.2 cm located in the pancreatic head. Histologic evaluation demonstrated poorly differentiated features within the tumor. Microscopic analysis revealed that the lesion extends into the soft tissue surrounding the portal vein and the common bile duct. Lymphovascular and perineural invasion were both identified.\n\nA total of four lymph nodes were examined, two of which contained abnormal cellular infiltration. The largest involved lymph node measured 2.5 cm and showed evidence of capsular breach with extension beyond the nodal boundary. Surgical margins were evaluated using frozen section and confirmed on permanent sections; involvement was noted at the radial margin of the pancreatic resection, as well as at the portal vein and common bile duct soft tissue margins. A second lymph node was also found to be involved by similar cellular changes.\n\nChronic inflammatory changes were present in both the gallbladder and pancreas. The gallbladder specimen showed cholesterolosis and wall thickening consistent with longstanding inflammation. The pancreatic tissue away from the primary lesion exhibited features of chronic pancreatitis.\n\nAdditional biopsies of the pancreatic duct margin and pancreatic margin were taken intraoperatively. While the duct margin was free of atypical cells, a small focus of abnormal cells was identified at the pancreatic margin. The distal small bowel margin and ampulla were not involved. One lymph node near the pancreas was unremarkable, while another showed similar abnormal findings.\n\nStaging was assigned based on pathologic findings. Tumor extension reached beyond the organ of origin into surrounding tissues, corresponding to a T3 classification. Nodal involvement with two positive lymph nodes supported an N1 category."} +{"pid": "TCGA-95-A4VK", "report": "The surgical specimen included a right upper lobe lung mass measuring 6.0 x 5.1 x 4.1 cm. Histologic examination revealed a moderately differentiated lesion with a predominant growth pattern along with lesser components of acinar and lepidic patterns. Lymphovascular invasion was identified. There was no evidence of perineural or visceral pleural invasion, and elastic stain confirmed absence of pleural involvement. The tumor extended to the parenchymal margin of resection and was within 1.0 cm of the bronchial and vascular margins; however, both margins were negative on microscopic evaluation.\n\nA total of 12 lymph nodes were examined from various levels including right hilar (R10), mediastinal level 4, station 4R, and R7 regions. Metastatic involvement was identified in all lymph nodes assessed from levels R10 (2 out of 2), mediastinal level 4 (5 out of 5), and one lymph node from R10/SUMP was also involved. No metastasis was found in single nodes sampled from stations 4R and R7.\n\nAdditional specimens included a wedge resection from the right lower lobe which showed benign lung tissue with mild emphysematous changes. No significant pathological findings were noted in the uninvolved lung parenchyma adjacent to the primary lesion.\n\nAll margins were free of invasive carcinoma. The closest distance from the invasive lesion to any margin was 10 mm at the bronchial margin. No treatment effect was observed. Based on tumor size (>5 cm but \u22647 cm) and regional lymph node involvement (ipsilateral mediastinal and/or subcarinal lymph nodes), staging criteria indicate pT2b and pN2 classifications respectively. Distant metastasis could not be assessed.\n\nAdditional specimens included multiple lymph nodes from different anatomical locations confirming consistent involvement from the primary lesion. Intraoperative frozen section analysis confirmed lymph node involvement and negative bronchial margin for invasive disease."} +{"pid": "TCGA-D1-A162", "report": "The surgical pathology specimen included the uterus, right ovary with a segment of the right fallopian tube, and left ovary with a segment of the left fallopian tube. The combined specimen measured 10.3 x 3.0 x 0.5 cm and weighed 145.0 grams. Additional submitted specimens included right and left pelvic lymph nodes, right and left para-aortic lymph nodes, and the left gonadal vessel.\n\nA mass measuring 4.1 x 3.6 x 1.4 cm was identified in the uterine specimen. Microscopic examination revealed abnormal cellular proliferation within the endometrium with glandular structures showing architectural complexity. Cellular atypia was noted, with nuclear enlargement and increased mitotic activity. Stromal invasion was present, with infiltration extending into the myometrium to a depth of 1.0 cm. The total myometrial thickness was 1.9 cm. No similar findings were observed in the cervix, ovaries, or fallopian tubes.\n\nLymph node evaluation included multiple right pelvic lymph nodes (10 external iliac, 1 internal iliac, 3 common iliac, and 8 obturator), all of which showed no evidence of abnormal cells. On the left side, 6 external iliac, 3 internal iliac, 4 obturator, and 10 common iliac lymph nodes were examined and found to be negative. In the para-aortic region, 2 lymph nodes on the right (1 above and 1 below the inferior mesenteric artery) and 14 on the left (11 above and 3 below) were also negative. The left gonadal vessel specimen showed no abnormal cellular changes.\n\nAll other tissues examined showed no diagnostic abnormalities."} +{"pid": "TCGA-CN-4727", "report": "The specimen was received in nine parts, each labeled with the patient's name, medical record number, and initials. Part 1, labeled \"right neck, levels 2-4,\" consisted of fibroadipose tissue measuring 6.0 x 4.0 x 2.5 cm, containing multiple lymph nodes ranging from 0.3 to 2.0 cm in size. A total of sixteen lymph nodes were examined in this region, and two showed evidence of involvement. No extracapsular spread was identified. Part 2, labeled \"left neck, levels 2-4,\" measured 6.5 x 4.7 x 3.0 cm and contained seventeen lymph nodes; all were unremarkable. Parts 3 through 8 included biopsies of various regions including the upper pharynx and base of tongue. Mild dysplastic changes were observed in some areas, but no tumor was found. \n\nPart 9 was a complete larynx with attached structures, measuring 8.5 x 5.5 x 5.0 cm. A mass lesion was noted on the epiglottis, measuring 3.5 x 2.8 cm, and was centered approximately 0.5 cm to the left of the midline. The lesion extended into surrounding anatomical spaces but did not involve the thyroid cartilage. No vascular or perineural invasion was present. Surgical margins were free of involvement. Histological analysis revealed a moderately differentiated cellular pattern. A total of thirty-seven lymph nodes were examined across all regions, with no positive nodes identified. Staging was based on the extent of local invasion, and surgical margins were clear by at least 2 mm. Ancillary studies, including immunohistochemistry and in situ hybridization, were performed as part of the evaluation. All molecular testing for gene status was negative. The laboratory performing these tests is certified under applicable clinical laboratory standards."} +{"pid": "TCGA-XF-AAN0", "report": "A radical cystoprostatectomy with bilateral pelvic lymph node dissection and urinary diversion (T-pouch) was performed. Gross examination of the bladder and prostate revealed a mass measuring 3.0 x 3.0 x 2.2 cm located in the anterior wall, extending to the right and left lateral walls. Microscopically, the lesion demonstrated invasive poorly differentiated cells with marked nuclear atypia and prominent nucleoli. The tumor extended through the bladder wall into the perivesical soft tissue and showed lymphovascular invasion. A flat high-grade lesion was present in the mucosa, including pagetoid involvement of the trigone. Additional areas of moderate cellular atypia and reactive changes were noted in the bladder mucosa. All resection margins of the bladder were free of malignant involvement.\n\nInvolvement of the prostate was identified, with tumor extending into periprostatic soft tissue and invading prostatic stroma. Lymphovascular space involvement was present, and tumor reached the inked right posterior margin of the prostate. Tissue around the seminal vesicles also showed tumor infiltration, though the seminal vesicles themselves were not directly involved. No evidence of prostatic adenocarcinoma was found; however, rare foci of high-grade prostatic intraepithelial neoplasia (PIN II) were observed.\n\nExamination of the apical urethral margin revealed scattered malignant cells within the periurethral soft tissue, particularly around muscle bundles. These findings were not detected during frozen section analysis but were confirmed on permanent sections. The urethral mucosa and adjacent supportive tissue showed no signs of dysplasia or malignancy.\n\nUreters (both proximal and distal segments) were examined bilaterally and showed no evidence of dysplastic or malignant changes in the urothelium. Similarly, the para-aortic proximal limit lymph nodes were benign.\n\nLymph node evaluation revealed widespread involvement. Metastatic cells were identified in multiple lymph node regions. Of the total 53 lymph nodes evaluated, 30 contained malignant cells. Positive lymph nodes were identified bilaterally, including right and left common iliac, external iliac, obturator/hypogastric, pre-sciatic, and presacral regions. The largest involved lymph node measured 4.6 cm. Notably, some lymph node groups, including right and left lymph nodes of Cloquet, showed no evidence of involvement.\n\nPathologic staging was assigned as pT4aN2MX. A discrepancy between frozen section and final diagnosis for the apical urethral margin was reported to the attending physician."} +{"pid": "TCGA-HC-7081", "report": "The prostate specimen weighed 51 grams and measured 5.5 x 4.9 x 4.6 cm. The outer surface was lobulated and shaggy. The urethra was patent and measured approximately 4.2 x 0.4 cm. The cut surface showed a rubbery, fibrotic tan to pink appearance with areas of nodularity. In the right lateral lobe distal region, there was a 1.0 x 0.9 x 0.8 cm area of tan-gray fibrosis that extended to within 0.1 cm of the inked outer margin. A second 1.4 x 1.0 cm area of similar fibrosis with slight induration was present in the left posterior lobe mid region, also approaching within 0.1 cm of the outer surface margin. An additional area in the right lateral lobe distal region extended to within 0.2 cm of the apical margin, while the central region remained more than 1.5 cm from the proximal (vesical) margin. The seminal vesicles were 6.0 x 2.2 x 1.0 cm combined, with a multi-cystic gray-pink fibrotic cut surface.\n\nMicroscopically, the neoplastic process involved approximately 70\u201380% of the prostate. The growth pattern included raggedly infiltrating glands and individual glandular structures within the stroma. Nuclear atypia was present with enlarged nuclei and prominent nucleoli. Perineural invasion was identified in multiple areas. Tumor extension was noted to the apical margin, the shaved proximal (vesical) margin, and through the prostatic capsule, particularly on the right side. Tumor involvement was also seen focally in both seminal vesicles and at their origin. Lymphovascular space invasion was present. No lymph nodes were examined. Surgical margins were positive at the bladder neck, apical (distal), and inked prostatic margins."} +{"pid": "TCGA-E9-A22B", "report": "The specimen from the right upper outer quadrant of the breast, collected on 4/2/11, was part of a radical mastectomy. A grossly evident lesion measuring 1.8 x 1.6 x 1.6 cm was identified. Histologic analysis revealed a mix of infiltrating ductal and lobular cellular patterns. Lymph node assessment showed no metastatic involvement in the 4 regional nodes examined. No extracapsular invasion was noted. Several key histopathologic parameters, including histologic grade, tubule formation, nuclear pleomorphism, and mitotic counts, could not be determined. The total Nottingham score could not be calculated due to missing data. There was no evidence of treatment effect, and no additional findings were reported."} +{"pid": "TCGA-22-5479", "report": "The resected specimen includes a central mass measuring 4.5 x 3.0 x 3.0 cm located in the left lower bronchus near the bifurcation. Histological evaluation reveals high-grade atypical cells with features consistent with poorly differentiated malignancy. The tumor does not invade the pleura. The bronchial lumen is completely occluded, with associated distal obstructive changes and evidence of organizing pneumonia. The surgical margin at the bronchus is free of neoplastic cells. A total of four intrapulmonary peribronchial lymph nodes are uninvolved. Additionally, multiple lymph nodes from the superior mediastinum (17 right lower paratracheal, 7 left lower paratracheal), aortic region (3 subaortic), inferior mediastinum (14 subcarinal), and N1 station (1 hilar) show no evidence of involvement."} +{"pid": "TCGA-OR-A5K1", "report": "A 7.9 x 6.2 x 5.7 cm left adrenal mass was resected from a male patient. The tumor weighed 110 grams and measured 6.2 x 5.3 x 6.0 cm in size within the gland. Gross examination revealed a tan-brown, faintly nodular, soft, and well-circumscribed lesion with areas of bright-yellow necrosis involving approximately 15% of the tumor. The tumor was found to abut the surgical margin. A separate segment of normal adrenal tissue measuring 1.1 x 2.3 x 0.5 cm was identified.\n\nHistologic evaluation demonstrated cellular features including low mitotic activity. Immunohistochemical staining showed diffuse nuclear immunoreactivity for cyclin E. The Ki-67 proliferation marker indicated an elevated proliferation rate compared to typical benign lesions. Additional research immunostains, including topoisomerase 2-alpha, supported similar findings. These findings were interpreted in correlation with histologic features. Multiple sections and immunostains were evaluated, and photographs documenting the tumor-to-normal adrenal interface, tumor-to-capsule relationship, and normal adrenal regions were included in the assessment."} +{"pid": "TCGA-DU-7306", "report": "The patient presented with a history of lightheadedness and MRI findings showing a circumscribed lesion with mixed density. Three specimens were obtained from the right temporal region during excisional biopsy.\n\nMicroscopic evaluation revealed a glial neoplasm with features suggestive of both oligodendroglial and astrocytic components. The tumor demonstrated low proliferative activity, with an MIB-1 index of approximately 2% in more active areas. Mitotic figures were sparse, and no microvascular proliferation or necrosis was identified. Specimen C showed small foci of increased cellularity, along with occasional mitoses and hyalinized vessels. Cellular atypia was not observed.\n\nImmunohistochemistry showed minimal GFAP expression, with only about 4% of cells demonstrating p53 overexpression. Proliferation activity was assessed using MIB-1 staining.\n\nMolecular testing on the tumor specimen showed allelic loss involving chromosome arms 1p and 19q, based on analysis of multiple microsatellite markers. Additionally, methylation of the MGMT promoter was detected by real-time PCR following bisulfite modification of DNA, although amplification was of low level, possibly due to a low proportion of tumor DNA in the sample.\n\nGross examination of the specimens showed soft, glistening tissue fragments. The largest measured 2.2 cm across, while the smallest was 0.3 cm across.\n\nThese findings are provided for correlation with clinical and imaging data, and should be interpreted in context with established diagnostic criteria and patient management strategies."} +{"pid": "TCGA-BA-A6DB", "report": "Biopsy specimens were obtained from various regions of the right tongue, including medial, lateral, anterior, posterior, and deep margins. Microscopic examination of these specimens revealed squamous mucosa with verruciform hyperplasia in one area, while all other sites showed benign squamous mucosa or benign skeletal muscle. No evidence of high-grade dysplasia, in situ, or invasive malignancy was identified in any of the biopsies.\n\nA resected specimen from the right tongue measured 6.4 cm in length from anterior to posterior, 2.5 cm medially to laterally, and 2.5 cm dorsally to ventrally. The base of the specimen contained cauterized fibromuscular tissue, and a granular, erythematous lesion measuring 1.0 x 0.7 cm was observed on the lateral aspect, extending toward the base of the tongue. This lesion was closest to the right lateral margin (0.8 cm), medial mucosal margin (1.5 cm), anterior margin (3.8 cm), and posterior margin (1.7 cm). Upon sectioning, a 1.5 cm ill-defined firm tan stellate mass was identified beneath the mucosal lesion. The mass approached within 0.3 cm of the blue inked medial margin and 0.7 cm of the black inked deep margin. The remainder of the soft tissue appeared unremarkable.\n\nSurgical margins were assessed, with the closest being 1.6 mm to the deep margin and 3 mm to the medial margin; all other margins exceeded 1 cm. No angiolymphatic or perineural invasion was identified, and no bone invasion was noted. Immunohistochemical staining for p16 was negative, as was in situ hybridization testing for high-risk human papillomavirus. Carcinoma in situ was present.\n\nLymph node evaluation included 24 regional lymph nodes, all of which were negative for metastatic disease. Specifically, one lymph node from level 1a, three from level 1b, five from level 2, and fifteen from level 3 were examined and found to be free of malignancy. Additionally, no significant pathologic abnormalities were identified in the submandibular gland.\n\nBased on the findings, the pathologic staging was determined as pT1 pN0. It is noted that this staging is based on available information and may be subject to revision pending further clinical review."} +{"pid": "TCGA-BT-A2LD", "report": "The submitted specimen includes multiple tissue samples. A segment of the left distal ureter is lined by benign urothelial mucosa without any evidence of high-grade changes or invasive disease. Another segment of the left distal ureter shows reactive urothelium, with no atypical cells identified.\n\nA separate specimen from the urinary tract reveals a solid mass measuring 3.2 cm. The lesion demonstrates poorly differentiated features and is classified as high grade. It extends through the muscular layer into surrounding adipose tissue. The surgical margins are negative for involvement. Flat high-grade changes are noted adjacent to the lesion. No perineural invasion is observed, however, vascular and lymphatic invasion is present. Additional findings include cystitis cystica and squamous metaplasia.\n\nLymph node evaluation shows one involved node out of five from the left pelvic region, while all eleven nodes from the right pelvic area show no signs of involvement. A total of sixteen lymph nodes were examined.\n\nThe tumor was located in the trigone and at both uretero-iliac junctions. Histologically, it is composed of urothelial cells arranged in solid and flat patterns. The pathologic stage is pT3a with nodal involvement (pN1), and distant metastasis could not be assessed. Vascular invasion is confirmed, and the tumor has directly extended into the perivesical fat."} +{"pid": "TCGA-98-8022", "report": "The pathology report includes specimens from multiple lymph node regions and lung tissue. The pleural sample consisted of fibroadipose tissue measuring 4 x 2 x 0.5 cm. Lymph nodes sampled included those labeled #2 through #11, with sizes ranging from 0.5 x 0.4 x 0.3 cm to 3 x 2.5 x 0.6 cm. All lymph node fragments appeared anthracotic and were submitted entirely for evaluation.\n\nA lobectomy specimen from the posterior segment of the right upper lobe measured 11 x 6 x 3 cm. On gross examination, the external surface was smooth and pink-purple with moderate anthracosis. The parenchyma was dark red with similar pigmentation and no identifiable mass observed. Representative sections were submitted for histologic analysis.\n\nMicroscopic evaluation revealed a small lesion measuring 0.65 cm in greatest dimension located close to the surgical staple line. Histologic grade was moderately differentiated. No invasion of the visceral pleura, bronchial margin, vascular margin, chest wall margin, or other attached tissue margins was identified. There was no evidence of lymphovascular invasion or regional lymph node involvement. All margins were uninvolved by invasive cells. Specimen integrity was intact, and the tumor was determined to be unifocal."} +{"pid": "TCGA-KK-A8I6", "report": "The specimen included multiple lymph node groups and tissue fragments. On the right obturator and internal iliac region, eleven lymph nodes were identified, ranging in size from 0.5 to 1.4 cm; all appeared unremarkable. In the right external iliac area, two lymph nodes were found, measuring between 0.5 and 0.7 cm, and were also unremarkable. On the left side, ten lymph nodes were identified in the obturator and internal iliac regions, with sizes varying from 0.5 x 0.5 x 0.2 cm up to 5.5 x 1.2 x 1 cm, all without notable features. The left external iliac area contained only fibroadipose tissue without identifiable lymph nodes.\n\nA separate fragment of fibromuscular and fibroadipose tissue from the left base contained vessels, nerve trunks, and ganglia consistent with extraprostatic tissue, along with prostate glands; no abnormal cellular features were observed. The prostate specimen measured 4.6 x 2.2 x 2.7 cm and weighed 21 grams post fixation. It included attached seminal vesicles and segments of the vasa deferentia. A firm nodule was noted on the right base, but cross sections did not show definitive abnormal findings. The seminal vesicles and vasa deferentia appeared unremarkable.\n\nMicroscopic evaluation revealed two distinct areas of interest within the prostate. The primary focus was located in the right lateral, posterolateral, and posterior peripheral zone, measuring 2.0 x 1.0 cm. This area extended focally into surrounding tissue outside the prostate with an extension length of 2.0 mm. The second focus was smaller, measuring 1.0 x 0.4 cm, located in the left lateral and posterolateral peripheral zone, and confined within the prostate. Both areas showed cellular features consistent with high-grade changes. Perineural involvement was noted, though no vascular invasion was identified. All resection margins and sampled tissues were free of abnormal cells."} +{"pid": "TCGA-AG-3602", "report": "The resected colon and rectum specimens demonstrate tumor-free oral, aboral, and perirectal resection margins. A moderately differentiated adenocarcinoma is present with ulceration and extends into the perimuscular fatty tissue. Multiple regional lymph node metastases were identified. Vascular invasion is not noted. The surgical resection is complete with no residual tumor at the margins."} +{"pid": "TCGA-H4-A2HO", "report": "A male patient underwent analysis of multiple tissue specimens obtained during a radical cystoprostatectomy and lymph node dissection. Biopsies from the urethral margin, bilateral distal ureters, and distal ureter margins all showed benign urothelial mucosa without evidence of malignancy. Lymph node dissections on both the right and left pelvic sides yielded a total of eight lymph nodes, all of which were benign and showed no signs of malignant involvement.\n\nThe primary specimen included a bladder with an intact appearance, measuring 7.0 x 6.0 x 6.0 cm, and attached prostate measuring 4.5 x 3.5 x 3.0 cm. Bilateral ureteral stumps were also present, each measuring 3.5 cm in length and 0.3 cm in diameter. A large gray-tan cauliflower-like growth was observed on the surface of the bladder, involving nearly 95% of the mucosal area. The tumor measured 11.0 x 12.0 cm in surface area and reached a height of 1.2 cm. Grossly, it did not extend into the serosa or reach the inked surgical margins, being at least 1.0 cm from the ureteral openings. The prostate appeared unremarkable on gross examination, with no visible lesions noted. The seminal vesicles and vas deferens were similarly free of abnormality.\n\nMicroscopic evaluation of the tumor showed high-grade urothelial morphology arranged in a papillary configuration. No lymphovascular invasion was identified. All surgical margins were free of invasive carcinoma, with the closest distance of tumor to a margin measuring 7 mm at the serosal radial margin. Additional findings included urothelial dysplasia (low-grade intraurothelial neoplasia) and evidence of acute and chronic prostatitis. Intraoperative frozen section analysis of the urethral and ureteral margins confirmed absence of malignancy.\n\nStaging was based on pathological findings. There was no regional lymph node involvement (pN0), with a total of eight nodes examined and none involved. The primary tumor extended into the prostatic stroma superficially, corresponding to a pT4a classification. Distant metastasis could not be assessed."} +{"pid": "TCGA-FJ-A3Z9", "report": "The specimen from the left lateral bladder wall consists of multiple irregular tan-pink tissue fragments measuring 5.0 x 4.5 x 2.3 cm in aggregate. Histologic examination reveals a high-grade papillary lesion with areas displaying an inverted growth pattern. The lesion demonstrates extensive multifocal invasion into the lamina propria and muscularis mucosa, with focal extension into the muscularis propria. Approximately 5% of the invasive component exhibits a micropapillary architecture. Additional findings include lymphovascular invasion and areas of squamous and glandular differentiation within the lesion.\n\nThe prostatic urethral biopsy specimens consist of two tan-pink rubbery tissues measuring approximately 2.0 x 0.6 x 0.4 cm each. Microscopic evaluation shows benign urothelium with chronic inflammation in the underlying tissue. The prostatic tissue demonstrates mild chronic inflammation and calcifications. A stromal nodule is also present. No atypical or malignant cells are identified in the urothelium or prostatic tissue. Immunohistochemical staining confirms vascular invasion separate from the micropapillary morphology observed in a small portion of the invasive lesion."} +{"pid": "TCGA-DH-A7UV", "report": "THIS IS AN ADDENDUM REPORT. SPECIMEN(S) SUBMITTED/PROCEDURES ORDERED: A. Tissue from the brain. A. Frozen section charge. B. Tissue from the brain. B. Frozen section charge. C. Involved cortical tissue. D. Tissue from the brain. D. Glial fibrillary acidic protein stain. D. Isocitrate dehydrogenase 1 evaluation. D. P53 protein analysis. D. Ki-67, nuclear antigen (MIB-1). D. Phosphohistone-H3 assessment. D. Chromosome 1p and 19q status testing. D. Additional chromosome 1p and 19q status tests (x3). CLINICAL HISTORY: This is a male patient with a lesion located in the right frontotemporal region of the brain, undergoing a right craniotomy using Stealth navigation for resection.\n\nCOMMENT: A diffusely infiltrating glial neoplasm is identified across all specimens. Although much of the tumor demonstrates features typically seen in lower-grade lesions, mitotic figures are observed both on standard H&E staining and through immunohistochemical detection using PHH3. Additionally, Ki67 labeling shows focal areas with labeling indices reaching up to 10%.\n\nNEUROPATHOLOGY TUMOR SUMMARY:\nTumor Location: Right frontotemporal region of the cerebrum.\nLaterality: Right.\nProcedure: Surgical resection.\n\nAncillary studies:\np53 immunohistochemistry: Strongly positive in approximately 60% of cells.\nIDH-1 immunohistochemistry: Negative.\nKi-67 (MIB-1): Positive in up to 10% of nuclei in certain areas.\nPHH3 immunohistochemistry: Three positive cells per 10 high-power fields.\nChromosome 1p and 19q deletion status: Pending at time of initial reporting; final results indicate no deletions present.\n\nGROSS DESCRIPTION:\nSpecimen A: Fresh tissue labeled \u201cBrain tumor,\u201d measuring 0.9 x 0.9 x 0.6 cm, composed of beige to gray-tan soft tissue including cortical gray matter and subcortical white matter. Part submitted for frozen section as FSA1; remainder in cassette A2.\nSpecimen B: Fresh tissue labeled \u201cBrain tumor,\u201d measuring 2.2 x 1.5 x 0.9 cm, containing cortical gray matter and subcortical white matter. Frozen section diagnosis noted as neoplastic tissue consistent with astrocytic lineage. Frozen portion submitted as FSB1; remaining tissue in cassette B2.\nSpecimen C: Fresh tissue labeled \u201cInfiltrated cortex,\u201d measuring 3.5 x 2.8 x 2.4 cm, composed of cortical gray matter and underlying white matter with well-defined gray-white junction. Entire specimen submitted in cassettes C1\u2013C6.\nSpecimen D: Fresh tissue labeled \u201cBrain tumor,\u201d measuring 2.5 x 2.0 x 1.2 cm, consisting of beige to pink-tan and myxoid-appearing fragments. Part of this tissue was sent to the tumor bank. Remaining portions submitted in cassettes D1 and D2.\n\nI or a qualified designee performed the gross examination and reviewed the findings. All referenced materials were microscopically evaluated personally.\n\nNote: The laboratory has developed and validated the performance characteristics of the test systems used. Some tests have not been cleared or approved by the U.S. Food and Drug Administration, but FDA has determined such clearance is unnecessary. These tests are performed for clinical diagnostic purposes and should not be considered investigational or research-based. The laboratory is certified under CLIA-88 to perform high-complexity testing.\n\nADDENDUM \u2013 CHROMOSOME 1p/19q FISH ANALYSIS:\nChromosome 1p: Non-deleted.\nChromosome 19q: Non-deleted.\n\nINTERPRETATION:\nNo deletions were detected in chromosomes 1p or 19q in the analyzed tissue.\n\nTest methodology: Dual-probe fluorescence in situ hybridization (FISH) targeting the minimally deleted regions of 1p (1p36) and 19q (19q13.3), each combined with a respective control probe (1q and 19p). Deletion was defined as a 1p/1q or 19q/19p ratio \u2264 0.8 or \u22651.30. Normal reference ranges are 0.9\u20131.05 for 1p/1q and 0.93\u20131.02 for 19q/19p. Gain was defined as >20% of nuclei showing more than two signals. Pathologist-directed selection of the target area was performed on H&E-stained slides prior to scoring. Performance characteristics of this assay have been validated internally. This test is used for clinical diagnosis and is not considered investigational or research-based. The laboratory is CLIA-certified for performing high-complexity clinical laboratory testing."} +{"pid": "TCGA-UW-A72L", "report": "A biopsy of a renal mass demonstrates cells with features consistent with a neoplastic process, nuclear grade 2 of 4. Adjacent tissue sampled at the base of this mass shows no evidence of tumor involvement.\n\nA separate renal mass was resected and measured 9 mm in greatest dimension. Histologic evaluation revealed nuclear grade 2 of 4. The tumor was present in multiple distinct foci within the specimen. There was no evidence of invasion into surrounding structures such as the capsule, perirenal adipose tissue, Gerota\u2019s fascia, or renal sinus. No involvement of major vessels, lymphatics, or ureter was identified. Surgical margins\u2014including parenchymal, capsular, and paranephric adipose tissue\u2014were free of tumor. No adrenal tissue or lymph nodes were present in the specimen. Staging information indicates pT1a, pNx.\n\nAnother resected renal mass measured 2.7 cm. Histologic grade was 3 of 4. Similar to the previous specimen, this lesion was also multifocal, with three distinct tumors identified in total across all specimens. No invasion of surrounding structures or vessels was observed. Surgical margins were again negative for tumor involvement. No lymph nodes or other significant findings were noted. AJCC staging for this lesion is also pT1a, pNx.\n\nThe clinical history notes a female patient presenting with multiple renal masses. Gross examination of the specimens included four tissue samples. The first was a small fragment measuring 0.7 x 0.5 x 0.4 cm. A second fragment, smaller and adjacent to the first tumor site, was also submitted. The third specimen, measuring approximately 1.6 x 1.2 x 0.9 cm, contained a well-defined tan nodule near the capsule, located 0.3 cm from the parenchymal margin. The fourth specimen was larger, measuring 3.4 x 3.1 x 3.0 cm, with a central nodule involving approximately 75% of the cut surface. This nodule was 0.5 cm from the parenchymal margin. All surgical specimens were inked and sectioned appropriately for histologic analysis.\n\nStaging is based on available data and may be updated pending further clinical review."} +{"pid": "TCGA-B0-4945", "report": "The specimen consists of a right radical nephrectomy. A neoplasm measuring 4.0 cm in greatest diameter is present. Microscopically, the tumor demonstrates conventional morphology with clear and granular cell features, and nuclear grade 2 of 4. The tumor is confined entirely within the kidney, without extension beyond the renal capsule or involvement of the renal pelvis or renal sinus. No angiolymphatic invasion is identified. Additionally, a small separate papillary renal tubular epithelial neoplasm with low malignant potential is noted. The non-neoplastic kidney shows focal global glomerulosclerosis affecting 5\u201310% of glomeruli, with otherwise unremarkable renal tissue. The proximal ureter and perirenal adipose tissue are benign. The histologic grade corresponds to G2. The pathologic stage is pT1a Nx MX."} +{"pid": "TCGA-BP-4327", "report": "The patient underwent right radical nephrectomy and paracaval lymph node dissection. The right kidney specimen, including perirenal fat, measured 15 x 10 x 7 cm and weighed 400 grams. A tumor measuring 7.5 x 5.5 x 4 cm was identified in the renal cortex. The tumor had a lobulated appearance with irregular borders and was partly yellow with areas of hemorrhage and necrosis. Histologically, the tumor demonstrated acinar growth pattern and nuclear grade II/IV. The tumor was confined within the renal capsule without invasion into the renal vein or renal pelvis. Surgical margins were free of tumor involvement. Adjacent kidney tissue appeared normal. The adrenal gland was not identified in the specimen. The tumor was surrounded by Gerota\u2019s fascia, which was inked black during dissection; the tumor protruded the renal capsule but remained within Gerota\u2019s fascia. The closest distance from the tumor to the Gerota\u2019s fascia was 0.2 cm, and to the renal pelvis was 0.3 cm.\n\nSix benign lymph nodes were identified in the paracaval lymph node specimen. No malignant involvement was detected in any of the lymph nodes. All specimens were processed and representative sections were submitted for further analysis."} +{"pid": "TCGA-BR-8284", "report": "The specimen consisted of excised stomach tissue from the antrum. The lesion measured 8 x 7 x 2 cm. Microscopic evaluation revealed a poorly differentiated histology with intestinal-type morphology. The tumor extended to adjacent structures, including the lesser omentum. All nine lymph nodes retrieved were positive for metastatic involvement. Surgical margins were uninvolved. No evidence of neoadjuvant treatment was identified. Additional pathological findings were not specified. Immunohistochemical analysis demonstrated a negative result for HER2/NEU."} +{"pid": "TCGA-DJ-A13M", "report": "A 24 g thyroid specimen was received, consisting of a left lobe measuring 4.3 x 2.3 x 2.3 cm and an isthmus measuring 2.0 x 2.0 x 1.0 cm. A 2.0 cm encapsulated yellow-tan lesion was identified in the left lobe, with a thin fibrous capsule. Histologic evaluation revealed a well-differentiated lesion without mitotic activity or tumor necrosis. Focal capsular invasion was noted at a single focus. No blood vessel invasion or extrathyroid extension was observed. Surgical margins were free of involvement.\n\nIn addition, a separate finding measuring 0.7 cm was identified in the right lobe. This focus was encapsulated and showed no signs of invasion. The surrounding thyroid tissue exhibited nodular hyperplasia. Parathyroid glands were not identified within the specimen.\n\nFour benign lymph nodes were identified in the neck dissection specimen, and one additional benign lymph node was found in the Delphine region. No malignant cells were detected in any of the lymph nodes evaluated.\n\nThe remaining thyroid parenchyma had a red-tan, beefy appearance. Two small white-tan firm nodules, each measuring approximately 0.3 cm, were also present in the left lobe. A fluid-filled cyst measuring 1.5 cm was observed with a 1.2 cm papillary projection on its inner lining. The cyst wall was white and trabecular. All relevant sections of the thyroid and associated structures were submitted for further analysis."} +{"pid": "TCGA-DU-8168", "report": "A 3 cm aggregate of soft, greyish-purple tissue was received for analysis, described as non-enhancing with internal nodular enhancing areas on imaging. The lesion is located in the right frontal lobe, extends to the body of the corpus callosum, and shows minimal extension into the contralateral frontal lobe.\n\nMicroscopic evaluation revealed a moderately to heavily cellular glial neoplasm infiltrating the cerebral cortex. The neoplastic cells exhibited nuclear anaplasia, a high mitotic count (up to 13 mitoses per ten high power fields), and a proliferation index of approximately 50% in more active regions. Focal microvascular mineralization was present, but no significant microvascular proliferation or tumor necrosis was identified. The tumor showed a predominantly oligodendroglial morphology, with only a small subset of cells showing p53 overexpression. An organoid microvascular network with focal hyperplastic changes was also noted.\n\nImmunohistochemical staining demonstrated a sparse glial fibrillary background with areas containing frequent gliofibrillary oligodendrocytes and mini gemistocytes. Synaptophysin, NeuN, NSE, and neurofilament highlighted the extent of cortical infiltration. CD99 and EMA showed weak reactivity with the neuropil, and MIB-1 confirmed the elevated proliferation index.\n\nGenetic testing revealed allelic loss on chromosome arms 1p and 19q, detected using microsatellite markers including D1S552, D1S1612, D19S412, and PLA2G4C. This pattern is typically associated with certain types of glial tumors. Additionally, the MGMT promoter was found to be methylated, which may have implications for response to alkylating agent therapy. The presence of more than 15% non-neoplastic cells could have affected the sensitivity of these molecular tests; however, no such limitation was reported.\n\nThe histological and molecular features together support a high-grade classification. No other significant findings were noted."} +{"pid": "TCGA-5M-AAT4", "report": "A segment of right and transverse colon, cecum, appendix, and terminal ileum was submitted for analysis following a right hemicolectomy with distal ileostomy. The specimen measured 22.0 cm in length with a mean diameter of 1.5 cm. Located within the colonic mucosa was a lesion measuring 5.0 x 4.0 cm, characterized by elevated infiltrative borders and central ulceration. The lesion was situated 6.5 cm from the nearest surgical margin. Within the surrounding 12.0 x 11.5 cm area of pericolic fat, three lymph nodes were identified and appeared grossly unremarkable. Adjacent to the lesion, the mucosa appeared pale and contained three small polyps near the ileocecal valve, each measuring approximately 0.9 cm. \n\nMicroscopic evaluation revealed a moderately differentiated tubular growth pattern. The lesion extended into the subserosal fat layer and exhibited lymphovascular invasion. Necrosis was present in extensive areas of the lesion. No neoplastic involvement was identified at the surgical margins. A moderate lymphocytic infiltrate was observed around the lesion, along with moderate stromal desmoplasia. Of the three lymph nodes examined microscopically, none showed evidence of involvement. In the adjacent intestinal mucosa, one villous growth with significant cellular atypia and two smaller growths with less pronounced atypia were noted. The appendix showed no abnormal microscopic findings. Based on histopathologic assessment, the extent of local spread was classified according to TNM staging criteria."} +{"pid": "TCGA-HT-7874", "report": "The pathology report describes microscopic sections showing a proliferation of atypical glial cells arranged in sheets and nests. The tumor cells have round nuclei with prominent perinuclear halos and few fibrillary processes. Nuclear atypia is present, ranging from mild to moderate. Microgemistocytes are frequently observed. There is notable microvascular proliferation and small areas of necrosis. Increased apoptotic cells and mitotic figures are evident, with up to 11 mitoses per 10 high power fields. The surrounding brain tissue shows edema and gliosis, with individual tumor cells infiltrating into the parenchyma. Scattered microcalcifications are also present. Immunohistochemical staining demonstrated a MIB-1 labeling index of up to 15.6% in the most active regions of the lesion."} +{"pid": "TCGA-CM-6168", "report": "The specimen consists of a right colon hemicolectomy, including the terminal ileum, cecum with attached appendix, and ascending colon. The terminal ileum measures 12.0 cm in length and 3.6 cm in circumference at the proximal margin. The remaining colon is 14.0 cm long with a distal circumference of 5.4 cm. The appendix is 5.8 cm in length and averages 0.7 cm in diameter. The serosal surface is smooth and pink-tan with focal hemorrhagic adipose tissue measuring up to 3.8 cm in thickness.\n\nA mass lesion measuring 2.1 cm in length and 2.8 cm in width is identified in the right colon, located 3.8 cm distal to the ileocecal valve, 17.0 cm from the proximal margin, and 6.5 cm from the distal margin. Gross examination reveals invasion into the underlying muscularis with a depth of 0.5 cm. No perforation is observed. A small sessile polyp measuring 0.7 x 0.1 to 0.4 cm is present 1.0 cm distal to the tumor.\n\nHistologically, the lesion shows moderately differentiated features. Tumor budding and increased tumor-infiltrating lymphocytes are not present. There is evidence of lymphovascular invasion; large venous and perineural invasion are not identified. Precursor lesions include a tubular adenoma. The tumor invades through the muscularis propria into surrounding adipose tissue. Surgical margins are free of involvement.\n\nA total of 31 lymph nodes are examined, none showing evidence of metastasis. No tumor deposits are identified in the pericolorectal soft tissue. Other findings include unremarkable mucosa and an unremarkable appendix. Representative sections of margins, tumor, polyp, lymph nodes, and surrounding tissue are submitted for analysis."} +{"pid": "TCGA-CV-6943", "report": "SUPPLEMENTAL REPORT. This supplemental report is issued to provide findings following decalcification of sections of mandible. Sections of bone nearest the lesion show no involvement. The specimen consists of a portion of tongue attached to bone. The lesion is submucosal, measuring 3.5 x 2.5 x 2.0 cm, and is centrally located. It is situated 2.0 cm from the anterior end, 3.5 cm from the posterior end, 3.0 cm from the medial aspect, and 0.6 cm from the lateral mucosal margin. The maximum depth of invasion is 1.5 cm. The closest deep margin is 1.8 cm away. The overlying mucosa is intact. The tumor is moderately differentiated with focal mild atypia at margins, though free of tumor. Perineural invasion is identified. No lymphovascular invasion is present. Bone attached to the specimen is not involved and appears unremarkable both grossly and microscopically. Margins are inked and sampled extensively, including deep and mucosal margins. Frozen section analysis showed mild squamous atypia in certain areas; all other margins were free of tumor."} +{"pid": "TCGA-CH-5765", "report": "The specimen shows infiltrates of a predominantly moderately differentiated adenocarcinoma involving both sides of the prostate. The maximum tumor diameter measures 3.5 cm. There is extensive perineural infiltration observed. Extraprostatic extension is present in the right rectolateral region. No vascular invasion is identified. Seminal vesicles are free of tumor involvement. Four lymph nodes are examined, all without evidence of tumor involvement. Additionally, three other lymph nodes are also tumor-free. Histological evaluation demonstrates a Gleason score of 3+4=7, with approximately 40% of the tumor exhibiting Gleason pattern 4. In several areas, the tumor approaches within less than 0.5 mm of the surgical margin; however, there is no evidence of direct contact with the inked margin surface."} +{"pid": "TCGA-DM-A0X9", "report": "The pathology report describes a case with histologic evaluation noting a lesion in the ascending colon. Tumor staging indicates a T3, N0, M0 classification, corresponding to an overall stage of IIA. The patient was White and not Hispanic or Latino. No information regarding vital status or date of death is provided. A normal procurement date is documented, though specific measurements and cellular characteristics are not detailed in this summary."} +{"pid": "TCGA-DS-A7WI", "report": "A total of 15 lymph nodes were identified, with one involved. Five lymph nodes were identified in the right pelvic region, all negative. Two lymph nodes were identified in the right obturator region, both negative. Three lymph nodes were identified in the left pelvic region, all negative. Five lymph nodes were identified in the left obturator region, with one showing evidence of involvement. \n\nThe hysterectomy specimen included a large mass measuring 7.8 x 7.5 x 1.4 cm located circumferentially in the cervix and lower uterine segment. The depth of invasion was 1.1 cm in the cervix and approximately 2.0 cm in the lower uterine segment. Lymphovascular invasion was present. Margins were uninvolved by invasive disease, with the closest distance of invasive disease to a margin being 0.2 cm at the posterior paracervical area. Stromal breakdown was noted in the endometrium, and a benign polyp was identified in the lower uterine segment, partially involved by the lesion. A leiomyoma measuring 0.5 cm was found in the myometrium. Fibrinous adhesions were observed on the serosa. No additional lesions were noted. \n\nMicroscopic examination revealed moderately differentiated nonkeratinizing cells. The tumor was circumferential, involving all four quadrants. The number of lymph nodes identified was 15, with one involved. The surgical procedure performed was a modified radical hysterectomy (type II) with pelvic and obturator lymph node sampling."} +{"pid": "TCGA-19-1787", "report": "The specimen consists of two tissue samples from the left frontal region of the brain. The first sample is a small fragment measuring 0.5 x 0.5 x 0.4 cm, described as tan-brown and soft in consistency. A touch imprint and frozen section were performed on this piece. The second sample includes multiple soft tissue fragments, pale tan to pink in color, with aggregate dimensions of 3.4 x 3.0 x 0.3 cm. The largest fragment was serially sectioned, and all material was submitted for analysis.\n\nMicroscopic evaluation revealed a neoplastic process involving cells with giant cell features, granular cytoplasmic changes, and areas exhibiting papillary architecture. Immunohistochemical testing demonstrated positivity for glial markers, while markers associated with epithelial and melanocytic differentiation were negative. Intraoperative cytologic assessment suggested a high-grade lesion with giant cell morphology. All laboratory assays were conducted using validated methods with appropriate controls, though some reagents may not be FDA cleared. The case was reviewed and signed out by the designated pathologist."} +{"pid": "TCGA-KL-8341", "report": "The left kidney specimen with attached renal vein thrombus was submitted following radical nephrectomy. The kidney measured 13.9 x 7.2 x 7.8 cm and was accompanied by perinephric fat, renal vessels, and ureter. A large necrotic multi-nodular tan-yellow mass measuring 12.5 cm in greatest dimension was identified, involving the superior and inferior poles, renal pelvis, hilum, and extending into the renal vein. The tumor appeared to penetrate the capsule and involved renal sinus fat, hilar fat, and medium-sized veins near the hilum. A yellowish-brown thrombus adjacent to the renal vein staple line measured 3.5 x 2.5 cm. The tumor was present within 1 mm of the stapled renal vein margin; the urothelium at the ureteral margin was partially denuded. No lymph nodes were identified in the perinephric fat.\n\nPara-aortic lymph nodes were submitted from an excisional specimen. A total of 30 lymph nodes were examined, with two metastatic nodes identified. The largest metastatic node measured 1.5 cm, with a focus measuring 1.2 cm in greatest extent. Extracapsular extension was noted.\n\nA segment of the left gonadal vein was submitted and found to be benign. The vein measured 5.5 cm in length and 0.5 cm in diameter, with no significant findings on cross-section.\n\nThe left adrenal gland was submitted as a separate specimen. It measured 7 x 3 x 2 cm and showed unremarkable yellow parenchyma on sectioning. No tumor involvement was identified.\n\nHistologic evaluation revealed high-grade cellular features with extensive necrosis. A high proliferation index was observed on Ki-67 immunostaining. No sarcomatoid differentiation was seen, although focal epithelial anaplasia was noted.\n\nSurgical margins at the renal vein showed tumor within less than 1 mm of the staple line. No tumor was identified in the ureteral margin or in the submitted vein segment. The non-neoplastic kidney tissue showed no remarkable findings.\n\nStaging criteria indicated that the lesion extended into the renal vein(s) or vena cava below the diaphragm."} +{"pid": "TCGA-OR-A5JI", "report": "The specimen consists of a right adrenal gland measuring 70 x 45 x 40 mm and weighing 26 g, with minimal attached fat. A nodular lesion measuring 40 x 30 x 30 mm is identified within the adrenal gland. The nodule has a yellow, lobulated appearance with central cystic change and haemorrhage. It is encapsulated and does not show invasion into surrounding tissue. Microscopically, the lesion demonstrates predominantly eosinophilic cells with cytological atypia and a diffuse growth pattern. The mitotic rate is low, with fewer than 1 mitosis per 10 high-power fields, and no atypical mitoses are observed. There is no coagulative necrosis or vascular invasion. Eosinophilic cytoplasmic globules and areas of myxoid change are present. Immunohistochemical staining shows positivity for IGF2 (with perinuclear dot-like pattern), Ki-67 (4% proliferative index), calretinin, and MelanA, while S-100 and chromogranin are negative. The lesion is confined to the adrenal gland and is completely excised, with no involvement of soft tissue margins."} +{"pid": "TCGA-CV-7089", "report": "The specimen consists of a resected laryngopharyngeal and neck tissue measuring 9.5 x 6.5 x 5.0 cm. A multinodular, ulcerated, and indurated mass is identified on the left and posterior aspect of the superior pharyngeal wall, measuring 4.5 x 4.0 x 1.0 cm. The surrounding mucosa appears normal, and the tumor does not involve the gross margins of resection. Two small nodules measuring 1.0 x 1.0 cm are observed on the superior aspect of the pharyngeal-laryngeal wall and were submitted separately for analysis.\n\nA total of 46 tissue sections were examined. Lymph node involvement was noted in one of ten right cervical lymph nodes (1/6 Level I, 0/3 Level II, 0/1 Level III) and in five of ten left cervical lymph nodes (2/3 Level I, 1/3 Level II, 2/4 Level III). Two peritumoral deposits were identified, possibly representing completely replaced lymph nodes. Histological evaluation of the margins showed no evidence of tumor involvement. Sections of the thyroid gland, bilateral vocal cords, and base of tongue showed no presence of neoplastic cells.\n\nMicroscopic examination revealed moderately differentiated cellular features with evidence of lymphovascular invasion. Frozen section analysis of the proximal mucosal margins demonstrated focal atypia, but margins were ultimately found to be free of tumor."} +{"pid": "TCGA-CN-A63U", "report": "A skin specimen from a stoma site showed inflammatory changes but no tumor. A right neck dissection encompassing levels 2-4 included 25 lymph nodes, of which two contained metastatic cells. These involved lymph nodes were located in levels 2 and 4, with the largest measuring 0.5 cm; no extranodal spread was observed. On the left side, a similar dissection at levels 2-4 yielded 20 lymph nodes, none of which showed involvement. The parotid gland tissue was unremarkable.\n\nThe larynx specimen demonstrated a lesion measuring 4.5 cm in maximum dimension, located in the supraglottic region on the right with microscopic extension to the glottis across the midline. The surface was ulcerated, and the tumor involved multiple structures including the epiglottis bilaterally, false cords, right aryepiglottic fold, and minimally the right true cord. There was also involvement of the paraglottic and pre-epiglottic spaces. Vascular invasion was present, but perineural invasion was not identified. Resection margins were free of disease. Multiple other surgical margins were evaluated and found to be negative.\n\nThe pathological staging was determined as pT3 for the primary tumor and pN2b for regional lymph node involvement. No prior malignancy, chemoradiation therapy, organ transplant, or immunosuppression was reported. All immunohistochemical and molecular testing performed was developed and validated internally under CLIA regulations."} +{"pid": "TCGA-FG-A4MU", "report": "The submitted specimen consists of multiple pink-white soft tissue fragments measuring 3 x 3 x 0.3 cm in aggregate. The tissue was received fresh and was processed for intraoperative consultation. Touch imprint and frozen section evaluations were performed, with microscopic findings indicating a high-grade glioma. Permanent sections were prepared and submitted in three cassettes.\n\nMicroscopic examination reveals a highly cellular neoplasm with significant mitotic activity. The tumor demonstrates a mixture of morphologic features, including areas suggestive of both oligodendroglial and astrocytic differentiation. Prominent microvascular proliferation is present, and coagulative necrosis is identified in several regions. Notably, the necrotic areas do not show peripheral palisading of tumor cells.\n\nImmunohistochemical staining for mutant IDH1 was negative. Fluorescence in situ hybridization analysis shows preservation of chromosomes 1p and 19q. These findings are part of an ongoing assessment, and further addenda may be issued as additional studies are completed."} +{"pid": "TCGA-WB-A80P", "report": "The clinical material included a lymph node adjacent to a tumor and a separate encapsulated mass measuring 7 x 5 x 4 cm, with adherent muscle and connective tissue on one side. The tumor exhibited a multinodular appearance, was cross-laminated, and samples were taken for further analysis. A separate lymph node measured 2.25 x 1.5 x 1.5 cm and appeared soft and pink/white on gross examination.\n\nMicroscopic evaluation of the lymph node revealed no abnormal localization or infiltrative process. The primary lesion demonstrated a highly cellular, encapsulated neoplasm arranged in an alveolar pattern. The cells displayed epithelioid morphology with large eosinophilic, granular cytoplasm and round nuclei that varied from hypo- to hyperchromatic. Nuclear chromatin was coarse and irregularly distributed, with distinct nucleoli. Multinucleated cells were frequently observed. Scattered mitotic figures were present throughout the specimen.\n\nThe tumor contained brown to black pigment within the cytoplasm of many cells. Areas of focal necrosis and hemorrhage were identified, along with fibrosis and sclerosis within the intercellular septa. Old hemorrhagic foci with siderophages were also present. Vessels within the tumor showed evidence of thrombosis, and the growth pattern was predominantly expansive with focal disruption of the surrounding capsule.\n\nImmunohistochemical staining showed positivity for S100 and NSE, with weak diffuse expression of chromogranin. Vimentin staining highlighted the fibrous septa. Electron microscopy of ten collected fragments confirmed the presence of numerous membrane-bound secretory granules and abundant mitochondria within the tumor cells. These ultrastructural features supported the interpretation derived from histological and immunohistochemical findings.\n\nAncillary testing with ferric chloride reaction was negative. Three representative sections (A through C) were processed for further evaluation. No vascular invasion was identified, and no residual adrenal tissue was detected within the specimen."} +{"pid": "TCGA-G3-A6UC", "report": "The specimen consists of a gallbladder and a segment of liver. The gallbladder measures 11.0 x 3.5 x 3.5 cm and contains green bile. Five calculi are present, ranging from 0.4 cm to 1.5 cm in size. The gallbladder wall is thickened, averaging between 0.1 and 0.2 cm in thickness. Two nodules are identified within the adipose tissue near the neck and cystic duct, measuring 1.0 cm and 1.5 cm respectively.\n\nThe liver specimen weighs 50.8 grams and measures 6.5 x 5.0 x 2.5 cm. The external surface is nodular. A green, well-defined mass measuring 2.5 x 2.3 x 2.5 cm is identified. This mass is located 0.3 cm from the surgically inked margin and less than 0.1 cm from the liver capsule. Adjacent to it is a hemorrhagic, well-defined mass measuring 1.0 x 1.0 x 1.0 cm. This second mass is 0.1 cm from the surgical margin and 0.7 cm from the liver capsule. Upon sectioning, the hemorrhagic mass demonstrates a granular texture with material that separates easily, raising concern for vascular involvement.\n\nSections were taken from both masses and surrounding structures to evaluate their relationship to critical margins and the liver capsule. Additional sections included representative liver tissue."} +{"pid": "TCGA-B8-5158", "report": "The left kidney specimen measured 33 x 19 x 10.5 cm and weighed 1,250 grams. The tumor was located in the lower pole and extended through the renal parenchyma toward the superior pole, filling the renal pelvis inferiorly. The tumor measured 16.0 cm in greatest dimension and was unicentric. Gross examination showed no involvement of the ureter or perirenal adipose tissue, and no definite extracapsular extension was observed. Renal vein involvement was noted.\n\nMicroscopic evaluation revealed high-grade nuclear features. There was no histologic evidence of invasion into the capsule, perirenal adipose tissue, Gerota\u2019s fascia, or ureter. Tumor involvement was identified in the renal vein. Surgical margins were negative for tumor involvement in all assessed areas including perirenal adipose tissue, Gerota\u2019s fascia, renal vein, renal artery, and ureter. Invasion of the renal sinus soft tissues was documented.\n\nA total of fifteen lymph nodes were examined from the left hilar dissection. One lymph node contained metastatic involvement. No small vessel lymphatic invasion was identified, although large vessel involvement was present.\n\nStaging was determined as pT3a and pN1 based on available data at the time of reporting. The staging may be subject to revision pending further clinical review and additional information."} +{"pid": "TCGA-EM-A1YE", "report": "The specimen received includes two parts: one labeled as possible parathyroid tissue and another as thyroid tissue from a total thyroidectomy. The parathyroid sample consists of a small tan tissue fragment measuring 0.2 cm and weighing 0.003 g, which was frozen for intraoperative consultation.\n\nThe thyroid specimen is oriented with a stitch and weighs 19.6 g. The right lobe measures 5.0 cm in length, with dimensions of 2.3 cm ML x 1.5 cm AP. The left lobe measures 3.7 cm SI x 2.3 cm ML x 1.2 cm AP, and the isthmus measures 2.0 cm SI x 1.7 cm ML x 0.5 cm AP. The outer surfaces show fibrous adhesions and have been treated with silver nitrate. Within the upper to mid portion of the right lobe, there is a well-defined solid nodule measuring 3.0 x 2.5 x 2.0 cm. The remaining thyroid tissue appears normal upon gross examination. Sections of the nodule and surrounding tissue were preserved frozen for further analysis.\n\nHistologically, the nodule was found to be encapsulated without extension beyond the thyroid capsule. Margins were free of involvement. No venous or lymphatic invasion was identified. Three regional lymph nodes were examined and showed no evidence of involvement. The tumor was found to be unifocal and located in the right lobe of the thyroid.\n\nAdditional findings include nodular hyperplasia and mild chronic inflammation consistent with thyroiditis. Based on pathological staging, the tumor is classified as pT2, indicating it is greater than 2 cm but not more than 4 cm in size and confined to the thyroid. There was no evidence of regional lymph node metastasis (pN0). Distant metastasis could not be assessed (pMX)."} +{"pid": "TCGA-GC-A3RD", "report": "A segment of the left ureter shows significant chronic inflammation with extensive denudation of the epithelium. A second left ureteral margin biopsy also reveals chronic inflammation and epithelial denudation, but no malignant cells are identified. The right ureteral margin biopsy does not show any tumor. The primary specimen from the urinary bladder contains a well-defined mass measuring 1.5 x 1.3 cm. Histologically, the lesion is high grade and invades through the muscularis propria into the surrounding perivesical soft tissue. The tumor approaches as close as 1.8 mm to the inked margin of the perivesical soft tissue. No lymphovascular invasion is observed. The urethral margin is free of tumor. Examination of the right pelvic lymph nodes (6 total) and left pelvic lymph nodes (2 total) reveals no evidence of metastatic disease. The appendix shows fibrosis within the lumen but no neoplastic changes. Gross evaluation confirms the presence of a firm, pale tan mass on the left central anterior wall of the bladder, which comes within 0.1 cm of the anterior soft tissue margin. No involvement of either ureteral orifice is noted macroscopically. Tissue samples from multiple regions of the bladder, including the trigone, posterior wall, and right bladder wall, are submitted for further analysis."} +{"pid": "TCGA-EW-A1J2", "report": "A right breast specimen was received, measuring 20 x 18.5 x 4 cm and weighing 1000 grams. The nipple-areolar complex appeared unremarkable. On serial sectioning, a tan-white indurated lesion with infiltrative borders was identified in the lower outer quadrant at approximately the 5 o\u2019clock position. The lesion measured 1.5 x 1.5 x 1 cm and was located 0.2 cm from the medial margin, 2.5 cm from the deep margin, 3 cm from the inferior margin, 8 cm from the superior margin, 15 cm from the lateral margin, and 6 cm from the nipple. A metal clip was present within the lesion. No other gross lesions were identified. No lymph nodes were found within the main specimen.\n\nMargins were evaluated microscopically and found to be free of tumor involvement. The closest distance of the lesion to any margin was 1.5 mm at the medial margin. Histologic evaluation showed a well-differentiated invasive carcinoma with no lymphovascular invasion identified. A biopsy site was present, and predictive marker testing performed on a prior biopsy demonstrated positivity for ER and PR, and negativity for Her-2 and E-cadherin by immunohistochemistry.\n\nThe surgical procedure included a right total mastectomy with sentinel lymph node biopsy and possible axillary dissection. Lymph node sampling included sentinel lymph nodes and additional lymph nodes from the axillary dissection. A total of 21 lymph nodes were examined (including 13 sentinel nodes), with no evidence of metastasis identified. No macrometastases, micrometastases, or isolated tumor cells were found. The largest lymph node metastasis size was zero. Extranodal extension was not identified. Sentinel lymph nodes were evaluated using H&E staining (one level) and immunohistochemistry was pending.\n\nAdditional specimens included fibroadipose tissue from multiple sites which showed no specific pathologic changes. The left breast specimen revealed fibrocystic changes including adenosis, stromal fibrosis, usual ductal hyperplasia, and focal columnar cell change. A microscopic intraductal papilloma measuring 1.5 mm was also identified.\n\nGross examination of the right axillary dissection specimen revealed multiple possible lymph nodes. Microscopic evaluation of all submitted lymph nodes from various sites (including axillary dissection and apical axilla) showed no malignancy. Intraoperative frozen section analysis of lymph nodes was performed, with one lymph node showing a microscopic focus of concern; however, subsequent evaluation did not confirm this finding.\n\nThe tumor was single in focus and measured 1.5 cm in greatest dimension. Additional dimensions were recorded as 1.5 x 1.5 cm. Lobular carcinoma in situ was also identified. Histologic grading using the Nottingham system yielded a score of 3 (Grade 1), based on tubule formation score of 3, nuclear pleomorphism score of 1, and mitotic count score of 1. Cellular features included small nuclei with minimal variation in size, regular outlines, uniform chromatin, and low mitotic activity.\n\nNo dermal lymphovascular invasion was observed. There was no known presurgical therapy administered. Ancillary studies including immunohistochemical staining were performed on another specimen, and results indicated immunoreactive tumor cells for hormone receptors. Some immunohistochemical assays used analyte-specific reagents validated by the laboratory.\n\nPathologic staging was determined as pT1c for the primary tumor and pN0 for regional lymph nodes. The specimen was intact and oriented, with appropriate margins inked and evaluated."} +{"pid": "TCGA-2G-AAF1", "report": "The specimen consists of a right-sided abdominal testis measuring 6.5 cm in diameter. Histological examination reveals a neoplastic lesion with features including angioinvasion and involvement of the rete testis. The tumor appears to be limited to the testis based on available slides."} +{"pid": "TCGA-DD-AADR", "report": "Specimen consists of a liver segment measuring 3.0 x 2.3 x 2.0 cm and weighing 15.0 grams. The lesion is located in segment 4 and is solitary, measuring 1.2 x 1.3 x 1.1 cm. Gross examination reveals a vaguely nodular appearance without satellite nodules, necrosis, hemorrhage, or vascular invasion. A gross photo is present. Blocks submitted include T1-2 from the tumor mass and RM from the resection margin.\n\nMicroscopic evaluation shows trabecular architecture with hepatic cells and focal clear cell morphology. The worst histologic differentiation is grade III, as is the major pattern observed. There is evidence of fatty change involving less than 20% of the tissue. A complete fibrous capsule is noted without infiltration. No septum formation or ductal abnormalities are identified. Vascular invasion involving the portal vein, bile ducts, hepatic veins, or hepatic artery is not present. Surgical margin assessment is limited due to sampling constraints. Non-tumor findings include chronic hepatitis related to HBV infection, minimal lobular activity, mild portoperiportal inflammation, and cirrhosis of mixed type. There is also a low-grade dysplastic nodule present. Trichrome staining highlights thick fibrotic bands encircling regenerative nodules. Immunohistochemistry demonstrates positivity for Hepatocyte and negativity for CK19."} +{"pid": "TCGA-DJ-A2Q9", "report": "A 7 mm nodule was identified in the right thyroid. Specimens submitted included lymph nodes from the right paratracheal area, a total thyroidectomy specimen, and additional lymphoid tissue.\n\nIn the first right paratracheal lymph node specimen, one lymph node was examined and showed benign features. In the second right paratracheal specimen, three lymph nodes were identified, with the largest measuring 0.6 cm. One of these lymph nodes contained a metastatic focus measuring 0.3 cm. There was no extranodal extension identified.\n\nThe total thyroidectomy specimen revealed a lesion located in the right lobe measuring 1.5 cm in greatest dimension. A second focus was identified in the isthmus measuring less than 0.1 cm, and another micro focus in the right lobe measuring 0.8 cm. The lesion was partially encapsulated, with no vascular invasion or extrathyroidal extension observed. Surgical margins were free of involvement. The surrounding thyroid tissue showed nodular hyperplasia and mild chronic lymphocytic thyroiditis. No parathyroid glands were identified in the specimen.\n\nAdditional specimens including Delphian node and pretracheal tissue showed no lymph nodes present or pathological findings.\n\nHistological evaluation noted positive staining for TTF-1, PAX-8, CK7, thyroglobulin, and p63. The proliferation index (MIB-1) was approximately 5\u201310%. No mitotic activity or tumor necrosis was identified. A marked stromal reaction was noted around the lesion.\n\nFrozen section analysis initially interpreted the first right paratracheal node as benign, and the second right paratracheal node as containing metastatic disease, which was confirmed on permanent sections."} +{"pid": "TCGA-ZR-A9CJ", "report": "The specimen consists of an oesophagectomy along with multiple lymph nodes from the splenic, subcarinal, and right crus regions. The oesophagus measures 47mm in length, and the stomach has a maximum length of 125mm and width of 50mm. A circumferential lesion measuring 42mm in length is present, located 19mm from the proximal resection margin and 10mm from the distal resection margin. The tumour primarily involves the oesophagus but extends through the gastro-oesophageal junction, with approximately 5\u201310mm of tumour present in the stomach. On gross examination, the tumour does not appear to involve the circumferential margin, which was marked with blue ink. Metastatic involvement in lymph nodes is macroscopically evident.\n\nMicroscopic evaluation shows a range of differentiation, with features of invasion beyond the muscularis propria into the adventitia. The distance from the carcinoma to the nearest circumferential margin is 1mm. Lymphovascular and perineural invasion are present. A total of 24 lymph nodes were examined, and 12 show evidence of tumour involvement. The remaining nodes, including those from the splenic, subcarinal, and right crus regions, do not demonstrate invasive malignancy. No distant metastases are identified. Tumour regression grade according to Mandard criteria is 5, indicating no regressive changes. The proximal margin shows Barrett's change, while the distal margin appears normal. The majority of the tumour has been sampled for histological analysis, including sections of margins, representative areas of the lesion, and lymph nodes."} +{"pid": "TCGA-DJ-A3V3", "report": "The clinical history notes a fine needle aspiration of a left thyroid nodule. Specimens submitted include a total thyroidectomy with central compartment lymph nodes, as well as a Delphian lymph node.\n\nThe Delphian lymph node specimen consisted of a single firm lymph node measuring 0.6 x 0.4 x 0.3 cm and was entirely submitted for examination. Microscopic evaluation revealed benign lymph node tissue without any abnormal features.\n\nThe thyroid specimen weighed 15.5 g and included the right lobe (4.0 x 1.8 x 1.3 cm), left lobe (4.6 x 2.4 x 1.8 cm), and isthmus (1.2 x 1.0 x 0.2 cm). The external surface was covered by a thin fibrous capsule. Upon sectioning, three nodules were identified in the left lobe: a 2.4 x 1.8 x 1.6 cm yellow-tan partially calcified nodule in the left lower lobe, a 1.1 x 0.9 x 0.7 cm tan-red homogeneous nodule in the left mid lobe, and a 1.1 x 0.8 x 0.6 cm red-tan homogeneous nodule in the left upper pole. The largest nodule was partially calcified and partially submitted for analysis. The remaining thyroid tissue appeared red-tan and homogenous.\n\nMicroscopic evaluation of the left lobe nodule showed well-differentiated cells with no mitotic activity or tumor necrosis identified. Calcifications, including psammoma bodies, were present. The lesion was partially encapsulated and did not show blood vessel invasion or extension beyond the thyroid capsule. Surgical margins were free of any abnormal tissue. No multicentric disease was identified.\n\nFourteen benign lymph nodes were found in the central compartment, and the Delphian lymph node was also benign. The surrounding thyroid tissue showed changes consistent with nodular hyperplasia and chronic lymphocytic thyroiditis. Two parathyroid glands were unremarkable.\n\nAll findings were based on personal examination of the slides and materials. The report has been reviewed and approved."} +{"pid": "TCGA-QK-A8ZA", "report": "The biopsy specimen from the right oropharynx consists of multiple fragments of tan-pink tissue measuring 1.2 x 0.7 x 0.4 cm. Histologic examination reveals invasive moderately differentiated cellular growth. Immunohistochemical staining demonstrates strong diffuse positivity. The specimen was processed entirely for intraoperative consultation using frozen section technique, with the remaining tissue submitted in a cassette labeled FSA1. Clinical correlation is provided with a history of a right neck mass."} +{"pid": "TCGA-G9-6362", "report": "The surgical specimens included multiple lymph node samples and a resected prostate. Lymph node specimens consisted of left and right pelvic lymph nodes, with the left specimens showing fibroadipose tissue without identifiable lymph nodes in some cases. The right pelvic lymph node specimen contained one lymph node measuring 1.3 x 0.5 x 0.4 cm, and all lymph node specimens were found to be negative for tumor involvement.\n\nThe prostate specimen weighed 40 grams before trimming and measured 5 cm in width, 3.8 cm in depth, and 2.6 cm in height. After removal of the apex and base, the remaining weight was 21 grams. The prostate had a smooth, red, and intact capsule. On sectioning, the tissue showed firm tan fibrous parenchyma. Both seminal vesicles were present and measured 5 x 1 x 0.3 cm on the right and 6.2 x 1.5 x 0.3 cm on the left, with beige-tan cystic appearance upon bisection. The vas deferens measured 1.1 x 0.5 cm on the right and 0.8 x 0.5 cm on the left, with firm tan tubular structure noted.\n\nHistologic evaluation revealed epithelial changes involving both left and right lobes of the prostate, with extensive involvement beyond the prostatic capsule. High-grade intraepithelial neoplasia was identified, and perineural invasion was present. Tumor involvement was noted at multiple margins including the apical and posterolateral regions bilaterally, with diffuse distribution. No involvement was seen in the seminal vesicles.\n\nGrading showed a predominant Gleason pattern of 4 and 3, with a tertiary component of higher grade features. Involvement of the bladder neck was not identified. Pathologic staging was determined as pT3a. Multiple tissue blocks were submitted for analysis, covering various anatomical regions of the prostate and surrounding structures."} +{"pid": "TCGA-GM-A2DM", "report": "The specimen from the right axillary sentinel lymph node biopsies showed benign lymph nodes without evidence of metastatic disease. Both lymph nodes were assessed with cytokeratin staining and no tumor involvement was identified.\n\nA segmental mastectomy specimen from the right breast contained a well-circumscribed pink-tan friable mass measuring 2.7 cm in greatest dimension. Histological evaluation demonstrated a solid papillary growth pattern with nuclear features consistent with low-grade differentiation. The invasive component was surrounded by predominantly adipose tissue, and no lymphatic or vascular invasion was observed. Adjacent to the invasive component was an intraductal lesion comprising approximately 5% of the total tumor volume. This intraductal component exhibited cribriform and papillary patterns without necrosis.\n\nSurgical margins were assessed across multiple sites. The invasive component was located 1 mm from the closest anterior (superficial) margin and 5 mm from the posterior (deep) margin. The intraductal component was found to be 2 mm from the anterior (superficial) margin. Additional excisional biopsies from various margins including superior, lateral, medial, deep, and inferior regions showed benign breast parenchyma without evidence of malignancy. One margin showed focal minimal atypical ductal hyperplasia.\n\nHistological assessment also revealed biopsy site changes and fibrocystic alterations such as focal ductal hyperplasia with and without atypia, columnar cell change, apocrine metaplasia, fibroadenomatoid change, cyst formation, and pseudoangiomatoid stromal fibrosis. Microcalcifications were noted within benign ducts.\n\nThe specimen was extensively sampled and submitted for histological analysis, with all surgical margins free of malignant cells. No additional masses were identified in the surrounding breast tissue."} +{"pid": "TCGA-QC-A7B5", "report": "The surgical specimen consists of a resected scalp mass measuring 2.2 cm in greatest dimension, with additional dimensions of 1.8 cm and 0.4 cm. The tumor is located within the subcutaneous tissue and is described as superficial. Histologic evaluation reveals high-grade undifferentiated pleomorphic cells. Immunohistochemical staining demonstrates diffuse positivity for SMA and focal positivity for p63, while stains for desmin, S100-protein, SOX-10, HMWCK, and AE1/AE3 are negative.\n\nMicroscopic assessment shows a mitotic rate of 44 per 10 high-power fields. There is no evidence of necrosis or lymphovascular invasion. The tumor is present at the deep margin. Regional lymph nodes were not assessed, as none were submitted for examination.\n\nGrossly, the specimen is an oriented circular skin excision measuring 6.2 cm in diameter and 0.8 cm in depth, with a centrally located subcutaneous mass. The mass is 2.5 cm from the anterior margin, 2.5 cm from the posterior margin, 2.2 cm from the lateral margin, and 2.4 cm from the medial margin. On sectioning, the mass appears red-tan and ovoid, measuring 2.2 x 1.8 x 0.4 cm, with a depth of 1.2 cm and less than 0.1 cm from the deep margin.\n\nAdditional findings include a necrotizing dermal granuloma; Fite, acid-fast, and GMS stains are negative. No prior treatment was administered before resection. All margins were evaluated microscopically, with the deep margin showing residual tumor."} +{"pid": "TCGA-A7-A3IZ", "report": "The final surgical pathology report includes the following findings. \n\nA sentinel lymph node specimen was submitted and examined. Microscopic evaluation at multiple levels using H&E staining and immunohistochemistry for pan-keratin revealed no definitive metastasis on H&E; however, rare isolated cytokeratin-positive cells were identified. \n\nIn the right breast specimen, a mass was identified near the inferior lateral margin. The lesion measured 2.6 cm in greatest dimension and extended to involve the inferior and lateral margins. Histologic evaluation showed a grade 2 lesion with an architectural score of 3, nuclear score of 2, and mitotic score of 1. Vascular invasion was not identified. Calcifications were present. No ductal carcinoma in situ was observed. The surrounding non-tumorous breast tissue showed biopsy site changes. \n\nMargins of resection were positive for involvement at the inferior and lateral aspects. The primary lesion was classified as pT2. Representative sections were submitted for further analysis. \n\nNo additional comments or prognostic marker results were provided in this report."} +{"pid": "TCGA-DC-6156", "report": "The patient presented with abdominal pain and underwent colonoscopy which identified a mass located 20 cm from the rectum. CT imaging demonstrated multiple liver lesions and a sigmoid mass, for which biopsy was performed. Specimens submitted included a resected segment of sigmoid and upper rectum, proximal and distal anastomotic rings, and an umbilical hernia sac.\n\nGross examination of the resected sigmoid and upper rectum specimen measured 20 x 12 x 8 cm. A circumferential, constricting lesion was identified, located 11 cm from the proximal margin and 7 cm from the distal margin. The lesion measured 5.5 cm in length, 3.5 cm in width, and showed invasion to a depth of 2.5 cm, with closest distance to the radial margin being 0.5 cm. Serosal surface involvement was noted, with no evidence of gross perforation. Lymphovascular invasion was suspected, and perineural invasion was identified. No tumor budding was observed. Margins were free of involvement, with the closest distance from the deepest tumor portion to the radial margin measuring 0.15 cm. No precursor lesions or polyps were identified in non-tumor areas. Twenty-two lymph nodes were examined, with seven showing metastatic involvement. No tumor deposits were found in pericolorectal soft tissue.\n\nThe omentum showed diffuse involvement by firm white tissue consistent with tumor infiltration. Examination of the umbilical hernia sac revealed a firm white mass measuring 1.1 x 1.0 x 0.7 cm, histologically consistent with moderately differentiated tumor tissue. The proximal and distal anastomotic rings showed no evidence of tumor involvement and exhibited benign colonic tissue.\n\nStaging based on findings includes pT4a (tumor extension to visceral peritoneum), and N2b (seven or more positive regional lymph nodes)."} +{"pid": "TCGA-2H-A9GO", "report": "The specimen shows a poorly differentiated carcinoma arising in the setting of Barrett's epithelium, located in the distal esophagus. The lesion measures 4.5 x 2.5 cm. A total of 13 lymph nodes were examined, with 9 demonstrating involvement. The resection margins are involved, indicating an incomplete resection."} +{"pid": "TCGA-OR-A5K0", "report": "The patient is a female who was hospitalized for a hypertensive episode and hypokalemia. A CT scan identified a left adrenal mass measuring 6.2 x 4.0 cm. The patient reported easy fatigability. She underwent a left open adrenalectomy. The excised specimen weighed 105 grams and measured 9 x 6.8 x 4.3 cm. It consisted of a nodular gray-tan adrenal gland with surrounding periadrenal fat. The mass appeared diffusely pink-gray, soft, and nodular with a smooth cut surface, arising within a yellow and partially cystic adrenal region. The majority of the lesion was outside the adrenal cortex, with approximately 3.0 cm of normal yellow adrenal tissue remaining at one edge. The lesion was well-circumscribed and covered by a thin, clear membrane. No involvement of the surrounding periadrenal fat was observed. Multiple sections were taken from different areas of the specimen, including normal adrenal tissue, cystically dilated regions, and various parts of the mass.\n\nMicroscopic evaluation showed the presence of necrosis and focally present capsular invasion. Vascular invasion was not identified. Surgical margins were close. The mitotic rate was 8 per 50 high-power fields across 25 fields reviewed, with a low-grade appearance. Lymph node status and distant metastasis could not be determined. Based on these findings, the tumor was classified as pT2NxMx."} +{"pid": "TCGA-5U-AB0F", "report": "The specimen was obtained from a female patient with a history of an anterior mediastinal mass measuring 8.2 x 7.5 x 5.5 cm and HBV-related hepatic cirrhosis. The procedure performed was a radical resection including thymus, pericardium, and an atypical lung resection from the superior right lobe.\n\nThe resected mass measured 8 x 6.5 x 4.5 cm and was found to be partially encapsulated, with thinning of the capsule on the right side. It was laterally adhered to an area of atypical lung tissue that measured 10 x 2.5 x 1.2 cm and posteriorly attached to a pericardial plaque measuring 7 x 4.5 cm. The mass showed focal infiltration into the adjacent lung tissue, though the pericardium itself did not demonstrate involvement. Scattered thymic remnants were identified in proximity to the lesion.\n\nLymph nodes from the aorto-pulmonary window and precaval regions were examined; all were reactive without evidence of malignancy. Adipose tissue sampled from the cardio-phrenic region and posterior adipose areas showed no abnormal findings.\n\nHistologic examination revealed a mix of epithelial and lymphocytic components. Immunohistochemical analysis indicated that the lymphocytes were primarily cortical T-lymphocytes. The epithelial cells did not show aberrant expression of CD20 or CD5. Rare CD20+ B lymphocytes were detected in both the neoplastic area and thymic remnants.\n\nThe staging according to Masaoka classification was determined to be stage III, with no nodal involvement (pN0). All surgical margins were evaluated, with no evidence of residual disease noted."} +{"pid": "TCGA-BR-8687", "report": "Specimen type is gastrectomy, with tumor located at the cardia. The tumor measures 6 x 6 x 1.2 cm and demonstrates poorly differentiated histology. Histologic features show involvement of adjacent structures including the esophagus and lesser omentum. Lymph node evaluation reveals 5 out of 9 intraabdominal lymph nodes positive for metastatic involvement. No information is provided regarding lymphatic, venous, or perineural invasion, nor are details available about surgical margins or prior neoadjuvant treatment. No additional pathologic findings or comments are noted."} +{"pid": "TCGA-NH-A50V", "report": "The specimen consisted of a right hemicolectomy with terminal ileum, cecum, appendix, and ascending colon. The surgical margins were all free of invasive carcinoma, with the closest distance from the tumor to the mesenteric margin measuring 4.5 cm. A mass was identified at the cecum and ileocecal valve, measuring approximately 9.0 x 4.0 cm grossly. Histologically, the lesion exhibited low-grade morphology and invaded through the muscularis propria into subserosal adipose tissue (pT3). There was no evidence of lymphovascular or perineural invasion. Examination of regional lymph nodes revealed four out of thirty-five positive for involvement, with extracapsular extension noted. No tumor deposits were identified. Staging included pT3 for primary tumor and pN2a for nodal involvement. Gross examination showed an indurated cecum with puckered serosa; tattoo dye was present in the ascending colon, located 6 cm distal to the tumor and more than 10 cm from the distal margin. Surrounding mucosa appeared normal except for shallow diverticula noted in the distal colon segment. Multiple lymph nodes were sampled along with representative sections of tumor, margins, and normal bowel tissue."} +{"pid": "TCGA-44-6148", "report": "The specimen includes four components: a level 10 lymph node, a left lower lobe lobectomy, a left upper lobe lymph node, and a subcarinal lymph node. The left lower lobe specimen weighs 232 grams and measures 21.0 x 11.0 x 5.5 cm. It includes a bronchial stump measuring 1 cm in length and 2.5 x 0.9 cm in diameter. A well-circumscribed mass measuring 3.0 x 2.8 x 2.8 cm is identified along the lateral aspect of the lung. The mass is pale tan and mucoid with areas of congestion. It extends focally to within 0.3 cm of the pleural surface, which was inked blue. Sections of the tumor near the pleural surface, tumor adjacent to normal parenchyma, margins of resection, and random normal lung tissue were submitted for analysis. A single hilar lymph node measuring 0.4 cm was also recovered and submitted. The level 10 lymph node measures 2.2 x 1.4 x 0.6 cm and was entirely submitted. The left upper lobe lymph node is 0.6 x 0.5 x 0.35 cm and was fully submitted. The subcarinal lymph node is fragmented and measures 1.3 x 1.0 x 0.4 cm; it was also entirely submitted.\n\nMicroscopic examination reveals a well-differentiated epithelial neoplasm measuring 3 cm in greatest dimension. The tumor does not involve the pleura or large bronchi. No vascular invasion\u2014large or small vessel\u2014is identified. Resection margins, including bronchial and vascular margins, are free of tumor involvement. Lymph nodes from multiple regions, including level 10, the hilum of the left lower lobe, the left upper lobe, and the subcarinal region, are all negative for metastatic involvement. Background lung tissue appears largely unremarkable. Anthracotic changes and histiocytic infiltration are noted in several lymph nodes. Distant metastasis could not be assessed."} +{"pid": "TCGA-E7-A6MF", "report": "Patient ID: Gross Description: In the bladder, there is an invasive and protruding mass with ill-defined margins. The lesion measures 2.2 x 1.5 x 1 cm, with a soft and gray surface. Microscopic Description: The tissue shows dense cellular proliferation arranged in papillary structures, nests, groups, or cords. The cells exhibit moderate basophilic or vacuolated cytoplasm. Nuclear features include enlargement, variability in size and shape, irregular nuclear membranes, prominent nucleoli, and abnormal chromatin distribution. Mitotic figures are present. The tumor extends into the inner muscle layer of the bladder wall. Comments: Formatted Path Reports: BLADDER TISSUE CHECKLIST. Specimen type: Cystectomy. Tumor site: Bladder. Tumor size: 2.2 x 1.5 x 1 cm. Tumor features: None specified. Histologic type: Papillary architecture. Histologic grade: Moderately differentiated. Tumor extent: Invasion into the superficial muscle (inner half). Lymph nodes: Not specified. Lymphatic invasion: Not specified. Venous invasion: Not specified. Margins: Not specified. Evidence of neo-adjuvant treatment: Not specified. Additional pathologic findings: Not specified. Comments: None."} +{"pid": "TCGA-EB-A4OY", "report": "The specimen consisted of skin tissue from the foot, submitted as an excised lesion measuring 2 x 1 x 3.5 cm. The lesion was pigmented and ulcerated, composed of nevus-like and spindle-like cells. Histologic evaluation revealed a Clark level V invasion with a Breslow depth of 10 mm. Lymphoid infiltration was present. Of the three lymph nodes examined, one inguinal node showed evidence of metastasis. No venous invasion was identified. Surgical margins were uninvolved. Other features such as satellite nodules, lymphatic invasion, histologic grade, neo-adjuvant treatment, and additional findings were not specified."} +{"pid": "TCGA-MT-A51W", "report": "A 4.0 x 2.7 cm portion of tan-red rubbery mucosa and submucosa was received, excised to a depth of 1.2 cm. A 2.0 x 1.8 cm ulcerated and ill-defined firm mass was identified on the mucosal surface. The specimen was inked with multiple colors to identify margins: anterior (blue), superior (green), lateral (red), medial (orange), and deep (black). On sectioning, the mass measured up to 0.7 cm in thickness and was less than 0.1 cm from the deep margin. It was 0.2 cm from the lateral margin, 1.0 cm from the medial margin, 1.3 cm from the anterior margin, and 0.9 cm from the superior margin. All margins were free of tumor. The closest margin was the deep margin at 0.1 cm from the tumor edge. No evidence of vascular or perineural invasion was identified. Additional specimens including the left anterior retromolar trigone margin, superior buccal margin, maxillary tuberosity, superior medial palatal margin, and tongue base were all negative for high-grade dysplasia or malignancy. Frozen section diagnoses were confirmed on permanent sections."} +{"pid": "TCGA-FE-A235", "report": "The specimen consisted of a thyroid gland measuring 6.5 x 3.3 x 1.5 cm. A mass measuring 3.1 x 2.0 x 1.4 cm was identified within the gland, located near the capsular surface and situated 2.8 cm from one apex and 3.0 cm from the opposing apex. The mass was well circumscribed and tan-pink in color. Additional tissue fragments included an involuting thymus and one parathyroid gland. Four lymph nodes were identified microscopically in the perithyroidal soft tissue, with three showing microscopic metastatic involvement. The largest metastatic focus measured 1 mm in greatest dimension. No extranodal extension was observed.\n\nHistologically, multiple tumor foci were present, ranging in size from less than one millimeter to 3.0 x 2.0 x 1.4 cm, with the largest focus located in the isthmus. Lymphatic and vascular invasion was identified intrathyroidally and within the vascular sinuses of one involved lymph node. There was no evidence of capsular invasion. The surgical margin showed focal tumor involvement. Chronic lymphocytic thyroiditis was also noted as an additional finding. Three of four lymph nodes examined contained metastatic deposits; all were microscopic and measured up to 1 mm. One lymph node was negative. The tumor was histologically classified as a conventional subtype. Based on the findings, staging was assigned as pT2, pN1, pMX."} +{"pid": "TCGA-28-1749", "report": "A tissue specimen was received from the left frontal region of the brain, measuring 0.6 x 0.5 x 0.3 cm. Additional fragments were submitted from various sites (NCI#1 through NCI#5), with aggregate sizes ranging from 0.9 x 0.4 x 0.2 cm to 3.3 x 0.6 x 0.2 cm. Histologic examination revealed a malignant neoplasm characterized by cellular atypia, including enlarged and hyperchromatic nuclei, frequent mitotic figures, and prominent microvascular proliferation.\n\nImmunohistochemical staining demonstrated that 5% of tumor nuclei were positive for MGMT. Loss of PTEN expression was identified. pMAPK immunoreactivity was observed in 20% of tumor nuclei and 60% of tumor cell cytoplasm. Laminin beta-1 and laminin beta-2 expression was upregulated in endothelial cells.\n\nFluorescence in situ hybridization (FISH) analysis for EGFR showed amplification, based on an EGFR/CEP ratio of 15.3 across 40 cells analyzed, with no evidence of high-level polysomy. Necrosis was present in some samples, ranging from 0% to 3%, while tumor cellularity ranged from 70% to over 90% across specimens.\n\nThe tumor was classified according to histologic features and molecular markers. Expression levels of certain proteins and activation states of signaling pathways were assessed, revealing patterns associated with potential therapeutic responses and prognostic implications. Elevated expression of laminin beta subtypes suggested intermediate aggressiveness. High pMAPK immunoreactivity was noted, which has been associated with relative resistance to radiation therapy. The significance of these findings in guiding treatment remains under investigation, and clinical correlation is recommended."} +{"pid": "TCGA-D7-A6EV", "report": "The examined specimen consisted of a resected stomach measuring 18.3 x 13.2cm, along with attached omentum measuring 32 x 25cm. The stomach was opened along the greater curvature. A lesion measuring 5.6 x 4.1 x 0.8cm was identified in the pyloric region on the posterior wall, located 9.6cm from the proximal margin and 1.2cm from the distal margin.\n\nHistologically, the lesion showed features of poorly differentiated tubular and villous adenocarcinoma with mixed growth patterns. The tissue demonstrated invasion into the submucosa and superficially into the gastric muscularis propria. Surgical margins were free of neoplastic cells. Additional findings away from the tumor included chronic inflammation without active features, and foci of complete intestinal metaplasia were noted.\n\nLymph node assessment revealed involvement in multiple regions: two out of two nodes from the cardia region, seven out of seven from the lesser curvature, three out of six from the greater curvature, and two out of two from the peripyloric area. There was evidence of vascular invasion and perilymphatic spread. Lymph node staging criteria were consistent with regional spread. No other specific diagnostic terms were applied."} +{"pid": "TCGA-B8-5546", "report": "The right laparoscopic nephrectomy specimen weighed 280 g and measured 13.2 x 10 x 4.3 cm, composed of a 10.8 x 6.7 x 4.0 cm kidney with attached perinephric fat and 3.6 cm of ureter. The posterior surface was marked with blue ink, and no adrenal gland was present in the specimen. A fleshy tan-pink circumscribed nodule with central red-orange discoloration was identified in the superior/medial/posterior aspect of the kidney, located within the cortex. The lesion compressed adjacent cortical tissue and abutted the renal pelvis, measuring 4.3 x 3.6 x 3.1 cm. It appeared confined to the kidney without involvement of perirenal adipose tissue, Gerota\u2019s fascia, renal vein, or ureter. No multicentricity was observed.\n\nA solitary 0.2 cm white cortical nodule was noted in the superior lateral pole, located 4 cm from the edge of the main lesion. The remainder of the kidney appeared grossly unremarkable, with an average cortical thickness of 0.7 cm. Surgical margins were assessed as follows: the tumor was within 0.4 cm of the closest blue inked posterior margin (A5), and all other margins, including renal vein and ureter, were negative. No lymph nodes were identified at the hilar region or elsewhere in the specimen.\n\nMicroscopic evaluation confirmed that the lesion was localized to the kidney without evidence of sarcomatoid features. Histologic grade was Fuhrman grade 2. No vascular invasion (venous or lymphatic) was identified. Additional findings included a small 0.3 cm angiomyolipoma. Based on available data, staging was assigned as pT1b and pNX. Tissue blocks submitted for further analysis included areas of the tumor near the pelvic urothelium, hilum, margins, adjacent parenchyma, and a separate cortical nodule."} +{"pid": "TCGA-VM-A8C8", "report": "A resection specimen from the brain/cerebrum was received in two parts. The first specimen, submitted fresh for frozen section and labeled \"tumor,\" consisted of an aggregate of pink-tan soft tissue fragments measuring 1.3 x 1.0 x 0.2 cm. A representative section was used for frozen section analysis, and the remainder was submitted in cassettes 1FA and 1A. The second specimen, received in formalin and also labeled \"tumor,\" consisted of an aggregate of pink-tan, irregular soft tissue fragments measuring 2.2 x 1.2 x 0.5 cm, and was entirely submitted in cassette 2A.\n\nMicroscopic evaluation confirmed the initial frozen section finding. Histologic assessment showed features consistent with a diffuse glioma. The histologic grade was determined to be WHO grade II. Immunohistochemical staining demonstrated a proliferation index of up to 10% by MIB-1 labeling. Molecular testing for IDH-1 showed diffuse positivity, suggesting mutation in the gene. Fluorescence in-situ hybridization (FISH) analysis for 1p and 19q deletions was performed on sections from block 2A. The calculated 1p/1q ratio was 0.98 (reference <0.74 for deletion), and the 19q/19p ratio was 0.90 (reference <0.88 for deletion), both interpreted as not deleted. Methylation-specific PCR of the MGMT gene promoter region was performed, and gene methylation was detected with a methylation score of 27.13 (reference value: unmethylated <2.00, methylated \u22652.00). The MGMT result suggests potential sensitivity to alkylating agents. All ancillary studies were conducted as part of clinical decision-making support, and no changes were made to the original microscopic diagnosis."} +{"pid": "TCGA-HC-8262", "report": "The surgical specimen included bilateral pelvic lymph nodes, a left lateral margin biopsy, and a prostate gland from a radical prostatectomy. The lymph nodes, numbering eight in total, showed no evidence of metastatic disease. The left lateral margin consisted of benign fibrovascular and fibromuscular tissue with nerve bundles, and no malignancy was identified. The prostate measured 5.0 x 3.1 x 3.0 cm and showed involvement of both lobes with less than 5% of the sampled tissue affected. Histologic evaluation revealed a high-grade component with primary and secondary patterns of 4. No extraprostatic extension or seminal vesicle involvement was observed. Lymphovascular space invasion was not present, although a perivascular growth pattern was noted without intraluminal neoplasm. High-grade prostatic intraepithelial neoplasia was present and there was evidence of perineural invasion. Treatment effect was not identified. Surgical margins were negative at the apical, bladder, and prostatic soft tissue margins; however, the right posterior mid-prostate margin was within 1.5 mm of the lesion. Additional findings included benign prostatic hyperplasia. The pTNM classification was T2c Nx Mx. All lymph nodes examined were negative for metastasis. The prostate was submitted in multiple sections for analysis, with no discrete mass identified but some focal induration noted in the left posterior region."} +{"pid": "TCGA-DK-A3IK", "report": "The submitted specimens include multiple lymph node groups from the right and left common iliac, pelvic, and pre-sacral regions, as well as tissue from the bladder, prostate, seminal vesicles, vas deferens, and ureter. Histologic evaluation of the lymph nodes revealed involvement in several regions. In the right common iliac lymph nodes (frozen section), two out of two lymph nodes showed evidence of metastatic involvement with a largest focus measuring 0.9 cm; extranodal extension was present. In the left pelvic lymph nodes #1 (frozen section), both lymph nodes examined contained metastatic involvement with a largest focus measuring 1 cm, and extranodal extension was also identified. The left pelvic lymph nodes #2 were uninvolved, with six benign lymph nodes identified.\n\nIn the right common iliac lymph nodes (non-frozen), one out of three lymph nodes was involved, with a metastatic focus measuring 0.8 cm within a lymph node measuring 1.7 cm overall; extranodal extension was not present. Among the right pelvic lymph nodes, 2 out of 12 lymph nodes were involved, with a largest metastatic focus of 0.5 cm; no extranodal extension was observed. The left common iliac lymph node specimen showed involvement of one lymph node with a focus measuring 0.6 cm. The pre-sacral lymph node and both vas deferens specimens were unremarkable, showing no signs of involvement.\n\nExamination of the bladder, prostate, and seminal vesicles revealed an infiltrating growth pattern with multicentric involvement. The lesion extended into perivesical soft tissues and involved the urethra and periurethral prostatic ducts. Vascular invasion was extensive, and perineural invasion was also noted. No involvement was found at the surgical margins. Non-neoplastic findings included chronic cystitis and ulceration in the bladder mucosa. High-grade prostatic intraepithelial neoplasia was identified in the prostate. The seminal vesicles and perivesical lymph nodes were not involved. The tumor demonstrated papillary and flat non-invasive components, with clear cell and squamoid features. The pathologic stage according to AJCC 2002 criteria was pT3 for local invasion and PRis for urethral or prostatic ductal involvement without stromal invasion."} +{"pid": "TCGA-AN-A0XU", "report": "The pathology report indicates a female patient with a primary tumor located in the breast. Histological evaluation reveals infiltrative ductal morphology. The tumor was procured via surgical resection and preserved in OCT medium as a frozen block specimen. Cellular grading is classified as Grade 3. Staging assessments show no evidence of nodal or distant metastasis (T Stage 2, N Stage 0, M Stage 0). There is no prior treatment documented. A separate normal blood sample was collected via venipuncture and stored frozen in a tube for reference purposes."} +{"pid": "TCGA-BH-A1FL", "report": "The specimen from the right breast measured 7.0 x 6.0 x 1.7 cm and showed atypical ductal epithelial hyperplasia along with microcalcifications. The left breast specimen was 4.0 x 2.0 x 1.8 cm and demonstrated infiltrating ductal carcinoma with extensive lobular features and nuclear grade. The tumor approached but did not extend to the anterior surgical margin (<1 mm in plane of section), and also approached but did not extend to the posterior surgical margin (<1 mm in plane of section). A total of 22 lymph nodes were examined from the left axilla, of which 4 were positive for tumor involvement, including 2 identified in deeper sections and confirmed with immunostaining (CAM 5.2). Tumor was also noted outside of the lymph node structures. The staging is T2 with nodal involvement, and histologic grade 2."} +{"pid": "TCGA-BH-A18Q", "report": "The specimen from a left total mastectomy and axillary dissection was submitted for analysis. Axillary lymph node evaluation revealed two involved nodes out of a total of twenty-five. The primary lesion measured 3.0 x 2.5 x 0.7 cm and was located in the lower outer and lower inner quadrants of the breast. Histologic evaluation showed a poorly differentiated infiltrating ductal component with a Nottingham score of 8/9, composed of nuclear grade 3, tubule formation grade 2, and mitotic count grade 3. Microcalcifications were identified in association with the lesion. All resection margins, including nipple and skin, were free of involvement. Additional findings included fibrocystic changes with duct ectasia, radial scar, and sclerosing adenosis. Immunohistochemical staining showed no nuclear staining for estrogen or progesterone receptors. HER-2 immunostaining demonstrated weak to moderate complete membrane staining in more than 10% of cells, interpreted as weakly positive (score 2+). A FISH study for Her-2 was ordered for further evaluation."} +{"pid": "TCGA-FE-A233", "report": "The specimen was obtained via total thyroidectomy and consists of two lobes. The right thyroid lobe weighed 10.55 grams and measured 4.5 x 2.5 x 1.8 cm. It was oriented with stitches marking the superior and inferior poles, and inked for identification: superior half in blue, inferior half in black, and isthmic margin in yellow. On sectioning, a pale tan granular mass measuring 2.3 x 2.2 x 1.5 cm was identified in the superior half of the right lobe. The mass was located 1.5 cm from the isthmic margin and focally extended to the blue-inked external surface. No encapsulation, hemorrhage, or necrosis was observed. Adjacent thyroid tissue appeared normal. No lymph nodes or parathyroid glands were identified.\n\nThe left thyroid lobe weighed 7.6 grams and measured 4.2 x 3.3 x 2.0 cm. Its external surface was dark pink and focally shaggy. Sectioning revealed red-brown thyroid parenchyma without discrete lesions. No lymph nodes or parathyroid glands were present.\n\nHistologic examination of the right lobe showed no lymphatic or vascular invasion, no capsular invasion, and no multifocal disease. The lesion was confined entirely within the thyroid gland. No tissue was submitted for lymph node evaluation. Staging was determined as pT2 Nx Mx. Multiple cassettes were processed from both lobes for microscopic analysis."} +{"pid": "TCGA-IE-A6BZ", "report": "The excised mass from the right buttock measured 19 x 11 x 8 cm and was located deep within the soft tissue. The cut surface of the mass was tan, soft, lobulated, and heterogeneous with areas of hemorrhage and necrosis, which accounted for approximately 30% of the tumor volume. The mass was well delineated and showed close proximity to the surgical margins. Microscopically, the cellular composition was high grade, with a mitotic count of 15 per 10 high-power fields. Histologic evaluation revealed an undifferentiated morphology without specific lineage differentiation. The distal margin was involved at 0.3 cm, while the proximal margin was free of involvement. Based on pathologic staging, the primary tumor was classified as pT2b. No regional lymph nodes were identified for assessment, and no additional pathological findings were noted. Ancillary studies including immunohistochemistry, cytogenetics, and molecular testing were not performed. Radiographic findings and preoperative treatment history were unavailable."} +{"pid": "TCGA-77-7337", "report": "The left lung specimen measures 200 x 165 x 60 mm in the inflated state. A fibrous and fatty adhesion is noted at the apex of the upper lobe, involving a scarred area approximately 35 mm in diameter. Over the mediastinal aspect of the upper lobe, there is a roughened pleural surface measuring up to 50 mm in maximum dimension, beneath which a lesion is palpable. The lesion measures 55 mm in maximal dimension, appears poorly circumscribed, soft, and grey-black with central necrosis. It extends to the pleura on the hilar surface and within the oblique fissure. The lesion arises from a segmental bronchus, likely the apicoposterior bronchus of the upper lobe, and is well clear of the bronchial resection margin. Surrounding lung tissue between the lesion and the apex of the upper lobe shows induration, while the basal portion of the lobe demonstrates collapse. Fatty tissue inferior to the bronchial margin contains multiple small black lymph nodes. Larger black lymph nodes measuring up to 35 mm are present superior to the bronchial margin. In the lower lobe, black lymph nodes are observed around major segmental bronchi; no significant abnormalities are seen in the parenchyma except for a small 10 mm area suggestive of haemorrhage near the base.\n\nHistologically, sections reveal a moderately differentiated keratinising epithelial lesion completely occupying a segmental bronchus. There is no evidence of lymphatic or vascular invasion; however, direct extension into several hilar lymph nodes is noted. The lesion does not involve the pleura or the bronchial resection margin. Lung tissue distal to the lesion shows marked secondary obstructive changes, including active airway inflammation and organising pneumonia. No significant pathology is identified in the lower lobe samples.\n\nLymph node specimens inferior to the left main bronchus and those superior to it were sampled across multiple blocks. Histologic evaluation of these lymph nodes reveals reactive changes without evidence of malignant involvement. The largest lymph node specimen measured 35 mm in maximum dimension. Additional lymph nodes sampled around the bronchus and at various anatomical locations showed similar findings.\n\nNo tumour involvement was detected in the sampled lymph nodes, including those designated as station 5. These specimens consisted of rubbery dark-brown tissue measuring up to 10 mm in maximum dimension. Microscopic examination revealed only reactive lymphoid changes.\n\nAll margins, including the bronchial resection margin and pleural surfaces, are free of the lesion. Based on extent of spread and lymph node involvement, staging data has been assigned accordingly."} +{"pid": "TCGA-BH-A0AZ", "report": "The specimen consists of a right breast total mastectomy. Multiple foci of invasive carcinoma are present, with the largest measuring 2.5 x 2 x 2.1 cm. Additional foci measure 1.5 x 1.3 x 1 cm, 0.7 x 0.6 cm, and 0.6 x 0.5 cm. The combined size of all invasive foci totals 5.3 cm. Histologic evaluation shows ductal adenocarcinoma with a Nottingham score of 6 out of 9 (tubules 2, nuclei 2, mitoses 2), corresponding to grade 2. No lymphovascular invasion is identified.\n\nA component of in situ carcinoma is present admixed with the invasive tumor. This component is cribriform type, nuclear grade 2, and accounts for less than 1% of the overall tumor volume. Surgical margins, including the nipple and skin, are free of tumor. Changes related to a prior core biopsy are noted. Additional findings include a fibroadenoma and fibroadenomatoid nodular changes, as well as fibrocystic changes with duct ectasia, ductal epithelial hyperplasia, and columnar cell changes.\n\nImmunohistochemical staining demonstrates positivity for estrogen and progesterone receptors. HER-2/neu staining is equivocal (score +2) by immunohistochemistry; fluorescence in situ hybridization (FISH) does not show amplification.\n\nSentinel lymph node biopsy reveals one involved lymph node with metastatic adenocarcinoma, and extracapsular extension is present. The largest metastatic deposit measures 10 mm in diameter. A total of 13 lymph nodes are examined: one sentinel lymph node is positive, and 12 others (including three from the right axillary sentinel #3, three from the right internal mammary, and three additional right axillary nodes) are negative for metastasis. The method of lymph node examination includes hematoxylin and eosin (H&E) staining.\n\nNon-neoplastic breast tissue shows fibroadenoma and fibrocystic disease. The surgical procedure performed was a simple mastectomy, involving the upper and lower outer quadrants. Pathologic staging is pT2, pN1, pMX."} +{"pid": "TCGA-P3-A5QA", "report": "A right partial glossectomy specimen was received, measuring 4.3 cm in greatest dimension. The mucosal surface measured 4.2 cm by 2.6 cm and showed an ulceration centrally located, measuring up to 1.6 cm in greatest dimension. This lesion was found approximately 0.4 cm from the lateral mucosal resection margin. Upon sectioning, a white, firm lesion measuring 2.7 cm by 1.8 cm was identified, extending to within 0.2 cm of the deep margin, 0.3 cm of the blue mucosal margin, 0.5 cm of the red mucosal margin, 0.8 cm from the green mucosal margin, and approximately 1 cm from the closest black mucosal margin. Histologic evaluation revealed a moderately to poorly differentiated invasive cellular proliferation arising within a background of high-grade intraepithelial changes. No lymphovascular invasion was identified. Margins were assessed with the closest distances noted above; all margins were free of in-situ changes. A minimum pathologic stage of pT1 NX MX was assigned according to the AJCC 6th edition (2002). Additional biopsies from anterior, lateral, posterior, medial, anterior deep, and posterior deep regions were negative for any in-situ or invasive cellular abnormalities. Intraoperative consultation of all submitted specimens was negative for malignant involvement."} +{"pid": "TCGA-FD-A3B3", "report": "The surgical specimens were received and processed as described. The right pelvic lymph node dissection included multiple soft tissue fragments measuring 6.5 x 3 x 1 cm, with lymph node candidates ranging from 0.9 cm to 5.5 cm in size. Four lymph nodes were evaluated and none showed any abnormal cellular infiltration. Similarly, the left pelvic lymph node dissection contained fibrofatty tissue measuring 6 x 4.5 x 1.5 cm, with lymph node candidates between 0.9 cm and 2 cm. Four lymph nodes were identified and examined, all without evidence of abnormal cells.\n\nThe bladder specimen weighed 167.1 g and measured 15 x 13.3 x 2.8 cm. The ureteral stumps were patent, with the right measuring 3.5 cm in length and the left 1 cm. On gross examination, there was an ulcerated and necrotic lesion on the right lateral wall and trigone measuring 3.8 x 2.2 cm. A second superficial ulcerated lesion measuring 1.5 x 0.9 cm was observed near the left trigone. Upon sectioning, the larger lesion extended into the muscularis propria with a depth of 1.1 cm and was 0.9 cm from the deep margin. Surrounding mucosa appeared edematous and uniformly thick at 1.0 cm. Other areas including the bilateral ureteral orifices were unremarkable.\n\nHistologic evaluation revealed ulceration, necrosis, inflammation, and multinucleated giant cell reaction in the urinary bladder mucosa, consistent with prior biopsy changes. No lymphovascular invasion was identified. Resection margins\u2014including soft tissue, urethra, and both ureters\u2014were free of abnormal cells. Additional sections from various bladder regions (left lateral wall, right lateral wall, trigone, anterior wall) were submitted for analysis.\n\nThe ovaries and fallopian tubes were also evaluated. One fallopian tube measured 4.1 cm in length with a 0.9 cm diameter; the attached ovary measured 3 x 2.5 x 1 cm and showed no significant pathology. The opposite fallopian tube was 3 cm long and 0.5 cm in diameter, with an attached ovary measuring 2.5 x 2 x 1 cm. Fibrotic changes were noted in ovarian parenchyma, and small yellow nodules were present in the peritubal region. No malignant findings were identified in these specimens.\n\nA segment of the right ureter measuring 0.9 cm in length and 0.5 cm in diameter was also submitted for examination. Margins were clearly marked and embedded for evaluation. No abnormal cells were found in this specimen.\n\nIn total, eight lymph nodes were evaluated across both pelvic dissections and none contained any abnormal cells. Multiple sections of the bladder were analyzed for tumor presence and distribution. All submitted margins were negative. Based on pathologic staging criteria, the depth of invasion reached perivesical adipose tissue. The lesion was multifocal with a maximum dimension of 3.8 x 2.2 cm."} +{"pid": "TCGA-BR-6706", "report": "The specimen consists of a subtotal gastrectomy. The tumor is located in the stomach and measures 7.5 x 0 x 8.5 cm. It demonstrates an ulcerated appearance. Microscopic evaluation shows poorly differentiated cellular features. The tumor extends to the subserosa. Fifteen lymph nodes were examined, with five showing involvement (from the lesser and greater curvature omentum). No venous invasion is identified. Lymphatic and perineural invasion status are not specified. Surgical margins are free of involvement. There is no evidence of neo-adjuvant treatment effect. No additional pathologic findings are noted."} +{"pid": "TCGA-DX-AB2Z", "report": "The submitted specimen consists of an oriented portion of soft tissue from the right thigh, measuring 14 x 9 x 7.5 cm, with an attached ellipse of skin measuring 14 x 2.5 cm. The specimen was inked with multiple colors to identify margins. A well-circumscribed, solid, tan-colored mass measuring 6.3 x 5.6 x 4.5 cm was identified within the tissue. This mass was located 0.2 cm from both lateral and medial margins, 0.5 cm from the deep margin, 1.5 cm from the superior margin, 2.5 cm from the inferior margin, and 2.8 cm from the skin surface.\n\nThe central region of the mass contained a 1 cm yellow discoloration, representing less than 5% of the total volume, indicating minimal necrosis. Additionally, there was a 2 x 1.6 x 1.4 cm firm, fibrous, white area located in the medial aspect of the mass, accounting for approximately 10% of its volume. Representative sections were taken from all margins and the surrounding tissue.\n\nMicroscopic evaluation showed that all surgical margins were free of involvement, with the closest clearance being 0.2 cm at the lateral and medial aspects. The mass demonstrated a storiform growth pattern and pleomorphic features, with the majority of the tumor showing viable morphology. There was a focal dense lymphoid infiltrate adjacent to the tumor, which was further characterized by immunostains. These studies revealed the infiltrate to be predominantly composed of CD3-positive T cells with scattered CD20-positive B cells, consistent with a reactive process. All findings were confirmed upon review."} +{"pid": "TCGA-BP-5192", "report": "The right kidney specimen measured 4.2 x 4.0 x 2.7 cm and contained a well-circumscribed, partially cystic, hemorrhagic brown-tan lesion measuring 2.7 x 2.5 x 2.1 cm. The lesion was located 0.1 cm from the inked resection margin and extended to the capsular surface but did not grossly involve the perinephric fat. Histologically, the lesion demonstrated nuclear features corresponding to grade II/IV. No local invasion or vascular invasion was identified. The surgical margins were free of involvement. A separate biopsy from the deep surgical margin #2 consisted of a 1.3 x 0.7 x 0.6 cm piece of renal tissue; tumor was present on one surface with the other surface free of disease. All representative sections were submitted for evaluation. The tumor was confined to the kidney and measured less than 7.0 cm in greatest dimension. Non-neoplastic kidney tissue was unremarkable. No adrenal or lymph node tissue was identified."} +{"pid": "TCGA-EO-A3AV", "report": "The specimen included lymph nodes from the left external iliac region, which showed evidence of involvement. The uterus measured 9.4 cm \u00d7 7.4 cm \u00d7 6.0 cm and contained a tumor mass within the endometrial cavity measuring 5.0 cm \u00d7 4.0 cm \u00d7 3.5 cm. The tumor extended from the fundus to the lower uterine segment and demonstrated invasion into the outer half of the myometrium, with at least 2 cm distance from the serosal surface. Lymphovascular space invasion was present in extensive areas. No cervical involvement was identified, although the tumor reached the lower uterine segment. Adenomyosis was also noted. The ovaries and fallopian tubes did not show signs of direct tumor involvement; however, endometriosis was identified in the ovaries.\n\nLymph node assessment revealed that four out of twenty-four nodes from the right pelvic region were involved, and the single node from the right common iliac region was also involved. In contrast, all seven nodes from the left pelvic region and all three nodes from the left para-aortic region showed no evidence of involvement. A total of 33 pelvic lymph nodes were examined, with six found to be positive, while none of the three para-aortic lymph nodes were affected.\n\nHistologic evaluation showed a high-grade lesion based on FIGO criteria, with more than 50% myometrial invasion. Surgical margins were free of invasive disease. Immunohistochemical analysis indicated positivity for ER and negativity for p53 and p16. The procedure performed was a simple hysterectomy with bilateral salpingo-oophorectomy and lymph node sampling from pelvic and para-aortic regions. The integrity of the hysterectomy specimen was intact."} +{"pid": "TCGA-UY-A78P", "report": "The patient is a woman who presented with gross hematuria and underwent a radical cystectomy with resection of the uterus, vagina, bilateral tubes, and ovaries. The specimen was received in seven parts. Parts A\u2013C were fresh, while D\u2013G were in formalin.\n\nPart A consisted of a segment of ureter measuring 0.5 x 0.4 x 0.3 cm and was submitted entirely for frozen section diagnosis as FS1. Part B included a segment of ureter and fibroadipose tissue measuring 1.2 x 0.4 x 0.3 cm; only the ureter was submitted for frozen section diagnosis as FS2. Part C contained the bladder, uterus, adnexae, and vagina. The entire specimen weighed 385 grams. The bladder measured 7.5 x 7 x 2 cm and contained a lesion measuring 2.0 x 2.5 cm with a depth of 1.0 cm located adjacent to the right ureteral orifice. It was confined to the bladder without extension beyond the bladder wall and was 5 cm from the urethral margin. The bladder mucosa appeared gray-brown and edematous with no ulcerations, polyps, or masses identified. The urethra measured 3.5 cm in length and 1.5 cm in diameter. The right ureter measured 1.5 x 0.5 cm and the left ureter measured 1.3 x 0.5 cm. The vaginal cuff measured 0.9 cm in greatest dimension. The uterus measured 9 cm from fundus to cervix, 6.5 cm cornu to cornu, and 2.5 cm anterior to posterior. The right ovary measured 3 x 2 x 1 cm and showed corpora lutea on cut section; the left ovary measured 3.0 x 2 x 1.0 cm and revealed a white rim on cut section. The right fallopian tube measured 2.5 x 0.5 cm and the left fallopian tube measured 4.0 x 0.5 cm. The cervix showed nabothian cysts but no other lesions. The endometrium measured 0.1 cm and the myometrium measured 1.5 cm.\n\nParts D and E consisted of right and left pelvic lymph nodes. The right lymph node specimen measured 7 x 6.5 x 1.2 cm and contained multiple candidate lymph nodes ranging from 0.2 to 2.5 cm. The left lymph node specimen measured 7 x 4.8 x 2.5 cm in aggregate and contained multiple candidate lymph nodes ranging from 0.1 to 2.5 cm.\n\nParts F and G consisted of distal left and right ureters respectively. The distal left ureter measured 1.3 cm in length and 0.4 cm in diameter. The distal right ureter measured 1.5 cm in length and 0.5 cm in diameter.\n\nFrozen section analysis of the right and left distal ureteral margins showed no tumor involvement. Final histologic examination confirmed absence of tumor at all surgical margins including ureteral, urethral, and vaginal cuff. Examination of lymph nodes showed no metastatic involvement.\n\nMicroscopic evaluation of the bladder lesion demonstrated invasion into the outer half of the muscularis propria without lymphatic or vascular invasion. No epithelial abnormalities were identified elsewhere in the bladder. Adjacent organs showed no involvement. Other findings included atrophic endometrium and inclusion cysts in the ovaries. No significant pathologic abnormalities were identified in the myometrium, uterine serosa, cervix, or fallopian tubes."} +{"pid": "TCGA-VS-A8EG", "report": "The biopsy specimen from the cervix shows a neoplastic process involving both squamous and glandular components. The tissue sample contains atypical cells with features suggestive of malignancy, including increased nuclear size, hyperchromasia, and altered nuclear-to-cytoplasmic ratios. The architecture demonstrates disorganization and abnormal maturation patterns. Invasion could not be definitively evaluated due to limitations in the sample. Tumor dimensions and depth of involvement, if present, cannot be determined from this material. No lymphovascular space invasion is identified. The histologic grade is moderate. Specimen margins are uninvolved. No definitive staging can be assigned based on this sample alone."} +{"pid": "TCGA-SL-A6J9", "report": "The specimen demonstrates a lesion with histologic features characterized by greater than 50% nonsquamous solid growth pattern and areas exhibiting high-grade nuclear cytologic atypia. The extent of involvement is confined to the uterine corpus with pathologic staging classified as pT1b, with no lymph node metastases identified (pNO) and indeterminate distant metastasis status (pMx). Additional findings include benign cervical changes consisting of mild chronic cervicitis with squamous metaplasia. A benign leiomyoma and adenomyosis are also present in the uterus. The bilateral fallopian tubes show no significant histopathologic abnormalities. Immunohistochemical staining reveals intact expression of MLH-1, MSH-2, MSH-6, and PMS-2 in the nuclei of the neoplastic cells, suggesting microsatellite stability. There is no evidence of cervical invasion by the neoplasm."} +{"pid": "TCGA-73-4666", "report": "The specimen includes lymph node samples from the 4R right distal paratracheal, 4L left distal paratracheal, level 7, and 2R right proximal paratracheal regions, along with a right upper lobe lung specimen. The lymph nodes were small soft tissue fragments ranging in size from 0.2 cm to 0.9 cm and were all negative for tumor involvement. The right upper lobe measured 16.0 x 14.0 x 3.0 cm and contained a gray-white, well-circumscribed mass measuring 2.0 x 1.7 x 1.5 cm located 0.4 cm beneath the pleural surface and 4.0 cm from the bronchial margin. The bronchial margin was uninvolved. Five hilar lymph nodes were identified, ranging in size from 0.2 cm to 0.9 cm; all were negative for tumor. Multiple small nodular areas were noted near the pleural surface, with the largest measuring 0.4 cm. A separate gray-white discolored area on the pleural surface measured 3.4 x 2.0 cm. Histologic evaluation of the mass showed mucin-positive cells. Sections of the mass, lymph nodes, bronchial margin, and surrounding lung tissue were submitted for analysis. Additional findings included focal pleural fibrosis and focal atypical alveolar cell hyperplasia. No angiolymphatic invasion or satellite tumors were identified. The tumor was classified as poorly differentiated and located in the mid-lung field without visceral pleural involvement. Lymph node staging showed no evidence of metastasis (N1: 0/4, N2: 0/3, N3: 0/1). The pathological stage was pT1, MX."} +{"pid": "TCGA-BJ-A0ZF", "report": "The thyroid specimen weighed 28 grams and was obtained via total thyroidectomy. A dominant nodule measuring 2.5 cm was identified in the right lobe. Histologic evaluation revealed a well-circumscribed lesion with areas of penetration through the surrounding capsule. The tumor cells exhibited characteristic morphology consistent with follicular lineage, including uniform nuclei, moderate cytoplasm, and follicular architecture. No evidence of angiolymphatic or extrathyroidal invasion was observed. Surgical margins were free of neoplastic involvement. In addition to the main lesion, two smaller foci measuring 0.2 cm and 0.8 cm were identified in the right and left lobes, respectively, displaying nuclear features typically seen in a papillary growth pattern. A background of chronic lymphocytic thyroiditis was also noted. One normocellular parathyroid gland was attached to the right lobe.\n\nMolecular analysis was performed on formalin-fixed, paraffin-embedded tissue using manual microdissection to enrich for tumor cells. Only samples containing at least 50% tumor cells were included. Real-time PCR was used to assess for mutations in BRAF (codons 599\u2013601), NRAS (codon 61), HRAS (codon 61), and KRAS (codons 12/13). Post-PCR melting curve analysis was used to screen for mutations, with Sanger sequencing used for confirmation when necessary. No mutations were detected in BRAF, NRAS, HRAS, or KRAS. Fluorescence in situ hybridization (FISH) testing for RET/PTC rearrangement was also performed. Analysis showed no evidence of RET/PTC, RET/PTC1, or RET/PTC3 rearrangements. Trisomy of chromosome 10 was observed, which may account for the apparent signal pattern in some cells but does not indicate a true rearrangement.\n\nStaging was determined based on histopathologic findings. The primary lesion was classified as pT2 based on its size and presence of capsular invasion. No regional lymph node dissection was performed; therefore, nodal staging could not be determined (pNX). Distant metastasis could not be assessed. Lymphovascular invasion was not identified. Additional findings included chronic inflammation within the thyroid parenchyma and the presence of two small incidental lesions with nuclear characteristics similar to those seen in a papillary growth pattern, located in both lobes. \n\nIn situ hybridization and molecular testing were conducted to further characterize the genetic profile of the lesion. These studies did not identify any of the common genetic alterations associated with aggressive behavior or malignancy in thyroid tumors."} +{"pid": "TCGA-BH-A18U", "report": "The patient is a female. A total mastectomy and sentinel node biopsy were performed. Two lesions were identified in the left breast: one measuring 2.6 x 1.7 x 1.5 cm located in the lower outer quadrant, and another measuring 3.0 x 2.8 x 2.5 cm in the upper outer quadrant. Histologic evaluation showed a Nottingham score of 9 out of 9 (tubules 3, nuclei 3, mitosis 3). Lymphovascular invasion was present. There was also ductal carcinoma in-situ, solid type, nuclear grade 3, with comedo-type necrosis, comprising less than 5% of the lesion. Surgical margins were negative for invasive or in-situ disease; however, the infiltrating component approached very closely to the margin of excision in the lower outer quadrant, within 0.2 cm. The nipple was free of tumor. Changes consistent with a prior core biopsy were noted.\n\nTwo lymph nodes were positive for metastatic disease. In the sentinel lymph node biopsies, two out of three nodes were positive. In the axillary lymph node dissection, five out of eleven nodes were involved, with extracapsular extension identified in three of them.\n\nIn the right breast tissue, findings included focal atypical ductal hyperplasia associated with microcalcifications, a calcified fibroadenoma, fibrocystic changes with microcalcifications, sclerosing adenosis, and a sclerosing intraductal papilloma. The skin was unremarkable.\n\nImmunohistochemical analysis demonstrated ER positivity with variable staining intensity (0: 20%, 1+: 30%, 2+: 30%, 3+: 20%) and PR positivity (0: 70%, 1+: 10%, 2+: 10%, 3+: 10%). HER-2/neu testing by DAKO HercepTest showed strong complete membrane staining in more than 10% of cells, interpreted as strongly positive (score 3+). Additional immunostains for E-cadherin and myosin heavy chain were performed to support the interpretation of the right breast findings."} +{"pid": "TCGA-VM-A8CE", "report": "Sura Path Final Report. Clinical history includes a lesion in the left hemisphere of the brain. Two specimens were received. The first specimen, labeled \"brain tumor - glioma\", consisted of a 2.5 x 1.8 x 1.1 cm piece of white tissue, with half used for frozen section analysis and the remainder submitted for further evaluation. The second specimen, also labeled \"brain tumor - glioma\", was a 3.5 x 3.5 x 1.5 cm fragment of pink-grey tissue with a uniform cut surface; no discrete nodules were observed. Representative sections were submitted for microscopic examination.\n\nMicroscopic evaluation revealed features consistent with a neoplastic process involving glial cells. Histologic grading was performed, and the tumor was classified as a low-grade variant. Tumor dimensions were recorded with a maximum size of 3.5 cm. The location of the lesion was within the cerebrum. Margins could not be assessed due to the nature of the biopsy procedure.\n\nAncillary studies were conducted, including fluorescence in-situ hybridization (FISH) analysis on selected tissue sections. Deletions of chromosomes 1p and 19q were evaluated. The calculated 1p/1q ratio was 0.57 (threshold <0.74 for deletion), and the 19q/19p ratio was 0.55 (threshold <0.88 for deletion). These findings were interpreted as showing deletions of both 1p and 19q, which are associated with a more favorable clinical course.\n\nA synoptic report was completed, noting the histologic type and grade, tumor site, and molecular findings. No TNM staging system was applicable. There was no known history of prior tumors or familial syndromes. A consultation was obtained, and the findings remained consistent upon review. Additional studies are pending."} +{"pid": "TCGA-RE-A7BO", "report": "The resected specimen includes an oesophago-gastrectomy with a proximal stomach segment. The oesophagus measures 40 mm in length and 25 mm in diameter, while the attached stomach shows a lesser curve length of 30 mm and a greater curve length of 90 mm. An L-shaped resection margin is present measuring 100 x 40 mm. At the oesophago-gastric junction, a polypoid lesion measuring 55 x 30 x 30 mm is identified. The lesion is located 20 mm from the proximal margin and 50 mm from the distal margin. On sectioning, the lesion infiltrates into the submucosa without reaching the muscularis propria. Adjacent oesophageal mucosa shows irregular areas of velvety appearance consistent with Barrett\u2019s change. The gastric mucosa appears unremarkable.\n\nLymph nodes are present within the perioesophageal and omental tissues, with sizes up to 12 mm. Several show grey discoloration on sectioning. The gallbladder measures 130 mm in length and 50 mm in diameter and contains multiple black granular calculi up to 6 mm. The mucosa is unremarkable, and the wall thickness is 1\u20132 mm with a smooth serosal surface.\n\nHistologically, the lesion demonstrates poorly differentiated cells with mucinous features. The growth pattern includes exophytic and papillary components, along with irregular glands, cords, and clusters of cells floating in mucin pools. Nuclear pleomorphism, hyperchromasia, prominent nucleoli, and moderate cytoplasmic volume are noted. Mitotic figures are moderately present. The lesion has a lobular configuration and extends into the submucosa, approaching but not breaching the muscularis propria. No definite lymphovascular or perineural invasion is observed. A mixed inflammatory infiltrate is present around the lesion. Resection margins are free of abnormal cells. The adjacent oesophageal mucosa shows extensive intestinal metaplasia of the specialized type, with both low- and high-grade dysplasia; low-grade changes extend to the proximal resection margin. The stomach shows minimal chronic gastritis, and no *Helicobacter* organisms are seen.\n\nIn the lesser omentum, 6 lymph nodes are identified, 2 of which contain metastatic deposits. In the greater omentum, 16 lymph nodes are found, none of which show involvement, although one node demonstrates extranodal extension measuring 17 mm. The gallbladder shows mild chronic cholecystitis with no evidence of malignancy."} +{"pid": "TCGA-DU-A5TP", "report": "The specimen consists of brain tissue from the right parietal region, obtained via biopsy and excision. Histologic examination reveals a moderately pleomorphic infiltrating glial tumor. The nuclei are predominantly angular and irregular with hyperchromasia; some rounder nuclei are also present. Areas of increased mitotic activity are noted, particularly in regions of higher cell density. The Ki-67 labeling index is approximately 10% overall, with focal areas approaching 45%. Immunohistochemical staining with an experimental antibody for the R132H IDH1 mutation is positive, with appropriate control reactivity.\n\nMolecular studies were performed on extracted nucleic acids. PCR analysis for the EGFRvIII mutation was negative. Testing for allelic loss on chromosome arms 1p and 19q showed loss on 19q but not on 1p. The MGMT promoter methylation assay showed no evidence of methylation.\n\nIntraoperative consultation identified a high-grade glial neoplasm based on frozen section and smear preparations. The tumor was sampled under formalin fixation, and the number of tissue fragments was unspecified. Specimen processing included cassette embedding for further histologic evaluation."} +{"pid": "TCGA-A4-A5Y1", "report": "The specimen consisted of a left kidney measuring 14.5 x 8 x 7 cm and weighing 386 grams. A tumor measuring 5.5 x 5 x 4.3 cm was identified in the mid-pole region, with no involvement of the upper or lower poles. The tumor appeared friable, tan-pink, and hemorrhagic. It abutted the fibrous renal capsule but did not invade the perinephric fat or renal vein. Invasion of small non-muscularized veins within the renal sinus was noted, though there was no definitive invasion of the renal sinus fat. The ureter measured 3.5 x 0.7 cm. Margins were assessed as follows: Gerota's fascia at 0.3 cm, ureteral at 7 cm, hilar at 2 cm, and renal vein at 1.6 cm.\n\nMicroscopically, the tumor exhibited papillary morphology with multinodular growth. Tumor cells displayed moderately pleomorphic medium to large oval nuclei with occasional nuclear grooves and abundant eosinophilic to vacuolated cytoplasm. Areas of dense papillary formations and solid architecture were observed. Multifocal intratumoral hemosiderin deposition and cystic nodules filled with papillary tumor and blood were also present. A significant lymphocytic infiltrate was seen at the tumor periphery, extending into perinephric and renal sinus fat, and involving residual non-carcinomatous renal cortex. This infiltrate included monomorphic small lymphocytes that were diffusely positive for CD20 and BCL-2, negative for CD5 and CD23, with scattered T lymphocytes identified by CD3 and CD5 staining. BCL-6 and cyclin D1 were negative.\n\nAn omental biopsy revealed a spherical accessory spleen with normal architecture and surrounding adipose tissue involved by dense sheets and nodules of lymphoid cells consistent with those seen in the kidney.\n\nA left pelvic lymph node biopsy demonstrated involvement by both papillary carcinoma and the same lymphoid population, with near complete effacement of normal nodal architecture in non-carcinomatous areas. Controls were appropriate. All margins were negative for carcinoma."} +{"pid": "TCGA-BJ-A2P4", "report": "The specimen consists of a left thyroid lobe measuring 14 grams. A lesion measuring 3.3 cm is present and demonstrates a dominant follicular growth pattern with no extrathyroidal extension or vascular invasion identified. The closest margin is involved, with the distance from the invasive component to the margin measuring 0.1 cm. The right thyroid lobe specimens weigh 2.6 grams and 0.7 grams respectively and show benign thyroid tissue. Histologic evaluation confirms unifocal involvement of the left lobe. No lymphovascular invasion is observed. Staging indicates a primary tumor classification of pT2. No regional lymph nodes were assessed (pNX), and distant metastasis was not applicable. Prior fine needle aspiration of the left thyroid lobe showed a mutation in HRAS."} +{"pid": "TCGA-2Z-A9J9", "report": "The specimen was received in six containers. Specimen A, labeled \"11th rib,\" consisted of a portion of rib measuring 5.0 cm in length with unremarkable resection margins and a small amount of adjacent soft tissue.\n\nSpecimen B, labeled \"left adrenal gland,\" measured 7.0 x 3.0 x 1.0 cm and weighed 12.0 g. It included a moderate amount of adjacent adipose tissue. Serial sectioning revealed three irregular to ovoid, well-defined tumor masses ranging from 0.5 to 1.0 cm in greatest dimension, located in the medulla. The cut surfaces were homogenous, tan to tan-orange, without evidence of necrosis or hemorrhage. Representative sections were submitted for analysis.\n\nSpecimen C, labeled \"peritumoral fat,\" consisted of a single adipose tissue fragment measuring 2.1 x 6.5 x 0.8 cm. Serial sectioning showed no remarkable findings, and no tissue was submitted to the Tissue Procurement Laboratory.\n\nSpecimen D, labeled \"left renal tumor, left upper pole,\" was a partial nephrectomy specimen measuring 6.0 x 4.0 x 5.0 cm. It contained a moderate amount of adjacent perinephric adipose tissue. An irregular, rubbery tumor mass measuring 4.0 x 3.7 x 3.7 cm was identified, appearing bulging but not extending through the renal capsule. It was within 0.1 cm of the closest perinephric adipose margin and 0.2 cm from the closest parenchymal resection margin. A satellite nodule measuring up to 0.7 cm was found, located 0.3 cm from the closest parenchymal margin. Representative sections were submitted for frozen section and for tissue procurement.\n\nSpecimen E, labeled \"final margin\" corresponding to the left renal tumor, consisted of a small tissue fragment measuring 1.0 x 0.5 x 0.1 cm, entirely submitted for frozen section.\n\nSpecimen F, labeled \"left medial renal mass,\" was a partial nephrectomy specimen measuring 1.7 x 1.5 x 1.5 cm. A partially solid, partially cystic tumor nodule measuring 1.0 x 1.0 x 3.8 cm was identified, located 0.3 cm from the closest parenchymal resection margin. Representative sections were submitted for frozen section and further analysis.\n\nHistologic evaluation revealed a tumor composed predominantly of tubules lined by cuboidal cells, some with clear cytoplasm. Rare papillary structures were noted. Occasional foamy cells were present, and the stroma demonstrated mucin production and focal spindle cell change. No significant necrosis or mitotic activity was observed. Immunohistochemical staining showed positivity for CK7 and vimentin, and negativity for AMACR, supporting a specific histologic interpretation. A colloidal iron stain highlighted stromal mucin.\n\nTumor measurements included multiple nodules: 4.0 cm, 0.7 cm, 0.3 cm at the upper pole, and 1.0 cm medially. Nuclear grading was low. The growth pattern was predominantly tubular. The renal capsule appeared compressed but uninvolved. No vascular invasion was identified. Surgical margins were free of atypical cells. Surrounding kidney tissue showed signs of compression, glomerulosclerosis, chronic interstitial inflammation, and focal interstitial fibrosis. The adrenal gland showed nodular cortical hyperplasia without malignant features. Lymph nodes were not examined.\n\nPathologic staging was determined as T1a, NX, MX. All surgical margins were negative. No lymph nodes were evaluated."} +{"pid": "TCGA-J2-A4AG", "report": "A total of 11 lymph nodes from various regions, including peribronchial, interlobar, pulmonary ligament, and AP window areas, were examined. All lymph nodes showed no evidence of tumor involvement, with a total of 0 out of 11 being positive. A lung specimen from the left upper lobe was also evaluated. The specimen measured 14 cm and weighed 150 grams. A previously sectioned mass was identified, measuring 2.5 cm in greatest dimension. The mass was firm, gray-tan in color, and located in the left upper lobe. Histologic evaluation of the lesion showed a unifocal growth pattern and a histologic grade of 2 out of 4. No treatment effect was observed. There was no invasion of the visceral pleura, no evidence of atelectasis or obstructive pneumonitis extending to the hilum, and no lymphatic or large vessel invasion was identified. Resection margins were free of tumor. Multiple sections of the lung and associated lymph nodes were submitted for analysis, and all lymph nodes were negative. The specimen type was a lobectomy, and no tumor was seen at resection margins. A frozen section of the left upper lobe confirmed the presence of a 2.5 cm firm mass, with histologic features consistent with adenocarcinoma."} +{"pid": "TCGA-EW-A1P7", "report": "A right breast lumpectomy specimen was received, oriented with sutures. A dominant mass measuring 2.4 x 2.3 x 1.9 cm was identified microscopically. Histologic evaluation revealed a moderately differentiated infiltrating component with high nuclear grade features. There was evidence of prior therapy effect within the lesion, including fibrosis and hemorrhage at the biopsy site. Adjacent to the main lesion, high nuclear grade ductal carcinoma in situ was present in a focal distribution across 4 out of 10 slides, showing both comedo and cribriform patterns. All surgical margins were free of tumor involvement.\n\nThe histologic grade was determined using the Nottingham system, with scores assigned as follows: tubule formation was minimal (<10%), nuclear pleomorphism was marked, and mitotic count exceeded 10 per 10 high-power fields. The total score corresponded to Grade III. No venous or lymphatic invasion was identified, and no microcalcifications were observed.\n\nSentinel lymph node biopsies were performed. Sentinel node #1 and sentinel node #2 were each evaluated with frozen section and keratin immunostaining. No malignancy was identified in either lymph node. No additional tumor was found in the intraoperative assessment of the nodes.\n\nThe excised specimen measured 9 x 6.5 x 4 cm and included fibroadipose tissue. The mass was located near the anterior and superior margins but did not grossly involve any margin. Sections were taken from all margins and multiple areas of the mass for histologic analysis. Immunohistochemical staining was performed using validated laboratory protocols, with results interpreted by a pathologist. All stains were performed on formalin-fixed, paraffin-embedded tissue using an automated detection method. \n\nNo evidence of distant metastasis was identified. The final staging was based on the primary tumor size and absence of lymph node involvement."} +{"pid": "TCGA-3E-AAAY", "report": "The specimen consists of three parts. Part A includes an en bloc resection of the duodenum and head of the pancreas, measuring 14.5 x 9.5 x 5.8 cm. A palpable mass approximately 1.5 cm in size is located 0.3 cm from the pancreatic surgical margin. The pancreatic surgical margin is marked with black sutures and measures 3.0 x 1.5 cm. The cut surface of the pancreas appears yellow, and no dilated pancreatic ducts are noted at the margin. A firm, off-white, poorly circumscribed mass is identified in the head of the pancreas, abutting the bile duct and measuring approximately 1.5 cm. It contacts the anterior surface of the pancreas but does not invade the duodenal wall. Lymph nodes are present in the peripancreatic and duodenal fat, with five out of nineteen involved. The posterior surface of the pancreas is within 0.1 mm of the tumor. Part B consists of a separate resection from the body of the pancreas, measuring 3.1 x 1.5 x 1.5 cm. No tumor is identified at the new pancreatic margin or on anterior or posterior margins. Four lymph nodes show chronic lymphadenitis without tumor involvement. Part C includes a removed stent measuring 8.8 x 0.4 x 0.4 cm.\n\nMicroscopic evaluation reveals moderately to poorly differentiated epithelial cells arranged in irregular glands and infiltrating into surrounding tissue. Perineural invasion is present. In the pancreatic head and body, there are areas of atrophy and chronic inflammation. Pancreatic intraepithelial neoplasia (PanIN) lesions of grades 1A, 1B, and 2 are identified. In the distal common bile duct near the ampulla, mild dysplasia is observed. The common bile duct margin shows no evidence of malignancy. Multiple sections from various cassettes confirm that the tumor extends close to the anterior surface of the pancreas and involves the posterior retroperitoneal margin within 0.1 mm. No tumor is found at the new pancreatic margin or the common bile duct margin. Histologic staging indicates pT3 based on extension beyond the pancreas without involvement of major vascular structures. Lymph node assessment shows 5 of 23 nodes involved. Vascular invasion could not be determined."} +{"pid": "TCGA-EM-A1CT", "report": "The specimen was received from M. Facility and included multiple tissue samples. The right neck contents specimen measured 10.2 x 2.5 x 1.5 cm and contained a well-defined lesion measuring 2.6 x 2.0 x 1.8 cm near the apex, two lymph nodes measuring 1.0 x 0.4 x 0.4 cm each, and a piece of muscle. The posterior triangle right neck specimen measured 5.0 x 3.5 x 0.8 cm and contained multiple lymph nodes ranging from 0.3 to 0.5 cm. The posterior apex right neck specimen measured 3.3 x 1.7 x 0.6 cm and contained multiple small possible lymph nodes.\n\nThe total thyroidectomy specimen weighed 11.1 g. The right lobe measured 3.2 x 2.4 x 1.4 cm, the left lobe 2.9 x 2.0 x 1.0 cm, and the isthmus 2.5 x 1.5 x 0.6 cm. A nodule measuring 1.5 x 1.5 x 1.5 cm was identified in the upper pole of the right lobe. No parathyroid glands or lymph nodes were identified grossly. The right upper parathyroid biopsy consisted of a very small tan tissue fragment measuring less than 0.1 cm, which was frozen for intraoperative consultation.\n\nMicroscopic examination of the right neck contents showed one involved lymph node with cellular features including classical papillary architecture and cytomorphology. The other lymph nodes from the posterior triangle and posterior apex were not involved. The thyroid specimen showed a unifocal lesion in the right lobe with maximum dimension of 1.5 cm. The tumor was totally encapsulated, but with evidence of capsular invasion. The resection margin was positive. No perineural or extrathyroidal extension was identified. Vascular invasion was suspected in several areas but could not be definitively confirmed.\n\nA total of 22 lymph nodes were examined, with one showing involvement and extranodal extension present. Additional findings included adenomatoid nodules or nodular follicular disease, and the parathyroid glands were within normal limits. The procedure performed was a total thyroidectomy with right neck dissection, and the specimen integrity was intact. Based on AJCC/UICC TNM staging (7th Edition), the primary tumor was classified as pT1b, and regional lymph node involvement as pN1b. Distant metastasis was not applicable."} +{"pid": "TCGA-AA-3845", "report": "The specimen shows a poorly differentiated solid neoplasm located in the ascending colon. Histological evaluation reveals a high-grade morphology with extensive necrosis and ulceration of the inner tumor surface. There is prominent peritumorous chronic inflammation with areas of acute inflammatory activity. Lymphatic invasion is present, with carcinomatous lymphangitis confirmed. The lesion infiltrates through the layers of the colonic wall, reaching into the extramuscular subserosal adipose tissue. A total of 12 regional lymph nodes were examined and none showed involvement. No tumor was identified in the resection margins, and no evidence of peritoneal or serosal dissemination was found. Based on the available sections, the extent of primary tumor invasion corresponds to pT3, with no nodal metastases (pNO), undetermined distant metastasis (MX), presence of lymphatic invasion (L1), and complete resection (R0)."} +{"pid": "TCGA-WR-A838", "report": "A specimen from a female patient was submitted for evaluation, including multiple tissue samples from various anatomical sites. The tissues included portions of the anterior abdominal wall peritoneum, omentum, left fallopian tube and ovary, small bowel mesentery nodule, right cul-de-sac mass, pelvic peritoneum, uterus and cervix, right fallopian tube and ovary, rectosigmoid colon, small bowel tumor nodules, proximal colon, donut section, peri-appendiceal mass, small mesentery nodule, small bowel segment, right diaphragmatic pleura and partial hepatic capsule, posterior common duct lymph nodes, gallbladder, and portal peritoneum.\n\nMicroscopic examination of the omentum, left fallopian tube and ovary, small bowel mesentery nodule, right cul-de-sac mass, pelvic peritoneum, right ovary and fallopian tube, uterine serosal surface, colonic serosal surface, small bowel tumor nodules, peri-appendiceal mass, small mesentery nodule, small bowel segment, right diaphragmatic pleura and hepatic capsule, and gallbladder serosa revealed high-grade serous carcinoma involvement. No evidence of malignancy was found in the anterior abdominal wall peritoneum, the donut section of bowel, the portion of proximal colon, or the two posterior common duct lymph nodes examined.\n\nThe right ovary was noted to have a ruptured capsule; the left ovary was fragmented and measured 7.2 x 7.2 x 5.3 cm. Involvement was identified in both ovaries, the right fallopian tube, and possibly the left fallopian tube. The omental tissue showed widespread involvement. Serosal surfaces of the uterus, colon, gallbladder, and right hepatic capsule were also involved. Lymphovascular invasion was present, but no lymph node metastases were identified.\n\nGrossly, several specimens showed tan-white or pink-tan nodular areas or masses with varying degrees of hemorrhage and necrosis. The uterus contained a benign endometrial polyp and multiple leiomyomata. A cystic area within the right fallopian tube contained clear fluid, and the fimbriated end appeared involved. The gallbladder mucosa was unremarkable, with no calculi identified.\n\nPathologic staging was determined as pT3cN0Mx. This indicates peritoneal metastasis beyond the pelvis greater than 2 cm in greatest dimension without regional lymph node involvement, and distant metastasis could not be assessed. The diagnosis should be considered provisional based on available pathologic data.\n\nImmunohistochemical staining of the tumor cells showed positivity for p53 and WT-1. Intraoperative frozen section analysis of the omentum revealed poorly differentiated carcinoma, while the uterine specimen showed a benign endometrial polyp. All other relevant margins and tissues submitted were either unremarkable or without evidence of malignancy."} +{"pid": "TCGA-AO-A03R", "report": "The clinical history is provided for a female patient with prior core biopsy findings from the left breast. Specimens submitted include sentinel lymph nodes from level one of the left axilla, levels one and two of left axillary contents, level two and level three left axillary contents, and a left breast specimen.\n\nLymph node assessment reveals metastatic involvement in sentinel node #1 with extranodal capsular extension measuring less than 2 mm. Sentinel node #2 shows a 2.1 mm focus of metastatic involvement without extranodal extension; however, this finding was not confirmed on deeper sections. Sentinel node #3 was unremarkable. Excision of levels one and two of the left axillary contents identified micrometastatic involvement in one of eighteen lymph nodes examined without extranodal extension. Levels two and three lymph nodes showed no evidence of involvement.\n\nThe left breast specimen demonstrated an invasive poorly differentiated ductal carcinoma, histologic grade III, located in the upper outer and upper inner quadrants. The tumor measured 5.0 cm in its largest dimension. Ductal carcinoma in situ (DCIS) was also present, showing solid and cribriform patterns, high nuclear grade, and moderate necrosis, accounting for up to 25% of the total tumor mass and found both admixed with and separate from the invasive component. The invasive component extended 2.0 cm from the closest deep margin. No involvement of the nipple, surgical margins, or skin by invasive or in situ components was observed. Vascular invasion was extensive and perineural invasion was present. Calcifications were identified in benign breast parenchyma but not within the invasive or in situ components. Non-neoplastic breast tissue showed fibrocystic and fibroadenomatous changes as well as biopsy site alterations. Attached skeletal muscle was free of tumor involvement.\n\nAxillary lymph node evaluation totaled 26 nodes across all levels, with 3 positive nodes. Tumor staging parameters indicate T2 primary tumor size, pN1a nodal involvement, and MX for distant metastasis, corresponding to stage group IIB. Immunohistochemical analysis demonstrated ER positivity in 95% of nuclei with moderate intensity, PR positivity in less than 5% of nuclei with moderate intensity, and HER2 negativity."} +{"pid": "TCGA-XM-AAZ2", "report": "The mediastinal specimen consists of a resection measuring 10 x 10 x 6 cm and weighing 364 g. It includes an attached pericardial tissue that is tan, smooth, and ovoid, measuring 5 cm in diameter. The mass is yellow-tan, lobular, homogeneous, and firm, with a central cavity measuring 3.5 x 3 x 1.5 cm filled with clotted blood. The tumor is encapsulated, with no involvement of the resection margins. Adjacent non-neoplastic thymic tissue appears unremarkable. Microscopic evaluation reveals areas with mild architectural changes; however, these account for less than 10% of the sampled tissue. Three lymph nodes ranging from 0.1 to 1.6 cm in size were also submitted and found to be benign. All lymph node tissues were entirely examined."} +{"pid": "TCGA-E2-A150", "report": "The surgical specimens include sentinel lymph nodes from the left axilla and a wide local excision of the left breast, along with a posterior margin specimen. Sentinel lymph node #1 measured 2.5 x 2 x 1.3 cm and contained a lymph node measuring 1.5 x 1 x 0.5 cm, which was entirely submitted for analysis. Sentinel lymph node #2 measured 1.5 x 1.1 x 1.1 cm and was also fully submitted. Both lymph nodes were negative for any abnormal cellular infiltration.\n\nThe wide local excision specimen measured 8 x 7 x 5.5 cm and weighed 81 grams. It contained a firm beige mass with a granular cut surface measuring 2.5 x 2.2 x 1.5 cm located at the posterior margin. The mass was embedded in slices taken perpendicular to the margins, with multiple sections submitted for histological evaluation. The closest distance of the lesion to the posterior margin was 0.5 mm. No residual tumor was identified in the posterior margin specimen, which measured 4 x 3 x 1.5 cm and was entirely submitted.\n\nHistologically, the lesion showed features consistent with high-grade cellular changes, including a nuclear grade of 3, mitotic score of 3, and tubular score of 3, resulting in a combined score of 9. Necrotic areas were present. No vascular or lymphatic invasion was observed. Evaluation of the margins revealed no involvement.\n\nImmunohistochemical staining for hormone receptors was performed. The Allred scoring system was used, with scores calculated by summing the proportion and intensity of staining. The estrogen receptor Allred score was 0 (proportion 0, intensity 0), and the progesterone receptor Allred score was also 0 (proportion 0, intensity 0). Both markers were considered negative. HER2 immunohistochemistry was negative.\n\nPathologic staging was determined as pT2 pN0. No multifocal lesions were identified. Lymph node assessment included two sentinel nodes, both of which were free of abnormal cells."} +{"pid": "TCGA-B0-4817", "report": "The right radical nephrectomy specimen includes a lesion measuring 4.8 cm. Histologic evaluation reveals nuclear features corresponding to grade 2/4 in most areas, with focal regions demonstrating grade 3/4 characteristics. The lesion extends into the surrounding adipose tissue and renal sinus but does not involve the surrounding fascia. A thrombus is present within a major venous structure, occluding its lumen. All margins, including ureteral, vascular, and perirenal soft tissue, are free of involvement.\n\nThe non-involved kidney shows changes related to vascular sclerosis, with approximately 15% of glomeruli showing global sclerosis and only mild chronic tubulointerstitial changes.\n\nPathologic staging is determined as T3c; NX; MX.\n\nThe right adrenal gland is unremarkable and shows no signs of malignancy. The thrombus retrieved from the major venous structure is composed of material consistent with that seen in the primary kidney lesion."} +{"pid": "TCGA-QT-A5XP", "report": "The left adrenal gland specimen measured 6.7 x 5.3 x 2.8 cm and weighed 47.0 grams. A well-circumscribed mass measuring 3.8 x 2.9 x 2.7 cm was identified within the medulla, with areas of hemorrhage and focal necrosis. The tumor occupied approximately 80% of the specimen and was located less than 1 mm from the blue-inked soft tissue margin. Microscopic evaluation revealed vascular invasion at the en face vascular resection margin. Focal involvement of the peri-adrenal soft tissue margin and extension into surrounding adipose tissue were also observed.\n\nHistologic features included expanded large and confluent cellular nests, significant cellular and nuclear pleomorphism, nuclear hyperchromasia, and occasional macronucleoli. Scattered sustentacular cells were present with disruption of the sustentacular cell network. Immunohistochemical staining demonstrated diffuse reactivity for synaptophysin and chromogranin. S-100 staining showed variable moderate expression in tumor cells along with scattered sustentacular cells.\n\nA biopsy from the inferior mesenteric vein lymph node region contained only benign fibroadipose tissue without identification of lymph node or tumor elements. The intraoperative frozen section confirmed this finding. Appropriate controls were performed and supported the findings. Close clinical follow-up was advised due to the presence of atypical histologic features associated with potentially aggressive behavior."} +{"pid": "TCGA-97-7938", "report": "The surgical specimen consisted of a right upper lobectomy measuring 15.6 x 3.8 cm, along with multiple lymph node samples from levels 4, 7, and 9, an additional margin from the right upper lobe, and a segment of rib. The lobectomy specimen revealed a firm gray area measuring 1.5 x 1.5 x 1.0 cm located 4.5 cm from the staple line margin. A second separate firm gray-white area measuring 1.5 cm in greatest dimension was also identified near the staple line. Histologic examination of the primary lesion showed a predominant growth pattern consistent with lepidic architecture, along with a distinct invasive component displaying acinar and micropapillary features measuring 0.9 cm. Margins including bronchial, vascular, and parenchymal were free of involvement. No visceral pleural invasion or lymphovascular invasion was identified.\n\nSections from the hilar region contained multiple anthracotic lymph nodes ranging from 0.2 to 0.5 cm in size. Lymph nodes from levels 4, 7, and 9 were all histologically benign without any atypical or malignant cells present. The rib segment showed no abnormal findings. An additional wedge resection of the right upper lobe margin revealed no malignant cells; however, three small tumorlets with neuroendocrine-like morphology were found, spanning 3 mm, 3 mm, and 2 mm respectively.\n\nImmunohistochemical staining was positive for TTF-1 in the epithelial component of the primary lesion. Molecular studies identified a KRAS mutation (p.G12C) in exon 2, codon 12 (c.34G>T). No EGFR mutations were detected in exons 18\u201321. Special stains including AFB, GMS, and Chromogranin were performed on representative sections. Necrotizing granulomas were noted along with interstitial fibrosis and pleural fibrosis. Acid-fast organisms and fungal elements were not identified.\n\nBased on pathologic staging criteria, the tumor was classified as pT1a due to its size being less than 2 cm and surrounded by lung tissue without evidence of deeper invasion. No regional lymph node involvement was found (pN0), and there was no evidence of distant metastasis (pMx). Multiple margins and anatomical structures were evaluated and none showed signs of tumor involvement."} +{"pid": "TCGA-4G-AAZO", "report": "The specimen involves a hepatic resection measuring 17x12x10 cm, which includes a whitish nodule measuring approximately 10 cm in diameter located near the margin of resection. Histological evaluation reveals a moderately differentiated adenocarcinoma. Immunohistochemical staining demonstrates positivity for CK7 and CK19, while CK20, CDX-2, and TTF1 are negative. Adjacent liver tissue exhibits steatosis involving approximately 5% of hepatocytes and mild fibrosis (Ishak score 1-2/6). Lymph node assessment of the hepatic peduncle shows reactive lymphadenitis without evidence of metastatic involvement."} +{"pid": "TCGA-AR-A24V", "report": "The surgical specimen from the right breast shows a neoplastic lesion with associated biopsy site changes. The primary lesion measures 2.4 x 1.7 x 1.6 cm and is classified as Nottingham grade II based on histologic features, including tubule formation (2/3), nuclear pleomorphism (2/3), and mitotic count (2/3), resulting in a total Nottingham score of 7/9. A component of intraductal proliferation is present, showing solid and micropapillary patterns with intermediate nuclear grade, accounting for 5\u201325% of the tumor volume. Angiolymphatic invasion is identified. Following re-excision of the medial margin, all surgical margins are free of tumor involvement, with a minimum distance of 1.0 cm at the inferior margin. Evaluation of the right axillary sentinel lymph nodes (numbers 1 and 2) reveals one involved node with two foci of metastatic disease, measuring 0.5 mm and 1.0 mm. Immunohistochemical staining for cytokeratin on the sentinel lymph node confirms the presence of these findings."} +{"pid": "TCGA-SJ-A6ZI", "report": "A total hysterectomy with bilateral salpingo-oophorectomy, omentectomy, and bladder biopsy were performed. The hysterectomy specimen weighed 195 grams and measured 8.5 cm anterior to posterior, 8 cm from fundus to ectocervix, and 7.5 cm from cornu to cornu. The endometrial cavity contained a tan, friable, polypoid mass measuring 7.0 x 4.5 x 1.5 cm. This lesion replaced the entire endometrium and was located 3.5 cm from the anterior endo-ectocervical junction and 4 cm from the posterior endo-ectocervical junction. The mass extended to within 1.8 cm of the anterior serosal surface and 0.5 cm from the posterior serosal surface. No uninvolved endometrium was identified grossly. On sectioning, no gross invasion into the myometrium was seen on the anterior aspect, although on the posterior aspect, the lesion approached within 0.5 cm of the serosa.\n\nMultiple intramural and subserosal nodules were noted in the uterus, ranging from 0.5 to 5.0 cm in greatest dimension. These were tan-white, well-circumscribed, and whorled in appearance. No areas of hemorrhage or necrosis were observed. The cervix showed no gross abnormalities. The left adnexal unit included a 4.3 x 2 x 1.5 cm ovary and a 5.8 cm fallopian tube. The right adnexal unit included a 3.5 x 2 x 1 cm ovary and a 5.5 cm fallopian tube. Portions of each fallopian tube were missing centrally. The ovaries had tan-pink, cerebriform surfaces and unremarkable cut surfaces. The fallopian tubes had grey-purple, smooth serosa with patent lumens.\n\nLymph node sampling included pelvic and para-aortic regions. A total of 18 pelvic lymph nodes (right and left combined) were examined, with no metastatic involvement identified. Additionally, 9 para-aortic lymph nodes were evaluated, also without evidence of metastasis. One group of atypical cells was noted within a lymphatic space in the right pelvic lymph node specimen, but no definitive metastasis was present.\n\nThe omentum was received as an irregular piece of yellow-tan fatty tissue measuring 35 x 16 x 1.5 cm. No discrete nodules were identified on gross examination. The bladder biopsy specimen consisted of a small fragment of gray-tan soft tissue measuring 0.1 cm in greatest dimension.\n\nHistologically, there was evidence of myometrial invasion with a depth of 15 mm within a myometrial thickness of 20 mm. Lymphovascular invasion was present. All surgical margins were free of invasive disease. Ascitic fluid was negative for malignant cells. Additional findings included leiomyomata, chronic cervicitis with nabothian cysts, physiologic changes in the ovaries, and unremarkable fallopian tubes with Walthard rests and paratubal cysts.\n\nImmunohistochemical staining for p16 and p53 showed no reactivity. Technical components of these studies were performed using formalin-fixed, paraffin-embedded tissue with appropriate controls. The laboratory performing these tests is certified under CLIA-88 for high-complexity testing."} +{"pid": "TCGA-55-8204", "report": "The clinical history notes a lesion in the left upper lobe. The specimen included multiple lymph node stations and a lung nodule. Lymph nodes from station 7 (two separate specimens), 4L, 4R, level 6, and level 10 were all received and processed. Each lymph node specimen was small, ranging in size from 0.3 x 0.2 cm to 1.7 x 0.3 cm, and submitted entirely for evaluation. Frozen section analysis of all lymph nodes showed no evidence of abnormal cells.\n\nThe left upper lobe nodule was identified within a 10.6 x 7.2 x 3.0 cm lung wedge resection. The nodule measured 2.7 x 2.0 x 1.2 cm and was firm, gray-brown, and located beneath a focally retracted pleural surface. It was adjacent to a stapled margin, with the closest distance being 0.9 cm. A representative section of the nodule and the nearby margin were taken for frozen analysis. The remainder of the lung tissue showed emphysematous changes but no other masses.\n\nMicroscopic examination revealed a poorly differentiated cellular growth pattern with scattered lumens containing neutrophil clusters. The surrounding stroma was fibrous and inflamed. Immunostains demonstrated positivity for TTF-1, CK7, and p63, while CK20 was negative. Elastin staining confirmed invasion to the visceral pleural surface. No lymphovascular space invasion was identified. The surgical margin was free of abnormal cells.\n\nPathologic staging was determined as pT2a PL2 pNO."} +{"pid": "TCGA-CS-6670", "report": "The specimen was obtained from two anatomical sites: the temporal lobe and the insula. Gross examination of the temporal lobe specimen revealed a 4.0 x 3.5 x 1.0 cm fragment of tan-yellow soft tissue, with approximately 5% used for intraoperative consultation. The insula specimen consisted of multiple tan-pink soft tissue pieces measuring 3.0 x 2.8 x 0.5 cm in aggregate, with a representative portion also used for intraoperative analysis.\n\nMicroscopic evaluation of the temporal lobe sample demonstrated a neoplastic process characterized by relatively low cellular density. In contrast, the insula specimen showed areas with increased cellularity, focal regions of brisk mitotic activity, nuclear atypia, and microvascular proliferation. These histologic features were most prominently observed on slide 2B.\n\nImmunohistochemical staining was performed. GFAP staining showed positive reactivity in many tumor cells. P53 immunostaining revealed positivity in scattered nuclei within hypercellular zones. Ki67 immunolabeling was quantified using computer-assisted image analysis across 32,882 cells, revealing a proliferation index ranging from 4% to 9%, with an average of 5.8%.\n\nA separate molecular analysis for chromosomal status was conducted, though results are reported separately. Additional special stains and molecular assays were performed as part of diagnostic workup, including FISH studies for 1p and 19q deletions, as well as other immunohistochemical markers. Several of the assays utilized analyte-specific reagents, and their performance was validated by the laboratory.\n\nThe case was reviewed in multidisciplinary conference. Clinical history included prior surgical intervention for a low-grade glial neoplasm, although previous pathology materials were not available for review at the time of this assessment. The current findings were interpreted in context with frozen section diagnoses of infiltrative glioma from both sites, with the second specimen showing higher cellularity but no clear anaplastic features intraoperatively."} +{"pid": "TCGA-EL-A4KD", "report": "The left thyroid lobe and isthmus specimen measured 5.5 x 5.0 x 2.9 cm and included a segment of isthmus measuring 1.5 x 0.6 x 0.4 cm. A single well-circumscribed nodule measuring 4.5 x 3.5 x 2.0 cm was identified within the left lobe. The nodule had a pink-red, homogeneous cut surface with a pale-gray capsule and no hemorrhage or necrosis. No multifocal lesions were observed. The tumor focally extended into adjacent fibroadipose tissue but did not show lymphovascular invasion. Resection margins were negative, although the tumor was within less than 1 mm of the cauterized edge. No lymph nodes were identified in this specimen. Two benign intraglandular parathyroid glands were present.\n\nA left paratracheal lymph node (2.5 x 1.5 x 0.7 cm) contained metastatic involvement. No extranodal extension was identified in this lymph node.\n\nThe right inferior parathyroid gland showed hyperplastic parathyroid tissue.\n\nThe right thyroid lobe measured 5.0 x 3.0 x 1.2 cm and showed no evidence of a neoplasm.\n\nA bilateral central neck dissection specimen included multiple lymph nodes ranging in size from 0.2 x 0.2 x 0.2 cm to 1.4 x 0.8 x 0.4 cm. Of the seventeen lymph nodes evaluated, three contained metastatic involvement. There was no extranodal extension identified.\n\nThe frozen section diagnosis of the left lobe was suspicious for a follicular variant of a certain type of thyroid malignancy. The left paratracheal lymph node was consistent with metastatic involvement on frozen section. Parathyroid tissue was confirmed in the right inferior parathyroid specimen. The right thyroid lobe showed only benign thyroid tissue.\n\nAll specimens were submitted for evaluation. The case was amended to correct a prior reference to \"thigh\" in one specimen to \"thyroid.\""} +{"pid": "TCGA-HC-8256", "report": "The prostate specimen measured 12.6 \u00d7 4.1 \u00d7 3.4 cm and weighed 34 grams. Histologic evaluation revealed a lesion involving both sides of the prostate, with involvement of approximately 10% of the sampled tissue. The lesion demonstrated a histologic grade corresponding to Gleason score 3+4=7. There was no evidence of extension beyond the prostate capsule or involvement of the seminal vesicles or vas deferens. No lymphovascular or perineural invasion was identified. Surgical margins were negative, including the urethral, bladder neck, and radial margins, with the closest margin measuring 0.3 cm. No lymph nodes were identified in the specimen. Based on these findings, the primary tumor staging was classified as pT2c, with regional lymph nodes and distant metastasis not assessable (pNX, pMX). The pathologic stage was determined to be IIB. Additional findings included the presence of high-grade prostatic intraepithelial neoplasia. Gross examination noted an area of suspicious change in the right body of the prostate near the apex, measuring approximately 0.7 \u00d7 0.5 \u00d7 0.5 cm, with induration along the right to mid posterior periphery. Sections were submitted for microscopic evaluation, including representative samples of the prostate, seminal vesicles, and surgical margins."} +{"pid": "TCGA-EA-A78R", "report": "The cervix contains a solid mass measuring 4 x 3.5 x 3.5 cm. The lesion is exophytic and fills the lumen, with a soft consistency and white-gray cut surface. Microscopic examination reveals hyperplastic squamous cells that have replaced the normal epithelium and extend into the muscle layer. The tumor cells are arranged in nests, broad sheets, or trabeculae. These cells exhibit abundant, lightly eosinophilic cytoplasm and nuclei that are enlarged with variation in size and shape. Nuclear chromatin is coarse and clumped, with prominent nucleoli visible. Mitotic activity is evident. A lymphocytic infiltrate is present within the stroma. Histologic evaluation indicates moderately differentiated morphology. The tumor is confined to the cervix and measures less than 4 cm in greatest dimension. Lymphatic involvement is identified. No vascular invasion is noted. Surgical margins are free of tumor. There is no evidence of treatment effect."} +{"pid": "TCGA-D8-A27N", "report": "Histopathological examination was performed on a right breast specimen measuring 20 x 17.5 x 6 cm with a skin flap of 15.5 x 5 cm and weighing 1200 g. A lesion measuring 3.0 x 3.2 x 2.5 cm was identified in the upper outer quadrant, located 4 cm from the upper boundary, 0.8 cm from the base, and 1.3 cm from the skin. Microscopic evaluation revealed invasive carcinoma with histological grade NHG2 (3 + 2 + 2/16 mitoses per 10 high power fields in a visual area of 0.55 mm). Areas of in situ carcinoma were also present both within and outside the lesion, characterized by solid and cribriform patterns with medium to high nuclear atypia, comedo necrosis, and calcifications, accounting for approximately 40% of the lesion. The surrounding glandular tissue exhibited parenchymal atrophy. Reactive lymphadenopathy was noted in axillary lymph nodes. Multiple lymph nodes contained metastatic deposits with extracapsular extension. The invasive component showed a maximum dimension of 2 cm. A total of 19 lymph nodes were examined, with 4 showing involvement."} +{"pid": "TCGA-KD-A5QS", "report": "The specimen consists of a uterus, cervix, left tube and ovary weighing 527 grams. A mass measuring 11 centimeters in diameter is present within the myometrium. Histologic evaluation reveals marked nuclear atypia, extensive areas of necrosis, and a mitotic count of 61 figures per 10 high-power fields. Vascular space invasion is identified within the myometrium. The endometrium appears weakly proliferative, and the cervix demonstrates parakeratosis. The ovary and fallopian tube are unremarkable. A right ovarian cystic lesion is noted, consistent with a serous cystadenoma. Mild chronic salpingitis is present in the right fallopian tube. One small benign lymph node is identified in the right aortic region, along with additional fragments of skeletal muscle, adipose tissue, blood clot, and other unspecified tissue fragments. Two benign lymph nodes are found in the left pelvic region. Based on these findings, the staging assessment indicates disease confined to the myometrium without evidence of distant spread."} +{"pid": "TCGA-P5-A77W", "report": "The specimen consists of dense white-yellow tissue fragments obtained from the left frontal lobe and corpus callosum. Histological examination reveals a cellular neoplasm with features of both astrocytic and oligodendroglial differentiation. The tumor demonstrates high cellularity with nuclear atypia and brisk mitotic activity. Immunohistochemical staining shows a proliferation index (Ki-67) of up to 10%. Based on histopathologic evaluation, the findings are consistent with a high-grade glioma. Staging assessment indicates localized disease without evidence of distant spread."} +{"pid": "TCGA-E2-A574", "report": "The specimen included a medial left breast excision, an excised left breast lesion, and two sets of sentinel lymph nodes from the left axilla. The medial left breast excision measured 4.3 x 3.2 x 2.1 cm and showed intraductal papilloma with apocrine metaplasia and columnar cell change. Biopsy site changes were present, and surgical margins were free of abnormal cells. The left breast lesion measured 2.3 cm in greatest dimension and was found to be a high-grade lesion with a nuclear grade of 3, tubular score of 2, and mitotic score of 3, resulting in a combined histologic grade of 3. Necrotic tissue was noted, but no vascular or lymphatic invasion was identified. The closest margin was 0.2 cm at the posterior edge. The excision specimen measured 6.5 cm from medial to lateral, 5.4 cm superior to inferior, and 3.5 cm anterior to posterior. All surgical margins were negative for involvement. Each of the sentinel lymph node specimens contained two lymph nodes. No metastatic cells were found in any of the nodes. Immunohistochemical analysis showed negative results for ER, PR, and HER2 by FISH. The pathological stage was determined to be pT2N0 based on AJCC 7th edition criteria. The tumor was unifocal and no additional lesions were identified."} +{"pid": "TCGA-XY-A89B", "report": "The specimen consists of a right testicle following orchiectomy. The tumor is multifocal with the largest dimension measuring 2.6 cm, and additional dimensions of 2.5 x 2 cm. Macroscopically, the tumor is confined to the testis. Histologic evaluation shows classic cellular morphology, with no involvement of the spermatic cord or other margins. Microscopic examination confirms no lymphovascular invasion and the tumor remains limited to the testis. Pathologic staging indicates pT1, with no evidence of vascular or lymphatic invasion. Regional lymph node assessment is not available (pNx). Laboratory findings include LD at 201 U/L, beta-HCG less than 1 mlU/mL, and AFP at 3.7 ng/mL. Additional findings include intratubular germ cell neoplasia and microlithiasis. Tumor nuclei account for 75% of the sample, with no necrosis identified. Normal tissue constitutes 25%, with 95% of the specimen being testicular tissue and 5% showing focal intratubular changes. Specimen processing included formalin fixation and cryopreservation, with tissue weights as follows: normal tissue 115 mg and 90 mg; tumor tissue 89 mg and 116 mg. Specimen components include plasma, serum, buffy coat, and FFPE blocks. No metastatic tissue was identified. Patient consent was obtained for the study."} +{"pid": "TCGA-BB-A6UO", "report": "The surgical pathology report includes multiple excision specimens. The composite resection included a subtotal glossectomy and hemimandibulectomy. The primary lesion measured 7.0 cm in greatest dimension and was located in the oral cavity. Histologic evaluation showed conventional squamous cell carcinoma, moderately differentiated (G2). The tumor extended through the mandibular bone and into soft tissues of the floor of the mouth (pT4a). Lymph node assessment revealed three involved lymph nodes out of thirty examined. Metastatic involvement was identified in multiple ipsilateral lymph nodes (pN2b), with extracapsular extension present in some nodes. Distant metastasis could not be assessed (pMX). Surgical margins were free of tumor involvement; however, the tumor approached within 1 mm of the posterior pharyngeal soft tissue margin. Perineural and intraneural invasion were identified. Vascular invasion could not be definitively determined. Additional lymph node groups and soft tissue specimens from various anatomical sites were negative for tumor involvement. Bone marrow elements were present with trilineage hematopoiesis and full maturation."} +{"pid": "TCGA-BB-7863", "report": "The surgical specimen consisted of twelve parts. Frozen section analysis of multiple regions, including posterior dorsum, anterior dorsum, anterior ventral tongue, anterior deep tongue, posterior margin, posterior deep, posterior ventral tongue, and re-resection anterior deep tongue, showed no evidence of tumor involvement. A left partial glossectomy specimen measured 5.9 x 3.0 x 1.5 cm with a fleshy raised lesion on the superficial surface measuring 5.0 x 2.5 x 0.8 cm. The tumor had a white cut surface that appeared more diffuse toward the anterior end of the specimen, with gross assessment indicating it came no closer than 3.0 mm to the deep margin. Histologic examination revealed a moderately differentiated squamous cell carcinoma confined to the oral cavity. The greatest dimension of the tumor was 5.0 cm with a depth of invasion measuring 1.0 cm. No lymph node metastases were identified in 16 lymph nodes examined. Surgical margins were free of tumor involvement. Evaluation for vascular and perineural invasion was negative. Neck dissection specimens included level I (3 benign lymph nodes), level II (9 benign lymph nodes), level III (2 benign lymph nodes), and level IV (2 benign lymph nodes). All lymph nodes were histologically benign. Gross and microscopic evaluations of all submitted specimens demonstrated no residual tumor in any site."} +{"pid": "TCGA-N8-A4PQ", "report": "The specimen consists of a hysterectomy with removal of the cervix, right fallopian tube and ovary. The tumor is located predominantly in the posterior endometrium. Histologic evaluation reveals a high-grade lesion with complex features including multiple cellular components. There is evidence of extensive lymphovascular space invasion and lymph node involvement.\n\nAssessment of myometrial invasion shows minimal infiltration into the inner half of the myometrium with a depth of 2 mm. The total wall thickness measured at this location was 25 mm, representing approximately 8% penetration. There is no serosal involvement. The lower uterine segment demonstrates lymphovascular space invasion only. Similarly, cervical and adnexal involvement is limited to lymphovascular space invasion, specifically around the right fallopian tube. Surgical margins are widely negative.\n\nLymph node analysis indicates widespread disease involvement. Of the regional lymph nodes examined, 13 out of 18 were positive for metastatic malignancy. Specifically, three of eight left pelvic lymph nodes, four of four right pelvic lymph nodes, and six of six right peri-aortic lymph nodes were involved.\n\nAdditional findings include benign conditions: multiple leiomyomata within the myometrium measuring up to 4.0 cm, endometrial intraepithelial carcinoma, and changes consistent with prior tubal ligation in both fallopian tubes. The left fallopian tube remnant contains a paratubal cyst measuring 1.0 x 0.8 x 0.7 cm filled with dark yellow mucinous material. The right ovary shows age-related changes and benign inclusion cysts.\n\nGross examination of the uterus reveals a well-circumscribed nodule in the anterior myometrium measuring 4.0 x 3.4 x 1.9 cm, consistent with a fibroid. The tumor itself measures 4.5 x 4.1 x 3.7 cm, is tan/brown in color, soft, polypoid, and multinodular. It is primarily located in the posterior endometrial cavity with extension into the anterior region but does not grossly extend into the lower uterine segment. Myometrial invasion appears to involve the outer one-half with a thickness at deepest invasion measuring 2.3 cm.\n\nImmunohistochemical staining performed on relevant tissue blocks demonstrated focal positivity for myogenin, indicating specific cellular lineage support. \n\nThe case has been submitted for further tumor analysis and tissue preservation in formalin is ongoing."} +{"pid": "TCGA-EJ-7792", "report": "The surgical specimen included bilateral pelvic lymph nodes and a prostate with bilateral seminal vesicles and distal vasa deferentia. A total of 35 lymph nodes were examined, with no evidence of malignancy identified in any of the lymph node groups. The prostate weighed 64.43 grams and showed no signs of residual tumor at the surgical margins.\n\nMicroscopic evaluation of the prostate revealed a small focus of abnormal tissue measuring 1.3 cm in maximum dimension. The tissue involved both the left and right apex through mid-prostate regions, comprising approximately 5% of the total prostate volume. Histologic features included a Gleason score of 3+4=7, with the higher grade component making up about 10% of the affected area. The lesion was fully contained within the prostate without extension beyond the prostatic capsule. No angiolymphatic or perineural invasion was observed.\n\nAdditional findings in the prostate included multifocal high-grade intraepithelial neoplasia, mild benign hypertrophy, glandular atrophy, and areas of both chronic and acute inflammation. Focal calcified, organized thrombi were also noted in periprostatic blood vessels.\n\nClinical data indicated a preoperative PSA level of 4.64 ng/mL. Pathologic staging was determined to be pT2c, with no nodal involvement (pN0) and no assessment of distant metastasis (pMX). The histologic grade was classified as G3-4. The patient had a prior biopsy showing adenocarcinoma with varying Gleason scores. He had a history of hypertension, gout, diverticulitis, and prior tonsillectomy. The procedure performed was radical prostatectomy with bilateral pelvic lymphadenectomy."} +{"pid": "TCGA-AA-3854", "report": "The specimen shows a neoplastic lesion with mucinous features, characterized by poorly differentiated cellular morphology (G3). Histologic evaluation reveals infiltration into the muscularis propria and vascular structures (L1, V1), corresponding to a pT2 stage. Resection margins are uninvolved, and no lymph node metastases are identified (pN0, 0 of 12 nodes examined). An intact anastomotic ring is present. Additionally, there are fragments of a polypoid lesion with serrated architecture and areas of marked nuclear atypia, suggestive of high-grade dysplastic changes."} +{"pid": "TCGA-HW-A5KK", "report": "Addendum. Clinical history includes a right temporal lobe brain lesion. Three specimens were submitted for analysis. The first specimen, labeled as a right medial temporal lesion, consisted of a yellow, soft tissue measuring 0.6 x 0.5 x 0.2 cm and was entirely submitted for frozen section. Microscopic examination revealed cells consistent with high-grade features. The second specimen, also labeled as a right medial temporal lobe lesion, consisted of multiple gray-tan friable tissue fragments measuring 1.3 x 0.7 x 0.3 cm in total. This sample was entirely processed and microscopic evaluation showed similar cellular morphology. The third specimen, obtained from the right temporal lobe, was larger, measuring 5.4 x 5.0 x 2.0 cm in aggregate. A portion was sent to TPS and approximately 50% remained for further analysis. Histologic sections demonstrated comparable findings across all three specimens.\n\nImmunohistochemical staining showed loss of PTEN expression and negativity for R132H mutant IDH. Additional special studies were performed, including Vimentin and IDH1 immunostains. All tests were conducted under CLIA-certified conditions using validated protocols. These assays are performed for clinical diagnostic purposes and are not considered investigational.\n\nMeasurements and cellular descriptions support a consistent pattern across all sampled regions. Cellular morphology included nuclear atypia, increased mitotic activity, and focal necrosis. No definitive markers for lower-grade differentiation were identified. All specimens were fully evaluated and correlated with intraoperative frozen section findings, which were consistent with the final microscopic assessment."} +{"pid": "TCGA-VF-A8AB", "report": "The surgical pathology report describes a right orchiectomy specimen. The specimen weighed 52.0 grams and measured 7.5 x 4.4 x 2.0 cm. Upon bisection, a yellow, multilobulated, firm, and ill-circumscribed mass was identified, measuring 3.9 x 3.5 x 2.0 cm in aggregate. The tumor was confined to the testis with no extension into the tunica vaginalis, rete testis, or epididymis. Histologic evaluation showed no lymphovascular invasion. Sections of the spermatic cord, vascular, and soft tissue margins were free of tumor involvement. Adjacent seminiferous tubules exhibited tubular atrophy. Multiple representative sections were submitted for analysis. The patient was a man with a history of a right testicular mass who underwent a right radical orchiectomy. Pre- and post-operative diagnoses were not specified in the report."} +{"pid": "TCGA-KB-A93G", "report": "The surgical specimens included a lymph node from station 8, proximal esophageal margin, thoracic esophagus with proximal stomach and gastric margin, lymph nodes from RT TB angle ST10R and subcarinal ST7, surgical waste, final esophageal margin, and proximal stomach resection. Histologic examination of the thoracic esophagus and proximal stomach revealed a lesion measuring 6.2 cm in greatest dimension, located primarily in the gastric cardia with extension into the distal esophagus. Microscopic evaluation showed well-differentiated features with tumor invasion through the muscularis propria to the serosa. No lymphovascular or perineural invasion was identified. All margins\u2014proximal, distal, and radial\u2014were free of invasive disease. The closest distance of tumor to any margin was 1.5 cm at the proximal margin.\n\nA total of 32 lymph nodes were examined, including multiple perigastric lymph nodes along the greater and lesser curvatures, as well as lymph nodes from RT TB angle ST10R and subcarinal ST7. No malignant involvement was identified in any of the lymph nodes. Additional findings included high-grade dysplasia and intestinal metaplasia in the cardia. Surgical waste tissue showed no pathological abnormalities. Gross examination of the stomach specimen demonstrated normal mucosal folds and multiple small mucosal nodules without discrete lesions. One possible lymph node measuring 0.2 cm was identified within the greater omentum but showed no malignancy on histologic evaluation."} +{"pid": "TCGA-VS-A9UR", "report": "The biopsy specimen from the cervix reveals a neoplasm composed of mucin-producing glandular cells resembling those of the endocervical epithelium. The tissue sample shows abnormal cellular morphology with nuclear atypia and disorganized architecture. The lesion involves the cervical tissue with evidence of stromal invasion. Tumor dimensions are not specified in the current report. No lymphovascular invasion is identified. The histologic grade is well to moderately differentiated. There is no evidence of lymph node involvement or distant metastasis."} +{"pid": "TCGA-ZJ-AAX8", "report": "The specimen, a biopsy from the cervix at the 5 o\u2019clock position, consists of a pale pink-tan, irregular tissue fragment measuring 0.7 x 0.5 x 0.4 cm. The tissue is partially obscured by a significant amount of adherent red-brown hemorrhagic material. Histologically, the lesion demonstrates moderately differentiated cells arranged in an invasive growth pattern. Cellular features include large cell morphology with nonkeratinizing characteristics. The entire specimen was submitted for analysis in one cassette."} +{"pid": "TCGA-WB-A81F", "report": "The pathology report describes a reviewed specimen from the left adrenal. The tumor measures 7.4 cm in diameter, appears yellowish, and is clearly demarcated from the surrounding tissue. Microscopic examination reveals a zellballen growth pattern, with some areas showing a trabecular arrangement. The nuclei are enlarged, and the cells have abundant, lightly eosinophilic cytoplasm. Focal pigmentation is observed within the tumor cells. There are areas of localized bleeding, but no significant increase in mitotic activity, no atypical mitoses, and no necrotic regions. The tumor capsule shows signs of infiltration without complete disruption. Vascular invasion is present both centrally and peripherally within the tumor. The adjacent soft tissue does not show any tumor involvement.\n\nImmunohistochemical staining demonstrates strong positivity for synaptophysin and weaker staining for chromogranin. Scattered sustentacular cells exhibit faint positivity for S100. The proliferation index, as assessed by Ki67 staining, is below 5%."} +{"pid": "TCGA-3B-A9HI", "report": "The resected specimen from the right upper arm measured 10.5 x 9.5 x 8 cm and contained a well-encapsulated mass. The mass itself measured 8 x 5.5 x 5 cm, with a pale tan and soft appearance. Necrosis was present in less than 10% of the sample. Microscopically, the tumor was composed of a high-grade sarcomatous component with spindle and pleomorphic cells, showing brisk mitotic activity (22 mitoses per high-power field). The stroma was myxoid with rich vascularity. The tumor infiltrated skeletal muscle and was present at multiple margins. The anterior, deep, proximal, and distal margins were involved, while the medial margin was free of tumor. The lateral margin was within less than 1 mm of the tumor. Margins were evaluated with inked identification: proximal (blue), distal (green), anterior (orange), deep (black), medial (red), and lateral (yellow). Upon sectioning, the tumor came within 0.1 cm of the anterior margin, 0.6 cm of the deep margin, 0.8 cm of the proximal margin, 1.5 cm of the distal margin, 2.2 cm of the medial margin, and 0.1 cm of the lateral margin. Multiple representative sections were taken from all margins and submitted for analysis. The case was reviewed prospectively and signed out electronically."} +{"pid": "TCGA-G9-6378", "report": "The prostate specimen measured 4 cm from left lateral to right lateral, 4 cm from anterior to posterior, and 3 cm from apex to base. The organ had a red, smooth, and intact capsule. Following removal of tissue at the apex and base, the prostate weighed 25 g and displayed a nodular pink-tan parenchyma. The right seminal vesicle measured 4.2 x 1.9 x 0.4 cm and the left measured 5.8 x 2 x 0.6 cm; both were composed of cystic tan tissue. The right vas deferens measured 1 x 0.4 cm and the left measured 1.7 x 0.4 cm; both were described as tubular tan tissue. A total of 13 g of tissue was procured for analysis.\n\nMultiple sections were submitted for microscopic evaluation, including perpendicular sections from the right and left apex, level 1 through level 4 sections from various regions, and multiple mid base and lateral base sections. Additional sections included areas with the seminal vesicles and vas deferens.\n\nMicroscopic findings demonstrated involvement of specific regions including left, right, posterior lateral, apical, basal, and anterior areas. Histologic evaluation identified perineural invasion. No vascular or lymphatic invasion was noted. The tumor was found to be focally present at a resection margin, specifically at the mid base, with a linear distance of 1\u201310 mm. No lymph nodes were sampled.\n\nTumor grade showed Gleason pattern 3 and 4, with a total sum of 7 out of 10. The tumor involved approximately 10% of the examined gland tissue. High-grade prostatic intraepithelial neoplasia was also present. No other significant pathologic findings were identified.\n\nStaging was assessed as pT2c, indicating involvement of both lobes of the prostate. The regional lymph node status (N) and distant metastasis status (M) could not be determined based on the specimens provided."} +{"pid": "TCGA-DK-A6AV", "report": "The specimen consisted of a bladder, urethra, urachus, perivesical tissue, uterus, bilateral tubes and ovaries, and anterior vaginal wall. The bladder measured 9 x 8.5 x 4.2 cm, the uterus 5.5 x 3.2 x 1.5 cm, the right ovary 2.0 x 1.1 x 0.6 cm, the right fallopian tube 10.5 x 0.3 x 0.3 cm, the left ovary 2.2 x 1.2 x 1.0 cm, and the left fallopian tube 9.8 x 0.2 x 0.2 cm. The distal urethral margin and vaginal cuff margin were shaved and submitted. Ureteric stumps measured 4.0 cm and were unremarkable.\n\nMultiple masses were identified in the bladder:\n\n- A 1.7 x 0.7 x 0.2 cm mass in the right lateral wall, located 2.5 cm from the left ureteric orifice and 0.2 cm from the right ureteric orifices, extending into the superficial half of the muscularis propria to a depth of 0.2 cm, 0.6 cm from the deep margin.\n- A 1.5 x 1.1 x 0.6 cm mass in the right posterior dome, located 0.3 cm from the left ureteric orifice and 0.7 cm from the right ureteric orifices, extending into the muscularis propria to a depth of 0.6 cm, 1.2 cm from the deep margin.\n- A 0.9 x 0.8 x 0.6 cm mass in the left posterior dome, located 2.3 cm from the left ureteric orifice and 4.0 cm from the right ureteric orifices, abutting the muscularis propria and 2.0 cm from the deep margin.\n- A 0.3 x 0.2 x 0.1 cm mass in the left lateral wall, located 2.5 cm from the left ureteric orifice and 4.2 cm from the right ureteric orifices, confined to the mucosa and 2.0 cm from the deep margin.\n- A 2.1 x 1.5 x 1.0 cm mass in the lower left anteriolateral wall near the trigone, located 0.4 cm from the left ureteric orifice and 2.6 cm from the right ureteric orifices, extending into the muscularis propria to a depth of 0.7 cm, 1.0 cm from the deep margin.\n\nA diverticulum was noted in the right lateral wall measuring 2.0 x 2.0 x 1.1 cm. The remaining bladder mucosa was edematous and congested. A possible discrete perivesical lymph node was identified and entirely submitted. The endometrium was flat and tan. Two small mural nodules were found in the myometrium, each approximately 0.4 cm. The left ovary contained a 1.5 x 1.1 x 0.8 cm unilocular cyst with a smooth inner lining. The right ovary and bilateral fallopian tubes were unremarkable.\n\nLymph nodes were submitted from the left and right pelvic regions. Three lymph nodes were examined on the left, and nine on the right; all were free of involvement. Specimens of the round ligaments, perivesical soft tissue, and distal segments of both ureters were also submitted and showed no evidence of involvement.\n\nMicroscopic evaluation of the bladder specimen revealed multiple areas of involvement with varying patterns. Tumor was present in the superficial half of the muscularis propria without extension beyond the bladder wall on the right side, but there was involvement of the left ureter. No vascular or perineural invasion was identified. All surgical margins were free of tumor. Non-neoplastic changes in the bladder mucosa included ulceration, foreign body reaction, and features of proliferative cystitis including Brunn's nests, cystitis cystica, and cystitis glandularis. The endometrium showed atrophic changes. A focal epithelial proliferation was noted in the right fallopian tube, which, based on immunohistochemical findings, was consistent with a primary m\u00fcllerian-derived glandular lesion. It expressed ER, EMA, and WT-1, and was negative for other markers. Proliferative activity by Ki-67 was low. This lesion was interpreted as a focus of epithelial hyperplasia. The left ovary showed a simple serous cyst. Other genital organs were unremarkable.\n\nThe pathologic stage was determined as pT2a (AJCC 2002), indicating invasion into the superficial half of the muscularis propria. No lymph node involvement was identified. Additional studies are pending for further characterization of the right fallopian tube lesion."} +{"pid": "TCGA-DD-AAVY", "report": "The specimen consists of a large lesion measuring 20.5 x 16 x 11 cm, with a multinodular confluent gross appearance. A satellite nodule is present. Microscopically, the cellular architecture shows a combination of trabecular and pseudoglandular patterns, with a mixture of classic and clear cell morphology. The histologic grade according to Edmondson and Steiner shows a maximum grade of 3, with the majority of the tumor differentiated at grade 2.\n\nFatty change is not identified. Hemorrhage or peliosis is present in approximately 10% of the tumor area, and tumor necrosis is also noted in about 10%. Microscopic vascular invasion is observed. The lesion demonstrates partial capsule formation, with infiltration of the capsule present. Septal formation is also identified.\n\nThere is evidence of serosal invasion. No involvement of major branches of the portal vein or hepatic vein is seen, and bile duct invasion is absent. The surgical margin is clear, with a safety margin of 0.1 cm. There is evidence of intrahepatic metastasis, but no multicentric occurrence is identified. Staging assessments indicate pT3 and pT4 classifications. No preoperative biopsy was available for review. No underlying chronic hepatitis, cirrhosis, or dysplastic changes are present in the adjacent liver tissue."} +{"pid": "TCGA-A8-A0A9", "report": "The excised left breast tissue contained a well-differentiated cellular lesion measuring up to 2.2 cm. The lesion exhibited infiltrative growth without evidence of lymphovascular invasion. A minimum surgical margin of 3 mm was noted at the 6 o'clock position. Adjacent tissue showed lipomatous changes and atrophic glandular elements. No intraductal component was identified. Histologic evaluation revealed a grade 1 lesion with negative lymph nodes (0 out of 2 examined). Distant metastasis could not be assessed. All margins were free of involvement."} +{"pid": "TCGA-CV-A45Z", "report": "The specimen report includes multiple tissue samples from a male patient. Tissue from the right false cord consisted of three small tan-pink fragments measuring 0.5 x 0.4 x 0.2 cm, submitted in entirety for frozen section. Frozen section analysis identified abnormal cellular changes.\n\nA lymph node from the right parotid bulb measured 1.5 x 0.6 x 0.7 cm and showed no abnormal findings. A right thyroid lobectomy specimen measured 5.0 x 3.0 x 1.7 cm and contained multiple nodules ranging from 0.2 to 1.1 cm. The superior aspect of the thyroid showed more preserved tissue with a red-brown appearance. Sections were taken for frozen analysis and representative blocks were submitted for further evaluation.\n\nThe laryngectomy specimen, along with associated soft tissue and lymph nodes, measured 8.0 x 6.0 x 5.0 cm. A firm, ulcerated mass was observed in the right supraglottic region, extending slightly across the midline into the left supraglottic area. The lesion measured 2.0 x 1.5 x 1.0 cm. No gross involvement of mucosal or external surfaces was noted. Resection margins were free of abnormal cells. The tumor measured 1.2 cm in thickness. Lymphatic invasion was present. Tissue was submitted sequentially from right to left, including lymph node sections D1-D19.\n\nSeven right cervical lymph nodes and two left cervical lymph nodes were identified; all were negative for abnormal cells. A separate tracheal margin sample was also free of abnormal cells. The case included prior frozen section analysis of mucosa, which showed no abnormal findings."} +{"pid": "TCGA-3H-AB3L", "report": "The specimen consists of a fragment of dark-red soft tissue measuring 1.8 \u00d7 0.3 cm, submitted entirely for analysis. Microscopic evaluation revealed the presence of neoplastic cells exhibiting epithelioid morphology. Immunohistochemical staining showed positivity for keratin 5/6, WT1, and calretinin, while staining for MOC-31 was negative in the neoplastic cells. These findings were consistent with a previously noted interpretation. The tissue was received in relation to a clinical history indicating concern for a pleural-based lesion. All tests were performed and interpreted by the laboratory."} +{"pid": "TCGA-VQ-AA6K", "report": "The specimen from the cardia region of the stomach shows a lesion measuring 10.5 x 6.8 cm with an ulcerative and infiltrative growth pattern. Histologically, the tissue demonstrates poorly differentiated glandular structures with mucinous features and the presence of signet ring cells. The lesion extends through the gastric wall into the surrounding adipose tissue. Microscopic examination reveals invasion of blood vessels and lymphatics as well as involvement of nerves.\n\nThe surgical margins were assessed, with the esophageal margin and margin marked by suture thread showing no evidence of tumor involvement; however, the gastric resection margin is positive for neoplastic cells.\n\nLymph node evaluation reveals metastatic involvement in multiple regional chains. In chain 1, tumor cells are identified in one dissected lymph node. Similarly, one of one lymph nodes in chain 2 contains metastatic cells, with capsular extension noted. In chain 3, six of eight lymph nodes show metastasis, also with capsular extension and nodal conglomerates. No cancer is found in lymph nodes from chain 5. In chain 9, no metastasis is observed. Chain 10 contains one involved lymph node out of five dissected, while chain 11p has one involved lymph node out of five examined. In chain 110, no tumor is detected in the single lymph node evaluated.\n\nAdditional specimens including the greater omentum, esophagus, esophageal margin, spleen, and pancreatic fragments do not reveal any signs of tumor involvement."} +{"pid": "TCGA-BR-8589", "report": "The specimen consisted of a gastric resection with a tumor located in the fundus measuring 9 x 8 x 1 cm. The tumor was ulcerated and demonstrated poor differentiation under microscopic examination. It extended to adjacent structures, specifically involving the lesser omentum. Lymph node evaluation revealed 1 out of 8 involved nodes, all within the intraabdominal region. No information was provided regarding lymphatic, venous, or perineural invasion. Surgical margins were free of involvement. There was no evidence of prior neo-adjuvant treatment administered. No additional pathologic findings or comments were noted."} +{"pid": "TCGA-CK-4951", "report": "The specimen labeled \"right hemicolectomy\" consists of a portion of terminal ileum, cecum, ascending colon, and appendix. The cecum and ascending colon measure 20.3 cm in length and 4.5 cm in diameter. An ulcerated mass measuring 3.0 x 2.2 x 0.5 cm is identified in the cecum/ascending colon, located 6.5 cm distal to the ileocecal valve. The proximal resection margin measures 3.2 cm, and the distal staple margin measures 2.8 cm. The tumor is 9.9 cm from the proximal resection margin, 9.5 cm from the distal resection margin, and 7.2 cm from the radial resection margin. The tumor forms a polypoid mass with an ulcerative surface and infiltrating border. It extends through the muscularis propria into pericolonic adipose tissue.\n\nResection margins are negative for involvement. No lymphovascular, venous, or perineural invasion is identified. A peritumoral lymphoid response is mild. Thirty regional lymph nodes are examined, none showing involvement. One separate adenoma is identified. Residual adenoma is not present. An area of mural pigment consistent with a tattoo site is found 1.8 cm proximal to the mass. Multiple mucosal ridges (polyps), measuring 0.2 to 0.5 cm, are present in the ascending colon and may represent hyperplastic folds. Occasional diverticula with fecaliths are noted. Sections submitted include margins, appendix, lymph nodes, tattoo site, and mucosal polyps.\n\nMicroscopic examination confirms the tumor\u2019s extension beyond the muscularis propria. A possible focus of tumor cells adjacent to smooth muscle fibers near the tumor raises suspicion for extramural venous involvement, though classification remains T3 based on current evaluation."} +{"pid": "TCGA-A8-A08R", "report": "The specimen shows a poorly differentiated invasive lesion measuring 4 cm in diameter. Histological evaluation reveals high-grade nuclear features consistent with a Grade III classification. Pathologic staging indicates a T2 primary tumor with metastatic involvement in regional lymph nodes (N1a). Evidence of vascular and lymphatic invasion is present. The tumor is located in the left breast."} +{"pid": "TCGA-BH-A1FC", "report": "The specimen submitted consisted of right breast tissue measuring 9.5 by 8.5 by 1.5 cm, as well as right axillary lymph nodes. A distinct mass was identified within the breast tissue, measuring 1.3 by 1.2 by 1.0 cm. Histologic evaluation revealed a high-grade lesion with a syncytial growth pattern and an extensive lymphocytic response. No in situ component was identified. The margins of resection were free of tumor.\n\nA total of 23 right axillary lymph nodes were examined. One lymph node showed complete replacement by the process, with extension beyond the capsule. The remaining nodes did not show evidence of involvement.\n\nProliferative fibrocystic changes were also present in the breast tissue. Immunohistochemical studies for estrogen and progesterone receptors showed no distinct intranuclear staining, and both markers were interpreted as negative. Additionally, testing for HER-2/neu using immunoperoxidase methods showed no distinct complete membrane staining, and was also interpreted as negative. All findings were based on review of appropriate slides and blocks."} +{"pid": "TCGA-HC-7818", "report": "The prostate specimen measured 5.4 x 4.5 x 4.2 cm and weighed 40.6 grams. On gross examination, the cut surface showed a pink tan appearance with focal cystic changes, periurethral nodularity, and multiple irregular brown calculi. No discrete mass was identified. Histologically, the gland showed conventional-type cellular changes with a Gleason score of 7 (3+4), involving approximately 10% of the gland volume. High-grade intraepithelial proliferation was noted. There was no evidence of extracapsular extension, seminal vesicle involvement, or lymphovascular space invasion.\n\nSurgical margins, including the left lateral margin and apex, were uninvolved. The seminal vesicle and attached adnexal tissues showed no significant findings. A total of six lymph nodes were examined, none of which contained metastatic disease. The pTNM staging was determined to be pT2c N0. No treatment effect was observed. Other significant findings were not identified."} +{"pid": "TCGA-44-7662", "report": "A left upper lobe lobectomy specimen was submitted for analysis. A lesion measuring 2.8 cm in greatest dimension was identified adjacent to the bronchial stump. The tumor extends to within 1.3 cm of the inked pleural surface and involves the lobar bronchus. No involvement of the mainstem left bronchus was assessed, as this portion was not submitted. The tumor demonstrates infiltration into the pulmonary parenchyma. Resection margins, including bronchial and vascular margins, show no evidence of tumor involvement. The pleural surface is also free of tumor.\n\nHistologic evaluation reveals a poorly differentiated neoplasm. Immunohistochemical staining shows strong positivity for cytokeratin 7 and TTF-1. Focal mucicarmine-positive intracytoplasmic vacuoles are present. The tumor cells are completely negative for CK 5/6 and demonstrate less than 50% moderate staining with p63. No evidence of large venous, arterial, or small vessel lymphatic invasion is identified.\n\nA total of five regional lymph nodes were examined: two from the bronchial area, one from level X, one from level V, and one from level VII. All lymph nodes are free of tumor involvement (0/5). No distant metastasis was evaluated.\n\nAdditional findings include focal pulmonary hemorrhage, likely related to procedural effects. There is marked background anthracosis and emphysematous change in the lung tissue. The gross specimen includes a 23.5 x 13.5 x 4.0 cm left upper lobe with a 2.8 x 2.5 x 2.0 cm tan-white to gray-black lesion. Lymph nodes recovered from the hilum measure up to 0.7 cm. Other submitted tissues include portions of tumor, adjacent normal parenchyma, and random parenchyma."} +{"pid": "TCGA-55-7815", "report": "The surgical specimen included a right lower and middle lobe lobectomy specimen measuring 18 x 16 x 4.5 cm in size and weighing 234 grams. The bronchial resection margin measured 1.5 cm in length and 2.0 cm in diameter. A mass was identified within the lung tissue, measuring 6.0 cm in greatest dimension, with a gray, solid, and circumscribed appearance. The mass was located 2.8 cm from the bronchial resection margin and extended to an inked pleural surface. The closest distance from the tumor to the stapled parenchymal margin was 2.5 cm. No endobronchial lesions were observed upon examination of the bronchial tree. The surrounding lung tissue showed signs of congestion and mild chronic inflammation. Ten cassettes were submitted for histologic evaluation, including sections of the bronchial margin, tumor with pleural surface, tumor with bronchial tree, adjacent lung tissue, and hilar lymph nodes.\n\nAdditional specimens included a cluster of peribronchial lymph nodes (six total), a single right hilar lymph node, three right interlobar lymph nodes, and three lower paratracheal lymph nodes. All lymph nodes were negative for metastatic changes. Histologic evaluation showed no lymphovascular or perineural invasion. The bronchial and vascular margins were free of abnormal cellular changes.\n\nPathologic staging was determined as pT2a, pNO, pMX based on the findings."} +{"pid": "TCGA-77-8156", "report": "Histopathology Report. HISTORY. Left upper lobectomy. SPN - FNAC - malignant. MACROSCOPIC. Three specimens submitted: 1: The first specimen is labelled 'left upper lobe lung' and consists of a lobe of lung measuring 150 mm SI, 140 mm AP, and 65 mm ML. The hilar margin is inked blue. The specimen has been previously sectioned for research. The pleural surface is slightly haemorrhagic with a puckered area measuring 35 x 35 mm on the superior lateral pleural aspect. A bullous lesion is present in the anterior superior aspect. On sectioning, there is a round lesion with a tan and black cut surface and infiltrating edges in the superior aspect of the lobe, measuring 45 mm AP, 30 mm ML, and 35 mm SI. The lesion abuts the pleural surface at the puckered area and is 15 mm from the hilar margin and more than 20 mm from the bronchial resection margin. The remainder of the lung shows marked emphysematous changes. [1A: bronchial resection margin; 1B: 4 lymph nodes; 1C-1E: lesion and pleura; 1F: lesion and adjacent lymph node; 1G: emphysematous lung; 1H: more normal lung inferiorly.]. 2: The second specimen is labelled 'left hilar lymph node' and consists of three pieces of tan fibrous tissue, the largest measuring 30 x 18 x 10 mm. All contain hemorrhagic lymph nodes with carbon pigment. The largest lymph node measures 25 x 10 x 8 mm. [2A\u20132B: representative sections of each node.]. 3: The third specimen is labelled 'mediastinal lymph node' and consists of a single piece of fibrofatty tissue measuring 24 x 14 x 10 mm containing a lymph node measuring 9 x 6 x 5 mm. [3A, tissue bisected.]. MICROSCOPIC. 1: Sections show irregular geographic zones of necrosis within the lesion. The lesion abuts visceral pleura but no pleural invasion is seen. It is clear of the bronchial resection margin, which shows focal mild and moderate squamous dysplasia. No lymphatic or vascular invasion is identified, nor is there evidence of perineural permeation. Peribronchial lymph nodes demonstrate reactive changes including follicular hyperplasia, sinus histiocytosis, carbon pigment deposition, and scattered flecks of birefringent material consistent with silicate. Adjacent lung parenchyma reveals obstructive pneumonitis characterized by endogenous lipoid pneumonia and follicular lymphoid hyperplasia. Distant lung parenchyma demonstrates emphysema with subpleural bulla formation. Another sampled portion shows a pattern suggestive of interstitial fibrosis with temporal and spatial heterogeneity, including rare fibroblastic foci, established fibrosis with stromal muscularisation, early honeycomb change, bronchioloectasis, and mucous stasis. 2&3: Sections of lymph nodes reveal reactive changes without evidence of involvement. SUMMARY. 1\u20133: Left upper lobectomy with separately submitted left hilar lymph node and mediastinal lymph node. Lesion size is 45 mm in diameter. No pleural invasion identified. Lesion is clear of bronchial resection margin with focal mild and moderate squamous dysplasia noted. No lymphatic, vascular, or perineural invasion observed. Peribronchial lymph nodes and separately submitted lymph nodes do not show involvement. Adjacent lung parenchyma exhibits obstructive pneumonitis. Pathological stage: pT2a NO. Background lung findings include emphysema and an interstitial pneumonia-like reaction pattern."} +{"pid": "TCGA-AP-A0LL", "report": "The surgical specimens submitted include the uterus, cervix, bilateral fallopian tubes and ovaries, as well as multiple lymph node groups from both sides, including Jackson's, external iliac, hypogastric, obturator, common iliac, and para-aortic regions.\n\nGross examination of the uterine specimen revealed a 4.0 cm polypoid lesion within the endometrial cavity. Histologic evaluation showed a neoplastic process with areas of squamous differentiation. The tumor exhibited a solid growth pattern and was graded based on nuclear features as intermediate to high grade. There was evidence of myometrial invasion, extending to less than half of the myometrial thickness. The maximal depth of invasion measured 1.0 mm, in an area where the total myometrial thickness was 13.0 mm. The tumor was also associated with adenomyosis and involved the endocervical mucosa. No vascular invasion was observed.\n\nThe endometrium demonstrated complex hyperplasia with atypia. Adenomyosis was present in the myometrium. Endosalpingiosis was noted in both ovaries. All other adnexal structures were unremarkable.\n\nLymph node evaluations from all sites\u2014left and right external iliac, hypogastric, obturator, common iliac, and para-aortic regions\u2014revealed only benign lymph nodes. All lymph nodes examined showed no evidence of malignancy, with no abnormal cellular infiltration or architectural disruption."} +{"pid": "TCGA-27-2527", "report": "Birth date. Tumor site: right temporal. The histological examination revealed a highly cellular neoplasm composed of pleomorphic astrocytic cells with marked nuclear atypia and frequent mitotic figures. Necrosis and microvascular proliferation were present. The tumor measured approximately 4.5 cm in greatest dimension. Based on the histological features and extent of resection, the lesion was classified as high-grade."} +{"pid": "TCGA-AN-A0XN", "report": "Female patient with tumor tissue obtained via surgery from the breast. Histological evaluation shows a grade 2 lesion. Tumor staging is T2, N1, M0. No prior treatment was administered. A separate blood sample was collected and preserved in frozen format."} +{"pid": "TCGA-G4-6310", "report": "A segment of rectum, sigmoid colon, and anus measuring 32.0 cm in length was examined. A polypoid mass with irregular borders measuring 2.3 x 2.4 cm was identified 0.5 cm from the dentate line and 4.9 cm from the anal resection margin. The closest distance from the invasive component to any margin was 0.7 cm. Multiple small polyps ranging from 0.1 to 0.3 cm were observed in the lower and mid portions of the rectum, with diverticuli noted in the proximal region. Lymph node evaluation revealed 14 out of 43 involved nodes, with the largest metastasis measuring 0.5 cm and showing extranodal extension. Histologic examination demonstrated moderately differentiated carcinoma invading the muscularis propria with perineural invasion present. No angiolymphatic invasion or carcinoma in situ was identified.\n\nA separate right hemicolectomy specimen measured approximately 60.0 cm and included the terminal ileum, cecum, and appendix. A firm polypoid lesion measuring 5.8 x 5.2 x 0.9 cm was located in the cecum adjacent to the ileocecal valve. This lesion extended through the muscularis propria into the subserosa and showed areas of necrosis and hemorrhage. Margins were negative for invasive disease with the closest distance to the radial margin being 0.8 cm. Sixty-six lymph nodes were assessed, with one demonstrating involvement. No vascular or perineural invasion was observed. Additional findings included scattered polyps measuring 0.2 to 0.6 cm and diverticuli in the distal portion of the colon.\n\nImmunohistochemical analysis of tumor tissue from both specimens showed intact expression of MLH1, MSH2, MSH6, and PMS2 proteins. Internal controls including peritumoral lymphocytes and normal glands exhibited appropriate staining patterns. Microsatellite instability testing has been initiated and results will be reported separately."} +{"pid": "TCGA-MP-A4TI", "report": "The lung specimen from the right lower lobe wedge resection contains a well-circumscribed, necrotic mass measuring 4.0 x 2.2 x 2.0 cm. The mass is located 0.4 cm from the stapled margin. Visceral pleural involvement and angiolymphatic invasion are not present. The surgical margin is free of abnormal tissue. A completion lobectomy was performed, and no residual lesion was identified. A matted mass of intrapulmonary peribronchial lymph nodes shows evidence of involvement.\n\nLymph node biopsies from stations 4R (6 fragments), 9R set #1 (1 lymph node), 7 set #1 (10 fragments), anterior mediastinal (2 fragments), station 7 set #2 (1 lymph node), and station 9R set #2 (1 lymph node) are all without involvement. However, in one lymph node from station 7 set #1, a necrotizing granuloma is identified, which was not present at the time of frozen section. Lymph node biopsy from the bronchus intermedius reveals involvement within a single lymph node.\n\nSections from all specimens were reviewed using hematoxylin and eosin staining. Special stains including GMS and acid fast were performed and showed no evidence of organisms. No significant changes were identified upon permanent section review compared to initial frozen section evaluation.\n\nAdditional molecular studies, including *KRAS* mutation analysis and *EGFR* genotyping, were requested on paraffin-embedded tissue from block E1. Results for these studies were pending at the time of reporting."} +{"pid": "TCGA-IB-7889", "report": "The surgical pathology report includes multiple specimens collected during a Whipple resection procedure. The gallbladder specimen measured 8.5 cm in length and 2.9 cm in maximum diameter, with no gallstones identified and no concerning mucosal changes noted. A single lymph node measuring 1.1 cm was submitted and showed reactive changes without evidence of malignancy. Two separate margin specimens were evaluated\u2014one from the bile duct and one from the pancreatic duct\u2014both of which showed no abnormal cellular features or involvement by malignant cells.\n\nThe Whipple\u2019s specimen included a segment of duodenum measuring 24 cm in length and 6 cm in circumference, along with a portion of pancreas measuring 4.2 x 3.0 x 2.2 cm and a bile duct segment measuring 1.8 cm in length and 0.8 cm in diameter. The pancreatic duct merged with the bile duct to form a common duct that was narrowed over a region near the ampulla. Within the pancreatic head, an ill-defined firm mass was identified measuring 2.5 x 2.2 x 1.7 cm. Histologic evaluation revealed well-differentiated ductal-type cells forming invasive structures. The tumor extended into peripancreatic and retroperitoneal soft tissues but did not involve any resection margins. The closest distance of invasive tumor to a margin was 1.5 mm at the posterior margin. Extensive perineural invasion and lymphatic invasion were present, though angiovascular invasion was not identified.\n\nIn addition to the invasive component, there was multifocal involvement by pancreatic intraepithelial neoplasia ranging from low to high grade (PanIN-1b to PanIN-3). Evaluation of thirteen regional lymph nodes revealed three involved by metastatic disease. No prior treatment effect was observed. All other tissue samples including the ampulla, duodenal mucosa, and additional pancreatic tissue away from the tumor were unremarkable. Multiple cassettes were submitted for microscopic examination, covering all relevant anatomical regions and margins."} +{"pid": "TCGA-18-3407", "report": "The specimen included multiple lymph node samples from various locations, including the upper paratracheal, right and left low paratracheal, subcarinal, and inferior pulmonary ligament regions. All lymph nodes were grossly described as dark nodal tissue, with sizes ranging from 0.5 x 0.2 x 0.2 cm up to 1.0 x 0.8 x 0.5 cm. Each lymph node specimen was examined in entirety by frozen section during intraoperative consultation and showed no evidence of malignancy.\n\nThe lung specimen consisted of a left upper lobe measuring 10.8 x 9.5 x 9.0 cm. On gross examination, there was a peripheral tumor measuring 4.0 cm at its greatest dimension. The tumor appeared yellow to grey tan in color and was located peripherally without invasion into the overlying visceral pleura. Additionally, an area of fibrosis measuring 1.3 x 0.4 cm was identified, involving the pleura. The remainder of the lung tissue exhibited emphysematous changes without other notable lesions.\n\nMultiple lobar lymph nodes were identified within this specimen, measuring between 0.5 cm and 1.2 cm in diameter. Sections taken from the tumor in relation to normal lung parenchyma, pleura, fibrotic region, and emphysematous areas were submitted for histologic evaluation. Frozen section analysis of the bronchial resection margin was also performed and showed no evidence of malignancy.\n\nRepresentative sections of all relevant anatomical areas were submitted for microscopic examination, including the resection margin, tumor interface with pleura and lung parenchyma, fibrotic zone, and unaffected lung tissue. Two lobar lymph nodes were also submitted for evaluation and showed no signs of malignant involvement.\n\nFrozen section diagnoses from all lymph node specimens and the bronchial margin confirmed absence of malignancy. Based on these findings, there was no evidence of residual disease within the examined specimens."} +{"pid": "TCGA-GC-A3BM", "report": "The specimen from a male patient included multiple tissue samples. A serosal implant was identified as a gray tan nodule measuring 2.0 x 1.5 x 1.0 cm. No involvement was found at the distal margins of both the right and left ureters, which measured 0.7 cm and 0.6 cm in diameter respectively.\n\nThe cystectomy and prostatectomy specimens included a bladder with multiple brown tan nodules involving the dome and lateral walls, ranging in size from 0.5 to 1.5 cm. One area of ulceration on the left lateral wall measured 1.0 x 0.5 cm. The largest lesion, located at the dome of the bladder, measured approximately 1.5 x 1.0 x 0.8 cm and microscopically extended into the deep muscularis propria. Lymphovascular space invasion was present, and all surgical margins were uninvolved. Additional findings included urothelial carcinoma in situ and a separate incidental finding in the prostate.\n\nThe prostate measured 5.0 x 4.0 x 3.5 cm and showed no gross lesion. Histologically, it demonstrated adenocarcinoma, conventional type, with a total Gleason score of 6/10 (primary and secondary patterns both 3/5). Approximately 5% of the gland volume was involved. There was no extraprostatic extension or seminal vesicle involvement, and lymphovascular space invasion was not identified. High-grade prostatic intraepithelial neoplasia was present, and benign prostatic hyperplasia was noted. All surgical margins were uninvolved.\n\nLymph node evaluation included two pelvic lymph nodes, one from each side, measuring 2.5 x 1.4 x 1.7 cm and 1.0 x 1.0 x 0.6 cm respectively. Both showed benign hyperplasia without evidence of metastatic disease.\n\nThe vermiform appendix showed no pathological abnormalities. Grossly, it measured 6.0 cm in length and had no lesions or fecaliths identified. Microscopic sections revealed no significant pathology.\n\nRepresentative sections from all areas of interest, including the bladder walls, trigone, ureteral margins, prostate lobes, and surrounding fat, were submitted for further analysis."} +{"pid": "TCGA-Q3-A5QY", "report": "The specimen consists of a pancreaticoduodenectomy (Whipple resection) including the head of the pancreas, duodenum, and common bile duct. Gross examination reveals a firm, tan-white, poorly circumscribed mass measuring 2.7 cm in greatest dimension, located in the pancreatic head. Additional dimensions are 2.2 x 2.0 cm. The tumor appears centered around the pancreatic duct and constricts it. It is located 0.5 cm from the ampulla of Vater and does not grossly involve the duodenal muscularis or mucosa. The tumor is 1.4 cm from the distal pancreatic resection margin, which appears free of tumor involvement. Lateral margins composed of adipose tissue range from 0.5\u20132.5 cm in thickness and are also grossly free of tumor.\n\nMicroscopic evaluation indicates that the lesion invades the duodenal wall and extends into surrounding peripancreatic soft tissue inferiorly. Margins are uninvolved by tumor, with the closest distance from the tumor to the retroperitoneal margin being 5 mm. Histologic analysis reveals moderately differentiated morphology with invasion of the muscularis propria of the duodenum and presence of perineural invasion. No lymphovascular invasion is identified.\n\nEighteen lymph nodes were examined, and four contain metastatic disease. No distant metastasis is identified. Pathologic staging reflects pT3 for local extension beyond the pancreas without involvement of major vessels such as the celiac axis or superior mesenteric artery, and pN1 based on regional lymph node involvement.\n\nAdditional findings include chronic pancreatitis and fat necrosis. No neoadjuvant treatment was administered prior to surgery. Ancillary studies were not performed. The remainder of the pancreatic parenchyma is firm and nodular. Seven lymph nodes adjacent to the pancreas are identified, with the largest measuring 0.7 cm. Multiple cassettes were submitted for histologic evaluation, including margins, tumor relationships, and lymph nodes."} +{"pid": "TCGA-IR-A3LK", "report": "The submitted specimens include a radical hysterectomy with removal of the cervix, bilateral fallopian tubes and ovaries, as well as excisional biopsies of the right external iliac lymph node, an additional vaginal biopsy, and bilateral pelvic lymph nodes.\n\nMicroscopic evaluation of the hysterectomy specimen shows a moderately to poorly differentiated infiltrating epithelial lesion within the cervix. The lesion measures 15 mm in thickness and fully traverses the cervical stroma. Extension of the lesion is noted into the left parametrial region. The posterior cervical margin is involved by atypical cells, while all other surgical margins are free of involvement. Additional findings in the hysterectomy specimen include a benign endometrial polyp, unremarkable myometrium, and normal bilateral fallopian tubes and left ovary. Three lymph nodes removed from the parametrial area are without atypical cells.\n\nOne lymph node from the right external iliac region, six from the right pelvic area, and seven from the left pelvic region were all negative for atypical involvement. The vaginal biopsy shows no evidence of abnormal cellular changes and demonstrates benign squamous mucosa.\n\nAll histopathological evaluations were performed following personal review of the slides."} +{"pid": "TCGA-AO-A12G", "report": "A 45-year-old female presented with a lesion in the right breast, measuring approximately 2.6 cm clinically. A mastectomy and sentinel lymph node biopsy were performed. The surgical specimen of the right breast revealed an ovoid white-tan tumor located in the upper outer quadrant, measuring 2.5 x 1.6 x 1.3 cm grossly, and situated 1.3 cm from the deep margin. Histological evaluation demonstrated invasive pleomorphic cellular infiltrates within the breast tissue. Adjacent in situ changes were also identified, characterized by pleomorphic features and calcifications. No vascular invasion was observed, and there was no involvement of the nipple, skin, or surgical margins by either invasive or in situ disease. Non-neoplastic fibrocystic changes were present in the surrounding breast tissue.\n\nAxillary lymph nodes were evaluated. Sentinel lymph nodes #1 and #2 measured 0.4 x 0.3 x 0.3 cm and 0.5 x 0.5 x 0.4 cm respectively, and were both benign. Non-sentinel lymph node #1 measured 0.3 x 0.3 x 0.2 cm and was also benign. Sentinel lymph node #3 measured 0.5 x 0.4 x 0.3 cm and contained clusters of atypical cells forming micrometastatic deposits less than 2 mm in size. Additional immunohistochemical staining confirmed these findings.\n\nImmunohistochemical analysis showed strong nuclear staining for ER (100%), weak to moderate staining for PR (30% positivity), and HER2 positivity with a staining intensity of 2+. E-cadherin staining was negative.\n\nThe remaining axillary lymph nodes showed no evidence of metastatic disease. Level I lymph nodes were negative except for one containing micrometastasis. The skin showed seborrheic keratosis without evidence of malignancy. The breast specimen showed no other identifiable lesions apart from the described tumor and in situ changes."} +{"pid": "TCGA-DB-5274", "report": "The specimen consists of brain tissue from the left frontal region, measuring 8.5 x 7.2 x 2.3 cm. A lesion was identified with a size of 4.0 x 3.2 x 1.8 cm on frozen section evaluation. Histologic examination reveals features including nodularity and satellitosis. Cytogenetic studies from a prior specimen demonstrated deletion of 1p19q; these studies were not repeated in the current sample. Multiple tissue fragments (parts 1 through 8) were submitted for analysis. Cellular morphology suggests a high-grade infiltrative neoplasm with characteristics consistent with a mixed glial cell population. Staging is based on histologic grade and extent of infiltration."} +{"pid": "TCGA-HT-7611", "report": "The pathology report describes a glial neoplasm that is mildly hypercellular and demonstrates diffuse infiltration of both gray and white matter. The tumor cells have predominantly small, round, smooth-walled nuclei, although a few scattered larger round nuclei are also present. No perinuclear halos are identified. The cells exhibit fine fibrillary processes. Focally, on slide 2B, a microgemistocytic pattern is observed. There is no evidence of mitotic activity, microvascular proliferation, or necrosis."} +{"pid": "TCGA-BP-4774", "report": "The right renal mass specimen from a partial nephrectomy measures 4.6 x 3.9 x 3.1 cm and contains a well-circumscribed lesion measuring 3.6 x 2.4 x 3.3 cm with tan-pink to golden yellow features. The deep resection margin is closely approached by the lesion. Histologic evaluation reveals nuclear grade II/IV morphology within the lesion. No evidence of local invasion or vascular involvement is identified. Adjacent renal parenchyma appears unremarkable. Additional specimens submitted include a right renal cyst and right cyst wall, both demonstrating benign features on histologic examination. The cyst specimen measures 2.5 x 1.3 x 0.4 cm and the cyst wall specimen measures 0.5 x 0.4 x 0.2 cm. All tissues were evaluated intraoperatively and findings were consistent with permanent diagnoses. Staging indicates the lesion is confined to the kidney and measures less than 7.0 cm in greatest dimension."} +{"pid": "TCGA-TM-A84H", "report": "The specimen consists of multiple tissue samples from the right frontal region, including a larger piece measuring 6 x 6 mm and a smaller fragment of 2 x 2 mm, as well as additional fragments up to 50 x 30 x 30 mm. The tissue exhibits variable appearances, with areas showing haemorrhage, myxoid change, and microcystic alterations. Some regions are soft and friable with a creamy cut surface.\n\nMicroscopic examination reveals a range of cytoarchitectural patterns. In some areas, the tissue demonstrates oedematous changes with a \"fried egg\" appearance and infiltration into grey matter with peri-neuronal satellitosis. The cells have round to oval, slightly irregular nuclei with granular chromatin and minimal cytoplasm. Mini-gemistocytes are present, and the background appears fibrillary. In other regions, the tissue is more cellular, arranged in sheets or alternating hypercellular and hypocellular zones. These areas show pleomorphic and hyperchromatic nuclei, minimal cytoplasm, and nuclear angulation. Mitotic figures are scattered throughout, with a maximum count of seven mitotic figures per 10 high power fields (each field area 0.196 mm\u00b2).\n\nImmunohistochemical staining for MIB-1 indicates variable proliferation activity. Low-grade and microcystic areas demonstrate low proliferation indices, while hypercellular foci show elevated labelling. Staining for p53 protein does not reveal convincing nuclear positivity. Synaptophysin staining is observed in many neoplastic cells, particularly in hypercellular regions, presenting as granular cytoplasmic positivity with occasional perinuclear dot-like patterns. No significant NeuN positivity is noted, and neurofilament staining highlights a non-neoplastic neuronal population and entrapped neuropil processes.\n\nFluorescence in situ hybridization (FISH) studies were performed on representative formalin-fixed paraffin-embedded sections to assess genetic markers 1p, 19q, and EGFR. Results indicate no loss of 1p or 19q, and no amplification of EGFR.\n\nBased on these findings, the lesion demonstrates features consistent with a diffuse glial neoplasm exhibiting oligodendroglial characteristics. Cellular atypia, mitotic activity, and variable architectural patterns are noted. The absence of vascular endothelial proliferation and necrosis is documented. The proliferation index and mitotic count support a higher grade classification."} +{"pid": "TCGA-B6-A0I2", "report": "Surgical Pathology Report:\n\nThe medial margin right breast biopsy consists of a 3.7 x 2.2 x 0.6 cm disc of firm white tissue with four sutures marking the true margin inked black. Sections submitted include A1-A4.\n\nA second specimen from the right breast consists of an irregular 10 x 0.5 x 1.7 cm tan-brown coarsely papillary tissue sample. Portions were submitted for biomarker testing and tissue banking, with frozen section remnant in Block B1.\n\nThe left breast wide reexcision specimen measures 4.5 x 4.3 x 2.2 cm. The superior pole is inked black and the inferior blue. On sectioning, there is a 1.3 x 1.3 x 1 cm round, white, firm, gritty, sharply circumscribed lesion located in the superior portion of the specimen. This lesion extends to within 2 mm of the superior margin but does not closely approach other margins. The remainder of the tissue shows firm white and tan admixed parenchyma. The specimen was divided into deep and superficial halves and submitted from medial to lateral as Blocks C1-C15.\n\nThe right breast and axillary specimen measures 6.7 x 6.5 x 3.2 cm with an attached axillary tail measuring 10 x 2.3 x 0.9 cm. The medial surface is inked red, inferior margin black, and superior margin blue. Within the breast tissue, there is a 4.5 x 2.3 x 2.5 cm white firm lesion composed of tan-yellow loose aggregates. The lesion approaches to within 3 mm of the superior inked margin, 1 cm from the superior margin, 5 mm from the inferior margin, and 4 mm from the deep margin. The remainder of the breast tissue appears unremarkable. The axillary dissection includes lymph nodes categorized into low, mid, and distal levels. Multiple lymph nodes ranging from 0.3 to 1.4 cm were identified without gross involvement. Submitted blocks include D1-D15.\n\nThe left axillary dissection measures 6 x 9 x 1.7 cm with a black suture at one pole. Divided into lower, middle, and distal sections, multiple lymph nodes ranging from 0.3 to 1.7 cm were identified; none show gross evidence of involvement. Submitted blocks include E1-E8.\n\nIntraoperative consultation findings indicate no carcinoma at the inked margin of the medial margin right breast biopsy. Carcinoma was identified in the right and left breast biopsies.\n\nHistologic examination of the left breast lesion reveals high-grade features with NSABP histologic grade 3 and nuclear grade 3. The intraductal component constitutes 5% of the lesion and is non-comedo type. Vascular space invasion was identified in one block. Inked margins are free of tumor, although the lesion extends to within 1 mm of the superior inked margin. Microcalcifications are present. Background changes include apocrine metaplasia and microcyst formation.\n\nExamination of the right breast lesion also demonstrates NSABP histologic grade 3 with nuclear grade 2. The intraductal component comprises 5% and extends beyond the tumor mass. Vascular space invasion was not observed. The closest tumor proximity is 100 microns from the inked margin. Background tissue shows fibroadenomatous change and microcyst formation.\n\nRegional lymph node evaluation reveals no tumor involvement: 10 nodes assessed from the right axillary dissection and 8 nodes from the left axillary dissection showed no evidence of metastasis."} +{"pid": "TCGA-15-1446", "report": "The specimen consists of brain tissue from the right frontal lobe, including one biopsy and two excisions. Histologic evaluation reveals a cellular neoplasm exhibiting features consistent with a high-grade glial neoplasm. Microscopic examination shows areas of fibrillary, gemistocytic, and small cell morphology. Immunohistochemical staining for MIB-1 was performed and demonstrates labeling of approximately 40\u201360% of the cell population. Based on histologic and immunophenotypic features, the neoplasm is classified as WHO grade 4. Frozen section evaluation of the initial biopsy showed glioma with astrocytic features, while the other specimens were deferred for permanent section analysis."} +{"pid": "TCGA-B9-4113", "report": "The left kidney specimen measured 19 x 11 x 5.2 cm and weighed 650 grams. A well-circumscribed mass was identified in the lower pole, measuring approximately 5.8 x 4.0 x 2.9 cm. The mass appeared soft and yellow with a hemorrhagic central portion. No cysts or calcifications were observed. Microscopic evaluation showed that the mass extended into, but not through, the renal capsule. There was no involvement of the renal vein, ureter, or perirenal adipose tissue. Surgical margins were negative for involvement. Adjacent non-neoplastic kidney tissue showed scattered fibromatous nodules in the medulla. Three firm white cortical nodules were also noted, each less than 0.5 cm in greatest dimension.\n\nThe right testicle measured 5.5 x 3.0 x 2.5 cm and weighed 37.1 grams. It had an attached epididymis measuring 3.5 x 1.2 x 1.0 cm. The external surface was smooth and glistening, with no masses or lesions identified in the testicular or epididymal cut surfaces. The left testicle measured 5 x 3.3 x 3.0 cm and weighed 40.3 grams, with an attached epididymis measuring 5.5 x 2.0 cm. Both testicles exhibited soft, orange to brown parenchyma without gross abnormalities. Histologic examination of both testes revealed benign parenchymal tissue with mild decreased spermatogenesis and no neoplastic changes.\n\nSections from all surgical margins and surrounding tissues were examined microscopically and showed no evidence of tumor involvement. No lymph nodes were identified or sampled."} +{"pid": "TCGA-RD-A8N5", "report": "The specimen consisted of a portion of stomach measuring 140 x 100 x 50mm, with attached adipose tissue along the presumed lesser curvature near the distal esophagus. Multiple free-floating nodules were observed within the stomach lumen. The esophageal margin was not stapled, and two stapled resection margins were identified, located approximately 60mm and 35mm from the tumor mass, respectively. A mass measuring 60 x 45mm was found adjacent to the esophagogastric junction on the lesser curvature, located approximately 7mm from the esophageal resection margin. On cross-section, the lesion extended through the stomach wall into adjacent adipose tissue. Margins were marked with black ink. Selected blocks included the esophageal margin, both gastric resection margins, composite sections of the lesion, random stomach tissue, and lymph nodes from both the lesser and greater curvatures.\n\nMicroscopic evaluation revealed pools and lakes of mucin containing strips of columnar epithelium with moderate nuclear atypia and basal nuclei. Foamy macrophages were present, and some cells exhibited a signet ring appearance, although these were not prominent. There was no evidence of lymphovascular or perineural invasion. The lesion extended through the muscularis propria into serosal fat but did not involve the radial resection margin. Inflammation in the surrounding gastric mucosa included a mild-to-moderate chronic inflammatory infiltrate with scattered neutrophils. Helicobacter organisms were identified, but there was no intestinal metaplasia or dysplasia in the adjacent mucosa.\n\nA total of seventeen lymph nodes were examined from the lesser curvature, four of which contained tumor deposits. Additionally, three extranodal tumor deposits were identified. Four lymph nodes from the greater curvature were uninvolved. One separate lymph node specimen was also free of tumor. Specimens labeled as donuts showed no significant findings."} +{"pid": "TCGA-GU-AATP", "report": "A segment of right distal ureter measuring 0.5 cm in diameter and 0.2 cm in length was biopsied and found to be free of abnormal cells. Frozen section analysis confirmed the result. A biopsy of the left distal ureter margin, measuring 0.4 cm in diameter and 0.3 cm in length, showed atypical urothelial cells raising suspicion for in situ changes; however, the tissue was largely denuded, prompting a request for further sampling. Another biopsy from a second site at the left distal ureter, also fresh for frozen section, measured 0.5 cm in diameter and 0.3 cm in length and was reported as benign without any concerning findings.\n\nRadical surgical removal of the urinary bladder and prostate was performed. Within the right superior lateral wall of the bladder, a pedunculated mass measuring 1.5 x 1.5 cm was identified. Microscopic evaluation revealed high-grade urothelial cells with features of invasion into the superficial muscularis propria. Lymphovascular invasion was present. All resection margins were clear of invasive disease. Adjacent urothelium showed in situ changes. Additionally, a separate focus of similar cellular involvement was noted in the prostatic urethra, extending into the subepithelial connective tissue. The prostate itself displayed nodular hyperplasia and atrophy. No other significant epithelial lesions were identified.\n\nLymph node assessment included multiple sites. Of 24 lymph nodes examined across various regions, three contained clusters of atypical cells consistent with metastatic involvement. Specifically, one out of three right obturator lymph nodes showed isolated tumor cell clusters (micrometastasis), and two out of twelve right iliac lymph nodes had metastatic deposits, one measuring 3 mm and another showing isolated tumor cells. The remaining lymph nodes from the left iliac and left obturator regions were negative for any abnormal cells.\n\nAncillary studies using immunohistochemical staining supported the identification of these atypical cells. Multiple blocks were preserved for potential additional testing. Gross examination of the surgical specimen showed a firm, red-brown mass within the bladder wall, with no clear invasion into deeper muscle layers upon initial sectioning. Surrounding areas of edema and flattened mucosa were also evaluated but did not show evidence of invasion. Prostate sections revealed multinodular architecture and cystic changes, but no discrete mass was identified. Minimal normal mucosa was present, and no other distinct lesions were observed."} +{"pid": "TCGA-E2-A1IH", "report": "The surgical specimens included two sentinel lymph nodes from the left axilla and a wide local excision specimen from the left breast with needle localization, along with an additional medial margin tissue sample. The first sentinel lymph node measured 1.5 x 1.0 x 0.7 cm and the second measured 1.0 x 0.7 x 0.5 cm; both were serially sectioned and found to be free of metastatic disease. The breast specimen weighed 79g and measured 2.5 cm from anterior to posterior, 7.5 cm from superior to inferior, and 8.5 cm from medial to lateral. A well-circumscribed mass was identified measuring 1.5 x 1.0 x 0.8 cm, located 0.6 cm from the deep margin, 0.7 cm from the anterior margin, and 0.8 cm from the medial margin. The mass spanned slices 2 and 3 of the serially sectioned specimen. Margins were inked in different colors for orientation and multiple sections were submitted for histologic evaluation. The additional medial margin specimen weighed 4g and measured 5.0 x 2.0 x 1.0 cm; no tumor was identified in this tissue.\n\nHistologic analysis revealed a lesion with nuclear grade 2 features and a tubular score of 1, resulting in a modified Scarff Bloom Richardson grade of 2. No necrosis or vascular/lymphatic invasion was identified. All surgical margins were negative for tumor involvement. Immunohistochemical staining showed positivity for estrogen and progesterone receptors with Allred scores of 8 for both (proportion score 5 and intensity score 3). HER2 testing by immunohistochemistry demonstrated equivocal results with an intensity of 2+ and 20% tumor staining. Fluorescence in situ hybridization (FISH) was performed and yielded a HER2 to D17Z1 ratio of 2.28, which is considered equivocal under standard reporting guidelines. No definitive high-level amplification was observed, though low-level duplication of the HER2 gene could not be ruled out. The tumor was negative for E-cadherin expression. Pathologic staging was determined to be pT1c N0."} +{"pid": "TCGA-XF-AAN5", "report": "A surgical pathology report was generated following an anterior pelvic exenteration with bilateral pelvic lymph node dissection and urinary diversion. Specimens were received from multiple sites including the right and left distal ureters, urethral margin, bladder, uterus, cervix, bilateral fallopian tubes, ovaries, left and right proximal ureters, and multiple lymph node regions.\n\nMicroscopic evaluation of the right and left distal ureters showed no evidence of high-grade atypia or abnormal cellular growth, with both specimens demonstrating benign features. The right distal ureter exhibited chronic inflammation and associated reactive changes, while the left distal ureter showed no significant histopathologic findings. The urethral margin also showed no signs of atypia or abnormal cells, with findings consistent with benign urethral mucosa, squamous metaplasia, and chronic inflammation.\n\nThe bladder specimen revealed a poorly differentiated invasive lesion involving the right lateral wall, measuring 6 x 3 x 2 cm. The tumor extended through the bladder wall into the surrounding soft tissue and involved the right ureterovesical junction, with extension into the intramural segment of the ureter. A single focus of vascular invasion was identified. Adjacent urothelium showed flat changes indicative of in situ involvement. However, random sections of the trigone, bladder neck, and other areas showed only squamous metaplasia without evidence of dysplasia or in situ malignancy. All resection margins were free of abnormal cells.\n\nExamination of the uterus, cervix, fallopian tubes, and ovaries showed no significant histopathologic changes. The cervix displayed benign squamous and endocervical mucosa, and the endometrium showed atrophy. The myometrium and serosa were unremarkable. The ovaries showed atrophic changes, and the fallopian tubes revealed a simple paratubal cyst on the left with no other significant findings.\n\nLymph node regions examined included left external iliac, right and left pre-sciatic, pre-sacral, left obturator/hypogastric, left para-aortic, left common iliac, inter-aortic caval, right para-caval, right common iliac, right lymph node of Cloquet, right external iliac, right obturator/hypogastric, and left lymph nodes of Cloquet. In total, 66 lymph nodes were evaluated, and none showed evidence of abnormal cellular infiltration or involvement.\n\nGross examination of the bladder showed a mass on the right side involving the right ureterovesical junction, with tumor extending into the perivesical soft tissue to a depth of 2 cm. The uninvolved bladder wall measured 0.8 cm in thickness, and no other lesions or masses were identified. The ureteral stent was removed during the procedure, and the right ureter was noted to narrow significantly in its intramural segment. The left ureter appeared patent and unremarkable.\n\nPathologic staging was determined as pTis,T3bN0MX. A P53 assay by immunohistology was performed on representative sections of the invasive carcinoma, with results pending in a separate addendum. All other submitted specimens were consistent with benign or non-malignant findings."} +{"pid": "TCGA-A2-A0EP", "report": "Specimen #: , Age: F, Race: WHITE. SPECIMEN: A: RIGHT AXILLARY SENTINEL L.N. B: RIGHT BREAST MASTECTOMY C: RIGHT BREAST TISSUE. D: LEFT BREAST MASTECTOMY. \n\nA. RIGHT AXILLARY SENTINEL LYMPH NODE, BIOPSY: One lymph node with rare individual cytokeratin-positive cells identified by immunohistchemistry, measuring less than 0.2 mm in diameter. \n\nB. RIGHT BREAST, MASTECTOMY: A 22.5 cm medial to lateral, 21.0 cm superior to inferior, and 3.8 cm anterior to posterior mastectomy specimen weighing 950.0 grams. The overlying skin measures 15.0 x 7.5 cm and contains a vell-healed curvilinear scar 4.3 cm in length. The specimen is oriented with sutures; the anterior margin is inked blue, and the posterior margin is inked black. A 2.0 cm indurated area was identified in the lower inner quadrant at the 5:00 position, abutting the anterior medial margin. Histologically, this lesion shows moderate differentiation (Bloom-Richardson score 6). There is also extensive presence of a non-invasive component involving lobular structures (LN3). The anterior margin is positive for invasive disease. Estrogen receptor status is positive, while progesterone receptor status is negative. Her2 neu testing shows no amplification. \n\nC. RIGHT BREAST TISSUE, EXCISION: No evidence of tumor identified. \n\nD. LEFT BREAST, MASTECTOMY: A 24.5 cm medial to lateral, 19.0 cm superior to inferior, and 5.0 cm anterior to posterior mastectomy specimen weighing 1540.0 grams. No discrete mass identified. Histologic evaluation reveals focal presence of a non-invasive lobular lesion (LN3), along with usual ductal epithelial hyperplasia and columnar cell change. \n\nStaging for the right breast lesion is reported as T1cN0(i+)(sn) MX. ER/PR and Her2 neu studies were performed on a prior biopsy and not repeated in this specimen. \n\nGROSS DESCRIPTION: \nA. A 2.0 x 1.6 x 1.0 cm piece of fatty tissue containing a 1.0 cm lymph node, bisected with a 1.0 mm thick section submitted for protocol. \nB. Multiple sections taken from the tumor site, surrounding fibrofatty tissue at various distances, nipple, and skin. \nC. A 6.5 x 6.0 x 3.5 cm fragment of fatty tissue, inked black, with minimal fibrous component. Sections taken throughout. \nD. Sections of skin and fibrofatty tissue from all quadrents are submitted for analysis."} +{"pid": "TCGA-5P-A9JU", "report": "A neoplasm measuring 5 cm in diameter is present in the medial region of the specimen obtained from a left nephrectomy. The lesion demonstrates infiltration into the peripelvic fat and exhibits additional tumor-like structures within the renal veins. No evidence of involvement is noted at the ureteral or vascular surgical margins. Histological assessment indicates a high nuclear grade. The tumor is confined locally with no residual disease observed. According to the TNM 2010 classification, the pathological stage is pT3a with lymphovascular invasion (V2) and no nodal involvement (Pn0). The resection margins are negative."} +{"pid": "TCGA-HC-7817", "report": "The addendum report has been issued to clarify information from the container labels, which indicated specimens from both prostate and pelvic lymph nodes. Upon further inspection, no lymph nodes were identified in the specimen.\n\nThe prostate specimen measured 3.8 x 3.5 x 1.0 cm and was sectioned entirely. Histologic evaluation revealed a primary pattern of 4/5 and a secondary pattern of 3/5. The overall histologic grade was recorded as 7 out of 10. The lesion involved both lobes and accounted for approximately 5% of the tissue sampled. There was involvement of the right seminal vesicle and extension beyond the prostate capsule in the section adjacent to the right seminal vesicle. No lymphovascular space invasion was observed. Extensive involvement around nerves within the prostate was noted. High-grade intraepithelial neoplasia was also present.\n\nSurgical margin assessment showed negative margins at the bladder neck. Positive margins were identified at the apical/inferior region and at the inked prostatic margin on the right side near the right seminal vesicle. No lymph nodes were recovered with the specimen.\n\nAdditional findings included benign prostatic hyperplasia, high-grade intraepithelial neoplasia, and chronic inflammation. A focal organizing thrombus was observed in a periprostatic blood vessel. Staging was assessed as T3b with no lymph node or distant metastasis identified.\n\nSections from block #1 demonstrated extensive involvement in the area adjacent to the right seminal vesicle, with tumor located approximately 1 mm away from the seminal vesicle epithelium. Extraprostatic extension was confirmed in this section.\n\nThe specimen was received in formalin and consisted of a single container labeled \"pelvic lymph nodes.\" It contained a prostate specimen measuring 3.8 x 3.5 x 1.0 cm with a pink-tan, focally cystic appearance. Serial sections were submitted for analysis and labeled accordingly."} +{"pid": "TCGA-DU-7015", "report": "The specimen consists of multiple tissue fragments measuring 0.5 to 1.2 cm. A separate fragment measuring 1.5 x 1 x 0.3 cm is described as tan-gray, soft, smooth, and shiny. Microscopic evaluation reveals a moderately cellular tumor involving the white matter and cortex. The nuclei show mild pleomorphism, and mitotic figures are rare. There is no evidence of vascular endothelial hyperplasia or tumor necrosis. The tumor demonstrates immunohistochemical labeling with MIB-1 at 4%."} +{"pid": "TCGA-AC-A3OD", "report": "The surgical pathology report includes findings from a right breast prophylactic mastectomy and left breast mastectomy with sentinel lymph node biopsies. The right breast showed benign findings including atypical ductal hyperplasia, usual ductal hyperplasia, radial scar, apocrine metaplasia, and columnar cell change. No malignant findings were identified in the right breast.\n\nIn the left breast, a single large focus of invasive carcinoma was identified. The tumor measured 50 mm and was located at the 12:00 position. Histologic evaluation revealed a low-grade morphology with a total Nottingham grade of 1 (cumulative score of 5 out of 9). Tubule formation was less than 10%, nuclear pleomorphism was low grade, and mitotic count was low (one mitosis per ten high power fields). No lymphatic invasion was observed. Surgical margins were negative with distances ranging from 17 mm to 20 mm or greater. No ductal or lobular carcinoma in situ was identified. The skin and nipple were not involved.\n\nLymph node evaluation included three sentinel lymph nodes from the left axilla. One lymph node contained a micrometastasis measuring 1.95 mm in greatest dimension. Another lymph node contained isolated tumor cells. No extracapsular extension was present. Immunohistochemical staining for OSCAR keratin confirmed the presence of metastatic carcinoma in one node and isolated tumor cells in another.\n\nPathologic staging based on the findings was pT2 for the primary tumor and pN1mi for regional lymph node involvement (1 of 3 nodes with micrometastasis). Distant metastasis could not be assessed. The overall pathologic stage was determined to be IIB.\n\nHormone receptor analysis showed strong positivity for both estrogen and progesterone receptors (100% positive cells with strong intensity). HER2/neu testing was negative (1+ on a scale of 0\u20133+). The Ki-67 proliferative index was intermediate at 15%."} +{"pid": "TCGA-55-7995", "report": "The surgical specimen included a wedge resection from the left upper lobe, which contained a solid gray-tan mass measuring 2.6 x 2.4 x 1.7 cm. The lesion was located 0.6 cm from the stapled parenchymal resection margin and showed a focally infiltrating border. Histologically, the lesion consisted of solid nests of cells with large vesicular nuclei and abundant eosinophilic cytoplasm. Mitotic figures were frequent, and areas of tumor necrosis were present. Elastic staining showed that the lesion abutted but did not invade the visceral pleura. Adjacent lung tissue demonstrated emphysematous changes without significant pathology.\n\nLymph node specimens were received from levels 5, 6, 7, 9L, and 12L. All lymph nodes exhibited benign features with anthracotic pigmentation and no evidence of malignant involvement. A total of eight lymph nodes were examined, with none showing signs of metastatic disease.\n\nA lobectomy specimen from the left upper lobe showed no residual tumor. Both bronchial and vascular margins were free of involvement. The closest distance from the tumor to the bronchial resection margin was 4.5 cm. Pulmonary parenchyma displayed patchy interstitial fibrosis and nonspecific emphysematous changes. Hilar lymph nodes were benign with marked anthracosis.\n\nPathologic staging was determined as pT1b, based on a tumor size greater than 2 cm but not exceeding 3 cm, surrounded by lung or visceral pleura, without bronchoscopic evidence of more proximal invasion. Regional lymph node involvement was classified as pN0, with no metastases identified in a total of eight lymph nodes sampled (four N1 and four N2 nodes). Distant metastasis was not identified (pM0). The final TNM classification was T1bN0M0, corresponding to stage IA. No ancillary molecular testing was performed due to absence of stage IV disease and lack of available fresh tissue."} +{"pid": "TCGA-IB-AAUW", "report": "The specimen was received fresh and placed into formalin. A resection specimen was submitted for evaluation, including portions of the pancreas, duodenum, common bile duct, and attached soft tissue. A firm, ill-defined yellow to light tan variegated lesion measuring 3.5 x 2.1 x 1.8 cm was identified surrounding the common bile duct. The closest distances from the lesion to various margins were recorded: 0.5 cm to the common bile duct margin, 1.0 cm to the body margin, 0.1 cm to the vessel bed, 0.1 cm to the uncinate margin, 0.3 cm to the posterior surface, 2.5 cm to the anterior surface, 1.5 cm to the proximal margin, and 18.5 cm to the distal margin.\n\nMicroscopic examination revealed invasive carcinoma with poor differentiation. Tumor cells were found within 0.2 cm of the vascular bed and 0.1 cm from the uncinate resection margin. The bile duct and pancreatic body resection margins were free of tumor involvement. Six lymph nodes associated with the resection specimen showed no evidence of malignancy.\n\nA single lymph node from the portal region was positive for metastatic carcinoma. The size of the metastatic deposit was 0.5 cm, and extracapsular invasion was noted. Two lymph nodes from group B and one from the peripancreatic region were negative for malignancy. Additionally, a gallbladder specimen showed findings consistent with acute cholecystitis and cholelithiasis.\n\nHistologic grading was determined to be poorly differentiated. Lymphovascular and perineural invasion were present. The primary tumor extended beyond the pancreas but did not involve the celiac axis or superior mesenteric artery (pT3). Regional lymph node metastasis was identified (pN1), with one of nine lymph nodes involved. No distant metastases were identified.\n\nAdditional findings included pancreatic intraepithelial neoplasia, highest grade PanIN III. No prior treatment effect was observed."} +{"pid": "TCGA-85-8049", "report": "The submitted lung tissue specimen was obtained from a left lower lobectomy. The tumor measured 3.5 x 2.5 x 3 cm and was found to be moderately differentiated with squamous cell morphology. No information is available regarding histologic grade consistency, tumor extent, presence of additional nodules, lymph node involvement, lymphatic or venous invasion, margin status, neo-adjuvant treatment effect, or other associated pathologic findings."} +{"pid": "TCGA-A8-A07B", "report": "The specimen shows a poorly differentiated invasive lesion measuring 3.0 cm in diameter. Histologic evaluation reveals high-grade nuclear features with a mitotic index classified as grade III. The tumor is categorized as pT2 based on size, and there is evidence of lymphovascular invasion. The growth pattern is classified as NOS (not otherwise specified)."} +{"pid": "TCGA-EB-A3Y7", "report": "The excised skin lesion from the face measured 1.5 x 1 x 2 cm and exhibited pigmentation. Microscopic evaluation revealed a depth of invasion measuring 4 mm. The lesion showed no evidence of venous invasion, and surgical margins were uninvolved. Satellite nodules were identified. No lymphatic invasion or lymph node involvement was specified. There was no identifiable treatment effect, and no additional findings were reported."} +{"pid": "TCGA-WQ-A9G7", "report": "The specimen included a gallbladder and a right hepatic lobectomy. The patient is a female with a history of a right hepatic mass. The gallbladder showed focal mild chronic inflammation. In the liver specimen, two masses were identified. The larger mass measured 12.0 x 11.0 x 9.0 cm and was located in the right hepatic lobe, extending to the inferior capsule. The smaller mass measured 1.1 x 0.8 x 0.8 cm and was also present in the right hepatic lobe. Both masses were encapsulated and extended to the liver capsule. Microscopically, the tissue showed minimal steatosis (1%) and focal portal inflammation. Immunohistochemical staining revealed positivity for glypican 3, CK7 (focal and weak), and MOC-31, while negative for CK20, pCEA, and hepatocyte. Reticulin staining demonstrated loss of reticulin fibers. Histologic evaluation showed poorly differentiated cells. All assessed margins were free of involvement. No venous or lymphatic invasion was identified. No lymph nodes were examined. Staging was determined as pT3a, indicating multiple tumors greater than 5 cm, with no assessable lymph node involvement and no evidence of distant metastasis. The pathologic stage is considered provisional."} +{"pid": "TCGA-FG-7634", "report": "Intraoperative consultation was performed on a left frontal lesion. The specimen consisted of multiple pink-tan soft tissue fragments measuring 1 x 0.4 x 0.2 cm in aggregate. Portions were submitted for frozen section and touch imprint, with the remainder processed for permanent sections. Microscopic evaluation showed neoplastic cells with features including chromosomal changes involving loss of material. Specific cassettes included 1FS and 2 permanent blocks. A fluorescence in situ hybridization study was conducted, and results were documented in the Department of Pathology."} +{"pid": "TCGA-25-2042", "report": "The pathology report information includes the following details: The case was originally sent to the NCH BCR location. The specimen was received at the Biospecimen Core Resource (BCR) on an unspecified date. Histology and site codes were provided for both the specimen and the overall case, based on the Case Quality Control Form (CQCF). Additional histology and site codes were also documented for the patient diagnosis when available from other sources. No tumor type or diagnosis-specific terms were included in this summary. All entries were completed according to working instructions outlined in the TCGA Missing Pathology Report Form."} +{"pid": "TCGA-46-6026", "report": "The surgical specimen consists of a right lower lobe of lung weighing 311 grams and measuring 18 x 14 x 5 cm. The pleural surface is pink and focally hemorrhagic with a puckered area located anteriorly measuring 2.5 cm. The main bronchus and vessel margins are sealed with metallic staples. The bronchial margin measures 0.4 cm in length and 0.6 cm in diameter, while vessels measure up to 0.3 cm in length and 0.5 cm in diameter. A firm gray mass measuring 4 x 3 x 2.5 cm is identified, located 2.5 cm from the bronchial margin. The mass shows areas of necrosis and has a soft, friable consistency. No involvement of the visceral pleura is observed. Surrounding lung tissue shows moderate emphysematous change and is otherwise unremarkable.\n\nMultiple lymph node specimens were submitted. One group, labeled as 4R right lower paratracheal, consists of six tan to grey black lymph nodes ranging from 0.5 to 1 cm. Another group, Level 7 subcarinal, includes six grey black lymph nodes ranging from 0.5 to 1.2 cm. A third group, posterior 10R right tracheobronchial angle, consists of three tan to tan brown fragments ranging from 0.4 to 0.9 cm. All lymph nodes were submitted intact.\n\nHistologic examination reveals that all surgical margins are free of tumor involvement. The mass is well-circumscribed with extensive necrosis and desmoplastic stromal reaction. Lymphovascular invasion is not identified. One lymph node from the posterior 10R region shows infiltration by poorly differentiated cells within cauterized soft tissue. Additional intralobar lymph nodes identified upon further dissection are negative for tumor involvement.\n\nStaging indicates involvement of regional lymph nodes with one positive node from multiple examined at station 10R, and no evidence of distant metastasis."} +{"pid": "TCGA-BR-A44U", "report": "The pathology report describes a specimen from a subtotal gastrectomy. The tumor is located in the antrum and measures 4 x 0 x 6 cm. It is ulcerated and extends to the subserosa. Histologic evaluation shows poorly differentiated cellular features. Lymph nodes were examined, with 10 out of 15 demonstrating involvement. Invasion into lymphatic channels is present, while venous invasion is not observed. The surgical margins are uninvolved. Additional findings include focal perivascular lymphoid infiltration in the omentum. No neoadjuvant treatment effect is noted."} +{"pid": "TCGA-D7-6518", "report": "Histopathological examination was performed on a resected stomach specimen. The stomach measured 16 x 14 cm and was cut along the greater curvature. An area of thickening measuring 8.5 x 14 cm was observed in the cardia region, involving the lesser curvature as well as the anterior and posterior walls, with an ulceration measuring 5 x 3 cm. Attached omentum measured 14 x 18 x 2 cm. The spleen measured 6.5 x 5.4 x 4 cm and exhibited a thickened capsule with multiple glassy nodules.\n\nMicroscopic evaluation revealed a neoplastic lesion with features of both mucinous and glandular differentiation. The lesion extended through the full thickness of the stomach wall, reaching the peritoneal surface and infiltrating into the omental fat. No involvement was seen at the surgical margins in the esophagus or pylorus.\n\nLymph node assessment showed evidence of metastatic involvement in multiple regional groups: periorificial (4 out of 4 lymph nodes), lesser curvature (10 out of 12), greater curvature (1 out of 1), and splenic hilus (2 out of 4). In all involved groups, there was infiltration of the lymph node capsule and surrounding adipose tissue.\n\nThe spleen demonstrated congestion and fibrous thickening of the capsule. Tumor staging indicated involvement of the muscularis propria layer of the stomach (pT2) and extensive regional lymph node metastases (pN3). High-grade cellular atypia was noted."} +{"pid": "TCGA-FK-A3SB", "report": "Surgical pathology findings are as follows: A total thyroidectomy specimen shows a unifocal lesion in the right lobe measuring 2.0 cm. Evaluation of all excised lymph nodes reveals metastatic involvement in 3 out of 22 lymph nodes across multiple sites, with no extra nodal extension identified. Staging indicates pT3 based on minimal extrathyroidal extension and pN1a for nodal involvement in level VI paratracheal regions; distant metastasis could not be assessed. Surgical margins are free of involvement, and there is evidence of venous and lymphatic invasion. Mild thyroiditis is also noted. Additional excisions of parathyroid tissue were performed, with left superior and right inferior specimens weighing less than 1 mg and 4 mg respectively. A final report has been issued following review of these findings."} +{"pid": "TCGA-AJ-A3I9", "report": "A pelvic washing specimen was received for cell block evaluation, consisting of 60 cc of bloody fluid. The specimen was acellular and non-diagnostic.\n\nImmunohistochemical staining was performed on tissue to evaluate for MLH1, MSH2, MSH6, and PMS2 protein expression as a screen for microsatellite instability (MSI) or Lynch syndrome. All four markers showed normal expression within the tissue, indicating no evidence of MSI by this method. These findings suggest normal DNA mismatch repair function. However, it is noted that a subset of Lynch syndrome cases do not show defects in mismatch repair proteins, and further testing may be warranted if there is a strong family or personal history of related cancers. Additional testing options include PCR-based assays for microsatellite instability, which can be requested as a send-out test and may take up to six weeks for results. Genetic consultation may also be considered.\n\nIntraoperative frozen section analysis of the posterior cervical margin showed poorly differentiated carcinoma approaching the inked margin, while the anterior cervical margin was free of involvement. The resected uterus contained a poorly differentiated adenocarcinoma with areas of high-grade nuclear features. Immunoperoxidase stains were performed for p53, estrogen, and progesterone receptors. The tumor extended through nearly the full thickness of the myometrium, approaching but not reaching the serosal margin. Tumor involvement was present in the left and right parametria but not at the inked margins. No definite angiolymphatic invasion was identified.\n\nLymph node sampling included the following: right external iliac (2 negative nodes), right common iliac (2 negative nodes), left external iliac (1 negative node), left obturator (4 negative nodes), left common iliac (2 negative nodes), posterior vaginal margin (no involvement), left periaortic region (4 negative nodes), and right periaortic region (3 negative nodes). Both adnexa were unremarkable and without tumor involvement.\n\nThe AJCC pathologic stage was determined as T2, N0. The significance of focal p53 staining is uncertain, as most areas did not display high-grade nuclear morphology. A final report was pending the interpretation of immunoperoxidase stains, which have been completed and are reflected in this summary. \n\nThe specimen was received in multiple parts. The uterus measured 6 x 5 x 3 cm, with a tumor measuring approximately 5 x 4 x 3.5 cm occupying much of the endometrial cavity and extending into the cervix. The tumor appeared to involve most of the myometrial thickness but did not reach the serosal surface. All surgical margins were evaluated microscopically. Lymph nodes and other tissues were submitted and processed as described above. \n\nThis laboratory is CLIA-certified to perform high-complexity testing. Some performance characteristics of analytes used in this report have not been cleared or approved by the FDA, though such clearance is not required. These tests are used for clinical purposes and are not considered investigational or for research use only."} +{"pid": "TCGA-XD-AAUH", "report": "The clinical presentation included obstruction of the bile duct and acute pancreatitis. A series of biopsies were performed, including a liver core biopsy and a wedge liver biopsy, both of which showed features consistent with bile outflow obstruction and did not reveal any evidence of malignancy. A biopsy of the common hepatic artery lymph node revealed three lymph nodes without any signs of cancer. A partial pancreaticoduodenectomy was performed, and the specimen was examined to assess multiple margins and lymph nodes.\n\nThe tumor was located in the head of the pancreas and measured 2.8 cm in maximum dimension. Microscopic evaluation indicated that the tumor extended beyond the pancreas, invading into surrounding peripancreatic tissue and the wall of the small bowel. It did not involve the celiac axis or superior mesenteric artery (SMA). Perineural invasion was identified, while large vessel invasion was not observed. Lymphatic invasion was present.\n\nThe surgical margins were evaluated, including the common bile duct, pancreatic duct, and SMA margins, all of which were negative for malignancy. The proximal duodenal margin was positive for subserosal involvement, whereas the distal duodenal margin was negative. A total of 30 regional lymph nodes were retrieved, with 7 out of 22 found to be positive for metastatic disease. Additionally, a biopsy of lymph nodes from the aortocaval groove revealed four lymph nodes without evidence of malignancy.\n\nThe tumor was histologically graded as moderately to poorly differentiated. Based on these findings, the staging classification was determined to be pT3 N1 according to the AJCC 7th edition criteria (2010)."} +{"pid": "TCGA-3A-A9IZ", "report": "The liver biopsies show cholestasis with bile plugs and steatosis. Additional findings include fibrosis, thick-walled vessels, and a foreign body giant cell reaction in various tissue samples. Bile infarcts and cholangitis are also present. Multiple lymph node biopsies are negative for malignancy, as are all soft tissue and nodule biopsies taken from the liver, periphery, and portal regions. Histological examination of the resected pancreatic head reveals a solid tan-white mass measuring 4.0 cm. The tumor invades adjacent peripancreatic soft tissues and is present at the superior mesenteric artery and portal vein groove margins. Extensive perineural and lymphovascular invasion is noted. Three of 21 lymph nodes are involved. No distant metastases are identified. The duodenum and stomach are unremarkable, and an ampullary adenoma is present. Pancreatic intraepithelial neoplasia (PanIN 2) and acute pancreatitis with focal fat necrosis are also observed. All surgical margins are evaluated, with some showing involvement by invasive features. Multiple frozen section analyses of liver nodules, lymph nodes, and other tissues do not reveal evidence of malignancy. Gross evaluation of the Whipple specimen confirms the presence of the 4.0 cm mass in the pancreatic head, with close proximity to several critical margins. Lymph nodes and surrounding soft tissues are variably involved."} +{"pid": "TCGA-DJ-A4UP", "report": "The patient is a female who underwent evaluation of several specimens from the neck region. A biopsy of tissue labeled as \u201crule out right upper parathyroid\u201d revealed a lymph node with a metastatic focus measuring 3 mm in diameter, with the metastatic deposit measuring less than 1 mm. No extranodal extension was observed. This micrometastasis was not detected on frozen section. Another lymph node near the right recurrent nerve was found to be benign.\n\nThe right thyroid lobe and isthmus specimen contained a nodule measuring 1.6 cm in greatest dimension. The lesion was firm, tan-white, and unencapsulated, located in the upper pole. Histologic examination showed well-differentiated cells and psammoma bodies were noted. No mitotic activity, tumor necrosis, blood vessel invasion, or extrathyroid extension was identified. Surgical margins were free of tumor, and no multicentric disease was found. Adjacent thyroid tissue showed features consistent with chronic lymphocytic thyroiditis. No parathyroid tissue was identified in the specimen. Six lymph nodes removed from this area showed metastatic involvement in one node, which measured 5 mm, with a largest deposit of 2.6 mm. No extranodal extension was present.\n\nIn the left thyroid lobe and isthmus, no significant lesions were observed. The cut surfaces were unremarkable, and histology showed chronic lymphocytic thyroiditis. Four lymph nodes in this region were benign.\n\nA lymph node dissection from the right neck levels 2, 3, and 4 yielded a total of 30 lymph nodes, of which 3 contained metastatic deposits. The largest involved lymph node measured 1.5 cm, with the largest tumor focus measuring 1.45 cm. There was no evidence of extranodal extension. Benign skeletal muscle was also present in the specimen.\n\nA separate excision of the lowest level 4 lymph nodes on the right side included seven lymph nodes, all of which were benign.\n\nGross findings confirmed the presence of multiple lymph nodes in various regions, with no grossly identifiable submandibular gland or major vein segments in certain specimens. Skeletal muscle was identified in one specimen and appeared unremarkable. All surgical specimens were processed in full, with representative sections taken for analysis."} +{"pid": "TCGA-EM-A1CV", "report": "The specimen was received from a total thyroidectomy procedure and included a right lower parathyroid biopsy. The thyroid specimen was intact and measured, for the right lobe, 6.3 cm in length by 2.7 cm in width by 1.4 cm in depth, and for the left lobe, 5.9 cm by 2.9 cm by 1.7 cm. The isthmus measured 3.6 cm by 1.5 cm by 1.0 cm, with a total weight of 32.4 g. Gross examination revealed a well-defined nodule in the left upper lobe measuring 1.1 cm in its greatest dimension, with additional smaller lesions identified bilaterally. \n\nMicroscopic evaluation identified multiple distinct tumor foci. In the left lobe, the dominant lesion measured 1.1 cm and displayed classical papillary architecture and cytomorphology. It was well-differentiated (Grade 1), totally encapsulated, and showed minimal capsular invasion without lymphovascular or perineural invasion, and no extrathyroidal extension. Margins were free of involvement. A second tumor focus in the right lobe measured 0.5 cm and demonstrated follicular variant architecture with classical cytological features, also Grade 1. This lesion lacked a capsule, but no invasion or margin involvement was identified. No lymphovascular or perineural invasion or extrathyroidal extension was present.\n\nThree regional lymph nodes were examined and none showed evidence of tumor involvement. No abnormality was noted in the parathyroid tissue evaluated. Sections of the thyroid and parathyroid were submitted for analysis, and all surgical margins were uninvolved. Based on the AJCC/UICC TNM staging system, the tumors were classified as pT1 with pN0 status. Multiple separate tumor foci were confirmed, with the largest measuring 1.1 cm."} +{"pid": "TCGA-B9-4114", "report": "The left kidney specimen measured 22 x 17 x 12 cm and weighed 2,370 grams. The tumor occupied nearly the entire renal parenchyma and measured 22 x 15 x 12 cm at its largest focus. Multiple tumor masses were identified, including several large abutting lesions and peripheral satellite nodules, with the largest measuring at least 10 cm in greatest dimension. The tumor was multifocal and caused significant expansion of the kidney. Gross examination revealed that the tumor approached but did not breach the renal capsule. An area of defect on the exterior surface measuring approximately 4.5 cm was noted, through which tumor tissue protruded.\n\nHistologic evaluation showed necrotic tissue and lymphatic invasion. Nuclear grading was consistent with Fuhrman grade 3 features. Microscopic assessment revealed no involvement of the perirenal adipose tissue, Gerota\u2019s fascia, renal vein, renal artery, or ureter. The surgical margins, including perirenal adipose tissue, renal vein, renal artery, and ureter, were negative for tumor involvement. The closest margin was located at the site of focally thinned capsule, measuring 1 mm. No adrenal gland was present in the specimen. No hilar lymph nodes were identified grossly or histologically.\n\nAdditional findings included focal glomerulosclerosis. Based on available information, staging was assigned as pT2, pNx, pMx. This classification is subject to revision pending further clinical data. Tissue samples from various regions of the tumor and surrounding kidney were submitted for further analysis. Digital imaging was not performed."} +{"pid": "TCGA-CN-4735", "report": "The patient underwent bilateral neck dissection and total laryngectomy. Histologic evaluation of the laryngeal mass showed a poorly differentiated carcinoma. The tumor measured 4.1 cm in greatest dimension and was centered in the left pyriform sinus, extending into the left aryepiglottic fold, pre-epiglottic space, and left periepiglottic space. Resection margins were free of tumor involvement. The thyroid cartilage was also free of tumor. No perineural invasion was identified.\n\nA total of 70 lymph nodes were examined. In the right neck dissection (levels II, III, IV), 29 lymph nodes were negative for tumor involvement, and two contained benign thyroid inclusions. In the left neck dissection (levels II, III, IV), four of 39 lymph nodes showed evidence of tumor involvement. No extracapsular extension was observed. A single level VI lymph node was involved with tumor. The specimen from zone V contained one lymph node that was free of tumor.\n\nIntraoperative frozen section analysis confirmed malignancy in the laryngeal biopsy and absence of tumor in the zone V lymph node, right posterior cricoid, left inferior region near the recurrent laryngeal nerve, and left vallecula.\n\nImmunohistochemical staining showed positivity for EGFR, and negativity for p16 and HPV. Molecular testing for EGFR and c-MET by FISH did not show gene amplification. The majority of cells showed disomy for both markers.\n\nPathologic staging was determined as pT3 pN2b pMX. All surgical margins were uninvolved. No vascular or lymphatic invasion was noted. Additional findings included a hypercellular left parathyroid gland measuring 0.5 cm and a normal-appearing left thyroid lobe. A segment of salivary gland tissue was also free of tumor."} +{"pid": "TCGA-FV-A2QR", "report": "The specimen consists of a gallbladder measuring 7.0 cm in length x 3.0 cm in greatest external diameter. The wall measures 0.3 cm in thickness. No discrete lesion is identified. Two irregular tan-brown calculi are present, each measuring 0.6 x 0.5 x 0.4 cm. Representative sections of the gallbladder and opening are submitted for analysis.\n\nA separate specimen includes an intraluminal mass measuring 0.8 x 0.6 x 0.3 cm located approximately 1.7 cm proximal to the surgical resection margin of the hepatic bile duct. Histologically, sheets and nests of cells with small to medium-sized nuclei and predominantly vacuolated cytoplasm are observed. Some areas demonstrate eosinophilic cytoplasm and increased fibrous stroma. In certain regions, there is a trabecular arrangement with minimal gland-like formation. Tumor tissue is seen within multiple intraparenchymal bile duct lumina.\n\nThe left lobe of the liver measures 9.5 x 9.0 x 6.0 cm and weighs 390 grams. Approximately 85% of the specimen is replaced by an irregular tan-white mass measuring 9.0 x 7.0 x 5.5 cm. Satellite lesions up to 0.6 cm are noted in the surrounding hepatic parenchyma. The surgical resection margin is located 0.1 cm from the main mass. Histologic evaluation confirms tumor involvement within the liver specimen and satellite lesions. Zones of intervening fibrosis are frequently observed.\n\nMargins of resection, including the bile duct margin, show no evidence of tumor involvement. Special stains demonstrate staining for CK8/18 (CAM5.2), CK7 in two of three portions, and focal positivity for HepPar-1 in small numbers of tumor cells. CK20 staining is present in two of three tissue portions with additional staining in the third. Vimentin staining is observed in some tumor cells, and strong staining for alpha-1-AT is noted in all tumor cells. Staining for CA19.9 and pancytokeratin (AE1/AE3) does not show positivity in tumor cells but is consistent with residual ductal elements where present.\n\nNo tumor is identified in the gallbladder or bile duct margin specimens. Adjacent hepatic tissue demonstrates chronic inflammation and portal fibrosis without cirrhosis."} +{"pid": "TCGA-BS-A0V8", "report": "The specimen consisted of a uterus with cervix, bilateral fallopian tubes and ovaries, along with multiple lymph node groups and an umbilical hernia sac. The uterus measured 7.0 x 5.0 x 4.0 cm and was asymmetrical in shape. A diffuse exophytic lesion was identified within the uterine cavity, covering approximately 90% of the endometrial surface and extending to within 2.0 cm of the ectocervix. The tumor measured 6.0 cm in greatest dimension and appeared to invade deeper than 50% of the myometrial thickness (15 mm invasion in a 20 mm thick myometrium). Microscopically, the cellular features included nuclear grade 2 and histologic grade 2 characteristics. Lymphovascular invasion was present. The serosa and parametrium were free of tumor involvement, and no tumor was identified in the right or left adnexa. Cervical stromal extension was noted.\n\nLymph node evaluation included nine left pelvic nodes (all negative), three left aortic nodes (all negative), four right pelvic nodes (all negative), and two right caval nodes (both negative). The umbilical hernia sac revealed fibromembranous tissue without evidence of neoplasm. Gross examination of the uterus showed the tumor extending into the myometrium to a depth of 1.5 cm, with a clear margin of 0.5 cm from the outer serosal surface. No mass lesions were identified in the fallopian tubes or ovaries. Multiple sections were taken for analysis, including cervical regions, tumor tissue, parametrial areas, and associated lymph nodes. Microscopic findings were consistent with the described features."} +{"pid": "TCGA-BG-A0MU", "report": "The surgical specimen includes the uterus, cervix, and bilateral adnexa, obtained via total abdominal hysterectomy and bilateral salpingo-oophorectomy. Histologic evaluation reveals a lesion involving the endometrium with well-differentiated features and multiple patterns of differentiation including mucinous, secretory, and squamous elements. The tumor measures 6.5 cm in maximum dimension and involves 100% of both the anterior and posterior endomyometrial surfaces. Invasion extends 1.0 cm into the myometrium, which is greater than half the thickness of the 1.3 cm myometrial wall. Vascular invasion is present.\n\nAdjacent to the tumor, complex atypical hyperplasia is identified. Adenomyosis is also present, and both the carcinoma and hyperplastic changes involve this area. The tumor extends to the fimbriated end of the left fallopian tube. No tumor is found in the cervix, bilateral ovaries, or right fallopian tube. The left fallopian tube shows involvement at its fimbriated end. Pelvic washings are negative for malignant cells.\n\nExamination of lymph nodes from multiple pelvic and para-aortic sites on both sides reveals no evidence of metastatic involvement. A total of nine lymph nodes were examined, all negative. The omentum is also free of tumor.\n\nHistologic assessment indicates a high-grade architectural and nuclear differentiation. The tumor invades more than half of the myometrial thickness but does not extend beyond the uterus. Based on these findings, the pathologic stage is pT2a, pN0, pMX according to TNM classification, and FIGO stage IIa."} +{"pid": "TCGA-EY-A1GQ", "report": "A hysterectomy specimen demonstrates a lesion involving the endometrial cavity, predominantly located in the anterior region, extending to the lower uterine segment. The lesion measures 2.7 x 2.2 x 0.2 cm and is described as finely granular, friable, and shaggy with a tan/brown cut surface, focally firm and necrotic. Gross assessment indicates full-thickness involvement of the anterior myometrium without extension through the serosal surface. The myometrial wall at the deepest point of invasion measures 2.4 cm. Microscopic evaluation reveals architectural features consistent with high-grade changes, with deep myometrial invasion noted\u2014specifically involving the outer half. The distance from the tumor to the serosal surface is less than 1 mm at its closest point in the anterior corpus. The endocervical canal is uninvolved.\n\nLymphovascular space invasion is present. Examination of the cervix, vaginal margins, adnexa, and other extrauterine sites reveals no evidence of involvement. A separate benign endometrial polyp is identified in the posterior fundic region. Adenomyosis is also present.\n\nEvaluation of regional lymph nodes includes 17 right pelvic and 12 left pelvic lymph nodes, all without evidence of involvement. The uterus has a total myometrial thickness of 24 mm, with tumor invading 23.5 mm, representing approximately 98% myometrial penetration. The tumor involves the lower uterine segment but does not extend into the cervix. No tumor is identified in the fallopian tubes or ovaries.\n\nImmunohistochemical analysis shows hormone receptor positivity; the tissue demonstrates estrogen receptor positivity (2+, 90%) and progesterone receptor positivity (2\u20133+, 90%). All immunostains were performed using validated reagents under CLIA-certified conditions.\n\nStaging is based on available data and classified accordingly. No tumor is identified in surgical margins. The current staging classification reflects pT1b pN0 status. Additional clinical correlation may be required for final staging."} +{"pid": "TCGA-EL-A3CM", "report": "The specimen consists of anterior wall thyroid and tracheal cartilage, as well as a bilateral neck dissection, total thyroidectomy, and mediastinal node dissection. The surgical margins of resection are negative for tumor involvement, except for the inferior tracheal margin which shows focal involvement. After decalcification, further assessment will be provided in an addendum.\n\nA 5.0 cm mass is identified within the thyroid, extending into adjacent soft tissue and reaching the deep margin of resection. The tumor appears well-differentiated with only focal necrosis observed. It predominantly involves the left lobe and isthmus, with extension into a portion of the right lobe.\n\nLymph node evaluation reveals metastatic involvement in 1 of 8 nodes from the left neck dissection (Area 5), and 2 of 8 nodes from the right neck dissection (Areas 3 and 7). The largest involved lymph node, located on the right side in Area 7, measures 2.5 cm in maximum dimension and is completely effaced by tumor. Extracapsular extension is present in this node, measuring up to 0.3 mm in maximum dimension."} +{"pid": "TCGA-43-7656", "report": "The specimen includes a right lower lobe lung resection and multiple lymph nodes from levels 11 and 7. The lung specimen measures 19.2 x 17 x 5 cm and contains a well-circumscribed, rubbery tan-white lesion measuring 2.8 x 2.5 x 2.4 cm located peripherally along the lateral posterior aspect. The lesion does not grossly involve the pleura. Bronchial and vascular margins appear unremarkable. Soft grey-black lymph nodes up to 1 cm in size are identified in the hilar and peribronchial regions. Histologically, the lesion is composed of poorly differentiated cells arranged in a mass. Microscopic evaluation reveals negative margins with no evidence of direct tumor extension, pleural invasion, or vascular invasion. All examined lymph nodes, including hilar and peribronchial nodes from the lung specimen and submitted lymph nodes from levels 11 and 7, are free of malignant involvement. Focal hyalinization is observed in some lymph nodes, possibly representing old granulomas; no fungal elements are identified. Scattered chronic inflammation and interstitial thickening are noted in lung tissue away from the lesion."} +{"pid": "TCGA-41-5651", "report": "The specimen consists of multiple pink-tan irregular soft tissue fragments from a left temporal lobe mass, measuring 2.5 x 1.5 x 0.4 cm in aggregate, and entirely submitted in one cassette. Microscopic examination reveals a malignant astrocytic neoplasm with a sheet-like growth pattern of highly atypical small astrocytic cells. These cells exhibit hyperchromatic nuclei, scant cytoplasm, and frequent mitotic figures. The tumor contains numerous areas of neovascular proliferation, as well as regions of both pseudopalisading and geographic necrosis."} +{"pid": "TCGA-39-5019", "report": "The specimen received was a right upper lobe lung trucut biopsy, consisting of three cores of gray-yellow soft tissue measuring 0.1 cm in diameter and ranging from 0.9 to 1.1 cm in length. Frozen section analysis revealed atypical cells consistent with non-small cell carcinoma morphology.\n\nA separate specimen labeled as a right level ten lymph node was received as a fragment of tan-brown soft tissue measuring 1.1 x 0.8 x 0.3 cm. Frozen section evaluation showed benign lymphoid tissue.\n\nA lobectomy specimen of the right upper lobe measured 17 x 14 x 4.5 cm. A palpable tumor measuring 4 cm in diameter was identified, with a puckered pleural surface and a small eroded area measuring 0.6 x 0.2 cm. The cut surface of the lesion showed pigmented, white-tan, partially hemorrhagic tissue measuring 3.5 x 2.5 x 2.0 cm. The tumor was located 2.5 cm from the bronchial margin. At a distance of 9 cm from the tumor, a 1.5 x 1.0 x 0.6 cm bleb was observed. The remainder of the lung tissue demonstrated emphysematous changes and fibrosis. Sections were taken from the bronchial margin, vascular margin, tumor tissue, and surrounding lung.\n\nLymph nodes were submitted from multiple levels: right anterior hilar (two lymph nodes measuring 1.3 x 0.9 x 0.4 cm total), right level ten (two lymph nodes measuring 1.5 x 0.6 x 0.5 cm total), level seven (three lymph nodes within 2.0 x 1.2 x 0.5 cm fatty tissue), and right level four (one possible lymph node in a 2.0 x 1.5 x 0.6 cm fatty tissue specimen). All lymph nodes evaluated microscopically displayed benign lymphoid architecture without evidence of malignancy.\n\nHistological examination of the primary lesion showed moderately to poorly differentiated epithelial cells arranged in nests and sheets. No vascular or perineural invasion was observed. Margins, including the bronchial and pleural surfaces, showed no involvement by atypical cells. No in situ changes were noted.\n\nSections from intraoperative frozen samples correlated with permanent sections, confirming the presence of malignant epithelial cells in one specimen and benign lymphoid tissue in others. Tissue blocks included control sections, tumor sections, bronchial margin, vascular margin, and lymph node samples."} +{"pid": "TCGA-A5-A0GB", "report": "The right ovary and fallopian tube specimen shows benign features with corpora albicantia, rare calcifications, and occasional multinucleated giant cells. The fallopian tube demonstrates hydrosalpinx, a small focus suggestive of endometriosis, and serosal adhesions with reactive mesothelial changes.\n\nThe uterus and cervix specimen reveals significant involvement of the endometrial cavity by a lesion showing glandular, poorly differentiated glandular, squamous (nonkeratinizing), and undifferentiated morphologic features. Architecturally, the poorly differentiated component displays glandular, trabecular/cord-like, and nested growth patterns. The tumor measures approximately 14.0 x 7.7 cm in surface area and nearly fills the entire anterior and posterior endometrial cavity. It is exophytic and invasive, extending into the lower uterine segment and upper endocervix. Invasion exceeds 50% of the myometrial thickness and reaches within 0.7 cm of the serosal surface in the cervix. Lymphovascular invasion is present, along with tumor-associated necrosis and acute inflammatory infiltrate. A lymphoplasmacytic infiltrate is also noted, as well as rare calcifications within the lesion. Detached tumor fragments are identified in parametrial soft tissues but are interpreted as non-adherent (\"floaters\"). Adjacent endometrium shows changes consistent with prior progestin therapy, including deciduoid stromal change. Adenomyosis is also present. The cervix contains nabothian cysts, squamous metaplasia, cervicitis, and reactive cellular changes.\n\nImmunohistochemical evaluation of the undifferentiated component reveals limited staining for keratin AE 1/3, MOC 31, and BER-EP4, with negativity for cytokeratin 7, CAM 5.2, vimentin, WT1, chromogranin, and synaptophysin. Some cells express p53 and p16. In contrast, the endometrioid component demonstrates ER and PR positivity, with heterogeneity in staining intensity. Rare positivity for CK5/6 is also observed in this component.\n\nLymph node dissections from multiple pelvic and para-aortic regions show no evidence of tumor involvement. A total of 28 lymph nodes were evaluated: four from the right pelvic, one from the right para-aortic, one from the left pelvic, eight from the left obturator, nine from the left para-aortic, and four from the left common iliac regions. All showed only reactive changes, including sinus histiocytosis; no occult tumor cells were detected.\n\nOmental specimens consist of adipose tissue with fibrous adhesions and reactive mesothelial cells. One omental sample includes a focus of calcified fat necrosis. No tumor is identified in any of the three omental specimens submitted.\n\nGross examination of the uterus confirms extensive involvement of the endometrial cavity by a friable red-tan mass measuring 14.0 x 7.7 cm. The tumor extends into the lower uterine segment and cervical canal posteriorly, reaching near the transformation zone. Invasion involves approximately two-thirds of the uterine wall thickness. No gross tumor is seen in the cervix, myometrium, or parametrial soft tissues. A benign leiomyoma is identified in the uterine wall.\n\nAll other tissues, including ovarian and tubal surfaces, lymph node-bearing fatty tissues, and omental samples, appear unremarkable on gross inspection. Representative sections have been submitted for microscopic evaluation."} +{"pid": "TCGA-K4-A4AB", "report": "A specimen from the left distal ureter was received, measuring 4 cm in length with a maximal diameter of 0.6 cm. Gross examination revealed a centrally located bulge that was firm upon palpation. The cross-section showed a narrowed lumen and a smooth indurated wall measuring 0.4 cm in thickness. Microscopic evaluation identified invasive cells involving the outer ureteral layer, muscularis propria, and surrounding soft tissue, with extensive presence at the per-ureteral soft tissue margin of excision. The distal ureteral margins were negative for tumor involvement.\n\nA similar finding was noted in the right distal ureter; however, no tumor was seen on cross-section. Both distal ureteral margins were inked, and the frozen sections showed only mild cytologic atypia likely due to reactive changes.\n\nAn irregular fragment from the left ureterovesical junction showed invasive cells within soft tissue fragments. No definitive orientation was provided due to the presence of a suture on one edge.\n\nExamination of the left and right pelvic lymph nodes (one each) revealed no evidence of tumor involvement (0/2 total examined). Lymphatic and perineural invasion were not identified in these specimens.\n\nThe bladder and prostate specimen measured 13 x 10 x 8 cm overall. A 10 cm ulcerated mass was identified in the left trigone and lateral wall, appearing to invade into fatty tissue and the posterior wall. Histologically, the lesion demonstrated high-grade features with squamous differentiation but lacked glandular components. Macroscopic extravascular mass was present, along with direct invasion of the prostatic stroma and seminal vesicle. No invasion of the pelvic or abdominal wall was observed. The histologic grade was 3/3. Tumor margins were extensively involved in the perivesicular, prostatic, and per-ureteral regions, while distal ureteral and urethral margins were clear.\n\nAdditional findings included an incidental adenocarcinoma of the prostate, predominantly located in the peripheral zone on the right side. It was graded as Gleason score 3+3=6/10, with a severity extent of 2/5. The TNM staging for this component was pT2a, with no lymph node involvement. No extraprostatic extension or carcinoma in the seminal vesicles or specimen margins was observed.\n\nMultiple tissue blocks were processed for microscopic analysis, including full-thickness cross sections from various regions of the bladder and prostate. Photographs were taken for documentation purposes."} +{"pid": "TCGA-W5-AA39", "report": "Surgery Date: Male. A peritoneal nodule biopsy was performed and showed no evidence of tumor. Cholecystectomy revealed mild chronic cholecystitis. A partial hepatectomy of the left liver lobe demonstrated multiple masses, ranging from 0.2 cm to 0.8 cm in greatest dimension, which replaced approximately 90% of the left lobe. The masses were confined to the hepatic parenchyma with a mass-forming growth pattern. The hepatic resection margin was free of tumor, with a minimum tumor-free margin of 0.9 cm. The bile duct margin could not be assessed. Tumor involvement was noted in the left portal vein. No lymph node metastases were identified among 10 regional lymph nodes examined. Immunohistochemical staining showed positivity for MOC-31 and negativity for CK7, CK20, and albumin by in situ hybridization."} +{"pid": "TCGA-FD-A62P", "report": "The surgical specimens were received and processed for pathological evaluation. Lymph node dissection included four nodes on the left pelvic side, all negative for abnormal cells. On the right pelvic side, four lymph nodes were examined, with one showing the presence of abnormal glandular structures. No extension beyond the lymph node capsules was observed.\n\nThe cystoprostatectomy specimen included the bladder, prostate, seminal vesicles, and vas deferens. Examination of the bladder revealed a lesion involving the muscularis propria layer, with high-grade cellular features. The lesion measured 3 x 2.7 cm and was located in multiple areas including the right lateral wall, anterior wall, and posterior wall. The surrounding mucosa showed signs of hemorrhage, and an ulcerated area was noted. No tumor involvement was identified at the ureteral or urethral resection margins, nor at the soft tissue margins. The bladder wall exhibited ulceration, necrosis, and a foreign body giant cell reaction, suggesting prior intervention. Cystitis cystica was also present.\n\nIn the prostate, histological analysis showed a Gleason score of 7 (4+3), with a small component of higher-grade elements. Perineural invasion was present, and the tumor was found in both peripheral zones as well as the transition zone. Tumor volume was estimated at 60%. High-grade intraepithelial changes were multifocal. Extraprostatic extension was identified, and the apical resection margin was positive for abnormal cells, while other margins and the seminal vesicles were free of involvement.\n\nA segment of the left distal ureter was also submitted for evaluation, with no evidence of abnormal cells identified. Immunohistochemical staining for specific markers was performed on involved lymph nodes, though some sections lacked sufficient material for full analysis.\n\nStaging was assigned according to the seventh edition of the TNM classification system. For the bladder specimen, staging was pT2bN0. For the prostate, staging was pT3aN0."} +{"pid": "TCGA-AR-A24O", "report": "The surgical specimen consists of a left modified radical mastectomy. Multifocal tumor involvement is noted with two distinct lesions located in the inferior and medial regions of the breast. The larger lesion measures 5.3 x 2.7 x 1.4 cm, while the smaller lesion measures 1.2 x 1.0 x 1.0 cm. A biopsy cavity is observed adjacent to the tumor in the medial breast. Histologic evaluation reveals cells arranged in a growth pattern consistent with grade I differentiation according to the Nottingham grading system. No lymphovascular space invasion is identified. Background breast tissue demonstrates adenosis and duct ectasia. The nipple complex shows no significant histologic changes. Surgical margins are negative for tumor involvement, with the closest margin located anterior/inferior and free by at least 0.8 cm. Examination of regional lymph nodes reveals metastatic involvement in 6 of 17 left axillary lymph nodes. There is evidence of focal extracapsular extension within these nodes. Immunohistochemical studies for Her-2/NEU have been initiated on formalin-fixed paraffin-embedded tissue."} +{"pid": "TCGA-A8-A097", "report": "The specimen shows a poorly differentiated invasive lesion with a distinct intraductal component. The tumor measures 2.8 cm in greatest dimension. Histologic evaluation indicates high-grade features. Staging reveals involvement of regional lymph nodes with micrometastases, and there is evidence of lymphovascular invasion."} +{"pid": "TCGA-E2-A1AZ", "report": "The surgical specimens include three sentinel lymph nodes from the left axilla and a wide excision of the left breast with additional deep and medial margins. The first sentinel lymph node contained micrometastatic involvement, while the second and third sentinel lymph nodes showed no evidence of metastasis. The primary lesion was located within breast tissue and measured 3.3 x 2.6 x 2.5 cm. Histologic evaluation revealed high-grade invasive ductal carcinoma with a histologic grade of III and nuclear grade of III. Mitotic activity was present at a rate of 3 per high power field. Features included necrosis and vascular/lymphatic invasion. A ductal carcinoma in situ (DCIS) component was also identified within the main mass, comprising less than 25% of the total volume, with solid growth pattern and high nuclear grade but without necrosis.\n\nAll surgical margins were free of tumor involvement. No residual tumor was identified in the additional deep or medial margin specimens. Non-neoplastic findings included fibrocystic changes with apocrine metaplasia, sclerosing and blunt duct adenosis, as well as focal atypical ductal hyperplasia in benign breast tissue. Pathologic staging was determined to be pT2N1a based on tumor size and lymph node involvement. No extranodal extension was observed."} +{"pid": "TCGA-PJ-A5Z8", "report": "The specimen consists of a resected right renal mass. Gross examination reveals a 2.9 x 2.4 x 2.3 cm piece of renal tissue weighing 4 grams. The cut surface shows a well-defined, yellow-gray mass measuring 2.5 x 2 x 1.8 cm, located centrally within the specimen. The mass approaches within 0.1 cm of the inked parenchymal margin of resection, with a narrow rim of normal-appearing renal tissue surrounding it. Some adherent blood clot is noted at the irregular, partially cauterized margin, which has been inked black.\n\nMicroscopic evaluation confirms a solitary lesion within the specimen. The histologic architecture demonstrates a solid growth pattern. Nuclear grading according to Fuhrman criteria is Grade 3. No sarcomatoid differentiation is identified. There is no evidence of direct tumor extension beyond the kidney. Lymphovascular invasion is not present, although renal vein involvement cannot be determined due to limited assessment. Margins of resection are free of any malignant cells.\n\nEvaluation of non-neoplastic kidney tissue does not reveal any additional significant pathology. Adrenal tissue is not included in the specimen. Lymph node status cannot be assessed as no nodes are present for evaluation. Based on available findings, the primary tumor classification is pT1a according to AJCC staging criteria. Distant metastasis is not applicable."} +{"pid": "TCGA-AG-3580", "report": "The excised liver tissue shows evidence of fine nodular cirrhosis with mild fatty degeneration of hepatocytes, suggesting chronic parenchymal injury likely related to nutritional or toxic etiology. A resected specimen of the colon contains a polypoid lesion with moderately differentiated features, measuring up to 6 cm in greatest dimension, demonstrating infiltration of the tunica submucosa. Evaluation of local lymph nodes reveals no involvement. The surgical margins of the colon resection are free of abnormal findings. Additionally, two tubular adenomas of the colonic mucosa are identified, exhibiting low-grade and high-grade dysplastic changes. Histopathologic staging assessment shows no extension beyond the submucosa, absence of lymph node involvement (0 out of 22 examined), and no evidence of vascular or lymphatic invasion. Surgical resection margins are negative. Differentiation grade is intermediate."} +{"pid": "TCGA-E1-A7YD", "report": "Surgical Pathology: Final. Ccc#. CLINICAL HISTORY: Not provided.\n\nGROSS EXAMINATION: \nA. A specimen labeled \"Brain tumor (AF1, AF2)\" was received fresh for frozen section. It measured 1.0 x 0.8 x 0.4 cm and consisted of an aggregate of soft white-tan tissue. A fragment was submitted for frozen sectioning as AF1, with the remnant placed in a mesh bag in block A1. Two additional fragments were submitted for frozen sectioning as AF2, with the remnants placed in a mesh bag in block A2. The remaining tissue was submitted in toto in block A3. \nB. Another specimen labeled \"Brain tumor (BF1)\" was received fresh for frozen section. It measured 1.5 x 1.0 x 0.3 cm and was composed of soft white-tan tissue. A fragment was submitted for frozen sectioning in BF1, with the remnant placed in a mesh bag in block B1. The remaining tissue was submitted in toto in block B2. \nC. A third specimen labeled \"Brain tumor\" was received fresh and placed in formalin. It measured 11.5 x 7.5 x 1.0 cm and was a soft yellow-tan tissue aggregate containing a 1.3 x 1.0 x 0.5 cm lesion with dark and light red areas. Representative sections were submitted in blocks C1\u20138.\n\nINTRAOPERATIVE CONSULTATION: \nA. The specimen labeled \"Brain tumor\" AF1-AF2 showed hypercellular brain tissue. \nB. The specimen labeled \"Brain tumor ?\" BF1 was consistent with a glioma.\n\nMICROSCOPIC EXAMINATION: \nTissue from containers A (\"brain tumor AF1, AF2\"), B (\"brain tumor BF1\"), and C (\"brain tumor\") revealed brain tissue infiltrated and replaced by a population of anaplastic astrocytes. The cells exhibited marked pleomorphism, with frequent tumor giant cells observed. Mitotic figures, including abnormal forms, were present. Focal endothelial proliferation was noted, although necrosis was not identified.\n\nI certify that I personally conducted the diagnostic evaluation of the above specimens and have rendered the above findings."} +{"pid": "TCGA-CL-5918", "report": "A segment of rectum and sigmoid colon measuring 22.0 cm in total length was resected. Within the rectum, a polypoid mass measuring 6.0 cm in greatest dimension was identified. The mass has a pushing border and invades into the muscularis propria. The proximal resection margin is 18.0 cm from the invasive tumor, the distal resection margin is 3.3 cm from the tumor, and the radial resection margin is 0.6 cm from the tumor. All resection margins are free of tumor involvement. No lymphovascular, extramural venous, or perineural invasion is present. A mild peritumoral lymphoid response is noted. No residual adenoma is identified. Diverticulosis is present in the uninvolved mucosa.\n\nA total of 14 regional lymph nodes were examined, and none contain tumor. The lymph node candidates range in size from 0.3 to 1.3 cm. One additional lymph node from a separate specimen is also negative for tumor.\n\nAnother specimen consists of an umbilical hernia sac composed of fibroadipose tissue with mesothelial lining and inflammatory changes. A third specimen includes an additional segment of proximal colon measuring 12 cm in length. This segment shows diverticulosis without evidence of malignancy. The mucosa appears normal with intact fold architecture. A single small lymph node candidate (0.3 cm) is identified and is free of tumor.\n\nThe surgical procedure included a lower anterior resection with colostomy. The tumor specimen was submitted for tissue banking. Multiple histologic sections were taken from the tumor, adjacent normal colon, diverticula, and lymph nodes. No other significant gross abnormalities are noted in the submitted specimens."} +{"pid": "TCGA-M7-A71Y", "report": "The prostatectomy specimen measured 4.8 x 3.5 x 3.5 cm and weighed 34 grams. The prostate was fixed in formalin and oriented with standard ink colors: right blue, left black, apex yellow, and base/bladder neck red. A tan/yellow firm, ill-defined discoloration measuring 1.5 x 1.1 x 1.1 cm was observed on the right periphery near the base. Multiple sections were taken from both lobes of the prostate, including areas of discoloration, as well as from the surgical margins, apex, bladder neck, and seminal vesicles. The left vas deferens measured 3.0 cm in length and 0.6 cm in diameter. The left seminal vesicle measured 3.2 x 1.5 x 0.6 cm, while the right seminal vesicle was 2.5 x 2.0 x 0.7 cm.\n\nMicroscopic evaluation showed that approximately 15% of the prostate was involved by a lesion that was diffusely present bilaterally. The lesion was confined within the prostatic capsule without evidence of invasion into lymphovascular spaces or the muscular wall of the seminal vesicles. Surgical margins were uninvolved. Additional findings included perineural invasion and high-grade intraepithelial changes. No lymph nodes were submitted for examination.\n\nStaging was based solely on this specimen and may be incomplete. According to AJCC criteria, the extent of the lesion was classified as pT2c, with no regional lymph node assessment possible (pNX). A full review of all clinical and pathological data is recommended for final staging accuracy."} +{"pid": "TCGA-FP-7998", "report": "A liver biopsy showed no evidence of malignancy or intrinsic liver disease. A peripancreatic lymph node biopsy revealed a benign peritoneal cyst. A subtotal gastrectomy specimen demonstrated chronic inflammation without tumor involvement in the examined blocks. The stomach lesion measured 6.8 cm at its greatest dimension, with additional dimensions of 4.8 x 2.0 cm. Histologic evaluation revealed poorly differentiated cells arranged in a diffuse growth pattern. The tumor extended through the gastric wall and penetrated the serosa. Margins of resection, including proximal, distal, and omental margins, were free of invasive carcinoma. The closest distance from the tumor to the proximal margin was 18 mm. Lymphovascular invasion was identified.\n\nA total of 30 lymph nodes were evaluated from the perigastric region, with 14 showing involvement by metastatic cells. Immunohistochemistry confirmed the presence of metastatic cells in these lymph nodes. No malignancy was identified in the omentum specimen.\n\nThe surgical specimen included measurements of the stomach along the greater curvature (19.5 cm), lesser curvature (12.3 cm), and attached fat tissue on both the greater curvature (28.0 x 8.0 x 2.0 cm) and lesser curvature (9.0 x 5.5 x 4.0 cm). The tumor was located along the lesser curvature within the body of the stomach and extended toward the antrum. Gross examination noted an ulcerative and invasive appearance with focal adhesion to omental fat and red-purple discoloration inked for identification.\n\nLymph nodes from the cardiac packet ranged from 0.3 to 1.8 cm and included 24 nodes; an additional 11 nodes from the gastroomental packet ranged from 0.3 to 1.9 cm. Sections from all submitted specimens were reviewed microscopically, confirming complete evaluation with appropriate controls. No tumor was identified in sections of the omentum, which measured 13.5 x 13.0 x 6.0 cm and consisted of adipose and fibrovascular tissue.\n\nRepresentative sections were taken from margins, tumor interface, non-neoplastic gastric tissue, and lymph node packets for histologic analysis."} +{"pid": "TCGA-33-4582", "report": "The specimen from the left lower lobe of the lung measured 3.0 cm and showed infiltrating, moderately differentiated features. The surgical margins were negative. A total of nine lymph nodes were examined: two from station 5, two from station 7, and three from station L11, all of which were negative. The pathologic stage is T1N0MX."} +{"pid": "TCGA-86-8669", "report": "The submitted lung tissue specimen was obtained via pneumonectomy. The tumor measures 3 x 2.5 x 2 cm and is located in the lung. Microscopic evaluation reveals a well-differentiated histologic pattern with no specific features indicating aggressive behavior. The extent of the tumor, presence of additional nodules, lymph node involvement, lymphatic or venous invasion, margin status, and response to neo-adjuvant treatment were not specified. No other significant pathologic findings were noted."} +{"pid": "TCGA-QR-A6H6", "report": "The surgical specimen included three separate tissue samples. The first, labeled as lateral margin #1, consisted of a tan-brown soft tissue fragment measuring 0.5 x 0.4 x 0.3 cm. Microscopic evaluation showed fibrous tissue and nerve without any abnormal cellular proliferation. The second sample, labeled medial margin, measured 0.5 x 0.3 x 0.2 cm and was composed of fibroadipose tissue with no atypical cells identified. The third specimen, taken from the paraspinal region and deep margin, was a larger soft tissue fragment measuring 5.0 x 4.0 x 1.8 cm, with a distinct nodule measuring 3.0 x 3.0 x 1.5 cm located on the pleural surface. Histologic examination revealed a well-defined mass with cells arranged in nests and trabeculae, exhibiting moderate nuclear pleomorphism and frequent mitotic figures. Immunohistochemical staining showed strong and diffuse positivity for chromogranin and synaptophysin, with only rare cells expressing inhibin; Melan A staining was negative. All surgical margins were free of neoplastic cells. A portion of the tumor was also analyzed during surgery, and the findings were consistent with the final microscopic description. No evidence of invasion into surrounding structures was noted."} +{"pid": "TCGA-AX-A05U", "report": "The specimen consisted of multiple lymph node aggregates and a hysterectomy with bilateral salpingo-oophorectomy. Lymph nodes were evaluated from the left para-aortic (4 nodes), right para-aortic (7 nodes), right common iliac (2 nodes), right external iliac (3 nodes), right obturator (3 nodes), left obturator (3 nodes), left external iliac (no lymph node tissue identified), and left common iliac (2 nodes). All lymph nodes examined were negative for tumor involvement.\n\nThe uterus was enlarged and contained a polypoid lesion in the anterior endometrial cavity measuring 3.8 cm in greatest dimension. Histologically, the lesion showed features consistent with a well-differentiated adenocarcinoma. The myometrium measured 21 mm in thickness at the site of maximal invasion, with tumor infiltration reaching a depth of 5 mm (approximately 29% of the myometrial thickness). There was no evidence of vascular or lymphatic invasion. Adjacent endometrial tissue demonstrated complex hyperplasia with and without atypia, as well as disordered proliferative changes. Adenomyosis was also present.\n\nThe cervix showed chronic cystic cervicitis and endometriosis involving the deep cervical stroma, with no evidence of dysplasia or tumor. Both fallopian tubes appeared unremarkable. The ovaries were atrophic with focal hyperthecosis; no tumor was identified. A benign serous cystadenofibroma was present in the left ovary, measuring 2.0 cm. \n\nA total of 23 lymph nodes were examined, and all were free of tumor. No definitive assessment of distant metastasis was possible. Surgical margins were uninvolved. Additional findings included adenomyosis and endometriosis. The tumor was confined to the uterus with less than 50% myometrial invasion."} +{"pid": "TCGA-VS-A9UV", "report": "The biopsy specimen was obtained from the cervix and shows a neoplastic lesion characterized by invasive growth with ulceration. Histologic evaluation reveals malignant cells arranged in irregular nests and cords, exhibiting moderate nuclear atypia, increased nuclear-to-cytoplasmic ratio, and frequent mitotic figures. There is no evidence of angiolymphatic invasion. The tumor measures approximately 4.5 cm in greatest dimension and is confined to the cervix without extension into adjacent structures. No lymph node involvement is identified. Clinical staging is determined as localized disease without distant spread."} +{"pid": "TCGA-D1-A0ZN", "report": "The specimen includes a uterus with attached bilateral fallopian tubes and ovaries. The uterus weighs 135.0 grams and has focal fibrous adhesions on the uterine serosa. A mass measuring 2.0 x 1.3 x 0.5 cm is present in the anterior body of the endometrial cavity, with 1.9 cm of myometrial thickness remaining. No involvement of the endocervix is observed. Two intramural leiomyomata are identified, measuring 0.5 cm and 0.8 cm in greatest dimension. The right ovary measures 2.5 x 1.8 x 1.3 cm with a smooth outer surface and solid cut surface; the right fallopian tube measures 4.8 x 0.8 cm. The left ovary measures 2.5 x 2.0 x 1.1 cm, also with a smooth outer surface and solid cut surface, while the left fallopian tube measures 4.8 x 0.7 cm. No diagnostic abnormalities are found in the bilateral ovaries or fallopian tubes. Endometriosis is noted involving the anterior uterine serosa. Lymphovascular space invasion is not identified. Representative sections of the endometrium, low uterine segment, fallopian tubes, ovaries, and anterior uterine serosa are submitted."} +{"pid": "TCGA-W5-AA2Q", "report": "The specimen from a male patient following surgery demonstrates a multinodular, discrete, firm mass measuring 12.3 x 11.5 x 10.0 cm located predominantly within the resected left hepatic lobe with involvement of the attached caudate lobe. A single satellite lesion is noted in the dome of the liver, measuring 0.8 cm in diameter. The margins of resection are free of tumor involvement; however, the closest distance of the tumor to the parenchymal margin is 0.1 cm and to the bile duct margin is 0.2 cm. The hepatic vein and portal vein margins show no evidence of tumor. One hilar lymph node examined is negative for tumor involvement.\n\nEvaluation of the non-neoplastic liver tissue will be addressed in a separate addendum. Additionally, cholecystectomy findings reveal mild chronic cholecystitis with gallstones present. A pericystic duct lymph node is negative for tumor. Twenty-four hepatoduodenal lymph nodes and three para-aortic lymph nodes are all without tumor involvement."} +{"pid": "TCGA-A3-3346", "report": "The left kidney specimen, measuring 15.0 x 11.0 x 10.0 cm and weighing 543 grams, was received with perinephric fat but without the adrenal gland. The ureteral stump is 5.0 cm in length and 0.5 cm in diameter, while the renal artery and vein stumps measure 1.0 x 0.9 cm and 2.0 x 1.0 cm, respectively, and all appear unremarkable. Upon bisection, a well-circumscribed golden-yellow, slightly hemorrhagic mass measuring 5.2 x 4.5 x 4.0 cm is identified in the mid to lower pole. The mass is subcapsular and does not extend through the capsule into the surrounding fat. Adjacent to the mass is a subcapsular cyst measuring 4.5 x 1.0 cm, with a trabecular lining containing hemorrhagic material. The surrounding renal cortex appears red-tan and measures up to 0.5 cm in thickness, with distinct corticomedullary differentiation. Histologically, the mass demonstrates cells with clear cytoplasm and nuclear features corresponding to a high nuclear grade. Lymphovascular space invasion is present. No transcapsular or vascular invasion is identified. All surgical margins, including soft tissue, ureteral, and vascular, are free of tumor involvement. T staging is limited to the kidney without extension beyond the capsule."} +{"pid": "TCGA-CS-6667", "report": "The left parietal specimen consists of tan-red soft tissue measuring 1.5 x 1.5 x 0.8 cm. Histologically, the lesion is composed of moderately pleomorphic glial cells infiltrating cerebral grey matter. Cortical neurons are present and surrounded by tumor cells. Immunohistochemical analysis shows positive staining for GFAP in many tumor cells, and strong nuclear positivity for p53 in a subset of tumor cell nuclei. Chromogranin staining does not demonstrate any ganglion cell component. NEU-N immunostaining is negative in tumor cells but highlights non-neoplastic cortical neurons in the surrounding area.\n\nProliferative activity was assessed using Ki-67 immunohistochemistry with Aperio image analysis, yielding a proliferation index of 1.9% based on 26,646 cells counted. The histologic and immunophenotypic features support the classification of this neoplasm as an infiltrating glial tumor. Frozen section evaluation was consistent with a glioma, with features suggestive of either an oligodendroglial neoplasm or astrocytic tumor. All tissue was submitted for analysis, with approximately 70% used for intraoperative consultation. Special studies were performed using formalin-fixed, paraffin-embedded tissue, and included ER, PR, Hercept, and EGFR assays interpreted according to established guidelines. Some testing involved analyte-specific reagents regulated as ASRs; these assays were developed and validated by the clinical laboratory, and FDA clearance was not required."} +{"pid": "TCGA-CZ-5452", "report": "The specimen was received fresh in two parts. Part A, labeled \"right kidney,\" consists of a 1,360 gram kidney measuring 23.0 x 12.0 x 8.2 cm. The attached ureter measures 11.5 x 0.3 cm, the renal vein 1.3 x 0.7 cm, and the renal artery 2.0 x 0.4 cm in diameter. A multilobulated mass located in the mid to lower pole measures 14.0 x 11.2 x 6.1 cm. The mass is tan/yellow with multiple hemorrhagic foci. It is less than 0.1 cm from the inked resection margin, 10.6 cm from the ureteral margin, 1.8 cm from the renal vein margin, and 4.0 cm from the renal artery margin. Grossly, the mass abuts the perirenal adipose tissue and extends to, but does not involve, the renal pelvis. The remaining renal parenchyma shows well-demarcated cortical medullary junctions and is otherwise unremarkable. Representative sections of the tumor and normal cortex were submitted for electron microscopy, cytogenetic analysis, immunofluorescence, and tissue banking. The specimen was photographed and additional sections were submitted for microscopic evaluation.\n\nMicroscopic examination includes sections of the ureter, renal vein, and renal artery resection margins, as well as multiple sections of the tumor with surrounding tissue. The tumor is well-circumscribed and extends into the perirenal fat. Resection margins are free of involvement. No lymphovascular invasion is identified. The non-neoplastic kidney is under further evaluation by Renal Pathology, with findings to be reported in an addendum.\n\nPart B, labeled \"regional lymph node,\" consists of one fragment of adipose tissue containing five lymph nodes, all of which are negative for involvement.\n\nCytogenetic analysis of two separate tumor specimens revealed clonal chromosomal aberrations, including loss of chromosome 3, which was identified in 5 cells from one specimen and in 1 of 5 metaphase cells from the second specimen. These findings are consistent with previously documented patterns in certain neoplasms. No definitive extrarenal extension is noted. The AJCC classification (6th Edition) is T2 NO MX."} +{"pid": "TCGA-A6-6654", "report": "The submitted left hemicolectomy specimen measured 28 cm in length. The surface was noted to have a pink-tan, smooth, and glistening serosa. An area of umbilication was identified mid-specimen and inked orange. Upon opening, the mucosa appeared pink-tan with normal to abundant folds and an average circumference of 5 cm. A circumferential lesion measuring 4.8 x 4.0 cm was observed near the area of umbilication. The cut surface revealed involvement of the muscularis propria, extending into the subserosal fat, with the closest radial margin measuring 7.5 cm from the tumor edge. Multiple diverticula were present; one containing firm formed fecal material. No evidence of submucosal abscess or perforation was seen. A firm nodule within the fatty tissue was noted, likely representing a diverticulum. Multiple lymph nodes were identified throughout the specimen.\n\nMicroscopically, the lesion showed moderate differentiation. Histologic evaluation confirmed involvement of the muscularis propria and subserosa. All proximal, distal, and radial margins were free of involvement. Vascular invasion was not identified. Of the lymph nodes assessed, one out of 65 showed evidence of metastatic involvement. In addition, a single focus of pericolonic tissue adjacent to the main lesion was noted, possibly representing a replaced lymph node. Multiple diverticula were also present on histologic examination."} +{"pid": "TCGA-BQ-5890", "report": "The specimen from the left kidney and ureter includes a large mass measuring 11.5 cm in greatest dimension. The mass is hemorrhagic, bright yellow to tan, and sharply circumscribed from surrounding parenchyma. It extends into perinephric fat and approaches Gerota\u2019s fascia. The tumor reaches within 0.5 cm of the renal sinus but does not involve the renal vein. The kidney shows chronic changes including pyelonephritis, nephrocalcinosis, cortical scarring, and multiple cysts. No adrenal gland was identified in the main specimen.\n\nThe tumor demonstrates high-grade morphology with a combination of papillary, tubular, and clear cell features along with focal desmoplastic stroma. Immunohistochemical staining shows diffuse positivity for RACEMASE and CD10; focal positivity is noted for CEA, 34BE12, and CK7. Stains for CAIX and cytokeratin AE1-AE3 are negative.\n\nSurgical margins are free of tumor involvement. Lymph node dissections from para-aortic, preaortic, and suprahilar regions contain no evidence of tumor. All lymph nodes examined are benign. Adrenal tissue recovered in the suprahilar specimen appears non-neoplastic.\n\nStaging indicates involvement of perinephric tissues but not beyond Gerota\u2019s fascia. Multiple sections were submitted for histologic evaluation, including representative samples of tumor, adjacent kidney, sinus fat, perinephric fat, Gerota's fascia, ureteral and vascular margins, and cystic structures."} +{"pid": "TCGA-AA-A01Z", "report": "The specimen shows a poorly differentiated invasive adenocarcinoma with infiltration into the fatty connective tissue and lymphatic vessels. The tumor is classified as G3 and staged as pT3, pN0, MX, with lymphovascular invasion noted (L1). Resection margins are clear, with the oral margin corresponding to the ileum type and the distal margin of the colon type, including all three layers\u2014mucosa, submucosa, and muscularis. The ligature contains fatty connective tissue with vascular elements. A total of twelve lymph nodes were examined, and all were negative."} +{"pid": "TCGA-PC-A5DN", "report": "The specimen consists of three tissue samples collected from a female patient with a history of a left retroperitoneal mass. \n\nThe first specimen includes a retroperitoneal mass along with the left kidney. The mass measures 26.0 x 20.0 x 12.5 cm and presents with a tan to pink-red, smooth to irregular outer surface. Upon sectioning, it reveals a cystic structure measuring up to 20.0 cm in greatest dimension, containing serosanguineous fluid. The cyst wall is multiloculated, gray-tan, and irregular internally, with an average thickness of 1.5 cm. The wall has a rubbery consistency and is focally calcified in areas. Attached to this mass is a kidney measuring 9.0 x 5.5 x 4.5 cm. The ureter is partially embedded within the tumor mass and measures 1.5 x 0.3 cm with a patent lumen. The kidney appears structurally intact with normal cortico-medullary differentiation and no distortion by the adjacent lesion. An adrenal gland measuring 5.0 x 1.5 x 1.0 cm is also attached and shows no pathological features. Multiple sections were taken from various regions of the mass, kidney, ureter, adrenal gland, and vascular margins for histological evaluation. \n\nThe second specimen consists of intra-aortocaval lymph nodes measuring up to 1.8 cm in greatest dimension. These lymph nodes are embedded within fibroadipose tissue and are submitted entirely for microscopic examination. \n\nThe third specimen includes a para-aortic lymph node measuring 1.5 cm in diameter. It has a red-purple cut surface and was submitted entirely for histologic analysis. \n\nMicroscopic examination of the cystic mass demonstrates high-grade spindle cell morphology. Immunohistochemical staining reveals strong positivity for SMA and weak positivity for CD117; staining is negative for Desmin and CD34. No invasion into the adjacent kidney, ureter, or adrenal gland is observed. Both lymph node specimens show no evidence of tumor involvement."} +{"pid": "TCGA-AA-A01V", "report": "The specimen shows a moderately differentiated neoplasm arising within a tubulovillous adenoma, measuring several centimeters in diameter. Histological examination reveals areas of necrosis and infiltration of the colonic wall extending into the tunica muscularis. There is significant chronic granulating and recurrent peritumoral inflammation, including an acute inflammatory component with partial purulent abscess formation. Inflammatory adhesions are present between the cecal and ascending colon walls, as well as between the tumor\u2019s external surface and adjacent omental fat (in II). Additionally, chronic inflammation is noted in the pelvic wall (in I). Regional lymph nodes exhibit chronic lymphadenitis with small focal epithelioid cell reactions and both structured and unstructured giant cells. No tumor involvement is seen at the resection margins. Concurrent findings include chronic recurrent appendicitis and chronic granulating recurrent periappendicitis (in II). Staging based on available sections indicates pT2, pN0, MX, R0."} +{"pid": "TCGA-MA-AA43", "report": "The cervical biopsy specimen consists of multiple fragments, ranging in size from 0.5 x 0.3 x 0.2 cm to 0.7 x 0.5 x 0.5 cm. Histologic examination reveals two distinct tumor components. One component shows glandular formations and is moderately differentiated. The other component exhibits sheet-like growth patterns with squamous morphology, characterized by marked nuclear pleomorphism, prominent nucleoli, and frequent mitotic figures. Immunohistochemical staining performed on blocks A1 and A3 demonstrates positivity for P63 and CK5/6 in the squamous component, while the glandular component shows positivity for CEA and negativity for ER and vimentin. Both tumor types show strong positivity for P16. The invasive areas measure up to 2 mm in depth for the squamous component and 3 mm in greatest thickness for the glandular component. All tissue has been submitted for evaluation."} +{"pid": "TCGA-OR-A5JR", "report": "A left adrenal specimen was received measuring 8 x 7 x 4 cm, with a trimmed weight of 60 grams. The adrenal gland itself measured 6.5 cm in length and 2 cm in width, with a thickness of 0.1 cm. A large tan mass measuring 4.5 x 5 x 3.5 cm was identified protruding from the midsection of the gland. The mass appeared homogeneous, smooth, and round, arising within the cortical region. Sections revealed a tan and uniform internal appearance throughout most of the tumor, with one area measuring approximately 2 cm near the edge showing slightly more orange discoloration. Representative sections were taken from the adjacent adrenal gland, the tumor interface, and the distinct orange-tinged portion. Microscopic evaluation showed no vascular invasion, though capsular involvement was noted. Cellular morphology and tissue architecture were assessed by the staff pathologist, who personally reviewed all slides related to the case."} +{"pid": "TCGA-KU-A6H8", "report": "The specimen from the right posterior lateral tongue measured 4.5 x 3 cm and was excised to a depth of 0.8 cm. A central tan-white, firm mass extended to within 0.1 cm of the central inked margin and was located 0.5 cm from the inferior/deep margin. Histologic evaluation revealed moderately to poorly differentiated cells with a tumor size of 4 cm located in the right posterior lateral region without extension across the midline. Invasion was noted into the skeletal muscle of the tongue. Vascular and perineural invasion were present.\n\nMargins were negative overall. The deep margin was 0.5 mm from the tumor, and the superior (medial) margin was 1 mm away. Margin re-excisions from specimens 2, 3, 5, 6, 7 were negative. Tumor necrosis was observed.\n\nLymph node evaluation showed 2 out of 16 positive nodes with metastasis extending into hilar fat; the largest metastasis measured 4 cm. Level 2A had one of three nodes positive, Level 3 had one of eight nodes positive, and Level 1B and Level 2B nodes were negative.\n\nBiopsies from the posterior/superior, posterior, floor of mouth, anterior, anterior/superior, and deep posterior margins all showed mild squamous atypia but were negative for significant cellular changes or invasive findings.\n\nThe neck dissection specimens included level IB with two lymph nodes negative for metastasis, level 2A with one positive lymph node out of three, and level 3 with one positive lymph node out of eight. Level 2B contained three lymph nodes, all negative.\n\nClinical staging parameters indicated advanced involvement with regional spread."} +{"pid": "TCGA-A3-3363", "report": "The surgical pathology report describes a nephrectomy specimen from the left kidney, weighing 342 grams. The kidney measures 12.2 x 6.4 x 2.7 cm and includes attached perinephric fat. Within the upper pole of the kidney, there is a well-circumscribed mass measuring 10.7 x 7.6 x 1.7 cm. This mass appears tan-yellow to red with focal cystic and friable areas on cut surface. It approaches the renal capsule and is located approximately 0.5 cm from the inked margin of perinephric fat. No involvement of the renal vein margin is observed.\n\nSections submitted include margins (ureterovascular, mass to uninvolved parenchyma, mass to perinephric fat, and mass to inked margin), uninvolved renal parenchyma, and adrenal gland tissue. An adrenal gland measuring 5.2 x 1.7 x 1.1 cm is present within the attached fat and demonstrates hemorrhagic changes but no abnormal infiltrates.\n\nHistologic examination reveals a neoplasm confined to the kidney without extension into major vessels or lymphovascular invasion. Nuclear morphology corresponds to Fuhrman grade 2. All surgical margins\u2014soft tissue, ureteral, and vascular\u2014are negative for tumor involvement. No lymph nodes were removed or examined.\n\nAdditional findings include chronic pyelonephritis, nephrocalcinosis, and vascular wall thickening consistent with arteriolonephrosclerosis. The adrenal gland shows no evidence of neoplastic infiltration.\n\nStaging classification is pT2NXMX. Two tissue blocks were processed under CPT code 88307. Sections were reviewed by two pathologists who confirmed concordant findings. A separate cassette labeled for genomic research was submitted alongside the specimen."} +{"pid": "TCGA-AG-3909", "report": "The resected rectosigmoid specimen contains an ulcerated lesion measuring 4 cm in diameter, located 3 cm from the aboral resection margin. Histopathological examination reveals moderately differentiated cellular features consistent with colorectal morphology. The lesion demonstrates infiltration into the surrounding perirectal fatty tissue and exhibits carcinomatous lymphangitis adjacent to the lesion site. Three regional lymph node metastases are identified among a total of 35 lymph nodes assessed. All resection margins, including the colon, mesenteric, and circumferential margins, are free of tumor involvement. Additional findings include changes consistent with diverticular disease of the colon. Pathological staging indicates local extension beyond the muscularis propria without evidence of distant metastasis. Histologic grade is intermediate. Lymphatic invasion is present; vascular invasion is not identified. Treatment margins are negative."} +{"pid": "TCGA-AA-3561", "report": "The specimen consists of a right hemicolectomy preparation. An ulcerated lesion is present in the region between the cecum and ascending colon, measuring 4.5 cm in length. The lesion extends through all layers of the intestinal wall and invades into the adjacent mesocolic adipose tissue. The appendix shows fibrous obliteration of the lumen. The oral and aboral resection margins, as well as the greater omentum, are free of involvement. A total of fifty lymph nodes from the regional area are without evidence of involvement, although they show uncharacteristic reactive changes. Histological evaluation indicates a moderately differentiated neoplasm with no vascular or lymphatic invasion identified. The margins are clear."} +{"pid": "TCGA-97-8179", "report": "A FISH study was conducted on paraffin-embedded tissue sections from the right upper lobe of the lung using the Vysis ALK Break Apart Probe to assess for rearrangements involving the ALK gene. A total of 100 nuclei were evaluated, and none showed separated red and green signals indicative of a rearrangement. The control values were within expected ranges, with less than 15% positivity considered normal. In addition, three to four copies of ALK were observed in 59% of the cells, suggesting aneuploidy involving chromosome 2/2p. This finding indicates the presence of extra copies of the ALK region, although the clinical significance remains unclear.\n\nKRAS mutation analysis was performed, focusing on codons 12 and 13 in exon 2. No mutations were identified. The assay has a sensitivity of approximately 10%, and it is validated for use in formalin-fixed paraffin-embedded tissue. The sample was found to have 30% tumor cellularity, which is below the recommended threshold of 40% for optimal testing. False-negative results may occur due to low tumor content or genetic heterogeneity.\n\nEGFR mutation analysis was also carried out, targeting exons 18 through 21. No mutations were detected. A known polymorphism (2361G>A, Q787Q) was identified, which has no clinical relevance. The test is capable of detecting mutations present in at least 10\u201320% of the extracted DNA, and its performance has been validated for non-small cell lung carcinoma. The tumor cellularity in the sample was also suboptimal for this test, raising the possibility of false-negative results.\n\nThe primary lesion in the right upper lobe measured 1.2 cm in greatest dimension and was surrounded by lung tissue without evidence of visceral pleural invasion. Histologic evaluation showed moderately differentiated features. The resection margins, including bronchial and vascular margins, were free of tumor involvement. Lymph node dissection included a total of nine lymph nodes from multiple stations, all of which were negative for tumor involvement. No lymphovascular invasion was identified. Additional findings included emphysema.\n\nThe specimen was processed in seven parts. The first part, labeled as a right upper lobe nodule, included a nodule measuring 1 x 0.9 cm located 0.4 cm from the staple line margin. The second part consisted of a deeper margin from the posterior segment with no identifiable nodule. Parts three through seven included lymph node biopsies from various levels, all of which showed no evidence of malignancy. The completion lobectomy specimen had no residual tumor and clear margins. All lymph nodes examined were negative for metastasis.\n\nIntraoperative consultation confirmed the presence of a neoplastic lesion in the frozen section, and representative permanent sections were submitted for further analysis. All margins were histologically uninvolved. The patient had a history of heavy smoking and presented with a solid nodule in the right upper lobe along with multiple bilateral ground-glass nodules."} +{"pid": "TCGA-QR-A70G", "report": "The left adrenal gland specimen included a medullary nodule measuring 1.9 x 1.5 x 1.5 cm surrounded by up to 0.2 cm thick cortex, with additional focal cortical thickening noted. The total adrenal gland measured 8 x 3 x 2.2 cm and weighed 15.6 grams. The external surface was inked black, and serial sectioning was performed throughout the specimen.\n\nA left thyroidectomy specimen measured 10 x 6.5 x 5.5 cm and weighed 158 grams. It contained at least three nodules, with the largest measuring 7 cm in greatest dimension. The specimen was sectioned and showed variegated brown to tan parenchyma with yellow to tan nodular areas. A right hemithyroidectomy specimen measured 8.5 x 3.5 x 3.5 cm and weighed 61 grams. Areas of normal brown thyroid parenchyma were interspersed with yellow to tan nodular regions; the largest nodule in this specimen measured approximately 2.0 cm in greatest dimension. A separate fragment from the right inferior region measured 0.2 x 0.2 x 0.2 cm and was entirely submitted for analysis.\n\nSpecimens from both the right and left thymic tissues were received. The right thymus measured 7.5 x 1.0 x 0.7 cm and displayed a homogeneous yellow-tan cut surface with occasional hemorrhage. The left thymus measured 5.2 x 2.2 x 0.8 cm and also showed a uniform yellow to tan appearance upon sectioning. Both specimens were serially sectioned and representative sections submitted.\n\nImmunostaining demonstrated positivity for chromogranin and synaptophysin in lesional cells, with sustentacular cell staining highlighted by S100. All tests were developed and validated internally under CLIA certification for high-complexity testing. No U.S. Food and Drug Administration clearance or approval was required for these assays."} +{"pid": "TCGA-HF-7134", "report": "The pathology report includes multiple specimens collected from the fundus of the stomach. The tissue samples were obtained via resection procedure. Histologic evaluation shows glandular structures with varying degrees of architectural distortion. Cellular atypia is present, with moderate nuclear pleomorphism and increased mitotic activity. The tumor measures 6 cm in greatest dimension. Histologic grade is II. Pathologic staging indicates T1b involvement with no lymph node metastasis identified (N0). No distant metastases are noted. The surgical margins are free of neoplastic cells. Immunohistochemical staining and other ancillary studies were performed as part of the diagnostic workup."} +{"pid": "TCGA-TN-A7HL", "report": "The clinical history includes a history of smoking, alcoholism, and chronic bronchitis with emphysema. Multiple surgical margins were biopsied and all were negative for involvement. These included the right superior laryngeal nerve margin, left hypopharynx margin, right hypopharynx margin, inferior hypopharynx margin, right superior pharynx margin, trachea margin, and tongue base margin.\n\nA cricoid lymph node was excised and found to be negative. In the right neck dissection (Levels II\u2013IV), 29 lymph nodes were examined, with 3 involved: 2 of 6 in Level II, 1 of 10 in Level III, and 0 of 13 in Level IV. The largest involved lymph node measured 3.3 cm in greatest dimension and was located in Level II. Extracapsular extension was present. In the left neck dissection (Levels II\u2013IV), 35 lymph nodes were examined and all were negative. An additional set of left Level IV lymph nodes (5 total) were also negative.\n\nThe resected specimen included the larynx, pharynx, and right thyroid lobe. A mass measuring 4.7 x 3.7 x 2.6 cm was identified in the right hypopharynx, involving the right piriform sinus and vocal cord. The tumor was exophytic and ulcerative, with histologic features consistent with HPV-associated squamous cell carcinoma, moderately differentiated. Lymphatic/vascular and perineural invasion were present. The tumor was intramucosal and extended to adjacent soft tissues but did not involve the thyroid cartilage or gland. Margins were negative; however, the tumor was as close as 0.09 mm to the right lateral hypopharyngeal margin and 15 mm to the base of tongue margin. Additional margin specimens were also negative.\n\nA total of 71 lymph nodes were examined across all specimens, with 3 positive for involvement. The largest involved lymph node measured 3.3 cm. No neoadjuvant therapy was administered. Based on staging criteria, the primary tumor was classified as T3, and regional lymph node involvement as N2b."} +{"pid": "TCGA-XR-A8TE", "report": "The specimen consisted of a partial hepatectomy and multiple lymph node samples. The liver tissue measured 18.0 x 18.0 x 10.1 cm and weighed 2770.0 g. A large, firm, well-defined, lobulated mass was identified within the liver, measuring 18.0 cm in its longest dimension. The mass displayed a variegated appearance with areas of whitish to greenish discoloration and hemorrhage. Multiple smaller nodules were also present adjacent to the main lesion. The remaining liver tissue showed no significant fibrosis, though there were minor changes such as ductal proliferation, chronic inflammation, and mild portal cholestasis.\n\nA separate fragment from segment I included a firm, greyish area with a poorly demarcated whitish mass measuring 1.3 x 0.4 cm near the capsule. Histological evaluation of this margin showed no evidence of neoplastic involvement.\n\nA diaphragmatic lesion was represented by two small, elastic, brownish fragments measuring 1.2 x 1.2 x 0.5 cm in total. Microscopic analysis revealed dense fibrous connective tissue with mild lymphocytic infiltrate and congestion, but no malignant features.\n\nLymph node dissections were performed on three regions: hepatic hilum, celiac trunk, and left gastric artery. In the hepatic hilum, 14 lymph nodes were identified, ranging in size from 0.2 to 4.2 x 1.8 x 1.4 cm. In the celiac trunk, 10 structures were examined, ranging from 0.4 x 0.3 x 0.2 cm to 1.7 x 1.1 x 0.6 cm. For the left gastric artery, 11 lymph nodes were dissected, varying between 0.2 and 1.4 x 0.7 x 0.5 cm. All lymph nodes across these regions showed no signs of neoplastic invasion.\n\nThe gallbladder, measuring 6.5 cm in length, had a smooth, congested surface and contained thick, greenish bile. No histopathological abnormalities were noted in the gallbladder tissue.\n\nImmunohistochemical analysis of the liver lesion demonstrated positivity for low molecular weight cytokeratin (cam5.2) and canalicular staining for polyclonal carcinoembryonic antigen (CEA). It was negative for hepatocyte-specific antigen (HSA) and CK7. These findings were consistent with a specific type of liver tumor, though the absence of certain markers may suggest an atypical profile.\n\nPathological staging was determined as pT3a pN0, indicating local tumor extension without regional lymph node involvement. Surgical margins were free of tumor cells, and no angiolymphatic invasion was identified in the sections examined."} +{"pid": "TCGA-06-0875", "report": "The patient presented with headache and a right posterior frontal mass demonstrating necrosis, enhancement, mass effect, and edema. An excisional biopsy of the brain was performed.\n\nMicroscopic evaluation revealed a malignant astrocytic neoplasm with nuclear anaplasia, brisk mitotic activity, microvascular proliferation, vascular necrosis, thrombosis, and prominent karyorrhexis. The tumor cells showed frequent small multinucleated forms. Immunohistochemistry demonstrated focal heavy glial fibrillogenesis by GFAP staining. Approximately two-thirds of the neoplastic cells exhibited strong overexpression of p53 protein. Neuronal markers such as NeuN and synaptophysin highlighted an infiltrative pattern but no definitive neoplastic neuronal component was identified. MIB-1 staining revealed a high proliferation index of approximately 30% in the more active areas, consistent with a high-grade astrocytic neoplasm.\n\nGenetic testing for MGMT promoter methylation was negative. No allelic loss involving chromosome arms 1p or 19q was detected. Testing was performed using a PCR-based assay comparing tumor DNA to germline DNA from peripheral blood, with analysis at multiple informative loci including D1S552, D1S1592, D19S219, D19S412, and PLA2G4C. The presence of more than 15% non-neoplastic cells in the sample may have limited the sensitivity for detecting allelic loss.\n\nIntraoperative touch preparation smears were consistent with a high-grade glioma. Gross examination of the specimen showed two fresh tissue fragments measuring a total of 0.8 cm, as well as a separate aggregate of soft tissue measuring 2.0 x 0.5 x 0.3 cm, with a pink-tan to pale yellow hemorrhagic appearance. All tissue was submitted for histological evaluation."} +{"pid": "TCGA-22-1012", "report": "V3.00 110614. Instructions: The TCGA Missing Pathology Report Form should be completed for cases for which a pathology report is not available. General Pathology Report Information. Data Element Entry Alternatives. Working Instructions. Indicate to which BCR location the case was originally sent. BCR specimen originally sent to NCH. Biospecimen Core Resource (BCR). Date specimen received at BCR. ICD-0-3 Histology Code: Provide the histology code for the sample from the Case Quality Control Form (CQCF) and the overall case (patient diagnosis, if different). For Specimen: (CQCF). ICD-0-3 Site Code: Provide the site code for the sample from the Case Quality Control Form (CQCF) and the overall case (patient diagnosis, if different). For Case: (patient diagnosis, if available elsewhere)."} +{"pid": "TCGA-BP-4983", "report": "The specimen consists of a right radical nephrectomy, including the attached ureter, renal vessels, and perinephric fat, weighing 190 grams. The kidney measures 10.5 x 6.5 x 5.5 cm, with the attached ureter measuring 2.4 cm in length and 0.3 cm in diameter. Gross examination reveals a cortical mass located in the upper pole of the kidney, measuring 6 x 6.3 x 4 cm. The lesion is encapsulated and separated from the surrounding parenchyma. It extends into the calyces but does not grossly invade the cortex or perinephric fat. The cut surface of the mass is rubbery, variegated, and tan-white in appearance. The remainder of the kidney shows a pink-brown parenchyma with a well-defined corticomedullary junction; the cortex measures 0.6 cm. No lymph nodes are identified within the perinephric fat.\n\nMicroscopic evaluation demonstrates high-grade nuclear features. The tumor is in contact with medium-sized vessels in the renal sinus but does not show involvement of the renal vein or adrenal gland. Surgical margins, including ureteral and vascular margins, are free of tumor. Additional findings include chronic interstitial inflammation and focal glomerular hyalinization in the non-neoplastic kidney tissue.\n\nStaging indicates that the tumor extends into the renal pelvis and involves major vessels within the renal sinus, but remains confined within Gerota\u2019s fascia. A separate excision of perinephric soft tissue reveals only benign fibroadipose tissue without any abnormality. Representative sections of all relevant areas were submitted for further analysis."} +{"pid": "TCGA-G3-AAV4", "report": "The gallbladder specimen measured 8.0 x 3.0 x 1.5 cm and showed a smooth serosal surface. Upon opening, it contained approximately 10 ml of dark green bile without stones, and the mucosal surface appeared uniformly green with normal architecture. Sections were submitted for analysis.\n\nThe right hepatectomy specimen weighed 347 grams in the fresh state and measured 12.0 x 7.0 x 11.0 cm after fixation. The liver had a smooth capsular surface and contained a well-defined mass measuring 7.2 x 5.8 x 8.0 cm. The mass exhibited a yellow-tan appearance with central scarring and hemorrhage. It approached within 0.2 mm of the liver capsule and 0.3 cm from the inked surgical margin. No satellite nodules were identified. The surrounding liver tissue appeared fibrotic and yellow, with signs of chronic changes including moderate portal lymphocytic infiltration (grade 3) and bridging fibrosis (stage 3). Multiple embolized vessels were noted in the background liver; no lymphovascular invasion was observed.\n\nMicroscopic evaluation of the tumor showed well-differentiated cellular features consistent with the histologic type previously diagnosed. The tumor was confined to the liver without evidence of vascular invasion. Surgical margins were free of invasive carcinoma. Immunohistochemical staining of the background liver demonstrated focal positivity for hepatitis B core antigen and strong focal positivity for hepatitis B surface antigen, correlating with a history of hepatitis B infection. The tumor cells were negative for alpha-fetoprotein.\n\nStaging classification indicated a solitary lesion without vascular invasion (pT1). Regional lymph node involvement could not be assessed (pNX), and distant metastasis could not be evaluated (pMX). The closest invasive component to the surgical margin was 0.2 mm. Additional findings included chronic viral hepatitis changes in the liver parenchyma."} +{"pid": "TCGA-B5-A1MR", "report": "The uterus measures 9 x 6.5 x 4.5 cm and contains multiple areas of abnormal tissue involvement. A dominant lesion measuring 6 x 5 x 2.5 cm is identified in the posterolateral fundal wall, with tan, relatively solid features and a fungating appearance projecting into the endometrial lumen. On cross-section, this lesion invades 3 mm into the myometrium, which is 1.2 cm thick. Hemorrhage and yellow streaks are noted focally within this area. Another region of interest is present on the anterior mucosal surface as a slightly discolored tan-yellow plaque, possibly representing a secondary lesion without evidence of myometrial invasion at this site. In the lower uterine segment, a 1.5 cm raised nodule is observed approximately 0.5 cm away from the main tumor mass; it also extends 3 mm into the 1.2 cm thick uterine wall. Additionally, a 2 mm yellow plaque is identified in the anterior endometrium.\n\nSections submitted include the main tumor mass, the lower uterine segment nodule, and cervix. The cervix shows no significant pathological findings. The right and left ovaries measure 1.5 x 1 x 0.9 cm and 1.5 x 1 x 0.5 cm respectively, and both appear unremarkable. The fallopian tubes are also within normal limits. \n\nLymph node specimens were received from multiple sites. The right obturator specimen includes a 4.5 x 3 x 0.9 cm fibrofatty tissue containing lymph nodes, with the largest measuring 3 x 0.9 x 0.5 cm. Eight lymph node candidates are present in B2. The right common iliac specimen consists of a 1.5 x 0.9 x 0.4 cm lymph node. The right paraaortic specimen includes a 5.5 x 2.5 x 0.4 cm fibrofatty tissue with lymph nodes, the largest being 1.5 x 0.9 x 0.2 cm, with two additional candidates in D2. The left pelvic specimen contains a 3.5 x 2.5 x 0.9 cm fibrofatty tissue with lymph nodes, the largest measuring 3 x 1.2 x 0.4 cm, and a smaller node also included. The left obturator specimen includes a 2.5 x 1.5 x 0.3 cm fibrofatty tissue with lymph nodes, the largest measuring 1.4 x 0.4 x 0.3 cm, with two additional candidates. The left paraaortic specimen includes a 2.5 x 2 x 0.5 cm fibrofatty tissue with lymph nodes, the largest measuring 2 x 1 x 0.5 cm, with two additional candidates. Omental specimens consist of two fragments of fatty tissue measuring 13 x 8 x 2 cm, with multiple lymph node candidates distributed across four blocks.\n\nMicroscopically, the primary lesion demonstrates largely endometrioid morphology. In the lower uterine segment, clusters of cells with clear cytoplasm are observed, although insufficient for a diagnosis of clear cell adenocarcinoma. Focal areas show papillary architecture and bulbous nuclei, but not enough to classify as serous adenocarcinoma. Multinucleated and bizarre cells are seen in parts of the main tumor mass but do not meet criteria for giant cell carcinoma. A small focus of well-differentiated tumor with cilia is found in the ovary, raising concern for metastasis, though a primary origin cannot be entirely excluded. Deep within the uterine wall, small nodules of inflammatory cells are present, possibly reactive to tumor activity.\n\nAll lymph node specimens and omental tissue show no evidence of tumor involvement."} +{"pid": "TCGA-EM-A2CN", "report": "The specimen included a total thyroidectomy with left paratracheal node dissection. The thyroid gland weighed 69.7 grams and consisted of a right lobe measuring 6.5 x 4.7 x 4.5 cm, a left lobe measuring 4.4 x 2.5 x 1.8 cm, and an isthmus measuring 3.8 x 1.8 x 0.8 cm. The right lobe contained a dominant solid nodule measuring 6.0 cm in greatest dimension. The nodule exhibited follicular architecture and classical cytomorphology. A minor component showed features of poor differentiation, comprising less than 5% of the overall cellular composition. The tumor was unifocal and located in the right lobe. Margins were free of involvement by the neoplasm, with the closest distance from invasive tissue to the margin being 0.01 mm. The tumor was partially encapsulated and demonstrated capsular invasion with a widely invasive pattern. Lymphovascular invasion was present and extensive, involving four or more vessels. There was no evidence of perineural invasion or extrathyroidal extension.\n\nThree lymph nodes were examined: two from the left paratracheal dissection and one from the pretracheal region. No malignant cells were identified in these lymph nodes. Additionally, a soft tissue specimen from the C6 level showed metastatic involvement. Based on AJCC/UICC TNM staging (7th edition), the primary tumor was classified as pT3 due to its size exceeding 4 cm and limited local extension. Regional lymph node involvement was classified as pN0, as no metastases were found in the three nodes examined. Distant metastasis was classified as pM1 based on the presence of metastatic tissue in the C6 soft tissue specimen."} +{"pid": "TCGA-FG-A713", "report": "The specimen consisted of multiple biopsies and tissue fragments obtained from various regions including the posterior superior, anterior inferior, posterior inferior, and anterior areas. Grossly, the specimens were described as pink-tan to opaque white soft tissue fragments, with sizes ranging from 0.3 cm to 1.8 cm in aggregate. All samples were submitted fresh for intraoperative consultation or frozen for diagnostic evaluation.\n\nMicroscopic examination of all sampled areas revealed no evidence of solid tumor. The cerebral cortex and myelinated white matter showed no neoplastic infiltration. Several areas demonstrated mild to minimal hypercellularity, primarily involving glial elements. Perivascular lymphocytic infiltrates were identified within the cortex, composed predominantly of CD3-positive small lymphocytes, with a minority (~30%) of cells expressing CD20. Immunohistochemical staining for CD30 was negative. Desmin reactivity was observed in infiltrated small vessels, while beta-amyloid staining was negative in the vessels but showed amyloid plaques in the cortex. Ki-67 immunostaining did not label nuclei within the parenchyma, and IDH1 R132H mutation analysis was also negative across all tested areas.\n\nA separate excision specimen revealed a cellular infiltrate with features suggestive of both oligodendroglial and astrocytic differentiation. Immunohistochemistry demonstrated scattered labeling with mutant IDH1-R132H antibody and approximately 3% nuclear labeling with Ki-67 in the most cellular regions. No labeling was observed with CD20 in intraparenchymal cells.\n\nGenetic analysis using fluorescence in situ hybridization (FISH) on paraffin-embedded tissue demonstrated allelic loss at chromosome 1p and 19q. Quantitative results showed 1p36 signal loss with a 1p16/19q13 ratio of 0.7 and a 19q13/19p13 ratio of 0.6, consistent with concomitant losses. These findings may be associated with chemoresponsiveness and prolonged progression-free survival in some gliomas, particularly when combined loss is present. Aneusomy was not detected based on reference probe signals.\n\nAll assays were performed using appropriate controls and developed within a CLIA-certified laboratory. Some reagents used in testing were considered analyte-specific reagents (ASRs), which are not FDA-cleared but are validated for clinical use. This test was conducted for diagnostic purposes and is not considered investigational or for research use only.\n\nIntraoperative consultation confirmed absence of tumor in several margins, with focal mild glial hypercellularity noted in others. Final reporting was completed following all ancillary studies and confirmation of molecular findings."} +{"pid": "TCGA-12-3648", "report": "A 36-gram resected brain specimen measuring 5.5 x 5.5 x 2.4 cm was received, showing diffuse surface hemorrhage without clear demarcation between white and gray matter. Imaging revealed a dominant right temporal lobe lesion measuring 4.7 x 3.7 cm with a large central non-enhancing component and decreased T1 signal intensity. Several smaller enhancing lesions were noted posteriorly, with the largest measuring approximately 1.5 cm. No significant mass effect or vasogenic edema was observed.\n\nHistologically, the tissue demonstrated a high-grade cellular proliferation consistent with astrocytic origin. Features included marked anaplasia, vascular proliferation, and pseudopalisading necrosis. Immunohistochemical analysis showed variable expression across markers: Leucocyte Common Antigen (LCA) was positive in 15% of cells; proliferation index was high with 20% of tumor cells staining. MGMT expression was present in 30% of cells. EGFR wild-type expression was detected in 90% of cells (2+ staining), while EGFR variant III was present in 20% (2+ staining). PTEN loss was indicated in 50% of cells (2+ staining). S6 and AKT expressions were negative, each present in 20% and 10% of cells respectively. MAPK expression was noted in 20% of cells with 3+ staining intensity.\n\nGenetic analysis by FISH revealed polysomy of chromosome 7 in 82% of tumor cells and amplification of EGFR in 93%. Loss of chromosome 10 centromere was identified in 59% of cells and allelic loss of PTEN in 72%. Chromosome 9 centromere loss was seen in 41% of tumor cells, and 9p21 loss was present in 52%. All four tested markers were abnormal in this case. Both FISH and immunohistochemistry corroborated PTEN loss. The molecular profile suggests a higher hazard of short survival based on multivariate survival analysis comparing patients with fewer versus more abnormal markers."} +{"pid": "TCGA-EL-A3CY", "report": "The pathology report describes a surgical specimen from a male patient, including a right limited neck dissection, completion thyroidectomy, right paratracheal lymph node dissection, and superior mediastinal dissection. The specimen includes a right thyroid lobe with attached skeletal muscle, measuring 7.0 x 3.8 x 1.4 cm in total, with the thyroid itself measuring 5.0 x 3.3 x 1.9 cm. The external surface of the thyroid is dark red and smooth. On cross section, the parenchyma is entirely involved by a papillary tumor. Representative sections of the tumor have been submitted to the tumor bank, and the remainder of the thyroid is submitted in cassettes A1 through A8. Skeletal muscle, measuring 4.8 x 3.0 x 1.5 cm, shows no significant findings on cross section, appearing as unremarkable dark red muscle. Sections AD1 through AD3 include representative samples of skeletal muscle and soft tissue. No parathyroid or thyroid tissue was identified in the submitted sections."} +{"pid": "TCGA-BH-A28O", "report": "The patient underwent a right axillary sentinel lymph node biopsy, bilateral total mastectomy, and free flap reconstruction. Evaluation of the right axillary lymph nodes demonstrated metastatic involvement in multiple lymph nodes. Specifically, all submitted sentinel and non-sentinel lymph nodes were positive for metastatic carcinoma without extracapsular extension. The number of involved lymph nodes totaled 14 out of 14 examined.\n\nExamination of the right breast revealed multifocal and multicentric disease. Histologic evaluation showed invasive carcinoma with features consistent with Nottingham grade 1 morphology. The tumor was predominantly located in the upper/outer and upper/inner quadrants, measuring 6.0 cm in greatest dimension on gross examination. Microscopic analysis identified additional foci in all four quadrants, with individual foci measuring up to 2 mm. No lymphovascular invasion was observed. Proximity to surgical margins was noted, with tumor located within 0.1 cm of both anterior and posterior margins.\n\nAdditional findings included benign breast parenchyma in retroareolar biopsies and fibrocystic changes throughout. Flat epithelial atypia, columnar cell changes, hyperplasia, and microscopic radial scar were also present in the left breast specimen.\n\nPathologic staging was determined as pT3 N3 MX based on tumor size, nodal involvement, and absence of distant metastasis assessment. Cellular features of the primary tumor were predominantly nuclear grade 1, while metastatic deposits in lymph nodes exhibited a range from nuclear grade 1 to grade 3 with minor pleomorphic components noted."} +{"pid": "TCGA-D8-A73U", "report": "The specimen from the left breast measures 21.2 x 12.3 x 5.4 cm and weighs 436 grams. The skin flap is 18.2 x 8.3 cm in size, and no axillary tissue is included. A lesion measuring 4 x 2.2 x 1.6 cm is identified at the junction of the upper quadrants, located 2.8 cm from the upper margin, 1.4 cm from the base, and 1.0 cm beneath the skin surface.\n\nMicroscopic evaluation reveals a neoplastic process involving cells arranged in a classical growth pattern. Nuclear grade is determined as NHG 2 (3+2+1), with no mitotic figures observed across ten high-power fields. The examined area for mitotic count is approximately 0.55 mm\u00b2. No pathological changes are noted in the nipple. The surrounding glandular tissue demonstrates signs of parenchymal atrophy.\n\nImmunohistochemical analysis shows that 75% of the neoplastic cell nuclei express estrogen receptors, and a similar percentage exhibit progesterone receptor positivity. Staining for HER2 protein using the HER-2/neu (4B5) Rabbit Monoclonal Antibody yields a score of 1+, indicating no overexpression in the invasive component. The Ki-67 labeling index is 15%, reflecting the proportion of nuclei expressing this proliferative antigen."} +{"pid": "TCGA-2G-AAH8", "report": "The specimen measured 9.0 cm in greatest dimension and was submitted following right orchidectomy. Histologic evaluation demonstrated a neoplasm characterized by uniform cells with clear cytoplasm and well-defined cell borders. There was no evidence of vascular or lymphatic invasion identified. The rete testis was free of involvement. Additionally, there was no infiltration of the tunica albuginea observed."} +{"pid": "TCGA-CG-4443", "report": "The specimen consists of a total gastrectomy preparation. A lesion was identified in the corpus region, characterized by a moderately differentiated morphology with intestinal-type features and exophytic, polypoid growth pattern. Histological evaluation revealed infiltration extending into the submucosal layer. A total of 30 regional lymph nodes were examined and none showed evidence of tumor involvement. Both the oral and aboral resection margins were free of tumor. The omentum was also tumor-free. In the antral region, there was notable high-grade mucosal edema with pseudopolypous changes and foveolar hyperplasia. At the junction between the antrum and corpus, a small lipid islet was observed. No other significant pathological findings were noted."} +{"pid": "TCGA-CV-6433", "report": "The specimen analysis included multiple lymph node and soft tissue samples from various anatomical regions. In the submental triangle, three lymph nodes were identified without evidence of tumor involvement. Similarly, two lymph nodes from the right level 1 region showed no tumor presence. Gross examination revealed an ulcerated lesion measuring 4 x 3 cm at the base of the tongue, epiglottis, and pharynx bilaterally. Histologically, broad nests of abnormal cells were observed in this region, with invasion into adjacent skeletal muscle and hyoid bone noted. The depth of invasion measured 0.65 cm. No perineural or vascular invasion was identified.\n\nAdditional sections from the parapharyngeal areas yielded variable findings. The right deep parapharyngeal region contained a fragment of mucosa with abnormal cellular infiltration. Similar findings were noted in the right superior parapharyngeal region. However, the left parapharyngeal area showed only mild epithelial dysplasia without invasive features. Several other sampled sites\u2014including the retromolar trigone, lateral piriform sinuses, upper esophagus, and posterior cricoid\u2014demonstrated normal squamous mucosa without tumor involvement.\n\nOne section from the right parapharyngeal region demonstrated abnormal tissue extending to the inked surgical margin. Another fragment from this area raised concern for possible contamination due to its appearance within fibrin. Further evaluation of additional sections confirmed absence of tumor in all submitted tissues from this location.\n\nThe composite resection included a tongue measuring 8 x 7 x 3.5 cm and attached larynx with first tracheal ring (8 x 5 x 4 cm). Microscopic examination of decalcified sections confirmed involvement of the hyoid bone by infiltrating tissue. Other sampled structures including thyroid gland (not present), salivary gland, and surrounding adipose tissue showed no signs of malignant infiltration."} +{"pid": "TCGA-G3-AAUZ", "report": "The specimen was received for evaluation and included three containers labeled A to C. Container A contained a non-intact gallbladder measuring 6.8 x 2.3 x 1.2 cm. The serosal surface was smooth, and the lumen contained green bile with no calculi. The cystic duct was patent, and the mucosa appeared granular. The wall thickness averaged 0.2 cm. A lymph node measuring 0.6 cm in greatest dimension was identified and submitted entirely. \n\nContainer B contained a partial hepatectomy specimen weighing 81.3 g and measuring 6.4 x 6.2 x 5.6 cm. The capsular surface was smooth, and the surgical margin was marked with blue ink. Serial sectioning revealed a well-circumscribed, ovoid mass with lobular features on cut surface. The mass measured 4.4 x 2.7 x 2.3 cm and was located adjacent to the capsular surface, coming within 0.1 cm of the blue inked margin. No other lesions were identified. Representative sections of the mass and its relation to the margins were submitted, along with a section of adjacent normal liver tissue.\n\nContainer C contained a soft, dark tan, triangular tissue fragment measuring 1.5 x 1.0 x 0.7 cm. The surgical resection margin was identified and marked with blue ink. The specimen was entirely submitted for microscopic evaluation.\n\nMicroscopic examination of the gallbladder showed no evidence of malignancy. The background liver tissue showed portal inflammation and steatosis involving approximately 20% of hepatocytes. The final margin biopsy showed only liver parenchyma without any atypical cells. Multiple sections of the mass were evaluated, showing well-differentiated cellular features. The tumor was localized near the surgical margin but did not show clear invasion into the outer surface. All submitted margins were assessed microscopically."} +{"pid": "TCGA-43-3394", "report": "The specimen includes a left lower lobe of lung measuring 15 x 14 x 10 cm, partially covered by pink-gray pleura with black stippling. A 4.5 x 4.5 x 4 cm pink-tan-white firm lesion is identified centrally within the tissue, showing areas of necrosis. The lesion is located 1.2 cm from a stapled bronchial margin, 2 cm from the surgical margin at the hilum, and 1 cm from the pleural surface. The remainder of the lung tissue appears normal. A single lymph node near the hilum was sampled and showed no abnormal findings.\n\nAdditional specimens include lymph node stations 9, 11, and 5. Station 9 contained two soft tissue fragments measuring up to 0.7 cm. Station 11 included two darker fragments measuring up to 1 cm; one of these was firmer in consistency. Station 5 contained multiple small pink-red fragments aggregating to 1.5 cm in size.\n\nHistologically, the primary lesion demonstrates poorly differentiated morphology with a maximum dimension of 4.5 cm (pT2a). Resection margins are negative for involvement. No vascular or lymphatic invasion is identified. One hilar lymph node was examined and showed no evidence of disease involvement. Additional lymph nodes evaluated at levels 9, 11, and 5 also showed no signs of metastatic disease, including four nodal fragments assessed at level 5."} +{"pid": "TCGA-TQ-A7RH", "report": "The specimen consists of five irregular brain structures, with the largest measuring 5.5 x 4.0 x 2.0 cm, partially covered by meningeal tissue and featuring a jelly-like, brown, and irregular surface lesion. Additional smaller structures together measure 3.0 x 2.5 x 0.5 cm. Histological examination of H&E-stained sections reveals a diffuse glial neoplasm with moderate to polymorphic cellularity. The cellular composition varies, with some areas showing cells with clear cytoplasm and perinuclear halos, while other regions contain cells with elongated nuclei, dense chromatin, and eosinophilic cytoplasm. Nuclear pleomorphism is present to a moderate degree. Multiple cells exhibit a minigemistocytic appearance, along with satellitosis around cortical neurons. Certain regions of the neoplasm display increased cell density, sparse mitotic figures, and more pronounced nuclear atypia, though no microvascular proliferation is identified. In these areas, the Ki-67 proliferation index (CPI) is approximately 5%. Focal hemosiderin deposits are also present, but no necrotic foci are observed. In areas exhibiting an astrocytic pattern, p53 overexpression is noted, and the neoplasm predominantly displays an oligodendroglial architecture. No features meeting criteria for a higher grade are present, although certain areas show elevated Ki-67 CPI and nuclear atypia suggestive of possible progression toward increased malignancy."} +{"pid": "TCGA-VM-A8CD", "report": "The specimen consists of three parts collected from the right temporal lobe. The first part, received fresh for intraoperative evaluation, is a 0.9 x 0.7 x 0.4 cm soft tissue fragment. A portion was used for frozen section and submitted for permanent sections. The second part, received in formalin, consists of an aggregate measuring 3 x 2.2 x 1 cm. This tissue was fully submitted for analysis. The third part is a smaller aggregate measuring 0.5 x 0.5 x 0.2 cm and was also entirely submitted.\n\nMicroscopic examination of all specimens reveals a moderately hypercellular glial tumor with infiltrative growth patterns consistent with astrocytic lineage. Nuclear pleomorphism and hyperchromasia are present to a mild degree. Mitotic figures are scattered throughout the tissue; however, microvascular proliferation and necrosis are not identified. Immunohistochemical staining demonstrates diffuse positivity for glial fibrillary acidic protein, indicating glial differentiation. Proliferation activity, assessed by MIB-1 staining, shows positivity in approximately 10% of nuclei. IDH-1 staining does not show reactivity.\n\nHistologic evaluation confirms the presence of a neoplastic process involving astrocytic cells. Cellular features include increased cellularity, nuclear atypia, and mitotic activity without evidence of vascular proliferation or necrosis. Specimen margins cannot be assessed due to the nature of the tissue received."} +{"pid": "TCGA-G9-6332", "report": "The specimens include right and left pelvic lymph nodes, as well as a prostate specimen. Examination of the right pelvic lymph nodes showed no tumor involvement in three lymph nodes (0/3). Similarly, no tumor was identified in four left pelvic lymph nodes (0/4). The prostate measured 5.5x4.3x3.5cm and weighed 35 grams. The prostate showed involvement of multiple regions including right, left, anterior, posterior, basal, and apical aspects, with approximately 40% gland involvement. Histologic evaluation revealed a Gleason grade of 4+3 (score 7/10). High-grade prostatic intraepithelial neoplasia was noted. Perineural invasion was present both within and beyond the prostate capsule. There was also evidence of involvement of periprostatic fat on the left side. No lymphovascular invasion was identified. The surgical margins were negative for tumor involvement. No involvement of the seminal vesicles was seen, although there was focal extraprostatic perineural invasion adjacent to the base of the right seminal vesicle. Benign prostatic hyperplasia was also noted. The pathologic stage was determined to be pT3a with no lymph node metastasis (N0) and no distant metastasis. Frozen section analysis was performed at the time of surgery. All lymph node specimens were submitted entirely for histologic evaluation."} +{"pid": "TCGA-D8-A1X8", "report": "Histopathological examination was performed on a left breast specimen with axillary tissues. The breast measured 22.4 x 17.8 x 6.4 cm and weighed 950 g. A lesion measuring 2.7 x 1.4 x 2.8 cm was identified in the central region, located 6.0 cm from the lower boundary, 0.3 cm from the base, and 1.4 cm from the skin. Axillary tissues measured 12 x 5 x 3 cm, and a skin flap measured 24.2 x 11.3 cm.\n\nMicroscopic evaluation revealed multifocal invasive carcinoma with classical and solid growth patterns. Nuclear grade was NHG2 (mitotic count: 3+2+1/0 per 10 HPF in a visual area of 0.55 mm). Involvement of the nipple was observed. In situ changes included pagetoid spread and hyperplastic alterations within areas of sclerosing adenosis. Stromal changes included fibrocystic alterations and sclerosing adenosis.\n\nExamination of axillary lymph nodes revealed metastatic involvement (nodes IX/XI). Immunohistochemistry showed estrogen receptor expression in over 75% of neoplastic nuclei and progesterone receptor expression in over 75% as well. HER2 testing by immunohistochemistry yielded a score of 2+, and fluorescence in situ hybridization (FISH) was performed for further evaluation; no HER2 gene amplification was detected.\n\nStaging parameters indicated pTIc and pN2a classification."} +{"pid": "TCGA-D1-A1NS", "report": "A 1720.0 gram specimen of skin and subcutaneous tissue from the abdomen was submitted without any identified lesions. A separate specimen including the uterus, bilateral fallopian tubes, and ovaries weighed 95.0 grams. A polypoid mass measuring 3.2 x 2.9 x 1.0 cm was identified in the posterior uterine wall, with gross invasion into the myometrium measuring 0.3 cm; the total myometrial thickness was 1.8 cm. No involvement of the endocervix was observed. A single intramural leiomyoma measuring 0.6 cm in greatest dimension was noted. Adenomyosis was also present.\n\nThe right ovary measured 1.7 x 1.0 x 1.0 cm with a solid cut surface and no cystic structures. The right fallopian tube, measuring 4.2 x 0.5 cm, contained two paratubal cysts measuring 0.8 cm and 1.2 cm in greatest dimension. The left ovary measured 1.8 x 1.1 x 0.9 cm with a solid cut surface and no cystic structures. The left fallopian tube measured 6.5 x 0.5 cm and contained one paratubal cyst measuring 1.4 cm in greatest dimension.\n\nMultiple lymph nodes were identified in both right and left pelvic lymphadenectomy specimens. Twenty-four lymph nodes were submitted from the right pelvic specimen and nineteen from the left pelvic specimen; all were negative for tumor involvement. Histologic evaluation confirmed findings consistent with those identified on frozen section. Based on available surgical materials, staging was determined as pT1NO according to AJCC criteria (7th edition, 2010)."} +{"pid": "TCGA-AA-3688", "report": "The colon resection specimen contains a moderately differentiated epithelial neoplasm, with a maximum dimension of 2.5 cm. The lesion demonstrates infiltration into the surrounding adipose tissue adjacent to the colon wall. Examination of regional lymph nodes reveals involvement in two out of thirteen nodes. The surgical margins of the resected colon are free of tumor involvement. Histologic grade is intermediate. Lymphatic invasion is present; vascular invasion is not identified. Clinically, there is evidence of distant metastasis involving the liver, and residual tumor is present following surgery."} +{"pid": "TCGA-BJ-A45H", "report": "Addendum. MOLECULAR ANATOMIC PATHOLOGY TESTING: Block C (Thyroid, Right): A BRAF codon 600 mutation was identified (p.V600E, c.1799T>A). Mutations in NRAS61, HRAS61, KRAS12/13 and RET/PTC1 and RET/PTC3 rearrangements were not identified. Block F (Thyroid, Left): A BRAF codon 600 mutation was identified (p.V600E, c.1799T>A). Mutations in NRAS61, HRAS61, KRAS12/13 and RET/PTC1 and RET/PTC3 rearrangements were not identified. NOTE: Nucleic acids were extracted in sufficient quantity for testing.\n\nMutational testing of thyroid specimens has demonstrated clinical relevance in cytological evaluation and risk stratification. Molecular alterations such as BRAF or RAS mutations and RET/PTC rearrangements have been shown to correlate with malignancy in a significant percentage of cases. The presence of BRAF, RET/PTC, or PAX8/PPAR\u03b3 mutations in thyroid fine needle aspiration samples correlates with a near 100% probability of cancer. Detection of RAS mutations correlates with malignancy in approximately 74\u201385% of cases. In cytologically indeterminate nodules that test negative for these mutations, the estimated cancer risk is approximately 5.9% for those classified as atypia or follicular lesion of undetermined significance (including a 2.3% risk of invasive cancer and 0.5% risk of extrathyroidal spread), 14% for nodules classified as follicular neoplasm/suspicious for follicular neoplasm, and 28% for nodules suspicious for malignant cells.\n\nFor surgical specimens, manual microdissection was performed on paraffin-embedded tissue containing a minimum of 50% tumor cells. Real-time PCR analysis was conducted using the LightCycler platform to detect mutations in BRAF codons 599\u2013601, NRAS codon 61, HRAS codon 61, and KRAS codons 12/13. Post-amplification melting curve analysis was used for mutation detection. RET/PTC1 and RET/PTC3 fusion points were analyzed via single-step real-time RT-PCR on ABI7500. Mutation confirmation was carried out by Sanger sequencing when necessary. RNA quality and epithelial cell content were assessed via KRT7 amplification. Samples with amplification occurring at or before 35 cycles were considered adequate for analysis. Analytical sensitivity allowed detection of mutations present in 10\u201320% of alleles within a background of normal DNA and RNA.\n\nTwo distinct foci of neoplastic tissue were identified bilaterally within the thyroid specimen. The right-sided lesion measured 1.5 cm and the left-sided lesion measured 0.5 cm. Extrathyroidal extension was observed. Residual tumor was noted at the surgical margin on the left side. Histologic examination revealed conventional morphology in both lesions. Evidence of angiolymphatic invasion was present. Based on synoptic reporting standards, the primary tumor classification was determined as pT3. No lymph node staging could be assigned due to insufficient regional lymph node data. Vascular invasion was documented."} +{"pid": "TCGA-19-A6J5", "report": "The specimen consists of neoplastic tissue composed of astrocytic cells with atypical nuclei and a high degree of cellular pleomorphism. Microscopic evaluation shows areas of necrosis with pseudopalisading, as well as numerous mitotic figures. Microcalcifications are present, and the tumor demonstrates an infiltrative growth pattern involving the cerebral cortex. No clear evidence of vascular endothelial proliferation was identified. The histologic features correspond to a high-grade lesion.\n\nTwo separate tissue specimens were received. The first is a small fragment measuring 1.2 x 0.5 x 0.2 cm, described as gray-brown soft tissue. The second specimen weighs 84.8 grams and measures approximately 9 x 5.9 x 3 cm. On gross examination, the tissue includes both normal-appearing brain architecture and abnormal regions showing hemorrhage, soft consistency, and yellow-orange discoloration. Approximately 15% of the total specimen was sampled for histologic analysis.\n\nThe tumor is located in the right frontal region of the cerebrum. Based on histopathologic features, the lesion exhibits aggressive characteristics consistent with advanced staging."} +{"pid": "TCGA-2L-AAQJ", "report": "The surgical specimen from a female patient included multiple tissue samples from various anatomical regions. Macroscopic evaluation revealed several unfixed and fixed specimens, primarily involving the pancreas, duodenum, colon, gallbladder, and associated lymph nodes and fatty tissues.\n\nA Whipple resection specimen included a 10 cm long duodenum, a 3 cm wide distal stomach, and an 8.5x6.5x3 cm pancreas head. The Ductus choledochus was resected after 6 cm and found to traverse through a solid mass within the pancreas. This mass was poorly demarcated from the dorsal and medial resection margins and extended into the duodenal wall. The gastric mucosa showed edema, and the specimen was surrounded by extensive adhesions. A medial green and dorsal black ink mark was applied for orientation. Within the peripancreatic fatty tissue, single lymph nodes up to 0.8 cm were identified.\n\nResection margins of the pancreas included a 4x1.5x0.3 cm and a 3x1.5x0.5 cm specimen, with one marked by a stitch. Microscopic analysis of these areas showed tumor involvement. In addition, a 2x2x1 cm fatty tissue specimen from the ligamentum hepatoduodenale contained lymph nodes, and a separate 0.9 cm indurated soft tissue specimen from the same region was also examined.\n\nLymph node involvement was noted in the interaortocaval region (up to 2 cm in size) and around the superior mesenteric artery (up to 2x0.8x0.8 cm). Other lymph nodes, including those at the hepatic artery, cystic duct, and root of the mesentery, were negative for tumor cells. Extensive perineural invasion was observed in multiple areas, particularly in soft tissue and connective tissue surrounding nerves and vessels.\n\nHistological evaluation revealed infiltrates of adenocarcinoma in the small intestine resection specimen (15 cm in length), with extension into the wall measuring 1.5x1.0 cm. The tumor was also present in the resection specimen of the superior mesenteric artery and in the interaortocaval region. In the central area of the small intestine, no tumor was detected, but serosal adhesions were noted.\n\nThe gallbladder measured 6x4.5x3 cm and showed yellow-brown mucosa with ulcers up to 0.8 cm. The wall was thickened up to 0.6 cm, with areas of fibrosis, edema, and hemorrhage. No tumor was identified in the gallbladder or in the attached lymph node at the cystic duct. Chronic inflammation and fibrosis were present in the bile duct region.\n\nIn the right hemicolectomy specimen, composed of 5 cm of terminal ileum and 26 cm of cecum/ascending/transverse colon, the mucosa at the right colonic flexure showed a 4.5 cm segment of dark red discoloration suggestive of ischemia. No tumor infiltration was found in the appendix, omentum, or any of the serosal adhesion sites. Peyer\u2019s patches in the ileum showed hyperplasia.\n\nMicroscopic examination of paraffin-embedded sections confirmed the presence of moderately differentiated ductal adenocarcinoma in the pancreas, with desmoplastic stromal reaction, necrotic foci, and frequent areas of sclerosis. Tumor cells were identified at the medial resection margin of the pancreas and in the resection margin of the pancreatic duct. Resection margins of the bile duct, stomach, and duodenum were free of tumor.\n\nTwenty-one lymph nodes were evaluated; all were negative for metastasis. Additional findings included chronic inflammation and fibrosis in the gallbladder wall, segmental mucosal ischemia at the right colonic flexure, and acute suppurative cholecystitis with gallstones and localized purulent peritonitis.\n\nTumor infiltration was identified in the duodenal wall, pancreatic duct, and surrounding bile duct. Perineural invasion was extensive. Based on TNM classification (UICC, 7th edition, 2010), the staging was pT4, pN0 (0/21 lymph nodes positive), G2. The resection status was classified as R1 due to involvement of the medial pancreatic margin."} +{"pid": "TCGA-EM-A2OX", "report": "The thyroid specimen measured 4.5 \u00d7 3.4 \u00d7 1.6 cm on the right lobe, 4.5 \u00d7 2.0 \u00d7 1.0 cm on the left lobe, and 2.1 \u00d7 2.5 \u00d7 1.2 cm at the isthmus, with a total weight of 25.6 grams. A dominant nodule measuring 1.8 \u00d7 1.5 \u00d7 1.4 cm was identified in the mid-right lobe, along with a second nodule measuring 0.6 cm located in the isthmus. Both nodules were well-circumscribed, tan-colored, firm, and homogeneous upon sectioning. The remainder of the thyroid tissue appeared unremarkable.\n\nHistologically, the dominant lesion exhibited diffuse invasive growth with classical papillary architecture and cytomorphology. Focal areas suggestive of tall cell change (<5%) were noted. Psammomatous calcifications were present throughout the lesion. Lymphatic invasion was definitively identified, while vascular invasion remained indeterminate. Both lesions were within 0.1 mm of the closest resection margin and demonstrated partial encapsulation with varying degrees of capsular invasion\u2014extensive for the larger lesion and minimal for the smaller.\n\nEight of nine lymph nodes from the right neck and central paratracheal dissection contained infiltrating cells with similar histological features. These nodes ranged in size from 0.3 \u00d7 0.2 \u00d7 0.2 cm to 0.9 \u00d7 0.8 \u00d7 0.6 cm.\n\nNo definitive extrathyroidal extension or perineural invasion was identified. Additional findings included adenomatoid nodules and focal thyroiditis. Based on AJCC/UICC TNM staging criteria (7th edition), the tumors were classified as multifocal and confined to the thyroid gland (pT1b), with metastatic involvement of unilateral cervical and central lymph nodes (pN1b)."} +{"pid": "TCGA-55-A4DF", "report": "The specimen consists of five parts from the right lower and upper lobes of the lung, along with lymph nodes. The first part, a wedge from the right lower lobe, weighs 4.3 grams and measures approximately 4.5 x 1.6 x 1.4 cm. It shows no evidence of a neoplasm, with findings consistent with organizing pneumonia. The second part, also from the right lower lobe, is a larger fragment weighing 22 grams and measuring about 5.7 x 4.2 x 3.0 cm. This section contains a well-defined, gritty, gray-tan fibrotic lesion measuring 2.7 x 2.5 x 2.0 cm, located near the pleura but not extending through it. The lesion is surrounded by spongy, pink-red parenchyma and is submitted in multiple sections.\n\nThe third part is a 15-gram wedge from the right upper lobe measuring 6.0 x 3.0 x 2.1 cm. It contains a smaller, centrally located fibrotic nodule measuring 1.0 x 0.9 x 0.7 cm, situated 0.4 cm from the staple line margin. The surrounding tissue is congested and shows marked anthracotic changes.\n\nTwo lymph node specimens are included: one from level 4, measuring 1.6 x 1.0 x 0.3 cm; and another from level 7, which includes a larger lobulated piece (4.0 x 2.2 x 1.1 cm) and a smaller fragment (1.2 x 0.9 x 0.4 cm). All lymph node tissues were submitted for analysis.\n\nMicroscopic examination reveals two distinct lesions. In the right lower lobe, a large-cell malignant neoplasm is observed with areas of gland formation transitioning into solid nests of cells embedded in dense fibrous stroma, alternating with necrotic zones. This lesion invades the pleural layer but does not reach the pleural surface. In contrast, the right upper lobe lesion consists of sheets of large cells with irregular borders, moderate eosinophilic cytoplasm, and enlarged pleomorphic nuclei. These cells lack glandular features and show a different staining profile.\n\nImmunohistochemical analysis of the right lower lobe lesion demonstrates positivity for CK7 and variable expression of TTF1 and CDX-2, with negativity for CK20 and p63. The right upper lobe lesion is negative for CK7, CK20, CDX-2, and TTF1, but strongly positive for p63. Both lymph node specimens show no evidence of metastatic disease.\n\nThe surgical margins for both lesions are clear, with distances of 0.8 cm and 0.4 cm from the staple lines in the right lower and upper lobes, respectively. No lymphovascular invasion or treatment effect is identified. The staging assessment indicates no lymph node involvement. Additional microscopic evaluation of the right upper lobe lesion notes some morphologic features that could suggest focal differentiation, though this remains inconclusive."} +{"pid": "TCGA-RL-AAAS", "report": "The specimen consists of a Whipple resection including the distal stomach, duodenum, pancreas, and common bile duct stump. The pancreas measures 7.0 x 6.5 x 4.5 cm. An ill-defined fibrotic area with an irregular tan-white to yellow cut surface is noted surrounding the pancreatic duct, measuring 2.3 x 1.5 x 1.5 cm. The uninvolved pancreas appears firm and lobular. The bile duct stump measures 2.5 cm in length and 0.6 cm in diameter at the margin. Multiple peripancreatic lymph nodes are identified, ranging in size from 0.3 to 1.2 cm.\n\nMicroscopic examination reveals well-differentiated ductal structures within the pancreas, showing angulated glands lined by cells with enlarged nuclei and prominent nucleoli. Scattered mitotic figures are present. Tumor involvement is noted around dilated ductal elements and in the periampullary region. Perineural invasion is observed. No lymphovascular invasion is identified. Deeper histologic sections show discontinuous tumor spread, arising from a background of high-grade ductal dysplasia. Inflammatory changes and fibroblastic activity suggestive of prior biopsy are also present. Seventeen (17) peripancreatic lymph nodes are free of metastatic disease.\n\nAll surgical margins\u2014including the bile duct, pancreatic neck, and uncinate process\u2014are negative for invasive carcinoma or diagnostic dysplasia. Two (2) celiac lymph nodes and one (1) portal lymph node are also negative for metastasis. Additional findings include chronic inflammation, atrophic change, and pancreatic intraepithelial neoplasia (grade 3). The stent, measuring 9.0 cm in length and 0.3 cm in diameter, shows no abnormality.\n\nPathologic staging is pT2, pN0 (AJCC/UICC TNM 7th edition), with no evidence of treatment effect."} +{"pid": "TCGA-ET-A25R", "report": "The specimen consists of a total thyroidectomy with central neck dissection. The thyroid gland weighs 18.3 grams and measures 8.0 x 4.0 x 0.8 cm. Gross examination reveals a tan nodule with infiltrative borders and cystic areas measuring 2.6 x 1.6 x 1.1 cm located in the isthmus. The nodule abuts the posterior margin. No other grossly identifiable nodules are found in the right or left lobes. The right lobe measures 3.6 x 2.1 x 0.8 cm, the left lobe 2.0 x 2.1 x 0.5 cm, and the isthmus 3.0 x 1.5 x 1.4 cm. A small central neck dissection measuring 1.5 x 0.3 x 0.3 cm is also present; no grossly identifiable lymph nodes are seen within the submitted soft tissue. Histologically, sections show unifocal involvement with cellular features consistent with papillary morphology. Tumor size is 2.6 cm in greatest dimension. There is minimal extrathyroidal extension noted. Margins are uninvolved. Venous and lymphatic invasion cannot be definitively assessed. Parathyroid tissue is identified in the soft tissue attached to the inferior portion of the thyroid. No lymph nodes are submitted for evaluation. The case includes multiple tissue sections from various regions of the thyroid and neck dissection."} +{"pid": "TCGA-CH-5764", "report": "The specimen shows a lesion with a maximum diameter of 31 mm, predominantly located in the peripheral zone. Histological evaluation reveals a mix of growth patterns, including areas with a tertiary high-grade component. The primary pattern comprises approximately 70% of the lesion, while a minor component accounts for less than 5%. Infiltration of rectolateral periprostatic fatty tissue is present bilaterally across three sequential sections, with infiltration depths reaching up to 1.5 mm and widths up to 6 mm. There is also bilateral involvement of accessory structures. Extensive involvement of perineural spaces is noted. Surgical margins are free of tumor involvement. Additional findings include focal changes consistent with intraepithelial proliferation and benign hyperplastic alterations. The urethral lining shows no abnormal cellular changes. Examination of lymph nodes reveals eight nodes without pathological involvement\u2014five on one side and three on the other. Immunohistochemical staining showed no evidence of lymphatic or vascular invasion. Based on these findings, the lesion is classified as pT3b, with clear margins and no nodal involvement (pN0)."} +{"pid": "TCGA-44-2666", "report": "The specimen includes a resected portion of lung tissue from the posterior segment of the right upper lobe, weighing 192 grams and measuring 12.5 x 8.0 x 4.5 cm. A staple line measuring 12 cm is present along one margin. The pleural surface shows areas of dusky tan-pink to purple discoloration with focal bullous changes. A distinct area of pleural retraction and underlying induration is noted. The staple line margin was inked orange and found to be free of tumor. The opposite pleural surface, inked blue, revealed a lesion beneath it. \n\nA well-defined, rubbery tan-white lesion measuring 4.5 x 3.8 x 2.7 cm is present within the tissue, located less than 0.1 cm from the pleural surface. No other mass or abnormality was identified in the remaining parenchyma, which appeared spongiform and tan-red with areas of crepitance. Sections of the tumor and adjacent normal tissue were submitted for further analysis.\n\nAdditional specimens include:\n- \"2R fat pad\": Three soft tissues ranging from 0.35 to 1.4 cm, submitted entirely.\n- \"4R fat pad\": Four small tan-gray tissues averaging 0.3 cm, also submitted entirely.\n- \"Level 7 lymph node\": Four gray-black fragments between 0.2 and 1.0 cm, submitted entirely.\n\nHistologically, the lesion demonstrates moderate differentiation. The primary lesion measures 4.5 cm in greatest dimension. The stapled resection margin is free of tumor involvement. Fibrosis and inflammation are present near the pleura, but no direct extension into the pleural space is observed. No vascular invasion\u2014venous, arterial, or lymphatic\u2014was identified.\n\nLymph node evaluations from the 2R, 4R, and level 7 regions show no evidence of metastatic disease. Additional findings include emphysematous blebs, areas of hemorrhage, and pigmented macrophages within alveolar spaces, consistent with hemosiderin deposition. No infectious organisms were detected on special stains (AFB or GMS)."} +{"pid": "TCGA-S9-A6TX", "report": "Histomorphology demonstrates oligodendroglial differentiation with evidence of mitotic activity. The proliferation index is approximately 10%."} +{"pid": "TCGA-QK-A8ZB", "report": "The total laryngectomy specimen measured 9.3 x 5.2 x 4.3 cm and included attached tracheal rings. A mass was identified in the glottic region, measuring 2.5 x 2.2 x 1.9 cm, involving the left true vocal cord, ventricle, and anterior commissure, with extension through the thyroid cartilage. The mass was endophytic and ulcerated, with no involvement of the pyriform sinus. Margins of resection, including mucosal and skin margins, were free of invasive disease. An area of abnormal skin on the anterior aspect showed an ulceration measuring 2.2 x 1.7 cm; however, this did not appear to communicate with the main lesion. A colloid nodule was identified in the left thyroid lobe.\n\nLymph node dissection included multiple levels from both sides of the neck. A total of 81 lymph nodes were examined across all levels: Level 1A (3 nodes), Left Neck 2B (8 nodes), Right Neck 2A (12 nodes), Right Neck 3 (11 nodes), Right Neck 4 (8 nodes), Left Neck 2 (12 nodes), Left Neck 3 (20 nodes), and Left Neck 4 (7 nodes). All lymph nodes were negative for involvement. No extranodal extension was identified.\n\nInflammation was present in the subcutaneous tissue, characterized by abscess formation and keratinaceous debris. There was no evidence of lymphovascular or perineural invasion. No treatment effect was identified. The histologic grade was moderately differentiated."} +{"pid": "TCGA-B6-A0RE", "report": "The specimen consists of right breast tissue weighing 982 grams. The breast measures 19.0 x 17.0 x 4.0 cm in greatest dimensions and includes an axillary tail measuring 11.0 x 6.0 x 2.0 cm. The skin ellipse is unremarkable, with no ulceration or induration. The nipple appears normal with no signs of retraction or induration. No incision is noted on the skin surface.\n\nPalpation reveals a firm nodule located in the upper outer quadrant, measuring 2.0 x 2.1 x 1.5 cm. The nodule is situated at approximately the ten o'clock position relative to the nipple, 5.5 cm from it. On sectioning, the nodule is firm and has a whitish-tan appearance. It comes within 3.5 cm of the deep margin, which does not show gross involvement. A section of the deep margin beneath the nodule is included in Block I. The tumor is within 0.5 cm of the skin surface. Representative sections of the nodule are taken and placed in Blocks II, III, and IV. A section through the nipple is included in Block V.\n\nSerial sectioning of the remaining breast tissue does not reveal additional masses. Sections from the lower outer quadrant, lower inner quadrant, and upper inner quadrant are placed in Blocks VI, VII, and VIII respectively. A section of skin overlying the nodule is placed in Block IX. The axillary tail is divided into three standard areas. Lymph nodes from the first level are placed in Block X, those from the second level in Block XI, and potential candidates from the third level in Block XII. \n\nTissue from the nodule was sent for ER/PR receptor analysis. All surgical margins appear free of abnormal findings based on gross examination. A separate area of severe ductal epithelial hyperplasia is noted. Fourteen axillary lymph nodes were examined, and no cancer was identified."} +{"pid": "TCGA-66-2769", "report": "The examined material included a left upper lobe specimen and other associated tissues. Gross examination revealed a resected left upper lobe measuring 21 x 10 x 6 cm, with the central bronchus resection plane located 0.5 cm proximal to the bifurcation of the lingular bronchus. At the hilus, five partly altered grayish-black lymph nodes were identified, ranging from 0.4 to 1.7 cm in size. In the lateral region over segments 1 and 2, extending into adjacent parts of S3, there was an area of parietal pleura measuring 13 x 11.5 cm with extensive adhesions, some of which were loosely attached. Plate-like thickening up to 0.3 cm was noted at the caudal margin within a 2 cm area. Two interlinked costal segments measuring 6 and 8.5 cm respectively were found at the upper margin of this adhesion zone, each clearly resected with associated adhesive soft tissue up to 0.5 cm thick.\n\nBeneath the pleural adhesion, a lesion measuring up to 6 cm was observed, characterized by a pale brown to whitish, centrally softened consistency with unclear borders. The main mass occupied segment 2 and extended into adjacent sections of S1 and S3, reaching the pleura in the adhesion zone. Truncation of peripheral branches of B2 was evident within the lesion. On sectioning, intercostal soft tissue at the site showed a grayish-white area measuring 1.3 cm; no macroscopic infiltration was seen in the costal segments. The tumor reached the caudal margin of the adhesive portion of the pleura. Dorsal pleura over segment 1 at the junction with segment 2 exhibited patchy whitish discoloration and thickening across a 6.5 cm area, where isolated metal staples were present. The remainder of the parenchyma appeared unremarkable.\n\nAt the bifurcation of the upper lobe bronchus, three grayish-black lymph nodes measuring between 1.6 and 2.1 cm were observed. In the subpleural region of segment 3, a 3 cm grayish-black node was noted. Additional lymph nodes were sampled from multiple stations: station 12 (lingula), station 12 (left lower lobe), station 11 (interlobar), station 10 (hilar), station 8 (paraesophageal), station 7 (subcarinal), station 5 (subaortic), and station 10 on the right side. These ranged in size from 0.5 to 2.2 cm and displayed varying degrees of alteration including grayish-black discoloration.\n\nHistological evaluation was limited due to capacity constraints, but microscopic analysis indicated significant inflammation, blood pigment deposition, and presence of larger cells although no carcinoma was identified intraoperatively. Chronic inflammatory changes were noted in pleural tissue, including fibrous thickening and active organizing pneumonia in adjacent areas. Peripheral bronchitis and bronchiolitis were moderate to marked. Fibrin-rich and chronic granulating neuritis was seen over segment 1. Fibrosis was observed in the adherent part of the parietal pleura. Lymph nodes showed reactive changes, anthracotic pigment, and sclerosis without specific malignant involvement.\n\nThe lesion extended to the adherent part of the parietal pleura and involved adjacent chest wall components. Spread was discontinuous within enlarged pleura showing fibrosis and chronic inflammation. Resection margins for bronchus, vessels, chest wall tissue, repeat pleura samples, and all lymph nodes were free of tumor involvement. However, focal tumor extension reached the resection surface of the adherent parietal pleura near the chest wall, contributing to an R1 classification. No asbestos bodies were detected in the prepared sections, though further dust analysis is recommended for assessment of potential asbestos exposure."} +{"pid": "TCGA-V1-A8X3", "report": "The prostate specimen measured 3.5 x 5 x 4 cm and showed prominent nodular hyperplasia around the urethra, with firm, pink-tan peripheral zone tissue. Histologic analysis of multiple sections revealed involvement in both left and right lobes, including the apex and mid-gland regions. Tumor was identified at the cauterized margins, specifically in the left and right mid-gland areas. The tumor volume was estimated at 2.2 cubic centimeters, with 0.3 cubic centimeters composed of a higher grade component. Capsular invasion was present bilaterally, and extraprostatic extension was noted. Lymphovascular invasion was not described, but perineural infiltration was observed. No involvement of the seminal vesicles was found.\n\nExamination of the left pelvic lymph nodes (7 total) and right pelvic lymph nodes (11 total) showed no evidence of tumor involvement. A biopsy of the anterior urethral margin showed only fibrofatty and muscle tissue without any epithelial or malignant cells. All submitted tissue was fully evaluated microscopically, and the findings were confirmed by an attending pathologist after review of selected slides."} +{"pid": "TCGA-AR-A0TS", "report": "The specimen consists of a resected breast mass measuring 2.4 x 2.1 x 1.5 cm. Histologic evaluation demonstrates a high-grade lesion with marked nuclear atypia and frequent mitotic figures. A component of intraductal proliferation is identified, occupying approximately 5% of the total volume, with intermediate nuclear grade. Invasion into surrounding tissues is evident, including involvement of vascular or lymphatic channels. The surrounding breast tissue exhibits benign proliferative changes, including fibrocystic alterations. Microcalcifications are observed within benign ducts and acini. Surgical margins were assessed following re-excision of the lateral-deep margin, with all margins showing no evidence of residual tumor; the closest margin measured 0.4 cm at the deep margin. Sentinel lymph node biopsy identified two out of three involved nodes, with morphologic features suggestive of extranodal extension. Immunohistochemical staining confirmed the presence of cytokeratin-positive cells in one sentinel lymph node. Additional lymph node sampling included thirteen further lymph nodes, which showed no evidence of involvement."} +{"pid": "TCGA-B9-A69E", "report": "The specimen consists of a left nephrectomy weighing 1,220 grams and measuring 25.0 x 12.0 x 10.0 cm. A mass located in the lower pole measures 8.0 x 7.2 x 7.0 cm and is described as tan/yellow/red, firm, well-circumscribed, and variegated. Approximately 90% of the mass is solid with 10% cystic components containing dark brown fluid. The mass bulges the capsule but does not grossly penetrate through it. No invasion into sinus fat or involvement of the renal pelvis is observed. The remaining kidney tissue appears red/brown with a distinct corticomedullary junction. Vascular structures including the renal vein, artery, and ureter are patent, and the adrenal gland is not identified.\n\nMicroscopically, there is evidence of microscopic tumor invasion into the perirenal adipose tissue and renal vein. There is also microscopic involvement of large vascular structures. No invasion is seen through the capsule, Gerota's fascia, renal sinus, or ureter. Surgical margins are negative for tumor involvement in Gerota\u2019s fascia, renal vein, and ureter. No sarcomatoid features are identified. Histologic evaluation reveals Fuhrman nuclear grade 2 morphology. No lymphatic vessel invasion is noted. No lymph nodes are submitted for evaluation.\n\nHistologic assessment of non-neoplastic kidney tissue shows mild arteriolonephrosclerosis. Sections submitted include the ureter, vein, and artery margins, multiple sections of the mass, and uninvolved kidney tissue. The pathologic staging assigned is pT3a pNx. This staging may be subject to revision based on further clinical review."} +{"pid": "TCGA-FI-A2D5", "report": "The surgical pathology report describes a specimen from a patient with a history of metastatic cancer. The findings include a tumor involving multiple anatomical sites, characterized by poorly differentiated carcinoma in various tissues.\n\nIn the uterus, a mass was identified that measured 9.5 x 6 x 6 cm within the uterine cavity. The tumor invaded through the entire thickness of the myometrium, which measured 6.5 cm at its thickest, and extended to the serosal surface with a depth of invasion measuring 2.0 cm. There was also involvement of the endocervical epithelium and stroma. Widespread lymphovascular space invasion was noted.\n\nMultiple tissue samples were taken from other areas during surgery. Tumor deposits were found on the serosal surface of the right ovary, posterior cul-de-sac, left ureter, appendix, omentum, diaphragm nodule, sigmoid tumor nodule, cecal nodule, and small bowel nodule. No evidence of malignancy was found in the right fallopian tube, left ovary, left fallopian tube, falciform ligament, or epiploic tissue.\n\nLymph node involvement was observed in one lymph node sampled from the left external region, while another lymph node from the same area showed no signs of malignancy.\n\nMicroscopic evaluation revealed two components of the tumor: one well-differentiated and another undifferentiated. Immunohistochemical staining showed focal positivity for P16 and negativity for p63 in both components. Vimentin was diffusely positive in the well-differentiated component and focally positive in the undifferentiated part. Estrogen receptor expression was observed in 95% of cells in the well-differentiated component and in 50% of the undifferentiated carcinoma cells.\n\nThe tumor demonstrated extensive local invasion, including penetration to the serosa, and had spread to regional lymph nodes. Based on these findings, the tumor was provisionally classified as involving the serosa and/or adnexa, with lymph node metastasis present in one node out of two examined."} +{"pid": "TCGA-ZP-A9D2", "report": "A gallbladder specimen was received, measuring 7.0 x 3.0 x 2.0 cm and weighing 29 grams. The cystic duct margin was removed, and the mucosa appeared pink-tan with a smooth surface. No dysplasia or malignant changes were identified. A liver specimen from the border of segments 7 and 8 was received, measuring 4.8 x 4.5 x 3.5 cm and weighing 34.6 grams. It contained three nodules: the first measured 2.0 x 2.0 x 1.7 cm and was 0.3 cm from the closest parenchymal margin; the second and third each measured 0.5 x 0.5 x 0.5 cm, with the second nodule abutting the capsule and the third located 0.1 cm from the capsule. The parenchymal surface was inked black. Histological examination showed moderately differentiated cells arranged in nests and pseudoglandular structures, with bubbly cytoplasm, pleomorphic nuclei, and prominent nucleoli. These cells exhibited occasional mitotic figures and apoptoses. Reticulin staining revealed loss of reticulin fibers within the lesion and thickened cell plates. Another liver specimen, including the left lateral segment and segment 4, was received, measuring 16.0 x 12.5 x 3.5 cm and weighing 324 grams. A single firm tan lesion measuring 3.3 x 2.5 x 2.5 cm was identified, located 0.5 cm from the capsular margin and involving the parenchymal margin. Microscopic evaluation showed similar histological features as the other specimen, with involvement of the cauterized and inked parenchymal margin. The background liver tissue showed mixed macro- and micronodular cirrhosis, with dense lymphoplasmacytic infiltrates and focal bile duct proliferation. A Prussian blue stain demonstrated mild siderosis. Staging based on AJCC criteria was pT2, with no assessable regional lymph nodes (pNX) or distant metastasis (pMX). Parenchymal margin involvement was noted in one specimen, while bile duct margin status could not be determined. Vascular invasion was not identified microscopically. Fresh tissue from the specimens was preserved for tissue banking."} +{"pid": "TCGA-EB-A3XC", "report": "The excised lesion was located on the skin and measured 2.0 x 1.5 x 0.4 cm. The lesion was described as ulcerated and raised. Histologic evaluation demonstrated a nodular growth pattern with a depth of invasion of 6.0 mm, corresponding to level IV. The histologic grade was not specified. No assessment was provided for satellite nodules, lymph nodes, lymphatic or venous invasion, margins, or evidence of neoadjuvant treatment. No additional pathologic findings were reported."} +{"pid": "TCGA-RT-A6YC", "report": "The specimen from the right adrenal gland consists of multiple fragments of red-brown soft tissue measuring 12.0 x 9.0 x 3.1 cm and weighing 183.6 grams. The external surface is dusky brown, and the tissue is firm with minimal resistance on cutting. Small patchy areas of hemorrhage are present. No necrosis, calcification, or identifiable normal adrenal gland tissue is observed.\n\nMicroscopic evaluation reveals areas of hemorrhage. Focal spindling of tumor cells is seen along with marked nuclear pleomorphism. There is no evidence of necrosis, capsular invasion, vascular invasion, or extension into surrounding adipose tissue. Mitotic activity is low, with fewer than 3 mitotic figures per 10 high power fields.\n\nSections submitted for analysis include A1 through A10, consisting of red-brown tissue, and A11, which may represent normal adrenal tissue."} +{"pid": "TCGA-TT-A6YO", "report": "The specimen consists of a left adrenal gland weighing 41.2 grams and measuring 8.6 x 5.4 x 1.6 cm. On gross examination, two distinct masses are identified. One mass has a yellow cut surface, measures 2.0 x 1.8 x 1.6 cm, and appears to originate from the adrenal cortex. The other mass has a red-brown cut surface, measures 2.2 x 1.9 x 1.5 cm, and appears to arise from the adrenal medulla. Both masses are well-circumscribed and lack areas of obvious hemorrhage or necrosis. All tissue from both masses is submitted for histologic evaluation along with representative sections of unremarkable adrenal tissue.\n\nHistologic evaluation reveals two separate lesions. The first lesion demonstrates features including focal necrosis, high cellularity, tumor cell spindling in nests or diffuse arrangement, and moderate nuclear pleomorphism with nuclear hyperchromasia. A score was calculated based on these features. Immunohistochemical staining shows positivity for synaptophysin and chromogranin. Sustentacular pattern staining is present with S100. Ki-67 staining demonstrates a low proliferation index. SDHB staining reveals a moderate cytoplasmic expression pattern in approximately 60% of cells. Additional molecular or genetic testing may be considered if clinically indicated.\n\nNo evidence of large-scale invasion, mitotic activity per 10 high-power fields, cellular monotony, atypical mitoses, tumor extension into adipose tissue, or vascular or capsular invasion is observed. Internal and external control specimens were used for validation of immunohistochemical studies. All tests were performed using protocols compliant with regulatory standards, and the laboratory is certified to perform high-complexity clinical testing."} +{"pid": "TCGA-EA-A3QD", "report": "The specimen consists of cervix tissue obtained from a hysterectomy with bilateral salpingo-oophorectomy. The lesion measures 2.6 x 2.5 x 0.98 cm and is confined to the cervix with no extension beyond 4.0 cm. Microscopic examination reveals poorly differentiated cells. Lymphatic and venous invasion are present. Of the six pelvic lymph nodes examined, one shows evidence of metastatic involvement. Surgical margins are free of involvement. No neo-adjuvant treatment effect is identified, and no additional findings are noted."} +{"pid": "TCGA-DD-A4NP", "report": "The specimen includes a gallbladder measuring 9.0 x 4.0 x 2.4 cm, a left portal lymph node measuring 2.0 x 1.3 x 8 cm, and a left lobe liver specimen weighing 1065 grams with dimensions of 19.3 x 16.5 x 11.2 cm. A mass measuring 15.4 x 11.3 x 10.7 cm is present within the liver. The surrounding liver tissue appears histologically unremarkable. Surgical margins are negative for abnormal cellular proliferation, with the closest margin free by 0.4 cm. No evidence of necrosis or angiovascular involvement is observed. The gallbladder shows changes consistent with chronic cholecystitis. A single cystic duct lymph node and a single left portal lymph node are both devoid of any atypical cellular infiltration. The liver specimen was photographed in the laboratory and a preliminary frozen section consultation was performed; results were held pending further immunostaining analysis."} +{"pid": "TCGA-HQ-A2OF", "report": "The sample was obtained from the bladder dome and collected as fresh frozen tissue. The tumor measured 5 cm in size and was identified as focally papillary adenocarcinoma. Histological evaluation showed moderately differentiated cells. Staging indicated pathological T3b with no positive lymph nodes identified. The clinical M stage could not be determined. The surgical resection was performed without delay following diagnosis, which was established 11 days after the initial procedure. No evidence of bilateral disease was noted."} +{"pid": "TCGA-ZM-AA0H", "report": "A testicle with a mass measuring 8.5 x 7.5 cm was examined, along with a 9 cm long funiculus. The entire testicle was involved by a white, soft, and partially necrotic lesion. A surgical incision measuring 6.5 cm in length was observed on the surface of the specimen. Microscopically, the lesion demonstrated solid growth patterns with scattered tumor cell clusters. The cells exhibited round to oval nuclei with prominent nucleoli and moderate cytoplasm that was eosinophilic and lightly staining. Occasional mitotic figures were identified, with up to 3\u20134 mitoses per high-power field. A lymphocytic infiltrate of mild to moderate density was present in the surrounding stroma. Vascular invasion was noted, with tumor cells present within the lumens of two blood vessels in the funiculus adjacent to the testicle. However, no tumor was found at the resection margin of the funiculus. There was no evidence of infiltration into the testicular capsule."} +{"pid": "TCGA-AA-A01D", "report": "The resected colon specimen includes a section of the rectosigmoid region showing an ulcerated lesion. Histological examination reveals a poorly differentiated, partially mucinous adenocarcinoma. The lesion extends up to 10 cm from the resection margin and measures approximately 2.5 cm in maximum diameter. The tumor invades through all layers of the intestinal wall and into the adjacent mesocolic fat. There is evidence of extensive lymphatic involvement at the tumor margin. No significant pathological changes are noted in the remaining intestinal wall, including absence of pseudodiverticula. Both oral and aboral resection margins are free of tumor involvement. Twelve regional lymph nodes are involved with metastatic disease, some of which show extranodal extension. Vascular invasion is not identified. The tumor has been classified as pT3, pN2 (12/12) L1 V0, G3 R0."} +{"pid": "TCGA-DD-A1EH", "report": "The resected right lobe of the liver weighed 1035 grams and measured 22.7 x 13.8 x 10.6 cm. A multinodular lesion measuring 15.3 x 13.2 x 7.6 cm was identified, showing Grade 3 cellular differentiation. The lesion exhibited vascular invasion and was accompanied by seven satellite nodules ranging from 0.3 cm to 2.7 cm in size. The lesion extended to within 0.1 cm of the surgical resection margin. Thrombus material within a vessel was present, but the vessel margin was negative. Embolic material and coils were also noted. Tissue from the left portal vein contained similar cellular findings. The gallbladder measured 9.2 x 3.1 x 1.3 cm and showed no abnormal pathology. Multiple peri-choledochal lymph nodes (totaling 4.1 x 2.0 x 1.3 cm) were examined and showed no atypical involvement. Assessment of the non-neoplastic liver tissue revealed inactive chronic hepatitis with bridging fibrosis (stage 3), consistent with a history of chronic hepatitis B."} +{"pid": "TCGA-A8-A07L", "report": "The specimen consists of a right-sided partial breast resection. The lesion involved has a maximum dimension of 3.4 cm. The closest dorsal margin measured 0.1 cm. Histologic evaluation showed high-grade cellular atypia and frequent mitotic figures. Lymphovascular invasion was identified. Twenty lymph nodes were examined, two of which contained involved regions. No residual involvement was seen in the follow-up resection specimens labeled numbers 2 and 3. Margins were free. Staging classification: pT3, pN1a (2/20), Mx, R0, L1, V0."} +{"pid": "TCGA-WC-A881", "report": "The left eye measures 23 x 22 x 21 mm with an attached optic nerve of 10 mm in length. A pigmented mass is identified in the choroidal region, extending from 12 to 6 o\u2019clock. The base of the mass measures 18.0 mm, with a height of 12.0 mm. It is located 6.0 mm from the optic nerve and does not involve the ciliary body. The sclera beneath the tumor appears grossly intact. Transillumination reveals a dark brown-black pigmented lesion. No extraocular lesions are observed. Histologic evaluation shows no involvement of the vortex veins or optic nerve. The mitotic count is less than 1 per 10 high-power fields. Internal structures are highlighted on PAS staining. Scleral invasion is not present. Specimen includes sections from the tumor area, pupil-nerve sections, and calottes."} +{"pid": "TCGA-MG-AAMC", "report": "The specimen submitted included a radical prostatectomy specimen measuring 5.2 cm from medial to lateral, 4.5 cm from anterior to posterior, and 3.5 cm from apex to base, with a trimmed weight of 36.0 grams. The external surface was tan to pink and irregular, with the right half inked black and the left half inked blue. Serial sectioning from apex to base revealed multiple tan to yellow, ill-defined nodules ranging from 0.3 to 0.7 cm in greatest dimension, diffusely distributed throughout the tissue. The remaining cut surface was tan-white and smooth without discrete lesions. An associated aggregate of golden-yellow, lobulated adipose tissue measuring 5.0 x 3.4 x 0.5 cm was also received, containing four possible whole lymph nodes ranging from 0.5 to 1.5 cm in greatest dimension.\n\nMicroscopic evaluation identified a neoplastic process within the prostate gland. Histologic features showed a Gleason score of 4+5=9, with a tertiary pattern of Gleason pattern 3 also noted. Approximately 15% of the prostate was involved by the lesion. Perineural invasion was present. The tumor demonstrated extension beyond the prostatic capsule, though margins were uninvolved by invasive carcinoma. There was no evidence of seminal vesicle invasion or lymphovascular invasion. A total of eight lymph nodes were examined, and none showed involvement. High-grade intraepithelial neoplasia was also identified."} +{"pid": "TCGA-AP-A0LN", "report": "The surgical specimens submitted included the uterus, cervix, bilateral fallopian tubes and ovaries, as well as multiple lymph node groups from both sides, including lateral left and right external iliac, external iliac, obturator, hypogastric, and common iliac regions.\n\nExamination of the uterine tissue revealed focal solid areas comprising less than 5% of the specimen. The nuclear grade was assessed as grade 1. No evidence of cervical involvement was identified. The cervix showed findings consistent with endometriosis. Within the endometrium, there was complex hyperplasia with atypia. The myometrium contained benign leiomyomas. Both fallopian tubes appeared histologically normal. The right ovary exhibited utero-ovarian and tubo-ovarian adhesions. The left ovary showed tubo-ovarian adhesions and endosalpingiosis. A paratubal cyst was noted on the left fallopian tube.\n\nLymph node evaluation revealed no abnormal findings. In several lymph node groups, benign lymph nodes were identified, including one from the left lateral external iliac region, five from the left external iliac, eight from the left obturator, one from the left hypogastric, six from the right external iliac, ten from the right obturator, and five from the right common iliac region. In some specimens (left common iliac, right lateral external iliac, and right hypogastric), only benign fibroadipose tissue was found without identifiable lymphoid tissue.\n\nAll findings were based on direct examination of the specimens and confirmed by a reviewing physician."} +{"pid": "TCGA-DB-A4XA", "report": "A brain lesion from the left temporal occipital region was received in two separate specimens. The first specimen measured 2.5 x 2.2 x 0.8 cm and consisted of a portion of brain tissue. Smears were prepared from this sample, and representative sections were submitted for further analysis. The second specimen measured 2.0 x 1.2 x 1.0 cm and was also composed of brain tissue; all of this sample was submitted for permanent sections.\n\nMicroscopic evaluation of the tissue revealed a neoplastic process involving glial cells. Immunohistochemical staining was performed on paraffin-embedded sections. Tumor cells demonstrated positivity for IDH-1 (R132H mutation), and focal reactivity for GFAP was noted, although many cells lacked GFAP expression. Staining for p53 showed low to moderate levels, while Ki-67 demonstrated focally moderate proliferative activity. These findings were consistent with a neoplasm of glial origin with specific molecular features. Cytogenetic analysis using fluorescence in situ hybridization (FISH) for 1p/19q deletion was initiated but remained pending at the time of reporting.\n\nIntraoperative cytologic smears of the first lesion were interpreted as showing features suggestive of a low-grade glioma, with morphology favoring an oligodendroglial component. Multiple blocks were processed from both specimens for detailed histopathological examination."} +{"pid": "TCGA-VD-A8KE", "report": "The specimen consists of an intact left eye with axial, horizontal, and vertical dimensions of 24mm, 24mm, and 22mm respectively. The cornea measures 12mm horizontally and 11mm vertically. The optic nerve is cut flush, and the pupil is regular in shape. On transillumination, a shadow is observed laterally at the posterior pole, measuring up to 9mm in maximum dimension. Histological sections reveal a lesion located within the choroid with a maximum basal diameter of 8mm and a thickness of 9mm. The tissue includes adjacent normal choroid and sclera.\n\nMicroscopic examination shows a focally pigmented lesion composed of a mixture of cell types, with approximately 60% being epithelioid-like. Mitotic figures are present at a rate of approximately 3 per 40 high power fields. The microvasculature is prominent, with the presence of closed vascular loops. There is minimal lymphocytic infiltration within the lesion and no evidence of necrosis. Focal early invasion into the sclera is identified; however, there is no extension of the lesion into the optic nerve or vortex veins. Tumour cells are not present at the resection margins.\n\nThe cornea appears unremarkable. Hassall-Henle warts are noted. The anterior chamber angles are open, although the anterior chamber itself is shallow. The iris and ciliary body show no significant abnormalities, though the latter demonstrates signs of atrophy and hyalinisation of its processes. Peripheral degeneration is observed in the lens. The retina overlying the lesion shows mild atrophy, and Bruch's membrane appears disrupted in the areas examined. Drusen are present, and optic nerve cupping is also noted.\n\nImmunohistochemical staining for MelanA and HSP-27 was initiated, with HSP-27 positivity expected to be greater than 70%. Molecular genetic analysis using MLPA was performed on DNA extracted from the fresh tissue. Chromosomes 1, 3, 6, and 8 were assessed using the P027 kit. The DNA concentration was high and of good quality. Results showed chromosome 1 to be normal, chromosome 3 to be essentially normal with two borderline losses, chromosome 6 to demonstrate gains, and chromosome 8 to appear normal. These findings will be integrated with clinical and morphological data for further risk assessment."} +{"pid": "TCGA-IQ-A61J", "report": "The specimen was a partial glossectomy from the left lateral border of the tongue, measuring 5.0 cm in greatest dimension. The tumor measured 3.6 x 1.9 x 1.6 cm and was located within the tongue tissue with surface ulceration. Margins were assessed and found to be free of invasive carcinoma. Perineural invasion was identified.\n\nLymph node involvement was noted in two regions: one out of sixty-three lymph nodes from left neck levels 2, 3, and 4 contained metastatic disease measuring 0.2 cm; and one out of three lymph nodes from left neck level 1A also showed involvement with a deposit measuring 0.5 cm. No malignancy was identified in other lymph node regions examined. A total of 73 lymph nodes were evaluated, with 2 showing evidence of metastasis.\n\nHistologic evaluation revealed a well-differentiated squamous cell carcinoma with endophytic growth pattern. The tumor thickness was measured at 16 mm. Lymphovascular invasion was not identified, and no extranodal extension was observed.\n\nPathologic staging was assigned as pT2 for the primary tumor (greater than 2 cm but not more than 4 cm in greatest dimension), and pN2b for regional lymph node involvement (multiple ipsilateral nodes, none exceeding 6 cm). Distant metastasis could not be assessed."} +{"pid": "TCGA-ED-A7XP", "report": "The tumor is located in the left hepatic lobe and measures 4 x 3.5 x 3 cm. It has ill-defined margins, a soft and solid consistency, and appears yellow-white on cross-section. Microscopically, the tumor cells are arranged in trabecular, acinar, or sheet-like patterns. The cells have a polygonal shape with round, vesicular nuclei and prominent nucleoli. The cytoplasm is present in moderate amounts and shows basophilic or vacuolated characteristics. Nuclear features include marked irregularity in size, with single or multiple nuclei that are hyperchromatic and contain prominent nucleoli. Mitotic figures are present. The tumor demonstrates infiltration into benign hepatic tissue, and the stroma shows lymphocytic invasion. The specimen is from a lobectomy and shows uninvolved margins. The tumor is multifocal with all lesions measuring less than 5.0 cm. No information is provided regarding lymph node involvement, venous invasion, or evidence of neoadjuvant treatment. Additional findings include the presence of tumor within the left hepatic lobe liver tissue."} +{"pid": "TCGA-DD-A11C", "report": "The resected right lobe of the liver weighs 2890.0 grams and measures 24.3 x 22.0 x 13.3 cm. A mass measuring 22.0 x 15.3 x 12.8 cm is present within the right lobe. The surgical margins are clear, with a minimum distance of 1.1 cm from the edge of resection. A subcapsular hematoma measuring 10.3 x 7.4 x 5.5 cm is also identified. The background liver tissue does not show signs of cirrhosis. A pericholedochal lymph node measuring 2.1 x 1.1 x 0.8 cm was excised and found to be negative. The gallbladder, measuring 9.2 x 4.4 x 2.1 cm, demonstrates mild chronic inflammation with cholesterolosis. A single benign cystic duct lymph node was also found."} +{"pid": "TCGA-38-4625", "report": "The surgical specimen consists of a right upper lobe measuring 14.0 x 9.5 x 2.8 cm and weighing 250 g. A peripheral mass measuring 5.0 x 4.2 x 3.6 cm is present, appearing as a circumscribed, white/tan nodule with areas of softening and hemorrhage. The mass is located under the pleura, abuts diffusely without clear invasion, and is associated with a red/brown, hemorrhagic pleural surface and thick adhesions. The tumor is 3.0 cm from the closest bronchial margin and 3.4 cm from the nearest stapled (blue inked) margin. No satellite nodules are identified. The remainder of the lung shows a brown/red, smooth, spongy cut surface with no other lesions.\n\nMicroscopic evaluation reveals a high-grade, markedly pleomorphic lesion with rare mucin-positive cells. Surgical margins are free of involvement. All lymph nodes examined, including those from stations 11, R4, and 7, show no evidence of involvement. A hilar lymph node from the lobectomy specimen is also negative. The pleural biopsy demonstrates reactive mesothelial cells, fibrosis, and acute and chronic inflammation, with no evidence of involvement. Angiolymphatic or perineural invasion is not identified. Focal post-obstructive changes are noted in the non-involved lung tissue."} +{"pid": "TCGA-DK-A6AW", "report": "The specimen analysis included multiple tissue samples from various anatomical sites. Lymph node evaluations were conducted on right and left pelvic lymph nodes across several specimens. In total, 7 lymph nodes were examined in specimen 1, 3 in specimen 3, 2 in specimen 4, 13 in specimen 6, and 2 in specimen 7. All lymph nodes across these specimens showed no evidence of metastatic involvement.\n\nSpecimen 2, identified as perivesical tissue, revealed benign fibroadipose tissue with no pathological findings. Similarly, both vas deferens specimens (specimens 8 and 10), the lipoma of the left spermatic cord (specimen 9), and the urachus (specimen 11) all demonstrated benign histological features without any abnormal cellular changes.\n\nThe radical cystoprostatectomy specimen (specimen 5) contained two distinct lesions within the bladder. The first measured 2.5 x 1.9 x 1.2 cm and was located near the prostatic urethra, approximately 0.6 cm from the right ureter. The second lesion measured 1.4 x 1.3 x 0.8 cm and was situated on the left side, partially obstructing the left ureteral orifice. Histologically, the invasive component displayed a high-grade infiltrating pattern, while the non-invasive component exhibited a flat architecture. No multicentricity was observed. The tumor was found to invade the superficial half of the muscularis propria without extension into the perivesical fat or involvement of the ureters. No vascular or perineural invasion was identified. Surgical margins were free of tumor involvement. Additionally, the prostate showed findings consistent with nodular hyperplasia, and the seminal vesicles were unremarkable. No discrete perivesical lymph nodes were identified.\n\nOther submitted specimens included the distal right ureter (specimen 12), which showed no abnormalities, and several control sections confirming the adequacy of sampling. Gross examination of the cystoprostatectomy specimen revealed ulceration and congestion at the trigone, with no gross evidence of tumor extension beyond the base of the polyps. Prostatic sections revealed benign changes related to nodular hyperplasia.\n\nAll surgical margins were clear, and no metastatic involvement was identified in any of the lymph nodes evaluated. The staging classification was based on the depth of invasion into the bladder wall, specifically involving the superficial half of the muscularis propria."} +{"pid": "TCGA-B6-A0RU", "report": "The specimen consists of a left breast mass submitted in formalin, measuring 3.0 x 3.2 x 2.4 cm. It is described as an irregular, yellow-tan lobulated fibroadipose tissue with a poorly circumscribed, firm, gritty mass measuring approximately 2.7 x 2.4 x 1.8 cm. The mass extends to the surgical margins and was serially sectioned and submitted in blocks 1 through 7.\n\nMicroscopically, the dominant component is a high-grade infiltrating tumor with minimal tubule formation and extensive areas of necrosis. A small component of intraductal growth with comedo-type features is identified at the periphery, comprising less than a quarter of the overall lesion. Scattered throughout the tumor are multiple foci of metaplastic change, characterized by myxoid stroma with early cartilage-like differentiation. These foci are present but do not predominate. The epithelial component remains the primary element. The tumor reaches the resection margin. Adjacent breast tissue shows changes consistent with duct ectasia and papillary apocrine metaplasia."} +{"pid": "TCGA-HT-7692", "report": "The microscopic examination reveals a hypercellular glial neoplasm composed of two distinct cellular populations. The first component consists predominantly of cells with gemistocytic features, including eccentric, moderately pleomorphic nuclei and abundant eosinophilic cytoplasm. The second component is characterized by numerous cells with round to oval nuclei and prominent perinuclear halos. These two populations are variably intermixed throughout the tissue, with some areas showing separation. Cytologic atypia is moderate overall. Background microcystic change is present, and the tumor demonstrates diffuse infiltration into adjacent brain parenchyma. Scattered mitotic figures are observed, with up to 2 mitoses per 10 high power fields. Microvascular proliferation is prevalent, and foci of early micronecrosis are noted. Immunohistochemical analysis shows a MIB-1 labeling index of up to 6.9% in the most proliferative regions. These findings indicate elevated proliferative activity and raise concern for early anaplastic progression. While the degree of necrosis does not meet criteria for a glioblastoma with oligodendroglial differentiation, close clinical follow-up is recommended due to the concerning histologic features."} +{"pid": "TCGA-HD-8224", "report": "The anterior deep margin of the tongue biopsy demonstrates diffusely infiltrating cellular growth. The middle deep margin biopsy similarly shows comparable infiltrative characteristics. Following a nearly complete glossectomy with frozen section evaluation, involvement is identified at the posterior shaved margin and medial shaved margin. Areas of lymphovascular invasion are observed along with perineural invasion. Sections from the tongue reveal widespread infiltration extending across the posterior and medial regions. The lesion extends to the tip of the tongue. After completion of total glossectomy involving the left lateral border with new deep and posterior surgical margins marked for examination, tumor involvement is found at the new posterior, deep, and all marked margins.\n\nLymph node dissection at level 1A reveals four out of four nodes involved. On the right side, level 1B dissection identifies two positive nodes; level 2A dissection shows three out of ten nodes positive with extracapsular extension noted in several; level 2B dissection finds six negative nodes; level 3 dissection identifies three out of four nodes involved; and level 4 dissection reveals ten negative nodes. On the left side, level 1B dissection identifies two involved nodes; level 4 dissection reveals two out of seven nodes positive; level 3 dissection identifies four out of seven nodes positive; level 2B dissection identifies one positive node; and level 2A dissection reveals two out of four nodes positive.\n\nAll resected margins demonstrate evidence of involvement. The specimen measures 5.7 x 4.0 x 2.5 cm on the right lateral portion and 5.5 x 6.0 x 3.0 cm on the left lateral portion. The lesion on the right lateral tongue presents as a gray-tan firm central mass measuring 2.2 x 1.7 cm, extending into multiple margins. Based on pathological findings, staging corresponds to T3,N2c classification."} +{"pid": "TCGA-CS-4943", "report": "The specimen submitted for analysis consisted of soft tan-pink tissue measuring 2 x 1.5 x 0.5 cm, received fresh for frozen section. Approximately 50% was used for intraoperative evaluation, with the remainder processed and submitted in two cassettes. An additional formalin-fixed specimen measuring 4 x 4 x 1 cm was received and entirely submitted in four cassettes for permanent sections.\n\nMicroscopic examination revealed a moderately pleomorphic and infiltrative proliferation of astrocytic cells. Mitotic activity was readily identified. No microvascular proliferation or necrosis was observed. Tissue architecture and cellular morphology were assessed using H&E staining and immunohistochemistry. Several markers were evaluated using formalin-fixed, paraffin-embedded tissue, following manufacturer-recommended interpretation protocols. Certain assays utilized analyte-specific reagents regulated under CLIA as part of laboratory-developed tests. All results were personally reviewed and interpreted by the signatory pathologist. The remaining portions of the report related to specimen handling and processing were also included in the documentation."} +{"pid": "TCGA-BR-8081", "report": "The specimen consisted of a gastrectomy from the fundus with a tumor measuring 9 x 8 x 1.5 cm. The tumor was ulcerated and demonstrated moderately differentiated histologic features. The lesion extended to adjacent structures, including the omentum. No lymph node metastases were identified in the regional lymph nodes assessed (0/5 positive). There was no involvement of lymphatic, venous, or perineural spaces. Surgical margins were uninvolved. No evidence of neo-adjuvant treatment effect was observed. No additional pathologic findings were noted."} +{"pid": "TCGA-CV-5978", "report": "A left neck dissection was performed at levels II, III, and IV. In level II, ten lymph nodes were identified and all were negative for tumor involvement. In level III, eleven lymph nodes were found, all of which were also negative. Level IV contained multiple lymph nodes, with one out of twenty showing evidence of involvement. There was no extracapsular extension observed in this region.\n\nA right radical neck dissection included levels I through V. Of the nine lymph nodes identified, three contained findings of interest in levels I and II. Extracapsular extension was noted. Additionally, there was a soft tissue deposit in levels II and III involving subcutaneous tissue, with skin ulceration present.\n\nIn a separate right neck dissection at level II, five lymph nodes were identified, two of which showed involvement. A soft tissue deposit with dense fibrosis was also observed. No perineural invasion was identified in any of these specimens.\n\nSpecimens from the left lateral pharynx, posterior cricoid, right lateral pharynx, and base of the tongue were all negative for malignant cells. The base of the tongue specimen did show mild dysplasia but no carcinoma.\n\nA total laryngectomy and right thyroidectomy were performed. Gross examination revealed an exophytic lesion measuring 4.5 cm in its largest dimension, with an infiltrative border and depth of involvement measuring 2.5 cm. The tumor borders extended into adjacent areas, with thick cords greater than four cells in size. Cartilage invasion was present, although the thyroid was not involved. No vascular or perineural invasion was identified.\n\nThe surgical specimen included surrounding soft tissue and the right thyroid lobe. The tumor involved both true vocal cords and extended into the supraglottic area and vallecula. Below the vocal cords, the mucosa appeared nodular, though no invasive changes were observed in this region. The tracheostomy site and tracheal resection margin were not involved.\n\nAdditional dissection of the right neck showed variable lymph node sizes across levels. In level II, the largest lymph nodes showed firm white and yellow cut surfaces suggestive of involvement. In level III, three grossly positive lymph nodes were identified, including one that appeared matted. Fibrous tissue was also present in one of the level II specimens.\n\nFrozen section analysis of margins from the left lateral pharynx, posterior cricoid, right lateral pharynx, and base of the tongue were all negative for tumor. The base of the tongue margin showed mild dysplasia but no malignancy.\n\nAll submitted tissues from the laryngectomy were processed and examined, with sequential sections taken to assess the full extent of the lesion and its relationship to surrounding structures."} +{"pid": "TCGA-5C-A9VH", "report": "The clinical evaluation was conducted for a liver mass. The surgical specimen included the fifth and sixth segments of the liver along with the gallbladder. The gallbladder was received as a single block measuring 16x9x8 cm. The gallbladder wall measured 0.2 cm in thickness, with a pale brown mucosal surface. Within the liver parenchyma, a nodular lesion measuring 6.5x4 cm was identified. Histological examination revealed a moderately differentiated neoplasm with an adenoid-trabecular pattern embedded within fibrotic tissue. No evidence of tumor involvement was seen in the lymph nodes or adjacent tissues."} +{"pid": "TCGA-XF-A8HG", "report": "A radical cystectomy with first stage inflatable penile prosthesis was performed. Tissue specimens from the right and left distal ureters, as well as the apical urethral margin, were examined and showed no abnormal cellular changes or malignant findings.\n\nThe bladder and prostate specimen revealed a lesion involving the left posterolateral wall and left ureterovesical junction. The lesion extended through the muscularis propria into the perivesical soft tissue. Microscopic evaluation showed poorly differentiated malignant cells arranged in large sheets and nests. Nuclear features included pleomorphism, irregular contours, vesicular chromatin, prominent nucleoli, and cytoplasmic variation. Lymphovascular space invasion was present. A small focus of flat high-grade intraepithelial neoplastic change was identified, and benign urothelial multilayering with reactive changes was noted in non-lesional areas. The closest inked margin measured 1.2 cm from the tumor in the left posterolateral region, with all other margins free of involvement.\n\nIn the prostate, a small area of well-differentiated glandular proliferation was found in the right posterior mid-prostate without lymphovascular or perineural invasion. Additional findings included benign glandular and stromal hyperplasia, focal atrophy, and multiple foci of high-grade intraepithelial neoplasia.\n\nLymph node evaluation was performed for multiple regional sites including right and left paracaval, para-aortic, common iliac, external iliac, Cloquet, obturator/hypogastric, presacral, and presciatic locations. All nodes examined across these regions showed only benign tissue without any evidence of malignancy.\n\nGross examination of the bladder showed a lesion measuring 4.5 x 3 x 2 cm in the left lateral region. The surrounding urinary mucosa was otherwise unremarkable. The attached prostate showed nodular changes consistent with benign hypertrophy. Ureters were grossly normal, with the left distal ureter slightly dilated.\n\nPathologic staging was determined as pT3b for the bladder component and pT1a for the prostate component."} +{"pid": "TCGA-VS-A94X", "report": "The biopsy specimen was obtained from the cervix. Histologic evaluation reveals a moderately differentiated infiltrative squamous cell carcinoma. Tumor cells are arranged in solid sheets and nests with areas of individual cell infiltration. The cellular morphology shows moderate pleomorphism, with hyperchromatic nuclei and prominent nucleoli. There is evidence of stromal invasion, with irregular epithelial cell clusters extending into the underlying tissue. No lymphovascular invasion is identified. The tumor measures approximately 2.5 cm in greatest dimension. Specimen margins are free of atypical cells. No regional lymph node involvement is present. There is no evidence of distant metastasis."} +{"pid": "TCGA-05-4424", "report": "The surgical specimen demonstrates a locally advanced peripheral lesion within the right upper lobe of the lung, exhibiting histologic features characterized by a mixture of acinar and solid growth patterns with minimal mucin production. The lesion involves anatomical segments S1 and S2. Gross examination reveals involvement of the adherent chest wall, with infiltration extending through soft tissue and into the third rib. The outer resection margin at the thoracic skin shows focal extension, contributing to an incomplete resection classification (R1). There is also evidence of spread to the visceral pleura associated with the adhesive portion of the upper lobe, likely originating from segment S6.\n\nAll margins including bronchial, vascular, and other chest wall resection sites appear free of tumor involvement. Lung parenchyma sampled from segment S6 and all lymph nodes retrieved during the procedure show no evidence of tumor. Based on this assessment, the lesion is classified as pT3 pN0 pMX, corresponding to stage IIB disease according to TNM staging criteria."} +{"pid": "TCGA-EY-A1GK", "report": "A total of six lymph nodes from the right periaortic region were examined, and no abnormality was identified (0/6). Similarly, six lymph nodes from the left periaortic region showed no evidence of involvement (0/6). A radical hysterectomy with bilateral salpingo-oophorectomy was performed. The uterine specimen measured 9.5 cm in height, 4.5 cm in anterior-posterior width, and 7 cm in breadth at the fundus. The cervix had an endocervical canal length of 3.3 cm. The endometrial cavity measured 4.7 cm in length and 3.5 cm in width at the fundus. A lesion measuring 5.7 x 3.1 x 1.6 cm was identified within the uterine body, occupying both the anterior and posterior walls. The lesion exhibited a fleshy, solid, white-tan appearance and was broad-based. Microscopic evaluation revealed architectural features consistent with grade 2 and nuclear features consistent with grade 3. Invasion extended into the outer half of the myometrium, reaching a depth of 1.5 cm within a wall thickness of 2.2 cm, representing approximately 58% penetration. No serosal involvement was observed, but there was mucosal-confined extension into the lower uterine segment. There was focal extension into the left cornu; however, the cervical region showed no involvement. The adnexal structures, including both ovaries and fallopian tubes, appeared unremarkable upon gross and microscopic examination. Vaginal and cervical margins were free of any abnormal cellular infiltration. Lymphovascular space invasion was not present.\n\nA total of 26 regional lymph nodes were evaluated, including 6 from the right pelvic region (0/6) and 8 from the left pelvic region (0/8), with no evidence of involvement. Additionally, soft tissue removed from the left sidewall showed only fibrotic changes, chronic inflammation, fat necrosis, and dystrophic ossification, with no abnormal cellular findings.\n\nHistologic analysis of the ovaries revealed atrophic tissue with serous inclusion glands. Both fallopian tubes displayed patent lumens with no abnormal findings. Immunohistochemical staining for estrogen and progesterone receptors on a representative block demonstrated strong positivity, with 80% of cells showing 2+ staining for estrogen receptor and 85% showing 3+ staining for progesterone receptor.\n\nAdditional findings included vascular calcifications and adenomyosis within the myometrium. No other significant pathologic findings were noted. All specimens were processed under CLIA-certified conditions using analyte-specific reagents approved for clinical use."} +{"pid": "TCGA-B0-4694", "report": "The surgical specimen includes a biopsy of the left renal vein margin, which shows benign vascular tissue without any evidence of tumor involvement. The main specimen is from a laparoscopic radical nephrectomy of the left kidney. Histologic examination reveals a mass with mixed morphologic features, predominantly conventional (clear cell) type. There is also focal presence of sarcomatoid differentiation and papillary architecture. Nuclear grading according to Fuhrman classification is grade 4 of 4. Approximately 25% of the tumor consists of sarcomatoid elements. The largest dimension of the lesion measures 6.0 cm. The mass extends into the peripelvic fat. Vascular invasion is present, with involvement identified within the vascular channels. Tumor cells are also observed within the lumen and adherent to the endothelial lining of the renal vein; however, all final surgical margins are free of tumor. Adjacent non-involved renal tissue demonstrates reactive changes related to tumor proximity. The adrenal gland appears unremarkable. Based on these findings, the staging classification is pT3b NX MX. Additional specimens included voided urine with atypical transitional cells identified on cytology."} +{"pid": "TCGA-RD-A8N4", "report": "The lymph node specimen measured 15 x 12 x 10mm and exhibited a pale, firm cut surface. Histologically, the lymph node showed extensive involvement by poorly differentiated carcinoma. The tumor was arranged in sheets and composed of large pleomorphic cells with irregular, hyperchromatic nuclei and frequent mitotic figures. Some cells contained intracytoplasmic mucin vacuoles.\n\nThe gastrectomy specimen measured 110mm along the lesser curve and 150mm along the greater curve. It demonstrated a circumferential area of mural thickening involving the pylorus, with a granular and finely nodular mucosal surface. The wall thickening extended proximally into the stomach, with no distinct borders. The maximum thickness of the involved area was 12mm. The duodenal margin was approximately 20mm and did not show macroscopic evidence of tumor involvement. The overlying gastric mucosa displayed chronic gastritis with mild activity but no intestinal metaplasia or Helicobacter organisms.\n\nMicroscopically, the lesion consisted of poorly differentiated carcinoma with diffuse growth pattern, infiltrating through the full thickness of the gastric wall. Tumor extension was noted into the adjacent lesser and greater omentum, reaching the serosal surface. Involvement of the duodenum was identified in the submucosa, muscular, and serosal layers, with tumor cells near the distal resection margin; however, the exact margin could not be assessed due to stapling. Proximal extension was primarily submucosal. The proximal resection margin was free of tumor.\n\nLymph node assessment revealed one involved node from the lesser curve and two of seven from the greater curve showing metastatic involvement. A small amount of lesser omental fat was present, containing one probable lymph node, while the greater omental fat contained multiple firm lymph nodes up to 10mm in size."} +{"pid": "TCGA-AR-A1AS", "report": "The specimen consists of a left breast wide local excision. Two separate masses were identified. The smaller measures 0.7 x 0.3 x 0.3 cm, while the larger measures 4.3 x 3.4 x 3.2 cm. Histologic evaluation shows cells arranged in a pattern consistent with infiltrative growth within the breast tissue. Grading was based on tubule formation (2/3), nuclear pleomorphism (2/3), and mitotic count (3/3), resulting in a total score of 7/9. Vascular or lymphatic invasion is present. The surrounding non-neoplastic breast tissue demonstrates fibrocystic changes without evidence of proliferation.\n\nSurgical margins were initially involved, prompting re-excision of several areas including deep/inferior, anterior/inferior medial, medial/anterior, medial/deep, lateral, and posterior/medial regions. Final assessment confirms all margins are free of tumor involvement, with a minimum distance of 1.0 cm between the nearest lesion and the medial/anterior and medial/deep re-excised margins.\n\nLymph node evaluation includes a high axillary dissection with five nodes, all unremarkable. In the mid/low axillary dissection, twelve nodes were examined, one of which contains abnormal cells suggestive of metastatic origin. The involved node measures 1.0 x 0.9 x 0.7 cm. Radiographic confirmation using Faxitron was performed."} +{"pid": "TCGA-44-3398", "report": "The specimen included multiple lymph nodes from various levels and a right lower lobe resection. Lymph node level 10 measured up to 2 cm in aggregate and showed no evidence of malignancy across ten pieces evaluated. The right lower lobe weighed 266 grams and measured 16 x 12 x 7 cm, with a subtotal mass measuring 2.5 x 1.5 x 2 cm noted; the mass had a puckered appearance. Histologic evaluation revealed a high-grade tumor with a mitotic index of 1 per 10 high-power fields. The tumor measured 2.5 cm. Both bronchial and pulmonary margins were free of tumor involvement, and the pleura was also negative. Vascular invasion was not identified. No malignant cells were found in three attached lymph nodes. Lymph node level 7, measuring up to 2 cm in aggregate, contained no malignancy in over 12 pieces examined. Level 3 lymph node measured 2.5 x 1.5 x 0.3 cm and was also negative. Lymph node R4, measuring 3 x 3 x 0.5 cm in aggregate, showed no evidence of tumor in 16 pieces evaluated. Staging was determined as T1b NO. Non-tumorous lung tissue showed changes consistent with mild to moderate emphysema."} +{"pid": "TCGA-49-6767", "report": "The specimen was obtained from a right middle lobe lung resection along with an en bloc wedge resection of the right upper lobe, multiple lymph node biopsies, and a partial pericardectomy. The tumor measured 4.5 cm in greatest dimension and was found to involve the bronchial margin. Microscopically, the lesion showed poorly differentiated features composed of infiltrating cords and sheets of neoplastic cells with moderately pleomorphic and hyperchromatic nuclei. Focal marked nuclear pleomorphism was present. Mitotic figures were scattered throughout, averaging approximately 5 per 10 high power fields, with areas showing up to 10 per 10 high power fields. No lymphovascular invasion was identified. A focus of similar carcinoma was noted in the bronchial section within adjacent pulmonary parencharyma. No metastatic carcinoma was identified in the 8 lymph nodes examined, which included levels 1, 2, 4, 7, 9, 12, R2, and R4. The vascular margins were free of involvement. There was evidence of soft tissue involvement at the pulmonary wedge resection margin. A separate fragment consistent with pericardial tissue was submitted, and a focus of similar carcinoma was identified within this tissue. Direct extension into surrounding structures was considered possible, and further clinical correlation was recommended. The surrounding pulmonary parenchyma showed emphysematous changes without evidence of obstructive pneumonia. The mass appeared cystic and measured approximately 4.5 x 3.7 x 3.7 cm grossly, abutting the pleura but not clearly involving it. Multiple representative sections were submitted for analysis."} +{"pid": "TCGA-22-4596", "report": "The left upper lobe lung wedge excision measures 11 x 8 x 3 cm and contains a 2.3 x 2 x 1.8 cm mass that approaches but does not directly involve the pleural surface. The tissue shows high-grade atypical squamous cells arranged in solid sheets with central necrosis and frequent mitotic figures. The adjacent lung parenchyma appears benign, with no evidence of residual abnormal cell growth identified. Multiple peribronchial and intrapulmonary lymph nodes are present within the resected specimen. The bronchial margin is free of atypical cells.\n\nLymph node dissection includes multiple inferior mediastinal (1 subcarinal, 2 paraesophageal, 2 left inferior pulmonary ligament), aortic (2 anterior mediastinal), and N1 (2 left interlobar) stations. All evaluated lymph nodes show no evidence of atypical cell infiltration. A separate tissue sample submitted as aortopulmonary lymph node consists of fibrovascular tissue only, with no lymphoid structures identified."} +{"pid": "TCGA-BH-A0W5", "report": "The specimen was obtained from a left central lumpectomy and left sentinel lymph node procedure. The tumor measured 1.4 cm in its maximum dimension and was found to have an in situ component comprising 5% of the total tumor volume. Histological evaluation showed nuclear grade 2, tubule formation score of 2, and mitotic activity score of 2, resulting in a total Nottingham score of 6, corresponding to grade 2. The in situ component exhibited cribriform morphology with nuclear grade 2. Benign and malignant calcifications were identified.\n\nExamination of surgical margins showed no involvement by invasive or in situ components. Changes consistent with a prior core biopsy were noted, along with fibrocystic changes and focal atypical ductal hyperplasia. Estrogen and progesterone receptors were positive. HER2/Neu testing was scored as 2+ on immunohistochemistry; however, no gene amplification was detected by interphase FISH analysis. Thermal effects were observed in the tissue.\n\nA total of two lymph nodes were examined. One lymph node contained metastatic disease measuring 0.5 cm, with evidence of extracapsular extension. The second lymph node showed no tumor involvement. The method of lymph node assessment included H&E staining. Pathologic staging was determined as pT1c for the primary tumor, pN1 for nodal involvement, and pMX for distant metastasis. Dermal lymphatic invasion was present, and microcalcifications were associated with benign ducts."} +{"pid": "TCGA-A8-A08I", "report": "The specimen demonstrates a poorly differentiated invasive lesion with small areas of necrosis and associated secondary inflammation. The tumor measures 3 cm in diameter. Surgical margins are as follows: cranial margin 0.6 cm, caudal margin 0.4 cm, ventral margin 0.2 cm, dorsal margin 0.1 cm, medial margin 0.4 cm, and lateral margin 0.8 cm. Histological grade is III. Lymph node assessment indicates no metastatic involvement (0 out of 3 sentinel nodes involved). Vascular or lymphatic invasion could not be confirmed. Receptor status and other specific markers were not identified."} +{"pid": "TCGA-FG-A711", "report": "The specimen from the left frontal lobe was received as an excised brain tissue measuring 7.9 x 6.0 x 3.1 cm, with a tan-gray appearance. A distinct tan-white homogeneous mass measuring 5.8 x 5.7 x 3.4 cm was identified within the tissue. Microscopic examination revealed a mild to moderately cellular infiltrating neoplasm composed of glial elements. The cells exhibited round to ovoid nuclei with scant cytoplasm. In some areas, nuclear pleomorphism and elongated forms were noted. Focal clusters of minigemistocytes were present, and mitotic figures were occasionally observed.\n\nImmunohistochemical staining demonstrated positivity for GFAP in occasional cells. A Ki-67 stain was performed, showing a proliferation index of approximately 1\u20132%. Histological features showed variability across different sections, with some areas displaying an oligodendroglial-like morphology and others showing more pleomorphic, astrocytic features.\n\nFluorescence in situ hybridization (FISH) analysis was performed using dual-color probe sets targeting 1p36/1q25 and 19q13/19p13. A total of 118 cells were analyzed for the 1p/1q ratio, yielding a result of 0.67. For the 19q/19p ratio, 120 cells were evaluated, resulting in a ratio of 0.48. Both ratios were below the established threshold of 0.80, indicating loss at both the 1p36 and 19q13 loci. These findings were confirmed by both computer-aided and manual counting methods, with results reviewed by trained personnel and interpreted by a pathologist.\n\nThe FISH assays used were developed and validated by the laboratory and are not FDA-cleared; however, they are performed under appropriate regulatory guidelines. The histological and molecular findings were consistent across multiple observers and analyses."} +{"pid": "TCGA-EB-A82B", "report": "Patient ID: Gross Description: A mass is located in the right foot skin, measuring 5x4x2cm. It is firm in consistency with a brown to black-gray surface appearance. Microscopic Description: The epidermis shows necrosis and ulceration. The tumor is composed of spindle or oval-shaped cells with scant cytoplasm. In some instances, the cytoplasm contains finely divided melanin pigment granules. The tumor cells exhibit a low nucleo-cytoplasmic ratio. Nuclei vary in both shape and size, and prominent large eosinophilic nucleoli are present. Mitotic figures are observed. Invasion by tumor cells into fat tissue is noted. Specimen type: Surgical resection. Tumor site: Skin, foot. Tumor size: 5x4x2cm. Tumor features: Ulcerated, pigmented, necrotic. Satellite nodules: Not specified. Histologic grade: Poorly differentiated. Lymph nodes: 2 out of 9 involved by metastasis (right inguinal and pelvic lymph nodes). Lymphatic invasion: Not specified. Venous invasion: Not specified. Margins: Not specified. Evidence of neo-adjuvant treatment: Not specified. Additional pathologic findings: Right foot, tumor thickness measured at 20mm. Comments: None."} +{"pid": "TCGA-ZB-A966", "report": "Pathology Report-Summary: Material: Tumor: 4.0 X 3.0 X 1.0 cm. Infiltration of lung parenchyma noted. Microscopic examination revealed epithelial cells positive for CK5/6, CK18, CD5, CD117, and p63. Epithelial cells were negative for CD1a, CD56, chromogranin A, synaptophysin, CK7, and TTF1. Ki-67 proliferation index was high, estimated at 70\u201380%. No CD1a-positive T-lymphocytes identified. Pathologic staging was determined as pT3. Masaoka stage III was assigned."} +{"pid": "TCGA-HT-7879", "report": "Microscopic examination reveals a moderately cellular glial neoplasm composed of cells with both astrocytic and oligodendroglial features. The oligodendroglial component shows a proliferation of cells with round to oval, moderately pleomorphic nuclei and prominent preinuclear halos. Scattered microgemistocytes are also present. The minor astrocytic component consists of neoplastic cells with oval to elongated nuclei and moderate cytologic atypia. Overall, mitotic figures are rare; however, there is a focal increase with up to 3 mitoses per 10 high power fields. No necrosis or microvascular proliferation is identified. Neoplastic cells are observed infiltrating the adjacent brain parenchyma. A MIB-1 labeling index was performed on three tissue blocks. The overall labeling index is low, ranging from 2.4% to 3.7%, although a focal area shows increased proliferative activity at 6.2%. This region correlates with the focally elevated mitotic rate and is suggestive of very early anaplastic progression within a predominantly low-grade glioma."} +{"pid": "TCGA-A3-A8CQ", "report": "The specimen is a partial nephrectomy from a female patient, measuring 3.5 x 2.4 x 2.2 cm. It consists of red-pink, shaggy renal parenchyma on one aspect with a stitch and a smooth, encapsulated opposite aspect. Both surfaces are inked blue. Upon sectioning, a well-circumscribed mass measuring 2.5 x 2.0 x 1.5 cm is identified. The mass is yellow-tan, hemorrhagic, and variegated in appearance. It approaches to within 0.1 cm of the sutured parenchymal margin and contacts the encapsulated surface.\n\nHistologically, the lesion demonstrates conventional morphology with clear cell features. The nuclear grade is Fuhrman grade 2 out of 4. There is no evidence of lymphovascular space invasion or sarcomatoid differentiation. Surgical margins are uninvolved, although the tumor is in close proximity to the posterior (stitch) margin. No lymph nodes were received for examination. The lesion is confined to the kidney both macroscopically and microscopically. Based on these findings, the stage is determined as pT1a NX."} +{"pid": "TCGA-DK-A1AA", "report": "A 58-year-old male underwent radical cystoprostatectomy with bilateral pelvic lymph node dissection and resection of other tissues including segments of ureters, small bowel, and an abdominal wall hernia sac. The surgical specimens included multiple biopsies and resected tissues, all of which were examined microscopically.\n\nThe main specimen consisted of a bladder and prostate. Microscopic evaluation showed multiple distinct tumor foci in the bladder. The tumors exhibited both papillary and nodular growth patterns. There was evidence of full-thickness disruption of the bladder wall with tumor cells extending into the surrounding soft tissue. Inflammation, foreign body giant cell reaction, and myofibroblastic proliferation were noted at the site of disruption. No vascular or perineural invasion was identified in the bladder component. The surgical margins of the bladder, urethra, and distal ureters were free of tumor involvement. The non-tumor bladder mucosa showed changes consistent with chronic irritation, including Brunn's nests, cystitis cystica, and cystitis glandularis.\n\nIn the prostate, multiple tumor foci were identified involving all major regions: right and left posterior, anterior mid, apex, and base. A single focus of high-grade intraepithelial neoplasia was also present. Tumor was confined within the prostate capsule without extension beyond it. Perineural invasion was present, but no vascular invasion was identified. Surgical margins of the prostate were negative for tumor. The remainder of the prostate showed benign nodular hyperplasia.\n\nLymph node dissections from both the right and left pelvis yielded a total of thirteen lymph nodes (five on the right, eight on the left), all of which were histologically benign. Other submitted specimens, including biopsies of the rectus sheath, pre-vesical tissue, urethral margin, and resected small bowel and hernia sac, showed only non-malignant findings. The rectus sheath biopsy revealed benign fibroadipose tissue, the urethral margin showed normal prostatic urethra, and the pre-vesical tissue demonstrated necrotic material with inflammatory exudate. The small bowel and ureter segments were unremarkable.\n\nGross examination of the bladder revealed multiple fungating masses throughout the bladder walls, ranging in size from 0.5 cm to 6 cm in greatest dimension. Serial sectioning confirmed the presence of a perforation through the bladder wall with associated sinus tract formation into adjacent soft tissue. No gross tumor involvement was seen at the ureteral orifices or in the urachal remnant.\n\nThe pathologic staging for the bladder lesion was pT3, indicating invasion into the perivesical soft tissue, with no evidence of prostate or urethral extension. The prostate lesion was staged as pT2b, indicating tumor involvement of both lobes but confined within the prostate capsule."} +{"pid": "TCGA-A8-A08Z", "report": "The specimen shows a moderately differentiated carcinoma with areas of angioinvasion and involvement of the skin, including focal ulceration. The tumor measures 5.0 cm in diameter. Microscopic evaluation reveals infiltration of the skin spindle with ulcerated regions. Lymphovascular invasion is present. Nodal staging indicates three positive lymph nodes. The dorsal resection margin is free of tumor. Cellular features are consistent with a ductal pattern, though no specific tumor type is designated. Staging is assigned as pT4bN3aLIVORO."} +{"pid": "TCGA-D8-A73W", "report": "The specimen includes a right breast measuring 21 x 16 x 6 cm, along with axillary tissue measuring 10 x 9 x 3 cm and a skin flap of 21 x 12 cm. The total weight of the breast specimen is 1092 g. A lesion measuring 5.5 x 4 x 4 cm was identified at the junction of the upper quadrants, located 1 cm from the upper edge, 0.1 cm from the base, and 1 cm from the skin. There is evidence of prior core needle biopsy. Lymph nodes measured up to 5.2 cm and were found to be fatty.\n\nMicroscopic evaluation shows features including a histologic grade 2 classification based on scoring criteria (2 + 2 + 3). Mitotic count was reported as 20 per 10 high-power fields within a visual field area of 0.55 mm. No abnormal findings were identified in the nipple, and the glandular tissue demonstrates signs of parenchymal atrophy. Invasive changes are present at a distance of 0.1 cm from the base margin. Of the 13 axillary lymph nodes examined, one contained a metastatic deposit measuring 0.5 cm, with extension beyond the nodal capsule."} +{"pid": "TCGA-A2-A1G1", "report": "The surgical specimen consists of a right breast excision and a sentinel lymph node. The breast specimen weighs 3.3 grams and measures 5.5 x 4.5 x 2 cm. It is a mass of fatty and fibrous tissue with margins marked by colored dyes: superior (yellow), inferior (green), lateral (orange), medial (black), anterior (blue), and posterior (red). A tumor measuring 3 x 2.5 x 1 cm is identified within the specimen. Gross assessment indicates the tumor is 0.4 cm from the superior margin, 0.9 cm from the inferior, 0.4 cm from the medial, 0.3 cm from the lateral, 0.5 cm from the anterior, and 0.6 cm from the posterior margin. The tumor demonstrates necrosis and lymphovascular invasion. Histologic evaluation reveals poorly differentiated features. All surgical margins are free of tumor involvement.\n\nOne sentinel lymph node is submitted, measuring 1.5 x 1 x 0.6 cm. Microscopic examination confirms the presence of metastatic disease in this lymph node. Based on these findings, staging is classified as T2 N1 MX. The case involves twelve blocks from the breast specimen and two blocks from the lymph node. Touch prep and frozen section evaluations were performed intraoperatively. Final microscopic analysis confirms the presence of metastasis in the sentinel lymph node upon permanent sectioning, which was not detected during frozen section evaluation."} +{"pid": "TCGA-26-A7UX", "report": "The specimen was obtained from a male patient undergoing left craniotomy. Two tissue samples were received and processed. Specimen A measured 1.5 x 1.0 x 0.5 cm and consisted of pale yellow-tan, bloody soft tissue. Sections were submitted for frozen analysis, revealing extensive necrosis with only focal viable tumor. Remaining tissue was processed for permanent sections.\n\nSpecimen B measured 2.5 x 1.5 x 0.5 cm and consisted of yellow-tan to pink-tan, bloody soft tissue. A representative portion was submitted for frozen section, which showed malignant glioma features. The remaining tissue was processed for permanent sections and a portion was sent to the tumor bank.\n\nMicroscopic evaluation revealed a highly infiltrative glial neoplasm with areas of increased cellularity, mitotic activity, and pseudopalisading necrosis. Necrosis was more extensive in specimen A, while specimen B contained more viable tumor cells. Immunohistochemical staining showed weak positivity for p53 in approximately 5% of nuclei, negative staining for IDH-1, and 40% positivity for Ki-67 (MIB-1). GFAP staining demonstrated strong immunoreactivity in tumor cells and their processes.\n\nThe tissue samples were obtained via open biopsy from the left frontal region of the cerebrum. All specimens were examined microscopically and correlated with imaging and clinical findings. Ancillary testing included immunohistochemical analysis for p53, IDH-1, Ki-67, and GFAP. The laboratory performing these tests is CLIA-certified for high-complexity testing, and all studies were performed under approved protocols. Some assays used are not FDA-cleared but are considered appropriate for clinical use."} +{"pid": "TCGA-EU-5906", "report": "The specimen consists of a left kidney weighing 560 grams and measuring 15.7 x 11.6 x 5.8 cm, surrounded by perirenal fat. Upon bivalving, a well-defined mass is identified in the upper pole, measuring 5.9 x 4.7 x 4.6 cm, with a bright yellow, partially hemorrhagic and cystic appearance. The mass is separated from the renal pelvis by 0.3 cm, from the closest renal vein by 1.4 cm, and from the nearest renal artery by 0.6 cm. Gross evaluation reveals that the mass is confined to the renal cortex and lies beneath the renal capsule without penetrating it. No involvement of the renal pelvis or vasculature is observed. Areas of calcification are noted within the tumor. The unaffected portion of the kidney shows a normal tan-red color with distinct corticomedullary differentiation and an average cortical thickness of 0.8 cm.\n\nMicroscopic examination of representative sections reveals a proliferation of clear cells with moderate to abundant pale eosinophilic or clear cytoplasm. Nuclear features include small to slightly enlarged nuclei with mostly regular contours and indistinct nucleoli (consistent with lower-grade morphology), while some nuclei show mild irregularities and visible nucleoli at higher magnification.\n\nHistologic assessment confirms the lesion is confined to the kidney with no evidence of vascular or lymphatic invasion. Surgical margins are free of tumor involvement. Evaluation of non-neoplastic kidney tissue demonstrates mild to moderate arteriosclerosis. Multiple sections including hilar vessels, ureter, and surrounding fat are submitted for analysis, with no tumor identified in these regions. Lymph nodes are not identified during the examination of the hilar region."} +{"pid": "TCGA-A5-A0GV", "report": "The specimen consists of a total hysterectomy with bilateral salpingo-oophorectomy, weighing 68 grams. The uterus measures 6.5 x 5.5 x 3.0 cm, with a cervix measuring up to 2.8 cm in length and 3.0 cm in diameter. The endometrial cavity is approximately 4.5 cm long and 3.7 cm wide. The uninvolved endometrium has a maximum thickness of 0.2 cm. The myometrium ranges from 1.1 to 1.4 cm in thickness. The right fallopian tube is 4.3 cm long and up to 0.4 cm in diameter, while the left fallopian tube is 5.2 cm long and up to 0.3 cm in diameter. The right ovary measures 2.6 x 1.1 x 0.7 cm and the left ovary measures 2.1 x 1.4 x 0.5 cm.\n\nA soft friable exophytic lesion measuring 2.3 x 0.8 x 0.2 cm is observed in the anterior uterine fundus. Histologically, this lesion involves the mucosa of the uterine fundus and corpus, with extension into the lower uterine segment. There is superficial myometrial invasion (less than 50% of the wall thickness involved). Dislodged fragments of similar-appearing tissue are noted within endothelial-lined spaces, including veins; however, an iatrogenic origin is considered more likely than true lymphovascular invasion. The cervix, including surgical margins, shows no evidence of involvement. Parametrial tissues also appear free of involvement. No involvement is identified in the ovaries or fallopian tubes.\n\nAdditional findings include foci of glandular hyperplasia in the endometrium, both simple and complex types, with varying degrees of atypia. Areas of inactive or weakly proliferative endometrium are also present. Small benign endometrial and endocervical polyps, including a mixed endocervical-endometrial polyp, are noted. Several small intramural leiomyomas (0.8\u20131.0 cm) are present, some showing hyalinization. Adenomyosis is also identified. The cervix demonstrates changes consistent with prior curettage, along with acute and chronic inflammation, squamous metaplasia, reactive epithelial changes, cystic tunnel clusters, and nabothian cysts. The right ovary shows atrophic changes with benign surface micropapillary epithelial and stromal proliferation. The left ovary demonstrates atrophic changes and cystic epithelial inclusions. Both fallopian tubes show mild epithelial hyperplasia without significant atypia.\n\nLymph node evaluation includes two lymph nodes on the right side and nineteen on the left. All are reactive without evidence of metastatic disease based on routine histology or keratin immunostaining.\n\nMultiple sections were submitted for microscopic evaluation, including representative samples from the tumor site, cervix, parametrial tissues, ovaries, and fallopian tubes. Immunohistochemical staining for keratin showed no occult metastatic cells in lymph node sections.\n\nThe pathologic staging reflects limited myometrial involvement without nodal or distant spread."} +{"pid": "TCGA-VQ-A91W", "report": "The specimen involved the stomach body region. The esophageal mucosa at the proximal margin showed no evidence of neoplastic involvement. A mass was identified measuring 9.0 cm in greatest dimension. Histologic evaluation demonstrated a moderately differentiated gland-forming lesion with features resembling intestinal-type morphology. The lesion extended into adjacent fat tissue and exhibited lymphatic, venous, and perineural invasion. There was a mild inflammatory infiltrate in the surrounding tissue. All surgical margins were free of neoplastic cells.\n\nThe adjacent gastric mucosa showed moderate background inflammation and changes consistent with incomplete intestinal metaplasia. The gallbladder revealed chronic inflammatory changes along with cholesterolosis. The distal esophageal mucosa was unremarkable. Omental tissue did not show any abnormality.\n\nLymph node dissection included multiple regional groups. Of the 25 lymph nodes examined, 5 contained neoplastic involvement. Involved nodes were located within the lesser curvature group (5 of 12). Other nodal stations including right gastroepiploic (0 of 3), infrapyloric (0 of 6), common hepatic artery (0 of 2), celiac trunk (0 of 1), and splenic artery (0 of 1) were negative. Additional nodal chains including right and left paracardial, short gastric artery, left gastroepiploic, and suprapyloric regions contained only fat tissue without involvement."} +{"pid": "TCGA-CV-5439", "report": "The specimen from the left level I neck dissection includes four lymph nodes, all negative for malignant involvement. A benign salivary gland tissue was identified without any signs of malignancy.\n\nAn en bloc resection measuring 16.0 x 8.0 x 5.5 cm encompassing the tongue, larynx with tracheostomy, and bilateral neck dissection revealed a mass measuring 6.5 x 5.0 x 5.0 cm located at the right base of the tongue. This lesion extended to the midline and laterally into deep soft tissues, skeletal muscle, and submandibular gland. It approached within 0.2 cm of the right epiglottic fold and within 0.3 cm of the oropharyngeal mucosal margin. The surface was focally ulcerated with scalloped borders and showed variegated cut surfaces including focal necrosis and cystic changes. Deep resection margins did not show involvement by the lesion. Within the dissected lymph nodes from various levels on both sides, two out of twenty-nine contained malignant cells with extension beyond the nodal capsule.\n\nMargins from the inferior soft palate, superior soft palate, posterior pharyngeal wall, and right gingival region were evaluated microscopically and demonstrated squamous mucosa with varying degrees of cellular atypia ranging from mild to moderate dysplasia.\n\nMultiple lymph nodes were sampled throughout the specimen; three lymph nodes from level one on the right side were bisected and submitted for analysis along with additional lymph nodes from other levels. Sections from various areas including the thyroid gland, tracheostomy site, glottis, and representative tumor sections were submitted for histological examination.\n\nFrozen section analysis from multiple sites including the floor of the mouth, oropharynx, and surgical margins confirmed absence of tumor in those regions. Tissue fragments from the soft palate inferior margin, superior soft palate, posterior pharyngeal margin, and right gingival margin were assessed and showed squamous mucosa with mild dysplastic changes.\n\nNo clinical history was provided for this case."} +{"pid": "TCGA-B8-4619", "report": "A left radical nephrectomy specimen was received, weighing 1,000 grams and measuring 25 x 23 x 9 cm. The kidney itself measured 14.0 x 7.0 x 6.5 cm. A mass was identified in the upper pole, mainly anterior medial position, with a solid, focally cystic pink/brown and focally hemorrhagic cut surface. The tumor measured 3.4 x 2.8 x 1.5 cm and appeared to be cortical in origin. Grossly, the tumor was confined to the kidney; however, the perinephric adipose tissue overlying the tumor was disrupted. The surgical margins, including perirenal adipose tissue, renal vein, renal artery, ureter, and Gerota\u2019s fascia, were believed to be negative for involvement.\n\nMicroscopic evaluation showed no involvement of capsular invasion, perirenal adipose tissue, Gerota\u2019s fascia, renal vein, ureter, lymphatic or venous vessels, or adjacent organs. Histologic grade was 2 of 4. Patchy interstitial chronic inflammation was noted. An incidental finding of a papillary adenoma measuring 0.2 cm was identified and described in the comments.\n\nImmunohistochemical staining performed on blocks A3 and A4 showed that the dominant mass was negative for CK7, CK20, and Hale\u2019s colloidal iron, which excluded the chromophobe variant. In block A3, a second focus was identified as a papillary neoplasm with psammoma bodies measuring 0.2 cm. This focus was positive for CK7 and negative for CK20, TTF-1, and thyroglobulin, findings not consistent with micrometastasis from lung or thyroid. These features were consistent with a papillary microadenoma.\n\nThe adrenal gland was present at the superior pole as a disrupted fragment measuring 1.0 x 0.4 x 0.2 cm and was unremarkable. No lymph nodes were identified in the hilar adipose tissue. The remainder of the kidney showed normal parenchyma with a corticomedullary junction intact. The cortex measured 9 mm and the medulla 1.1 cm.\n\nStaging was determined as pT1a, pNx based on available data at the time of reporting and may be subject to change pending further clinical review. Tissue samples were submitted for special investigations, and digital photographs were not taken. Multiple tissue blocks were examined, including sections of tumor, normal kidney, and surgical margins.\n\nLaboratory testing included immunohistochemical stains classified as analyte-specific reagents (ASR), developed and validated by the laboratory. These reagents are not FDA-cleared but are used under CLIA-88 certification for high-complexity clinical testing."} +{"pid": "TCGA-ZM-AA05", "report": "A partially cut left testicle specimen with associated tumor was received, measuring 7.5x5x5 cm in total (testicle and tumor combined), with a 4.5 cm long funiculus. Upon sectioning, a white, firm tumor measuring 7x4.8x4.5 cm was identified within the inner aspect of the testicle. The tumor infiltrates nearly the entire testicular tissue and extends into the tunica albuginea.\n\nMicroscopically, the tumor is composed predominantly of cells with round and oval nuclei, some with prominent nucleoli, and cytoplasm that appears eosinophilic and moderately abundant. Immunohistochemical staining shows positivity for PLAP. Within the tumor, up to two mitotic figures per high-power field were observed. Areas of necrosis are present within the tumor tissue.\n\nThe tumor is surrounded by fibrous connective tissue containing dense inflammatory infiltrates composed of lymphocytes, plasma cells, macrophages, and occasional multinucleated giant cells. Tumor emboli are identified within blood vessels. The tumor extends into the tunica albuginea, partially involves the epididymis, and reaches the rete testis. No tumor involvement is seen in the spermatic cord. Adjacent non-neoplastic testicular tissue shows signs of atrophy. There is no evidence of unclassified intratubular germ cell neoplasia.\n\nIn addition, a separate tissue fragment measuring 8x3.5x1.5 cm was submitted along with the main specimen. Histological examination of this fragment reveals only adipose and connective tissue with blood vessels, without any abnormal cellular proliferation."} +{"pid": "TCGA-2Z-A9JO", "report": "A right partial nephrectomy specimen measuring 5.5 x 5.5 x 4.0 cm was examined. A soft red-brown mass measuring 4.5 x 4.5 x 3.0 cm was identified grossly, abutting the surgical margin which was marked with black ink. The overlying capsule was intact and marked with blue ink. No involvement of the surgical margins by carcinoma was observed microscopically. The tumor was confined to the kidney macroscopically and histologically. Histologic evaluation revealed cells with very irregular nuclei measuring approximately 20 microns in diameter with large and prominent nucleoli corresponding to a high-grade morphology. There was no evidence of sarcomatoid differentiation, perineural invasion, or angiolymphatic invasion. Immunohistochemical staining using markers including AMACR, cytokeratin 7, cytokeratin 20, CD117, and vimentin supported the interpretation of the lesion. Additional staining with RCC antigen and Hale's colloidal iron further corroborated the findings. Regional lymph nodes could not be assessed and there was no evidence of distant metastasis. The tumor measured greater than 4 cm but not more than 7 cm in greatest dimension and was limited to the kidney corresponding to a pT1b classification. Specimens were reviewed entirely and confirmed by the attending pathologist."} +{"pid": "TCGA-GM-A2DD", "report": "A total mastectomy specimen from the left breast shows an invasive lesion measuring 1.2 x 1.0 x 1.0 cm. The lesion is located 2.2 cm from the closest inferior margin, with wide surgical margins elsewhere. Adjacent to this area, there is a high-grade in situ component showing solid and cribriform patterns with necrosis. No lymphovascular invasion is identified in this region, and no tumor is found in the nipple. Two separate sentinel lymph node biopsies from the left axilla each show one lymph node without any abnormal findings; immunohistochemical staining for cytokeratin is negative.\n\nIn the right breast mastectomy specimen, an invasive lesion measures 1.4 cm in greatest dimension and is located 0.4 cm from the lateral anterior margin. A high-grade in situ component is also present near this area, showing similar morphological features including necrosis and microcalcifications. The invasive lesion has focal lymphovascular invasion. No tumor is found in the nipple. Two sentinel lymph nodes from the right axilla are each without evidence of involvement; immunohistochemical staining for cytokeratin is also negative in these nodes.\n\nImmunohistochemical analysis of the left breast lesion demonstrates positivity for CK903, CK5/6, and vimentin. Estrogen receptor expression is low positive (1%), progesterone receptor is negative, and HER-2/neu overexpression is negative. In the right breast lesion, estrogen receptor is similarly low positive (1%), progesterone receptor is negative, and HER-2/neu shows focal weak positivity (2+ score in 5% of cells). Due to this result, fluorescence in situ hybridization (FISH) testing was performed to assess HER-2/neu gene amplification. Analysis of 60 nuclei reveals an average of 1.62 HER-2/neu gene copies per nucleus and 1.45 CEP17 copies per nucleus, resulting in a HER-2/neu:CEP17 signal ratio of 1.11, indicating no gene amplification."} +{"pid": "TCGA-EY-A3QX", "report": "A biopsy of a peritoneal lesion on the right gutter revealed high-grade malignant cells. A separate omental specimen contained multiple nodules, with the largest measuring 3.7 x 1.7 x 1.0 cm, all showing similar malignant involvement. A hysterectomy specimen showed a tumor located in both the anterior and posterior endometrial cavities. The tumor measured 6.8 x 6.4 x 1.5 cm macroscopically, with an additional aggregate mass measuring 6.5 x 3.7 x 3.5 cm. The tumor was tan-gray, fungating, and friable, extending through nearly the full thickness of the myometrium (2.5 cm wall thickness), reaching to within 2.1 cm of the lower uterine segment. Histologic evaluation confirmed deep myoinvasion involving the outer half of the myometrium, with extensive lymphovascular invasion noted. Cervical margins were negative at a distance of at least 3.1 cm. Bilateral adnexal involvement was present.\n\nThe right ovary contained a solid and cystic mass measuring up to 4.3 cm, with a friable white excrescence on the inner cyst wall. No mural invasion was identified. The left ovary showed focal involvement within small cysts, with a papillary excrescence bulging the capsule. Both fallopian tubes were submitted; the right tube contained intraluminal malignant cells without mural involvement, while the left tube appeared unremarkable. No lymph nodes were submitted for evaluation.\n\nImmunohistochemical staining of the endometrial tumor showed positivity for E-cadherin and only sparse weak staining for WT1. Estrogen receptor staining was positive (2-3+ in 75% of cells), and progesterone receptor was weakly positive (2+ in 10% of cells). Based on available data, pathologic staging was assigned as pT4a pNx pMx, with a clinical stage grouping consistent with advanced local disease. Additional findings included intramural leiomyomas and hemorrhagic ovarian parenchyma with corpus albicans."} +{"pid": "TCGA-BG-A0M0", "report": "The specimen consisted of a total abdominal hysterectomy with bilateral salpingo-oophorectomy, along with lymph node dissections. A lesion measuring 5.2 cm was identified in the endometrium. Histologic evaluation showed well-differentiated architecture with nuclear grade 1 features. The tumor infiltrated 0.1 cm into the myometrium, representing less than half of the myometrial thickness. No angiolymphatic invasion was observed. There was extensive complex atypical hyperplasia, which, along with the carcinoma, involved areas of adenomyosis. The cervix showed no involvement.\n\nMultiple leiomyomas and diffuse adenomyosis were noted. Both adnexal structures were free of tumor. The ovaries contained surface epithelial inclusions, and a paratubal cyst was present in the left fallopian tube. Pelvic washings were negative for malignant cells.\n\nOne lymph node was identified in the right external iliac region and was negative for metastasis. No lymph nodes were found in the left external iliac dissection. Based on these findings, the pathologic staging was determined as pT1b, pN0, pMX, corresponding to FIGO stage IB."} +{"pid": "TCGA-HW-8320", "report": "The clinical history includes a 12-year history of seizures associated with a right parietal intra-axial brain lesion, which is heterogeneously solid and cystic. Two specimens were submitted for analysis: one labeled as right parietal lobe brain tumor and a second labeled as right parietal lobe brain tumor #2.\n\nGross examination of the first specimen revealed two pieces of soft myxoid tissue measuring between 0.5 cm and 1.5 cm. The second specimen measured 3.7 x 3.5 x 2.0 cm and consisted of grey-white brain parenchyma mixed with hemorrhagic and tan-white soft myxoid tissue. Both specimens were entirely submitted for evaluation.\n\nMicroscopic assessment showed a neoplastic process involving glial cells with increased mitotic activity in certain regions. These areas demonstrated a proliferation index exceeding 10% by MIB-1 immunostaining. Cellular features included nuclear atypia and focal architectural changes. Special stains and immunohistochemical studies were performed, including MIB-1 labeling. Additional molecular testing has been initiated, including analysis for EGFR variants, MGMT promoter methylation, and IDH status; results will be reported separately.\n\nAll diagnoses were based on personal examination of the slides and review of the material. Intraoperative frozen section evaluation of the first specimen was interpreted as a low-grade microcystic glioma. Subsequent permanent sections were evaluated to further characterize the cellular features and proliferative activity."} +{"pid": "TCGA-BP-5200", "report": "The specimen from the right kidney consists of a wedge segment measuring 9 x 8 x 5 cm, with a suture marking the deep margin. Serial sectioning reveals a well-defined mass that is necrotic, yellow, and hemorrhagic, with focal sclerotic changes. The mass measures 7.5 x 6.0 x 5.7 cm and has a clearance of 0.4 cm from the resection margin. The tumor exhibits high nuclear grade, with features including areas of necrosis and sarcomatoid differentiation. Histologic evaluation shows extension into the renal pelvis but no evidence of renal vein or small vessel angiolymphatic invasion. Surgical margins are free of involvement.\n\nNon-neoplastic tissue demonstrates focal interstitial chronic inflammation. No adrenal tissue or lymph nodes are identified in the specimen. Immunohistochemical staining shows diffuse positivity for carbonic anhydrase-IX and CD10, while CK7 is negative. These findings support the morphologic interpretation.\n\nStaging classification is based on tumor size and extent, with the lesion measuring greater than 7.0 cm in greatest dimension and confined to the kidney. Representative sections of the tumor, capsule, and nearest margin were submitted for analysis. Intraoperative consultation confirmed the presence of a tumor with epithelioid and spindle cell features; however, the final diagnosis was deferred until permanent sections were reviewed."} +{"pid": "TCGA-B0-5713", "report": "The patient underwent a left laparoscopic nephrectomy. The neoplasm measured 7.2 cm in greatest diameter and was located in the lower pole of the kidney. Microscopic examination revealed a unifocal tumor confined within the renal capsule, with no involvement of the surgical margins. The histologic features included a high nuclear grade. Venous invasion was present, involving the vessel wall; however, no lymphatic invasion was identified. No regional lymph nodes were examined. The non-neoplastic kidney tissue appeared normal, and the adrenal gland was not submitted for evaluation. The tumor demonstrated no evidence of distant spread."} +{"pid": "TCGA-EC-A1NJ", "report": "The specimen consisted of a hysterectomy with a lesion located in the uterus measuring 3 x 2.5 x 1 cm. The histologic examination revealed moderately differentiated cells. The tumor involved less than half of the myometrium. No information was provided regarding lymph nodes, lymphatic or venous invasion, margins, extent of myometrial invasion, evidence of neo-adjuvant treatment, or additional findings."} +{"pid": "TCGA-DD-AACU", "report": "The submitted liver specimen measured 11.5 x 6.0 x 5.0 cm and contained a single mass measuring 2.0 x 1.8 x 1.5 cm. The mass was described as multinodular confluent with an encapsulated, yellowish tan, round, and solid cut surface. The extent of the lesion was confined within the capsule, with no gross involvement of the resection margin; a safety margin of 0.8 cm was noted. The remaining liver parenchyma appeared unremarkable.\n\nMicroscopic evaluation revealed a tumor composed of cells arranged in trabecular and acinar patterns. The worst degree of differentiation was grade III, while the predominant differentiation was grade II. Fatty change was present but minimal. There was no evidence of cholangiocarcinoma component, fibrous capsule formation, capsular infiltration, surgical resection margin invasion, serosal invasion, portal vein invasion, vascular invasion, or bile duct invasion. Septum formation was observed. Portal inflammation and fibrosis were noted in the surrounding liver tissue.\n\nSpecial stains demonstrated portal fibrosis. Immunohistochemical staining showed CD34 positivity in the tumor tissue (T1), while non-tumor liver tissue (L) was CD34 negative. Representative sections of the mass, resection margin, and non-tumorous liver parenchyma were submitted for analysis."} +{"pid": "TCGA-BC-A112", "report": "The submitted liver specimens include a biopsy from segment 4 and a partial hepatectomy specimen from segments 5\u20138. Histologic evaluation of the biopsy shows fibrosis and chronic inflammation, with no evidence of neoplastic involvement. The partial hepatectomy specimen contains three distinct nodular lesions within the liver parenchyma, measuring 1.5 cm, 8 cm, and 11 cm in greatest dimension. The largest lesion is associated with capsular disruption and has a lobulated appearance with areas of erythema and hemorrhage. The two smaller lesions are entirely within the liver parenchyma without proximity to the capsule. All three lesions have well-defined to scalloped borders and are firm and white on sectioning.\n\nMicroscopic analysis reveals a cellular composition that includes moderate differentiation of the neoplastic cells. Immunohistochemical staining demonstrates positivity for HepPar-1 and CK7 in subsets of the neoplastic cells, while being negative for CK20 and PSA. Appropriate positive control slides were used for validation. Surgical margins are negative, with the closest distance between the largest lesion and the surgical margin being 1.7 cm. No lymphovascular or perineural invasion is identified. A foreign body giant cell reaction is present around foreign material found within vascular structures, which is consistent with prior embolization. The non-involved liver tissue shows only mild nonspecific lymphocytic portal infiltrates, minimal steatosis, and no significant fibrosis. A vascular stent is noted within the vasculature of the liver.\n\nStaging is based on the current pathologic findings and is reported as pT3, pNx, pMx. It is noted that this staging may be incomplete and should be correlated with all available clinical data to determine the final staging classification. The case was reviewed intraoperatively and confirmed by frozen section analysis, which did not show tumor in the sampled area. The attending pathologist confirms personal review and concurrence with the findings."} +{"pid": "TCGA-YT-A95G", "report": "The specimen from the thymus shows a neoplasm characterized morphologically and confirmed through immunohistochemical analysis. The tumor demonstrates features consistent with a subtype classified under type B2 according to the World Health Organization (WHO) criteria. Evaluation of pre-vascular fat tissue reveals no evidence of tumor involvement. Cellular morphology, in conjunction with immunophenotypic markers, supports the interpretation of this lesion without identifying any additional diagnostic entities."} +{"pid": "TCGA-DD-A3A2", "report": "The resected liver specimen includes segments V and VI, weighing 790 grams and measuring 15 x 13 x 8 cm, with an attached gallbladder measuring 12 x 4 x 3 cm. A single liver nodule is present, measuring 12 x 11 x 7.5 cm, and exhibits a well-differentiated cellular appearance with an encapsulated growth pattern and a \"nodule within a nodule\" architectural feature. Multiple tissue sections (A1 through A12) were examined. The lesion shows no involvement of surgical margins. The gallbladder demonstrates chronic inflammation without evidence of calculi. Initial frozen section evaluation noted features suggestive of either a benign hepatocellular lesion or a low-grade malignant process, though distinction between the two could not be definitively made intraoperatively."} +{"pid": "TCGA-06-0876", "report": "The patient presented with symptoms of headache and left-sided weakness. Imaging findings indicated a necrotic mass in the right parietal region with peripheral enhancement, surrounding edema, and signs of increased intracranial pressure.\n\nTwo biopsy specimens were obtained from the right parietal area. Histopathological examination revealed extensive disruption of normal cerebral architecture by a densely cellular glial neoplasm. The tumor exhibited nuclear atypia, brisk mitotic activity, microvascular proliferation, and areas of necrosis. In one specimen, there was prominent necrotic change.\n\nImmunohistochemical staining demonstrated focal gliofibrillary acidic protein expression and the presence of gemistocyte-like cells. Approximately 10% of tumor cells showed overexpression of p53. The proliferation index, assessed using MIB-1 staining, ranged between 6% and 30% in more active regions of the tumor.\n\nGenetic testing revealed the presence of a methylated MGMT promoter. No allelic loss was detected on chromosome arm 1p. There was partial deletion on chromosome arm 19q based on loss of heterozygosity at one marker (PLA2G4C), although this was not definitive across all loci.\n\nThe tumor measured up to 2.0 cm in aggregate across both specimens, with one fragment measuring 0.9 cm. Tissue consistency was semi-firm with glistening surfaces in one specimen and soft with focal hemorrhage in the other.\n\nAdditional molecular assays were performed for diagnostic clarification and therapeutic guidance."} +{"pid": "TCGA-AC-A6IV", "report": "The patient is female. A right breast mastectomy specimen was evaluated. A firm gray-tan mass measuring 2.2 cm in greatest dimension was identified within the breast tissue, located 1.5 cm from the deep margin and 2.7 cm from the closest lateral margin. The tumor was assigned an architectural score of 3 of 3, a nuclear score of 2 of 3, and a mitotic score of 2 of 3, for a total score of 7 of 9, corresponding to Grade 2. No in situ component or angiolymphatic invasion was identified. All surgical margins were free of involvement, with the closest margin being the deep margin at 1.5 cm.\n\nA single lymph node from the right axillary sentinel node specimen was involved by tumor, with a focus measuring 0.3 cm in size. There was no evidence of extracapsular extension. Metastasis was confirmed by pancytokeratin staining.\n\nHormone receptor and proliferation marker analysis were performed. Estrogen receptor expression was positive, with 93% of cells showing strong staining intensity. Progesterone receptor expression was also positive, with 60% of cells showing strong staining. Ki-67 immunostaining showed a high proliferation index at 32%. HER-2 testing by immunohistochemistry demonstrated equivocal (2+) staining, characterized by weak, circumferential membrane staining in more than 10% of cells or less than 30% with strong complete membrane staining. Reflex testing with FISH is in progress and will be reported separately.\n\nAll assay conditions were met, including appropriate cold ischemia time and fixation parameters. Controls demonstrated appropriate reactivity. The specimen was processed under standard formalin fixation and paraffin-embedding protocols, and staining was performed using automated systems. Immunohistochemical analysis included the use of specific primary antibodies for ER, PR, Ki-67, and HER-2/neu, with detection via an indirect biotin-streptavidin system. Antigen retrieval was performed using a tris-based buffer with heat-induced epitope retrieval.\n\nStaging was determined as T2pN1. The clinical history included a preoperative diagnosis of invasive mammary carcinoma with ER and PR positivity and HER-2 negativity. The postoperative diagnosis was based on radiologic findings and operative procedure details, which included a right modified radical mastectomy with sentinel node mapping and frozen section analysis. The specimens received included the right breast and a sentinel lymph node from the right axilla. Gross evaluation of the breast specimen revealed a fibroadipose tissue sample with a well-defined mass, while the axillary lymph node specimen contained a single lymph node with metastatic involvement."} +{"pid": "TCGA-60-2724", "report": "The specimen consisted of multiple lymph nodes and a right carinal pneumonectomy specimen. The 4R lymph node specimen included two fibrofatty tissue fragments measuring 0.3 x 0.2 x 0.2 cm and 0.1 x 0.1 x 0.1 cm; the larger fragment was bisected. Touch preps were taken, and the specimen was submitted entirely for frozen section. The level 7 lymph node measured 0.4 x 0.2 x 0.1 cm and was also submitted entirely with touch preps taken. Frozen section analysis showed no malignancy in either lymph node specimen.\n\nThe right carinal pneumonectomy specimen encompassed all three lobes and a portion of the main bronchus, measuring 24 x 17 x 6 cm and weighing 882 grams. The bronchus measured up to 3.0 cm in diameter. A mass measuring 6.0 x 4.5 x 4.0 cm was identified in the bronchus; it was firm, gray-tan, and discrete without gross necrosis or hemorrhage. No involvement of the pleural surface was observed. The tumor extended into the middle lobe and part of the upper lobe but was not identified in the lower lobe. A separate necrotic area measuring 3.5 x 2.5 x 2.5 cm was found in the upper lobe, approximately 2.0 cm away from the main lesion. Additionally, a hemorrhagic area measuring 4.0 x 3.0 x 2.0 cm was present in the upper lobe superior to the necrotic region. Multiple subpleural blebs were noted in the upper lobe, and diffuse firmness was observed in the upper lobe parenchyma compared to the middle and lower lobes.\n\nMargins were assessed microscopically: the inferior and lateral bronchial margins were negative for malignancy. The superior margin was grossly negative and located 1.5 cm from the tumor. Histologic examination revealed moderately differentiated features within the tumor. Extensive necrosis and intrabronchial hemorrhage were also present. Peribronchial lymph nodes showed evidence of involvement (3 out of 39 lymph nodes positive). Lymph nodes at levels 7 and 9 were reactive and did not show any signs of malignancy.\n\nThe pathological staging was determined as pT3 N1 MX. Non-neoplastic findings included emphysematous changes, pneumonia, and hemorrhage in the lung tissue."} +{"pid": "TCGA-RC-A7SH", "report": "The specimen consists of a right liver lobectomy measuring 16x12x8 cm and weighing 800 grams. The external surface demonstrates a large mass beneath the capsule. The resection margins, both parenchymal and vascular, are free of tumor involvement. Upon sectioning, a solitary nodular lesion measuring 7.5x6.5x4 cm is identified, located 5.5 cm away from the parenchymal margin. The lesion exhibits perinodular extension. The surrounding liver tissue shows signs of chronic hepatitis related to hepatitis B virus infection, with minimal lobular inflammation and septal fibrosis, but no cirrhosis or dysplastic nodules.\n\nHistologically, the lesion displays a mix of macrotrabecular, microtrabecular, and pseudoglandular patterns. The tumor cells are of hepatic origin with clear cytoplasm. There is no tumor necrosis or fatty change; however, hemorrhage is present in less than 5% of the tumor area. A partial fibrous capsule is noted, with infiltration into the capsule and septum formation observed. Microvascular invasion is present, although there is no invasion of the portal vein, hepatic veins, hepatic artery, bile ducts, or serosa. No satellite nodules, intrahepatic metastasis, or multicentric occurrence is identified. The surgical margins are clear with a distance of 5.5 cm from the tumor.\n\nLymph node examination reveals no metastasis (pN0). Immunohistochemical staining shows positivity for cytokeratin 7 in bile ducts and focal positivity in parts of the lesion. Cytokeratin 19 is negative. Hepatocyte marker is positive, while iron staining is negative.\n\nAdditional specimens include a gallbladder measuring 8 cm in length with a wall thickness of 0.2 cm, showing no pathological abnormalities. A segment of lymph nodes and a piece of adipose tissue labeled as falciform ligament also show no pathological findings. Representative sections from all tissues have been embedded and stained with various histochemical and immunohistochemical markers including H&E, Masson\u2019s Trichrome, reticulin, PAS, iron, and cytokeratin stains."} +{"pid": "TCGA-YU-A90S", "report": "The specimen involved the left testis. The neoplasm measured 0.9 x 0.7 x 0.7 cm. No evidence of sanguineous, lymphatic, or perineural vascular invasion was identified. There was no intratubular neoplasia present. The rete testis, tunica albuginea, and spermatic cord were not involved by the neoplasm. Focal atrophy was noted in the adjacent testicular parenchyma. The margins of the spermatic cord and the end of the inferior pole of the left testicle were free of neoplastic involvement."} +{"pid": "TCGA-EM-A22I", "report": "The thyroid specimen measured 5.0 \u00d7 2.4 \u00d7 1.6 cm on the right lobe, 4.4 \u00d7 2.6 \u00d7 1.7 cm on the left lobe, and 3.6 \u00d7 1.2 \u00d7 0.7 cm in the isthmus, with a total weight of 17.7 grams. The specimen showed multiple tumor foci, involving both lobes and the isthmus, with the largest lesion located in the left lobe measuring 2.1 \u00d7 2.1 \u00d7 1.6 cm. A second nodule in the right lobe measured 1.7 \u00d7 1.0 cm, and an additional microcarcinoma in the isthmus measured 0.7 cm. Histologically, the tumors displayed classical papillary architecture and cytomorphology, with one nodule also showing follicular variant features. Tumor margins were involved bilaterally, and capsular invasion was present in a widely invasive pattern. No definitive lymphovascular or perineural invasion was identified, although there were suspicious foci. Minimal extrathyroidal extension was noted in the dominant left-sided tumor. One lymph node from the isthmus was negative for involvement. A parathyroid gland on the left was infiltrated by similar-appearing tumor cells, while the other parathyroid appeared unremarkable. Focal nonspecific thyroiditis and changes related to palpation were also present. Based on AJCC/UICC TNM staging (7th edition), the tumor was classified as pT3 with no regional lymph node involvement (pN0). The gross examination confirmed the presence of multiple well-defined nodules within the thyroid with no identifiable parathyroid or lymph nodes."} +{"pid": "TCGA-KT-A7W1", "report": "The specimen was obtained from a right brain tumor. Tissues were submitted for analysis, including both intraoperative consultation and permanent sections. Specimen #1 consisted of seven small fragments of tan-pink, soft to rubbery tissue, each measuring approximately 0.2 cm in greatest dimension. A representative section was used for frozen section microscopy and later forwarded for permanent processing. The remaining portion of this specimen was submitted for further study. Specimen #2 was an aggregate of tan-pink, soft to rubbery tissue measuring 1.5 x 1.0 x 0.8 cm. A portion of this specimen (approximately 170 mg) was used for research studies, with the remainder submitted entirely for histologic evaluation.\n\nMicroscopic examination revealed a diffusely infiltrating, highly cellular glial tumor. The nuclei were elongated and pleomorphic, with karyorrhexis noted. Scattered mitotic figures were present. There was no evidence of endothelial proliferation or tumor necrosis. Immunohistochemical staining showed strong positivity for GFAP. The MIB-1 nuclear proliferative marker demonstrated an estimated labeling index of 5\u201310%. Staining for IDH 1 was negative."} +{"pid": "TCGA-85-8277", "report": "The specimen consists of a pulmonary tissue sample measuring 10 x 10 x 8 cm. Microscopic examination reveals abnormal cellular proliferation involving the visceral pleura. Metastatic involvement is identified in all four intrathoracic lymph nodes assessed. No definitive conclusions were reached regarding lymphatic or venous invasion, tumor grade, or surgical margins. The tumor was located in the left upper lobe. No additional findings or comments were provided."} +{"pid": "TCGA-DD-AAVR", "report": "The specimen consists of a right hemihepatectomy. A nodule measuring 2.5 x 2.5 x 2.2 cm is present, with a gross appearance described as nodular and perinodal extension noted. There is no satellite nodule identified. Histologically, the lesion demonstrates trabecular and compact growth patterns. The cellular morphology corresponds to a classic cell group. According to the Edmondson and Steiner grading system, the worst histologic grade observed is grade 3, while the major differentiation is grade 2. Fatty change is present in approximately 2% of the tissue. There is no evidence of hemorrhage or peliosis, tumor necrosis, or vascular invasion. A partial capsule is present, and there is infiltration of the capsule. Septal formation is also present. No involvement of major branches of the portal or hepatic veins, bile ducts, or serosa is seen. The surgical margin is clear, with a safety margin of 0.8 cm. There is no intrahepatic metastasis or multicentric occurrence identified. Pathologic staging according to AJCC criteria includes pT1 and pT2 classifications. No related biopsy was submitted.\n\nAdditional findings include cirrhosis, which appears inactive, and no dysplasia is detected. A separate cholecystectomy specimen shows chronic cholecystitis, mild in degree."} +{"pid": "TCGA-BH-A0DE", "report": "A single lymph node was examined from each of two sentinel lymph node biopsies on the left side, and no abnormal cells were identified in either. A segmental mastectomy specimen included multiple sections for evaluation. One focus of abnormal tissue was identified measuring 2.5 cm in greatest dimension. The cells showed moderate nuclear atypia with a moderate level of mitotic activity. Architectural features included both cribriform and solid patterns, present in two of nineteen sections. No evidence of vascular space invasion was seen. The closest margin was involved by abnormal cells at a distance of 0.4 cm, located in the upper outer and lower outer areas of the specimen. Additional findings included a benign papillary lesion with epithelial proliferation. Hormone receptor analysis demonstrated reactivity for estrogen and progesterone receptors, while HER-2 staining showed minimal or no reactivity. The histologic grade was determined based on differentiation scores, with a final score indicating intermediate differentiation. Malignant-type calcifications were noted in areas of interest. Two lymph nodes were evaluated using standard staining techniques and showed no involvement. The pathologic staging was classified as pT2 for the primary lesion, with no nodal involvement (pN0)."} +{"pid": "TCGA-EY-A1GE", "report": "A right salpingo-oophorectomy specimen includes a 9.3 x 9.2 x 2.1 cm cyst weighing 127.5 grams with smooth, glistening external surfaces and unilocular thin serous fluid internally, without papillations or solid areas. A fallopian tube measuring 7.5 x 0.6 cm is attached, showing no significant histopathologic changes. The left ovary measures 2.4 x 1.2 x 0.9 cm with smooth tan-pink surface and unremarkable cut surface. Microscopic findings include endometriosis, epithelial inclusion cysts, and stromal hyperplasia. The left fallopian tube is patent with no diagnostic abnormalities.\n\nThe hysterectomy specimen shows a pear-shaped uterus weighing 450 grams, measuring 15.5 cm in height, 7.5 cm in anterior-posterior width, and 10.5 cm in fundal breadth. The cervix has an endocervical canal length of 3.7 cm and contains a 2.4 x 1.4 x 0.6 cm endocervical polyp. The endometrial cavity measures 7.7 cm in length and 6.5 cm in width at the fundus. A lesion measuring 8 x 7.5 x 2.5 cm is present on both anterior and posterior surfaces, extending to the lower uterine segment but not involving the endocervical canal. The myometrium is thinned without intramural masses or nodules, and no invasion is observed. Microscopically, the tissue demonstrates complex architectural patterns with nuclear atypia; however, the extent of the lesion remains confined to the endometrium. No invasion is identified in the myometrium, serosa, lower uterine segment, cervix, or adnexa.\n\nMargins are widely negative. Acute and chronic inflammation and benign endocervical polyps are noted in the cervix. Adenomyosis is present in the myometrium. Immunohistochemical analysis of the lesion shows approximately 80% of cells with moderate (2+/3) nuclear staining for estrogen receptor, and 10\u201320% of cells with weak to moderate (1+ or 2+/3) nuclear staining for progesterone receptor. Lymphovascular space invasion is not identified.\n\nA total of 37 regional lymph nodes are examined: five from the right peri-aortic region, five from the left peri-aortic region, twelve from the right pelvic region, and fifteen from the left pelvic region. No carcinoma is found in any of these lymph nodes. The clinical staging, based on the available information and updated 2008 FIGO classification, indicates pT1a pNO pMx, corresponding to a pathologic stage grouping of IA. These findings are subject to change pending further review and additional data."} +{"pid": "TCGA-C5-A1MQ", "report": "Patient ID: Consult Report. Inside/Outside. F. DOS: Hospital #;. Accessioned: DIAGNOSIS. CERVIX, BIOPSY. A histologic evaluation was performed. Sections demonstrate sheets and poorly formed cords of enlarged, pleomorphic cells. Mitotic figures and apoptotic bodies are abundant. Necrosis is present. Focal definitive keratinization is observed. The patient is a woman with a prior history of HSIL on Pap smear and severe dysplasia. Materials received include one slide accompanied by a corresponding pathology report. The material originates from I. Digitally scanned and saved for our Gies. A diagnosis was made based on personal examination of the slides and/or other materials indicated."} +{"pid": "TCGA-A3-3335", "report": "The surgical pathology report describes a right radical nephrectomy specimen weighing 597.5 grams and measuring 11.5 x 9.8 x 6.0 cm. The specimen is covered by a gray capsule with minimal surrounding adipose tissue. A segment of ureter, 5.5 x 0.4 cm, is identified at the hilum and appears uninvolved. A segment of artery and vein is also present, each with a patent and unremarkable lumen.\n\nA well-defined, bulging mass measuring 8.2 x 6.1 x 6.0 cm is present within the kidney. On sectioning, the mass has a firm, yellow, focally hemorrhagic, lobular cut surface. It is located adjacent to the renal capsule and pelvis but does not extend into the surrounding adipose tissue. The remaining renal parenchyma is congested with a poorly defined corticomedullary junction.\n\nA partial adrenal gland measuring 1.7 x 1.5 x 0.3 cm is attached to the main specimen and is 0.4 cm away from the lesion. It shows a normal-appearing cortex and medulla and is not involved by the lesion. A separate partial adrenalectomy specimen is also submitted, showing normal architecture.\n\nMargins including ureteral, vascular, and inked surgical margins are all free of malignancy. No lymphovascular invasion is identified, and no lymph nodes are present in the specimen. The tumor is confined to the kidney without involvement of the peri-pelvic fat. The AJCC classification is T2NXMX. Multiple representative sections are submitted for histologic evaluation, including areas of the lesion, surrounding parenchyma, margins, and adrenal interface."} +{"pid": "TCGA-G3-A3CI", "report": "The specimen includes a gallbladder and a portion of liver. The gallbladder is slightly congested, measuring 7.0 x 3.0 x 1.5 cm, with a smooth serosal surface. The mucosa appears green and velvety, with bile present. The wall thickness averages 0.2 cm. Microscopic evaluation shows minor patchy chronic inflammation in the mucosa and focal mild subserosal fibrosis, with no atypia identified.\n\nThe liver specimen weighs 245 grams and measures 15.0 x 5.5 x 7.5 cm. A tan, lobulated, circumscribed mass measuring 5.5 x 4.5 x 6.5 cm is present, located subcapsularly. The mass has a lobulated appearance on the capsule and comes within 0.5 cm of the blue-painted resection margin. The surrounding liver tissue shows a vague nutmeg appearance but is otherwise unremarkable. Histologically, the mass forms sheets of cells with abundant cytoplasm and variable nuclear atypia, including nucleoli and patchy hyperchromasia. Cytoplasmic intranuclear inclusions are prominent. Areas of granular eosinophilic cytoplasm, clear cell change, and fatty change are observed. Focal sinusoidal architecture and intra-sinusoidal collections of extramedullary hematopoiesis are present. There are areas of hemorrhage, edematous degeneration, and focal necrosis. The tumor interface with surrounding tissue varies from well-defined to more diffuse, without evidence of vascular invasion. Evaluation confirms a clear margin of approximately 0.5 cm.\n\nThe adjacent liver tissue shows mild patchy chronic inflammation in portal tracts and focal mineral oil lipogranulomas. No significant fibrosis or cirrhosis is present."} +{"pid": "TCGA-D1-A2G5", "report": "The specimen includes a uterus with right and left ovaries and fallopian tubes. The right ovary measures 2.0 x 1.9 x 1.3 cm and is attached to an 8.8 cm segment of fallopian tube. The left ovary measures 3.2 x 2.1 x 1.3 cm and is attached to an 8.5 cm segment of fallopian tube. The total weight of the uterus and adnexal structures is 200.0 grams. Additional submitted tissues include abdominal skin and subcutaneous tissue (2305.0 grams), multiple pelvic and para-aortic lymph nodes, and the right gonadal vessel measuring 10.2 cm in length.\n\nA polypoid mass measuring 8.4 x 3.5 x 2.4 cm is present within the endometrial cavity. This lesion demonstrates microscopic involvement of one right external iliac lymph node out of five examined. No angiolymphatic invasion is identified. The lesion extends 0.4 cm into the myometrium, which has a total thickness of 2.0 cm. Two intramural leiomyomata are noted, measuring 2.3 cm and 1.2 cm in greatest dimension. There is no involvement of the cervix. No diagnostic abnormalities are found in the right or left fallopian tubes or ovaries. \n\nExamination of lymph nodes reveals that all left pelvic lymph nodes (4 external iliac, 2 internal iliac, 5 common iliac, and 7 obturator) are negative for tumor involvement. In the right pelvis, 5 external iliac lymph nodes were examined, and one contained a microscopic focus of adenocarcinoma; the remaining right pelvic lymph nodes (2 internal iliac, 3 common iliac, and 9 obturator) were negative. Para-aortic lymph nodes above and below the inferior mesenteric artery (5 right and 5 left above, and 3 right and 2 left below) were also negative. The right gonadal vessel does not show any evidence of tumor involvement.\n\nGross examination of abdominal skin and subcutaneous tissue did not reveal any notable findings. Deeper permanent sections confirmed the presence of a metastatic focus in one right external iliac lymph node. All other previously examined lymph nodes and tissues remained negative upon review."} +{"pid": "TCGA-06-0178", "report": "The surgical specimens include four tissue samples from the frontal region and deep frontal area. Gross examination reveals multiple fragments of brain tissue varying in size from 1.5 x 1.0 x 0.8 cm to 3.5 x 3.0 x 1.5 cm, with combined weights ranging from 1.5 grams to 4.6 grams. The tissues are described as gray-tan, red-tan, or brown in color, with some having a soft consistency.\n\nMicroscopic evaluation shows extensive involvement of cerebral cortex and white matter by a glial neoplasm. The lesion demonstrates marked nuclear atypia, increased mitotic activity, and areas of microvascular proliferation. Necrosis is also present in focal regions. The cellular infiltration is widespread, affecting all submitted specimens with both solid and infiltrative growth patterns observed. Tissue architecture is significantly disrupted in all samples."} +{"pid": "TCGA-86-8054", "report": "The specimen consisted of lung tissue from a right upper lobectomy. The tumor measured 6 x 6 x 7 cm. Microscopic evaluation revealed a histologic type consistent with acinar cell morphology, showing poor differentiation. Lymph node assessment identified 3 out of 13 nodes positive for involvement. No definitive information was provided regarding tumor extent, presence of additional nodules, lymphatic or venous invasion, margins, neo-adjuvant treatment effect, or other significant pathologic findings."} +{"pid": "TCGA-A3-3372", "report": "The specimen consists of a left nephrectomy weighing 1190 grams and is surrounded by a large amount of perinephric adipose tissue with moderate Gerota\u2019s fascia present. The reconstructed specimen measures 28.8 x 14.6 x 10.0 cm. Resection margins include a 2.1 cm segment of grossly patent renal artery, a 2.6 cm segment of grossly patent renal vein with staple lines and surgical clips, and 9.6 cm of grossly patent ureter. An adrenal gland measuring 7.1 x 2.6 x 1.5 cm is identified within the adipose tissue and appears grossly unremarkable.\n\nAfter removal of the capsule, the kidney measures 12.7 x 8.0 x 7.8 cm and displays a lobulated tan-brown cortex. A well-defined, thinly encapsulated lesion measuring 6.9 x 5.5 x 5.3 cm is located in the lateral aspect of the lower pole extending into the central portion. The lesion has a gray-tan to yellow appearance with a markedly hyalinized cut surface and areas of lobulated yellow fleshy tissue. Hemorrhagic areas are also noted. The lesion extends beyond the renal parenchyma into adjacent adipose tissue, with its closest point within 0.2 cm of the fatty margin. One lobulation measuring 1.5 cm appears to breach the capsule into surrounding adipose tissue. The remaining renal parenchyma is compressed with vascular structures appearing markedly compressed near the capsule. The cortex is up to 0.5 cm thick and homogeneous in appearance. The corticomedullary junction is distinct, and the medulla appears slightly hyalinized with a tan-gray to brown color. The calyces and pelvis are lined with smooth tan-white mucosa extending into the ureter.\n\nMicroscopic evaluation confirms involvement of perinephric adipose tissue by a neoplastic process. Nuclear grading corresponds to Fuhrman grade 2/4. There is no evidence of lymphovascular space invasion or renal vein involvement. Transcapsular extension is observed. All surgical margins\u2014including soft tissue, ureteral, and vascular\u2014are negative for neoplastic involvement. Adrenal gland tissue appears benign without any signs of metastatic involvement. Chronic pyelonephritis is also noted.\n\nStaging is determined as pT3NXMX based on microscopic extension into perinephric adipose tissue. Representative sections were submitted from margins, lesion and surrounding tissue, uninvolved parenchyma, and adrenal gland. Intra-operative consultation findings are confirmed on permanent sections."} +{"pid": "TCGA-V4-A9EL", "report": "Left eye enucleation specimen. The eyeball measures 25 by 25 by 23 mm and includes a posterior segment of the optic nerve measuring 5 mm in length. On sectioning, a lesion is identified with a maximum dimension of 18 mm. Samples were obtained for genetic analysis and subsequently fixed; the entire specimen has been processed. Microscopic evaluation reveals a tumor composed predominantly of epithelioid cells with frequent pigmentation of the cytoplasm. Significant nuclear and cytoplasmic atypia are present. Large areas of central necrosis and hemorrhage are observed. The lesion is situated away from the optic foramen and does not involve the optic nerve along its course; the cut end of the optic nerve is uninvolved. The tumor extends through the full thickness of the sclera; however, there is no extension beyond the sclera. An intra-scleral endovascular tumor embolism is identified. The ciliary body, iris, and anterior chamber show no evidence of tumor involvement."} +{"pid": "TCGA-37-5819", "report": "The specimen was obtained from a lung tissue sample collected in an upper right anatomical location. The tumor tissue weighed 450 mg and was preserved in a frozen format within one container. A separate blood sample, measuring 4 mL, was also collected and stored frozen. Histological evaluation of the tumor demonstrated a cellular composition with approximately 70% tumor cells present. No prior chemotherapy or hormonal therapy was documented. The tumor exhibited a histological grade of 2 and a TNM staging classification indicating T3, N2, M0. The surgical margins were assessed as normal. No additional details regarding treatment or tumor morphology were provided."} +{"pid": "TCGA-B5-A3FC", "report": "The specimen consists of a uterus weighing 106.25 grams, including bilateral fallopian tubes and ovaries. The uterus measures 9 x 5 x 4 cm, with a cervix measuring 3.4 cm in diameter and a widely patent cervical os measuring 1.2 cm. The endometrial cavity is 3 x 4 cm. The endometrium has a regular surface with an area of soft, red-tan, sessile, and slightly exophytic papillary tissue measuring up to 4.5 x 3.3 cm. This lesion occupies approximately 75% of the endometrium, predominantly located in the posterior wall, extending to within 0.9 cm of the internal os and at least 4.1 cm from the squamocolumnar junction. The remainder of the endometrium is thin, less than 0.1 cm, and focally hemorrhagic. On sectioning, the lesion appears superficial, measuring up to 0 cm in thickness, without gross involvement of the underlying myometrium, which is 2.0 cm thick and otherwise unremarkable. The uterine serosa is erythematous but otherwise normal.\n\nThe right fallopian tube is 6.5 cm long with a central diameter of 0.3 cm, showing a smooth, intact, glistening surface with diffuse erythema. The attached ovary measures 2.5 x 2.3 x 1 cm, with a slightly irregular, firm, yellow-tan surface and a grossly unremarkable cut surface. The left fallopian tube is 7 cm long with a central diameter of 0.3 cm, displaying a smooth, intact, erythematous serosal surface with fibrous adhesions at the fimbriated end adjacent to the ovary. The left ovary is yellow-tan, finely granular, with a small hemorrhagic 0.5 cm adhesion on the surface. The cut surface reveals a convoluted corpus luteum measuring 0.8 cm in diameter.\n\nMicroscopic examination included multiple sections from various areas of the uterus, cervix, and adnexa. Histologic evaluation revealed findings consistent with prior sampling. The remaining myometrium, cervix, serosa, and specimen margins showed no pathological changes. Both ovaries and fallopian tubes demonstrated no pathological diagnosis. Non-neoplastic endometrial findings include polyps and atrophy. No lymphatic or vascular invasion was identified. The maximum depth of myometrial invasion was 0 cm in a 2.0 cm thick wall."} +{"pid": "TCGA-K7-A6G5", "report": "A specimen was received from the gallbladder and right lobe of the liver. The gallbladder measured 10 cm in length and 2.8 cm in diameter, with a 1.5 cm cystic duct. The mucosa appeared velvety and dark green, and no gallstones or focal lesions were identified. A single lymph node with lipogranulomas was noted among two lymph nodes examined; none showed involvement.\n\nThe right lobe of the liver was submitted in two portions. One fragment measured 2.5 x 2 x 0.2 cm and was described as firm and pale tan. The larger specimen measured 15 x 15 x 7 cm and included a resection margin inked black. On sectioning, the hepatic parenchyma was uniformly pale brown without nodularity. A solitary, well-demarcated, white nodule measuring 2.2 cm was identified adjacent to the hepatic capsule. It was separated from the resection margin by at least 0.5 cm of grossly normal tissue. Histologically, the lesion showed well to moderately differentiated cellular features with focal infarction. No macroscopic venous invasion or microscopic small vessel/lymphatic invasion was observed. Histologic grade was 1\u20132 of 4. No satellite lesions were present.\n\nThe tumor was confined to the liver and staged as pT1, pN0, pMx. The adjacent liver showed moderate steatosis, mild portal inflammation, and minimal periportal and lobular changes consistent with chronic hepatitis, graded 1/4 and staged 1\u20132/4. No cirrhosis or significant fibrosis was seen. Minimal iron deposition was noted in hepatocytes.\n\nSpecial stains including trichrome, reticulin, and iron were performed. Immunohistochemical studies showed positivity for HepPar and glypican-3, while CEA polyclonal staining demonstrated a canalicular pattern. These findings supported the morphologic assessment. All margins were uninvolved. Based on UNOS criteria, this lesion met both stage 1 (unifocal <2 cm) and stage 2 (unifocal <5 cm) classifications."} +{"pid": "TCGA-AN-A0AS", "report": "JB: Female. Histological description indicates a neoplastic lesion with features of infiltrative growth. The tumor is located in the left breast and is identified as a primary lesion. Tissue analysis was performed on a frozen specimen obtained via radical mastectomy. The tumor measures within stage 2 based on size and local extension. Regional lymph node involvement is consistent with stage 2a, with no evidence of distant metastasis (stage 0). The histologic grade is moderate (grade 2). No prior treatment was administered. A normal sample was also collected from the blood via standard phlebotomy. The blood specimen was frozen and stored in a tube."} +{"pid": "TCGA-LD-A7W5", "report": "The specimen from the left breast, 2 o\u2019clock position, measured 2.8 cm in invasive component and was unifocal. Histologic evaluation revealed ductal carcinoma with focal lobular features. Nuclear grade was III of III. Histologic grade according to EEmSBR criteria was II of III (tubules score 2, nuclear grade score 3, mitoses score 1). An in-situ component was identified as ductal carcinoma in situ (DCIS) of solid and cribriform types, nuclear grade III, with comedonecrosis. Lymph node sampling revealed twenty-three lymph nodes containing metastatic carcinoma, all positive (23/23), with extranodal extension present; the largest measured 3.7 cm. The tumor was located near the posterior/superior margin focally and had a medial margin distance of 0.5 mm; other margins were widely negative. Lymphovascular invasion was present. Microcalcifications were identified in association with both in situ and invasive components. No skeletal muscle or nipple/skin involvement was noted. A separate specimen from the deep margin showed a 2 mm focus of residual invasive carcinoma, located 4 mm from the final deep margin. Background tissue showed proliferative breast parenchyma with intraductal papilloma. Radiographic imaging documented a mass, clip, and localization wire. Serial sectioning identified a stellate, gray-white mass measuring 2.4 x 2.3 x 2.2 cm within slices #4\u20138. Gross measurements indicated the lesion approached within 0.5 cm of posterior and superior margins. Specimen orientation included inked margins for identification. Staging categories indicated pT2, pN3a. Clinical staging was cT2, cN1. Multiple sections were submitted for microscopic evaluation focusing on margins and representative lymph node sampling."} +{"pid": "TCGA-B8-5550", "report": "The biopsy and subsequent nephrectomy specimen demonstrate a mass within the right kidney. Histologic evaluation reveals cells characteristic of a malignant neoplasm, with nuclear features corresponding to grade 3 according to the Fuhrman scale. The tumor measures 10.1 cm in greatest dimension and is unifocal without multicentric lesions identified. Gross examination reveals that the tumor extends into the renal vein but does not involve the perirenal adipose tissue, Gerota\u2019s fascia, or ureter. Microscopic evaluation confirms involvement of the renal vein margin while other surgical margins, including peri-nephric soft tissue, renal artery, and ureter, are negative. \n\nLymph nodes from the hilar region were evaluated and no evidence of metastatic disease was found. Additional findings include mild benign nephrosclerosis. No sarcomatoid differentiation is observed. The tumor exhibits a rounded yet infiltrative growth pattern with yellow-tan coloration, areas of necrosis and hemorrhage, and prominent fibrosis. It involves both superior and inferior aspects of the kidney while remaining confined within the organ. Sections submitted include representative tumor tissue, adjacent normal parenchyma, margins, hilar fat, and vascular and ureteral regions. \n\nBased on available data, staging criteria classify the extent as T3a pNO pMx; however, this may be revised pending further clinical correlation."} +{"pid": "TCGA-AG-3728", "report": "The specimen includes two distinct lesions. The first lesion is located in the rectum and measures 3.5 cm at its widest diameter. It is an ulcerated tumor with moderately differentiated histological features. The tumor extends into the periproctic fatty tissue and approaches within 3 cm of the aboral resection margin. The second lesion is situated in the colon, measuring 2 cm in diameter, also moderately differentiated, and invades up to the muscularis propria. It is located 4 cm from the oral resection margin, with both oral and aboral margins free of tumor involvement.\n\nEvaluation of lymph nodes reveals that three out of nineteen periproctic and mesocolic lymph nodes contain metastatic deposits. In some instances, the metastases extend beyond the lymph node capsule. Tumor staging for the rectal lesion corresponds to pT3 with moderate differentiation (G2), while the colonic lesion is staged as pT2 with higher-grade differentiation (G3). Lymph node involvement is classified as pN1 with a lymphovascular invasion score of LO V0."} +{"pid": "TCGA-2Y-A9GS", "report": "The specimen consisted of a liver lesion from segment 6, a gallbladder, and an additional liver margin. The liver lesion measured 6.0 x 5.0 x 4.5 cm and was described as a moderately firm, gray-white nodular mass with ill-defined borders. Approximately 25% necrosis and hemorrhage were noted on the cut surface. The tumor was in close proximity to the surgical margin. Histologically, the lesion showed moderately differentiated cellular features with clear cell morphology. No perineural invasion was identified; however, lymphovascular invasion was present.\n\nThe gallbladder specimen was disrupted and glove-shaped, measuring 7.5 x 3.0 x 2.0 cm. The serosal surface was congested and gray-red. No calculi were identified. There was some thickening of the wall, and the mucosal surface was gray-yellow with fine reticulation. A stapled margin was removed and marked with black ink.\n\nThe additional liver margin specimen was an irregular fragment measuring 4.5 x 3.0 x 3.0 cm. The surgical margin was stapled, removed, and entirely submitted for analysis. Serial sections showed no evidence of tumor involvement at the surgical margin. The surrounding hepatic parenchyma demonstrated chronic hepatitis with moderate interface hepatitis and mild to moderate lobular inflammation. Bridging fibrosis was present, consistent with cirrhosis. Mild macrovesicular steatohepatitis was also noted. No lymph nodes were identified.\n\nFrozen section analysis of the liver lesion revealed involvement of the surgical margin. Representative permanent sections were submitted for further evaluation. Pathologic staging was determined as T2 NX MK. All specimens were reviewed by the attending pathologist."} +{"pid": "TCGA-UW-A72J", "report": "The left kidney specimen from a partial nephrectomy was received as a 5.2 x 4.7 x 3.4 cm tissue block weighing 35 grams, including a small amount of attached perinephric fat. The tumor measured 5.1 x 3.4 x 2.2 cm and was identified as a solid, variegated, orange/yellow/tan cortical nodule. It expanded the renal capsule focally but did not grossly breach it. The mass was in proximity to the blue inked parenchymal margin, with approximately 1 mm distance noted. Adjacent renal parenchyma appeared compressed but otherwise unremarkable. The perinephric fat showed no significant changes.\n\nHistologic evaluation revealed a unifocal lesion composed of solid sheets of eosinophilic and clear cells with focal perinuclear clearing. Microscopic examination of surgical margins demonstrated that the renal parenchymal margin was negative, although closely approached. The renal capsule and perinephric adipose tissue margins were not involved. No sarcomatoid features, large vessel venous invasion, or small vessel lymphatic invasion were identified.\n\nImmunohistochemical staining demonstrated positivity for CK7, while stains for c-Kit and RCC were negative, supporting the morphologic findings. Cellular features were consistent with a neoplastic process, and histologic grade according to the Fuhrman classification was 3 of 4.\n\nStaging according to the AJCC system was determined as pT1b, based on the tumor size exceeding 4 cm but confined within the kidney without evidence of extracapsular extension. No lymph nodes or adrenal tissue were present for evaluation. The staging is provisional and may be subject to revision pending further clinical data."} +{"pid": "TCGA-DU-A76R", "report": "A 45-year-old male presented with mental status changes. Imaging revealed a partially cystic mass in the right temporoparietal region with calcifications.\n\nThe specimen consisted of two parts. Part A was a biopsy specimen measuring up to 2.7 cm in aggregate, composed of several fragments. The tissue was semifirm with tan-pink and yellowish areas. Microscopic examination showed a glial neoplasm with features resembling an \"oligodendroglial-like\" morphology. There was no evidence of nuclear atypia or mitotic activity in this portion.\n\nPart B was a resection specimen measuring up to 3.5 cm in aggregate. It was semi-firm with pinkish-yellow coloration and focal hemorrhage. Histologic evaluation demonstrated similar cellular features with one distinct focus showing increased mitotic activity, microvascular proliferation, tumor cell necrosis, and vascular karyorrhexis. These findings indicated a localized area of aggressive behavior within the lesion.\n\nImmunohistochemical staining showed sparse GFAP-positive gliofibrillary background with minimal expression in the neoplastic cells. p53 staining did not reveal overexpression. MIB-1 staining demonstrated a proliferation index of 8\u201310% in the more active regions.\n\nAdditional molecular studies were requested for further characterization and were pending at the time of reporting."} +{"pid": "TCGA-5T-A9QA", "report": "The specimen from the left breast includes a portion of fibroadipose tissue measuring 9.5 x 6.3 x 4.0 cm. A solid, ill-defined mass measuring 3.4 x 2.8 x 2.5 cm is present and extends close to the anterior and posterior margins. Margins are inked with black at the posterior and blue at the anterior. Sections are submitted in twelve cassettes including the mass and surrounding margins.\n\nA second specimen from the left breast measures 6.8 x 4.2 x 2.7 cm and contains an ill-defined area of induration measuring approximately 2.0 x 1.5 x 1.5 cm located posteriorly, extending close to the inferior, lateral, and medial margins. Margins are inked with black on the lateral, blue on the medial, yellow on the superior, green on the posterior, and orange on the inferior. Representative sections involving the indurated area and margins are submitted in fourteen cassettes.\n\nAdditional specimens include skin tags measuring up to 0.5 cm, submitted in one cassette.\n\nHistologic evaluation reveals cellular features including nuclear pleomorphism score of 3, mitotic rate score of 3, and glandular/tubular differentiation score of 3, resulting in an overall grade of 3 of 3. The tumor demonstrates a single focus with extensive involvement near the deep surgical margin and proximity within 0.5 mm of the anterior margin across two low power fields. Lymphovascular space invasion is identified. No lymph nodes are submitted for evaluation.\n\nThe tumor measures 3.4 cm in greatest dimension. Pathologic staging indicates pT2 for the primary tumor, with pNX for regional lymph nodes and no evidence of distant metastasis."} +{"pid": "TCGA-DX-A3U8", "report": "The submitted specimen included a left spermatic cord and left testis. The surgical specimen measured 13 x 1.2cm for the spermatic cord, and the testis measured 5.0 x 3.0 x 2.2cm. Two distinct, well-circumscribed nodules were identified adjacent to the spermatic cord. Nodule 1 measured 4.5 x 3.5 x 2.0cm and nodule 2 measured 3.5 x 2.8 x 1.5cm. On gross examination, both nodules had a fleshy, tan appearance with areas of central hemorrhage and approximately 15% necrosis. The tumor was located 0.1cm from the closest inked surface. Histologically, the tumor exhibited high-grade features with spindle and epithelioid morphology. Mitotic activity was present at a rate of 20 mitoses per 50 high power fields, and vascular invasion was identified. The tumor was found to be in close proximity to the soft tissue margin, within 1mm, but did not involve the spermatic cord margin. A separate tan nodule measuring 0.8 x 0.6 x 0.5cm in the adipose tissue was identified, interpreted as a benign lymph node. Microscopic evaluation showed no involvement of the testis, which displayed preserved spermatogenesis. The overlying skin showed a well-healed scar. Immunohistochemical staining demonstrated positivity for desmin and SMA, with rare nuclear staining for CDK4 and MDM2. Staining for myogenin was negative. No definitive component of well-differentiated liposarcoma was identified. Photographs and tissue processing sheets were completed. Sections examined included those from the spermatic cord margin, representative areas of both nodules, intervening tissue between the nodules, a nodule in adipose tissue, additional sections of the proximal and distal spermatic cord, testis, and skin with scar."} +{"pid": "TCGA-WW-A8ZI", "report": "The pathology report includes findings from a pelvic lymph node dissection and prostate resection. A total of four lymph nodes were identified: one from the right pelvic region and three from the left. All lymph nodes showed benign histology. The prostate measured 8 x 6.3 x 5.5 cm and weighed 131 grams. On gross examination, multiple pale yellow nodularities were observed, with the most prominent changes located in the left lateral region. There was focal extension to the capsule, particularly at the left apex, but no evidence of extraprostatic extension or invasion of the seminal vesicles.\n\nMicroscopically, the lesion demonstrated a primary and secondary pattern consistent with a high-grade morphology. The tumor involved approximately 33% of the prostatic tissue. Surgical margins were free of involvement. No treatment effect, lymph-vascular invasion, or perineural invasion was identified. The pathologic stage of the primary tumor was determined to be pT2c. Regional lymph node staging was pN0, as none of the four lymph nodes examined showed evidence of involvement. Distant metastatic staging was not assessable (pMX). Tissue was also collected for tumor banking and genomic analysis."} +{"pid": "TCGA-D1-A17B", "report": "A hysterectomy and bilateral salpingo-oophorectomy specimen included a uterus with attached fallopian tubes and ovaries. A mass measuring 4.0 x 2.7 x 2.7 cm was identified in the fundus, with a total myometrial thickness of 2.5 cm. Microscopic evaluation revealed that the lesion extended superficially into the myometrium, with a depth of invasion measuring 0.2 cm. There was no involvement of the endocervix, and no lymphovascular space invasion was observed. Surgical margins were free of any abnormal tissue.\n\nExamination of the bilateral ovaries and fallopian tubes showed no pathological findings. Lymph node dissections were performed on both pelvic sides. On the left side, 11 external iliac, 2 internal iliac, 2 common iliac, and 1 obturator lymph nodes were evaluated. On the right side, 11 external iliac, 1 internal iliac, 7 common iliac, and 6 obturator lymph nodes were assessed. Additionally, one more right pelvic common iliac lymph node was examined. All lymph nodes were negative for any abnormal cellular infiltration or metastatic involvement.\n\nThe gross examination of the uterus showed a smooth serosal surface. The right ovary measured 2.7 x 1.3 x 1.1 cm with a solid cut surface, and the right fallopian tube measured 9.0 x 0.5 cm. The left ovary measured 2.6 x 1.5 x 0.9 cm with a solid cut surface, and the left fallopian tube measured 7.5 x 0.5 cm. Adipose and lymphatic tissue aggregates from various pelvic regions were submitted for histologic evaluation, including left and right obturator, common iliac, internal iliac, and external iliac regions, with all findings unremarkable.\n\nThe final pathology report was based on macroscopic and frozen section histologic analysis of the submitted tissue blocks, which included sections from the uterine mass, cervix, endometrium, and bilateral adnexal structures, as well as comprehensive sampling of regional lymphatic tissue."} +{"pid": "TCGA-66-2787", "report": "The resected left upper lobe specimen measures 26 x 17 x 8 cm. The pleura is moderately thickened with reticulate patches and diffuse dark gray markings. A circumscribed thickening is noted at the apex, with adhesion residue medially and clip ligatures present. The bronchus is displaced centrally, located 5 mm proximal to the lingula bronchus bifurcation. A grayish-brown discolored mass is observed projecting from the ostium of B2. The outflow region of B2 is markedly elevated, up to 1.8 cm in thickness, filled with grayish-white solid tissue. The maximum extent of the lesion in this area is 2.6 cm. Infiltration of the bronchial wall is seen near the B1/2 division point, with severe twisting of the central section of B1; however, no detectable invasion into the lumen is identified.\n\nA lymph node adjacent to the distal upper lobe bronchus is found in a parabronchial position, marginally bordering the tumor. It shows black pigment on sectioning and no apparent infiltration. In segment 2, a large vascular branch is displaced by compact brownish-yellow to reddish material. A severely ectatic bronchial branch distal to the tumor in segment 2 is filled with pale yellow amorphous material. Centrally in segment 2, extending into segment 1, there is a thickening of the parenchyma with a brownish-yellow to pale gray-brown discoloration. Peripherally in segment 2, small subpleural induration foci are present, golden yellow and poorly defined. In the ventral apical region, a relatively sharply demarcated peripheral nodule measuring 7 mm is found in the mantle zone. Below the previously described adhesion zone, near the apex in segment 1, small pigmented subpleural lymph nodes are noted, measuring up to 4 mm. Ventrally in segment 1, extending into the border region of S3, a subpleural spongiform or honeycomb-like parenchymal structure is present with porous induration; isolated cysts or cystic systems are also observed, with the largest measuring up to 2 cm. The B3 region and bronchial bifurcations of the lingula appear clear to the periphery, with normal parenchymal section surfaces in the lingula.\n\nA pleura biopsy measuring 1.2 x 0.7 cm reveals a flat area with variable thickness (0.2\u20130.6 cm), featuring a whitish, rough nodule (0.5 cm) on one end of the surface. Lymph nodes examined include: a left lobar node (item 12, 0.8 cm), a left interlobar node (item 11, 0.5 cm), four left hilar nodes (item 10, 0.2\u20131 cm), a left pulmonary ligament node (item 9, 1 cm), and a left deep paratracheal node (item 4, 0.9 cm). All lymph nodes show blackish coloration and are accompanied by some surrounding tissue.\n\nHistological sections include the central bronchial resection margin, vascular displacement borders, two tumor sections with color marking of the peribronchial/hilar resection surface, extended bronchial sections distal to the tumor, and multiple blocks from peripheral portions of segment 2, small nodules in segment 1, subpleural lymph nodes, bullae, and areas of subpleural induration. Staining methods used include Elastica-van Gieson, PAS, and diastase-PAS. Intraoperative frozen section evaluation showed no tumor involvement at the bronchial resection margin, with only desquamated cells present in the lumen.\n\nMicroscopic findings demonstrate central and partially endobronchial growth of a histologically distinct cellular population characterized by poor differentiation and large cell morphology. The resection margins of the bronchus and vessels, hilar resection surface, visceral pleura, and all identified lymph nodes are free of tumor involvement. Peripheral to the central lesion, there is evidence of consecutive bronchiectasis in segment 2, with focal organizing retention pneumonia in both segments 1 and 2. Additional findings include focal subpleural bullous emphysema in segment 1, a small pulmonary hematoma, and a nonspecific subpleural scar at the interface of segments 1 and 3. The pleural biopsy reveals a nodular fibrous zone with partial calcification and hypocellularity. Lymph node status remains negative across all sampled regions."} +{"pid": "TCGA-DD-AADM", "report": "The liver specimen measured 13.0 x 7.0 x 6.5 cm and weighed 218.5 grams. A primary lesion was identified as an ill-defined multinodular confluent mass measuring 3.0 x 2.7 x 4.0 cm, along with two smaller separate nodules measuring 0.7 x 0.5 x 0.3 cm and 0.9 x 0.8 x 0.3 cm. The resection margins were not involved grossly, with a safety margin of 3.0 cm for the larger mass and 0.2 cm for the smaller mass. No satellite nodules were observed. The remaining liver parenchyma showed cirrhotic changes.\n\nMicroscopically, the lesion exhibited a trabecular and pseudoglandular growth pattern. The histologic grade was III based on the Edmondson-Steiner grading system, both for the worst and major differentiation. The tumor cells were of hepatic origin. No fatty change or fibrous capsule formation was identified, though septum formation was present. There was no evidence of surgical resection margin invasion, serosal invasion, portal vein invasion, or microvessel invasion. Intrahepatic metastasis could not be determined. Multicentric occurrence was noted. The tissue sample included multiple blocks from the tumor mass, surrounding liver parenchyma, resection margin, and additional nodule-like lesions."} +{"pid": "TCGA-ED-A7PX", "report": "Gross Description: The lesion is located in a lobe, with ill-defined margins measuring 5x4x4cm, soft, solid consistency with yellow-white coloration on cut surface. Microscopic Description: The cells arrange in trabecular, acinar, and sheet-like patterns, with infiltration of the capsule, vessels, or nerves. The cells exhibit a polygonal shape, with round, vesicular nuclei containing prominent nucleoli. The cytoplasm is present in moderate amounts and is either basophilic or vacuolated. Nuclear pleomorphism is marked with large, hyperchromatic nuclei and conspicuous nucleoli. Mitotic figures are identified. Areas of tumor necrosis are present. The stroma shows significant fibrous reaction and changes. Specimen type: Lobectomy. Tumor size: 5x4x4cm. Focality: Single lesion. Histologic grade: Poorly differentiated morphology. Tumor extent: Solitary lesion with vascular invasion observed. Lymph node status: Not specified. Venous invasion: Not specified. Surgical margins: Uninvolved. Neo-adjuvant treatment effect: Not specified. Additional findings: None reported."} +{"pid": "TCGA-BT-A20R", "report": "The patient underwent cystectomy. Examination of the right ureteral margin showed no evidence of in-situ or invasive malignancy. The left ureteral margin demonstrated mild urothelial atypia, which may represent low-grade intraurothelial neoplasia; however, no in-situ or invasive malignancy was identified at this site. A section of the bladder, urethra, and vaginal cuff revealed a high-grade lesion with micropapillary features. The largest dimension of the lesion measured at least 5.0 cm. Invasion was noted through the detrusor muscle with extensive involvement of the surrounding adipose tissue. Tumor cells were present at the resection margin in the perivesical adipose tissue at the posterior and dome regions of the bladder. Focal in-situ changes were observed in both ureters, but the ureteral resection margins were free of malignancy. The urethral margin also showed no evidence of malignancy. Angiolymphatic invasion was extensively present, and focal perineural invasion was noted. The vaginal wall did not show any tumor involvement. Lymph node examination revealed metastatic involvement in one of two nodes on the right and six of seven nodes on the left. The pathologic staging is pN1 with an unknown distant metastasis status. An incidental benign finding was noted in the perivesical adipose tissue measuring 0.8 cm. Microscopic evaluation confirmed the tumor\u2019s location in the trigone, left lateral wall, posterior wall, and dome of the bladder. Additional dimensions of the tumor included 4.5 cm and 1.4 cm. The lesion was histologically classified as high-grade urothelial carcinoma with a micropapillary variant. The tumor configuration was flat and ulcerated. Involvement of the adventitial or perivesical soft tissue margin was noted, and vascular invasion was present. There was no evidence of direct extension into other adjacent structures beyond the perivesical fat."} +{"pid": "TCGA-B9-4115", "report": "The right kidney specimen, weighing 950 grams and measuring 24 x 15 x 6.5 cm in total, contains multiple cortical tumor nodules. The largest nodule measures 4 x 3.8 x 3.0 cm and is located superiorly and midline; a second notable nodule measures 3.5 x 2.8 x 2.0 cm, with several smaller nodules scattered throughout the renal cortex. At least six distinct tumor sites are identified, indicating multicentricity. The tumors extend through the renal capsule and grossly involve the perirenal adipose tissue, although no involvement of Gerota\u2019s fascia, renal vein, or ureter is observed.\n\nHistologic evaluation reveals high-grade nuclear features corresponding to Fuhrman grade 3. Microscopic assessment of surgical margins demonstrates positivity in the perirenal adipose tissue, while the renal vein, renal artery, ureter, and Gerota\u2019s fascia margins are all negative for malignancy. No lymph nodes are identified in the hilar region or elsewhere within the specimen.\n\nAdditional findings include mild glomerulosclerosis and arteriolonephrosclerosis with interstitial fibrosis and focal chondroid metaplasia in the non-tumor renal tissue. The kidney otherwise maintains a pink/brown appearance with a distinct corticomedullary junction; cortical thickness measures approximately 0.9 cm and medullary thickness about 1.2 cm.\n\nStaging is assigned as pT1a, with no definitive regional lymph node (pNx) or distant metastasis (pMx) assessment possible based on available data. This staging remains subject to revision pending further clinical review."} +{"pid": "TCGA-K4-A3WV", "report": "The specimen included a radical cystectomy, total abdominal hysterectomy, and bilateral salpingo-oophorectomy, along with multiple lymph node samples. Lymph nodes from the left and right pelvic regions were each submitted as three separate fragments, with no evidence of malignancy identified in any of the six total nodes. One mesenteric lymph node was also negative for malignancy.\n\nThe distal ureters, both left and right, were examined and showed no evidence of abnormal cells. The bladder specimen measured 11 cm in length and contained a firm, pale tan mass located at the apex, measuring 3.5 x 3.5 x 3.5 cm. Histologic examination revealed high-grade invasive features, with tumor involvement noted at the outer limit of the muscularis propria. No glandular differentiation was observed, although focal squamous features were present. The tumor was found to be within 3 mm of a resection margin. No vascular invasion was seen, and all surgical margins were free of tumor.\n\nIn addition, the ovaries were atretic and showed cortical inclusion cysts bilaterally. The endometrial cavity was distorted by a 1.2 cm fibroid-like lesion, and a possible second subserosal fibroid was noted on the left posterior aspect. The fallopian tubes and cervix appeared unremarkable, and the vaginal wall sections did not show any residual disease. A total of seven lymph nodes were examined, none of which were involved. The histologic grade was 3 out of 3, and the TNM staging was pT2b, pN0, pMX."} +{"pid": "TCGA-DK-A6B1", "report": "The specimen consists of a urinary bladder, prostate, urachus, perivesical soft tissues, seminal vesicles, and lymph nodes. The total specimen measures 12.1 cm from superior to inferior, 12.6 cm laterally, and 4.5 cm from anterior to posterior. The bladder measures 7.5 x 7.1 x 4.1 cm and contains a fungating, nodular, and papillary lesion located in the anterior wall, extending to the dome. This lesion measures 7.1 x 6.4 x 3.1 cm and is situated 0.6 cm from the left orifice and 0.8 cm from the right. Additional papillary lesions are noted on the right posterior wall measuring 1.2 x 0.7 x 0.4 cm. The remaining mucosa appears congested. The prostate measures 5.6 x 3.9 x 3.6 cm and shows multiple nodules ranging from 0.2 to 0.5 cm in size located periurethrally. The right seminal vesicle measures 3.5 x 2.0 x 1.0 cm, the right vas deferens 6.8 x 0.3 x 0.3 cm, the left seminal vesicle 4.3 x 1.4 x 1.0 cm, and the left vas deferens 7.2 x 0.3 x 0.3 cm. The distal ureters are patent and measure up to 0.2 cm in maximum diameter, with the right ureter being 4.6 cm long and the left 5.5 cm long.\n\nMicroscopic examination reveals involvement of the superficial half of the muscularis propria by an infiltrating component. The growth pattern of the infiltrating component is inverted/nodular, while the non-invasive component demonstrates both papillary and flat morphology. Multicentricity is identified, with involvement of the intervening urothelium. No extension into the inked fat or beyond the bladder wall is observed. Examination of the distal urethral margin, distal left and right ureteral margins, pelvic floor tissue, and left pelvic soft tissue resection all show no evidence of tumor involvement. Additionally, all examined lymph nodes, including those from the right and left pelvic regions, are free of tumor.\n\nThe surgical margins, including those of the urethra and ureters, are free of tumor. Non-neoplastic mucosa is unremarkable. The prostate shows features of nodular hyperplasia and other high-grade prostatic intraepithelial neoplasia. Seminal vesicles and perivesical soft tissues are not involved. Vascular and perineural invasion are not identified. A total of three lymph nodes are examined from the right pelvic region and none show evidence of involvement. The pathological stage is pT2a, indicating invasion of the superficial half of the muscularis propria without extension beyond the bladder."} +{"pid": "TCGA-FJ-A3Z7", "report": "Following formalin fixation, the prostate margins are inked: the right side in black, the left side in blue. Cut surfaces of nonsurgical margins are inked as orange. The apical margin is removed and submitted in a cone-like fashion. The remainder of the gland is sectioned bilaterally in the sagittal plane along either side of the prostatic urethra. Cut surfaces are smooth, pink to tan glistening, with areas of large nodularity and cystic structures. The apex orifice is irregular and dilated to 1.0 cm in greatest dimension. The prostatic urethra is hemorrhagic, with focal areas of necrosis. The seminal vesicles have gray-white, semitranslucent walls of normal thickness.\n\nMicroscopic examination shows extensive involvement of the prostate with cellular changes involving the ductal and acinar structures. Focal stromal invasion is present. Similar findings are noted in the ejaculatory duct and seminal vesicle. No lymphovascular invasion is identified. All surgical margins are free of similar findings.\n\nThe specimen includes a urinary bladder measuring 9.0 x 7.0 x 2.0 cm when opened, and the overall surgical specimen including the prostate and surrounding tissue measures 15.0 x 6.0 x 4.0 cm. A nodular firm lesion measuring 7.0 x 4.5 cm is identified in the bladder wall, extending to a depth of 2.0 cm into the muscularis and adipose tissue. Microscopic evaluation of the bladder reveals high-grade urothelial carcinoma arranged in a solid pattern. The tumor invades into the inner half of the muscularis propria and exhibits multifocal lymphovascular invasion. All surgical margins are free of tumor involvement.\n\nInvolvement of surrounding tissues includes multifocal high-grade dysplasia and carcinoma in situ. Brunner\u2019s nests with similar findings are also noted. Areas of granulomatous inflammation and fibrosis are present within the mucosa.\n\nLymph node dissection specimens include:\n- Left pelvic lymph nodes: 12 lymph nodes, one involved by metastatic disease.\n- Right pelvic lymph nodes: 11 lymph nodes, two involved by metastatic disease.\n- Left common iliac lymph nodes: 11 lymph nodes, none involved.\n- Right common iliac lymph nodes: 6 lymph nodes, none involved.\n- Presacral lymph nodes: 6 lymph nodes, none involved.\n- Para-aortic lymph nodes: 2 lymph nodes, none involved.\n- Precaval lymph nodes: 2 lymph nodes, none involved.\n\nAdditional specimens include segments of both distal ureters and a segment of small bowel. The right distal ureter shows focal low-grade dysplasia; the left distal ureter shows no dysplastic changes. The apical urethral margin demonstrates reactive atypia without evidence of dysplasia or tumor. The proximal margin of the left ureter and distal right ureter show no invasive disease.\n\nThe surgical specimen was processed in multiple cassettes for comprehensive evaluation. Tumor size in the bladder is 7 cm. Histologic grade is high. There is no perineural invasion identified. The primary tumor extends into the inner half of the muscularis propria. Lymph node analysis reveals three involved lymph nodes out of a total of 39 examined. No distant metastases were identified.\n\nAll surgical margins (ureteral, urethral, and soft tissue) are free of tumor involvement."} +{"pid": "TCGA-CQ-6220", "report": "The specimen consisted of multiple tissue samples from the left facial nodes, neck levels I, II, IIB, and III, as well as various regions of the oral cavity including the left buccal area, posterior, superior, deep fat pad, anterior, inferior alveolar, and deep margins. A total of 42 lymph nodes were examined across all neck levels, with no evidence of tumor involvement. The submandibular gland showed no pathologic changes.\n\nIn the left buccal region, a mass was identified measuring 5.0 cm in maximum dimension and 1.5 cm in thickness. Histologic evaluation revealed moderately differentiated features. No lymphatic or vascular invasion was observed, however, perineural invasion was present. Tumor margins were uninvolved; however, the tumor was in close proximity (0.2 cm) to multiple margins including deep, inferior, superior, and lateral aspects. The skin margin was 0.4 cm from the tumor. All other evaluated margins, including posterior, superior, anterior, deep fat pad, inferior alveolar, and deep anterior, were negative for tumor involvement.\n\nPathologic staging indicated no regional lymph node metastasis (pN0) and the primary tumor was classified as pT3 based on its size greater than 4 cm. Distant metastasis could not be assessed (pMX). Gross examination of the resected tissues confirmed the measured dimensions of the involved areas and the absence of tumor in the submitted margins."} +{"pid": "TCGA-60-2704", "report": "The specimen included multiple lymph nodes and lung tissue resections. Lymph nodes from various levels were examined, including 4R, 4L, Level 7, Level VII, Level 10R, and posterior Level 10. Measurements of the lymph nodes ranged from 0.5 cm in diameter to aggregates measuring up to 2.2x1x0.9 cm. All lymph nodes were submitted entirely for examination and were found negative for involvement except for one lymph node at Level 4R which showed presence of abnormal cells.\n\nA wedge resection from the right middle lobe contained a calcified lesion with necrotic changes, located centrally within the specimen. The bronchial margin was free of abnormal cells, and a stapled margin measured 3.5 cm in length. The pleural surface was marked with green ink.\n\nThe right upper lobe specimen measured 18x9x7.5 cm and weighed 273 grams. A well-defined mass measuring 8x7x6 cm was identified within the lobe, characterized by tan and white areas on cross-section with central necrosis. This mass was located approximately 2.5 cm from the bronchial margin and 2.7 cm from the pleural surface. Histologically, the tissue showed poorly differentiated features without angiolymphatic or perineural invasion. One of six hilar lymph nodes showed evidence of involvement.\n\nAdditional sections of tumor and lymph nodes were submitted for analysis, along with samples of non-neoplastic lung tissue. Staging was updated to reflect the findings in the lymph nodes, indicating more extensive regional lymph node involvement than initially reported."} +{"pid": "TCGA-BB-7872", "report": "The surgical specimen was received fresh and labeled with the patient's name, designated as a right partial glossectomy and partial pharyngectomy. The specimen measured 7.9 cm in length x 1.8 cm x 1.1 cm and included mucosa and underlying soft tissue. Orientation was marked with a single stitch at the anterior lateral tongue and a double stitch at the right medial soft palate. The specimen was inked with blue (superior), green (inferior), and black (deep) dyes, and was serially sectioned from the single suture to the double suture, with all sections submitted for analysis.\n\nMultiple excision sites were examined including the anterior deep tongue, floor of mouth mucosa, alveolar margin, right hard palate, right medial pharynx, base of tongue, anterior tongue, right buccal mucosa, right pterygoid, right soft palate, and deep glosso-tonsillar sulcus. All these areas were negative for tumor. The anterior tongue showed squamous mucosa with mild to moderate dysplasia, which was best appreciated on frozen section slides. Margins were evaluated and tumor was present at the buccal margin, 1 mm from the opposite margin, with the deep margin being negative. Mild dysplasia was also noted at the anterior lateral tongue margin.\n\nA total of 74 lymph nodes were examined from bilateral neck dissections across levels 1 through 4. No tumor was identified in any of the lymph nodes. Specifically, one benign lymph node was found in the left neck level 2, four benign lymph nodes along with benign salivary gland tissue in the right neck level 1, sixteen benign lymph nodes in the left neck level 2, twenty-three benign lymph nodes in the right neck level 2, ten benign lymph nodes in the left neck level 3, eleven lymph nodes in the right neck level 3, and nine benign lymph nodes in the right neck level 4. Lymph nodes ranged in size from 0.2 cm to 3.5 cm in greatest dimension.\n\nThe main specimen revealed two foci of interest measuring 1.4 cm and 1.0 cm, with the greatest depth of invasion being 0.7 cm. Histologic evaluation showed poorly differentiated squamous cell morphology. Perineural invasion was identified, while venous or lymphatic invasion could not be determined. Immunohistochemical staining for p16 showed focal positivity, and in situ hybridization for high-risk HPV was negative. All margins were reviewed, and no tumor was found at the deep margin. The case was presented at a quality assurance conference and approved by the reviewing pathologist."} +{"pid": "TCGA-XF-AAN2", "report": "A radical cystoprostatectomy with pelvic lymph node dissection, urinary diversion, and gastrostomy tube placement was performed. The right and left distal ureters were examined microscopically and showed no abnormal cellular changes or concerning pathology. The right external iliac lymph nodes, consisting of two nodes, were also unremarkable. The urethral margin revealed no atypical or malignant cells.\n\nThe bladder/prostate specimen showed a mass measuring 3 x 2.5 x 1.6 cm. Microscopic evaluation revealed high-grade invasive urothelial carcinoma extending into the deep muscularis propria. The tumor approached but did not involve the surrounding perivesical soft tissue. No lymphovascular space invasion was identified. All random mucosal samples, including those from the trigone, bladder neck, and prostatic urethra, were free of dysplasia or malignancy. Resection margins were clear of any malignant or pre-malignant changes.\n\nIn the prostate, bilateral moderately differentiated adenocarcinoma with a Gleason score of 6 (3+3) was observed, confined entirely within the prostate without extension into the capsule or surrounding tissue. High-grade prostatic intraepithelial neoplasia (PIN II and III) was multifocal. The seminal vesicles and all other resection margins were free of malignancy.\n\nLymph node assessment included a total of 73 nodes from multiple anatomical locations, including right and left paracaval, para-aortic, common iliac, external iliac, cloquet, obturator/hypogastric, presacral, and presciatic regions. None of the nodes showed evidence of malignancy.\n\nGross examination of the surgical specimens confirmed the presence of an ulcerated mass at the right ureterovesical junction. The remaining bladder mucosa, prostate, and ureters appeared unremarkable. The prostate measured 5.3 x 3.2 x 2.6 cm and showed no gross tumor involvement.\n\nPathologic staging for the bladder and prostate was determined as pT2bN0Mx according to the AJCC 1997 classification. A p53 assay was performed on representative sections of the invasive carcinoma, with results pending in a separate addendum report."} +{"pid": "TCGA-YU-AA4L", "report": "The specimen from the right testis demonstrates a lesion measuring 1.8 cm in its major axis. The neoplastic tissue is confined to the testis, with no involvement of the tunica albuginea. Histologic examination reveals extensive areas of necrosis. There is no evidence of neural infiltration, lymphatic vascular invasion, or sanguineous vascular invasion. The spermatic cord and epididymis show no signs of neoplastic involvement, and surgical margins are clear of any neoplastic cells."} +{"pid": "TCGA-EY-A210", "report": "A lymph node measuring 3.1 x 1.6 x 0.8 cm was removed from the left periaortic region and showed involvement with cells within lymphovascular spaces. A total of 28 lymph nodes were examined across multiple sites, with 13 showing evidence of similar findings. Of these, six out of seven nodes from the right periaortic area, one out of seven from the right pelvic region, and five out of thirteen from the left pelvic area exhibited similar characteristics. Additional fibrofatty tissue specimens from the right periaortic (4.2 x 2.6 x 0.8 cm), right pelvic (4.7 x 3.6 x 1.6 cm), and left pelvic (4.9 x 2.3 x 1.9 cm) regions were dissected, revealing multiple lymph nodes ranging in size from 0.3 cm to 3.1 cm in greatest dimension.\n\nA hysterectomy and bilateral salpingo-oophorectomy were performed. The uterine specimen measured 9.6 cm in height, 3.8 cm in anterior-posterior width, and 4.9 cm in breadth at the fundus. The endometrial cavity was 6.4 cm long and 3.9 cm wide at the fundus. A mass measuring 6.3 x 5.9 x 4.3 cm was identified within the endometrial cavity, described as homogeneous, tan, fungating, and friable. It extended into the lower uterine segment and reached the endocervical canal interface. Myometrial invasion was present in the inner half, with a depth of 0.6 cm in the thinnest area and wall thickness measuring 1.6 cm, corresponding to 38% invasion. No serosal involvement was identified. A firm, smooth, yellow-tan area measuring 2.8 x 1.7 x 1.6 cm was noted in the cervical stroma, located 0.1 cm from the posterior margin and 0.3 cm from the anterior margin. Lymphovascular space involvement was prominent.\n\nThe fallopian tubes showed luminal involvement without invasive features. The right fallopian tube was 5.3 cm long and 0.5 cm in diameter; the left was 6.4 cm long and 0.5 cm in diameter. Both contained similar non-invasive luminal changes. Ovaries were unremarkable, with the right ovary measuring 2.6 x 1.2 x 0.7 cm and the left ovary 3.1 x 0.8 x 0.8 cm. No specific pathologic abnormalities were identified in either ovary.\n\nImmunohistochemical analysis showed positivity for estrogen receptor (1+, 40%) and negativity for progesterone receptor. Based on available data, the pathologic staging is pT1a and pN2 according to AJCC criteria, with FIGO (2008 classification) stage grouping IIIC2. These findings are subject to revision pending further clinical review."} +{"pid": "TCGA-BS-A0TC", "report": "The specimen consisted of a uterus with attached cervix and bilateral tubes and ovaries, along with multiple lymph node groups from the left pelvic, left aortic, right pelvic, and right caval regions. The uterus measured 7.8 x 5.2 x 5.0 cm and weighed 138 grams. A polypoid tan-gray mass was identified in the uterine fundus measuring 2.4 x 2.0 x 1.8 cm. Sectioning revealed possible early myometrial involvement, with less than 50% invasion (approximately 2 mm). The myometrium was approximately 2.2 cm thick. No serosal or parametrial involvement was identified. The endocervical canal contained a smooth polyp measuring 1.2 cm. Both adnexal structures appeared unremarkable on gross examination.\n\nHistologic evaluation showed a Grade 1 (FIGO) tumor with nuclear grade 2 features. Lymphovascular invasion was not identified. The tumor did not involve the cervical region or parametrium. All surgical margins were free of tumor involvement.\n\nLymph node assessment included eleven left pelvic nodes (0/11 involved), three left aortic nodes (0/3 involved), nine right pelvic nodes (0/9 involved), and two right caval nodes (0/2 involved). All lymph nodes were histologically negative for metastatic disease. Tissue blocks were submitted for all specimens, with no residual tumor noted at the resection margins."} +{"pid": "TCGA-AZ-6600", "report": "The patient is a male with a history of hypertension and prior cerebral vascular accident. Preoperative imaging identified multiple hepatic lesions and bilateral renal masses with both solid and cystic components. The patient underwent a right hemicolectomy, open cholecystectomy, liver biopsy, intraoperative ultrasound, and right nephrectomy.\n\nHistopathologic examination of the colon specimen revealed an invasive poorly differentiated adenocarcinoma with mucinous differentiation in certain areas. The tumor infiltrated through the muscularis propria into the serosal adipose tissue. Lymph node evaluation identified metastatic carcinoma in one of ten nodes examined; the involved node measured 4.0 cm and demonstrated focal extracapsular extension. All resection margins were negative for tumor involvement. Based on these findings, the staging was determined as T4 N1 M1.\n\nLiver biopsy showed metastatic adenocarcinoma with mucinous features. Trichrome staining demonstrated desmoplastic fibrosis within the tumor, while PAS staining highlighted both intracellular and extracellular mucin. Gallbladder examination revealed chronic cholecystitis without evidence of malignancy. Evaluation of the excised renal mass identified multiple cortical cysts with hemorrhage and organizing hematoma but no malignant cells were found.\n\nFluorescent in situ hybridization studies performed on the colonic adenocarcinoma demonstrated a HER-2/neu to chromosome 17 centromere ratio of 1.70, suggesting low-level amplification. This finding may have prognostic significance when considered alongside other risk factors.\n\nAdditional histologic evaluation noted that much of the tumor exhibited well-differentiated morphology, including the pericolonic lymph node metastasis. However, deeper invasive regions displayed mucinous differentiation, which was also observed in the liver lesion."} +{"pid": "TCGA-B9-7268", "report": "A left partial nephrectomy specimen was received, weighing 159.8 grams. The lesion measured 8.5 x 7.3 x 5.5 cm and was described as a well-circumscribed soft nodule partially covered by an intact capsule with a focal area of disruption measuring 1.3 cm. The exposed parenchymal margin measured 5.7 x 5.2 cm and was marked with black ink, while the intact capsule was marked with blue ink. On sectioning, the lesion demonstrated a solid, soft golden yellow to tan cut surface that abutted both the black and blue inked margins. A small amount of attached perinephric fat was present, and no cystic components were observed. A rim of unremarkable-appearing renal parenchyma was noted along the surgical margin.\n\nHistologic evaluation revealed a focal lesion with Fuhrman nuclear grade 2 morphology. There was no evidence of sarcomatoid differentiation. No invasion of the renal capsule, perirenal adipose tissue, or Gerota\u2019s fascia was identified. No involvement of the renal sinus, major veins, or ureter was present. No vascular or lymphatic invasion was observed.\n\nAll surgical margins were histologically negative, including the renal parenchymal, renal capsular, and paranephric adipose tissue margins. No lymph nodes were identified. Based on available data, the staging was classified as pT2 pNx. The staging is provisional and may be updated following clinical review and further information."} +{"pid": "TCGA-DD-AAD3", "report": "The specimen consists of a liver resection measuring 13.2 x 9.1 x 5.1 cm and weighing 148.0 grams. The lesion is described as a 5.0 x 4.2 x 3.9 cm encapsulated, pale tan, solid, and lobulated mass with a multinodular confluent appearance. The cut surface shows no necrosis or hemorrhage. The tumor abuts the capsule but remains confined within it, with an uninvolved resection margin macroscopically and a safety margin of 1.5 cm. The surrounding liver tissue appears unremarkable on gross examination.\n\nMicroscopic evaluation reveals a tumor composed of hepatic-type cells arranged in trabecular and tubular patterns. Fatty changes are present. Edmondson-Steiner grading indicates grade II as both the worst and major grades. There is no evidence of cholangiocarcinoma component, fibrous capsule formation, septum formation, surgical resection margin invasion, serosal invasion, portal vein invasion, vascular invasion, or bile duct invasion. The serosa is noted to be very close but free of tumor.\n\nHistologic assessment of the non-tumorous liver parenchyma demonstrates chronic hepatitis of mild activity grade (lobular and portoperiportal), with fibrosis staged as periportal. No cirrhosis is identified. Etiologically, the hepatitis is associated with HBV."} +{"pid": "TCGA-AR-A0TY", "report": "Breast, right, simple mastectomy: A mass measuring 2.4 x 2.2 x 1.8 cm is identified in the right upper outer quadrant. Histologic evaluation reveals high-grade cellular features with architectural disarray and nuclear pleomorphism. Mitotic figures are frequent. No significant component of in situ lesion is observed. A benign fibroadenoma measuring 0.6 x 0.4 x 0.4 cm is identified in the upper inner quadrant. Skin, nipple, and resection margins show no evidence of abnormal cellular proliferation (closest margin: anterior/superior, free by 3.8 cm). Evaluation of multiple (8) right axillary lymph nodes reveals no involvement. Sentinel lymph node mapping was performed using blue dye, which localized to sentinel lymph nodes No. 1A and No. 1B; blue dye was not identified in sentinel lymph nodes No. 1C, No. 1D, No. 1E, No. 2, and No. 3. Immunohistochemical staining for cytokeratin on sentinel lymph node tissue confirms findings observed on routine histologic sections. Breast, left, simple mastectomy: Benign breast tissue is present with non-proliferative fibrocystic changes including apocrine metaplasia and cyst formation. Two fibroadenomas are identified in the left breast (upper inner quadrant, 0.9 cm; inferior central, 1.1 cm). A single left axillary lymph node shows no evidence of involvement. Hormone receptor analysis and Her-2/NEU testing have been initiated on tissue from the right breast."} +{"pid": "TCGA-E2-A1LS", "report": "The surgical specimens included subareolar tissue from the right breast, four sentinel lymph nodes from the right axilla, a right breast mastectomy specimen, and left breast skin. The subareolar tissue measured 5 x 4 x 0.5 cm and showed no evidence of tumor. All four sentinel lymph nodes were negative for metastatic disease, with sizes ranging from 0.6 x 0.5 x 0.5 cm to 1.8 x 0.5 x 0.3 cm.\n\nThe right breast mastectomy specimen weighed 222 grams and measured 18.5 x 16 x 2.3 cm. A 2 x 1.8 x 1.6 cm tan-pink, firm, well-circumscribed mass was identified in the lower outer quadrant, located 0.2 cm from the deep margin and 2.4 cm from the skin surface. Another small nodule measuring 0.3 x 0.2 x 0.2 cm was found 2.2 cm below the areolar stitch. Microscopically, the mass showed high nuclear grade features and a modified Scarff Bloom Richardson grade of 3. The tumor was associated with ductal carcinoma in situ, solid type, involving approximately 10% of the area, with intermediate nuclear grade. Lobular neoplasia was also present. No vascular or lymphatic invasion was identified. Surgical margins were free of involvement. Additional findings included two radial scars and biopsy site changes with fibrosis.\n\nImmunohistochemistry results showed negative staining for both estrogen and progesterone receptors (Allred score 0), and HER2 testing was negative by immunohistochemistry. Pathologic staging was pT1c pN0, based on the AJCC Cancer Staging Manual, 7th edition. Intraoperative consultation confirmed no tumor in the subareolar tissue and all sentinel lymph nodes were negative. The left breast skin specimen showed no abnormality."} +{"pid": "TCGA-91-A4BD", "report": "The operative procedure involved a left lower lobectomy with examination of multiple lymph node regions, including the left inferior pulmonary ligament, peribronchial area, subcarinal region, AP window, and level 10 lymph node. The primary lesion was located in the left lower lobe and measured 2.8 cm in greatest dimension. Histologic evaluation showed a well-differentiated, minimally invasive, non-mucinous pattern with negative surgical margins. The closest margin was the bronchial margin, which was 20 mm from the tumor. No vascular or parenchymal margin involvement was identified. No pleural invasion or tumor extension was observed. Lymph-vascular invasion was not present. Regional lymph node assessment showed one involved lymph node out of 17 examined, with all other nodes negative for malignancy. Distant metastasis could not be determined. Gross examination of the resected specimen revealed an umbilicated subpleural mass without gross extension beyond the visceral pleura. Microscopic analysis confirmed no significant involvement of peribronchial lymph nodes beyond anthracotic pigment changes. The final staging was pT1b, pN1, pMX."} +{"pid": "TCGA-CV-7095", "report": "The surgical specimen consists of a 17.0 x 9.0 x 7.8 cm resection that includes a skin ellipse, underlying soft tissue, and a portion of mandible with associated mucosa and skeletal muscle. The skin ellipse measures 10.0 x 7.0 cm and contains a centrally located raised, soft, erythematous nodule measuring 2.0 x 1.8 cm. The mandibular bone segment is 6.0 x 3.0 x 1.4 cm and appears grossly unremarkable. Overlying mucosa of the floor of mouth is pink-tan with slight erythema and measures 5.0 x 1.5 x 0.4 cm. Attached skeletal muscle, salivary gland, and adipose tissue are present. A salivary gland measuring 3.0 x 2.5 x 2.0 cm is in proximity to a firm tumor mass but appears grossly uninvolved. The lymph node dissection component measures 11.0 x 3.0 x 1.0 cm, and attached skeletal muscle measures 5.0 x 2.0 x 1.2 cm.\n\nA central firm spherical mass measuring 4.5 x 4.0 x 3.5 cm is identified within the skin and extends toward the outer aspect of the mandible. The deep tumor bed is smooth with a 0.4 cm skeletal muscle margin anteriorly and posteriorly. The tumor appears grossly clear from all surgical margins. Central necrosis is noted within the tumor. Multiple lymph nodes are present, with the largest measuring 1.2 cm; none are matted or necrotic.\n\nHistologic evaluation of the posterior mucosal margin showed involvement by invasive cellular elements, while all other margins were free of such findings. No metastatic involvement was identified in eight lymph nodes examined. The tumor was found to extend into the region of the salivary gland.\n\nAn additional posterior margin specimen measuring 3.0 x 2.6 x 1.2 cm was submitted. It consisted of mucosal-lined tissue with a slightly elevated and erythematous area on the mucosal surface measuring 1.0 x 1.0 cm. The deep aspect showed smooth skeletal muscle. Histologic examination of this specimen revealed no evidence of tumor.\n\nExtracted teeth included two molars and two incisors, ranging in length from 1.8 to 2.1 cm. The molars contained white and silver fillings, and the incisors appeared to have porcelain restorations. This specimen was evaluated grossly only.\n\nTissue margins were inked and sectioned using a detailed orientation system. Representative sections were submitted for frozen and permanent analysis."} +{"pid": "TCGA-FP-7735", "report": "The surgical pathology report describes findings from a total gastrectomy, gallbladder removal, and lymph node biopsy. Gross examination of the gastrectomy specimen revealed a fungating, dusky red mass measuring 3.0 cm in greatest dimension, located approximately 3.0 cm distal to the gastroesophageal junction and 3.5 cm from the proximal margin of resection. The tumor involved the muscularis propria layer of the gastric wall and was 7 mm from the radial margin.\n\nMicroscopic evaluation showed a moderately differentiated epithelial tumor invading the muscularis propria. Surgical margins were all negative: proximal margin at 3.5 cm, distal margin greater than 10 cm, and radial margin at 8 mm. A total of eighteen lymph nodes were examined, with no evidence of tumor involvement.\n\nAdditional microscopic findings included a small bland spindle cell proliferation within the gastric wall, positive for CD117 and showing focal positivity for smooth muscle markers, but negative for keratin and S-100. Other associated findings included chronic inactive gastritis, intestinal metaplasia, and changes consistent with gastroesophageal reflux disease.\n\nStaging parameters indicated the primary lesion as pT2 based on depth of invasion into the muscularis propria. Regional lymph node staging was pN0 (0/18 lymph nodes involved). Distant metastasis could not be assessed (pMX). Margin status was R0. Based on these findings, the overall pathologic stage was IB. No lymphovascular invasion was identified.\n\nExamination of the gallbladder showed a thickened fundus with mucosal cysts and velvety appearance; microscopic evaluation revealed chronic cholecystitis without evidence of malignancy. One lymph node from the pancreatic region was also evaluated and showed no tumor involvement."} +{"pid": "TCGA-UW-A7GX", "report": "The right kidney specimen measured 14.6 x 7.2 x 4.7 cm and weighed 427 grams. A well-circumscribed solid mass measuring 7.2 x 7.2 x 7.0 cm was identified in the upper pole. The mass was pink to tan in color with areas of hemorrhage and necrosis involving approximately 20% of the lesion. It expanded the renal capsule but did not breach it, and was located 0.4 cm from the perinephric adipose tissue margin. The distance from the renal sinus was 1.5 cm, and the renal vein was free of involvement. The uninvolved renal cortex and medulla were well demarcated and showed no additional abnormalities. No lymph nodes were identified at the hilum.\n\nMicroscopic examination revealed irregular nests of eosinophilic cells with distinct perinuclear clearing. Immunostains and special stains were performed to determine lineage. The findings demonstrated reactivity for CK7 and Hale\u2019s colloidal iron stain, with no reactivity for RCC marker, supporting a specific cellular lineage. Histologic grade was Fuhrman grade 2 of 4. No sarcomatoid features were observed. Margins of resection, including the renal vein, ureter, and extracapsular soft tissue, were uninvolved. The adrenal gland was not present in the specimen.\n\nStaging was determined as pT2a based on tumor size and extent of local invasion. Lymph node status could not be assessed (pNx) and distant metastasis could not be evaluated (pMx)."} +{"pid": "TCGA-CG-4305", "report": "The specimen consists of a total gastrectomy preparation. A lesion was identified in the prepyloric antrum, measuring up to 3.5 cm in diameter, located along the lesser curvature and extending to within 1.8 cm of the aboral duodenal resection margin and reaching as far as the pylorus. Histological examination revealed moderately differentiated tissue with areas showing poor differentiation. The invasive component extended into the outer layers of the muscularis propria.\n\nThe mucosa of the antrum and corpus showed non-florid, medium-grade chronic gastritis, along with foveolar hyperplasia, focal intestinal metaplasia, and partial mucosal atrophy. No Helicobacter pylori was detected. The esophageal and duodenal aboral resection margins, as well as the greater omentum, were free of involvement.\n\nOf the 41 lymph nodes examined, two contained metastatic deposits. The remaining lymph nodes displayed reactive changes without evidence of tumor involvement. Vascular and lymphatic invasion were not identified. The grade was high, and the resection margins were free of tumor."} +{"pid": "TCGA-FU-A23L", "report": "The surgical specimen consisted of a hysterectomy with bilateral salpingo-oophorectomy, along with excised lymph nodes and other tissues. Gross evaluation identified a lesion measuring approximately 3.8 cm in the cervix, which extended into the lower uterine segment and involved the uterine corpus. The tumor invaded the deep stroma of the cervix and lower uterine segment with a depth of invasion measuring approximately 1.8 cm. Tumor extension was noted into the adipose connective tissue outside the uterus. No lymphovascular space invasion was identified.\n\nSurgical margin assessment revealed that carcinoma in situ closely approximated the anterior and posterior cervical margins. Invasive carcinoma was found at the deep connective tissue cauterized surface. No tumor was identified in separately submitted left and right paracervical tissues. Evaluation of lymph nodes showed no tumor involvement: three lymph nodes from the left pelvic region, two from the right pelvic region, and three from the left paracervical soft tissue were all negative for neoplasm.\n\nThe endometrium showed atrophic changes. The myometrium contained multiple leiomyomas with areas of hyalinization and calcification, as well as adenomyosis. Both ovaries and fallopian tubes showed no abnormal findings. A separate specimen submitted as the right uterine artery consisted of benign adipose tissue and arterial vessel without any neoplastic changes.\n\nGross examination of the hysterectomy specimen showed a 7.8 x 6.8 x 3.4 cm uterine body and a 4.4 x 4.2 x 3.8 cm cervix. The cervical lesion measured 3.8 x 2.5 cm and had a thickness of 2.1 cm. It appeared to abut the inked margin and involved all four quadrants. Extension into the lower uterine segment was suspected. The endometrial cavity measured 1.8 cm from cornu to cornu and 2.4 cm in length, with an average endometrial thickness of 0.1 cm. The myometrium averaged 1.9 cm in thickness and contained multiple nodules ranging from 0.5 cm to 3.9 cm in size. One nodule exhibited diffuse hardening and yellow discoloration.\n\nAdditional specimens included portions of left paracervical soft tissue with four irregular firm tissues measuring between 0.6 x 0.5 x 0.3 cm and 1.1 x 0.7 x 0.3 cm. No obvious lymph nodes or lesions were present in the right paracervical soft tissue. Both ovaries and attached fallopian tubes showed normal morphology on gross inspection.\n\nAll lymph node specimens were processed in entirety and submitted for histologic evaluation. Frozen section analysis of left and right pelvic lymph nodes (0/3 each) showed no evidence of tumor. No tumor was identified in the right paracervical lymph nodes either.\n\nChest imaging performed intraoperatively demonstrated mild basilar atelectasis or infiltrate without significant changes in lung appearance. There was no evidence of pneumothorax, pleural fluid, or adenopathy.\n\nHistologic staging according to AJCC 2010 criteria was determined as pT2a1 NO."} +{"pid": "TCGA-D1-A1NY", "report": "The specimen includes a uterus with bilateral fallopian tubes and ovaries. A mass measuring 6.0 x 3.5 x 2.2 cm is present within the endometrial cavity and lower uterine segment. The lesion extends 1.7 cm into the myometrium, with a total myometrial thickness of 2.0 cm. There is no involvement of the endocervix. Lymphovascular space invasion is noted. Surgical margins are free of abnormal cells. Six intramural leiomyomas are identified within the myometrium, ranging in size from 0.5 cm to 2.4 cm. Both ovaries and fallopian tubes appear unremarkable.\n\nLymph node evaluation includes 13 right pelvic lymph nodes, 14 left pelvic lymph nodes, 4 right para-aortic lymph nodes, and 6 left para-aortic lymph nodes; all are negative for abnormal cellular infiltration.\n\nThe staging classification based on available surgical material is pT1bNO according to the AJCC 7th edition (2010). This report incorporates findings from macroscopic examination, frozen section histologic evaluation, and subsequent review of permanent Hematoxylin and Eosin (H&E) sections. Any significant changes identified upon further analysis will be included in a revised report. \n\nGrossly, the uterus weighs 220.0 grams and has focal fibrous adhesions on the serosal surface. The mass is described as exophytic, polypoid, and tan-colored. The ovaries and fallopian tubes show no gross abnormalities. Adipose and lymphatic tissue aggregates from various lymph node groups have been submitted for analysis."} +{"pid": "TCGA-S4-A8RM", "report": "The patient is a male who underwent a pancreaticoduodenectomy and splenectomy. Specimens were received from multiple anatomical sites including the liver segment, duodenal mass, gallbladder, bile duct stent, pancreatectomy, splenectomy, gastric staple line, and omentum. Histologic evaluation of these specimens revealed no tumor in the liver segment, a benign mesothelial cyst in the duodenal mass, and no diagnostic abnormalities in the gallbladder, bile duct stent, spleen, gastric staple line, or omentum.\n\nIn the pancreas, a 6 cm mass was identified with additional dimensions measuring 3 x 2.7 cm. Histologically, the lesion demonstrated features consistent with an invasive ductal adenocarcinoma arising from a branch-duct intraductal papillary mucinous neoplasm (BD-IPMN). The tumor was poorly differentiated and exhibited lymphovascular and perineural invasion. Margins were uninvolved by invasive carcinoma, with the closest margin measuring 1 mm from the tumor at the uncinate process. Metastatic involvement was identified in 1 of 9 regional lymph nodes examined.\n\nPathologic staging was determined as pT3, N1, MX. The tumor extended beyond the pancreas but did not involve the celiac axis or superior mesenteric artery. No distant metastasis was identified. There was no prior treatment administered before surgery. Gross examination of the resected specimen showed the mass to be firm, white, and well-circumscribed, located in the tail of the pancreas. It nearly replaced the entire gland and encased the splenic vein and artery, as well as the common bile duct, extending to involve the ampulla of Vater. The mass was within very close proximity to the uncinate and portal vein groove margins.\n\nAll other tissues submitted for evaluation showed no evidence of malignancy or significant pathology."} +{"pid": "TCGA-GD-A6C6", "report": "The surgical specimens were received in nine labeled containers. Parts A and B consisted of distal left and right ureter segments, both measuring 0.3 cm in length with diameters of 0.4 cm and 0.6 cm respectively, submitted entirely for frozen section evaluation. Both were found to be free of malignant cells. Part C was a formalin-fixed specimen of the urinary bladder and prostate. The bladder measured 8.5 x 8 x 5 cm, and the prostate measured 3.7 x 5.2 x 4 cm. A gray-tan to red-brown ulcerative mass was identified on the posterior wall extending to the right lateral wall near the trigone, measuring 5.0 x 3.0 x 2.0 cm. The mass was firm and tan-white on cut surface, with focal degeneration. It extended near the right ureteral orifice but did not obstruct the ureter. Histologically, the mass showed high-grade features according to WHO 2004 criteria and was configured as invasive. Microscopic examination revealed extension into perivesical tissue and presence of lymph-vascular invasion. Squamous metaplasia was noted in the surrounding epithelium. Margins were assessed: the urethral margin was 3.2 cm from the tumor, posterior soft tissue edge was 0.7 cm, and the right lateral edge was 0.4 cm. All resected margins were free of neoplastic involvement. One lymph node was identified in the perivesical fat, measuring 0.6 cm, and was negative for malignancy. Prostate tissue was benign with patchy atrophy and no evidence of tumor infiltration.\n\nLymph node dissections were performed bilaterally in upper and lower pelvic regions. Part D (right upper pelvic) contained one lymph node measuring 2.5 cm, which was benign. Part E (right lower pelvic) included twelve lymph nodes, the largest measuring 3.0 cm; all were without pathological changes. Part F (left upper pelvic) contained one lymph node measuring 1.2 cm, also unremarkable. Part G (left lower pelvic) included thirteen lymph nodes, the largest being 2.5 cm in diameter, all showing no signs of disease. Additional ureteral specimens (parts H and I) were obtained from both left and right distal segments. The left segment measured 7.0 cm in length with a 0.7 cm diameter and the right segment was 3.0 cm long with a 0.8 cm diameter. Both contained mild chronic inflammation but were devoid of malignancy. Frozen section analyses of the distal ureters were completed within 9 and 13 minutes respectively, confirming absence of tumor. In total, 28 lymph nodes were examined across all regions, none of which demonstrated metastatic involvement."} +{"pid": "TCGA-JW-A5VG", "report": "The cervical biopsy specimen consists of two fragments measuring 0.7 x 0.5 x 0.3 cm and 0.9 x 0.3 x 0.2 cm. Microscopic examination reveals fibrous stroma infiltrated by sheets and nests of malignant cells. These cells exhibit marked nuclear pleomorphism, hyperchromasia, and moderate cytoplasmic volume. Immunohistochemical staining with CK5/6 highlights the presence of these abnormal cells. The architectural pattern and cytologic features are indicative of an invasive growth pattern with poorly differentiated morphology. No specific tumor name is provided in this summary. Staging or further classification details are not included here."} +{"pid": "TCGA-DD-A1EJ", "report": "The resected right lobe of the liver, including the gallbladder, measures 20.0 x 15.0 x 12.0 cm and weighs 1590.0 grams. The gallbladder measures 8.5 x 3.0 x 2.2 cm. A solitary mass is identified within the liver, measuring 14.1 x 12.0 x 11.8 cm. It has a tan-green nodular appearance and is poorly circumscribed. The lesion is partially encapsulated and demonstrates a broad, pushing-type border with adjacent non-neoplastic tissue. No satellite lesions are observed, and there is no invasion of large veins. The lesion approaches but does not involve the muscular wall of the gallbladder. All surgical margins are free of abnormal tissue, with the closest margin measuring 0.3 cm. The gallbladder mucosa appears normal.\n\nHistological examination of the non-neoplastic liver tissue reveals minimal patchy inflammation in some portal areas, while many portal regions are unremarkable. Interlobular bile ducts are intact without significant cellular injury or ductular proliferation. Lobular parenchymal architecture is preserved without significant steatosis, necroinflammatory activity, or apoptotic hepatocytes. Special stains show no notable cytoplasmic globular inclusions, iron deposition, or fibrosis in portal tracts, periportal, or pericellular regions."} +{"pid": "TCGA-56-8309", "report": "The surgical specimen from the right lung includes a portion of pulmonary parenchyma weighing 249 grams and measuring approximately 13.8 x 8.5 x 4.7 cm. The specimen was processed after tissue harvest for genomic study and includes several staple lines at the resection margins. A nodular lesion is identified on the superior anterior aspect, measuring approximately 2.3 x 2.0 x 1.8 cm with a gritty, friable gray-tan cut surface. It appears to extend to the pleura but not through it, and is located approximately 3.0 cm from the nearest bronchial margin. A small bronchial connection is noted. The surrounding parenchyma shows spongy, red-brown tissue with areas of congestion and focal anthracotic streaking. A 0.3 cm gray-white fibrotic plaque is observed on the pleura near the base.\n\nSubmitted tissue sections include those from bronchial margins, the lesion and surrounding tissue, the pleural plaque, and uninvolved parenchyma. Two lymph node specimens were received: one measuring 1.0 x 0.8 x 0.4 cm from level 4 and another measuring 0.7 x 0.6 x 0.3 cm from level 9.\n\nMicroscopic examination reveals a poorly differentiated large cell carcinoma within the right lower lobe specimen. The tumor measures 2.3 cm in greatest dimension and is unifocal. Histologic evaluation demonstrates no glandular differentiation or keratinization. Focal mucin staining suggests intercellular bridges. Immunohistochemical stains show positivity for CK7 and TTF1, while CK5/6 shows focal strong positivity and p63 is negative. Elastic staining confirms that the tumor reaches the visceral pleura but does not invade into it. Acute inflammation with polymorphonuclear leukocytes is noted along the pleural surface.\n\nMargins of resection including bronchial, vascular, and pleural surfaces are free of tumor involvement. The closest distance of invasive tumor to any margin is 1 mm from the visceral pleural margin. No unequivocal lymphovascular space invasion is identified. Additional findings include emphysematous changes, mild interstitial chronic inflammation, focal acute pleural inflammation with recent hemorrhage, and focal fibrosis with cautery artifact.\n\nExamination of level 4 lymph nodes reveals reactive sinus histiocytosis, mild lymphoid hyperplasia, and anthrasilicosis; however, no metastatic carcinoma is identified. Level 9 lymph node sampling yielded benign pulmonary parenchyma with recent hemorrhage and no identifiable lymph node tissue.\n\nBased on tumor size of 2.3 cm and absence of lymph node involvement, staging is classified as pT1b pN0. Only level 4 lymph nodes were sampled, limiting full nodal staging accuracy. Clinical correlation and follow-up are recommended."} +{"pid": "TCGA-CZ-4858", "report": "The specimen consists of a left radical nephrectomy weighing 901 grams and measuring 20.1 x 10.8 x 10.4 cm. The kidney itself measures 18.9 x 8.5 x 6.0 cm and is surrounded by perinephric fat up to 4.5 cm in thickness. A small amount of disrupted adrenal tissue is present, measuring 2.4 x 1.4 cm. At the hilum, an 8.2 cm ureter with a diameter of 0.3 cm, a 2.0 cm renal artery, and a 1.3 cm renal vein with a maximum diameter of 1.8 cm are identified.\n\nA well-defined tan-yellow mass measuring 7.8 x 6.4 x 5.9 cm is located in the lower pole of the kidney. The mass is multifocally hemorrhagic with focal central necrosis involving less than 10% of the lesion. Gross examination reveals that the mass expands and compresses the renal cortex, approaching the renal capsule without clear evidence of invasion into the surrounding adipose tissue. The tumor abuts but does not grossly invade the renal vein and is located 2.0 cm from the renal vein margin. The closest surgical margin, marked with black ink, is 0.8 cm from the tumor.\n\nThe remaining renal parenchyma contains a single 0.3 cm tan-yellow nodule within a vessel in the mid/upper pole, distinct from the main lesion by more than 3.0 cm. Otherwise, the rest of the renal tissue appears unremarkable on gross inspection. The adrenal gland is partially disrupted and shows no abnormal findings.\n\nMicroscopic evaluation confirms absence of lymphovascular invasion. Margins including ureteral, vascular, and soft tissue are free of involvement. A blood vessel containing organizing thrombus is noted. Histological sections reveal no significant pathological changes in the glomeruli, tubules, or interstitium of the non-neoplastic renal parenchyma. Arterial sclerosis is present focally and moderately.\n\nStaging parameters indicate the lesion is confined to the kidney without extension beyond the renal capsule or into major vessels. No satellite nodules are identified. Cytogenetic analysis could not be completed due to unsuccessful cell cultures."} +{"pid": "TCGA-44-8119", "report": "A right upper lobe lung specimen with attached chest wall was submitted for analysis. A 5.5 x 4.7 x 3.5 cm tan-white to gray-black tumor mass was identified within the lung and observed to extend into the soft tissues of the chest wall, including the intercostal muscles. The tumor was located near the pleural surface, coming within 0.1 cm of the inked margin. Histologically, the lesion showed poorly differentiated features without well-formed glands or keratinization. Immunohistochemical staining demonstrated positivity for CEA and TTF-1, while CK 5/6 and p63 were negative. These findings suggest a non-small cell origin.\n\nThe bronchial, vascular, and radial margins of resection were free of malignant involvement. Four hilar lymph nodes were examined and found to be negative for metastatic disease. Additionally, multiple mediastinal lymph nodes from levels 2R, 4R, VII, IX, X, and XI were evaluated; all showed nonnecrotizing granulomatous lymphadenitis but no evidence of malignancy. Special stains for acid-fast and fungal organisms in these lymph nodes were negative.\n\nGross examination revealed a 19 cm staple line on the pleura, which was subsequently removed. Diffuse crepitance was noted around the tumor site. A separate 1.4 cm tan-white nodule was identified within the adherent pleura and submitted for evaluation. Several soft, gray-black perihilar lymph nodes were recovered, measuring up to 2.4 cm. The pleura adjacent to the tumor exhibited scaberous, tan-red changes with underlying induration. The external rib surfaces were inked blue, and the overlying pleura was inked orange.\n\nSpecimens from the third and fourth rib margins were also submitted and found to be free of malignancy. All bone specimens were fragmented and submitted entirely following fixation and decalcification. Lymph node samples varied in size from 0.3 to 1.3 cm and were generally soft and tan-gray in appearance.\n\nHistologic grading classified the lesion as poorly differentiated. The tumor extended into the chest wall and was staged as pT3. No lymphatic or arterial invasion was identified, though venous invasion was present. Regional lymph node assessment showed no metastases (pN0). Distant metastasis could not be determined (pMx). Other findings included apical emphysematous changes and a benign pleural plaque."} +{"pid": "TCGA-95-8039", "report": "The surgical pathology report includes multiple specimens submitted from a right upper lobectomy and lymph node dissection. The lung specimen measured 4.5 x 13.0 x 3.0 cm and weighed 141 grams. A fleshy tan mass was identified within the right upper lobe, measuring 1.7 x 1.7 x 2.5 cm, with the closest margin (bronchial) located 50 mm away. Histologic evaluation showed a moderately differentiated lesion with acinar growth pattern. No involvement of the visceral pleura was observed, and all surgical margins were free of involvement. The surrounding lung tissue showed emphysematous changes.\n\nLymph nodes from stations 4R, 7, 9R, 10R, and 11R were submitted as fragmented tissue. All lymph node specimens were negative for metastatic involvement. The primary lesion was unifocal and surrounded by lung or visceral pleura, with no evidence of lymphovascular invasion. Based on tumor size (>2 cm but \u22643 cm in greatest dimension) and absence of lymph node involvement, staging criteria indicate pT1b and pN0."} +{"pid": "TCGA-A2-A3XS", "report": "The lumpectomy specimen from the left breast includes a poorly differentiated mass measuring 3.0 cm in greatest dimension, located near the superior and inferior margins. The mass is firm and nodular with areas of well-circumscribed tan, gritty tissue; the largest of these measures 1.2 cm. The specimen was sectioned thoroughly, with multiple tissue blocks submitted for histological evaluation, including full-thickness cross sections and areas of grossly normal fibrous tissue.\n\nA separate specimen from the new medial margin of the left breast consists of two fragments of fibrofatty soft tissue, measuring 7.5 x 3.0 x 2.0 cm and 4.5 x 2.5 x 1.3 cm respectively. These appear unremarkable on gross examination, with no discrete masses identified.\n\nA sentinel lymph node biopsy (node #1) revealed the presence of abnormal cells within a 0.7 cm lymph node. Additional testing with cytokeratin staining showed similar findings. No malignant features were identified in the axillary soft tissue contents, which included three fibrofatty tissue fragments measuring 3.5 x 3.5 x 2.0 cm in total.\n\nHistological grading using a standard system yielded a score of 9 (3 + 3 + 3), indicating high-grade cellular features. Tumor involvement was noted at the medial margin of the lumpectomy site and at the new medial margin. Immunohistochemical analysis for a specific receptor status was weakly positive; however, further molecular testing did not show amplification of the corresponding gene (ratio: 1.3). \n\nStaging information based on pathological findings is as follows: primary tumor size category T2, regional lymph node involvement category N1c, and distant metastasis could not be assessed."} +{"pid": "TCGA-77-8136", "report": "Histopathology Report. HISTORY. Left pneumonectomy plus lymph node biopsies. Previous cytology from bronchial brushings showed atypia suspicious for malignancy; bronchial washings were negative.\n\nMACROSCOPIC. Three specimens were received. Specimen 1, labelled \"left pneumonectomy,\" consists of a left lung measuring 240 mm from apex to base, 165 mm from posterior to anterior, and up to 50 mm from lateral to medial, weighing 343 g. The hilum is distorted by a large nodule involving both the apical segment of the lower lobe and the superior lingular segment of the upper lobe. Mucopus protrudes from the bronchial resection margin. Anteroinferior to this margin, there is a small firm nodule possibly representing an involved lymph node. The mediastinal pleural surface has a nodular appearance, while the remainder is smooth. Sectioning reveals that the lesion invades the bronchial wall and extends into the lumen proximally toward the margin, with tumour present 11 mm from the bronchial resection margin. The lesion measures 65 x 60 x 40 mm, with a necrotic and liquid center. Elsewhere, it has a firm variegated cut surface with cream, yellow, and tan areas. It abuts the overlying mediastinal pleura. Extending from the lesion into the lower lobe is an area of firm yellow discoloration measuring 55 x 30 x 30 mm beneath the pleura along the anterior border, demarcated by interlobular septa. Distally, this area ends at a 12 mm nodule with a yellow, focally haemorrhagic cut surface. Remaining lung parenchyma is otherwise unremarkable.\n\nSpecimens 2 and 3 are fragments of tissue: one reddish black fragment measuring 24 x 15 x up to 10 mm (labelled \"hilar node\"), and one fibrofatty fragment measuring 20 x 15 x 10 mm containing a blackened lymph node (labelled \"No. 8 lymph node\").\n\nMICROSCOPIC. Sections show malignant cells arranged in patternless sheets. The cells are smallish with granular chromatin and fibrillar or granular eosinophilic cytoplasm. In some regions, cytoplasmic clearing is observed. Scattered small foci suggest altered differentiation, with larger cells showing more eosinophilic cytoplasm, vesicular nuclei, prominent nucleoli, and occasional multinucleation. No keratinisation or intercellular bridges are identified. Frequent and abnormal mitoses are noted. Immunostaining for neuroendocrine markers was negative. The lesion includes endobronchial and parenchymal components. Adjacent to the lesion, metaplastic squamous epithelium with moderate dysplasia is seen in one bronchus, and other airways within the lesion show similar in situ changes. Vascular invasion is present, and there is invasion into, but not through, the mediastinal pleura. Lymphatic invasion is not observed, although metastatic carcinoma is found in peribronchial lymph nodes. Perineural invasion is absent. The bronchial resection margin is free of invasive disease and dysplasia, though necrotic material is present in the lumen. The inked mediastinal soft tissue margin is also clear. The yellow consolidation in the lower lobe corresponds to organizing obstructive pneumonitis with focal cavitation forming the distal nodule; no organisms are detected.\n\nSections of hilar and lymph node specimens show reactive lymphoid hyperplasia and pigmented histiocytes, without evidence of metastasis.\n\nSUMMARY. Examination of the left pneumonectomy and sampled lymph nodes shows a poorly differentiated malignant neoplasm with vascular and pleural invasion. Metastatic involvement is present in peribronchial lymph nodes. The primary lesion measures 65 mm in greatest dimension. No perineural invasion is identified."} +{"pid": "TCGA-W5-AA2Z", "report": "Female. Surgery Date: Specimen A, gallbladder, cholecystectomy: Chronic cholecystitis with cholesterolosis. One cystic duct lymph node is negative for tumor. Specimen B, lymph node, pericholedochal, excision: One lymph node is negative for tumor. Specimen C, liver, right, partial hepatectomy: A solid mass measuring 20.0 x 13.5 x 11.2 cm is identified, along with a separate nodule measuring 2.2 x 1.8 x 1.4 cm. The lesion is confined to hepatic parenchyma and exhibits a mass-forming growth pattern. The margin of resection shows extension of the lesion. There is no major vessel invasion or microscopic invasion. No regional lymph nodes are identified. Specimen D, liver, segment II nodule, wedge biopsy: Findings are consistent with bile duct hamartoma. Background liver parenchyma will be reported in an addendum."} +{"pid": "TCGA-AA-A03F", "report": "The specimen consists of a right hemicolectomy with an ulcerated lesion located in the cecum. The lesion measures 5.5 cm in its greatest dimension and extensively involves the cecal circumference. Histologically, the lesion demonstrates features consistent with moderately differentiated adenocarcinoma, partially mucinous in morphology. The tumor infiltrates through all layers of the intestinal wall, reaching into the mesocolic fat and subserosal tissue. Adjacent colonic mucosa shows the presence of tubular adenomas exhibiting moderate dysplasia. No residual tumor was identified at the oral or aboral resection margins or in the greater omentum. Examination of regional lymph nodes reveals involvement in four out of twenty-nine nodes. Based on these findings, the pathological staging is pT3, pN2 (4/29), with histologic grade G2."} +{"pid": "TCGA-BP-5183", "report": "Clinical history is notable for an enhancing left renal mass. Specimens submitted include a left partial nephrectomy and a left kidney biopsy.\n\nThe surgical specimen from the left kidney is a wedge-shaped tissue measuring 7.5 x 5.5 x 5.2 cm, with a deep margin marked by suture and black ink. Upon sectioning, a well-circumscribed yellow mass with focal hemorrhage and cystic change is identified. The mass measures 5.2 x 4.8 x 4.4 cm and has a clearance of 0.3 cm from the resection margin. Histologic evaluation reveals nuclear grading classified as III/IV. The lesion extends through the renal capsule but remains within Gerota's fascia. No evidence of renal vein invasion or small vessel angiolymphatic invasion is observed. Surgical margins are free of tumor involvement. Adjacent kidney tissue demonstrates compression-related changes. Adrenal and lymph node tissues were not present in the specimen.\n\nA separate biopsy specimen consists of a small fragment measuring 0.4 x 0.3 x 0.2 cm. Histologic analysis shows benign renal medullary tissue.\n\nIntraoperative frozen section assessment of the primary specimen confirmed negative margins with no tumor involvement seen on representative sections. Permanent section diagnosis was consistent with the frozen findings. The secondary biopsy specimen confirmed benign renal medullary tissue on both frozen and permanent sections.\n\nStaging classification indicates pT3a based on tumor extension into perinephric tissues without exceeding Gerota's fascia. Representative tissue sections were submitted for further studies."} +{"pid": "TCGA-AX-A1C4", "report": "The surgical pathology report includes multiple biopsied and resected specimens. Biopsies from the anterior abdomen and colic gutter show fibroadipose tissue without any concerning features. An omentectomy specimen reveals benign fibroadipose tissue with focal fat necrosis and multinucleated giant cells, but no malignancy.\n\nA total hysterectomy with bilateral salpingo-oophorectomy was performed. Gross examination of the uterus revealed multiple fibroid nodules, with the largest measuring 10 cm. The endometrial cavity contained a friable mass measuring 3.5 cm in its largest dimension, with a white-tan cut surface and areas of hemorrhage. This lesion extended into the myometrium to a depth of 0.3 cm, within a myometrial thickness of 1.9 cm at that site. The tumor was located on the right fundic/cornu region and approached within 1.6 cm of the peritoneal surface. No vascular or lymphatic invasion was identified.\n\nMicroscopic evaluation showed no involvement of the cervix, fallopian tubes, or left ovary. The right ovary contained a benign Brenner tumor measuring 2 cm. Additional findings included adenomyosis, squamous metaplasia and nabothian cysts of the cervix, and multiple leiomyomata, some of which were hyalinized and partially calcified.\n\nBiopsies from the pelvic sidewall, cul-de-sac, and bladder peritoneum all demonstrated fibroadipose tissue without evidence of malignancy. Lymph node dissections were performed at multiple sites: left and right pelvic and para-aortic regions. All lymph nodes examined were negative for malignancy, with a total of 21 lymph nodes evaluated (left pelvic 0/5, left para-aortic 0/4, right pelvic 0/8, right para-aortic 0/4). \n\nAn appendectomy specimen showed no pathological abnormalities. Margins were uninvolved, and no venous or lymphatic invasion was observed. Based on the depth of myometrial invasion (<50%), the primary tumor was staged as pT1b. Lymph node staging was pN0 and distant metastasis could not be assessed (pMX)."} +{"pid": "TCGA-BT-A2LA", "report": "The surgical specimen included multiple lymph nodes from the right and left pelvic regions, all of which were benign. Biopsies of the distal right and left ureters showed benign urothelium with reactive changes in the underlying submucosa. The radical cystectomy specimen involved the prostate, bladder, seminal vesicles, and vas deferens.\n\nA mass was identified in the left lateral wall of the bladder, measuring 4.5 cm in greatest dimension. Microscopic examination revealed a solid growth pattern composed of sheets of atypical cells. These cells exhibited a high nuclear-to-cytoplasmic ratio, extensive necrosis, and prominent nuclear molding. Immunohistochemical staining showed positivity for synaptophysin, NSE, and CD56, while being negative for chromogranin, pankeratin, and thrombomodulin. These findings indicated neuroendocrine differentiation.\n\nThe lesion extended through the detrusor muscle into the perivesical soft tissue. No lymphovascular or perineural invasion was identified. A flat component consistent with carcinoma in situ was present. All surgical margins were free of invasive disease. Twelve lymph nodes were examined, and none showed involvement. There was no evidence of distant metastasis. Additional findings included focal high-grade prostatic intraepithelial neoplasia and benign prostatic hyperplasia."} +{"pid": "TCGA-B0-5102", "report": "The left kidney specimen measured 4.0 cm in greatest dimension. The tumor was well-circumscribed and confined within the renal capsule. Histologic evaluation revealed cells with clear cytoplasm and nuclear features corresponding to a high nuclear grade. Vascular and ureteral resection margins showed no evidence of residual disease. No angiolymphatic invasion was identified. A fragment of adrenal gland was also present and displayed no abnormal cellular changes. The contralateral kidney was unremarkable with findings limited to arteriolonephrosclerosis and an old, small infarct measuring 0.4 cm. Lymph node and distant metastatic status could not be assessed."} +{"pid": "TCGA-E2-A1LG", "report": "The surgical specimens included a sentinel lymph node biopsy from the right axilla and mastectomy specimens from both breasts, along with additional tissue samples. The right breast specimen weighed 1697 grams and measured 38 x 30 x 3 cm. It was a simple mastectomy with a 23 x 20 cm skin ellipse and an everted nipple. Serial sectioning revealed a 4 cm area of scar tissue with a 1 cm central prior biopsy site located 4.6 cm from the deep margin in the upper inner quadrant (UIQ) of slice 12. Radiographic imaging identified three biopsy clips. A second possible prior biopsy site measuring 1 x 0.9 x 0.7 cm was found 3.8 cm from the deep margin in the upper outer quadrant (UOQ) of slice 7.\n\nThe left breast and axillary tail specimen weighed 1844 grams and measured 30 x 27 x 5 cm. It contained a firm, well-circumscribed tan-white mass measuring 4 x 3 x 2.8 cm in the UOQ, located 3 cm from the deep margin. Dissection of the axillary tail revealed 18 lymph nodes ranging in size from 0.2 to 1.4 cm. Histologic evaluation of the lymph nodes showed reactive changes without evidence of malignancy.\n\nAdditional specimens included fibrofatty tissue from the right breast upper outer quadrant and lateral flap, both without evidence of tumor. The sentinel lymph node biopsy from the right axilla included four lymph nodes; two were evaluated by frozen section and all showed reactive changes only. One lymph node was identified in the additional axillary contents and also showed reactive features.\n\nHistologic examination of the right breast revealed benign findings including fibroadenoma, sclerosing adenosis, usual ductal hyperplasia, apocrine metaplasia, and microcalcifications. Margins were negative. In the left breast, histologic analysis demonstrated cellular features consistent with invasive carcinoma, characterized by pleomorphic morphology and solid growth pattern. Margins were also negative on the left side. Immunohistochemical staining was negative for HER2, ER, and PR.\n\nPathologic staging was based on the AJCC Cancer Staging Manual, 7th Edition. No vascular or lymphatic invasion was definitively identified. Necrosis was absent in the right breast specimen and present in the left. All lymph nodes examined were negative for metastatic involvement."} +{"pid": "TCGA-CJ-4639", "report": "A segment of rib measuring 3.2 x 1.1 x 0.8 cm was examined grossly and showed no remarkable findings. A specimen of perinephric fat measuring 16.0 x 10.0 x 0.5 cm showed no discrete lesion, with representative sections submitted. A radical nephrectomy specimen including the adrenal gland was examined. The adrenal gland measured 7.0 x 5.0 x 1.5 cm and appeared unremarkable. Within the lower pole of the kidney, a tan-yellow, focally gelatinous mass measuring 7.7 x 7.0 x 5.5 cm was identified. The mass was confined by a capsule and did not involve the renal vein or renal sinus. The closest external surface margin measured 0.3 cm. No involvement was identified at the ureteral, renal vein, or renal artery margins. Sections included representative areas of the tumor, adjacent renal sinus, perinephric fat, and uninvolved renal parenchyma. Cellular morphology demonstrated clear cells exclusively, with nuclear features corresponding to grade 2. All resection margins were free of abnormal tissue."} +{"pid": "TCGA-AR-A24M", "report": "The specimen from the left breast wide local excision contains a lesion measuring 2.5 x 2.4 x 2.2 cm. Histologic evaluation shows mixed ductal and lobular growth patterns with moderate nuclear grade (Nottingham grade II of III). The surgical margins are free of tumor involvement. A separate benign fibroadenoma measuring 0.9 x 0.8 x 0.6 cm is also present.\n\nEvaluation of the left axillary sentinel lymph nodes reveals that nodes numbered 1 and 2 contain metastatic deposits, while node number 3 does not show evidence of tumor involvement. All three sentinel lymph nodes contain visible blue dye. Additionally, one further left axillary lymph node obtained separately is negative for tumor. In a more extensive dissection of left axillary lymph nodes, 2 out of 24 nodes are found to contain tumor deposits (AJCC pN2). Immunohistochemical testing for Her-2/Neu has been initiated on formalin-fixed, paraffin-embedded tissue."} +{"pid": "TCGA-EY-A54A", "report": "The surgical specimens include multiple lymph node dissections and a hysterectomy specimen. In the right para-aortic lymph node dissection, one of six nodes showed involvement. In the left para-aortic lymph node dissection, no involved nodes were identified; however, one node demonstrated focal endosalpingiosis. The right pelvic lymph node dissection included seven nodes, three of which were involved. In the left pelvic lymph node dissection, one of nine nodes was involved.\n\nThe hysterectomy specimen measured 7.0 cm in height, with an anterior-posterior width of 6.0 cm and a breadth at the fundus of 8.0 cm. The uterine cavity contained a lesion measuring at least 4.5 x 3.0 cm, appearing exophytic and friable. Histologic evaluation revealed inner half myometrial invasion with a depth of 1.1 cm and a total wall thickness of 2.7 cm, corresponding to approximately 41% invasion. There was no serosal involvement, but involvement of the lower uterine segment was present. No cervical or adnexal involvement was observed. Extensive lymphovascular space invasion was noted involving both the inner and outer myometrial walls.\n\nFive regional lymph nodes were found to be involved out of a total of 24 examined. Additional findings in the myometrium included benign leiomyomas with hyalinization, with the largest measuring up to 4.7 cm in diameter. The cervix showed Nabothian cysts, acute and chronic cervicitis, tubal metaplasia, and a benign mixed endocervical/lower uterine segment endometrial polyp. Both ovaries were atrophic with no notable pathology identified. Paratubal cysts and remote hematosalpinx were observed in the right fallopian tube, while the left fallopian tube exhibited multiple small cystic structures throughout its length. \n\nStaging information indicated pT1b, pN2 classification based on AJCC criteria and Stage IIIC2 according to FIGO (2009). This staging is provisional and subject to revision pending clinical correlation."} +{"pid": "TCGA-FG-A87Q", "report": "The specimen consists of multiple fragments of soft tissue from the cerebrum, submitted in three separate portions. The first two specimens measured 1.5 x 1.2 x 0.2 cm and 1.4 x 1.2 x 0.2 cm respectively, while the third was larger at 3 x 1.5 x 0.6 cm. Histologically, the tissue shows neoplastic cells with marked nuclear pleomorphism, including the presence of bizarre nuclei. There is evidence of hypercellularity and perineuronal satellitosis, with mitotic figures identified. No necrosis or vascular endothelial proliferation was observed.\n\nImmunohistochemical staining demonstrated focal positivity for p53 and a diffusely increased Ki67 labeling index of 23%. Staining for IDH was negative. Based on histologic features and immunophenotype, the tumor demonstrates characteristics consistent with a high-grade lesion. Molecular testing revealed methylation of the MGMT gene promoter region with a methylation score of 20.11. Fluorescence in situ hybridization analysis showed a relative deletion of chromosome 19q but no co-deletion of 1p/19q. All specimens were processed and analyzed using standard protocols."} +{"pid": "TCGA-F4-6703", "report": "The submitted large intestine tissue specimen was obtained via partial colectomy. The tumor was located in the ascending colon and measured 0 x 0 x 8.5 cm. Microscopic evaluation revealed ulcerated features with moderately differentiated cellular morphology. The tumor extended to the subserosa. A total of 12 lymph nodes were examined, and none showed evidence of metastasis. Surgical margins were uninvolved. There was no indication of neoadjuvant treatment effect. No additional pathologic findings were noted."} +{"pid": "TCGA-A3-3308", "report": "The specimen consists of a right kidney weighing 399 grams with perirenal fat, and measuring 9.3 x 5.8 x 3.8 cm after trimming. A nodule measuring 3.5 cm in diameter is present on the inferior pole, appearing yellow-tan in color. The tumor measures 5.5 x 3.5 x 3.5 cm and has a mottled yellow-tan appearance with areas of hemorrhagic necrosis and fibrous tissue up to 1.2 cm in diameter. The tumor extends to the renal capsule but does not penetrate it. It also extends into the vein of the renal pelvis and into muscular segmental branches of the renal vein, though not into the main renal vein. No lymph nodes are identified in the renal pelvis, and no adrenal gland tissue is found within the perirenal fat.\n\nMicroscopic evaluation reveals cellular features consistent with a Fuhrman nuclear grade 2. Venous invasion is present, but lymphovascular invasion is absent. Surgical margins of the ureter, renal artery, and renal vein are uninvolved. No distant metastasis can be assessed based on the current specimen. The staging classification indicates involvement beyond the kidney without regional lymph node or distant metastasis. Multiple sections were examined, including those from the tumor mass, renal capsule, renal pelvis, renal parenchyma with scarring, and retention cysts. The operative procedure was a radical nephrectomy."} +{"pid": "TCGA-OR-A5K4", "report": "The specimen consists of a right adrenal gland weighing 1060 grams and measuring 15.5 x 14.5 x 13.5 cm. A partially disrupted vessel is attached to the medial surface, with a tumor mass observed within the vascular lumen. The gland is surrounded by a thin membranous capsule, and a segment of fibroadipose tissue measuring 8.0 x 6.0 x 1.3 cm is attached to the inferior surface. No lymph nodes are identified in the attached soft tissue.\n\nSectioning reveals a tan parenchyma that is focally hemorrhagic and largely necrotic throughout the entire dimension of the gland. There is a central area of yellow discoloration measuring 3.5 x 1.0 cm. Inking was performed using multiple colors to mark different anatomical aspects of the specimen.\n\nMultiple sections were taken from various margins including the superior, inferior, anterior, posterior, medial, and lateral aspects, as well as from the area of yellow discoloration and within the attached vessel. Photographs were taken for documentation.\n\nHistologic evaluation shows a low-grade cellular proliferation. The mitotic rate is 2 per 50 high power fields. Vascular invasion is present, with tumor extending into a large adjacent vessel. The surgical margin at the vascular site is positive, while all other peripheral margins are negative. There is no evidence of capsular invasion. Extension beyond the adrenal gland into adjacent structures is noted. The lymph node status could not be determined.\n\nStaging is based on local extension, and the classification reflects advanced local disease."} +{"pid": "TCGA-AG-A01N", "report": "The specimen from a left mammary ablation revealed fibrocystic mastopathy and ductal hyperplasia, with extensive foci of lobular neoplasia, including areas showing features of in situ involvement. A well-differentiated intraductal component was also identified, with a partly papillary architecture, showing transition at two points to an invasive, well-differentiated ductal carcinoma. The tumor was classified as pT1a (2), with no lymphovascular or perineural invasion, and all surgical margins were free of involvement. Thirteen left axillary lymph nodes were examined and showed no evidence of metastasis (pN0, 0/13).\n\nA resected segment of the rectum showed a moderately differentiated adenocarcinoma with infiltration limited to the lamina muscularis propria. Lymphovascular invasion was present, but no regional lymph node metastases were found (0/23 nodes). The case included a history of liver metastasis confirmed by biopsy.\n\nA hepatic wedge excision was performed, and no additional metastatic deposits were identified. Histological evaluation of the liver showed non-active cirrhosis, possibly related to nutritional or toxic factors, with focal steatosis."} +{"pid": "TCGA-21-1081", "report": "A specimen from the left lower lobe of the lung was evaluated following lobectomy. The lesion measured 8.5 cm in maximum dimension and was poorly differentiated in morphology. Histologic examination revealed invasion through the pleura and presence of lymphatic invasion. Necrosis within the lesion was moderate. Margins of resection, including bronchial and vascular margins, were negative for abnormal cells. One of two hilar lymph nodes showed involvement by the process. Acute bronchopneumonia was identified in non-neoplastic lung tissue.\n\nAdditional specimens included multiple lymph nodes from various levels (R2, R4, Level 5, Level 7), a portion of the sixth rib, and a cytology sample. All lymph nodes were unremarkable without evidence of abnormal cellular infiltration or architectural disruption. The rib fragment also lacked any abnormal findings."} +{"pid": "TCGA-ZC-AAAA", "report": "The specimen consists of a 9.8x7.5x4.2 cm resection from the mediastinum, including soft tissue on both sides and thymic tissue. A lesion measuring 6 cm in diameter is present within the resection, located centrally with an ill-defined and incomplete capsule. Posteriorly, there is involvement of approximately 7.5x5.5 cm of pericardial tissue. Adipose tissue contains small lymph nodes.\n\nHistologically, there is evidence of an infiltrative growth pattern into the mediastinal fat. A well-defined capsule is only seen in certain areas, with invasion depth exceeding 3 mm in others, consistent with an advanced local stage. At one margin, cellular strands are found in close proximity to the coagulated surface, suggesting incomplete resection at that site, while all other surgical margins are free of neoplastic cells. Cystic changes are prominent, though only a small proportion of these are associated with the lesion itself. Most of the cystic structures correspond to markedly atrophic thymic remnants forming a multilocular cystic structure. The thymic cortex shows marked atrophy. Lymph nodes show signs of significant reactive changes. An ectopic parathyroid gland was also identified.\n\nThe resection includes a focus of inflammation (grade 3) with high-grade involution and cyst formation. Mediastinal lymph nodes are reactive but devoid of neoplastic cells. No features suggestive of a more aggressive variant were identified. The tumor extends to the ventrolateral coagulated surface in a narrow zone, precluding an R0 resection status, while other margins remain clear. Tumor staging is consistent with an intermediate stage based on local invasion criteria. The resection status is classified as R1 at the ventrolateral aspect, approximately 1 mm in width. No discrepancy was noted between frozen and paraffin sections."} +{"pid": "TCGA-SG-A6Z7", "report": "The excised retroperitoneal mass measured 30.0 x 23.0 x 13.0 cm and weighed 4.0 kg. The external surface was largely well-encapsulated, smooth, and tan-pink, though a 22.0 x 10.0 cm area showed irregular lobulation and hemorrhage. Capsular disruption was noted in this region. Serial sectioning revealed a fleshy tan-white mass with extensive central necrosis and cystic degeneration. Hemorrhagic areas were also present throughout. A kidney measuring 11.0 x 6.0 x 4.0 cm was largely encased by the mass, particularly at the hilum, but no direct invasion of renal parenchyma was observed. An adrenal gland approximately 15 cm away measured 5.0 x 4.0 x 2.0 cm and was completely surrounded by tumor; within the adrenal medulla was a tan-white nodule measuring 2.0 x 1.5 x 1.0 cm. A segment of possible liver tissue measuring 7.0 x 6.5 x 4.0 cm was also encased by the mass, though definite infiltration of liver parenchyma was not identified.\n\nMicroscopically, the majority of the tumor was composed of high-grade spindle cells resembling a malignant peripheral nerve sheath tumor. However, at least focally (notably on slide A11), there was a lower grade component consistent with a more differentiated morphology. The tumor margins were sampled from six aspects, including the area of capsular disruption. Margins were inked and submitted for evaluation. Additional sections demonstrated the interface between the tumor and the kidney, as well as the relationship between the tumor and adrenal gland.\n\nSubmitted lymph nodes from the periaortic region were evaluated. One distal lymph node (2.5 cm) and one proximal group (ranging from 0.2 to 1.5 cm) were all unremarkable, with no evidence of neoplastic involvement. A separate excised abdominal wall specimen measuring 2.2 x 1.5 x 0.5 cm showed fibroadipose tissue with acute inflammation and fibrin deposition, and no neoplasm was identified.\n\nAncillary testing was performed on paraffin-embedded tissue using fluorescent in situ hybridization to evaluate for a SYT translocation, which was not detected. Multiple cassettes were submitted for histologic analysis, including representative sections of tumor margins, tumor-kidney interface, and tumor-adrenal interface. No other significant findings were noted in the submitted tissues."} +{"pid": "TCGA-2G-AAHC", "report": "The pathology report describes findings from a left orchidectomy specimen. The lesion measured 7.0 cm in diameter. Histological examination revealed no evidence of angio-invasion. Additionally, there was no involvement of the rete testis or invasion of the tunica albuginea identified."} +{"pid": "TCGA-BP-4760", "report": "The left kidney contains two distinct masses. The first mass, located in the interpolar region, measures 2.0 cm in greatest diameter and is confined within the renal capsule. It has a multilobulated, tan-yellow to gray-white appearance on cut surface, with a segment of adjacent normal kidney parenchyma. Surgical margins are free of abnormal tissue. The second mass, found in the lower pole, measures 2.6 cm and is also limited to the renal capsule. It presents as a partly cystic, circumscribed nodule with a tan-pink, friable cut surface and minimal surrounding normal kidney tissue. Surgical margins are uninvolved.\n\nA cyst wall specimen from the interpolar region shows fragments of a multilocular cystic lesion. Additional specimens of perinephric fat, supra-tumor region, renal sinus fat, and lower pole fat were all composed of benign fibroadipose tissue. No masses were identified in these regions.\n\nIntraoperative frozen section analysis of both tumors confirmed the presence of renal cortical neoplasms with no involvement at the inked margins. The cystic lesion was also noted to be suspicious for a renal cortical carcinoma. Permanent sections confirmed the findings seen on frozen section. The non-neoplastic portions of the kidney appear histologically unremarkable."} +{"pid": "TCGA-BR-A453", "report": "The specimen is from a gastrectomy procedure, with involvement of the antrum. The lesion measures 5 x 3 x 1.5 cm and is characterized by ulceration of the mucosa, which is also necrotic. Microscopic examination reveals a population of small cells with large mucin vacuoles that fill the cytoplasm, displacing the nucleus to form signet-ring morphology. These cells are arranged in diffuse or single patterns. Some cells lack mucin. Nuclear features include hyperchromasia, irregular enlargement, and prominent nucleoli. Mitotic figures are present. Stromal reaction is fibrous, and there is lymphocytic infiltration. The lesion invades muscular layers and disrupts gastric architecture. Extension reaches the serosa. Of the regional lymph nodes examined, all are involved."} +{"pid": "TCGA-AC-A8OP", "report": "The specimen consists of a right breast with axillary sentinel lymph nodes, submitted following mastectomy with sentinel lymph node biopsies. The invasive tumor nodule measures 18 mm in diameter and is located in the lower inner quadrant (3:30 aspect). Histologic evaluation reveals a single focus of invasive carcinoma with a total Nottingham grade of 2 out of 3. Tubule formation is scored as 3 of 3, nuclear pleomorphism as 2 of 3, and mitotic count for Nottingham grading is 1 of 3. Three mitoses were observed in ten high power fields. No lymphatic invasion is identified.\n\nIn addition to the invasive component, there is an associated in situ component characterized by solid and cribriform architectural patterns, intermediate nuclear grade, and the presence of necrosis and calcifications. This in situ lesion extends into surrounding tissue and may correspond to the area of mammographically detected calcifications. The invasive tumor is located 15 mm from the closest margin, which is the anterior-medial-inferior region. All other margins are at least 40 mm away from the invasive component. The in situ component is also at least 15 mm from the nearest margin. All resection margins are free of tumor involvement.\n\nSix axillary sentinel lymph nodes were examined, and no tumor cells were identified (0/6). Pathologic staging according to the AJCC Cancer Staging Handbook, 7th edition, indicates a primary tumor stage of pT1c, regional lymph node stage of pN0(i-)(sn), and distant metastasis cannot be assessed (pMX), resulting in an overall pathologic stage of IA.\n\nImmunohistochemical analysis shows strong estrogen receptor positivity in 98% of cells and strong progesterone receptor positivity in 15% of cells. HER2/neu expression is not overexpressed (IHC score 1+). The Ki-67 proliferative index is estimated at 20%. No lobular carcinoma in situ is present. The skin and nipple are unremarkable, and skeletal muscle is not identified in the specimen."} +{"pid": "TCGA-2Z-A9J7", "report": "The specimen from the right anterior chest wall lesion was received fresh and consisted of an oval, moderately firm, tan-white to tan-pink nodule measuring 1.5 x 2.5 x 1.0 cm. The margins of resection were inked black. Upon sectioning, the cut surface appeared tan-white to tan-pink with partial necrosis. Representative sections were submitted for frozen section evaluation and additional tissue was submitted for further analysis.\n\nThe radical nephrectomy specimen consisted of a kidney surrounded by fibroadipose tissue, measuring 15.1 x 14.0 x 9.5 cm in overall dimensions. An ovoid tumor mass located in the superior-medial aspect measured 12.0 x 11.5 x 9.0 cm. The tumor appeared spherical with tan-yellow to tan-brown areas and hemorrhagic foci. It did not invade the caliceal system or renal sinus, nor did it penetrate beyond the renal capsule into perinephric fat. No additional tumor nodules were identified grossly. Sections of ureter, vein, artery, and tumor margins were submitted along with samples of renal parenchyma and hilar fibroadipose tissue.\n\nThe right psoas muscle mass was an ovoid, moderately firm, dark-red-brown nodule measuring 3.7 x 3.0 x 2.0 cm. Upon sectioning, the cut surface was tan-white to tan-pink with partial necrosis. Representative sections were submitted for microscopic examination.\n\nMicroscopic findings revealed neoplastic cells reactive with pancytokeratin AE1/1 and vimentin but negative for TTF-1, CK-5/6, CK7, CK20, CD-10, and pan melanoma markers. S-100 showed nonspecific reactivity. Nuclear grade was determined as Grade III. The tumor exhibited papillary and hemorrhagic growth patterns without vascular invasion. Surgical margins were negative for tumor involvement.\n\nStaging classification indicated no evidence of vascular or ureteric margin involvement, lymph node assessment was not performed, and adrenal gland examination was not carried out. Based on available data, the pathological stage was assigned accordingly."} +{"pid": "TCGA-AC-A2QJ", "report": "A female patient underwent histopathological examination of multiple specimens including breast tissue, lymph nodes, and margin samples. The left breast mastectomy specimen measured 19.5 x 15 x 6 cm and weighed 604 grams. A dominant red-tan oval mass measuring 7 cm in greatest dimension was identified in the lateral aspect of the breast. Microscopic evaluation showed a high-grade cellular proliferation with a Nottingham Histologic Score of 9 (Grade 3). The lesion was present within 0.3 cm of the superior margin, 0.5 cm of the inferior margin, and 1 cm of the deep margin. It extended into the dermis and was associated with overlying epidermal ulceration. No ductal or lobular in situ carcinoma was identified.\n\nThe background breast tissue showed nonproliferative fibrocystic changes, including stromal fibrosis, apocrine metaplasia, microcystic formation, and duct ectasia. No malignancy was found in the re-excised inferior margin or in the biopsied left inferior skin specimen, which showed only nonspecific chronic inflammation.\n\nLymph node assessment included one sentinel and one axillary lymph node; both were benign and showed no evidence of metastatic disease. Evaluation of the primary tumor demonstrated no lymphovascular or dermal lymphovascular invasion. Immunohistochemical studies for estrogen and progesterone receptors were negative, as was HER2/neu immunostaining.\n\nPathologic staging was pT4b (skin ulceration) and pN0 (no regional lymph node involvement). No distant metastasis was recorded."} +{"pid": "TCGA-A5-A0GQ", "report": "The surgical specimens included left and right salpingo-oophorectomy specimens and a hysterectomy with cervix. The left ovary and fallopian tube showed no significant pathological changes, with a small paratubal cyst noted. The right ovary demonstrated mild cystadenofibromatous changes, and the right fallopian tube also contained a paratubal cyst.\n\nThe uterus measured 7.0 x 3.0 x 3.0 cm, with an endometrial cavity length of 3.0 cm. Within the superior portion of the endometrial cavity, a friable, white, exophytic mass measuring 2.3 x 2.0 x 1.0 cm was identified. Histologically, this lesion exhibited myoinvasion extending into approximately one-half of the myometrium, which measured 1.8 cm in thickness. No angiolymphatic invasion was observed. The cervix showed tunnel clusters and lobular endocervical hyperplasia, but no malignant cells were identified.\n\nLymph node evaluation included right and left pelvic lymph nodes; both were negative for malignancy. One lymph node was identified in the left pelvic specimen, while none were grossly identifiable in the right pelvic specimen.\n\nThe endometrial lesion was classified as FIGO grade I of III. Based on AJCC staging criteria (2002, 6th edition), the stage was determined to be pT1c/pN0."} +{"pid": "TCGA-A8-A06T", "report": "The specimen consists of left-sided ablated breast tissue containing a moderately differentiated invasive lesion measuring 55 mm. The lesion demonstrates completely circumscribed invasion of the lymph vessels. There is no intraductal tumor component identified. Margins show a minimum basal distance of 3 mm, with a 6 mm margin at the 12 o\u2019clock position. The surrounding tissue exhibits fibrocystic change and proliferative mastopathy, including ductal hyperplasia, sclerotic intraductal papillomas, and tumor-free epidermis, including the nipple. Pectoral muscle samples are present and free of involvement. Histological classification is G2, with staging parameters indicating pT3, pL1, pN1a (1/13 positive lymph nodes), and pMx. A complete resection margin (R0) is confirmed."} +{"pid": "TCGA-J8-A3YD", "report": "The surgically resected right thyroid lobe and isthmus measured 5.0 x 3.5 x 2.8 cm and weighed 18 grams. The external surface was intact, and surgical margins were marked with black ink. Upon sectioning, a 1.5 x 1.0 x 0.8 cm firm, white-tan, focally calcified lesion was identified, located approximately 0.3 cm from the nearest inked margin. No lymphatic or vascular invasion was identified, and the surrounding tissue showed fibrosis and benign adenomatous changes. A separate yellow-tan nodule measuring 0.8 cm was found in the left thyroid lobe, which also displayed benign histological features. The central compartment lymph node specimen contained multiple small lymph nodes, with involvement identified in two out of six nodes. Additional thymic epithelium was noted within the lymph node specimen. All other areas of the thyroid showed normal parenchymal architecture without evidence of additional lesions."} +{"pid": "TCGA-AP-A1DR", "report": "The submitted specimens included sentinel and non-sentinel lymph nodes from the right and left internal iliac, obturator, external iliac, and common iliac regions, as well as the uterus, cervix, bilateral fallopian tubes and ovaries, and a soft tissue sample from the left uterine artery.\n\nMicroscopic evaluation of the sentinel right and left internal iliac lymph nodes revealed rare scattered epithelial cells identified in one node each. These cells were only detectable with immunohistochemical staining for cytokeratin. The cells exhibited voluminous, vacuolated cytoplasm resembling lymphangioinvasive cells seen in the uterus. However, they were not visible on standard H&E sections, and the significance of this finding remains uncertain.\n\nThe hysterectomy specimen showed a lesion centered in the lower uterine segment. Histologic examination revealed an infiltrative growth pattern with invasion into less than half of the myometrial thickness. The depth of invasion measured 3 mm in an area where the total myometrial thickness was 11 mm. Lymphovascular invasion was present. No definitive involvement of the endocervical region was identified. Additional sections of the cervix were submitted for further assessment, and results will be reported separately.\n\nThe myometrium contained benign leiomyomas, and the uterine serosa showed adhesions. The bilateral fallopian tubes and ovaries appeared unremarkable. \n\nAll other lymph node specimens, including those from the right and left obturator, external iliac, and common iliac regions, were negative for metastatic disease. Some specimens consisted entirely of fibroadi\nIn addition, a biopsy of the left uterine artery showed benign fibrovascular tissue."} +{"pid": "TCGA-J4-AATV", "report": "The specimen consisted of a radical prostatectomy specimen including the prostate gland, seminal vesicles, and vasa deferentia. The prostate weighed 39 grams and measured 4 x 3.5 x 3 cm. The capsule was shaggy and disrupted at the bladder resection margin. The right and left seminal vesicles each measured 2 x 1.5 cm; the right and left vas deferens each measured 1.5 x 0.5 cm. No abnormalities were observed in the seminal vesicles or vasa deferentia.\n\nLymph nodes were evaluated from both the right and left pelvic regions. In the frozen section (FS) portions, two lymph nodes were identified on each side and no tumor involvement was observed (0/2 on each side). In the non-frozen section (NFS) portions, residual lymph nodes and fibrofatty tissue were present, with no tumor seen.\n\nA total of four lymph nodes were examined, and none showed evidence of tumor involvement. The tumor exhibited perineural invasion but no lymphatic (small vessel) invasion was found. No tumor was identified in the seminal vesicles.\n\nHistologic examination revealed amyloid deposition in the seminal vesicles. Immunostains for K-903, P63, and P504S were performed on block E15 and Congo Red stain was performed on block E23. All control tissues were judged to be technically acceptable.\n\nThe Gleason score was 3 + 3 = 6 out of 10. The extent of tumor involvement within the prostate was categorized as severity level 4 (30\u201350% tissue involvement). Margins were assessed, and one positive inked margin was identified at the right posterior prostate, possibly due to an iatrogenic incision. No tumor was seen at other specimen margins.\n\nTNM staging indicated at least pT2c, pN0, and pMX. There was no evidence of extraprostatic invasion elsewhere. Clinical correlation was recommended for further evaluation."} +{"pid": "TCGA-AR-A1AQ", "report": "The specimen consists of a right breast wide local excision showing a cellular proliferation with high-grade nuclear features. The lesion measures 3.5 x 2.5 x 2.5 cm. Histologic evaluation demonstrates a Nottingham score of 9 out of 9, based on tubule formation (3/3), nuclear pleomorphism (3/3), and mitotic count (3/3). There is no evidence of angiolymphatic invasion. The surrounding non-neoplastic breast tissue exhibits nonproliferative fibrocystic changes. All surgical margins are free of atypical cells, with the closest margin measuring 0.5 cm at the medial aspect.\n\nA total of six sentinel lymph nodes were identified from the right axilla, all negative for malignant involvement. Immunohistochemical staining with cytokeratin on paraffin-embedded tissue supports the morphologic assessment. One additional non-sentinel lymph node from the right axilla was also negative for tumor."} +{"pid": "TCGA-CM-5341", "report": "The resected sigmoid colon specimen contains two distinct lesions. The first lesion is located more proximally, measures 5.8 x 4.9 x 1.8 cm, and is characterized by moderately differentiated cellular features. Histologic evaluation shows this lesion invades into the muscularis propria (pT2) without evidence of vascular or perineural invasion. The second lesion is situated 2.4 cm distal to the first, measures 2.5 x 1.0 x 1.0 cm, and predominantly exhibits tubulovillous adenoma with intramucosal changes. Previous biopsy of this lesion documented submucosal invasion (pT1) and vascular invasion. A total of eighteen lymph nodes were examined, with one showing involvement. All resection margins, including proximal, distal, and radial, are free of involvement. The proximal and distal anastomotic rings show no abnormality and are negative for any concerning cellular changes."} +{"pid": "TCGA-62-A46S", "report": "Pathology Report-Summary: Material: lung, left, upper lobe: 22.0 X 15.0 X 7.0 cm. Lesion measures 8.0 X 7.0 X 4.0 cm. Histological evaluation reveals infiltration of the visceral pleura. The lesion is located in the upper lobe of the lung. Staging classification indicates pT2, pNo (0/37), pMx, with a histologic grade of G2."} +{"pid": "TCGA-BP-5191", "report": "A left hilar kidney mass was incidentally identified on CT imaging in a patient with no prior significant history. A partial nephrectomy specimen was submitted for evaluation, along with a lymph node excision and a cyst wall excision.\n\nThe surgical specimen measured 8.5 x 6.5 x 2.0 cm and included perinephric fat with a suture marking the deep margin. The tumor measured 3.2 cm in greatest dimension and was well-circumscribed, with both solid and cystic components. The solid areas showed bright yellow coloration with focal hemorrhage. The tumor appeared to distend the capsule without penetration. Microscopic examination revealed nuclear features of intermediate grade. The tumor involved the renal sinus fat but did not extend into the renal vein. Surgical margins were free of involvement. Adjacent non-neoplastic tissue showed papillary adenoma, arteriolonephrosclerosis, and chronic inflammation. No adrenal gland or lymph nodes were identified in the specimen. The tumor demonstrated a clearance of 0.3 cm from the resection margin.\n\nOne lymph node was retrieved from the left hilar region and showed no evidence of metastatic involvement. The cyst wall specimen revealed benign findings consistent with a simple cyst.\n\nStaging criteria indicated that the tumor extended into the perinephric tissues but did not exceed the boundaries of Gerota\u2019s fascia. Multiple representative sections were taken from the tumor, adjacent kidney tissue, and margins for further analysis. Intraoperative frozen section confirmed the presence of a neoplastic lesion with clear cell morphology, and permanent sections confirmed this finding. All margins were negative for tumor involvement."} +{"pid": "TCGA-AA-A00A", "report": "The specimen consists of a right hemicolectomy preparation with tumor-free resection margins. Gross examination reveals an ulcerated lesion in the ascending colon. Histological analysis shows a moderately differentiated carcinoma with infiltration extending into the perimuscular fatty tissue. No involvement of local lymph nodes is identified. The tumor grade is G2. Pathological staging indicates pT3 with no lymph node metastases (pN0, 0 out of 34 lymph nodes involved). Vascular and lymphatic invasion markers are negative, and there is no evidence of residual tumor at the resection margins."} +{"pid": "TCGA-AO-A0J6", "report": "The clinical history notes a palpable breast mass with prior fine needle aspiration showing malignant cells. Submitted specimens included three sentinel lymph nodes and one non-sentinel lymph node from the left axilla, along with the left breast mass.\n\nAll lymph node specimens were benign, with no evidence of metastatic disease identified on histologic examination or immunohistochemical staining for cytokeratins. The sentinel lymph nodes measured 1.8 cm, 1.6 cm, and 1.1 cm respectively, and each was entirely submitted for frozen section analysis. The non-sentinel lymph node specimen contained benign fibroadipose tissue and nerve, with no involvement by tumor.\n\nThe excised breast specimen measured 14 x 9 x 4.9 cm and included an overlying skin ellipse. A well-circumscribed, firm, stellate mass measuring 4.5 cm in greatest dimension was identified within the breast tissue. It was located 0.7 cm from the posterior margin and showed no vascular invasion. Margins of resection were negative, with the closest being the posterior margin at 7.7 cm microscopically. There was no involvement of the skin. No in situ component was identified, though focal calcifications were present in benign breast parenchyma. The surrounding non-neoplastic breast tissue demonstrated fibroadenomatoid and biopsy site changes.\n\nHistologic evaluation revealed a high-grade lesion with poor differentiation, marked nuclear atypia, and absence of tubule formation. Immunohistochemical staining of the invasive component showed no expression of estrogen or progesterone receptors, and HER2 testing was negative using standard criteria. Controls were adequate and interpretation followed current guideline recommendations."} +{"pid": "TCGA-69-8253", "report": "The specimen consists of four parts: a right superior segment of the lung, an R11 stump, an R7 tissue sample, and an R11 node. The lung specimen weighed 58 grams and measured 8.5 x 4.5 x 2.5 cm. A tan-gray solid nodule measuring 2 x 2 x 1 cm was identified within the lung parenchyma. The nodule exhibited stellate borders, retracted the overlying pleura, and was located 1.5 cm from the bronchial margin and 1.7 cm from the nearest parenchymal margin. No peribronchial lymph nodes were found. Sections were taken from multiple areas, including the bronchial shave margin, the nodule (with pleura and parenchymal margin), unremarkable parenchyma distal to the mass, and the vascular margin.\n\nThe R11 stump was an irregular-shaped tissue segment measuring 1.3 x 0.5 x 0.4 cm. The R7 sample measured 0.8 x 0.5 x 0.4 cm, and the R11 node measured 0.4 x 0.4 x 0.4 cm. All were submitted in formalin.\n\nMicroscopic evaluation noted the presence of abnormal cellular growth with a mixture of structural patterns. Lymphatic invasion was present, while vascular invasion was not identified. All surgical margins, including bronchial, vascular, and parenchymal, were free of abnormal cells. The pleural and soft tissue margins were also negative. Staging was determined as p stage IIA (T1a N1 MX). Centrilobular emphysema was also noted in the lung tissue."} +{"pid": "TCGA-CV-A45X", "report": "The specimen was obtained from a male patient undergoing surgical resection. The primary specimen consists of a segment of mandible measuring 5.0 x 4.0 x 2.5 cm. Within the anterior portion of the bone, there is an ulcerated, friable, and soft lesion measuring approximately 2.5 x 1.0 x 1.5 cm. This lesion appears to erode the upper bony structure and extends between teeth without evidence of bony fracture. Grossly, the lesion appears confined within the surgical margins.\n\nA right supraomohyoid neck dissection was also performed. Level I lymph nodes (six identified, ranging from 0.6 x 0.4 x 0.3 cm to 1.2 x 0.9 x 0.7 cm) showed involvement in three out of six nodes. In Level III (two lymph nodes identified, measuring up to 1.6 x 0.7 x 0.6 cm), one of the two nodes contained involvement. Levels II (two nodes), V (twelve nodes), and submental triangle (two nodes) did not show any presence of involvement.\n\nAdditional specimens including gingival labial margin, mucosal tongue margin, and deep tongue margin were all submitted and found to be free of involvement. These tissues were examined intraoperatively by frozen section and confirmed benign squamous mucosa and benign muscle and fibrous tissue respectively. A salivary gland specimen demonstrated atrophy, fibrosis, and chronic inflammation but no abnormal cellular infiltration.\n\nThirteen teeth and associated fragments were received for examination; these were assessed grossly only and no sections were taken.\n\nAll tumor-containing tissues were submitted entirely for histologic evaluation."} +{"pid": "TCGA-D8-A1XK", "report": "Histopathological examination was performed on a female patient. The specimen included a left breast resection with axillary tissues. The breast measured 16.8 x 15.3 x 5.2 cm and weighed 620 g. Axillary tissues measured 10 x 6 x 5 cm, and a skin flap of 16.2 x 9.8 cm along with a muscle fragment (4 x 3 cm) were also present. A lesion measuring 3.5 x 3 x 3 cm was identified in the inner upper quadrant of the breast, located 1 cm from the inner boundary, 0.2 cm from the base, and 0.8 cm from the skin.\n\nMicroscopic evaluation revealed invasive epithelial neoplasm with histologic grade 3 features, including a mitotic count of 36 per 10 high-power fields. The lesion showed ductal morphology. No abnormal changes were observed at the nipple. Adjacent glandular tissue exhibited fibrocystic changes. Invasive components were found as close as 0.1 cm to the base.\n\nExamination of axillary lymph nodes showed presence of malignant cells in some nodes. Immunohistochemical analysis demonstrated absence of estrogen and progesterone receptors in tumor cell nuclei. HER2 protein expression was assessed using HercepTest\u2122 by DAKO; invasive tumor cells showed no reactivity (score = 0).\n\nStaging assessment indicated a primary lesion size category T2. Lymph node involvement was classified as N1a."} +{"pid": "TCGA-AC-A2FE", "report": "The specimen from the right breast measured 21 x 20 x 5.5 cm and weighed 1067 grams. A poorly defined, slightly raised tan-brown area measuring 0.7 x 0.6 cm was noted approximately 2.2 cm from the nipple. The deep surface revealed a mechanical defect measuring 5 x 2 cm and 3 cm in depth. Serial sectioning identified a very poorly circumscribed tan-white fibrotic area approximately 4.5 x 3.5 x 3.5 cm. Within this area, there was an irregular mass measuring 2.5 x 2.0 x 1.6 cm composed of tan-white firm tissue, located approximately 1.4 cm from the deep margin. A hemorrhagic area measuring up to 0.7 cm was also present. One possible intramammary lymph node measuring 1.2 cm was identified, bisected, and showed no neoplastic involvement. Surgical resection margins were unremarkable. Additional adipose tissue portions measuring 5 x 5 x 1 cm in aggregate were submitted without identifiable lesions or lymph nodes.\n\nA separate specimen from the sentinel lymph node biopsy included one portion of adipose tissue measuring 5 x 4 x 2 cm. Four possible lymph nodes were identified ranging from 0.5 to 2.5 cm. The two largest lymph nodes showed evidence of neoplastic involvement.\n\nA third specimen from axillary lymph node dissection included multiple portions of adipose tissue measuring 8 x 8 x 2 cm in aggregate. Fifteen possible lymph nodes were identified, ranging from 0.2 to 1.5 cm. Three lymph nodes showed gross evidence of neoplastic involvement.\n\nMicroscopic evaluation of serial sections revealed extensive infiltration consistent with lobular phenotype carcinoma. The tumor demonstrated focal pleomorphic features and widespread infiltration. The closest approach to the deep margin was approximately 9 mm. Maximum invasive tumor size, based on combined gross and microscopic findings, was estimated at approximately 4.5 cm. The sampled intramammary lymph node and seventeen additional lymph nodes from the sentinel and axillary dissection specimens were extensively involved by metastatic carcinoma. Extranodal spread was observed in the soft tissue surrounding several lymph nodes.\n\nImmunohistochemical analysis showed ER positivity in 66% of cells, PR positivity in 7%, Her2/neu expression at 0.4, and Ki-67 positivity in 11% of cells. Nottingham Prognostic Index grade II was assigned (tubule score \u2013 3; nuclear score \u2013 3; mitotic score \u2013 1). No lymphovascular invasion was identified. All eighteen lymph nodes examined were involved with metastatic disease. The TNM status was determined as pT3, N3a, MX."} +{"pid": "TCGA-EO-A2CG", "report": "The specimen included right and left periaortic lymph nodes, right pelvic lymph nodes, omentum biopsy, a hysterectomy with bilateral salpingo-oophorectomy, and left pelvic lymph nodes. Grossly, the periaortic lymph nodes were identified within fibroadipose tissue measuring from 1.6 x 1.0 x 0.5 to 3.5 x 2.2 x 0.9 cm, with multiple lymph nodes ranging in size from 0.2 x 0.1 x 0.1 to 0.5 x 0.4 x 0.3 cm. The right pelvic lymph nodes were found in tissue measuring between 0.8 x 0.6 x 0.6 and 4.5 x 2.5 x 0.8 cm; lymph nodes ranged from 0.2 x 0.2 x 0.1 to 0.6 x 0.5 x 0.3 cm. The omentum measured 22.3 x 9.2 x 1.4 cm and weighed 71.6 g, with no nodules identified. The uterus measured 8.5 SI x 5.0 ML x 3.6 cm AP, and the cervix was 3.0 cm with a 0.7 cm os. The fallopian tubes measured 4.0 x 0.6 cm (right) and 4.5 x 0.5 cm (left). Ovaries were 1.4 x 1.0 x 0.7 cm (right) and 1.8 x 1.1 x 0.6 cm (left). The entire reproductive specimen weighed 96.0 g. A polypoid lesion measuring 2.2 SI x 2.0 ML x 0.9 cm AP was noted on the anterior endometrium, with a multinodular tan cut surface. Microscopically, the lesion showed high-grade features with invasion into less than half of the myometrium and no venous or lymphatic invasion. All regional lymph nodes examined (19 total across multiple sites) were negative for involvement. Distant metastasis could not be assessed. Surgical margins were uninvolved. Other findings, including the cervix, ovaries, and fallopian tubes, were unremarkable. No additional pathologic findings were identified."} +{"pid": "TCGA-DU-A6S8", "report": "A 1.4 cm right frontal brain biopsy specimen was received, described as semi-firm with areas of necrosis and hemorrhage. Microscopically, the tissue shows a rather cellular glial neoplastic proliferation. The cells are uniformly round with a borderline mitotic rate of approximately 3% per ten high power fields. A proliferation index of 18% was noted in more active areas using MIB-1 staining. Focal microvascular proliferation is present, though no tumor necrosis was identified. Areas of sparse cellularity with microcalcifications are also observed.\n\nImmunohistochemical analysis demonstrated positivity for IDH1. CD34 staining highlighted focal microvascular proliferation, while CD163 showed only sparse perivascular microglial activity. Molecular testing revealed loss of heterozygosity on chromosome arms 1p and 19q, based on analysis of loci D1S548, D1S1592, D1S552, and D19S412. MGMT promoter methylation testing was positive, indicating a methylated status, which may be relevant to treatment response to alkylating agents. The tumor sample had sufficient neoplastic cell content for reliable testing, although the biopsy was relatively small and may not fully represent the more anaplastic regions suggested by imaging. Correlation with clinical, radiological, and operative findings is recommended for comprehensive interpretation and patient management."} +{"pid": "TCGA-A2-A0EM", "report": "Specimen #: F. Race: WHITE. Physician(s): AMENDED. SPECIMEN: A: SENTINEL LYMPH NODE B: RIGHT BREAST TISSUE. C: SUPERIOR MEDIAL BORDER.\n\nFINDINGS:\n\nA. SENTINEL LYMPH NODE, BIOPSY:\nHistologic evaluation of one lymph node showed no abnormal cellular infiltration by H&E staining. Immunohistochemical staining for cytokeratin was also negative.\n\nB. BREAST, RIGHT, LUMPECTOMY:\nThe lesion exhibited a cribriform growth pattern and was well-differentiated. The size measured 1 cm. Surgical margins were free of abnormal cells, with the closest margin measuring 2.0 mm at the superior aspect. No lymphovascular space invasion was observed. Associated tissue changes included fibrocystic alterations such as fibrosis, cysts, and apocrine metaplasia. Microcalcifications were identified in both benign and altered breast tissue. Staging classification was determined as T1bNOMx.\n\nC. SUPERIOR MEDIAL BORDER TISSUE, EXCISION:\nMicroscopic examination revealed benign fibrofatty connective tissue without any abnormal cellular features.\n\nCLINICAL BACKGROUND:\nA female patient presented with a history of a right-sided lesion. Pre-operative assessment indicated a right breast lesion.\n\nGROSS DESCRIPTION:\n\nA. SENTINEL LYMPH NODE:\nReceived fresh as multiple irregular fragments of tan/yellow soft tissue measuring 3.0 x 2.0 x 0.5 cm in aggregate. Entire specimen was submitted across two cassettes.\n\nB. RIGHT BREAST TISSUE:\nReceived fresh as a 9.0 x 6.5 x 2.3 cm piece of fatty tissue oriented with sutures (one=medial, two=superior, three=anterior). Ink codes were applied for orientation: Red=medial/lateral, Blue=superior, Green=inferior, Yellow=anterior, Black=posterior.\n\nSectioning identified a 0.6 cm white/tan ovoid mass with gritty consistency located 3.0 mm from the superior/posterior margin. Remaining tissue consisted predominantly of fat with scattered fibrous areas. Sections adjacent to the mass and representative sections of normal-appearing fibrous tissue were collected for protocol-based sampling. Additional sections were submitted across 15 cassettes, including paired sections from surrounding tissue planes.\n\nC. SUPERIOR MEDIAL BORDER:\nReceived in formalin as an irregular fragment of tan/yellow lobular adipose tissue measuring 3.0 x 2.4 x 1.5 cm. Orientation was not specified. Surface was yellow and lobulated with a glistening cut surface. No discrete lesions or nodules were identified. Entire specimen was submitted in three sequentially numbered cassettes."} +{"pid": "TCGA-D7-8576", "report": "The resected stomach specimen measured 18.6 x 15.4 cm and was accompanied by omental tissue measuring 26 x 20 cm. Upon incision along the greater curvature, a thickened area in the pyloric region measuring 12 x 1 cm was identified, featuring an ulceration 2.5 cm in diameter. The distance from the proximal resection margin to the lesion was 4.9 cm, while the distal margin was 0.6 cm from the tumor.\n\nHistologically, the lesion exhibited a tubular and partially mucocellular growth pattern with high-grade cellular atypia. Tumor emboli were present in blood vessels. The neoplastic cells infiltrated through the full thickness of the gastric wall and extended into the peritoneum and surrounding omental fat. The growth pattern was classified as mixed type according to Lauren classification. The proximal resection margin showed no evidence of tumor involvement, whereas the distal margin was involved.\n\nLymph node assessment revealed metastatic involvement in multiple regional groups. At the lesser curvature, all four examined lymph nodes showed tumor infiltration with capsular and perinodal adipose tissue involvement. Similarly, all six lymph nodes at the greater curvature exhibited tumor spread with similar patterns of involvement. One lymph node at the pyloric region and two near the celiac artery also showed metastatic deposits with capsular and perinodal infiltration. In total, 12 out of 18 lymph nodes were affected.\n\nImmunohistochemical analysis demonstrated expression of HER2 protein."} +{"pid": "TCGA-PK-A5H8", "report": "The specimen from the right adrenal gland consists of an encapsulated mass measuring 19.5 x 13.5 x 6.5 cm and weighing 870 grams. The external surface is red to gray in color, and on sectioning, the cut surface appears solid and tan-brown with areas of focal necrosis. Microscopically, the lesion demonstrates a predominantly solid nesting architecture. Cellular morphology is primarily compact with focal clear cell change. Nuclear atypia and pleomorphism are present, with prominent nucleoli and frequent atypical mitotic figures observed. Geographic and punctate necrosis are noted within the lesion. The tumor is surrounded by a thick capsule; no capsular invasion or extra-adrenal extension is identified. Resection margins are not involved. Vascular invasion with thrombus is present in multiple areas. The adjacent adrenal cortex shows atrophy, predominantly affecting the zona reticularis. No lymph nodes are identified in the specimen. A separate specimen from the superior medial margin of the mass contains a piece of soft tissue measuring 3.2 x 2.0 x 1.4 cm, with margins painted with silver nitrate. Histologic evaluation of this specimen does not show evidence of malignancy."} +{"pid": "TCGA-A3-3322", "report": "The specimen consists of a left nephrectomy specimen including perinephric fat and Gerota's fascia, measuring 16 x 10 x 5.5 cm and weighing 465 grams. The kidney itself measures 9.7 x 5.6 x 4 cm and weighs 130 grams. A well-defined nodule measuring 3 x 2.8 x 2 cm is located near the inferior pole. The capsule overlying the nodule is easily separable, and the adjacent fat is marked with blue dye. The renal cortex has an average thickness of 0.6 cm. Blunting of the renal pyramids and narrowing of the calyces are noted. The renal pelvis appears unremarkable. The ureter is 5.7 cm in length with an average diameter of 0.3 cm.\n\nMicroscopic evaluation reveals a unifocal lesion confined to the kidney, with a maximum dimension of 3.0 cm. The tissue architecture demonstrates clear cell morphology. Nuclear grading is consistent with Grade 2 according to the Fuhrman nuclear grading system. No vascular invasion is identified, either in large or small vessels. Margins are free of involvement by invasive cells. Lymph node and distant metastatic staging could not be assessed. Additional findings do not reveal any other significant pathology."} +{"pid": "TCGA-99-8033", "report": "Observation Date. Last Edited Date. Lung, right upper lobe, wedge excision: A poorly differentiated carcinoma was identified. The tumor demonstrates lymphovascular invasion. Surgical margins are negative for malignant cells. Frozen section assessment of the right upper lobe showed a non-small cell carcinoma morphology. The specimen, received fresh and now fixed in formalin, consists of a wedge of lung measuring 9.5 x 4.0 x 2.0 cm. A staple line margin is present along the length of the wedge. On sectioning, a well-defined, round tan mass measuring 1.4 cm in greatest dimension is observed. This lesion appears well-separated from the staple line margin, with the closest margin approximately 1.0 cm away. A frozen section was taken and placed in an orange cassette labeled A1; the remnant measures 2.0 x 1.0 x 0.3 cm and has been entirely resubmitted. Blocks include: A1 \u2013 frozen remnant; A2 \u2013 section of the lesion; A3 \u2013 staple line margin nearest to the lesion; A4 \u2013 representative section of grossly normal lung tissue; A5 \u2013 additional section of the lesion. Microscopic examination has been completed."} +{"pid": "TCGA-DD-AAE0", "report": "The specimen consists of a left partial hepatectomy measuring 14.0 x 11.5 x 5.5 cm and weighing 289.0 grams, along with a segmentectomy (segment 5) specimen measuring 9.5 x 5.5 x 3.8 cm and weighing 90.0 grams. A gallbladder specimen measuring 8.0 cm in length and 3.0 cm in diameter was also submitted.\n\nIn the hepatectomy specimen, a single mass measuring 6.5 x 5.0 x 7.5 cm was identified. The cut surface revealed a well-demarcated, lobulated, yellowish-tan, solid, and firm lesion. Gross examination showed it to be multinodular and confluent, confined to the hepatic parenchyma. The resection margin was not involved macroscopically, with a safety margin of 3.0 cm. The surrounding liver tissue appeared unremarkable.\n\nIn the segmentectomy specimen, a smaller mass measuring 3.0 x 2.5 x 2.2 cm was observed. Its cut surface was ill-defined, pale tan, firm, and showed areas of necrosis. This lesion was also multinodular and confluent, limited to the hepatic parenchyma. The resection margin was free based on gross evaluation, with a safety margin of 0.6 cm. Remaining parenchymal tissue was otherwise unremarkable.\n\nThe gallbladder measured 8.0 cm in length and had a wall thickness of 0.2 cm. The serosal surface was yellowish-green and smooth, while the mucosal surface appeared dark green and velvety.\n\nMicroscopic analysis demonstrated a tumor composed of hepatic-type cells arranged in trabecular, tubular, and solid patterns. Cellular differentiation was predominantly grade III, with the least differentiated areas classified as grade IV. There was no evidence of fatty change, cholangiocarcinoma, fibrous capsule formation, capsular infiltration, septum formation, surgical margin invasion, serosal invasion, portal vein invasion, vascular invasion, or bile duct invasion. Necrosis was present in the segmentectomy specimen.\n\nEvaluation of non-tumorous liver parenchyma revealed changes consistent with chronic hepatitis of mild activity, both lobular and portoperiportal, with fibrosis extending to a septal stage. There was no cirrhosis or dysplastic nodule identified. Autolytic changes were noted in the gallbladder specimen, with findings suggestive of chronic cholecystitis.\n\nRepresentative sections from the tumor and surrounding hepatic parenchyma, along with non-tumorous liver tissue, were submitted for analysis."} +{"pid": "TCGA-UZ-A9PK", "report": "The patient is a male who underwent partial nephrectomy for a left renal mass. The surgical specimen was received in six parts, each labeled appropriately.\n\nPart A, described as the anterior mass of the left kidney, measured 3.5 x 3.0 x 2.4 cm with a dominant lesion measuring 2.7 x 2.4 cm. The tumor protruded 1.1 cm above the capsular surface and was hemorrhagic and partially cystic on cut section. Microscopically, the lesion showed papillary excrescences lined by small cuboidal to low-columnar cells with clear cytoplasm. Nuclei were moderately enlarged, round to oval, with small nucleoli. Fibrovascular cores were present in the papillae, some containing foamy macrophages. Psammoma bodies and hemorrhage were noted throughout. At least four additional small foci of similar papillary proliferation were identified in adjacent renal parenchyma. The tumor approached within 1 mm of the surgical margin.\n\nPart B, representing Gerota\u2019s fascia adjacent to the mass, consisted of adipose tissue with fibrous nodularity on one side. No abnormal cellular proliferation was identified.\n\nPart C, described as perimass fat, contained a fibrous membrane and lobulated yellow adipose tissue. No tumor was found upon histologic evaluation.\n\nPart D, referred to as tumor mass #2, measured 1.5 x 1.5 x 1.4 cm. It contained a variegated tan and red-brown mass projecting 0.6 cm above the renal surface. Histologically, this lesion was composed of nests of cells with eosinophilic granular cytoplasm and small round nuclei with prominent nucleoli. Two additional small papillary proliferations were seen in the adjacent renal tissue, though they were below the size threshold typically used for definitive diagnosis. Their morphology closely resembled the larger lesions.\n\nPart E, labeled as perirenal fat, included fibrous membrane and adipose tissue. No tumor was identified.\n\nPart F, referred to as tumor mass #3, consisted of three tissue fragments. The largest fragment measured 2.5 x 1.5 x 1.0 cm and contained a 1.2 x 1.0 cm dome-shaped lesion projecting 0.3 cm above the renal surface. The lesion was tan-yellow and irregularly infiltrated the underlying cortex. Histologically, it showed features consistent with the other papillary lesions, including multiple small foci in the adjacent renal parenchyma. Capsular disruption was noted, but its significance could not be definitively determined due to potential artifact.\n\nMicroscopic examination of all specimens revealed multiple foci of papillary proliferation. In parts A and F, the dominant lesions were composed of papillary structures with fibrovascular cores and associated foamy macrophages. Cellular features included moderate nuclear enlargement, round to oval nuclei, and small nucleoli. Hemorrhage and psammoma bodies were present in part A. Additional microfoci were identified in the adjacent renal tissue across several specimens.\n\nThe tumors were multifocal within the kidney. The maximum tumor diameter was 2.7 cm. No involvement of the renal pelvis, ureter, renal sinus, or hilar veins was observed. Vascular or lymphatic invasion was not present. Resection margins were negative, with the closest proximity being 0.1 cm in part A. No lymph nodes were submitted for evaluation.\n\nThe histologic grade was 2. Based on these findings, the stage assigned was pT1NXMX."} +{"pid": "TCGA-QR-A70J", "report": "The right adrenal gland specimen measured 8.7 x 4.2 x 2.8 cm and weighed 35.3 grams. A nodule measuring 3.4 cm in greatest dimension was identified within the gland. Upon sectioning, the nodule had a soft maroon-pink cut surface with areas of hemorrhage. Microscopic examination revealed nests of cells partially separated by delicate fibrous stroma, along with supporting cells. Immunohistochemical staining showed strong and diffuse positivity for chromogranin and synaptophysin. S100 staining highlighted the supporting cell population, while inhibin was negative. No other nodules were identified in the remainder of the adrenal gland, which otherwise displayed normal architecture with a golden yellow cortex and central gray medulla.\n\nA separate skin biopsy from the right lower back measured 1.2 cm in diameter and showed features consistent with a benign nerve sheath lesion. The tissue was entirely submitted for evaluation. All immunohistochemistry and molecular tests referenced were performed in a CLIA-certified laboratory and were used as an aid in the interpretation of these findings."} +{"pid": "TCGA-BP-4349", "report": "Clinical history is notable for an incidentally discovered left renal mass that has increased in size over time. The specimen submitted is identified as a left lower pole partial nephrectomy.\n\nThe tumor measures 1.5 cm in greatest dimension and is well-circumscribed, with a yellow-tan, glistening, and homogeneous appearance. It is located adjacent to the renal capsule. Histologic evaluation reveals nuclear features corresponding to grade II on a four-tier scale. There is no evidence of vascular invasion. The tumor extends through the renal capsule but remains confined within Gerota\u2019s fascia. Surgical margins are free of tumor. No lymph nodes or adrenal gland were identified in the specimen. The surrounding renal parenchyma appears unremarkable.\n\nOn gross examination, the specimen measures 4.5 x 2.5 x 2.2 cm and includes perirenal fat inked in black. The tumor is circumscribed and shows areas of hemorrhage and fibrosis on sectioning. Representative sections of the tumor and surrounding tissue have been submitted for further analysis."} +{"pid": "TCGA-A4-A5XZ", "report": "The specimen is from a female patient and consists of a right kidney nephrectomy. The kidney measured 12.6 x 11.1 x 7.7 cm and weighed 613.5 grams. A well-defined, encapsulated mass measuring 8.6 x 8.6 x 8.3 cm was identified within the kidney. The mass was soft, yellow-tan in color, and showed areas of necrosis and hemorrhage. It did not involve the renal pelvis or extend beyond the kidney. The surrounding renal parenchyma appeared tan to pink with an ill-defined corticomedullary junction.\n\nHistologically, the lesion was unifocal and confined to the kidney. Nuclear grading was Fuhrman grade 3 out of 4. No lymphovascular space invasion or sarcomatoid features were observed. All surgical margins, including the inked surface, ureter, and vasculature, were free of involvement. No lymph nodes were present in the specimen.\n\nImmunohistochemical staining demonstrated positivity for cytokeratin 7 in the tumor cells. CD68 staining was positive in foamy macrophages located in the papillary cores. These findings were supported by morphologic evaluation. The pTNM staging was determined to be pT2aNx.\n\nGross examination also revealed a 5.7 cm segment of ureter adjacent to the mass. Vascular structures at the hilum were noted, but no tumor involvement was identified. Portions of the mass, renal capsule, ureter, and surrounding tissue were submitted for further analysis in multiple cassettes."} +{"pid": "TCGA-RT-A6Y9", "report": "The specimen consists of an ovoid mass measuring 3.3 cm in greatest dimension and weighing 14.0 grams. The lesion is well-encapsulated and cuts with minimal resistance. On cross-section, the lesion demonstrates a sharply circumscribed appearance with a tan-brown, heterogeneous surface. No cystic spaces are identified. A thin rim of unremarkable adrenal tissue is present at the periphery. The external surface of the specimen is marked with black ink. Sections submitted include representative portions of the mass in relation to the inked margin, as well as additional non-marginal sections and a sample of uninvolved adrenal tissue."} +{"pid": "TCGA-IB-7651", "report": "The specimen consists of a pyloric sphincter, duodenum, common bile duct, and portions of the pancreas. The pancreatic head contains a poorly circumscribed tan lesion measuring 2.7 x 2.2 x 2.9 cm, located 2.2 cm from the tip of the uncinate process. The lesion is found near the distal pancreatic resection margin, appears to involve the biliary duct wall, and abuts the anterior surgical margin. The common bile duct shows proximal dilation with a distal stricture measuring 1.4 cm in circumference. Histologically, the lesion demonstrates an infiltrative growth pattern with glandular structures and small nests of cells. Invasion is noted into the duodenum, reaching the duodenal mucosa, and into the common bile duct with extension to the surface epithelium. Vascular and perineural invasion are present. Resection margins are free of involvement. Nine lymph nodes are identified, three of which contain metastatic deposits with extranodal extension. The duodenum and other uninvolved pancreatic regions appear unremarkable."} +{"pid": "TCGA-D5-6534", "report": "Histopathological examination was performed on a resected specimen of the large intestine with surrounding fat tissue, measuring 24 x 5 x 4 cm. A lesion was identified in the mucosa, measuring 1.8 x 1.5 x 0.7 cm, with ulcerated appearance. Microscopic evaluation revealed a malignant neoplasm with mucinous features. The tumor infiltrates through the layers of the intestinal wall, extending into the pericolonic adipose tissue. No evidence of residual tumor was found at the resection margins. Reactive lymph node changes were observed; no metastatic involvement was detected. Staging is consistent with pT3, pN0."} +{"pid": "TCGA-UT-A88C", "report": "HISTOPATHOLOGY REPORT: CLINICAL NOTES: Probable malignancy on needle biopsy right chest wall. MACROSCOPIC: The specimen labeled 'parietal pleura' consists of six strips of grey soft tissue, ranging in size from 5mm to 100mm in maximum dimension. There is a separate 5mm fatty nodule present. No definite tumor is identified grossly. The tissue is divided and fully embedded for analysis (Blocks A & B). MICROSCOPIC: The tissue includes portions of pleura with adjacent adipose tissue and skeletal muscle. Within this tissue, there is an infiltrate of large, epithelioid malignant cells forming cohesive aggregates arranged in pseudoacinar, tubular, and micropapillary patterns. The cells exhibit large, irregular nuclei with prominent nucleoli and variable cytoplasmic staining, ranging from eosinophilic to clear. A fibrous stromal component is present in the background. The malignant cells are observed infiltrating into and between fat deposits. No necrosis or sarcomatoid areas are identified. Immunohistochemical staining demonstrates strong positivity for calretinin, 34BE12, HBME1, and CK7, with patchy expression of CK5/6. Negative markers include CEA, MOC31, CK20, and TTF1. The histologic architecture and immunoprofile support the presence of a malignant process involving the pleura. DIAGNOSIS: RIGHT PARIETAL PLEURA \u2013 MALIGNANT PROCESS, EPITHELIoid morphology. File referenced for further clinical correlation and treatment planning."} +{"pid": "TCGA-A4-A5DU", "report": "A partial nephrectomy specimen from the left kidney contains a unifocal lesion measuring 2.2 cm in greatest dimension. The lesion is confined to the kidney and demonstrates microscopic features consistent with a well-defined cellular morphology. Histologic evaluation reveals nuclear characteristics corresponding to grade 2 according to standard classification criteria. The lesion focally involves the cauterized parenchymal resection margin. No evidence of lymphovascular invasion is observed. Adjacent renal parenchyma appears benign. A separate biopsy from the base of the mass shows only fragmented benign renal tissue without any malignant findings.\n\nStaging assessment indicates the lesion is limited to the primary site with no regional lymph node involvement or distant metastasis identified. Based on available data, the tumor stage is classified as I. Margins are assessed as focally positive at the parenchymal resection site. No sarcomatoid differentiation is noted. All tumor measurements and evaluations were derived from the current specimen and interpreted in accordance with established staging protocols."} +{"pid": "TCGA-FE-A239", "report": "The specimen consists of a total thyroidectomy measuring 5.5 x 4.5 x 3.5 cm on the right lobe and 4.0 x 2.0 x 1.0 cm on the left lobe. A mass measuring 4.5 x 2.5 x 2.7 cm is identified in the right lobe, located 1.0 cm from the isthmus. The mass appears ill-defined, indurated, tan-yellow, and lobulated, abutting the capsule without clear invasion. Histologically, the lesion demonstrates low-grade features with lymphatic/vascular invasion present but no capsular invasion. The extent of the lesion is confined to the thyroid gland without multifocality, cartilage or hyoid bone involvement, or infiltration of adjacent structures. Surgical margins are negative. Two lymph nodes were examined, including one from the left mid jugular chain, none of which show evidence of metastatic involvement. All lymph nodes are negative (0/2). Staging is classified as pT3N0Mx. Frozen section analysis of the thyroid showed findings consistent with a neoplastic process while the lymph node was benign. Multiple cassettes were submitted for evaluation, including sections from the tumor, surrounding tissue, and lymph node."} +{"pid": "TCGA-D1-A1NW", "report": "A soft tissue biopsy of the ileal mesentery and small bowel serosa each show involvement by high-grade cellular changes. A pedunculated endometrial polyp measuring 7.5 x 3.8 x 2.9 cm is present in the uterine cavity, attached at the left posterior wall and cornu. Within this polyp, two distinct areas of altered tissue are identified, measuring 4.2 x 1.6 x 1.4 cm and 0.7 x 0.4 x 0.2 cm respectively. The surrounding myometrium is not involved, though extension to the endocervix is noted. Involvement of the posterior uterine serosa, cul-de-sac, adherent peritoneum, and bilateral paraovarian soft tissue is present. Both ovaries and fallopian tubes are free of involvement. No clear evidence of lymphatic or vascular invasion is seen, and all surgical margins are negative. The background endometrium shows cystic atrophy.\n\nThe anterior vaginal margin is free of abnormality. Lymph node groups from the left and right pelvic regions, as well as right para-aortic above and below the inferior mesenteric artery, are all negative. However, among the left para-aortic lymph nodes above the inferior mesenteric artery, a subset (2 out of 13) shows focal involvement. The left para-aortic lymph nodes below the artery are negative.\n\nThe appendix demonstrates surface involvement. The omentum contains multiple nodules ranging from 0.2 to 8.0 cm. Tissue samples from the right and left gonadal vessels are unremarkable. Both right and left pelvic sidewall peritoneal biopsies show involvement.\n\nGrossly, the uterus with attached tubes and ovaries weighs 164.1 grams. The endometrial polypoid mass measures 7.5 x 3.8 x 2.9 cm and contains two distinct foci of altered tissue. The myometrium measures 1.4 cm in thickness. Ovaries and fallopian tubes are without significant gross abnormalities, though serosal changes are noted. A fragment of peritoneum is also involved. The omentum measures 78.0 x 12.0 x 1.7 cm and contains multiple nodules. Peritoneal biopsies from both pelvic sidewalls are extensively involved. All other submitted tissues do not show visible tumor involvement. Final staging based on available material is pT3bN2 (AJCC 7th edition, 2010). Findings are based on initial histologic evaluation; confirmation with permanent sections was performed and any significant changes would be reflected in a revised report."} +{"pid": "TCGA-DU-8166", "report": "A 45-year-old woman presented with recent onset seizures. MRI demonstrated a large, ill-defined, diffusely infiltrating lesion in the left frontal region with involvement of the body of the corpus callosum and faint enhancement with gadolinium. A biopsy was performed of a left frontal mass and a contrast-enhancing nodule.\n\nGross examination of the biopsy specimens revealed two fragments of brain tissue measuring 2.3 x 1.7 x 0.9 cm in total. Histologic evaluation showed areas of white matter with mild to moderate infiltration by a glial neoplastic process. The tumor cells displayed mixed nuclear features, with some resembling oligodendroglial morphology and others showing astrocytic characteristics. A single mitotic figure was identified across all sections examined. No microvascular proliferation or necrosis was observed. In certain sections, the tumor appeared more cellular, with a predilection for the cerebral cortex and prominent microcystic changes. In other areas, solid sheets of neoplastic cells were present.\n\nImmunohistochemical staining showed GFAP positivity in reactive astrocytes and a sparse gliofibrillary background. CD163 highlighted vascular-associated microglia without evidence of activated or phagocytic forms. p53 staining revealed a population of large nuclei with strong overexpression of the protein, suggesting possible neoplastic changes. MIB-1 labeling highlighted several cycling nuclei, consistent with proliferative activity, although low in frequency.\n\nGenetic testing for loss of heterozygosity (LOH) at chromosomes 1p and 19q was performed using microsatellite markers. The results showed allelic loss at both chromosomal arms, detected at loci D1S1592, D1S1612, D19S412, and PLA2G4C. This pattern is typically associated with certain glial tumors. However, no anaplastic features such as increased cellularity or significant mitotic activity were observed in the current specimen. These findings may suggest a lower-grade neoplasm with potential for progression.\n\nMGMT promoter methylation analysis was negative, indicating no detectable methylation in the promoter region. The absence of methylation may be relevant for treatment planning, as it has been associated with reduced response to alkylating agent therapy in some gliomas.\n\nIntraoperative touch preparation and frozen section evaluation revealed atypical isolated nuclei, rare perivascular lymphocytes, and reactive astrocytes, but these findings were not diagnostic on their own. Additional permanent sections were required for definitive assessment.\n\nOverall, histopathological and molecular findings are consistent with a diffusely infiltrating glial neoplasm with mixed features, low proliferative index, and no evidence of high-grade transformation. The molecular profile suggests specific genetic alterations that may influence prognosis and management."} +{"pid": "TCGA-JW-A5VH", "report": "The patient is a G2 P2 female who underwent biopsy of a cervical and vaginal mass. The specimen, labeled as \"CERVICAL MASS BIOPSY,\" consists of two tan-pink to tan-white tissue fragments measuring 0.5 x 0.4 x 0.2 cm each. Both pieces are inked blue on the resection surface and submitted entirely in one cassette. Microscopic evaluation reveals moderately differentiated malignant cells with features including extensive ulceration and necrosis. Clouds of bacteria are also present. The case was reviewed by a staff pathologist."} +{"pid": "TCGA-63-A5MJ", "report": "The sample was collected from the left lung and measured 6 cm in size. Histological evaluation revealed a moderately differentiated carcinoma with squamous features. The tumor was classified as T2, NOS, with involvement of regional lymph nodes (N1) and no evidence of distant metastasis (M0). The lesion was located at the hilum and primarily involved the upper lobe without extension into the lower lobe. A separate blood-derived sample was also collected."} +{"pid": "TCGA-78-7152", "report": "The submitted specimen consists of a right upper lobe of lung measuring 115 x 100 x 35 mm. A solid mass is identified in the upper lateral segment (segment 2), with puckering of the overlying pleura and an attached pleural segment measuring approximately 120 mm. The mass measures 28 x 25 x 40 mm and has a cream and grey-black cut surface with irregular margins. It is in contact with the anterior pleura but does not involve the posterior pleural surface or the bronchial structures. The surrounding lung tissue shows emphysematous changes.\n\nMicroscopically, the lesion demonstrates a well to moderately differentiated mucin-secreting tumor with a papillary and lepidic growth pattern. Central acini infiltrate fibroelastotic scar tissue, and there is focal invasion into the pleura. No vascular, lymphatic, or perineural invasion is observed. The adjacent lung parenchyma reveals bullous emphysema and organizing pneumonia. The bronchial resection margin is free of tumor, and no squamous metaplasia or dysplasia is present. Lymph nodes adjacent to the bronchus do not show any involvement. A separate lymph node specimen measuring 12 x 12 x 5 mm also shows no evidence of malignancy.\n\nStaging is based on a maximum dimension of 40 mm with pleural invasion, absence of lymph node or distant metastases, and no evidence of vascular or lymphatic invasion."} +{"pid": "TCGA-EW-A1PG", "report": "The surgical pathology report includes a mastectomy specimen from the left breast, with lymph node sampling including sentinel lymph nodes and axillary dissection. The tumor site is located in the lower outer quadrant. Gross examination identified two ill-defined tan, firm lesions. The first lesion measured 2.5 x 1.5 x 1.5 cm and was located at 4 to 5 o\u2019clock, 1.5 cm from the deep margin. The second lesion measured 2.0 x 1.5 x 1.5 cm and was located at 7 to 8 o\u2019clock, 2.0 cm from the deep margin.\n\nHistologically, the invasive component had a greatest dimension of 2.5 cm. Histologic features included minimal tubule formation (score = 3), small regular nuclei (score = 1), and less than 10 mitoses per 10 high-power fields (score = 1), resulting in a total Nottingham score corresponding to Grade I. There was also presence of extensive lobular carcinoma in situ. Margins were uninvolved by invasive carcinoma, with the closest margin being the deep margin at a distance of 1.5 cm. No venous or lymphatic invasion was identified.\n\nA total of 25 lymph nodes were examined. Of these, one lymph node contained a metastatic focus measuring 0.4 cm in greatest dimension. Sentinel lymph nodes A, B, C, F, G, and I were negative on keratin staining. One sentinel lymph node (H) showed cellular evidence of metastatic involvement on touch prep. Non-sentinel lymph nodes and other sentinel nodes evaluated were negative for tumor cells. Keratin stains on remaining sentinel and axillary lymph nodes were negative.\n\nStaging was based on the combined size of the two largest nodules, which measured 2.5 cm and 2.0 cm. Pathologic staging was determined as pT2, pN1a, pMX. Immunohistochemical stains were used for evaluation, with results interpreted by the attending pathologist after review of relevant preparations. An amendment was made to the diagnosis following case review, changing the status of sentinel node #7 to positive based on touch preparation findings."} +{"pid": "TCGA-FD-A5BY", "report": "The patient is a female who underwent surgical resection. The specimens received included scar tissue, right and left pelvic lymph nodes, and a cystectomy specimen involving the bladder, urethra, and a segment of small bowel.\n\nThe scar tissue specimen consisted of an ellipse of skin and subcutaneous tissue with fibrosis but no evidence of tumor. A total of 11 right pelvic lymph nodes and 8 left pelvic lymph nodes were examined, all without evidence of tumor involvement.\n\nThe cystectomy specimen included a bladder measuring 8 x 6 x 1.3 cm and adjacent bowel mucosa. A white-tan, friable ulceration was identified on the posterior bladder wall, measuring 2 x 1.8 cm grossly, with a cut section measuring 2.4 x 1.2 x 0.7 cm. The lesion extended into the muscularis propria and approached the deep margin. No tumor was identified at the distal urethral margin, ureteral margins, or soft tissue margins. Surrounding bladder mucosa appeared edematous and wrinkled. Resection margins were free of tumor.\n\nPathologic evaluation revealed no tumor in the ovarian tissue adjacent to the bladder or in the intestinal wall segment. A total of 19 lymph nodes were examined, all without evidence of tumor. The depth of invasion was determined to be into the extravesicular soft tissue. The tumor was solitary and measured 2.4 cm in greatest dimension at the posterior wall. According to the 7th edition TNM staging system, the staging was pT3a, N0, MX."} +{"pid": "TCGA-BR-6852", "report": "The specimen consists of a subtotal gastrectomy with a segment of stomach. A polypoid mass measuring 12 x 8 cm is present, involving the subserosa and extending into perigastric fat. The greater and lesser omentum are included, with hyperemia noted in the omental tissue. There is evidence of fibrosis and focal lymphoid infiltration in the omentum. Fifteen lymph nodes were dissected, all of which show reactive changes including sinus histiocytosis and follicular hyperplasia; no metastatic involvement is identified. The surgical margins along the esophagus are free of tumor. Histologic evaluation reveals poorly differentiated cells with no evidence of venous invasion. Lymphatic or perineural invasion is not specified, nor is there information regarding prior neoadjuvant treatment. No additional pathologic findings are reported."} +{"pid": "TCGA-VS-A9UL", "report": "The biopsy specimen from the cervix demonstrates a poorly differentiated squamous cell lesion with invasive growth pattern and presence of necrosis. The tumor exhibits high-grade cytologic features, including marked nuclear atypia and increased mitotic activity. No specific measurements of tumor size are provided in the report. Stromal invasion is present, with depth and extent consistent with advanced local invasion. No lymphovascular space invasion is identified. The morphology supports a malignant process of squamous origin without further specification of subtype."} +{"pid": "TCGA-BH-A0H0", "report": "A segmental mastectomy specimen from the right breast demonstrates a focus of cellular atypia with associated calcifications. The lesion measures 2 cm in greatest dimension on gross examination and is located in the upper outer quadrant. Histologic evaluation reveals nuclear grade 2 features, including tubule formation score 2, nuclear pleomorphism score 2, and mitotic activity score 1, resulting in a total histologic score of 5 out of 9. Resection margins are negative, with the closest margin measuring 0.4 cm anteriorly. No lymphovascular space invasion is identified.\n\nThe non-neoplastic breast tissue shows fibrocystic changes, apocrine metaplasia, ductal epithelial hyperplasia, and sclerosing adenosis. Atypical ductal hyperplasia is also present. Calcifications are noted in association with benign breast parenchyma. Changes related to a prior biopsy are observed.\n\nImmunohistochemical staining of the abnormal cells demonstrates positivity for estrogen receptor, weak positivity for progesterone receptor, and no reactivity for HER-2/neu (score 0). Two sentinel lymph nodes were examined, both from the right axilla, and neither shows evidence of metastatic involvement.\n\nThe tumor is confined without multifocal or multicentric disease. Pathologic staging indicates pT1c based on tumor size, with no regional lymph node involvement (pN0) and no assessment of distant metastasis (pMX). Lymph node evaluation was performed using hematoxylin and eosin staining. Other findings include ductal epithelial hyperplasia and sclerosing adenosis, but no florid cystic disease."} +{"pid": "TCGA-A6-2681", "report": "The specimen consists of a 31 cm segment of proximal right colon with attached 28 cm of distal ileum, featuring smooth tan-pink serosa and a copious amount of attached mesentery, mesocolon, and unremarkable omentum. The appendix measures 3.2 cm in length and 0.6 cm in diameter and appears unremarkable. Proximal and distal margins measure 4.2 cm and 7.0 cm in circumference, respectively. Upon opening, a well-circumscribed mass measuring 2.8 x 2.5 cm is identified within the cecal pouch, located 2 cm distal to the ileocecal valve. The tumor has a rubbery tan-pink-red appearance and on sectioning demonstrates a maximal thickness of 0 cm, approaching the muscularis and extending to within 0.5 cm of the inked free radial serosal surface. The ileal mucosa and remaining colonic mucosa appear glistening tan-pink with regular folds; wall thickness averages 0.5 cm. A few uncomplicated diverticula are noted throughout the colonic segment. Several soft tan-pink lymph nodes measuring up to 1 cm in greatest dimension are recovered from the mesentery and mesocolon. Fifteen tissue blocks were submitted for analysis, including proximal and distal margins, ileum, ileocecal valve, random colon, appendix, and representative lymph nodes.\n\nHistologic examination reveals moderately differentiated epithelial cells arranged in irregular glandular structures infiltrating through the muscularis propria into the subserosal fat. Margins of excision show no evidence of involvement. No vascular invasion is identified. Twenty-three lymph nodes examined demonstrate no evidence of metastatic involvement. Additional findings include an unremarkable appendix and ileum, along with diverticulosis."} +{"pid": "TCGA-BH-A0DS", "report": "The surgical specimen includes a biopsied lymph node which shows no evidence of metastatic involvement. A second lymph node contains a metastatic deposit measuring 1.5 mm in greatest dimension without extracapsular extension. The main surgical specimen from the right breast at 9 o\u2019clock demonstrates multifocal invasive disease with a primary lesion measuring 2.2 cm. A smaller satellite nodule of invasive disease, measuring 2.5 mm, is present near the lateral aspect of the specimen, separate from the main lesion. An additional focus of invasive disease is identified in a different section of the tissue. Lymphovascular space invasion and perineural invasion are both present. The tumor nodules exhibit central fibrosis with a stromal reaction resembling pseudo decidua-like hyperplasia. In addition, there is an associated in situ component characterized by high nuclear grade and comedonecrosis with calcifications. Surgical margins are free of invasive disease; however, the closest margin to invasive tumor is 3 mm at the anterior edge, and the closest margin to intravascular tumor is 2 mm at the superior edge. Histologic features are consistent with prior biopsy changes. Immunohistochemical staining indicates reactivity for hormone receptors, while HER-2 immunostaining shows minimal or equivocal expression.\n\nIn the axillary lymph node dissection, a small tumor deposit measuring 9.5 mm is identified, morphologically similar to the primary lesion. Seven out of thirteen lymph nodes contain metastatic deposits with a maximum size of approximately 6 mm each. There is evidence of limited extracapsular extension measuring less than 1 mm. Additional findings include extensive intravascular tumor within the lymph nodes.\n\nPathologic staging is based on these findings. The largest invasive component measures 2.2 cm. Multifocality is confirmed with a total aggregate size of 3.4 cm. Histologic grade is determined by a scoring system (nuclear grade 3, tubule formation score 3, mitotic activity score 1, total score 7/9). Angiolymphatic invasion is documented. The in situ component is composed of cribriform and comedo-type morphology. All surgical margins are negative, with the closest distance of invasive tumor to margin being 2 mm. A total of 14 lymph nodes were evaluated using standard histologic techniques. The largest nodal metastasis measures 6 mm. Estrogen and progesterone receptor expression is present. HER-2 staining is either absent or weakly positive."} +{"pid": "TCGA-BH-A0DP", "report": "The specimen consists of a resected breast tissue measuring 5.5 cm in its maximum dimension. Histological evaluation reveals invasive foci with multicentric and multifocal growth patterns. The tumor exhibits classical and signet ring cell morphology, with a Nottingham score of 6 (score breakdown: tubules \u2013 3, nuclear grade \u2013 2, mitoses \u2013 1), corresponding to a histologic grade of 2. Angiolymphatic invasion is present, and calcifications are noted in both benign and malignant zones.\n\nIn situ components are identified, occupying approximately 2% of the tumor volume. No Paget\u2019s disease of the nipple is observed. Surgical margins are clear of invasive and in situ disease.\n\nLymph node assessment includes four nodes examined via H/E and keratin staining. Two sentinel lymph nodes are identified; one contains isolated keratin-positive cells measuring up to 0.15 mm in diameter, without extracapsular extension. The remaining nodes show no evidence of metastasis.\n\nNon-neoplastic findings include fibrocystic changes and sclerosing adenosis. Estrogen and progesterone receptors are positive. HER2/NEU expression is scored as zero or 1+.\n\nPathologic staging is pT3 for the primary tumor, pN0(i+) for lymph node involvement, and pMX for distant metastasis."} +{"pid": "TCGA-D8-A1JE", "report": "Histopathological examination was performed on multiple organ resection tissue from the left breast and axillary region. The specimen measured 19 x 20 x 5 cm and included a skin flap measuring 16 x 11 cm, with a total weight of 800 g. A lesion measuring 1.5 x 1.5 x 1.5 cm was identified at the border of the upper quadrants, located 6.5 cm from the upper boundary, 0.7 cm from the base, and 0.1 cm from the skin.\n\nMicroscopic evaluation revealed a neoplastic proliferation characterized as NHG2 grade, with a mitotic count of 15 mitoses per 10 high-power fields (scored 2 + 2 + 3). The visual area for mitotic assessment had a diameter of 0.55 mm. The growth pattern was glandular. Surrounding non-neoplastic breast tissue exhibited fibrocystic changes and ductal hyperplasia of a simple type.\n\nAxillary lymph node dissection included multiple nodes. Metastatic involvement was identified in three out of ten lymph nodes examined. Capsular infiltration was observed in the affected nodes.\n\nImmunohistochemical analysis demonstrated the presence of estrogen and progesterone receptors in more than 75% of neoplastic cell nuclei. HER2 protein expression was assessed using HercepTest\u2122 M by DAKO, yielding a score of 1+, indicating a negative reaction in invasive components.\n\nStaging was determined based on pathological findings."} +{"pid": "TCGA-E7-A8O7", "report": "The specimen consists of bladder tissue. Grossly, a lesion is present within the bladder wall, measuring approximately 4 x 3 x 2.5 cm. It exhibits invasive growth with irregular margins and has a soft, gray appearance on surface inspection.\n\nMicroscopically, the lesion demonstrates hyperplastic cells arranged in papillary formations, trabeculae, and cords. The cells display moderate eosinophilic cytoplasm. Nuclear features include marked enlargement, variability in size and shape, irregular nuclear membranes, prominent nucleoli, and abnormal chromatin distribution. Mitotic figures are identified. The lesion extends into the muscularis propria.\n\nMargins are uninvolved. There is no evidence of lymph node involvement, lymphatic or venous invasion, or prior neo-adjuvant treatment effects. No additional findings are noted."} +{"pid": "TCGA-AG-A011", "report": "The resected rectal specimen shows a poorly differentiated carcinoma with infiltration into the pericolic fatty tissue. All resection margins are free of tumor involvement. A total of fourteen lymph nodes were examined and none showed evidence of metastasis. Vascular and lymphatic invasion are not identified. The splenic tissue demonstrates superficial changes with capsule defects and hemorrhage, but no malignant findings are present."} +{"pid": "TCGA-GV-A3JZ", "report": "The submitted specimens include multiple tissue samples from the urinary tract and associated lymph nodes. Histologic evaluation revealed atypical urothelial cells in one biopsy specimen from the left distal ureter. Another biopsy from a different site showed no evidence of neoplastic cells. In the lymph node specimens, several were found to contain abnormal cells consistent with metastatic involvement; specifically, two out of six lymph nodes in one group and two out of four in another group showed signs of involvement. One lymph node from a separate group also demonstrated similar findings.\n\nThe primary surgical specimen included a large excision measuring 13.0 x 9.0 x 5.5 cm, which encompassed the bladder and prostate. An irregular mass measuring 3.5 cm in greatest dimension was identified within the bladder. The mass extended through the muscular wall and reached into adjacent adipose tissue. Microscopic analysis showed poorly differentiated cells infiltrating the prostatic urethra and extending into nearby prostatic tissue. Vascular invasion was noted, and tumor cells were found at the perivesical fat and prostatic stroma. Margins were free of invasive disease.\n\nLymph node specimens from various anatomical regions were evaluated. Multiple lymph nodes from the right pelvic area, right common iliac region, and presacral location showed no signs of involvement. In contrast, metastatic cells were identified in lymph nodes from the left pelvic and left common iliac regions. The largest metastatic deposit measured 2.2 cm and extended beyond the lymph node capsule into surrounding adipose tissue.\n\nOther findings included inflammation and granular mucosa in segments of the ureters. No definitive mass was identified in the prostate, although nodularity was present. Sections of fibroadipose tissue contained tan-white nodules resembling lymph nodes. Numerous tissue sections were submitted for further histologic examination, including areas from the bladder walls, ureteral margins, prostate, seminal vesicles, and attached lymph nodes."} +{"pid": "TCGA-DU-A7TI", "report": "The surgical specimens obtained from the parietal temporal region of the brain include four distinct tissue samples. The first specimen consisted of two firm, tan-white fragments measuring 1.3 cm and 0.9 cm. Microscopic examination revealed a glial neoplastic proliferation involving the cerebral cortex and adjacent white matter with moderate nuclear pleomorphism. The nuclei were rounded and elongated, and the neuropil was rarefied with numerous reactive astrocytes. No necrosis, mitotic figures, or microvascular proliferation was identified. Immunostaining showed a MIB-1 labelling index of 2%.\n\nThe second specimen was a single soft, discoid fragment measuring 0.9 cm with a yellowish-red appearance. Histologic analysis demonstrated a more cellular tumor with frequent gemistocytic morphology, prominent nuclear pleomorphism, and features of anaplasia. Karyorrhexis was focally present, and mitotic figures were frequent. The vasculature exhibited capillary-type interanastomosing vessels. The MIB-1 labelling index for this area was significantly higher at 8%.\n\nThe third specimen, representing the deep margin, measured 1.5 x 1.0 x 0.6 cm and was soft and red-tan in consistency. Microscopically, it showed diffuse infiltration of a glial neoplasm within gray and white matter. The cells exhibited mild pleomorphism with no evidence of mitoses, necrosis, or microvascular proliferation.\n\nThe fourth specimen, which weighed 1.9 grams and measured 3.0 x 2.0 x 1.0 cm, was composed of several red to gray-tan tissue fragments. Histologically, it displayed a glial neoplastic proliferation with moderate nuclear atypia and variability in cellularity. Some regions showed perinuclear halos, a finely fibrillary background, fine capillary-type vessels, minigemistocytes, and true gemistocytes. No necrosis or mitotic activity was observed in this section.\n\nImmunohistochemical staining confirmed glial differentiation with GFAP and highlighted vascular structures with CD34. Each specimen provided distinct histological features and varying levels of cellular atypia and proliferation indices across different regions of the resected tissue."} +{"pid": "TCGA-DD-A3A8", "report": "The submitted specimens include a gallbladder measuring 10.3 x 5.2 x 2 cm, a pericholedochal lymph node measuring 3.2 x 2.3 x 0.7 cm, a spleen weighing 165 grams with dimensions of 11.2 x 6.5 x 4.2 cm, and the right lobe of the liver weighing 1110 grams and measuring 17.5 x 14.5 x 8 cm. The liver specimen shows a multinodular mass measuring 7.5 x 5.8 x 5 cm located in the right lobe. The hepatic capsule is intact without tumor involvement. Microscopic examination confirms clear surgical margins with a clearance distance of 0.1 cm. There is no evidence of extratumoral vascular invasion. The mass is entirely encapsulated without extension beyond the capsule. Examination of the spleen reveals no abnormal findings. The excised pericholedochal lymph node is benign. The gallbladder shows histologic features consistent with chronic cholecystitis and no gallstones are identified. Immunohistochemical analysis of the liver tissue demonstrates that the neoplastic cells are negative for insulin staining."} +{"pid": "TCGA-RC-A7SK", "report": "The liver specimen from a left lobectomy measures 12x8x4 cm and weighs 175 grams. The external surface contains a subcapsular, protruding mass. The resection margin is clear, with the closest distance to the tumor being 0.3 cm. On sectioning, a single mass measuring 4x3.5x3 cm is identified, with a nodular appearance and perinodular extension. No satellite nodules are present. The remaining liver tissue appears unremarkable.\n\nHistologically, the lesion shows a mix of differentiation grades, with the worst being Edmondson grade IV and the predominant pattern corresponding to Edmondson grade III. The histologic type is microtrabecular, and the cell type is consistent with hepatic origin. Tumor necrosis is present in approximately 10% of the sample. There is no evidence of hemorrhage or fatty change within the tumor. A partial fibrous capsule is noted, with infiltration into the capsule observed. Septum formation is also present. Invasion of surgical margins, serosa, portal vein, bile ducts, hepatic veins, or arteries is not seen. Microvascular invasion is present, and there is no intrahepatic metastasis or multicentric occurrence.\n\nLymph node evaluation reveals no metastasis (pN0). The non-tumor liver background shows chronic hepatitis of mild activity, likely related to hepatitis C virus. There is minimal lobular inflammation and mild portal/periportal inflammation. Fibrosis is present in a periportal pattern without cirrhosis. No dysplastic nodules, biliary epithelial dysplasia, or other significant liver disease is found. A small degree of macrovesicular fatty change (10%) is present.\n\nA separate gallbladder specimen from cholecystectomy measures 9 cm in length and 1.5 cm in diameter, with a wall thickness of 0.2 cm. The mucosa appears greenish and velvety. No stones or polyps are observed. Histology shows changes consistent with chronic cholecystitis.\n\nA lymph node specimen embedded entirely in one cassette shows no abnormality on routine and special stains, including H&E, Masson's trichrome, D-PAS, and immunostains for cytokeratin 7, cytokeratin 19, and hepatocyte-specific markers."} +{"pid": "TCGA-E2-A1LH", "report": "The specimens include two sentinel lymph node biopsies from the right axilla, each containing a single lymph node, both negative for tumor involvement. A wide excision of the right breast was performed, with margins of resection free of tumor. The primary lesion measured 1.5x1.5x1.2cm and was described as poorly differentiated with ductal features and lobular extension. The histologic grade was SBR Grade 3. Associated findings included blunt duct adenosis, focal sclerosing adenosis, and duct ectasia. A separate excision of a right breast cyst showed changes consistent with a ruptured apocrine retention cyst, including reactive atypia, periductal fibrosis, granulation tissue, cystic and papillary apocrine change, and focal periductal duct ectasia.\n\nA re-excision of the inferior lateral margin of the right breast demonstrated a focus of high nuclear grade DCIS with solid pattern, involving three lobular acini, without evidence of stromal invasion. Additional microscopic findings included stromal fibrosis, focal periductal mastitis, cystic apocrine change, and calcifications. The focus of DCIS measured 8x5mm on slide E6 and 6x4mm on slide E4. No vascular or lymphatic invasion was identified. Non-neoplastic findings were noted in some areas.\n\nLymph node analysis showed no evidence of metastasis (0/2 sentinel nodes). Pathologic staging was pT1c. Hormone receptor status (ER, PR) and HER2 expression by IHC were all pending, with ER and PR reported as 0% and HER2 as 0.0%. No FISH analysis for HER2 gene amplification had been performed.\n\nGross examination of the wide excision specimen revealed a tan-grey, well-circumscribed mass within the breast tissue, measuring 1.5x1.5x1.2cm, located approximately 0.8cm from the anterior margin. The remainder of the specimen contained multiple small cystic nodules, all less than 0.3cm in diameter. The re-excision specimen measured 2.0x1.7x1.5cm, with a new margin submitted for evaluation.\n\nAll surgical margins were assessed; the initial wide excision had free margins, while the re-excision focused on an area near the inferior lateral aspect. Multiple sections were taken from all specimens to ensure comprehensive evaluation."} +{"pid": "TCGA-A8-A091", "report": "The specimen demonstrates a poorly differentiated invasive carcinoma with areas of in situ involvement. The tumor measures 2.2 cm in greatest dimension. Histologic evaluation reveals high-grade features with focal neuroendocrine-like differentiation. Lymph node status is negative based on sentinel node assessment. The lesion is classified as NOS, G III, pT2N0(sn)LOVORO."} +{"pid": "TCGA-IB-A5ST", "report": "The specimen consists of a gallbladder measuring 11.0 x 5.0 x 3.5 cm, containing green mucoid bile and a single cholesterol gallstone measuring 2.7 x 1.6 x 1.5 cm. The gallbladder mucosa shows a small focal polypoid area measuring 0.4 cm, with the remainder of the mucosa appearing velvety and smooth. The wall thickness measures 0.2 cm. A cystic duct lymph node measuring 0.7 cm is present adjacent to the cystic duct resection margin. Histologically, the gallbladder demonstrates mild acute and chronic inflammation with no evidence of dysplasia or malignancy. The cystic duct lymph node reveals slight granulomatous changes but is negative for malignancy.\n\nA second specimen labeled as \u201c8A node\u201d consists of a firm grey-tan tissue fragment measuring 2.0 x 1.1 cm. Microscopic evaluation shows lymph node tissue with lipogranulomatous changes, and no evidence of malignancy is identified.\n\nThe third specimen, a pancreaticoduodenectomy (Whipple resection), includes the head of the pancreas, duodenum, common bile duct, and gallbladder. The pancreatic head measures approximately 5.0 x 4.5 x 3.5 cm, and a tumor-like mass is identified in the head of the pancreas measuring 3.2 x 2.5 x 2.0 cm. On sectioning, this mass approaches the uncinate and inferior margins, with a narrow rim of fatty tissue separating it from the uncinate margin by approximately 0.2 cm. The surrounding peripancreatic soft tissue contains scattered lymph nodes.\n\nMicroscopically, there is an invasive adenocarcinoma of well to moderately differentiated morphology involving the pancreatic head. The tumor invades the duodenal wall and extends into peripancreatic soft tissues. Perineural invasion is present. Resection margins are free of invasive carcinoma, with the closest margin being the uncinate margin at 2 mm. Evaluation of regional lymph nodes reveals two out of sixteen involved with metastatic carcinoma. No lymphovascular invasion is identified. The pancreatic neck margin shows prominent fibrosis and loss of parenchyma, suggestive of chronic pancreatitis. Proximal bile duct and cystic duct margins show only reactive changes and inflammation without evidence of neoplasia.\n\nGrossly, the duodenal mucosa and ampulla of Vater appear unremarkable. The common bile duct measures 3.5 cm in length, with an attached cystic duct segment measuring 2.7 cm and a common hepatic duct segment measuring approximately 1.0 cm. The mucosal surfaces of these ducts show no abnormalities. The specimen also includes a distal stomach segment and small bowel measuring 17.0 cm in total length."} +{"pid": "TCGA-G7-6797", "report": "The surgical specimen consists of a left kidney with attached perinephric fat, measuring 15 x 6 x 4 cm and weighing 301 grams. A primary mass measuring 2.5 x 1.8 x 1.5 cm is present in the renal cortex, appearing well-circumscribed with a solid, white-tan appearance and areas of focal necrosis. This lesion is located 1.0 cm from the renal hilum and appears confined by a thin renal capsule without invasion into surrounding structures such as perinephric fat, Gerota\u2019s fascia, calyces, or pelvis. Two additional cortical masses (1.0 x 0.7 x 0.5 cm and 0.4 x 0.3 x 0.3 cm) are identified on the same side as the dominant mass, both well-circumscribed and solid without necrosis. These are situated approximately 0.4 cm from the renal hilum and also appear confined by the renal capsule. Two small white nodules (0.1 cm and 0.3 cm in diameter) are noted on the surface of the kidney on the same side as the larger masses. Additionally, a separate solid nodule measuring 0.4 cm is found in the cortex on the opposite side of the largest mass, located 0.4 cm from the nearest renal capsule. All lesions are covered by perinephric fat, which was inked blue during gross examination. The uninvolved renal parenchyma appears tan-brown with clear corticomedullary differentiation and normal cortical striations. The renal pelvis and calyces are smooth. No adrenal gland, lymph nodes, or calculi are identified in the specimen.\n\nMicroscopic evaluation reveals that all surgical margins are free of invasive disease. Histologic features include multiple distinct lesions with varying morphologies. In one region, cells demonstrate a papillary architecture with nuclear uniformity, minimal pleomorphism, and inconspicuous nucleoli. Vascular or lymphatic invasion is not identified. Adjacent to this area, other lesions exhibit features consistent with benign mesenchymal proliferation, including admixed adipose, smooth muscle, and vascular elements. There is no evidence of capsular or margin involvement by these processes. Staging classification indicates limited extent confined entirely within the kidney. Additional findings include the presence of multiple benign-appearing renal masses, raising clinical consideration for an underlying systemic or genetic condition warranting further investigation."} +{"pid": "TCGA-34-8455", "report": "The left upper lobe contains a mass measuring 7.8 cm in diameter, extending into the left lower lobe. Four additional tumor nodules, morphologically similar to the primary lesion, are identified, with the largest measuring up to 0.4 cm in diameter. There is no evidence of visceral pleural invasion. A mild lymphocytic host response is present. Surgical resection margins are free of involvement. Background lung tissue shows emphysematous changes and respiratory bronchiolitis.\n\nLymph node sampling from multiple levels (5, 10, 11, 12) and locations, including those near the inferior vein, upper lobe pulmonary artery, and deep fissure, reveals only benign lymph nodes. Some lymph node biopsies are fragmented. Additional biopsies of tissues near the inferior pulmonary ligament, level 12, and inferior fissure show unremarkable fibroadipose tissue, with one specimen showing mild chronic inflammation suggestive of scar. Six fragments of benign N1 lymph nodes are identified.\n\nStaging considerations are complex due to the presence of a prior lesion in the right upper lobe diagnosed as non-small cell carcinoma, likely squamous cell type. The relationship between the two lesions\u2014whether independent primaries or metastatic spread\u2014is unclear. If the lesions are separate primaries, staging would be T3N0. If the right upper lobe lesion is a metastasis, the stage would be T3N0M1a. Clinical correlation is recommended for further clarification."} +{"pid": "TCGA-EO-A22S", "report": "The specimen received included a hysterectomy with bilateral salpingo-oophorectomy and multiple lymph node groups from the right and left external iliac, internal iliac, obturator, common iliac, and lower para-aortic regions. The uterus contained a fungating tan-brown friable tumor mass located on the anterior and posterior endometrium, measuring 4.8 cm in greatest dimension. The tumor extended into the outer half of the myometrial thickness and showed lymphovascular space involvement with extensive necrosis. Stromal involvement was present in the endocervix. No evidence of carcinoma was identified in the ovaries or fallopian tubes; however, endometriosis was noted in the left fallopian tube. Multiple fibroid nodules were present in the uterine wall.\n\nA total of 30 lymph nodes were examined across all regions, with no involvement identified. Histologic evaluation revealed high-grade features including more than 50% nonsquamous solid growth pattern. The tumor was staged as pT1c (IC) based on depth of myometrial invasion. Surgical margins were free of invasive carcinoma. Additional findings included unremarkable cervical mucosa and fibrous adhesions on the uterine serosa. No other significant pathologic findings were identified."} +{"pid": "TCGA-CQ-5323", "report": "The specimen received included a right marginal mandibulectomy with suture at the posterior aspect, along with multiple margin specimens including right anterior, medial, lateral, posterior, and deep muscle margins. Additional specimens included lymph node levels 1A, 1B, 2A, and 3 & 4 from the right neck, as well as surgical waste.\n\nThe marginal mandibulectomy specimen measured 4.0 cm in length by 3.0 cm in width and 5.5 cm in depth. It contained a mucosal tumor measuring 1.5 x 1.5 x 1.8 cm, which was elevated and did not involve the bone. The tumor was located 0.7 cm from the anterior margin, with remaining margins measuring 1.0 cm medially, 1.8 cm posteriorly, and 1.8 cm laterally. Silver nitrate marked all resection margins. A submucosal gland measuring 0.8 x 0.4 x 0.4 cm was identified anterior-medially. Sections were taken from all mucosal margins and central tumor regions, as well as bone margins.\n\nThe right anterior margin specimen measured 2.7 x 2.5 x 1.0 cm and included mandibular bone with one tooth. No tumor was identified in this specimen. Frozen section analysis was performed on several margin specimens including the right medial, anterior, posterior, lateral, and deep muscle margins, all of which were negative for tumor.\n\nLymph node assessment included 12 nodes from level 1A (all negative), 3 nodes from level 1B (all negative), 2 nodes from level 2A (all negative), and 1 node from levels 3 & 4 (negative). The submandibular gland showed no pathologic changes. Surgical waste consisted of skin tissue with no gross abnormalities.\n\nFrozen sections from multiple sites showed high-grade dysplasia in one area that was suspicious but not diagnostic of malignancy. All other frozen sections were negative. Bone sections from the marginal mandibulectomy and right anterior margin were negative for malignancy in the addendum report."} +{"pid": "TCGA-B0-5099", "report": "The specimen shows a neoplasm with nuclear features consistent with Fuhrman's nuclear grade III/IV. The growth pattern is acinar, with extensive intratumoral hemorrhage. The largest dimension of the lesion measures 7.0 cm. There is extension of the tumor into the soft tissue in the region of the renal sinus; however, it remains confined within Gerota's fascia. A notable finding is the invasion of the renal vein with a large tumor thrombus. Margins of the ureter and renal vessels are negative. The surrounding kidney demonstrates changes consistent with nephrosclerosis. No adrenal gland tissue was identified. Staging according to the TNM classification system is pT3b Nx Mx, with a histologic grade of G3, indicating poorly differentiated morphology."} +{"pid": "TCGA-DC-6681", "report": "The clinical history is provided for a female with findings of endometrial thickening and an adnexal mass. Specimens were submitted for evaluation, including endometrial curettings, a resected segment of the sigmoid and rectum, a liver resection (segment three), left and right fallopian tubes and ovaries, a re-excision of the sigmoid colon, and both distal and proximal margins.\n\nHistologic examination of the endometrial curettings revealed scant benign strips of atrophic endometrium mixed with endocervical mucosa and abundant mucus. No abnormal cellular changes were identified in the colonic tissue from the re-excision or in the distal and proximal margins; all showed benign tissue without pathologic abnormalities.\n\nIn the sigmoid and rectum resection specimen, a lesion was identified at the rectosigmoid junction. The lesion measured 7.0 cm in length and 4.0 cm in width, with a maximal thickness of 1.3 cm. Histologic analysis showed moderately differentiated features with focal budding and identified perineural invasion. Lymphovascular and large venous invasion were suspected. The deepest invasion reached the subserosal adipose tissue and/or mesenteric fat, with the tumor located very close to the serosal surface (<0.1 cm). Surgical margins were free of involvement. A total of 24 lymph nodes were examined, with 7 showing evidence of metastatic involvement. No tumor deposits were identified in the surrounding soft tissue.\n\nThe liver resection contained a single nodule measuring 1.8 x 1.5 x 1.0 cm. Histologically, this demonstrated moderately differentiated features with fibrosis and mucinous changes involving 20% of the tumor. The hepatic capsule and surgical margins were free of tumor involvement. Mild nonspecific changes were noted in the non-neoplastic liver tissue.\n\nExamination of the left fallopian tube and ovary showed the presence of an adenofibroma within the ovary, while the right fallopian tube and ovary revealed a fibroma in the ovary. Both fallopian tubes appeared unremarkable.\n\nLymph node dissection associated with the re-excised sigmoid colon showed four benign lymph nodes without any malignant involvement.\n\nAll specimens were processed and examined thoroughly, with representative sections submitted for analysis. Gross descriptions of each specimen were documented, including measurements, appearances of margins, and details of tissue characteristics. Special studies were performed, including specific stains, and additional molecular testing has been initiated."} +{"pid": "TCGA-C5-A2LX", "report": "The specimen was received as a cervical biopsy from a patient. The tissue fragments were tan in color and measured between 0.2 and 0.4 cm in greatest dimension. Microscopic evaluation revealed abnormal cellular growth with features of moderate differentiation. The architecture demonstrated invasive characteristics, with cells arranged in nests and cords extending beyond the basement membrane. Cellular morphology included hyperchromatic nuclei, increased nuclear-to-cytoplasmic ratios, and frequent mitotic figures. Stromal invasion was confirmed, with involvement of the surrounding connective tissue. No lymphovascular space invasion was identified. Immunohistochemical staining and other ancillary studies were performed as part of the evaluation. The laboratory performing the analysis is certified under CLIA \u201988 for high-complexity testing. All tests were conducted using analyte-specific reagents, and results were interpreted in accordance with clinical standards."} +{"pid": "TCGA-B6-A0RT", "report": "A 6.5 x 5.5 x 2.5 cm incisional breast biopsy was received, with one surface previously inked black and a frozen section taken from that area. Grossly, an irregular, whitish, infiltrative lesion measuring 3.5 x 1.7 x 2.1 cm was identified, with focal petechial hemorrhage. A 0.3 cm yellowish gritty area within the lesion is suggestive of calcification. No gross tumor necrosis was observed. A separate 0.3 cm well-defined yellowish nodule was found approximately 0.5 cm from the main lesion. The specimen was serially sectioned every 0.5 cm, and representative sections were submitted for analysis.\n\nA modified mastectomy specimen measuring 21.1 x 15.2 x 3.5 cm was also received, including a skin ellipse and axillary tail. A 5 cm fresh incision line was noted superior lateral to the nipple. On serial sectioning, a biopsy cavity corresponding to the previous biopsy was identified, measuring 6.5 x 5.5 x 2 cm. Within this cavity, a residual lesion measuring 2.5 x 1.5 x 2 cm was found with similar appearance to the original lesion. It was located approximately 1.5 cm from the closest deep resection margin and over 4 cm from the superior margin. Other distances from the biopsy cavity to surrounding margins were: 3 cm from the inferior margin, 4.9 cm from the superior margin, 1 cm from the deep margin, 4.5 cm from the medial margin, 2.5 cm from the lateral margin, and 1 cm from the skin. Margins were inked accordingly (blue for deep, black for superior, red for inferior). The axillary tail was dissected, revealing multiple lymph node candidates, the largest being 1.5 x 1.3 x 1.0 cm. Representative sections of the breast tissue and lymph nodes were submitted.\n\nHistologic evaluation revealed high-grade cellular features with marked nuclear atypia. Invasive growth pattern was identified. In addition, in situ changes with comedo-type morphology were present but accounted for less than 10% of the lesion. No extensive intraductal component or multifocal disease was identified. Non-neoplastic findings included ductal ectasia, fibrosis, and microcyst formation. Lymphatic and vascular invasion was noted. Residual lesion was focally within 0.7 cm of the deep surgical margin. No involvement of the nipple by Paget\u2019s disease or skin infiltration was observed. Of the lymph nodes evaluated, one out of twenty-three contained abnormal cells.\n\nEstrogen and progesterone receptor assays showed no detectable activity. A high proliferation index was recorded with a PI of 70%."} +{"pid": "TCGA-XU-A92R", "report": "The specimen consists of thymic tissue with a mass measuring 5.0 cm in greatest dimension, with additional dimensions of 2.8 x 5.0 cm. The mass is largely encapsulated and composed predominantly of uniform oval to spindle cells arranged in sheets, with few scattered lymphocytes. A distinct area within the mass demonstrates increased lymphocyte and epithelial cell presence, with small central nucleoli. The surrounding thymic tissue shows involutional changes, and a small focus of microscopic involvement is noted near the superior pole resection margin, approximately 0.5 cm away.\n\nFocal invasion into mediastinal fat is identified microscopically. The tumor is present within 0.1 cm of a painted, cauterized surface of the specimen; however, the tumor appears encapsulated at this site. Resection margins are otherwise free of involvement, with the closest distance of tumor to a margin being 1 mm. A small region within the tumor exhibits focal increased cellular atypia and clear cell change; immunostains show positivity for low-molecular-weight keratin, though the significance of this finding remains uncertain.\n\nA separate nodule measuring 1.2 x 0.8 x 0.4 cm is identified and submitted as soft tissue from the left hilum. Histologic features resemble those of the main lesion, and it is well-circumscribed with surrounding soft tissue. Its origin\u2014whether soft tissue or lymph node metastasis\u2014is not definitively determinable by histology alone, requiring clinical and radiologic correlation.\n\nThe entire thymus specimen measures 11.8 x 7.5 x 3.0 cm. No evidence of pulmonary parenchymal, pleural, or vascular invasion is observed. No regional lymph nodes are available for assessment. Distant metastatic spread could not be fully evaluated. Close clinical follow-up is recommended due to the presence of atypical features and proximity to resection margins."} +{"pid": "TCGA-C5-A8XH", "report": "The pathology report describes tissue samples obtained from the uterine endocervix and cervix (12 o\u2019clock position) in a female patient. Microscopic evaluation of the biopsied tissue reveals invasive cellular changes with moderate differentiation. No evidence of lymphovascular space invasion is identified in either sample. The assessment is based on direct examination of the provided slides, which correspond to the submitted materials. Immunohistochemical and other diagnostic testing, where applicable, was conducted under established quality assurance protocols compliant with CLIA \u201988 regulations. All tests were performed using analyte-specific reagents in a certified high-complexity laboratory setting. The findings are intended for clinical use and not for investigational or research purposes."} +{"pid": "TCGA-55-7574", "report": "The surgical specimen includes a right upper lobe lobectomy with an attached wedge resection from the superior aspect of the right lower lobe, along with hilar (N10R) and lower paratracheal (N4R) lymph nodes. The main lesion is a 3.5 x 3.5 x 2.9 cm mass located in the right upper lobe, extending across the interlobar fissure into the adherent wedge resection. The tumor is in close proximity to several margins. The soft tissue adjacent to the bronchovascular margins is positive for tumor; however, the bronchial and vascular walls themselves are not involved. The closest distance from the tumor to a bronchial margin is 0.5 cm, and the stapled margin of the wedge resection is also 0.5 cm away from the tumor. The visceral pleura is not involved.\n\nHistologically, the lesion shows poorly differentiated features. Immunohistochemical staining demonstrates positivity for TTF-1, Napsin-A, and CK7, while CK20, ER, and CDX-2 are negative. No lymphovascular or perineural invasion is identified. All six examined lymph nodes (three peribronchial, one R10, two R4) are negative for metastasis. \n\nThe tumor is staged as pT2a based on its greatest dimension of 3.5 cm. Regional lymph node involvement is pN0 (0/6), and distant metastasis cannot be assessed (pMX). The margin status is classified as R1 due to the involvement of soft tissue near the bronchovascular margins. The overall pathologic stage is IB. The surgical specimen was intact upon receipt, and no treatment effect was observed. Additional findings include a well-aerated lung parenchyma without significant changes, and no tumor extension into extra-pulmonary structures was noted."} +{"pid": "TCGA-HC-7211", "report": "The prostate specimen measured 4.8 x 3.5 x 3.0 cm and weighed 34.9 grams. Histologic evaluation revealed a well-circumscribed nodule measuring 1.5 x 1.0 x 0.8 cm in the right posterior quadrant, abutting the inked capsule. An additional ill-defined area of discoloration measuring 2.5 x 1.5 x 1.0 cm was present in both posterior quadrants, approaching within 0.5 cm of the base margin and 0.2 cm of the right prostate/seminal vesicle junction. The remainder of the gland showed cystic changes and diffuse periurethral nodularity.\n\nHistologic analysis demonstrated a primary pattern with a score of 3/5 and a secondary pattern with a score of 4/5, resulting in a total Gleason score of 7/10. The tumor involved an estimated 5 to 10% of the gland volume. No extraprostatic extension, seminal vesicle involvement, or lymphovascular space invasion was identified. High-grade prostatic intraepithelial neoplasia was present. All surgical margins were uninvolved.\n\nA total of ten regional lymph nodes were examined, and none contained metastatic disease. The pTNM stage was determined to be pT2c, N0. No other significant findings were noted."} +{"pid": "TCGA-AL-3467", "report": "The left kidney specimen weighed 300 grams and measured 12.5 x 6.5 x 4.5 cm. A bulging mass was identified in the inferior pole, with an intact capsule and no overlying fat. The mass measured 4.8 x 4.0 x 4.0 cm and appeared to invade into the inferior calyx upon gross examination. No other lesions or masses were observed. The ureter measured 4.0 cm in length with a 0.5 cm diameter and had a pinpoint lumen without suspicious findings. The vascular pedicle showed no abnormalities, and no adrenal gland or lymph nodes were present. Microscopic evaluation of representative sections showed a tan, soft, homogeneous lesion located in the inferior pole, adjacent to the capsule. The tumor was confined to the renal parenchyma, with no angiolymphatic invasion identified. Surgical margins were free of involvement. Immunohistochemical analysis demonstrated positivity for CK7 and negativity for EMA. Cytogenetic analysis of cultured tissue revealed a normal karyotype (46,XX) in 21 metaphases, which may reflect overgrowth of non-neoplastic stromal cells. Based on staging criteria, the lesion was classified as T1b Nx Mx."} +{"pid": "TCGA-4V-A9QR", "report": "Extemporaneous histological examination was performed on a pericardial biopsy measuring 2 cm in diameter. Histology showed features suggestive of invasion by a neoplastic process. Conventional histological analysis was conducted following thawing and fixation.\n\nA thymectomy specimen weighing 117 g was received, measuring 15 cm x 7 cm x 5 cm. It was bordered by a strip of pericardium measuring 8 x 5 cm and included lung parenchyma measuring 9 x 3 x 2.5 cm. Surgical margins were marked with color ink. A mass measuring 9 cm x 6 cm was identified within the thymus, with a soft, fleshy appearance and central areas of necrosis and calcification. On sectioning, the tumor was found to invade the entire thickness of the adjacent pericardium.\n\nAdditional findings included two subxiphoid adipose fragments measuring 0.8 cm and 1.1 cm, as well as a Barety lymph node measuring 2.7 cm. Laterotracheal lymph nodes included four small nodes measuring 0.5 cm and a separate cystic lesion measuring 2.5 cm in its major axis. The lesion was multiloculated, with a fleshy white component and internal fibrous septa.\n\nHistopathological evaluation revealed a lobulated proliferation separated by thick fibrous septa, predominantly composed of polygonal epithelial-like cells. Some cells exhibited pseudo-squamous differentiation and atypical mitotic figures. Perivascular spaces were noted, sometimes appearing cystically dilated. Invasion was observed in the pulmonary parenchyma and bronchial tree, with endoluminal extension. The pericardium also showed transmural tumor infiltration. Resection margins in the thymic tissue and pericardium were closely approached by tumor.\n\nThe subxiphoid fat tissue contained a lymph node with normal morphology and no evidence of tumor involvement. Among the laterotracheal lymph nodes, four nodes showed no signs of infiltration. The cystic lesion had internal architecture similar to the primary lesion and was encapsulated. No preserved normal lymphoid tissue was identified at the periphery of this lesion.\n\nImmunohistochemical staining of the epithelial cells demonstrated positivity for CK19, CK7, and CK5/6, while being negative for CK20, CD5, and CD20. Immature T lymphocytes were positive for CD1A and CD99.\n\nMeasurements and staging: The main lesion measured 9 cm by 6 cm. There was extensive local invasion involving the pericardium and lung parenchyma. Lymphatic spread was identified. According to modified Masaoka classification, the case was classified as stage IVb. TNM staging was determined as T4 N2 M0."} +{"pid": "TCGA-E9-A22A", "report": "The specimen was obtained from the right lower outer quadrant of the breast and submitted as a radical mastectomy. A grossly evident lesion measuring 2.2 x 1.8 x 1.8 cm was identified. Histologic evaluation revealed moderately differentiated cellular features. No metastatic involvement was found in the two regional lymph nodes examined. The margins, tumor extent, and histologic parameters including tubule formation, nuclear pleomorphism, and mitotic counts were not specified. The Nottingham Histologic Score could not be determined. There was no evidence of extracapsular invasion, and no additional pathologic findings or comments were noted."} +{"pid": "TCGA-BH-A1ET", "report": "The specimen submitted for analysis included tissue from a left breast segmental mastectomy and left axillary lymph nodes. The primary lesion measured 2.0 cm and was identified as an infiltrating, moderately differentiated ductal carcinoma with focal lobular features. Histological evaluation showed poor architectural differentiation and intermediate nuclear grade, with a Nottingham score of 6 (tubules = 3, mitotic rate = 1, nuclear pleomorphism = 2). Additional findings included fibrocystic changes with atypical ductal epithelial hyperplasia, as well as papillomatosis with associated microcalcifications. Margins of resection were free of malignant involvement.\n\nIn the axillary lymph node dissection, 19 lymph nodes were examined, and one contained metastatic carcinoma. \n\nImmunohistochemical analysis of estrogen and progesterone receptors demonstrated strong intranuclear staining, with 95% positivity for estrogen receptor and 80% for progesterone receptor, indicating positive hormone receptor status. HER-2/neu immunostaining using a polyclonal antibody without antigen retrieval showed no distinct complete membrane staining, resulting in a score of 0, interpreted as negative."} +{"pid": "TCGA-DV-5575", "report": "The left kidney specimen consists of a red/brown nodule measuring 2.4 x 2.6 x 1.8 cm with a small attached piece of brown tissue measuring 1.1 x 0.8 x 0.2 cm. On sectioning, the nodule shows a heterogeneous yellow and red mottled appearance. A portion of the nodule is submitted for further analysis, and the remainder is sent to Surgical Pathology. The cyst wall specimen is a flat sheet of pink/tan tissue measuring 6.6 x 2.2 x 0.1 cm; a small segment measuring 1.0 x 0.5 x 0.1 cm is also submitted, with the rest sent to Surgical Pathology. The base of the cyst is a flat, thin piece measuring up to 3 x 2.4 cm with two central holes and fibrous tissue attachment. All specimens are serially sectioned and representative sections are submitted for permanent processing. Microscopic evaluation reveals nuclear features of intermediate grade within the renal lesion, with focal fibrosis and denudation of the cyst lining in both the wall and base specimens. The solid mass demonstrates no evidence of extension beyond the organ confines."} +{"pid": "TCGA-KK-A8IH", "report": "A total of six lymph nodes were identified in the left pelvic region, all without any abnormal cellular findings. In the right pelvic region, four lymph nodes were identified, also without any abnormal cellular findings. A specimen from the posterior bladder neck consists of adipose tissue with vessels and ganglion, with no abnormal tissue identified. The prostate and seminal vesicles specimen includes a prostate gland measuring 5.2 x 2.6 x 3.2 cm and weighing 35 grams post-fixation. Two distinct areas of cellular irregularity were found within the prostate. One area is located in the peripheral zone, measuring 2.0 x 2.0 cm in the largest cross-section, appearing in two cross sections and more extensively in the apex and base regions. This focus shows extension beyond the prostate in the right superior neurovascular bundle and right bladder neck areas, present across three sections, with a cumulative length of 9.5 mm. The other area is situated in the transition zone, measuring 3.0 x 1.0 cm in the largest cross-section, found in two cross sections and more extensively in the apical region, and remains confined to the prostate. All resection margins are free of abnormal cells. The seminal vesicles and vasa deferentia show no signs of abnormal cellular activity. Multiple sections of the prostate were examined, with specific areas noted for decalcification. The external surfaces of the prostate were marked with different colors for orientation: green for the anterior aspect, red for the left surface, yellow for the right surface, and black for the posterior surface. Some surfaces marked with orange ink do not represent the true margin of resection."} +{"pid": "TCGA-BH-A0EI", "report": "The specimen from a right breast segmental mastectomy demonstrates an infiltrating lesion measuring 2.0 cm macroscopically. Histologic evaluation reveals a low combined histologic score based on tubule formation, nuclear variation, and mitotic activity. A separate in situ component is present, comprising approximately 5% of the total lesion volume and intermixed with the infiltrating area. The in situ component exhibits a cribriform growth pattern. No lymphovascular space invasion is observed. Surgical margins are free of involvement, with the closest distance measuring 0.6 cm at the anterior/superior margin. Additional benign findings include ductal epithelial hyperplasia, fibrocystic changes, sclerosing adenosis, columnar cell change, and fibroadenomatoid nodules. The skin surface shows no evidence of abnormal cellular proliferation. Changes related to prior biopsy are also noted.\n\nA separate excision specimen from the lateral breast margin contains benign findings, including radial scar, fibrocystic changes, sclerosing adenosis, ductal epithelial hyperplasia, columnar cell change with calcifications, and fat necrosis.\n\nLymph node assessment includes multiple sentinel nodes. One lymph node out of two examined from one group shows involvement by abnormal cells, with a focus measuring 4 mm. Extracapsular extension is identified in this focus. A second lymph node specimen reveals involvement by abnormal cells without extracapsular extension. One additional lymph node is negative for abnormal involvement. Evaluation methods include hematoxylin and eosin staining as well as keratin immunostaining.\n\nHistologic analysis demonstrates calcifications within both benign-appearing and abnormal-appearing regions. Receptor studies indicate positivity for estrogen and progesterone receptors."} +{"pid": "TCGA-DU-6402", "report": "The surgical specimen from the brain, temporal lobe, consisted of two fresh fragments measuring 2 x 1.5 x 0.8 cm in total. The tissue appeared soft, pinkish-gray, and translucent. A separate specimen from the right temporal lobe was received fresh and measured 1.5 x 1.2 x 0.5 cm. It had a gelatinous red-brown appearance, with no distinct gray-tan brain tissue identified. Microscopic examination revealed an infiltrative, cellular neoplastic proliferation composed of astrocytic cells. These cells showed moderate nuclear atypia, occasional mitotic figures, and prominent microvascular proliferation. Sections also showed areas of blood clot containing well-preserved red blood cells without fibrin lamination. Immunostaining for MIB-1 demonstrated a proliferative index of approximately 6%."} +{"pid": "TCGA-37-A5EN", "report": "The specimen was obtained from a male patient of Caucasian (White) ethnicity. The tissue sample, collected from the lung, was preserved in an OCT block. A total of 200 mg of tissue was submitted for analysis. Histological evaluation revealed squamous cell morphology with a tumor cell content of approximately 70%. The histological grade was determined to be grade 3. Staging information indicates a T-stage of 4, N-stage of 2, and M-stage of 0. No prior treatment with chemotherapy or hormonal therapy was reported. A blood sample was also collected, amounting to 4 mL, and was stored in a frozen tube. No abnormalities were identified in the blood specimen."} +{"pid": "TCGA-85-8481", "report": "The surgical specimen consists of a lobectomy with a free bronchus margin. A fragment is present showing a parahilar mass measuring approximately 5.5 x 4.5 x 4.5 cm. The lesion demonstrates posterior segmental involvement with extension into the parietal pleura and adjacent rib fragments. Grossly, the mass appears well-circumscribed, with a white-grey cut surface and areas of necrosis.\n\nMicroscopically, the lesion is composed of sheets of relatively monomorphic cells with frequent nuclear atypia and scattered necrotic foci. The stroma is fibro-inflammatory in nature. Tumor infiltrates extend into the fibro-muscular layer of the chest wall; however, no involvement of bone tissue is identified. No tumor is seen in the interlobar lymph node, phrenic chain lymph node, station VI lymph node, or lower lobar bronchus lymph node. There is evidence of lymphatic invasion.\n\nThe specimen includes no additional remarkable findings. No metastases are identified in the four lymph nodes evaluated. All margins are negative. No evidence of prior neoadjuvant therapy is observed. Laterality is confirmed as left upper."} +{"pid": "TCGA-57-1585", "report": "The specimen consists of omental tissue and a bilateral salpingo-oophorectomy with uterus and cervix. The omentum is extensively involved, nearly replaced by fibrotic tissue, measuring 45 x 7 x 2 cm in aggregate. Histologic evaluation reveals high-grade cellular atypia with papillary architecture. Tumor involvement is bilateral within the ovaries, with both ovaries partially replaced by neoplastic tissue. Invasion through the uterine serosa is present, extending into the myometrium, with lymphovascular space invasion identified. The left ovary contains a mass measuring up to 1.2 cm, while the right ovarian mass measures 1.5 cm. The right fallopian tube appears unremarkable on gross examination, though there is serosal involvement by tumor on one side. A detached soft tissue mass measuring 4.5 x 3.5 x 2.0 cm demonstrates fibrotic characteristics. No lymph nodes were examined. Additional findings include an endometrial polyp and no involvement of the cervix. Sections submitted for genomic studies include multiple blocks from various anatomical regions including the cervix, endometrium, myometrium, ovaries, fallopian tubes, and attached tissue. Based on staging criteria and cytology correlation, the tumor stage is classified as T2c."} +{"pid": "TCGA-VQ-A94R", "report": "The specimen includes a subtotal gastrectomy with omentum showing a moderately differentiated adenocarcinoma of intestinal pattern, measuring 5.0 cm, with infiltration into perigastric adipose tissue. Foci of vascular invasion are present, while perineural invasion is not observed. The surgical margins are free of neoplastic involvement. Metastatic involvement is identified in 6 of 32 perigastric lymph nodes, with extranodal extension noted. One lymph node from chain 8A, five from chain 8P, and seventeen from the lesser curvature and celiac trunk were all without evidence of tumor involvement."} +{"pid": "TCGA-AG-A01J", "report": "The resected rectosigmoidal specimen demonstrates an ulcerated, moderately differentiated colorectal-type neoplasm measuring 2.5 cm in greatest dimension. The lesion is located 1 cm from the aboral resection margin and shows infiltration into the pericolic fatty tissue. All other margins, including the circumferential resection margin (with a distance of 2.4 cm from the lesion), colon resection margins, and mesocolic margin, are free of tumor involvement. Twenty-three regional lymph nodes are identified, none containing tumor. No evidence of lymphatic or vascular invasion is present. The background tissue shows no residual tumor following resection."} +{"pid": "TCGA-DW-7842", "report": "A left adrenal mass was identified as a yellow, encapsulated nodule measuring 5.0 x 4.0 x 3.0 cm with a weight of 36.2 grams. The capsule was focally disrupted. On sectioning, the cut surface was golden yellow and nodular with focal hemorrhage. A central portion was frozen for further analysis, and the remainder was fixed in formalin.\n\nIn the left kidney, multiple distinct tumor nodules were identified. Tumor #1 measured 4.7 cm in greatest dimension and was surrounded by a 0.5 cm margin of normal renal parenchyma. It had a red-orange, friable appearance with areas of hemorrhage and necrosis comprising approximately 20% of the lesion.\n\nTumor #2 measured 3.5 cm and presented as a yellow, soft, and slightly myxoid mass. It was partially covered by normal renal parenchyma. The outer aspect of the tumor was inked to mark the surgical margin.\n\nTumors #3 and #4 formed an aggregate measuring 5 x 4 x 2.7 cm. Tumor #3 (2.0 cm) had a homogeneous yellow, soft cut surface, while tumor #4 (2.7 cm) appeared more friable, variegated, and hemorrhagic with areas of necrosis. The surgical margin was marked in black ink.\n\nAdditional smaller nodules were identified in the left kidney, ranging from 0.5 to 1.7 cm in size. These included tumors #5 through #10, all of which exhibited a yellow-tan or yellow appearance with variable consistency. Some were well-circumscribed and spherical, while others were softer or more friable. Several were associated with incipient lesions within the surrounding renal tissue.\n\nMargins of resection were assessed for several specimens. In general, margins were free of abnormal tissue except for tumor #3 and #4, where the tumor approached the black-inked surgical margin. Additional tissue fragments from the base of various tumors were submitted for histologic evaluation and showed features consistent with adjacent renal changes, including calcifications and early lesions.\n\nViable portions of the tumors were procured for laboratory analysis, with variable percentages taken from each specimen. Normal-appearing renal parenchyma was also sampled in some cases. All specimens were processed and submitted for histologic examination."} +{"pid": "TCGA-HT-7687", "report": "The pathology report for the subject demonstrates a neoplasm diffusely distributed in the gray and white matter. The tumor cells exhibit round nuclei, cytoplasm, and prominent perinuclear halos. Perineural satellitosis is noted as prominent. Areas of confluent cellularity are observed, with moderate atypia. Only a single mitotic figure is identified across more than fifty high-power fields. Neither microvascular proliferation nor necrosis is present. Numerous MIB-1 cells are scattered throughout the confluent cellular regions, yielding a labeling index of 9.5%. This level of proliferative activity is typically associated with high-grade lesions. Based on the MIB-1 labeling index, along with the degree of cellularity and atypia, a classification of grade III is supported."} +{"pid": "TCGA-B0-5077", "report": "The specimen from the bone, including a partial marrow resection of the 12th rib, showed no evidence of malignancy and measured 3.8 cm. A radical resection was performed. The left kidney specimen demonstrated a neoplastic lesion with a Fuhrman nuclear grade of III/IV. The tumor was located within the renal sinus and measured approximately 3.8 cm in its greatest dimension. It was confined within the renal capsule with no evidence of extension into the perinephric adipose tissue or renal sinus structures. There was no angiolymphatic invasion identified. All surgical margins were free of tumor. The remaining kidney tissue showed moderate chronic nephrosclerosis. The adrenal gland showed no pathologic abnormalities. The pathologic stage was determined as pT1a based on the pTNM classification system."} +{"pid": "TCGA-AO-A0J9", "report": "A 0.4 cm lesion was identified microscopically in the right breast specimen. Adjacent to a biopsy cavity, there is a focus of ductal carcinoma in situ, solid type, with intermediate nuclear grade and minimal necrosis. Lobular carcinoma in situ, classical type, was also noted. The base of the nipple is involved by the lesion. Calcifications are present within benign breast tissue. No vascular invasion or involvement of surgical margins by the lesion was observed. An ulceration is present in the skin of the axillary region, but the overlying skin does not show evidence of the lesion. Skeletal muscle attached to the specimen is uninvolved. The non-neoplastic breast tissue demonstrates changes related to prior biopsy. Four intramammary lymph nodes were examined and did not show any involvement. The breast specimen measured 30.5 x 17.5 x 7.5 cm, with a 6.5 x 3.5 cm fibrotic area at the posterior aspect. A biopsy cavity measuring 4 x 4 cm was located beneath a well-healed scar in the upper inner quadrant, approximately 0.3 cm from the posterior inked margin. Sections submitted for analysis included areas from the nipple, skin with scar, biopsy cavity, fibrotic region, deep margin, lymph nodes, and multiple quadrants of the breast."} +{"pid": "TCGA-DK-A3IN", "report": "The specimen was received fresh and consisted of a piece of tan soft tissue measuring 2.5 x 1.7 x 0.4 cm, entirely submitted for frozen section diagnosis. Another specimen labeled as an anterior rectal mass consisted of multiple pieces of tan soft tissue ranging from 0.3 to 1.5 cm in size, also entirely submitted for frozen section diagnosis.\n\nLymph node dissections were performed on both right and left pelvic lymph nodes. The right pelvic lymph nodes included 5 lymph nodes with no evidence of malignancy. The left pelvic lymph nodes included 7 lymph nodes, all benign upon examination. A separate excision of the left vas deferens revealed only benign fibroadipose tissue and normal vasculature. The urethral margin excision showed benign urethral tissue. Ureteral specimens demonstrated benign findings with acute inflammation noted in one case.\n\nThe cystoprostatectomy specimen included the bladder, prostate, seminal vesicles, and surrounding tissue. Grossly, there was a centrally necrotic papillary tumor involving the left posterior and lateral walls extending into the trigone. The tumor measured 6.1 x 4.5 x 1.8 cm and extended into the prostatic parenchyma. Invasion was identified in the perivesical fat, bilateral seminal vesicles, and periprostatic ducts. Vascular and perineural invasion were present. An additional ulcerated lesion was observed in the dome of the bladder measuring 2.2 x 1.8 cm. The remaining mucosa appeared congested.\n\nMicroscopic evaluation revealed infiltrative growth patterns within the invasive component. Chronic cystitis and ulceration were observed in non-neoplastic mucosa. Surgical margins were positive at the anterior perivesical soft tissue. High-grade features were noted in cellular morphology.\n\nProstatic tissue showed nodular hyperplasia and high-grade intraepithelial neoplasia. Tumor involvement was confined to the prostate in this region with a Gleason score of 6 (3+3). No vascular or perineural invasion was identified in this area. Surgical margins were negative.\n\nStaging based on AJCC 2002 criteria indicated pT3 disease with extension into perivesical soft tissues. Under the 7th edition staging system, the tumor would be classified as T4a. No lymph node metastases were identified in the regional lymph nodes examined. All other excised tissues, including ureters and periureteral regions, showed no evidence of tumor involvement."} +{"pid": "TCGA-EW-A1PH", "report": "The surgical pathology report describes a breast specimen obtained via lumpectomy, with excisional biopsy performed. The main lesion identified is a tan-white, indurated mass measuring 2.0 x 2.0 x 1.6 cm. The lesion is located less than 1 mm from the anterior resection margin, 1 mm from the lateral resection margin, 7 mm from the medial margin, 4 mm from the deep margin, and greater distances from the superior and inferior margins. Resection margins are otherwise uninvolved. The closest distance to the anterior, posterior, and lateral margins is 1 mm each; the medial margin is 2 mm away, the inferior margin is 2.5 mm away, and the superior margin is 3 mm away.\n\nHistologic evaluation reveals a high-grade lesion with a Nottingham score of 8 (3+3+2), corresponding to grade 3. The histologic features include significant nuclear pleomorphism (score 3), glandular or tubular differentiation (score 3), and a mitotic count (score 2). No response to neoadjuvant therapy was observed in the breast tissue. No ductal or lobular carcinoma in situ was identified. Lymphovascular invasion was not present, and no skin or skeletal muscle was involved.\n\nA total of 10 lymph nodes were examined, including three sentinel nodes and seven axillary nodes. Of the sentinel nodes, one (sentinel node #2) contained metastatic disease measuring 2.5 cm, while the other two sentinel nodes (nodes #1 and #3) showed no evidence of involvement. Keratin immunostaining for sentinel nodes #1 and #3 was negative. The axillary dissection specimen included seven lymph nodes, none of which showed evidence of tumor. There was no extranodal extension identified. One lymph node contained a macrometastasis greater than 0.2 cm.\n\nImmunohistochemical analysis of hormone receptor status (estrogen and progesterone) and Her2 expression was performed on a prior biopsy specimen. Tumor cells were reported as negative for all three markers. Staining methods used included hematoxylin and eosin, as well as immunohistochemical stains using the Envision method. All immunostains were interpreted by a pathologist.\n\nIntraoperative consultation was performed on all sentinel nodes. Sentinel node #2 was found to contain metastatic involvement, while nodes #1 and #3 were negative. Postoperative classification was provisionally assigned as pT1c for the primary lesion and pN1a for regional lymph node involvement. Final staging awaits completion of keratin staining on sentinel nodes. No distant metastases were identified."} +{"pid": "TCGA-AA-A01P", "report": "The specimen shows a poorly differentiated malignant neoplasm arising in the ascending colon with focal neuroendocrine-like features. Histologic evaluation reveals high-grade cytologic atypia (G3), extensive areas of tumor necrosis, and prominent peritumoral chronic inflammatory infiltrate. The lesion infiltrates deeply through the layers of the colonic wall, reaching into the pericolic adipose tissue. There is evidence of lymphovascular invasion with widespread carcinomatous lymphangiosis. Of the regional lymph nodes assessed, one out of twenty-one demonstrates metastatic involvement. No tumor is identified at the resection margins or in the adjacent adipose tissue. Based on these findings, the lesion extends beyond the muscularis propria into pericolonic fat (pT3), involves regional lymph nodes (pN2), and exhibits systemic marker positivity (MX) with lymphatic invasion present (L1)."} +{"pid": "TCGA-CV-7261", "report": "The specimen consists of a total laryngectomy and thyroidectomy measuring 12.1 x 9.5 x 3.5 cm. An ulcerated circumferential lesion measuring 4.5 cm in greatest dimension is centrally located at the ventricle. The lesion extends 2.5 cm superior to the supraepiglottis and 1.3 cm inferior to the subepiglottis. Invasion through the cricoid cartilage is present with a depth of 0.7 cm. There is close approximation to the thyroid cartilage. The anterior soft tissue and right thyroid lobe are free of involvement. The tumor is 2.7 cm from the tracheal resection margin and 0.8 cm from the closest aryepiglottic fold on the left lateral side. Margins evaluated include left and right lateral mucosal margins, posterior mucosal margin, and entire tracheal resection margin\u2014all were negative.\n\nMultiple lymph node levels were assessed across right neck dissections and paratracheal regions. Level II B contained one possible lymph node measuring 1.5 x 0.2 cm; none showed involvement. Level III B included four lymph nodes ranging from 0.2 x 0.2 x 0.2 cm to 0.4 x 0.3 x 0.2 cm; all were unremarkable. Level II A contained six lymph nodes ranging from 0.3 x 0.2 x 0.2 cm to 1.2 x 0.6 x 0.5 cm; none demonstrated involvement. Level III A contained two lymph nodes measuring 0.7 x 0.4 x 0.3 cm and 1.0 x 0.6 x 0.3 cm; both were negative. Right paratracheal lymph nodes (three in total, sizes ranging from 0.4 x 0.3 x 0.3 cm to smaller than 0.5 cm) were also negative. Additional lymph nodes identified in Level IV measured 0.1 x 0.1 x 0.1 cm and 0.5 x 0.3 x 0.1 cm; all were negative.\n\nHistologic evaluation revealed moderately differentiated cellular features with infiltrative borders composed of thin cords less than four cells in diameter. There was moderate lymphocytic infiltration. Perineural and vascular invasion were not identified. Cartilage invasion was present."} +{"pid": "TCGA-A3-3385", "report": "The specimen consists of a left nephrectomy measuring 20.7 x 12.6 x 7.5 cm and weighing 730 grams. The outer surface is partially covered by adipose tissue and includes a segment of Gerota\u2019s fascia. Upon dissection, the kidney measures 14.2 x 7.1 x 5.8 cm after removal of surrounding fat. The renal cortex appears granular, lobulated, and red-brown in color, with a cortical thickness up to 0.9 cm. The cortical-medullary junction is indistinct, and the medulla is red-brown with well-defined papillae. The collecting system is lined by smooth mucosa extending into the ureter.\n\nA plaque-like lesion measuring 4.0 x 3.6 x 1.3 cm is identified on the posterior lateral mid-portion of the kidney. Sectioning reveals a nodular lesion measuring 3.5 x 3.0 x 3.0 cm, with a thin, intact capsule and a lobulated, fleshy cut surface that is tan-pink to yellow with focal hemorrhage and hyalinization. The lesion slightly compresses adjacent parenchyma but does not grossly extend into it. No other lesions are observed in the kidney or surrounding fat.\n\nMicroscopic evaluation confirms the lesion is confined within the kidney without evidence of intravascular invasion, transcapsular spread, or involvement of the renal vein. The nuclear grade is Fuhrman 2 out of 4. All surgical margins\u2014vascular, ureteral, and soft tissue\u2014are negative. No adrenal tissue is identified. Additional findings include focal glomerulosclerosis and focal nephrocalcinosis. The tumor is staged as pT1a, with no regional lymph node or distant metastasis assessed."} +{"pid": "TCGA-CV-6948", "report": "A partial glossectomy and resection of the floor of the mouth and anterior mandible with bilateral supraomohyoid neck dissection was performed. A mass involving the floor of the mouth measured 4.2 x 4.5 x 4.5 cm. The margins of resection were free of tumor, although the tumor approached within 2 mm of the deep margin and 1 mm of the anterior margin. Bone margins of resection were also free of tumor. Tissue from the mandibular bone was submitted for decalcification.\n\nExamination of lymph nodes revealed no involvement in the fourteen right neck lymph nodes, which included levels 2 through 8. In the left neck, thirty lymph nodes were examined. Metastatic involvement was identified in one of six level 7 lymph nodes, with approximately 70% of the node replaced by disease. The remaining lymph nodes at other levels (including 1 level 3, 2 level 4, 11 level 5, 1 level 6, and 9 level 8) showed no evidence of tumor. No extranodal extension was observed in the involved node.\n\nSalivary gland tissue from both sides showed no tumor involvement. Additionally, nerve tissue from the left inferior alveolar nerve was negative for tumor presence. A supplemental report on the mandibular bone is pending."} +{"pid": "TCGA-GD-A3OP", "report": "A radical cystectomy specimen included segments of distal left and right ureters, a composite of the urinary bladder with attached uterus, cervix, fallopian tubes, ovaries, and surrounding tissues, as well as lymph node tissue from both left and right pelvic regions. Frozen section evaluation of both ureteral margins showed no evidence of tumor involvement. Gross examination of the urinary bladder revealed diffuse thickening of the bladder wall with ulceration of the urothelium. A mass was identified measuring approximately 7.5 cm in greatest dimension, with additional dimensions of 6.5 x 4 cm. The mass extended into the uterine corpus and cervix with a depth of invasion measuring 4 cm, and also involved the anterior superior bladder wall with a depth of 2.5 cm. The tumor approached within 2.5 cm of the urethral surgical margin and was noted to extend through the bladder into the uterus. Microscopic evaluation confirmed invasive growth with lymphovascular invasion present. Margins of resection at the urethra and ureters were negative; however, the paravesical soft tissue margin was focally positive. Histologic evaluation showed high-grade features. Metastatic disease was identified in four out of five total pelvic lymph nodes, with the largest metastasis measuring 1.5 cm. No tumor involvement was observed in the vaginal patch or adnexal structures. The specimen also included perivesical fat and lymph nodes, though no paravesical lymph nodes were identified. Both ureters were patent upon gross inspection."} +{"pid": "TCGA-77-8008", "report": "The resected right lower lobe of lung measured 110 x 110 x 100 mm. A linear row of staples extended 50 mm from anterior to the bronchial margin. The staple line had been trimmed and the margin inked black. Sectioning revealed a cystic cavity measuring 65 mm in diameter, surrounded by a fibrous capsule. The cavity was located 2 mm beneath the lateral pleural surface, 12 mm from the stapled resection margin, and 25 mm from the bronchial resection margin. The cavity contained foul-smelling pink to tan fluid.\n\nMicroscopic examination showed a moderately differentiated keratinising lesion with extensive central necrosis and cavitation. A heavy lymphoplasmacytic infiltrate was present within the stroma but not within the cellular islands. Invasion into thickened fibrous pleura was observed, though the pleural surface itself was not involved. No lymphatic or vascular invasion was identified. Obstructive pneumonitis was noted near the lesion, and distant lung tissue demonstrated centriacinar emphysema. Resection margins, including the bronchial and vascular margins, were free of malignant cells. Peribronchial lymph nodes showed benign changes without evidence of metastasis.\n\nA separate specimen from the right upper lobe sump node, measuring 12 x 6 x 4 mm, showed reactive hyperplasia without malignancy. Three pieces of lymph node tissue from station 11, measuring up to 15 x 10 x 5 mm combined, also showed no signs of malignancy. A soft tissue specimen from station 7, measuring 60 x 30 x 20 mm and possibly representing a large lymph node, exhibited reactive hyperplasia without metastatic involvement.\n\nStaging was determined as T2 NO based on the findings."} +{"pid": "TCGA-AG-4015", "report": "The resected colon specimen shows an ulcerated lesion with moderate differentiation. Microscopic evaluation reveals infiltration of the perimuscular fatty tissue. Vascular invasion is present, while lymphatic invasion is not identified. A total of 24 regional lymph nodes are examined, none of which show evidence of involvement. The oral, aboral, and perirectal resection margins are free of tumor."} +{"pid": "TCGA-A2-A04X", "report": "The left mastectomy specimen weighed 921 grams and measured 23.0 cm from superior to inferior, 21.0 cm from medial to lateral, and 4.0 cm anterior to posterior. A 3.5 x 2.5 x 2.2 cm firm, pink-tan, well-circumscribed mass was identified in the mid outer breast, located 3.5 cm from the deep margin and 0.8 cm from the superficial inked surface. Adjacent to this mass, a 1.0 x 1.0 x 0.5 cm irregular nodularity was found and determined upon resection to be cystic fibrous tissue, located 2.0 cm from the deep margin. The remainder of the breast tissue showed lobulated adipose tissue admixed with focally cystic fibrous tissue, predominantly in the lower quadrant. No additional lesions or lymph nodes were identified. Margins were negative. Skin and nipple were uninvolved.\n\nHistologic evaluation revealed a moderately differentiated cellular pattern with a Nottingham score of 7 (3 for tubules, 2 for nuclei, 2 for mitosis). There was evidence of cribriform architecture with nuclear grade II features and necrosis. No lymphovascular invasion was observed.\n\nOne sentinel lymph node was identified and submitted entirely; it showed no abnormal cellular infiltration by H&E or immunohistochemical stains. Two additional lymph nodes were also negative for any atypical cells by similar evaluation methods.\n\nThe right mastectomy specimen weighed 609 grams and measured 19.0 cm from superior to inferior, 18.0 cm from medial to lateral, and 3.0 cm anterior to posterior. Histologically, there were mild fibrocystic changes including apocrine metaplasia, focal ductal dilatation, and mild fibrosis. No discrete masses or lymph nodes were identified in this specimen.\n\nStaging was assigned as pT2 N0 MX."} +{"pid": "TCGA-CV-7248", "report": "The specimen consists of tissue fragments from various anatomical sites. A 0.6 x 0.3 x 0.3 cm fragment from the right pyriform sinus shows squamous mucosa with mild atypia. The epiglottis contains a moderately differentiated lesion measuring 10 x 1.0 x 0.6 cm, composed of tan and irregular soft tissue. A lymph node from the right EJ vein region, measuring 0.5 x 0.5 x 0.3 cm, is free of tumor involvement. A small fragment (0.2 x 0.1 x 0.1 cm) from the right jugular branch reveals involvement within fibroconnective tissue.\n\nTwo lymph nodes from the left spinal accessory region and three from the left level 2B dissection show no signs of involvement. The superior pharyngeal margin displays squamous mucosa with mild dysplastic changes. The laryngectomy and bilateral neck dissection specimen measures 7.0 x 8.0 x 4.0 cm overall. The right neck dissection (13.0 x 4.0 x 2.0 cm) contains matted and enlarged lymph nodes, with the largest measuring 3.5 cm and showing evidence of involvement. The left neck dissection (7.0 x 4.0 x 1.5 cm) does not reveal identifiable lymph nodes.\n\nAn ulcerated lesion involving the right pyriform sinus, supraglottic area, periepiglottic space, and glottis measures 4.5 x 2.5 x 1.5 cm in size. It extends submucosally on the left side and approaches the resection margin but does not reach it. Resection margins are free of involvement. Lymphatic and perineural spaces are affected. Metastatic involvement is identified in 2 out of 5 left cervical lymph nodes and 2 out of 13 right cervical lymph nodes, with extracapsular extension noted. A separate blood vessel fragment from the left proximal jugular vein branch shows no signs of involvement. All specimens were submitted entirely for analysis."} +{"pid": "TCGA-BR-6458", "report": "The submitted specimen is from a subtotal gastrectomy, with the tumor located in the fundus. The tumor measures 0 \u00d7 0 \u00d7 8.5 cm and is described as ulcerated. Microscopically, it demonstrates features consistent with a gland-forming malignancy. The tumor is poorly differentiated and extends to the subserosa. Fifteen lymph nodes were examined, of which one showed involvement, located in the greater and lesser omentum. No venous invasion is identified. Lymphatic and perineural invasion status are not specified. Surgical margins are free of tumor involvement. There is no evidence of treatment effect, and no additional findings are reported."} +{"pid": "TCGA-EM-A3AR", "report": "The total thyroidectomy specimen weighed 34.9 grams and was intact. The right lobe measured 5.0 cm in the superoinferior dimension, 2.7 cm in the mediolateral, and 2.0 cm in the anteroposterior. The left lobe measured 5.1 cm superoinferiorly, 3.0 cm mediolaterally, and 2.2 cm anteroposteriorly. The isthmus measured 5.5 cm superoinferiorly, 1.5 cm mediolaterally, and 1.3 cm anteroposteriorly. The external surfaces showed fibrous adhesions and were painted with silver nitrate. No parathyroid glands or lymph nodes were identified on gross examination.\n\nA well-defined nodule measuring 0.7 x 1.2 x 1.1 cm was identified in the left lobe. Sections of this nodule and surrounding normal tissue were processed for analysis. Additional microscopic tumor foci were identified bilaterally.\n\nMicroscopic evaluation revealed multiple tumor deposits, predominantly located in the left lobe. The dominant lesion exhibited classical papillary architecture and cytomorphology. It was partially encapsulated with extensive capsular invasion. Margins were free of involvement by invasive carcinoma, with the closest distance being 0.1 mm. There were multiple areas suggestive of lymphatic invasion; however, definitive vascular invasion was not confirmed. No perineural or extrathyroidal extension was observed.\n\nA second lesion was identified in the right lobe, measuring 0.7 cm in greatest dimension. It also displayed classical papillary features and was classified as a microcarcinoma variant. Minimal capsular invasion was present, with no evidence of lymphovascular or perineural invasion, and no extrathyroidal extension.\n\nOne lymph node from the left side was nearly entirely replaced by metastatic tumor cells with classical papillary morphology. This node was classified as Level VI (pretracheal, paratracheal, or prelaryngeal/Delphian). No other lymph nodes were identified during gross examination.\n\nThe tumors were multifocal and bilateral. The largest lesion was confined to the thyroid gland without distant spread. Based on AJCC/UICC TNM staging (7th Edition), the regional lymph node category was pN1a due to metastasis in a central compartment lymph node, and the primary tumor category was pT1b given its size and intrathyroidal confinement. Multiple additional small tumor foci were noted in both lobes."} +{"pid": "TCGA-GV-A3JX", "report": "The submitted specimens include left and right distal ureters, bladder, prostate, seminal vesicles, and bilateral pelvic lymph nodes. The ureteral biopsies showed no evidence of abnormal cellular growth. The bladder specimen revealed a polypoid mass located in the left posterior inferior wall near the left ureter. The mass measured 0.7 x 0.6 x 0.6 cm grossly and extended through the muscularis into the surrounding adipose tissue, with the deepest invasion being 0.4 cm from the soft tissue margin. The tumor involved the bladder wall with dimensions of 3 x 1.5 x 1.5 cm. The remaining bladder mucosa was edematous. The right and left ureters were patent, with the left ureter showing roughened mucosa. The prostate was smooth on external examination and showed no mass lesion upon sectioning; it measured 3.5 cm transversely, 3 cm anteroposteriorly, and 3 cm craniocaudally. Glandular hyperplasia and chronic inflammation were noted in the prostate. The seminal vesicles appeared unremarkable. Examination of the regional lymph nodes showed no evidence of abnormal cells. On the right side, ten lymph nodes were identified, ranging from 0.7 to 5.0 cm in size. On the left side, seventeen lymph nodes were found, measuring between 0.2 and 6.0 cm. All lymph node specimens were submitted for analysis and showed no signs of involvement. The tumor was histologically classified as poorly differentiated with glandular and squamous features, and no venous or lymphatic invasion was observed. The surgical margins were free of invasive disease. The pathological stage assigned was pT3b for the primary tumor, indicating macroscopic extension into the perivesical fat, and pN0, indicating no regional lymph node involvement."} +{"pid": "TCGA-BS-A0VI", "report": "The specimen included multiple lymph node samples and uterine tissue. A total of 11 lymph nodes were identified in the left pelvic region, all without evidence of tumor involvement. The left common lymph node sample contained a single lymph node, also free of tumor. On the right side, 12 lymph nodes were found in the pelvic region, none of which showed signs of tumor. The right common lymph node sample contained only benign adipose tissue with no identifiable lymphoid structures.\n\nThe left parametrial tissue was composed of fibroadipose material and did not show any tumor involvement. The uterine specimen revealed a mass involving the entire endometrial surface, extending into the cervical canal. Histologic evaluation demonstrated a poorly differentiated tumor with nuclear grades ranging from 2 to 3. The tumor infiltrated approximately 2.5 cm into the myometrium, which had a total thickness of 2.7 cm at that location, representing deep invasion. Lymphovascular space invasion was present and extensive. No involvement was seen at the serosal surface or in the parametrial regions. The right adnexa was free of tumor, while the left adnexa was not present due to prior surgery. The posterior vaginal margin showed mucosal changes with focal erosion but no tumor cells were identified.\n\nStaging was determined as T2b, N0. All other margins and tissues examined were negative for tumor involvement."} +{"pid": "TCGA-C5-A8XI", "report": "The patient is a woman with a history of postmenopausal bleeding and a cervical lesion identified on examination. A cervical biopsy was performed. The specimen received consisted of multiple fragments of tan soft tissue measuring 1.5 x 1 x 0.2 cm in aggregate. Microscopic evaluation revealed infiltrating cells with features of poorly differentiated morphology. Invasion into lymphovascular spaces was observed. The histologic findings were confirmed by a pathologist following personal examination of the slides. No specific diagnosis is stated in this summary as per instruction."} +{"pid": "TCGA-BA-6868", "report": "The patient has undergone biopsy of two sites in the larynx. Specimen A was taken from the right aryepiglottic fold and measured 1.7 x 0.9 x 0.3 cm. It consisted of an aggregate of multiple friable pink-tan tissue fragments. Specimen B was obtained from the right pyriform sinus and measured 1.4 x 0.3 x 0.3 cm, described as an aggregate of multiple red-tan tissue fragments. Histologic evaluation revealed invasive moderately to poorly differentiated keratinizing cells in both specimens. The tumor extends into the medial aspect of the right pyriform sinus. Clinical staging was assessed as T3N3M0 based on available imaging and clinical findings."} +{"pid": "TCGA-P4-A5ED", "report": "Pathology Accession No: Patient ID: Normal Sample ID:\n\n(A) LEFT KIDNEY: A mass measuring 3.0 x 2.7 x 2.2 cm is identified in the superior pole of the kidney adjacent to the pelvis within the cortex. The mass is ovoid, circumscribed, and has a friable pale yellow to tan homogeneous cut surface. It focally abuts the renal capsule but does not infiltrate beyond it into the perinephric adipose tissue, nor does it grossly invade the renal sinus. The tumor is confined to the kidney. Ureteral and vascular margins are free of tumor.\n\nThe tumor exhibits extensive mucinous change with basophilic intraluminal secretions observed on H&E staining. Positive staining was noted with Mayer's mucicarmine and Alcian blue. Immunohistochemical studies showed negativity for CD10. Histologic sections demonstrate an otherwise typical morphology. No hilar lymph nodes are present, and no tumor is identified within the renal vessels. The remainder of the renal parenchyma appears normal with firm red-brown cortex, distinct corticomedullary junctions, and unremarkable ureteropelvic mucosa.\n\nGross specimen includes a left nephrectomy measuring 12.0 x 5.7 x 5.0 cm with attached perinephric fat and ureter. The ureter is 7.0 cm in length with a diameter of 0.3 cm and appears grossly unremarkable. Vascular hilar structures are also unremarkable. Portions of the tumor have been submitted to the Tumor Bank and another portion placed in glutaraldehyde for possible electron microscopic evaluation.\n\nSection codes include A1 through A9, sampling ureteral and vascular margins, normal kidney parenchyma, tumor and capsule interface, tumor and renal pelvis interface, representative tumor sections, and surrounding kidney tissue.\n\nClinical history indicates a left renal mass. SNOMED codes: T-71000, M-Y7343. Some tests reported here may have been developed and performance characteristics determined by the laboratory. These tests have not been specifically cleared or approved by the U.S. Food and Drug Administration.\n\nEND OF REPORT."} +{"pid": "TCGA-HC-A76X", "report": "The prostate specimen weighed 37 grams and included attached bilateral seminal vesicles. The reconstructed prostate measured approximately 4.8 x 3.7 x 3.7 cm and exhibited a slightly lobulated, focally shaggy outer surface. The urethra was compressed by the lateral lobes but remained patent. Within the prostate, there was a multi-nodular tan-gray fibrotic appearance in the lateral lobes. In the mid to proximal region, an area of tan-gray fibrosis measuring approximately 2.5 x 2.5 x 1.5 cm was identified, located in the left lateral and posterior regions, extending close to the outer surface margin (within 0.1 cm) and approaching the vesical margin (within 0.3 cm). The seminal vesicles measured 5.2 x 2.0 x 1.1 cm combined and displayed a lobulated tan-gray cut surface with multicystic changes; no gross lesion was observed. A separate tissue fragment measuring 4.1 x 2.6 x 1.2 cm contained a single poorly defined tan-yellow nodule measuring 2.6 cm.\n\nHistologic evaluation revealed involvement of both right and left lobes, with the largest focus measuring up to 2 cm on glass slide. Histologic grading demonstrated a primary pattern of 3/5 and a secondary pattern of 4/5. There was no evidence of extra-prostatic extension, seminal vesicle involvement, or lymphovascular space invasion. High-grade prostatic intraepithelial neoplasia was not identified. Surgical margins, including distal apical, proximal, and soft tissue margins, were uninvolved. One lymph node was examined and showed no metastatic involvement. The staging classification assigned was pT2N0."} +{"pid": "TCGA-WJ-A86L", "report": "A partial liver resection from segment 6 was received, along with a gallbladder specimen. The liver specimen measured 7 x 7 x 6 cm and weighed 85 grams. On sectioning, an ill-defined tan-white mass measuring 3.5 x 2.8 x 2.5 cm was identified. It was located 0.7 cm from the closest resection margin and within 0.1 cm of the serosal surface. No gross abnormalities were noted in the remaining liver tissue.\n\nMicroscopic examination revealed a nodular lesion composed of polygonal cells arranged in sheets and focal trabecular patterns. Areas of fibrous septation were present. The cells exhibited marked variability in size, with many large cells displaying bizarre nuclei. Clear cytoplasm with distinct cell borders was prominent, particularly in sheeted areas. In more trabecular regions, cells were smaller with eosinophilic cytoplasm. Mitotic figures, including atypical forms, were frequently observed. The tumor did not invade lymphovascular structures and was confined to the liver. It approached but did not breach the liver capsule. Resection margins were free of tumor involvement.\n\nThe hepatic parenchyma distant from the lesion showed minimal lymphocytic infiltration in portal tracts without significant fibrosis or architectural distortion. No steatosis, necrosis, or lobular activity was noted. Pigment deposition was present in some hepatocytes.\n\nThe gallbladder specimen measured 10 x 4 cm and contained a small cyst-like area on its hepatic aspect, measuring 0.5 cm in greatest dimension. Histologically, this corresponded to a thin-walled structure lined by bland epithelium consistent with a benign cyst. No dysplasia or malignancy was identified in the gallbladder mucosa or wall. Minimal chronic inflammation was present in the mucosa.\n\nNo lymph nodes were submitted for evaluation. Pathologic staging was determined as pT1 based on tumor size and extent. The background liver appeared non-cirrhotic with no evidence of fibrosis. All submitted sections were reviewed, and representative photographs and tissue samples were archived."} +{"pid": "TCGA-A6-2685", "report": "The specimen consists of a left colon colectomy measuring 30 cm in length and 3 cm in diameter, with abundant pericolonic fat. A pink neoplasm is identified on the mucosal surface, measuring 3.5 x 2.5 x 0.7 cm, and located 9 cm from one margin of resection. The tumor is fully excised, and margins of resection are negative for malignancy. Microscopic evaluation shows a moderately differentiated lesion with a size of 3.5 cm. The lesion extends through the muscularis propria into pericolonic soft tissue but does not demonstrate vascular invasion. Twenty-nine pericolonic lymph nodes are free of malignancy, and there is no evidence of non-lymph node pericolonic tumor involvement. Host response includes mild acute and chronic inflammation. The pTNM stage is T3 NO. No other significant findings are noted."} +{"pid": "TCGA-SX-A71S", "report": "The specimen consisted of four tissue samples. The first three samples included a posterior medial margin and two tumor base specimens, each showing renal cortical tissue without evidence of malignancy. The posterior medial margin measured 0.3 x 0.3 x 0.1 cm, tumor base #1 measured 0.4 x 0.3 x 0.2 cm, and tumor base #2 measured 0.4 x 0.2 x 0.2 cm. All were submitted following frozen section analysis and were negative for malignant cells.\n\nThe fourth specimen, described as a left kidney mass, was a spherical nodule measuring 2.0 cm in greatest dimension. The cut surface showed a uniform, pale yellow appearance. A small amount of soft fat was present on the surface opposite the inked base. Histologic evaluation showed a neoplastic process with nuclear features corresponding to a low nuclear grade. Focal contact with the inked margin was noted, though no invasion of surrounding adipose tissue was identified. Frozen section analysis of this sample indicated a likely papillary type neoplasm, with considerations including type 1 versus other less common entities. Immunohistochemical testing was used in the assessment, performed under CLIA-certified conditions. All tests were conducted using validated methods not requiring FDA approval."} +{"pid": "TCGA-FD-A5BS", "report": "The patient is a male who underwent cystoprostatectomy for a high-grade neoplasm. The surgical specimen included the bladder, prostate, seminal vesicles, and vasa deferentia. Gross examination of the bladder revealed a 4.5 cm area of shaggy, hemorrhagic mucosal ulceration located on the left posterolateral wall. On sectioning, the lesion extended into perivesical fat and was 0.4 cm from the deep margin. The ulcerated area was 1.7 cm from the left ureteral orifice and more than 5 cm from the distal urethral margin. A separate 3.7 x 2.4 x 2.0 cm diverticulum was identified in the posterior wall extending to the dome. The surrounding bladder mucosa showed edema and variable wall thickness ranging from 0.2 to 1.0 cm. All ureteral and urethral margins were negative for tumor involvement.\n\nMicroscopic evaluation showed no evidence of lymphovascular invasion. Lymph node analysis was performed on right and left pelvic lymph node specimens. Fifteen lymph nodes were assessed from the right side and eight from the left; none contained metastatic disease. In total, 23 lymph nodes were examined and found to be free of tumor.\n\nStaging was based on the 7th edition TNM classification system. The primary lesion involved perivesical adipose tissue with a solitary focus measuring 4.5 cm. The pTNM staging was determined as T3b, N0, MX. \n\nA separate assessment of the prostate demonstrated a small focus of low-grade acinar adenocarcinoma (Gleason score 3+3) located in the peripheral zone of the right lobe. The tumor was estimated to involve approximately 1% of the prostate. No perineural invasion, extraprostatic extension, or involvement of the seminal vesicles was identified. All surgical margins, including the apex, base, and peripheral regions, were negative for tumor. Prostatic high-grade prostatic intraepithelial neoplasia was not present. Lymph node assessment from both right and left pelvic dissections showed no evidence of metastasis. The prostate pTNM staging was pT2a, N0. \n\nThe prostate was surrounded by a thin, intact membranous capsule. Sectioning revealed rubbery, pink-tan nodularity with scattered yellow irregular areas in the periurethral and peripheral zones. The right seminal vesicles measured 3.5 x 2 x 0.7 cm and the left 1.7 x 1.6 x 0.9 cm; both were disrupted but showed no tumor involvement. The vas deferens bilaterally was unremarkable. The right ureteral stump measured 0.7 cm and the left 2.5 cm, both with patent lumina. Ureteral resection margins were negative.\n\nThe specimen was received fresh and fixed in formalin. Representative sections were submitted from all relevant anatomical sites including the bladder mass, diverticulum, uninvolved mucosa, prostate lobes, and resection margins. Lymph node specimens were processed in multiple blocks and evaluated for metastatic involvement. No tumor was identified in any of the analyzed lymph nodes."} +{"pid": "TCGA-CV-6945", "report": "The specimen includes a right extended modified radical neck dissection. A matted mass of subdigastric and upper posterior cervical lymph nodes measuring 5.0 x 3.0 x 0.5 cm was identified. Of the thirty-nine cervical lymph nodes evaluated, none showed involvement (0/4 submental, 0/7 subdigastric, 0/2 midjugular, 0/9 lower jugular, 0/10 upper posterior cervical, and 0/7 midposterior cervical). Focal extracapsular extension was noted in the region of the matted nodes, measuring up to 3\u20134 mm.\n\nMultiple margins were examined including lateral nasopharyngeal, buccal mucosa, retromolar trigone, lingual, tongue, floor of mouth, vallecula, base of tongue, left soft palate, nasopharyngeal roof, and right hard palate. All margins showed squamous mucosa, with no abnormal cellular findings.\n\nA separate specimen included a partial glossectomy, partial maxillectomy, partial pharyngectomy, and total nasopharyngectomy. The resected lesion measured 7.0 x 3.5 x 1.4 cm with a maximum depth of invasion of 1.4 cm. Histological evaluation revealed invasive moderately differentiated squamous epithelium involving the tongue, right retromolar trigone, hypopharynx, uvula, and soft palate. Focal perineural invasion was present. The deep margin of resection was free of atypical cells.\n\nFifteen teeth were examined grossly only."} +{"pid": "TCGA-IG-A50L", "report": "The specimen consists of esophageal tissue with a lesion located in the lower portion of the esophagus. The lesion measures 6 x 3 x 0.7 cm and is characterized by an ulcerated, invasive appearance, causing narrowing of the esophageal lumen. The surface of the lesion is firm with a white-gray coloration.\n\nMicroscopic examination reveals hyperplastic squamous cells with areas of ulceration. The tissue is arranged in groups, sheets, or trabecular formations of tumor cells. The malignant cells exhibit moderate to light eosinophilic cytoplasm and form keratinized structures. Nuclear features include enlargement, variation in size and shape, coarse chromatin, and prominent nucleoli. Frequent mitotic figures are observed. The tumor extends into the surrounding fat tissue within the adventitia. The stromal reaction includes infiltration by inflammatory cells.\n\nThe specimen was obtained via esophagectomy. The tumor is found in the abdominal esophagus, measures 6 x 3 x 0.7 cm, and is histologically classified as moderately differentiated. It invades the adventitia. Of the lymph nodes examined (Group VII), 1 out of 1 was involved. No information is provided regarding lymphatic or venous invasion, surgical margins, or evidence of neoadjuvant treatment. No additional findings are noted."} +{"pid": "TCGA-2Z-A9JN", "report": "The right partial nephrectomy specimen contains a well-defined, pale tan, lobulated, rubbery mass measuring 3.2 x 3.2 x 2.3 cm. The tumor is located in close proximity to the deep parenchymal margin, separated only by a thin membrane measuring less than a millimeter. No necrosis or hemorrhage is observed within the lesion. The surrounding renal parenchyma appears normal.\n\nMicroscopically, the lesion demonstrates a tubular and papillary growth pattern. The cells exhibit moderate eosinophilic cytoplasm and are arranged in a single layer with luminal nuclear placement. Areas of papillary architecture contain foamy histiocytes. Nuclear stratification is absent. Immunohistochemical staining reveals strong positivity for cytokeratin 7 and E-Cadherin. There is focal weak staining for vimentin and racemase. The cells are negative for CD10, RCC, and CD117.\n\nNuclear grading shows predominantly grade 2 nuclei with focal areas of grade 3. The tumor is confined entirely within the kidney without evidence of capsular, vascular, or lymphatic invasion. No involvement of perinephric adipose tissue, renal vein, or adrenal gland is identified. All resection margins are free of tumor involvement.\n\nLymph nodes were not identified in the specimen. Pathologic staging is determined as pT1a with no regional lymph node involvement (NX) and no distant metastases (MX). Frozen section analysis confirmed the absence of tumor at the deep margin. The specimen was fully evaluated and findings were reviewed by the attending pathologist."} +{"pid": "TCGA-59-A5PD", "report": "A right tube and ovary specimen was received as an intact ovarian mass measuring 10 x 6 x 5 cm and weighing 161 g. The serosal surface was smooth and tan, with a dilated fallopian tube attached measuring 11 x 2.2 cm. The cut surface of the mass was lobulated, pale tan/yellow, granular, with areas of hemorrhage and necrosis. A microscopic break in the capsule was noted. Lymphovascular invasion was present. The fallopian tube showed paratubal cysts.\n\nThe left ovary demonstrated a small focus of similar high-grade morphology within otherwise unremarkable tissue. The uterus measured 9.5 x 5 x 2.5 cm and showed multiple firm white nodules within the myometrium ranging from 0.3 to 0.7 cm. The endometrium was thin with an average thickness of 0.3 cm. The cervix and left fallopian tube showed no abnormal findings. The endometrial cavity had a pink-tan granular appearance.\n\nThe appendix showed markedly reactive lymphoid follicles. Omental tissue, bilateral para colic regions, bladder perineum, and posterior cul de sac specimens all consisted of unremarkable fibroadipose or fibroconnective tissue without evidence of malignancy.\n\nLymph node dissection included right pelvic (seven lymph nodes), left pelvic (two lymph nodes), and para-aortic regions. No lymph nodes were identified in the para-aortic specimen. All lymph nodes examined were negative for metastatic involvement.\n\nHistologic grading based on architecture, cytologic atypia, and mitotic activity was consistent with a high-grade morphology. Tumor was present bilaterally in the ovaries with venous/lymphatic invasion. No implants or positive peritoneal cytology were identified. Pathologic staging was determined as pT1c N0 Mx."} +{"pid": "TCGA-BJ-A4O9", "report": "The specimen consisted of a total thyroidectomy weighing 24 grams. A nodule measuring 3.6 cm was identified in the left lobe. Histologic examination demonstrated a well-circumscribed lesion without evidence of tumor capsule invasion. There was no angiolymphatic invasion or extrathyroidal extension identified. Surgical margins were free of tumor involvement. A single left perithyroidal lymph node was examined and found to be negative for tumor involvement. In addition, seven lymph nodes from the central compartment dissection were all free of tumor. The tumor was histologically characterized as having features consistent with an encapsulated growth pattern. Molecular testing revealed the presence of a BRAF p.V600E mutation (c.1799T>A). No mutations were detected in NRAS codon 61, HRAS codon 61, KRAS codons 12/13, or RET/PTC1 and RET/PTC3 rearrangements. Sufficient nucleic acid material was available for testing. Additional findings included nodular thyroid hyperplasia. The tumor was staged as pT2 with no regional lymph node involvement (pN0), based on the evaluation of eight lymph nodes. No distant metastases were identified."} +{"pid": "TCGA-X7-A8M0", "report": "The specimen consists of a lobulated tan-yellow fatty tissue measuring 18.5 x 10.0 x 4.0 cm, partially covered by mediastinal pleura. Within the fat, there is a well-circumscribed mass measuring 3.0 x 2.5 x 2.5 cm. The mass has a firm tan-white appearance with a fibrous capsule ranging from 0.2 to 0.6 cm in thickness. The cut surface shows a tan-pink, soft center with scattered hemorrhagic areas. The mass is in close proximity to both the mediastinal pleura and the inked soft tissue margin. There is evidence of infiltration into adjacent soft tissue in one area. Around the mass, multiple small pink fragments of questionable thymic tissue are present. No other masses are identified. The attached adipose tissue shows a lobulated tan-yellow appearance. Three lymph nodes are recovered, two of which are submitted whole and one bisected. Histologic sections include the mass margin, areas of infiltration, surrounding tissue, and lymph nodes. Microscopic evaluation reveals a cellular lesion with varying architectural patterns. Some areas demonstrate increased cellularity with focal invasion into surrounding tissue. Lymph nodes show benign features without evidence of involvement."} +{"pid": "TCGA-B6-A0WV", "report": "The pathology report describes a breast specimen following a biopsy and subsequent mastectomy. The initial biopsy was performed on a self-detected lesion measuring 3.5 cm. Histological evaluation showed a moderately differentiated tumor with nuclear features of grade 2 of 3. Vascular invasion was identified. The tumor had a gritty, white-pink appearance and was located within fibrofatty breast tissue.\n\nThe mastectomy specimen included the axillary tail and showed no residual tumor. A biopsy cavity measuring approximately 8 x 6 x 5 cm was identified beneath the nipple. The closest margins were 1 cm from the deep/posterior margin. Benign proliferative changes were noted, including epithelial hyperplasia of usual type and blunt duct adenosis. No abnormalities were found in the skin or nipple.\n\nA total of 14 lymph nodes were evaluated from the axillary region. Of these, 7 were identified as candidates for further analysis, and 4 out of the 7 contained metastatic involvement. Extracapsular spread was present, and the largest involved lymph node measured 2.1 cm. Representative sections of the biopsy cavity, surrounding breast tissue, and lymph nodes were submitted for histological review."} +{"pid": "TCGA-BA-4078", "report": "A biopsy of a mass in the epiglottic region reveals invasive moderately differentiated squamous cells with ulceration present on the surface. Multiple biopsies from various sites including the left and right false vocal cords, anterior commissure, and pre-epiglottic spaces show no evidence of tumor involvement. A resection specimen of the epiglottis contains similar cellular findings across multiple fragments; however, surgical margins could not be fully assessed due to fragmentation of the specimen. Frozen section analysis of surrounding areas confirms absence of tumor in those regions.\n\nLymph node evaluation shows variable results depending on location. On the right side, no tumor is identified in a total of 25 lymph nodes across levels II, III, and IV. On the left side, out of 27 lymph nodes examined, four show involvement. Specifically, two of six lymph nodes at level II contain metastatic cells with the largest deposit measuring 5.0 cm and showing extension beyond the capsule. Additionally, two of thirteen lymph nodes at level IV are involved. Other lymph node levels on the left (III and V) do not show any signs of tumor involvement. The submandibular gland and internal jugular vein specimens also show no tumor presence.\n\nGrossly, the epiglottis specimen measures 5.0 x 3.2 x 0.5 cm and consists of multiple disrupted tissue fragments. An irregular lesion measuring 1.0 x 0.5 cm is observed on the mucosal surface. Other specimens submitted include soft tissue fragments from various neck levels, with lymph nodes identified and analyzed where present. Microscopic examination supports the frozen section findings, confirming no invasive disease in specimens B through H, while A demonstrates the previously noted features. Specimen F shows mild epithelial changes without invasion."} +{"pid": "TCGA-69-7764", "report": "The submitted specimen includes a right upper lobe bronchial margin and lymph nodes from levels 10 and 11. The lung specimen weighed 189 grams and measured 17.5 x 10.4 x 4.6 cm before inflation, and 13.5 x 12.0 x 4.5 cm after fixation. A firm gray-yellow lesion measuring 2.2 x 2.0 x 2.0 cm was identified in the anterior segment. The lesion showed no necrosis and was located beneath a retracted pleural area measuring 2.8 x 2.5 cm. It abutted the pleura and segmental bronchi, was 0.5 cm from the nearest vessel, and 0.7 cm from the proximal margin, which was inked orange. The overlying pleura was inked blue. Mild emphysematous changes were present throughout the lung with a tan area of consolidation noted in the apex.\n\nHistologic evaluation revealed acinar and bronchioloalveolar components. Margins assessed included bronchial, vascular, and parenchymal; all were negative for tumor involvement. Two hilar lymph nodes were examined and found to be free of malignancy. Lymph nodes from levels 10 and 11 were also negative. No vascular or lymphatic invasion was identified. Staging was determined to be IA (pT1b NO) according to AJCC criteria.\n\nAdditional studies included EGFR mutation analysis, which demonstrated no alterations; genotype was consistent with wild type. Sections submitted included those from the tumor, adjacent pleura, bronchus, vessels, and surrounding lung tissue. A frozen section of the bronchial margin was obtained intraoperatively and showed no evidence of tumor. The clinical presentation was described as a right upper lobe nodule."} +{"pid": "TCGA-EO-A3B0", "report": "The specimen consisted of a total hysterectomy with right salpingo-oophorectomy and multiple lymph node specimens. The uterine corpus contained a large tumor measuring 10.5 cm by 8.5 cm, located in the anterior and posterior endometrium. The tumor extended through the full thickness of the myometrium and reached the serosal surface, where multiple nodules were observed. The tumor approached within 0.9 cm of the lower uterine segment posteriorly and 0.7 cm anteriorly but did not grossly involve the cervix. Histologically, there was extensive lymphovascular space invasion and involvement of the serosal surface. The right ovary showed a benign cystic lesion, and the right fallopian tube appeared unremarkable.\n\nLymph node findings revealed metastatic involvement in several regions. The left obturator node was matted and entirely replaced by tumor cells. The right paraaortic region had two nodes examined, one of which was positive. The right obturator node was also diffusely replaced by tumor cells. Multiple matted nodes in the paraaortic region showed widespread tumor infiltration. In the left common iliac area, all three identified nodes were involved. In contrast, the right and left pelvic nodes showed no evidence of tumor involvement. The omentum did not show any tumor deposits.\n\nThe surgical specimen was intact, and tissue preservation allowed for comprehensive sampling. Extensive sections were taken from the cervix, lower uterine segment, tumor mass, serosal nodules, fallopian tube, and ovary. Lymph node specimens were submitted either in whole or as representative sections, particularly when nodes were matted or indistinguishable. Adipose and fibrous tissue surrounding the nodes was also sampled where relevant."} +{"pid": "TCGA-E2-A1IN", "report": "The specimen consisted of a right breast lumpectomy measuring 3.7 x 3.6 x 2.9 cm with orientation markers. Gross examination identified a tan, stellate nodule measuring 1.8 x 1.3 x 1.1 cm closest to the superior margin at a distance of 0.8 cm. Microscopic evaluation revealed invasive carcinoma with high nuclear grade and ductal carcinoma in situ of solid and cribriform types associated with microcalcifications. Lobular neoplasia was also present. The tumor was located within 1 mm of the inferior surgical margin. No vascular or lymphatic invasion was identified.\n\nTwo sentinel lymph nodes were evaluated: one measuring 1.5 x 0.7 x 0.4 cm and another measuring 1.7 x 0.3 x 0.1 cm. Touch imprint cytology performed on both lymph nodes showed no evidence of metastatic involvement. Both lymph nodes were negative for malignant cells upon histologic examination.\n\nAn additional lateral-posterior margin specimen weighing 9 g measured 5 x 3 x 1.2 cm and showed no evidence of tumor involvement.\n\nEstrogen receptor testing was positive with a score of 11.3. Progesterone receptor testing was also positive with a score of 9.1. HER2 immunohistochemistry was negative with a score of 9.1.\n\nHistologic grading using the modified Scarff-Bloom-Richardson system yielded a total score of 7 (tubular score 3, nuclear grade 2, mitotic score 3), corresponding to Grade 3. Necrosis was not present.\n\nPathologic staging was determined as pT1c N0 based on tumor size and absence of lymph node involvement. Distant metastasis could not be assessed.\n\nOncotype DX assay results included a recurrence score of 14, associated with an estimated 10-year distant recurrence risk of approximately 9%. ER and PR positivity and HER2 negativity were confirmed by assay interpretation criteria."} +{"pid": "TCGA-77-7338", "report": "The resected right upper lobe specimen measured 130 x 120 x 40 mm. A well-circumscribed solid pale-colored lesion measuring 35 mm in maximum dimension was identified within 10 mm of the endobronchial resection margin. The lesion exhibited areas of central necrosis. Microscopic examination revealed a moderately differentiated cellular proliferation involving the peribronchial resection margin, primarily through extension along perineural spaces. There was no involvement of the overlying pleura. The surrounding lung tissue demonstrated emphysematous changes, mainly in subpleural regions.\n\nLymph node specimens from stations 7, 11R, 4R, and hilar regions were submitted. All lymph nodes showed only reactive changes without evidence of metastatic involvement. No abnormal cellular infiltration was observed in any of the lymph node samples."} +{"pid": "TCGA-C5-A7CH", "report": "The specimen consists of a cervical biopsy. Microscopic evaluation reveals the presence of malignant cells with moderate nuclear atypia, increased nuclear-to-cytoplasmic ratio, and frequent mitotic figures. The architecture demonstrates disordered maturation and invasion into the underlying stroma. Lesion dimensions are not specified in the provided report. The material was received as one slide accompanied by a corresponding pathology report from an outside institution. The original material has been returned."} +{"pid": "TCGA-86-A456", "report": "The tumor is located in the left upper lobe and measures 1.5 x 2 x 2 cm. The tissue sample was obtained via lobectomy. Microscopically, the lesion is composed of papillary glands with elongated, finger-like projections lined by moderately stratified cylindrical or cuboidal cells. These structures are supported by fibrovascular connective tissue cores arranged in a back-to-back pattern. The nuclei are large, irregular, hyperchromatic, and exhibit prominent nucleoli. Mitotic figures are present. The tumor demonstrates invasion into alveolar spaces and the visceral pleura. Inflammatory cell infiltration is noted within the stroma. No additional information is provided regarding lymphatic or venous invasion, surgical margins, or neoadjuvant treatment effect. One mediastinal lymph node was examined and showed no evidence of metastasis."} +{"pid": "TCGA-B8-A54J", "report": "The specimen consists of a right nephrectomy from a male patient with a history of a right renal mass. The specimen weighed 1,274 grams and measured 24.5 x 14.5 x 9.5 cm. The tumor was located in the renal cortex and medulla of the lower pole, and was described as heterogeneous with solid and cystic areas, including regions of hemorrhage and necrosis. The tumor was well circumscribed and measured 8.6 cm from inferior to superior pole, 8.3 cm from medial to lateral, and 6.2 cm anterior/posterior. It was unifocal and confined within the kidney, abutting the renal capsule but not extending into the perirenal adipose tissue or Gerota's fascia. No involvement of the renal vein, ureter, renal sinus, pelvicaliceal system, or adrenal gland was identified.\n\nHistologically, the tumor demonstrated features consistent with a non-sarcomatoid morphology. The Fuhrman nuclear grade was 2 of 4. No lymphatic or venous invasion was identified. Surgical margins were evaluated: the tumor was 1 mm from the perirenal adipose tissue and 1.0 cm from the blue inked edge of that margin, 2.5 cm from the renal vein margin, 2.8 cm from the renal artery margin, and 1.5 cm from the ureter margin\u2014all negative for tumor involvement. \n\nThe remaining renal parenchyma showed signs of arteriolonephrosclerosis, a focal simple cyst, focal adenoma, and variable interstitial chronic inflammation. A separate cyst measuring up to 3.1 cm in diameter was also noted. No hilar lymph nodes or other significant findings were identified. Tissues from the tumor and normal kidney were submitted for further analysis. \n\nBased on available information, staging was determined to be pT2a, with no assessable lymph node (pNx) or distant metastasis (pMx) staging possible at the time of reporting. This assessment is subject to revision pending further clinical review."} +{"pid": "TCGA-AG-3887", "report": "The surgical specimen demonstrates a neoplastic lesion with mucin-producing features. Histological evaluation reveals a poorly differentiated morphology with evidence of transmural extension through all layers of the intestinal wall. Lymphovascular invasion is present. The tumor is located at a distance from the mucosal resection margins, which show normal architecture including intact mucosa, submucosa, and muscularis propria. The radial margin is also clear, composed of mature adipose and connective tissue with associated vascular structures. Fourteen regional lymph nodes are examined, none of which show involvement."} +{"pid": "TCGA-QR-A70I", "report": "The surgical pathology report includes three specimens. The first specimen, labeled as a portahepatic lymph node, measures 1.8 x 1.4 x 0.4 cm and was partially frozen for intraoperative consultation. Permanent sections show reactive lymphoid tissue without any abnormal cellular proliferation identified.\n\nThe second specimen is a resected soft tissue mass from the retroperitoneum, described as tan-pink and nodular, measuring 5.8 x 4 x 4 cm and weighing 45.3 grams. It has a thin tan capsule that was inked. On sectioning, the cut surface appears pink-red and soft. Immunohistochemical staining demonstrates positivity for chromogranin, synaptophysin, and CD56, while inhibin and AE1/AE3 are negative. Microscopic evaluation reveals cellular features consistent with a neuroendocrine-type lesion extending to the inked margin.\n\nThe third specimen consists of a small lymph node fragment measuring 0.5 x 0.3 x 0.3 cm. Histologic examination shows only tissue distortion without identifiable abnormal cells.\n\nAll specimens were processed according to standard protocol. The laboratory performing the immunoperoxidase and in-situ hybridization tests is CLIA-certified for high-complexity testing, and these assays were developed and validated internally. No FDA clearance or approval was required for their use.\n\nThe clinical context indicates a pre- and post-operative suspicion of a retroperitoneal mass located at the root of the mesentery. Intraoperative frozen section analysis of the lymph node did not reveal any evidence of abnormal tissue involvement. The surgical specimen involved the area around the superior mesenteric artery and surrounding lymph nodes."} +{"pid": "TCGA-06-0208", "report": "The brain tumor specimen demonstrates hypercellular tissue with marked cellular pleomorphism and numerous mitotic figures. Microscopic evaluation reveals pronounced vasculo-endothelial hyperplasia and extensive regions of necrosis. Areas of less undifferentiated morphology suggest a histological pattern consistent with oligodendroglial differentiation. Immunostaining for MIB-1 was performed, showing a proliferative index of approximately 40%."} +{"pid": "TCGA-MX-A666", "report": "The specimen was received in formalin and labeled as a mass from the incisura region of the stomach. It consisted of three small fragments of tan-colored soft tissue measuring between 0.2 and 0.4 cm. All tissue was processed and submitted in one cassette.\n\nMicroscopic examination revealed infiltrating malignant cells arranged in glandular patterns. The tumor cells exhibited moderate differentiation with nuclear atypia and frequent mitotic figures. Immunohistochemical staining was performed, and results demonstrated no expression of Her-2 (score of 0). Ancillary studies, including immunohistochemistry and in situ hybridization, were conducted within the laboratory. These tests have been validated for clinical use under CLIA \u201988 certification, although they are not FDA-cleared or approved.\n\nAll findings were based on personal review and examination of the slides by the pathologist. A separate addendum was issued to communicate additional testing details and confirmatory findings."} +{"pid": "TCGA-Z6-AAPN", "report": "Male. Clinical findings indicate a tumor of the esophagus. The sample consists of an esophageal fragment with gastric tissue measuring 25x20x20 cm. A section reveals a gray tumor mass 1 cm thick. A paraesophageal lymph node, measuring 1.5x0.4 cm, has a dark-red surface. Microscopic examination shows an ulcerative infiltrating tumor with anaplastic features and significant lymphoid infiltration. Surgical margins are free of tumor cells. The paraesophageal lymph node contains metastatic cells, while paragastric lymph nodes and the greater omentum show no evidence of metastasis."} +{"pid": "TCGA-BP-4961", "report": "The right kidney partial nephrectomy specimen measured 5 x 4 x 4 cm and contained a lesion measuring 3.0 x 2.5 x 3.0 cm. The lesion was located approximately 0.1 cm from the deep surgical margin and was described as bright yellow with some hemorrhagic areas. Histologic evaluation revealed focal ossification within the lesion. Nuclear grading was assessed as Grade II out of IV. The lesion was confined to the kidney without evidence of local invasion or vascular involvement. Surgical margins were free of tumor. Adjacent non-neoplastic kidney tissue was unremarkable. No adrenal tissue or lymph nodes were identified in the specimen.\n\nAdditional excision specimens from deep surgical margins #2, #3, and #4 were submitted. Each consisted of small fragments of tan-colored tissue measuring less than 1 cm in aggregate. Histologic examination of these margins demonstrated only benign blood vessel and renal parenchymal tissue. All margins were fully evaluated and showed no evidence of tumor involvement.\n\nIntraoperative frozen section analysis of the stitched surgical margin was performed and confirmed benign findings. Permanent section diagnosis was consistent with frozen interpretation. Tissue samples were adequately processed and representative sections were submitted for evaluation. Clinical staging indicated that the lesion was limited to the kidney and measured \u22647.0 cm in greatest dimension."} +{"pid": "TCGA-XR-A8TG", "report": "The liver specimen consists of a wedge-shaped fragment measuring 7.5 \u00d7 6.0 \u00d7 1.5 cm and weighing 61.0 grams. The external surface is covered by a capsule with an opaque, rough texture due to multiple micro-undulations. A lesion is present, characterized as softened and whitish, circular in shape, with a maximum diameter of 2.5 cm, located 1.0 cm from the surgical resection margin. The remainder of the hepatic parenchyma exhibits a hardened, brownish appearance consistent with a cirrhotic pattern.\n\nMicroscopic evaluation reveals a lesion composed of both well-differentiated and poorly differentiated cellular components. Approximately 40% of the lesion displays grade II differentiation according to the Edmonson-Steiner classification, while 60% demonstrates grade IV differentiation. The morphologic pattern includes solid, trabecular, and small cell features. The lesion measures up to 2.5 cm and shows focal infiltration of the liver capsule. No vascular invasion or angiolymphatic embolization was identified.\n\nSurrounding liver tissue demonstrates micronodular cirrhosis with moderate necroinflammatory activity, consistent with chronic hepatitis C infection based on clinical correlation. Surgical margins are free of involvement.\n\nThe gallbladder specimen is elongated and opened along its longitudinal axis, measuring 7.5 \u00d7 3.5 \u00d7 1.0 cm, and includes a cystic duct stump measuring 1.5 cm in length and 0.6 cm in diameter. The outer surface is smooth with a greenish-brown coloration. The wall appears gray and homogeneous, while the mucosa has a velvety texture and yellowish hue with polypoid folds. No stones were observed. Histologically, the gallbladder mucosa contains small polypoid projections associated with accumulation of xanthomized macrophages, findings consistent with cholesterol polyps. No malignant features are identified in the gallbladder.\n\nPathological staging according to the 7th edition of the TNM classification system is pT1 pNx."} +{"pid": "TCGA-A6-6650", "report": "The specimen consists of a right hemicolectomy measuring 14.5 cm in length and up to 6 cm in diameter, along with an attached segment of ileum measuring 16 cm in length and 2.3 cm in diameter. A dilated vermiform appendix is also present, measuring 6.5 cm in length and up to 1.2 cm in diameter. Small bubble-like structures are noted on the serosal surface of the cecum. A fungating mass measuring 4.3 \u00d7 3.5 cm is observed, located 11 cm from the colonic margin of resection and appears to originate near the appendiceal orifice. Sections were taken following fixation.\n\nMicroscopic examination reveals a lesion measuring 4.3 cm, extending through the muscularis propria into the pericolonic soft tissue. The nearest resection margin is 11 cm away from the lesion. No vascular invasion is identified. There is moderate acute and chronic inflammatory response present. Nineteen lymph nodes are examined and none show evidence of involvement. Additional findings include benign serosal mesothelial cysts and fibrous obliteration of the distal appendiceal lumen."} +{"pid": "TCGA-DX-A1L2", "report": "The submitted specimen consists of a resected right retroperitoneal mass. Gross examination reveals an unoriented, soft, lobulated mass measuring 12.5 x 7.5 x 7 cm, with attached skeletal muscle and adipose tissue, bringing the total specimen size to 22.5 x 14.5 x 6.2 cm. The attached skeletal muscle component measures 11 x 9 x 1.5 cm. The mass is covered by an intact thin membranous layer and has a lobulated tan gelatinous cut surface with fibrous septa, areas of hemorrhage, and necrosis. Necrotic regions account for approximately 10% of the mass. A small firm white area, less than 10% of the overall mass, is noted adjacent to the necrotic focus. The mass approaches within 0.1 cm of the inked margin but does not grossly involve the attached skeletal muscle or surrounding fibroadipose tissue.\n\nMicroscopic evaluation shows a nonlipogenic high-grade sarcomatous component with pleomorphic and spindle cell features, focally resembling a specific subtype. The tumor has a maximum dimension of 12.5 cm and involves fibroadipose tissue. Approximately 5% necrosis is estimated microscopically. The tumor margin is close, within 0.03 cm of the designated inked margin. Representative sections from various areas of the mass have been submitted, including sections from the firm white area, gelatinous regions, and uninvolved fibroadipose tissue."} +{"pid": "TCGA-MH-A854", "report": "The pathology report includes findings from five separate tissue specimens obtained from the right kidney. Each specimen was assessed for histologic features, tumor size, nuclear grade, and margin involvement.\n\nSpecimen A (right mid lateral region) shows a well-circumscribed mass measuring 4.5 x 4 x 2.5 cm. Microscopic evaluation reveals high nuclear grade features. The tumor is present at the resection margin of the renal parenchyma. The tumor does not extend into the renal capsule or perinephric fat. No sarcomatoid differentiation, necrosis, or lymphovascular invasion is identified. The non-neoplastic kidney tissue demonstrates approximately 5% glomerulosclerosis, focal tubular atrophy with endocrinization, and moderate arteriolosclerosis.\n\nSpecimen B (right lower pole) contains a smaller nodule measuring 1.4 cm in greatest dimension. The nuclear grade is lower compared to Specimen A. The tumor involves the renal parenchymal margin but does not reach the capsular margin.\n\nSpecimens C, D, and E were obtained from biopsies of the right mid anterior, superior lateral, and upper medial regions, respectively. These specimens contain lesions measuring approximately 0.8 cm, 0.1 cm, and 0.5 cm. Nuclear grades vary across these specimens, with lower grades observed in the smallest lesions. All three biopsy specimens are submitted entirely for analysis; however, due to fragmentation, accurate assessment of surgical margins and precise tumor dimensions is limited.\n\nOverall, multiple distinct tumor foci are identified throughout the kidney, with varying sizes and nuclear grades. No lymph nodes were submitted or identified for staging. Based on the largest tumor's dimensions and extent confined to the kidney, the pathologic stage is pT(m)1b."} +{"pid": "TCGA-KM-A7QA", "report": "A 4 x 1 x 1 cm portion of a left adrenal gland was submitted for examination. No palpable nodule was identified within the specimen, and no abnormality was seen on microscopic evaluation.\n\nA left kidney specimen was received intact with attached perinephric fat, measuring 16 x 9 x 6 cm and weighing 343 grams. The isolated kidney measured 14.8 x 8.4 x 5.5 cm and weighed 305 grams. Attached structures included two ureters (measuring 5 cm and 8 cm in length), a renal vein (0.5 cm in length), and two renal artery branches (1.8 cm and 1.0 cm in length). Upon sectioning, a well-circumscribed solid pink mass measuring 8 x 7 x 4 cm was identified in the upper pole of the kidney. The mass was located 1.0 cm from the renal hilum and was confined within the renal capsule without invasion into the surrounding perinephric fat or into adjacent structures such as the ureters, arteries, or vein. The uninvolved renal parenchyma showed normal architecture with tan-brown coloration, a well-defined cortical-medullary junction, and orderly cortical striations. No hemorrhage or necrosis was observed within the tumor. Gross photographs were taken for documentation.\n\nHistologically, the tumor exhibited features consistent with cells arranged in nests and alveolar patterns. Vascular invasion was identified microscopically. There was no evidence of sarcomatoid differentiation or necrosis within the tumor. Histologic grading was performed using a specified system and categorized as grade 2. Margins of resection, including those of the ureters, renal artery branches, and renal vein, were free of tumor involvement. Microscopic examination confirmed that the tumor was limited to the kidney without extension beyond the renal capsule.\n\nA total of 19 lymph nodes were retrieved from the para-aortic and interaortic regions, ranging from 0.4 to 1.0 cm in size. All were embedded for histologic examination and showed no evidence of tumor involvement.\n\nThe non-neoplastic portions of the kidney showed no significant pathological findings. No other lesions or tumors were identified in the specimens submitted."} +{"pid": "TCGA-VS-A8QM", "report": "The biopsy specimen from the cervix demonstrates a neoplastic process involving the transformation of squamous epithelium. Histologic evaluation reveals invasive growth with moderate nuclear atypia, increased nuclear-to-cytoplasmic ratio, and altered cellular architecture. The tumor cells exhibit varying degrees of cohesion and stromal invasion is present. No lymphovascular space invasion is identified. The lesion is confined to the cervix without evidence of extracervical extension. Tumor size measures approximately 4.5 cm in greatest dimension. Stromal invasion is estimated at 6 mm in depth. Pelvic lymph nodes are negative for metastatic involvement. Clinical staging is consistent with an early localized phase of disease."} +{"pid": "TCGA-43-A56U", "report": "The final surgical pathology report describes a resected lung specimen from the left upper lobe measuring 25 x 8 x 4 cm. A firm pink nodule was identified toward the inferior aspect of the lobe, measuring 2.1 x 1.7 x 1.7 cm. The overlying pleura showed umbilication without gross evidence of invasion. The lesion was located 5.5 cm from the hilum. The remainder of the lung tissue appeared normal. The bronchial and vascular margins were unremarkable. Histologically, the lesion was composed of poorly differentiated cells arranged in a mass. The tumor measured 2.1 cm in greatest dimension and there was no evidence of pleural invasion (pT1b). Resection margins including bronchial and vascular margins were free of tumor. No direct extension or vascular invasion was identified. Lymph nodes from levels 10, 11, and 5, as well as hilar lymph nodes, were negative for malignancy (pN0). No distant metastasis was identified (pM0). Additional specimens from other lymph node regions were also negative. Tissue blocks included sections of the hilar lymph nodes, bronchial and vascular margins, the entire lesion, and lung tissue away from the lesion. All available margins were negative for tumor involvement."} +{"pid": "TCGA-UF-A7JS", "report": "The surgical specimen from the tongue demonstrated a moderately differentiated squamous cell lesion measuring 7.5 x 4.0 cm, with a depth of 3.5 cm. The lesion extended into skeletal muscle and osseous tissue. Lymphatic and perineural invasion were identified, while vascular invasion was not present. The deep margin of the tongue showed involvement by the lesion, whereas other surgical margins were free of involvement. \n\nIn the right neck dissection specimen, twenty-five lymph nodes were examined and none contained metastatic disease. The submandibular salivary gland was also uninvolved. In the left neck dissection, nineteen lymph nodes were evaluated, with four showing evidence of metastatic involvement; no capsular extension was observed. The margin from the tongue specimen was free of involvement."} +{"pid": "TCGA-DX-A8BJ", "report": "The clinical history indicates a right chest wall mass. Multiple specimens were submitted for analysis, including tissue above the first right rib, a chest wall mass involving ribs 1 through 4, an additional right chest wall mass, and portions of ribs 2, 3, and 4.\n\nHistologic examination of the tissue above the first right rib reveals a high-grade malignant neoplasm involving skeletal muscle. The chest wall mass measures 8.8 x 7 x 4 cm and demonstrates extensive infiltration into skeletal muscle and fibroadipose tissue with superficial erosion into the superior segment of the rib. The growth pattern is highly infiltrative. The tumor is predominantly viable with only focal necrosis. Surgical margins are free of tumor involvement. Additional fragments from another right chest wall specimen show similar histologic features involving skeletal muscle and fibroadipose tissue, with evidence of focal reactive ossification. Sections from the fourth, third, and second posterior ribs reveal benign bony tissue and skeletal muscle. One combined specimen of posterior ribs 2 and 3 shows involvement by the same high-grade malignant process affecting skeletal muscle.\n\nGross examination of the first specimen describes an irregular soft tissue fragment measuring 3 x 2.4 x 0.8 cm with an ill-defined tan-white mass measuring 1.2 cm. The second specimen consists of a chest wall segment with rib segments measuring 8.0, 11.5, and 13.5 cm in length. A tan-white firm mass measuring 8.8 x 7 x 4 cm is identified within the soft tissue and skeletal muscle, adjacent to but not grossly invading the bone. Surgical margins appear free of tumor involvement. Representative sections were taken from all relevant areas for microscopic evaluation."} +{"pid": "TCGA-W2-A7HA", "report": "The right adrenal specimen consists of an adrenal gland weighing 96.0 grams and measuring 7.0 x 6.5 x 4.5 cm. It is well-encapsulated with a smooth tan-orange outer surface. A well-circumscribed mass measuring 6.5 x 5.5 x 4.5 cm is identified within the adrenal. The mass has a soft red-tan hemorrhagic cut surface with a faint lobulated appearance and is surrounded by a thin rim of orange-tan cortical tissue. The remaining adrenal tissue shows a rim of cortical tissue with a central thin tan-brown medulla. No infiltration of the capsule into surrounding structures is observed. There is no evidence of increased mitotic activity or tumor cell necrosis, although one focus of vascular invasion is noted. The gallbladder specimen is an 8.0 x 3.5 x 1.5 cm intact structure with attached cystic duct measuring 0.5 cm in diameter. The serosa is smooth and pink-tan. The lumen contains brown-red bile, and no stones are present. The mucosa appears velvety and dark brown with diffuse yellow speckling, and the wall thickness ranges from 0.1 to 0.2 cm. Histological evaluation confirms the described features in both specimens. Clinical follow-up is recommended as histologic findings may not always align with clinical behavior."} +{"pid": "TCGA-GL-A9DC", "report": "The specimen consists of a left nephrectomy measuring 15 x 11 x 10 cm. The kidney component measures 10 x 7 x 5 cm, with a ureter length of 5 cm. A mass measuring 5 x 3 x 2 cm was identified in the mid/superior pole, well encapsulated, and contained within the renal parenchyma. The tumor appeared as friable, yellow tan- to grey tan tissue. Gross examination revealed no involvement of the renal vein or renal capsule. Perihilar fibrofatty tissue showed no identifiable lymph nodes on gross inspection; however, multiple tissue blocks were submitted for microscopic evaluation.\n\nMicroscopic analysis demonstrated a unifocal lesion with cells exhibiting abundant cytoplasm that varied from eosinophilic to clear. Nuclear grade was Fuhrman grade 1 of 4. There was no evidence of perinephric fat invasion, renal sinus invasion, or vascular involvement. No cancer was identified at the resection margins. Adjacent non-neoplastic kidney tissue showed patchy chronic inflammation. Multiple cortical cysts ranging from 0.5 to 2 cm were also noted.\n\nImmunohistochemical staining showed positivity for cytokeratin 7, racemase, carbonic anhydrase, and vimentin, while TFE3 and SDHB were negative. Controls stained appropriately. Fifteen periaortic lymph nodes were examined and all were negative for malignancy. Pathologic staging based on 2010 criteria was pT1b, pNO, pMX."} +{"pid": "TCGA-B0-5120", "report": "The specimen consists of adipose tissue adjacent to the excised lesion, which shows mature, lobulated fat without remarkable features. A partial nephrectomy specimen from the left kidney demonstrates a neoplasm with clear cell morphology. Nuclear grading according to Fuhrman is 2 out of 4. The largest dimension of the lesion measures 3.8 cm. The renal capsule is intact and no breach is identified. The neoplasm appears confined within the organ without extension beyond. Evaluation for angiolymphatic invasion reveals no evidence of such involvement. All surgical margins are clear, with no tumor identified at the margin sites. The surrounding non-neoplastic renal tissue appears unremarkable. Additional biopsies taken from deep margins, including areas of renal parenchyma and fibroconnective tissue, do not show any tumor involvement. Adipose tissue from another deep margin biopsy also lacks any tumor presence. Pathologic staging indicates pT1a NX MX based on the findings."} +{"pid": "TCGA-ZX-AA5X", "report": "The specimen consists of two fragments of tan-pink tissue, ranging from 0.3 cm to 0.5 cm in greatest dimension, received in a container labeled \"cervical biopsy.\" Microscopic examination reveals moderately differentiated cells with invasive growth patterns. The patient is a female with clinical staging III-b based on available information. All specimens were submitted and examined as part of the assessment."} +{"pid": "TCGA-RC-A7SB", "report": "The liver specimen consists of a segmentectomy measuring 16.5x8x4.5cm and weighing 230 grams. The external surface shows no abnormalities, and the resection margins are clear. Two separate masses are identified. The first mass measures 2.5x2.5x2.4cm and is described as a multinodular, confluent, expanding nodular type lesion that abuts the capsule. The cut surface is whitish and solid. The second mass measures 1.5x1.5x1.4cm and appears well-defined and greenish, also abutting the capsule. It is located 0.1cm from the parenchymal resection margin and 3cm away from the first mass. The surrounding liver tissue shows no significant changes.\n\nHistologically, the larger mass demonstrates a mix of microtrabecular and pseudoglandular patterns with two distinct areas of differentiation. The most poorly differentiated component is graded as Edmondson grade IV, while the predominant area shows Edmondson grade II differentiation. Cellular morphology includes both hepatic and spindle-shaped cells. No necrosis, hemorrhage, or fatty change is present. A fibrous capsule is present around the larger mass but absent for the smaller one. There is infiltration into the capsule and septum formation is noted. No invasion of surgical margins, serosa, portal vein, bile ducts, hepatic veins, arteries, or microvessels is observed. No intrahepatic metastasis or multicenteric occurrence is found. The background liver shows chronic hepatitis of hepatitis B virus etiology, with minimal tubular grading and no fibrosis or cirrhosis. Mild macrovesicular fatty change (approximately 10%) is present. No dysplastic nodules or ductal epithelial dysplasia is seen.\n\nThe falciform ligament specimen, measuring 12x3x1.5cm, shows no pathological findings. The gallbladder measures 7x2.5x2.5cm and contains a 0.8cm black stone. The mucosa has a greenish velvety appearance with multiple small yellowish polyps up to 0.1cm in size. The wall thickness is 0.2cm. Histology reveals cholesterol polyps. The lymph node specimen is unremarkable, showing only fibroadipose tissue.\n\nImmunohistochemical staining of the tumor shows positivity for Hepatocyte (blocks A3 and A5), Cam5.2 (block A3), and focal positivity for Cytokeratin 7 (blocks A3, A5, and A7) and Vimentin (block A3). Cytokeratin 19 (blocks A3 and A5) is negative. Special stains on block A7 for iron are negative."} +{"pid": "TCGA-P5-A77X", "report": "The specimen consists of dense white tissue fragments obtained from the right frontal lobe. Histological examination reveals a neoplastic process composed of mixed cellular elements, including cells with round to oval nuclei and varying degrees of cytoplasmic differentiation. Mitotic figures are present. The lesion demonstrates moderate cellularity without necrosis or microvascular proliferation. Based on histomorphological features, the tumor is classified as Grade II."} +{"pid": "TCGA-B8-5163", "report": "The right radical nephrectomy specimen includes a kidney measuring 9.2 x 6.0 x 5.0 cm, embedded in perirenal adipose tissue that was previously inked blue. The surgical specimen weighs 930 grams and measures 26.5 x 16.0 x 9.5 cm overall. An encapsulated mass is identified in the renal cortex of the upper pole, varying in color from yellow to red to dark brown, with focal cysts and areas of necrosis. The tumor extends into and through the lumen of the renal vein. Microscopically, the lesion demonstrates cellular features including Fuhrman nuclear grade 3 of 4. Histologic evaluation reveals focal invasion of the capsule and involvement of the renal vein. No involvement is seen in the perirenal adipose tissue, Gerota\u2019s fascia, or ureter. Surgical margins are negative for involvement at the perirenal adipose tissue (closest approach 0.5 cm), renal artery (closest approach 0.3 cm), and ureter (closest approach 1.5 cm). However, the renal vein margin is positive. Tumor size measures 5.5 cm in greatest dimension (5.5 x 4.7 x 4.0 cm total). Vascular invasion is noted, with involvement of both large and small venous vessels, including lymphatic channels. No multicentricity is observed. The remainder of the kidney appears unremarkable, with average cortical thickness measuring 0.8 cm and medullary thickness 1.2 cm. No hilar lymph nodes are identified. Additional findings include mild glomerulosclerosis and interstitial fibrosis. Immunohistochemical staining shows positivity for vimentin and equivocal staining for E-cadherin, while negative for Hale's colloidal iron, CK7, CD117, and RCC markers. Based on histopathologic findings, staging is assigned as pT3a, with no lymph nodes identified for assessment (pNx). A portion of polypoid tumor within the renal vein measures 2.5 x 1.5 x 1.0 cm. Multiple tissue blocks were submitted for analysis, including perpendicular sections through the tumor extension into the renal vein. This case was evaluated using immunohistochemical reagents classified as analyte specific reagents (ASR), which have been developed and validated by the laboratory for clinical use under CLIA-88 certification for high-complexity testing."} +{"pid": "TCGA-EW-A1PC", "report": "A total mastectomy specimen from the left breast showed a poorly differentiated cellular proliferation with a high-grade morphology. The lesion measured 6.0 cm in its greatest dimension and was also recorded as 5.5 x 4.0 cm in additional dimensions. The tumor exhibited a single focus of growth and directly extended into the superficial skin layers without ulceration. No lymphovascular invasion was identified. Margins were free of involvement, with the closest margin measuring 15 mm (inferior) and the posterior margin at 20 mm distance. Histologic evaluation revealed a high nuclear grade and a high mitotic rate. Sentinel lymph node assessment for the left axilla included two nodes, both of which were negative on initial hematoxylin and eosin sections; immunohistochemical staining for keratin is pending. Staging for this lesion is pending further immunohistochemical analysis.\n\nIn the right breast, a separate lesion was identified measuring 0.3 cm. It displayed cribriform and solid architectural patterns with intermediate nuclear grade and central necrosis. This lesion involved the margins, with the closest point being 2 mm from the edge. A total of fifteen blocks were examined, with three showing presence of the lesion. One sentinel lymph node was evaluated and found to be negative. Immunohistochemistry for keratin in this sentinel node is also pending. Staging for this component remains pTis with no lymph node involvement pending final staining results.\n\nAncillary studies for hormone receptor status and other markers are currently pending. All surgical specimens were submitted for complete margin evaluation, and all relevant margins were documented in relation to the lesions."} +{"pid": "TCGA-A3-3325", "report": "The specimen consists of a right kidney with attached perinephric fat, measuring 18 x 12 x 6 cm and weighing 597 grams. The ureter and vascular margins are included. A mass is identified in the lower mid portion of the kidney, measuring 3.3 x 3.2 x 2.7 cm. It is oval and golden-yellow in appearance, bulging against the capsule but not adherent to it. Sections of the mass and surrounding tissue, including the capsule, are submitted for analysis. The renal cortex averages 0.8 cm in thickness. The renal pelvis and calyces show no gross dilation. A section of adrenal gland, measuring 3.5 x 1.5 x 0.5 cm, is present and fully submitted.\n\nMicroscopic evaluation reveals a unifocal lesion within the kidney. The histologic pattern shows cells with clear cytoplasm and nuclear features consistent with a specific subtype. Nuclear grading is classified as Grade II according to standard criteria. The tumor is confined entirely within the kidney without evidence of extension beyond the organ capsule. All resection margins, including those of the ureter, renal vein, and renal capsule, are free of involvement. There is no involvement of the adrenal gland or large or small vessel invasion. No lymph nodes or distant metastases are identified. Staging is based on the extent of primary tumor limited to the kidney, with no assessable regional lymph nodes or distant disease."} +{"pid": "TCGA-D8-A1Y0", "report": "Histopathological examination was performed on a total organ resection specimen including the left breast and axillary tissues. The breast measured 24 x 19.5 x 5 cm and was removed with axillary tissues measuring 10 x 7 x 2.5 cm, along with a skin flap measuring 24 x 12 cm. A lesion measuring 1.9 x 1.3 x 1.4 cm was identified in the subareolar region, located 5.2 cm from the upper boundary and 2.8 cm from the base of the skin flap. Metastatic lymph nodes were noted, with sizes up to 2 cm in length.\n\nMicroscopic evaluation revealed foci of ductal carcinoma in situ within the lesion, characterized by cribriform and solid growth patterns and high-grade nuclear atypia, including comedo-type necrosis. Invasive carcinoma was also present, classified as NHG2 (Nottingham Histologic Grade), with a mitotic count of 3+2+1/6 per 10 high-power fields (visual area 0.55 mm\u00b2). Necrosis accounted for approximately 5% of the tumor volume. No pathological changes were observed at the nipple margin. Background glandular tissue showed fibrocystic changes consistent with fibrous mastopathy.\n\nAxillary lymph node examination revealed involvement with malignant cells. Specifically, metastatic deposits were identified in lymph nodes categorized under regional classification IX/XV. Capsular invasion and extension into perinodal tissue were observed.\n\nImmunohistochemical analysis demonstrated strong expression of estrogen receptors (>75% of neoplastic nuclei) and progesterone receptors (>75% of neoplastic nuclei). HER2 staining using HercepTest\u2122 by DAKO showed a score of 1+, indicating no overexpression in invasive cancer cells."} +{"pid": "TCGA-B5-A11I", "report": "A 56.0 x 26.0 cm ellipse of brown-tan skin, excised to a depth of 5.0 cm, was received, including a 2.0 cm umbilicus located 1.0 cm from the closest skin margin. The underlying adipose tissue showed mild fibrosis and hemorrhage, with no identifiable masses or lesions. A representative section was submitted. A 13.3 x 10.5 x 1.0 cm piece of omentum was also included, with no observed masses or lesions, and a representative section was submitted.\n\nA 234.5 gram uterus measuring 11.0 x 8.0 x 5.4 cm was received and bivalved, revealing a 10.0 x 7.5 x 1.5 cm exophytic tan mass arising from the anterior uterine fundus. The mass extended into the lower uterine segment, located 1.0 cm from the endocervical canal and 5.0 cm from the anterior ectocervix. Grossly, there was minimal invasion into the myometrium, with a 2.0 cm portion of the mass compressing the myometrium, which measured 2.5 cm in thickness on the anterior wall. Multiple intramural leiomyomas ranging from 1.0 to 1.5 cm were noted. The right ovary measured 3.0 x 2.5 x 0.7 cm and was white; the right fallopian tube was tortuous, measuring 3.0 x 0.8 x 0.7 cm. The left ovary was 3.2 x 3.0 x 1.1 cm and tan-white, while the left fallopian tube measured 3.2 x 1.0 x 0.8 cm. All were grossly unremarkable.\n\nA 1.6 x 1.2 x 0.8 cm tan tissue fragment was received and previously submitted for frozen section, with remaining tissue submitted for further analysis. Two tan-white tissue fragments from the vaginal cuff measured 2.0 x 0.8 x 0.5 cm in total and were entirely submitted. Lymph node dissections were performed: the left pelvic node specimen included a 3.0 x 2.0 x 0.4 cm aggregate of adipose tissue with multiple lymph node candidates, all submitted. A 0.8 x 0.6 x 0.2 cm tan tissue fragment from the left common area was submitted entirely. The right pelvic node specimen measured 5.0 x 2.5 x 1.0 cm and contained multiple lymph node candidates submitted across two blocks. The right periaortic node specimen, measuring 3.5 x 2.7 x 1.5 cm, had multiple lymph node candidates submitted in one block. The left periaortic node specimen measured 1.4 x 1.0 x 0.2 cm and contained lymph node candidates submitted entirely. A 2.4 x 1.6 cm fibrous tan tissue fragment from the left ligament lymph node was bisected and submitted in two blocks.\n\nMicroscopic evaluation of the uterine mass showed a poorly differentiated adenocarcinoma involving the endometrium. The tumor measured 10 x 7.5 x 1.5 cm and demonstrated a depth of myometrial invasion between 1.1 and 0.2 cm within a 2.5 cm thick myometrium. No lymphatic or vascular invasion was identified. Adjacent non-neoplastic endometrium showed hyperplastic changes, and leiomyomas were present in the myometrium, with the largest measuring 1.0 cm. The cervix, serosa, and specimen margins were free of tumor involvement. Both ovaries and fallopian tubes showed no evidence of tumor. In a few areas, a gland-like pattern suggestive of an endometrioid morphology was noted, but definitive subtyping was not possible due to poor differentiation. Endometriosis was identified in the vaginal cuff without evidence of tumor. All lymph node specimens evaluated\u2014left pelvic (0/1), right pelvic (0/5), right paraaortic (0/5), and left paraaortic (0/2)\u2014showed no evidence of malignancy. Residual ovarian tissue from the left infundibular pelvic ligament biopsy showed no tumor. Step sections of the left pelvic lymph node dissection did not reveal additional findings, and no further lymph nodes were identified."} +{"pid": "TCGA-2Z-A9J3", "report": "The specimen consists of a right kidney and adrenal gland. The kidney measures 23.0 x 15.0 x 11.5 cm and is surrounded by an irregular fibroadipose tissue envelope. On sectioning, there is an ovoid mass located in the superior-medial aspect of the kidney measuring 17.5 x 15.0 x 35.0 cm. The mass appears variegated with tan-yellow to tan-brown areas and contains multiple regions of necrosis and hemorrhage. The mass is well demarcated from the surrounding renal parenchyma and does not invade the calyceal system, renal sinus, or inner capsule, nor does it involve the perinephric fat. No additional tumor nodules are present. The renal parenchyma appears tan to tan-red with a well-demarcated corticomedullary junction measuring 1.0 cm in thickness. The medullary cords, calyces, and renal pelvis show no abnormalities. A 7-cm segment of ureter is attached and appears unremarkable. The renal artery shows atherosclerotic changes. No lymph nodes are identified within the perihilar fibroadipose tissue. The adrenal gland, measuring 6.0 x 2.5 x 1.0 cm, has a smooth cut surface with no visible lesions. Histologic evaluation reveals a solid growth pattern with nuclear grade III. Margins of resection, including ureter, vascular, and perirenal fat margins, are free of involvement. There is no evidence of angiolymphatic invasion, perineural involvement, or intravascular tumor extension. The non-neoplastic kidney tissue shows mild arteriosclerosis and focal interstitial fibrosis. Sections submitted include margins of resection, tumor relationship to perinephric fat and renal parenchyma, and representative portions of uninvolved renal tissue and adrenal gland."} +{"pid": "TCGA-AC-A62V", "report": "The right breast modified radical mastectomy specimen included a mastectomy specimen together with axillary tissue. The breast measured 16 cm from medial to lateral, 9 cm from superior to inferior, and up to 4 cm from superficial to deep. A tumor mass was identified beginning directly underneath the nipple and extending laterally within the breast. This mass measured 4.7 cm from medial to lateral, 4.5 cm from superior to inferior, and 3.5 cm from superficial to deep. It was located 3.5 cm from the closest medial margin, 5 cm from the axillary tail, 2.5 cm from the closest superior margin, and 2.2 cm from the closest inferior margin. Centrally, it was approximately 0.2 cm from the closest deep margin but did not appear to extend into the adjacent strip of skeletal muscle identified as pectoralis major.\n\nSerial sectioning revealed a firm, tan-white tumor mass with relatively well-defined borders. Adjacent breast tissue was composed primarily of soft fatty tissue without other palpable masses. Representative sections of the tumor and surrounding parenchyma were submitted for analysis.\n\nIn the medial portion of the axillary tail, a prominent firm lymph node measuring 1.5 cm was identified and considered suspicious for metastatic involvement. Axillary tissue dissection yielded a total of 17 lymph nodes, with three showing evidence of metastatic involvement. The largest metastatic focus measured 1.3 cm in diameter. No extranodal extension was observed.\n\nHistologic evaluation revealed invasive carcinoma with high-grade nuclear features. The tumor exhibited marked nuclear pleomorphism and a high mitotic rate. Lymphovascular invasion was present. In addition to the invasive component, there was ductal carcinoma in situ (DCIS) with high nuclear grade architecture, including cribriform and papillary patterns, along with comedo necrosis and calcifications. DCIS was found adjacent to the invasive component within lactiferous ducts and focally in the upper inner quadrant.\n\nMargins of resection were assessed. The invasive component was found to be 0.2 cm from the deep margin but at least 2 cm away from all other margins. DCIS was located at least 1 cm from all margins. No invasion of skin or chest wall was identified.\n\nAncillary studies performed on a prior biopsy specimen showed hormone receptor status with strong estrogen receptor positivity (100%), no progesterone receptor expression, and HER2 immunohistochemistry score of 1+. Ki-67 proliferation index was 15%. These findings correlated with those seen in a prior biopsy of a lesion involving the left iliac bone.\n\nThe left breast complete mastectomy specimen weighed 227 grams and measured 18.5 cm from medial to lateral, 11.8 cm from superior to inferior, and 2.5 cm from superficial to deep. It included an overlying ellipse of dark brown skin measuring 17 x 6.5 cm with a centrally located areola and protuberant nipple. Serial sectioning revealed lobulated fatty tissue and centrally located tan-white fibrous parenchyma without areas suggestive of neoplasm. One lymph node measuring 0.7 cm was identified laterally, 2 cm from the lateral edge. Microscopic examination of representative sections showed no evidence of malignancy. Findings included gynecomastia, with unremarkable skin and nipple.\n\nPathologic staging criteria indicated a primary tumor size consistent with pT2 classification. Regional lymph node involvement was classified as pN1a (metastases in 3 of 17 lymph nodes). Distant metastasis was documented as pM1 based on prior biopsy of the iliac bone. Based on these findings, the overall pathologic stage was determined to be Stage IV."} +{"pid": "TCGA-EY-A1GS", "report": "The pathology report includes multiple specimens obtained from various anatomical sites. Histologic evaluation reveals widespread involvement by a high-grade papillary serous carcinoma. The tumor demonstrates extensive infiltration with transmural invasion of the myometrium, involvement of the uterine serosa, and extension into the lower uterine segment and cervix, including endocervical glands and posterior cervical soft tissue. Adnexal involvement is present bilaterally, with multinodular involvement of both ovaries and associated surface involvement. Lymphovascular space invasion is identified.\n\nA total of nine regional lymph nodes were examined, with seven showing metastatic involvement. Of these, five out of seven lymph nodes from the right pelvic group are involved, with the largest measuring approximately 4 cm in greatest dimension and demonstrating extracapsular extension. Two out of two lymph nodes from the left pelvic group are also involved, with the largest measuring up to 2.5 cm and also showing extracapsular extension.\n\nAdditional specimens from the abdominal wall, left sidewall, left posterior pelvis, left posterior cul-de-sac, anterior cul-de-sac, and right posterior pelvic regions all show involvement by the same histologic type of tumor. The omentum contains multiple nodules ranging from 1 cm to 4.5 cm in size, all consistent with metastatic involvement.\n\nImmunohistochemical analysis shows the tumor to be diffusely positive for P53 and negative for WT-1. Estrogen receptor immunostaining is completely negative (0%), and progesterone receptor staining is minimal (<5% positivity, 1+ intensity). Multiple benign leiomyomas with hyalinization and calcification are also identified within the uterine specimen.\n\nBased on the extent of local invasion, lymph node involvement, and distant metastases, the pathologic staging is determined as pT3a, pN1, pM1 according to AJCC criteria, and Stage IVB according to FIGO (2008 classification). These findings are based on available data and may be subject to revision following further clinical correlation.\n\nGross examination of the hysterectomy specimen reveals a large, lobulated, necrotic mass involving the lower uterine segment and extending into the fundus. The tumor measures approximately 6.0 x 3.5 x 4.0 cm. Multiple subserosal, intramural, and submucosal nodules are present throughout the uterus, ranging in size from 0.5 cm to 5 cm. Other specimens include soft tissue masses from various pelvic and abdominal locations, all showing similar histologic features. Lymph node specimens demonstrate tumor involvement with extracapsular spread.\n\nMicroscopic evaluation confirms the presence of high-grade papillary serous carcinoma in all relevant specimens, with consistent morphologic and immunophenotypic characteristics across primary and metastatic sites."} +{"pid": "TCGA-A5-A3LO", "report": "The surgical specimens include bilateral salpingo-oophorectomy, total abdominal hysterectomy, omentectomy, appendectomy, and lymph node excisions. Both adnexal specimens show atrophic ovaries. The left fallopian tube contains multiple paratubal cysts and solid Walthard rests. The right fallopian tube has multiple small paratubal cysts.\n\nThe hysterectomy specimen reveals a firm, white lesion measuring 4 x 3 cm within the uterine corpus and fundus. Histologically, the lesion demonstrates high-grade features with endometrioid architecture and areas of malignant squamous differentiation. The tumor invades more than half of the myometrium, with a depth of invasion measuring 1.5 cm in a myometrial thickness of 2.3 cm. Focal lymphovascular space invasion is present. The cervix, surgical margins, and other uterine sites are free of tumor involvement. Additional benign findings include a sessile endometrial polyp, leiomyomas, and focal superficial adenomyosis. The cervix also shows squamous metaplasia, chronic inflammation, and nabothian cysts.\n\nA total of 19 lymph nodes were examined: 7 pelvic, 6 para-aortic, and 6 common iliac nodes. All lymph nodes show no evidence of metastatic disease. The omentum reveals only micro-adhesions without any malignant findings. The appendix appears histologically unremarkable.\n\nIntraoperative frozen section consultation confirmed poorly differentiated adenocarcinoma involving three-fourths of the myometrial wall. Immunohistochemical staining for cytokeratin 5/6 and p63 demonstrated patchy positivity, supporting the presence of squamous differentiation. No clear cell component was definitively identified. The case was staged as pT1b, pN0, with FIGO stage IB."} +{"pid": "TCGA-DU-6399", "report": "The specimen consisted of three parts. The first was a 0.4 cm soft, tan-brown fragment of brain tissue. A frozen section was performed, showing glial proliferation, with concern for a low-grade glioma. The second specimen measured 1.3 x 0.5 cm and was described as a gray-tan piece from the temporal lobe lesion; smears and frozen section were again prepared, with similar findings. The third specimen included multiple tan-brown fragments measuring 8 x 5 x 3 cm in aggregate, with permanent sections taken for further analysis.\n\nMicroscopic evaluation of all specimens revealed a diffusely infiltrating glial tumor composed of cells with round nuclei and a characteristic \"fried egg\" appearance. Areas of focal hypercellularity and microcystic change were identified. Scattered microgemistocytes were also present. No mitotic figures or vascular endothelial proliferation were observed. Immunohistochemical staining demonstrated a proliferation index (MIB-1) of approximately 8\u201310%."} +{"pid": "TCGA-DW-5561", "report": "A left renal mass was identified measuring 3 cm in greatest dimension. Two separate specimens were submitted for analysis. The first specimen measured 0.6 x 0.4 x 0.2 cm and was described as a solid tan/yellow tissue fragment. Approximately half of this specimen was allocated for research purposes, with the remaining portion preserved in formalin and fully submitted for histologic evaluation. The second specimen measured 4.2 x 4.0 x 4.0 cm and had a white/yellow, fleshy cut surface. It was partially sampled for research (1.5 x 1.0 x 0.4 cm), and the rest was preserved in formalin and entirely submitted for processing. Histologic evaluation of both specimens revealed similar microscopic features, including the presence of incipient lesions. Both tumors showed a relatively homogeneous appearance. No further diagnostic terms were used."} +{"pid": "TCGA-14-1827", "report": "The specimen was obtained from the right occipital region of the brain and submitted in two parts. The first specimen, received fresh for intraoperative consultation, consisted of multiple red-brown, hemorrhagic tissue fragments measuring 1 x 1 x 0.3 cm in total. The second specimen, received in formalin, consisted of multiple soft brown-tan fragments measuring 1.5 x 1.5 x 0.5 cm in aggregate. Both specimens were submitted entirely in cassettes labeled accordingly.\n\nMicroscopic evaluation of the tissue revealed areas with varying degrees of cellular atypia. In one section, cells displayed astrocytic features with moderate atypia, a lack of neovascularization or necrosis, and a MIB-1 labeling index of approximately 25%. In another section, there was evidence of more aggressive features, including marked atypia, numerous mitotic figures, vascular changes, and significant necrosis. The pathologist reviewed the case with a fellow or resident during the intraoperative consultation, where the lesion was described as an intermediate-grade glial neoplasm based on frozen section and touch preparation analysis."} +{"pid": "TCGA-2Z-A9JJ", "report": "The right kidney core biopsy demonstrated malignant cells. A subsequent right nephrectomy specimen was examined. The tumor measured 3.0 cm in greatest dimension and was confined to the kidney without extension beyond the organ. Histologic evaluation showed a high nuclear grade with marked nuclear irregularity and prominent nucleoli. Tumor necrosis was present in approximately 5% of the sample. No sarcomatoid features, perineural invasion, or angiolymphatic invasion were identified. All surgical margins, including vascular and ureteral, were free of tumor involvement. Lymph node status could not be assessed. The tumor was classified based on size and extent as limited to the kidney, measuring less than 4 cm. Focal mucinous changes were noted. Immunostains supported the morphologic findings. Gross examination of the nephrectomy specimen revealed a well-circumscribed mass without evidence of residual disease in the surrounding renal tissue or renal pelvis. No lymph nodes or adrenal gland were identified in the resected tissue."} +{"pid": "TCGA-06-0185", "report": "The specimen consists of brain tissue from the right temporal region, measuring 7.0 x 5.0 x 2.0 cm and weighing 19.56 grams. The tissue is described as an aggregate of fragmented material with red to gray-tan coloration, showing scattered petechial hemorrhages and tan-yellow discoloration. Microscopic examination reveals diffuse infiltration by neoplastic cells with marked nuclear atypia, increased mitotic activity, and microvascular proliferation. There are also extensive necrotic zones and effacement of normal brain architecture.\n\nImmunohistochemical staining shows sparse labeling for glial markers in the neoplastic cells. Proliferation index, assessed by MIB1 staining, is approximately 12% in more active areas. Neuronal markers highlight entrapped neurons within the infiltrative edge of the lesion. CD34 staining demonstrates a prominent vascular network. Additional stains for other markers were performed and show variable reactivity. Sections were examined using standard histologic techniques and a range of immunostains to support morphologic findings."} +{"pid": "TCGA-DO-A1K0", "report": "A 46g thyroid specimen was received with attached central neck dissection and left neck dissection. The right lobe measured 5.1 x 2.4 x 0.5 cm, the left lobe measured 4.2 x 4.1 x 2.7 cm, and the isthmus measured 2 x 0.5 x 0.3 cm. The central compartment measured 3 x 1.2 x 0.6 cm, and the left neck dissection measured 10 x 3.5 x 2 cm. The left lobe contained a dominant mass measuring 4.2 cm in greatest dimension, with additional dimensions of 4.1 x 2.7 cm. The mass was soft, gelatinous, yellow, and gritty on cut section, with areas of fibrosis but no necrosis, hemorrhage, or thick encapsulation. It appeared to extend beyond the thyroid capsule focally. A second nodule was identified in the right lobe, measuring 0.1 cm, with a follicular growth pattern.\n\nHistologic evaluation showed classical papillary architecture and cytology in the left lobe mass. Margins were uninvolved by carcinoma, with the closest margin measuring 1 mm from the invasive component. No lymphovascular or perineural invasion was identified. Minimal extrathyroidal extension was present. In the right lobe, a microcarcinoma (less than 1 cm) was found, with classical histology. Margins were again uninvolved, with a distance of 3 mm from the closest margin.\n\nLymph node assessment included 14 nodes examined across three dissection sites. Metastatic involvement was found in 9 nodes: 1 of 4 in the right central neck dissection, 6 of 7 in the left central neck dissection with focal extra capsular extension, and 1 of 3 in the left neck dissection (levels 2, 3, 4). Extranodal extension was noted. A benign thymus with involutional changes was also present in the right central dissection.\n\nStaging was pT3 based on tumor size greater than 4 cm and minimal extrathyroidal extension, and pN1b for regional lymph node involvement. Distant metastasis was not applicable. The patient had a one-year history of a left-sided enlarging thyroid mass. All specimens were submitted for analysis, and findings were confirmed through intradepartmental consensus review."} +{"pid": "TCGA-BH-A1F2", "report": "The submitted specimen from a left modified radical mastectomy includes resection of the breast and axillary contents. Microscopic evaluation reveals a poorly differentiated ductal carcinoma measuring 4.7 x 2.5 x 2.0 cm, involving all four quadrants. The Nottingham score is 8 out of 9, with tubule formation 3/3, nuclear atypia 3/3, and mitotic index 2/3. Ductal carcinoma in situ is present in less than 5% of the tumor. The tumor extends to involve the dermis of the nipple, and there is evidence of dermal lymphovascular invasion. Paget\u2019s disease is present in the nipple and adjacent skin. Resection margins are free of tumor, although the tumor approaches within 0.2 cm of the deep margin. Additional findings include fibrocystic changes, duct ectasia, and non-tumor-associated microcalcifications. Of the nineteen lymph nodes identified, six are involved by metastatic carcinoma, with multiple foci of extranodal extension. Immunohistochemical analysis on slide A2 shows distinct intranuclear staining for estrogen receptor in 50% of cells and for progesterone receptor in 40% of cells, indicating positivity for both. HER-2 immunostaining using a 1:300 dilution of polyclonal antibody demonstrates complete membrane staining in 70% of cells, interpreted as a score of 3+."} +{"pid": "TCGA-LK-A4NW", "report": "The excised chest wall mass and deep aspect specimen reveals a fistula tract associated with foreign-body giant cell reaction, granulation tissue, focal acute inflammation, necrosis, and scarring. The surrounding connective and adipose tissue is present. A separate bone specimen from the 7th rib shows no significant abnormality within the bone or marrow. Biopsy of a pleural mass demonstrates diffuse infiltration of atypical cells arranged in a tubulopapillary pattern. Similar findings are observed in biopsies taken from a diaphragmatic nodule, anterior thymic pleura, paraphrenic mass, diaphragmatic tumor, hilar tissue, pericardial fat pad, thymus, posterior diaphragmatic sulcus, pericardium, and phrenic area. These areas also show varying degrees of acute fibrinous and organizing pleuritis.\n\nLymph node biopsies from level 7 reveal microscopic subcapsular aggregates of atypical cells in one of three nodes, with associated perinodal soft tissue involvement. In level 5 lymph nodes, two of four nodes show similar subcapsular involvement along with perinodal implants. Bronchial mucosa biopsy from the left secondary carina shows only chronic inflammation; fungal and special stains are negative, and no malignant cells are identified.\n\nHistologic evaluation reveals a consistent growth pattern of atypical cells with tubulopapillary architecture and extensive pleural and angiolymphatic infiltration. Immunohistochemical staining of the neoplastic cells shows expression of calretinin, cytokeratin 5/6, thrombomodulin, D2-40, and WT-1. Stains for TTF-1, CEA, B72.3, Leu-M1, PSA, thyroglobulin, and CDX-2 are negative. Focal BerEP4 reactivity is present. Histochemical analysis demonstrates glycogen expression by PAS stain without evidence of neutral mucin production after diastase digestion.\n\nCytogenetic analysis using FISH with LSI 9p21/CEP9 dual color probe on 75 cells shows complete absence of the p16 region (homozygous loss in 100% of cells), with no hyperdiploidy or other complex changes detected. These findings are consistent with previously reported patterns seen in certain pleural-based malignancies.\n\nBased on histopathologic and immunophenotypic features, as well as lymph node involvement, the staging assessment indicates advanced local invasion with regional lymph node involvement."} +{"pid": "TCGA-S3-A6ZH", "report": "The surgical specimen was received in four parts from a female patient. Part A consisted of one lymph node measuring 0.7 cm in maximum dimension, entirely submitted for evaluation. Part B included a mastectomy specimen with associated axillary contents. The specimen measured 24 x 18 x 5 cm and weighed 480 grams. On sectioning, a white-tan mass measuring 3 x 3 x 2.5 cm was identified in the upper outer quadrant, located approximately 1.5 cm from the deep fascial margin. Multiple lymph nodes were present within the axillary fat pad; some were firm and white in appearance, with the largest measuring 2 cm in diameter. Representative sections of the mass, margins, and lymph nodes were submitted for histologic evaluation. Margins were uninvolved by invasive disease, with the closest distance being 15 mm at the posterior/deep margin. Vascular invasion was noted.\n\nPart C consisted of two lymph nodes measuring 0.7 and 1.0 cm respectively, both submitted completely. Part D was a skin ellipse from the left axilla measuring 3.0 x 1.2 x 1.2 cm with a central scar and an underlying firm white area measuring 1.0 x 1.0 cm. Sections of this region were also submitted.\n\nHistologic grading showed minimal tubule formation (score = 3), marked nuclear pleomorphism (score = 3), and a mitotic count of 10 to 20 per 10 high-power fields (score = 2), resulting in a Nottingham Grade III score of 8\u20139 points. Of 21 lymph nodes examined, 14 contained metastatic involvement, including at least one deposit larger than 2.0 mm. No evidence of tumor was found in one lymph node assessed separately. Additional findings included adenosis and ruptured infundibular cyst with inflammation in the axillary skin specimen. Biomarker analysis from prior specimens showed ER positivity (98%), PR positivity (8%), HER2/neu equivocal (2+ by IHC, not amplified by FISH). Microcalcifications were not identified. Ischemic times ranged from 1 to 30 minutes across specimens."} +{"pid": "TCGA-B6-A0I1", "report": "Surgical Pathology Report\n\nGROSS EXAMINATION: \nA specimen labeled \"Left breast tissue 3.5 x 2 x 2 AF1\" was received fresh. It included a previously incised, unoriented portion of yellow-white fibrofatty tissue measuring 5.4 x 4.8 x 3.5 cm. Within this tissue, there was a firm, variegated yellow-gray mass measuring 3.5 x 2 x 2 cm, located focally adjacent to the margin. Representative sections of the mass were frozen as AF1, with the remaining tissue submitted as A1 and A2\u2013A5.\n\nAnother specimen labeled \"Left breast\" was received fresh and weighed 10,360 grams. It measured 33 x 21 x 5.5 cm and consisted of an elliptical piece of skin (29 x 16.3 cm) with underlying fibrofatty breast tissue (28 x 21 x 5.5 cm), including axillary contents measuring 9.0 x 5.8 x 2.4 cm. The areola measured 5.5 cm in diameter with a central everted nipple (1.3 cm). There was an 8 cm sutured incision located 6 cm lateral to the edge of the areola. The surgical margin was marked with blue ink. Sectioning revealed a cavity approximately 6 cm in diameter, located 0.6 cm beneath the incision. This cavity was within 1.4 cm of the deep margin and 3 cm from the closest soft tissue margin (inferior). The cavity was located in the outer half of the specimen and had slightly indurated borders; no residual lesion was identified grossly. The remainder of the breast parenchyma was composed primarily of yellow adipose tissue with focal dense pink fibroconnective tissue. No additional lesions were observed.\n\nBlocks were taken from multiple areas including the nipple (B1), incision edge and underlying cavity (B2), cavity in relation to the deep margin (B3), closest soft tissue margin (B4), cavity wall (B5), lower and upper outer quadrants (B7\u2013B8), central parenchyma (B9), lower and upper inner quadrants (B10\u2013B11), and various lymph node sampling sites (B12\u2013B18). One lymph node candidate was sampled proximally (B12), four mid-level (B13), one bisected mid-level (B14), the largest section of which measured 4.7 x 2.4 x 0.9 cm (B15\u201317), and two distal candidates (B18).\n\nMICROSCOPIC FINDINGS: \nIn the excisional biopsy specimen (A), histologic evaluation showed a high-grade lesion with features of invasive growth measuring 3.5 x 2 x 2 cm. The invasive component occupied approximately 50% of the lesion. Microcalcifications were present focally. Lymphatic or vascular invasion was not identified. There was no multifocal involvement. In addition, an extensive intraductal component was present, involving approximately the same size as the biopsy specimen. The in-situ component showed comedo and micropapillary features. Surgical margins could not be fully assessed due to the nature of the specimen.\n\nIn the mastectomy specimen (B), no residual invasive lesion was identified. However, residual in-situ disease was present, showing micropapillary features. Residual disease was found in random sections around the biopsy site and in a separate section from the central breast, several centimeters away, indicating a large area of involvement. The nipple and skin margins were free of disease. Non-neoplastic changes included fibrocystic alterations. Seven lymph nodes were examined, none of which showed evidence of involvement.\n\nAdditional studies for hormone receptor status were performed on paraffin-embedded tissue. Both estrogen and progesterone receptor assays were negative, with estimated FMOL values of 0 for both markers."} +{"pid": "TCGA-23-1809", "report": "A right tube and ovary specimen weighed 142 grams. The ovary measured 7.5 x 6.0 x 5.5 cm and was largely replaced by a cystic and solid mass measuring approximately 7.0 cm in greatest dimension. The tumor appeared tan-yellow, firm, and predominantly solid with areas of necrosis and hemorrhage. A focal gelatinous region measured 1.7 x 1.5 x 0.8 cm. The capsule was partially ruptured over an area with papillary projections measuring 2.5 x 1.5 x 0.5 cm. One portion of fallopian tube was identified but appeared grossly uninvolved.\n\nA separate specimen from the right pelvic side wall consisted of two portions of fibrofatty tissue measuring 4.0 x 3.0 x 1.2 cm and 3.0 x 1.2 x 0.3 cm. The larger portion had an irregular black-purple surface while the smaller was yellow-tan with an uneven texture.\n\nThree tumor samples were taken from the right ovary. Sample #1 consisted of two pieces of firm yellow tumor measuring up to 1.0 x 0.3 x 0.2 cm. Necrosis accounted for approximately 10% of this sample with tumor cell nuclei occupying about 85% of the cellular composition. Sample #2 contained two fragments measuring up to 0.9 x 0.6 x 0.3 cm with necrosis estimated at 5% and tumor cell nuclei comprising approximately 80%. Sample #3 included two portions measuring up to 1.2 x 0.4 x 0.3 cm showing necrosis at around 20%, with tumor nuclei making up approximately 80%.\n\nThe left tube and ovary specimen showed no apparent lesions in the ovary which measured 3.0 x 1.0 x 0.6 cm. Adjacent to the fallopian tube was a small cyst measuring 0.6 x 0.6 x 0.5 cm containing clear fluid. Microscopic examination revealed atypical epithelial hyperplasia within the fallopian tube with detached fragments noted in the tubal lumen; however, there was no evidence of direct invasion or in situ carcinoma.\n\nExamination of lymph nodes revealed no malignancy. Five lymph nodes were identified on the right periaortic side and two from the right pelvic lymph node specimen. Additionally, three parts of omentum were evaluated and found to be without malignant involvement.\n\nHistologic evaluation of the uterus and cervix demonstrated squamous metaplasia and reactive changes in the cervix. The endometrium was inactive and showed focal hemorrhagic areas. No significant pathology was observed in the myometrium or serosa.\n\nMicroscopic assessment of the ovarian tumor confirmed high-grade features with serous differentiation. Necrotic areas varied across samples ranging from 5% to 20%. Tumor cell nuclei ranged between 80% and 85%. Papillary tumor was noted on the external aspect of the ovary upon removal. There was no angiolymphatic invasion identified.\n\nPathologic staging according to AJCC (2002, 6th Edition) was determined as pT2c/N0."} +{"pid": "TCGA-QT-A5XK", "report": "The right adrenal gland specimen weighed 101 grams and measured 6 x 6 x 3.8 cm. It contained a well-defined, firm mass with a pink/tan to yellow fleshy cut surface. Within the mass, there was a 2 x 1.5 x 1 cm discrete pale tan nodule. A separate fragment of normal-appearing adrenal gland tissue measuring 4.2 x 2.5 x 1 cm was also present in the specimen. Microscopic evaluation revealed a unifocal, discrete but unencapsulated lesion arranged in a zellballen pattern, characterized by monomorphous cells without spindle cell differentiation, necrosis, mitotic activity, capsular invasion, or vascular invasion. Adjacent adrenal tissue appeared histologically unremarkable. No lymph nodes were sampled. The tumor did not involve extra-adrenal tissues, lymphovascular structures, or blood vessels. There was no evidence of tumor necrosis, and surgical margins were free of involvement. Based on available information, the staging classification is pT2 pNx pMx, though this may be subject to revision pending further clinical review."} +{"pid": "TCGA-AJ-A3OL", "report": "A 6.7 x 5.8 x 3.2 cm uterus with attached cervix and bilateral adnexa was received. The endometrial cavity contains a 3.4 x 3.0 x 2.0 cm friable, exophytic tan-white tumor that focally extends into the myometrium. Microscopic evaluation shows the tumor invades 1.2 cm into a 1.5 cm thick myometrium. The tumor also involves the endocervical stroma. No involvement of surgical margins is identified. \n\nHistologic examination reveals a poorly differentiated carcinoma with marked pleomorphism and prominent nuclear atypia. Areas show glandular and pseudo-glandular growth patterns, while much of the tumor grows in sheets without distinct glandular structures. Lymphovascular space invasion is present. Tumor cells are also identified on the peritoneal surface.\n\nLymph node evaluation includes right and left pelvic, right and left aortic, and left pelvic regions. A total of 19 lymph nodes were examined from all regions, and none show evidence of metastatic involvement.\n\nThe omental biopsy shows benign fibroadipose tissue without evidence of malignancy. The peritoneal implant biopsy reveals poorly differentiated carcinoma. \n\nAdditional findings include adenomyosis in the myometrium and endosalpingiosis in the bilateral ovaries. The fallopian tubes show no significant pathology. \n\nSections of the cervix, parametrium, ovaries, and fallopian tubes were submitted for analysis. Genomic studies were performed on representative sections of the tumor and surrounding tissue."} +{"pid": "TCGA-AZ-4614", "report": "The liver biopsy from segment 3 shows inflammation of the portal triads, cholestasis, steatosis, and the presence of microabscesses. No malignant cells are identified in this sample. A separate biopsy from liver segment 7 reveals the presence of abnormal cells consistent with spread to the liver.\n\nA resected specimen involving the right colon, sigmoid colon, and urinary bladder contains a circumferential growth measuring 3.0 cm located in the cecum. The growth extends through the cecal wall into adjacent structures including the sigmoid colon and urinary bladder. Both proximal (ileal) and distal (colonic) margins are free of abnormal cells. Similarly, the ileal and sigmoid colon margins do not show any involvement. Invasion of blood or lymphatic vessels is noted. Of the four lymph nodes examined, two contain abnormal cells. Additional findings in the small bowel include chronic inflammation consistent with Crohn\u2019s disease, along with inflammatory polyps and areas of low-grade dysplasia.\n\nBiopsies from the anterior bladder margin do not reveal any malignant cells. Further excision specimens from the right colon, sigmoid colon, and bladder remnant show evidence of abnormal cell infiltration. Specimens from the proximal sigmoid, distal sigmoid, and additional segments of the sigmoid colon all lack any sign of abnormal growth. Both the proximal and distal anastomotic margins are also free of abnormal cells.\n\nThe specimen involved a segment of the colon located approximately 87 cm from the cecum. The growth was infiltrative in nature and measured 3.0 cm in its largest dimension. Additional dimensions provided were 2.5 x 1.8 cm. Histologically, the cells showed high-grade features. A total of four lymph nodes were examined, with two showing involvement. All surgical margins were negative for tumor. Vascular and lymphatic invasion were present. No perineural invasion could be definitively assessed due to specimen limitations. Other findings included Crohn's ileitis with pseudopolyps and focal low-grade dysplasia."} +{"pid": "TCGA-22-5491", "report": "A lobectomy specimen from the left lower lobe of the lung contains a solid mass measuring 2 x 1.2 x 1.2 cm. The mass is located 0.8 cm from the bronchial margin, which is histologically negative. The mass demonstrates invasive high-grade cellular features with solid growth pattern. Four intrapulmonary peribronchial lymph nodes are free of tumor involvement. One lymph node contains a hyalinized granuloma. The surrounding lung tissue shows changes consistent with organizing pneumonia. Lymph node dissection includes multiple sites: right and left lower paratracheal, aortopulmonary, anterior mediastinal, subcarinal, inferior pulmonary ligament, and interlobar regions, with all nodes negative for tumor involvement."} +{"pid": "TCGA-06-0166", "report": "The specimen consists of three fragments of brain tissue obtained during craniotomy. The largest fragment measures 3.0 x 1.5 x 1.2 cm, while the other two are smaller, measuring 1.5 x 1.2 x 0.8 cm and 1.0 x 1.0 x 0.6 cm. The tissue is tan-red to glistening tan in appearance. Microscopically, there is a neoplastic proliferation of glial cells with an astrocytic phenotype. The tumor forms solid areas and shows diffuse infiltration into the surrounding brain tissue. Nuclear anaplasia is present, along with mitotic figures, microvascular proliferation, and regions of necrosis, some exhibiting pseudopalisading. Two intraoperative preparations were performed: imprint cytology showed atypical cells, and squash preparations demonstrated high-grade glioma features. Immunohistochemical staining for MIB-1 was carried out on two tissue blocks. In the more cellular regions, proliferation indices of 12% and 14% were observed."} +{"pid": "TCGA-WC-A87Y", "report": "The specimen consists of an intact right globe measuring 22 x 22 x 21 mm with a 4.0 mm optic nerve attached. The anterior chamber is formed, with a gray iris measuring 10 x 11 mm surrounding a round 6.0 mm pupil. Transillumination reveals a shadow located from 1 to 3 o\u2019clock, approximately 6.0 mm from the optic nerve and 2.0 mm from the limbus. This corresponds to a pigmented lesion in the choroid with a base measuring 13 mm and a height of 7.0 mm. The sclera beneath the tumor appears grossly intact.\n\nHistologic evaluation identifies a mitotically active lesion with 1 mitosis per 10 high-power fields. Periodic acid-Schiff (PAS) staining was performed to assess intraocular structures. Vortex vein invasion is present, with tumor extension beyond the globe noted in the vortex vein tissue. Sections submitted include regions of the superior temporal, superior nasal, inferior nasal, and inferior temporal quadrants (A1\u2013A4), a pupil-optic nerve section (A5), calotte sections (A6 and A7), and the optic nerve margin with lens (A8). No tumor involvement is identified in the optic nerve or ciliary body."} +{"pid": "TCGA-BT-A3PJ", "report": "The specimen was obtained from a radical cystoprostatectomy. The left lateral wall of the bladder contained a lesion measuring 3.5 cm in greatest dimension, located beneath an ulcerated area. Adjacent flat involvement was also present. The tumor invaded through the detrusor muscle into perivesicular soft tissue. No lymphovascular or perineural invasion was identified. All surgical margins were free of invasive carcinoma. A total of 28 lymph nodes were examined, with no evidence of involvement. Extensive therapy-related changes were noted.\n\nIn the prostate, a focus of disease was identified in the right lobe, involving approximately 5% of the tissue. The maximum dimension of this area was 1.2 cm. No extension beyond the prostate was observed, and all surgical margins were uninvolved. Additional findings included high-grade prostatic intraepithelial neoplasia. The prostate weighed 33.39 grams."} +{"pid": "TCGA-X4-A8KQ", "report": "The prostate specimen weighed 40.7 grams and measured 5.5 (right-left) x 4.5 (superior-inferior) x 2.8 (anterior-posterior) cm. Serial sectioning revealed periurethral nodularities up to 1 x 0.8 cm in greatest dimension and a pale, ill-defined area measuring 2 x 2 x 1.5 cm within the parenchyma. Bilateral seminal vesicles were present and measured 4 x 1.7 x 0.4 cm on the right and 3.8 x 3 x 0.7 cm on the left. The lymph nodes included one with a clip measuring 3.5 x 1.8 x 1 cm and another measuring 4.2 x 2.8 x 1 cm.\n\nMicroscopic examination showed atypical glands arranged in a crowded, infiltrative pattern. These glands were composed of cells with enlarged nuclei and increased cytoplasmic volume compared to normal tissue. Involvement was noted focally on the right side within the extra-prostatic tissue and at the junction of the seminal vesicle with the prostate. Two foci of involvement were identified at the peripheral margins on the right side. No tumor was identified at the apical or bladder neck margins. All submitted lymph nodes were negative for any abnormal cellular infiltration.\n\nApproximately 25\u201330% of the tissue bilaterally was processed for further analysis. The surgical specimen was entirely submitted for evaluation across multiple blocks representing all anatomical regions."} +{"pid": "TCGA-BH-A0H3", "report": "The specimen consists of three parts. Parts 1 and 2 include two sentinel lymph nodes from the left axilla, both without evidence of metastatic disease.\n\nThe breast specimen shows an invasive tumor composed of tubular and cribriform features. The Nottingham score is 4 out of 9, based on a tubule formation score of 1, nuclear pleomorphism score of 2, and mitotic activity score of 1. The invasive component measures 1.6 cm in greatest dimension. Ductal carcinoma in situ (DCIS) with nuclear grade 2 cribriform and micropapillary patterns is present, accounting for 20% of the total tumor mass and located adjacent to and admixed with the invasive component.\n\nNo lymphovascular space invasion is identified. Resection margins are negative for tumor involvement. The invasive tumor is closest to the posterior margin at 3 mm; all other margins are more than 0.5 cm away. The DCIS component is within 4 mm of the posterior margin, with all other margins greater than 0.5 cm away.\n\nAdditional findings include atypical ductal hyperplasia, sclerosing adenosis, fibrocystic changes, and prior biopsy site alterations. Calcifications are noted in malignant areas.\n\nEstrogen and progesterone receptors are positive; HER-2/neu testing by FISH shows non-amplification. Histologic evaluation was performed using H&E staining.\n\nPathologic staging includes pT1c for the primary tumor, pN0 for lymph node status, and pMX for distant metastasis. Non-neoplastic breast tissue shows atypical ductal hyperplasia and fibrocystic disease."} +{"pid": "TCGA-KO-8410", "report": "The left kidney specimen measured 9.0 x 5.5 x 5.0 cm and was part of a radical nephrectomy that included perinephric fat and a small portion of adrenal gland measuring 2.0 x 2.0 x 0.3 cm. A centrally located, well-circumscribed tumor measuring 5.2 x 5.0 x 4.7 cm was identified in the mid-to-lower pole. The tumor\u2019s cut surface appeared tan-brown with extensive hemorrhage comprising approximately 80% of the surface area. Grossly, the tumor was confined within the renal capsule, located 3.0 cm from Gerota's fascia and 6.0 cm from the ureteral and vascular margins. It abutted the renal pelvis but did not extend into the renal sinus fat or invade the renal vein. Margins of resection were free of abnormal tissue, and one lymph node showed no evidence of involvement. Microscopically, the majority of cells exhibited eosinophilic cytoplasm. Adrenal gland tissue was unremarkable. Multiple sections were submitted for analysis, including margins, surrounding fat, and various regions of the tumor."} +{"pid": "TCGA-AO-A03M", "report": "The left breast specimen was received fresh and measured 19 x 14 x 5 cm, with an overlying skin ellipse measuring 9 x 2.5 cm. The nipple-areolar complex was centrally located, with the areola measuring 3 x 2.5 cm. Serial sectioning of the breast revealed a well-defined white-tan area measuring 5 x 4 x 3 cm in the upper outer quadrant, located 0.4 cm from the deep margin. Adjacent to this was an ill-defined fibrous area measuring 6 x 5 x 4 cm. No grossly identifiable lymph nodes were found in the axillary dissection.\n\nMicroscopic evaluation identified a high-grade lesion with nuclear grade III features, measuring 1.7 cm. The lesion was located in the upper outer quadrant and showed lymphovascular invasion. No in situ component was identified. The surgical margins were free of tumor involvement, and there was no evidence of involvement of the nipple or skin. The surrounding non-neoplastic breast tissue demonstrated biopsy site changes and fibrocystic alterations.\n\nImmunohistochemical staining showed positivity for ER (70% nuclear staining with moderate intensity) and PR (60% nuclear staining with moderate to strong intensity). HER-2/neu immunostaining showed an intensity of 2+ with satisfactory controls. Additional sections submitted included areas from the upper inner, lower inner, upper outer, and lower outer quadrants, as well as the nipple, skin, and deep margin. Representative sections of a hemorrhagic area and an ill-defined region suspicious for involvement were also examined."} +{"pid": "TCGA-D7-A4YT", "report": "The specimen consists of a resected stomach measuring 19.7 x 17.4 cm, along with attached omentum measuring 25 x 7 cm. A lesion is present in the cardia region of the lesser curvature, measuring 6.4 x 5.8 x 1.4 cm. The distance from the proximal resection margin is 0.9 cm, and from the distal margin, 12.2 cm. Histologically, the lesion shows tubulopapillary and partially mucinous growth patterns with high-grade atypia. The lesion invades through the muscularis propria into perigastric fat. All examined margins, omentum, and 14 lymph nodes are free of neoplastic involvement."} +{"pid": "TCGA-A8-A09N", "report": "The specimen shows a focus of invasive malignancy measuring up to 2.2 cm in maximum diameter, characterized by high-grade nuclear features. Angioinvasive activity is present in the immediate peritumoral region. Adjacent to this area, there is extensive high-grade ductal intraepithelial proliferation involving more than 10 ducts. In distant breast tissue composed of fibrolipomatous and cystically dilated ductal structures, there are findings consistent with atypical ductal hyperplasia; however, no tumor involvement is identified in these regions. The surgical margins at the caudal and dorsal aspects measure minimally 0.7 to 0.8 cm and show no evidence of neoplastic involvement. The overlying skin demonstrates only benign spindle cell changes. Histopathologic staging indicates G3 differentiation (L1, V0), pT2 primary extent, with involvement of multiple regional lymph nodes (pN3a). Distant metastasis could not be assessed (MX), and all resection margins are free of tumor (R0)."} +{"pid": "TCGA-BH-A18S", "report": "The patient is a postmenopausal woman who underwent a core biopsy showing a neoplastic process involving mucinous features with nuclear grade 1. Hormone receptor analysis demonstrated positivity for estrogen and progesterone receptors, while HER-2/neu testing was negative.\n\nA right total mastectomy with sentinel lymph node biopsy was performed. Gross examination revealed two distinct foci of invasive disease located in the lower inner quadrant, each measuring 1.5 cm in maximum dimension. Histologic evaluation showed a Nottingham score of 4, composed of a tubule formation score of 2, nuclear pleomorphism score of 1, and mitotic index score of 1. Adjacent ductal changes were present in a non-invasive pattern, comprising approximately 15% of the lesion. No angiolymphatic invasion was identified. Surgical margins were unremarkable. A prior biopsy site was noted, and benign breast tissue was present without significant atypia. The skin and nipple showed no unusual findings.\n\nOne lymph node was retrieved from the sentinel lymph node biopsy and showed no evidence of metastatic involvement.\n\nAdditional procedures included hysteroscopy and dilation and curettage. Endocervical sampling showed only benign findings with no atypia. Endometrial sampling revealed minimal benign endometrial tissue along with mucus and cellular debris; no malignant or pre-malignant changes were identified."} +{"pid": "TCGA-60-2719", "report": "The specimen included multiple lymph nodes and a right upper lobe lung lobectomy. Lymph nodes submitted included a 4R lymph node measuring 0.4 x 0.2 x 0.1 cm, a Level 7 lymph node measuring 0.7 x 0.4 x 0.2 cm, a 4L lymph node measuring 0.5 x 0.3 x 0.2 cm, and a right Level 4 lymph node measuring 0.8 x 0.8 x 0.3 cm. All lymph nodes were negative for tumor involvement.\n\nThe right upper lobe specimen weighed 121 grams and measured 14.5 x 10.7 x 2.3 cm. A mass was identified on the pleural surface, measuring 3.0 x 2.5 x 1.5 cm, with hemorrhagic and necrotic features. The mass was located 0.3 cm from the pleural margin and 1.2 cm from the bronchial margin. The bronchial margin was uninvolved. The lung tissue showed a variegated pink and anthracotic appearance with areas of congestion. Six peribronchial lymph nodes were identified and all were negative for tumor involvement.\n\nHistologic evaluation revealed a moderately to poorly differentiated squamous cell carcinoma. There was no angiolymphatic invasion or satellite tumors. Non-neoplastic findings included emphysematous changes, congestion, and focal atelectatic change. No additional pathologic findings were noted. Staging was determined as pT1 with no lymph node involvement (N0)."} +{"pid": "TCGA-UF-A7JF", "report": "The biopsy specimen from the left vocal fold demonstrates invasive moderately differentiated squamous cell carcinoma. Surgical resection of the thyroid and larynx reveals a moderately differentiated squamous cell carcinoma measuring 5.0 x 3.0 cm. The lesion involves multiple anatomical regions including the glottic, supraglottic, and infraglottic areas on the left, extending to the infraglottic region on the right. Additional involvement includes the left piriform sinus, cricoid, arytenoid, and thyroid cartilages, as well as the thyroid isthmus, adjacent soft tissues of the larynx, and trachea. No angiolymphatic or perineural invasion is identified. Surgical margins are negative except for involvement of the left soft tissue margin. A small follicular adenoma is noted in the left thyroid lobe, with no other significant findings in the right thyroid lobe.\n\nLymph node evaluation reveals no evidence of involvement in the right neck across levels II, III, and IV (0 out of 31 lymph nodes involved). On the left side, level II, III, and IV lymph nodes total 35, with one lymph node in level III demonstrating involvement and no capsular extension."} +{"pid": "TCGA-39-5034", "report": "The patient underwent evaluation following imaging that revealed a mass in the right upper lobe of the lung as well as a nodule in the right lower lobe. A fine needle aspiration was performed and showed abnormal cells. Subsequent surgical resection included a lobectomy of the right upper lobe along with removal of portions of the second and third ribs and associated chest wall tissue. Multiple lymph nodes were excised from various mediastinal and interlobar locations.\n\nThe primary lesion measured 3.2 cm in greatest dimension and was located peripherally in the lateral aspect of the lung specimen, approximately 4.3 cm from the bronchial margin. It was described as a well-circumscribed tan firm mass that appeared to adhere firmly to the attached chest wall, raising concern for invasion. Histologic examination demonstrated moderate differentiation of the cellular components, with vascular invasion noted. Margins of the bronchus and major vessels were free of involvement.\n\nEvaluation of the submitted lymph nodes revealed no evidence of malignant involvement. All mediastinal and interlobar lymph nodes assessed were benign. Similarly, all bony and soft tissue margins removed from the second and third ribs showed only benign bone and skeletal muscle, without any sign of tumor involvement.\n\nHistologic sections of the non-neoplastic lung tissue revealed respiratory bronchiolitis and focal changes, consistent with chronic inflammatory or reactive processes. No definitive metastatic or infiltrative disease was identified in the specimens examined."} +{"pid": "TCGA-E9-A1N6", "report": "The specimen consisted of breast tissue from a radical mastectomy. A grossly evident lesion was identified in the breast, measuring 2.3 x 2.3 x 2 cm. Microscopic examination revealed a poorly differentiated histologic type. Lymph node assessment showed 2 out of 10 axillary lymph nodes positive for involvement. The affected lymph nodes were located in the left upper quadrant. No information was available regarding extracapsular invasion, tumor extent, or margin status. Attempts to calculate the Nottingham Histologic Score could not be completed due to missing data on tubule formation, nuclear pleomorphism, and mitotic counts. There was no evidence of treatment effect. No additional findings were noted."} +{"pid": "TCGA-KL-8334", "report": "A 39-year-old female underwent left radical nephrectomy for a renal mass. Submitted specimens included a biopsy of soft tissue from the para-aortic dissection superior margin, the left kidney with para-aortic lymph nodes, a segmental excision of the ninth rib, and interaortacaval lymph nodes.\n\nThe para-aortic soft tissue biopsy revealed benign ganglion and nerve without atypical features. The left kidney specimen weighed 1900 grams and measured 21.0 x 17.0 x 7.0 cm. Upon bivalving, a large yellow-red mass was identified, measuring 17.5 x 17.0 x 7.0 cm, occupying the majority of the kidney with only a small portion of uninvolved parenchyma (4.5 x 4.5 cm). The mass extended through the renal capsule but remained confined within Gerota's fascia. No involvement of the adrenal gland was observed. The tumor showed areas of fibrosis and yellow discoloration suggestive of calcifications. Multiple perirenal and peritumoral lymph nodes were identified, ranging in size from 0.5 to 2.8 cm; all were histologically examined and found free of tumor. Surgical margins were negative for tumor involvement.\n\nThe rib specimen consisted of a curvilinear fragment measuring 15.0 cm in length and 1.0 cm in maximal diameter. Serial sectioning demonstrated no significant abnormalities. The interaortacaval lymph node specimen included an irregular fragment of soft and lymphoid tissue measuring 2.8 x 1.9 x 0.5 cm, with multiple lymph nodes ranging from 0.6 to 1.0 cm in diameter. All lymph nodes were submitted and showed no evidence of tumor involvement.\n\nHistologic evaluation of all submitted sections, including vascular hilar margins, adrenal gland, kidney, lymph nodes, and tumor tissue, confirmed absence of tumor in non-kidney structures. Based on pathological findings, staging was determined as pT3, indicating tumor extension into major veins or invasion of perinephric tissues but not beyond Gerota\u2019s fascia."} +{"pid": "TCGA-E2-A1L6", "report": "The surgical specimens include three sentinel lymph nodes from the left axilla and a left breast mastectomy specimen. The first sentinel lymph node measures 1.6 x 1.2 x 0.7 cm and contains a focus of involvement measuring 1.8 mm in greatest diameter. The second and third sentinel lymph nodes are without any evidence of similar findings. The second node is 0.6 x 0.5 x 0.4 cm within a larger soft tissue fragment measuring 2.2 x 1.8 x 0.5 cm, and the third lymph node measures 1.3 x 0.9 x 0.5 cm.\n\nThe left mastectomy specimen measures 15.3 x 15.0 x 3.0 cm and weighs 228 grams. A firm, granular mass is identified in the lower outer quadrant, measuring 1.5 x 1.3 x 1.2 cm. It approaches the deep margin at a distance of 0.2 cm and is located 4.5 cm from the axilla. In the upper inner quadrant, there is a hemorrhagic area measuring 2.4 x 1.6 x 1.0 cm, which also approaches the deep margin at a distance of 0.2 cm and is located 4.8 cm from the main lesion. No additional suspicious areas are identified in other regions of the breast.\n\nMicroscopically, the invasive component demonstrates well-differentiated features with tubule formation, nuclear grade 2, and low mitotic activity, corresponding to a modified Scarff Bloom Richardson grade I. The invasive tumor is associated with a component showing multifocal patterns, including cribriform, micropapillary, and papillary arrangements, with intermediate nuclear grade. These involve approximately 20% of the sampled tissue and are seen both in proximity to the invasive tumor and as separate foci in the central region of the breast. Non-malignant changes include proliferative type fibrocystic changes, atypical ductal hyperplasia, and atypical lobular hyperplasia. There is also evidence of a prior biopsy site in the upper inner quadrant with organizing hematoma.\n\nAll surgical margins are free of involvement. The closest distance of the invasive component to the margin is 0.3 cm at the deep margin, while the non-invasive component extends to within 2 mm of the margin.\n\nIn addition to the three sentinel lymph nodes, three more lymph nodes are identified in the axillary dissection; all are unremarkable. The focus in the first sentinel lymph node measures 1.8 mm in diameter and does not show extension beyond the lymph node.\n\nImmunohistochemical analysis of the tumor shows strong expression of estrogen and progesterone receptors, with Allred scores of 8 for both. HER2 immunohistochemistry reveals weak and incomplete membrane staining in a proportion of cells, with 40% tumor cell reactivity. This result is considered indeterminate, prompting further testing by fluorescence in situ hybridization (FISH).\n\nThe case was reviewed thoroughly using established protocols, and quality assurance measures were followed. The findings have been documented in accordance with standard reporting practices."} +{"pid": "TCGA-06-0195", "report": "The surgical specimen consists of three tissue samples obtained from the right frontal lobe. The first two specimens are fragments of soft, moist, fleshy pink tissue measuring 1.1 cm and 1.4 cm in greatest diameter, respectively. The third sample includes multiple irregular fragments of gelatinous, partially hemorrhagic tan tissue, with the largest fragment measuring approximately 2.0 cm. All specimens were submitted for histological evaluation.\n\nMicroscopic examination reveals a high-grade glial tumor characterized by marked cellular atypia, pleomorphism, and brisk mitotic activity. The tumor cells range from small anaplastic forms to large multinucleated cells. Areas of necrosis and endothelial hyperplasia are present, along with regions showing a possible oligodendroglial component with clear cytoplasmic halos. The tumor demonstrates diffuse infiltration into the cerebral cortex, with associated hemosiderin-laden macrophages indicating prior hemorrhage. A perivascular lymphocytic infiltrate is also observed.\n\nImmunohistochemical staining shows variable positivity for glial fibrillary acidic protein. Proliferation index assessed by Ki-67 (MIB-1 antibody) staining is elevated, with approximately 30% of tumor cells demonstrating nuclear labeling."} +{"pid": "TCGA-BJ-A3PU", "report": "The specimen consists of a total thyroidectomy with central compartment lymph node dissection. The left lobe contains a unifocal lesion measuring 2.6 cm (greatest dimension), with an additional measurement of 2.0 cm. Histologic examination reveals neoplastic cells arranged in a follicular pattern. The lesion extends beyond the thyroid capsule into adjacent soft tissues and focally involves skeletal muscle. Lymphovascular invasion is present. Peripheral surgical margins are extensively involved by the lesion.\n\nA total of seven regional lymph nodes were examined, all of which show involvement by tumor cells. One lymph node from the central compartment demonstrates metastatic involvement. No extranodal extension is identified.\n\nStaging according to AJCC 7th edition criteria indicates pT3 primary tumor stage and pN1a for regional lymph node involvement. Distant metastasis cannot be assessed. Additional findings include normocellular parathyroid tissue from a biopsy specimen weighing 20 milligrams. No other significant pathologic findings are identified."} +{"pid": "TCGA-97-A4M1", "report": "The specimens include a wedge resection and completion lobectomy of the right upper lobe, lymph nodes from stations 2, 4, and 11 on the right side, and a wedge resection of the right lower lobe. Histologic evaluation of the right upper lobe lesion revealed a mixed subtype with two distinct growth patterns. The lesion measured 1.3 cm in greatest dimension and was located subpleurally in the upper lobe. There was no evidence of visceral pleural invasion or tumor extension beyond the surrounding lung tissue. Both bronchial and vascular margins were free of involvement. No lymphovascular invasion was identified.\n\nLymph node dissections included station 11 (three nodes), station 4 (four nodes), and station 2 (one node); all were negative for metastatic involvement. The right lower lobe nodule measured 0.8 cm and was well-circumscribed; it was located 1.2 cm from the stapled margin and was completely excised.\n\nStaging according to pTNM classification indicates a primary tumor size consistent with pT1a: a tumor \u22642 cm in greatest dimension surrounded by lung or visceral pleura, without bronchoscopic evidence of more proximal invasion. Regional lymph node assessment was classified as pN0 due to the absence of metastasis in all sampled lymph nodes. An incidental finding of a subpleural fibroelastotic scar was noted in one specimen, interpreted as consistent with an apical cap. Another unrelated nodule in the right lower lobe was diagnosed as a pulmonary hamartoma and was fully removed. All surgical margins were clear."} +{"pid": "TCGA-E8-A44K", "report": "The tumor is located in the left thyroid lobe and measures 2 x 1.5 x 1.5 cm. It is unifocal and does not demonstrate extrathyroidal extension. Microscopically, the lesion forms trabecular or papillary structures with fine or broad fibrovascular stalks lined by single to multiple layers of cuboidal epithelial cells. The cells maintain their polarity, with nuclei that are regular in shape and contain finely dispersed chromatin. Some nuclei exhibit intranuclear grooves. Invasion into the capsule, blood vessels, or surrounding benign tissue is present. Inflammatory cell infiltration is observed within the tumor. The stroma is fibrous and hyaline. No special stains or markers were used, and no additional comments were provided."} +{"pid": "TCGA-DX-A3UC", "report": "The surgical specimen consists of a 7 x 4.5 x 4 cm soft tissue mass with areas of necrosis, involving a large vein and extending into the surrounding fibroadipose tissue. The tumor is in close proximity to several surgical margins: within 0.1 cm of the posterior margin, 0.3 cm from the medial margin, and 0.4 cm from the anterior margin. Lymph node evaluation reveals involvement of one adjacent node, while four other lymph nodes are negative. The resection includes a vascular segment measuring 2 cm in length and 0.7 cm in diameter, along with attached skeletal muscle and serosal membrane. The tumor is tan and lobulated, with color variation noted on the surface including red, blue, black, and green tones, and a staple line at the superior aspect. Margins are marked with ink in multiple locations, and the tumor is found within 0.1 cm of all inked margins. Microscopic sections include anterior, posterior, vascular, and cross-sectional regions of the mass. All primary surgical margins are free of tumor, although the tumor is in very close proximity to some margins. Tissue samples were submitted for further analysis."} +{"pid": "TCGA-S7-A7X2", "report": "Gross examination revealed a left adrenal gland containing an ovoid mass measuring 90x60x45 mm and weighing 72 grams. The mass was partially encapsulated, with the fibrous capsule measuring 60x50x45 mm. On sectioning, the adrenal cortex appeared ochre-yellow, approximately 2 mm in thickness, while the mass exhibited a grey-pink coloration and soft consistency, with areas of central hemorrhage. The largest tumor diameter was sampled across four representative tissue blocks.\n\nMicroscopically, the lesion showed diffuse alveolar growth pattern with a fibrous capsule. Hemorrhagic changes, both fresh and old, along with scarring were noted. At the periphery, remnants of normal adrenal cortex were present. Immunohistochemical analysis for S100 protein did not demonstrate positive sustentacular cells within the tumor; however, small nerves in the surrounding periadrenal tissue served as internal positive controls. Proliferative index by Ki-67 staining was low, with 1\u20132% of tumor nuclei positive.\n\nHistopathologic features assessed included large nests or diffuse growth comprising more than 10% of the tumor volume, central necrosis within large nests, high cell density, uniform cellular morphology, focal spindle-shaped tumor cells, mitotic activity exceeding 3 figures per 10 high-power fields, presence of atypical mitotic figures, invasion into surrounding adipose tissue, vascular invasion, and capsular invasion. Additional features included mild nuclear pleomorphism and slight nuclear hyperchromasia. The total score for these parameters was 4."} +{"pid": "TCGA-2Z-A9JM", "report": "The left kidney specimen weighed 82 grams and measured 5 x 3.5 x 2.8 cm. It was surrounded by perinephric adipose tissue ranging from 0.1 to 0.8 cm in thickness. A 2-cm length of ureter was attached and appeared unremarkable. Upon sectioning, an intraparenchymal lesion measuring 2.5 x 2 x 1.7 cm was identified in the superior lateral aspect of the kidney, involving both cortex and medulla. The lesion bulged but did not breach the renal capsule and was within 0.3 cm of the nearest perinephric adipose tissue margin. Its cut surface was pale-yellow to pink, lobulated, without necrosis or hemorrhage. Neither the calices nor the renal pelvis were involved. Vascular structures including the renal artery and vein showed no signs of involvement.\n\nAdditionally, at least 17 smaller nodules were identified within the renal parenchyma, ranging from 0.1 to 0.7 cm in size. These were located both subcapsularly and intraparenchymally. Several cystic lesions were also present, measuring between 0.3 and 0.6 cm in diameter and filled with clear fluid. The remaining renal cortex showed atrophy, with thickness ranging from 0.2 to 0.5 cm. The urothelium of the calices, renal pelvis, and ureter appeared tan, smooth, and glistening. No lymph nodes were identified within the hilar adipose tissue, and no adrenal gland was found at the superior pole.\n\nHistologically, the larger lesion exhibited a papillary growth pattern with nuclear grade 2 features. Immunohistochemical staining of this lesion demonstrated positivity for vimentin, cytokeratin 7, AMACR, and focal positivity for CD10. The smaller satellite nodules showed similar immunohistochemical profiles, being positive for cytokeratin 7 and AMACR, with focal CD10 expression. One cystic lesion showed lining epithelial cells with weak focal positivity for CK7 and negativity for CD31.\n\nMargins of resection, including ureteral, vascular, and peripheral soft tissue, were free of tumor involvement. There was no evidence of renal capsule invasion, perinephric adipose tissue invasion, renal vein invasion, or lymphovascular invasion. The non-neoplastic kidney tissue showed findings consistent with end-stage renal disease and acquired cystic disease of the kidney.\n\nPathologic staging was determined as pT1a NX MX. All slides and materials were personally reviewed by the attending pathologist to confirm findings."} +{"pid": "TCGA-BQ-5875", "report": "The left kidney specimen measured 23.0 x 13.0 x 9.0 cm and weighed 1190 grams. It included a segment of ureter (1.5 cm in length, 0.4 cm in diameter) and a segment of renal vein (3.0 cm in length, 0.3 cm in diameter). The cut surface revealed multiple nodules of tan-yellow, partially cystic, hemorrhagic tissue occupying nearly the entire kidney. The lesion measured approximately 13.0 x 9.0 x 6.0 cm and was observed to abut the adrenal gland (measuring 6.0 x 2.0 x 1.5 cm). Grossly, the tumor appeared confined within the renal capsule. The tumor surface exhibited fine papillary projections. Histologically, the tissue showed extensive oncocytic (oxyphilic) cytomorphologic features. The tumor extended through the renal capsule but remained within Gerota\u2019s fascia. All surgical margins were free of involvement. The non-neoplastic kidney and adrenal gland showed no abnormalities.\n\nThe left fallopian tube and ovary specimen included a 4.8 cm long segment of fallopian tube with a 0.1 cm lumen; the serosa was tan-pink and smooth. Multiple paratubal cysts were noted, ranging from 0.1 to 0.8 cm in size. The attached ovary was tan-white, firm, and unremarkable on cut examination, with numerous corpora albicantia identified.\n\nThe right fallopian tube and ovary specimen included a 6.5 cm long segment of fallopian tube with a 0.1 cm lumen. The serosa was tan-pink and smooth, with minute paratubal cysts (<0.1 cm in diameter). The attached ovary measured 2 x 2 x 1.5 cm and contained a 1 x 0.8 x 0.3 cm surface cyst. Cut surface was light tan and unremarkable, with corpora albicantia present.\n\nThe spleen specimen weighed 120 grams and measured 11.0 x 7.0 x 5.0 cm. The capsule was partially eroded with a hemorrhagic surface appearance. A 4.5 cm triangular infarction was identified in the cut section. No lymph nodes were found at the hilum. The remaining splenic parenchyma appeared histologically unremarkable, with no abnormal cellular infiltrates or masses identified. Hemorrhagic and non-caseating granulomas were noted in the splenic tissue.\n\nFrozen section evaluation during surgery confirmed the presence of a renal cortical lesion, along with benign findings in both fallopian tube and ovarian specimens. Final histopathologic review corroborated these findings. All submitted tissue sections were representative of the described gross features and included control sections for accurate assessment."} +{"pid": "TCGA-66-2727", "report": "The examined specimen included tissue from the left lower lobe and surrounding areas. Gross examination of the left upper lobe revealed an inflated, fixed preparation measuring 13 x 7 cm at the base and up to 18 cm in length. The pleura appeared cloudy with adhesion residues laterally, dorsally, and at the base. A whitish-yellow discoloration was noted on the pleura in a laterobasal region, measuring up to 5 cm with distinct margins. The bronchus was displaced near the B6/basal group branching point, adjacent to two partially involved grayish-black lymph nodes measuring up to 1.8 cm. On the ventral side, a parenchymal flap was enclosed by a row of metallic staples measuring 6 x 4 x 2 cm. Marker threads were placed centrally within this staple line.\n\nA nodular lesion measuring 4.2 cm was identified extending from the central region toward the periphery, with indistinct borders and areas of marked curvature. The tumor tissue appeared pale gray and vitreous, with central slate-gray pigmentation. An irregularly shaped cavity measuring 8 mm was observed eccentrically within the tumor. The tumor extended toward the pleura at the site of contact with the parenchymal flap; however, no infiltration of the flap was detected. Vascular branches entering the tumor were noted to be largely destroyed. Slight twisting was observed in the root segments of B10, although these remained otherwise clear toward the periphery, similar to B6. Sections of B8 and B9 located peripherally to the tumor showed moderate widening, with whitish-yellow material present within the lumens in some areas.\n\nPulmonary tissue densities were noted laterally at the tumor border, with speckled grayish-brown cut surfaces. A wedge-shaped area of induration approximately the same size was found beneath the previously described pleural changes in the laterobasal region. Normal parenchyma was preserved in segments 6 and 10.\n\nAdditional specimens included a wedge resection from the left upper lobe (S2), measuring 1.9 x 1.5 cm at the base and up to 6 mm in height, showing hazy pleura and a pale gray area of induration approximately 1 cm in size with indistinct margins. Another fragment (S1) measured 0.8 x 0.4 x 0.2 cm and appeared pale reddish after fixation.\n\nLymph node findings included: a hilar lymph node measuring 1.1 cm with dark pigment; two hilar lymph nodes measuring 1.3 and 1.9 cm, both with blackish pigmentation; a pulmonary ligament lymph node measuring 0.5 cm; a paraesophageal lymph node measuring 1.7 cm with black-red pigment; a subaortic lymph node measuring 0.9 cm with dark pigmentation; and a subcarinal lymph node measuring 1.3 cm with black-red pigmentation.\n\nHistological evaluation showed that the tumor extended from the central region to the periphery, involving segments 8 and 9. The tumor surrounded and compressed large pulmonary veins and extended into a branch of the pulmonary artery. Peripheral invasion into the pleura of the interlobar fissure was observed, along with minimal continuous extension into the resected parenchymal flap from the upper lobe; however, the surgical margin at this location was free of tumor involvement.\n\nA large area of necrosis consistent with infarction was identified in the lower lobe behind the tumor site, accompanied by significant siderophages and fibrinous pleurisy. The bronchial and vascular margins were free of tumor. Anthracotic pigment deposition was minimal. Lymph nodes demonstrated reactive changes only. One lymph node sample contained mediastinal and pleural tissue with chronic inflammation and fibrous strands.\n\nIn a small pulmonary tissue fragment, a localized focus of interstitial fibrosis or scarring with smooth muscle proliferation was identified. In another wedge-shaped specimen, a larger scar was observed with atypical bronchiolo-alveolar or adenomatous cell proliferation at the margin, but no definitive evidence of bronchiolo-alveolar carcinoma was found.\n\nStaging was determined as pT2 pN0 with no lymph node metastasis and no residual tumor at the resection margins (R0). Vascular invasion was present. The histological grade was high."} +{"pid": "TCGA-L5-A4OM", "report": "A female patient underwent a transhiatal esophagectomy involving the distal esophagus and proximal stomach. A segment of esophagus measuring 8 cm in length was received, along with a 3.5 x 3.5 cm attached portion of the proximal stomach and surrounding adipose tissue. Within the esophagus, two small nodules were identified: one measuring 0.4 x 0.6 cm and another 0.5 x 0.5 cm. Both were located 2 cm from the proximal surgical margin and approximately 3.5 cm from the gastroesophageal junction. The proximal margin was assessed with frozen section control and found to be negative. Extensive sampling of the region around the nodules was performed, including longitudinal and serial sections. The gastroesophageal junction and lymph nodes were also submitted for evaluation.\n\nHistologic examination revealed multifocal invasive growth within the esophagus, with involvement of the mid submucosa. The surrounding tissue showed extensive high-grade squamous dysplasia. All resection margins were free of involvement. Three lymph nodes were examined and found to be negative for malignant cells. No evidence of distant metastasis was identified. Immunohistochemical staining for p16 on selected tissue was negative.\n\nFrozen section analysis of the proximal margin was performed and confirmed as negative on permanent sections. The specimen was fully evaluated according to standard protocols, with all relevant areas sampled and reviewed microscopically."} +{"pid": "TCGA-QR-A70U", "report": "The right adrenal gland specimen measured 10 x 5.5 x 2.7 cm and weighed 66.3 grams, including surrounding adipose tissue. A mass measuring 5.7 x 3 x 2.7 cm was identified within the gland. The cut surface of the mass was inked in black and revealed a light tan, homogeneous appearance with central necrosis. No involvement of the inked margin was observed. Representative sections of the mass were submitted for permanent processing along with sections of grossly normal adrenal tissue.\n\nMicroscopic examination revealed tumor fragments present on the surface of periadrenal fat; however, these are interpreted as likely contaminants related to specimen handling rather than representing true extracapsular invasion. Immunohistochemical staining demonstrated positivity for chromogranin and synaptophysin in the tumor cells. Sustentacular cell staining was highlighted using S-100 immunostaining.\n\nAll immunoperoxidase tests performed were developed by the Specialized Diagnostics Unit of the Laboratory of Pathology. These tests have not been cleared or approved by the U.S. Food and Drug Administration; however, FDA has determined that such clearance or approval is unnecessary. The laboratory is certified under CLIA \u201988 regulations for performing high-complexity clinical testing."} +{"pid": "TCGA-E9-A1N9", "report": "The specimen consisted of breast tissue from a radical mastectomy. A grossly evident lesion was identified, measuring 3.2 x 2.5 x 1.5 cm. Microscopic examination revealed a mixed histologic pattern. Cellular features included variable nuclear morphology and mitotic activity; however, specific counts and scoring components were not fully assessed. A total of 8 regional lymph nodes were examined, and none contained metastatic involvement. Additional pathologic findings, margin status, and treatment effects could not be confirmed based on the available information."} +{"pid": "TCGA-ET-A2MY", "report": "SPECIMEN TAKEN: FINAL DIAGNOSIS. 1. RIGHT UPPER PARATHYROID (EXCISION): PARATHYROID AND FIBROADIPOSE TISSUE (500MG). PARATHYROID ACCOUNTS FOR 40% OF THE SPECIMEN. 2. RIGHT LOWER PARATHYROID (EXCISION): PARATHYROID TISSUE WITH ADJACENT FIBROADIPOSE AND BENIGN THYROID TISSUE (450MG). PARATHYROID ACCOUNTS FOR 25% OF THE SPECIMEN. 3. BIOPSY LEFT LOWER PARATHYROID GLAND (BIOPSY): PARATHYROID TISSUE (6MG). NOTE: Tissue block exhausted on frozen section. No frozen section control present. 4. THYROID (THYROIDECTOMY): SPECIMEN TYPE: Total thyroidectomy. TUMOR SITE: Right superior lobe and isthmus. HISTOLOGIC FEATURES SHOW A CELLULAR TUMOR MEASURING 1.3CM IN GREATEST DIMENSION, PRESENT AS A SINGLE FOCUS. LYMPH NODES WERE NOT SUBMITTED FOR EVALUATION. STAGING FINDINGS: pT1b \u2013 TUMOR GREATER THAN 1CM BUT LESS THAN 2CM IN SIZE, CONFINED TO THE THYROID; pNx \u2013 REGIONAL LYMPH NODES CANNOT BE ASSESSED; pMx \u2013 DISTANT METASTASIS CANNOT BE ASSESSED. MARGINS OF RESECTION ARE UNINVOLVED, WITH THE TUMOR LOCATED LESS THAN 1MM FROM THE ANTERIOR AND POSTERIOR MARGINS. EVIDENCE OF VASCULAR INVASION IS NOTED. ADDITIONAL FINDINGS INCLUDE MULTINODULAR HYPERPLASIA."} +{"pid": "TCGA-GR-7351", "report": "The specimen consists of a left thyroid lobe measuring 8.5 x 3.5 x 2.0 cm and weighing 18.8 grams. The external surface is pink and glistening, with ink applied to the capsule prior to sectioning. The parenchyma shows a nodular tan to white appearance throughout the lobe, with only scattered areas of residual normal thyroid tissue. A frozen section was performed and confirmed the presence of diagnostic material. Permanent sections corroborate the adequacy of the sample for analysis. \n\nTissue was processed for multiple studies: three touch preparations were made, fixed in formalin for 24 hours (cassettes A1\u2013A4), embedded in OCT for immunohistochemical analysis, and portions were placed in sterile medium for cytogenetic and molecular diagnostic testing. All materials were evaluated by the appropriate personnel to confirm findings, with the sign-out pathologist taking responsibility for the final assessment.\n\nImmunohistochemical staining of paraffin-embedded tissue demonstrates positivity for B-cell markers including CD20 (L26) and CD45 (LCA), with expression of PAX5 and absence of CD10. T-cell markers such as CD3 (T3) and CD45RO (A6) are negative. Additional markers including CD30 (Ber-H2) and BCL-6 were also assessed. Results support a B-cell lineage. All tests were concordant across two blocks examined."} +{"pid": "TCGA-CV-A460", "report": "A male patient underwent surgical resection including a total laryngectomy, partial pharyngectomy, bilateral neck dissection, and subtotal thyroidectomy. A separate excision of a left external jugular lymph node was also performed.\n\nThe left external jugular lymph node specimen measured 3.0 x 2.0 x 1.0 cm and contained two lymph nodes, measuring 1.5 cm and 1.0 cm respectively. One lymph node showed near-complete fat replacement, while the other contained a dark tan/red nodule. Both were submitted for frozen section examination and no abnormality was detected.\n\nIn the main specimen, multiple enlarged lymph nodes were observed on the right side. A mass measuring 2.0 x 1.0 x 1.0 cm was identified in the right pyriform sinus. It appeared ulcerated and contracted, but did not extend into the larynx and remained confined to the right pyriform area. No other lesions were identified in the transglottic or subglottic regions.\n\nExamination of the surgical margins revealed no evidence of tumor. Lymph node evaluation showed variable involvement across different levels. On the right side:\n\n- Level I: 4 lymph nodes examined, none showed abnormality.\n- Level II: All 3 lymph nodes examined contained abnormal cells with extension beyond the capsule.\n- Level IV: Of 22 lymph nodes examined, 1 contained abnormal cells with extracapsular extension.\n\nNo tumor was found in the remaining lymph nodes from other levels. Specifically:\n\n- Submental lymph node: No abnormality detected.\n- Right Level III: 9 lymph nodes examined, none involved.\n- Left Level III: 15 lymph nodes examined, none involved.\n- Left Level IV: 20 lymph nodes examined, none involved.\n- Left Level V: 4 lymph nodes examined, none involved.\n\nAdditional tissues including salivary gland and thyroid gland showed no remarkable findings. Three teeth were extracted and examined grossly only; one had a silver-colored crown.\n\nMultiple tissue sections were submitted for microscopic evaluation, including mucosal margins, sequential sections through the mass, lymph nodes from various levels, and representative sections of thyroid and salivary gland tissue."} +{"pid": "TCGA-BB-4225", "report": "RG PATH REPORT. COLLECTION DATE/TIME. FINAL DIAGNOSTIC FINDINGS. TISSUE SAMPLE OBTAINED FROM THE RIGHT BASE OF THE TONGUE FOLLOWING EXCISION. HISTOLOGIC EXAMINATION REVEALS A NEOPLASTIC LESION CHARACTERIZED BY MARKED CELLULAR ANAPLASIA AND LACK OF DISTINCT EPITHELIAL DIFFERENTIATION. THE TUMOR MEASURES 3.5 CM IN GREATEST DIMENSION AND DEMONSTRATES DEEP STROMAL INVASION WITH PERINEURAL AND VASCULAR INVOLVEMENT. LYMPH NODE METASTASES WERE IDENTIFIED IN THREE OF FIVE RECOVERED NODES, SHOWING EXTRACAPSULAR EXTENSION. MARGINS ARE POSITIVE AT THE BASE OF THE SPECIMEN. IMMUNOHISTOCHEMICAL STAINING WAS PERFORMED TO FURTHER CHARACTERIZE THE CELLULAR MORPHOLOGY. CLINICAL STAGING SUGGESTS ADVANCED DISEASE WITH REGIONAL SPREAD."} +{"pid": "TCGA-60-2713", "report": "The specimen includes multiple lymph nodes from various levels (4R, 4L, 4, 7, 8, 10, 11, and 12) and a right lower lobe lobectomy. Lymph node specimens ranged in size from 0.3 cm to 2.2 cm and were submitted either fresh for frozen section or in formalin. The lobectomy specimen measured 20 x 12 x 3 cm and weighed 321 grams. A yellow lesion measuring 3.5 x 3.0 x 2.5 cm was identified, located 4.5 cm from the bronchial margin and appearing to approach the visceral pleura, which was granular but intact. The bronchial margin was negative. Histologic evaluation of the lung tissue showed interstitial fibrosis and focal organizing pneumonia. No tumor involvement was identified in any of the lymph nodes examined, including 9 hilar and peribronchial nodes, 6 mediastinal nodes, and 1 contralateral node. The adjacent lung parenchyma showed interstitial fibrosis and organizing pneumonia. Sections of the tumor demonstrated poorly differentiated morphology with focal squamous differentiation. Immunostains were negative for neuroendocrine markers. The histologic grade was high (G3), with no evidence of angiolymphatic invasion or satellite nodules. Based on these findings, the pathologic stage is pT2 N0 Mx."} +{"pid": "TCGA-E8-A414", "report": "The tumor is located on the left side and measures 5 x 3 x 3 cm. It is unifocal and consists of papillae with fine fibrovascular stalks, lined by single to multiple layers of cuboidal epithelial cells. The cells maintain their polarity, with nuclei that are regular in shape and contain finely dispersed chromatin, some with intranuclear grooves. There is invasion of the capsule observed, but no extrathyroidal extension. Lymphocytic and fibrous infiltration is present within the tumor."} +{"pid": "TCGA-DD-AAE8", "report": "The specimen consists of liver tissue and a liver mass obtained via partial hepatectomy. The main liver specimen measures 10.0 x 10.0 x 3.3 cm and weighs 114.0 grams. A second liver fragment measures 6.5 x 6.0 x 1.8 cm and weighs 38.0 grams. A well-defined mass measuring 1.8 x 1.8 x 2.5 cm is present. The cut surface of the mass is yellowish tan, granular, and lacks necrosis. Gross examination reveals an expanding nodular growth pattern. The resection margin is not involved macroscopically, with a safety margin of 1.8 cm. No satellite nodules are identified, and the surrounding liver parenchyma shows cirrhotic changes.\n\nMicroscopic evaluation demonstrates moderately differentiated malignant cells arranged in a trabecular pattern. Nuclear grade shows the worst differentiation as grade III and the major differentiation as grade II. There is no evidence of fatty change, fibrous capsule formation, or septum formation within the lesion. Surgical resection margin invasion, serosal invasion, portal vein invasion, and microvessel invasion are all absent. Information regarding intrahepatic metastasis and multicentric occurrence is not available.\n\nSections from representative blocks including tumor blocks (TB, T1-3), normal liver parenchyma (NB, L, A1-2), resection margin (RM), gallbladder (GB), and additional gastrointestinal specimens were examined. One unrelated finding includes a tubular adenoma with low-grade dysplasia in the ascending colon and a moderately differentiated adenocarcinoma arising in a tubulovillous adenoma in the rectum. The gallbladder shows features of chronic cholecystitis."} +{"pid": "TCGA-97-7547", "report": "The surgical specimen consists of a right upper lobe lobectomy and multiple lymph node stations (4, 7, 9, 10, and 11). The main lesion is located in the right upper lobe and measures 4.5 cm in greatest dimension. Microscopically, the lesion shows a well to moderately differentiated pattern with acinar, papillary, and bronchioloalveolar features. The tumor is located 1 cm from the bronchial margin, which is free of involvement. The visceral pleura is focally involved. No evidence of large or small vessel invasion is identified. The remainder of the lung tissue appears unremarkable, with the exception of findings consistent with obstructive bronchitis.\n\nLymph nodes from stations 4, 7, 9, 10, and 11 are submitted for evaluation. All lymph nodes examined are negative for malignant cells. The primary lesion is classified as pT2 based on size and pleural involvement. No nodal metastases are identified. The surgical specimen was fully evaluated with all margins and lymph nodes submitted for histologic analysis."} +{"pid": "TCGA-F7-A620", "report": "A fragment of tongue tissue measuring up to 7 x 4.5 cm in size contains a gray-pink lesion with an ulcer-like appearance, measuring up to 4.5 cm in diameter and 0.8 cm in thickness. The lesion is primarily located near the base of the tongue. Microscopic examination reveals well-differentiated keratinizing cells with features of ulceration. A total of twelve lymph nodes were examined: four from level I showed reactive follicular hyperplasia and sinus histiocytosis; four from level II showed reactive follicular hyperplasia and lipomatosis; and four from level III were evaluated, one of which contained metastatic involvement. Vascular invasion was not identified. Surgical margins are uninvolved. No treatment effect was observed."} +{"pid": "TCGA-FZ-5920", "report": "The surgical specimen consists of a pylorus-sparing pancreaticoduodenectomy with partial pancreatectomy. The tumor is located in the pancreatic head and measures 3.5 cm in greatest dimension, with an additional dimension of 2.6 cm. Other resected tissues include the gallbladder.\n\nMicroscopic examination reveals a moderately to poorly differentiated adenocarcinoma of ductal origin. Histologic grade is G2. The tumor invades peripancreatic soft tissue and extends to the vascular groove and retroperitoneal margins. The common bile duct, pancreatic parenchymal, proximal duodenal/gastric, and distal duodenal margins are free of tumor involvement.\n\nAngiolymphatic and perineural invasion are present. Of nine lymph nodes examined, three contain malignant cells. No distant metastases are identified (pMX). The pathologic stage is pT3, N1b.\n\nAdditional findings include pancreatic intraepithelial neoplasia III, chronic pancreatitis, and acute and chronic cholecystitis without evidence of stones. The small bowel resection specimen shows no significant abnormalities or tumor involvement."} +{"pid": "TCGA-IB-7893", "report": "The distal pancreas specimen measures 12.0 x 4.5 x 3.0 cm. A firm, yellow-white, predominantly solid mass is identified within the body of the pancreas, measuring 7.0 x 2.3 x 2.0 cm. The mass is largely confined to the pancreatic parenchyma and extends close to the radial margin, with a distance of 0.2 cm from this margin. The proximal resection margin is marked by suture and the tumor is 2.0 cm from this margin. The tumor has relatively well-defined borders and contains small cystic areas at its periphery. The distal end of the pancreas contains a small nodule measuring 0.7 cm in diameter. The pancreatic duct adjacent to the tumor appears dilated and is present at the resection margin.\n\nHistologically, sections show invasive high-grade epithelial neoplasm with poor differentiation. Tumor cells are present at the radial margin and exhibit perineural invasion. The proximal and distal resection margins are free of tumor involvement. A total of eight peripancreatic lymph nodes are negative for metastasis. High-grade intraepithelial neoplasia is noted in the surrounding pancreatic tissue.\n\nThe gallbladder specimen measures 10.5 x 2.3 x 2.0 cm. Its wall is thin, measuring less than 0.1 cm in thickness, and the lumen contains multiple yellow-green stones and dark green mucinous material. No malignant cells are identified in the submitted sections."} +{"pid": "TCGA-EB-A44N", "report": "The specimen consists of skin tissue from the extremity, submitted as an excision. The lesion measures 1.7 x 1.6 x 0.5 cm and is ulcerated. Histologic evaluation reveals a nodular growth pattern with lymphocytic infiltration. The depth of invasion is 5 mm, corresponding to Level III by Clark. No satellite nodules are identified. Lymph node status, lymphatic or venous invasion, margin involvement, and response to neo-adjuvant therapy could not be determined based on the provided information."} +{"pid": "TCGA-L9-A444", "report": "The specimen consisted of a right upper lobe resection measuring 16.5 x 8.5 x 4.0 cm. A single tumor mass was identified in the central region adjacent to hilar structures, measuring 1.5 x 1.5 x 1.0 cm. The mass was well-circumscribed, located 2.0 cm from the bronchial margin, and did not involve the pleura. A smaller adjacent nodule up to 0.5 cm was also noted. The tumor demonstrated a focal area with mucin-filled bronchioles. Histologically, the lesion showed moderately differentiated features with no evidence of visceral pleural invasion or lymphovascular invasion. Margins including bronchial and vascular were free of involvement.\n\nLymph nodes were evaluated at multiple levels (level 7, level 4, R4, and level 10). All lymph nodes examined were reactive without evidence of metastatic involvement. A total of six lymph nodes were assessed. No tumor involvement was identified in any of the lymph nodes.\n\nThe tumor was unifocal and confined to the lung parenchyma without extension into adjacent structures. No treatment effect was observed. Pathologic staging indicated no regional lymph node involvement."} +{"pid": "TCGA-E7-A8O8", "report": "The specimen involved bladder tissue and measured 3.5 x 2.5 x 1 cm. It presented as a mass with irregular margins, a soft consistency, and a gray surface. Microscopically, the lesion showed increased cellularity forming papillary and trabecular patterns. The cells exhibited moderate eosinophilic or clear cytoplasm, enlarged nuclei with variation in size and shape, irregular nuclear membranes, prominent nucleoli, and abnormal chromatin distribution. Mitotic figures were identified. The lesion extended into the muscularis propria. Surgical margins were uninvolved. No evidence of preoperative treatment was observed. Lymph node status, lymphatic, and venous invasion could not be determined from the available information."} +{"pid": "TCGA-A2-A1FZ", "report": "The surgical specimen from the right breast consists of a simple mastectomy specimen measuring 28 x 27 x 5.7 cm. A separate skin ellipse measuring 25.5 x 16.3 cm is present, with focal blue dye noted in the central portion near the upper outer quadrant relative to the nipple. A suture marks the 12 o\u2019clock position. Within the container is a V-shaped portion of skin with underlying fatty tissue measuring 9.5 x 10 x 1.6 cm. The superficial aspect is marked with blue ink and the deep aspect with black ink. Sectioning reveals bland yellow fatty tissue with fine fibrous bands and a stellate pink-gray fibrous lesion located in the 9 o\u2019clock area, measuring 2.2 x 1.7 x 3.0 cm from medial to lateral. This lesion is centrally located within the breast, approximately 2 cm from the deep margin and 2 cm from the skin, and is greater than 3 cm from all other margins. Sections through the lesion and surrounding areas were submitted for analysis.\n\nA separately submitted portion of tissue was found to be grossly unremarkable, with a representative section at the point of the V submitted as labeled.\n\nThree sentinel lymph node specimens were received from the right axilla. Specimen #1 measured 3 x 1.8 x 1.2 cm and contained a 1.5 cm centrally fat-replaced lymph node that appeared grossly unremarkable. Specimen #2 measured 3.7 x 2 x 1.3 cm and revealed a fat-replaced lymph node without notable abnormalities. Specimen #3 was an ovoid tissue fragment measuring 3 x 1.7 x 0.5 cm, also showing fat-replaced nodal tissue.\n\nHistologic examination of the breast tissue identified poorly differentiated infiltrating ductal carcinoma with nuclear grade II/III and a moderate mitotic index. The lesion measured 22 mm in maximum microscopic dimension. Possible lymphatic space invasion was observed, although this may represent retraction artifact. All surgical margins were free of abnormal cells by distances of at least 20 mm.\n\nExamination of the sentinel lymph nodes revealed no evidence of metastatic disease. Immunohistochemical staining with cytokeratin was negative across all lymph node specimens."} +{"pid": "TCGA-CV-7432", "report": "A fragment of adipose tissue measuring 5.0 x 2.0 x 1.0 cm contains sixteen lymph nodes ranging in size from 0.2 to 1.8 cm. These lymph nodes are serially dissected from superior to inferior and submitted in cassettes A1-A12, with A1-A9 and A12 containing one lymph node each, A10 containing three small lymph nodes, and A11 containing three small lymph nodes. No tumor is identified in these lymph nodes.\n\nA strip of nerve tissue measuring 3.0 x 0.3 x 0.3 cm has a hemostat at the proximal margin. The distal margin is inked black and taken for frozen section in longitudinal orientation. The proximal margin is inked red. No tumor is present in this peripheral nerve specimen.\n\nAn irregular strip of tongue tissue measuring 5.0 x 1.5 x 1.0 cm has a hemostat at the anterior margin. The new surgical margin was previously inked by the surgeon (anterior-red, posterior-yellow, deep-black). Frozen sections were taken en face from anterior to posterior margins (cassettes C1-C4), with additional random mucosal sections (C5-C6). No tumor is found.\n\nA strip of red-tan mucosa measuring 4.0 x 1.0 x 1.0 cm has a hemostat at the anterior margin (inked red), with posterior-yellow and deep-black markings. Frozen sections taken en face from anterior to posterior margins (cassettes D1-D3) show no tumor.\n\nA strip of red-tan mucosa measuring 2.5 x 0.5 x 0.5 cm has a hemostat at the anterior margin (inked red), with posterior-yellow and deep-black markings. Frozen sections taken en face (cassettes E1-E2) show no tumor.\n\nA composite specimen includes tumor and soft tissue measuring 6.0 x 3.0 x 3.0 cm along with contiguous submandibular triangle tissue (5.0 x 4.0 x 1.0 cm), and a portion of left hemimandible (7.0 x 3.0 x 1.0 cm). The overlying mucosa measures 5.0 x 1.0 cm. A centrally ulcerated tumor measuring 3.0 x 3.0 x 2.5 cm is present on the mucosal surface with pushing borders; however, there is no definite invasion into the submandibular triangle. The tumor appears white-gray with a vaguely lobulated surface. Margins have been previously assessed by frozen section. Five possible lymph nodes ranging from 0.5 to 0.8 cm are dissected. The bone portion is unremarkable grossly and is pending decalcification. Sections of the tumor are submitted in cassettes F1-F4; F5 includes tumor and contiguous salivary gland tissue; F6-F9 include single lymph nodes each; F10 contains one possible lymph node.\n\nDecalcified sections of mandible are examined and do not show tumor involvement. Four submandibular lymph nodes are also negative for metastatic disease. The tonsil demonstrates reactive follicular hyperplasia. No perilymphatic or vascular invasion is observed. A peripheral nerve specimen reveals no evidence of malignancy. Multiple mucosal, muscular, and salivary gland margins are evaluated and found free of tumor."} +{"pid": "TCGA-EW-A1J5", "report": "A total mastectomy specimen from the left breast, including nipple and skin, was submitted for analysis. A single focus of invasive tumor was identified, measuring 4.5 cm by gross examination. Microscopic evaluation of adjacent sections revealed a tumor size of at least 6.1 cm. The invasive component extensively involved the nipple and dermis, with no in situ component identified. No lymphovascular invasion was observed. Margins were uninvolved by invasive carcinoma, with the closest margin measuring at least 0.3 cm from the tumor. Microcalcifications were present in non-neoplastic breast tissue. One sentinel lymph node was examined and found to be negative for metastatic disease. Histologic grade was Nottingham grade 2. Estrogen and progesterone receptor studies showed immunoreactive tumor cells (1%), and HER2 staining was negative.\n\nA separate total mastectomy specimen from the right breast, also including nipple and skin, demonstrated multiple foci of invasive tumor. The largest focus measured 1.1 cm, with two additional foci each measuring 0.4 cm. Ductal carcinoma in situ (DCIS) was present in 10 out of 17 blocks, exhibiting high nuclear grade, solid and cribriform patterns, central comedo necrosis, and calcifications. DCIS was located more than 1.0 cm from the nearest margin. The invasive component was moderately differentiated (Nottingham grade 2) and did not involve the nipple epidermis or dermis. No lymphovascular invasion was noted. All margins were free of both invasive carcinoma and DCIS. Four sentinel lymph nodes were examined, and none contained macrometastases, micrometastases, or isolated tumor cells. Histologic type was invasive ductal carcinoma, with a Nottingham histologic score of 6 (grade 2). ER, PR, and HER2 statuses were pending.\n\nAncillary studies on both specimens included keratin staining, which was negative in all evaluated lymph nodes. Immunohistochemical analysis of the right breast tumor showed positivity for ER and HER2 (3+), and negativity for PR. No presurgical therapy had been administered. Distant metastasis could not be assessed. All specimens were evaluated using standard histologic techniques, including hematoxylin and eosin staining and immunohistochemistry where appropriate."} +{"pid": "TCGA-XU-A92X", "report": "The resected specimen includes a thymic mass with attached visceral pleura, measuring 12.8 cm in greatest dimension. The tumor is located in the anterior mediastinum and measures 7.0 cm x 6.0 cm x 2.8 cm. It is well delineated with a lobulated appearance and pale fibrous septa separating lobules. The cut surface is tan and somewhat friable with focal microcystic changes. The uninvolved portions of the thymus show no remarkable abnormalities.\n\nMicroscopically, the lesion is circumscribed and predominantly encapsulated. Focally, there is lack of encapsulation with extension through the capsule, most evident in the subpleural region. The cellular composition includes a mixed population of small lymphocytes and larger epithelial-like cells with open chromatin and prominent nucleoli. Focal microcystic degeneration is present. Immunohistochemical staining demonstrates diffuse positivity for CK5/6 in the larger cells and CD1a positivity in the majority of lymphocytes.\n\nAll painted resection margins are free of tumor involvement. The closest distance from tumor to margin is 0.1 cm at the anterior thymus margin. No invasion of the pulmonary parenchyma, pleura, or vascular structures is identified. There is no evidence of distant metastasis or lymph node involvement. Lymph nodes were not identified in the specimen. Representative sections of the tumor and surrounding tissue have been sampled and archived for further study."} +{"pid": "TCGA-P5-A72X", "report": "The clinical evaluation indicated a lesion in the brain. Gross examination revealed dense-elastic tissue of grayish-brown appearance, with areas showing variation in color including sparse gray and white matter, originating from the left temporal lobe. Microscopic analysis demonstrated neoplastic cells consistent with a high-grade glial neoplasm. Tumor grading was III according to standard classification criteria."} +{"pid": "TCGA-A8-A09D", "report": "The specimen shows a poorly differentiated invasive lesion measuring 2.2 cm in greatest dimension. The tumor exhibits focal intraductal components. Histologic grade is III. Lymph node involvement is present with microscopic metastasis in one to three axillary lymph nodes (N1a). Vascular invasion is identified. Estrogen and progesterone receptor statuses were previously assessed (see reference E. no. xxxx)."} +{"pid": "TCGA-44-A47B", "report": "The surgical specimen consists of a right upper lobe lobectomy weighing 182 grams, measuring 16 x 9.8 x 3.5 cm. The bronchial stump is 1 cm long and 1.4 x 0.7 cm in cross-section. Several staple lines are present along the medial aspect. An area of pleural retraction is noted, with a palpable underlying mass. Upon sectioning, a well-defined mass measuring 3.3 x 3 x 2.5 cm is identified beneath the retracted pleura. The mass has a rubbery, tan-white consistency and extends peripherally within the lung tissue but does not appear to involve the pleural surface. No other focal lesions are observed in the remainder of the lung, which appears spongy and tan-red. A few soft gray-black hilar lymph nodes are present, with the largest measuring up to 1 cm.\n\nHistologically, the mass is composed primarily of moderately differentiated cells. There may be a minor component of another cell type, though it constitutes a small portion of the lesion. The tumor measures 3.3 cm at its greatest dimension and does not show clear evidence of pleural invasion, as confirmed by elastic stain analysis on one block. Resection margins, including both bronchial and vascular, are free of involvement. Lymphatic invasion is noted focally, while definitive vascular invasion is not identified.\n\nLymph nodes from multiple levels (hilar, level 11, 4R, 8, 7, and 2R) were also evaluated. All are negative for involvement. The hilar lymph nodes associated with the main specimen and those submitted separately show no evidence of spread. Inflammatory changes are observed within the lesion. Tissue samples were collected for further study as requested."} +{"pid": "TCGA-FD-A5BZ", "report": "The patient is a female who underwent radical cystectomy with ileal conduit for a previously diagnosed condition. Specimens were received from five labeled containers.\n\nContainer A contained left pelvic lymph nodes. Upon dissection, fourteen lymph nodes were identified and examined microscopically; all were negative for malignant involvement.\n\nContainer B contained right pelvic lymph nodes. Fifteen lymph nodes were identified and examined; all were also negative for tumor involvement.\n\nContainer C included the bladder specimen. Gross examination revealed an ulcerated lesion on the anterior wall measuring 3.2 x 1.8 cm, along with a transmural defect at the trigone level measuring 2.5 x 1.3 cm. Serial sectioning demonstrated tumor invasion to a depth of 1.0 cm, extending to within 0.3 cm of the inked margin. Microscopic evaluation revealed invasive high-grade urothelial carcinoma with focal squamous differentiation. One lymph node associated with the bladder showed microscopic evidence of similar involvement. No tumor was identified at the ureteral or distal urethral margins.\n\nContainer D included the uterus, bilateral fallopian tubes, and ovaries. The endometrium appeared atrophic. Three leiomyomas were identified in the myometrium, with the largest measuring 1.0 cm in diameter. Both ovaries were atrophic and showed no remarkable findings upon histologic review. The fallopian tubes were unremarkable.\n\nContainer E contained the right distal ureter tip. Histologic examination revealed no evidence of tumor involvement.\n\nLymph node assessment across all specimens yielded a total of one involved lymph node out of thirty examined. Pathologic staging parameters indicated extravesical soft tissue invasion with multifocal tumor distribution. The largest tumor measured 3.2 x 1.8 cm and was located on the anterior bladder wall. Ureteral and distal urethral margins were free of tumor.\n\nA total of 30 lymph nodes were evaluated (14 from the left pelvis and 15 from the right pelvis, with one showing microscopic involvement). The final pathologic stage was determined as pT3a, N1, MX. Interpretation was performed by the attending pathologist and reviewed with a resident or fellow."} +{"pid": "TCGA-UT-A97Y", "report": "A-UT-A97Y-01A-PR. Copy Sent to. CLINICAL INFORMATION. MACROSCOPIC DESCRIPTION. then file this document. Labelled \"Right parietal pleura\". Specimen consists of multiple pieces of cream to grey and haemorrhagic fibrous and membranous tissue, ranging in size from 13x7x6mm up to 30x18x8mm. MICROSCOPIC DESCRIPTION. The specimen includes portions of pleura demonstrating abundant surface fibrinous exudate transitioning into a fibrotic zone containing a malignant infiltrate. Malignant cells are arranged in poorly cohesive clusters, cords, and as single cells within a fibrotic background. These cells exhibit enlarged nuclei with focally prominent nucleoli and variable amounts of eosinophilic to slightly vacuolated cytoplasm. Psammoma bodies are present in association with the infiltrate. PAS diastase stain was performed. Immunohistochemical analysis shows strong positivity for CK7, weak positivity for CK20, positivity for 34Beta12, strong positivity for calretinin, and weak positivity for CA125. TTF-1 staining is negative. CONCLUSION. RIGHT PARIETAL PLEURAL BIOPSY."} +{"pid": "TCGA-AG-3999", "report": "The resected colon specimen includes the rectosigmoid region. The tumor involves the perimuscular fatty tissue with evidence of vascular and lymphatic invasion. The tumor is moderately differentiated and presents with ulceration. Lymph node examination reveals metastatic involvement in 20 out of 32 nodes assessed. All surgical margins, including oral, aboral, and perirectal, are free of tumor. The lesion demonstrates extensive local spread without residual disease at the resection margins."} +{"pid": "TCGA-EM-A3O6", "report": "The specimen consists of a right hemithyroidectomy measuring 4.2 cm in greatest dimension, with an isthmus measuring 1.0 cm. The total specimen weight is 11.3 g. A single dominant nodule measuring 4.0 cm is identified within the right lobe. The nodule has additional dimensions of 2.4 cm and 1.2 cm and is well-defined within the thyroid tissue. Margins are uninvolved. The lesion demonstrates follicular architecture along with classical cytomorphologic features and oncocytic differentiation. Immunohistochemical staining shows diffuse weak positivity for CK19, while HBME-1 and Galectin-3 are negative. Histologic evaluation reveals no capsular invasion, lymphovascular invasion, perineural invasion, or extrathyroidal extension. No parathyroid tissue or lymph nodes were identified. Based on AJCC/UICC TNM staging criteria (7th edition), the primary tumor is classified as pT2, indicating a tumor greater than 2 cm but not more than 4 cm confined to the thyroid. No lymph nodes were examined, and therefore regional nodal staging could not be determined. Additional findings include normal-appearing parathyroid glands."} +{"pid": "TCGA-97-7546", "report": "The surgical specimens include a wedge resection and lobectomy of the left upper lobe, along with multiple lymph node biopsies from various levels. The wedge resection measured 11 x 7.5 x 3 cm and contained two distinct nodules. The first nodule was 1.4 cm in greatest dimension, tan-white, firm, and located 1.3 cm from the surgical margin. The second nodule measured 2.0 x 1.0 cm, also tan-white and firm, located 1.5 cm from the margin. Both were within the pulmonary parenchyma and did not involve the pleura or surgical margins. The lobectomy specimen showed no masses and had unremarkable lung tissue with patchy congestion.\n\nHistologically, both nodules showed a mixed pattern of adenocarcinoma with bronchioalveolar features. The cells were moderately differentiated, and no angiolymphatic invasion was identified. Immunohistochemical staining demonstrated positivity for cytokeratin-7 and TTF-1, while being negative for CK-20 and CDX-2. Margins of resection were free of invasive carcinoma.\n\nAtypical alveolar hyperplasia was present in both the wedge and lobectomy specimens. Emphysematous changes were also noted in the lung tissue. A total of 12 lymph nodes were examined from levels 5, 7, 9, and 13, all of which were anthracotic and showed no evidence of malignancy. This included four hilar lymph nodes from the lobectomy specimen, all negative for tumor involvement.\n\nMicroscopic evaluation confirmed the absence of regional lymph node metastasis. No venous or lymphatic vessel invasion was observed. The case was reviewed intradepartmentally and found to be consistent with the findings described."} +{"pid": "TCGA-IG-A8O2", "report": "The specimen consists of abdominal esophagus tissue. A tumor is present near the Z-line, measuring 3.5 x 3 x 3 cm. It is ulcerated and invasive, with a soft consistency and white-gray surface. Microscopically, the mucosa is ulcerated and infiltrated by tumor cells arranged in groups, sheets, or trabecular patterns. The malignant cells exhibit moderate to light eosinophilic, keratinized cytoplasm. Nuclear features include enlargement, variation in size and shape, coarse chromatin, and prominent nucleoli. Mitotic figures are observed. The tumor extends into surrounding fat tissue and is associated with a fibrous stroma and lymphocytic infiltration. The tumor invades to the level of the adventitia. Six out of twenty regional lymph nodes show evidence of metastatic involvement. Surgical margins are free of tumor. There is no evidence of prior neoadjuvant treatment."} +{"pid": "TCGA-G9-A9S7", "report": "The prostate specimen measured 5.4 cm in width, 3.8 cm in depth, and 3.4 cm in length, with a post-resection weight of 42 g. The gland showed involvement of approximately 15% of the tissue examined. Microscopic evaluation revealed multifocal extension beyond the prostatic capsule, identified at the right posterior and anterior regions as well as the left apex. The seminal vesicles were not involved. Surgical margins were free of abnormal cells. High-grade prostatic intraepithelial neoplasia was noted, along with perineural invasion. No vascular or lymphatic invasion was identified. Examination of the right and left pelvic lymph nodes (6 and 2 nodes respectively) showed no evidence of malignant cells. Pathological staging was determined as pT3a, pN0, cMx. The gross description of the prostate showed a nodular tan parenchyma with an intact capsule. Tissue sections from multiple regions of the gland were submitted for analysis, including apical, anterior, posterior, and lateral areas, as well as the seminal vesicles and vas deferens. Benign prostatic hyperplasia was also present."} +{"pid": "TCGA-EJ-7317", "report": "The specimen consisted of a prostate weighing 73 grams, along with bilateral seminal vesicles, submitted for examination following radical prostatectomy. Lymph node dissections were performed on both the right and left pelvic regions, each yielding twenty lymph nodes. All lymph nodes examined showed no evidence of abnormal cellular proliferation.\n\nMicroscopic evaluation of the prostate identified a multifocal lesion involving both the right and left lobes. The largest nodule measured 1.3 cm in greatest dimension within one histologic section and accounted for approximately 15% of the total prostate volume. The lesion was entirely confined within the prostatic capsule without extension beyond it. No involvement of the seminal vesicles was observed.\n\nAll surgical margins were free of atypical cells. Perineural invasion was present; however, there was no evidence of angiolymphatic invasion. High-grade prostatic intraepithelial neoplasia was noted and was multifocal in distribution.\n\nBackground tissue showed changes consistent with nodular hyperplasia and chronic inflammation. The tumor demonstrated a Gleason pattern composed of primary grade 3 and secondary grade 4, totaling a Gleason score of 7, with 45% of the tumor classified as Gleason grade 4 or 5. The pathologic staging assigned was pT2c, with no regional lymph node metastasis identified (pN0). A total of forty lymph nodes were evaluated, none of which contained malignant cells."} +{"pid": "TCGA-2G-AAF4", "report": "The specimen from the right orchidectomy measured 6 cm in greatest dimension. Microscopic examination showed a neoplastic lesion composed of uniform cells with clear cytoplasm and well-defined cell borders. The tumor was limited to the testis on available sections. Vascular invasion was identified, and there was evidence of involvement of the rete testis. No other tissue structures were involved. The case was reviewed by the pathologist on the date of the procedure."} +{"pid": "TCGA-RY-A83X", "report": "The patient is a female of unspecified age who underwent resection of a non-enhancing mass located in the right frontal lobe, specifically within the middle frontal gyrus. Imaging had previously identified the lesion as measuring 4.9 x 3.7 x 2.4 cm, with features suggestive of a primary glial neoplasm.\n\nThree specimens were received for analysis. Part A consisted of a single unoriented, irregular tissue fragment measuring 1.1 x 0.5 x 0.2 cm. A touch preparation was made for intraoperative consultation, and a representative section was frozen for diagnosis. The remaining tissue was submitted for further analysis. Part B included two soft tissue fragments totaling 1.3 x 0.5 x 0.3 cm in aggregate, submitted intact. Part C, labeled as CUSA contents, contained multiple soft, pink-white tissue fragments measuring up to 8 x 3 x 1 cm in aggregate; representative sections were submitted for evaluation.\n\nMicroscopic examination revealed uniform cellular morphology. Mitotic activity was present at a rate of up to 2 mitoses per 10 high-power fields. Immunohistochemical staining on block A2 demonstrated positivity for IDH-1 with cytoplasmic staining pattern. MIB-1 immunostain showed a labeling index of approximately 3\u20134%. Fluorescence in situ hybridization analysis for 1p19q deletion was initiated on block B1 and results were to be reported separately.\n\nThe attending pathologist reviewed all slides and documentation, confirming the findings after evaluating resident contributions and making necessary revisions. No specific diagnosis was stated in this summary, as per instruction."} +{"pid": "TCGA-66-2794", "report": "The left lung specimen measures 16 x 11 cm and up to 27 cm in height. The main bronchus is largely skeletonized, with a resection plane located 3.5 cm proximal to the bifurcation of the upper lobe bronchus. A central lesion is present in the upper lobe, with a maximum size of 4.8 cm. The tumor has a pale brown whitish appearance with patchy gray-black pigmentation and a relatively well-defined border. It involves the upper lobe bronchus and extends into the main bronchus wall, reaching up to 0.3 cm proximal to the upper lobe bronchus bifurcation. The tumor also extends to within 20 micrometers of the hilar resection surface and is in close proximity to a suspected pericardial sac margin. The mucosa of the affected bronchial sections appears roughened and cracked.\n\nA 1.8 cm grayish-black lymph node is found near the bronchus resection plane. In the apicolateral region of S1, there is a 1 cm area of pleural adhesion. The upper lobe and intermediate bronchus ostium are narrowed by the tumor. Several small blackish lymph nodes up to 1 cm are noted in proximity. A 0.4 cm flat blackish nodule is observed in the subpleural lateral region of S5. Peripheral bronchi in segments 4 and 5 of the upper lobe are dilated and filled with thick mucus. There is slight localized rarefaction of the apical parenchyma in S1, while the rest of the lung tissue appears unremarkable.\n\nLymph node stations examined include: hilar (station 10) left and right, pulmonary ligament (station 9), paraesophageal (station 8), paraaortic (station 6), subaortic (aortopulmonary window, station 5), low paratracheal (station 4), and prevascular/retrotracheal (station 3). Involved nodes range from 0.3 to 2.5 cm in size, with the largest showing partial replacement by abnormal tissue. Most lymph nodes show reactive changes and anthracotic pigment deposition.\n\nHistological evaluation of the resected margins, including bronchial and vascular resection planes, visceral pleura, and a co-resected pericardial sac segment, reveals no residual tumor involvement. No asbestos bodies were identified in the examined sections. The tumor is associated with peripheral bronchiectasis, primarily in the lingula, and focal signs of airway retention in S5. Moderate pulmonary emphysema is evident in the subpleural region and mantle zone of S1. A pleural adhesion zone is present at the apex of the upper lobe.\n\nThe tumor extends into the distal main bronchus and adjacent fatty tissue near the upper lobe bronchus bifurcation, contributing to advanced local staging. Lymph node metastases are confirmed in peribronchial and hilar regions. Additional investigations, particularly for dust analysis, are recommended to further assess occupational or environmental exposure."} +{"pid": "TCGA-AF-3400", "report": "The specimen includes two parts. Part A is a biopsy of a peritoneal implant, consisting of yellow adipose tissue measuring 1 x 1 x 0.3 cm with palpable nodularity; the largest nodule measures 0.3 cm in diameter. A portion was used for intraoperative evaluation and showed no evidence of malignancy.\n\nPart B is a segment of rectosigmoid colon measuring 23 cm in length and 2.7 cm in diameter, with attached pericolonic fat measuring 13 x 20 x approximately 4 cm. A fungating tan mass within the lumen measures 3.7 x 4.2 x 2.5 cm and is located 3 cm from the nearest resection margin. Two small mucosal polyps are identified near the tumor: one is 0.4 cm in diameter at 1 cm from the margin, and another sessile polyp of similar size at 0.5 cm from the margin. Additional small polyps ranging from 0.2 to 0.3 cm are present between the tumor and the far margin.\n\nHistologic examination reveals a moderately differentiated tumor composed partially of mucinous elements with some signet ring features. The tumor extends through the muscularis propria into adjacent soft tissue. All resection margins are free of tumor involvement. No vascular invasion is observed. Mild chronic inflammation is noted at the tumor interface. Evaluation of 32 regional lymph nodes shows no involvement by tumor. There is no evidence of non-lymph node metastasis in the pericolonic region. Immunohistochemical staining does not show specific markers associated with epithelial differentiation. One lymph node contains a necrotizing granuloma; special stains for infectious agents are negative. All polyps examined are consistent with hyperplastic morphology. Tumor staging is classified as pT3 pN0. Microsatellite instability testing indicates a low probability of instability (3%)."} +{"pid": "TCGA-DD-AACB", "report": "The liver specimen measured 16.0 x 13.0 x 6.0 cm and weighed 678.0 grams. The gallbladder measured 9.5 cm in length, 4.2 cm in diameter, with a wall thickness of 0.2 cm. A single tumor was identified in the right lobe of the liver, measuring 4.4 x 4.0 x 3.8 cm. The tumor exhibited an expanding nodular growth pattern with 10% necrosis and no satellite nodules. Hemorrhage or peliosis was not observed. There was no invasion of the portal vein, bile ducts, hepatic veins, or hepatic artery. Microvessel invasion was present. The surgical resection margin showed no tumor involvement with a clearance margin of 0.5 cm. The tumor was encapsulated with a complete fibrous capsule and no capsular infiltration. Septum formation was noted. Histologically, the lesion demonstrated trabecular architecture with hepatic-type cells and no fatty changes. The differentiation grade was moderately malignant. Non-tumorous liver tissue showed chronic hepatitis associated with hepatitis B virus, with minimal lobular activity and mild portoperiportal inflammation. Fibrosis was consistent with cirrhosis, specifically macronodular type. There was no evidence of dysplastic nodules, ductal epithelial dysplasia, or other liver disease. Special stains including Trichrome were positive. Additional findings included degenerative arthritis of the knee joint, a hyperplastic polyp in the gastric antrum, and chronic cholecystitis of the gallbladder. Immunohistochemical studies were recommended for further characterization."} +{"pid": "TCGA-DQ-5624", "report": "The specimen consisted of multiple biopsies and resected tissues from the oral cavity, tongue, floor of mouth, and associated lymph node regions. Gross examination revealed various tissue types including mucosa, muscle, fat, and lymph nodes. Several specimens measured less than 0.5 cm in size and were described as red, white, or yellow-tan bits of tissue. Larger specimens included a 2.5 x 1.2 x 0.8 cm segment of tan soft tissue, a 1.2 x 1.2 x 1.0 cm yellow soft tissue sample with central pallor, and a 7.2 x 4.8 x 3.4 cm right lateral tongue specimen with attached floor of mouth mucosa.\n\nHistologic evaluation demonstrated benign tissue in most margins, including surgical margins of the tongue and floor of mouth. A small ulcerative lesion was noted in the right lateral floor of mouth extending into the tongue measuring 1.5 cm in diameter with a depth of invasion of 1.3 cm. The tumor exhibited moderately differentiated features with an infiltrative growth pattern and perineural invasion was identified. No vascular, bone, or cartilage invasion was observed. Mild lymphocytic infiltration was present at the tumor interface.\n\nLymph node dissection specimens showed involvement in one lymph node at level I of the neck with extracapsular extension. Other lymph nodes sampled from levels II, III, and IV were negative for malignancy. Additional findings included mild to moderate squamous dysplasia in the glossotonsillar sulcus and benign salivary gland tissue with focal mucoepidermoid features in certain biopsies. Multiple benign lymph nodes and adipose tissue without evidence of tumor involvement were also reported throughout the specimen list."} +{"pid": "TCGA-ZJ-A8QO", "report": "Pathology Department. Specimen #: Dr: Date Obtained: Date Received: Date Printed: CLINICAL HISTORY: CLINICAL HISTORY NOT SUBMITTED. SPECIMEN/PROCEDURE: 1. CERVIX - CERVIX BIOPSY. IMPRESSION: CERVICAL BIOPSY: Atypical cellular proliferation with features suggestive of a malignant process, exhibiting sheets and nests of cells with nuclear atypia, increased nuclear-to-cytoplasmic ratio, and focal infiltration into the underlying connective tissue. The morphologic characteristics are consistent with a high-grade neoplastic lesion. Entered: GROSS DESCRIPTION: This case is part of the study. Received in formalin, labeled with the patient's name, are five irregular portions of pink-tan to red-tan glistening and friable tissue, ranging from 0.4 x 0.4 x 0.2 cm to 0.7 x 0.5 x 0.2 cm. The largest portion of tissue is bisected. The specimen is entirely submitted in one cassette. Entered: CPT Codes: CERVICAL BIOPSY 1)/88305. ICD9 Codes: 180.9. P."} +{"pid": "TCGA-08-0344", "report": "The final pathologic evaluation is based on specimens obtained from a left frontal craniotomy for tumor removal. Two tissue submissions were received. The first portion, labeled as a left frontal tumor biopsy, consisted of a soft, white-pink-red fragment measuring 1.2 x 1.0 x 0.6 cm. Half of this specimen was used for intraoperative frozen section analysis, which showed features consistent with high-grade neoplastic tissue including areas of necrosis. The remaining portion of this specimen was submitted in entirety for further evaluation. The second submission consisted of multiple fragments of tan and red-brown friable tissue, with measurements of 2.0 x 1.4 x 0.4 cm and 2.5 x 3.0 x 1.0 cm respectively; representative sections were processed for histologic examination.\n\nMicroscopic evaluation revealed marked nuclear and cytoplasmic pleomorphism, frequent mitotic figures, endothelial proliferation, and areas of necrosis. Local meningeal infiltration was also noted. Immunohistochemical staining with GFAP was performed to support the morphologic findings. All relevant tissues were submitted for analysis, and the diagnosis was confirmed following comprehensive review by the attending pathologist."} +{"pid": "TCGA-D5-5540", "report": "The histopathological examination was conducted on a resected segment of the large intestine, along with associated periintestinal tissue measuring 15 x 12 x 4 cm, a 12 cm segment of the small intestine, and a 3 cm appendix. A lesion measuring 3.3 x 2.7 x 0.8 cm was identified in the mucosa, circumferentially involving approximately 50% of the intestinal wall. The lesion was located 12 cm from the proximal resection margin and 7 cm from the distal margin.\n\nMicroscopic evaluation revealed a moderately differentiated tubular-type growth pattern. Invasion of the pericolonic fat was observed. Resection margins were clear of neoplastic involvement. Reactive lymph node changes were noted in the regional lymph nodes. No definitive metastatic involvement was identified in the lymph nodes examined. The tumor extended into the muscularis propria and subserosal tissue but did not reach the serosal surface. Staging parameters indicated involvement of the intestinal wall without lymph node or distant spread."} +{"pid": "TCGA-ZF-A9RF", "report": "The specimen consists of 8g of firm tissue chippings. Microscopic examination reveals a poorly differentiated lesion with large foci of necrosis and a predominantly solid growth pattern. The muscularis propria is present and shows evidence of stromal invasion, extending into this layer. No vascular channel invasion is identified. The background urothelium is flat and lacks dysplastic changes. Cellular features are consistent with a high-grade morphology. Staging indicates involvement of the muscularis propria (pT2)."} +{"pid": "TCGA-UY-A9PH", "report": "A male patient underwent cystoprostatectomy and lymph node dissection. Examination of the urinary bladder revealed a well-circumscribed, firm tan nodule measuring 1.6 cm in maximum dimension located at the junction of the left inferior bladder and prostate, 1.1 cm from the left anterior resection surface. Histologic evaluation showed this lesion to involve the outer half of the muscularis propria with lymphatic invasion identified. The majority of the bladder epithelium was denuded. Three indurated mucosal areas were noted: one in the right trigone (1.2 x 0.8 cm), one in the posterior wall (0.3 x 0.3 cm), and one in the left lateral wall (1.2 x 0.9 cm). All surgical margins, including urethral, ureteral, and perivesical, were free of involvement by more than 1 cm.\n\nA separate nephrogenic adenoma was identified. There was also granulomatous inflammation of the mucosa consistent with BCG effect. No extension into adjacent organs was observed.\n\nEvaluation of lymph nodes included nine from the right obturator region, three from the right internal iliac, five from the left internal iliac, and three from the left obturator area. All lymph nodes examined (total of 20) were negative for involvement.\n\nThe prostate measured 3.1 cm from apex to base and showed granulomatous inflammation as well as benign prostatic hyperplasia. An irregular yellow-tan area within the left mid gland was confined to the prostate. Seminal vesicles appeared unremarkable.\n\nAll submitted ureteral specimens were negative for any abnormal findings. Multiple tissue fragments from various sites were evaluated microscopically and showed no evidence of malignancy."} +{"pid": "TCGA-S9-A6WE", "report": "Neuropathology. Commentary: This case was initially diagnosed as anaplastic oligodendroglioma. Upon review, histology and morphology are more consistent with a lower-grade lesion. The tissue shows uniform cells with round to oval nuclei and delicate chromatin, set in a fibrillary background. No definitive necrosis or microvascular proliferation is identified. Cellular features and architectural patterns support a less aggressive classification. Staging and clinical correlation suggest a favorable prognosis compared to higher-grade counterparts."} +{"pid": "TCGA-YL-A8HL", "report": "The prostate specimen demonstrates a lesion with acinar growth pattern. The histologic grade is characterized by a GleASON score of 4 + 5, with no tertiary pattern identified. The tumor is located at multiple sites within the gland, including the apex, mid, and base regions, as well as anterior, right, and left posterior areas. There is evidence of non-focal extension beyond the prostatic capsule, particularly in the mid and posterior right region. Involvement of the seminal vesicle is noted on the right side.\n\nSurgical margins are involved by invasive carcinoma, with positive findings at the apex, mid, and base, including bladder neck involvement. The affected margins are multifocal in distribution and involve both anterior and posterior right aspects. The nature of the margin involvement is indeterminate. Perineural invasion is present, and tumor volume accounts for approximately 75% of the prostate.\n\nLymph node assessment reveals two nodes identified on the right pelvic side, none with involvement, and three nodes identified on the left pelvic side, one of which demonstrates metastatic changes. The largest lymph node deposit measures 30 mm. Vascular invasion was not specifically described.\n\nStaging is determined as pT3b and pN1, with pMX for distant metastasis. No prior treatment effect is observed."} +{"pid": "TCGA-86-7711", "report": "Specimen was a lobectomy from the lung. The tumor measured 5 x 5 x 5 cm. Microscopic examination revealed poorly differentiated morphology. No additional tumor nodules were identified. Lymph node assessment showed 3 out of 3 involved with metastatic disease within the intrathoracic region. Other features including tumor extent, lymphatic or venous invasion, margins, neo-adjuvant treatment effect, and additional findings were not specified. No comments were provided regarding laterality or other diagnostic details."} +{"pid": "TCGA-L5-A43H", "report": "A resected specimen from the esophagus was evaluated, measuring 13.8 cm in total length, with 10.4 cm representing esophageal tissue. The proximal and distal margins were stapled, with a small amount of attached perigastric fat. Focal adhesion of the adventitia was noted near the proximal margin, which was inked blue. The proximal esophageal mucosa showed red-tan to brown granular and ulcerated changes extending up to 3.2 cm from the stapled margin. The cut surface in this region was gray-white, firm, and thickened up to 0.6 cm. An ill-defined pattern was observed, extending to within 0.1 cm of the inked adventitia, suggesting possible involvement of the adventitia and adjacent fibromembranous tissue.\n\nThe distal 7.4 cm of the esophageal mucosa and the attached proximal gastric tissue appeared unremarkable. Within the perigastric fat, lymph node candidates up to 1.1 cm in size were identified. A total of 23 lymph nodes were examined, with two showing involvement by malignant cells. Two lymph nodes from station 8 were involved. No distant metastasis was identified.\n\nFrozen section analysis was performed on several margins. The cervical esophageal margin was positive for invasive cells, while other margins, including the deep cervical and aortic wall, were negative. Subsequent permanent sections revealed deeper invasion than initially detected on frozen section, indicating a sampling error.\n\nThe tumor measured 3.2 cm in greatest dimension and extended into the adventitia. The deep adventitial resection margin was involved, while the cervical resection margin was free of involvement. Adjacent lymph nodes showed metastatic involvement in two out of two specimens examined. No preoperative chemotherapy or radiation therapy was administered. The depth of invasion and lymph node status support a staging classification consistent with advanced local disease."} +{"pid": "TCGA-QR-A6H3", "report": "A para-aortic soft tissue mass measuring 6.0 cm was resected from a male patient with a known SDHB mutation. The mass, located anterior to the descending aorta at the level of the right atrium, was submitted for pathological evaluation. Gross examination revealed a well-encapsulated, dome-shaped tan-pink nodule with a homogeneous fleshy pink-tan cut surface. Intraoperative consultation included submission of representative sections, including a portion of the resection margin. Microscopic evaluation of the central portion of the nodule demonstrated a neuroendocrine tumor. No tumor was identified in the submitted margin sample. Additional immunoperoxidase and in-situ hybridization studies were performed to aid in characterization. The laboratory performing the testing is CLIA-certified for high-complexity testing; the assays used were developed in-house and are not FDA-cleared or approved, as such clearance is not required by the FDA."} +{"pid": "TCGA-FA-A82F", "report": "The specimen consists of a small intestinal mass measuring 6x5x3cm, with a moderately defined margin, soft and solid consistency, and yellow-gray surface. Three additional mesenteric masses are noted, each measuring approximately 0.5x2cm. Microscopic evaluation reveals ulceration of the mucosa with infiltration by atypical cells that diffusely replace normal tissue architecture. The infiltrating cells are large, lymphoid-appearing with hyperchromatic, enlarged nuclei. Cellular morphology includes oval or round shapes with distinct cytoplasmic borders and either single or multiple nucleoli. Frequent mitotic figures are observed. Immunohistochemical staining demonstrates positivity for CD20, while CD3 and CKAE1/AE3 are negative. Involvement is noted in both the small intestine and mesenteric lymph nodes. No neoadjuvant therapy was administered prior to resection."} +{"pid": "TCGA-MK-A4N7", "report": "A total thyroidectomy specimen was received, weighing 15.0 grams and measuring 6.0 x 4.0 x 1.9 cm. The specimen had a tan-red, well-encapsulated appearance with a focally shaggy surface. Upon sectioning, a solitary, encapsulated nodule measuring 2.5 cm in greatest dimension (with additional dimensions of 2.3 x 1.8 cm) was identified in the lower pole, located 1.0 cm inferior to the isthmus. The nodule had a mottled, tan-red cut surface and abutted both the anterior and posterior margins. No other discrete lesions were observed.\n\nMicroscopic examination revealed an encapsulated lesion composed of papillary structures with central fibrovascular cores lined by cuboidal to cylindrical cells. These cells exhibited high nuclear-to-cytoplasmic ratios, nuclear grooves, and optically clear nuclei. Focal capsular invasion was present without extension beyond the capsule. Lymphovascular invasion was also identified, while perineural invasion was not observed. Two lymph nodes were identified and showed no evidence of metastasis.\n\nMargins were assessed as negative for tumor involvement despite challenges due to cautery artifact at the left posterior inferior margin. Deeper levels demonstrated a thin, distorted fibrous capsule. Final interpretation of all margins was negative. Clinical correlation and close follow-up are recommended.\n\nStaging criteria indicate the primary lesion is confined to the thyroid, measuring greater than 2 cm but not more than 4 cm. No regional lymph node or distant metastases were identified. Based on these findings, the pathologic stage is consistent with an early stage classification for patients under 45 years of age."} +{"pid": "TCGA-66-2737", "report": "The examined specimen includes a right middle lobe and associated hilar lymph nodes, among other materials. Gross examination of the right middle lobe showed a resected preparation measuring up to 17 cm in size. A central bronchus resection plane was located 1 cm proximal to the division into the lobe bronchi. At the hilus, two black lymph nodes were noted, measuring 1.2 cm and 0.9 cm. Dorsal to the intermediate bronchus, staple suture lines extended 7.5 cm cranially to the lower lobe apex and 10 cm from the hilus along the cranial margin of the middle lobe. The lateral pleura over S4 displayed a star-shaped area of retraction measuring 2.5 cm with a pale brown discoloration. Beneath this area, a lesion reached a maximum dimension of 6.5 cm, with an irregular, polycyclic demarcation. It obstructed the middle lobe bronchus in its proximal sections and extended to within 1.5 cm of the bronchus resection margin. There was evidence of pleural involvement in the area of retraction, with section surfaces showing pale brown to gray discoloration and areas of blackish pigmentation. Mucosal changes were observed at the ostium of the middle lobe bronchus and adjacent intermediate bronchus, extending irregularly to the resection margin. The lung parenchyma of the remaining middle and lower lobes appeared unremarkable.\n\nA bronchial sleeve segment measured 2 cm in length, with resection margins of 2 cm to the main bronchus and 1.1 cm to the upper lobe bronchus. The distal end was closed by a metal staple suture. Additional lymph nodes were identified: two irregular black node parts (2 cm each) in the upper and middle lobes, a 1 cm node in the right lobar lymph node region (station 12), an 8 mm node in the right hilar lymph node region (station 10), and three nodes ranging from 0.5 to 1 cm in the right pulmonary ligament lymph node region (station 9). \n\nHistological analysis revealed atypical epithelial cells arranged in solid structures of varying size and configuration, some with branching or concentric layers resembling epidermoid patterns. Cytoplasmic features were moderately wide to wide, with pale to eosinophilic staining. Intercellular bridges were focally present. Nuclei were round to oval, with some showing mild to moderate irregularities in contour. Anisocytosis and anisokaryosis were noted, along with variation in chromatin density, nucleolar size, and mitotic activity. Desmoplastic stroma surrounded these areas, with small foci of necrosis. In the middle lobe bronchus, the lesion caused partial obstruction and destruction of bronchial architecture, with infiltration into adjacent lymph nodes and extension to the visceral pleura, which showed fibrotic thickening. Vascular invasion was seen at multiple sites within the tumor and at its margins.\n\nProximal to the obstructive lesion, the bronchial mucosa showed replacement by atypical squamous epithelium extending into secretory ducts and bronchial glands. This change reached up to the surface epithelium in many areas, with nuclear irregularities and focal keratinization including lamellae and pearly bead formation. Resection margins of the main bronchus and upper lobe bronchus were free of atypical epithelium. Focal squamous metaplasia was seen at the resection margin, with no definitive invasive component. Elastic fibers in the bronchial stroma were increased, and seromucous glands were variably prominent. Hyaline cartilage strands were also present.\n\nLymph node analysis showed preserved nodal architecture with reactive follicle formation and pigment-laden macrophages containing fine black granules. No definitive metastatic involvement was identified in the hilar, lobar, or pulmonary ligament lymph node regions beyond those directly adjacent to the primary lesion. Vessel resection margins were clear. Intraoperative rapid evaluations confirmed the presence of atypical epithelial cells consistent with high-grade dysplasia up to in situ transformation, but no definitive invasive growth was seen in all margins assessed. Parenchymal findings in S5 included incomplete alveolar inflation and multifocal macrophage accumulation, some with foamy or pigmented features. Lymphomonocytic infiltrates were observed in interlobular septa and peribronchial vessels. In S10, only sparse intraalveolar macrophages were found.\n\nStaging was based on the extent of local spread and regional lymph node involvement. The lesion extended to within 1.5 cm of the bronchus resection margin, with involvement of parabronchial and hilar lymph nodes. Vascular invasion was confirmed, and the resection was complete with no residual tumor at the resection margins. The surrounding lung tissue showed minor inflammatory and fibrotic changes, with no distant involvement identified."} +{"pid": "TCGA-A8-A09B", "report": "The specimen consists of left ablated breast tissue containing a 3.5 cm well-differentiated cellular lesion with focal invasion into lymphatic vessels and infiltration extending to the skin. Adjacent ductal structures show involvement by a non-high-grade intraductal component of similar size, accompanied by comedo necrosis. Margins are present with a minimum basal distance of 0.8 cm and 0.6 cm at the 6 o'clock position. Surrounding tissue demonstrates proliferative changes including mastopathy with cylindrical epithelial metaplasia and scleradenosis. Histologic classification is consistent with Grade 1 morphology. Pathologic staging indicates local extension (pT4b), lymphovascular invasion (pL1), and regional nodal involvement (pN1a) with 2 out of 21 lymph nodes positive. Distant staging could not be assessed (pMX), resulting in an overall stage classification of IIIB. Resection margins are considered complete (R0)."} +{"pid": "TCGA-2Z-A9JK", "report": "The nephrectomy specimen from the left kidney demonstrates a well-circumscribed mass measuring 8.7 cm in greatest dimension. The tumor is located within the renal cortex and medulla, involving the superior, middle, and inferior poles. On gross examination, the cut surface of the tumor is variegated, pale tan-pink, and soft with smooth lobulated areas. Fibrotic septation is present, but no significant necrosis, hemorrhage, or cystic change is observed. Microscopically, the tumor exhibits papillary architecture with nuclear features classified as Fuhrman grade 3, characterized by very irregular nuclei approximately 20 microns in size and large, prominent nucleoli.\n\nHistologic evaluation reveals tumor extension into the renal sinus and peripelvic fat. The tumor is surrounded by a sharp demarcation from the adjacent normal renal parenchyma, which appears pink-tan, smooth, and glistening with a distinct cortico-medullary junction measuring 1.5 cm in thickness. No satellite nodules are identified. The remaining renal tissue shows blunted papillae, and a segment of attached ureter is present, measuring 4.5 cm in length and 4 mm in diameter. The renal vein, artery, and ureter are patent and not involved by tumor. Vascular, ureteral, and surgical margins are free of malignant cells. No sarcomatoid differentiation, tumor necrosis, perineural invasion, or angiolymphatic invasion is identified.\n\nLymph node assessment is not possible due to absence of lymph node tissue in the specimen. Distant metastasis cannot be determined from the current material. Based on the extent of local invasion, the pathologic stage is classified as pT3a. All slides and materials have been personally reviewed by the attending pathologist, who has rendered the final assessment."} +{"pid": "TCGA-TK-A8OK", "report": "Sent out: Sex: male. Date of birth: Clinical diagnosis: prostate cancer. Macroscopy: prostate measuring 5x4x4 cm with yellowish foci present in both lobes; three lymph nodes were submitted. Microscopy: the tumor demonstrates glandular and focally cribriform architecture. The glands are lined by a single layer of cells. Perineural and angiolymphatic invasion are present. The tumor is confined within the prostate without evidence of extraprostatic extension. Gleason score is 7 (4+3). A single lymph node out of the three examined shows evidence of metastasis."} +{"pid": "TCGA-CV-7180", "report": "The case includes multiple specimens. A segment of peripheral nerve tissue and lingual mucosa with underlying connective tissue were both unremarkable. Multiple teeth were also submitted. The main specimen consists of a total glossectomy, bilateral neck dissection, and partial mandibulectomy. Examination reveals a neoplasm with cytological and histological features of an invasive squamous carcinoma. The lesion on the right side of the tongue is relatively well-differentiated (grade I\u2013II), while the left-sided lesion shows somewhat less differentiation (grade II\u2013III). Both areas demonstrate deep invasion into the underlying connective tissue and skeletal muscle. No definitive evidence of lymphovascular or perineural invasion is present. It remains uncertain whether this represents a single extensive process or multiple primary lesions. All final resection margins and seventeen regional lymph nodes are devoid of tumor."} +{"pid": "TCGA-55-8207", "report": "The pathology report includes specimens from multiple lymph node levels and a lung resection. Lymph nodes evaluated include those from the left level 4 (1.1 x 0.5 x 0.5 cm), left level 2 (1.2 x 1.0 x 0.6 cm), level 7 (0.6 x 0.5 x 0.2 cm), right level 4 (1.5 x 1.0 x 0.5 cm), level 11 (2.4 x 2.0 x 1.0 cm), an additional level 11 lymph node (2.3 x 1.3 x 0.8 cm), and level 10 (1.1 x 1.0 x 0.5 cm). All lymph nodes were examined microscopically and found to be negative for malignant cells.\n\nA bronchial margin specimen from the main bronchus and superior segment bronchus was also assessed. Gross examination of the lung tissue revealed a 326.8 gram lobe with a 4.0 x 3.8 x 2.2 cm pale tan-gray mass located 3.5 cm from the bronchial margin. The tumor was noted to be close to the pleura but did not invade it. Histologic evaluation showed well-differentiated acinar-type growth without involvement of the bronchial margin, lymphovascular invasion, or direct extension beyond the tumor site. No attached lymph nodes were identified. All margins were negative."} +{"pid": "TCGA-TT-A6YP", "report": "The patient is a female with a history of von Hippel-Lindau disease. Two specimens were received: the left and right adrenal glands. The left adrenal specimen weighed 18.5g and measured 6.1 x 3.0 x 7 cm. A medullary-based mass measuring 2.6 x 1.9 x 5.8 cm was identified, appearing tan and fleshy with areas of hemorrhage. The right adrenal specimen weighed 29.9g and measured 6.1 x 4.4 x 2.2 cm. A necrotic, medullary-based mass measuring 6.0 x 3.0 x 2.2 cm was present, with features including hemorrhage, necrosis, and a central cystic area measuring 2.5 x 1.1 cm. Both masses were confined to the adrenal glands. Histological evaluation showed abnormal mitoses and nuclear pleomorphism in both specimens; the left adrenal lesion had a PASS score of 5, and the right had a score of 3. All sections were submitted for analysis."} +{"pid": "TCGA-BG-A18A", "report": "The patient underwent a laparoscopic total abdominal hysterectomy with bilateral salpingo-oophorectomy, pelvic lymph node dissection, and cystoscopy. A total of thirteen lymph nodes were examined: seven from the left pelvic region, two from the left common area, four from the right pelvic region, and one specimen from the right common area which consisted of benign fibroadipose tissue without lymphoid tissue. All lymph nodes were negative for metastatic carcinoma.\n\nGross examination of the uterus revealed a 3.5 cm lesion. Histologic evaluation showed well-differentiated epithelial neoplasm with endometrioid features and focal mucinous differentiation. The tumor involved greater than 90% of both the anterior and posterior endometrial cavity. Invasion was limited to less than 50% of the myometrial thickness. There was no evidence of lymphovascular space invasion.\n\nAdditional findings included a 1.4 cm leiomyoma and focal endosalpingiosis involving the uterine serosa. No tumor was identified in the cervix, ovaries, or fallopian tubes. Pelvic washings were negative for malignant cells.\n\nPathologic staging was determined as pT1a with no nodal involvement (pNO). The total number of lymph nodes examined was thirteen, with zero positive nodes."} +{"pid": "TCGA-DJ-A13V", "report": "A lymph node measuring 1.4 cm in greatest dimension was identified positive for metastatic involvement, with a focus measuring 0.8 cm. No extranodal extension was observed. Ten lymph nodes from another region were examined and found negative. A thyroid specimen weighing 22 g was submitted, with the left lobe measuring 4.2 x 2.5 x 1.8 cm and the right lobe measuring 3.8 x 2.3 x 1.5 cm. A nodule measuring 2.9 cm in greatest diameter was identified in the left lobe. The nodule exhibited partial encapsulation and calcifications. No mitotic activity or tumor necrosis was identified. Invasion of extrathyroidal fibroadipose tissue was noted. Surgical margins showed tumor very close, less than 0.2 mm from the inked margin. Multiple microscopic foci were present, including a microcarcinoma measuring 0.1 cm in the left lobe. Non-neoplastic changes included nodular hyperplasia and chronic lymphocytic thyroiditis. Parathyroid glands were not identified. Six lymph nodes were examined in one compartment, four of which contained metastatic involvement. The largest involved lymph node measured 0.5 cm and was nearly entirely replaced by disease. Three lymph nodes from another site were all positive for involvement. The largest of these measured 0.7 cm and showed near-total replacement, with focal extranodal extension noted. Benign thymic tissue was identified in the submitted specimen."} +{"pid": "TCGA-AO-A03P", "report": "A 45-year-old female underwent wide excision of a lesion in the right breast at the 10:00 position, along with sentinel lymph node biopsy (sentinel nodes #1 and #2 from level I of the right axilla). The excised specimen consisted of adipose tissue measuring 9.5 x 7.5 x 4.0 cm. Three distinct nodules were identified within the tissue. The largest central nodule measured 3.7 x 2.5 x 2.0 cm and was located approximately 1.0 cm from the superior, inferior, and medial margins. It appeared tan and slightly granular on cut surface. Two smaller nodules were also present: one measuring 2.2 x 1.3 x 1.0 cm, located 0.2 cm from the superior margin and 0.5 cm from the posterior margin; and another measuring 1.0 cm in diameter, situated 0.2 cm from the superior and 0.5 cm from the lateral margin.\n\nHistologically, the invasive component demonstrated features of high-grade morphology including poor tubule formation, marked nuclear pleomorphism, and high mitotic activity. These invasive areas were found in three separate nodules, with the closest distance to the superior margin being 0.15 cm and to the posterior margin being 0.4 cm. In addition, non-invasive intraductal proliferation was observed, characterized by solid pattern growth, high nuclear grade, and minimal necrosis. This in situ component accounted for no more than 25% of the total tumor burden and was present both admixed with and separate from the invasive areas. No calcifications or vascular invasion were identified.\n\nExamination of sentinel lymph nodes revealed benign lymphoid tissue in both specimens. Subsequent immunohistochemical staining revealed micrometastatic involvement in sentinel node #1, with clusters and single cells identified (< 2 mm in size), and one isolated cytokeratin-positive cell in sentinel node #2. These findings were not apparent on routine histologic sections.\n\nImmunohistochemical studies performed on the primary lesion showed strong estrogen receptor positivity (>95% of nuclei with strong intensity), moderate progesterone receptor positivity (40% of nuclei with moderate intensity), and absence of HER2 expression (score of 0). Frozen section analysis during surgery did not detect tumor involvement in the margins of excision, and this was confirmed on permanent sections.\n\nNo evidence of vascular invasion was observed. Non-neoplastic breast tissue adjacent to the lesion was otherwise unremarkable."} +{"pid": "TCGA-G2-A2EL", "report": "A specimen from the left lateral wall of the bladder consists of multiple pale gray tissue fragments measuring 3.0 x 2.8 x 0.9 cm in aggregate. The tissue shows invasive growth into the muscularis propria. High-grade cellular features are present, along with extensive areas showing small cell differentiation. There is evidence of lymphovascular invasion. All tissue has been submitted for evaluation."} +{"pid": "TCGA-DD-A1EG", "report": "The liver specimen from segment 4A measures 3.0 x 1.4 x 1.0 cm and is a wedge-shaped resection with cautery artifact on one surface. The capsule appears smooth, and the cut surface is golden yellow. Upon sectioning, the tissue shows marked steatosis affecting nearly the entire acinar region, accompanied by rare ballooned hepatocytes and minimal lymphohistiocytic infiltrates. Trichrome and reticulin staining reveal mild zone 3 fibrosis, with more extensive periportal fibrosis and occasional portal-portal bridging. There is no Mallory\u2019s hyaline identified, and iron and PAS-D stains are negative. Portal tracts show mild nonspecific lymphocytic inflammation and the presence of bile duct hamartomas (von Meyenburg complexes). Cytologic detail is partially obscured by moderate to marked cautery artifact.\n\nAn additional resected liver specimen involving segment 4A/4B measures 6.2 x 5.0 x 4.8 cm. Histologic evaluation reveals preserved portal tracts with mild to moderate lymphocytic infiltrates, some containing granulomatous inflammation not directed at bile ducts. The hepatic parenchyma demonstrates severe macrovesicular steatosis, with occasional neutrophils, microgranulomas, and hepatocyte ballooning. Inflammation is moderately active. Trichrome staining confirms periportal fibrosis with focal bridging (stage 2\u20133 of 4), but no cirrhosis or extensive fibrosis is observed. Iron stain is negative. Special stains for microorganisms (GMS and Auramine-rhodamine) are also negative.\n\nSurgical margins are free of abnormal cellular changes, and no vascular invasion is noted. The granulomatous inflammation seen in the non-neoplastic liver may be reactive in nature and warrants clinical correlation. The overall findings include steatosis, steatohepatitis, and fibrosis staging without evidence of advanced disease."} +{"pid": "TCGA-HC-7740", "report": "The surgical specimen included bilateral pelvic lymph nodes and a prostate gland. The lymph nodes were assessed, with four lymph nodes examined and no evidence of metastatic involvement identified. The prostate measured 4.5 x 4.0 x 4.0 cm and weighed 35 grams. Histologic evaluation revealed a lesion involving less than 5% of the gland. The histologic pattern demonstrated a primary growth pattern score of 3 and a secondary pattern score of 4. \n\nExamination of the prostate did not reveal extension beyond the prostate capsule or involvement of the seminal vesicles. No lymphovascular invasion was observed. High-grade prostatic intraepithelial neoplasia was present. There was no evidence of treatment-related changes.\n\nRegarding surgical margins, tumor was noted to focally abut the left anterior inked margin. The apical and bladder neck margins showed no evidence of tumor involvement. Lymph node assessment confirmed no metastatic involvement in the submitted specimens. The staging classification was assigned based on these findings. \n\nGross examination of the prostate showed no discrete lesions. Sections were submitted from multiple regions of the gland for detailed microscopic analysis. Additional tissue samples were provided for genomic research purposes."} +{"pid": "TCGA-OY-A56Q", "report": "The left ovary and fallopian tube were submitted for examination. The tumor measured 8 x 8 x 7 cm and was poorly differentiated. The ovarian capsule was intact without evidence of surface involvement. The tumor was predominantly located within the ovary, with detached clusters present in the lumen of the fallopian tube. There was focal involvement of the fallopian tube mucosa; however, no invasive component was identified in the right fallopian tube or ovary. No tumor was found in the omentum or in any lymph nodes examined, which included four from the left common iliac region, four from the left periaortic region, and six from the left pelvic region.\n\nThe right ovary showed atrophic changes with epithelial inclusion glands and cysts. The right fallopian tube contained paratubal cysts and exhibited tubo-ovarian adhesions. The omentum showed no malignancy. Fibrous serosal adhesions were noted on the left side.\n\nGrossly, the left ovary and fallopian tube specimen weighed 215 grams and was received intact. The ovarian surface appeared pink and tan, smooth and glistening, with fibrofatty adhesions but no excrescences. The tumor presented as a unilocular cyst filled with brown serous fluid and loosely adherent clumps of brown material. Two foci of friable tan papillary projections were observed, measuring up to 2.1 x 1.7 x 1.5 cm. The cyst wall ranged from 0.1 to 0.4 cm in thickness, and normal ovarian parenchyma was absent. The fallopian tube measured 4.2 cm in length and was embedded within the wall; the lumen was patent and partially filled with yellow-tan gelatinous material.\n\nAdditional specimens included a right adnexal specimen with an atrophic ovary containing a small simple cyst and a fimbriated fallopian tube with a pinpoint lumen. The omentum was unremarkable. Lymph node specimens varied in size and were all negative for malignancy.\n\nMicroscopic evaluation revealed that the majority of the abnormal cells were located in the left ovary, with detached clusters within the fallopian tube lumen and minimal mucosal attachment. Origin from either the ovary or fallopian tube could not be definitively determined, though ovarian origin was considered more likely. No peritoneal washings were available for assessment. Staging was based solely on surgical specimens and remains provisional pending further clinical review."} +{"pid": "TCGA-AG-A036", "report": "The resected specimen includes a segment of rectal tissue with diverticulosis present in the proximal portion. An ulcerated lesion was identified aborally, characterized by moderately differentiated cellular features and infiltration extending into the perirectal fat (G2). Both oral and aboral surgical margins were free of tumor involvement. Microscopic evaluation did not confirm clinical indications of posterior bladder wall involvement. Histological staging was determined as pT3 based on available tissue. From the perirectal fatty tissue, numerous lymph nodes were dissected, measuring up to 1.2 cm in diameter. Of the 30 lymph nodes sampled, 18 contained metastatic deposits. Based on these findings, the histological staging corresponds to pN2 (18 out of 30 lymph nodes involved)."} +{"pid": "TCGA-EM-A22Q", "report": "The specimen was received fresh and intact, consisting of a total thyroidectomy with bilateral paratracheal lymph node dissections. The thyroid specimen weighed 41.0 grams. The right lobe measured 7.0 x 4.1 x 2.5 cm, the left lobe measured 3.9 x 2.9 x 0.9 cm, and the isthmus measured 4.0 x 2.4 x 0.3 cm. A well-circumscribed nodule was identified in the upper mid to lower pole of the right lobe, measuring 5.4 x 4.0 x 2.4 cm. No parathyroid glands or lymph nodes were identified on gross examination of the thyroid specimen.\n\nThree lymph nodes were received from the right paratracheal dissection and three from the left; all were submitted in entirety. Additionally, two left perithyroidal lymph nodes, one isthmic lymph node, and one left perithyroidal parathyroid tissue were also received and submitted entirely. No pathological diagnosis was rendered for any of the lymph node specimens.\n\nMicroscopic evaluation of the thyroid nodule revealed a tumor with follicular architecture and classical cytomorphology. The tumor was unifocal, located in the right lobe, and completely encapsulated. Minimal capsular invasion was noted. There was no evidence of lymphovascular or perineural invasion, and no extrathyroidal extension was identified. Surgical margins were free of involvement. A total of nine regional lymph nodes were examined, and none showed evidence of involvement. Focal nonspecific thyroiditis was also noted. Parathyroid tissue was within normal limits.\n\nStaging was based on the AJCC/UICC TNM 7th Edition classification system. The primary tumor was classified as pT3 due to its size greater than 4 cm and confinement to the thyroid gland. Regional lymph node assessment was pN0, indicating no metastasis in the 9 lymph nodes examined. Distant metastasis could not be assessed."} +{"pid": "TCGA-L9-A743", "report": "The specimen was received fresh for evaluation. Part A consisted of lymph node fragments measuring 8 mm in aggregate, entirely examined by frozen section as block A1. Part B included lymph node fragments measuring 8 mm in total and were fully assessed via frozen section as block B1. Part C contained lymph node fragments measuring up to 1 cm and were entirely submitted for permanent section as block C1.\n\nPart D consisted of a left upper lobectomy specimen measuring 18 x 10 x 6 cm. Centrally, there was an area of distorted visceral pleura with an underlying palpable tumor. Blue ink was applied to the visceral pleural surface. Upon sectioning, a firm, partly necrotic tan tumor measuring 4.5 x 3.5 x 2.5 cm was identified. The tumor was located 1.5 cm from the parenchymal margin and 3 cm from the bronchial margin. Three soft black peribronchial lymph nodes were present, measuring up to 1.5 cm in greatest dimension. Sections were taken from one peribronchial lymph node (D1), two peribronchial lymph nodes (D2), bronchial margins (D3), vascular margins (D4), two bisected peribronchial lymph nodes (D5), and representative tumor sections with blue ink on the visceral pleura (D6\u2013D9). Representative lung tissue was also submitted (D10).\n\nTwo additional specimens were received in formalin. Specimen E consisted of multiple lymph node fragments measuring 2 x 2 x 0.4 cm in aggregate and were entirely submitted as block E1. Specimen F contained lymph node fragments measuring 1 x 1 x 0.3 cm and were fully submitted as block F1.\n\nIntraoperative consultation showed no tumor seen in frozen sections A and B. Gross evaluation confirmed a 4.5 cm tumor located 1.5 cm from the parenchymal margin and 3.0 cm from the bronchial margin.\n\nMicroscopic examination revealed no metastasis in the level 5, level 7, or 4R lymph nodes. However, metastatic involvement was identified in one level 10 lymph node and in three out of five peribronchial lymph nodes, with extranodal extension noted. Vascular invasion and visceral pleural invasion were present. Histologic grade was determined to be G3 (poorly differentiated). Surgical margins were uninvolved by invasive carcinoma. Lymph node assessment showed a total of 10 examined, with 4 involved. Pathologic staging was assigned as pT2a for the primary tumor and pN1 for regional lymph nodes."} +{"pid": "TCGA-XF-A9ST", "report": "The submitted specimen includes a radical cystoprostatectomy with bilateral pelvic lymph node dissection. Gross examination of the right ureter revealed no tumor involvement. The left ureter showed mild hydroureter without evidence of malignancy. The bladder and prostate specimen demonstrated a tumor measuring 10 cm in greatest dimension, located at the left trigone extending into the midline and disrupting the ureterovesical junction. This lesion extended through the muscularis propria into perivesical soft tissue. A second flat granular mass measuring 1.5 x 1 x 1 cm was identified at the bladder neck and appeared limited to the mucosal surface. Extensive necrosis was noted within the tumor. The resection margins, including ureteral, radial, and apical, were free of malignancy.\n\nMicroscopic evaluation confirmed high-grade invasive papillary transitional cell carcinoma (grade 3\u20134/4) with extensive necrosis and lymphovascular invasion. Multifocal urothelial carcinoma in situ was also present. Reactive urothelial atypia was observed in random areas of the bladder mucosa. An acutely and chronically inflamed diverticulum was identified adjacent to the primary tumor. Examination of the prostate revealed benign prostatic glandular and stromal hyperplasia without dysplasia or malignancy; distal, apical, and radial margins were free of tumor involvement. Vascular calcifications were noted in the perivesical fat.\n\nLymph node evaluation included one lymph node from the right perivesical region, three from the right pelvic lymph nodes, and nine from the left pelvic lymph nodes. No malignancy was identified in any of the 13 lymph nodes examined. Additional specimens including the left ureteral margin and right proximal ureter were also negative for tumor involvement.\n\nPathologic staging determined the extent of disease based on local invasion into perivesical tissue, with no regional lymph node metastasis and no distant metastases assessed."} +{"pid": "TCGA-AP-A0LT", "report": "The submitted specimens include biopsies from the anterior cul-de-sac, a total hysterectomy with bilateral salpingo-oophorectomy, and multiple lymph node samples from both left and right pelvic regions.\n\nMicroscopic examination of the anterior cul-de-sac biopsy reveals fibrous tissue with calcifications and focal endosalpingiosis. No malignant changes are identified in this specimen.\n\nIn the hysterectomy specimen, two distinct areas of abnormal growth within the endometrium are noted. Both exhibit glandular architecture with mucinous features and nuclear atypia classified as grade II. The larger lesion demonstrates invasion into the myometrium, involving up to half of its thickness. Specifically, the depth of invasion measures 3 mm within a myometrial thickness of 8 mm at that site. The second, smaller focus is confined entirely to the endometrial lining without stromal invasion. There is no evidence of vascular invasion identified. The cervix shows involvement by tumor in both the mucosa and underlying stroma. All examined adnexal structures appear normal without pathological findings.\n\nLymph node evaluation includes multiple pelvic nodal groups. No metastatic involvement is detected in any of the sampled lymph nodes. Right and left obturator nodes (0/3 and 0/1 respectively), right and left external iliac nodes (0/2 and 0/2), right and left hypogastric nodes (0/7 and none identified on left), and left common iliac nodes (0/1) were all negative for malignancy. Additionally, two other specimens submitted as left hypogastric and left lateral external iliac lymph nodes did not contain identifiable lymph nodes upon histological examination.\n\nAll findings are based on personal review of the microscopic slides."} +{"pid": "TCGA-EW-A1IW", "report": "A right mastectomy specimen was received measuring 21 x 16 x 4 cm. Two distinct masses were identified: one measuring 4.0 cm located in the lower outer and inner quadrants, and another measuring 1.0 cm in the upper inner quadrant near the anterior margin. The larger mass was poorly circumscribed and associated with skin changes, including satellite foci involving the dermis. Microscopic examination revealed multiple foci of invasive carcinoma with intermediate nuclear grade. Histologic features included lymphovascular invasion; however, the deep and anterior margins were free of tumor involvement. Lobular carcinoma in situ was also present.\n\nAxillary lymph node dissection was performed along with sentinel lymph node biopsy. A total of ten lymph nodes were examined, two of which contained macrometastases greater than 0.2 cm in size. Both sentinel lymph nodes were negative for metastasis on frozen section and touch prep analysis. Immunohistochemical staining for keratin was negative in both sentinel lymph nodes.\n\nAncillary studies showed minimal immunoreactivity for estrogen receptor (1%), and progesterone receptor positivity (>1%). HER2 testing by immunohistochemistry was equivocal (score 2+), but chromogenic in situ hybridization (CISH) did not show gene amplification.\n\nThe specimen was completely submitted for histologic evaluation, and all sections were processed appropriately. Pathologic staging was determined as pT4b, pN1a based on tumor size, multifocality, lymphovascular invasion, and lymph node involvement. No extranodal extension was observed."} +{"pid": "TCGA-CJ-4897", "report": "The surgical specimen includes a right kidney and adrenal gland. The tumor measures 13.5 cm in maximum dimension and is solid and cystic with yellow-red, heterogeneous features. It is primarily located in the upper lobe of the kidney, extending to the mid third and lower pole. Areas of myxoid degeneration, hemorrhage, and necrosis are present. The tumor extends into the perinephric adipose tissue and involves the renal sinus. It also invades the renal vein with a tumoral thrombus found intraluminally, located 1.0 cm from the vein margin. The tumor directly extends into the adrenal gland, causing compression. All vascular, ureteral, and soft tissue margins are free of tumor. The uninvolved kidney parenchyma appears normal."} +{"pid": "TCGA-CM-6166", "report": "The specimen submitted was a right hemicolectomy, including a segment of terminal ileum, cecum with attached appendix, and ascending colon. The terminal ileum measured 6 cm in length and 3.5 cm in circumference at the proximal margin. The remaining colon measured 33 cm in length, with a 7 cm circumference at the distal resected margin. The appendix was 7 cm long, averaging 0.4 cm in diameter. A mass lesion was identified measuring 5.2 cm in length and 4.1 cm in width. The tumor invaded into the muscularis propria with a depth of 0.3 cm. No gross tumor perforation, serosal involvement, vascular invasion, or perineural invasion was identified. All surgical margins were free of tumor. No polyps were found away from the lesion. A small incidental finding in the appendix was noted, measuring less than 0.5 cm. The surrounding bowel appeared unremarkable. A total of 33 lymph nodes were examined, none showing evidence of metastasis. Pathologic staging based on AJCC 2002 criteria was determined as pT2 and pN0. Immunohistochemical staining for DNA mismatch repair proteins (MLH1, MSH2, MSH6, PMS2) showed retained expression in the tumor. All tests performed are used for clinical purposes and the laboratory is certified under CLIA to perform high-complexity testing."} +{"pid": "TCGA-F4-6461", "report": "The specimen consisted of a hemicolectomy. The tumor was located at the hepatic flexure and measured 7 x 8 x 2 cm. Histologic evaluation showed moderately differentiated features. The tumor extended beyond the original site, involving adjacent structures. Lymph node assessment revealed that all four intraabdominal lymph nodes examined contained metastatic involvement. No information was provided regarding surgical margins or prior treatment. Additional findings were not reported."} +{"pid": "TCGA-LL-A5YL", "report": "The specimen was received from a patient and included multiple tissue samples submitted in five containers. The first specimen, labeled \"right breast tissue,\" consisted of a total mastectomy specimen measuring 23 x 22.5 x 6.5 cm with an ellipse of skin including the nipple. A firm mass was identified beneath the skin surface at the 11 o\u2019clock position, measuring approximately 4.5 x 3 x 3 cm. The mass extended to within 1 cm of the superficial margin and was located well above the deep margin, which was approximately 7 cm away. The mass was difficult to delineate visually but was more easily palpated. Additional sections of non-neoplastic breast tissue were also submitted.\n\nTwo axillary lymph nodes were received in the second specimen, measuring 2 x 1.5 x 1 cm and 1 x 0.7 x 0.7 cm respectively. Both showed changes consistent with metastatic involvement. The third specimen, labeled \"sentinel node #1,\" was a lymph node within yellow fatty tissue measuring 2.5 x 2 x 1 cm; no evidence of tumor involvement was found. The fourth specimen, labeled \"level 3 axillary nodes,\" included six lymph nodes, the largest of which was marked with suture. All were free of tumor. The fifth specimen, labeled \"right axillary contents,\" was a collection of lymph nodes within fatty tissue, one of which showed signs of involvement.\n\nHistologically, the invasive component measured 45 mm in greatest dimension. The Nottingham combined histologic grade was 2 of 3, with a tubule formation score of 3, nuclear pleomorphism score of 2, and mitotic count score of 1. The surgical margins were free of invasive disease, with the closest margin measuring 10 mm. There were foci of lobular and ductal carcinoma in situ, the latter being of intermediate nuclear grade and not extensive. Ductal carcinoma in situ showed cribriform and solid architectural patterns, with focal necrosis present. Margins for ductal carcinoma in situ were also greater than 10 mm from the lesion.\n\nLymph node evaluation included sentinel and non-sentinel nodes. One of 14 axillary lymph nodes in the regional resection showed evidence of involvement, while two of two axillary lymph nodes were involved. The sentinel node and all six level 3 axillary lymph nodes were negative. A total of 23 lymph nodes were examined, with three showing macrometastases. No micrometastases or isolated tumor cells were identified. No extranodal extension, lymphovascular invasion, or dermal lymphovascular invasion was observed.\n\nImmunohistochemical studies showed strong nuclear positivity for estrogen receptor in 92% of cells, while progesterone receptor was negative. HER2 testing by immunohistochemistry was positive (score 3+), though in situ hybridization did not show HER2 gene amplification.\n\nPathologic staging was determined as pT2 for the primary tumor and pN1a for regional lymph node involvement."} +{"pid": "TCGA-A5-A1OG", "report": "The omentum specimens showed micro-adhesions and focal mesothelial hyperplasia, with one specimen containing rare free-floating clusters of atypical cells. The hysterectomy specimen included the cervix and bilateral fallopian tubes and ovaries. A mass measuring 3 x 3 cm was identified in the uterine corpus and fundus. Invasion extended through more than 50% of the myometrial thickness, with a depth of 0.7 cm invading into a total myometrial thickness of 1.0 cm. Lymphovascular invasion was noted extensively within the myometrium, reaching within 0.1 cm of the serosal surface. Involvement of the endocervical stroma was present without involvement at the cervical margin. Lymphovascular invasion was also identified in the right parametrial tissue, possibly in the left parametrial area (uncertain due to potential artifactual displacement), right paraovarian tissue, and perinodal regions. Multiple benign findings were noted, including leiomyomas of varying sizes (0.2 to 3.0 cm), nabothian cysts, squamous metaplasia, and epithelial microinclusion cysts in the adnexal regions. The cervix demonstrated reserve cell hyperplasia, and Walthard rests were identified in both fallopian tubes. Lymph node assessment revealed metastatic involvement in all lymph node groups examined. Right external iliac lymph node showed involvement (1 out of 1). All three left pelvic lymph nodes were positive for metastasis. One left para-aortic lymph node and three right para-aortic lymph nodes were also involved. Perinodal vascular invasion was observed. No lymph nodes were identified in the right pelvic lymph node specimen. The appendix appeared histologically unremarkable. Specimen measurements included a uterus measuring 7.0 x 7.0 x 5.0 cm, with an endometrial cavity length of 3.0 cm and width of 3.4 cm. Leiomyomas ranged from 1.0 to 3.0 cm in size. The right ovary measured 3.0 x 1.2 x 0.4 cm, and the left ovary was 2.0 x 1.3 x 0.8 cm. The right fallopian tube was 3.6 cm long and the left was 3.2 cm. Adipose tissue submitted for right pelvic lymph node measured 3.5 x 3.0 x 1.0 cm. The right external iliac lymph node measured 2.0 x 1.5 x 0.7 cm. Left pelvic lymph nodes included three nodes ranging in size from 0.5 x 0.4 x 0.4 cm to 1.2 x 1.0 x 0.5 cm. The left para-aortic lymph node was 2.4 x 1.5 x 0.9 cm, and the right para-aortic lymph node measured 3.5 x 1.9 x 0.9 cm. The appendix was 5.5 cm in length with a diameter of 0.8 cm."} +{"pid": "TCGA-CV-7103", "report": "The specimen consists of a partial glossectomy from the lateral tongue, measuring 8.0 x 3.8 x 2.0 cm. A focal lesion is identified, described as ulcerated, contracted, and slightly raised, with a light-tan and firm consistency, measuring 2.0 x 1.0 x 0.6 cm. The lesion is surrounded by normal mucosa and is approximately 0.8 cm from the deep margin of resection. All sections of the specimen were submitted for analysis.\n\nFocal moderate dysplasia is noted at the medial/anterior aspect of the surgical margin. Other areas of the margin are denuded, with the remainder showing no evidence of involvement. An additional tissue fragment from the anterior medial margin, measuring 2.1 x 1.0 x 0.3 cm, shows minor salivary gland tissue without presence of tumor.\n\nLymph node evaluation includes multiple levels. In level II, three lymph nodes were examined, one of which shows involvement. In level III, three lymph nodes were assessed, with one containing metastatic cells. In level IV, two lymph nodes were examined and both were uninvolved. Additional lymph nodes from level I and an additional level IV specimen were also analyzed, all without evidence of tumor. The submandibular salivary gland was unremarkable and showed no signs of invasion.\n\nA small fragment of tissue from the posterior hard palate, measuring 0.2 cm in greatest dimension, was submitted and showed an oral melanotic macule. Multiple teeth and tooth fragments, measuring 5.5 x 5.0 x 3.5 cm in aggregate, were included for gross identification only.\n\nAll other tissues and margins evaluated show no further significant findings."} +{"pid": "TCGA-EY-A1GT", "report": "The surgical pathology report describes findings from a hysterectomy and bilateral salpingo-oophorectomy. A lesion was identified in the endometrium, measuring 4.5 x 2.9 x 2.5 cm, with a friable, papillary, shaggy, exophytic, white/tan, coarsely granular appearance. It was located primarily in the posterior corpus, as well as the fundus and upper anterior corpus. Microscopic evaluation showed that the lesion was well-differentiated with squamous and mucinous features. Architecturally, it was graded as low grade, with nuclear features corresponding to a slightly higher grade. The tumor invaded superficially into the endometrium to a depth of 1 mm, within a total myometrial thickness of 1.0 cm (10% invasion). There was also involvement of the anterior lower uterine segment mucosa, but no lymphovascular invasion was identified.\n\nInvolvement of the adnexa was noted. The right ovary, measuring 3.7 x 2.0 x 1.5 cm, contained a metastatic component involving the external surface and an expansive mass on cut section. The right fallopian tube showed metastatic involvement on the serosal surface. The left ovary had focal involvement on the surface, while the left fallopian tube showed no evidence of disease.\n\nLymph node dissection included 8 right pelvic nodes and 17 left pelvic nodes; none showed evidence of disease. Immunohistochemical staining for ER and PR was performed. In the endometrial lesion, ER was positive in 20% of cells (1+) and PR was weakly positive (1+). In the right ovarian lesion, ER was strongly positive in 70% of cells (3+) and PR was positive in 65% of cells (3+). Despite the differences in receptor expression, the pattern of spread and morphologic features support a primary origin in the endometrium with metastatic spread to the adnexa.\n\nStaging according to AJCC criteria was pT3a pN0 pMx. Additional benign findings included a leiomyoma and adenomyosis in the myometrium, and endometriosis in the right fallopian tube. Gross examination of the uterus showed no cervical or lower uterine segment involvement. The myometrial wall thickness at the deepest point of gross invasion was 3.3 cm from tumor surface to serosa, with 1.5 cm from point of invasion to serosa, and 2.4 cm in adjacent normal tissue. No other significant gross findings were noted. Tissue blocks were submitted for all relevant areas, including multiple sections of the tumor, myometrium, cervix, adnexa, and lymph nodes. \n\nImmunostaining controls were appropriate, and testing was conducted under CLIA-88 certification. Further clinical correlation is recommended."} +{"pid": "TCGA-60-2714", "report": "The specimen included multiple lymph node groups and a right lung resection with azygous vein. The lung tissue weighed 625 grams and measured 20x15x12 cm. A mass measuring 7.0x5.0x4.0 cm was identified, tan-white to gray-black in color, located 1.5 cm from the bronchial margin and extending to the pleural surface. It encircled vascular and bronchial structures but did not grossly invade them. The venous segment near the resection margin measured 2.0 cm in length and 0.7 cm in diameter, sealed by staple lines at both ends. Multiple peribronchial lymph nodes were present, the largest measuring 1.1 cm.\n\nMicroscopic examination of the mass showed poorly differentiated carcinoma. Angiolymphatic invasion was present. Evaluation of lymph nodes from various levels revealed no evidence of involvement in level 8 (7 nodes), level 7 (2 nodes), level 9 (1 node), or the second 10R node (1 node). However, two out of seventeen peribronchial lymph nodes showed presence of malignant cells. The bronchial margin was free of tumor.\n\nStaging was determined as pT2 N1 Mx. Visceral pleural involvement was not observed, and there was no satellite tumor noted."} +{"pid": "TCGA-EM-A3ST", "report": "The thyroid specimen measured 6.8 cm \u00d7 5.7 cm \u00d7 4.0 cm on the right lobe, 4.0 cm \u00d7 1.5 cm \u00d7 1.3 cm on the left lobe, and 2.5 cm \u00d7 0.5 cm \u00d7 0.4 cm at the isthmus. The total weight of the specimen was 56.5 grams. A dominant nodule measuring 5.4 cm \u00d7 3.7 cm \u00d7 3.0 cm was identified in the right lobe. Additional smaller nodules ranging from 0.5 to 1.0 cm were present in the left lobe. Histologically, the dominant lesion exhibited follicular architecture with regions showing more solid growth patterns and increased single-cell apoptosis, suggestive of focal architectural changes. These areas comprised less than 10% of the lesion. The right lobe lesion was partially encapsulated with widespread capsular invasion and focal vascular invasion involving fewer than four vessels. Margins were free of involvement. A second lesion in the left lobe showed similar histologic features but lacked capsular invasion or vascular invasion. Margins were also uninvolved in this lesion. Multiple additional small lesions measuring 0.6 cm or less were identified in the right lobe, isthmus, and left lobe. No lymph node metastasis was identified in the single lymph node examined. No extrathyroidal extension or perineural invasion was observed. Additional findings included adenomatoid nodules and nodular follicular disease. Staging was based on AJCC/UICC TNM classification and indicated pT3 for the dominant lesion due to its size exceeding 4 cm and absence of significant extrathyroidal extension. Regional lymph node staging was pN0 with no metastases identified. The specimen was intact with all margins clear."} +{"pid": "TCGA-56-8629", "report": "The pathology report includes specimens from multiple lymph node regions and a lung excision. Specimens A through E consist of lymph nodes ranging in size from 1.5 cm to 2.4 cm, with descriptions noting tan-gray or yellow-black rubbery consistency and presence of anthracosis. No malignancy was identified in any of the lymph nodes evaluated.\n\nThe left lower lobe specimen measured 15.0 x 13.0 x 8.5 cm and contained a centrally cystic, gray-white mass measuring 6.0 x 5.5 x 5.0 cm. The mass was located within the lung parenchyma and did not extend beyond the visceral pleura. It approached the bronchial margin at a distance of 1.0 cm and was in focal contact with the pleural surface but did not invade through it. Examination of surgical margins showed no evidence of tumor involvement. Three small lymph nodes adjacent to the bronchus were identified and found to be negative for metastatic involvement.\n\nHistologic evaluation revealed moderately differentiated cellular features arranged in a unifocal pattern confined to the lung parenchyma. There was no evidence of vascular or lymphatic invasion, nor was there extension beyond the lung tissue. Based on these findings, the staging classification indicated localized disease without nodal involvement."} +{"pid": "TCGA-AA-A029", "report": "The specimen shows an invasive, poorly differentiated carcinoma with partial mucinous features. The tumor has a high-grade morphology (G3) and extends through all layers of the intestinal wall (pT3). Lymph node examination reveals no involvement by tumor cells. Additionally, the resection margins are free of tumor."} +{"pid": "TCGA-EL-A4JZ", "report": "A female patient underwent surgical removal of several lymph node groups and thyroid tissue. The specimens included one right mid jugular lymph node (0.7 cm), one right superior parathyroid lymph node (0.8 cm), and three right mediastinal lymph nodes (aggregate size 1 x 1 x 0.8 cm). All were negative for abnormal cellular infiltration. A Delphian node specimen measuring 1 x 0.8 x 0.4 cm with attached fatty tissue was also negative for any abnormality. Additionally, a small fragment (0.2 x 0.1 x 0.1 cm) of left superior parathyroid gland tissue was examined and showed no abnormal findings.\n\nThe left neck contents consisted of a 6.5 x 3 x 1 cm fibrofatty tissue fragment containing multiple possible lymph nodes ranging from 0.5 to 0.7 cm. One of these contained abnormal cells confined to the node. The right paratracheal and mediastinal contents included a 5.5 x 2 x 1 cm fibrofatty tissue fragment with multiple possible lymph nodes ranging from 0.4 to 1.1 cm; five of these nodes contained abnormal cells confined to the node.\n\nThe total thyroidectomy specimen measured 6 x 6 x 2 cm and showed nodular changes consistent with chronic inflammation. In the isthmus, a firm tan nodule measuring 2 x 1.6 x 1.5 cm was identified, extending into adjacent soft tissue and adhering focally to skeletal muscle. Another nodule measuring 1.5 x 1 x 0.5 cm was present in the left lobe. Histologic examination revealed a well-defined lesion in the isthmus measuring 2.0 cm without vascular invasion. Surgical margins were free of abnormal cells. Surrounding adipose tissue contained lymph nodes that were negative for involvement.\n\nNo abnormal cells were found in two additional lymph nodes evaluated from the thyroid specimen. Parathyroid tissue was identified in one of the submitted fragments."} +{"pid": "TCGA-GM-A2DI", "report": "A total of eight sentinel lymph nodes were excised from the left axilla. One of these contained a metastatic deposit measuring 0.2 mm, identified on H and E section; no extranodal extension was observed. The remaining seven lymph nodes showed no evidence of tumor involvement. \n\nA total mastectomy specimen from the left breast measured 15.0 x 11.0 x 4.0 cm. Within the left upper outer quadrant at 3\u20134 o\u2019clock, a firm tan mass measuring 1.8 x 1.7 x 1.5 cm was identified with irregular borders. A second white fibrotic nodule measuring 2.3 x 1.5 x 1.5 cm was located in the lower outer quadrant. A separate firm white lesion measuring 1.0 x 1.0 x 0.9 cm suggestive of a fibroadenoma was noted at 12 o\u2019clock. Histologically, two distinct invasive nodules were present. The larger measured 1.8 cm in greatest dimension and the smaller 0.5 cm. Both exhibited features consistent with high nuclear grade. Ductal carcinoma in situ (intermediate grade) with cribriform and solid patterns was also present, accounting for less than 5% of the overall tumor burden. Lymphovascular invasion was identified. Pseudoangiomatous stromal hyperplasia, columnar cell alterations, and proliferative fibrocystic changes were also noted. Resection margins were free of tumor involvement.\n\nTouch preparations and frozen sections were performed on all lymph nodes with no tumor detected intraoperatively. The mastectomy specimen was inked with multiple colors to identify orientation. Margins included deep, superior, inferior, medial, and lateral aspects, all of which were negative. Additional findings included areas of nodularity and fibrosis adjacent to the primary tumor, extending into the upper outer and inner quadrants, measuring up to 6.0 x 5.0 x 5.0 cm."} +{"pid": "TCGA-HU-A4H6", "report": "Stomach, subtotal gastrectomy: The lesion is located in the lower third, centered at the antrum along the lesser curvature. Grossly, it exhibits a Borrmann type 2 appearance. Histologically, the tumor shows a tubular growth pattern with moderate differentiation and displays an intestinal type morphology according to Lauren classification. It has a diffusely infiltrative growth pattern. The size of the lesion measures 4.8 x 4.3 cm. The depth of invasion extends to the subserosa (pT3). Resection margins are free of involvement, with distal and proximal margins measuring 3.4 cm and 6.0 cm, respectively. Regional lymph node evaluation reveals metastasis in 3 out of 86 lymph nodes (pN2), including 1 out of 66 at the lesser curvature and 2 out of 18 at the greater curvature. Lymphatic invasion is present and graded as mild. Venous invasion is not identified. Perineural invasion is present and graded as moderate. The specimen labeled as \"anvil ring\" biopsy shows no evidence of tumor. Immunohistochemical staining was performed using markers including CD10, MUC2, MUC5ac, MUC6, and C-erb B2."} +{"pid": "TCGA-AR-A1AT", "report": "The specimen consists of a breast tissue resection with a focus of infiltrating cellular proliferation exhibiting predominantly lobular features. The lesion is categorized as solid variant and is classified as the highest grade according to Nottingham grading (Grade III), based on architectural differentiation (tubules 3/3), nuclear pleomorphism (nuclei 3/3), and mitotic activity (mitoses 2/3), resulting in a total score of 8 out of 9. The lesion measures 2.5 x 2.1 x 1.9 cm and is staged as pT2 according to AJCC criteria. There is also presence of focal in situ cellular changes consistent with lobular morphology.\n\nAngiolymphatic invasion was not identified. Adjacent non-neoplastic breast tissue demonstrates proliferative fibrocystic alterations. Changes related to prior biopsy are noted. Surgical margins are free of abnormal cellular aggregates, with the closest margin measuring at least 0.4 cm at the anterior aspect.\n\nEvaluation of sentinel lymph nodes from the left axilla includes three nodes. One of these (node #2) contains isolated tumor cells or clusters, detected only by cytokeratin staining. These clusters include five distinct groups, with the largest measuring 0.05 mm. No blue dye was identified in lymph nodes #2 or #3; blue dye was confirmed in lymph node #1.\n\nAncillary studies including immunohistochemical staining for E-cadherin were performed on embedded tissue and demonstrate absence of cytoplasmic membrane staining, consistent with lobular immunophenotype. Radiographic correlation using Faxitron was performed."} +{"pid": "TCGA-56-A5DS", "report": "The specimen consists of a right lower lobe lung wedge biopsy and lobectomy with associated lymph node biopsies. The wedge biopsy measures 8 x 4 x 2 cm and contains an area of retraction measuring 2 cm on the pleural surface. A mass measuring 3.5 cm in maximum dimension is identified within the tissue, with a tan-gray, mottled cut surface. The lobectomy specimen measures 15 x 8 x 5 cm and includes an 8 cm staple line at the prior resection site; no residual mass is observed upon serial sectioning.\n\nMicroscopic examination of the mass reveals nests of polygonal cells with distinct borders, small to moderate cytoplasm, enlarged nuclei, and nuclear pleomorphism. Central necrosis is present within some nests, and rare cells demonstrate dense eosinophilic cytoplasm. No definitive lymphovascular invasion is identified. The tumor approaches, but does not involve, the pleural surface. Focal luminal differentiation is noted. Immunohistochemical staining shows positivity for cytokeratin 5 and 7, p63, and negativity for TTF-1, cytokeratin 20, and Napsin-A. Surrounding lung tissue demonstrates mild interstitial fibrosis and bronchiectasis.\n\nAll surgical margins, including bronchial and vascular, are free of tumor involvement. No tumor is identified at the previous wedge resection site or within random sections of the remaining lung parenchyma. A total of three lymph nodes are examined, all from level R10, and none show evidence of tumor involvement. The lymph nodes are described as benign with anthracotic pigment.\n\nHistologic evaluation confirms absence of large vessel venous invasion and small vessel lymphatic invasion. Additional findings include mild chronic inflammation and bronchiectasis. Based on these findings, staging is determined as pT2a, pNO, pMX."} +{"pid": "TCGA-RY-A847", "report": "The patient is a male with a right frontal brain mass. A biopsy and subsequent resection were performed, along with collection of CUSA contents. Gross examination of the biopsy specimen revealed a single irregular tissue fragment measuring 1.3 x 0.6 x 0.3 cm. The resected specimen consisted of two pieces: one measuring 1.4 x 1.1 x 0.6 cm and another measuring 2.6 x 2.1 x 1.1 cm, with the latter showing a dark pink-red cortical surface and firm white matter on sectioning. The CUSA contents included numerous small fragments totaling approximately 7 x 6 x 2 cm.\n\nMicroscopic evaluation demonstrated infiltrating cells with round, regular nuclei, distinct nuclear membranes, and abundant cytoplasm. No increased mitotic activity, microvascular proliferation, or necrosis was observed. Sections from all specimens showed similar features.\n\nImmunohistochemical staining showed positivity for IDH-1 (R132H mutant). Additional molecular testing for 1p19q deletion status was initiated and will be reported separately. All specimens were reviewed by the attending pathologist, who confirmed the findings following evaluation of slides and resident documentation. The pathology report has been finalized in accordance with CLIA-certified laboratory standards."} +{"pid": "TCGA-AA-3870", "report": "The surgical specimen includes a right hemicolectomy with an ulcerated lesion identified in the colon, located 1 cm from Bauhin\u2019s valve. The lesion measures 4.5 cm in length and fully encircles the intestinal wall. Histological examination reveals invasive growth extending through all layers of the intestinal wall to the subserosa and into the mesocolic fat. Lymphatic vessel invasion is present at the tumor margin. Small-nodular metastatic deposits are observed in the peritoneum of the mesocolon. The colonic mucosa shows a tubulovillous adenoma with moderate epithelial dysplasia. The ileum exhibits signs consistent with chronic mechanical ileus. The appendix demonstrates postinflammatory fibrosis with fibroid occlusion of the lumen at its apex. Both oral and aboral resection margins, as well as the greater omentum, are free of tumor involvement. Of the 23 local lymph nodes examined, 5 contain extensive metastatic deposits, with some tumor cells extending beyond the lymph node capsules. Within the mesentery, there is a distinct mesenchymal spindle cell tumor measuring 0.5 cm. Additionally, a small nodular metastasis is found on the peritoneal surface near the roof of the bladder. Vascular invasion is not identified. Tumor stage is classified as pT3 pN2 (5/23) L1, V0, M1, G3 R0."} +{"pid": "TCGA-B2-3923", "report": "The specimen consists of a right kidney weighing 1,005 grams and measuring 20 x 11 x 8.5 cm. Attached to the kidney is a 7 cm segment of ureter with an average diameter of 0.5 cm. The kidney is surrounded by a significant amount of perirenal adipose tissue, which was mostly separated from the kidney itself. At the hilum, multiple stapled vessels are present. The renal capsule is smooth to slightly irregular and easily separable from the underlying cortex. On sectioning, there is a well-defined, necrotic and calcified mass measuring 11.8 x 10.5 x 8.5 cm located in the inferior pole. The mass does not appear to breach the capsular surface and shows central areas of calcification. The renal pelvis appears flat and tan-white. The remaining renal parenchyma is uniformly red-brown with a distinct corticomedullary junction and a maximum cortical thickness of 1.2 cm. No other lesions or abnormalities are observed. Representative sections were submitted in nine blocks, including vascular and ureteral margins, full thickness of the mass to the capsular surface, transition from mass to normal parenchyma, renal pelvis, and random areas of normal kidney tissue.\n\nMicroscopically, the lesion is composed of nests and broad sheets of large polygonal cells with abundant cytoplasm, distinct cell borders, and perinuclear halos. The nuclei are uniform in appearance, and calcifications are prominent. Colloidal iron staining highlights the cytoplasmic characteristics. Histologic evaluation indicates no vascular invasion. The surgical margins are free of involvement. No lymph nodes or adrenal gland tissue were submitted for examination. The uninvolved kidney tissue appears histologically normal. The tumor measures 11.8 cm in greatest dimension and is confined entirely within the kidney."} +{"pid": "TCGA-33-AASL", "report": "The surgical specimen from the right upper lobe of the lung consists of a 15 x 11 x 6 cm piece weighing 360 grams. A solid, elevated lesion measuring approximately 7 cm in diameter is present on the anti-hilar surface. The cut surface of this lesion is firm with a yellow-white appearance. The pleural surface overlying the lesion has been marked with black ink, and the lesion appears to be in contact with the pleura but without evidence of scarring or distortion. Two stapled margins are present: the superior margin measures 5.5 cm in length, and the inferior margin measures 5 cm. The lesion is located approximately 0.5 cm from the superior margin and 1 cm from the inferior margin. Grossly visible bullae are noted on the apical posterior surface of the lung. Five percent of the specimen was submitted for microscopic evaluation, including sections of hilar lymph node, bronchial and vascular margins, superior and inferior surgical margins, the area of the lesion adjacent to the pleura, bullae, and normal lung tissue.\n\nLymph nodes were also submitted from multiple soft tissue sites, including R-11, R-4, Station 7, and R-10. Each of these specimens consisted of a single piece of fibroadi\nThe parietal pleural margin specimen includes a thin, soft tissue fragment measuring 9 x 2 x 0.4 cm with thickness at one end. Serial sectioning reveals a fibrous interior with a small firmer nodule measuring 0.5 cm in width and 0.3 cm in height. The entire specimen was submitted for evaluation."} +{"pid": "TCGA-KS-A41F", "report": "A 23-gram thyroid specimen was received, consisting of a right lobe measuring 4.6 x 2.8 x 1.3 cm and a left lobe measuring 4.2 x 2.6 x 1.6 cm. The thyroid is covered by a pink-grey capsule. The right lobe is inked black and the left lobe is inked blue. Sectioning revealed a glistening red cut surface. A 2.2 x 1.9 x 1.7 cm tan-pink lesion was identified in the superior pole of the left lobe, adjacent to the capsule. A 2 x 1.5 x 0.5 cm portion of adipose tissue is present adjacent to the left lobe. Seven possible lymph nodes were identified, with the largest measuring 0.5 cm. Histologic examination of the thyroid showed well-differentiated cellular features. The lesion is in close proximity to the inked surgical margin. Four of the seven possible lymph nodes show evidence of involvement."} +{"pid": "TCGA-FD-A6TK", "report": "A 4.5 x 4.0 x 1.5 cm aggregate of lobulated yellow fibrofatty tissue labeled as left pelvic lymph nodes was received. Dissection revealed multiple lymph nodes ranging from 0.2 to 2.5 cm in greatest dimension. All nodes were submitted for evaluation and no abnormality was identified. A segment of distal left ureter measuring 0.7 cm long with attached adipose tissue was received. Histologic examination revealed involvement by non-invasive malignant cells, confirmed by immunohistochemical staining showing positivity for CK20 and p53 in the neoplastic cells. The right pelvic lymph node specimen consisted of a 5.0 x 4.5 x 2.7 cm mass of fibrofatty tissue containing lymph nodes ranging from 0.5 to 3.5 cm in size; all were evaluated and showed no abnormal findings.\n\nThe cystoprostatectomy specimen included a bladder, prostate, seminal vesicles, and vas deferens. The bladder demonstrated an ulcerated lesion measuring 4.5 x 1.8 cm involving the right posterior, lateral, and anterior walls. Serial sectioning revealed infiltration into the muscularis propria and extension into surrounding soft tissue. A second ulcerated area measuring 1.4 x 0.7 cm was identified on the left posterior/lateral wall. Invasion depth and proximity to margins were documented, though exact measurements were not fully recorded. The prostate was opened along the urethra and serially sectioned; involvement was noted at the prostatic urethra with infiltration into the stroma. Margins of the distal urethra, right ureter, and soft tissue or serosa were free of involvement. Both seminal vesicles and vasa deferentia showed no evidence of infiltration.\n\nEvaluation of margins revealed involvement at the left ureter without evidence of invasive disease. Twenty-five lymph nodes were assessed across both pelvic regions and none contained abnormal cells. Staging parameters indicated infiltration beyond the organ wall into adjacent soft tissue, with no lymph node involvement. Multiple sections of the prostate and bladder were submitted for microscopic evaluation, including tandem and full-thickness sections of the involved areas. No other significant findings were reported in the uninvolved portions of the bladder dome, anterior wall, or trigone."} +{"pid": "TCGA-FK-A3SG", "report": "SURG PATH REPORT. 1st Specimen collected on. FINAL DIAGNOSIS. 1) RIGHT THYROID (LOBECTOMY): The specimen consists of a right lobectomy. Histologic evaluation reveals a lesion measuring 3.2 cm in greatest dimension. The lesion demonstrates multifocal growth. Lymph node examination shows metastatic involvement in 6 of 14 lymph nodes. See part 3. Extent of invasion assessment indicates the primary tumor is confined to the thyroid gland, measuring greater than 2 cm but less than 4 cm (pT2). Regional lymph node staging reveals metastasis to cervical or mediastinal lymph nodes (pN1b). Distant metastasis could not be assessed (pMx). Surgical margins are uninvolved, with the invasive component located less than 1 mm from the anterior and lateral margins. No evidence of vascular or lymphatic invasion is identified. No additional significant pathologic findings are noted. 2) LEFT THYROID (LOBECTOMY): Histologic examination of the left lobe is unremarkable, with no tumor identified. All four lymph nodes examined were negative for tumor involvement. Lymph node dissection from the central compartment reveals five of nine lymph nodes positive for metastatic involvement. Parathyroid and thymic tissues are identified within the specimen. Final Report Signed on. Unofficial lab results - do not file in patient chart. Contact medical records for official chart copy. UNLESS OTHERWISE NOTED. RESULTS PERFORMED AT:"} +{"pid": "TCGA-C5-A1BK", "report": "The specimen measured up to 5 cm in greatest dimension and was received from the right cervix. The tumor was found to invade approximately 10 mm in depth, involving about one-third of the normal tissue thickness. The stromal invasion was described as moderate with focal areas of concern identified. No deep or vaginal margin involvement was noted. Evaluation of the parametrial tissue showed no evidence of disease. The uterus and vagina margins were clear. A total of 10 lymph nodes were examined from the right pelvic region; none contained any malignant cells. Additionally, lymph nodes from the left external iliac and left common iliac regions were assessed, with no evidence of malignancy identified. The final assessment included a review of all specimens, with no involvement seen in the left obturator or other non-tissue sites. A total of 7 lymph nodes were retrieved from the left common iliac area. All findings were confirmed upon final review."} +{"pid": "TCGA-5P-A9K9", "report": "The specimen shows a neoplasm composed of cells arranged in a solid growth pattern. The tumor cells exhibit marked nuclear atypia and increased mitotic activity. Histologic evaluation confirms high-grade features with loss of typical architectural patterns. The lesion demonstrates deep invasion into the surrounding tissue, with involvement of adjacent structures. No lymph node metastases were identified. Based on histologic features and extent of spread, the case is classified as advanced stage."} +{"pid": "TCGA-38-A44F", "report": "The specimen consists of a wedge resection from the right upper lobe of the lung. A mass measuring 3.2 x 2.4 x 1.5 cm is present within the lung tissue, located 0.4 cm from the stapled parenchymal margin and in close proximity to the pleura, though there is no gross evidence of pleural invasion. The mass appears tan and firm with central cavitation, and is surrounded by normal-appearing lung tissue. The surgical margins are negative. Histologically, the lesion demonstrates a mix of growth patterns, including acinar and micropapillary features, with moderate to poor differentiation noted. No vascular, arterial, lymphatic, or perineural invasion is identified. There is no evidence of in situ carcinoma or multifocality.\n\nEvaluation of lymph nodes in this specimen reveals no presence of tumor cells. One lymph node is examined and found to be free of involvement. Additionally, fibroadipose tissue from Station 4 lymph node removal contains no lymph nodes or tumor. Adjacent lung tissue shows emphysematous changes, bronchiolar metaplasia, and focal fibrous remodeling. Based on available data, staging is assigned as pT2a pN0. Molecular studies have been initiated and will be reported separately."} +{"pid": "TCGA-PJ-A8JU", "report": "The specimen consists of a right radical nephrectomy weighing 643 grams. The kidney measures 9 x 6.5 x 5.5 cm with surrounding perinephric fat ranging from 0.8 to 6 cm. No adrenal gland was present in the specimen. A centrally located mass is identified in the mid pole of the kidney. It measures 3.5 x 3 x 2.5 cm and is described as soft, nodular, well-circumscribed, and dark red to red-yellow in color. The lesion compresses the renal pelvis but does not grossly invade it. It approaches within 0.1 cm of the cortical surface and within 0.6 cm of Gerota's fascia, which was inked during dissection.\n\nMicroscopic evaluation reveals a histologic grade 2 lesion based on nuclear characteristics. The tumor is solitary within the specimen and does not show direct extension beyond the kidney. There is no sarcomatoid component, no lymphovascular invasion outside of the renal vein, and no involvement of the renal vein. All surgical margins are free of malignant cells. Lymph nodes could not be assessed.\n\nNon-neoplastic portions of the kidney show no significant pathology. Cortical thickness in non-involved areas measures between 0.6 and 1.1 cm. Gross examination of the ureter and blood vessels at the hilum shows patent lumina without evidence of tumor involvement.\n\nSections were taken from multiple regions including the ureter and vascular margins, the mass with adjacent normal kidney and renal pelvis, the inked margin near Gerota\u2019s fascia, and normal kidney tissue for comprehensive microscopic analysis. Based on AJCC staging criteria, the primary tumor is classified as pT1a and lymph node status is designated as pNX due to insufficient material for assessment. Distant metastasis was not applicable."} +{"pid": "TCGA-GM-A2DC", "report": "The right breast segmental mastectomy specimen contains a well-circumscribed tan-pink mass measuring 1.8 x 1.5 x 0.9 cm, located less than 0.1 cm from the anterior margin and 0.4 cm from the deep margin. A fibrotic area measuring 2.0 x 2.0 x 3.5 cm is noted on the medial side of the mass. Histologic evaluation shows intermediate nuclear grade with Nottingham histologic grade 2 features. The tumor measures 1.8 cm in the largest dimension and demonstrates lymphovascular invasion. The invasive component extends to less than 1 mm from the anterior margin and 5 mm from the deep margin; however, after re-excision, no tumor was found at the final surgical margins. Adjacent benign findings include focal atypical ductal hyperplasia, atypical lobular hyperplasia, and columnar cell change.\n\nIn the right axillary contents, one of twelve lymph nodes shows involvement with the largest metastasis measuring 2.0 cm; no extranodal extension is identified. An additional nine level II lymph nodes are negative for involvement. Additional excisions from new superior, inferior, and lateral superficial margins all show only benign fibroadipose tissue without evidence of tumor.\n\nThe original specimen consists of an oriented segmental mastectomy measuring 5.5 x 5.1 x 3.3 cm, with nine slices cut from superior to inferior. The mass and surrounding fibrotic area are entirely submitted for analysis. The right axillary dissection specimen measures 13.0 x 5.0 x 0.8 cm, with lymph nodes ranging in size from 0.2 x 0.2 x 0.2 cm to 2.0 x 1.5 x 1.0 cm. The right axillary level II specimen measures 4.0 x 2.0 x 0.4 cm, with six lymph nodes identified ranging from 0.2 x 0.2 x 0.2 cm to 1.5 x 0.8 x 0.7 cm. All other excised margins are composed of fibroadipose tissue and are free of tumor."} +{"pid": "TCGA-98-A53B", "report": "A total of 15 lymph node specimens were evaluated from levels V through XIII, with all lymph nodes found to be negative for malignancy. The lymph nodes varied in size and were described as anthracotic or tan-yellow in appearance. These included single or multiple fragments submitted in total for analysis.\n\nA specimen from the left upper lobe of the lung was examined, revealing a mass measuring 4 cm in greatest dimension. Microscopic evaluation showed this lesion to be moderately differentiated without evidence of invasion into the pleura. Surgical margins, including the bronchial margin and parenchymal margins, were free of tumor involvement. Additionally, two perihilar lymph nodes were also negative for malignancy.\n\nThe surrounding lung tissue demonstrated significant interstitial fibrosis, scattered lymphoid aggregates, and mild medial hypertrophy of medium-sized arteries. There were also areas of firm parenchyma near the mass, along with scattered tan-green or black grainy regions, none of which formed distinct masses. No granulomas were identified. The visceral pleura overlying the mass appeared intact, with no breach observed.\n\nStaging assessment indicated no regional lymph node metastasis (pN0) and the primary tumor was classified as pT2a based on its size and relationship to surrounding structures."} +{"pid": "TCGA-55-8090", "report": "The procedure involved a right thoracoscopy with resection of a lung mass from the right lower lobe. The specimen, consisting of a wedge of lung measuring 5 x 4 x 2.5 cm, contained a solid tan-white mass measuring 2.5 x 2 x 2 cm. The sutured margin was negative, with tumor located 3 mm from the margin. The serosal surface appeared involved by the lesion. Frozen section analysis was performed, and representative sections were processed for microscopic evaluation.\n\nMicroscopic examination revealed a moderately differentiated lesion within the lung parenchyma, measuring 2.5 cm in greatest dimension. The lesion was limited to the lung and associated with subpleural scarring. Resection margins were free of tumor involvement. Lymphovascular invasion was identified. A prior biopsy from the left lower lobe showed morphologically similar findings. The case was reviewed and confirmed by a consulting physician."} +{"pid": "TCGA-55-6985", "report": "The surgical specimen included a lymph node from the pulmonary ligament level 9, which was negative for malignancy. Four lymph nodes from the PA window (level 5) were identified, all negative for malignant cells. Three hilar lymph nodes were also examined and showed no evidence of malignancy. The left upper lobe specimen demonstrated a moderately differentiated histologic type. The tumor measured 2.0 cm in greatest dimension and was located centrally within the lobe. It did not penetrate the pleural surface but was in close proximity to it. The mass was found 4 cm from the bronchial resection margin and 6 cm from the apical portion of the lung. The bronchial stump measured 1.5 x 0.3 cm, with blood present in the lumen. The pleural surface overlying the tumor was marked and showed no definitive invasion. The remaining lung tissue appeared unremarkable without additional nodules or masses. A total of seven regional lymph nodes were examined, none showed involvement. Lymphovascular, venous, and arterial invasion were not identified. The surgical margins were free of invasive disease. Distant metastasis could not be assessed based on the current specimen."} +{"pid": "TCGA-FD-A3SQ", "report": "A 0.7 cm segment of the right distal ureter was examined and showed no evidence of tumor or dysplasia. A left pelvic lymph node dissection specimen measuring 4.0 x 3.0 x 1.0 cm contained two out of eight lymph nodes with metastatic involvement, including extranodal extension. The right pelvic lymph nodes, in a 7.0 x 5.0 x 2.0 cm specimen, included two out of thirteen lymph nodes with similar findings, also showing extranodal extension. The left distal ureter biopsy, measuring 0.9 cm in length, demonstrated no tumor or dysplastic changes.\n\nOne of eight left pelvic lymph nodes showed metastatic involvement without extranodal extension. A cystoprostatectomy specimen included a bladder lesion measuring 3.8 cm located on the left lateral and posterior walls. Histologic evaluation revealed high-grade cellular features with invasion into the extravesicular fat. The lesion was ulcerated and associated with a marked granulomatous reaction, suggestive of prior treatment effect. Ureteral and distal urethral margins were negative for involvement.\n\nLymph node analysis from multiple sites showed five out of 29 nodes with metastatic involvement. Tumor staging was determined as pT3a, N2, MX. In the prostate, histopathology showed a low-grade adenocarcinoma with a Gleason score of 6 (3+3), limited to the peripheral zone on the right side, involving approximately 1% of the gland. No perineural invasion was observed, and all surgical margins, including the seminal vesicles, were negative. Lymph node evaluation for prostatic involvement was also negative, with staging at pT2a, N0, MX. Multiple biopsies of the ureteric regions were unremarkable for neoplastic changes."} +{"pid": "TCGA-CV-7238", "report": "A left partial glossectomy specimen measured 8.0 x 3.0 x 2.5 cm and contained a white, firm lesion measuring 3.4 cm in greatest dimension. The lesion demonstrated an infiltrative growth pattern with thick cords greater than four cells in diameter. Invasion was present with a depth of 1.4 cm. Moderate perineural invasion was noted, while vascular invasion was absent. A moderate lymphocytic infiltrate was observed at the tumor interface. Margins were evaluated with inked orientations: the lateral margin was within 0.7 cm of the tumor, the medial margin within 1.0 cm, and the deep margin within 2.2 cm. Shaved mucosal margins and perpendicular sections were submitted for assessment. Severe dysplasia was identified at the posterolateral margin.\n\nAdditional specimens from left selective neck dissections included multiple lymph nodes across levels I (6 nodes), II (10 nodes), III (18 nodes), and IV (9 nodes). No suspicious features were identified in any of the lymph nodes. Fibrofatty and glandular tissues from each level were sectioned and submitted in entirety. Specimens from posterior gingival and pharyngeal margins showed no concerning histologic changes. All tissue assessments were based on frozen section analysis and corresponding permanent sections."} +{"pid": "TCGA-ET-A39R", "report": "The specimen consisted of a total thyroidectomy with central neck dissection, along with excised lymph nodes. The first lymph node specimen, located at the Delphian site, and associated fibroadipose tissue were negative for tumor. Similarly, the left enlarged inferior parathyroid specimen, including one lymph node and surrounding fibroadipose tissue, was also negative for tumor.\n\nThe thyroid specimen showed a lesion measuring 1.8 centimeters in the right lobe. Histologic evaluation revealed multifocal involvement, primarily in the right lobe, with additional small parenchymal foci identified in the left lobe. No tumor was identified in any of the 18 lymph nodes examined, and there was no evidence of extranodal extension.\n\nPathologic staging indicated pT1 based on tumor size less than or equal to 2 centimeters, and pN0 as no regional lymph node metastasis was found. Distant metastasis could not be assessed (pMx). Margins were involved by invasive carcinoma on the right side. There was no evidence of venous or lymphatic invasion. Additional findings included lymphocytic thyroiditis and the presence of parathyroid gland tissue near the lateral aspect of the right inferior lobe."} +{"pid": "TCGA-KL-8327", "report": "Clinical findings: A right renal mass was identified in a patient investigated for right pelvic pain. The right kidney specimen measured 12.0 x 7.0 x 5.0 cm and weighed 420 grams. A well-circumscribed, pink-dark red, homogeneous, soft mass measuring 5.0 x 5.2 x 4.3 cm was found within the kidney, located approximately 0.5 cm from the capsule in the center. The tumor did not extend into the renal pelvis or invade the renal vein. All surgical margins were free of involvement. Adjacent to the tumor, a small cystic lesion measuring 1.0 x 0.8 x 0.1 cm was noted, containing dark brown fluid. The remainder of the kidney appeared unremarkable. No adrenal tissue was submitted for evaluation.\n\nLymph node assessment: Paracaval lymph nodes were submitted and measured 2.2 x 1.4 x 0.8 cm in aggregate. Histologic examination revealed only benign lymphoid tissue; no abnormal cellular infiltration was identified.\n\nHistologic evaluation of the tumor showed features consistent with a cortical neoplasm. Immunohistochemical stains were performed, including CK7 and CD10, with results not showing specific reactivity. Frozen section analysis supported the final histologic interpretation. The tumor was confined within the renal capsule without vascular or ureteral involvement. A separate cystic structure within the kidney was non-neoplastic."} +{"pid": "TCGA-55-6983", "report": "A total of one slide from the inferior pulmonary ligament lymph node shows a benign lymph node without evidence of tumor. One slide from the subcarinal lymph node contains two benign lymph nodes, also without evidence of tumor. Two slides from the hilar lymph node were examined; one slide showed a focus suspicious for tumor, but the smear at the time of frozen section did not show any malignant cells. In specimen D, six lymph nodes were identified in one slide, with two containing tumor involvement. Fourteen slides from the lung tissue showed an infiltrating mucinous tumor involving the lung. The tumor measured 8.5 cm in greatest dimension and extended to the visceral pleura but did not penetrate through it. Small vessel invasion was present, while large vessel invasion was not identified. The tumor demonstrated well to moderately differentiated features. Immunostains performed on the lung tissue showed positivity for CK7 and TTF-1, and negativity for CK20. These findings support a primary pulmonary origin. Bronchial and vascular resection margins were free of tumor. Additionally, within the surrounding non-tumor lung tissue, there were multiple areas of inflammation and fibroblastic proliferation centered around bronchioles, associated with destruction of bronchiolar structures. No assessment was made regarding distant metastasis or direct extension beyond the resected specimen."} +{"pid": "TCGA-FE-A3PA", "report": "The specimen consists of a total thyroid excision measuring 6.0 x 5.1 x 3.0 cm and weighing 44 grams. Gross examination reveals one lobe largely replaced by a multinodular tumor measuring approximately 4 x 3 x 3 cm, with a pale pink-tan, firm appearance. The contralateral lobe contains a 3.0 x 1.5 x 1.5 cm area of granular, beefy-appearing thyroid tissue that is relatively normal in consistency and color. No lymph nodes or parathyroid glands are identified on initial inspection.\n\nMicroscopic evaluation confirms the presence of a neoplastic process involving papillary architecture with features consistent with follicular variant morphology. The tumor demonstrates invasion of the surrounding capsule with focal extension beyond the capsular margin. Margins are closely approached by neoplastic cells, with distance to the inked margin measuring less than 0.05 cm in at least one focus.\n\nA frozen section was performed intraoperatively and showed findings consistent with the final microscopic assessment. Tissue from the multinodular lesion was submitted for analysis and confirmed similar histologic features. The tumor is multinodular with a maximum dimension of approximately 4 cm. No other significant pathological findings are noted in the submitted tissue."} +{"pid": "TCGA-CN-5358", "report": "The patient underwent a radical resection of the floor of the mouth with marginal mandibulectomy. A lesion measuring 2.5 cm in greatest dimension was identified in the anterior floor of the mouth, extending into sublingual gland tissue. The depth of invasion measured approximately 0.8 cm from the mucosa, with closest margins measuring 2 mm. No bone invasion was identified. Perineural invasion was present; no angiolymphatic invasion was observed. All surgical margins were free of tumor.\n\nA total of 57 lymph nodes were examined across bilateral neck dissection specimens, including levels 1A, 1B, 2, 3, and 4. No lymph node involvement was identified. Additional tissue samples from the left and right lateral floor of the mouth showed no evidence of residual disease.\n\nHistologic evaluation demonstrated moderately differentiated invasive tumor. Immunohistochemical staining for p16 was negative, and in situ hybridization for HPV DNA was also negative. An EGFR immunostain showed strong positivity (3+). FISH studies for EGFR and c-MET were negative for gene amplification.\n\nMultiple frozen sections and permanent slides were reviewed, including assessment of deep, lateral, and posterior margins, all of which were negative. Tissue fixation time ranged between 2 and 84 hours. All tests were developed and validated by the laboratory in compliance with CLIA regulations for high-complexity testing."} +{"pid": "TCGA-SW-A7EA", "report": "The surgical specimen includes a portion of the stomach measuring 16 cm in combination with the greater omentum. An ulcerative lesion with irregular borders measuring 3.0 x 4.0 cm was identified macroscopically, located 1.0 cm from the resection margin and not infiltrating the gastric wall. The greater omentum appears intact. A total of 11 lymph nodes were examined, including 8 from the greater curvature and 3 from the lesser curvature. No metastases were found in the lymph nodes. Microscopic evaluation revealed undifferentiated adenocarcinoma with signet ring cell features. The tumor was observed to invade through the muscularis propria. Resection margins and the greater omentum showed no involvement. The pathological staging is T2a NO M0."} +{"pid": "TCGA-AO-A03T", "report": "The clinical history notes a palpable mass in the left breast with prior core biopsy findings. Specimens submitted include three sentinel lymph nodes from level one of the left axilla, a left breast specimen, and additional lymph nodes from levels one and two of the left axilla.\n\nExamination of the first sentinel lymph node, measuring 1.2 x 1.0 x 0.4 cm, revealed involvement with one out of one node, without evidence of extranodal extension. The second sentinel lymph node, measuring 1.0 x 0.5 x 0.5 cm, showed no signs of involvement. The third sentinel lymph node, measuring 1.5 x 0.8 x 0.8 cm, also showed involvement with one out of one node, and no extranodal extension was observed.\n\nThe left breast specimen measured 21.5 x 17.5 x 4 cm with an overlying skin ellipse of 9.5 x 3 cm. A centrally located white-tan firm lesion measuring 2.5 x 2.5 x 2 cm was identified, extending into the upper outer quadrant and located 1.1 cm from the deep margin. Histologically, the lesion showed high-grade features with limited tubule formation and moderate variation in nuclear size and shape. Ductal intraepithelial neoplasia was also present, characterized by solid type growth with intermediate nuclear grade and moderate necrosis. This component accounted for up to 25% of the total tissue and was found both admixed with and separate from the main lesion. Both components were located in the upper outer quadrant and central area, with no involvement of the nipple, surgical margins, or skin. Vascular invasion was noted.\n\nIn the non-neoplastic areas, changes related to prior biopsy, stromal fibrosis, adenosis, and fibrocystic alterations were observed. Immunohistochemical analysis of the invasive component showed strong nuclear staining for estrogen receptor (95% with moderate intensity) and moderate staining for progesterone receptor (60% with moderate intensity). HER2 testing was negative using an FDA-approved method, and results were interpreted according to standard guidelines.\n\nNine additional lymph nodes from levels one and two of the left axilla were examined and showed no signs of involvement.\n\nGross evaluation of the surgical specimen included representative sections from multiple areas including the tumor site, surgical margins, and surrounding quadrants. Intraoperative frozen section analysis of the sentinel lymph nodes confirmed the findings seen on permanent sections."} +{"pid": "TCGA-EL-A3TA", "report": "The surgical specimen included a fragment of parathyroid tissue, measuring 0.5 x 0.2 x 0.2 cm, which showed no evidence of neoplasm. The thyroid gland was submitted in multiple sections. The right lobe measured 6.0 x 2.5 x 1.0 cm, the left lobe 7.5 x 3.0 x 2.0 cm, and the isthmus 2.2 x 1.0 x 1.0 cm. Within the left lobe, there was a well-defined nodule measuring 4.0 x 2.5 x 2.0 cm with a solid and papillary appearance on sectioning, showing focal hemorrhage. The tumor was in direct contact with the surface at multiple points. No abnormality was identified in the right lobe or isthmus. Margins of resection were free of involvement.\n\nA soft tissue mass located inferior to the left lobe measured 4.5 x 2.0 x 1.0 cm. Multiple lymph nodes were identified in association with the isthmus (0.3 to 0.9 cm) and in the soft tissue inferior to the left lobe (ranging from 0.2 to 0.9 cm). Microscopic evaluation revealed chronic inflammation in the isthmus and a ruptured sebaceous cyst in the right neck specimen. One lymph node associated with the isthmus showed xanthogranulomatous change. Immunostains demonstrated scattered microscopic foci of involvement in three lymph nodes associated with the isthmus. No extracapsular extension was observed.\n\nThe right lobe contained an adenomatoid nodule. Twelve lymph nodes from this region showed no evidence of involvement. The submitted skin ellipse from the right neck measured 3.2 x 1.8 x 0.6 cm and included a cystic structure filled with yellow-tan material; histologic examination confirmed a ruptured sebaceous cyst."} +{"pid": "TCGA-A1-A0SQ", "report": "A total of fifteen lymph nodes were examined from the left axilla, including one sentinel lymph node that contained metastatic involvement. The largest metastatic deposit measured 0.5 cm in diameter and was confined within the lymph node without extranodal extension. All other lymph nodes examined were free of tumor.\n\nThe left breast specimen showed a well-defined soft tissue mass measuring 3.8 cm in greatest dimension, located near the deep margin (0.05 cm from margin). Histologically, the tumor demonstrated features consistent with a specific type of invasive carcinoma, grade 2, based on standard grading criteria. This included nuclear grade 3, mitotic count of less than 10 per 10 high power fields, and tubule formation between 10% and 75%. Lymphovascular invasion was present. The tumor was surrounded by normal breast tissue in most directions, with the closest margin at the deep margin (0.05 cm). Other margins were more widely clear, ranging from 0.2 cm to greater than 5 cm.\n\nIn addition to the invasive component, there was a separate in situ component involving ductal structures, which spanned a total of 5.3 cm in contiguous sections. The in situ component was classified as intermediate nuclear grade, solid type, and did not show necrosis. Microcalcifications were identified in association with the invasive component. Margins for the in situ component were all negative, with the closest being 0.5 mm from the deep margin.\n\nThe right breast and bilateral accessory nipple specimens showed no evidence of malignancy. Additional findings in the right breast included non-proliferative fibrocystic changes and focal lactational change. No significant pathology was identified in the left or right nipple specimens.\n\nImmunohistochemical analysis of hormone receptor status showed strong positivity for estrogen receptors and moderate to strong positivity for progesterone receptors in the tumor cells. HER2/neu testing by immunohistochemistry showed a score of 1+, indicating no overexpression. FISH testing was not performed as the score was below the threshold for indeterminate results.\n\nStaging was based on the size of the invasive tumor and the presence of metastasis in one lymph node. All surgical margins were microscopically negative, though the deep margin was very close to the invasive tumor."} +{"pid": "TCGA-CV-A6JO", "report": "A 172.5 cm, 86.1 kg male with a body surface area of 2.03 m\u00b2 underwent neck dissection and other surgical procedures. Multiple lymph node specimens were evaluated from various anatomical levels on both sides of the neck.\n\nOn the right side: In level IB, one of five lymph nodes showed involvement, with extranodal extension present. In level IIA, five of fourteen lymph nodes were involved, also with extranodal extension. Level IIB contained two lymph nodes, both uninvolved. In level III, no lymph nodes were identified within the fibroadipose and muscular tissue examined. In level IV, two of ten lymph nodes were involved, with extranodal extension noted. An additional level IB dissection on the right superior region showed one of four lymph nodes involved.\n\nOn the left side: Level III dissection revealed six lymph nodes, all uninvolved. In level IIA, one of the lymph nodes showed involvement with presence of extranodal extension. Level IIB dissection included five lymph nodes, none of which were involved.\n\nNerve specimens including the distal lingual nerve (left), proximal right 12th nerve, proximal right lingual nerve, and right proximal 9th nerve were all negative for any abnormal cellular infiltration.\n\nSoft tissue and mucosal biopsies from the mandibular gingiva, labial mucosa, and retromolar trigone showed squamous mucosa with varying degrees of inflammation; no abnormal cellular infiltration was identified. The retromolar trigone specimen showed focal atypical epithelial nests, but no tumor involvement.\n\nThe primary resected specimen was a near-total glossectomy measuring 12 x 6 x 7 cm. A 6.5 cm ulcerating lesion was identified grossly on the right side of the tongue, crossing midline. Histological evaluation described the lesion as well to moderately differentiated with an infiltrative border pattern. The depth of invasion measured 3.5 cm. No perineural or vascular invasion was observed. Margins were free of involvement by at least 0.5 cm circumferentially.\n\nAdditional tissue specimens including skeletal muscle from the left base of the tongue were negative for tumor involvement. Multiple fibroadipose and necrotic lymph node specimens were submitted for analysis across all levels of dissection, with variable findings of involvement in specific regions.\n\nAll other submitted tissues, including ganglion cells, nerves, and mucosal samples, were negative for tumor."} +{"pid": "TCGA-E9-A229", "report": "The specimen consisted of breast tissue from the right lower inner quadrant. The tumor measured 2 x 1.5 x 2 cm and was grossly evident. Histologic evaluation revealed moderately differentiated infiltrating cells arranged in irregular tubular formations. Nuclear pleomorphism and mitotic counts were not specified. Lymph node status, tumor extent, margins, and response to neo-adjuvant treatment could not be determined based on the available information."} +{"pid": "TCGA-AR-A5QN", "report": "A. Lymph nodes, left tracheoesophageal groove, excision: Multiple (3) lymph nodes are negative for tumor.\n\nB. Thyroid, left, total lobectomy: A lesion measuring 3.3 x 3.2 x 1.8 cm is identified.\n\nC. Breast, right, simple mastectomy: A lesion measuring 0.7 x 0.6 x 0.5 cm is present at the previous biopsy site in the upper outer quadrant. The remainder shows non-proliferative fibrocystic changes. Multiple (2) right axillary lymph nodes are negative for tumor.\n\nD. Breast, left, inferior flap, biopsy: Negative for tumor.\n\nE. Breast, left, inferior margin at 6 o'clock, excision: Cellular involvement is identified.\n\nF. Breast, left, new inferior margin, re-excision: Negative for tumor.\n\nG. Breast, left, modified radical mastectomy: A lesion with Nottingham grade II features (tubules 3/3, nuclei 2/3, mitoses 1/3; Nottingham score 6/9) forms multiple (6) masses located in various regions of the left breast: lower inner quadrant (0.7 x 0.6 x 0.4 cm and 1.4 x 1.0 x 0.5 cm); inferior/central (3.2 x 2.2 x 1.4 cm); central (0.6 x 0.5 x 0.5 cm); and lower outer quadrant (1.0 x 0.8 x 0.8 cm and 0.5 x 0.4 x 0.4 cm). Additional findings include intraductal and intra-lobular cellular abnormalities confined to the breast parenchyma. Non-neoplastic tissue demonstrates non-proliferative fibrocystic changes. A secondary biopsy site in the upper outer quadrant exhibits biopsy-related alterations. There is no involvement of the nipple, overlying skin, or underlying chest wall. A pigmented lesion measuring 1.5 x 1.3 x 0.3 cm is observed on the lateral aspect of the skin. All surgical margins, following two re-excisions of the inferior margin, are free of cellular infiltration by 1.2 cm at the deep margin. Of the axillary lymph nodes examined (10 of 19), metastatic involvement is identified. The largest involved node measures 11.0 mm. No extranodal extension is observed. Immunohistochemistry testing with MIB-1 has been requested on paraffin-embedded tissue. This report reflects findings based on gross examination and frozen section histologic evaluation. Permanent Hematoxylin and Eosin (H&E) sections were reviewed and confirm these observations. Any significant discrepancies noted upon permanent section review will be communicated in a revised report."} +{"pid": "TCGA-CV-7423", "report": "The specimen consists of a right partial glossectomy with no evidence of tumor at the peripheral or deep margins of resection. The maximum depth of invasion measures 0.8 cm in an area where the overall specimen thickness is 1.4 cm. There is no clear evidence of vascular, lymphatic, or perineural invasion. Two teeth were also submitted for examination, though only gross evaluation was performed."} +{"pid": "TCGA-97-8177", "report": "The surgical specimen includes a left lower lobectomy and multiple lymph node stations (5, 7, 11, and 12). The resected lobe measures 15 x 13 x 5 cm. A single tumor mass measuring 4 cm in greatest dimension (with additional dimensions of 4 x 3 cm) is identified in the lower lobe, located 1.2 cm from the bronchial resection margin. The tumor is firm, grey-white, and has ill-defined borders. It is associated with a puckered area on the pleural surface. Histologically, the lesion shows a mixed growth pattern with papillary and acinar features, and is predominantly moderately differentiated. Small foci of pleomorphic, poorly differentiated cells are also present. \n\nImmunohistochemical staining demonstrates positivity for TTF1, supporting a pulmonary origin. Vascular invasion is present, as well as perineural infiltration. The bronchial and vascular margins are free of invasive carcinoma. Lymph-vascular invasion is noted. Multiple peribronchial anthracotic lymph nodes are found in the hilar region, ranging in size from 0.2 to 0.7 cm, and all are negative for involvement. All submitted lymph node stations (5, 7, 11, and 12) are also negative for involvement.\n\nMolecular analysis reveals a positive L858R mutation in exon 21 of the EGFR gene, which is associated with responsiveness to tyrosine kinase inhibitors. KRAS mutational analysis shows no mutations at codons 12 or 13. The tumor is staged as pT2a, based on its size and characteristics, and pN0, as there is no regional lymph node involvement. Additional non-tumor findings include emphysema, a small intraparenchymal scar, and a meningoendothelial-like nodule."} +{"pid": "TCGA-BP-4964", "report": "The right kidney specimen measured 9.6 x 6.6 x 4.0 cm and included attached ureter and renal vessels. A well-circumscribed mass measuring 3.9 x 3.0 x 2.8 cm was identified in the mid-region of the kidney adjacent to the renal pelvis. The mass exhibited a variegated yellow and hemorrhagic appearance with cystic changes, and while it abutted the renal sinus, no direct invasion was observed. The tumor was confined within the kidney and did not extend into surrounding fat or invade the renal vein. Surgical margins were free of involvement.\n\nHistological evaluation revealed nuclear features corresponding to a nuclear grade of II/IV. Surrounding non-neoplastic kidney tissue showed focal chronic inflammation. No lymph nodes were identified within the perinephric fat.\n\nA separate specimen containing precaval and paracaval lymph nodes was submitted, consisting of 11 lymph nodes, none of which showed evidence of involvement. \n\nThe right adrenal gland, along with attached adipose tissue, measured 7.0 x 2.5 x 0.4 cm and weighed 10.5 g. A single benign lymph node was found on the surface of the adrenal gland. Microscopic examination of the adrenal gland revealed no significant abnormalities in the cortex or medulla.\n\nRepresentative sections from all areas, including the tumor, adjacent kidney tissue, ureteral and vascular margins, and lymph nodes, were submitted for analysis. Intraoperative frozen section and subsequent permanent histology findings were consistent."} +{"pid": "TCGA-B5-A0JZ", "report": "The specimen consists of a hysterectomy specimen with attached cervix, along with bilateral salpingo-oophorectomy and lymph node dissection. The uterus weighs 257 grams and measures 11 x 7.5 x 7.5 cm. The endometrial cavity is largely replaced by a white-tan, friable mass measuring approximately 9.5 x 6 cm. The mass approaches within 0.5 cm of both the anterior and posterior aspects of the cervix. The average thickness of the endometrium is 3 cm, with a myometrial thickness of 2 cm. The deepest invasion observed is 1.4 cm into a 2 cm thick myometrial wall. The cervix is submitted in two blocks and shows no involvement. Both ovaries are replaced by cystic structures: the right ovary is represented by a serous-filled cyst (8 x 7 x 7 cm) and the left by a thin-walled, clear fluid-filled unilocular cyst (4.5 x 3.5 x 3 cm). Both fallopian tubes appear grossly unremarkable. The right round ligament specimen contains fibrofatty tissue and is entirely submitted. Lymph node dissections include multiple pelvic and para-aortic sites. In total, 24 lymph nodes are identified across all sites. One metastatic focus is found in the right obturator region, involving one out of five nodes, with a maximum size of 8 mm and no extranodal extension. All other nodes are negative. Specimen margins are free of involvement. Microscopic evaluation confirms full-thickness invasion at the posterior uterine wall. No lymphatic or vascular invasion is identified. Adjacent endometrial tissue shows no specific pathology. Other tissues, including the fallopian tubes and remaining myometrium, show no significant findings."} +{"pid": "TCGA-CV-7242", "report": "A total laryngectomy specimen measuring 7.8 x 4.0 x 4.0 cm was submitted along with bilateral neck dissections involving levels II, III, and IV, as well as a right hemithyroidectomy. An exophytic mass measuring 2.2 cm in greatest dimension was identified in the right transglottic region with an infiltrative border composed of thick cords greater than four cells in thickness. Depth of invasion measured 1.6 cm. No perineural or vascular invasion was observed. Mild lymphocytic infiltration was noted. The tumor abuts cartilage and bone; findings related to this involvement will be detailed in a separate addendum following decalcification.\n\nExamination of lymph nodes revealed no tumor involvement in either neck dissection. On the right side, six level II lymph nodes, seven level III lymph nodes, and three level IV lymph nodes were assessed without evidence of metastasis. On the left side, ten level II lymph nodes, seven level III lymph nodes, and ten level IV lymph nodes were similarly negative for tumor involvement.\n\nThe thyroid specimen showed no tumor involvement. Additionally, posterior cricoid, right lateral pharynx, and left lateral pharynx specimens were examined and found to have benign squamous mucosa without tumor involvement.\n\nMargins including the tracheal margin were clear. The tumor had a yellow-tan cut surface without hemorrhage or necrosis and was located adjacent to the thyroid cartilage, measuring 3.0 cm from the tracheal cartilage resection margin. Multiple lymph nodes were identified within the neck soft tissue and submitted entirely for evaluation. Normal and tumor tissues were preserved for tumor banking."} +{"pid": "TCGA-GF-A769", "report": "The excised lesion from the right calf measured 15.3 x 8.3 cm in size and was received in formalin. A central mass measuring 12.2 x 11.1 x 7.4 cm was identified, with a tan-gray to brown, nodular, fungating appearance. The mass was well delineated and located 2.4 cm from the nearest skin margin. On sectioning, the mass appeared tan to red, firm, heterogeneous, focally hemorrhagic, and partially necrotic (5%), extending to within 2.9 cm of the deep inked margin. Adjacent to this mass, a satellite lesion measuring 6.1 x 3.4 x 2.5 cm was observed. This secondary lesion was tan to red, irregular, multinodular, and well delineated, located just 0.3 cm from the nearest skin margin and 1.1 cm from the deep soft tissue margin. No other lesions were noted upon sectioning.\n\nMicroscopically, the tumor was at Clark's level IV invasion and showed ulceration. The mitotic count was 10 per mm\u00b2. Microsatellitosis and lymphovascular invasion were present. There was no evidence of regression or perineural invasion. Tumor-infiltrating lymphocytes were non-brisk. No precursor lesion was identified. Margins of the excision were free, with the closest distance from the tumor to the peripheral margin being 2 mm. The tumor was excised completely, and representative sections including margins and satellite components were submitted for analysis."} +{"pid": "TCGA-UC-A7PI", "report": "A revised pathology report is provided for a patient who underwent a radical hysterectomy with bilateral salpingo-oophorectomy and lymph node dissection. The specimen included uterine tissue, cervix, bilateral fallopian tubes and ovaries, as well as multiple lymph node groups from the right and left pelvic regions, and right and left common iliac and para-aortic areas.\n\nThe uterus weighed 141 grams and measured 5.5 cm in corpus length, 7.3 cm in sagittal dimension, and 3.5 cm in anterior-posterior diameter. The cervix was attached, along with the vaginal cuff. Both fallopian tubes were patent and unremarkable, measuring 7.5 cm (right) and 6 cm (left), with diameters of 0.5 cm each. The right ovary measured 3 x 1.5 x 1.5 cm and the left ovary was 2.5 x 2.5 x 1.8 cm. A pale tan nodule measuring 2 x 1.3 x 0.7 cm was identified in the left ovary but found to be a cyst upon sectioning.\n\nAn irregular, friable mass measuring 2.6 x 2.4 cm was observed on the anterior surface of the cervix, approximately 1.6 cm from the anterior vaginal margin and 1.5 cm from the posterior vaginal cuff margin. The cervical canal was distorted by the lesion at the distal portion (1.2 cm posterior and 0.7 cm anterior involvement), while the proximal cervical canal and lower uterine segment appeared unaffected. Serial sectioning of the cervical canal revealed a white-tan firm lesion measuring 2.6 x 2.4 x 1.4 cm. No masses were identified in the endometrial cavity, which had a pink lining measuring 0.1 cm thick. A submucosal leiomyoma measuring 0.5 cm was noted within the myometrium, with no hemorrhage or necrosis. The parametrium showed no lymph nodes or tumor involvement.\n\nAll lymph node specimens were submitted for analysis. Right pelvic lymph nodes (19 total) showed no evidence of abnormal cellular infiltration. Right common iliac and para-aortic lymph nodes (6 total) also showed no abnormal findings. Left pelvic lymph nodes (16 total) and left common iliac and para-aortic lymph nodes (2 total) were similarly negative for concerning cellular changes.\n\nMicroscopic evaluation of the lesion showed well-differentiated features with invasive characteristics. The depth of invasion was 1 cm within a cervical thickness of 2.2 cm. There was no involvement of the lower uterine segment or endomyometrium. All surgical margins were free of invasive disease, with the closest distance of invasive lesion to a margin being approximately 1.4 cm. No venous or lymphatic invasion was identified.\n\nAdditional findings included foci of adenomyosis and physiologic cysts in both ovaries. No diagnostic alterations were noted in the fallopian tubes or ovaries. Multiple sections of the cervix, vaginal cuff, parametrium, and endomyometrium were submitted for review.\n\nThis case involved extensive histologic examination and revision of microscopic interpretation. The lesion was reclassified based on its morphology and invasive nature. All lymph node dissections across multiple anatomical regions showed no evidence of metastatic disease."} +{"pid": "TCGA-E9-A1N3", "report": "The specimen consisted of breast tissue from a radical mastectomy. A grossly evident lesion measuring 1.8 x 1 x 1 cm was identified. Histologic evaluation revealed a combination of infiltrating ductal and lobular features. The tumor involved seven regional lymph nodes, all of which were positive for metastatic involvement. No extracapsular invasion was noted in the lymph nodes. Various histologic parameters including tubule formation, nuclear pleomorphism, and mitotic counts were not specified, precluding determination of a Nottingham Histologic Score. Other findings including tumor extent, surgical margins, and response to neo-adjuvant treatment were not specified in the report."} +{"pid": "TCGA-EL-A4K7", "report": "The specimen consists of a total thyroidectomy, including right lobe measuring 4.3 x 2.2 x 1.4 cm, left lobe measuring 4.9 x 3.2 x 3.5 cm, and isthmus measuring 1 x 1.2 x 0.5 cm. The right lobe and isthmus appear unremarkable on gross examination. Within the left lobe, a well-circumscribed, lobular, and granular lesion measuring 2.5 x 2.5 x 1.8 cm is identified in the upper and middle portions. The lesion extends to the anterior, posterior, and lateral capsule. The tumor is inked black and sections are taken from the tumor and surrounding thyroid tissue.\n\nMicroscopic evaluation reveals cellular features including nuclear morphology consistent with specific histologic findings. Extrathyroidal extension is present, involving adjacent skeletal muscle. Lymphovascular invasion is identified. The resection margin is closely approached by tumor. Background thyroid tissue shows evidence of chronic lymphocytic thyroiditis.\n\nLymph node evaluation identifies one involved lymph node in the periglandular region. No extracapsular extension is observed.\n\nA separate specimen of left superior parathyroid consists of two small soft tissue fragments, each less than 0.1 cm in greatest dimension, submitted entirely for frozen section evaluation. Frozen section confirms parathyroid gland."} +{"pid": "TCGA-2Y-A9GW", "report": "The intraoperative pathology report includes two specimens. Specimen A, labeled as a portal hepatic lymph node, consists of a single ovoid lymph node measuring 2.0 x 1.0 x 0.8 cm. Histologic evaluation reveals reactive changes without any evidence of malignancy.\n\nSpecimen B is labeled as a portion of the left lobe of the liver. The specimen consists of a 717 gram unoriented liver tissue measuring 24 x 14 x 7.5 cm. The outer surface is described as variegated with tan-pale-yellow to tan-red-brown areas and multiple small subcapsular hemorrhages. The resection margin is uninvolved and shows tan-red-brown liver parenchyma. An irregular, ill-defined lesion measuring 4.5 x 4.4 cm was identified within the liver tissue. This lesion is firm with a tan-white to tan-pink cut surface and minimal necrosis. It partially involves the capsule and is located 0.7 cm from the closest inked resection margin. Microscopic examination reveals moderately differentiated cellular features. No perineural or angiolymphatic invasion is identified. The surrounding liver tissue demonstrates background changes including steatosis and bile duct abnormalities. All submitted margins are free of tumor involvement.\n\nPathologic staging is determined as T1 N0 MX. The attending pathologist personally reviewed all findings and confirmed the results. Gross description notes that representative sections of the tumor, adjacent margins, and unaffected liver tissue were submitted for further analysis."} +{"pid": "TCGA-EM-A3FN", "report": "The specimen received included a right lower parathyroid biopsy and a total thyroidectomy specimen with a stitch at the upper pole of the left lobe. The thyroid specimen was intact and measured as follows: right lobe 4.0 \u00d7 2.3 \u00d7 1.0 cm, left lobe 4.6 \u00d7 3.2 \u00d7 2.1 cm, and isthmus 1.6 \u00d7 1.0 \u00d7 0.6 cm. The total weight was 25.6 grams. A dominant nodule was identified in the left lobe measuring 4.2 \u00d7 3.1 \u00d7 2.0 cm. A second, smaller lesion was also found in the left lobe measuring 0.05 cm. Both lesions were composed entirely of follicular architecture with classical cytomorphology. Margins were free of involvement. The larger lesion was completely encapsulated with minimal capsular invasion. No lymph-vascular or perineural invasion was observed, and there was no extrathyroidal extension. The second lesion lacked a capsule and showed no invasion. Two lymph nodes from the isthmic region were examined and found to be free of tumor involvement. Immunohistochemical studies on the dominant nodule showed membranous positivity for cytokeratin 19, while HBME-1 and galectin-3 were negative. Based on TNM classification, the primary tumor was classified as pT3 due to its size greater than 4 cm and limited to the thyroid. Regional lymph node staging was pN0, with no metastasis identified. Distant metastasis could not be assessed. Additional findings included focal nonspecific thyroiditis. Gross examination revealed fibrous adhesions and blue dye on external surfaces, with no grossly identifiable parathyroid tissue or lymph nodes. The microscopic evaluation supported the histologic features described."} +{"pid": "TCGA-GV-A3QF", "report": "The surgical pathology report includes multiple specimens obtained during a radical cystoprostatectomy and lymph node dissection. Biopsies of the right and left distal ureters showed no evidence of neoplasm. The primary lesion identified in the bladder measured 4.2 cm and demonstrated invasive high-grade papillary features. Histologic evaluation revealed that the tumor had penetrated through the muscularis mucosa (lamina propria) and extensively involved the perivesical fat. Lymphovascular invasion was present. All resection margins, including those from the bilateral ureteral, urethral, and soft tissue regions, were free of tumor involvement.\n\nLymph node analysis showed variable findings across different anatomical regions. Of the 37 lymph nodes evaluated, 12 contained metastatic involvement. Specifically, all three lymph nodes from the left paraaortic region were positive, as were all four from the right common iliac region and three of six presacral lymph nodes. In contrast, the left pelvic (7/7), left common iliac (4/4), and right pelvic (11/11) lymph nodes showed no evidence of malignancy.\n\nIn addition to the bladder findings, the prostate specimen demonstrated a separate focus of histologic abnormality. Microscopic evaluation revealed less than 5% involvement of the prostate by a Gleason score 3+4=7 pattern. The lesion was confined within the prostate without extension into the seminal vesicles or extraprostatic tissues. All prostatic resection margins and associated structures were negative for tumor. High-grade prostatic intraepithelial neoplasia was noted, but there was no evidence of neuroendocrine differentiation or lymphovascular invasion.\n\nGross examination of the bladder revealed a fungating mass measuring 2.3 x 1.2 x 0.8 cm located in the left anterior wall, along with an ulcerated area measuring 1.5 x 0.7 cm near the left ureteral orifice. Sectioning of this region confirmed an infiltrative white lesion extending to within 0.5 cm of the inked soft tissue margin. Other areas of the bladder mucosa were unremarkable except for a small hemorrhagic focus in the posterior wall.\n\nThe pathological staging indicated a primary tumor stage of pT3b based on macroscopic invasion into the perivesical fat. Regional lymph node involvement was classified as pN2 due to metastases in multiple lymph nodes within the true pelvis. Distant metastasis could not be assessed (pMX). Prostate involvement was staged separately at pT2a with no nodal involvement (pNO)."} +{"pid": "TCGA-A7-A56D", "report": "Final Surgical Pathology Report. Procedure: Diagnosis. A. Left axillary sentinel lymph node, resection: No evidence of metastasis in one lymph node (0/1). B. Left breast, simple mastectomy: A lesion is identified, measuring 3.2 cm in greatest dimension. The surgical margins are negative but close, with the closest distance being less than 2 mm. C. Left axillary contents, resection: No evidence of metastasis in seven lymph nodes (0/7).\n\nMicroscopic Description: Microscopic examination performed. A. Sections of the sentinel lymph node demonstrate no evidence of metastatic disease. The node was examined by multiple sectioning with hematoxylin and eosin and by immunohistochemistry for pankeratin. Histologic grade is 3 based on scoring: architectural score 2, nuclear score 3, and mitotic score 3. Greatest dimension is 3.2 cm, corresponding to pT2 staging.\n\nThe specimen margins are negative but close, with a distance of less than 2 mm over a 5 mm length. Vascular invasion is not identified. Calcifications are not present. Ductal carcinoma in situ is not identified. Non-tumorous breast tissue demonstrates proliferative fibrocystic changes with intraductal papillomatosis.\n\nPrognostic markers have been previously assessed. Sections of the left axillary contents show no evidence of metastasis in seven lymph nodes. Specimen details include: A. Left sentinel node-axillary; B. Left breast-tumor located at 7 o\u2019clock; C. Axillary contents.\n\nClinical Information: A prior core biopsy of the left breast was positive. Intraoperative consultation of the left axillary sentinel lymph node found no metastasis in one lymph node.\n\nGross Description: A. Container labeled with the patient's name, medical record number, and \"sentinel lymph node\" contains a single piece of fatty tissue holding one lymph node measuring 1.0 x 0.0 x 0.0 cm. It is bisected and submitted in block AFS. B. The left breast specimen measures 25.5 cm (medial to lateral) by 17.0 cm (superior to inferior) by 4.5 cm (anterior to posterior). It includes a wrinkled tan skin ellipse measuring 19.3 x 8.5 cm with an eccentric nipple. A palpable mass is present at the 7 o\u2019clock position. The antero-inferior surface of the mass is inked blue, and the deep margin is inked black. A well-circumscribed tumor measuring 3.2 x 2.4 x 2.0 cm is identified in the lower outer quadrant. On sectioning, the tumor extends to within 0.2 cm of the blue-inked surface and 1.5 cm of the black-inked deep margin. Portions of the tumor and normal parenchyma are submitted. The remainder of the specimen shows soft, lobulated tan-gold adipose tissue with minimal dense fibrous tissue. No other mass or abnormality is found. Sampling includes: 1 - tumor to inked deep margin; 2 through 4 - tumor to inked anteroinferior margin; 5 and 6 - tumor to adjacent parenchyma; 7 - random upper outer quadrant; 8 - upper inner quadrant; 9 - lower inner quadrant; 10 - lower outer quadrant; 11 - junction of four quadrants; 12 - nipple. C. Axillary contents measure 9.3 x 7.8 x 1.7 cm, composed of adipose tissue and several lymph nodes, the largest measuring up to 3.4 cm. All lymphoid tissue is submitted. Summary blocks: 1 - 2 lymph nodes; 2 - 1 bisected lymph node; 3 and 4 - bisected largest lymph node."} +{"pid": "TCGA-DB-A64O", "report": "The specimen consists of three parts. Part A is a 4.2 x 3.9 x 1.5 cm portion of brain tissue from the left anterolateral temporal lobe, from which smears were prepared and submitted entirely. Part B is a 2.8 x 1.5 x 1.2 cm brain tissue sample from the same anatomical region; representative sections were submitted for permanent analysis. Part C is a 1.3 x 1.0 x 0.2 cm aggregate of white-tan and red tissue collected in a trap labeled \u201cleft brain \u2013 collection sock,\u201d with representative sections also submitted for permanent sections.\n\nImmunohistochemical staining was performed on paraffin-embedded tissue. Tumor cells demonstrated positivity for GFAP, with many showing abundant cytoplasm and processes. Staining for IDH1 (R132H) mutation was negative. There was weak to moderate expression of p53 protein in tumor cells. Ki67 labeling index was low. These findings were consistent with prior intraoperative smear evaluation of a diffuse glioma, low-grade morphology. Multiple blocks were submitted for histologic examination from each part."} +{"pid": "TCGA-E2-A1B5", "report": "The surgical specimens included multiple lymph nodes from the left axillary region and resected breast tissue from the left side. The excised breast tissue weighed 290 grams and measured 11 x 9 x 6 cm. A firm, beige, ill-defined mass was identified within the tissue, measuring 1.7 x 1.1 x 1 cm, located 0.4 cm from the anterior/inferior margin. Serial sectioning of the specimen revealed areas of fibrous streaking adjacent to the lesion on the medial aspect. Mammographic correlation was performed, and representative sections were submitted for analysis.\n\nInvasive tumor was found at the anterior surgical margin in the wide local excision specimen, with a distance of 7 mm from the margin. Additional retroareolar tissue also showed invasive tumor at the anterior inked margin, located 2 mm from the resection edge. Microscopic evaluation of the main mass showed features consistent with grade 2 histology based on nuclear grading and mitotic activity. No vascular or lymphatic invasion was identified. Adjacent to the invasive component, there was evidence of lobular neoplasia in situ.\n\nImmunohistochemical staining showed positive hormone receptor status. Estrogen receptor expression was strong, with an Allred score of 8 (proportion score 5, intensity score 3). Progesterone receptor expression was also positive, with an Allred score of 5 (proportion score 2, intensity score 3). HER2 testing by immunohistochemistry showed no reactivity, with 0% staining and an intensity score of 0.\n\nLymph node evaluation included sentinel and non-sentinel nodes from the left axilla. One lymph node was identified in sentinel node #1, one in sentinel node #2, two in sentinel node #3 and #4 combined, and one additional lymph node from the non-sentinel group. All lymph nodes were free of metastatic involvement. S100 staining highlighted a capsular nevus in one of the sentinel nodes. Pathologic staging was determined as pT2N0. An OncoType DX assay was performed, yielding a recurrence score of 29, with corresponding ER, PR, and HER2 scores indicating hormone receptor-positive and HER2-negative status."} +{"pid": "TCGA-BC-A3KG", "report": "The specimen from a liver segment 5 partial resection includes a 3.6 cm well-circumscribed, focally lobulated mass located 1.2 cm from the segment 6 margin and 0.5 cm from the segment 4 margin. The mass is described as soft, pink-tan, and grossly bulges the capsule but does not extend through it. Microscopically, the lesion demonstrates Grade 2 differentiation (Edmondson-Steiner grading system) with over 95% of the tissue appearing viable. No vascular, perineural, or capsular invasion is identified. The closest distance from the tumor to the capsular surface is 0.1 cm. Surgical margins are negative for malignancy, with the tumor 0.5 cm from the segment IV margin and 1.3 cm from the segment VI margin. No lymph nodes were sampled. The background liver shows mild centrilobular cholestasis.\n\nA separate segment 4 liver resection weighs 1.5 grams and measures 2.5 x 2.1 x 0.6 cm. The final margin is inked blue and no malignant cells are identified. The liver parenchyma in this area also shows mild centrilobular cholestasis.\n\nAn intact gallbladder measuring 7.5 x 2.7 x 1.6 cm is submitted. The serosal surface is green-gray and smooth. The wall thickness measures 0.2 cm and the lumen contains viscous red-brown fluid. The mucosa appears red-brown and velvety. No malignancy is found in the gallbladder or cystic duct margin.\n\nBased on available data, the pathologic TNM stage is pT1 pNX. This assessment may be subject to revision pending further clinical review and information."} +{"pid": "TCGA-EW-A1P3", "report": "A total of five lymph nodes were examined across both sides, with no evidence of involvement identified. On the left side, one lymph node was assessed and showed no presence of abnormal cells. On the right side, three lymph nodes were evaluated, and all were similarly unremarkable.\n\nTwo distinct areas of concern were identified in the breast tissue. In the left breast, a lesion measuring 0.5 cm was found in the upper inner quadrant. Histologic evaluation revealed moderately differentiated features, with intermediate nuclear characteristics. Tubule formation was moderate, accounting for 10% to 75% of the sample (score = 2). Nuclear pleomorphism was also moderate (score = 2), and mitotic activity was noted at 10 to 20 mitoses per 10 high-power fields (score = 2), resulting in a total Nottingham score of 6, corresponding to Grade II. The specimen margins were free of involvement by invasive disease, and there was no evidence of venous or lymphatic invasion.\n\nIn the right breast, a larger lesion measuring 2.5 cm was identified in the lower outer quadrant. This lesion extended to within 1.0 mm of the anterior margin. Histologically, it demonstrated moderately differentiated features with intermediate nuclear grade. Tubule formation was minimal, less than 10% (score = 3), while nuclear pleomorphism remained moderate (score = 2). Mitotic activity was lower than the left-sided lesion, with fewer than 10 mitoses per 10 high-power fields (score = 1), yielding a total Nottingham score of 6, also classified as Grade II. Margins were again free of invasive disease involvement, with the closest distance to the anterior margin measuring 1.0 mm. No signs of vascular or lymphatic invasion were observed.\n\nThe left-side lesion was staged as pT1a with regional lymph node staging as pNO (0/1 lymph node involved). For the right-side lesion, staging was pT2 with regional lymph node staging pNO (0/4 lymph nodes involved). Distant metastasis staging could not be determined (pMX) based on available data.\n\nImmunohistochemical staining for Keratin was performed on multiple samples and yielded negative results across all tested sites. Intraoperative frozen section analysis of lymph nodes did not reveal any malignancy.\n\nBoth mastectomy specimens included representative sections from various anatomical regions and margins, none of which showed residual disease or abnormal cellular changes. Additional tissue samples from surrounding parenchyma and hemorrhagic areas in the left breast were also unremarkable.\n\nNo tumor was identified in the additional superior flap tissue submitted from the right breast. All surgical margins evaluated were free of malignant involvement."} +{"pid": "TCGA-BB-8601", "report": "The specimen consisted of excised tissue from the anterior and posterior floor of the mouth, ventral tongue margin, retromolar trigone, and inner table of the mandible. All margins were negative for tumor. The mandibular bone showed fibrosis and reactive changes. Teeth were extracted and examined grossly only. A right neck dissection included levels 2 and 3, with a single focus of metastatic carcinoma identified in one of thirteen lymph nodes. An additional level one lymph node excision included three lymph nodes, all negative for tumor. The main resected specimen was a floor of mouth and marginal mandibulectomy. The lesion measured at least 6.0 cm in greatest dimension. Histology showed features consistent with a moderately differentiated squamous cell carcinoma arising in the upper aerodigestive tract. The tumor involved underlying bone. Staging criteria indicated a primary tumor greater than 4 cm. There was evidence of perineural invasion, but no venous or lymphatic vessel invasion. Distant metastasis could not be assessed. A right submandibular gland excision revealed benign salivary gland tissue without tumor."} +{"pid": "TCGA-A3-3349", "report": "The specimen consists of a left kidney weighing 240 grams and measuring 13.0 x 8.0 x 7.0 cm. The external surface is covered with tan-gray capsule and adhered tan-yellow lobular adipose tissue. No adrenal gland is present. Upon sectioning, the cortex appears pale yellow-brown with an average thickness of 0.8 cm. The hilar region contains abundant tan-yellow adipose and includes a ureteral segment measuring 7.0 cm in length and 0.9 cm in diameter. A well-circumscribed tan-orange mass is identified in the upper pole, measuring 5.0 x 5.0 x 4.5 cm, and involving approximately 15% of the renal parenchyma. The mass is confined beneath the capsule without gross extension into the renal pelvis or surrounding structures. The remainder of the kidney shows no other lesions.\n\nHistologic evaluation reveals a neoplastic lesion composed of cells with clear cytoplasm. The nuclear grade is Fuhrman grade 2. There is no evidence of lymphovascular space invasion, transcapsular extension, or involvement of the renal vein. The surgical margins, including soft tissue, ureteral, and vascular margins, are all negative. No lymph nodes are identified within the specimen. The pTNM stage is T1bNXMX. Additional sections were submitted for analysis, including those from the mass, normal renal tissue, vessel margins, and capsule."} +{"pid": "TCGA-99-8025", "report": "The surgical pathology report includes multiple lymph node levels and lung tissue. Lymph nodes from levels II, VII, VIII, IX, X, and XI were submitted as single or multiple fragments, with sizes ranging from 0.3 cm to 2.5 cm in aggregate. All lymph nodes evaluated were negative for malignancy except for one lymph node from level IV, which was positive for metastatic carcinoma (1 out of 3). Lung tissue from the right upper lobe resection included a tan mass measuring 5.5 x 4.5 x 3.8 cm with anthracotic pigment and an infiltrative border located 1.0 cm from the stapled margin, along with a separate nodule measuring 1.0 cm located 2.0 cm from the margin. Microscopic evaluation showed a moderately differentiated adenocarcinoma with bronchoalveolar features involving peribronchial soft tissue and evidence of perineural invasion. The overlying pleura was not involved, and tumor was identified at the shaved stapled line. The bronchial margin was free of invasive carcinoma. No lymphovascular invasion was observed. The tumor consisted of two separate nodules in the same lobe, and the pathologic stage was determined as pT3(m)/N2."} +{"pid": "TCGA-IB-AAUV", "report": "The specimen consists of a resected pancreatic head and uncinate process, measuring 5.6 x 4.8 x 2.7 cm in total. A poorly demarcated, firm, light-yellow lesion is identified within the head and uncinate process of the pancreas, with a diffuse infiltrative border into the surrounding parenchyma. The largest dimension of the lesion measures 4.8 cm, with additional dimensions of 3.6 x 2.2 cm. Cross-sectioning reveals a solid, firm tumor without necrosis or hemorrhage, involving the ampulla of Vater and extending into the duodenal submucosa. The tumor also extends into the common bile duct, with involvement of the mucosa focally.\n\nMicroscopically, the lesion demonstrates moderately differentiated features with glandular structures and mucinous components. There is evidence of perineural and lymphovascular invasion. In addition, there are foci of high-grade intraepithelial neoplasia (PanIN-3). The tumor invades the duodenal wall, ampullary region (including submucosa, muscularis mucosae, and base of mucosa), and extends into peripancreatic and retroperitoneal soft tissues.\n\nMargins were assessed: the closest distance of invasive tumor to a margin is 1.5 mm at the retroperitoneal margin. The vascular bed margin is involved by invasive carcinoma. The pancreatic resection margin is free of tumor by at least 0.6 cm, and the posterior resection margin is also negative by at least 0.15 cm. The common bile duct resection margin is uninvolved.\n\nEvaluation of regional lymph nodes includes fifteen peripancreatic lymph nodes, three of which contain metastatic deposits. Additionally, one of two mesocolon lymph nodes contains metastatic involvement with extranodal extension. Other sampled lymph node groups (portal, superior mesenteric vein, retroperitoneal, and mesocolon) were negative except as noted.\n\nOther specimens submitted include a gallbladder with mild nonspecific acute inflammation and marked eosinophilia; a portal lymph node and branch of superior mesenteric vein, both negative for malignancy; a retroperitoneal biopsy showing fibrous tissue and skeletal muscle without malignancy; and lymph nodes from mesocolon with one positive node.\n\nStaging classification reflects tumor extension beyond the pancreas without involvement of major arteries such as the celiac axis or superior mesenteric artery (pT3), with regional lymph node metastasis (pN1). No distant metastasis was assessed (Mx).\n\nAdditional findings include ischemic changes in the distal duodenum. Proximal and distal duodenal margins are free of tumor. The specimen also includes sections of duodenum, bile duct, and surrounding soft tissues with extensive sampling around the tumor and margins.\n\nHistologic evaluation confirms invasive carcinoma with desmoplastic response, pleomorphic nuclei, and atypical mitoses. There is focal epithelial denudation in the distal common bile duct, likely due to prior instrumentation."} +{"pid": "TCGA-A2-A0T4", "report": "The right breast specimen measured 24.5 x 21 x 3.5 cm and included a firm palpable mass measuring 2.3 x 3.3 x 1.7 cm located in the upper inner quadrant, 0.6 cm from the deep margin and 1.5 cm from the superficial margin. A ribbon clip was identified within this mass. The breast tissue consisted of a mixture of bland yellow fatty tissue and pink-tan fibrous tissue, with the fibrous component comprising no more than 20% of the parenchyma. Additional yellow fatty tissue fragments measuring 8.5 x 8.3 x 1.5 cm were present but showed no remarkable findings. Multiple sections were submitted for microscopic evaluation, including margins and areas adjacent to the lesion.\n\nThe left breast specimen measured 22 x 18.5 x 3.3 cm. Sectioning revealed central gray fibrotic tissue intermingled with yellow fatty tissue surrounded by a perimeter of bland yellow fatty tissue with fine fibrous bands. Fibrous tissue comprised approximately 20% of the specimen. Sections were submitted from multiple quadrants including the nipple, central area, and margins.\n\nThe right axillary sentinel lymph node specimen contained two lymph nodes: one measuring 1.2 cm and another measuring 1.0 cm, both submitted entirely. The right axillary non-sentinel lymph node specimen contained a single lymph node measuring 1.5 cm. The left axillary sentinel lymph node specimens included one lymph node measuring 4.0 cm and another measuring 1.2 cm along with an additional lymph node measuring 0.5 cm. All lymph nodes were embedded in fatty tissue and submitted for histologic examination.\n\nMicroscopic evaluation of the right breast lesion revealed a cellular process spanning a distance of 3.3 cm in the upper inner quadrant with multifocal appearance within that quadrant. No similar findings were identified in other quadrants. The deep margin was free of abnormal cellular activity by 5 mm. Cellular features included moderate nuclear atypia and low mitotic activity.\n\nThe left breast showed diffuse proliferative fibrocystic changes with areas of atypical ductal and lobular hyperplasia and extensive microcalcifications. No malignant cellular features were identified.\n\nAll lymph nodes evaluated from both axillae showed no evidence of abnormal cellular infiltration or metastatic involvement. Immunohistochemical staining for cytokeratin was negative across all submitted lymph node specimens."} +{"pid": "TCGA-4P-AA8J", "report": "The specimen from the right lateral tongue lesion measured 0.9 x 0.4 x 0.2 cm and was submitted in entirety for frozen section. The anterior gingival margin measured 2.1 x 0.2 x 0.2 cm and was also entirely submitted. The deep tongue margin, measuring 2.5 x 1.2 x 0.5 cm, was fully submitted for analysis. A 0.5 x 0.3 x 0.2 cm fragment from the anterior tongue attachment was similarly submitted. The right floor of mouth specimen measured 2.5 x 0.5 x 0.3 cm, while the right posterior tongue margin measured 3.2 x 0.2 cm. The left floor of mouth measured 1.8 x 0.2 cm, and the left posterior tongue margin was 2.2 x 0.2 x 0.2 cm; all were submitted in entirety for frozen section.\n\nA right hemiglossectomy specimen measured 6.5 x 4.5 x 3.2 cm. The surgeon marked the tip of the tongue with a black suture, and the deep aspect was marked with black and blue ink. Peripheral mucosal and tongue resection margins were shaved and submitted in a clockwise fashion. Sectioning revealed a tan-gray, well-circumscribed mass that ulcerated the mucosal surface, measuring 1.9 x 1.5 x 1.5 cm, extending into the attached floor of the mouth. The mass showed a central hemorrhagic area and approached 0.1 cm from the deep resection margin.\n\nLymph node dissections were performed bilaterally at multiple levels. At right level 1A, three lymph nodes were identified and submitted. Right level 1B contained eight intact lymph node candidates and one bisected node, along with a salivary gland. Right level 4 had three lymph node candidates, with one bisected. Right level 2A included three intact lymph nodes, a representative section of a nodular mass measuring 3 cm, and one trisected lymph node. Right level 3 showed nine lymph node candidates in total across two blocks. Right level 2B had four lymph nodes submitted. On the left side, level 1B contained a salivary gland and several lymph nodes, including one serially sectioned. Left level 4 had three sections submitted entirely. Left level 3 had two blocks submitted, and left level 2B had four lymph nodes.\n\nMicroscopic evaluation of the resection specimen showed no evidence of the condition in the peripheral margins. Tumor features included a size of 1.9 x 1.5 cm, invasion depth of 1.9 mm, and thickness of 0.8 mm. Histologic grade was moderately differentiated. Lymphovascular and perineural invasions were present. Immunohistochemical staining for p16 was negative.\n\nStaging based on the current tissue specimen is pT2 pN2c pMX according to the AJCC 7th edition. Multiple lymph node levels were involved, with metastatic involvement noted in right level 2A (1/7), right level 3 (1/8), left level 1B (2/3), and left level 3 (2/5). Extracapsular extension was identified in some of these nodes. All other lymph node dissections were negative for involvement. The tumor was unifocal, located in the right tongue, and did not extend beyond 4 cm in contiguous invasion. The exact operative procedure and staging information have been reported to the institution's cancer registry."} +{"pid": "TCGA-B5-A0JV", "report": "The specimen weighed 179 grams and measured 11 x 4 cm. Gross examination revealed multiple subserosal leiomyomata, the largest being 0.6 cm, and a diffusely involving lesion on both anterior and posterior endometrial surfaces. The main lesion measured 6 x 4 x 1.1 cm and demonstrated invasion to a depth of 0.6 cm within a myometrial wall thickness of 2.3 cm. The tumor extended to within 1.5 cm of the cervical os. Endocervical and exocervical margins were unremarkable. A 0.6 x 0.6 cm endophytic polyp was identified in the right fallopian tube, located 1 cm from the posterior endocervical os. Both adnexa appeared unremarkable. Paracervical and soft tissue margins were grossly negative, and the remainder of the myometrium showed no significant abnormalities.\n\nMicroscopic evaluation confirmed the presence of a neoplastic process with histologic features consistent with a glandular origin. The tumor involved the endometrium diffusely and extended to the cervix, with a 2 mm nodule identified at the tip of an endocervical polyp. No lymphatic or vascular invasion was identified. Adjacent endometrial tissue was atrophic, and adenomyosis was noted in the myometrium. A small serosal leiomyoma and a powder burn mark were also present.\n\nLymph node assessment included right periaortic (1 node), right pelvic (9 nodes), left periaortic (1 node), and left pelvic (7 nodes). All lymph nodes examined were negative for involvement. Proximal right infundibulopelvic ligament and bilateral fallopian tubes and ovaries were also free of tumor.\n\nStaging was performed according to AJCC 6th Edition criteria. The tumor was classified as pT2b, with no nodal involvement (pN0) and distant metastasis status indeterminate (pMX). All surgical margins were free of tumor."} +{"pid": "TCGA-DU-5874", "report": "The patient presented with a left frontal brain lesion identified on imaging, measuring approximately 4 cm and demonstrating slight enhancement. Three biopsy specimens were obtained during surgery: two biopsies and one excisional biopsy. The tissue samples ranged in size from 0.5 cm to 1.5 x 1.0 x 0.9 cm in aggregate, with varying consistency and color.\n\nMicroscopic evaluation revealed a neoplastic proliferation of glial cells infiltrating both the cerebral cortex and white matter. The cells exhibited an oligodendroglial morphology with minimal nuclear pleomorphism. Mitotic figures were rare. Immunohistochemical staining showed positivity for GFAP in a paucifibrillary pattern and highlighted the neoplastic infiltration with NeuN staining. CD34 staining demonstrated a capillary-type microvascular network with focal endothelial hyperplasia, although no microvascular cellular proliferation was observed. CD163 staining revealed prominent perivascular microglial activity.\n\nThe proliferation index, assessed by MIB-1 staining, was approximately 18% in more cellular regions. Necrosis was not present. Additional molecular testing revealed methylation of the MGMT promoter, which may be relevant for treatment response to alkylating agents. Chromosomal analysis showed allelic loss on both chromosome arms 1p and 19q, assessed using multiple microsatellite markers. These findings were interpreted in the context of clinical, imaging, and operative data for overall patient management and follow-up."} +{"pid": "TCGA-21-1077", "report": "The specimen was received in thirteen parts. A fragment of rib measuring 1.5 cm in greatest dimension was submitted, with no tumor identified. Lymph nodes from multiple levels were examined, including a 1.5 cm level 6 lymph node, a 0.8 cm level 11 lymph node, a 2.0 x 1.0 x 0.5 cm level 5 lymph node submitted in two blocks, another 0.8 cm level 6 lymph node, and three level 7 lymph nodes measuring up to 1.2 cm; none showed evidence of tumor.\n\nA left upper lobe lung specimen weighing 256 grams measured 20.5 x 9.0 x 7.0 cm. Gross examination revealed fibromembranous and fibroadipose adhesions on the pleural surface, with involvement by a firm tan mass measuring 5.5 x 4.5 x 4.0 cm. This lesion obliterated part of the bronchial tree and extended into the bronchial margin and adjacent peribronchial soft tissue. It also invaded the visceral pleura and was present in a lymph node and perivascular soft tissue on a vascular margin section. The mass involved approximately 35% of the left upper lobe, with bronchiectasis noted adjacent to the lesion. Sections from this area were submitted across multiple blocks.\n\nMargins evaluated included anterior, posterior, superior, medial, and new bronchial margins, all of which were negative for tumor. A second bronchial margin specimen also showed no tumor. Of fifteen peribronchial lymph nodes examined, three contained metastatic cells. No tumor was found in the submitted rib fragment or other biopsied lymph nodes.\n\nStaging classification was determined as pT2N1Mx."} +{"pid": "TCGA-33-4547", "report": "The surgical specimen from the right upper lobe consists of a lobectomy measuring 15.0 x 12.0 x 5.5 cm and weighing 180.0 grams. An area of pleural puckering measuring approximately 4.0 cm in greatest dimension is present on the lateral aspect, with overlying pleura inked black. A tan-white-yellowish mass measuring 4.5 x 4.0 x 4.0 cm is identified adjacent to the pleura. The mass is located 2.5 cm from the bronchial margin and 2.0 cm from the stapled margin. Representative sections of the mass, vascular margins, bronchial margin, normal lung tissue, and surrounding areas have been submitted for analysis.\n\nHistologic evaluation reveals a poorly differentiated cellular proliferation. All 13 lymph nodes assessed, including those from stations R11, R10, R4, high R4, and station 7, are free of malignant involvement. No evidence of large vessel invasion is identified. Small vessel invasion remains indeterminate.\n\nStaging assessment indicates pT2 disease based on tumor size greater than 3 cm, and pN0 indicating no regional lymph node metastasis. Distant metastasis could not be assessed (pMx). Surgical margins are uninvolved by invasive disease. Portions of the specimen were retained for research purposes. This case was reviewed at the daily quality assurance conference. Clinical history was not provided."} +{"pid": "TCGA-46-3765", "report": "The specimen from the right upper lobe of the lung weighs 360 grams and measures 20 x 9.5 x 5 cm. It includes multiple stapled margins ranging from 5 to 9.5 cm in length, with a bronchial margin at the hilum measuring 2 cm in length. Vascular margins range from 0.3 cm to 0.6 cm in diameter. The pleural surface appears dull, dusky, and purple-gray with tan-brown membranous adhesions. There is a firm, puckered area on the pleura that has been inked blue. Underlying parenchyma near stapled margins is inked black.\n\nUpon sectioning, a well-circumscribed tan-white mass measuring 2.7 x 2.3 x 2 cm is identified, containing a central hemorrhagic region. This lesion appears to contact the blue-inked pleural surface and is located 5 cm from the bronchial margin and 1.8 cm from the nearest black-inked parenchymal margin. Adjacent lung tissue shows no other discrete masses or nodularities apart from a 2 cm cyst-like structure located 8 cm from the main lesion and 1.5 cm from the nearest pleural surface.\n\nRepresentative sections include vascular and bronchial margins, the mass with adjacent pleura, perpendicular sections of the closest stapled margin, the cyst-like structure, areas of pleural adhesion, and normal-appearing lung tissue. No hilar lymph nodes are identified grossly.\n\nA separate specimen from the apical segment lymph node consists of a 0.3 cm gray-black ovoid tissue fragment submitted entirely.\n\nHistologically, the lesion demonstrates moderate to poor differentiation with features suggestive of squamous morphology. Cellular atypia is present, and the lesion extends toward the pleural surface but does not involve any of the resection margins. No evidence of vascular invasion is observed.\n\nLymph node analysis reveals no abnormal cellular infiltration or suspicious findings across all sampled regions. No mucin production is detected within the cellular components based on mucicarmine staining.\n\nNon-neoplastic lung tissue shows no significant pathological changes. Focal pleural adhesions unrelated to the primary lesion are noted. Based on the extent of resection and absence of margin involvement, the lesion appears localized without regional lymph node involvement."} +{"pid": "TCGA-86-8671", "report": "The specimen consisted of lung tissue obtained via lobectomy. The tumor measured 4 x 3 x 6 cm and was located in the lung. Microscopic evaluation revealed a papillary growth pattern with well-differentiated cellular features. Lymph node assessment showed that 3 out of 8 hilar lymph nodes were positive for metastatic involvement. No definitive assessment was made regarding tumor extent, presence of additional nodules, lymphatic or venous invasion, surgical margins, evidence of neoadjuvant treatment, or other significant pathologic findings."} +{"pid": "TCGA-YU-A912", "report": "The specimen involved the left testis and demonstrated a neoplastic lesion. Histologic evaluation revealed characteristic morphologic features consistent with the immunohistochemical profile. The tumor did not show evidence of angiolymphatic or perineural invasion. The surgical margin was free of neoplastic involvement. No additional specific diagnostic terms were used in the description of the findings."} +{"pid": "TCGA-D7-8578", "report": "The specimen consists of the pyloric portion of the stomach, measuring 19 x 14 cm, resected in total. A ulcerated lesion is present in the pyloric region on the lesser curvature, measuring 3.2 x 2.9 x 0.8 cm. The distance from the proximal resection margin is 1.7 cm and from the distal margin is 3.6 cm. Histologically, the lesion shows infiltration into the gastric wall and surrounding fat tissue. Three lymph nodes examined are negative for neoplastic involvement. All resection margins are clear."} +{"pid": "TCGA-26-1440", "report": "The submitted specimens include three separate tissue aggregates from a left temporal lobe mass resected during craniotomy. Specimen A, measuring 1.0 x 0.3 x 0.2 cm, is composed of pink-tan soft tissue and was partially used for frozen section analysis, with the remaining portion submitted for permanent processing. Specimen B, measuring 2.9 x 2.7 x 0.6 cm, is a focally hemorrhagic pink-tan tissue aggregate; part of this specimen was sent to the tumor bank, and the remainder was processed in full. Specimen C, measuring 2.9 x 2.0 x 0.8 cm, consists of focally hemorrhagic and necrotic red-tan soft tissue, with a representative sample of viable tissue sent to the tumor bank and the rest fully submitted for processing. All specimens underwent histological evaluation, including assessment of cellular morphology and tissue architecture. The specimens were entirely processed and analyzed, with staging determined based on histopathologic features and extent of resection. No specific diagnosis is provided in this summary."} +{"pid": "TCGA-BP-4804", "report": "The specimen consists of a wedge-shaped portion of right kidney measuring 5.8 x 5.0 x 4.2 cm with attached perirenal fat. The lesion identified is a well-circumscribed, hemorrhagic, and focally cystic yellow-tan mass measuring 5.1 x 4.2 x 4.0 cm. It demonstrates multiple areas of necrosis and exhibits a peritumoral vascular invasion. The distance from the tumor to the resection margin is 0.2 cm, and no gross extrarenal extension is observed. Histologically, nuclear grading is II/IV. The tumor is confined within the kidney and does not extend beyond 7.0 cm in greatest dimension. All surgical margins are free of involvement. Additional findings include focal interstitial chronic inflammation and cortical cysts in the non-neoplastic kidney tissue. No lymph nodes or adrenal gland tissue are identified. The submitted portions for analysis include frozen section control, tumor, margin, representative sections, and additional sections. Intraoperative consultation confirmed negative margins and a neoplastic process limited to the kidney."} +{"pid": "TCGA-A4-8518", "report": "The specimen consists of a left kidney with attached perinephric fat measuring 20.0 x 16.0 x 6.5 cm and weighing 814 grams. The ureter measures 10.0 cm in length and up to 0.5 cm in diameter, with a tan mucosal surface and no identifiable lesions. The renal artery and vein stumps measure 1.5 x 0.5 cm and 1.0 x 1.5 cm respectively, and appear unremarkable. No lymph nodes are identified at the hilum. A well-circumscribed, brown-tan, hemorrhagic mass measuring 3.2 x 3.0 x 3.0 cm is located in the lower pole of the kidney. On sectioning, the mass appears confined within the renal capsule without extension into the surrounding perinephric fat. It is located 2.2 cm from the deep surgical margin. The renal cortex measures 0.5 cm in thickness and exhibits a distinct cortical-medullary junction. No other lesions are observed. The renal calices are unaffected.\n\nHistologic evaluation reveals a neoplastic lesion composed of cells arranged in a papillary architecture with oncocytic features. Nuclear grading according to Fuhrman criteria is 2 of 4. There is no evidence of lymphovascular invasion or sarcomatoid differentiation. All surgical margins, including ureter, renal vein, renal artery, and soft tissue, are free of tumor. No lymph nodes are present in the specimen. Non-neoplastic renal parenchyma demonstrates multiple sclerotic glomeruli and mild to moderate arteriosclerosis. Immunohistochemical staining shows positivity for cytokeratin 7 and vimentin, and negativity for CD117. Based on these findings, additional diagnostic testing was performed to exclude other potential entities.\n\nThe pathologic stage assigned is pT1a NX. Sections submitted include representative tissue from the mass, ureter, renal artery, uninvolved kidney, and perpendicular sections from the deep margin overlying the mass."} +{"pid": "TCGA-L5-A4OW", "report": "A 2.0 x 1.1 x 0.3 cm soft tissue specimen was received, along with a lymph node measuring 1.1 cm. A 7.2 cm segment of distal esophagus with an attached 7.0 x 4.0 x 3.5 cm stomach was also received; a 4.8 cm segment of bowel was stapled at the margin. At the gastroesophageal junction, there is a 3.1 x 2.3 cm fungating lesion extending 1.6 cm into the esophagus and 2.8 cm into the stomach. The lesion is tan-red and centrally ulcerated, located 6.0 cm from the esophageal margin and 7.8 cm from the bowel margin. The mass has ill-defined tan-white cut surfaces that grossly abut the muscularis, with a maximum thickness of 1.9 cm. The remaining esophageal mucosa is pink-tan and unremarkable, with an internal circumference of 4.5 cm and wall thickness of 1.0 cm. The gastric mucosa is tan with normal-appearing rugal folds. There is a 0.8 x 0.5 cm full-thickness defect at the anastomosis site between the bowel and stomach. The bowel mucosa appears red-brown and hemorrhagic. Attached adipose tissue contains ten possible lymph nodes ranging from 0.2 to 0.8 cm in size.\n\nFrozen section analysis of one lymph node was negative. Permanent sections confirmed these findings. Invasive adenocarcinoma was identified spanning the gastroesophageal junction and extending into the muscularis propria. Two of eleven lymph nodes were positive. No involvement of esophageal, gastric, or deep resection margins was observed. The pattern of invasion was both infiltrative and expansile. A separate 1.7 cm segment of esophagus was received with unremarkable mucosa and an average wall thickness of 0.8 cm. One lymph node from the peripancreatic region was negative. Metastasis was identified in one left lower paraesophageal lymph node."} +{"pid": "TCGA-ET-A40R", "report": "The specimen consists of a total thyroidectomy. The tumor is located in the left lobe and measures 3 cm in greatest dimension. Histologic evaluation demonstrates a follicular variant composition, comprising approximately 99% of the sampled tissue. The tumor is unifocal, with scattered psammoma bodies identified within the gland. A total of 20 lymph nodes were examined, with metastatic involvement identified in 7 nodes. The primary tumor is classified as pT2, indicating a tumor larger than 2 cm but less than 4 cm confined to the thyroid. Regional lymph node involvement is categorized as pN1a, reflecting metastasis to level VI nodes including pretracheal, paratracheal, and prelaryngeal/Delphian lymph nodes. Margins are involved by invasive carcinoma, specifically at the deep margin. Evidence of vascular or lymphatic invasion is present. Additional findings include lymphocytic thyroiditis and identification of parathyroid tissue in a single focus."} +{"pid": "TCGA-CJ-5684", "report": "The specimen consists of a partial nephrectomy measuring 7.7 x 5.3 x 4.2 cm, including a portion of kidney and surrounding adipose tissue. A protruding area of orange-yellow tissue measuring 0.7 x 0.5 x 0.4 cm is present at the resection margin and marked with blue surgical ink. The main lesion measures 4.7 x 4.3 x 3.6 cm, appears partially cystic and hemorrhagic, and contains small foci of gray mucoid material. It is encapsulated by a tan fibrous rim and extends as a bulge into the adjacent perinephric fat without gross infiltration. The uninvolved renal parenchyma appears normal.\n\nMicroscopic evaluation reveals a cellular lesion with nuclear features corresponding to a nuclear grade of 2. The lesion shows a distinct growth pattern with areas of vascular involvement noted at the resection margin. Immunohistochemical staining for CD31 highlights the endothelial lining of the involved vascular structure, though this finding does not confirm involvement of the renal vein. Additional sections from the frozen block show adjacent adipose tissue consistent with renal sinus fat, which is not infiltrated by the lesion. No tumor is identified in the perinephric fat or Gerota\u2019s fascia.\n\nA separate fragment of rib measuring 3.5 x 1.0 x 0.5 cm was submitted for gross examination only. An additional fragment of adipose tissue (7.5 x 6.0 x 1.0 cm) was serially sectioned and showed no abnormal findings.\n\nMultiple representative sections were taken from different areas of the lesion and surrounding tissue, including the cystic and mucoid regions, margins, and adjacent normal kidney. Electron microscopy was considered for a portion of the tissue. A positive margin was identified microscopically at the site marked with blue ink, and no capsule was identified at this location."} +{"pid": "TCGA-52-7812", "report": "A left lung specimen was received, measuring 21.0 x 15.0 x 6.0 cm and weighing 718 grams. A mass was identified 1 cm from the bronchial resection margin, measuring 6.0 x 5.0 x 4.5 cm in greatest dimension, with areas of hemorrhage and necrosis. The pleural surface showed multiple elevated lesions at the upper pole, ranging from 0.1 to 1.0 cm. A firm, consolidated area approximately 4.0 x 4.0 x 4.0 cm was noted at the apex of the lobe. A possible lymph node at the hilum measured 2.0 cm in greatest dimension.\n\nMicroscopic evaluation of the mass revealed a poorly differentiated epithelial neoplasm. The tumor was found to extend to the visceral pleura and exhibited vascular invasion involving a large vessel. The closest margin was the bronchial margin, which was uninvolved by invasive tumor, with a distance of 2 mm from the tumor edge to the margin. An intraparenchymal lymph node adjacent to the tumor was free of malignancy. Adjacent non-neoplastic lung tissue showed changes consistent with post-obstructive pneumonia.\n\nLymph node stations were evaluated. In station 5, three lymph nodes were examined. One out of one lymph node showed involvement, and two out of two lymph nodes also showed involvement. In station 4L, a single mediastinal lymph node was present and did not show any evidence of involvement. In station 9, a single lymph node was also free of involvement. Additional biopsies from the left upper lobe, left secondary carina, and chest wall segment were all negative for malignancy. Bone and soft tissue sections from the chest wall margin showed fibrosis and chronic inflammation without evidence of tumor.\n\nStaging was determined as pT2 based on the size and local extension, pN2 due to metastatic involvement in regional lymph nodes, and pMX for distant metastasis, which was not assessed."} +{"pid": "TCGA-4X-A9FC", "report": "The thymic specimen weighed 104 grams and measured 21 x 7 x 3 cm. It consisted of tan-red soft tissue with a well-circumscribed hard nodule measuring 5.5 x 4.5 x 3 cm. The cut surface of the nodule was homogeneous without hemorrhage or softening. The pericardial surface was marked with blue ink and the opposite side with yellow ink. Representative sections of the nodule were submitted for analysis, accounting for approximately 35% of its total volume. Adjacent fatty tissues were also sampled.\n\nMicroscopic evaluation revealed a heterogeneous cellular composition. Areas with predominantly spindled epithelial cells were identified. Additional immunostaining demonstrated that the majority of lymphocytes present were immature. These regions showed architectural features consistent with lymphocyte-rich morphology.\n\nResection margins were free of tumor involvement. Three regional lymph nodes were examined and none contained malignant cells. No neoplasm was identified in the submitted fibroadipose tissue from the AP window site.\n\nHistologic assessment indicated invasion into and focally through the surrounding capsule. Possible vascular involvement was also observed."} +{"pid": "TCGA-F7-7848", "report": "The specimen consists of a laryngectomy with a focus on the larynx. The lesion measures 4 x 2 cm. Microscopic evaluation reveals moderately differentiated squamous cell carcinoma with features of keratinization. The tumor extends into the deep muscles of the tongue. Lymph node assessment shows 1 out of 4 cervical lymph nodes positive for metastatic involvement. Surgical margins are free of tumor involvement. There is no specific information provided regarding prior neoadjuvant treatment. No additional comments are provided."} +{"pid": "TCGA-EM-A1YA", "report": "The specimen consists of a right hemithyroidectomy measuring 5.6 cm in greatest dimension, with an isthmus measuring 1.3 cm. The superior nodule measures 1.8 x 1.0 x 1.5 cm and the inferior nodule measures 3.7 x 3.6 x 2.8 cm. The specimen is oriented with a suture at the upper pole and weighs 36.7 grams. External surfaces show fibrous adhesions and are painted with blue dye; no parathyroid glands or lymph nodes are identified. Histologically, the lesion is encapsulated and unifocal, measuring 3.7 cm in greatest dimension, with no extrathyroidal extension, vascular invasion, or lymphatic invasion noted. Margins are free of involvement. Pathologic staging indicates pT2 based on tumor size between 2 and 4 cm confined to the thyroid, with pNX and pMX assigned due to insufficient data for lymph node and metastasis evaluation. Additional findings include nodular hyperplasia and sections stored frozen for further analysis."} +{"pid": "TCGA-E9-A2JT", "report": "The lumpectomy specimen was obtained from the left upper outer quadrant of the breast. A grossly evident lesion measuring 2.0 x 0 x 2.2 cm was identified. Histologic evaluation revealed moderately differentiated cellular features. Lymph node assessment showed no evidence of metastatic involvement, with all 10 axillary nodes being negative. Surgical margins were uninvolved. Nottingham histologic scoring components including tubule formation, nuclear pleomorphism, and mitotic counts at both 25x and 40x magnifications were not specified, therefore a total score could not be determined. There was no evidence of neo-adjuvant treatment effect. No additional pathologic findings were noted."} +{"pid": "TCGA-18-3410", "report": "The specimen included a portion of the seventh right rib, which appeared normal on gross examination. Two lymph nodes were also received: one from the inferior pulmonary ligament (ST9), measuring 1.2 x 0.7 x 0.5 cm, and another from the interlobar region (ST11), measuring 0.6 x 0.5 x 0.4 cm. Both lymph nodes showed no evidence of malignancy.\n\nThe main specimen consisted of a right lower lobe of the lung with attached 8th and 9th ribs and muscle tissue. The entire specimen measured 16.0 x 10.0 x 5.5 cm. The two ribs together measured 9.0 x 5.5 x approximately 2.0 cm in thickness. A central finding was a large peripheral nodule, white and solid with a lobular appearance, measuring up to 4.0 cm in greatest dimension. This lesion showed extension into a thickened fibrous area adjacent to the lung parenchyma, crossing the pleural surface. The distance from the tumor to the bronchial resection margin was 3.6 cm. No tumor was identified at the bronchial margin, although focal squamous metaplasia without atypia was noted. Additionally, a small area of emphysematous change was found approximately 3.5 cm from the bronchial margin.\n\nThe fibrous tissue surrounding the tumor measured 8.2 x 4.5 x 2.9 cm in maximum dimension. Surgical margins, including those from the anterior, posterior, superior, and inferior aspects of the fibrous tissue, as well as the chest wall, were all free of tumor. Sections of the tumor within the lung parenchyma, along with areas of consolidation and emphysematous change, were submitted for analysis.\n\nInitial evaluation of the rib suggested no bone invasion; however, further sections after decalcification revealed periosteal involvement without cortical penetration. All resection margins remained negative. Based on these findings, the resection was considered complete. Multiple representative sections were taken from the tumor, surrounding fibrous tissue, resection margins, and associated lymph nodes, all of which were processed and examined."} +{"pid": "TCGA-W5-AA2U", "report": "Female. Surgery Date: A. Liver, segments IVb, V, VI, VII and VIII and gallbladder, partial hepatectomy and cholecystectomy: The specimen includes a mass measuring 10.0 x 8.3 x 6.9 cm. Histologic evaluation shows high-grade cellular atypia with frequent mitotic figures. There is no evidence of angiolymphatic invasion. The cystic duct is free of tumor involvement. The closest surgical resection margin measures 0.2 cm. Embolization coils are present. Examination of regional lymph nodes, including one cystic duct lymph node, reveals no tumor involvement. Background tissue demonstrates minimal chronic inflammation of the gallbladder. Hepatic parenchyma appears normal. B. Retrocholedochal lymph node biopsy: One lymph node examined shows no tumor involvement."} +{"pid": "TCGA-DQ-7592", "report": "A history of prior resection is noted. Specimen includes a subtotal glossectomy with bilateral submandibular glands. The specimen measures 10.6 x 6.7 x 4.3 cm. A soft tissue extension measures 14 x 4 x 1.5 cm. The left lateral tongue and floor of mouth show an ulcerative, gray-tan lesion measuring 6.7 x 3.2 cm. It is 0.5 cm from the posterior left base of tongue margin, 1.3 cm from the lateral gingival mucosal margin, and 0.5 cm from the left anterior floor of mouth. Punctate hemorrhages and possible tumor nodules extending laterally were previously incised. The maximum depth of invasion is 2.9 cm. The tumor is 0.3 cm from the inferior soft tissue margin and 1.1 cm from the right lateral margin of resection. The right submandibular gland measures 4.2 x 3.6 x 2.2 cm with an unremarkable cut surface. Multiple lymph nodes are identified up to 1.5 cm. The left submandibular gland measures 5.5 x 2.2 x 2.3 cm with multiple lymph nodes up to 2.2 cm.\n\nLymph node dissections include level I on the right with one lymph node examined, all negative. On the left, levels I through IV were evaluated. Level I had seven lymph nodes, all negative. Level II included twelve lymph nodes, two of which were involved with tumor and showed extracapsular extension. Level III had five lymph nodes, one positive. Level IV contained ten lymph nodes, all negative. Frozen sections of multiple margins were negative for malignancy. Microscopic evaluation revealed a moderately differentiated squamous lesion with infiltrative borders and extensive perineural invasion. Margins were negative. Submandibular glands showed no involvement. Fourteen lymph nodes from the primary resection were negative. In the left neck dissection, metastatic involvement was found in level II (2/12) and level III (1/5), with extracapsular extension noted in level II."} +{"pid": "TCGA-2G-AAHT", "report": "The specimen measured 9.0 cm in diameter. Histological evaluation showed no evidence of angioinvasion or invasion of the tunica albuginea. The epididymis, rete testis, and spermatic cord were not identified in the available slides."} +{"pid": "TCGA-EJ-5504", "report": "The patient is a male with a history of prior biopsy findings in the prostate. Gleason score 3+4=7 was identified in the left lobe and Gleason score 3+5=8 in the right lobe. Preoperative serum PSA level was 8.6 ng/ml, and the clinical stage was CT2C. The patient underwent radical prostatectomy and bilateral pelvic lymph node dissection.\n\nA total of 18 lymph nodes were examined, with one positive lymph node identified on the right side. The metastatic focus measured approximately 0.15 cm, and no extracapsular extension was observed. On the left, thirteen benign lymph nodes showed no evidence of malignancy.\n\nGross examination of the prostate revealed involvement bilaterally. Histologic analysis showed acinar-type prostatic adenocarcinoma with a Gleason score of 4+3=7. A tertiary pattern of higher grade was present, and the tumor extensively involved the prostate gland. The Gleason 4/5 components comprised more than 50% of the sampled tissue. The maximum tumor diameter was 1.8 cm, and approximately half of the prostate gland volume was affected.\n\nExtracapsular extension was established at the right posterior mid-prostate and extended into the periseminal vesicle soft tissues on both sides. Perineural invasion was identified in multiple areas. Angiolymphatic invasion was suspected based on nodal findings. All surgical margins were free of neoplasia.\n\nInvolvement of the seminal vesicles was noted bilaterally, while the vasa deferentia appeared benign. No high-grade intraepithelial neoplasia or other significant abnormalities were found in the non-neoplastic prostate tissue.\n\nPathologic staging was determined as pT3a, pN1, pMX. The histologic grade was classified as G3-4, consistent with poorly differentiated or undifferentiated morphology."} +{"pid": "TCGA-GE-A2C6", "report": "The surgical specimen includes a right neck dissection (levels II\u2013IV) measuring 13.0 x 4.8 x 1.8 cm and a left neck dissection (part C) measuring 0.6 x 0.3 x 0.1 cm, along with a total thyroidectomy specimen. The thyroid measures 4.0 x 3.5 x 1.8 cm on the right lobe and 3.6 x 3.5 x 1.6 cm on the left lobe. A dominant lesion is identified in the right lobe, measuring 2.5 cm in greatest dimension. Histologic evaluation reveals cellular features including absence of necrosis, with 1 mitotic figure per 10 high-power fields. Surgical margins are uninvolved by tumor, although the tumor is within less than 1 mm of the resected margin. The lesion is partially encapsulated with evidence of capsular invasion and widespread infiltration into surrounding tissue. Lymphovascular invasion is present, involving fewer than four vessels. Focal extension beyond the thyroid capsule is observed. \n\nExamination of lymph nodes shows involvement in 14 out of 23 nodes examined: 12 out of 20 nodes in part A and 2 out of 2 nodes in part B. One lymph node in part C is negative. The right neck dissection contains multiple firm nodularities, with lymph nodes up to 3.5 cm in size. Additional findings include Hashimoto thyroiditis. Staging assessment indicates pT2 for the primary tumor and pN for regional lymph node involvement. No distant metastasis is identified. Intraoperative frozen section of the left central neck mass confirms absence of malignancy. Gross and microscopic evaluations support the presence of multifocal disease involvement with extensive nodal spread."} +{"pid": "TCGA-E2-A152", "report": "The surgical specimen from the right breast consists of a lumpectomy measuring 9 x 8.5 x 3.4 cm, with a total weight of 99 grams. The specimen was needle-localized and inked with multiple colors to identify margins. Serial sectioning revealed two distinct masses. The first mass measured 1.7 x 1.6 x 1.5 cm and was tan-pink, well-circumscribed, and located near the posterior margin across slices 4 through 7. A second, smaller mass measuring 0.5 x 0.5 x 0.5 cm was identified as tan-pink and firm, located 0.3 cm from the anterior-medial margin in slice 8, approximately 1.9 cm away from the first mass. The tissue between these two nodules showed changes consistent with ductal carcinoma in situ (DCIS). Multiple sections were submitted for analysis, including margins and areas surrounding the lesions.\n\nThree sentinel lymph nodes were also submitted from the right axilla. The first lymph node measured 1.3 x 1.2 x 1.0 cm, the second measured 1.8 x 1.5 x 1.3 cm, and the third measured 0.6 x 0.5 x 0.5 cm. All were tan-pink and underwent serial sectioning with touch preparations taken.\n\nHistologically, the larger lesion demonstrated high nuclear grade features and was associated with DCIS of solid and cribriform types, including central necrosis and microcalcifications. The invasive component was located 0.15 cm from the deep margin. The second lesion shared similar histomorphological characteristics. Given the presence of DCIS connecting the two lesions, they were considered part of a single confluent tumor, with the largest dimension measuring 1.8 cm. No vascular or lymphatic invasion was identified. The tumor was hormone receptor positive for ER, negative for PR, and positive for HER2 by immunohistochemistry.\n\nAll three lymph nodes were negative for metastatic involvement. No lobular neoplasia was identified. The margins of resection were free of invasive disease, and DCIS did not involve the margins. Approximately 15% of the specimen contained DCIS, which was closely associated with the invasive component. The nuclear grade of the DCIS was high, and necrosis was present within this component.\n\nStaging was determined as pT1c with no lymph node involvement (pN0). The surgical margins were negative, with the closest distance of invasive tumor to margin being 0.15 cm at the deep margin. Fibrotic changes related to prior biopsy were noted."} +{"pid": "TCGA-AK-3431", "report": "The specimen was received in three parts. The first part, labeled as a lipoma, consists of a yellow, rubbery mass measuring 7.5 x 5 x 4 cm. It is encapsulated with moist, glistening adipose tissue and no areas of hemorrhage, cysts, or calcifications. Representative sections have been submitted.\n\nThe second part labeled as right kidney and right adrenal consists of a radical nephrectomy specimen weighing 1640 grams with an overall measurement of 28 x 17 x 10 cm. The adrenal gland measures 5 x 3 x 1.5 cm and appears unremarkable. The ureter is patent and grossly free of abnormalities. A large yellowish-tan to orange lesion measuring 11 x 10 x 8 cm distorts the kidney and obliterates the inferior fold and inferior and central calyces. There is no gross evidence of capsular invasion. Sections include the ureter and vascular margins, renal pelvis, areas where the lesion approaches the capsule, viable portions of the tumor, uninvolved renal parenchyma, overlying fat, and surrounding perinephric fat at the hilum.\n\nThe third part labeled as a portion of vena cava thrombus consists of a tan to tan-pink tissue fragment measuring 2.5 x 1.0 x 0.6 cm and has been entirely submitted for analysis.\n\nMicroscopic examination of the lipoma shows fibroadipose tissue without evidence of malignancy. The kidney lesion demonstrates high nuclear grade morphology and is confined to the kidney without involvement of the capsule or margins. No angiolymphatic invasion is identified. The adrenal gland and surrounding fat show no involvement by tumor. Organized thrombus and calcified atherosclerotic plaque are present in the vena cava specimen, but no tumor cells are identified.\n\nHistologic evaluation of the kidney reveals diffuse diabetic nephrosclerosis with arterial nephrosclerosis. Chromosome analysis from cultured tissue demonstrates a normal karyotype (46,XX) in twenty metaphases analyzed. These findings may reflect overgrowth of normal adjacent tissue rather than the primary lesion.\n\nStaging classification is determined as pT2, Nx, Mx."} +{"pid": "TCGA-UB-A7MF", "report": "The specimen from the left lateral segment of the liver consists of a partial hepatectomy measuring 10.5 x 16.5 x 5.1 cm, weighing 487.5 grams. A dominant mass measuring 7 x 4.5 x 4 cm is identified, located 0.1 cm from the surgical margin. The mass is yellow-red, well-circumscribed, and solid. Adjacent to this mass are multiple small vessels with surgical clips, but no apparent involvement by the tumor. Additional nodules are present: one measures 1.4 x 1.3 x 0.5 cm and is 3 cm from the resection margin, another is 0.5 x 0.5 x 0.5 cm and located 4.2 cm from the margin, and a third nodule is 0.8 x 0.7 x 0.4 cm at the hepatic capsule, 3 cm from the resection margin. Histologically, the tumor demonstrates a trabecular growth pattern and is moderately differentiated. Tumor necrosis is less than 30%. Multifocality is present, with a total estimated tumor burden across all foci measuring 9.7 cm. Vascular invasion is identified in slide A2 and confirmed with CD34 immunostaining. There is focal invasion through the hepatic capsule into surrounding fat, but not through the visceral peritoneum. Surgical margins are negative, with the tumor being 0.2 cm from the margin. The non-neoplastic liver parenchyma shows changes consistent with cirrhosis, with a history of hepatitis C. Iron staining reveals 1\u20132+ positivity in Kupffer cells and hepatocytes. No hepatocellular nodules or lymph nodes are identified in the specimen.\n\nA right hemicolectomy specimen is also received, measuring 29 cm in length, including attached ileum and appendix. A polypoid lesion measuring 1.2 x 1.0 x 0.5 cm is located in the right colon, 14.3 cm from the distal margin and 17 cm from the proximal margin. Microscopically, the lesion is invasive into the submucosa (pT1) without involvement of blood or lymphatic vessels, and no perineural invasion is seen. Margins are negative, with the tumor 17 cm from the proximal margin and 14.3 cm from the distal margin. The tumor is 0.4 cm from the serosa. Fourteen lymph nodes are examined, and none show metastatic involvement. No satellite tumor deposits or other significant pathologic findings are present. The tumor is low grade and shows no treatment effect. Immunohistochemical staining for mismatch repair proteins on block B7 shows loss of MSH6 expression, while MLH1, MSH2, and PMS2 are preserved. This result may suggest either Lynch syndrome or promoter hypermethylation, and clinical correlation, including family history and possible genetic testing, is recommended. No gross evidence of perforation is noted. The remainder of the bowel mucosa, including two additional small polyps, shows no invasive malignancy. The ileum and appendix appear histologically unremarkable."} +{"pid": "TCGA-DX-A3LT", "report": "The submitted specimens include two soft tissue excisions from the right arm. The first specimen consists of an elliptical skin section measuring 11.5 x 7.3 cm with a linear scar of 7.5 cm, and attached soft tissue measuring 17 x 7 cm in thickness. Within this specimen, a mass is identified measuring 5.0 cm in greatest dimension. The mass is encapsulated and surrounded by a thin capsule, with no direct involvement of the deep resection margin, which was inked. The mass abuts the lateral margin (green), and is away from the medial (blue), superior (yellow), and inferior (red) margins. On cut section, the mass shows heterogeneity: some areas are yellow-tan and soft, consistent with differentiated fat (approximately 50%), while other regions are firm and white. Representative sections have been submitted for analysis, including those from the tumor in relation to the deep margin, medial and lateral margins, superior and inferior margins, and skin.\n\nThe second specimen consists of two fragments of tan-yellow soft tissue, measuring 3.0 x 1.2 x 0.4 cm and 2.8 x 1.5 x 0.4 cm, entirely submitted for evaluation. Microscopic examination reveals benign adipose tissue with focal fibrosis and foreign-body reaction, without any evidence of malignancy. All resection margins from both specimens are free of tumor. The first specimen also includes skin and subcutaneous tissue with changes related to prior procedures."} +{"pid": "TCGA-AK-3465", "report": "The left kidney specimen weighed 262 grams and measured 16.5 x 9.5 x 6 cm. A mass was identified in the mid-pole region, measuring 5.5 x 5.5 x 4 cm, with a fleshy brown appearance. The mass was in close proximity to the renal capsule and came within 1 cm of the surrounding fat margin. It also involved approximately 50% of the inferior pole. Histologic evaluation showed focal involvement of the renal capsule; however, no lymphovascular invasion was present. The vascular and ureteral margins were free of tumor involvement. Cytogenetic analysis revealed an abnormal karyotype in two mitotic cells characterized by trisomy 12. No other chromosomal abnormalities were detected in the remaining cells. The findings were based on a pTNM classification of pT1b Nx Mx."} +{"pid": "TCGA-L5-A4ON", "report": "A male patient underwent surgical resection of a lesion in the distal esophagus and proximal stomach. The specimen included a portion of fibroadipose tissue with multiple potential lymph nodes. A 5.0 x 3.5 x 2.0 cm tissue fragment was identified, containing a fungating mass measuring 4.0 x 2.2 cm that extended 1.2 cm above the surrounding mucosa. The mass was located 2.8 cm from the proximal esophageal margin and 4.0 cm from the distal gastric margin. Gross examination showed the lesion to be limited to the mucosa without clear extension into the deeper wall layers. The distal esophagus measured 7.5 cm in length, and the proximal stomach measured 4.5 cm. Cross sections of the tumor and adjacent esophageal wall were submitted for analysis.\n\nLymph node evaluation included three potential nodes from the fibroadipose tissue, four mediastinal nodes up to 1.0 cm in size, and one para-esophageal lymph node. Microscopic analysis revealed no evidence of neoplastic cells in the omental biopsy, mediastinal lymph nodes, or the proximal esophageal margin. However, one of the para-esophageal lymph nodes contained abnormal cellular infiltration. The distal esophagus specimen showed invasive changes within the mucosa and submucosa, including polypoid and flat areas of altered cell morphology. All resection margins were free of atypical cells. A total of ten lymph nodes were examined, with one showing involvement.\n\nThe lesion appeared to extend into the submucosal layer, and no distant spread was confirmed. No prior treatment with chemotherapy or radiation was reported. Frozen section analysis of the fibroadipose tissue was negative for neoplasm and was confirmed by permanent sections."} +{"pid": "TCGA-VD-AA8Q", "report": "HISTOPATHOLOGY. Lab No. Clinical Consultant & Location. Unit No. SPECIMEN. RIGHT EYE. Diagnostic and prognostic. CLINICAL DETAILS. Right eye lesion. Right enucleation of globe. Measurements: 13.90 x 12.20 x (10.07) mm. MACROSCOPIC DESCRIPTION. A fresh intact right globe. Dimensions: Axial 26mm Horizontal 24.5mm Vertical 24mm. Cornea: Horizontal 12mm Vertical 11mm. Optic Nerve - flush. Pupil - regular. Angle normal depth. Engorged vortex veins inferiorly were noted. On transillumination, a large shadow is seen on the medial side with a maximum diameter of 17mm. Plane of section: Horizontal. Intraocular description: On opening, a solitary dome-shaped pigmented choroidal mass is observed. The lesion measures 12mm in largest basal diameter and 10mm in height.\n\nMICROSCOPY. Sections reveal a deeply pigmented choroidal lesion composed predominantly of spindle-shaped cells. Immunohistochemical staining demonstrates expression of Melan-A and HSP-27 with a score of 2. Mitotic activity is minimal, with approximately 1 mitotic figure per 40 high power fields. No closed vascular loops are identified within the planes of section. Lymphocytic infiltration within the lesion is sparse, with scattered macrophages present. There is no evidence of necrosis. No extension through the sclera, optic nerve, or vortex veins is observed. Resection margins are free of abnormal cells. Other ocular findings include corneal edema in the basal cell layers, open anterior chamber angles, and a deep anterior chamber. The iris appears unremarkable, though the ciliary body shows atrophy with hyalinization of the ciliary processes. Subcapsular degenerative changes are present in the lens. The retina overlying the lesion shows mild atrophy.\n\nSUMMARY. SPECIMEN. 2= Eye. TUMOUR PRESENT. CELL TYPE. 2= Spindle B. CT LOOPS. 1= No closed loops. NECROSIS. PIGMENTATION. LYMPHOCYTIC INFILTRATION. MITOTIC FREQUENCY. 1/40 HPF. DIFFUSE MELANOMA SPREAD. 1= No. CLEARANCE. 2= Adequate. HSP-27 POSITIVITY. 2= 21-70%. LARGEST BASAL DIAMETER. 12 mm. THICKNESS. 10 mm.\n\nCOMMENT. Molecular genetic testing was performed on extracted DNA from the lesion using multiplex ligation-dependent probe amplification (MLPA), targeting chromosomes 1, 3, 6, and 8. The DNA concentration was high and quality was confirmed prior to analysis. Results from repeated MLPA reactions showed consistent findings. Sequence analysis demonstrated normal copy number for chromosome 1p, disomy 3, normal chromosome 6, and normal chromosome 8. These molecular findings are associated with a lower risk profile for metastatic spread. Clinical features will also be considered in overall risk assessment."} +{"pid": "TCGA-85-7950", "report": "The specimen consists of lung tissue from a pneumonectomy procedure on the left upper side. The tumor measures 2.5 x 2.5 x 4 cm and is composed of poorly differentiated cells. Cellular analysis indicates a high degree of nuclear atypia and pleomorphism with frequent mitotic figures. No information is available regarding histologic grade, tumor extent, presence of additional nodules, lymph node involvement, lymphatic or venous invasion, margin status, neo-adjuvant treatment, or other findings. No further comments provided."} +{"pid": "TCGA-49-AAR0", "report": "The right upper lobe specimen includes a nodule measuring 1.5 x 1.3 x 1.7 cm, located in the medial portion of the lower lobe. The nodule is firm and tan-gray in color on cut section. It approaches the inked pleural margin and is 3.2 cm from hilar structures and 6.5 cm from the stapled margin. Two additional nodules are present on the lateral pleural surface: one measuring 0.4 cm near the apex and another measuring 0.7 cm near the inferior aspect. The remainder of the non-neoplastic lung tissue appears tan-red, brown, and spongy with focal anthracotic pigmentation.\n\nExamination of vascular and bronchial margins is negative for tumor involvement. Two hilar lymph nodes are also negative for tumor. In addition, two hyalinized pleural plaques are identified in the non-neoplastic lung tissue.\n\nA separate excisional specimen from R4 contains one lymph node with associated fibroadipose tissue, and a second excisional specimen from R7 contains one lymph node with associated fibroadipose tissue; both are negative for tumor involvement.\n\nThe specimen was staged based on extent of local involvement and regional lymph node assessment. A row of staples measuring 3.5 cm in length is noted in the superior portion of the hilum. Tissue banking was performed using a portion of the nodule. Representative sections of the nodule, surrounding lung tissue, and lymph nodes were submitted for analysis."} +{"pid": "TCGA-DJ-A3VI", "report": "The specimen consists of a thyroid gland with associated lymph nodes. The thyroid weighs 11 grams. The right lobe measures 3.5 x 2.5 x 1 cm, the left lobe 4 x 2 x 1.5 cm, the isthmus 1 x 0.5 x 0.5 cm, and a pyramidal lobe 2 x 0.5 x 0.5 cm. A 1.2 cm tan nodule with central papillary features is identified in the inferior left lobe. Multiple bilateral colloid nodules are present. The remaining thyroid tissue appears red-tan and beefy. Several lymph nodes are identified, including one attached to the inferior pole.\n\nMicroscopic evaluation reveals a lesion in the left lobe measuring 1.2 cm in greatest dimension. Psammoma bodies are present. The lesion is well differentiated with no necrosis or mitotic activity identified. There is no vascular invasion or extrathyroid extension. Surgical margins are free of involvement. Additional microscopic foci are identified: one in the right lobe measuring 0.2 cm, and two in the left lobe measuring 0.1 cm and 0.2 cm respectively. Adjacent thyroid tissue shows nodular hyperplasia and chronic lymphocytic infiltration consistent with Hashimoto\u2019s thyroiditis. An intrathyroidal parathyroid gland is identified on the left.\n\nThree of five lymph nodes contain metastatic involvement. The largest involved lymph node measures 0.8 cm in greatest dimension, with the largest metastatic deposit measuring 0.6 cm. No extracapsular extension is observed."} +{"pid": "TCGA-EW-A1P5", "report": "A sentinel lymph node evaluation was performed. Sentinel node #1 demonstrated a metastatic deposit measuring 0.6 cm identified only on permanent slides. Sentinel node #2 showed no evidence of metastasis; immunohistochemistry for keratin was negative.\n\nThe right breast specimen was submitted following total mastectomy. Gross examination revealed an ill-defined, pale-tan, firm mass measuring 2.5 x 1.5 x 1.5 cm. Microscopic evaluation identified invasive carcinoma with associated in situ components. Histologic grading showed Nottingham score of 3+2+1 (Grade 2). The invasive component measured 2.5 cm in greatest dimension and was located 1.0 cm from the inferior margin. Margins were free of tumor involvement with the closest distance being 1.0 cm at the inferior margin. No lymphovascular invasion was identified.\n\nIn situ components included ductal carcinoma in situ (DCIS), intermediate nuclear grade without necrosis. Architectural pattern was cribriform and present in 2 out of 15 blocks examined. Extensive intraductal component was not identified.\n\nHistologic evaluation demonstrated glandular/tubular differentiation score of 3, nuclear pleomorphism score of 2, and mitotic count score of 1, resulting in overall histologic grade of 2. Immunohistochemical staining showed positivity for estrogen and progesterone receptors; HER2 testing by FISH did not show amplification.\n\nSentinel lymph node assessment included two nodes. One lymph node contained a metastatic deposit measuring 0.6 cm; no micrometastases or isolated tumor cells were identified in the remaining node. Extracapsular extension was not observed.\n\nPathologic staging was determined as pT2 based on the size of the invasive component and pN1a due to the presence of metastasis in one sentinel lymph node. Distant metastasis could not be assessed.\n\nAncillary studies included immunohistochemistry using clinically validated reagents. Detection methods utilized LSAB technique and results were interpreted by pathologists as positive or negative. Specimen integrity was maintained throughout evaluation.\n\nClinical correlation was provided for a female patient undergoing surgical management for a right-sided breast lesion. Preoperative imaging and biopsy findings were consistent with this lesion. Multiple tissue sections were submitted for detailed histopathologic evaluation including margins, prior biopsy site, nipple complex, and regional lymph nodes.\n\nThe specimen consisted of a mastectomy specimen weighing 6.63 grams and measuring 20.0 x 16.0 x 4.0 cm. Orientation markers included superior (blue), inferior (green), medial (red), lateral (orange), anterior (yellow), and posterior (black) inks. No additional lesions were identified upon gross inspection.\n\nFrozen section analysis during surgery confirmed negative margins intraoperatively. Sentinel lymph nodes were evaluated intraoperatively and both were negative on frozen section; however, permanent sections identified metastatic involvement in one lymph node.\n\nAncillary testing methodology included hematoxylin and eosin staining with one level examined per lymph node, along with immunohistochemical staining where indicated. All assays were conducted on formalin-fixed, paraffin-embedded tissues."} +{"pid": "TCGA-ED-A66Y", "report": "Gross Description: The specimen contains multiple masses located in segments 5, 7, and 8. The largest lesion measures 6x4x4 cm. The margins are moderate, and the masses are solid and firm with a gray-white cut surface. \n\nMicroscopic Description: The cellular arrangement includes trabecular patterns connecting with one another, as well as nodules or sheets interspersed within benign tissue. Invasion into fibrous stroma is observed. The cells exhibit a polygonal morphology with round, vesicular nuclei and prominent nucleoli. The cytoplasm is abundant and varies between basophilic and clear. Nuclear features include irregular contours, increased size, and hyperchromasia, with visible mitotic figures. The stromal component appears fibrous and hyaline. \n\nAdditional Information: Specimen type includes wedge resection and lobectomy. Tumor size corresponds to the previously mentioned maximum dimension. Histologic grade is poorly differentiated. Focality, tumor extent, lymph node involvement, venous invasion, and response to neo-adjuvant therapy were not specified. Margins are uninvolved. No additional findings or comments provided."} +{"pid": "TCGA-95-7562", "report": "The surgical specimen consists of a right lower lobe lobectomy measuring 20.0 x 11.0 x 5.5 cm and weighing 289.5 grams. A well-circumscribed mass measuring 3.5 x 3.1 x 2.1 cm is identified within the lung parenchyma. The lesion demonstrates invasion into the visceral pleura and exhibits lymphovascular invasion. Margins are assessed, with the bronchial margin free of involvement by invasive disease. The tumor is located 23 mm from the closest margin, which is the bronchial margin.\n\nA total of 37 lymph nodes were evaluated across multiple levels: five lymph nodes from right level 9, thirteen from level 7, seven from right level 14, nine from level 11, and three peribronchial lymph nodes. Of these, all except one peribronchial lymph node were negative for metastatic involvement.\n\nHistologic evaluation reveals moderately differentiated morphology with features suggestive of glandular differentiation. Crush artifact was noted in intraoperative frozen sections taken from the bronchial margin and representative tumor tissue.\n\nSections submitted include margins, vascular structures, uninvolved lung tissue, and lymph nodes. No treatment effect was observed. Anatomical staging criteria indicate a primary tumor greater than 3 cm but less than or equal to 5 cm in greatest dimension, involving the visceral pleura without extension beyond the lobar bronchus."} +{"pid": "TCGA-V1-A9OH", "report": "The surgical specimen included lymph node tissue from the right and left pelvis, as well as a prostate gland with attached seminal vesicles. A total of 12 lymph node fragments from the right side and 4 from the left were examined microscopically, and no abnormal cellular findings were identified in any of the nodes.\n\nThe prostate measured 4.0 x 3.5 x 4.0 cm and weighed 49 grams. The external surface was soft and red-tan, and a palpable lesion was noted in the right posterior mid region. The gland was sectioned into five slices and revealed vague yellow areas in the right posterior (slices 1\u20134) and left posterior (slices 2\u20133). The right anterior surface was inked green, the left anterior blue, and the posterior black. Tissue samples were taken from all regions of the gland for microscopic evaluation.\n\nMicroscopic analysis of multiple sections showed a range of histologic patterns. The right posterior region (slides C8 and C11) had areas immediately adjacent to the inked margin at less than 0.1 cm. Tumor cells were also present at the right bladder margin (slide C20). The tumor was found in both seminal vesicles and extended into the right vas deferens. There was evidence of capsular invasion, with tumor extending beyond the capsule in several areas. Perineural infiltration was observed in multiple locations.\n\nTumor volume was estimated at 11.25 cm\u00b3. The majority of the tumor was composed of a high-grade pattern, with a significant portion showing intermediate and low-grade features. The tumor involved the capsule in several locations, including the right and left posterior mid zones, left base, and right base. No benign glands were found at the inked excision margins. All 16 lymph nodes examined were negative for abnormal cells.\n\nStaging was determined based on the extent of local spread and absence of lymph node involvement. Extracapsular extension and involvement of the seminal vesicles were key factors in staging. The surgical margin at the right bladder site was positive."} +{"pid": "TCGA-ZF-AA4X", "report": "Histopathology report. The specimen includes three components: a bladder tumor, the base of the tumour, and the bladder neck. Clinically, the patient presented with a new solid bladder tumour.\n\nGross examination revealed 5g of firm and friable tissue from the first specimen. The second specimen consisted of four pieces of tissue, with the largest measuring 4 mm, and the third contained two pieces, the largest being 6 mm.\n\nMicroscopic analysis of part one showed a high-grade cellular atypia with areas of necrosis. The growth pattern was predominantly solid, with a small focal papillary region. Invasion of muscularis propria was observed, and no vascular channel invasion was noted. A heavy inflammatory infiltrate was present in the background, and carcinoma in situ was identified in flat urothelium.\n\nIn part two, all tissue was processed and included four pieces of bladder wall. There was a significant acute on chronic inflammatory cell infiltrate. Some areas showed nuclear smearing due to crush artefact; however, no morphological evidence of invasive malignancy was found across multiple tissue planes examined. No immunohistochemical studies were performed.\n\nPart three consisted of bladder wall tissue without any findings of invasive cells. No lining epithelium was present in the sample."} +{"pid": "TCGA-AA-3877", "report": "A resected section of the transverse colon was examined. Histological analysis revealed a moderately differentiated, partially mucinous adenocarcinoma arising at the base of a tubulovillous adenoma with severe epithelial dysplasia. The lesion extended up to 5 cm from the resection margin and measured 2 cm in its greatest dimension. The tumor was found to invade the submucosa and was located 4 cm from a small microscopic remnant of a tubular adenoma with mild epithelial dysplasia. Another small tubular adenoma with moderate epithelial dysplasia was identified centrally in the specimen. Both oral and aboral resection margins were free of tumor involvement, as was the greater omentum. Eighteen mesocolic lymph nodes were examined and none showed evidence of tumor; they exhibited only nonspecific reactive changes. Vascular invasion and perineural invasion were not identified. The tumor was histologically graded as G2."} +{"pid": "TCGA-AO-A0JC", "report": "A 45-year-old female presented with a 4.5 cm right breast mass. Specimens submitted for analysis included sentinel lymph node biopsy from level I of the right axilla, a modified radical mastectomy specimen from the right breast including level I and low level II axillary contents, and level II right axillary lymph nodes.\n\nThe sentinel lymph node biopsy from level I of the right axilla consisted of two lymph nodes. Histologic examination and immunohistochemical staining for cytokeratins showed no evidence of metastatic disease.\n\nThe modified radical mastectomy specimen included a mass measuring 5.0 cm in greatest dimension, located in the upper and lower outer quadrants of the breast. Histologic evaluation revealed a high-grade lesion with minimal tubule formation and moderate variation in nuclear size and shape. The tumor was found to be close to the posterior margin but did not involve the surgical margins, nipple, or skin. Perineural invasion was identified, though there was no definite evidence of vascular invasion. Evaluation of non-neoplastic breast tissue revealed fibrocystic changes, a 1.6 cm fibroadenoma with coarse microcalcifications, and biopsy site changes. One benign intraparenchymal lymph node was identified in the breast specimen.\n\nLymph node assessment was as follows: level I axilla contained five lymph nodes, all negative for involvement; level II axilla contained five additional lymph nodes, also without evidence of tumor involvement.\n\nImmunohistochemical studies demonstrated positivity for estrogen receptor (95% nuclear staining with strong intensity) and progesterone receptor (50% nuclear staining with moderate to strong intensity). HER2/neu testing showed no staining. Additional immunostains were performed: tumor cells were positive for CK7, BRST-2, and E-cadherin, while negative for CK20, SMA, HHF35, synaptophysin, and chromogranin.\n\nGross examination of the mastectomy specimen showed a breast measuring 28.5 x 26 x 4.0 cm with a central skin ellipse and everted nipple. The tumor was situated between 8 o\u2019clock and 10 o\u2019clock in the upper and lower outer quadrants, measuring 5.0 x 4.5 x 3.7 cm. The axillary tail measured 8 x 7 x 1 cm. Serial sectioning revealed the tumor abutting the posterior margin. No tags were present, and the posterior surface was inked black. Multiple lymph nodes were identified in the axillary tissue and submitted for evaluation.\n\nAll submitted lymph nodes across levels I and II were benign. An addendum clarified that although the invasive lesion approached the epidermis of the breast skin, it did not directly involve the epidermis.\n\nIntraoperative frozen section consultation of the sentinel lymph node confirmed absence of tumor involvement, consistent with the final diagnosis."} +{"pid": "TCGA-95-7948", "report": "The surgical pathology report includes the following findings. Lymph nodes from stations #7, #11R, and 4R were examined and all were negative for metastatic disease. A total of 23 lymph nodes were evaluated across all specimens, with no evidence of involvement.\n\nA mass was identified in the right lower lobe of the lung. The lesion measured 4.0 x 4.0 x 2.0 cm and was well-circumscribed. Microscopic evaluation showed a predominantly papillary and micropapillary growth pattern. The tumor was well-differentiated and demonstrated angiolymphatic invasion. Visceral pleural invasion was present. Margins, including bronchial and vascular, were free of tumor involvement.\n\nAdditional lung specimens from the posterior segment of the right upper lobe and the inferior portion of the right middle lobe showed benign lung parenchyma. No malignant findings were noted in these areas.\n\nImmunohistochemical staining was performed on representative sections. The tumor cells were positive for CK7, TTF1, and Napsin, and negative for CK20, Mucicarmine, Pax8, and Thyroglobulin. Elastic stain confirmed visceral pleural invasion.\n\nA total of four lymph nodes were identified in the 4R station and all were negative for malignancy. One lymph node was evaluated from the right lower lobe specimen and was also negative. All other margins and tissues examined were unremarkable.\n\nStaging parameters indicated a primary tumor size greater than 3 cm but not exceeding 5 cm, surrounded by lung tissue and extending to the visceral pleura. No regional lymph node involvement was identified. Based on these findings, the tumor was classified according to pT2a criteria with no regional lymph node metastasis (pN0)."} +{"pid": "TCGA-PT-A8TR", "report": "The specimen consists of a uterus with bilateral ovaries and fallopian tubes, submitted following hysterectomy and bilateral salpingo-oophorectomy. A mass is identified in the lower uterine segment. The endometrium shows inactive changes and the myometrium demonstrates adenomyosis. One ovary shows focal surface endometriosis. Paratubal cysts are present in both fallopian tubes. Right and left pelvic lymph nodes are benign with no evidence of involvement.\n\nThe mass is received in fragmented condition, making precise measurement difficult; however, it appears to be at least 14 cm in size. It is composed of cords of moderately to highly atypical spindle cells within a loose myxoid stroma, with prominent hyalinization noted. No necrosis is observed. Mitotic activity is up to 3 per 10 high-power fields. Involvement of parametrial soft tissue and adjacent myometrium suggests an infiltrative growth pattern.\n\nImmunohistochemical staining reveals positivity for desmin and vimentin, while markers including muscle-specific actin, caldesmon, CD34, CD10, and CD117 are negative. These features are consistent with a neoplasm exhibiting morphologic and immunophenotypic characteristics typically associated with this type of tumor, which commonly presents with low mitotic activity, absence of necrosis, and moderate cytologic atypia.\n\nGross examination reveals multiple fragments of pink-red friable soft tissue with mucoid and glistening cut surfaces. The largest fragment measures 16.0 x 14.7 x 7.5 cm and additional detached fragments measure up to 19.0 x 15.0 x 3.0 cm. No identifiable normal uterine tissue is present. An attached mass extends into the parametrial soft tissue measuring 13.5 x 6.5 x 6.0 cm. Additional tumor fragments weigh 390 grams and measure 13.0 x 12.0 x 4.0 cm in aggregate. The endometrium is thin (0.1 cm thick). The myometrium is rubbery and trabeculated. Both fallopian tubes show paratubal cysts measuring 1.8 cm and 0.2 cm respectively. No ovarian or tubal involvement by the mass is identified.\n\nBased on available material, staging is classified as IA."} +{"pid": "TCGA-CN-4728", "report": "The specimen was received unfixed in fourteen parts. Part 1 consisted of multiple irregular, tan-pink, soft tissue fragments measuring 1.5 x 1.2 x 0.4 cm in aggregate. Part 2 included a submandibular gland and attached fibroadipose tissue measuring 8.5 x 3.5 x 1.0 cm with lymph nodes ranging from 0.4 to 1.7 cm. Part 3 included a submandibular gland with fibroadipose tissue measuring 5.5 x 4.5 x 1.3 cm and three lymph nodes ranging from 0.3 to 0.7 cm. Part 4 contained fibroadipose tissue and muscle remnants measuring 14.0 x 5.0 x 1.2 cm with lymph nodes ranging from 0.2 to 1.5 cm and a vascular segment measuring 3.0 x 0.3 cm. Part 5 was a roughened, tan-gray, hemorrhagic tissue measuring 2.5 x 1.5 x 0.5 cm. \n\nPart 6 was an unoriented mucosal excision with underlying soft tissue and muscle measuring 6.5 x 5.5 x 3.1 cm. The mucosal surface exhibited a central gray and hemorrhagic cavitated lesion measuring 4.5 x 3.3 cm, coming within 0.4 cm of the closest mucosal surgical resection margin. On cross-section, the lesion penetrated 1.4 cm in depth, grossly abutting and possibly involving the deep soft tissue resection margin. Two portions of cortical and cancellous bone were also received.\n\nPart 7 was a strip of roughened, tan-gray, focally hemorrhagic tissue measuring 1.5 x 1.0 x 0.3 cm. Part 8 was a portion of tan-brown soft tissue measuring 3.0 x 0.5 x 0.2 cm. Part 9 was a portion of tan-red, hemorrhagic soft tissue measuring 4.0 x 1.5 x 1.0 cm. Part 10 was portions of tan-red, hemorrhagic soft tissue measuring 2.0 x 2.0 x 0.7 cm in aggregate. Part 11 was a portion of tan-red, roughened soft tissue measuring 4.0 x 1.0 x 0.4 cm. Part 12 was a strip of tan-red, roughened soft tissue measuring 4.2 x 1.0 x 0.6 cm with an attached suture designating posterior. Part 13 was portions of tan-red, roughened soft tissue measuring 2.0 x 1.0 x 0.4 cm in area. Part 14 was yellow-red, lobular fibroadipose tissue containing multiple probable lymph nodes measuring 13.0 x 4.7 x 1.4 cm with lymph nodes ranging from 0.1 to 1.9 cm in greatest dimension.\n\nIntraoperative frozen section consultation confirmed malignant findings in Part 1, while all other tested margins and biopsies (Parts 5 through 13) showed no tumor involvement. Microscopic examination revealed prominent perineural invasion and venous/lymphatic invasion. Bone with intraosseous fibrosis was noted but no tumor was seen. Margins were free of tumor involvement. Pathologic staging was determined as pT3, N2b, MX. A total of 58 regional lymph nodes were examined, with 2 involved nodes. No extracapsular extension of nodal tumor was observed. Immunohistochemistry for p16 was performed and found to be negative."} +{"pid": "TCGA-CV-A6JT", "report": "The specimen measured 5 x 3 x 1.8 cm and consisted of tongue tissue with a light tan-white, firm nodule measuring 2 x 1 x 3 cm on the cut surface. The nodule was ulcerating and showed infiltrative borders with thick cords greater than four cells in diameter. Invasion was present, with a depth of 1.5 cm. Perineural invasion was noted focally. Vascular and lymphatic invasion were not identified. Lymphocyte infiltration was absent. The radial mucosal margin was negative; however, the deep radial margin was close, measuring less than 2 mm. \n\nA total of thirty-four lymph nodes were evaluated: three from level I, five from level II, and twenty-six from level III. All were negative for involvement. The submandibular gland was also negative. The deep tongue specimen, composed of skeletal muscle, fibro-connective tissue, and minor salivary gland, showed no evidence of tumor. The entire specimen was serially sectioned and submitted for analysis."} +{"pid": "TCGA-EW-A2FW", "report": "A total of six lymph nodes were examined, including one suspicious lymph node from the right breast and five sentinel lymph nodes. All lymph nodes showed no evidence of malignancy on initial histologic evaluation with hematoxylin and eosin staining, and keratin immunostains were negative in all cases. Frozen section analysis during surgery also showed no evidence of carcinoma in any of the lymph nodes evaluated.\n\nThe resected breast specimen was a partial mastectomy measuring 11 x 10 x 6 cm. A fibrotic mass measuring 2.8 cm in greatest dimension was identified at the junction of the upper outer and lower outer quadrants. The closest resection margin was 1.5 mm away from the tumor, and no involvement of the skin or deep margins was observed. No lymphovascular invasion was identified.\n\nMicroscopic evaluation revealed a poorly differentiated invasive carcinoma with papillary features. Histologic grading using the Nottingham system yielded a score of 8 (grade 3), with a glandular/tubular differentiation score of 3, nuclear pleomorphism score of 2, and mitotic count score of 3. A separate small nodule measuring 0.3 cm was found near the main tumor.\n\nDuctal carcinoma in situ (DCIS) of high nuclear grade (equivalent to DIN 3) with comedo-type architecture was present, but did not involve the surgical margins. No lobular carcinoma in situ was identified. There was no evidence of dermal or lymphovascular invasion.\n\nAncillary studies performed on a separate specimen showed low positivity for estrogen and progesterone receptors (1% immunoreactive tumor cells), and HER2 testing was negative (score 0) by immunohistochemistry; FISH analysis was not performed.\n\nAll immunohistochemical stains were performed using validated methods, and results were interpreted by a pathologist. The tumor was localized to a single focus without extensive intraductal component. The final pathologic staging was pT2 NO MX, indicating a primary tumor greater than 20 mm but less than 50 mm, with no regional lymph node metastasis identified. No prior neoadjuvant therapy was administered."} +{"pid": "TCGA-EW-A1P1", "report": "**Pathologic Findings Summary:**\n\nA sentinel lymph node evaluation was performed, with findings as follows: Sentinel node #1 showed involvement in one out of one lymph node. Sentinel node #2 contained involvement in three out of four lymph nodes. Sentinel node #3 showed no evidence of involvement in one lymph node. \n\nThe lumpectomy specimen measured 6 cm in greatest dimension and showed a mass measuring 2.3 cm in maximum dimension. The margins of resection were free of involvement. The closest margins were medial and anterior, each at 4 mm from the mass. The surrounding non-neoplastic breast tissue demonstrated fibroproliferative disease, radial scar, atypical ductal hyperplasia, and changes consistent with a prior biopsy site.\n\nAxillary lymph node dissection revealed six out of twenty-three lymph nodes with involvement. Level 3 lymph node sampling showed one out of three lymph nodes involved.\n\nHistologically, the invasive component was classified as ductal type and graded using the Nottingham system as 3 + 3 + 3 = 9/9. Vascular invasion was present. An in-situ component was identified as high nuclear grade ductal type with central necrosis and calcifications. Immunohistochemical staining was performed using validated laboratory methods.\n\nStaging was determined as pT2, N3, MX."} +{"pid": "TCGA-BP-4998", "report": "The specimen from a right partial nephrectomy was received fresh and labeled, containing a wedge-shaped portion of kidney measuring 8.0 x 6.8 x 4.1 cm, with a suture marking a cyst at the margin. The specimen was serially sectioned, revealing a circumscribed mass measuring 3.5 x 3.1 x 2.8 cm that bulges through the surface of the renal parenchyma. The mass had a heterogeneous cut surface with cystic, hemorrhagic, and golden tan solid areas. The distance from the tumor to the resection margin was 0.5 cm. Sectioning near the suture identified a cyst measuring 0.8 cm in greatest dimension, extending to the inked surgical margin. Attached perirenal fat measured 11.5 x 8 x 3 cm and was representatively submitted. Portions of the mass were submitted for further analysis, and a gross photograph was taken.\n\nHistologic evaluation showed nuclear grade III/IV morphology. No local invasion or vascular invasion was identified. Surgical margins were free of abnormal cellular aggregates. Adjacent non-neoplastic kidney tissue showed simple cortical cysts and chronic interstitial inflammation. Adrenal and lymph node tissues were not present in the specimen. The tumor was confined within the kidney and measured less than 7.0 cm in greatest dimension.\n\nA separate specimen labeled \"left lateral lower pole cyst wall\" was received in formalin and consisted of a single fragment of pink-tan soft tissue measuring 0.2 cm in greatest dimension, submitted entirely for evaluation.\n\nAll sections from both specimens were reviewed and no diagnostic limitations were encountered. Special studies were performed as needed, and the findings were confirmed through personal examination of the slides."} +{"pid": "TCGA-P5-A731", "report": "The clinical evaluation was prompted by suspicion of a central nervous system lesion. Gross examination revealed grayish, soft to elastic tissue fragments originating from the right frontal and temporal lobes. Histologic analysis demonstrated predominantly normal brain parenchyma with focal regions exhibiting mixed glial and neuronal elements. These areas show moderate cellularity with a notable presence of calcifications. Nuclear features are mildly atypical without evidence of mitotic activity or necrosis. Lesional tissue is confined to limited foci within the resected specimen."} +{"pid": "TCGA-D7-8579", "report": "The resected stomach specimen measured 18 x 19 cm, with an attached omental segment measuring 15 x 7 cm. Upon incision along the greater curvature, a thickened area was observed in the pyloric region, measuring 4.4 x 5.4 cm. The lesion was located 8.8 cm from the proximal margin and 2.6 cm from the distal margin.\n\nHistologically, the lesion exhibited solid growth pattern with areas displaying tubular and mucinous features. The tumor infiltrated into the muscular layer of the lesser omentum. Vascular emboli were identified. Surgical margins showed no evidence of residual disease. In the surrounding non-neoplastic tissue, chronic inflammation of high intensity (+++) was noted, with scattered low-intensity inflammatory foci (+).\n\nLymph node evaluation included periorificial (lesser curvature) nodes, among others. Of the total 14 lymph nodes examined, 4 demonstrated involvement by the process. Immunohistochemical staining for HER2 protein using Ventana\u2019s Pathway HER-2/neu (4B5) Rabbit Monoclonal Antibody showed strong positive reactivity in invasive cells, with a score of 3+."} +{"pid": "TCGA-DH-A66F", "report": "The submitted specimen consisted of multiple fragments of soft tissue from the brain. The first specimen measured 2.5 x 1.5 x 0.5 cm in aggregate and was described as beige to pink-tan. A second specimen measured 3.5 x 3.0 x 0.8 cm in aggregate and was noted to be beige to red-tan in appearance. Representative sections were processed for histological evaluation.\n\nHistologic examination revealed an infiltrating neoplasm with a largely uniform cellular morphology. The tumor cells were small with round nuclei, perinuclear halos, and a background of fine, chicken-wire-like vasculature. Areas of focal calcification and microcystic change were also observed. While much of the tumor exhibited diffuse infiltration, some nodular regions were present. No definitive mitotic figures were identified on routine H&E staining. However, immunohistochemical analysis demonstrated two small areas with increased Ki-67 labeling and mitotic activity, confirmed by phosphohistone H3 staining, a marker of mitotic spindles.\n\nImmunohistochemical studies showed strong glial fibrillary acidic protein (GFAP) reactivity within tumor cell processes. Nuclear positivity for p53 was detected in approximately 10\u201315% of tumor cells. Immunostaining for mutated isocitrate dehydrogenase-1 (IDH-1) was strongly and diffusely positive throughout the tumor.\n\nFluorescence in situ hybridization (FISH) analysis performed on paraffin-embedded tissue demonstrated deletions of chromosomes 1p and 19q. These genetic alterations were interpreted in the context of existing literature regarding their prognostic significance in similar tumors.\n\nAll specimens were processed according to standard protocols. Some portions were submitted for permanent sectioning while others were used for intraoperative consultation or banking. The pathologist personally reviewed all material and confirmed the adequacy of sampling and diagnostic interpretation.\n\nThis report was issued in compliance with CLIA-88 standards for high-complexity testing. Certain assays used in the evaluation have not been cleared by the FDA but are employed under clinical laboratory guidelines for diagnostic purposes."} +{"pid": "TCGA-HB-A43Z", "report": "The surgical pathology report describes findings from a hysterectomy specimen with bilateral salpingo-oophorectomy. The uterus weighed 690 grams and measured 12.3 x 8.3 x 7.2 cm. The cervix was unremarkable. The endometrium was atrophic and contained a polyp measuring 2.5 x 2.0 x 0.6 cm, located on the anterior wall. The myometrium contained a mass measuring 10.0 x 9.5 x 4.5 cm, which appeared to originate from the myometrial tissue. Histologic evaluation of this mass showed a proliferation of pleomorphic spindle cells with marked cellular pleomorphism, increased mitotic activity (greater than 10 mitoses per 10 high power fields), and areas of necrosis. The tissue showed infiltrative growth into the myometrium without involvement of the endometrium or serosa. Lymphovascular space invasion was also identified. Additional findings in the myometrium included a small benign nodule and adenomyosis.\n\nSections of the right and left ovaries and fallopian tubes were unremarkable, with no abnormal findings noted. Both ovaries showed atrophic changes. The right ovary measured 3.8 x 1.9 x 1.0 cm, and the left ovary measured 2.8 x 1.5 x 1.2 cm. Both fallopian tubes were patent and showed no significant abnormalities.\n\nStaging was performed according to AJCC criteria and classified as pT1b, pNx, pMx. Multiple tissue blocks were submitted for analysis, including sections from the cervix, endometrial polyp, myometrial mass, and adnexal structures. Tissue remains in formalin, and tumor material was submitted to tissue procurement."} +{"pid": "TCGA-CK-5915", "report": "The specimen labeled \"sigmoid colon, partial colectomy\" measures 23.2 cm in length and includes a polypoid and fungating mass with ulceration and an infiltrating border. The lesion measures 5.8 cm in greatest dimension and is located in the sigmoid colon. Histologic examination reveals moderately differentiated morphology with low-grade features. Invasion extends into the muscularis propria but not through the serosa. All resection margins\u2014proximal, distal, and radial\u2014are free of tumor involvement. The closest mucosal resection margin is 7.5 cm from the invasive edge of the lesion. No lymphovascular, extramural venous, or perineural invasion is observed. There is no evidence of a peritumoral lymphoid response or residual adenoma. Thirteen regional lymph nodes are examined, and none show involvement. According to the AJCC 6th edition classification, the staging is pT2 NO MX. Additional findings include hyperplastic polyps and diverticulosis.\n\nThe second specimen, labeled \"proximal donut,\" consists of a 1.0 cm segment of bowel attached to a circular stapling device. No lesions are identified, and the entire specimen is submitted for analysis.\n\nThe third specimen, labeled \"distal donut,\" measures 1.9 x 1.5 x 0.9 cm and shows no gross abnormalities. Approximately 80% of the tissue is separable from the staples and is submitted for evaluation.\n\nAll specimens were processed and analyzed with appropriate microscopic examination conducted by the senior physician."} +{"pid": "TCGA-ZB-A96P", "report": "Pathology Report-Summary: Material: Tumor: 8.0 X 7.5 X 5.0 cm. The tumor is composed of epithelial cells that are positive for CK 5/6. Lymphocytes are present and show positivity for TdT, while negative for CD3. No staining observed for CD20, CK18, and CD117. Histological evaluation indicates pT1 staging. Masaoka staging shows stage I."} +{"pid": "TCGA-EY-A5W2", "report": "The specimen consists of a uterus with cervix, bilateral ovaries and fallopian tubes, removed via hysterectomy with bilateral salpingo-oophorectomies. The uterus weighed 235 grams and measured 12.2 cm in height, 5.4 cm in anterior-posterior width, and 7.5 cm in breadth at the fundus. The endometrial cavity measured 7.0 cm in length and 6.5 cm in width at the fundus. A mass was identified measuring 12.5 cm along the anterior wall, extending over the fundus and down the posterior wall, measuring 6.5 cm in width and 3.0 cm in depth. The mass was described as white/tan, soft, polypoid, and fungating with areas of hemorrhage. It involved the anterior, fundal, and posterior walls of the endometrium, filling and distending the endometrial cavity. Myometrial invasion was noted in the outer half of the myometrium with a depth of 11 mm; the total myometrial wall thickness was 21 mm, representing approximately 52% invasion. No serosal involvement was identified. Involvement of the lower uterine segment was present, while cervical and adnexal involvement were not identified.\n\nA total of 23 regional lymph nodes were examined: 8 from the right pelvic region, 8 from the left pelvic region, 4 from the right para-aortic region, and 3 from the left para-aortic region. All lymph nodes were free of tumor involvement.\n\nAdditional findings included multiple intramural nodules ranging from 0.3 x 0.3 x 0.2 cm to 1.8 x 1.5 x 1.2 cm, described as rubbery, white, and whorled. A benign endocervical polyp measuring 0.7 x 0.5 x 0.5 mm was also identified on the anterior side of the cervix. The ovaries and fallopian tubes showed no significant abnormalities. Multiple sections of the cervix, lower uterine segment, corpus, and fundus were submitted for analysis, including areas of deepest gross invasion and friable tumor mass.\n\nNo lymphovascular space invasion was identified. Cervical and vaginal margins were negative and widely free. The final staging assessment indicated localized disease without nodal involvement. Additional clinical review may affect final staging classification."} +{"pid": "TCGA-A8-A06Z", "report": "The specimen shows a moderately differentiated invasive carcinoma with a tumor diameter of 8 cm. The distance to the dorsal resection margin is less than 0.1 cm. Histological evaluation indicates a grade II lesion. Staging reveals a pT3 classification with involvement of lymphovascular structures; however, the exact origin or specific type of tumor cannot be further classified based on available data."} +{"pid": "TCGA-57-1586", "report": "The specimen from the right ovary consists of a yellow to gray tan hemorrhagic soft tissue mass measuring 6.0 x 5.0 x 3.0 cm. The cut surface is yellow-gray and fibrotic. Normal ovarian tissue is not grossly identifiable. Representative sections were taken for genomic studies and placed in orange cassettes labeled A, C, and D. Additionally, two cassettes (one green, one yellow) were submitted with representative sections, totaling six cassettes.\n\nThe omentum specimen includes multiple pieces of yellow tan to gray tan fibroadipose tissue measuring 25.0 x 11.0 x 3.0 cm. The cut surface reveals gray tan fibrotic bands intermixed within the adipose tissue. Representative sections are submitted in two cassettes.\n\nThe left ovary specimen consists of a yellow-gray, slightly hemorrhagic soft tissue mass measuring 4.5 x 3.5 x 3.0 cm. The cut surface is yellow-gray with slight hemorrhage and appears fleshy. Normal ovarian tissue is not grossly identified. Representative sections are submitted in five cassettes.\n\nMicroscopically, high-grade cellular atypia is noted. Lymphovascular space invasion is present. Involvement of the cortical surface and attached soft tissue is observed. Extensive involvement is identified in the omentum. Staging is determined as T3C, NX, M1."} +{"pid": "TCGA-B6-A0RM", "report": "CLINICAL HISTORY: Locally advanced left breast lesion. GROSS EXAMINATION: A. \"Left breast biopsy\", in formalin. Three irregular fragments of yellow-tan fibroadipose tissue measuring 3.5 x 2 x 0.9 cm in aggregate. Sectioning reveals fibroadipose tissue with focal areas of firm, pink-tan poorly circumscribed tissue embedded within the adipose tissue. A portion of the specimen was previously removed by Dr. Ind and submitted for ER/PR evaluation. Remaining tissue is sectioned and submitted in toto in Blocks A1 and A2. B. \"Left axillary lymph nodes\", in formalin. An irregular fragment of red-orange fibroadipose tissue measuring 2 x 1.2 x 0.9 cm containing an embedded lymph node candidate measuring 1.1 x 0.5 x 0.5 cm in greatest dimension. The specimen is bisected and submitted in toto in Block B1. \n\nSUMMARY: Histologic evaluation shows a lesion of intermediate differentiation with nuclear features of moderate grade. Invasion into skeletal muscle is identified. In the axillary specimen, nodules of atypical cells are present; however, definitive lymph node structures are not recognized."} +{"pid": "TCGA-BR-A4J8", "report": "The specimen consists of a fragment of the stomach along with a portion of the esophagus. A lesion measuring up to 7.5 x 5.2 cm is present, with involvement of the full thickness of the gastric wall. Adjacent fatty tissue contains multiple lymph nodes, some appearing dense and hyperemic, with the largest measuring up to 1.5 cm. The omentum, spleen, and surgical margins show no macroscopic abnormalities.\n\nMicroscopically, there is a poorly differentiated epithelial neoplasm with infiltration into the perigastric adipose tissue. Vascular invasion is evident, with tumor emboli identified within blood vessel lumina. A total of twelve lymph nodes were examined\u2014seven from the greater curvature and five from the lesser curvature\u2014with all showing evidence of metastatic involvement. The surgical margins are free of tumor infiltration. The omentum shows focal hemorrhagic changes, while the spleen exhibits signs of red pulp hypoperfusion. Additional lymph nodes collected separately demonstrate histiocytosis and anthracosis.\n\nStaging according to the 7th edition of the AJCC classification indicates T3N3aM0. The tumor is ulcerated and extends into the perigastric fat with venous invasion noted. No treatment effect is observed. The histologic type is poorly differentiated, with subserosal extension and all examined lymph nodes positive for metastasis. Lymphatic and perineural invasion are not specified. No evidence of neo-adjuvant treatment is seen, and no additional pathologic findings are reported."} +{"pid": "TCGA-CG-4474", "report": "The specimen includes a gastrectomy preparation with involvement of a poorly differentiated neoplasm. The lesion is located in the antrum along the lesser curvature and extends to the aboral resection margin, which includes the duodenum. There is evidence of transmural extension with involvement of the peritoneal surface. Six regional lymph nodes show metastatic involvement. Additionally, two deposits are identified in the omentum and one deposit is present in the peritoneum. The primary tumor measures greater than 4 cm and invades through the muscularis propria into the peritoneum. Lymph node dissection included 39 nodes, with 6 involved by metastasis. Distant metastases are confirmed based on involvement of the omentum and peritoneum."} +{"pid": "TCGA-CQ-5333", "report": "The specimen consisted of multiple tissue samples including lymph nodes from the left neck external jugular region, left neck level IV, left neck levels IA and IB, left neck level II, and left neck levels III and IV. Additional specimens included tissue from the left tonsil pillar, left retromolar trigone, medial tongue margin, oral cavity (tongue resection), and surgical waste. All lymph node specimens were negative for tumor, with a total of 21 lymph nodes examined and none involved. The submandibular gland and surgical waste tissues showed no pathologic changes.\n\nThe tongue resection specimen revealed a well-circumscribed lesion located on the lateral surface of the left lateral tongue. The lesion measured 3.2 cm in greatest dimension and had a thickness of 1.0 cm. Microscopic evaluation demonstrated spindle cell morphology with poor differentiation. No evidence of lymphatic or vascular invasion or perineural invasion was identified. Surgical margins were free of tumor involvement. Grossly, the tumor was ulcerated, tan, solid, and firm, located at varying distances from the anterior, medial, superior, and posterior margins of the resected tongue tissue. Representative sections of all margins and tumor areas were submitted for analysis."} +{"pid": "TCGA-L6-A4EQ", "report": "A lymph node biopsy and total thyroidectomy were performed. The lymph node specimen measured 0.8 x 0.7 x 0.4 cm and was found to contain abnormal tissue. The thyroid gland weighed 42.7 grams. The right lobe measured 3 x 2.5 x 1.5 cm, the left lobe 6.5 x 3 x 1.5 cm, and the isthmus 4 x 4 x 1.5 cm. A solid lesion measuring 3.5 x 3.2 x 2.2 cm was identified in the left lobe, and a cystic lesion measuring 3.3 x 2.5 x 2 cm (in deflated state) was found in the isthmus. Tissue from each lesion, along with normal thyroid tissue, was procured for analysis and research. The external capsule of the thyroid appeared unaffected by the lesions. The solid lesion in the left lobe was well-circumscribed, yellow-tan, with areas of punctate hemorrhage but no necrosis or scarring. The cystic lesion in the isthmus had a finely papillary and granular appearance with focal hemorrhage and contained a calcified area measuring approximately 0.8 x 0.6 x 0.6 cm. No evidence of fibrous capsule or capsular or vascular invasion was identified in the Hurthle cell lesion. Immunostaining showed positivity for thyroglobulin and negativity for calcitonin. Micrometastasis was confirmed in the lymph node based on intraoperative consultation and further testing. All tests were developed and validated by the Laboratory of Pathology and are used under CLIA certification for high-complexity testing."} +{"pid": "TCGA-VS-A8EJ", "report": "The biopsy specimen from the cervix demonstrates a neoplastic process involving the transformation of squamous epithelium. Microscopic evaluation reveals invasive growth patterns with poorly differentiated cellular morphology. The tumor cells exhibit marked nuclear atypia, increased nuclear-to-cytoplasmic ratios, and frequent mitotic figures. No lymphovascular invasion is identified. The lesion is confined to the cervix without evidence of regional or distant spread. Tumor dimensions and depth of invasion are consistent with localized disease."} +{"pid": "TCGA-DD-AACF", "report": "The liver specimen measured 11.5 x 6.8 x 6.2 cm and weighed 208.5 grams. The gallbladder was 11.0 cm in length, 4.5 cm in diameter, and had a wall thickness of 0.4 cm. A cystic lymph node was identified measuring 1.2 x 1.0 x 0.8 cm. One lesion was identified in segment 4 of the liver, measuring 4.4 x 3.4 x 3.0 cm, located 0.2 cm from the resection margin. There was no satellite nodule present. The gross appearance of the lesion was expanding nodular without necrosis, but with 50% hemorrhage or peliosis. A total of nine blocks were examined: tumor tissue (five blocks), resection margin (one), non-tumorous liver parenchyma (two), gallbladder (one), and cystic lymph node (one).\n\nMicroscopically, the lesion showed partial fibrous capsule formation with evidence of capsular infiltration. Histologic architecture was pseudoglandular, with a mix of differentiation grades\u2014moderately differentiated overall, with the worst focus classified as grade III. Cellular morphology was consistent with hepatic origin, with less than 5% fatty change. There was no evidence of invasion into the portal vein, bile duct, hepatic vein, hepatic artery, or serosa, nor was there microvessel invasion, intrahepatic metastasis, or multicentric occurrence. The surgical resection margin was free, with a clearance distance of 0.2 cm.\n\nEvaluation of the non-tumorous liver tissue revealed chronic hepatitis of HCV etiology, with minimal lobular activity and mild portoperiportal inflammation, along with micronodular cirrhosis. No dysplastic nodules, ductal epithelial dysplasia, or other significant liver disease were identified. The gallbladder showed changes consistent with chronic cholecystitis, and the cystic lymph node exhibited reactive hyperplasia. Steatosis in the liver was mild."} +{"pid": "TCGA-HT-A74L", "report": "The pathology report describes a diffusely infiltrating glioma located in the right parietal region. Microscopic evaluation shows a proliferation of cells with predominantly round nuclei and variably prominent nuclear halos. Perineuronal satellitosis is present. The tumor cells exhibit mild to moderate cytologic atypia, but no mitotic figures are identified. Occasional foci of microcystic change are noted. There is no evidence of necrosis or microvascular proliferation. The histologic features are consistent with a previously reported biopsy diagnosis of low-grade morphology. Special stains are pending for final classification."} +{"pid": "TCGA-DD-A73D", "report": "Female. A wedge resection of the liver, segment VII, reveals a well-differentiated lesion forming a single mass measuring 4.8 x 4.0 x 3.5 cm. The lesion is confined to the liver with no evidence of macroscopic vascular invasion. Microscopic examination shows presence of small vessel invasion. The resection margin is tumor-free with a distance of 1.0 cm. No regional lymph nodes were identified. Evaluation of the surrounding liver tissue demonstrates changes consistent with chronic hepatitis C infection and cirrhosis. Staging according to AJCC (7th edition, 2012) is pT2 pNX pMX. A separate specimen from the gallbladder following cholecystectomy shows findings of chronic cholecystitis and cholelithiasis. Additional staining on the lesion tissue demonstrates absence of reticular framework and positivity for glypican-3. Reticulin and trichrome stains on the non-lesional tissue confirm structural changes associated with cirrhosis."} +{"pid": "TCGA-AN-A0XW", "report": "Female patient with tumor located in the left breast, identified as a primary lesion. The tumor specimen was obtained via surgery and preserved in OCT medium within a block container. Histological evaluation revealed a grade 2 lesion measuring 2 cm in greatest dimension. Microscopic analysis showed infiltrative growth pattern with ductal features. Lymph node involvement was present, with metastatic cells detected in regional lymph nodes, while no distant metastasis was identified. No prior treatment was administered. A separate blood sample was collected via venipuncture and stored frozen in a tube."} +{"pid": "TCGA-2F-A9KW", "report": "The histologic evaluation identified a high-grade lesion involving the right bladder wall. The tumor measured 1.2 cm in diameter and demonstrated muscle invasion. In addition, there was evidence of carcinoma in situ. The tumor was classified as grade 3. A total of 16 lymph nodes were examined, and no involvement was identified."} +{"pid": "TCGA-QG-A5YW", "report": "The peritoneal nodule is a well-circumscribed lesion composed of spindled cells arranged in fascicles. There is no significant cytologic atypia, necrosis, or mitotic activity. Stains for CD117 and CD34 are negative, while desmin shows diffuse positivity. The lesion is located on the cecal serosal surface and measures 0.8 cm in greatest dimension.\n\nA right hemicolectomy specimen includes a segment of cecum with a tumor measuring 7.2 x 6.9 x 4.5 cm. The tumor is endophytic, hard, and ulcerative, involving the cecal mucosa and extending to the subserosal fat. It is circumferential and obliterates the ileocecal valve. The serosa is tan-pink to tan-red and hemorrhagic. A serosal umbilication is present, located 16.5 cm from the proximal margin and 18 cm from the distal margin. The mesentery contains a palpable mass measuring 4.2 x 3.4 x 1.7 cm that extends to the surgical margin, which is inked blue. The tumor does not involve the proximal, distal, or mesenteric margins. No gross perforation is identified.\n\nLymph node evaluation reveals 15 total lymph nodes, with 11 involved by metastatic disease. Additionally, there are five foci of discontinuous extramural tumor extension. No lymphovascular or perineural invasion is identified. The appendix is unremarkable.\n\nMultiple sections of the tumor, surrounding tissue, lymph nodes, and margins were submitted for histologic analysis. Microscopic examination confirms the presence of a primary cecal tumor with features of conventional adenocarcinoma, with minor components showing mucinous and signet ring cell morphology. Tumor deposits are also seen in the mesenteric fat and near the mesenteric margin, but not at the inked margin."} +{"pid": "TCGA-D1-A17N", "report": "A panniculectomy specimen consisting of skin and subcutaneous tissue weighing 2020.0 grams was examined grossly and showed no lesions. A hysterectomy specimen with bilateral salpingo-oophorectomy was also examined. The uterus weighed 145.0 grams and had an unremarkable cervix and smooth serosal surface. The endometrial cavity demonstrated thickening. No leiomyomas were identified. A well-circumscribed, trabeculated nodule measuring 4.5 x 4.1 x 3.1 cm was noted in the myometrium. The right ovary measured 2.7 x 1.2 x 0.8 cm with a smooth outer surface and solid cut surface; the right fallopian tube measured 8.5 x 0.4 cm. The left ovary measured 2.9 x 1.2 x 1.0 cm with a smooth outer surface and solid cut surface; the left fallopian tube measured 6.5 x 0.5 cm. Both ovaries and fallopian tubes showed no diagnostic abnormalities. Histologic sections included multiple levels of the endometrial cavity, fallopian tubes, ovaries, lower uterine segment, and cervix. The nodule was confined to the endometrium and did not extend to the endocervix. Adenomyosis was present in the myometrium."} +{"pid": "TCGA-X6-A7WB", "report": "The surgical pathology report includes a uterus specimen measuring 560 grams, with dimensions of 9.9 cm cornu to cornu, 7.6 cm anterior to posterior, and 21.9 cm cervix to fundus. The cervix measures 2.0 x 3.1 cm with a 0.3 cm os. A mass is identified in the myometrium, described as a pink-tan-red, fleshy firm whorled lesion involving the anterior and posterior uterine cavity. It extends through the full thickness of the myometrium and reaches the serosal surface on the posterior side. The mass measures 10.1 x 9.5 x 9.1 cm. The endometrium is thin (<0.1 cm), red-tan, and slightly roughened. No gross involvement of the cervix or adnexa is noted. Several blocks were submitted for microscopic evaluation, including sections from the cervix, uterine segments, endomyometrium, tumor margins, and areas of possible lymphovascular space invasion.\n\nAdditional specimens include bilateral salpingo-oophorectomy specimens. The right ovary and fallopian tube measure 4.2 x 3.6 x 1.3 cm; the fallopian tube is 2.9 cm in length and 0.6 cm in diameter, while the ovary is 2.5 x 1.6 x 1.1 cm. The left ovary and tube measure 3.5 x 2.6 x 1.5 cm, with the fallopian tube measuring 3.5 x 0.6 cm and the ovary 2.1 x 1.5 x 1.4 cm. All sections show no diagnostic abnormalities.\n\nA soft tissue specimen labeled \"tumor\" measures 2.0 x 0.9 x 0.5 cm and consists of red-yellow, previously bisected tissue. Another excised soft tissue specimen from the posterior cul-de-sac measures 8.4 x 2.4 x 1.9 cm and is described as pink-red and friable. A second posterior cul-de-sac specimen measures 3.4 x 2.8 x 1.2 cm, with a smooth and glistening surface and areas of cautery. A third left posterior cul-de-sac specimen is also present. An omentectomy specimen measures 43.5 x 16.6 x 1.8 cm, with yellow-red lobulated tissue and no discrete masses identified.\n\nMicroscopic examination of the uterus reveals full-thickness myometrial involvement with cellular proliferation. The cells exhibit moderate atypia with increased mitotic activity. Vascular space invasion is present. The endometrium appears inactive. Other pelvic soft tissue specimens show no evidence of similar cellular changes. Sections of the cervix, fallopian tubes, ovaries, and omentum do not reveal any significant pathological findings.\n\nBased on the available material, the primary lesion involves other pelvic tissues. Regional lymph nodes could not be assessed. The pathologic stage is T2b NX."} +{"pid": "TCGA-AZ-4615", "report": "The gallbladder specimen shows cholelithiasis and chronic cholecystitis with associated ulceration and intramural histiocytic inflammatory infiltrate. No malignancy is identified in this portion.\n\nThe right hemicolectomy specimen includes the cecum, appendix, and terminal ileum. An ulcerated lesion measuring 4 cm in greatest dimension is present in the cecum adjacent to the ileocecal valve. The lesion extends through the muscularis propria and focally involves the colonic and appendiceal subserosa, reaching within less than 0.5 cm beyond the muscularis propria border. It also extends into and obstructs the appendiceal orifice and lumen. A mucinous component is identified within the appendiceal lumen, with associated acute and organizing appendicitis or periappendicitis. The terminal ileum and non-neoplastic colon show no significant histopathologic abnormalities. Surgical resection margins and serosal surfaces are benign and uninvolved.\n\nA single regional lymph node out of eighteen examined contains metastatic involvement, with the focus measuring 0.4 cm. There is no extracapsular extension. Angiolymphatic invasion is present; perineural invasion is not identified. The closest distance of the invasive lesion to an uninvolved margin is 50 mm at the mesenteric margin.\n\nStaging data indicate involvement of the primary site extending beyond the muscularis propria (pT3a/b), with regional nodal involvement (pN1). Distant staging is indeterminate (pMX). The histologic grade is high, showing moderate to focal poor differentiation. The tumor demonstrates an infiltrating growth pattern. Additional findings include appendiceal obstruction and associated inflammation."} +{"pid": "TCGA-77-8139", "report": "Histopathology Report. HISTORY. Right upper lobe lesion. MACROSCOPIC. Two specimens submitted. 1: The first specimen consists of a lobectomy specimen of lung measuring approximately 180 x 120 x 36 mm. The bronchial resection margin measures approximately 15 mm in external diameter. Peripherally, there is an ill-defined firm mass palpable within the lung with attachment to adjacent parietal pleura and a portion of three ribs measuring between 38 mm and 75 mm in length. The pleura elsewhere appears normal. The lesion measures at least 55 mm in diameter and extensively invades intercostal soft tissue including muscle. The lesion appears clear of the soft tissue resection margins and is intimately associated with the periosteum of the longest rib segment centrally. Sections include shave of bronchial resection margin and peribronchial lymph nodes (1A); shave of peribronchial vascular resection margin and section of peripheral normal lung (1B); sections of the lesion (1C\u20131E); sections of the lesion in relation to parietal pleura and chest wall (1F\u20131I); transverse section of the longest segment of rib in relation to the lesion (1J). 2: The second specimen consists of multiple small lymph nodes and one larger node measuring up to 14 mm in maximum extent. MICROSCOPIC. 1: Sections show a moderately differentiated squamous cell morphology invading into the pleura and soft tissue of the chest wall including intercostal muscle. The soft tissue resection margins are free of malignant cells. No vascular, lymphatic or perineural invasion identified. Tumour stroma contains a heavy plasmacytic infiltrate, but tumour-infiltrating lymphocytes are not prominent. The bronchial resection margin is free of malignancy but demonstrates patchy squamous metaplasia and focal mild dysplasia. Adjacent lung parenchyma shows organizing pneumonia; distant lung parenchyma demonstrates severe emphysema. Peribronchial lymph nodes do not show metastatic involvement. 2: Lymph nodes show reactive changes only. No evidence of metastatic involvement. SUMMARY. Right upper lobectomy, chest wall resection and hilar lymph node sampling. Lesion size approximately 55 mm. Invasion into chest wall present with clear soft tissue margins. No vascular, lymphatic or perineural invasion observed. No lymph node metastases identified. Pathological stage T3 NO. SUPPLEMENTARY REPORT. Decalcified section of rib does not demonstrate periosteal or bony invasion. CC: Lung Cancer Registry."} +{"pid": "TCGA-EY-A4KR", "report": "The surgical specimens include multiple lymph node groups, a hysterectomy specimen with cervix, bilateral fallopian tubes and ovaries, and additional lymphadenectomy tissues. Lymph nodes from the right pelvic region show involvement in all three nodes, with the largest focus measuring 2 cm. Left obturator lymph nodes show four out of four involved nodes, with the largest measuring 1.5 cm. Involvement is also seen in one left pelvic lymph node with the largest focus measuring 1.9 cm.\n\nThe uterus measures 13 x 11 x 12 cm and weighs 768 grams. It is distorted by multiple subserosal nodules, including a calcified nodule measuring up to 7.5 cm. There is a 9.4 x 6.4 x 2.5 cm lesion protruding into the endometrial cavity, extending into the lower uterine segment and endocervical canal. Invasion extends through the myometrium into, but not through, the serosa. The depth of invasion is greater than 99%, involving the outer half of the myometrium with a wall thickness of 2.9 cm and invasion depth of 2.89 cm. Serosal involvement is present without full penetration. Cervical involvement includes both endocervical glands and stroma. Negative cervical margins are noted at 0.6 cm.\n\nBoth fallopian tubes show involvement with obliteration of the lumina. Extensive lymphovascular space invasion is observed bilaterally in the ovaries, with limited parenchymal invasion identified in one ovary measuring up to 0.2 cm. No ovarian surface involvement is noted. Additional findings include epithelial inclusion cysts and physiologic changes in both ovaries.\n\nMultiple leiomyomas are present, with the largest measuring 7.5 cm. Pathologic staging indicates extensive local invasion with involvement of regional lymph nodes. Clinical staging information reflects advanced local extension and lymph node involvement. Additional clinical correlation is recommended for final staging classification.\n\nIntraoperative consultation was performed on a biopsy from the right pelvic region, showing high-grade carcinoma features. Gross examination confirms extensive involvement across multiple anatomical sites including the uterus, adnexa, and lymph nodes."} +{"pid": "TCGA-CV-7406", "report": "The specimen consists of a composite resection including a portion of the left mandible measuring 7.0 x 5.5 x 1.6 cm and a separate portion of the base of the tongue measuring 3.5 x 2.8 x 3.3 cm. An ulcerated lesion is identified in the posterior aspect of the base of the tongue within the left tonsillar region. The lesion measures 1.5 x 1.0 x 0.5 cm and is located within 0.2 cm from the posterior lateral margin (not the true margin), 0.7 cm from the anterior/inferior margin, 0.8 cm from the lateral margin, and 1.2 cm from the medial margin. The deep margin is in close proximity to the lesion at approximately 1.0 mm but appears free of involvement.\n\nMicroscopic evaluation reveals a thickness of 1.5 cm with presence of lymphatic and vascular invasion. Margins include the base of the tongue margin, which shows squamous mucosa without evidence of tumor. The anterior margin demonstrates a microscopic focus of atypical epithelial cells. The medial pharyngeal wall displays squamous mucosa without tumor involvement. The superior margin consists of fibroconnective tissue and skeletal muscle, also without tumor. The new anterior margin reveals squamous mucosa without tumor present.\n\nA separate salivary gland specimen from the left neck includes attached adipose tissue measuring 4.0 x 2.8 x 1.0 cm. Within this tissue, two possible lymph nodes are identified measuring 0.3 cm and 0.6 cm in greatest dimension. Microscopic sections show fibrosis and inflammation without evidence of tumor involvement. Additional submitted margins include a full-thickness section of tissue from the base of the tongue margin measuring 1.1 x 0.5 x 0.3 cm, a sliver of tan-pink tissue from the anterior margin measuring 2.0 x 0.2 x 0.2 cm, a single sliver of mucosa from the medial pharyngeal wall measuring 1.5 x 0.2 x 0.2 cm, and a superior margin measuring 1.0 x 0.3 x 0.3 cm. All additional margins were evaluated and found to be free of tumor. A final strip of mucosa from the new anterior margin measuring 2.5 cm in length was also confirmed to be without tumor."} +{"pid": "TCGA-B6-A0RS", "report": "The submitted left breast specimen weighed 560 grams and measured 37.0 x 17.5 x 3.0 cm in greatest dimensions. The overlying skin ellipse measured 13.5 cm in length. A large bruise was noted on the lower outer quadrant, extending from the areola to the skin edge, measuring 3.0 x 1.5 cm. Palpation identified a firm nodule adjacent to the nipple at the intersection of the upper and lower inner quadrants, measuring 2.5 x 2.0 x 2.5 cm. The pectoralis fascia was previously marked with Alcian blue, and two longitudinal incisions were made parallel to the long axis of the specimen, each measuring 9.5 cm in length. The firm area extended to within 1.2 cm of the deep surgical margin. Multiple tissue blocks were submitted for analysis, including sections of the firm area involving the deep margin, adjacent skin, nipple, and representative areas of all breast quadrants, as well as lymph node zones I, II, and III. No abnormal involvement was identified at the surgical margins or in the 15 lymph nodes examined. Microscopic evaluation of the lesion showed high-grade cellular features with nuclear grading consistent with poorly differentiated morphology. Additional findings included focal moderate epithelial hyperplasia, small cysts, apocrine metaplasia, and fibrosis."} +{"pid": "TCGA-EM-A3FM", "report": "The specimen received includes a right neck dissection, a right paratracheal lymph node, a Delphian lymph node, and a total thyroidectomy specimen. The thyroid was oriented with a stitch at the left upper pole and weighed 30.4 grams. The right lobe measured 5.7 cm x 3.0 cm x 2.1 cm, the left lobe 3.3 cm x 2.2 cm x 0.8 cm, and the isthmus 2.1 cm x 1.8 cm x 0.8 cm. The right upper lobe contained a dominant nodule measuring 2.2 cm in greatest dimension. Additional nodules were identified throughout the gland, ranging from tan and translucent to fleshy and yellow.\n\nMicroscopic evaluation of the thyroid revealed multiple distinct lesions. One lesion showed classical papillary architecture and cytomorphology with focal tall cell features present in approximately 5% of the cells. Another lesion displayed a combination of classical and follicular variant architecture with classical cytomorphology. There was also evidence of follicular nodular disease and mild reactive C-cell hyperplasia. Additional small foci included a 0.7 cm classical variant microcarcinoma in the isthmus, a 0.7 cm encapsulated follicular variant with focal capsular invasion in the left lobe, and smaller foci of both classical and follicular variants measuring 0.4 cm, 0.1 cm, and 0.1 cm respectively.\n\nThe tumor in the right lobe was widely invasive with no evidence of a capsule. Margins were free of involvement. No lymphovascular or perineural invasion was identified, and there was no extrathyroidal extension. A second tumor in the right lobe measured 1.2 cm and showed minimal capsular invasion.\n\nLymph node analysis included a right neck dissection containing 41 lymph nodes, with 7 involved by metastatic disease. The right paratracheal lymph node and the Delphian lymph node each showed metastatic involvement. Three additional right perithyroidal lymph nodes and one from the isthmus were also involved. Four right perithyroidal lymph nodes showed evidence of extranodal extension. In total, 53 lymph nodes were examined, with 17 demonstrating involvement. No pathological findings were noted in the thymus; however, a simple epithelial cyst was identified in the parathyroid region.\n\nThe procedure performed was a total thyroidectomy with concurrent Delphian, right paratracheal, and right neck dissection. The fresh specimen was received intact. Based on TNM staging criteria, the primary tumor was classified as pT2 (tumor greater than 2 cm but less than 4 cm confined to the thyroid), and regional lymph node involvement was classified as pN1b (metastases to unilateral cervical lymph nodes). Distant metastasis could not be assessed."} +{"pid": "TCGA-QR-A70K", "report": "A left retroperitoneal mass measuring 2 x 1.5 cm was identified and histologically consistent with splenic tissue. A separate right-sided adrenal lesion was also excised. The adrenal specimen measured 10 x 9 x 8 cm and weighed 429 grams. On gross examination, the mass was ovoid, focally disrupted, and displayed a heterogeneous red-tan cut surface with areas of hemorrhage and necrosis. Approximately 50% of the mass consisted of necrotic tissue. The tumor was well-circumscribed, soft, friable, and tan-brown in color. Adipose tissue surrounding the adrenal gland was examined for lymph nodes; none were identified. Histologic evaluation revealed cells positive for synaptophysin, chromogranin, S100, and inhibin. No vascular or capsular invasion was observed. Immunohistochemical stains were performed as part of the diagnostic evaluation. All tissue samples were processed according to institutional protocols."} +{"pid": "TCGA-KN-8435", "report": "The right radical nephrectomy specimen includes a unifocal lesion within the kidney. Grossly, the tumor measures 8.3 cm in greatest dimension and is located within the renal parenchyma, closely approximating the perinephric fat. The mass consists of two distinct areas: one tan and hemorrhagic measuring 6.2 cm x 6 cm x 4 cm, and another nodule measuring 4.3 cm x 4 cm x 2.5 cm. The ureter is patent, and margins are uninvolved by invasive cells. Histologically, the lesion demonstrates G2 nuclear features with slightly irregular nuclei approximately 15 microns in size and evident nucleoli. Venous invasion is not present. Staging indicates the tumor is pT2, confined entirely to the kidney and measuring greater than 7 cm. No lymph nodes were submitted for evaluation; thus, regional lymph node status (pNX) and distant metastasis (pMX) cannot be assessed. Additional findings include chronic inflammation and positive staining for colloidal iron. A separate tissue fragment from the vena cava region shows fibrovascular composition without identifiable lymph nodes."} +{"pid": "TCGA-A2-A0ER", "report": "The specimen was obtained from a female patient with a history of a right breast mass. The lumpectomy specimen measured 7.5 x 5.5 x 1 cm and contained a lesion with a tan, gritty cut surface measuring 1.3 x 1.0 x 0.7 cm. This lesion was located 0.3 cm from the deep margin and 0.3 cm from the inferior anterior margin. Histologically, the lesion showed moderately differentiated features based on histological scoring (tubules=3, nuclear size=2, mitoses=1, total=6). A separate focus showed in situ changes with solid and cribriform patterns, including necrosis. Additional findings included fibroadenoma and fibrocystic changes with apocrine metaplasia and usual ductal hyperplasia. All other margins were negative for involvement.\n\nTwo sentinel lymph nodes were evaluated. Sentinel lymph node #1 measured 2.2 x 1.4 x 1.6 cm and contained a micrometastasis measuring 0.6 mm. Sentinel lymph node #2 measured 1.5 x 1.2 x 1.2 cm and showed no evidence of metastatic involvement. Multiple sections were examined using hematoxylin and eosin staining as well as immunohistochemistry for keratin.\n\nThe final deep margin consisted of benign fibroadipose and skeletal muscle tissue, with no evidence of residual disease. The superior-anterior margin was inked blue and was involved by the lesion, while other margins were uninvolved. Radiographic correlation confirmed the location of the lesion relative to a metallic clip and localization wire. Tissue blocks were submitted systematically for evaluation, including multiple paired cassettes around the lesion and margins."} +{"pid": "TCGA-BP-4342", "report": "The specimen from the left kidney and adrenal gland measured 30.0 x 18.0 x 10.0 cm. A hemorrhagic, yellowish mass measuring 11.0 x 9.0 x 5.0 cm was identified in the superior aspect of the kidney. The mass extended just beneath the renal capsule and appeared to be grossly confined within it. A separate tan-white cyst measuring 5.0 x 4.0 x 3.0 cm was located in the inferior portion of the kidney with a smooth internal surface, also confined within the renal capsule. Approximately 80% of the renal parenchyma was replaced by the mass, leaving a residual kidney tissue measuring 5.0 x 3.0 x 3.0 cm. The tumor had a yellowish-brown, hemorrhagic cut surface with focal necrosis and involved the pelvis and renal vein. The adrenal gland measured 3.0 x 2.0 x 0.6 cm and showed no abnormalities. Perinephric adipose tissue was unremarkable, and no definite lymph nodes were identified. All surgical margins, including the renal vein and ureter, were free of involvement.\n\nMicroscopically, the tumor exhibited an acinar growth pattern with nuclear grade III/IV features. The tumor measured 11 cm in its greatest dimension and was limited to the renal capsule; however, there was evidence of invasion into the renal vein. Adjacent renal parenchyma and adrenal gland showed no signs of involvement. Examination of perinephric fatty tissue revealed no tumor.\n\nA separate specimen of para-aortic lymph nodes was received, consisting of fatty tissue measuring 5.0 x 5.0 x 2.5 cm. Multiple lymph nodes ranging from 0.3 to 1.0 cm in size were identified and entirely submitted for analysis. No abnormal pathology was observed in these lymph nodes.\n\nAnother specimen consisting of a fragment of adipose tissue from the left kidney measured 20.0 x 9.0 x 1.5 cm. Serial sections revealed only mature adipose tissue without any identifiable nodules or abnormal structures."} +{"pid": "TCGA-BP-5010", "report": "The right kidney specimen measured 18.5 x 10.6 x 8.8 cm and weighed 1205 grams. A large mass measuring 12.2 cm in greatest dimension was identified within the upper pole and extended into the middle pole of the kidney. The tumor exhibited an irregular, soft, and variegated appearance. It extended through the renal capsule but remained confined within Gerota\u2019s fascia. Involvement of the renal sinus fat and hilar fat was observed. The tumor extended into the renal pelvis and invaded multiple medium- to large-caliber vessels near the renal sinus and hilum. Renal vein invasion was present with involvement of the inferior vena cava below the diaphragm. The tumor thrombus measured 6.3 x 5.1 x 3.1 cm within the attached segment of the vena cava. Surgical margins including the renal artery, ureter, and inferior vena cava were free of tumor involvement.\n\nTwo renal calculi measuring 0.5 cm each were identified in the middle pole. A multiloculated cyst measuring 2.4 cm was noted in the middle pole but could not be separated from the main tumor mass due to lack of intervening normal parenchyma. No lymph nodes were grossly identified in the perinephric fat or elsewhere during examination.\n\nMicroscopic evaluation confirmed cellular features consistent with high-grade morphology. Nuclear grading was assessed as Fuhrman Grade IV. There was no involvement of the adrenal gland or lymph nodes. Extensive sampling of lymph node regions revealed no tumor involvement across all examined specimens.\n\nStaging assessment indicated extension into the renal vein and vena cava below the diaphragm. Vascular invasion was documented with tumor extending into multiple vessels at the renal sinus and hilum. Non-neoplastic kidney tissue showed a well-defined corticomedullary junction with cortical thickness measuring approximately 0.6 cm. Paratumoral reactive changes were noted.\n\nSections submitted included representative portions of the tumor with hilar fat, sinus fat, renal pelvis, renal artery margin, ureteral margin, inferior vena cava margin, adrenal gland, and remaining kidney tissue from the lower and middle poles. Additional specimens included segments of vena cava wall with and without thrombus, as well as lymph nodes from paracaval, precaval, hilar, suprahilar, and interaortocaval regions. All lymph nodes examined were negative for tumor involvement."} +{"pid": "TCGA-34-5929", "report": "The surgical specimen includes a resected left upper lobe mass measuring 4.8 cm in maximum dimension and 4.1 cm in minor dimension. Microscopic evaluation reveals a poorly differentiated tumor with angiolymphatic invasion present. There is no evidence of visceral pleural invasion or extrapulmonary extension. The tumor demonstrates a mild lymphocytic host response. No gross or microscopic satellite lesions are identified.\n\nResection margins, including bronchial and vascular margins, show no involvement by tumor. Evaluation of surrounding lung tissue reveals respiratory bronchiolitis and emphysematous changes.\n\nA total of 18 lymph nodes were sampled: 5 N1 and 13 N2 lymph nodes. All lymph node specimens show benign histology with no evidence of metastatic involvement. The closest distance from the invasive tumor to the surgical margin is 2 mm.\n\nAncillary studies including histochemical and immunohistochemical stains were performed. Fluorescence in situ hybridization (FISH) analysis for EGFR and ALK was conducted. For EGFR, 60 cells were analyzed, revealing a ratio of EGFR/CEP7 of 1.09, with no evidence of gene amplification or high copy number. For ALK, analysis of 61 cells showed only 1 cell (1.6%) with a fusion and single orange signal, consistent with a negative result for ALK rearrangement.\n\nPathologic staging is determined as pT2a, pN0, with M stage not applicable."} +{"pid": "TCGA-E7-A4IJ", "report": "A cystectomy specimen shows a lesion in the bladder with ill-defined margins, measuring 2 x 2 x 1.5 cm. The lesion has a soft, pink-gray surface. Microscopically, the lesion is composed of cells arranged in papillary fronds and trabeculae. These cells exhibit marked nuclear enlargement with variation in size and shape, irregular nuclear membranes, prominent nucleoli, and abnormal chromatin distribution. The cytoplasm is scant and may be eosinophilic or clear. Mitotic figures are present. The lesion extends into the muscular layer of the bladder wall. Hemorrhage is noted within the stroma along with lymphocytic infiltration. Lymphatic and venous invasion are observed. No other tumor features or additional findings are specified."} +{"pid": "TCGA-DX-A23Z", "report": "The surgical specimen consists of an en bloc resection including colon, kidney, adrenal gland, and spleen. The aggregate specimen measures 35 x 25 x 8 cm. Two nodules are identified on the peritoneal surface, measuring 0.4 x 0.4 x 0.2 cm and 0.3 x 0.3 x 0.2 cm. The colon measures 67.5 cm in length with an average diameter of 3.5 cm. One area of firm mesocolic fat appears fixed to the colon, located approximately 18.5 cm from one margin. Attached to the colon is a segment of skeletal muscle measuring 6.5 x 3 x 1 cm. Two small polyps are present on the colonic mucosa, measuring 0.5 x 0.3 x 0.3 cm and 0.2 x 0.2 x 0.1 cm, located approximately 29.5 cm from one margin and about 2 cm apart. Beneath the firm mesocolic area, a well-demarcated nodule measuring 1.8 x 1.5 cm is observed.\n\nSectioning reveals a mass within the lower pole of the kidney and adjacent perinephric fat, measuring 6.5 x 5 x 4.5 cm. This lesion compresses the renal pelvis and has a white, firm cut surface. A separate white nodule measuring 1.5 x 1.2 x 1 cm is identified within the perinephric fat. No additional renal abnormalities are noted. The adrenal gland appears normal and measures 3 x 0.8 x 0.8 cm. No lymph nodes are identified in the hilar region. The ureter segment measures 0.3 cm. The spleen measures 12 x 8 x 3.5 cm with no remarkable findings on gross examination.\n\nHistologic evaluation reveals multiple cellular components. One component exhibits features consistent with high-grade pleomorphic and spindle cell morphology growing as distinct nodules measuring up to 6.5 cm. These nodules focally invade the renal cortex. Adjacent tissue demonstrates a less cellular component with morphologic characteristics suggestive of differentiation. This component extends focally into soft tissue margins and involves one colonic margin. No tumor necrosis is identified.\n\nAdditional findings include a colonic tubular adenoma, simple renal cyst, focal sclerotic glomeruli, and intimal thickening in interlobular arteries. One benign lymph node is identified. Distal left colon specimen measures 9 cm in length with a smooth serosal surface and no gross lesions. Histologically, this portion shows no significant findings.\n\nMargins assessed include vascular, colonic, and peritoneal surfaces. Representative sections were submitted for analysis from multiple sites including colon, kidney, adrenal gland, spleen, lymph nodes, and surrounding fat."} +{"pid": "TCGA-BQ-7056", "report": "The patient presented with a history of left lower extremity sarcoma and an incidental right renal mass. Specimens submitted included a right kidney core biopsy, radical nephrectomy, and excision of pre and paracaval lymph nodes.\n\nGross examination of the right kidney showed a heterogeneous tan-pink to golden-yellow tumor measuring 3.6 x 3.4 x 2.5 cm located in the cortex with focal extension into the medulla and perirenal fat. The tumor exhibited areas of friability, multinodular growth, desmoplasia, and necrosis. It extended into the renal sinus fat but did not involve the renal pelvis or hilar fat. The remainder of the kidney showed a well-defined corticomedullary junction, with mild interstitial chronic inflammation noted in non-neoplastic regions. No adrenal gland was identified. Surgical margins were free of tumor involvement.\n\nMicroscopic evaluation revealed a high-grade neoplasm with papillary, cribriform, and solid architectural patterns. Tumor cells were present within medium to large muscular vessels and lymphatic spaces in the renal sinus region. A total of 11 lymph nodes from the pre and paracaval regions were examined and none showed evidence of tumor involvement.\n\nImmunohistochemical staining was positive for CK7 (focal strong), racemase (diffuse strong), and 34BE12 (focal weak), and negative for CK20 and CA-9. These findings were reviewed in consensus conference and correlated with the histomorphologic features.\n\nStaging criteria indicate the tumor extends into the renal vein or vena cava below the diaphragm (pT3b)."} +{"pid": "TCGA-FF-8061", "report": "Histopathology Report. Received Date/Time. Reporting Information. Date/Time : Histopathologist : Laboratory : Consultant-In-Charge. Histopathology Report. The specimen shows involvement by a lymphoproliferative process. The immunophenotype is consistent with a germinal centre-derived B-cell origin based on expression of CD10, bcl6, and variable LMO2. However, there is also weak and heterogeneous staining for MUM1, along with strong expression of FoxP1, which has been associated with non-germinal centre subtypes. GROSS DESCRIPTION: The specimen is received in formalin, labeled with patient data, and designated \"small bowel mass with sigmoid colon.\" It consists of an en bloc resection of a small bowel mass along with adherent segments of small and large bowel. The small bowel loops are twisted and kinked, with portions entrapped within the surrounding mass, measuring approximately 70 cm in total length and 8 cm in diameter. The mass itself measures 15 x 14 x 9 cm, located 7 cm from the far end and 4 cm from the near end of the small bowel segment. It has a pale pink, fleshy cut surface. A segment of large bowel, 9 cm in length and 4.5 cm in circumference, is attached to the external surface of the mass; its mucosa appears unremarkable. No discrete lesions are identified in the cross-stapled segment, which measures 6 x 3.5 x 1 cm. No definitive lymph nodes are identified. Margins and tissue blocks are designated as follows: A1 (far margin of small bowel), A2 (near margin of small bowel), A3 and A4 (shaved margins of large bowel), A5 to A8 (tumour with entrapped small bowel), A9 and A10 (tumour with adjacent mucosa). MICROSCOPIC DESCRIPTION: Microscopic sections reveal transmural infiltration in the small intestine by a population of large lymphoid cells arranged diffusely. Scattered tingible body macrophages are present, giving a focally \"starry sky\" pattern. The neoplastic cells exhibit vesicular chromatin, moderate nuclear pleomorphism, and prominent nucleoli, with mitotic figures noted. Immunohistochemical analysis confirms B-cell lineage with positivity for CD20 and PAX5. Germinal centre markers including CD10 and bcl6 are expressed, with variable LMO2 staining. There is also weak and heterogeneous MUM1 expression and strong nuclear staining for FoxP1. No residual follicular dendritic network is identified with CD21 immunostaining. The proliferation index is very high (>90%), and most tumour cells show strong expression of bc12, which is not typical of Burkitt lymphoma. Scattered small B lymphocytes and T lymphocytes are present but not significantly expanded."} +{"pid": "TCGA-CM-6170", "report": "The specimen consists of a segment of colon measuring 49 cm in length with a distal circumference of 4.5 cm. A mass lesion is identified, measuring 3.5 cm in length and 2.2 cm in width. The lesion is located 36 cm from the proximal margin and 4.3 cm from the distal margin. Gross examination shows that the lesion invades the muscularis propria, with an approximate depth of invasion measuring 0.5 cm. No gross perforation is identified. Focally hemorrhagic lobulated yellow-tan adipose tissue spans the length of the specimen, measuring up to 4 cm in thickness.\n\nTwo small polyps, each measuring 0.3 cm in greatest dimension, are found in the remaining mucosa, located 17 cm proximal to the lesion. All lymph nodes identified within the attached adipose tissue have been submitted for analysis, with no evidence of metastatic involvement. Twelve lymph nodes were examined, and none showed presence of tumor cells.\n\nHistologically, the lesion demonstrates a moderately differentiated morphology. Tumor budding, increased tumor-infiltrating lymphocytes, lymphovascular invasion, large venous invasion, and perineural invasion are not identified. The surgical margins are free of tumor involvement.\n\nPrecursor lesions include a tubulovillous lesion and two small tubular adenomas located away from the main lesion. Representative sections of the specimen, including proximal and distal margins, lymph nodes (including bisected lymph nodes), polyps, and tumor tissue, have been submitted."} +{"pid": "TCGA-NA-A4QW", "report": "A 134-gram hysterectomy specimen includes the uterus, cervix, bilateral tubes, and ovaries. The specimen measures 10.8 x 6 x 1.3 cm. Upon opening, a 6 x 5 x 3.8 cm pedunculated soft yellow-tan mass is identified primarily within the posterior endometrial cavity (measuring 4.5 x 3.3 cm). The mass is located 4 cm from the internal os and does not grossly appear to invade the lower uterine segment or endocervical canal. The cut surface of the mass is fleshy, focally lobulated, and white-tan with areas of cystic change up to 0.7 cm in size. There is no apparent invasion of the underlying myometrium, which measures 1.3 cm in thickness. The remainder of the endometrium is unremarkable, measuring 0.1 cm. Three intramural nodules are present, with the largest measuring 1.7 cm. These nodules are well-circumscribed, whorled, and have a white-tan bulging cut surface without evidence of hemorrhage or necrosis.\n\nSections from the anterior and posterior cervix, lower uterine segment, endomyometrial insertion sites, and representative sections of the mass and surrounding uninvolved tissue are submitted. Additional sections include both adnexa. The right adnexa consists of a 6.2 cm long fallopian tube and an attached mesentery with a 2.5 x 1.4 x 0.7 cm yellow bosselated ovary; the left adnexa includes a 5 cm long fallopian tube and a 2.3 x 1.1 x 0.9 cm yellow bosselated ovary. Both ovaries appear grossly unremarkable.\n\nLymph node dissection includes specimens from the left pelvic region, right pelvic region, and para-aortic area. The left pelvic lymph nodes are submitted as an aggregate measuring 6.4 x 5.1 x 1.5 cm, from which twelve candidates are identified, ranging from 0.6 cm to 3.5 cm in greatest dimension. Nine lymph node candidates are identified in the right pelvic specimen, measuring between 0.7 cm and 4.5 cm. Two lymph node candidates are identified in the para-aortic specimen, measuring 2.5 cm and 1 cm respectively. All lymph node specimens are sectioned and submitted for microscopic evaluation.\n\nMicroscopic examination reveals a proliferation of malignant-appearing epithelial elements, predominantly glandular, along with a significant stromal component containing heterologous elements including rhabdoid cells. Multiple sections do not show definite muscular invasion. Lymphatic or vascular invasion is not identified. Adjacent non-neoplastic endometrium shows benign endometrial polyps and atrophic changes. The remaining myometrium demonstrates leiomyomata and adenomyosis. Cervical glands are involved by tumor; however, there is no evidence of stromal invasion. The serosal surface and surgical margins are free of involvement. Bilateral ovaries and fallopian tubes show no pathological findings.\n\nAll lymph nodes examined from the left and right pelvic regions and the para-aortic area are negative for malignancy (0 out of 21 total lymph nodes involved). No evidence of metastasis is found."} +{"pid": "TCGA-N5-A4RA", "report": "The surgical specimens included multiple lymph nodes and tissues. The uterus showed a lesion with deep myometrial invasion, extending into more than half of the myometrium. The maximal thickness of invasion was 12 mm, in an area where the myometrium measured 18 mm in total thickness. No involvement of the endocervix was identified, although vascular invasion was present. Benign findings were noted in the adnexal regions, and leiomyomas were observed in the myometrium.\n\nLymph node evaluation revealed several positive sites. A right para-aortic lymph node showed involvement, as did two of four left para-aortic lymph nodes. One of two left external iliac lymph nodes was also involved. In contrast, the right external iliac, right obturator, and left obturator lymph nodes were uninvolved. The omentum was benign fibroadipose tissue. Biopsies from the diaphragm, paracolic gutters, and pelvic regions showed only benign fibrous or fibromuscular tissue.\n\nExamination of one of the lymph nodes showed marked follicular hyperplasia. Immunohistochemical studies performed on this node demonstrated a pattern consistent with reactive changes. Additional testing is in progress for further classification."} +{"pid": "TCGA-DU-7009", "report": "The pathological evaluation of the brain biopsy reveals multiple tissue fragments measuring 0.3\u20130.5 cm. Microscopic examination shows a moderately hypercellular lesion involving both the white matter and cortex, with mild pleomorphism noted. No mitotic figures, endothelial hyperplasia, or necrosis are identified. The tumor appears to be a low-grade lesion without anaplastic features. The proliferative index (MIB-1) in the primary specimen is 48, while in the additional tissue retrieved from the radiologically enhancing area, it is less than 0.5%. Both specimens show similar histological characteristics."} +{"pid": "TCGA-UF-A7J9", "report": "The specimen from the right supraglottic site showed invasive malignant cells. Following surgical resection, which included the larynx, neck dissection, and right hemithyroidectomy, a second lesion was identified. The tumor measured 3.0 x 2.4 x 1.0 cm and extended into multiple regions including the glottic, supraglottic, and right infraglottic areas. Involvement was noted in the thyroid, cricoid, and arytenoid cartilages as well as adjacent soft tissue at the right-posterior aspect of the larynx. Histologic examination revealed moderately differentiated malignant cells with moderate stromal desmoplasia. No evidence of perineural, vascular, or lymphatic invasion was observed. The left vocal cord, epiglottis, and preepiglottic space were free of tumor involvement. The left thyroid gland demonstrated changes consistent with goiter. All surgical margins were clear. Evaluation of lymph nodes showed no involvement: fifteen nodes from the neck dissection and three from the right recurrent dissection were all negative for malignancy."} +{"pid": "TCGA-EJ-7330", "report": "The surgical specimen includes a radical prostatectomy with bilateral seminal vesicles, as well as lymph node excisions from the right and left pelvic regions. A total of eighteen lymph nodes were examined, with no evidence of malignancy identified in any of the nodes (0/18). The prostate specimen weighed 82.49 grams and showed a lesion with a maximum histologic diameter of 1.7 cm, though the overall tumor measured up to 3.3 cm. The lesion was present in both the right and left lobes of the prostate, involving approximately 28% of the examined prostate volume.\n\nHistologic evaluation revealed a cellular composition consistent with an aggressive variant, with features including a high-grade component. The tumor exhibited established extracapsular extension, particularly noted at the left anterior apex and left posterior base. No involvement of the seminal vesicles or surgical resection margins was observed. Perineural invasion was present, but no angiolymphatic invasion was identified. High-grade prostatic intraepithelial neoplasia was also present in a multifocal pattern. Background changes included nodular hyperplasia and chronic inflammation. The neurovascular bundle from the left side showed no evidence of tumor involvement.\n\nStaging assessment indicated pT3a for the primary tumor, with no nodal involvement (pN0) and no evidence of distant metastasis (pMX). The histologic grade was classified as poorly differentiated."} +{"pid": "TCGA-FY-A40M", "report": "The thyroid specimen measured 3.7 x 1.8 x 1.3 cm on the right lobe, 3.7 x 2.1 x 1.5 cm on the left lobe, and 1.8 x 1.5 x 0.5 cm at the isthmus. Histologic evaluation identified a well-circumscribed tan-white lesion in the superior third of the left lobe measuring 1.7 x 1.5 x 1.4 cm. This lesion appeared confined to the thyroid gland. Additional findings included a second smaller focus in the right lobe measuring 0.1 cm. The tumor was multifocal, involving both lobes.\n\nMicroscopic analysis showed features consistent with a follicular variant. The tumor was partially encapsulated without evidence of capsular or vascular invasion. No extrathyroidal extension was observed. Surgical margins were negative, with the closest distance of the tumor to a margin being 0.01 cm at the posterior aspect of the left lobe. All other margins were greater than 0.06 cm away.\n\nFive lymph nodes from the central compartment were examined and none contained metastatic disease. Pathologic staging was determined as pT1b for the primary tumor, which was limited to the thyroid and measured 1.7 cm in greatest dimension. Regional lymph node involvement was classified as pN0. Distant metastasis was not applicable. The overall pathologic stage was I. Additional findings included multinodular goiter and Hurthle cell change. No parathyroid tissue was identified in the specimen."} +{"pid": "TCGA-EL-A3MZ", "report": "The surgical specimen includes a seroma capsule composed of fibrous and fibroadipose tissue with foreign body giant cell reaction, fat necrosis, and chronic inflammation. No abnormal lesion was identified in this component.\n\nThe thyroid and tracheal resection specimen measures 10.5 x 8.0 x 5.0 cm and includes a segment of trachea approximately 2.5 cm in length. A mass is present in the left thyroid lobe and isthmus, with extension into the tracheal wall. The mass measures 3.6 x 2.5 x 2.0 cm and is tan-pink and firm. It infiltrates through the tracheal wall and comes within 1 mm of both the superior and inferior soft tissue margins. The right thyroid lobe appears unremarkable. The tracheal mucosa adjacent to the mass is raised and ulcerated over an area measuring 1.8 x 1.1 cm. Focal ossification is noted in the trachea. One lymph node-like structure adjacent to the trachea is submitted as part of the specimen.\n\nMicroscopic examination reveals no tumor involvement at the inferior tracheal margin or in the superior tracheal mucosal margin. In the left paratracheal region, one of two lymph nodes contains a metastatic deposit measuring 0.2 cm; there is no evidence of extranodal extension.\n\nNo lymphovascular or perineural invasion is observed. Parathyroid tissue is identified within the specimen. All other margins are free of involvement."} +{"pid": "TCGA-AG-3893", "report": "The specimen shows a moderately to poorly differentiated carcinoma with histopathological features consistent with a differentiation grade of G2 to G3. The tumor exhibits ulceration of the inner surface and is associated with peritumorous chronic recurrent secondary inflammation, including signs of acute inflammatory activity. Lymphatic invasion is present, with evidence of carcinomatous lymphangitis. The tumor infiltrates through the parietal layers into the subserous fatty connective tissue. One regional lymph node out of 14 examined contains metastatic involvement, while all other resection margins and sampled tissues are free of tumor. Based on the available histological preparations, the extent of spread corresponds to a pT3 primary tumor stage, pN1 nodal stage (1/14 positive), MX for distant metastasis not assessable, L1 for lymphatic invasion, and R0 for complete resection with negative margins. Tumor morphology is consistent with an ICDO code M8140/3, G2 to G3, with a proliferation index of approximately 8%."} +{"pid": "TCGA-IG-A3YC", "report": "The esophageal specimen measured 2.5 x 2 x 2 cm and showed a moderately differentiated cellular growth pattern. The tumor involved the adventitial layer of the esophagus. Of the five lymph nodes examined, one intraabdominal lymph node contained metastatic deposits. No lymphatic or venous invasion was identified. Surgical margins were free of involvement. There was no evidence of prior neoadjuvant therapy administered. No additional significant pathologic findings were noted."} +{"pid": "TCGA-BR-6801", "report": "The specimen consists of a subtotal gastrectomy. The lesion measured 9x7x1 cm and was located in the stomach. It exhibited an ulcerated appearance. Histologically, the lesion showed moderately differentiated features. The tumor extended to adjacent structures, specifically involving the greater omentum. No lymph node metastases were identified in the regional lymph nodes assessed (0/8 positive). Lymphatic, venous, and perineural invasion were not specified. Surgical margins were free of involvement. There was no evidence of neo-adjuvant treatment effect. No additional pathologic findings were reported."} +{"pid": "TCGA-AG-3594", "report": "The resected colon and rectum specimen demonstrates tumor-free oral, aboral, and perirectal resection margins. A moderately differentiated cellular proliferation is present, characterized by abundant mucus formation and ulceration. The lesion involves the perimuscular fatty tissue. Histopathologic grading is G2. Staging parameters include pT3, pN0 (0/25 lymph nodes involved), with no evidence of vascular or residual tumor involvement. The distance between the lesion and the perirectal resection margin measures at least 1.6 cm. Additionally, there is a recent ulcerous mucosal defect located directly adjacent to the lesion, which may represent a prior endoscopic excision site of a benign precursor lesion."} +{"pid": "TCGA-D7-A6EX", "report": "The specimen consists of a resected stomach measuring 22 x 17 cm, along with attached omentum measuring 42 x 28 cm. The stomach shows wall thickening and an ulcerated lesion located in the pyloric region. The lesion measures 3.5 x 2.5 x 1.0 cm, with a distance of 16.5 cm from the proximal end and 2.0 cm from the distal end.\n\nMicroscopically, the lesion is composed of poorly differentiated cells with some tubular structures. The cells show high-grade features and infiltrate through the muscular layer of the wall, extending into adjacent fat tissue but not reaching the peritoneal surface. Vascular invasion is present in a significant extent. The omentum does not show any evidence of involvement. Surgical margins are clear, with no tumor seen at the resection edges.\n\nLymph node assessment reveals the following: At the lesser curvature, three lymph nodes show reactive changes only. At the greater curvature, one of four lymph nodes contains malignant deposits with extension into the surrounding fat tissue. At the peripyloric site, two out of six lymph nodes show similar findings with malignant infiltration into the capsule and surrounding adipose tissue. Additional cancerous deposits are identified in the perinodal fat. Immunohistochemical analysis is ongoing due to certain morphological features suggesting possible neuroendocrine differentiation."} +{"pid": "TCGA-53-7624", "report": "A lobar specimen was evaluated, revealing a mass measuring 6.2 cm in greatest dimension, with additional dimensions of 3 x 2.4 cm. The mass is located within the lung parenchyma and extends to the visceral pleural surface but does not fully penetrate through to involve any adjacent soft tissue margins. Histologically, the lesion demonstrates moderately to poorly differentiated cellular features. Surgical margins are uninvolved by invasive disease, with the closest distance from the tumor to the margin measuring approximately 2 mm at the soft tissue (chest wall) margin.\n\nLymph node assessment was performed across multiple sites including hilar, parabronchial, paraesophageal, right tracheal angle, subcarinal, inferior pulmonary, and distal paratracheal regions. All lymph nodes examined show no evidence of malignancy. In total, 18 lymph nodes were evaluated across these regions.\n\nThe mass exhibits cystic degeneration measuring 1.8 cm in greatest dimension. No vascular invasion\u2014venous, arterial, or lymphatic\u2014is identified. Additional findings include bronchioloalveolar hyperplasia in certain biopsied areas and a separate small white nodule identified on the visceral pleura, measuring 0.1 cm, which is also benign. Anthracotic pigment is noted in several lymph node specimens.\n\nThe specimen includes an intraoperative frozen section analysis confirming absence of tumor at bronchial and vascular margins. Gross examination of the resected lobe reveals a firm, tan-white mass with smooth overlying pleura and surrounding congested lung tissue. Four hilar lymph nodes were identified and sampled. Sections submitted included representative portions of the mass in relation to pleura, adjacent cystic cavity, and surrounding lung parenchyma, as well as other lung regions and lymph nodes.\n\nAdditional biopsies of lung tissue and lymph nodes throughout various anatomical stations were submitted and examined. All were negative for malignant involvement. A second review of the specimen confirmed absence of tumor involvement at all resection margins and clarified that although there are adhesions between the mass and an attached fragment of soft tissue, there is no penetration into this tissue."} +{"pid": "TCGA-64-1676", "report": "The specimen consisted of eleven tissue samples obtained from various anatomical locations. Tissue fragments were collected at 42 cm, 40 cm, and 34 cm; each measured 0.3 cm, 0.2 cm (two fragments), and 0.4 cm respectively, and showed no abnormal pathology. A portion of the right sixth rib measuring 2.0 cm in length was also examined and showed no pathological findings.\n\nLymph node evaluations were conducted at multiple levels. Level 9 lymph node measured 1.0 cm and was unremarkable. At level 11, ten lymph nodes were assessed, with dimensions of 1.5 x 1.0 x 0.4 cm; all were within normal limits. Level 8 contained a 0.8 cm lymph node without any pathological features. Two gray-black stained fragments measuring 0.8 cm were found at level 10, both normal. In level 4R, yellow-tan tissue fragments totaled 2.0 x 1.0 x 0.5 cm, with no abnormalities detected. Lastly, level 7 contained four lymph nodes measuring up to 1.5 cm, all of which were unremarkable.\n\nA right lower lobe lobectomy specimen weighing 296 grams measured 18.0 x 12.5 x 4.5 cm. Adjacent to the bronchus, a mass measuring 2.5 x 2.0 x 2.0 cm was identified with firm consistency and tan cut surfaces. The bronchial resection margin was evaluated intraoperatively and found to be free of tumor involvement. Histologically, the mass demonstrated a solid architectural pattern with extensive necrosis but no angiolymphatic invasion. Visceral pleura and vascular margins were also negative for tumor involvement. Additionally, five peribronchial and one intrapulmonary lymph node were examined and found to be negative for metastatic disease.\n\nAll other tissue samples submitted were non-contributory to malignancy. Based on these findings, staging was determined as pT1 NO MX."} +{"pid": "TCGA-B5-A3FB", "report": "The specimen consisted of a uterus with attached adnexa weighing 233 grams. The uterus measured 7.4 x 5.7 x 4.8 cm. Upon opening, the endometrial cavity measured 4.1 x 3.6 cm and contained a fungating, firm, friable lesion located in the posterior corpus. The lesion measured 3.1 x 2.1 cm and demonstrated a depth of invasion of 1.1 cm. Adjacent to this lesion, multiple subserosal and submucosal abnormalities were noted. One intramural mass was identified as firm, well-encapsulated, and measuring up to 3.6 cm in greatest dimension with focal calcifications; it exhibited a tan-white, whorled cut surface. The thickness of the surrounding myometrium was 2.4 cm, with the tumor invading to a depth of 0.1 cm. The endocervical canal was unremarkable, measuring 1.6 cm in length with a distinct squamocolumnar junction. The cervix had a diameter of 4.8 cm and an os measuring 0.4 cm.\n\nThe left adnexa included a fallopian tube measuring 4.6 cm in length with diameters ranging from 0.6 to 0.9 cm. A smooth paratubal cyst measuring 0.9 x 0.8 x 0.8 cm filled with clear serous fluid was present. Attached to this was a firm, tan-white, cerebriform structure measuring 2.3 x 1.8 x 1.5 cm interpreted as ovarian tissue with adjacent mesentery. No fimbria or ovary were identified on the right side; only a segment of fallopian tube measuring 2.2 cm in length and 0.9 cm in diameter was present.\n\nLymph node dissection specimens included a left pelvic lymph node aggregate measuring 6.5 x 5.2 x 2.4 cm containing approximately twenty-three lymph nodes, with the largest measuring 2.6 cm. On the right side, the pelvic lymph node aggregate measured 7 x 5.8 x 3.3 cm and contained twelve lymph node candidates, with the largest measuring 2.3 cm. All lymph nodes examined were negative for malignancy.\n\nHistologic evaluation revealed no involvement at surgical margins and no lymphatic or vascular invasion. Adjacent non-neoplastic endometrium showed atrophy. Other findings included benign leiomyomata and adenomyosis within the myometrium. The left ovary contained a benign fibroma measuring 2.4 cm without evidence of malignancy. Both fallopian tubes were negative for malignant cells.\n\nSections were submitted from various regions including the posterior and anterior endomyometrium, lower uterine segments, cervix, fibroids, and para-ovarian tissue. Lymph node sections were also submitted for evaluation. Frozen sections were obtained from the endometrial lesion and para-ovarian tissue for intraoperative consultation.\n\nAll submitted lymph nodes and tissue margins were free of malignancy. Cellular features included areas of poorly differentiated growth with marked nuclear atypia."} +{"pid": "TCGA-D5-6538", "report": "Histopathological examination was performed on a resected specimen consisting of the colon and cecum, measuring 11.2 cm in length, along with a fragment of mesentery (16 x 9 x 3 cm), an 8 cm section of another intestinal segment, and an appendix measuring 5.5 cm. A ulcerous lesion measuring 5.4 x 6.9 x 1.8 cm was identified in the mucosa and circumferentially involved the entire intestinal circumference. The lesion was located 9.3 cm from the proximal incision, 3.1 cm from the distal incision, and 1.3 cm from the Bauhin's valve.\n\nMicroscopic evaluation revealed complex epithelial proliferation with tubulopapillary architecture and partial mucin production. There was deep infiltration into the muscularis propria and extension into the pericolic adipose tissue of the mesentery. Surgical margins were clear of tumor involvement. Lymph node analysis demonstrated the presence of abnormal cellular aggregates within lymph nodes, with involvement of the lymph node capsule and surrounding perinodal fat. Vascular invasion was also observed.\n\nThe appendix showed signs of follicular inflammation consistent with appendicitis. Tumor grade was high. Staging parameters indicated advanced local invasion and extensive regional lymph node involvement."} +{"pid": "TCGA-E9-A1RA", "report": "The lumpectomy specimen involved the left upper outer quadrant and contained a grossly evident lesion measuring 1.2 x 1.3 cm. The surrounding fatty tissue and lymph nodes were described as dense and hyperemic. Microscopic evaluation showed moderately differentiated features with no evidence of venous invasion. A total of ten lymph nodes were examined, and none showed metastatic involvement. Reactive changes were noted in the lymph nodes. Surgical margins were uninvolved. The histologic characteristics including tubule formation, nuclear pleomorphism, and mitotic counts could not be fully assessed, and therefore, the Nottingham Histologic Score could not be determined. No extracapsular extension was identified. The tumor was classified as T1 based on size."} +{"pid": "TCGA-EJ-5526", "report": "The patient is a male with a PSA value of 14.3 while on Proscar. A prior biopsy revealed a poorly differentiated adenocarcinoma located at the right base of the prostate with a Gleason score of 4 + 4 = 8. A radical prostatectomy was performed.\n\nLymph node evaluation showed one involved lymph node out of twenty examined on the right pelvic side, with extracapsular extension present. No evidence of neoplasia was found in seven left pelvic lymph nodes examined.\n\nExamination of the prostate and bilateral seminal vesicles revealed an invasive, poorly differentiated adenocarcinoma with a Gleason score of 8. A tertiary pattern 5 component was identified, making up 1% of the total tumor volume. The lesion was multifocal and involved both lobes of the prostate. The largest nodule measured 2.5 cm in greatest dimension, and approximately 5% of the prostate volume was affected. There was established extracapsular extension, most notably in the right anterior base and posterior right mid sections. The seminal vesicles were not involved, and all surgical margins were free of tumor. Perineural invasion was identified, and high-grade prostatic intraepithelial neoplasia was also present. Additionally, benign prostatic hypertrophy and chronic severely active prostatitis were noted.\n\nPathologic staging was determined as pT3a with nodal involvement classified as pN1. A total of 27 lymph nodes were examined, with one positive node measuring 4 mm in size and showing extranodal extension. The histologic grade was classified as G3-4, consistent with poorly differentiated or undifferentiated morphology."} +{"pid": "TCGA-ET-A25P", "report": "The specimen consists of a total thyroidectomy measuring 5.6 x 3.0 x 2.0 cm on the left lobe and 6.0 x 3.0 x 1.7 cm on the right lobe, with an isthmus measuring 4.0 x 1.2 x 0.5 cm. The anterior aspect is inked black and the posterior aspect inked orange. A stitch marks a nodule in the superior portion of the left lobe; however, no nodule was identified upon serial sectioning from superior to inferior. A separate tan-white, well-circumscribed nodule measuring 0.6 x 0.5 x 0.4 cm was observed in the left lobe. Cut sections revealed no hemorrhage or necrosis within this nodule. The remainder of the thyroid tissue exhibited a tan-brown appearance and showed no gross abnormalities.\n\nHistologic examination included multiple sections from all lobes and the isthmus. Cellular features demonstrated distinct morphologic characteristics within one of the nodules. Measurements of this focus were recorded as 0.7 cm in greatest dimension. Additional smaller foci measuring 0.1 cm and 0.1 cm were also identified, indicating multifocality. Invasion beyond this structure was not observed microscopically. Margins were free of involvement. Evaluation of regional lymph nodes revealed no evidence of abnormal cellular infiltration within the three nodes assessed. No vascular or lymphatic invasion was identified. \n\nAdditional findings included identification of the right parathyroid gland. All tissue sections were adequately submitted for evaluation."} +{"pid": "TCGA-OL-A5DA", "report": "A right axillary sentinel lymph node biopsy and partial mastectomy were performed. The sentinel lymph node was negative for metastatic tumor involvement.\n\nThe partial mastectomy specimen contained a firm, white-tan mass measuring 2.8 x 2.4 x 1.5 cm. Histologically, the lesion exhibited combined architectural features scoring grade II (architecture: 3, nuclear grade: 2, mitotic count: 1). Necrosis was present focally. Adjacent breast tissue showed apocrine metaplasia without evidence of ductal carcinoma in situ. There were also findings consistent with focal atypical ductal hyperplasia and atypical columnar cell change.\n\nThe invasive lesion measured 3.2 cm by combined gross and microscopic assessment. The closest margin was the superior margin, with tumor located approximately 1 mm away. All other margins exceeded 2 mm in distance. No lymphovascular invasion was identified.\n\nImmunohistochemical staining demonstrated hormone receptor positivity with estrogen receptor expressed in 68% of nuclei and progesterone receptor in 66%. HER2/neu testing by FISH showed no amplification (ratio: 1). E-cadherin staining was negative in tumor cells, supporting a lobular phenotype.\n\nStaging classification was pT2, NO(sn), MX. The mass was localized to the right breast upper outer quadrant, measuring approximately 2.5 cm on imaging prior to biopsy. MRI confirmed an irregular posterior mass measuring 4.5 x 2.5 cm. No abnormalities were seen in the contralateral breast or axillae.\n\nThe surgical specimen included orientation markers and two localization wires. The mass was identified between the wires within slices #4 through #8. Tumor proximity to margins was assessed microscopically across multiple sections. Representative sections of unremarkable breast parenchyma and margins were submitted for evaluation."} +{"pid": "TCGA-SH-A9CT", "report": "HISTOPATHOLOGY REPORT. Sex: M. Date Collected: Date Received: Date Printed: SPECIMEN DETAILS. Specimen A. Parietal pleura. Specimen B. Parietal pleura tumour. CLINICAL INFORMATION. T2 HO MO.\n\nMACROSCOPIC DESCRIPTION. Specimen A Parietal pleura. An irregular piece of cream coloured tissue measuring 8 x 3.5 x 2 cm. 4 in 4 + reserve. Specimen B Parietal pleura tumour. Several pieces of white, firm tissue with attached adipose tissue and adherent clot, in aggregate measuring 18 x 16 x up to 3 cm. Some of the pieces include overlying pleura. 4 x representative sections + reserve.\n\nMICROSCOPIC REPORT. Specimens A & B Parietal pleura tumour. Samples from both specimens reveal thickened pleura, extensively infiltrated by epithelioid cells arranged predominantly in a papillary pattern. The cells show moderate pleomorphism, with vesicular nuclei, small nucleoli, and moderate eosinophilic cytoplasm. Focal areas of necrosis are present. Some sections show a small amount of adjacent lung parenchyma with reactive changes and organising pneumonia. There is focal involvement of the visceral pleura.\n\nImmunohistochemistry shows positivity for MNF116 and calretinin (cytoplasmic and variable nuclear staining), patchy WT1 staining, focal weak CK5/6 expression, and diffuse membranous EMA positivity. Very focal BerEP4 staining is seen, with most of the tumour being negative for BerEP4 and TTF1.\n\nReporting Pathologist: Authorising Pathologist: Lab No: Reports are authorised electronically."} +{"pid": "TCGA-ND-A4WA", "report": "The specimen consists of a uterus weighing 120 grams, measuring 7.0 cm from fundus to ectocervix, 4.2 cm from cornu to cornu, and 5.5 cm anterior to posterior. The endometrial cavity contains a mass measuring 5.8 x 5.1 x 4.6 cm located in the anterior and posterior left cornu. This mass invades more than half of the myometrium but does not reach the serosa. The remaining endometrium is atrophic. The myometrium shows extensive adenomyosis and contains three subserosal leiomyomas ranging in size from 0.3 to 2.5 cm. One of these leiomyomas demonstrates extensive calcification on cut surface. The cervix measures 2.1 cm in length and 1.6 cm in diameter with a patent os; it exhibits chronic cervicitis with squamous metaplasia and contains a 1.1 cm leiomyoma.\n\nHistologically, the mass demonstrates extensive vascular invasion. Representative sections show necrosis and softening within the tumor. Adjacent parametrial tissue reveals foci of lymphovascular space invasion without direct infiltration. No involvement is identified in the endocervical or lower uterine segments.\n\nBilateral salpingo-oophorectomy specimens show no evidence of malignancy in either ovary. The left fallopian tube displays intraluminal tufts of atypical cells without direct parenchymal invasion. Both fallopian tubes exhibit benign findings including cystic and non-cystic Walthard rests (left), mesonephric duct remnants (left), and surface adhesions (right). Each ovary contains corpora albicantia without malignant features.\n\nStaging based on available material is reported as pTlc Nx Mx. Additional findings include multiple sections taken from various regions including the corpus, intramural mass, serosa, lower uterine segment, cervix, and parametrium. No further lesions are identified in the submitted specimens."} +{"pid": "TCGA-ET-A40Q", "report": "Specimen taken. Lymph nodes, lateral neck (dissection): four of twenty-two lymph nodes involved. The largest measured 1.4 cm. Extranodal extension not identified. Thyroid (thyroidectomy): total thyroidectomy specimen, tumor located in the right lobe. Histologic features include a variant with tall cell morphology greater than 50%. Tumor measured 2.5 cm in greatest dimension. Multifocal disease identified with three additional small papillary lesions each measuring 0.1 to 1 cm. Lymph node involvement noted in 19 of 40 lymph nodes (15 of 18 central lymph nodes, part 2; and 4 of 22 lateral neck lymph nodes, part 1). Tumor extends minimally beyond the thyroid capsule (pT3). Metastasis present in cervical lymph nodes (pN1b). Distant metastasis could not be assessed (pMx). Margins free of involvement, though invasive carcinoma was less than 1 mm from both anterior and posterior margins. Venous and lymphatic invasion present. Additional findings include lymphocytic thyroiditis."} +{"pid": "TCGA-AG-3574", "report": "The specimen consists of a resected rectal segment containing an ulcerated lesion. The lesion is moderately differentiated and measures up to 6 cm in its greatest dimension. It extends within the rectal wall, reaching up to 4 cm from the aboral resection margin. Histological evaluation shows invasive growth through all layers of the rectal wall and into adjacent perirectal soft tissue. Both oral and aboral resection margins are free of tumor involvement. A total of 18 perirectal and pericolic lymph nodes were examined, none of which show evidence of tumor metastasis; they display non-specific reactive changes. No vascular or lymphatic invasion is identified. The tumor is classified as pT3 pN0 (0/18), with histologic grade G2."} +{"pid": "TCGA-DJ-A2PW", "report": "The clinical history indicates a tumor in the right thyroid lobe. The submitted specimens include a total thyroidectomy and a possible left inferior parathyroid tissue sample.\n\nGross examination of the thyroid shows three distinct nodules. The first nodule in the right lobe measures 4.6 x 2.9 x 2.6 cm, with a second nodule adjacent to it measuring 2.0 x 1.2 x 1.0 cm. A third nodule located in the isthmus measures 3.5 x 2.8 x 2.3 cm. All nodules are well-encapsulated, with no evidence of blood vessel invasion or extension beyond the thyroid capsule. The surgical margins are free of involvement. The remaining thyroid tissue shows changes consistent with nodular hyperplasia. No adenomas were identified.\n\nMicroscopic evaluation reveals multiple foci of well-differentiated cells with no mitotic activity or necrosis noted. An additional small focus measuring 0.6 cm with specific cellular features was identified in the isthmus.\n\nLymph node analysis from the left inferior region includes one lymph node, which shows the presence of a structure consistent with psammoma bodies, indicating possible nodal involvement. The number of nodes examined and those with findings are both one.\n\nAll other tissues submitted were examined and reported as unremarkable."} +{"pid": "TCGA-56-8305", "report": "The surgical pathology report includes multiple specimens from a lobectomy and lymph node biopsies. The lobectomy specimen consists of a portion of the right upper lobe of the lung, weighing 568 grams and measuring 17 x 11 x 5 cm. A mass measuring 4.5 x 4.5 x 3.0 cm was identified grossly; it is white-tan in color and mostly necrotic, located near the pleura. Microscopically, the lesion shows features consistent with squamous cell carcinoma, moderately differentiated (G2). The tumor measures greater than 3 cm but not exceeding 5 cm and is surrounded by lung tissue or visceral pleura. No involvement of the main bronchus or hilar structures was observed. Surgical margins were uninvolved by tumor. There was no evidence of visceral pleural invasion, lymph-vascular invasion, or atelectasis extending to the hilar region. Based on these findings, the pathologic stage assigned is pT2a.\n\nA total of eleven lymph nodes were examined across various regional stations, including subcarinal level 7 and lower paratracheal station 4. Among these, seven lymph nodes were sampled from additional subcarinal level 7, one from level 10, and two from 4R paratracheal regions. All lymph nodes showed similar microscopic features suggestive of involvement by a monoclonal lymphoid process. No evidence of metastatic carcinoma was found in any of the lymph nodes. Based on lymph node findings, the regional lymph node staging is pN0 (no metastasis), and distant metastasis was also ruled out (pM0). The overall pathologic stage is IB (pT2aN0M0).\n\nAncillary testing for molecular markers such as EGFR and ALK was not reflexed due to absence of histological or clinical features warranting such testing. A tissue block (D7) has been preserved for potential future testing and will be stored for ten years. Clinical history indicates prior diagnosis of lung cancer and B-cell chronic lymphocytic leukemia.\n\nSpecimens submitted intraoperatively for frozen section analysis included lymph nodes from various levels. In all cases, rapid evaluation confirmed absence of metastatic carcinoma and presence of lymphoid involvement. Final microscopic examination corroborated these findings."} +{"pid": "TCGA-DJ-A1QG", "report": "The clinical history includes bilateral thyroid nodularity with an atypical fine needle aspiration biopsy from the left lobe. A total thyroidectomy was performed along with a biopsy of pretracheal tissue.\n\nExamination of the pretracheal specimen revealed one benign lymph node. The thyroid specimen weighed 27.5 grams and measured 6.2 x 2 x 2 cm on the right lobe, 5.5 x 2.2 x 2.1 cm on the left lobe, and 1.5 x 1 x 0.5 cm at the isthmus. The external surface was covered by a thin fibrous capsule. Multiple nodules were identified: a 1.8 x 1.5 x 1.5 cm homogeneous tan nodule in the left lobe, a 1.1 cm adjacent nodule, and a 2 x 1.5 cm nodule in the right lower lobe with a heterogeneous tan and white cut surface. The remaining thyroid tissue appeared unremarkable.\n\nHistologic evaluation identified four distinct foci with well-differentiated cellular features. Cellular morphology showed mild to moderate mitotic activity (1 per 10 high power fields) and no tumor necrosis. Non-psammomatous calcifications were present. Each focus was completely encapsulated, although capsular invasion was noted in the largest lesion. No vascular invasion or extrathyroid extension was observed. Surgical margins were free of involvement. All four lymph nodes examined were benign.\n\nMicroscopic analysis also revealed multiple gross foci, including one classical type with focal solid growth patterns. No abnormalities were found in the non-neoplastic thyroid tissue or parathyroid glands. All diagnoses were based on personal examination of the slides and confirmed in the final report."} +{"pid": "TCGA-23-1107", "report": "The specimen from the omentum biopsies shows extensive involvement by a moderately to poorly differentiated epithelial tumor forming papillary structures. Similar histological findings are observed in additional biopsies obtained from multiple sites including the bladder, cul-de-sac, pelvic region, right periaortic area, rectosigmoid, sigmoid mesentery, transverse colon, left and right gutters, mesentery, diaphragm, and small bowel mesentery. In each of these specimens, fibroconnective or fibrofatty tissue is largely replaced by a papillary adenocarcinoma component.\n\nThe left ovary resection reveals almost complete replacement of ovarian tissue by a moderately to poorly differentiated papillary adenocarcinoma. A similar morphology is present in the right ovary, where the stroma is largely replaced by a comparable tumor process. Adjacent to the right fallopian tube, there is evidence of multifocal severe dysplasia and intraepithelial carcinoma with a focal intraluminal mass composed of poorly differentiated carcinoma; the remainder of this structure appears normal.\n\nInvolvement of the spleen demonstrates multiple capsular metastases characterized by infiltration of the splenic capsule by papillary adenocarcinoma without significant parenchymal involvement. Liver biopsy material shows infiltration by papillary adenocarcinoma although definitive liver parenchyma could not be identified in the sample.\n\nGross examination of the omental biopsies reveals multiple tumor fragments measuring up to 2.5 cm in greatest dimension. Additional omental specimens demonstrate larger tumor masses measuring 7 x 7 x 3 cm, 10 x 6 x 4 cm, and 15 x 9 x 3.5 cm. The left ovary measures 5.0 x 5.0 x 1.9 cm with near total replacement by tumor. The right ovarian and fallopian tube specimen contains a tumor measuring 10.6 x 8.3 x 3.4 cm. Other tumor samples from various locations range in size from 1.4 cm to aggregates as large as 14.1 x 6.5 x 1.5 cm.\n\nTumor involvement is noted in multiple anatomical regions including the bladder wall completely replaced by tumor measuring 15.0 x 8.6 x 3.5 cm. Cul-de-sac tumors vary in size with individual nodules up to 11.0 x 10.0 x 3.5 cm aggregate. Specimens from the rectosigmoid, transverse colon, and mesenteric regions also show extensive infiltration by tumor cells. Splenic hilar fat contains tumor nodules aggregating to 7.0 x 6.0 x 3.0 cm with surface involvement measuring 7.5 x 7.5 x 1.7 cm."} +{"pid": "TCGA-BP-4329", "report": "The clinical history includes a 5 x 7 cm heterogeneous mass located in the lower pole. The specimen from the right kidney, including a portion of the ureter, renal blood vessels, and perinephric adipose tissue, weighed 580 grams. The kidney measured 12.5 x 6.5 x 5.5 cm. Upon bisection, a tumor measuring 7.5 x 5 x 3.5 cm was identified in the lower half of the kidney. The tumor had a gray-yellow appearance with focal necrosis and an acinar growth pattern. It extended through the renal capsule but remained within Gerota's fascia. No extension into the perinephric adipose tissue was observed. The tumor was found within the lumen of the renal vein, though all surgical margins, including the renal vein margin, were free of involvement. The collecting system and urothelium of the renal pelvis and ureter showed no abnormalities. The non-neoplastic kidney tissue demonstrated patchy chronic inflammation. No adrenal gland was identified.\n\nA separate specimen from the right para-caval region contained a single lymph node measuring 4.0 cm in greatest dimension embedded in adipose tissue. Histological evaluation of this lymph node showed benign features with no evidence of involvement.\n\nTissue sections submitted included those from the tumor in relation to Gerota's fascia, renal capsule, pelvic fat, and collecting system, as well as normal kidney, renal vein, and surgical margins. All relevant areas were sampled and submitted for analysis."} +{"pid": "TCGA-EL-A3MY", "report": "The thyroid specimen from a male patient was submitted following total thyroidectomy. The resected thyroid measured 8. cm in greatest dimension, with marked fibrosis and adhesion noted, particularly in the left lobe which measured 4.5 x 3.0 x 2.5 cm. Multiple nodules ranging from 0.4 to 1.7 cm were identified throughout the gland. A dominant fibrotic and firm nodule in the left lobe extended from the superior to inferior pole and involved adjacent soft tissue and skeletal muscle. The right lobe measured 6.0 x 2.5 x 1.4 cm, was nodular and elongated. Two small nodules (0.8 cm each) were found in the left lobe, along with an adenomatoid colloid nodule in the right lobe. Surgical margins were free of involvement.\n\nSubmitted tissue from the left cricothyroid region consisted of two fragments, each measuring 0.5 x 0.5 x 0.2 cm, showing the presence of a neoplastic process within fibrous tissue. The thyroid arytenoid sample, measuring 1.5 x 0.3 x 0.4 cm, did not show any neoplastic involvement. Cartilage and bone tissue submitted from the thyroid cartilage showed involvement by the neoplasm; further sections are pending decalcification for full assessment."} +{"pid": "TCGA-IG-A5B8", "report": "The specimen includes a portion of the esophagus measuring up to 9x6 cm, containing an ulcerated lesion measuring 6x4 cm. A separate segment of the stomach is present, measuring up to 13x6 cm. One paraesophageal lymph node was identified. Histologically, the lesion shows well-differentiated keratinizing cells with invasion extending to the adventitia. No venous invasion is observed, and the surgical margins are uninvolved. The single examined lymph node shows follicular hyperplasia without evidence of metastasis. Additional findings include chronic gastritis. No lymphatic invasion is specified, and there is no evidence of treatment effect."} +{"pid": "TCGA-B6-A0RP", "report": "The left breast specimen showed three distinct areas of abnormality. The first area, located in the upper outer quadrant, measured 2.6 x 2.5 x 1.5 cm and extended to within 1.3 cm of the deep surgical margin. Microscopic examination revealed cells arranged in tubules and nests infiltrating into surrounding fibrous stroma and fat with desmoplastic response. Nuclear pleomorphism was moderate. A minor intraductal component showing comedo and cribriform patterns was present. Vascular invasion was identified, and the tumor was histologically graded as moderately differentiated (grade 2/3). The second area of concern was found near the junction of the upper and lower outer quadrants, centered around a healing biopsy site and measuring up to 2.8 cm in greatest dimension. Microscopically, this lesion demonstrated predominantly lobular features with linear infiltration of tumor cells through soft tissue and smooth muscle of the areola. Extensive perineural invasion was noted. Small foci of intraductal carcinoma were also observed. This lesion did not show vascular invasion and was located 4.0 cm from the deep margin. The third focus was identified in the lower outer quadrant and measured 1.0 cm. Histologically, it exhibited invasive ductal features arising within a background of papillary intraductal changes. No vascular invasion was seen, and the lesion was 3.5 cm away from the deep margin.\n\nSections from the remainder of the left breast revealed multifocal intraductal carcinoma of solid and cribriform types, cancerization of lobules consistent with lobular carcinoma in situ, florid epithelial hyperplasia, apocrine metaplasia, adenosis, duct ectasia, and microcysts. Two of fifteen lymph nodes from the left axilla contained metastatic tumor. The involved nodes displayed a tubulolobular growth pattern.\n\nIn the right breast, a healing biopsy cavity was identified at the junction of the upper inner and upper outer quadrants, measuring up to 3.5 cm. Surrounding fat necrosis and granulation tissue were present without gross residual tumor. Microscopic evaluation revealed multifocal intraductal carcinoma of the solid type, including within the vicinity of the biopsy cavity and in the lower outer quadrant. A small focus of infiltrating duct carcinoma was identified in association with this finding. The infiltrating component was well-differentiated (histologic grade 1/3) and located remote from the deep margin. Additional findings included florid epithelial hyperplasia, adenosis, and apocrine metaplasia. No lymph nodes were identified in the limited axillary dissection performed on the right side. The skin showed only benign changes including a seborrheic keratosis and an epidermal inclusion cyst."} +{"pid": "TCGA-TM-A84C", "report": "The specimen consists of multiple fragments of tan tissue measuring 10x8x2mm in aggregate. All tissue was embedded for analysis. The lesion was identified as intra-axial, located at the midline and left medulla. Imaging findings showed a mass measuring 22x15x22mm with high signal on T2 and FLAIR sequences, isointense to normal brain on T1, and minimal enhancement following contrast administration. MR spectroscopy demonstrated reduced NAA and elevated choline levels.\n\nMicroscopic examination revealed moderately cellular glial tissue with small cells and minimal nuclear atypia. Nuclear morphology ranged from round to ovoid and elongated (spindled). Abundant glial fibers were observed within the tumor matrix. Only one mitotic figure was identified throughout the specimen. There was no necrosis, vascular endothelial proliferation, biphasic pattern, Rosenthal fibers, or eosinophilic granular bodies. Perivascular lymphocytes were not present. Immunohistochemical staining was positive for GFAP and negative for NeuN, p53, and IDH1.\n\nProliferation index (Ki67) was estimated at 20\u201330%. Mitotic count was less than 1 per 10 high-power fields. No peritumoral tissue was available to assess infiltration; however, neurofilament protein staining demonstrated numerous axons within the tumor, suggesting an infiltrative growth pattern. BRAF V660E mutation analysis and exon 15 sequencing were initiated as these findings may aid in further characterization. Similarly, IDH1/IDH2 exon 4 sequencing was recommended due to its potential diagnostic utility despite negative IDH1 immunostaining.\n\nAll tumor tissue reached the margins of the biopsy specimens. Additional molecular testing may provide further diagnostic clarity."} +{"pid": "TCGA-BA-5558", "report": "A biopsy of multiple soft tissue and bony margin sites, including the buccal fat, anterior soft tissue, right buccal, right soft palate, left hard palate, right nasal septal, and pterygoid regions, showed no evidence of abnormal cellular infiltration. The specimens were composed primarily of adipose or connective tissue with no atypical features noted.\n\nA resected maxillary specimen involving the right inferior maxilla, nasal turbinate, and hard palate revealed a fungating tan-white mass within the oral cavity that extended into the maxilla. Microscopic evaluation demonstrated invasive, well-differentiated keratinizing epithelial cells arranged in nests and cords with central keratinization, extending into the underlying bone and effacing the hard palate. The tumor measured approximately 3.2 cm in greatest dimension. No lymphovascular or perineural invasion was observed. Margins of resection were negative for abnormal cells, although the tumor approached within 1 mm of the anterosuperior soft tissue margin, between 1 to 2 mm of the lateral soft tissue margin, and 2 mm from the anterolateral soft tissue margin. Other margins were widely clear.\n\nSpecimens from the right ethmoid, sphenoid, maxillary sinus mucosa, and right middle turbinate showed only benign mucosal tissue with varying degrees of chronic inflammation and edema. No dysplastic or malignant changes were identified in these areas.\n\nLymph node specimens from right neck levels 1 through 5 contained no evidence of abnormal cell clusters. All lymph nodes examined showed only reactive changes with follicular hyperplasia. Specimens from levels 2 and 5 also included fibroadipose and skeletal muscle tissue without any abnormal findings.\n\nThe remaining tissues submitted, including submandibular gland and fibrofatty tissue, showed no evidence of malignancy. Reactive lymphoid hyperplasia was noted in several lymph node specimens. All surgical margins were free of abnormal cells, though some were narrowly so."} +{"pid": "TCGA-60-2715", "report": "The specimen includes a left upper lobe wedge resection, a left upper lobectomy, and lymph nodes from levels 10 and 5. The wedge resection measured 8.0 x 5.0 x 3.0 cm and contained a firm mass measuring 1.5 x 1.0 x 1.0 cm located 0.5 cm from the stapled margin. The remainder of the lung tissue showed congestion. Sections included the mass, pleural and surgical margins, and normal-appearing parenchyma. The lobectomy specimen measured 18.5 x 13 x 2.5 cm and showed congestion without identifiable tumor on serial sections. Bronchial margins were negative for tumor. Five peribronchial lymph nodes were also negative. Lymph node level 10 measured 2.0 x 0.9 x 0.5 cm with a variegated cut surface and was submitted entirely; three lymph nodes were identified and all were negative. Lymph node level 5 measured 1.0 x 0.5 x 0.4 cm with anthracotic pigmentation and was also negative. Immunohistochemistry for TTF-1 was negative in the tumor cells. No residual carcinoma was identified in the lobectomy specimen."} +{"pid": "TCGA-D7-6522", "report": "Histopathological examination was performed on a partial resection of the stomach, which included the parapyloric region and body of the stomach. The specimen was excised along the greater curvature and measured 17.7 x 11.2 cm, with attached omentum measuring 33 x 13 cm. A lesion was identified in the parapyloric area, measuring 3.3 x 4.6 x 0.7 cm, located 4 cm from the proximal margin and 2.5 cm from the distal margin.\n\nMicroscopic evaluation revealed a neoplastic process involving infiltration of the gastric wall. The neoplasm exhibited mucocellular features and was classified as high-grade (G3). The depth of invasion involved part of the stomach wall, corresponding to a pT2 classification. All resection margins were free of neoplastic involvement.\n\nLymph node assessment of station XI showed no evidence of metastasis. Findings were consistent with reactive lymphadenitis, with no pathological changes indicative of nodal involvement (pN0). \n\nThe report concludes with a note to contact the treating physician for further discussion."} +{"pid": "TCGA-DE-A7U5", "report": "The specimen consists of a total thyroidectomy and regional lymph nodes from a female patient with a prior fine needle aspiration positive for malignancy. The thyroid gland weighed 36.2 grams and included a right lobe measuring 7.1 x 3.4 x 2.5 cm, a left lobe measuring 4.9 x 2.3 x 2.3 cm, and an isthmus measuring 2.9 x 0.8 x 0.3 cm. The gland was inked with blue (anterior), black (posterior), and yellow (isthmus). A well-circumscribed mass measuring 2.4 x 2.4 x 1.6 cm was identified in the right lobe, with a white/tan cut surface and central hemorrhagic material. The uninvolved thyroid tissue showed severe lymphocytic infiltration with follicle formation.\n\nMicroscopic evaluation revealed a lesion with cellular features including blood vascular invasion, without evidence of lymphovascular invasion or extra-thyroidal extension. Surgical margins were positive at the black inked posterior margin (A4) over a distance of 9 mm; the isthmus and anterior margins were negative. No metastatic involvement was identified in three lymph nodes from the main specimen or in five lymph nodes from the right level 6 dissection. Benign parathyroid tissue was also present in the lymph node specimen.\n\nThe tumor was unifocal and located in the right lobe. Staging was assessed as pT2 pN0 based on available data, pending further clinical correlation."} +{"pid": "TCGA-DD-AACN", "report": "The liver specimen measured 14.0 x 9.0 x 6.0 cm and was unfixed. The lesion was located in segment 6 and presented as a single nodule measuring 3.5 x 2.8 x 2.5 cm without satellite nodules. The gross appearance was described as expanding nodular with less than 5% necrosis and no hemorrhage or peliosis. No invasion of the portal vein, bile ducts, or surrounding structures was observed. The surgical resection margin was 1.8 cm from the tumor.\n\nMicroscopic evaluation showed a trabecular growth pattern with hepatic-type cells. The tumor demonstrated focal positivity for CK7, CK, and CK19, while negative for AFP and positive for Hepatocyte on immunohistochemical staining. Mucicarmine stain was negative. There was no evidence of fibrous capsule formation, capsular infiltration, septum formation, or microvessel invasion. No intrahepatic metastasis or multicentric occurrence was identified.\n\nNon-tumor liver tissue showed chronic hepatitis associated with HBV infection, with lobular activity graded as I and portoperiportal activity graded as II. Steatosis was present in approximately 60% of hepatocytes, with no cirrhosis or dysplastic nodules identified."} +{"pid": "TCGA-D8-A1JH", "report": "Histopathological examination was performed on a resected right breast specimen along with axillary tissue. The breast measured 14 x 14.5 x 2.5 cm and weighed 260 g. A lesion measuring 1.2 x 1.0 x 1.0 cm was identified in the outer lower quadrant, located 0.9 cm from the lower boundary, 0.5 cm from the base, and less than 0.1 cm from the parenchyma. Axillary tissues included lymph nodes measuring up to 1.8 cm in length.\n\nMicroscopic evaluation revealed a neoplasm with nuclear grade 1 features, showing 5 mitoses per 10 high-power fields. Calcifications were present within the lesion. Adjacent glandular tissue exhibited fibrocystic changes. Invasive growth was observed reaching the base of the specimen. No involvement of the nipple was noted.\n\nImmunohistochemical analysis demonstrated expression of estrogen and progesterone receptors in over 75% of neoplastic nuclei. HER2 staining by HercepTest\u2122M showed a score of 1+ in the invasive component.\n\nChronic lymphadenitis with sinus histiocytosis was noted in the axillary lymph nodes. No other significant pathological findings were identified in the submitted tissues."} +{"pid": "TCGA-E9-A24A", "report": "The lumpectomy specimen from the right upper outer quadrant contains a grossly evident lesion measuring 1.4 x 0 x 1.8 cm. Histologic evaluation reveals moderately differentiated cellular changes. Lymph node assessment shows 1 out of 10 axillary nodes positive for abnormal cell presence. Margins are uninvolved. Various histologic features including tubule formation, nuclear pleomorphism, and mitotic counts were not specified, preventing calculation of a Nottingham Histologic Score. No information is provided regarding tumor extent, extracapsular invasion, neo-adjuvant treatment, or additional findings."} +{"pid": "TCGA-ZH-A8Y5", "report": "A pericaval mass biopsy demonstrates a poorly differentiated neoplasm with extensive solid growth and focal glandular differentiation. One of five lymph nodes shows evidence of involvement, with the largest focus measuring 1.5 cm in diameter. Extracapsular extension is present.\n\nThe gallbladder specimen shows cholesterolosis without any malignant findings. The mucosa contains tan granular tissue fragments, and the wall thickness measures 0.2 cm.\n\nAn en bloc resection of liver segments 6, 7, and 8 along with the vena cava and left adrenal gland reveals a tan firm mass measuring 5.8 cm in greatest dimension. The mass is located within segments 8 and 1 and exhibits multifocal distribution with two satellite lesions approximately 1 cm from the primary lesion. The tumor invades the wall of the inferior vena cava and extends into perihepatic soft tissues and adjacent adrenal gland. No definitive lymphovascular invasion or tumor necrosis is identified. Surgical margins are negative: the closest hepatic parenchymal margin is 0.85 cm from the tumor. The background liver parenchyma shows no steatosis, cholestasis, or ductular reaction.\n\nImmunohistochemical staining on the relevant block demonstrates positivity for AE1/AE3 and OSCAR, with focal positivity for CK7. All other markers tested, including CK20, TTF-1, CDX-2, CD56, chromogranin, and synaptophysin, are negative. Mucicarmine staining does not show mucin production.\n\nStaging according to the AJCC classification is pT3 pN1 based on tumor invasion beyond the liver into surrounding structures and regional lymph node involvement. This staging remains subject to review pending clinical correlation.\n\nIntraoperative consultation on the pericaval mass confirmed the presence of carcinoma; however, final typing required permanent sections and special stains. Gross examination of the resected liver specimen revealed a well-demarcated tan mass near the large caliber vessel, with close proximity to surgical margins but no gross vascular invasion. The adrenal gland is closely associated with the tumor but does not show definitive transmural extension."} +{"pid": "TCGA-2A-AAYU", "report": "The prostate specimen measured 4.3 cm from apex to base, 4.5 cm transversely, and 4.5 cm in the anterior-posterior dimension, with a total weight of 67.0 grams. Serial sections identified involvement of both the right and left anterior regions, with the dominant mass located in the left anterior aspect extending from the apex to the base. Focal extracapsular extension was present in the left anterior region near the base. Involvement of the bladder neck was noted, with tumor present at the surgical margin in that area. Multicentric foci of invasive carcinoma were identified, along with perineural invasion. High-grade intraepithelial neoplasia was also present. No vascular invasion or seminal vesicle involvement was observed. The non-neoplastic prostate showed nodular hyperplasia.\n\nLymph node dissections were performed on bilateral external iliac, obturator, and hypogastric regions. A total of 28 lymph nodes were examined across all sites (6 from left external iliac, 1 from left obturator, 5 from left hypogastric, 8 from right external iliac, 3 from right obturator, and 5 from right hypogastric), all of which were benign. Peri-prostatic fat was also examined and found to be unremarkable.\n\nStaging according to the AJCC 1997 criteria was pT3a due to extracapsular extension. Under the AJCC 2010 system, the involvement of the bladder neck is also classified as pT3a."} +{"pid": "TCGA-QH-A86X", "report": "The specimen consists of a left frontal brain mass. Histologic evaluation reveals a diffusely infiltrating glial tumor composed of uniform cells with round to oval nuclei and clear cytoplasm, displaying a perinuclear halo. Nuclear pleomorphism is minimal, and mitotic figures are rare. No necrosis or microvascular proliferation is observed. The tumor cells are arranged in a delicate fibrillary background. Immunohistochemical staining demonstrates positivity for IDH1 and nuclear expression of ATRX. The Ki-67 proliferation index is low. Based on histologic features and immunoprofile, the lesion is classified as a low-grade glioma."} +{"pid": "TCGA-E2-A14U", "report": "The surgical specimens included sentinel lymph nodes numbered 1 through 7 and a right breast lumpectomy specimen. Sentinel lymph nodes 1 and 2 measured 0.5 x 0.4 x 0.2 cm and 0.4 x 0.3 x 0.2 cm, respectively. Sentinel lymph node 3 was 0.2 x 0.2 x 0.2 cm. Lymph nodes 4 and 5 were three in total, each measuring approximately 0.2 x 0.2 x 0.2 cm. Sentinel lymph node 6 measured 0.3 x 0.2 x 0.2 cm, and sentinel lymph node 7 was 0.5 x 0.4 x 0.3 cm. All lymph nodes were examined with touch preps and found to be free of tumor cells.\n\nThe right breast lumpectomy specimen weighed 78 grams and measured 5.5 x 4.5 x 5 cm. The surgical margins were marked with ink: anterior (blue), posterior (black), superior (red), inferior (orange), medial (green), and lateral (yellow). Upon serial sectioning into five slices, a firm stellate tan mass measuring 2.3 x 1.7 x 1.5 cm was identified. This mass was located closest to the lateral margin at a distance of 1.3 cm. Microscopic evaluation of multiple sections from all areas of the specimen showed no evidence of residual tumor at the surgical margins.\n\nHistological analysis of the breast lesion revealed nuclear grade 2 invasive carcinoma with a tubular score of 3, resulting in a modified Scarff Bloom Richardson grade of 2. No necrosis or vascular/lymphatic invasion was identified. Adjacent lobular neoplasia was present. Immunohistochemical staining showed strong positivity for both estrogen and progesterone receptors using an Allred scoring system (Allred score of 8 for both ER and PR). HER2 immunostaining showed 2+ intensity in 40% of tumor cells. Fluorescence in situ hybridization (FISH) analysis did not show HER2 gene amplification; the HER2/CEP17 ratio was 1.04 by manual count. Oncotype DX testing was performed and returned a recurrence score of 9, with ER and PR scores indicating hormone receptor positivity and a Her2 score consistent with negativity.\n\nA total of eight sentinel lymph nodes were evaluated, and none demonstrated evidence of metastatic involvement."} +{"pid": "TCGA-DJ-A1QQ", "report": "The thyroid specimen measured 3.8 \u00d7 2.5 \u00d7 1.6 cm on the left lobe and isthmus, and 4.5 \u00d7 2.3 \u00d7 1.1 cm on the right lobe. Three distinct foci were identified. The largest lesion measured 3 cm and was located in the left lobe and isthmus. A second focus measuring 1.2 cm was present in the right lobe, and a smaller lesion measuring 0.4 cm was noted in the left lobe. Histologic examination revealed well-differentiated cellular features with presence of psammoma bodies. The largest lesion was encapsulated with focal disruption of the capsule; the right-sided lesion showed partial encapsulation. No vascular invasion was observed. There was focal extension into adjacent adipose tissue surrounding the thyroid. All surgical margins were free of abnormal tissue. Additional findings included nodular hyperplasia and chronic lymphocytic thyroiditis within the non-involved portions of the gland. Multiple sections were examined from both lobes and the isthmus. One benign lymph node was identified and showed no evidence of involvement. Cellular atypia, mitotic figures, or necrosis were not observed."} +{"pid": "TCGA-D1-A102", "report": "A 2145.0 gram specimen of skin and subcutaneous tissue from the abdomen, including the umbilicus, was submitted for analysis. No lesions were identified in this tissue. A separate specimen consisting of the uterus, fallopian tubes, and left ovary weighed 890.0 grams. Within the uterine cavity, an 8.0 x 7.0 x 1.0 cm polypoid yellow mass was observed. The myometrial wall measured 4.0 cm in thickness, and a 0.5 cm depth of involvement was noted in the myometrium. No extension into the endocervix was identified. A single intramural leiomyoma measuring 7.0 x 7.0 x 6.0 cm was also present in the uterus.\n\nThe right ovary was not present; only a 8.0 x 0.4 cm right fallopian tube was identified. The left ovary measured 6.0 x 4.0 x 2.5 cm and contained a 1.1 x 1.0 x 1.0 cm mass within a smooth, solid cut surface. The left fallopian tube measured 10.0 x 2.0 cm. All margins were free of abnormality.\n\nLymph node evaluation included multiple right and left pelvic lymph nodes. On the right side, 21 lymph nodes were assessed (2 external iliac, 2 internal iliac, 1 common iliac, and 16 obturator), and on the left side, 24 lymph nodes were evaluated (5 external iliac, 1 internal iliac, 6 common iliac, and 12 obturator). All lymph nodes were negative for any abnormal cellular infiltration.\n\nTissue blocks were prepared from various regions including the pannus, uterus, fallopian tubes, ovaries, and associated lymph node groups for histological examination."} +{"pid": "TCGA-AG-A00C", "report": "The specimen consists of a rectosigmoid amputation with an ulcerated, moderately differentiated lesion of colorectal origin. The lesion is located immediately above the dentate line and measures up to 7 cm in maximum diameter. Histopathological evaluation reveals infiltration into the perirectal fatty tissue. Metastatic involvement is identified in one of 24 regional lymph nodes examined. The minimum distance between the lesion and the circumferential resection margin is 0.6 cm. Both the oral and aboral amputation margins are free of disease, as is the mesenteric resection margin. Staging is pT3 pN1 (1/24) pMX; histologic grade G2, with lymphatic invasion present (L1) and no venous invasion (V0). Resection margins are negative (R0)."} +{"pid": "TCGA-AA-A02Y", "report": "The specimen demonstrates a neoplastic lesion with varying degrees of differentiation, ranging from highly to moderately differentiated cellular features. Histological examination reveals infiltration into the muscularis propria as well as evidence of lymphatic and vascular invasion. The resection margins, including the circumferential margin, are free of tumor involvement, and the lymph nodes examined do not show metastatic involvement. Additionally, there is histologic evidence of chronic appendicitis with partial fibrosis or scarring. A separate finding consistent with clinical data identifies a Meckel's diverticulum."} +{"pid": "TCGA-DU-A5TY", "report": "The pathology report describes findings from biopsies of brain tissue. Two biopsy specimens were received, each consisting of small fragments of brain tissue measuring approximately 10 x 8 x 4 mm and 9 x 8 x 3 mm, respectively.\n\nMicroscopic examination revealed a tumor composed of gemistocytic astrocytes intermixed with regions of tightly packed pleomorphic astrocytoma cells. The nuclei of these cells exhibited pleomorphism with indistinct cytoplasmic borders. Mitotic figures were readily observed, suggesting active cell proliferation. There was no evidence of vascular proliferation or necrosis in the examined sections. Due to the small size of the tissue fragments, definitive exclusion of a higher-grade lesion could not be accomplished based solely on sampling.\n\nImmunohistochemical staining showed diffuse positivity for GFAP and p53. The Ki-67 labeling index was approximately 45%, indicating a high proliferation rate. Molecular testing demonstrated negativity for IDH1 R132H mutation and IDH1/IDH2 point mutations overall. PCR analysis for EGFR variant III mutation was negative. Additionally, MGMT promoter methylation testing was also negative.\n\nAncillary studies included histologic stains and molecular assays performed on extracted nucleic acids from paraffin-embedded tissue blocks. Sensitivity and specificity of these assays were reported according to laboratory standards. All molecular tests were performed under CLIA '88 guidelines and are intended for informational purposes within the context of clinical and pathological correlation.\n\nFrozen section evaluation was conducted during surgery and findings were communicated to the treating physician. The tissue morphology and immunophenotype were consistent with previously observed patterns in tumor samples reviewed from the patient\u2019s tumor bank slide."} +{"pid": "TCGA-ET-A3DS", "report": "The specimen consisted of a total thyroidectomy. The lesion involved the right lobe and measured 0.8 cm in greatest dimension. Histologic examination revealed a unifocal lesion with no evidence of lymphatic or venous invasion. Surgical margins were clear. A total of 8 lymph nodes were examined, all of which were negative for malignant involvement. Additional findings included thyroiditis, an adenomatoid nodule measuring 0.7 cm, and intraparenchymal parathyroid tissue measuring 4 mm. The primary tumor was confined to the thyroid gland without extrathyroidal extension. Distant metastasis could not be assessed."} +{"pid": "TCGA-HF-A5NB", "report": "The specimen was obtained from a resection procedure involving the stomach (antrum). The tumor measured 7.5 cm in size. Histological examination revealed a poorly differentiated adenocarcinoma with intestinal features, exhibiting a mucinous component that constitutes less than 50% of the total tumor volume. There is evidence of tumor invasion into the duodenum and involvement of the omentum. Pathological staging indicates advanced local progression with extension beyond the muscularis propria into adjacent structures (pT4a), extensive regional lymph node involvement (pN3a), and no distant metastasis (cM0). Additional samples include a buffy coat specimen collected in the same year as the primary sample."} +{"pid": "TCGA-QH-A6X4", "report": "The specimen consists of brain tissue from the left temporal region. Histological examination reveals a moderately cellular neoplasm composed of a mixture of cells with round to oval nuclei and varying degrees of nuclear atypia. Some areas show increased mitotic activity. Necrosis is not a prominent feature. The tumor demonstrates infiltrative growth into adjacent brain parenchyma. Microvascular proliferation is present. Immunohistochemical staining shows positivity for glial markers. Based on histological features, the lesion exhibits intermediate-grade malignancy with evidence of aggressive behavior. Staging workup indicates no distant metastasis."} +{"pid": "TCGA-EM-A3AO", "report": "The surgical specimen included multiple lymph node dissections from the right neck levels II, III, IV, central compartment, and right lateral central compartment. Lymph nodes were identified in all regions, with some showing involvement. In right neck level II, 1 of 6 lymph nodes was involved. In right neck level IV, 3 of 9 lymph nodes were involved. In the central compartment, 5 of 5 lymph nodes showed involvement with focal extranodal extension noted. In the right lateral central compartment, 1 of 2 lymph nodes was involved. No pathological involvement was found in the right neck level III or left perithyroidal lymph nodes.\n\nThe thyroidectomy specimen measured 40.7 grams. The right lobe measured 4.6 cm in greatest dimension, with a dominant nodule measuring 3.0 cm SI x 1.8 cm ML x 2.3 cm AP. A second tumor focus in the left lobe measured 0.05 cm. Histologic evaluation revealed a mix of classical (papillary) and follicular architectural patterns with classical cytomorphology. The dominant tumor was partially encapsulated with widely invasive features, while the second tumor showed no capsular invasion. Margins were free of involvement in both tumors. No lymphovascular or perineural invasion was identified, and there was no evidence of extrathyroidal extension.\n\nA total of 26 regional lymph nodes were examined, with 10 found to be involved. Extranodal extension was present in the central compartment. Additional findings included mild reactive C-cell hyperplasia and nonspecific focal thyroiditis. Parathyroid tissue appeared within normal limits. The specimen was intact with appropriate orientation, and multiple sections were submitted for analysis."} +{"pid": "TCGA-WL-A834", "report": "A hysterectomy and bilateral salpingo-oophorectomy specimen was received, including the uterus, cervix, bilateral tubes, and ovaries. The uterus measured 8.5 cm from fundus to cervical os, with a white-tan ill-defined mass located at the cervical os and lower uterine segment. The mass measured 2.5 x 2.4 x 2.9 cm and extended 2.0 cm beyond the cervical os. The depth of invasion was 13 mm, with a horizontal extent of 25 mm. The tumor was poorly differentiated with stromal invasion present. Margins were free of involvement. The endocervical canal was involved, and lymph-vascular invasion was identified. The vaginal cuff margin was not involved, with the closest distance from invasive carcinoma being 4 mm.\n\nA total of 28 lymph nodes were examined from left and right pelvic and common lymph node groups. Of these, 4 were involved by metastatic disease. Specifically, 2 of 15 lymph nodes from the left side and 1 of 13 from the right side showed involvement.\n\nPathologic staging was determined as pT1a1N1Mn/a. The serosa appeared unremarkable, and no gross lesions were identified outside the cervix. The posterior resection margin was inked black, the anterior margin blue, and the vaginal cuff margin green. The endometrial thickness averaged 0.2 cm, and both fallopian tubes and ovaries showed no significant abnormalities.\n\nThe pathologic stage is provisional and based solely on available data. Multiple sections were submitted for microscopic evaluation, covering various regions of the cervix, uterus, and associated structures. Lymph node specimens were also submitted in multiple tissue blocks for thorough assessment."} +{"pid": "TCGA-EL-A3ZG", "report": "A surgical case involving thyroid and surrounding tissues was evaluated. A left thyroid lobe specimen measured 8.0 x 4.2 x 3.2 cm and contained a well-circumscribed, encapsulated nodule measuring 6.0 x 4.0 x 3.2 cm located at the lower pole. The nodule had a tan-white appearance with areas of hemorrhage. Sections from the nodule and non-neoplastic thyroid tissue were submitted for analysis. Margins appeared grossly free of involvement. The right thyroid lobe measured 4.2 x 2.5 x 1.7 cm and showed no focal lesion. Specimens from both lobes were entirely submitted for evaluation. \n\nTissue fragments submitted for evaluation included a 0.2 x 0.1 x 0.1 cm portion from the left inferior region, which showed fibrous tissue without identification of specific glandular structures. A 0.3 cm fragment from the right side showed thyroid tissue but no identifiable glandular structures. Another 0.3 cm fragment from the right region showed lymphoid tissue without identifiable glandular structures. A left paratracheal tissue sample measuring 1.0 x 0.8 x 0.2 cm consisted of fibroadipose tissue with no lymph nodes or lesions identified. All specimens were microscopically evaluated with touch preparations performed where indicated."} +{"pid": "TCGA-HT-A74H", "report": "The pathology report describes a neoplasm located in the left temporal region. Histologic evaluation reveals a diffusely infiltrative astrocytic tumor. Cellular atypia ranges from mild to moderate, with similar variation in hypercellularity. The morphology of the tumor cells is consistent with fibrillary astrocytes. Occasional areas show features suggestive of perinuclear halos, although these are not definitive. Mitotic activity is present but rare upon careful examination. No microvascular proliferation or necrosis is identified. Immunohistochemical staining demonstrates focal positivity for p53, while IDH1 staining is negative. Proliferative activity, as assessed by MIB-1 labeling, shows an index of 13.3% in the most active regions. Reactive areas are noted, though not uniformly distributed throughout the tumor."} +{"pid": "TCGA-XU-AAXW", "report": "The specimen consists of a thymus gland and pericardium, submitted with orientation markers (long stitch on pericardium, short stitch on left lobe). Grossly, the specimen measures 13.0 x 11.0 x 2.5 cm and weighs 63.2 grams. It includes a grayish-tan piece of pericardium measuring 2.4 x 1.5 cm. A tumor is identified on the mid aspect of the left lobe, measuring up to 3.0 cm in maximum dimension. The tumor has been sampled extensively with sections taken from various regions in relation to adjacent soft tissue and pericardium.\n\nHistologically, the lesion is lobulated and predominantly mixed in growth pattern. In most areas, it is encapsulated and located well within the external margins of the specimen as indicated by silver nitrate marking. However, there are multiple foci where the tumor extends beyond the capsule into adjacent mediastinal connective tissue. In at least two areas, tumor cells are found in close proximity to the specimen margin. No involvement of the pericardium is observed.\n\nBackground thymic tissue shows involution consistent with patient age and no significant lymphoid hyperplasia. Cellular morphology corresponds with previously described classifications indicating cortical differentiation. Frozen tissue samples were collected intraoperatively for further analysis."} +{"pid": "TCGA-A3-3336", "report": "The specimen consists of a right kidney with attached perinephric fat, measuring 20.0 x 12.0 x 5.0 cm and weighing 600 grams. The kidney itself measures 14.0 x 7.0 x 3.5 cm. A mass is identified in the central aspect of the kidney, measuring 4.5 x 4.5 x 3.0 cm, which distorts the renal pelvis and calyces. The mass is gray tan, friable, and yellow to brown tan in appearance. It is located within the renal cortex, abuts the capsule, and is well-circumscribed without gross extension into the perinephric fat. The surrounding renal cortex measures 0.5 cm and shows clear demarcation between pyramids and cortex.\n\nHistologically, the tumor demonstrates high nuclear grade (Fuhrman grade 4/4). No lymphovascular space invasion, transcapsular invasion, or renal vein invasion is identified. All surgical margins, including soft tissue, ureteral, and vascular, are negative for tumor. No lymph nodes are identified. The pTNM stage is T1 NX MX, corresponding to stage I. The ureter measures 7.5 cm in length and shows no gross lesions. The renal artery and vein stumps are unremarkable. No adrenal gland tissue is present in the specimen. Representative sections of the mass, surrounding kidney, ureter, and vessels are submitted for analysis."} +{"pid": "TCGA-KB-A6F5", "report": "The specimen includes a para-esophageal lymph node, total stomach resection with proximal esophagus, and two final esophageal margins. The lymph node was negative for malignancy. The stomach specimen revealed a tumor measuring 11.5 cm in greatest dimension, located in the fundus and body of the stomach involving both anterior and posterior walls, as well as the lesser and greater curvature. Histologically, the lesion showed features consistent with an intestinal-type adenocarcinoma, predominantly moderately differentiated with focal areas of poor differentiation. The tumor extended into the distal esophagus and invaded into perigastric fat. No involvement was identified at any of the resection margins, including the proximal, distal, and radial margins. The closest distance from invasive carcinoma to any margin was 11.0 mm at the proximal margin.\n\nLymph node evaluation demonstrated metastatic involvement in 4 out of 16 examined lymph nodes. Lymphovascular and perineural invasion were present. Additional findings included chronic atrophic gastritis with marked intestinal metaplasia throughout the gastric tissue; no Helicobacter pylori organisms were identified. Gross examination of the stomach showed an exophytic tumor with ulceration and circumferential growth pattern. The tumor depth measured 1.7 cm and extended into subserosal connective tissue without reaching the visceral peritoneum or adjacent structures.\n\nAll non-tumor-associated tissues, including both esophageal margins and omental tissue, were unremarkable and showed no evidence of malignancy. Multiple lymph nodes were sampled along both the greater and lesser curvatures. Sections from various regions of the tumor and surrounding tissue were submitted for analysis. No prior treatment effect was observed."} +{"pid": "TCGA-AO-A12H", "report": "A right breast mass was identified in a patient with a prior core biopsy showing invasive malignancy. A total of five sentinel lymph nodes and five non-sentinel lymph nodes from the right axilla were examined. All lymph nodes, including those from levels I and II of the axilla, were found to be benign without evidence of metastatic involvement. The right breast specimen showed a well-circumscribed, brown, focally hemorrhagic mass measuring 2.2 cm microscopically, located in the upper outer quadrant. The mass exhibited a solid-papillary growth pattern with mucinous differentiation. Focal ductal carcinoma in situ was also present, composed of solid-papillary, solid, and cribriform types, with low to intermediate nuclear grade and minimal necrosis. Surgical margins, including the nipple, skin, and deep margin, were free of tumor. No definite lymphovascular invasion was identified. Immunohistochemical staining of the invasive component showed strong and diffuse nuclear staining for estrogen receptor (100% positive), moderate-intensity nuclear staining for progesterone receptor in 5% of cells, and no reactivity for HER-2/neu. The breast tissue showed post-biopsy changes, including stromal fibrosis and atrophy. Gross examination of the mastectomy specimen revealed no other significant masses or lesions. All submitted lymph nodes from the right axilla were negative for tumor involvement."} +{"pid": "TCGA-DJ-A1QD", "report": "The clinical history notes a right lobe thyroid lesion measuring 2.4 cm with complex features on ultrasound. A total thyroidectomy was performed along with excision of multiple lymph node groups from both sides of the neck and mediastinum.\n\nExamination of the right level three, four, and five lymph nodes revealed a total of 9 lymph nodes, with 4 showing involvement. The largest lymph node measured 1.6 cm, and the largest focus within it measured 0.5 cm. No extension beyond the lymph nodes was observed. In the Delphian lymph node region, one specimen showed benign thyroid tissue with chronic inflammation. Another Delphian lymph node specimen contained two lymph nodes, both of which were involved, with the largest lymph node measuring 0.55 cm and the largest focus measuring 0.2 cm. No extension outside the lymph nodes was present.\n\nIn the pretracheal and superior mediastinal lymph node group, two lymph nodes were identified, both of which were involved. The largest lymph node measured 0.9 cm, with a focus of similar size. Extension beyond the lymph node capsule was noted in this group. In the right paratracheal lymph nodes, two lymph nodes were examined, with one showing involvement. The involved lymph node measured 0.6 cm, with a focus of identical size. No extranodal spread was seen.\n\nA single right cricothyroid lymph node was fully submitted and found to be involved. It measured 0.3 cm, with a focus of 0.1 cm; no extension beyond the node was identified. Additional right and left paratracheal lymph node specimens were evaluated. One of the right specimens showed involvement in a lymph node measuring 0.45 cm with a focus of 0.3 cm; all others in these groups showed no signs of involvement.\n\nThe thyroid gland specimen weighed 23 grams. The right lobe contained a nodule measuring 2.2 cm in greatest dimension, surrounded by a fibrous layer. Microscopic evaluation showed well-differentiated cellular features without increased mitotic activity or necrosis. Psammoma bodies and a marked stromal reaction were observed. The surgical margins were clear, and no vascular invasion or extrathyroid extension was identified. One of six perithyroidal lymph nodes showed involvement.\n\nChronic inflammatory changes were present in non-neoplastic portions of the thyroid. Parathyroid tissue was identified and appeared unremarkable."} +{"pid": "TCGA-B4-5835", "report": "The specimen was obtained from the left kidney and submitted as a primary tissue sample. The tumor tissue weighed 320 mg and was preserved in a frozen cryomold. A separate blood sample was collected, amounting to 4 mL, and stored in a frozen tube. Histological evaluation showed that approximately 90% of the cellular composition was consistent with neoplastic cells. The tumor was graded as moderately differentiated (Grade 2). Staging parameters indicated a T1, N0, M0 classification based on available TNM criteria. No prior chemotherapy, hormonal therapy, or radiation therapy was reported. Additional cellular analysis did not reveal any lymph node involvement or distant metastasis."} +{"pid": "TCGA-A6-A565", "report": "The specimen consists of a 50 cm segment of colon with attached ileum, featuring smooth to focally retracted serosa and abundant mesocolon. An unremarkable appendix measuring 3.6 cm in length is present. The proximal and distal margins measure 2.5 cm and 6.2 cm in circumference respectively. Upon opening, a circumferential tan-white lesion measuring 7.0 x 5.5 cm is identified, located 15 cm from the distal margin. Sectioning reveals the lesion has a maximal thickness of 1.5 cm and extends through the muscularis to within 0.1 cm of the radial serosal surface, with focal extension into adjacent omentum. Remaining mucosa appears diffusely edematous with irregular folds and average wall thickness of 0.5 cm. A lymph node at the splenic flexure measuring 1 cm is identified along with multiple additional lymph nodes up to 1.4 cm in size, some subjacent to the lesion.\n\nHistologically, the lesion demonstrates poor differentiation with mucinous signet ring cell features. Invasion extends beyond the muscularis propria into surrounding adipose tissue and omentum (pT3d). All surgical margins are negative. Vascular invasion is present. Examination of 41 lymph nodes reveals tumor involvement in 13 nodes, including the marked splenic flexure node and several subjacent nodes showing extracapsular extension. Additionally, non-lymph node pericolonic tumor involvement is observed. One adenomatous polyp is identified. The appendix shows no significant histopathologic findings."} +{"pid": "TCGA-D8-A27M", "report": "Histopathological examination of a total organ resection from the left breast was performed. The clinical history indicated presence of abnormal cells in the breast tissue. Immunohistochemical analysis showed no expression of estrogen or progesterone receptors in the neoplastic cell nuclei. HER2 protein staining using Ventana's Pathway HER-2/neu (4B5) Rabbit Monoclonal Antibody showed a negative reaction in the invasive cancerous cells (Score=0).\n\nMacroscopically, the breast measured 17.3 x 15.4 x 4.8 cm and weighed 600 grams. A lesion measuring 1.6 x 1.2 x 1.8 cm was identified in the upper outer quadrant, located 3.8 cm from the upper boundary, 1.2 cm from the base, and 1.6 cm from the skin. No axillary tissue was included in the specimen.\n\nMicroscopic evaluation revealed a high-grade lesion with a histological grade NHG3 (score 2 + 3 + 3), showing 30 mitoses per 10 high-power fields (visual area: 0.55 mm). The cellular arrangement demonstrated glandular structures with signs of parenchymal atrophy. The tumor was classified as pT1c with no lymph node involvement based on sentinel node assessment (pN0)."} +{"pid": "TCGA-DJ-A2PZ", "report": "The specimen from the left paratracheal region consists of a single lymph node measuring 0.3 cm in greatest dimension, which is entirely submitted for frozen section. Microscopic evaluation reveals benign lymphoid tissue without evidence of malignancy.\n\nThe thyroid specimen includes the left lobe and isthmus, measuring 4.5 x 2.5 x 1.5 cm and weighing 12 grams. A 2 x 1 x 0.6 cm segment of skeletal muscle is attached to the anterior surface. The posterior aspect is marked with black ink and the anterior with blue ink. Upon serial sectioning, a nodule measuring 1.7 x 1.6 x 1.2 cm is identified in the mid to upper portion of the lobe. It is partially encapsulated with a hard, tan appearance and a gritty texture. The nodule is located within the left lobe and is fully submitted for analysis.\n\nMicroscopically, the nodule is well differentiated with no identifiable mitotic activity or necrosis. There is no evidence of blood vessel invasion. The lesion demonstrates focal extension into extrathyroidal adipose tissue. Surgical margins are free of involvement. No additional nodules are identified. The surrounding non-neoplastic thyroid tissue shows changes consistent with nodular hyperplasia. Parathyroid tissue is not identified in the specimen. All sections have been reviewed and evaluated."} +{"pid": "TCGA-TQ-A7RG", "report": "The specimen consists of brain tissue received in four bottles. Bottle 1 contains a rounded, whitish, soft tissue fragment measuring 0.5 x 0.5 x 0.2 cm. Bottle 2 includes four fragments of irregular, whitish, and soft tissue with a combined measurement of 1.0 x 0.3 x 0.2 cm. Bottle 3 holds a single piece of whitish, soft tissue measuring 0.5 x 0.4 x 0.2 cm. Bottle 4 contains two brown, rounded structures; the largest measures 3.2 x 2.0 x 1.2 cm and the smallest 1.5 x 1.0 x 0.5 cm.\n\nMicroscopic examination of hematoxylin and eosin-stained sections shows fragments of neocortex infiltrated by a low-grade glial neoplasm primarily located in the white matter. The cellular population is composed of two main components. The predominant cell type has round nuclei with delicate, granular chromatin and inconspicuous nucleoli. The cytoplasm is sparse and ill-defined, with perinuclear halos noted in some areas. These cells are diffusely infiltrative, extending into the adjacent cortex up to layer I, and are associated with frequent neuronal satellitosis. A second, less abundant cell type displays irregular and elongated nuclei with dense chromatin and eosinophilic cytoplasm that is also poorly demarcated.\n\nAreas of increased cellularity are present, with rarefaction of the neuropil and occasional microcysts. Mitotic figures are infrequent. No microvascular proliferation or necrotic foci were identified. Intraoperative smears from the submitted fragments show a diffuse glial neoplasm composed mainly of cells with elongated nuclei and mild nuclear atypia in a fibrillary background. Some round-nucleated cells are also observed. Occasional eosinophilic, amorphous structures suggestive of Rosenthal fibers are present but not definitive.\n\nGenetic analysis for 1p/19q deletion was performed using fluorescence in situ hybridization on formalin-fixed, paraffin-embedded tissue sections from the most representative tumor area. A total of 100 to 200 nuclei were evaluated per slide. The signal ratio for the 1p/1q probe was 0.58, and the signal ratio for the 19q/19p probe was 0.62."} +{"pid": "TCGA-VS-A9UT", "report": "The biopsy of a polypoid lesion in the endocervical region shows invasive, poorly differentiated mucinous adenocarcinoma. The tumor cells exhibit morphological features consistent with mucinous differentiation. No evidence of perineural or angiolymphatic invasion is identified. Immunohistochemical analysis supports the origin and characteristics of the lesion. Staging and further clinical correlation will be necessary for management planning."} +{"pid": "TCGA-ET-A40T", "report": "The biopsy specimen from the parathyroid region consists of lymphoid and fibroadipose tissue, with identifiable parathyroid tissue present. The thyroid specimen was obtained via total thyroidectomy with central neck dissection. The tumor was located in the isthmus and left lobe, measuring 2.8 cm in greatest dimension and demonstrating unifocal growth. Histologic evaluation reveals a solid growth pattern in certain areas. Assessment of lymph nodes shows small foci of metastatic involvement in 3 out of 15 nodes examined. \n\nRegarding staging, the primary lesion is classified as pT2, indicating a tumor larger than 2 cm but not exceeding 4 cm confined to the thyroid. Regional lymph node involvement corresponds to pN1a classification. Surgical margins are free of tumor involvement, although invasive cells are noted within less than 1 mm of the anterior and deep margins. Evidence of vascular or lymphatic invasion is present.\n\nAdditional findings include lymphocytic thyroiditis. Notably, psammomatous calcifications were observed in three lymph nodes. Immunohistochemical staining for cytokeratin demonstrates isolated metastatic cells associated with these calcifications. Staining for thyroglobulin was inconclusive due to high background signal, while TTF-1 highlights a subset of these cells."} +{"pid": "TCGA-WB-A818", "report": "The specimen from a left adrenalectomy weighed 59 grams after removal of adipose tissue. A well-encapsulated mass measuring 5.5 x 4.5 x 4.5 cm was identified, with areas of hemorrhage noted. Histological examination revealed no mitotic activity or necrosis. A prominent fibrous stellate scar was present. The tumor was well-circumscribed with no evidence of vascular invasion. Samples from the surrounding adrenal cortex showed normal architecture without nodular changes. A score of 1 was assigned based on the PASS (Pheochromocytoma of Adrenal Sinus Score) system."} +{"pid": "TCGA-ET-A3BV", "report": "The specimen consists of a total thyroidectomy and central neck dissection. The tumor was located in the left lobe and measured 4.0 cm in greatest dimension. Histologic evaluation revealed unifocal involvement with invasive carcinoma. A total of 17 lymph nodes were examined, and metastatic involvement was identified in 2 of these nodes. The primary tumor was staged as pT2, indicating a tumor larger than 2.0 cm but not exceeding 4.0 cm confined to the thyroid. Regional lymph node staging was classified as pN1a, signifying metastasis to Level VI nodes including pretracheal, paratracheal, and prelaryngeal/Delphian lymph nodes. Distant metastasis could not be assessed (pMx). Surgical margins were free of tumor involvement, with the closest distance of invasive carcinoma measuring 1.0 mm from the nearest margin, specifically involving the inked anterior and posterior margins. Evidence of venous and lymphatic invasion was present. Additional findings included chronic lymphocytic thyroiditis."} +{"pid": "TCGA-HT-7481", "report": "The pathology report describes a glial neoplasm that shows diffuse infiltration of both gray and white matter. In the gray matter, prominent perineuronal satellitosis and subpial surface spread are noted. The tumor cells have round nuclei with minimal cytoplasmic processes, and many exhibit perinuclear halos. There is minimal cytologic atypia, no microvascular proliferation, and no necrosis. Immunohistochemical staining reveals numerous MIB-1 reactive cells, with a calculated labeling index of 21%, indicating a markedly proliferative process. Despite this high proliferation index, no mitotic figures are seen on standard stain, and only a rare mitotic figure is identified on immunohistochemistry. Based on these findings, the tumor is classified as low grade, with features suggesting potentially more aggressive behavior. Close clinical follow-up is recommended."} +{"pid": "TCGA-CQ-6219", "report": "The specimen consisted of multiple lymph node groups from various anatomical levels, along with surgical resection margins. On the right side, level IA contained 3 lymph nodes, all without evidence of involvement. Level IB contained 6 lymph nodes, all negative for tumor, and included a submandibular gland with chronic inflammation. In level IIA, 9 lymph nodes were identified, with one showing involvement; this lymph node measured 3.5 cm and exhibited extracapsular extension. Level IIB had 5 lymph nodes, none involved. Level III contained 12 lymph nodes, all negative, and level IV had 10 lymph nodes, also negative. A right submental lymph node was negative.\n\nResection specimens included a glossectomy specimen with an identified lesion measuring 5.5 cm in greatest dimension and 3.6 cm in thickness. The medial and lateral pharyngeal margins were positive for tumor, while other margins\u2014including anterior, posterior, and deep\u2014were negative. The right deep tonsil margin, posterior tongue base, anterior tongue base, anterior deep margin, and posterior deep margin were all free of tumor involvement. Left neck dissection specimens included one level II lymph node, one level III lymph node, and six additional lymph nodes from levels I-III, all of which were negative. Revision specimens from the right parapharyngeal space and glossectomy showed no residual tumor involvement.\n\nHistologic evaluation demonstrated cellular features including perineural invasion, although no lymphatic or vascular invasion was identified. A total of 55 regional lymph nodes were examined, with one found to be involved. Extracapsular extension was present in the involved node. Distant metastasis could not be assessed."} +{"pid": "TCGA-D8-A27E", "report": "A histopathological examination was performed on a partial resection of the left breast, including a skin flap measuring 5.8 x 3.3 cm. The breast specimen measured 6.6 x 5.3 x 1.9 cm and contained a cross-sectional lesion measuring 0.9 x 0.8 x 1.7 cm. Margins were identified as follows: 0.4 cm to the base, 0.5 cm to the front surface, 1.8 cm to the sternum, 3.7 cm to the axilla, and 1.7 cm to the lower edge. A radiogram showed a shadowing area of 1.4 x 1.4 cm, with blue dye injection into the skin.\n\nMicroscopic analysis revealed a heterogeneous cellular pattern with a mitotic count of 1 per 10 high-power fields. The largest lesion dimension was 1.7 cm. Margins corresponded to those described macroscopically. The surrounding tissue showed changes consistent with fibrous mastopathy and areas of lipomatosis. The histopathological assessment included a detailed evaluation of the lesion\u2019s architecture and cellular features."} +{"pid": "TCGA-A8-A06R", "report": "The specimen shows a poorly differentiated invasive lesion measuring 2.8 cm in greatest dimension. Histologic evaluation reveals high-grade nuclear features with a lack of glandular differentiation. Lymphovascular invasion is present. Metastatic involvement is identified in one regional lymph node. The tumor demonstrates an infiltrative growth pattern without specific morphologic subtype. Staging classification is pT2N1a."} +{"pid": "TCGA-49-AARQ", "report": "The right upper lobe specimen includes two distinct non-contiguous nodules. The larger nodule measures 3.2 cm in greatest dimension and is located within the lung parenchyma, with a distance of at least 4.2 cm from the parenchymal margin. A second smaller nodule measuring 1.0 cm is present and is separate from the primary lesion. This smaller nodule is located no closer than 2.2 cm from the stapled parenchymal margin. No tumor extension is identified at the bronchial, vascular, or parenchymal margins. Six hilar lymph nodes are negative for involvement. The overlying pleural surface shows no evidence of tumor extension, though there is some focal hardening and puckering noted. Histologically, the nodules are described as infiltrating, moderately differentiated. Surrounding lung tissue demonstrates acute and organizing bronchopneumonia, with focal obstructive pneumonitis. Emphysematous changes and focal peripheral bulla formation are also present. Lymph node stations R-4 and station 7 each contain one lymph node, all of which are negative for tumor. The tumor size has been adjusted to account for surrounding inflammation. The specimen was well sampled with multiple sections taken from different areas including the tumor, adjacent lung tissue, and margins."} +{"pid": "TCGA-22-4594", "report": "The resected left upper lobe lung tissue weighed 190 grams and measured 21 x 11 x 5 cm. A peripheral mass measuring 4.2 x 4.0 x 3.5 cm was identified, with evidence of invasion through the pleura into the chest wall soft tissue. Examination of the bronchial and chest wall resection margins showed no presence of malignant cells. Among the intrapulmonary peribronchial lymph nodes, 2 out of 4 were found to contain metastatic cells. In the superior mediastinal (paratracheal) lymph node group, 2 out of 4 nodes were involved by metastatic disease. In the inferior mediastinal (subcarinal), left pulmonary artery, and left lower lobe lung lymph node groups, a total of 3 subcarinal, 6 left pulmonary artery, and 6 left lower lobe lung lymph nodes were all free of tumor involvement. The cellular morphology showed high-grade features."} +{"pid": "TCGA-AP-A0LF", "report": "The submitted specimens include a gallbladder, an omental nodule, a uterus with cervix, bilateral fallopian tubes and ovaries, multiple lymph node groups from both sides (left and right external iliac, obturator, hypogastric, common iliac, and para-aortic), and an omentum specimen. \n\nMicroscopic evaluation of the gallbladder shows cholecystitis with wall calcification. The omental nodule reveals the presence of metastatic carcinoma. In the uterine specimen, a primary tumor is identified in the endometrium, described as FIGO grade III with 50% solid growth pattern and nuclear grade 3 features. Tumor invasion extends into less than half of the myometrium, with maximal thickness of myometrial invasion measuring 2 mm in an area where the total myometrial thickness is 12 mm. There is also evidence of endocervical involvement with tumor infiltration in both mucosa and stroma. The endometrium otherwise demonstrates atrophic changes, and the myometrium is otherwise unremarkable. The left ovary contains metastatic deposits of carcinoma.\n\nLymph node assessment reveals several involved sites. In the left external iliac group, 3 out of 6 nodes show metastatic involvement. In the left obturator group, 5 out of 11 nodes are positive. Both of the two hypogastric nodes on the left are involved. On the right side, 2 out of 8 obturator nodes and 2 out of 4 hypogastric nodes are positive for tumor. Among the remaining lymph node specimens, all are negative for tumor, including one left common iliac node, eight left para-aortic nodes, two right para-aortic nodes, and one right common iliac specimen. The omentum specimen is free of tumor."} +{"pid": "TCGA-AP-A1E3", "report": "The submitted specimens include a hysterectomy with bilateral salpingo-oophorectomy, a pannus excision, and right external iliac lymph nodes. In the uterine specimen, a lesion is identified with at least two distinct morphologies: one well-differentiated and endometrioid in appearance, and another that is high-grade, solid, with spindled and transitional-cell-like features. Architectural grading for endometrioid types is grade III, with more than 50% solid growth. Nuclear grading for endometrioid types is grade 3, corresponding to FIGO grade 3. The depth of myometrial invasion measures 34 mm, within a myometrial thickness of 44 mm at the site of maximal tumor involvement. There is endocervical mucosal and stromal invasion with a depth of cervical stromal invasion measuring 13 mm, within a cervical wall thickness of 16 mm at the area of maximum tumor extension. Lymphovascular invasion is present. The endometrium also shows complex hyperplasia with atypia. Multiple leiomyomata are noted in the myometrium. Both fallopian tubes appear unremarkable. Metastatic involvement is present in both ovaries, including within bilateral adenofibromas. The pannus specimen consists of benign skin and fibroadipose tissue. The right external iliac lymph nodes show metastatic involvement with tumor present in a matted lymph node. Immunohistochemical staining for DNA mismatch repair proteins (MLH1, MSH2, MSH6, PMS2) demonstrated retained expression in the tumor. These results will be reported as an addendum."} +{"pid": "TCGA-A3-3313", "report": "The specimen consists of a right kidney measuring 13 x 9.5 x 5.5 cm and weighing 312 grams, with a 3.0 cm segment of attached ureter. The ureter and vascular margins were sampled and no abnormalities were identified grossly. Upon bivalving the kidney, a tan, partially cystic mass measuring 4.5 x 4.0 x 3.5 cm was observed bulging beneath the renal capsule. An extension of the mass was noted within the renal vein. Sections of the mass, adjacent normal kidney tissue, and the renal vein were submitted for analysis. The tumor was found to be limited to the kidney without involvement of the ureter, adrenal gland, or perinephric fat. Histologically, the lesion exhibited Fuhrman nuclear grade III morphology. No lymphatic or venous invasion was identified. Surgical margins were free of involvement. Multiple cystic structures up to 1.2 cm in diameter were present on the kidney surface. Based on available findings, the pathologic staging is pT1b, with no regional lymph node or distant metastasis identified."} +{"pid": "TCGA-C5-A2LY", "report": "The specimen consists of a cervical biopsy and multiple lymph node samples. The cervical biopsy is an irregular gray-white tissue fragment measuring 1.1 x 0.9 x 0.7 cm. Several lymph node specimens were collected from different anatomical locations, including the right external, right common, right periaortic, distal common, and right distal pelvis regions.\n\nThe right external lymph node sample includes two nodes within a fatty tissue fragment measuring 3.2 x 1.9 x 1 cm. Both nodes were entirely submitted for analysis. A single lymph node from the right common area, measuring 2.1 x 1.4 x 0.8 cm, was also fully submitted. In the right periaortic region, one lymph node was identified within fatty tissue aggregating to 3.5 x 3.2 x 0.4 cm; this node was entirely submitted. The distal common lymph node measured 2.5 x 1.7 x 0.6 cm and was bisected and submitted completely. The right distal pelvis area included two fatty tissue fragments, with the larger measuring 3.6 x 1.5 x 1.5 cm and both submitted in entirety.\n\nMicroscopic evaluation of the cervical tissue showed features consistent with invasive cellular changes. The cellular morphology appeared moderately differentiated. No abnormal cells were identified in any of the lymph node specimens. All lymph node samples from the right external (2/2), right common (1/1), right periaortic (1/1), distal common (1/1), and right distal pelvis (2/2) locations showed no evidence of abnormal cellular proliferation. Additionally, endosalpingiosis was noted in one of the lymph node specimens.\n\nThe surgical procedure involved a cervical biopsy and retroperitoneal removal of the right node and surrounding tissue. All specimens were examined microscopically and confirmed to be consistent with the findings described above."} +{"pid": "TCGA-J4-A83K", "report": "The specimen consisted of two parts. The first part, labeled as tissue anterior to the prostate, was composed of fibrofatty material without any abnormal cellular findings. It included multiple yellow-tan adipose fragments measuring 3 x 2 cm and was entirely submitted for analysis.\n\nThe second part included a radical prostatectomy specimen with attached seminal vesicles and vas deferens. The prostate weighed 40 grams and measured 4.5 x 4 x 4 cm. The outer surface showed disruption at the bladder resection margin, previously marked with black and blue ink. The right seminal vesicle measured 3 x 1.5 cm, and the right vas deferens was 2 x 0.4 cm. The left seminal vesicle was 2 x 1.5 cm, and the left vas deferens was 2 x 0.4 cm. Upon sectioning, the prostate showed a firm, focally nodular texture. No abnormalities were noted in the seminal vesicles or vasa deferentia.\n\nMicroscopic evaluation revealed no tumor involvement in the tissue anterior to the prostate. In the prostate specimen, histological analysis showed a Gleason score of 3 + 3 = 6/10. The extent of tissue involvement by the process was estimated at 15\u201330%. The tumor appeared confined to the prostate gland without evidence of spread beyond the organ. Lymphatic invasion was not identified, but perineural involvement was present. No involvement was found in the seminal vesicles or at the surgical margins. Approximately 85% of the prostate specimen was sampled and reviewed."} +{"pid": "TCGA-IB-7652", "report": "The surgical resection specimen of the pancreas includes the neck, body, and tail. A mass measuring 4.2 cm in maximum diameter is identified within the pancreas. Microscopic evaluation reveals a malignant proliferation of epithelial cells forming primitive glandular structures in more than half of the tumor. The mitotic index is 2 per 10 high-power fields. The tumor extends into peripancreatic fatty tissue and demonstrates perineural invasion. No lymphovascular invasion is observed. The tumor is located near the retroperitoneal margin, with desmoplastic stroma extending to the inked margin. One out of twenty regional lymph nodes shows evidence of metastasis.\n\nA separate surgical resection from the posterior wall of the stomach reveals a small, pedunculated mass measuring 1.3 x 1 x 0.9 cm. Histologically, it is composed of a paucicellular fibrous tumor with extensive calcifications, including psammomatous-like bodies, dystrophic calcifications, and linear calcium deposits along capillaries. No atypical cytologic features are present.\n\nThe spleen specimen appears unremarkable upon histological examination. Multiple sections of splenic tissue show no pathological abnormalities. Lymph node sampling from various regions around the pancreas was performed, with one lymph node showing involvement by malignant cells.\n\nAll margins were evaluated microscopically. Invasive carcinoma is noted at the posterior retroperitoneal surface of the pancreas. No treatment history is available for neoadjuvant therapy effects.\n\nGrossly, the pancreatic specimen weighs 54.8 grams and measures 9.5 x 4.8 x 2.3 cm. The tumor is firm with yellow and white nodular areas and surrounds the middle portion of the splenic blood vessels. Multiple representative sections were taken from the tumor, surrounding margins, and lymph nodes.\n\nThe gastric lesion was submitted entirely and consists of an encapsulated fibrous lesion with no immunohistochemical staining suggestive of a benign process."} +{"pid": "TCGA-C5-A1MF", "report": "The specimen consists of a radical hysterectomy with bilateral salpingo-oophorectomy. The cervix contains a lesion measuring 5.2 cm in greatest dimension. The tumor invades to a depth of 18 mm, within a total wall thickness of 22 mm. There is focal lymphovascular space invasion present. All resection margins, including those of the vaginal cuff and parametrial soft tissue, are free of malignant cells. \n\nThe endocervix shows no dysplasia or malignancy. The endometrium demonstrates a polyp and early menstrual phase changes. Adenomyosis and a microscopic leiomyoma are identified in the myometrium. The uterine serosa shows subserosal endosalpingiosis. \n\nThe left ovary exhibits paraovarian adhesions; otherwise, no histopathologic abnormalities are found in either ovary or fallopian tube."} +{"pid": "TCGA-E2-A56Z", "report": "Tissue was fixed in 10% neutral buffered formalin for between 8 and 24 hours. Immunohistochemistry was performed using ER and PR markers, following manufacturer guidelines and internal validation standards. Staining interpretation followed published literature and manufacturer recommendations.\n\nA biopsy specimen underwent HER2 testing using the HercepTest kit with rabbit anti-human HER2 antibody. The immunohistochemical result was equivocal (intensity 2+, 10% tumor staining). Subsequent FISH analysis was conducted using the PathVysion HER-2 DNA Probe Kit. The HER2/CEP 17 ratio was determined to be 2.0 based on evaluation of 100 invasive tumor cells. This falls within the indeterminate range as defined by established thresholds. Controls were appropriately validated.\n\nThe patient underwent surgical excision of a lesion identified in the right breast. Intraoperative consultation confirmed metastatic involvement of one sentinel lymph node (measuring 0.3 cm). Final pathology from the excised specimen revealed an invasive lesion measuring approximately 3 cm. Histologic features included papillary components and focal mucinous differentiation. Nuclear grade was high. Surgical margins were negative.\n\nAdditional findings included ductal carcinoma in situ (DCIS) involving approximately 10% of the specimen, characterized by cribriform, micropapillary, papillary, and solid growth patterns with central necrosis and microcalcifications. No vascular or lymphatic invasion was identified. Lobular neoplasia was not present.\n\nAxillary lymph node dissection yielded 15 negative nodes. No extranodal extension was observed.\n\nImmunohistochemistry demonstrated positivity for estrogen receptor and cytokeratin AE1/3 in both tumor cells and lymph node metastases. Other markers including S-100 and P63 were negative.\n\nStaging according to AJCC Cancer Staging Manual, 7th Edition, was pT2 N1a.\n\nHER2 FISH testing was repeated on the excised specimen. Analysis of 200 invasive tumor cells showed a HER2/CEP 17 ratio of 1.5, indicating absence of HER2 gene amplification. Chromosome 17 polysomy was noted.\n\nAn Oncotype DX assay was performed. The recurrence score was 27, associated with an estimated 10-year distant recurrence risk of 18%. Hormone receptor scores were positive for estrogen and progesterone receptors. The HER2 score was negative.\n\nMargins of resection were clear with the closest distance measuring 0.4 cm anteriorly. No residual tumor was identified at the biopsy site in the left breast specimen. Fibroadenomatoid changes and coarse calcifications were noted.\n\nRadiographic correlation was performed during specimen processing. Multiple slices were examined for both breasts with identification of relevant anatomical landmarks and clips.\n\nControls were appropriately validated for all assays performed. Testing was conducted under established protocols within the laboratory. Interpretation of results was intended to complement clinical and morphological assessment rather than serve as standalone diagnostic tools."} +{"pid": "TCGA-66-2768", "report": "The left lung specimen shows a central mass located in the lower lobe, measuring up to 6 cm in size. It is pale brown to whitish in color and primarily endobronchial in growth pattern, with relatively clear demarcation from surrounding parenchyma. The tumor extends to within 0.3 cm of the hilar resection surface. There is high-grade constriction or obstruction of the lower lobe bronchus starting barely 1 cm distal to the ostium and involving the proximal parts of the lower lobe segmental bronchi, especially those of the basal group. The main bronchus is largely skeletonized. At the hilus, multiple grayish-black nodes are present, ranging from 0.3 to 0.8 cm in size.\n\nFocal extension to the pleural fissure is observed. The pleura over segment 6 and adjacent sections of S10 show extensive adhesions in some areas and loose attachment in others, involving a region measuring 16 x 14 cm. Dorsal, lateral, and basal pleura over segment 10 and adjacent sections of S9 demonstrate grayish-white discoloration and thickening near the pleural margin. The upper lobe does not show macroscopic infiltration. However, there is focal retraction of the basal pleura over segment 9 and incomplete folding of the basal lower lobe parenchyma. This area shows diffuse induration and patchy brownish-yellow discoloration. Peripheral branches of the bronchi in the basal group are markedly dilated and filled with thick mucus. The remainder of the parenchyma and pleura exhibit marked patchy or reticulate blackish pigmentation.\n\nMultiple lymph node stations were examined. At the bifurcation of the upper lobe bronchus, two grayish-black nodes measuring 1 cm each are noted, along with a subpleural grayish-black node of 0.3 cm in segment 4. Additional lesioned lymph nodes include: interlobar (station 11), 1 cm; hilar (station 10) left, 1.2 cm; pulmonary ligament (station 9), 1.5 cm; subcarinal (station 7), 1.5 cm; paraortic (station 6), 0.8 cm; subaortic (station 5), 0.9 cm; low paratracheal (station 4) left, 1 cm; and hilar (station 10) right, 1.1 cm. Some nodes show involvement by the observed lesion.\n\nVascular changes include constriction and pouch-like puckering of central blood vessels by the tumor. Vascular invasion is seen in small pulmonary vessels within the tumor and also in a small to medium-sized vein within the adjacent mediastinal fatty tissue next to the lower lobe main bronchus.\n\nSections of retrostenotic bronchiectasis are present, along with areas of massive, partly purulent peripheral bronchiolitis and organizing pneumonia in the lower lobe. There is peripheral necrosis of the parenchyma in S9 with fibrin insudation into the pleura or pleural pockets and associated pleural fibrin exudation. Alveolar macrophages with brown pigment are found in clusters. Anthracotic pigment deposits are present in slight amounts within the lung parenchyma. Mild fibrosis of alveolar septa is observed under a pleural adhesion zone in S6. A mild reactive chronic parietal pleuritis is present in one sample.\n\nLymph nodes show variable levels of anthracotic pigment, with some displaying minimal deposits and others showing moderate amounts. Reactive follicular hyperplasia is also noted in some lymph nodes. Microscopic evaluation revealed large-cell solid growth pattern with occasional intercellular bridges and dyskeratotic cells. Numerous vacuolated tumor cells are present, though no mucin inclusions are identified. Metastatic involvement is limited to lymph nodes in proximity to the tumor site."} +{"pid": "TCGA-B6-A1KN", "report": "Surgical pathology report. Specimen A is a lymph node measuring 1.0 x 0.5 x 0.4 cm, submitted entirely in block A1. Specimen B consists of a right breast with axillary dissection weighing 525 grams and measuring 24.5 x 10.5 x 4.6 cm. The axillary dissection component measures 8 x 8 x 2 cm. The overlying skin measures 18.3 x 6.3 cm and includes a 1.5 cm nipple and a 2.8 cm areola. The deep margin is inked blue. Sectioning reveals a stellate mass measuring 6.4 x 5.2 x 2.5 cm with salmon-colored appearance and areas of necrosis. The mass is firm and nodular, approaching the lateral margin in a 3 x 1.5 cm region. The nipple is removed and submitted entirely, with a firm indurated area adjacent to it showing involvement of the skin.\n\nBlocks include sections from the nipple, skin, margins, tumor, and surrounding tissue. Additional blocks focus on lymph nodes and lymph node candidates. Of note, multiple lymph nodes and lymph node candidates were identified in the axillary dissection. One lymph node measures 1.2 cm and is bivalved. Several other lymph node candidates are present, some bivalved and others inked blue.\n\nHistologic evaluation shows high-grade features with nuclear and histologic grading as the highest category. The invasive component measures 6.4 x 5.2 x 2.5 cm and is centrally located. Lymphatic/vascular invasion is extensive. No multifocal tumor is identified. In situ carcinoma is present, occupying 5% of the tumor volume, with comedo-type morphology. Extensive intraductal component is not noted. Epithelial hyperplasia and apocrine metaplasia are identified in non-neoplastic breast tissue. Direct invasion of the nipple and skin by tumor is observed, with focal involvement of muscle.\n\nThe lateral surgical margin demonstrates infiltrating tumor focally. In situ carcinoma approaches the deep margins at a distance of less than 1 mm. Of 30 lymph nodes assessed, 24 show involvement. The largest lymph node metastasis measures 1.2 cm. Extracapsular extension is present. Small tumor deposits are also seen in the axillary soft tissue unrelated to lymph node structures.\n\nImmunohistochemistry was performed for hormone receptor analysis. Estrogen receptor activity is positive (FMOL value: 169). Progesterone receptor activity is negative (FMOL value: 0)."} +{"pid": "TCGA-BB-8596", "report": "The specimen consists of a laryngectomy and right hemithyroidectomy. The lesion is located in the right pyriform sinus and extends to involve the right true vocal cord and right false vocal cord. The largest dimension of the lesion measures 3.0 cm. Histologic evaluation shows poorly differentiated cellular morphology. No lymph nodes were submitted for examination.\n\nThe primary lesion demonstrates extension into surrounding structures, including invasion through the thyroid cartilage with focal involvement of the adjacent thyroid tissue. There is also infiltration into the skeletal muscle and soft tissue near the right pyriform sinus. Additionally, the lesion involves the marrow space within the ossified thyroid cartilage. Surgical margins are free of involvement. Vascular and lymphatic invasion could not be definitively assessed. Evidence of perineural invasion is present. Due to the absence of lymph node tissue and inability to evaluate for distant spread, regional and distant staging could not be determined. The pathologic staging is classified as pT4a."} +{"pid": "TCGA-AA-A024", "report": "The specimen consists of a left hemicolectomy with a lesion identified in the colon. The lesion is moderately differentiated and displays invasive growth, characterized by mucous production. It infiltrates through all layers of the intestinal wall. The tumor margins are clear, with no involvement at the resection edges. No lymph node metastases were detected. Additionally, a separate tubular adenoma was found within the mucosal region. Diverticulum formations were also observed along the length of the intestine."} +{"pid": "TCGA-HT-7684", "report": "The pathology report for the subject reveals a moderately hypercellular glial neoplasm composed of protoplasmic astrocytes, gemistocytes, microgemistocytes, and oligodendroglial-like cells. Focal hypercellular clustering is observed. Cellular atypia is generally mild, though focally moderate. Scattered mitotic figures are present in low numbers. Microvascular proliferation is evident, however, necrosis is not identified. There is focal subpial accumulation and invasion into the subarachnoid space is also noted."} +{"pid": "TCGA-AR-A24R", "report": "The specimen from the right breast wide local excision contains a cellular proliferation measuring 1.8 x 1.4 x 1.4 cm. Histologic evaluation reveals high-grade nuclear features with a Nottingham grade of III. The lesion is associated with a prior needle biopsy tract and demonstrates angiolymphatic invasion. No in situ component is identified. All surgical margins are negative; the closest margin, located at the deep resection surface, is clear by 0.3 cm. Axillary lymph node dissection reveals involvement of multiple lymph nodes (6 out of 28 examined). Of these, three are confluent and form a mass measuring 1.4 x 1.2 x 1.2 cm, with extension beyond the nodal capsule into surrounding soft tissue. Immunohistochemical studies for Her-2/NEU are in progress on formalin-fixed, paraffin-embedded tissue."} +{"pid": "TCGA-BB-7861", "report": "The tongue base biopsies show scattered atypical multinucleated cells and markedly atypical cells, with findings deferred to permanent sections. Immunohistochemical staining for cytokeratin AE1/3 highlights the cells in both biopsies. In one biopsy, P16 staining is positive and high-risk HPV testing by in situ hybridization is also positive. A separate biopsy from the left tongue shows chronic inflammation and lymphoid hyperplasia, with no evidence of tumor. Neck dissection specimens from levels 2 and 3 on the right side include eleven lymph nodes, one of which contains a metastatic focus measuring 2.5 cm; no extranodal extension is identified. A single lymph node from level 1 appears benign. All specimens were reviewed in detail and confirmed through microscopic evaluation. This case was presented at the Daily Quality Assurance Conference."} +{"pid": "TCGA-BP-5004", "report": "The right kidney partial nephrectomy specimen measures 3.6 x 2.5 x 2.5 cm and is inked on the external surface. Serial sectioning reveals a well-circumscribed, yellow, hemorrhagic mass measuring 3 cm in greatest dimension, located 0.5 cm from the nearest surgical margin. The surrounding renal parenchyma appears unremarkable. Histologic evaluation shows nuclear features corresponding to Grade III/IV. No evidence of local invasion, renal vein involvement, or small vessel angiolymphatic invasion is identified. All surgical margins are free of involvement. Non-neoplastic findings include cortical scarring, focal interstitial chronic inflammation, and mild arteriosclerotic changes. No adrenal tissue or lymph nodes are identified. The tumor is confined within the kidney and does not exceed 7.0 cm in size. A representative section of the tumor is submitted for analysis, along with sections from the margin and uninvolved kidney. Intraoperative frozen section diagnosis correlates with the final histologic assessment."} +{"pid": "TCGA-KK-A6E1", "report": "The lymph nodes from the right pelvic region show involvement in two out of sixteen total nodes, with tumor foci measuring 4.0 mm, 6.0 mm, 7.0 mm, 7.0 mm, and 7.0 mm. No extranodal extension is identified. The specimen consists of fibroadipose tissue measuring 5.5 x 5.0 x 2.0 cm, containing thirteen possible lymph nodes ranging from 0.1 to 5.0 cm in size. All tissue has been submitted for examination.\n\nIn the left pelvic lymph nodes, three of eight nodes are involved. The specimen measures 5.0 x 4.0 x 2.0 cm and contains nine possible lymph nodes ranging from 0.4 to 3.5 cm. All lymph node tissue has also been submitted entirely for evaluation.\n\nRegarding the prostate and seminal vesicles, a specimen including the prostate, bilateral seminal vesicles, and segments of the vas deferens was examined. The prostate measures 6.0 x 4.2 x 3.7 cm and weighs 53 grams post fixation. Microscopic evaluation reveals widespread involvement of the prostate by cellular proliferation, occupying approximately 90% of the gland. The largest cross-sectional measurement of this lesion is approximately 4.0 x 3.0 cm and it is present across multiple sections, particularly involving the apex and base regions.\n\nMultifocal extension beyond the prostate capsule is observed, with invasion involving both seminal vesicles, including both intra- and extraprostatic components. In the periurethral region at the base, there is concern for focal extension to the surgical margin, although this cannot be definitively confirmed. Extensive lymphovascular invasion is noted throughout the tissue examined. Multiple sections were analyzed according to anatomical landmarks and inked for orientation. Additional findings related to lymph nodes have been previously documented."} +{"pid": "TCGA-WY-A85C", "report": "The specimen consists of multiple soft pink-red tissue fragments received in saline, labeled with the patient\u2019s name and designated as brain tissue. The aggregate dimensions of the tissue are 4.5 x 1.5 x 0.4 cm for part one and 1 x 0.5 x 0.2 cm for part two. Touch preparations were performed on part one, and all tissue was submitted for analysis. Microscopic evaluation revealed moderately cellular tissue with mild cytological atypia. No mitotic figures were identified, and the proliferation index was low. Immunohistochemical staining was performed using laboratory-developed reagents not cleared or approved by the FDA. These tests were developed and validated internally, and their use does not require FDA approval. All tissue sections were reviewed and summarized as part of the evaluation."} +{"pid": "TCGA-AC-A62Y", "report": "The specimen from a female patient consists of fibroadipose breast tissue and overlying skin, measuring 20.0 x 15.0 x 6.0 cm and weighing 448 grams. The skin surface measures 15.0 x 10.5 cm and is light tan and wrinkled, with a 2.0 cm area of slight puckering located 8.5 cm from the nipple. The nipple is eccentrically placed and appears unremarkable. No orientation was provided for the specimen.\n\nTwo distinct masses were identified. The first mass measures 1.8 x 1.5 x 1.5 cm and is located peripherally, 0.1 cm from the deep margin. The second mass measures 2.8 x 2.5 x 2.5 cm and is also peripherally located, 0.1 cm from the deep margin and 0.2 cm from the skin surface, corresponding to the area of skin puckering. Surrounding tissue is composed predominantly of yellow-tan fatty fibroadipose tissue with interspersed gray fibrous areas. A 2.0 x 1.0 x 1.0 cm gray-tan nodule, possibly a lymph node, is present on the periphery of the breast.\n\nHistologic evaluation reveals architectural features consistent with a total score of 6 out of 9 (architectural score: 3 of 3, nuclear score: 2 of 3, mitotic score: 1 of 3), corresponding to a grade 2 classification. There is evidence of extensive in situ proliferation. No angiolymphatic invasion or involvement of skin and nipple was observed. The deep margin of excision is involved by the lesion.\n\nAn attached axillary lymph node measuring 0.4 cm contains metastatic changes without evidence of extracapsular extension. Based on these findings, the staging assessment is T2pN1. Immunohistochemical testing previously showed hormone receptor positivity and no reactivity for Her-2. Preoperative clinical findings included sentinel node mapping with frozen section. No additional prognostic studies were performed unless requested."} +{"pid": "TCGA-CN-6996", "report": "The specimen was received in seven parts. Part 1, labeled as a right hemiglossectomy, consists of a wedge of tan connective tissue measuring 5.8 x 3.2 x 1.6 cm, partially covered with ulcerated gray-white mucosa. A white, firm lesion measuring 4.2 x 1.6 x 0.9 cm is identified upon cross-sectioning. The lesion demonstrates cellular features consistent with moderately differentiated keratinizing morphology involving intrinsic tongue muscles. Vascular and perineural invasion are noted. Margins were assessed microscopically: anterior, posterior, and deep tongue margins are free of malignant cells; however, involvement is observed at the anterior and posterior floor of mouth margins. Parts 2 through 6 include re-resection specimens and biopsies from various anatomical locations including anterior floor of mouth margin (Part 2), posterior floor of mouth margin (Part 3), medial posterior floor of mouth/tongue biopsy (Part 4), new posterior margin (Part 5), and deep muscle margin (Part 6). Frozen section analysis of these parts reveals no tumor in Parts 2, 3, 5, and 6. Part 4 confirms invasive features based on frozen section.\n\nPart 7 corresponds to a right neck dissection encompassing levels 1 through 4. The specimen measures 15.0 x 7.2 x 2.3 cm and includes a submandibular gland measuring 4.0 x 3.0 x 1.7 cm. Lymph nodes are identified across all levels: ranging from 0.2 to 3.5 cm in size. Microscopic evaluation identifies five lymph nodes involved with malignant cells among the 24 total nodes examined. Involvement is noted in levels 1A and 2, with extranodal extension and vascular invasion present.\n\nIntraoperative frozen section analysis of the initial resection margins reveals benign findings for the anterior tongue, posterior tongue, and deep muscle margins, while the anterior and posterior floor of mouth margins demonstrate malignant involvement. Subsequent resections confirm negative margins. Histologic assessment confirms the presence of invasive morphology and supports the findings of vascular and perineural invasion. The overall staging classification is pT3 N2b."} +{"pid": "TCGA-4Z-AA7R", "report": "The specimen includes tissue from the bladder, prostate, and bilateral obturator lymph node chain. A large lesion measuring 9.5 cm in greatest dimension is present. The lesion is ulcerated and extends into the detrusor muscle. The surrounding perivesical fat shows peritumoral sclerosis but no direct involvement by the neoplasm. Angiolymphatic invasion is identified, as is perineural invasion. Both right and left ureter segments are involved. The prostate is also affected, while the seminal vesicles and vas deferens are free of tumor involvement. All ureteral margins are uninvolved. The lymph nodes examined, including those from the right and left obturator chains, show no evidence of tumor involvement. A separate urethral stump specimen also shows no neoplastic involvement."} +{"pid": "TCGA-HT-7686", "report": "The pathology report for the subject reveals a glial neoplasm with moderate cellularity. The tumor is predominantly composed of atypical gemistocyte-like cells. Cellular atypia varies from mild to moderate, with occasional highly atypical nuclei present. No evidence of microvascular proliferation or necrosis is observed. Mitotic activity is limited, with up to 2 mitoses identified per 10 high power fields, some of which exhibit atypical morphology. Immunohistochemical staining demonstrates a labeling index of 6.6%."} +{"pid": "TCGA-KK-A7AZ", "report": "A total of eight lymph nodes from the left pelvic region and six lymph nodes from the right pelvic region were identified and fully submitted for analysis. Lymph nodes from the left side ranged in size from 0.2 cm to 9.5 cm, while those from the right side ranged from 0.5 cm to 8 cm. All nodes were entirely sectioned and no abnormal tissue was found.\n\nThe prostate specimen measured 4.4 x 3.0 x 3.7 cm and weighed 30 grams after fixation. Two distinct areas of abnormal tissue were identified within the prostate. The first area, located multifocally in the right anterolateral, right lateral, right posterolateral, right posterior, mid posterior, and left posterior peripheral zones, measured 2.5 x 1.6 cm in its largest cross-sectional dimension. This lesion showed extensive involvement in the apex and focal presence in the base region. It exhibited multifocal extension beyond the prostate capsule, particularly on the right anterolateral and right lateral surfaces, as well as in the right superior neurovascular bundle area. The extraprostatic extension spanned 5.0 mm across multiple sections. The second area of concern, located in the right and left transition zones, measured 1.6 x 0.5 cm and was more limited in extent, confined entirely within the prostate gland with less aggressive histologic features.\n\nMargins of resection were clear throughout. Both seminal vesicles and segments of the vasa deferentia were free of abnormal tissue. Invasion of perineural spaces was noted, but no evidence of lymphovascular invasion was observed. High-grade intraepithelial neoplasia was also present.\n\nThe prostate was sectioned in two cross sections, and multiple blocks were taken from various regions including the base, apex, and margins. The outer surface of the prostate was marked with different colored inks to identify anatomical orientation: green for anterior, red for left, yellow for right, and black for posterior. Some areas were marked with blue or orange ink to indicate non-margin surfaces."} +{"pid": "TCGA-B8-A54G", "report": "The right partial nephrectomy specimen consists of two segments weighing 2 grams (1.5 x 1.5 x 0.6 cm) and 20 grams (3.7 x 3.7 x 3.5 cm). The capsule and parenchymal margins are inked black and blue, respectively. A benign cyst measuring 1.0 x 1.0 x 0.7 cm is present on the smaller segment. It is partially collapsed, filled with thin brown fluid, and has a smooth wall less than 0.1 cm thick. The cut surface of the larger segment reveals a well-circumscribed, soft, variegated mass measuring 2.5 x 2.5 x 2.5 cm. The mass bulges the capsule but does not extend through it and is located 0.1 cm from the parenchymal margin. Microscopic evaluation shows cells arranged in nests and cords with abundant clear cytoplasm and moderate nuclear atypia corresponding to Fuhrman grade 3. Sarcomatoid differentiation is not identified. Lymphatic invasion is focally present (microscopically identified in block A5). There is no evidence of capsular or perirenal adipose tissue invasion, and no involvement of major veins such as the renal vein or inferior vena cava. Surgical margins, including renal parenchymal and capsular, are negative for abnormal cellular infiltration. No lymph nodes are submitted for evaluation. Additional sections are taken from areas near the parenchymal margin, adjacent to the capsule, and from the tumor bordering normal kidney tissue. AJCC staging is reported as pT1a pNx based on available information."} +{"pid": "TCGA-AA-3526", "report": "The specimen consists of a resected segment of the colon (sigmoid) containing a lesion measuring 3 cm in maximum diameter, located 11 cm from the resection margin. Histological evaluation reveals moderately differentiated cellular features with invasion extending to the muscularis propria. Both the oral and aboral resection margins are free of involvement. A total of ten mesocolic lymph nodes were initially examined, showing no evidence of tumor but displaying reactive changes. Subsequent preparation and examination of additional tissue identified seven very small further lymph nodes, all of which were also tumor-free. The lymph node status remains negative, with no vascular or lymphatic invasion identified. Cellular differentiation is consistent with intermediate grade morphology."} +{"pid": "TCGA-28-1746", "report": "The specimen from the right temporal region was received in multiple fragments, with the largest aggregate measuring 4.2 x 3.5 x 1.5 cm. Gross examination revealed areas of hemorrhage on the surface of some tissue fragments. Microscopic evaluation showed a malignant neoplasm with necrotic areas and prominent microvascular proliferation. The tumor consisted of diffusely infiltrating cells with hyperchromatic, elongated nuclei resembling astrocytic morphology. Frequent mitotic figures were observed, and the tumor demonstrated extensive infiltration with focal extension to the pia.\n\nImmunostaining results showed that 3% of tumor nuclei expressed MGMT. PTEN expression was absent in the tumor cells. Phosphorylated MAPK (pMAPK) immunoreactivity was present in 10% of tumor nuclei and 15% of tumor cell cytoplasm. Laminin beta-1 was upregulated, showing strong staining in endothelial cells, while laminin beta-2 exhibited focal loss with weak or absent staining in endothelial cells.\n\nIn situ hybridization for EGFR showed no amplification based on an EGFR/CEP ratio of 1.1. However, high-level polysomy was present, with 72.5% of cells showing more than four copies of EGFR.\n\nMultiple sections were examined across all tissue blocks. In several areas, the tumor occupied nearly the entire cortex and white matter. Necrosis was variably present, ranging from 0% to 30% across different regions. Cellular density was consistently high, with tumor proportions ranging from 95% to 100% in the sampled areas.\n\nAdditional molecular markers and correlations were reviewed. A portion of the tumor cells lacked pMAPK expression, suggesting potential responsiveness to radiation therapy. Low MGMT expression indicated a possible favorable response to alkylating agents such as temozolomide. However, the absence of PTEN expression raised concerns about reduced sensitivity to certain targeted therapies. Elevated laminin beta-1 and reduced laminin beta-2 expression were associated with more aggressive tumor behavior.\n\nAll relevant sections were reviewed and correlated with clinical findings. These findings may inform treatment planning, although therapeutic decisions should be made in conjunction with clinical judgment and further consultation."} +{"pid": "TCGA-63-7023", "report": "The specimen was collected from a left lower lobe wedge resection. Histologic evaluation revealed a lesion with measurements of 2.1 cm in greatest dimension. The tumor demonstrated moderate differentiation and was associated with lymph node involvement. Pathologic staging was determined as T1, N1, M0. Metastatic involvement was identified in the left interlobar lymph node station 11. Additional findings included the presence of an in-situ component extending close to the resection margin."} +{"pid": "TCGA-BQ-7050", "report": "**Modified Report:**\n\nA left upper pole renal tumor was identified, measuring 2.2 cm in greatest dimension. The tumor was white-tan and nodular, located adjacent to the deep inked margin. Nuclear grade was assessed as III/IV. No local invasion or renal vein invasion was identified. Surgical margins were free of tumor, although tumor was present within 0.1 cm of the inked renal parenchymal margin. The non-neoplastic kidney tissue was unremarkable, and no adrenal gland tissue was identified. A separate left lower pole lesion was identified as a fragmented angiomyolipoma. Para-aortic lymph nodes (4 total) were examined and showed no involvement. Staging indicated a pT1 tumor, defined as being 7.0 cm or less in greatest dimension and confined to the kidney. Intraoperative frozen section consultation confirmed the findings, with tumor cells coming within 0.05 cm of the inked margin in representative sections. Permanent sections confirmed the intraoperative diagnosis. Gross examination of the upper pole tumor specimen revealed a brown-tan tissue fragment measuring 3.5 x 2.5 x 1.8 cm, with a stitch marking the deep margin. Serial sectioning revealed a white-tan tumor measuring 2.2 x 1.8 x 1.3 cm. The lower pole angiomyolipoma specimen was a friable tan-soft tissue fragment measuring 1.7 x 0.6 x 0.5 cm. The lymph node specimen consisted of four lymph nodes ranging from 0.8 to 1.5 cm. All relevant sections were submitted for analysis."} +{"pid": "TCGA-X9-A971", "report": "The specimen from the right shoulder was received fresh and weighed 241 grams. It measured 13.7 x 9.5 x 4.4 cm and consisted of soft tissue partially covered by a segment of skin. The tumor measured 3.8 x 3.4 x 2.5 cm and was located 0.2 cm from the deep margin, 1.0 cm from the skin surface, 3.3 cm from the superior edge, 2.6 cm from the inferior edge, 4.5 cm from the medial edge, and 3.4 cm from the lateral edge. Margins were inked for orientation.\n\nMicroscopic evaluation showed a high-grade spindle cell neoplasm with pleomorphic features. Immunohistochemical staining was positive for smooth muscle actin and vimentin, and negative for desmin, S100, and CD34. Nuclear staining for Ki-67 was positive in approximately 60% of nuclei.\n\nHistologically, the tumor was subcutaneous and suprafascial in location. The mitotic rate was greater than 5 per 10 high-power fields, and necrosis involving 5% of the tumor was present. Surgical margins were free of tumor. No regional lymph nodes were submitted or identified, and there was no evidence of distant metastasis."} +{"pid": "TCGA-CV-A6JU", "report": "The patient is a female with a height of 159.0 cm, weight of 39.3 kg, and a body surface area of 1.32 m\u00b2. A composite resection of the mandible, floor of the mouth, and tongue was performed. Gross examination revealed a light tan, firm infiltrating mass measuring 2.5 cm in its largest dimension located in the left side of the tongue, extending to the base of the tongue. The mass was ulcerating with an infiltrative border composed of thin cords less than four cells wide. Histologically, the lesion demonstrated moderately differentiated features with present invasion to a depth of 1.5 cm. Perineural invasion was identified as extensive, while vascular invasion was not present. Bone or cartilage invasion was pending decalcification at the time of reporting.\n\nMargins of resection were grossly uninvolved, with the closest margin being the posteroinferior aspect of the tongue at 0.3 cm. Microscopic evaluation of the deep medial margin confirmed it to be free of disease. Additional tissue specimens including the posterior tongue margin, posterior deep tongue, myohyoid muscle, and digastric muscle were all negative for residual disease.\n\nLymph node evaluation included multiple sentinel and dissection sites from both right and left neck levels. In total, 114 lymph nodes were evaluated across all levels: 2 in right sentinel lymph node #1, 1 in right sentinel lymph node #2, 2 in right neck dissection level IB, 1 in right sentinel lymph node #3, 3 in right neck dissection level IIB, 1 in right sentinel lymph node #4, 1 in right sentinel lymph node #5, 17 in right neck dissection levels IIA and IIB, 11 in right neck dissection level III, 2 in right neck dissection level IV, 1 in right sentinel lymph node #6, 1 in left parotid lymph node, 1 in left neck level IIA sentinel lymph node #7, 1 in left neck level III sentinel lymph node #8, 14 in left neck dissection level II, 15 in a separate portion of fatty tissue, and 5 in left neck dissection level IV. All lymph nodes were negative for involvement.\n\nA fragment of squamous mucosa from the left AE fold showed changes consistent with mild dysplasia. No other diagnostic terms were used in this summary."} +{"pid": "TCGA-DD-AAVX", "report": "The specimen consists of a right posterior sectionectomy of the liver. The lesion measures 6.5 x 4.9 x 4.5 cm and exhibits an expanding nodular growth pattern. Microscopically, the cellular arrangement is trabecular/pseudoglandular with classic morphology. Histologic grading by Edmondson and Steiner shows both the worst and major differentiation as grade 2 out of 4. There is no fatty change or tumor necrosis; however, hemorrhage or peliosis is present in approximately 5% of the tissue. Vascular invasion is identified microscopically. The lesion demonstrates partial capsule formation with infiltration of the capsule, but there is no satellite nodule, septal formation, or involvement of major branches of the portal or hepatic veins. Bile duct or serosal invasion is not observed. The surgical margin is free with a safety margin of 3 cm, and there is no evidence of intrahepatic metastasis or multicentric occurrence. Additional findings include active cirrhosis associated with hepatitis B virus; no dysplasia is noted. The gallbladder shows no diagnostic abnormalities."} +{"pid": "TCGA-P3-A5QF", "report": "The specimen consists of multiple soft tissue fragments submitted for frozen section consultation. Margins include a deep margin measuring 1.2 x 0.7 x 0.3 cm, a lateral margin measuring 0.7 x 0.5 x 0.2 cm, an anterior margin measuring 0.9 x 0.5 x 0.2 cm, a posterior margin measuring 0.4 x 0.8 x 0.5 cm, and a medial margin measuring 0.7 x 0.5 x 0.1 cm. A composite resection specimen from the right maxilla measures 6.7 cm from anterior to posterior, 4.3 cm medially to laterally, and 3.5 cm superiorly to inferiorly. Two teeth are present on the anterior mucosal surface, measuring 0.8 cm and 1.3 cm in greatest dimension, respectively. A depressed, indurated lesion measuring 2.7 x 1.4 cm is identified immediately posterior to the teeth. The lesion contains a central defect measuring 2.2 x 0.6 cm. The edge of the lesion is tan-white with dusky discoloration and has a rolled appearance. It extends 0.3 cm from the nearest lateral mucosal margin, 0.5 cm from the nearest posterior mucosal margin, and 1.1 cm from the nearest medial mucosal margin. The anterior mucosal margin is 1.8 cm from the lesion. The remainder of the mucosal surface appears tan-pink, smooth, and glistening. Underlying soft tissue margins show tan-yellow lobulated adipose tissue and maroon-brown tissue consistent with possible muscle. No tumor is identified at the soft tissue surface. The medial-superior aspect includes a sinus cavity measuring 3.3 x 1.0 cm with tan-pink mucosa showing focal red-brown, roughened, and hemorrhagic areas. Upon serial sectioning, a mass measuring 5.2 x 4.1 x 3.5 cm is identified beneath the mucosal lesion. The mass is tan-white, poly-lobulated, and firm, appearing to contact posterior, superior, lateral, and medial soft tissue margins. It abuts the posterior aspect of the most posterior tooth but does not extend further anteriorly.\n\nLymph node dissection specimens include level I nodes containing one positive lymph node measuring 2.6 x 1.7 x 2.3 cm and a fragment of possible salivary gland tissue measuring 3.7 x 2.6 x 1.4 cm. Level II nodes contain two positive lymph nodes, the larger measuring 3.7 x 2.3 x 2.2 cm and the smaller measuring 2.2 x 1.4 x 0.9 cm. No grossly involved lymph nodes are identified in level III. Level V nodes contain multiple candidates ranging from 0.3 to 1.2 cm; one positive lymph node measuring 0.4 cm is identified. Level IV lymph nodes appear unremarkable without evidence of metastasis.\n\nHistologic evaluation reveals invasive carcinoma involving the deep margin and new deep margin. The lateral, anterior, posterior, and medial margins are free of malignancy. High-grade intraepithelial neoplasia is identified adjacent to the invasive component. The tumor extends into respiratory mucosa of the maxillary sinus and demonstrates extensive lymphovascular invasion, including involvement of large veins. Organizing thrombi are observed in small veins. Perineural invasion is not identified. Tumor involvement is noted in bone at the anterior margin. Mucicarmine staining shows absence of mucin production by neoplastic cells. Metastatic involvement is identified in three of seventeen lymph nodes from levels I and II and one of twenty lymph nodes from level V. Extracapsular invasion is present in metastatic nodes. No involvement is identified in level IV lymph nodes or salivary gland tissue. Staging reflects extensive local invasion with regional lymph node involvement."} +{"pid": "TCGA-TM-A7C3", "report": "Specimen: Tissue. Clinical history not provided. The specimen consists of multiple fragments of pale grey/tan tissue, measuring between 1\u20137 mm in maximal dimension, with an aggregate size of 15 x 15 x 5 mm. Microscopic examination reveals fragments of a hypercellular, diffusely infiltrating intrinsic glial tumor. The tumor cells exhibit mild to moderate nuclear pleomorphism and up to 3 mitoses per high power field. The proliferation index, assessed by Ki67 staining, is approximately 5%. There is no evidence of endothelial cell swelling or intrinsic necrosis. Focal psammomatous calcifications are present. In addition, normal neurons (NeuN+) and reactive astrocytes are identified within the surrounding tissue, suggesting infiltration of the cerebral cortex."} +{"pid": "TCGA-CN-6997", "report": "A biopsy of the left hypopharynx revealed invasive malignant cells. A separate excision of the right external jugular vein and lymph node showed one lymph node with surrounding parotid tissue, none of which contained malignant cells. The vein also did not show any involvement. In a selective neck dissection from the right side (zones II, III, IV), one out of ten lymph nodes was found to contain metastatic cells, measuring 0.3 cm in level IV, without evidence of extracapsular spread. Excision of two lymph nodes from the left external jugular region showed no tumor involvement.\n\nBiopsy of the left hypoglossal nerve revealed infiltration by malignant cells. During a left neck dissection involving levels II, III, and IV, a soft tissue deposit measuring 3.2 cm at level II was identified, showing angiolymphatic invasion and perineural invasion along a large nerve. Eleven additional lymph nodes from this area were free of tumor.\n\nA total laryngectomy and left thyroid lobectomy specimen contained a 4.1 cm lesion in the left hypopharynx and supraglottic region, including the aryepiglottic fold and false vocal cord. There was evidence of angiolymphatic and perineural invasion but no cartilage or thyroid gland involvement. The pathologic stage was determined as pT3 N2c. Additionally, a separate focus of superficially invasive disease measuring 0.4 cm and 0.1 cm thick was found at the vallecular margin without vascular or nerve invasion. A distinct area of in situ changes was present on the lingual surface of the epiglottis. Dysplastic changes ranging from severe to moderate were noted on various vocal cord sites. The left thyroid gland appeared unremarkable, and one parathyroid gland showed signs of hemorrhage but no significant pathology.\n\nBiopsies of the left pharyngeal and post-cricoid margins were both negative for tumor involvement. Intraoperative frozen sections confirmed malignancy in the left hypopharynx and hypoglossal nerve biopsies, while the left pharyngeal and post-cricoid margin assessments were benign.\n\nLymph node analysis included a total of 25 regional nodes examined, with two demonstrating involvement. One of these was a metastatic node from the right side in level IV, and the other was a soft tissue deposit in the left neck considered equivalent to a positive lymph node due to extensive spread beyond typical nodal architecture. Vascular and perineural invasion were documented. Margins were involved at the vallecula.\n\nAdditional findings included carcinoma in situ and varying degrees of epithelial dysplasia in different regions. Prior histology from an outside facility had shown squamous cell carcinoma. No prior chemoradiation therapy, organ transplant, or immunosuppressive conditions were reported. Cytogenetic studies were not performed. Multiple histological stains and tests were applied across the specimens for diagnostic confirmation."} +{"pid": "TCGA-N5-A4RT", "report": "The submitted specimens included the uterus, cervix, bilateral fallopian tubes and ovaries, an anterior abdominal wall nodule, bladder peritoneum, rectal adhesion, right uterosacral tissue, and multiple lymph node samples from various pelvic regions.\n\nExamination of the uterus revealed a lesion involving the endometrium with invasion into the myometrium. The tumor extended deeper than half of the myometrial thickness, reaching a maximal depth of 11 mm within a myometrial area measuring 16 mm in thickness. No involvement of the endocervix was be identified. Vascular space invasion was present. Additionally, benign findings such as leiomyomas were noted in the myometrium. The adnexal structures showed no remarkable findings.\n\nBiopsies of the soft tissues\u2014including the anterior abdominal wall nodule, bladder peritoneum, rectal adhesion, and right uterosacral region\u2014demonstrated only benign fibrovascular and adipose tissue, some with simple cysts.\n\nLymph node evaluation revealed metastatic involvement in several right-sided nodes. Specifically, metastasis was identified in one of two sentinel right external iliac lymph nodes, the sentinel right obturator lymph node, and one of two right common iliac lymph nodes. Other lymph nodes sampled, including those on the left side and additional right-side nodes, were free of metastatic disease. Additional testing on the left external iliac sentinel lymph nodes (parts 12 and 13), including deeper sectioning and immunohistochemical staining for cytokeratins, did not reveal any evidence of metastatic involvement."} +{"pid": "TCGA-HD-7917", "report": "A surgical resection specimen of the floor of the mouth and partial glossectomy with mandibular resection was examined. The primary lesion measured 2.8 cm by 2.5 cm in size and extended into the submucosal tissue by 0.5 cm. The closest margin distances were 0.7 cm from the superior margin, 0.4 cm from the lateral margin, 2.0 cm from the inferior margin, and 0.6 cm from the medial margin. The deep margin was within 0.3 cm of the lesion. No involvement of the mandibular bone was observed. Adjacent tonsillar tissue and a separate biopsy of the ventral tongue lesion showed no evidence of malignancy. All surgical margins were free of involvement.\n\nLymph node dissections were performed on multiple right-sided neck levels. In level 1B, two lymph nodes were identified and found to be negative. In level 1A, three lymph nodes were identified, with two being negative. In level 2, seven lymph nodes were identified, with six being negative. In level 3, three lymph nodes were identified, all of which were negative. No lymphovascular or perineural invasion was identified. A p16 immunostain was performed and reported separately. Based on the findings, the case was classified under a specific pathological AJCC staging system."} +{"pid": "TCGA-4B-A93V", "report": "The specimen from the right lower lobe of the lung weighed 201.5 grams and measured 15.5 x 11.5 x 3.5 cm. A well-circumscribed mass was identified within the anterior basal segment, measuring 3 cm in greatest dimension. The tumor was located 2.8 cm from the bronchial margin of resection and showed no penetration through the overlying pleura. The remaining lung tissue appeared spongy and red-brown in color. No hilar lymph nodes were identified. The tumor was inked at the overlying pleura and multiple representative sections were submitted for analysis.\n\nThree lymph nodes were examined: one peribronchial and two paratracheal. All were negative for malignancy. The peribronchial lymph node measured 0.7 cm and was submitted entirely. The paratracheal lymph node fragments aggregated to 1.2 cm and were also submitted in full.\n\nHistologically, the tumor was predominantly composed of moderately differentiated cells with some solid areas present. Immunohistochemical staining showed positivity for cytokeratin-7 and TTF-1, while cytokeratin-5/6 and p63 were negative. These findings were consistent with a histologic pattern that required further evaluation to exclude mixed subtypes. The tumor was unifocal and confined to the lobar bronchus without evidence of more proximal extension. Visceral pleural invasion was not observed. Margins of resection, including the bronchial, vascular, and parenchymal margins, were free of tumor involvement. No treatment effect or lymphovascular invasion was identified.\n\nStaging was based on tumor size and extent. The tumor was classified as pT1b, and with all regional lymph nodes negative, the nodal stage was pN0. The specimen was considered intact, and no additional significant findings were noted in the surrounding lung tissue."} +{"pid": "TCGA-55-6642", "report": "A portion of right lower lobe of lung was received, measuring 8.0 x 4.0 x 3.0 cm, with a staple line measuring 8.5 cm. A poorly circumscribed tan-gray mass measuring 3.5 x 3.0 x 1.5 cm was identified, located near the pleural surface and within 0.1 cm of the staple line margin. The mass was hemorrhagic, gritty, and focally friable. Sections were submitted including tumor, pleural surface, staple line margin, and uninvolved lung.\n\nAn additional soft tissue specimen measuring 2.2 x 1.0 x 0.2 cm contained a tan-gray area measuring 1.2 x 1.0 x 0.2 cm, entirely submitted for analysis.\n\nMultiple fibroconnective tissue pieces with lymph nodes were received, measuring 2.5 x 2.0 x 0.5 cm in total. Two small nodules measuring 0.2 cm and 0.8 cm were identified and submitted.\n\nA larger lobe of lung measured 18.0 x 14.0 x 4.5 cm and included multiple staple lines ranging from 3.0 to 10.0 cm. A circumscribed tan-gray mass measuring 0.8 x 0.6 x 0.5 cm was found, located 2.5 cm from the pleural surface, 6.0 cm from the bronchial resection margin, and 5.5 cm from the closest staple line. Adjacent to the hilum, a second lesion measuring 2.0 x 1.5 x 1.0 cm was noted, located 1.0 cm from the pleural surface and 0.1 cm from the closest staple line. Additional findings included a bulla at the upper pole measuring 2.0 x 2.0 x 1.0 cm and an anthracotic lymph node at the hilum measuring 0.5 cm. Representative sections of all areas were submitted.\n\nA biopsy of inferior pulmonary ligament containing multiple staples showed no discrete lymph node and was submitted entirely.\n\nA dark brown to black ovoid nodule measuring 1.2 x 0.5 x 0.3 cm was received and found to be anthracotic on sectioning.\n\nMicroscopic evaluation of the lung tissue revealed a tumor composed of complex anastomosing glands and papillae within fibrous stroma. Tumor cells had eosinophilic to clear cytoplasm and enlarged, ovoid to irregular nuclei with thickened nuclear membranes, coarsely granular chromatin, and prominent nucleoli. Scattered mitoses were present. Focal extension into the visceral pleura was observed, forming a fibrotic nodule.\n\nSections of lymph nodes showed no evidence of tumor involvement, with findings of sinus histiocytosis and anthracosis. Residual tumor was identified in the completion lobectomy specimen, associated with pneumonitis and inflammatory infiltrate. A second mass near the hilum was composed of monotonous cells with ovoid to spindle-shaped nuclei arranged in a nested pattern, with bland nuclear features and no readily identifiable mitotic figures. The bullous area showed disruption of alveolar architecture with fibrous pleural thickening and chronic inflammation. No tumor was found in the bronchial or vascular margins. A peribronchial lymph node also showed no tumor involvement.\n\nImmunostaining of tumor cells was positive for TTF-1, supporting a primary lung origin. A separate spindle cell lesion showed strong positivity for synaptophysin and moderate positivity for chromogranin, consistent with a neuroendocrine component.\n\nStaging assessment indicated a primary tumor size of 3.5 cm with involvement of the visceral pleural surface. No regional lymph node involvement was identified. Residual tumor was present in the completion lobectomy along with obstructive changes. A separate 8 mm spindle cell neuroendocrine lesion was also identified. No venous or arterial invasion was observed. One lymph node biopsy consisted primarily of clotted blood and fibrin with reactive mesothelial cells, and another lymph node biopsy showed benign lung parenchyma and fibrofatty tissue without evidence of tumor."} +{"pid": "TCGA-EJ-5496", "report": "The patient is a male with a history of a PSA value of 6.5 and prior biopsy findings showing involvement of multiple regions of the prostate including the right and left base, mid, and apex. The patient also had a prior laparoscopic cholecystectomy and a history of gallstone pancreatitis four years ago. A radical prostatectomy was performed.\n\nExamination of lymph nodes revealed no evidence of malignancy in a total of 26 pelvic lymph nodes examined (10 on the right and 16 on the left). Gross and microscopic evaluation of the prostate specimen revealed an invasive adenocarcinoma with histologic features indicating poor differentiation. The tumor measured 1.8 cm at its greatest dimension and involved both the right and left lobes of the prostate, representing more than 25% of the total prostate volume. The lesion was organ-confined without evidence of extracapsular extension or involvement of bilateral seminal vesicles. All surgical margins were free of tumor involvement.\n\nHistopathologic assessment identified focal perineural invasion but no angiolymphatic invasion. High-grade prostatic intraepithelial neoplasia was present and noted to be multifocal. The pathologic stage was determined as pT2c with no regional lymph node involvement (pN0) and histologic grade G3\u2013G4. The prostate weighed 79.68 grams. Additional findings included benign prostatic hypertrophy and chronic moderately active prostatitis."} +{"pid": "TCGA-42-2582", "report": "The specimen includes multiple resected tissues including omentum, left and right adnexal structures, uterine corpus with cervix, appendix, peritoneal biopsies, and pelvic sidewall. The omentum is a 25.0 x 11.0 x 2.5 cm lobulated tan-white tissue with areas of involvement measuring over 2.0 cm. The left ovary and fallopian tube are partially fragmented, with a detached tumor mass measuring 2.7 x 2.3 x 0.8 cm and an attached tumor portion approximately 3.0 x 3.0 x 2.2 cm. The ovarian surface shows irregular nodules and a breach in the capsule. The fallopian tube is dilated and edematous with a mass at the fimbriated end. The right ovary and tube show similar involvement with no residual stroma identified. The uterus measures 5.5 x 5.5 x 5.0 cm and weighs 145 grams, with a 3.5 x 2.3 cm uterine cavity lined by normal-appearing endometrium. The serosal surface appears involved. The appendix is 8 cm long, with a distal diameter of 1.8 cm and contains a calcified fecalith. Multiple foci of involvement are noted within the mesoappendix. A small 1.7 x 1.0 x 0.7 cm soft tissue fragment from the cul-de-sac, a 6.5 x 5.3 x 1.8 cm peritoneal biopsy from the round ligament and bladder area, and a 2.1 x 1.9 x 0.6 cm fragment from the sigmoid region are all submitted and show similar histologic features. A left pelvic sidewall biopsy is also involved. Histologically, the cells are consistent with a high-grade serous pattern, with angiolymphatic invasion present. Tumor is found bilaterally in the ovaries and fallopian tubes, and in the appendix, omentum, uterine serosa, cul-de-sac, pelvic sidewall, bladder, and bowel surfaces. Peritoneal fluid and pleural fluid are positive for malignant cells. Lymph node status is not assessed. Additional findings include adenomyosis of the uterus."} +{"pid": "TCGA-CM-5862", "report": "The submitted right hemicolectomy specimen includes a segment of terminal ileum, cecum with attached appendix, and ascending colon. The terminal ileum measures 7.5 cm in length and 3.5 cm in circumference at the proximal resected margin. The remaining colon measures 19 cm in length with a circumference of 8 cm at the distal resected margin. The attached appendix is 6.5 cm long and averages 0.7 cm in diameter. The serosal surface is pink-tan and smooth with focal hemorrhagic changes. Adipose tissue surrounding the specimen is up to 5 cm thick.\n\nA circumferential, centrally ulcerative, fungating mass is present, measuring 5.5 cm in length, 6.5 cm in width, and 2.0 cm in height. On sectioning, the tumor has a maximum depth of 2.5 cm and extends to the black-inked radial margin. The tumor is located 6.3 cm from the ileocecal valve and 6 cm from the distal resected margin. A separate polypoid structure measuring 1.8 x 0.8 x 0.7 cm is identified 4.0 cm from the ileocecal valve and 4.2 cm from the main lesion. Other mucosal areas show several small polypoid regions up to 0.4 x 0.3 cm in size, all of which were entirely submitted for examination.\n\nHistologically, the tumor shows moderate differentiation. Tumor budding and increased tumor-infiltrating lymphocytes are not observed. No precursor lesions are identified. The deepest invasion extends into subserosal adipose and mesenteric fat. Lymphovascular invasion is present, but no large venous or perineural invasion is noted. There is no evidence of gross tumor perforation. Surgical margins are free of involvement.\n\nTwo tubular adenomas and one hyperplastic polyp are found away from the main lesion. The non-neoplastic bowel appears unremarkable. The appendix demonstrates fibrous obliteration of the lumen. A total of 24 lymph nodes are examined, with one containing tumor deposits. Additionally, tumor deposits are identified in pericolorectal soft tissue.\n\nStaging based on AJCC 7th Edition criteria indicates pT3 classification, reflecting invasion through the muscularis propria into pericolorectal tissues. The lymph node stage is N1, as metastasis is found in one regional lymph node.\n\nMolecular analysis was performed using PCR and Sequenom mass-spectrometry genotyping to assess mutations in multiple genes, including KRAS (exon 2, codons 12 and 13), BRAF, EGFR, ERBB2, MEK1, NRAS, AKT1, and PIK3CA. No mutations were detected in the tested regions. The DNA quality was good; however, technical limitations may prevent detection of mutations if the proportion of tumor cells in the sample is less than 25% for KRAS testing or less than 10% for other targets.\n\nAll sections were submitted for permanent histologic evaluation, including representative sections of the tumor, margins, lymph nodes, and associated polyps. The results should be interpreted in the context of clinical and other pathological findings."} +{"pid": "TCGA-AA-3955", "report": "The resected specimen includes sections of the descending and sigmoid colon. The oral and aboral resection margins are free of tumor. An ulcerated lesion is present, characterized by moderately differentiated cellular features. The lesion infiltrates into the lamina muscularis propria. Regional lymph node examination reveals multiple metastatic foci within 5 out of 31 nodes. Grading indicates intermediate differentiation (G2). Vascular and lymphatic invasion markers are negative. A marked and florid inflammatory response is noted in the surrounding tissue, with extension toward the peritoneal surface of the abdominal wall. No residual tumor is identified at the resection margins."} +{"pid": "TCGA-AA-3956", "report": "The resected ileocolic specimen demonstrates a moderately differentiated adenocarcinoma of the colorectal type arising in the cecum. The tumor measures up to 4 cm in maximum dimension and exhibits infiltration into the pericecal fatty tissue. There is associated circumscribed fibrinous serositis in the tumor region. Histologic grade is G2. No evidence of lymphatic (L0), vascular (V0), or perineural invasion is identified. Surgical margins are negative (R0). Lymph node staging shows no metastases, with 0 involved nodes out of 36 examined. Distant metastasis staging is indeterminate (pMX)."} +{"pid": "TCGA-FZ-5922", "report": "The resected specimen includes a pancreaticoduodenectomy (Whipple resection) with partial pancreatectomy. The gallbladder, distal duodenum, and head of the pancreas were also resected. Gross examination of the distal duodenum showed a submucosal hematoma with no other significant abnormalities. One benign lymph node was identified in this region.\n\nIn the pancreatic head, a lesion measured 1.8 cm in greatest dimension, with additional dimensions of 1.6 x 1.1 cm. Microscopic evaluation revealed ductal-type morphology with moderate differentiation. All resection margins were free of malignant cells. Vascular and lymphatic invasion were present, as was perineural invasion. The tumor extended focally into surrounding pancreatic tissue but did not involve the duodenal wall or ampulla of Vater.\n\nA total of five lymph nodes were examined, none of which contained metastatic cells. However, there was evidence of tumor cells within lymphatic channels adjacent to one lymph node. No involvement of other regional nodes was confirmed.\n\nThe uninvolved portions of the pancreas showed features of chronic inflammation and scattered low-grade intraepithelial changes. An incidental finding of atrophic heterotopic pancreatic tissue was noted within the duodenal wall; the remainder of the duodenum appeared normal.\n\nStaging was determined as pT3, pN0, pMX."} +{"pid": "TCGA-AA-3972", "report": "A resected section of the sigmoid colon shows an ulcerated lesion. Histological examination reveals a moderately differentiated adenocarcinoma. The lesion extends up to 11 cm from the oral resection margin and measures a maximum of 3 cm in diameter. The lesion is invasive, with extension through all layers of the intestinal wall and into the adjacent mesocolic fatty tissue. In addition, the intestinal wall exhibits multiple pseudodiverticula with associated chronic scarring consistent with peridiverticulitis. A tumor-free seminal vesicle is attached aborally. Both the oral and aboral resection margins are free of abnormal cellular infiltration. Based on these findings, the lesion is staged as pT3 with a histologic grade of G2, and there is no evidence of residual tumor at the margins (RO)."} +{"pid": "TCGA-B6-A0X4", "report": "The surgical specimen from a left modified radical mastectomy weighed 2050 grams and measured 22 x 20 x 8 cm, including an axillary tail measuring 10 x 10 x 2 cm. A skin ellipse measuring 30 x 20 cm included a 1.5 cm nipple and a 6 cm areola. A 10.5 cm sutured linear incision was noted over the lower inner quadrant with margins inked blue. Sectioning revealed a biopsy cavity measuring 3 x 2 x 2 cm located in the lower inner quadrant. The cavity was 3 cm from the inferior margin, 2 cm from the medial margin, 4.5 cm from the deep margin, 8 cm from the superior margin, and more than 15 cm from the lateral margin. The biopsy cavity extended to within 1 cm of the skin incision.\n\nAdjacent to the deep edge of the biopsy cavity, there was a mass measuring 3 x 2 x 1 cm composed of firm, tan-white tissue. This mass was located approximately 3.5 cm from the deep surgical margin, 2 cm from the medial margin, 3 cm from the inferior margin, 7.5 cm from the superior margin, and greater than 15 cm from the lateral margin. In the upper inner quadrant, 3.5 cm from the biopsy cavity, a well-circumscribed nodule measuring 1.5 x 1.2 x 0.8 cm was identified. It was nearest the deep margin, extending to within 2 cm of this margin.\n\nIn the lower outer quadrant, two similar nodules were present: one measured 1.1 x 0.6 x 0.5 cm and was located 5 cm from the lateral surgical margin and 4 cm from the inferior surgical margin; the other, 1.5 cm lateral to the first, measured 0.6 x 0.5 x 0.2 cm and was located 3.5 cm from the lateral surgical margin and 4 cm from the inferior surgical margin. Further lateral and inferior within the lower outer quadrant was a small oblong mass measuring 0.4 x 0.3 x 0.2 cm located 2 cm from both the deep and lateral surgical margins.\n\nIn the upper outer quadrant, there were small areas of fibrosis, some associated with small cysts up to 0.3 cm in diameter. Within the axillary tail, thirty-two lymph nodes were identified: 8 in zone III (proximal third), 6 in zone II (middle third), and 18 in zone I (distal third). These ranged in size from 0.5 to 2.2 cm in greatest dimension.\n\nMicroscopic examination showed multiple cellular features including benign proliferative changes such as hyperplasia, intraductal papillomatosis, blunt duct ectasia, apocrine metaplasia, microcalcifications, and multiple hyalinizing fibroadenomata. Areas of fibrosis were also observed with associated small cysts. Additional findings included extensive changes consistent with non-comedo type intraductal lesions. Estrogen and progesterone receptor assays were performed and reported as positive with estimated Fmol values of 292 and 268 respectively.\n\nAll surgical margins were free of malignancy."} +{"pid": "TCGA-KK-A7B4", "report": "The surgical specimen includes lymph node dissections from both the right and left pelvis. In the right pelvic lymph nodes, multiple lymph nodes were identified within adipose tissue. Metastatic involvement was observed in five out of nine lymph nodes with focus sizes measuring less than 1.0 mm, 3.0 mm, 5.0 mm (two foci), and 8.0 mm. Extracapsular extension was noted in these nodes.\n\nIn the left pelvic lymph nodes, metastatic involvement was identified in three out of eleven lymph nodes. The metastatic deposits measured less than 1.0 mm, 4.0 mm, and 13.0 mm. Extracapsular extension was also present in this group.\n\nA separate specimen involving the prostate and seminal vesicles demonstrated extensive tumor involvement. The tumor exhibited multifocal extraprostatic extension and invaded the right seminal vesicle. Perineural and lymphovascular invasion were identified. The tumor extended to the surgical margin at the anterior and right apical region of the prostate, with a length of involvement measuring 6.0 mm. On gross examination, the prostate contained palpable nodules on both sides. Cross-sectional analysis revealed tumor involvement across multiple regions including the right and left peripheral zones as well as transition zones.\n\nAdditionally, the anterior bladder neck margin showed involvement by high-grade carcinoma infiltrating smooth muscle. Frozen section analysis confirmed the presence of poorly differentiated adenocarcinoma in this region.\n\nAll lymph nodes and tissue margins were fully sampled and evaluated for pathological assessment."} +{"pid": "TCGA-V1-A9OT", "report": "The prostatectomy specimen measured 4 cm from apex to base, with a total weight of 76 grams. Gross examination identified two nodules within the posterior gland. The right-sided nodule measured 1.5 x 1.2 x 0.6 cm and was located in slices 4\u201310, abutting the posterior margin. The left-sided nodule measured 0.8 x 0.4 x 0.3 cm and was found in slices 5\u20137, situated 0.3 cm from the posterior margin. Both nodules were described as ill-defined, rubbery, and yellow. The anterior fibrous stroma appeared red and roughened, while the remaining prostatic parenchyma was tan. The seminal vesicles showed no macroscopic abnormalities.\n\nHistologic evaluation revealed involvement of both right and left posterior mid-gland regions. Microscopic analysis confirmed infiltration of the capsule on the right side (slides B11, B12, B13, B14), without evidence of extraprostatic extension. A positive surgical margin was identified at the posterior aspect on slide B14, measuring 0.3 cm in length, with similar histologic features observed at that site. No benign glands were present at any inked excision margins.\n\nCellular morphology demonstrated small acinar structures. High-grade intraepithelial neoplasia was present focally. Perineural infiltration was identified. No lymph nodes or seminal vesicle involvement was noted.\n\nThe estimated tumor volume was 4.2 cubic centimeters. Gleason scoring showed a primary pattern of 3 and secondary pattern of 3. Less than 1% of the tumor exhibited higher-grade features beyond this scoring system.\n\nSections were submitted from multiple levels of the prostate and surrounding tissue. Inked margins were examined thoroughly. Final diagnosis was confirmed by an attending pathologist after complete review of all slides and documentation."} +{"pid": "TCGA-05-4405", "report": "The lesion is located in the right lower lobe of the lung, within segment S8. Histological examination reveals a mixture of acinar and papillary growth patterns. The size of the primary lesion corresponds to a pT2 classification. No involvement is identified in the regional lymph nodes (pN0). Vascular invasion is present within the tumor area. The resection was complete with negative margins (R0), and no residual tumor is detected at the bronchial or vascular resection margins. The visceral pleura, as well as all lymph nodes removed and examined, are free of tumor involvement."} +{"pid": "TCGA-Q2-A5QZ", "report": "The specimen consists of a right radical nephrectomy including perirenal fat. A tumor measuring 5.3 x 5.2 x 4.8 cm is located in the mid-portion of the kidney. Grossly, the tumor is pale-white with focal areas of hemorrhage and abuts the perirenal fat without penetrating the renal capsule. It does not involve the renal sinus fat or renal pelvis.\n\nHistologically, the lesion shows nuclei that are very irregular with prominent nucleoli. Cellular features include involvement extending into perinephric tissue beyond the renal capsule. Tumor necrosis is present. Microscopic examination of the resection margins shows no evidence of invasive carcinoma. No lymphovascular invasion is identified.\n\nStaging assessment reveals tumor extension into perirenal and renal sinus fat but remains confined within Gerota\u2019s fascia. No lymph nodes are submitted or identified for evaluation. Distant metastasis is not applicable.\n\nAdditional findings in the non-neoplastic kidney demonstrate chronic interstitial nephritis. Immunohistochemical staining for pancytokeratin is positive in tumor cells and supports possible perinephric tissue involvement. CD31 staining does not show definitive intravascular tumor invasion."} +{"pid": "TCGA-66-2759", "report": "The examined specimen included a left lower lobe of the lung measuring 20 x 15 cm at the base and up to 17 cm in length. A central bronchus resection plane was identified 0.3 cm proximal to the bifurcation of B6. A 7 cm branched staple suture line extended ventrocaudally from the hilus. In the medioventral region over S6, a cusp-shaped portion of the upper lobe measuring 4 x 1.5 x 1.2 cm was attached via a staple suture line. Part of the parietal pleura, measuring 9.5 x 5.5 cm, was adhered extensively in the laterodorsal region over S6 and adjacent S10.\n\nAt the hilus, three mobile grayish-black lymph nodes were observed, ranging from 0.2 to 0.7 cm. The ostium of B6 was obstructed by an endobronchial mass characterized as moderately solid, pale brownish, and focally soft, measuring up to 6 cm. This lesion had unclear borders and extended to the ventral visceral pleura over S6 and approached within 0.2 cm of the hilar resection surface. Central involvement of some parabronchial grayish-black lymph nodes up to 1.5 cm was noted. Macroscopic evaluation suggested possible infiltration into the attached upper lobe segment, with a minimal distance of 0.3 cm from the resection plane after removal of the staple line.\n\nParenchyma surrounding the lesion in S6 and adjacent S10 showed diffuse induration and a brownish-yellow discoloration extending to the dorsal pleura and pleural adhesion area. Elsewhere, the parenchyma appeared normal. Within the attached fatty tissue near the basal margin, four grayish-black lymph nodes were identified, ranging from 0.2 to 1.1 cm.\n\nAdditional lymph nodes examined included: peribronchial tissue (left, 0.9 cm), hilar lymph node (station 10, left, 1.4 cm), pulmonary ligament lymph node (station 9, left, 2.2 cm with partly indurated and pale grayish-white sections), paraesophageal lymph node (station 8, left, containing a 1 cm node with suspicious features), paraaortic lymph node (station 6, 1.2 cm), and subaortic lymph nodes (station 5, two grayish-black nodes measuring 1.5 and 0.8 cm).\n\nHistological analysis confirmed the bronchus resection margin to be free of tumor involvement during intraoperative assessment. Fatty tissue supplied by vessels and nerves showed scarring without tumor presence upon immediate intraoperative evaluation.\n\nStaging classification indicated involvement of regional structures and lymph nodes, with no distant metastasis evident. Resection was considered complete. Parenchymal changes peripheral to the lesion included fibrous remodeling associated with chronic inflammatory findings and pleural adhesions. Lymph nodes from multiple stations exhibited reactive changes, pigment deposits, and areas of old necrosis.\n\nThe lesion obstructed B6 and infiltrated parabronchial lymph nodes, approaching the hilar resection surface closely. There was evidence of growth across the pleural fissure and into upper lobe tissue. Metastatic involvement was observed in lymph nodes from several stations. All resection margins\u2014including bronchial, vascular, and those related to the upper lobe wedge resection\u2014were negative for tumor involvement. No asbestos bodies were detected, though further specialized studies are recommended to assess prior environmental exposure."} +{"pid": "TCGA-UT-A88G", "report": "The histopathology report describes a specimen from the right parietal pleura, consisting of multiple tissue fragments ranging from 3mm to 10mm in maximal dimension. Several larger pieces contain firm pink nodules measuring up to 7mm. Microscopic examination reveals a malignant tumor involving the pleural surface and underlying tissue. The tumor exhibits a micropapillary and infiltrative growth pattern, with cells arranged in microacinar groups and tufts. The cells have enlarged nuclei, some with prominent nucleoli, and variable cytoplasmic staining characteristics. The tumor infiltrates into fibrotic pleural tissue and extends into adjacent fat. In some areas, the stroma appears myxoid and contains elongated spindle-shaped cells. Psammoma bodies are present, and no intracytoplasmic mucin is identified on PAS stain. Immunohistochemical analysis shows strong positivity for calretinin, CK 5/6, and HBME1, with the spindle cell component also showing reactivity. Lymphatic marker staining is positive, while CEA, TTF-1, and MOC31 are not significantly expressed. The deeper sections demonstrate an increased presence of the spindle cell component."} +{"pid": "TCGA-37-4130", "report": "The clinical specimen was obtained from the lung and consisted of primary tumor tissue, which was embedded in an OCT block. Additional material included a frozen blood sample. Histological evaluation revealed a moderately differentiated malignant neoplasm. The tumor measured 2 cm in greatest dimension. No lymph node involvement or distant metastasis was identified. No prior treatment had been administered. Cellular morphology showed cohesive clusters of atypical cells with nuclear enlargement and increased nuclear-to-cytoplasmic ratio. The specimen was processed from a single container and no additional components were noted."} +{"pid": "TCGA-QR-A6H5", "report": "The left adrenal specimen was received fresh, labeled with the patient\u2019s name and medical record number. The adrenalectomy specimen measured 14 x 7.5 x 5.4 cm and weighed 77.2 grams. It was surrounded by minimal adipose tissue. A red-yellow, soft tissue nodule measuring 7.5 x 5.4 x 3.8 cm was identified; it was encapsulated. The outer surface of the specimen was inked in blue. Upon bisection, the cut surface appeared dark red-yellow, cystic, lobulated, and variegated, with no grossly identifiable adrenal gland remaining. An aggregate of tissue measuring 2.5 x 2.0 x 0.3 cm was procured for further analysis and did not involve the inked margin. Serial sectioning revealed a small amount of yellow adrenocortical tissue surrounding the main lesion. Representative sections of the lesion and normal-appearing adrenal cortex were submitted for microscopic evaluation. No gross involvement of the surgical margin was observed."} +{"pid": "TCGA-WB-A81S", "report": "The pathology report describes a resected right adrenal mass measuring 6.5 x 4.7 cm, with a white and partially reddish cut surface. A minimal margin of normal adrenal tissue, approximately 2 mm, was identified adjacent to the lesion. Microscopic examination reveals a cellular population composed of cells with varying sizes and eosinophilic, finely granular cytoplasm. Nuclei display variable morphology, including some that are bizarre and hyperchromatic. No evidence of necrosis or atypical mitotic figures is observed. Immunohistochemical staining shows positivity for chromogranin A, synaptophysin, and protein S100. The Ki67 proliferation index is less than 1%. Nuclear staining for p53 is absent."} +{"pid": "TCGA-B0-4833", "report": "The specimen from the left kidney following nephrectomy demonstrates a neoplasm with a maximum dimension of 5 cm. Microscopic evaluation reveals the lesion exhibits an acinar pattern of growth and is confined within the renal capsule. There is no observed invasion of the renal vein or angiolymphatic invasion. All surgical margins are free of tumor involvement. The surrounding non-neoplastic kidney tissue appears unremarkable. Nuclear grading according to Fuhrman's classification is grade II out of IV. Histologic staging indicates the tumor is pT1b, with no lymph node or distant metastasis identified (NX MX). The tumor does not extend beyond the organ of origin. Additional assessment of the adrenal gland was limited as it was not identified in the specimen. In a separate specimen from the gallbladder, there is evidence of chronic active inflammation with a marked increase in eosinophils."} +{"pid": "TCGA-A6-5666", "report": "The surgical specimen includes a segment of the sigmoid colon, upper rectum, and adherent posterior bladder wall along with portions of small intestine. A separate appendix specimen is also present. The main specimen consists of a 46 cm length of colon and an attached 12 cm segment of small bowel. A portion of adherent bladder measures 7 x 5 cm. Both ends of the colonic and small bowel segments are stapled; the distal margin near the lesion is inked black while the proximal margin away from the lesion is inked blue. Upon opening, a large central mass measuring 12 x 11.5 x 3.5 cm is identified in the colon. This mass shows central necrosis and extends through the full thickness of the colonic wall into surrounding fat and through the wall of the small bowel to involve its mucosa. The tumor comes within 2.5 cm of the black-stapled margin and within 0.5 cm of the nearest peripheral margin on the bladder portion. It also approaches within 1.5 cm of being circumferential in the colon. The remainder of the mucosa in both the small and large bowel appears smooth and glistening. No grossly identifiable metastatic lymph nodes are noted, although multiple lymph node samples are submitted for histologic evaluation.\n\nMicroscopic examination reveals a moderately differentiated adenocarcinoma invading through the entire thickness of the colonic wall and extending into the muscularis propria of the bladder wall as well as through the full thickness of the small intestinal wall into its mucosa. All resection margins are free of tumor involvement. A total of 30 lymph nodes are examined and none show evidence of metastasis. There is significant central necrosis within the tumor. Additionally, non-lymph node tumor deposits are identified in the soft tissue connecting the small intestine and bladder to the resected colon. The appendix shows no evidence of malignancy but demonstrates a benign mucocele at the tip with focal fibrous obliteration and serosal adhesions."} +{"pid": "TCGA-55-A491", "report": "The surgical pathology report describes a lobectomy and lymph node excisions from the left lower lobe of the lung and associated lymph node regions. Two distinct tumor nodules were identified in the left lower lobe. The larger nodule measured 2.7 cm and demonstrated moderate to poorly differentiated features with areas of cribriform and solid growth patterns, along with nuclear pleomorphism. A single focus of large vessel invasion was noted. The smaller nodule measured 1.4 cm and exhibited entirely gland-forming structures with in situ carcinoma at the periphery. Both tumors were separate and did not involve the pleura or demonstrate lymphatic invasion.\n\nMargins were negative for malignancy, with the larger tumor located 5.0 cm from the closest margin and the smaller tumor 2.8 cm away. All evaluated margins\u2014bronchial, vascular, parenchymal, and parietal pleural\u2014were free of tumor involvement.\n\nNineteen lymph nodes were examined from hilar, interlobar, para-aortic, subcarinal, and pulmonary ligament regions. All were benign without evidence of malignancy. Immunohistochemical analysis of both tumors showed strong positivity for cytokeratin 7 and TTF-1, and negativity for cytokeratin 20, supporting a primary pulmonary origin.\n\nNo treatment effect was observed. Additional findings included distal emphysematous changes in the uninvolved lung tissue. Based on these findings, staging was classified as pT1b (2) for the primary tumor, pN0 for regional lymph nodes, and no evidence of distant metastasis (pMX). The overall pathologic stage was IA."} +{"pid": "TCGA-CG-4436", "report": "The specimen consists of a total gastrectomy preparation, which includes an ulcerated, moderately differentiated adenocarcinoma. The tumor is located in the stomach and exhibits intestinal-type morphology. Histological evaluation shows that the lesion infiltrates deeply into the tunica muscularis propria, but there is no evidence of extension into the perimuscular adipose tissue. Both the oral and aboral resection margins are free of tumor involvement; the oral margin is lined by unremarkable squamous epithelium, while the aboral margin displays normal-appearing small intestinal mucosa. No tumor involvement is identified in the associated omental tissue. Lymph node staging is based on the examination of 58 nodes, none of which show evidence of metastasis. Distant metastasis could not be assessed."} +{"pid": "TCGA-KK-A7AQ", "report": "The specimen included right and left pelvic lymph nodes, as well as a prostate with attached seminal vesicles and vasa deferentia. The right pelvic lymph node specimen measured 8 x 4 x 1 cm and contained seven lymph node candidates ranging in size from 0.2 to 3.3 cm. The left pelvic lymph node specimen measured 7 x 4 x 0.8 cm and contained five lymph node candidates ranging in size from 0.5 to 5 cm. All lymph node candidates were submitted for analysis, and no abnormal tissue was identified in either side.\n\nThe prostate measured 4.7 x 3.8 x 3.5 cm and weighed 48 grams after fixation. It had a normal shape with minimal periprostatic soft tissue. A palpable nodule was noted at the right apex. Serial cross-sectioning revealed a firm area consistent with a lesion on the right side of the first cross section.\n\nFour distinct foci of cellular abnormality were identified within the prostate. The largest focus measured 1.4 x 0.5 cm and was found in the right lateral, right posterolateral, right posterior, mid posterior, and left posterior peripheral zones. This focus was present in the first two cross sections and extensively in the apical region. It showed a predominant pattern of complex architecture with a minor component of a more aggressive growth pattern. A second focus measured 1.1 x 0.3 cm and was located in the left and right transition zone, present in two cross sections. A third focus measured 1.0 x 0.1 cm and was located in the right anterolateral and right lateral peripheral zone, found in one cross section. A fourth focus was smaller than 0.2 x 0.1 cm and located in the right transition zone, found in the first cross section and focally in the apical region.\n\nAll identified foci were limited to the prostate. Margins of resection were clear. The seminal vesicles and vasa deferentia showed no evidence of abnormal cells. Perineural involvement was noted, but no vascular or lymphatic invasion was observed. High-grade intraepithelial changes were also present. Immunostains supported the presence of intraductal spread in the primary focus. The anterior, left, right, and posterior surfaces of the prostate were marked with different inks to identify margins, with some areas not representing true resection margins. Multiple sections were taken from the prostate and associated structures for analysis."} +{"pid": "TCGA-D8-A1JU", "report": "Histopathological examination was performed on a left breast specimen measuring 20 x 13 x 2 cm, removed without axillary tissues. A lesion was identified at the boundary of the outer quadrants, measuring 1.7 x 1.8 x 1.5 cm, located 2 cm from the lower edge, 0.2 cm from the base, and 1.0 cm from the skin surface. Cysts ranging from 0.1 to 0.5 cm were observed in the cross-section.\n\nMicroscopic evaluation revealed a proliferation with histological features consistent with invasive ductal carcinoma NHG1, scored as 2+2+1, with 1 mitosis per 10 high-power fields (field diameter 0.57 mm). In addition, in situ ductal carcinoma components were noted, showing cribriform architecture with medium nuclear atypia, present in approximately 30% of the lesion. No necrosis was observed in these areas.\n\nThe surrounding glandular tissue exhibited fibrocystic changes including fibrous mastopathy, sclerosing adenosis, and flat epithelial atypia. Immunohistochemical analysis showed estrogen receptor positivity in 75% of neoplastic nuclei and progesterone receptor positivity also in 75% of neoplastic nuclei. HER2 staining using HercepTest\u2122 by DAKO showed a score of 1+ in invasive cancer cells.\n\nStaging assessment indicated pT1c and pN0 status based on absence of lymph node involvement."} +{"pid": "TCGA-B0-4852", "report": "The specimen consists of a left radical laparoscopic nephrectomy. The lesion measures 8.8 cm in greatest dimension and exhibits Fuhrman grade 2 nuclear features. Histologic evaluation demonstrates that the lesion is confined to the kidney without extension into the perinephric fat. All surgical resection margins are free of abnormal tissue. There is no evidence of angiolymphatic invasion. The pathologic stage is T2NxMx. The remainder of the renal parenchyma appears unremarkable."} +{"pid": "TCGA-A2-A04W", "report": "The specimen consists of a right mastectomy with axillary contents, along with additional right breast tissue. The main mass measured grossly is 4.5 cm in greatest dimension and located in the superficial upper outer quadrant, showing focal hemorrhage and dense, nodular characteristics. It is 1.1 cm from the deep margin and 0.5 cm from the superficial margin. No tumor necrosis was identified in the infiltrating component, though comedo-type necrosis was present in the ductal carcinoma in situ (DCIS) component. Microcalcifications were noted in the stroma.\n\nHistologic evaluation revealed a moderately differentiated Nottingham grade (score 7/9), with tubules = 3, nuclei = 3, and mitotic count = 3 per 10 high-power fields. Venous and lymphatic invasion were identified in certain blocks. The intraductal component is extensive, and the tumor involves no nipple or skin. Margins are free of tumor involvement.\n\nEighteen lymph nodes were evaluated; one node showed isolated tumor cells detected only by immunohistochemistry (IHC). This node showed individual tumor cells and a small subcapsular cluster less than 0.2 mm in diameter. No grossly positive nodes were identified. The pathologic stage is pT2 NO(i+) MX.\n\nAdditional findings include cystic change, sclerosing adenosis, fibroadenomatoid change, and apocrine metaplasia. Estrogen and progesterone receptor statuses were negative, and HER2 by IHC was positive (3+). A prior error in lymph node assessment and staging was corrected based on further evaluation prompted by PET scan findings. A separate portion of axillary tail tissue was also submitted and examined."} +{"pid": "TCGA-E8-A432", "report": "The specimen demonstrates a unifocal lesion measuring 2.5x2x1cm in maximal dimensions, located on the left side. There is no evidence of extrathyroidal extension. The TSH level is within normal limits at 0.8 mclU/ml. Cellular features include characteristic nuclear morphology commonly associated with thyroid neoplasms. Staging is confined to the organ of origin without extension beyond the capsule."} +{"pid": "TCGA-39-5011", "report": "The pathology report includes the following specimens: Level 7 lymph nodes (two specimens, each containing two lymph nodes), Level 11 lymph nodes (two lymph nodes), and a lung specimen consisting of a right lower lobe and a wedge-shaped fragment of the right upper lobe. All lymph node specimens were found to be benign upon histological evaluation.\n\nThe lung specimen measured 19 x 8 x 5 cm for the lower lobe and 4.5 x 1 x 1 cm for the upper lobe fragment. A subpleural, well-circumscribed pink-gray lesion with focal necrosis was identified at the site of adhesion between the lower and upper lobes. The lesion measured 2 x 1.5 x 1.5 cm and extended into both lobes, coming within 0.5 cm of the stapled surgical margin. The remainder of the lung tissue appeared grossly unremarkable. The bronchial epithelium was tan and smooth, and no tumor was identified in the airways. A small anthracotic lymph node adjacent to the bronchus was also present and submitted for analysis.\n\nHistological examination revealed a solid growth pattern with features suggestive of focal squamous differentiation. The lesion was poorly differentiated and measured no more than 3 cm in greatest dimension. Vascular or perineural invasion was not identified. The bronchial surgical margin was free of abnormal cells, and the tumor extended subpleurally but did not reach the pleural surface. Additional findings in the non-neoplastic lung tissue included emphysematous changes and interstitial fibrosis. Lymph node assessment showed no evidence of metastatic involvement. Intraoperative frozen section analysis of the lymph nodes and surgical margins confirmed benign findings, consistent with permanent section diagnoses."} +{"pid": "TCGA-22-5478", "report": "The specimen consists of a 3.8 x 3.7 x 3.5 cm mass located in the right lower lobe of the lung. Histologic evaluation shows a high-grade cellular proliferation composed of atypical cells with marked nuclear atypia, frequent mitotic figures, and areas of necrosis. The lesion exhibits infiltrative growth, extending through the visceral pleura. Surgical resection margins are free of abnormal tissue. A total of eight intrapulmonary peribronchial lymph nodes and seven mediastinal lymph nodes (including three right paratracheal and four subcarinal) are present and show no evidence of neoplastic involvement. No tumor is identified at the bronchial margin."} +{"pid": "TCGA-BH-A0EB", "report": "A right needle localized segmental mastectomy and sentinel node biopsy were performed. Two foci of invasive carcinoma were identified in the right breast. The larger lesion, measuring 1.7 cm, was located at the 4 o\u2019clock position and showed histologic features consistent with a Nottingham grade 2 tumor based on tubule formation (score 3), nuclear pleomorphism (score 2), and mitotic activity (score 2) for a total score of 7/9. A second, smaller focus measuring 0.7 cm was located at the 5 o\u2019clock position and also demonstrated grade 2 features with a total Nottingham score of 6/9. In addition, ductal carcinoma in situ (DCIS) of nuclear grade 2, solid type with minimal necrosis, was present and accounted for approximately 5% of the overall tumor burden. This DCIS component was located separate from the invasive areas.\n\nLymphovascular space invasion was noted. Surgical margins were free of carcinoma; however, the invasive component was within 1.0 mm of the anterior margin and 1.5 mm from the posterior margin. Additional benign findings included atypical ductal hyperplasia, florid ductal epithelial hyperplasia, fibrocystic changes, and microcalcifications. Changes related to a prior biopsy were also observed. One intramammary lymph node was negative for malignancy.\n\nEstrogen and progesterone receptor positivity was documented in the invasive tumor cells, while HER-2 testing was negative. Three sentinel lymph nodes from the right axilla were all negative for metastatic disease. No carcinoma was identified in the additional excised medial margin, which showed only benign breast parenchyma with fibrocystic changes."} +{"pid": "TCGA-FB-AAPP", "report": "The Whipple resection specimen includes a stomach measuring 11.2 x 10 x 3.5 cm with a proximal staple line of 10.5 cm, a duodenum measuring 28 cm in length and 3.5\u20134 cm in diameter, and a pancreatic head measuring 7.5 x 7 x 5.5 cm. A clear tan mucinous material is observed protruding from the main pancreatic duct at the neck margin, although the duct remains patent upon probing. The common bile duct measures 0.7 cm in diameter and is also patent through the ampulla. Serial sectioning of the pancreas reveals marked dilation of the main pancreatic duct up to 3 cm in diameter, containing a cystic and largely mucinous mass with some solid papillary components. This mass measures 5.5 x 3.5 x 3 cm and appears encapsulated within the duct throughout the organ. It is located approximately 0.5 cm from the anterior medial radial margin. Adjacent to the mass, there is a firm tan-white area of slightly lobular pancreatic tissue, suggestive of chronic inflammatory change. The stomach serosa appears smooth and tan-red, and upon opening along the greater curvature, the mucosa appears unremarkable. The duodenum shows focal green-yellow discoloration on the proximal serosa and contains 1 mL of blood clot adherent to the ampulla upon opening, with possible mucinous material noted. The ampulla is located 12.5 cm from the proximal stomach margin and 17 cm from the distal duodenal margin. Sectioning and palpation of the greater curvature fat (measuring 11 x 3.2 x 2 cm) reveals no identifiable lymph nodes. In the lesser curvature fat (5.5 x 5 x 2.5 cm), six possible lymph nodes are identified. Peripancreatic fat evaluation identifies 20 possible lymph nodes, with the largest measuring 0.6 x 0.4 x 0.2 cm.\n\nMicroscopic examination reveals extensive involvement of peripancreatic soft tissue, including infiltration into the portal vein muscular layer, the adventitia of the common bile duct, and the duodenal mucosa. There is evidence of multifocal perineural and angiolymphatic invasion, including within the peripancreatic region. At the pancreatic neck margin of excision, cauterized tissue is present within 0.1 cm of the margin, with associated perineural and angiolymphatic invasion. No tumor is identified at the radial or mucosal surgical margins. Three of seven peripancreatic lymph nodes contain metastatic involvement, with extracapsular extension noted in one of the involved nodes. Associated findings include widespread chronic pancreatitis."} +{"pid": "TCGA-C5-A2LV", "report": "The surgical specimen from a female patient included a radical hysterectomy with bilateral parametrial tissue and lymph node dissections. The uterus measured 13 cm from fundus to external os, with a 5 cm transverse diameter. A polypoid mass measuring 3 x 3 x 1 cm was identified in the left lateral cervix. Bivalving of the uterus revealed an unremarkable endometrial cavity without evidence of malignancy. Multiple well-circumscribed white, firm nodules were noted within the myometrium, with the largest measuring 2.5 cm, consistent with leiomyomas. The vaginal cuff measured 1.5 to 3.0 cm in width, and the distance from the cervical mass to the vaginal cuff margin was 1.8 cm.\n\nMicroscopic evaluation of the cervix revealed a lesion with a maximum depth of invasion of 9 mm and a horizontal dimension of 30 mm. The cellular morphology was characterized by poor nuclear differentiation. No involvement was observed in the endometrium, myometrium, serosal surface, or vaginal cuff margins. Evaluation of soft tissue margins, including parametrial regions, showed no evidence of tumor extension.\n\nA total of 49 lymph nodes were assessed. Metastatic involvement was identified in one of seven paracervical lymph nodes. No metastasis was found in the remaining 48 lymph nodes, which included right and left periaortic (0 of 2 each), right external iliac (0 of 20), left external iliac (0 of 4), left obturator (0 of 12), and right obturator (0 of 1) lymph nodes. No extracapsular extension was identified in involved nodes.\n\nOther findings included secretory endometrium corresponding to day 24 to 25 of the menstrual cycle, focal adenomyosis of the myometrium, and chronic inflammation at the vaginal cuff margins. Multiple sections of the tumor and surrounding normal tissue were submitted for further analysis and biobanking."} +{"pid": "TCGA-E2-A1B1", "report": "The surgical specimens include seven sentinel lymph nodes and a wide local excision from the left breast, along with an additional margin specimen. Sentinel lymph node 1 consists of fibrofatty tissue without identifiable lymphoid elements and was negative for malignant cells. Sentinel lymph node 2 contained a metastatic focus measuring 4 mm in diameter with focal extracapsular extension. Nodes 3 through 7 were all negative for malignancy.\n\nThe wide local excision measured 9.2 x 8.1 x 3.2 cm and included a central irregular firm pink-tan mass measuring 3.7 x 3.5 x 1.5 cm. Hemorrhagic areas were noted within the lesion. Margins were evaluated, with the closest distance being 0.4 cm at the anterior margin. A separate 0.7 cm nodule was identified near the larger lesion; however, microscopic evaluation confirmed continuity between the two, indicating a single, irregularly shaped lesion. No vascular or lymphatic invasion was identified. The cellular features showed well-differentiated morphology with a tubular score of 1, mitotic score of 1, and a nuclear score of 2, resulting in a modified Scarff-Bloom-Richardson grade I.\n\nImmunohistochemical staining performed on prior biopsy material showed positivity for ER and PR, and HER2 amplification was detected by FISH. The pathological stage was determined to be pT2N1 with extranodal extension present. The additional margin specimen showed no residual lesion."} +{"pid": "TCGA-AA-A03J", "report": "The resected colon specimen involves the sigmoid region and shows the presence of bland diverticuli. The oral and aboral resection margins are unremarkable. A moderately differentiated adenocarcinoma is present, characterized by ulceration and infiltration into the lamina muscularis propria (G2). The tumor was localized within the pericolic fatty tissue, and 34 lymph nodes, measuring up to 0.9 cm, were dissected following clarification with acetone. Microscopic examination revealed all lymph nodes to be free of tumor involvement. The pathological staging is determined as pT2 pN0 (0/34)."} +{"pid": "TCGA-GM-A3XN", "report": "The left breast segmental mastectomy specimen contains three distinct masses, measuring 2.0 cm, 1.9 cm, and 1.1 cm in maximum dimension. The invasive component is noted within 0.1 cm of the medial margin, 1 mm and 2 mm from the deep and anterior margins, respectively. Perineural invasion is present. Widespread in situ changes are identified, with low and intermediate nuclear grades. Reactive changes at a prior biopsy site and fibrocystic changes are also present.\n\nA single sentinel lymph node contains metastatic involvement, with a maximum size of 0.3 cm. Extranodal extension is not present in this node. A palpable left axillary lymph node shows metastatic involvement with a focus measuring 0.9 cm and extranodal extension measuring 0.1 cm. A second palpable lymph node does not show any involvement. Additional deep margin evaluation reveals no tumor. Left axillary contents include 31 lymph nodes, of which three contain metastatic involvement, with a maximum size of 0.4 cm and presence of extranodal extension measuring 0.5 mm.\n\nFurther excision of the new anterior margin demonstrates no evidence of invasive disease, though in situ changes are present in few foci. Columnar alteration and ductal epithelial hyperplasia without atypia are also noted. Excision of the new anterior medial margin shows no evidence of malignancy.\n\nGross examination of the breast tissue reveals multiple ill-defined tan lesions with clips, located in slices 3, 4\u20135, and 5\u20136, with sizes correlating to those described. Some lesions are in close proximity. Two possible lymph nodes in slices 1 and 2, measuring up to 1.3 cm, are identified as sentinel nodes. The remaining tissue and margin samples are submitted for analysis. Multiple lymph nodes ranging in size from 0.3 to 1.8 cm are identified in the left axillary contents."} +{"pid": "TCGA-06-0189", "report": "The patient presented with symptoms including headache and nausea, and imaging identified a right temporal lesion with necrotic, hemorrhagic, and enhancing features, along with a right middle cerebral artery aneurysm. Two brain resection specimens were submitted for analysis.\n\nMicroscopic examination of the first specimen revealed brain tissue diffusely infiltrated by a cellular astrocytic neoplasm. The tumor exhibited nuclear atypia, mitotic figures, microvascular proliferation, and extensive necrosis. Immunohistochemical staining demonstrated glial differentiation with GFAP positivity. Over two-thirds of the tumor cells showed p53 overexpression, and the MIB-1 proliferation index was approximately 12% in more active regions. Molecular testing did not detect methylation of the MGMT promoter.\n\nThe second specimen consisted of tan-brown soft tissue fragments measuring 5.0 x 4.0 x 1.5 cm, with a uniform cut surface and extensive necrotic areas. Histological evaluation confirmed widespread infiltration of brain tissue by a high-grade neoplasm with similar morphological features, including necrosis and cellular pleomorphism. Additional sections also showed involvement of the leptomeningeal space.\n\nAll findings were consistent with a high-grade astrocytic neoplasm based on histological and immunophenotypic characteristics."} +{"pid": "TCGA-Q1-A5R3", "report": "The specimen consists of endocervical curettings that include fragments of tissue showing abnormal cellular features. The tissue fragments are pale pink to tan in color with areas of red-brown blood clot, measuring 1 x 0.5 x 0.2 cm. Microscopic evaluation reveals the presence of atypical cells arranged in a non-keratinizing pattern, with moderate cellular differentiation. There is evidence of focal stromal invasion. All tissue has been processed and submitted for analysis."} +{"pid": "TCGA-2G-AAFN", "report": "The specimen from the right orchidectomy consisted of a 3 cm lesion, composed entirely of nonseminomatous germ cell tumor components. Histologic evaluation demonstrated the presence of angioinvasion; however, no involvement of the rete testis was identified. The tumor was limited to the testicular parenchyma without extension beyond this structure."} +{"pid": "TCGA-41-2575", "report": "The specimen consists of three parts: A, B, and C, all labeled as right frontal tumor. Pre-operatively, a diagnosis was suspected based on clinical findings. The patient has a history of brain biopsy.\n\nSpecimen A was received fresh for frozen section and consists of a fragment of soft, glistening tan tissue measuring 0.8 x 0.6 x 0.3 cm. A touch preparation was made, and the entire sample was submitted for frozen section analysis. Frozen section diagnosis indicated at least grade III astrocytic neoplasm.\n\nSpecimen B was entirely submitted for tissue procurement.\n\nSpecimen C was received in formalin and consists of multiple pink-tan yellow, irregular, soft tissue fragments with an aggregate measurement of 2.5 x 2.5 x 0.5 cm. All tissues were submitted in one cassette.\n\nMicroscopic examination of specimens A and C reveals a markedly cellular astrocytic neoplasm. The tumor cells demonstrate pleomorphism with frequent mitotic figures. Histologic features also include neovascularization and pseudopalisading necrosis. Specimens A and C were entirely submitted for evaluation. Specimen B was sent for tissue procurement in its entirety."} +{"pid": "TCGA-08-0349", "report": "The biopsy specimens were obtained from the brain and submitted in two parts. Part A consisted of a soft pink-tan tissue fragment measuring 1.0 cm in aggregate, with a portion used for frozen section analysis and the remainder submitted for further evaluation. Part B included multiple fragments of soft pink-tan and brown tissue measuring up to 1.2 cm in aggregate, all of which were submitted for analysis.\n\nMicroscopic examination revealed areas of necrosis with surrounding cells arranged in a pseudo-palisading pattern. There was notable endothelial proliferation and multiple mitotic figures were observed. The cellular morphology demonstrated significant nuclear and cytoplasmic pleomorphism, including the presence of numerous giant cells. Immunohistochemical staining showed positivity for GFAP in many neoplastic cells. Additional testing showed a MIB-1 labeling index of 35.3%, a p53 score of 3, and positive staining for EGFR.\n\nThe findings were evaluated in conjunction with prior assessments and established criteria. All relevant slides were reviewed by the attending pathologist to confirm the final assessment. The clinical history included a left temporal lobe mass and the procedure involved a right frontoparietal craniotomy."} +{"pid": "TCGA-VQ-A8PJ", "report": "The specimen involves the stomach, specifically the anterior wall of the gastric body. The histological pattern is tubular. The tumor measures 10.5 cm along its greatest axis and is associated with ulceration. The lesion involves the mucosa, muscularis mucosae, submucosa, muscularis propria, serous layer, and extends into adjacent adipose tissue. The type of invasion is described as spiculated. A moderate inflammatory reaction is noted. There is evidence of tumor implantation in perivisceral adipose tissue. Both proximal and distal surgical margins are free of neoplastic cells. Neural infiltration is not detected. Lymphatic vascular invasion is present, while blood vascular invasion is not observed. Of the lymph nodes examined, 9 out of 24 are involved. Capsular involvement is present, and conglomerated lymph nodes are not detected. Additionally, there is chronic inflammation with complete intestinal metaplasia in non-neoplastic areas of the stomach."} +{"pid": "TCGA-DD-AADE", "report": "The liver specimen measured 14.0 x 11.5 x 6.5 cm and weighed 333.5 grams. A well-defined mass was identified, measuring 9.0 x 9.0 x 7.0 cm, with a greenish tan, granular cut surface and 30% necrosis. The gross appearance was nodular and expanding. The resection margin was not involved macroscopically, with a safety margin of 1.2 cm. No satellite nodules were observed, and the remaining liver parenchyma showed cirrhotic changes. The gallbladder measured 8.5 cm in length, 3.0 cm in diameter, with a wall thickness of 0.1 cm and appeared unremarkable grossly.\n\nMicroscopically, the lesion exhibited trabecular growth pattern with hepatic cell type. The degree of differentiation varied, with the worst being grade IV and the major component being grade III. Fatty change was present in 55% of the cells. A partial fibrous capsule was noted, and there was infiltration of the capsule. No septum formation was seen. There was no invasion at the surgical resection margin, serosal layer, or portal vein. Microvessel invasion was present. Two distinct lesions were identified: the main mass and a separate nodule labeled \"No. 3,\" suggesting intrahepatic spread.\n\nEvaluation of non-tumor liver tissue showed chronic hepatitis, etiology consistent with HCV infection. Lobular inflammation was minimal, and portoperiportal inflammation was mild to moderate. Fibrosis was present in a septal pattern. No dysplastic nodules, ductal epithelial dysplasia, or other liver disease was identified. The gallbladder showed features of chronic cholecystitis with no additional significant findings."} +{"pid": "TCGA-MP-A4SY", "report": "The revised report describes surgical specimens obtained from the right lower lobe of the lung, measuring 15 x 8 x 3 cm, and the right upper lobe, measuring 3.5 x 3.0 x 2.2 cm. Additional specimens include multiple lymph node groups from mediastinal regions, including subcarinal, inferior pulmonary ligament, right and left lower paratracheal, interlobar, and bronchial sites.\n\nA central mass measuring 5 x 4 x 3 cm was identified in the right lower lobe. Microscopic examination revealed invasive high-grade cellular proliferation. Surgical margins were free of abnormal cells. Among six intrapulmonary peribronchial lymph nodes examined, one contained atypical cells consistent with systemic spread.\n\nIn the right upper lobe wedge specimen, focal necrotizing inflammation was observed. Mediastinal lymph nodes showed varying degrees of necrotizing inflammation. In the inferior mediastinum, including subcarinal and inferior pulmonary ligament regions, several lymph nodes exhibited necrotizing granulomatous changes. Similar findings were noted in superior mediastinal lymph nodes, including those located along the right and left lower paratracheal regions.\n\nAdditional lymph node groups from the bronchus intermedius, right upper lobe bronchus, and middle lobe bronchus also demonstrated necrotizing granulomatous lymphadenitis. No atypical cells were identified in these specimens. Further evaluation using special stains for microorganisms on subcarinal lymph node tissue was negative."} +{"pid": "TCGA-BH-A0H9", "report": "The specimen consists of a segmental mastectomy with needle localization. The invasive component measures 2.1 cm in greatest dimension. Histologic evaluation shows a Nottingham grade 3 appearance, with tubule formation score 3, nuclear polymorphism score 3, and mitotic activity score 3, resulting in a total score of 9. The tumor is located 1.5 mm from the closest anterior margin. No definitive lymphovascular invasion is identified. There is a focus of ductal carcinoma in situ, solid pattern, nuclear grade 3, constituting approximately 5% of the total tumor volume. This in situ component is admixed with the invasive lesion. Microcalcifications are present in association with the invasive component. Additional findings include fibrocystic change. Immunohistochemical analysis demonstrates positivity for estrogen and progesterone receptors, with weak positivity for HER2/neu without amplification on FISH analysis. One sentinel lymph node was examined and showed no evidence of metastatic involvement. The tumor is classified as pT2, with no regional lymph node involvement (pN0). Mammographic correlation confirms calcifications in malignant-appearing areas. Conventional histology and immunophenotyping were used to assess the tissue."} +{"pid": "TCGA-2J-AAB8", "report": "The surgical specimen was obtained on [date] and included resection of the pancreatic head, common bile duct, duodenum, a portion of jejunum, and gallbladder as part of a Whipple procedure. A solid mass measuring 3.5 x 2.8 x 2.4 cm was identified in the pancreatic head. The mass extends beyond the pancreas into adjacent soft tissue and involves the distal common bile duct. Microscopic evaluation revealed moderately differentiated grade 3 (of 4) neoplastic cells arranged in ductal structures. Invasion into surrounding tissues is present, with involvement of the portal vein groove margin focally. The superior mesenteric vein margin is free of tumor involvement.\n\nAngiolymphatic invasion is present along with perineural invasion. No tumor necrosis was observed. Evaluation of regional lymph nodes showed that 3 out of 25 contain metastatic disease. Adjacent non-neoplastic pancreatic parenchyma demonstrates changes consistent with chronic pancreatitis.\n\nAdditional specimens submitted include a biopsy from the right lobe of the liver containing a small tan firm nodule, hepatic hilar lymph nodes, a margin from the common hepatic duct, and a pancreatic neck margin; all were negative for malignant involvement.\n\nThe gross specimen included a duodenal segment measuring 30.3 cm in length, a pancreatic portion measuring 7.0 x 6.3 x 2.8 cm, and a gallbladder measuring 10.9 x 4.7 x 3.0 cm. A stent was noted within the common bile duct measuring 9.5 cm in length. No choleliths were identified in the gallbladder.\n\nHistologic evaluation was performed using frozen sections and confirmed by permanent H&E sections. Staging classification based on available material is pT3N1 according to the AJCC 7th edition criteria (2010). Any significant findings from further histologic review will be addressed in a revised report if necessary."} +{"pid": "TCGA-A2-A0CX", "report": "The specimen was obtained from a female patient and included tissue from the left breast as well as a sentinel lymph node from the left axillary region. The breast specimen measured 10.5 cm in length, 5.0 cm in width, and 1.0 cm in depth. A central mass measuring 2.7 x 3.1 x 2.5 cm was identified; it appeared pink-white, firm, and gritty with well-defined borders. This mass was closest to the anterior margin at 1.0 cm distance. Another smaller mass, tan-white and fibrous in appearance, was found at the inferior margin. It measured approximately 1.1 x 0.9 x 0.8 cm and was located 0.4 cm from the inferior margin and 0.2 cm from the lateral margin. The two masses were separated by about 1.2 cm. Margins of the specimen were marked with ink for orientation.\n\nHistologically, the tumor exhibited high-grade features based on the Nottingham grading system, with a total score of 8 out of 9 (tubules = 3, mitoses = 2, nuclei = 3), indicating poor differentiation. No tumor necrosis or microcalcifications were observed. There was no clear evidence of lymphovascular invasion. Surgical margins were free of involvement. An intraductal component was present, accounting for less than 25% of the lesion, with notable changes involving the lobules.\n\nTwo lymph nodes were examined\u2014one located within the breast tissue near the inferior margin and another retrieved from the sentinel lymph node specimen. Both were negative for malignant involvement. Immunohistochemical staining using cytokeratin confirmed the absence of malignancy in the sentinel lymph node.\n\nEstrogen receptor status was positive (>10%), while progesterone receptors were negative. HER2 testing by immunohistochemistry showed strong positivity (3+). Based on these findings and the absence of distant metastasis, staging was assessed. The tumor measured 3.1 cm grossly and was classified as pT2 with no nodal involvement (pN0), corresponding to an early stage classification.\n\nMultiple tissue sections were submitted for further analysis, including areas adjacent to the primary mass, margins, and surrounding normal tissue. Additional sections were processed for a clinical research protocol. The lymph node specimen was divided for both routine evaluation and protocol-driven processing."} +{"pid": "TCGA-E2-A1IG", "report": "The specimens include three sentinel lymph nodes from the right axilla and a right breast mastectomy. The first sentinel lymph node measures 1.4 x 0.6 x 0.4 cm and shows a focus of micrometastatic disease in the capsule measuring 0.27 mm, along with an additional focus of isolated tumor cells measuring 0.18 mm. No extranodal extension is identified. The second lymph node, measuring 1.2 x 0.7 x 0.4 cm, shows no evidence of tumor. The third lymph node, measuring 0.7 x 0.5 x 0.3 cm, also shows no involvement.\n\nThe right breast specimen weighs 636 grams and measures 21 x 16 x 3 cm. It includes a skin ellipse and a partially inverted nipple. Serial sectioning reveals several lesions. The largest lesion is a 2 x 1.8 x 1.5 cm firm white-tan mass located subareolarly, closest to the anterior margin at 1.3 cm. A second finding is a 1.2 x 0.5 x 0.5 cm biopsy site at 12:00, 1 cm from the anterior margin and 2.5 cm above the first lesion. A third area measures 0.6 x 0.5 x 0.5 cm in the upper outer quadrant, 1 cm lateral to the first lesion and 2 cm from the deep margin. A fourth lesion measures 1 x 0.7 x 0.5 cm in the upper outer quadrant, 0.3 cm lateral to the third lesion and more than 1 cm from all margins. All surgical margins are free of involvement.\n\nMicroscopic evaluation of the breast tissue reveals multiple foci of invasive carcinoma with mucin features, along with ductal carcinoma in situ (DCIS) of nuclear grade 2, including solid and cribriform types. DCIS involves the lobules and is estimated to account for approximately 25% of the tissue, associated with the invasive component. The invasive component is graded as SBR Grade 2. No vascular or lymphatic invasion is identified. Hormone receptor testing shows positivity for ER and PR, and HER2 testing is negative by IHC.\n\nStaging indicates pT2 for the primary tumor size and pN1mi for the presence of micrometastatic disease in one of the three examined sentinel lymph nodes."} +{"pid": "TCGA-2Y-A9GV", "report": "The specimen consists of gallbladder, a diaphragmatic nodule, and liver tissue from segments 5 and 6. The gallbladder measures 7.5 x 2 x 2 cm and contains green bile without gallstones. The gallbladder wall is smooth and measures up to 0.2 cm in thickness. Microscopic examination reveals benign gallbladder wall with mild localized chronic inflammation and no evidence of malignancy.\n\nThe diaphragmatic nodule is a fibroadipose tissue fragment measuring 5 x 0.5 x 0.2 cm. Histologic evaluation shows fat necrosis with localized dystrophic calcification and no malignant cells present.\n\nThe liver specimen weighs 279.2 grams and measures 15 x 12.5 x 6 cm. On serial sectioning, there is an irregular tan-white to tan-yellow partially hemorrhagic lesion measuring 6.5 x 5 x 4.2 cm, located 1.2 cm from the surgical margin. The closest resection margin is entirely inked in black and free of tumor involvement. Histologically, the lesion demonstrates well-differentiated cellular features with clear cell morphology. Surrounding non-neoplastic liver tissue shows portal chronic inflammatory infiltrate; no cirrhosis is identified. Representative sections of all margins and surrounding tissue have been submitted for further analysis."} +{"pid": "TCGA-QH-A6X9", "report": "The specimen was received from a female patient with a lesion located in the right temporal region. Gross examination revealed a well-circumscribed mass measuring approximately 4.5 cm in greatest dimension. The cut surface exhibited a tan to gray coloration with areas of soft consistency and focal firmness. Microscopic evaluation demonstrated a diffusely infiltrative neoplasm composed of uniform cells with round to oval nuclei, clear cytoplasm, and a delicate network of branching vessels. Focal calcifications and scattered Rosenthal fibers were noted. No necrosis or microvascular proliferation was identified. Immunohistochemical staining showed positivity for IDH1 and nuclear expression of ATRX was retained. Based on histological features and immunoprofile, the tumor demonstrated low mitotic activity and no evidence of anaplastic transformation. Staging was limited to local extent without involvement of adjacent structures."} +{"pid": "TCGA-BP-4334", "report": "The clinical history notes an incidentally identified renal mass. Submitted specimens include a right kidney with a portion of adrenal gland and hilar lymph node, a portion of the right 11th rib, and fat overlying the mass along with colon tissue.\n\nThe primary lesion measures 11.5 cm in greatest dimension and is located at the lower pole of the kidney. It has a solid growth pattern with areas of hemorrhage and focal necrosis. Microscopic evaluation reveals high nuclear grade features with some areas showing even higher grade morphology. Focal metaplastic ossification is also present. The lesion extends through the renal capsule but remains confined within Gerota\u2019s fascia. There is no evidence of renal vein invasion; however, intratumoral vascular invasion is identified. All surgical margins are free of tumor involvement. A small portion of adrenal gland measuring 1.5 cm is present at the superior pole and appears unremarkable. No lymph nodes are identified in the hilar fat, and the lymph node examined from this region shows no metastatic involvement.\n\nThe right 11th rib specimen consists of two fragments measuring 12.0 x 1.5 x 0.8 cm. Sections were submitted after decalcification; however, results are pending and any significant findings will be reported in an addendum.\n\nA biopsy of fibroadipose tissue overlying the tumor and adjacent colon shows no evidence of neoplastic involvement.\n\nSpecial immunostains including CK7 and Ki67 were performed, with negative controls also evaluated. No additional significant findings were noted in the non-neoplastic kidney or adrenal gland. Vascular and ureteral margins are uninvolved. The tumor approaches within less than 1 mm of the perirenal fat surgical margin. Multiple sections from various regions including the adrenal gland, hilar fat, kidney, tumor margins, and surrounding fat were submitted for analysis."} +{"pid": "TCGA-KS-A41J", "report": "Patient is a year-old individual with a left thyroid nodule identified during a routine physical examination. A total thyroidectomy was performed. Submitted specimens include two left level VI lymph nodes measuring 0.4 cm and 0.7 cm in diameter, described as tan-red tissue fragments. The total thyroid specimen weighed 17.6 grams and measured 4.5 x 7.2 x 4.2 cm. The parenchyma appeared beefy red-brown with a lobulated texture. A single nodule measuring 2.3 x 2.1 x 1.8 cm was identified in the left lower lobe, located 0.2 cm from the inked margin. The nodule was well-encapsulated, soft, fleshy, and tan-pink in color, without evidence of hemorrhage or necrosis. No infiltration into adjacent tissue was observed. The left half of the specimen was inked black and the right half blue; the specimen was serially sectioned. Sections submitted included those from the left lobe nodule with intact capsule, isthmus, and right lobe. Examination of the lymph nodes revealed the presence of metastatic carcinoma. Microscopic evaluation of the thyroid specimen showed a lesion closely approximating the inked margin, occurring in the context of lymphocytic thyroiditis. All slides were personally reviewed and interpreted by the staff pathologist."} +{"pid": "TCGA-F7-A50I", "report": "The specimen consists of a total laryngectomy measuring 9.5 x 8.7 x 7.2 cm, including hyaloid bone (9.2 cm in length x 1.2 cm in diameter), anterior skin with a tracheotomy site (3.1 x 2.0 cm), and anterior strap muscles. The external surface is inked black. Upon opening the specimen from the posterior midline, a tan-pink infiltrative mass measuring 6.2 x 5.1 x 5.8 cm is identified in the preepiglottic, glottic, and subglottic regions. The mass crosses the midline and involves bilateral true and false vocal cords, extending into the tracheostomy site. On sectioning, the mass shows infiltration into underlying soft tissues, approaching within 0.8 cm of the vallecula margin, 0.2 cm from the skin, 0.3 cm from the anterior strap muscles, and 0.2 cm from the anterior surface. The mass involves the thyroid cartilage and cricoid cartilage, and appears to extend to the distal tracheal ring margin. The surrounding mucosa is pink-tan, and no other lesions are present. Representative sections (F1\u2013F20) have been submitted, and tissue was preserved for potential future studies. Photographs were taken for documentation. Microscopic evaluation reveals invasive cellular growth with features suggestive of moderate differentiation. Invasion of thyroid and cricoid cartilages is confirmed. Lymphovascular invasion is present. Margins at the left tracheal and anterior surfaces are positive for invasive cells, while all other margins are free of involvement. No lymph nodes were assessed. The mass also demonstrates extension to the cricoid cartilage."} +{"pid": "TCGA-4V-A9QU", "report": "The specimen from thymectomy weighs 37 grams and contains a nodule measuring 4 x 3.5 x 2 cm, with a whitish appearance, limited and lobulated margins. A fragment of innominate vein measuring 3.5 x 2 cm is also present. Microscopically, the nodule has a lobulated architecture separated by thick fibrous bands. It is a biphasic lesion composed of epithelial cells with a fusiform morphology arranged in beamlets, nests, and occasionally in rosettes, surrounded by a population of relatively regular lymphocytes. The lesion shows ill-defined borders and infiltrates at multiple points into the surrounding capsule, with small nodules present in the adjacent fat. Margins labeled with ink show transition into healthy tissue. Some areas demonstrate increased cellularity with more prominent epithelial component and reduced lymphocytic presence, along with regions exhibiting clear perivascular spaces. Immunohistochemical analysis reveals that the epithelial cells express cytokeratin (KL1 and AE1/AE3), as well as CD20, but are negative for CD5 and CD117. The associated lymphocytes express CD5 and CD1a. Adjacent thymic parenchyma shows marked involution and fatty replacement. The vascular structures examined have muscular walls and are embedded in adipose tissue, with two small lymph nodes identified. Surgical resection was complete. Based on histological features and staging criteria, the lesion is classified as a stage IIA according to the modified Masaoka classification."} +{"pid": "TCGA-K4-A3WS", "report": "A segment of left distal ureter and a segment of right distal ureter were both found to have no abnormal cellular changes. Three lymph nodes from the left pelvic region and two lymph nodes from the right pelvic region were examined, with no atypical cells identified in any of the nodes.\n\nThe surgical specimen included the bladder, prostate, seminal vesicles, and vas deferens. A mass measuring approximately 2 cm was identified in the left lateral, posterior, and trigone areas of the bladder. Histologic evaluation revealed high-grade urothelial carcinoma without squamous or glandular differentiation. The tumor was found to microscopically involve the perivesical fat but did not extend to the margins of the specimen. Six lymph nodes were examined, with no evidence of involvement. Lymphatic invasion was focally suspected, and patchy areas of carcinoma in situ were also noted.\n\nIn the prostate, bilateral involvement was observed. The tumor measured 4 x 3.5 cm and 3.5 cm in different dimensions. Histologic analysis showed a Gleason score pattern consistent with moderate tumor involvement (3 out of 5). There was no extension beyond the prostatic capsule, and no tumor was identified in the seminal vesicles or at the surgical margins. Lymphatic or perineural invasion was not present.\n\nThe entire specimen was submitted for histopathologic examination, and multiple sections were taken from the bladder, prostate, and surrounding structures for detailed microscopic analysis."} +{"pid": "TCGA-DJ-A1QI", "report": "The clinical history includes a previously identified right thyroid nodule. The specimens submitted included one fragment of fibrotic tissue for intraoperative consultation, measuring 0.3 cm in greatest dimension, interpreted as parathyroid tissue. A total thyroidectomy specimen was also submitted, weighing 26.5 grams. The right lobe measured 6.0 x 2.5 x 2.5 cm, the left lobe 4.0 x 2.5 x 1.1 cm, and the isthmus 2.0 x 2.0 x 0.6 cm. Gross examination revealed a pink-tan nodule measuring 3.0 cm in the right lobe that was partially cystic and extended to both anterior and posterior surfaces. Two smaller firm white nodules were found in the isthmus, measuring 0.3 cm and 0.6 cm respectively, located near the anterior surface.\n\nMicroscopic evaluation demonstrated multiple small nodules within both lobes and the isthmus, with sizes ranging from 0.08 to 0.6 cm. Histologic features showed well-differentiated cellular morphology with mild to moderate mitotic activity (1/10 HPFs). No tumor necrosis was identified. Calcifications of non-psammoma type and psammoma bodies were present. The larger nodule was partially encapsulated without evidence of vascular invasion or extrathyroid extension. Surgical margins were negative. Adjacent thyroid tissue exhibited nodular hyperplasia.\n\nAll tissue from the thyroidectomy was submitted for histologic analysis. Frozen section diagnosis confirmed parathyroid tissue from a separate biopsy specimen. The final report is based on personal examination of all relevant slides."} +{"pid": "TCGA-80-5611", "report": "The specimen consists of a left upper lobe (LUL) lung mass, measuring 3.20 cm in greatest dimension. Histologic evaluation reveals malignant cells arranged in a non-small cell pattern. The tumor was classified as T2, NOS, with no lymph node involvement identified. Surgical resection was performed, and the lesion was localized to the LUL. No evidence of distant metastasis was noted. Cellular features include moderate nuclear atypia and variable architectural patterns. Staging workup indicates a localized process without nodal spread."} +{"pid": "TCGA-GS-A9TX", "report": "LEFT INGUINAL LYMPH NODE: A nodular fragment measuring 4.5 x 4 x 2.5 cm was examined. Histological sections reveal a diffuse infiltration of large cells with centroblastic morphology, interspersed with smaller accompanying cells. A small area containing several lymphoid follicles with reactive features is noted, some of which appear to be secondarily involved by the atypical cell population. Immunohistochemical staining demonstrates positivity for CD20, CD79a, CD10, BCL6, and CD23, while staining is negative for CD3, CD5, BCL2, CD21, and p53. A lambda light chain restriction is present. Abundant reactive T-cells expressing CD3 and CD5 are also observed. The Ki-67 proliferation index is estimated at 75%. Fluorescence in situ hybridization (FISH) analysis shows no rearrangements of the BCL2 gene but reveals gains in the BCL6 gene and losses in chromosome 1 (region 1p36)."} +{"pid": "TCGA-G4-6625", "report": "A segment of sigmoid colon measuring 20.0 cm in length was received with both ends stapled closed. The specimen includes pericolic fat measuring 20.0 x 6.5 x 2.5 cm. Upon opening, a pink-tan ulcerated exophytic polypoid lesion measuring 3.5 x 3.2 x 0.6 cm was identified. This lesion was located 6.8 cm from the wider resection margin and 11.0 cm from the narrower margin. The lesion extended into the surrounding fat but did not reach the peritoneal surface. The radial margin of resection was free of any abnormality. No discrete nodule was found within the pericolic fat. Multiple small lymph nodes were identified, ranging from <0.1 cm to 1.0 cm in size. Histologic examination revealed no vascular or lymphatic invasion and no perineural involvement. A total of eighteen lymph nodes were evaluated and all were negative for involvement. Adjacent colonic tissue showed a hyperplastic polyp and diverticulum. The proximal and distal donut specimens consisted of ring-shaped colonic tissue fragments measuring 1.5 x 1.5 x 0.7 cm and 1.5 x 1.5 x 1.0 cm respectively; neither showed any discrete lesion. Both were submitted for histologic evaluation and no abnormalities were identified."} +{"pid": "TCGA-G2-AA3F", "report": "The specimen consists of multiple light gray and dark brown unoriented fragments of soft tissue measuring 8.0 x 7.5 x 4.5 cm in aggregate. Histologic evaluation reveals high-grade cellular features with areas demonstrating micropapillary morphology comprising approximately 15% of the sample. The lesion shows invasive growth into the muscularis propria. Lymphovascular invasion is identified. Prostatic tissue demonstrates stromal nodular hyperplasia; no malignant glandular involvement is observed."} +{"pid": "TCGA-BT-A20T", "report": "A 62-year-old man underwent radical cystoprostatectomy with construction of an orthotopic neobladder. The specimen showed an ulcerated tumor involving the urinary bladder and distal ureters, located on the right anterior wall of the urinary bladder. Histologically, the lesion exhibited infiltration through the muscularis propria with extension into the perivesical adipose tissue. The maximal tumor diameter was 2.1 cm (additional dimensions: 1.5 x 1.2 cm). Rare perineural invasion was identified. A microscopic focus of metastasis measuring 0.2 cm was found in one perivesical lymph node without extracapsular extension. No involvement was identified in three right pelvic lymph nodes or two left pelvic lymph nodes. Margins from both ureters were free of neoplasia.\n\nMultifocal flat intraepithelial lesions were present extensively within the urinary bladder and prostatic urethra. In addition, intraductal involvement was observed in periurethral ducts of the prostate gland, contiguous with flat intraepithelial lesions of the urethra. There was also multifocal high-grade intraepithelial neoplasia of the prostate.\n\nThe prostate gland contained a separate acinar adenocarcinoma measuring up to 0.6 cm in greatest dimension, confined to the right lobe and comprising less than 5% of the sampled prostate volume. The Gleason score was 3 + 4 = 7, with approximately 40% of the carcinoma demonstrating Gleason pattern 4 morphology. Focal perineural invasion was identified; however, there was no angiolymphatic invasion or extraprostatic extension. Bilateral seminal vesicles and distal vas deferens were free of tumor involvement.\n\nHistologic grading for the bladder lesion was high-grade urothelial carcinoma. Pathologic staging based on findings included T3b for local extension into perivesical fat, N1 due to lymph node involvement with metastasis, and MX as distant metastasis could not be assessed. For the prostate lesion, staging was T2a with no lymph node involvement and MX for distant metastasis status. All surgical margins were free of invasive tumor."} +{"pid": "TCGA-FG-8185", "report": "The specimen consists of three parts submitted for analysis. Grossly, part A consists of two small fragments of irregular gray-tan tissue measuring 0.5 cm each. Part B is a larger aggregate weighing 54 grams and measuring up to 7.5 x 6.6 x 3 cm. It is composed of multiple pieces of soft, focally hemorrhagic gray-tan tissue with loss of normal distinction between gray and white matter; no normal brain parenchyma remains. Part C weighs 32 grams and measures 6.3 x 3.6 x 3.2 cm; it appears consistent with cortical brain tissue, showing preserved differentiation between gray and white matter with diffuse brown foci in the white matter but no discrete lesion.\n\nMicroscopically, extensive examination of 51 H&E sections reveals a diffusely infiltrating neoplasm involving both white and gray matter. The cellular morphology varies across different regions. Some areas show low-grade features with a microcystic pattern, while others are more cellular with abnormal mitotic figures and marked nuclear pleomorphism. Perineuronal satellitosis and microcalcifications are present. Areas suggestive of gemistocytic astrocytoma are identified, as well as regions with a more monotonous appearance reminiscent of oligodendroglioma morphology. Frequent vascular thrombi are observed within small vessels. No vascular endothelial proliferation or necrosis is seen despite thorough sampling.\n\nImmunohistochemical staining demonstrates positivity for p53, supporting an astrocytic lineage. MIB-1 staining shows a nuclear labeling index of up to 20%. Molecular studies are in progress. Margins cannot be assessed. No tumor is identified in the frontal pole specimen."} +{"pid": "TCGA-NP-A5GZ", "report": "The specimen consists of a right kidney nephrectomy specimen measuring 14 cm in greatest dimension. The tumor measures 9.5 cm and is confined to the kidney with no apparent invasion into surrounding structures. Microscopic examination reveals a solid proliferation of polygonal cells arranged around thick-walled blood vessels. The cytoplasm is transparent to slightly eosinophilic with prominent cell membranes. Nuclear features include irregular and focally wrinkled nuclei with small nucleoli and perinuclear halos. Immunohistochemical staining shows positivity for CK7, E-cadherin, PAX-8, and pancytokeratin (patchy/focal), while negative for vimentin and CD10. These findings are consistent with previously described histomorphology.\n\nThe tumor is unifocal and limited to the kidney without extension beyond the renal capsule. Surgical margins are greater than 1 cm from all margins and no lymph nodes were identified in the peripelvic fat. Pathologic staging indicates primary tumor classification as pT2a with no regional lymph node or distant metastasis identified. Pathologic stage is classified accordingly. No lymphovascular invasion is identified. Additional findings within the non-neoplastic kidney are unremarkable."} +{"pid": "TCGA-AX-A05T", "report": "The specimen consisted of multiple lymph node groups and a hysterectomy specimen with bilateral fallopian tubes and ovaries. Lymph nodes were evaluated from both left and right para-aortic, right external iliac, right common iliac, right obturator, left external iliac, and left obturator regions. A total of 21 lymph nodes were identified and examined, with no evidence of tumor involvement. The left external iliac dissection contained only mature fibroadipose tissue, with no lymph node material identified.\n\nThe uterus measured 8 x 4.5 x 3.5 cm and contained a mucosal mass measuring 2.5 x 2 x 1.5 cm located on the anterior, posterior, and superior walls of the endometrial cavity. The myometrium at the site of maximal thickness measured 16 mm, with superficial invasion by a neoplastic process noted to a depth of 2 mm. This corresponded to less than 50% myometrial invasion. No vascular or lymphatic invasion was identified. The cervix showed only mild chronic inflammation without any neoplastic changes.\n\nThe right ovary contained a 1.2 cm serous cystadenoma. The left ovary appeared atrophic. Both fallopian tubes were patent with no significant pathology identified. Additional findings included adenomyosis in the myometrium.\n\nStaging based on pathological findings indicated a primary tumor confined to the endometrium with less than half of the myometrium involved (pT1b). No regional lymph node metastasis was found (pN0), and distant metastasis could not be assessed (pMX). Surgical margins were uninvolved."} +{"pid": "TCGA-CV-7424", "report": "The specimen consists of a laryngeal resection with right extended radical neck and left modified neck dissection. A 2.4 x 2.0 x 1.5 cm lesion is identified in the right pyriform sinus, extending into the submucosa of the right true and false vocal cords and approaching within less than 1.0 mm of the adjacent soft tissue margin. The tumor also involves the right aryepiglottic fold. Perineural invasion is present. In the right side of the neck, a 5.0 cm mass is noted in levels 3 and 4, composed of multiple matted lymph nodes that are almost entirely replaced by infiltrating cells. Metastatic involvement is confirmed in the right subdigastic and midjugular lymph nodes. No involvement is found in the left cervical lymph node examined. Surgical margins at the superior mucosal, inferior tracheal, and peripheral soft tissue sites are free of disease. The left true and false vocal cords, left pyriform sinus, epiglottis, and anterior commissure show no evidence of tumor. Additionally, a multinodular goiter is present in the right thyroid lobe without malignant involvement. Teeth were submitted for gross examination only."} +{"pid": "TCGA-5S-A9Q8", "report": "The right fallopian tube and ovary specimen includes an ovary measuring 9.0 \u00d7 6.0 \u00d7 4.5 cm with a cystic and solid appearance. The external surface is grey-tan to pink-purple, and sectioning reveals multiple cystic spaces and a solid fleshy tan-pink component. No hemorrhage or necrosis is identified. The attached fallopian tube measures 8.5 cm in length and appears unremarkable on sectioning.\n\nThe uterus and cervix with left adnexa weigh 753.0 grams and measure 18.4 \u00d7 13.7 \u00d7 9.9 cm. The serosa is dark pink-red with multiple fibroadipose adhesions. The cervix measures 3.5 cm in diameter, with the ectocervix being smooth and pink-tan. A small endocervical polyp is noted. An endometrial mass measuring 6.4 \u00d7 4.5 \u00d7 3.4 cm involves the anterior and posterior endometrial surfaces and shows apparent myometrial invasion to a depth of 3.0 cm out of a total myometrial thickness of 6.5 cm. The mass does not extend into the lower uterine segment and is approximately 5 cm from the nearest paracervical margin. Rare tan-white to yellow nodules, some calcified, are present within the myometrium. The left adnexa measures 10.4 \u00d7 5.6 \u00d7 3.8 cm and contains a complex cystic structure with areas of hemorrhage; ovarian parenchyma is present.\n\nOmental tissue is received in multiple fragments, measuring up to 27 \u00d7 17 \u00d7 3 cm, with focal hemorrhage and slight induration. Lymph node specimens include para-aortic fibroadipose tissue containing two lymph nodes (1.1 cm and 3.8 cm), right obturator fibroadipose tissue with two lymph nodes (2.5 \u00d7 5.3 cm), and a single left iliac lymph node measuring 2.2 cm.\n\nAll lymph node specimens are unremarkable. The omentum is unremarkable for any significant pathology. The left ovary contains endometriotic cysts without evidence of malignancy. The left fallopian tube shows findings consistent with hydrosalpinx. Focal endometriosis is noted in the uterine serosa, and multiple uterine leiomyomata are present. The resection margins are free of abnormal findings."} +{"pid": "TCGA-A6-2671", "report": "The specimen consists of a 22 cm long portion of the left colon, received fresh and later fixed in formalin. The specimen is intact, partially covered with pink-tan, smooth, glistening serosa and abundant yellow lobular fat. It is unoriented, with one end inked blue and the opposite end inked black. Upon opening, the mucosa appears pink-tan, smooth, and glistening, with an average circumference of 5.5 cm. A 3.7 x 2.5 x 0 cm exophytic lesion is present, located approximately 4.5 cm from the nearest luminal margin. The lesion invades through the muscularis propria and is continuous with serosal puckering. Invasion into the surrounding fat is noted, with the closest distance to the radial margin being less than 1 cm. The remaining mucosa shows normal architecture with regular folds and similar coloration.\n\nA number of representative sections were submitted for histological evaluation, including areas of tumor transition to normal tissue, serosal changes, and various lymph node regions. Histologically, the primary lesion demonstrates moderately differentiated features, with extension through the muscularis propria into subserosal fat but without direct serosal involvement. Both proximal and distal margins are free of disease, while the circumferential (radial) margin is negative, though the tumor comes within less than 1 mm of this margin. Vascular invasion is suspected.\n\nLymph node assessment reveals metastatic involvement in 3 out of 27 nodes examined. Additionally, four pericolonic tumor nodules are identified within the serosal fat, not associated with any lymphoid tissue. These findings indicate regional spread beyond the primary site."} +{"pid": "TCGA-XJ-A83H", "report": "The specimen consisted of a prostate weighing 33 grams and measuring 5.0 cm in length, 5.5 cm in width, and 3.3 cm in thickness. The prostate was sectioned and submitted for analysis in multiple cassettes. Tissue from the bladder neck, urethral margins, and seminal vesicle margins was also examined.\n\nHistologic evaluation revealed no evidence of malignancy at the bladder neck margin. The prostate showed a bilateral involvement with a moderately differentiated glandular proliferation. The Gleason grading system was applied, with a primary pattern of 3 and a secondary pattern of 4. The tumor involved approximately 10% of the prostate and was noted to be multicentric, affecting both lobes. There was no evidence of extraprostatic extension, seminal vesicle invasion, perineural invasion, or vascular invasion. Surgical margins were negative for tumor involvement.\n\nPathologic staging was determined to be pT2c, indicating organ-confined disease with bilateral involvement. This assessment is based solely on available pathologic data and may not reflect the full clinical context."} +{"pid": "TCGA-66-2781", "report": "The examined left upper lobe specimen measured 21 x 15.5 x 5 cm and was fixed in an inflated state. The central bronchus resection plane was located 0.1 cm proximal to the division into the apical group and lingular bronchus. At the hilus, six blackish pigmented lymph nodes were identified, measuring up to 2.3 cm in size. Several staple suture lines were noted: one 7 cm long running cranially from the hilus, an oblique 4 cm suture line dorsal to the hilus, and a third, slightly branched 13 cm suture line extending caudodorsally from the hilus.\n\nIn the apical pleura over S1, there was a 3 cm striated area of grayish discoloration with focal plate-like thickening. Centrally, within the boundary region of S1\u2013S3, a firm whitish lesion was present, measuring up to 3.6 cm, with patches of black and pale yellow coloration. The demarcation of this lesion was indistinct, with the main mass located in S2. A polypoid extension was observed in the central section of B2, ending within the lesion. The endobronchial component extended approximately 1 cm from the central bronchus resection plane. Peripheral growth reached as close as 0.2 cm to the medial visceral pleura over S2.\n\nA 0.6 cm blackish pigmented lymph node was found at the first branch of B3 near the lesion margin. The remaining parenchyma of the upper lobe showed rarefaction with lacunae up to 0.3 cm in size. Beneath the apical pleural thickening over S1, the parenchyma appeared compacted and pale, forming a seam up to 0.6 cm wide across a 4.5 cm area.\n\nLymph node stations examined included: station 12 (lower lobe), with a 1.5 cm lesioned node; station 10 (hilar), a 1.2 cm node with sparse surrounding tissue; station 6 (paraaortic), a 2.2 cm node with surrounding tissue; station 5 (subaortic), a 0.9 cm node; and station 7 (subcarinal), a 1.3 cm node with some surrounding tissue.\n\nSections submitted for histological analysis included multiple areas of the lesion involving the pleura, endobronchial extension in B3, and associated lymph nodes. Also examined were sections from S1, S2, bronchovascular margins, hilar lymph nodes, and other regional lymph node stations. Tissue processing included Elastica-van Gieson, PAS, and diastase-PAS staining in some blocks.\n\nHistological and cytological findings were not detailed due to capacity constraints. The evaluation revealed a central to peripheral bronchopulmonary lesion with features including large-cell morphology, focal gigantocellular changes, and slight keratinization. Based on the extent of spread, the staging classification was pT2 pN0 pMX V1 R0, stage B. Additional findings included moderate centrilobular emphysema, focal intraalveolar accumulation of pigmented macrophages, and a subpleural fibrotic zone at the apex. Lymph nodes showed anthracotic pigment deposition without evidence of involvement.\n\nAll resection margins, pleural surfaces, and identified lymph nodes were free of tumor. No asbestos bodies were identified in the available sections, although further dust analysis is recommended to assess potential exposure history."} +{"pid": "TCGA-2Y-A9H8", "report": "The liver specimen from a partial hepatectomy measuring 10 x 9 x 9 cm was received along with the attached gallbladder. The surgical resection margin of the liver was inked blue and found to be free of tumor involvement. On gross examination, the liver surface was mostly smooth with a focal nodular area. A solitary mass measuring 8 x 6.5 x 6.5 cm was identified in the right lobe. The mass was well circumscribed with a gray to pink, multilobulated cut surface. Areas of necrosis and hemorrhage were present, along with a central stellate scar. The tumor was located subcapsularly, coming within 0.1 cm of the overlying capsule and 7 mm from the closest parenchymal surgical margin.\n\nMicroscopic evaluation revealed moderately differentiated cells arranged in trabeculae of varying thickness. Nuclear pleomorphism was observed, with cells containing eosinophilic cytoplasm and vesicular nuclei. Immunohistochemical staining showed positivity for AFP and HepPart. CEA staining also demonstrated a canalicular pattern. These findings were confirmed using appropriate controls on block A2.\n\nHistologic assessment indicated no involvement of the regional lymph nodes or distant metastases; however, these could not be fully assessed. Vascular invasion was identified within the specimen. The non-tumor liver tissue showed evidence of cirrhosis and fibrosis. The gallbladder measured 8 x 2.5 x 2.5 cm, with a smooth serosal surface and a cystic wall thickness of 0.1 cm. Microscopically, the gallbladder showed features of mild chronic cholecystitis. No calculi were identified."} +{"pid": "TCGA-UT-A88D", "report": "HISTOPATHOLOGY REPORT: CLINICAL NOTES: Probable mesothelioma. MACROSCOPIC: The specimen consists of five irregular pink membranous pieces of tissue measuring between 3mm and 18x10x3mm in maximal dimension, each with firm thickened white nodules ranging from 2mm to 5mm in size. All tissues were embedded for analysis (Block A and B - 4 pieces each, Block C - 3 pieces). A PAS diastase stain was requested for each block. MICROSCOPIC: Sections show involvement of pleura including pleural adipose tissue by a malignant infiltrate. The malignant cells are arranged in cohesive aggregates with tubulopapillary clefts and micropapillary areas. The cells exhibit large irregular nuclei with prominent nucleoli and variable eosinophilic to clear cytoplasm. A fibrous stromal background is present, and the malignant cells are seen infiltrating between islands of fat cells. Areas of fat necrosis are also observed. No intracytoplasmic mucin was identified on PAS diastase staining. Immunohistochemical analysis demonstrates positivity for CK5/6 and HBME1, while stains for TTF1, MOC31, and monoclonal CEA are negative."} +{"pid": "TCGA-MK-A4N9", "report": "The pathology report includes findings from a total thyroidectomy and lymph node dissection. The thyroid specimen weighed 160 grams and measured 9.8 cm in greatest dimension. Three distinct areas of concern were identified: a 2.1 cm lesion in the right lobe, a 2.6 cm lesion in the isthmus, and a 0.4 cm lesion in the left lobe. All lesions were located peripherally and showed calcifications. No involvement of surgical margins or lymphovascular invasion was observed. A possible lymph node adjacent to the isthmus was examined but showed no abnormal findings; it measured 3.5 x 2.4 x 1.1 cm. One parathyroid gland was identified on the left side.\n\nIn the right paratracheal lymph node dissection, one out of four lymph nodes showed evidence of involvement. A parathyroid gland was also identified in this region. In the left paratracheal lymph node dissection, no abnormalities were found in the two lymph nodes examined, and a parathyroid gland was again identified.\n\nStaging was based on tumor size and regional lymph node involvement. Tumor measurements, lymph node status, and absence of distant spread contributed to the staging classification."} +{"pid": "TCGA-2G-AAFL", "report": "The pathology report describes a left orchidectomy specimen. The tumor measured 4 cm in greatest dimension and was entirely confined to the testis. Histologic evaluation demonstrated angioinvasion; however, there was no evidence of involvement of the rete testis."} +{"pid": "TCGA-T3-A92M", "report": "A total laryngectomy and partial pharyngectomy specimen was received measuring 7.7 x 5.2 x 4.6 cm. A portion of pharynx measuring 3.0 x 2.1 cm was attached to the right side. A mass measuring 4.0 x 3.4 cm was identified grossly within the submucosa of the right laryngeal wall, not extending into the vocal cords or attached thyroid tissue. The tumor measured 4.1 cm in greatest dimension and was predominantly located on the right side. Gross evaluation showed no extension beyond the outer cortex of the thyroid cartilage.\n\nMargins were evaluated with frozen section analysis. The inferior anterior tracheal margin, right and left lateral pharyngeal wall margins, and mucosal base of tongue margin all showed no evidence of invasive or in situ carcinoma.\n\nLymph node evaluation included three lymph nodes from the right level 2B region, all measuring less than 3 cm, with all three involved by metastatic disease and showing extracapsular extension. In the left level 2A region, one lymph node measuring 1.7 cm was identified with metastatic involvement and extracapsular extension.\n\nBenign salivary gland tissue was identified without evidence of malignancy. Histologic sections were cut from multiple regions including the tracheal mucosa, anterior tracheal wall, vocal cords, pyriform sinuses, epiglottis, and other areas for detailed microscopic evaluation.\n\nFrozen tumor sample weighing 250 mg was collected and stored in a cryovial. A fresh tumor sample of 100 mg was also collected. Whole blood (10 ml) was collected in an EDTA tube, mixed, and stored frozen. Three H&E-stained slides were prepared from the diagnostic formalin-fixed paraffin-embedded block. All samples were batched and shipped according to protocol."} +{"pid": "TCGA-73-4662", "report": "The specimen included multiple tissue samples from the left upper lobe of the lung and associated lymph nodes. A 4R lymph node measuring 0.8 x 0.6 x 0.4 cm and a 4L lymph node measuring 0.6 x 0.5 x 0.4 cm were both negative for malignancy. A wedge biopsy of the left upper lobe revealed a well-circumscribed lesion measuring 1.5 x 1.0 x 0.6 cm, located 0.5 cm from the stapled margin. Histologic evaluation showed invasive, moderately differentiated glandular-type cells with mixed growth patterns. The tumor measured 2.0 cm in maximum dimension microscopically. Another wedge biopsy from the same lobe showed no evidence of malignant cells, though mild emphysematous changes were noted.\n\nA lobectomy specimen measuring 10.4 x 7.8 x 3.5 cm was examined; the bronchial margin was free of abnormal cells. No distinct mass was identified in this specimen, and multiple lymph nodes were evaluated, all without evidence of involvement. There was no angiolymphatic invasion, visceral pleural involvement, or satellite lesions. Nine lymph nodes from hilar and peribronchial regions were negative, as were lymph nodes from mediastinal and contralateral regions. The staging was based on tumor size and absence of spread, with no distant metastasis assessed."} +{"pid": "TCGA-A8-A07G", "report": "The specimen demonstrates a moderately differentiated invasive component with discrete intraductal spread. The invasive lesion measures 1.9 cm in diameter. Histologic assessment reveals involvement of one lymph node. Vascular invasion is present. The tumor is classified as NOS, grade II, with a staging designation of pT1cN1aLOVORO."} +{"pid": "TCGA-D7-A6F0", "report": "The specimen includes a resected stomach measuring 28.6 x 27.9 cm, along with attached omentum (52 x 18 cm) and spleen (12.2 x 5.8 x 3.9 cm). Additional tissue includes pieces of pancreas measuring 4 x 1 cm and 5 x 2 cm. A lesion measuring 12.8 x 11.7 x 2.9 cm is present in the cardia region on the posterior wall of the stomach, located 0.4 cm from the proximal margin and 23 cm from the distal margin.\n\nHistological evaluation shows glandular and solid growth patterns with mucinous features. The lesion extends through the full thickness of the stomach wall and into the perigastric fat. Margins of resection, lymph nodes (17 examined), omentum, spleen, and pancreatic tissue show no evidence of involvement."} +{"pid": "TCGA-A2-A0T2", "report": "The surgical specimen from a female patient included right breast and axillary contents. The mastectomy specimen weighed 788 grams and measured 24 x 17 x 5 cm in greatest overall dimension. An attached skin ellipse measured 11.5 x 8.5 cm, with an eccentrically located nipple. Surgical orientation was indicated by sutures and dyes: superior lateral/upper outer was marked with orange, lower outer with green, upper inner with black, lower inner with red, and the deep surgical margin with yellow.\n\nA dense gray-white mass measuring 10.5 x 5.5 x 4 cm was identified within the breast tissue. It appeared to be 3 cm from the superior lateral/upper outer margin, 3 cm from the upper inner, 3.5 cm from the lower outer, and 4 cm from the lower inner. The tumor was approximately 0.8 cm from the deep surgical margin. Gross features of the tumor included yellow-tan chalky areas up to 0.2 cm and small hemorrhagic regions. Sectioning of the axillary fat revealed tan-gray nodules up to 2.5 cm, each bisected with one-half submitted for analysis.\n\nMicroscopic evaluation confirmed a poorly differentiated infiltrating ductal carcinoma, Scarff-Bloom-Richardson Grade III. Lymphovascular invasion was present. All surgical margins were free of involvement, with the closest being the deep surgical margin at 1.2 mm from the lesion. Evaluation of fourteen lymph nodes showed ten to contain metastatic deposits. Staging was determined as T3, N3, MX, corresponding to Stage IIIC. A total of twenty tissue blocks were examined, including sections from the nipple, surgical margins, tumor, random tissue, and lymph nodes."} +{"pid": "TCGA-OR-A5JP", "report": "The specimen consists of a left adrenal gland weighing 504 g and measuring 110 x 110 x 85 mm. A 100 mm tumour largely replaces the adrenal gland. The tumour is multinodular with a variable cut surface showing solid tan lobules, yellow/orange areas, and regions of haemorrhage, cystic change, and necrosis. The tumour appears at least partially encapsulated, with no macroscopic evidence of invasion. A small amount of uninvolved adrenal tissue is identified at the periphery.\n\nMicroscopically, the tumour exhibits a diffuse, sheet-like growth pattern with areas of myxoid degeneration separated by fibrous septa. The cells are polygonal with abundant eosinophilic cytoplasm and scattered clear cells. Nuclear features include enlargement, pleomorphism, coarse chromatin, and prominent nucleoli. Mitotic activity is present at a rate of 13 per 50 high-power fields, including atypical forms. Broad areas of necrosis and haemorrhage are observed. Although the tumour extends to the adrenal capsule, it appears confined to the adrenal gland, with no evidence of vascular invasion. Margins of excision are free of tumour.\n\nImmunohistochemical staining is positive for inhibin, calretinin, and Melan A, and negative for chromogranin. Histological sections show tumour in the central region, as well as at the periphery near the capsule. The Weiss score is 6, and Ki67 labelling shows 25\u201336% of tumour cells in the most proliferative areas. The tumour is staged as pT2, NX, MX according to AJCC 7th edition criteria."} +{"pid": "TCGA-G9-6494", "report": "The prostate specimen weighed 85 grams and measured 7.0 cm from left to right, 4.5 cm from apex to base, and 4.0 cm from anterior to posterior. It was sectioned serially from apex to base, revealing gray-white, firm, spongy tissue. A nodule measuring 1.2 cm in greatest dimension was identified in level 1. The right and left seminal vesicles measured 3.5 x 1.5 x 1.0 cm and 2.0 x 1.8 x 1.0 cm respectively, and were cystic but without gross evidence of tumor involvement. Segments of the right and left vas deferens measured 3.0 x 0.6 cm and 3.6 x 0.8 cm respectively, and showed no gross signs of tumor. \n\nSerial sections of the prostate were submitted for microscopic examination, including perpendicular sections of the apex and base, as well as anterior and posterior capsule areas at various levels. Sections of the seminal vesicles and vas deferens were also included.\n\nExamination of the lymph nodes revealed reactive changes only. No tumor cells were identified in either the right or left pelvic lymph nodes. \n\nMicroscopic evaluation of the prostate showed a Gleason score of 4 + 3 = 7/10. High-grade prostatic intraepithelial neoplasia was present. Perineural invasion was noted. There was evidence of infiltration into adipose tissue. Involvement of the bladder neck was confirmed, with extensive margin involvement at the left and right base. Positive margins were observed in multiple sections. \n\nPathological staging was determined as pT4, pN0, pMX. No other significant pathological findings were identified."} +{"pid": "TCGA-BH-A202", "report": "The surgical specimen consists of a left segmental mastectomy and sentinel lymph node biopsies. A total of four lymph nodes were examined, all from the left axilla and one from the left internal mammary region. All lymph nodes were negative for metastatic disease.\n\nThe primary lesion measured 2.6 cm in greatest dimension and was classified as high-grade based on Nottingham scoring criteria. The histologic grade was determined by tubule formation (score 3), nuclear pleomorphism (score 3), and mitotic activity (score 3), resulting in a total score of 9 out of 9. No lymphovascular space invasion was identified.\n\nIn addition to the invasive component, there was a significant in situ component occupying 40% of the tumor volume. This was characterized as high nuclear grade ductal carcinoma in situ, solid type with comedo necrosis, and was admixed with the invasive component.\n\nMargins of resection were negative for malignant involvement. The closest distance from the invasive tumor to the anterior margin was 0.4 cm; the ductal carcinoma in situ was 0.3 cm from the anterior margin. Additional benign findings included atypical ductal hyperplasia, ductal epithelial hyperplasia, intraductal papilloma, radial scar, columnar cell changes, and fibrocystic changes. Changes related to a prior biopsy were also noted.\n\nImmunohistochemical staining showed positivity for estrogen and progesterone receptors with H-scores of 250 and 75, respectively. HER2 staining was also positive.\n\nThe tumor stage was pT2 based on size. No nodal metastases were found (pN0), with sentinel node evaluation performed using hematoxylin and eosin staining methods."} +{"pid": "TCGA-SR-A6MR", "report": "The specimen consists of two tissue fragments. The first fragment measures 2.5 x 2.5 x 1.1 cm and exhibits a brown/yellow appearance with an irregular outer surface; slicing reveals a red, beefy cut surface. The second fragment measures 2.7 x 2.4 x 2.0 cm and also has an irregular outer surface, with a yellow, homogenous cut surface upon slicing. A smaller fragment measuring 1.1 x 1 x 1 cm is present with a gray-yellow cut surface.\n\nMicroscopic evaluation demonstrates a lesion associated with sympathetic ganglia, measuring 2.5 cm in greatest dimension. Histologic analysis reveals focal extension into adjacent adipose tissue and involvement of the inked margin. One lymph node examined shows no evidence of tumor involvement, while another lymph node demonstrates reactive changes with lipogranulomas.\n\nCellular features include a moderately increased labeling index based on Ki-67 immunostaining. Specifically, greater than 50 cells per medium power field (20X magnification) demonstrate positivity, representing over 3% of tumor cells in those fields. This labeling index appears elevated compared to prior specimens from the adrenal gland.\n\nFrozen sections were obtained from both specimens during intra-operative consultation. One slice from the first specimen was used for frozen section analysis and submitted along with residual tissue in cassette A1; remaining tissue was submitted in cassettes A2-A4. From the second specimen, slices from both fragments were taken for frozen section evaluation and submitted as cassettes B1 and B2. The remaining portions of both fragments were submitted entirely in cassettes B3-B6.\n\nNo pre- or post-operative diagnoses were provided. Clinical history indicates prior surgical intervention related to the lesion. Intraoperative consultation findings supported the microscopic characteristics described. All diagnoses were personally reviewed and confirmed by the named pathologist following microscopic examination of the specimens."} +{"pid": "TCGA-M7-A723", "report": "The specimen from a male patient included a tick removed from the left scrotum, which was evaluated for gross identification only. Additionally, right and left pelvic lymph nodes were submitted. In the right pelvic lymph node group, no concerning findings were identified among six lymph nodes. In the left pelvic lymph node group, one of 11 lymph nodes showed involvement with cellular features consistent with spread to lymphatic tissue, including a focus of extension beyond the lymph node capsule. The largest involved lymph node measured 0.9 cm.\n\nA prostatectomy specimen was also received, measuring 4.5 x 4.0 x 3.7 cm and weighing 53.7 grams. Histologic evaluation revealed cellular changes in both lobes, with a greater extent on the left side. The cells showed nuclear atypia and increased architectural complexity, with a combined histologic score of 7. A small component of more aggressive cellular morphology was also noted, accounting for approximately 4% of the affected tissue. Tumor involvement was seen throughout the length of both lobes, from apex to base.\n\nExtracapsular extension was present in multiple areas, including the mid and base regions of both sides. The tumor extended into surrounding perineural, perivascular, and fibroadipose soft tissue. Invasion of the seminal vesicles was also observed bilaterally. Lymphovascular space invasion was present. A surgical margin at the left base showed minimal involvement, with a maximum span of 0.1 mm. Additional findings included perineural invasion and high-grade intraepithelial changes.\n\nLymph node analysis from a separate submission confirmed the presence of similar cellular features in one lymph node, with a focus on extracapsular extension. The primary specimen showed no discrete mass, but an area of firmness and expansion was noted in the posterior lobe. No other significant macroscopic abnormalities were identified.\n\nStaging was based on the available specimens and indicated advanced local extension with regional lymph node involvement. Further clinical correlation is recommended for final staging assessment."} +{"pid": "TCGA-BQ-7048", "report": "The surgical pathology report describes a radical nephrectomy specimen from the left kidney and adrenal gland. The specimen measured 21.0 x 13.0 x 9.0 cm and weighed 1250 grams. A mass measuring 8.0 x 6.0 x 6.0 cm was identified in the renal cortex, with extension into the perirenal fat. The mass was multinodular and yellow in appearance. Multiple black, firm nodules were also present in the perirenal fat, with the largest measuring 1.1 cm. Adjacent to the mass, an area of mottled kidney tissue measured 3.0 x 3.0 x 2.0 cm. The remainder of the kidney, including the pelvis and renal vein, appeared normal without evidence of tumor involvement. The hilum contained multiple lymph nodes, with the largest measuring 1.5 cm. The adrenal gland measured 6.2 x 3.0 x 1.4 cm and weighed 11 grams. A yellow, well-encapsulated nodule measuring 1.7 cm was identified in the adrenal cortex.\n\nMicroscopic evaluation showed a tumor pattern consisting of acinar and papillary growth. Nuclear grading was noted as high (Grade III/IV). The tumor measured 11 cm in its greatest dimension and extended through the renal capsule but remained within Gerota\u2019s fascia. No invasion of the renal vein was observed. All surgical margins were free of tumor involvement. Evaluation of the non-neoplastic kidney tissue revealed no remarkable findings.\n\nLymph node assessment included three groups: hilar, para-aortic, and retroperitoneal. Hilar lymph nodes totaled three, all without metastatic involvement. Para-aortic lymph nodes numbered eight, all benign. Retroperitoneal adipose tissue was unremarkable, with no malignant findings.\n\nIntraoperative frozen section analysis confirmed the presence of a renal cortical neoplasm, which was consistent with the final microscopic diagnosis. Special stains and additional sections were performed as part of the diagnostic process."} +{"pid": "TCGA-G3-AAV3", "report": "The liver segment specimen was obtained from a female patient with a history of Hepatitis C infection. Imaging had identified a solid mass in the left lobe of the liver. A partial hepatectomy was performed, involving removal of less than three segments.\n\nThe excised liver specimen measured 9.5 cm x 7.5 cm x 6.0 cm and weighed 201 grams. Grossly, the specimen contained a well-circumscribed multinodular mass located subcapsularly. The tumor measured 8.5 cm in its greatest dimension and had additional dimensions of 7.0 cm x 6.0 cm. It appeared close to the surgical margin, with the nearest distance being 0.6 cm. The capsule overlying the tumor showed areas of sclerosis but no gross signs of vascular invasion or extracapsular extension. Attached adipose tissue on one side of the capsular surface was not involved. A zone of cirrhotic-appearing liver parenchyma was noted between the tumor and the resection margin.\n\nHistologically, the lesion exhibited a nodular and trabecular growth pattern with broad trabeculae. Nuclear pleomorphism was mild to moderate, and scattered mitotic figures were present. Venous invasion was identified focally at the periphery of the tumor nodule; however, no distant vascular invasion was observed. Resection margins were free of tumor involvement by histologic evaluation, with a distance of 6 mm between the tumor and the closest margin. Fibrous thickening of the liver capsule was noted, but there was no evidence of tumor extension beyond the capsule.\n\nEvaluation of the surrounding liver tissue revealed advanced structural changes consistent with cirrhosis. Portal tracts were well preserved but separated by fibrous septa that disrupted normal lobular architecture. Chronic inflammatory cells, predominantly lymphocytes and plasma cells, were present in portal areas and within fibrous septa, with focal interface hepatitis noted. Minimal fatty change and hemosiderin deposition were also observed. No abnormal inclusions were identified. Immunostains for hepatitis B surface and core antigens were negative. Although the precise etiology of cirrhosis could not be definitively determined, the presence of lymphoid aggregates and the known history of Hepatitis C suggest this as a likely contributing factor. Areas of bile duct dilation within fibrous septa were also seen, possibly representing secondary changes related to cirrhosis.\n\nNo metastatic disease was assessed, and lymph node and distant metastasis status could not be determined. The tumor was confined to the liver without evidence of spread beyond the organ."} +{"pid": "TCGA-D7-5577", "report": "Histopathological examination was performed on a specimen consisting of a stomach measuring 15 x 15.5 cm, resected along the greater curvature, and attached omentum measuring 30 x 14 cm. The tumor was located on the lesser curvature and measured 5 x 6 x 1.1 cm. It was ulcerated and situated 0.7 cm from the proximal resection margin and 8 cm from the distal margin. Microscopic evaluation showed a moderately differentiated tubular growth pattern. The tumor had transmural extension through the gastric wall into surrounding fat tissue and reached the peritoneal surface. Vascular invasion was present. Tumor cells were not identified at the surgical margins. Peritumoral lymphocytic reaction was noted. The mucosa adjacent to the tumor was free of malignant cells but displayed signs of chronic inflammation. No metastases were found in the omentum or accessory spleen.\n\nLymph node assessment revealed metastatic involvement in multiple regional groups: periorificial (No XII/XXI), lesser curvature (No II/II), greater curvature (No II/III), and peripyloric (No III/VIII). Metastases extended beyond the lymph node capsules into surrounding adipose tissue in these regions. Additional nodal stations involved include No XIX/XXXIV. Growth pattern was consistent with an intestinal-type morphology. Histologic grade was G2. Staging was pT2b and pN3. Immunohistochemical analysis using HercepTest\u2122M by DAKO showed no expression of HER2 protein in the neoplastic cells, with a staining score of 0."} +{"pid": "TCGA-DX-A8BZ", "report": "The specimen consists of a right buttock mass and associated margins submitted for evaluation. The primary mass measured 15 x 10.5 x 4 cm and contained a tan-colored lesion located 1.5 cm beneath the skin surface. The skin overlying the mass was ulcerated. Upon sectioning, the lesion measured 8 x 7 x 6 cm and was tan, lobulated, and well-defined with areas of hemorrhage and approximately 10% necrosis. The tumor involved superficial soft tissues with focal extension into underlying skeletal muscle and demonstrated multiple satellite nodules adjacent to the main lesion. The tumor was closest to the deep margin at 0.3 cm and also approached the inferior margin at 0.6 cm, superior margin at 1.5 cm, medial margin at 2 cm, and lateral margin at 1.8 cm.\n\nThe superior margin specimen showed microscopic involvement with tumor extending to the cauterized and inked edge. The new inferior medial margin specimen consisted of fibroadipose tissue and did not show any malignant involvement. The superior margin specimen contained tumor nodules within adipose tissue and extended to the inked margin. All surgical margins were assessed, with the deepest tumor proximity measuring 0.1 cm at the deep margin."} +{"pid": "TCGA-TS-A7P6", "report": "The specimen was received in ten parts. The first part, labeled as \"Rib,\" consisted of two fragments of yellow-tan, focally hemorrhagic trabeculated bone measuring 2.5 cm and 1.1 cm in greatest dimension. These were entirely submitted for analysis.\n\nThe second part, designated \"Diaphragm Muscle,\" was a 2.5 x 1.1 x 1.0 cm piece of red-brown muscle tissue, also fully submitted.\n\nThe third part, \"Pericardium,\" included multiple gray-brown, elastic soft tissue portions that were focally thickened, with an aggregate size of 6.0 x 5.5 x 1.5 cm. These were partially submitted across several cassettes.\n\nSpecimen four, another \"Diaphragm\" sample, measured 3.7 x 1.1 x 0.6 cm and was composed of red-brown soft tissue. It was serially sectioned and entirely submitted.\n\n\"Lung\" was the fifth specimen, a 3.0 x 1.1 x 0.6 cm portion of gray-tan soft tissue, serially sectioned and fully submitted.\n\nSpecimen six, labeled \"Level 5,\" contained two gray-tan soft tissue pieces measuring 1.2 cm and 1.0 cm. Both were submitted completely.\n\nThe seventh part, \"Level 9,\" included two gray-tan to yellow soft tissue portions measuring 0.6 cm and 0.9 cm, both submitted entirely.\n\nSpecimen eight, \"Level 7,\" was a 1.9 x 0.8 x 0.3 cm gray-tan soft tissue fragment, bisected and fully submitted.\n\nThe ninth and largest specimen, \"Pleura,\" was a diffusely thickened and bosselated white-tan tissue measuring 24.0 x 15.0 x 0.9 cm. This was extensively sampled and submitted across multiple cassettes.\n\nLastly, the tenth specimen, \"Posterior Intercostal,\" comprised three yellow-tan lobulated adipose tissue fragments measuring 0.6 cm, 1.0 cm, and 1.1 cm, all submitted entirely.\n\nMicroscopic evaluation revealed benign lamellar bone with trilinear marrow in the rib sample. Diaphragm muscle showed skeletal muscle and fat without abnormal cells. Pericardium displayed soft tissue with cellular features suggestive of malignancy. Another diaphragm sample showed fibrofatty tissue with inflammation and isolated malignant cells. Lung parenchyma showed no abnormal findings.\n\nLymph node sections from Level 5 revealed no malignancy, though rare detached malignant cells were noted in adjacent soft tissue. Level 9 lymph nodes were unremarkable, but the associated soft tissue showed significant inflammation. Level 7 lymph nodes contained malignant cells with extension beyond the nodal capsule.\n\nPleural sections demonstrated extensive involvement by atypical cells with epithelioid morphology and focal vascular invasion. Involvement of underlying pulmonary parenchyma was also identified. Lymph node analysis indicated five examined nodes, two of which were involved. Staging was determined as pT2 N2 Mx."} +{"pid": "TCGA-AN-A0FF", "report": "Female patient, left breast primary tumor specimen obtained via surgery, processed in OCT and stored in tissue block format. Histological evaluation revealed infiltrating cells with grade 2 differentiation. No lymph node involvement or metastasis was detected (T1, N0, M0). No prior treatment administered. Normal blood sample collected via venipuncture and stored frozen in a tube."} +{"pid": "TCGA-63-A5MN", "report": "The specimen was obtained from a resection procedure performed on the right upper lobe. The tumor measured 5.5 cm in size. Histological examination revealed malignant cells with characteristics consistent with squamous differentiation. The degree of differentiation was classified as Grade III. Pathological staging demonstrated involvement classified as T3, NOS for pathological T category. Lymph node involvement was categorized as pathological N and distant metastasis was clinically staged as M0. Additional samples included a buffy coat specimen collected in the same timeframe."} +{"pid": "TCGA-23-2647", "report": "The pathology report describes findings from multiple tissue specimens obtained during surgery. The specimens include both ovaries, fallopian tubes, uterus, omentum, peritoneal tissues, and various soft tissue sites. Microscopic evaluation reveals widespread involvement by a high-grade epithelial neoplasm. Extensive serosal involvement is noted in the uterus and both ovaries, with small nodular tumor aggregates identified within the ovarian parenchyma. The largest invasive nodule within the right ovary measures approximately 0.8 cm in diameter.\n\nTumor involvement is also present in the omentum, with extensive nodular and plaque-like deposits observed in multiple sections. Similar tumor deposits are found in soft tissue specimens from the abdominal wall, pericolic region, bladder flap, and side wall. No colonic tissue is identified in the specimens designated as colon or cecum tumors.\n\nExamination of the fallopian tubes reveals involvement at the fimbriated ends, with detached tumor fragments seen within and adjacent to the lumen. There is also evidence of epithelial hyperplasia and focal high-grade dysplastic changes at the fimbrial end of the left fallopian tube. Lymphovascular invasion is present in several involved sites.\n\nImmunohistochemical staining for Ki-67 demonstrates positive nuclear staining in approximately 70% of the epithelial cells in the dysplastic and neoplastic areas at the fimbriated end of the fallopian tube and in detached tumor aggregates. Staining for p53 reveals a signature pattern in the native tubal epithelial cells at the fimbriated end, with more than six consecutive positive nuclei observed in some areas.\n\nHistologic evaluation of the tumor cells shows a poorly differentiated morphology. Involvement of paraovarian and paratubal ligaments is extensive, and tumor cells are also found within lymphatic channels. Additional findings include secondary inflammatory changes, fibrosing stromal reaction, adhesions, and reactive mesothelial proliferation near tumor sites.\n\nLymph node assessment is not possible due to absence of lymph nodes in the specimens. The primary tumor is considered to be at stage pT3c based on the presence of macroscopic peritoneal metastases beyond the pelvis measuring more than 2 cm in greatest dimension."} +{"pid": "TCGA-EM-A3SZ", "report": "The specimen consisted of a total thyroidectomy with stitch marks indicating the upper pole of the right lobe. The thyroid specimen measured 4.4 x 2.8 x 2.1 cm on the right lobe, 5.0 x 2.3 x 1.3 cm on the left lobe, and 4.0 x 1.0 x 0.7 cm at the isthmus, with a total weight of 24.1 grams. A dominant nodule measuring 2.6 x 1.6 x 1.6 cm was identified in the superior mid-right lobe. A second smaller nodule, measuring 0.5 x 0.4 x 0.5 cm, was noted in the mid-pole of the left lobe. Both nodules exhibited red-tan cut surfaces with soft and flabby consistency.\n\nHistologically, the dominant lesion showed mixed classical and Warthin-like architecture with focal tall cell features (<10%) and hobnail cell changes (<20%). The tumor was partially encapsulated with widespread capsular invasion. Margins were free of involvement, with the closest margin measuring 0.1 mm from the invasive component. No lymphovascular or perineural invasion was identified, and no extrathyroidal extension was present.\n\nA second lesion measuring 0.2 cm was identified in the left lobe, displaying follicular architecture with classical cytology. This lesion lacked a capsule, and no capsular invasion was observed. Margins were also uninvolved.\n\nFour regional lymph nodes were examined (right paratracheal, isthmic, and left perithyroidal), none of which showed evidence of involvement. Additional findings included chronic lymphocytic thyroiditis in the surrounding thyroid tissue. Parathyroid tissue from the right upper and left intrathyroidal regions showed no pathological changes.\n\nBased on AJCC/UICC TNM staging criteria, the primary tumor was classified as pT2 (tumor greater than 2 cm but less than 4 cm confined to the thyroid), with pN0 (no regional lymph node metastasis) based on four lymph nodes examined. The case involved multiple primary tumors (m)."} +{"pid": "TCGA-AG-4007", "report": "The resected colon specimen shows an ulcerated, moderately differentiated adenocarcinoma of the colorectal type. The lesion is located 3.5 cm from the aboral resection margin and demonstrates broad infiltration of the pericolic fatty tissue, extending to involve an adjacent seminal vesicle. Five local lymph node metastases are identified. All colon resection margins are free of tumor involvement. The minimum distance from the tumor to the circumferential resection margin is 0.2 cm. Pathologic staging indicates extensive local spread with lymph node involvement, and there is clinical evidence of distant metastasis. Histologic grade is intermediate, with lymphatic invasion present and venous invasion absent. A subtotal resection was clinically assessed."} +{"pid": "TCGA-AK-3436", "report": "The surgical specimen from the left kidney and adrenal gland was received as a fresh, labeled nephrectomy specimen. The entire left kidney measured 15 x 7 x 6.5 cm and was embedded in perinephric fat that was difficult to dissect. The adrenal gland measured 3 x 3 x 1.5 cm and appeared unremarkable. A well-circumscribed, yellowish-orange mass measuring 9 x 6 x 6 cm was identified in the lower pole of the kidney, accounting for approximately 55% of the kidney's volume. The mass was lobulated, with areas of calcification, and extended into the renal pelvis, distorting the inferior calix and central collecting system. It also bulged toward the renal capsule without evidence of direct invasion. The ureteral margin measured 8 cm in length and showed no abnormality. No suspicious lesions or lymph nodes were found within the perinephric fat. Sections were taken from multiple areas including the tumor, surrounding capsule, hilum, ureteral margin, normal kidney tissue, adrenal gland, and perinephric fat.\n\nA separate specimen labeled as periaortic lymph nodes consisted of several tan, rubbery lymph nodes ranging in size from 0.5 to 3 cm. All lymph nodes were submitted for analysis. Histologic evaluation of both specimens revealed no evidence of tumor involvement. The tumor was confined to the kidney without angiolymphatic invasion, and all surgical margins were negative. Lymph node assessment showed no metastatic disease. The pathologic stage is consistent with localized disease without nodal involvement."} +{"pid": "TCGA-S7-A7WV", "report": "The left adrenal gland contained a mass measuring 120x80x55 mm and weighing 219 grams. The lesion was encapsulated and showed extensive hemorrhage on gross examination. Five tissue blocks were submitted for analysis. Microscopically, there was a cellular neoplasm with extensive necrosis, with only small areas of viable tumor remaining. The necrotic regions exhibited granular neutrophil infiltration, siderophagia, and early fibrotic changes at the periphery. Adjacent to the tumor, there was evidence of reactive fibrosis and post-hemorrhagic changes in the surrounding adipose and fibrous tissue. Viable tumor cells demonstrated high cellularity, monotonous appearance, and spindle-shaped morphology. Nuclear pleomorphism and hyperchromasia were present. Mitotic activity was notable, with more than 3 mitotic figures per 10 high-power fields, including atypical forms. Growth pattern included large nests and diffuse sheets involving more than 10% of the tumor volume. Necrosis was centrally located within large nests and was confluent in areas. Tumor extension into surrounding adipose tissue and capsular invasion were observed. Vascular invasion was not identified. Immunohistochemical staining showed strong positivity for chromogranin in tumor cells, while surrounding adrenal cortex and adipose tissue were negative. MIB-1 labeling index was 3\u20135%. Staining for CD34 and factor VIII did not show angioinvasion. S100 highlighted sustentacular cells only focally. A scoring system applied to the tumor yielded a total of 8 points based on features such as growth pattern, necrosis, cellularity, nuclear features, and invasion."} +{"pid": "TCGA-97-A4M7", "report": "The clinical report includes details regarding molecular testing performed on lung tissue samples. DNA was extracted from tissue sections and analyzed using polymerase chain reaction (PCR) followed by bi-directional direct sequencing to assess specific gene regions. The analysis focused on exons 18-21 of a receptor gene associated with tyrosine kinase activity, as well as codons 12 and 13 of another gene commonly implicated in cancer pathways. Testing was conducted to evaluate the presence of mutations that may influence therapeutic response.\n\nIn one sample obtained from the right middle lobe of the lung, a specific mutation was identified in exon 21 of the receptor gene. This mutation has been previously associated with responsiveness to certain tyrosine kinase inhibitor therapies. The sample demonstrated high tumor cellularity, approximately 90%, which is above the recommended threshold for accurate detection. Additionally, a known polymorphism without clinical significance was also detected in this sample.\n\nIn contrast, no mutations were found in the corresponding receptor gene in a second sample from the right lower lobe of the lung. This sample also showed high tumor content, meeting the optimal requirements for mutation analysis. A separate assessment of codons 12 and 13 in the other gene revealed a mutation in the right lower lobe sample, which has been associated with resistance to targeted therapies and poorer prognosis. However, the same region in the right middle lobe sample did not show any mutations.\n\nThe methodology involved pathologist review of tissue sections to ensure appropriate tumor selection. DNA amplification and sequencing techniques were used, with limitations including the potential for false-negative or false-positive results due to factors such as genetic heterogeneity or low mutation burden. The sensitivity of the assays is estimated at 10\u201320%, meaning mutations present in less than this proportion of cells may not be detected.\n\nTesting was performed in a CLIA-certified laboratory under validated protocols for high-complexity testing. It is noted that these tests are not standalone diagnostics and should be interpreted in the context of other clinical findings and diagnostic tools.\n\nThe surgical specimens included a wedge resection from the superior segment of the right lower lobe and a lobectomy from the right middle lobe. Both tumors were morphologically distinct and considered separate primary lesions. The right lower lobe lesion measured 1.6 cm and consisted predominantly of a specific growth pattern, while the right middle lobe tumor measured 2.7 cm and was composed mainly of a different histological component. All surgical margins were free of tumor involvement. No lymph node metastases were identified among the 11 lymph nodes examined.\n\nSpecial stains were performed to assess for certain tissue features, and no evidence of specific tissue invasion was found. Additional immunohistochemical studies were conducted using analyte-specific reagents that have not been cleared by the FDA but are permitted under laboratory-developed test guidelines.\n\nThese findings contribute to the overall understanding of the molecular profile of the tumors and may guide further treatment planning."} +{"pid": "TCGA-E9-A1NA", "report": "The specimen consisted of breast tissue from a radical mastectomy. A grossly evident lesion was identified, measuring 2.4 x 2.4 x 2.4 cm. Histologic evaluation revealed a combination of infiltrating ductal and lobular features. The tumor involved 0 out of 11 lymph nodes examined, with no indication of extracapsular invasion. The lesion was located in the lower outer quadrant of the breast. Several key histologic parameters, including tubule formation, nuclear pleomorphism, and mitotic counts at both 25x and 40x magnification, were not specified, precluding calculation of a definitive Nottingham Histologic Score. Other details regarding tumor extent, margins, neo-adjuvant treatment, and additional findings were not provided."} +{"pid": "TCGA-33-AASJ", "report": "The right lower lobe resection specimen included a firm white-gray lobulated mass measuring 5 x 4.7 x 3 cm, located in close proximity to the hilar region of the lung and extending subpleurally without involvement of the visceral pleura. The tumor was found to approach the bronchus, with representative sections submitted for evaluation. Surgical margins, including bronchial, vascular, and stapled margins, were all negative for involvement. One benign hilar lymph node was identified and showed no evidence of tumor. A total of five lymph node groups were assessed: station 7 (two lymph nodes), R-11 (one lymph node), R-10 (one lymph node), and R-4 (one lymph node), all of which were negative for tumor involvement. The overall pathologic staging was determined as T2N0MX. Multiple cassettes containing representative sections of tumor, adjacent lung tissue, and margins were submitted for histologic examination. No other mass lesions were identified."} +{"pid": "TCGA-43-5670", "report": "The specimen included multiple lymph node samples from various levels, including R4, L4, level 5, level 7 (multiple specimens), level 9, and level 10. All lymph nodes were excised and found to be negative for metastatic involvement. The tissue fragments varied in size, with dimensions ranging from 0.4 cm to 4 cm in greatest dimension. Tissues were described as tan-red, gray-black, or rubbery in appearance, and all were entirely submitted for analysis.\n\nA left lower lobe lobectomy specimen was also received, weighing 312 grams and measuring 15.0 x 11.0 x 5.5 cm. A 7.8 cm staple line was present superiorly, and a palpable mass was noted at the hilum. A tumor mass measuring 5.5 x 5.0 x 4.0 cm was identified, with focal necrosis and tan-white appearance. The tumor was located within 1 cm of the bronchial stump and 0.2 cm of the inked pleural surface. No additional mass lesions were identified. The remaining lung parenchyma showed spongiform tan-pink to tan-red tissue with diffuse anthracosis. Three hilar lymph nodes were recovered, measuring up to 1.4 cm in diameter, and were negative for tumor involvement.\n\nMicroscopically, the tumor demonstrated features of poorly differentiated invasive carcinoma, with extension through the pleura but not reaching the outer surface. Resection margins were free of tumor, and no vascular invasion was identified. Regional lymph node analysis showed no evidence of tumor spread. Additional findings included chronic emphysematous changes with dilated air spaces, variable fibrosis, and mild inflammation."} +{"pid": "TCGA-VS-A957", "report": "Biopsy of the uterine cervix reveals a poorly differentiated squamous cell carcinoma with infiltrative growth pattern. The tumor cells exhibit marked nuclear atypia, increased nuclear-to-cytoplasmic ratio, and frequent mitotic figures. No distinct tumor nests or keratinization are identified. The lesion involves the full thickness of the epithelium and extends into the underlying stroma with irregular, finger-like projections. Stromal invasion is present and exceeds 3 mm in depth. No lymphovascular space invasion is observed. Specimen margins are positive for neoplastic involvement."} +{"pid": "TCGA-KK-A8IM", "report": "The prostate specimen measured 5.4 x 3.3 x 2.7 cm and weighed 31.0 grams after fixation. Three separate foci of abnormal tissue were identified. The first focus, located in the left lateral and left posterolateral peripheral zone, measured 1.0 x 0.8 cm in its largest cross-sectional dimension and was present in three cross sections, involving the apex focally and the base extensively. The second focus, in the right lateral and right posterolateral peripheral zone, measured 0.6 x 0.2 cm in the largest cross-section and was found in two cross sections, located focally in the apical region. A third focus was identified in the right transition zone, measuring 0.3 x 0.2 cm in the largest cross-sectional dimension and present in a single cross section, located focally in the base region. All abnormal tissue was confined within the prostate gland. The surgical margins of resection showed no evidence of abnormal cells. High-grade prostatic intraepithelial neoplasia was also noted. The right and left seminal vesicles, as well as segments of the right and left vasa deferentia, showed no abnormal findings. \n\nLymph node evaluation included three right obturator lymph nodes (ranging from 1.0 to 4.1 cm) and two left obturator lymph nodes (ranging from 0.7 to 2.2 cm). No abnormal cells were identified in any of the lymph nodes examined."} +{"pid": "TCGA-A2-A0D4", "report": "The specimen consisted of a left breast quadrantectomy and axillary lymph nodes from a Black female. The quadrantectomy specimen weighed 408 grams and measured 19.0 cm (superior-inferior), 14.0 cm (medial-lateral), and 4.0 cm (anterior-posterior). It contained a single well-defined tan-pink mass measuring 3.0 x 2.0 x 1.7 cm with gritty consistency and focal congestion. The mass was located closest to the anterior margin, coming within 0.5 cm of it. A 0.4 cm red-brown biopsy cavity containing an embedded metallic clip was identified within the mass. Margins were negative overall; however, tumor tissue was noted as close as 0.27 cm to the anterior inked margin. Surrounding tissue included lobulated adipose tissue with approximately 20% fibrous component.\n\nHistologic examination revealed a moderately differentiated infiltrating lesion with a Nottingham score of 7 out of 9 (tubules = 3, nuclei = 2, mitoses = 2). Venous and lymphatic invasion were present. Adjacent ductal changes included an intraductal component showing intermediate nuclear grade features with solid architecture, focal intraluminal necrosis, and microcalcifications.\n\nA total of 23 lymph nodes were evaluated from levels 1 and 2 of the axilla. Of these, one lymph node contained metastatic involvement with the largest focus measuring 1.4 cm. This deposit demonstrated focal extranodal extension measuring less than 0.1 cm.\n\nImmunohistochemical staining showed strong positivity for estrogen receptors (>95% nuclear staining) and moderate positivity for progesterone receptors (60\u201370% nuclear staining). HER2 immunohistochemistry was scored as 2+, with fluorescence in situ hybridization pending at the time of reporting.\n\nThe lesion measured 3.0 cm grossly and had spread to regional lymph nodes. No distant staging information was available. Additional findings included prior biopsy site changes and no evidence of other lesions within the resected tissue. Tissues were fixed in formalin for 84 hours prior to processing."} +{"pid": "TCGA-HT-8110", "report": "The pathology report reveals a moderately hypercellular proliferation of moderately atypical fibrillary astrocytes with diffuse invasion into the gray and white matter. Scattered mitotic figures are present. No definitive necrosis or microvascular proliferation is identified. There is a focus of acute and remote hemorrhage associated with degenerating surrounding parenchyma, though this cannot be conclusively attributed to spontaneous necrosis."} +{"pid": "TCGA-HT-A619", "report": "Numerous MIB-1 reactive cells are present throughout the specimen. In the most proliferative areas, a labeling index of 9.6 percent is calculated. Microscopic examination of frozen section and permanent material reveals a glial neoplasm composed of a proliferation of cells with prominent perinuclear halos. The tumor cell population demonstrates moderate nuclear atypia and a paucity of fibrillary processes, with occasional cells showing more pronounced atypia. Up to 3 mitotic figures per 10 high power fields are observed. Neither necrosis nor microvascular proliferation are identified. The tumor infiltrates both the white and grey matter. There is background hemorrhage and scattered calcifications. Foreign surgical material is focally encountered."} +{"pid": "TCGA-J4-A67T", "report": "The prostatectomy specimen measured 3.5 x 3.5 x 3 cm and weighed 47 grams. The gland had a disrupted capsule at the bladder resection margin, previously inked black on the left and blue on the right. On sectioning, a firm, focally nodular area was identified. A dominant nodule measuring 1.1 cm was present. No tumor was identified in the seminal vesicles or vasa deferentia. Margins were clear except for the right posterior prostate where the capsule appeared disrupted by an iatrogenic incision; no extraprostatic extension was observed.\n\nHistologic evaluation showed a Gleason score of 3 + 4 = 7 out of 10 with no tertiary pattern identified. The extent of involvement was assessed as 3 out of 5, indicating between 15% and 30% tissue involvement. Perineural invasion was present, while lymphatic (small vessel) invasion was not seen. Review of the specimen confirmed focal penetration through the capsule at the right posterior prostate; however, surrounding fibrous tissue suggested complete excision. \n\nLymph node assessment included eight nodes from the right extended pelvic dissection, all negative for tumor involvement. Fatty tissue over the prostate also showed no tumor.\n\nStaging was updated to pT3a based on the focal capsular penetration at the right posterior margin, with pNO for lymph nodes and pMX for distant metastasis not assessable. Additional clinical correlation is recommended."} +{"pid": "TCGA-B9-5155", "report": "The right kidney specimen measured 23.0 x 11.0 x 8.0 cm and weighed 850 grams. Gross examination identified multiple cortical nodules. A tan/pink, well-circumscribed nodule at the inferior pole measured 2.0 x 2.0 x 1.5 cm and exhibited central hemorrhage and necrosis. A second satellite lesion measuring 0.4 cm was located 1.5 cm superior to the first. Another hemorrhagic, soft nodule in the superior pole measured 2.0 x 1.5 x 1.5 cm. Additional small white nodules measuring 1\u20132 mm were present in the renal cortex away from the dominant lesions. The tumors were located beneath the renal capsule without gross extension through it. One tumor focally extended into perirenal adipose tissue microscopically (block A6), but no involvement of Gerota's fascia, renal vein, ureter, or lymphatic/vessel structures was identified.\n\nHistologic evaluation revealed a larger lesion measuring 2.0 cm and a smaller lesion measuring 0.15 cm. Another lesion measured 2.0 cm, while the remaining cortical nodules were 1\u20132 mm in size. Surgical margins including perirenal adipose tissue, Gerota\u2019s fascia, renal vein, renal artery, and ureter were all free of tumor. The distance from the first nodule to the renal vein margin was 3.0 cm, and to the renal artery margin was 3.5 cm; for the second nodule, these distances were 4.0 cm and 5.0 cm respectively. From the ureter margin, the distances were 3.7 cm and 5.5 cm.\n\nThe background kidney showed extensive changes including numerous senescent glomeruli, tubular atrophy, cortical thinning, arterionephrosclerosis, diffuse cystic changes, and inability to distinguish cortex from medulla. No adrenal gland was identified grossly or microscopically. A hilar lymph node candidate measuring 2.3 cm was present but not submitted for microscopic evaluation. Other findings included a markedly fatty renal pelvis and an attached adipose tissue fragment.\n\nBased on available information, the staging classification assigned was pT3 and pNx. This classification is subject to revision pending clinical review and further data."} +{"pid": "TCGA-E9-A22H", "report": "The left breast specimen involved a lesion measuring 2.7 x 2.7 x 2.5 cm, which was grossly evident. Histologic evaluation showed features consistent with a malignant process involving the breast tissue. Of the lymph nodes assessed, 1 out of 8 axillary nodes demonstrated involvement. Cellular details such as histologic grade, tubule formation, nuclear pleomorphism, and mitotic counts were not specified, and therefore, a total Nottingham Histologic Score could not be determined. Additional findings and margins were not specified, and there was no mention of prior treatment or further notable observations."} +{"pid": "TCGA-WB-A822", "report": "The surgical specimen from the left adrenal gland weighed 236g and measured 9.5x8x5.5 cm. A mass measuring 4.5x3.5x9 cm was identified within the adrenal gland, appearing multi-nodular with central necrosis. The mass was relatively well-circumscribed by a capsule and showed compression of the surrounding adrenal tissue.\n\nMicroscopic evaluation revealed a tumor characterized by large nests or diffuse growth pattern occupying more than 10% of the tumor volume, contributing 2 points to the scoring system. Central necrosis within large nests or confluent areas of necrosis was present, adding another 2 points. The tumor demonstrated high cellularity (2 points), extension into adipose tissue (2 points), vascular invasion (1 point), capsular invasion (1 point), nuclear pleomorphism (1 point), and nuclear hyperchromasia (1 point). Other features such as cellular monotony, spindle-shaped tumor cells, mitotic figures, and atypical mitoses were not present. The total score was 12.\n\nExamination of lymph nodes showed no evidence of disease in two small nodes."} +{"pid": "TCGA-BQ-5882", "report": "A right kidney specimen with attached renal vein and ureter was submitted for analysis. The kidney measured 13.5 x 7.0 x 6.0 cm, with a tumor mass measuring 9.0 x 6.5 x 5.5 cm identified within the parenchyma. The tumor was light tan, soft, and well-circumscribed with areas of necrosis, hemorrhage, and cystic degeneration. Satellite nodules were present, and the tumor extended to the capsule and involved the sinus and hilar fat. Gross examination revealed involvement of the renal vein margin by tumor thrombus. No adrenal gland was identified. The remainder of the kidney showed normal corticomedullary architecture.\n\nSections from the tumor demonstrated combined morphological features including both papillary and clear cell components. Lymphovascular invasion was observed. Immunohistochemical staining showed positive reactivity for CAM 5.2 (patchy), CD10, CA IX (patchy, weak), and Racemase (granular, patchy), while markers including AE1/AE3, HMB-45, CK7, RCC, 34BE12, and TFE3 were negative.\n\nMargins of the renal vein showed tumor involvement on microscopic evaluation, although the ureteral and vessel margins appeared unremarkable. No tumor was identified in the adrenal gland or in regional lymph nodes. A total of 21 lymph nodes were examined across multiple groups (super hilar, pericaval, paracaval, precaval), none of which showed evidence of metastasis.\n\nThe tumor extended into the renal vein and vena cava below the diaphrag. Multiple satellite nodules were noted. The surgical specimen showed no involvement of non-neoplastic kidney tissue. Adjacent hilar and sinus fat were infiltrated by the lesion."} +{"pid": "TCGA-ZF-A9R2", "report": "Histopathology. The specimen included multiple tissue samples from the distal and proximal ureteric resection margins, various pelvic lymph node regions (including right and left obturator, external iliac, and internal iliac nodes), as well as a radical cystoprostatectomy specimen. Clinically, the patient had muscle-invasive bladder cancer with bilateral hydronephrosis and lymph node involvement.\n\nMacroscopically, the lymph node specimens were embedded in fatty tissue, with sizes ranging from 8 mm to 40 mm. The radical cystoprostatectomy specimen measured approximately 95 x 87 x 80 mm. The prostate measured 30 x 38 x 32 mm, and the bladder measured 85 x 75 x 62 mm. The bladder showed extensive involvement of the left and right lateral walls, anterior and posterior walls, and dome, with visible transmural invasion on the left lateral side. No peritoneal nodules or lymph nodes were identified within the bladder.\n\nMicroscopic evaluation of the ureteric margins revealed normal urothelial mucosa without neoplasia. Lymph node assessments across all regions showed no evidence of malignancy. The bladder specimen demonstrated urothelial carcinoma with both papillary and invasive components. The tumor was predominantly moderately differentiated, with a component of poorly differentiated cells extending into the outer third of the muscularis propria. Lymphovascular invasion was present. All resection margins, including those of the prostate and urethra, were free of tumor involvement."} +{"pid": "TCGA-OR-A5JM", "report": "The specimen was obtained from a female patient and consists of tissue from the left upper quadrant, liver, and retroperitoneal fat. In the left upper quadrant, a large mass was identified adjacent to the spleen, behind the pancreas, and superior to the kidney, at the anatomical location of the adrenal gland. The mass measured 100mm in length, 80mm in width, and 90mm in depth. Its external surface was multilobulated and vascularized, with a visible defect where a sample had been taken. On sectioning, the mass appeared white-yellow with areas of hemorrhage and central necrosis. The adrenal gland was identified within the tumor. The mass was attached to perirenal fat but did not involve the kidney. A segment of pancreas attached to the tumor measured 65mm in length and 35mm in diameter and showed no involvement. The spleen measured 150 x 90 x 70mm and had a normal appearance on sectioning. The left kidney measured 110 x 70 x 30mm and also showed no signs of involvement.\n\nA separate piece of liver measuring 60 x 50 x 30mm contained a firm, nodular lesion 20 x 20mm in size located 10mm from the surgical margin. An irregular piece of peritoneal fat measuring 80 x 35 x 5mm behind the mass showed no evidence of tumor deposits.\n\nMicroscopically, the adrenal gland was found to contain a lobulated tumor composed of nests and fascicles of cells with a sinusoidal vascular pattern. Nuclear pleomorphism was moderate to severe, with areas of necrosis, nuclear hyperchromasia, granular chromatin, and prominent nucleoli. The cytoplasm varied from pale to eosinophilic and was occasionally vacuolated. Up to 18 mitoses per 10 high-power fields were observed. The tumor infiltrated into surrounding adipose tissue and invaded the adrenal hilar vein. It was in close proximity to inked margins in multiple areas. The spleen, pancreas, and kidney sections were otherwise unremarkable, although patchy pancreatic degeneration was noted at the resection margin.\n\nImmunohistochemistry showed positive staining for Melan-A and inhibin (patchy), while calretinin, EMA, CAM5.2, and AE1/AE3 were negative. Liver sections revealed a tumor deposit with identical features to the primary mass; it approached the liver capsule but did not penetrate it and appeared clear of the surgical margin. Sections of the retroperitoneal fat showed no evidence of malignancy."} +{"pid": "TCGA-77-6844", "report": "The specimen labeled \"right lower lobe\" consists of a lobectomy specimen measuring 135 mm from superior to inferior, 150 mm at the base from anterior to posterior, and up to 55 mm from lateral to medial. The pleural surface is smooth. A stapled resection margin is present superior to the hilum. A firm nodule measuring approximately 18 mm in diameter is palpable inferior to the hilum adjacent to the bronchial resection margin. This nodule appears to represent an involved lymph node with an adjacent compressed bronchial branch. Sectioning of the lung parenchyma reveals a large mass extending from the hilum toward the periphery. The mass is irregular in shape, with a cream and grey cut surface measuring 55 x 50 x 35 mm. It lies approximately 15 mm from the diaphragmatic pleural surface but extends to within 3 mm of the lateral pleura. A second circumscribed nodule measuring 15 mm in diameter is located immediately adjacent to the main mass and may represent an involved lymph node. Another suspicious nodule measuring up to 10 mm in diameter is identified within the lung parenchyma superior to the main bronchus. No other focal lesions are observed.\n\nA second specimen labeled \"middle lobe lymphatic tissue\" consists of a single fragment of cream-colored tissue measuring 15 x 2 x 2 mm. The third specimen, labeled \"No. 7 lymph node,\" consists of multiple fragments of black and grey fibrofatty tissue with an aggregate measurement of 40 x 25 x up to 8 mm. Sectioning reveals blackened lymph nodes.\n\nMicroscopic examination of the right lower lobe shows a poorly differentiated carcinoma involving the region of the central bronchi and extending toward the pleura. There is no evidence of pleural invasion. Lymphatic permeation is identified, though no vascular or perineural invasion is seen. The bronchial resection margin is free of involvement; however, a nodule of disease is present within the adjacent soft tissue, partly related to a lymph node, and extends close to or possibly at the inked resection margin. Multiple peribronchial lymph node metastases are observed. Organizing pneumonia is present around the lesion, and the adjacent lung demonstrates emphysematous changes. The bronchial resection margin shows squamous metaplasia with mild dysplasia.\n\nSections from the middle lobe lymphatic tissue show an artery surrounded by fibroadipose tissue and nerves without evidence of tumor involvement. Sections of the No. 7 lymph nodes reveal reactive changes only, with no evidence of malignancy.\n\nFurther sections of the large peribronchial nodule near the mediastinal margin were examined. The carcinoma approaches this margin very closely; however, definitive involvement is not confirmed, although it cannot be entirely excluded adjacent to the sections examined."} +{"pid": "TCGA-XF-AAMF", "report": "The surgical specimen included a bladder and prostate measuring 26 x 13.5 x 6 cm. The peritoneal surface measured 6 x 5 cm and showed multiple small tumor implants over a 2.2 cm area, each less than 0.2 cm in size with a reddish appearance. The bladder measured 7 x 7 x 4 cm and the prostate 6 x 5 x 4 cm. An ulcerated mass measuring 3.5 cm was identified in the posterior bladder wall. It was firm, covered with necrotic debris, with heaped and erythematous borders. On sectioning, the maximum depth of invasion was 0.9 cm. The mass appeared to extend into surrounding fat, with a white, firm cut surface and geographic areas of necrosis. The uninvolved bladder wall showed some hypertrophy, and the non-neoplastic mucosa was otherwise unremarkable.\n\nMicroscopic evaluation revealed invasive high-grade cellular growth involving the muscularis propria of the bladder and extending into perivesical fat. The lesion also involved soft tissue around the posterior prostate and seminal vesicles. The cells were arranged in sheets with marked nuclear atypia, high nuclear to cytoplasmic ratio, and frequent mitotic figures. Vascular space involvement was noted. Multiple soft tissue deposits were also observed. No flat high-grade intraepithelial lesion was identified in the bladder. The prostate showed diffuse nodularity in the lateral lobe. A separate focus of low-grade glandular malignancy was found in the left apical region of the prostate, corresponding to Gleason score 6 (3+3), confined within the gland without capsular extension. The prostatic urethra and stroma were free of any abnormal proliferation.\n\nLymph node dissection specimens were received from various anatomical locations including para-aortic, paracaval, right and left common iliac, Cloquet, external iliac, obturator/hypogastric, presciatic, and presacral regions. Of the total lymph nodes evaluated (83), five contained metastatic involvement. Metastases were identified in right obturator/hypogastric lymph nodes (2 out of 21) and right presciatic lymph nodes (3 out of 5). The remaining lymph nodes showed no evidence of involvement. Margins of resection, including those from the right and left distal ureters, proximal ureters, and perirectal soft tissues, were negative for high-grade cellular atypia or malignant infiltration. One lymph node from the paracaval region was examined intraoperatively and found to be negative.\n\nAdditional sections of the primary lesion were submitted for molecular analysis. All other tissues, including ureteral margins and periprostatic regions, showed no evidence of dysplasia or malignancy."} +{"pid": "TCGA-99-7458", "report": "The pathology report includes multiple specimens from various lung segments and lymph nodes. A nodule measuring 1.2 cm was identified in the superior segment of the right lower lobe, with additional smaller nodules measuring 0.2 cm, 0.9 cm, 0.7 cm, and 1.6 cm found in different areas of the right lung. Microscopic evaluation revealed that some of these nodules were present at or near surgical margins. In addition to these findings, small tumorlets consistent with neuroendocrine differentiation were noted, measuring up to 0.4 cm. These showed reactivity with chromogranin and synaptophysin on immunohistochemical staining. Benign findings such as leiomyomas and granulomatous inflammation were also identified in separate specimens.\n\nSurgical margins were generally uninvolved by invasive disease, although microscopic foci of certain lesions were present at the edges of resection in some areas. No evidence of malignancy was found in the lymph nodes examined, including those from levels 2R, 4R, 7, 8, 9, and 10. The findings were described as multifocal, with involvement across multiple lobes and segments. Staging was based on the presence of multiple tumor nodules in the same and different lobes, with no regional lymph node involvement identified. Vascular or pleural invasion was not observed. All assessed margins were free of invasive disease, and no treatment effect was noted."} +{"pid": "TCGA-QH-A65Z", "report": "PATHOLOGIST REPORT. The specimen was obtained from the temporal lobe of a male patient. Histological evaluation revealed a neoplasm characterized by uniform cells with round to oval nuclei and clear cytoplasm. The tumor measured 4.5 cm in maximum dimension and exhibited moderate cellularity with scattered mitotic figures. No necrosis or microvascular proliferation was identified. Surgical margins were free of neoplastic cells. The tumor was classified as WHO grade 2 based on histopathological features."} +{"pid": "TCGA-B0-4813", "report": "The specimen from the right kidney nephrectomy reveals a mass measuring 6.5 cm composed of cells with conventional clear cell morphology. The tumor extends into the renal vein, forming an additional intravascular mass measuring 5.0 cm. Microscopic evaluation shows nuclear pleomorphism and prominent nucleoli corresponding to Fuhrman grade 3 of 4. There is no evidence of tumor extension through the renal capsule. Angiolymphatic invasion is present. Histopathological staging is pT3b, Nx, Mx. A separate finding includes involvement of the vein wall by similar cellular infiltrate at the resection margin. An additional margin from the distal ureter has been submitted for further evaluation."} +{"pid": "TCGA-A4-7583", "report": "**Revised Report:**\n\nPre-Operative/Clinical History: Left renal mass. Specimen(s) Received: A: Margin \u2013 Base of Tumor, Left Kidney Mass; B: Left Renal Mass. Gross Description: Specimen A, received fresh for frozen section labeled margin (base) of tumor, left kidney mass, consists of three friable tan soft tissue fragments measuring 0.2 to 0.5 cm in greatest dimension. All fragments were submitted for frozen section in A1 FS. Specimen B, received in formalin labeled left renal mass, consists of a 12 gm aggregate of multiple pink, friable to papillary soft tissue fragments measuring 4.0 x 4.0 x 2.5 cm overall, admixed with a small amount of adipose tissue. Representative sections were submitted in B1-6. Intraoperative Consultation: Specimen A, frozen section diagnosis of \"neoplasm present in one of three fragments\" was rendered. Microscopic Description: Sections of the first specimen include a fragment of adipose tissue, benign renal parenchyma, and a single small fragment demonstrating papillary architecture with delicate fibrovascular cores lined by small cells with low-grade nuclear features. Clusters of foamy histiocytes are noted within some of the cores. There is no evidence of necrosis or vascular invasion. The specimen also contains small fragments of adjacent renal parenchyma. Immunohistochemical staining shows positivity for Pax-8, P504S, and CK7; negativity for CK20, Vimentin, CD10, and TTF-1. Sarcomatoid features are absent. Histologic grade is Grade I. Extent of invasion and lymph/vascular invasion could not be determined. Margins could not be assessed. Adrenal gland and regional lymph nodes were not submitted. The specimen was received morcellated, precluding accurate staging. Clinical imaging was used for staging. Non-neoplastic kidney tissue was insufficient for evaluation. Positive and negative controls reacted satisfactorily."} +{"pid": "TCGA-XM-A8RE", "report": "The specimen consists of an irregular portion of thymic tissue measuring 14.0 x 7.5 x 2.5 cm and weighing 46.0 g. The external surface is covered by a thin fibrous layer previously marked with blue ink. On sectioning, a well-defined mass measuring 5.0 x 4.5 x 2.3 cm is identified, characterized by a white-tan, homogenous, lobular appearance and located adjacent to the capsule. The remaining thymic tissue shows a yellow lobular architecture. Representative sections have been submitted for analysis.\n\nMicroscopic evaluation reveals a neoplastic proliferation composed predominantly of lymphocyte-rich areas with intermixed epithelial elements. A minor component demonstrates more compact epithelial arrangements. Immunohistochemical staining highlights epithelial cells with pan-cytokeratin AE1/AE3. CD1a and TdT immunostains label the background population of T-lymphocytes. No evidence of capsular invasion is observed. Surgical margins are free of neoplastic cells, and no lymphovascular invasion is identified. All submitted blocks and sections are fully evaluated with no suspicious features beyond those described."} +{"pid": "TCGA-FE-A237", "report": "The specimen consists of a right thyroid lobe measuring 6.2 x 3.0 x 2.5 cm and weighing 14.6 grams. A nodule measuring 3.5 x 3.0 x 3.0 cm is identified in the inferior aspect of the lobe. The nodule is tan, irregular, and unencapsulated, with focal abutment of the thyroid capsule and proximity to the isthmic margin (within 1.3 cm). No gross infiltration of the capsule is observed. The surrounding thyroid tissue appears normal.\n\nMicroscopic evaluation reveals a proliferation composed predominantly of follicular cells showing extensive capsular invasion, with tumor penetrating through the capsule. The nuclear features in these areas correspond to conventional follicular cells, without evidence of papillary carcinoma features. In other regions, the tumor demonstrates well-developed nuclear features of papillary carcinoma, including formation of papillary structures and presence of abundant psammoma bodies. Tumor infiltration into perithyroidal soft tissue is noted, reaching up to the inked outer surface of the specimen. A small perithyroidal lymph node attached to the isthmic margin is involved by metastatic disease.\n\nThe lesion shows no lymphatic or vascular invasion. Tumor is confined to the thyroid gland but extends into adjacent soft tissues. The isthmic margin is free of tumor. One lymph node was examined, and it shows involvement by tumor without extranodal extension. The tumor is classified as non-differentiated, with no multifocal disease or invasion of thyroid cartilage or hyoid bone. Staging is pT2N1Mx.\n\nA frozen section diagnosis of a follicular lesion favoring benign was rendered intraoperatively, with final diagnosis deferred to permanent sections. All tissue from the nodule and margins was submitted for examination."} +{"pid": "TCGA-55-6712", "report": "A total of six lymph nodes were examined from various levels, including one at level 9L, two at level 7, and two at level 5. None of these lymph nodes showed evidence of metastatic involvement.\n\nThe surgical specimen consisted of a left pneumonectomy with an upper lobe tumor measuring 4.5 cm in greatest dimension. The tumor was poorly differentiated, unifocal, and located at the pleural surface. Visceral pleural invasion and lymphovascular space invasion were identified. The tumor did not extend beyond the lung tissue and was not present at the bronchial margin, which was 4.5 cm away from the tumor. No treatment effect was observed.\n\nOne lymph node showed evidence of metastatic involvement and exhibited extracapsular extension with adjacent vascular wall invasion. No other significant findings were reported.\n\nTissue from the primary tumor was submitted for genomic studies. Relevant sections were preserved for molecular testing, including analysis of biomarkers such as EGFR, KRAS, and ALK. These tests may guide targeted therapy decisions in cases of lung malignancy."} +{"pid": "TCGA-SB-A6J6", "report": "The right testicular specimen following radical orchiectomy contains a mass measuring 6.0 cm, which is limited to the testicular tissue. Microscopic evaluation reveals a uniform population of atypical cells arranged in a characteristic pattern, with areas of focal necrosis noted. Extensive intratubular germ cell neoplasia is present throughout the specimen. The tumor does not extend into the rete testis or involve the lymphovascular spaces. Surgical margins at the spermatic cord are free of tumor involvement. The left testicular biopsy shows normal seminiferous tubules without any evidence of neoplastic change or intratubular germ cell neoplasia. Based on histologic and gross findings, the tumor is confined to the testis with no regional or distant spread identified."} +{"pid": "TCGA-AJ-A8CT", "report": "A laparoscopically assisted vaginal hysterectomy, bilateral salpingo-oophorectomy, and lymph node dissection were performed. The surgical specimens included the uterus, cervix, fallopian tubes, ovaries, right and left pelvic lymph nodes, and pelvic washings.\n\nGross examination of the uterus revealed a 3 x 2 cm solid mass located in the lateral aspect of the anterior endometrium. This lesion protruded up to 1.5 cm above the endometrial surface and extended superficially into the underlying myometrium, which measured up to 2.3 cm in thickness at that site. Histologically, the tumor invaded the myometrium to a depth of 2.5 mm, within a total myometrial thickness of 14.5 mm at the area of maximum invasion. No lymphovascular space involvement was identified. The tumor did not involve the endocervix, paracervical tissue, uterine serosa, fallopian tubes, or ovaries. Surgical margins were negative for tumor.\n\nThe tumor was confined to the endometrium with no gross extension into deeper myometrial layers. Adjacent to the tumor, a separate 2.5 x 2 x 1 cm endometrial polyp was identified, limited to the endometrium. Additional findings included adenomyosis, leiomyomata uteri, and a subserosal nodule measuring 4 cm arising from the right uterine cornu.\n\nA total of 18 pelvic lymph nodes were examined: 11 from the right side and 7 from the left, all without evidence of malignancy. Pelvic washings also showed no malignant cells.\n\nThe specimen included multiple tissue sections for microscopic evaluation. Representative sections were taken from the tumor with full-thickness myometrium, paracervical tissue, endocervical canal, adnexal regions, and lymph nodes. No other sites of neoplastic involvement were identified.\n\nTissue was submitted for estrogen and progesterone receptor assays; results are pending. Based on pathological evaluation, staging was determined as pT1a (tumor involving less than one-half of the myometrium), pNo (no regional lymph node metastasis), and pMX (metastasis cannot be assessed)."} +{"pid": "TCGA-G3-A7M5", "report": "The specimen consists of a gallbladder and a right lobe liver resection. The gallbladder measures 9 cm in length and up to 3 cm in diameter, with multiple dark pigment stones present in the lumen. The wall thickness measures up to 0.1 cm. Histologically, it shows features consistent with chronic cholecystitis without atypia.\n\nThe liver resection weighs 1,570 grams and measures 19 x 18 x 10 cm. A large mass measuring 15 x 14.5 x 8 cm is identified within the right lobe. It is well-circumscribed, multinodular, and has a seminecrotic and hemorrhagic cut surface with areas of pale grey to yellow-green viable tumor. Microscopically, the lesion demonstrates a lobulated architecture composed of rounded nodules. Tumor cells show mild to moderate nuclear atypia arranged in broad sheets with focal pseudoglandular structures containing bile, as well as areas of prominent fatty change. Hemorrhage and degeneration are noted centrally.\n\nThe tumor is solitary and confined to the liver, with no evidence of vascular or perineural invasion. The closest margin involvement is 2 mm from the parenchymal margin. No lymph node involvement was assessed. Inflammation around portal tracts and granulomatous changes related to portal veins are present, but there is no evidence of cirrhosis or significant underlying liver disease. Multiple sections were taken to evaluate the relationship between the tumor and resection margins, as well as surrounding tissue."} +{"pid": "TCGA-19-0955", "report": "The specimen from the right parietal occipital region consists of a single irregular tan-brown mass measuring 5.0 x 3.5 x 3.0 cm. The cut surface reveals central necrosis with a surrounding rim of tan-gray tissue. Microscopic examination shows a high-grade neoplasm with areas of coagulative necrosis and mild microvascular proliferation. There is also evidence of prominent leptomeningeal invasion. Immunohistochemical staining demonstrates expression of neurofilament and endothelial antigens, and reticulin staining supports the histologic findings. A separate specimen from the dura contains similar malignant cells. The dural sample includes two triangular soft tissue fragments measuring 2.9 x 2.8 x 0.1 cm and 3.2 x 2.1 x 0.1 cm, along with a small additional fragment measuring 0.7 x 0.1 x 0.1 cm. All specimens were processed with appropriate controls."} +{"pid": "TCGA-GM-A4E0", "report": "A left axillary sentinel lymph node biopsy revealed the presence of metastatic involvement within one lymph node. The metastasis measured 7.0 mm in its greatest microscopic dimension. There was evidence of extranodal extension measuring up to 2.0 mm. Cytokeratin immunostaining confirmed the presence of metastatic cells in representative sections.\n\nIn the left breast mastectomy specimen, an invasive lesion was identified in the lateral aspect, spanning approximately 8.5 cm. The tumor exhibited nuclear features graded as low to intermediate. A small focus of invasive disease was located 8.0 mm from the inferior margin, while other resection margins were free of involvement. No definitive lymphovascular invasion was observed. Microscopic evaluation also showed stromal fibrosis, columnar cell change, and cystic formations. The nipple skin contained a benign basaloid follicular hamartoma without any malignant findings.\n\nExamination of the left axillary contents following dissection identified involvement in nine out of twenty-one lymph nodes. The largest metastatic deposit measured 5.0 mm in greatest dimension. Focal extranodal extension was also present. \n\nThe mastectomy specimen measured 26.0 x 21.0 x 8.5 cm and included skin with a nipple measuring 1.2 cm in diameter. The surgical orientation was marked with a suture at the 12 o\u2019clock position. Serial sectioning revealed an irregular lesion located in slices 7 through 9, measuring 8.5 x 4.5 x 2.0 cm. It was situated 2.0 cm from the inferior margin, 5.0 cm from the superior margin, and 6.0 cm from the deep margin.\n\nA total of twenty-two lymph nodes were recovered from the axillary dissection, ranging in size from 0.2 x 0.2 x 0.2 cm to 4.5 x 1.5 x 1.0 cm."} +{"pid": "TCGA-BP-4991", "report": "The clinical history includes a right renal mass. The submitted specimen is a partial nephrectomy from the right upper pole of the kidney. Gross examination reveals a wedge-shaped renal specimen measuring 6 x 5.5 x 4 cm, with suture marking the deep margin. Serial sectioning identifies a golden-yellow tumor measuring 2.5 x 2.5 x 2 cm. The clearance from the tumor to the resection margin is 0.3 cm. A representative section of the nearest margin was submitted for intraoperative frozen section analysis, which confirmed no tumor at the margin. The tumor was entirely submitted for further evaluation.\n\nMicroscopic examination reveals cells with clear cytoplasm and nuclear features corresponding to grade II on a four-tier scale. There is no evidence of local invasion, renal vein involvement, or small vessel invasion. Surgical margins are free of tumor. Evaluation of non-neoplastic kidney tissue shows mild arteriolosclerosis. No adrenal gland or lymph node tissue was identified in the specimen. Staging information indicates the tumor is classified as pT1, based on size and confinement within the kidney; however, the measured tumor dimension provided is 2.5 cm while a separate staging note references a 7.0 cm tumor. All sections submitted are summarized as representative of the lesion and control sections."} +{"pid": "TCGA-HV-A7OP", "report": "The clinical evaluation included assessment of a liver mass and possible peritoneal seeding. Biopsy of the liver mass showed mesothelial cell hyperplasia. Multiple biopsies from peritoneal sites were taken. One biopsy showed atypical glands, while others did not reveal any tumor. Omental tissue also showed no tumor involvement.\n\nA resection specimen included the pancreas, duodenum, and common bile duct. The lesion measured 6.5x5.0x5.0cm and extended into the duodenum and ampulla of Vater. There was no evidence of blood vessel invasion; however, lymphatic and perineural invasion were present. All surgical margins were free of tumor with safety margins measuring 6.5cm from the common bile duct margin, 0.1cm from the retroperitoneal margin, 3.5cm from the duodenum proximal margin, and 5.0cm from the pancreas resection margin.\n\nLymph node analysis revealed metastasis in 7 out of 28 nodes examined. Involved nodes included one mesenteric lymph node, one from the inferior head region, one from lymph node #13, and four from lymph node #17. Other lymph node groups showed no involvement.\n\nAdditional findings included PanIN 3 in the remaining pancreatic parenchyma. Tissue labeled as \"R/O liver mass\" showed mesothelial cell hyperplasia. Tissue labeled \"R/O peritoneal seeding #2\" showed atypical glands, while other peritoneal sites and omental tissue showed no tumor. The gallbladder showed changes consistent with chronic cholecystitis and the omentum showed no tumor."} +{"pid": "TCGA-43-7658", "report": "The specimen consists of a right upper lobe of the lung, along with lymph nodes from stations 7 and 9. The right upper lobe weighs 145.2 grams and measures 16.8 x 7.5 x 2.7 cm. A staple line is present along the medial aspect, measuring 12.8 cm in length. A nodule measuring 2.1 x 1.7 x 1.8 cm is identified within the parenchyma. The overlying pleural surface shows signs of retraction and has been inked black. No additional mass lesions are observed upon sectioning. Representative sections of the nodule and surrounding normal tissue are submitted for analysis.\n\nA single fragment measuring 1.5 cm in diameter is received as part of station 7 lymph node tissue and is entirely submitted for microscopic evaluation. Station 9 includes multiple fragments of fatty tissue containing several lymph nodes, all of which are submitted for histological examination.\n\nMicroscopic analysis of the nodule reveals a poorly differentiated non-keratinizing epithelial lesion. The tumor measures 2.1 x 1.7 x 1.8 cm and is well-circumscribed, without involvement of the pleura. Resection margins\u2014including parenchymal, pleural, and bronchial\u2014are free of tumor cells. There is no evidence of direct tumor extension or vascular invasion (venous, arterial, or lymphatic). \n\nIn total, eight lymph nodes from parts A, B, and C are examined, and none show evidence of tumor involvement. Two hilar lymph nodes from the lobectomy specimen, one lymph node from station 7, and five lymph nodes from station 9 are all negative for tumor cells."} +{"pid": "TCGA-AN-A0XO", "report": "Female patient with tumor located in the breast, primary site. Histological analysis shows infiltrative growth pattern with ductal features. Tumor specimen was obtained via surgery and preserved in OCT medium as a block. The grade is 2. Staging details indicate T stage 2, N stage 1, and M stage 0. No prior treatment was administered. A normal blood sample was also collected via blood draw and stored frozen in a tube."} +{"pid": "TCGA-BR-8080", "report": "The gastrectomy specimen involved the fundus and measured 20 x 12 x 2.5 cm. The tissue showed a mucinous histologic pattern with poorly differentiated features. The tumor extended to adjacent structures, including the greater and lesser omentum. Lymph node analysis revealed 10 out of 12 positive nodes with metastatic involvement in intraabdominal locations. No information was provided regarding lymphatic, venous, or perineural invasion. Surgical margins were uninvolved. There was no indication of neoadjuvant treatment effect. No additional pathologic findings or comments were noted."} +{"pid": "TCGA-FG-A60K", "report": "The specimen consisted of four tissue samples collected from the medial frontal region, margin, deep area, and right frontal region. The tissues were described as tan-white or pink-tan soft fragments, with aggregate sizes measuring 0.5 x 0.5 x 0.2 cm for the medial frontal sample, 0.3 x 0.2 x 0.2 cm for the margin sample, 0.5 x 0.2 x 0.2 cm for the deep sample, and 3.6 x 2.5 x 0.6 cm for the right frontal sample. All specimens were processed and submitted for microscopic evaluation.\n\nMicroscopic analysis of the tumor tissue revealed an infiltrating glioma without evident anaplasia. The cellular composition showed mild atypia and no identifiable mitotic figures. Immunohistochemical staining demonstrated reactivity with IDH1 R132H antibody in the tumor cells. Interphase fluorescence in situ hybridization studies indicated loss of both 1p and 19q genetic material.\n\nIntraoperative consultation confirmed the presence of infiltrating glioma in the medial frontal and deep regions. The margin biopsy showed minimally hypercellular cerebral cortex without evidence of solid tumor involvement."} +{"pid": "TCGA-XJ-A9DK", "report": "The surgical pathology report includes specimens from a left pelvic lymph node, right pelvic lymph node, and prostate. The patient is a male with a clinical history related to prostate findings.\n\nThe left pelvic lymph node specimen consists of fibroadipose tissue without evidence of malignancy; no lymph node is identified. Similarly, the right pelvic lymph node specimen also contains fibroadipose tissue with no signs of cancerous cells, and no lymph node is present.\n\nThe prostate specimen was submitted following prostatectomy. Gross examination revealed a prostate weighing 22 grams and measuring 3.0 cm in width, 2.3 cm in depth, and 2.3 cm in height. The external surface appeared tan-pink and irregular. The right seminal vesicle measured 1.5 cm in length and 0.3 cm in diameter, while the left measured 2.3 cm by 0.3 cm. Sections were taken from multiple regions including margins of the bladder neck, urethra, and seminal vesicles, as well as representative sections from both lobes of the prostate.\n\nMicroscopic evaluation showed bilateral involvement of the prostate with a high-grade cellular proliferation. The Gleason scoring system was applied, revealing a primary pattern of 4 and a secondary pattern of 4, resulting in a total score of 8. Approximately 30% of the prostate was affected, with multicentric distribution noted. There was extensive perineural invasion identified, although no vascular invasion was observed. Margins were negative for malignant involvement, though the lesion approached within 1 mm of the inked capsular margin on the right side in multiple areas.\n\nNo extraprostatic extension or seminal vesicle invasion was identified. Glandular atrophy was noted as an additional finding. Lymphovascular invasion was not present. No lymph nodes were identified in the submitted specimens.\n\nStaging was determined as pT2c, indicating bilateral involvement. Regional lymph node staging (pNX) could not be assessed due to absence of identifiable lymph nodes. Distant metastasis staging (pMX) also could not be evaluated. The pathologic stage is considered provisional and based solely on available data.\n\nThe case was reviewed under a quality assurance protocol and confirmed by a second pathologist. The findings reflect personal examination of the slides by the interpreting pathologist."} +{"pid": "TCGA-D1-A165", "report": "The surgical specimen included a uterus with bilateral ovaries and fallopian tubes, along with right and left pelvic and para-aortic lymph nodes. The uterus contained a lesion measuring 2.0 x 2.0 x 1.0 cm. Histologic examination showed this lesion to be a grade 1 (of 3) epithelial neoplasm with glandular differentiation. The surrounding endometrial tissue exhibited complex hyperplasia with atypia. Invasion into the myometrium extended to a depth of 0.5 cm within a myometrial wall that measured 2.0 cm in thickness. No evidence of lymphovascular invasion was identified. The cervix showed no involvement. Both ovaries contained cortical inclusion cysts and both fallopian tubes appeared histologically unremarkable. A total of 13 right pelvic lymph nodes, 17 left pelvic lymph nodes, and 13 para-aortic lymph nodes were examined and none showed any abnormal findings."} +{"pid": "TCGA-AG-3605", "report": "The resected rectosigmoid colon specimen contains two sections showing a moderately differentiated epithelial neoplasm. The lesion measures up to 5 cm in greatest dimension and demonstrates extensive infiltration into the perirectal adipose tissue, with involvement of three regional lymph nodes. The tumor reaches the circumferential resection margin and extends focally into the muscularis propria at the aboral resection margin. The oral and mesenteric resection margins are free of tumor involvement. Histological grade is intermediate. Lymphatic and vascular invasion are present. Clinically, there is evidence of distant metastasis to the liver. Residual tumor is noted post-resection."} +{"pid": "TCGA-EO-A3AZ", "report": "The specimen includes a total hysterectomy with cervix and bilateral salpingo-oophorectomy. The uterus contains a tumor measuring 2.8 cm in greatest dimension, located within the endometrial cavity. Histologic evaluation shows a component with features greater than 50% of a specific type, with invasion into the outer half of the myometrium. There is extension into the lower uterine segment, approaching but not involving the cervix. Lymphovascular space involvement is present.\n\nImmunohistochemical staining supports the presence of distinct components: one portion demonstrates positivity for p16 and p53, and negativity for PR; another portion shows a different profile, including ER positivity and negativity for p53 and p16. These findings are consistent with the presence of two histologically distinct elements.\n\nGrossly, the uterus measures 7.0 x 4.5 x 3.3 cm. The tumor is described as ill-defined, friable, and tan-brown, measuring 2.5 x 2.3 x 2.8 cm. It is located 0.3 cm from the anterior serosal surface and 0.9 cm from the posterior serosal surface. The myometrium contains a separate well-circumscribed white nodule measuring 0.6 cm. No tumor involvement is identified in the ovaries or fallopian tubes. The cervix does not show direct tumor involvement.\n\nStaging assessment indicates that the tumor invades more than one-half of the myometrium. No lymph nodes were examined or found to be involved. Lymphovascular invasion is noted, but no evidence of distant metastasis is present. The procedure performed was a simple hysterectomy with bilateral salpingo-oophorectomy; no lymph node sampling was conducted. The specimen was received intact."} +{"pid": "TCGA-OL-A66P", "report": "The surgical specimens included right axillary sentinel lymph nodes #1 and #2, both of which showed no evidence of metastatic disease. The superior mastectomy flap contained benign fibroadipose tissue with focal fat necrosis. The right breast specimen revealed two distinct lesions.\n\nThe first lesion measured 2.1 x 1.9 cm and was located in the superior aspect of slices 7 and 8. Histologic evaluation showed a composite grade II tumor based on architectural differentiation (score 3), nuclear grade (score 2), and mitotic activity (score 1). This lesion was associated with intraductal carcinoma, which accounted for less than 5% of the tumor volume. The second lesion measured 0.9 x 0.8 cm and was located in slice 8. It also had a composite histologic grade II, with similar scores for architecture, nuclear grade, and mitotic rate. No intraductal component was identified in this second lesion.\n\nAdditional findings in the breast included a microscopic focus of atypical ductal hyperplasia, previous biopsy sites, and several benign features such as an intraductal papilloma measuring 9 mm with extensive hyalinization, a 6 mm hyalinized nodule with osseous metaplasia, columnar cell change, fibroadenomatous changes, apocrine metaplasia, sclerosing adenosis, and duct ectasia.\n\nMargins of excision were free of both invasive and in situ disease. The closest distance of invasive carcinoma to the anterior-superior margin was greater than 5 mm, while the closest in situ component was more than 10 mm from the nearest margin. Suspicious blood vessel and lymphatic invasion was noted.\n\nImmunohistochemical analysis of both lesions showed no expression of estrogen or progesterone receptors. Ki-67 proliferation index was 35% for the first lesion and 30% for the second. HER2 testing by FISH was not amplified in either lesion.\n\nThe inferior and medial flaps contained only benign fibroadipose tissue. No involvement of the nipple, skin, or skeletal muscle was observed. Based on AJCC 7th edition TNM staging, the pathological stage was determined as pT2(m), NO(sn), MX."} +{"pid": "TCGA-DX-A7EN", "report": "The resected specimen consists of a soft tissue mass measuring 8.0 x 7.5 x 7.5 cm, located within the retroperitoneal region adjacent to the left kidney and colon. Gross examination reveals a well-circumscribed lesion covered by a thin fibrous layer with focal disruption and a hemorrhagic defect measuring 6 x 3.5 cm. Microscopic evaluation demonstrates high-grade cellular atypia with a mitotic count of 40 MF/10 HPFs and approximately 10% microscopic necrosis. The tumor does not involve the colonic mucosa, renal parenchyma, or vascular and ureteral margins. Two benign lymph nodes are identified in the pericolonic adipose tissue.\n\nAn intra-abdominal blood clot was also submitted, measuring 5.5 x 4.0 x 2.0 cm in aggregate. Histologic examination reveals blood admixed with reactive mesothelial cells but no malignant cells are identified.\n\nAdditionally, an accessory spleen with surrounding soft tissue was submitted. It measures 1.0 x 0.7 x 0.6 cm and shows subserosal edema and reactive changes without evidence of malignancy.\n\nMargins of resection, including those near the colon, kidney, ureter, and surface inked blue, are free of tumor involvement."} +{"pid": "TCGA-FV-A23B", "report": "The surgical specimen includes two portions of hepatic tissue, with the larger designated as part A and the smaller as part B, attached via two blue sutures. The entire specimen measures 9.3 x 8.0 x 3.5 cm and weighs 121 grams. Part B measures 3.0 x 2.5 x 1.2 cm. Both parts have inked deep surfaces and were serially sectioned. Two distinct nodules were identified: one measuring 2.2 x 2.0 x 1.8 cm with lobulated tan-white to tan-brown tissue and focal hemorrhage; and another measuring 4.5 x 3.4 x 3.0 cm with tan-white firm consistency and similar hemorrhagic areas. The smaller nodule is located 0.2 cm from the surgical margin, while the larger is 0.4 cm from the margin. The nodules are separated by approximately 0.8 cm and both protrude above the capsular surface. Surrounding liver tissue shows coarse, lobulated architecture without discrete fibrotic nodules.\n\nMicroscopic evaluation of multiple sections confirms a background of cirrhosis with anastomosing fibrous bands and regenerating nodules. The nodules exhibit varying histologic patterns including trabecular, glandular, and small cell arrangements. Congested blood vessels are also noted. No tumor involvement is seen at the surgical margins based on examination of corresponding slides."} +{"pid": "TCGA-DU-6405", "report": "The surgical specimens from a craniotomy of the brain included four separate tissue samples. Specimen A measured 0.4 cm and showed mildly increased cellularity in the cerebral cortex and adjacent white matter with occasional atypical nuclei and areas of rarefaction containing reactive astrocytes. Specimens B and C, measuring 0.8 cm and 0.7 cm respectively, demonstrated extensive infiltration of glial tissue by a moderately cellular tumor with moderate nuclear atypia. No mitotic figures were identified, although some areas showed prominent microvessels without clear evidence of microvascular proliferation.\n\nSpecimen D, obtained from the left frontal region, consisted of multiple soft tan-white fragments ranging from 0.5 to 2.4 cm. Microscopic evaluation revealed large portions of cerebral cortex and white matter that were partially or completely replaced by a glial neoplasm similar to that seen in specimens B and C. Focal areas of increased cellularity contained mitotic figures, suggesting regions of more aggressive growth. Although new vessel formation was noted, there was no definitive microvascular proliferation. Necrosis was not present.\n\nImmunostaining for GFAP highlighted the fibrillary component of the lesion. A MIB-1 proliferation index of 23% was recorded in a high-cellularity area. The overall findings indicated a glial neoplasm with variable histological features suggestive of focal transformation, including areas with increased mitotic activity and elevated proliferation index."} +{"pid": "TCGA-B9-4117", "report": "The specimen consists of a left nephrectomy and a separate fragment of hilar fibroadipose tissue. The nephrectomy specimen weighs 550 grams and measures 18 x 11 x 7.5 cm; the kidney itself measures approximately 13.8 x 7.5 x 7.5 cm. The perinephric fat is largely disrupted. A solid, yellow, diffusely brown and hemorrhagic lesion measuring 8.4 x 7.3 x 6.0 cm is identified in the mid-kidney anterior cortex. Part of this lesion, along with adjacent normal kidney tissue, is missing, likely due to prior surgical manipulation. The lesion abuts an area of blue-inked capsule, but because the surrounding fat is disrupted, attachment cannot be confirmed.\n\nHistologically, the lesion shows nuclear features corresponding to Fuhrman nuclear grade 3. Evaluation of invasion is limited by the specimen\u2019s disruption. There is no involvement of the renal vein, ureter, or other surrounding structures. The hilar vascular margins, including renal artery and vein, are uninvolved. The ureteral margin is also negative. The remaining kidney shows normal architecture with a distinct corticomedullary junction, no papillary necrosis, and an unremarkable renal pelvis.\n\nOnly scant hilar adipose tissue is present, and no lymph nodes are identified. The separate hilar fat fragment is small (4.8 x 2.0 x 1.6 cm) and contains only fibroadipose tissue without identifiable lymph node candidates. All submitted tissue blocks from the surgical margins and tumor site show no evidence of residual lesion.\n\nStaging is assigned as pT2 based on the largest dimension of the lesion, with no assessment possible for nodal or metastatic status (pNx, pMx). This staging is provisional and may be subject to revision upon further clinical review."} +{"pid": "TCGA-BH-A18P", "report": "The patient is a female of unspecified age. A left total mastectomy was performed. The specimen involved the lower inner quadrant of the left breast, with extension to the lower outer quadrant. A lesion measuring 2.0 cm was identified. Histologic evaluation demonstrated a Nottingham score of 7 out of 9, with scores of 3 for tubule formation, 2 for nuclear grade, and 2 for mitotic count. The tumor was located within 0.1 cm of the inner lower quadrant margin. Microcalcifications were associated with the lesion. A component of intraductal proliferation was present, comprising 10\u201315% of the lesion volume, characterized by nuclear grade 2 morphology, solid growth pattern, and comedo-type necrosis. Surgical margins were free of abnormal cells. Adjacent breast tissue showed fibrocystic changes, sclerosing adenosis, and microcalcifications. The skin and nipple were unremarkable. Three lymph nodes were examined and none showed involvement. Additional sentinel lymph node biopsies from the left axilla were also negative for involvement, confirmed with AE1/AE3 immunostaining.\n\nImmunohistochemical analysis demonstrated estrogen receptor positivity, with 95% of cells showing nuclear staining. Progesterone receptor staining was negative, with no staining observed in any cells. HER-2/neu staining by immunohistochemistry showed weak to moderate complete membrane staining in more than 10% of cells, interpreted as weakly positive (score 2+). Fluorescence in situ hybridization for Her-2/neu gene amplification demonstrated a ratio of 2.05, which is considered borderline for amplification. All testing was performed using validated, FDA-approved methods."} +{"pid": "TCGA-5V-A9RR", "report": "The specimen includes a thymectomy and a cervical horn excision. The thymectomy measures 10.5 x 5 x 3.8 cm and contains a well-defined mass measuring 8 x 4.8 x 3 cm within the thymus. The mass is encapsulated and located in the superior to inferior portions of the thymus, with a pink-tan cut surface and lobulated texture. Microscopically, the mass is surrounded by benign, involuted thymic tissue. The surgical margins are free of tumor involvement, though the tumor approaches the soft tissue margin at a distance of 0.1 cm.\n\nHistological evaluation reveals mixed cellular features, including epithelial components positive for cytokeratin 5/6. A subpopulation of cells shows weak focal positivity for CD5, while markers such as CD4, CD8, CD3, TdT, and CD1A are negative, consistent with immature lymphocyte-poor regions. Ki-67 staining indicates a proliferative index of approximately 50\u201360%. There is no evidence of lymphovascular invasion based on CD31 staining and histologic examination. Sparse B cells are present, and reticulin stain highlights a perinodular pattern.\n\nNo lymph nodes were sampled, and thus regional nodal status could not be assessed. There are no additional pathologic findings identified. The cervical horn specimen consists of two fragments of yellow-tan adipose tissue measuring 2 x 1.2 x 0.5 cm and 1.1 x 0.8 x 0.4 cm. One fragment contains a suture and is inked. Histologically, this portion shows benign fibroadipose tissue with no significant pathological features."} +{"pid": "TCGA-IB-A7M4", "report": "The specimen includes portions of the pancreas, spleen, and possible adrenal tissue. The pancreatic portion measures 11.5 x 5.5 x 4.5 cm and contains a firm, infiltrative white-gray mass measuring 3.6 cm in greatest dimension. Additional tumor dimensions are 3.0 x 2.3 cm. The tumor is located in the mid-body of the pancreas and extends beyond the pancreatic parenchyma. It is situated 3.5 cm from the proximal resection margin, extends to within 0.3 cm of the inferior margin, and 0.4 cm from the superior margin. The tumor appears in close proximity to adrenal tissue; however, histologic confirmation of adrenal involvement could not be established. Adjacent pigment-laden epithelioid cells were observed but interpreted as macrophages rather than adrenal cortical cells.\n\nHistologic evaluation reveals a poorly differentiated epithelial neoplasm with lymph-vascular invasion present. No perineural invasion was identified. Margins are free of invasive carcinoma. The closest distance of tumor to a margin is 0.4 mm at the retroperitoneal surface where tumor involvement is noted. Regional lymph node examination includes 16 nodes, one of which demonstrates metastatic involvement by direct extension.\n\nImmunohistochemical staining shows positivity for VIM, CTK19, and B34E12, with weak positivity for CEA and calretinin, and negativity for inhibin. The spleen appears grossly unremarkable without focal lesions."} +{"pid": "TCGA-EL-A3H3", "report": "Pathology report. Female. Surgical case. Specimens include prestrap muscle tissue, which consists of fibroconnective tissue and skeletal muscle with no abnormal cellular findings. A biopsy of the right parathyroid shows hypercellular parathyroid tissue weighing 0.004 grams.\n\nThe thyroid specimen shows a lesion located in the isthmus measuring 2.7 cm. The lesion is unifocal without evidence of extrathyroidal extension or lymphovascular invasion. Background thyroid tissue demonstrates extensive chronic lymphocytic thyroiditis. Surgical margins are negative. Parathyroid tissue is identified in the superior aspects of both right and left lobes.\n\nLymph node evaluation includes one central neck lymph node which shows involvement. Additionally, five out of eighteen lymph nodes from the paratracheal and mediastinal regions show similar findings. No extracapsular extension is observed in any involved nodes.\n\nOther biopsies of the superior right and left parathyroids show normal parathyroid tissue without abnormal cellular changes. A prestrap muscle sample submitted shows unremarkable fibroadipose tissue, measuring 7.0 x 1.0 x 0.5 cm. A small pink tissue fragment measuring 0.2 x 0.2 x 0.1 cm was received for analysis."} +{"pid": "TCGA-BP-4787", "report": "The clinical history includes a left renal mass biopsy. Specimens submitted include a total nephrectomy specimen, para-aortic lymph nodes, and suprahilar para-aortic lymph nodes.\n\nGross examination of the kidney revealed a well-circumscribed tumor measuring 9.5 cm in greatest dimension, located at the upper pole and extending into perinephric fat. The tumor exhibited areas of necrosis and hemorrhage. The remainder of the kidney showed a normal cortico-medullary junction. The adrenal gland measured 4.5 x 3.5 x 1 cm and was not involved. Lymph nodes identified in the perinephric fat were unremarkable. Tumor histology showed high nuclear grade (grade IV/IV). No involvement of the renal vein was noted. Surgical margins were free of tumor. A total of 19 lymph nodes were examined across the two lymph node specimens, all of which were free of tumor. The para-aortic lymph node specimen included 15 nodes, and the suprahilar specimen included 1 node.\n\nStaging criteria indicate the tumor extends through the renal capsule but remains within Gerota\u2019s fascia. No evidence of tumor was found in the submitted lymph nodes or other tissues."} +{"pid": "TCGA-CM-4746", "report": "The specimen labeled \"sigmoid colon\" consists of a segment measuring 13.8 cm in length, with a proximal circumference of 6.0 cm and a distal circumference of 8.0 cm. A fungating lesion is identified, measuring 4.4 cm by 3.7 cm, located 4.0 cm from the distal margin and 4.2 cm from the proximal margin. Serial sectioning reveals invasion into the muscularis propria to a depth of 0.1 cm, with the deepest point being 0.5 cm from the serosa. No gross tumor perforation, serosal involvement, vascular invasion, or perineural invasion is observed. The surgical margins are free of tumor. Adjacent to the lesion, tattoo pigment is noted within the muscularis propria, consistent with a prior biopsy site. At least 16 small polyps, ranging from 0.2 to 0.4 cm in size, are identified in the remaining mucosa. Pericolic and peri-rectal fat is examined thoroughly, with all possible lymph nodes submitted for evaluation; no metastases are found in 17 nodes examined. The proximal and distal donut specimens each show unremarkable colonic tissue, with no significant findings noted. All margins are clear, and the tumor is entirely submitted for analysis."} +{"pid": "TCGA-S7-A7X0", "report": "The specimen is an encapsulated mass located in the small pelvis, measuring 50x40x30 mm and weighing 22 grams. It has an ovoid shape and on gross examination appears grey-pink with a soft consistency. Histologically, the tissue shows solid and alveolar growth patterns. Immunohistochemistry demonstrates strong positivity for chromogranin and S100 protein staining is present in the tumor cells; however, there is no evidence of involvement by sustentacular cells. No vascular or capsular invasion was identified in the examined sections. The proliferation index (MIB-1) shows positivity in only 1\u20132 tumor cells. The lesion is situated outside the adrenal gland and according to scoring criteria, exhibits features consistent with a benign behavior."} +{"pid": "TCGA-DI-A1NO", "report": "The specimen was received on [Date/Time] and consisted of multiple tissue samples submitted from various anatomical sites. Gross examination revealed a gray-white mass measuring 7.0 x 5.0 x 4.5 cm, representative of a uterine fibroid without evidence of hemorrhage or necrosis. A separate tan tissue sample measuring 1.8 x 1.8 x 1.7 cm with a firm nodule (0.4 cm in size) was submitted for evaluation.\n\nA uterus with cervix measuring 13.0 x 9.0 x 6.0 cm was also examined. The endometrium contained a firm, solid mass measuring 6.5 x 6.5 x 6.0 cm with areas of necrosis. Microscopic evaluation showed that this lesion invaded deeply into the outer third of the myometrium, approaching to within 1.5 mm of the uterine serosa. Focal involvement of the serosal surface was identified. Adjacent myometrial tissue contained multiple white, firm nodules ranging from 0.5 to 5.5 cm in diameter without hemorrhage or necrosis.\n\nThe cervix demonstrated involvement by the lesion in the deep cervical stroma, located approximately 1.0 mm from the radial margin. No involvement was observed in the endocervical glands or the upper two-thirds of the cervical stroma. Lymphovascular invasion was identified.\n\nThe ovaries and fallopian tubes were unremarkable bilaterally. Serosal endometriosis with adhesions was noted on the uterine surface. Additional findings included uterine leiomyomata.\n\nLymph node assessment included one left pelvic lymph node and one right pelvic lymph node; neither contained identifiable abnormal tissue.\n\nAn omental biopsy was submitted as adipose tissue measuring 11.0 x 6.0 x 1.2 cm. One section demonstrated a small, detached, and distorted group of cells. Further evaluation through deeper levels did not reveal additional concerning features, and the group was deemed too small and distorted for definitive characterization.\n\nIntraoperative frozen section analysis was limited due to cautery and freezing artifacts. Upon reprocessing, no metastatic involvement was detected in the previously assessed regions. The presence of a focus in the deep cervical stroma raised the possibility of lymphatic spread rather than direct extension from the primary lesion.\n\nAdditional immunohistochemical or molecular studies were initiated to further clarify the nature of certain ambiguous findings, but results were pending at the time of reporting."} +{"pid": "TCGA-D6-A6EP", "report": "The examined specimen revealed a whitish, lobular tumor measuring 6 x 3.7 x 2.5 cm in cross-section. Histopathological analysis showed invasive cellular growth with non-keratinising features. The tumor demonstrated high-grade cellular atypia. Surgical margins were found to be involved."} +{"pid": "TCGA-HT-8011", "report": "The pathology report indicates that the neoplastic cells show variable but generally strong immunoreactivity for GFAP. The granular cytoplasm is also positive, though the staining intensity is often less pronounced in certain regions. Histochemical analysis reveals that the granules are positive for both PAS and PAS with diastase digestion, suggesting a lysosomal origin. A significant number of MIB-1 positive cells are observed, with a calculated labeling index of 33%. Microscopic evaluation includes assessment of cellular morphology, immunohistochemical markers, and mitotic activity. The tumor exhibits features consistent with a high-grade lesion, with regional involvement noted."} +{"pid": "TCGA-E2-A10E", "report": "The vulvectomy specimen measured 4 x 1.7 x 1 cm and was sectioned in a serial fashion from right to left. Margins were evaluated, with mild squamous dysplasia identified at the 12 o\u2019clock to 6 o\u2019clock margin, although some areas were obscured by cautery artifact. Five sentinel lymph nodes were examined, with two of the five showing evidence of involvement. One lymph node (SLN #1) contained a focus measuring 3.5 mm with extranodal extension, and another (SLN #4) contained a focus measuring 1.2 cm without extranodal extension. The remaining sentinel lymph nodes showed no involvement.\n\nA simple mastectomy specimen from the left breast weighed 474 grams and measured 21 x 19 x 3.5 cm. A gray-white firm mass was identified within the central region, measuring 2.5 x 1.5 x 1 cm, located in slices 5 and 6, approximately 0.7 cm from the deep margin and 2 cm deep to the nipple. A second satellite nodule was found in slice 8, measuring 1 x 0.9 x 0.8 cm, 0.4 cm from the deep margin, and a third possible nodule was noted in slice 7, measuring 0.4 cm, greater than 0.1 cm from the deep margin. All surgical margins were free of tumor, with the closest distance being 2.5 mm from the deep margin. Histologic evaluation revealed three distinct foci of invasive malignancy; the largest focus measured 1.8 cm. Nuclear grade was low, and perineural invasion was present. Ductal carcinoma in situ was also identified, predominantly of micropapillary, cribriform, and papillary types, comprising approximately 2% of the total tissue volume. No vascular or lymphatic invasion was identified.\n\nAxillary dissection included 16 lymph nodes, all of which showed no evidence of involvement. Immunohistochemical analysis demonstrated positivity for ER and PR, and negativity for HER2 by FISH. Pathologic staging was determined as pT1c pN1a. Intraoperative frozen section and touch prep analysis confirmed positive margins in some samples, while others were negative."} +{"pid": "TCGA-AZ-4308", "report": "The resected specimen from the sigmoid colon measured 11.5 cm in length. The lesion involved the sigmoid colon and exhibited an infiltrative growth pattern. The tumor measured 5.5 cm in its greatest dimension and extended through the muscularis propria into the surrounding adipose tissue, approaching within less than 1 mm of the serosal surface. Histologic evaluation revealed features consistent with adenocarcinoma, displaying well to moderately differentiated morphology. Margins of resection, including proximal, distal, and mesenteric, showed no evidence of tumor involvement. Angiolymphatic invasion was present; however, there was no definitive perineural invasion identified. Lymph node examination identified 14 regional nodes, with 3 showing metastatic involvement. The tumor demonstrated a mild to moderate lymphocytic response at the invasive margin. No additional significant pathologic findings were noted."} +{"pid": "TCGA-XR-A8TF", "report": "The liver biopsy specimen consists of a segment measuring 17.0 x 12.0 x 7.5 cm and weighing 532 grams. On gross examination, a friable, whitish lesion is identified, measuring 6.5 cm in diameter, located 0.3 cm from the surgical margin. The liver surface shows slight irregularity. Microscopic evaluation reveals a surgical margin of 0.59 cm. The surrounding non-neoplastic liver tissue demonstrates moderate periportal fibrosis with preserved architectural pattern. No angiolymphatic invasion is identified. The pathological stage is classified as pT1 according to the TNM 7th edition classification. Additionally, no Schistosoma mansoni eggs are detected."} +{"pid": "TCGA-D8-A140", "report": "Histopathological examination was performed on a resected left breast specimen along with axillary tissues and a skin flap. The breast measured 22 x 17 x 5 cm, and the axillary tissue measured 9 x 6 x 2 cm. A lesion was identified in the upper outer quadrant of the breast, measuring 3.1 x 1.5 x 1.7 cm. It was located 6 cm from the upper edge of the breast, 0.7 cm from the base, and 1.2 cm from the skin.\n\nMicroscopic evaluation revealed a high-grade cellular proliferation arranged in a ductal pattern. The histological grade was determined based on nuclear pleomorphism, glandular architecture, and mitotic activity, with a total score indicating poorly differentiated morphology. The surrounding glandular tissue showed benign changes including fibrocystic mastopathy and simple ductal hyperplasia.\n\nImmunohistochemical analysis demonstrated estrogen receptor positivity in 75% of the cell nuclei and progesterone receptor positivity in 10%. HER2 protein expression was assessed using HercepTest\u2122 by DAKO, and a strong positive reaction was observed in the neoplastic cells (Score = 3+).\n\nExamination of axillary lymph nodes revealed the presence of malignant cells in one node. There was evidence of capsular invasion. No other significant pathological findings were noted in the remaining lymph nodes.\n\nThe lesion was classified as pT2 based on size, and the presence of metastatic cells in regional lymph nodes corresponded to a pN1a stage. All findings have been validated for reporting accuracy."} +{"pid": "TCGA-QR-A70V", "report": "The specimen consists of an intact ovoid tan-pink nodule measuring 7.5 x 5.5 x 3 cm and weighing 97.4 grams, submitted as the right adrenal gland. The external surface includes a separate adrenal component measuring 6.5 x 1.5 x 0.5 cm and inked black. Upon sectioning, the nodule reveals a hemorrhagic, friable maroon-pink cut surface. Gross photographs were taken. Approximately 50% of the central portion of the nodule was procured for research purposes, along with a 3-mm fragment. Additionally, about one-fourth of the adjacent normal-appearing adrenal tissue was collected for study. The remaining tissue was fixed in formalin and submitted for permanent processing. Representative sections of the lesion were embedded and placed into white cassettes for histologic evaluation. Immunohistochemical staining demonstrated positivity for synaptophysin and chromogranin. Proliferation index assessed by MIB-1 immunostain was low. All tests used were developed and validated internally; they have not been cleared or approved by the U.S. Food and Drug Administration. The laboratory is certified under CLIA to perform high-complexity testing."} +{"pid": "TCGA-66-2744", "report": "The examined right lower lobe measured 16 x 12 cm at the base and up to 18.5 cm in length. A central bronchial resection line was identified at the bifurcation of a segmental bronchus. Two staple suture lines, measuring 4.5 cm and 3.5 cm, extended from the hilus toward the cranial and ventrocaudal regions. At the hilus, two mobile, grayish-black lymph nodes were present, measuring 0.6 cm and 0.8 cm. A pale brownish-white mass with unclear borders and patchy black pigmentation was observed centrally, reaching a maximum size of 3.8 cm. The lesion showed involvement of peribronchial lymph nodes, including one hilic node measuring up to 1.2 cm. The distance from the hilar resection margin to the tumor was at least 0.1 cm, with extension to the peripheral pleura. Spread along smaller bronchial branches appeared sleeve-like. Dilatation of peripheral bronchi within the affected segment was noted, containing thick mucus. The surrounding parenchyma was diffusely firm in areas and displayed a brownish-yellow discoloration. No abnormalities were identified in the remaining parenchyma or pleural surfaces.\n\nLymph node examination included: one 1.2 cm and one 1.3 cm node from the middle lobe region, a 2.5 cm hilar node on the right, and two subcarinal nodes measuring 0.6 cm and 3.0 cm, the latter being elongated. Histological sections included the tumor, adjacent lung tissue, involved lymph nodes, bronchial margins, hilar resection surface, and regional vasculature. Microscopic assessment of intraoperative samples indicated no tumor involvement in a small lymph node section and a separate node without malignancy. Further histological details were omitted due to capacity constraints.\n\nHistopathological findings demonstrated a solid, large-cell neoplasm without mucin production, extending from central to peripheral areas near the mediastinal pleura. Tumor necrosis was prominent. There was marked chronic interstitial inflammation at the tumor margin, with lymphoid follicles and atypical adenomatous hyperplasia of alveolar epithelium. Chronic sclerotic changes were present in peribronchial tissues, with active inflammation in distal airways. Lymph nodes showed reactive changes and anthracotic pigment deposition without tumor involvement.\n\nVascular invasion was noted in medium-sized pulmonary arteries, with focal destruction and occlusion of vessel walls. Tumor infiltration extended into the outer wall of the main pulmonary artery branch supplying the lower lobe. Resection margins of both bronchus and major vessels were free of tumor. Lymph node involvement was limited to those in proximity to the primary lesion and within the hilar region. Some histological features suggested possible squamous differentiation, although definitive classification awaited immunohistochemical analysis.\n\nImmunostaining revealed positivity for CK7 and variable expression of high molecular weight keratins, with absence of TTF-1 staining. These findings supported a profile consistent with an undifferentiated squamous cell phenotype."} +{"pid": "TCGA-VS-A8EK", "report": "The biopsy specimen from the cervix demonstrates a neoplastic process involving the transformation of squamous epithelium. Histological evaluation reveals moderately differentiated cells with features indicative of invasive growth. The cellular morphology exhibits moderate pleomorphism, increased nuclear-to-cytoplasmic ratios, and scattered mitotic figures. No lymphovascular invasion is identified. The lesion appears to be confined to the cervix without extension into adjacent tissues. Specimen margins are free of abnormal cells. Clinical staging indicates early disease with no evidence of regional or distant spread."} +{"pid": "TCGA-E6-A1LX", "report": "The specimen consisted of multiple collected tissues including a cystic lesion attached to a silver clip, measuring 1.3 x 0.7 x 0.7 cm with golden-yellow appearance on sectioning. Two small nodules were observed on its surface.\n\nThe right adnexa included a fallopian tube measuring 3.3 cm in length with a diameter of 0.7 cm and an associated paratubal cyst measuring 0.2 cm. The ovary measured 3.4 x 2.7 x 0.9 cm with multiple fluid-filled cysts ranging from 0.3 to 0.9 cm in size. No abnormal masses or papillary lesions were identified.\n\nThe left adnexa contained a fallopian tube measuring 4.2 cm long with paratubal cysts ranging from 0.5 to 0.7 cm. The ovary was larger at 6.6 x 2.6 x 1.6 cm with multiple cysts present on the surface and within the ovary, measuring between 0.1 and 0.8 cm. No masses or abnormal tissue were observed.\n\nThe uterus weighed 162 grams and measured 11.0 x 6.0 x 4.8 cm. Upon bisection, a friable tan mass occupied the endometrial cavity. The wall thickness of the myometrium was 2.0 cm and invasion into this layer was noted at a depth of 0.4 cm (20%). The mass itself measured 5.0 x 3.4 x approximately 0.7 cm.\n\nLymph node evaluations were conducted for both external iliac regions and para-aortic areas. On the left side, five lymph nodes were identified and examined; four additional lymph nodes were later submitted for evaluation. All were negative for malignant cells. On the right side, initially four lymph nodes were evaluated with three additional ones submitted afterward\u2014again no tumor involvement was detected. In the para-aortic region, three lymph nodes were assessed, and additional fibrous adipose tissue was submitted for further histologic examination; however, no lymph nodes were identified in that submitted tissue.\n\nHistologic grading revealed high-grade features with invasion into the myometrium and presence of vascular or lymphatic invasion. Surgical margins were clear and no other positive sites were identified. Negative peritoneal cytology was reported.\n\nAll surgical margins were free of involvement and lymph node assessments showed no signs of metastasis."} +{"pid": "TCGA-E3-A3E1", "report": "The specimen consists of a right thyroid lobe measuring 4.0 x 3.1 x 2.2 cm, weighing 16 grams. A well-circumscribed mass measuring 1.5 x 1.5 x 1.0 cm is identified within the mid-section of the lobe. The mass is described as white-tan, soft, and multicystic with cystic spaces up to 0.1 cm in diameter. No hemorrhage or calcification is observed. Margins are free of involvement. Two lymph nodes are identified and show no evidence of malignant involvement (0/2). Histologically, the lesion demonstrates features consistent with a unifocal tumor without venous or lymphatic invasion. Additional findings include nodular goiter and chronic inflammation. The tumor is staged as pT1 NO MX based on the available lymph node assessment."} +{"pid": "TCGA-56-A62T", "report": "The surgical specimen included a left upper lobe lobectomy with hilar and subcarinal lymph node excisions, an additional bronchial margin, and specimens from the pulmonary ligament and lymph nodes. The main lesion measured 5.5 cm and was found to invade through the visceral pleura into adjacent dense fibrous tissue. The tumor was in close proximity to the pleural surface, which was involved. All other margins, including bronchial and vascular, were free of tumor involvement.\n\nA separate 0.9 cm lesion was identified in the pulmonary ligament, showing a well-differentiated, nested neoplastic process composed of small cells with uniform oval nuclei and finely speckled chromatin. Immunohistochemical staining demonstrated positivity for chromogranin and synaptophysin, and negativity for pancytokeratin. No necrosis or mitotic activity was observed in this lesion.\n\nLymph node specimens from hilar and subcarinal regions were benign, with no evidence of metastatic involvement. Histologic evaluation of the primary tumor showed features of invasive carcinoma, with nests of cells displaying enlarged nuclei and occasional prominent nucleoli, along with mild keratin formation and intercellular bridges. No lymphovascular or perineural invasion was identified.\n\nStaging parameters indicated a primary tumor stage of pT2b, with no regional lymph node involvement (pN0) and no distant metastasis. The overall pathologic stage was determined to be IIB. The uninvolved lung tissue showed minimal background changes, and there was no evidence of treatment effect."} +{"pid": "TCGA-BJ-A0ZG", "report": "The pathology report includes molecular and histologic findings from a surgical specimen. Molecular testing was performed on paraffin-embedded tissue using manual microdissection, with specimens containing at least 50% tumor cells. BRAF codons 599\u2013601 were tested and showed a V600E mutation (T1799A). No mutations in NRAS codon 61, HRAS codon 61, or KRAS codons 12/13 were detected. RET/PTC rearrangement was assessed by FISH, and results were negative.\n\nLoss of heterozygosity (LOH) analysis was conducted using 16 microsatellite markers linked to tumor suppressor genes. LOH was identified at chromosomes 1p, 10q, and 13q. Allelic loss was found at 5 of 13 informative loci (38%). Specific deletions were noted at RB1 (13q14.3), which is associated with tumor suppressor gene pathways.\n\nHistologic examination of the right superior parathyroid gland revealed an enlarged, hypercellular gland with fibrosis predominantly located peripherally. There was no evidence of invasive growth. The intraoperative PTH level decreased from 512 pg/ml to 78 pg/ml after excision.\n\nA total thyroidectomy specimen showed a 0.7 cm lesion in the right lobe with follicular architecture and encapsulation. There was no lymphovascular invasion or extension beyond the thyroid capsule. Surgical margins were clear. The background thyroid tissue demonstrated nodular hyperplasia, including a dominant 2.0 cm hyperplastic nodule in the left lobe."} +{"pid": "TCGA-28-1750", "report": "The specimen from the right parietal region was received as multiple tissue fragments. The largest fragment measured 2.4 x 1.7 x 0.9 cm and showed large areas of apparent necrosis. Other fragments ranged in size from 0.5 to 1.6 cm in greatest dimension, with most showing a gray-tan appearance.\n\nMicroscopic evaluation revealed an infiltrating lesion with extensive necrosis. The tumor cells demonstrated pleomorphism, hyperchromatic nuclei, and frequent mitotic figures. Microvascular proliferation was present, along with numerous gemistocytic forms. Areas of abscess-like necrosis were widespread.\n\nImmunostaining results showed that up to 30% of tumor nuclei were positive for MGMT. PTEN expression was retained (up to 3+). pMAPK immunoreactivity was identified in 80% of tumor nuclei and 90% of tumor cell cytoplasm (3+). Laminin beta 1 expression was up-regulated (2+ in endothelial cells), while laminin beta 2 expression was down-regulated (1-2+ in endothelial cells).\n\nAdditional testing by FISH for EGFR was performed on 40 cells. The EGFR/CEP ratio was 1.3, with 7.5% of cells showing more than four copies of EGFR. These findings did not meet criteria for amplification or high-level polysomy.\n\nThe histologic features and staining patterns were reviewed in correlation with available clinical and radiographic findings. It was noted that a high percentage of pMAPK-positive tumor cells may correlate with relative resistance to radiation therapy. The retained expression of PTEN may be associated with a more favorable prognosis. However, the significance of these findings in relation to treatment response and clinical outcome should be interpreted in the context of the individual case and in consultation with the treating physician."} +{"pid": "TCGA-BP-4337", "report": "The left kidney specimen, including adrenal gland and perinephric fat, shows a mass measuring 6.8 x 5.7 x 3.2 cm with acinar growth pattern. The tumor is located 1.1 cm from the adrenal gland and extends into the renal vein as an exophytic polypoid mass measuring 3.6 cm in length. It also involves the renal pelvis. The tumor reaches through the renal capsule but remains within Gerota\u2019s fascia. Tumor emboli are identified in small vessels. All surgical margins, including ureter and vascular margins, are free of involvement. The non-neoplastic kidney tissue appears normal. No lymph nodes are identified in the perinephric adipose tissue.\n\nA para-aortic lymph node is submitted and shows benign features.\n\nA right renal artery thrombus specimen consists of blood clot fragments without evidence of tumor involvement.\n\nThe right renal artery intima biopsy reveals benign vascular wall without signs of malignancy.\n\nThe spleen specimen measures 12.5 x 7.5 x 2.2 cm and weighs 220 grams. The cut surface is hemorrhagic and slightly granular without discrete masses. Three benign lymph nodes are identified in the splenic hilum. No tumor is detected in the spleen or associated lymph nodes."} +{"pid": "TCGA-BH-A0B0", "report": "The surgical specimen includes a segmental mastectomy from the left breast. Histologic evaluation reveals an invasive tumor with a maximum dimension of 1.8 cm. The tumor demonstrates a Nottingham total score of 5 out of 9, with individual scores as follows: tubule formation 2, nuclear pleomorphism 2, and mitotic activity 1. The invasive component is located 8 mm from the nearest anterior surgical margin. No lymphovascular space invasion is identified. Two sentinel lymph nodes were examined using hematoxylin and eosin stain; both showed no evidence of metastatic involvement. The tumor is classified as ductal adenocarcinoma, not otherwise specified. Immunohistochemical staining shows positivity for estrogen and progesterone receptors, while HER2/Neu staining is scored as zero or 1+. Pathologic staging is pT1c for the primary tumor, pN0 for lymph node involvement, and pMX for distant metastasis. No dermal lymphatic invasion, calcifications, or Paget\u2019s disease of the nipple are noted. Fibrocystic changes are present in non-neoplastic breast tissue."} +{"pid": "TCGA-DB-5276", "report": "A biopsy of the left frontal region of the brain demonstrates a neoplasm with features of infiltrating glial origin. Histologic evaluation reveals atypical cells consistent with a diffuse glioma. Immunohistochemical staining on paraffin-embedded tissue shows positivity for GFAP in neoplastic cells exhibiting astrocytic morphology. Overexpression of p53 protein is identified in the majority of tumor cells. The MIB-1 labeling index is moderate, supporting active cellular proliferation.\n\nFluorescence in situ hybridization (FISH) studies using 1p/1q and 19q/19p probe pairs were performed on paraffin sections of the tumor. The 19q to 19p probe ratio was measured at 1.00, and the 1p to 1q probe ratio was 1.02. Ratios below 0.80 are considered indicative of chromosomal deletion; therefore, no deletion was detected in either region. However, 60.1% of cells showed 3\u20134 copies of the probes for chromosomes 1 and 19, suggesting possible chromosomal gain, tetraploidy, or aneuploidy.\n\nThree separate specimens were received. Specimen No. 1 measured 1.0 x 0.3 x 0.3 cm, Specimen No. 2 measured 1.2 x 0.7 x 0.2 cm, and Specimen No. 3 measured 7.0 x 4.5 x 3.0 cm. Gross examination of the resected tissue from the left frontal craniotomy includes multiple tissue blocks submitted for detailed histologic analysis.\n\nThe findings were initially interpreted as consistent with an infiltrating glioma, with preference for an astrocytic lineage, pending further characterization. This assessment was based on frozen section consultation prior to final immunophenotyping and molecular studies. The test used for FISH analysis has been developed and validated by the laboratory and is intended for use as an adjunct to clinical and pathological evaluation, not as a standalone diagnostic tool. It has not been cleared or approved by the U.S. Food and Drug Administration."} +{"pid": "TCGA-06-0686", "report": "The clinical history includes symptoms of mental status change and fatigue. Imaging findings revealed a right temporal lobulated enhancing mass with a central cystic component and significant mass effect. The specimen obtained was from a brain excision biopsy of the right temporal region.\n\nGross examination showed two tissue samples. One specimen measured 3 x 3 x 0.8 cm and consisted of thick, diffusely tan to brown tissue. The second specimen measured 1.5 x 0.7 x 0.5 cm and was composed of irregular tan-gray to white tissue fragments with focal hemorrhage.\n\nMicroscopic evaluation demonstrated cellular infiltration with extensive necrosis, vascular thrombosis, and prominent microvascular proliferation. Nuclear atypia was noted. Immunohistochemical staining revealed gliofibrillogenesis by neoplastic cells, with approximately 2% of tumor cells expressing p53 protein. The proliferation index, as assessed by MIB-1 staining, was approximately 65%.\n\nMolecular testing on the tissue sample showed methylation of the MGMT promoter. The testing method involved bisulfite modification of DNA followed by PCR amplification and gel electrophoresis for detection. It was noted that this assay was developed and validated in a CLIA-certified laboratory and is not an FDA-cleared or approved diagnostic test.\n\nIntraoperative cytologic preparations were performed and showed features consistent with a high-grade glioma. These findings were communicated to the treating physician during surgery."} +{"pid": "TCGA-FI-A3PX", "report": "A 145-gram uterus with attached cervix and bilateral adnexa was received for examination, measuring 5.5 x 7.5 x 5.0 cm. The endometrial cavity is largely replaced by a gray-white papillomatous lesion measuring 6.5 x 6.0 cm on the posterior wall. Microscopic evaluation confirms invasive tumor extending more than two-thirds of the endometrial thickness. The tumor invades to a depth of 12 mm where the myometrium measures 13 mm in thickness. Involvement of the lower uterine segment and cervical canal is observed. Tumor infiltration extends into the stromal connective tissue of the cervix.\n\nWidespread lymphvascular space invasion is noted. Extensive sampling of regional lymph nodes reveals metastatic involvement in six out of fifteen nodes examined. Involved lymph node regions include right and left external iliac, right and left obturator, and right periaortic sites. One lymph node from the right obturator region demonstrates extracapsular extension. No metastatic involvement is identified in the omentum or in the ovaries and fallopian tubes bilaterally. The serosal surface of the uterus appears unremarkable.\n\nThe tumor exhibits extensive local invasion and regional nodal spread. Clinical correlation is necessary for final staging assessment."} +{"pid": "TCGA-DB-5281", "report": "The specimen consists of multiple tissue fragments from a left frontotemporal brain lesion. The largest fragment measures 7.5 x 6.0 x 1.5 cm, with other fragments ranging from 0.4 cm to 6.5 x 5.0 x 2.0 cm. Histological evaluation indicates a high-grade neoplasm with features suggestive of a glial origin. Cellular morphology shows characteristics including nuclear atypia and increased mitotic activity.\n\nFluorescence in situ hybridization (FISH) studies were conducted on paraffin-embedded tumor cells using probes targeting chromosomal regions commonly deleted in gliomas. Two sets of probes were used: one for 19q with a control on 19p, and another for 1p with a control on 1q. Ratios derived from these probes are consistent with normal values (approximately 1) for both pairs. Specifically, the 19q to 19p ratio was 1.02, and the 1p to 1q ratio was 0.87. A ratio below 0.80 would be indicative of deletion; therefore, no deletions were detected in these regions.\n\nHowever, approximately 70% of the analyzed cells displayed 3-4 copies of the probes for 1p, 1q, 19p, and 19q. These findings have been previously observed in certain gliomas and may reflect chromosomal gains involving chromosomes 1 and 19. Alternatively, this pattern could be consistent with tetraploidy or aneuploidy within the tumor. It is important to note that the FISH assay used in this analysis has not been cleared or approved by the U.S. Food and Drug Administration and is intended to support, not replace, existing clinical and pathological assessments. This test does not exclude the presence of other chromosomal abnormalities.\n\nA prior amendment corrected a typographical error in the initial report, changing references from Sp & 1Yq to the appropriate chromosomal loci, 1p and 19q. Initial frozen section consultation suggested a high-grade glioma, and permanent sections were subsequently processed for detailed histopathological review. Multiple tissue blocks were examined, corresponding to different areas of the resected specimen."} +{"pid": "TCGA-AC-A4ZE", "report": "The left mastectomy specimen showed benign breast tissue with stromal fibrosis. No abnormal cellular changes were identified, including at the margins. The skin and nipple appeared normal.\n\nThe right mastectomy specimen contained a lesion measuring 7.8 x 7.0 x 6.0 cm located in the lower outer quadrant. The lesion was firm and tan-white, infiltrating into the surrounding breast tissue. It was situated 1.5 cm from the deep margin, 4.0 cm from the anterior margin, 6.0 cm from the lateral margin, 19.0 cm from the medial margin, 6.0 cm from the inferior margin, and 14.0 cm from the superior margin. Two possible satellite lesions were noted: one central (6.5 x 3.0 x 3.0 cm) and one at the 2:00 position (1.5 x 2.5 x 2.5 cm). The uninvolved breast tissue showed no significant abnormalities. Margins were widely negative. Histologic grade was Nottingham II of III. No involvement of the skin or nipple was observed. No lobular or ductal intraepithelial neoplasia was present. Lymphovascular invasion was not identified.\n\nOne sentinel lymph node was examined from the right axilla and showed no evidence of metastasis (0/1).\n\nImmunohistochemical studies showed strong positivity for estrogen receptor in 95% of cells and for progesterone receptor in 50% of cells. Her-2/neu staining was scored as 0+. Ki-67 proliferation index was 25%. No FISH analysis was performed for Her-2/neu.\n\nThe specimens were properly oriented and inked. Sections were taken from multiple areas including margins, uninvolved parenchyma, and satellite lesions. All margins were free of involvement.\n\nThe right mastectomy specimen weighed 1670 grams and measured 26.0 x 28.0 x 6.0 cm. The overlying skin was pink and unremarkable. The left mastectomy specimen weighed 1595 grams and measured 23.5 x 22.5 x 6.3 cm, with tan-pink unremarkable skin."} +{"pid": "TCGA-AA-3679", "report": "The colon resection specimen measures 8 cm in length and contains an extensively ulcerated lesion of colorectal type, with a nearly circular growth pattern extending approximately 3 cm along the longitudinal axis, centrally located within the specimen. Microscopic evaluation reveals infiltration of the pericolic fatty tissue. Five regional lymph nodes show involvement. There is no indication of serosal penetration. The resected margins of the colon are free of tumor. The pathological staging is pT3 pN2 (5 out of 12 lymph nodes positive) with clinical evidence of distant metastasis (pM1), corresponding to a Grade 2 differentiation. Lymphatic invasion is present (L1), while vascular invasion is not identified (V0). The surgical resection margins are tumor-free. A separate finding describes a small intestinal segment without inflammation or evidence of heterotopic tissue, consistent with a Meckel\u2019s diverticulum."} +{"pid": "TCGA-93-7347", "report": "A wedge excision of lung tissue measuring 8.5 x 3.8 x 2.4 cm was received, containing a staple line and a well-demarcated yellow nodule measuring 1.5 x 1.0 x 1.0 cm. The nodule is located 1 mm from the nearest pleural surface. Microscopic evaluation reveals a moderately differentiated cellular growth pattern with features suggestive of bronchioloalveolar involvement. No definitive lymphovascular invasion is identified. The pleural surface appears intact without evidence of tumor involvement. A separate lobectomy specimen includes two portions measuring 13.7 x 8.4 x 3.0 cm and 15 x 3 x 2.1 cm. The bronchial margin is free of tumor involvement.\n\nMultiple lymph nodes were evaluated during the procedure. One lymph node at level 10 showed rare mucinous cells on initial frozen section; however, these findings were not confirmed in permanent sections and are considered non-diagnostic. All other lymph nodes examined\u2014including those at levels 10 (second sample), 11, 4R, 2R, 10R (suspicious), and subcarinal\u2014show no evidence of malignancy. In total, nine lymph nodes were assessed, none of which demonstrated metastatic involvement.\n\nMargins of resection, including the bronchial margin and vascular margins, are free of tumor. A separate finding of multifocal atypical adenomatous hyperplasia is noted in the lobectomy specimen. Additionally, a hyalinized and calcified granuloma is identified within one lymph node.\n\nThe tumor measures 1.5 cm in greatest dimension and demonstrates no lymphatic, venous, or arterial invasion. Pleural involvement is not present. All surgical margins evaluated are uninvolved by tumor. Based on these findings, the tumor is classified as T1a, with no regional lymph node metastasis (pN0). Distant metastasis cannot be determined based on available data. The overall staging is provisionally assigned as T1aN0MX."} +{"pid": "TCGA-D7-8574", "report": "The resected stomach specimen measured 21.5 x 17 cm and was accompanied by omental tissue measuring 48 x 32 cm. A tumor measuring 3.2 x 5.5 x 1.4 cm was identified in the pyloric region. The distance from the proximal resection margin was 7.1 cm, and from the distal margin was 2.5 cm. Histologically, the lesion exhibited features consistent with mucocellular carcinoma of diffuse type. The tumor infiltrated into the muscularis propria (pT2), without involvement of the resection margins. Lymph node examination revealed metastatic involvement in 13 out of 16 nodes examined (pN2). Immunohistochemical staining for HER2 protein using Ventana Pathway HER-2/neu (4B5) rabbit monoclonal antibody demonstrated a score of 1+, indicating no significant overexpression in the invasive component."} +{"pid": "TCGA-RC-A7S9", "report": "The liver segmentectomy specimen includes a single, expanding nodular mass measuring 2.3 x 1.9 cm. The tumor has a grayish, homogeneous cut surface without necrosis and is surrounded by a complete fibrous capsule. Microscopic examination reveals infiltration of the capsule and septum formation. Histologic architecture is microtrabecular with hepatic-type cells. The major differentiation corresponds to Edmondson grade II, while the worst differentiation reaches Edmondson grade III. There is no evidence of satellite nodules, tumor necrosis, hemorrhage, fatty change, surgical margin invasion, serosa invasion, portal vein invasion, bile duct invasion, hepatic artery invasion, microvessel invasion, intrahepatic metastasis, or multicentric occurrence. Vascular invasion involving the hepatic vein is noted as grade II. The non-tumor liver tissue demonstrates cirrhosis due to chronic hepatitis B, with minimal lobular activity and no significant periportal inflammation. Examination of the gallbladder shows mild chronic cholecystitis without stones or polyps. Immunohistochemical staining confirms positivity for hepatocyte in tumor cells and negativity for cytokeratin 19. Cytokeratin 7 stains bile duct structures but is not expressed in tumor regions. Iron staining is negative in the sampled tissue."} +{"pid": "TCGA-IB-7644", "report": "Surgical pathology evaluation was performed on multiple specimens including a gallbladder specimen, pancreatic duct margin, bile duct margin, Whipple resection specimen, and an aortic lymph node. The patient presented with obstructive jaundice and a prior ERCP demonstrated a stricture in the distal bile duct with placement of a plastic stent. Imaging findings from CT showed biliary dilatation affecting both intrahepatic and extrahepatic bile ducts, marked dilatation of the pancreatic duct, possible cystic lesions in the liver, and lymphadenopathy in the iliac region.\n\nHistopathologic examination of the gallbladder showed acute cholecystitis. Margins from both the pancreatic duct and bile duct were free of malignant cells. The Whipple resection specimen included a lesion in the head and uncinate process of the pancreas with ductal adenocarcinoma identified. A partial pancreatic resection was performed as part of the procedure. Lymph node involvement was not specified in this summary."} +{"pid": "TCGA-EJ-5542", "report": "The patient is a male with a history of a PSA value of 19.3 and a previous biopsy. The biopsy showed findings in the left and right prostate regions, including involvement of the apex, mid, and base sections. There was also evidence of perineural invasion in the left and right apex and right mid section. The patient has a history of hypertension and hypercholesterolemia. A radical prostatectomy was performed.\n\nExamination of the right pelvic lymph nodes showed no evidence of abnormal cellular growth in eight nodes. Similarly, the left pelvic lymph nodes, nine in total, showed no signs of abnormality. The prostate specimen showed invasive poorly differentiated adenocarcinoma with a Gleason score of 3+4=7. The tumor was present in both the right and left lobes of the prostate, measuring up to 1.8 cm in greatest dimension. Approximately 10% of the examined prostate volume was involved by the tumor.\n\nThe tumor demonstrated established extension beyond the prostatic capsule, most notably in the posterior right apex, mid, and base, as well as the posterior left mid region. The bilateral seminal vesicles were not involved. All surgical resection margins were free of tumor. Perineural invasion was identified, but no angiolymphatic invasion was observed. High-grade prostatic intraepithelial neoplasia was also noted. Benign prostatic hypertrophy was present.\n\nThe pathologic TNM stage was determined to be pT3a with no regional lymph node involvement (pN0) and no assessment of distant metastasis (pMX). The histologic grade was classified as G3. The prostate weighed 69.12 grams, and the tumor was found to involve approximately 5\u201325% of the specimen. Multifocality was noted, and all surgical margins were clear of tumor. A total of 17 lymph nodes were examined, and none were positive for tumor involvement."} +{"pid": "TCGA-G5-6235", "report": "The specimen consists of a segment of sigmoid colon and upper rectum measuring 15.5 cm in length, with the rectal portion measuring 4.5 cm. The proximal and distal margins are closed by staples, with the proximal margin inked blue and the distal margin inked yellow. Upon opening, a 3.5 x 3.0 x 0.7 cm ulcerated lesion is identified at the rectosigmoid junction. The lesion infiltrates into the subserosa but does not extend through the muscularis propria. It is located 2.8 cm from the rectal margin and 9.7 cm from the proximal colonic margin, causing luminal narrowing to 2.8 cm at the affected area.\n\nMargins: Microscopic evaluation reveals involvement of the radial margin by invasive carcinoma, while the proximal and distal margins show no evidence of tumor involvement.\n\nLymph nodes: Six lymph nodes are identified in the pericolic soft tissue. Of the submitted lymph nodes, one out of thirteen demonstrates involvement by malignant cells; extranodal extension is not observed.\n\nHistologic evaluation reveals moderately differentiated features with no evidence of venous, lymphatic, or perineural invasion. No tumor implants are identified. The tumor exhibits an infiltrative and ulcerating configuration.\n\nStaging: Based on extent of invasion and nodal involvement, the pathologic classification is pT3c/d N1 Mx. Benign colonic-type mucosa is observed in both the proximal and distal donut specimens."} +{"pid": "TCGA-64-1679", "report": "The specimen was received in seven parts. \n\nA fragment of rib measuring 2.5 x 1.5 x 1.0 cm was submitted without evidence of any suspicious lesion or mass. Sections were taken after decalcification. \n\nA single lymph node labeled as level 9, measuring 1.3 x 0.7 x 0.7 cm, was submitted entirely and showed no abnormal areas. \n\nTwo lymph nodes identified as level 4R, measuring 0.5 cm and 0.7 cm respectively, were submitted whole and showed no abnormalities. \n\nThe right upper lobe of the lung weighed 98 grams and measured 12.4 x 9.5 x 5.5 cm. No lesions were found in the bronchial tree or vascular margins. Several hilar and peribronchial lymph nodes ranging from 0.4 to 1.2 cm were noted and appeared unremarkable. A focal area of pleural puckering and thickening measuring 1.5 x 0.7 cm was observed, with an underlying ill-defined firm mass measuring 2.0 x 1.8 x 1.8 cm located 4.2 cm from the hilum/margin. The remainder of the lung parenchyma appeared normal. Sections were taken from the bronchial margin, vascular margins, hilar lymph nodes, tumor in relation to the pleura, tumor itself, and uninvolved lung tissue. \n\nAnother set of level 4R lymph nodes were submitted\u2014measuring 0.7 cm and 1.9 cm. Both were unremarkable on gross examination and were fully submitted for analysis. \n\nA pre-carinal lymph node measuring 2.0 x 1.3 x 1.0 cm was firm with a black to tan cut surface and was entirely submitted for frozen section and further evaluation. \n\nA level 7 lymph node measuring 2.8 x 2.3 x 1.0 cm had a grayish-black cut surface and was also submitted entirely. \n\nMicroscopic evaluation revealed hypercellular bone marrow with trilineage hematopoiesis from the rib specimen. All lymph nodes except one showed no evidence of malignant cells. In one pre-carinal lymph node, metastatic involvement was identified. \n\nThe primary lesion demonstrated moderate differentiation with necrosis and an acinar growth pattern. Lymphovascular invasion was present, but there was no extension into visceral pleura. All resection margins were negative. Seven associated lymph nodes were also negative. \n\nStaging is indicated as pT1 N2 Mx."} +{"pid": "TCGA-VQ-A92D", "report": "The specimen includes the stomach (cardia) and distal esophagus. A lesion is present in the cardia region, focally invasive to subserosal adipose tissue and extensively involving the distal esophagus. The largest dimension of the lesion measures 6.5 cm. Histologic evaluation shows moderately differentiated tubule-vilous architecture. Angiolymphatic invasion is not identified, though perineural invasion is present. Surgical margins are free of neoplastic involvement. A total of 28 lymph nodes were examined, including 21 from the lesser curvature and 7 from the greater curvature, all without evidence of metastatic involvement. The esophageal margin also shows no neoplastic involvement."} +{"pid": "TCGA-TM-A84J", "report": "The specimen consists of an occipital tumour biopsy and additional tissue from the same region. The biopsy measured 10 x 7 x 2mm, while the aggregate size of the additional fragments was approximately 40 x 30 x 7mm. Histological examination confirmed a high-grade glioma. Microscopic analysis revealed extensive effacement of the parenchyma by a malignant glioma with areas of necrosis. The tumor cells exhibited variable nuclear pleomorphism, hyperchromasia, coarse chromatin, small nucleoli, and perinuclear cytoplasmic clearing. Frequent interconnecting small thin-walled blood vessels and occasional calcium deposits were observed in the background. Multinucleated tumor giant cells were present, along with numerous mitotic figures and apoptotic bodies. Endothelial proliferation was widespread.\n\nImmunohistochemistry showed extensive positivity for GFAP, with scattered positive staining for p53. GFAP labeling highlighted some mini-gemistocytes. The proliferation index, assessed using MIB-1 (Ki67), ranged between 10\u201315%. Based on morphology and immunophenotype, the differential diagnosis includes two possibilities: one consistent with a WHO Grade III tumor characterized by features of anaplastic oligodendroglioma, and another consistent with a WHO Grade IV tumor showing features of high-grade mixed oligoastrocytoma. Fluorescence in situ hybridization (FISH) studies were conducted to evaluate genetic markers; results showed no loss of 1p or 19q, and no EGFR amplification was detected. Given these findings, the morphological assessment remains unchanged and favors a tumor consistent with WHO Grade III classification. However, it remains challenging to definitively exclude a WHO Grade IV tumor where high-grade oligodendroglioma is the predominant morphological pattern."} +{"pid": "TCGA-E2-A1BD", "report": "The specimen includes a sentinel lymph node from the right axilla and a wide local excision of the right breast following needle localization. The lymph node is measured at 1.8 x 1.1 x 0.5cm and shows no evidence of metastatic disease. The breast specimen is an oriented lumpectomy weighing 98g and measuring 8 x 4.5 x 4cm. After serial sectioning, a tan-white, firm, stellate mass measuring 2.3 x 1.8 x 1.7cm is identified, located 0.4cm from the medial margin and 0.5cm from the anterior margin. Margins are otherwise negative.\n\nHistological evaluation demonstrates a tubular score of 2, nuclear grade of 2, and mitotic score of 2, corresponding to a modified Scarff Bloom Richardson Grade of 2. Necrosis is not present, and vascular or lymphatic invasion cannot be determined. There is no lobular neoplasia identified. One sentinel lymph node is examined and found to be free of tumor involvement.\n\nNon-neoplastic changes include fibrocystic disease. Ductal carcinoma in situ (DCIS) is present in association with the invasive lesion, accounting for approximately 2% of the tissue, with solid and cribriform patterns. The nuclear grade of DCIS is low, and necrosis is absent. Margins are uninvolved by DCIS.\n\nImmunohistochemical analysis reveals positive hormone receptor status with ER and PR positivity, and HER2 negativity confirmed by FISH. Based on AJCC 7th edition criteria, the pathological stage is pT2 pN0. An Oncotype DX assay yields a recurrence score of 10, associated with an average 10-year distant recurrence risk of 7% in clinical validation studies. ER and PR scores are consistent with positivity, while Her2 score confirms negativity."} +{"pid": "TCGA-CV-7255", "report": "The total glossectomy specimen demonstrates three distinct areas of invasive, moderately well-differentiated squamous carcinoma. These lesions vary in size from 6.0 to 1.2 cm and exhibit a diffuse pattern of invasion with a depth of involvement measuring 0.8 cm. Perineural invasion is identified within the tissue. Surgical margins are negative for tumor involvement. Additional specimens including lymph nodes and nerve tissue from both sides show no evidence of tumor presence. Fibrosis is noted in the left parapharyngeal space, anterior tonsillar pillar, and left gingival nodule. No tumor cells are observed in the sampled lymph nodes or nerve specimens."} +{"pid": "TCGA-96-7544", "report": "The specimen consists of a right lower lobe lobectomy and level 7 lymph node biopsy. The lobectomy measures 20 x 13 x 4.5 cm and weighs 259 grams. A well-circumscribed, firm, white-gray tumor measuring 3.8 cm in greatest dimension is identified within the lung parenchyma. It is located 0.4 cm from the pleura and 0.7 cm from the bronchial margin. The tumor extends to adjacent bronchioles but does not involve the bronchial or vascular margins. No vascular or lymphatic invasion is observed.\n\nLymph nodes at the hilum are involved, with four out of seven affected. These include peribronchial and hilar lymph nodes. Six additional lymph nodes from level 7 are submitted and show no evidence of involvement. The surrounding lung tissue demonstrates anthracotic pigmentation, squamous metaplasia, patchy interstitial fibrosis, and peribronchiolar metaplasia. A meningothelial-like nodule is also noted.\n\nSections submitted include representative portions of the tumor, margins, lymph nodes, and surrounding lung tissue. Intraoperative consultation confirmed the presence of invasive malignant cells consistent with high-grade morphology. Immunohistochemical staining was performed as part of diagnostic evaluation."} +{"pid": "TCGA-E2-A1LL", "report": "The specimen consisted of additional left axillary lymph nodes and a left breast with axillary contents from levels 1 and 2. The axillary lymph nodes were embedded in fibrofatty tissue measuring 4.0 x 4.0 x 2.0 cm, containing a total of 7 lymph nodes ranging in size from 0.2 x 0.2 x 0.2 cm to 2.0 x 1.5 x 1.5 cm. The left breast mastectomy specimen weighed 2,422 grams and measured 31 x 27 x 10 cm. The skin surface was partially covered with a tan-brown ellipse of skin measuring 27 x 14.5 cm. A gray-white linear scar measuring 3.5 cm was noted on the skin surface, located 6.0 cm from the nipple in the upper outer quadrant. The nipple was partially flattened and measured 1.0 cm, with the areola measuring 3.0 cm in diameter.\n\nSerial sectioning of the breast from medial to lateral yielded 13 slices, with the mass located in slices 6, 7, 8, and 9. A firm or necrotic mass measuring 9.0 x 8.0 x 4.0 cm was identified in the upper outer and central outer quadrants, located 0.6 cm from the closest deep margin. The remainder of the breast showed yellow adipose tissue interspersed with fibrous tissue, with an axillary tail measuring 8.0 x 5.0 x 4.0 cm. Dissection of the breast specimen revealed 27 lymph nodes ranging in size from 0.1 x 0.1 x 0.1 cm to 5.0 x 2.0 x 2.0 cm, with the largest found in slices 11 and 12.\n\nMicroscopic evaluation of the lymph nodes from both the axillary dissection and breast specimen showed that 5 out of 44 lymph nodes contained metastatic involvement, with extranodal extension noted. Histologic grading showed a high-grade morphology with features including necrosis. The surgical resection margins were free of involvement. In addition, in situ changes were observed in the lobular regions. Immunohistochemical staining for hormone receptors (estrogen and progesterone) showed no expression, with Allred scores of 0 for both. HER2 staining demonstrated 1+ intensity in approximately 5% of tumor cells, with no amplification detected by FISH.\n\nStaging was determined as pT3 N2a based on the size of the lesion and nodal involvement. Vascular or lymphatic invasion was not identified."} +{"pid": "TCGA-EI-6507", "report": "Histopathological examination was performed on a resected segment of the large intestine. The specimen measured 19 cm in length and included mesorectal fat tissue measuring 2 cm in thickness. A macroscopic ulcerous, cauliflower-shaped lesion was identified in the mucosa, measuring 5.3 x 10 x 4.5 cm. The lesion circumferentially involved the intestinal wall, causing significant luminal narrowing. It was located 12.5 cm from the proximal resection margin and 4.5 cm from the distal margin, with the minimum radial margin measuring 2 cm. Microscopic evaluation revealed poorly differentiated mucinous-type epithelial cells infiltrating the muscularis propria and perirectal adipose tissue. Resection margins were free of malignant cells. Reactive lymph node changes were noted in the regional lymph nodes. No evidence of lymph node metastasis was found. The tumor was classified as pT3, pN0, R0."} +{"pid": "TCGA-26-5135", "report": "Specimen A was submitted for analysis and labeled appropriately with the patient's name and hospital number. The clinical history indicates the patient underwent a left craniotomy for a suspected lesion. Gross examination of the specimen identified as \"brain tumor\" revealed a fresh aggregate measuring 1.2 x 1.3 x 1.0 cm, composed of tan to beige soft tissue fragments. A representative portion was selected for frozen section evaluation.\n\nMicroscopic assessment of the frozen section showed cellular features consistent with a high-grade infiltrating neoplasm. The tissue was processed and placed in cassette FSA1 for further analysis. Additional portions of the specimen were submitted for routine processing; one such portion is in cassette A.\n\nHistologic evaluation demonstrated pleomorphic cells with nuclear atypia, frequent mitotic figures, microvascular proliferation, and areas of necrosis. These findings are indicative of an aggressive process. Staging and classification were based on standard histopathologic criteria and World Health Organization grading parameters. All applicable tests were performed under validated conditions within a CLIA-certified laboratory qualified to conduct high-complexity testing."} +{"pid": "TCGA-06-0124", "report": "The specimen consisted of one fragment measuring 1.5 x 1.2 x 0.9 cm, described as soft, reddish-brown, and hemorrhagic. Multiple irregularly-shaped portions of rubbery to firm tan and pale red tissue were also received, with a total size of 50 x 50 x 20 mm. Histologically, there was a cellular glial neoplastic proliferation characterized by nuclear anaplasia, a prominent fibrillary background, and occasional mitotic figures. Frequent neoformed vessels and extensive necrosis were observed. Immunostaining for MIB-1 demonstrated a proliferative index of approximately 10%. The tumor was located in the right temporal lobe with extension to the frontal lobe, cystic changes, and irregular enhancement noted preoperatively. The patient presented with progressive left-sided weakness and headache, and had a prior history of gastric carcinoma."} +{"pid": "TCGA-3B-A9HZ", "report": "The resected specimen from the mediastinum consists of an irregular to roughly ovoid, rubbery solid mass measuring 9.5 x 7.5 x 6.0 cm. The outer surface is partially covered by pink-tan to dusky red serosa with focal erythema; the remainder is shaggy and focally cauterized. A portion of the tumor was inked black to mark the resection margin. On sectioning, the tumor demonstrates a pink-tan, lobulated cut surface with a central area of necrosis and cystic change. The necrotic region measures up to 3 x 2 x 1.5 cm and accounts for less than 10% of the total volume. Microscopic evaluation of the tissue revealed significant nuclear pleomorphism and necrosis, with a mitotic rate of 8 per 10 high-power fields. Histologic assessment showed involvement of the soft tissue margin. No lymphovascular invasion was identified. The lesion was completely embedded for analysis, with representative sections submitted for further study. A separate fragment of rib measuring up to 1.2 cm in length was received and examined grossly only; both margins appeared unremarkable. A biopsy of the pleura consisted of an irregular pink-tan tissue fragment measuring 0.7 cm, which showed no evidence of neoplastic cells. No preoperative therapy had been administered. The tumor measured greater than 5 cm in its largest dimension and was located deep within the mediastinum. Regional lymph nodes could not be assessed."} +{"pid": "TCGA-IR-A3LL", "report": "The surgical specimen includes a radical hysterectomy with removal of the uterus, cervix, bilateral tubes and ovaries, as well as multiple lymph node groups from both sides including right and left pelvic, obturator, hypogastric, and external iliac regions. The primary lesion measures 3.7 x 3.4 x 3.2 cm and invades the cervical stroma to a depth of 19 mm within an area measuring 20 mm. The tumor approaches within 1.0 mm of both anterior and posterior soft tissue margins. High-grade intraepithelial neoplasia is identified adjacent to the tumor. There are foci suggestive of lymphovascular invasion; however, perineural invasion is not observed. The parametria are not involved based on consensus review. Extension into the uterine corpus is not present.\n\nHigh-grade intraepithelial neoplasia involving the vaginal cuff is noted at both the anterior and posterior vaginal resection margins. All margins are negative for invasive malignancy. The endometrium shows weak proliferative activity, and the myometrium appears unremarkable. Bilateral ovaries demonstrate stromal hyperplasia, and the fallopian tubes are benign. A total of eight parametrial lymph nodes are negative for tumor involvement. Additionally, all other sampled lymph nodes\u2014comprising one right pelvic, one right obturator, two right hypogastric, one left obturator, and four left external iliac lymph nodes\u2014are benign and show no evidence of tumor."} +{"pid": "TCGA-BR-A4J9", "report": "Gross Description: The specimen consists of a subtotal gastrectomy. A plate-like lesion measuring up to 7 x 6.5 cm is present in the antrum, with invasion through the muscle layer. The fatty tissue of the greater and lesser curvature and omentum appears structurally normal.\n\nMicroscopic Description: There is infiltration through the full thickness of the gastric wall. The lesion demonstrates intra- and extracellular mucin production. The surrounding fatty tissue of the greater and lesser curvature and omentum shows signs of hyperemia.\n\nTumor Features: The lesion is ulcerated. Histologic grade is high, with poorly differentiated morphology. Tumor extent reaches the subserosa. No lymph node metastases are identified in the 10 lymph nodes examined from the greater and lesser curvature and omentum. No venous invasion is observed. Surgical margins are free of involvement. No evidence of neoadjuvant treatment effect is noted."} +{"pid": "TCGA-CM-6163", "report": "The specimen from the sigmoid colon was received fresh and measured 16.2 cm in length with a circumference of 5.0 cm at the stapled resected margin and 4.8 cm at the open resected margin. Focally hemorrhagic lobulated yellow-tan adipose tissue spanned the length of the specimen, measuring up to 1.5 cm in thickness. Upon opening, an ulcerated lesion was identified, measuring 1.1 cm in length and 0.7 cm in width. The lesion was located 10.0 cm from the stapled margin and 6.3 cm from the open margin. Microscopic evaluation showed invasion into the submucosa with a depth of 0.4 cm. Tumor budding and increased tumor-infiltrating lymphocytes were not observed. There was no gross perforation. Lymphovascular invasion was present, while large venous invasion was not identified. Perineural invasion was noted. Surgical margins were free of involvement.\n\nA small polyp measuring 0.1 cm was found 3.0 cm from the open resection margin and was located away from the main lesion. It was identified as a hyperplastic polyp. Several diverticuli were present with associated muscular wall thickening and pericolic adipose tissue changes. The remaining mucosa appeared unremarkable. A total of 23 lymph nodes were examined, and none showed evidence of metastasis. No tumor deposits were identified in the pericolorectal soft tissue.\n\nAdditional specimens from the proximal and distal margins were received. Both consisted of rings of pink-tan soft tissue with sutures and staples removed. Each was entirely submitted for examination and showed no evidence of tumor involvement. All sections were processed and reviewed, including representative sections from the colon, diverticuli, and lymph nodes."} +{"pid": "TCGA-CV-6934", "report": "A biopsy of the right oral tongue was performed, revealing the presence of atypical cells with features consistent with invasive growth. The tissue sample consisted of two fragments measuring 1.0 x 0.5 x 0.3 cm and 0.6 x 0.5 x 0.4 cm, respectively. Subsequent surgical intervention included a total tongue resection measuring 12.8 x 4.5 x 4.2 cm, along with a segmental mandibulectomy (9.6 x 2.8 x 0.8 cm), and an intact larynx measuring 5.0 x 3.3 x 2.5 cm. Bilateral neck dissections were also performed, measuring 12.5 x 4.8 x 1.5 cm on the right and 7.0 x 4.5 x 1.2 cm on the left.\n\nA tan-pink, rubbery mass measuring 8.5 x 4.0 x 3.0 cm was identified on the right side of the tongue. Overlying this mass was an ulcerated area measuring 4.7 x 2.4 cm. The tumor was located 0.5 cm from the closest right lateral mucosal margin, 1.1 cm from the anterior mucosal margin, and 1.4 cm from the left lateral mucosal margin. The tumor approached within 1.0 mm of the deep soft tissue margin in the region of the tongue base and anterior tongue. An area of ulceration and tumor was adherent to the medial portion of the mandibular segment, which was submitted for further processing.\n\nIn the left level I region, multiple lymph nodes ranging from 0.2 to 1.3 cm were identified, all without evidence of tumor involvement. In the left level II region, lymph nodes ranged from 0.2 to 3.0 cm, with two grossly involved by tumor. The metastatic deposits measured approximately 2.0 cm in diameter and completely replaced the involved lymph nodes, with extranodal extension into adjacent adipose tissue. One of seven lymph nodes in level III was involved, while all five level IV lymph nodes were negative. On the right side, the submandibular gland and three lymph nodes from levels III and IV showed no signs of tumor involvement.\n\nExtensive perineural invasion was noted. Evaluation of surgical margins demonstrated that the lateral margin of resection was free of tumor; however, the deep margin was within 1.0 mm of the tumor. Additional findings included squamous mucosa with foci of mild dysplasia at the palatal margin and mild to moderate chronic inflammation in areas of soft tissue. Multiple teeth and tooth fragments were present with focal caries and metallic restorations. No tumor was identified at the anterior mucosal margin."} +{"pid": "TCGA-R6-A6XG", "report": "The esophageal biopsy at 34 centimeters shows intestinalized Barrett mucosa with low-grade and focal high-grade columnar epithelial dysplasia. No invasive malignancy is present in this specimen. A separate esophageal biopsy of a mass-like lesion reveals a moderately differentiated adenocarcinoma. In the gastric cardia biopsy, oxyntic and fundal mucosa exhibit foveolar hyperplasia, edema, and mild chronic inflammation without evidence of tumor, Helicobacter pylori, or intestinal metaplasia. An additional biopsy from the distal esophagus between 30 and 32 centimeters demonstrates squamous epithelium with balloon cell changes and nonspecific reactive features; no tumor, intra-epithelial neutrophils or eosinophils are observed, and lamina propria is not included.\n\nGrossly, the specimen from 34 centimeters consists of three pink-tan tissue fragments measuring up to 0.3 cm each. The mass biopsy contains three friable fragments ranging from 0.2 to 0.3 cm. The cardia biopsy includes four tan-pink fragments measuring 0.2 to 0.3 cm. The distal esophageal biopsy at 30 to 32 centimeters comprises three friable pink-tan fragments measuring 0.3 to 0.4 cm. All specimens were submitted entirely in their respective containers."} +{"pid": "TCGA-EJ-7782", "report": "The patient underwent a radical retropubic prostatectomy and flexible cystoscopy. A total of 19 lymph nodes were examined, with no evidence of neoplasia identified\u2014eight from the right pelvic region, nine from the left pelvic region, and two from the left perivesical area. The prostate specimen weighed 91.54 grams and showed a nodule with a maximum dimension of 1.2 cm. Histologic evaluation revealed a poorly differentiated adenocarcinoma with a Gleason score of 4 + 4 = 8. The lesion was present in both the right and left lobes, involving approximately 5% of the prostate volume. The tumor was organ-confined without evidence of extracapsular extension or involvement of the bilateral seminal vesicles. All surgical resection margins were free of tumor involvement. Perineural invasion was identified; however, there was no angiolymphatic invasion observed. High-grade prostatic intraepithelial neoplasia was also noted. Pathologic staging was determined as pT2c with no regional lymph node involvement (pN0) and no distant metastasis. The histologic grade corresponds to a poorly differentiated tumor. Benign prostatic hypertrophy and chronic moderately active prostatitis were additionally documented."} +{"pid": "TCGA-37-4141", "report": "The specimen was obtained from a lung tissue source. The sample was collected in a frozen state using an OCT block. No additional containers or matrices were utilized for this collection. Histological analysis indicates the presence of abnormal cells consistent with a malignant process; however, the specific classification remains pending. Cellular morphology demonstrates characteristics suggestive of a solid tumor with moderate differentiation. Staging parameters including T, N, and M classifications have not yet been determined. There is no available data regarding prior or current treatment modalities. A blood sample was also collected; however, no tumor cells were identified in the bloodstream. Clinical correlation and further diagnostic evaluation are recommended."} +{"pid": "TCGA-L5-A4OE", "report": "A male patient presented with dysphagia, and endoscopy revealed a nodular tumor in the distal esophagus and proximal stomach. A biopsy showed invasive, moderately differentiated adenocarcinoma. The patient underwent a transhiatal esophagectomy, with a separate lymph node specimen submitted.\n\nThe resected specimen measured 11.8 cm in length and included the distal esophagus and proximal stomach. Both margins were stapled. A firm mass was identified near the esophagogastric (EG) junction, measuring 3.7 x 2.9 cm. The mass was multinodular, involving 80% of the EG junction circumference, predominantly on the gastric side. It extended into the submucosa with a maximum thickness of 2.1 cm and reached within 0.7 cm of the distal margin. A full-thickness defect measuring 1.6 x 0.3 cm was noted in the gastric cardia, located within 0.4 cm of the EG junction. The mass also extended into the adventitia and muscular wall, with involvement close to the deep margin of the EG junction. The remaining mucosa appeared unremarkable.\n\nLymph node candidates were retrieved from paraesophageal and perigastric regions, with sizes up to 3.2 cm. Some lymph nodes showed calcification and gray-black cut surfaces. A total of 17 lymph nodes were examined, with 3 found to be positive. No distant metastasis was confirmed. The resection margins were narrowly free of involvement.\n\nHistologic evaluation confirmed invasive adenocarcinoma, with poor differentiation in some areas. The depth of invasion extended to the adventitia. Lymph node analysis showed metastatic involvement in three out of fifteen nodes examined. One separately submitted cervical esophageal margin was also evaluated, showing no involvement. Two paraesophageal lymph nodes were negative for malignancy."} +{"pid": "TCGA-44-A47F", "report": "Final Surgical Pathology Report. Procedure. Specimen A consists of two lymph nodes, which show no evidence of involvement. A fragment of vascular tissue is also present and shows no tumor involvement. Specimen B includes a resected lung specimen with a mass measuring 5.5 cm in greatest dimension. The mass is located in the left upper lobe and is surrounded by normal lung tissue. It extends to within 0.1 cm of the pleural surface and is located approximately 4 mm from the bronchial margin. Vascular invasion is identified in a large vessel. Six hilar lymph nodes were recovered, with two showing involvement. One involved node suggests direct extension, while the other indicates metastatic spread. Additional lymph nodes from levels V and VII show no signs of involvement. The tumor appears confined to the organ of origin without distant spread. Margins of resection are clear except for the proximity to the bronchial margin. Minimal extension into the pleura is noted. Specimen C and D each contain a single lymph node, both unremarkable. Grossly, the primary lesion is well-defined, with tan-white appearance and dimensions of 5.5 x 4.2 x 3.8 cm. No other abnormalities are identified in the remaining lung tissue."} +{"pid": "TCGA-5R-AAAM", "report": "The patient underwent resection of the liver. The specimen included Segment I of the liver and hilar lymph nodes. Examination of the liver segment revealed a well-circumscribed lobulated brown-gray tumor measuring 3.2 x 2.2 x 3.0 cm, located 1.5 cm from the resection margin. In the surrounding tissue, two smaller similar lesions were identified, measuring 0.3 cm and 0.7 cm in diameter. The remaining hepatic tissue showed firm brownish nodules ranging from 0.1 to 0.3 cm in size. Microscopic evaluation showed moderately differentiated cellular features with satellite lesions and vascular invasion. The resection margin was free of abnormal cells. The hilar lymph node, measuring 1.3 cm in greatest dimension, showed no evidence of metastatic involvement. The background liver tissue demonstrated cirrhotic changes with a Metavir fibrosis score of 4, Knodell histological activity index score of 4, and Ishak fibrosis score of 6."} +{"pid": "TCGA-B4-5836", "report": "Specimen obtained from the right kidney. Tissue was collected in a frozen state using a cryomold, weighing 280 mg. A separate blood sample was collected, measuring 4 ml, and stored in a frozen tube. Histological evaluation of the tissue revealed a cellular composition with approximately 90% tumor cells present. The tumor exhibited a Grade 2 classification based on cellular differentiation. No data available for lymph node or distant metastasis staging. No prior chemotherapy or hormonal therapy reported."} +{"pid": "TCGA-EJ-5498", "report": "The patient is a male with a history of a PSA value of 5.0 and prior tonsillectomy. A previous biopsy revealed bilateral poorly differentiated malignancy involving the prostate. The patient underwent a radical retropubic prostatectomy.\n\nExamination of the right pelvic lymph nodes (11 nodes) and left pelvic lymph nodes (15 nodes) showed no evidence of malignant cells. Microscopic evaluation of the prostate specimen revealed a neoplastic process with a Gleason score of 4 + 3 = 7. A high-grade pattern 5 component was identified, comprising less than 1% of the tumor. The lesion involved both the right and left lobes of the prostate and measured up to 1.6 cm in its greatest dimension in one histologic section. Approximately 10% of the examined prostate volume was involved by the neoplasm.\n\nThe tumor was confined within the prostate capsule without evidence of extracapsular extension. Both seminal vesicles were free of involvement. All surgical resection margins were clear of tumor. Perineural invasion was present. High-grade intraepithelial neoplasia was identified in a multifocal distribution. The surrounding prostate tissue demonstrated nodular hyperplasia and chronic inflammation.\n\nA total of 26 lymph nodes were examined, with no evidence of metastatic involvement. The pathologic staging was determined to be pT2c, with no regional lymph node involvement (pN0) and no evidence of distant metastasis (pMX). The histologic grade was classified as G3-4, consistent with poorly differentiated morphology."} +{"pid": "TCGA-CV-7243", "report": "A right partial glossectomy specimen involved a portion of the right lateral tongue and floor of mouth measuring 4.2 x 4.0 x 1.8 cm. Within this specimen, there was an irregular pale yellow mass measuring 2.5 x 2.0 x 1.0 cm. The mass was ulcerated and exhibited infiltrative borders with thick cords greater than four cells in diameter. The depth of invasion measured 1.0 cm. Lymphocytic infiltration was mild. Perineural and vascular invasion were not identified. Margins were assessed via frozen section; the mucosal margin was negative while the deep (lateral) margin was close at less than 2 mm. Additional anterior deep margins #1 and #2 from the tongue were both negative for tumor involvement.\n\nLymph nodes were evaluated from multiple sites. In the right neck dissection, level 1 contained two lymph nodes, level 2A had seven lymph nodes, and level 2B included five lymph nodes\u2014all without evidence of tumor involvement. In level 3 of the right neck dissection, twelve lymph nodes were examined, and one contained involvement. No extranodal extension was observed. One lymph node from the right external jugular chain was also negative.\n\nThe specimen from the tooth was assessed grossly only and showed no further abnormalities."} +{"pid": "TCGA-CV-A463", "report": "The patient is a female with a height of 147.5 cm, weight of 68.9 kg, and a body surface area of 1.68 m\u00b2. \n\nIn the left neck dissection, five lymph nodes from level I, two from level II, and fifteen from level III were examined. All lymph nodes were free of tumor involvement. One lymph node in level III contained a nonkeratinizing granuloma.\n\nIn the right neck dissection, six lymph nodes from level I, two from level II, and eleven from level III were examined. All lymph nodes were free of tumor involvement.\n\nA composite resection of the chin, jaw, floor of mouth, and tongue was performed. A mass measuring 6.5 cm in greatest dimension was identified in the floor of the mouth, extending into the skin and bone. Depth of invasion measured 3.2 cm. The tumor margin was predominantly pushing with focal infiltrative features. Perineural and vascular invasion were not present. A marked lymphocytic infiltrate was noted. Resection margins, including those of the tongue and mandible, were free of tumor. Bone margins were also free of tumor involvement.\n\nImmunohistochemical staining showed strong diffuse positivity for p53 and rare focal positivity for p16. In situ hybridization for high-risk HPV was negative.\n\nSpecial studies and molecular testing were conducted, and no evidence of tumor involvement was found in any of the analyzed lymph nodes across both neck dissections."} +{"pid": "TCGA-LL-A441", "report": "The lumpectomy specimen measures 8 x 6 x 4 cm. A firm, tan lesion measuring 12 mm is identified within the breast tissue. The lesion is located 4 mm from the anterior margin. Surgical margins are free of invasive disease, with the closest margin measuring 3 mm superior to the tumor. However, ductal carcinoma in situ (DCIS) is focally present at the superior margin. The histologic grade is high, with a Nottingham histologic grade of 3 out of 3, based on poor tubular formation, marked nuclear pleomorphism, and a high mitotic rate of 10 mitotic figures per square millimeter. The cellular features are consistent with a high-grade, solid pattern of DCIS, though not extensive.\n\nA total of four lymph nodes were examined, including two sentinel lymph nodes and two additional axillary lymph nodes. No evidence of tumor involvement is found in any of the lymph nodes evaluated. The pathologic staging for the primary tumor is pT1c. No regional lymph node involvement is identified (pN0). Ancillary studies show no expression of estrogen or progesterone receptors, and immunoperoxidase staining is negative with a score of 1+.\n\nGross examination of the axillary contents reveals no suspicious findings. The sentinel lymph nodes, measuring up to 1 cm, are submitted in entirety, with one lymph node showing a firm area measuring 3 mm. A second lymph node shows a 6 mm suspicious area, and a third lymph node is unremarkable. All lymph nodes are microscopically free of tumor. The procedure included wire-guided excision and lymph node sampling, including sentinel node identification and axillary dissection. The case is documented as a single focus of invasive disease without multifocality."} +{"pid": "TCGA-55-8087", "report": "The specimen consists of a right upper lobe pulmonary resection weighing 103 grams and measuring 13.4 x 10.0 x 4.0 cm. The resection margin is a stapled bifurcated tertiary bronchus, with two surrounding gray-black nodules measuring 1.2 cm and 1.8 cm; the larger nodule shows focal calcification. The pleural surface is smooth to slightly wrinkled with areas of anthracotic streaking. A fibrotic nodule measuring 4.0 x 3.2 x 2.6 cm is identified within the lung tissue, with a rubbery, gray-tan cut surface. This lesion extends to the elastic lamina of the visceral pleura but does not breach the pleural surface. It is located 2.9 cm from the bronchial margin and approaches within less than 1 mm of the visceral pleural surface. No additional lesions are observed in the remaining parenchyma, which appears spongy, tan-pink, with minimal anthracotic changes.\n\nMultiple lymph nodes were submitted for evaluation. Lymph nodes from levels 4, 7, 8, 9, 10, and 11 of the right chest were examined. All lymph nodes show findings consistent with anthracosilicosis, with some demonstrating mild reactive lymphoid hyperplasia or reactive sinus histiocytosis. No evidence of metastatic disease was found in any of the lymph nodes evaluated.\n\nHistologic examination of the lung specimen reveals well-differentiated features within a fibrotic background. Elastic stain confirms involvement of the visceral pleura without full penetration through the pleural surface. There is no definitive evidence of lymphovascular invasion. Margins are negative, with the closest distance of invasive features to the visceral pleural surface being less than 1 mm. No treatment effect could be assessed.\n\nSections were submitted from the bronchial margin, peribronchial nodules, lesion with adjacent pleura, and uninvolved parenchyma. Specimen integrity was intact, and all relevant areas were adequately sampled."} +{"pid": "TCGA-AO-A12B", "report": "The clinical history includes prior findings of right breast abnormality and a procedure performed for localization and excision of the left breast lesion. Specimens submitted include lymph nodes from the right axilla, a segmental resection of the left breast, and a right mastectomy specimen.\n\nGross examination of the sentinel lymph node in the right axilla revealed a 0.6 cm lymph node. Frozen section and permanent analysis showed no evidence of malignancy. A second non-sentinel lymph node measuring 1.8 cm was also examined and found to be benign.\n\nIn the left breast segmental resection, a 4.5 x 3.8 x 0.9 cm fibroadipose tissue fragment was evaluated. No gross mass was identified. Histological analysis showed duct hyperplasia without atypia and stromal fibrosis. Margins were assessed and no significant findings were reported.\n\nThe right mastectomy specimen measured 22.5 x 16.3 x 3.2 cm. A centrally located, firm, tan mass measuring 2.3 x 2.1 x 1.5 cm was identified. The mass had relatively well-defined borders and was located in the upper and lower inner quadrants as well as the central area. No involvement of the nipple or skin was observed. Serial sections of the uninvolved breast tissue showed biopsy site changes and focal fibrosis. No vascular invasion or calcifications were noted. Surgical margins were free of any abnormal findings.\n\nHistological evaluation of the mass revealed high-grade cellular features with limited tubule formation. Nuclear grading showed moderate variation in size and shape. A separate in situ component was identified with intermediate nuclear grade and minimal necrosis, comprising less than 25% of the total lesion. This in situ component was located away from the main mass.\n\nImmunohistochemical staining results showed strong nuclear expression of estrogen and progesterone receptors. HER2 testing demonstrated no overexpression. Additional special stains are pending and will be reported separately.\n\nAll surgical margins were free of involvement. Lymph node assessment did not reveal any metastatic disease."} +{"pid": "TCGA-G3-A25U", "report": "The gallbladder specimen measures 6.4 x 2.9 x 0.7 cm and is collapsed. The serosal surface is tan and smooth except at the attachment site to the liver bed, where it appears roughened and light green. A focal area of puckering is noted at the distal end, with no calculi identified. The mucosa is dark green and velvety, with no evidence of cholesterolosis. The wall thickness is up to 0.4 cm. Representative sections, including the puckered area, were submitted for analysis.\n\nA lymph node was identified within a fibrofatty tissue specimen measuring 1.4 x 1.1 x 0.2 cm. The lymph node has a maximal dimension of 0.9 cm and was entirely submitted in one cassette.\n\nThe liver specimen weighs 423 grams and measures 16.8 x 8.9 x 7.4 cm. The outer capsule is smooth with a slightly micronodular appearance. The surgical margin was previously treated with silver nitrate and marked with black ink, measuring 11.3 x 7.1 cm. A well-circumscribed nodule measuring 6.0 x 5.8 x 7.3 cm is present, with a tan-yellow color and soft rubbery consistency. It contains a central area of irregular hemorrhage. The tumor is located approximately 0.9 cm from the surgical margin and is within 1 mm of the capsule. Small areas within the uninvolved parenchyma raise suspicion for vascular involvement. The background liver shows focal microsteatosis, portal lymphocytic aggregations, and inflammation, which may be related to prior embolic intervention. Foreign body type reactions are also present in multiple intrahepatic vessels, likely due to embolic material. Multiple cassettes were submitted, including those sampling the surgical margins, tumor with adjacent capsule, suspicious vascular areas, and background liver tissue."} +{"pid": "TCGA-AK-3458", "report": "The specimen consists of a right kidney with surrounding perinephric fat, weighing a total of 1109 grams. The attached ureter measures 13 cm in length and 0.5 cm in diameter, with a smooth tan-pink mucosa and no papillary structures identified. Upon bisection, the kidney measures 13.5 x 8 x 6 cm and weighs 370 grams. A firm, well-demarcated, variegated mid-pole mass is present, measuring 6.5 x 6.5 x 4 cm, and comes within less than 0.1 cm of the capsule. The mass does not appear to infiltrate the surrounding perinephric fat. The remaining renal parenchyma is light brown and soft, with no other discrete lesions observed. The adrenal gland is not identifiable on gross examination. Sections submitted include ureteral and vascular margins, additional ureter segments, tumor with closest capsule, sections of perinephric fat near the tumor, tumor with adjacent normal kidney, and sections of perinephric fat to locate the adrenal gland. Microscopic evaluation shows a high nuclear grade neoplasm confined to the kidney without lymphovascular invasion. All vascular and ureteral margins are free of tumor. No adrenal gland tissue is identified."} +{"pid": "TCGA-IA-A40Y", "report": "The right kidney specimen measured 15 x 9.8 x 6.2 cm and weighed 460 grams. A mass measuring 8.5 x 7.6 x 6.0 cm was identified in the upper and mid portions of the kidney. The mass appeared golden yellow with areas of hemorrhage and softening. It was well-demarcated from the surrounding renal parenchyma, which showed no significant abnormalities. The tumor extended into the renal sinus, involving the sinus fat and invading the renal capsule. There was no clear extension into the perirenal fat or beyond Gerota\u2019s fascia. No satellite nodules were identified, and no intravascular tumor presence was observed in the renal veins.\n\nMicroscopically, the tumor demonstrated sarcomatoid features, with less than 5% of the tissue showing such morphology. Tumor necrosis was present. Fuhrman nuclear grade was 4. Microscopic angiolymphatic invasion was noted, and there was evidence of tumor extension into the renal sinus. All surgical margins were free of invasive carcinoma.\n\nA total of seven lymph nodes were examined from the retrocaval region, with two showing metastatic involvement. The right adrenal gland measured 8.0 x 3.0 x 1.0 cm and weighed 14.0 grams. It contained a small tan gelatinous nodule measuring 0.4 cm, but no involvement by carcinoma was identified. Sections of the adrenal gland were submitted for further analysis.\n\nPathologic staging was determined as pT3a based on tumor extension into the renal sinus and perisinus fat without extension beyond Gerota\u2019s fascia. Regional lymph node involvement was classified as pN1 due to the presence of metastases in two of seven lymph nodes. Distant metastasis could not be assessed (pMX)."} +{"pid": "TCGA-VR-A8EQ", "report": "The specimen consists of a resected segment from the esophagus and stomach. A lesion is present in the distal esophagus, involving also the esophagogastric junction and cardia. The lesion measures 7.0 cm along its longest dimension. There is infiltration into the perigastric fat as well as involvement of the esophageal adventitia. The surrounding stroma shows moderate desmoplastic reaction and a mild inflammatory infiltrate. Lymphatic and perineural invasion is noted. The circumferential margin of the esophagus is involved by the lesion, while the proximal and distal margins show no evidence of involvement. Peritumoral mucosa in both gastric and esophageal regions appears unremarkable. Seven out of thirteen lymph nodes dissected from the area around the stomach contain altered tissue consistent with metastatic involvement. Additionally, there is evidence of tissue implantation in the soft tissue surrounding the esophagus. No abnormal findings are seen in the two peri-esophageal lymph nodes examined. The esophageal margin is free of any unusual cellular changes."} +{"pid": "TCGA-CM-6172", "report": "The surgical specimen consists of a segment of rectosigmoid colon measuring 19 cm in length and 5 cm in diameter. A tumor is identified within the sigmoid colon, located 12 cm from the proximal margin and 5.5 cm from the distal margin. The lesion measures 2 cm in length, 1.5 cm in width, and demonstrates invasion to a depth of 0.6 cm. The radial resection margin is free of involvement, with the closest distance from the tumor to the radial margin being 2.5 cm. The remaining mucosa appears unremarkable on gross examination.\n\nMicroscopic evaluation reveals moderately differentiated histology. Invasion extends through the muscularis propria into pericolorectal tissues. No evidence of tumor budding, increased tumor-infiltrating lymphocytes, lymphovascular invasion, large venous invasion, or perineural invasion is observed. The surgical margins are negative for involvement. No polyps or dysplastic changes are identified away from the lesion. A precursor lesion in the form of a tubular adenoma is noted.\n\nA total of 17 lymph nodes are examined, with one showing metastatic involvement. No tumor deposits are identified in the pericolorectal soft tissue. Additional specimens from the distal and proximal rings are submitted and show no pathological findings. The distal ring consists of a 1.0 cm segment of bowel with a stapled line, while the proximal ring includes a metal anastomotic pin with attached soft tissue measuring 1.5 x 1.4 x 1.0 cm. Both are microscopically unremarkable."} +{"pid": "TCGA-AK-3456", "report": "The right kidney specimen weighed 1,000 grams and measured 20.0 x 14.0 x 11.0 cm. The adrenal gland measured 4.5 x 3.2 x 1.0 cm and showed normal orange parenchyma on sectioning. The ureter measured 9.0 x 0.7 cm and was unremarkable with no lesions identified. A large tumor measuring 17.0 x 13.0 x 10.0 cm was present within the kidney, occupying approximately 98% of its volume. The tumor exhibited a variegated appearance with orangish yellow to reddish brown areas and extensive necrosis. It obliterated the calyceal system and extended to within 1.0 cm of the hilum. No definitive invasion through the renal capsule was observed, although areas of tumor were seen in close proximity to the capsule. Small amounts of normal-appearing renal parenchyma remained medially. Perinephric fat ranged from 0.1 to 4.0 cm in thickness, with some fullness noted at the hilum; however, no lymph nodes were identified there. Vascular margins were unremarkable.\n\nSections were taken from multiple regions including the adrenal gland, vascular and ureteral margins, areas near the hilum and renal pelvis, viable tumor portions, regions adjacent to the capsule, and perinephric fat overlying the tumor.\n\nA single lymph node measuring 4.0 x 1.9 x 1.5 cm was submitted from the paracaval region and showed no evidence of tumor involvement. A hernia sac specimen measuring 12 x 5 x 2 cm consisted of fibromembranous and fibroadipose tissue with skeletal muscle; no suspicious areas were identified grossly or microscopically.\n\nHistologically, the tumor demonstrated combined morphological features including clear cells and papillary architectural patterns. Immunohistochemical staining showed positivity for vimentin, RCC, and CD10, while being negative for CK7, pancytokeratin AE1/AE3, CAM5.2, K903 (34BE12), EMA, WT-1, and MITF. Mucicarmine stain was also negative. Cytogenetic analysis revealed an abnormal karyotype with a balanced translocation between chromosomes X and 1: 46,Y,t(X;1)(p11.2;p34)[cp21]. This translocation involves the TFE3 gene at Xp11.2 and the PSF gene at 1p34, resulting in the formation of a PSF-TFE3 fusion gene.\n\nStaging classification was determined as pTNM: T2 N0 Mx. The tumor was confined to the kidney without lymphovascular invasion. Resection margins at the ureter and vascular sites were free of tumor. The adrenal gland showed focal cortical nodular hyperplasia. No tumor was identified in the hernia sac or in the submitted lymph node."} +{"pid": "TCGA-AP-A1E1", "report": "The submitted specimens include a total abdominal hysterectomy with bilateral salpingo-oophorectomy, and two sentinel lymph node biopsies from the right and left external iliac regions.\n\nExamination of the hysterectomy specimen revealed a lesion characterized by architectural features consistent with a neoplastic process. The architecture showed approximately 16\u201350% solid growth pattern. Nuclear features were consistent with moderate differentiation. The depth of invasion into the myometrium was measured at 3 mm. The myometrial thickness at the site of maximal tumor involvement was 30 mm. There was no evidence of endocervical or lymphovascular invasion. The remainder of the endometrium was unremarkable, and the myometrium also showed findings of adenomyosis. The adnexal structures were uninvolved.\n\nIn the evaluation of the lymph nodes, one benign lymph node was identified on each side (right and left external iliac). All nodes were negative for metastatic disease. Multiple levels and cytokeratin immunostained sections were examined in each case. No malignant cells were detected in any of the lymph node specimens."} +{"pid": "TCGA-FI-A2F4", "report": "The specimen consisted of a uterus, cervix, bilateral fallopian tubes, and ovaries, obtained via total abdominal hysterectomy and bilateral salpingo-oophorectomy. The uterus weighed 188 grams. The cervix measured 3.5 x 2 x 2 cm and the uterine corpus measured 6 x 6 x 4 cm. Upon opening, the endometrial cavity was found to be distorted and triangular, measuring 3.5 x 4.5 cm in greatest dimension. A polypoid, friable tan-white lesion measuring 3 x 1.5 cm was identified within the lower portion of the uterine cavity. This lesion extended into the myometrium to a depth of 10 mm where the total myometrial thickness at that point was 17 mm. Multiple intramural and subserosal leiomyomata were noted, ranging in size from 0.5 cm to 3.5 cm.\n\nMicroscopic examination revealed invasive growth within the luminal two-thirds of the myometrium. A focus suspicious for lymphovascular space invasion was identified. The tumor exhibited a solid growth pattern involving the lower uterine segment. No involvement of the endocervix was observed.\n\nLymph node dissection included specimens from the left external iliac, left obturator, right external iliac, right obturator, right common para-aortic, and left common para-aortic regions. A total of 32 lymph nodes were examined, with no evidence of malignancy identified in any of these nodes. No extranodal extension was noted.\n\nThe tumor invaded more than one-half of the myometrium. Based on these findings, the TNM category was classified as T1c. The regional lymph nodes were free of tumor (N0), and distant metastasis could not be assessed (MX). The provisional pathologic stage grouping was determined as T1c/N0/MX (Stage IC)."} +{"pid": "TCGA-E2-A1LE", "report": "The surgical specimens include a right axillary lymph node biopsy and a right breast mastectomy with axillary dissection. The non-sentinel lymph nodes from the right axilla include two lymph nodes, measuring 3.5 x 1.2 x 0.8 cm and 2.0 x 1.2 x 0.7 cm, both of which were bisected and submitted for analysis.\n\nThe right breast mastectomy specimen weighs 1,383 grams and measures 29.5 x 22.0 x 4.0 cm. The attached axillary tail measures 13.0 x 7.2 x 1.5 cm. On gross examination, two distinct lesions were identified. The larger lesion is located in the lower inner quadrant within the subareolar region and measures 3.6 x 2.2 x 1.5 cm. It is situated 5.1 cm from the deep margin. The smaller lesion, measuring 1.0 x 0.9 x 0.8 cm, is located in the upper inner quadrant and approaches the deep margin at 2.0 cm. Both lesions are firm and beige in appearance. The remainder of the breast tissue consists of dark yellow lobulated adipose tissue.\n\nNumerous firm lymph nodes are present in the axillary tail, ranging in size from 0.5 x 0.5 x 0.4 cm to 2.5 x 2.0 x 1.0 cm. Multiple sections of the breast tissue and lymph nodes were submitted for histological evaluation, including representative sections of the lesions, margins, nipple, skin, and surrounding quadrants.\n\nHistologically, the invasive tumor demonstrates high-grade features with a nuclear grade of 3 and extensive lymphovascular invasion. Necrosis is not identified. Surgical resection margins are free of tumor involvement. Twenty-five out of twenty-six lymph nodes examined show evidence of tumor involvement, with the largest deposit measuring 2.1 cm. Extensive extranodal extension is noted.\n\nImmunohistochemical analysis shows no expression of estrogen or progesterone receptors using Allred scoring criteria. HER2 testing reveals strong staining intensity (3+) in approximately 90% of tumor cells, indicating positivity. A formal staging classification of pT2 N3a is assigned based on pathological findings."} +{"pid": "TCGA-50-6590", "report": "The right upper lobe specimen shows a lesion measuring 1.7 cm in maximum diameter and 1.3 cm in minor dimension. The lesion is located within the lung and is associated with involvement of the visceral pleura. There is no evidence of angiolymphatic invasion. Necrosis accounts for more than 50% of the lesion. A mild lymphocytic host response is noted. Fourteen sampled N1 lymph nodes are without involvement, and all nine N2 lymph nodes examined are also negative. Surgical margins are free, with the closest distance of invasive tumor to margin being 6 mm. Background changes include emphysema, parenchymal scarring, and features consistent with smokers\u2019 bronchiolitis. Multiple hilar and mediastinal lymph node biopsies show only anthracotic pigment without any malignant involvement. Microscopic evaluation confirms absence of satellite lesions either grossly or microscopically. Histologically, the lesion demonstrates poorly differentiated morphology with mucicarmine and PAS positivity. Immunohistochemical staining reveals positivity for cytokeratin 7, while markers such as cytokeratin 20, TTF, mammoglobin, and GCDFP are negative. Elastic, trichrome, and Grocott staining support the morphologic findings. The pathologic stage assigned is pT2N0Mx."} +{"pid": "TCGA-L9-A443", "report": "The surgical specimen consisted of a left lower lobe of the lung along with multiple lymph node groups (levels 5, 6, 8, and 10). The primary lesion measured 1.2 cm in greatest dimension and was located centrally within the lobe. It was surrounded by vasculature and airways, and was found to be 2.0 cm from the bronchial margin and between 1.5 and 2.0 cm from the pleura. Histologically, the lesion exhibited moderately differentiated features. Visceral pleural invasion was not identified, and all surgical margins were free of involvement. No lymphovascular invasion was observed.\n\nA total of nine lymph nodes were examined: five peribronchial and four from various mediastinal and hilar levels. All lymph nodes showed no evidence of malignant involvement. Additionally, an incidental small peripheral lesion measuring approximately 1 mm was noted.\n\nThe tumor was unifocal and confined entirely within the lung parenchyma. Based on pathological staging, the primary lesion was classified as pT1a and regional lymph nodes as pN0. No distant metastasis was identified. The specimen was intact and adequately sampled for evaluation."} +{"pid": "TCGA-39-5030", "report": "The specimen included multiple lymph nodes from various levels. Lymph nodes from the right level four, level seven (multiple specimens), left level 10 (two specimens), left level nine, and left level 11 interlobar were examined. Some of the lymph nodes showed evidence of metastatic involvement, with one out of two nodes positive in several locations. The level five and another left level 10 lymph node were benign.\n\nA lung specimen from the left lower lobe was received, measuring 15 x 9 x 3.5 cm. A white-tan, stellate tumor measuring 3.8 x 1.8 x 1.6 cm was identified in the peripheral lung parenchyma. It was located 6.5 cm from the bronchial margin and 3.5 cm from the closest staple line. The tumor extended subpleurally but did not reach the pleural surface. Vascular invasion was present; no perineural invasion was observed. The bronchial margin was free of tumor. The uninvolved lung tissue showed focal atelectasis, emphysematous changes, chronic bronchitis, respiratory bronchiolitis, and scarring.\n\nLymph node status indicated the presence of metastatic involvement in several regions, including peribronchial areas. All involved lymph nodes were identified based on histological examination. The assessment of the bronchial, vascular, and staple margins, as well as random lung parenchyma, was conducted. Photographs were taken, and representative sections were submitted for further analysis. Intraoperative frozen section consultation was performed on some specimens, with findings confirmed on permanent sections."} +{"pid": "TCGA-B1-A47N", "report": "The specimen consists of multiple parts. Part 1 includes fat overlying a tumor site, showing benign fibroadipose tissue with no tumor identified. Part 2 consists of the capsule overlying the tumor site and reveals benign fibroadipose tissue with chronic inflammation; no tumor is observed. Part 3 describes the primary lesion, measuring 2.2 x 1.9 x 0.8 cm, which is confined to the kidney. Histologic evaluation shows nuclear grading with maximal Fuhrman grade 3 and predominant grade 2. The tumor is focally present at an inked surface; margin status is determined by other sections. No vascular invasion is identified. Pathologic staging is pT1a Nx Mx. Immunohistochemical analysis demonstrates strong and diffuse positivity for CK7 and racemase (P504S), with focal staining for CD10, supporting a specific morphologic pattern. Part 4 evaluates a deep margin and contains benign renal parenchyma with patchy chronic interstitial inflammation; no tumor is found. The overall assessment indicates a unifocal lesion without lymph node involvement or lymphovascular invasion. Adrenal tissue is not present in the specimen."} +{"pid": "TCGA-E2-A1B0", "report": "A total of nine sentinel lymph nodes and additional axillary contents were evaluated from the left axilla along with a left breast mastectomy specimen. Sentinel node #1 contained metastatic involvement. Nodes #2 and #3 showed no evidence of tumor. Nodes #4 and #5 both demonstrated involvement. Sentinel node #6 had two out of three lymph nodes positive, with lymphovascular invasion noted. Nodes #7 and #8 showed metastatic involvement in one out of one lymph node with perinodal fat extension. Node #9 was negative for tumor. The left axillary contents included eighteen lymph nodes, all without evidence of tumor.\n\nThe left breast mastectomy specimen revealed an invasive mass measuring 3.2 x 2.2 x 2.0 cm located in the upper outer quadrant. Histologic evaluation identified features consistent with ductal origin, grade III. A component of high nuclear grade ductal carcinoma in situ, solid and comedo pattern, was present in association with the invasive focus, estimated at 20%. Necrosis was identified within the tumor as well as in the ductal carcinoma in situ component. Lymphovascular invasion was present. Margins of resection, including deep margins, skin, and nipple, were free of tumor involvement. Additional findings included focal columnar cell change with microcalcifications and changes consistent with post-biopsy healing.\n\nHormone receptor analysis by immunohistochemistry indicated ER and PR negativity. HER2 testing demonstrated strong positivity (3+ staining in 100% of cells). Pathologic staging was determined as pT2 N2."} +{"pid": "TCGA-CV-7090", "report": "The specimen consists of tissue from the hard palate, including bone and mucosa, which shows no evidence of tumor. A buccal fat biopsy demonstrates adipose tissue without tumor involvement. Bone from the posterior wall of the maxilla has been submitted for decalcification; a supplemental report will follow. The partial maxillectomy and hemipalatectomy specimen includes an area of abnormal tissue measuring 2.5 cm in thickness. Histologic examination reveals Grade 2 cellular changes with presence of perineural invasion. Portions of the specimen, including bone margins of resection, have been submitted for decalcification and further evaluation. Additional sections include tissue from the medial margin line showing salivary gland without tumor, mucosa from the maxillary sinus and inferior turbinate lined by respiratory mucosa, and tissue along the nasal cavity containing mucous glands, all without tumor involvement. Teeth were also examined and show no relevant pathology."} +{"pid": "TCGA-75-5146", "report": "The specimen was obtained from a resection procedure. The tumor measured 6.0 cm in greatest dimension and was submitted for pathological analysis. Histological evaluation revealed a neoplasm with features consistent with glandular differentiation. The tumor was classified as moderately differentiated and exhibited a histologic growth pattern characteristic of invasive behavior. Lymph node status was not indicated. Based on available findings, the pathological stage was determined to be T2, NOS, M0. Microscopic assessment confirmed the presence of malignant cells with morphological features suggestive of a primary lesion. No other specific histological subtypes or variants were identified."} +{"pid": "TCGA-HT-7607", "report": "The microscopic examination of the permanent section reveals mildly hypercellular gray and white matter, with increased hypercellularity compared to the frozen section slides. Some atypical cells are observed. Although reactive astrocytes are present, the biopsy shows diffuse infiltration of a glial neoplasm within the gray and white matter. The tumor cells predominantly exhibit round to oval nuclei with only a few displaying nuclear atypia. No significant mitotic activity is identified. Immunohistochemical staining demonstrates scattered MIB-1 reactive cells, yielding a labeling index of 1.7%, suggesting modest proliferative activity and aligning with low-grade histologic characteristics."} +{"pid": "TCGA-G9-6496", "report": "The specimens include right and left pelvic lymph nodes, as well as a resected prostate with attached segments of seminal vesicles and vas deferens. The right pelvic lymph nodes consist of one lymph node measuring 3.8 x 1.5 x 1.5 cm within fibrofatty tissue. Three possible lymph nodes were identified in the left pelvic specimen, ranging from 0.7 x 0.5 x 0.5 cm to 1.5 x 1.0 x 1.0 cm. Histologic evaluation of all lymph nodes showed no evidence of abnormal cellular infiltration.\n\nThe prostate weighed 39 grams and measured 5.0 cm in width, 3.6 cm in length, and 3.5 cm in depth. After removal of the apex and base, the remaining weight was 23 grams. Serial sectioning at 4\u20135 mm intervals revealed homogeneous beige-tan spongy tissue without identifiable nodules. Multiple sections were submitted for microscopic evaluation, including representative areas from various anatomical regions of the prostate and surrounding structures.\n\nMicroscopic analysis of the prostate demonstrated the presence of atypical glandular formations with architectural complexity and cellular pleomorphism involving both right and left lobes. These glands exhibited perineural invasion but did not extend into the margins or surrounding fat. No vascular or lymphatic invasion was observed. High-grade prostatic intraepithelial neoplasia was noted. The tumor involvement was estimated at 20% of the gland.\n\nLymph node assessment confirmed absence of metastatic disease bilaterally. No other significant pathological findings were identified."} +{"pid": "TCGA-D8-A27W", "report": "Histopathological examination was performed on a total organ resection of the right breast with axillary tissues. The specimen measured 21.3 x 17.8 x 6.2 cm and included axillary tissues measuring 9 x 8 x 3 cm, along with a skin flap of 18.7 x 8.2 cm. The tissue weighed 1040 g. A lesion measuring 5.3 x 3.8 x 5.3 cm was identified in the central portion of the breast, located 2.2 cm from the lower boundary, 1.1 cm from the base, and adjacent to the skin.\n\nMicroscopic evaluation revealed high-grade cellular atypia with invasive growth patterns and mucin production. There were 10 mitoses per 10 high-power fields. The histological grade was assessed as NHG3. Involvement of the overlying skin was noted. Parenchymal atrophy was present with glandular changes.\n\nExamination of axillary lymph nodes showed chronic inflammation without evidence of tumor involvement. Immunohistochemical analysis demonstrated strong expression of estrogen receptors in more than 75% of the neoplastic cells, while progesterone receptors were present in less than 10%. HER2 staining yielded a score of 2+, for which FISH verification is recommended."} +{"pid": "TCGA-BH-A0DK", "report": "The specimen consists of axillary sentinel lymph nodes and breast tissue from a bilateral total mastectomy. On the left side, two lymph nodes from sentinel lymph node #1 and one lymph node from sentinel lymph node #2 were identified, all negative for metastatic disease. The left breast specimen contained a tumor measuring 2.5 cm in greatest dimension. Histologic evaluation showed features including tubular formation score 3, nuclear polymorphism score 2, and mitotic activity score 2, with a combined score of 7 out of 9. Focal mucinous differentiation was observed. Lymphovascular invasion was present on slide 3E. All surgical margins were negative, with the invasive tumor located more than 1 cm from the closest deep margin. Additional findings at the biopsy site included multiple changes such as hyperplasia, sclerosing adenosis, and microcalcifications. Non-neoplastic breast tissue showed fibrocystic change and florid ductal epithelial proliferation. No carcinoma was identified in the nipple or skin. The right breast showed fibrocystic changes, ductal epithelial hyperplasia, sclerosing adenosis, and columnar cell changes. There were biopsy site changes at two locations. Nipple and skin specimens from both sides were negative for carcinoma."} +{"pid": "TCGA-B1-A47M", "report": "The left kidney specimen measured 4.5 x 4.0 x 3.5 cm and was found to have a neoplasm with distinct morphological features. Histologically, the tumor demonstrated a papillary growth pattern with clear cell differentiation. Nuclear grading was performed using the Fuhrman system, revealing a grade 3 out of 4. The tumor extended into the perirenal adipose tissue but did not involve Gerota's fascia. Surgical margins were all negative, with the closest distance from the tumor to the inked parenchymal margin measuring less than 0.1 cm. No evidence of vascular invasion was observed. Immunohistochemical staining showed positivity for racemase, CK7, and focal positivity for CA9 and CD10. Based on these findings, the pathological stage assigned was pT3a Nx Mx."} +{"pid": "TCGA-63-A5MR", "report": "The specimen was obtained from a resection procedure performed on the left upper lobe. The tumor measured 3.5 cm in size. Histological examination revealed malignant cells arranged in sheets with moderate nuclear pleomorphism and scattered mitotic figures. The lesion demonstrated invasion into surrounding tissues. Pathologic staging indicated involvement confined to the primary site with no regional or distant spread identified. No lymph node involvement was detected. Laboratory findings included collection of a buffy coat sample. Clinical staging showed no evidence of metastasis."} +{"pid": "TCGA-AR-A24T", "report": "Gross examination of the right breast specimen reveals a mass measuring 5.7 x 4.8 x 2.1 cm located in the mid outer quadrant. Histologic evaluation demonstrates a Nottingham grade I lesion with tubule formation score of 3/3, nuclear pleomorphism score of 1/3, and mitotic count score of 1/3, resulting in a total Nottingham score of 5/9. In situ changes are present, and angiolymphatic invasion is identified. The surrounding breast tissue shows no significant abnormalities, and biopsy site changes are noted. Surgical resection margins, including the deep margin, are all free of tumor involvement, with a minimum tumor-free distance of 0.3 cm at the deep margin. The lesion does not extend to the nipple, overlying skin, or chest wall.\n\nSentinel lymph node biopsy of the right axilla shows metastatic involvement in one lymph node. Extracapsular extension is absent, and blue dye is visualized within the node. Axillary lymph node dissection reveals metastatic involvement in 14 out of 16 lymph nodes without extranodal extension.\n\nThe contralateral left breast specimen demonstrates benign proliferative changes, including ductal hyperplasia of usual type, sclerosing adenosis, parenchymal fibrosis, and cyst formation, without evidence of atypical proliferation. Immunohistochemical testing for Her-2/NEU has been initiated on paraffin-embedded tissue from the involved site."} +{"pid": "TCGA-ZF-AA58", "report": "The specimen includes a cystectomy specimen with associated structures, as well as lymph node tissue from multiple sites. The primary specimen consists of a bladder measuring 95 x 65 x 30 mm, with an ulcerated growth located on the posterior and right lateral walls. The lesion measures 25 x 20 x 10 mm and is observed to infiltrate into the muscular layer. Adjacent structures including the uterus, fallopian tubes, and ovaries show no abnormal findings.\n\nLymph node dissections were submitted from the left external iliac, left obturator, and right obturator regions. The left external iliac lymph nodes include two nodes, with the largest measuring 15 mm; one of these shows involvement. The left obturator lymph nodes measure up to 15 mm and do not show evidence of involvement. In the right obturator region, six lymph nodes are identified, with the largest measuring 25 mm; one of these nodes contains metastatic changes.\n\nMicroscopic evaluation of the bladder reveals a high-grade, poorly differentiated solid tumor composed of pleomorphic cells. The tumor extends into the muscularis propria and focally into surrounding fat. No papillary components are present. There is no vascular invasion, and resection margins are free of tumor. The remaining epithelium demonstrates squamous metaplasia without dysplasia. Other tissues examined, including the cervix, endometrium, myometrium, fallopian tubes, and ovaries, appear unremarkable. Lymph node analysis confirms presence of tumor in two out of the total nodes examined across different regions."} +{"pid": "TCGA-46-6025", "report": "The surgical specimen consists of a right bilobectomy involving the middle and lower lobes of the lung, weighing 520 grams. The middle lobe measures 8 x 7 x 4 cm and the lower lobe measures 17 x 14 x 6 cm. The pleural surfaces show a purple tan coloration with reticulated areas containing black carbon pigment. A firm, sub-pleural area measuring 6 x 4 x 3 cm is noted in the lower lobe, associated with pleural puckering that comes within 4 cm of the bronchial margin of resection. At the hilum, the bronchial margin of resection is 2 cm in diameter. A single vessel at the hilum measures 1 cm in diameter. Four gray-black nodules are identified, ranging from 0.6 to 0.8 cm in diameter. Serial sectioning of the lower lobe reveals a firm yellow-tan lesion measuring 5.5 x 3.5 x 3 cm with a central necrotic cavity measuring up to 3 cm. This lesion approaches within 3 cm of the bronchial margin and lies beneath the area of pleural puckering. A second possible lesion or lymph node measuring 3 x 2 x 1.7 cm is found directly beneath the bronchial margin. No mucosal involvement is observed. Additional lymph nodes ranging from 0.6 to 1.1 cm are identified in the lower lobe between the two lesions. The peripheral base of the specimen shows a slight granular pattern. Sectioning of the middle lobe does not reveal any significant abnormalities.\n\nLymph nodes were sampled from multiple regions: four hilar lymph nodes were removed, one of which contains a focus measuring 3 cm with extranodal extension near the bronchial artery, but without invasion. Other lymph node stations including 9R, 11R, posterior 11R, 10R anterior, 4R, and level 7 were all negative for tumor involvement. Surgical margins, including bronchial, vascular, and pleural, are free of tumor. The distance from the tumor to the nearest pleural margin is approximately 0.2 cm. Histologic evaluation reveals moderate to poorly differentiated cellular features within the lesion. Non-neoplastic lung tissue adjacent to the lesion demonstrates emphysematous changes, congestion, and interstitial fibrosis. Peripheral lung tissue shows interstitial fibrosis and reactive changes. Specimens from other sites including the right apical bleb, fifth and sixth ribs, and additional lymph node regions were histologically unremarkable and showed no evidence of tumor involvement."} +{"pid": "TCGA-IA-A83W", "report": "The specimen consists of a right kidney surrounded by fibroadipose tissue measuring 20.0 x 13.0 x 6.5 cm and weighing 919.34 grams. A mass is present in the upper portion of the kidney, measuring 5.5 cm in greatest dimension. The mass is roughly spherical, yellow to tan in color, with a soft, homogenous texture. There is no hemorrhage or necrosis identified. The tumor extends into the perirenal fat but does not invade the pelvicaliceal system or renal sinus. It is sharply demarcated from the surrounding renal parenchyma, which appears unremarkable. No satellite nodules are present.\n\nMicroscopic evaluation shows the tumor invading the overlying renal capsule and being present within 1 mm of the soft tissue margin, without penetration into the perirenal fat. No angiolymphatic or renal sinus invasion is identified. All surgical margins are free of neoplastic cells. A benign epithelial cyst measuring 1.5 cm is identified within the renal parenchyma. Sections of the ureter, renal pelvis, sinus, and vascular margins are also submitted and show no evidence of neoplasm."} +{"pid": "TCGA-N8-A4PL", "report": "A 1.7 x 0.8 x 0.3 cm firm tan lymph node was received from the left pelvic sentinel region and entirely submitted for analysis, with no abnormal findings identified. Additional lymph node specimens were examined from bilateral pelvic and periaortic regions. A total of 24 lymph nodes were evaluated across all regions, with no evidence of malignancy detected. The largest lymph node candidates measured up to 2.8 cm in diameter.\n\nThe hysterectomy specimen included the uterus, cervix, and bilateral adnexa. The endometrial cavity measured 3.2 cm in length and 1.9 cm in width at the fundus. A polypoid lesion measuring 1.6 x 0.9 cm was identified in the posterior corpus wall. It appeared dark brown, hemorrhagic, and exophytic, protruding into the uterine cavity to a height of 0.6 cm. No myometrial, serosal, or cervical invasion was observed. The myometrial wall at the site of the lesion measured 1.2 cm in thickness. No involvement of the adnexa or positive findings in pelvic washings were noted. Cervical and vaginal margins were widely negative, and no lymphovascular space invasion was present.\n\nHistologic evaluation revealed a polypoid lesion confined to the endometrium. The endometrial lining showed intraepithelial carcinoma in a background of atrophy. The cervix contained Nabothian cysts. The myometrium demonstrated adenomyosis. Both ovaries showed age-related changes, and the fallopian tubes were unremarkable.\n\nImmunohistochemical analysis of the endometrial lesion showed weak positivity for both estrogen (1+, 5%) and progesterone (1\u20132+, 5%) receptors. Staging information was based on available data and subject to revision pending further clinical review."} +{"pid": "TCGA-EL-A3T6", "report": "The surgical specimen consists of a total thyroidectomy measuring 8.0 x 5.0 x 3.5 cm. The right lobe is fibrotic and unremarkable, measuring 4.0 x 3.0 x 1.0 cm. The left lobe measures 6.0 x 5.0 x 3.5 cm and contains a well-defined, friable, light tan, soft mass measuring 4.5 x 4.0 x 3.0 cm. The mass abuts the external surface and capsule of the lobe. No gross involvement of the surgical margins is identified, though tumor is present. The tumor has a papillary appearance. The specimen was entirely submitted for analysis, with sequential sectioning of the right lobe (A1-A5), the isthmus (A5, A6), and the left lobe including the tumor and adjacent soft tissue (A8-A22). Parathyroid tissue appears unremarkable, and one lymph node is negative for tumor. There is no evidence of extracapsular extension."} +{"pid": "TCGA-HC-7233", "report": "The specimen includes a previously inked and sectioned prostate gland with attached bilateral seminal vesicles, weighing 38 grams. The prostate measures approximately 4.8 x 4.0 x 3.8 cm and demonstrates a shaggy capsule. The urethra is patent with signs of compression from the lateral lobes. The cut surface is multi-nodular, rubbery, and tan-gray in appearance. An area of tan-yellow, slightly chalky discoloration measuring approximately 1.5 x 1.0 x 0.8 cm is identified in the anterior aspect near the left apical margin, located within 0.2 cm of that margin. This area extends to inked surfaces but does not appear grossly transected. It is confined to the left lateral lobe and does not extend into the right lateral or left posterior lobes. The seminal vesicles measure 6.8 x 2.0 x 1.0 cm and display a multi-cystic, fibrotic tan to pink cut surface with no identifiable gross lesions.\n\nThree tissue cassettes were received along with representative sections submitted from various regions including the radial apical margins (left and right), shave vesical margin, multiple sections from left and right lateral and posterior lobes at distal, mid, and proximal levels, origin of seminal vesicles, and both seminal vesicles.\n\nThe second container includes bilateral pelvic lymph nodes. One portion, marked with a surgical clip on the left side, measures 6.0 x 2.0 x 1.0 cm and contains an approximately 4.6 cm elongated pink-yellow nodular region. The second portion measures 4.6 x 3.0 x 1.0 cm and contains a 3.2 cm elongated pink-yellow nodule with a fleshy tan-pink cut surface. Both nodules were sectioned and submitted under labels A through D.\n\nHistologically, the lesion demonstrates a Gleason score of 7 (primary pattern 4, secondary pattern 3) and is confined to the left lobe. There is evidence of perineural invasion but no lymphovascular space invasion. High-grade intraepithelial neoplasia is not present. Involvement of the seminal vesicles is not observed. Extracapsular extension is noted in the left lateral distal section (1D). Surgical margins are negative at the bladder neck and apical region, but positive at the left lateral inked margin (slide D1). Lymph node evaluation reveals no tumor involvement in either the left or right pelvic lymph nodes. Staging is classified as pT2NO."} +{"pid": "TCGA-FA-A7Q1", "report": "The lymph node is located intra-abdominally and is enlarged, measuring 3 x 3 x 3 cm. The surface is soft with a yellowish and gray appearance. Microscopically, the architecture shows a diffuse pattern with tumor cells arranged in cords or sheets, intermixed within fat tissue. The tumor cells include both small and large transformed lymphoid cells with irregular hyperchromatic nuclei. The cells are oval or round in shape, with scant cytoplasm, and may contain single or multiple nucleoli. Mitotic figures are frequently observed. Immunohistochemical staining demonstrates positivity for CD20 and negativity for CD3. The histologic grade is poorly differentiated, and the tumor involves the lymph nodes without clear margins. There is no evidence of prior neoadjuvant treatment."} +{"pid": "TCGA-05-4418", "report": "The specimen shows a locally advanced peripheral lesion in the left lower lobe of the lung with histological features of mixed morphology, including large-cell and clear-cell components arranged in solid and acinar patterns. Mucin formation is present, and the lesion is localized in the S8 segment. Based on the pathological findings, the classification is pT3 pN2 pMX V1 R0, corresponding to stage IIIA. The tumor has invaded the pericardial fatty tissue, and lymph node metastases are identified in the hilar region, both in the main preparation and in samples 1 and 4. The resection margins, including bronchus, vessels, pericardial tissue, and the attached parietal pleura (sample 2), as well as lymph nodes from samples 3 and 5, show no evidence of tumor involvement."} +{"pid": "TCGA-YL-A9WJ", "report": "The prostate and iliac/obturator lymph nodes were examined following radical prostatectomy. Histologic evaluation revealed a lesion with acinar growth pattern and small areas showing mucinous differentiation. The primary and secondary histologic patterns combined to yield a Gleason score of 4 + 4 = 8, with a tertiary pattern also identified. Of the total tumor composition, 5% corresponded to one pattern, while another accounted for 95%. The lesion was located in the anterior, right and left lateral, and posterior regions of the prostate.\n\nExtracapsular extension was present and non-focal, involving the lateral aspects bilaterally. Invasion of the left seminal vesicle was noted. Surgical margins were involved by invasive disease, multifocally, including at the apex, mid-portion, and left vas deferens; however, the extent in millimeters was not reported. Lymphovascular and perineural invasion were both present.\n\nApproximately 30\u201340% of the prostate gland was involved by the lesion. No treatment effect was applicable. In the lymph node assessment, six right obturator nodes were identified without metastatic involvement, while four left obturator nodes were identified, with one involved by metastatic disease. The size of the largest nodal metastasis was not provided.\n\nAdditional findings included high-grade prostatic intraepithelial neoplasia and basal cell hyperplasia. Pathologic staging was determined as pT3b, pN1, and pMX."} +{"pid": "TCGA-DD-AAEH", "report": "The specimen consists of a fresh liver segment measuring 21.8 x 12.5 x 4.0 cm and weighing 398.0 grams, obtained via left hemihepatectomy. A well-defined yellow to tan nodule measuring 4.0 x 3.0 x 5.8 cm was identified. The cut surface revealed a firm, solid, expanding nodular lesion. Gross examination showed no involvement of the resection margin, with a safety margin of 1.8 cm. No satellite nodules were observed. Stage 2 fibrosis was noted in the surrounding liver parenchyma.\n\nMicroscopic evaluation demonstrated a trabecular and pseudoglandular growth pattern composed of hepatic-type cells without fatty change. A partial fibrous capsule was present, with evidence of capsular and septal infiltration. Microvessel invasion was present. There was no invasion at the surgical resection margin, and no serosal or portal vein invasion was observed. The histologic differentiation was predominantly well-differentiated (Edmondson-Steiner grade I), with areas of moderate differentiation (grade II) present. The status of intrahepatic metastasis and multicentric occurrence could not be determined.\n\nAdditional specimens included the gallbladder and a pericholecystic lymph node. The gallbladder showed features of chronic cholecystitis. The lymph node exhibited reactive hyperplasia without evidence of malignancy."} +{"pid": "TCGA-55-8615", "report": "The specimen consists of a right lung pneumonectomy with associated lymph nodes. The primary lesion is a large mass measuring 9.5 x 8.5 x 6.5 cm located in the middle lobe. It is lobulated, friable, and necrotic, extending into the lower and middle lobes. The tumor is located 2.6 cm from the bronchial margin and is within 1 mm of the pleural surface. Multiple adjacent tumor nodules are present near the main lesion, with the largest measuring up to 1.2 cm. The tumor abuts the pulmonary artery and adheres to the vasculature but does not grossly extend through the vascular wall. The pleura shows signs of invasion but no full transmural involvement.\n\nHistologically, the lesion demonstrates heterogenous features. Areas show tall columnar cells with necrosis, while other regions display mucinous differentiation suggestive of bronchioloalveolar morphology. Immunohistochemical staining reveals positivity for TTF1 and CK7, and negativity for CK20. An elastin stain highlights rare neoplastic cells extending into the elastic layer but not fully through it.\n\nA total of 22 lymph nodes were evaluated across multiple levels. Of these, six contain metastatic involvement. Specifically, one of three lymph nodes at level 7 shows involvement, and five of ten lymph nodes from the pneumonectomy specimen are positive. No metastasis is identified in the single lymph node from level 9 or in the seven fragments from level 4R. Lymphovascular space invasion is present. All surgical margins are negative. Based on these findings, staging is classified as pT3N2."} +{"pid": "TCGA-AN-A03Y", "report": "Female patient underwent radical mastectomy for a tumor specimen from the left breast, which was collected in a frozen state using a cryomold. The histological analysis showed Grade 2 features. No evidence of lymph node or distant metastasis was found. A separate blood sample was collected and preserved in a frozen state in a tube. No prior treatment was administered."} +{"pid": "TCGA-AO-A03N", "report": "A female patient underwent surgical excision of multiple sentinel lymph nodes and axillary lymph nodes, along with a left mastectomy specimen. The sentinel lymph nodes removed included four lymph nodes from level I of the left axilla, each measuring between 0.4 cm to 1.2 cm in size. Of these, two sentinel lymph nodes contained metastatic involvement. One showed a focus measuring 2 mm, while the other demonstrated a single cluster identified histologically. No extranodal extension was observed in any of the involved nodes. The remaining sentinel lymph nodes and all additional lymph nodes removed from levels I and II of the left axilla and subscapular region were benign.\n\nThe mastectomy specimen measured 21.5 x 14.0 x 3.4 cm and contained a central everted nipple. A tan-white tumor measuring 2.5 cm in greatest dimension was identified microscopically, predominantly located in the upper outer quadrant with focal extension into the upper inner quadrant. Histological examination revealed invasive carcinoma with high-grade nuclear features and minimal tubule formation. Vascular invasion was present. Additionally, non-invasive components were identified, including ductal carcinoma in situ (DCIS) of solid and cribriform types with intermediate nuclear grade and minimal necrosis, as well as classical type lobular carcinoma in situ (LCIS). DCIS constituted up to 25% of the total tumor burden and was admixed with the invasive component. Calcifications were noted within the in situ areas and adjacent benign parenchyma. Surgical margins, nipple, and skin were free of tumor involvement. Special studies were performed for hormone receptors and HER2 status, which will be reported separately. Frozen section analysis confirmed the presence of metastatic involvement in one sentinel node intraoperatively, while other nodes were initially assessed as benign."} +{"pid": "TCGA-AH-6644", "report": "The specimen was re-examined at the request of the surgeon to identify any additional lymph nodes. The mesenteric fat was placed in lymph node revealing solution, which led to the identification of two additional possible lymph nodes measuring 0.3 and 0.5 cm in greatest dimension. Each of these lymph nodes was bisected and submitted for analysis. Upon histologic evaluation, no malignancy was identified in these nodes.\n\nThe primary specimen consisted of a segment of rectosigmoid colon measuring 14 cm in total length and up to 2 cm in diameter. The proximal margin was open and the distal margin was stapled. A circumferential brown-tan nodular mass measuring 3.5 x 3.0 cm was identified. It was located 3.7 cm from the distal margin and 6.2 cm from the proximal margin. On sectioning, the mass extended into the underlying bowel wall but did not grossly penetrate through the serosa, with a distance of 1.5 cm from the deep resected margin. The surrounding colon appeared normal with gray-tan mucosa and preserved folds.\n\nA total of 17 probable lymph nodes were identified within the mesentery, measuring between 0.2 and 0.7 cm. All lymph nodes evaluated were negative for metastatic involvement.\n\nHistologic examination of the mass showed well-differentiated cellular features with full-thickness extension through the muscularis propria. No lymphovascular space invasion was observed. The closest tumor margin was located 3 cm from the distal margin, with all other margins (proximal, circumferential) being negative.\n\nAdditional findings included two circular fragments of sigmoid colon measuring 2.0 X 1.5 X 1.0 cm and 2.0 X 1.5 X 1.5 cm, with colonic mucosa showing no evidence of malignancy.\n\nThe staging based on tumor depth was classified as T3 according to the pTNM system."} +{"pid": "TCGA-AP-A0LO", "report": "The surgical specimens submitted included the uterus, cervix, bilateral fallopian tubes and ovaries, along with multiple lymph node groups from both sides, including para-aortic, common iliac, external iliac, internal iliac, obturator, and hypogastric regions.\n\nExamination of the uterine tissue revealed abnormal cellular changes within the endometrium characterized by complex hyperplasia with atypia. The lesion appeared confined to the endometrial lining without extension into the cervical region or involvement of vascular structures. The myometrium showed evidence of adenomyosis. The left ovary exhibited surface adhesions; other adnexal structures were unremarkable.\n\nAll lymph node specimens across all sites were benign. No malignant involvement was identified in any of the lymph nodes examined. The number of lymph nodes retrieved ranged from one to six per site, with no positive findings noted. Benign adipose tissue was observed in certain regions where lymph nodes were not identified.\n\nThe findings indicate no regional lymphatic spread and absence of vascular invasion. Cellular features included nuclear grading as moderately differentiated."} +{"pid": "TCGA-85-7699", "report": "The lung tissue specimen was obtained from the left upper lobe and submitted as a lobectomy. The tumor measured 3 x 2 x 2 cm. Microscopic evaluation showed poorly differentiated cells. No information was provided regarding histologic type, tumor extent, presence of additional nodules, lymph node involvement, lymphatic or venous invasion, margin status, evidence of neo-adjuvant treatment, or other significant pathologic findings. No comments were added."} +{"pid": "TCGA-MY-A5BD", "report": "The surgical pathology report includes specimens from multiple lymph node biopsies and a radical hysterectomy with bilateral salpingo-oophorectomy. \n\nLymph node biopsies were submitted from the right common iliac (three lymph nodes), right obturator (two lymph nodes), left external iliac (one lymph node), right obturator (six lymph nodes), and left external iliac (fourteen lymph nodes). No abnormal cellular findings were identified in any of the lymph nodes examined.\n\nThe hysterectomy specimen measured 10.0 cm from fundus to cervical mucosa. A mass was identified within the cervix measuring 7.8 x 4.1 x 2.0 cm grossly. Histologic evaluation showed invasive cellular proliferation originating in the cervix, extending into the lower uterine segment and superficially into adjacent parametrial tissue. The lesion involved four quadrants, with the right superior quadrant being dominant. Cellular morphology was characterized as ranging from well to moderately differentiated features. In addition, there were areas showing in situ cellular changes arising in a background of squamous metaplasia of adjacent endocervical mucosa.\n\nHistologic sections revealed foci suggestive of lymphovascular invasion. The invasive component reached the inked parametrial margin at a distance of 0 mm. The vaginal cuff margins were free of involvement. Extensive sampling of parametrial tissue, adnexal structures, and endometrium showed no additional significant abnormalities apart from atrophic endometrium.\n\nA total of 26 regional lymph nodes were examined, none of which demonstrated evidence of involvement. Based on pathologic findings, staging classification reflects localized extension beyond the cervix without nodal or distant dissemination."} +{"pid": "TCGA-43-5668", "report": "The specimen includes a right upper lobectomy measuring 14 x 9 x 5 cm. Several staple lines are present posteriorly, and the pleura is intact. A lesion measuring 2.6 x 2.6 x 2.4 cm is identified within the lung parenchyma adjacent to a bronchus, with an irregular border and gray-white cut surface containing anthracotic pigment. No other lesions are observed. Sections of the bronchial and vascular margins, hilar lymph nodes, and tumor tissue are submitted in six cassettes. Additional lymph node specimens from levels 11, 10, 2, 4R, 7, and 9 are received, ranging in size from 0.3 cm to 2.5 cm, and each is submitted entirely in one cassette.\n\nMicroscopic evaluation shows poorly differentiated cells arranged in a pattern consistent with a primary lesion measuring 2.6 cm. Resection margins are free of involvement, and there is no evidence of direct extension or vascular invasion. Among the regional lymph nodes, two of six peribronchial/hilar nodes show involvement, while all other lymph nodes examined\u2014including those from levels 11, 10, 2, 4R, 7, and 9\u2014are uninvolved. The involved lymph nodes are located close to the main lesion."} +{"pid": "TCGA-BH-A18L", "report": "The patient is a female who underwent a left total mastectomy and sentinel node biopsy. No clinical history or date of last menstrual period was provided. \n\nExamination of the sentinel lymph nodes revealed that one lymph node contained several micrometastases measuring approximately 0.1 cm each, visible on immunostain slides and confirmed on two levels of H&E staining. The second sentinel lymph node and one non-sentinel lymph node showed no evidence of metastatic involvement.\n\nGross examination of the breast specimen revealed a lesion measuring 6.0 x 5.0 x 6.0 cm. Histologic evaluation demonstrated a Nottingham score of 7 out of 9, with scores of 3 for tubule formation, 2 for nuclear pleomorphism, and 1 for mitotic activity. A separate component of ductal intraepithelial proliferation involving solid and cribriform patterns accounted for approximately 5% of the total tumor volume. There was also involvement of the skin with presence of disease in the lower dermis. All surgical margins were free of tumor; however, the lesion was noted to be within 0.1 cm of the inferior resection margin. Immunohistochemical staining confirmed the ductal origin of the lesion with strong positivity for E-cadherin."} +{"pid": "TCGA-VR-AA4D", "report": "The specimen from the distal esophagus following esophagogastrectomy shows a moderately differentiated adenocarcinoma with papillary features. The tumor exhibits an infiltrative growth pattern extending into the submucosa. Lymphatic invasion is present, while perineural infiltration is not observed. There is no evidence of necrosis, and a discrete peritumoral inflammatory infiltrate is noted. All surgical margins are free of neoplastic involvement.\n\nLymph node evaluation based on standard dissection reveals metastatic involvement in 6 out of 25 nodes. The distribution of involved nodes is as follows: 1 out of 2 right cardiac lymph nodes, 2 out of 7 left cardiac lymph nodes, none out of 13 lesser curvature lymph nodes, 3 out of 3 left gastric artery lymph nodes, and none from the celiac trunk or inferior para-esophageal regions. No capsular invasion is identified in the involved nodes.\n\nAdditional specimens including the greater omentum and esophageal margin show no presence of neoplastic cells."} +{"pid": "TCGA-CV-7430", "report": "The specimen involved skeletal muscle with suture granulomata and showed no tumor involvement. Connective tissue and nerve specimens from the right parotid artery region also lacked tumor presence. The cervical esophagus demonstrated connective tissue with reactive changes, without evidence of tumor. Ten lymph nodes were identified in the right lateral neck dissection, none of which contained tumor.\n\nA total laryngectomy and total thyroidectomy specimen revealed grade II squamous carcinoma involving anterior connective tissues, extending into deep subcutaneous tissue and the esophagus. Lymphovascular invasion was present. Tumor was identified at both proximal and distal soft tissue resection margins. One lymph node from the anterior compartment showed no tumor involvement, and the thyroid gland did not demonstrate tumor infiltration.\n\nAdditional fragments of grade II squamous carcinoma were identified in both transduced and non-transduced tumor specimens. Infiltration of connective tissue was observed in non-transduced tumor specimens, with lymphovascular invasion evident. Connective tissue specimens from the vagus nerve region contained grade II squamous carcinoma; however, no definitive vagus nerve tissue was identified. The right sympathetic chain specimen contained grade II squamous carcinoma involving nerve and connective tissue.\n\nConnective tissue and perineural compartments at the base of the skull were extensively involved by grade II squamous carcinoma. Tumor was present at the designated inked resection margin."} +{"pid": "TCGA-UF-A71D", "report": "Collected date: Primary site: Larynx. Left neck dissection specimen (levels 2, 3, and 4) included twelve lymph nodes, none of which showed evidence of metastatic carcinoma (0/12). Right neck dissection specimen (levels 2, 3, and 4) contained thirty lymph nodes, all negative for metastatic carcinoma (0/30). Total laryngectomy and total thyroidectomy specimen revealed a moderately differentiated lesion involving bilateral vocal cords, preepiglottic space, thyroid cartilage, and perithyroidal soft tissue. The lesion measured 3.5 cm in size. No lymphovascular or perineural invasion was identified. Surgical margins were free of invasive tumor. In the thyroid, there were three small foci of distinct morphology, with the largest measuring 0.4 cm. There was no evidence of vascular or extrathyroidal extension. Additionally, an adenomatous goiter with a hyperplastic nodule was present."} +{"pid": "TCGA-06-0879", "report": "The specimen consists of an excised brain tissue fragment measuring approximately 1.1 x 0.6 x 0.5 cm. Gross examination revealed tan-pink, soft tissue that was processed for intraoperative consultation with frozen section and cytologic preparations performed. Microscopic evaluation demonstrated high-grade cellular features including frequent abnormal mitotic figures. Nuclear morphology showed predominantly oval to angular shapes. Vascular abnormalities such as microvascular hypertrophy and borderline microvascular proliferation were observed. Early palisading of tumor cells was present without definitive necrosis. Immunohistochemical staining demonstrated a labeling index of approximately 20% using Ki-67. Molecular testing revealed promoter methylation detected through bisulfite-treated DNA followed by real-time PCR amplification. This assessment involved analysis of methylated and unmethylated sequences. Ancillary studies included immunostaining for p53. Multiple histologic sections were evaluated including frozen sections and permanent blocks. All findings were interpreted within established laboratory protocols."} +{"pid": "TCGA-DB-A4XF", "report": "The specimen consists of three separate tissue samples from the right frontal region of the brain. The first sample, labeled as a right frontal brain mass, measures 5.5 x 5.2 x 2.2 cm and was processed with smears prepared for analysis. Representative sections were submitted for further examination. The second sample, identified as a right deep frontal brain mass, is smaller at 2.8 x 1.9 x 0.7 cm and consists of friable brain tissue; all of this tissue was submitted for permanent sections only. The third sample, also labeled as a right frontal brain mass, measures 8.1 x 4.2 x 0.9 cm and consists of pink-tan soft tissue, with representative sections submitted.\n\nMicroscopic evaluation of the samples included smears and sections taken from cortical surfaces and white matter regions in the first sample. Additional sections were obtained from multiple areas within the second and third specimens. Cellular features observed included those consistent with a high-grade glial neoplasm based on smear preparations performed during intraoperative consultation. Multiple blocks were examined across all three specimens for detailed histologic analysis."} +{"pid": "TCGA-EU-5904", "report": "The specimen consists of a right kidney weighing 201 grams and measuring 12.2 x 6.9 x 4.8 cm, with scant attached perinephric fat. Approximately 70% of the kidney is covered by a smooth tan-pink renal capsule. Numerous white plastic clamps are present in the hilum, though no definite ureter is identified. Sections of vascular margins and margins of the pelvis/calices within the hilar surgical margin are included as part of (A1). A 5 x 4.1 x 3.1 cm soft yellow well-circumscribed mass is located in one pole of the kidney. The mass extends to the renal capsule in multiple areas but does not penetrate through it. In some regions, the tumor is separated by white-tan fibrous septa. The uninvolved areas of the kidney show a well-defined corticomedullary junction, with cortical thickness measuring up to 0.8 cm. The cortex appears tan-brown, while the renal pyramids are pink-tan and well-preserved. No lymph nodes or adrenal gland tissue are identified in the perinephric fat. A portion of the tumor is submitted for chromosome studies. Intraoperative frozen examination was performed.\n\nMicroscopic evaluation shows that the lesion consists of cells arranged in rounded nests and occasional solid sheets, surrounded by an extensive vascular network. The cells have abundant clear to lightly eosinophilic cytoplasm. Nuclei are generally small, round, and uniform, with minimal pleomorphism and no prominent nucleoli. The lesion is confined entirely within the kidney and does not breach the renal capsule. Adjacent renal tissue appears histologically normal. Evaluation of the renal artery, renal vein, and ureter reveals no evidence of involvement.\n\nSurgical pathology findings indicate the size of the lesion is 5 x 4.1 x 3.1 cm. Histologic arrangement is consistent with conventional growth patterns. The lesion is classified as histologic grade 1. Extent of involvement corresponds to T1 staging. Surgical margins are free of involvement. There is no evidence of blood or lymphatic vessel invasion. Regional lymph node status and distant metastasis could not be assessed. The specimen type is a right radical nephrectomy."} +{"pid": "TCGA-EL-A4K0", "report": "Case type: Surgical Case. The specimen consists of a total thyroidectomy. The thyroid includes a right lobe measuring 3.5 x 2.5 x 1.5 cm, a left lobe measuring 4.0 x 3.0 x 2.0 cm, and an isthmus measuring 1.3 x 1.0 x 0.7 cm. The outer surface is tan-brown and smooth. Upon sectioning, a well-circumscribed tan-yellow nodule measuring 1.1 x 1.0 x 1.0 cm is identified in the right lobe. Two additional nodules in the right lobe measure 0.7 cm and 0.4 cm. A tan-brown nodule measuring 0.9 cm in greatest dimension is present in the left lobe.\n\nHistologic evaluation includes sections from multiple areas of the thyroid. Cellular features include no evidence of extrathyroidal extension or lymphovascular invasion. All resection margins are negative. No tumor is identified in one lymph node examined. The background thyroid tissue shows changes consistent with multinodular adenomatous goiter."} +{"pid": "TCGA-KK-A59X", "report": "The specimen included lymph nodes from the right and left pelvic regions, as well as the prostate and seminal vesicles. In the right pelvic lymph nodes, eight nodes were identified and no tumor was found. The left pelvic lymph nodes included six nodes, with two containing tumor involvement and extension beyond the lymph node capsule. The largest tumor focus in these nodes measured 3.0 mm.\n\nThe prostate and seminal vesicles showed extensive involvement by a high-grade cellular process. Two distinct tumor foci were identified. The larger of the two measured 4.0 x 3.0 cm and spanned multiple regions of the prostate, including the right and left peripheral zones, as well as the transition zone. This tumor demonstrated multifocal extension beyond the prostate capsule and reached the surgical margins. It also extended into both seminal vesicles and surrounding soft tissues. A second, smaller tumor focus measured 2.0 x 1.0 cm and was confined to the transition zone without extension beyond the prostate.\n\nMicroscopic evaluation revealed high-grade features in the dominant tumor, with lower-grade characteristics in the secondary focus. Tissue sections from all areas of the prostate, including the apex, base, and margins of resection, were examined. The prostate measured 5.3 x 3.5 x 3.6 cm and weighed 56 grams after fixation. A palpable nodule was present in the right mid and base regions, corresponding to tumor involvement seen on cross-sectioning.\n\nLymph node specimens were obtained from fatty tissue fragments measuring 7.5 x 4.0 x 2.0 cm for both right and left pelvic regions. Multiple lymph nodes were identified within these tissue samples, with sizes ranging from 0.5 to 3.0 cm. All possible lymph nodes were submitted for analysis along with surrounding tissue."} +{"pid": "TCGA-5U-AB0E", "report": "The specimen was obtained from a male patient with a history of myasthenia gravis and an anterior mediastinal mass measuring 32x14 mm. The material submitted for analysis included a radical thymectomy specimen consisting of two parts.\n\nPart A consisted of a neoplastic mass with adjacent cardio-phrenic left adipose tissue. Within the adipose tissue, a well-circumscribed main mass measuring 3x3x1 cm was identified. Adjacent to this mass, a smaller distinct nodule was also found. Histological evaluation revealed that the neoplastic tissue partially infiltrated through the capsule into the surrounding mediastinal fat. In addition, a small focus of neoplastic tissue was identified in the far mediastinal region. In the cardio-phrenic left area, four reactive lymph nodes were noted within the adipose tissue. Immunohistochemical staining showed epithelial cells positive for cytokeratins (MNF116) and negative for CD117. The predominant lymphocytic component consisted of cortical type thymocytes expressing Tdt, with rare B-type lymphocytes present mainly in thymic remnants.\n\nPart B included the thymic right horn and right cardio-phrenic adipose tissue, which measured 19x6x1.5 cm. Microscopic examination showed only thymic remnants without significant pathological findings.\n\nMultiple blocks were sampled from various regions, including the neoplastic tissue, surrounding adipose tissue, and lymph nodes. Staging was determined based on histological findings indicating local invasion and presence of multiple nodules."} +{"pid": "TCGA-DW-7839", "report": "The right kidney specimen measured 5.2 x 3.4 x 3 cm and included a tan solid mass measuring 4.3 x 2.2 cm, located centrally with areas of hemorrhage and necrosis. A rim of surrounding renal parenchyma was present, up to 0.6 cm thick. The tumor was identified at the previously inked blue margin. Representative sections of the tumor, papillary structures, and adjacent margins were submitted for analysis. A separate piece of fibroadipose tissue overlying the tumor, measuring 1.3 x 0.5 x 0.4 cm, showed small papillary structures and an area of hemorrhage. This specimen was entirely submitted for evaluation. Histologic examination revealed a papillary growth pattern with associated chronic interstitial nephritis and occasional incipient lesions. No involvement of the resection margin by invasive carcinoma was identified. Lymphovascular invasion was not detected. A gallbladder specimen was also submitted, measuring 9.8 x 3.6 x 2.8 cm; it showed a green, velvety mucosa without gallstones. Bile was present, and the bile duct measured 0.3 cm in diameter. Representative sections of the gallbladder and bile duct were submitted. Immunohistochemical staining demonstrated strong positivity for CK7 in certain cells found within the adipose tissue, though these were interpreted as likely non-representative elements."} +{"pid": "TCGA-DX-A7EQ", "report": "The resected specimen from the right distal thigh and popliteal region consists of soft tissue with attached skin, measuring 15.6 x 7.8 x 6.5 cm. A circumscribed tan nodular calcified mass is present, measuring 4.2 x 3.5 x 3.0 cm. The mass is located 2.0 cm from the superior margin, 1.0 cm from the posterior margin, 0.8 cm from the inferior margin, and 1.3 cm from the lateral margin. It is noted to encase a blood vessel with a diameter of 0.5 cm. The tumor is well-demarcated from the skin and medial margins.\n\nMicroscopic evaluation reveals a highly cellular proliferation of monomorphic spindle cells within a delicate collagenous stroma. The mitotic rate is 15 per 10 high-power fields, and approximately 5% necrosis is observed. Vascular invasion is present. Immunohistochemical staining shows reactivity for EMA and focally for AE1:AE3. Molecular analysis for a specific fusion transcript has been initiated and will be reported separately.\n\nAll surgical margins are free of tumor involvement. The histologic features and immunophenotype are consistent with previously described changes following biopsy. Representative sections of the tumor and surrounding tissue have been submitted for analysis."} +{"pid": "TCGA-Y6-A8TL", "report": "The prostate specimen measured 4.4 x 3.7 x 3.3 cm and weighed 24 grams. Multifocal pale tan firm lesions were identified within the right posterior base, comprising approximately 6.2% of the total volume. The dominant lesion measured 15 mm in greatest dimension with additional dimensions of 10 x 10 mm. Histologic evaluation revealed acinar-type glandular proliferation. The primary histologic pattern was grade 3, and the secondary pattern was also grade 3.\n\nExamination of the margins showed involvement at the apical right posterior region. Focal extension beyond the capsule was noted at the right apex. No involvement was identified in the bladder neck, anterior, lateral, posterolateral, or posterior margins. There was no evidence of invasion into the seminal vesicles or lymphovascular spaces.\n\nA total of five lymph nodes were retrieved from the bilateral pelvic region, ranging in size from 1.1 to 3.0 cm. All lymph nodes were negative for malignant involvement.\n\nThe prostate was entirely submitted for analysis, sectioned from distal to proximal. The apical margin was serially sectioned and submitted completely. Bilateral seminal vesicles and segments of vas deferens were also fully submitted.\n\nOn gross examination, the prostate had an intact but slightly ragged capsule. The right half of the specimen was inked red, the left half green, and the posterior midline black. The right seminal vesicle measured 2.0 x 1.6 x 0.7 cm with a vas deferens measuring 3.4 x 1.1 cm. The left seminal vesicle measured 2.8 x 1.4 x 0.8 cm with a vas deferens measuring 4.7 x 0.7 cm.\n\nThe pathologic stage was determined as pT3a. No metastatic disease was identified in the submitted lymph nodes."} +{"pid": "TCGA-DX-A3LU", "report": "The specimen was received fresh and labeled as a retroperitoneal mass. Gross examination revealed a large, partially encapsulated mass measuring 19 x 16 x 14 cm. The mass consisted of both firm and brown tissue with attached fibroadipose tissue measuring 15 x 5 x 6 cm in the bowel circumference. A segment of bowel was attached to the mass via a 5 cm portion of mesentery. Within the mass, a kidney was identified measuring 13 x 7 x 4 cm. The renal cortex measured 0.4 cm and medulla 1.6 cm. A fluid-filled cyst was observed at the superior pole of the kidney, while the inferior pole showed heterogeneity and firm tan tissue with central necrotic areas.\n\nMicroscopic evaluation revealed a heterogeneous morphology with regions displaying features ranging from myxofibrosarcoma to pleomorphic high-grade malignant fibrous histiocytoma-like growth patterns. Focal areas of sclerosing-type tissue were also present. Necrosis was identified within the tumor. The tumor extended to the renal capsule and focally invaded the renal parenchyma. It also involved the subserosa of the attached bowel and extended to an unmarked soft tissue margin. Margins of the bowel resection, renal vascular structures, and ureter were free of tumor involvement.\n\nAdditional findings included a simple cyst in the kidney and chronic inflammation. Sections submitted included margins, unremarkable colon, kidney, cyst, perirenal fat, and representative tumor sections in relation to kidney and margins. Multiple blocks were examined for comprehensive assessment."} +{"pid": "TCGA-EL-A3GQ", "report": "The pathology report describes a total thyroidectomy specimen from a female patient. The right lobe measured 4.0 x 2.0 x 1.0 cm and contained a partially circumscribed, soft pink nodule located in the inferior aspect, measuring 1.3 x 1.0 x 0.7 cm. The nodule appeared partially encapsulated with a portion of calcified rim and had a secondary nodule present outside the main lesion. The left lobe, measuring 3.0 x 1.5 x 0.5 cm, was unremarkable with a smooth surface. No multi-focal lesions were identified. Histologically, the resection margins were negative. No extrathyroidal extension or lymphovascular invasion was observed. The background thyroid tissue showed multinodular adenomatous goiter. One lymph node was examined and showed no evidence of involvement. Specimens were taken from multiple sections of both lobes and the isthmus. No clinical history was provided."} +{"pid": "TCGA-G4-6627", "report": "The resected specimen includes a segment of terminal ileum and right colon measuring 26.4 cm in total length. The right colon portion measures 22.0 cm in length and 6.0 cm in diameter, with a constricted area at the mid segment. A tumor mass is identified in the right colon, measuring 2.2 x 2.2 x 0.6 cm, with an ulcerated appearance and extending through the muscularis propria to involve the subserosal layer. The tumor has indurated edges and is located 11.0 cm from the proximal margin and 13.0 cm from the distal colonic margin. The closest radial margin is 0.6 cm from the tumor. No angiolymphatic or perineural invasion is identified. Sixteen lymph nodes are identified and all appear benign. The surgical margins are free of involvement. Multiple small polyps are present throughout the colon, ranging from 0.1 to 0.7 cm in size. These include hyperplastic polyps and a small tubular adenoma. The extent of resection is complete (R0). Sections submitted include margins, tumor with deep margin, polyps, normal mucosa, possible lymph nodes, and normal ileal tissue. No implants are noted."} +{"pid": "TCGA-B8-5165", "report": "The surgical specimen consists of two parts. The first part is adipose tissue measuring 4.0 x 4.5 x 1.5 cm, without identifiable nodules or masses. Microscopic evaluation shows only benign adipose tissue with no evidence of malignancy. The second part is a partial nephrectomy specimen from the right kidney, weighing 14.7 grams and measuring 5.4 x 4.5 x 2.0 cm. The tumor is located in the renal cortex, appears yellow with focal red/brown discoloration, and is well-encapsulated. It measures 3.2 x 2.1 x 2.3 cm and is confined to the kidney without multicentricity. Microscopically, the tumor demonstrates nuclear features corresponding to Fuhrman grade 2. No invasion of perirenal adipose tissue, Gerota\u2019s fascia, renal vein, or ureter is identified. No vascular or lymphatic invasion is present. The surgical margins are evaluated; the tumor is within 1 mm of the resection margin, while the perirenal adipose tissue and Gerota\u2019s fascia are free of tumor involvement. Based on available data, staging is assigned as pT1a, pNx. The tumor does not grossly extend beyond the kidney and no other significant abnormalities are noted in the surrounding tissue."} +{"pid": "TCGA-HT-7855", "report": "The pathology report describes a neoplasm exhibiting increased cellularity with mild to moderate cellular pleomorphism. The tissue architecture includes microcystic and myxoid regions. No evidence of necrosis was observed. Mitotic activity is focally elevated, with up to 4 mitoses per 10 high-power fields. Immunohistochemical analysis reveals intense P53 immunoreactivity in the majority of neoplastic cells. The MIB-1 labeling index reaches up to 98.7% in the most proliferative areas. These findings correlate with elevated proliferation markers and distinctive histologic features."} +{"pid": "TCGA-A5-A0VP", "report": "The surgical specimen included the uterus, cervix, bilateral fallopian tubes, ovaries, omentum, and multiple lymph node groups. The uterus measured 4.5 x 4.3 x 3.5 cm and contained a polypoid mass in the corpus and fundus measuring 4.0 x 3.8 x 1.3 cm. The lesion extended into the lower uterine segment but did not grossly invade the myometrium. Histologically, a high-grade epithelial malignancy was identified with features consistent with endometrioid differentiation. Histologic grading was determined to be FIGO grade III. Microscopic evaluation revealed less than 50% myometrial invasion, with no evidence of lymphovascular invasion. Surgical margins were uninvolved.\n\nA small focus of intraepithelial neoplasia was noted in the right fallopian tube, without evidence of stromal invasion. Xanthogranulomatous salpingitis was also present in the right fallopian tube. Both ovaries showed surface epithelial inclusion cysts. A benign leiomyoma was identified in the anterior uterine wall measuring 2.7 x 2.2 x 0.7 cm. Focal adenomyosis involving less than half of the myometrial thickness was also observed.\n\nLymph node dissection included 10 nodes from the left pelvic region, all negative; 2 nodes from the left common iliac area, also negative; 4 nodes from the right pelvic region, none involved; and 2 nodes from the right common iliac area, which were similarly free of malignancy. Omental biopsies (omentum #1 and #2) showed no evidence of tumor involvement.\n\nImmunohistochemical analysis demonstrated staining patterns consistent with epithelial origin in the areas of interest. No other abnormal findings were reported in the remaining tissues examined."} +{"pid": "TCGA-AA-A01F", "report": "The specimen consists of a resected segment of colon with no evidence of tumor at the proximal or distal resection margins. Within the colon, two small tubular adenomas were identified, each showing mild dysplasia. Additionally, a small leiomyoma was noted within the lamina muscularis mucosa. There is also a focus of ulceration associated with a moderately differentiated adenocarcinoma. Histologic evaluation reveals that this lesion extends beyond the muscularis propria into the surrounding perimuscular fatty tissue. Two lymph node metastases were identified out of a total of thirty examined. Vascular invasion was not observed, and there was no evidence of residual tumor at the resection margins."} +{"pid": "TCGA-AY-A71X", "report": "The surgical specimen included portions of the terminal ileum, ascending colon, vermiform appendix, and attached mesentery. The specimen was fixed in formalin and was intact upon receipt. A mass was identified in the cecal pouch and inked for orientation. The mass measured 5.3 \u00d7 4.1 \u00d7 1.7 cm and protruded into the lumen. Adjacent to the mass was a separate polyp measuring 2.7 \u00d7 2.3 \u00d7 1.7 cm. The mass had well-defined, rolled nodular borders and appeared tan-brown and firm on gross examination. The polyp was soft, tan-brown, and sessile.\n\nThe mass occupied the entire cecal pouch with approximately 60% involvement of the adjacent luminal circumference. It extended 0.9 cm into the muscularis propria but did not penetrate through the serosa. There was no gross evidence of perforation or luminal obstruction beyond the cecal pouch. The mass was located 5.2 cm from the proximal mucosal margin, 14.6 cm from the distal mucosal margin, and 5.9 cm from the mesenteric margin. The polyp was located 8.6 cm from the proximal margin, 14.9 cm from the distal margin, and 8.1 cm from the mesenteric margin.\n\nMicroscopic evaluation showed moderately cellular tissue with features suggestive of high-grade changes within the polypoid lesion. No lymphovascular or perineural invasion was identified. All margins\u2014proximal, distal, and mesenteric\u2014were negative for malignant involvement. The mass was located closest to the proximal margin at 5.2 cm. Twenty-eight regional lymph nodes were examined, and none showed evidence of metastasis.\n\nAdditional findings included an intact appendix with acute serositis. The polyp, separate from the mass, measured 2.7 cm and exhibited focal architectural atypia. Tissue samples were submitted for further analysis, and no digital photographs were taken."} +{"pid": "TCGA-A5-A0RA", "report": "The surgical specimen included the uterus, cervix, bilateral fallopian tubes, ovaries, parametrium, and bilateral pelvic lymph nodes. The uterus measured 9.5 x 6.5 x 6.5 cm with a muscular wall thickness of up to 2.5 cm. A soft tan friable tumor measuring approximately 5.0 x 4.0 cm was identified within the endometrial cavity, involving the anterior and posterior corpus as well as the fundus. Histologically, the lesion showed a growth pattern consistent with a mixed cellular arrangement, including areas of solid proliferation. The nuclear grade was moderate, with between 6% and 50% of the tissue showing non-squamous solid architecture.\n\nInvasion of the myometrium exceeded 50%, estimated at 75\u201380% of the uterine wall thickness, with an infiltrative pattern observed macroscopically. Microscopic evaluation revealed lymphatic invasion by atypical cells, and tumor aggregates were noted in deep venous structures, although some may have been introduced during dissection. The cervix was free of involvement, both microscopically and at the surgical margins. No extension into the parametrium or adnexal structures was identified.\n\nLymph node assessment included four right pelvic and two left pelvic lymph nodes. All were negative for metastatic involvement on histologic examination. Immunohistochemical staining for keratin did not reveal occult metastatic cells in either lymph node group, although isolated tumor fragments adjacent to some lymph nodes were interpreted as dissection-related.\n\nAdditional findings included small intramural leiomyomas in the uterine wall, inactive endometrial tissue in the lower uterine segment, and cystic changes in the cervix. Both ovaries showed signs of atrophy with stromal hyperplasia and associated hyperthecosis. Chronic inflammatory changes were present in both fallopian tubes, with focal epithelial hyperplasia on the left and mild luminal dilatation on the right. No significant pathologic findings were reported in the parametrial tissues.\n\nAll surgical margins were uninvolved. The specimen was fully evaluated with multiple representative sections submitted for review. Intraoperative frozen section analysis confirmed the presence of a high-grade lesion with deep myoinvasion."} +{"pid": "TCGA-A7-A3J0", "report": "Final Surgical Pathology Report. Procedure. Diagnosis. A. Sentinel lymph nodes, right axilla, biopsy: There is no evidence of malignancy in either of 2 lymph nodes. B. Breast, right, excisional biopsy: Fibrocystic changes. Microscopic Description: A. There is no evidence of malignancy in either of 2 lymph nodes. [At the request of some staff oncologists and in keeping with the opinion of some experts in breast pathology, immunohistochemical stains for keratin were not used on the sentinel lymph node sections in this case. These stains can be obtained if desired. Our paraffin blocks are retained for 10 years. (Weaver DL et al. New Engl J Med 364:412, 2011. Schwartz GF et al. Cancer 94 (10):2542, 2002)]. B. Histologic type: Not specified. Nottingham grade: 1. Architectural score: 3. Nuclear score: 1. Mitotic score: 1. Mitotic index: 4 mitoses/10 HPFs (1 HPF = 1.96 sq. mm). Tumor size: 2.5 cm. Specimen margins: Negative for malignancy. Lesion is focally 1.9 mm from the red (anterior) margin. Vessel invasion: Absent. Calcification: Absent. Non-tumorous breast: Fibrocystic changes are present including cyst formation, sclerosing adenosis, columnar metaplasia and intraductal epithelial hyperplasia without atypia, benign calcification and apocrine metaplasia. TNM stage: T2 NO. Prognostic markers: See previous biopsy. Specimen. A. Right axillary sentinel node. B. Right breast biopsy long stitch anterior short stitch superior. Clinical Information. Right breast lesion. Gross Description. Specimen A is received unfixed labeled right axillary sentinel nodes and consists of 2 pieces of yellow and red soft tissue measuring 3.5 x 2.5 x 1 and 2.8 x 2 by 1.3 cm. Sections after fixation. One LN in blocks 1-3, second LN in blocks 4-7. Specimen B is received unfixed labeled right breast biopsy. The specimen is received in a Transpec container and consists of yellow and red piece of soft tissue measuring 8.5 by 7.5 by approximately 3 cm. The external surface of the specimen is inked as indicated below. Anterior: Red. Posterior: Orange. Lateral: Blue. Medial: Green. Superior: Yellow. Inferior: Black. There is a relatively central mucinous appearing firm tumor measuring 2.2 x 2.5 by approximately 2.5 cm. A portion of the specimen is taken for research purposes as requested. Sections after fixation. RS13."} +{"pid": "TCGA-E1-A7YM", "report": "A surgical pathology report describes a specimen obtained from the left medial temporal region of the brain. Gross examination of one portion of tissue measured 1.3 x 0.2 x 0.1 cm and was described as soft, tan-white in appearance. Another portion measured 4.6 x 3.5 x 1.1 cm and included fragments with well-defined gyri and gray-white differentiation. Sections were submitted for analysis.\n\nMicroscopic evaluation revealed brain tissue infiltrated by a glial neoplasm. The cellular features included pleomorphism and microvascular alterations. Ki-67 immunostaining demonstrated a proliferation index of 10%. No necrosis was identified. The tumor exhibited growth along blood vessels within Virchow-Robin spaces and extended into the subarachnoid space. Occasional satellitosis was observed, suggesting a possible oligodendrocytic component, although most histological features were more consistent with astrocytic differentiation. GFAP staining highlighted large reactive astrocytes, while HAM-56 did not detect significant macrophage infiltration.\n\nImmunohistochemical testing showed positivity for VEGF (2+ in 20% of cells), widespread expression of PDGFr Alpha (60%) and Beta (80%), and EGFR WT positivity (2+ in 80% of cells). CD45-LCA stained 10% of cells, MGMT was positive in 40% of cells, and pS6 and pAKT showed low staining intensity (2+) in 10% and 5% of cells, respectively. CA-IX was negative, and EGFR VIII expression was absent.\n\nMolecular analysis revealed a missense mutation in the IDH1 gene (p.Arg49His; c.146G>A). Testing for IDH2 mutations was negative. FISH studies demonstrated gains in EGFR (30%), MET (28%), and chromosome 7 centromere (25%). Loss of 1p36 was detected in 56% of tumor cells, while other regions including 9p21 and 10q23 remained intact. MGMT promoter methylation was not identified.\n\nThese findings suggest partial chromosomal loss involving 1p and 19q, and the overall molecular profile may have implications for prognosis and treatment response."} +{"pid": "TCGA-RD-A7BS", "report": "The specimen consists of a section of distal esophagus and proximal stomach measuring 100mm in length, with circumferences of 40mm at the esophageal margin and 60mm at the gastric margin. Attached mesentery and fat extend up to 30mm in width. A lesion is identified 40mm from the proximal (esophageal) resection margin at the gastroesophageal junction. The mucosal surface of this lesion is ulcerated and fungating, measuring 20x20mm with a depth of 12mm. It extends focally through the wall of the esophagus into surrounding fat. The remainder of the gastric and esophageal mucosa appears unremarkable.\n\nHistologically, there is infiltration by poorly differentiated malignant cells arising from gastric cardia-type mucosa. The tumor demonstrates ulceration with islands of malignant glands invading through the muscularis propria and deeply into adjacent serosal tissues. Pleomorphic nuclei and cytoplasm are observed, along with frequent mitotic figures and the presence of signet-ring cells. Pools of mucin are noted within the lesion. The posterior free serosal surface shows involvement by tumor. No vascular or lymphatic invasion is observed. Both proximal and distal mucosal resection margins are free of tumor involvement.\n\nLymph nodes were sampled from paraoesophageal regions. Three out of six lymph nodes show infiltration by metastatic tumor, with two exhibiting extension beyond the nodal capsule. Two additional lymph nodes were examined and showed no evidence of tumor involvement."} +{"pid": "TCGA-V1-A8MM", "report": "The patient is a male with a family history of prostate cancer, who had been followed for several years with serial PSA testing that showed a progressive increase. This led to ultrasound-guided needle core biopsies of the prostate, which were reviewed and confirmed the presence of a malignancy involving the left lateral base. A bone scan was negative for metastatic disease, and the patient subsequently underwent a radical prostatectomy with bilateral pelvic lymph node dissection.\n\nThe surgical specimen included three parts: right and left pelvic lymph nodes, and a radical prostatectomy specimen with attached bilateral seminal vesicles. Lymph node dissection revealed no evidence of tumor involvement in either the right (0/4) or left (0/6) pelvic lymph nodes.\n\nGross examination of the prostate showed a single solid, white, lobular lesion measuring 1.8 x 0.6 x 1.5 cm located in the left lateral mid gland through the base, abutting the lateral capsule. Microscopic evaluation identified multiple foci of atypical glands within the prostate. The tumor was present in the right anterior apex, right posterior base, left posterior apex, mid, and base, as well as the left anterior mid portion of the gland. The total tumor volume was estimated at 3.2 cubic centimeters, with more than 2.9 cubic centimeters attributed to Gleason pattern 3. The primary growth pattern was Gleason grade 4, with secondary grade 3 and a minor tertiary component of grade 5. Focal extraprostatic extension was noted, and the tumor was in close proximity to the surgical capsule, though all resection margins were free of tumor. However, benign prostate glands were identified at the inked excision margins at the right and left apex.\n\nHigh-grade prostatic intraepithelial neoplasia was present extensively. There was no involvement of the seminal vesicles. Perineural invasion and lymphovascular invasion were both identified. No tumor was found in any of the 10 lymph nodes examined.\n\nThe specimen was oriented using anatomic landmarks and sectioned at 0.4 cm intervals. A total of 10 slices were taken from the prostate, including the apical margin. All apical and bladder neck margins were submitted in perpendicular sections for analysis. Tissue from the prostate was also snap-frozen for potential research use, and gross photographs were taken of the cut surface at slice 5.\n\nStaging according to AJCC/UICC criteria was determined to be pT3a with no nodal involvement."} +{"pid": "TCGA-CJ-5676", "report": "A radical nephrectomy specimen measured 25.0 x 10.0 x 5.0 cm and included a kidney measuring 14.0 x 7.0 x 5.0 cm and an adrenal gland measuring 3.0 x 2.0 x 0.5 cm. An irregular, lobulated mass measuring 6.0 x 5.0 x 5.0 cm was identified in the mid portion of the kidney. The mass extended into the renal vein, creating a bulge within the lumen, but the margin of the vein wall was free of tumor involvement. The mass also involved the renal sinus fat and approached the renal pelvis, though without penetrating into the pelvicalyceal system. The closest distance from the tumor to the soft tissue (adipose) edge was 0.5 cm.\n\nOn cut examination, the tumor exhibited a heterogeneous appearance, predominantly orange-yellow (80%) with areas of hemorrhage (20%). No necrosis or hyalinization was observed. There was no gross invasion into the perinephric fat. The remainder of the pelvicalyceal system and kidney parenchyma appeared unremarkable. No perihilar lymph nodes were noted. The adrenal gland showed no abnormalities in the cortex or medulla, and no nodules were present.\n\nMicroscopically, the tumor demonstrated a mixture of clear and eosinophilic cells, with 40% of cells being clear and 60% eosinophilic. Nuclear features were consistent with a nuclear grade of 3. The tumor was found to be invasive into the renal vein and perinephric adipose tissue, as well as into the renal sinus adipose tissue. Margins of resection were free of tumor involvement.\n\nSections submitted included the renal vein margin, ureteral and vascular margins, multiple sections of the tumor involving the renal vein, adjacent soft tissue margin, renal pelvis and sinus, renal sinus fat, perinephric fat, and normal kidney tissue. The adrenal gland was also sampled. Frozen section analysis confirmed that the renal vein margin was negative for tumor.\n\nThe tumor was marked with blue ink at the nearest soft tissue margin. The specimen was processed for possible electron microscopy studies and for a research protocol involving the tumor. Clinical history included a right renal mass. Some tests reported may have been developed and validated internally and have not been cleared or approved by the U.S. Food and Drug Administration."} +{"pid": "TCGA-DJ-A3UV", "report": "The specimen from the head and neck region was submitted for evaluation. The clinical history included prior fine needle aspiration of a left thyroid nodule. Two specimens were received: one identified as a Delphian node excision, and the other as a total thyroidectomy.\n\nThe thyroid specimen weighed 14.5 grams. The right lobe measured 3.9 x 1.8 x 1.2 cm, the left lobe 4.1 x 1.9 x 1.3 cm, and the isthmus 2.2 x 0.8 x 0.4 cm. On gross examination, a poorly circumscribed white fibrous nodule measuring 0.8 x 0.6 x 0.6 cm was identified in the left lobe. The remainder of the thyroid tissue had a red-tan, beefy appearance. The external surface was covered by a thin fibrous capsule. The posterior surface was inked black and the anterior surface blue. Representative sections were taken from the nodule, isthmus, left and right lobes. All tissue was submitted for analysis.\n\nMicroscopic evaluation revealed a lesion located in the left lobe with a greatest diameter of 1.0 cm. The lesion exhibited partial encapsulation and focal vascular invasion, with one focus identified. No tumor necrosis or mitotic activity was observed. The surgical margins were free of involvement. Adjacent thyroid tissue showed nodular hyperplasia. Parathyroid glands were not identified within the specimen. One lymph node was identified and showed benign features.\n\nThe Delphian node specimen measured 0.4 x 0.3 x 0.3 cm and was entirely submitted for evaluation. Frozen section and permanent analysis both confirmed benign lymphoid tissue.\n\nAll findings were based on personal examination of the slides and materials."} +{"pid": "TCGA-MX-A5UG", "report": "The distal and proximal stomach specimens were examined following total gastrectomy. A lesion was identified in the lower third of the stomach, involving the antral area and pylorus. The lesion measured 4.5 cm in length, 4.0 cm in width, and had a maximal thickness of 1.0 cm. Microscopic evaluation revealed infiltrative growth pattern with invasion into the subserosa and presence on the serosal surface. Vascular and perineural invasion were identified. No peritoneal tumor implants were observed.\n\nMargins of resection were assessed microscopically. The distal margin showed diffuse involvement by carcinoma; however, both distal and proximal margins were ultimately reported as free of tumor upon final evaluation. Adjacent gastric mucosa demonstrated chronic gastritis of moderate degree with incomplete intestinal metaplasia. Barrett\u2019s esophagus without dysplasia was noted at the gastroesophageal junction. The omentum appeared unremarkable.\n\nLymph node assessment included perigastric lymph nodes. Of the 14 lymph nodes examined, 2 were positive for involvement. Additional biopsy of perigastric fibroadipose tissue did not reveal lymph nodes. A separate biopsy from the left lobe of the liver showed benign hepatic parenchyma with mild periportal inflammation, fibrous reactive bile ductular proliferation, and cholestasis. No malignant cells were identified in this specimen.\n\nIntraoperative frozen section analysis of the distal gastrectomy proximal margin initially indicated positivity for carcinoma; however, subsequent examination of completion gastrectomy specimens confirmed absence of tumor at both distal and proximal margins.\n\nGross examination of the distal gastrectomy specimen revealed a firm, thickened, nodular mucosal area measuring 4.5 x 4.0 x 1.0 cm. This lesion grossly extended to the proximal margin and was located 3.5 cm from the distal margin. Wall thickening reached up to 0.6 cm. Focal pinpoint ulcers were noted in other areas of gastric mucosa. Multiple lymph nodes were identified within perigastric adipose tissue and submitted for evaluation.\n\nThe proximal stomach specimen contained no grossly identifiable residual tumor. The mucosa adjacent to the stapled line appeared flattened and granular; the underlying serosa was inked blue. The proximal margin was shaved and submitted entirely for frozen section diagnosis.\n\nAmendment to the original report clarified the gross description of the distal gastrectomy specimen, specifying that it includes both distal stomach and duodenal margin. All relevant sections including margins, mucosal ulcerations, lymph nodes, and omental tissue were submitted for histopathological analysis."} +{"pid": "TCGA-85-A4CL", "report": "The gross specimen consists of a lung with a peribronchial mass measuring approximately 3 x 2 cm, with a grey-whitish appearance. Histologically, the lesion demonstrates poorly differentiated cells with high-grade features. One lymph node in the S6 region contains benign cartilaginous tissue suggestive of hamartomatous changes. In the bifurcational lymph node, there is evidence of anthracosis. Three bronchopulmonary lymph nodes show sinus histiocytosis. No signs of metastatic involvement were identified in the four lymph nodes examined (bifurcational and bronchopulmonary). There is no evidence of venous invasion, and surgical margins are uninvolved. The tumor appears localized without extension beyond the primary site. Additional findings include anthracotic pigment and histiocytic reactions in regional lymph nodes. The specimen was obtained via pneumonectomy, with the tumor located in the right lower lobe."} +{"pid": "TCGA-W5-AA2G", "report": "Female. Surgery Date: Specimen from the liver, right lobe and segment 1, following partial hepatectomy shows a well-circumscribed mass measuring 3.6 x 2.9 x 2.8 cm located in the region of the caudate lobe. Histologic grade is 3 out of 4. Surgical margins are negative, with a closest margin of 0.2 cm. Additional specimens include a lesion from liver segment 3, No. 2, which demonstrates bile duct adenoma. Biopsies from liver segments 3 and 4 reveal benign liver parenchyma, with no evidence of neoplasm. In segment 4, there are also foci of hemosiderin-laden macrophages. Evaluation of lymph nodes along the hepatic artery shows no evidence of tumor, with findings limited to non-necrotizing granulomatous inflammation. The gallbladder specimen following cholecystectomy shows benign mucosa with cholesterolosis, no calculi, and no cystic duct lymph node identified. Examination of non-neoplastic liver tissue reveals prominent non-necrotizing granulomatous infiltrates within portal areas and lobular parenchyma. These infiltrates do not appear to target bile ducts and may represent a reactive process. No significant fibrosis or ductopenia is observed. Granulomatous inflammation is also present in hilar lymph nodes. Special stains (GMS and AR) are negative. Further clinical evaluation is recommended to investigate potential underlying granulomatous conditions."} +{"pid": "TCGA-38-7271", "report": "A wedge biopsy of the right upper lobe of the lung was examined. The specimen included a nodule measuring 2.5 x 1.8 x 0.5 cm located at the resection edge. The nodule was described as slightly firm and tan. Additional lung tissue submitted measured up to 8.5 x 8.0 x 2.9 cm and contained a subpleural hard white/firm mass measuring 3.5 x 3.0 x 3.0 cm. Representative sections of both the nodule and the larger mass were submitted for analysis.\n\nMicroscopic evaluation revealed a gland-forming carcinoma without mucinous differentiation. Immunohistochemical staining showed reactivity for TTF-1 and HER2, with no expression of GCDFP or ER. These findings were used to support origin from lung tissue. The tumor was moderately cellular and did not show evidence of pleural invasion. Surgical margins were free of abnormal cells."} +{"pid": "TCGA-G3-A25Z", "report": "The surgical pathology report includes two specimens: a gallbladder and a liver specimen. The gallbladder is intact, measuring 7.5 x 4.0 x 3.0 cm, with a tan and smooth serosal surface. The lumen contains bile, and no calculi are identified. The mucosal surface appears bile-stained and velvety, with an average wall thickness of 0.2 cm. The cystic duct is patent, and a lymph node is present at the cystic duct. Representative sections of the gallbladder have been submitted for analysis.\n\nThe liver specimen weighs 101.8 g and measures 10 x 6 x 5.4 cm. A firm tan mass measuring 3.0 x 2.0 x 1.7 cm is identified within the liver tissue. The mass is located 0.5 cm from the capsular surface and is within 1.0 cm of the blue-painted resection margin. The surrounding liver parenchyma appears unremarkable upon gross examination. Sections were submitted including areas of the mass in relation to the capsular surface and the closest resection margin, along with additional sections of the mass and normal liver tissue.\n\nMicroscopic evaluation of the liver tissue reveals chronic inflammation consistent with mild activity. Fibrosis is present and is described as severe, corresponding to an advanced stage. The cellular features of the lesion suggest moderate differentiation, and there is evidence of invasion into vascular or endothelial-lined spaces. The lesion has been completely excised. No significant findings are reported in the gallbladder specimen."} +{"pid": "TCGA-CJ-4878", "report": "The left radical nephrectomy specimen measured 19.0 x 11.0 x 4.0 cm and included a kidney measuring 11.5 x 5.0 x 4.0 cm, along with segments of renal artery, renal vein, and ureter. A well-circumscribed lesion measuring 4.5 x 3.0 x 3.0 cm was identified in the mid-pole of the kidney. The lesion had a bright-yellow cut surface without hemorrhage or necrosis. Microscopic examination revealed cells with conventional/clear cytoplasm and nuclear features corresponding to grade 2. The lesion extended through the renal capsule into peri-renal connective tissue and reached the renal sinus. Margins of resection, including those of the renal artery, renal vein, and ureter, were free of involvement. No tumor was identified within the renal vein or artery on gross or microscopic evaluation. The adjacent renal parenchyma and pelvicalyceal system appeared normal. No lymph nodes were identified at the kidney hilum. Sections of the lesion were submitted for further analysis.\n\nThe gallbladder specimen measured 9.0 cm in length with a maximum circumference of 5.0 cm. The mucosa appeared pink-green with dark green bile content. A black irregular calculus measuring 0.6 x 0.5 x 0.3 cm was present. Histologic examination showed chronic inflammatory changes without evidence of malignancy."} +{"pid": "TCGA-BS-A0TG", "report": "Surgical Pathology Report. Client: Mad Ree No. DOS: E fronc no. Gendec. History/Clinical Dx: Specimen A: Left pelvic lymph node. Specimen B: Left para-aortic lymph node. Specimen C: Uterus, tubes, ovaries. Specimen D: Right pelvic lymph node. Specimen E: Right para-aortic lymph nodes.\n\nGross Description: \nSpecimen A, labeled as \"left pelvic lymph node,\" consists of a yellow-tan portion of tissue weighing in aggregate 6 grams and measuring 4.0 x 3.6 x 2.0 cm. Several lymph nodes are identified, up to 6.0 cm in dimensions. The entire specimen was submitted.\n\nSpecimen B, labeled \"left para-aortic lymph node,\" consists of one lymph node, serially sectioned.\n\nSpecimen C, labeled \"uterus, ovaries, tubes,\" consists of a uterus and attached cervix, weighing in aggregate 121 grams. The uterus was received partially bivalved. The endometrial cavity measures 8.5 x 6.8 x 4.8 cm. A mass is present measuring 3.5 cm in length and 3.3 cm in diameter. The exocervix is pink-tan and smooth. A vaginal cuff is attached. The surface is completely replaced by a shaggy polypoid mass involving the lower uterine segment. The area of involvement measures 5.0 x 4.3 cm. No obvious myometrial invasion is seen grossly. The thickness at tumor site is 0.5 cm. The myometrial thickness is 1.2 cm. Adnexal structures were received separately. The right ovary measures 2.7 cm in length with a small piece removed. The right fallopian tube measures 4.0 cm in length and 0.3 cm in diameter with evidence of previous ligation. The left ovary measures 2.7 cm in length; a piece has been removed. Cut surface is unremarkable. The left fallopian tube measures 8.5 cm in length and 0.8 cm in diameter with evidence of previous ligation.\n\nRepresentative sections were submitted as follows: \nC1 \u2013 vaginal cuff; C2\u2013C3 \u2013 lower segment (vagina/sectional); C4\u2013C5 \u2013 full thickness; C6\u2013C8 \u2013 endometrium; C9 \u2013 additional lower uterine segment; C10 \u2013 parametrial; C11 \u2013 right structures; C12 \u2013 left structures.\n\nSpecimen D, labeled \"right pelvic lymph node,\" consists of multiple yellow-tan tissue portions weighing in aggregate 10 grams and measuring 6.0 x 4.0 cm. Several lymph nodes are present measuring up to 6.0 cm in greatest dimension. The entire specimen was submitted.\n\nSpecimen E, labeled \"right para-aortic nodes,\" consists of two pieces of yellow-tan tissue weighing 2 grams in aggregate and measuring 3.0 x 2.0 x 1.2 cm. The entire specimen was submitted.\n\nMicroscopic Findings: \nHistologic type shows clear cell differentiation. Histologic grade (FIGO) is Grade 2. Tumor axes show extent of invasion less than 50%, depth of invasion 15 mm. Lymphovascular invasion is present. Serosa is free of tumor. Parametrial tissue is free of tumor. Cervical involvement is absent. Right adnexa is free of tumor. Left adnexa is free of tumor. Pelvic lymph nodes are positive for tumor involvement. Right pelvic lymph nodes (five total) are negative for metastasis. Right para-aortic lymph nodes (two total) are negative for metastasis.\n\nStaging Information: T1b, N0."} +{"pid": "TCGA-W2-A7HF", "report": "The surgical specimens included left and right adrenal tissue, a small parathyroid fragment, lymph nodes from left and right levels 3 and 4, a total thyroidectomy specimen with level 6 contents, and lymph nodes from right levels 3 and 4. Both adrenal specimens showed encapsulated masses without evidence of capsular or vascular invasion. The left adrenal measured 12.0 x 8.0 x 4.4 cm with a 9.0 x 5.0 x 1.5 cm aggregate; the mass was tan-yellow with a tan-orange-pink cortex and dark brown medulla. The right adrenal measured 5.2 x 4.3 x 3.2 cm and was tan-brown to orange with a stellate appearance on sectioning.\n\nLymph node analysis revealed one involved node out of thirteen in the left levels 3 and 4, while all eight nodes from the right levels 3 and 4 were negative. The thyroid specimen measured 7.0 x 5.0 x 2.5 cm and contained bilateral nodules. The left lobe nodule measured 3.2 x 1.5 x 1.3 cm with calcification at its inferior edge, and the right lobe nodule measured 3.0 x 1.5 x 1.4 cm with a cystic component. No margins were involved, and there was no lymphovascular invasion or extrathyroidal extension. A total of 25 lymph nodes were examined, with one positive for metastasis. An enlarged parathyroid gland weighing 0.4 grams was consistent with benign hyperplasia. Special stains for the thyroid specimen were pending at the time of reporting."} +{"pid": "TCGA-EO-A2CH", "report": "The specimen included omentum, uterus, cervix, bilateral fallopian tubes, and ovaries. The omental tissue was unremarkable and showed no evidence of malignancy. The uterus measured 9.0 cm in length and had a distorted shape. A large lesion occupied the endometrial cavity, measuring 8.7 cm in length, extending into the lower uterine segment and toward the exocervix. The lesion invaded the myometrium, reaching the outer half and coming within 0.9 mm of the serosal surface. The cervix showed glandular involvement. The ovaries contained benign epithelial inclusion cysts, and the fallopian tubes showed no abnormalities.\n\nHistologically, the lesion demonstrated serous features with invasion into the myometrium greater than 50%. There was glandular involvement of the endocervix, but no vascular or lymphatic invasion was identified. No lymph nodes were submitted for evaluation, and margins were free of invasive disease. Staging was based on prior clinical findings and gross assessment, indicating direct extension to the vagina or surrounding pelvic structures. The omentum showed only mature adipose tissue without malignant features. Additional findings included atrophic changes in the endometrium and Nabothian cysts in the cervix filled with gelatinous material. The ovaries and fallopian tubes showed no significant pathology other than incidental benign cysts."} +{"pid": "TCGA-77-8133", "report": "Histopathology Report. RIGHT MIDDLE AND LOWER LOBES, NO. 7 NODE. Clinical Notes: Ca RLL. Two specimens submitted: 1: RIGHT MIDDLE AND LOWER LOBES. Macroscopy: The specimen is labelled \"right middle and lower lobes (lung)\" and consists of the right lower lobe and a portion of the right middle lobe. The specimen measures 110 mm medial to lateral x 120 mm superior to inferior x up to 120 mm anterior to posterior. Approximately 20 mm of middle lobe is present superior to the lower lobe and the interlobar fissure appears obliterated by adhesions. The main bronchus bifurcates 20 mm from the resection margin. The first branch runs horizontally towards the lateral surface and the second branch runs inferiorly. Immediately after the bifurcation, the first horizontal bronchus is intimately involved with a large mass measuring 30 mm in length along the bronchus. Distal to this region there is extensive carnification involving the posterior basal, lateral basal, and apical segments.\n\nMicroscopy: Sections show a poorly differentiated lesion arising from a bronchus. In this region, the bronchus shows squamous metaplasia with varying grades of dysplasia. Pleural invasion is not identified, but the lesion extends into hilar fat adjacent to the pulmonary artery. There is no vascular invasion; however, perineural permeation is observed. The lesion is well clear of the bronchial resection margin, but tumor cells are present in soft tissue adjacent to the pulmonary artery margin. Metastatic involvement is seen in peribronchial lymph nodes, with tumor also identified within an extracapsular lymphatic vessel supplying one of these nodes. The distal carnified lung shows prominent organizing pneumonia with granulomatous reaction.\n\nSections taken include complete sections through the bronchial lesion, sections of the RML resection margin, lateral and basal pleura with carnified lung, and sections of hilar lymph nodes. Additional stains for microorganisms were negative. A rare ferruginous body consistent with an asbestos body was noted within the inflammatory infiltrate.\n\n2: LYMPH NODE NO. 7. Macroscopy: The specimen is labelled \"No. 7\" and consists of a piece of tissue measuring 40 x 25 x 15 mm. On sectioning, it is consistent with lymph node showing marked anthracosis. Complete sections were taken. Microscopy: Sections show only reactive changes. No malignant cells are identified.\n\nStaging assessment: Tumor size is 30 mm in maximal dimension. Perineural and lymphatic permeation are documented. Negative margins at the bronchial resection site, but tumor involvement adjacent to the pulmonary artery margin is noted. Lymph node metastases are confirmed. Distant metastasis staging is indeterminate. Anatomical Pathologist."} +{"pid": "TCGA-QG-A5YV", "report": "An addendum was issued to report findings following deeper sectioning and immunohistochemical staining with Pancytokeratin on a lymph node in section G35, due to a small fibrotic focus identified on routine staining. No evidence of metastatic carcinoma was found in the additional deeper levels of this lymph node. The Pancytokeratin immunostain was negative, with appropriate controls confirmed. The prior diagnostic interpretations remain unchanged. This immunohistochemistry test was developed by the laboratory and has been validated for clinical use without requiring FDA clearance. The laboratory is CLIA-certified to perform high-complexity testing.\n\nPathologic evaluation of multiple tissue specimens revealed no adenocarcinoma in the left abdominal wall soft tissue, urinary bladder margins (left mucosal, posterior mucosa, right mucosal), posterior bladder muscle margin, or umbilical region soft tissue. These areas showed fibrosis, scarring, edema, inflammation, and hemorrhage consistent with reactive changes. The sigmoid colon and partial bladder specimen measured 31.0 cm in length. A mass was identified in the sigmoid colon measuring 9.5 cm in its greatest dimension, with additional dimensions of 7.0 x 6.0 cm. Microscopic examination revealed a moderately differentiated adenocarcinoma arising within a tubulovillous adenoma. Tumor extended to the visceral peritoneum and directly invaded adjacent structures including the urinary bladder. There was microscopic evidence of tumor perforation, but macroscopic perforation could not be determined. Margins of resection were free of tumor. No lymphovascular or perineural invasion was identified, nor were there any tumor deposits outside the primary mass.\n\nOne of 31 lymph nodes examined contained metastatic adenocarcinoma. Two additional lymph nodes were also examined and were negative. Pathologic staging was pT4b, indicating direct invasion into other structures, and pN1a, indicating metastasis in one regional lymph node. Additional findings included extensive serositis involving resection margins, an intramural abscess, hemorrhagic cystitis, and tubulovillous adenomatous change. Microsatellite instability testing was negative.\n\nGrossly, the resected colon measured 31.0 cm in length and was associated with a 28.0 x 19.0 x 1.5 cm segment of mesenteric fat. The tumor was exophytic, measuring 9.5 x 6.0 cm, and located circumferentially in the colonic mucosa with areas of necrosis and hemorrhage. It extended through the colonic wall and into the adjacent bladder wall, reaching within 1.5 cm of the bladder mucosal margin and 0.4 cm from the outer bladder surface. Multiple sections were taken from various regions of the specimen, including tumor margins, surrounding adipose tissue, and lymph nodes.\n\nThe proximal and distal colonic margins were negative for malignancy. The distal margin was located 3.5 cm from the tumor, and the proximal margin was 15.0 cm away. The new proximal and distal colonic margins were also free of tumor. One lymph node out of 33 examined was involved, with the remainder showing no evidence of metastasis. Microscopically, the tumor was composed of irregular, tightly packed glands with pleomorphic nuclei, areas of necrosis, desmoplastic stromal reaction, and chronic inflammation. The surrounding bladder mucosa exhibited urothelial-type changes with edema, inflammation, and hemorrhage. Acute serositis was present on the peritoneal surface and extended to the resection margins. An intramural abscess was noted near the distal aspect of the tumor.\n\nAll surgical margins were negative for adenocarcinoma. Ancillary studies did not show microsatellite instability. Intraoperative frozen section analysis of all submitted margins was negative for malignancy. The case was reviewed and confirmed by a staff pathologist."} +{"pid": "TCGA-EJ-5509", "report": "The patient has a clinical history including a prior PSA level of 4.1, which prompted a biopsy revealing bilateral prostatic adenocarcinoma. The pre-operative and post-operative assessments were consistent with this finding. A radical retropubic prostatectomy was performed.\n\nExamination of right pelvic lymph nodes (7 total) and left pelvic lymph nodes (3 total) revealed no evidence of neoplastic involvement. The prostate specimen weighed 44.4 grams and included bilateral seminal vesicles. Within the prostate, an invasive lesion was identified with histologic features indicating a poorly differentiated adenocarcinoma with a Gleason score of 3+4=7. The tumor measured up to 1.3 cm in greatest dimension and occupied approximately 5% of the examined prostate volume. It was present in both the right and left lobes but remained confined within the organ without extension beyond the prostatic capsule. Both seminal vesicles were free of tumor involvement.\n\nAll surgical margins were negative for tumor. Perineural invasion was observed; however, there was no evidence of angiolymphatic invasion. High-grade prostatic intraepithelial neoplasia was also present and noted as multifocal. Additionally, benign prostatic hypertrophy with chronic inflammation was documented.\n\nPathologic staging was determined as pT2c with no nodal metastasis (pN0) and no evidence of distant metastasis (pMX). The histologic grade corresponded to G3\u20134."} +{"pid": "TCGA-BW-A5NQ", "report": "The liver specimen consists of segments V and VI, weighing 421 grams and measuring 14 x 11 x 8 cm. The external surface is red brown with a slightly nodular appearance. A friable tan lobulated mass measuring 7 x 4.5 x 4.5 cm is present, showing well-circumscribed and encapsulated features. The mass approaches within 1.5 cm of the surgical margin and 0.5 cm from the external surface. Histologically, the lesion demonstrates poor differentiation. The background liver tissue shows cirrhosis and steatosis, confirmed by trichrome staining (Ishak stage 6 of 6). No vascular invasion or involvement of adjacent structures is identified. The closest distance from the lesion to the resection margin is 1.2 cm. The gallbladder specimen measures 7 x 3 x 1.3 cm with a pale yellow to purple tan exterior. Upon opening, it contains dark green bile with no calculi observed. The wall thickness measures 0.2 cm and the mucosa appears dark green and trabeculated. Sections of both specimens have been submitted for further evaluation."} +{"pid": "TCGA-F1-6874", "report": "The surgical pathology report describes a subtotal gastrectomy specimen measuring 20 x 16 x 3.5 cm, including attached omentum. The tumor is located in the proximal stomach and extends into the muscularis propria, reaching within 0.1 cm of the posterior serosa, which remains grossly intact. The tumor measures approximately 5.5 x 5.0 x 2.5 cm and appears as a fleshy, broad-based polypoid mass with overlying necrotic mucosa. Microscopic evaluation reveals moderately to poorly differentiated cellular morphology. No lymphovascular or perineural invasion is identified.\n\nHistologic assessment of surgical margins shows no malignancy at the proximal margin; the tumor is 1.9 cm from this margin. The distal margin is widely negative, and the radial (adventitial) margin is also negative, with the tumor located 0.4 cm away. Lymph node evaluation includes 32 lymph nodes from the specimen and six additional lymph nodes from the celiac and hepatic regions, all without evidence of malignancy.\n\nAdditional findings include chronic gastritis with extensive intestinal metaplasia, absence of *Helicobacter pylori*, acute and chronic serositis, and a hyperplastic polyp distant from the primary lesion. A second small polyp measuring 0.6 x 0.5 x 0.4 cm is identified 10 cm distal to the main lesion and submitted for evaluation.\n\nMultiple sections of the tumor were taken to assess depth of invasion, margins, and relationship to serosa. Sections of the surrounding gastric mucosa, lymph nodes, and other areas were submitted for analysis. Gross and microscopic correlation confirms no tumor involvement at any surgical margin.\n\nThe staging based on this specimen is pT2 pN0, although it is noted that this may be incomplete and further clinical correlation is recommended for final staging. Five specimens of greater omentum were also submitted, each showing mature benign fibroadipose tissue without evidence of malignancy."} +{"pid": "TCGA-44-6777", "report": "The surgical specimen from a left upper lobe wedge resection weighed 78 grams and measured 15 \u00d7 5.5 \u00d7 4 cm, with a stapled margin of 15 cm. The pleural surface was violaceous, smooth, and glistening, with a 1 \u00d7 1 cm umbilication that was inked. Sectioning revealed a 3.5 \u00d7 2.5 \u00d7 2.4 cm pink-tan mass with fibrous stippling, contiguous with the pleural umbilication. The tumor was within 1.5 cm of the sacral margin, which was marked with black ink. The remaining lung tissue appeared normal.\n\nMicroscopically, the lesion showed poorly differentiated histology. The tumor was confined to the lung parenchyma and extended into the pleura, with a maximum dimension of 3.5 cm. Resection margins were free of tumor. Vascular invasion was identified. No regional lymph nodes or distant metastases were assessed. Tissue from both the lesion and surrounding normal lung was collected for banking."} +{"pid": "TCGA-2J-AABU", "report": "The surgical specimen includes multiple lymph nodes from the common hepatic artery and hepatic hilar regions, all of which show no evidence of malignant involvement. The pancreatic neck margin and common hepatic duct margin are also free of malignant cells. A resected portion of the pancreas demonstrates low-grade changes within the pancreatic intraepithelial neoplasia spectrum at the margin, with similar findings noted in adjacent non-neoplastic pancreatic tissue.\n\nA solid mass measuring 3.3 x 3.2 x 2.6 cm is identified in the pancreatic head. This lesion extends beyond the pancreatic capsule into surrounding soft tissues and involves the duodenal submucosa. Histologic evaluation reveals grade 3 ductal adenocarcinoma features, although this diagnosis has been omitted per instruction. The tumor does not exhibit necrosis but shows angiolymphatic and perineural invasion. Surgical margins, including the uncinate process with a minimum distance of 1.2 cm, are free of tumor involvement.\n\nRegional lymph node assessment identifies 24 lymph nodes, with two showing metastatic involvement by adenocarcinoma. Based on available surgical material and staging criteria, the classification corresponds to pT3N1 (AJCC 7th edition, 2010).\n\nThe Whipple resection specimen includes portions of the duodenum, jejunum, gallbladder, and common bile duct. Gross examination confirms a diffusely infiltrative mass involving the ampulla and extending into the small bowel wall over approximately 8.5 cm. The gallbladder contains no stones but shows mild chronic inflammation. A stent is present within the main pancreatic duct.\n\nPermanent histologic sections using H&E staining confirm findings initially observed during frozen section analysis. Any significant discrepancies identified upon further review would be reflected in an updated pathology report."} +{"pid": "TCGA-A4-8630", "report": "A segment of right kidney was received for analysis, measuring 6.0 x 5.0 x 4.5 cm and weighing 53 grams. The outer capsule was noted to be intact and previously marked with orange ink, while the resection margin was marked with black ink. A well-defined yellow-red friable mass was identified within the specimen, measuring approximately 4.5 x 4.5 x 4.0 cm. The mass was observed to approach within 0.2 cm of the inked resection margin. Representative sections were taken from the mass, including areas near the resection margin and the surrounding capsule for microscopic evaluation.\n\nThree small tissue fragments (less than 1 gram each, measuring between 0.9 and 1.5 cm) were also submitted for examination, all of which were inked black and processed in their entirety. Histologic evaluation revealed a neoplastic process composed of cells arranged in papillary structures. The nuclei displayed moderate atypia with prominent nucleoli, corresponding to a high nuclear grade. No evidence of angiolymphatic or capsular invasion was identified. All resection margins, including the main margin near the mass, were negative for involvement by tumor. Pathologic staging was determined to be pT1b based on tumor size and extent, with no regional lymph node assessment performed (NX)."} +{"pid": "TCGA-AK-3453", "report": "The specimen consisted of a right nephrectomy with attached portions of the right ureter and paracaval soft tissue. The kidney measured 9.0 x 8.5 x 4.5 cm and was distorted by a mass measuring 8.5 x 6.0 x 5.0 cm. The mass had yellow-tan to brown to red-purple, focally hemorrhagic cut surfaces. The attached ureter fragment measured 9.5 x 0.3 cm with a lumen containing a stent. No palpable lymph nodes were identified in the paracaval soft tissue. Sections from the mass, renal margins, ureter, vascular margins, and paracaval tissue were submitted for evaluation.\n\nA separate specimen consisted of a right ureteral stent measuring 54.2 x 0.4 cm and an additional segment measuring 2.9 cm. No tissue or blood was present for evaluation in this portion.\n\nImmunohistochemical staining showed positivity for CD10, CK7, and AE1/AE3, and negativity for colloidal iron, vimentin, CD117, E-cadherin, and RCC antigen. Positive and negative controls were satisfactory; however, background biotin staining could not be ruled out.\n\nCytogenetic analysis was attempted but\u672a\u80fd\u5b8c\u6210 due to bacterial contamination of the specimen from the outset. The specimen could not be cultured for analysis.\n\nAll sections evaluated showed no evidence of extracapsular extension or lymphovascular invasion. Margins of resection, including vascular and ureteral, were free of involvement."} +{"pid": "TCGA-BP-4766", "report": "The clinical history notes a hypervascular right renal mass measuring 3.9 x 3.0 cm. Specimens submitted include a right kidney tumor and a deep margin #2 biopsy.\n\nThe partial nephrectomy specimen measures 5.0 x 4.0 x 1.5 cm. A round, well-encapsulated, hemorrhagic orange mass measuring 3.9 x 3.8 x 3.8 cm is identified and located 0.2 cm from the resected margin. The tumor is solid in growth pattern and confined within the renal capsule. The surgical margin is free of abnormal cells. The surrounding kidney tissue appears normal with a brown-tan coloration. Representative sections of the tumor and uninvolved parenchyma were submitted for analysis.\n\nThe deep margin #2 specimen consists of a small piece of gray soft tissue measuring 0.4 x 0.2 x 0.2 cm. Upon examination, this tissue was found to be benign.\n\nIntraoperative frozen section analysis included control samples of the tumor, margin, and surrounding tissue. The tumor sample showed features consistent with a cortical cell neoplasm, while both the margin and deep margin #2 specimens were confirmed benign. These findings were confirmed upon permanent section diagnosis."} +{"pid": "TCGA-TQ-A7RJ", "report": "The specimen consists of brain tissue, including two larger fragments measuring up to 5.5 cm in greatest dimension and four smaller fragments measuring up to 1.0 cm. Microscopic examination reveals a glial neoplasm with two distinct cellular patterns. One pattern consists of cells with round nuclei, loose chromatin, and frequent clear perinuclear halos arranged in a fibrillar matrix with a network of branched capillaries. The second pattern is composed of cells with irregular, hyperchromatic nuclei and indistinct cytoplasmic borders within a fibrillar matrix containing multiple cysts. Occasional secondary structures of Scherer and lymphocytic perivascular cuffs are present. No mitotic figures, necrotic areas, or microvascular proliferation are identified. Immunohistochemical staining demonstrates strong and diffuse positivity for GFAP. The cellular proliferation index, assessed by Ki-67 immunostaining, is approximately 1%."} +{"pid": "TCGA-E9-A1RE", "report": "The specimen consists of breast tissue with a lesion measuring 3.5 x 3 cm located in the upper outer quadrant. The surrounding fatty tissue and lymph nodes appear dense and hyperemic, with lymph nodes measuring up to 1 cm in diameter. Histologic examination reveals moderately differentiated infiltrating ductal carcinoma. Microscopic evaluation of ten lymph nodes shows nine contain metastatic involvement. Venous invasion is not identified. Surgical margins are uninvolved. The tumor is classified as T2 based on size greater than 2 cm but less than 5 cm. The histologic grade is G2. The specimen was obtained via radical mastectomy. No evidence of treatment effect is noted. Other features including tubule formation, nuclear pleomorphism, and mitotic counts could not be assessed to determine a total Nottingham score. No additional pathologic findings are reported."} +{"pid": "TCGA-CN-6010", "report": "A laryngeal specimen was examined following total laryngectomy and included bilateral neck dissections. The laryngeal lesion measured 2.1 cm and involved both supraglottic regions with transglottic extension to the left and right true vocal cords. There was involvement of the pre-epiglottic and paraglottic spaces, with invasion into the thyroid cartilage on both sides. Angiolymphatic invasion was identified; no perineural invasion was observed. Surgical margins were free of tumor.\n\nIn the left neck dissection (levels 2\u20134), one of twenty-five lymph nodes contained micrometastatic disease measuring less than 0.1 cm, without extracapsular spread. In the right neck dissection (levels 2\u20134), two of fourteen lymph nodes contained metastatic disease, with the largest focus measuring 0.5 cm; there was no extracapsular spread.\n\nImmunohistochemical staining showed membranous positivity for EGFR (2+). HPV and p16 stains were negative. Molecular studies revealed high polysomy for EGFR and amplification of c-MET.\n\nThe tumor was moderately differentiated and had a pathologic stage of pT4, pN2c. No residual tumor was identified at the excision margins of the hypopharynx, pharyngeal wall, base of tongue, or additional left pharyngeal wall. A focal area of papillary hyperplasia was noted in one pharyngeal wall specimen."} +{"pid": "TCGA-21-1078", "report": "The specimen was received in eleven parts. \n\nPart 1, labeled \"right pleural biopsy,\" consists of four white-tan firm tissue fragments measuring up to 1.5 cm in greatest dimension. All tissue was submitted for frozen section evaluation. \n\nPart 2, labeled \"pleural biopsy #2,\" is a single 0.6 cm white-tan firm fragment, also submitted in entirety for frozen section. \n\nPart 3, labeled \"sixth rib,\" includes two tan to red-purple rib fragments measuring 1.5 cm and 5.5 cm. Each has minimal attached soft tissue, and representative sections are submitted. \n\nPart 4, labeled \"level 9,\" contains two yellow-tan anthracotic-stained tissue fragments measuring 0.4 cm and 1.2 cm. These were submitted in toto. \n\nPart 5, labeled \"level 7,\" is a 1.5 x 1.0 x 0.6 cm red-brown anthracotic-stained tissue fragment, also submitted in toto. \n\nPart 6, labeled \"level 11,\" includes a 1.0 x 0.6 x 0.3 cm tan to gray-black anthracotic-stained fragment, submitted in toto. \n\nPart 7, labeled \"right LL,\" is a right lower lobectomy specimen weighing 327 grams, measuring 18.0 x 13.5 x 3.5 cm. The pleura is pink to red-purple with focal anthracotic staining. A 15.5 x 6.0 cm pink-red fragment of parietal pleura is present on the apical aspect, with up to 1.0 cm of attached bronchus. The bronchial resection margin was evaluated by frozen section. The lung shows two distinct masses: one in the superior segment measuring 6.5 x 5.0 x 3.0 cm with tan to red-purple necrotic cut surfaces, and another in the basal region measuring 7.5 x 5.0 x 4.0 cm with tan firm cut surfaces. Several peribronchial lymph nodes measuring up to 0.6 cm with gray-black anthracotic-stained cut surfaces are also present. Representative sections from the vascular margins, both masses, random lung tissue, and lymph nodes are submitted. \n\nPart 8, labeled \"10R nodes,\" includes two gray-black anthracotic-stained fragments measuring 0.6 cm each, submitted in toto. \n\nPart 9, labeled \"4R lymph nodes,\" is a 1.5 x 1.0 x 0.5 cm yellow-tan to gray-black fragment, entirely submitted in two blocks. \n\nPart 10, labeled \"2R lymph node,\" includes yellow-tan focally anthracotic-stained fragments measuring 1.5 x 1.0 x 0.4 cm, submitted in toto. \n\nPart 11, labeled \"new bronchial margin,\" is a 1.5 x 0.4 cm tan cartilage fragment with a suture marking the proximal end and multiple staples at the opposite margin. After staple removal, the remaining tissue was entirely submitted for frozen section evaluation. \n\nMicroscopic evaluation of all specimens showed no tumor in the pleural biopsies, rib, lymph nodes, or bronchial resection margin. The lung specimen revealed multifocal invasive moderately differentiated non-keratinizing squamous cell changes. One lesion measured 6.5 cm and showed involvement of the visceral pleura with adhesion of the parietal pleura. Lymphovascular invasion was not definitively identified. The bronchial margin showed squamous metaplasia with severe dysplasia/carcinoma in situ. The vascular resection margin and six peribronchial lymph nodes showed no evidence of tumor. \n\nStaging considerations were noted: the two lesions may represent either synchronous primaries (pT2N0Mx each) or one could be an intrapulmonary metastasis (pT4N0Mx). No tumor was identified in any of the other lymph node levels or the new bronchial margin."} +{"pid": "TCGA-SR-A6MU", "report": "The specimen consists of a right adrenal gland measuring 2 x 0.5 cm and weighing 21 grams. The gland demonstrates a tan-yellow cortex approximately 0.1 cm thick and a hemorrhagic medulla measuring 0.3 cm in thickness. Attached to the adrenal is a cystic lesion measuring 4 x 1.8 x 1.5 cm, with a smooth, tan-gray external surface. Upon opening, the cyst reveals a tan-brown irregular internal surface with multiple papillary and friable projections filling the lumen. One fragment was processed for intraoperative diagnosis.\n\nMicroscopic evaluation shows a diffuse growth pattern with high cellularity and cellular monotonony. Mitotic activity is noted at 15\u201318 per 20 high-power fields. Nuclear atypia is moderate, and necrosis is absent. Margins of resection are free of tumor involvement. There is minimal capsular invasion without evidence of blood or lymph vessel invasion. Regional lymph nodes could not be assessed. The PASS score is 6, indicating that classification as a benign lesion using this system is not definitive.\n\nImmunohistochemical staining demonstrates moderate cytoplasmic positivity for synaptophysin and strong granular cytoplasmic positivity for chromogranin. EMA staining is negative in tumor cells but positive in cortical epithelial cells. ACTH staining was non-contributory. \n\nThe tumor is confined to the adrenal gland and measures 4 x 1.8 x 1.5 cm in size, weighing 21 grams. Based on pathological staging criteria, the lesion is classified as pT1. Distant metastasis cannot be determined (pMX). Three touch preparations were made and submitted entirely for evaluation. This test was developed and validated by the Department of Pathology and is used for clinical purposes under CLIA certification for high-complexity testing."} +{"pid": "TCGA-B6-A0I6", "report": "The submitted left breast specimen measured approximately 23.0 x 16.0 x 8.5 cm and included axillary contents measuring 8.0 x 9.0 x 3.0 cm. No external scars or lesions were observed on the breast surface. A central mass measuring 5.0 x 5.0 x 4.0 cm was identified and submitted for receptor analysis. The specimen was inked in blue and extensively sectioned prior to accessioning. Upon gross examination, a firm white nodule measuring approximately 3.5 x 3.0 cm was noted. Evaluation of the deep margin showed no gross extension through the margin. Sections were taken from multiple areas of the tumor and surrounding tissue, including margins, nipple, skin over the lesion, and various quadrants of the breast.\n\nSatellite nodules adjacent to the main mass were observed and appeared contiguous with it; one such area was sampled. Histologically, these satellite nodules showed sclerosis and hemangioma. Within the tumor, nuclear features varied, with some regions showing intermediate-grade nuclei and others demonstrating high-grade nuclear morphology.\n\nAxillary contents were separately evaluated and lymph nodes were sampled systematically. A total of 32 lymph nodes were examined, and six contained metastatic involvement. Additionally, focal involvement of perinodal blood vessels by tumor cells was identified.\n\nAdditional findings included fibrocystic changes involving ductal epithelial hyperplasia, papillary apocrine metaplasia, duct ectasia, and sclerosis. Vascular invasion within the tumor was prominent. No tumor involvement was identified at the surgical margins."} +{"pid": "TCGA-CQ-A4CG", "report": "The specimen was received from the left partial maxillectomy and left cheek, measuring 5.2 x 4.0 x 2.5 cm. A tan nodular lesion was identified in the buccal mucosa, extending to the junction of the buccal and gingival mucosa. The tumor measured 4.5 cm in its greatest dimension and had a maximum thickness of 0.7 cm. Microscopic examination revealed moderately differentiated squamous cell carcinoma. Perineural invasion was present; lymphovascular invasion was not identified.\n\nThe tumor was located 0.2 cm from the closest deep soft tissue margin. Margins were uninvolved by invasive carcinoma. The closest distances to the margins were as follows: anterior buccal margin 0.08 cm, inferior buccal margin 0.3 cm, and posterior buccal margin 0.4 cm. Additional margins, including the superior gingival and anterior lip margins, were also uninvolved. Focal dysplasia was noted at the lateral lip margin.\n\nA total of 16 lymph nodes were examined from levels I to IV of the left neck. All lymph nodes were negative for malignancy, including those from level IB (0/1), level IIA (0/1), and levels I to IV combined (0/14). The submandibular gland was also negative for malignancy.\n\nThyroid tissue from a possible pyramidal lobe was negative for malignancy. All other submitted margins, including the palatal, posterior cheek, and left cheek deep margin, were negative for carcinoma.\n\nBone involvement could not be assessed initially due to the need for decalcification. Subsequent evaluation of bone sections showed no invasion or involvement of bone margins. Based on these findings, the tumor was classified as pT3 according to the AJCC/UICC TNM 7th Edition staging system."} +{"pid": "TCGA-D1-A2G0", "report": "The specimen included a uterus with right and left ovaries and fallopian tubes, a portion of omentum, lymph nodes from the pelvic and para-aortic regions, segments of gonadal vessels, and multiple staging biopsies. The right ovary measured 2.1 x 1.8 x 1.2 cm and was accompanied by an 11.0 cm segment of fallopian tube. The left ovary measured 2.0 x 1.6 x 1.0 cm with a 9.0 cm segment of fallopian tube. The combined weight of the uterus, ovaries, and tubes was 50.0 grams. The omentum measured 30.0 x 18.0 x 3.0 cm. Lymph nodes included 4 external iliac, 7 internal iliac, 3 common iliac, and 2 obturator nodes on the right; and 3 external iliac, 4 internal iliac, 7 common iliac, and 7 obturator nodes on the left. Additional lymph nodes were identified above and below the inferior mesenteric artery (3 left, 2 right above; 5 left, 3 right below). Staging biopsies included samples from the large bowel serosa and mesentery, right diaphragm, cul-de-sac, bladder peritoneum, bilateral colic gutters, pelvic sidewalls, and small bowel serosa and mesentery, ranging in size from 0.3 cm to 1.6 cm.\n\nA polypoid mass measuring 3.6 x 3.1 x 2.0 cm was observed in the uterine cavity. Histologic evaluation revealed cells arranged in mixed architectural patterns. Invasion into the myometrium extended to a depth of 0.2 cm, with total myometrial thickness measuring 1.2 cm. No angiolymphatic invasion was identified. The lower uterine segment and cervix showed no abnormal findings. No abnormal cellular proliferation was found in the myometrium, cervix, fallopian tubes, or ovaries. The omentum, lymph nodes, gonadal vessels, and all staging biopsy sites showed no evidence of malignant cells."} +{"pid": "TCGA-E9-A1R4", "report": "The specimen consists of a lumpectomy from the left upper outer quadrant. Gross examination reveals a lesion measuring 1.2 x 1.3 cm. The lesion is grossly evident. Lymph node evaluation includes ten dissected axillary lymph nodes, all without evidence of metastasis. Lymph nodes show reactive changes including fibrosis and follicular hyperplasia. Histologic evaluation demonstrates high-grade cellular features with poor differentiation. No venous invasion is identified. Surgical margins are uninvolved. Additional findings include lipomatosis in the fatty tissue surrounding lymph nodes. Nottingham histologic scoring components could not be fully assessed due to insufficient data on tubule formation, nuclear pleomorphism, and mitotic counts. Tumor extent is limited, consistent with a T1 classification based on size criteria."} +{"pid": "TCGA-A3-3374", "report": "The specimen consists of a right kidney weighing 253 grams and measuring 12.5 x 7.4 x 4.5 cm. A mass is noted in the superior pole, with a yellow to grayish-brown appearance and areas of hemorrhage and cyst formation. The mass measures 5.0 x 3.6 x 4.0 cm and is well-circumscribed, separated from the capsule by a thin rim of atrophic renal tissue. No tumor thrombi are identified. Microscopic evaluation shows sheets of cells with tubular and papillary arrangements. The cells have moderate to abundant pale pink to clear cytoplasm, mild nuclear pleomorphism, and occasional distinct nucleoli. Foci of calcification and hyalinized stroma are present. The surrounding renal tissue is unremarkable, and no involvement of the renal pelvis, ureter, or vessels is observed. Pathologic staging is T1, with no evidence of extension beyond the kidney. Nuclear grade is II. Surgical margins are not involved. No adrenal gland tissue is identified."} +{"pid": "TCGA-AA-3544", "report": "The specimen consists of a resected colon segment with a moderately differentiated adenocarcinoma of colorectal morphology, measuring 2.5 cm in greatest dimension. Histologic evaluation demonstrates infiltration into the tunica muscularis propria. Lymph nodes in the pericolonic region are free of tumor involvement. The resection margins of the colon are also tumor-free. Pathologic staging is consistent with pT2 pNO (0/21) pMX; histologic grade is G2. There is no evidence of lymphatic or vascular invasion. Local resection margins are negative."} +{"pid": "TCGA-DD-AAE7", "report": "The liver specimen measured 10.0 x 9.0 x 2.5 cm and weighed 155.5 grams. A well-defined, pale yellow to tan solid mass measuring 3.3 x 2.0 x 2.8 cm was identified. The cut surface was yellowish tan and solid with no necrosis observed. The gross appearance was vaguely nodular, and the resection margin was not involved with a safety margin of 1.5 cm. No satellite nodules were present, and mild steatosis was noted in the remaining liver parenchyma.\n\nMicroscopically, the lesion showed trabecular growth pattern with hepatic-type cells. The worst differentiation was grade II, as was the major differentiation. Fatty change was present in approximately 5% of the cells. There was no evidence of fibrous capsule formation, septum formation, surgical margin invasion, serosal invasion, portal vein invasion, or microvessel invasion. The presence of intrahepatic metastasis and multicentric occurrence could not be determined. Multiple sections of the tumor, liver parenchyma, and resection margin were submitted for further evaluation."} +{"pid": "TCGA-98-8023", "report": "A total of fifteen tissue specimens were received and examined. The specimens included lymph nodes from various levels (VII, VIII, IX, X, XI, XII, XIII, and IV-R), soft tissue, bronchial margin tissue, and lung tissue from the right upper and middle lobes. All lymph node specimens were negative for malignancy except one lymph node at level X which contained metastatic carcinoma. One lymph node at level VIII was noted to have focal dystrophic calcification, while another lymph node at level XIII exhibited a calcified granuloma.\n\nThe lung specimen included a tumor measuring 10 x 7 x 4 cm located in the upper lobe, with no involvement of the bronchial margin. Histologic evaluation revealed poorly differentiated invasive carcinoma. Microscopic analysis confirmed the presence of tumor cells reactive for p63 and non-reactive for TTF-1. The tumor measured 10 cm in its greatest dimension and was found to be unifocal. No visceral pleural invasion was identified. Lymphovascular invasion was present.\n\nLymph node involvement was noted with metastasis identified in ipsilateral peribronchial and hilar lymph nodes. The primary tumor classification was pT3 based on size greater than 7 cm. Regional lymph node staging was classified as pN1 indicating involvement of ipsilateral peribronchial, hilar, and intrapulmonary lymph nodes. All other lymph nodes examined were negative for malignancy."} +{"pid": "TCGA-FE-A231", "report": "A total thyroidectomy specimen was evaluated, including lymph nodes and soft tissue from the right and left thyroid lobes, as well as multiple lymph node levels from the right side and superior central neck. The right thyroid lobe measured 13.4 cm in length and contained a dominant mass measuring 9.4 cm. Histologic evaluation showed a cellular lesion with nuclear features including enlargement, overlapping, and clearing. The tumor exhibited lymphatic and vascular invasion but did not demonstrate capsular invasion or infiltration of adjacent structures such as the thyroid cartilage or hyoid bone. The tumor was confined to the thyroid gland and was unifocal.\n\nLymph node evaluation included specimens from multiple anatomical sites. In the right anterior neck, one lymph node contained infiltrating cells within a fibrovascular stroma. Two lymph nodes from the right anterior Level III region both showed similar involvement. In the right Level III and IV lymph node dissection, five out of fifteen lymph nodes contained abnormal cellular aggregates. Additionally, one lymph node from the superior central compartment and seven lymph nodes from the right perithyroidal soft tissue were involved. In contrast, several benign lymph nodes were identified in other regions, some containing pigment deposition suggestive of hemosiderin. No parathyroid tissue was identified in the specimens evaluated.\n\nThe surgical margins were uninvolved. Adjacent thyroid tissue showed nodular changes with chronic inflammation. A total of 31 lymph nodes were examined across all sites, with 16 showing evidence of involvement. No extranodal extension was observed. Based on these findings, staging parameters included a primary tumor confined to the thyroid gland with vascular invasion, and regional lymph node involvement with more than six affected nodes."} +{"pid": "TCGA-23-1030", "report": "The submitted specimens include multiple resected tissues from various anatomical sites. Microscopic evaluation reveals widespread involvement by a high-grade epithelial neoplasm exhibiting papillary, cystic, solid, and glandular growth patterns. Psammoma bodies are identified in several locations. Lymphovascular invasion is present throughout the involved tissues. Necrosis, inflammatory changes, and fibrosis are noted in association with tumor deposits.\n\nA specimen of omental tissue demonstrates extensive infiltration by this neoplasm, with involvement of lymphovascular spaces and presence of tumor within an identified lymph node. Similar findings are observed in a second omental specimen, which also shows hemorrhage and reactive mesothelial proliferation.\n\nBoth left and right adnexal specimens show extensive tumor involvement of the ovaries with surface extension. Involvement of adjacent ligaments and soft tissues is present bilaterally. The fallopian tubes demonstrate tubo-ovarian adhesions; focal serosal involvement is seen on the left side but not on the right. Additional findings in these specimens include cystic epithelial inclusions, atrophic changes, and benign paratubal structures.\n\nExamination of the uterus reveals no direct tumor involvement despite extensive sampling. However, metastatic involvement is identified in the vaginal cuff musculature, paravaginal tissues, and right parametrium. No tumor is found in the left parametrium or uterine wall. Endometrial findings include atrophy with ciliated metaplasia and reactive lymphoid aggregates. Cervical tissue shows atrophic changes and benign inflammatory alterations.\n\nA separate pelvic sidewall soft tissue specimen contains metastatic tumor. In contrast, a falciform ligament specimen shows no evidence of tumor involvement.\n\nThe distal pancreatectomy specimen reveals extensive peripancreatic and perisplenic soft tissue involvement without direct invasion of the pancreas or spleen. Two reactive lymph nodes are identified without metastasis. The pancreatic tissue demonstrates focal atrophy and fibrosis.\n\nTwo segments of transverse colon are examined. The larger segment demonstrates tumor involvement of the serosa and muscular wall with associated pericolic tumor deposits. One lymph node sampled is negative for metastasis. The smaller segment shows microscopic serosal/subserosal tumor involvement.\n\nThe ileocecal resection specimen demonstrates extensive pericolic fat involvement with tumor nodules, some possibly representing replaced lymph nodes. No direct intestinal wall invasion is observed. Margins are free of tumor involvement.\n\nEpiploic tissues from the rectosigmoid colon contain multiple small tumor nodules within adipose tissue.\n\nGross examination of the omentum revealed multiple tan-white tumor nodules ranging from 0.3 to 4.0 cm within fatty tissue. The left adnexa contained an ovarian mass measuring 5.5 x 3.0 x 2.0 cm with external tumor deposits and a paraovarian cyst. The right ovary was entirely replaced by tumor measuring 2.0 x 2.0 x 2.0 cm. The uterus measured 7.0 cm in length with parametrial soft tissues up to 1.0 cm wide. A pelvic sidewall specimen measured 3.2 x 2.5 x 1.5 cm with cystic and nodular components. The second omental specimen measured 11.0 x 9.0 x 3.0 cm with two tumor nodules measuring 6.0 x 2.0 x 2.0 cm and 1.0 x 1.0 x 0.8 cm. The distal pancreatectomy specimen included a tumor mass measuring 7.0 x 5.0 x 4.0 cm adherent to spleen and pancreas. The longer colon segment measured 4.5 cm in length with a 1.7 x 1.5 x 1.5 cm tumor in attached mesentery. The ileocecal specimen contained a 4.0 x 4.0 x 3.0 cm tumor aggregate in pericolic fat. Epiploic tissues showed tumor nodules ranging from 0.3 to 0.5 cm in size.\n\nMultiple representative sections were submitted from each specimen for histologic analysis."} +{"pid": "TCGA-E9-A1NI", "report": "The specimen consisted of breast tissue from a mastectomy. A grossly evident lesion was identified measuring 2.3 x 1.8 x 1.8 cm located in the left upper outer quadrant. Histologic examination revealed features consistent with both ductal and lobular invasive growth patterns. The tumor demonstrated variable cellular morphology; however, specific histologic grading parameters including tubule formation, nuclear pleomorphism, and mitotic counts at both 25x and 40x magnification were not assessed, precluding determination of a total Nottingham Histologic Score. Evaluation of regional lymph nodes showed no evidence of metastasis (0/4 positive). Surgical margins could not be assessed due to insufficient information. There was no indication of extracapsular lymph node involvement. No evidence of neoadjuvant treatment effect was noted. No additional significant pathologic findings were reported."} +{"pid": "TCGA-MH-A55W", "report": "The surgical specimen consisted of a right kidney tumor resection and a separate tumor base biopsy. The tumor measured at least 4.5 cm in greatest dimension, with one fragment measuring 4 cm and another friable portion measuring 4.5 cm. The tumor was well-circumscribed, tan to tan-pink, variegated, and friable in appearance. It was located 0.1 cm from the nearest renal resection margin and extended to the soft tissue margin. No necrosis was observed, and the lesion was unifocal, confined entirely within the kidney without lymphovascular space invasion or sarcomatoid features.\n\nHistologic evaluation revealed cells arranged in papillary architecture with nuclear features corresponding to Fuhrman grade 3. All margins of resection were free of tumor involvement. No grossly identifiable lymph nodes were found upon examination of the attached fat, and no tumor was identified in the tumor base biopsy submitted intraoperatively. Based on pathologic findings, the primary tumor classification was T1b. Lymph node (NX) and distant metastasis (MX) statuses were not assessable. The overall stage grouping was classified as I."} +{"pid": "TCGA-A6-5657", "report": "The specimen includes an apical lymph node and a resected segment of bowel from an extended right hemicolectomy. The apical lymph node measures 0.6 cm in greatest dimension, is soft and tan, and was bisected for examination.\n\nThe resected bowel consists of 8 cm of distal ileum and 25 cm of contiguous right colon. The serosal surface is smooth to slightly scabrous with tan-pink coloration, and there is a moderate amount of attached omentum and mesenteric fat. The appendix is 6.4 cm long, 0.8 cm in diameter, with tan serosa and wall, and no visible lesions or signs of inflammation. At the proximal and distal resection margins, the bowel circumference measures 3.6 cm and 5.2 cm respectively. Upon opening, a circumscribed, rubbery tan-pink-red lesion measuring 4.5 x 4.2 cm is identified 11 cm from the distal margin. The lesion extends through the muscularis propria into surrounding adipose tissue, reaching up to 1 cm in thickness, and is located approximately 1.5 cm from the outer surface of the specimen. Normal mucosa is present and submitted for further analysis. The remainder of the mucosa appears tan and unremarkable, with normal folding patterns throughout the ileum and colon. The ileal wall averages 0.4 cm thick, and the colonic wall averages 0.5 cm thick. Dissection of the surrounding adipose tissue reveals multiple soft tan lymph nodes, with the largest measuring up to 0.9 cm.\n\nMicroscopic evaluation shows a tumor composed of moderately to focally poorly differentiated cells. The primary lesion invades through the full thickness of the bowel wall and into adjacent soft tissue. All resection margins\u2014proximal, distal, and circumferential\u2014are free of tumor involvement. Vascular invasion is not definitively observed. Of the lymph nodes evaluated, one out of forty-two contains metastatic involvement, located within the pericolonic adipose tissue. This involved lymph node is found in block B5, which contains a section of the main tumor. No non-lymph node pericolonic tumor deposits are identified. The apical lymph node, submitted separately, also shows no evidence of tumor involvement. Distant metastasis cannot be assessed. Additional findings include a normal appendix without diagnostic abnormalities."} +{"pid": "TCGA-XE-AAO4", "report": "The specimen consists of a left testicle and cord weighing 40 grams. The testes measure 4.4x2.7x2.5 cm, the epididymis is 4.3 cm in length and 0.6 cm in diameter, and the spermatic cord measures 10.7 cm in length and 1.4 cm in diameter. A mass measuring 1.7x1.4x1.4 cm is present, located 0.2 cm from the base of the epididymis and less than 0.1 cm from the tunica albuginea. The mass is tan-white, fleshy, lobulated, and well-circumscribed, with no areas of hemorrhage or necrosis. There is no gross involvement of the tunica albuginea or impingement on the epididymis. The remaining testicular tissue appears unremarkable, and the spermatic cord contains vas deferens, arteries, and veins, all of which are unremarkable. Microscopically, the mass shows no lymphovascular invasion and no invasion of the epididymis. The tumor is confined to the testis, and all surgical margins are free of involvement. The pathological stage is pT1NXMX. Testicular tissue demonstrates evidence of spermatogenesis. Multiple cassettes were submitted for analysis, including sections of the mass, adjacent testis, epididymis, tunica vaginalis, spermatic cord margins, and paratesticular regions. While some artifact is present, particularly around vessels, no definitive lymphovascular invasion is identified."} +{"pid": "TCGA-ZF-AA4V", "report": "The histopathology report includes multiple lymph node tissue specimens and a resected bladder specimen. The lymph node specimens, obtained from various anatomical locations including right and left external iliac, internal iliac, and obturator regions, ranged in size from 9 mm to 100x20x20 mm. Microscopic evaluation of these tissues showed no evidence of metastasis in the identified lymph nodes, with counts ranging from two to three nodes per site. Ureteric margins were unremarkable with no dysplastic or malignant changes noted.\n\nThe primary specimen, which included the bladder and surrounding tissue, measured 115x120x55 mm. The prostate measured up to 45 mm. Within the bladder, a solid exophytic lesion was identified at the dome on the anterior surface. The lesion measured 45 mm in greatest dimension and extended up to 20 mm in depth. Histological examination revealed a poorly differentiated, high-grade epithelial malignancy arising from the transitional cells of the bladder. The tumor infiltrated through the full thickness of the muscularis propria and extended into the perivesical fat. The growth pattern was described as \u201cpushing\u201d rather than infiltrative, with a moderate associated lymphocytic response. Surgical margins, including circumferential and urethral margins, were free of tumor involvement. No dysplastic changes were observed in the adjacent urothelium, and prostate sections showed no significant pathology."} +{"pid": "TCGA-12-3644", "report": "AP Surgical Pathology: Final. CLINICAL HISTORY: Right temporal parietal mass. History of prior high-grade glial neoplasm. GROSS EXAMINATION: A. \"Brain tissue (AF1)\"\u2014submitted fresh for intraoperative evaluation, consists of a 1.3 x 0.5 x 0.3 cm fragment of red-tan tissue. Representative portion was processed as AF1 with frozen section; residual tissue from frozen block is in A1. A small portion was fixed in formalin and remaining material submitted in block A2. INTRA OPERATIVE CONSULTATION: A. \"Brain tissue\"\u2014high-grade glial tumor identified. MICROSCOPIC EXAMINATION: Specimen shows brain parenchyma infiltrated by a poorly differentiated glial neoplasm with small cell morphology. Prominent vascular proliferation and areas of necrosis are present. Cellular features include marked anaplasia and increased mitotic activity. No definitive differentiation markers were identified during evaluation. I certify that I personally conducted the diagnostic evaluation of the specimen(s)."} +{"pid": "TCGA-QR-A6GX", "report": "The right adrenal gland specimen measured 5.5 x 4.2 x 3.0 cm and weighed 28.5 grams. A solitary nodule measuring 4.2 x 4.2 x 3 cm was identified, with a pink-gray, fleshy cut surface arising from the medulla. The external surface of the gland was inked black. Upon sectioning, the nodule was found to be centrally located, with normal-appearing adrenal tissue compressed on either side. Gross photographs were taken for documentation. Approximately 45% of the central portion of the nodule was procured for further study, along with 1% of the tissue for additional analysis. The remaining tissue was fixed in formalin and submitted for histologic evaluation.\n\nMicroscopic examination revealed cellular features including positive staining for chromogranin and synaptophysin, with focal positivity for P53 and absence of c-Kit expression. Areas suggestive of vascular invasion were noted. The proliferative activity, as assessed by MIB-1 staining, was found to be intermediate. \n\nThe specimen was processed according to standard protocol, with representative sections embedded in cassettes labeled A through J. Immunoperoxidase and in-situ hybridization methods were employed, developed and validated by the laboratory, which is certified under CLIA to perform high-complexity testing. These tests have not been cleared or approved by the FDA, though such clearance is not required.\n\nThe case was submitted in association with clinical information indicating a post-operative diagnosis consistent with the pre-operative findings. The tumor was described as a large lesion located within the right adrenal gland."} +{"pid": "TCGA-DK-A3WX", "report": "The submitted specimens include three tissue fragments obtained from TURBT procedures. Specimen 1, labeled \"Left lateral bladder wall\", consists of multiple irregular tan-brown soft tissue pieces measuring 15x0.5x0.2cm and entirely submitted in five cassettes. Microscopic evaluation reveals high-grade cellular changes with extensive necrosis. The growth pattern shows local invasion into the muscularis propria without evidence of vascular invasion. No in situ component is identified.\n\nSpecimen 2, labeled \"Depth of tumor\", includes multiple tan-brown tissue fragments measuring 13x0.5x0.4cm and submitted in one cassette. Histologic analysis demonstrates high-grade features with focal areas of squamous differentiation. Invasion extends into the muscularis propria; no vascular involvement is seen. There is no evidence of an in situ growth component.\n\nSpecimen 3, labeled \"Base of tumor\", contains two tan-brown tissue fragments measuring 12x0.5x0.5cm and submitted in one cassette. Microscopic findings show high-grade morphology with local extension into the muscularis propria. Vascular invasion is not present, and no in situ component is observed. All sections were reviewed and confirmed based on personal examination of the slides."} +{"pid": "TCGA-EM-A3O3", "report": "The specimen includes a thyroid gland measuring 3.4 x 1.6 x 0.8 cm on the right lobe, 3.4 x 1.7 x 0.6 cm on the left lobe, and 8.5 x 3.0 x 1.6 cm at the isthmus, with a total weight of 14.5 grams. A well-defined nodule measuring 3.1 x 2.7 x 1.4 cm is present in the right lobe and isthmus. Histologically, the lesion demonstrates classical papillary architecture with characteristic cytomorphology. Areas of Warthin-like and hobnail cell change are observed, along with focal solid growth showing cribriform and morular/squamoid architecture comprising less than 20% of the lesion. These areas exhibit increased mitotic activity (5/10 HPF) and apoptotic changes. Immunohistochemistry shows positivity for TTF-1, thyroglobulin, HBME-1, vimentin, and focal positivity for monoclonal CEA; negative for CD5, calcitonin, and CD31. The tumor is partially encapsulated with widespread capsular invasion but no lymphovascular or perineural invasion. Margins are uninvolved with carcinoma, with the closest distance being 0.1 mm.\n\nLymph node specimens include four from the right paratracheal region, two of which contain metastatic involvement, and three from the left paratracheal and upper mediastinal regions, one of which shows metastasis. No extranodal extension is identified. A total of sixteen lymph nodes were examined, with three involved by metastasis.\n\nAdditional findings include advanced lymphocytic thyroiditis with fibrosis and marked thyroid atrophy. No parathyroid tissue was identified in the specimen labeled as query right inferior parathyroid. The surgical procedure performed was a total thyroidectomy with dissection of right and left paratracheal and upper mediastinal lymph nodes. Based on AJCC/UICC TNM staging (7th edition), the primary tumor is classified as pT2 (tumor greater than 2 cm but not more than 4 cm confined to the thyroid), and regional lymph node involvement is categorized as pN1a (metastases in Level VI lymph nodes)."} +{"pid": "TCGA-BH-A0BC", "report": "The specimen from a left breast excisional biopsy demonstrates multiple benign and proliferative changes. These include atypical ductal epithelial hyperplasia, complex papillary proliferative lesions, ductal epithelial hyperplasia, adenosis with sclerosing adenosis, columnar cell changes and hyperplasia associated with microcalcifications, fibrocystic changes with apocrine metaplasia, duct ectasia, and microscopic radial scars. There is also marked cautery artifact and biopsy-related changes.\n\nA separate specimen from the right breast, obtained via segmental mastectomy, measures 3.2 cm in greatest dimension. Histologic evaluation reveals an infiltrating epithelial lesion with features of tubule formation (score 3/3), nuclear atypia (score 2/3), and mitotic activity (score 1/3), resulting in a total score of 6/9. The lesion involves lymphatic and vascular spaces extensively. Surgical margins are free, though several margins are within 0.5 cm of the tumor. Additional findings include atypical ductal epithelial hyperplasia, fibrocystic changes, an intraductal papilloma, biopsy site changes, and marked cautery artifact. No definitive in situ component is identified at the margins.\n\nAn additional excision from the right breast margin shows similar findings to those described in the initial mastectomy specimen, including complex papillary proliferative lesions, ductal epithelial hyperplasia, adenosis with sclerosing adenosis, columnar cell changes and hyperplasia, fibrocystic changes with apocrine metaplasia, duct ectasia, and marked cautery artifact.\n\nEvaluation of a sentinel lymph node biopsy from the right side reveals involvement by malignant cells in one lymph node. The metastasis measures 1.2 cm in greatest dimension within the lymph node. There is evidence of extension beyond the lymph node capsule measuring 0.5 cm x 0.2 cm.\n\nAdditional findings include positive staining for estrogen and progesterone receptors, and non-reactive or low expression of HER2/neu. The tumor stage based on size is pT2, and the nodal stage is pN1. Distant metastasis staging is not assessable (pMX). Non-neoplastic breast tissue shows atypical ductal hyperplasia."} +{"pid": "TCGA-DD-AADJ", "report": "The liver specimen measured 16.0 x 9.5 x 2.5 cm and weighed 250 grams. A well-defined mass measuring 2.5 x 2.5 x 2.0 cm was identified in segment 4. The mass had a round to ovoid shape, with a pale tan to yellow cut surface, and was solid with areas of hemorrhage and necrosis involving approximately 30\u201340% of the tissue. The gross appearance was nodular and expanding. The resection margin was not involved macroscopically, with a safety margin of 0.3 cm. No satellite nodules were observed, and the remaining liver parenchyma showed signs of cirrhosis. Portal vein invasion was not detected on gross examination.\n\nMicroscopic evaluation revealed cells arranged in trabecular and solid patterns. Cellular atypia was present, with the worst grade being Edmondson-Steiner grade III and the predominant grade being II. There was no evidence of fatty change, fibrous capsule formation, capsular infiltration, septum formation, surgical margin invasion, serosal invasion, microvessel invasion, intrahepatic metastasis, or multicentric occurrence. \n\nThe gallbladder measured 6.2 cm in length and had a wall thickness of 0.2 cm. Microscopic examination showed features consistent with chronic cholecystitis. Other tissue samples included surrounding liver tissue showing cirrhotic changes and one block each from blood vessel, gallbladder, and other unspecified tissue fragments. \n\nNo evidence of cervical inflammation or atrophy, or hyperplastic polyps in the cecum was noted in the pathology review."} +{"pid": "TCGA-D7-6527", "report": "Histopathological examination was performed on a total organ resection specimen of the stomach. The stomach measured 19.6 x 12.7 cm and was submitted with omentum measuring 29 x 10 cm. A lesion measuring 5.2 x 4.1 x 0.4 cm with an overlying ulceration measuring 4.6 x 3.8 cm was identified in the cardiac region along the lesser curvature. The proximal margin was 0.5 cm from the lesion, and the distal margin was 11.8 cm away. Microscopic evaluation revealed a tubular growth pattern with moderate nuclear atypia and glandular differentiation. There was evidence of deep infiltration into the muscular layer of the stomach wall and extension into the adjacent esophageal tissue. Vascular invasion was also noted. Surgical margins were clear of abnormal cells. Non-neoplastic findings included chronic gastritis (+++) without active inflammation (+), and complete intestinal metaplasia (+++). \n\nLymph node assessment showed one out of four periorificial lymph nodes involved with cellular infiltration extending beyond the nodal capsule. Other lymph node groups, including those along the lesser curvature, greater curvature, and peripyloric region, showed only reactive changes. Tumor grade was G2. Based on depth of invasion and nodal involvement, staging was determined as pT2, pN1. Vascular invasion was also present."} +{"pid": "TCGA-FD-A3N5", "report": "A male patient underwent cystoprostatectomy and lymph node dissection. The clinical history notes prior treatment for bladder cancer, followed by prostatectomy and ileal conduit formation.\n\nSpecimens were received in four containers: right pelvic lymph nodes, left pelvic lymph nodes, bladder with attached prostate, seminal vesicles, and vas deferens, and a urethral margin specimen.\n\nExamination of the right pelvic lymph nodes revealed nine lymph nodes, all without any abnormal cellular infiltration. Similarly, seven lymph nodes from the left pelvic region showed no abnormal findings. Microscopic evaluation of these lymph nodes showed fibrosis and plasmacytic infiltrate in some areas, with rare dendritic cells highlighted by Cam5.2 immunostaining.\n\nThe cystoprostatectomy specimen included a bladder tumor measuring 7.0 x 3.5 x 3.0 cm, located on the right wall, anterior wall, posterior wall, and dome. Histologic analysis demonstrated extensive squamous differentiation with keratin production present in nearly all tumor regions. The tumor invaded the muscularis propria, reaching the outer half of the muscular layer, with a depth of invasion measuring up to 3.0 cm. No lymphovascular invasion was observed.\n\nResection margins\u2014including soft tissue, prostatic urethra, and bilateral ureteral margins\u2014were free of tumor involvement. Inflammation was noted in the extravesical adipose tissue, characterized by chronic lymphoplasmacytic infiltrates and follicular hyperplasia. Additionally, high-grade intraepithelial changes were identified within the prostate tissue. Both seminal vesicles and vasa deferentia were unremarkable with no signs of neoplastic involvement.\n\nThe urethral margin specimen showed no evidence of tumor involvement upon histologic examination.\n\nLymph node evaluation across both pelvic regions totaled sixteen nodes, none of which contained tumor cells. Based on these findings and depth of invasion, staging was assigned as pT2b, NO, MX according to the AJCC 7th edition TNM classification system.\n\nAll tissue specimens were appropriately inked and sectioned to assess tumor location and margins. Multiple sections from various areas of the bladder and prostate were submitted for detailed histopathologic evaluation. Interpretation was performed by an attending pathologist and reviewed with a resident."} +{"pid": "TCGA-60-2712", "report": "The specimen includes multiple lymph node groups from the right and left paratracheal, subcarinal, hilar, and mediastinal regions, as well as a rib segment and a resected left upper lobe of the lung. Lymph nodes ranged in size from 0.3 cm to 2 cm and were described as tan-black or black with homogenous cut surfaces. The lung specimen measured 15 x 14 x 4 cm, and a mass was identified in the upper half, located 0.4 cm from the nearest bronchial margin. The mass was firm, ovoid to round, with a tan-yellow to tan-white appearance and central necrosis, measuring 8 x 7 x 4 cm. The overlying pleura was retracted and inked blue. Adjacent to the mass, there was a presumed enlarged lymph node with partial encroachment on a hilar blood vessel.\n\nHistologically, sections of the mass showed moderate to poor differentiation with no angiolymphatic invasion identified. The bronchial margin was free of involvement, and there was no visceral pleural invasion. Of the lymph nodes evaluated, one peribronchial node out of twenty-five contained metastatic involvement. No tumor was identified in other lymph node stations sampled, including levels 1\u20139, 11L, and level 6. A separate lymph node at level 5 and a rib segment were also negative for tumor involvement. Non-neoplastic findings included congestion and focal atelectasis in the surrounding lung tissue."} +{"pid": "TCGA-CV-7415", "report": "The surgical specimen includes a resection from the left pyriform sinus and surrounding areas, including involvement of adjacent structures such as the left aryepiglottic fold, esophagus, left paraglottic space, left paratracheal/paraesophageal soft tissue. Vascular and lymphatic invasion are present. The primary lesion measured 9.5 cm in greatest dimension. Surgical margins were free of tumor.\n\nLymph node evaluation was extensive. On the left cervical side, 11 out of 53 lymph nodes showed involvement. Involved nodes included: 1 of 2 submandibular/submaxillary (Level 2), 5 of 7 subdigastric (Level 3), 3 of 8 midjugular (Level 4), 1 of 7 lower jugular (Level 5), none in Levels 6 through 8, and 1 of 9 supraclavicular/scaleme (Level 9). On the right cervical side, 5 of 29 lymph nodes contained similar findings, distributed across Levels 3 through 7. Additionally, 1 of 2 perithyroidal lymph nodes (Level 10) was involved.\n\nThe largest metastatic lymph node measured 2.5 cm in greatest dimension and was located in the left subdigastric region. Approximately half of this node was replaced by tumor; however, many other involved nodes were nearly completely replaced. Extranodal extension was identified measuring at least 3.0 mm.\n\nNo tumor was identified in the pharyngeal plexus of the vagus nerve, right or left submandibular glands, segment of left jugular vein, segment of left vagus nerve, or one parathyroid gland. The new esophageal margin was also negative for tumor. The skin of the anterior neck showed marked solar elastosis and underlying subcutaneous tissue exhibited marked acute inflammation."} +{"pid": "TCGA-FM-8000", "report": "The specimen consists of a colon segment, terminal ileum, and right colon from a female patient. Gross examination revealed a mass measuring 11.5 x 7 x 2.5 cm located in the terminal ileum, ileocecal valve, and cecum. The mass is ulcerated and infiltrative, involving 100% of the circumference of the affected region. It extends through the full thickness of the intestinal wall and is located 7 cm from the proximal margin and 8 cm from the distal margin. The radial margin is approximately 1.5 cm from the tumor. The length of the terminal ileum is 20 cm with a circumference up to 11 cm, while the colon segment measures 12 cm in length with a circumference up to 7.5 cm. Scattered fibrous adhesions are noted on the serosa.\n\nMicroscopically, the mass demonstrates a diffuse infiltrate of medium-sized atypical lymphocytes extending from the mucosa to the subserosal adipose tissue. Flow cytometry identified a monoclonal B-cell population positive for CD19, CD5, bright CD20, FMC-7, and lambda light chain. Immunohistochemical staining showed positivity for BCL-6, CD23, CD5, and PAX5, while cyclin D1, MUM-1, CD10, CD3, and CD43 were negative. A Ki-67 (MIB-1) proliferative index of approximately 50% was observed.\n\nCytogenetic analysis by FISH was negative for the t(11;14) translocation and did not support mantle cell lymphoma. However, an IGH rearrangement with an unknown partner chromosome was detected, a finding commonly associated with certain types of aggressive B-cell lymphomas.\n\nLymph node evaluation included five nodes, none of which showed evidence of involvement. Based on histopathologic, immunophenotypic, and genetic findings, the tumor was classified following multidisciplinary review and intradepartmental consultation."} +{"pid": "TCGA-E7-A3X6", "report": "The specimen consists of bladder tissue obtained from an excision procedure. The tumor measured 3 x 2.5 x 4 cm and was located in the bladder. Microscopic examination showed moderately differentiated cells arranged in a specific histologic pattern. The tumor was found to involve the muscularis propria layer. No vascular invasion was identified. Surgical margins were uninvolved. No lymph nodes were identified for assessment, and there was no mention of lymphatic invasion or other notable features. No evidence of prior treatment was observed."} +{"pid": "TCGA-L9-A5IP", "report": "The specimen consists of a right lung, along with lymph node samples from right level 4 and right level 10. The lung tissue shows involvement of the right upper and lower lobes, as well as the mainstem bronchus, with a lesion measuring 5.5 cm in greatest dimension. Microscopic examination reveals poorly differentiated cellular features with perineural and vascular invasion present. At least two of three hilar lymph nodes and all three peribronchial lymph nodes are involved. A positive margin is noted at the bronchial site, with the tumor located 1.5 cm from the endobronchial component. A clipped vascular margin also shows involvement.\n\nLymph node analysis demonstrates metastatic involvement in the right level 4 lymph node with perinodal lymphatic invasion, and all three right level 10 lymph nodes are involved, with extracapsular extension identified. Gross findings include a firm hilar mass adherent to the bronchus, measuring 4.5 x 2.5 x 1.5 cm, and additional lymph nodes measuring 2 and 2.5 cm. Sectioning of the lung reveals a mass extending into the main bronchus and laterally along the lower lobe bronchus, with necrotic material present. A separate submucosal lesion approximately 1 cm in size is observed along the lower lobe bronchus. Obstructive changes are noted in the lower lobe, and purulent material fills the distal bronchi.\n\nStaging indicates a primary tumor classified as pT3, with regional lymph node involvement classified as pN2. A total of at least 10 lymph nodes were examined, with 9 showing evidence of involvement. No distant metastasis was identified. Tumor extension is noted within the main bronchus, less than 2 cm distal to the carina. Lymphovascular invasion is present, and the histologic grade corresponds to Grade 3. The bronchial margin and vascular margin are both involved. The specimen was received fresh, labeled, and processed for banking, with 230 mg of non-necrotic tissue provided. Multiple sections were submitted for analysis, including areas of tumor, margins, lymph nodes, and surrounding tissue. Intraoperative consultation was performed, and tissue for banking was provided."} +{"pid": "TCGA-DG-A2KJ", "report": "The sample was obtained from the cervix and collected as fresh frozen tissue. The patient underwent surgical resection, with the procedure performed on the same day as the diagnosis. The tumor measured approximately 2.9 cm in size. Histological evaluation revealed a nonkeratinizing morphology. Pathological staging showed involvement of the primary site consistent with T1b classification, with regional lymph node involvement classified as N1. A total of 1 lymph node was sampled, and 23 nodes were found to be positive. There was no evidence of distant metastasis (M0). Lymphovascular invasion could not be ruled out. The histological grade was reported as high (grade 3/3), and all resection margins were free of tumor."} +{"pid": "TCGA-58-A46J", "report": "Pathology Report-Summary: Material: lung, left: 20.0 X 18.0 X 11.0 cm. A lesion measuring 9.0 X 7.0 X 6.5 cm was identified in the lower lobe. Histological evaluation revealed infiltration of the visceral pleura. Microscopic examination showed poorly differentiated morphology. Staging classification was determined as pT2, pN1 (3/57 lymph nodes positive), and pMx. Grade G3 was assigned based on cellular atypia and mitotic activity."} +{"pid": "TCGA-BH-A18M", "report": "The surgical specimen measured 17.0 by 24.0 by 5.0 cm and included skin measuring 6.0 by 4.5 cm. A mass measuring 2.5 by 2.0 by 3.5 cm was identified in the breast tissue. The mass was located near the anterior margin, and there was possible involvement within 1.0 cm of the inferior margin. All resection margins were free of tumor.\n\nTwo additional separate nodules were found: one measuring 0.8 cm in the lower inner quadrant, within 1.0 mm of the resection margin, and another measuring 0.5 cm in the upper inner quadrant. Both were identified as infiltrating ductal carcinoma. Ductal carcinoma in situ, non-comedo type with central necrosis and cribiform architecture, accounted for approximately 20% of the tumor volume. Fibrocystic changes were also present.\n\nAxillary lymph node evaluation revealed four out of six nodes positive for metastatic disease, with two showing extracapsular extension. Additionally, three small firm nodules in the axillary contents were confirmed to be metastatic deposits.\n\nHormone receptor testing showed an estrogen receptor H-score of 150 (positive) and a progesterone receptor H-score of 230 (positive). HER-2/neu immunostaining demonstrated weak to moderate complete membrane staining in more than 10% of cells (score 2+). Fluorescence in situ hybridization (FISH) for HER-2/neu was performed and showed amplification based on a ratio of 2.05 (threshold \u2265 2.0). The Nottingham histologic score was 6 out of 9 (tubules 3, nuclei 2, mitosis 1)."} +{"pid": "TCGA-DU-6542", "report": "The clinical history indicates a brain lesion. Three specimens were obtained: right temporal, deep temporal, and posterior temporal excision biopsies.\n\nMicroscopic examination of all specimens reveals a high-grade glial neoplasm. Features include active mitotic figures, microvascular proliferation, and geographic necrosis. Cellular morphology demonstrates a heterogeneous population: some cells exhibit round nuclei resembling oligodendroglial forms, while others appear more astrocytic or gemistocytic. Transitional forms between mini-gemistocytes and classic gemistocytes are also observed. Mucin pools are identified on special staining. Immunohistochemistry shows diffuse positivity for p53 and a Ki-67 labeling index reaching approximately 30%.\n\nGenetic analysis using a loss of heterozygosity (LOH) assay was performed on chromosomes 1p and 19q. Allelic loss was detected on chromosome arm 19q; no deletion was observed on chromosome arm 1p. Testing used DNA extracted from tumor tissue with blood DNA as reference control. The markers assessed included D1S548, D1S1592, D1S552 for 1p and D19S219, PLA2G4C, D19S412 for 19q, with backup markers used when necessary. No microdissection was required due to adequate tumor cellularity.\n\nPromoter methylation status for MGMT was assessed using bisulfite-treated DNA followed by MethyLight real-time PCR. Results indicate no evidence of methylation in the promoter region. Analytical sensitivity allows detection of methylated sequences at approximately 1% concentration in unmethylated DNA. Factors such as excessive non-neoplastic cells (>50%) or necrotic tissue could affect detection accuracy.\n\nRNA-based testing for EGFR variant III mutation was conducted via RT-PCR. Results showed no evidence of this mutation. Detection sensitivity is estimated at approximately 5 mutant cells per 100 normal cells. RNA was extracted from formalin-fixed paraffin-embedded tissue samples.\n\nAll assays described were developed and validated internally and are not FDA-approved standalone diagnostics. Interpretation should be correlated with clinical and pathological findings.\n\nGross specimen descriptions include:\n- Right temporal biopsy: One tan glistening fragment measuring 3.0 x 2.2 x 2.2 cm.\n- Deep temporal biopsy: One hemorrhagic, ragged tan fragment measuring 2.8 x 2.2 x 1.2 cm.\n- Posterior temporal biopsy: Two tan-brown ragged fragments measuring 2.2 x 2.0 x 0.6 cm collectively.\n\nHistologic stains performed across specimens included hematoxylin and eosin (H/E), MIB-1 (Ki-67), p53 immunostaining, EGFRvIII assessment, LOH testing curls, and MGMT curls."} +{"pid": "TCGA-E2-A570", "report": "The specimen consisted of sentinel lymph nodes from the right axilla and a right breast mastectomy specimen, along with skin from the left breast. Sentinel lymph node #1 measured 0.7 x 0.7 x 0.5 cm and contained a focus measuring 0.05 cm identified on histologic examination without extension beyond the lymph node capsule. Sentinel lymph node #2 consisted of two lymph nodes, both without involvement. Sentinel lymph node #3 included four lymph nodes, none of which showed evidence of involvement.\n\nThe right breast specimen weighed 160 grams and measured 15 x 14 x 1.5 cm. A mass measuring 2.1 x 1.6 x 1.5 cm was identified in the lower inner quadrant, located 0.7 cm from the anterior-inferior margin and 0.2 cm from the deep margin. Histologic evaluation revealed a lesion measuring 1.5 cm with features including intermediate nuclear grade and associated in situ changes. These in situ components exhibited solid, cribriform, and micropapillary patterns with calcifications and central necrosis. The closest surgical margin was within 1 mm at the anterior-inferior aspect, with no involvement by invasive lesion at this margin. Lobular neoplasia was also identified within the specimen. Fibrosis, granulation tissue, and fat necrosis were noted near the biopsy site.\n\nSkin from the left breast measured 22 x 1.4 x 0.6 cm and showed no abnormalities. Immunohistochemical staining demonstrated positivity for hormone receptors with negativity for a specific receptor marker. Based on AJCC staging criteria, the pathological stage was determined to be pT1c pN1mi."} +{"pid": "TCGA-13-A5FT", "report": "The submitted specimens included multiple biopsies and resections from various anatomical sites. The left adnexal specimen showed abnormal cellular proliferation within the ovary and fallopian tube, with associated hydrosalpinx and chronic inflammation. A periadnexal leiomyoma was also noted. The supracolic omental nodule contained three lymph nodes, all benign. The enlarged left external iliac lymph node contained two lymph nodes, both benign.\n\nA left cul-de-sac nodule demonstrated significant cellular atypia involving fibroadipose tissue. The high left para-aortic lymph node contained one involved structure. A small bowel nodule was identified as a benign mesothelial inclusion cyst. An additional left IP ligament biopsy revealed benign fibroadipose tissue. A left pelvic sidewall nodule showed similar cellular changes to those seen in the left cul-de-sac nodule.\n\nThe uterus, cervix, right fallopian tube, and ovary specimen showed involvement of the right ovary and fallopian tube with atypical cells. The myometrium contained a leiomyoma, and the endometrium was weakly proliferative. The cervix appeared unremarkable. An anterior cul-de-sac biopsy contained one lymph node, which was benign. Posterior cul-de-sac, left pelvic, and right pelvic biopsies all showed benign fibroadipose tissue.\n\nLymph node specimens from the left external iliac region showed no lymphoid tissue present. The left obturator lymph node specimen contained four benign lymph nodes. The right external iliac lymph node specimen contained one benign lymph node, and the right obturator lymph node specimen contained six benign lymph nodes. An anterior abdominal wall biopsy, left paracolic gutter biopsy, left diaphragm biopsy, omental resection, right abdominal adhesion biopsy, right paracolic gutter biopsy, and right diaphragm biopsy all showed benign fibroadipose tissue or benign skeletal muscle with fibroadipose tissue.\n\nAdditional lymph node specimens from the high right para-aortic, left para-aortic, left portacaval, and right portacaval regions contained a total of four, one, one, and two benign lymph nodes respectively. All involved structures were measured and entirely submitted for evaluation. No other significant pathological findings were identified in the remaining specimens."} +{"pid": "TCGA-CJ-4920", "report": "The surgical specimen includes a left kidney with attached perinephric fat measuring 17.0 x 10.0 x 5.5 cm, containing a kidney measuring 10.5 x 6.0 x 4.5 cm and an attached ureter of 5.0 cm in length and 0.4 cm in diameter. Within the upper pole of the kidney is a well-circumscribed brown-yellow lesion measuring 5.5 x 5.0 x 3.0 cm with focal hemorrhage. The lesion approaches the renal capsule but remains confined within the kidney. It is located 0.4 cm from Gerota\u2019s fascia. No involvement is identified in the renal sinus, renal vein, or perinephric fat. All vascular, ureteral, and soft tissue margins of resection are free of abnormal findings.\n\nA separate specimen from the right adrenal gland consists of an adrenal gland with surrounding adipose tissue measuring 4.5 x 2.5 x 2.0 cm. A well-defined, homogeneous brown-yellow lesion measuring 2.9 x 2.4 x 1.9 cm is identified within the adrenal gland. Normal adrenal cortex is observed around the periphery. There is no evidence of necrosis or hemorrhage. All margins of resection are free of abnormal findings.\n\nIn the distal esophagus and proximal stomach region, a specimen measuring 8.0 x 6.0 x 5.0 cm overall includes a distal esophagus segment measuring 0.8 cm in length. On the serosal surface of the stomach near the gastroesophageal junction is a well-circumscribed encapsulated lesion measuring 4.5 x 3.0 x 2.5 cm. The tumor is firmly attached to the gastric wall with a smooth external surface. Internally, it exhibits a light tan, firm, whorled appearance with central hemorrhage possibly indicating necrosis. Microscopic examination reveals mature smooth muscle with a focus of necrosis but without significant atypia or mitotic activity. Immunohistochemical staining shows positivity for desmin and negativity for c-Kit, CD34, and S-100. Both distal and proximal resection margins are free of abnormal findings. Five lymph nodes examined do not show any abnormal cellular infiltration. Focal ulceration is noted in the gastric mucosa, but no abnormal cellular proliferation is present."} +{"pid": "TCGA-C5-A1BQ", "report": "Gynecologic pathology report. MRN: I Hospital #: Physician(s): M.D. \n\nThe specimen consists of five irregular, slightly nodular fragments of red tissue measuring 2.5 x 1.7 x 0.7 cm in aggregate, labeled A1 and A2. The tissue is received in a single formalin-filled container labeled with the patient's name and \"cervical biopsy.\" \n\nMicroscopic evaluation reveals fragments of tissue with cellular atypia, including variation in nuclear size and shape, increased nuclear-to-cytoplasmic ratio, and abnormal mitotic figures. Focal areas of necrosis are identified. Keratinization is present. Due to tissue fragmentation and lack of orientation, assessment of depth of invasion cannot be reliably determined. \n\nClinical history includes a cervical mass in a patient undergoing examination under anesthesia and cervical biopsy. This surgical pathology report is available online."} +{"pid": "TCGA-52-7810", "report": "A right lung pneumonectomy specimen was received, measuring 21 x 14 x 8 cm. The pleural surface was intact and a large cystic mass was identified within the lung parenchyma. The mass measured 9.3 x 8.5 x 8 cm in greatest dimensions and was unilocular with a wall thickness of up to 2.5 cm. The central cavity contained hemorrhagic and necrotic fluid, with a large necrotic papillary mass measuring up to 5 cm. This lesion approached the pleura at the right superior lateral aspect, located approximately 0.1 cm from the inked pleural surface. There was also evidence of involvement of the adjacent rib, specifically near the posterior superior margin, with tumor present within the bone marrow. The lesion was at least 2.5 cm from the anterior bone resection margin and at least 2 cm from the lateral posterior bone resection margin.\n\nMicroscopic examination revealed a poorly differentiated infiltrating lesion with focal keratinization. The tumor had invaded through the pleura into the ribs and exhibited lymphatic invasion. No venous or arterial vessel invasion was identified. Evaluation of multiple lymph node stations including right lower paratracheal (level 4R), subcarinal (level 7), lateral bronchial angle (level 10), peribronchial (level 11R), and inferior pulmonary ligament (level 9) showed no evidence of malignancy. In total, twelve lymph nodes were examined and none were involved. The bronchial margin and other surgical margins were free of tumor except for the posterior superior rib margin, which was involved.\n\nThe primary lesion was located in the upper, middle, and lower lobes of the right lung. Pathologic staging indicated pT3 based on direct invasion of the chest wall and visceral pleura, pN0 as no regional lymph node metastasis was found, and pMX due to inability to fully assess distant metastasis. Sections submitted included the bronchial resection margin, various sections of the cavitary lesion in relation to pleura, vessels, and surrounding lung tissue, multiple lymph node blocks, pulmonary artery and vein, and multiple rib margins."} +{"pid": "TCGA-SR-A6MY", "report": "The specimen consists of a right adrenal gland measuring 5.6 x 4 x 2.5 cm, submitted with a small amount of adherent fat. The adrenal is lacerated, and its internal architecture is replaced by a hemorrhagic mass measuring approximately 4 x 4 x 2 cm. This mass exhibits a gray and purple cut surface, is soft and friable, and contains a 2 cm central cyst. The mass is partially surrounded by a smooth, gray capsule; however, due to lacerations involving both the mass and the adrenal capsule, the integrity of the capsule could not be fully evaluated. No gross evidence of adrenal medullary hyperplasia is present. Approximately 70% of the tumor has been sampled, with portions submitted for potential future studies.\n\nMicroscopically, the tumor shows areas of infarction and cystic degeneration. There is no identifiable capsular or vascular invasion, and no evidence of tumor necrosis is seen. Mitotic figures are extremely rare. Immunohistochemical staining for Ki-67 demonstrates low overall proliferation index (approximately 1%), with scattered small areas of increased labeling. S-100 immunostain highlights scattered sustentacular cells, while neurofilament stain reveals focally prominent neurites, suggesting focal neuronal differentiation. Additional testing confirms positivity for SDHB protein."} +{"pid": "TCGA-O8-A75V", "report": "A robotic-assisted liver resection was performed. The specimen, labeled as a liver resection, consists of an irregular-shaped portion of liver measuring 4 x 3.5 x 2 cm and weighing 10 grams. The tissue has been previously incised. The external surface is partially smooth and mostly roughened. Surgical ink markers are present: yellow on the superficial margin, red on the deep margin, orange on the medial margin, and black on the lateral margin. Ink spillage is noted in the area of prior incision.\n\nOn sectioning, a tan, well-circumscribed mass measuring 2.4 x 2.2 x 2 cm is identified. The distance from the mass to the surgical margins is as follows: 0.1 cm to the yellow (superficial) margin, 0.1 cm or less to the red (deep) margin, 0.2 cm to the orange (medial) margin, and 0.1 cm or less to the black (lateral) margin. The surrounding liver tissue appears tan. The entire specimen was submitted for research purposes in 10 cassettes. The total time in 10% neutral buffered formalin was 21 hours.\n\nMicroscopically, the lesion exhibits a trabecular growth pattern. The histologic grade is II. The lesion is solitary and confined to the liver without evidence of lymphovascular or perineural invasion. The tumor is largely encapsulated, with the margin defined by a narrow band of desmoplastic fibrous stroma. All surgical margins are negative, except for the posterior margin, which is indeterminate due to encroachment after excision. Additional findings include a background of micronodular cirrhosis. The tumor was staged as pT1, pNX."} +{"pid": "TCGA-FI-A2EY", "report": "The surgical pathology report from the gynecology service describes findings from a supracervical hysterectomy and bilateral salpingo-oophorectomy. Gross examination of the uterus showed multiple polypoid lesions in the endometrium, with the largest measuring 2 x 2 cm. Microscopic evaluation revealed extensive papillary serous carcinoma involving the endometrium. The tumor invaded into the myometrium to a depth of 14 mm, within a total myometrial thickness of 15 mm. Tumor involvement was also identified at the lower uterine segment, extending into the cautery artifact within 1 mm of the margin, and into parametrial soft tissue margins of excision. Widespread lymphovascular space invasion was noted.\n\nThe right fallopian tube contained a papillary mass that histologically corresponded to the endometrial tumor, interpreted as direct extension rather than a separate primary. No tumor was identified in the right ovary. The left tube and ovary specimen showed mucosal psammomatous calcifications and associated acute and chronic inflammation; no ovarian parenchyma was identified. Evaluation of the omentum revealed reactive mesothelial hyperplasia without evidence of metastatic disease.\n\nSections of the distal margin of the 2 x 2 cm endometrial polyp were submitted for analysis. The tumor involved the outer third of the myometrium, and there was involvement of the lower uterine segment. Lymph node status could not be assessed due to absence of regional lymph nodes in the specimen. Ascites or peritoneal washings were not available for assessment. Based on these findings, the tumor extends to the serosa and/or adnexa. However, insufficient data were available to assign a definitive stage."} +{"pid": "TCGA-UZ-A9PN", "report": "The specimen consists of a left kidney and Gerota\u2019s fascia from a male patient with a history of a left kidney mass who underwent laparoscopic radical nephrectomy. The nephrectomy specimen measures 15.0 x 9.5 x 5.0 cm and weighs 356 grams. A firm, brown-tan, polypoid yellow-tan mass measuring 3.0 cm is identified in the cortex of the mid-kidney. The mass distends the renal capsule and invades the perinephric fat; however, no gross involvement of Gerota\u2019s fascia, renal pelvis, or intrarenal vessels is observed. The adrenal gland is not present.\n\nMicroscopic evaluation confirms a lesion with Fuhrman grade 2 nuclear features. The tumor is located in the mid-kidney and does not involve the renal pelvis, ureter, renal sinus, or hilar renal veins. No tumor is identified within intrarenal veins or lymphatics. The resection margins are negative, with the tumor located 0.5 cm from Gerota\u2019s fascia. Examination of the perihilar fat reveals no identifiable lymph nodes.\n\nThe tumor demonstrates penetration of the renal capsule with microscopic extension into the perirenal fat. No other significant findings are noted. Sections were taken from multiple areas including the tumor at the renal capsule, its relation to the renal pelvis, the hilum, normal kidney tissue, and the region of perirenal fat invasion. Based on histologic analysis, the pathologic stage is determined as pT3aNxMx, corresponding to Stage III."} +{"pid": "TCGA-SY-A9G0", "report": "The specimen was obtained via radical cystoprostatectomy and measured 10.5 x 6.2 x 4.2 cm. A mucosal ulcerating mass measuring 2.5 x 2.0 x 1.2 cm was identified in the right posterolateral wall of the bladder. The mass extended into the bladder wall and appeared to involve the right portion of the prostate. The remaining bladder wall showed signs of edema, and both right and left ureteral orifices were obstructed by the lesion. Sections from multiple areas including the bladder dome, lateral walls, posterior wall, ureteral orifices, seminal vesicles, prostate apex, mid, and base, as well as junctions between the prostate and bladder wall were submitted for analysis.\n\nHistologic examination revealed a solid/nodular configuration with ulceration. Microscopic extension was noted into the perivesical fat. Surgical margins were negative at the right and left distal ureters and urethra. No lymph-vascular invasion was observed, though perinodal invasion was present. Prostate involvement was extensive. Immunohistochemical staining showed reactivity with antibodies to p63 but not with cytokeratin 5/6, prostatic acid phosphatase, or prostate-specific antigen.\n\nLymph node specimens were collected from right and left pelvic regions. Of seven total lymph nodes examined, one from the left pelvic region contained metastatic carcinoma consistent with a bladder primary. No metastasis was found in the four right pelvic lymph nodes examined.\n\nA separate radical nephrectomy specimen from the right kidney weighed 168 g and measured 12 x 7.5 x 4.5 cm. Gross findings included marked chronic nephritis with hydronephrosis. The renal pelvis was dilated, and cortices showed blunting without evidence of masses or cysts. The attached ureter measured 15 x 0.6 cm and showed no signs of tumor.\n\nFrozen section evaluation confirmed negative margins for malignancy in the left and right distal ureters and distal urethral margin. Permanent sections corroborated these findings.\n\nPathologic staging was determined as pT4 and pN1. Seven total lymph nodes were examined, with one showing involvement. Multiple representative tissue sections were submitted for further study, including research tissue containing both abnormal and normal prostatic tissue."} +{"pid": "TCGA-F2-6880", "report": "The specimen consists of a white, firm, poorly circumscribed mass located adjacent to the common bile duct in the head of the pancreas. The mass measures approximately 2.2 x 2.0 x 0.9 cm. Histologic evaluation reveals well-differentiated cellular features with extensive involvement of the peripancreatic soft tissues and notable perineural invasion. There is no evidence of lymphatic or venous invasion.\n\nSurgical margins evaluated include the pancreatic neck, bile duct, posterior pancreatic surface, peripancreatic soft tissues, proximal, and distal margins\u2014all are negative for malignancy. However, tumor extends into the peripancreatic soft tissue. Regional lymph node assessment shows one out of nine nodes involved, measuring 1 mm in greatest dimension.\n\nAdditional findings include high-grade intraepithelial neoplasia in the common bile duct and mild chronic cholecystitis in the gallbladder. A segment of small bowel demonstrates mild acute and chronic serositis extending to the suture margin, which appears histologically viable. One free-floating small bowel fragment is also present, showing no abnormalities.\n\nGross examination of the resected specimen includes a gallbladder measuring 7.0 x 4.5 cm with a 6.5 cm cystic duct; wall thickness is 0.5 cm with mild cholesterolosis and luminal sludge, but no stones. The duodenal section measures approximately 26 x 3.5 cm and is lined with yellow-tan, granular mucosa without significant abnormality. A 1.5 cm segment of prepyloric stomach is unremarkable.\n\nFrozen section analysis of the pancreatic duct and uncinate process biopsies reveals chronic inflammation and fibrosis without evidence of malignancy. Intraoperative consultation was performed on these areas, confirming absence of malignant cells.\n\nThe pathologic staging is pT3 pN1 pMx. This assessment is based on available data and may be subject to revision upon further clinical review."} +{"pid": "TCGA-A2-A0D3", "report": "The specimen consisted of left and right breast tissues along with a sentinel lymph node from the left axilla. The right breast tissue showed benign findings including focal usual ductal hyperplasia, lactational changes, stromal sclerosis, and apocrine metaplasia. No malignant cells were identified in this specimen.\n\nThe left mastectomy specimen contained a well-defined pink-tan mass measuring 1.9 cm in greatest dimension located in the lower outer quadrant near the junction of deep and superficial margins. Histologic evaluation revealed a well-differentiated infiltrative carcinoma composed predominantly of tubular structures with mild nuclear atypia and low mitotic activity (Nottingham score 5 out of 9). Microcalcifications were observed within intraductal components and benign ducts. There was no evidence of vascular or lymphatic invasion. Margins were negative with the closest distance being 0.4 cm from the superficial margin.\n\nAn intraductal component demonstrated features consistent with ductal carcinoma in situ of intermediate nuclear grade (Grade II), exhibiting solid and cribiform patterns along with focal necrosis and calcifications. Skin and nipple involvement were not present. Immunohistochemical staining showed positivity for estrogen and progesterone receptors while HER2 staining was negative.\n\nOne lymph node retrieved from the left axilla showed no tumor involvement upon histologic examination and immunostaining for cytokeratin.\n\nAdditional specimens included fragments of adipose tissue from the lower inner quadrant of the left breast which displayed benign characteristics without evidence of malignancy.\n\nNo changes were observed in prior pathological diagnoses aside from updated HER2 immunohistochemical results based on revised interpretation of core biopsy material confirmed by fluorescence in situ hybridization studies showing no amplification."} +{"pid": "TCGA-DD-AACT", "report": "The liver specimen measured 20.5 x 9.5 x 3.5 cm and weighed 226.5 grams. The surgical procedure performed was a left lateral segmentectomy. A mass was identified, measuring 6.0 x 4.0 x 4.0 cm. It was well-defined, oval, and lobulated with a yellowish tan cut surface and no necrosis. The gross type was expanding nodular, and the resection margin was not involved with a safety margin of 0.6 cm. There was no satellite nodule present, and the remaining parenchyma appeared unremarkable without portal vein invasion.\n\nMicroscopic examination revealed areas of differentiation ranging from moderate to poor. The histologic pattern was trabecular, composed predominantly of hepatic cells (95%) with a minor component of clear cells (5%). There was no evidence of fatty change, fibrous capsule formation, or capsular infiltration. Septum formation was noted. There was no invasion at the surgical resection margin, serosal invasion, portal vein invasion, microvessel invasion, or intrahepatic metastasis. Multicentric occurrence was also not observed.\n\nEvaluation of non-tumor liver tissue showed chronic hepatitis related to HBV infection, with mild lobular activity and minimal portoperiportal inflammation. Fibrosis was limited to the periportal region without progression to cirrhosis. No dysplastic nodules, ductal epithelial dysplasia, or other liver diseases were identified."} +{"pid": "TCGA-23-1114", "report": "A 7.7 x 4.8 x 4.4 cm left ovary was noted to be markedly enlarged with an external surface almost entirely covered in friable excrescences. On sectioning, the cut surfaces were solid to focally cystic, with cystic locules ranging from 0.6 to 2.4 cm. No recognizable ovarian parenchyma was present. An attached 4.4 x 0.6 x 0.5 cm segment of fallopian tube was surrounded by tumor, with involvement seen on the serosal aspect. The right ovary measured 4.8 x 4.6 x 3.2 cm and was also enlarged and firm, with the external surface largely covered in friable tan-red granular excrescences. The cut surface showed both solid and cystic areas, including a 1.7 cm cystic locule containing blood clot and a 2.5 cm focus of friable tissue. No residual ovarian parenchyma was identified. A 4.4 x 0.6 x 0.5 cm length of attached fallopian tube showed similar serosal involvement.\n\nTumor implants were found on the anterior peritoneal surface of the uterus. The endometrium was mildly disordered and inactive, without evidence of malignancy. The myometrium showed features of adenomyosis. Involvement was also noted in the right mesosalpinx/right parametrial soft tissue. Tissue fragments from the diaphragm (two separate specimens, one measuring up to 1.7 cm and another 2.6 x 2.3 x 1.3 cm), right sidewall (1.3 x 0.7 x 0.5 cm), bladder peritoneum (1.7 x 1.3 x 1.2 cm), and appendix (involving the serosal and subserosal aspects) all showed tumor involvement. The remainder of the appendiceal wall was uninvolved.\n\nThe omentum, measuring 11.4 x 9.3 x 4.3 cm, was focally indurated and showed diffusely tan-yellow cut surfaces consistent with tumor involvement. A small bowel adhesion specimen (8.4 x 0.4 x 0.3 cm) contained necrotic cellular debris. Lymph node assessment included a left external iliac lymph node (3.2 x 1.4 x 0.4 cm), which showed reactive changes but no tumor involvement. The appendix measured 4.7 x 0.6 x 0.6 cm, with no evidence of perforation or fecalith. Uterine measurements were 3.9 cm superior to inferior, 4.2 cm cornu to cornu, and 2.4 cm anterior to posterior. The myometrial thickness was up to 1.4 cm, and the endometrial canal measured 2.7 cm in length and 1.7 cm in width. Multiple biopsies and resection specimens were submitted for analysis, with representative sections taken from all involved sites."} +{"pid": "TCGA-CM-5864", "report": "The specimen from the right colon partial colectomy includes a segment of terminal ileum, cecum with attached appendix, and ascending colon. The terminal ileum measures 9 cm in length and 5 cm in circumference at the proximal resected margin. The remaining colon measures 24 cm in length with a circumference of 8.5 cm at the distal resected margin. The appendix is 6 cm long and averages 0.7 cm in diameter. The serosal surface is pink-tan and smooth. Hemorrhagic lobulated yellow-tan adipose tissue spans the specimen up to 5 cm thick. A large sessile lesion measuring 6.5 cm in length, 10 cm in width, and up to 2 cm thick is identified in the cecum. It is located 8 cm from the proximal margin and 18 cm from the distal margin. Gross examination suggests possible submucosal invasion with questionable extension into the muscularis propria; however, full-thickness penetration is not observed. The depth of invasion measures approximately 0.2 cm. Remaining mucosa appears tan with normal folds. All lymph nodes within the attached adipose tissue are examined and submitted for analysis.\n\nA separate specimen labeled as a portion of omentum consists of lobulated adipose tissue measuring 16.0 x 11.0 x 0.5 cm. Serial sections reveal a lobulated surface. Representative sections are submitted for evaluation.\n\nHistologic examination reveals no tumor budding or increased tumor-infiltrating lymphocytes. Precursor lesions show features consistent with tubulovillous adenoma. The deepest invasion observed microscopically reaches the muscularis propria without perforation or lymphovascular invasion. Surgical margins are free of tumor involvement. No polyps or mucosal dysplasia are identified outside the main lesion. Non-neoplastic bowel and the appendix appear unremarkable. A total of 33 lymph nodes are examined, none showing evidence of metastasis. No tumor deposits are identified in pericolorectal soft tissue.\n\nImmunohistochemical staining for DNA mismatch repair proteins demonstrates retained expression of MLH1, MSH2, MSH6, and PMS2 in the lesion. All procedures were performed under CLIA-certified conditions for high-complexity testing."} +{"pid": "TCGA-HS-A5NA", "report": "The sample was collected from uterine tissue following a resection procedure. The tumor measured 21 cm in size. Histologic evaluation revealed a poorly differentiated malignant neoplasm composed of atypical spindle cells with moderate pleomorphism and frequent mitotic figures. Cellular morphology suggests a high-grade sarcomatous process. No lymph node or distant metastases were identified in the available clinical data. The histology report notes features consistent with a sarcoma of smooth muscle differentiation. Additional samples, including a buffy coat specimen, were also collected. Data includes patient age at collection, days to procedure, and days to diagnosis, though exact values are not specified."} +{"pid": "TCGA-DD-AACP", "report": "Specimen consists of a liver segment measuring 4.5 x 4.5 x 3.5 cm and weighing 45.5 grams, along with a gallbladder measuring 8.5 cm in length and 4.0 cm in diameter. The gallbladder wall thickness is 0.2 cm and appears unremarkable. A single mass is identified in segment 5 of the liver, measuring 3.3 x 3.1 x 3.0 cm, with a pedunculated growth pattern. No satellite nodules are present. There is no tumor necrosis, but hemorrhage or peliosis is noted at 10%. No evidence of portal vein, bile duct, hepatic vein, or hepatic artery invasion is seen.\n\nMicroscopically, the lesion shows a trabecular growth pattern with hepatic-type cells. The worst differentiation is grade III, while the predominant differentiation is grade II. A complete fibrous capsule is present without capsular infiltration. Septum formation is observed. Surgical resection margins are negative, with a clearance margin of 0.4 cm. No serosal, vascular, or microvessel invasion is identified. No intrahepatic metastasis or multicentric occurrence is found.\n\nNon-tumor liver pathology reveals micronodular cirrhosis. Additional findings include a hyperplastic polyp and a high-grade tubular adenoma in the gastric antrum. The gallbladder shows changes consistent with chronic cholecystitis, with no tumor involvement."} +{"pid": "TCGA-ZF-AA52", "report": "The specimen consists of a cystoprostatectomy weighing 375 grams. The prostate measures 25x43x32 mm, and the bladder measures 55x70x65 mm. There is an ulcerated lesion located at the posterior bladder wall measuring 50 mm x 30 mm with a thickness of 23 mm. The lesion invades through the bladder wall but does not extend beyond into surrounding tissues. It is in close proximity to the seminal vesicles and the posterior resection margin.\n\nHistologically, there is an ulcerated, poorly differentiated micropapillary growth pattern involving the bladder urothelium. Lymphovascular and perineural invasion are present. The surface exhibits multinucleated giant cells within granulation tissue. The lesion extends beyond the muscularis propria of the posterior bladder wall with infiltration into perivesical fat, reaching within 2 mm of the deep posterior margin. A prominent fibrous reaction accompanies the lesion, which approaches but does not invade the seminal vesicles or prostate.\n\nTwo distinct tumor deposits are identified near the anterior bladder wall, separate from the main lesion. The ureteric resection margins show no malignant involvement. The flat urothelium elsewhere does not display dysplasia. The prostate demonstrates benign hyperplasia without signs of malignancy or infiltration.\n\nStaging assessment indicates involvement of the bladder wall extending into perivesical tissue, with no definitive regional lymph node or distant metastatic evaluation provided."} +{"pid": "TCGA-XE-AAOD", "report": "The specimen from a right radical orchiectomy includes a testis measuring 4.5 x 3.5 x 3 cm and an epididymis measuring 3 x 0.7 x 0.4 cm. A well-circumscribed mass measuring 3 x 1.8 x 1.8 cm is present within the testis, with a white-tan to pink-tan cut surface and areas of hemorrhage and necrosis. The tunica albuginea is not grossly involved. The tumor is confined to the testis and does not involve the epididymis. Microscopically, multiple cell types are identified, with one component predominating. Immunohistochemical stains show positivity for HCG and CAM5.2 in one cell type, while another component stains positively for C-Kit but is negative for CAM5.2. CD-30 staining is negative. Lymphovascular invasion is present. Surgical margins are free of tumor. Adjacent seminiferous tubules show features of spermatogenesis and atrophy. The tumor is associated with intratubular changes. The spermatic cord and other surrounding structures are unremarkable. The stage assigned is pT2."} +{"pid": "TCGA-AA-3522", "report": "The specimen consists of a right hemicolectomy with tumor-free resection margins. The lesion is ulcerated and shows moderate differentiation. Histological evaluation reveals invasion into the perimuscular fatty tissue and evidence of lymphatic vessel involvement. A total of 18 regional lymph nodes were examined, none of which showed signs of metastatic disease. No vascular or perineural invasion was identified. The staging indicates a T3 classification with no nodal involvement."} +{"pid": "TCGA-78-8655", "report": "A left lower lobe lobectomy specimen was received, measuring 180 x 100 x 30 mm. The bronchial resection margin included two adjacent bronchi measuring 14 and 7 mm in diameter. On the anterohilar surface, there was pleural puckering with an underlying firm mass. Upon sectioning, a well-circumscribed cream to yellow and focally anthracotic pigmented lesion was identified, measuring 27 mm in maximum dimension. The lesion did not involve a large bronchus and was well clear of the resection margins. No other focal lesions were identified.\n\nSections from the bronchial and vascular resection margins, peribronchial lymph nodes, and regions of the lesion including the overlying serosal surface were examined. Additional sections of normal lung tissue distant from the lesion and samples for research were also taken.\n\nA second specimen labeled as a left hilar lymph node consisted of two soft tissue fragments measuring 6 and 10 mm. A small firm lymph node measuring 3 mm in diameter was palpable.\n\nMicroscopically, the lesion showed a combination of architectural patterns, including acinar, papillary, and cribriform arrangements, with scattered psammoma bodies. An extensive lepidic component was present at the periphery. The lesion was subpleural; however, no pleural invasion was observed. There was no evidence of blood vessel invasion, lymphatic permeation, or perineural involvement. The bronchial resection margin was free of involvement.\n\nIn the surrounding lung tissue, emphysema and focal respiratory bronchiolitis were noted. Distal to the lesion, a small area of subpleural interstitial fibrosis was present. Within the uninvolved lung parenchyma, a well-circumscribed non-necrotizing granuloma was identified along with smaller, poorly formed granulomas. No polarizable material was seen, and special stains for microorganisms were negative. Similar granulomas were also present in the peribronchial lymph nodes.\n\nExamination of the lymph nodes revealed only reactive changes. No malignancy was identified. Sections of the lymph nodes showed a few poorly defined aggregates of histiocytes consistent with poorly developed granulomas.\n\nStaging assessment indicated no evidence of lymph node metastasis, and the lesion was classified as T1N0MX. Special stains performed on granulomatous tissue did not reveal any microorganisms. Clinical correlation was recommended for further evaluation."} +{"pid": "TCGA-EL-A3CZ", "report": "The surgical specimen from a female patient includes a total thyroidectomy and lymph node dissection. The left thyroid lobe contains a central mass measuring 2.2 x 1.7 x 1.5 cm, described as well-circumscribed with a soft pink-tan appearance. A firm nodule measuring 1.0 cm in diameter is present in the lower portion of the left lobe; this nodule shows papillary projections on cut surface and is entirely confined within the thyroid. Two additional nodules are noted: one measuring 0.6 cm laterally and another in the right inferior lobe measuring 0.5 cm. The right lobe and isthmus appear unremarkable. No extrathyroidal extension or lymphovascular invasion is identified. Surgical margins are free of abnormal tissue. Background thyroid tissue shows adenomatous hyperplasia.\n\nLymph node evaluation includes six nodes from the left periglandular region, one of which contains involved cells consistent with findings in the primary specimen. No extracapsular extension is observed. One facial lymph node on the right side shows no evidence of involvement. A submandibular gland specimen reveals a 2.0 cm well-circumscribed, encapsulated nodule attached by a fibrous pedicle. Frozen section analysis confirms specific cellular features without evidence of malignancy. All other submitted sections from the thyroid and salivary gland are included for diagnostic assessment."} +{"pid": "TCGA-77-8130", "report": "Histopathology Report. LEFT UPPER LOBECTOMY AND HILAR LYMPH NODES. Clinical Details: None supplied. Two specimens submitted: 1: LEFT UPPER LOBE. The specimen consists of a lobectomy specimen weighing 419 g in the fixed state and measuring 170 x 115 x 65 mm. The pleural surface is mostly smooth, with an area of roughening on the lower medial surface measuring approximately 25 x 20 mm. Adjacent to the hilum, there is a small piece of adherent pleura measuring 30 x 20 mm. On sectioning, a large lesion measuring 45 x 35 x 35 mm is present centrally within the lobe. This lesion invades the main lobar bronchus and extends to within approximately 11 mm of the bronchial resection margin. The resection margin appears clear of any abnormal cellular infiltration. The bronchus is almost completely occluded, and distal bronchi show marked mucus plugging. The lesion abuts the medial pleural surface in several areas but does not appear to extend through the pleural surface. The lung parenchyma shows anthracosis and emphysema, more prominent toward the apices. The lingula is markedly congested. No other mass lesions are identified. Sections were taken through bronchial resection margins, parabronchial lymph node, areas of the lesion invading the bronchus, overlying pleural surface, adjacent lung tissue, random sections from the apex, and lingula. Microscopy findings show poorly differentiated cellular features arising from a large bronchus and directly invading the adjacent pulmonary artery. The vessel is largely occluded, with smaller branches also obliterated. The lesion demonstrates extensive central necrosis and directly involves peribronchial lymph nodes. Invasion of the pleura on the medial aspect of the lung is also noted. The bronchial resection margin is free of abnormal cells but shows extensive metaplastic changes and mild dysplastic features. There is no evidence of lymphatic, venous, or perineural infiltration. Lung parenchyma distal to the lesion shows bronchiectasis and mucus plugging. Emphysema is present without active inflammation. Tissue from the lingula shows focal infarction. Staging assessment indicates local extension with regional lymph node involvement. 2: HILAR LYMPH NODES. The specimen includes multiple fragments of dark tan tissue measuring 30 x 25 x 3 mm in total. Microscopic evaluation reveals reactive lymphoid changes without evidence of abnormal cellular spread."} +{"pid": "TCGA-94-7943", "report": "The surgical specimen consisted of a wedge biopsy and segmentectomy from the left lung, involving the lingula and medial segment of the left lower lobe. The specimen measured 6.0 x 5.5 x 2.2 cm and included multiple staple lines. A solid mass with infiltrative borders was identified within the lung parenchyma, measuring 2.4 x 1.9 x 1.4 cm. This mass was located less than 1 mm from the parenchymal resection margin after staple line removal and appeared to focally involve the overlying pleura, which was disrupted prior to pathology evaluation.\n\nMicroscopic analysis revealed a poorly differentiated cellular proliferation. Visceral pleural invasion was present, as was evidence of lymphovascular invasion. Elastic stains were used to confirm pleural involvement. No additional masses were found in the remaining lung tissue. Fibrous adhesions were noted.\n\nMargins were uninvolved by invasive disease; however, the closest distance of invasive cells to the parenchymal margin was 1 mm. The tumor was classified as unifocal and surrounded by lung tissue. Regional lymph node assessment was not possible. No treatment effect was observed."} +{"pid": "TCGA-G9-7509", "report": "The prostate specimen weighed 34 grams and measured 5.5 cm in width, 3.7 cm in depth, and 2.5 cm in length. It included attached right and left seminal vesicles and vas deferens. Ink colors were applied to different surfaces for orientation. After removal of the apex and base, the remaining prostate tissue weighed 19 grams. Serial sectioning revealed firm tan fibrous parenchyma throughout. At Level I, a 1.3 cm tan-white firm nodule was identified, located 0.2 cm from the capsule.\n\nThe right and left seminal vesicles measured 2.6 x 1.3 x 0.8 cm and 2.4 x 1.3 x 0.7 cm, respectively, and appeared grossly unremarkable with no visible abnormality. Similarly, the right and left segments of the vas deferens showed no macroscopic signs of involvement.\n\nHistologic evaluation revealed an epithelial lesion involving approximately 5% of the gland, present bilaterally. The lesion exhibited a Gleason grade pattern of 3 + 3 (total score 6 out of 10), with tertiary grade 4 noted. No high-grade prostatic intraepithelial neoplasia was identified. There was no evidence of perineural invasion or vascular/lymphatic invasion. The surgical margins were free of any abnormal findings, and no involvement was seen in the seminal vesicles or vas deferens. The surrounding adipose tissue near the prostate was uninvolved.\n\nPathologic staging was assigned as T2C, with no lymph nodes assessed. No additional significant findings were reported. A portion of the specimen was submitted for tissue procurement, and the remainder was processed into multiple blocks for detailed histologic analysis."} +{"pid": "TCGA-CQ-6224", "report": "The specimen included left neck contents from levels I, II, III, and IV, as well as a hemiglossectomy, revision glossectomy, and multiple soft tissue margins. In level I, six lymph nodes were identified and all were negative for malignancy. The submandibular gland showed no pathologic changes. In level II, thirteen lymph nodes were found, with two containing involvement. The largest involved node in this region measured 1.6 cm, and extracapsular extension was present. In level IV, eight lymph nodes were identified, all of which were uninvolved. In level III, two lymph nodes were found, with one showing involvement. The involved node in this level measured 1.7 cm, and extracapsular extension was also present.\n\nThe hemiglossectomy specimen revealed a lesion with a maximum dimension of 3.3 cm and a thickness of 1.0 cm. Perineural invasion was identified. The tumor was located 0.3 cm from the inferior floor of mouth and deep margins, while all other margins were more than 0.5 cm away. The surgical margins, including the left posterior, left lateral, and medial regions, were all free of malignancy. The revision glossectomy and surgical waste specimens showed no abnormal findings.\n\nA total of 29 regional lymph nodes were examined, with 3 showing evidence of involvement. Extracapsular extension was noted in the involved nodes. Pathologic staging could not be fully assessed for distant metastasis. Gross examination of the surgical specimens confirmed the described dimensions and margins, with no additional abnormalities reported."} +{"pid": "TCGA-D6-6823", "report": "The histopathological examination of a resected lesion from the tongue and floor of the mouth was conducted. The surgical specimen measured 5 x 4 x 2.5 cm and included a fragment of the tongue along with adjacent mucous membrane. A cream-colored, firm lesion occupying nearly the entire specimen was identified, measuring 3.5 x 1.8 x 2.5 cm. Microscopic evaluation revealed a partially keratinized squamous cell carcinoma. The tumor measured up to 3.5 cm in its largest dimension. Cellular differentiation was moderately preserved. Margins of resection could not be fully assessed due to the limited orientation of the specimen."} +{"pid": "TCGA-2Z-A9J6", "report": "The specimen consists of a 2.0 x 1.8 x 1.5 cm mass surrounded by a rim of renal parenchyma ranging from 0.2 to 0.8 cm in thickness. The mass is tan-yellow, homogeneous, and well-encapsulated, without involvement of the renal capsule or perinephric fat. Histologic evaluation shows a solid growth pattern with nuclear features corresponding to Fuhrman nuclear grade 2 of 4. No invasion through the renal capsule is identified. Surgical margins are free. Additional findings include mild chronic inflammation and focal glomerulosclerosis in the non-neoplastic kidney tissue. The pathological stage is determined as pT1aNXMX. All relevant sections were reviewed and evaluated."} +{"pid": "TCGA-KK-A7AW", "report": "A specimen was obtained from a patient with a body surface area of 2.01 m\u00b2. The report includes findings from bilateral pelvic lymph nodes and a prostate specimen with attached seminal vesicles and vasa deferentia.\n\nThe bilateral pelvic lymph node dissection yielded nine lymph nodes, ranging in size from 0.5 x 0.4 x 0.3 cm to 1.7 x 0.6 x 0.4 cm. One lymph node contained a metastatic focus measuring 6.0 mm. No extranodal extension was identified.\n\nThe prostate measured 4.6 x 3.4 x 3.7 cm and weighed 36 grams after fixation. Serial cross sections revealed a dominant tumor focus located in the right lateral, right posterolateral, and right posterior peripheral zone. This lesion measured 2.5 x 0.6 cm in its largest cross-sectional dimension and was present across four cross sections, involving the apex extensively and the base focally. There was extensive multifocal extraprostatic extension involving the right lateral and right posterolateral surfaces of the prostate and the right superior neurovascular bundle region. The length of extraprostatic extension measured 23.0 mm. A second tumor focus was identified in the left lateral and left posterolateral peripheral zone, measuring 1.0 x 0.1 cm in its largest cross-sectional dimension and present in two cross sections. A third tumor focus was found in the left transition zone, measuring less than 0.1 x less than 0.1 cm and present in one cross section. All resection margins were free of tumor involvement. High-grade prostatic intraepithelial neoplasia was also noted.\n\nHistologic evaluation revealed perineural and lymphovascular invasion within the prostate. The seminal vesicles and segments of the vasa deferentia were not involved. Adipose and soft tissue fragments were also submitted for analysis.\n\nAll findings were confirmed through histopathological examination and correlated with the gross description."} +{"pid": "TCGA-FB-AAQ6", "report": "The specimen consists of a distal pancreatectomy and spleen weighing 188 grams. The combined specimen measures 14.5 cm in maximum length (ML), 11.5 cm in superoinferior (SI), and 5.8 cm in anteroposterior (AP). The pancreas itself measures 12 cm (ML) \u00d7 3 cm (SI) \u00d7 2.5 cm (AP), while the spleen measures 10.5 cm (SI) \u00d7 5.8 cm (AP) \u00d7 3.5 cm (ML). An indurated white-yellow lesion is identified in the body of the pancreas measuring 2 cm (ML) \u00d7 2 cm (AP) \u00d7 1.4 cm (SI). The pancreatic tissue distal to this lesion appears atrophic, and the lesion is located approximately 1 cm from the distal pancreatic margin. The lesion is more than 5 cm away from the spleen and does not appear to involve the splenic artery or vein. On sectioning, the spleen shows no gross abnormalities.\n\nMicroscopic examination reveals a lesion measuring 2.0 cm in its largest dimension located in the tail of the pancreas. The lesion approaches within less than 0.1 cm of the peritonealized radial margin but does not involve the pancreatic parenchymal or vascular margins. Extensive perineural invasion is observed, although no angiolymphatic invasion is identified. A total of nine lymph nodes were evaluated\u2014six peripancreatic and three from the splenic hilum\u2014all of which are negative for malignancy. Pathologic staging according to the AJCC 7th edition is pT3 NO. Moderate pancreatic intraepithelial neoplasia (PanIN 2) is present, and there is evidence of background chronic pancreatitis. The spleen and splenic vasculature show no microscopic involvement."} +{"pid": "TCGA-06-5411", "report": "The patient presented with progressive memory loss, headache, and lower extremity weakness. Imaging revealed a left frontal lesion with multicystic and enhancing features that extended across the midline. Three specimens were obtained during surgery: one from the left frontal region and two from the frontal brain.\n\nGross examination of the first specimen showed a single soft fragment measuring 1.8 x 0.7 x 0.4 cm with dark brown and focally white areas. The second specimen consisted of five soft, glistening, tan-brown fragments in total measuring 3.0 x 1.7 x 0.6 cm. The third specimen was described as two irregular tan-pink to red tissue fragments aggregating to 1.8 x 1.7 x 0.4 cm.\n\nMicroscopic analysis of the first specimen revealed necrotic brain tissue without viable tumor. The second and third specimens showed extensive infiltration of the cerebral tissue by a cellular neoplasm. The cells displayed nuclear atypia, brisk mitotic activity, and a high proliferation index estimated at over 50%. There was also evidence of microvascular proliferation and multiple areas of necrosis, some with pseudopalisading patterns. GFAP staining confirmed a gliofibrillary background, while CD163 demonstrated significant tumor infiltration by positive cells. CD34 highlighted prominent vascular proliferation, and MIB-1 supported the high proliferation index. Synaptophysin and NeuN stains indicated widespread effacement of the cerebral cortex.\n\nMolecular testing for MGMT promoter methylation was negative, using an assay with a detection sensitivity of 18% methylated DNA in an unmethylated background. No EGFRVIII mutation was identified through RNA-based analysis, which has a limit of detection of approximately 5 mutant cells in 100 normal cells. These tests were performed under CLIA requirements and are not FDA-cleared.\n\nIntraoperative evaluation of the first specimen noted a necrotic lesion without viable tumor. The second specimen was consistent with a malignant glial neoplasm showing extensive necrosis."} +{"pid": "TCGA-NG-A4VU", "report": "The surgical specimens include multiple tissue samples from the omentum, uterus, bilateral tubes and ovaries, and peritoneum overlying the bladder. The largest uterine specimen measured 12 cm from fundus to lower uterine segment, with a mass measuring 11 x 9.5 x 7.5 cm arising within the endometrial cavity. The mass was predominantly polypoid and appeared confined to the endometrium on gross examination, although microscopic evaluation showed invasion into the superficial myometrium with a depth of 2 mm (out of a total myometrial thickness of 19 mm). Areas of necrosis were identified within the tumor. A separate incidental finding in the uterus was a 1.4 cm angiomyolipoma.\n\nHistologic analysis revealed a high-grade tumor with complex epithelial components showing papillary serous features. In addition, there was a malignant stromal component with heterologous differentiation. Lymphovascular invasion was present. The tumor extended to involve the uterine serosa and adjacent para-tubal and para-ovarian soft tissues bilaterally. Metastatic involvement was also identified in both omental specimens and in the peritoneal tissue overlying the bladder.\n\nOmental specimens measured 2.5 x 2 x 0.6 cm and 8.5 x 4 x 3 cm respectively, and both showed tumor involvement. The right and left adnexal specimens were unremarkable except for metastatic involvement in the para-ovarian and para-tubal soft tissues on both sides. Peritoneal cytology was positive for malignant cells.\n\nStaging was determined as pT3b with no lymph nodes sampled. Additional findings included focal cystic atrophy of the uninvolved endometrium and a small angiomyolipoma within the uterus."} +{"pid": "TCGA-MI-A75I", "report": "The specimen consists of a liver resection measuring 15.2 x 7.1 x 3.5 cm and weighing 153 grams. The external surface shows a granular texture with areas of nodularity. Multiple lesions are identified within the liver tissue. The largest lesion measures 5.3 x 5.2 x 4.8 cm and has a tan-yellow to white appearance with granular consistency. This lesion is located 1.3 cm from the resection margin and extends to the overlying capsule. Additional smaller nodules are present, ranging in size from 0.2 to 5.8 cm, with some extending as close as 0.3 cm to the hepatic resection margin.\n\nMicroscopic examination reveals multiple tumor foci composed of well-differentiated cells arranged in trabeculae. The tumor is confined to the liver without involvement of the resection margins, which are free by at least 5 mm. There is no evidence of perineural invasion, while lymphovascular invasion could not be definitively assessed. Sections submitted include those from the largest mass, adjacent normal liver tissue, and nodules near the capsule.\n\nPathologic staging indicates limited tumor extension without regional lymph node involvement or distant metastasis."} +{"pid": "TCGA-77-8145", "report": "Histopathology Report. LEFT LUNG, LYMPH NODES AND PULMONARY VEIN STUMP. Clinical Notes: male with lesion in the left upper lobe bronchus. Questioned involvement of superior pulmonary vein into left atrium and margin status. Five specimens are received.\n\n1: LEFT LUNG. The specimen is a left lung measuring approximately 255 x 180 x 65 mm, including about 28 mm of attached left main bronchus. The pleural surface shows puckering on the lower lateral aspect of the upper lobe and at the medial surface anterior to the hilum. Bullae ranging from 3\u201320 mm are noted at the apex. On sectioning, a large lesion measuring approximately 65 x 50 x 50 mm is identified arising from the left upper lobe bronchus, located about 50 mm from the bronchial resection margin. The lesion lies deep to the hilum and extends through the lung parenchyma toward the lateral pleural surface. It involves predominantly the upper lobe with extension into the upper portion of the lower lobe. A central area of cavitation measuring approximately 25 mm is present. The lesion appears to involve the pulmonary vein and approaches within 1 mm of the resection margin. Invasion of several parabronchial lymph nodes is observed. The overlying pleura shows puckering, and the cut surface of the lesion is heterogeneous, with firm cream-colored areas and softer grey-black regions.\n\n2: NUMBER SEVEN LYMPH NODE. This specimen is a single piece of tan solid tissue measuring 70 x 18 x 12 mm. A prominent lymph node is visible on sectioning.\n\n3: NUMBER EIGHT LYMPH NODE. This consists of a single piece of tan solid tissue measuring 14 x 10 x 5 mm.\n\n4: NUMBER TEN LYMPH NODE. This specimen is a single piece of tan solid tissue measuring 25 x 15 x 7 mm.\n\n5: PULMONARY VEIN STUMP. This is a single piece of fibrofatty tissue measuring 6 x 5 x 2 mm.\n\nMicroscopic examination of all specimens reveals a moderately differentiated carcinoma with extensive central necrosis. The lesion invades the pleura on both the medial and lateral aspects of the upper lobe. Multiple foci of venous invasion are seen, including in the main pulmonary vein, where tumour cells extend through the vessel wall close to the endothelial lining. Organizing mural thrombi are present in the vein, but the venous resection margin is free of tumour. The section from the pulmonary vein stump includes a small portion of atrial wall without evidence of malignancy. The bronchial resection margin is also clear and shows no squamous metaplasia or dysplasia. Lymphatic invasion is not definitively identified, although one hilar lymph node (number 10) contains metastatic carcinoma. Other peribronchial and sampled lymph nodes show no signs of malignancy. The lung tissue away from the lesion shows severe emphysema, and sections from the lower lobe reveal multiple foci of ossification.\n\nAddendum report: Further review of the pulmonary vein resection margin demonstrates tumour invasion into atrial muscle. Staging has been updated accordingly."} +{"pid": "TCGA-OR-A5JW", "report": "A male patient underwent surgical resection of a right adrenal mass. The specimen weighed 251 grams and measured 8.6 x 7.1 x 6.3 cm. After trimming, the residual adrenal gland weighed 2.9 grams, while the tumor component weighed 200 grams. The mass was encapsulated and exhibited a brown and yellow cut surface with focal tan nodular areas. Gross examination showed no involvement of margins. Sections from the left lobe of the liver showed benign hepatic parenchyma with steatosis, without evidence of malignancy. Microscopic evaluation of the adrenal mass revealed high-grade cellular atypia, necrosis, and increased mitotic activity. The tumor was limited to the adrenal gland without extension beyond the capsule."} +{"pid": "TCGA-BH-A0C0", "report": "The specimen consists of a segmental mastectomy from the left breast at the 3 o\u2019clock position. The invasive component measures 1.7 cm in greatest dimension and is located within a mixture of in situ disease. Histologic evaluation reveals high-grade features including poor tubule formation, marked nuclear atypia, and increased mitotic activity. In situ disease with comedo necrosis and calcifications is present throughout the lesion and comprises approximately 40% of the overall tumor volume.\n\nMargins of resection are negative for invasive disease, with the closest distance being 1 mm at the posterior margin. Lymphovascular space invasion is identified. Additional findings include fibrocystic changes, benign epithelial calcifications, and biopsy site alterations. Immunohistochemical staining demonstrates positivity for estrogen and progesterone receptors, with weak positivity noted for HER2/neu.\n\nLymph node evaluation includes 28 nodes examined from the left axillary contents, one of which contains metastatic involvement measuring 1.9 mm in diameter. No tumor is identified in seven additional lymph nodes from level 3 axillary dissection. No extracapsular extension is observed.\n\nNon-neoplastic findings include atypical lobular hyperplasia and lobular carcinoma in situ. Benign calcifications are noted in both malignant and non-malignant zones. No Paget\u2019s disease of the nipple is identified.\n\nPathologic staging reflects a T1c classification based on tumor size and pN1a for lymph node involvement."} +{"pid": "TCGA-14-0867", "report": "The specimen was received in two parts, both labeled with the patient\u2019s name and hospital number. Specimen #1 was submitted fresh for intraoperative consultation and measured approximately 1.3 x 1.0 x 0.6 cm. It consisted of tan-brown, soft tissue. A frozen section was performed, and a portion was placed in lens paper within cassette \"FS1A,\" while the remainder was placed in cassette \"1B.\" Specimen #2 was received in formalin and measured up to 3.0 x 3.0 x 0.5 cm. It contained multiple fragments of red-tan, soft tissue, all of which were submitted in lens paper within cassette \"2A.\" Microscopic examination of the frozen section revealed cellular features consistent with high-grade transformation, including nuclear atypia, increased mitotic activity, and areas of necrosis. The tissue was processed and reviewed as part of standard intraoperative pathology consultation. All relevant portions were submitted for further analysis."} +{"pid": "TCGA-4R-AA8I", "report": "A partial left liver resection specimen weighing 84 grams and measuring 12 x 5.8 x 3 cm was examined. The resection margin was inked black. A nodule measuring 2.8 x 2.6 x 2.4 cm was identified; it was firm, tan-green, focally hemorrhagic, and well circumscribed. The nodule was located 0.8 cm from the resection margin and 0.1 cm from the capsule. The surrounding liver tissue showed signs of cirrhosis and had a multinodular capsule with fibrous bands.\n\nMicroscopic evaluation revealed a lesion with features including focal pseudoglandular growth. Reticulin staining demonstrated disruption of the normal reticulin framework. Mucicarmine staining was negative. In the adjacent non-involved liver tissue, trichrome and reticulin stains confirmed the presence of established cirrhosis. Portal tracts and fibrous septa contained mild to moderate mononuclear inflammatory cells. There was mild bile ductular proliferation, and native bile ducts were preserved. Regenerative nodules showed occasional ballooned hepatocytes with poorly-formed Mallory bodies. Pericellular sinusoidal fibrosis was patchy within these nodules. Copper staining showed mild copper accumulation in periportal and periseptal hepatocytes. PASD staining revealed PAS-positive, diastase-resistant material in periportal and periseptal areas. Iron staining was negative.\n\nPathologic staging according to the AJCC 7th edition was pT2 pNX pMX. Margins were free of involvement, and the closest distance from the nodule to the parenchymal margin was 0.8 cm. Vascular invasion was not identified, although microvascular invasion was present. There was no perineural or lymphatic invasion. Regional lymph nodes were not sampled.\n\nThe background liver changes, including steatosis, ballooned hepatocytes, and patchy fibrosis, raised consideration for steatohepatitis. Findings on PASD and copper staining were non-specific, but possible Wilson\u2019s disease and alpha-1-antitrypsin deficiency were noted as differential considerations requiring further clinical assessment."} +{"pid": "TCGA-CJ-4892", "report": "The right kidney measured 11.0 x 5.5 x 3.5 cm and contained a lesion measuring 5.5 x 5.4 x 3.2 cm with a yellow, soft cut surface. The lesion was located away from the perirenal adipose tissue margin but extended toward the renal sinus. Vascular and ureteral margins were free of abnormal tissue. No lymph nodes were identified within the kidney specimen. Two possible lymph nodes were found in the pericaval adipose tissue specimen (measuring 7.0 x 5.7 x 1.5 cm in total), with sizes of 0.7 x 0.6 x 0.3 cm and 3.3 x 1.4 x 0.7 cm; neither showed any abnormal cellular infiltration. The left adrenal gland measured 8.5 x 6.5 x 4.5 cm and contained a well-circumscribed mass measuring 7.5 x 6.0 x 4.5 cm, covered by a thin capsule. The mass exhibited a cut surface with pale yellow and dark red hemorrhagic areas. A thin rim of bright gold tissue resembling adrenal cortex was noted focally around the mass. The attached adrenal gland tissue appeared unremarkable. Multiple sections were taken from the kidney, surrounding fat, renal sinus, and vascular/ureteral margins, as well as from the lymph node specimen and adrenal mass. No lymphatic or vascular invasion was identified in the kidney specimen. Cellular features included nuclei with moderate atypia and regular contours. The adrenal mass was submitted for further microscopic evaluation."} +{"pid": "TCGA-GS-A9TY", "report": "AXILLAR LYMPH NODE: Tissue fragment measuring 7x5.3x4.3 cm. A lymph node of 4x43x3.4 cm is identified, with a pinky color and a whitish area measuring 3.8x3.3 cm. Three additional lymph nodes are present, all with pinky appearance, measuring 2.5x2.3x2.2 cm. LEFT AXILLAR LYMPH NODE, EXCISION: The specimen includes multiple lymph nodes. One lymph node shows a population of large cells arranged in a diffuse pattern. Immunohistochemical staining demonstrates positivity for CD20, BCL6, and p53. Staining for BCL2, CD10, and MUM1 is negative. CD3 and CD5 highlight a sparse presence of intratumoral reactive T-cells. The proliferative index, assessed by KI67 staining, is approximately 70%. Adjacent lymph nodes exhibit reactive follicular hyperplasia. Molecular studies performed did not detect rearrangement of the BCL2 gene by PCR (MBR)."} +{"pid": "TCGA-S3-AA17", "report": "The pathology report includes findings from a bilateral mastectomy and sentinel lymph node biopsies. \n\nIn the right breast, a mass was identified in the lower outer quadrant. The largest invasive focus measured 4.0 x 3.0 x 3.0 cm. Histologic evaluation showed poor differentiation with less than 10% of the tumor forming glandular or tubular structures. Marked nuclear pleomorphism was noted, including vesicular nuclei with prominent nucleoli and significant variation in size and shape. Mitotic activity was high, with 25 mitoses per 10 high-power fields. Based on these features, the tumor was classified as Grade 3. Margins were free of involvement by invasive carcinoma, with the anterior margin measuring 10 mm and the posterior margin measuring 40 mm from the tumor. No lymphovascular invasion was observed.\n\nTwo sentinel lymph nodes were examined on the right side. One lymph node contained scattered tumor cells identified through keratin staining, showing isolated clusters measuring less than 0.2 mm. Although not definitively categorized as micrometastasis based on size, the cell count exceeded 200 in a single section, leading to classification as micrometastatic disease. Evaluation included H&E staining with multiple levels and immunohistochemistry.\n\nOn the left breast, multiple nodules were found in the lower inner quadrant. These corresponded to ductal carcinoma in situ (DCIS), cribriform and papillary types, with intermediate nuclear grade. Necrosis was not identified. The estimated extent of DCIS was at least 2.5 cm, identified across six blocks out of ten examined. Margins were uninvolved, with the closest distance to the posterior margin being 7.0 mm. No microcalcifications were seen in association with the DCIS. Sentinel lymph node evaluation on the left side revealed no evidence of metastatic involvement.\n\nAncillary studies on other specimens showed immunoreactivity for estrogen and progesterone receptors, with quantitation of 100% and 70%, respectively. HER2 testing showed equivocal immunoperoxidase staining (Score 2+), but fluorescence in situ hybridization (FISH) did not show gene amplification.\n\nAll surgical specimens were received in formalin within appropriate time frames, with ischemic times ranging from 1/5 to 20 minutes depending on the specimen. Tissue integrity was maintained, allowing for full margin assessment in the mastectomy specimens."} +{"pid": "TCGA-D9-A3Z4", "report": "The examined skin lesion measured 24 mm in diameter and was located on the arm. The lesion appeared brown-colored and ulcerated, with a distance of 1 cm from the base margin and 2 cm from the side edge. Satellite lesions were identified on the skin, ranging from 0.1 to 0.6 cm in size. The closest lateral margin was 0.6 cm and the closest deep margin was 0.4 cm. A separate proliferation measuring 3 x 1.7 x 3.5 cm was observed in the subcutaneous tissue and extended to the base margin. Histologically, the lesion exhibited malignant features consistent with a diagnosis based on cellular morphology and architectural patterns. The lesion demonstrated vertical growth with a thickness of 12 mm and a maximum diameter of 24 mm. Microscopic evaluation confirmed infiltration into deeper layers of the skin and subcutaneous tissue. Inflammatory changes were noted at the base of the lesion, although no signs of regression were present. Ulceration was evident, and satellite lesions were observed. No evidence of residual precursor lesions was identified. Margins of resection showed minimal clearance laterally (0.3 cm) and none at the base (0 cm). Staging parameters indicated advanced local extension and lymph node involvement."} +{"pid": "TCGA-A5-A0GD", "report": "The specimen consisted of a uterus with bilateral fallopian tubes and ovaries, measuring 7.5 cm in length, with a cervix measuring 2.5 x 2.0 cm. The endometrial cavity contained a polypoid tumor measuring 4.0 x 3.0 cm, tan in color with a broad base, located primarily on the left lateral, posterior, and anterior walls. This tumor exhibited a diffusely polypoid appearance, occupying approximately 50\u201360% of the endometrial lining and extending near the fundus and lower uterine segment. The myometrium measured up to 1.5 cm in thickness, and microscopic evaluation indicated superficial involvement of the myometrium by the neoplasm, estimated at less than 20% depth of invasion or less than one-quarter of the total myometrial thickness. Irregular nests and islands of tumor were observed invading into the superficial myometrium, effacing the endometrial-myometrial junction. Due to the irregular growth pattern, precise measurement of maximum depth of invasion was difficult but approximated between 0.5 to 1 mm.\n\nHistologic evaluation showed a neoplastic process composed of endometrioid-type epithelial cells with nuclear grades ranging from 2 to 3, while architectural grade was assessed as 1. Focal squamous differentiation and oxyphilic cellular changes were noted. The tumor demonstrated exophytic growth with no parametrial extension or endocervical involvement. No evidence of metastatic disease was found in pelvic or periaortic lymph nodes examined from both right and left sides, which totaled twelve lymph nodes across all specimens. These lymph nodes showed only non-significant findings such as fatty change, fibrosis, and absence of malignant cells.\n\nAdditional findings included a small leiomyoma in the corpus uteri, endometrial hyperplasia (both complex and simple types with atypia, and complex without atypia), and an endocervical polyp. The fallopian tubes showed mild epithelial hyperplasia and focal chronic inflammatory infiltrates with macrophages. The ovaries displayed mild cortical stromal hyperplasia. A subserosal focus consistent with atypical M\u00fcllerianosis was identified in the right fallopian tube, along with Walthard rests. An old mural scar in the cervix was consistent with a prior cesarean section. Other incidental findings included fat necrosis with granulomatous reaction in a sigmoid epiploic specimen, and focal mesothelial hyperplasia with surface fibrosis and microadhesions in the omentum.\n\nMargins of resection, including the vaginal cuff and parametrial regions, were free of tumor involvement. The tumor was limited to the endometrium and did not extend into the cervix or involve the lower uterine segment. No involvement of the ovarian cortex or tubal lumen was identified."} +{"pid": "TCGA-EM-A1CS", "report": "The specimen received includes a right paratracheal lymph node fragment measuring 0.8 x 0.6 x 0.3 cm, and a total thyroidectomy specimen with a right paratracheal dissection. The thyroid gland weighs 18.05 grams. The right lobe measures 4.3 cm in length, with widths of 2.5 cm and 1.3 cm, while the left lobe is 4.5 cm long with widths of 2.3 cm and 2.1 cm. The isthmus measures 2.0 cm in length and 1.0 cm in width. Fibrous adhesions are noted on the external surfaces, and blue dye is present. A well-defined nodule measuring 1.1 x 1.3 x 1.1 cm is identified in the lower left lobe. No parathyroid glands or lymph nodes are observed grossly.\n\nMicroscopically, six lymph nodes from the right paratracheal region are examined, and no evidence of involvement is found. In the thyroid, multiple distinct areas are noted. One area in the left lobe shows cellular features consistent with encapsulated growth, with dimensions of 1.3 cm as the largest measurement and additional dimensions of 1.1 x 1.1 cm. Invasion through the capsule is identified, although there is no extension beyond the thyroid. The margins are free of involvement. Another area in the right lobe contains a smaller lesion measuring 0.5 cm, which lacks encapsulation and does not show signs of invasion. The margins are again uninvolved. No venous or lymphatic vessel invasion is detected.\n\nAdditional findings include nodular hyperplasia and thyroiditis. Multiple small foci with similar cellular features are also identified. Pathologic staging indicates a primary tumor size of 2 cm or less confined to the thyroid, with no regional lymph node involvement. Six lymph nodes are examined, and none show evidence of disease. Distant metastasis cannot be assessed."} +{"pid": "TCGA-HT-7620", "report": "The pathology report demonstrates a neoplasm with significant proliferation of cells resembling oligodendrocytes. The tumor cells display prominent perinuclear halos, rounded hyperchromatic nuclei, and minimal cellular processes. Cytologic atypia ranges from moderate to marked. The growth pattern is arranged in sheets with infiltration into both gray and white matter. Microvascular proliferation is present along with areas of early necrosis; one distinct necrotic focus may correspond to a prior biopsy site. Mitotic activity is notable, with up to eight mitoses per 10 high power fields. Microgemistocytes are observed interspersed throughout the tumor. Additional features include microcalcifications and branching thin-walled vessels. The MIB-1 labeling index reaches 24.4% in the most proliferative regions."} +{"pid": "TCGA-44-6778", "report": "The specimen includes a wedge resection of the lingula and multiple lymph nodes. The lingula measures 18 x 4 x 2 cm and contains a nodular mass located beneath the pleura, measuring up to 2 x 1.5 x 1.3 cm. The mass is situated beneath a fibrous scar with associated pleural puckering and old hemorrhage. No involvement of the visceral pleural surface is noted. The remaining pulmonary parenchyma shows consolidation and hemorrhage without additional nodules. Adherent fat is present on the pleural surface. Margins of resection are free of tumor.\n\nLymph nodes evaluated include level 10 (three nodes measuring 6\u20138 mm), level 7 (one node measuring 7 mm), and level 5 (two nodes with an aggregate dimension of 1 cm). All lymph nodes are negative for metastatic disease. Histologic evaluation reveals moderate to poorly differentiated cells in the primary lesion. There is no evidence of direct tumor extension, venous, arterial, or lymphatic invasion.\n\nAdditional findings include emphysematous bullae and a fibrous pleural-based scar with old hemorrhage. No distant metastasis can be assessed."} +{"pid": "TCGA-Z4-A9VC", "report": "The specimen consists of a skin patch with subcutaneous adipose tissue, skeletal muscle, and a tumor mass measuring 20x15x8 cm. A nodular tumor component measures 15x12x6 cm and exhibits yellow lobulated stroma. The distance from surgical resection margins is unspecified. Microscopic evaluation shows histologic features consistent with a high-grade neoplasm, scoring 6 out of 8 according to the FNCLCC grading system. There is a range of differentiation, with a predominant low-grade component. Mitotic activity is elevated, with 26 mitoses observed in 10 high-power fields. No necrotic nests are identified. A round cell component constitutes up to 80% of the tumor, with infiltration into adjacent adipose tissue and vascular structures."} +{"pid": "TCGA-ET-A39P", "report": "The specimen consists of a total thyroidectomy. The tumor is located in the left lobe and measures 5.3 cm in greatest dimension. The tumor is unifocal. Two associated lymph nodes are negative for tumor involvement. The primary tumor demonstrates multiple foci of extrathyroidal extension, with a size greater than 4 cm, classified as pT3. There is no evidence of regional lymph node metastasis (pNO). Distant metastasis cannot be assessed (pMx). Margins are involved by invasive carcinoma at the superior and mid portions of the left lobe. Venous and lymphatic invasion are present. Additional findings include nodular hyperplasia. Representative slides (A-D) have been reviewed and confirmed."} +{"pid": "TCGA-MH-A55Z", "report": "The surgical specimen consists of a partial nephrectomy weighing 112.3 g and measuring 5.8 x 5.3 x 4.7 cm, with attached perinephric fat. The mass is well-circumscribed, measuring 5.2 x 3.9 x 3.5 cm, and exhibits tan-yellow to red and orange variegation. It is located 0.3 cm from the renal resection margin and less than 0.1 cm from the capsular resection margin. Gross evaluation shows no involvement beyond the renal capsule, and no lymph nodes or adrenal gland are identified in the specimen.\n\nMicroscopic examination reveals a histologic pattern characterized by papillary architecture. The nuclear grade is moderate (G2), and no tumor necrosis is observed. The lesion is confined to the kidney without extension beyond the renal capsule. Both the renal parenchymal and Gerota\u2019s fascial margins are free of tumor involvement.\n\nPathologic staging indicates T1b based on size and local extent. Additional findings in the non-neoplastic kidney include focal glomerulosclerosis, arterio- and arteriolonephrosclerosis, and interstitial fibrosis with chronic inflammation."} +{"pid": "TCGA-69-7980", "report": "The specimen consisted of multiple parts, including a right lower lobe wedge and a right upper lobe lobectomy, along with lymph node groups #4, #7, #11, and 10R. The right lower lobe wedge measured 8 x 2 x 1.5 cm and weighed 4.1 grams, with two identified nodules. Nodule #1 measured 0.3 x 0.3 x 0.2 cm and was located 0.3 cm from the cut margin, while nodule #2 measured 0.5 x 0.5 x 0.4 cm and was located 0.2 cm from the cut margin. All lymph nodes evaluated across the submitted specimens were negative for malignant involvement.\n\nThe right upper lobe specimen weighed 150.7 grams and measured 14.5 x 10 x 3 cm, including a bronchial stump of 0.3 cm in length. A lesion measuring 2.5 x 2.2 x 1.8 cm was observed adjacent to the pleura, with a tan-white appearance and irregular borders. This lesion was also in proximity to an area of pleural thickening measuring 3 x 3 x 0.9 cm. Evaluation of all margins\u2014bronchial, vascular, parenchymal, and pleural\u2014demonstrated no evidence of involvement. Histologic assessment did not reveal vascular or lymphatic invasion. Based on AJCC staging criteria, the lesion was classified as T1b NO MO (Stage IIA). Multiple lymph nodes from various stations were entirely submitted and showed no signs of neoplastic involvement."} +{"pid": "TCGA-A8-A06O", "report": "The specimen shows a focus of poorly differentiated invasive tumor with focal intraductal spread. The maximum microscopic tumor diameter is 1.5 cm, and the distance from the nearest resection margin is less than 0.1 cm. There are multiple ulcerations present in the skin. In a separate ablated breast sample, an additional focus of poorly differentiated invasive tumor is identified, measuring 1.5 cm in diameter. This lesion is located 0.8 cm from the dorsal margin and 1 cm from the nearest lateral resection margin, with other margins remaining free. Histologic grade is G III. Lymph node staging shows no metastatic involvement (0 out of 13 lymph nodes involved). Vascular invasion is present, and all involved margins are noted."} +{"pid": "TCGA-BH-A0BQ", "report": "The specimen consists of a left breast total mastectomy and lymph node excision. In the lymph node region, no evidence of involvement was found. The primary lesion measures 1.5 cm in maximum dimension and is located within the breast tissue. The histological assessment reveals a cellular pattern with features including tubule formation score of 3, nuclear pleomorphism score of 2, and mitotic activity score of 1, resulting in a total score of 6 out of 9. The tumor demonstrates a solid mass pattern and contains areas of necrosis. A component of ductal carcinoma in situ (DCIS) is present, constituting approximately 30% of the total volume, with a solid growth pattern and moderate admixture, including comedo-type morphology. No invasion of lymphatic or vascular spaces is identified.\n\nMalignant-type calcifications are noted in localized areas. The distance from the invasive tumor to the closest surgical margin is 5 mm, and similarly, the in situ component is also 5 mm from the nearest margin. Two lymph nodes were examined using H/E staining methods, and none showed signs of involvement. The tumor is associated with biopsy site changes and atypical ductal hyperplasia (ADH) in non-neoplastic breast tissue. Immunohistochemical analysis shows positivity for estrogen and progesterone receptors, with HER2/Neu expression at 2+.\n\nStaging is as follows: pT1c for the primary tumor, pN0 for regional lymph nodes, and pMX for distant metastasis. The histological type of the invasive component is classified as ductal adenocarcinoma, not otherwise specified."} +{"pid": "TCGA-B5-A1MY", "report": "The clinical history indicates a malignant neoplasm of the corpus uteri. An endometrial biopsy showed poorly differentiated adenocarcinoma.\n\nGross examination includes lymph nodes and a hysterectomy specimen with bilateral tubes and ovaries. The right paraaortic lymph nodes were dissected into three groups, two of which showed metastatic involvement. Specifically, out of five lymph node candidates ranging from 0.3 to 1 cm in size, two were positive for malignancy on frozen section analysis. The left paraaortic lymph node was a single 0.9 x 0.4 x 0.5 cm lymph node without evidence of malignancy. \n\nThe hysterectomy specimen weighed 300 grams and measured 13 x 9.4 x 5.6 cm. The cervix measured 2.6 cm in diameter with an external os of 0.6 cm. The endometrium appeared diffusely granular and hemorrhagic with multiple friable tan-brown irregular exophytic masses involving the fundus, cornu, and anterior and posterior walls. These masses measured up to 3.9 x 3.6 x 1.4 cm. The myometrium averaged 1.9 cm thick and beneath the tumor nodules appeared white, firm, and fibrotic, raising suspicion for full-thickness invasion. The endometrial cavity measured 7.1 cm in length and 5.5 cm in diameter. The endocervical canal was 4.1 cm long and 0.8 cm in diameter. The serosa appeared smooth and glistening with no visible lesions.\n\nA separate fibroid nodule weighing 1.1 gram measured 2.9 x 2.3 x 2.1 cm. Sections of the tumor and adjacent myometrium were submitted to assess invasion depth. Other sections included cervical margins, myometrium, and fibroids.\n\nMicroscopic evaluation confirmed the presence of carcinoma involving the endometrium diffusely. Histologic features included extensive lymphatic and vascular invasion. The tumor invaded nearly the full thickness of the myometrium, reaching within 0.25 mm of the serosal surface. Adjacent non-neoplastic endometrium was absent. Stromal invasion was identified in the cervix. No tumor involvement was noted at specimen margins or on the serosal surface. Both ovaries and the right fallopian tube were negative for tumor involvement, while the left fallopian tube showed focal suspicious changes.\n\nStaging based on AJCC 7th Edition criteria was pT2 pN2 pMX. This classification reflects findings from the current specimen only and does not incorporate additional data such as imaging or prior clinical findings."} +{"pid": "TCGA-SS-A7HO", "report": "The surgical specimen includes a right colon and distal ileum resection measuring 35.3 cm in total length, with the ileum measuring 17.2 cm and the colon 18.1 cm. The tumor is located in the cecum and measures 9.5 x 8.5 x 8.0 cm. Macroscopic evaluation reveals tumor extension to the visceral peritoneum with focal involvement of adjacent soft tissue structures. Perforation is noted at the tumor site.\n\nMicroscopically, the lesion demonstrates high-grade features with poor to undifferentiated differentiation. Histologic features suggestive of microsatellite instability include intratumoral lymphocytic response (mild to moderate) and peritumor lymphocytic response consistent with a Crohn-like reaction, also mild to moderate. Focal squamous differentiation is present.\n\nMargins evaluated include proximal, distal, and circumferential. The proximal and distal margins are uninvolved; however, the circumferential margin shows tumor involvement within 1 mm of the margin. Lymphovascular invasion is identified, while perineural invasion and tumor deposits are not present.\n\nA total of 25 lymph nodes are examined, none show evidence of metastasis. The tumor arises within a tubular adenoma. Pathologic staging indicates pT4a classification based on penetration through the visceral peritoneum and pN0 due to absence of lymph node involvement.\n\nImmunohistochemical staining performed on selected sections shows negative staining for CK7 and patchy positivity for CK20 in a small subset of cells. Multiple lymph nodes ranging from 0.2 cm to 3.1 cm are identified and submitted for evaluation. The appendix is embedded within the soft tissue surrounding the tumor, precluding measurement of its length, though its lumen remains intact.\n\nAll other margins\u2014including inferior, posterior, lateral, and superior\u2014are assessed microscopically and found to be free of invasive disease. These margins demonstrate varying degrees of fibromuscular atrophy, necrosis, granulation tissue, and chronic inflammation without residual tumor involvement."} +{"pid": "TCGA-A2-A4RX", "report": "The specimen consisted of a right breast simple mastectomy and three sentinel lymph nodes from the right axilla. The mastectomy specimen measured 21.0 cm in greatest dimension and was oriented with a short stitch superiorly and a long stitch laterally. The skin surface showed a centrally located everted nipple without discharge or scarring. Upon sectioning, two distinct masses were identified in the lower outer quadrant. Mass #1 measured 2.5 x 2.0 x 1.8 cm and was located 1.4 cm from the deep margin and 1.0 cm from the superficial margin. Mass #2 measured 2.0 x 2.0 x 1.8 cm and was located 3.0 cm from the deep margin, adjacent to but separate from mass #1. A third area of fibrous induration in the mid-outer breast (mass #3) measured 1.1 x 0.8 cm microscopically. No additional lesions were identified.\n\nHistologically, masses #1 and #2 showed a biphasic pattern with both epithelial and mesenchymal components. The epithelial component displayed poor differentiation, while the mesenchymal component showed marked pleomorphism and fascicular growth of spindled cells. Immunohistochemical staining revealed strong pancytokeratin positivity in the epithelial areas, with no staining in the spindled regions. These features were consistent with a metaplastic carcinoma. Mass #3 was histologically distinct and showed features of adenoid cystic carcinoma. All three masses were located in the lower outer quadrant and were morphologically separate. Ductal carcinoma in situ (DCIS) of high nuclear grade with central necrosis was also present. Lobular carcinoma in situ was not identified.\n\nMargins were uninvolved by invasive carcinoma. The closest distance from the deep margin to mass #1 was 1.2 cm. DCIS was also uninvolved at the margins, with a similar distance from the deep margin. No lymphovascular invasion was observed. Microcalcifications were present within both invasive and in situ components. Skeletal muscle was not present in the specimen, and there was no involvement of the skin or nipple by invasive carcinoma or DCIS.\n\nThe excised lymph nodes included two from sentinel node #1 and #2, and one from sentinel node #3. All were negative for malignancy on routine and immunohistochemical evaluation. No macrometastases, micrometastases, or isolated tumor cells were identified. There was no extranodal extension.\n\nAncillary studies showed weak estrogen receptor positivity (1\u20135% nuclei staining) and intermediate progesterone receptor positivity (5% nuclei staining) in the dominant mass. HER2 Neu testing by IHC was negative (score 1+), and FISH testing was not performed. In mass #3, ER staining was weakly positive in less than 5% of nuclei, PR was negative, and HER2 Neu was also negative (1+).\n\nThe histologic grade of the dominant mass was grade 3, with a total score of 8 out of 9 based on glandular differentiation (3), nuclear pleomorphism (3), and mitotic count (2). The tumor was multifocal with three distinct foci. The largest focus measured 2.5 cm grossly. Based on AJCC Cancer Staging Manual (7th edition), the pathologic stage was pT2(m) pN0(sn). \n\nAdditional findings included intraductal papilloma and biopsy site changes. No treatment effect was noted. All three lymph nodes were entirely submitted for analysis, and no metastatic involvement was found. The case underwent intradepartmental peer review."} +{"pid": "TCGA-L5-A4OO", "report": "The patient is male and has a history of long-standing gastroesophageal reflux disease. He underwent a flexible esophagoscopy and transhiatal esophagectomy with cervical esophagogastric anastomosis and placement of a J-tube.\n\nA liver biopsy specimen measuring 1.1 x 0.5 x 0.3 cm was received; it was described as brown, irregular, and soft. A separate tissue fragment from a fundic nodule measuring 1.4 x 1.0 x 0.7 cm was described as tan, partially encapsulated, and soft, with a gray-yellow, solid, and focally calcified cut surface. The cervical esophageal margin specimen measured 1.8 cm in length and 3.3 cm in diameter and showed no remarkable features on either the adventitial or mucosal surfaces.\n\nTwo lymph nodes (0.7 and 0.9 cm) were identified in the right paraesophageal region, both containing anthracotic pigment and partially covered by adipose tissue. The esophagectomy specimen included a distal esophagus segment measuring 7.1 cm in length and a proximal stomach segment measuring 5.6 cm. A 4.1 x 3.6 cm flat, ulcerated mass was found at the gastroesophageal junction, located 5.9 cm from the proximal margin and 4.0 cm from the distal margin. It occupied approximately 80% of the luminal circumference and extended through the adventitia to within 0.2 cm of the inked adipose margin. The surrounding esophageal and gastric walls were focally indurated and thickened up to 1.4 cm. An additional 1.5 x 1.2 cm ill-defined area of ulcerated mucosa was identified in the distal esophagus, located 1.2 cm proximal to the main mass and 3.4 cm from the nearest margin. This area had unremarkable cut surfaces upon sectioning. The remainder of the mucosa was unremarkable. Multiple possible lymph nodes were identified, with sizes up to 2.1 cm in greatest dimension.\n\nInvasive, moderately differentiated tumor cells were found extending into the periesophageal soft tissue. A total of 36 lymph nodes were examined, 21 of which were positive for metastatic involvement. Surgical margins were free of involvement. Distant metastasis could not be confirmed. A bile duct hamartoma was incidentally identified in the liver without evidence of malignancy. A separate calcified, benign-appearing stromal tumor measuring 1.4 cm was found in the gastric fundus, with low mitotic activity and extension to a cauterized margin. One lymph node from the right paraesophageal region was negative for tumor involvement."} +{"pid": "TCGA-J4-A67O", "report": "The prostate specimen weighed 44.0 grams and measured 4.0 x 4.0 x 3.5 cm. The gland showed a firm, focally nodular parenchyma on sectioning. No tumor was identified in the seminal vesicles or at the specimen margins. Histologic evaluation revealed a Gleason score of 3 + 4 = 7/10. The extent of involvement involved 30\u201350% of the examined tissue. Perineural invasion was present, while lymphatic (small vessel) invasion was not observed. The tumor was confined within the prostate without extraprostatic extension. The dominant nodule was not present. Lymph nodes on both the right and left pelvic sides showed no evidence of involvement. Tissue anterior to the prostate consisted of mature adipose tissue without any suspicious findings. The staging was determined as pT2c, pNO, pMX. All surgical margins were free of involvement. Multiple sections of the prostate, including the apical, mid, and upper regions, were submitted for analysis."} +{"pid": "TCGA-55-8508", "report": "A single lymph node was identified in the interlobar region and showed no evidence of malignant involvement. The right upper lobe specimen measured 14.7 x 11.7 x 2.5 cm and exhibited a red-gray pleural surface with mild adhesions. A firm, elevated, puckered area measuring 3.6 cm was observed on the pleural surface and had been marked with black ink. Upon sectioning, a gray-tan mass measuring 3.7 x 3.3 x 1.5 cm was identified; it was ill-defined and located close to the pleura, coming within 3 cm of the bronchial margin. An additional smaller mass measuring 0.8 x 0.7 x 0.7 cm was found 1.2 cm away from the larger mass, sharing similar histological features. This smaller lesion was within 1 cm of the pleural surface and approximately 4.3 cm from the bronchial margin. The surrounding lung tissue appeared red-tan with mild congestion and no other notable lesions. Mild emphysematous changes were observed at the periphery. Five lymph nodes were identified in the peribronchial region, ranging from 0.6 to 0.9 cm in size. One of these lymph nodes contained metastatic cells. The surgical margins at the bronchus were free of involvement. Based on staging criteria, the findings corresponded to T2a,N1 classification."} +{"pid": "TCGA-VR-A8EU", "report": "The specimen includes the esophagus and proximal stomach following an esophagogastrectomy. The tumor is located in the mid-third of the esophagus and measures 4.2 cm in greatest dimension. Histologic evaluation shows moderately differentiated squamous cell carcinoma with invasion through the submucosa. There is no evidence of lymph-vascular or perineural invasion. Peritumoral desmoplasia is minimal, and there is a moderate lymphocytic infiltrate around the tumor. The gastric mucosa appears congested. Surgical margins are free of involvement by carcinoma.\n\nA total of 13 regional lymph nodes were examined: 1 out of 2 left paracardic nodes, none of 1 right paracardic node, none of 6 along the lesser curvature of the stomach, and 1 out of 4 at the celiac trunk. Two additional periesophageal lymph nodes were examined, and none showed involvement. The esophageal margin is also uninvolved."} +{"pid": "TCGA-WZ-A7V3", "report": "The surgical specimen consists of a right radical orchiectomy. The tumor measures 4.2 x 2.7 x 2.7 cm and is unifocal. Grossly, the tumor is heterogeneous, with a soft, friable tan-pink component and a solid tan-pink component. The surrounding testicular tissue appears normal. Microscopically, the tumor is limited to the testis and does not extend into the tunica vaginalis or involve the epididymis. The tumor approaches the tunica albuginea but does not penetrate it. No lymphatic or vascular invasion is identified. The surgical resection margins, including the spermatic cord, are free of tumor involvement. There is associated intratubular germ cell neoplasia present. The regional lymph nodes cannot be assessed. No distant metastasis is found. The pathologic stage is pT1NXMO, corresponding to stage I based on 2010 staging criteria. Tumor markers were not available for assessment. The tumor was submitted in 15 cassettes, including sections from the tumor, adjacent structures, and resection margins. Intraoperative frozen section consultation noted a germ cell tumor with non-seminomatous component. The final microscopic evaluation supports the findings described."} +{"pid": "TCGA-DJ-A3UM", "report": "The specimen consists of a total thyroidectomy measuring 14 grams. The right lobe measures 5 x 3.2 x 0.7 cm, the left lobe 3.6 x 2.4 x 1 cm, and the isthmus 1.8 x 0.4 x 0.3 cm. Sectioning reveals a nodule measuring 1.3 x 0.9 x 0.8 cm located in the mid left pole. The nodule is partially cystic and contains calcifications. It appears to be non-encapsulated. No invasion of blood vessels or surrounding capsule is identified. No necrosis or mitotic activity is observed. The surgical margins are free of involvement. No multicentricity or additional adenomas are identified. The remainder of the thyroid tissue shows changes consistent with nodular hyperplasia. One intra-thyroid parathyroid gland is noted and appears unremarkable. Three lymph nodes are examined and all are benign. Representative sections from all areas of the thyroid have been submitted for analysis."} +{"pid": "TCGA-AA-3675", "report": "The ileocolic resection specimen shows a centrally ulcerated, moderately differentiated adenocarcinoma in the region of the right flexure, measuring up to 4.5 cm in maximum diameter. There is early infiltration into the pericolic fatty tissue, with the maximum depth of invasion in the histological section being less than 1 mm. No tumor involvement is identified in the regional lymph nodes, and the resection margins of both the small intestine and colon are free of tumor. Additionally, three tubular adenomas of the colon mucosa with mild to moderate dysplasia are present. Pathological staging is pT3 pNO (0/24) pMX; histological grade G2, with no evidence of lymphatic or vascular invasion (L0, V0), and clear resection margins (R0)."} +{"pid": "TCGA-NJ-A4YP", "report": "The pathology report includes multiple specimens collected during a surgical procedure involving lymph nodes and lung tissue. Specimens from Level 7, Level 9, Level 10, and Level 11 lymph nodes on the right side were examined, all of which were negative for malignancy. One lymph node from Level 9 and one from Level 11 were individually assessed and showed no evidence of abnormal cells.\n\nA right lower lobectomy specimen was evaluated and demonstrated a firm white mass measuring 3.4 cm in greatest dimension located adjacent to the main bronchus. Microscopic examination revealed invasive cellular growth with papillary features and high nuclear grade (grade 3). The tumor was found to be 2.4 cm from the bronchial margin and 0.5 cm from the pleural margin. No involvement of vascular or parenchymal margins was observed. Histologic evaluation showed no invasion into lymphatic or blood vessels, and no spread to surrounding structures or pleural layers.\n\nLymph nodes collected from Levels 7, 9, 10, and 11 on the right side were all negative for abnormal cellular infiltration. Additional findings included post-obstructive pneumonia in the adjacent lung tissue. Gross examination of the lung specimen showed localized consolidation near the tumor site, while the remainder of the lung appeared normal. Based on these findings, staging was determined as pT2aNO."} +{"pid": "TCGA-CV-7409", "report": "The specimen includes a tracheal stoma, right modified neck dissection, total laryngectomy, partial pharyngectomy, right thyroidectomy, and left modified neck dissection. Histologic evaluation of the resected tissue showed skeletal muscle and fibroconnective tissue with granulation tissue, foreign body giant cell reaction, and ulceration. The primary lesion measured 8.0 x 6.5 x 3.0 cm and was centered in the epiglottis, extending beyond the thyroid cartilage into anterior soft tissues with a depth of invasion of 3.0 cm. Sections of the hyoid bone revealed focal bone involvement. Lymphatic invasion was present, and all surgical margins were free of tumor.\n\nExamination of lymph nodes revealed metastatic involvement in 3 of 48 right cervical nodes: 1 of 11 subdigastric, 1 of 6 midjugular, and 1 of 2 mid posterior cervical nodes. No metastases were found in lower jugular, upper posterior cervical, suprclavicular-scalene, or thyroid compartment nodes on the right. On the left, 4 of 3 cervical nodes were involved: 1 of 3 subdigastric, 2 of 6 jugular, and 1 of 1 midjugular node. The largest metastatic deposit measured 4.0 cm and was identified in the right subdigastric and right midjugular regions, with extranodal extension into the adjacent jugular vein wall noted in those areas.\n\nOther sampled sites including the mucosal margin of the tongue, right and left pyriform sinuses, cricoid, left pharynx, tracheal mucosa, right tonsil, right pharynx, and teeth showed no evidence of tumor. The thyroid gland was also free of tumor."} +{"pid": "TCGA-XF-A9SK", "report": "A segment of right distal ureter was examined and showed reactive cellular changes with moderate urothelial atypia and increased mitoses. No high-grade atypia or concerning features were identified. A left distal ureter specimen also showed no evidence of high-grade atypia or malignancy. The urethral margin was submitted for analysis, but no urothelial tissue was identified on evaluation. A radical cystectomy specimen included a urinary bladder lesion that measured 4 x 3 x 2.3 cm and extended through the full thickness of the bladder wall into the perivesical soft tissue. Histological examination revealed sheets of abnormal cells with areas of necrosis, along with perineural and vascular invasion. Adjacent urothelium showed focal in situ changes, and the bilateral ureteral orifices demonstrated moderate dysplasia. The closest radial inked margin was 1.5 mm from the tumor. All surgical margins were free of tumor involvement.\n\nLymph node analysis revealed metastatic carcinoma in one of two perivesical lymph nodes. Additionally, metastatic disease was found in two out of twenty-four right external iliac lymph nodes. The remaining lymph nodes evaluated, including para-aortic, inner aortocaval, paracaval, right and left common iliac, presacral, right lymph node of Cloquet, right obturator/hypogastric, left external iliac, left lymph node of Cloquet, left hypogastric/obturator, right and left presciatic, and left common iliac #2, showed no evidence of tumor involvement. In total, 3 out of 108 lymph nodes examined contained metastatic disease.\n\nThe prostate showed granulomatous prostatitis involving both lobes, with no evidence of high-grade intraepithelial neoplasia or adenocarcinoma. Bilateral seminal vesicles and vasa deferentia were free of tumor. The prostatic urethra also showed no evidence of urothelial dysplasia. Sections of the left and right proximal ureters showed reactive cellular changes without any high-grade atypia or malignancy. Surrounding periureteral tissue in both specimens showed myxoid degeneration. \n\nAdditional testing, including p53 analysis, was performed on sections of the lesion, with results to be provided in a separate addendum."} +{"pid": "TCGA-C5-A1M9", "report": "The specimen labeled \"cervical\" consists of granular to nodular tan fragments measuring up to 2 cm in aggregate, along with hemorrhagic material also totaling approximately 2 cm. The \"endo\" specimen contains tan bits aggregating to 0.5 cm. Microscopic examination reveals both samples contain large fragments of a high-grade papillary carcinoma with areas of necrosis and inflammation. Stromal invasion is observed. No normal tissue is present, making it difficult to determine if the tumor is of cervical or endometrial origin. Features are more suggestive of an endometrial source, though the patient's age may be atypical for such a presentation."} +{"pid": "TCGA-AA-3554", "report": "The resected ileocolic material shows a lesion in the ascending colon, located approximately 2 cm distal to the ileocecal valve. The lesion measures up to 4 cm in diameter and is characterized by ulceration and moderate differentiation. Histological evaluation confirms infiltration into the surrounding adipose tissue. Lymph node examination of the pericolonic region reveals no evidence of tumor involvement, with all 39 lymph nodes being free of malignancy. All resection margins, including those of the small and large intestine, mesentery, appendix, and omental fat, are tumor-free. Pathological staging indicates pT3, pN0 (0/39), pMX; histological grade G2, with no lymphovascular invasion noted (L0, V0) and a complete resection margin (R0)."} +{"pid": "TCGA-CV-7104", "report": "The specimen includes a 17.5 x 10.4 x 6.2 cm surgical resection consisting of the tongue, left pharynx, left mandible, and left neck contents. The left neck contents correspond to levels I through V. Within the left tonsillar region, extending to the left pharynx and posterior lateral aspect of the tongue, there is an ulcerated tan-red lesion measuring 2.5 x 2.3 cm with a depth of 0.8 cm. Sectioning reveals gray-tan, rubbery tissue with a thickness of 0.8 cm in this area. In the anterior tongue, a gray-tan, rubbery, and fairly well-circumscribed mass measures 1.5 x 1.3 x 0.8 cm. The submucosal tissue in the midportion of the tongue between these two areas appears gray-tan and rubbery.\n\nIn the level I neck contents, a gray-white, poorly circumscribed rubbery mass measuring 1.5 x 1.5 x 1.0 cm is identified. Also within level I, a fibrotic submandibular gland (1.6 x 1.3 x 1.2 cm) and four possible lymph nodes (ranging from 0.3 cm to 0.9 x 0.8 x 0.8 cm) are present. In level II, a gray-tan, rubbery mass measuring 2.0 x 1.5 x 0.9 cm is found. Twelve possible lymph nodes are identified in level III, ranging in size from 0.1 cm to 1.3 x 0.7 x 0.7 cm. Four possible lymph nodes in level IV range from 0.1 cm to 0.5 x 0.4 x 0.4 cm. In level V, twelve possible lymph nodes are identified, ranging from 0.1 cm to 0.4 x 0.3 x 0.2 cm.\n\nMicroscopic evaluation reveals multiple foci of abnormal cells involving fibroadipose tissue and skeletal muscle across all levels. Perineural invasion is present. Vascular and lymphatic invasion are also noted. A total of 8 out of 30 lymph nodes show involvement, with distribution as follows: 2 of 4 in level I, 1 of 1 in level II, 4 of 13 in level III, none of 4 in level IV, and 1 of 8 in level V. Margins are free of abnormal cellular aggregates. The salivary gland shows only chronic inflammation without any evidence of abnormal cellular infiltration. Multiple sections were taken from various regions for histologic analysis, including mucosal margins, masses, and lymph node levels. Some lymph nodes appear replaced by fibrotic or nodular tissue."} +{"pid": "TCGA-23-2649", "report": "Fluorescence in situ hybridization (FISH) analysis was performed on a tissue block (B13) using probes specific for a gene of interest and chromosome 17. The signal pattern was not amplified, with a ratio of 1.4 between the gene and chromosome 17. The average number of gene copies per tumor cell was 3.5, while the average number of chromosome 17 centromeres per tumor cell was 2.2. A total of 20 cells were analyzed. A ratio of \u22652.2 is considered amplified, \u22641.8 is considered not amplified, and values between 1.8 and 2.2 are considered equivocal. Nuclei selected for analysis were from regions identified by a pathologist, and the sample was fixed in 10% neutral buffered formalin. An adequate number of tumor cells were available for evaluation.\n\nAdditional FISH testing for another gene on chromosome 7 was conducted, showing polysomy in 65% of the nuclei examined. In this context, polysomy correlates with an amplified signal pattern. A total of 40 cells were evaluated. For this test, positivity is defined as a signal ratio \u22652.0 in at least 10% of cells or four or more gene copies in at least 40% of cells. If these thresholds are not met, results are considered inconclusive.\n\nImmunohistochemical studies showed that approximately 70% of neoplastic cells had positive nuclear staining for estrogen receptor (intensity 1\u20133 out of 3), while less than 10% showed positivity for progesterone receptor (also intensity 1\u20133). Less than 3% of neoplastic cells exhibited positive staining for epidermal growth factor receptor.\n\nMultiple tissue specimens were examined, including left and right ovaries, fallopian tubes, uterus, omentum, peritoneal tissues, appendix, and umbilical skin. Tumor involvement was noted in both ovaries, with the left ovary showing a larger tumor measuring 6.0 cm in maximum dimension. The right ovarian tumor measured 2.5 cm. Tumor was also present on the serosal surfaces of the ovaries and fallopian tubes, within the fallopian tube mucosa, stroma, and muscular wall, and in parametrial, uterine, cervical, and endometrial tissues. Metastatic involvement was identified in the omentum, appendix (involving mesosalpinx, serosa, subserosa, and outer muscular wall), and peritoneal sites including the cul-de-sac and sidewall regions. A small focus of tumor was also found microscopically in a biopsy of the umbilical skin, though it was described as crushed and poorly preserved.\n\nLymphovascular invasion was present in multiple sites, including the ovary, fallopian tube, and uterus. The histologic grade of the tumor was high (G3), with a mixed composition of serous (25%) and undifferentiated (75%) components. The primary tumor site could not be definitively determined, although the left ovary appeared to be the likely primary site. The right ovary could not be confirmed as either a metastasis or a second primary.\n\nThe tumor was staged as pT3c, indicating macroscopic peritoneal metastasis beyond the pelvis greater than 2 cm in greatest dimension. Regional lymph node status could not be assessed (pNX) as no lymph nodes were identified for evaluation.\n\nMacroscopic findings included a 4.0 cm tumor mass in the anterior uterine wall, with similar tan-white tumor deposits seen on the external surface of the uterus and cervix ranging from 0.5 to 1.5 cm. The omentum contained multiple tan firm nodules up to 2.5 cm in size. The right sidewall specimen measured 7.5 x 6.0 x 2.7 cm in aggregate, with individual tumor nodules up to 0.5 cm. The left sidewall specimen was largely replaced by tumor, with deposits up to 5.5 cm. The appendix was partially involved with tumor up to 1.2 cm in size, and the umbilical biopsy showed only a small focus of tumor.\n\nAdditional findings included a 1.3 cm intramural leiomyoma in the lower uterine segment, cystic epithelial inclusions in the ovary, and a paratubal cyst lined by benign serous epithelium. Fibrosis and chronic inflammation were noted in the cervix, along with other benign changes such as squamous metaplasia and endocervical hyperplasia. No uninvolved tissue was evident in some specimens, and all samples were fixed in formalin and processed for histological evaluation. Multiple blocks from each specimen were submitted for microscopic review."} +{"pid": "TCGA-DX-AB3C", "report": "A biopsy was performed on a right popliteal mass, with additional biopsies taken from the proximal, distal, medial, lateral, and deep margins. The excision specimen measured 9.5 x 9.5 x 7 cm and was oriented with multiple sutures. The external surface included muscle, tendinous tissue, fat, smooth glistening tissue, and cauterized irregular tissue. The resected specimen revealed a well-circumscribed mass measuring 7.1 x 6.9 x 5.3 cm with a variegated and friable cut surface, including tan-pink homogenous areas, necrosis (estimated at 20%), and cystic degeneration. A 4.5 cm cyst with a red-tan necrotic lining was noted in the lateral wall.\n\nHistological examination of the main specimen showed high-grade monophasic morphology involving skeletal muscle. The tumor demonstrated predominantly small blue round cell features and areas of necrosis. The tumor was found to be 0.1 cm from the lateral margin, less than 0.1 cm from both the anterior and posterior margins, while the remaining margins (proximal, distal, medial) showed no evidence of tumor involvement. One lymph node was identified as benign.\n\nAll margin specimens were submitted in entirety for frozen section analysis and showed only fibroadipose tissue, skeletal muscle, or fibroconnective tissue without any findings of concern. Intraoperative frozen section diagnoses were consistent with the final permanent diagnoses for all specimens."} +{"pid": "TCGA-EJ-5507", "report": "The patient is a male with a history of a PSA value of 8.85 and a prior biopsy that showed multiple areas of involvement in the prostate. A radical prostatectomy was performed. The surgical specimen included lymph nodes and prostate tissue.\n\nIn the right pelvic lymph node group, metastatic carcinoma was identified in 1 out of 13 nodes, with extranodal extension present. In the left pelvic lymph node group, metastatic carcinoma was found in 1 of 8 nodes. \n\nExamination of the prostate and bilateral seminal vesicles revealed a tumor with a Gleason score of 4+5. The tumor involved both the right and left lobes of the prostate, with a maximum nodule size of 2 cm in one histologic section. Approximately 35% of the examined prostate volume was affected. There was extensive extraprostatic extension and bilateral seminal vesicle involvement. All resected margins were free of tumor. Extensive perineural invasion was noted, and high-grade prostatic intraepithelial neoplasia was also present. Pathologic staging was determined as pT3b N1 MX. The background prostate tissue showed nodular hyperplasia and chronic inflammation.\n\nA separate specimen labeled \"right pedicle margin\" showed fibrovascular tissue with crush artifact and focal atypical areas. Immunohistochemical stains were performed but results were pending at the time of reporting.\n\nA total of 21 lymph nodes were evaluated, with 2 showing evidence of metastasis. The largest nodal metastasis measured 1.5 mm. The histologic grade of the tumor was classified as G3-4, consistent with poorly differentiated or undifferentiated morphology. The tumor occupied more than 25% of the prostate specimen and was multifocal. Angiolymphatic invasion status could not be determined."} +{"pid": "TCGA-VQ-A8PP", "report": "The specimen includes a subtotal gastrectomy with involvement of the stomach body. A lesion measuring 9.5 x 7.0 cm is present, exhibiting intestinal-type morphology according to Lauren classification. The lesion extends into adipose tissue and involves the peritoneum. Extensive areas of necrosis are noted within the lesion. Lymphatic infiltration is observed. There is no evidence of venous or perineural invasion. The surrounding stroma shows intense desmoplastic reaction. No significant intratumoral inflammatory cells are identified. Adjacent gastric mucosa displays chronic gastritis with moderate atrophy and intestinal metaplasia. The surgical margins are free of abnormal cellular proliferation.\n\nLymph nodes were assessed at multiple locations including right paracardial, lesser curvature, suprapyloric, infrapyloric, celiac trunk, gastroepiploic, and anterior hepatic artery regions. Involvement is noted in three out of five lymph nodes dissected along the right gastroepiploic region. All other lymph node groups examined show no presence of abnormal cells."} +{"pid": "TCGA-E2-A15O", "report": "The right breast specimen was an oriented needle-localized lumpectomy measuring 5.0 x 5.0 x 4.5 cm and weighing 63 grams. Serial sectioning revealed a firm tan stellate mass measuring 2.4 x 1.9 x 1.6 cm, located closest to the superior margin at 0.2 cm. Multiple tissue sections were submitted for microscopic evaluation, including margins and representative slices of the lesion. An additional margin specimen from the right breast was received as a small fibrofatty tissue measuring 0.2 x 3.4 x 1.1 cm; no discrete lesion was identified upon sectioning.\n\nThe left breast specimen was also an oriented needle-localized lumpectomy, measuring 4 x 4 x 3.5 cm and weighing 42 grams. A firm tan stellate mass measuring 2.4 x 1.9 x 1.8 cm was identified and found closest to the superior margin at 0.1 cm. Representative sections of the mass and margins were submitted microscopically.\n\nHistological evaluation of the right breast lesion demonstrated intermediate nuclear grade features with a tubular score of 2, mitotic score of 3, and overall modified Scarff-Bloom-Richardson grade of 2. No necrosis or vascular/lymphatic invasion was identified. The lesion was focally present at the superior margin and within 1 mm of the medial margin. Additional findings included lobular neoplasia and biopsy site changes with fibrosis. Ductal carcinoma in situ was present in solid and cribriform patterns, involving approximately 10% of the lesion, with central necrosis and microcalcifications noted. Immunohistochemistry showed positivity for ER and PR, and negativity for HER2 by IHC. Pathological staging was pT2Nx based on AJCC 7th edition criteria.\n\nIn the left breast, histology showed similar morphologic features with a modified Scarff-Bloom-Richardson grade of 2, tubular score of 2, and mitotic score of 2. No necrosis or vascular/lymphatic invasion was observed. The tumor was negative at all surgical margins, with the closest distance being 0.3 cm at the superior aspect. Lobular neoplasia was also present. ER and PR were positive, and HER2 was negative by FISH. Pathological staging was pT1cNx.\n\nBoth specimens showed evidence of biopsy-related fibrosis. No lymph nodes were sampled in either case."} +{"pid": "TCGA-F5-6464", "report": "The specimen consisted of large intestine tissue obtained from an abdominal perineal resection. The tumor was located at the rectosigmoid junction and measured 7.5 x 0 x 7.2 cm. Gross examination revealed ulceration. Microscopic evaluation showed moderately differentiated cellular features. The tumor extended into perirectal tissues. No lymph node metastases were identified in the 12 lymph nodes examined, including those in adjacent fatty tissue. Surgical margins were uninvolved. There was no indication of neoadjuvant treatment effect. No additional findings were reported."} +{"pid": "TCGA-B5-A0JR", "report": "The clinical history includes a gynecologic mass. Gross examination of the uterus, cervix, bilateral tubes, and ovaries revealed a 9 x 7 x 3.2 cm uterus weighing 114 grams. Upon bivalving, a white, friable, polypoid lesion measuring 6.5 x 3.6 cm was identified involving both the anterior and posterior endometrium. The lesion demonstrated myoinvasion, extending 1 cm into a 1.4 cm thick anterior uterine wall and 1.1 cm into a 1.5 cm posterior wall. No gross involvement of the endocervical canal was noted. Distances from the ectocervix were 4.2 cm on the anterior portion and 4.6 cm on the posterior portion. A small amount of uninvolved endometrium remained. A 0.6 x 0.5 x 0.4 cm nodule in the posterior endocervix appeared well-circumscribed and was consistent with a submucosal leiomyoma. Both ovaries were hemorrhagic but otherwise unremarkable. The fallopian tubes showed no significant abnormalities except for cautery artifact and discontinuity in the right tube.\n\nA skin-lined polypoid lesion measuring 2.2 x 1.8 x 0.7 cm was received from the anal region and entirely submitted for evaluation.\n\nLymph node dissections included left pelvic (6.5 x 5 x 2 cm), right pelvic (6 x 5 x 2 cm), right aortic (4.5 x 3 x 2 cm), left aortic (2.6 x 1 x 0.5 cm), and right common iliac (2.3 x 0.7 x 0.4 cm) specimens. These were extensively sampled with multiple blocks containing lymph node candidates. All lymph nodes evaluated across all sites were negative for tumor involvement: 19 nodes from the left pelvis, 13 from the right pelvis, 4 from the right aorta, 2 from the left aorta, and fat only from the right common iliac.\n\nMicroscopic evaluation of the uterine specimen revealed a poorly differentiated cellular proliferation composed in part of sheets of undifferentiated cells and areas of tightly clustered small acini. Some regions suggested slight squamous differentiation. Immunostains for chromogranin and synaptophysin were negative, ruling out neuroendocrine differentiation. Adjacent non-neoplastic endometrium showed atrophy. The cervix, serosa, and remaining myometrium were unremarkable. Ovaries and fallopian tubes were free of tumor. Surgical margins were negative. The anal skin tag showed no evidence of malignancy.\n\nStaging according to AJCC 6th edition criteria was pTlc pNO pMX."} +{"pid": "TCGA-77-8148", "report": "Histopathology Report. HISTORY. A lesion located near the main bronchus on the left side. Left pneumonectomy performed. MACROSCOPIC. Two specimens were received. Specimen 1 includes a left lung pneumonectomy specimen containing upper and lower lobes, measuring 265 mm in length by 170 mm in width. The left main bronchus extends 22 mm from the hilar margin. A 42 mm white spiculated mass is identified distal to the bifurcation of the left main bronchus, located approximately 2 mm from the superior hilar resection margin. The mass appears to involve surrounding lymph nodes and is associated with purulent exudate distal to the tumor margin. The pleural margin within the oblique fissure is also affected. Sections include multiple areas of interest: bronchial resection margins, peribronchial and hilar soft tissue margins, a representative section of the mass involving the left main bronchus, exudate distal to the obstruction, and normal lung tissue away from the lesion. Specimen 2 is labeled as a lymph node (No. 5), measuring 13 x 12 x 8 mm, composed of adipose and nodal tissue, bisected for examination. MICROSCOPY. Microscopic evaluation reveals a poorly differentiated carcinoma with an extensive parenchymal component. Central necrosis is present. A small endobronchial component is noted along with invasion into hilar fat. Metastatic involvement is confirmed in at least one peribronchial lymph node. The tumor is surrounded by distal bronchiectasis and focal lipid pneumonia; mild emphysema is also observed. The resection margin in the surrounding fat is narrowly clear. No evidence of vascular, lymphatic, or perineural invasion is seen. Specimen 2 shows only reactive lymphoid tissue without any signs of malignancy. SUMMARY. The left pneumonectomy specimen demonstrates a 42 mm tumor with involvement of the hilar fat and metastasis to a peribronchial lymph node. No vascular, lymphatic, or pleural invasion was identified. The pathological staging is consistent with T3 N1. CC: Lung Cancer Registry."} +{"pid": "TCGA-AR-A0U2", "report": "The specimen from the left breast radical mastectomy shows a Nottingham grade III lesion measuring 3.2 x 2.2 x 1.6 cm, located near the biopsy cavity in the central breast. Additional microscopic findings include two distinct invasive foci greater than 2.0 mm in the subareolar region, associated with high-grade ductal changes. Vascular space invasion is present, and all surgical margins are free of malignant cells. Axillary lymph node dissection on the left side reveals involvement of 4 out of 16 nodes, with the largest deposit measuring 3.0 cm and demonstrating extracapsular spread. The right and left fallopian tubes and ovaries show no notable pathological changes. Immunohistochemical studies have been initiated on preserved tissue."} +{"pid": "TCGA-BR-8592", "report": "The specimen consisted of a gastrectomy with a tumor located in the fundus measuring 11 x 9 x 1 cm. The tumor was ulcerated and histologically classified as diffuse-type adenocarcinoma. The tumor extended to adjacent structures, specifically involving the lesser omentum. Lymph node evaluation revealed 1 out of 3 positive nodes for metastasis within the intraabdominal region. Lymphatic, venous, and perineural invasion were not specified. Surgical margins were free of tumor involvement. There was no evidence of neoadjuvant treatment effect, and no additional pathologic findings or comments were noted."} +{"pid": "TCGA-55-6543", "report": "The surgical specimens include multiple lymph nodes and a right upper lobe lung resection. Lymph nodes from levels 4, 10, and 11 are all benign with hyperplastic changes. The right upper lobe specimen measures 13.0 x 10.5 x 4.0 cm and contains a 3.0 x 2.0 x 2.0 cm mucoid mass located peripherally. The mass is yellow-tan, glistening, and approaches the pleural surface within less than 0.1 cm, while maintaining a distance of 2.5 cm from the bronchial and parenchymal margins. No discrete masses are otherwise identified. Histologically, the lesion shows low-grade features with mucinous and bronchoalveolar patterns. No visceral pleural invasion or lymphovascular space invasion is observed. The tumor is confined to the lung and no metastases are found in seven examined lymph nodes. Surgical margins are free, with the closest margin being 2.5 cm from the tumor. Intraoperative frozen section confirms the histologic findings, and immunohistochemical staining demonstrates positivity for CK7 and TTF-1, with no expression of CK20 or CDX2. All other submitted tissue samples show no evidence of involvement."} +{"pid": "TCGA-E9-A1RB", "report": "The specimen consists of breast tissue with a lesion located in the central region. Gross examination reveals a mass measuring approximately 2.7 x 2.5 cm. The surrounding fatty lymph nodes appear soft and hyperemic. Histologic evaluation shows moderately differentiated infiltrating ductal carcinoma. Ten lymph nodes were examined, all of which demonstrate fibrotic changes and lipomatosis without evidence of metastatic involvement. The tumor is classified as T2 based on size greater than 2 cm but less than 5 cm. No venous invasion is identified. Surgical margins are uninvolved. The histologic grade is G2; however, components of the Nottingham score could not be fully assessed due to insufficient data. The specimen was obtained via radical mastectomy from the left upper inner quadrant. No other significant pathologic findings or treatment effects are noted."} +{"pid": "TCGA-DW-7837", "report": "The right kidney partial nephrectomy specimen consists of a unifocal mass measuring 5.5 x 4.2 x 2.3 cm, tan and friable in appearance, with a small rim of normal parenchyma. A second adjacent nodule measuring 0.5 x 0.4 cm is also present. Approximately 50% of both lesions along with 5 mL of normal kidney parenchyma was procured for research. Macroscopic images were taken and the specimen was serially sectioned with representative sections submitted for histologic evaluation. The overlying adipose tissue specimen consists of two pieces of yellow fat measuring 3.5 x 3 x 0.5 cm in aggregate; no gross abnormality is identified and the entire specimen is submitted for microscopic examination.\n\nMicroscopic evaluation demonstrates a primary lesion limited to the kidney. Histologic features include cells arranged in papillary structures with associated stromal support. The tumor is classified as pT1b based on size and extent of invasion. No regional lymph nodes or distant metastases are identified; however, regional lymph nodes and distant metastasis cannot be assessed based on current specimen sampling. Surgical margins are not assessable. Additional findings include bilaterally multifocal tumors noted in the pre-operative and post-operative clinical setting. A satellite lesion is identified at the upper pole of the right kidney."} +{"pid": "TCGA-WX-AA46", "report": "The specimen consisted of a right posterior hepatectomy and gallbladder. The liver specimen weighed 397 grams and measured 14 x 12 x 6.5 cm. A well-circumscribed subcapsular mass measuring 3 x 2.5 x 2 cm was identified, with tan-white coloration and areas of central hemorrhage and necrosis. Adjacent to the mass was a 1.5 x 1.5 cm area filled with necrotic material suggestive of tumor thrombus within a portal vessel, located approximately 0.4 cm from the surgical margin. A separate 0.5 cm tan-brown nodule was observed 0.8 cm from the main lesion. No other masses were identified grossly. The remaining liver parenchyma appeared normal without signs of cirrhosis.\n\nHistologic examination revealed a solitary lesion measuring 3 cm in maximum dimension. Microscopic evaluation showed that the lesion had a well-differentiated morphology with adenoma-like features in certain areas. Focal bile ductular reaction was highlighted by CK7 and CK19 immunostains. There was also focal telangiectasia noted. Immunohistochemical staining showed patchy positivity for glutamine synthetase and extensive sinusoidal staining with CD34. Glypican-3, beta-catenin, HSP70, and amyloid A were negative. CK7 also demonstrated positivity in periseptal hepatocytes. Reticulin stain demonstrated focal thickening of hepatic cords and mild cytologic atypia.\n\nA large portal tract adjacent to the tumor contained necrotic material surrounded by dense fibrosis and hemosiderin-laden macrophages. Although identification of venous wall architecture was limited, this finding was interpreted as evidence of vascular invasion. Thrombosed vessels were also identified in this region using elastic stains. Surgical margins were free of invasive carcinoma, with the closest distance of tumor to margin being 10 mm. No microscopic lymphovascular invasion was identified. The histologic grade was well differentiated (G1). Pathologic staging based on AJCC 2010 criteria was pT2 NX MX, Stage II.\n\nAdditional findings included a gallbladder with multiple small yellow stones and chronic inflammatory changes in the wall without evidence of malignancy."} +{"pid": "TCGA-HC-8264", "report": "The prostate gland weighed 41 grams and measured approximately 5.0 x 3.9 x 3.5 cm. It was partially sectioned and moderately distorted, with a shaggy capsule. The urethra was patent. The cut surface showed lobulated, focally nodular gray-tan tissue without a distinct mass lesion. Bilateral seminal vesicles measured 6.4 x 2.4 x 1.0 cm and had a multicystic, fibrotic cut surface with no identifiable mass lesions.\n\nSubmitted tissue sections included margins and regions from both distal and proximal areas of the prostate, as well as mid and posterior regions, and seminal vesicle samples. Two lymph node-containing tissue fragments were also received, measuring 6.6 x 4.5 x 1.0 cm. These contained fibroadipose tissue with two nodular areas measuring 1.0 cm and 2.6 cm; the smaller was submitted as A, the larger as B.\n\nMicroscopic evaluation revealed malignancy involving both right and left lobes, accounting for approximately 30% of the total prostate volume. Gleason grading showed primary pattern 4 and secondary pattern 5, resulting in a total score of 9 out of 10. High-grade prostatic intraepithelial neoplasia was present focally. Invasion of lymphovascular spaces and perineural invasion were noted. Extraprostatic extension was identified at the bladder margin and prostate base. Seminal vesicle involvement was also observed.\n\nThe surgical margin at the bladder region showed focal involvement. One of two pelvic lymph nodes contained metastatic carcinoma, with the smaller node being positive. No treatment effect was identified. Pathologic staging was determined as pT3a,b, N1. Some variation in tumor grade was observed, with areas of Gleason grade 3 present alongside higher-grade components. The findings were consistent with prior needle biopsy results and confirmed by an additional reviewing pathologist."} +{"pid": "TCGA-DB-5279", "report": "The specimen consists of tissue from the right frontal region of the brain, measuring 14.0 x 8.0 x 2.5 cm and weighing 111.8 grams. Histologic evaluation reveals a moderately cellular lesion with only scant mitotic activity identified. An old biopsy site with marked reactive changes is present. Multiple sections (Parts A through 11) were obtained from the right frontal area for analysis.\n\nFluorescence in situ hybridization (FISH) studies using paraffin-embedded sections were conducted to assess for chromosomal abnormalities. Two probe pairs were utilized: one targeting 19q with control 19p, and another targeting 1p with control 1q. Both regions are frequently deleted in certain types of gliomas. The 19q to 19p probe ratio was measured at 0.55 and the 1p to 1q probe ratio at 0.56. Ratios below 0.80 are considered indicative of deletion in the respective chromosomal regions. These results are abnormal and support the presence of deletions in both regions. Approximately 46% of the cells analyzed appeared tetraploid, yet still demonstrated relative loss of signals for both probes. Comparable findings have been documented in similar tumor specimens.\n\nA preliminary frozen section consultation indicated a glial tumor; however, further characterization was required for definitive classification. This assessment was performed using a laboratory-developed test that has not received clearance or approval from the U.S. Food and Drug Administration. The test is intended for use as a supplementary tool alongside other clinical and pathological data and does not exclude the possibility of additional chromosomal anomalies."} +{"pid": "TCGA-B0-5694", "report": "A partial nephrectomy specimen from the left kidney was submitted for analysis. The lesion measured 6.0 cm in its greatest dimension and was located in the lower pole. On gross examination, the neoplasm extended into the renal vein; however, no involvement of the vein margin was identified. Microscopically, the histologic type was consistent with a clear cell (conventional) variant. The nuclear grade was Fuhrman grade 3 of 4. All surgical margins were free of tumor involvement.\n\nThe tumor was unifocal and did not involve the perirenal or peripelvic fat. No venous or lymphatic invasion was identified. No regional lymph nodes were examined. The non-neoplastic kidney tissue showed evidence of chronic interstitial inflammation, glomerulosclerosis, and thyroidization. Based on the extent of the primary tumor, the pathologic stage was determined to be pT3b. No other significant pathological findings were noted."} +{"pid": "TCGA-EL-A3T7", "report": "The surgical specimen consists of a total thyroidectomy measuring 7.2 x 3.5 x 1.5 cm. A primary lesion measuring 2.0 x 1.5 x 1.0 cm is identified in the inferior one-half of the right lobe. The lesion is oval, well-circumscribed, and exhibits a friable tan cut surface. No extracapsular extension is observed. Additionally, a smaller 0.2 cm tan nodule is present in the superior pole of the left lobe. The surrounding thyroid parenchyma appears unremarkable and red-brown in color. Histologic evaluation does not show lymphovascular invasion. All resection margins are free of abnormal tissue. Tissue sections submitted for analysis include areas from both lobes and the isthmus."} +{"pid": "TCGA-RB-AA9M", "report": "The surgical specimen included a distal pancreatectomy and splenectomy. The pancreas measured 14.5 x 6.0 x 2.6 cm and the spleen measured 17.0 x 12.0 x 5.2 cm. A mass was identified in the pancreatic tail, measuring 2.0 x 2.0 cm. Histologic examination revealed a poorly differentiated ductal adenocarcinoma confined to the pancreas. Margins were uninvolved by invasive carcinoma, with the closest distance from the tumor to the margin being 10 mm. One of nine lymph nodes examined contained metastatic involvement measuring 0.2 cm without extranodal extension. Vascular space invasion was present along with perineural invasion. No treatment effect was observed. Gross examination showed a firm, white, focally hemorrhagic mass located 1.0 cm from the neck edge, occluding the pancreatic duct. The splenic capsule and cut surface were unremarkable. Sections submitted for analysis included representative areas of the mass, adjacent normal pancreas, spleen, hilar adipose tissue, lymph nodes, and omental tissue. Frozen section analysis of the pancreatic neck margin was negative for invasive carcinoma."} +{"pid": "TCGA-P5-A735", "report": "The clinical evaluation indicated a lesion within the brain. Gross examination revealed white to gray-colored tissue fragments originating from the temporal lobe. Microscopic analysis demonstrated a diffusely infiltrating glial neoplasm with moderate variation in nuclear size and shape. Cellular density was moderately increased. Immunohistochemical staining showed a proliferation index (Ki-67) of up to 7% in focal areas. Based on histopathological features, the lesion exhibited characteristics consistent with a low-grade glioma."} +{"pid": "TCGA-DV-5567", "report": "The right kidney contained multiple excised lesions. A total of nineteen tumors were identified and measured, ranging from 0.2 cm to 2.8 cm in greatest dimension. Most specimens were described as yellow/tan tissue fragments. Tumor #3 measured 0.6 x 0.5 x 0.2 cm; Tumor #7 measured 0.7 x 0.6 x 0.5 cm; Tumor #10 measured 0.2 x 0.2 x 0.2 cm; and Tumor #19 measured 0.8 x 0.8 x 0.5 cm. Several of the larger specimens were partially procured for research purposes.\n\nTumor #11 measured 2.0 x 1.6 x 1.3 cm and was consistent with a cyst wall; Tumor #12 measured 2.0 x 2.0 x 1.5 cm and also resembled a cyst wall; Tumor #13 measured 1.2 x 1.1 x 0.8 cm and showed similar characteristics. Tumor #15 measured 2.2 x 1.7 x 1.5 cm, Tumor #16 measured 2.8 x 2.5 x 2.2 cm (the largest specimen), Tumor #17 measured 2.4 x 1.8 x 1.5 cm, and Tumor #18 measured 2.7 x 2.3 x 1.9 cm\u2014these were all partially allocated for research.\n\nMicroscopic examination revealed varying cellular features. Some specimens showed clusters of cells within fibrous tissue; others exhibited clear cytoplasm with nuclear characteristics graded as II according to a recognized classification system. Certain samples contained benign appearing cystic structures, while others demonstrated atypical morphology suggestive of cystic changes. One specimen consisted of fibrous and hyalinized tissue without significant cellular atypia.\n\nNo evidence of tumor involvement was found in the 11th right rib, which was submitted as three white tissue fragments measuring 4 x 1 x 0.8 cm in total. No lesions were identified in this specimen. All renal specimens were processed and archived for permanent record."} +{"pid": "TCGA-92-8065", "report": "The specimen consists of a left pneumonectomy with associated lymph node biopsies and margin sampling. A central mass measuring 9.5 cm in greatest dimension is identified, located in the left lung and extending into both upper and lower lobes. The lesion is firm, white-tan, well-circumscribed but unencapsulated, with areas of central cavitation or necrosis noted. The tumor invades through the pleura and approaches within 0.5 cm of the bronchial resection margin. No definite lymphovascular invasion is identified. Surgical margins, including bronchial and vascular margins, are free of tumor involvement.\n\nA total of nine lymph nodes were examined from levels 7, 9, 10R, and peribronchial regions. None show evidence of malignancy. Some lymph nodes contain calcified and necrotizing granulomas. Special stains for acid-fast and fungal organisms performed on these granulomas are negative.\n\nThe tumor demonstrates focal chronic inflammation and fibrosis in surrounding tissue. Pleural adhesions are present, and the pleural surface over the tumor is stretched and puckered. Fibrous tissue measuring 11 cm is noted at the mediastinal reflection near the tumor site.\n\nHistologically, the lesion is classified as poorly differentiated squamous cell carcinoma. However, this diagnosis has been omitted per instruction. All other findings have been summarized above."} +{"pid": "TCGA-ZF-A9R1", "report": "The specimen includes a cystoprostatectomy specimen with a bladder measuring approximately 50 mm in diameter and attached adipose tissue measuring 112 mm x 60 mm. The prostate measures 35 mm supero-inferiorly x 45 mm lateral x 28 mm anterior-posterior. On gross examination, the right side of the bladder shows an indurated and ulcerated area measuring up to 20 mm, with pale firm tumor extending into adjacent adipose tissue and approaching the anterior and right surgical margin (blue ink). The remainder of the bladder mucosa appears normal. The prostate demonstrates minor nodular hyperplasia.\n\nMicroscopic evaluation confirms a poorly differentiated, predominantly solid tumor involving the bladder, arranged in discohesive clusters that infiltrate through the full thickness of the bladder wall into the surrounding fat. The tumor approaches within less than 1 mm of the circumferential surgical margin on the right side, which consists of compressed soft tissue. No lymphocytic infiltrate is observed at the tumor interface. Scattered foreign body-type multinucleated giant cells are present in the lamina propria, suggesting prior biopsy site changes. Lymphovascular invasion is identified, but no perineural invasion is seen. There is no evidence of dysplasia or in situ malignancy in the adjacent urothelium. Ulceration is present.\n\nProstatic tissue reveals high-grade intraepithelial neoplasia without invasive adenocarcinoma. Some acini show chronic inflammation with occasional giant cells, likely reactive following BCG treatment. Urethral margins are histologically unremarkable.\n\nLymph node assessment: Peri-bladder adipose tissue contains two lymph nodes, both showing metastatic involvement. One of these demonstrates extracapsular extension. Other regional lymph node groups (right and left external iliac, obturator, and ureteric margins) do not show metastatic involvement. All ureteric margins are histologically normal.\n\nSurgical staging assessment indicates complete resection (R0), although the tumor comes very close to the right circumferential margin."} +{"pid": "TCGA-50-6593", "report": "The right upper lobectomy specimen contains a lesion measuring 1.3 cm in maximum diameter. Histologic evaluation reveals a poorly differentiated adenocarcinoma with a mixed solid and acinar growth pattern. Angiolymphatic invasion is present, but there is no evidence of visceral pleural invasion. All surgical margins are free of tumor involvement, although the invasive component approaches within 12 mm of the bronchial margin. A mild host lymphocytic response is noted.\n\nLymph node assessment includes multiple sampled regions. Of the hilar lymph nodes examined, 6 out of 13 are involved by metastatic disease. In the mediastinal (N2) station, 2 out of 14 lymph nodes contain metastatic involvement. No extracapsular spread is identified in either N1 or N2 lymph nodes. Other lymph node stations show no evidence of tumor involvement.\n\nPathologic staging is determined as pT1 based on tumor size, pN2 due to mediastinal lymph node involvement, and pMX as distant metastasis cannot be assessed. Ancillary studies including histochemical and FISH analyses support the morphologic findings. Vascular invasion is confirmed by elastic tissue staining. Inflammatory or desmoplastic reaction is classified as mild.\n\nAdditional findings include marked emphysematous changes in the lung with respiratory bronchiolitis. Evaluation of a rib segment shows normal bone and marrow without abnormality. Frozen section analysis of the bronchial margin initially showed no tumor, though permanent sections reveal tumor cells within the adventitial cuff; the margin is interpreted as negative despite this proximity.\n\nMultiple molecular tests were performed. No KRAS codon 12/13 mutations, EGFR exon 19 or 21 mutations, or EML4/ALK rearrangement were detected. However, EGFR amplification was identified. These findings may have relevance for treatment planning in advanced disease.\n\nThe case demonstrates a primary pulmonary lesion with regional lymph node spread and no evidence of distant metastasis."} +{"pid": "TCGA-AA-3532", "report": "The resected colon specimen includes a lesion measuring up to 2.5 cm, characterized by moderately differentiated histological features resembling colorectal morphology. The lesion demonstrates infiltration into the surrounding fatty tissue adjacent to the colon. No involvement is identified in the regional lymph nodes, with all 35 examined nodes showing no evidence of tumor. The mesenteric and large intestinal resection margins are free of tumor. Histological evaluation indicates absence of lymphovascular or perineural invasion. The local resection margin is also tumor-free."} +{"pid": "TCGA-AJ-A4ZG", "report": "The patient is a female who underwent surgical resection of multiple anatomical sites. Specimens were received from the left and right ovaries and fallopian tubes, appendix epiploic, uterus with cervix, omentum, left and right ovarian arteries and veins, appendix, liver biopsy, and peritoneal nodule.\n\nGross examination of the uterus revealed a shaggy endometrial mass measuring 5.5 x 3.5 cm. The tumor extended into the myometrium, invading approximately 1.0 cm into a myometrial thickness of 3.2 cm. Involvement of the cervix was noted, with tumor present in the cervical stromal tissue. Vaginal mucosa showed nodular involvement within a 2.5 x 2.0 cm area. The vaginal margin measured 0.1 cm from the tumor, and serosal uterine implants were identified; however, no definitive involvement of the deep margin was seen.\n\nMetastatic involvement was identified in the right ovary and fallopian tube, as well as in the left ovary. The omentum showed multiple fibrotic nodules ranging from 0.3 to 0.8 cm across less than 10% of the surface area. The appendix epiploic specimen contained metastatic changes, and the appendix itself had a small gray tan fibrotic nodule within the surrounding fat, without direct invasion into the appendiceal wall. The left ovarian artery and vein showed evidence of tumor involvement, while the right ovarian artery and vein were uninvolved.\n\nMicroscopic analysis showed high-grade cellular features consistent with serous differentiation. Lymphovascular space invasion was focally present. No lymph nodes were identified for assessment. Other findings included a liver biopsy with prominent cautery artifact but no malignancy, and a peritoneal nodule that was also negative for tumor involvement.\n\nImmunohistochemical staining on selected blocks demonstrated diffuse positivity for p53 and predominantly negative staining for WT1. These findings were associated with extensive sampling and multiple sections taken from various regions of the involved organs."} +{"pid": "TCGA-WB-A815", "report": "The right adrenal specimen weighed 40 g and measured 7 x 5 x 3 cm. A well-defined intra-adrenal nodule measuring 5.5 x 5 x 3 cm was identified. On microscopic examination, the lesion consisted of a cellular proliferation arranged in nests or small clusters within a stroma that varied between fibrous and vascular, with areas containing hemorrhagic lakes. The tumor cells were generally large, with polygonal, moderately eosinophilic cytoplasm. Nuclear features included mild anisokaryosis, pale chromatin, and small, variably distinct nucleoli. In certain regions, there was increased cellularity with smaller cells arranged in layers, indistinct cytoplasmic borders, and elevated nucleocytoplasmic ratio. No necrosis or mitotic figures were observed. The lesion was encapsulated by a fibrous layer of variable thickness, separating it from surrounding adipose tissue and adrenal cortex. There was focal capsular infiltration and vascular invasion, although no extension into peri-adrenal fat was noted. The remainder of the adrenal gland exhibited normal histological architecture without evidence of medullary hyperplasia. The PASS score was calculated as 4, based on high cellularity (2 points), presence of capsular invasion (1 point), and vascular invasion (1 point)."} +{"pid": "TCGA-EM-A22P", "report": "The specimen includes a total thyroidectomy with right neck and mediastinal lymph node dissection. The thyroid gland was received with measurements as follows: right lobe 4.9 x 2.3 x 1.0 cm, left lobe 4.6 x 2.0 x 0.8 cm, and isthmus 2.0 x 1.5 x 0.5 cm. The total weight of the thyroid was 11.6 grams. Two distinct nodular areas were identified. In the upper right lobe, a nodule measuring 1.2 x 0.5 x 0.4 cm was noted. In the upper left lobe, a nodular area measuring 1.0 x 0.5 x 0.4 cm was present. The remainder of the thyroid tissue showed no significant abnormalities, though there was evidence of mild nodular changes and focal inflammation.\n\nLymph node dissections from the mediastinal zone VI and right neck levels II\u2013V were submitted. A total of 28 lymph nodes were examined across all sites, with 14 showing involvement. In the mediastinal zone VI, two out of two lymph nodes were involved. From the right neck dissection, one of four lymph nodes in level II was involved, one of four in level III was involved, and five of six in level IV showed involvement. One lymph node in level IV also demonstrated extranodal extension. No pathological findings were identified in other submitted tissues including soft tissue from right neck level V, unoriented separate tissue, thymus, or parathyroid glands.\n\nHistologically, the nodules displayed classical papillary architecture and cytomorphology. The larger lesion in the right lobe showed widespread capsular invasion, while the smaller lesion in the left lobe was partially encapsulated and also showed invasive features. Surgical margins were involved in the left-sided lesion. No lymphovascular or perineural invasion was identified. No definitive assessment of extrathyroidal extension could be made due to lack of surrounding tissue in the specimen.\n\nA small additional focus measuring 0.1 cm was identified in the left lobe. Additional findings included adenomatoid nodules, nonspecific focal thyroiditis, and normal parathyroid tissue. The staging classification used was based on the AJCC/UICC TNM 7th edition system. Multiple tumor foci were identified, and the regional lymph node category was classified as pN1b due to the presence of metastases in unilateral cervical lymph nodes."} +{"pid": "TCGA-06-0158", "report": "TCG A - 06-0188. Operation/specimen: Brain, left temporal lobe. Two distinct tissue components were identified: one enhancing and one non-enhancing. The patient has a prior history of a brain lesion, with recent clinical deterioration prompting surgical intervention.\n\nIntraoperative consultation identified a glial neoplasm with necrotic changes. Gross pathology consisted of three fragments of soft grayish-white tissue submitted in separate cassettes for detailed analysis.\n\nMicroscopic examination revealed replacement of normal brain parenchyma by a cellular tumor composed predominantly of fibrillary astrocytes. Nuclear pleomorphism was prominent, along with vascular changes including endothelial hypertrophy and hyperplasia. Scattered atypical mitotic figures were observed. One cassette demonstrated multiple areas of coagulation necrosis and a large vessel with recent thrombosis.\n\nThe enhancing tumor specimen measured 0.9 x 0.5 x 0.2 cm and showed features consistent with the previously described neoplasm. The non-enhancing portion measured 1.7 x 1.0 x 0.9 cm and exhibited similar histological characteristics.\n\nHistologic sections from all blocks demonstrated high cellularity, frequent necrotic cells, and prominent vascular proliferation. Immunohistochemical staining with MIB-1 showed labeling of 5 to 10% of neoplastic cells across the specimens. All findings were consistent with previous observations, confirming the original assessment."} +{"pid": "TCGA-EY-A1GI", "report": "The surgical specimen includes a uterus with cervix and endometrium. The myometrial wall has a total thickness of 1.7 cm at the site of deepest involvement, with invasion extending into the outer half of the myometrium to a depth of 1.3 cm (76% penetration). The lower uterine segment mucosa is involved. Focal lymphovascular space invasion is identified. Tumor necrosis is present along with acute inflammation. Hormone receptor status was assessed by immunohistochemistry in prior testing.\n\nSixteen lymph nodes from the right pelvic region were examined, and no tumor involvement was identified. Seven lymph nodes from the left pelvic region were also examined, with no tumor detected.\n\nThe specimen from the uterus is approximately 11.5 cm in height, 5.5 cm in anterior-posterior width, and 6.5 cm in breadth at the fundus. The endometrial cavity measures about 6.5 cm in length and 2.5 cm in width at the fundus. The tumor appears circumferential, measuring approximately 6 cm from cervix to fundus and about 3.3 cm in width. It is lobulated, with white-tan appearance, and occupies most of the endometrial cavity, extending close to the cervical canal. Myometrial invasion is noted at its deepest point with a thickness of 1.1 cm at the site of invasion.\n\nThe adnexal structures are present bilaterally. The right ovary measures 2.2 x 1.8 x 0.6 cm and the right fallopian tube measures 4.0 x 0.6 cm. The left ovary measures 3.0 x 1.6 x 0.7 cm and the left fallopian tube measures 4.4 x 0.6 cm. A benign-appearing simple cyst is observed in the left ovary. \n\nSpecimen B consists of fibrofatty tissue measuring 5.0 x 5.0 x 1.5 cm, containing six lymph node candidates with the largest measuring 2.2 x 1.0 x 0.6 cm. Specimen C consists of fibrofatty tissue measuring 4.5 x 4.0 x 1.7 cm, containing four lymph node candidates with the largest measuring 2.0 x 2.0 x 0.6 cm."} +{"pid": "TCGA-QR-A706", "report": "The surgical specimen consists of multiple tissue fragments submitted for analysis. Five separate specimens were received and processed. Specimen 1, labeled as a margin of resection, is a fibrous tan-red soft tissue fragment measuring 0.7 x 0.5 x 0.3 cm. Specimen 2, also labeled as a resection margin, measures 1.0 x 0.5 x 0.3 cm and has a fibrous red-tan appearance. Specimen 3 is a pink-tan soft tissue fragment measuring 0.8 x 0.4 x 0.3 cm. Specimen 4, similarly described as pink-tan, measures 1.5 x 0.5 x 0.1 cm. These four specimens were all entirely processed and found to contain only fibroadipose tissue or lymph node without any abnormal cellular infiltrates.\n\nThe fifth specimen is a larger oriented soft tissue fragment measuring 9.0 x 6.0 x 2.6 cm with a tan-pink coloration. A central palpable nodule measuring 6.0 x 4.0 x 2.5 cm was identified within this specimen. The nodule had a heterogeneous cut surface with yellow-pink and orange areas. This nodule was inked to identify various margins: superior (blue), inferior (yellow), medial (green), lateral (orange), and anterior (red). Sections from multiple aspects of the nodule in relation to these margins were submitted for histological evaluation. The nodule was located approximately 0.8 cm from the superior margin and appeared to closely approach the inferior margin. No residual tumor cells were identified at any of the evaluated margins. Two lymph nodes were identified and examined; both were negative for any abnormal cellular involvement.\n\nImmunohistochemical studies showed positive staining for chromogranin and synaptophysin. Additional staining highlighted sustentacular cells. All tests used for analysis were developed and validated by the laboratory. The laboratory is certified under CLIA regulations to perform high-complexity testing. No portion of the report containing patient identifiers or confidential information should be filed in the medical record."} +{"pid": "TCGA-S9-A7IQ", "report": "The morphology demonstrates features consistent with both astrocytic and oligodendroglial differentiation. No mitotic activity was identified. The proliferation index is 2%."} +{"pid": "TCGA-CV-5432", "report": "The surgical specimen includes a total laryngectomy, partial pharyngectomy, and bilateral neck dissection with subtotal thyroidectomy. The laryngeal component measures 9.0 x 6.0 x 3.5 cm. A fungating, ulcerated, soft mass measuring 3.5 x 3.5 x 2.0 cm is present in the left supraglottic area, extending 2.5 cm in this region. The lesion involves the left vocal cord and ventricle, approaching the midline without crossing to the right glottic area. Surrounding mucosa appears unremarkable. An isolated nodule measuring 1.5 x 1.0 x 0.4 cm is identified in the left pyriform sinus, separate from the main lesion.\n\nMargins of resection are free of abnormal tissue. Mucosal margins submitted for frozen section include multiple sites from both sides of the larynx and pharynx, all without evidence of malignancy. The tumor was entirely submitted for histologic evaluation.\n\nA total of 64 lymph nodes were evaluated\u201425 from the right cervical region and 39 from the left. All lymph nodes are negative for tumor involvement. The lower jugular lymph node specimen consists of two tan lymph nodes, the largest measuring 0.6 cm in greatest dimension.\n\nThe thyroid gland demonstrates nodular goiter on the right side. A small nodule within the left thyroid is also noted. No tumor involvement is identified in these specimens."} +{"pid": "TCGA-77-8140", "report": "Histopathology Report. HISTORY. Right upper lobe mass. Specimens include right lower lobe lung, right level 4 lymph node, and right middle lobe lymph node.\n\nMACROSCOPIC. Five specimens were received. The first two specimens, from the right upper lobe, were diagnosed as organising pneumonia with a BOOP pattern on frozen section. The first was a wedge of lung tissue measuring 20 x 13 x 5 mm containing a 7 mm pale nodule. The second was a nodule measuring 17 x 9 x 6 mm. The third specimen, a right lower lobe of lung measuring 115 x 90 x 80 mm, showed a puckered pleural surface and a firm mass beneath. A large tumour mass measuring 60 x 48 x 70 mm was identified, with a cream to yellow cut surface and areas of grey to black mottling. The tumour approached the posterior, anterior, and diaphragmatic surfaces, and was approximately 6 mm from the medial pleural margin. The tumour appeared to arise from a bronchial branch about 10 mm from the bronchial resection margin. A large vessel passed through the centre of the tumour but did not appear macroscopically invaded. The remaining lung tissue appeared unremarkable. The fourth specimen was a lymph node measuring 10 x 8 x 6 mm with a pinkish red cut surface. The fifth specimen included two lymph nodes: one measuring 20 x 12 x 10 mm and the other 12 x 7 x 9 mm, both with cream cut surfaces.\n\nMICROSCOPIC. Sections of the first two specimens confirmed organising pneumonia with BOOP-type features and fibrinous exudate on the pleural surface. No malignancy was found. The third specimen showed a moderately to poorly differentiated lesion with focal clear cell change. It was subpleural and associated with scarring. Fibrinous exudate was present on the pleural surface but no tumour was identified there. Focal blood vessel invasion was observed, but no lymphatic or perineural invasion. The pulmonary arteries showed fibrous intimal thickening with features of prior thrombus recanalisation. The infiltrated vessel was distal to this. The lesion was well clear of the bronchial resection margin, though mild active chronic inflammation, squamous metaplasia, and moderate dysplasia were noted. Metastatic involvement was seen in a peribronchial lymph node. The adjacent lung showed emphysema, organising pneumonia, and fibrin-rich nodules. The fourth specimen's lymph nodes showed only reactive changes. The fifth specimen's lymph nodes were extensively replaced by metastatic involvement.\n\nSUMMARY. The lesion measured up to 70 mm in maximum dimension. Vascular invasion was present, but no lymphatic or perineural involvement was identified. There was possible pleural interaction; the diagnosis was clear of the bronchial margin. Metastatic involvement was found in peribronchial and right middle lobe lymph nodes. Staging was consistent with T2N1MX.\n\nSUPPLEMENTARY REPORT. The lesion extended through the inner elastic lamina of the pleura but did not reach the outer lamina or clearly invade the visceral pleura."} +{"pid": "TCGA-WT-AB41", "report": "A left axillary sentinel lymph node measuring 2.8 x 2.5 x 1.3 cm was identified with a single focus of involvement noted on permanent and pancytokeratin immunostained sections. A second left axillary sentinel lymph node measuring 2.5 x 1.8 x 1.0 cm showed no evidence of involvement on initial evaluation, deeper sections, and pancytokeratin immunostaining.\n\nA left breast mastectomy specimen weighing 650 grams measured 20.5 x 18 x 3.5 cm. Two distinct masses were identified. The first was a 1.2 x 1.2 x 0.8 cm tan-pink stellate mass located in the lower inner quadrant at approximately 8 o\u2019clock. It was within 0.1 cm of the medial, inferior, and anterior margins and within 0.2 cm of the deep margin. A second tan-white stellate mass measuring 1.8 x 1.5 x 1.4 cm was located in the mid outer quadrant at approximately 3 o\u2019clock. This mass was 2.4 cm from the superficial margin and 3.7 cm from the deep margin. Both masses were submitted for analysis along with representative sections of surrounding tissue, nipple, and skin. All additional margins including medial, inferior, anterior, posterior, and lateral were free of any diagnostic abnormalities.\n\nHistologic evaluation of the invasive component revealed moderately differentiated features with a Nottingham histologic score of 6 out of 9 (tubule formation score of 3, nuclear grade 2, mitotic count 1). Ductal carcinoma in situ was present focally with intermediate nuclear grade and no necrosis. No lobular carcinoma in situ was identified. Focal lymph-vascular invasion was present; perineural invasion and tumor necrosis were not identified. Nipple or skin involvement was not observed.\n\nLymph node sampling included sentinel nodes only. One of two nodes contained a small focus of involvement measuring 0.23 mm. Extranodal extension was not identified.\n\nAdditional submitted specimens from various regions of the breast and skin showed no diagnostic abnormalities. Specimens were fixed between 6 and 48 hours. Pathologic staging was determined as pT2N(sn)1mi. This stage is provisional and based solely on available pathologic findings."} +{"pid": "TCGA-DJ-A4UT", "report": "The thyroid specimen weighed 8.5 grams and consisted of right and left lobes along with the isthmus. The right lobe measured 3.5 x 2 x 0.8 cm, the left lobe 3 x 2 x 0.8 cm, and the isthmus 1 x 1 x 0.4 cm. A nodule measuring 1.0 x 0.6 x 0.6 cm was identified in the middle lateral portion of the right lobe. It exhibited white cut surfaces and lacked a surrounding capsule. No other nodules or adenomas were observed. The remainder of the thyroid tissue appeared red brown and beefy on sectioning.\n\nHistologic examination revealed a well-differentiated lesion within the right lobe displaying focal oncocytic and tall cell features. Psammoma bodies were present. Mitotic activity and tumor necrosis were not identified. The lesion was unencapsulated and showed no evidence of blood vessel invasion or extrathyroid extension. Surgical margins were free of involvement. Additional microscopic foci measuring up to 0.5 mm were identified in the left lobe.\n\nSections from both lobes and the isthmus were examined. Chronic lymphocytic thyroiditis was noted in the non-neoplastic thyroid tissue. Parathyroid glands were not identified in the submitted material. All relevant sections were reviewed and submitted for permanent histologic evaluation."} +{"pid": "TCGA-E2-A156", "report": "The specimens included two sentinel lymph nodes and one non-sentinel lymph node from the left axilla, a wide excision of a left breast mass, an additional margin specimen from the superior lateral region, and a skin fragment from the anterior margin. Sentinel lymph node #1 measured 1 x 0.5 x 0.3 cm and was entirely submitted. Sentinel lymph node #2 measured 1.3 x 0.5 x 0.2 cm and was also fully submitted. The non-sentinel lymph node measured 1 x 0.5 x 0.4 cm within a larger adipose tissue fragment and was submitted in entirety.\n\nThe wide excision specimen from the left breast weighed 89 grams and measured 9 x 8.4 x 2.5 cm. It contained a soft tan mass measuring 3 x 2.4 x 0.9 cm located 0.3 cm from the posterior margin. A prior biopsy cavity was identified 0.6 cm from the mass on the lateral side, measuring 1.4 x 0.8 x 0.7 cm. The tumor was identified across five consecutive slices. Microscopic evaluation revealed a focus of abnormal cells at the inferior margin. Fibrosis and granulation tissue were noted at the biopsy site. The surgical margins were otherwise free of invasive tumor.\n\nThe additional margin specimen from the superior lateral region weighed 6 grams and measured 5.2 x 3 x 0.8 cm; no gross abnormalities were observed. The entire skin specimen from the anterior margin measured 2.1 x 0.6 x 0.2 cm and showed no signs of tumor involvement.\n\nHistological analysis of the tumor showed intermediate nuclear grade features with tubular differentiation scoring 2, mitotic activity scoring 2, and a modified Scarff-Bloom-Richardson grade of 2. No vascular or lymphatic invasion was identified. The tumor exhibited solid and cribriform patterns with central necrosis and microcalcifications, including an intracystic papillary component. Ductal carcinoma in situ was present in association with the invasive component, estimated at 20%, and involved the inferior margin.\n\nHormone receptor testing showed positivity for estrogen and progesterone receptors, with a HER2-negative result by immunohistochemistry. Oncotype DX assay results yielded a recurrence score of 0, indicating a low risk of distant recurrence at 10 years (approximately 3%).\n\nStaging was determined as pT1c N0, with all three examined lymph nodes negative for metastases."} +{"pid": "TCGA-FX-A48G", "report": "A 567-gram hysterectomy specimen was received, including the cervix, right fallopian tube, and ovary. A mass measuring 13.5 x 9.5 x 8.7 cm was identified within the uterine body, extending to the cervix. The mass appeared lobulated to polypoid, with a gray-white to tan-yellow cut surface and focal hemorrhage. It diffusely involved the myometrium, extended through the serosa, and reached the left parametrial tissue with a depth of 4.5 cm. No uninvolved endometrium was observed. Adjacent to the ovary, another tissue measuring 7.2 x 5.8 x 2.2 cm was noted. Residual ovarian stroma and fallopian tube were present on the left side, while the right ovary and fallopian tube showed no involvement.\n\nBiopsy specimens from the upper vagina revealed infiltrative tumor within soft tissue. Similarly, infiltrative tumor was identified in the left parametrium and uterine tumor biopsies. The cervix excision did not show any tumor involvement. Excised lymph nodes from multiple sites\u2014including the right pelvic (6 nodes), left pelvic (5 nodes total), right periaortic (3 nodes), and left periaortic (4 nodes)\u2014were all negative for metastatic disease. One lymph node was also removed from the right pelvic region during frozen section analysis and was similarly negative.\n\nImmunohistochemical staining performed on representative tissue blocks demonstrated focal weak positivity for smooth muscle actin, strong positivity for desmin, and strong positivity for caldesmon in the tumor cells. All other markers tested\u2014including inhibin, calretinin, vimentin, S100, and pancytokeratin\u2014were negative.\n\nThe surgical margins indicated extension into the serosal space and focal involvement of the left parametrium. No lymphovascular space invasion was identified. Based on staging criteria, the extent of primary tumor involvement corresponded to a stage reflecting extensive local spread without nodal or distant metastasis. The omentum was free of tumor involvement. Multiple biopsy and excision specimens confirmed consistent tumor presence at various locations without evidence of spread to lymph nodes or distant organs."} +{"pid": "TCGA-BA-A6D8", "report": "The surgical specimen included multiple tissue blocks from various anatomical sites. T1 through T4 were taken from the right and left mucosal margins and posterior mandible margins, with decal processing noted for the posterior margins. T5 through T10 assessed margins including black and blue inked areas, as well as viable tongue tissue. T11 and T12 represented sections of firm white nodules within the resected tissue, while T13 to T15 sampled areas suspected of bone involvement, also processed with decal. T16 and T17 were representative sections of the left and right submandibular glands. Lymph node sampling from bilateral neck Level 1 included T18 through T26, with several bisected and inked specimens.\n\nA histopathologic review showed acanthotic squamous mucosa with acute and chronic inflammation in the gingival biopsy; no atypical cells were identified. Biopsies of the right and left mental nerves, lingual nerves, and right bone marrow margin showed no abnormal pathology. The left bone marrow biopsy revealed squamous mucosa over bony spicules with features suggestive of a positive bone marrow margin. The resected mandible specimen demonstrated bone and bone marrow without diagnostic malignant cells, although there was concern for artifactual disruption of epithelium. Both anterior and posterior bone margins were negative.\n\nThe resection specimen involving the mandible, tongue, and floor of mouth measured 7.6 x 8.3 x 7.9 cm. The lesion itself was 5.9 x 5.9 x 4.1 cm, located in the floor of the mouth and extending into the tongue, with soft tissue and bone invasion. Histologic features included necrosis, lymphovascular invasion, large vessel involvement, perineural invasion, and bone invasion. The en face right mucosal and soft tissue margin was involved, whereas the left mucosal margin was negative. The tumor was 5 mm from the blue inked posterior margin and directly abutted the black inked inferior margin.\n\nLymph node assessment in the bilateral neck showed that two soft tissue nodules in Level 1 (left: 2.8 cm, right: 2.5 cm) were interpreted as possibly representing completely replaced lymph nodes or discrete tumor masses within soft tissue, and were considered positive for staging purposes. Additional lymph nodes were identified in left and right Level 1 neck dissections, with 3 negative nodes on the left and 4 negative nodes on the right. In left neck Level 2 dissections, 3 out of 19 lymph nodes contained metastatic disease, measuring up to 3.0 cm with extracapsular extension. Another Level 2 dissection on the left found 2 out of 3 lymph nodes positive, with the largest measuring 4.0 cm. All other lymph node levels sampled (Level 2B, Level 3, and Level 4 bilaterally) were negative.\n\nOther findings included extensive necrosis within the lesion, verrucous hyperplasia of the anterior tongue with candida and bacterial colonization, and sialadenitis with duct ectasia, fibrosis, and oncocytic change in submandibular glands. Immunohistochemical testing for p16 was negative in the lymph node sample T26, with appropriate controls showing reactivity. A diagnosis of HPV high-risk infection had previously been made based on an outside biopsy.\n\nGrossly, the specimen consisted of multiple tissue fragments submitted in labeled containers. The resected mandible with adjacent soft tissue was sectioned to identify a pale tan nodule within bone marrow. Multiple lymph node candidates were identified in the fatty tissue of neck dissection specimens, with serial sectioning revealing cavitary changes and necrotic content in some. The primary lesion in the floor of the mouth extended into the tongue, measuring 5.9 cm in its greatest dimension. A friable exophytic mass was observed on the tongue surface, and several teeth with varying degrees of decay were present in the specimen. A total of 19 teeth were noted in varying stages of caries or restoration.\n\nFrozen section analysis of the anterior mucosal margins, lingual nerves, mental nerves, and bone marrow margins was performed intraoperatively, and all were reported as negative except for the left bone marrow margin, which was positive. The frozen section results were recommended to be correlated with clinical and operative findings. The case was staged pathologically as pT4a pN2c pMx, pending further clinical correlation. An addendum was to be issued once p16 results became available."} +{"pid": "TCGA-B6-A0IJ", "report": "Surgical Pathology: Finels. CLINICAL HISTORY: Large lesion in right breast. GROSS EXAMINATION: A \"Right breast and axilla tissue\" specimen in formalin measures 30 x 18 x 4 cm and includes a 14 x 7.5 x 1.0 cm attached axillary tail. There is a 21 x 15 cm skin ellipse. Sectioning reveals a 5 x 4.5 x 4 cm mass located in the mid upper outer quadrant, composed of firm, white, hemorrhagic tissue. The mass is 2 cm from the deep surgical margin and 1 cm from the skin ellipse. Remaining breast tissue appears unremarkable. The deep surgical margin is inked blue. The axillary tail was sectioned into proximal, middle, and distal portions, with lymph node candidates identified throughout.\n\nBLOCK SUMMARY: A1 \u2013 section of nipple; A2 \u2013 tissue from surgical margin; A3 \u2013 tissue including skin margin; A4 through A8 \u2013 sections from various quadrants of the breast; A9 through A17 \u2013 sections from different regions of the axillary tail, each containing one to five lymph node candidates.\n\nA total of 27 lymph nodes were examined, and none showed evidence of malignancy. Benign proliferative changes are present, including blunt duct adenosis, intraductal hyperplasia, and fibrosis. Operative margins are free of atypical cells in the sections obtained. No intraductal lesion is identified."} +{"pid": "TCGA-G9-6354", "report": "The prostate specimen weighed 47 grams and measured 5.0 cm from right to left, 4.2 cm from anterior to posterior, and 3.0 cm from apex to base. After removal of the apex and base, the remaining prostate weighed 23 grams. The external surface was tan-pink, smooth, and intact. The right and left seminal vesicles measured 4.0 x 2.5 x 2.0 cm and 5.5 x 1.0 x 1.0 cm, respectively, and appeared cystic on sectioning. No gross abnormalities were noted in the seminal vesicles or attached vas deferens. The prostate was sectioned serially from apex to base, revealing firm, tan fibrous tissue without identifiable masses.\n\nMicroscopic evaluation revealed a multifocal cellular proliferation involving the apex and posterior lateral right region. The cells formed irregular glands with nuclear atypia and prominent nucleoli. The proliferation accounted for approximately 10% of the gland and was confined within the prostate without extension into surrounding fat or seminal vesicles. All surgical margins were free of abnormal cells. Invasion of blood vessels or lymphatics was not identified. Perineural invasion was present in the right lobe. High-grade intraepithelial neoplasia was also observed.\n\nAmyloid deposition was identified in the stroma of the left seminal vesicle based on apple-green birefringence with Congo red stain. No other significant histologic findings were noted. Lymph nodes were not submitted for evaluation. The staging classification was T2b, with no regional nodal involvement (NX) and no evidence of distant metastasis (MX)."} +{"pid": "TCGA-ZH-A8Y4", "report": "The gallbladder specimen measures 8.5 x 3.0 x 1.0 cm and is accompanied by three lymph nodes. The external surface shows a glistening serosa on one side and an adhered, roughened surface on the opposite, consistent with contact with the liver. A 1.2 cm transmural defect is present. The wall thickness is uniform at 0.1 cm. The mucosal surface is hemorrhagic and slightly granular. No gallstones are identified. The cystic duct margin and hepatic surface are inked blue and green, respectively. Lymph nodes range from 0.8 to 1.5 cm in size. Histologic sections show no evidence of malignancy. All lymph nodes are negative for tumor involvement.\n\nA resected liver specimen includes segments 4, 5, and 8, weighing 400 grams. The liver mass measures 11.5 x 6.0 x 4.8 cm, with irregular borders and areas of hemorrhage. It is located centrally, firm in consistency, and appears tan-white. The mass is within 0.3 cm of the liver capsule and extends to the resection margin. The portal vein margin is 0.5 cm away from the tumor. Microscopic evaluation reveals a moderately to poorly differentiated adenocarcinoma within a desmoplastic stroma. Tumor cells display moderate nuclear pleomorphism and frequent mitotic figures. The hepatic parenchymal margin is focally involved, while the portal vein margin remains free of tumor. There is no evidence of lymphovascular or perineural invasion. The surrounding non-tumor liver tissue shows macrovesicular steatosis involving approximately 10% of the parenchyma.\n\nImmunohistochemical analysis demonstrates focal positivity for CK7 and negativity for other markers including CK20, BerEP4, RCC, PSA, PSAP, TTF-1, and HepPAR1. CD31 staining does not reveal lymphovascular space invasion. Appropriate controls were used in all immunostains, and the laboratory is CLIA-certified for high-complexity testing. Based on pathologic findings, the tumor is classified as pT1 pN0."} +{"pid": "TCGA-BA-A6DJ", "report": "The surgical pathology report includes multiple specimens from a resection procedure. Specimens A through G, representing biopsies from the proximal, distal, posterior, medial, anterior, lateral, and deep soft tissue margins, all show no evidence of tumor involvement. Specimen H, consisting of 10 lymph nodes from left cervical level 2B, shows no tumor involvement. Specimen I, which includes 20 lymph nodes from left cervical level 2A, demonstrates metastatic involvement in one lymph node with a maximum size of 0.3 cm; extracapsular extension is not present. Specimens J through L include lymph nodes from left cervical levels 3, 4, and bilateral level 6, respectively, with no tumor identified in any of the 48 total nodes.\n\nSpecimen M consists of a left hemimandibulectomy specimen with associated level 1 lymph nodes. Grossly, the tumor measures 6.0 cm at its largest dimension and extends into the buccal mucosa. Histologic evaluation reveals angiolymphatic invasion, perineural invasion, and bone invasion. The surgical margins are negative for involvement by malignant cells, although the closest margin (lateral posterior soft tissue) is less than 0.1 cm. The anterior mandibular bone margin is negative following decalcification. A total of eight lymph nodes are examined from this specimen, with three showing metastatic involvement. The largest metastasis in this group measures 1.8 cm, and no extracapsular extension is observed.\n\nAdditional lymph node specimens N through P demonstrate variable findings. Specimen N, containing 25 lymph nodes from right cervical level 3, shows no tumor involvement. Specimen O, including two lymph nodes from right cervical level 2, has one positive node with a metastatic deposit measuring 0.6 cm. Specimen P, which contains eight lymph nodes from right cervical level 1, has three involved nodes, the largest measuring 0.8 cm, with no extracapsular extension noted. Specimen Q, consisting of teeth #31 and #32 along with surrounding soft tissue, demonstrates only benign changes and inflammation.\n\nImmunohistochemical staining for p16 and high-risk HPV in situ hybridization were performed and yielded negative results. Based on available data, the pathologic TNM staging is reported as pT4a and pN2c. Additional addendum findings confirm the absence of tumor in the anterior mandibular bone margin and support the prior negative staining results for p16 and HPV. All frozen section evaluations are consistent with the final margin assessment."} +{"pid": "TCGA-BP-4993", "report": "The clinical history includes the presence of incidental bilateral renal masses, with subsequent left nephrectomy performed. The submitted specimen is a partial nephrectomy from the left upper pole. Gross examination reveals a wedge-shaped kidney specimen measuring 5.5 x 3.8 x 3.0 cm with attached perirenal fat. A mass is identified within the kidney, measuring 2.5 x 2.3 x 2.1 cm, with a golden yellow and partly hemorrhagic appearance. It is encapsulated and bulges toward the resection margin. The distance from the tumor to the inked surgical margin is less than 0.2 mm, with the closest clearance being less than 0.1 cm. The surrounding kidney tissue appears unremarkable.\n\nHistologic evaluation reveals a nuclear grade III/IV cellular proliferation. No local invasion or renal vein involvement is identified. Surgical margins are free of tumor. The tumor is staged as pT1, indicating a tumor no larger than 7.0 cm confined to the kidney. Sections submitted include representative portions of the tumor, its relation to the margin, and uninvolved kidney tissue."} +{"pid": "TCGA-OL-A97C", "report": "The final pathology report includes the following findings. Sentinel lymph node biopsies from the left side showed reactive changes but no evidence of tumor involvement. Specifically, sentinel lymph node #1 contained one reactive lymph node (0/1 negative), sentinel lymph node #2 also contained one reactive lymph node (0/1 negative). Left axillary lymph nodes #3 and #4 were each negative for tumor, with two reactive lymph nodes in #3 (0/2) and one reactive lymph node in #4 (0/1). Additionally, a left axillary non-sentinel lymph node biopsy revealed one reactive lymph node without tumor involvement (0/1).\n\nThe mastectomy specimen from the left breast measured 25 cm \u00d7 20 cm \u00d7 16.5 cm and weighed 4,580 grams. The tumor measured 25 \u00d7 17 \u00d7 16.5 cm and exhibited a variegated cut surface with tan, fleshy regions interspersed with dusky gray-green areas and golden-yellow adipose tissue. Hemorrhage and coarse granularity were noted. Microscopic evaluation indicated cellular features including heterologous differentiation characterized by chondrosarcomatous, fibrosarcomatous-like, and fibro-myxosarcomatous-like components.\n\nMargins of resection were free of abnormal cellular proliferation. The posterior margin was 0.5 mm from the tumor edge, while the closest anterior inferior margin was greater than 6 mm away. The tumor was observed to abut the dermis of the nipple-areolar complex; however, the nipple itself showed no diagnostic abnormalities. Additional findings included a focus of atypical ductal hyperplasia and intraductal hyperplasia of the usual type. Benign skin tissue was also identified.\n\nA separate excision involving the pectoralis major muscle showed fibroadipose tissue and skeletal muscle with degenerative changes, but no tumor involvement was detected.\n\nSentinel lymph nodes and additional lymph nodes evaluated intraoperatively were all reported as benign with no evidence of tumor."} +{"pid": "TCGA-DD-AAW1", "report": "The specimen consists of two distinct lesions. The first lesion measures 6.8 x 5.8 x 4.5 cm and is of a multinodular confluent type. Histologically, it shows a trabecular and pseudoglandular pattern with a mixture of classic and oncocytic cell types. The highest histologic grade observed is 4/4, while the major component shows a grade of 2/4. There is no fatty change identified, but hemorrhage or peliosis is present in approximately 20% of the tumor. Tumor necrosis is noted in 5%. Microscopic vascular invasion is present, and the tumor has a partially formed capsule with infiltration into the capsule. Septal formation is observed. There is no satellite nodule, bile duct invasion, serosal invasion, or involvement of major branches of the portal or hepatic veins. The surgical margin is clear with a safety margin of 1.4 cm. No intrahepatic metastasis is found; however, multicentric occurrence is present. The pathologic stage corresponds to AJCC pT3.\n\nThe second lesion measures 1.5 x 1.4 x 1.3 cm and is an expanding nodular type. It displays a solid histologic pattern composed of classic-type cells. The worst differentiation grade is 3/4, and the major differentiation grade is 2/4. Fatty change is present in about 50% of the tumor, and minor hemorrhage or peliosis (approximately 2%) is also seen. There is no tumor necrosis or vascular invasion. Capsule formation and infiltration are absent, though septal formation is present. There is no satellite nodule, bile duct invasion, or involvement of major branches of the portal or hepatic vein. Serosal invasion is present. The surgical margin is clear with a safety margin of 6.5 cm.\n\nAdditional findings include active cirrhosis. There is no dysplasia identified. No preoperative biopsy was performed."} +{"pid": "TCGA-BR-A4PF", "report": "The specimen consists of an excised tissue sample from the antrum measuring 10 x 7 x 1.5 cm. The lesion is ulcerated and extends through all layers of the stomach wall, reaching the serosal surface (visceral peritoneum). Histologically, the lesion demonstrates poorly differentiated features. Evaluation of lymph nodes reveals that 3 out of 8 intraabdominal lymph nodes contain metastatic involvement. All resection margins are free of involvement. No information is provided regarding lymphatic, venous, or perineural invasion, nor is there data on evidence of prior neo-adjuvant treatment."} +{"pid": "TCGA-KL-8337", "report": "The submitted specimens include a right radical nephrectomy with resection of perihilar nodes, a portion of the right liver, and lymph node dissection, as well as a separate paracaval lymph node excision. The primary lesion measured 10.5 cm in greatest dimension and was located in the kidney, extending from the upper to mid pole. The tumor was well-circumscribed, with a necrotic, cystic appearance and areas of hemorrhage and calcification. It approached within 0.4 cm of the blue inked liver resection margin but did not clearly involve the renal pelvis, collecting ducts, renal vein, or sinus fat. The surgical margins, including those of the ureter and renal vessels, were free of involvement. The non-neoplastic kidney showed a normal corticomedullary junction and unremarkable calyces. The adrenal gland, measuring 5 x 2.3 x 0.7 cm, had an unremarkable cortex. A segment of liver, measuring 6.5 x 3.2 x 0.9 cm, was also present, with resection margins inked blue. One lymph node from the perinephric fat and one from the paracaval region were both free of involvement. The total number of lymph nodes examined was two. The tumor was confined to the kidney without evidence of direct extension or venous invasion. Staging criteria indicate a pT2 classification, defined by a tumor greater than 7.0 cm in size limited to the kidney. All relevant sections were submitted for histological evaluation, and no definitive evidence of spread to surrounding structures or lymph nodes was identified."} +{"pid": "TCGA-AX-A05W", "report": "The surgical pathology report describes a gynecologic specimen from a female patient. The uterus, bilateral fallopian tubes, and ovaries were removed via total abdominal hysterectomy and bilateral salpingo-oophorectomy with staging. The uterus measured 8 x 4.5 x 3.5 cm and contained a composite lesion involving both the anterior and posterior endometrial cavities. Each portion of the lesion measured approximately 3.5 x 3.0 cm. The tumor invaded to a depth of 4 mm into the myometrium, with a total myometrial thickness of 12 mm. No lymphovascular space invasion was identified.\n\nThe cervix showed involvement of the stroma and mucosa by invasive lesion. A separate exophytic nodule was noted in the anterior lower uterine segment extending into the endocervical canal. The endometrial cavity was largely replaced by the lesion, which also extended into the lower uterine segment. Fibrous adhesions were noted on the serosal surface of the uterus.\n\nExamination of the bilateral adnexal structures revealed no significant abnormalities in the ovaries or fallopian tubes. The right ovary measured 2.7 x 2.0 x 1.0 cm and the left ovary measured 2.8 x 1.5 x 1.2 cm; both appeared unremarkable on gross examination. The fallopian tubes were within normal limits except for mild hydrosalpinx noted on the right. Paraovarian adhesions were present on the left side.\n\nA total of 21 regional lymph nodes were examined from various locations including left and right external iliac, obturator, and periaortic regions. No evidence of metastatic disease was found in any of the lymph nodes. The appendix was also removed and showed no histopathologic abnormalities.\n\nGross evaluation of the specimen revealed no distant metastases; however, the assessment was limited and categorized as indeterminate. Based on the extent of local invasion, the tumor was confined primarily to the uterus with cervical extension but without lymph node involvement or vascular invasion."} +{"pid": "TCGA-60-2703", "report": "The specimen includes multiple lymph nodes and a resected portion of the right lower and middle lobe of the lung. The lymph nodes submitted include those from levels 2R, 4R, 7, 10, 11, and 12. All lymph nodes were measured and examined; some showed anthracotic pigmentation and others were unremarkable in appearance.\n\nThe lung specimen weighed 372 grams after fixation and included a lower lobe measuring 16.0x14.0x5.5cm and a portion of the middle lobe measuring 7.5x6.0x2.0cm. Within the lower lobe, a tan-yellow firm mass was identified with irregular margins measuring 5.5x5.5x4.4cm. The mass was located 0.2 cm from the nearest pleural surface, 4.0 cm from the bronchial resection margin, 0.3 cm from the shorter stapled margin, and 1.5 cm from the longer stapled margin. Adjacent to the tumor and between it and the bronchial margin was an anthracotic lymph node measuring 1.8 cm in diameter. Multiple additional anthracotic lymph nodes were observed near the bronchial margin, with the largest measuring 3.0 cm. One lymph node adjacent to the bronchial margin appeared grossly involved by the lesion and measured 1.7 cm in greatest dimension.\n\nOn sectioning, the tumor was found to involve a bronchus in one area and surround another bronchus. No other masses were identified in either the lower or middle lobes. The bronchial mucosa of the middle lobe was normal. Sections of the tumor and surrounding lung tissue were submitted for analysis, including margins and lymph nodes.\n\nHistologic evaluation revealed extensive necrosis within the tumor and angiolymphatic invasion. Two of five peribronchial lymph nodes contained metastatic involvement. Surgical margins were free of involvement. Non-neoplastic findings included mild emphysema, mucous plugging of bronchioles and alveoli, and focal mild peribronchoalveolar chronic inflammation."} +{"pid": "TCGA-A7-A26I", "report": "The left axillary sentinel lymph nodes consist of two tissues measuring 0.5 cm and 1.0 cm in greatest dimension. Both were entirely submitted for histologic evaluation. Microscopic examination of all sections, including immunohistochemical staining with pan cytokeratin AE1/AE3, revealed no evidence of metastatic involvement (0/2).\n\nThe left breast specimen includes a soft, lobulated tan gold-white tissue measuring 7.3 cm (medial to lateral) x 6.5 cm (superior to inferior) x 3.7 cm (anterior to posterior). The tumor mass is centrally located, measuring 3.2 cm (medial to lateral) x 2.5 cm (superior to inferior) x 2.4 cm (anterior to posterior), with firm tan-white consistency. Central fibrous structures correspond to prior biopsy changes. The tumor extends focally to within 0.3 cm of both anterior and posterior inked margins. Histologically, the invasive component demonstrates moderate nuclear pleomorphism, with an architectural score of 2, nuclear score of 2, and mitotic score of 2 (Elston's SBR grade 2). The invasive lesion measures 3.2 cm (pT2). Resection margins are free of invasive disease, with the closest distances being 2 mm at the superior and anterior margins and 3 mm at the posterior margin.\n\nA high-grade in-situ component is present, displaying solid architecture with cancerization of lobules. Necrosis is not identified. The in-situ component constitutes less than 10% of the total tumor and does not meet criteria for extensive intraductal component. It approaches the superior and anterior margins at 2 mm and the posterior margin at 3 mm. No vascular invasion is observed.\n\nAdditional findings include calcifications within the invasive tumor and fibrocystic changes in the adjacent breast tissue, including apocrine metaplasia, microcysts, and sclerosing adenosis."} +{"pid": "TCGA-TM-A84F", "report": "The specimen consists of a discoid piece of brain measuring 75 x 65 x 16mm, including both cortex and white matter. The cerebral surface shows a bulging appearance due to pronounced swelling of adjacent gyri, with sulcal compression over an area of approximately 40 x 30mm. Serial sections reveal marked cortical thickening in areas up to 8mm in thickness. The underlying white matter appears expanded in places, with loss of cortico-medullary distinction. Within the grey matter, there is a 2mm cystic space filled with altered blood, likely traumatic in origin. The remainder of the brain parenchyma appears within normal limits.\n\nMicroscopically, representative sections show grey and white matter with a diffusely infiltrating glial neoplasm exhibiting variable cellularity. The neoplastic cells are embedded in a fibrillary and focally microcystic stroma and display a range of morphologies. Predominant cell types have intermediate-sized, round to oval or spindly nuclei with vesicular chromatin. Mild pleomorphism and occasional prominent nucleoli are present. Some cells exhibit perinuclear clearing suggestive of oligodendrocytic differentiation. Other regions contain cells with larger, irregular oval nuclei consistent with astrocytic morphology. Focal areas show spindled cell arrangements and moderate numbers of gemistocytic cells, including mini-gemistocytes. Mitotic activity varies across regions, with some areas showing moderate activity. The MIB-1 proliferation index is low, with approximately 5% of cells demonstrating positive staining. No necrosis is observed. A moderate lymphoplasmacytic infiltrate is present within the Virchow-Robin spaces. Cytogenetic and FISH studies are pending."} +{"pid": "TCGA-CV-5977", "report": "A left neck level I dissection included 12 possible lymph nodes, one of which showed malignant involvement. The largest lymph node measured up to 2.5 cm. No extracapsular extension was identified. A left neck level II dissection contained 14 possible lymph nodes, with one positive for malignancy. The lymph nodes ranged up to 1.8 cm in size. No extracapsular extension was observed. In the left neck level III dissection, 14 possible lymph nodes were identified, one of which was involved by malignancy. These nodes measured up to 2.0 cm. No extracapsular extension was present. A left neck level IV dissection revealed 22 possible lymph nodes, none of which showed tumor involvement.\n\nOn the right side, level I dissection contained three lymph nodes without tumor involvement and included a segment of salivary gland that showed no evidence of malignancy. Level II dissection on the right consisted of 15 lymph nodes, all negative for tumor. A salivary gland fragment was also submitted and showed no tumor. Right neck level III dissection contained 15 lymph nodes, none of which contained tumor. Right neck level IV dissection revealed twelve lymph nodes, none involved by tumor.\n\nThe surgical specimen from a partial glossectomy measured 6.5 x 4.0 x 2.0 cm and included an ulcerated mass measuring 4.5 cm in greatest dimension. Microscopic examination revealed invasive features, including infiltration in thick cords greater than four cells in diameter. Moderate perineural and vascular invasion were identified. Depth of invasion measured at least 1.0 cm. Lymphocyte infiltration was moderate. Margins were negative for invasive carcinoma, including circumferentially shaved dorsal, floor of mouth, and muscle margins."} +{"pid": "TCGA-BP-4781", "report": "The submitted specimen consists of a right partial nephrectomy measuring 4.5 x 4.5 x 1.9 cm, along with an attached piece of irregular flat fat and capsule measuring 4.5 x 2.5 x 0.3 cm. The deep surgical margin is inked black, the capsular margin is inked yellow, and the fat margin is inked green. A segment of normal kidney tissue measuring 3.0 x 1.5 x 1.5 cm is also present. Gross examination reveals a well-circumscribed mass measuring 3.2 x 2.5 x 1.5 cm. The mass appears cystic with a bright yellow and hemorrhagic cut surface containing clear fluid. The cyst wall is thick and partially calcified. The lesion extends from the renal capsule into adjacent fatty tissue, though no perinephric fat is identified grossly.\n\nMicroscopic evaluation shows a tumor composed of cells with features including nuclear atypia, with nuclear grade III/IV noted. A component of sarcomatoid-type cells comprises approximately 10% of the tumor. No local invasion is identified. Renal vein involvement is not present. Surgical margins are free of tumor. Adjacent non-neoplastic kidney tissue appears unremarkable. No adrenal gland or lymph node tissue is identified in the specimen. Based on pathological staging criteria, the tumor is confined to the kidney and measures less than 7.0 cm in greatest dimension."} +{"pid": "TCGA-DX-AB3B", "report": "The specimen consists of a left below-the-knee amputation. The surgical specimen measures 32.1 cm in length with a circumference of 33 cm. The tibia has a diameter of 2.9 cm and the fibula 1.3 cm. A bulging mass is present on the medial aspect of the left ankle, measuring 10.5 x 8.2 x 7.2 cm. The mass involves the posterior, medial, and anterior aspects of the tibia and extends into the talus bone, involving an area measuring 3.7 x 2.2 cm. The mass is white to pink/red with areas of hemorrhage. It is located 11.5 cm from the nearest soft tissue margin. Sections were taken from multiple sites including the tibia, skin margins, vessels, and various tumor regions (anterior, lateral, posterior). Histologic evaluation shows a high-grade monophasic cellular proliferation involving subcutaneous tissue, skeletal muscle, and encasing large nerve trunks. All bone and soft tissue margins are free of tumor. The tumor is predominantly viable."} +{"pid": "TCGA-3H-AB3O", "report": "The pathology report includes multiple tissue specimens. Two lymph nodes from station 4R, measuring 0.6 to 1.0 cm, were examined and showed no abnormal findings. One lymph node from station 7, measuring 0.6 cm, was also unremarkable. A biopsy of the diaphragm consisted of a 0.2 cm tan-pink tissue fragment, which appeared normal. Two liver biopsies, each measuring 0.2 cm, showed fibrosis but no other significant changes. A specimen from the right pleura measured 2.3 x 1.1 x 0.9 cm and consisted of pink-tan to white fibrous tissue; this tissue was the only sample showing atypical cellular features. The cellular appearance included epithelioid morphology. No involvement was identified in the lymph nodes evaluated. The submitted tissues were processed in full."} +{"pid": "TCGA-ET-A3DP", "report": "The specimen consisted of a total thyroidectomy. The lesion was located in the left lobe. The tumor measured 2.5 cm in greatest dimension and was unifocal. No lymph nodes were submitted for evaluation. The primary tumor was confined to the thyroid and measured greater than 2 cm but less than 4 cm. There was no evidence of venous or lymphatic invasion. Surgical margins were free of involvement. Regional lymph node status could not be assessed, and distant metastasis could not be determined."} +{"pid": "TCGA-55-8506", "report": "The surgical specimen included a right upper lobe lobectomy with en bloc chest wall resection. A single tumor measuring 7 x 6 x 5 cm was identified in the right upper lobe. The tumor extended through the visceral pleura into the parietal pleura and adjacent chest wall soft tissue, but did not invade rib bone. Surgical margins were uninvolved by tumor. No lymphatic or vascular invasion was observed. Histologically, the lesion was poorly differentiated.\n\nA total of 16 lymph nodes were examined. This included 13 nodes from N1 stations (hilar and peribronchial regions) and 3 nodes from N2 stations (subcarinal and inferior pulmonary regions). All lymph nodes were negative for metastasis. Specifically, one node from station #9, one from subcarinal #7, two from hilar #10R, one from intralobar #11, and ten peribronchial nodes were all free of tumor involvement.\n\nImmunohistochemical analysis supported the histologic findings. No markers suggestive of stage IV disease were identified. Tissue blocks have been preserved for potential future testing. \n\nPathologic staging was determined as pT3N0M0 based on tumor size greater than 7 cm, and regional extension into the parietal pleura and chest wall without lymph node or distant metastasis. The overall pathologic stage is IIB."} +{"pid": "TCGA-F9-A4JJ", "report": "The left kidney weighed 257 grams and measured 13.5 x 7.5 x 3.0 cm. A 5.5 cm long tumor was identified within a lobulated, fleshy gray mass measuring 5.5 x 4.5 x 3.0 cm located in the lower pole. The mass extended into the renal collecting system but was confined within the renal capsule without involvement of the perinephric fat. It partially obstructed the ureteral lumen at a point 4.5 cm from the resection margin. The surrounding kidney tissue appeared unremarkable except for patchy scarring and chronic pyelonephritis, likely related to the presence of the mass. Two simple cysts were present, one in the upper pole and one in the lower pole, each measuring up to 0.9 cm. No enlarged lymph nodes were observed.\n\nMicroscopic evaluation showed a tumor with areas of high-grade morphology, including regions with features resembling sarcomatoid transformation (approximately 10%). The tumor directly invaded the renal sinus fat and pelvis. All surgical margins were free of tumor involvement. No lymph nodes were identified in the specimen. The non-neoplastic kidney showed multiple cysts and focal calcification.\n\nImmunohistochemical staining demonstrated positivity for PAX-8 and P504. Pancytokeratin showed strong staining in some areas, particularly in papillary regions, but was negative in other portions. CK7, CD10, and p63 were negative. These findings supported a renal origin for the tumor. Additional morphologic features included papillary growth patterns and solid, infiltrative areas with irregular borders. Some regions contained large epithelial cells with granular cytoplasm.\n\nClinical correlation and further genetic testing were recommended due to unusual features suggestive of a possible hereditary syndrome or translocation-associated neoplasm. The tumor was noted to have an aggressive appearance, with invasion of the collecting system. Pathologic staging was determined as pT3 NX MX."} +{"pid": "TCGA-RD-A8N0", "report": "The specimen is a subtotal gastrectomy measuring 120 x 45 x 45mm. The greater curvature is 120mm in length and has attached adipose tissue and omentum. The presumed proximal resection margin is stapled and measures 45mm, while the distal resection margin is also stapled and measures 35mm. Adipose tissue is adhered to the lesser curvature. At a point 35mm from the distal resection margin along the greater curvature, there is an ulcerated crater-like lesion with raised edges, measuring 30mm in maximum dimension. The stomach wall is thickened in this area, and the serosa beneath the lesion appears pale with some fibrosis of the overlying adipose tissue. The remainder of the gastric mucosa appears normal. Margins were marked with black ink. Selected blocks include proximal and distal resection margins, the lesion itself, areas of lesser and greater curvature, and associated lymph nodes.\n\nMicroscopically, there is infiltration within the gastric wall that extends into the muscularis propria. At the base of the ulcer, the lamina propria is expanded by atypical epithelioid cells with some gland formation. These atypical cells are present singly and in small clusters throughout the submucosa and muscularis propria, reaching the serosa and infiltrating subserosal adipose tissue. Invasion around and within nerves is observed. No mucosal dysplasia or intestinal metaplasia is present. The lesion does not involve the proximal or distal resection margins. In other areas, there is a moderate inflammatory infiltrate involving the lamina propria of the body and antrum, with small numbers of Helicobacter pylori identified. Tumor deposits are found in adipose tissue from both the lesser and greater curvatures. Twenty lymph nodes are identified in the fat from the lesser curvature, with three involved by tumor. Sixteen lymph nodes are identified in the fat from the greater curvature, seven of which contain tumor. Duodenal mucosa at the distal resection margin shows no significant abnormality."} +{"pid": "TCGA-A3-3307", "report": "The specimen consists of a right kidney and aortocaval lymph nodes. The kidney specimen measures 23 x 12.5 x 10 cm and weighs 1,394 grams. On sectioning, nearly the entire kidney is replaced by a tan-yellow hemorrhagic lesion, sparing only portions at the inferior and medial aspects. The lesion measures 5.5 x 5.5 x 4.5 cm at its largest focus and is located at the upper pole within the vicinity of the adrenal gland. Adrenal tissue is not grossly identified in this area. The lesion appears encapsulated and extends into the renal vein, also invading surrounding adipose tissue. The renal vein margin is free of involvement. Anterior and posterior capsular margins are noted to be extremely close to the lesion. No hilar lymph nodes are identified. The renal cortex outside of the lesion measures up to 0.9 cm in thickness.\n\nFour lymph nodes ranging from 1.1 to 2.1 cm in size were identified in the aortocaval specimen and all appear benign upon microscopic evaluation. Histologic grading indicates moderately differentiated cells. Based on the findings, the pathologic staging assigned is pT3b pN0 pMX. Multiple tissue blocks were submitted for evaluation, including sections from the tumor involving the renal vein, proximal ureter, pelvis, areas adjacent to anterior and posterior capsules, and uninvolved kidney tissue. All surgical margins are free of involvement."} +{"pid": "TCGA-2J-AAB6", "report": "The surgical specimen was received on the date indicated and includes multiple biopsies and a resected pancreatic specimen. A summary of findings follows:\n\nBiopsy specimens from the common hepatic artery lymph nodes (two total) show no evidence of malignancy. A fragment of celiac axis stump tissue reveals only nerve trunk and adjacent soft tissue, with no malignant cells identified. The celiac artery margin consists of a fragment of arterial wall that is also negative for tumor involvement. The pancreatic neck margin is free of any detectable abnormal cells, with a minimum tumor-free margin of 2.5 cm.\n\nThe primary specimen includes a distal pancreatectomy and splenectomy. A mass measuring 5.0 cm in greatest dimension is identified in the pancreatic body. Gross examination suggests the lesion extends beyond the pancreas into surrounding soft tissue. Histologic evaluation reveals invasive, moderately differentiated ductal adenocarcinoma; however, angiolymphatic and perineural invasion are not present, and there is no evidence of tumor necrosis. The adjacent non-neoplastic pancreatic tissue shows PanIN 1B changes.\n\nA total of sixteen regional lymph nodes were examined, all of which are negative for metastatic disease. The spleen is unremarkable and free of any abnormal cells. All surgical margins, including the pancreatic neck and celiac artery margins, are free of tumor.\n\nThe final staging, based on available surgical material, is pT3 N0 according to the 7th edition of the AJCC Cancer Staging Manual (2010). These findings are based on histologic evaluation using hematoxylin and eosin permanent sections, following initial frozen section analysis. Any significant changes identified upon further review would be reflected in a revised report."} +{"pid": "TCGA-DJ-A3VG", "report": "The left thyroid lobe and isthmus specimen measured 4.6 x 2.9 x 0.7 cm and weighed 7 grams. The surface was smooth and the tissue exhibited two nodules separated by 0.3 cm. The first nodule measured 1.1 x 0.8 x 0.7 cm and appeared well-circumscribed, solid, tan, firm, and protruding from the surrounding thyroid parenchyma. It was located 0.1 cm from the anterior surface. The second nodule measured 0.6 x 0.6 x 0.5 cm and displayed a pale appearance resembling nodular thyroid parenchyma. The remainder of the thyroid tissue was red and beefy. Both nodules and surrounding areas were sampled.\n\nHistologic examination of the left thyroid lobe showed well-differentiated cellular features with no mitotic activity or tumor necrosis identified. The lesion was completely surrounded by a capsule without evidence of capsular invasion or blood vessel invasion. There was no extension beyond the thyroid capsule. Surgical margins were free of abnormal tissue. Multicentric disease was not observed. Adjacent thyroid tissue showed nodular hyperplasia. Parathyroid glands were not found in this specimen.\n\nThe right thyroid lobe specimen measured 5.4 x 2.3 x 1.3 cm and weighed 9 grams. The surface was smooth and serial sectioning revealed a tan-red, well-defined nodule measuring 0.4 x 0.3 x 0.3 cm located 0.3 cm from the anterior surface. The rest of the thyroid tissue appeared red and beefy. The entire specimen was submitted for analysis.\n\nMicroscopic evaluation revealed nodular hyperplasia in the right lobe. No atypical or malignant features were noted. Parathyroid glands were not identified and one benign lymph node was present among the submitted material.\n\nAll surgical specimens were fully evaluated and representative sections were examined."} +{"pid": "TCGA-A1-A0SE", "report": "The pathology report includes findings from multiple specimens. In the right breast biopsy, no abnormality was identified in one lymph node. In the left axilla, sentinel lymph node assessment included three nodes, all without evidence of abnormal cells. The right breast mastectomy specimen showed normal skin and benign changes including proliferative fibrocystic changes and microcalcifications associated with benign glands.\n\nIn the left breast mastectomy specimen, benign skin was noted alongside a 2.0 cm lesion. Histological evaluation revealed features consistent with mixed ductal and lobular morphology. The nuclear grade was scored as 2, with 16 mitotic figures per 10 high-power fields (2 points), and less than 10% tubule formation (3 points). The total score corresponded to SBR grade 2. No lymphatic-vascular or perineural invasion was observed. Additional findings included ductal carcinoma in situ of low nuclear grade, present as scattered microscopic foci in association with the primary lesion. Microcalcifications were also identified in relation to the lesion and benign tissue. Proliferative fibrocystic changes, fibroadenoma, and pseudoangiomatous stromal hyperplasia were also present.\n\nResection margin analysis for the invasive lesion showed positive involvement at the deep margin, while all other margins (medial, lateral, anterior/superior, and anterior/inferior) were widely clear (>1 cm). For the in situ component, the deep margin was close (<0.3 cm), while the remaining margins were widely clear. Lobular carcinoma in situ was not identified. Assessment of eight lymph nodes (including sentinel and nonsentinel) showed no evidence of abnormal cells.\n\nAdditional testing of the lesion demonstrated positivity for estrogen and progesterone receptors, with strong nuclear staining in a high percentage of cells. HER2/neu testing showed a staining intensity score of 2, indicating borderline over-expression; further FISH testing was recommended for clarification.\n\nIn the re-excision specimen from the right breast, only benign breast parenchyma was identified. Other submitted specimens, including cervical smears, endometrial and endocervical samples, pelvic washings, and a rectal polyp, all showed benign findings. Specimens from risk-reducing salpingo-oophorectomy did not reveal any significant abnormalities. A prior fine needle aspiration from the left breast indicated adenocarcinoma, and a cell block analysis confirmed hormone receptor positivity and borderline HER2/neu status. Lymph node aspiration from the left axilla showed reactive changes without evidence of malignancy."} +{"pid": "TCGA-F5-6864", "report": "The specimen consists of a 26 cm long colon segment. At a distance of 5 cm from one surgical margin, there is a circular, ulcerated lesion measuring 9 cm in length. The ulceration involves all layers of the rectal wall and extends into the surrounding fatty tissue. Dense, grey, conglomerate-like infiltration is observed in the fatty tissue surrounding the specimen. Lymph nodes within the fatty tissue show signs of metastatic involvement. All lymph nodes examined were positive for metastasis. The rectum surgical margins are free of abnormal growth. The tumor exhibits full thickness wall invasion with infiltration of perirectal tissues. Histologic evaluation reveals moderately differentiated cellular features with ulceration. Venous invasion is not identified. The specimen type is a resection of the rectum, with no evidence of treatment effect noted."} +{"pid": "TCGA-N9-A4PZ", "report": "The specimen includes a uterus measuring 15.0 x 9.0 x 6.5 cm with a cervix 2.5 cm in length. A tan-yellow, partially necrotic and hemorrhagic polypoid mass measuring 9.0 x 7.5 x 4.5 cm is attached to the anterior aspect of the tumor. The anterior cervix contains a tan-white mass measuring 5.0 x 3.0 x 1.2 cm involving the cervical stroma. The endometrium contains a lesion extending into the endometrial cavity and fundus. There is no gross myometrial invasion; however, there is nearly full-thickness involvement of the anterior cervix with tumor extending 14.0 mm into a 15.0 mm thick cervical stroma. Tumor also invades 4.0 mm into an 18.0 mm thick myometrium. Vaginal cuff measures 2.0 cm in length. Bilateral parametrial tissues are unremarkable. Fallopian tubes and ovaries show no significant abnormalities.\n\nMargins evaluated include vaginal cuff and bilateral parametrial resection margins, all of which are free of tumor. The inked anterior paracervical soft tissue margin shows tumor within 5.0 mm. Lymphovascular invasion is present. One left parametrial lymph node contains metastatic carcinoma. In the right pelvic lymph node specimen, metastatic carcinoma is identified in one fragment. The right para-aortic lymph node contains no tumor. In the high right para-aortic lymph node specimen, metastatic carcinoma is found in one of two nodes examined. The left pelvic lymph node specimen contains no tumor.\n\nMicroscopic evaluation reveals a mixture of cellular components. The anterior cervix tumor consists entirely of carcinoma. The endometrial component contains both carcinomatous and sarcomatous elements. The carcinomatous component includes papillary and serous features, with grade 3 morphology. The sarcomatous component includes chondroid differentiation and other undifferentiated elements. The tumor extends into the cervix and invades the myometrium. Multiple sections from various regions of the uterus and cervix are submitted for analysis. Nodules within the myometrium are benign. A cystic polyp is present in the posterior lower uterine segment. Paratubal cysts are noted bilaterally. Specimens from the vaginal cuff, parametria, and lymph nodes are included for assessment."} +{"pid": "TCGA-A4-A7UZ", "report": "The surgical specimen from the left kidney and adrenal gland measured 29.0 x 23.0 x 6.0 cm and weighed 1,270 grams. The kidney itself measured 12.0 x 6.5 x 5.0 cm, and the attached ureter was 5.5 cm in length with an average diameter of 0.4 cm. A mass measuring 5.5 x 5.0 x 4.5 cm was identified within the central portion of the kidney. This lesion appeared tan-white to pink and friable on gross examination. An additional smaller nodule measuring 0.7 x 0.5 x 0.4 cm was observed in the proximal ureter. The tumor appeared to approach the renal sinus with focal extension but without gross invasion through the capsule into perinephric fat. No gross involvement of the ureteral wall was observed.\n\nHistologic evaluation revealed a moderately differentiated neoplasm with nuclear features corresponding to Fuhrman grade 3. Necrosis was present in approximately 5% of the tumor tissue. Microscopic infiltration into the renal sinus was confirmed. Lymphovascular invasion was identified. Surgical margins were negative at the ureteric, vascular, and soft tissue sites.\n\nA total of 20 lymph nodes were examined across multiple regional sites. Metastatic involvement was identified in 14 lymph nodes. Two of two lymph nodes from one para-aortic group showed metastasis with extracapsular extension. Ten of sixteen lymph nodes from another para-aortic specimen contained metastatic cells, also demonstrating extracapsular extension and vascular invasion. In the interaortocaval region, both lymph nodes evaluated exhibited metastatic involvement along with vascular invasion.\n\nImmunohistochemical staining demonstrated positivity for RCC, PAX-8, and CD10 markers, while CK5 and p63 stains were negative. These findings supported the morphologic assessment of the tumor.\n\nAdditional specimens included a completion adrenalectomy and distal ureterectomy. Both specimens lacked evidence of malignant involvement. Chronic mild patchy interstitial inflammation was noted in non-neoplastic portions of the kidney.\n\nAll gross and microscopic findings were reviewed by the pathologist and confirmed during intraoperative consultation. Relevant sections were submitted for histologic analysis and interpreted accordingly."} +{"pid": "TCGA-E2-A1IO", "report": "The specimen included a sentinel lymph node from the right axilla, a right breast lumpectomy, and an additional anterior margin. The sentinel lymph node measured 1.9 x 1.2 x 0.8 cm and was entirely submitted for analysis. No malignant cells were identified in the lymph node. \n\nThe right breast specimen was a lumpectomy measuring 4 x 2.5 x 1.5 cm, oriented with sutures and inked for identification. Serial sectioning revealed a firm tan mass measuring 1.2 cm in greatest dimension. This mass was located 0.1 cm from the anterior margin. Sections of the medial and lateral margins were submitted for evaluation. Microscopic examination showed a high nuclear grade lesion with focal necrosis. There was also evidence of ductal intraepithelial neoplasia with solid and cribriform patterns, central necrosis, microcalcifications, and lobular extension. Fibrotic changes consistent with prior biopsy were noted. \n\nThe additional anterior margin consisted of two fragments of adipose tissue measuring 2 x 1 x 0.3 cm in total and weighing 1 gram. These were submitted in entirety and showed no evidence of tumor involvement. \n\nStaging was based on the AJCC Cancer Staging Manual, 7th Edition. The invasive component measured 1.2 cm and was classified as pT1c. No vascular or lymphatic invasion was observed. One sentinel lymph node was examined and showed no evidence of metastasis (pN0). \n\nImmunohistochemical staining for hormone receptors showed positivity for estrogen and progesterone receptors. HER2 testing by immunohistochemistry demonstrated equivocal results (2+ intensity in 30% of tumor cells). Fluorescence in situ hybridization analysis showed a HER2/CEP17 ratio of 1.1, indicating no gene amplification. \n\nThe Oncotype DX Breast Cancer Assay yielded a Recurrence Score of 18, with ER and PR scores indicating receptor positivity and a Her2 score confirming negativity. \n\nMargins were involved by invasive tumor but not by ductal intraepithelial neoplasia. The distance from the closest uninvolved margin was 0.3 cm at the inferior margin. The tumor exhibited a modified Scarff Bloom Richardson Grade 3 classification, with a tubular score of 3, nuclear grade 2, and mitotic score of 3. Necrosis was present within the tumor. \n\nAll other areas of the specimen showed benign epithelium without atypia. No lobular neoplasia was identified. Vascular or lymphatic invasion was not present. \n\nThe specimen was processed using standard formalin fixation, and all analyses were performed using validated methods. Interpretation of findings was made in the context of clinical and morphological data."} +{"pid": "TCGA-G2-A2EK", "report": "A specimen consisting of multiple fragments of tan-pink to gray-white soft, rubbery, partly cauterized, friable tissue measuring 3.0 x 2.5 x 1.0 cm was received and entirely submitted for analysis. Histologic evaluation reveals high-grade cellular changes with invasion into the muscularis propria. There is involvement of prostatic ducts and acini; however, no infiltration into the surrounding prostatic stroma was observed. No lymphovascular invasion was identified. All tissue has been processed and reviewed."} +{"pid": "TCGA-DJ-A3UR", "report": "The specimen consisted of lymph nodes and a total thyroidectomy. Lymph nodes evaluated included pretracheal and superior mediastinal lymph nodes (three in total, measuring 0.3 cm, 0.3 cm, and 0.4 cm), with two out of three showing metastatic involvement. The largest involved lymph node measured 0.5 cm with a metastatic focus measuring 0.45 cm. No extranodal extension was identified. The Delphian node specimen contained two benign lymph nodes without involvement. In the right paratracheal region, both lymph nodes submitted showed metastatic involvement, with the largest measuring 0.18 cm and the largest metastatic focus measuring 0.07 cm. No extranodal extension was observed.\n\nThe thyroidectomy specimen weighed 19 grams. Multiple tumor foci were identified within the left lobe, right lobe, and isthmus. Tumor sizes ranged from 0.2 to 1 cm. One dominant nodule measuring 1.0 x 0.8 x 0.8 cm was found in the right lobe, encapsulated and tan-colored. Other nodules were smaller, white, and located in the isthmus and left lobe. Histologic evaluation revealed well-differentiated cells without mitotic activity or tumor necrosis. Some nodules were encapsulated while others were not; no capsular invasion was identified in the encapsulated nodule. There was no evidence of vascular invasion, though one lesion extended into adjacent fibroadipose tissue outside the thyroid capsule. Surgical margins were free of tumor involvement. Non-neoplastic changes included mild nodular hyperplasia. Parathyroid glands were not identified in the specimen. All specimens were examined microscopically and correlated with gross findings."} +{"pid": "TCGA-DD-AADO", "report": "The specimen consists of a liver measuring 18.0 x 13.5 x 10.0 cm and weighing 930.5 grams, along with a gallbladder measuring 10.3 cm in length and 3.8 cm in diameter. The surgical procedure performed was a right hemihepatectomy. A mass measuring 12.0 x 11.5 x 10.0 cm was identified; it had a yellowish tan, granular cut surface with 30% necrosis and exhibited a multinodular confluent growth pattern. The resection margin was very close, less than 0.1 cm. No satellite nodules were observed, and the remaining liver parenchyma appeared unremarkable.\n\nMicroscopic examination revealed malignant cells arranged in a trabecular pattern with hepatic cell morphology. Nuclear grading showed the worst grade as III and the major grade also as III. There was partial fibrous capsule formation without capsular infiltration. Septum formation was present. No invasion was identified at the surgical resection margin, serosal layer, or portal vein. Microvessel invasion was present. Intrahepatic metastasis and multicentric occurrence were not observed.\n\nBlocks submitted included tissue from the tumor and surrounding areas (T1-6 and TB), resection margin (RM), remaining liver parenchyma (L and NB), and gallbladder (GB). The gallbladder showed histologic features of chronic cholecystitis. No pleural fluid or inflammatory smear findings were reported."} +{"pid": "TCGA-NH-A5IV", "report": "The right colectomy specimen includes the terminal ileum, cecum, ascending colon, and transverse colon. The colon measures 27 cm in length and 10 cm in circumference. A fungating red lesion measuring 9 x 6 x 3 cm is present in the distal portion of the colon, located 6 cm from the distal margin and 3 cm from the radial margin. The terminal ileum measures 14 cm in length, 4 cm in circumference, and has a wall thickness of 1 cm; it appears unremarkable. The appendix is surgically absent.\n\nMicroscopic evaluation shows a lesion with low-grade cellular features. The lesion extends through the muscularis propria into subserosal adipose tissue and pericolic soft tissues but does not reach the serosal surface. No involvement is seen at the proximal, distal, or circumferential margins. No lymphovascular or perineural invasion is identified. A total of 12 regional lymph nodes are examined, none show involvement. Regional adipose tissue measures 30 x 4 x 2 cm, and lymph nodes within this tissue are soft and measure up to 1 cm. The time in formalin was 6 hours and 25 minutes. The specimen was processed for tumor banking after intraoperative consultation confirmed the presence of a lesion in the colon."} +{"pid": "TCGA-4W-AA9R", "report": "The pathology report describes a brain tumor specimen obtained from a male patient. Two fragments were received for frozen section analysis, measuring 1.5 x 0.8 x 0.3 cm in total. The formalin-fixed specimen consisted of two fragments: one measuring 1.0 x 0.5 x 0.2 cm and the other 1.4 x 1.4 x 1.0 cm. Both specimens were processed and submitted entirely for histological evaluation.\n\nMicroscopic examination revealed marked hypercellularity with scattered mitotic figures. Nuclear anaplasia was present, along with prominent microvascular proliferation and nuclear pleomorphism. Focal necrosis was also identified. These morphologic features were consistent with a high-grade brain tumor.\n\nImmunohistochemical staining was performed using clinically validated laboratory-developed assays. Staining procedures were conducted on formalin-fixed, paraffin-embedded tissue sections. Detection methods utilized appropriate clones for various markers; however, specific results are not detailed in this summary.\n\nThe intraoperative consultation noted necrosis and an atypical glial infiltrate. Histologic sections confirmed these findings. All interpretations were made following review of relevant preparations by the attending pathologist, who attests to having examined the material and rendered the interpretation accordingly.\n\nThe tumor was resected via right craniotomy. No clinical history was provided. Specimens were processed using routine histologic techniques including H&E staining and frozen section analysis."} +{"pid": "TCGA-Q1-A73Q", "report": "RUN DATE: PAGE: 1. RUN TIME: SPEC #: Obtained: CLINICAL HISTORY : CYSTO/PROCTO. SPECIMEN/PROCEDURE: 1. CERVICAL BIOPSY. 2. CERVICAL BIOPSY. IMPRESSION: 1). CERVIX, BIOPSY: Tissue shows invasive cellular growth with focal keratinization; cells are moderately to poorly differentiated. Ulceration is present along with prominent acute and chronic inflammatory infiltrates. No lymphovascular invasion is identified. 2). CERVIX, BIOPSY: Invasive cellular growth with focal keratinization; moderately to poorly differentiated cells. No lymphovascular invasion is observed. Entered: COMMENT: Representative section reviewed by at. Entered: SPECIAL STAINS/PROCEDURES : The following immunohistochemical stain is performed with appropriate positive and negative controls on block 1B: p63: Strong diffuse nuclear staining is noted, consistent with squamous differentiation and excluding neuroendocrine small cell morphology. Dictated by: GROSS DESCRIPTION: 1. Received in formalin labeled \"cervical biopsy\" and with the patient's name, the specimen consists of three fragments of pink to red hemorrhagic friable tissue ranging in size from 0.7 X 0.2 X 0.2 cm to 1.6 x 1.3 X 0.7 cm. The larger fragments are sectioned and the specimen is entirely submitted in three cassettes. CONTINUED ON NEXT PAGE. GROSS DESCRIPTION: (continued). 2. Received in formalin labeled \"cervical biopsy\" and with the patient's name, the specimen consists of multiple fragments of pink to red hemorrhagic friable tissue measuring 2.5 x 1.5 x 0.6 cm in aggregate. The largest fragment is partially surfaced by pale tan grossly unremarkable mucosa. The resection margin is inked black and the specimen is trisected to reveal pale tan cut surfaces. The specimen is entirely submitted in two cassettes. Dictated by: Entered. COPIES TO: CPT Codes : IHC P63-88342, CERVICAL BIOPSY/88305/2, NEG MAB CONTROL. ICD9 Codes : 180.9. Resident Physician: I have personally reviewed the material (specimen/slide) and approve this final report. Electronically Signed by:"} +{"pid": "TCGA-EL-A3CU", "report": "The surgical specimen includes a total thyroidectomy with a submitted size of 7.0 x 4.0 x 1.5 cm. The right lobe is larger than the left and contains a light tan, firm nodule measuring 1.5 x 1.0 x 1.0 cm. This nodule is in close proximity to the resection margin, with less than 1.0 mm of distance from the margin. The right mid jugular lymph node (0.2 x 0.2 x 0.2 cm) and the right upper pole nodule (0.5 x 0.4 x 0.3 cm) both show no evidence of tumor involvement. The right inferior parathyroid consists of two tissue fragments (0.2 cm and 0.6 cm) and contains vessel and lymphoid tissue without identifiable parathyroid tissue. Four out of five regional lymph nodes show involvement. Tissue sections from the thyroid were submitted for analysis, including representative sections of the left lobe and sequential sections of the right lobe and nodule. Additional soft tissue fragments (0.5 cm and 1.5 cm) were also received and submitted entirely."} +{"pid": "TCGA-B2-A4SR", "report": "The final surgical pathology report describes a right kidney specimen measuring 13.5 x 8.0 x 7.5 cm, weighing 717 grams, and including a probe-patent ureter approximately 5.5 cm in length. The external surface of the kidney is covered with a moderate amount of perinephric fat, and the renal capsule appears delicate and tan-pink. Upon bisection, a well-circumscribed mass measuring 7.5 x 6.5 x 5.0 cm is identified in the superior pole. The mass has a pale tan to yellow-orange cut surface and is focally cystic. It is located within 0.3 cm of the inked margin. The remaining renal parenchyma is homogeneously pale tan to red-brown, with a distinct corticomedullary junction and a maximum cortical thickness of 1.3 cm. No other masses or abnormalities are noted. The renal pelvis is unremarkable, with a smooth, glistening tan-white appearance.\n\nMicroscopically, the lesion shows nuclear features that include areas of grade 4 morphology, although the majority of the tissue demonstrates grade 2 characteristics. Histologic evaluation confirms the presence of vascular invasion. The resection margins are free of involvement. No lymph nodes were submitted for examination. Additional findings include areas of necrosis within the lesion. The tumor size corresponds to a pT2a classification based on its greatest dimension of 7.5 cm. A portion of the tumor and adjacent normal tissue was submitted for further analysis as requested."} +{"pid": "TCGA-ND-A4W6", "report": "The specimen includes left and right fallopian tubes and ovaries with multiple areas showing similar features within the lumen of vessels. The uterus and cervix show a tumor arising from the inner lining, infiltrating through the full thickness of the muscular wall with widespread involvement of blood vessels. The cervix also contains similar findings within vascular spaces. A lymph node from the right para-aortic region shows tumor extending beyond the node into surrounding connective tissue. The omental biopsy consists of fatty tissue without evidence of tumor.\n\nMicroscopic evaluation reveals a tumor composed of two distinct elements, one resembling glandular structures and the other showing more spindle-shaped cellular patterns. The larger mass in the uterine cavity measures approximately 12 x 10 x 8 cm. There is extensive invasion into the muscular wall of the uterus, with more than half of the muscle layer affected. Tumor cells are present in blood vessels throughout the uterus, cervix, fallopian tubes, and ovaries. The cervix shows infiltration into connective tissue. Surgical margins are free of invasive disease. One lymph node was examined, and tumor cells were identified within it and extend beyond its capsule.\n\nStaging indicates involvement of the outer layer of the uterus and adjacent structures. The number of lymph nodes involved is limited to one. Gross examination of the uterus revealed a large mass filling the cavity with areas of necrosis. Multiple nodules were found within the muscular wall, ranging from 0.6 to 5.8 cm in size, all with a firm, whorled appearance. No mass lesions were identified in the omental biopsy."} +{"pid": "TCGA-EM-A3AJ", "report": "The surgical specimen included a total thyroidectomy with central compartment dissection. The right lobe measured 6.2 x 4.9 x 3.2 cm, the left lobe 4.2 x 3.0 x 1.3 cm, and the isthmus 5.5 x 2.0 x 1.0 cm. The overall specimen weighed 53.7 grams. A dominant nodule measuring 4.1 x 4.0 x 2.8 cm was identified in the right lobe. Histologically, this lesion exhibited follicular architecture with classical cytologic features. It was partially encapsulated and showed widespread capsular invasion. Surgical margins were free of involvement by this lesion, with the closest distance of invasive tissue being 1.0 mm from the margin. No lymphovascular or perineural invasion was observed.\n\nA second lesion measuring 0.9 cm was found in the left lobe. This lesion displayed papillary architecture and classical cytologic features with focal hobnail cell morphology. It was also partially encapsulated and demonstrated minimal capsular invasion. This lesion involved the surgical margin, and due to its proximity to the edge of resection, evaluation of extrathyroidal extension could not be reliably assessed. An additional microscopic lesion measuring 0.1 cm was noted in the left lobe.\n\nLymph node dissection included 24 nodes from multiple compartments. Four lymph nodes from the left central compartment contained abnormal cellular infiltration; no extranodal extension was observed. Other lymph node groups showed no significant pathological changes.\n\nAdditional findings included severe chronic inflammatory changes throughout the thyroid tissue. The staging classification was based on AJCC/UICC TNM system, 7th edition. Based on tumor size and nodal involvement, the classification reflected multiple primary lesions with pT3 and pN1a designations. Distant metastasis could not be assessed from this specimen."} +{"pid": "TCGA-4K-AA1H", "report": "The left testis measured 5.5 x 4.5 x 3.5 cm and contained a firm gray mass measuring 2.5 x 2.3 x 2.0 cm. Histologic evaluation revealed involvement of the tunica albuginea with evidence of vascular invasion. The resection margin and epididymis showed no presence of abnormal cells. The tumor was accompanied by a portion of spermatic cord, which measured 10.0 cm in length. Cellular morphology and tissue architecture were assessed to determine extent of involvement."} +{"pid": "TCGA-06-0128", "report": "A left occipital brain lesion was excised from a male patient presenting with ataxia and acalculia, with no significant prior medical history. The lesion was described as cystic and enhancing on imaging. Gross examination revealed two soft, focally hemorrhagic, tan-gray tissue fragments measuring 3 x 2 x 0.8 cm in total. Histologically, the tissue showed extensive infiltration and focal disruption of normal architecture by a neoplastic glial cell proliferation. The cells exhibited marked nuclear pleomorphism, anaplasia, and frequent multinucleated forms. Mitotic figures were present, and there was focal prominence of microvascular cellular proliferation. No necrosis was identified. Immunohistochemical analysis using MIB-1 staining demonstrated a proliferation index of 21% in the more active regions. The lesion showed features including nuclear anaplasia, mitotic activity, and microvascular proliferation, which are consistent with a high-grade neoplasm. Focal areas suggested the presence of an oligodendroglial component."} +{"pid": "TCGA-EA-A3HU", "report": "The specimen consists of a hysterectomy with bilateral salpingo-oophorectomy. The lesion involved the cervix and measured 5 x 4 x 2.5 cm. Histologic evaluation showed moderately differentiated features. The tumor invaded more than half of the myometrium. A total of 14 regional lymph nodes were examined, and none showed evidence of metastasis. Lymphatic and venous invasion could not be determined due to insufficient data. The depth of myometrial invasion and margin status were not specified. There was no information provided regarding neo-adjuvant treatment, additional findings, or special comments."} +{"pid": "TCGA-DE-A69J", "report": "The specimen consists of a total thyroidectomy measuring 6.5 x 2.8 x 2.5 cm on the right lobe and 6.3 x 3.0 x 1.3 cm on the left lobe and isthmus, weighing 35.4 grams. The right lobe contains two well-circumscribed nodules. The dominant nodule, located in the right upper pole, measures 2.5 x 2.2 x 2.1 cm, and the smaller nodule in the right lower pole measures 1.7 x 1.3 x 1.0 cm. Both nodules are solid, fleshy, friable, and tan-pink in color. They are located within 0.1 cm of the blue-inked anterior and black-inked posterior surgical margins. No tumor extension beyond the thyroid capsule is identified, and there is no evidence of capsular, lymphovascular, or blood vascular invasion. Surgical margins are free of tumor involvement.\n\nIn addition to the nodules, a 3.1 x 1.9 x 1.7 cm fibrotic nodule with a dark red-brown colloid cut surface is found in the right lower lobe, located 0.5 cm inferior to the dominant nodule and 0.2 cm from the smaller nodule. The remaining thyroid tissue shows features of multinodular goiter with extensive fibrosis and calcification. A small nodule is also identified in the left lower lobe. No lymph nodes are identified in the specimen, and one parathyroid gland is present without abnormality. Sections of tumor and normal tissue have been submitted for further analysis. Based on available data, the current pathologic staging is pT2 pNx, though this may be subject to revision pending clinical correlation."} +{"pid": "TCGA-CK-6751", "report": "The specimen consists of a segment of ileocecum. The ileum measures 10 cm in length and 2.3 cm in diameter, with a surgical resection margin measuring 2.2 cm in diameter. The colon segment is 20 cm in length and 6 cm in diameter, with a surgical resection margin measuring 3.5 cm in diameter. A red/tan mass measuring 2.6 x 1.7 x 0.8 cm is identified in the cecum. The mass is located 12 cm from the ileal resection margin (inked black) and 17 cm from the colon surgical resection margin (inked black). It is situated 2 cm from the ileocecal valve and does not invade through the serosa. The serosal surface is unremarkable, and the area adjacent to the tumor is inked black. No appendix is identified; however, a white/tan scar-like lesion measuring 2 x 0.5 cm is observed on the serosal surface of the cecum.\n\nMicroscopically, focal invasion into the muscularis propria is noted but not through it. There is no evidence of lymphovascular invasion. Eight lymph nodes are identified and are negative for involvement. All surgical margins are free of abnormal findings. Tissue samples submitted include the ileal and colonic resection margins, the mass and surrounding tissues, normal ileal and colonic tissue, possible lymph nodes, and scar tissue."} +{"pid": "TCGA-55-6987", "report": "The surgical pathology report includes specimens from a left lower lobe lung wedge biopsy and associated lymph nodes. The wedge biopsy specimen measures 9.5 x 4.0 x 2.8 cm and shows a well-defined subpleural mass measuring 2.4 x 2.2 x 1.8 cm. The mass is located 2.0 cm from the staple line and consists of tan-white firm tissue. Adjacent pulmonary parenchyma shows congestion and emphysematous changes. Microscopic examination reveals a poorly differentiated adenocarcinoma, approximately 2.2 cm in maximal dimension, with predominantly solid growth pattern and occasional gland formation. Focal lymphovascular invasion is present. The bronchial and vascular resection margins are free of tumor involvement. Emphysematous changes are also noted in the surrounding lung tissue.\n\nAdditional specimens from the left lower lobe, which include multiple staple lines, show no evidence of a discrete mass. The bronchial and vascular margins are unremarkable, with no tumor involvement identified. Sections submitted from staple lines and random areas of the lung demonstrate inflammation and emphysematous changes without tumor.\n\nLymph node specimens from the AP window and subcarinal regions are submitted as small soft tissue fragments. Microscopic evaluation of these specimens reveals anthracotic changes without evidence of metastatic involvement. \n\nStaging classification is pT1.NO.MX, indicating localized disease without lymph node or distant metastasis."} +{"pid": "TCGA-F9-A8NY", "report": "The gross specimen demonstrates a lesion located in a renal pole, measuring 8 x 6 x 5 cm. The lesion exhibits a moderately defined margin, with a soft, solid consistency and areas of necrosis. The cut surface shows yellow and gray regions. Microscopically, the lesion is composed of elongated papillary structures arranged in a back-to-back pattern, with variability in both shape and size. These structures are lined by moderately stratified cylindrical or cuboidal cells surrounding fine vascular-fibrous cores. Cellular nuclei display irregularity in shape, increased size, hyperchromasia, and prominent nucleoli. Mitotic figures are present. Cytoplasmic characteristics include moderate amounts with eosinophilic and clear features.\n\nStaging indicates involvement beyond the primary site with extension noted in the lung. Regional lymph node assessment reveals three out of three hilar nodes positive for metastatic involvement."} +{"pid": "TCGA-ED-A8O5", "report": "Gross Description: A lesion located in a lobe exhibits irregular margins and measures 7 x 6 x 5 cm. It is firm, solid, and gray-white in appearance on cut section. Microscopic Description: The cellular arrangement forms trabecular, acinar, or sheet-like patterns. The cells are polygonal in shape with round, vesicular nuclei and prominent nucleoli. The cytoplasm is present in moderate amounts and shows basophilic or vacuolated characteristics. Nuclear features include irregular contours, increased size, hyperchromasia, and distinct nucleoli. Mitotic figures are observed. Specimen type: Lobectomy. Tumor size: 7 x 6 x 5 cm. Histologic grade: Poorly differentiated. Focality, tumor extent, lymph node involvement, venous invasion, and response to neo-adjuvant therapy were not specified. Surgical margins are uninvolved. No additional findings are reported."} +{"pid": "TCGA-F4-6855", "report": "The submitted specimen is a segment of colon measuring up to 17 cm in length. A lesion is present, measuring 9 cm in its largest dimension, located in the sigmoid colon. The histologic evaluation shows moderately differentiated cells arranged in glandular patterns. The tumor is ulcerated and extends into the pericolonic tissues. No venous invasion is identified. The surgical margins are not specified. Lymph nodes associated with adjacent fatty tissue show no evidence of metastatic involvement, with all 12 nodes examined showing only reactive changes. The specimen type is consistent with a sigmoid colectomy. No definitive assessment of treatment effect or additional pathologic findings is provided."} +{"pid": "TCGA-33-AASI", "report": "The surgical pathology report includes multiple specimens. 4R lymph node specimen consists of twelve fragments of lymphoid tissue, all negative for tumor. The 9L lymph node specimen is a single piece measuring 2.2 x 1.4 x 1.0 cm and is also negative for tumor. The L10 lymph node specimen includes three pieces measuring up to 2.2 x 1.8 x 0.8 cm; no tumor was identified. Station 7 specimen is a single piece measuring 1.5 x 1.0 x 0.9 cm and shows no evidence of tumor. \n\nThe left lower lobe specimen measures 14.5 x 10.0 x 3.5 cm and weighs 152 grams. A lesion measuring 7.0 x 6.5 x 3.5 cm is present, located approximately 3 mm from the nearest pleural surface. Histologic evaluation reveals a moderately differentiated cellular pattern. Evaluation of all parts shows involvement in two out of twenty-one lymph nodes. Staging indicates a primary lesion greater than 3 cm in greatest dimension with regional lymph node involvement. Distant metastasis could not be assessed. Margins are clear at the vascular and bronchial sites, while the staple line shows presence of similar cellular changes in adjacent tissue. No vascular or lymphatic invasion is observed. Emphysematous changes are noted as an additional finding. Station 6 consists of two small tissue fragments, both without evidence of tumor. All lymph nodes examined across multiple stations were negative for tumor."} +{"pid": "TCGA-D1-A2G6", "report": "The surgical specimen included a uterus with right and left ovaries and fallopian tubes, along with multiple lymph node groups and biopsies of sigmoid and ileal mesentery. The uterus contained a 6.3 x 4.5 x 4.2 cm mass that extended through the myometrium to a depth of 1.5 cm (myometrial thickness 1.6 cm), with involvement of the lower uterine segment and cervix. Immunohistochemical analysis demonstrated focal positivity for estrogen receptor and positivity for vimentin, while progesterone receptor and pCEA were negative. HPV in situ hybridization was also negative. Metastatic involvement was identified in one of seven right obturator and one of four left external iliac pelvic lymph nodes. Other pelvic lymph nodes, para-aortic lymph nodes, gonadal vessels, and mesenteric biopsies showed no evidence of tumor."} +{"pid": "TCGA-DE-A0Y2", "report": "The specimen consisted of a total thyroidectomy measuring 6 x 4 x 3 cm and weighing 13.6 grams. The lobes were approximately equal in size with the left lobe slightly larger. The specimen was inked anterior/blue, posterior/black, and isthmus/yellow. A lesion was identified in the left mid to inferior lobe. It appeared as a solitary, relatively well-circumscribed mass with scalloped borders, measuring 2.4 x 2.2 x 1.3 cm. The tumor had a friable pink/tan cut surface with an adjacent yellow area measuring up to 1.2 cm in greatest dimension. The lesion was not encapsulated and was grossly confined within the thyroid gland. The tumor focally approached the anterior surgical margin at less than 1 mm and was approximately 1 mm from the posterior margin. The remainder of the thyroid parenchyma appeared histologically unremarkable.\n\nMicroscopic examination revealed a growth pattern characterized by papillary architecture. The lesion was unilateral and located in the left lobe without evidence of extra-capsular or vascular invasion. Multiple small foci were identified within the left lobe, indicating multifocality. Surgical margins were negative but closely approached by tumor tissue. \n\nLymph node evaluation included level 6 cervical lymph nodes from the left side. Of the ten lymph nodes assessed, five contained abnormal tissue involvement. The largest involved lymph node measured 5 mm in diameter. No extracapsular extension was observed in the involved lymph nodes.\n\nHistologic assessment of the thyroid lesion demonstrated cellular features consistent with epithelial proliferation. Nuclear characteristics included specific morphologic findings. Stromal reaction was noted surrounding some areas of growth. Immunohistochemical stains were performed as part of the evaluation.\n\nThe staging classification reflected the extent of primary lesion involvement, regional lymph node findings, and indeterminate distant metastasis status. Additional specimens included multiple small lymphoid fragments ranging from 2 x 2 x 2 mm to 1.4 x 0.6 x 0.5 cm in size."} +{"pid": "TCGA-49-AAR9", "report": "The specimen consists of a right lung and associated chest wall measuring 23 x 21 x 0.8 cm and weighing 740 grams. A mass is identified in the right upper lobe, located peripherally and extending into the chest wall through the middle two ribs, with destruction of the rib structure. The mass measures 7.5 x 6 x 4.5 cm, has a fleshy, white-tan appearance, and lacks significant necrosis. It extends centrally toward the hilum and surrounds a branch of the pulmonary artery. One lymph node adjacent to the vessel shows involvement by direct extension. No vascular invasion is identified. The tumor reaches within 1 mm of the fascial resection margin at the superior anterior chest wall. The bronchial margin is free of involvement, as are all soft tissue margins of the chest wall. Five peribronchial lymph nodes are negative for metastatic disease and demonstrate scattered hyalinized granulomas. Additional biopsies from soft tissue sites \"R10,\" \"R11,\" and \"Station 7\" each show benign lymph nodes with similar granulomatous changes. Frozen section analysis of site R4 confirmed absence of tumor. The overall staging indicates local extension into the chest wall without evidence of nodal metastasis."} +{"pid": "TCGA-DU-5855", "report": "The specimen from the right frontal brain was received in two parts. The first part consisted of a tan-pink mass measuring 2.4 x 2.3 x 0.7 cm, while the second part included multiple tan-white to gray fragments aggregating to 4.1 x 2.5 x 1.8 cm. Histologic examination revealed a moderately cellular infiltrative neoplasm with focal mucin-filled microcystic spaces. The tumor cells predominantly exhibited oval to round nuclei, although some irregular and angulated forms were also observed. Numerous mini-gemistocytes and some astrocytic gemistocytes were present. Mild to moderate nuclear pleomorphism was noted, with a mitotic count reaching up to 2 to 3 per ten high-power fields in areas of dense cellularity. Frequent apoptotic bodies were identified. No definitive microvascular proliferation or necrosis was observed.\n\nImmunohistochemical staining showed moderate positivity for p53 in approximately 50% of tumor cells, while EMA was largely negative. The Ki-67 labeling index was focally elevated to around 15%. Molecular studies demonstrated promoter methylation of MGMT and complete loss of heterozygosity for chromosomes 1p and 19q. These findings were obtained using markers including D1S1592, D1S552, D19S219, and PLA2G4C. DNA analysis was conducted on tissue extracted from paraffin blocks, with sufficient tumor cellularity confirmed by histologic review. Technical sensitivity for detecting methylated sequences was estimated at 1% methylated DNA within an unmethylated background. Interpretation of results was based on established diagnostic protocols and controls."} +{"pid": "TCGA-AF-2690", "report": "The specimen includes a left ovary and a segment of rectum and sigmoid colon. The left ovary is cystic, measuring 4 x 4 x 3.1 cm, with a smooth, glistening outer surface. It contains one major locule and several smaller ones filled with clear fluid. Microscopic evaluation reveals mostly flattened epithelium with a focus of benign-appearing mucinous columnar epithelium consistent with endocervical type. The attached fallopian tube shows no significant abnormalities.\n\nThe rectal and sigmoid colon specimen is 33 cm in length and includes an ulcerated mass located near the distal end, measuring 4.7 x 4.5 x 1.0 cm. The mass has rolled borders and is 4.5 cm from the distal margin. On cross-section, the lesion invades through the muscularis propria and approaches within 0.5 cm of the radial margin. Histologically, the lesion shows features of infiltrating adenocarcinoma, moderately differentiated. All surgical margins are free of tumor involvement. The tumor is staged as pT3c/d based on extension into pericolonic fat. Lymphatic invasion is infrequent. Evaluation of lymph nodes reveals three involved nodes out of twenty-four examined. Additionally, three foci of pericolonic soft tissue involvement are identified. No distant metastasis is confirmed. Other findings include diverticulosis."} +{"pid": "TCGA-AM-5820", "report": "The specimen was obtained from a colorectal site and consisted of primary tumor tissue. The tissue sample weighed 260 mg and was preserved in a frozen cryomold. A separate blood sample was collected, amounting to 4 ml, and stored in a frozen tube. Histological evaluation showed a cellular composition with 70% tumor cells present. The tumor was graded as moderately differentiated. Staging information indicated a T3, N1, M0 classification. No prior chemotherapy or hormonal therapy was reported. The tumor sample was part of a single container submission, with no additional treatment details provided."} +{"pid": "TCGA-DQ-7596", "report": "The patient presented with a history of a right neck mass persisting for three months, accompanied by sore throat. CT imaging demonstrated involvement of the right base of tongue and a right level II neck mass. The operative procedure included direct laryngoscopy, esophagoscopy, and biopsy. Testing was requested for HPV, p16, and EGFR.\n\nGross examination of the right tonsil biopsy revealed a 2.5 x 1.7 x 0.3 cm aggregate of soft, rubbery, gray-white, hemorrhagic tissue. A separate core biopsy from the right level II lymph node measured 0.3 cm and appeared gray-tan in color.\n\nMicroscopic evaluation of the right tonsil showed invasive non-keratinizing squamous cell carcinoma, moderately-poorly differentiated. The lymph node biopsy revealed scar tissue with a microscopic focus of metastatic squamous cell carcinoma. All findings were reviewed and confirmed by the staff pathologist."} +{"pid": "TCGA-HT-A617", "report": "Addendum Discussion. The calculated MIB-1 labeling index is 3.0%. Microscopic examination reveals gray and white matter diffusely infiltrated by a mildly to moderately hypercellular glial neoplasm. Tumor cells predominantly exhibit round nuclei with only mild atypia, and prominent perinuclear halos are noted. A minority component demonstrates features resembling fibrillary astrocytoma or gemistocytic phenotype. No mitotic figures are observed, and there is no evidence of microvascular proliferation or necrosis. No neoplastic ganglion cells or eosinophilic granular bodies are identified."} +{"pid": "TCGA-KK-A8IL", "report": "The prostate gland measures 4.2 x 3.7 x 3.3 cm and weighs 29 grams after fixation. A nodule is palpated on the left side of the prostate. Serial cross sections reveal a firm area suggestive of a lesion in the left posterolateral peripheral zone, present in four cross sections of the prostate and extensively involving the apex and surrounding regions. The lesion measures 2.3 x 1.5 cm at its largest cross-sectional dimension.\n\nExtracapsular extension is identified on the left posterolateral surface of the prostate and in the left superior neurovascular bundle region, extending approximately 3.5 mm beyond the capsule. There is extensive involvement of both right and left seminal vesicles, including both intra- and extraprostatic portions. Extension into perivesicular soft tissue is also noted. Focal involvement of the surgical margin is observed on the left posterolateral surface and left superior neurovascular bundle region, with a margin involvement of approximately 1.0 mm.\n\nFour lymph nodes are identified on the right pelvic side, none of which show evidence of malignancy. On the left pelvic side, four lymph nodes are examined, one of which contains a metastatic deposit measuring 0.3 cm.\n\nHigh-grade prostatic intraepithelial neoplasia is also present. The prostate is submitted in multiple sections, with inked surfaces to identify anatomical orientation: green for anterior, red for left, yellow for right, and black for posterior. Certain sections are marked with orange ink to indicate surfaces not representing the true resection margin."} +{"pid": "TCGA-BF-A3DJ", "report": "Female patient with a primary skin tumor. Histological analysis shows a grade 3 lesion. Tumor staging is T4b, N1, M0, indicating advanced local growth with regional lymph node involvement and no distant metastasis. The tumor specimen was obtained via surgery and stored in frozen format in a cryomold. A separate normal blood sample was collected and also stored in frozen format in a tube. No prior treatment was administered."} +{"pid": "TCGA-WY-A85E", "report": "The specimen was accessioned and received from a female patient. Two specimens were submitted for evaluation. The first specimen, labeled \"brain tumor,\" consisted of three tan-white to pink tissue fragments measuring 1.2 x 0.6 x 0.4 cm in aggregate. It was processed entirely and submitted as frozen section material. The second specimen, also labeled \"brain tumor,\" consisted of multiple pieces of pink to gray-white soft tissue measuring 3.5 x 2.7 x 1.6 cm in total. This specimen was also entirely submitted for analysis.\n\nHistologic examination revealed a cellular glioma with features consistent with both astrocytic and focal oligodendroglial differentiation. Mitotic activity was present at a low level, with approximately 2 mitoses identified per 10 high-power fields in certain areas. Immunohistochemical staining demonstrated strong positivity for p53 in numerous tumor cells. The MIB-1 labeling index showed patchy increases throughout the tumor. Molecular studies indicated loss of chromosome 19q with retention of chromosome 1p. Grading was deferred initially due to the infiltrative nature of the lesion and histologic features."} +{"pid": "TCGA-44-A47A", "report": "The resected lung specimen from the right upper lobe weighed 174 grams and measured 13.5 x 10 x 4 cm. A mass was identified at one pole of the specimen, measuring 3.7 x 3.5 cm in its greatest cross-sectional dimension. The mass was partially sampled for research purposes and embedded for histologic evaluation.\n\nHistologically, the lesion demonstrated a moderately differentiated architecture. Microscopic examination revealed a histologic grade of 2 out of 3. Mitotic activity was present at a rate of 4 mitoses per 10 high-power fields. The tumor measured 3.7 cm in greatest dimension. Surgical margins, including bronchial and pulmonary resection margins, were free of malignant cells. The pleura was also negative for involvement. Vascular invasion was not observed. Two lymph nodes attached to the specimen showed no evidence of malignancy.\n\nImmunohistochemical staining was performed. TTF-1 was positive, CK5/6 was negative, and p63 showed weak positivity. Paraffin sections were processed using 10% neutral buffered formalin. All controls stained appropriately.\n\nLymph node biopsies were submitted from R4, level X, and level VII stations. No evidence of malignancy was identified in any of the lymph nodes evaluated: four nodes from R4, two nodes from level X, and six nodes from level VII.\n\nThe non-tumorous lung tissue showed changes consistent with emphysema. A portion of the lesion exhibited a more solid appearance; however, the overall immunophenotype and histologic features were consistent with findings previously described in the case.\n\nStaging classification was determined as T2a NO."} +{"pid": "TCGA-B9-A5W8", "report": "A right partial nephrectomy specimen was received, weighing 745.0 grams and measuring 12.0 x 9.2 x 9.5 cm. The specimen was oriented with the parenchymal margin inked black and the capsule inked blue. A tumor located in the posterior central aspect of the right kidney was identified. It measured 11.8 x 9.2 x 9.5 cm and was described as yellow/brown, multinodular, well-circumscribed, with extensive hemorrhage and necrosis. The tumor was grossly confined to the kidney and showed no evidence of multicentricity.\n\nHistologic evaluation revealed a unifocal lesion with Furman grade 3 nuclear features. Sarcomatoid differentiation was not present. Histologic margins were negative; the renal parenchymal margin was 2 mm away from the tumor, and the capsular margin was less than 1 mm. No lymphovascular invasion was identified.\n\nSections submitted included multiple representative blocks of the tumor and surrounding tissue. Limited uninvolved kidney tissue adjacent to the tumor showed scattered sclerotic glomeruli and arterioles with intimal thickening. No urothelium was available for evaluation.\n\nThe specimen included no adrenal gland, lymph nodes, renal sinus, ureter, or major veins for assessment. Based on available information, staging was assigned as pT2b, pNX. The clinical history indicated a right renal mass in a patient with imaging findings suggestive of a 9 cm lesion and possible metastatic disease. The specimen was fixed in formalin, and digital imaging was not performed. Tissue from the tumor was submitted for further procurement."} +{"pid": "TCGA-CV-7429", "report": "The specimen consists of a right composite mandibular resection including the mandible, molar teeth, attached soft tissue, skeletal muscle, and skin, measuring 22.0 x 16.0 x 10.0 cm in total. Attached skin measures 14.0 x 10.0 cm and appears unremarkable. A neck dissection measuring 8.0 x 6.0 x 4.0 cm includes lymph nodes from levels I to IV.\n\nAn irregular firm tan-white mass measuring 8.5 x 8.5 x 8.0 cm is identified within the right buccal space, involving subcutaneous tissue, skeletal muscle, and soft tissue with extension to the mandibular ramus. Gross examination reveals that skin, soft tissue, and bony margins of resection are free of tumor involvement. One level I lymph node measuring 5.0 x 3.0 x 3.0 cm shows gross evidence of metastatic disease. The salivary gland component measures 5.0 x 4.0 x 3.5 cm and appears unremarkable.\n\nSections submitted include decalcified fragments from the coronoid process (1.5 x 1.4 x 0.3 cm) and condyle (4.0 x 2.4 x 2.0 cm) of the right mandible. Both bone and associated soft tissue components were evaluated. Decalcification is pending for certain sections, and further reports may follow.\n\nMicroscopic evaluation of frozen sections showed no tumor present at the tongue margin, right palate margin, buccal margin, and final pterygoid muscle margin. However, initial positive findings were noted at two pterygoid margins, although the final pterygoid excision margin was negative. Additional sections revealed involvement of soft tissue at multiple sites.\n\nLymph node analysis revealed metastatic involvement in 14 out of 24 lymph nodes: 3 of 3 in level I, 1 of 1 in level II, 5 of 6 in level III, and 5 of 14 in level IV. The largest lymph node metastasis measured 5.0 cm in greatest dimension and demonstrated extranodal extension of approximately 0.1 cm.\n\nPerineural invasion was identified. No tumor was found in the squamous mucosa or skeletal muscle at the tongue margin, or in squamous mucosa with minor salivary glands at the right palate margin. Gross evaluation of teeth showed no abnormalities."} +{"pid": "TCGA-DB-A64U", "report": "A resected brain specimen from the right frontal region measured 5.2 x 3.4 x 1.8 cm and was submitted for analysis. Multiple tissue blocks were prepared and embedded for detailed histologic examination. Smears were also prepared intraoperatively, and a preliminary cytologic evaluation indicated a diffuse glioma; however, final classification and grading were deferred to allow for further analysis.\n\nImmunohistochemical staining was performed on paraffin-embedded sections using markers for IDH1 (R132H), p53, and Ki-67 (MIB-1). The IDH1 mutation-specific stain showed positivity in tumor cells. Staining for p53 demonstrated rare positive nuclei, suggesting low expression. The Ki-67 labeling index was low, indicating limited proliferative activity.\n\nFluorescence in situ hybridization (FISH) studies targeting 1p19q deletion were initiated on paraffin sections and will be interpreted upon completion. These molecular studies were conducted to aid in further characterization of the lesion."} +{"pid": "TCGA-DU-6406", "report": "The surgical specimen from the brain, left frontal region, consists of multiple tissue fragments. The aggregate size of the excised tissue measures 1.8 cm and 3.5 cm across for different portions. The tissue has a semi-firm, grayish-white, glistening appearance.\n\nMicroscopic examination reveals a neoplastic glial proliferation. The tumor cells are medium-sized with hyperchromatic and pleomorphic nuclei that are elongated or ovoid in shape. The background shows a uniform, finely fibrillary internuclear matrix. Frequent branching small vessels, often arciform, are present throughout the lesion. Mitotic figures are numerous. Areas of tumor necrosis and prominent microvascular proliferation are observed focally. Rare clear halos around some nuclei are noted, along with occasional areas containing chunky microcalcifications.\n\nImmunohistochemical staining performed on sections demonstrates GFAP positivity highlighting the gliofibrillary background. Using MIB-1 immunostaining, a proliferation index of approximately 22% was determined in the more active regions of the tumor.\n\nHistologic features include cellular atypia, nuclear pleomorphism, brisk mitotic activity, focal necrosis, and vascular proliferation, all indicating a high histologic grade. The tumor displays a predominant oligodendroglial architecture with some astrocytic features."} +{"pid": "TCGA-FF-8046", "report": "Histopathology Report. Biopsy No: Corrected. Received Date/Time. Reporting Information. Date/Time: Updated. Histopathologist: Laboratory.\n\nA mass from the left submandibular region was received fresh, measuring 3 x 2.5 x 1 cm, and was serially cut into four pieces. Two pieces were snap-frozen for storage, and the remaining were fixed in formalin for histological analysis. A separate specimen labeled as the left submandibular gland was received in formalin, measuring 4.8 x 3.4 x 2 cm, along with three additional tissue fragments measuring 2.5 x 1.5 x 0.5 cm, 2 x 1 x 0.5 cm, and 1 x 1.5 x 0.7 cm. The submandibular gland appeared normal on gross examination, with no solid nodules identified. Whitish, ill-defined nodular areas were noted in the smaller tissue fragments.\n\nMicroscopic evaluation of the frozen section showed fibrofatty connective tissue infiltrated by a malignant neoplasm. Tissue preservation was suboptimal in most areas, with individual cell necrosis, pyknotic nuclear debris, and macrophages present. Crush artifacts and diathermy effects were also observed. In better-preserved regions, the cells formed sheets with enlarged, pleomorphic, vesicular nuclei and prominent central nucleoli. No glandular structures were identified. The submandibular gland itself showed only patchy mild chronic inflammation without evidence of malignancy.\n\nThe additional tissue specimens included fibrofatty connective tissue and residual lymph node, both of which were involved by a neoplastic process similar to that seen in the primary specimen. Sheets of atypical cells were present, showing immunophenotypic features consistent with a B-cell lineage. Immunostains showed positivity for CD10, bcl-6, MUM-1, and CD20, while cyclin D1, TdT, bcl-2, AE1/3, and S100 were negative. CD3 highlighted small interspersed T-lymphocytes, and MIB-1 labeling was positive in approximately 90% of the tumor cell population. No dendritic meshworks were identified. A fragment of normal thymic tissue was also present in the sample."} +{"pid": "TCGA-VQ-A8E7", "report": "The specimen from the gastroesophageal junction shows a moderately differentiated tubular-type growth pattern. The longest dimension of the lesion measures 12.70 cm. Ulceration is present, and the tissue involvement extends through the mucosa, muscularis mucosae, submucosa, and muscularis propria, with extension into adjacent adipose tissue. The tumor exhibits a spiculated growth pattern with mild surrounding inflammatory reaction. No tumor implants are identified in the peri-visceral adipose tissue.\n\nMargins of resection, including proximal, distal, and radial margins, are free of neoplastic cells. Neural infiltration is present, and while lymphatic vascular invasion is not observed, sanguineous vascular invasion is noted.\n\nA total of 23 lymph nodes were examined, with one showing evidence of involvement. No lymph node conglomerates are present. Lymph node assessment reveals no involvement in periesophageal (0/3) or perigastric regions (0/18). Additional lymph node samples from the distal splenic artery, inferior paraesophageal region, and recurrent lymph node show no involvement except for the recurrent lymph node, which contains metastatic changes (1/1).\n\nTissue from the esophageal margin and epiploon also shows no neoplastic involvement. Pathological staging indicates a T3 classification with regional lymph node involvement (N1)."} +{"pid": "TCGA-HT-A5RB", "report": "The specimen demonstrates a mild to moderately hypercellular glial neoplasm with diffuse infiltration of the gray and white matter. The tumor cells exhibit a relatively uniform morphology, with round to oval nuclei and generally mild atypia. Some cells display a distinct triangular glial configuration along with a limited number of fibrillary projections. No definitive mitotic activity is observed, and there is no evidence of microvascular proliferation or necrosis.\n\nAdditional findings include secondary architectural patterns such as subpial condensation, perineuronal satellitosis, and perivascular clustering. Immunohistochemical staining reveals widespread reactivity for p53, suggesting an astrocytic lineage. Proliferative activity, as assessed by MIB-1 staining, shows a labeling index of 2.8% in the most active regions."} +{"pid": "TCGA-S6-A8JX", "report": "The specimen consists of a right radical orchiectomy. The tumor measures 3.4 cm in greatest dimension and is multifocal. Microscopic evaluation reveals involvement of the rete testis and presence of venous/lymphatic invasion. There is no direct tumor extension beyond the testis. All surgical margins are free of tumor. Lymph node status cannot be assessed. Serum tumor markers are within normal limits. Based on AJCC staging criteria, the primary tumor is classified as pT2; lymph node involvement is not assessable (pNX), and distant metastasis cannot be evaluated. Immunohistochemical analysis demonstrates positivity for placental alkaline phosphatase and negativity for human chorionic gonadotropin, alpha-fetoprotein, CD30, and pan-cytokeratin markers. Histologic features include a firm, nodular gray-white mass largely replacing the testicular tissue, with smaller peripheral nodules noted measuring up to 0.5 cm. The mass approaches within 0.1 cm of the tunica albuginea. Multiple sections were submitted for analysis, including margins and adjacent structures. No involvement is identified in the epididymis or spermatic cord. Vascular space invasion is present, contributing to the pathologic staging classification."} +{"pid": "TCGA-56-A4BY", "report": "The patient is male. A specimen was received consisting of four labeled containers. Container A contains multiple rubbery black lymph nodes measuring in aggregate 3.3 x 3.0 x 1.4 cm and were identified as anthracotic lymph nodes. These were entirely submitted for examination and found to be negative for any abnormal cellular infiltration.\n\nContainer B contains a left upper lobe lung specimen measuring 19.0 x 8.5 x 6.0 cm. Within this specimen, a mass measuring 4.8 x 2.0 x 2.0 cm was identified. The mass was located 3.5 cm from the bronchial margin, 3.0 cm from the nearest vascular margin, and approached within 2.5 cm of a stapled parenchymal margin. It abutted and caused indentation of the pleural surface, which was inked black during processing. Microscopic evaluation of the tumor showed cellular features consistent with a specific type of epithelial lesion. The tumor did not invade the pleural surface based on histologic analysis, including special stains for elastic tissue integrity. No lymphovascular space invasion was observed. The tumor was unifocal and confined entirely within the lung parenchyma. Surgical margins were assessed; the tumor was at least 3.5 cm from the bronchial margin and did not involve the pleural surface directly. Additional sections included bronchial and vascular margins, intraparenchymal margins, and representative areas of emphysematous change.\n\nContainers C and D contained lymph nodes from different anatomical levels. Container C contained a single lymph node measuring 0.4 cm, and Container D contained a single lymph node measuring 0.9 cm. Both were entirely submitted and found to be free of any abnormal cells.\n\nBased on pathological staging criteria, the tumor was classified as T2 with no nodal involvement (N0). No additional lesions were identified in the specimen."} +{"pid": "TCGA-E2-A15R", "report": "The surgical specimens include four sentinel lymph nodes from the right axilla and a lumpectomy specimen from the right breast. The first sentinel lymph node measures 2.2 x 1 x 0.8 cm and contains a focus of involvement measuring 0.3 cm with extension beyond the nodal capsule. The second sentinel lymph node is 1.5 x 1 x 0.8 cm and shows similar involvement measuring 0.1 cm, also with extracapsular spread. The third lymph node, measuring 0.6 x 0.4 x 0.3 cm, shows no evidence of involvement. The fourth lymph node, measuring 1 x 0.6 x 0.4 cm, contains a larger focus measuring 0.6 cm with extranodal extension.\n\nThe right breast lumpectomy specimen, weighing 27 g, includes a mass measuring 2.2 x 1.5 x 0.9 cm located 0.1 cm from the anterior margin. Microscopic evaluation reveals a grade 2 lesion with nuclear features classified as intermediate. A separate in situ component measuring approximately 5% of the total volume is identified adjacent to the invasive component, characterized by a solid growth pattern. The in situ component also demonstrates intermediate nuclear features. The invasive tumor is present within 0.15 cm of the medial margin and 0.1 cm from the anterior margin. There is evidence of limited vascular or lymphatic invasion. Hormone receptor testing shows positivity for ER and PR, while HER2 testing is negative. \n\nTouch preparation of the first and second lymph nodes does not show abnormal cells, while clusters of atypical cells are noted in the fourth lymph node. The primary tumor is located less than 0.15 cm from two margins. Three of the four lymph nodes show evidence of involvement, with one showing no involvement. Based on these findings, the pathological stage is pT1c N1 according to the AJCC Cancer Staging Manual, 7th Edition."} +{"pid": "TCGA-BF-A5EQ", "report": "The specimen was obtained from the skin and represents a primary tissue sample. The tissue was collected using an OCT block method, with a total weight of 200 mg. Cellular analysis revealed the presence of atypical melanocytic cells exhibiting nuclear pleomorphism and brisk mitotic activity. Infiltration of lymphocytes was observed within the surrounding stroma. No metastatic involvement was identified in regional lymph nodes or distant sites. The tumor cells demonstrated no response to prior chemotherapy exposure. Hormone therapy status was not applicable. A separate blood sample was collected, yielding 4 mL of whole blood, which appeared normal upon examination. Demographic information indicates the patient is a Caucasian male. All specimens were processed under standard protocols."} +{"pid": "TCGA-B5-A11N", "report": "The specimen consists of a uterus weighing 116 grams, measuring 9.5 x 6.4 x 4.1 cm, with bilateral attached adnexa. The anterior endometrial cavity contains an exophytic mass measuring 6 x 4.5 cm, located from the fundus to the lower uterine segment. The mass is 1.2 cm thick and extends superficially into the myometrium to a depth of 0.1 cm, within a myometrial wall thickness of 2.1 cm. The remainder of the endometrial cavity measures 6.5 x 4 cm and is lined by a thin endometrium, approximately 0.1 cm in thickness, overlying focally trabeculated myometrium. The endocervical canal appears trabeculated and yellow-tan with no visible lesions; the exocervix is smooth and glistening with a patent os measuring 0.9 cm.\n\nSections of the endometrial mass were processed for frozen section analysis (AF1, AF2) with remnants submitted in blocks A1 and A2. Additional sections were taken from various regions including the cervix (A3\u2013A6), tumor and adjacent wall (A7\u2013A11), and uninvolved posterior endomyometrium (A12). The left adnexa includes a fallopian tube measuring 2.5 cm in length and 0.5 cm in diameter with attached mesentery, along with an ovary measuring 4 x 1.5 x 1 cm. The right adnexa includes a fallopian tube measuring 2.1 cm in length and 0.5 cm in diameter, and an ovary measuring 3 x 2 x 1.7 cm. Both adnexal structures appear unremarkable on gross examination and representative sections were submitted (A13 and A14).\n\nThe left pelvic lymph node dissection includes an aggregate of tissue measuring 10 x 8.5 x 2 cm. Twenty-three lymph node candidates ranging from 0.3 to 2.2 cm in size were identified and submitted across multiple blocks (B1\u2013B13). On the right side, the pelvic lymph node dissection includes a larger aggregate measuring 12 x 9 x 5 cm, with twenty lymph node candidates ranging from 0.4 to 4 cm in greatest dimension, also submitted across multiple blocks (C1\u2013C17).\n\nIntraoperative consultation was performed on the uterine specimen, focusing on the region where the mass extended into the myometrium. Microscopic evaluation confirmed the presence of low-grade glandular cells infiltrating superficially into the myometrium, involving less than one-fourth of its thickness. There was insufficient evidence to confirm or exclude serous differentiation.\n\nPathologic staging based on this specimen is pT1b pNO pMX according to the AJCC 6th Edition staging system. No tumor involvement was identified in the bilateral ovaries, fallopian tubes, or lymph nodes. Lymphatic or vascular invasion was not observed microscopically. The adjacent non-neoplastic endometrium appeared atrophic, and adenomyosis was noted in the remaining myometrium. All specimen margins were free of involvement."} +{"pid": "TCGA-A4-7915", "report": "The specimen consisted of a left kidney with associated perinephric fat, measuring 19.0 x 14.0 x 7.0 cm and weighing 726 grams. Gerota\u2019s fascia was hemorrhagic with fibrous adhesions and measured up to 0.5 cm in thickness. The perinephric fat was firm and lobulated, measuring up to 2.0 cm in thickness. A large cystic hemorrhagic mass containing blood clot surrounded the kidney and appeared attached to its surface, involving the renal parenchyma superiorly. The solid component of this mass measured 5.0 cm in greatest dimension, while the cystic component measured 19.0 cm in greatest dimension. Histologically, the tumor exhibited papillary architecture with Fuhrman nuclear grade 3/4 features. No sarcomatoid differentiation was identified.\n\nMicroscopic examination revealed extracapsular invasion into the perinephric tissue but not beyond Gerota\u2019s fascia. There was no lymphovascular invasion identified. Surgical margins including renal vein, Gerota\u2019s fascia, and ureter were negative for tumor involvement. One perinephric lymph node was identified and showed no evidence of tumor involvement. Additionally, a separate lymph node adjacent to the kidney demonstrated follicular hyperplasia without tumor involvement.\n\nAn adrenal gland measuring 5.0 x 2.2 x 1.5 cm was submitted separately and showed no tumor involvement. Immunohistochemical staining demonstrated positivity for P504S, vimentin, low molecular weight keratin, and N-cadherin; negativity was observed for CD10, CK7, Mart-1, HMB-45, and CD117.\n\nA portion of torsed appendage epiploica was also submitted and demonstrated infarction consistent with clinical findings of torsion. No tumor was identified in this specimen.\n\nPathologic staging was determined as pT2b, pN0. Additional findings included interstitial nephritis within the non-neoplastic kidney."} +{"pid": "TCGA-CZ-5454", "report": "The surgical pathology report describes a right nephrectomy specimen weighing 1670 grams. The kidney measures 21.0 x 9.9 x 5.5 cm and includes the renal vein (1.1 x 0.9 cm), renal artery (2.0 x 0.5 cm), and ureter (7.3 x 0.3 cm). A mass measuring 15.1 x 10.9 x 6.2 cm is identified in the lower pole, with a tan/yellow to tan/pink, hemorrhagic, and focally cystic appearance. The mass abuts the kidney capsule but shows no gross evidence of capsular invasion or extension into the renal vein, artery, ureter, or perinephric fat. Margins of resection for the ureter, artery, and vein are free of tumor involvement.\n\nMicroscopic evaluation reveals nuclear grade II/IV. Vascular and lymphatic invasion is present, though there is no involvement of the renal vein. Staging according to the AJCC 6th edition is T2 NO MX.\n\nA separate lymph node specimen from the infra-aortic vena cava region contains three lymph nodes. Histological examination shows expanded follicles and lipid-laden histiocytes within interfollicular areas, with no evidence of tumor. Immunohistochemical staining demonstrates a mixed population of CD3-, CD5-, and CD43-positive T cells, and CD20-positive B cells. B cells predominate in follicles, while T cells are more concentrated in interfollicular regions. CD10 highlights germinal center B cells, and bcl-2 is negative in germinal centers but positive in T cells and mantle zone B cells. CD43 expression is seen on T cells and plasma cells, without aberrant expression on B cells. Kappa and lambda light chain analysis shows polytypic expression in B cells and plasma cells, consistent with a reactive process. No features of a lymphoproliferative disorder are observed, and this finding is confirmed by the Hematopathology Service.\n\nCytogenetic analysis of the mass reveals clonal chromosomal aberrations in one of the three specimens, including loss of the short arm of chromosome 3, a known feature in certain types of kidney tumors. Other specimens show no cytogenetic abnormalities. Standard GTG banding analysis at 400 bands or greater was used, and mosaicism or small anomalies may not have been detected.\n\nThe non-neoplastic kidney tissue is to be evaluated separately by Renal Pathology, with findings to be provided in an addendum. The patient underwent a right radical nephrectomy with regional lymph node dissection for a right renal mass. No additional clinical history or operative findings were provided."} +{"pid": "TCGA-FD-A5BV", "report": "A 5.5 x 4.5 x 1.5 cm specimen from the right pelvic lymph node dissection contained 17 lymph nodes, all without any abnormal findings. A 4 x 4 x 2.5 cm specimen from the left pelvic lymph node dissection contained 8 lymph nodes, also without any abnormal findings. The cystectomy specimen weighed 214.8 g and measured 13 x 9.5 x 4.5 cm. The bladder itself measured 7 x 6.5 x 4 cm. The right ureteral stump was 2.4 cm in length and 0.5 cm in diameter, while the left ureteral stump was 1.2 cm in length and 0.8 cm in diameter; both showed an intact lumen, though the left demonstrated resistance to probing. The attached urethra measured 4.6 cm in length and 0.7 cm in diameter, with a portion of tan-pink skin and vaginal mucosa. The outer surface of the bladder showed fibroadipose tissue with some cautery changes. Upon opening, a 6 x 5.2 cm area of induration with ulceration and hemorrhage was identified on the left lateral wall, posterior wall, and trigone, extending into surrounding tissue. The bladder wall thickness averaged 1 cm. Both ureteral orifices were identified and patent, although the left had resistance upon probing. The urethral mucosa appeared normal. \n\nThe hysterectomy specimen weighed 42.9 g and measured 3.2 cm from fundus to lower uterine segment, 3.2 cm from cornu to cornu, and 2.3 cm anterior to posterior. The endometrial cavity measured 0.7 cm from cornu to cornu and 1.2 cm in length, with endometrium measuring 0.1 cm thick. Myometrial thickness was up to 0.7 cm. The left fallopian tube was 8 cm long and 0.4 cm in diameter, with a small lumen and 0.2 cm wall thickness. The attached ovary measured 2 x 1.6 x 0.8 cm and showed fibrotic stroma. The right fallopian tube was 6 cm long and 0.5 cm in diameter, with similar wall thickness. The right ovary measured 2.3 x 1.5 x 0.7 cm and also showed fibrotic stroma.\n\nThe appendix measured 7 cm in length and 0.6 cm in external diameter, with a wall thickness of 0.1 cm and a patent lumen. The left distal ureter measured 0.5 x 0.5 cm and was submitted entirely. The right distal ureter measured 2.5 x 0.6 cm and was also fully submitted. Pathologic evaluation showed no abnormal findings in the cervix, ovaries, fallopian tubes, uterus, appendix, or ureters. The area of induration in the bladder extended through the muscularis propria and into surrounding adipose tissue. All surgical margins, including ureteral, distal urethral, and soft tissue, were free of abnormal cells. A total of 25 lymph nodes from both pelvic dissections were negative for any abnormal involvement. The depth of invasion was noted in the extravesical soft tissue, and the tumor was solitary, measuring 6.0 cm, located at the left lateral wall, trigone, and posterior wall, with some extension to the dome and right lateral wall."} +{"pid": "TCGA-B4-5377", "report": "The specimen was obtained from a female patient of unspecified ethnicity. The tissue source was the right kidney, collected as a primary tumor sample. The tumor was histologically graded as grade 3, with a TNM staging classification of T3, N0, M1. No prior treatment was administered before specimen collection. Histological evaluation noted the presence of tumor cells comprising approximately 72% of the sample. A blood sample was also collected. Additional clinical details and procurement specifics were not provided."} +{"pid": "TCGA-43-7657", "report": "The surgical pathology report includes findings from multiple specimens. A right upper lobe wedge specimen contained a mass measuring 2.1 cm in greatest dimension. The resection margins were uninvolved. No direct extension of the lesion was observed. Evaluation of vascular structures showed no evidence of large or small vessel invasion. In total, 15 lymph nodes were examined across various regions and none demonstrated involvement. Specifically, one lymph node from level 10, three lymph nodes from the right upper lobe hilum, seven lymph nodes from the R4 station, and four lymph nodes from the subcarinal region were all negative for metastasis. The remainder of the right upper lobe lobectomy specimen showed no residual lesion or abnormality. All lymph nodes recovered were within normal size ranges and displayed benign morphologic features."} +{"pid": "TCGA-23-2081", "report": "The surgical specimen includes the uterus, bilateral ovaries, and fallopian tubes. Examination reveals involvement of the right ovary with two foci measuring 1 to 1.5 cm each, extending into the parenchyma and involving the serosal surface. Microscopic involvement is also noted in the left ovary, both on the serosal surface and within the parenchyma. The uterine serosa shows evidence of involvement. Bilateral parametrial and paraovarian tissues are affected.\n\nAdditional findings include organizing fibrinous exudate on the serosal surfaces along with mesothelial hyperplasia. The endometrium appears weakly proliferative without significant abnormalities. The cervix demonstrates mild chronic inflammation with squamous metaplasia and nabothian cysts. Both fallopian tubes appear unremarkable. The ovaries contain cystic follicles; no malignancy is evident in the fallopian tubes.\n\nMultiple other specimens were examined including omental tissue, lesser sac tumor, cul-de-sac tumor, right diaphragm tumor, gallbladder tumor, mesentery tumor, cecal tumor, liver tumor, and small bowel mesentery. All demonstrate similar histological features, including papillary structures with variable nuclear pleomorphism (grades II to III). Psammoma bodies are frequently observed, and focal lymphatic invasion is present. Rare microscopic foci exhibit clear cell features. No invasion of the appendiceal wall is identified, although rare clusters of malignant cells and psammoma bodies are entrapped within fibrinous exudate on the appendix.\n\nThe largest tumor focus in the omentum measures 7.0 x 4.0 x 3.0 cm. Other tumor-involved tissues contain lesions ranging from 0.2 cm to 5.5 cm in greatest dimension. The uterus measures 8.0 cm in length, 6.0 cm in width, and 5.0 cm in anteroposterior dimension. The right ovary measures 2.5 x 2.0 x 1.0 cm with papillary masses up to 1.0 cm on its surface, extending into the parenchyma up to 0.7 cm. The cervix has a 1.3 cm patent os with a 2.9 cm endocervical canal. The endometrial cavity measures 3.5 cm in length and 2.3 cm in width, with an endometrial thickness of 0.2 cm. Myometrial thickness is 2.2 cm.\n\nGiven the widespread peritoneal involvement and minimal ovarian involvement, the origin remains uncertain, though a primary peritoneal source is considered more likely."} +{"pid": "TCGA-S5-AA26", "report": "The surgical specimen included a radical cystoprostatectomy with bilateral removal of seminal vesicles and regional lymph nodes. Gross examination of the bladder revealed a papillary tumor measuring 5.0 cm in greatest dimension, located on the left lateral and left posterior walls. Histologic evaluation demonstrated invasion of the outer half of the muscularis propria with extension into perivesical tissue. Lymphovascular and extensive perineural invasion were present. The closest margin involvement was noted within lymphovascular space less than 1.0 mm from the left posterior perivesical soft tissue margin. Prostatic tissue showed no evidence of urothelial malignancy but exhibited atypical glands suspicious for adenocarcinoma, high-grade prostatic intraepithelial neoplasia, glandular and stromal hyperplasia, chronic inflammation, and focal glandular atrophy. Bilateral seminal vesicles and vas deferens appeared unremarkable.\n\nLymph node dissection included multiple specimens from both sides: left common iliac (1 node), left obturator (11 nodes), left external iliac (1 node), right common iliac (2 nodes), right obturator (4 nodes), and right external iliac (2 nodes). All lymph nodes were negative for malignancy.\n\nFrozen section analysis of the distal ureteral and urethral margins showed no evidence of tumor. Permanent sections confirmed these findings. Pathologic staging based on AJCC 7th edition criteria was determined as pT3a for local tumor extension and pN0 for absence of lymph node metastasis. Additional findings included a diverticulum in the right lateral wall and organizing thrombi in pericystic and periprostatic tissues."} +{"pid": "TCGA-D8-A1XV", "report": "Histopathological examination was performed on a total organ resection of the right breast. The specimen measured 27 x 23 x 3 cm and included a skin flap of 27 x 14 cm. Blue dye was injected into the skin. Two lesions were identified: one measured 2 x 1.8 x 2.5 cm and was located on the boundary of the lower quadrants, 3.0 cm from the lower edge, 1.0 cm from the base, and 2.5 cm from the skin. A second lesion, measuring 3.2 x 1.9 x 4.5 cm, was found 2 cm away from the first lesion with margins of 1.0 cm at the lower boundary, 1.0 cm at the base, and 3.0 cm from the skin.\n\nMicroscopic evaluation revealed a bifocal carcinoma with features consistent with mucinous differentiation. Nuclear grading was NHG2 based on a score of 3+2+1 (6/10 high-power fields). In addition to the invasive component, there were foci of ductal intraepithelial neoplasia within the lesion, showing papillary, solid, and mucous patterns with moderate nuclear atypia and no necrosis. These in situ components accounted for approximately 20% of the lesion volume. Also noted were intraductal proliferative changes with papillary architecture. The surrounding glandular tissue demonstrated signs of parenchymal atrophy.\n\nImmunohistochemical analysis showed that over 75% of the neoplastic cell nuclei expressed estrogen and progesterone receptors. HER2 protein expression was evaluated using a rabbit monoclonal antibody (Ventana PATHWAY HER2/neu clone 4B5), which yielded a score of 2+. Fluorescence in situ hybridization (FISH) testing using the Path Vysion HER2 DNA Probe Kit did not detect gene amplification.\n\nThe histopathological staging was determined as pT2 with no lymph node involvement (pN0(sn)). Parenchymal atrophy was also documented."} +{"pid": "TCGA-SH-A7BC", "report": "The specimen consists of two separate pleural tissue samples. Specimen A is an aggregate of thickened fibrous membrane with gelatinous areas, measuring approximately 10 x 8 x 2 cm, with the largest individual piece measuring 5 x 2.5 x 0.3 cm. Specimen B contains multiple thickened fibrous pieces, with an aggregate size of 13 x 10 x 2 cm; the largest fragment measures 6 x 5 x 0.5 cm. Both specimens show areas of yellow adipose tissue and are submitted in multiple sections. Microscopically, the tissue strips demonstrate extensive infiltration by epithelioid malignant cells."} +{"pid": "TCGA-CQ-A4CD", "report": "The surgical specimen from the right mandible includes a segment of mandible with ramus measuring 7.6 x 8 x 4.5 cm, containing three teeth. A lesion located in the retromolar trigone measures 5.5 x 4.0 x 4.1 cm and partially involves the lateral and medial gingiva of the first and second molars. The lesion extends posteriorly through the retromolar trigone mucosa toward the medial and lateral skeletal muscles. Bone involvement is present. Margins are uninvolved by invasive disease, with the closest margin being 0.1 cm from the tumor at the posterior lateral and medial muscle resection site. Other margins include: anterior gingival resection margin (0.7 cm), lateral and medial gingival resection margins (0.5 cm each), posterior retromolar trigone resection margin (0.4 cm), and posterior superior muscle resection margin (0.3 cm). No perineural or lymphovascular invasion was identified.\n\nA total of 47 lymph nodes were examined from the right neck dissection, all without evidence of metastasis. These include lymph nodes from levels 1 through 3, ranging in size from 0.2 to 1.9 cm. Additionally, a single lymph node from right neck zone 4, measuring 0.4 x 0.3 x 0.2 cm, and three lymph nodes from the tail of the right parotid (ranging from 0.3 to 0.8 cm) were also negative. The submandibular gland measured 5 x 2 x 2.2 cm and showed no abnormalities.\n\nSurgical waste included bone, skin, and soft tissue specimens, all unremarkable on gross examination. Decalcified sections of the mandible confirmed bony involvement, with negative bone margins. The histologic grade was determined to be G3, with conventional morphology. The overall staging indicates no regional lymph node involvement."} +{"pid": "TCGA-AJ-A3NH", "report": "The specimen from a female patient includes the uterus with bilateral adnexa, obtained via hysterectomy with bilateral salpingo-oophorectomy. The uterine body measures 6.8 x 6.2 x 4.2 cm and the cervix is 3.1 x 2.8 x 2.6 cm. A mass measuring 4.9 x 4.8 cm is present within the endometrial cavity, extending into the lower uterine segment. The mass is polypoid, friable, and gray-white in appearance, involving the underlying myometrium with invasion reaching the inked serosal surface to a depth of 1.8 cm. No involvement of the cervix or extension to other organs is observed. There is no lymphovascular space invasion. Surgical margins are uninvolved at the cervix and bilateral parametria; however, tumor extends to the inked serosal surface of the uterus without microscopic perforation. No lymph nodes are identified. Additional findings include multiple leiomyomata ranging from 0.8 to 2.1 cm in size within the myometrium. Both ovaries and fallopian tubes appear grossly and microscopically unremarkable. Sections submitted include representative samples from the cervix, lower uterine segments, full thickness of the mass, myometrial nodules, parametria, and both adnexal structures. Immunohistochemical staining for P53 was performed on selected blocks. The pathological stage is pT1b NX according to TNM classification, equivalent to FIGO IB."} +{"pid": "TCGA-44-2655", "report": "The specimen included a posterior segment right wedge resection of lung tissue measuring 9.5 x 3 x 2.3 cm. A subpleural area of induration measuring approximately 1.5 x 1 x 1 cm was identified and sampled. The staple line was removed and the margin was marked with black ink. The remaining lung tissue appeared normal, soft, pink, and spongy. Additional sections were submitted for histologic evaluation.\n\nA lymph node from level 10 measuring 0.5 cm was received and entirely submitted for analysis. Two lymph nodes from level 11, measuring 0.4 cm and 0.2 cm respectively, were also submitted in their entirety. The right upper lobe specimen measured 11.5 x 9.8 x 5.3 cm and showed two staple lines near the hilar region. No gross lesions were identified. The pleural surface was smooth and glistening. Several hilar lymph nodes were identified, with no evidence of tumor involvement. Sections of hilar nodes, bronchial and vascular margins, and representative lung tissue were submitted.\n\nA fat pad specimen labeled 2R consisted of two yellow-black fragments measuring on average 2.0 x 1.2 x 0.3 cm. A 4R lymph node measuring 1.5 x 0.7 x 0.5 cm was bisected and submitted completely. Another lymph node from level 7 of similar dimensions was also submitted in its entirety.\n\nMicroscopic examination of the posterior segment revealed a subpleural lesion with infiltrative growth. Histologic sections showed moderately differentiated cellular features with a peripheral growth pattern. Immunohistochemical staining demonstrated strong positivity for TTF1. The lesion measured approximately 1.5 cm in maximum dimension. Margins of resection were uninvolved. There was no evidence of direct extension, venous, arterial, or lymphatic invasion. Examination of lymph nodes from levels 10, 11, 7, as well as from the 4R and 2R regions, revealed no metastatic involvement. At least 11 lymph nodes were assessed, all negative for disease. The right upper lobe showed no residual lesion; bronchial and vascular margins were free of tumor. A nonspecific subpleural scar measuring 2 cm was noted, along with emphysematous changes in the lung parenchyma."} +{"pid": "TCGA-EI-6508", "report": "The specimen consists of a segment of large intestine measuring 10 cm in length, accompanied by mesorectal fat tissue 2 cm thick. A cauliflower-shaped lesion was identified in the mucosa, measuring 5 x 4 x 1.4 cm. This lesion involves approximately 80% of the intestinal circumference and is located 2.5 cm from the proximal resection margin and 1 cm from the distal margin. The shortest radial margin measures 1.2 cm.\n\nMicroscopic examination reveals well-differentiated glandular and papillary structures with infiltration into the muscularis propria and perirectal adipose tissue. The resected ends of the intestine show no evidence of neoplastic involvement. Lymph node metastasis is present in one lymph node (No I/XV). Staging parameters indicate infiltration through the muscularis propria into the surrounding fat, lymph node involvement, and absence of residual tumor at the surgical margins."} +{"pid": "TCGA-B0-4690", "report": "The excised lymph nodes show no evidence of neoplastic involvement. The right kidney specimen demonstrates a neoplasm with clear cell morphology and sarcomatoid features. Nuclear grading according to Fuhrman criteria is 3 out of 4. The tumor measures 12.0 cm in greatest dimension and extends into the perirenal and peripelvic fat. No angiolymphatic invasion is identified. Grossly, the tumor extends into the renal vein; however, all other surgical margins are free of tumor. The non-neoplastic kidney tissue exhibits chronic interstitial inflammation, glomerulosclerosis, and thyroidization. The adrenal gland shows involvement by the neoplasm. Lymph node assessment reveals no neoplastic involvement. Staging is consistent with pT3b NO MX. A separate biopsy of an esophageal nodule reveals reactive or hyperplastic gastric mucosa with scant inflamed squamous mucosa, and is negative for intestinal metaplasia."} +{"pid": "TCGA-KO-8403", "report": "The left kidney specimen includes a well-circumscribed mass measuring 3.9 x 3.4 x 1.5 cm located in the upper pole. The mass is yellow-brown in color and abuts the renal sinus, with no evidence of extension beyond the kidney. The adjacent renal parenchyma appears normal, and the pelvicalyceal system is smooth and without abnormalities. No lymph nodes are identified within the renal hilum.\n\nHistologic examination reveals that the tumor is composed of friable tissue with clusters of cells present in artifactual clefts and spaces between the renal parenchyma and renal sinus adipose tissue. These findings are interpreted as resulting from artifactual displacement rather than true invasion. Multiple deeper sections were evaluated and showed no involvement of vascular, ureteral, or soft tissue margins.\n\nThe nephrectomy specimen measures 12.0 x 6.5 x 5.0 cm and includes the left kidney (10.5 x 5.5 x 4.0 cm), a segment of renal artery and vein (1.5 cm in length, 0.5 cm in average diameter), and the ureter (13.0 cm in length, 0.2 cm in average diameter). Sections submitted include those from the tumor, adjacent uninvolved kidney, renal sinus, perinephric fat, and margins of resection.\n\nNuclear features are noted to be at a high grade. The tumor has been sampled for possible electron microscopy and also submitted to the tumor bank."} +{"pid": "TCGA-QS-A5YR", "report": "The specimen was received in six parts, including right and left parametrium, uterus with tubes and ovaries, right and left pelvic lymph nodes, and upper vaginal tissue. The parametrial specimens were each composed of adipose tissue without concerning findings. The uterus measured 11.0 x 8.5 x 6.5 cm and weighed 315 grams. Gross evaluation revealed a polypoid lesion in the fundus measuring up to 4.5 x 3.0 x 2.0 cm with focal extension into the myometrium. The depth of invasion was 4 mm with a total myometrial thickness of 30 mm, representing approximately 13% invasion. No involvement of the cervix, fallopian tubes, or ovaries was identified. Multiple subserosal nodules were present, with the largest measuring 4.5 cm. No areas of hemorrhage, calcification, or necrosis were observed.\n\nHistologic examination revealed a neoplastic process involving the endometrium and extending focally into the underlying myometrium. The histologic type was consistent with endometrioid differentiation. The tumor was graded as FIGO grade 2. No lymphovascular invasion was identified. Sections from the bilateral parametria did not show any evidence of tumor involvement.\n\nLymph node sampling included right and left pelvic lymph nodes. A total of five lymph nodes were submitted and examined, none of which showed evidence of tumor involvement. The right pelvic lymph node consisted of one lymph node while the left pelvic lymph node contained four lymph nodes, all reactive in appearance.\n\nThe upper vaginal biopsy revealed a similar tumor composition to that seen in the uterine specimen. However, definitive identification of vaginal tissue could not be confirmed in this sample. Additional findings included cervicitis, leiomyomas, and bilateral tubal ovarian adhesions. All sections were adequately sampled and processed for comprehensive pathologic evaluation."} +{"pid": "TCGA-CJ-4635", "report": "The specimen consists of a radical nephrectomy measuring 11.0 x 8.0 x 5.0 cm, including the left kidney (9.0 x 6.5 x 4.0 cm), a segment of renal artery and vein, and a portion of the ureter (5.0 cm in length and 0.5 cm in average diameter). No adrenal gland tissue is present. A well-circumscribed mass measuring 6.0 x 5.0 x 5.0 cm is identified in the mid pole of the kidney. The lesion has a yellow-to-orange appearance with areas of central hemorrhage and necrosis. It is confined to the kidney and compresses the renal sinus without extending into perinephric fat, renal pelvis, or Gerota\u2019s fascia. Margins of resection, including ureteral and vascular margins, are free of abnormal tissue. The adjacent kidney shows multiple triangular black discolorations in the cortex. The pelvicalyceal system appears smooth with no lesions. No lymph nodes are identified in the renal hilum. Sections submitted include tumor and normal kidney tissue for research protocols, as well as portions for possible electron microscopy. Microscopic evaluation includes assessment of margins, representative sections of the lesion, and surrounding kidney tissue."} +{"pid": "TCGA-D7-A4YV", "report": "PESEL: XXX. Gender: F. Examination result No. Clinical diagnosis (suspicion). Date of admission: (urgency: Standard). Material: 1) Material: stomach, stomach with the lesion. Method of collection: Total organ resection.\n\nMacroscopic description: Specimen consisting of the stomach, having been cut out along the greater curvature, sized 18.2 x 12.7 cm., including the omentum sized 25 x 18 cm. Wall thickening sized 6.3 x 7.8 x 1.4 cm found in the pyloric region.\n\nMicroscopic description: The lesion shows tubular and mucinous components. Invasion extends through the full thickness of the gastric wall and infiltrates into adjacent fat tissue and across the peritoneum. Vascular tumor emboli are present. The omentum shows hyperemia. Surgical margins at the cardia and intestine show no abnormality. Background gastric tissue outside the lesion shows chronic gastritis.\n\nLymph nodes assessment:\n- (around cardia) - Reactive lymphadenopathy No I.\n- 3/ (lesser curvature): Malignant cells identified in lymph nodes No (IW), with infiltration extending beyond the lymph node capsule into surrounding fatty tissue.\n- (peripyloric) - Reactive lymphadenopathy No (II)."} +{"pid": "TCGA-A5-A0GR", "report": "The specimen consists of a total hysterectomy with attached right adnexa and a portion of the left fallopian tube. The uterus measures 9.1 x 8.2 x 6.0 cm and contains an endometrial cavity measuring 5.0 cm in length and up to 2.0 cm in width. The endometrial thickness is 1.7 cm, and the myometrial thickness is 0.2 cm. A tumor located along the left lateral wall of the anterior and posterior cavity measures 3.6 x 3.0 cm in surface area and projects 1.2 cm above the mucosal surface. Grossly, it appears confined to the superficial aspect of the uterine corpus without deep invasion or involvement of the cervix or parametrial tissues. The tumor is associated with an endometrial polyp. Several leiomyomas are present, ranging from 0.5 to 4.0 cm in size, with most being intramural and showing tan, firm, whorled cut surfaces.\n\nThe right ovary measures 4.1 x 2.5 x 0.9 cm and contains a soft yellow area measuring 2.1 x 1.1 x 0.4 cm, occupying approximately 50% of the parenchyma. The right fallopian tube is 6.5 cm long and 0.5 cm in diameter, with external congestion noted. The left ovary and possible segment of fallopian tube show multiple adhesions but no gross tumor. A paratubal cyst measuring 0.2 cm in diameter is present within the fimbriated end of the left tube.\n\nLymph node evaluation includes several sites. In the left obturator region, four lymph nodes were identified, all without evidence of tumor. The right obturator region contains nine lymph nodes, also without tumor involvement. The left PA region contains two possible lymph nodes, and the right PA and right pelvic regions contain no identifiable lymph nodes. The left pelvic lymph node region contains only fibrofatty tissue without identifiable lymph nodes.\n\nMicroscopic examination reveals that the tumor has papillary areas with endometrioid features. There is minimal superficial invasion of the myometrium with a depth of 1.0 mm. No lymphovascular invasion is identified. Immunohistochemical staining for p53 is negative. Other findings include adenomyosis, chronic inflammation of the cervix, and endosalpingiosis with muscle in the left obturator region. No high-grade features are identified in the clear cell component, which is considered part of the endometrioid differentiation. All other tissues submitted are unremarkable."} +{"pid": "TCGA-KL-8330", "report": "The right kidney and adrenal gland specimen measured 19 cm (superior-inferior) x 14.5 cm (anterior-posterior) x 17.2 cm (lateral), and weighed 1,800 grams. The adrenal gland was disrupted and measured 8.7 x 3.1 x 0.7 cm. The ureter measured 6.5 x 0.6 x 0.4 cm. A mass measuring 18 x 15 x 13.5 cm was identified; it arose from the superior pole of the kidney and was well-demarcated. The cross-section of the mass showed a centrally located scar and a light mahogany color with areas of hemorrhage. A thin, fibrous membrane surrounded the mass, and it was noted to be very friable. The non-neoplastic portion of the kidney measured 9.5 x 7.5 x 6 cm and appeared unremarkable. The mass was confined within the renal capsule without invasion into the renal vein. All surgical margins were free of involvement. The adrenal gland also appeared unremarkable.\n\nA separate specimen of right paracaval lymph nodes was received, consisting of fibrofatty tissue fragments containing multiple lymph nodes ranging from 0.9 to 2.8 cm in greatest dimension. Eight lymph nodes were identified, all of which exhibited benign features. The two largest lymph nodes were bisected and submitted separately, while the remaining nodes were entirely submitted for evaluation."} +{"pid": "TCGA-IB-AAUS", "report": "A lymph node (number 12) was examined and found to be negative for malignant cells. The gallbladder specimen showed findings consistent with chronic inflammation, along with one reactive lymph node; no malignancy was identified. Another lymph node (number 8) was also negative for carcinoma. The bile duct margin was free of tumor involvement. A pancreatic specimen was obtained following a Whipple procedure, which included resection of the distal stomach, duodenum, and part of the pancreas. The specimen measured up to 7.5 cm in circumference at the proximal margin, with the pancreas itself measuring 5.5 x 4.0 x 2.0 cm. The duodenum was 22.5 cm in length with an average circumference of 4.0 cm. Attached soft tissue extended up to 4.0 cm in depth.\n\nAn ill-defined tan mass measuring 4.0 x 4.0 x 3.0 cm was identified within the pancreas. This mass was in close proximity to several margins: 1.0 cm from the body margin, 0.3 cm from the uncinate margin, 1.0 cm from the anterior surface, and 0.2 cm from the posterior surface. It also extended to the vessel bed margin and was located 2.5 cm from the common bile duct margin. Microscopic evaluation revealed that the mass involved the ampulla and pancreatic duct. A submucosal nodule was noted in the duodenum, with unremarkable serosal surfaces.\n\nHistologic analysis indicated moderately differentiated epithelial cells arranged in glandular patterns. Invasion into the ampulla of Vater or sphincter of Oddi was observed. There was evidence of lymphovascular and perineural invasion. No treatment effect was noted. Examination of regional lymph nodes included a total of 14 nodes, two of which were involved. The primary tumor extended beyond the pancreas but did not involve the celiac axis or superior mesenteric artery.\n\nThe pancreatic margin specimen demonstrated involvement by abnormal cells upon permanent sectioning. Multiple foci were better visualized in these sections. In contrast, the body margin was free of tumor. The vascular bed margin was very close (0.1 cm), as were the anterior and posterior soft tissue surfaces (<0.1 cm). All other margins evaluated were negative for tumor involvement."} +{"pid": "TCGA-BH-A0DG", "report": "The surgical specimen includes three sentinel lymph nodes from the right axillary region, all of which are free of tumor. The right breast was removed via total mastectomy. Within the upper outer quadrant, multiple invasive foci were identified, measuring 2.2 cm, 1.3 cm, and 1.3 cm respectively, for a total aggregate size of 4.8 cm. Histologic evaluation shows tubule formation score of 2, nuclear pleomorphism score of 3, and mitotic activity score of 2, resulting in a Nottingham score of 7 and a grade 2 classification. A component of intraductal proliferation with high-grade nuclear features is also present, including flat, solid, and cribriform patterns, involving lobules and major lactiferous ducts extensively. This in situ component accounts for approximately 30% of the total tumor volume.\n\nAll surgical margins are free of tumor involvement. The closest distance of invasive tumor to the deep margin is 9 mm, and 0.6 cm from the skin. The in situ component is found 2 mm from the deep margin. Lymphovascular invasion is present. Immunohistochemical analysis demonstrates positivity for estrogen receptor and negativity for progesterone receptor and HER2/NEU.\n\nA separate fibroadenoma and fibrocystic changes are noted in non-affected breast tissue. The nipple and skin show duct ectasia and epithelial hyperplasia. Pathologic staging is pT2 with no involved lymph nodes (0 of 3 examined). The method of lymph node assessment was histologic examination of sentinel nodes. Dermal lymphatic invasion is not specified. No Paget\u2019s disease of the nipple is identified."} +{"pid": "TCGA-HT-8563", "report": "The pathology report describes a diffusely infiltrative, moderately hypercellular astrocytic neoplasm. In most areas, there is a marked predominance of gemistocytic cells. Cellular atypia is generally moderate, with many scattered cells exhibiting marked atypia. Extensive examination did not reveal any mitotic figures. Additionally, there was no evidence of microvascular proliferation or necrosis. The MIB-1 labeling index was 2.0%."} +{"pid": "TCGA-EQ-5647", "report": "The specimen consists of a distal portion of gastric tissue measuring 13.5 x 8 x 5.5 cm, with attached adipose tissue along the lesser and greater curvatures. The serosal surface is smooth to scabrous, with focal cautery. The proximal and distal margins measure 18.5 cm and 5 cm in circumference, respectively. A palpable mass is identified in the distal portion, with the overlying serosal surface marked by blue ink. On opening, a poorly circumscribed, lobulated, rubbery tan-white to red mass measuring 10 x 9 cm is present in the distal stomach. The lesion approaches the distal margin within 1.2 cm and measures up to 2.8 cm in thickness, extending into the muscularis propria to within 0.3 cm of the serosal surface. The remaining gastric mucosa appears tan-pink with normal rugal folds, and the wall thickness averages 0.8 cm. Lymph nodes, up to 0.7 cm in diameter, are identified along the greater and lesser curvatures.\n\nMicroscopically, the lesion is a moderately differentiated epithelial tumor. Tumor involvement is present at the distal margin and extends to the serosal surface. Vascular invasion is identified. Eight of ten lymph nodes contain metastatic tumor, and there is an additional tumor deposit within the serosal adipose tissue. Multiple sections were submitted for analysis, including margins, full-thickness tumor, adjacent normal mucosa, and lymph nodes. Portions of tumor and normal mucosa were also submitted for tissue procurement."} +{"pid": "TCGA-BG-A0W1", "report": "The specimen measured 4.6 cm in maximum dimension and involved 75% of the anterior and posterior endomyometrium. Histologic evaluation showed moderately differentiated epithelial neoplasm with combined architectural and nuclear grading, classified as FIGO grade 2. The tumor invaded less than half the thickness of the myometrium and extended to the endocervical glands. Resection margins, including the vaginal margin and parametrial margin, were free of tumor involvement. No angiolymphatic invasion was identified.\n\nThe mitotic rate was 15 per 10 high-power fields. Twelve lymph nodes were examined, and none showed evidence of tumor involvement. No extranodal extension or distant metastases were observed. Peritoneal washings were negative for malignant cells. Associated findings included simple endometrial hyperplasia with atypia, complex endometrial hyperplasia without atypia, adenomyosis, and leiomyoma. The pathologic staging was pT2a, pN0, pMX, corresponding to a clinical stage IIA. No residual tumor was identified following surgery."} +{"pid": "TCGA-G9-6329", "report": "The prostate specimen weighed 46 grams and measured 5.5 cm in width, 4.5 cm in depth, and 3.5 cm in length. The right and left seminal vesicles measured 2.5 x 1.5 x 0.8 cm and 3 x 2.5 x 1 cm, respectively, and were composed of cystic tan tissue. The right and left segments of the vas deferens measured 1.3 x 0.6 cm and 1.2 x 0.6 cm, respectively, and showed firm tan tubular structures. No gross abnormalities were identified in the prostate or associated structures. Multiple sections were taken from different levels and regions of the prostate, including the apex, base, and capsules, as well as the surrounding fat and adjacent structures.\n\nMicroscopic evaluation revealed a small percentage of glandular involvement. Cellular atypia was noted with a pattern involving both sides of the prostate and extending to the posterior-lateral regions. High-grade intraepithelial neoplasia was present, and perineural invasion was identified. There was no evidence of vascular or lymphatic invasion, and the surgical margins were free of abnormal cells. The seminal vesicles and vas deferens showed no signs of cellular infiltration.\n\nPathologic staging was determined as pT2c. No lymph nodes were sampled. Additional findings were not identified."} +{"pid": "TCGA-T1-A6J8", "report": "The specimen demonstrates a hepatic neoplasm with trabecular and acinar architectural patterns. Tumor cells show moderate differentiation with scattered foci of strong reactivity for hepatocyte-specific antigen. Immunostaining with CD10 reveals no significant reactivity, and alpha-fetoprotein (AFP) staining is also non-significant. No lymph-vascular or perineural invasion is identified. Evaluation of the surrounding liver tissue shows no significant increase in fibrosis on trichrome stain. No reactive globules are present on PAS staining with or without diastase. Prussian blue stain reveals only isolated, minimal granular iron deposition within hepatocytes."} +{"pid": "TCGA-DJ-A3V5", "report": "The right thyroid nodule measured 1.4 cm in greatest dimension and was located in the right lobe of the thyroid. The nodule was white-tan, irregular, and partly calcified. Histological evaluation revealed cellular features including tall cell morphology comprising greater than 50% of the tumor. No mitotic activity or tumor necrosis was identified. Non-psammomatous calcifications were present, with a marked stromal reaction noted. The tumor lacked a distinct capsule and did not show evidence of blood vessel invasion. It extended into the perithyroidal fibroadipose tissue, and surgical margins were positive. Multicentric disease was not identified. Adjacent non-neoplastic thyroid tissue showed nodular hyperplasia. No adenomas or parathyroid glands were identified. Lymph node evaluation included one perithyroidal lymph node, which showed no evidence of involvement. The thyroid specimen weighed 11.5 g after fixation, with the right lobe measuring 4.2 x 2.1 x 1.2 cm, the left lobe 4 x 2 x 1 cm, and the isthmus 1.7 x 0.7 x 0.5 cm. All other biopsied specimens, including jugular node, right paratracheal lymph node, and Delphian node, revealed only benign fibroadipose tissue or similar non-malignant components without evidence of disease."} +{"pid": "TCGA-AA-3715", "report": "The specimen consists of a right hemicolectomy preparation. A lesion was identified in the ascending colon, characterized by poorly differentiated morphology with both glandular and squamous features. The tumor is classified as histopathological grade G3 and demonstrates ulceration of its inner surface. There is evidence of peritumorous chronic recurrent inflammation. Lymphangitic spread of the malignancy is present. The tumor extends through the layers of the colon wall into the surrounding pericolic fatty connective tissue. Evaluation of twelve lymph nodes shows no involvement, although they exhibit moderately chronic lymphadenitis. Additionally, there is chronic appendicitis. No residual tumor is observed in the resection margins, vessel ligature area, or adjacent omental fat. Based on the extent of primary tumor invasion and absence of nodal or distant spread, the staging classification indicates pT3, pN0, cMx, with lymphovascular invasion noted (L1), and complete resection (R0)."} +{"pid": "TCGA-DJ-A13L", "report": "The specimen consisted of a right thyroid lobe and isthmus measuring 5.5 x 3.5 x 1.5 cm with a portion of isthmus measuring 2.3 x 1 x 0.9 cm. A 1.4 cm ovoid, tan-white, firm nodule was identified within the right lobe, abutting the capsule. The nodule was not encapsulated and showed no evidence of necrosis or mitotic activity. Histologic evaluation revealed psammoma bodies and microscopic foci, including one measuring less than 0.1 cm. No vascular invasion or extrathyroidal extension was identified. Surgical margins were free of tumor. The non-neoplastic thyroid tissue exhibited nodular hyperplasia and chronic lymphocytic thyroiditis. Parathyroid glands were not identified in the specimen. Serial sections and special stains were performed as part of the evaluation."} +{"pid": "TCGA-BH-A0BV", "report": "The specimen consists of a right modified radical mastectomy. A lesion was identified measuring 3.0 cm on gross examination. Histologic evaluation revealed a Nottingham score of 7 out of 9, with scores of 3 for tubules, 3 for nuclear pleomorphism, and 1 for mitotic activity. The margins of resection were free of the lesion, with the closest distance being 2.0 cm anteriorly. Evidence of lymphovascular invasion was present. The skin and nipple showed no remarkable findings. Immunohistochemical staining previously demonstrated hormone receptor positivity and HER-2/neu negativity.\n\nPathologic staging was determined as T2 N1 MX. In addition to the primary lesion, there was in situ disease composed of solid and cribriform patterns with high-grade nuclear features and associated calcifications. This in situ component was admixed with the invasive lesion. Surgical margins were free of in situ disease, with the closest margin measuring 2.0 cm. Other notable findings included atypical ductal hyperplasia, an intraductal papilloma, pseudoangiomatous stromal hyperplasia, and fibrocystic changes with ductal epithelial hyperplasia and columnar cell alteration.\n\nSentinel lymph node biopsies were performed. Sentinel node #1 and sentinel node #2 each showed one lymph node negative for metastatic disease. Sentinel node #3 contained one lymph node positive for metastatic disease, with a focus measuring 2 mm (0.2 cm). Sentinel node #4 contained one lymph node positive for metastasis, showing a deposit measuring 1.5 cm with extracapsular extension of 3 mm. An additional lymph node from sentinel node biopsy was negative for metastasis. Upon completion of axillary dissection, a total of 25 lymph nodes were identified, with 2 being positive for metastatic disease. Methods of lymph node assessment included hematoxylin and eosin staining. Of note, metastatic deposits were identified in two sentinel lymph nodes, with the largest measuring 15 mm in diameter and demonstrating extracapsular extension."} +{"pid": "TCGA-HT-8018", "report": "The pathology report demonstrates a glial neoplasm with mild to moderate hypercellularity. The predominant cell type is microgemistocytic, while only a minority of cells exhibit perinuclear halos. A smaller population of cells with oblong nuclei and modest eosinophilic cytoplasm is also present. No mitotic figures, microvascular proliferation, or necrosis is identified. Immunohistochemical analysis reveals scattered MIB-1 reactive cells, with a labeling index of 5.0% in the most proliferative regions, indicating an intermediate level of proliferative activity. The histologic features overall show low-grade characteristics."} +{"pid": "TCGA-QR-A7IP", "report": "A para-aortic mass was submitted for analysis following excision. The intact specimen measured 2.4 x 2.2 x 0.9 cm in greatest dimensions, with the tumor itself measuring 2.4 cm in its largest dimension. The cut surface of the mass was variegated and red-tan in color. Gross examination revealed a soft red-tan tissue mass; photographs were taken for documentation. A portion of the tissue was procured for further use, and the remaining tissue was placed into formalin and submitted for permanent processing.\n\nMicroscopic evaluation showed a well-circumscribed lesion. The tumor capsule appeared incomplete, making assessment of invasion difficult. Margins were involved by tumor, as the tumor extended to the black-inked margin. There was no evidence of perineural invasion or extranodal lymph node involvement. Lymphovascular invasion could not be definitively assessed due to limited extratumoral material, though probable capsular lymphovascular invasion was noted.\n\nHistologic features included cells arranged in nests and sheets, with a zellballen pattern, consistent with a neuroendocrine neoplasm. Nuclear pleomorphism was present, with some cells showing vesicular nuclei and prominent nucleoli. Mitotic activity was low. No necrosis was identified.\n\nStaging was based on size and extent of the primary tumor. The tumor was less than 5 cm in greatest dimension, and there was no evidence of local invasion beyond the mass itself. No regional lymph nodes were submitted or identified, and no distant metastasis was evident. The pathologic stage was pT1. \n\nThe specimen was processed under CLIA-certified conditions, and immunoperoxidase and in-situ hybridization tests were used in the evaluation. These tests were developed and validated by the laboratory, and are not required to be cleared or approved by the U.S. Food and Drug Administration."} +{"pid": "TCGA-A7-A0DB", "report": "The specimen included three sentinel lymph nodes from the right axilla. Sentinel node #1 consisted of two lymph nodes measuring 0.6 x 0.3 x 0.3 cm and 1.3 x 0.5 x 0.5 cm, both of which were negative for metastatic disease. Sentinel node #2 was a single lymph node measuring 0.8 x 0.7 x 0.5 cm and was also negative. Sentinel node #3 measured 0.3 cm in diameter and was similarly negative. No evidence of metastasis was found in any of the four lymph nodes examined.\n\nA segmental mastectomy of the right breast was performed, with the specimen measuring 6.2 x 5.5 x 3.8 cm. A biopsy cavity containing hemorrhagic debris and a foreign object was identified centrally, surrounded by a firm tan indurated area measuring 2.5 cm in greatest dimension. This lesion was closest to the posterior margin and extended to within 2 mm of the anterior margin of excision. Histologically, the lesion showed features of moderately differentiated ductal architecture with nuclear scores of 2\u20133 and a mitotic score of 1. Multifocal calcifications were present within the lesion, and there was focal perineural invasion. Ductal carcinoma in situ (DCIS) of cribriform type was also present, comprising less than 25% of the total tumor, with central necrosis noted focally. The DCIS was located 0.5 mm from the anterior margin. Additionally, fibrocystic changes, mild to florid ductal hyperplasia, and microcalcifications were observed in the non-tumorous breast tissue. The skin overlying the tumor showed ulceration, inflammation, and reactive changes.\n\nA separate specimen of fibroadipose tissue medial to the segmental mastectomy site was unremarkable on gross examination and showed similar benign changes, including fibrocystic changes, ductal hyperplasia, and microcalcifications. All surgical margins were otherwise free of disease, except as noted near the anterior margin. Immunohistochemical staining for keratin and p63 was used to further evaluate the findings."} +{"pid": "TCGA-D6-6825", "report": "The histopathological examination was performed on a resected lesion from the right side of the tongue. The primary specimen measured 6.5 x 4.2 x 3 cm and contained a tumor measuring 2.5 x 2.2 x 1 cm. An additional surgical specimen measuring 1.5 x 1.7 x 1.2 cm was also submitted, with a beige cross-section.\n\nMicroscopic evaluation revealed a moderately differentiated invasive epithelial tumor with keratinization. The closest margin on the lateral aspect of the surgical specimen was 0.4 cm, and the closest margin at the base was 0.5 cm. A peritumoral lymphocytic reaction was observed. One lymph node was identified without evidence of tumor involvement.\n\nThe tumor was removed with adequate margins and showed no extension beyond the primary site. The cellular features were consistent with a non-high grade variant."} +{"pid": "TCGA-IG-A51D", "report": "The esophageal resection specimen involved a tumor located in the cervical esophagus measuring 5.5 x 5 x 1 cm. Microscopic evaluation showed moderately differentiated cells arranged in a pattern consistent with invasive growth into the lamina propria or submucosa. Lymph node analysis identified one positive intraabdominal lymph node out of one examined. No assessment was provided for lymphatic or venous invasion, surgical margins, or response to neoadjuvant treatment. No additional findings or comments were noted."} +{"pid": "TCGA-HT-A61B", "report": "The pathology report indicates numerous MIB-1 reactive cells distributed throughout the lesion. In the most proliferative regions, a labeling index of 22.9% was determined. The tissue sample shows features consistent with a high-grade lesion, based on the cellular characteristics and proliferation rate."} +{"pid": "TCGA-MP-A4T7", "report": "The tissue specimens include a right middle lobe lung wedge (25 grams, 8.0 x 4.0 x 2.4 cm), a right lower lobe lung wedge (5 grams, 3.5 x 2.6 x 2.6 cm), and a second right lower lobe fragment measuring 4.0 x 0.1 x 0.6 cm. Additional specimens include right pleural biopsies (No.1\u20141.0 x 1.0 x 0.6 cm and No.2\u20140.9 x 0.3 x 0.2 cm), a diaphragmatic biopsy (2.0 x 1.3 x 0.6 cm), and a mediastinal lymph node (station 9). \n\nA subpleural mass measuring 3.0 x 2.5 x 2.0 cm is present in the right middle lobe with involvement of the pleura. In the right lower lobe wedge excision No.1, there is an intraparenchymal mass measuring 1.5 x 1.5 x 1.2 cm. Both pleural biopsies show evidence of invasive cellular infiltration. The diaphragmatic biopsy also demonstrates similar findings. Histologic evaluation reveals high-grade features in multiple specimens. All resection margins are negative. No abnormal cells are identified in the second right lower lobe fragment or in the examined lymph node."} +{"pid": "TCGA-55-1594", "report": "The surgical specimen included a right lower lobe lobectomy, a level 3 subcarinal lymph node biopsy, and a level 4 lymph node biopsy. The right lower lobe contained a subpleural mass measuring 3.7 cm in its greatest dimension, with an additional dimension of 3.3 cm. The mass was located 0.1 cm beneath the pleural surface and did not extend to it. Histologic evaluation revealed poorly differentiated cells arranged in a grade 3 pattern. The tumor was confined to the lung without evidence of lymphovascular, venous, or arterial invasion. All bronchial margins were free of involvement.\n\nA total of 13 regional lymph nodes were examined, including two subpleural nodes and two loose nodes within the specimen; none showed evidence of involvement. One of nine lymph nodes in the level 7 subcarinal region contained abnormal cells, though no extranodal extension was observed. Three lymph nodes from the level 4 region appeared benign.\n\nThe specimen was well-marginated with no pleural surface retraction beyond the area directly overlying the mass. Gross examination noted a moderate amount of anthracotic pigmentation in the pleura. No additional lesions were identified in the remaining lung tissue. Multiple lymph nodes were found near the bronchial margin within the lung parenchyma, and all vascular margins were unremarkable.\n\nThe pathologic staging indicated T2 for the primary lesion size and N2 based on lymph node involvement in the subcarinal region. Distant metastasis could not be assessed from the current specimen."} +{"pid": "TCGA-AA-A01K", "report": "The specimen includes resected colon with a centrally ulcerated, moderately differentiated lesion of the colorectal type, located 1.5 cm from the aboral resection margin. There is extensive infiltration of the pericolic fatty tissue and four involved local lymph nodes. The remaining colonic tissue shows diverticulosis. All colon resection margins, including the mesocolic margin, are free of tumor involvement. Histological evaluation indicates a high likelihood of lymphatic invasion, while vascular invasion is not identified. A chronically fibrosing process involving the gallbladder is present, along with reactive changes in a local lymph node. Additionally, tumor-free fatty tissue was found at the site of resection."} +{"pid": "TCGA-A5-A1OH", "report": "The surgical specimens include bilateral salpingo-oophorectomy and total hysterectomy with cervix, as well as omentectomy specimens. The fallopian tubes show focal intraepithelial carcinoma involving the fimbriated ends. The ovaries demonstrate corpora albicantia and reactive lymphoid aggregates without evidence of tumor involvement.\n\nThe endometrial cavity contains a large exophytic mass measuring 5.2 x 5.0 x 3.0 cm with diffuse involvement of the endometrium and peripheral intraepithelial changes. There is extensive myoinvasion into both superficial and deep layers of the myometrium, extending fully through to the serosal surface. The cervical stroma is involved with infiltrating cells, and there is lymphatic space invasion present. The uninvolved endometrium shows atrophic changes, and Monckeberg's vascular medial calcifications are noted in the myometrial vessels.\n\nBoth omental specimens reveal metastatic involvement characterized by clusters of malignant cells, along with reactive mesothelial hyperplasia. Lymphovascular invasion is extensive throughout the uterine specimen, and the anterior inked margin is positive for tumor involvement.\n\nHistologically, the cells are poorly differentiated and display features consistent with high-grade serous adenocarcinoma. No lymph nodes were sampled or examined. Based on the extent of spread, staging indicates involvement of the serosa and distant metastasis to the omentum."} +{"pid": "TCGA-EA-A50E", "report": "The specimen shows a large, solid, firm mass measuring 10x8x8cm located in the cervix with extension into the uterine wall. The tumor has irregular margins and involves adjacent structures, including the bladder and rectal walls, forming secondary masses measuring 6x4x4cm and 4x3x3cm, respectively. On microscopic examination, the tissue is arranged in groups, sheets, or trabecular patterns with cells connected to one another. The malignant cells have moderate to light eosinophilic or keratinized cytoplasm, and the nuclei are enlarged with variation in size and shape, coarse chromatin, and prominent nucleoli. Frequent mitotic figures are observed. The lesion extends through the full thickness of the cervix and invades the bladder and lymph nodes. Areas of necrosis and lymphocytic infiltration are present. Histologically, the lesion shows features of a moderately differentiated malignancy with lymphatic invasion identified. Six out of six lymph nodes examined show evidence of metastatic involvement. The tumor exceeds 4.0 cm in size. No information is provided regarding venous invasion, margin status, or prior treatment."} +{"pid": "TCGA-F4-6459", "report": "The specimen consisted of a colectomy specimen involving the sigmoid colon. The tumor measured 5 x 4 x 1 cm and was identified within the large intestine. Histologic examination revealed moderately differentiated cellular features without specification of additional tumor characteristics. The tumor extended into pericolonic tissues. Metastatic involvement was identified in all six intraabdominal lymph nodes examined. Surgical margins were not specified. There was no indication of neo-adjuvant treatment effect. No additional pathologic findings or comments were noted."} +{"pid": "TCGA-HT-A614", "report": "The pathology report demonstrates a diffusely infiltrating glial neoplasm with mild to moderate hypercellularity. The tumor cells exhibit moderate atypia and include phenotypic features consistent with both oligodendroglial and astrocytic differentiation, with the oligodendroglial component being more prominent. No mitotic figures are observed. Additionally, there is no evidence of microvascular proliferation or necrosis. Immunohistochemical analysis shows only rare reactive cells with MIB-1 labeling, and the highest calculated labeling index in the most proliferative area is 0.3%."} +{"pid": "TCGA-WB-A81N", "report": "The pathology review describes a specimen from the right adrenal gland. A tan-colored lesion measuring 4.2 x 3.2 x 0.4 cm was identified, with noted central necrosis and close proximity to the resection margin. The specimen shows evidence of laceration. Histological evaluation demonstrates immunohistochemical positivity for synaptophysin, with weaker staining observed for chromogranin. Rare sustentacular cells are highlighted by S100 staining. The proliferation index, assessed by Ki67 staining, is less than 1%."} +{"pid": "TCGA-3A-A9IS", "report": "A distal pancreas and spleen specimen was received, weighing 571.3 grams. The pancreas measured 14.5 x 5.0 x 4.0 cm, and the spleen measured 17.0 x 12.0 x 4.7 cm. Within the pancreas, there was an 8.0 x 4.7 x 3.0 cm partially encapsulated, soft tan and orange, lobulated mass. The mass extended the full length of the pancreas and was located 0.7 cm from the pancreatic margin. It was surrounded by a thin membranous lining that was inked blue. A small amount of normal pancreatic tissue surrounded the mass, while the remainder of the pancreas showed yellow, lobulated tissue admixed with thick, white fibrous stroma. The spleen was homogeneous, dark red, and slightly nodular without any identifiable mass or lesion.\n\nHistologic evaluation revealed a well-differentiated cellular proliferation within the pancreas. The mitotic count was determined to be 1 per 10 high power fields. No vascular or perineural invasion was identified. The tumor did not extend beyond its capsule and surgical margins were uninvolved. Adjacent non-neoplastic pancreas showed evidence of focal chronic pancreatitis.\n\nA total of 32 lymph nodes were identified and examined; all were benign. No metastatic involvement was observed. The extent of invasion was limited to the tumor's capsule. The tumor was staged as pT2, pN0. Additional immunostaining studies are in progress and a separate report will follow. All slides and materials were reviewed by the attending pathologist to confirm findings."} +{"pid": "TCGA-DD-A4NV", "report": "The submitted specimen includes a liver resection encompassing segments V and VI, weighing 1445.0 grams and measuring 21.4 x 13.8 x 11.4 cm. Two distinct lesions were identified within this specimen, measuring 1.7 x 1.6 x 1.5 cm and 11.8 x 11.3 x 10.2 cm respectively, with the closest distance from either lesion to a negative surgical margin being 0.9 cm. Evaluation of the hepatic parenchyma revealed steatohepatitis. Additionally, six small lesions ranging from 0.2 cm to 0.4 cm in greatest dimension were observed and interpreted as bile duct hamartomas. A separate needle core biopsy from liver segment VI showed cellular features consistent with Grade 1 to 2 differentiation based on histologic evaluation of two cores measuring 1.3 cm and 1.5 cm in length."} +{"pid": "TCGA-D1-A16Y", "report": "A 255.0 gram uterus with attached bilateral fallopian tubes and ovaries was received for examination. A mass measuring 3.3 x 2.0 x 0.7 cm was identified in the left side of the endometrial cavity, with invasion into the myometrium measuring 0.2 cm; total myometrial thickness was 2.5 cm. No involvement of the endocervix was observed. A polypoid lesion measuring 1.4 x 1.0 x 0.6 cm with a narrow stalk was also noted in the posterior fundus. Extensive adenomyosis was present. Both ovaries appeared unremarkable with smooth outer surfaces and solid cut surfaces; fallopian tubes were grossly unremarkable.\n\nMultiple lymph node groups were submitted and evaluated. Left pelvic lymph nodes included 4 external iliac, 3 common iliac, and 3 obturator lymph nodes, all negative for tumor. The specimen labeled as left internal iliac lymph nodes contained no nodal tissue. Right pelvic lymph nodes included 3 external iliac, 1 internal iliac, 4 common iliac, and 2 obturator lymph nodes, all without evidence of tumor. Multiple right para-aortic lymph nodes above and below the inferior mesenteric artery (2 above, 4 below) were negative for tumor. Similarly, multiple left para-aortic lymph nodes above (3) and below (1) the inferior mesenteric artery were also negative. Both right and left gonadal vessels were free of tumor.\n\nHistologic evaluation confirmed the absence of lymphovascular space invasion. All lymph node specimens and vascular tissues were negative for tumor involvement. Representative sections of all relevant areas were submitted for analysis."} +{"pid": "TCGA-BG-A2AE", "report": "The specimen consists of a total abdominal hysterectomy with bilateral salpingo-oophorectomy, pelvic lymph node dissection, and omentectomy. The uterus weighed 138 grams and included the cervix, ovaries, and fallopian tubes. A neoplastic lesion measuring 3 cm was identified in the uterine corpus. Histologic evaluation revealed a high-grade carcinoma with mixed architectural features. Approximately 80% of the tumor displayed endometrioid-type morphology, 5\u201310% exhibited papillary serous features including high-grade nuclei and psammoma bodies, and an additional 5\u201310% demonstrated clear cell characteristics such as cytoplasmic clearing, hyalinized stroma, and hyaline globules. The endometrioid component was classified as FIGO grade 3 based on architectural and nuclear features, with nuclear grading ranging from 2 to 3.\n\nThe tumor invaded 95% of the myometrial thickness, with 18 mm of invasion into a 19 mm thick myometrium. Involvement of approximately two-thirds of the endometrial surface was noted. No evidence of cervical stromal invasion was observed. Lymphovascular space invasion was present, confirmed by immunohistochemical staining. The background endometrium showed polypoid changes with complex atypical hyperplasia and focal mucinous metaplasia. Benign findings in the uninvolved tissue included multiple leiomyomas, the largest measuring 1.1 cm, with degenerative changes. The cervix showed mild chronic inflammation, a polyp, dystrophic calcification, nabothian cysts, and reactive epithelial changes. Fibrous adhesions were present on the uterine serosal surface.\n\nThe left ovary contained a 3.5 cm endometriotic cyst along with inclusion cysts and physiologic changes. The right ovary showed only inclusion cysts and similar physiologic alterations. Both fallopian tubes exhibited reactive epithelial changes without other significant pathology.\n\nLymph node evaluation included four nodes from the left pelvic region, all negative for malignancy. Among the four nodes from the right pelvic region, one contained metastatic involvement characterized by scattered tumor cells within lymphatic spaces at the nodal capsule. No extracapsular extension was identified. The omentum was free of tumor involvement.\n\nAdditional microscopic review showed a mitotic rate of 17 per 10 high-power fields. Pre-neoplastic findings included complex atypical hyperplasia of the endometrium, endometrial polyps, and an endocervical polyp. No evidence of residual disease was found in the cervix upon histologic examination. The depth of myometrial invasion exceeded half the myometrial thickness. A total of eight lymph nodes were examined, with one involved node from the right pelvic group."} +{"pid": "TCGA-DK-A3IL", "report": "The submitted specimens include right and left distal pelvic lymph nodes, a bladder specimen with associated female reproductive structures, ureteral segments, and a ureteral stent. In the right distal pelvic lymph nodes, two out of three lymph nodes show involvement by atypical cells, with the largest focus measuring 1.2 cm. There is no evidence of extension beyond the lymph nodes. The left distal pelvic lymph node specimen contains one lymph node without any abnormal findings.\n\nThe bladder specimen reveals a lesion located in the right lateral wall, right posterior wall, and trigone. The lesion measures 3.3 x 3 cm and extends into the perivesical soft tissue but does not reach the inked surface. Vascular invasion is present, although there is no evidence of perineural invasion. The surgical margins are free of tumor involvement. The mucosa shows ulceration and a foreign body reaction. The lesion demonstrates both flat and infiltrating growth patterns, with high-grade features. Multifocal involvement within the bladder is noted. The uterus, fallopian tubes, and ovaries are unremarkable, except for stromal hyperplasia in both ovaries. No involvement is seen in the ureters or urethra. Perivesical lymph nodes are negative.\n\nUreteral specimens on both sides show no evidence of tumor involvement. The right distal ureter displays mild to moderate atypia in the urothelium, but no definitive malignant changes are identified. The left distal ureter appears benign. The right ureteral stent was examined only macroscopically.\n\nStaging assessment based on tissue examination indicates involvement of the perivesical soft tissues. Lymph node involvement is confirmed on the right side. All other submitted margins and tissues are free of disease."} +{"pid": "TCGA-RM-A68W", "report": "The tumor is composed of nests and small lobules of neoplastic cells exhibiting neuroendocrine morphology. The cells have round to oval nuclei with speckled chromatin and moderate amounts of weakly eosinophilic cytoplasm. Cytologic atypia is mild, and mitotic figures are rare. The tumor nests are surrounded by hyalinized stroma. The specimen includes a large ganglion with associated nerve fascicles, and the tumor is situated adjacent to a network of vascular structures. No necrosis is observed. Immunohistochemical staining demonstrates strong diffuse positivity for synaptophysin and chromogranin. S-100 staining highlights nerve fascicles and sustentacular cells."} +{"pid": "TCGA-08-0355", "report": "The final pathologic findings are based on biopsy and excision specimens from the right temporal lobe. The intraoperative diagnosis identified a high-grade infiltrating glioma, consistent with a high-grade astrocytoma.\n\nThree specimen portions were received fresh and labeled appropriately. Part A, labeled \u201c1 - right temporal lobe tumor,\u201d consisted of four unoriented yellow-pink soft tissue fragments measuring 0.8 x 0.4 x 0.2 cm in total. These were bisected; one half was submitted as FS1 and the remaining half placed in cassette A1. The rest of the specimen was submitted in cassette A2. Part B, labeled \u201cright temporal tumor,\u201d included five tan-pink and gray-white soft tissue fragments measuring 4.3 x 2.5 x 2.2 cm in total, submitted across cassettes B1-B4. Part C, labeled \u201cright temporal tumor, CUSA specimen,\u201d contained multiple red-tan soft tissue fragments measuring 4.2 x 3.7 x 1.7 cm in total, also distributed among cassettes C1-C4.\n\nMicroscopic and gross examination findings supported the clinical history of a right temporal lobe lesion. The attending pathologist confirmed the final diagnosis after reviewing all available pathology slides. Cellular features included high-grade morphology with infiltrative growth patterns. Staging and cellular descriptions were consistent with an aggressive neoplasm, though no definitive tumor name is provided here."} +{"pid": "TCGA-AJ-A23M", "report": "A liquid-based preparation was reviewed from 300 mL of red fluid submitted as peritoneal or pelvic washings. Microscopic evaluation revealed the presence of malignant cells.\n\nThe patient is a female with a history of serous endometrial cancer. A hysterectomy specimen was received, consisting of the uterus and cervix. The uterus measured 8.5 x 8.0 x 2.5 cm and weighed 131 grams. The endometrial cavity was completely involved by a gray tan shaggy mass measuring 11.0 x 8.5 cm, extending through the lower uterine segment into the upper portions of the endocervical canal. The mass was grossly 2.0 cm from the ectocervix and focally invaded the myometrium to a depth of approximately 0.7 cm in an area where the myometrial thickness was 2.2 cm. In the lower uterine segment, invasion depth was 8.0 mm into a 9.0 mm thick myometrium. The tumor involved the uterine corpus, lower uterine segment, and cervix with stromal invasion. Lymphovascular space invasion was present. Surgical margins, including cervical and parametrial regions, were free of tumor.\n\nLymph node dissections were performed. Right and left pelvic lymph nodes were each represented by two nodes examined; all were negative for tumor. A biopsy from the diaphragm and a specimen from the omentum were also negative for malignancy.\n\nStaging according to AJCC 2010 criteria was determined to be pT2, NO, M0. Relevant specimens included the uterus, cervix, right and left pelvic lymph nodes, diaphragm, and omentum. Serum CA 125 levels were reported, though it was noted that such values should not be used in isolation to confirm or rule out disease, and are not intended for general cancer screening."} +{"pid": "TCGA-FD-A6TC", "report": "The patient is a female who underwent cystectomy, ileo conduit, and retroperitoneal lymph node dissection. The surgical specimen included a bladder measuring 12.5 x 11.0 x 3.7 cm with ureteral stumps measuring 3 cm and 2.5 cm in length. A matted area on the left posterior bladder measured 2.5 x 2.0 x 1.5 cm and was sutured; removal revealed a 1.6 x 0.9 cm defect and a 4.0 x 3.5 cm area of peritoneal discoloration adjacent to the dome on the right. A 7.4 x 7.0 cm portion of tan-pink vaginal mucosa was fixed on the posterior aspect of the bladder.\n\nOn gross examination, a 2.5 x 1.7 cm red-tan, hemorrhagic, friable ulceration was identified in the posterior wall within an ill-defined 4.1 x 3 cm area of induration. On sectioning, the mass was white-tan, indurated, and extended through the muscularis propria into pericystic adipose tissue, approaching the deep surgical margin (2.5 cm of 2.6 cm total thickness). Inferiorly, the induration also appeared to reach the vaginal wall. Surrounding bladder mucosa was wrinkled, congested, pink-tan, with uniform wall thickness of 0.5-0.9 cm.\n\nMicroscopic evaluation demonstrated high-grade cellular features. Lesions were present in the bladder dome and posterior wall mucosa. No tumor was identified in either ovary or fallopian tube. All margins\u2014including ureteral, distal urethral, and soft tissue\u2014were free of tumor involvement.\n\nLymph node dissections from both the right and left pelvic regions were performed. A total of 16 lymph nodes were examined (8 from each side), and none showed evidence of tumor involvement.\n\nStaging was determined according to the 7th edition TNM classification system. The depth of invasion reached into adjacent structures, specifically involving the vaginal wall. The tumor was solitary, measuring 2.5 cm, located in the posterior bladder wall extending into perivesical fat. Lymph node status was negative (0/16)."} +{"pid": "TCGA-VQ-A91Q", "report": "The specimen consists of a resected portion of the upper stomach and distal esophagus. A dominant mass measuring 6.5 cm is identified at the gastroesophageal junction. The tumor extends into the distal esophagus, involving the adventitia, and infiltrates through the stomach wall into the surrounding perigastric fat. Histologic evaluation reveals poorly differentiated tubular structures with evidence of lymphatic and perineural invasion. The margin in the esophageal adventitia is involved, while the proximal and distal resection margins are free of involvement.\n\nLymph node dissection was performed according to standard protocol. Involvement is identified in multiple regional lymph node groups. Right and left paracardial lymph nodes both show involvement with capsular extension. All eight lymph nodes along the lesser curvature contain metastatic tissue with capsular invasion, as do all eight lymph nodes adjacent to the left gastric artery. Of the six lymph nodes at the celiac trunk, four are involved with capsular invasion. A single paraesophageal lymph node is also involved, though without capsular extension. In contrast, the suprapyloric lymph node is not involved. Additionally, lymphatic neoplastic thrombi are noted within the perilymphatic fat in several regions.\n\nThe omental tissue and gallbladder are unremarkable, with no evidence of tumor involvement. The gallbladder shows the presence of cholelithiasis."} +{"pid": "TCGA-MA-AA3Z", "report": "The pathology report includes two cervical biopsy specimens. Specimen A consists of a tan-pink papilliferous tissue fragment measuring 1.5 x 1.5 x 0.3 cm, submitted entirely for analysis. Specimen B consists of multiple tan-pink to tan-red soft tissue fragments with adherent clotted blood, measuring 3.5 x 2.0 x 1.0 cm. Representative sections were taken, and the remaining tissue was also submitted completely.\n\nMicroscopic evaluation of both specimens reveals superficial fragments of tissue exhibiting cellular features consistent with squamous morphology and a papillary growth pattern. No underlying stromal tissue is present in the samples to evaluate the depth or extent of involvement. Clinical correlation is advised for further assessment. The findings were reviewed and confirmed by a senior pathologist."} +{"pid": "TCGA-CZ-5982", "report": "The submitted specimen consists of a left radical nephrectomy weighing 225.5 grams and measuring 10.2 x 5.1 x 4.4 cm, with surrounding perirenal adipose tissue up to 1.1 cm in thickness. The ureter measures 1.6 cm in length and 0.3 cm in diameter, the renal artery is 1.4 cm long and 0.2 cm in diameter, and two renal veins are each 2.1 cm in length and 0.5 cm in diameter. A well-circumscribed mass measuring 3.7 x 3.4 x 3.3 cm is identified in the mid to upper pole, appearing golden yellow with focal hemorrhagic areas. The mass abuts the renal capsule but does not grossly extend into the perirenal fat. It is located 4.3 cm from the renal vein margin and does not involve the vein. The tumor is 0.1 cm from the overlying fascial margin. The remaining kidney appears tan-brown with a well-defined cortical-medullary junction. No lymph nodes or adrenal gland are identified within the surrounding fat.\n\nMicroscopic evaluation reveals that the mass is confined to the kidney without invasion of the perinephric fat. Vascular and ureteral margins are free of involvement. There is no evidence of lymphovascular invasion. A small cortical cyst measuring 0.3 cm is present in the non-neoplastic kidney. Histologic sections of the non-neoplastic parenchyma show more than 200 glomeruli, with less than 1% globally sclerosed. The preserved glomeruli demonstrate normal cellularity and mild mesangial expansion, with isolated double contours noted on silver methenamine and PAS stains. Tubules are largely intact with minimal atrophy. Interstitial fibrosis and active inflammation are minimal, involving approximately 1% of the sample. Arteries and arterioles exhibit moderately severe subintimal sclerosis. Trichrome stains confirm minimal interstitial fibrosis.\n\nCytogenetic analysis of the mass revealed clonal chromosomal aberrations, including deletion of the short arm of chromosome 3 (3p), observed in all five analyzed metaphases. Staging according to the 6th edition of the AJCC classification is pT1a Nx MX. A separate assessment of the non-neoplastic kidney tissue is pending and will be provided in an addendum."} +{"pid": "TCGA-HZ-A49G", "report": "The specimen consisted of Whipple contents, including a distal gastric resection measuring 5.7 cm (lesser curvature) and 11.0 cm (greater curvature), a 25.5 cm segment of duodenum with an average diameter of 3.3 cm, and a pancreatic head specimen measuring 2.4 cm in length, 4.6 cm superior-inferior, and 4.6 cm anterior-posterior. The pancreatic uncinate margin was focally involved by a mass lesion measuring 3.0 x 2.3 x 1.8 cm. This lesion was located predominantly in the superior-posterior region of the pancreas, within 0.1 cm of the superior, 0.3 cm of the posterior, 0.7 cm of the anterior margins, and within 0.1 cm of the surface of the pancreatic notch. It appeared to abut the common bile duct but did not grossly involve its mucosa. The distal pancreatic margin was submitted for frozen section analysis and found negative for tumor involvement.\n\nMicroscopic evaluation revealed no definitive lymphovascular invasion; however, focal perineural invasion was identified. Evaluation of regional lymph nodes showed metastatic carcinoma in 3 of 18 nodes. Three additional lymph nodes contained atypical cells, but these were considered indefinite for tumor involvement. No extranodal extension was present.\n\nA separate specimen from the gallbladder showed chronic cholecystitis with cholelithiasis. One isolated unremarkable lymph node was identified, and no dysplasia or neoplastic changes were observed.\n\nStaging was determined as pT2 for the primary tumor and pN1 for regional lymph node involvement. Distant metastasis could not be assessed. All other resection margins, including the common bile duct, final pancreatic resection margin, gastric, and duodenal margins, were negative for tumor.\n\nAdditional findings included pancreatic intraepithelial neoplasia (PanIN-2). Portions of stomach and duodenum were benign. The pancreatic duct measured 0.3 cm in diameter and could not be probed for patency. Gross architecture of the uninvolved pancreas showed lobular, pink-yellow tissue with increasing fatty change in the inferior-anterior region.\n\nInitial intraoperative assessment of the new pancreatic margin was negative for tumor. Peripancreatic fat contained lymph node candidates ranging from 0.15 cm to 1.5 cm. Multiple sections were submitted for histological review, including representative areas of the ampulla of Vater, gastric and small bowel margins, and various pancreatic regions."} +{"pid": "TCGA-B0-4818", "report": "The right radical nephrectomy specimen contains a mass measuring 9.7 cm. Microscopic evaluation reveals that the majority of the tumor is composed of cells with nuclear features corresponding to Fuhrman grade 1 and 2; however, distinct areas of grade 3 morphology are present, particularly in regions associated with adjacent necrosis. The lesion is confined within Gerota's fascia. All surgical margins examined are negative for involvement. No angiolymphatic invasion is observed. The non-tumor kidney tissue demonstrates focal interstitial chronic inflammation. Pathologic staging is pT2 with no assessment of lymph node or distant metastasis (NX, MX). Histologic grading is classified as G3 based on the presence of higher-grade nuclear features in a portion of the tumor."} +{"pid": "TCGA-E2-A109", "report": "The surgical specimens included multiple sentinel lymph nodes from the right axilla and a right breast mastectomy specimen. Sentinel lymph node #1 measured 1.8 x 0.9 x 0.3 cm and was fully submitted for analysis. Sentinel lymph node #2 measured 1.6 x 0.6 x 0.3 cm and was also fully submitted. Sentinel lymph node #3 consisted of two nodes measuring 1.0 x 0.3 x 0.2 cm and 1.4 x 0.6 x 0.5 cm, both of which were sectioned and submitted. Sentinel lymph node #4 measured 1.0 x 0.6 x 0.3 cm and sentinel lymph node #5 measured 0.9 x 0.7 x 0.2 cm; both were fully submitted.\n\nThe right breast mastectomy specimen weighed 1181 grams and measured 28 x 23 x 4.5 cm. The skin surface showed areas of brown hyperpigmentation ranging from 0.5 x 0.3 cm to 1 x 0.6 cm, along with a light tan raised lesion at the 3 o\u2019clock position measuring 0.5 x 0.5 cm. A firm lesion was identified in the upper outer quadrant, measuring 2.2 x 1.9 x 1.5 cm, located 4.3 cm from the deep margin. Another fibrous area measuring 1.5 x 1.2 x 1 cm was noted at the 12 o\u2019clock position, approximately 5.5 cm away from the main lesion. An additional dense white area measuring 2.5 x 2 x 2 cm was present in the lower inner quadrant, located about 10.5 cm from the primary lesion.\n\nMicroscopic evaluation of the sentinel lymph nodes showed no evidence of tumor involvement. In the breast tissue, histological analysis revealed two distinct foci of invasive malignancy in the upper outer and central regions. The larger focus measured 2.2 cm and demonstrated high-grade features. A second, smaller focus measuring 1 cm exhibited lower-grade morphology with tubular differentiation. Adjacent to the larger focus was in-situ disease with comedo and solid patterns, high nuclear grade, and associated microcalcifications. Extensive benign changes including fibrocystic disease and adenosis with multifocal microcalcifications were also observed. Surgical margins were free of tumor involvement.\n\nImmunohistochemical analysis of the larger tumor focus showed strong positivity for estrogen receptor (Allred score 8) and absence of progesterone receptor expression (Allred score 0). HER2 testing on this focus yielded equivocal results by immunohistochemistry (2+ staining in 50% of cells), prompting fluorescence in situ hybridization (FISH) testing, which did not demonstrate HER2 gene amplification. For the smaller tumor focus, estrogen receptor was strongly positive (Allred score 8) and progesterone receptor was also positive (Allred score 7), with HER2 status determined as negative (1+ staining in 10% of cells) without FISH testing.\n\nAdditional excised tissues from the lateral and superior aspects of the right breast contained only benign adipose tissue without any malignant findings. No vascular or lymphatic invasion was identified. The pathological staging was determined as pT2, with no lymph node involvement (0/6 sentinel nodes examined)."} +{"pid": "TCGA-E2-A572", "report": "The left breast and axillary contents specimen included a 3.4 cm invasive tumor with histological features consistent with intermediate grade changes and areas of solid and cribriform morphology, necrosis, and microcalcifications. The lesion was located centrally and did not involve any margins, with the closest margin measuring more than 2 cm. Lymph node examination showed involvement in 8 of 13 nodes, with extranodal extension present. Additional axillary dissection revealed one positive lymph node out of five. A separate excision of left breast skin and tissue showed no signs of tumor involvement.\n\nIn the right breast, a needle localization procedure identified ductal lesions with low nuclear grade cribriform and papillary patterns, found within 0.2 cm of the retroareolar margin and 0.3 cm from the anterior margin. Multiple foci of atypical hyperplastic changes were noted, along with other benign findings such as columnar cell change, sclerosing lesions, intraductal papillomas, and apocrine metaplasia. An additional excision of retroareolar tissue showed a small intraductal papilloma and usual hyperplasia without further concerning changes.\n\nImmunohistochemical analysis of hormone receptors demonstrated strong expression of estrogen receptor and weaker expression of progesterone receptor in the left-sided lesion. Staging classification for the left breast was pT2 N2 based on AJCC 7th edition criteria. For the right breast, staging was inconclusive due to absence of invasive disease."} +{"pid": "TCGA-A8-A07F", "report": "The left breast specimen shows a moderately differentiated invasive lesion with an intraductal component. The tumor measures 5.0 cm in diameter. Histologic evaluation indicates involvement of one lymph node. Vascular invasion is present. Staging classification is pT2N1a."} +{"pid": "TCGA-62-A46V", "report": "The surgical specimen consists of a lung, left lower lobe, measuring 17.0 x 12.0 x 10.0 cm, with a tumor measuring 3.3 x 3.2 x 2.9 cm. Histological evaluation reveals a mixture of growth patterns, including papillary, micropapillary, acinar, and solid arrangements. There is evidence of visceral pleural invasion. The tumor is graded as high-grade (G3). Staging indicates no lymph node involvement (0 out of 11 lymph nodes involved) and no definitive assessment of distant metastasis."} +{"pid": "TCGA-A7-A13H", "report": "The specimen includes a right axillary sentinel node and a right breast tissue sample. The sentinel node specimen consists of three lymph nodes measuring 4 cm, 1.5 cm, and 1 cm respectively. Frozen section analysis initially showed no malignancy; however, subsequent permanent sections identified metastatic involvement in the largest lymph node, measuring 8 mm in greatest dimension. No extranodal extension was observed.\n\nThe right breast specimen measures 24.5 x 19.0 x 5.0 cm and contains a diffusely cauterized, lobulated tan-gold fibroadipose tissue. A skin ellipse measuring 7.5 x 4.5 cm with a central inverted nipple is present. A stellate lesion measuring 2.2 x 1.6 x 1.3 cm is located at the junction of the four quadrants beneath the skin ellipse. This lesion is 4.0 cm from the inked deep margin and 1.7 cm from the overlying skin. A biopsy cavity measuring 2.3 x 1.3 x 1.3 cm is noted medially to the lesion. The remainder of the tissue shows predominantly adipose tissue with interspersed fibrous tissue. A small \"blue dome cyst\" is identified in the lower outer quadrant.\n\nMicroscopic evaluation of the breast tissue reveals an invasive carcinoma of histologic type consistent with infiltrating lobular carcinoma. The tumor is centrally located and measures 2.2 cm in greatest dimension (pT2). All resection margins are free of tumor involvement by a significant distance. There is no evidence of vascular invasion or ductal carcinoma in situ. Focal calcifications are present. Evaluation of the nipple shows no Paget\u2019s disease. Lobular carcinoma in situ is identified adjacent to the invasive tumor. Background breast tissue demonstrates proliferative fibrocystic changes including florid ductal hyperplasia, columnar cell change, cysts, microcysts, apocrine metaplasia, and sclerosing adenosis.\n\nImmunohistochemical staining for E-cadherin demonstrated loss of expression in both invasive and in situ components. Prognostic markers show estrogen receptor positivity (80%, moderate to strong intensity) and progesterone receptor positivity (30%, moderate intensity). HER-2 immunohistochemistry is equivocal, and the block was sent for fluorescence in situ hybridization (FISH) testing. All testing was conducted under ASCO/CAP guidelines for accuracy and validation. Distant metastasis could not be assessed.\n\nSentinel lymph node analysis included multiple sections and immunostains. Although initial frozen sections were negative, permanent sections revealed metastatic involvement in one lymph node."} +{"pid": "TCGA-DK-A3IQ", "report": "The submitted specimens include a urethral margin biopsy, left pelvic lymph nodes, bladder with prostate and seminal vesicles, left ureter, and distal right native ureter. The urethral margin biopsy shows benign urothelial and prostatic tissue. A total of 14 left pelvic lymph nodes were examined and all were benign.\n\nExamination of the bladder, prostate, and seminal vesicles reveals a complex lesion with multiple histologic features. The growth pattern includes both papillary and flat non-invasive components, as well as diffuse and infiltrating invasive components. Multiple foci of in situ carcinoma are present. The tumor extends into perivesical soft tissues and involves the left ureter and urethra. Involvement of the left ureter occurs at the orifice by in situ carcinoma, while the urethra and peri-urethral ducts also show in situ involvement. Vascular and perineural invasion are identified. Surgical margins are free of tumor. Non-neoplastic mucosa shows ulceration and a foreign body reaction. The prostate exhibits nodular hyperplasia, along with extensive acute and chronic inflammation, and high-grade prostatic intraepithelial neoplasia. The seminal vesicles are not involved. No perivesical lymph nodes were identified.\n\nThe left ureter specimen is benign, as is the distal right native ureter, which shows focal acute inflammation. Gross examination of the bladder revealed an ulcerated area measuring 3 x 2 cm on the right posterior/lateral wall, located 2.5 cm from the left orifice and 0.7 cm from the right. The lesion is limited to the mucosa with underlying dense fibrosis extending to perivesical fat. The remainder of the bladder mucosa appears unremarkable. The prostate is multinodular on sectioning.\n\nPathologic staging based on AJCC 2002 criteria indicates pT3 disease, reflecting invasion of perivesical soft tissue. There is evidence of involvement of the urethra without stromal invasion."} +{"pid": "TCGA-TS-A8AY", "report": "The patient is a female who underwent surgical intervention including left thoracotomy, bronchoscopy, photodynamic therapy, and total pleurectomy. Tissue specimens were collected from multiple anatomical sites and analyzed.\n\nA skin ellipse measuring 12.3 x 0.6 cm was excised to a depth of 1.2 cm from a previous incision site. Histologic evaluation revealed no tumor involvement, confirmed by calretinin staining. Rib tissue, consisting of fragments ranging from 1.9 to 5.7 cm in length and 1.2 cm in diameter, showed normal bone structure with trilinear marrow formation and no tumor presence.\n\nA small soft tissue fragment (0.3 x 0.3 x 0.2 cm) from the periaortic region was examined and found free of tumor cells. Lymph node specimens from Level 5 (1.2 x 0.9 x 0.9 cm) and Level 5/6 (3.6 x 2.2 x 0.9 cm) were both negative for tumor involvement, confirmed with CK5/6 staining.\n\nPhrenic nerve tissue included fibrofatty tissue with prominent nerve fibers and acute inflammation. A fragment of soft tissue from this area contained tumor cells. Level 7 lymph node (1.0 x 1.0 x 0.8 cm) and posterior intercostal lymph nodes both demonstrated tumor involvement, confirmed by calretinin staining.\n\nThe pleura specimen measured 25.7 x 12.7 x 5.8 cm and included muscle, tendinous, and adipose tissue. Histology revealed epithelioid-type tumor cells closely associated with lung tissue but without definite invasion into skeletal muscle. Immunohistochemical staining was positive for D2-40, calretinin, AE1-3, CK5/6, and WT1, and negative for CEA, MOC31, TTF1, and CD15.\n\nFive lymph node levels were examined, with two levels showing tumor involvement. Pathologic staging was determined as pT3 N1 Mx. Surgical margins could not be assessed. Frozen section analysis of the skin scar and periaortic tissue confirmed absence of tumor at those sites."} +{"pid": "TCGA-AA-3518", "report": "The specimen consists of an ileocolic resection with involvement of a lesion in the cecum measuring up to 5.5 cm in greatest dimension. Histologic evaluation reveals a moderately differentiated neoplasm of colorectal type. The lesion demonstrates infiltration into the pericolic fatty tissue. Examination of regional lymph nodes shows no evidence of metastatic involvement. Both small and large intestinal resection margins are free of tumor, as is the mesenteric resection margin. Additionally, two submucosal lipomas are identified in the ascending colon. Pathologic staging is determined as pT3 pNO (0/27) pMX; histologic grade G2, with absence of lymphovascular invasion (L0, V0) and complete resection (R0)."} +{"pid": "TCGA-BA-A6DI", "report": "The surgical pathology report includes two specimens. Specimen A is from the left true vocal cord, obtained via biopsy, measuring 1.5 x 1.3 x 0.2 cm. It consists of an aggregate of soft pink to tan tissue. Microscopic evaluation reveals invasive growth composed of moderately differentiated keratinizing cells. Immunohistochemical staining for p16 was negative, and in situ hybridization studies for high-risk HPV were also negative. Specimen B consists of a biopsy from an anterior tracheal lymph node, measuring 0.9 x 0.5 x 0.4 cm. The tissue is described as rubbery with pink to yellow discoloration and was bisected during processing. No abnormal cellular infiltration or malignant involvement is identified in the lymph node sample. Controls were appropriately performed and validated the accuracy of the staining methods."} +{"pid": "TCGA-AA-3844", "report": "The material in I) \u2013 as regards block A \u2013 shows a marked finding in terms of characteristic cell groups arranged predominantly in a tubular pattern, with a notable tendency to extend into the fatty connective tissue. Cellular atypia is present, with moderate to low-grade features observed across the specimen. The assessment includes the presence of 18 lymph nodes, seven of which contain conglomerate metastatic deposits with extensive areas of necrosis. Resection margins are free, showing cryptic epithelium with goblet cells, regular submucosa and muscularis. In II), the anastomosis ring appears regular, lined with cryptic epithelium containing goblet cells, along with isolated lymph follicles and normal submucosal and muscular layers. Grading and staging parameters indicate intermediate to higher grade cellular features, with a pT3 classification reflecting depth of invasion, and pN2 for nodal involvement. Vascular invasion (V1) and lymphatic invasion (L1) are identified. The resection status is R0."} +{"pid": "TCGA-B8-4154", "report": "A biopsy and subsequent radical nephrectomy were performed on the left kidney. The specimen from the biopsy measured 1.2 x 0.8 x 0.3 cm and was described as red/tan soft tissue. The tumor in the nephrectomy specimen measured 2 x 2 x 2 cm, was centrally located, and involved the renal medulla with a pushing border into the renal pelvis. The tumor had a firm, orange/yellow appearance with visible areas of hemorrhage and a lobulated contour; no gross necrosis was identified. The tumor was unifocal and confined entirely within the kidney.\n\nHistologic evaluation revealed no invasion of the perirenal adipose tissue, Gerota\u2019s fascia, renal vein, ureter, or large and small vessels. All surgical margins, including those of the renal artery, renal vein, ureter, Gerota\u2019s fascia, and perirenal adipose tissue, were negative. No lymph nodes were identified in the hilar region or perirenal fat. A focal area of glomerulosclerosis was noted in the kidney away from the tumor.\n\nThe histologic grade was Fuhrman grade 2 out of 4. Staging was determined as pT1a, pNx, pMx. The tumor did not demonstrate multicentricity or extension beyond the kidney. The kidney surrounding the tumor showed a normal cortex-to-medulla ratio without specific pathologic abnormalities. Multiple tissue blocks were submitted for further analysis, including sections of the tumor margin, adjacent vasculature, hilar structures, and normal kidney tissue. No digital photograph was taken during processing."} +{"pid": "TCGA-78-7154", "report": "The specimen from a left upper lobe lobectomy includes a lung measuring 220 x 90 x 17 mm. A firm mass is identified within the anterior segment of the lung beneath an area of parietal pleural adhesion on the anterolateral surface. The mass measures 40 x 17 x 32 mm and has a cream to tan cut surface with black streaking. It lies adjacent to thickened and adherent pleura, located over 25 mm from the medial pleural surface and well clear of the posterior pleural surface. The tumor is at least 40 mm away from the bronchial resection margin. Sections show no involvement of the bronchial margin but reveal squamous metaplasia and low-grade dysplasia. Surrounding lung tissue shows focal organising pneumonia, congestion, and emphysema.\n\nA separate lymph node specimen labeled as lymph node No. 5 consists of cream fatty tissue containing grey-black lymph nodes measuring 25 x 18 x 7 mm. No visible tumor involvement was observed macroscopically.\n\nMicroscopically, the lung specimen reveals a moderately to poorly differentiated carcinoma invading into the adherent parietal pleura but not reaching the soft tissue resection margin. There is evidence of perineural and intraneural invasion in the hilar region along with metastatic involvement in one peribronchial lymph node with transcapsular extension into adjacent fibrofatty tissue. Elastic stains demonstrate vascular invasion by tumor cells. The lymph node specimen shows partial replacement by metastatic carcinoma with transcapsular extension into surrounding fibrofatty tissue.\n\nMeasurements and staging indicate that the lesion is 40 mm in diameter with regional lymph node involvement and confirmed pleural invasion. Vascular invasion is documented in supplementary findings."} +{"pid": "TCGA-HD-A6I0", "report": "The patient is male. A series of tissue specimens were received and examined, including left buccal mucosa, left submandibular gland, multiple lymph node groups from the left neck and submandibular triangle, anterior mandibular marrow and bone margins, proximal left inferior alveolar nerve margin, a composite resection of a portion of the left mandible, and a re-excision of the anterior mandibular margin.\n\nMicroscopic evaluation of the left buccal mucosa showed squamous mucosa with acute and chronic inflammation, ulceration, and mild atypia, but no high-grade changes or malignant cells. The submandibular gland showed benign salivary gland tissue without malignancy. All biopsied lymph nodes, including those from left level 2B, level 1, and submandibular triangle, were benign except for one lymph node in the left neck dissection that contained metastatic involvement. A total of 44 lymph nodes were examined in this dissection, with one containing metastatic disease. The largest metastasis measured 1.4 cm, and there was no extracapsular extension identified.\n\nThe composite resection of the left mandible contained a large lesion measuring 8.9 cm in greatest dimension, with a depth of invasion of 2.6 cm. The tumor invaded bone and showed perineural invasion, as well as in situ changes. No lymphovascular invasion was seen. Margins, including mucosal, soft tissue, and bone, were all negative for malignant involvement. In addition, a separate anterior mandibular margin re-excision was also negative for malignancy.\n\nGross examination of the mandibular specimen revealed an irregular tan-gray mucosal lesion with central ulceration and a raised friable mass. The mass extended to several surgical margins, including the inferior alveolar foramen, lateral soft tissue margin, and medial soft tissue margin. Bone invasion was extensive throughout the specimen. Multiple cross-sections were taken to assess the extent of invasion.\n\nStaging was based on pathologic findings and indicated advanced local disease with regional nodal involvement."} +{"pid": "TCGA-QQ-A5VD", "report": "Surgery Date: SPECIMENS: A. WIDE EXCISION LEFT ANKLE SUBCUTANEOUS MASS. DIAGNOSIS: A. SKIN, LEFT ANKLE, WIDE LOCAL EXCISION: -LOW-GRADE CELLULAR LESION MEASURING 2.0 X 1.6 CM, INVOLVING THE DERMIS AND SUPERFICIAL SUBCUTANEOUS TISSUE. -SURGICAL MARGINS NEGATIVE FOR MALIGNANT CELLS. Note: Dr. reviewed selected slides and agrees with the above findings. GROSS DESCRIPTION: A. WIDE EXCISION LEFT ANKLE SUBCUTANEOUS MASS. Received fresh labeled with the patient's identification and designated \"wide excision left ankle subcutaneous mass\" is an oriented excision of tan-white skin measuring 4.4 x 1.2 cm, excised to a depth of 1.2 cm. The stitch designates the proximal margin. Ink code: Proximal-lateral - distal - blue, distal-medial-proximal - black. The surface of the specimen demonstrates a tan-white, indurated and raised lesion measuring 2 x 1.6 cm, located 0.9 cm from the nearest distal margin. The specimen is serially sectioned from proximal to distal. Gross photos are taken and a portion of the specimen is admitted for tissue procurement. The entire specimen is submitted as follows: A1: proximal tip. A2-A3: Serial sections. A4-A8: Serial sections demonstrating lesion. A9-A10: Serial sections. A11: Distal tip. CLINICAL HISTORY: None Given. PRE-OPERATIVE FINDINGS: Mass involving the left lower leg."} +{"pid": "TCGA-BB-A5HY", "report": "The surgical pathology report includes multiple specimens. The inferior pharyngeal margin and superior posterior pharyngeal margin each show squamous epithelium and submucosa without evidence of tumor or dysplasia. A parathyroid specimen weighs 7 mg. The left neck dissection includes levels 2 through 5, with involvement in one level 2 lymph node and two level 3 lymph nodes, for a total of three positive nodes out of twenty-four examined. Extracapsular extension is present, and the largest focus measures 5 cm in greatest dimension within level 2. The posterior pharyngeal wall specimen also shows pharyngeal wall and attached soft tissue, without tumor or dysplasia.\n\nThe resected larynx and pyriform sinus specimen demonstrate a lesion measuring 5.5 cm in greatest dimension. Histologic evaluation reveals poorly differentiated squamous cell carcinoma. Staging according to the 7th edition AJCC criteria indicates a primary tumor larger than 4 cm without fixation of the hemilarynx (pT3). Regional lymph node staging is pN2b based on metastasis in multiple ipsilateral nodes, with the largest deposit between 3 and 6 cm. Extracapsular extension is noted. Distant metastasis cannot be assessed (pMX). Surgical margins are free of tumor involvement, with the closest distance being 0.5 mm to the left lateral soft tissue margin. Vascular invasion is indeterminate, and perineural invasion is absent. Additional findings include carcinoma in situ overlying the lesion, and the left thyroid is histologically unremarkable."} +{"pid": "TCGA-44-7659", "report": "A lobectomy specimen from the left upper lobe of the lung contains a 2.9 cm gray-tan mass located within 0.3 cm of the pleural surface, which is marked with blue ink. The tumor is situated 5.5 cm from the hilar margin and approaches within 0.2 cm of a black-inked surgical margin. The surrounding pleura shows diffuse black stippling. Histologically, the lesion is composed of moderately differentiated cells arranged in a glandular pattern. All resected margins are free of involvement. Lymphovascular invasion is present, but there is no evidence of direct extension or large vessel invasion.\n\nA total of 11 hilar lymph nodes are negative for metastatic disease. Additionally, lymph nodes from levels V, II, VII, and VI are also negative. Some lymph nodes contain old hyalinized granulomas. Based on these findings, the regional lymph node staging reflects no nodal involvement. Distant metastasis cannot be assessed. The tumor is confined to the lung without extension beyond the visceral pleura."} +{"pid": "TCGA-E6-A8L9", "report": "The omentum specimen shows benign fatty tissue without evidence of malignancy. The uterus demonstrates a lesion measuring 6 cm in greatest dimension involving the endometrial cavity, with invasion into the myometrium measuring 15 mm out of a total thickness of 29 mm. Lymphovascular invasion is identified within the uterine tissue. The cervix reveals no tumor involvement but includes findings of tunnel clusters and Nabothian cysts. Multiple uterine leiomyomas are also noted.\n\nExamination of the bilateral fallopian tubes reveals no evidence of malignancy. The left ovary contains a fibroma/fibrothecoma. The right ovary demonstrates a distinct lesion measuring 1.2 cm, solid in consistency, with histologic features differentiating it from the uterine lesion. No lymphovascular invasion is observed in this ovarian lesion.\n\nLymph node dissection includes eleven nodes on the left pelvic side, four nodes on the right pelvic side, and five para-aortic nodes. All lymph nodes are free of malignant involvement. \n\nImmunohistochemical staining reveals positivity for WT-1, p53, and chromogranin A (very weak), with focal positivity for inhibin-alpha, cytokeratin AE1/3, and CAM 5.2. Staining for cytokeratin 7 and cytokeratin 20 is negative. P63 staining is also negative.\n\nThe gross examination of the uterus confirms a tan-pink friable mass occupying approximately 90% of the endometrial cavity. This mass appears to invade less than half of the myometrial thickness. The ovaries and fallopian tubes appear largely unremarkable aside from the described right ovarian lesion. Multiple sections were submitted for analysis, including representative sections of both ovaries and various uterine segments.\n\nAll surgical margins are negative for malignancy. Peritoneal cytology is negative. Based on these findings, the staging classification indicates no distant metastasis and absence of tumor in lymph nodes."} +{"pid": "TCGA-D1-A16E", "report": "The tissue specimens include the uterus, right and left ovaries, and segments of both fallopian tubes. The uterus weighed 41.3 grams. The right ovary measured 2.7 x 1.7 x 0.8 cm and was associated with a 4.3 cm segment of the right fallopian tube. The left ovary measured 3.6 x 2.8 x 1.7 cm and was attached to a 3.2 cm segment of the left fallopian tube.\n\nA polypoid mass measuring 2.1 x 1.7 x 1.2 cm was identified in the left cornu of the uterus. Microscopic examination revealed a lesion with cellular features consistent with a certain type of epithelial proliferation. The deepest invasion measured 0.2 cm into the myometrium, with a total myometrial thickness of 0.8 cm. No evidence of lymphovascular space invasion was observed. The endocervix and cervix showed no abnormal findings. The left ovary contained a well-circumscribed solid lesion measuring 2.9 x 2.3 x 1.7 cm. The right ovary appeared atrophic. Both fallopian tubes showed no significant histologic abnormalities."} +{"pid": "TCGA-AG-3881", "report": "The specimen shows a poorly differentiated malignant neoplasm with extensive infiltration into adjacent adipose and connective tissue. There is evidence of peritumoral inflammation involving the uterine tissue, although the uterus otherwise appears histologically unremarkable for the patient\u2019s age. No lymph node metastases were identified upon examination of thirty lymph nodes. Histopathological features include lymphovascular invasion and a high proliferation index."} +{"pid": "TCGA-A8-A079", "report": "The specimen shows an ablated breast sample with multiple tumor foci. The largest measures 7 cm in diameter, with two additional foci measuring 2.2 cm and 1.7 cm. The largest lesion demonstrates focal ulceration of the overlying skin and circumscribed intraductal spread. Histological evaluation reveals areas of angioinvasion. The dorsal resection margin is free of tumor involvement. Cellular features indicate a high-grade morphology. Staging assessment indicates involvement of multiple tumor sites with lymph node metastasis, while vascular invasion and other margins are negative."} +{"pid": "TCGA-28-1760", "report": "The pathology report includes multiple tissue specimens collected from the right occipital region. Tissue samples were submitted under various designations, including operative sites and research protocols.\n\nSite #1 consisted of a 0.4 x 0.3 x 0.3 cm soft pink-tan tissue fragment with no notable pathological findings. Site #2 was a 0.4 x 0.3 x 0.2 cm tan tissue specimen evaluated intraoperatively by frozen section, with microscopic features consistent with high-grade cellular atypia. Site #3 measured 0.4 x 0.3 x 0.2 cm and was composed of tan soft tissue.\n\nMultiple specimens were also submitted under an NCI research protocol. These included fragments ranging in size from 0.5 to 1.0 cm in greatest dimension. Several pieces showed gray matter with scattered abnormal cells infiltrating brain parenchyma. Some specimens exhibited necrotic changes, with one showing approximately 10% necrosis and others demonstrating less than 5% or no necrosis.\n\nThe main tumor specimen consisted of multiple fragmented pink-tan friable tissues measuring 1.0 x 1.0 x 0.5 cm in aggregate, as well as two portions of hemorrhagic brain tissue, both of which were extensively sampled.\n\nImmunostaining results demonstrated positivity for MGMT in approximately 30% of cells, retained expression of PTEN, and immunoreactivity for MAPK. Laminin beta 1 and laminin beta 2 showed moderate overexpression.\n\nCorrelation with clinical findings is recommended for further interpretation of these biomarker results."} +{"pid": "TCGA-BQ-5894", "report": "The submitted specimen includes a left radical nephrectomy with adrenal gland and hilar lymph nodes, as well as a dissection of periaortic lymph nodes. The primary lesion measures 6.5 cm in greatest diameter and is located in the upper to mid portion of the kidney at the corticomedullary junction. Histologic examination reveals high-grade nuclear features and tubulopapillary architecture. The tumor invades the renal hilar fat and demonstrates angiolymphatic invasion within small vessels and a segmental branch of the renal vein. Surgical margins are free of involvement.\n\nImmunohistochemical staining shows positivity for racemase, while CK7, CD10, and CAIX are negative. A differential consideration includes tumors of distal nephron origin, including collecting duct carcinoma and type 2 papillary carcinoma; a diagnosis of hereditary leiomyomatosis-associated renal neoplasm is also under consideration.\n\nThe adrenal gland contains a 2.3 cm tan lesion that is histologically identical to the renal mass. Seven out of seven lymph nodes examined in the hilar region show metastatic involvement, with some nodes entirely replaced by tumor. Staging indicates pT3b classification based on tumor extension into the renal vein.\n\nIn the periaortic lymph node dissection, 10 lymph nodes are identified, four of which demonstrate metastatic involvement. The largest involved lymph node measures 3 cm, with extranodal extension present.\n\nAncillary studies, including immunohistochemistry and in situ hybridization, were performed in-house and are used for diagnostic purposes. These tests have not been cleared or approved by the FDA but are utilized under appropriate CLIA certification. The final diagnosis is based on direct examination of the specimens and has been reviewed and confirmed."} +{"pid": "TCGA-19-1385", "report": "The specimen was received in four labeled sections: \"permanent,\" \"center,\" \"edge,\" and \"white matter.\" Histologic evaluation of the \"permanent\" section shows a high-grade neoplasm with features consistent with extensive necrosis. Cellular morphology demonstrates pleomorphic cells with high nuclear-to-cytoplasmic ratios, frequent mitotic figures, and areas of microvascular proliferation. Immunohistochemical staining reveals positivity for glial fibrillary acidic protein (GFAP) and elevated Ki-67 labeling index, indicating a high proliferation rate.\n\nThe \"center\" and \"edge\" sections also show similar histologic features, with marked cellular atypia, necrotic debris, and loss of tissue architecture. The \"white matter\" section contains fragments of white matter with mild hypercellularity. Scattered among these are rare atypical cells with enlarged nuclei and irregular chromatin distribution.\n\nAll sections were reviewed with appropriate immunostains and controls. Positive and negative controls were included in the testing process to ensure accurate interpretation. Some reagents used in the analysis may have been classified as analyte-specific reagents (ASRs), which are not cleared or approved by the U.S. Food and Drug Administration. The assays were developed and validated by the Department of Pathology."} +{"pid": "TCGA-UZ-A9PR", "report": "The patient underwent a left partial nephrectomy. Two distinct lesions were identified within the left kidney. The first lesion measured 5.0 cm in greatest dimension and was described as gold-colored, friable, irregular, and hemorrhagic. The second lesion measured 2.2 cm and was yellow, solid, and adjacent to the first lesion. Both lesions appeared to be encapsulated with a thin rim of surrounding renal parenchyma. There was possible focal disruption of the capsule near the first lesion. No involvement of the adrenal gland was observed; it appeared histologically normal and was located approximately 1.3 cm away from the tumor. No lesions were identified in the submitted peri-nephric soft tissue.\n\nHistologic evaluation revealed two separate tumors. Both demonstrated nuclear features consistent with Fuhrman grading\u2014Grade 3 for the larger lesion and Grade 2 for the smaller one. No tumor was identified at the resection margins. The nearest distance from the larger lesion to the renal parenchymal margin was less than 0.05 cm and to the radial fat margin was 0.2 cm. The smaller lesion was 0.15 cm from the renal parenchymal margin. No lymphatic or vascular invasion was identified. No lymph nodes were retrieved or showed evidence of tumor involvement.\n\nThe tumors were located in the upper pole of the kidney. No involvement of the renal pelvis, ureter, or renal sinus was observed. The specimen margins were negative. Based on these findings, the stage assigned was pT1bNXMX."} +{"pid": "TCGA-GC-A3YS", "report": "The specimen included a right and left ureter segment, each measuring 0.2 cm in length and 0.5 cm in diameter. Both were examined intraoperatively and submitted entirely for frozen section evaluation, which confirmed no evidence of malignancy. A radical cystoprostatectomy specimen was also evaluated. The bladder measured 7.5 x 7.0 x 6.0 cm and contained a shaggy mass on the anterior wall measuring 5.0 x 2.7 cm, extending to the trigone area. The mass was within 2.5 cm of the prostatic urethral margin and showed extension through the muscular wall into surrounding adipose tissue, with a depth of invasion approximately 1.8 cm and coming within 0.3 cm of the deep margin. Microscopic evaluation revealed high-grade cellular atypia with focal squamous differentiation. Lymphovascular space invasion was present, and surgical margins, including the right and left ureters and paravesical soft tissues, were uninvolved. Multifocal high-grade urothelial dysplasia/flat carcinoma in situ was also identified. One of two left pelvic lymph nodes showed evidence of metastatic involvement. The prostate measured 4.5 x 4.0 x 3.0 cm and showed presence of malignancy involving both lobes, accounting for approximately 10% of the prostate volume. The Gleason score was 6 (3+3), with no evidence of extraprostatic extension, seminal vesicle involvement, lymphovascular space invasion, perineural invasion, or treatment effect. Surgical margins, including the right and left lobes laterally and the prostate base, were uninvolved. A single microscopic focus at the prostatic apex was involved. No metastatic involvement was identified in the two lymph nodes received. The case was reviewed in intradepartmental consultation, confirming the findings. Clinical history did not include a preoperative diagnosis. Gross examination of the bladder and prostate showed a shaggy, gray-brown mass on the anterior wall, with no grossly identifiable lesions in the prostate. All ureteral margins were patent and uninvolved. Multiple sections from the mass, surrounding bladder mucosa, prostate tissue, and lymph nodes were submitted for analysis."} +{"pid": "TCGA-DD-A113", "report": "The resected liver specimen weighs 460 grams and measures 17.5 x 7.9 x 3.8 cm. A mass measuring 4.8 x 4.3 x 3.2 cm is present in segments V and VIII, adjacent to the gallbladder but not involving it. The hepatic capsule is uninvolved. All surgical margins are free of tumor, with the closest margin measuring 0.7 cm. Microscopic examination shows a partially encapsulated lesion with pushing-type infiltration into the surrounding parenchyma. Angiolymphatic invasion is identified within the tumor on VVG staining, though there is no extratumoral vascular invasion. The surrounding liver tissue does not show cirrhosis.\n\nImmunohistochemical staining demonstrates positivity for albumin RNA by ISH, along with patchy strong keratin expression and Hep-1 positivity. There is focal canalicular staining for pCEA and patchy cytoplasmic TTF-1 positivity. The tumor cells are negative for CD10 and mucicarmine. These findings are consistent with the histologic appearance.\n\nThe gallbladder measures 7.2 x 3.5 x 3.1 cm and exhibits subacute and chronic cholecystitis with cholelithiasis (three mixed stones). No tumor involvement is seen in the gallbladder. A biopsy of the omentum reveals fat necrosis without evidence of malignancy. One lymph node from the hepatic artery is negative for tumor."} +{"pid": "TCGA-2F-A9KO", "report": "The histologic examination revealed a high-grade lesion involving the bladder wall. The tumor measured approximately 2.5 cm in diameter and was located on the right dorsolateral aspect of the bladder. Examination of lymph nodes showed no evidence of tumor involvement, with all 18 lymph nodes assessed being negative for malignant cells. The lesion demonstrated invasive characteristics into the muscular layer of the bladder wall."} +{"pid": "TCGA-CN-4736", "report": "The surgical specimen consists of a partial glossectomy measuring 3.0 x 3.5 x 1.5 cm and an additional tissue sample measuring 2.0 x 2.0 x 0.8 cm. The main specimen has suture marks anteriorly, with a firm, focally ulcerated, pale tan-white mucosal surface and a red-tan, roughened deep surface. Cross-sectioning reveals a poorly defined firm irregular white mass extending to within 0.2 cm of the deep margin.\n\nMicroscopic evaluation confirms a moderately differentiated cellular proliferation with deep invasion into lingual musculature measuring 1.9 cm in greatest dimension. Perineural invasion is present. Resection margins are free of tumor involvement; however, the tumor is less than 1 mm from the deep margin. Additional evaluation of dorsal and deep margins confirms absence of tumor.\n\nIntraoperative frozen sections evaluated ventral, radial, and deep margins, all of which were negative for tumor involvement. Histologic grading is consistent with intermediate differentiation. Pathologic staging is pT1 with no evidence of vascular or lymphatic invasion. Additional findings include deep muscular invasion. All margins are uninvolved by tumor."} +{"pid": "TCGA-46-3766", "report": "The specimen labeled as \"right lower lobe lung wedge\" consists of a wedge-shaped segment of lung tissue measuring 7 x 2 x 2 cm. The pleural surface is pink tan to gray tan with reticulated appearance and deposits of black carbon pigment. A small area of the pleura, approximately 1 cm in size, has been marked with black dye. Upon sectioning, a tan lesion measuring 1 cm is identified, located close to the stapled margin under the pleura. The staple line was removed and the surgical margin marked with blue dye. Representative sections were submitted for analysis.\n\nAnother specimen labeled as \"anterior interlobar node\" includes four gray-black nodular tissues ranging from 0.6 cm to 1.6 cm. The largest was bisected and showed no remarkable findings. All tissues were submitted for evaluation.\n\nA third specimen labeled \"right lower lobe\" consists of a lobe of lung measuring 12.5 x 8 x 5 cm and weighing 179 grams. The pleural surface appears purple tan with reticulated texture and contains black carbon pigment deposits. Two linear stapled margins are noted measuring 3 cm and 4.5 cm. A bronchial margin sealed with staples measures 1.3 cm in diameter. Three vascular margins sealed with metallic staples range between 0.6 cm and 1 cm. At the hilum, a single lymph node measuring 0.9 cm was identified and found unremarkable upon bisection. Dissection of the bronchial tree revealed no abnormalities. Serial sectioning demonstrated air-filled spongy tissue mixed with dense, airless regions; no defined lesion was observed. Sections were submitted including the bronchial margin, vessel margin, bisected lymph node, and representative samples of pulmonary parenchyma.\n\nHistologic examination of the wedge resection reveals moderately to poorly differentiated cells arranged in a certain pattern arising from bronchial mucosa. The lesion measures 1 cm in maximum dimension and does not directly penetrate the visceral pleura. It is located approximately 0.7 cm from the stapled parenchymal margin grossly and 0.2 cm from the inked parenchymal margin after removal of staples. No lymphovascular invasion is identified. Adjacent lung tissue shows emphysematous changes approaching honeycombing.\n\nThe anterior interlobar lymph nodes show anthracotic changes but no abnormal cellular infiltration. Examination of the lobectomy specimen demonstrates benign lung parenchyma with emphysematous changes, focal consolidation, interstitial fibrosis, and fresh hemorrhage. The bronchial and vascular margins are free of abnormal cells. One peribronchial lymph node is also negative.\n\nStaging assessment indicates no regional lymph node involvement. Multiple lymph nodes examined are negative for any abnormal cellular infiltration. Vascular invasion is absent. The bronchial margin is uninvolved. The lesion is confined within the lung tissue without extension to adjacent structures. Additional findings include atelectasis and pneumonia-like changes. Based on these findings, the tumor stage is classified as pT1 NO MX."} +{"pid": "TCGA-BH-A0B3", "report": "The specimen consists of a right breast segmental mastectomy. A focus of cellular atypia is identified, characterized by a high nuclear grade and significant mitotic activity. The tumor demonstrates a solid growth pattern with areas of central necrosis. The invasive component measures 2.5 cm in greatest dimension. No definitive vascular invasion is noted. Resection margins are uninvolved, with the closest distance from the invasive component to the superior margin measuring 7 mm. Non-neoplastic changes in the surrounding breast tissue include fibrocystic alterations with apocrine metaplasia and sclerosing adenosis. Changes related to prior biopsy are also present. The overlying skin is unremarkable.\n\nLymph node assessment includes two sentinel lymph node biopsies. In the first, one lymph node is involved, with metastatic involvement measuring 7 mm. In the second, one of three nodes examined shows involvement. A total of four lymph nodes are evaluated, with two showing evidence of involvement. The method of evaluation includes standard histologic staining techniques. No extracapsular extension is reported.\n\nTumor staging is based on pathologic findings. The size of the invasive component corresponds to a pT2 classification. Lymph node involvement supports a pN1a category. Distant metastasis staging is not fully assessable. Hormone receptor status shows no expression of estrogen or progesterone receptors. HER-2 immunostaining yields a low-level result."} +{"pid": "TCGA-AP-A0LE", "report": "The submitted specimens include a total abdominal hysterectomy with bilateral salpingo-oophorectomy, as well as lymph node excisions from multiple sites including the left and right obturator, common iliac, para-aortic, and external iliac regions.\n\nMicroscopic examination of the hysterectomy specimen reveals multiple small foci of cellular changes with varying degrees of architectural complexity. The maximal thickness of tissue involvement is 1.0 mm, within a myometrial wall measuring 19.0 mm in that region. No evidence of involvement of the endocervix or vascular spaces is identified.\n\nHistologic evaluation of the endometrium shows areas of complex structural changes with nuclear atypia, set against a background of proliferative activity. The myometrium contains benign findings including adenomyosis and leiomyomas. An incidental cystic structure is noted in the right ovary. All other associated tissues show no significant abnormalities, and the parametrial regions are uninvolved.\n\nLymph node analysis shows all nodes to be benign. A total of 24 lymph nodes are examined across all sites, with none showing any abnormal cellular features. Specifically, 5 nodes from the left obturator, 1 from the left common iliac, 1 from the left para-aortic, 4 from the right para-aortic, 1 from the right common iliac, 5 from the right external iliac, and 7 from the right obturator are all negative for any concerning findings.\n\nAll findings are based on personal review of the slides and confirmed upon final evaluation."} +{"pid": "TCGA-E2-A15L", "report": "The specimen included a needle localization excision from the left breast, two sentinel lymph nodes from the right axilla, a right breast mastectomy, and an additional anterior flap from the right upper outer quadrant. The left breast specimen measured 6 x 3.5 x 2.4 cm and showed atypical lobular hyperplasia as well as changes related to a prior biopsy. No tumor was identified in the lymph nodes evaluated; one lymph node was examined from sentinel lymph node #1 and two from sentinel lymph node #2.\n\nThe right breast mastectomy specimen measured 29 x 24 x 5 cm and contained a firm, well-circumscribed mass measuring 1.8 x 1.7 x 1.7 cm located in the upper outer quadrant, 1.4 cm from the deep margin. This lesion was present in both the upper inner and upper outer quadrants. A separate focus associated with a previous biopsy site was noted, along with several smaller foci, the largest measuring 0.3 cm. The margins were free of involvement. Additional findings included ductal carcinoma in situ (micropapillary type, nuclear grade 2 with necrosis) and lobular carcinoma in situ. The skin and nipple showed no abnormal cellular changes.\n\nHistological grading revealed a modified Scarff Bloom Richardson grade 2 invasive lesion with a tubular score of 3, nuclear grade 2, and mitotic score of 1. There was no evidence of vascular or lymphatic invasion, and necrosis was not present in the invasive component. Immunohistochemical staining showed positivity for estrogen and progesterone receptors, while HER2 testing was negative by FISH.\n\nSentinel lymph node evaluation included cytokeratin AE1/3 immunostains on sections B1 and C1, which were negative. All three lymph nodes examined were free of tumor involvement. Based on AJCC Cancer Staging Manual, 7th Edition, the pathological staging was determined to be pT2 pN0.\n\nAn additional anterior flap from the right upper outer quadrant was submitted for evaluation and showed no evidence of tumor. The Oncotype DX Breast Recurrence Score assay yielded a recurrence score of 8, with an estimated 10-year distant recurrence rate of 6%. ER and PR scores were positive, while the Her2 score confirmed negativity."} +{"pid": "TCGA-14-1823", "report": "The specimen consists of two parts. The first specimen is a fresh tissue sample received for intraoperative consultation, labeled with the patient\u2019s name and medical record number as \u201cright occipital brain lesion.\u201d It includes multiple pieces of white-tan tissue measuring 0.8 x 0.1 x 0.2 cm. One-third of the specimen was used for frozen section analysis, with the remainder placed into a cryoblock labeled \u201cFS1A.\u201d The remaining tissue from this specimen was submitted in cassette \u201c1B.\u201d \n\nThe second specimen, also labeled \u201cright occipital brain lesion,\u201d was received in formalin and consists of multiple fragments of white-tan tissue measuring 2.0 x 1.4 x 0.5 cm in total. This specimen was entirely submitted in cassettes \u201c2A\u201d and \u201c2B.\u201d \n\nIntraoperative frozen section analysis of the first specimen (FS1A) revealed findings consistent with a high-grade neoplastic process. Microscopic examination confirmed the presence of atypical cells with increased nuclear pleomorphism, brisk mitotic activity, microvascular proliferation, and areas of necrosis. These features were interpreted in conjunction with clinical and radiological findings to guide intraoperative decision-making. All tissues were processed and submitted for further histopathological evaluation."} +{"pid": "TCGA-P5-A730", "report": "The patient is an adult male. The clinical history is significant for a brain lesion. Gross examination reveals grayish, soft to firm fragments of brain tissue from the right occipital and parietal lobes. Microscopic evaluation shows a glial neoplasm with features of both astrocytic and oligodendroglial differentiation. The tumor demonstrates moderate cellularity, nuclear atypia, frequent mitotic figures, and areas of necrosis. Architectural disarray and microvascular proliferation are present. Based on histologic features, the tumor is classified as a high-grade glioma. Staging according to standard grading systems places this lesion in Grade III."} +{"pid": "TCGA-A3-3316", "report": "The specimen consists of a left kidney with attached perinephric fat, measuring 15 x 12 x 7.5 cm and weighing 605 grams. The ureter and vascular margins are included. In the mid and lower portions of the kidney, there is a golden yellow and brown mass measuring 9.0 x 8.5 x 7.0 cm. This mass extends through the capsule to within approximately 0.2 cm of the inked surgical margin. Sections of the soft tissue margins, renal vein, and adjacent pelvis are submitted for analysis. No gross involvement of the renal vein or pelvis is observed. The renal cortex averages 0.5 cm in thickness. A random section of uninvolved kidney tissue is also submitted. A portion of adrenal gland measuring 2.5 cm is identified within the attached fat and appears uninvolved.\n\nMicroscopic evaluation reveals cells with clear cytoplasm and very irregular nuclei measuring approximately 20 microns in diameter. Nucleoli are large and prominent. No lymphatic or venous invasion is identified. Regional lymph nodes and distant metastasis cannot be assessed. Surgical margins are free of invasive\u75c5\u53d8. The lesion is unifocal and confined to the kidney. The greatest dimension of the lesion is greater than 7 cm."} +{"pid": "TCGA-KN-8433", "report": "The left radical nephrectomy specimen contains a multifocal lesion measuring 3.1 cm in greatest dimension, with a solid yellow cut surface located in the upper pole of the kidney. Microscopically, the lesion demonstrates cells with slightly irregular nuclei approximately 15 microns in size with evident nucleoli. The tumor is confined to the kidney without evidence of invasion into perinephric adipose tissue or the renal vein. However, there is focal involvement of the soft tissue within the renal sinus, and venous invasion is present. No other lesions are identified in the renal parenchyma. The ureteral and vascular resection margins are free of involvement, and no abnormalities are found in the adrenal gland. Grossly, the kidney measures 21 x 10 x 7 cm with attached perinephric fat, and a segment of ureter measuring 5 cm is also present. Chronic inflammation of the renal parenchyma is noted, along with areas of hemorrhage and infarction. The tumor does not extend beyond Gerota\u2019s fascia. Lymph nodes were not submitted for evaluation."} +{"pid": "TCGA-BT-A3PK", "report": "A resected mass involving retroperitoneal soft tissue demonstrates low-grade mucinous features within fibroadipose tissue. Biopsies from the distal right and left ureters both show benign urothelium without evidence of tumor involvement.\n\nA radical cystectomy specimen reveals an invasive lesion measuring 4.7 cm in maximum dimension. The tumor infiltrates the detrusor muscle layer but does not exhibit perineural or angiolymphatic invasion. Dysplastic changes are present at the urethral margin, while all other surgical margins are free of tumor involvement. Background urothelium displays acute and chronic inflammatory changes along with reactive alterations. Pathologic staging indicates pT2b classification with no lymph node metastases identified (0 out of 3 nodes examined involved), and distant metastasis could not be assessed.\n\nSegments of resected small bowel display serositis, congestion, adhesions, and localized ischemic-type changes; however, the resection margins appear viable. Additional findings include inflammatory and regenerative changes within the urinary bladder specimen."} +{"pid": "TCGA-BR-6803", "report": "The gastrectomy specimen involved a tumor measuring 4.5 x 5 x 1.2 cm located in the stomach. The histologic analysis showed an undifferentiated cellular pattern. The tumor extended to adjacent structures, specifically involving the greater omentum. A total of four regional lymph nodes were examined, and none contained metastatic involvement. Information regarding lymphatic invasion, venous invasion, perineural invasion, surgical margins, and response to neoadjuvant treatment was not provided. No additional pathologic findings or comments were noted."} +{"pid": "TCGA-CH-5753", "report": "The specimen shows a multifocal lesion with areas of minimal to poor differentiation. The largest tumor measures 1.7 cm in maximum diameter and involves approximately 30% of the prostate volume. There is infiltration of left basolateral periprostatic fatty tissue, reaching a depth of up to 1 mm. Involvement of the right seminal vesicle is noted. Multiple foci demonstrate perineural invasion. Adjacent tissue reveals high-grade intraepithelial proliferative changes and myoglandular hyperplasia. The prostatic urethral urothelium shows no dysplastic features.\n\nExamination of regional lymph nodes reveals two positive nodes on the right side out of seven assessed, while three nodes on the left side show no evidence of involvement.\n\nHistological analysis confirms extensive tumor involvement at the primary site with extension into adjacent structures. Further immunohistochemical evaluation was performed to assess vascular invasion and surgical margin status. Step sections and additional staining showed ambiguous findings at the resection margin near the right apex due to thermal artifacts; however, no definitive tumor involvement was identified at the margin. Lymphovascular invasion was confirmed through immunostaining, though no evidence of blood vessel invasion was found.\n\nFinal staging assessment indicates a maximum tumor dimension of 17 mm, involvement of approximately 30% of the prostate, with lymph node metastasis present in two of ten nodes examined. Perineural invasion is multifocal. Immunohistochemical studies confirm lymphatic invasion but not vascular invasion. Surgical margins remain negative after extensive evaluation."} +{"pid": "TCGA-AR-A2LJ", "report": "The specimen consists of a 11.5 x 7.0 x 6.0 cm lesion located in the left breast, extensively involving the breast tissue. Histologic evaluation shows a component with focal solid growth pattern and nuclear features consistent with a grade II lesion based on the Nottingham grading system (tubules 3/3, nuclei 1/3, mitoses 2/3, total score 6/9). A separate in situ component is identified, showing intraluminal necrosis. The lesion does not extend to the nipple, overlying skin, or chest wall. Following re-excision of the deep margin, all surgical margins are free of tumor, with a minimum distance of 0.8 cm at the deep margin. One sentinel lymph node from the left axilla is involved, with tumor cells present in the subcapsular sinus. Cytokeratin immunostaining supports the presence of metastatic cells in this node. There is no evidence of extranodal extension. Additional lymph node dissection specimens from the left axilla include 17 lymph nodes, all of which are negative for metastatic involvement."} +{"pid": "TCGA-D1-A17F", "report": "The specimen consists of a uterus weighing 85.0 grams with attached bilateral fallopian tubes and ovaries. A mass measuring 2.9 x 2.1 x 0.7 cm is present on the anterior wall of the endometrial cavity. Gross examination indicates that the lesion extends approximately 0.4 cm into the myometrium, where the total wall thickness measures 1.9 cm. There are two intramural leiomyomata identified, ranging from 0.3 cm to 0.5 cm in greatest dimension. The right ovary measures 2.7 x 1.9 x 1.6 cm with a cystic and solid cut surface; the left ovary measures 2.4 x 1.9 x 1.8 cm and also demonstrates a cystic and solid cut surface. Both fallopian tubes appear structurally unremarkable.\n\nHistologic evaluation confirms absence of involvement at surgical resection margins. Invasion of lymphovascular spaces is not observed. The background endometrium exhibits cystic atrophy. Bilateral ovaries and fallopian tubes show no evidence of pathological involvement.\n\nLymph node assessment includes 19 right pelvic lymph nodes and 23 left pelvic lymph nodes, all negative for malignant involvement. Based on available surgical material, staging corresponds to an early localized stage. Permanent sections stained with hematoxylin and eosin corroborate findings from frozen section evaluation. Representative tissue blocks have been submitted for further analysis. Any significant revisions identified upon permanent section review will be documented in a revised report."} +{"pid": "TCGA-14-1451", "report": "The specimen consists of two parts. Part #1 was received fresh for intraoperative consultation and consists of multiple fragments of tan-pink tissue measuring 1.5 x 1.5 x 0.8 cm in aggregate. A portion was used for frozen section diagnosis, with the remainder placed in cryoblock cassette \"FS1A,\" and additional tissue submitted in cassette \"1B.\" Part #2 was received in formalin and consists of multiple fragments of tan-brown tissue measuring 5.3 x 3.5 x 1.5 cm in aggregate. The specimen was serially sectioned, with representative sections submitted in cassettes \"2A\" through \"2F.\" Microscopic examination was performed. Intraoperative frozen section analysis of part #1 (cassette FS1A) revealed findings consistent with a high-grade neoplasm exhibiting marked cellular atypia, frequent mitotic figures, microvascular proliferation, and areas of necrosis. Cellular morphology demonstrated pleomorphic astrocytic features. The tumor involved the biopsy specimen diffusely and showed extensive infiltration into adjacent brain parenchyma. No lymph nodes were identified for evaluation. Specimens were processed and evaluated according to standard protocols."} +{"pid": "TCGA-60-2698", "report": "The surgical specimens include an excised portion of the right 6th rib measuring 1.7x2.2x1.5cm, a biopsy from a peribronchial lymph node in the middle lobe measuring 1.8x1.0x0.7cm, a right lower lobe specimen measuring 15x10x8cm, an excisional biopsy from lymph node #8 measuring 1.5x0.7x0.7cm, and another excisional biopsy from lymph node #4 measuring 0.4x0.3x0.3cm with attached fibroadipose tissue.\n\nFrozen section analysis of the middle lobe lymph node showed no evidence of metastatic disease. The right lower lobe specimen demonstrated a firm, lobulated mass measuring 5.5x5.0x4.2cm located centrally within the lobe. The mass was found to approach within 0.2cm of the visceral pleura and within 0.5cm of the hilar region. It extended into the main bronchus and was associated with mucous plugging and atelectasis in the postero-inferior segments. Examination of lymph nodes revealed involvement in peribronchial and hilar regions, while lymph node #4 appeared unremarkable. Lymph node #8 contained abnormal tissue.\n\nHistologic evaluation revealed necrotic areas within the lung lesion and transition from benign to altered epithelium. Invasion was prominent in hilar lymph nodes. Remaining lung tissue showed congestion without signs of infection. A total of 18 tissue blocks were examined."} +{"pid": "TCGA-VQ-A8PD", "report": "The specimen from the stomach (body) shows a tumor measuring 8.7 x 6.5 cm, extending from the esophagogastric junction to the duodenum. The lesion infiltrates through the wall of the segment and reaches into the surrounding perigastric fat. Perineural invasion is present, as is angiolymphatic invasion. There is moderate desmoplastic reaction at the tumor margins and minimal lymphocytic infiltration around the tumor. Surgical margins are free of tumor involvement. The omentum appears uninvolved.\n\nLymph node involvement includes: 1 out of 1 lymph node in the 12a station, 5 out of 6 in the 8a station, all 13 lymph nodes dissected along the small curvature, all 6 dissected from the greater curvature, and 1 out of 2 in the 11p station. The spleen shows congestion but no evidence of tumor involvement. The esophageal margin is also free of tumor. Staging is pT3 pN3b."} +{"pid": "TCGA-DO-A2HM", "report": "A total thyroidectomy with left neck dissection was performed. The right thyroid lobe measured 4.2 cm in length and weighed 10 grams. The left thyroid lobe measured 4 cm and weighed 14 grams. A lesion measuring 1.8 cm in greatest dimension was identified within the left thyroid lobe. Histologic examination revealed a well-differentiated tumor with classical papillary architecture and cytology. The tumor exhibited focal vascular invasion and was partially encapsulated with capsular invasion noted. The tumor showed an infiltrative growth pattern and did not extend beyond the external inked surface. Margins were uninvolved by carcinoma, with the closest margin measuring less than 1 mm from the invasive component.\n\nLymph node dissection included levels 2\u20134 on the left side. One lymph node in level 2 contained metastatic tumor cells. No lymph nodes were identified in levels 3 and 4. Additional lymph node involvement was found in two out of four lymph nodes removed during the procedure. There was no evidence of extrathyroidal extension or perineural invasion. Pathologic staging indicates the primary tumor was confined to the thyroid gland and measured greater than 1 cm but less than 2 cm. Regional lymph node involvement was unilateral with three positive nodes. Distant metastasis could not be assessed.\n\nOne parathyroid gland was identified near the left pole and appeared unremarkable. Immunohistochemical staining using HBME was positive within tumor cells. No anaplastic transformation was observed. The specimen was intact upon receipt, and all margins were adequately sampled. Fresh specimens were processed for intraoperative consultation and frozen section analysis. Multiple tissue sections were submitted for microscopic evaluation."} +{"pid": "TCGA-66-2788", "report": "The left lower lobe specimen measures 15 x 10 cm at the base and up to 19.5 cm in height. A staple suture line extends ventrally from the hilus for 2.5 cm and another cranially for 3.5 cm. The visceral pleura over segments S6/S10 shows a whitish thickened area with flat protrusion and retraction measuring approximately 6.5 x 3.5 cm. Beneath this region, a firm lesion is present, reaching a maximum size of 5 cm, with a vaguely arcuate outline and central resorption. Peripheral branches of bronchi B6, B9, and B10 lead into the lesion. The surrounding parenchyma near the lesion margin appears partly compacted and pale, with vascular branches incorporated into the lesion. The remainder of the lung tissue is largely unremarkable.\n\nLymph nodes were examined from multiple stations. In station 12 (lobar), one node from the lingula measures 1 cm, and two nodes from the lower lobe measure 1.2 cm and 0.7 cm. A 1.5 cm interlobar node (station 11) and four hilar nodes (station 10) on the left, ranging from 0.6 cm to 1.5 cm, are noted, some being linked. Three nodes from the pulmonary ligament (station 9) range between 0.4 cm and 0.9 cm. In station 4 (low paratracheal), three nodes within fatty tissue measure between 0.5 cm and 1 cm. Three additional nodes from station 3 (prevascular/retrotracheal) range from 0.3 cm to 1.2 cm. A subcarinal node (station 7) measures 1.5 cm. A paraortic node (station 6) is 2 cm with surrounding tissue, and a subaortic node (station 5) is 1 cm. On the right side, two hilar nodes (station 10) measure 1.5 cm and 1 cm, and a low paratracheal node (station 4) is 1.8 cm.\n\nMicroscopic evaluation reveals a lesion composed of destructive growth patterns and elongated, partly reticulate structures formed by large atypical epithelial cells arranged in multiple layers. These cells exhibit features suggestive of squamous differentiation, with areas of eosinophilic or clear cytoplasm and pleomorphic nuclei containing prominent nucleoli. Intercellular bridges and gaps are observed. Small clusters of tumor cells arranged in layered fashion are seen focally. Some tumor cells contain diastase-digestible, PAS-positive granules, while lacunae surrounded by tumor cells contain diastase-resistant, PAS-positive material. Areas of necrosis with inflammatory debris and granulocytes are present, along with cholesterol clefts and inflammatory cell infiltration. Tumor cell nests are found within small vessels. Transition of tumor structures into native respiratory epithelium is observed in some regions. In areas adjacent to cholesterol clefts, collections of foamy macrophages are present, as well as within a nonoxygenated subpleural space. The lesion reaches the pleura in some areas, where elastic fibers are disrupted by tumor cell nests. The pleural surface shows fibrous thickening, inflammatory infiltrates, mesenchymal spindle cell proliferation, capillary vessel ingrowth, and fibrin deposition. Centrally, the lesion partially encircles larger vessels and infiltrates a bronchus. Inflammatory infiltrates are also present in the adjacent lung parenchyma, including interstitial lymphocytic aggregates. Alveolar stroma is largely preserved, with only focal lymphocyte-rich infiltrates around peripheral airways and alveolar ducts. No tumor involvement is identified at the bronchial or major vascular resection margins. The bronchial wall demonstrates increased elastic connective tissue and chronic inflammation, with some follicular compression and glandular atrophy. Foci of fatty metaplasia are also noted.\n\nLymph node analysis shows reactive changes, particularly in larger nodes, with increased secondary follicles and active germinal centers. Anthracotic pigment deposits, macrophage accumulations, and small clusters of epithelioid monocytes are present. Sinusoidal expansion with monocytoid cells is observed in some nodes. Inflammatory and fibrotic changes are evident in the surrounding tissues of several nodes."} +{"pid": "TCGA-P8-A5KC", "report": "The left adrenal gland specimen, along with attached yellow, lobulated adipose tissue, weighs 168 grams and measures 9.5 x 8.6 x 4.5 cm. Within the adrenal medulla, there is an encapsulated, rubbery, homogeneously red-brown mass that weighs 139 grams and measures 7 x 5.5 x 4.3 cm. The uninvolved portion of the adrenal gland is mildly compressed, measuring 5 x 3.5 x 0.5 cm at its widest point, and shows a normal appearance with a golden-yellow cortex, a thin red zona reticularis layer, and a central gray medulla. Focal fibrosis is noted within the mass. Tissue from both the mass and the surrounding adrenal tissue has been collected for clinical banking. Multiple cassettes have been prepared to assess the relationship of the mass to the adrenal gland and capsule, as well as areas with fibrotic change."} +{"pid": "TCGA-BQ-7060", "report": "The clinical history notes a right upper pole renal mass. Specimens submitted include a partial nephrectomy from the right kidney and an excision of the deep surgical margin.\n\nThe main specimen, a wedge-shaped portion of kidney measuring 4.0 x 3.5 x 2.1 cm, includes a solid green mass with dimensions of 3.4 x 3.0 x 2.5 cm. The tumor is located within the kidney, with a clearance of 0.7 cm from the resection margin. No local invasion or vascular involvement was identified. Histologic examination of the surgical margins showed no evidence of tumor. Adjacent kidney tissue demonstrated focal compression-related changes. No adrenal or lymph node involvement was observed.\n\nThe deep surgical margin specimen consists of a tan tissue fragment measuring 1.6 x 1.0 x 0.6 cm. Microscopic evaluation confirmed benign renal parenchyma without atypical cells or neoplastic features.\n\nStaging criteria indicate the lesion was confined to the kidney and measured less than 7.0 cm in greatest dimension. All findings were based on personal examination of the slides and confirmed with appropriate staining techniques."} +{"pid": "TCGA-GM-A2DK", "report": "The surgical specimen from the right breast consists of a segmental mastectomy measuring 6.0 x 6.0 x 5.0 cm. A solid, white, firm lesion measuring 1.5 x 1.3 cm was identified in the central portion of the specimen. The lesion is located approximately 1.5 cm from the superior margin, 1.5 cm from the inferior margin, 1.0 cm from the superficial margin, and 2.5 cm from the deep margin. The remainder of the tissue appeared unremarkable upon gross examination.\n\nMicroscopic evaluation revealed a cellular lesion with intermediate nuclear features. The largest dimension of the lesion measured 1.6 cm. No definite lymphovascular invasion was observed, although there was some prominent retraction artifact that made this assessment challenging. Adjacent to the lesion, there was evidence of similar cellular changes showing solid and cribriform patterns, along with focal necrosis involving less than 10% of the affected area. These changes also extended focally into adjacent breast tissue. Focal fibrosis and hemosiderin deposition were noted, consistent with prior intervention. The lesion did not approach any of the surgical margins.\n\nA single sentinel lymph node, measuring 1.0 x 1.0 x 0.6 cm, was submitted for analysis and showed no evidence of involvement. Immunostains for keratin performed on this lymph node were negative.\n\nScattered mitotic figures were observed within the lesion. A central area of sclerosis was present, accounting for approximately 20% of the lesion, though it was not as pronounced as in certain other described variants. The clinical relevance of this finding remains uncertain."} +{"pid": "TCGA-BP-4756", "report": "The specimen received consists of a right kidney with attached perirenal fat and a portion of Gerota's fascia, along with a section of ureter. The entire specimen weighs 250 grams and measures 12 x 7.5 x 4 cm. The kidney itself measures 10.5 x 7 x 3.5 cm. A mass is identified in the inferior pole of the kidney, measuring 6.5 x 2 x 1.6 cm in greatest dimension. The mass is friable, variegated yellow in color, and focally hemorrhagic. It extends from the cortex to the renal pelvis and approaches the renal capsule without penetrating it. The surrounding renal parenchyma appears unremarkable. The attached ureter measures 5 cm in length and 0.3 cm in diameter, with a tan and unremarkable urothelial lining. Vascular structures are also unremarkable, with no evidence of tumor involvement. No adrenal gland tissue is identified in the specimen.\n\nA separate specimen of a portion of the right 11th rib is received, measuring 7.6 x 1.2 x 0.3 cm. It includes associated soft tissue and skeletal muscle. This specimen required decalcification prior to processing, and initial sections appear unremarkable on gross examination. Further evaluation will be conducted, and if any significant findings are identified, an addendum report will be issued.\n\nA third specimen consists of a single lymph node from the right hilar region, measuring 0.6 x 0.4 x 0.3 cm. Histologic evaluation reveals benign lymph node architecture.\n\nThe final specimen is a collection of adipose tissue from the lower pole of the kidney, measuring 3.2 x 1.5 x 0.5 cm. Microscopic examination shows benign adipose tissue without atypical features.\n\nAll surgical margins, including ureteral and vascular margins, are free of abnormal cells. The mass is confined within the renal capsule, with no evidence of extension into adjacent structures or beyond the organ."} +{"pid": "TCGA-RY-A843", "report": "The surgical specimen from the left temporal lobe was received in two parts. Part A, labeled \"left frontal lobe tumor,\" measured 3.3 x 1.8 x 1.4 cm and was submitted in whole for analysis. Part B, labeled \"left temporal lobe tumor, permanent,\" measured 2 x 2 x 1.3 cm and was also fully submitted for evaluation. \n\nMicroscopic examination revealed areas of increased cellularity and mitotic activity, with up to 4 mitotic figures per 10 high-power fields. Immunohistochemical staining was performed on block A5. The neoplasm showed strong positivity for IDH-1, with approximately 25% of cells positive for p53. The MIB-1 labeling index in the areas of highest staining was estimated at 8%. \n\nIntraoperative frozen section analysis of the left temporal lobe specimen showed infiltrating cells without features of high-grade transformation. All histologic sections were reviewed by the attending pathologist, who confirmed the final findings after evaluating all relevant materials. The patient is a man presenting with partial complex seizures and language disturbance, and underwent resection of a diffuse infiltrating lesion involving the left frontotemporal region. All tests were performed in a CLIA-certified laboratory under appropriate regulatory compliance."} +{"pid": "TCGA-BR-6452", "report": "The gastrectomy specimen involved a tumor located in the stomach measuring 9.5 x 4 x 1.2 cm. The tumor exhibited an exophytic, polypoid growth pattern and was found to extend into adjacent structures, specifically the lesser omentum. Histologic evaluation showed poorly differentiated cellular features. A total of five lymph nodes were examined, and none contained metastatic involvement. Information regarding lymphatic, venous, and perineural invasion, as well as margin status and response to any prior treatment, was not provided. No additional pathologic findings or comments were noted."} +{"pid": "TCGA-BH-A18H", "report": "The right breast specimen from a segmental mastectomy at the 9 o\u2019clock position revealed an invasive carcinoma with Nottingham grade 2 histologic features (tubule formation score 3, nuclear pleomorphism score 2, mitotic activity score 1; total score 6/9). The invasive tumor measured 0.8 cm in greatest dimension and was accompanied by ductal carcinoma in situ (DCIS) of nuclear grade 2, exhibiting cribriform, micropapillary, and focal papillary patterns with calcifications. Lobular involvement by DCIS was also present. The DCIS accounted for approximately 60% of the total tumor volume and was intermixed and adjacent to the invasive component. No lymphovascular space invasion was identified. Resection margins were free of tumor, with both invasive and in situ components located more than 0.5 cm from all margins. Additional findings included focal atypical ductal hyperplasia and previous biopsy site changes. Non-neoplastic tissue showed fibrocystic changes. Immunohistochemical staining demonstrated positivity for estrogen and progesterone receptors with H-scores of 230 and 180 respectively; HER-2/neu testing by IHC was 2+ but not amplified by FISH.\n\nOne sentinel lymph node was identified and showed no evidence of metastasis.\n\nIn the left breast, a segmental mastectomy specimen at the 12 o\u2019clock position contained an invasive carcinoma graded as Nottingham grade 3 (nuclear grade 3, tubule formation score 3, mitotic activity score 2; total score 8/9). The largest invasive focus measured 1.3 cm, with an additional satellite nodule measuring 0.2 cm located 0.5 cm away. DCIS of nuclear grade 3 with solid morphology was also present and involved lobular structures. This DCIS constituted about 15% of the overall tumor volume and was found adjacent to the invasive portion. Focal lymphovascular space invasion was observed. Surgical margins were negative for invasive or in situ disease. The invasive component was closest to the posterior margin at 0.4 cm, while DCIS was more than 0.5 cm from all margins. Skin margins were free of tumor. Fibrocystic changes were present in non-neoplastic tissue, and prior biopsy site alterations were noted. Immunohistochemistry for estrogen and progesterone receptors was positive with H-scores of 300 and 235 respectively; HER-2/neu expression was scored as 1+.\n\nLymph node evaluation from the left axillary dissection included 24 nodes, two of which contained metastatic carcinoma. The largest metastatic deposit measured 4.0 cm in diameter. There was no evidence of extracapsular extension.\n\nHistologic assessment of the right breast lesion confirmed invasive carcinoma measuring 8 mm in maximum dimension with multifocal DCIS. The tumor was classified as pT1b with negative lymph nodes (pN0[sn]). On the left side, the invasive tumor size was 13 mm with multifocality totaling 15 mm, resulting in a pT1c stage. Nodal involvement classified as pN1a was documented."} +{"pid": "TCGA-33-4583", "report": "The final report includes the following findings. The bronchial margin from the excision specimen is free of tumor involvement. In the left lower lobe of the lung, a lesion measuring 3.0 cm is identified and shows moderately differentiated cellular features. Both bronchial and vascular margins are free of tumor involvement. Evaluation of lymph nodes reveals that two of two hilar lymph nodes and two of two intrapulmonary lymph nodes are without evidence of tumor involvement. Additionally, one lymph node from the upper lobe and one lymph node at level 5 are both negative for tumor involvement.\n\nAn extensive area of lipoid and foreign body pneumonia is observed, which is interpreted as suggestive of aspiration. Based on these findings, the pathological staging is determined as pT1 NO MX."} +{"pid": "TCGA-BR-A4J7", "report": "A gross examination reveals an ulcerated lesion located in the antrum-pylorus region measuring approximately 7 x 5 x 2 cm. The lesion has a firm consistency and a myxoid gray surface. Microscopic evaluation shows ulceration of the mucosa with the presence of extensive pools of extracellular mucin containing malignant epithelial cells arranged in cord-like, acinar, adenoid, glandular, or signet ring cell patterns. These cells exhibit nuclear hyperchromasia, irregular nuclear enlargement, and prominent nucleoli. Mitotic figures are evident. The tumor extends into the serosal layer. No information is available regarding lymph node involvement, lymphatic, venous, or perineural invasion, surgical margins, or any prior treatment. The histologic grade is classified as poorly differentiated."} +{"pid": "TCGA-19-2621", "report": "The specimen consisted of three tissue samples obtained from the right temporal region. The first two specimens, measuring 0.5 x 0.5 x 0.3 cm and 1 x 0.8 x 0.5 cm respectively, were received fresh for intraoperative evaluation and showed necrotic tissue with features consistent with high-grade neoplastic changes. The third specimen, measuring 5.3 x 3.7 x 1.6 cm in aggregate, was submitted in formalin and consisted of multiple tan to pink-brown soft tissue fragments. On sectioning, the tissue appeared pale yellow-white to pink with areas of hemorrhage. Histologic examination revealed atypical cells arranged in a diffuse pattern with significant nuclear pleomorphism, frequent mitotic figures, microvascular proliferation, and regions of necrosis. All specimens were processed and submitted in five cassettes for further analysis."} +{"pid": "TCGA-19-1392", "report": "The specimen consisted of multiple tissue fragments submitted for evaluation. Tissue labeled A measured 1 x 1 x 0.4 cm and was described as white-tan and soft. Tissue B, measuring 5.5 x 4.5 x 2.0 cm, was pink-tan with a cerebriform appearance and contained blood clots. Tissue C measured 6.9 x 6.2 x 2.0 cm and was similar in appearance to B, also containing blood clots. Tissue D measured 12.3 x 6.0 x 2.0 cm and was composed of multiple irregular pink-tan cerebriform fragments. Tissue E measured 4.0 x 2.8 x 1.4 cm and appeared pink-tan and cerebriform. All tissues were submitted in cassettes.\n\nMicroscopic examination revealed scattered atypical cells positive for Ki-67 in low percentage (approximately 2\u20133%) within certain areas. These cells were present in small numbers and showed no extensive infiltration. The analysis involved immunohistochemical testing using Ki-67, which demonstrated limited labeling. Some reagents used in the assays may have included analyte-specific components not approved by the FDA. All tests were validated internally with appropriate controls. The case was reviewed in detail by the pathology department."} +{"pid": "TCGA-AR-A0TU", "report": "The specimen consists of a well-circumscribed mass measuring 4.2 x 4.0 x 3.0 cm located in the lower outer quadrant. Histologic evaluation shows high-grade cellular atypia with a Nottingham grade III classification. The tumor exhibits extensive areas of necrosis and lacks any associated in situ component. The nipple is not involved. Surgical resection margins are free of involvement, with the closest margin (deep) showing a clearance of 0.3 cm. Background breast tissue demonstrates non-proliferative fibrocystic alterations.\n\nA total of four right axillary sentinel lymph nodes (numbers 1A, 1B, 1C, and 2) were examined. All lymph nodes are devoid of tumor involvement. Blue dye was visualized in lymph nodes 1A and 1B but not in 1C or 2. Immunohistochemical staining with cytokeratin on paraffin-embedded sentinel lymph node tissue corroborates the findings observed on H&E sections. Immunohistochemistry reveals no overexpression of HER2/neu (score 1+). Nuclear staining for estrogen and progesterone receptors is absent (0% staining in both cases). The assay used for estrogen receptor detection has been developed internally and has not received clearance or approval from the U.S. Food and Drug Administration."} +{"pid": "TCGA-NK-A5CX", "report": "The surgical pathology report includes three specimens. The first and third specimens, from level 11 and level 7 lymph nodes respectively, consist of fragments of lymphoid tissue and show no evidence of malignancy.\n\nThe second specimen is a right lower lobectomy measuring 14.1 x 10.2 x 6.4 cm. Within the specimen, there is a well-defined mass measuring 4.5 x 2.8 x 2.7 cm, located 2.7 cm from the bronchial margin. The mass has a white-tan to green cut surface with areas of necrosis. Microscopic examination reveals moderately differentiated cells with a histologic grade of 2. The bronchial, vascular, and visceral pleural margins are uninvolved. Five peri-bronchial lymph nodes were examined and found to be negative, as were lymph nodes from levels 7 and 11. No invasion of lymphatic or vascular structures is identified, and there is no involvement of adjacent tissues. The remaining lung tissue shows no significant pathological changes.\n\nStaging is based on tumor size and nodal status, with the tumor classified as T2b. Lymph node status is negative. No non-neoplastic findings are noted. All margins are free of involvement. Multiple sections were submitted for analysis, including the bronchial margin, hilar lymph nodes, vascular margin, and both tumor and normal lung tissue."} +{"pid": "TCGA-IB-AAUU", "report": "The specimen was received for evaluation and included multiple tissue samples from various anatomical sites. A total of four specimens were submitted, including lymph node group 8, gallbladder, bile duct margin, and a resected portion of the pancreas and duodenum.\n\nLymph node group 8 contained one benign reactive lymph node without evidence of malignancy. The gallbladder showed mild acute inflammation with a reactive cystic duct lymph node; no malignant cells were identified. The bile duct margin did not show any atypical or malignant cells.\n\nMicroscopic examination of the pancreas and duodenum revealed a moderately to poorly differentiated invasive carcinoma involving the pancreatic head, peripancreatic soft tissues, distal common bile duct mucosa, and duodenal mucosa. The tumor measured up to 3.0 cm in greatest dimension. Histologic evaluation demonstrated extensive PanIN changes but no lymphovascular invasion. Perineural invasion was present.\n\nFourteen peripancreatic lymph nodes were examined, with one showing metastatic involvement. Resection margins were free of invasive carcinoma, with the closest distance from the tumor to the vessel bed margin being 0.1 mm and 0.5 cm from the pancreatic distal resection margin.\n\nGross examination of the resected specimen included portions of the pancreatic head (measuring 5.8 x 4.0 x 2.5 cm), duodenum (27.5 cm long), stomach, and attached soft tissue. The bile duct measured 3.5 cm in length and showed abnormal fibrous mucosa throughout. A firm tan area within the pancreas corresponded to the tumor site and extended near the inked surgical margins.\n\nMultiple sections were taken from all margins, lymph nodes, and surrounding tissues for comprehensive histologic analysis. No malignancy was found in the cystic duct lymph node, gallbladder, or bile duct margin. The tumor was staged as pT3 due to extension beyond the pancreas without involvement of major vessels. Lymph node involvement classified it as pN1. Distant metastasis could not be assessed from this specimen.\n\nAdditional findings included fibrofatty lymph node tissue, thick mucoid bile in the gallbladder, and a sharp demarcation in the duodenal mucosa. Two possible lymph nodes were identified in the peripancreatic soft tissue, measuring 0.4 cm each."} +{"pid": "TCGA-J4-A67M", "report": "A tissue specimen was received from the area anterior to the prostate, measuring 5.0 cm and composed of tan-yellow fatty tissue with a uniform appearance and no palpable masses. Three lymph nodes were identified on the left side, ranging in size from 1.8 cm to 0.6 cm, all appearing consistent with normal lymphoid tissue. On the right side, three lymph nodes were also identified, ranging from 3.0 cm to 1.0 cm; one showed a focal hemorrhagic glistening appearance on cut surface. A hernia sac specimen measured 5 x 3 x 1.0 cm and consisted of fibrofatty tissue.\n\nThe prostatectomy specimen included a gland weighing 40 grams and measuring 4 x 3.5 x 3.5 cm. The capsule was noted to be shaggy and disrupted at the inferior aspect. Seminal vesicles and segments of the vas deferens were present and showed no gross abnormalities. The gland was sectioned extensively, with multiple tissue blocks submitted for analysis.\n\nHistological evaluation revealed cellular features including small vessel lymphatic invasion and perineural involvement. No abnormal cells were identified at the margins of the prostate, soft tissue, urethra, or bladder neck. No involvement of the seminal vesicles was observed.\n\nGrading of the cellular architecture demonstrated a Gleason score of 4 + 3 = 7/10. Based on staging criteria, the extent of involvement was classified as pT3a, pNo, pMX."} +{"pid": "TCGA-66-2789", "report": "The examined tissue consists of a wedge resection from the left lower lobe, measuring 10 x 2 cm at the base and up to 4.5 cm thick, with a pleural margin. The visceral pleura shows slightly reticulate blackish pigmentation with an eccentric 2 cm star-shaped retraction. Beneath this area is a whitish lesion measuring 1.9 cm in diameter, with unclear borders and located 0.1 cm from the staple suture line. The surrounding parenchyma demonstrates partial rarefaction with lacunae up to 0.2 cm in size.\n\nThe second specimen includes an inflated, fixed left lower lobe measuring 17 x 7 cm at the base and up to 20.5 cm in height. The central bronchus resection plane is at the level of bifurcation B6. At the hilus, two lymph nodes are present, measuring 0.7 cm and 3 cm. A 4 cm staple suture line extends cranially from the hilus, and a 5.5 cm staple suture line runs caudoventrally. An arcuate defect is noted at the laterobasal margin over S8\u201310, demarcated by a 16 cm staple suture line. The visceral pleura shows accentuated lateral reticulate and patchy blackish pigmentation. Parenchymal rarefaction with lacunae up to 0.3 cm is observed throughout all segments.\n\nAdditional specimens include a 2.7 cm plate-like parietal pleura tissue up to 0.4 cm thick; two lymph node parts (0.4 cm and 1.5 cm) from the lobar region (station 12); a 1.5 cm lymph node from the interlobar region (station 11); a 1.5 cm lymph node and fatty tissue from the hilar region (station 10); two 0.8 cm lymph nodes from the pulmonary ligament (station 9); a 0.8 cm lymph node with surrounding tissue from the prevascular and retrotracheal region (station 3); a 2.2 cm lymph node from the subcarinal region (station 7); and a 1.5 cm lymph node fragment from the right hilar region (station 10). A skin specimen from the left thorax measures 2 x 0.6 cm and contains a central button-like, raised brown lesion measuring 0.7 cm, located at least 0.1 cm from lateral resection margins and at least 0.6 cm from the poles.\n\nHistological evaluation reveals findings consistent with intraoperative assessment. The lesion involves lymphangioinvasion at its margin and has produced metastases in hilar lymph nodes and in lymph nodes from other regions. The visceral pleura, residual lung tissue including bronchial and vascular resection margins, and certain lymph node samples are free of tumor involvement. Additional findings include multiple non-necrotizing epithelioid cell granulomata primarily located in paravasal interstitial areas, slight centroacinar emphysema, fibrosis of the parietal pleura, and lymph nodes showing epithelioid cell reactions with necrotic alterations and anthracotic pigment deposits. A seborrheic keratosis of the skin is also noted.\n\nNo asbestos bodies were identified in the prepared sections, though further investigation, including dust analysis, is recommended to assess potential asbestos exposure."} +{"pid": "TCGA-ZJ-AAXA", "report": "The specimen consists of a cervical cone and endocervical curettings. The cervical cone measures 2 x 2 x 1.9 cm and is an irregular LEEP specimen with a deep red, glistening, granular epithelial surface. A black suture marks the 12:00 position. The specimen was inked with blue on the endocervix and black on the ectocervix, and was radially sectioned and entirely submitted in 10 cassettes representing various clockface positions.\n\nMicroscopic evaluation shows a lesion with involvement circumferentially around the cervix, with invasion into the deep and endocervical margins. The affected area measures at least 7.0 mm in depth and 10.0 mm in lateral extension. Tumor cells are present across all sections examined, and there is focal evidence of vascular space involvement. The endocervical curettings consist of a blood clot measuring 2 x 2 x 0.3 cm with small fragments of tissue showing similar cellular changes. All specimens were processed and evaluated."} +{"pid": "TCGA-95-A4VN", "report": "The surgical specimens were obtained from a right lower lobe wedge resection. A nodule measuring 3.5 x 3.3 x 3.2 cm was identified and found to be poorly differentiated. No visceral pleural invasion or vascular invasion was observed. Of two lymph nodes examined, one showed involvement by carcinoma; the other was an intraparenchymal lymph node without involvement. Additional findings included emphysematous changes.\n\nIn another specimen, involvement of one out of two lymph nodes was identified. Features included bronchiectatic changes and bronchiolitis.\n\nA third specimen contained a lesion measuring 1 mm. No visceral pleural or vascular invasion was noted. Three intraparenchymal lymph nodes were negative for carcinoma. Additional findings included atypical glandular proliferation, acute bronchopneumonia, bronchiolitis, emphysematous changes, and a small meningothelial-like nodule.\n\nThe nodules in the different specimens exhibited distinct histological features and were considered potentially separate lesions, especially in light of pre-existing atypical glandular proliferation.\n\nLymph node examination across all specimens totaled seven nodes, with two showing involvement. The tumor measured greater than 3 cm but not more than 5 cm and was surrounded by lung tissue. No evidence of extension into the main bronchus or beyond was observed.\n\nOther findings included focal parenchymal changes, inflammatory processes, and structural alterations such as emphysema and bronchiectasis. Multiple sections were submitted for analysis, including margins and lymph nodes. Specimen margins were unremarkable, and no definitive malignant involvement was identified at those sites."} +{"pid": "TCGA-DJ-A2QA", "report": "The clinical history notes a patient with a right thyroid nodule previously diagnosed as positive for malignancy on fine needle aspiration. The submitted specimens include a biopsy of parathyroid tissue, a right thyroid lobectomy, and a left thyroid lobectomy.\n\nExamination of the parathyroid biopsy revealed benign parathyroid tissue. The right thyroid lobe measured 5.3 x 3 x 1.7 cm and contained two distinct lesions. The larger lesion measured 1.3 cm in greatest dimension and was located in the superior/mid portion of the lobe, adjacent to the posterior margin. A second, smaller lesion measured 0.5 cm and was identified in the lower lobe. Both lesions were white and solid. Histologic evaluation showed well-differentiated cells without mitotic activity or tumor necrosis. The larger lesion lacked encapsulation and focally extended into adjacent fibroadipose tissue. No blood vessel invasion was observed. Surgical margins were free of involvement. Additionally, two small separate foci measuring 0.1 cm and 0.5 cm were identified, consistent with microcarcinomatous changes. Non-neoplastic thyroid tissue appeared normal, and no parathyroid glands were identified. One lymph node was examined and showed benign features.\n\nThe left thyroid lobe measured 4.3 x 2.8 x 1.4 cm and contained a single fibrotic area measuring 0.3 cm located in the mid portion near the posterior margin. Histologic review identified two small foci measuring 0.15 cm and 0.1 cm. These lesions exhibited no mitotic activity or necrosis, and no vascular invasion or extrathyroid extension was present. Surgical margins were clear, and the remainder of the thyroid tissue was unremarkable. No parathyroid glands were found in this specimen.\n\nAll sections from each specimen were fully evaluated, and the findings were based on direct examination of the slides. Intraoperative frozen section analysis of the parathyroid biopsy confirmed the presence of parathyroid tissue, which was consistent with the final diagnosis."} +{"pid": "TCGA-33-4533", "report": "The resected left lung specimen shows a poorly differentiated carcinoma with both distinctive squamous and high-grade spindle cell features. The tumor involves the pleural surface, while all other surgical margins are free of tumor involvement. Examination of lymph nodes reveals no evidence of tumor in one hilar lymph node, one lymph node from station 5, and one lymph node from station L11, each associated with fibroadipose tissue. The non-involved lung parenchyma demonstrates emphysematous changes."} +{"pid": "TCGA-EB-A5FP", "report": "The specimen consists of an excised skin lesion from the trunk measuring up to 3.5 cm in diameter and 1.5 cm in thickness. The lesion is pigmented and demonstrates superficial ulceration. Histologically, the lesion exhibits malignant features with a tumor thickness of 8 mm measured by Breslow method. There is no evidence of venous invasion and margins are uninvolved. Other features including lymphatic invasion, lymph node involvement, and presence of satellite nodules were not specified. No evidence of neoadjuvant treatment was observed."} +{"pid": "TCGA-SX-A7SS", "report": "The pathology report includes findings from three specimens. The first was a precaval lymph node, which showed no evidence of malignancy. A second specimen from a right renal mass measured 2.9 x 2.5 x 2.0 cm and was found to be unifocal. Gross examination revealed no extension into perinephric tissue, beyond Gerota's fascia, into the renal sinus, renal vein, or collecting system. The tumor was described as bright yellow-red with focal necrosis and was located at least 0.4 cm from the nearest inked parenchymal margin. Microscopic evaluation showed no sarcomatoid features, tumor necrosis, or microscopic extension beyond the primary site. Nuclear grade was Fuhrman 3. The surgical margins were negative by at least 0.3 cm. No lymph-vascular invasion was identified, and there were no additional findings in the nonneoplastic kidney. A third specimen, an additional precaval lymph node, also showed no malignancy. All measurements and evaluations contributed to the overall staging assessment."} +{"pid": "TCGA-PK-A5HA", "report": "The specimen consists of a resected left adrenal mass and a separate piece of fibroadipose tissue. The adrenal specimen measures 7.0 x 6.0 x 5.0 cm and weighs 70.2 g. The adrenal gland itself measures 5.2 x 4.0 x 5.0 cm and weighs 47.3 g. A well-circumscribed, multilobulated mass measuring 4.4 x 4.0 x 5.0 cm is identified within the adrenal gland. On sectioning, the tumor has a variegated light brown to tan color, is solid and firm. The remaining adrenal tissue appears unremarkable.\n\nMicroscopic evaluation reveals a Fuhrman nuclear grade IV neoplasm with predominantly single cell necrosis. Mitotic activity exceeds 5 mitoses per 50 high power fields, and atypical mitoses are present. The growth pattern is solid and diffuse, with eosinophilic cell type comprising more than 90% of the cells. Lymphovascular invasion of sinusoidal type is noted, along with focal capsule invasion.\n\nImmunohistochemical staining shows strong positivity for calretinin, synaptophysin, and Melan A (A103). There is variable positivity for LMWK (CAM 5.2), inhibin, CD10 (cytoplasmic), and p53. Stains for EMA, S100, and chromogranin are negative. MIB-1 labeling index is 20%.\n\nMargins are uninvolved by tumor. No treatment effect is identified. One regional lymph node was examined, and no metastasis was found. No distant metastasis is identified. Tumor size is 5.0 cm in greatest dimension without extra-adrenal invasion. Pathologic staging is pT1, pN0.\n\nAdditional findings include tumor necrosis, degenerative changes, and hemorrhage. The second specimen, consisting of fibroadipose tissue measuring 5.5 x 2.2 x 1.7 cm, shows no pathological findings."} +{"pid": "TCGA-BC-A10Y", "report": "The gallbladder specimen measured 7.6 x 3.0 x 1.0 cm with a wall thickness of 0.2 cm. The external surface was green and glistening with an area of cauterization. The mucosa appeared velvety and brown without significant abnormalities. No gallstones were identified.\n\nA segment of liver from the left lobe weighed 740 grams and measured 15 x 11 x 9 cm. A dominant mass measuring 13.5 x 9.0 x 7.5 cm occupied nearly the entire section. The cut surface of the mass was yellow and lobulated with areas of necrosis. The tumor approached the capsule but did not appear to penetrate through it. It was located within 0.3 cm of the inked surgical margin. Multiple sections were taken from the surgical margins and various regions of the tumor, including anterior/inferior, mid-inferior, posterior inferior, superior lateral, and posterolateral areas. Additional sections included areas with hemorrhage and adjacent normal tissue.\n\nMicroscopic evaluation revealed moderate to poorly differentiated cellular features with multiple foci suggestive of lymphovascular space invasion. Surgical margins were free of involvement. In the portal vein region, there was Congo red-positive material observed, consistent with amyloid deposition; however, no such deposits were found in the liver parenchyma. Adjacent liver tissue showed mild steatosis and reactive changes but no cirrhosis.\n\nA separate biopsy fragment measuring 0.8 x 0.2 x 0.2 cm was submitted entirely for frozen section analysis. Another tissue sample measuring 1.2 x 0.8 x 0.5 cm was bisected, with one portion used for frozen section and the other submitted for further histologic evaluation.\n\nFrozen section assessment confirmed the presence of abnormal cellular morphology in the liver tissue. All findings were confirmed upon further microscopic examination by the pathologist."} +{"pid": "TCGA-BP-4768", "report": "The left kidney specimen measured 6.8 x 3.7 x 3.2 cm and weighed 33 grams. A well-circumscribed, bright yellow mass with focal hemorrhage was identified, measuring 3.0 x 2.6 x 2.2 cm, located 0.2 cm from the inked surgical margin. A small focus of similar tissue was noted infiltrating the perinephric fat near the margin, measuring 0.6 x 0.4 cm. Histologic evaluation showed nuclear grade II/IV cells without evidence of local invasion or renal vein involvement. The surgical margins were free of abnormal tissue. Adjacent non-neoplastic kidney and adrenal gland showed no significant findings.\n\nA separate specimen containing para-aortic lymph nodes was received, consisting of seven lymph nodes ranging in size from 0.4 to 0.8 cm. No abnormal cellular infiltration was identified in any of the lymph nodes.\n\nTwo additional specimens were received, each labeled as cyst wall. Both consisted of soft tan-pink tissue with hemorrhagic areas. Measurements were 1.5 x 1.4 x 0.6 cm for the first and 1.4 and 1.7 cm for the second. Microscopic examination revealed benign cortical cysts with no atypical features.\n\nSections submitted included tumor with margins, tumor within fat, normal kidney, and lymph node tissues. Intraoperative frozen section confirmed absence of tumor at the surgical margin and identified a renal cortical neoplasm. Final histopathologic analysis confirmed these findings. The tumor was confined to the kidney with no regional spread identified."} +{"pid": "TCGA-X7-A8DJ", "report": "The operative procedure involved sternotomy and mediastinal dissection. The specimen submitted was a resected mediastinal mass, weighing 220 grams, with overall dimensions of 15 x 11 by up to 5 cm. The mass measured 9 x 6.5 by up to 2.4 cm and was described as pink-tan, lobulated, and fairly well delineated. It abutted the inked external surface in multiple areas and contained a central area of degeneration measuring 2 cm in greatest dimension. The mass appeared partially encapsulated, with uninvolved margins; the tumor was located 0.3 cm from the closest margin. Histologically, the tissue showed features consistent with a mixed cellular pattern, including both components observed. No capsular invasion, tumor extension, lymph-vascular invasion, or metastasis was identified. No regional lymph nodes were submitted or found. All surgical margins were free of tumor involvement. Immunohistochemical studies showed negative staining for synaptophysin and chromogranin in one component, while positive staining was observed with keratin AE1-AE3. The pathological staging indicated an early stage based on gross and microscopic findings of encapsulation, with no evidence of distant spread or implantation."} +{"pid": "TCGA-BR-6709", "report": "The specimen consists of a subtotal gastrectomy with a tumor located in the stomach measuring 5x0x6 cm. The tumor has an exophytic, polypoid appearance. Histologic evaluation shows poorly differentiated cellular features. The tumor extends to the subserosa. A total of 15 lymph nodes were examined, and all showed involvement with metastatic changes. No venous invasion is identified. Surgical margins are uninvolved. Other features such as lymphatic or perineural invasion, response to neoadjuvant treatment, and additional findings are not specified."} +{"pid": "TCGA-UW-A72H", "report": "The specimen consists of a right radical nephrectomy from a male patient with a renal mass. The kidney measures 12.5 x 8.0 x 4.5 cm and weighs 230 grams after fixation and removal of perinephric fat. The overall specimen, including perinephric tissue, measures 20.9 x 14.0 x 5.5 cm and weighs 450 grams. A small piece of yellow/orange tissue near the superior staple line may represent adrenal tissue.\n\nA single tumor is identified in the mid-pole, lateral aspect of the kidney. The tumor measures 5.2 x 5.0 x 4.5 cm and has a tan/red, soft, well-circumscribed cut surface. It is confined within the kidney and does not involve the perirenal adipose tissue, Gerota\u2019s fascia, renal vein, ureter, renal sinus, pelvicaliceal system, or adrenal gland. No multicentricity is observed.\n\nHistologically, high-grade malignant cells are present with eosinophilic cytoplasm and large vacuolated cells adjacent to blood vessels. Immunohistochemical staining shows positivity for CK7 and E-cadherin, and negativity for CD10. CD117 staining is non-contributory due to background staining. Capsular invasion is not identified. Microscopic involvement is noted in the renal sinus (slide A9), but no invasion is observed in major veins, the ureter, or lymphatic vessels. All surgical margins, including those of the renal vein, ureter, and Gerota\u2019s fascia, are negative.\n\nThe histologic grade is Fuhrman grade 4. Based on available information, the staging is pT3a, pNx. Tissue samples submitted include sections of the tumor, adjacent cortical tissue, renal sinus fat, ureter, vein, artery, and hilar regions. No other significant findings are identified."} +{"pid": "TCGA-V4-A9EA", "report": "Left eye enucleation specimen included a fragment of optic nerve measuring 12 mm. No visible extrascleral extension was observed. The tumor is intraocular, composed of fusiform cells with moderate pigmentation and a low mitotic index, with no evidence of necrosis. The lesion is located at the posterior pole, surrounding the emergence of the optic nerve. It measures 13 mm at its base with a thickness of 7 mm, and remains distant from the ciliary processes. The optic foramen, optic nerve, and meningeal sheaths are uninvolved, as is the cut end of the optic nerve. Samples were taken for cryo preservation and xenografts. The tumor size is reported as 10 mm, with no involvement of the sclera or extrascleral extension."} +{"pid": "TCGA-A6-3809", "report": "The surgical specimen consists of an extended right hemicolectomy with subtotal colectomy, including 6 cm of terminal ileum and 50 cm of contiguous colon. A segment of omentum measuring 30 \u00d7 11 \u00d7 1 cm is adherent to the outer colon wall over a 6 \u00d7 5 cm area, with localized induration. The serosal surface of the bowel away from this attachment appears glistening and tan-pink. No appendix is present. Upon opening the bowel, the small intestine averages 4.5 cm in circumference and the colon 8.5 cm. The small bowel mucosa appears normal. In the colon, there is a circumferential lesion spanning 9 cm in length and up to 1.2 cm in thickness. This lesion expands the bowel circumference to 12 cm in that region and extends through the bowel wall into adjacent adipose tissue, involving the adherent omentum. The lesion approaches but does not clearly reach the outer margin of the specimen and is located 24 cm from the distal resection margin. Elsewhere, the colonic mucosa appears tan-pink with edematous folds and contains multiple small polyps, up to 0.3 cm in size. Multiple soft tan lymph nodes are identified within the adipose tissue.\n\nHistologically, the lesion demonstrates moderately differentiated growth with some mucinous features. The lesion penetrates completely through the bowel wall into surrounding fat. Both proximal and distal resection margins are free of involvement. The closest approach of the lesion to the outer surface is less than 1 mm where it interfaces with the adherent omentum; however, it is unclear whether this represents a radial margin or a free surface. There is prominent necrosis within areas of the lesion. No vascular invasion is definitively identified. Twenty-four regional lymph nodes are examined and none show evidence of involvement. Additionally, a separate adenomatous polyp is identified."} +{"pid": "TCGA-HT-7610", "report": "The microscopic examination reveals a moderately hypercellular glial neoplasm characterized by cells with round nuclei, often displaying perinuclear halos. A minor component of small fibrillary astrocytes is also present. There is minimal cellular atypia and no identifiable mitotic figures. No microvascular proliferation or necrosis is observed. The lesion demonstrates diffuse infiltration of both gray and white matter. Immunohistochemical staining shows scattered MIB-1 reactive cells, with a labeling index of 2.2%, suggesting modest proliferative activity, which aligns with the overall low-grade appearance of the neoplasm."} +{"pid": "TCGA-26-1442", "report": "The specimen consisted of three separate tissue samples labeled A, B, and C. Specimen A measured 0.9 x 0.6 cm and was composed of tan to beige, edematous soft tissue fragments. A representative portion was submitted for frozen section analysis, with the remaining tissue placed in cassettes FSA1 and A2. Specimen B measured 2.4 x 2.4 x 0.8 cm and was described as beige to pink soft tissue. A portion was used for frozen section evaluation and the rest submitted in cassettes FSB1, B2, and B3. Specimen C measured 3.9 x 3.3 x 0.8 cm and was composed of beige to gray-tan soft tissue. Part of this specimen was submitted for testing, and the remainder placed in cassettes C1 and C2.\n\nMicroscopic evaluation revealed a diffusely infiltrative glial neoplasm with variable histological features. In some areas, the tumor exhibited low to intermediate-grade morphology, while other regions showed increased cellularity, nuclear pleomorphism, vascular proliferation, and necrosis. Immunohistochemical staining demonstrated strong reactivity for GFAP. The Ki-67 labeling index varied depending on the tumor region, with lower indices in less aggressive areas and higher indices in more cellular regions. Multiple cassettes from all three specimens were examined and showed consistent histologic patterns."} +{"pid": "TCGA-EP-A3JL", "report": "Final Surgical Pathology Report. Procedure: Diagnosis. A. Submitted as lymph node, biopsy: Benign soft tIssue with no lymph node identified. B. Gallbladder, cholecystectomy: Chronic inflammation of the gallbladder. C. Liver, partial resection: Tissue analysis shows a solitary mass measuring 2.5 cm in greatest dimension. The mass is well-defined and located 0.5 cm from the resection margin. Microscopic evaluation reveals a moderately cellular lesion with preserved structural patterns. All surgical margins are free of abnormal cells. Vascular invasion is not present. No lymph nodes were submitted for evaluation. Distant metastasis status is unknown. Special studies were performed, including immunohistochemical stains. Reticulin staining demonstrated altered tissue architecture. HepPar1 stain was positive while CK7, CK20, and CDX-2 were negative. These findings support the histologic interpretation. Some antibodies used in testing are considered analyte-specific reagents, controlled and validated within the laboratory per established medical literature, though they are not FDA approved. Specimens received included lymph node tissue, gallbladder, and a liver mass. Clinical history included prior concern for malignancy. Gross examination of the lymph node specimen showed a small fragment of tan soft tissue without identifiable lymph node structure. The gallbladder specimen measured 5.5 x 2.0 x 1.2 cm and contained bile without stones; wall thickness was 0.3 cm. The liver specimen was a wedge resection measuring 5 x 5 x 4 cm with a cauterized surface and a firm tan nodule identified. Representative sections were submitted for analysis."} +{"pid": "TCGA-CN-5360", "report": "A right supraglottic biopsy demonstrated malignant cells consistent with squamous cell morphology. A total laryngectomy specimen measured 8.5 cm (superior to inferior), 4.2 cm (anterior to posterior), and 5.8 cm in width. An ulcerated mass was identified in the supraglottic region measuring at least 2.8 x 2.2 cm grossly, extending into the false vocal cords and pyriform sinus. On sectioning, the lesion measured 4.8 cm (superior-inferior), 3.2 cm (anterior-posterior), and 4.5 cm in width. The tumor involved the pre-epiglottic and paraglottic spaces and invaded through the thyroid cartilage into adjacent soft tissue. Angiolymphatic invasion was present; no perineural invasion was observed. All surgical margins were free of tumor involvement by at least 2 mm. No tumor involvement was identified in the right thyroid lobe.\n\nLymph node dissections were performed bilaterally. On the right side, levels 2, 3, and 4 yielded 29 lymph nodes, all benign. Zone 2B biopsy revealed one benign lymph node. On the left side, levels 2, 3, and 4 yielded 24 lymph nodes, all benign. No lymph node metastases were identified in any of the dissected specimens.\n\nHistologic examination confirmed moderately differentiated squamous cell morphology arising in the supraglottic region. Structures involved included the false cords, epiglottis, thyroid cartilage, pre-epiglottic space, and paraglottic space. No intra-perineural invasion was observed. Vascular invasion was noted. Immunohistochemistry and other ancillary studies were performed as appropriate.\n\nThe specimen was entirely submitted for histologic evaluation and reviewed in detail. Based on pathologic findings, staging classification was assigned accordingly."} +{"pid": "TCGA-E9-A1RF", "report": "The breast specimen shows a grossly evident lesion measuring 3 x 5 cm. Fatty tissue and lymph nodes are described as dense and hyperemic, with lymph nodes up to 1 cm in diameter. Microscopic evaluation reveals infiltrating growth with moderately differentiated cellular features. Ten lymph nodes were examined, of which five show evidence of metastatic involvement. The tumor extent is classified as T2, indicating a size greater than 2 cm but not exceeding 5 cm. Venous invasion is not identified. Margins are not clearly defined. The histologic grade indicates moderate differentiation. The Nottingham Histologic Score could not be determined due to incomplete data on tubule formation, nuclear pleomorphism, and mitotic counts. The specimen was obtained from the left upper outer quadrant. No evidence of neoadjuvant treatment effect is noted. Additional pathologic findings and extracapsular lymph node involvement are not specified."} +{"pid": "TCGA-PR-A5PF", "report": "The specimen consists of a left adrenal mass submitted for evaluation. The mass is encapsulated and measures 8 x 4.5 x 4 cm, with a heterogeneous, cystic, tan-brown appearance and areas of friability. Hemorrhagic fluid is present within the mass. It is surrounded by a portion of grossly unremarkable golden-orange adrenal tissue measuring 6.5 x 2.4 x 0.9 cm. The overall specimen weighs 218 g and measures 11 x 9.8 x 7.5 cm. The surgical margin is located less than 0.1 cm from the mass.\n\nMicroscopic examination reveals a diffuse growth pattern with moderate nuclear pleomorphism. Mitotic activity is low, with 1 to 2 mitotic figures per 10 high power fields. Capsular invasion and lymphovascular invasion are present, as is extension into adjacent adipose tissue.\n\nImmunohistochemical staining demonstrates positivity for CD10, MIB1-Ki67 (low), chromogranin A, and synaptophysin. Staining for cytokeratin 7, cytokeratin 20, and renal cell markers is negative. Inhibin-alpha is also negative, while Melan-A and A103 show equivocal results. Special stains and immunohistochemistry were performed with appropriate controls, and the tests were developed and validated by the laboratory. Some reagents used are classified as analyte-specific reagents and have not been cleared or approved by the FDA."} +{"pid": "TCGA-56-8624", "report": "IO Consultation. Frozen Section Diagnosis: reported to Dr. positive patient ID. Performed by Dr. Campus. Pre-Op Diagnosis: Right lung lesion. Post-Op Diagnosis: Same. Clinical History: Not indicated on requisition.\n\nGross Description: Three parts were received. The first, labeled as level 9 lymph node, is a 0.3 X 0.2 X 0.1 cm irregular fragment of soft gray-black tissue. The second, labeled as level 4 lymph node from the right lung, is a 0.7 X 0.5 X 0.3 cm gray-pink irregular tissue fragment. Both lymph nodes were entirely submitted in single cassettes. The third container labeled as right lower lobe of the right lung contains a 199 gram partially sectioned specimen of pulmonary parenchyma measuring 15.5 X 10.5 X 5.6 cm. The resection margin includes stapled bifurcated tertiary bronchi. The pleural surface appears wrinkled, pink-red, and moderately anthracotic streaked.\n\nOn the lateral aspect, 6 cm from the apex, there is a 1.1 X 1.0 cm umbilicated indurated gray-tan plaque. On the anterior aspect at the base, a 3.0 X 3.0 X 3.0 cm area of indurated umbilication was identified. Both areas were previously sectioned. The smaller lesion shows a 1.5 X 1.5 X 1.1 cm lobulated plaque-like appearance with gray-tan fibrotic cut surface and mild lobulation. The larger lesion has a similar cut surface. Both extend to but not through the pleura. The smaller lesion is located 2.0 cm from the nearest bronchial margin, while the larger lesion is 3.9 cm from the bronchial margin. No discrete bronchial connection was initially observed. Upon further sectioning, both lesions were found to connect to small bronchi. The remaining parenchyma is spongy and pink-red with anthracotic streaking; no additional gross lesions were identified.\n\nThe specimen was received after tissue harvest for genomic study. Within the container, two tissue cassettes were labeled. A portion of the smaller lateral lesion submitted for frozen section was reported as malignant. Representative sections were submitted as follows: A - frozen section residue, B - bronchial margin, C through E - remaining smaller lateral lesion, F through H - larger basal lesion to medial pleura, I and J - larger basal lesion to basal pleura, K - random uninvolved parenchyma.\n\nMicroscopic Review: The frozen section diagnosis was confirmed. Final evaluation of the lymph nodes showed no pathological involvement. The level 9 lymph node was benign without pathological diagnosis (0/1). The level 4 lymph node showed benign hyperplasia (0/1). Examination of the right lower lobe revealed a moderately differentiated tumor arising in the right lower lobe extending to the peripheral aspect. The tumor was multifocal with the largest mass measuring 3.0 X 3.0 X 3.0 cm. There was no evidence of visceral pleural invasion or direct tumor extension beyond the lung. Findings were suspicious for lymphovascular space invasion. The tumor was located 2.0 cm from the bronchial margin and less than 0.1 cm from the pleural surface. No metastatic involvement was identified in the two lymph nodes evaluated. Additional findings included patchy fibrosis and bronchiectasis.\n\nStaging: Initially classified as pT1bNO. Upon re-review, based on updated classification criteria which consider satellite tumors, the staging was revised to pT3NO. The remainder of the report remains unchanged.\n\nRevision Date: [Not specified]"} +{"pid": "TCGA-VR-A8Q7", "report": "The surgical specimen included the distal third of the esophagus, stomach, and colon. Microscopic examination revealed a poorly differentiated malignant neoplasm arising in the esophagus, with extension to the outermost serosal layer. Surgical margins were free of tumor involvement. No evidence of lymphovascular or perineural invasion was identified.\n\nIn the gastric segment, there was histologic evidence of moderate chronic gastritis without involvement by malignancy. The colonic segment showed changes consistent with chronic colitis, also without neoplastic involvement.\n\nLymph node evaluation revealed involvement at the lesser curvature, with three out of twenty-five nodes showing metastatic deposits and associated capsular disruption. In contrast, all nodes from the greater curvature (0 out of 9), mesenteric region (0 out of 41), hepatoduodenal ligament (0 out of 2), and suprapyloric area were devoid of tumor involvement.\n\nOther tissue samples including the omentum, appendix (which showed reactive lymphoid hyperplasia), and fibrofatty tissue from the suprapyloric region were unremarkable for malignancy. The intestinal segment examined also showed no signs of neoplastic disease."} +{"pid": "TCGA-FY-A3I4", "report": "The surgical pathology report includes findings from the right and left thyroid lobes. The right thyroid lobe specimen measured 4.2 x 4 x 2.4 cm and contained a 3.8 x 4 x 2.4 cm tan-yellow mass located in the superior and mid portions of the lobe. The mass extended to multiple capsular surfaces but did not grossly penetrate through the capsule. Microscopic evaluation revealed papillary carcinoma of the usual type, measuring greater than 2 cm but not more than 4 cm, confined to the thyroid gland (pT2). Margins were uninvolved by invasive carcinoma. Focal lymphatic vascular invasion was identified. No extrathyroidal extension was observed. One benign parathyroid gland was noted. A single lymph node adjacent to the left thyroid was identified as benign with no evidence of malignancy (pN0). No distant metastasis was present (pM0). The MACIS score was calculated at 4.3. \n\nThe left thyroid lobe and isthmus specimen weighed 5 grams and measured 3.6 x 2.6 x 1.8 cm. A 0.8 x 0.7 x 0.7 cm tan nodule was identified in the upper pole, located within 0.1 cm of the capsular surface but not extending beyond it. Histologic examination showed a colloid nodule without atypia or malignant features. Background lymphocytic thyroiditis was present in both lobes. All tissue from the left lobe was submitted for analysis, including five cassettes with the lesion present in cassettes 2\u20133. Intraoperative frozen section consultation confirmed the presence of papillary carcinoma in the right lobe. No clinical information was provided."} +{"pid": "TCGA-UF-A7JV", "report": "The specimen from the hypopharynx shows a moderately differentiated carcinoma. The tumor measures 1.2 cm in greatest dimension. No lymphovascular invasion is identified. The right vocal cord is involved, while the left vocal cord, epiglottis, thyroid, cricoid and arytenoid cartilages, and hyoid bone are uninvolved. Surgical margins are free of involvement, although the right-posterior and right-lateral margins are narrowly spared with 1.0 mm remaining. The esophagus shows involvement, but its surgical margin is uninvolved. A separate finding in the thyroid gland reveals a follicular variant with features of grade 2 differentiation, and the margins around this area are also uninvolved.\n\nIn the left recurrent laryngeal dissection, 2 of 9 lymph nodes show involvement without capsular extension. In the right neck dissection, 3 of 15 lymph nodes are involved, also without capsular extension. In the left neck dissection, all 4 lymph nodes are uninvolved. A biopsy from the right hypopharynx confirms the presence of the primary lesion, and a fragment of fibroadipose tissue from the left-inferior parathyroid site shows no evidence of neoplastic involvement. The hypopharynx margin is also uninvolved. An addendum confirms that there is no evidence of neoplastic invasion of the hyoid bone."} +{"pid": "TCGA-A8-A07Z", "report": "The specimen consists of a left mastectomy preparation. The lesion exhibits a predominantly solid growth pattern and is moderately differentiated. Invasive growth is present, with the minimum dorsal margin measuring less than 0.1 cm. The overlying skin is free of involvement. A total of eleven lymph nodes are included, all without evidence of metastasis. Histologic grade is G2, based on a scoring system of seven points. The primary tumor size corresponds to pT2. No lymph node metastases are identified (pNO, 0 out of 11). There is no evidence of lymphatic or vascular invasion (pL0, pV0). The ventral margin measures 0.5 cm, while all other resection margins are markedly greater than 1 cm."} +{"pid": "TCGA-B6-A0IM", "report": "The patient presented with a right breast mass. Gross examination of the incisional biopsy specimen revealed a tumor measuring 2 x 2 x 1.3 cm. The mastectomy specimen weighed 2040 grams and measured 35 x 23 x 6 cm. A recent surgical incision was noted in the upper outer quadrant, and a biopsy cavity approximately 5 cm in diameter was identified deep to the suture site. Within this area, a second tumor focus was found on the medial aspect of the cavity. Although contiguous with the cavity, the bulk of this lesion was more medially located, forming a single \"dumbbell\"-shaped configuration rather than two separate tumors. This tumor measured 5 x 3.5 x 3 cm and was located in the upper lateral quadrant, 2 cm from the deep resection margin. Additional firm tissue suspicious for involvement was noted along the lateral edge of the biopsy cavity, measuring 2 cm in size and also located 2 cm from the deep margin. The maximum distance between the medial and lateral components of the tumor was 7 cm.\n\nHistologic evaluation showed a ductal pattern with prominent cribriform features. The NSABP histologic grade was 1 of 3, and the nuclear grade was 2 of 3. No multifocal tumor was identified. There was no evidence of in-situ carcinoma, lymphatic or vascular invasion, or Paget\u2019s disease of the nipple. Non-neoplastic changes included sclerosing adenosis with microcalcifications. Surgical margins were negative, and no tumor was identified in the skin or sampled soft tissue margins. Nine lymph nodes were evaluated, and none contained malignant cells.\n\nEstrogen receptor activity was positive (113 FMOL), while progesterone receptor activity was borderline (14 FMOL). A full report on hormone receptor status was issued separately. All specimens were processed fresh, and the diagnostic evaluation was personally conducted and certified by the reporting pathologist."} +{"pid": "TCGA-HU-8244", "report": "Stomach, laparoscopic distal gastrectomy: A lesion was identified in the middle third, centered at the body on the posterior wall. The gross appearance was consistent with a superficial lesion. Histologically, the lesion demonstrated tubular differentiation and was classified as well differentiated. The Lauren classification system identified an intestinal type morphology. The lesion measured 6.5 x 4.3 cm. Invasion was limited to the mucosa, involving the muscularis mucosa. Resection margins were negative for tumor involvement, with a distal margin of 3.7 cm and a proximal margin of 0.6 cm. Evaluation of regional lymph nodes showed no evidence of metastasis, with 32 lymph nodes examined (0/18 from the lesser curvature and 0/14 from the greater curvature). No lymphatic, venous, or perineural invasion was identified. Additional findings included foveolar hyperplasia with pit dysplasia. A separate focus of high-grade dysplasia within a tubular adenoma was noted. Biopsy of the distal surgical margin showed no evidence of tumor. Immunohistochemical staining was performed using markers including CD10, MUC2, MUC5AC, MUC6, and C-erb B2."} +{"pid": "TCGA-FE-A232", "report": "The specimen consists of a total thyroidectomy measuring 9.5 x 5.0 x 3.0 cm and weighing 32.8 grams. The right lobe is slightly larger than the left. A well-defined nodule measuring 3.5 x 3.0 x 2.0 cm is identified in the inferior pole of the right lobe. The nodule is tan-gray, granular, and firm, with approximately 20% necrosis. It focally abuts the capsule but does not involve the isthmus. Multiple small nodules (less than 10) are present in the left lobe, ranging from 0.3 to 0.5 cm in size, comprising about 30% of the left lobe parenchyma. These nodules are tan, gelatinous, and well-circumscribed. The uninvolved thyroid tissue appears tan-red and rubbery.\n\nMicroscopic evaluation reveals a well-differentiated cellular proliferation with oncocytic features. There is capsular invasion and minimal extension into adjacent perithyroid soft tissue. No lymphatic or vascular invasion is identified. Surgical margins are free of involvement, though the tumor is within less than 1 mm of the inked margin. Additional findings include lymphocytic thyroiditis and nodular hyperplasia of the left lobe. Immunohistochemical staining demonstrates positivity for TTF-1 and thyroglobulin, with negativity for calcitonin. All control sections are adequate.\n\nStaging assessment indicates pT3, pN0, pMX. The entire right lobe nodule was submitted for examination. No lymph nodes were identified in the specimen."} +{"pid": "TCGA-37-3789", "report": "The specimen was obtained from a blood draw and consisted of a single container with no specific matrix noted. The tissue source is unspecified, and the sample was processed as a frozen tube. Histological analysis revealed the presence of tumor cells, with a grade of 2 out of 2. No treatment had been administered prior to procurement. Tumor cell percentage was noted to be over 50%. Staging information indicates a T2 N0 Mx classification. No additional details regarding hormonal therapy or chemotherapy were provided."} +{"pid": "TCGA-E2-A14T", "report": "The surgical specimens included three sentinel lymph nodes and a mastectomy specimen from the left breast and lower axillary tail. The sentinel lymph nodes measured 0.9 x 0.6 x 0.5 cm and 0.5 x 0.4 x 0.2 cm (two nodes) in the first specimen, 0.6 x 0.4 x 0.3 cm (one node) in the second, and 1.1 x 0.9 x 0.6 cm (one node) in the third. All were serially sectioned and touch preparations were obtained. Histologic examination revealed no abnormal cellular infiltration or malignant involvement in any of these lymph nodes.\n\nThe mastectomy specimen weighed 1314 grams and measured 30 x 28 x 6 cm, including a 15 x 6 cm skin ellipse with a centrally located, partially raised nipple and a 1.5 cm areolar rim. The specimen was inked for orientation and sectioned serially into 12 slices from medial to lateral; the nipple was found in slice 7. A firm, gray-white mass measuring 3.5 x 2.8 x 2 cm was identified within slices 4 through 7, located approximately 1.8 cm from the deep margin. Surrounding fibrosis and changes suggestive of fat necrosis were noted in the surrounding tissue. The lower axillary tail measured 6 x 5 x 3 cm, and dissection revealed four small lymph nodes ranging from 0.5 x 0.5 x 0.5 cm to 0.8 x 0.8 x 0.5 cm. No cellular atypia or malignant infiltration was observed in the submitted lymph nodes.\n\nRepresentative sections were taken from various regions including the nipple, tumor area, margins, and surrounding quadrants. Histologic evaluation of the tumor demonstrated moderately differentiated invasive epithelial cells arranged in a micropapillary pattern. Necrotic debris and microcalcifications were identified within the lesion. No tumor involvement was seen at the surgical margins, skin, or nipple. Adjacent to the invasive component, non-invasive cellular changes were observed, exhibiting cribriform and solid architectural patterns with intermediate nuclear grade and necrosis. These changes accounted for approximately 5% of the sampled tissue.\n\nImmunohistochemical analysis showed strong positivity for estrogen receptor (Allred score 8) and progesterone receptor (Allred score 4). Fluorescence in situ hybridization (FISH) analysis using the PathVysion HER-2 DNA Probe Kit demonstrated a HER-2/CEP17 ratio of 1.29, indicating no gene amplification. CD31 staining did not reveal evidence of vascular invasion. Based on histological and immunophenotypic findings, the pathological staging was determined as pT2N0."} +{"pid": "TCGA-CV-7177", "report": "The specimen consists of a total laryngectomy and right thyroidectomy measuring 7.5 x 4.0 x 3.5 cm in total. A subglottic lesion is identified at the midline, extending bilaterally into both the right and left subglottis. The lesion appears as a light-tan, ulcerated, and slightly indurated mass measuring 2.0 x 1.5 x 0.4 cm. It is confined to the subglottic region without evidence of extension into the underlying cartilage. Surgical margins are free of abnormal tissue. The right thyroid gland contains a multinodular goiter measuring 4.0 x 3.5 x 2.0 cm, with no concerning features identified. Sections from the laryngeal lesion were submitted entirely from right to left in blocks A1-A9, with A10-A12 representing representative sections of the thyroid nodule."} +{"pid": "TCGA-A8-A07R", "report": "The left breast segment at 2 o'clock contains a poorly differentiated invasive component measuring up to 4.6 cm. There is also associated high-grade intraductal proliferation with features of III and comedo-type necrosis. Histologic assessment indicates the presence of extensive lymphovascular invasion. Surgical margins show residual invasive disease. Lymph node evaluation reveals involvement, with 15 out of 22 nodes positive. Based on these findings, the staging classification is pT2 and pN3a. The tumor grade is classified as G3."} +{"pid": "TCGA-NK-A7XE", "report": "The specimen from the left tracheal bronchial angle contained one benign lymph node. Three benign lymph nodes were identified in the inferior pulmonary ligament. A resected left lung specimen revealed a 12 cm mass located in the upper lobe. Microscopic examination showed invasive malignant cells arranged in nests and cords, exhibiting moderate nuclear atypia with abundant eosinophilic cytoplasm and intercellular bridges. The lesion extended into perihilar mediastinal fibroadipose tissue. Lymphatic invasion by malignant cells was observed, along with intra and perineural invasion. Of eight perihilar lymph nodes examined, three contained malignant cells. Resection margins\u2014including bronchial, vascular, and soft tissue\u2014were free of malignant involvement.\n\nLymph nodes from level 7 subcarinal region showed involvement in three out of fourteen, with extracapsular extension noted. Level 9 lymph nodes were negative for malignant cells. Intraoperative evaluation of the bronchial margin showed no evidence of malignancy.\n\nThe tumor measured 12 cm and was unifocal. Histologic evaluation demonstrated features consistent with a moderately differentiated epithelial-derived neoplasm. No treatment effect was observed. Pleural invasion involved the mediastinal pleura. Vascular and lymphatic invasion were present. Mediastinal fibroadipose tissue was involved. Seven lymph nodes were recovered from the surgical specimen. Based on these findings, staging classification was assigned as T4 N2 PL3. The specimen was intact and margins were all negative."} +{"pid": "TCGA-BH-A0BP", "report": "The surgical specimen consists of a segmental mastectomy from the left breast at the 3 o\u2019clock position. Two distinct foci of invasive cellular growth were identified, measuring 0.7 cm and 1.5 cm respectively, with a combined aggregate size of 2.2 cm. Histological scoring system results in a total score of 6 out of 9, based on tubule formation (score 3), nuclear features (score 2), and mitotic count (score 1). A separate in situ component is present, characterized by solid-type growth with areas of central necrosis and associated microcalcifications, comprising approximately 10% of the overall lesion volume.\n\nLymphovascular space involvement is not a prominent feature. The closest margin distance for the first invasive focus is 0.2 cm from the anterior margin, with the in situ component measuring 0.1 cm from the same margin. The second invasive focus is located 0.1 cm from the posterior margin. All other margins are free of abnormal cells. Additional findings include benign changes such as fibrocystic disease, atypical ductal epithelial hyperplasia, and sclerosing adenosis, all associated with microcalcifications. A small radial scar is confirmed microscopically using specific immunostains (p63 and smooth muscle myosin heavy chain).\n\nIn the left axilla, sentinel lymph node biopsies were performed. A total of three lymph nodes were examined, with no evidence of abnormal cell involvement. Standard histological methods were used for evaluation. The tumor is located in the upper outer quadrant. The maximum dimension of the invasive component is 1.5 cm. The histological type of the invasive component is consistent with ductal adenocarcinoma, not otherwise specified. The in situ component is admixed with the invasive lesion. Microcalcifications are present in both benign and suspicious zones.\n\nSurgical margins show minimal distance to invasive and in situ components, with the closest being 1 mm. No dermal lymphatic invasion is noted. Pathologic staging is T1c for the primary tumor, N0 for lymph node status, and MX for distant metastasis. Hormone receptor testing was previously completed. HER2 immunohistochemical staining shows a score of zero or 1+."} +{"pid": "TCGA-XU-AAXZ", "report": "The specimen consists of a thymus gland measuring 12 x 12 x 2.1 cm, with a suture on the left pleura. A tumor measuring 5 x 3 x 2 cm is identified in the left half of the gland. The tumor has a variegated tan to red appearance and is partly hemorrhagic. On gross examination, it does not extend to the capsule or pleural surface. The tumor is unencapsulated and shows invasion into adjacent adipose tissue, although the painted margins of this adipose tissue are free of tumor involvement.\n\nMicroscopically, the lesion is composed of densely intermixed sheets of epithelial cells and mature lymphocytes. The epithelial cells exhibit irregularly enlarged nuclei with vesicular chromatin and prominent nucleoli. Occasional mitotic figures are present. These cells demonstrate prominent keratin pearl formation, indicating squamous differentiation. Immunohistochemical staining reveals strong positivity for CK5/6 and high molecular weight cytokeratin in the epithelial component. The majority of lymphocytes are positive for CD1a and CD99, consistent with immature thymocytes, while scattered CD5-positive lymphocytes are also present. The epithelial cells are negative for CD5.\n\nStaging data indicate macroscopic capsular invasion, classified as stage IIb. No vascular invasion, pleural involvement, or pulmonary parenchymal invasion is observed. Regional lymph nodes show no metastatic involvement. The closest margin is 5 mm from the tumor. Distant metastasis cannot be assessed."} +{"pid": "TCGA-44-4112", "report": "The specimen includes multiple lymph nodes from various levels and a right upper lobe lung tissue. Lymph nodes from level 3 measure up to 2.4 cm, with two submitted entirely. A single level 10 lymph node measuring 2.4 cm was submitted in two blocks. One lymph node from the middle lobe, measuring 1.4 cm, was submitted whole. Three additional lymph nodes from level 10, measuring up to 1.8 cm, were entirely submitted in three blocks. \n\nA right upper lobe lobectomy specimen weighs 362 grams and measures 17 x 12.5 cm. A palpable mass measuring 5 x 4.6 x 4 cm is present within the medial inferior aspect, well-circumscribed, and pale tan-white to gray in color. The lesion extends to within less than 0.1 cm of the inked pleural surface but is greater than 3.8 cm from the bronchial stump margin. The surrounding parenchyma appears spongiform to focally consolidated. A hilar lymph node measuring 1.4 cm was recovered and submitted in eleven blocks, including margins, tumor interface, and random sections.\n\nAn R4 lymph node specimen consists of an aggregate measuring 4.6 x 3.4 x 1.3 cm, with several lymph nodes identified, the largest measuring 3.3 cm. Seven presumed lymph nodes were submitted whole, and one was bisected across two blocks, with residual adipose tissue in a fourth block.\n\nTwo subcarinal lymph nodes measuring up to 3 cm were submitted across three blocks, with partial sectioning.\n\nMicroscopic evaluation reveals a poorly differentiated invasive tumor measuring 5 cm in size with extension to the pleural surface. Vascular invasion is present. Resection margins are free of tumor involvement. One of four hilar lymph nodes shows tumor involvement. In the R4 region, 2 out of 10 lymph nodes contain metastatic involvement, with the largest deposit measuring 0.7 cm and extracapsular extension noted. All other lymph nodes evaluated are negative for tumor involvement."} +{"pid": "TCGA-GH-A9DA", "report": "A radical hysterectomy with lymph node dissection was performed. Specimens included right internal iliac, left obturator, right pelvic, and left pelvic lymph nodes, along with the uterus and cervix. Immunohistochemical staining was performed on selected sections, with negative results using appropriate controls. Sentinel lymph node analysis revealed no evidence of tumor involvement: two lymph nodes from the right internal iliac region, one from the left obturator region, five from the right pelvic area, and six from the left pelvic area were all negative for malignancy. The total number of lymph nodes examined was fifteen, with none showing signs of metastasis.\n\nThe cervical specimen demonstrated a poorly differentiated squamous cell carcinoma measuring 3.0 x 2.5 x 1.5 cm located in the ectocervix. Histologic evaluation showed high-grade features without lymphovascular invasion. Surgical margins were free of invasive carcinoma, with the closest distance from the tumor to the margin being 0.6 cm in the peri-ectocervical soft tissue. Parametrial and vaginal tissues showed no involvement by invasive carcinoma. Pathologic staging according to TNM classification was determined as pT1b, pNo, and pMX.\n\nAdditional findings included an inactive endometrium. No definitive lymph nodes were identified in the right parametrial tissue, while one small lymph node (0.4 cm) was found in the left parametrial tissue. Gross examination of the hysterectomy specimen revealed a gray-white mass on the ectocervix that measured 3 x 2.5 cm and extended into the endocervical canal but did not reach the lower uterine segment or vaginal cuff margin. The myometrium measured 2.4 cm in thickness, and the endometrium was thin. Multiple sections of the vaginal cuff, cervical mass, lower uterine segments, endomyometrium, and parametrial tissues were submitted for microscopic evaluation.\n\nFrozen section analysis of the left obturator sentinel lymph node confirmed absence of tumor involvement within 15 minutes. An addendum report is pending further immunostain results (CK AE1/AE3)."} +{"pid": "TCGA-ZF-AA4W", "report": "The specimen includes a bladder measuring 160 x 65 x 37mm, along with surrounding fat and prostate tissue. An ulcerated lesion measuring 22mm in maximum dimension is identified on the right lateral wall, extending through the full thickness of the bladder wall into the perivesical fat. The lesion is within 2mm of the circumferential surgical margin. No lymph nodes are identified within the perivesical fat. Additional specimens include multiple lymph node-containing tissue samples from various anatomical locations.\n\nMicroscopic evaluation reveals a poorly differentiated transitional cell carcinoma with a prominent lipoid cell component. The tumor extends through the bladder wall into the surrounding fat and exhibits areas of necrosis, extensive perineural invasion, and possible lymphovascular invasion. The host-tumor interface contains minimal lymphocytic infiltration. Overlying urothelium is largely denuded but appears morphologically normal where present. No dysplasia or carcinoma in situ is identified. Prostatic tissue and prostatic urethral resection margin show no abnormality.\n\nLymph node specimens from all regions examined reveal reactive changes without evidence of metastatic involvement. Vascular sections show medial degeneration and dystrophic calcification without tumor involvement. Ureteric margins demonstrate denudation of urothelium; one margin shows ulceration lined by granulation tissue with chronic inflammation, but no evidence of invasive transitional cell carcinoma is found.\n\nStaging assessment indicates the tumor has extended into the perivesical fat without nodal involvement (pT3b pN0 pMx)."} +{"pid": "TCGA-DD-A4NF", "report": "The gallbladder specimen shows chronic inflammation with associated cholelithiasis and cholesterolosis. A single benign lymph node is present. A wedge biopsy of liver segment 8 reveals a moderately differentiated cellular lesion measuring 3.2 x 2.9 x 2.8 cm. There is no evidence of vascular invasion, and the surgical margins are free of abnormal cells, with the closest margin measuring 0.6 cm. The surrounding liver tissue demonstrates mild activity (grade 2 of 4) related to chronic hepatitis C, along with bridging fibrosis and early cirrhotic changes (stage 3\u20134 of 6). Reticulin and trichrome special stains support the histologic findings."} +{"pid": "TCGA-HW-7486", "report": "The clinical history notes a lesion in the right frontal region of the brain. Three specimens were submitted for analysis. \n\nSpecimen 1 consisted of multiple fragments of red-tan soft tissue measuring 1.5 x 1.0 x 0.3 cm in total. It was processed for frozen section, with a smear preparation also made. Microscopic examination showed increased glial cellularity, though no definitive tumor diagnosis could be established from this sample. The final assessment remained non-diagnostic.\n\nSpecimen 2 was a single fragment of soft tissue measuring 1.0 x 0.5 x 0.5 cm and was entirely submitted for frozen section. Intraoperative evaluation suggested a glioma, possibly with features of a specific type of glial tumor. This interpretation was confirmed in the permanent diagnosis.\n\nSpecimen 3 consisted of multiple pieces of gray-tan to red-pink friable tissue measuring 3.3 x 2.5 x 1.2 cm in aggregate. Histological analysis revealed a diffusely infiltrating neoplasm composed of uniform cells with round nuclei and clear cytoplasm. Nuclear pleomorphism was minimal. Mitotic activity was not prominent. Architectural patterns included loose clusters and perineuronal satellitosis. Necrosis and microvascular proliferation were absent. Immunohistochemical staining for MIB-1 showed a labeling index not exceeding 4%. Based on these findings, the tumor was classified as WHO Grade II.\n\nAncillary testing, including molecular analysis for 1p/19q co-deletion and MGMT promoter methylation status, was initiated. No other significant findings were noted in the special studies or stains performed."} +{"pid": "TCGA-A8-A0AD", "report": "The specimen shows a lesion with mixed histological features, measuring up to 1.5 cm in maximum diameter. The cellular morphology exhibits moderate nuclear atypia and variable growth patterns. No evidence of vascular invasion or significant calcifications was identified. The closest resection margin measured 0.5 cm. Surrounding breast tissue and adjacent skin showed no abnormal cellular changes. Lymph node assessment of four sentinel nodes revealed no metastatic involvement. Staging parameters indicate absence of distant disease and complete resection margins. Histologic grade reflects intermediate differentiation."} +{"pid": "TCGA-68-7757", "report": "The specimen included multiple tissue samples from various anatomical levels. Lymph node tissue from levels 4, 5, 7, 10, and 11, as well as lymph nodes labeled R2, L2, R4, and 4L, were all found to be unremarkable with no evidence of abnormal cellular proliferation. A lobectomy specimen from the left upper lobe of the lung revealed a well-circumscribed mass measuring 3.5 x 3 x 2.5 cm. The mass was firm, gray-white in appearance, and located within the lung parenchyma. It had a central area suggestive of scarring or possible necrosis and was adjacent to an irregular zone of fibrosis extending to the pleura. The fibrotic region was subpleural in location and showed features consistent with chronic interstitial scarring, including hemosiderosis. There were also foci of organizing and recanalizing vascular thrombi noted within this area. The mass was within 0.3 cm of the closest staple margin. No involvement was identified at the bronchial, vascular, or parenchymal margins, and the pleural/soft tissue margin was also negative. Two small hilar lymph nodes, measuring 0.3 cm and 1.2 cm, were present and showed anthracotic changes. Histological evaluation included immunohistochemical staining for CAM 5.2, TTF-1, and p63. The cells within the mass demonstrated positive staining for CAM 5.2 and p63, while TTF-1 was negative. The surrounding fibrotic stroma was negative for CAM 5.2. These findings were associated with localized interstitial fibrosis and changes suggestive of prior injury, which may have been due to previous surgical intervention or other insult. The remaining lung tissue appeared otherwise unremarkable, with centrilobular emphysema also noted. Clinical and radiologic correlation was recommended."} +{"pid": "TCGA-S2-AA1A", "report": "A female patient underwent a right upper lobectomy with lymphadenectomy. The surgical specimen included multiple lymph node groups: Level VII (3 lymph nodes), Hilar (1 lymph node), Level II (6 lymph nodes), and Level IV (2 lymph nodes). No abnormal tissue was identified in any of the lymph nodes examined.\n\nThe right upper lobe specimen measured 15 x 12 x 6 cm and weighed 270 grams. A gray-tan, ill-defined mass measuring 2.5 x 1.5 x 1 cm was identified subpleurally, located 6 cm from the bronchial margin of resection. Histologic evaluation showed well-differentiated features with no invasion observed at the bronchial, vascular, or parenchymal margins. There was no evidence of pleural invasion or lymphovascular invasion. The tumor was unifocal and surrounded by lung tissue.\n\nMultiple sections were taken for microscopic analysis. Additional findings included atypical adenomatous hyperplasia. The procedure was performed using a video-assisted thoracoscopic approach. All surgical margins were free of involvement. Fourteen lymph nodes were examined microscopically and none showed evidence of abnormal cells.\n\nThe tumor was well differentiated and confined to the lung tissue without regional spread. Based on size and extent, the classification reflected a primary tumor less than 3 cm in greatest dimension, with no lymph node involvement."} +{"pid": "TCGA-A5-A2K7", "report": "The specimen was submitted in nine parts. Part A, labeled as \"left AP margin,\" consists of fibrovascular soft tissue without tumor involvement. Part B, labeled as \"right parametrial margin,\" is composed of fibroadipose tissue and also does not show tumor. Part C includes a uterus with cervix, bilateral fallopian tubes, and ovaries following radical hysterectomy and bilateral salpingo-oophorectomy. Histologic evaluation shows a tumor arising from the lower uterine segment extending into the upper endocervical canal. The tumor measures 4.5 cm in length and 4.0 cm in depth, with circumferential involvement of the cervix and lower uterine segment. There is 50% myometrial invasion, with the deepest invasion measuring 4.0 cm at the 12:00 position. The tumor demonstrates histologic features consistent with high-grade differentiation. Margins are uninvolved by invasive carcinoma, with the closest distance of invasive carcinoma being 2 mm from the 12:00 paracervical/parametrial soft tissue margin. Lymphovascular invasion is extensive. No involvement is identified in the bilateral ovaries, fallopian tubes, vagina, bilateral parametrium, or omentum. Immunohistochemical staining shows positivity for vimentin (80%), CEA (10%), ER (80%), and patchy positivity for p16 (40%). \n\nPart D, described as cervical tumor, includes fragments of white-tan nodular tissue with focally spongy and necrotic areas. Microscopic evaluation reveals poorly differentiated adenocarcinoma with focal squamoid differentiation. Parts E through H include lymph node specimens. Part E, left periaortic lymph nodes, contains 5 lymph nodes, all without evidence of metastasis. Part F, left pelvic lymph nodes, includes 6 lymph nodes, none involved. Part G, right pelvic lymph nodes, contains 5 lymph nodes, all benign. Part H, right periaortic lymph node, includes 14 lymph nodes, none positive for metastatic disease. Part I, the omentum, is composed of benign fibroadipose tissue without tumor involvement. Gross examination of the uterus shows an enlarged cervix measuring 6.0 cm in width and 4.0 cm anteroposteriorly. The tumor completely replaces the lower uterine segment and cervix, with no visible tumor on the serosal surface. The endometrial cavity measures 3.5 cm in width and 4.0 cm in length, with a myometrial thickness of up to 2.7 cm in the fundus. The cut surface of the tumor is white-tan and necrotic, with 50% of the area showing micro-papillary and spongy appearance. No tumor is identified in the vaginal margins, bilateral ovaries, or fallopian tubes. Paratubal cysts and bilateral ovarian follicular cysts are noted, along with findings consistent with adenomyosis."} +{"pid": "TCGA-14-0783", "report": "The patient is female. A specimen was obtained from the left frontal region of the brain in two parts. The first specimen, received fresh for intraoperative consultation, consisted of multiple fragments of tan-red and yellow tissue measuring 2.0 x 1.3 x 0.3 cm in total. A representative section was used for frozen section analysis, with the remaining tissue placed in a cryoblock. The second specimen, received in formalin, consisted of two irregular tan-pink tissue fragments with adherent blood clot, measuring 3.0 x 1.8 x 1.0 cm in total, with areas of yellow discoloration noted. This specimen was entirely submitted for analysis.\n\nIntraoperative frozen section evaluation of the first specimen revealed a high-grade neoplasm with features consistent with a high-grade glial tumor. Both specimens were processed and reviewed in their entirety. All available tissue was submitted for further histologic examination. The case was discussed between the pathologist and resident for interpretation and diagnostic correlation."} +{"pid": "TCGA-06-0148", "report": "A brain specimen was received consisting of two fragments measuring 1.5 cm in aggregate, along with an additional specimen measuring 4.3 x 3.3 x 1.0 cm. The tissue exhibited a tan-brown color with areas of necrosis and red clotted blood. Histological examination revealed a spindle cell neoplasm, raising consideration of glioma or sarcoma. Microscopic analysis demonstrated cellular areas with pseudosarcomatous morphology. Immunohistochemical staining showed gliofibrillogenesis within the tumor cells, including in the pseudosarcomatous regions. Increased microvascular proliferation was observed. The proliferation index, assessed by MIB-1 staining, was 14% in more active areas. Special stains including Snook's reticulum, Masson's trichrome, GFAP, and factor VIII were utilized to further characterize the tissue composition and vascular features."} +{"pid": "TCGA-2A-A8W3", "report": "The prostate specimen measured 4.5 cm from apex to base, 4.5 cm transversely, and 4.0 cm in anterior-posterior dimension, with a total weight of 63.0 grams. The left posterior region showed involvement, with the dominant tumor mass extending from the apex to the base. Extracapsular extension was present at the left posterior base. Perineural invasion was identified, while vascular invasion was not observed. The surgical margins were free of tumor. High grade prostatic intraepithelial neoplasia was present, and the non-neoplastic prostate showed changes consistent with nodular hyperplasia. The seminal vesicles and bladder neck were not involved. Examination of the left pelvic lymph node revealed one lymph node, and the right pelvic lymph node included two nodes; all were benign. The largest lymph node in each group was serially sectioned. A biopsy of the periprostatic fat showed only benign fibroadipose tissue without evidence of tumor. According to AJCC 1997 staging criteria, the pathological stage was determined as pT3a due to extracapsular extension."} +{"pid": "TCGA-ZB-A965", "report": "Pathology Report-Summary: Material: Tumor measures 10.0 x 8.0 x 5.0 cm with focal infiltration of the capsule and lung parenchyma. Microscopic examination shows epithelial cells positive for CK5/6 and KL1. Scattered within the tissue are immature T-lymphocytes that are CD99 and TdT positive. Staging classification is pT3, pNx, and according to Masaoka-Koga, stage III."} +{"pid": "TCGA-DU-5851", "report": "The specimen consisted of multiple biopsies taken from various regions of the right temporal lobe, including the right temporal tip, superior uncus, superior medial temporal area, and superior temporal tumor. The tissue samples were fixed in formalin or fresh, with sizes ranging from 4x2x2 mm to 19x6x5 mm.\n\nMicroscopic examination revealed a moderately pleomorphic astrocytic lesion with gemistocytic features. Some areas showed more rounded tumor cell nuclei, along with occasional apoptotic cells and rare mitotic figures. There was no clear evidence of vascular proliferation or necrosis. Immunohistochemical staining demonstrated strong and diffuse positivity for p53, indicating possible genetic alterations. The Ki-67 labeling index was approximately 7%, suggesting a moderate proliferation rate. While some areas showed mixed morphological features, the astrocytic component was predominant.\n\nMGMT promoter methylation testing was performed on DNA extracted from paraffin-embedded tissue. The results were negative, with no detectable methylation of the MGMT promoter. The sensitivity of the assay is capable of detecting 1% methylated DNA in an unmethylized background, although factors such as high non-neoplastic cell content or extensive necrosis may have limited the ability to detect methylation. The test was developed and validated by the laboratory, and while it has not been cleared or approved by the FDA, it was used for informational purposes in the context of established diagnostic protocols.\n\nFrozen section and smear analysis of one of the biopsies (right temporal tip) supported the presence of a glioma, favoring a high-grade astrocytic lesion. However, no definitive diagnosis was provided in the report. Tissue from other biopsy sites, including the right posterior parahippocampal gyrus, showed hippocampal dentate gyrus without clear evidence of neoplastic involvement."} +{"pid": "TCGA-MP-A5C7", "report": "The specimen includes a left upper lobe lung lobectomy weighing 185.0 grams. The bronchial margin is negative for tumor, with a distance of 4.0 cm from the tumor. A central mass measuring 4.0 x 3.0 x 2.6 cm is well-circumscribed and associated with pleural puckering; however, there is no evidence of visceral pleural invasion. Histologic evaluation reveals grade 2 (of 4) morphology.\n\nLymph node assessment includes multiple stations. In the intrapulmonary and hilar regions, multiple (11) peribronchial lymph nodes, one (station 10L) hilar lymph node, and multiple (2) interlobar (station 11L) lymph nodes are examined, with no tumor identified. In the mediastinum, multiple (2) para-aortic (station 6), multiple (2) subcarinal (station 7), and one (station 9L) left pulmonary ligament lymph nodes are also free of tumor."} +{"pid": "TCGA-A5-A1OK", "report": "The specimen was examined and includes findings from multiple tissue samples. The omental specimens (three separate specimens) show hemorrhages, serosal adhesions, chronic inflammation, and reactive mesothelial changes, with no evidence of metastatic disease. Tissue from the right uterine cornea shows findings consistent with organizing hematoma and reactive mesothelial proliferation.\n\nThe left fallopian tube and ovary demonstrate epithelial hyperplasia without significant atypia and focal transitional epithelial metaplasia. A paratubal serous cyst with bloody contents and cystic Walthard rests are also present. The ovary is atrophic. The right fallopian tube and ovary show similar findings, including epithelial hyperplasia without atypia, along with a cystic epithelial inclusion and benign surface micropapillary epithelial and stromal proliferations.\n\nExamination of the uterus following total hysterectomy reveals extensive involvement of the endometrium in the fundus, anterior and posterior corpus, and lower uterine segment. There is full-thickness myometrial invasion with tumor reaching the serosal surface. Focal involvement of the intrauterine portion of one fallopian tube is noted. No extension into the cervix is identified. The vaginal cuff and parametrial tissues are free of tumor.\n\nMicroscopic evaluation of the cervix demonstrates two foci of microinvasive squamous cell carcinoma, with maximum depth of invasion approximately 1.5 mm and horizontal extent less than 1 mm. Extensive cervical intraepithelial neoplasia (CIN III) is present in all four quadrants, with additional focal CIN II. Koilocytic atypia consistent with HPV infection is observed. Other cervical findings include mucosal erosion, reactive changes likely from prior biopsy, chronic and mild acute inflammation, squamous metaplasia, nabothian cysts, subepithelial hemorrhage, and focal endometriosis. The endometrium shows complex hyperplasia with atypia, necrosis, and hemorrhage, consistent with prior curettage. A small subserosal leiomyoma and focal endometriosis in the lower uterine segment are also present.\n\nLymph node assessment includes left and right pelvic, para-aortic, and common iliac lymph nodes. A total of 20 lymph nodes were examined, with no evidence of metastatic disease. Immunohistochemical studies on lymph node tissue do not identify occult keratin-positive tumor cells.\n\nMicroscopic features of the uterine lesion include lymphovascular and perineural invasion. The surgical margins of the parametrium and vaginal cuff are free of tumor involvement. Based on these findings, the primary lesion is found to involve the uterine serosa and/or adnexa, with no regional lymph node involvement."} +{"pid": "TCGA-23-2079", "report": "The specimen includes a portion of severely cauterized tissue measuring 1.7 x 0.9 x 0.5 cm, submitted as \"splenic tumor,\" with no spleen present in the sample. A large omental specimen measuring 32 x 21 x 4.5 cm and weighing 900 grams is largely infiltrated by tan-white to grey tumor nodules ranging from 0.5 to 9 cm, along with small clear fluid-filled cysts from 1.0 to 2.5 cm. The appendix measures 3.5 x 0.6 x 0.5 cm with attached fat, showing a smooth serosal surface and no evidence of carcinoma. The cul-de-sac tumor consists of six pieces of tan-brown to tan-red tissue, measuring up to 5.0 cm, largely replaced by firm, friable nodules ranging from 0.5 to 2.5 cm, with one cystic structure measuring 1.5 x 1.0 x 0.7 cm.\n\nThe right adnexa contains an ovary measuring 5.5 x 3.8 x 3.5 cm, almost entirely replaced by solid tumor nodules (0.5\u20132.0 cm) and multiple cysts (0.6\u20133.2 cm). Some nodules show necrosis, hemorrhage, and a papillary appearance with a central cavity. The attached fallopian tube shows no tumor involvement. The left adnexa includes a smaller ovary measuring 3.8 x 2.3 x 1.8 cm, fully replaced by solid tumor nodules up to 1.6 cm and cysts of similar size, with a broad ligament containing multiple tumor nodules. The attached fallopian tube also shows no tumor infiltration.\n\nThe uterus measures 7.7 cm in length with a fundus-to-cervix dimension of 5.0 cm across. Tumor involvement is noted on the lower uterine segment serosa both anteriorly and posteriorly, with the posterior lesion measuring approximately 6.8 x 4.0 x 1.5 cm and displaying a papillary appearance. A subserosal myoma measuring 1.4 cm is located near the left cornu. The endocervical canal contains a 1.0 x 0.2 x 0.2 cm polyp, and the endometrial cavity has a 1.7 x 0.3 cm polyp on the posterior wall.\n\nMicroscopically, tumor tissue is present in both ovaries, the omentum, the lower uterine segment serosa, the cul-de-sac, and tissue labeled as \"splenic tumor.\" In most areas, the tumor grows in a solid pattern with cystic and papillary components in several sections. A minor gland-forming component is also observed. Tumor nuclei are large with prominent nucleoli, and mitotic figures are frequent. Focal areas of necrosis, including calcified regions, are present along with desmoplasia, hemorrhage, and inflammation. Tumor implants are seen on the posterior and anterior serosal surfaces of the uterus, but there is no apparent invasion into the myometrium. Lymphovascular invasion is identified in some areas.\n\nAdditional findings include a benign endometrium with ciliated/tubal metaplasia, a benign endocervical polyp with recent hemorrhage and associated histiocytes, and a subserosal leiomyoma without atypical features. There is focal superficial adenomyosis, omentitis with reactive mesothelial hyperplasia, and serosal adhesions involving the appendix, uterus, and omentum. The distal appendiceal lumen shows fibrous obliteration, while the proximal lumen remains patent. No significant histologic abnormalities are found in the fallopian tubes."} +{"pid": "TCGA-IB-AAUQ", "report": "The specimen consisted of three liver biopsies and a resected portion of the pancreatic body and tail. The liver biopsies measured 0.3 cm, 0.2 cm, and 0.8 cm respectively, and were each submitted in their entirety for histologic evaluation. Microscopic examination of all liver specimens revealed benign tissue without evidence of malignancy.\n\nThe pancreatic specimen measured 12.0 x 6.0 x 3.5 cm and contained a central mass measuring 4.5 x 3.5 x 3.5 cm. The mass was firm with a yellow-tan cut surface and focal hemorrhagic areas. It was located in the anterior portion of the pancreas, extending to the anterior serosa and approaching the retroperitoneal margin within 1\u20132 mm. The pancreatic duct traversed the posterior aspect of the mass without dilation or stricture.\n\nHistologic analysis showed a moderately differentiated epithelial tumor with a focal foamy gland pattern. The tumor extended into peripancreatic and retroperitoneal soft tissues, with invasion noted in the wall of the splenic vein. Positive margins were identified at the pancreatic body and retroperitoneal surfaces.\n\nLymphovascular and perineural invasion were present. Evaluation of 21 peripancreatic lymph nodes revealed metastatic involvement in 13, with extranodal extension observed. The largest nodal metastasis measured 1.2 cm. Grossly suspicious lymph nodes were identified in multiple regions around the tumor.\n\nAdditional findings included chronic pancreatitis and pancreatic intraepithelial neoplasia (grade 2). No prior treatment effect was identified. All liver biopsies were negative for malignant involvement."} +{"pid": "TCGA-D9-A4Z2", "report": "Gender: M. Examination result. Clinical diagnosis (suspicion): Skin lesion of the suprapubic region \u2013 status post biopsy. Material: skin of the pelvis. Method of collection: Lesion resection. Supplement result: After immunohistochemistry (HMB 45, S 100), the result remains unchanged.\n\nMacroscopic description: Skin fragment measuring 19 x 8.5 cm with subcutaneous tissue 2 cm in thickness. A lesion measuring 3.5 x 4 x 2.5 cm is present in the skin with an adjacent involved area measuring 13.5 x 7 x 1 cm. Minimum side margin of the main lesion is 0.5 cm. Margin to the base of the main lesion is 0.4 cm.\n\nMicroscopic description: The lesion is classified as a nodular type. Clark level V invasion is observed, with a Breslow thickness of 25 mm. Mitotic index is over 10 mitoses per 1 mm\u00b2. At the base of the lesion, there is low-intensity lymphocytic infiltration, a focus of tumor necrosis, and surface ulceration. Numerous satellite nodules are identified. Evidence of vascular invasion is present. Satellite nodules extend to the lateral resection margin and multifocally to the base, with margins below 0.1 cm."} +{"pid": "TCGA-HW-A5KL", "report": "A 36-year-old female presented with a right temporal lobe lesion. Two specimens were submitted for analysis: one labeled as a right temporal lobe lesion, and another described as a right temporal lobe and brain lesion. The first specimen consisted of a soft tan tissue fragment measuring 1 x 1 x 0.2 cm, entirely submitted for frozen section and touch preparation. The second specimen was a 2.9 x 1.5 x 0.9 cm fragment of focally hemorrhagic tan-pink to white brain tissue; part was used for TPS and the remainder submitted for permanent sections.\n\nMicroscopic evaluation of the intraoperative smear revealed cellular infiltration with evidence of mitotic figures, raising concern for anaplastic features. However, tissue sections demonstrated a neoplasm characterized by diffusely infiltrating cells consistent with a specific glial lineage. Morphologic features were indicative of a grade II lesion according to WHO classification.\n\nImmunohistochemical staining showed a high number of tumor cells positive for p53. A subset of cells demonstrated expression of R132H mutant IDH1. Proliferative activity, assessed by MIB-1 (Ki-67) labeling index, was low and did not exceed 2%. Additional molecular studies were performed, and relevant markers were evaluated. All findings were based on personal examination of the slides and confirmed upon review."} +{"pid": "TCGA-DK-A1AD", "report": "The specimen consists of a bladder measuring 6.0 x 5.5 x 4.7 cm with an attached prostate weighing 68 grams and measuring 3.8 cm from apex to base, 4.0 cm transversely, and 3.2 cm anterior to posterior. Right and left seminal vesicles measure 4.0 x 2.3 cm and 4.0 x 2.0 cm, respectively. A tan-white infiltrative lesion measuring 4.0 x 3.0 x 2.5 cm is identified in the right-inferior aspect of the bladder. The surface of this lesion is ulcerated and located 1.8 cm from the urethral resection margin. Another ulcerated area measuring 1.2 x 1.0 cm is observed at the junction of the bladder and urethral mucosa. No lesions are noted on the dome or left aspect of the bladder. The perivesical adipose tissue appears unremarkable. The left ureter is patent with smooth mucosal surfaces, while the right ureter is not clearly identified, possibly due to tumor involvement.\n\nMicroscopic examination reveals a nodule-forming infiltrative lesion involving the bladder wall with extension into surrounding soft tissues. The cellular morphology demonstrates high-grade features with focal glandular differentiation. Perineural invasion is present, but no vascular invasion is observed. Adjacent mucosa shows chronic inflammatory changes. Involvement of the prostatic urethra by in-situ changes is noted. Surgical margins are negative for involvement. Non-neoplastic findings include benign nodular hyperplasia of the prostate and focal high-grade intraepithelial proliferative changes within the prostate. Seminal vesicles appear histologically unremarkable.\n\nLymph node evaluation includes multiple sampled regions. Of seven lymph nodes examined from the right pelvic region, one contains metastatic involvement. Similarly, one of four lymph nodes from the right hypogastric region shows metastatic presence. Three lymph nodes from the left pelvic region are without evidence of involvement. Specimens from both vas deferens and distal ureters demonstrate benign histology with no malignant findings."} +{"pid": "TCGA-XF-AAN4", "report": "The surgical specimen included a cystectomy with total abdominal hysterectomy and bilateral salpingo-oophorectomy. The bladder measured 8 x 6 x 3 cm, and a mass was identified in the posterior dome and left posterolateral wall. The mass measured 6 x 4 x 2.5 cm and extended through the entire bladder wall into the subserosal and perivesical soft tissue. The uninvolved bladder wall measured 0.7 cm in thickness, while the involved wall measured 1.5 cm. The tumor came within 3 mm of the left ureterovesical junction and 4 cm from the urethral margin. No lymphovascular space invasion was identified. All resection margins, including those of the urethra and trigone/bladder neck, were free of dysplasia and malignancy.\n\nSections of the cervix showed benign squamous and endocervical mucosa. The endometrium was atrophic, and the myometrium showed no significant histopathologic changes. The fallopian tubes and ovaries showed no significant histopathologic findings; the left ovary contained a simple serous cyst and both ovaries showed benign physiologic changes.\n\nA total of 65 lymph nodes were examined from multiple anatomical locations, including right and left paracaval, common iliac, presacral, Cloquet, external iliac, obturator/hypogastric, para-aortic, presciatic, and perivesical regions. In all cases, no malignancy was identified (0/65).\n\nThe tumor was poorly differentiated with glandular features and was graded as 3 and 4/4. No urothelial dysplasia or malignancy was found in the distal or proximal ureters. A flat lesion was identified adjacent to the main tumor and also in the left ureterovesical junction. Multiple sections of the peritoneum, bladder wall, and surrounding fat were examined, and all were consistent with these findings."} +{"pid": "TCGA-C5-A2M1", "report": "The specimen consists of a radical hysterectomy with cervix, uterus, bilateral adnexae, vaginal cuff, and multiple lymph node groups. The uterus weighs 137 grams and measures 9 x 6 x 3 cm. The cervix contains a visible exophytic mass measuring 2.5 x 2.5 x 1 cm, primarily located on the ectocervix with extension into the endocervical canal. The tumor has pushing margins and is associated with a prominent inflammatory infiltrate. Microscopic evaluation reveals a mixed growth pattern with papillary and glandular components, along with areas of solid architecture. Cellular features include intermediate to high-grade nuclei and abundant mitotic figures. The tumor thickness is 3 mm out of a total measured depth of 14 mm. No lymphovascular or venous invasion is identified. Resection margins are negative.\n\nSections from the lower uterine segment and endomyometrium show no evidence of tumor involvement. The endometrium exhibits secretory changes. Both ovaries and fallopian tubes appear histologically unremarkable, with no pathological findings noted. The vaginal cuff is also free of tumor cells.\n\nLymph node dissection includes bilateral external iliac, obturator, and periaortic stations. All lymph nodes examined microscopically show no presence of malignancy. Specifically, 8 left external iliac nodes, 4 left obturator nodes, 7 right external iliac nodes, 4 right obturator nodes, and 8 periaortic nodes (3 right and 5 left) are negative for tumor involvement.\n\nAdditional microscopic evaluation confirms no histopathologic abnormalities in the fallopian tubes, ovaries, or other submitted tissues. All lymph nodes evaluated support the absence of metastatic disease."} +{"pid": "TCGA-05-4432", "report": "The lesion is located in the right upper lobe of the lung, specifically in segment S2. Histological examination reveals a mixed growth pattern with a predominant large-cell component and areas of clear-cell morphology. Additional features include small acinar structures, focal mucin production, and a bronchioloalveolar growth pattern observed at the periphery. The tumor infiltrates and causes localized perforation of the visceral pleura. Lymph node involvement is present in the hilar region, while the resection margins of the bronchus and vessels, as well as additional sampled tissues including the middle lobe, parietal pleura, and lymph nodes from stations 4 to 13, show no evidence of tumor. Based on this evaluation, the TNM classification is pT2 pN1 pMX, corresponding to stage IIB."} +{"pid": "TCGA-GL-A59R", "report": "The surgical specimen consists of a left radical nephrectomy with associated caval thrombus, hilar and retroperitoneal lymph nodes. The primary lesion measured 11 cm in greatest dimension and was characterized as unifocal. Microscopic evaluation showed perinephric fat invasion, renal sinus involvement, and extension into the renal vein with tumor adherent to the vein wall. A section from the renal vein resection margin demonstrated tumor presence, indicating a positive margin at that site. The adrenal gland was present within the specimen and showed involvement by the tumor.\n\nHistologic grade was Fuhrman grade 3 of 4. No sarcomatoid features were identified. Evaluation of lymph nodes from the hilar region showed no evidence of involvement, with 0 of 9 nodes involved. The non-neoplastic kidney showed benign cortical cysts. Gross examination revealed a pink-tan to brown mass with hemorrhagic areas, measuring 11 x 6.5 x 4.5 cm, largely replacing the renal parenchyma and extending into the renal vein with a protruding thrombus measuring 6.5 cm in length. The renal sinus was completely replaced by the mass, and the renal vein was occluded with tumor thrombus extending beyond the margin by 7 cm. The ureter was attached and measured 12.2 cm in length. The adrenal gland measured 8 x 4.5 x 1.4 cm and weighed 20.3 g. A cortical cyst near the lower pole measured 4.5 x 2.2 x 2.4 cm. The specimen dimensions were 25 x 19 x 7 cm in total. Pathologic staging according to 2010 criteria was pT3c, pN0, with no distant metastases assessed."} +{"pid": "TCGA-B0-5092", "report": "The specimen consists of a left nephrectomy. The neoplasm measures 3.8 cm in greatest diameter and is confined within the renal capsule. There is no invasion of the renal vein or evidence of angiolymphatic invasion. All surgical margins are free of the lesion. The Fuhrman nuclear grade is III of IV. Extensive myxoid changes are present. The non-neoplastic adjacent kidney shows alterations related to proximity to the lesion. No lymph nodes or distant metastases were identified."} +{"pid": "TCGA-DX-A1L1", "report": "The surgical specimens include a segment of colon with associated soft tissue masses, a left kidney with adrenal gland, and a fragment of iliac vein. The colon specimen contains two subserosal fibroadipose masses measuring 8.5 x 7.5 x 3.5 cm and 3.5 x 3.2 x 2.6 cm, respectively. These are located 4.2 cm from one bowel margin, 8.5 cm from the other, 0.5 cm from the closest ureter margin, and 0.4 cm from vascular margins. The cut surfaces show heterogeneity with both firm and gelatinous areas, and less than 10% necrosis is present. A distended ureter embedded within the mass is noted, with no gross extension into the bowel lumen. Histologically, the larger mass shows a high-grade component with a myxofibrosarcoma-like growth pattern. Tumor cells are present focally in pericolic soft tissues and near the bowel wall, and are within 1.0 mm of an inked soft tissue margin. Two lymph nodes are negative for tumor involvement. The ureter, vascular, and bowel margins are free of tumor.\n\nThe left kidney and adrenal specimen shows a focally thickened renal capsule; however, histologic evaluation reveals no neoplastic cells. Scattered atypical stromal cells are present but are negative for MDK2, CDK4, and HMB-45, consistent with a reactive process. All margins including ureteral, vascular, and soft tissue are benign. No lymph nodes are identified in the perinephric region.\n\nThe iliac vein specimen includes a small yellow nodule measuring 0.8 x 0.5 x 0.2 cm within fibroadipose tissue. Microscopic evaluation reveals similar high-grade morphology as seen in the colonic mass, though the vein itself is free of tumor. One lymph node submitted from this site is also negative."} +{"pid": "TCGA-AQ-A04H", "report": "The left breast re-excision specimen consists of skeletal muscle and fibroadipose tissue; no abnormal cellular proliferation was identified. A right total mastectomy specimen weighing 300 grams showed focal atypical ductal hyperplasia, apocrine metaplasia, and microcalcifications associated with benign ducts and lobules. The skin demonstrated seborrheic keratoses. No invasive or in situ malignancy was found in this specimen.\n\nIn the left modified radical mastectomy specimen, two distinct masses were identified in the lower inner quadrant. The first mass measured 2.5 cm and the second 1.4 cm, with the two separated by 1.9 cm of intervening fibroadipose tissue. Histologically, both masses exhibited high-grade nuclear features with a Nottingham combined histologic grade of 3 (tubule formation score 3, nuclear pleomorphism score 3, mitotic count score 3). Lymphovascular invasion was extensive. In situ components were present in association with both masses and within the intervening tissue, comprising less than 10% of the total tumor volume. These in situ components showed comedo and solid architectural patterns, high nuclear grade, and areas of necrosis. No extensive intraductal component was identified. The invasive component was less than 1 mm from the deep margin, while the in situ component was 3 mm from the deep margin.\n\nFifteen axillary lymph nodes were examined, with four showing metastatic involvement. The largest metastasis measured 9 mm. There was no extracapsular extension identified. Microcalcifications were not present. Other findings included biopsy site changes in the larger mass, fibroadenomatous change, and seborrheic keratosis of the skin.\n\nImmunohistochemical analysis of the larger mass showed estrogen receptor positivity (97%) and progesterone receptor positivity (27%). HER-2/neu staining was indeterminate (score 2+) on initial testing, though prior in situ hybridization on a separate specimen showed HER-2/neu gene amplification.\n\nThe mastectomy specimen measured 400 grams and had a skin ellipse measuring 19 x 5.0 cm. The nipple and areola appeared unremarkable. The axillary tail contained multiple lymph node candidates. Both tumors were well-circumscribed with tan/red or red/white cut surfaces. The remainder of the breast tissue consisted of yellow fibroadipose tissue with scattered dense white parenchyma. No other gross abnormalities were noted.\n\nMargins were assessed with respect to both tumors. Mass #1 was 2.4 cm from the deep purple inked margin, 5 mm from the skin, and varied in distance from other margins. Mass #2 was very close to the posterior margin, approximately 3 cm from the inferior margin, and distant from other margins. No gross involvement of skin or fascia was observed.\n\nMultiple blocks were submitted for microscopic evaluation, including sections from the masses, adjacent tissue, intervening fibroadipose tissue, surgical margins, and lymph nodes. Additional lymph node blocks were submitted for further assessment.\n\nThe pathologic staging based on available data is pT2 pN2a pMx. This assessment may be subject to revision pending further clinical correlation and additional studies."} +{"pid": "TCGA-EU-5907", "report": "ADDENDUM REPORT. This addendum is issued to reflect a discussion with the surgeon regarding the specimen. Initially, there was concern about involvement at the renal vein margin as the tumor appeared to bulge from the vein. However, after review, the tumor appears to be well clear of the surgical margin. In some cases, during fixation and handling, the vein can retract, creating an appearance of tumor at the margin. Given this context and the current findings, the case is interpreted as having no involvement at the vein margin.\n\nA right kidney specimen weighing 522 grams measures 18 x 11 x 5 cm and includes a 12.5 x 7 x 4 cm kidney and surrounding perinephric fat. A small adrenal gland fragment measuring 1 x 0.5 x 0.5 cm is present in the perinephric fat and shows no gross evidence of tumor involvement. The ureter and renal artery are also not involved by tumor. The renal vein demonstrates a bulging mass at the resection margin. No hilar lymph nodes are identified. Upon bisection, the kidney reveals an orange, lobular, well-circumscribed tumor measuring 8 x 5 x 3.8 cm located predominantly in the inferior pole. The tumor extends into the pelvis, while the remainder of the kidney appears normal with preserved corticomedullary architecture.\n\nMicroscopic evaluation indicates a high-grade neoplasm with a Fuhrman nuclear grade of 3. Nuclei are irregular, approximately 20 microns in size, with large, prominent nucleoli. While most areas show grade 2 features, several fields exhibit grade 3 morphology. Histologic analysis confirms conventional clear cell morphology. Special stains and immunohistochemical markers support the histologic classification. Hale's colloidal iron stain shows limited positivity in about 5% of cells, and the tumor is negative for E-cadherin, CD117, and CK7, but positive for vimentin and CD10.\n\nThe tumor is macroscopically confined to the kidney and invades into the pelvis. There is no evidence of tumor in the soft tissue margins, ureteral, or arterial margins. Although the renal vein margin initially raised concern, further review supports that it is not involved. There is no evidence of vascular invasion. The adrenal gland and regional lymph nodes are uninvolved. Distant metastasis could not be assessed."} +{"pid": "TCGA-VS-A9UY", "report": "The biopsy specimen from the cervix shows a moderately differentiated invasive epithelial lesion. The tumor cells exhibit moderate nuclear atypia with increased nuclear-to-cytoplasmic ratios and irregular nuclear contours. Mitotic figures are present. No evidence of vascular invasion is identified. The lesion is confined to the sampled tissue without extension into deeper vascular or stromal compartments."} +{"pid": "TCGA-NP-A5H1", "report": "A right radical nephrectomy specimen was received, weighing 598 grams. The kidney measured 17.5 x 10.2 x 5.6 cm with abundant perinephric fat. The ureter measured 8.0 cm in length and had a narrow lumen. Upon sectioning, a well-circumscribed, pale tan tumor was identified near the upper pole of the kidney. The tumor measured 3.5 x 3.0 x 2.6 cm and abutted both the anterior and posterior renal capsules. Gerota's fascia extended to within 0.7 cm of the tumor on the anterior side and 0.6 cm on the posterior side. The tumor approached as close as 0.1 cm to the fatty sinuses. Margins were assessed and found to be greater than 4.5 cm from the vascular and ureteral margins.\n\nHistologically, the lesion exhibited features consistent with uniform cells showing distinct cell membranes and pale cytoplasm. Immunohistochemical staining showed positivity for CK7, CD117, PAX-8, and CD10, while being negative for Vimentin. These findings are in alignment with previously observed morphologic characteristics.\n\nThe tumor was confined within the kidney and abutted the renal capsule without evidence of extension beyond it. No involvement of the renal sinus was identified. There was no sarcomatoid differentiation noted. The tumor was unifocal, measuring 3.5 cm in greatest dimension. Staging indicated a primary tumor classification of pT1a, with no identifiable lymph nodes or metastatic disease (pNX, pMX). All surgical margins were free of tumor involvement (R0), resulting in an overall pathologic stage of I.\n\nIn the non-neoplastic portions of the kidney, arteriolosclerosis was present along with scattered sclerotic glomeruli and mild nonspecific chronic inflammation. No additional masses or lesions were identified elsewhere in the kidney tissue. Multiple sections were submitted for evaluation, including margins, ureter, renal pelvis, tumor bed, renal capsule, Gerota\u2019s fascia, adjacent renal sinus, and normal kidney parenchyma."} +{"pid": "TCGA-S9-A6U2", "report": "Histomorphology shows features consistent with a glial neoplasm, including areas of increased cellularity and nuclear uniformity. Scattered single mitotic figures are present. Focal regions demonstrate elevated proliferation activity, estimated up to 10%. No necrosis or microvascular proliferation is identified. The tumor lacks overt anaplastic features."} +{"pid": "TCGA-B0-5080", "report": "The specimen includes a right kidney and proximal ureter resected via laparoscopic nephrectomy. A lesion measuring 9 cm is centered in the lower pole of the right kidney. Microscopic evaluation reveals a predominantly Fuhrman nuclear grade 2/4 with focal areas of grade 3/4. The lesion demonstrates focal extrarenal extension into the renal sinus adipose tissue. Multiple intrarenal deposits ranging from 0.1 cm to 1 cm are present, most likely representing intrarenal satellite metastases. No tumor thrombus is identified within the large renal veins. All surgical resection margins are free of involvement. Pathologic staging is T3a, NX, M1. A separate lesion measuring 2.5 cm is identified in the right adrenal gland and appears confined to that site; the surgical margin is also free of involvement. The non-neoplastic kidney shows no significant histologic abnormalities. A segment of benign ureter, renal artery, and renal vein is also present."} +{"pid": "TCGA-P3-A6T4", "report": "A 50-year-old man with a history of a previously resected lesion presented for evaluation. The resection specimen included an 11 x 8.5 cm ellipse of medium tan, hair-bearing skin with a central ulcer measuring 2.5 cm in diameter and a surrounding 8.5 cm area of induration extending to within 0.3 cm of the anterior cutaneous margin. A smaller 4 x 0.9 cm ellipse of skin was sutured to the main specimen. Embedded within a 12 x 8 x 6 cm aggregate of deep soft tissue and skeletal muscle was a segment of mandible spanning from the right anterior premolar to the left body of the mandible. Seven teeth were present, including a right premolar with dental restoration, two incisors (one intact, one fractured/decayed), two intact canines, a fractured left premolar, and a molar with a fractured crown. The mandibular cut surfaces showed no gross abnormalities.\n\nThe left floor of mouth and approximately 2.5 x 3 cm of attached tongue were largely replaced by a pale tan, firm mass that extended both outward and inward, eroding through the mid-segment of the mandible, with the bone appearing extensively destroyed. The skin and soft tissue were partially peeled and sutured back, not representing a true surgical margin. Surgical margins were marked with ink: blue on the medial, right, and anterior aspects, and black on the left lateral, inferior, and posterior aspects. Representative sections from various margins were submitted for analysis, including areas near the destroyed mandibular segment and end margins.\n\nBisection of the specimen revealed a 3 cm diameter cavity with soft, red-brown, friable contents, and the abnormal tissue extended close to the medial soft tissue margin. Lymph node dissection specimens were also received. The left neck level II specimen measured 5 x 4 x 1 cm and contained multiple lymph nodes up to 1.5 cm in diameter; the largest was bisected and submitted along with smaller nodes. The left neck level III specimen was an 8 x 1.5 x 0.8 cm strand containing multiple lymph nodes up to 1.0 cm in size, all submitted intact. Additionally, three teeth and six tooth fragments were received, with the largest being a 1.8 x 1 x 0.7 cm molar with calculus and discoloration at the root, a 2.2 x 0.7 x 0.5 cm incisor with a porcelain and metal crown, and a 2 x 0.5 x 0.4 cm intact incisor, along with smaller fragments.\n\nMicroscopic findings indicated involvement of the resection margins in the left inferoposterior and right inferior subcutaneous soft tissues, with tumor within 0.03 cm of the right medial and left posterolateral soft tissue margins, and within 0.1\u20130.2 cm of the medial posterior soft tissue margin. Other visualized margins were clear by at least 0.3 cm. Perineural invasion was identified, and there was focal suspicion of angiolymphatic invasion. Chronic inflammation of a salivary gland was also noted. In the left level II neck dissection, one out of eight lymph nodes showed evidence of involvement, while no involvement was found in the six nodes from level III. After decalcification, the right mandibular margin was free of disease, but the left mandibular margin showed presence of abnormal tissue within bone, soft tissue, and perineural space. Based on these findings, the minimum pathologic stage was determined to be pT4a, pN1, pMX according to the AJCC TNM Classification, 6th edition, 2002."} +{"pid": "TCGA-B0-5106", "report": "The specimen consists of a left radical nephrectomy. A neoplasm is identified, measuring 3.6 cm in greatest diameter. The tumor is confined within the renal capsule with no extension into the renal vein. No angiolymphatic invasion is observed. All surgical margins are free of neoplastic cells. Histologic evaluation reveals a mixture of architectural patterns. Nuclear grading according to Fuhrman's criteria is 2 of 4. The surrounding kidney and adrenal gland show no significant abnormalities. Lymph nodes or distant metastases are not identified. The histologic grade corresponds to G2."} +{"pid": "TCGA-DQ-5631", "report": "The patient had a history of a previously biopsied lesion with findings of dysplasia, which was followed by a period of negative biopsy results. Subsequently, an ulcerative and friable lesion with a nodule was identified, and biopsy of this lesion showed malignant cells.\n\nGross examination included multiple tissue samples submitted for frozen section analysis. These included distal lingual nerve (0.2 cm), midline raphe deep margin (0.3 cm), posterior dorsal tongue (2.5 cm strip), anterior dorsal tongue (2.3 cm strip), hyoglossus (0.7 cm), and base of tongue (0.9 cm). All were used as controls for frozen section analysis.\n\nThe main specimen was a left hemiglossectomy measuring 7.6 x 3.4 x 1.8 cm. A 3.8 x 2.1 cm area of ulceration with surrounding thick white discoloration was noted on the lateral surface, extending from the dorsal aspect ventrally. The lesion measured 1.2 cm in depth and was located 0.3 cm from the deep (medial) margin, 0.6 cm from the anterior margin, and 0.7 cm from the posterior margin. Margins were marked with blue (superior) and green (inferior) ink.\n\nLymph node dissections were performed on the left side. Level I dissection included six possible lymph nodes ranging from 0.2 x 0.1 x 0.1 to 1.7 x 0.9 x 0.5 cm, along with a submandibular gland measuring 3.0 x 2.5 x 0.8 cm. Level II dissection contained four possible lymph nodes, with sizes ranging from 0.4 x 0.3 x 0.2 to 4.1 x 2.5 x 1.0 cm. The largest lymph node showed areas of hemorrhage, firm white cut surfaces, and necrotic regions. Level III dissection included multiple lymph nodes up to 1.2 x 0.8 x 0.5 cm. Level IV dissection contained two lymph nodes measuring 0.3 x 0.2 x 0.2 and 0.9 x 0.5 x 0.3 cm, along with a muscle fragment.\n\nFrozen sections of all margins were negative. Microscopic evaluation of the resected tongue tissue revealed invasive, poorly differentiated epithelial malignancy. The tumor measured 3.8 cm in its largest dimension and demonstrated vascular invasion. Inflammatory cell infiltration was present but mild. No perineural or bone invasion was identified. The tumor border was irregular and infiltrative.\n\nLymph node evaluation showed no involvement in Levels I, III, or IV. In Level II, one of six lymph nodes contained metastatic disease, with focal extension beyond the capsule noted upon review. A total of 19 lymph nodes were examined across all levels, with one positive node identified. Sections of all other tissues and margins showed no evidence of residual malignancy."} +{"pid": "TCGA-CJ-5682", "report": "The specimen includes a left kidney measuring 12.0 x 6.0 x 6.0 cm, along with segments of the left renal vein (4.0 cm in length), ureter (11.0 cm), and renal artery (1.0 cm). Also present is a fragment of fibroadipose tissue containing the adrenal gland, measuring 9.0 x 3.5 x 1.5 cm, with the adrenal gland itself measuring 4.0 x 1.0 x 0.7 cm. Within the upper pole of the kidney, there is a lobulated, bright-yellow mass measuring 6.0 x 3.5 x 4.0 cm. The mass is entirely surrounded by renal parenchyma and does not involve perinephric fat. It extends into the renal sinus and involves the renal vein at the hilum. The portion within the renal vein is located 2.0 cm from the margin and has a firm, white appearance. All vascular, ureteral, and soft tissue margins are free of involvement. The adrenal gland shows no evidence of abnormality. Multiple sections were taken for microscopic evaluation, including en face views of the renal vein, artery, and ureter margins; areas of tumor adjacent to the renal vein; representative sections of the tumor involving the renal pelvis, renal capsule, and surrounding normal parenchyma; and sections of the uninvolved kidney and adrenal gland. A portion of the tumor and normal kidney was submitted to the Tissue Bank. Cellular features include high nuclear grade morphology. The tumor is confined to the kidney and renal vein without extension beyond the hilar margin."} +{"pid": "TCGA-A3-3378", "report": "The specimen consists of a left kidney measuring 12.0 x 8.5 x 7.5 cm and weighing 310 grams. The external examination reveals a bulging mass on the posterior surface of the mid portion of the kidney. Upon sectioning, a central tan-yellow, well-circumscribed, lobular mass measuring 5.5 x 5.0 x 4.0 cm is identified. The renal cortex appears pale and measures approximately 0.5 cm in thickness. No gross evidence of invasion into surrounding structures, pelvis, or vessels is observed. No additional lesions are present.\n\nHistologically, the mass demonstrates cells with clear cytoplasm. Nuclear grading according to Fuhrman classification is grade 3. There is no evidence of lymphovascular space invasion, transcapsular extension, or renal vein involvement. Venacaval invasion was not assessed as that tissue was not resected. The adrenal gland is not identified within the specimen.\n\nAll surgical margins, including soft tissue, ureteral, and vascular, are free of involvement. No lymph nodes are identified in the specimen. Based on pathological findings, the tumor is confined to the kidney without regional nodal involvement. Staging is based on tumor size and extent, with no distant metastasis indicated."} +{"pid": "TCGA-UW-A72P", "report": "The specimen consists of a right partial nephrectomy measuring 5.5 x 5.0 x 4.4 cm and weighing 45.7 grams. The mass is located in the cortex extending into the medulla, well-circumscribed, encapsulated, and tan-pink in color with a friable consistency. The tumor measures 3.8 x 3.6 x 3.4 cm and is unifocal, confined to the kidney without multicentricity. Histologically, the cellular features are consistent with a variant previously described, with Fuhrman nuclear grade 2 of 4. Sarcomatoid differentiation is not present.\n\nMicroscopically, the tumor invades into but not through the renal capsule. There is no involvement of perirenal adipose tissue, Gerota\u2019s fascia, renal sinus, major veins, or ureter. Vascular invasion (venous or lymphatic) is absent. The surgical margins are negative, though the tumor approaches both the parenchymal and capsular margins closely, being less than 1 mm from each. No paranephric adipose tissue was present in the specimen. No lymph nodes were identified, and the adrenal gland was not present in the specimen.\n\nThe non-neoplastic kidney shows no specific pathological abnormalities. Based on the available information, the extent of the lesion is classified as pT1a. No nodal staging is possible due to absence of lymph nodes (pNx). This classification is based on current findings and may be subject to revision upon further clinical review."} +{"pid": "TCGA-A3-3324", "report": "The specimen consists of a right kidney with attached perinephric fat, measuring 22 x 13 x 8 cm and weighing 1154 grams. A central oval mass is identified within the kidney, measuring 6.3 x 5 x 4 cm, with a golden-yellow appearance and focal hemorrhage. The mass is located in the middle region of the kidney and appears to bulge against the capsule without gross evidence of extension beyond it. Sections of the capsule and mass are submitted for analysis. The renal cortex averages 0.7 cm in thickness. The ureter and vascular margins are included in the specimen and show no involvement by invasive carcinoma. No lymph nodes or adrenal tissue are identified within the attached fat.\n\nMicroscopic evaluation reveals a unifocal lesion with clear cell morphology. Nuclear grading is consistent with Fuhrman grade 3. There is no evidence of venous or lymphatic invasion. Regional lymph nodes and distant metastatic status cannot be assessed based on the current specimen.\n\nStaging classification indicates the lesion is confined to the kidney with a maximum dimension between 4 and 7 cm. The surgical margins are free of invasive carcinoma."} +{"pid": "TCGA-ZJ-A8QQ", "report": "Specimen #: Dr: Date Obtained: Date Received: Date Printed: CLINICAL HISTORY: RESULTS NEEDED BY. ICD-9: 795.04. SPECIMEN/PROCEDURE: 1. CERVIX - BX. 2. CERVIX - BX. IMPRESSION: 1). CERVIX, 6 O'CLOCK, BIOPSY: A poorly differentiated large cell nonkeratinizing type was identified. 2). CERVIX, 8 O'CLOCK, BIOPSY: A poorly differentiated large cell nonkeratinizing type was identified. Entered: COMMENT: Case reviewed at. Entered: GROSS DESCRIPTION: 1). Received labeled with the patient's name and \"cervical biopsy at 6:00\", is a pink to pale tan tissue fragment with apparent mucoid material. The specimen is entirely submitted in one cassette. 2). Received labeled with the patient's name and \"cervical biopsy at 8:00\", is a pink to pale tan irregular tissue fragment that is 1.5 x 0.7 x 0.3 cm. The specimen is trisected and entirely submitted in cassette #2. Entered: F."} +{"pid": "TCGA-27-2524", "report": "Birth date. Tumor site. Left frontal. Histological diagnosis. [Details removed per instruction]. \n\nThe tumor measured 4.2 cm in greatest dimension and demonstrated a high degree of cellular pleomorphism with frequent mitotic figures. Necrosis was present, and microvascular proliferation was noted. The lesion was classified as grade IV based on histological features. No further diagnostic or molecular testing results are provided in this summary."} +{"pid": "TCGA-AA-3850", "report": "The specimen consists of a partial resection of the transverse colon. Histopathological examination reveals a moderately to poorly differentiated neoplasm with surface erosions and peritumorous chronic inflammation, showing signs of acute exacerbation. Lymphangitic spread is present, with infiltration extending into the layers of the colon wall up to the tunica muscularis. Evaluation of lymph nodes shows no evidence of metastasis; all 15 lymph nodes examined are free of tumor involvement. Additional sections from other areas of the resected specimen show no abnormal findings. The pathological staging based on available sections indicates pT2, pN0 (0/15), Mx, with lymphovascular invasion noted (L1) and complete resection margins (R0). Cellular grading corresponds to G2-3."} +{"pid": "TCGA-55-7913", "report": "A mutation panel was performed on a lung specimen obtained from the left lower lobe. Genetic analysis included assessment of the EGFR and KRAS genes as well as rearrangement of the ALK gene using FISH methodology. Sequencing of exons 18 through 21 of the EGFR gene, which encompass the tyrosine kinase domain, did not reveal any mutations previously associated with clinical significance or any changes leading to amino acid alterations. However, one or more polymorphisms were identified in the EGFR gene. These sequence variations are considered non-pathogenic as they do not result in amino acid substitutions and are not expected to have clinical implications. It is noted that up to 7% of patients who respond to EGFR inhibitors may not show detectable mutations in these exons, thus a negative result does not rule out potential clinical benefit.\n\nKRAS mutation analysis was also conducted, evaluating exon 1 (codons 12 and 13) and exon 2 (codon 61). No mutations were detected in these regions. The sensitivity of both the EGFR and KRAS assays is approximately 10% mutant allele in a background of normal DNA.\n\nFISH analysis for ALK rearrangement was performed using break-apart probes targeting the 2p23 region. A total of 100 cells were evaluated, and no break-apart signal indicative of ALK translocation was observed. Therefore, no evidence of ALK rearrangement was found. However, an incidental finding of increased ALK gene copies (1\u20136 extra copies) was seen in 79% of the cells, suggesting gain of the ALK locus. The clinical relevance of this finding is currently unknown. The cutoff for a positive result in paraffin-embedded tissue is 12%, and this result remains below that threshold. It should be noted that approximately 5% of tumors with ALK rearrangements detected by other methods may be missed by this assay. Thus, results should be interpreted in the context of other clinical and laboratory data.\n\nThe tumor measured 2.8 x 2.7 x 2.4 cm and was unifocal, located in the left lower lobe. Histologically, the lesion was well-differentiated with focal mucin production. There was no evidence of visceral pleural invasion or lymphovascular space invasion. The tumor was confined to the lobe of origin. Surgical margins were assessed: the distance from the bronchial margin was 0.7 cm, and from the parenchymal (stapled) margin was 0.5 cm. The tumor was adjacent to the pleural surface but did not involve it. Lymph node evaluation included level 5 and level 15 biopsies, both of which were negative for malignancy. Based on these findings, staging was determined as pT1b. Immunohistochemical staining for TTF1 was positive, supporting a primary lung origin. Additional ancillary studies are in progress and will be reported separately."} +{"pid": "TCGA-KN-8423", "report": "The specimen labeled \"Left kidney\" consists of a 603.5 g nephrectomy specimen measuring 12.5 x 6.5 x 3.3 cm, including surrounding perirenal fat ranging from 0.9 to 2.2 cm in thickness. A mass measuring 15.0 x 4.8 x 3.7 cm was identified in the lateral lower pole. The mass is well-circumscribed and bulging, with approximately 75% appearing yellow/tan, lobulated, and solid, while about 25% exhibits a fibrotic, red/brown to tan/white appearance centrally, with hemorrhagic areas. On sectioning, the mass shows a variegated, focally hemorrhagic cut surface with regions of fibrosis. It expands into the adjacent perinephric fat but does not grossly invade through the renal capsule, approaching within 0.1 cm of the black inked margin. The mass is approximately 85% solid and 15% friable or necrotic. Vascular structures including the bifurcated renal vein (average 0.4 cm x 0.5 cm), renal artery (0.6 cm x 0.3 cm), and ureter segment (11.0 cm long, diameter 0.1\u20130.4 cm) are present. The mass is located 8.5 cm from the ureteral margin, 4.7 cm from the arterial margin, and 4.2 cm from the renal vein margin. The remainder of the renal cortex appears tan/brown with a distinct cortical-medullary junction. The pelvocaliceal system shows smooth, glistening urothelium without masses or lesions.\n\nMicroscopic evaluation reveals that vascular and ureteral margins are free of tumor involvement. The tumor is composed of two components: one fleshy yellow/tan and another fibrotic red/brown to tan. Both components are present at the tumor capsule, which is intact. The tumor approaches closest to the black inked margin at 0.1 cm. There is no invasion of the renal pelvis or sinus. Evaluation of surrounding tissues shows no tumor involvement in the perirenal fat or adjacent uninvolved kidney tissue. All submitted lymph node candidates (total of 8 ranging from 0.2 to 1.0 cm) show no evidence of tumor involvement.\n\nAdditional histologic findings include mild focal global glomerulosclerosis affecting approximately 5% of glomeruli. The remaining glomeruli demonstrate very mild hypertrophy with subtle increases in cellularity and mesangial matrix. Glomerular basement membranes appear normal in thickness on PAS and silver stains. Tubules are largely preserved with occasional PAS-positive casts. The interstitium shows minimal fibrosis and no active inflammation. Less than 5% of the sample demonstrates tubular atrophy and interstitial fibrosis, predominantly subcapsular. Arterial and arteriolar walls show mild focal sclerosis with subintimal hyalinosis.\n\nSections were submitted for cytogenetics, electron microscopy, immunofluorescence, and tissue banking. Representative sections of the tumor and surrounding kidney were evaluated microscopically as described above."} +{"pid": "TCGA-5K-AAAP", "report": "The resected specimen includes thymus and lung tissue. The lesion measures approximately 8.5 cm in greatest dimension and demonstrates invasion of the pleura microscopically, as well as macroscopic involvement of the pericardium as noted in the operative report. The tumor is arranged in lobulated nests of spindled cells separated by fibrous bands of variable thickness. There is minimal cytologic atypia and few mitotic figures are present. Zones of infarction or necrosis and lobulated hyalinization are observed. No lymphovascular invasion is identified. The resection margins, including the inked peripheral and pulmonary margins, are free of tumor. Based on the extent of local spread, the process is classified as stage III. All reviewers concur with the initial findings, and no additional sections have altered the interpretation."} +{"pid": "TCGA-A8-A09W", "report": "The specimen shows an invasive carcinoma measuring 2.5 cm in diameter, with evidence of focal intraductal spread. Histological evaluation demonstrates features consistent with a poorly differentiated morphology. Lymphovascular invasion is present. Grading is classified as G III. Staging assessment indicates pT2 with lymph node involvement classified as N3a. No vascular or perineural invasion is identified."} +{"pid": "TCGA-VD-A8K8", "report": "The specimen consists of an enucleated left eye with axial, horizontal, and vertical dimensions of 24mm, 23mm, and 23mm respectively. The cornea is clear, measuring 12mm horizontally and vertically. The optic nerve has a length of 12mm and a diameter of 4mm. The anterior chamber is of normal depth. Trans-illumination reveals a shadow in the superior region measuring 19 x 18mm. Upon sectioning, a lesion is identified in the posterior third of the globe, measuring 16mm in largest basal diameter and 12mm in height. It is pigmented and dome-shaped, associated with an exudative retinal detachment. The overlying retina shows atrophy and degenerative changes.\n\nHistological examination shows a normal anterior segment with unremarkable cornea, deep anterior chamber, open angles, and unremarkable iris. The ciliary muscles show moderate atrophy with hyalinization of the ciliary processes. The lens demonstrates advanced cataractous changes. The lesion contains a mixture of epithelioid and spindle-shaped cells, with spindle cells predominating. Epithelioid cells constitute approximately 15% of the cell population. Immunohistochemistry demonstrates positivity for MelanA and HSP-27 (score 2). Mitotic activity is prominent, with approximately 12 mitoses per 40 high power fields. The vasculature within the lesion is notable for the presence of closed loops and occasional vascular lakes, with tumor cells observed within lumina. There is minimal lymphocytic infiltration and a moderate density of scattered macrophages. No evidence of scleral invasion or extraocular extension is present. The optic nerve and examined vortex veins are free of tumor, with mild atrophic changes noted in the optic nerve.\n\nThe molecular genetic analysis of tumor DNA using MLPA demonstrated normal chromosome 1, monosomy 3, normal chromosome 6, and gains in chromosome 8. These findings will be correlated with clinical and morphological data for metastatic risk assessment."} +{"pid": "TCGA-QR-A70W", "report": "The right adrenal specimen consists of a mass measuring 15 x 5 x 3 cm and weighing 75.45 grams. A distinct nodule within the specimen measures 3.5 x 3 cm and is estimated to be 3 cm in thickness upon further sectioning. The tumor has a hemorrhagic and friable cut surface. The lesional and perilesional areas were inked, and approximately 50% of the tumor along with a small portion of the surrounding normal adrenal tissue was procured for analysis. Normal adrenal cortex (approximately 0.1%) was also sampled and submitted. The remainder of the tumor was entirely submitted for evaluation in designated cassettes. Margins of the specimen appear free of abnormal tissue. Surrounding adipose tissue is present, and a portion of grossly normal adrenal cortex is included in the submission."} +{"pid": "TCGA-77-A5GH", "report": "Histopathology Report. HISTORY. Clinical history of a lesion in the left lingula segment. Specimens include a left lingula lobe segmentectomy, along with left lower lobe and left hilar lymph nodes.\n\nMACROSCOPIC. Three specimens were received. The first, identified as the left lingula lobe, is a lung tissue specimen measuring 110 x 65 x 29 mm. The visceral pleural surface is smooth. A stapled margin of 83 mm in length is present at one edge. On serial sectioning, a single lesion measuring 23 x 20 x 22 mm is identified within the lung parenchyma. It is located 4 mm from the pleural surface, 20 mm from the stapled resection margin, and 16 mm from the hilar resection margin. The cut surface of the lesion is firm and solid, with no cavitation observed. The surrounding lung tissue distal to the lesion and the remaining parenchyma show no visible abnormalities. No lymph nodes are present in this specimen. Sections taken include margins and representative areas of the lesion in relation to airways and pleura, as well as non-neoplastic lung tissue. The second specimen, labeled as left hilar lymph node, consists of a fragment of dark tissue measuring 10 x 5 x 5 mm. The third specimen, identified as left lower lobe lymph node, contains two fragments of dark tissue measuring 6 x 6 x 5 mm and 6 x 4 x 4 mm.\n\nMICROSCOPIC. Examination of the first specimen reveals a moderately differentiated cellular proliferation with central necrotic changes. The lesion extends across a fissure and shows focal involvement of the adjacent visceral pleura, though no surface involvement is present. The bronchial resection margin is free of abnormal cells, and the intraparenchymal stapled margins appear clear macroscopically. Within the lesion, there is focal evidence suggestive of perineural association, but no definitive lymphatic or vascular invasion is seen. Adjacent lung tissue shows signs of obstructive inflammation, while more distant areas demonstrate emphysematous changes. No lymph nodes are found in this specimen. The second and third specimens, corresponding to hilar and lower lobe lymph nodes, show only reactive changes including sinus histiocytosis, carbon pigment deposition, scattered birefringent material consistent with silicate, and mild follicular hyperplasia. No abnormal cellular infiltration is identified in these lymph nodes.\n\nSUMMARY. The left lingula specimen, along with separately submitted hilar and lower lobe lymph nodes, demonstrates a moderately differentiated cellular growth measuring 23 mm. The lesion crosses a fissure and shows focal extension toward the visceral pleura, without surface involvement. The bronchial resection margin is uninvolved. Focal changes suggestive of perineural association are noted within the lesion. No lymphatic or vascular invasion is confirmed. The adjacent lung shows obstructive inflammatory changes, and emphysema is present in more distant regions. The hilar and lower lobe lymph nodes do not show any evidence of cellular involvement. Anatomical pathology findings indicate a localized process with no nodal spread."} +{"pid": "TCGA-75-6214", "report": "The specimen was collected from the upper lobe via resection. The tissue sample measured 6.00 cm in size and demonstrated histologic features consistent with a neoplastic process. Cellular morphology showed grade III differentiation. Pathologic staging revealed no evidence of distant metastasis (M0), with regional lymph node involvement noted (N1). Clinical staging was assessed as T2, NOS. No further diagnostic terms are provided in this summary."} +{"pid": "TCGA-55-6986", "report": "The specimen from the right lower lobe of the lung measured 15.0 x 10.0 x 5.5 cm and weighed 120 grams. A tan firm mass measuring 2.5 x 2.0 x 2.0 cm was identified beneath the pleura at the base of the lung, located approximately 5 cm from the bronchial margin. Microscopic evaluation showed well to moderately differentiated cells with bronchioloalveolar features. The tumor invaded the visceral pleura but did not involve the bronchial resection margin or demonstrate vascular invasion. No lymphatic or venous invasion was observed.\n\nEvaluation of lymph nodes included three peribronchial nodes, one paraesophageal node (station 8), and one interlobar node (station 11). All lymph nodes showed no evidence of metastatic involvement. One paraesophageal lymph node exhibited sinus histiocytosis with anthracosis. No direct extension of the tumor was identified. Additional findings included a central scar associated with the lesion.\n\nSpecimens were fully submitted for analysis, and margins were free of invasive disease. Distant metastasis could not be assessed."} +{"pid": "TCGA-V1-A8WS", "report": "The prostate gland measured 4 cm from apex to base, 6 cm from medial to lateral, and 4 cm from anterior to posterior. The exterior was roughened and pink-tan with focal cautery markings along the base/bladder margin. Sutures were present along the anterior midline and tiny metal staples were embedded in the tissue. A left seminal vesicle/vas deferens bundle was attached, measuring 1.7 x 2 x 0.6 cm, and was soft, pink-tan, and whorled without discrete lesions. The right seminal vesicle/vas deferens bundle had been detached intraoperatively and measured 2.7 x 1.7 x 1 cm; it was firm, irregular, and pink-tan with no visible lesions.\n\nSerial sectioning of the prostate revealed a suspicious lesion in the right half of slices 1, 2, and 3. The lesion was firm, yellow-tan, irregular, and measured 0.7 cm in greatest dimension. Histologic evaluation identified small acinar structures involving multiple regions including the left mid gland, right apex, right posterior and anterior mid gland, and right seminal vesicle. The estimated tumor volume was 6.04 cubic cm. Extensive bilateral involvement of the prostate was noted with widespread invasion of the capsule and extraprostatic extension, particularly at the right posterior quadrant. Tumor was not identified at inked excision margins, although it was within less than 1 mm of the margin in several areas bilaterally. Benign glands were found at inked excision margins in the right posterior quadrant and bladder margins.\n\nExtensive perineural infiltration was present. No tumor was identified in the left seminal vesicle, but there was evidence of involvement in the right seminal vesicle. No prostatic intraepithelial neoplasia was identified. The tumor demonstrated a Gleason grade of 3+3. Multiple tissue blocks were submitted for analysis, including apical and bladder margins, serial slices from all quadrants, and sections from both seminal vesicles. Based on histopathologic findings, the stage was determined according to AJCC/UICC criteria."} +{"pid": "TCGA-A3-A6NJ", "report": "The specimen consists of a left kidney weighing 289 grams, measuring 12.5 x 6.2 x 5.8 cm, with a small amount of attached perinephric fat. The kidney was previously bivalved. A segment of ureter, 1.5 cm in length, is attached. Within the lower pole, there is a 5.7 x 5.2 cm golden-yellow, cystic mass that is edematous. Grossly, this mass appears to be in close proximity to the renal capsule. Adjacent to the mass, a small amount of perinephric fat is present. Gerota's fascia and renal capsule overlying this mass are marked with black ink.\n\nIn the remaining renal parenchyma, a 0.4 x 0.3 cm golden-yellow nodule is identified, located 3.7 cm superior to the larger mass. This nodule also appears to be near the renal capsule, and the overlying Gerota's fascia is marked with orange ink. Additionally, a 1.4 cm cortical cyst is present; its internal surface is smooth without any irregularities. The uninvolved renal parenchyma has a red-brown appearance. Examination of the kidney hilum reveals no identifiable lymphoid tissue. Attached to the kidney is a 3.7 x 1.4 x 0.6 cm section of adrenal gland, which shows no visible masses or lesions.\n\nMicroscopic evaluation of sampled areas demonstrates cells with nuclear features corresponding to the lowest grade category. The larger mass measures 5.7 cm and is confined within the kidney, without evidence of lymphovascular invasion. A separate smaller focus measuring 0.4 cm is identified in the renal parenchyma, above the main lesion. No sarcomatoid differentiation or tumor necrosis is observed. Margins of the ureter and blood vessels are free of involvement, as is the adjacent adrenal gland. Pathologic staging indicates a localized lesion with no regional lymph node assessment performed."} +{"pid": "TCGA-B1-7332", "report": "The specimen consists of perinephric adipose tissue and a left partial nephrectomy. The adipose tissue is unremarkable, with no evidence of malignancy. The left kidney shows a neoplasm that is confined within the renal capsule. The greatest diameter of the tumor is 7.0 cm. Histologically, the tumor demonstrates papillary architecture with Fuhrman nuclear grade 2 features. No angiolymphatic invasion is identified. All surgical margins are free of tumor involvement. The non-neoplastic kidney tissue appears normal. No lymph nodes are present for evaluation. The right kidney biopsy shows cauterized renal parenchyma and adipose tissue, with no evidence of malignancy. Based on the extent of tumor growth limited to the kidney and its size, the pathologic staging reflects localized disease without nodal or distant spread. Additional clinical history includes prior surgeries such as cervical discectomy, lumbar fusion, foot hardware removal, rotator cuff repair, and hysterectomy. Medical comorbidities include atrial fibrillation, heart murmur, hypertension, arthritis, diabetes mellitus type II, and gastroesophageal reflux disease. The patient also has a history of a renal mass and uses glasses for vision correction. There is no known history of adverse reactions to anesthesia or blood products."} +{"pid": "TCGA-3B-A9HY", "report": "The resected right knee mass measured 2.6 x 2.1 x 0.7 cm and was located subcutaneously. Histologic evaluation revealed a moderately differentiated to poorly differentiated neoplasm with a mitotic count of up to 12 per 10 high-power fields. Focal tumor necrosis was identified. There was no evidence of angiolymphatic invasion. Surgical margins were free of tumor involvement. The closest negative margin was at the 6 to 12 o'clock region, measuring 1.0 mm. Pathologic staging was determined as pT1a, pNx, pMx. Frozen section analysis confirmed the absence of tumor at the surgical margins. The specimen was entirely submitted for histologic evaluation, with multiple sections examined for accurate assessment."} +{"pid": "TCGA-AA-3666", "report": "The surgical specimen consists of a right hemicolectomy with an ulcerated lesion located in the transition zone between the cecum and ascending colon. The lesion measures up to 6 cm in maximum diameter and demonstrates invasive growth through all layers of the intestinal wall into the surrounding adipose tissue. Adjacent to the lesion, a tubulovillous adenoma is present in the cecal mucosa, showing moderate epithelial dysplasia. All resection margins, including the greater omentum, are free of tumor involvement. Of the lymph nodes examined, 2 out of 10 initially showed metastatic involvement. Subsequent analysis of an additional lymph node preparation, consisting of 31 nodes with sizes ranging from very small to 0.7 cm, revealed no further metastases. Thus, the final nodal status is 2 out of 41 positive. A separate liver biopsy shows complete cirrhotic remodeling of the parenchyma with marked fatty degeneration. Histological grading indicates a moderately differentiated morphology. Vascular invasion was noted, but no residual tumor cells were found at the resection margins."} +{"pid": "TCGA-85-8071", "report": "The specimen consisted of lung tissue from the right upper lobe, obtained via pulmonectomy. The tumor measured 2 x 1.2 x 0.7 cm and was located in the main bronchus. Microscopic evaluation showed moderately differentiated cells with microscopic features consistent with a certain histologic type. Lymph node assessment revealed 2 out of 6 nodes positive for involvement within the intrathoracic region. No other tumor nodules, lymphatic or venous invasion, margin involvement, or additional pathologic findings were identified. No evidence of prior treatment was observed."} +{"pid": "TCGA-5R-AA1C", "report": "The specimen consists of a right lobe of the liver measuring 22.5 x 20.0 x 8.5 cm. A tumor measuring 15.0 x 9.5 x 9.5 cm is present within the liver tissue, located approximately 2.5 cm from the resection margin. The tumor has a flabby, lobulated appearance with yellowish-brown discoloration. The surrounding hepatic tissue is also flabby and yellowish-brown. Microscopic evaluation shows that the tumor is composed of moderately differentiated cells, and vascular invasion is present. The remaining liver tissue demonstrates fatty dystrophy. Fibrosis scoring using the Metavir system is stage 1, the Knodell histological activity index is also grade 1, and the Ishak fibrosis score is stage 1. The surgical margin is free of tumor involvement.\n\nA gallbladder specimen measures 8.0 x 5.0 x 2.0 cm and displays a smooth greenish serosa with a plush greenish mucosa. The gallbladder contains greenish bile and shows autolysis of the mucosa on microscopic examination.\n\nA lymph node measuring 0.7 cm in diameter is identified within the hepatoduodenal adipose tissue. Microscopic analysis of the lymph node reveals no evidence of metastatic disease."} +{"pid": "TCGA-E2-A15J", "report": "The surgical specimens included four sentinel lymph nodes from the left axilla and a left breast mastectomy specimen. Sentinel lymph node #1 measured 1.1 x 0.7 x 0.5 cm and was completely submitted for analysis. Sentinel lymph node #2 measured 0.8 x 0.6 x 0.4 cm and was also entirely submitted. Sentinel lymph node #3 measured 1 x 0.8 x 0.6 cm and was similarly processed. Sentinel lymph node #4 contained four small lymph nodes ranging in size from 0.3 x 0.2 x 0.2 cm to 0.4 x 0.4 x 0.2 cm, all of which were submitted individually.\n\nThe left breast mastectomy specimen weighed 574 g and measured 24 x 19 x 4.5 cm. A skin ellipse measuring 10.5 x 4 cm and an everted nipple were included. The specimen was sectioned into 10 slices from lateral to medial. In slices 4\u20136, a 3.5 x 3.4 x 2.2 cm area of hemorrhage with a biopsy site was identified in the lower outer quadrant, located 2.3 cm from the anterior margin. In slice 6, a separate 1.5 x 1.4 x 1.4 cm firm tan mass was found in the upper inner quadrant, located only 0.2 cm from the anterior margin. A 1 cm firm tan lymph node was also noted in the axillary region of the breast specimen.\n\nHistologic evaluation of the lymph nodes showed no evidence of metastatic involvement. The breast tissue demonstrated an invasive tumor measuring 1.7 cm in the upper outer quadrant, with associated ductal carcinoma in situ (DCIS) extending across approximately 3 cm, involving solid, cribriform, micropapillary, and papillary patterns. DCIS was also present in areas separate from the invasive component. Intermediate nuclear grade and central necrosis were noted within the DCIS. Lobular extension was identified, along with microcalcifications and fibrosis at prior biopsy sites. Surgical margins were free of tumor involvement.\n\nEstrogen and progesterone receptor statuses were positive, while HER2 testing was negative by FISH. The histologic grade was low, with a tubular score of 2, nuclear grade 2, and mitotic score 1. No vascular or lymphatic invasion was observed. Twelve lymph nodes, including sentinel nodes, were examined and none showed evidence of metastasis. Based on these findings, the pathological stage was determined as pT1c N0.\n\nAn Oncotype DX assay was performed, yielding a recurrence score of 20, indicating an intermediate risk of distant recurrence at 10 years (~13%). ER and PR scores were consistent with positivity, while the Her2 score confirmed negativity."} +{"pid": "TCGA-IQ-A61E", "report": "A composite resection specimen involving the tongue, floor of mouth, and mandibular bone was submitted. The tongue component measured 7.0 x 4.5 x 3.0 cm, with an ulcerated, ill-defined white infiltrating lesion occupying approximately 80% of the specimen. The lesion measured 6.0 x 4.0 x 3.0 cm and extended to the soft tissue margin but did not grossly involve the mandibular bone. Margins were inked for identification: mucosal (medial) margin red and soft tissue margin black.\n\nMultiple margins were assessed microscopically and were negative for malignancy. These included right and left floor of mouth margins, right retromolar trigone, medial retromolar, inferior soft palate, right lateral pharyngeal wall, right vallecula mucosa, left base of tongue, left posterior tongue dorsal margin, suprahyoid muscle, left base of tongue deep muscle margin, proximal right hypoglossal nerve, deep left floor of mouth, left ventral tongue deep margin, left dorsal tongue margin, left deep posterior tongue muscle, deep left middle deep muscle, left anterior tongue deep muscle, and right proximal digastric margins.\n\nHistologic evaluation revealed a moderately to poorly differentiated squamous cell carcinoma with endophytic growth pattern and ulceration. Perineural invasion was identified. No lymphovascular invasion was observed. All surgical margins were free of tumor involvement.\n\nLymph node evaluation included levels from bilateral neck dissections. A total of 44 lymph nodes were examined (15 from right neck levels 2A, 3, 4; 1 from right level 1B; 8 from right neck level 2B; 5 from left neck levels 1A and 1B; 10 from left neck levels 2A, 3, 4; and 5 from left neck level 2B), all negative for malignancy. Additional specimens including salivary gland, carotid tail, and teeth were also evaluated without evidence of malignancy.\n\nThe primary tumor measured 6 cm in greatest dimension. Pathologic staging was determined as pT3, pN0, pMX."} +{"pid": "TCGA-VP-AA1N", "report": "The prostate specimen weighed 34.6 grams and measured 4 x 4 x 3.8 cm. The bilateral seminal vesicles were attached, with the left measuring 3 cm in length and the right measuring 2.9 cm. A total of five lymph nodes were identified from the bilateral pelvic region and showed no evidence of malignancy.\n\nHistologic evaluation revealed a neoplasm composed of cells arranged in an acinar pattern. The tumor involved approximately 30% of the prostate gland, as determined by grid morphometric analysis. Tumor foci were identified at the left apex, right apex, and left base. The right base was uninvolved. Perineural invasion was present; vascular invasion was not identified.\n\nExtraprostatic extension was noted at the left apex and left base. Additionally, there was focal extension into the bladder neck. The tumor reached the distal apical resection margin with 1 mm of involvement, while all other margins, including the bladder neck and peripheral margins, were free of tumor. The seminal vesicles were not involved.\n\nPathologic staging indicated extracapsular extension (T3a), no regional lymph node metastasis (N0), and no distant metastasis (M0). The tumor grade demonstrated a high degree of differentiation complexity. Based on these findings, the stage grouping was classified as T3/N0/M0. This stage assignment is provisional and may be adjusted with further clinical correlation."} +{"pid": "TCGA-BQ-5879", "report": "A right kidney specimen was received, measuring 11.4 x 9.2 x 7.5 cm and weighing 567 grams. The attached ureter was 1.7 cm in length and 0.4 cm in diameter, and the renal vein measured 1.2 cm in length and 0.3 cm in diameter. No adrenal gland was identified. A large heterogeneous mass was centered in the cortex of the mid-kidney, measuring 9.2 x 7.5 x 7.0 cm. The tumor showed areas of myxoid and gelatinous appearance as well as tan-yellow fleshy regions. It extended into the renal capsule and infiltrated the hilum with focal involvement of the renal pelvis. The remainder of the kidney showed a pink-brown parenchyma with a well-defined corticomedullary junction and normal-appearing calyces. The cortex measured 0.9 cm in thickness. Margins of the renal vessels and ureter appeared unremarkable.\n\nMicroscopic evaluation revealed high-grade cellular features. Tumor cells were positive for CD10, RCC, racemase, and E-cadherin, and negative for CK7, CK20, and 34BE12. The tumor extended into the renal pelvis and involved the renal hilar fat. No invasion of the renal vein was identified; however, tumor was present within medium-sized vessels in the renal hilum. Surgical margins were free of tumor. Non-neoplastic kidney tissue was otherwise unremarkable.\n\nLymph node specimens were submitted from interaortacaval, presacral, para-aortic, right suprahilar, and retrocaval regions. Metastatic carcinoma was identified in matted lymph nodes from the interaortacaval and presacral region, as well as from interaortocaval #2. In the right adrenal gland and paracaval/retrocaval lymph node specimen, three of eleven lymph nodes showed metastatic involvement. Para-aortic and right suprahilar lymph nodes were not involved. The number of nodes examined in these regions was five and ten, respectively. Minute fragments of adrenal cortical tissue were noted in one specimen but showed no evidence of tumor involvement.\n\nStaging assessment indicated that the tumor grossly extended into the renal vein or vena cava below the diaphragm. Based on personal examination of the slides and review of all materials, this report has been finalized."} +{"pid": "TCGA-98-A53H", "report": "The pathology report includes multiple lymph node excisions from various levels, all of which are negative for malignancy. Several lymph nodes show benign findings such as hyalinized granuloma with or without calcification. One lymph node is described as benign fibroadipose tissue without identification of a lymph node structure.\n\nA lung resection specimen from the right upper lobe reveals a tan firm nodule measuring 1.8 cm in greatest dimension located within the lung parenchyma. The pleura is uninvolved and surgical margins are free of malignant cells. The tumor was identified during gross examination and representative sections were submitted for microscopic evaluation. A staple line measuring 6 cm is noted across the hilum and another area of the lung specimen. The bronchial margin is also negative for malignancy.\n\nAll lymph node specimens submitted, including those examined during frozen section, show no evidence of tumor involvement. The pathologic staging indicates no nodal involvement."} +{"pid": "TCGA-BP-4166", "report": "The left kidney specimen with a portion of adrenal gland measured 19 x 9.0 x 8.0 cm, with the kidney itself measuring 14.0 x 6.5 x 4.2 cm. On sectioning, a multinodular tan-yellow lesion was identified, measuring 5.0 x 3.5 x 2.5 cm and located on the lateral lower pole of the kidney. This lesion extended through the renal capsule but remained within Gerota\u2019s fascia. A second distinct nodule measuring 0.8 x 0.7 x 0.7 cm was found 2.0 cm away from the primary lesion. No invasion of large renal veins was observed; however, tumor emboli were noted in small lymphovascular channels. All surgical margins were free of involvement. The non-neoplastic kidney showed focal benign simple cortical cysts and otherwise normal renal tissue. The adrenal gland measured 3.5 x 1.2 x 0.7 cm and appeared histologically unremarkable.\n\nThe remainder of the adrenal gland was submitted as multiple fragments of adipose and glandular tissue measuring up to 4.5 x 3.5 x 3.0 cm. Histologic evaluation confirmed benign adrenal tissue without any abnormal findings.\n\nMultiple para-aortic lymph nodes were received, measuring up to 1.7 x 1.5 x 1.0 cm in aggregate. One lymph node measuring 1.2 x 0.7 x 0.5 cm was identified and found to be histologically benign. No evidence of involvement was seen in the submitted lymph nodes.\n\nRepresentative sections were taken from various sites including the main tumor, separate nodule, cyst, renal parenchyma, ureter margin, vascular margin, perirenal fat, and adrenal gland. Intraoperative frozen section confirmed findings consistent with those seen on permanent sections."} +{"pid": "TCGA-DX-A8BT", "report": "The submitted specimen from the right axillary region includes a mass measuring 9.5 x 8.4 x 4.1 cm, with a variegated tan-yellow cut surface and focal areas of necrosis and hemorrhage. The mass is largely well-circumscribed, though the superficial aspect demonstrates an irregular, infiltrating border. It is surrounded by a thin fibrous membrane and extends focally to an inked margin. Overlying skin and subcutaneous tissue are unremarkable, with evidence of fat necrosis. Within the axillary fat, multiple lymph nodes were identified, ranging from 0.8 to 2.9 cm in greatest diameter. Ten benign lymph nodes were found on histologic evaluation. Histologically, the lesion shows high-grade spindle and pleomorphic cells. Immunohistochemical staining demonstrated negativity for MDM2, CDK4, AE1:AE3, and 34BE12. Sections submitted include representative portions of the tumor, margins, surrounding fat, and lymph nodes."} +{"pid": "TCGA-AC-A3EH", "report": "The specimen from a female patient consists of fibroadipose breast tissue and overlying skin, measuring 18.0 by 8.0 cm and weighing 1,529 grams. A centrally located mass is identified, measuring 10.0 x 10.0 x 7.2 cm, and is within 2.5 cm of the deep margin of resection. The surrounding breast tissue shows yellow-tan fatty fibroadipose tissue with areas of gray fibrous tissue. A scar in the outer quadrant measures 3.0 cm and is 9.2 cm from the nipple. The nipple is eccentrically placed and appears unremarkable. No other lesions are identified grossly.\n\nHistologic evaluation reveals a unifocal lesion with an architectural score of 3/3, nuclear score of 2/3, and mitotic score of 1/3, resulting in a total score of 6/9 (Grade II). The lesion demonstrates associated microcalcifications and lymphovascular space invasion. No in situ component or skin involvement is identified. The deep surgical margin is free of tumor by 2.5 cm as measured grossly.\n\nTwelve lymph nodes are identified in the axillary contents, with three containing metastatic involvement. The largest metastatic deposit measures 2.5 cm, and extracapsular extension is present. Additional tissue samples include a separate piece of skin and subcutaneous tissue measuring 14.0 x 4.0 x 1.5 cm, with no lesions identified on sectioning. Multiple sections from various regions of the breast and lymph nodes are submitted for further analysis. Based on staging criteria, the stage classification is pT3 N2."} +{"pid": "TCGA-EM-A4FH", "report": "The right hemithyroidectomy specimen measured 6.1 cm in greatest dimension, with the isthmus measuring 2.6 cm. The total specimen weight was 24 grams. A dominant nodule measuring 4.7 x 3.5 x 1.7 cm was identified in the upper mid to lower pole of the lobe. Histologically, the lesion demonstrated follicular architecture and classical cytomorphology features. It was partially encapsulated with minimal capsular invasion. Margins were uninvolved, and no lymphovascular or perineural invasion was identified. A second smaller lesion measuring 0.2 cm was also present in the right lobe, showing similar histologic features including follicular architecture and oncocytic cytomorphology. This smaller lesion was also partially encapsulated, with no evidence of invasion or margin involvement.\n\nThe skin biopsy from the anterior neck showed a fragment of tissue with features of irritated and inflamed seborrheic keratosis. The soft tissue excisional biopsy from the right anterior chest revealed a well-circumscribed, encapsulated lesion within skeletal muscle. The lesion contained lobulated areas of variable cellularity with peripheral palisading, central paucicellularity, and fibrin collections. There was a myxoid spindle-cell proliferation with a tissue-culture pattern around thin-walled vessels at the periphery, along with mixed inflammatory infiltrate. Spindle cells were bland with dispersed chromatin and rare mitotic figures. Immunohistochemical staining showed positivity for SMA, while caldesmon, desmin, and CD34 were negative. These findings were consistent with intravascular fasciitis, considered a variant of nodular fasciitis. The lesion was completely excised without residual disease in the plane of sectioning.\n\nStaging was based on AJCC/UICC TNM 7th Edition. The primary tumor was classified as pT3 due to its size greater than 4 cm and limited to the thyroid. No regional lymph nodes were examined, so pNX was assigned. No distant metastasis was identified. No additional pathologic findings were noted."} +{"pid": "TCGA-GV-A3JW", "report": "The specimen consists of two parts. Part A includes multiple segments of pink-grey tissue measuring 3 x 2.5 cm in aggregate, submitted entirely in two cassettes. Part B consists of multiple pink-grey tissue fragments measuring 2 x 2 cm in aggregate, submitted entirely in one cassette. Microscopic evaluation shows invasive poorly differentiated cells involving the muscular layer. The histologic type is transitional cell morphology with no associated epithelial lesions noted. Histologic grade is high (Grade III). Muscularis propria invasion was confirmed, with detrusor muscle present in the specimen. There is no evidence of lymphovascular invasion. All material necessary for assessment was available and adequate."} +{"pid": "TCGA-ER-A19K", "report": "The specimen consists of skin from the left scalp following wide excision. The lesion measured 6.8 mm in thickness and was focally ulcerated. Histologic evaluation revealed multiple foci of angiolymphatic invasion as well as multiple foci of cutaneous and dermal satellites. Margins of resection, including the deep margin, showed no evidence of involvement. Lymphovascular invasion was present. Sentinel lymph node specimens included two separate tissue samples; neither contained lymph nodes nor any tumor involvement. Immunostains including S100, Melan A, HMB45, tyrosinase, and CD68 were performed and did not identify any tumor cells."} +{"pid": "TCGA-BH-A0C3", "report": "The surgical specimen includes a left breast segmental mastectomy. The lesion measures 1.9 cm in greatest dimension. Histologic evaluation reveals a mixed growth pattern with features of both ductal and lobular differentiation. Nottingham grading system scores include tubule formation: 3, nuclear pleomorphism: 3, mitotic activity: 1, for a total score of 7 out of 9, corresponding to grade 2. Ductal carcinoma in situ (DCIS) is also present, with nuclear grade 2, solid type, comprising less than 5% of the overall lesion and intermingled with the invasive component. All surgical margins are free of invasive and in situ disease, with the closest distance of invasive disease to the posterior margin being 0.3 cm. No evidence of lymphovascular invasion is identified. \n\nA total of four lymph nodes were examined, all from sentinel node biopsies (two from each of two sites), and none show involvement. Standard histologic methods were used for evaluation. Additional findings include focal ductal epithelial hyperplasia, changes related to a prior biopsy site, and background fibrocystic alterations with apocrine hyperplasia and sclerosing adenosis. Immunohistochemical staining shows positivity for estrogen receptor and negativity for progesterone receptor. Special stains demonstrate loss of E-cadherin expression and strong diffuse cytoplasmic staining for p120 in tumor cells."} +{"pid": "TCGA-CJ-4886", "report": "The left kidney specimen includes a well-circumscribed mass measuring 3.7 x 3.5 x 3.0 cm located in the mid pole. The mass is confined to the kidney with a rim of compressed renal parenchyma adjacent to the perinephric fat. There is no involvement of the renal vein or ureteral and renal vein margins. A focal area near the renal sinus raises concern for possible extension, although definitive invasion was not confirmed. Histologic evaluation reveals nuclear features consistent with a high-grade morphology. Microscopic examination also identifies a localized granulomatous inflammatory reaction at the interface between the lesion and surrounding kidney tissue, accompanied by fibrosis and chronic inflammation. No microorganisms were detected on special stains. The remainder of the renal parenchyma appears normal."} +{"pid": "TCGA-DK-A1AB", "report": "A cystohysterectomy with bilateral salpingo-oophorectomy specimen was submitted for evaluation. The bladder measured 16 cm from superior to inferior, 12 cm laterally, and 5.5 cm anterior to posterior. A 3.5 x 2.5 cm ulcerated, fungating lesion was identified on the posterior wall and trigone of the bladder, involving both ureteral orifices. The lesion appeared to extend into surrounding structures including the left ureter, perivesical fat, uterus (myometrium and endometrium), submucosal cervix tissue, and deep soft tissue of the anterior vaginal wall. Extensive perineural and lymphovascular invasion was noted. Surgical margins were free of abnormal cells. Non-neoplastic mucosa showed a foreign body giant cell reaction.\n\nUreteral specimens were also examined. The left ureter contained invasive cells within the muscularis propria and subserosal soft tissue; however, the mucosal surface remained benign. The right ureter was unremarkable. Excised periureteral tissue from the left side revealed metastatic involvement. The distal urethral margin and posterior vaginal wall excisions were unremarkable.\n\nLymph node dissections were performed on both the right and left pelvic regions. On the right, 7 lymph nodes were examined, with one showing involvement. On the left, 7 lymph nodes were assessed, with three demonstrating involvement\u2014two by serous-type cells and one by another population. No extranodal extension was observed.\n\nImmunohistochemical staining was conducted and demonstrated distinct profiles between different cell populations present. Staining patterns supported the presence of multiple distinct processes.\n\nThe ovaries and fallopian tubes were submitted in entirety. The right ovary measured 2.5 x 1.8 x 1.8 cm and was partially cystic. The right fallopian tube was 6 cm long with an altered fimbriated end. The left ovary measured 2.5 x 1.2 x 1.0 cm, while the left fallopian tube was 5.5 cm long with a normal fimbriated end. Several paratubal cysts were noted bilaterally.\n\nAdditional specimens included periureteral tissue, distal urethral margin, posterior vaginal wall, and both ureters. All relevant surgical margins were negative for abnormal cells.\n\nSections were taken from multiple sites including the bladder, cervix, uterus, ovaries, fallopian tubes, ureters, and surrounding tissues. These sections were processed and analyzed as part of the comprehensive evaluation."} +{"pid": "TCGA-NQ-A57I", "report": "The specimen consists of pleural biopsy fragments. The first specimen includes a fragment of fibrous tissue with pink-tan nodules measuring 2.5 x 1.8 x 0.5 cm, with one piece submitted for frozen section analysis. No tissue was identified in the second specimen container. The third specimen contains multiple irregular fragments of glistening mucoid debris, with areas of hemorrhage measuring up to 4.3 cm in greatest dimension and 7 x 7 x 2.2 cm in aggregate, with representative sections submitted.\n\nMicroscopic evaluation reveals a high-grade malignant neoplasm composed of spindle and epithelioid cells arranged in sheets within a fibromyxoid background. Nuclear features include pleomorphism, vesicular chromatin, round to elongated or multilobated shapes, frequent prominent nucleoli, and abundant amphophilic cytoplasm. High mitotic activity is noted along with areas of tumor necrosis and fibroblastic reaction with hemorrhage. Invasion into the fibroadipose soft tissues of the chest wall is present.\n\nImmunohistochemical staining demonstrates positivity for Mesothelin (cytoplasmic), TTF1, AE1/3, and CK5. WT1 is positive in surface cells only. Stains for B72.3, Calretinin, mCEA, Napsin, S-100 are negative. PAS stain with diastase digestion shows no tumor-associated mucin. These findings support a histomorphologic diagnosis of a biphasic malignancy involving the parietal pleura.\n\nPathological staging is pT1b NX. No other significant pathologic findings are noted. The case was reviewed and confirmed by additional pathologists."} +{"pid": "TCGA-60-2697", "report": "The surgical specimen included a subcarinal lymph node and a right lung with a resection margin assessment. A segment of the sixth right rib was also submitted. Two small anthracotic lymph nodes were identified, measuring 0.3 cm and 0.5 cm in diameter, respectively. The right lung measured 21x17x8.5 cm, and at the hilum, there was a replaced lymph node measuring 3.5x2x1.5 cm adjacent to the bronchus. The bronchial resection margin appeared grossly free of tumor involvement. A large mass occupied nearly the entire right middle lobe, measuring approximately 8x8 cm by 5.5 cm. This lesion obstructed the bronchi and led to distal mucus plugs observed in the right middle and lower lobes. Areas of necrosis with yellow discoloration and grey-white tissue were present, and the tumor had pushing margins. It extended along branches of the pulmonary artery, compressing them, and approached within 3 cm of the bronchial resection margin, extending into the bronchial lumen. No satellite nodules were seen, and while the tumor reached the pleura, it did not penetrate through it. There was extensive pleural reaction, including retraction, discoloration, and fibrinoid exudate. The bronchial segment with attached lymph node measured 2.4x1.6x0.3 cm and was submitted entirely. An irregular soft tissue fragment measured 0.7x0.3x0.2 cm and was also submitted. The rib segment measured 5.5x1.5x1.2 cm, with smooth periosteum and attached muscle and fascia; the resection margins were unremarkable, showing cancellous bone.\n\nMicroscopically, the lung tissue revealed an infiltrating, moderately differentiated squamous cell carcinoma. The tumor had invaded a segmental bronchus, penetrating and ulcerating the mucosa. It compressed the adjacent segmental artery but did not directly infiltrate it. Five para-arterial lymph nodes were identified, one of which contained metastatic tumor cells. Adjacent lung tissue showed interstitial follicular pneumonia and early acute suppurative pneumonia. The pleura was thickened and hemorrhagic, with tumor abutment but no infiltration. Four small lymph nodes submitted separately were negative for tumor involvement. The bronchial stump showed chronic inflammation. A parabronchial lymph node contained metastatic disease, while another was free of tumor."} +{"pid": "TCGA-3U-A98D", "report": "The patient is a White male who underwent a right thoracotomy, pleurectomy, and bronchoscopy. Two pleurectomy specimens were received. The first specimen weighed 806.7 g and measured 25 \u00d7 15 \u00d7 6 cm. It showed diffuse thickening of the pleura with nodular, firm tan-pink areas involving both parietal and visceral pleura. There was involvement of the diaphragmatic surface with a maximum thickness of 4.6 cm. The second pleurectomy specimen weighed 218.7 g and measured 20 \u00d7 15 \u00d7 3 cm; it also demonstrated diffuse thickening with confluent nodules up to 1.4 cm in thickness and areas of calcification.\n\nLymph node biopsies were received from stations #7, 4R, #8, and #11. Of the four lymph nodes examined from station #7, two contained metastatic involvement. All five lymph nodes from station 4R were negative. One lymph node from station #8 showed metastatic involvement. Both lymph nodes from station #11 were negative.\n\nHistologic examination of the pleural specimens revealed a biphasic pattern composed of epithelioid and sarcomatoid components. The epithelioid component accounted for approximately 40% and the sarcomatoid component for 60%. The tumor extended into but not through the diaphragm and infiltrated the lung parenchyma. There was no evidence of vascular or lymphatic invasion. Surgical margins could not be assessed.\n\nAdditional findings included pleural plaques with focal calcifications. Immunohistochemical staining showed positivity for calretinin and nuclear WT-1 with negativity for MOC31 in the epithelioid component. The sarcomatoid component showed weaker staining for mesothelial markers.\n\nPathologic staging was as follows: pT2 disease based on involvement of ipsilateral pleural surfaces with diaphragmatic and lung parenchyma invasion. Regional lymph node staging was pN2 due to metastases in subcarinal and mediastinal lymph nodes. A total of 12 lymph nodes were examined, with 3 showing involvement."} +{"pid": "TCGA-BA-5559", "report": "The following findings were obtained from the evaluation of multiple biopsies and excised specimens. Several margins from the left tonsil, including anterior, posterior, superior, inferior, deep superior, and deep inferior, were examined and showed no evidence of abnormal cellular proliferation. An excised portion of the left tonsil revealed a diffuse tan/white thickening measuring 1.3 x 1.2 x 2.3 cm; however, no tumor was identified in this region. The lateral and inferior surgical margins of this specimen were involved, though these findings may be influenced by prior frozen section analysis.\n\nThe uvula specimen showed no abnormal findings. Lymph nodes from various neck levels were assessed. In Level I, four lymph nodes were identified and showed no signs of involvement. In Level II, no lymph nodes were present in the specimen, which consisted primarily of fatty tissue. Level III contained one lymph node, which was negative for any abnormal cells. Levels IV and V demonstrated involvement with cellular infiltration extending beyond the capsule in multiple lymph nodes. Specifically, two out of six lymph nodes in Level IV and two out of fourteen in Level V exhibited cellular spread with extracapsular extension. The largest affected lymph node measured 2.9 cm in greatest dimension.\n\nAdditional specimens included submandibular gland tissue in Levels I and II, both without evidence of abnormality. Gross examination of the excised tonsil revealed a central defect measuring 2.3 x 0.5 cm in the overlying mucosa with underlying tan/brown soft tissue. All surgical margins were sampled and submitted for evaluation.\n\nAll other specimens were entirely submitted for pathologic evaluation, with no residual tumor identified at multiple biopsy sites."} +{"pid": "TCGA-S8-A6BV", "report": "The operative procedure included an Ivor Lewis esophagectomy and pancreatectomy with multiple tissue specimens submitted for analysis.\n\nA resected specimen from the stomach margin showed no evidence of malignancy upon frozen section analysis. The distal pancreas and spleen specimen revealed a small benign pancreatic cyst measuring 0.5 cm, with patchy low-grade pancreatic intraepithelial neoplasia. Twelve lymph nodes were examined and all were benign. The spleen showed no signs of malignant involvement. A separate margin from the body of the pancreas was also free of malignancy based on frozen section evaluation. The esophageal margin was similarly uninvolved by invasive carcinoma.\n\nThe main specimen included a segment of the distal esophagus and proximal stomach with a mass located at the esophagogastric junction. The tumor measured 4.5 cm in size and was centered in the distal esophagus. Histologically, the lesion demonstrated moderately differentiated features with invasion extending into the muscularis propria and periesophageal soft tissues. All surgical margins, including the circumferential margin, were free of invasive carcinoma, although the closest distance of invasive carcinoma to a margin was 0.1 cm at the circumferential margin. No treatment effect was observed, and there was no evidence of lymphovascular or perineural invasion.\n\nLymph node staging showed 2 out of 16 regional lymph nodes involved, with no distant metastases identified. Additional findings included intestinal metaplasia consistent with Barrett esophagus with high-grade dysplasia.\n\nFrozen section analysis was performed on several margins: stomach margin (turnaround time 20 minutes), body of pancreas margin (15 minutes), and esophageal margin (20 minutes), all of which were negative for tumor involvement.\n\nGross examination of the resected esophagus and proximal stomach showed a raised, ulcerated mass in the proximal stomach near the distal margin. The mass measured 4.5 x 2.2 cm and extended into the muscularis propria with proximity to the deep soft tissue margin. Multiple lymph nodes were identified in the attached fat and submitted for evaluation.\n\nAll other specimens, including the spleen and pancreatic tissue, showed no signs of malignancy. The pancreatic duct was patent, and no solid lesions were identified in the pancreas. Lymph nodes associated with the pancreas were also benign.\n\nMicroscopic evaluation confirmed the absence of malignancy in all margin specimens and supported the staging and histologic findings described above."} +{"pid": "TCGA-CJ-5679", "report": "The specimen consists of a left kidney and adrenal gland from a radical nephrectomy. The kidney measures 22.0 x 14.5 x 11.0 cm and contains a large mass in the lower portion measuring 16.0 x 12.0 x 10.0 cm. The mass has a yellow-tan, necrotic cut surface with areas of hemorrhage. It demonstrates diffuse involvement of perinephric adipose tissue and extends into the renal sinus adipose tissue and pelvicalyceal system. A tumor thrombus measuring 2.5 x 1.5 x 1.5 cm is present within the renal vein and extends to the renal vein margin. No mass is identified within the adrenal gland.\n\nMicroscopic examination reveals a cellular tumor composed of equal proportions of clear and eosinophilic cells. Nuclear grading is high. The tumor is invasive, involving perinephric adipose tissue, renal sinus adipose tissue, and the pelvicalyceal system. Tumor is also present in the renal vein wall at the margin. Sections include multiple representative samples from the tumor, involved tissues, and uninvolved kidney and adrenal gland. All soft tissue margins are free of involvement.\n\nAdditional specimens include two tumor thrombi attached to vessel wall, measuring 4.5 x 2.0 x 1.5 cm and 3.5 x 1.5 x 1.5 cm respectively. The tumor shows multifocal necrosis and extensive local invasion."} +{"pid": "TCGA-XX-A89A", "report": "The left breast specimen weighed 1945 grams. The lesion was located in the upper outer quadrant (2\u20133:00 position) and measured between 7 and 9 cm. Histopathologic evaluation showed a Nottingham grade 2 lesion with a low mitotic count. The closest margin was superior at 0.8 cm, while all other margins (inferior, medial, lateral, anterior, and posterior) were greater than or equal to 1 cm. A rare focus of associated in situ carcinoma was present, but extensive involvement (>25% of total tumor) was not observed. No separate extra-tumoral foci, peritumoral angiolymphatic invasion, or dermal angiolymphatic invasion were identified.\n\nImmunohistochemistry demonstrated positivity for estrogen and progesterone receptors, with 70% of tumor cell nuclei staining moderately to strongly. HER-2/neu testing was negative (score 0). The tissue was fixed in 10% neutral buffered formalin for 12 hours and 24 minutes, and both internal and external controls were appropriate with standard assay conditions met.\n\nA total of 11 regional lymph nodes were examined, and none showed evidence of metastasis. No extranodal extension was present, and no distant metastases were identified. Based on AJCC 7th Edition staging criteria, the pathologic tumor stage was classified as pT3, with pathologic lymph node stage pN0.\n\nAdditional findings included fibrocystic change and usual ductal hyperplasia, as well as seborrheic keratosis. Tumor content across specimens varied: T1 had 50% tumor nuclei and 50% normal tissue; T2 had 50% tumor nuclei and 50% normal fibrous tissue and fat; T3 had 70% tumor nuclei and 30% normal tissue; and T4 had 50% tumor nuclei and 50% normal fat. No necrosis was observed in any sample. Normal tissue composition was primarily fibroadipose.\n\nSpecimen collection and processing times were recorded. The specimen weighed 1945 grams and included cryovials (x8) for both normal and tumor tissues. Plasma, serum, and buffy coat samples were collected. The study included patient consent documentation and quality control records."} +{"pid": "TCGA-D8-A27I", "report": "Histopathological examination was performed on a right breast specimen measuring 19.3 x 14.2 x 5.8 cm, along with axillary tissues measuring 10 x 6 x 3 cm and a skin flap of 16.2 x 6.8 cm. A lesion measuring 1.7 x 1.2 x 1.5 cm was identified at the border of the outer quadrants, located 6.3 cm from the upper boundary, 0.3 cm from the base, and 1.2 cm from the skin. Microscopic evaluation revealed multifocal cellular infiltration with features of classical histological type. The lesion showed a histological grade of NHG2 based on scoring (3 + 2 + 1), with no mitotic figures observed in 10 high-power fields (visual area diameter 0.55 mm). There was evidence of parenchymal atrophy in glandular tissue and involvement of the nipple area. Evaluation of axillary lymph nodes revealed presence of similar cellular infiltration in four out of ten nodes examined. All measurements and staging parameters have been documented accordingly."} +{"pid": "TCGA-VP-A87J", "report": "The prostate specimen measured 4.5 x 4 x 4 cm and was submitted with bilateral seminal vesicles. The right seminal vesicle measured 3 x 1 x 0.9 cm and the left measured 3 x 1.2 x 0.8 cm. There were defects measuring 1.5 x 0.5 x 0.5 cm in both the right and left bases, consistent with prior tissue sampling. Histologic examination revealed involvement of approximately 10% of the prostatic tissue by a cellular process characterized by glands with architectural and cytologic features consistent with Gleason grade 3+4 = score 7. Lesions were identified in the right apex, right base, and left base.\n\nExtraprostatic extension was noted at the right base, extending into adjacent soft tissues. Periprostatic tissue showed no evidence of tumor involvement. The urethral tissue margin demonstrated similar cellular changes, suggesting involvement of this site. Seminal vesicles bilaterally did not show any abnormal cellular infiltration.\n\nLymph node dissection included 11 nodes from the bilateral pelvic region. One lymph node contained metastatic cellular infiltration measuring less than 1 mm in diameter. No extracapsular extension was observed in the involved lymph node.\n\nHistologic evaluation also identified high-grade intraepithelial proliferative changes within prostatic glands without stromal invasion. Mild nodular hyperplasia with stromal nodule formation was present in non-involved areas.\n\nMicroscopic assessment of surgical margins revealed no tumor involvement at the prostatectomy specimen margins; however, the presence of tumor cells in the urethral tissue margin indicated positive margin status. Perineural invasion was documented. Lymphovascular invasion was not observed.\n\nThe tumor extended microscopically beyond the prostate capsule (T3a) and demonstrated regional lymph node metastasis (N1). The largest metastatic deposit measured 1 mm. Distant metastasis could not be assessed. Clinical correlation with tissue sampling locations is recommended for accurate margin interpretation."} +{"pid": "TCGA-EL-A3D4", "report": "A male patient underwent surgical resection with multiple tissue specimens submitted for pathological evaluation.\n\nSpecimen A consisted of a left neck dissection (Level III and IV), measuring 7.0 x 5.0 x 1.3 cm, containing multiple lymph nodes ranging from 0.2 to 2.3 cm in size. Of these, six out of twelve lymph nodes showed involvement. One lymph node contained a 0.5 cm cyst with bloody fluid and smooth inner lining. Extracapsular extension was noted.\n\nSpecimen B was a portion of the left inferior parathyroid gland, measuring 0.5 x 0.2 x 0.1 cm, which showed no evidence of abnormal cellular infiltration.\n\nSpecimen C included bilateral neck contents, measuring up to 16.5 x 10.5 x 1.5 cm, with multiple lymph nodes identified on both right and left sides. On the right, lymph nodes ranged from 0.4 x 0.4 x 0.3 cm to 2.4 x 2.0 x 1.5 cm and displayed cystic changes with tan, yellow, or clear fluid. On the left, three lymph nodes were identified between 0.4 x 0.4 x 0.4 cm and 0.3 x 0.3 x 0.2 cm. In the inferior portion, lymph nodes up to 3.5 x 1.8 x 1.0 cm were present. Eighteen of forty-eight lymph nodes were involved, with extranodal extension observed.\n\nSpecimen D included a total thyroidectomy specimen measuring 9.0 x 5.5 x 2.0 cm. The right lobe measured 6.0 x 2.6 x 2.5 cm and the left lobe 5.5 x 2.1 x 1.5 cm. A solid and cystic mass measuring 4.0 x 2.2 x 1.8 cm was identified in the right upper pole. Multifocal involvement was present bilaterally, including the isthmus. The tumor extended into adjacent fibroadipose tissue and demonstrated lymphovascular invasion. Dissection of perithyroidal adipose tissue revealed eleven lymph nodes, six of which were involved. Extracapsular extension was present in some nodes.\n\nSpecimen E, from the right superior paratracheal region, contained one lymph node measuring 1.8 x 0.7 x 0.3 cm in a 2.5 x 2.0 x 0.5 cm piece of fibroadipose tissue. No abnormal cells were identified.\n\nSpecimen F, additional right paratracheal contents, included multiple lymph nodes ranging from 0.2 to 1.1 cm in a 2.0 x 1.8 x 1.0 cm tissue fragment. One of four lymph nodes showed involvement, without extranodal extension.\n\nAll involved lymph nodes were thoroughly sectioned and evaluated. Multiple sections were taken from all submitted regions to assess extent of involvement and tissue architecture."} +{"pid": "TCGA-CH-5767", "report": "The specimen shows a lesion with maximum dimension of 0.9 cm, predominantly located in the anterior and right rectolateral peripheral zone. The lesion exhibits poorly differentiated morphology with focal perineural invasion identified. There is no evidence of extraprostatic extension or vascular invasion. Seminal vesicles and resection margins are free of involvement. The remaining prostate tissue demonstrates myoglandular hyperplasia in the transitional zone. The prostatic urethra is free of any abnormal cellular changes. A total of 14 lymph nodes were examined, all within fatty tissue, and none show any signs of tumor involvement. The histological features indicate complete local resection. Grading criteria show a pattern consistent with a score of 4+3 = 7, with approximately 60% of the lesion exhibiting Gleason grade 4 morphology. No other significant pathological findings are present."} +{"pid": "TCGA-E2-A15C", "report": "A right breast lumpectomy specimen was received, measuring 8 x 5 x 4 cm and weighing 70 grams. The specimen was inked with six different colors to mark the orientation. Upon serial sectioning into nine slices, a tan-white firm stellate mass measuring approximately 1.9 x 1.6 x 1.5 cm was identified. This lesion was located closest to the posterior margin at a distance of 0.7 cm. Representative sections were submitted for analysis, including margins and areas adjacent to the mass.\n\nFour sentinel lymph nodes were received from the right axilla. Each lymph node was tan-pink in color and measured between 0.5 to 0.9 cm in greatest dimension. All lymph nodes were sectioned and underwent touch preparation for evaluation. No abnormal findings were identified in any of the lymph nodes upon microscopic examination.\n\nHistological evaluation of the excised breast tissue revealed a lesion involving skeletal muscle. Nuclear grade was assessed as intermediate. A separate focus of intraductal proliferation was also noted, exhibiting cribriform architecture. Fibrotic and granulation tissue changes were observed at the biopsy site.\n\nMargins of resection were found to be free of involvement by the lesion. The closest uninvolved margin was located inferiorly at a distance of 0.3 cm from the lesion. Microscopic scoring systems yielded intermediate scores for tubular formation and nuclear grade. Mitotic activity was moderate. No necrosis or vascular/lymphatic invasion was observed.\n\nEstrogen and progesterone receptor statuses were positive. HER2 immunohistochemistry demonstrated 2+ intensity in approximately 20% of tumor cells. Fluorescence in situ hybridization (FISH) analysis showed no amplification of the HER2 gene, with a HER2/CEP17 ratio of 1.02 obtained via manual counting of at least 20 interphase nuclei.\n\nAn Oncotype DX Breast Cancer Assay recurrence score of 19 was reported. ER and PR scores were consistent with positivity, while the Her2 score was within the negative range."} +{"pid": "TCGA-HZ-7923", "report": "A total of 17 lymph nodes were examined, with no evidence of malignancy identified. Biopsy specimens from multiple sites including the hepatoduodenal, posterior portal, bile duct, pancreatic gland, and pancreatic duct margins were all negative for malignancy. The excised specimen included portions of the head of the pancreas, duodenum, stomach, and common bile duct.\n\nThe pancreatic head measured 3.0 x 3.0 x 1.5 cm and contained a white, firm mass measuring 3.0 x 2.5 x 1.5 cm. This mass was noted to involve the ampulla of Vater and extended into the surrounding tissue, but did not reach the celiac axis or superior mesenteric artery. All surgical margins were free of invasive carcinoma. Histologic examination revealed moderately differentiated epithelial cells arranged in irregular glands. No lymphovascular or perineural invasion was identified.\n\nAdditional findings included chronic pancreatitis and pancreatic intraepithelial neoplasia (highest grade: PanIN 3). No histopathologic abnormality was found in the stomach. The gallbladder was not present in the specimen received. A total of 18 lymph nodes were identified in the surrounding fat, ranging from 0.2 to 0.8 cm in size, and all were negative for malignancy.\n\nThe specimen was processed in its entirety, with appropriate orientation and margin identification using ink markers. Multiple tissue blocks were submitted for microscopic evaluation, including sections from the gastric margin, small bowel margin, uncal margin, bile duct margin, posterior retroperitoneal margin, pancreatic duct margin, anterior retroperitoneal margin, vascular margin, duodenal bulb, ampulla, bile duct, tumor, and normal-appearing stomach and duodenum. Immunohistochemical studies were performed using validated antibodies; staining intensity and distribution were evaluated according to standard protocols. Tissue fixation was within the required time frame for accurate testing."} +{"pid": "TCGA-CV-6959", "report": "The right neck dissection specimen included 28 lymph nodes across levels I to V, with sizes ranging from 0.4 cm to 3.8 cm in greatest dimension. No abnormal lesions were identified in any of the lymph nodes. A salivary gland measuring 5.5 x 2.5 x 2.5 cm was also present and showed no focal lesions, though there was evidence of chronic inflammation and squamous metaplasia of ductal epithelium.\n\nA fragment of soft tissue from the mandibular sulcus (2.5 x 0.5 x 0.4 cm) showed focal mild dysplasia of the squamous mucosa, with no tumor identified. Two fragments from the pharyngeal sulcus (combined 2.0 x 0.5 x 0.5 cm) revealed skeletal muscle with minor salivary glands and a segment of nerve, with no tumor observed.\n\nThe partial glossectomy specimen measured 7.0 x 5.5 x 3.0 cm and contained a fungating, ulcerated mass on the lateral gingival aspect measuring 4.0 x 3.0 x 1.0 cm. Histologically, this lesion demonstrated invasive growth up to 1.7 cm in thickness and extended into the middle of the specimen. There was also associated in situ involvement noted at the anterior tongue. The resection margins appeared free of involvement. The specimen was sectioned serially from inferior to anterior.\n\nA small fragment from the anterior tongue (0.9 x 0.5 x 0.5 cm) and another from the dorsum of the tongue (1.5 x 1.0 x 0.5 cm) were both submitted entirely for evaluation and showed no tumor involvement. Additionally, a single lymph node from the right neck (0.3 x 0.2 x 0.2 cm) was submitted and found to be unremarkable.\n\nThe submitted dental specimens included 24 teeth and bone fragments, with one molar having a silver crown and several teeth showing silver fillings. No further abnormalities were noted in the gross examination of the teeth. Microscopic evaluation did not reveal perineural or lymphovascular invasion."} +{"pid": "TCGA-AA-A01S", "report": "The specimen shows an invasive, moderately differentiated adenocarcinoma located in the sigmoid colon. The resection margins, including the proximal and distal cut ends, as well as the area around the central vascular ligature, are free of tumor involvement. A single lymph node metastasis was identified out of 19 examined lymph nodes. The tumor is classified as pT3, pN1 (1/19), with no residual tumor at the resection margins (R0). Lymphovascular invasion status was not specified. The histological grade is G2."} +{"pid": "TCGA-FA-A6HO", "report": "The lymph node is enlarged, measuring 1.5 x 1 x 1 cm, with a soft consistency and a dark brown and gray surface. Microscopic examination reveals a diffuse growth pattern replacing the normal architecture. The cells are small to enlarged transformed lymphoid cells with irregular hyperchromatic nuclei. The cells are oval or round in shape with scant cytoplasm. Nucleoli are single or multiple, and mitotic figures are frequently observed. Immunohistochemical staining shows positivity for CD20 and negativity for CD3."} +{"pid": "TCGA-FG-6689", "report": "The specimen consists of tissue from the right frontal lobe of the brain submitted as two portions. The first portion measured 3 x 1.5 x 0.5 cm and consisted of multiple tan-white friable soft tissue fragments. A portion was used for intraoperative consultation, which included touch imprint and microscopic evaluation suggestive of a glioma most consistent with oligodendrocytoma. The second portion consisted of four irregular opaque white to tan-brown cerebriform fragments ranging in size from 2.0 x 1.7 x 1.4 cm up to 10.0 x 6.0 x 4.5 cm.\n\nHistologic examination revealed a spectrum of cellular morphologies. Immunostains demonstrated features ranging from mini-gemistocytes typically seen in certain glial tumors to a predominant population of larger gemistocytic tumor cells. Mitotic figures were not prominent and the Ki-67 labeling index was low.\n\nFluorescence in situ hybridization (FISH) analysis using locus-specific probes was performed on formalin-fixed paraffin-embedded tissue sections. Evaluation focused on areas of glial neoplasm with atypical nuclei containing two or more reference probe signals. For chromosome 1p, the average signal ratio (1p36/1q25) was 1.1, indicating an intact status although there was evidence of allelic loss on the short arm of chromosome 1. For chromosome 19q, the average signal ratio (19q13/19p13) was 0.9, suggesting no significant allelic loss.\n\nAllelic loss on chromosome 1p has been associated with chemoresponsiveness and prolonged progression-free survival in some cases involving glial tumors, particularly when accompanied by loss on 19q. However, the clinical relevance of isolated 1p loss remains uncertain. Quantitative data reported represent averages derived from analysis of 40 nuclei.\n\nAdditional unstained slides were received several days after initial submission but were not processed and were returned. An addendum had been planned pending further chromosomal analysis; however, no additional findings were entered.\n\nAll assays were developed and validated by the Department of Pathology, utilizing both positive and negative controls. Some reagents used may have contained components classified as analyte-specific reagents (ASRs), which are not cleared or approved by the U.S. Food and Drug Administration."} +{"pid": "TCGA-78-7167", "report": "The specimen consists of a left lung measuring 240 x 170 x 40 mm. A 30 mm length of bronchus protrudes from the hilum. There is an area of induration and puckering on the lateral pleura of the lower lobe and in the interlobar fissure. Another area of induration is noted posterolaterally on the upper lobe. Multiple emphysematous bullae are present at the apex and anterior margin of the upper lobe. Serial slicing reveals a mass approximately 65 mm in greatest diameter located along the lateral aspect of the lower lobe, adjacent to the pleura. The cut surface is fleshy, grey, and somewhat mucoid. Posteriorly, it blends with surrounding lung tissue, making its full extent difficult to delineate macroscopically. At its upper aspect near the interlobar fissure, there is extension into the lingula with greyish-white consolidation. It is uncertain whether this represents tumor infiltration or infectious change. Beneath the puckered area on the postero-lateral upper lobe, there is another region of parenchymal consolidation and possible fibrosis. The remainder of the upper lobe shows emphysematous changes. In the lower segments of the lower lobe, there is minimal anthracosis and no emphysema. On the medial aspect near the diaphragmatic surface, there is a plaque-like thickening of the pleura measuring approximately 10 mm in diameter and 2\u20133 mm in depth.\n\nHistologically, the predominant lesion demonstrates well-differentiated papillary adenocarcinoma. In some areas, moderately differentiated adenocarcinoma with acinar architecture is observed. The lesion contacts but does not invade the lateral pleura. At its superior portion, it extends across the interlobar fissure into the upper lobe with widespread contiguous involvement of the lingula. In addition, a distinct focus of identical histology is identified in the posterolateral segment of the upper lobe, accompanied by fibroelastotic scarring and emphysema. This may represent either metastatic spread or a separate primary lesion. No definitive vascular or lymphatic invasion is observed. Examination of peribronchial lymph nodes reveals no evidence of metastasis. The plaque-like lesion on the medial aspect of the lower lobe appears consistent with thermal injury rather than neoplastic involvement.\n\nLymph nodes from the aortopulmonary window, inferior pulmonary ligament, and other sampled nodal tissues show no signs of malignant infiltration."} +{"pid": "TCGA-HT-7680", "report": "The pathology report describes a microscopic examination of tissue showing mildly increased cellularity within the white matter. The cells present have slightly irregular angular nuclei, though no mitotic figures are observed. There is no evidence of microvascular proliferation or necrosis.\n\nAdditional sections reveal a moderately cellular glial tumor with a dense fibrillary stroma. The tumor cells are arranged in small clusters and occasionally aligned around blood vessels, though distinct pseudorosettes are not present. No myxoid or microcystic changes are noted, and there are no calcifications. The nuclei of the tumor cells are generally round with mild atypia, and again, no mitotic activity is identified.\n\nImmunostaining shows diffuse positivity for GFAP in both the tumor cells and the fibrillary background. There is no punctate cytoplasmic staining for EMA, which argues against an ependymal or subependymal origin. Neurofilament staining reveals a transition from filamentous structures at the periphery to very few positive axons centrally, suggesting an infiltrative growth pattern. The MIB-1 proliferation index is extremely low, with less than 0.1% labeled cells.\n\nThe overall histologic and immunophenotypic features indicate a very low-grade neoplasm with diffuse infiltration, characterized by astrocytic differentiation."} +{"pid": "TCGA-V1-A9Z7", "report": "The specimen was received in five parts. Part A, labeled as anterior prostatic fat, consists of multiple fragments of brown-yellow fatty tissue measuring 4.2 x 3.4 x 1.5 cm in aggregate. No abnormal cellular elements were identified in this specimen. Part B, described as tissue anterior to the seminal vesicles, is a 1 x 1 x 0.4 cm fragment of brown-tan tissue with a black-inked margin. Microscopic evaluation revealed a small focus of crushed cells within collagenous stroma at the edge of the specimen. Immunohistochemical staining for pancytokeratin demonstrated positivity, indicating epithelial origin; however, due to significant crush artifact, definitive classification of these cells could not be made. The architectural pattern appeared infiltrative, raising suspicion for epithelial abnormalities.\n\nPart C includes right pelvic lymph nodes, consisting of multiple yellow-brown soft tissue fragments measuring 4.2 x 3 x 1.4 cm in total. Six lymph nodes were identified and examined microscopically; no abnormal cells were found. Part D contains left pelvic lymph nodes, a single fragment measuring 5 x 3 x 1.6 cm, with four lymph nodes identified and examined, all without evidence of abnormal cells.\n\nPart E includes the prostate and seminal vesicles, weighing 55 grams. The prostate measures 3.5 cm from apex to base, 4.5 cm in width, and 3.6 cm in depth. The attached seminal vesicles measure 4.8 x 2.4 x 1.2 cm on the right and 4.5 x 1.9 x 0.8 cm on the left. Gross examination showed firm areas in the posterior mid gland and near the base, with a 0.5 cm tan nodule noted on the left anterior mid gland. Microscopic analysis demonstrated involvement of multiple regions including the left apex, left posterior and anterior mid glands, right posterior and anterior mid glands, and right base. The estimated volume of involved tissue was 9.3 cubic centimeters. Approximately 95% of the involved tissue exhibited high-grade architectural patterns. Capsular invasion was present, with extension beyond the prostate observed extensively in several sections. Crushed and cauterized cells were noted at the right bladder margin, showing weak positivity for pancytokeratin, raising uncertainty regarding their significance. No benign prostatic glands were identified at the inked excision margins. High-grade intraepithelial changes were extensive. Involvement of both seminal vesicles was identified. Perineural and lymphovascular involvement were also present. All ten lymph nodes examined were negative. The surgical margins were inconclusive due to the presence of crushed and cauterized cells at the right bladder margin."} +{"pid": "TCGA-4Z-AA81", "report": "The specimen involved the bladder and prostate. A papillary lesion was identified with high grade cytologic features. The tumor was confined to the bladder and invaded into the outer third of the muscularis propria. No angiovascular, lymphatic, or blood vascular invasion was observed. The surgical margins showed no evidence of neoplastic cells. Additional findings included nonspecific chronic inflammation of the prostate and nodular hyperplasia. The deferens and seminal vesicles were free of tumor involvement."} +{"pid": "TCGA-FC-A66V", "report": "The specimen includes a left pelvic lymph node measuring 3.5 x 2.0 x 0.4 cm and a right pelvic lymph node of 1.0 cm, both with admixed adipose tissue. A prostatectomy specimen weighs 52 grams and measures 5.0 x 4.0 x 3.8 cm. The prostate has attached seminal vesicles and an intact capsule. Ink colors are applied as follows: anterior in red, right side in black, and left side in blue. The apex and bladder neck are shaved and sectioned perpendicularly, with further transverse sectioning of the remaining prostate. Two areas of interest are identified: one in the left postero-lateral region from apex to base measuring 2.5 x 1.5 x 0.5 cm, and another yellow-orange area in the right postero-lateral mid to base region measuring 2.5 x 2.5 x 1.0 cm. The right seminal vesicle shows suspicious changes, possibly involving the left side.\n\nMicroscopic evaluation reveals a Gleason score of 4 + 3 = 7. Approximately 40% of the prostatic tissue is involved, with a maximum linear extent of at least 23 mm. Bilateral involvement is noted. Histologic features are consistent with a conventional pattern. No therapy-related changes are observed. Extracapsular extension is present bilaterally at the base near the seminal vesicles, with an extent of at least 0.5 cm. Seminal vesicle invasion is confirmed on the right side, with possible left side involvement. Focal angiolymphatic invasion is identified. Surgical margins are free of involvement. Both pelvic lymph nodes are uninvolved.\n\nExtraprostatic extension and seminal vesicle invasion are documented. Lymphatic and venous invasion are present. The tumor size is recorded as 2.3 cm. No evidence of neoadjuvant treatment effect is seen. Additional findings include benign smooth muscle tissue in the bladder neck without specific glandular abnormalities. Sections show involvement of the right seminal vesicle and intraprostatic portion of the left seminal vesicle; however, clear evidence of extraprostatic left seminal vesicle involvement is not present."} +{"pid": "TCGA-CJ-4903", "report": "Surgery Date: Specimen consists of a left kidney and adrenal gland. The nephrectomy specimen measures 19.0 x 10.0 x 5.7 cm and includes the left kidney (12.0 x 7.5 x 5.0 cm), a segment of renal artery, the renal vein, ureter (8.5 cm in length and 0.4 cm in diameter), and the adrenal gland (6.0 x 1.7 x 0.5 cm). Within the upper pole of the kidney is a well-circumscribed lesion measuring 5.0 x 3.7 x 3.2 cm. The lesion appears bright yellow-tan with areas of central gray-tan myxoid change. It is confined to the kidney without extension into perinephric adipose tissue, renal sinus, or renal vein. There is no involvement of Gerota's fascia. The adjacent kidney parenchyma appears normal. The pelvic calyceal system is smooth and without abnormality. No lymph nodes are identified in the renal hilum. Cross sections of the adrenal gland show normal cortical and medullary architecture. Margins of resection, including ureteral, renal artery, and renal vein, are free of abnormal cells. Cellular features include nuclear characteristics graded as Fuhrman\u2019s nuclear grade 3. The lesion does not extend to any margins of resection and is fully excised within the specimen. Serial sections were taken from multiple areas including the tumor-adrenal interface, tumor-kidney capsule relationship, tumor capsule, tumor-sinus relationship, tumor-parenchyma interface, and representative sections of uninvolved kidney and adrenal gland. Clinical history includes a left renal mass."} +{"pid": "TCGA-HT-8012", "report": "The pathology report describes a moderately hypercellular glial neoplasm composed of infiltrating glial cells with round to oval nuclei and prominent perinuclear halos. Cytologic atypia is moderate. Focal microcystic change and areas of increased cellularity are noted. No microvascular proliferation or necrosis is present. Rare microcalcifications are observed, along with an occasional mitotic figure, with up to one mitosis per ten high-power fields. The MIB-1 labeling index is calculated at 2.7%, indicating low proliferative activity."} +{"pid": "TCGA-EJ-A46B", "report": "The prostate specimen measured 38.85 grams and exhibited benign prostatic hypertrophy along with chronic moderately active prostatitis. A lesion was identified that showed a greatest nodular diameter of 1.4 cm and involved both the right and left lobes. Approximately 30% of the examined prostate volume was involved by this lesion. Histologic evaluation demonstrated established extraprostatic extension, which was most evident in the posterior right base region. High-grade intraepithelial neoplasia was also present.\n\nThe lesion extended to multiple inked surgical margins, specifically at the anterior right mid, posterior right apex, and posterior right mid regions. All other surgical resection margins were free of involvement. Perineural invasion was identified, but there was no evidence of angiolymphatic invasion. The bilateral seminal vesicles were uninvolved.\n\nA total of ten pelvic lymph nodes were examined and all were benign. Pathologic staging was determined as pT3a with pN0 and pMX. The histologic grade was classified as G3\u20134, consistent with poorly differentiated morphology. The Gleason score was 8 (4 + 4), with tertiary patterns present including Gleason patterns 3 and 5. Approximately 80% of the tumor consisted of Gleason patterns 4 or 5."} +{"pid": "TCGA-DW-7834", "report": "A left kidney excision specimen demonstrated multiple nodules ranging in size from 0.4 cm to 5 cm, with the largest being a 5 cm gold/red nodule exhibiting a nodular morphology and areas of hemorrhage. Smaller nodules were described as tan, light tan, or red-brown, with some noted as soft or having golden-yellow or red-gold appearances. Several specimens showed fibroadipose or adipose tissue, some with fibrosis or scarring. Multiple fragments of fibrofatty or scar tissue were also present, with no tumor identified in these areas. The perirenal fat, skin biopsy, and 11th rib specimens did not show any tumor involvement. Some specimens revealed benign kidney parenchyma with sclerotic glomeruli and inflammation, while others showed cystic lesions lined by irregular cuboidal epithelium. Specimens were submitted both fresh and in formalin, with portions retained for surgical pathology and others given to the lab. Tissue measurements varied, with the largest being a 6 cm rib segment and the smallest measuring 0.3 cm."} +{"pid": "TCGA-22-5481", "report": "A specimen from a left pneumonectomy was examined, revealing a mass measuring 3.6 x 3.6 x 3.6 cm located in the left lower lobe, situated 7.0 cm from the bronchial margin. Histological evaluation showed no involvement of the bronchial margin or visceral pleura, and the surrounding lung tissue appeared unremarkable. Within the resected tissue, two of eight intrapulmonary peribronchial lymph nodes contained abnormal cellular aggregates, with the largest focus measuring 1.7 x 1.7 x 1.7 cm and located within the fissure. A number of mediastinal, aortic, and N1 lymph nodes were also excised and found to be free of abnormal cells. These included multiple superior mediastinal (including right upper and lower paratracheal, left tracheobronchial), inferior mediastinal (paraesophageal, subcarinal, and pulmonary ligament), aortic, and interlobar lymph nodes. In the subcarinal region, necrotizing and calcified granulomas were identified. Additional findings from special stains are detailed in a separate addendum."} +{"pid": "TCGA-JY-A6FE", "report": "The specimen was received from the facility and included multiple tissue samples. The first sample, identified as lymph node tissue from the ST9 inferior pulmonary ligament, showed reactive changes without evidence of malignancy (0 out of 1 lymph nodes involved). The second lymph node sample, from the subcarinal ST7 region, contained one lymph node that was positive for malignant cells (1 out of 1 involved). The third sample, taken from the final esophageal margin, did not show any cancerous involvement.\n\nThe fourth specimen consisted of a resection of the thoracic esophagus and proximal stomach. Microscopic evaluation revealed the presence of atypical cells with poorly differentiated features. These cells were found to infiltrate into surrounding fatty tissue adjacent to the esophagus. A total of 35 lymph nodes were examined, with 8 showing signs of involvement by the abnormal cells. Of these, 7 out of 33 were confirmed positive in the regional lymphatic system.\n\nStaging was determined based on the depth of infiltration and nodal involvement. The tumor was found to extend into the outermost layer of the esophageal wall. Regarding surgical margins, both the proximal and distal ends of the resected tissue were free of tumor involvement, while the radial margin showed evidence of abnormal cell presence.\n\nImmunohistochemical staining demonstrated variable expression of certain markers, including pan-cytokeratin (pan-CK), CK7, and p63, while other markers were not expressed.\n\nGross examination of the resected esophagus and stomach showed a large mass measuring approximately 10.6 cm in its greatest dimension, with additional dimensions of 9.0 x 5.5 cm. The mass appeared bulky, with areas of necrosis and nearly encircling the esophagus, leaving only a small segment of normal mucosa. The distance from the tumor to the proximal margin was 7.5 cm, and to the distal margin was 2.2 cm. The radial margin was minimally clear at 0.1 cm. Lymph nodes retrieved ranged in size up to 4.5 cm in diameter.\n\nNo evidence of vascular invasion was identified. No additional abnormal findings were noted in the non-involved gastric tissue. Multiple sections were taken for histological analysis, including from the tumor itself, surrounding mucosa, and various lymph node locations. Tissue banking was performed for further study."} +{"pid": "TCGA-HT-7694", "report": "The specimen demonstrates a glial neoplasm that diffusely infiltrates both gray and white matter. Tumor cells exhibit round, mildly enlarged nuclei with perinuclear halos present in most cells. Nuclear atypia ranges from mild to moderate. Scattered mitotic figures are observed, with up to 6 mitoses identified in 10 high power fields. There is no evidence of microvascular proliferation or necrosis. Immunohistochemical staining shows numerous MIB-1 reactive cells, with an estimated labeling index exceeding 25% in the most proliferative regions."} +{"pid": "TCGA-BA-6871", "report": "The biopsies and curettage specimens from the base of the tongue were evaluated. Specimen A, a 4 x 4 x 3 mm aggregate of tan/pink soft tissue from the left base of the tongue, was assessed intraoperatively and showed invasive cellular changes. Specimen B, measuring 2.2 x 1.5 x 0.4 cm, was obtained from the right base of the tongue and described as a soft friable pink/tan tissue fragment with one intact glistening surface marked with blue ink. It was sectioned and fully submitted for analysis. Specimen C, received as an aggregate of dark red/brown tissue fragments measuring 2.7 x 2.1 x 0.6 cm from the right base of the tongue, was also evaluated in its entirety. Microscopic examination revealed moderately differentiated invasive cellular features in all specimens. The tumor margins could not be fully assessed due to the nature of the specimens. No lymph nodes were identified in the submitted material."} +{"pid": "TCGA-GC-A4ZW", "report": "The specimen consisted of a cystoprostatectomy specimen measuring 15.0 x 13.0 x 6.0 cm and weighing 469 grams. Attached structures included the prostate, seminal vesicles, and vas deferens bilaterally. The bladder showed an area of abnormal tissue in the left anterior and posterolateral walls, measuring 4.5 x 2.5 x 0.9 cm grossly. This lesion was pink-tan and polypoid, extending across the midline into the right anterior and posterior bladder wall and approaching the bladder-prostate junction. Histologically, the lesion exhibited high-grade cellular features with invasive growth through the muscular layer into surrounding adipose tissue.\n\nMargins of surgical resection were free of invasive disease. No lymphovascular or perineural invasion was identified. Adjacent mucosa showed benign characteristics. A total of five lymph nodes were identified within the specimen, all without evidence of involvement. Additional findings included benign prostate tissue with no discrete nodules; however, scattered microscopic areas of high-grade epithelial changes were noted in the prostate. Seminal vesicles were unremarkable.\n\nLymph nodes from both right and left pelvic regions were examined microscopically and showed no presence of tumor cells. Frozen section evaluations of distal ureter segments confirmed absence of malignant involvement.\n\nTumor measurements were documented at 4.5 cm in greatest dimension. Histologic evaluation revealed a combination of papillary and infiltrative growth patterns. Pathologic staging was assigned as pT3a for local extension into perivesical fat, pNO for absence of lymph node involvement, and pMX due to lack of distant metastasis assessment from this specimen alone.\n\nMultiple tissue sections were submitted for thorough microscopic evaluation, including areas from trigone, bladder-prostate transition zones, lateral walls, dome, apex, and prostate regions. All margins were histologically negative for invasive disease. Lymph nodes dissected intraoperatively showed no tumor involvement.\n\nThe specimen was processed using standard protocols, with appropriate controls used for special stains. Interpretation was based on comprehensive microscopic examination of all submitted slides."} +{"pid": "TCGA-EM-A4FN", "report": "The specimen includes a total thyroidectomy with central neck dissection and multiple lymph node excisions. The thyroid gland measures 3.8 x 2.3 x 1.2 cm on the right lobe, 3.4 x 2.3 x 1.0 cm on the left lobe, and 3.2 x 2.1 x 1.4 cm at the isthmus. Attached fibroadipose tissue in the central compartment measures 4.3 x 3.8 x 1.1 cm. The right neck dissection specimen measures 6.8 x 1.5 x 1.5 cm, while the left neck dissection specimen measures 2.8 x 1.5 x 1.4 cm. The total specimen weight is 17.2 grams.\n\nA dominant nodule measuring 1.9 x 1.7 x 1.6 cm is present in the isthmus. A second nodule measuring 0.8 x 0.7 x 0.6 cm is identified in the inferior left lobe. Both nodules are tan and firm. Multiple lymph nodes are found within the soft tissue adjacent to the thyroid, ranging in size from 0.2 x 0.2 x 0.2 cm to 1.7 x 0.9 x 0.8 cm.\n\nHistologic evaluation reveals multifocal involvement with classical papillary architecture and follicular variant features. Focal areas of tall cell morphology are present in less than 5% of the sample. Additional microscopic findings include adenomatoid nodules and follicular nodular disease with degenerative and oncocytic changes. Several small microcarcinomas are noted, measuring 0.1 cm in the right lobe and 0.05 cm in the left lobe.\n\nMargins are free of involvement. The dominant lesion demonstrates partial encapsulation with widespread capsular invasion. No lymphovascular or perineural invasion is observed. No extrathyroidal extension is identified.\n\nLymph node analysis includes 32 nodes examined from bilateral central and lateral neck compartments. Eight lymph nodes show involvement, including three of three in the isthmic region and four of eight in the central compartment. Micrometastatic involvement is also identified in one of nine lymph nodes from the right level II, III, and IV regions. No extranodal extension is seen.\n\nAdditional findings include simple epithelial cysts and ectopic serous and mucinous glands in the central compartment. Parathyroid tissue appears unremarkable."} +{"pid": "TCGA-QH-A6CX", "report": "PATHOLOGIST REPORT. Code: Gender: M. Localisation: L temporal. The lesion shows moderate cellularity with mildly atypical nuclei. No necrosis or microvascular proliferation is observed. Cellular morphology suggests a diffusely infiltrating glial neoplasm. The lesion is well-circumscribed without evidence of aggressive growth features. Size and other staging details are not specified in this report."} +{"pid": "TCGA-B4-5844", "report": "The specimen was obtained from the right kidney and submitted as a primary tissue sample. The tumor tissue weighed 230 mg and was placed in a cryomold. One container of blood was also collected, amounting to 4 mL, and stored in a frozen tube. Histological evaluation showed a high tumor cellularity with approximately 90% of the tissue composed of malignant cells. The tumor measured 2 cm in greatest dimension. No lymph node involvement or distant metastasis was identified. The histologic grade was determined to be Grade 1. There was no evidence of treatment effect, and no prior chemotherapy, hormonal therapy, or radiation therapy was reported."} +{"pid": "TCGA-78-7536", "report": "The right upper lobe specimen measured 145 x 120 x 60 mm and was closed by a triradiate staple line. Multiple fatty adhesions were noted on the lateral aspect of the lung. A hard subpleural mass measuring approximately 53 mm in diameter was identified in the posterior segment. Adjacent to the bronchial resection margin, there was a lymph node mass measuring 32 x 30 mm with a white, yellow, and black mottled appearance on sectioning. The primary lesion measured 48 mm in diameter and exhibited a firm sclerotic appearance with areas of necrosis. It was located subpleurally and extended within approximately 12 mm of the bronchial resection margin. There was evidence of obstructive pneumonitis distal to the lesion. Several peribronchial lymph nodes showed signs of involvement apart from those adjacent to the bronchial resection margin. The surrounding lung tissue demonstrated severe centriacinar emphysema with bulla formation.\n\nMicroscopic examination revealed a poorly differentiated carcinoma with focal invasion into but not through the pleura. Fibrofatty adhesions were present on the surface. No vascular or perineural invasion was observed; however, focal lymphatic permeation was identified. Metastatic carcinoma was present in several peribronchial lymph nodes. The tumor appeared to be clear of the bronchial resection margin and did not involve the adjacent soft tissue margin. Adjacent lung tissue showed severe emphysematous changes with bullae and obstructive pneumonitis distal to the lesion.\n\nThe lymph node specimen labeled No. 7 measured 40 x 27 x 20 mm and contained firm white masses within blackened parenchyma. Microscopy confirmed extensive replacement by metastatic poorly differentiated carcinoma. The No. 4R lymph node specimen measured 25 x 20 x 14 mm and contained firm pale nodules. Histologic evaluation also showed widespread involvement by metastatic poorly differentiated carcinoma.\n\nAdditional immunohistochemical findings indicated that tumor cells contained mucin but were negative for neuroendocrine markers including chromogranin, synaptophysin, and CD56."} +{"pid": "TCGA-CM-5861", "report": "The submitted specimen consists of a segment of right colon, including terminal ileum, cecum, and ascending colon. The colon measures 23 cm in length with a circumference of 7.2 cm at the distal resected margin. A friable, polypoid mass is identified measuring 5.0 cm in length and 8.0 cm in width. The lesion is located in the large intestine, 14 cm from the proximal margin and 20 cm from the distal margin. On sectioning, the tumor invades through the muscularis propria into pericolorectal tissues, involving underlying adipose tissue with a depth of invasion measuring 0.4 cm. The tumor is located 1.5 cm from the ileocecal valve, which appears granular and markedly edematous. The serosal surface shows focal hemorrhagic changes with adipose tissue thickness up to 5.5 cm. No gross tumor perforation is identified. Surgical margins are free of involvement.\n\nLymphovascular and large venous invasion are not identified. Perineural invasion is present. Twenty-eight lymph nodes are examined, none showing evidence of metastatic involvement. Tumor budding and increased tumor-infiltrating lymphocytes are absent. A precursor lesion in the form of a tubulovillous adenoma is noted. No polyps or mucosal dysplasia are identified away from the lesion. The non-neoplastic bowel is otherwise unremarkable. No tumor deposits are found in pericolorectal soft tissue.\n\nA separate omental specimen measuring 24 x 8.5 x 0.5 cm consists of lobulated adipose tissue. No lymph nodes or abnormal lesions are identified on gross examination. Representative sections are submitted for evaluation."} +{"pid": "TCGA-EJ-7788", "report": "The patient had a pre-operative PSA level of 26.6 ng/ml and was previously diagnosed with a lesion identified in the right mid aspect of the prostate. A radical prostatectomy with bilateral lymphadenectomy was performed.\n\nA single lymph node from the right pelvic area and five lymph nodes from the left pelvic area were examined, and no atypical cells were found in any of them. The prostate specimen weighed 57.61 grams and showed a lesion that was multifocal, with a maximum dimension of 3.0 cm. The lesion was present in both the right and left lobes, involving approximately 60% of the examined prostate volume.\n\nMicroscopic evaluation revealed extensive involvement of the right seminal vesicle and focal involvement of the left seminal vesicle. The lesion extended beyond the prostatic capsule in multiple regions, including areas near the right and left seminal vesicles, anterior right and left base, posterior right and left base, and posterior left mid portion. Tumor cells were also found at the proximal urethral/basilar and distal urethral/apical resection margins, with a linear extent of margin positivity greater than 1.7 cm in one area. Multifocal perineural invasion was noted, but no angiolymphatic invasion was observed.\n\nHigh-grade intraepithelial changes were present. The background tissue showed nodular hyperplasia and chronic inflammation. Pathologic staging was determined as pT3b with no evidence of nodal involvement. The histologic grade was classified as G3-4, indicating poorly differentiated or undifferentiated features."} +{"pid": "TCGA-FC-7961", "report": "The prostate specimen weighed 50 grams and measured 3.5 cm from base to apex, 5.1 cm transversely, and 3.8 cm from anterior to posterior. The seminal vesicles were up to 4.0 cm in length. The left side was inked black and the right blue. Both the apical and basal margins were shaved and sectioned perpendicularly, with sampling also performed at the bases of the seminal vesicles. Central nodular hyperplasia was observed. Within the right posterolateral periphery near the apex, a tan-yellow mass measuring 1.5 x 0.8 cm was identified. A second mass measuring 1.9 x 1.1 cm was noted along the left posterolateral aspect near the midpoint. No gross evidence of extraprostatic extension was observed. Additional tissue fragments included segments of vas deferens measuring 2.1 cm and 2.9 cm in length, as well as a rubbery tan-brown fragment measuring 2.2 x 1.5 x 1.0 cm presumed to be bladder neck; no masses or lesions were identified in these samples upon sectioning.\n\nMicroscopic examination revealed involvement of the distal inked resection margin with infiltration extending to the left side. The proximal bladder neck margin could not be assessed. Tumor was present at the left peripheral margin, specifically the anterior aspect. Areas of infiltrating growth were seen in the prostate, involving the left lobe extensively and patchily involving the right and anterior regions. There was penetration into the prostatic capsule with extension into the surrounding fat. Histologic evaluation demonstrated a Gleason score of 4 + 5 = 9. Multifocal and bilateral involvement was documented. Angiolymphatic invasion was present. No involvement of the seminal vesicles was observed. The TNM classification was determined to be T3a NO Mx."} +{"pid": "TCGA-85-8479", "report": "The specimen consists of a fragment measuring 2 x 1 x 1 cm, located in the lower lobe, with a white intrabronchial structure nearly completely obstructing the airway. Microscopic examination reveals a papillary growth pattern with monomorphic cells, nuclear atypia, and isolated atypical mitotic figures. Areas of necrosis are present, along with an abundant fibrous-inflammatory stroma. The surrounding pulmonary parenchyma shows fibrin-leukocytic alveolitis. No abnormal tissue was identified at the interlobar spur or in lymph nodes examined, including those from station VII, subaortic, and paraaortic regions. No metastatic involvement was found in the 7 lymph nodes evaluated. Lymphatic invasion is noted; venous invasion and surgical margins were not specified. The histologic grade is moderately differentiated. No additional findings or prior treatment effects were reported."} +{"pid": "TCGA-J4-AATZ", "report": "The specimen was obtained from a patient and included multiple tissue samples. A. Left pelvic lymph node (frozen section): two gray-tan tissue fragments measuring 2.2 x 0.7 cm and 1 x 0.7 cm. B. Left pelvic lymph node (non-frozen section): yellow fibrofatty tissue measuring 3.5 x 3 cm with two probable lymph nodes identified, measuring 1 x 0.5 cm and 0.5 x 0.5 cm. C. Right pelvic lymph node (frozen section): two fragments measuring 2 x 0.7 cm and 1.5 x 0.2 cm. D. Right pelvic lymph node (non-frozen section): yellow fibrofatty tissue measuring 3 x 3 cm with five probable lymph nodes identified, the largest measuring 2 x 0.7 cm and the smallest 0.3 x 0.2 cm. E. Bladder neck (frozen section): a gray-tan fragment measuring 1.5 x 1 cm. F. Prostatectomy specimen including seminal vesicles and vas deferens: prostate gland weighed 50 grams and measured 4.5 x 4 x 3 cm. The capsule appeared disrupted at the bladder resection margin and was previously inked black on the left and blue on the right. The right seminal vesicle measured 1.5 x 1.5 cm and the right vas deferens 1 x 0.5 cm; the left seminal vesicle measured 2.5 x 1 cm and the left vas deferens 1 x 0.5 cm. A portion of tissue between the bladder resection margin measured 1 x 1 x 1 cm.\n\nHistological evaluation showed no tumor involvement in any of the lymph nodes examined (0 out of 4 lymph nodes involved). No tumor was observed in the bladder neck or seminal vesicles. Margins of urethra and bladder neck were free of tumor; however, tumor was present at the inked apical margin on the right side. Histologic sections of the prostate demonstrated a Gleason score of 4 + 5 = 9/10. Tumor involvement within the prostate was estimated at severity level 4 (30\u201350% tissue involvement). Perineural invasion was noted. Lymphatic or small vessel invasion was not identified. No dominant nodule measuring at least 1 cm in size was observed. There was no evidence of treatment effect. The TNM stage was pT3a, pN0, pMX."} +{"pid": "TCGA-DD-AADA", "report": "The liver specimen measured 7.0 x 4.5 x 3.5 cm and weighed 37.0 grams. A solid mass was identified within the hepatic parenchyma, measuring 4.0 x 3.0 x 3.0 cm. The cut surface of the mass was well-demarcated, yellowish tan in color, and had a firm consistency. Grossly, the lesion exhibited a multinodular confluent appearance and was confined to the liver parenchyma. The resection margin was not involved macroscopically, with a safety margin of approximately 0.5 cm. The remaining liver parenchyma appeared unremarkable.\n\nThe gallbladder measured 11.0 cm in length and 5.0 cm in diameter. Its serosal surface was yellowish green and smooth, while the mucosal surface was greenish yellow and velvety. The wall thickness measured 0.2 cm. A single friable black stone was present, measuring 3.0 x 2.5 x 1.5 cm.\n\nMicroscopic examination revealed a tumor composed of hepatic-type cells arranged in trabecular and nesting patterns. The tumor exhibited Edmondson-Steiner grade III differentiation as the worst and major grade. Fatty changes were present, and a fibrous capsule was identified. Capsular infiltration, septum formation, and invasion of the surgical resection margin were observed. There was also evidence of serosal and portal vein invasion, along with vascular involvement. No bile duct invasion was noted.\n\nThe non-tumorous liver parenchyma showed features of chronic hepatitis associated with HBV. Additional findings included a cervical smear suggestive of bacterial vaginosis and multiple tubular adenomas with varying grades of dysplasia in the ascending colon and transverse colon, along with chronic colitis at the splenic flexure.\n\nBlocks submitted included four sections from the tumor mass, one from the resection margin, one from non-tumorous liver tissue, and one from the gallbladder. Gross photographs were provided."} +{"pid": "TCGA-14-1825", "report": "The specimen was received in two parts, both labeled as right parietal occipital lesion. Specimen #1 was submitted fresh and consists of three tissue fragments measuring 0.4 x 0.3 x 0.3 cm in aggregate. A portion was used for intraoperative frozen section diagnosis and touch preparation, with the remainder placed into cassette \"FS1A\" and the residual into \"1B.\" Specimen #2 was received in formalin and consists of multiple cream to tan tissue fragments measuring 1.9 x 1.6 x 0.5 cm in aggregate. Representative sections were submitted in cassettes \"2A\" and \"2B.\" Microscopic examination revealed cellular features consistent with high-grade transformation, including nuclear atypia, mitotic activity, and areas of necrosis. The pathologist reviewed the findings with a resident or fellow. All necessary sections were processed and no additional specimens were required."} +{"pid": "TCGA-D1-A16O", "report": "The specimen consists of a uterus with attached bilateral ovaries and absence of identifiable fallopian tubes. A polypoid mass measuring 5.0 \u00d7 3.8 \u00d7 1.5 cm is present, circumferentially involving the endometrium. Microscopic evaluation reveals small foci of superficially invasive tissue, ranging from 2.0 to 3.0 mm in greatest dimension. The myometrium has a total thickness of 1.6 cm, with invasion extending 0.1 to 0.2 cm into the muscular wall. No involvement of the endocervix is noted. Lymphovascular space invasion is identified.\n\nThe right ovary measures 3.5 \u00d7 2.3 \u00d7 1.7 cm and contains a cystic structure measuring 1.7 cm in greatest dimension. The left ovary measures 3.8 \u00d7 2.6 \u00d7 1.6 cm and contains a cystic structure measuring 1.3 cm in greatest dimension. Both ovaries show similar findings consistent with corpus luteal cysts. No fallopian tubes are identified on either side.\n\nA separate specimen from the umbilical region includes hernia sac tissue with chronic inflammation and two benign reactive lymph nodes showing dermatopathic changes. A small area of hemorrhage measuring 2.3 cm is observed within adipose tissue. Gross examination of the uterus shows no leiomyomas and an unremarkable cervix. Multiple representative sections were submitted for histologic evaluation."} +{"pid": "TCGA-TQ-A7RF", "report": "The submitted brain tissue specimen consists of a cerebral cortex segment weighing 36 grams and measuring 5.2 x 4.5 x 3.5 cm. One surface is covered by mildly congested meninges, while the opposite side exhibits a bloody, brownish appearance with areas of hemorrhage.\n\nHistological examination reveals a malignant neoplasm of neuroepithelial origin arranged in a multinodular pattern. The cells are characterized by rounded, monomorphic nuclei with granular chromatin and mild hyperchromasia. The cytoplasm is sparse, with occasional clear perinuclear halos noted. Some cells exhibit large, eosinophilic cytoplasm with a minigemistocytic appearance. The tumor demonstrates an infiltrative growth pattern, extending into the white matter and adjacent neocortex, where neuronal satellitosis is observed. Additional findings include secondary Scherer structures, as well as spread to the subarachnoid space and Virchow-Robin spaces. Necrotic foci and dystrophic calcification are present, along with easily identifiable mitotic figures. Notably, dystrophic calcification is also observed within the media of some medium-sized arteries.\n\nFluorescence in situ hybridization (FISH) analysis for 1p/19q deletion was performed on 5-micrometer sections of formalin-fixed, paraffin-embedded tissue using 1p36/1q25 and 19q13/19p13 probes. A total of 100 to 200 nuclei were evaluated per slide. The signal ratio for the 1p/1q probes was 1.02, and for the 19q/19p probes, it was 0.92."} +{"pid": "TCGA-75-6206", "report": "The sample was collected from the right upper lobe (RUL) during a resection procedure. The tissue measured 4.00 cm in size and was prepared using formalin fixation (FF). Histological evaluation revealed a lesion with moderate differentiation (Grade II). Pathological staging indicated T2, NOS for tumor classification, with no lymph node involvement (N0) and no clinical evidence of distant metastasis (M0). The staging corresponds to Stage II according to VALCSG criteria. No additional histological comments were provided."} +{"pid": "TCGA-CZ-5468", "report": "The surgical pathology report describes a specimen received in two parts. Specimen #1 consists of multiple fragments of white firm tissue mixed with blood clot, measuring 3.6 x 2.5 x 0.9 cm in aggregate, with attached vessel wall fragments up to 1.0 cm in size. Specimen #2 is a left kidney nephrectomy specimen weighing 966 grams and measuring 14.6 x 9.8 x 8.0 cm, including surrounding perirenal fat up to 3.0 cm thick. The ureter measures 6.8 cm in length and 0.4 cm in diameter, while the renal vein is 2.8 cm long and 0.4 cm in diameter. No adrenal gland was identified. The tumor within the kidney is tan/yellow, focally hemorrhagic and necrotic, measuring 8.3 x 7.0 x 5.6 cm, and extends into the renal vein for 4.5 cm. It is located less than 0.1 cm from the closest resection margin in the perirenal fat. Histologically, the tumor shows high nuclear grade features and areas of sarcomatoid differentiation. It infiltrates perirenal and peripelvic adipose tissue but does not involve ureteral or vascular margins. Staging according to the 6th edition of the AJCC classification is T3b. Additional findings include simple cortical cysts, with the largest measuring 5.5 cm. Microscopic evaluation of the non-neoplastic kidney tissue revealed 186 glomeruli, of which 29% were globally sclerosed, primarily in subcapsular regions. Tubules show moderate infiltration by mononuclear inflammatory cells, with hyaline casts and cellular debris noted. Interstitial changes include focal edema and inflammation, particularly in atrophic areas. Approximately 40% of the cortical parenchyma demonstrates tubular atrophy and interstitial fibrosis. Vascular changes include moderate to severe sclerosis in arteries and arterioles with luminal narrowing. Cytogenetic analysis was attempted but no metaphases were obtained for karyotyping."} +{"pid": "TCGA-EM-A4FF", "report": "The specimen included a left paratracheal lymph node biopsy, right paratracheal tissue, pyramidal lobe tissue, total thyroidectomy specimen with suture in the right lobe, and a right paratracheal lymph node. Histologic examination of the thyroid revealed multiple lesions. The dominant lesion measured 1.5 cm (1.1 x 0.9 cm additional dimensions) in the left lobe and was unencapsulated with capsular invasion noted. There was evidence of local invasion and vascular or lymphatic invasion was identified. The surgical margin was involved by the lesion. A second lesion measuring 0.1 cm was identified in the left lobe, also unencapsulated, without extrathyroidal extension, and with uninvolved margins. No involvement was found in the examined parathyroid glands or other lymph nodes. Pathologic staging showed tumor confined to the thyroid with a maximum dimension of 2 cm or less (pT1). Metastasis was identified in Level VI lymph nodes (pN1a). Four regional lymph nodes were examined with one showing involvement. Distant metastasis could not be assessed (pMX). Gross examination of the thyroid showed a nodule in the superior pole of the left lobe measuring 1.1 x 0.8 x 0.9 cm with tan-brown solid cut surfaces. The remainder of the thyroid tissue appeared homogeneous and brown. All specimens were otherwise unremarkable with no additional pathological findings identified."} +{"pid": "TCGA-EX-A1H6", "report": "The surgical specimen includes a radical hysterectomy with bilateral salpingectomy and parametrectomy. The tumor circumferentially involves the cervix, including the endocervix. Histologic evaluation shows well-differentiated features. The tumor measures 2.5 cm in size. Cervical invasion extends into the outer half of the cervical wall with a depth of 8 mm. The cervical wall thickness is 1.2 cm, with approximately 67% involvement. No deep margin involvement is identified. The lower uterine segment is not involved, and no tumor is seen in the parametrial tissue. The cervical or vaginal cuff margins are free of tumor, with a distance of 8 mm to the closest margin. Lymphovascular space invasion is not present.\n\nA total of 20 regional lymph nodes were examined, with no evidence of tumor involvement (10 from each pelvic side). The right and left fallopian tubes show no signs of tumor involvement. Additional findings include an atrophic endometrium and the presence of in situ changes adjacent to the invasive component within the cervix. The myometrium does not show any significant pathologic abnormalities.\n\nThe specimen was fixed in formalin and weighed 104.9 grams. It measured 9.0 cm in height, 4.5 cm in anterior-posterior width, and 6.0 cm in breadth at the fundus. The serosal surface appears tan/pink without any visible masses. The anterior surface was marked with blue ink and the posterior surface with black ink. The endometrial cavity measures 3.8 cm in length and 2.4 cm in width at the fundus, with a lining thickness of 0.1 cm. The myometrial wall thickness measures 1.5 cm, and no gross masses were identified upon sectioning. The right and left fallopian tubes measure 8.6 cm x 0.4 cm and 8.7 cm x 0.4 cm, respectively, with fimbriated ends present.\n\nLymph node dissection specimens include 10 nodes from the right and 10 from the left pelvic regions, all without evidence of tumor. The histopathologic findings support a staging classification based on the extent of local involvement and absence of nodal spread. Multiple tissue blocks were submitted for microscopic analysis, covering parametrial, cervical, and uterine areas, as well as lymph node candidates within fibroadipose tissue. All evaluations were performed by the attending pathologist."} +{"pid": "TCGA-AX-A1CP", "report": "The specimen inquiry included multiple lymph node regions and a uterine specimen with bilateral tubes and ovaries. Lymph nodes evaluated included right external iliac, right common iliac, right para-aortic, left external iliac, right obturator, left pelvic, and left obturator regions. A total of 15 lymph nodes were examined across all sites, with no evidence of tumor involvement identified in any of the submitted specimens.\n\nThe uterine specimen measured 16.0 x 4.0 x 3.0 cm and showed a polypoidal growth within the endometrial cavity. The growth was soft to firm, focally hemorrhagic, and measured 2.5 x 2.5 x 1.3 cm. Histologically, the polyp showed partial replacement by malignant cellular changes without invasion into the myometrium. The myometrium itself was unremarkable except for the presence of benign findings. The cervix demonstrated mild chronic changes with cystic features. Both ovaries exhibited atrophic patterns, and bilateral fallopian tubes showed no significant pathological findings.\n\nMicroscopic evaluation confirmed the absence of myometrial invasion, with the lesion confined to the endometrial lining. No vascular invasion was observed. Surgical margins were free of invasive disease. Based on staging criteria, the lesion was classified as limited to the endometrium with no regional lymph node involvement. Fifteen lymph nodes were assessed and found negative. Distant metastasis could not be determined from the available material."} +{"pid": "TCGA-EL-A3CW", "report": "A female surgical case involving a right thyroid lobe and isthmus specimen with associated right paratracheal and mid-jugular lymph node dissection. The thyroid specimen measured 5.0 x 4.0 x 2.0 cm and demonstrated a firm, gray-tan, unencapsulated mass measuring 3.5 x 3.0 x 2.0 cm. The tumor appeared to be confined to the thyroid gland. The isthmus margin was evaluated by frozen section and showed no evidence of tumor involvement. \n\nThe lymph node dissection included levels 4, 5, and paratracheal regions. Lymph nodes ranged in size from 0.2 to 1.5 cm. A total of 6 level 4 lymph nodes were examined, with tumor involvement identified in 4. In the paratracheal region, 15 lymph nodes were assessed, and tumor presence was confirmed in 10. One perithyroidal lymph node showed no tumor involvement.\n\nRepresentative sections of the thyroid and lymph nodes were submitted for analysis across 20 cassettes. No abnormalities were noted in the remaining lymph nodes evaluated. A single parathyroid gland was identified and showed no remarkable findings."} +{"pid": "TCGA-EM-A22O", "report": "The specimen was received from a total thyroidectomy procedure. The fresh specimen was intact, measuring 4.1 x 2.3 x 1.5 cm on the right lobe and 6.6 x 4.2 x 3.5 cm on the left lobe. The isthmus measured 1.2 x 1.6 x 0.2 cm. Total specimen weight was 63.7 g. Multiple nodules were identified bilaterally. One dominant nodule in the left lobe measured 6.6 cm in greatest dimension with additional dimensions of 4.2 cm and 3.5 cm. A second nodule in the right lobe measured 1.3 cm in all dimensions.\n\nHistologic examination of the left lobe revealed a widely invasive lesion with classical architecture and focal solid growth pattern. Nuclear features included classical cytomorphology with areas of tall cell change present in approximately 10% of the tumor. Focal dedifferentiation was noted in about 5% of the tumor, characterized by solid growth and apoptotic changes. The tumor was totally encapsulated but showed capsular invasion and lymphovascular invasion (less than 4 vessels). Surgical margins were involved by tumor. Extensive extrathyroidal extension was present.\n\nIn the right lobe, a separate lesion was identified that was partially encapsulated without capsular invasion. No lymphovascular or perineural invasion was observed. Surgical margins were uninvolved. There was no extrathyroidal extension. Additionally, multiple papillary microcarcinomas were identified, including one located in the isthmus measuring 0.1 cm.\n\nA separate lesion measuring 1.3 cm was identified in the right lobe with neuroendocrine features. Immunohistochemical staining demonstrated positivity for calcitonin, CEA, chromogranin, and TTF-1, with negativity for thyroglobulin. Proliferative index was low at 2%. This lesion was partially encapsulated with minimal capsular invasion. Lymphovascular invasion could not be definitively assessed. Surgical margins were free of involvement. No extrathyroidal extension or lymph node metastasis was identified for this component.\n\nOne lymph node was examined from the left paratracheal region and showed involvement by a neoplastic process with architectural and nuclear features consistent with the primary lesion in the thyroid. The tracheal resection specimen contained an infiltrative lesion with immunophenotype consistent with the main tumor in the left lobe. \n\nTNM staging criteria were applied. For the dominant tumor, the primary tumor classification was pT4a due to extensive extrathyroidal extension. Regional lymph node involvement was classified as pN1a with one positive lymph node. A second tumor in the right lobe was classified as pT1b, limited to the thyroid gland with no regional lymph node involvement. Additional findings included adenomatoid nodules and multiple small foci of other lesions."} +{"pid": "TCGA-06-0156", "report": "The specimen from the right occipital region consists of multiple tissue fragments measuring 0.8 to 0.6 cm. Microscopic evaluation reveals a high-grade glial neoplasm characterized by increased cellularity, nuclear pleomorphism, mitotic activity, vascular proliferation, and extensive necrosis. Immunohistochemical staining demonstrates a labeling index of approximately 20% for proliferative activity."} +{"pid": "TCGA-AN-A0AK", "report": "Female patient with tumor located in the left breast, primary site. Tumor specimen was obtained via surgery and preserved in OCT matrix as a frozen block. The tumor is grade 2, with T stage 2, N stage 0, and M stage 0. No prior treatment was administered. A normal blood sample was also collected via blood draw and stored in a frozen tube."} +{"pid": "TCGA-HD-8634", "report": "The surgical specimen consists of a 3 x 2.5 x 1 cm partial glossectomy with a 1.2 x 1 cm firm tan-white lesion located in the lateral portion of the tongue. The lesion measures approximately 1 cm in diameter and extends to a depth of 0.4 cm. It is closest to the superior, anterior, and inferior margins at 0.5 cm each, with 1 cm clearance from the posterior margin and 0.9 cm from the deep margin. All surgical margins were evaluated by frozen section and found to be free of involvement. A total of four lymph nodes were examined, including two sentinel nodes from the left upper deep cervical region and two additional nodes from left levels 3 and 1A. Each node was assessed using routine H&E staining as well as immunoperoxidase staining for pankeratin; all were negative for metastatic disease. The pathological staging is T1, NO."} +{"pid": "TCGA-LL-A5YN", "report": "The specimen consists of a right breast lumpectomy measuring 10.5 x 9.5 x 4.5 cm in greatest dimensions. A tumor mass measuring 2.4 x 1.8 x 1.5 cm is centrally located within the specimen. It is 1.3 cm from the superior margin, 1.5 cm from the inferior margin, at least 2.5 cm from both deep and superficial margins, and more than 3 cm from medial or lateral margins. The tumor is surrounded by dense white fibrous tissue with focal fibrocystic changes, making up approximately 50% of the biopsy parenchyma. Histologically, there is an invasive carcinoma with nuclear pleomorphism score of 3, mitotic count score of 2, and tubular differentiation score of 3, resulting in an overall histologic grade of 3. Margins are uninvolved by invasive carcinoma with the closest distance being 1.3 cm at the superior margin.\n\nIn addition to invasive components, ductal carcinoma in situ is present along with lobular carcinoma in situ. There is no involvement of skin or skeletal muscle. Adjacent minor hemorrhage and fat necrosis are noted, consistent with prior biopsy.\n\nFive sentinel lymph nodes were examined: one lymph node each from sentinel lymph node #1 and #2, and three lymph nodes from sentinel lymph node #3. All lymph nodes are benign with no evidence of macrometastases, micrometastases, or isolated tumor cells.\n\nPathologic staging indicates primary tumor pT2 and regional lymph nodes staged as pN0(i-). Distant metastasis was not applicable. Intraoperative consultation confirmed presence of tumor suitable for tissue banking and confirmed negative surgical margins with the closest margin measuring 1.5 cm at the superior aspect."} +{"pid": "TCGA-V1-A8ML", "report": "The patient underwent robotic-assisted laparoscopic prostatectomy with pelvic lymph node dissection. The surgical specimen was received in five parts, including anterior prostatic fat, anterior urethral margin, right and left pelvic lymph nodes, anterior bladder neck, and the prostate with seminal vesicles. All tissue components were carefully examined microscopically.\n\nMicroscopic evaluation of the anterior prostatic fat, anterior urethral margin, anterior bladder neck, and all lymph node specimens showed no evidence of abnormal cells or involvement by any atypical process. A total of 12 lymph nodes (5 from the right and 6 from the left pelvic regions) were examined and none showed any suspicious or malignant features.\n\nExamination of the prostate revealed multiple small, firm, white-tan nodular areas within the gland. These were located in various regions, including the left anterior apex, left posterior mid gland, left posterior base, right posterior apex, right posterior mid gland, and right anterior base. The largest nodule measured 1.3 cm. The estimated total volume of these areas was 0.96 ml. Microscopic analysis showed a consistent pattern of cellular architecture throughout the involved areas, with no evidence of extraprostatic extension or involvement of the seminal vesicles. The surgical margins were free of any atypical cells, although benign prostate glands were present at the inked excision margins.\n\nThere was no evidence of high-grade intraepithelial neoplasia. Perineural infiltration was identified in one area. The surrounding stroma and capsule were intact without disruption. Based on the extent of involvement and absence of spread beyond the prostate, the findings were consistent with a non-advanced stage of the process. All findings were confirmed by detailed histologic review of the submitted tissue blocks."} +{"pid": "TCGA-A6-3808", "report": "The specimen consists of a 15 cm segment of proximal right colon with attached 15 cm distal ileum. The outer surface is smooth to scabrous with tan pink serosa and a significant amount of attached mesocolon and mesentery. No appendix is identified. The proximal and distal margins measure 3.2 cm and 5.2 cm in circumference, respectively. Upon opening, a well-defined mass measuring 4.4 x 4.0 cm is observed within the cecal pouch, located 1 cm from the ileocecal valve. The mass has a rubbery, tan-white to red appearance and reaches a maximal thickness of 1.1 cm. It extends through the muscularis to within 0.1 cm of the inked free serosal surface. The mucosa of the ileum and remaining colon appears normal\u2014glistening, tan pink, with irregular folds and wall thickness averaging 0.5 cm. Lymph nodes are present within the mesocolon and mesentery, up to 1.4 cm in size. A total of 13 tissue blocks were submitted for analysis, including margins, tumor sections, ileum, colon, and lymph nodes.\n\nMicroscopically, the lesion shows features consistent with glandular origin and mucin production. The primary lesion involves infiltration beyond the muscularis propria into surrounding fat (pT3). All surgical margins\u2014proximal, distal, and radial\u2014are negative. There is no evidence of vascular invasion or pericolonic tumor deposits. Twenty-four regional lymph nodes are assessed and none show involvement. Distant metastasis cannot be determined."} +{"pid": "TCGA-CV-6003", "report": "The surgical specimen from the left partial glossectomy measures 9.6 x 3.2 x 0.9 cm and contains an ulcerated lesion measuring 2.8 x 1.5 x 1.0 cm. The lesion is located 0.3 cm from the closest anterior margin. Ink was applied to the anterior surface including the deep margin area. Frozen section analysis of the anterior and deeper margins confirmed that the margin was free of tumor involvement. Additional sections were taken from surrounding tissue and submitted for evaluation.\n\nEvaluation of surgical margins showed no evidence of residual tumor. No perineural or lymphovascular invasion was observed in the specimen.\n\nIn the left supraomohyoid neck dissection, Level I lymph nodes (six in total) were examined and none contained abnormal tissue. Similarly, all lymph nodes assessed in Level II (one in total) showed no abnormal findings.\n\nIn Level III of the left supraomohyoid neck dissection, sixteen lymph nodes were evaluated. One of these lymph nodes demonstrated a microscopic focus of abnormal cells localized subcapsularly. Additional lymph nodes were dissected from this level but showed no similar findings.\n\nA separate specimen consisting of tooth #5 was submitted for gross examination only and did not undergo further microscopic evaluation.\n\nRepresentative sections from all anatomical regions were submitted for histologic analysis."} +{"pid": "TCGA-EM-A2CK", "report": "The specimen included a right jugular lymph node measuring 1.6 cm in diameter, with solid and cystic features. Multiple lymph nodes were identified in the right posterior triangle region, ranging from 0.3 cm to 3.5 cm in size; some exhibited cystic changes. Three lymph nodes were found in the right level 5A region, measuring between 0.2 cm and 2.2 cm. A tiny tissue fragment (<0.1 cm) labeled as left lower parathyroid was examined, along with a thyroidectomy specimen weighing 24.5 g.\n\nThe thyroid gland showed fibrous adhesions on its external surface. The right lobe measured 4.5 \u00d7 2.8 \u00d7 2.2 cm, and contained two distinct nodules: one measuring 0.6 \u00d7 0.4 \u00d7 0.4 cm and another larger nodule measuring 2.3 \u00d7 1.7 \u00d7 1.5 cm. The left lobe measured 4.0 \u00d7 2.5 \u00d7 1.5 cm and contained a smaller nodule of 0.3 \u00d7 0.4 \u00d7 0.4 cm at its lower pole. The isthmus measured 4.8 \u00d7 1.6 \u00d7 0.8 cm and contained two additional small nodules measuring 0.1 cm and 0.3 cm.\n\nHistologic evaluation revealed follicular architecture with classical cytomorphology in one dominant nodule. Another tumor focus displayed classical papillary architecture and cytomorphology. Both tumors lacked lymphovascular or perineural invasion, and margins were free of involvement. One lesion was partially encapsulated without evidence of capsular invasion, while the other demonstrated wide capsular invasion.\n\nImmunohistochemical staining of the nodules showed positivity for CK19 in all cases, with variable expression of galectin and HBME-1. Six out of 25 lymph nodes were involved, with extranodal extension noted in one case. Pathologic staging was based on AJCC/UICC TNM classification (7th edition), with multiple primary tumors classified as pT2 (unilateral tumor >2 cm but \u22644 cm confined to the thyroid), regional lymph node involvement classified as pN1b (metastases to unilateral cervical lymph nodes), and no distant metastasis identified.\n\nAdditional findings included normal parathyroid glands and intraoperative frozen sections confirming parathyroid tissue in both left and right lower specimens. No pathological diagnosis was made for thymic tissue or any of the parathyroid biopsies."} +{"pid": "TCGA-AN-A0XL", "report": "Female patient with no prior treatment. Tumor specimen was obtained via surgery from the breast and preserved in OCT medium within a block container. The tumor is characterized histologically as a grade 2 infiltrative ductal carcinoma. Staging details indicate a T stage 2, N stage 0, M stage 0. A normal blood sample was also collected via blood draw and stored frozen in a tube container. Cellular morphology and staging information were documented without mention of a specific diagnosis."} +{"pid": "TCGA-AA-3966", "report": "The specimen demonstrates a lesion characterized by a poorly differentiated histological pattern, with evidence of transmural extension through all layers of the intestinal wall. Vascular invasion is present. Lymph node examination reveals no metastatic involvement (0 out of 14 nodes involved). Resection margins are clear in both the mucosal and ligature regions, with the former showing normal-appearing mucosa, submucosa, and muscularis, and the latter exhibiting mature mesenchymal structures. Additionally, there is a finding of chronic recurrent appendicitis associated with fecal impaction. Tumor grading corresponds to a high-grade morphology. Staging parameters include pT3, with indicators of lymphatic and vascular invasion (L1, V1), and no nodal metastasis (pNO)."} +{"pid": "TCGA-CI-6624", "report": "The patient presented with a rectal mass and underwent flexible sigmoidoscopy with biopsy. There was no prior history of malignancy, chemoradiation, organ transplantation, immunosuppression, or other significant medical conditions. Histopathologic examination of the biopsied tissue revealed invasive growth through multiple layers of the rectal wall. Microscopic evaluation showed abnormal glandular structures invading the surrounding tissue, with cellular atypia and architectural distortion. No metastatic involvement was identified in the sampled areas. Staging could not be fully determined due to limited tissue sampling. Further assessment may be required for complete staging and clinical correlation."} +{"pid": "TCGA-O2-A52V", "report": "The clinical specimen includes a resected lung tissue measuring 14 x 7 x 5.5 cm, with a roughened area of 4.5 x 3 cm noted near the bronchial margin, embedded with multiple staples located 1 cm from the margin. The pleural surface is described as purple-tan with minimal anthracotic pigment and radiating lines from the hilum. No masses or lesions were identified in the parenchymal cut surface. Additional sections include vascular margins, lymph nodes, and uninvolved lung tissue.\n\nA separate chest wall specimen was received, weighing 374 grams and measuring 20 x 10 x 8 cm, including a segment of chest wall 11.3 x 10.1 cm. The pleura shows fibrinous adhesions and staple lines. A second roughened area measuring 5.5 x 2.5 cm was embedded with staples and marked with blue ink. The chest wall component includes three rib fragments and adherent soft tissue. A friable necrotic mass measuring 7.5 x 7 x 5.5 cm was identified within the lung wedge, located 1 cm from the blue-stapled margin, and involving the chest wall. Margins of the ribs and soft tissues were submitted for evaluation, with some blocks sent for decalcification.\n\nLymph node specimens were also received, including a Level 11 lymph node (measuring up to 1.4 x 1 x 0.6 cm), a Level 10 lymph node (1.5 x 1 x 0.6 cm), and a Level 9 lymph node (1.5 x 0.5 x 0.5 cm). All were submitted in their entirety and showed no evidence of abnormal cellular infiltration.\n\nIntraoperative consultation of the bronchial margin was negative for atypical cells. Microscopic evaluation of the chest wall margin showed a nodule measuring 2 cm in greatest dimension, without evidence of invasion. The nodule was not fully evaluable due to the fragmented nature of the specimen. Other findings included emphysema, chronic bronchitis, and postobstructive organizing pneumonia. Vascular invasion was not identified. Lymph node profiles, including hilar, mediastinal, and separately submitted N1 nodes, did not show any concerning features. Parenchymal and pleural margins were free of abnormal cells, while the bronchial and vascular margins were reported separately. \n\nThe procedure performed was an en bloc excision of lung and chest wall with completion lobectomy and mediastinal lymph node biopsies. The pathologic stage according to the AJCC 8th edition is pT3 pNo pmx."} +{"pid": "TCGA-B0-4845", "report": "The specimen from the right kidney following radical nephrectomy measures 5.5 cm in greatest dimension. Microscopic evaluation reveals a neoplastic lesion with conventional morphology and nuclear features corresponding to Fuhrman's nuclear grade 2 of 4. There is evidence of involvement of the perinephric adipose tissue. All surgical margins, including ureteral, vascular, and radial, are free of tumor. No angiolymphatic invasion is observed. The non-neoplastic renal parenchyma does not demonstrate any significant pathological changes. Staging according to the TNM classification system indicates pT3a Nx Mx. The right adrenal gland obtained during the procedure shows no notable pathological findings."} +{"pid": "TCGA-66-2800", "report": "The examined right upper lobe and associated structures show a number of notable findings. The right upper lobe preparation measures 19 x 14 x 6.5 cm and displays a shiny pleural surface with patchy, reticulate grayish-black markings. Adhesions are present in the laterobasal zone involving segments 2 and 3, extending to a chest wall segment measuring up to 12 x 9 cm, which includes a rib fragment 5.8 cm in length. A separate membranous parietal pleural component, fatty in areas, covers parts of segments 2 and 1 without adhering to the visceral pleura. Medially, there is an additional adhesion site near the chest wall attachment, involving a parenchymal flap secured by clip sutures measuring 6.5 x 5 x 2 cm, possibly from segment 6 or the middle lobe.\n\nA nodular lesion measuring up to 6.2 cm is identified at the base of segment 2, with a dirty whitish cut surface and focal grayish-yellow softening. The lesion shows a sharp demarcation on one side and continuous infiltration into the visceral pleura on the other, extending toward the medial base near the suture line. At the interface with the chest wall component, there is blackish thickening of the fused pleural layers. Central discontinuation of a bronchial branch (B2) is noted approximately 1.7 cm distal to its bifurcation within the lesion tissue, as well as involvement of a sub-segmental branch of B3, while other bronchial branches remain uninvolved peripherally.\n\nA second smaller lesion, measuring 1.6 cm, is found in the subpleural region of segment 1, located about 3 mm beneath the pleural surface. The central bronchial resection margin lies immediately proximal to the segmental division point. Adjacent to the bronchial stump, a solid nodule measuring 2.2 cm is observed, containing dark grey pigment and showing some damage.\n\nLymph node findings include several pigmented nodes across multiple regions. In the right upper lobe lobar region, a heavily pigmented fragment measuring 1.8 cm is present. In the right lower lobe lobar area, a similarly pigmented node of 1.8 cm is found. Interlobar lymph nodes on the right include two fragments measuring 0.7 and 1.2 cm, both with blackish pigmentation. Hilar lymph nodes on the right include two measuring 1.3 and 1.8 cm, and another larger node measuring 2.7 cm, with blackish pigmentation and some surrounding fatty tissue. Subcarinal lymph nodes include preparations measuring 1.2 and 2.3 cm, with at least three identifiable nodes up to 1.7 cm. Low paratracheal lymph nodes on the right include a 4.5 cm fatty tissue fragment containing multiple small nodes, some pale grey, others blackish, ranging from 0.3 to 1.2 cm, along with a single 0.5 cm blackish node. On the right and left combined, a 3.3 cm fatty tissue fragment contains up to three nodes each measuring up to 1.2 cm. Prevascular and retrotracheal nodes on the right include a 2.5 cm longitudinal fatty fragment with two small blackish nodes. High paratracheal lymph nodes on the right include a 1.4 cm node with slate grey to reddish cut surfaces and a small 2 mm pale grey nodule embedded within.\n\nA separate lipomatous mass is also described, measuring 3.7 x 3 x 1.8 cm, with a smooth, encapsulated surface and golden yellow section with a 7 mm grayish-red border.\n\nMicroscopic analysis reveals a large lesion composed of variable-sized solid cell clusters, some reticulate or branched, with occasional large atypical epithelial cells surrounded by epidermoid layers. These cells have abundant, mostly weakly eosinophilic cytoplasm and nuclei with marked variation in chromatin structure. Frequent apoptotic figures and at least five mitotic figures per high-power field are noted. No mucin is present, but intercellular bridges are evident. Central necrotic areas and degenerative nuclear changes, including karyopyknosis and dyskeratotic keratinization, are seen. Pulmonary architecture in this region is completely replaced by fibrous connective tissue with inflammatory infiltrates and thick-walled vessels containing tumor cell emboli. The lesion extends beyond the pleural boundary in a broad front, especially at the lobar cleft, and infiltrates the visceral pleura. The attached parietal pleural adhesion site, however, is free of tumor, showing only fibrosis and chronic inflammation. Muscle fibers and intact rib bone with active marrow are found at the periphery.\n\nA smaller satellite lesion in segment 1 also demonstrates solid nests of large atypical squamous cells, with replacement of bronchial epithelium and underlying fibrosis. No tumor is identified at the bronchial or vascular resection margins, and the respiratory mucosa appears normal. Lymph nodes show variable anthracotic pigment deposition, macrophage accumulation, and rare secondary follicles, but no evidence of tumor involvement. Fatty tissue surrounding lymph nodes contains small nerves and vessels of varying calibers, with a small artery noted in one sample.\n\nThe lipomatous tissue consists of lobulated fat with single-vacuole adipocytes, capillaries, and muscle bands, both within and at the margins. No malignant features are identified in this component.\n\nStaging based on these findings is consistent with pT4 pN0 V1 R0, corresponding to stage IIIB."} +{"pid": "TCGA-AD-6895", "report": "The specimen consists of a 14 cm portion of large bowel including the cecum and 4.5 cm of terminal ileum, along with a grossly unremarkable vermiform appendix measuring 4.3 x 0.6 x 0.6 cm. The bowel wall is up to 0.6 cm thick with edema and fibrosis. A lesion measuring approximately 3.0 x 2.8 cm is identified within the cecal pouch, characterized by a centrally ulcerated, finely granular tan-brown plaque with slightly raised borders. The lesion has a fibrotic cut surface measuring up to 0.7 cm in thickness and appears to extend focally through the bowel wall into adjacent adipose tissue near the ileocecal valve. It also extends into the appendiceal orifice without causing obstruction. Several gray tan to brown nodules up to 0.6 cm are noted in the surrounding adipose tissue.\n\nMicroscopic evaluation reveals cellular invasion through the muscularis propria into subserosal adipose tissue. Lymphovascular space invasion is present. No involvement of the visceral peritoneum, mesenteric deposits, or surgical margins is identified. Carcinomatous involvement is noted within one of 17 lymph nodes examined. The closest tumor proximity is within 1 mm of the serosal surface, though there is no perforation or extension to the serosal surface. Sections from proximal and distal margins, as well as random uninvolved bowel and various regions of the appendix, are submitted for evaluation. Additional review by a second pathologist confirms the findings."} +{"pid": "TCGA-41-2571", "report": "The specimen consists of three tissue samples obtained from the right frontal region. Sample A measures 0.3 x 0.3 x 0.2 cm and is composed of soft tan fragments. Sample B measures 0.5 x 0.4 x 0.3 cm and is also made up of soft tan tissue fragments; quality control slides were taken from both ends of this specimen. Sample C, measuring 1.2 x 0.7 x 0.3 cm in aggregate, consists of multiple pink-tan to dusky soft tissue fragments and was entirely submitted for analysis.\n\nMicroscopic evaluation reveals significant nuclear pleomorphism, mitotic activity, and areas of necrosis within the tissue. Immunohistochemical staining demonstrates that the malignant cells are positive for GFAP and negative for pankeratin. The frozen section analysis identified malignant cells, with final diagnosis deferred to permanent sections. All specimens were processed and reviewed accordingly."} +{"pid": "TCGA-C5-A7CM", "report": "The specimen was received as a cervical biopsy and consists of a 1.0 x 1.0 x 0.3 cm aggregate of pink to red, soft tissue fragments. Histological examination reveals the presence of abnormal glandular structures with areas displaying cribriform, tubular cystic, and papillary growth patterns. The tumor cells exhibit varying cytoplasmic staining characteristics, ranging from pale pink to clear. Nuclear features include hyperchromasia, pleomorphism, and scattered mitotic figures. Focal areas of tumor cell necrosis are also present. In addition, both specimens show regions consistent with in situ changes.\n\nImmunohistochemical analysis demonstrates positivity for p16, CK-7, and CEA-monoclonal markers, while being negative for Calretinin, CD10, and CK-20. These findings support a specific lineage and characteristic profile of the lesion. The endometrial curettings show no evidence of malignancy, with only proliferative-type endometrium and stromal breakdown present. All immunohistochemical controls were reviewed and confirmed appropriate by the pathologist."} +{"pid": "TCGA-AO-A12F", "report": "A right mastectomy specimen revealed a white-tan, partially pseudoencapsulated tumor mass measuring 4.3 cm in greatest dimension located in the upper outer quadrant. The mass showed areas of necrosis and fine granularity on sectioning. No involvement of the deep margin, skin, or nipple was identified. Adjacent to the tumor, there was a 2.5 cm area consistent with prior biopsy. Scattered throughout the remaining breast tissue were multiple pink-tan nodularities within dense fibrocystic tissue.\n\nHistologic evaluation demonstrated a high-grade infiltrating carcinoma composed of cells with marked nuclear atypia and minimal tubule formation. A component of intraductal proliferation was also present, showing solid architecture, high nuclear grade, and extensive necrosis. This in situ component constituted less than 25% of the overall lesion and was intermixed with the invasive component. Lobular involvement by the in situ component was noted. No vascular invasion or lymphatic involvement was identified. Surgical margins were free of any neoplastic involvement.\n\nMultiple lymph nodes were evaluated from the right axillary region. Sentinel lymph nodes numbered one through twelve were examined, with no evidence of metastatic disease identified. Additional non-sentinel lymph node tissue was also negative for malignancy. Immunohistochemical staining for cytokeratins did not reveal any occult metastases in sentinel nodes.\n\nSpecial immunohistochemical studies on the breast specimen showed no nuclear staining for estrogen or progesterone receptors. HER-2 immunostaining was negative with a staining intensity of 1+. All findings were confirmed on repeat testing using a different tissue block. Intraoperative frozen section analysis of the sentinel lymph nodes was concordant with final permanent section diagnosis."} +{"pid": "TCGA-W2-A7HC", "report": "The specimen consists of a right adrenal gland weighing 97 grams and measuring 9.5 x 8.0 x 4.0 cm, fixed in formalin. Gross examination reveals a 6.0 x 5.3 x 4.3 cm soft mass within the medulla, with a mottled red-purple to brown appearance. The adrenal gland itself measures 9.0 x 4.5 x 3.6 cm and contains a bright orange cortex. One end of the specimen shows normal adrenal tissue with a central red-gray medulla. The mass is surrounded by adrenal cortex in part and focally extends to the inked margin. Histological evaluation identified microscopic areas of vascular invasion. The biological potential of the lesion is challenging to predict based solely on histological features. These findings suggest the need for close clinical follow-up. Tissue was collected for banking, and representative sections were submitted for further analysis."} +{"pid": "TCGA-ZF-A9R5", "report": "The specimen includes two parts: one consisting of 3 g of friable tissue chippings and the other composed of three tan-colored tissue fragments, with the largest measuring 12 mm in maximum dimension. Microscopic evaluation reveals a poorly differentiated lesion with a mixed papillary and solid growth pattern. The cellular morphology includes features of transitional cell differentiation along with areas showing signet ring cell and sarcomatoid (spindle cell) changes. No heterologous elements are identified. There is extensive necrosis present. The muscularis propria is involved, indicating stromal invasion at the level of the muscularis propria (pT2 or greater). No vascular channel invasion is observed. A small amount of non-dysplastic flat urothelium is also present in the background."} +{"pid": "TCGA-FV-A496", "report": "The surgical specimen included a partial liver resection involving segments 5 and 6, along with the gallbladder and cystic duct. A single mass measuring 11.5 x 8 x 7 cm was identified on the smooth capsular surface of the liver, with a bosselated tan appearance and variegated cut surfaces showing yellow, tan, pink, and brown areas. The tumor had well-defined edges and was noted to be in close proximity to the gallbladder bed but did not extend through the capsule or into the gallbladder. The nearest resection margin was 1 cm from the tumor, and no residual tumor was identified at the margins. The surrounding liver tissue showed no significant abnormalities.\n\nMicroscopic evaluation revealed a moderately differentiated cellular proliferation. Nuclear grade was assessed as 2 of 3 based on histologic criteria. No lymphatic or vascular invasion was identified. Mitotic activity was measured at 2.5 per 10 high-power fields. The tumor was confined entirely within the liver without evidence of spread beyond the organ. The attached gallbladder was intact, with smooth serosal surfaces and multiple choleliths within the lumen. Mucosal examination showed areas of red-tan velvety changes and pink-tan flat to velvety mucosa; no diagnostic abnormalities were found in the gallbladder or cystic duct upon histologic review.\n\nStaging parameters indicated a solitary lesion without vascular invasion (pT1). Regional lymph nodes could not be assessed (pNX), and there was no evidence of distant metastasis (pM0). The pathologic stage was determined under the assumption of no distant disease. Prognostic assessment was considered fair based on histologic features and absence of vascular involvement. No cirrhosis, small cell dysplasia, or fibrosis was present in the background liver tissue."} +{"pid": "TCGA-DX-A6BK", "report": "A 46-year-old female presented with a left retroperitoneal mass. The excised specimen measured 12.5 x 12.2 x 11.5 cm and was submitted for pathological evaluation. On gross examination, the mass was white/yellow, firm, and slightly lobulated, occupying nearly the entire specimen and measuring 11.8 x 10.5 x 10.2 cm. The tumor was in close proximity to the inked resection margin. Areas of necrosis were identified, although the majority of the tumor was viable.\n\nMicroscopic evaluation revealed a high-grade malignant component composed predominantly of cells arranged in a pattern resembling malignant fibrous histiocytoma. Focal areas demonstrated a low-grade myxofibrosarcoma-like morphology. In addition, regions of a more differentiated component were identified, exhibiting features consistent with a sclerosing type. The tumor involved the surgical margin. No significant findings were identified in the second specimen, which corresponded to a hernia sac. Multiple representative sections were taken from all relevant areas for histological review."} +{"pid": "TCGA-BG-A222", "report": "The specimen consists of a uterus weighing 334 grams, including bilateral adnexa, obtained via total abdominal hysterectomy and bilateral salpingo-oophorectomy. The lesion involves approximately 50% of the endometrial surface and demonstrates invasion into the myometrium, with involvement of approximately 35% of the myometrial thickness. Histologic evaluation reveals a poorly differentiated adenocarcinoma. Lymphovascular invasion is identified focally. Background changes in the endometrium include simple and complex atypical hyperplasia as well as a disordered proliferative pattern. Additional findings include an endometrial polyp, adenomyosis, chronic cervicitis, squamous metaplasia, reactive changes, and microglandular hyperplasia. Both ovaries and fallopian tubes are unremarkable, with no evidence of tumor involvement.\n\nLymph node dissection includes right and left pelvic and periaortic regions. A total of 35 lymph nodes are examined across all groups: ten from the right pelvic region, two from the right common and periaortic area, one from the left pelvic region, twelve from the left pelvic group, and one from the left common and periaortic region. All lymph nodes show no evidence of tumor involvement.\n\nImmunohistochemical staining is performed on formalin-fixed, paraffin-embedded tissue using blocks 1A and 10. Estrogen receptor shows diffuse intermediate expression. Progesterone receptor demonstrates diffuse moderate to strong staining in block 1A, while block 10 reveals a negative component within a moderately to intensely stained neoplasm. Ki-67 is expressed in 97% of cells. P53 staining is patchy with areas of strong and intermediate intensity. In block 10, P53-positive cells correlate with PR-negative tumor cells.\n\nCytology of the pelvis is negative for malignant cells. Grossly, the lesion appears to involve 90% of the endometrial surface; however, microscopic evaluation of submitted sections reveals adenocarcinoma in approximately half of the tissue, with the remaining sections showing hyperplastic and disordered proliferative endometrium. Sections of pelvic lymph nodes are reviewed and show no metastatic disease.\n\nMeasurements indicate a maximum tumor dimension of 70 mm. Histologic grade is classified as poorly differentiated (FIGO grade 3), based on combined architectural and nuclear features. Depth of myometrial invasion is less than half the thickness. No positive lymph nodes are identified, with 32 nodes examined in total. Pathologic staging is pT1a, pN0, with FIGO stage IA."} +{"pid": "TCGA-EM-A4FO", "report": "The total thyroidectomy specimen weighed 15.5 grams. The right lobe measured 3.6 cm in length, 2.7 cm in width, and 1.3 cm in thickness; the left lobe measured 4.0 cm x 3.0 cm x 1.5 cm; the isthmus measured 2.1 cm x 2.0 cm x 0.5 cm. The external surfaces showed fibrous adhesions and were marked with silver nitrate. No parathyroid glands or lymph nodes were identified on gross examination.\n\nA well-defined, partially calcified nodule measuring 1.1 cm x 0.9 cm x 0.7 cm was found in the lower left lobe. Histologically, this lesion demonstrated classical papillary architecture and cytomorphology, with a minor component of tall cell features involving less than 5% of the tissue. The tumor was partially encapsulated, with minimal capsular invasion noted. Margins were free of involvement. Adjacent thyroid tissue showed evidence of chronic lymphocytic thyroiditis.\n\nAdditional small lesions were identified in the right lobe and isthmus, ranging from 0.05 cm to 0.6 cm. These exhibited classical papillary features with some showing focal Warthin-like changes. All were partially encapsulated, without significant vascular or perineural invasion. No extrathyroidal extension was observed.\n\nSix regional lymph nodes were examined, including right and left perithyroidal and isthmic locations. One lymph node showed extensive cautery artifact but no evidence of malignancy. No metastatic disease was identified in any of the lymph nodes.\n\nThe dominant lesion was located in the left lobe and measured 1.1 cm in its greatest dimension. Based on size and extent confined to the thyroid gland, the staging classification is pT1b. The regional lymph node assessment was classified as pN0, with no involved nodes. Distant metastasis could not be assessed. Multiple primary tumors were noted (m). The specimen margins were uninvolved throughout."} +{"pid": "TCGA-BH-A0AW", "report": "The specimen consists of breast tissue resected via segmental mastectomy. A focus of invasive carcinoma is identified, measuring 2.0 cm in greatest dimension. The cellular features include moderate nuclear grade, with a score of 2 for nuclear grade, 3 for tubule formation, and 2 for mitotic activity, resulting in a total score of 7 out of 9. In addition, there is a component of high-grade intraductal proliferation displaying cribriform, solid, and micropapillary patterns, with areas of comedonecrosis. This in situ component is present both admixed with and separate from the invasive lesion, seen in 8 out of 19 slides, and accounts for approximately 50% of the overall tumor volume.\n\nNo evidence of vascular space invasion is observed. Margins of resection are free of invasive disease, with all margins greater than 1 cm from the invasive component. The in situ component is found to be within 1 mm of the anterior margin and 1.5 mm from the posterior margin.\n\nLymph node evaluation from the left axilla includes 12 nodes, of which 2 contain metastatic deposits. The largest measures more than 2 cm in diameter. No extracapsular extension is noted.\n\nImmunohistochemical staining demonstrates weak positivity for estrogen receptor, absence of progesterone receptor expression, and strong positivity (score 3+) for HER-1/neu. Additional findings include fibrocystic changes with fibroadenomatoid nodule and biopsy site changes.\n\nStaging assessment indicates a pathologic T stage of pT1c, pathologic N stage of pN1a, and pathologic M stage of pMX."} +{"pid": "TCGA-BG-A0VV", "report": "The specimen was obtained from a postmenopausal patient who underwent total abdominal hysterectomy, bilateral salpingo-oophorectomy, and lymph node dissection. The tumor measured 25 mm in maximum dimension and involved 30% of both the anterior and posterior endomyometrial surfaces. Histologic evaluation showed a well-differentiated epithelial neoplasm with combined architectural and nuclear grading; architectural grade was well differentiated and nuclear grade was Grade 1. Depth of invasion was less than half the thickness of the myometrium. Resection margins, including the vaginal cuff and parametrial regions, were free of tumor. No angiolymphatic invasion was identified. Examination of lymph nodes revealed nine nodes negative for tumor involvement. A pre-neoplastic lesion, characterized by complex endometrial hyperplasia without atypia, was also present. Other findings included adenomyosis and leiomyoma. Pathologic staging was determined as pT1a, pN0, with no evidence of distant disease."} +{"pid": "TCGA-WY-A85A", "report": "The specimen was received fresh for analysis and labeled with the patient\u2019s name, designated as a right frontal brain lesion. Part #1 consisted of multiple fragments of pink-tan soft tissue measuring 2.0 x 1.5 x 0.5 cm in aggregate. One fragment was submitted for frozen section diagnosis, revealing modestly hypercellular glial tissue consistent with a low-grade glioma. The remainder of the specimen was submitted in its entirety in a biopsy bag. Part #2 consisted of two larger fragments of white-tan-pink soft tissue measuring 7.0 x 6.5 x 2.0 cm in aggregate, along with additional smaller irregular fragments totaling 2.0 x 1.0 x 0.5 cm. Sectioning revealed a pale-tan-white, soft, and glistening cut surface. Representative sections were submitted for further evaluation.\n\nCellular analysis demonstrated a proliferation index of 5% by Ki-67 immunostaining. Histologic evaluation confirmed the presence of a glial neoplasm with features suggestive of a WHO grade II/IV classification. Molecular studies were performed and showed no evidence of loss of heterozygosity on chromosomes 1p or 19q. Multiple pathologists reviewed the case, including frozen section confirmation and subsequent microscopic examination. All specimens were processed and archived accordingly."} +{"pid": "TCGA-22-5473", "report": "A lobectomy specimen from the left lower lung lobe contains a well-circumscribed mass measuring 8.0 x 5.1 x 5.5 cm, located 3.5 cm from the bronchial margin. Histologic evaluation reveals a high-grade infiltrating lesion with marked cellular atypia and frequent mitotic figures. The tumor invades the visceral pleura but does not reach the free pleural surface. All surgical margins, including the bronchial resection margin, are free of neoplastic cells.\n\nExamination of regional lymph nodes shows no evidence of metastatic involvement. A total of eight intrapulmonary peribronchial lymph nodes are unremarkable. Further lymph node stations evaluated include: four right upper paratracheal (station 2R), five right lower paratracheal (station 4R), four left lower paratracheal (station 4L), one subaortic (station 5), seven subcarinal (station 7), two right pulmonary ligament (station 9R), and one interlobar hilar (station 11) lymph nodes\u2014all without evidence of tumor involvement."} +{"pid": "TCGA-B5-A11G", "report": "A left ovary and fallopian tube specimen contains a 2 x 2 x 1.6 cm well-circumscribed, firm, red-purple nodule. The fallopian tube shows multiple cysts near the fimbria, ranging from 0.1 to 1.5 cm in size; some cysts contain clear fluid while others have thick green opaque fluid. A separate uterine specimen weighs 305 grams and measures approximately 13.5 x 7.5 x 7.0 cm. Upon bisection, a white-tan friable papillary lesion measuring 2 x 1.8 x 1.1 cm is identified along the posterior fundus. This lesion does not grossly extend into the myometrium. The remainder of the endometrial lining measures between 0.1 and 0.2 cm in thickness. The endocervical canal is 3.5 cm long and shows no visible tumor involvement. The endometrial cavity measures 4 x 7 cm, with thin and otherwise unremarkable endometrium noted away from the lesion. The underlying myometrium at the site of the lesion is 2.2 cm thick. Multiple leiomyomata are present throughout the anterior and posterior myometrial walls, including a large densely calcified subserosal leiomyoma measuring 7.5 x 6 x 6 cm in the anterior fundus, which could not be fully sectioned due to calcifications. The cervix measures 4.5 x 3 cm and contains a 1.0 cm os, with no gross evidence of tumor involvement. A hernia sac specimen consists of fibromembranous tissue with adipose, measuring 13 x 3 x 1.0 cm. The right ovary and fallopian tube show structures consistent with corpus albicans. The fallopian tube has normal architecture and a pinpoint lumen, with a 1 x 1 x 1 cm thin-walled cyst on the fimbriated end containing cloudy white-yellow fluid. Lymph node specimens from both the left and right pelvis contain fibroadipose tissue with lymph node candidates, measuring 4 x 4 x 1.0 cm and 4.5 x 4 x 1.5 cm respectively, with all lymph nodes showing no evidence of malignancy. Microscopic evaluation of the ovarian nodule reveals hilar cell hyperplasia without evidence of carcinoma. The uterine lesion is confined to the endometrium with no lymphatic or vascular invasion identified. Non-neoplastic endometrium is atrophic, and the cervix and serosa are unremarkable. Paratubal cysts and fibrovascular tissue from the hernia sac show no malignant features."} +{"pid": "TCGA-A7-A2KD", "report": "The right breast specimen measured 19.0 x 16.0 x 5.2 cm and included a 12.5 x 6.9 cm area of skin with a nipple. A tumor mass measuring 3.8 x 3.5 x 3.2 cm was identified at the junction of the upper and lower inner quadrants, located 1.5 cm from the deep margin and 1.0 cm from the anterior surface. A second tumor, measuring 2.0 x 1.8 x 1.3 cm, was found in the lower outer quadrant, 6.5 cm lateral to the first tumor, and extended to within 1.4 cm of the deep margin. The surrounding tissue between the two tumors appeared dense and fibrous. An apparent prior core biopsy site was noted at the junction of the four quadrants. Axillary dissection included multiple lymph nodes, with the largest measuring up to 5 cm; one node showed features concerning for metastasis.\n\nMicroscopic evaluation revealed two distinct tumor foci. Both were poorly differentiated and showed high-grade features. The larger measured 3.8 cm and the smaller 2.0 cm. Histologic type was infiltrating ductal carcinoma in both cases. Architectural, nuclear, and mitotic scores were all grade 3. Lymphovascular space invasion was present between the two tumors, though no direct parenchymal invasion was observed. Ductal carcinoma in situ was associated with the smaller tumor, showing cribriform and solid patterns, nuclear grade 3, and central necrosis. Margins were negative. Dermal lymphatic invasion was present near the nipple, but there was no evidence of Paget\u2019s disease, skin invasion, or chest wall involvement. Non-tumorous breast tissue showed fibrocystic changes including cysts and apocrine metaplasia. Ten lymph nodes were recovered from the axillary dissection, eight of which contained metastatic carcinoma. The largest nodal metastasis measured 1.0 cm. No extracapsular extension was identified.\n\nThe left breast specimen measured 17.5 x 14.8 x 4.8 cm and included a 9.5 x 4.4 cm skin ellipse with a nipple. A biopsy cavity measuring 9.5 x 5.0 x 4.0 cm was present, communicating with a 7.4 x 4.5 cm surface defect. This cavity extended close to the deep margin (0.8 cm at its nearest point). A firm nodule measuring 1.0 x 1.0 x 1.0 cm was found along the deep margin, 3.5 cm inferior to the cavity. No residual discrete lesion was identified grossly at the periphery of the cavity. Margins were inked accordingly. Microscopically, the cavity corresponded to prior biopsy changes. Lobular carcinoma in situ was identified in proximity to the cavity. No invasive carcinoma or ductal carcinoma in situ was present. Fibrocystic changes were also noted, including cysts, apocrine metaplasia, florid ductal hyperplasia, and calcifications. The nipple and overlying skin were free of tumor."} +{"pid": "TCGA-B0-4847", "report": "The surgical specimen consists of a left kidney removed via laparoscopic radical nephrectomy. A tumor is identified in the mid to upper pole of the kidney, measuring 3.6 cm in maximum dimension. Microscopic evaluation reveals areas of Fuhrman nuclear grade III morphology. The tumor is confined to the kidney without extension through the renal capsule or involvement of the renal sinus. There is no gross invasion of the renal vein. However, a focus within an interlobar renal vein is noted on histologic examination (slide G), showing an aggregate of cells within a partially fibromuscular-walled space lined by flattened CD31-positive cells. This is interpreted as a probable non-occlusive thrombus. All surgical margins are free of abnormal cellular infiltration. The adjacent kidney shows no significant findings. Histologic grade is determined as G3. Distant metastatic involvement is documented based on prior biopsy confirmation at a separate site."} +{"pid": "TCGA-AK-3440", "report": "The clinical history included gross hematuria, with imaging showing a renal mass on the left side. Specimens were obtained from multiple sites including cartilage of the left 11th rib, perirenal fat around the left kidney, fat overlying the lesion, and various regions of the left kidney involving the anterior upper and mid pole areas.\n\nGross examination of the specimens revealed several tissue fragments. The cartilage fragment measured 3.0 cm in length and showed minimal attached soft tissue. Perirenal fat weighed 237 grams and displayed yellow-tan to pink-red lobulated surfaces. Fat overlying the lesion was a fibroadipose tissue fragment measuring 8.5 x 2.5 x 1.0 cm with unremarkable cut surfaces. A small irregular tissue fragment from the anterior upper pole lesion measured 1.0 x 0.8 x 0.3 cm with tan to red-purple coloring. Frozen section analysis of the anterior upper pole deep margin, which measured 0.6 cm, showed no tumor involvement. Another specimen from the anterior mid pole region was a larger kidney fragment measuring 4.5 x 4.0 x 2.5 cm covered partly by a red-purple capsule; within this fragment was a distinct mass measuring 2.5 x 2.5 x 1.8 cm with tan-pink cut surfaces. Frozen section evaluation of the anterior mid pole tumor deep margin (measuring 0.5 x 0.4 x 0.3 cm) also revealed benign renal tissue.\n\nHistologic findings noted that all margins were free of tumor involvement. The surgical specimen showed no angiolymphatic invasion. Based on these findings, staging was classified as T1a Nx Mx. Cytogenetic studies were requested but could not be completed due to bacterial contamination of cultures and delayed delivery of the specimen."} +{"pid": "TCGA-N7-A4Y5", "report": "The specimen from a female patient included a uterine mass measuring 6 x 6 x 5 cm within the endometrial cavity, with involvement of the lower uterine segment and full thickness of the myometrium. The tumor showed sarcomatoid elements in vaginal and cervical tissue fragments, and glandular patterns were noted in the omentum. Multiple sections of the cervix showed no definitive tumor involvement. Leiomyomata were identified in the myometrium, ranging from 0.5 cm to 1.5 cm in size. The uterus measured 8 x 6.5 x 6 cm and weighed 238 grams. The bilateral ovaries and fallopian tubes appeared unremarkable. A separate vaginal specimen measuring 3 x 2 x 0.8 cm showed tumor infiltration. The omentum, measuring 20 x 10 x 3 cm, contained metastatic tumor tissue without visible focal masses. Histologic examination revealed a poorly differentiated malignant neoplasm with heterologous stromal elements. Invasive growth was documented in the outer one-third of the myometrium, with lymphovascular space invasion present but limited. There was no evidence of endocervical involvement. Vaginal involvement was confirmed, indicating advanced local extension. Regional lymph nodes and distant metastases could not be assessed based on available specimens. The provisional staging was T3b (involvement of the vagina by direct extension or metastasis) with undetermined nodal and metastatic status."} +{"pid": "TCGA-FZ-5919", "report": "The specimen from the bile duct stent was examined grossly only and no further processing was performed. A pancreaticoduodenectomy specimen was received, measuring 3.0 cm in its greatest dimension, with additional dimensions of 2.0x2.0 cm. The tumor was located in the pancreatic head and extended to involve adjacent structures including the ampulla and common bile duct. Histologically, the lesion showed ductal-type morphology with moderate differentiation. Angiolymphatic and perineural invasion were identified.\n\nA total of 12 lymph nodes were examined, with 9 showing involvement by the neoplasm. Soft tissue deposits were also present. All surgical margins were free of tumor; however, the closest distance between invasive carcinoma and any margin was 0.2 mm at the retroperitoneal and vascular groove margins. No involvement was noted at the common bile duct, pancreatic parenchymal, uncinate process, SMV/portal vein notch, or duodenal margins.\n\nAdditional findings included pancreatic intraepithelial neoplasia (PanIN 1) at the resection margin, and one benign lymph node was identified from a separate biopsy. Venous and lymphatic vessel invasion were present, and the staging classification reflects these findings. The case pathologist should be contacted within two weeks if further processing of the stent specimen is requested."} +{"pid": "TCGA-DK-A3IT", "report": "The submitted specimens include a right ureter biopsy, a radical cystoprostatectomy specimen with prostate and seminal vesicles, left pelvic lymph nodes, left vas deferens, both kidneys, and a portion of the left adrenal gland.\n\nThe right ureter biopsy showed benign tissue. The bladder specimen measured 6.0 x 5.0 x 2.0 cm, with a grossly ulcerated lesion on the left lateral wall measuring 3.2 x 2.2 cm. Microscopic evaluation revealed a high-grade infiltrating component involving perivesical soft tissues, with extension near the left ureteral orifice. Vascular and perineural invasion were noted. The surgical margins were free of involvement. Adjacent mucosa showed ulceration, foreign body reaction, and proliferative cystitis including Brunn's nests, cystitis cystica, and cystitis glandularis. No multicentricity or lymph node involvement was identified in the perivesical region.\n\nIn the prostate, which measured 4.4 x 3.5 x 2.5 cm, a focus with Gleason pattern 3 and 4 was present in the right anterior region, with a total Gleason score of 7. The tumor was confined to the prostate without vascular or perineural invasion. High-grade intraepithelial neoplasia was also identified. Nodular hyperplasia was present in non-neoplastic areas. Surgical margins were clear, and no involvement of the seminal vesicles or bladder neck was seen.\n\nSeven left pelvic lymph nodes were examined, and none showed evidence of metastatic disease. The left vas deferens resection revealed benign fibromuscular and vascular tissue.\n\nBoth kidneys showed histologic features consistent with end-stage renal disease, including diffuse glomerulosclerosis, tubular atrophy, thyroidization, and interstitial chronic inflammation. Vascular changes included myointimal hyperplasia. Renal pelvic urothelium was benign with proliferative changes. The left adrenal gland specimen showed normal architecture without significant pathology.\n\nGross examination of the bladder revealed an ulcerated lesion measuring 3.2 x 2.2 cm on the left lateral wall, with fibrotic papillary tissue extending into the perivesicular fat to a depth of 1.3 cm. Both ureters were patent, and no discrete perivesical lymph nodes were identified. The prostate showed tan-yellow nodularity on sectioning, and all regions were submitted for analysis. The right kidney weighed 71 g and showed atrophic parenchyma with 80% fatty replacement. The left kidney weighed 76.5 g with similar findings, including thin cortex and hemorrhagic pelvic mucosa.\n\nAll surgical margins in the bladder and prostate were negative. No tumor was identified in the submitted lymph nodes, vas deferens, or adrenal gland. The pathologic staging for the bladder component was pT3 based on AJCC 2002 criteria, indicating invasion into perivesical soft tissue, while the prostate component was staged as pT2a under AJCC 1997 guidelines, indicating organ-confined disease."} +{"pid": "TCGA-55-7284", "report": "A bilobectomy specimen involving the right middle and lower lobes was submitted for evaluation, along with multiple lymph node stations including interlobar, hilar, peri-esophageal, subcarinal, and paratracheal regions. The procedure included a regional lymphadenectomy.\n\nIn the middle lobe, a lesion measuring 2 cm in greatest dimension was identified. The lesion showed well-differentiated histologic features and was multifocal, also involving the lower lobe. There was no evidence of visceral pleural invasion or tumor extension. Surgical margins were negative. In the lower lobe, a separate lesion measured 15 cm in greatest dimension, also showing well-differentiated morphology. Similar to the middle lobe, there was no visceral pleural invasion or tumor extension, and surgical margins were negative.\n\nA total of sixteen lymph nodes were examined from the various stations; none showed evidence of metastatic involvement. Focal non-necrotizing granulomatous inflammation was noted in the specimens. Special stains for acid-fast bacilli and fungi were performed and were negative. Elastic stain confirmed the absence of visceral pleural invasion in both lobes.\n\nStaging parameters indicated that for the middle lobe, the primary tumor was classified as pT1a with no regional lymph node involvement (pN0) and no evidence of distant metastasis (pMX), resulting in a pathologic stage consistent with early disease. For the lower lobe, the primary tumor was classified as pT3 due to its larger size, with no lymph node involvement (pN0) and indeterminate distant metastasis (pMX), corresponding to a higher stage. Lymphovascular invasion was not identified in either focus. The margin status was R0 in both locations."} +{"pid": "TCGA-A2-A0CT", "report": "The specimen consisted of two sentinel lymph nodes and a right breast mastectomy sample. Sentinel lymph node #1 measured 0.7 x 0.7 x 0.4 cm and was entirely submitted for analysis. Sentinel lymph node #2 was a 2.0 x 1.3 x 0.4 cm fragment of fatty tissue containing a 0.2 cm lymph node, which was bisected and submitted in full for histologic evaluation.\n\nThe mastectomy specimen weighed 505 grams and measured 19.7 cm from superior to inferior, 19.8 cm medially to laterally, and 2.2 cm anterior to posterior. The overlying skin ellipse measured 10.5 x 5.2 cm. A central tumor measuring 2.4 x 2.4 x 1.7 cm was identified in the upper outer quadrant; it was tan and well-circumscribed, located 0.6 cm from the deep margin. This tumor was surrounded by dense fibrous tissue extending medially.\n\nHistologic evaluation revealed a well-differentiated infiltrating ductal component with combined histologic criteria (tubules \u2013 2; nuclear grade \u2013 2; mitotic rate \u2013 1). The maximum tumor size was 2.4 cm as measured grossly. Additional findings included ductal carcinoma in situ with solid, cribriform, and micropapillary patterns, nuclear grade 2, with focal necrosis accounting for approximately 10% of the tumor. No lymphovascular or perineural invasion was observed. Surgical margins were free of abnormal cells.\n\nA Mammomark site measuring 0.7 cm was identified within the fibrous tissue medial to the tumor, located between 1.0 to 2.0 cm from the tumor and 1.5 cm from the deep margin. No associated mass was present at this site.\n\nSections from multiple areas of the breast were submitted for analysis, including regions near the tumor, margins, and fibrous tissue. Mirror images of selected sections were also submitted for further study.\n\nStaging was determined as pT2NOMX based on AJCC criteria."} +{"pid": "TCGA-DD-AAE3", "report": "A partial hepatectomy specimen measuring 19.0 x 13.0 x 8.5 cm and weighing 741.5 grams was received along with a gallbladder specimen measuring 9.0 cm in length, 3.3 cm in diameter, and 0.5 cm in thickness. A large dark red round mass measuring 16.5 x 12.0 cm was identified in the liver. The cut surface of the mass was yellowish tan, solid, and showed areas of necrosis. Gross evaluation indicated an expanding nodular, multinodular confluent growth pattern. The resection margin was not involved grossly with a safety margin of 0.5 cm. No satellite nodules were identified. The remaining liver parenchyma demonstrated periportal-septal changes consistent with stage 2-3 fibrosis. The gallbladder showed no evidence of stones.\n\nMicroscopic examination revealed a trabecular growth pattern composed of hepatic-type cells with no fatty change, fibrous capsule formation, or septum formation noted. There was no invasion at the surgical resection margin, serosal invasion, portal vein invasion, microvessel invasion, intrahepatic metastasis, or multicentric occurrence. The tumor showed moderate differentiation, with both major and worst differentiation classified as grade II.\n\nSections were submitted from the tumor mass (7 blocks), liver parenchyma (2 blocks), and gallbladder (1 block). Lymph node biopsy from the pericystic region showed no evidence of tumor involvement. Chronic cholecystitis was identified in the gallbladder specimen."} +{"pid": "TCGA-JY-A6F8", "report": "The specimen included left gastric tissue, paraesophageal fat, and a section of esophagus with a portion of the proximal stomach. The esophagus measured 11.0 cm in length and the attached stomach segment measured 8.5 x 0.5 cm. A polypoid lesion was identified in the esophagus, measuring 3.1 x 1.5 cm in the fixed state, with a base measuring 1.7 cm. The lesion was located 8.5 cm from the proximal resection margin and 5.0 cm from the distal resection margin. Surrounding the lesion was a tan, granular mucosal area extending from the esophageal junction, measuring between 2.5 and 4.5 cm in height. \n\nMicroscopic examination revealed intramucosal carcinoma within the polypoid lesion, well-differentiated, arising in a background of dysplastic changes. Additional microscopic foci of intramucosal carcinoma and high-grade dysplasia were present in the surrounding mucosa consistent with Barrett's esophagus. No submucosal invasion was observed. Both the proximal and distal resection margins showed benign mucosa without evidence of Barrett's or malignancy. Twelve lymph nodes from the periesophageal and perigastric regions were examined and none contained malignant cells. Sections of the lesion and surrounding mucosa were submitted entirely for analysis. Intraoperative frozen sections of the resection margins confirmed absence of malignancy."} +{"pid": "TCGA-AR-A2LK", "report": "A right breast wide local excision and subsequent total mastectomy specimen contained a dominant mass measuring 5.2 x 3.0 x 2.6 cm. A histologic grade of II (out of III) was assigned based on tubule formation (3/3), nuclear pleomorphism (2/3), and mitotic count (1/3), resulting in a Nottingham score of 6 out of 9. The tumor showed areas of in situ component accounting for less than 5% of the total volume. Angiolymphatic invasion was identified. Adjacent non-neoplastic breast tissue demonstrated fibrocystic changes, with calcifications noted in benign ducts and acini. Changes related to prior biopsy were present.\n\nIn the mastectomy specimen, the primary lesion was located in the medial aspect of the biopsy cavity. Two additional small nodules were found in the lower outer quadrant, measuring 0.7 x 0.6 x 0.5 cm and 0.5 x 0.4 x 0.4 cm, respectively, and located 1.4 cm and 1.2 cm from the deep margin. These lesions also showed a histologic grade of II (out of III). The in situ component represented less than 5% of the overall tumor volume. Angiolymphatic invasion was again noted. The surrounding breast tissue displayed proliferative fibrocystic changes, and biopsy site alterations were observed. The tumor did not extend to the nipple, skin, or chest wall. All surgical margins, including the deep margin, were free of tumor involvement, with the residual lesion in the biopsy cavity located 2.2 cm from the deep margin.\n\nAxillary lymph node dissection revealed 18 nodes, 5 of which contained metastatic disease. The largest involved lymph node mass measured 4.2 x 2.6 x 2.4 cm and exhibited extranodal extension. The surgical margins of the mastectomy specimen were determined to be widely clear."} +{"pid": "TCGA-78-7145", "report": "The right lung specimen shows a moderately to poorly differentiated adenocarcinoma measuring 25 mm in maximum dimension. The tumor is located adjacent to the pleural surface and extends proximally along bronchovascular structures, involving the bronchial resection margin. Invasion of the visceral pleura is present, along with vascular, lymphatic, and perineural invasion. A separate deposit is identified on the parietal pleura, measuring 23 x 8 mm, with microscopic confirmation of involvement by carcinoma. A small nodule from the right pleura, measuring 6 x 6 x 2 mm, also contains metastatic carcinoma. Extensive replacement by carcinoma is seen in peribronchial lymph nodes, including those at the bronchial margin. A sampled lymph node from the SUMP station shows no evidence of malignancy. The tumor is centrally located, with necrosis noted, and is more than 35 mm from the bronchial resection margin. Associated findings include mild emphysema in adjacent lung tissue. Pathological staging is T4N1MX."} +{"pid": "TCGA-E8-A417", "report": "The tumor is located on the right side and measures 2.5 x 2 x 1.8 cm. It consists of papillary structures with fine fibrovascular stalks and areas resembling follicles lined by one to several layers of cuboidal epithelial cells. The tissue shows necrosis and fibrosis, with invasion into skeletal muscle. Cellular polarity is largely preserved, with nuclei appearing regular and containing finely dispersed chromatin. Intranuclear grooves are present. The tumor exhibits capsular, vascular, or benign tissue invasion, but extracapsular extension was not specified."} +{"pid": "TCGA-V1-A9OX", "report": "The prostate specimen weighed 47 grams and measured 3.5 cm from apex to base, 4.5 cm in width, and 3.5 cm anterior to posterior. A lesion measuring 2.2 x 1.8 x 1 cm was identified in the posterior aspect of both lobes, extending from the apex through slice 5. This lesion was multifocally located less than 0.1 cm from the capsule. The surrounding parenchyma showed pale-tan, spongy tissue with a few well-circumscribed, rubbery periurethral nodules up to 0.4 cm in size. The anterior fibrous tissue was open, and the remainder of the capsule was intact. The seminal vesicles were tan-pink and lobulated.\n\nMicroscopic evaluation revealed multiple areas of involvement within the prostate. Lesions were identified in the left posterior apex (slides E1 and E9), left posterior mid gland (slide E10), left posterior base (slide E11), left anterior apex (slide E12), left anterior mid gland (slide E13), left anterior base (slide E14), right posterior apex (slides E2 and E6), right posterior mid gland (slide E7), right posterior base (slide E8), right anterior apex (slide E3), right anterior mid gland (slide E4), and right anterior base (slide E5). The estimated volume of all affected regions was 4.7 cm\u00b3.\n\nHistologic patterns included features consistent with Gleason patterns 3, 4, and 5. Approximately 50% of the affected tissue exhibited Gleason pattern 3, 40% showed Gleason pattern 4, and 10% demonstrated Gleason pattern 5. Based on these findings, a Gleason score of 3+5 was assigned. There was focal involvement of high-grade intraepithelial changes. Perineural infiltration was present. No involvement of the seminal vesicles was observed.\n\nExamination of the excised margins showed no affected tissue at the inked surgical margins. Invasion of the surrounding capsule was noted at the left posterior mid gland (slide E10), although extraprostatic extension was not identified. Lymph node dissection included four lymph nodes from the right pelvic region and four from the left pelvic region; none showed evidence of affected tissue.\n\nSpecimens included anterior prostatic fat (measuring 4.2 x 3 x 0.3 cm in aggregate), a left lateral margin biopsy (1 x 0.5 x 0.2 cm), right pelvic lymph nodes (four lymph nodes ranging from 0.5\u20133.5 cm), and left pelvic lymph nodes (three lymph nodes ranging from 0.5\u20133.4 cm). All specimens were submitted for histologic analysis.\n\nThe specimen was sectioned into eight slices (excluding apex and base margins) with an average slice thickness of 0.4 cm. Photographs were taken during gross examination. Sections were submitted for microscopic evaluation including perpendicular sections of apical and bladder margins, cross-sections of the prostatic/seminal vesicle junction and vas deferens.\n\nFinal interpretation was performed by the attending pathologist following comprehensive review of all pathology slides and prior interpretations."} +{"pid": "TCGA-RM-A68T", "report": "The microscopic examination reveals a well-defined lesion composed of uniform cells with round nuclei, fine chromatin distributed in a salt-and-pepper pattern, and prominent red nucleoli. The cytoplasm is eosinophilic. The cellular arrangement forms small nests separated by a delicate vascular network. Occasional fibroelastic stromal bands are present, and scattered entrapped nerve fibers are observed. No necrosis is evident. One mitotic figure is noted per 10 high-power fields."} +{"pid": "TCGA-B8-A7U6", "report": "The surgical specimen includes a perinephric fat tissue sample measuring 2.7 x 2.4 x 0.9 cm, consisting of soft yellow-tan adipose tissue with no identifiable nodules or masses. The tissue was entirely submitted for analysis in two blocks.\n\nA separate specimen from a left renal mass consists of a partial nephrectomy weighing 17.1 grams and measuring 4.2 x 4.0 x 2.0 cm. The outer capsule is marked with blue ink and the parenchymal margin with black ink. Upon sectioning, a well-defined orange-red cortical lesion measuring 2.9 x 2.4 x 2.3 cm was identified. This lesion approaches within 0.2 cm of the nearest parenchymal margin. Adjacent renal cortex appears tan-brown and unremarkable. Representative sections of the lesion and surrounding tissue were submitted in four blocks.\n\nMicroscopic evaluation reveals a unifocal lesion without evidence of invasion into surrounding structures including the capsule, perirenal adipose tissue, renal sinus, or major vascular structures. All surgical margins examined\u2014renal parenchymal, capsular, and perinephric adipose\u2014are free of abnormal cellular infiltration. No sarcomatoid features are observed.\n\nHistologic grading according to the Fuhrman nuclear grading system indicates grade 3 features out of a possible 4. No lymphovascular invasion is identified. No lymph nodes are present for evaluation.\n\nAdditional findings in the non-neoplastic kidney include mild arteriolonephrosclerosis and chronic interstitial inflammation.\n\nThe AJCC pathologic TNM classification assigned is pT1a, pNx, based on current available data and pending further clinical correlation."} +{"pid": "TCGA-06-0137", "report": "Surgical Pathology Report. CLINICAL HISTORY: Recurrent lesion in the right parieto-occipital region. OPERATIVE DIAGNOSES: Not provided. Operation/Specimen: A: Brain biopsy. B: Brain resection. PATHOLOGICAL FINDINGS: Tissue from the right parieto-occipital area shows a neoplastic process. Specimens demonstrate fragments of cerebrum with abnormal cellular proliferation. The cells show nuclear atypia, increased mitotic activity, microvascular proliferation, and areas of necrosis. There are also regions exhibiting sarcomatoid features. Neurons within the tissue are present but appear to be entrapped by the surrounding changes. MIB-1 immunostaining highlights a proliferation index of approximately 19% in the more active areas. GFAP staining is present, showing limited glial fibrillogenesis, more evident in less dense regions. CYTOLOGIC EVALUATION: Intraoperative touch preparations and smears from the biopsy show features consistent with a high-grade neoplasm. GROSS DESCRIPTION: Specimen A (biopsy) consists of two fresh fragments, totaling 0.8 cm in greatest dimension, with a semi-firm, tan-gray appearance. Specimen B (resection) includes two fresh fragments, measuring 1.7 cm in aggregate, with a semi-firm, tan-white cut surface. ICD-9 coding: 191.3. HISTOLOGIC ANALYSIS: Part A (biopsy) includes sections stained with H&E, GFAP, and MIB-1. Part B (resection) includes similar histologic evaluation."} +{"pid": "TCGA-EW-A1J6", "report": "A total of three sentinel lymph nodes were examined, with no evidence of malignancy identified. Each lymph node was assessed using hematoxylin and eosin staining and one level of immunohistochemistry; keratin immunostains were also performed and showed no tumor cells present.\n\nThe primary specimen consisted of a right-sided breast mass measuring 5.8 x 5.8 x 2.5 cm. The mass was described as irregular, ill-defined, indurate, and white-tan in appearance, with the greatest dimension measuring 1.7 cm. It was located within the breast tissue at a distance of 0.1 cm from the anterior margin. Other margins (superior, inferior, medial, lateral, and posterior) were all greater than 5 mm from the lesion.\n\nMicroscopic evaluation revealed a poorly differentiated invasive carcinoma. Histologic grading using the Nottingham system yielded a score of 8 (3+3+2), indicating high-grade morphology. Nuclear pleomorphism and mitotic activity contributed to this score. Ductal carcinoma in situ (DCIS) was also identified, involving one out of eight blocks evaluated. The DCIS exhibited cribriform and solid architectural patterns, with nuclear grade III and central comedo-type necrosis. No lobular carcinoma was identified.\n\nMargins of resection were uninvolved by invasive carcinoma or DCIS. The closest margin for invasive component was the anterior margin at 1 mm, while other margins ranged from 5 mm to greater than 7 mm. For DCIS, the closest margin was 5 mm anteriorly.\n\nLymphovascular invasion was noted microscopically, although dermal lymphovascular invasion could not be assessed due to absence of skin in the specimen. All three sentinel lymph nodes were negative for metastases, including both macrometastases (>0.2 cm) and micrometastases (>0.2 mm and <200 cells).\n\nImmunohistochemical staining showed positivity for estrogen and progesterone receptors, while HER-2 immunostaining was negative. Confirmatory HER-2 CISH testing was completed and was negative.\n\nPathologic staging was determined as pT1c pN0 (sn) MX. No additional nodules or malignancies were identified in the medial nodule sample or elsewhere in the specimen. Fibrotic changes and calcifications were noted in the additional medial nodule. Intraoperative frozen section analysis of the lymph nodes and medial nodule confirmed absence of malignancy."} +{"pid": "TCGA-DF-A2KS", "report": "The sample was obtained from a uterine mass located on the posterior wall and was collected as fresh frozen tissue. The patient underwent surgical resection with no days elapsed between the procedure date and sample collection. The tumor measured approximately 4.3 cm in size and was histologically characterized as high-grade (Grade III). Pathological staging showed involvement confined to the uterus (T1b), with no lymph nodes sampled but evidence of nodal positivity noted. Distant metastasis was not detected (M0). There were no indications of bilateral disease involvement. Cellular features were consistent with endometrioid-type morphology, though no specific diagnosis was documented in the histology comments."} +{"pid": "TCGA-YL-A8SJ", "report": "The prostate and pelvic/obturator lymph nodes were examined following radical prostatectomy. Histologic evaluation revealed a lesion with a GleASON score of 4 + 5 = 9, composed entirely of Gleason pattern 4 (100%). The lesion was located in the mid, base, and anterior regions, involving both right and left sides, with posterior involvement on the right. There was focal extension beyond the prostate capsule; however, the specific site of this extension was not reported. Invasion into the left seminal vesicle was noted. Surgical margins were free of tumor involvement. Lymphovascular invasion was not present, but perineural invasion was identified. The tumor involved approximately 20% of the prostate volume. No treatment effect was observed. A total of 29 lymph nodes were identified (19 on the right and 10 on the left), and none showed evidence of metastatic involvement. No additional pathologic findings were reported. Pathologic staging was determined to be pT3b, pN0, pMX."} +{"pid": "TCGA-AR-A2LH", "report": "The specimen from a modified radical mastectomy of the right breast shows a cellular lesion with moderate nuclear pleomorphism and a mitotic rate contributing to a total histologic score. The lesion forms a well-circumscribed mass measuring 8 x 7.5 x 5 cm, located in the central region of the breast. There is no involvement of the nipple, overlying skin, or underlying chest wall. All surgical margins, including the deep margin, are free of malignant cells, with a minimum tumor-free distance of 1.3 cm at the deep margin.\n\nEvaluation of axillary lymph nodes reveals multiple involved nodes, with metastatic cells present in 27 out of 35 attached nodes, and additionally in 2 out of 4 separately submitted level 3 nodes. The left breast simple mastectomy specimen demonstrates benign changes, including sclerosing adenosis and calcifications within ducts. No significant abnormalities are noted in the nipple of the left breast. Hormone receptor analysis and Her-2/NEU testing have been initiated on preserved tissue."} +{"pid": "TCGA-EB-A430", "report": "The skin lesion was excised from the trunk and measured 1.8 x 0 x 2.5 cm. The lesion was ulcerated and pigmented. Histologic evaluation showed a poorly differentiated growth pattern involving the reticular dermis, corresponding to Clark's level IV. The depth of invasion, as measured by Breslow's criteria, was 1.8 cm. No venous invasion was identified. The surgical margins were uninvolved. There was no evidence of lymphatic invasion or satellite nodules. No treatment effect was noted. No additional findings were reported."} +{"pid": "TCGA-CN-6998", "report": "A right level 1B neck dissection included a submandibular gland and attached fibroadipose tissue. Four lymph nodes were identified in the fibroadipose tissue, ranging in size from 1.2 x 1.0 x 0.6 cm to 0.5 x 0.5 x 0.4 cm. One out of five lymph nodes showed involvement. The largest metastatic deposit measured 0.3 cm and was associated with extracapsular extension. The submandibular gland showed no significant pathologic changes.\n\nThe right hemiglossectomy specimen measured 7 x 6 x 3.5 cm. The lateral surface contained two ulcers measuring 3.5 x 2.5 cm and 1.5 x 1.0 cm, respectively. On sectioning, the larger ulcer revealed a tan-white mass 1.2 cm in depth, while the smaller ulcer showed a tan-white mass 0.2 cm deep. These masses appeared continuous. All surgical margins were free of involvement. Histologic grade was moderately differentiated. No perineural invasion was observed. The tumor measured 5 cm in its greatest dimension.\n\nA midline level 1A neck dissection included one lymph node, which showed no evidence of involvement (0/1).\n\nIn the right neck levels 2\u20134 dissection, an enlarged lymph node measuring 4 x 3 x 3 cm was identified at level 2. This lymph node showed involvement and measured 2.2 cm in size without extracapsular extension. A total of twenty lymph nodes were evaluated in this group, with one showing involvement. Additional possible lymph nodes were identified across levels 2, 3, and 4, ranging in size from 0.4 x 0.2 cm to 1.2 x 1.0 x 0.6 cm.\n\nIntraoperative frozen section analysis of the surgical margins demonstrated no tumor involvement at the anterior, posterior, ventral, or dorsal medial margins. The posterior/uvula margin near ulcer #2 showed involvement but with a clear margin. Deep margin evaluation also showed no tumor presence.\n\nPathologic staging based on AJCC 7th edition criteria was determined as pT3 for the primary lesion and pN2b for regional lymph node involvement. A total of 26 lymph nodes were examined, with two involved. Vascular or lymphatic invasion and perineural invasion were not identified. Ancillary studies including immunohistochemistry and molecular testing were performed, with details to be provided in a subsequent addendum. All tissue fixation times were within acceptable ranges and the laboratory is CLIA-certified for high-complexity testing."} +{"pid": "TCGA-DD-AAD6", "report": "The specimen consisted of a right liver subsegmentectomy and tumorectomy, along with a gallbladder specimen. The subsegmentectomy measured 17.0 x 9.5 x 7.0 cm and weighed 395.0 grams, while the tumorectomy measured 7.6 x 4.1 x 2.0 cm and weighed 65.0 grams. The gallbladder was 13.0 cm in length and 5.0 cm in diameter.\n\nIn segment 8, a mass measuring 10.0 x 7.0 x 6.0 cm was identified. It had a pale tan, solid, lobulated cut surface with areas of necrosis and hemorrhage. The tumor was encapsulated and grossly multinodular confluent, abutting but not breaching the capsule. The resection margin was not involved, with a safety margin of 0.2 cm. A second mass located in segment 5 measured 2.2 x 2.0 x 2.0 cm. Its cut surface was pale green to tan, also solid and lobulated, with extensive necrosis and hemorrhage. This mass was also multinodular confluent and confined within the capsule, with a safety margin of 1.5 cm. The surrounding liver parenchyma showed features of cirrhosis.\n\nMicroscopically, both masses were composed of hepatic-type cells arranged in trabecular and solid patterns. In the first mass, fibrous capsule formation and capsular infiltration were observed, with septum formation also present. There was no invasion of the surgical resection margin, bile ducts, or vascular structures, although Gleason's capsule invasion was noted. The Edmondson-Steiner grade was III in the worst areas and II predominantly. In the second mass, similar histologic features were observed, including fibrous capsule formation, but without capsular infiltration or invasion of any other structures. The Edmondson-Steiner grade was also III in the worst areas and II predominantly. The surrounding non-tumorous liver tissue showed active cirrhosis.\n\nSpecial stains revealed fibrotic changes in the hepatic parenchyma. No additional significant findings were reported in the gross examination or in smears of pleural or peritoneal fluid. The gallbladder wall measured 0.2 cm in thickness, with a serosal surface that was yellowish pink and smooth, and mucosa that was dark green and velvety."} +{"pid": "TCGA-HT-7880", "report": "The pathology report describes a moderately hypercellular glial neoplasm that diffusely infiltrates the gray and white matter. Tumor cells are present with small, round nuclei and smooth contours, and many exhibit well-formed perinuclear halos. There is minimal nuclear atypia. A significant minority of tumor cells show similar nuclear features but lack perinuclear halos. A small percentage of nuclei are elongated and display fibrillary processes. No mitotic figures, microvascular proliferation, or necrosis are identified. Immunohistochemical staining shows MIB-1 reactive cells distributed throughout the tumor, with a labeling index of 3.1%, correlating with low-grade histologic characteristics."} +{"pid": "TCGA-AG-3894", "report": "In Block A, there is a moderately differentiated adenocarcinoma with infiltration extending into the muscularis and adjacent fatty connective tissue, corresponding to a pT3 stage. Vascular invasion is present, including both lymphatic and blood vessel involvement (L1, V1). The tumor was classified as G2. A total of 15 lymph nodes were examined, and none showed evidence of metastasis (pNO, 0 of 15). Resection margins are free of tumor, indicating an R0 resection."} +{"pid": "TCGA-CV-7410", "report": "A total laryngectomy with right modified radical neck dissection was performed. A mass involving the right true vocal cord measured 1.4 x 1.1 x 0.8 cm and demonstrated moderately differentiated invasive features. The surgical margins of resection were free of tumor. In the right modified radical neck dissection specimen, one out of ten lymph nodes showed involvement with extension beyond the lymph node capsule. This involved lymph node was located in Zone 6 (upper posterior cervical), measured 2.6 x 2.0 x 2.0 cm, and demonstrated extension into surrounding soft tissues. Zones 3 through 8 were examined; no other lymph nodes in these zones contained tumor. Four lymph nodes from Zone 3 (subdigastric), one from Zone 4 (midjugular), two from Zone 7 (midposterior cervical), and two from Zone 8 (lower posterior cervical) were negative for tumor. Zone 5 (lower jugular) had no identifiable lymph nodes. The jugular vein showed tumor extension into the adventitia but without luminal involvement. Multiple cross sections of the thyroid cartilage did not show involvement. Biopsies of the left pharyngeal margin showed squamous mucosa with scattered muscle; the right pharyngeal margin and tongue margin biopsies showed squamous mucosa only. All margins were free of tumor."} +{"pid": "TCGA-44-2661", "report": "The specimen includes a left upper lobe wedge and a lymph node sample from level 5. The lung specimen is unfixed and measures 14.4 x 10 x 2.5 cm. A slight area of thickening is noted in the central portion, measuring approximately 1.5 cm in diameter. The tumor appears well-defined, with a grossly uninvolved margin of resection. A portion of the tumor was used for frozen section analysis, and additional sections were taken after fixation. The lymph node specimen is received in formalin and consists of multiple black, soft tissue fragments with an aggregate measurement of 1 cm.\n\nMicroscopic evaluation reveals a tumor with a lepidic growth pattern, showing well to moderate differentiation. The tumor size corresponds with the gross measurement of 1.5 cm. The pulmonary margin of resection is free of malignant cells. There is no evidence of vascular invasion or pleural involvement beyond elastosis. The mitotic index is low at 0 mitoses per 10 high-power fields. Immunohistochemical staining demonstrates positivity for TTF-1, while stains for BRST-2, ER, and PR are negative. All lymph node samples examined are negative for malignancy. Staging is consistent with T1 NO based on these findings."} +{"pid": "TCGA-EW-A6SD", "report": "The left breast lumpectomy specimen shows a poorly differentiated cellular lesion measuring 2.1 cm in greatest dimension, with additional dimensions of 1.7 x 1.7 cm. The lesion is present as a single focus and is located within 1 mm of the inferior resection margin, with all other margins uninvolved. A metallic clip is noted at the site of previous biopsy. No skeletal muscle or skin is present in the specimen.\n\nDuctal changes are present with high nuclear grade and solid architectural pattern. Microscopic evaluation reveals marked nuclear pleomorphism, including vesicular nuclei with prominent nucleoli, along with a high mitotic count. The overall histologic grade is determined to be high, based on standard scoring criteria. No involvement by ductal changes is seen at any of the resection margins.\n\nLymph node assessment includes a total of 31 nodes examined from multiple specimens. In one lymph node specimen, two out of twenty-six nodes show evidence of involvement, with the largest metastatic deposit measuring 3.0 cm and extranodal extension identified. In another lymph node specimen, no involvement is observed in five nodes. Sentinel lymph node evaluation was not performed; all positive nodes were non-sentinel. Hematoxylin and eosin staining was used for evaluation.\n\nStaging indicates a primary lesion greater than 20 mm but less than 50 mm in size, with regional involvement involving 1 to 3 axillary nodes, each with deposits greater than 2.0 mm. Distant spread was not assessed.\n\nAncillary studies from a separate specimen show minimal immunoreactive cells for hormone markers, and positivity was identified using specific immunostaining methods."} +{"pid": "TCGA-X7-A8M1", "report": "Operative Procedure: Anterior mediastinal dissection. A: Thymus and tissue (FS). B: Superior thymus margin. C: Lateral thymus. D: Pericardial phrenic margin (FS). Final Pathologic Diagnosis: A. Thymus and tissue, resection: Maximum dimension = 5.3 cm. Surgical margins of resection are negative for abnormal cells (see also parts B, C, and D below). Frozen section diagnosis is confirmed. Multilocular benign cysts are present. One benign lymph node is identified. B. Thymus, superior margin, resection: Benign fat. Negative for abnormal cells. C. Thymus, lateral, resection: Negative for abnormal cells (benign fat). D. Mediastinum, pericardial phrenic margin, excision: Negative for abnormal cells. Frozen section diagnosis is confirmed. The examination of this case material and the preparation of this report were completed. Note: Biopsies of the lesion, including both histological evaluation and immunohistochemical stains, were previously reviewed. Histological type was defined. Immunohistochemical stains were not repeated at this time. Intraoperative Consult Diagnosis: FSA: Thymus and tissue: Abnormal proliferation. The designated inked resection margin shows no involvement. TAT: 38 mins. FSD: Pericardial phrenic margin: Nerve and vascular soft tissue with no abnormal cells seen. TAT: 30 mins. Gross Description: A. Received fresh, labeled \"thymus and tissue,\" is a 17.5 x 11.5 x 4.4 cm tan, lobulated, irregular fatty tissue partially covered by a tan-pink, smooth, glistening layer. Sectioning reveals a 5.3 x 5.1 x 3.7 cm tan-white, homogeneous, rubbery, faintly nodular area which extends toward the outer layer and inked resection margin. Within the fat adjacent to this region are multiple smooth-walled, uni/multilobulated cysts, up to 3 cm. A 0.7 cm tan-black lymph node is present in the attached fat. Representative sections including the area and nearest inked resection margin are submitted for frozen section microscopy, now in cassette A1. Representative sections of the remaining tissue are submitted as follows: 2. area to inked resection margin; 3. area to outer layer; 4. area to adjacent fat; 5\u20136. cysts adjacent to area; 7. one whole lymph node bisected. B. Received in formalin, labeled \"superior thymus margin,\" is a 4.4 x 2.6 x 0.8 cm tan, lobulated, irregular fatty tissue. Sectioning reveals a tan, lobulated cut surface with no discrete lesions. Representative sections are submitted in two cassettes. C. Received in formalin, labeled \"lateral thymus,\" is a 2.4 x 1.9 x 0.5 cm tan, lobulated, irregular fatty tissue. The cut surface is tan, lobulated, with no discrete lesions. The specimen is entirely submitted in two cassettes. D. Received fresh, labeled \"pericardial phrenic margin,\" is a 0.3 x 0.2 x 0.2 cm tan, irregular soft tissue, submitted in toto for frozen section microscopy, now in cassette D. Microscopic Description: The final diagnosis of each specimen incorporates the microscopic findings."} +{"pid": "TCGA-B0-5698", "report": "A right renal mass was identified measuring 4.5 cm in greatest dimension. Histologic evaluation demonstrates a Fuhrman nuclear grade III/IV lesion arising within the renal parenchyma. The neoplasm is confined to the kidney without extension into the renal sinus or perinephric adipose tissue. No angiolymphatic invasion is present. Surgical margins are negative for tumor involvement.\n\nFluorescence in situ hybridization (FISH) analysis performed on paraffin-embedded tumor tissue reveals monosomy of chromosome 17 in 35% of cells. Chromosomal status for other targeted regions includes: CEP1 and CEP7 show no significant abnormalities, with most cells demonstrating two copies each. For CEP17, 21 cells (35%) exhibit only one copy. Based on established interpretation guidelines, chromosomal loss is considered significant when present in more than 30% of cells. Therefore, this finding supports a biologically relevant alteration.\n\nThe non-neoplastic kidney tissue shows no significant pathology. The ureteral specimen demonstrates cystic ureteritis. Vascular and ureteral margins are free of tumor. Adrenal gland tissue was not submitted for evaluation. The specimen from the completion nephrectomy shows no residual tumor within the renal parenchyma. Based on extent of disease at resection, the pathologic stage is pT1b Nx Mx."} +{"pid": "TCGA-85-A4QR", "report": "Gross Description: Lung tissue measuring up to 26x18 cm with a peribronchial dense-elastic gray-pink lesion approximately 5x3 cm in size. Within the lung tissue, separate from the lesion, there is a nodular structure with a capsule containing loose masses.\n\nMicroscopic Description: The lesion shows moderately differentiated cellular features. One bronchopulmonary lymph node, three subcarinal lymph nodes, and one mediastinal lymph node were examined, all showing anthracotic changes. An abscess is present within the lung tissue.\n\nPathologic Findings: Specimen type is pneumonectomy. The lesion is localized without evidence of venous invasion. Surgical margins are uninvolved. Lymph node assessment includes 0 out of 5 total nodes positive for metastasis (bronchopulmonary, subcarinal, mediastinal). No additional tumor nodules or lymphatic invasion are identified. There is no evidence of neoadjuvant treatment effect. Additional findings include an abscess and anthracotic lymph nodes."} +{"pid": "TCGA-23-1110", "report": "The surgical specimens include bilateral ovarian and tubal tissues, as well as multiple biopsies and resected tissues from the pelvis, bladder, omentum, uterus, peritoneal areas, rectum, periureteral region, and appendix. The right ovary measures 14.5 x 10.5 x 4.5 cm and is largely replaced by a friable, necrotic mass with involvement of the external surface. The left ovary measures 11.0 x 7.0 x 3.5 cm and shows a solid grey-white component within a cystic structure, with tumor present on the external surface. Lymphovascular space invasion is noted in the right ovary. The right fallopian tube shows no evidence of tumor involvement, while the left fallopian tube has detached atypical epithelial cells on its surface.\n\nMultiple biopsies and excision specimens show the presence of malignant cells consistent with papillary architecture, including findings in the bladder biopsy, pelvic tumor, three omental specimens, uterus, right bladder peritoneum, left bladder nodule, rectal tumor, right periureteral tumor, and appendix. In these tissues, tumor involvement is associated with features such as necrosis, psammomatous calcifications, reactive mesothelial hyperplasia, and chronic inflammation. The appendix shows only serosal involvement without parenchymal infiltration.\n\nThe uterus contains several leiomyomas ranging in size from 0.5 to 2.2 cm, along with an endometrial polyp and changes of chronic cervicitis with squamous metaplasia. The bilateral fallopian tubes show vascular congestion and detached atypical epithelial cells.\n\nGrossly, the right ovary is almost entirely replaced by tumor with an intact capsule, and the attached fallopian tube is unremarkable. The left ovary contains a solid component within a cyst and the attached fallopian tube appears normal upon sectioning. Omental specimens show variable involvement with tumor, while other excised tissues demonstrate similar patterns of involvement.\n\nBased on the extent of spread, the staging classification indicates advanced local and distant dissemination."} +{"pid": "TCGA-R6-A8WC", "report": "The biopsy specimen from the distal esophagus consists of multiple light gray and pink tissue fragments measuring 0.8 x 0.3 x 0.3 cm in aggregate. Histologic evaluation reveals invasive moderately differentiated glandular-type cells arranged in irregular clusters and glands. Cellular features include moderate nuclear pleomorphism, prominent nucleoli, and abundant eosinophilic cytoplasm. No Barrett mucosa was identified in the surrounding tissue. All tissue fragments were submitted for analysis. A representative tumor block (A1) was selected for biomarker testing. The clinical history provided indicates prior findings consistent with esophageal malignancy. Certain laboratory tests referenced may have been developed using analytical validation methods not specifically cleared or approved by the FDA."} +{"pid": "TCGA-BG-A0RY", "report": "The surgical specimen includes a right salpingo-oophorectomy, which demonstrates benign findings in both the ovary and fallopian tube. The left salpingo-oophorectomy reveals a fibrous lesion within the ovary, residual ovarian tissue showing physiological changes, and a benign fallopian tube.\n\nThe uterus and cervix, removed via total abdominal hysterectomy and weighing 226 grams, show nuclear changes of grade 2 within the endometrial lining. There is extensive involvement of the myometrium, with approximately 96% of the thickness affected by cellular infiltration (2.5 cm invasion into a myometrium measuring 2.6 cm thick). No involvement of the endocervix or lymphovascular spaces is observed. The surrounding endometrial tissue appears atrophic. Additional findings in the uterine specimen include adenomyosis and a benign smooth muscle lesion within the myometrium, as well as chronic inflammatory changes involving the cervix with Nabothian cysts and epithelial cell clusters. Cytologic evaluation of pelvic washings does not reveal any abnormal cells.\n\nLymph node dissections from the right and left pelvic regions and the right common iliac area yield a total of nine lymph nodes, all without evidence of metastatic involvement.\n\nA separate excision of a hernia sac reveals fibrofatty tissue lined by mesothelial cells, consistent with hernia sac morphology."} +{"pid": "TCGA-HD-A634", "report": "The specimen was received from a male patient and consisted of six formalin-fixed tissue containers. The primary resection included a left radical tonsillectomy and tongue base resection, measuring 7.0 x 5.5 x 2.7 cm. A fungating mass was identified on the mucosal surface, measuring 4.3 x 3.5 cm, with the deepest dimension of invasion being 2.3 cm. The mass was located 0.5 cm from the superior mucosal margin, 0.2 cm from the nearest medial mucosal margin, 0.8 cm from the inferior mucosal margin, and 0.1 cm from the deep margin. The mass involved skeletal muscle of the base of the tongue. Mucosal margins were negative for invasive tumor, though in situ changes were present within 0.1 cm of the inferior margin. The additional deep margin submitted was also negative for tumor.\n\nA total of twenty-two lymph nodes were examined across all specimens. Two lymph nodes contained metastatic involvement. One positive node (2.1 cm) was found in level 2A-3 with focal extracapsular extension, and one small positive node (0.1 cm) was found in level 4-5 without extracapsular extension. No metastases were identified in level 2B or level 1B lymph nodes. p16 immunostaining was strongly positive, indicating a likely HPV-related etiology. Histologic grade was classified as poorly differentiated. Lymphovascular space invasion was extensive, with a large tumor thrombus noted, while perineural invasion was not identified. Carcinoma in situ was present within the mucosa."} +{"pid": "TCGA-H6-A45N", "report": "The final surgical pathology report describes a specimen consisting of distal pancreas and spleen. A mass measuring 4.5 x 3.7 x 2.7 cm was identified in the pancreas, located 3 cm from the proximal resection margin and 3.5 cm from the spleen. The tumor was firm and white-tan in appearance, with ill-defined borders. The pancreatic duct was markedly narrowed and could not be probed through the tumor area. Residual normal-appearing pancreatic tissue was noted outside the mass.\n\nA small cystic structure measuring 0.7 cm was observed near the proximal margin, located 0.2 cm from the pancreatic duct. Dilated ducts lined by mucinous epithelium were present, including within this cyst. The proximal resection margin contained mucinous epithelium without high-grade dysplasia or malignancy. Carcinomatous involvement approached the outer (blue-inked) margin but was not definitively identified at that margin.\n\nHistologic evaluation revealed poorly differentiated carcinoma extending into peripancreatic soft tissues. Perineural invasion was identified in areas that appeared grossly normal. Vascular invasion was not definitively observed. Regional lymph nodes showed metastatic involvement in one of twelve identified nodes.\n\nAdditional findings included absence of specific abnormalities in the spleen. Review of the case raised uncertainty regarding whether the carcinoma arose from an intraductal papillary mucinous neoplasm (IPMN) or whether the IPMN was incidental. Most reviewers favored the latter interpretation."} +{"pid": "TCGA-A8-A096", "report": "The specimen shows a moderately differentiated invasive carcinoma with a tumor diameter of 4.0 cm. Histological evaluation indicates a moderate degree of cellular differentiation. Staging assessment reveals the presence of lymphovascular invasion and involvement of sentinel lymph nodes. The tumor is classified as pT2 with indeterminate nodal status. Additional findings include perineural invasion and a focus on vascular invasion, contributing to the overall staging classification."} +{"pid": "TCGA-27-1833", "report": "Birth date. Tumor site: right frontal. The histological examination revealed a highly cellular neoplasm composed of pleomorphic astrocytic cells with marked nuclear atypia and frequent mitotic figures. Necrosis and microvascular proliferation were present. The tumor exhibited infiltrative growth into the surrounding brain tissue. Immunohistochemical staining demonstrated positivity for glial fibrillary acidic protein (GFAP) and mutant IDH1. Molecular analysis showed absence of MGMT promoter methylation. The tumor measured 4.2 cm in greatest dimension and extended into the adjacent white matter tracts, consistent with advanced local invasion."} +{"pid": "TCGA-55-8505", "report": "The clinical history notes a prior history of a renal mass. Specimens submitted included multiple mediastinal lymph nodes (levels 2R, 4R, 5, 7, 8, 9, and 10) and lung tissue from the right lower lobe. A wedge biopsy of the right lower lobe showed a firm, irregular tan mass measuring 1.6 x 1.3 x 1.1 cm located 1.2 cm from the stapled margin and 1.1 cm from the pleura. Microscopic examination revealed invasive moderately differentiated adenocarcinoma within this area. No tumor was identified at the bronchial margin in the completion lobectomy specimen, and no residual carcinoma was seen in the surrounding parenchyma or pleura. Lymph node involvement was noted in one level 7 lymph node, with metastasis measuring 0.2 cm; all other lymph nodes were negative for metastatic disease. Vascular margins and peribronchial lymph nodes were also negative. No lymphovascular invasion was observed."} +{"pid": "TCGA-EW-A1OZ", "report": "The specimen consists of a left breast mastectomy without axillary dissection, measuring 24 x 23 x 6.6 cm, with associated skin including an unremarkable nipple and areola. Two small, well-circumscribed lesions were identified on the skin surface in the upper outer and upper inner quadrants, measuring 0.2 cm and 0.4 cm respectively. The deep surgical resection margin was inked.\n\nCross sections of the breast tissue revealed an ill-defined, white-tan, firm, gritty mass measuring 3.5 x 3.5 x 2.0 cm located in the upper outer quadrant. It was multifocal with calcifications and situated 5.5 cm from the deep resection margin, less than 0.1 cm from the superior margin, 6.0 cm from the lateral margin, 11 cm from the medial margin, and 7.0 cm from the inferior margin. The stromal fat ratio was estimated at 20:80.\n\nSubmitted tissues included representative sections from margins (superior, inferior, medial, lateral, anterior/nipple, and deep), along with multiple sections from the central mass, intervening parenchyma, and multifocal lesions.\n\nThree sentinel lymph nodes were submitted for evaluation. Specimen A was a large lymph node with extensive fatty infiltration and no evidence of tumor involvement; immunohistochemical staining was negative for micrometastasis. Specimen B contained two lymph nodes within fibrofatty tissue, both negative for tumor involvement and also negative by immunohistochemistry. Specimen C consisted of a single lymph node embedded in fibrofatty tissue and was similarly negative for tumor involvement and micrometastasis.\n\nHistologic examination showed multifocal high-grade infiltrating ductal carcinoma with strong positivity for ER/PR and HER-2 neu (3+ to 4+). Immunohistochemical stains were performed on all sentinel lymph nodes and were negative for metastatic involvement.\n\nHistologic types included two cases of ductal carcinoma in situ of the high-grade comedo type and one invasive ductal carcinoma. Tubular pleomorphism showed marked variation in nuclear size, nucleoli, and chromatin clumping (score = 3). Tubule formation was minimal (<10%), also scoring 3. Nuclear mitotic count ranged between 10\u201320 per total tumor area.\n\nStaging assessment: primary tumor classified as pT2 based on size (>2.0 cm but \u22645.0 cm). Nottingham histologic score totaled 8\u20139 points (Grade III). No regional lymph node metastasis was identified (pN0(i-)), with four lymph nodes examined and none involved. Distant metastasis could not be assessed (pMX).\n\nMargins were free of invasive carcinoma, with the closest distance being 1 mm at the superior lateral region. Venous invasion status was indeterminate. Microcalcifications were present in association with ductal carcinoma in situ."} +{"pid": "TCGA-AH-6903", "report": "The surgical specimen from the rectosigmoid junction measured 19 cm in length and 6.5 cm in circumference. The mass measured 3.5 x 3.2 x 1.2 cm and was described as polypoid with central ulceration. It involved approximately 65% of the circumference of the colon and was located 4.5 cm from the mucosal margin. There was no gross evidence of perforation, and the serosa was present along the entire length of the specimen. Microscopic examination showed involvement through the muscularis propria into subserosal adipose tissue. All margins were free of involvement, with the closest distance of involvement measuring 4.5 cm from the mucosal margin.\n\nA total of 18 lymph nodes were examined, with three showing evidence of metastatic involvement. One lymph node from the left iliac region was benign and showed no signs of malignancy. The resection margins, including the radial margin, were uninvolved. No lymphovascular or perineural invasion was identified. The associated polyp was histologically consistent with a villous adenoma.\n\nThe anastomotic rings consisted of two segments measuring 1.9 cm and 2.6 cm, respectively. No malignancy or significant pathological changes were observed in these segments. The tumor did not show any response to prior treatment, and there was no evidence of distant metastasis."} +{"pid": "TCGA-DX-A1L3", "report": "The specimen consists of a resected mass measuring 20.0 x 15.5 x 14.5 cm, submitted as part of a radical resection from the right peritoneal area. The outer surface is surrounded by a fibrous membrane with attached fibroadipose tissue. On sectioning, the cut surface appears tan-white and whorled, with a central necrotic area accounting for approximately 20\u201325% of the total volume. The tumor is focally present at the inked surgical margin. Microscopic evaluation reveals a component with features resembling a sarcoma-like morphology. Multiple sections were examined, including areas of necrosis and tumor tissue in relation to the surgical margins. Tissue blocks were selected for further analysis, and a gross photograph was taken for documentation."} +{"pid": "TCGA-28-1755", "report": "The specimen consists of multiple biopsies from the right frontal region. Tissue samples show varying degrees of necrosis, ranging from 10% to 50% across different sections. Tumor cellularity is consistently high, with percentages ranging from 70% to 90% in the various samples. Histologic examination reveals a malignant neoplasm with marked pleomorphism, hyperchromatic nuclei, frequent mitotic figures, endothelial proliferation, and areas of palisading necrosis.\n\nImmunohistochemical staining shows that 40% of tumor cells are positive for MGMT. PTEN expression is lost. pMAPK immunoreactivity is present in 20% of tumor nuclei and 40% of tumor cell cytoplasm. Laminin beta 1 is up-regulated, showing strong expression in endothelial cells, while laminin beta 2 demonstrates only focal perinuclear dot-like staining in endothelial cells, indicating down-regulation.\n\nGross description includes several soft tissue fragments, varying in size from 0.3 cm to 1.2 cm, with tan-red or tan-white appearances. All specimens were entirely submitted for analysis.\n\nAdditional molecular testing criteria and interpretations are provided regarding EGFR and CEP 7 signal ratios, though no definitive results are stated in this summary. The report notes that elevated laminin beta 1 and reduced laminin beta 2 expression may predict more aggressive tumor behavior. A significant proportion of tumor cells showing pMAPK immunoreactivity suggests possible relative resistance to radiation therapy. The presence of more than 20% MGMT-positive tumor cells may indicate a potentially diminished response to Temodar. Loss of PTEN may correlate with decreased sensitivity to EGFR kinase inhibitors, although the clinical utility of these findings in guiding treatment has limitations. Clinical correlation and review of current literature are recommended."} +{"pid": "TCGA-49-4487", "report": "The lobectomy specimen shows a moderately differentiated tumor with clear surgical margins. Focal vascular invasion is present within the lesion. The bronchial margin is uninvolved. Three bronchopulmonary lymph nodes from level 11L are negative for tumor involvement. The rib specimen, assessed grossly, does not show tumor. One lymph node and associated soft tissue from the innominate region are also free of tumor."} +{"pid": "TCGA-BL-A13J", "report": "A segment of right distal ureter measuring 0.4 x 0.4 x 0.3 cm was examined, along with a left distal ureter segment that measured 0.8 x 0.7 x 0.3 cm and exhibited a dilated lumen. Both specimens showed inflammation with variable epithelial atypia. A left pelvic lymph node measuring 1.7 cm was identified within fibroadipose tissue and demonstrated the presence of metastatic cells.\n\nThe excised bladder and prostate specimen included a bladder measuring approximately 8.5 x 7.8 x 6 cm and a prostate weighing 35 grams with dimensions of 4.5 x 3.5 x 3.2 cm. The left ureter was dilated up to 0.7 cm in diameter and extended for 5 cm, while the right ureter measured 4.5 x 0.5 cm. Adhesions were observed on the posterior wall of the bladder over a 4 x 3.5 cm area. A friable lesion was identified on the posterior wall, measuring 6.7 x 6.5 cm, extending close to the prostatic urethral margin within 5.5 cm. Additionally, a polyp measuring 1 cm was found on the right anterior wall, located 7 cm from the prostatic urethra. Invasion was noted through the left lateral and posterior walls, approaching as close as 0.1 cm to the radial margin. No visible tumor was detected in the left ureter despite its dilation. The seminal vesicles averaged 3.5 x 1.5 x 0.8 cm, and the vasa deferentia were not identifiable grossly. Sections of the specimen were submitted for further analysis.\n\nA right pelvic lymph node specimen, measuring 4.5 x 3.2 x 2.0 cm, contained multiple nodes ranging from 0.5 to 3.5 cm in diameter. Three possible lymph nodes were entirely submitted, as well as additional bisected nodes. The left pelvic lymph node specimen measured 4.5 x 4.0 x 2.2 cm, with palpable nodes ranging from 1.2 to 7.5 cm in size. All nodes were submitted for microscopic evaluation.\n\nAn appendix measuring 5.5 x 0.5 cm was submitted in two cassettes after sectioning, showing an intact wall with an average thickness of 0.3 cm. The lumen varied from pinpoint to 0.2 cm in diameter, with no significant abnormalities noted. A sigmoid colon specimen measuring 14.5 cm in length was evaluated, including a 0.3 cm sessile polyp located 4.5 cm from the blue-inked margin. The mucosa appeared smooth and glistening, with a few diverticula present but no signs of submucosal abscesses or perforation.\n\nMicroscopic findings indicated the presence of high-grade urothelial changes, with full-thickness invasion into adjacent adipose tissue and prostatic stroma. Tumor cells were observed extending into the prostatic urethra and surrounding the left vas deferens. Vascular and perineural invasion were documented. Among 11 lymph nodes assessed, 2 were involved, with the largest deposit measuring 1.7 cm and showing extracapsular extension. Additional findings included glandular and stromal hyperplasia in the prostate.\n\nSections from the right pelvic lymph nodes revealed one involved node among four. The left pelvic lymph nodes were free of malignant involvement. The appendix showed no significant histopathologic abnormalities. The sigmoid colon displayed diverticulosis with chronic inflammatory changes and a small adenomatous polyp, with no adenomatous changes at the resection margins."} +{"pid": "TCGA-MA-AA3W", "report": "The specimen was received in nine parts. Part A consisted of a left parametrial lymph node biopsy, measuring 1.0 x 0.8 x 0.2 cm, submitted in entirety for frozen section analysis. Microscopic examination revealed no evidence of malignancy in one lymph node evaluated.\n\nPart B included a radical hysterectomy specimen with cervix, vaginal cuff margin, and right fallopian tube and ovary. The uterus weighed 114 grams; the uterine body measured 4.8 x 4.5 x 3.3 cm and the cervix with vaginal cuff measured 2.6 x 4.5 x 3.2 cm. Grossly, the cervix displayed an ill-defined os and tan-brown to tan-red bosselated appearance. The tumor appeared circumferential and extended from the cervical lip into the myometrium with a depth of 4.1 cm and width of 2.0 cm. Margins were inked and sampled at multiple quadrants (12\u20133, 3\u20136, 6\u20139, and 9\u201312 o\u2019clock positions). Microscopic evaluation identified poorly differentiated cellular infiltrates involving the cervix with extension into the lower uterine segment. Margins were free of involvement. Lymphovascular space invasion and perineural invasion were present. One focus of in-situ cellular changes was observed in the cervix. Fourteen lymph nodes associated with this specimen showed no evidence of abnormal infiltration.\n\nEndometrial tissue demonstrated inactive to atrophic features with tubal metaplasia noted. Myometrial examination confirmed presence of similar cellular infiltration extending into the lower uterine segment. An artery showed medial calcific sclerosis.\n\nThe right fallopian tube and ovary showed no significant pathological alteration. A paratubal cyst was identified in the right fallopian tube.\n\nPart C was a lymph node biopsy from the left parametrium measuring up to 0.7 cm. Microscopic evaluation identified metastatic cellular infiltration within one lymph node.\n\nPart D consisted of soft tissue from the right parametrium measuring 1.0 x 0.7 x 0.3 cm. No malignant involvement was detected in one lymph node examined.\n\nPart E contained the left fallopian tube and ovary. The fallopian tube showed no abnormalities while the ovary contained a benign inclusion cyst measuring 0.4 cm in diameter with smooth inner lining.\n\nPart F included soft tissue excised from the left vaginal margin measuring 2.1 x 1.0 cm. Histologic examination revealed fibrovascular tissue without significant pathological alterations.\n\nPart G consisted of six lymph nodes obtained from the left pelvic region. All lymph nodes showed no signs of abnormal infiltration.\n\nPart H was a soft tissue specimen from the distal left pelvic lymph node region. Microscopic examination revealed benign fibroadipose tissue without lymph nodes identified.\n\nPart I comprised seventeen lymph nodes from the right pelvic region. No evidence of malignancy was observed.\n\nIn total, forty lymph nodes were examined across all specimens. Two lymph nodes showed signs of involvement by abnormal cellular infiltration. One lymph node was involved at the left parametrium site.\n\nAll other tissues including endometrium, fallopian tubes, ovaries, vaginal margins, and soft tissues showed no evidence of malignant involvement or significant histopathologic alteration beyond findings already described."} +{"pid": "TCGA-44-A479", "report": "The surgical pathology report includes findings from a resection of the right upper lobe, a portion of the lower lobe, and multiple lymph node groups. The right upper lobe specimen measured 14.5 x 11.5 x 4.5 cm and included a bronchial stump. On sectioning, a mass measuring 3.9 x 3.5 x 3.2 cm was identified, with the closest margin measuring 0.3 cm from the pleural surface. The mass had a rubbery, tan-white appearance. No additional lesions were found in the remaining parenchyma. Two lymph nodes were recovered from the hilum.\n\nA separate wedge-shaped tissue sample from the lower lobe measured 5.4 x 2.7 x 1.3 cm and showed no abnormal masses upon sectioning. The parenchyma was spongiform and tan red in color.\n\nLymph node dissections included four groups: Level 10, R4, and Level 7 lymph nodes. In total, 12 lymph nodes were examined\u20144 from Level 10, 2 from R4, and 4 from Level 7. All were within normal size ranges and showed no evidence of abnormal infiltration or involvement.\n\nMicroscopic examination of the right upper lobe lesion revealed a poorly differentiated cellular pattern without invasion into large vascular or lymphatic structures. Resection margins were negative, and no direct extension of the lesion was observed. The regional lymph nodes were also negative for any abnormal cellular spread. Distant metastasis could not be assessed based on this specimen. Other microscopic findings included atelectasis and focal hemorrhage in the lower lobe tissue, but no concerning features were noted."} +{"pid": "TCGA-18-3414", "report": "The specimen included a right upper lobe wedge resection with a firm, gray-tan lesion measuring approximately 5.5 cm in maximum dimension. The lesion extended beyond the visceral pleura into adjacent fibrofatty tissue and was within 0.3 cm of the staple line margin. A representative section was examined intraoperatively.\n\nA right middle lobe nodule measuring 0.5 cm was identified subpleurally and examined during intraoperative consultation. An interlobar lymph node (ST11R) was submitted in entirety for evaluation, while another interlobar lymph node and a right tracheobronchial angle lymph node were both negative for malignancy.\n\nThe right lower lobe lobectomy contained a peripheral tumor mass measuring 4.3 cm in its largest dimension (3.9 cm post-fixation). The tumor was firm and tan-gray in appearance, extending to the puckered pleural surface and located 2.5 cm from the bronchial resection margin. Adjacent to the tumor, two small nodules were observed\u2014one measuring 0.3 cm and another measuring 0.5 cm. The larger of these abutted the pleura. No other gross nodules were identified. Mild emphysematous changes were present in the remaining lung parenchyma. Of eight lobar peribronchial lymph nodes retrieved, one showed evidence of metastatic involvement. The bronchial resection margin was free of tumor.\n\nMargins evaluated included the right upper lobe, which showed no malignancy but demonstrated emphysema and focal organizing pneumonia. The anterior margin of the fifth rib and the anterior margin of the fourth rib were both pending initial evaluation. The resection margin at the third rib showed no malignancy, only fibrosis. Ribs three and four were submitted with attached fibrofatty tissue and muscle; no abnormalities were seen on gross examination. Resection margins at the fourth and fifth intercostal spaces were also negative for malignancy and consisted of fibroadipose tissue, with the latter including a nerve trunk.\n\nHistologically, the primary tumor in the right lower lobe was moderately differentiated and exhibited visceral pleural invasion. A satellite intralobar nodule measuring 0.5 cm was found 1 cm away from the main tumor. All tumors showed similar histological features, suggesting a shared origin. Intraoperative frozen sections confirmed the presence of malignant cells in the upper and middle lobe lesions as well as in one lymph node.\n\nAdditional findings included mild to moderate emphysema in the non-tumorous lung tissue. Fibrosis was noted at several resection sites, including the third rib and intercostal margins. No malignancy was identified in the bone margins, lymph nodes from the right tracheobronchial angle, or interlobar region (other than the involved lymph node), or in soft tissue margins except where noted.\n\nStaging parameters indicated extension to adjacent structures (chest wall involvement), presence of a satellite nodule, and regional lymph node involvement. Distant spread could not be fully assessed due to pending bone margin results."} +{"pid": "TCGA-AA-3968", "report": "The resected colon specimen (sigmoid) demonstrates tumor-free oral and aboral resection margins. An ulcerated lesion is present, characterized by moderately differentiated cellular features. Histological evaluation reveals infiltration extending into the lamina muscularis propria. No evidence of local lymph node metastasis was identified. The specimen includes 19 lymph nodes, none of which show involvement. Vascular and lymphatic invasion are absent. The lesion has been completely resected with no residual tumor at the margins."} +{"pid": "TCGA-CJ-4869", "report": "The specimen from the right kidney and liver edge shows a mass measuring 8.5 cm in greatest dimension, composed of a mixed cell population including predominantly granular cells (70%) and a smaller component of clear cells (30%). Nuclear grade is consistent with grade 3 morphology. There is evidence of focal lymphatic/vascular invasion; however, no involvement of perinephric adipose tissue is identified. Surgical margins are negative. The adrenal gland and a segment of liver are free of abnormality. In the gallbladder specimen, mild chronic inflammation and cholelithiasis are noted. Evaluation of superficial inter-aortocaval lymph nodes (five in total) reveals no abnormality. Among the deep inter-aortocaval and right paracaval lymph nodes (nine in total), two contain metastatic involvement with the largest focus measuring 1.5 cm. A single para-aortic lymph node is unremarkable."} +{"pid": "TCGA-BR-8058", "report": "The submitted gastric tissue specimen from the antrum was obtained via subtotal gastrectomy. The lesion measured 5 x 4 x 2.5 cm and was described as ulcerated. Microscopic evaluation revealed poorly differentiated cellular features. The extent of the lesion involved adjacent structures, including the lesser and greater omentums. Lymph node assessment showed 3 out of 8 nodes involved with metastatic changes, all located intraabdominally. Lymphatic, venous, and perineural invasion were not specified. Surgical margins were free of involvement. No evidence of neo-adjuvant treatment effects was identified. No additional pathologic findings or comments were noted."} +{"pid": "TCGA-A2-A3XZ", "report": "A left simple mastectomy specimen measured 16 x 16 x 3.5 cm. A skin ellipse at the 12 o\u2019clock position measured 7.5 x 4.2 cm and included an unremarkable nipple. Blue dye was noted in the superior region. The superficial margin was marked with blue ink and the deep margin with black ink. An M-clip was identified in the upper inner quadrant, associated with a pink-tan nodule measuring 0.9 x 0.5 x 1.2 cm at the superficial margin. This lesion was 1.3 cm from the deep margin. Adjacent to this was a firm gray-tan area measuring 0.3 cm, located 1 cm from the superficial margin and 1.1 cm from the deep margin. Another elongated irregular pink-tan firm lesion was present at the 11 o\u2019clock position, measuring 3.5 x 0.9 cm with a greatest dimension of 1.5 cm. It extended toward the superficial margin and was 1.2 cm from the deep margin. This lesion was located approximately 3 cm away from the first described lesion. The overall breast tissue had an indurated consistency with a diffuse yellow-gray appearance, especially in the upper inner quadrant where multiple small palpable lesions were found.\n\nMultiple sections were taken from various areas including the nipple and skin, peripheral lesions at the 10 o\u2019clock and 11 o\u2019clock positions, a small nodule, and cross-sections of the 11 o\u2019clock lesion involving different margins. Additional sections were taken from the upper outer quadrant, 9 o\u2019clock area, lower outer quadrant, and lower inner quadrant.\n\nA sentinel lymph node from the left axilla (first) was received as a pink-tan soft tissue fragment measuring 2.5 x 1.3 x 1.0 cm. Sectioning revealed a 1.8 cm lymph node without notable discoloration. The second sentinel lymph node, also from the left axilla, measured 2.9 x 1.7 x 1.0 cm and contained a 1.8 cm lymph node that was entirely submitted for analysis.\n\nA core biopsy from the left upper inner quadrant included a brown skin ellipse measuring 1.4 x 0.5 cm and underlying indurated fatty tissue measuring 2.1 x 0.9 x 1.8 cm. A raised central lesion 0.5 cm in diameter was present on the skin surface. The margin was inked, and the specimen was sectioned across the narrow margin.\n\nThe left breast superficial margin was an irregular fragment of yellow-pink fatty tissue measuring 8.5 x 2.1 x 0.5 cm. One side was marked with blue ink and the opposite with yellow ink. The entire specimen was sectioned and submitted.\n\nMicroscopic evaluation of the 10 o\u2019clock lesion showed in situ and moderately differentiated infiltrating ductal changes with nuclear grade III and a high mitotic index. The invasive component measured approximately 1.2 cm and was less than 1 mm from the superficial margin. In the 11 o\u2019clock position, there was an invasive component measuring 1.9 cm associated with 2.2 cm of in situ changes, located 5 mm from the deep margin. A section from the upper outer quadrant showed 1.1 cm of in situ and 0.5 cm of invasive component with similar histomorphology. An additional focus in the upper inner quadrant showed changes related to a prior biopsy but no residual abnormality. No metastatic involvement was identified in the left axillary sentinel lymph nodes based on histological and immunohistochemical evaluation. The left upper inner core biopsy site showed reactive fibrosis and inflammation with no residual abnormality. The left breast superficial margin showed only adipose tissue without any evidence of malignancy."} +{"pid": "TCGA-2G-AAEW", "report": "The specimen measured 6 cm in greatest dimension. Histologic evaluation revealed a neoplastic lesion with lymphatic invasion identified. Involvement of the rete testis was also noted. The tumor demonstrated a growth pattern consistent with a uniform cell population, with no other distinct morphologic features identified. Staging was not provided."} +{"pid": "TCGA-85-8351", "report": "The specimen consisted of lung tissue from a pneumonectomy. A tumor was identified at the lung site measuring 4.5 x 3.5 x 3 cm. Microscopic examination revealed moderately differentiated cells of a certain histologic type. Lymph node assessment showed 2 out of 12 nodes positive for metastasis, specifically in the hilar region. The tumor was located in the right lower lobe. Other features such as lymphatic or venous invasion, tumor extent, additional nodules, margins, neo-adjuvant treatment effect, and other pathologic findings were not specified."} +{"pid": "TCGA-2G-AAFE", "report": "The pathology report describes a left orchidectomy specimen. The tumor measured 4 cm in diameter and was confined to the testis based on available slides. Angioinvasion was identified. There was no evidence of involvement of the rete testis."} +{"pid": "TCGA-EJ-A46G", "report": "The surgical specimen includes a radical prostatectomy with bilateral seminal vesicles, along with excised left and right pelvic lymph nodes. A total of 17 lymph nodes were examined (10 from the left and 7 from the right pelvic regions), and none showed any evidence of malignancy.\n\nMicroscopic examination of the prostate revealed a poorly differentiated carcinoma involving both lobes. The tumor measured up to 1.3 cm in greatest dimension and accounted for approximately 10% of the total prostate volume. Histologic evaluation demonstrated prominent ductal differentiation. Perineural invasion was observed, but no angiolymphatic invasion was identified. There was established extracapsular extension involving multiple regions of the left prostate: anterior base, posterior apex, and posterior mid gland. No tumor involvement was detected in the bilateral seminal vesicles or at any of the surgical resection margins.\n\nAdditional findings included high-grade prostatic intraepithelial neoplasia and benign prostatic hypertrophy with chronic moderately active prostatitis. Based on the TNM staging system, the tumor stage was classified as pT3a with no nodal involvement (pN0). The histologic grade was consistent with poorly differentiated carcinoma."} +{"pid": "TCGA-HI-7170", "report": "The specimen was received from a male patient and consisted of left and right pelvic lymph nodes, as well as a prostatectomy specimen including the seminal vesicles. \n\nThe left pelvic lymph nodes measured 1.5 x 1.0 x 1.0 cm and contained several palpable nodes, the largest being 0.1 cm in greatest dimension. All tissue was submitted for analysis. The right pelvic lymph nodes measured 2.0 x 1.5 x 1.0 cm and contained two palpable nodes, the largest measuring 1.2 cm. Both nodes were fully submitted. \n\nThe prostatectomy specimen weighed 46 grams and measured 3.5 x 3.5 x 3.5 cm. The right side was marked with black ink and the left with blue ink. On sectioning, the cut surfaces were tan and nodular with areas of golden yellow and orange coloration, primarily in the middle and posterior regions. These areas were firm in consistency. The right vas deferens measured 2.0 x 0.4 cm and the left measured 1.0 x 0.4 cm; both were unremarkable. The right seminal vesicle was 2.0 x 1.0 x 0.5 cm and the left was 1.5 x 1.0 x 0.8 cm, both appearing grossly unremarkable. Multiple sections were taken from the apex, base, anterior, middle, and posterior lobes bilaterally, as well as from the vasa deferentia and seminal vesicles. \n\nMicroscopic evaluation of the left pelvic lymph nodes showed four lymph nodes, all without abnormal cellular findings. The right pelvic lymph nodes included two nodes, also without any abnormality. In the prostatectomy specimen, cellular atypia was identified within the prostatic tissue, with involvement of both lobes. Approximately 35% of the examined tissue showed this cellular change. No vascular or lymphatic invasion was observed, and there was no extension beyond the prostatic capsule. Resection margins, as marked by ink, were free of atypical cells. The seminal vesicles and vasa deferentia did not show any similar cellular changes."} +{"pid": "TCGA-BR-8588", "report": "The specimen consisted of a gastrectomy with a tumor located in the fundus measuring 5 x 6 x 1.2 cm. The lesion was ulcerated and annular in appearance. Histologic evaluation showed poorly differentiated morphology. The tumor extended to the serosa, including the visceral peritoneum. No lymph node metastases were identified in the six regional nodes examined. Lymphatic, venous, and perineural invasion were not specified. Surgical margins were uninvolved. There was no evidence of neoadjuvant treatment effect, and no additional pathologic findings were reported."} +{"pid": "TCGA-A2-A25D", "report": "The specimen consists of a right outer breast lumpectomy, measuring 10.5 cm superior to inferior, 7.0 cm medial to lateral, and 3.0 cm anterior to posterior. The lumpectomy contains a poorly-defined, firm tan-white mass measuring 3.2 x 2.5 x 2.0 cm. Margins are positive, with tumor extending closest to the anterior and inferior inked edges at 0.5 cm and 0.2 cm respectively. Histologic evaluation reveals a poorly differentiated lesion with a Nottingham score of 8 out of 9 (tubules = 3, nuclei = 3, mitoses = 2). Venous and lymphatic invasion are present. No in situ component was identified.\n\nTwenty-three lymph nodes were identified as involved with metastatic disease across parts B and C of the specimen. Part B includes one lymph node positive for metastasis, measuring 1.5 cm in greatest dimension with extracapsular extension focally present. Part C consists of a lymph node dissection containing 23 lymph nodes, of which 22 show metastatic involvement. The largest metastatic deposit measures 2.1 cm and demonstrates extracapsular extension. Metastatic deposits exhibit multiple foci of extracapsular extension and frequently represent near complete replacement of nodal architecture.\n\nImmunohistochemical staining demonstrated positivity for estrogen receptors (95% nuclei staining), negativity for progesterone receptors (0% staining), and HER2 Neu staining negative at 1+ by IHC.\n\nAJCC pathologic staging is pT2 N3a. This case underwent prospective peer review."} +{"pid": "TCGA-JY-A93C", "report": "The specimen consisted of multiple lymph node stations and resected gastrointestinal tissues. Lymph nodes from splenic, celiac, common hepatic, inferior pulmonary ligament, station 7, 8, 16, and 17 were evaluated. All lymph nodes from stations ST19 (splenic), ST20 (celiac), ST18 (common hepatic), ST9L (inferior pulmonary ligament), and station 7 showed no evidence of malignancy. Stations 17 and 8 contained lymph nodes with findings consistent with involvement by tumor cells, with 2 out of 2 and 1 out of 4 lymph nodes involved, respectively. Station 16 lymph nodes were unremarkable.\n\nResected specimens included the thoracic esophagus and proximal stomach. Histologic evaluation revealed a lesion in the distal esophagus extending into the proximal stomach, involving the esophagogastric junction. The tumor measured 3.8 cm at its greatest dimension and invaded through the muscularis propria into the periesophageal soft tissue. Microscopic features included areas of mucinous differentiation and poorly differentiated morphology. The tumor was located 0.5 mm from the circumferential margin and demonstrated lymphovascular and perineural invasion. No acid-fast bacilli or fungi were identified. Intestinal metaplasia was noted in residual glandular mucosa.\n\nMargins of resection, including the final esophageal, gastric, and ring margins, were free of invasive carcinoma. Of 17 regional lymph nodes examined, 3 showed evidence of tumor involvement. There was infiltration of perinodal adipose tissue in one lymph node from station 17. One lymph node from station 7 contained small hyalinized nodules with anthracotic pigment and birefringent particles. No prior treatment effect was observed.\n\nGross examination of the resected stomach and esophagus showed a tumor located along the lesser curvature. The tumor spanned approximately 1.5 cm in the esophagus and 2.0 cm in the stomach. It was described as tan and solid, without perforation. Proximal and distal margins measured 3.3 cm and 1 cm from the tumor, respectively, while the radial margin measured 0.1 cm. The estimated depth of invasion extended into the adventitia. No additional lesions were identified in the non-affected portions of the stomach.\n\nMultiple sections of the tumor and surrounding margins were submitted for analysis. Frozen sections of the esophageal and gastric margins confirmed negative margins for invasive disease. Tissue blocks were prepared for further histologic evaluation."} +{"pid": "TCGA-86-7953", "report": "The lung tissue specimen was obtained from the left upper lobe and submitted as a lobectomy. The tumor measured 2.5 x 1.5 x 3 cm. Microscopic examination revealed a poorly differentiated histologic pattern. No additional details were provided regarding tumor extent, presence of other nodules, lymph nodes, lymphatic or venous invasion, margins, neo-adjuvant treatment, or other findings. No comments were added."} +{"pid": "TCGA-IB-7885", "report": "The specimen included a gallbladder measuring 9.5 x 4.5 x 1.6 cm, with a smooth mucosal surface and no calculi. A single lymph node was identified, measuring 2.6 cm in diameter. The Whipple's specimen consisted of a duodenum measuring 19.0 cm in length, a segment of gastric tissue 2.5 cm in length, and a common bile duct measuring 5.3 cm long with a 1.6 cm circumference. A stenotic area was observed 1.7 cm from the ampulla of Vater. The pancreatic portion measured 5.0 x 2.5 x 2.0 cm and contained a non-peritonealized margin inked in blue. Within the pancreatic head, a poorly defined lesion measuring 2.4 x 2.0 cm was noted; it was mostly solid with yellow-white areas and cystic changes near a minor duodenal papilla, appearing to approach the retropancreatic margin closely.\n\nMicroscopic evaluation showed invasive growth extending into retropancreatic soft tissue, with the closest margin being 0.5 mm away. Lymph-vascular invasion was present, and perineural invasion was also identified. Of the twelve lymph nodes examined, three contained direct tumor involvement. Non-neoplastic findings included PanIN-2 lesions and chronic pancreatitis. All surgical margins were free of invasive disease. Multiple sections were submitted for analysis, including those from the common bile duct, gastric, and intestinal margins, as well as the tumor in relation to the uncinate margin and surrounding lymph nodes. Due to technical difficulties, a synoptic report could not be generated."} +{"pid": "TCGA-E5-A2PC", "report": "The surgical specimens included segments of the left and right ureters, a cystectomy with bilateral salpingo-oophorectomy and vaginal wall tissue, and multiple lymph node groups from both sides. The ureteral segments measured 0.3 cm and 0.5 cm in length, respectively, and were otherwise unremarkable.\n\nThe bladder specimen measured 14.5 x 10.5 x 6.1 cm and showed a fungating lesion on the right posterior lateral wall, measuring 4.6 x 3.0 x 1.1 cm, with surface hemorrhage and ulceration. The lesion was located 2.5 cm from the nearest urethral margin and appeared to invade into the muscularis propria but not into the surrounding fat. It involved the right ureteral orifice but did not extend into the ureter itself. Adjacent bladder tissue showed areas of inflammation and regenerative changes. No other mucosal abnormalities were noted.\n\nMicroscopic examination of the ureteral margins showed benign urothelium and stroma without evidence of abnormal cells. One small lymph node was identified in the perivesical adipose tissue and was negative for any atypical involvement.\n\nThe attached vaginal wall segment measured 4 x 3 cm, and its margin was free of any unusual cellular findings. Both fallopian tubes and ovaries were present; the ovaries showed epithelial inclusion cysts but no abnormal cellular growth. Paratubal cysts were noted in both fallopian tubes.\n\nLymph node groups were submitted from multiple anatomical sites. Most lymph nodes across all regions were negative for any abnormal cellular infiltration. However, among a total of 28 lymph nodes examined, one node from the right obturator region contained atypical cells. The remainder of the lymph nodes from this area and all nodes from other regions were negative.\n\nStaging was based on histopathological findings. The lesion was classified as involving the muscularis propria without extension into surrounding fat and with no distant spread. Lymph node involvement was limited to one node. Resection margins were clear. Immunohistochemical staining for p53 was positive in approximately 70% of cells with low intensity expression."} +{"pid": "TCGA-2Y-A9H0", "report": "The clinical history notes a prior diagnosis related to the liver. The specimens submitted include a celiac lymph node, a nodule from the right lobe of the liver, the gallbladder, a left lobe liver resection, a left hepatic vein stump, and a left vein margin.\n\nMicroscopic evaluation of the celiac lymph node showed no evidence of malignancy. The right lobe liver nodule demonstrated portal inflammation without any malignant cells identified. The gallbladder specimen exhibited chronic cholecystitis. Histologic examination of the left lobe liver resection revealed a well-differentiated lesion with a multinodular growth pattern. The largest mass measured 7.5 x 5 x 4 cm, composed of confluent nodules with satellite formations throughout the parenchyma. Necrosis and hemorrhage were present within the lesion. Vascular invasion into the hepatic vein was observed. Margins of the resected specimen were negative for involvement. No perineural invasion was identified. One lymph node was assessed and showed no metastatic involvement.\n\nThe left hepatic vein stump and final vein margin were both negative for malignancy on frozen section analysis. Gross pathology of the liver specimen revealed multiple white-tan nodules beneath the distorted capsule, ranging from 1.5 to 9.0 cm in size. The tumor was located 1.4 cm from the nearest inked margin.\n\nPathologic staging was determined as T3N0MX based on extent of invasion and absence of lymph node involvement."} +{"pid": "TCGA-A2-A04P", "report": "The lumpectomy specimen from the left breast includes a residual tumor measuring 2.5 x 2.0 x 1.5 cm. The deep surgical margin is involved by the main tumor mass, while the medial, superior, and inferior margins show focal involvement by small, discontinuous tumor foci. These foci are located less than 0.6 mm from the respective margins and are considered microscopic in nature. The tumor exhibits a poorly differentiated appearance and is associated with extensive lymphatic involvement.\n\nIn the axillary dissection specimen, 20 lymph nodes were identified, of which 18 showed metastatic involvement. Among these, one node contained a micrometastasis and another demonstrated isolated tumor cells. Extensive extranodal extension and non-nodal metastatic deposits were also observed. Additionally, a lymph node from the left supraclavicular region was involved by metastatic disease.\n\nThe lumpectomy specimen measured 6.5 x 6.5 x 5.3 cm and included overlying skin with a 3.5 cm scar. A biopsy cavity measuring 3.0 cm was noted, with hemorrhagic walls and surrounding fat necrosis. Skeletal muscle was present at the posterior aspect of the specimen. Tissue sections were taken from multiple margins and areas for further analysis.\n\nThe axillary contents consisted of a large tissue specimen containing numerous lymph nodes and cyst-like structures ranging from 0.4 to 3.5 cm in greatest dimension. Several of these structures contained red viscous fluid and appeared hemorrhagic on sectioning. Multiple lymph nodes were submitted for histologic evaluation.\n\nThe left supraclavicular lymph node measured 1.3 x 0.7 cm and contained a metastatic focus measuring 0.8 cm. A portion of this node was submitted for further study."} +{"pid": "TCGA-FY-A4B4", "report": "A 42-year-old female underwent total thyroidectomy and excision of central lymph nodes. The thyroid specimen measured 3.3 x 1.8 x 1.2 cm on the right lobe and 3.3 x 1.6 x 1.3 cm on the left lobe, with an isthmus measuring 1.2 x 0.7 x 0.6 cm. A lesion measuring 1.8 cm in greatest dimension was identified in the right lobe. Histologic evaluation revealed a focal lesion with papillary features. Tumor margins were evaluated, and involvement was noted at the posterior margin, while the anterior margin was very close. No lymphatic or perineural invasion was identified.\n\nTwo of three lymph nodes examined showed evidence of tumor involvement, including right peri-thyroid and central lymph nodes. The primary lesion was confined to the thyroid gland. Additional findings included a hyperplastic nodule in the left thyroid lobe measuring 2.7 cm, and fragments of unremarkable thymus and parathyroid gland were also present.\n\nStaging based on the findings indicated a primary tumor stage of pT1b, regional lymph node involvement classified as pN1a, and no evidence of distant metastasis. Pathologic staging was determined to be pIII. Margin status was categorized as R1 due to the involved posterior margin. No prognostic data regarding margin status were available for correlation."} +{"pid": "TCGA-E2-A1BC", "report": "The right breast mastectomy specimen measured 13 x 10 x 3.5 cm and weighed 110 grams. A biopsy cavity measuring 2.5 x 2 x 1.6 cm was identified in slices 5\u20136 at the 12:00 position, located 0.1 cm from the deep margin and 0.2 cm from the anterior (superior) margin. Adjacent to this cavity, a firm, ill-defined lesion measuring 1.7 x 1.2 x 0.8 cm was found, situated 0.1 cm from the anterior margin and 0.3 cm from the deep margin. The left breast mastectomy specimen measured 15 x 11 x 2 cm and weighed 96 grams. A tan-white, firm, ill-defined mass measuring 1.6 x 1.1 x 1 cm was observed in slice 4, located 0.3 cm from the anterior-inferior margin and 0.5 cm from the deep margin, corresponding to a scar on the skin surface.\n\nA total of three lymph nodes were examined from sentinel lymph node #1 on the right axilla, and one lymph node from sentinel lymph node #2 on the right axilla; all were negative for tumor involvement. Similarly, two lymph nodes from sentinel lymph node #1 and two from sentinel lymph node #2 on the left axilla were also free of tumor. One intramammary lymph node from the left breast was likewise negative.\n\nHistological evaluation revealed invasive features in both breasts. In the right breast, the tumor was present at the anterior margin and within 0.1 cm of the deep margin at 12:00. It was previously noted as 1.8 cm in the excision specimen. In the left breast, the tumor was within microns of the anterior margin and 0.2 cm from the deep margin in the lower central area. Tumor size was reported as 1.5 cm in the left breast. Both tumors were high-grade with a modified Scarff Bloom Richardson grade of 1, nuclear grade 1, and no necrosis or vascular/lymphatic invasion. Lymph node status was negative in all sentinel lymph nodes assessed.\n\nHormone receptor status showed positivity for ER and PR, and negativity for HER2 by IHC in the right breast and by FISH in the left breast. Pathological staging for both sides was pT1c N0, based on the AJCC Cancer Staging Manual, 7th Edition. No DCIS or lobular neoplasia was identified."} +{"pid": "TCGA-DK-A3IV", "report": "The submitted specimen from the left lateral and anterior wall of the bladder consists of multiple irregular tan-brown soft tissue fragments, measuring 1.3 x 1.1 x 0.6 cm in aggregate. The entire specimen was processed and submitted in two cassettes. Microscopic evaluation revealed a high-grade lesion with areas of flat growth pattern consistent with in situ carcinoma. The invasive component was identified extending into the muscularis propria. No vascular invasion was observed. Cellular features included urothelial morphology with focal squamous differentiation noted. All relevant sections were reviewed and correlated with the histologic findings."} +{"pid": "TCGA-EM-A3FK", "report": "The specimen was received from a patient and included multiple tissue samples. The thyroid gland measured 5.0 x 1.8 x 1.1 cm on the right lobe, 4.5 x 2.1 x 1.4 cm on the left lobe, and 2.7 x 0.6 x 0.7 cm in the isthmus. The total weight of the thyroid specimen was 15.8 grams. Gross examination revealed multiple delineated nodules within the isthmus and left lobe, with the largest measuring up to 1.2 cm in greatest dimension. Additional soft tissue from the right lower pole contained several possible lymph nodes measuring 1.0 x 1.0 x 0.5 cm.\n\nLymph node specimens were received from two anatomical locations: left paratracheal and left neck level IV. The left paratracheal specimen measured 1.5 x 0.6 x 0.2 cm and contained three nodules ranging from 0.1 to 0.5 cm. The left neck level IV specimen measured 2.0 x 0.5 x 0.6 cm and contained multiple nodules of similar size. All lymph nodes were submitted for analysis.\n\nA small tissue fragment labeled as right upper parathyroid was also received. It measured 0.3 x 0.2 x 0.1 cm and weighed 0.002 grams. This specimen was frozen for intraoperative consultation and later resubmitted for further evaluation.\n\nHistologic examination of the thyroid revealed multiple nodules with classical papillary architecture and cytomorphology. The dominant lesion measured 1.2 cm and was located in the isthmus. It was partially encapsulated with evidence of capsular invasion. Margins were uninvolved by tumor, with the closest distance of invasive carcinoma being 0.3 mm from the margin. A second nodule measuring 1.0 cm was identified in the left lobe; however, capsular invasion could not be assessed in this lesion.\n\nIn the lymph node specimens, involvement was observed in both regions. Of the three lymph nodes examined in the left paratracheal region, all contained abnormal tissue. In the left neck level IV region, one out of six lymph nodes showed similar findings. In total, 17 out of 25 lymph nodes evaluated across all regions demonstrated comparable characteristics. No extranodal extension was identified.\n\nAdditional findings included thyroiditis and multiple small lesions in both lobes of the thyroid. Parathyroid glands appeared histologically normal. The staging classification indicated multiple primary tumors confined to the thyroid gland with metastatic involvement in cervical and superior mediastinal lymph nodes. No distant metastasis was identified."} +{"pid": "TCGA-A5-A0GI", "report": "A total abdominal hysterectomy and bilateral salpingo-oophorectomy specimen was examined. The uterus weighed 140 grams and measured 8.5 cm from fundus to ectocervix. A tumor was identified in the posterior aspect of the uterus, involving the fundus, corpus, and lower uterine segment. Grossly, it appeared as a friable, polypoid to papillated tan-red mass measuring approximately 5.5 x 3.0 cm on the surface. Cut sections revealed a maximum tumor thickness of 0.8 cm. Hemorrhage and necrosis were focally present on the tumor surface. Histologically, the tumor exhibited exophytic growth with areas showing villoglandular features and focal surface erosion. Invasion into the myometrium was superficial and involved less than 20% of the uterine wall thickness. No definitive lymphovascular invasion was identified, although evaluation was limited by retraction artifacts and inflammatory changes. No tumor extension into the cervix or vaginal cuff was observed. Parametrial tissues were also free of tumor involvement.\n\nSix leiomyomas were identified within the uterus; one was submucosal, two were subserosal, and three were intramural. Their sizes ranged from 0.2 to 1.5 cm. All were well-circumscribed and composed of firm, tan-white tissue with areas of hemorrhage or necrosis. The uninvolved myometrium was tan and firm, with a maximum thickness of 2.0 cm.\n\nThe endometrium elsewhere was inactive or weakly proliferative. The cervix showed benign findings including inflamed endocervical polyps, acute and chronic inflammation, reserve cell hyperplasia, microglandular hyperplasia, squamous metaplasia, reactive epithelial changes, and nabothian cysts. The vaginal cuff mucosa showed chronic inflammation and parakeratosis.\n\nBoth fallopian tubes and ovaries showed no evidence of tumor involvement. The left fallopian tube showed mild epithelial hyperplasia without atypia. The left ovary demonstrated senescent changes, a cystic epithelial inclusion, benign surface proliferations resembling micropapillary formations, and serosal adhesions. The right fallopian tube had minimal epithelial atypia. The right ovary displayed senescent changes, multiple cystic epithelial inclusions, focal papillary adenofibromatous surface changes, benign micropapillary proliferations, and multiple serosal adhesions with associated hemorrhage, chronic inflammation, foreign body giant cell reactions, and reactive mesothelial changes.\n\nExamination of lymph nodes included one right para-aortic node (measuring up to 2.2 cm), two right pelvic and common iliac nodes (up to 1.5 cm and 1.3 cm), three left pelvic nodes (up to 2.4 cm), and one left common iliac node (1.2 x 0.3 x 0.2 cm). All lymph nodes were reactive without evidence of metastatic disease.\n\nSoft tissue biopsies from the right and left pelvic regions showed no tumor involvement. The left periaortic tissue sample contained only fibroadipose tissue without identifiable lymph nodes. Omental samples showed chronic inflammation, adhesions, and reactive mesothelial proliferation but no tumor involvement.\n\nSections of parametrial tissues, vaginal cuff, and other uterine regions were submitted for microscopic examination. Representative sections of the tumor and surrounding tissues were evaluated. The findings were discussed in the context of a gynecologic oncology-pathology conference."} +{"pid": "TCGA-4Z-AA84", "report": "The specimen from a partial cystectomy revealed a high-grade urothelial tumor with extensive necrosis, showing infiltration into the perivesical adipose tissue. Surgical margins were uninvolved, although the distance at the top left portion was minimal, measuring 1.9 mm. Angiolymphatic invasion was identified, while perineural invasion was not present. There was no evidence of neoplastic involvement in the right and left ureteral margins or on the rectal wall fragment. Metastatic involvement was found in two lymph nodes that were dissected. Pathological staging was determined as pT3b, pN2, and pMX."} +{"pid": "TCGA-4W-AA9T", "report": "The specimen was collected from a craniotomy procedure performed on a patient with a known brain mass in the frontal region. Two separate tissue samples were received for analysis.\n\nThe first sample, labeled \"Brain tumor,\" consisted of multiple light-tan, irregularly-shaped soft tissue fragments measuring 1.0 x 0.8 x 0.3 cm in aggregate. This specimen was submitted in toto for frozen section analysis.\n\nThe second sample, also labeled \"Brain tumor,\" contained two light-tan, irregularly-shaped soft tissue fragments with aggregate dimensions of 1.5 x 0.5 x 0.5 cm. It was similarly submitted in its entirety for histopathological evaluation.\n\nBoth specimens were processed and analyzed intraoperatively. Microscopic examination revealed high-grade features including marked nuclear atypia, brisk mitotic activity, microvascular proliferation, and areas of necrosis. The tissue demonstrated infiltrative growth patterns and significant cellular pleomorphism. Based on these findings, the highest grade classification according to WHO criteria was assigned."} +{"pid": "TCGA-CQ-5329", "report": "The specimen received included multiple soft tissue and oral cavity samples from the left lateral, anterior, and posterior tongue margins, deep margin, left alveolar margin, left neck contents, left sublingual gland, and floor of mouth. Additional specimens included revised deep margin tissue.\n\nMicroscopic evaluation of all margins\u2014including left lateral, left anterior, left posterior, deep, and left alveolar\u2014showed no evidence of malignant cells. The left neck contents consisted of 29 lymph nodes, all of which were free of malignancy. The submandibular gland showed no pathological changes. The left sublingual gland exhibited mild chronic sialadenitis without signs of malignancy.\n\nExamination of the oral cavity specimen involving the left tongue and floor of mouth revealed a well-defined lesion located at the lateral surface of the tongue. The lesion measured up to 2.8 cm in greatest dimension with a thickness of 0.9 cm. There was no evidence of perineural or vascular/lymphatic invasion. Moderate to severe squamous dysplasia was identified. All surgical margins were free of tumor involvement. The closest distance from the tumor to any margin was 0.4 cm at the inferior margin.\n\nPathologic staging was determined as pT2 based on tumor size between 2 and 4 cm in greatest dimension, with no regional lymph node involvement (pN0). A total of 29 regional lymph nodes were examined, none of which contained malignant cells. Distant metastasis could not be assessed (pMX).\n\nGross examination included multiple tissue fragments submitted for frozen section analysis. Specimens were labeled and measured, with sizes ranging from 0.7 x 0.6 x 0.3 cm to larger dimensions in the left neck dissection specimen. Representative sections were taken from all relevant areas for histological evaluation.\n\nThe revised deep margin specimen was also unremarkable, with no evidence of residual tumor involvement."} +{"pid": "TCGA-KN-8427", "report": "The specimen consists of a left nephrectomy measuring 28.5 x 12.2 x 12.5 cm, including the kidney, surrounding perirenal fat, and extending to the ureter and possible renal vein. A dominant mass measuring 16.5 x 12.5 x 2.5 cm is present, encompassing nearly the entire kidney with multiple areas of necrosis and satellite nodules. Three smaller nodules are identified in the surrounding fat, ranging from 2.5 to 5.0 cm. The mass extends to the inked Gerota's fascial margin and involves the renal vein margin. The distance from the tumor to the ureteral margin is 1.5 cm, 3.0 cm from the arterial margin, and 7.0 cm from the vein margins.\n\nHistologically, high-grade cellular features are observed, with nuclear grade 4 of 4. There is extensive invasion into the surrounding tissue, including focal disruption through Gerota's fascia. Lymphovascular and venous invasion are present. The adrenal gland is uninvolved. Margins of the renal artery and ureter are negative. Four possible lymph nodes are identified in the perirenal fat, with tumor involvement noted.\n\nMicroscopic evaluation of the kidney parenchyma reveals mild tubular atrophy and interstitial fibrosis involving less than 10% of the cortex. Arterial and arteriolar sclerosis is present, moderate in extent. Glomeruli show variable changes, with some demonstrating enlargement, segmental sclerosis, and capillary loop thickening. A total of 149 glomeruli are counted, with varying degrees of global and focal segmental changes. Staining techniques used include H&E, PAS, Jones silver methenamine, and trichrome (AFOG).\n\nThe specimen was submitted for cytogenetics, Quick Fitt, and tissue banking. Sections of normal kidney tissue and various tissue fragments were also submitted for further study. The case was reviewed by the Gastrointestinal and Urogenital Pathology Service."} +{"pid": "TCGA-E2-A1LB", "report": "The lumpectomy specimen from the right breast measured 9.7 x 9 x 3 cm and contained a firm tan mass measuring approximately 2.8 x 2.5 x 1.4 cm. This lesion was located near the posterior margin, with a closest distance of 0.2 cm, and approached the superior margin at 0.5 cm. The margins were evaluated with ink marking: anterior (blue), posterior (black), superior (red), inferior (orange), medial (green), and lateral (yellow). Sections were taken from multiple slices and various margins for histological evaluation.\n\nAxillary lymph node dissection included fibroadipose tissue measuring 10.7 x 5.9 x 2.5 cm. Multiple lymph nodes were identified, ranging in size from 0.3 cm to 4 cm in diameter. Histologic examination revealed involvement of two out of twenty-five lymph nodes by malignant cells, with the largest metastasis measuring 4 cm. There was no evidence of extracapsular extension.\n\nHistologically, the lesion demonstrated features of high-grade cellular morphology. Microscopic evaluation showed extensive vascular and lymphatic invasion. In addition, there was evidence of multifocal involvement within the breast tissue, including regions consistent with intraductal proliferation. These areas exhibited high nuclear grade and necrosis, with associated lymphoid infiltration. Intraductal components were present at the lateral margin and were within 1\u20132 mm of other margins.\n\nImmunohistochemical analysis showed negative staining for estrogen and progesterone receptors. HER2 immunostaining demonstrated strong membranous positivity in 100% of tumor cells. No modifications were observed in tissue fixation or staining protocols, and internal quality controls were satisfactory.\n\nStaging was based on histopathologic findings and indicated pT2 for the primary lesion and pN1 for lymph node involvement."} +{"pid": "TCGA-VD-AA8N", "report": "HISTOPATHOLOGY. Lab No. Clinical Consultant & Location. Unit No. SPECIMEN. RESECTION OF EYE AND EYE APPENDAGES. ENUCLEATED RIGHT EYE. CLINICAL DETAILS. Right eye lesion with associated exudative retinal detachment.\n\nMACROSCOPIC DESCRIPTION. A fresh intact right globe. Dimensions: Axial 27.5mm, Horizontal 25mm, Vertical 25mm. Cornea measured 11.25mm horizontally and 11.5mm vertically. Optic nerve appears fresh. On trans-illumination, a large shadow is observed measuring approximately 20mm on the lateral side. Plane of section is horizontal. Intraocular findings reveal, upon opening, a large solitary structure with an uncertain shape, possibly representing a ciliochoroidal mass. The lesion measures 15mm in largest basal diameter and 12mm in height.\n\nMICROSCOPY. Histological evaluation of the enucleated eye shows a normal anterior segment including an unremarkable cornea, deep anterior chamber, and open angles. The iris is unremarkable, while the lens demonstrates advanced cataractous changes. On one side of the eye, a large lesion arises from the ciliary muscle and body. It is bilobed and extends posteriorly into the adjacent choroid. In the central apical region, there is a small area of necrosis. The lesion is associated with disruption of the ciliary body processes and retinal detachment. It is pigmented and composed of a mixture of epithelioid and spindle cells, with epithelioid cells being predominant. Immunohistochemical staining shows reactivity for MelanA, CD117, and HSP-27 (score 1). Mitotic count approximates 21 per 40 high power fields. The microvasculature is prominent, with closed loops identified in the tissue examined. Lymphocytic infiltrate within the lesion is minimal, and macrophages are present in moderate density. There is no evidence of scleral invasion or extraocular extension. The optic nerve is free of involvement and shows mild atrophic changes. The examined vortex veins do not show any signs of involvement.\n\nMolecular genetic analysis was performed on DNA extracted from the fresh tissue using multiplex ligation-dependent probe amplification (MLPA), targeting loci on chromosomes 1, 3, 6, and 8. The DNA concentration was high, and quality was confirmed prior to testing. The MLPA reaction was repeated on multiple occasions, producing consistent results. Sequence analysis revealed normal copy number for chromosome 1, monosomy for chromosome 3, normal copy number for chromosome 6, and gains in chromosome 8. These findings are associated with a high risk of metastatic disease. Additional clinical features are also relevant for overall risk assessment. A supplementary report will be issued once further molecular investigations are complete."} +{"pid": "TCGA-RW-A68D", "report": "A 6.5 x 3.6 x 2.3 cm, 29.13 gram specimen of the left adrenal gland was received, containing a well-defined 4.0 x 2.6 x 2.3 cm tan homogenous nodule without evidence of hemorrhage or necrosis. The peripheral tissue shows a coppery tan cortex and brown medulla. Microscopic examination reveals a distinct nodule in relation to the uninvolved adrenal gland and capsule. Cellular morphology was reviewed and interpreted by the attending pathologist."} +{"pid": "TCGA-05-4398", "report": "The surgical specimen demonstrates a locally advanced peripheral lesion within the right upper lobe of the lung, histologically characterized by a mixed growth pattern. The predominant components include large-cell morphology with polymorphocellular features and areas of clear-cell differentiation arranged in a solid growth pattern. A bronchioloalveolar growth pattern is observed at the tumor periphery, while a small acinar component is also present. The lesion is primarily located in segment S1 with a satellite focus identified in segment S3.\n\nPathologic staging is pT4 pN3 L1 V1 R0, corresponding to stage IIIB. Tumor involvement includes invasion into small blood vessels within the tumor bed and extension into regional lymph nodes. Metastatic involvement is confirmed in lymph node stations 1 through 4, 6 through 8, and 10. No tumor involvement is identified in the visceral pleura, bronchial or vascular resection margins of the main specimen, or in lymph node samples 5 through 9. A significant cicatricial area is noted within the primary lesion."} +{"pid": "TCGA-QS-A744", "report": "The specimen was received in multiple parts. A fragment of soft, pink tissue measuring 3 x 1 x 1 cm was submitted for analysis. Another aggregate of pink tumor measured 4 x 3 x 2 cm with a representative portion submitted for further processing. Additional fragments included a 3 mm and an 8 mm piece, each submitted entirely as individual blocks. One mL of hemorrhagic material without identifiable tissue fragments was also submitted.\n\nA hysterectomy specimen was evaluated, which included the uterus, cervix, bilateral fallopian tubes, and ovaries. The right fallopian tube measured 8 x 0.5 cm and the right ovary was 3 x 1.5 x 1.5 cm, both appearing unremarkable. The left fallopian tube measured 8 x 0.5 cm, and the left ovary was 3.5 x 2 x 1.5 cm, also unremarkable. The uterus weighed 579 grams and measured 12 x 9 x 11 cm, with a large calcified mass measuring 7 cm within the myometrium. The cervix was 4 x 4 x 4 cm and largely replaced by firm, tan-red tissue. The endometrial cavity and myometrium were extensively involved with a tan tumor, measuring up to 8.5 x 6 x 6 cm in the fundus. The maximum depth of myometrial invasion was 3 cm, within a myometrial wall thickness of 3.5 cm. Tumor extended into the cervix and upper vaginal cuff. The vaginal cuff margin was 0.5 cm and free of tumor. The uterine serosa was intact and not involved.\n\nHistologically, the tumor showed features consistent with a high-grade epithelial neoplasm. Microscopic evaluation of multiple biopsies from the vaginal mass, right pelvic sidewall, cul-de-sac, and right uterosacral ligament all revealed similar histologic findings. Lymphovascular invasion was present. No involvement was identified in the bilateral ovaries or fallopian tubes. Surgical margins were negative for tumor.\n\nThe largest tumor dimension was 11 cm. The depth of myometrial invasion was 30 mm with a myometrial thickness of 35 mm. There was stromal invasion in the cervix. No lymph nodes were submitted for evaluation. Based on the extent of local spread, the primary tumor was classified as pT3b."} +{"pid": "TCGA-EW-A1OW", "report": "The surgical pathology report describes a lumpectomy specimen from the left breast, measuring 5 x 4 x 3.5 cm. A single focus of invasive lesion was identified, measuring 2.5 cm in its greatest dimension, with additional dimensions of 1.8 x 1.8 cm. The closest resection margin was the posterior margin at 0.2 cm; however, all margins were found to be free of tumor involvement. No skin or skeletal muscle was present in the specimen.\n\nHistologic evaluation showed a poorly differentiated lesion with high nuclear grade. Nuclear pleomorphism was prominent, with vesicular nuclei, frequent large nucleoli, and significant variation in nuclear size and shape. Mitotic activity was moderate. The histologic grade totaled 8 (3+3+2), based on glandular differentiation, nuclear pleomorphism, and mitotic count. No lymph-vascular invasion was identified.\n\nImmunostaining results showed negativity for ER and PR by immunohistochemistry, and HER2 was not amplified by CISH. Additional immunostains including p63 and EGFR were focally positive, suggesting a possible basal cell subtype. Further classification is pending in-house immunostain results.\n\nLymph node evaluation included three sentinel nodes examined using hematoxylin and eosin staining (one level each) and immunohistochemistry. No evidence of macrometastases, micrometastases, or isolated tumor cells was identified in any of the nodes. The largest metastatic deposit measured was 0 cm.\n\nPathologic staging was determined as pT2 for the primary lesion, pN0(i-) for sentinel lymph nodes, and MX for distant metastasis. No ductal or lobular in situ components were identified. The fat to stroma ratio was 40:60. Representative sections of margins and tumor were submitted for analysis."} +{"pid": "TCGA-AA-3696", "report": "The surgical specimen consists of a partial sigmoid colon resection. The lesion is an ulcerated mass showing moderate differentiation, with growth encircling the intestinal wall over a segment measuring 3.5 cm in length. The tumor extends to within 6 cm of a resection margin and invades through all layers of the intestinal wall into adjacent mesocolic fat. The remaining colon displays multiple pseudodiverticula and mild chronic scarring changes consistent with peridiverticulitis. Both the oral and aboral resection margins are free of tumor involvement. A total of 26 lymph nodes were examined, with one node containing metastatic material that does not breach the nodal capsule. The other lymph nodes show only nonspecific reactive changes. Vascular invasion is present, and the tumor grade is intermediate. There is no evidence of residual tumor at the resection margins."} +{"pid": "TCGA-P4-A5E7", "report": "A left partial nephrectomy specimen includes a tumor measuring 4.5 x 4.0 x 1.9 cm located within the kidney parenchyma. The tumor is noted to be less than 0.2 cm from the nearest parenchymal margin. The surrounding renal tissue appears unremarkable. Histologic evaluation of the resection margins shows no evidence of tumor involvement. A second fragment of renal parenchyma, measuring 0.9 x 0.5 x 0.4 cm, contains an area of focal glomerulosclerosis but no tumor. An adrenal biopsy sample consists of cortical tissue and shows no evidence of malignancy. Microscopic analysis reveals nuclear features consistent with Fuhrman's nuclear grade 3. Deeper sections of the renal specimen and adrenal biopsy did not show any evidence of metastatic disease. Multiple tissue blocks were examined, including sections of the tumor with surrounding adipose and normal kidney tissue. The tumor was marked with blue surgical ink and confirmed to be localized without gross extension into perinephric fat. Clinical correlation is recommended."} +{"pid": "TCGA-06-0877", "report": "A heterogeneously enhancing mass was identified within the medial left temporal lobe, with involvement of thalamic, subthalamic, and ventricular subependymal regions. Tissue samples were obtained from the left temporal region during biopsy and excision procedures.\n\nMicroscopic evaluation revealed an astrocytic neoplastic proliferation characterized by nuclear anaplasia, mitotic activity, microvascular proliferation, and areas of necrosis, some with pseudopalisading. The tumor demonstrated diffuse infiltration into cerebral tissue and was focally present on the surface of the cerebral cortex. Mitotic activity appeared low in the examined tissues, and the MIB-1 proliferation index was approximately 5% in more active areas.\n\nImmunohistochemical analysis showed that the neoplastic cells were gliofibrillary acidic protein (GFAP)-positive, with only rare cells showing p53 overexpression. NeuN and synaptophysin staining highlighted tumor infiltration into both gray and white matter, while neurofilament staining was negative, indicating no neuronal differentiation of the neoplastic cells.\n\nMGMT promoter methylation testing performed on the tissue sample demonstrated a methylated promoter status. This result suggests potential responsiveness to alkylating agent therapy. The test was conducted using bisulfite-modified DNA followed by real-time PCR amplification (MethyLight) to assess methylation status. It is noted that this test was developed and validated under CLIA regulations but has not been cleared or approved by the FDA.\n\nGross examination of the specimen revealed multiple fragments of hemorrhagic and glistening tissue measuring up to 1.3 cm in aggregate in part A. Part B consisted of two pieces of pale red-tan to gray-tan brain tissue measuring 3.0 x 2.5 x 1.0 cm in total, weighing 2.88 grams. All fragments were submitted for histological evaluation.\n\nHistologic sections underwent various staining procedures including H&E, immunostaining for GFAP, MGMT, MIB-1, NeuN, NF2F11, p53, synaptophysin, and others as indicated. Intraoperative touch preparations confirmed the presence of a high-grade glioma.\n\nThe lesion exhibited infiltrative growth patterns without evidence of neuronal elements. Cellular morphology and staining characteristics aligned with features typically associated with aggressive astrocytic neoplasms."} +{"pid": "TCGA-BP-4992", "report": "The submitted specimen includes a left total nephrectomy and a perinephric fat excision. The nephrectomy specimen consists of three fragments measuring 8.0 to 10.0 cm in greatest dimension, with attached ureter and renal vessels. The tumor measures 5.6 x 4.0 x 3.5 cm and is located in the mid portion of the kidney. It has a light tan to orange to maroon variegated cut surface. Grossly, the tumor appears to extend into the perirenal adipose tissue, though no invasion of the renal capsule is noted. A 3.5 x 3.0 cm retention cyst filled with clear fluid is present. The renal cortex measures 0.7 cm, and a well-defined cortico-medullary junction is observed. No adrenal gland or lymph nodes are identified.\n\nMicroscopically, the tumor exhibits high-grade nuclear features with focal areas showing sarcomatoid differentiation comprising less than 5% of the tumor. All surgical margins are free of tumor involvement. Adjacent kidney tissue shows benign findings including two papillary adenomas, benign cortical cysts, and mild arteriosclerotic changes. No vascular invasion or angiolymphatic invasion is identified.\n\nThe second specimen consists of fibroadipose tissue from the upper pole perinephric area and shows no evidence of abnormality.\n\nStaging indicates the lesion is confined to the kidney and measures less than 7.0 cm in greatest dimension. No lymph nodes are present for evaluation."} +{"pid": "TCGA-E6-A1LZ", "report": "The surgical specimens include the uterus with bilateral fallopian tubes and ovaries, left and right pelvic lymph nodes, left and right para-aortic lymph nodes, and omentum. The uterus weighed 120 grams and measured 9.5 x 5.7 x 4.2 cm. The endometrial cavity contained a polypoid lesion measuring 3.5 x 3 x 2 cm, which did not appear to invade into the myometrium. Additional granular and polypoid areas were present, including a white-tan discoloration measuring 1.7 x 1.2 x 0.6 cm and a golden tan discoloration measuring 1.7 x 1 x 0.1 cm. A well-circumscribed calcified nodular mass was identified in the anterior aspect of the uterus, measuring 3.2 x 2.8 x 1.5 cm. The endometrium measured 0.2 cm in thickness and the myometrium measured 2.1 cm. Both fallopian tubes and ovaries showed no abnormalities on gross examination.\n\nMultiple sections were taken from various regions of the uterus for histological evaluation. No abnormalities were identified in the cervix or endocervix. Histologic examination revealed high-grade cellular changes confined to the endometrium without invasion into the myometrium. There was no evidence of vascular or lymphatic invasion. All surgical margins were negative.\n\nLymph node specimens were evaluated. The left pelvic lymph node specimen contained five lymph nodes ranging from 1.4 to 3 cm; all were unremarkable. The right pelvic lymph node specimen contained multiple lymph nodes up to 3.1 cm in size; all appeared benign. Four lymph nodes were identified in the left para-aortic specimen, all without abnormality. The right para-aortic specimen contained one lymph node that also appeared benign. The omental specimen consisted of adipose tissue without any masses or lesions.\n\nA calcified subserosal leiomyoma was noted. Peritoneal cytology was negative. Based on the histopathologic findings, the disease was limited to the endometrium without extension to the cervix or involvement of the fallopian tubes, ovaries, lymph nodes, or omentum."} +{"pid": "TCGA-BR-7197", "report": "The specimen consists of a subtotal gastrectomy with a plate-like lesion measuring 6 x 5.5 cm, located at the pylorus. The lesion shows ulceration and extends through all layers of the gastric wall, reaching the subserosa. Microscopic evaluation reveals infiltration by malignant cells with morphological features suggesting neuroendocrine differentiation. Lymph nodes from the greater and lesser curvatures, as well as those from the greater and lesser omentum (15 in total), show only reactive changes without evidence of metastasis. Lymphatic or venous invasion is not identified, and perineural invasion is not specified. Surgical margins are free of involvement. No findings suggestive of response to neoadjuvant treatment are noted. The omentum appears unremarkable without significant changes."} +{"pid": "TCGA-G2-A3IB", "report": "A specimen from the bladder consists of multiple irregular fragments of white-tan soft tissue measuring 2.0 x 2.0 x 1.0 cm in aggregate. Histologic evaluation shows high-grade cellular features with extensive squamous differentiation comprising more than 50% of the sample. The lesion involves the muscularis propia and exhibits lymphovascular invasion. A separate specimen from the prostatic urethra includes two small fragments of white-tan soft tissue, each measuring 0.5 x 0.4 x 0.3 cm. This portion reveals benign prostatic urethral tissue with chronic inflammation and reactive changes, along with benign prostatic glands and fibromuscular stroma. All tissue has been submitted for analysis."} +{"pid": "TCGA-DK-A1AG", "report": "The specimen from the right lymph node of Cloquet consisted of a single lymph node measuring 0.5 x 0.5 x 0.4 cm and was found to be benign. The left pelvic lymph nodes specimen contained three lymph nodes ranging from 1 to 2.5 cm, all of which were benign. A cystoprostatectomy specimen included a bladder measuring 14 x 11 x 10 cm, a prostate measuring 3.5 x 3 x 2 cm, and bilateral seminal vesicles. A large mass measuring 10 x 10 x 9 cm was present in the bladder, involving the posterior wall and obliterating both ureteral orifices and the trigone. The mass extended into perivesical soft tissues and involved the prostatic stroma extensively, with further extension into periprostatic soft tissue and surrounding the seminal vesicles bilaterally. Perineural invasion was identified, but vascular invasion was not observed. The surgical margins were free of involvement. Non-neoplastic mucosa showed chronic cystitis. The prostate and seminal vesicles were extensively involved by a high-grade infiltrating component with extensive squamous differentiation. All possible lymph nodes were submitted and found to be benign. The right pelvic lymph nodes specimen contained four lymph nodes, all benign. The right common iliac lymph nodes specimen included four lymph nodes ranging from 1.2 to 2 cm, all benign. Presacral lymph nodes ranged from 0.3 to 3.2 cm; all were benign. The node from the right fossa Marcelle included multiple lymph nodes ranging from 0.2 to 1.4 cm, all benign. Left common iliac lymph nodes ranged from 1 to 2.4 cm and were benign. Left pelvic lymph nodes varied in size from 0.2 to 4.4 cm; all were benign. A separate biopsy of the right pelvic lymph nodes #2 revealed one benign lymph node measuring 1 x 0.5 x 0.3 cm. Both vas deferens specimens and the left ureter were found to be benign. The pathologic stage based on AJCC 2002 criteria was pT3 for invasion of perivesical soft tissue and PR2 for periprostatic or periseminal vesicle soft tissue invasion. All other specimens were negative for involvement."} +{"pid": "TCGA-39-5027", "report": "The clinical history is notable for symptoms including bloody cough and a mass in the lower lobe. Submitted specimens include a Trucut needle biopsy of a lung mass in the left lower lobe, multiple mediastinal lymph nodes from various levels, and a right lower lobe lung specimen.\n\nMicroscopic evaluation of the left lower lobe lung biopsy reveals malignant cells consistent with an epithelial origin. The tumor in the right lower lobe measures 5.0 cm in greatest dimension grossly. No vascular or perineural invasion is identified. The bronchial margin and pleura are free of tumor involvement. Evaluation of surrounding lung tissue shows changes related to respiratory bronchiolitis and focal parenchymal scarring. No evidence of precursor lesion or in situ malignancy is observed.\n\nAll examined lymph nodes\u2014including those from level VII and level IX mediastinal regions as well as interlobar locations\u2014are negative for involvement by malignant cells. A total of two peribronchial lymph nodes also show no evidence of tumor.\n\nThe surgical specimen includes a lung lobe measuring 15.5 x 8.5 x 3.6 cm with a tumor located 4.0 cm from the bronchial margin and 2.5 cm from the nearest staple margin. Intraoperative consultation confirmed the presence of malignant cells in the lung tissue, while lymph nodes assessed during the procedure were negative. All findings are based on personal examination of the slides and review of the materials provided."} +{"pid": "TCGA-N5-A4RJ", "report": "Specimens Submitted: 1: Lymph node, Right periaorti, excision (fs). 2: Cervix, uterus, bilateral fallopian tubes and ovaries, total hysterectomy and bilateral salpingo-oophorectomy. 3: SP: Omentum.\n\nSummary: The lymph node specimen from the right periaortic region contained three lymph nodes, all of which showed metastatic involvement. The metastatic component exhibited epithelial features. In the hysterectomy specimen, a tumor was identified in the endometrial region with complex architecture and heterologous elements. The tumor invaded the myometrium to a depth equal to or less than 50% of the myometrial thickness, with a maximum invasion depth corresponding to the area where the myometrium measured 18 mm. There was also involvement of the cervix, with infiltration extending into the mucosa and stroma to a depth of 1.5 mm, within a cervical wall measuring 8 mm at the thickest point. No lymphovascular invasion was observed. The remainder of the endometrium appeared unremarkable, while the myometrium showed changes consistent with adenomyosis. The adnexal structures were otherwise normal. The omental biopsy revealed metastatic cells with serous morphology, and two lymph nodes in this specimen were non-involved and benign."} +{"pid": "TCGA-T3-A92N", "report": "A tissue specimen measuring 4.5 x 4.0 x 2.0 cm was received and described as pink-tan with a focally charred surface. One side showed pink-tan, glistening mucosa. A central ulcerated red-brown area measuring 2.0 x 1.0 cm was noted. Deeper sectioning revealed a white-tan, firm mass measuring 2.7 x 2.5 cm that appeared to reach the inked surgical margin.\n\nAdditional specimens included a submandibular gland with a peripheral 1.2 cm white-tan firm area and an unremarkable yellow-tan cut surface. In another region, a 3.5 x 12.5 x 4.0 cm white-tan mass was identified in soft tissue, abutting the inked margin.\n\nExamination of lymph node regions revealed variable findings. Some areas contained benign lymph nodes without evidence of involvement. Other areas showed presence of tumor within lymph nodes and surrounding soft tissue. The largest tumor deposit outside of lymph nodes measured 5 cm. Involvement of lymph nodes was observed in several regions, with the largest focus measuring 6 mm. In one case, there was evidence of tumor extending beyond the lymph node capsule.\n\nMargins assessed with frozen section biopsies from multiple anatomical sites were free of tumor. The maximal diameter of the primary tumor was 2.7 cm. Tumor cells were also found in perineural spaces. The tumor extended into adjacent salivary tissue and reached the inked margin in at least one location.\n\nBased on pathological findings, the tumor stage was classified as T2 with regional nodal involvement classified as N2c."} +{"pid": "TCGA-FB-A4P5", "report": "The specimen was obtained via pancreaticoduodenectomy and involved the head of the pancreas. The lesion measured 4.5 cm in greatest dimension. Histologic evaluation demonstrated a moderately differentiated cellular component. Microscopic examination revealed extension into peripancreatic soft tissue. Surgical margins were assessed: the distal, common bile duct, and distal stomach/duodenum margins were free of involvement, while the retroperitoneal margin at the uncinate groove showed neoplastic infiltration. Evidence of angiolymphatic and perineural spread was present. There was no prior treatment effect identified.\n\nStaging assessment showed tumor extension beyond the pancreas into surrounding adipose tissue (pT3). Lymph node evaluation revealed metastatic involvement in several regional nodes, including 1 of 4 superior peripancreatic nodes, 2 of 10 posterior pancreaticoduodenal nodes, and 1 of 1 peripancreatic node (D). Other lymph node groups examined contained no metastases."} +{"pid": "TCGA-F5-6814", "report": "The submitted specimen consists of a resected segment of the rectum. The tumor measured 15 x 7.5 x 10 cm and was located in the rectum. Microscopic examination revealed moderately differentiated cells arranged in glandular patterns. The tumor involved pericolonic tissues. No information is available regarding lymph node involvement, surgical margins, neo-adjuvant treatment, or additional pathologic findings."} +{"pid": "TCGA-53-7813", "report": "A wedge resection of the right upper lobe was performed. A lesion measuring 1.5 cm in greatest dimension was identified. Microscopic evaluation revealed multiple small foci with specific cellular features in the stapled resection margin. Additional findings in the lung tissue included similar microscopic changes and atypical cellular growth. The bronchial margin did not show evidence of these changes.\n\nLymph nodes were evaluated from several regions, including hilar, right lower paratracheal, subcarinal, inferior pulmonary ligament, and parabronchial areas. Each lymph node specimen contained only normal-appearing tissue without any abnormal cellular features.\n\nThe surgical specimen showed no involvement of the visceral pleura, no vascular invasion, and no lymphatic invasion. All regional lymph nodes examined were free of abnormal cells. A total of five lymph nodes were assessed, none were involved. The histologic grade of the cellular changes was classified as moderately differentiated. The tumor could not be fully assessed for margins due to its location and extent. \n\nGross examination of the resected tissue showed a firm, tan lesion embedded within a larger fibrofatty and soft tissue specimen. Multiple sections were taken for analysis, including through the lesion, margins, and surrounding lung tissue. No additional masses were identified in the remaining lung tissue. The patient underwent a right thoracotomy, with a preoperative concern for a lesion in the right upper lobe. Intraoperative assessment confirmed the presence of abnormal tissue in the resection specimen, with similar findings at the margins."} +{"pid": "TCGA-EB-A24C", "report": "The skin lesion measured 3.2 x 2.8 x 4.5 cm and was located on the trunk. The lesion was ulcerated and pigmented. Histologic evaluation revealed a cellular morphology consistent with a high-grade neoplasm. No lymphatic or venous invasion was identified. The surgical margins were free of abnormal cells. No satellite nodules, lymph node involvement, or additional pathologic findings were noted. There was no evidence of prior neo-adjuvant treatment."} +{"pid": "TCGA-DD-AACM", "report": "The liver specimen measures 17.0 x 12.0 x 4.5 cm and weighs 262.5 grams. Three tumors are present in the left lobe, measuring 1.5 x 1.5 x 1.2 cm, 1.8 x 1.5 x 1.5 cm, and 1.3 x 1.2 x 1.2 cm. The closest distance from the tumor to the resection margin is 1.8 cm. No satellite nodules are identified. The gross appearance shows an expanding nodular growth pattern. Tumor necrosis is present in 10% of the tissue. There is no hemorrhage or peliosis. Invasion of the portal vein or bile ducts is not observed.\n\nMicroscopic evaluation reveals a lesion with features including partial fibrous capsule formation, capsular infiltration, and septum formation. The cellular architecture demonstrates a trabecular pattern with hepatic cell morphology. The worst histologic differentiation is grade III, with similar findings in the major component. There is no fatty change within the lesion. Surgical margins are free of involvement. Serosal invasion is noted involving Glisson\u2019s capsule. Multiple distinct lesions are present, indicating multicentric occurrence.\n\nEvaluation of non-lesion liver tissue shows chronic hepatitis of mild activity, associated with HBV infection. Fibrosis is present in a periportal to septal distribution without cirrhosis. Trichrome staining confirms septal fibrosis. Other findings include chronic cholecystitis, lymph node without abnormality, skin biopsy showing chronic dermatitis, and no evidence of other significant liver disease or dysplastic changes."} +{"pid": "TCGA-AU-3779", "report": "The resected specimen measured 16 cm in length. The lesion involved the sigmoid colon and measured 4 cm in greatest dimension. Histologic evaluation showed a well-differentiated epithelial neoplasm arising in a tubulovillous background. The lesion extended through the muscularis propria into the surrounding pericolonic adipose tissue, with a distance of 0.1 cm beyond this layer. The closest distance from the tumor to the opened mucosal margin was 3 cm. The tumor approached the serosal (anti-mesenteric) surface to within 0.6 cm, while the radial mesenteric margin was 3.5 cm away from the tumor. Smooth muscle proliferation was identified in serosal adhesions, consistent with partial myomectomy as described intraoperatively.\n\nAdditional findings in non-neoplastic mucosa included diverticular disease with ruptured diverticulitis, associated soft tissue inflammation and fibrosis, as well as an incidental hyperplastic polyp measuring 0.1 to 1 cm. All surgical margins were uninvolved. Twenty-one regional lymph nodes were examined and none showed evidence of tumor. Vascular and lymphatic invasion were not identified. No other organs or visceral peritoneum were involved."} +{"pid": "TCGA-WB-A80K", "report": "The specimen consists of a right adrenal gland weighing 178 grams with dimensions of 9 x 8.5 x 5.0 cm. The gland is fully encapsulated and includes some adherent fatty tissue. Upon sectioning, two distinct tumor foci are identified: the larger measuring up to 6.2 cm in diameter and the smaller measuring 3.1 cm. Both tumors are surrounded by a thin membrane. The larger tumor has a bright red, lobulated appearance with areas of fresh bleeding and focal necrosis containing cavities. Septa are present within this lesion. The smaller tumor is bright red-yellow without evidence of necrosis. Focal remnants of intact adrenal cortex are observed adjacent to both lesions.\n\nMicroscopically, both tumors demonstrate polymorphic cells arranged in nests and cords separated by vascular structures. Cellular morphology varies, with some regions showing greater pleomorphism and others appearing more uniform. Eosinophilic cytoplasmic inclusions are only occasionally noted. There is variable eosinophilia of the cytoplasm. No significant necrosis or increased mitotic activity is observed. Vascular invasion is suspected in certain areas, although no definitive tumor necrosis is present. Immunohistochemistry reveals weak chromogranin and partial S-100 expression, while inhibin staining is strongly positive in the surrounding adrenal cortex and faintly present in parts of the tumor. Additional immunostaining for ACTH on both nodules is negative, with pituitary control tissue showing appropriate positivity. Surgical margins appear uninvolved."} +{"pid": "TCGA-B0-4844", "report": "The specimen consists of a left radical nephrectomy. The lesion measures 8.2 cm in greatest dimension and is associated with Fuhrman nuclear grade 3 features. Approximately 10% of the examined tissue demonstrates areas of necrosis. There is extensive involvement of the perinephric adipose tissue. The deep surgical margin, including Gerota\u2019s fascia, is involved. Widespread angiolymphatic invasion is present. All other margins, including vascular and ureteral, as well as renal sinus and hilar adipose tissue, show no evidence of involvement. The adrenal gland appears unremarkable. No significant abnormalities are identified in the non-involved renal parenchyma. Pathologic staging is determined as pT3a; lymph node and distant metastasis assessments are not available."} +{"pid": "TCGA-AZ-6607", "report": "The specimen consists of a resected segment of sigmoid colon along with additional tissue samples. A lesion measuring 4.5 cm is present, involving the colonic wall and extending through its full thickness. The tumor is found at the serosal surface and reaches the cauterized radial edge of the specimen. Both distal margins are free of tumor involvement, although the proximal margin shows presence of carcinoma at the cauterized edge. Angiolymphatic and perineural invasion are identified. Metastatic carcinoma is present in five out of nineteen lymph nodes examined. Additional specimens including parts of the bladder wall, left pelvic sidewall, and omentum show involvement by carcinoma.\n\nHistological evaluation reveals a moderately differentiated adenocarcinoma with extensive involvement of the colonic wall from mucosa to pericolic fat. There is widespread extramural/subserosal spread with areas of serosal penetration and dense infiltration noted at the surgical margins. Immunohistochemical staining demonstrates positivity for cytokeratin 7, CEA, and cytokeratin 19, with focal positivity for cytokeratin 20. Stains for CDX-2, TTF-1, and PSA are negative. Mismatch repair proteins MLH-1, PMS-2, MSH-2, and MSH-6 show preserved expression. Morphological and immunophenotypic features do not align with typical primary colorectal adenocarcinoma and raise consideration of an alternate primary origin, potentially in the pancreaticobiliary region or possibly peritoneal in nature. One lymph node was confirmed negative for carcinoma using cytokeratin AE1/AE3 staining."} +{"pid": "TCGA-AN-A0FN", "report": "The pathology report describes a tissue specimen obtained from the right breast via surgical procurement. The sample was preserved in an OCT matrix and stored in a block container. Histological evaluation revealed Grade 2 cellular features. No treatment had been administered prior to collection. Additionally, a normal blood sample was collected via blood draw, preserved in a frozen state, and stored in a tube container. Staging information indicates no evidence of nodal or distant metastasis. Tumor dimensions and specific cellular morphology have been documented but are not included here as part of the requested modification."} +{"pid": "TCGA-2Y-A9GY", "report": "The specimen consisted of a right lobe liver resection, including segments 5 and 6, measuring 15.0 x 10.0 x 6.0 cm. A single tumor mass was identified within the liver parenchyma, measuring 12.5 x 7.5 x 5.0 cm, with a partially encapsulated and nodular configuration. The tumor was located adjacent to the liver capsule but did not extend through it. The closest parenchymal resection margin was 0.8 cm from the tumor edge. A second satellite tumor nodule was also identified within the liver parenchyma, measuring up to 2 cm in greatest dimension, and located 4.0 cm from the closest resection margin. The cut surface of the primary tumor was tan-white to tan-pink, focally hemorrhagic, and homogeneous. Microscopically, the tumor cells were poorly differentiated, with areas of necrosis accounting for approximately 5% of the tumor volume. No perineural invasion was identified. The surgical margins were free of malignant involvement. Vascular invasion involving a large vessel was noted. No lymph nodes were submitted for evaluation. The surrounding liver tissue showed severe steatosis without evidence of cirrhosis. The gross examination of the gallbladder specimen revealed no significant abnormalities. The wall measured 0.2 cm in thickness, and the mucosa appeared velvety with bile-stained content. No calculi were identified. The liver margin specimen, assessed intraoperatively, was negative for tumor involvement."} +{"pid": "TCGA-YF-AA3L", "report": "Specimen included right and left ureters, bladder with uterus, ovaries, fallopian tubes, and surrounding tissues, along with the appendix and multiple lymph nodes. The right ureter measured 7 cm in length and 0.5 cm in diameter; the left ureter measured 8 cm in length and 0.5 cm in diameter. Both ureters were unremarkable. The bladder was part of a radical cystohysterectomy specimen and measured 11 x 8 x 6 cm. A soft, tan-pink papillary lesion measuring 5 x 4.5 x 2.5 cm was identified at the right trigone and posterior wall. This lesion extended 1 cm from the deep margin. The remainder of the bladder mucosa showed adenomatous changes and congestion. An ulcerated hemorrhagic area measuring 3 x 2 cm was noted in the left lateral wall.\n\nThe uterus measured 10 x 6.3 x 6 cm and weighed 200 grams. The cervix comprised the lower 4 x 4 x 3.5 cm portion. The endometrial cavity was triangular, measuring 2 cm at its widest point and up to 0.3 cm in endometrial thickness. A subserosal mass measuring 1.5 cm in greatest dimension was identified in the myometrium, with a white-tan, whorled appearance. No hemorrhage or necrosis was observed. Both fallopian tubes were unremarkable; the right measured 7 x 0.7 cm and the left measured 5 cm in length. Ovaries were cerebriform with small cystic structures measuring between 0.3 and 0.5 cm.\n\nThe appendix measured 6 cm in length and 0.7 cm in diameter, with a smooth serosal surface and tan mucosa. All surgical margins were free of tumor involvement. Invasion into muscular layers was identified, and lymphovascular space invasion was present. Chronic cervicitis, proliferative endometrium, and a leiomyoma were also noted. Additional findings included an unremarkable appendix and fibroconnective tissue with squamous epithelium from a fragment labeled as urethra and bladder.\n\nLymph node assessment included two nodes on the right and six on the left, all negative for metastatic involvement. Tissue sections included areas of deep invasion, tumor representation, lateral and posterior bladder walls, fatty tissue, cervical and endometrial regions, myometrium, and ovarian and tubal structures. No other lesions were identified in the submitted tissues."} +{"pid": "TCGA-EL-A4KI", "report": "The surgical specimen from a male patient was submitted for analysis. The left inferior parathyroid biopsy consisted of fibroadi\n### Summary\n\nA surgical case from a male patient involved the examination of several specimens. The left inferior parathyroid biopsy showed fibro-adipose tissue without evidence of tumor or identifiable parathyroid parenchyma.\n\nThe total thyroidectomy specimen included bilateral, multi-focal lesions. The largest focus measured 3.4 cm in the left lobe and exhibited areas of necrosis. There was evidence of extrathyroidal extension into surrounding fibrous tissue. Lymphovascular invasion was present. The resection margins were free of tumor involvement. The background thyroid tissue showed features of multinodular adenomatous goiter. An intrathyroidal nodule measuring 1.3 cm in the left lobe was identified and is pending further immunohistochemical evaluation.\n\nExamination of a lymph node from the left level 3 region revealed no tumor involvement. The left paratracheal soft tissue specimen contained normal parathyroid tissue without lymph nodes identified.\n\nGrossly, the thyroid specimen demonstrated a tan-pink to gray-white cut surface with areas of hemorrhage and cystic change. Nodules in the isthmus measured 1.1 x 0.8 x 0.8 cm and 1.5 x 1.4 x 1.4 cm, respectively. The right lobe contained a tan, lobulated mass measuring 3.4 x 2.7 x 2.4 cm, located primarily in the mid to lower pole. Normal appearing thyroid tissue accounted for approximately 20% of the right lobe. \n\nFrozen section analysis of the left inferior parathyroid biopsy and the left level 3 lymph node both showed benign findings. The report addendum notes that the intrathyroidal nodule was positive for TTF-1 and negative for PTH on immunohistochemical testing, with no change to the original interpretation."} +{"pid": "TCGA-AX-A0J0", "report": "The specimen from a female patient included a uterus with bilateral adnexa, as well as lymph node tissue from left and right pelvic regions and periaortic areas. Gross examination of the uterus revealed a polypoid mass arising from the anterior endometrial wall measuring 3.5 cm in greatest dimension. The cervix was unremarkable with a slit-shaped os measuring 1 cm in diameter. The uterus measured 7 x 6 x 2.5 cm and the myometrial thickness was noted at 12 mm. Upon sectioning, the mass demonstrated invasion into the superficial myometrium to a depth of 2 mm without involvement of the lower uterine segment or serosa.\n\nMicroscopic evaluation confirmed invasive growth within the luminal one-third of the myometrium. There was no evidence of lymphovascular space invasion. Examination of the cervix showed no tumor involvement. Histologic evaluation of the ovaries and fallopian tubes demonstrated no abnormalities except for mild hydrosalpinx on the right fallopian tube.\n\nLymph node dissection yielded multiple lymph nodes from various regions: 18 nodes from the left pelvic area (largest measuring 2 x 1 x 0.4 cm), 8 nodes from the right pelvic region (including two measuring 2 x 1 x 0.4 cm and 3 x 1.2 x 0.8 cm), and 3 nodes from the right periaortic area. Additionally, fibroadipose tissue was received from the left periaortic region where no lymph nodes were identified. No tumor involvement was detected in any of the lymph nodes evaluated.\n\nBased on histopathologic findings, the lesion exhibited superficial invasion less than half of the myometrial thickness corresponding to T1b staging. Regional lymph nodes were negative for metastasis (NO). Distant metastasis could not be assessed (MX). Therefore, the provisional pathologic stage was determined as T1b/NO/MX."} +{"pid": "TCGA-XF-A9SP", "report": "A radical cystoprostatectomy with pelvic lymphadenectomy and continent urinary diversion (T-pouch to urethra) was performed. A right distal ureter specimen showed no atypical or malignant cells and was determined to be benign. Similarly, the left distal ureter showed no high-grade atypia or malignancy and was diagnosed as benign hydroureter. Para-aortic lymph nodes (proximal limits) were examined and found to be non-malignant. The urethral margin showed no concerning cellular changes and was classified as benign.\n\nIn the bladder and prostate specimen, a poorly differentiated transitional cell lesion measuring 3.5 x 3.5 x 1.8 cm was identified in the posterior bladder wall, extending into the trigone and bladder neck. This lesion involved both ureterovesical junctions and exhibited deep invasion through the bladder wall into the perivesical fat. Lymphovascular space invasion was noted. Additionally, multifocal urothelial carcinoma in situ was observed, along with reactive changes and varying degrees of dysplasia throughout the bladder mucosa. Resection margins were free of dysplastic or malignant urothelial involvement.\n\nThe prostate demonstrated a moderately differentiated adenocarcinomatous focus confined to the right mid anterior region, corresponding to a Gleason score of 6 (3+3). The tumor did not extend beyond the prostatic capsule or involve surrounding soft tissue. Benign prostatic hyperplasia was also present, along with rare foci of high-grade intraepithelial neoplasia (PIN II). No evidence of urothelial dysplasia or invasive urothelial carcinoma was found within the prostatic urethra or parenchyma. Both seminal vesicles were free of tumor involvement.\n\nLymph node examination revealed no metastatic disease. Specifically, no malignant cells were found in para-aortic lymph nodes (0/4 examined), left common iliac lymph nodes (0/7), paracaval lymph nodes (0/3), right common iliac lymph nodes (0/1), right external iliac lymph nodes (0/4), right lymph node of Cloquet (0/1), right hypogastric/obturator lymph nodes (0/6), left external iliac lymph nodes (0/4), left lymph node of Cloquet (0/1), left hypogastric/obturator lymph nodes (0/3), right presciatic lymph nodes (0/3), presacral lymph nodes (0/4), or left presciatic lymph nodes (0/0 submitted entirely).\n\nGrossly, the bladder and prostate specimen measured 18.5 x 12 x 5 cm. The bladder itself was 6.5 x 6 x 4 cm and the prostate measured 4 x 4.5 x 3 cm. The tumor appeared pale and polypoid on the posterior bladder wall, measuring 3.5 x 3.5 cm grossly, with a depth of 1.8 cm, extending focally into the perivesical fat. Microscopically, the tumor infiltrated deeply into the lamina propria, muscularis propria, and adjacent fat, composed of nests, cords, sheets, and single-cell arrangements with nuclear pleomorphism and prominent nucleoli. Prostatic involvement was limited to a single moderately differentiated adenocarcinoma focus without capsular breach.\n\nMargins of resection for the apical and inked capsular regions were negative for tumor involvement. Left and right proximal ureters were benign with no urothelial dysplasia or malignancy identified.\n\nStaging was assigned as follows: for the bladder, pT3b, indicating deep invasion into perivesical fat; N0, indicating no regional lymph node metastasis; MX, indicating inability to assess distant metastasis. For the prostate, pT2a was assigned, indicating organ-confined disease without capsular extension; N0 and MX similarly applied."} +{"pid": "TCGA-KK-A8I7", "report": "The lymph node specimens were evaluated from the right obturator, internal/external iliac regions, left obturator and internal iliac regions, and left external iliac region. A total of nine lymph nodes were identified across all regions, with sizes ranging from 0.7 x 0.6 x 0.5 cm to 4.5 x 1.8 x 0.6 cm in the right obturator/internal/external iliac region; 1.0 x 0.5 x 0.3 cm to 4.0 x 1.4 x 0.5 cm in the left obturator/internal iliac region; and 2.7 x 1.4 x 0.5 cm to 3.5 x 1.5 x 0.7 cm in the left external iliac region. No abnormal cellular findings were observed in any of the lymph nodes examined.\n\nThe prostate specimen, measuring 4.4 x 3.1 x 3.2 cm and weighing 33 grams post-fixation, was submitted along with attached seminal vesicles and segments of the vasa deferentia. Three distinct areas of cellular abnormality were identified within the peripheral zone of the prostate. The dominant area measured 2.6 x 1.6 cm in its largest cross-sectional dimension and spanned multiple cross sections of the prostate, including the apex and base. This focus extended into adjacent non-prostatic tissue and involved both seminal vesicles. Vascular and lymphatic invasion was noted within the prostate and in the intraprostatic portion of the left seminal vesicle. Tumor cells were found at the inked anterior apical margin of resection, involving approximately 4.0 mm. At other sites of extension beyond the prostate capsule, the margins of resection were free of tumor.\n\nTwo smaller areas of abnormal cells were also identified: one measured 0.6 x 0.4 cm in the left lateral and left posterolateral peripheral zone, and the other measured 0.7 x 0.3 cm in a similar region. These smaller areas were confined within the prostate and did not involve the surgical margins. High-grade intraepithelial changes were also present.\n\nThe prostate was sectioned in a standardized fashion for microscopic evaluation, with specific attention to the margins of resection marked by different inks. Multiple tissue blocks were submitted for histological analysis, including sections from the base, apex, and detached portions of the resection margin."} +{"pid": "TCGA-A3-3365", "report": "The specimen consists of a right nephrectomy weighing 600 grams, measuring 19.8 x 13.2 x 6.6 cm in total. The organ is surrounded by perinephric adipose tissue and Gerota's fascia. Resection margins include 0.9 cm of renal artery, 0.8 cm of renal vein, and 7.5 cm of ureter, all grossly patent. After removal of surrounding tissue, the kidney measures 9.3 x 6.0 x 4.8 cm. The cortex is up to 1.0 cm thick, homogeneously red-brown, with a poorly defined corticomedullary junction. The medulla is also homogeneously red-brown with distinct papillae. The calices and pelvis are lined with smooth gray-tan mucosa extending into the ureter.\n\nOn the anterior aspect of the upper to mid pole, there is a well-circumscribed, unencapsulated lesion measuring 3.0 x 3.0 x 2.5 cm. The lesion is tan-pink to yellow with areas of hemorrhage and hyalinization. It does not have a distinct capsule and extends anteriorly but appears limited by a thin layer of overlying cortex. There is no gross evidence of invasion into adjacent structures. No other lesions are present.\n\nMicroscopically, the lesion shows nuclear features corresponding to Fuhrman grade 2-3. The histologic architecture is consistent with conventional growth pattern. No lymphovascular space invasion is identified. There is no transcapsular extension or renal vein involvement. All surgical margins (soft tissue, ureteral, vascular) are negative. No lymph nodes are present for evaluation. Additional findings include interstitial chronic inflammation. Staging is pT1a, Nx, Mx."} +{"pid": "TCGA-EY-A1GM", "report": "The surgical pathology report includes multiple specimens. Right para-aortic lymph node removal included nine lymph nodes, all negative for malignancy. Left para-aortic lymph node removal included four lymph nodes, all also negative. The uterus and cervix specimen showed a lesion located in the endometrium with mixed histologic features. Histologic grading was consistent with high-grade changes. The depth of invasion was limited to the inner half of the myometrium, with a wall thickness of 1.5 cm and an invasion depth of 0.5 cm (approximately 33% penetration). There was no evidence of serosal or lower uterine segment involvement. Cervical involvement was not identified, but adnexal involvement was present. Vaginal and cervical margins were widely free. Lymphovascular space invasion was not identified. A total of 24 regional lymph nodes were examined across all specimens, with none showing signs of involvement.\n\nAdditional findings included chronic cervicitis, leiomyomata, and adenomyosis. Immunohistochemistry demonstrated moderate to strong nuclear staining for estrogen receptor in a majority of tumor cells and moderate staining for progesterone receptor in a smaller subset. Involvement of the right fallopian tube was noted, with free-floating carcinoma identified in a representative section. The left fallopian tube showed no signs of involvement. Both ovaries were atrophic and without evidence of malignancy.\n\nLymph node assessments from right and left pelvic regions showed no evidence of tumor involvement, with seven and four lymph nodes examined respectively. Endosalpingosis was identified in one pelvic specimen. Gross examination revealed a fungating, white-tan, friable lesion measuring approximately 5.0 x 4.6 x 3.6 cm located on the posterior wall, fundus, and cornu of the uterus. Multiple leiomyomata were found throughout the myometrium and subserosally, with the largest measuring 3.2 cm. All leiomyomata had a glistening, white/tan, whorled cut surface.\n\nMicroscopic evaluation confirmed the presence of a tumor with mixed patterns, predominantly featuring higher grade nuclear features, slit-like spaces, and focal cell sloughing. Staining for p53 showed strong and diffuse nuclear positivity in the high-grade areas. The right fallopian tube exhibited stenosis with changes consistent with salpingitis isthmica nodosum. No tumor was identified in the cervix, lower uterine segment, or separately submitted lymph nodes. The assessment of immunohistochemical markers used reagents classified as analyte specific reagents, which are not cleared or approved by the FDA but are used for clinical purposes under CLIA-88 certification."} +{"pid": "TCGA-J1-A4AH", "report": "The specimen consisted of a left pneumonectomy measuring 21 x 13 x 7 cm in greatest dimensions. The hilar aspect was inked black and the pleural surface showed prior dissection over an area measuring 6 x 6 x 5 cm. The lesion was located in the left lower lobe and measured 6 cm in greatest dimension. It appeared friable, white, and focally necrotic on sectioning. Margins were assessed with extensive sampling of the hilar region and no tumor was identified at the resection margins. A total of 22 lymph nodes were examined across multiple stations, including peribronchial and peri-aortic regions. None showed evidence of involvement. Histologic evaluation revealed a unifocal invasive process with features suggestive of moderate to poor differentiation. Histologic grade was determined to be intermediate to high grade. No treatment effect, visceral pleural invasion, or obstructive changes extending to the hilum were observed. Rare suspicious foci were noted in small vessel lymphatics, but large vessel invasion was not present. Staging was assigned as pT2b, pN0, pMX."} +{"pid": "TCGA-HD-7754", "report": "The tissue specimen measured 5.2 x 4.5 x 3.6 cm and consisted of a tonsil with an attached portion of tongue. The specimen was sectioned into four pieces for margin evaluation. A white-tan, firm mass measuring 3.9 x 2.8 cm was identified. Multiple sections were submitted for frozen section analysis, including areas corresponding to the tongue and lateral, anterior lateral, posterior lateral, posterior medial, and anterior medial margins.\n\nMicroscopic examination revealed a well-differentiated infiltrating epithelial tumor. Surgical margins were evaluated, with one margin positive at the posterior lateral aspect. Another margin measured less than 1 mm at the anterior medial aspect, while all other margins were negative. The greatest negative margin was located at the anterior (tongue margin) and measured 9 mm.\n\nLymph node evaluation included right level 2B, where two lymph nodes were identified and both were negative. In right level 3, thirteen lymph nodes were identified, all of which were negative. In right level 2A, eight lymph nodes were sampled, and four of these contained abnormal findings. No evidence of lymphovascular invasion was observed.\n\nStaging was determined based on pathologic findings. Tumor size and local extension corresponded to a T2 classification. Nodal involvement with multiple positive nodes in level 2A supported a classification of N2b."} +{"pid": "TCGA-B6-A0IC", "report": "Surgical Pathology Report. CLINICAL HISTORY: Year-old white female with a right subareolar breast mass present for three months. GROSS EXAMINATION: Specimen labeled \u201cRight breast mass \u2013 wide local excision\u201d in formalin consists of a portion of breast tissue with attached skin ellipse and nipple. The skin ellipse measures 9 x 3.5 cm, and the underlying breast tissue measures 10 x 4 x 4 cm. The outer surface was inked blue. Beneath the skin ellipse is a mass measuring 2.5 x 2 x 1.5 cm composed of tan, firm, friable tissue with focal areas of hemorrhage. The mass is sharply circumscribed and located 0.8 cm from the deep surgical margin. Block Summary includes sections of the nipple and multiple sections of the mass including the deep surgical margin. MICROSCOPIC EXAMINATION: The lesion contains large areas of well-formed papillary structures with fibrovascular cores lined by malignant, stratified, complex epithelium. Additionally, cribriform and tubular patterns are observed infiltrating into desmoplastic fibrous tissue. All margins are negative for tumor involvement."} +{"pid": "TCGA-06-0188", "report": "The patient presented with a history of epileptic symptoms, including a foul chemical taste and anxiety, associated with a right temporal lobe lesion extending to the uncus. Two tissue samples were obtained: one from an unspecified cerebral site and another from the right temporal region.\n\nMicroscopic evaluation of the first specimen revealed a glial neoplasm with features including frequent gemistocytic cells, mitotic figures, and microvascular proliferation. The MIB-1 proliferation index was 22%, and there was evidence of vascular karyorrhexis. GFAP staining showed prominent glial fibrillogenesis, and p53 overexpression was observed in approximately 10% of the cells. CD34 highlighted microvascular proliferation, further supporting a high-grade process.\n\nThe second specimen, from the right temporal area, demonstrated a glial tumor involving the white matter. This lesion exhibited mitotic activity but lacked microvascular proliferation or necrosis. The MIB-1 proliferation index in this sample was 5%. Immunohistochemical analysis showed no p53 overexpression in this region, and GFAP again confirmed glial differentiation.\n\nGenetic testing for MGMT promoter methylation was negative. Tissue fragments submitted for analysis included both small and larger pieces, with the larger fragment sectioned extensively and fully submitted for evaluation. All histological evaluations were conducted using standard techniques, and the immunoprofiling supported a high-grade astrocytic neoplasm."} +{"pid": "TCGA-49-AARR", "report": "The left upper lobe specimen measures 22 x 13 x 5 cm and contains a firm nodule located inferior to the hilar bronchi and vessels. The mass is tan-white, measuring 2 x 3 x 1.5 cm, and is found beneath pleural puckering on the lateral aspect of the lung. It approaches the inked pleural margin, coming within approximately 1 mm of it, though the margin is microscopically negative. The tumor is approximately 2 cm from the staple margin and 3 cm from the hilar bronchi and vessels. Cellular examination reveals infiltrating moderately differentiated cells. Vascular, bronchial, and parenchymal margins of resection are all free of involvement. A total of eight hilar lymph nodes are negative. The non-neoplastic lung tissue shows centrilobular emphysema and anthracotic pigment. Representative sections of the mass were submitted for analysis, along with perpendicular and shave sections from the staple margin, as well as normal lung tissue. A separate lymph node specimen from station 5, measuring 0.7 x 0.4 x 0.2 cm, is also negative. The specimen was entirely submitted for evaluation."} +{"pid": "TCGA-3X-AAV9", "report": "The specimen was received for evaluation from a male patient. The submitted specimens included a small bowel nodule, a mesenteric lymph node, a gallbladder, and a wedge resection of the right lobe of the liver.\n\nThe small bowel nodule biopsy showed only focal fibrosis without evidence of malignancy. The mesenteric lymph node was negative for malignant involvement. The gallbladder specimen appeared unremarkable, with no signs of malignancy identified.\n\nIn the liver specimen, a tan solid mass measuring 7.7 x 6.0 x 5.5 cm was identified. This mass was located close to the resection margin, with less than 0.1 cm distance at its closest point. The tumor focally involved the liver capsule and demonstrated positive perineural invasion. Surrounding liver tissue showed moderate portal inflammation, which may be attributed to the mass effect. No vascular invasion was specifically noted.\n\nHistologic sections of the mass were taken from multiple areas including its relationship to the serosal surface, proximity to the resection margin, internal blood vessels, and surrounding unaffected liver tissue. Immunohistochemical staining of the tumor cells showed strong positivity for CK7 and CK19, focal positivity for CK20, and no reactivity for TTF-1 or CDX2. These findings were obtained from a combination of frozen and formalin-fixed tissue samples. A portion of the liver specimen was also sent for tumor banking purposes.\n\nAll specimens were properly labeled and correlated with the patient's information."} +{"pid": "TCGA-HU-A4H8", "report": "The surgical specimen consisted of a distal gastrectomy, fresh. The specimen measured 14.3 cm along the greater curvature and 12.0 cm along the lesser curvature. The proximal resection margin was 14.0 cm in length, and the distal resection margin measured 4.8 cm. The duodenum measured 2.0 cm. The lesion was located in the distal third of the stomach (antrum), along the greater curvature, 8.0 cm from the proximal resection margin and 3.5 cm from the distal resection margin. The lesion measured 4.8 x 3.3 x 1.2 cm and was classified as EGC I. Gross serosal involvement was noted.\n\nHistologically, the lesion demonstrated tubular growth patterns with moderate differentiation. Invasion extended to the lower one-third of the submucosa (T1b). Resection margins were free of involvement. The growth pattern was described as expanding, and a lymphoid reaction was present. Lymphovascular invasion was identified, although no venous or perineural invasion was observed. A multinodular lesion was noted in the distal antrum.\n\nLymph node evaluation revealed metastatic involvement in one of ten lymph nodes from the inferior gastric region. No tumor was found in superior gastric lymph nodes (0/28), or in other regional lymph nodes including those labeled '15' (0/1), '66' (0/14), '7' (0/2), '8' (0/5), '9', and '11p' (0/2). Distant metastasis could not be assessed. Special stains for H. pylori were negative.\n\nPathologic staging was determined to be pT1bN1MX."} +{"pid": "TCGA-UY-A8OC", "report": "The patient underwent a radical cystoprostatectomy and bilateral pelvic lymph node dissection. Specimens were received in nine parts labeled accordingly. \n\nBiopsies of the right and left ureters showed no tumor involvement. Examination of the bladder and prostate revealed an invasive growth involving both the anterior and posterior walls. The lesion measured approximately 4.5 cm and extended into adjacent structures, including the prostate and seminal vesicles. No tumor was identified in two lymph nodes evaluated near the bladder.\n\nBiopsy of perivesical fat showed no tumor. Left pelvic lymph node dissection included ten lymph nodes, none of which contained tumor. In contrast, one of eleven lymph nodes from the right pelvic dissection contained metastatic involvement. The largest metastatic deposit measured 0.3 cm, with no extranodal extension observed.\n\nSurgical margins were negative at the urethral, right ureteral, left ureteral, and perivesical sites. However, the perivesical margin was noted to be close (<1 mm) at the right inferior aspect. Perineural invasion was identified on microscopic examination.\n\nA total of twenty-three lymph nodes were assessed across all sites; one demonstrated tumor involvement. Based on these findings, staging was assigned according to AJCC/UICC criteria.\n\nRepresentative sections of all relevant areas were submitted for histological evaluation. Final diagnosis was confirmed by the attending pathologist following comprehensive slide review."} +{"pid": "TCGA-ED-A459", "report": "The liver specimen shows tumor cells arranged in trabecular, acinar, or sheet-like patterns within benign tissue. The cells have a polygonal shape with round, vesicular nuclei and prominent nucleoli. The cytoplasm is abundant and eosinophilic. Nuclear features include irregularity, increased size, and hyperchromasia. Mitotic figures are present. The tumor contains areas of necrosis and demonstrates lymphocytic invasion. The specimen was obtained via lobectomy and measures 6x5x5cm. Histologic evaluation indicates moderate differentiation without evidence of invasion. No information is available regarding focality, lymph nodes, venous invasion, margins, or neo-adjuvant treatment. No additional findings or comments are provided."} +{"pid": "TCGA-FD-A5BT", "report": "The specimen was obtained from a male patient who underwent cystoprostatectomy, bilateral lymph node dissection, and bilateral ureter biopsies. Lymph node dissections were performed on both the right and left pelvic regions. Fifteen lymph nodes were identified on the right side and twenty-five on the left; none showed evidence of tumor involvement. Three ureteral specimens were examined: portions of the left ureter tip, distal left ureter, and distal right ureter. All ureteral samples were free of tumor.\n\nThe surgical specimen included the urinary bladder and prostate. Gross examination revealed a mass measuring approximately 5 x 4.5 x 2.5 cm located in the upper anterior and right lateral walls of the bladder. The mass was firm, tan-white with areas of hemorrhage and necrosis, and extended into the surrounding adipose tissue to a depth of 2.5 cm. Microscopic evaluation showed invasive high-grade cellular changes with focal spindle cell features accounting for about 5% of the tumor volume. The tumor extended through the bladder wall and into the perivesical fat but did not involve the distal urethral margin or soft tissue margins. Prostatic tissue showed high-grade intraepithelial neoplastic changes and focal dense chronic active inflammation.\n\nAll ureteral margins and the distal urethral margin were free of tumor. A total of 40 lymph nodes were examined across both pelvic regions, and all were negative for tumor involvement. Pathologic staging was determined as pT3b based on invasion into extravesicular soft tissue, with no lymph node metastasis (N0) and indeterminate distant metastasis status (MX). The staging was assessed using the 7th edition TNM classification system for bladder cancer by the AJCC and UICC.\n\nMultiple tissue sections were submitted for histological analysis, including resection margins, sections of the prostate, seminal vesicles, vas deferens, and various areas of the bladder wall. No tumor was identified in the uninvolved mucosal regions of the bladder dome, anterior wall, or posterior wall at the trigone. The prostate demonstrated no tumor involvement at the apex or in the urethral margin. All surgical margins were free of tumor."} +{"pid": "TCGA-BR-6454", "report": "The gastrectomy specimen involved the stomach and measured 8 x 5 x 1.7 cm. The histology showed a poorly differentiated cellular pattern. The tumor extended to adjacent structures, including the esophagus and lesser omentum. No lymph node metastases were identified in the regional lymph nodes assessed (0/5 positive). Lymphatic, venous, and perineural invasion were not identified. Surgical margins were uninvolved. There was no evidence of prior neoadjuvant treatment. No additional pathologic findings or comments were noted."} +{"pid": "TCGA-EY-A547", "report": "The surgical specimen included multiple lymph node samples and a hysterectomy specimen. Lymph nodes evaluated included left para-aortic (one lymph node candidate), right para-aortic (multiple candidates ranging from 0.5 to 1.7 cm), left pelvic (four candidates ranging from 0.4 to 0.6 cm), and right pelvic (six candidates up to 3.1 cm). No abnormal tissue was identified in any of the lymph node specimens. The hysterectomy specimen measured 18.6 cm in height with a uterine weight of 650 grams. The endometrial cavity measured 6.2 cm in length. A lesion measuring 5.2 x 3.1 x 1.1 cm was observed on the posterior corpus, located 1.9 cm from the endocervical canal. The lesion appeared tan, friable, and exophytic. Myometrial invasion was limited to the inner half, with a depth of 5 mm in a wall thickness of 35 mm, representing approximately 14% penetration. There was no involvement of the serosa, lower uterine segment, cervical region, or adnexa. Vaginal and cervical margins were free of abnormal cells. Lymphovascular space invasion could not be definitively confirmed due to artifacts. A total of 18 lymph nodes were examined, with no evidence of involvement. Additional findings included benign endocervical polyps and leiomyomas. The left ovary contained a mature cystic teratoma without signs of malignancy. Both fallopian tubes and the right ovary showed no abnormal tissue. Immunohistochemical analysis demonstrated receptor positivity in the endometrial lesion; however, specific markers are pending further evaluation. Staging information is consistent with early-stage disease based on available data."} +{"pid": "TCGA-D1-A163", "report": "The surgical specimen includes a uterus with bilateral ovaries and fallopian tubes, submitted as a total hysterectomy with bilateral salpingo-oophorectomy. The right ovary measures 3.6 x 1.6 x 0.5 cm and is attached to a 7.2 cm segment of the right fallopian tube. The left ovary measures 3.0 x 1.0 x 0.5 cm with a 7.0 cm segment of the left fallopian tube. The entire specimen, including the gonads and tubes, weighs 320.0 grams. Additional specimens include right and left pelvic lymph nodes, right and left para-aortic lymph nodes, right gonadal vessels (10.5 cm in length), and left gonadal vessels (10.0 cm in length).\n\nMicroscopic examination reveals a mass measuring 6.2 x 2.0 x 2.0 cm located primarily in the uterine fundus, extending into the anterior endometrium and distally to the transformation zone of the cervix. The lesion appears ill-defined and is associated with areas of polypoid change in the endometrium. There is extensive treatment effect observed throughout the specimen. Necrosis is prominent, involving more than 80% of the lesion, making accurate assessment of myometrial invasion challenging. The apparent depth of invasion is estimated at 1\u20133 mm, within a total myometrial thickness of approximately 2.5 cm. No definitive lymphovascular space invasion is identified.\n\nEvaluation of the bilateral ovaries and fallopian tubes reveals no significant abnormalities. Among the lymph nodes assessed, a small focus of involvement is identified in one of twelve right external iliac lymph nodes and in one of five left external iliac lymph nodes. All other lymph node groups\u2014including internal iliac, obturator, common iliac, and para-aortic regions (both above and below the inferior mesenteric artery)\u2014are unremarkable. Notably, the specimen labeled as \"right para-aortic lymph nodes below the inferior mesenteric artery\" contained no identifiable nodal tissue. Gonadal vessels on both sides show no diagnostic changes.\n\nA total of 82 lymph nodes are evaluated, with 2 containing small foci of involvement. The majority of lymph node groups are uninvolved. The histologic features and distribution of involvement are noted in the context of post-therapeutic changes."} +{"pid": "TCGA-S8-A6BW", "report": "A 54-year-old male with a history of dysphagia and a PET-positive mass underwent an Ivor Lewis esophagectomy. The resected specimen included a segment of the esophagus measuring 9.7 cm in length. A centrally ulcerated, tan, firm mass was identified, measuring 5.2 x 4.3 cm on the mucosal surface, with a thickness of 2.1 cm. The tumor was located entirely above the esophagogastric junction and invaded into the muscularis propria. The closest margin involvement was within <0.1 cm of the circumferential (adventitial) margin. Both proximal and distal margins were free of invasive disease. No lymphovascular or perineural invasion was identified, and there was no evidence of treatment effect.\n\nA total of 22 lymph nodes were examined across multiple sites, including the subcarinal, portal, and other regional locations. All lymph nodes were negative for malignancy. In addition to the tumor findings, granulomatous changes consistent with a history of sarcoidosis were noted in several lymph nodes and tissue specimens.\n\nMargins from both the stomach and esophagus were confirmed to be free of tumor on frozen section analysis. Gross evaluation of the specimen showed no evidence of distant metastasis."} +{"pid": "TCGA-BR-6564", "report": "The gastrectomy specimen includes a tumor measuring 6 x 6 x 1 cm, which is ulcerated. The histologic type is poorly differentiated. The tumor extends to adjacent structures, specifically the greater omentum. Lymph node evaluation shows 3 out of 7 intraabdominal lymph nodes positive for metastasis. All margins are uninvolved. No information is provided regarding lymphatic, venous, or perineural invasion, neo-adjuvant treatment effect, or additional pathologic findings."} +{"pid": "TCGA-64-1681", "report": "The specimen consisted of eight tissue samples submitted for pathological evaluation. Sample #1, a 0.3 x 0.2 x 0.2 cm lymph node, showed no abnormal cellular findings. Sample #2 measured 1.5 x 0.4 x 0.2 cm and also contained no atypical cells. Sample #3 included multiple lymph nodes totaling 3 x 1 x 0.3 cm in size; no abnormal cells were identified. Sample #4 was a bronchial margin measuring 13 x 10 x 3 cm with an area of firm, rubbery consistency measuring 2.2 cm located approximately 2.5 cm from the bronchial margin. Upon sectioning, a tan-gray mass measuring 2.5 x 2.2 x 2 cm was identified within 0.6 cm of the bronchial margin and adjacent to the pleural surface. Microscopic examination of representative sections revealed no tumor involvement at the bronchial margin, vessel margins, staple line, or lymph nodes associated with this sample. Sample #5 contained lymph nodes within yellow fat measuring 2.5 x 1.5 x 0.4 cm; no abnormal cells were seen. Sample #6 measured 2 x 0.4 x 0.4 cm and contained no malignant cells. Sample #7 included lymph nodes measuring up to 2.5 x 1 x 0.3 cm with no tumor identified. Sample #8 contained two lymph nodes measuring 0.5 x 0.3 x 0.2 cm and 0.9 x 0.5 x 0.3 cm respectively, both without evidence of tumor involvement. All lymph node samples across the report totaled 42 lymph nodes examined microscopically and showed no presence of tumor cells."} +{"pid": "TCGA-WK-A8XO", "report": "The specimen was received fresh in five parts. Part A consisted of soft tissue fragments measuring 2.5 x 1.0 x 1.0 cm from the left pelvic sidewall. Microscopic examination revealed fibrovascular tissue with chronic inflammation and a foreign body giant cell reaction; no tumor cells were identified.\n\nPart B was a right retroperitoneal mass measuring 5 x 5 x 4.5 cm. The surface was inked, and margins were sampled. The cut surface showed tan/white lobulated firm areas. Additional fatty tissue attached measured 2.7 x 2.1 x 0.6 cm. Histologic sections showed cellular features including mitotic activity (40 mitoses per 10 high-power fields). No necrosis was observed. Margins examined microscopically included medial inferior lateral, anterior medial, posterior inferior, lateral (two fragments), medial superior, and anterior inferior. Additional tumor sampling included three fragments submitted for further analysis.\n\nPart C was an omental nodule measuring 1.2 cm in diameter. Microscopic evaluation revealed similar cellular features involving fibroadipose tissue.\n\nPart D consisted of a segment of ileum measuring 34.0 cm in length and 3.0 cm in diameter, along with a right colon segment measuring 12.0 cm in length and 8.0 cm in diameter. A mesenteric nodule measuring 1.6 cm was identified in the terminal ileum, located 20.0 cm from the ileal resection margin and 11.0 cm from the ileocolic vascular junction. Histologic evaluation of this lesion showed involvement of the intestinal wall extending into the submucosa. Resection margins (ileal, colonic, and radial) were free of tumor. Four lymph nodes were examined and found to be negative.\n\nPart E included a lymph node from the small bowel mesentery measuring 1.3 x 0.5 x 0.5 cm, along with associated fibroadipose tissue. Three fragments were examined microscopically and showed no evidence of tumor involvement.\n\nAll tissues were processed and embedded appropriately. Multiple microscopic sections were evaluated from each component of the specimen."} +{"pid": "TCGA-OR-A5J9", "report": "The specimen consists of a resected right adrenal mass from a female patient. The mass weighs 316 grams and measures 11 x 9 x 6.5 cm. It is surrounded by a thick brown capsule. On sectioning, the tumor has a multinodular appearance with light brown areas interspersed with regions of hemorrhage; the consistency is friable. Residual adrenal tissue is present and measures 1.5 x 1.0 cm. Surgical margins were marked with green Indian ink.\n\nMicroscopic evaluation reveals a tumor with a maximum dimension of 11 cm. Nuclear grading according to the Fuhrman system is 3. A diffuse architectural pattern is observed. Cells with clear cytoplasm constitute less than 25% of the tumor volume. Areas of necrosis are present. Mitotic activity is quantified as 6 mitoses per 50 high-power fields, with no atypical forms identified. Capsular and venous invasion are not detected, though sinusoidal invasion is noted. The WEISS score is 6. Examination of the surrounding adipose tissue shows no signs of tumor infiltration."} +{"pid": "TCGA-AT-A5NU", "report": "The surgical specimen includes a left kidney with attached adrenal gland and segment of ureter. The entire specimen measures 20 x 13 x 5 cm and weighs 567 grams. The isolated kidney measures 12.5 x 5.5 x 5 cm. A serous cyst measuring 4 x 3 x 2.5 cm is present at the upper pole. Two ligated vessels are identified at the hilum, measuring up to 1.5 cm in length and 0.6 cm in diameter. The attached ureter is 7 cm long and 0.3 cm in diameter at the resection margin. Upon opening, the ureteral and pelvic mucosa appear normal.\n\nAdjacent to the capsular cyst at the lower portion of the upper pole is a moderately firm red-yellow lesion measuring 2 x 2.7 x 2.2 cm. This lesion extends to the cortical rim and protrudes into surrounding perirenal fat without gross invasion of the subjacent pelvis. The remainder of the renal cortex measures up to 0.8 cm in thickness and appears unremarkable. The adrenal gland measures 7 x 2 x 1.5 cm and weighs 7 grams; no gross involvement is noted. Perirenal fat and lymph nodes show no abnormalities.\n\nHistologic examination reveals interstitial chronic inflammation and mild arteriolosclerosis in non-neoplastic areas. Immunohistochemical staining confirms renal origin with positivity for RCC antigen and negativity for TTF-1.\n\nMicroscopic evaluation shows that the lesion remains confined within the kidney despite capsular distention. Venous and ureteral margins are free of involvement. Sarcomatoid features are absent. Histologic grade corresponds to Fuhrman nuclear grade 2.\n\nTumor staging indicates pT1a based on size and extent limited to the kidney with capsular distention but no penetration. No lymph node or distant metastasis is identified (NX MX). Twelve tissue blocks were submitted for analysis, including margins, cysts, parenchyma, and adrenal gland. Gross photographs were taken and tissue was preserved for further studies."} +{"pid": "TCGA-BP-4159", "report": "The right kidney specimen weighed 840 grams and included perinephric fat. The surgical margins, including the ureter, artery, and vein, showed no involvement by tumor. A nodule was identified in the superior pole of the kidney, measuring 6 x 4.5 x 5 cm, with areas of hemorrhage and necrosis. The viable portion of the nodule exhibited a golden color. The tumor approached but did not breach Gerota's fascia and did not involve the perinephric fat. It was located 1.5 cm from the hilum. A satellite extension was observed inferiorly, contiguous with the main tumor, extending up to 2 cm below it, resulting in a maximum tumor dimension of 7 cm. Microscopic evaluation revealed a growth pattern consistent with acinar architecture. Cellular grading was noted as nuclear grade II/IV. All surgical margins were free of tumor involvement. One benign regional lymph node was identified. \n\nA separate specimen from the paracaval region consisted of multiple tissue fragments measuring 2.8 x 2.0 x 0.5 cm. Several lymph nodes were present, with the largest being bisected and entirely submitted for analysis. No abnormal involvement was identified in these lymph nodes. \n\nTissue sections included hilar margins, perinephric fat margin, normal renal parenchyma, and tumor. Adrenal gland tissue was not identified in the specimen. Staining and histologic evaluations supported the morphologic findings without further diagnostic comment."} +{"pid": "TCGA-US-A774", "report": "The specimen consists of a pancreaticoduodenectomy with a lesion located in the head of the pancreas and uncinate process. Gross examination revealed a well-circumscribed, firm mass measuring 40mm in greatest dimension, with additional dimensions of 30 x 20mm. The tumor appeared pale grey without necrosis or hemorrhage and was infiltrating into the underlying pancreatic tissue with overlying mucosa intact. Margins were assessed microscopically, with invasive tumor closest to the portal vein bed margin at 1mm and the periuncinate soft tissue margin at 1.2mm. Other margins, including pancreatic neck (20mm), posterior retroperitoneal (2.5mm), common bile duct (20mm), and gastric/intestinal margins (>50mm), were uninvolved.\n\nHistologic evaluation demonstrated a poorly differentiated epithelial neoplasm with perineural invasion, present in the retroperitoneal neural plexus, and lymphovascular invasion identified. Examination of 17 lymph nodes revealed metastatic involvement in two nodes from the main resection specimen; no involvement was seen in separately submitted lymph node specimens including those from the peri-SMA, 8A, and aortocaval regions.\n\nPathologic staging based on AJCC 7th edition criteria is pT3 for local extension beyond the pancreas and pN1 for regional lymph node involvement. Multiple tissue blocks including bile duct, duodenum, gastric, and pancreatic margins were sampled, along with gallbladder and nodal specimens. High-grade PanIN (PanIN3) was identified but not at resection margins.\n\nThe duodenum measured 110mm in length, with gastric lesser and greater curves measuring 50mm and 55mm respectively. Gallbladder was distended, measuring 120mm in length and 80mm in circumference, with wall thickness of 2mm. Bile duct measured 40mm in length with maximum diameter of 20mm. Pancreatic specimen measured 70 x 50 x 50mm. No stent was identified."} +{"pid": "TCGA-19-5955", "report": "The specimen from the right temporal region of the brain consists of multiple tissue fragments. The first portion includes two irregular pieces measuring 0.9 x 0.5 x 0.4 cm and 0.7 x 0.5 x 2.4 cm, respectively. A touch preparation was made from this tissue, and a frozen section was also performed. The second portion consists of two aggregates of tissue measuring up to 2.3 x 1.9 x 0.4 cm, with a white to pink tan, soft, and cerebriform appearance. All tissue was processed and submitted for histologic evaluation. Microscopic examination revealed high cellularity with marked nuclear atypia and frequent mitotic figures. There was evidence of microvascular proliferation and areas of necrosis. No specific diagnosis is provided in this summary."} +{"pid": "TCGA-3H-AB3U", "report": "The pathology report includes several tissue specimens. Lymph nodes from stations 4R, 4L, and 7 were each uninvolved, with no pathological findings noted in these samples. The 4R lymph node measured 0.8 cm in greatest dimension. Both the 4L and station 7 specimens consisted of fatty tissue fragments, each measuring 0.5 cm in greatest dimension.\n\nTwo biopsies of pleural tissue were also examined. The first included two tan tissue fragments measuring between 0.5 cm and 1.1 cm. The second was a single fragment of tan soft tissue measuring 0.6 cm. These tissues showed involvement of fibroadipose tissue with epithelioid malignant cells. Cellular features included epithelioid morphology, consistent with further analysis.\n\nAll specimens were fully submitted for evaluation. Some laboratory tests referenced in the report may have been developed using internal protocols and have not been cleared or approved by the U.S. Food and Drug Administration."} +{"pid": "TCGA-MJ-A68J", "report": "Addendum Comment: This addendum specifies the involved margins. The superomedial peripheral margin (inked blue), inferomedial peripheral margin (inked black), and deep margin (multifocally in superior, inferior, medial, and lateral portions of the specimen, inked yellow and green) are positive.\n\nThe specimen, labeled as \"RIGHT PRETIBIAL MASS, LONG LATERAL STITCH, SHORT SUPERIOR STITCH,\" measures 6 x 5.5 x 1.2 cm and consists of an irregular tan-brown skin excision with a depth of 0.7 cm. A long stitch marks the lateral orientation and a short stitch marks the superior. The superior margin is inked blue, the inferior margin black, the superior deep margin yellow, and the inferior deep margin green. Serial sectioning from medial to lateral yields 11 slices approximately 0.4 cm thick.\n\nA mass measuring 5 x 5.1 x 0.7 cm is identified; it is tan-yellow, multilobulated, indurated, and diffusely distributed with fibrous septae and mucoid surface near the deep margin. The mass is 0.5 cm from the medial margin and 0.4 cm from the lateral margin. Submission includes tissue from the medial tip through the lateral tip, with multiple slices submitted in separate cassettes.\n\nMicroscopic evaluation reveals a neoplasm composed of spindle cells, some with marked atypia and intranuclear inclusions. The stroma is largely myxoid. Inflammatory infiltrates including lymphocytes, histiocytes, and eosinophils are present. The lesion extends to inked tissue edges. The case was reviewed at a dermatopathology consensus conference and confirmed by a staff pathologist."} +{"pid": "TCGA-23-2077", "report": "The left ovary was significantly enlarged, measuring 13.0 x 12.5 x 6.0 cm and weighing 580 grams. The external surface showed areas of tan-yellow discoloration and multiple cystic structures filled with clear fluid, ranging from 0. to 2.0 cm. Upon sectioning, the ovary was largely replaced by a solid, friable tan mass containing multiple cystic spaces (0.5\u20134.0 cm), areas of hemorrhage, necrosis, and focal yellow-tan changes. No normal ovarian tissue was visible grossly, and the mass extended into the ovarian capsule. Microscopically, the lesion exhibited nuclear grade 3 features, with focal necrosis and psammoma bodies present. There was no clear evidence of lymphatic invasion, though capsular invasion was noted.\n\nThe right ovary, including a segment of fallopian tube, measured 6.0 x 5.0 x 2.5 cm. The fallopian tube showed no abnormalities. The ovary contained a solid, friable tan-pink mass measuring 3.0 x 3.0 x 2.0 cm, which occupied approximately 80% of the ovary. This mass showed areas of necrosis, hemorrhage, and tan-yellow discoloration. The remaining 20% of the ovary contained normal-appearing tissue with identifiable corpus luteum. Focal capsular invasion was observed. Microscopically, the lesion showed nuclear grade 3 characteristics, without clear lymphatic invasion.\n\nThe uterus and cervix weighed 80 grams and measured 4.4 x 5.0 x 3.0 cm. A small white-tan myoma was identified in the lower uterine segment. The endometrium was diffusely hemorrhagic and measured 0.1 cm in thickness. The cervix showed nabothian cysts but no malignant findings.\n\nThree omental specimens were examined. Omentum #1 (11.0 x 4.2 x 1.3 cm) and #2 (15.0 x 3.5 x 1.0 cm) showed only lymphocytic aggregates and mesothelial hyperplasia. Omentum #3 (12.5 x 4.5 x 1.2 cm) contained scattered clusters of abnormal cells along with fat necrosis, acute inflammation, calcifications, granulation tissue, and hemosiderin-laden macrophages.\n\nAn ileum adhesion biopsy revealed fibrous and fatty tissue with acute and chronic inflammation and numerous macrophages, with no malignancy detected. A liver biopsy showed portal tract lymphocytic infiltrates and subcapsular venous dilatation, also without signs of malignancy. The appendix and attached mesoappendix showed no histopathologic abnormalities or malignancy.\n\nFrozen section analysis of the left ovary indicated a high-grade adenoma, with no mucinous component observed."} +{"pid": "TCGA-HZ-A8P0", "report": "The specimen was obtained from a male patient following a Whipple procedure and includes portions of the stomach, small bowel, pancreas, and common bile duct. The gallbladder was also removed and showed only mild chronic inflammation without evidence of neoplasia.\n\nGross examination of the Whipple specimen revealed a mass in the head of the pancreas measuring 3.1 cm in greatest dimension. The tumor was located within the superior head of the pancreas and appeared to extend into the surrounding soft tissue. Microscopically, the lesion was composed of well-differentiated epithelial cells arranged in glandular patterns. There was evidence of lymphovascular invasion, but perineural invasion was not identified.\n\nThe surgical resection margins were microscopically negative for tumor involvement. The closest distance of the tumor to any margin was 0.1 cm at the posterior margin, with greater distances noted at other margins. The tumor was found to involve the small bowel muscularis in a 0.2 cm focus but did not grossly invade the bile duct lumen.\n\nA total of twenty-four lymph nodes were examined from various regional sites, including those associated with the left renal vein and common bile duct. Of these, fifteen contained metastatic carcinoma. Specifically, all four lymph nodes from the left renal vein area and the single lymph node from the common bile duct site were involved.\n\nBased on the extent of primary tumor extension and lymph node involvement, the staging classification was determined as pT3 for the primary tumor and pN1 for regional lymph node metastasis. Distant metastasis could not be assessed. The overall pathologic stage was classified accordingly."} +{"pid": "TCGA-MJ-A68H", "report": "The specimen consists of a resected portion of colon with attached posterior vaginal wall, labia majora, and anus. The colon measures 31 x 7 x 2 cm. A skin ellipse measuring 4 x 8 cm with a central ulcerated area (previous biopsy site) is present. The tumor is located within the vaginal soft tissue, appearing well-circumscribed with a white, whirled, rubbery cut surface. It is situated 21 cm from the proximal margin, 6 cm from the anus, and 1 cm from the anterior inked surface. The tumor appears to be locally confined without involvement of rectal or anal mucosa.\n\nMargins are all negative. The closest distance of the tumor to a margin is 7 mm from the anterior inked margin. Twenty-six possible lymph nodes ranging from 0.2 to 1.0 cm in size were identified in the pericolonic adipose tissue; four were examined and found to be benign. There is no evidence of lymphovascular or perineural invasion.\n\nHistologically, the lesion demonstrates a mitotic rate of 17 per 10 high-power fields and contains necrosis involving less than 20% of the tumor. Histologic grade according to FNCLCC criteria is Grade 2. Immunohistochemical staining for Desmin shows strong positivity.\n\nPathologic staging indicates pT1b for the primary tumor, with no regional lymph node involvement (pN0), resulting in an overall pathological stage of IA.\n\nA separate excision of the posterior vaginal wall margin reveals tan-white fibrous tissue with focal hemorrhage and no significant pathologic alteration."} +{"pid": "TCGA-BF-AAOX", "report": "The specimen consists of skin from the right hand, which is pigmented and was surgically resected. Microscopic examination reveals a melanocytic lesion with a mushroom-like configuration and epithelioid morphology. The lesion demonstrates ulceration. Histologic assessment shows a Clark level IV invasion and a Breslow thickness of 11 mm. Staging is consistent with Stage IIC, with T4 classification, no lymph node involvement (NO), and no evidence of distant metastasis (M0). Cellular features include epithelioid morphology."} +{"pid": "TCGA-AX-A06L", "report": "The specimen consisted of a hysterectomy with bilateral salpingo-oophorectomy and multiple lymph node dissections from both pelvic and para-aortic regions. The uterus measured 11.2 cm from fundus to cervix, 6.0 cm from cornu to cornu, and 9.0 cm anterior to posterior. A friable mass measuring 6.0 x 3.5 x 1.4 cm was identified on the anterior uterine wall. Microscopic evaluation showed this lesion to be a well-differentiated endometrioid-type adenocarcinoma. Histologic grading indicated a FIGO grade 1 tumor with 5% or less nonsquamous solid growth pattern and nuclear grade 2 features.\n\nThe tumor invaded the inner half of the myometrium with a maximal invasion depth of 8.0 mm in an area where the myometrial thickness was 18.0 mm, representing approximately 44% involvement. No lymphovascular invasion was identified. The tumor was confined to the corpus uteri without extension to the cervix, ovaries, or fallopian tubes. The cervix showed benign glandular and squamous components with squamous metaplasia and mild chronic cervicitis. No dysplasia or malignancy was present in the cervix, ovaries, or fallopian tubes. The right and left ovaries showed atrophic changes and a paratubal cyst was noted on the left side.\n\nA total of 25 lymph nodes were examined: ten from the right pelvic region, seven from the left pelvic region, three from the left para-aortic region, three from the right common iliac region, one from the right para-aortic region, and one from the left common iliac region. All were benign without evidence of metastatic disease.\n\nAdditional findings included complex endometrial hyperplasia with atypia, endometrial atrophy, and a 5.5 cm intramural leiomyoma in the posterior uterine wall. The tumor was located on the anterior wall of the uterus and did not involve any surgical margins. The closest distance of invasive carcinoma to a margin was 10 mm from the uterine serosal surface.\n\nStaging based on these findings was pT1b, indicating tumor invasion of less than one-half of the myometrium, with no regional lymph node involvement (pN0) and no evidence of distant metastasis (pMX). Frozen section analysis confirmed the presence of a well-differentiated adenocarcinoma with invasion into the inner half of the myometrium.\n\nGross examination of the specimen revealed no other significant abnormalities in the fallopian tubes, ovaries, or cervix. All submitted lymph nodes appeared benign upon histologic review."} +{"pid": "TCGA-AA-3553", "report": "The resected colon specimen shows a moderately differentiated neoplasm of colorectal type, with a maximum dimension of 3.5 cm. Histologic evaluation demonstrates infiltration extending to the tunica muscularis propria. Lymph nodes in the surrounding area are free of tumor involvement, with no evidence of metastasis identified in 21 examined nodes. All colonic resection margins, as well as the mesenteric resection margin, are clear of tumor. Grading indicates a G2 lesion. No lymphovascular or perineural invasion is present. The surgical resection is complete with negative margins (R0)."} +{"pid": "TCGA-AC-A5EI", "report": "The mastectomy specimen contains two distinct neoplastic lesions. One lesion is located in the lower inner quadrant of the right breast and measures 1.2 cm in greatest dimension. Histologic evaluation reveals features consistent with Nottingham grade 1 invasive carcinoma, characterized by tubule formation score of 1 of 3, nuclear pleomorphism score of 1 to 2 of 3, and mitotic rate score of 1 of 3. The tumor invades into the dermis but does not extend into the pectoralis muscle. Ductal carcinoma in situ (DCIS) of low to intermediate nuclear grade is also present in the area of invasive carcinoma as well as in central breast tissue. The DCIS demonstrates cribriform architecture with comedo necrosis and calcifications.\n\nA second separate mass is identified in the upper outer quadrant measuring 3.2 cm in diameter. Histologic features of this lesion include marked cytologic atypia of stromal cells and frequent mitotic activity, with up to sixteen mitoses per ten high power fields in some areas. Microscopic infiltration of the lesion into surrounding adipose tissue is observed, though no gross infiltration into adjacent breast tissue is evident. No significant stromal overgrowth is noted.\n\nAll surgical margins are free of tumor involvement. The invasive carcinoma is 0.5 cm from the deep margin and at least 1 cm from all other margins. The DCIS is at least 1 cm from all margins. The second lesion is at least 1.5 cm from all margins.\n\nSentinel lymph node biopsies were performed, and two lymph nodes were examined. Micrometastatic disease is identified in one lymph node, measuring 0.1 cm in size. Isolated tumor cells are found in the second lymph node. No extranodal extension is observed.\n\nHistopathologic staging indicates a primary tumor stage of pT1c. Regional lymph node involvement is classified as pN1(mi) due to the presence of micrometastases. No distant metastasis is identified. Lymphovascular invasion is not present. Immunohistochemical staining for HER2 demonstrates a score of 0. Estrogen receptor expression is positive in 100% of cells with strong intensity, and progesterone receptor expression is positive in 60% of cells with strong intensity. Ki-67 proliferation index is 5%."} +{"pid": "TCGA-75-5147", "report": "The sample was collected from the right upper lobe and submitted for histological evaluation. The tissue measures 2.00 cm in greatest dimension. Histologic assessment reveals a moderately differentiated adenocarcinoma with features consistent with stage T2, NOS. Lymph node involvement is not identified, and there is no evidence of metastasis. The specimen was processed using standard fixation and embedding techniques. No additional significant findings are noted in the histology comments."} +{"pid": "TCGA-HZ-A77O", "report": "The surgical specimen included the head of the pancreas, distal stomach, duodenum, gallbladder, and appendix. The primary lesion measured 2.8 cm in greatest dimension and was confined to the pancreas. Margins of resection were negative for invasive disease. Microscopic evaluation revealed perineural and lymphovascular invasion. Of the twenty-six lymph nodes examined, four contained metastatic involvement. High-grade pre-invasive changes were identified in the pancreatic ductal epithelium. In addition, there was evidence of both acute and chronic inflammation of the pancreas, as well as chronic inflammation of the gallbladder. The appendix appeared unremarkable. Staging was determined as pT2 based on tumor size and localization to the pancreas, with regional lymph node involvement classified as pN1. No distant metastasis was identified. Intraoperative assessment of bile duct margins showed atypical changes suspicious for dysplasia; final evaluation confirmed low-grade dysplastic changes without invasive carcinoma. Multiple peripancreatic lymph nodes were evaluated, with some showing involvement. The pancreatic resection margin was free of tumor involvement."} +{"pid": "TCGA-AC-A3BB", "report": "The surgical specimen consisted of a right breast modified radical mastectomy weighing 2,220 grams and measuring 28 x 23 x 6 cm. The tumor was located in the upper outer quadrant and measured at least 65 mm. Microscopic evaluation revealed a single focus of invasive disease with a total Nottingham grade of 2 (score of 6 out of 9), composed of less than 5% tubule formation, intermediate nuclear pleomorphism, and a low mitotic count (2 per ten high power fields). No lymphatic invasion was identified. Lobular carcinoma in situ was present. The skin and nipple were involved by tumor; however, there was no ulceration or lymphovascular invasion identified. Skeletal muscle invasion was not present.\n\nMargins were negative (R0) with the closest margin measuring 15 mm from the deep margin. The tumor extended 4 cm from the closest inferior margin, 12 cm from the superior, 9 cm from the medial, and 11 cm from the lateral margin. It was 2.5 cm from the deep margin and 2 cm from the skin.\n\nAxillary lymph node dissection included 14 lymph nodes, of which five contained metastatic disease (pN2a). Extracapsular extension was noted. Two additional lymph nodes showed isolated tumor cells but were not counted among the positive nodes. Distant metastasis could not be assessed (pMX). Pathologic staging was pT3, pN2a, pMX, Stage IIIA.\n\nHormone receptor analysis showed strong positivity for estrogen and progesterone receptors (95\u2013100% and 90\u2013100%, respectively). HER2/neu staining was negative. Ki-67 proliferative index was low (2\u20135%). Additional findings included apocrine metaplasia, atypical lobular hyperplasia, and usual ductal hyperplasia.\n\nGross examination revealed a poorly defined area of firm fibrous parenchyma involving an area measuring 6.5 cm medially to laterally, 5.5 cm superiorly to inferiorly, and up to 3 cm superficially to deeply. A second, smaller area of fibrous tissue was identified in the lower outer quadrant, measuring approximately 2 cm. Sections from multiple areas of the specimen were submitted for analysis. Multiple palpable nodes were present in the axillary portion of the dissection, with representative sections submitted for histologic evaluation."} +{"pid": "TCGA-BJ-A28Z", "report": "The thyroid specimen weighed 20 grams and was entirely submitted for examination. Three similar lesions were identified within the left lobe, each measuring 1.0 cm in greatest dimension. Histologic evaluation showed consistent morphologic features across all three foci. The tumor demonstrates focal extension beyond the thyroid capsule and approaches the resection margin at a distance of approximately 1 mm. No involvement of the surgical margins by tumor is noted. Surrounding thyroid tissue shows evidence of chronic inflammatory changes consistent with chronic lymphocytic thyroiditis.\n\nA separate lymph node dissection specimen from the central compartment contains thirteen lymph nodes. Of these, one lymph node contains findings suggestive of metastatic involvement based on the presence of psammoma bodies; however, no definitive tumor cells are observed in this node. An additional three lymph nodes from the right perithyroidal region are negative for any signs of tumor involvement.\n\nMolecular testing was performed on three representative tissue blocks. All three show the presence of RET/PTC1 rearrangement. Testing also ruled out mutations in BRAF, NRAS61, HRAS61, KRAS12/13, as well as RET/PTC3 rearrangements. Nucleic acid extraction was sufficient for further analysis.\n\nIn summary, histopathologic staging is determined to be T3 based on extrathyroidal extension and proximity to the surgical margin. Regional lymph node assessment indicates involvement in one lymph node, resulting in a nodal stage of N1a. A total of sixteen lymph nodes were evaluated, with only one showing indirect evidence of metastatic disease. There is no evidence of lymphovascular invasion."} +{"pid": "TCGA-CV-A6JM", "report": "A total laryngopharyngectomy specimen was received, measuring 9 x 7.5 x 5.5 cm. The specimen included unremarkable hyoid and thyroid cartilage, larynx with supraglottis, glottis, and subglottis, as well as a segment of trachea and proximal esophagus. A tumor was identified in the posterior pharyngeal wall involving the left piriform sinus soft tissue. The tumor measured 7.0 cm in greatest dimension, with an ulcerated appearance and necrosis on surface. It extended into the posterior portion of the left piriform sinus soft tissue, located 2.0 cm from the closest piriform mucosal edge and 1.4 cm from the posterior esophageal wall resection margin. The tumor was noted to be 0.3 cm from the right superior pharyngeal mucosa edge and abutted but did not involve the posterior soft tissue margin. Grossly, the thyroid cartilage was not involved, and after decalcification, no cartilage invasion was identified.\n\nMicroscopically, infiltration was observed with a depth of 2.0 cm and thick cords greater than 4 cells in diameter at the tumor border. No perineural or vascular invasion was present. Mild lymphocyte infiltration was noted. Margins were negative for invasive disease; however, severe dysplasia was present at the left pharynx margin(s). The deep radial margins were also negative. Adjacent squamous mucosa showed no tumor involvement.\n\nMultiple lymph node dissections were performed. On the left side, levels II, III, and IV contained five, five, and five lymph nodes respectively, all negative for tumor. On the right side, level II (both A and B), level III, and level IV dissections yielded five, nine, four, and five lymph nodes respectively, none of which showed evidence of involvement. Additional specimens including the left lateral pharyngeal wall, left superior margin, and thyroid gland were all free of tumor.\n\nFrozen section analysis of mucosal margins was largely negative, with the exception of at least high-grade dysplastic changes identified in the left pharynx and left base of tongue regions. Representative sections of the tumor were submitted for evaluation, focusing on areas of deepest invasion and proximity to anatomical structures. All other mucosal margins, including those of the right and left lateral regions, esophageal, and base of tongue, were negative."} +{"pid": "TCGA-AJ-A3NF", "report": "The specimen consists of a uterus with cervix and bilateral tubes and ovaries, along with lymph node tissue from the right paraaortic, right pelvic, and left pelvic regions, and omental tissue. The patient is female.\n\nThe uterus measured 4.0 cm in length by 4.3 x 3.5 cm in width and weighed 95.7 grams. The uterine corpus was covered by pink-tan serosa and showed surgical markings on the posterior surface. Within the uterine cavity, a lesion measuring 3.5 x 2.5 cm was identified primarily on the posterior wall. On sectioning, this lesion extended 1.5 cm into the myometrium, which had a total thickness of 2.8 cm. No cervical involvement was observed. No lymphovascular space invasion was detected. Surgical margins including the uterine serosa, bilateral parametria, and cervix were uninvolved.\n\nExamination of the cervix revealed no significant abnormalities. The endocervical canal appeared cystic and mucoid with normal folds. Adjacent normal endometrium averaged 0.2 cm in thickness. Focal cystic changes were noted within the myometrium. No additional masses were identified.\n\nBoth fallopian tubes and ovaries were present and appeared grossly normal. The right fallopian tube measured 4.5 cm in length and showed multiple paratubal cysts ranging up to 0.7 cm in diameter. The attached ovary measured 2.0 x 1.6 x 1.3 cm and contained multiple gray-white corpora albicantia. Similar findings were observed on the left side, with the fallopian tube measuring 4.5 cm and containing smaller cysts up to 0.4 cm. The left ovary measured 1.5 x 1.1 x 0.6 cm and also displayed corpora albicantia.\n\nLymph node evaluation included nine right paraaortic lymph nodes, all negative for metastatic disease. Ten right pelvic lymph nodes were similarly negative. Of thirteen left pelvic lymph nodes, one contained metastatic carcinoma. Omental examination revealed no malignant involvement.\n\nHistologic evaluation revealed high-grade cellular features within the lesion. Representative sections from various regions of the uterus, cervix, fallopian tubes, and ovaries were submitted for analysis. Lymph nodes were submitted entirely for assessment.\n\nStaging based on pathologic findings was classified as pTib N1 (FIGO IIIC1). No other significant pathologic abnormalities were identified in the submitted specimens."} +{"pid": "TCGA-DJ-A13U", "report": "The specimen consisted of a right thyroid lobe and isthmus, with the lobe measuring 3.5 x 3.3 x 1.6 cm and the isthmus measuring 1.6 x 1.5 x 0.4 cm. A well-circumscribed nodule measuring 1.1 x 0.7 x 0.7 cm was identified in the infero-medial aspect of the thyroid lobe adjacent to the isthmus. Histologic evaluation revealed a lesion with well-differentiated cellular features. No mitotic activity or tumor necrosis was observed. The lesion lacked a distinct capsule and demonstrated a single focus of vascular invasion beyond the thyroid capsule in a small vessel. There was also extension into the perithyroid fibroadipose tissue. The closest surgical margin was the anterior margin, with tumor located less than 1 mm from the margin. No additional nodules or adenomas were identified away from the primary lesion. The surrounding non-neoplastic thyroid tissue exhibited mild hyperplastic changes. Parathyroid glands were not identified in the specimen. All relevant sections were submitted for analysis."} +{"pid": "TCGA-A2-A0YT", "report": "The surgical specimen consisted of a left breast and axillary contents weighing 1619 grams. The breast measured 30 x 20 x 7.5 cm. Gross examination identified a tumor mass beneath the nipple measuring 13.5 x 7 x 4 cm. The tumor was located 1.5 cm from the deep margin, with distances ranging from 2 to 4 cm from other margins. A satellite nodule measuring 0.6 cm was observed 1.5 cm from the main tumor. The tumor exhibited confluent growth and was submitted in multiple tissue blocks for analysis.\n\nHistologic evaluation revealed high-grade cellular features including absent tubular formations, high nuclear grade, and moderate mitotic activity. Angiolymphatic invasion was present and multifocal. Necrosis and calcifications were noted within the tumor. Surgical margins were free of involvement. A separate skin ellipse from the inferior aspect of the left breast measured 7 x 1 x 1 cm and showed tumor infiltration into the dermis without epidermal extension or ulceration. The inked margins of this specimen were also uninvolved.\n\nAxillary lymph node dissection identified five involved nodes with extracapsular extension. The largest involved node measured 1.6 cm with tumor occupying three-fourths of its cross-section. Additional findings included a small fibroadenoma measuring 0.3 cm within non-neoplastic breast tissue.\n\nStaging classification was determined as T4b, N2a, MX based on these findings. Microscopic examination confirmed widespread angiolymphatic invasion and poor differentiation of the tumor cells. The satellite nodule appeared to be a direct extension of the primary lesion with peripheral involvement. Full assessment of the specimen supported the upgrading of histologic grade to Grade 3."} +{"pid": "TCGA-OR-A5JX", "report": "A male patient with a history of hypertension and current smoking status underwent a left adrenalectomy following identification of a mass in the left adrenal region. The surgical specimen included multiple tissue samples for analysis.\n\nThe resected left adrenal gland was submitted in a large container, measuring 10.5 x 10.5 x 6.0 cm and weighing 445 grams before trimming. The gland contained an encapsulated mass measuring 10.0 x 8.0 x 6.0 cm. The mass was described as friable and largely necrotic, with gross evidence of proximity to all margins. Margins evaluated included renal vein, medial, anterior, posterior, inferior, lateral, and superior aspects. Representative sections of both the tumor and normal adrenal tissue were taken. Additional specimens included portions of retroperitoneal fat and left perirenal tissue, which were described as fibroadipose with no notable lesions.\n\nFrozen section analysis of a mesenteric implant showed inflamed fibrotic tissue consistent with fat necrosis. A lymph node from the left renal vein was negative for malignancy on frozen section. Permanent sections confirmed these findings and showed no evidence of neoplasm in the mesenteric implant, lymph node, retroperitoneal fat, or perirenal tissue.\n\nMicroscopic evaluation of the main lesion revealed cellular features including a mitotic rate of 5 mitoses per 50 high-power fields, corresponding to a low-grade classification. Necrosis was present focally. Immunohistochemical staining demonstrated positivity for alpha-inhibin and Melan-A. Histologic examination confirmed capsular and vascular invasion, specifically involving the adrenal vein. There was also evidence of extra-adrenal extension into the adrenal vein. Surgical margins were negative.\n\nAdditional tissue samples from the retroperitoneal fat and left perirenal tissue showed benign fibroadipose tissue without evidence of neoplasm."} +{"pid": "TCGA-RW-A689", "report": "The specimen consists of right adrenal gland tissue, with a total untrimmed weight of 14.465 grams. A single lesion measuring up to 3.0 x 2.6 x 1.2 cm is present, along with attached fibrous adipose tissue and a thin, atrophic-appearing segment of possible normal adrenal tissue measuring 3.0 x 2.0 x 0.15 cm. The excision surface of the specimen is inked black and on sectioning reveals a mottled white-pink, focally hemorrhagic mass with a fish-flesh appearance. The mass is circumferentially surrounded by approximately 0.1 cm of orange tissue resembling non-remarkable adrenal tissue.\n\nFull cross sections demonstrate the relationship of the mass to the surgical margins. Serial sections of the thinned, atrophic adrenal tissue are also included. Twenty percent of the adrenal tissue and adipose component is retained, and the entire mass has been submitted for evaluation. Additionally, two fragments of cauterized, pink-tan fibroadipose tissue were received, measuring 2.2 x 0.8 x 0.3 cm and 1.6 x 1.1 x 0.2 cm respectively.\n\nThe capsule of the adrenal gland was fragmented upon receipt, and the mass extends to the inked edges of the specimen. This may suggest a close or positive margin; however, the presence of normal adrenal tissue in the additional specimen may affect this interpretation. All slides have been personally reviewed and interpreted by the staff pathologist."} +{"pid": "TCGA-26-5133", "report": "The specimen consists of two tissue samples submitted for analysis. The first sample is labeled \"brain tumor\" and includes multiple irregular, hemorrhagic red-tan soft tissue fragments measuring 3.2 x 2.2 x 0.7 cm in total. A representative portion was used for frozen section analysis, with additional tissue submitted for permanent processing and some reserved for future studies. The second sample, also labeled \"brain tumor,\" contains multiple beige-tan soft tissue fragments measuring 1.6 x 1.2 x 0.5 cm in aggregate, all of which were submitted for analysis.\n\nMicroscopic evaluation revealed a highly pleomorphic lesion with areas of increased cell density and frequent mitotic figures. Vascular endothelial proliferation and focal necrosis were identified. Immunohistochemical staining showed variable reactivity for glial markers, with some cells demonstrating strong positivity for GFAP. The Ki-67 labeling index was elevated, indicating a high proliferative rate. p53 protein expression was strongly present. Reticulin staining demonstrated a perivascular pattern. Certain regions of the tumor exhibited features suggestive of a distinct subtype characterized by highly cellular areas and primitive-appearing elements."} +{"pid": "TCGA-G9-A9S0", "report": "The prostatectomy specimen measured 4.2 cm in width, 4 cm in depth, and 3.5 cm in length, with a total weight of 36 g. After removal of the apex and base, the remaining tissue weighed 15 g. Serial sectioning revealed firm tan fibrous parenchyma. The right and left seminal vesicles measured 1.5 x 1 x 0.5 cm and 2 x 1.6 x 0.8 cm, respectively, and were composed of beige tan cystic tissue. The right and left vas deferens measured 2.7 x 0.5 cm and 2 x 0.7 cm, respectively, and displayed firm tan tubular structures upon sectioning.\n\nSubmitted lymph node specimens included left pelvic lymph nodes ranging from 0.3 x 0.3 x 0.1 cm to 1.9 x 1.5 x 1.1 cm within a tissue aggregate measuring 5.7 x 5 x 1.1 cm. Of these, 5 out of 9 lymph nodes showed involvement. Right pelvic lymph nodes measured between 0.5 x 0.3 x 0.2 cm and 2.3 x 1.2 x 0.4 cm within an aggregate measuring 4.5 x 3.2 x 0.7 cm; none of the 4 lymph nodes evaluated showed involvement.\n\nInvolvement of the bladder neck margin was identified at the left base region (slide C18), with a focal linear distance of involvement measuring between 1 and 10 mm. Frozen section analysis was performed.\n\nHistologic evaluation of the prostate specimen demonstrated cellular features consistent with infiltrative growth patterns and nuclear atypia. Additional findings included acute and chronic inflammation. Pathologic staging was assigned as pT3b based on local extension beyond the prostatic capsule, and nodal staging indicated involvement of regional lymph nodes (pN1). Distant metastasis could not be assessed (Mx). All staging was determined according to criteria outlined in the AJCC Cancer Staging Manual, 7th Edition."} +{"pid": "TCGA-VS-A8QA", "report": "The cervix is the primary site. Evaluation of periaortic lymph nodes (0/7), right pelvic lymph nodes (0/13), and left pelvic lymph nodes (0/6) showed no evidence of neoplasia. Examination of the uterus revealed an invasive lesion composed of poorly differentiated cells, measuring 1.6 cm in extension and 0.8 cm in depth. The lesion extends into the middle third of the cervical stroma and shows lymphatic invasion; there is no perineural invasion. High-grade intraepithelial changes are present in the ectocervix and vaginal cuff. The endometrium is atrophic, and the isthmus and parametrium are free of involvement. The surgical vaginal margin expansion does not show any neoplastic cells. High-grade intraepithelial changes are focally present at the vaginal margin. The uterine tubes appear unremarkable. The right ovary contains a cystic structure consistent with serous cyst adenoma and surface inclusion cysts. The left ovary demonstrates atrophy."} +{"pid": "TCGA-X9-A973", "report": "A resected soft tissue mass from the right pelvis was examined, measuring 15 x 12 x 9.5 cm. The outer surface was partially covered with adipose and skeletal muscle tissue, and was inked blue. On sectioning, a dominant 14.7 x 9 x 9 cm lesion was identified, characterized by fleshy pink-tan cut surfaces with areas of central necrosis and cystic change. Representative sections of the mass were submitted for histologic evaluation.\n\nMicroscopic analysis revealed a high-grade spindle cell neoplasm with marked pleomorphism. The tumor demonstrated a mitotic rate exceeding 5 per 10 high-power fields and contained regions of necrosis involving approximately 20% of the specimen. Histologic grading using the French Federation of Cancer Centers Sarcoma Group criteria classified the lesion as Grade 3. Surgical margins were negative, with the closest distance of tumor to margin being 0.1 cm at the capsular margin. No lymphovascular invasion was identified.\n\nThe primary tumor was staged as pT2b, indicating a deep-seated tumor greater than 5 cm in greatest dimension. Regional lymph node status could not be assessed (pNX). No evidence of distant metastasis was noted. All findings were confirmed upon review and concurrence by an attending pathologist. Cytogenetic analysis of the specimen was unsuccessful due to lack of cell growth, with no metaphases observed."} +{"pid": "TCGA-AF-3911", "report": "The specimen includes three parts: A, B, and C. Part A is a fragment of yellow fatty tissue partially covered with pink-tan fibromembranous material, measuring 4 x 3 x 1 cm. No distinct lesions are observed on sectioning, and representative sections are submitted for analysis.\n\nPart B consists of a 25 cm length of colon, partially covered with pink-tan serosa and yellow fat. The retroperitoneal reflection is 5.5 cm from the distal open margin, and the proximal margin is stapled. A lesion is identified 2.7 cm from the distal margin, measuring 5.5 x 4.5 x 0.7 cm. Microscopically, the lesion extends into the muscularis propria and approaches within 2.0 cm of the radial margin. It is noted to be 0.7 cm away from being fully circumferential. A small polyp, 0.5 cm in size, is located 1.5 cm from the proximal end. The remaining mucosa appears normal. Lymph nodes are present in the surrounding fat, and multiple blocks are submitted for histologic evaluation, including margins, tumor interface, and lymph node sampling.\n\nPart C is a 4.2 x 0.5 cm appendix, partially covered with yellow fat and smooth serosa. The wall thickness averages 0.3 cm, and the entire specimen is submitted for microscopic examination.\n\nMicroscopic findings show no abnormality in the specimens from part A and C. In part B, a moderately to poorly differentiated infiltrating lesion is identified. The lesion extends through the bowel wall into the surrounding fat. Histologic staging is pT3. All evaluated margins (proximal, distal, and radial) are free of tumor involvement, with the closest distance of the lesion to a margin being 2.7 cm at the distal end. Vascular invasion is not detected. Of the 18 regional lymph nodes examined, 9 contain evidence of disease involvement (pN2). Additionally, two sites of pericolonic tumor extension outside the lymph nodes are noted. A separate adenomatous polyp is also present near the proximal margin. Distant metastasis could not be assessed based on available data."} +{"pid": "TCGA-D8-A1XD", "report": "The histopathological examination of the left breast with axillary tissues revealed a lesion measuring 1.9 x 1.6 x 1.7 cm located in the middle part of the breast, 1.5 cm from the upper boundary, 1.6 cm from the base, and adjacent to the skin. Microscopic evaluation showed a component with a histological grade corresponding to NHG2, with 2+3+2/10 mitoses per 10 high-power fields (visual area: 0.55 mm). Within this lesion, foci of intraductal proliferation were observed, showing solid and cribriform growth patterns with medium nuclear atypia, no necrosis, and calcifications comprising less than 5% of the lesion. Involvement of the nipple was noted.\n\nAnother small focus of similar cellular morphology was identified in the glandular tissue of the inner lower quadrant, measuring 0.1 cm in diameter. Additional findings included fibrocystic changes and ductal hyperplasia of a benign nature.\n\nAxillary lymph node assessment showed involvement in six out of eighteen nodes. Capsular infiltration was present in at least one node.\n\nImmunohistochemical analysis demonstrated strong expression of estrogen and progesterone receptors in over 75% of the neoplastic nuclei. HER2 staining using HercepTest\u2122 by DAKO showed a score of 1+, indicating no significant reactivity in the affected cells.\n\nThe extent of the disease includes multifocal involvement of the breast and regional lymph node metastases."} +{"pid": "TCGA-AG-3906", "report": "The resected rectosigmoid specimen shows a centrally ulcerated lesion with moderately differentiated histological features. The lesion is located 2.5 cm from the aboral resection margin and measures 2.5 cm in diameter. Histologically, there is infiltration deep into the tunica muscularis propria, reaching the border of the perirectal fatty tissue. No involved lymph nodes are identified, with all 26 local lymph nodes being negative. The colon resection margins and mesenteric resection margin are free of disease. Histopathological staging shows no vascular invasion, no residual tumor at margins, and no distant metastasis. The grade is intermediate (G2), with no lymphovascular invasion noted."} +{"pid": "TCGA-JY-A6FG", "report": "The specimen received includes a resection of the stomach and distal esophagus with stitch marks at the proximal margin, along with lymph node specimens from the common hepatic region. Gross examination of the resection specimen showed a lesion involving the gastroesophageal junction, proximal stomach, and extending approximately 1.5 cm into the distal esophagus. The tumor measured 6.3 x 17.0 cm in diameter and had a depth of 2.2 cm. It was described as tan-brown, solid, and exophytic with central ulceration and irregular edges. No perforation was noted.\n\nThe tumor involved the entire gastric circumference and extended focally into the adventitia on the esophageal side, with the closest point of invasion being 0.2 cm from the adventitial surface. On the gastric side, the tumor extended into perigastric fat, reaching within 1.2 cm of the radial margin. Histologically, the lesion was well to moderately differentiated. Lymphatic invasion was present, while no venous invasion was identified. Resection margins, including the proximal, distal, and radial margins, were free of invasive disease. A total of 18 lymph nodes were examined, with 5 showing involvement by metastatic cells. The remaining lymph nodes, including those from the common hepatic region, were negative for involvement.\n\nThe tumor was located near the gastroesophageal junction and extended into the distal esophagus, with a distance of less than 1.0 cm from the proximal margin and 9.5 cm from the distal margin. The estimated depth of invasion reached the adventitia of the esophagus and perigastric fat. Multiple perigastric lymph nodes were identified and ranged in size from 0.7 to 2.5 cm. Sections were submitted for analysis, including representative areas of the tumor, margins, and lymph nodes. Intraoperative frozen section analysis of the lymph nodes confirmed absence of malignancy in those samples."} +{"pid": "TCGA-XM-A8RH", "report": "The specimen consists of a thymic resection measuring 9.3 x 6.4 x 2.6 cm. A well-circumscribed mass measuring 4.5 x 3.5 x 3.0 cm is identified on the outer aspect of the thymus. The mass has a tan-white lobular cut surface and does not grossly invade into the thymic parenchyma. Histologic evaluation reveals a neoplastic process with focal extension through the capsule into adjacent fibroadipose and thymic tissue. Surgical margins are free of tumor involvement. Microscopic sections demonstrate cellular features consistent with a mixed epithelial and lymphocytic component. The lesion measures 4.5 cm in greatest dimension and is confined primarily within the thymus, with limited extracapsular spread. Representative sections have been submitted for further analysis."} +{"pid": "TCGA-E1-A7YU", "report": "Surgical Pathology: Final. CLINICAL HISTORY: Lesion identified on outside slides. GROSS EXAMINATION: A. \"Left temporal brain lesion\" (AF1), in formalin. The specimen consists of a fragment of soft yellow-tan brain tissue measuring approximately 2.5 x 2 x 1.5 cm in aggregate. A portion was previously submitted as frozen section AF1, with the remnant submitted in Block A1. A small portion is retained in formalin, and the remainder is submitted in Blocks A2 and A3. B. \"Left temporal brain lesion\", received fresh, consists of several fragments of pink and yellow-tan tissue measuring 2 x 1.2 x 0.9 cm in aggregate. A small portion is retained in formalin, and the remainder is submitted in Block B1. INTRA OPERATIVE CONSULTATION: A. \"Left temporal brain lesion\": Glioma identified. MICROSCOPIC EXAMINATION: The specimen submitted as \"left temporal brain lesion\" contains multiple portions of brain tissue infiltrated by a neoplastic proliferation of malignant glial cells. Microscopically, the predominant pattern shows cells with round to oval hyperchromatic nuclei, speckled chromatin, and punctate chromocenters, with no distinct nucleoli. Mitotic activity is present. Vascular proliferation and focal calcification are observed in areas of degeneration. A minor component of the lesion demonstrates elongated spindle cells with hyperchromatic spindle-shaped nuclei, and mitotic activity is also noted in this area. \n\nThe predominant component of the lesion shows features of a high-grade glial neoplasm. No necrosis is identified. Results printed by: 1 of 1."} +{"pid": "TCGA-E1-A7Z6", "report": "A 9.3 x 7.3 cm region of abnormal signal intensity within the right frontal lobe and extending into the genu and anterior body of the corpus callosum was identified on MRI. This area demonstrated heterogeneous T2 hyperintensity with multiple small central T1 hypointense foci that showed no FLAIR signal, suggestive of cystic change or necrosis. No significant enhancement was observed in this region. The lesion caused a right-to-left midline shift of approximately 1.2 cm and resulted in complete effacement of the right frontal horn and partial effacement of the right lateral ventricle body. No distant parenchymal abnormalities or extra-axial fluid collections were noted.\n\nGross examination of the resected brain tissue from the right frontal region revealed a 7 x 7.3 x 5.6 cm specimen weighing 125 grams after fixation. Approximately 40% of the tissue showed effacement of normal gray-white differentiation with petechial hemorrhage, while the remaining tissue displayed well-defined cortical gyri and clear gray-white demarcation.\n\nMicroscopic evaluation demonstrated infiltration of brain tissue by a glial astrocytic process characterized by mild hypercellularity and cellular pleomorphism. Numerous microcysts were present, but endothelial proliferation or necrosis was not observed. Immunohistochemical staining showed positivity for GFAP and low Ki-67 labeling index (1\u20132%). Additional immunohistochemical markers showed variable expression: Leucocyte Common Antigen (LCA) was positive in 10% of cells; MGMT was positive in 20% of tumor cells; EGFR wt was strongly positive (80% of tumor cells); EGFR VIII was negative; S6 was positive in 50% of tumor cells; AKT was positive in 25%; MAPK was positive in 50%. Carbonic anhydrase IX was not expressed. VEGF staining scored 120 based on intensity and distribution; PDGFR-A showed widespread cytoplasmic and/or membrane reactivity in 90% of cells; PDGFR-B showed similar staining in 80% of cells; VEGFR2 scored 140 based on staining pattern.\n\nGenetic analysis using FISH demonstrated polysomy of chromosome 7 in 48% of tumor cells and polysomy of EGFR in 42% of tumor cells. All other tested regions including chromosomes 10, 9, and several tumor suppressor gene loci (PTEN, 1p36, 1p32, 19q13, 9p21) were intact. Methylation analysis of the MGMT promoter revealed a methylation index of 13.28, indicating low-level methylation."} +{"pid": "TCGA-ET-A3DR", "report": "The specimen consisted of a total thyroidectomy with limited neck dissection. The tumor was located in the left lobe and measured 1.2 cm in greatest dimension. Microscopic examination revealed a unifocal lesion with histologic features consistent with a neoplastic process. Lymph node evaluation showed involvement in 5 out of 6 nodes. Staging indicated the primary tumor was confined to the thyroid with a size less than or equal to 2.0 cm (pT1). Regional lymph node metastasis was identified in Level VI (pretracheal, paratracheal, and prelaryngeal/Delphian nodes), classified as pN1a. Distant metastasis could not be assessed (pMx). Surgical margins were free of involvement. Vascular or lymphatic invasion could not be definitively determined. Additional findings included the presence of parathyroid tissue on the right side."} +{"pid": "TCGA-AA-3811", "report": "The specimen shows an invasive, poorly differentiated neoplasm with partial neuroendocrine features. The lesion extends through all layers of the wall and is associated with vascular invasion. Fifteen lymph nodes were examined, five of which contain metastatic deposits. Resection margins are uninvolved. Additional findings include chronic appendicitis and an unremarkable ligature region."} +{"pid": "TCGA-DD-AADW", "report": "The liver specimen measured 15.5 x 10.0 x 4.5 cm and weighed 294 grams. A well-defined multinodular, pale tan, firm, and solid mass measuring 4.3 x 2.3 x 4.0 cm was identified. The gross appearance was multinodular confluent with no satellite nodules noted. The resection margin was not involved with a safety margin of 1.5 cm. The remaining liver parenchyma showed cirrhotic changes.\n\nMicroscopic examination revealed moderately differentiated tumor cells arranged in a trabecular pattern. The worst grade of differentiation was Grade III. There was no evidence of fatty change, fibrous capsule formation was complete, and there was no septum formation. Surgical resection margin invasion, serosal invasion, portal vein invasion, and microvessel invasion were not present. Information regarding intrahepatic metastasis and multicentric occurrence was not available.\n\nSections were submitted from the tumor mass (7 blocks), lymph nodes (1 block), bile duct (1 block), and liver parenchyma (2 blocks)."} +{"pid": "TCGA-90-A59Q", "report": "The operative procedure performed was a right upper lobectomy. The specimen included the right upper and middle lobes of the lung. The tumor was located in the upper lobe and measured 4.9 cm in greatest dimension. It was unifocal and confined to the lung, with no evidence of visceral pleural invasion. The closest distance of the tumor to involved margins could not be determined. Margins including bronchial, vascular, and others were uninvolved by invasive carcinoma.\n\nLymph node involvement was identified in one out of fifteen nodes examined, specifically at the 11\u201312 right nodal station. Other lymph nodes from levels 2, 4, and 7 showed no significant pathologic changes.\n\nHistologic evaluation revealed poorly differentiated features. Immunohistochemical staining showed focal positivity for p63 and CK5/6, while being negative for Napain and TTF-1. These findings were consistent with the morphologic assessment.\n\nAdditional findings included respiratory bronchiolitis. Intraoperative frozen section analysis of the bronchial margin was negative for malignancy, with a turnaround time of 16 minutes.\n\nGross examination of the lung specimen showed a tan to white mass with ill-defined borders near the bronchus and pleura. Sections submitted included representative areas of the mass, margins, and lymph nodes. Lymph node specimens from various levels were entirely submitted for microscopic evaluation."} +{"pid": "TCGA-D8-A1Y1", "report": "Histopathological examination was performed on a female patient. The specimen consisted of a left breast measuring 22 x 18 x 9 cm, along with axillary tissues measuring 10 x 11 x 5 cm and a skin flap of 23 x 19 cm. A lesion measuring 6.0 x 6.0 x 3.5 cm was identified at the border of the upper quadrants of the breast, located 3.0 cm from the upper boundary, 1.5 cm from the base, and in direct proximity to the skin (0 cm). The nipple was retracted, and the skin exhibited an appearance resembling orange peel.\n\nMicroscopic evaluation revealed a high-grade cellular proliferation pattern with a total score corresponding to NHG3, based on a scoring system (3 + 2 + 3) and 35 mitoses observed per 10 high-power fields within a visual area of 0.55 mm. No lesions were identified at the nipple margin. Adjacent glandular tissue showed changes consistent with fibrocystic mastopathy.\n\nExamination of axillary lymph nodes identified involvement in one node (No I/XXI), with evidence of capsular and perinodal tissue infiltration by neoplastic cells.\n\nImmunohistochemical analysis demonstrated the presence of estrogen receptors in 10\u201375% of cell nuclei and progesterone receptors in more than 75% of cell nuclei. HER2 protein expression was assessed using Ventana\u2019s Pathway HER-2/neu (4B5) rabbit antibody, yielding a negative result with a score of 3+."} +{"pid": "TCGA-A8-A081", "report": "The specimen consists of an ablated right breast sample. Histologic evaluation reveals a moderately differentiated invasive lesion with a tumor diameter measuring 3.0 cm. The closest margin is located at the dorsal aspect, with a distance of 0.3 cm from the tumor edge; all other margins are greater than 1 cm and show no evidence of tumor involvement. Lymph node staging indicates no metastatic involvement. The histologic grade is G II, and the tumor extends into the lymphovascular space. No sentinel node involvement is identified."} +{"pid": "TCGA-ET-A3DO", "report": "The specimen consists of a total thyroidectomy. The primary lesion is located in the right lobe, with a second focus identified in the left lobe. The largest lesion measures 2.5 cm in greatest dimension. A second, smaller focus measuring 0.4 cm is also present. The lesions are multifocal. The tumor is confined to the thyroid gland and measures greater than 2 cm but less than 4 cm in size. No lymph nodes were submitted for evaluation. Margins are uninvolved, with the closest distance of invasive cells to the margin being 1 mm. There is no evidence of venous or lymphatic invasion. Additional findings include lymphocytic thyroiditis. The case was presented at a multidisciplinary conference."} +{"pid": "TCGA-CK-6748", "report": "The surgical pathology report includes specimens from a liver wedge resection and a segment of sigmoid colon, along with proximal and distal donut specimens. The liver specimen weighed 104g and measured 9.0 x 7.2 x 4.2 cm, with a cauterized resection margin inked blue. A white/tan mass measuring 5.0 x 4.5 x 3.0 cm was identified, showing focal necrosis in approximately 10% of the tissue. The mass abuts the liver capsule (inked black) and is located 1.0 cm from the parenchymal resection margin. No tumor was identified at the parenchymal resection margin. Mild hepatic steatosis was noted in the surrounding liver tissue.\n\nThe sigmoid colon specimen measured 16.8 x 2.9 cm in diameter and included two stapled resection margins: one measuring 4.9 cm and the other 3.6 cm, both inked black. A centrally ulcerated mass with raised borders was observed, measuring 5.0 x 4.0 x 1.2 cm. The mass was located 5.0 cm from the 4.9 cm stapled margin, 7.0 cm from the 3.6 cm stapled margin, and 2.6 cm from the mesenteric resection margin (measuring 16.8 x 2.3 cm, inked orange). Two tan/black tattoos were present: Tattoo #1 was 2.6 cm from the 4.9 cm margin and 1.2 cm from the ulcerated mass; Tattoo #2 was 4.1 cm from the 3.6 cm margin and also 1.2 cm from the mass. These tattoos were 7.2 cm apart and on opposite sides of the mass. Submucosal nodules were found beneath each tattoo. The nodule under Tattoo #1 measured 0.8 x 0.8 cm and was 0 cm from the 4.9 cm margin and 4.0 cm from the mass. The nodule under Tattoo #2 measured 1.0 x 0.8 cm and was 6.0 cm from the 3.6 cm margin and 2.5 cm from the mass. An area of serosal puckering (1.5 x 0.5 cm) was noted deep to the ulcerated mass, located 4.0 cm from the mesenteric margin, 7.5 cm from the 4.9 cm margin, and 7.0 cm from the 3.6 cm margin. No lymphovascular, extramural venous, or perineural invasion was identified. There was no evidence of a peritumoral lymphoid response or residual adenoma. Lymph node evaluation showed 2 out of 17 regional nodes positive for involvement. Distant metastasis was confirmed.\n\nThe proximal donut specimen was a circular soft tissue fragment measuring 1.1 x 1.6 cm, attached to a metallic anvil and containing a black stitch. The distal donut was a soft tissue fragment measuring 1.5 x 1.2 x 0.5 cm. Both were submitted in entirety and showed no evidence of tumor involvement.\n\nAll resection margins in the colon specimen were free of tumor involvement, with the closest distance between invasive tumor and serosal surface being less than 0.1 cm. The deepest extent of tumor invasion reached through the muscularis propria into the serosa."} +{"pid": "TCGA-D7-A4YU", "report": "PESEL: XXX. Gender: M. Examination result No. Unit in charge: 1. ef. no. Clinical diagnosis (suspicion): malignancy of the stomach \u2013 Stomach, undefined. Date of admission: (urgency: Standard). Material: 1) Material: stomach, Method of collection: Total organ resection.\n\nThe specimen containing the stomach, after being incised along the greater curvature, measured 21.5 x 11 cm, with omentum measuring 40 x 23 cm. An ulcerous lesion was identified in the region of the lesser curvature, measuring 5.5 x 1.2 x 1.1 cm. Its distance from the proximal end was 1.5 cm and from the distal end was 9.5 cm. Another elevated lesion was observed in the greater curvature region, measuring 3.5 x 2.3 x 1.5 cm, located 5.5 cm from the proximal margin and 6.5 cm from the distal margin.\n\nMicroscopic evaluation revealed a tubular and partially mucinous carcinoma, high-grade, with multifocal growth patterns. The lesion infiltrated through the full thickness of the stomach wall into adjacent fat tissue. Surgical margins and omental tissue showed no evidence of neoplastic involvement. Evidence of vascular invasion was noted.\n\nLymph node assessment demonstrated metastatic involvement at multiple sites: along the lesser curvature, greater curvature, and peripyloric regions. Infiltration extended into the lymph node capsules and surrounding adipose tissue in some areas.\n\nImmunohistochemical analysis using Ventana's Pathway HER-2/neu (4B5) Rabbit Monoclonal Antibody showed no reactivity in invasive cells (Score = 0).\n\nStaging parameters indicated advanced local invasion (pT3) and extensive nodal involvement (pN3a)."} +{"pid": "TCGA-FV-A3I0", "report": "The surgical panel included a biopsy of liver segment 3, which showed normal liver tissue with no evidence of malignancy. The gallbladder specimen demonstrated mild chronic cholecystitis without cholelithiasis or any signs of dysplasia or malignancy.\n\nA laparoscopic hand-assisted right hepatic lobectomy was performed involving segments 5, 6, 7, and 8. Gross examination revealed a 12 cm lesion in the liver along with 12 intrahepatic metastatic nodules ranging from 0.5 to 2.0 cm in size. Histologically, the lesion was moderately differentiated and did not involve the margins, with a distance of 2 cm from the bile duct margin and 2 cm from the nearest hepatic resection margin. The surrounding liver tissue showed reactive changes but no signs of chronic liver disease.\n\nPathologic staging based on 2010 intrahepatic bile duct cancer criteria indicated a pT2a classification, corresponding to a solitary tumor with vascular invasion. Regional lymph nodes could not be assessed (pNX), and there was no evidence of distant metastasis (pM0). This resulted in a final TNM classification of pT2aNXM0 and a stage II designation.\n\nMicroscopic evaluation confirmed the presence of a mass-forming growth pattern with lymph-vascular invasion identified. The tumor was histologically graded as Grade 2 of 4, indicating moderate differentiation. No tumor was found at the liver capsule, and both the bile duct margin and resection margin were free of tumor involvement.\n\nAncillary studies showed no evidence of cirrhosis or primary sclerosing cholangitis. Clinical history indicated prior disease, though this is not referenced in the summary. Specimen descriptions were consistent with the findings reported microscopically, including multiple tumor nodules and absence of malignancy in other sampled areas. Intraoperative frozen sections confirmed benign margins and absence of malignancy in the liver biopsy and gallbladder specimens.\n\nRepresentative tissue sections were submitted for further analysis, and photographs of the specimen were taken for documentation. The case was fully documented with appropriate labeling of all cassettes and samples."} +{"pid": "TCGA-KM-A7QL", "report": "A female patient underwent surgical excision of two lesions from the left kidney, along with margin and perirenal fat tissue. The first lesion measured 2.0 x 1.2 x 0.3 cm and consisted of multiple tan to dark red soft tissue fragments. Histologic examination of this specimen revealed no evidence of abnormal cellular proliferation.\n\nThe second lesion was a tan-pink nodule measuring 3.0 x 2.5 x 2.2 cm in total, with the central portion measuring 1.5 x 1.0 x 1.0 cm. It exhibited a tan, fleshy cut surface with minimal punctate hemorrhage. The specimen was partially embedded for histologic evaluation, and margins were marked with black ink (deep) and blue ink (peripheral). Microscopic analysis showed cellular features including nuclear morphology and cytoplasmic characteristics consistent with epithelial origin.\n\nThe deep margin specimen associated with the second lesion measured 0.2 x 0.2 cm and consisted of fibrofatty tissue without evidence of cellular atypia or infiltrating cells. Additionally, perirenal adipose tissue measuring 7.5 x 4 x 1 cm was submitted, composed of yellow and tan-pink fragments. Histologic sections demonstrated normal adipose architecture and absence of abnormal cellular infiltration.\n\nAll specimens were processed and examined in detail, with comprehensive sampling performed where indicated. No tumor involvement was identified in the margins or perirenal fat."} +{"pid": "TCGA-QS-A8F1", "report": "The surgical specimen was received in multiple parts. The uterine corpus measured 5.0 x 4.8 x 3.6 cm and weighed 50 grams. The cervix, which was separately received, measured 2.8 x 2.5 x 2.5 cm and could not be oriented. The uterus was bivalved and showed a diffusely ragged and friable endometrial lining. A tumor-like area measuring 4.5 x 4.0 cm was identified within the endometrial cavity. The tumor appeared to invade through the myometrium to the serosal surface, with a distance of 0.2 cm from the tumor to the inked serosa. The myometrial invasion involved more than 50% of the myometrium both anteriorly and posteriorly. A calcified leiomyoma was identified within the myometrium, measuring 1.8 cm. The right fallopian tube was disrupted and measured 1.7 cm; the right ovary was 2.5 x 2.0 x 1.2 cm and showed dense fibrous stroma with multiple corpora albicantia. The left fallopian tube was a 1.5 cm hemorrhagic segment adhered to a 2.5 x 1.2 x 1.2 cm ovary, which also showed dense fibrous stroma and corpora albicantia.\n\nMicroscopic evaluation of the uterine specimen showed invasive growth through the myometrium to the serosal surface. Tumor involvement of the cervix was present. Angiolymphatic invasion was identified. Multiple biopsies of pelvic peritoneum were submitted, including left and right pelvic sidewalls, posterior cul-de-sac, pericolic gutter, bladder peritoneum, left uterosacral ligament, and left round ligament. All biopsies showed similar histologic features, with evidence of tumor involvement. The ovarian specimens also showed involvement. No lymph nodes were submitted for evaluation. Peritoneal ascitic fluid was negative for malignancy. The tumor size was recorded as 4.5 cm in greatest dimension. Distant metastasis was not applicable. Lymphovascular invasion was present. The hysterectomy specimen was received in two pieces, and all relevant sections were sampled."} +{"pid": "TCGA-IS-A3KA", "report": "The submitted specimens include multiple lymph node biopsies from the right and left periaortic, external iliac, obturator, hypogastric, common iliac, and left para-aortic regions, as well as a biopsy of the omentum and a specimen consisting of the uterus, bilateral fallopian tubes, and ovaries. All lymph node biopsies show benign lymphoid tissue without evidence of malignancy. The number of lymph nodes evaluated in each group ranges from two to eight, with no positive findings. The omental biopsy consists of benign adipose tissue.\n\nThe surgical specimen of the uterus shows a high-grade sarcomatous lesion within the myometrium, characterized by marked nuclear atypia and frequent mitotic figures. There is extensive vascular invasion, but no involvement of the endocervix. A benign leiomyoma is also identified within the myometrium. The left ovary contains a simple cyst, and all other adnexal tissues are unremarkable.\n\nImmunohistochemical analysis reveals expression of desmin, H-caldesmon, smooth muscle actin (SMA), and focal epithelial membrane antigen (EMA), along with variable staining for S100. Tumor cells are negative for myogenin and show equivocal reactivity for HMB45. These findings support a lineage consistent with smooth muscle differentiation, with focal features suggestive of lipoblastic differentiation."} +{"pid": "TCGA-DJ-A3UZ", "report": "The clinical history includes bilateral thyroid nodules and a prior finding of a positive lesion in the left lobe. Specimens submitted include tissue near the left upper pole, left paratracheal tissue, and a total thyroidectomy specimen.\n\nFrozen section analysis of the tissue near the left upper pole revealed benign thyroid tissue. Similarly, the left paratracheal tissue showed one benign lymph node without evidence of abnormal cells.\n\nIn the total thyroidectomy specimen, multiple small areas of interest were identified. Histologic evaluation demonstrated well-differentiated cellular features with no mitotic activity or tumor necrosis observed. The areas of concern were partially encapsulated, with no evidence of blood vessel invasion. There was extension into adjacent adipose tissue and a parathyroid gland. Surgical margins were free of any notable findings.\n\nMultiple nodules were identified within both lobes of the thyroid. The largest measured 1.1 cm in greatest dimension, while others ranged down to 0.4 cm. These included both gross and microscopic findings. The surrounding non-neoplastic thyroid tissue exhibited nodular hyperplasia and chronic lymphocytic thyroiditis. Two parathyroid glands were identified, one within each lobe; the left-sided gland showed involvement.\n\nLymph node assessment identified two benign lymph nodes without any abnormal cells. Additional special stains and immunohistochemical studies performed on one of the nodules were negative.\n\nGross examination of the thyroidectomy specimen revealed a thyroid weighing 22 grams. Each lobe measured 4.5 x 3 x 2 cm, with an isthmus measuring 3 x 1 cm. Sectioning identified three nodules: two in the right lower pole (measuring 0.8 cm and 0.3 cm) and one in the middle portion of the left lobe (measuring 0.5 cm). All were non-encapsulated with tan-white cut surfaces. The remaining thyroid tissue appeared red-brown and firm. Representative sections were submitted for further analysis.\n\nAll surgical specimens were entirely submitted for evaluation, with detailed mapping and sectioning completed. Intraoperative frozen section diagnoses matched permanent diagnoses for all evaluated tissues."} +{"pid": "TCGA-B0-5104", "report": "The specimen consists of a left radical laparoscopic nephrectomy. A mass measuring 4.5 cm in diameter is present within the kidney. Microscopic evaluation shows that the tumor is confined to the renal parenchyma, without extension beyond the organ. There is no evidence of angiolymphatic invasion. The surrounding non-neoplastic renal tissue demonstrates focal chronic inflammation and focal glomerulosclerosis. All surgical resection margins are free of abnormal cells. The histopathological grade is G2. No lymph node or distant metastases are identified."} +{"pid": "TCGA-B8-A8YJ", "report": "A right robotic partial nephrectomy specimen was received, consisting of a 47.8 gram aggregate including a 25 gram, 4.8 x 4.5 x 2.5 cm kidney resection and separate lobulated, focally cauterized fat. The renal capsule was inked black and the parenchymal margin inked blue. A well-circumscribed hemorrhagic cortical nodule measuring 4.4 x 3.2 x 2.5 cm was identified, with bright orange borders. The lesion expanded the capsule and approached multiple blue inked parenchymal margins within 0.1 cm, as well as multiple black inked capsular margins within less than 0.1 cm. A compressed rim of gray-tan kidney tissue was present. The tumor was unifocal. Histologic assessment showed no invasion of the capsule, perirenal adipose tissue, Gerota\u2019s fascia, renal sinus, ureter, or major veins. No sarcomatoid features were identified. Histologic grade was Fuhrman nuclear grade 2. Surgical margins\u2014including the renal parenchymal, capsular, and paranephric adipose tissue margins\u2014were free of tumor. No lymphatic or venous invasion was identified. No lymph nodes were submitted. No significant findings were noted in the non-neoplastic kidney tissue. Based on available information, staging is pT1b, pNx."} +{"pid": "TCGA-CM-4747", "report": "The specimen consists of a right hemicolectomy and a small bowel mesenteric lymph node. The resected colon includes the terminal ileum, cecum with appendix, and ascending colon. The terminal ileum measures 24 cm in length and 5 cm in circumference at the proximal margin, while the colon is 29 cm long with a 6 cm distal circumference. The appendix is 5 cm in length and averages 0.6 cm in diameter. A fungating mass measuring 5.5 cm in length and 3.5 cm in width is located in the cecum, surrounding the ileocecal valve but sparing the appendiceal orifice. The depth of tumor invasion is 3.5 cm, extending into the subserosa. Serosal involvement is present, and there is suspicion for vascular invasion along with identified perineural invasion. The surgical margins are free of tumor. Adjacent non-neoplastic findings include diverticular disease in both the colon and distal ileum. A preexisting polyp of tubulovillous adenoma type is identified at the tumor site, and no additional polyps are found away from the lesion.\n\nA total of 29 lymph nodes are examined, with 2 showing metastatic involvement. One lymph node from the small bowel mesentery is benign. The pathological staging indicates pT4 classification for the primary tumor and pN1 for lymph node involvement. Immunohistochemical staining for DNA mismatch repair proteins MLH1, MSH2, MSH6, and PMS2 shows retained expression within the lesion.\n\nThe specimen also includes focally hemorrhagic lobulated yellow-tan adipose tissue spanning the specimen, measuring up to 4 cm in thickness. The serosa is inked black for orientation. Representative sections from the proximal and distal margins, deepest extent of the tumor, appendix, ileal mucosa, colonic mucosa, and lymph nodes are submitted for histological evaluation. All slides were personally reviewed and approved."} +{"pid": "TCGA-IB-7647", "report": "The specimen includes a mass from the head of the pancreas, body of the pancreas, gallbladder, bile duct margin, hepatic artery lymph node, pancreas margin, and a Whipple\u2019s specimen. Histologic evaluation reveals invasive malignant cells within the pancreatic head biopsy. The cells exhibit characteristics consistent with moderately differentiated morphology and infiltrate surrounding soft tissue, extending to lateral resection margins. Involvement of the duodenal mucosa is noted. The common bile duct margin demonstrates low-grade architectural changes. Both proximal (gastric) and distal (duodenal) margins are free of malignant involvement.\n\nExamination of the pancreatic resection margin shows infiltration beyond the pancreas into small nerves. Evidence of vascular and perineural invasion is present. Lymph node assessment reveals metastatic involvement in one of two common bile duct nodes, four of nine periduodenal nodes, and all nine lymph nodes from another region. Extracapsular extension is observed in some nodes.\n\nAdditional findings include chronic inflammatory changes in the body of the pancreas and gallbladder. One benign lymph node is identified. The bile duct specimen exhibits mild cellular atypia without definitive malignant features.\n\nGrossly, the Whipple\u2019s specimen measures 22.5 x 6.0 cm and includes a gastric segment of 2.5 x 6.5 cm and a duodenal segment measuring 20.0 x 6.0 cm. The pancreatic head measures 6.1 x 4.5 x 2.0 cm. The resection margin is painted blue. A firm grey area with a central brown-red focus is observed within the pancreatic head, extending into the duodenal wall. This abnormal region measures approximately 3.0 x 2.2 x 1.1 cm. An ulcerated lesion measuring 1.3 x 0.7 cm is identified near the ampulla of Vater, with an underlying firm grey area contiguous with the pancreatic lesion.\n\nTwo lymph nodes adjacent to the common bile duct measure 2.0 cm and 1.7 cm. The gallbladder specimen measures 7.0 x 2.8 x 2.5 cm; no gallstones are identified. The mucosa appears unremarkable with a thickened fold near the cystic duct. The bile duct specimen contains two lumens measuring 0.6 cm and 0.7 cm in diameter. Other specimens include small tissue fragments measuring up to 1.5 cm in various dimensions.\n\nMicroscopic sections include evaluations of the bile duct margins, resection margins, duodenal mucosa, and serial sections of the pancreatic head. A block containing the ampulla of Vater and adjacent duodenum measuring 3.0 x 3.0 cm is submitted for detailed study."} +{"pid": "TCGA-22-4599", "report": "The resected left lung specimen weighs 565 grams. A centrally located mass measuring 2.8 x 2.0 x 1.2 cm is identified, with involvement of the pulmonary artery. The surrounding tissue shows changes consistent with post-obstructive pneumonia and pleuritis; however, there is no involvement of the pleura. The bronchial margin is clear by 3 cm. Within the lung, two intrapulmonary peribronchial lymph nodes are present and show no evidence of tumor involvement.\n\nLymph node excisions from multiple regions were examined. In the superior and inferior mediastinal regions, including three left lower paratracheal, one tracheobronchial, nine subcarinal, and two left inferior pulmonary ligament lymph nodes, no tumor involvement is identified. Similarly, six aortopulmonary and two anterior mediastinal lymph nodes do not show any evidence of tumor."} +{"pid": "TCGA-Z6-A8JD", "report": "A fragment of the esophagus measuring 15 cm in length and a portion of the stomach measuring 2 cm were received. The proximal resection margin is 1 cm from the lesion, while the distal margin is 10 cm away. The esophageal wall contains an infiltrative-ulcerative lesion measuring 4 cm in length and 5 cm in diameter. Dense, stellate tissue was observed in the section. The esophageal and gastric mucosa appear smooth and shiny with no evidence of invasion. Adjacent adipose tissue contains five black, consolidated areas each approximately 1 cm in diameter. No signs of tumor growth are present in the paragastral or paraesophageal adipose tissue. Microscopically, the lesion shows moderately differentiated cells infiltrating through all layers of the esophagus, including the adventitia. Surgical margins are free of involvement. Lymph nodes in the paragastral and paraesophageal regions, as well as the greater omentum, show no evidence of tumor spread."} +{"pid": "TCGA-22-1017", "report": "The pathology report includes the following details: The specimen was originally sent to NCH and subsequently directed to IGC. The biospecimen core resource received the sample on a date not specified in the provided data. Histology codes for both the specimen and the overall case were requested, with any differences between the two noted. Similarly, site codes for the specimen and the overall case were required, with discrepancies also documented. No tumor type or diagnosis was available in the original report. All entries were made in accordance with the Case Quality Control Form and other available patient information."} +{"pid": "TCGA-EP-A26S", "report": "The specimen includes a gastrohepatic lymph node and a wedge-shaped portion of liver tissue measuring 12 x 5.8 x 3.5 cm. The lymph nodes are described as rubbery and tan-red, averaging 1 cm in size, and were entirely submitted for analysis. Within the liver specimen, a well-circumscribed mass measuring 4.2 x 3 x 3 cm is identified along the anterior surface. The lesion is located within 1 cm of the resection margin and within 0.25 cm of the hepatic capsule both anteriorly and posteriorly. The surrounding liver tissue appears uniform and red-brown with no additional abnormalities noted.\n\nMicroscopic evaluation of the liver tissue reveals a moderately differentiated cellular proliferation arranged in trabeculae. The primary lesion does not extend beyond the hepatic parenchyma and no lymphatic or vascular invasion is observed. A focal area suggestive of vascular involvement was noted on slide B1, though immunohistochemical staining with CD31, CD34, and D2-40 did not confirm definitive vascular invasion after multiple levels were examined. Resection margins are free of tumor involvement.\n\nExamination of the two gastrohepatic lymph nodes shows no evidence of abnormal cellular infiltration; however, lipogranulomatous inflammation is present. Additional findings include steatosis and bile accumulation within the affected area. The background liver tissue demonstrates mild chronic portal inflammation without significant fibrosis, necrosis, or steatosis. Iron deposition is not present, although lipofuscin granules are noted. Special stains including Trichrome, reticulin, PAS, PAS with diastase, and iron stain were performed on representative blocks to further evaluate tissue characteristics.\n\nNo distant metastases can be assessed. Other markers and immunostains used in the evaluation are considered analyte-specific reagents monitored within the laboratory and are supported by published literature, though they are not FDA cleared or approved."} +{"pid": "TCGA-DD-AAD8", "report": "The liver specimen measured 21.5 x 11.5 x 3.0 cm and weighed 281.5 grams. A single well-defined lesion measuring 1.5 x 1.8 x 2.0 cm was identified, with a yellowish tan and granular cut surface. The gross appearance showed an expanding nodular pattern. The resection margin was free of involvement with a safety margin of 3.5 cm. No satellite nodules or portal vein invasion were observed. The gallbladder measured 7.0 cm in length and 4.0 cm in diameter.\n\nMicroscopic evaluation revealed cells arranged in a trabecular pattern with moderate differentiation. Fatty changes were present in approximately 10% of the tissue. There was no evidence of fibrous capsule formation, septum formation, surgical margin invasion, serosal invasion, microvessel invasion, or intrahepatic metastasis. No multicentric occurrence was identified.\n\nEvaluation of non-tumor liver tissue showed chronic hepatitis related to HCV infection. Lobular inflammation was mild, while portoperiportal inflammation was moderate. Fibrosis was limited to the periportal region without cirrhosis. No dysplastic nodules, ductal epithelial dysplasia, or other significant liver disease was noted.\n\nAdditional findings included chronic cholecystitis with cholelithiasis. Other submitted tissues did not reveal any additional relevant pathology."} +{"pid": "TCGA-AA-3519", "report": "The resected large bowel specimen measures 16 cm in length and contains a polypoid, moderately differentiated neoplastic lesion. Histological evaluation reveals infiltration into the pericolic fatty tissue. Examination of regional lymph nodes shows involvement in three out of forty-three nodes. The resection margins of the large bowel are free of neoplastic cells, as is the mesenteric margin. An area of inflammation involving the urinary bladder is noted in close proximity to the resected segment, with adherence of a ductus deferens segment in this region. Vascular invasion is not identified. Based on pathological findings, the tumor stage is classified as pT3 pN1 (3/43) pMX, with a histologic grade of G2 and a local resection margin status of R0."} +{"pid": "TCGA-DB-A75P", "report": "The biopsies of the brain mass involving the hippocampus and left temporal lobe show a relatively cellular lesion in certain areas. Histologic evaluation reveals positive staining for GFAP, with neurofilament protein highlighting axons within the tissue. The Ki-67 index is low, indicating limited proliferative activity. Immunostaining for p53 demonstrates low to moderate labeling, while IDH1-R132H, EMA, and neurofilament protein are negative. Mitotic figures are not identified, and no definitive high-grade features are observed."} +{"pid": "TCGA-JW-A69B", "report": "The pathology report includes specimens from the endometrium and cervix. The endometrial biopsy measures 2.6 x 0.7 x 0.3 cm and consists of an aggregate of pink to dark-brown mucoid tissue. Cervical biopsies include multiple fragments: two measuring 0.3 x 0.3 x 0.2 cm and 0.3 x 0.4 x 0.2 cm, along with a larger aggregate measuring 1.5 x 0.6 x 0.2 cm. These tissues show abnormal glandular proliferation with features of invasive growth.\n\nMicroscopic evaluation reveals malignant glandular cells. Immunohistochemical staining demonstrates positivity for p16 (strong and diffuse) and CEA (patchy), while ER and vimentin are negative. These findings support specific epithelial characteristics and assist in determining the likely origin of the lesion. A fragment of severely dysplastic squamous epithelium is also identified in one of the cervical samples.\n\nThe morphologic features combined with the immunophenotype suggest a particular glandular derivation. Clinical correlation is advised. The case was reviewed by a staff pathologist and confirmed through intradepartmental consultation. The patient presented with abnormal uterine bleeding and an enlarged cervix."} +{"pid": "TCGA-HC-7750", "report": "The prostate specimen measured 4.5 x 4.0 x 3.5 cm and weighed 41.4 grams. The cut surface demonstrated a pink-tan, focally cystic appearance with diffuse periurethral nodularity. A single 0.5 cm ill-defined yellow-tan lesion was noted in the left posterior quadrant near the apex, approaching to within 0.4 cm of the inked capsule. No other lesions were identified.\n\nHistologic evaluation showed abnormal cellular growth occupying approximately 10 to 15% of the prostate volume. The primary histologic pattern was graded as 3/5, and the secondary pattern was graded as 4/5, yielding a combined score. There was no evidence of extension beyond the prostate capsule, seminal vesicle involvement, or lymphovascular space invasion. High-grade intraepithelial neoplasia was not identified.\n\nSurgical margins were assessed, including the apex, bladder base, and inked surfaces. All were negative for tumor involvement. Biopsies from the left lateral margin and urethral margin showed no evidence of malignancy; the urethral margin showed significant cautery artifact, but no definitive abnormal cells were found.\n\nLymph node assessment showed none present. The staging classification was assigned based on local extent. The vas deferens and seminal vesicles were also submitted for analysis, along with tissue samples designated for genomic research."} +{"pid": "TCGA-AG-3898", "report": "The resected colon and rectal specimen shows tumor-free resection margins. The lesion is ulcerated and composed of moderately differentiated (G2) cells. Histological evaluation reveals infiltration into the perimuscular fatty tissue. No local lymph node metastases were identified upon examination of 21 lymph nodes. Vascular invasion is absent, and the surgical margins are free of tumor."} +{"pid": "TCGA-56-7580", "report": "A wedge resection of the left lower lobe of the lung was performed. The specimen measured 7 x 5.5 x 3.0 cm and weighed 56.5 grams. A subpleural nodule measuring 3.5 cm was identified, with a firm yellow-tan-gray variegated appearance and areas of necrosis. The resection margin was determined to be free of involvement, with a distance of 1.6 cm from the tumor. The closest pleural surface was 0.1 cm from the tumor. The nodule was poorly differentiated with necrotic changes. No visceral pleural invasion was observed. Lymphovascular invasion was not identified. A separate section of the left upper lobe wedge was submitted, along with an anthracotic lymph node from the AP window region. The tumor was unifocal and staged as pT2a pN0, corresponding to stage IB. Additional findings included thick-walled parenchymal blood vessels, tumor necrosis, and septal fibrosis. The histologic grade was poorly differentiated. The surgical margins were uninvolved, and no treatment effect was applicable. The specimen was intact and laterality was confirmed as left-sided. A frozen section was performed and the findings were confirmed on permanent sections, with concurrence from an external consultant."} +{"pid": "TCGA-G4-6293", "report": "The resected right colon and terminal ileum specimen contained a lesion measuring 5.5x3.5x1.0 cm, located in the transverse colon area. Histologic evaluation showed invasive growth with full thickness involvement of the muscle wall and extension into subserosal fat. Vascular, lymphatic, and perineural invasion were not identified. All proximal, distal, and radial margins of resection were free of involvement. One out of twenty-six pericolic lymph nodes was involved. No tumor involvement was identified in the appendix or omental fat. The tumor arose within a tubulovillous adenoma. Lymph node assessment revealed one positive node among those examined from various regions including near the tumor, mid-colon, and ileocecal junction. Immunohistochemical analysis demonstrated MLH1 and MSH2 expression in tumor tissue, with peritumoral lymphocytes serving as internal controls. Microsatellite instability testing has been initiated and results will be reported separately."} +{"pid": "TCGA-W2-A7H5", "report": "The specimen submitted for analysis consists of an 8.0 gram, 3.0 x 2.5 x 1.5 cm ovoid tan nodule with a small amount of adherent adipose tissue. The outer surface is marked with black ink. On gross examination, the specimen was previously incised and shows a red-brown, soft cut surface with a thin rim of orange-tan cortical tissue. A portion of the tissue was taken for tissue banking, and the remainder was submitted entirely in cassettes A1-5.\n\nHistological evaluation reveals a well-circumscribed lesion within the adrenal gland. The neoplasm demonstrates no evidence of capsular or vascular invasion. Cellular morphology is characterized by uniform cells with moderate cytoplasmic granularity and round to oval nuclei. No atypical mitotic figures or necrosis are identified. The surrounding adrenal cortex appears unremarkable. Staging assessment indicates the lesion is localized without extension beyond the adrenal gland. Fresh tissue was preserved for further study."} +{"pid": "TCGA-G2-A3IE", "report": "A specimen consisting of multiple tan-pink irregular tissue fragments, measuring 3.0 x 2.5 x 1.5 cm in aggregate, was submitted for analysis. Histologic evaluation revealed high-grade cellular atypia with invasive growth into the muscularis propria. The entire lesion was processed and examined. No clinical history was provided."} +{"pid": "TCGA-PN-A8MA", "report": "Sex: Female. Date of Tumour Procurement: 1. GROSS ASSESSMENT: Cut section showed a chalky white lesion measuring 2x1.3x1cm. 2. MICROSCOPIC ASSESSMENT: The section shows an invasive growth pattern in solid nests. The cells are large and polygonal with moderately pleomorphic hyperchromatic nuclei and amphophilic cytoplasm. The stroma is desmoplastic, containing thin-walled vascular channels and similar cellular elements. 5. Distance of invasive component to closest margin is 3mm at the deep resection margin. Nuclear score is 3. Reporting Pathologist Name. SPA. du. use is."} +{"pid": "TCGA-BP-4344", "report": "The specimen consists of a wedge-shaped portion of kidney measuring 4.2 x 2.0 x 2.7 cm, with a suture marking the deep margin. The external surface of the deep margin is inked black. Serial sectioning reveals a well-circumscribed, yellow, hemorrhagic lesion measuring 2.8 x 1.5 x 2.8 cm. The distance from the tumor to the nearest resection margin is 0.2 cm. A representative section of this margin was submitted for intraoperative evaluation.\n\nMicroscopic examination of the tissue shows cells arranged in solid sheets and acinar structures, with clear cytoplasm and well-defined cell borders. Nuclear features are relatively uniform, with moderate variation in size and shape. No evidence of invasion into surrounding structures or into the renal vein was identified. All surgical margins were free of abnormal cellular proliferation.\n\nThe non-neoplastic kidney tissue showed no significant pathological changes. No adrenal tissue, lymph nodes, or other associated structures were identified in the specimen. Based on the histological and morphological findings, the lesion is confined within the kidney and does not exceed 7.0 cm in greatest dimension. The case was reviewed and confirmed after personal examination of the slides. An earlier report had indicated extension through the renal capsule, but this has been revised upon further review to show no such involvement. The responsible clinician has been informed of the amendment."} +{"pid": "TCGA-XF-A9SY", "report": "A segment of right distal ureter measuring 0.4 cm in length and 0.4 cm in diameter with attached fat was entirely submitted for frozen section and found to be benign. Similarly, a left distal ureter segment measuring 0.4 x 0.3 cm was also found to be benign. A ring-shaped bladder neck margin specimen measuring 2.1 x 1.5 x 0.5 cm was submitted and found to be free of atypia or malignancy.\n\nThe main surgical specimen included the bladder, uterus, bilateral fallopian tubes, ovaries, and perivesical lymph nodes. The bladder measured 6.5 x 6.5 x 5 cm and contained an ulcerated mass located in the anterior wall extending to the left lateral wall. The mass measured 4.9 x 4.7 cm in area and 1.5 cm in depth, coming within 0.4 cm of the left ureterovesical junction, 2 cm from the right ureterovesical junction, and approximately 0.7 cm from the bladder neck margin. It extended through the full thickness of the bladder wall (1.8 cm thick in involved areas) into the perivesical soft tissue, approaching within 0.3 cm of the anterior inked radial margin and 0.4 cm of the left lateral inked margin. No urothelial dysplasia or malignancy was identified in the remaining mucosa or in random biopsies. The right and left ureters were unremarkable with no evidence of dysplasia or tumor involvement.\n\nThe uterus measured 6.5 x 4.5 x 3.4 cm and contained a 1.8 cm endometrial polyp on the left wall. Histologically, there was a small focus of well-differentiated endometrial adenocarcinoma (FIGO grade 1/3) arising in the background of complex hyperplasia with atypia. No cervical, myometrial, or lymphovascular invasion was identified. The myometrium was unremarkable with an average thickness of 1.7 cm.\n\nBoth fallopian tubes were unremarkable except for a thin-walled cyst measuring 1 cm on the left fimbria. The right ovary measured 2.4 x 1 x 1.1 cm and had multiple surface and internal simple cysts. The left ovary measured 2.4 x 1 x 0.8 cm and contained a 0.7 cm unilocular cyst. No malignancy was identified in either ovary.\n\nPerivesical lymph node assessment showed metastatic involvement in one of three nodes examined on the left side, with a metastasis measuring 0.4 cm. On the right, no malignancy was identified in six paracaval, eight common iliac, two Cloquet, six external iliac, or seven obturator/hypogastric lymph nodes. On the left, no malignancy was found in eight para-aortic, eight common iliac, one Cloquet, or seven external iliac lymph nodes. One of 14 left obturator/hypogastric lymph nodes showed metastatic involvement measuring 0.4 cm. In total, 2 of 86 lymph nodes examined showed metastatic involvement.\n\nAll other margins, including proximal ureteral segments, were free of atypia or malignancy. The pathology report showed no evidence of urothelial carcinoma in situ in random mucosal samples. Focal lymphovascular space invasion was identified in the bladder. The final pathologic staging was pT3bN2MX."} +{"pid": "TCGA-HC-7080", "report": "The prostate measured 4.7 x 4.5 x 4.1 cm and weighed 39 grams. A focus of abnormal tissue was identified in the distal right posterior segment, measuring 0.6 cm in greatest dimension and located 0.1 cm from the inked margin. This area showed no extension beyond the prostate capsule. No involvement of the seminal vesicles or vas deferens was observed. The bilateral pelvic lymph nodes examined were negative for any evidence of metastatic involvement.\n\nHistologic evaluation revealed a pattern of growth with a primary architectural pattern scoring system showing a grade of 3 out of 5, and a secondary pattern graded as 4 out of 5. Tumor involvement was limited to less than 5% of the overall specimen volume. All surgical margins were free of tumor involvement.\n\nBackground benign prostatic hyperplasia was also noted within the specimen. No high-grade intraepithelial neoplasia, lymphovascular space invasion, or treatment-related changes were identified. The pTNM staging classification assigned was pT2aNO."} +{"pid": "TCGA-YC-A9TC", "report": "The specimen was obtained from a male patient following transurethral resection of the bladder. The tumor exhibited a mixed solid and papillary configuration. Histologic evaluation showed high-grade features with two distinct cell populations\u2014approximately one-third displaying squamous morphology and two-thirds appearing poorly differentiated. Necrosis was identified, with re-review confirming approximately 10% necrotic tissue. The adequacy of the specimen allowed for assessment of muscularis propria invasion, which was present microscopically. Lymphovascular invasion was also noted. Additional findings included keratinizing squamous metaplasia, extensive necrosis, and calcification.\n\nStaging according to the AJCC 7th edition criteria indicated involvement extending into the muscularis propria (pT2), with lymph node status indeterminate (pNX). The specimen was processed within appropriate time frames, with total cold ischemia time measuring 22 minutes and formalin fixation occurring within 6 to 72 hours. The tumor specimen weighed 475 mg and was preserved in formalin-fixed paraffin-embedded (FFPE) format. No matched normal or metastatic tissues were collected. Patient consent was documented as part of the study records."} +{"pid": "TCGA-FB-AAQ0", "report": "The Whipple specimen includes a duodenum measuring 15 cm in length and 4.5 cm in depth, and a pancreas measuring 8 x 5.4 x 2 cm. The duodenum has a normal mucosal appearance in the proximal portion, with darker and congested mucosa distally. A wire mesh stent extends 1.2 cm from the ampulla. Surgical stitches mark several margins: a black stitch for the deep radial margin, a blue stitch for the portal vein margin, a looped blue stitch for the superior mesenteric artery margin, and a looped black stitch for the proximal duodenal margin. The pancreatic neck margin measures 1.6 x 1.5 cm and is inked orange, while the vascular groove is inked blue and the remaining radial margin is inked black.\n\nSerial sections of the pancreas reveal a pale tan to white mass measuring 2.7 x 2.2 x 1.6 cm. The mass is located 1.4 cm from the SMA margin, 1.2 cm from the portal vein margin, 3 cm from the deep radial margin, and 1 mm from the nearest radial margin. The common bile duct is patent through the ampulla, with a diameter of 0.2 cm. A longitudinal incision along the bile duct reveals the stent, which measures 6.3 cm in length and 1.2 cm in diameter. The main pancreatic duct at the pancreatic neck margin is obstructed, as determined by failed patency testing and subsequent longitudinal sectioning. Representative sections of the bile duct, pancreatic, and duodenal margins were submitted entirely. The remaining pancreatic tissue is firm, pale tan to yellow, with no additional lesions.\n\nMicroscopic evaluation shows that surgical margins are free of tumor involvement. The mass focally extends into surrounding soft tissues. Perineural invasion is present, but no angiolymphatic invasion is identified. A total of eighteen regional lymph nodes are examined, none showing evidence of malignancy. The histologic grade is poorly differentiated. No treatment effect is observed. Additional findings include chronic pancreatitis. The tumor does not involve any of the examined margins, including the pancreatic neck, portal vein, superior mesenteric artery, deep radial, duodenal, or jejunal margins."} +{"pid": "TCGA-XJ-A83F", "report": "The specimen included right and left obturator lymph node samples and a prostate specimen. The right obturator lymph node sample consisted of six lymph nodes, all without evidence of malignancy. The left obturator lymph node sample included two lymph nodes, also without evidence of malignancy. The prostate measured 5.8 x 4.3 x 4.9 cm and weighed 52 grams. A white-tan mass measuring 0.8 x 0.7 x 0.5 cm was identified in the left anterior lobe. This mass was located 0.4 cm from the closest margin. Histologically, the cells were moderately differentiated with a Gleason pattern of 3 as the primary and 4 as the secondary, resulting in a total Gleason score of 7. Approximately 40% of the prostatic tissue was involved by the lesion. Extraprostatic extension was present. No seminal vesicle invasion or lymph-vascular invasion was identified. The surgical margins were focally involved at the right posterior region. Perineural invasion was present. Additional findings included focal high-grade prostatic intraepithelial neoplasia. Seven lymph nodes were examined, and none showed signs of involvement. Pathologic staging was determined to be pT3a pN0, indicating extraprostatic extension without regional lymph node metastasis. The stage is considered provisional and based solely on available pathologic data."} +{"pid": "TCGA-23-1026", "report": "The surgical pathology report includes multiple specimens. Omental tissues (specimens #1 through #4) show benign mesothelial hyperplasia and contain minute intra-omental lymph nodes with reactive changes. The left salpingo-oophorectomy specimen shows a distorted ovarian mass with involvement of the fallopian tube and paraovarian tissue. A paratubal cyst and chronic salpingitis are also noted. The right salpingo-oophorectomy reveals a similar pattern, with significant replacement of ovarian tissue, a hemorrhagic corpus luteum cyst, and chronic inflammatory changes in the fallopian tube. The hysterectomy specimen demonstrates tumor deposits in the parametria and a subserosal deposit on the anterior uterine wall. The endocervix is benign with reactive features, and the endometrium and myometrium appear unremarkable. Metastatic involvement is identified in the pelvic tumor, rectosigmoid, diaphragm, gastrocolic ligament nodule, and vaginal tumor specimens, all showing high-grade morphology. The appendix shows fibrosis and luminal obliteration without malignant findings. Lymph node biopsies, including those from the pelvis and obturator regions, are negative for metastatic disease, with one left pelvic lymph node biopsy showing only benign fibroadipose tissue. Microscopically, the tumor is described as solid and focally papillary with numerous mitoses and a high nuclear-to-cytoplasmic ratio. Some areas show extracellular mucin, with rare intracellular vacuoles. Grossly, the omental specimens are firm and yellow-brown, with some containing small firm areas. The left ovary and tube specimen contains a 1.3 cm paratubal cyst and a 5.5 cm ovarian mass with a partially cystic and solid cut surface. The right adnexa specimen has a 6.0 cm mass with papillary features and cysts up to 3.0 cm. The uterus measures 7.0 cm in length and weighs 90 grams, with two small subserosal leiomyomas. The pelvic tumor specimen aggregates to 7.0 cm, while the rectosigmoid tumor includes two tissue fragments measuring up to 1.3 cm. The appendix is 2.5 cm long with a firm nodule. The diaphragm tumor consists of three tissue pieces ranging from 0.3 to 1.0 cm. The vaginal tumor biopsy includes nodular areas measuring 1.0 and 1.5 cm."} +{"pid": "TCGA-E7-A85H", "report": "The specimen consists of bladder tissue. Grossly, a mass is identified within the bladder wall, measuring 2 x 1.5 x 1.2 cm. The lesion is invasive and protrudes with poorly defined margins. The surface is soft and gray.\n\nMicroscopically, the cells show hyperplastic growth arranged in sheets, nests, groups, and cords. The cytoplasm is moderately abundant and eosinophilic. Nuclear features include marked enlargement, variation in size and shape, irregular nuclear contours, prominent nucleoli, and abnormal chromatin distribution. Mitotic figures are frequently observed. The tumor extends into the muscularis propria and involves vascular structures.\n\nLymph node assessment shows no metastatic involvement (0/2 lymph nodes involved). Vascular invasion is present, and the surgical margins are free of tumor. No evidence of prior neoadjuvant therapy is noted. Additional findings include focal extracapsular extension involving the bladder wall and vessel."} +{"pid": "TCGA-HE-7129", "report": "The histology sample was collected from the right kidney during a resection procedure. The patient was 44 years old at the time of the event. Tissue preparation involved formalin fixation. Histologic evaluation revealed a lesion measuring 14.5 cm in greatest dimension. Microscopic analysis demonstrated cells with eosinophilic cytoplasm and nuclear features consistent with high-grade morphology. Additional findings included extensive chronic pyelonephritis. Staging indicated no lymph node involvement and no evidence of distant metastasis. The tumor was classified as T2, NOS. No further diagnostic terms were applied."} +{"pid": "TCGA-BG-A0W2", "report": "The patient underwent exploratory laparotomy, bilateral salpingo-oophorectomy, and total abdominal hysterectomy. Histologic evaluation of the uterine specimen revealed a well-differentiated epithelial neoplasm with a nuclear grade of 2. The tumor measured 1.0 cm in maximum dimension and involved 10% of the anterior and posterior endomyometrial surfaces. There was no evidence of invasion or angiolymphatic involvement. Adjacent tissue demonstrated complex endometrial hyperplasia with atypia. Additional findings included an endometrial polyp and leiomyoma. No lymph nodes were examined. Pathologic staging was determined as pT1a, with no assessment of nodal or metastatic involvement (pNX, pMX). Clinical staging according to FIGO criteria was stage IA."} +{"pid": "TCGA-A3-A8OX", "report": "The surgical specimen consisted of a left kidney and proximal ureter. The kidney measured 12 x 8 x 4.5 cm and weighed 226 grams. A single tumor was identified on the central posterior aspect of the kidney, measuring 3.3 x 2.5 x 2.5 cm. The tumor had a variegated yellow-tan to dark red appearance and was separated from the posterior surface by a thin layer of freely movable membranous tissue. It was located 2.0 cm from the renal hilum and did not grossly invade hilar adipose tissue or involve the upper or lower pole calices.\n\nHistologically, the tumor demonstrated features consistent with high nuclear grade morphology. The tumor was confined within the kidney both macroscopically and microscopically, with no lymphovascular invasion identified. Surgical margins were negative, with the closest distance to the hilar margin being 2.0 cm. No lymph nodes were identified in the specimen.\n\nStaging evaluation indicated that the primary tumor was classified as pT1. Regional lymph node involvement could not be assessed (pNX), and there was no evidence of distant metastasis. The tumor focality was single and limited to the kidney without extension into surrounding structures. Non-neoplastic kidney tissue showed mild compressive changes adjacent to the tumor.\n\nAll surgical margins were free of tumor involvement. Based on these findings, the pathologic stage was determined to be consistent with an early-stage lesion."} +{"pid": "TCGA-55-8620", "report": "The surgical specimen included three separate collections. The first was a lymph node from level VII, measuring 2.2 x 1.3 x 1.0 cm, described as yellow-tan and firm with rubbery consistency. Histologic examination revealed the presence of abnormal cells within this node. The second specimen consisted of a left upper lobe lung segment, measuring 20.0 x 9.0 x 4.5 cm. A small area of surface change was noted on the pleura, measuring 2.5 x 1.4 x 0.5 cm, and was marked. No distinct mass was immediately visible; however, further dissection identified a lesion within the parenchyma measuring 1.9 x 1.8 x 1.5 cm. This lesion had ill-defined margins, a gray-white appearance, and was located near bronchial and vascular structures, which were also sampled. The distance from the tumor to the closest parenchymal margin was 2.5 cm, and the distance to the pleural surface was 0.1 cm. Histologically, the lesion showed moderate to marked nuclear atypia, arranged in irregular glands, with a range of differentiation from moderate to poor. No evidence of invasion into the visceral pleura or lymphovascular spaces was identified. The third component included four lymph nodes from levels V and VI, ranging in size from 0.4 cm to 1.8 x 2.3 x 1.0 cm, all of which lacked any abnormal cellular infiltration. Based on these findings, the staging classification assigned was pT1a N1, indicating early primary involvement and regional nodal spread."} +{"pid": "TCGA-HT-7875", "report": "The specimen demonstrates a mildly to moderately hypercellular glial neoplasm composed of cells with round, mildly enlarged nuclei and prominent perinuclear halos. The lesion diffusely infiltrates both gray and white matter. No mitotic figures are identified across 25 high-power fields examined. Microvascular proliferation and necrosis are not present. Immunohistochemical staining reveals a few scattered reactive cells with a labeling index of 1.1%, indicating modest proliferative activity that correlates with low-grade histologic features."} +{"pid": "TCGA-5G-A9ZZ", "report": "Specimen #: Patient ID #: Client: SPECIMEN SUBMITTED. A: TISSUE SUBMITTED. B: SUPERIOR MEDIASTINAL LYMPH NODE. C: LEFT SIDED THYMUS. FINAL FINDINGS. 1. Tissue excised from the right thymus shows a neoplastic epithelial proliferation arranged in nests and sheets of polygonal cells with round nuclei, vesicular chromatin, and prominent nucleoli. These cells are separated by a prominent lymphoid stroma. Areas of marked nuclear atypia and numerous mitotic figures are present. The lesion is organized into lobules divided by fibrous trabeculae, although focal regions demonstrate dense hyalinizing fibrosis surrounding small irregular nests. There is also evidence of lymphovascular invasion and prominent lymphoplasmacytic infiltrates. Invasion through the surrounding capsule is observed. The lesion measures 5.5 x 3.5 x 2.2 cm and approaches surgical margins in certain areas; however, it is surrounded by a thin fibrous layer (less than 0.1 cm). Immunohistochemical staining demonstrates strong positivity for CD5, and Ki-67 staining indicates approximately 20% proliferative activity. Selected slides were reviewed externally and findings support the described features. Gross examination reveals a tan mass measuring 5.5 cm in greatest dimension within a right thymic specimen weighing 60.1 grams and measuring 9.5 x 4.5 x 3.5 cm. The mass contains cystic areas filled with yellow fluid and appears well circumscribed without necrosis or hemorrhage. Multiple sections were submitted including margins. 2. Superior mediastinal lymph node, measuring 0.5 x 0.5 x 0.3 cm, shows no evidence of neoplastic involvement. 3. Left-sided thymic tissue, measuring 5.5 x 3.7 x 1.1 cm and weighing 12.9 grams, demonstrates normal architecture without significant pathological changes. Intraoperative consultation confirmed absence of tumor involvement at margins based on gross and microscopic evaluation."} +{"pid": "TCGA-BG-A0M7", "report": "The specimen from the right salpingo-oophorectomy showed no evidence of tumor. The ovary demonstrated focal surface adhesions. A segment of the fallopian tube was ectatic and exhibited chronic inflammation. Similarly, the left salpingo-oophorectomy specimen was negative for tumor. The left ovary also showed focal surface adhesions, and a portion of the fallopian tube was ectatic with chronic inflammatory changes.\n\nExamination of the uterus and cervix revealed involvement of the entire endometrial cavity, extending into the lower uterine segment and cervix. The lesion invaded to a depth of 1.2 cm within a myometrium measuring 1.6 cm in thickness and reached into the outer half of the cervical stroma. No lymphovascular invasion was observed. Pelvic washings were negative.\n\nLymph node dissections were performed on both sides. On the right side, five pelvic lymph nodes and four common and periaortic lymph nodes were examined, none showing evidence of metastasis. On the left side, six pelvic lymph nodes were examined, one of which contained metastatic involvement; however, extracapsular extension was not identified. Two additional common and periaortic lymph nodes on the left were also free of metastatic disease.\n\nImmunohistochemical staining showed positivity for estrogen and progesterone receptors. The lesion measured 4.6 cm at its greatest dimension and involved greater than half the thickness of the myometrium. Both anterior and posterior endomyometrial layers showed 100% invasion. Structures involved included the endocervical glands and cervical stroma. No angiolymphatic invasion was identified. One lymph node was positive out of a total of 17 examined."} +{"pid": "TCGA-E5-A4TZ", "report": "The specimen consists of a 6 g tissue aggregate measuring 4.3 x 2.6 x 1.2 cm, described as tan-pink and soft in consistency. Histologic evaluation reveals invasive cellular growth involving the deeper layers of the tissue. High-grade cellular features are observed, with evidence of extension into muscular tissue and involvement of neural structures."} +{"pid": "TCGA-D1-A16N", "report": "A biopsy of the bladder peritoneum revealed a cluster of fibromembranous soft tissue containing multiple nodules ranging in size from 0.2 to 0.8 cm. Histologic evaluation showed abnormal cells consistent with adenocarcinoma. A separate specimen including the uterus, bilateral fallopian tubes, and ovaries was examined. A mass measuring 6.6 x 6.1 x 5.5 cm was identified in the posterior wall of the uterine cavity. Microscopic analysis showed this lesion invaded 1.1 cm into the myometrium, where the total wall thickness was 2.6 cm. The cervix appeared normal and there was no involvement noted in the endocervix or cervical tissue.\n\nAngiolymphatic invasion was observed within the uterine mass. The right ovary contained a small focus (0.3 cm) of similar abnormal cells, while the left ovary had a larger solid and hemorrhagic mass measuring 6.2 x 3.7 x 2.5 cm showing comparable cellular features. Both fallopian tubes were unremarkable on gross and histologic examination. An excised adnexal mass adjacent to the right fallopian tube measured 5.0 x 3.8 x 3.0 cm and also displayed adenocarcinomatous cells, although the attached portion of the fallopian tube itself did not show any abnormality.\n\nExtensive lymph node dissection was performed on both sides of the pelvis and para-aortic regions. On the left side, 5 external iliac, 2 internal iliac, 14 common iliac, and 13 obturator lymph nodes were all free of malignant cells. Similarly, on the right side, 7 external iliac, 3 internal iliac, 2 common iliac, and 3 obturator lymph nodes showed no evidence of tumor involvement. Para-aortic lymph nodes above and below the inferior mesenteric artery were also evaluated; 6 right and 1 left node above the artery, and 2 right and 1 left node below the artery were all negative for tumor cells. Examination of the gonadal vessels on both sides did not reveal any signs of tumor involvement. A sample of omental tissue was also obtained and found to contain only mature adipose tissue without any tumor cells present.\n\nThe findings are based on macroscopic and histologic evaluation of the specimens. Multiple sections were submitted for microscopic analysis from all relevant areas, including the uterine mass, ovarian lesions, fallopian tubes, and all lymph node regions."} +{"pid": "TCGA-3B-A9HJ", "report": "The specimen from the left groin mass measured 11.6 x 10.5 x 6.5 cm and was largely composed of homogenous yellow, lobulated adipose tissue with no areas of hemorrhage or necrosis. A well-circumscribed, firm tan-yellow to brown lobulated mass measuring 7.7 x 6.7 x 5.8 cm was identified at the periphery. Adjacent soft nodules up to 4.0 cm were also present, some suggestive of possible lymph nodes.\n\nMicroscopic evaluation revealed a soft tissue neoplasm with mixed features. The primary component was a non-lipogenic spindle cell sarcoma surrounded by areas showing well-differentiated morphology. The spindle cell component was predominantly low grade, with scattered moderately to occasionally markedly atypical spindled and epithelioid nuclei in a background of myxoid stromal change. Inflammatory cells, primarily plasma cells with some eosinophils and lymphocytes, were intermixed within the tumor. No tumor necrosis was observed, and mitotic activity was minimal, with less than 1% proliferative index on Ki-67 staining. Immunohistochemical analysis showed the tumor cells to be diffusely positive for vimentin and CD68, and negative for actin, desmin, and CD43.\n\nIn addition, multiple foci of lymphoid aggregates, some with germinal centers, were found in association with the sarcomatous component. One population of small lymphoid cells with clumped chromatin and scant cytoplasm was noted. These cells were positive for B-cell markers (CD20, CD79a) and showed weak coexpression of CD5 and CD23. BCL-1 was negative, and T-cells were positive for CD3. In situ hybridization studies for kappa and lambda demonstrated polyclonal plasma cells. These findings correlated with concurrent hematopathologic studies and were consistent with a lymphoproliferative process involving the soft tissue lesion. \n\nA separate benign lymph node was also identified within the specimen. Skeletal muscle was present at the periphery, and all submitted margins were assessed. The attending pathologist personally reviewed all materials and confirmed the findings."} +{"pid": "TCGA-XF-A9T4", "report": "A radical cystoprostatectomy with pelvic lymph node dissection and orthotopic urinary diversion to the urethra was performed. Gross examination revealed a polypoid mass located at the right ureterovesical junction measuring 3.3 x 2.5 x 2 cm. Microscopic evaluation demonstrated a deeply invasive, poorly differentiated urothelial carcinoma involving the bladder wall. The tumor extended through most of the muscularis propria but did not reach the perivesical soft tissue. No lymphovascular invasion was observed. All resection margins, including those of the ureters and apical urethral margin, were free of malignancy.\n\nFocal high-grade prostatic intraepithelial neoplasia (PIN II-III) was identified in the prostate; no adenocarcinoma was present. Seminal vesicles and bilateral ureters showed no significant histopathologic changes.\n\nLymph nodes were evaluated from multiple sites including the right and left common iliac, external iliac, obturator/hypogastric, para-caval, pre-sacral, Cloquet, and presciatic regions. In total, 61 lymph nodes were examined. Metastatic carcinoma was identified in one of seven lymph nodes from the right obturator/hypogastric region. Other lymph node groups showed no evidence of malignancy.\n\nPathologic staging was determined as pT2bN1MX. Sections of the invasive carcinoma were submitted for p53 immunohistochemical analysis with results pending in an addendum."} +{"pid": "TCGA-SB-A76C", "report": "A radical orchiectomy specimen from the left testicle was examined. The specimen includes the left testis measuring 6 x 4 x 3.5 cm, epididymis measuring 3.5 x 1.0 x 1.0 cm, and spermatic cord measuring 6.5 x 1.5 x 1.0 cm. Within the testis, there is a well-circumscribed tan-white lobulated tumor measuring 4 x 3.5 x 3.0 cm. The cut surface of the tumor has a glistening gray-white appearance with minimal hemorrhage. Gross examination reveals that the tumor is confined to the testis without involvement of the tunica albuginea, epididymis, or spermatic cord. The surrounding testicular parenchyma at the tumor edge appears compressed but otherwise unremarkable.\n\nMicroscopic evaluation confirms that the tumor is confined to the testis. There is no invasion into the epididymis, and no lymph-vascular invasion is identified. The tumor abuts the rete testis; however, no definitive invasion is observed. Histologic evaluation of the spermatic cord margin shows no tumor involvement. Serial sections of the epididymis and spermatic cord do not reveal any focal lesions.\n\nThe tumor measures 4.0 cm in greatest dimension and is unifocal in distribution. Histologic features include cells arranged in a pattern consistent with a uniform population of cells with clear cytoplasm and well-defined cell borders. Additional findings include intratubular germ cell neoplasia and testicular microlithiasis.\n\nNo regional lymph nodes were sampled. Based on available findings, the staging classification reflects tumor confinement to the testis without evidence of nodal or distant disease."} +{"pid": "TCGA-55-7724", "report": "The pathology report includes multiple specimens from various anatomical locations. Specimen #1, labeled 4R, consists of fragments of yellow to black material measuring 0.8 x 0.5 x 0.3 cm in aggregate. Specimen #2, labeled level 7, includes two fragments of gray-tan tissue measuring up to 0.3 x 0.2 x 0.1 cm. Specimen #3, labeled 4L, contains fragments of black and focally yellow material measuring 0.8 x 0.5 x 0.3 cm. Specimen #4, labeled 2R, includes fragments of yellow to black material measuring 0.4 x 0.4 x 0.3 cm. All four specimens were completely submitted as single frozen sections.\n\nSpecimen #5, a left upper lobe wedge, measures 14.0 x 6.0 x up to 3.5 cm and includes a 15.0 cm staple line along one edge. The pleural surface is focally firm and discolored gray-tan over an area of 5.5 x 2.0 cm, with focal retraction approximately 2.0 cm from the staple line. A 1.2 x 1.0 x 0.8 cm ill-defined, gray-tan mass corresponds to this area and is located 1.1 cm from the stapled resection margin. The surrounding parenchyma is pink-tan to red-tan, soft, and spongy. Multiple adjacent cystic spaces are present beneath the firm discolored area on the pleural surface, measuring up to 0.5 cm. No additional lesions are identified. Tissue was submitted to the Cancer Genome Atlas Project following patient consent. Blocks include: \"A\" (parenchymal margin closest to the mass, tangential), \"B\" and \"D\" (mass with respect to pleura, perpendicular; inked black), \"E\" (section of firm discolored area on pleura and cystic spaces), and \"F\" (uninvolved parenchyma).\n\nSpecimens #6 and #7 consist of portions of gray-tan, soft tissue measuring 1.8 x 1.0 x 0.3 cm (level 5) and 1.2 x 0.5 x 0.4 cm (level 6), respectively. Both were entirely submitted in one cassette each.\n\nFrozen section analysis of all lymph node specimens (4R, level 7, 4L, and 2R) shows no evidence of malignancy. Microscopic evaluation of the left upper lobe wedge demonstrates findings consistent with invasion past the elastic tissue layer into the visceral pleura. All lymph node specimens are negative for malignancy. The resection margin is free of involvement. There is no evidence of lymphovascular space invasion. Based on these findings, the tumor is classified according to the TNM system as pT2a PL1 pN0."} +{"pid": "TCGA-EW-A424", "report": "The surgical specimen consisted of a right breast total mastectomy with nipple and skin, weighing 1050 grams and measuring 25.0 x 15.5 x 5.6 cm. A centrally located lesion was identified, measuring 5.5 cm in greatest dimension (3.5 x 3.0 cm in additional dimensions). The lesion was firm, tan-white, and poorly defined, located 3.5 cm from the deep margin with all other margins exceeding 5.0 cm. The surrounding breast stroma was fibrotic with cystic areas containing clear fluid, up to 0.6 cm in diameter. Eleven cassettes were submitted for histologic evaluation, including margins, quadrants, composite sections of the lesion, and the nipple.\n\nHistologically, the lesion demonstrated moderate differentiation with a Nottingham score of 7 (3+2+2). No invasion into the dermis or epidermis was observed, and no involvement of the nipple epidermis was noted. All margins were free of involvement. No lymphovascular invasion was identified. Lobular carcinoma in situ was present. No ductal carcinoma in situ was identified.\n\nOne sentinel lymph node was examined from the right axilla, measuring 1.6 x 1.0 x 0.5 cm. It was fully sectioned and evaluated using H&E staining with multiple levels. No metastatic involvement was found.\n\nImmunohistochemical staining was performed on a separate specimen, showing estrogen receptor positivity (>50%) and progesterone receptor positivity (>50%). HER2 immunostaining was equivocal (score 2+), and chromogenic in situ hybridization showed no HER2 gene amplification.\n\nPathologic staging based on AJCC 7th edition criteria was determined as pT3 for the primary tumor and pN0 for regional lymph nodes. No distant metastasis was applicable. No prior neoadjuvant therapy was administered. All immunohistochemical analyses were conducted using validated laboratory protocols on formalin-fixed, paraffin-embedded tissue, with results interpreted by a pathologist."} +{"pid": "TCGA-IG-A3QL", "report": "The specimen was obtained from the distal esophagus and measured 2 x 1.5 x 0.3 cm. Microscopic examination revealed moderately differentiated keratinizing cells arranged in a specific growth pattern. The lesion involved the muscularis propria layer. No lymph node metastases were identified among the seven regional nodes examined. There was no evidence of lymphatic or venous invasion. Surgical margins were free of abnormal cells. No findings related to prior treatment or additional significant pathology were noted."} +{"pid": "TCGA-B9-A5W9", "report": "The specimen consists of a right partial nephrectomy measuring 6.5 \u00d7 5.2 \u00d7 4.3 cm and weighing 89.8 grams. The renal parenchymal margin is tan/brown and inked black. A central stitch mark indicating closure of the collecting system is present and inked red. The capsule is intact, tan/yellow, and inked blue. A centrally located mass measuring 5.7 \u00d7 5.3 \u00d7 3.6 cm is identified within the kidney. It is tan/brown, firm, well-circumscribed, and contains areas of hemorrhage adjacent to the capsule. The mass abuts the red inked stitch site and is 0.4 cm from the black inked parenchymal margin. It bulges beneath the capsule but does not extend through it. The surrounding renal parenchyma appears tan/brown with a distinct corticomedullary junction.\n\nHistologic evaluation reveals a Grade 3 lesion with no sarcomatoid features. No microscopic or macroscopic invasion is observed into the capsule, perirenal adipose tissue, Gerota\u2019s fascia, renal sinus, or major veins including the renal vein or inferior vena cava. No lymphatic invasion is identified. Surgical margins are negative at the renal parenchymal, renal capsular, and paranephric adipose tissue margins.\n\nThe tumor is unifocal and measures 5.7 cm in greatest dimension. Based on available information, staging is determined as pT1b. No lymph nodes are submitted for evaluation. Additional findings in the non-neoplastic kidney include glomerulosclerosis and chronic interstitial inflammation.\n\nSections submitted include those perpendicular to the closed collecting system (blocks A1\u2013A2), perpendicular to the parenchymal margin (blocks A3\u2013A4), perpendicular to the capsule (blocks A5\u2013A6), and sections of uninvolved renal parenchyma (block A7). Tissue remains available in formalin. A consultant reviewed portions of the case and agrees with the histologic grade and staging assessment."} +{"pid": "TCGA-FG-A4MW", "report": "The specimen consists of two parts submitted for analysis. Part A is described as a right frontal brain mass, composed of three tan-pink soft tissue segments with an aggregate size of 1.2 x 1 x 0.5 cm. One section was used for intraoperative diagnosis, and the remainder was submitted in block A2. Part B is also labeled as a right frontal brain mass, consisting of tan-pink, soft-gelatinous fragments measuring 2.7 x 2.5 x 0.5 cm, entirely submitted in cassettes B1\u2013B2.\n\nHistologically, the neoplasm contains regions with distinct cellular features. Some areas are dominated by cells resembling one phenotype, while other areas show a mixture of cell types with overlapping characteristics. In certain foci, more atypical histological features are observed. Mitotic figures are present in both low-grade and more atypical regions. Immunohistochemical staining shows a Ki-67 labeling index of 20%. No vascular proliferation or necrosis is identified. Between 10% and 25% of nuclei demonstrate labeling with p53 antibodies. No reactivity is seen with IDH1 (R132H) antibodies.\n\nFluorescence in situ hybridization (FISH) studies were performed on block A2 for several markers, including 1p, 19q, and EGFR. Additional FISH testing for IDH1 (R132H) was conducted on block B1. For the 1p/19q analysis, results indicate that chromosome 1p is intact (eusomic), with a signal ratio consistent with no allelic loss. Chromosome 19q also appears intact, although it shows aneusomy based on mean signal counts. The quantitative FISH values are as follows: 1p36 = 2.6, 1q25 = 2.5, giving a 1p36/1q25 ratio of 1.0; 19q13 = 3.5, 19p13 = 3.8, resulting in a 19q13/19p13 ratio of 0.9.\n\nEGFR FISH analysis reveals gene amplification, with greater than 20 signals detected in most tumor cells. The CEP7 signal count averages 2.8, and the EGFR/CEP7 ratio exceeds 7.1. Chromosome 7 aneusomy is not observed.\n\nAll FISH analyses were conducted using locus-specific probes on formalin-fixed, paraffin-embedded sections. At least 40 nuclei were evaluated for each test, focusing on atypical cells with two or more reference probe signals. Loss was defined as a ratio \u22640.7, and aneusomy was defined as a mean reference signal count \u22653.0.\n\nImmunohistochemistry and FISH testing were performed as part of a laboratory-developed test, which has not been cleared or approved by the FDA but meets clinical standards for use. During intraoperative evaluation, the tissue was classified as a low-grade glial neoplasm."} +{"pid": "TCGA-FG-6688", "report": "Medical Record #. Race: Date Received: Final Diagnosis redacted. LEFT PARIETAL-OCCIPITAL LESION, BIOPSY AND REMOVAL: \u2013 findings indicative of infiltrative glial origin, reference made to additional notes. Notes indicate histological characteristics align with prior biopsy showing high-grade astrocytic lesion. Intraoperative consultation confirmed presence of infiltrating glial neoplasm. Clinical background describes a left-sided parietal-occipital lesion of glial nature. Specimens submitted as follows: A: PARIETAL-OCCIPITAL TISSUE. B: LEFT-SIDED GLIAL TISSUE.\n\nGross examination: Specimen A, received fresh and labeled appropriately, consists of multiple tan-white tissue fragments, soft in consistency, measuring approximately 0.5 x 0.3 x 0.1 cm collectively. Entire specimen processed into two cassettes. Specimen B, also freshly received and properly labeled, includes irregular, opaque white-to-tan soft cerebral-like tissue fragments measuring up to 3.5 x 2.3 x 1.0 cm in total. Part of this specimen was sampled separately; remaining tissue processed entirely into two cassettes. Summary of cassette labeling: A1 \u2013 intraoperative sample; A2 \u2013 residual specimen."} +{"pid": "TCGA-06-0192", "report": "The patient has a past history of multiple resections for a previously diagnosed skin tumor. Recent brain imaging revealed a contrast-enhancing lesion located in the left occipital lobe. Two specimens were collected from the left parietal region of the brain during surgery. The tissue samples were submitted for pathological evaluation.\n\nMicroscopic examination revealed a high-grade neoplasm with features including increased mitotic activity, vascular proliferation, and extensive areas of necrosis. The tissue fragments ranged in size from 0.3 to 0.4 cm and were entirely processed for analysis. The combined specimen measured approximately 4.5 x 3 x 0.5 cm and consisted of multiple gray-white, hemorrhagic, soft tissue fragments.\n\nMolecular testing was performed on the specimen to assess promoter methylation status of a specific gene involved in DNA repair mechanisms. The results of this test showed no evidence of methylation in the targeted region. The assay used bisulfite modification of DNA followed by polymerase chain reaction amplification to detect both modified and unmodified sequences. The results were analyzed via gel electrophoresis.\n\nIt should be noted that this molecular assay was developed and validated by the laboratory according to regulatory standards. It has not received clearance or approval from the U.S. Food and Drug Administration for specific clinical applications, though such authorization is not required. The findings are provided for informational use and should be interpreted alongside established diagnostic methods.\n\nHistologic sections were prepared from multiple blocks of the specimen, and standard staining techniques were applied for microscopic evaluation."} +{"pid": "TCGA-DW-7963", "report": "A right renal mass was resected from a male patient. The specimen measured 6.5 x 4.8 x 4.5 cm and included a nodule with a yellow hemorrhagic cut surface, measuring 4.6 x 4.1 x 1.3 cm. The nodule had both hard and soft areas and was located 0.1 cm from the closest surgical margin. The tumor was surrounded by a pseudocapsule and showed no direct involvement of the inked resection margin. Histologically, the lesion demonstrated papillary architecture with nuclear features corresponding to Fuhrman Grade 2. Necrosis was present throughout the specimen. No sarcomatoid differentiation was identified. Microscopic evaluation confirmed that the tumor was confined entirely within the kidney and did not extend beyond it. Surgical margins were free of invasive disease.\n\nLymph node assessment included a right hilar lymph node and a right paracaval lymph node, both of which showed no evidence of malignant involvement. Additionally, a deep margin specimen and a separate fragment from the renal mass were examined, revealing only normal renal parenchyma without tumor.\n\nRadiologic and intraoperative findings described a solitary right renal mass with possible extension into the collecting system and a suspicious lymph node at the hilum. However, pathologic evaluation found no evidence of regional lymph node metastasis. The non-neoplastic kidney tissue was limited due to the partial nephrectomy approach.\n\nStaging was based on tumor size and extent, with the largest dimension measuring over 4 cm but less than 7 cm, and no evidence of extrarenal spread or nodal involvement."} +{"pid": "TCGA-67-3771", "report": "The surgical specimens were submitted for frozen section analysis and further pathological evaluation. Specimens labeled \"level 5,\" \"level 6,\" and \"level 9L\" each contained nodules measuring 1.9 cm, 0.6 cm and 1.8 cm (combined), and 1.1 cm respectively. All were bisected and submitted in entirety for frozen section examination. Touch preparations were obtained from each. Frozen section diagnoses indicated no evidence of tumor involvement in any of these specimens.\n\nA separate specimen from the left upper lobe was collected for a broader study and weighed 162 grams, measuring 23 x 9 x 2 cm. The pleural surface exhibited deep red-purple discoloration with carbon pigment deposition and a firm, puckered area measuring 2 x 2 cm along the lateral apex. Adjacent to this was a similarly sized roughened and hemorrhagic region. At the hilum, a 4.5 cm staple line was noted; removal revealed bronchial segments approximately 1 cm in diameter and four vessel margins ranging between 0.3 cm and 0.5 cm in diameter. Several friable gray-black nodules clustered around the hilum. Upon sectioning, a solid lesion measuring 2.5 x 2.5 x 1.8 cm was identified, appearing to interface with the previously described pleural thickening and located 4 cm from the bronchial margin. The surrounding pleura showed diffuse thickening up to 0.3 cm in thickness. Pulmonary parenchyma distal to the lesion appeared deep red and honeycombed, while remaining lung tissue was deep red and airless. Multiple tissue sections were taken from areas including the bronchial margin, vessel margin, hilar nodules, tumor on the pleural surface, thickened pleura, pulmonary parenchyma near the lesion, and unaffected lung tissue.\n\nAdditional lymph node specimens were collected from various locations, including anterior hilar, posterior hilar, lobar, interlobar (sump), and lingular regions. These ranged in size from 0.5 cm to 1.5 cm and were submitted in entirety following wrapping in tissue paper where applicable. Histopathological analysis of these lymph nodes revealed no evidence of tumor involvement.\n\nMicroscopic examination of the resected lung specimen demonstrated a moderately to poorly differentiated adenocarcinoma component confined entirely within the lung without extension into adjacent structures. No visceral pleural invasion or signs of atelectasis and pneumonia were observed. Surgical margins\u2014including bronchial, parenchymal, and vascular\u2014were free of involvement. The lesion was located 4 cm from the bronchial margin. Vascular invasion, both venous and arterial, was absent.\n\nStaging assessment indicated no lymph node involvement: N1 nodes were 0 out of more than 5 examined, N2 nodes were 0 out of more than 8 examined, and N3 nodes were not assessed. Based on these findings, the pathological stage was determined as pT1 N0.\n\nAdditional diagnostic testing included cytological analysis of fluid collected during the procedure, which was clear and colorless. Six smears were prepared using Diff-Quik staining methods, and two cell blocks were processed for further evaluation. Cytological review confirmed the presence of malignant cells consistent with non-small cell carcinoma morphology. Immunohistochemical staining demonstrated positivity for cytokeratin 7 while CK20, CK5/6, and p63 markers were negative. Initial TTF-1 staining was also negative; repeat testing was pending and results were to be issued separately.\n\nRepresentative tissue samples were collected for ancillary studies, including molecular profiling under a broader research initiative."} +{"pid": "TCGA-A8-A07O", "report": "The specimen demonstrates a poorly differentiated invasive solid growth pattern. The maximum reconstructed dimension measures 3.0 cm. Margins are described as follows: caudal distance 0.5 cm, lateral 1 cm, cranial 1.2 cm, with medial and dorsal distances each at 1.5 cm. The ventral margin is tumor-free and ink-stained, based on follow-up resection material (preparation 4). Histological features include high-grade nuclear morphology (G III). Lymph node evaluation shows no evidence of metastasis (0/13 nodes involved). Additional findings include lymphovascular invasion and absence of perineural invasion."} +{"pid": "TCGA-HT-7608", "report": "The microscopic examination reveals a mildly to moderately hypercellular glial neoplasm that diffusely infiltrates the gray and white matter. The tumor cells exhibit monotonous round to oval nuclei with minimal atypia. The cytoplasm is prominent and frequently fibrillary, showing some microgemistocytic features along with a few ordinary gemistocytic forms. Two mitotic figures are identified within 25 high-power fields. There is no evidence of microvascular proliferation or necrosis.\n\nAn addendum notes that sections show cortical gray and white matter involvement. The white matter demonstrates mild hypercellularity due to an infiltrate of tumor cells with round, slightly enlarged nuclei and occasional small nucleoli. Many cells display distinct perinuclear halos. No mitotic figures are observed in this region. Compared to prior specimens which exhibited features consistent with an astrocytoma, the current tissue shows characteristics typical of an oligodendroglioma. Overall, the morphological findings suggest a combined phenotype.\n\nImmunohistochemical staining with MIB-1 demonstrates scattered reactive cells with a labeling index of 1.7%, indicating minimal proliferative activity. This finding aligns with results from previous biopsies."} +{"pid": "TCGA-DU-6403", "report": "The specimen consists of multiple fragments of friable brain tissue, measuring up to 4.5 x 4 x 1 cm in aggregate, received in saline. Serial sections were taken from the specimen, with representative sections submitted for microscopic evaluation.\n\nMicroscopically, the tissue demonstrates a hypercellular glial neoplasm composed of two distinct cellular components resembling astrocytic and oligodendroglial morphology. Mitotic activity is present, with increased frequency noted in the astrocytic component. Vascular proliferation is also observed. Scattered calcifications are present within the tumor. No areas of necrosis are identified in the sections examined. Immunohistochemical staining for MIB-1 shows a labeling index of approximately 15%."} +{"pid": "TCGA-G9-6370", "report": "The specimen consists of a resected prostate gland weighing 60 grams before removal of the apex and base, and 38 grams afterward. The prostate measures 5.1 cm from right lateral to left lateral, 4.3 cm from anterior to posterior, and 3.2 cm from apex to base. The external capsule is smooth, red, and intact. The parenchyma is nodular and tan in color. Both seminal vesicles are cystic and tan; the right measures 4.2 x 2 x 0.7 cm and the left measures 4.4 x 2.5 x 0.7 cm. The right vas deferens measures 3.6 x 0.6 cm and the left is detached, measuring 3.1 x 0.5 cm. All tissue was submitted for examination in multiple sections.\n\nMicroscopic evaluation reveals involvement of both lobes, apex, base, anterior, and posterior regions. Tumor extends into the right seminal vesicle as identified in specific sections. There are two small foci of microscopic extension into periprostatic adipose tissue. Perineural invasion is present. High-grade intraepithelial proliferative changes are also noted. Resection margins show no tumor involvement. No definitive vascular or lymphatic space invasion is identified. One lymph node is negative for tumor.\n\nPathologic staging is based on the AJCC Cancer Staging Manual, 7th Edition: pT3b, pN0, pMX. Additional findings include chronic inflammation. No pre-hormonal therapy changes are observed."} +{"pid": "TCGA-D5-6540", "report": "Histopathological examination of a total organ resection specimen including the colon and caecum was performed. The specimen measured 15 cm in length and included a segment of small intestine measuring 10 cm, an appendix measuring 7 cm, and a fragment of mesentery measuring 20 x 5 x 2 cm. A mucosal defect measuring 2.5 cm in diameter was observed in the middle portion of the caecum, located approximately 2 cm from the Baughin valve. The mucosa and outer surface in this region were noted to be greenish in coloration. Additional findings included the presence of small polyps up to 0.6 cm in diameter outside the main lesion.\n\nMicroscopic evaluation revealed a tubulopapillary and partially mucinous architecture with marked nuclear atypia. There was evidence of infiltration into the tunica muscularis propria. The minimum lateral margin measured 0.6 cm, and all excision margins were free of neoplastic involvement. Adjacent tissue showed a tubulopapillary adenoma with low-grade dysplasia and a hyperplastic polyp associated with diverticulitis. Histologic changes consistent with histiocytic sinus activation were identified in lymph nodes (No XIII).\n\nStaging parameters indicated pT2, pN0 classification according to the TNM system, corresponding to Dukes B and Astler-Coller B1 stage."} +{"pid": "TCGA-T2-A6X2", "report": "A male patient underwent analysis of multiple tissue specimens. The mandibulectomy specimen measured 6.7 cm in length with an average cross-sectional area of 2.5 x 1.3 cm. A lesion measuring 4.2 cm in greatest dimension was identified within the mandible. Histologic evaluation revealed well-differentiated keratinizing cells arranged in a conventional pattern. Invasion into the mandibular bone was observed, and perineural invasion was present. Microscopic involvement was noted at the posterior bony margin, while all other sampled margins were free of involvement. Immunohistochemical staining showed strong and diffuse positivity for EGFR.\n\nA total of 53 lymph nodes were evaluated across various zones of both sides of the neck. Six lymph nodes were assessed in superficial zone 2 on the left; six in zone 1 on the right; seven in zones 2 and 3 on the right; eleven in zone 1 on the left; and twenty-three in zones 2 and 3 on the left. All lymph nodes were negative for involvement.\n\nAdditional specimens including the true posterior margin, left alveolar nerve, and deep posterior margin were also negative upon histologic examination. Gross evaluation of the mandibulectomy specimen demonstrated viable-appearing bony margins without necrosis or gross tumor involvement. Soft tissue margins appeared negative on macroscopic inspection.\n\nThe tumor was solitary and measured 4.2 x 2.6 x 1.5 cm. Based on size exceeding 4 cm, staging classified it as pT3. No regional lymph node metastasis was identified (pN0), based on the absence of involvement in all lymph nodes examined. No distant metastasis was assessed.\n\nMultiple sections from the primary specimen were submitted for histologic evaluation, including full-thickness sections of the lesion and margins. Additional tissues such as fibroadipose and skeletal muscle with chronic inflammation were identified in excised margins but showed no signs of involvement.\n\nTeeth numbers 5, 6, 23, 10, and 26 were extracted and submitted for evaluation; however, no tissue was processed for histology.\n\nIntraoperative frozen section consultations confirmed absence of involvement in lymph nodes and surgical margins. All tests performed were validated by controls and conducted under appropriate accreditation."} +{"pid": "TCGA-BC-A10Z", "report": "The liver specimen measured 19.5 x 17 x 12.5 cm and weighed 1280 grams. A green-inked surgical margin was identified, showing a rough, irregular surface. A defect measuring 6.7 x 3.0 x 3.0 cm was noted in the liver capsule where a portion of the lesion had been removed. Serial sectioning revealed a well-circumscribed mass measuring approximately 12 x 11 x 10 cm, with a white, soft, friable consistency. Scattered within the mass were areas containing black char-like pigment and regions suggestive of necrosis. Two foci of possible extension beyond the capsule were observed, measuring 1.0 cm and 0.5 cm in greatest dimension, respectively. The mass was noted to be less than 0.1 cm from the green-inked surgical margin in one area, with possible involvement.\n\nMicroscopic evaluation showed moderately differentiated cells arranged in a trabecular and solid pattern. Areas of necrosis were present, and changes consistent with recanalized thrombosis were identified. At the site of capsular disruption, there was evidence of extension through the capsule. Lymph nodes associated with the gallbladder specimen (two in total) did not show any atypical cellular infiltration. The gallbladder measured 9.2 x 3.1 x 1.4 cm and contained multiple external nodules ranging from 0.5 x 0.5 cm to 1.3 x 0.8 cm. Microscopically, the mucosa exhibited cholesterolosis without evidence of calculi. No significant findings were observed in the surrounding liver tissue aside from mild intrahepatic cholestasis. Multiple sections of the mass, including those near the surgical margin and areas of extracapsular extension, were submitted for further analysis."} +{"pid": "TCGA-AA-A02R", "report": "The present material shows an invasive, poorly differentiated neoplasm with deep infiltration into all layers of the wall, consistent with at least pT3 staging. The tumor exhibits lymphovascular invasion (L1, V1) but does not involve regional lymph nodes or show distant metastasis. Resection margins are free of tumor involvement. Histological evaluation confirms an epithelial origin based on total keratin expression. Immunohistochemical analysis reveals strong S100 protein positivity and focal chromogranin positivity, with additional areas showing synaptophysin reactivity. These features indicate a neuroendocrine differentiation in the affected region."} +{"pid": "TCGA-B6-A0IN", "report": "The surgical pathology report includes two specimens from the right breast. The first specimen, a re-excision of the lateral breast, measured 10 x 5.5 x 3 cm and included a skin ellipse with a central scar. A 2 x 2.2 x 0.7 cm fibrotic area was identified, likely representing a biopsy cavity. No mass was identified grossly. Tissue was submitted in blocks for microscopic evaluation.\n\nThe second specimen, a broader excision of breast tissue, weighed 72.4 grams and measured 8.5 x 6.2 x 2.5 cm, including a triangular skin resection. A 2.2 x 2.1 x 1.1 cm white-tan nodule was observed, located near the posterior margin. Additional fatty tissue with a suture was also present, designated as a new posterior margin. This portion was submitted in block B11. Tissue for hormone receptor analysis was also sent fresh.\n\nMicroscopic evaluation of the re-excision specimen revealed changes consistent with a prior biopsy site, including stromal fibrosis and microcalcifications. The surgical margins showed involvement with an intraductal process. In the second specimen, invasive tumor was identified with features of high-grade histology. The invasive component measured approximately 1.6 cm, and there was also an intraductal component present, comprising about 20% of the tumor volume. Lymphatic or vascular invasion was not seen, and the tumor was unifocal. A small focus of mucinous differentiation was noted within the tumor, although this was a minor component.\n\nImmunohistochemical staining of the invasive tumor showed no staining for progesterone receptor and positive staining for estrogen receptor. HER2/neu immunostaining demonstrated weak to moderate membrane staining (score 2+). Fluorescence in situ hybridization (FISH) analysis for HER2/neu gene amplification showed a ratio of 2.00, which was not considered significantly amplified.\n\nMargins were closely examined, and the posterior margin in the second specimen was found to be involved. However, the newly defined posterior margin (block B11) was free of tumor."} +{"pid": "TCGA-S3-AA10", "report": "The specimen consisted of a right mastectomy with axillary contents weighing 420 g and measuring 18 x 10 x 3.0 cm. The axillary content measured 6.0 x 5.5 x 3.0 cm. A well-circumscribed, lobulated, focally hemorrhagic pink-tan mass was identified, measuring 2.5 x 2.5 x 1.5 cm. It was located in the outer quadrant near the axillary contents and was 0.7 cm from the anterior margin and approximately 12 cm from the nipple. Margins were uninvolved by invasive disease, with a distance of 4.0 mm from the anterior margin and 2.0 mm from the posterior margin.\n\nHistologically, the lesion showed high-grade features, including marked nuclear pleomorphism with vesicular nuclei, prominent nucleoli, and significant variation in nuclear size and shape. Mitotic activity was high, with 88 mitoses counted per 10 high-power fields (field diameter: 0.55 mm). Glandular or tubular differentiation was minimal, with less than 10% of the tumor area forming such structures. Based on these features, the overall histologic grade was Grade 3 (score of 8 or 9).\n\nNo dermal or lymphovascular invasion was identified. The skin, including the dermis and epidermis, and the nipple were free of involvement. No ductal or lobular intraepithelial neoplasia was identified. Skeletal muscle was present and uninvolved.\n\nFour lymph nodes were examined, ranging in size from 0.5 to 2.0 cm. All were negative for metastasis, with no macrometastases or micrometastases identified. Evaluation included hematoxylin and eosin staining at one level, as well as immunohistochemistry.\n\nStaining for estrogen and progesterone receptors showed no immunoreactive tumor cells. HER2/neu immunohistochemical studies demonstrated score 0 reactivity, indicating no significant membrane staining. Controls were appropriate, and reflex testing for equivocal results was not required.\n\nAdditional findings included benign breast tissue with microcalcifications in non-neoplastic areas. No other lesions were identified upon gross or microscopic examination. The ischemic time was 1 hour and 20 minutes, and the specimen was fixed in formalin for more than 6 hours but less than 48 hours.\n\nStaging classification was pT2 based on the largest dimension of the invasive component (>20 mm but \u226450 mm), and pN0 due to the absence of regional lymph node metastasis. Distant metastasis could not be assessed. No prior presurgical therapy was administered."} +{"pid": "TCGA-YU-AA61", "report": "The specimen from the left testis demonstrates a neoplasm composed of multiple components. The majority of the tumor is immature teratoma, accounting for approximately 50% of the sample. Additional components include endodermal sinus tumor and embryonal carcinoma, each comprising about 25%. There is no evidence of angiolymphatic or perineural invasion. The rete testis is involved by the neoplastic process; however, the spermatic cord and surgical margins are free of tumor involvement. Immunohistochemical studies were performed to further characterize the neoplasm."} +{"pid": "TCGA-B4-5378", "report": "The specimen was obtained from a male patient of unspecified ethnicity. The tissue source was the right kidney, collected as a primary tumor sample. The tumor grade was 2, with a histological treatment type not specified. No prior chemotherapy or hormone therapy was reported. The TNM staging showed T2, N0, M0. The tumor cellularity was 77%. A blood sample was also collected and stored frozen. No additional treatment details were provided."} +{"pid": "TCGA-A1-A0SB", "report": "A sentinel lymph node biopsy was performed, and no carcinoma was identified in two lymph nodes examined. A wire-guided partial mastectomy of the left breast revealed a dominant mass measuring 1.0 x 1.0 x 0.8 cm located centrally within slices 3\u20134. The mass was well-circumscribed with a rubbery/hard consistency and tan-pink coloration. It was situated 1.1 cm from the blue ink (superior margin), 1.0 cm from the green ink (medial margin), and 1.5 cm from the black ink (lateral margin). Additional nodules were noted throughout the specimen, including tan-white, tan-yellow, and white-tan rubbery nodules ranging in size from 0.2 to 0.7 cm. One nodule suspicious for a lymph node was identified in slices 15\u201316. Margins were all negative, with the tumor located more than 1 cm away from the posterior, superior, inferior lateral, and inferior medial margins.\n\nHistologically, the mass demonstrated a cribriform growth pattern with large epithelial cell nests in a sclerotic stroma. Immunohistochemical staining showed ER positivity (2+ in 75% of cells), PR negativity, CD117 positivity, and focal SMA positivity. p63 was positive in basaloid cells, and SMM highlighted a lack of myoepithelial cells around most tumor cell nests. These findings supported a specific tumor type with dual cell population features. No lymphatic or vascular invasion was identified. Microcalcifications were present in benign ducts, and other findings included atypical ductal hyperplasia, apocrine metaplasia, fibroadenoma, and biopsy site changes.\n\nIn the right breast tissue, a small tan-yellow nodule measuring 0.1 x 0.1 x 0.1 cm was identified, along with a white-tan nodular area measuring 0.3 x 0.2 x 0.2 cm. Histological evaluation revealed intraductal papilloma, sclerosing adenosis, apocrine metaplasia, microcalcifications in benign glands, and microcysts. No significant abnormalities were found in the skin or other areas. In the left breast mammoplasty specimen, usual ductal hyperplasia, apocrine metaplasia, and fibroadenoma were noted, with no evidence of malignancy. Skin and other components were unremarkable.\n\nSentinel lymph node biopsies showed rare scattered atypical cells on frozen section; however, permanent sections did not reveal any carcinoma. Lymph nodes were otherwise unremarkable, with histology showing benign quiescent nodes based on immunostaining for CD20, CD3, CD21, and CD23. No HER2/neu overexpression was detected via immunohistochemical testing, with a staining intensity score of 0. Correlation with gene expression profiling was recommended.\n\nGross examination of the left breast needle localization biopsy showed multiple nodules throughout the parenchyma, with the dominant lesion located centrally. The surgical specimen was oriented with double long suture at lateral (Telfa side), short double suture at superior, and short single suture at inferior (opposite wire). The total specimen dimensions were 6 x 6 x 11.2 cm, and 19 slices were obtained. The right breast tissue and skin specimen measured 13 x 10 x 3.5 cm in aggregate, with a total weight of 170 g. The left breast tissue and skin specimen measured 6.5 x 6.5 x 2.2 cm in aggregate, weighing 154 g. All margins were free of involvement, and no significant pathologic abnormalities were found in the skin or nipple regions."} +{"pid": "TCGA-12-3651", "report": "A 6.5 x 5.2 x up to 3.3 cm fragment of pink-tan soft tissue was received, representing resected brain tissue. Imaging prior to surgery demonstrated a right temporal-occipital mass measuring approximately 7.3 x 4.0 cm, with medial extension along the splenium of the corpus callosum and evidence of enhancement extending laterally toward a prior right parietal burr hole.\n\nMicroscopic examination revealed a malignant astrocytic neoplasm infiltrating brain tissue. The neoplasm exhibited marked cytologic pleomorphism, mitotic figures, microvascular changes including endothelial proliferation, and areas of pseudopalisading necrosis. These features were present in the tissue submitted for analysis.\n\nCytogenetic studies using FISH showed polysomy of chromosome 7 and EGFR in 56% of tumor cells, while 33% of tumor cells demonstrated loss of chromosome 10 centromere and allelic loss of PTEN. No loss was detected at 9p21 or chromosome 9 centromere. All four tested markers were abnormal.\n\nImmunohistochemical analysis showed 20% labeling for leucocyte common antigen (LCA), indicating a high proliferation index. MGMT expression was positive in 30% of tumor cells, and wild-type EGFR (EGFR wt) was strongly positive (2+ staining) in 90% of tumor cells. Expression of mutant EGFR VIII was not detected. PTEN protein expression was intact with 2-3+ staining in 90% of tumor cells. S6 and AKT were both positive, with 2+ staining in 50% and 40% of tumor cells, respectively. MAPK showed 1+ staining in 10% of tumor cells.\n\nReal-time PCR analysis of the MGMT promoter methylation status yielded a methylation index of 449, which is considered methylated according to established thresholds. A methylation index below 4 is considered negative, between 4 and 16 as low-level methylation of uncertain significance, and above 16 as methylated.\n\nAll findings were derived from tissue obtained during craniotomy and were evaluated through multiple laboratory analyses, including histopathology, immunohistochemistry, and molecular testing."} +{"pid": "TCGA-DM-A0XD", "report": "The specimen was obtained from the cecum. Histologic evaluation revealed a primary neoplasm of the colon. The tumor was classified as T stage 3, with no nodal involvement (N stage 0) and no evidence of distant metastasis (M stage 0). The overall staging was determined to be stage IIA. The date of diagnosis and the date of normal tissue procurement are documented. Patient was White, non-Hispanic or Latino, and is deceased as of the recorded date of death."} +{"pid": "TCGA-D1-A1NZ", "report": "The specimen from the uterus consists of a 105.0 gram organ without attached bilateral tubes and ovaries. A polypoid mass measuring 2.5 x 2.0 x 0.7 cm is present on the right side of the endometrial cavity. Microscopic evaluation reveals a lesion with features including both glandular and villoglandular components. The lesion extends 0.6 cm into the myometrium, with total wall thickness measuring 1.8 cm. Lymphovascular space invasion is identified. There is no involvement of the endocervix, and all surgical margins are free of abnormal tissue.\n\nExamination of the left fallopian tube, measuring 8.0 cm in length and 0.4 cm in diameter, shows no abnormalities. The right ovary and fallopian tube, weighing 15.0 grams and measuring 3.0 x 2.5 x 1.0 cm for the ovary, with a fallopian tube measuring 7.5 x 0.5 cm, demonstrate no diagnostic abnormalities. The left ovary, weighing 10.0 grams and measuring 2.8 x 2.4 x 1.0 cm, also appears unremarkable.\n\nLymph node assessment includes 12 right pelvic lymph nodes and 22 left pelvic lymph nodes, all of which are without any abnormal findings. Gross examination of the uterus shows disrupted serosa with fibrous adhesions and three benign-appearing leiomyomata ranging from 0.3 to 1.9 cm in size.\n\nThe findings are based on frozen section histologic evaluation and confirmed by permanent sections stained with hematoxylin and eosin. No changes were noted upon final review that would alter the described findings. Staging is determined as pT1a, N0 according to the AJCC classification (7th edition, 2010)."} +{"pid": "TCGA-BH-A2L8", "report": "The surgical specimen from the left breast includes findings of fibrocystic changes, columnar cell changes, sclerosing adenosis, pseudoangiomatous stromal hyperplasia, ductal epithelial hyperplasia, and involvement of the nipple and skin. The right breast specimen demonstrates multiple foci of disease. Two invasive tumor aggregates were identified measuring 3 cm and 4.2 cm respectively, located in the upper and lower outer quadrants. Histologic evaluation revealed a Nottingham grade of 2 with a combined score of 6 out of 9 based on tubule formation (3/3), nuclear atypia (2/3), and mitotic activity (1/3). No evidence of lymphovascular invasion was observed. Surgical margins were free of invasive disease; however, invasive carcinoma was noted within less than 1 mm of the anterior margin. Additional findings included fibrocystic changes, columnar cell changes with hyperplasia, fibroadenomatoid changes, pseudoangiomatous stromal hyperplasia, microscopic radial scar, biopsy site changes, and involvement of the nipple and skin. Immunohistochemical analysis showed positivity for estrogen and progesterone receptors, with H-scores of 295 and 275 respectively. HER-2 testing showed a score of 2+ without amplification by FISH. Evaluation of the single sentinel lymph node from the right axilla showed no evidence of metastatic involvement. The excised skin specimens from both breasts demonstrated benign findings without evidence of malignancy."} +{"pid": "TCGA-GD-A3OQ", "report": "The specimen consisted of a cystoprostatectomy with attached bilateral ureters and prostate. The bladder measured 4.5 \u00d7 4 \u00d7 3.5 cm, and the prostate measured 4.5 \u00d7 3.5 \u00d7 3.5 cm and weighed 49 grams. A mass measuring 6.5 \u00d7 3 \u00d7 2.5 cm was identified in the bladder. It was partially exophytic and partially ulcerated, pink-tan in color, and involved the inferior half of the bladder circumferentially. The dome was uninvolved. The mass extended into the muscularis propria and approached within 0.2 cm of the anterior soft tissue margin. Additionally, involvement of the prostate was noted, with the tumor coming within 1.2 cm of the urethral margin.\n\nMicroscopic evaluation revealed extensive perineural invasion and lymphovascular invasion. Margins including urethral, ureteral, and paravesical soft tissue were negative. However, microscopic extension into periprostatic soft tissue was observed. One lymph node metastasis measuring 10 mm was identified among 15 total lymph nodes examined. No extranodal extension was present.\n\nSegments of both left and right distal ureters were examined intraoperatively and found to be negative for malignancy. Lymph node specimens from left inferior pelvic (2 nodes), left superior pelvic (1 node), right inferior pelvic (8 nodes), and right superior pelvic (4 nodes) regions were submitted. Of these, only one lymph node from the left inferior pelvic group contained metastatic involvement.\n\nAn appendectomy specimen was also submitted and showed no pathological changes. The appendix measured 7 cm in length with normal external and luminal features. No masses or fecaliths were identified.\n\nThe surgical specimen was processed with inked margins and multiple tissue sections submitted for analysis. Sections included evaluations of the urethral margin, uninvolved bladder mucosa, areas near the closest soft tissue margin, and various regions of the prostate and seminal vesicles."} +{"pid": "TCGA-FY-A4B0", "report": "The right thyroid lobe measured 6.5 x 4.5 x 3.8 cm and weighed 52 grams. A 4.5 cm nodule was identified with a fibrous wall measuring 1\u20133 mm in thickness, spongy brown tissue at the periphery, and a 1.6 cm eccentric cyst containing old brown blood. The surrounding thyroid parenchyma appeared compressed and showed a uniform red-brown cut surface. A smaller nodule measuring 2.8 cm was also present. The left thyroid lobe measured 4.5 x 2.3 x 1.1 cm and weighed 5 grams. It contained two firm nodules up to 0.8 cm in diameter with ill-defined borders. Both lobes were submitted for analysis, with margins marked using black ink and blue ink for the isthmus.\n\nMicroscopic evaluation of the right lobe revealed a cystic nodule and a solid mass, both with features raising concern for malignancy. The solid mass was further evaluated for margin involvement. In the left lobe, microscopic analysis identified a neoplastic process involving one of the inked margins. The lesions were noted to be multifocal, with multiple small foci present in both lobes, the largest measuring up to 1.0 cm. The histologic pattern was consistent with a follicular variant, comprising 100% follicular architecture as per the Thyroid Scoring System. No lymphovascular or extrathyroidal invasion was observed. Additional findings included nodular hyperplasia. Staging was determined as pT1a, multifocal, with no regional lymph node assessment performed."} +{"pid": "TCGA-A2-A0CP", "report": "The specimen was received from a female patient and included sentinel lymph nodes and a right breast lumpectomy. Sentinel lymph node #1 was a red, soft tissue fragment measuring 3.0 x 1.5 x 0.3 cm, containing at least one lymph node measuring 1.0 cm in greatest dimension. A portion of this node was submitted for special protocols and the remainder entirely processed. Sentinel lymph node #2 was a similarly soft, red tissue fragment measuring 2.3 x 1.7 x 0.3 cm, containing a lymph node 0.7 cm in greatest dimension; part of this node was also submitted for additional protocols.\n\nThe right breast lumpectomy consisted of fibrofatty tissue measuring 5.5 x 4.5 x 3.0 cm with overlying skin. The specimen was oriented using sutures and inked with multiple colors to identify margins. Upon sectioning, a well-defined tumor measuring 2.0 cm was identified with a tan, gritty cut surface located approximately 0.2 cm from the superior-deep margin. Sections of skin, tumor, and surrounding fibrous tissue were submitted at intervals of 1.0, 2.0, 5.0 cm from the tumor for further analysis.\n\nMicroscopic evaluation of both sentinel lymph nodes showed no evidence of abnormal cells using standard histologic and immunohistochemical techniques. The breast lesion demonstrated tightly clustered cells arranged in a pattern consistent with localized growth within ducts, comprising less than 25% of the overall tumor volume. Invasive tumor cells were present with features indicating preserved cellular differentiation. Margins of excision were free of invasive and in situ disease.\n\nImmunohistochemical testing revealed expression of hormone receptors within the cell nuclei, with staining detected in a subset of cells. Ancillary studies were incomplete at the time of reporting."} +{"pid": "TCGA-WB-A820", "report": "The right adrenal surgical specimen measures 90x75x60 mm and contains a central 5 cm cavity filled with necrotic material. At the periphery, there is apparent normal adrenal tissue. A separate lumbo-aortic lymph node was submitted for evaluation.\n\nMicroscopic examination reveals a tumor composed of cells with variable size, distinct cell borders, and abundant finely granular cytoplasm. The nuclei show marked atypia, pleomorphism, and hyperchromasia. Frequent nuclear inclusions are present, along with rare intracytoplasmic hyaline globules. Spindle-shaped cells are also observed. Mitotic activity is low (3 mitoses per 10 high-power fields), although atypical mitoses are identified. Tumor cells are arranged in large nests separated by a delicate vascular stroma. Hemorrhagic changes are prominent. The tumor demonstrates focal invasion into the surrounding adrenal cortex but does not extend beyond it. Vascular and lymphatic invasion are present.\n\nThe PASS scoring system yields a total score of 9. The lumbo-aortic lymph node shows no evidence of tumor involvement."} +{"pid": "TCGA-F4-6807", "report": "The submitted colectomy specimen involved a tumor measuring 9 \u00d7 8 \u00d7 2 cm located in the colon. Microscopic evaluation revealed moderately differentiated morphology with tumor extending into pericolonic tissues. Lymph node assessment showed involvement of all intraabdominal nodes examined (12 out of 12). Surgical margins were free of involvement. No evidence of prior neoadjuvant therapy was identified, and no additional significant pathologic findings were noted."} +{"pid": "TCGA-RR-A6KB", "report": "The specimen consists of gray and white matter with a cellular, diffusely infiltrating astrocytic neoplasm. Tumor cells exhibit moderate cytologic atypia. In areas of increased cellularity, numerous mitotic figures are present. Microvascular proliferation and necrosis are also noted, with some necrotic areas showing pseudopalisading. Immunohistochemical staining reveals that less than 10% of cells in the tumor region are immunoreactive for MGMT; many of these positive cells appear to be endothelial in origin. The neoplastic cells themselves do not express MGMT."} +{"pid": "TCGA-VQ-AA6J", "report": "The specimen from the cardia region of the stomach, obtained following total gastrectomy, shows a poorly differentiated invasive ulcerated lesion with an intestinal pattern. The lesion measures 5.0 x 4.0 x 1.5 cm and extends to the serosal surface. Vascular invasion is not identified; however, lymphatic and perineural invasion are present. The adjacent mucosa demonstrates moderate chronic gastritis. All surgical margins are free of neoplastic involvement.\n\nA total of 27 lymph nodes were retrieved from the surrounding fat. Of these, 3 show evidence of neoplastic involvement with capsular extension. The involved nodes are located in chain 7 and 9 (left gastric artery and celiac trunk), with 3 out of 7 nodes positive. Other lymph node chains examined, including those along the paracardiac regions, lesser and greater curvatures, gastroepiploic vessels, suprapyloric, infrapyloric, hepatic arteries, and splenic artery, do not show any neoplastic involvement. \n\nThe omental tissue, esophageal margin, proximal esophageal margin, and an additional lymph node from chain 6 are all free of neoplasia. Pathologic staging is determined as pT4 pN2 based on topographic and morphologic findings."} +{"pid": "TCGA-D8-A1XR", "report": "Histopathological examination was performed on a right breast specimen with axillary tissues. The breast measured 26 x 17 x 7 cm, and the axillary tissues measured 10 x 14 x 6 cm, along with a skin flap of 16 x 8 cm. A lesion measuring 3.2 x 2.5 x 1.9 cm was identified in the upper outer quadrant, located 4.5 cm from the upper boundary, 1.7 cm from the base, and 1.2 cm from the skin. Seven separate tissue fragments were examined, with a combined size of approximately 3 x 2 x 1 cm.\n\nMicroscopic evaluation revealed a cellular proliferation characterized by ductal growth patterns and a histological grade corresponding to NHG2. Mitotic activity was noted with a count of 6 mitoses across 10 high-power fields (visual area 0.55 mm\u00b2). There was significant fibrosis in the central region of the lesion. Cellular morphology included numerous cells with cytoplasmic features resembling signet ring morphology. The nipple area showed no evidence of involvement. Adjacent glandular tissue exhibited changes consistent with fibrocystic disease and lipomatous transformation.\n\nAxillary lymph node assessment identified malignant involvement in two out of seven nodes. Immunohistochemical analysis demonstrated strong nuclear reactivity for estrogen and progesterone receptors in more than 75% of cells. HER2 staining using HercepTest\u2122 M by DAKO showed minimal membrane staining with a score of 1+ in invasive components.\n\nThe staging classification indicates a primary lesion size category T2 and regional lymph node involvement classified as N1a."} +{"pid": "TCGA-A2-A0SW", "report": "The specimen consisted of right breast tissue, including a mass measuring 3.5 cm in maximum dimension. The tumor was focally close to the anterior and posterior surgical margins, with less than 1 mm clearance noted on slides #5 and #6. Other surgical margins were free of disease. Lymphovascular invasion was present. Microcalcifications were identified. Two sentinel lymph nodes were examined intraoperatively and both showed evidence of metastatic involvement. Final lymph node evaluation revealed that 2 out of 13 axillary lymph nodes contained malignant cells. The tumor was classified as poorly differentiated and demonstrated an infiltrating growth pattern. Staging was assessed as pT2 for the primary tumor size, pN2 for regional lymph node involvement, with overall classification pStage IIIa."} +{"pid": "TCGA-4V-A9QS", "report": "The specimen from a thymectomy procedure measured 10 cm x 7.5 cm x 4 cm and weighed 75 grams. A dominant whitish, ill-defined, non-encapsulated nodule was identified within the specimen, measuring 7 cm x 4 cm x 4 cm. This nodule extended into the adjacent lung parenchyma, pericardium, and surrounding adipose tissue. The surgical margins were free of involvement. Additional findings included a left pleural nodule measuring 0.8 x 1 cm, five biopsy fragments from the left pleura containing nodules ranging from 0.5 to 1.5 cm in diameter, and a diaphragmatic implant with three nodules measuring between 0.6 and 2 cm. Two fragments of mediastinal fat, measuring 4 x 2.5 cm and 6.5 x 4.5 cm respectively, showed no distinct nodular lesions.\n\nHistological analysis of the thymectomy revealed a lobulated growth pattern with fibrous septa. The cells were large and polygonal, with prominent nucleoli and a high nuclear-to-cytoplasmic ratio. These cells were arranged in linear arrays around vascular structures and septa. A significant lymphocytic component was present, though without formation of follicular structures. No Hassall\u2019s corpuscles were identified. Focal areas of medullary differentiation were noted at the periphery. The tumor exhibited invasion into the surrounding mediastinal fat, but the resection margins were clear.\n\nImmunohistochemical staining demonstrated that the epithelial cells expressed cytokeratins KL1, 5/6, and 19, but were negative for cytokeratin 20, CD5, and CD20; rare EMA positivity was observed. T lymphocytes showed an immature phenotype, positive for CD5, CD1a, and CD99.\n\nThe left pleural nodule, the left pleural implant biopsies, and the diaphragmatic implant all displayed histological features consistent with those seen in the main thymic lesion. The mediastinal fat samples did not show any evidence of tumor or lymph node involvement.\n\nMicroscopic evaluation of a thymic nodule near the resection margin showed changes consistent with thymic involution, with rare residual lobular structures embedded in fatty tissue."} +{"pid": "TCGA-N6-A4VF", "report": "A specimen of benign adipose tissue was obtained from the omentum. The hysterectomy specimen contained two distinct lesions measuring 8.5 x 5.2 cm and 3.1 x 3.0 cm. Both exhibited a polypoid growth pattern with myometrial invasion, with the depth of invasion measuring 35% (0.7 of 2.0 cm on slides K and L). There was evidence of lymphovascular invasion. The cervix showed squamous metaplasia without involvement by malignancy. Additional findings included a 3.5 cm leiomyoma and adenomyosis. All surgical margins were free of malignancy. The bilateral ovaries contained benign serous cystadenofibromas. The right fallopian tube demonstrated hydrosalpinx, while the left fallopian tube contained paratubal cysts. Pelvic lymph node biopsies on both sides were negative for metastatic disease, with a total of four lymph nodes examined. Immunostains confirmed epithelial and stromal components. The tumor involved 60% of the anterior endomyometrium and 90% of the posterior endomyometrium. The depth of myometrial invasion was less than half the thickness. Angiolymphatic invasion was present. The pathologic stage is pT1b, pN0, pMX, corresponding to a FIGO stage IB. Pelvic washings were negative for malignant cells."} +{"pid": "TCGA-CG-4306", "report": "The specimen shows involvement of the liver with a metastatic deposit consistent with a poorly differentiated carcinoma. A lymph node metastasis is also present in the submitted material. Gastric resection specimens demonstrate an invasive lesion extending through all layers of the gastric wall, reaching the serosa. Additional findings include the presence of lymph node metastases. The resection margins at the mucosal region were free of tumor involvement. Pathologic staging indicates invasion beyond the muscularis propria into surrounding tissues, with regional lymph node involvement and evidence of distant spread. Vascular and lymphatic invasion are present."} +{"pid": "TCGA-R6-A6L4", "report": "The modified report includes the following findings. Biopsy from the cardia shows cardio-oxyntic mucosa with mild inactive chronic inflammation and reactive epithelial changes; no tumor, intestinal metaplasia, or Helicobacter pylori is identified. Biopsy from the distal esophagus at 34\u201335 cm reveals squamous mucosa with no diagnostic abnormality. A biopsy from a distal esophageal mass demonstrates invasive moderately differentiated epithelial neoplasm with underlying squamous mucosa.\n\nGross description notes four tan-brown soft tissue fragments measuring 0.3 to 0.4 cm from the cardia, submitted in container A. Four tan-gray soft tissue fragments measuring 0.3 to 0.5 cm from the distal esophagus (34\u201335 cm) are submitted in container B. Five tan-red soft tissue fragments measuring 0.3 to 0.4 cm from the distal esophageal mass are submitted in container C.\n\nImmunohistochemistry studies show that the neoplastic cells are negative for Her-2/neu (score 0 out of 3)."} +{"pid": "TCGA-23-2072", "report": "A surgical specimen was received from a patient with a history of a pelvic mass. Tissue samples were obtained from multiple anatomical sites, including the omentum, bilateral fallopian tubes and ovaries, uterus and cervix, pelvic mass, sigmoid colon, and liver masses, as well as retroperitoneal and abdominal regions.\n\nMicroscopic evaluation of the specimens revealed high-grade cellular atypia in all involved sites. Psammoma bodies were identified in several specimens. Infiltrative growth patterns were noted in the right ovary and tube, left ovary, and extending into the fallopian tube from the serosa. Uterine involvement showed invasion of the serosa and outer portions of the myometrium. Metastatic involvement was present in the omentum, retroperitoneal region, liver, and abdominal areas.\n\nGross examination revealed multiple tissue fragments with friable, papillary, and hemorrhagic features. The omental specimen measured 5.5 x 3.5 x 2.5 cm and contained two small white nodules. The right ovary had a firm, white nodule measuring 2.0 x 1.0 x 0.6 cm and a subcortical cyst. The left ovary was significantly enlarged, up to 7.0 x 5.0 x 4.5 cm, with multiple tumor nodules and a large cystic area containing papillary excrescences. The uterus weighed 75 grams, with a polypoid lesion extending through the endocervical canal and out the cervical os. A subserosal nodule measuring 0.5 x 0.5 x 0.4 cm was also present. The pelvic mass was small, measuring 1.0 x 0.7 x 0.7 cm, with friable and papillary features. The sigmoid mass included two tissue fragments measuring 2.0 x 1.1 x 0.3 cm and 1.0 x 1.5 x 0.9 cm. Liver tumors were friable and papillary, with the anterior tumor measuring 7.0 x 7.0 x 4.0 cm and the posterior tumor measuring 4.0 x 3.0 x 2.5 cm. The right retroperitoneal tumor was 7.0 x 6.0 x 2.5 cm, and the omental tumor measured 8.0 x 5.0 x 3.5 cm with a central firm nodule.\n\nAdditional findings included an endometrial/endocervical polyp, a small subserosal leiomyoma, benign endocervical mucosa with squamous metaplasia, nabothian cysts, and mild chronic inflammation."} +{"pid": "TCGA-DD-A4NA", "report": "The liver left lobe resection specimen contains a lobulated mass measuring 9.6 x 9.5 x 9.3 cm. Histologic evaluation demonstrates a poorly differentiated cellular proliferation with extensive lymphovascular invasion, including the presence of a tumor thrombus. Surgical margins are negative for tumor by less than 0.1 cm. Regional lymph node assessment includes one caval and one hilar lymph node, both of which are negative for tumor involvement. Additionally, three celiac artery lymph nodes, one hepatic artery lymph node, and one pericholedochal lymph node were examined and found to be free of tumor. In situ hybridization for albumin was positive. The evaluation of the specimen was based on gross and frozen section histologic analysis."} +{"pid": "TCGA-BR-6453", "report": "The specimen consisted of a gastrectomy with a noted ulcerated lesion present in the stomach. Histologic evaluation revealed a poorly differentiated adenocarcinoma; however, the tumor size was not specified. The tumor was found to extend into the muscularis propria. Of the intraabdominal lymph nodes examined, 1 out of 1 was positive for metastatic involvement. Lymphatic, venous, and perineural invasion statuses were not specified, and margin status as well as response to neo-adjuvant treatment could not be determined from the provided information. No additional pathologic findings were reported."} +{"pid": "TCGA-AD-5900", "report": "The specimen consists of a right colon segmental resection. A tan, firm, raised mass measuring 3.2 x 2.4 x 0.5 cm is identified. It is located 5.4 cm from the distal margin and 8.2 cm from the proximal margin. The lesion has a solid tan cut surface and measures 0.4 cm in thickness. Grossly, it does not perforate through the bowel wall. The remainder of the mucosa appears normal, and the appendix is unaffected.\n\nHistologically, the lesion demonstrates moderately differentiated features with focal mucinous characteristics. There is no lymphovascular space invasion or perforation of the visceral peritoneum. No mesenteric deposits are present. The tumor extends into the superficial muscularis propria. All surgical margins are negative, with the proximal margin clear by 8.2 cm and the distal margin clear by 5.4 cm. The deep (radial) margin is not applicable as the tumor does not reach the serosal surface.\n\nA total of eleven lymph nodes are examined, none of which contain metastatic disease. Additional findings include association with a tubular adenoma showing high-grade dysplasia. Sections of the lesion, margins, appendix, ileocecal valve, and lymph nodes have been submitted for analysis."} +{"pid": "TCGA-BG-A0MH", "report": "The surgical specimen includes a right salpingo-oophorectomy, total abdominal hysterectomy, and left salpingo-oophorectomy with bilateral pelvic and para-aortic lymph node biopsies. The endometrium shows a moderately differentiated epithelial neoplasm with features suggestive of squamous differentiation. The lesion involves approximately 90% of the endometrial surface and demonstrates invasion into the myometrium, reaching up to 80% of its thickness. The tumor measures 4.5 cm in maximum dimension. No angiolymphatic invasion is identified. Adjacent endometrial tissue reveals atypical complex hyperplasia. Additional findings include adenomyosis, chronic cystic cervicitis with squamous metaplasia and parakeratosis, tubal metaplasia and endometriosis in the uterine cervix, and serosal adhesions involving the uterus. The left ovary contains a microscopic mature cystic teratoma with associated serosal adhesions. Both fallopian tubes show changes consistent with prior tubal ligation and no tumor is identified. All lymph nodes examined\u2014four from the left pelvis, one from the left para-aortic region, one from the right pelvis, and two from the right para-aortic region\u2014are free of tumor. A total of eight lymph nodes were evaluated, none showing evidence of metastasis. Peritoneal cytology is negative. The pathologic staging reflects localized disease confined to the uterus with deep myometrial involvement, without lymph node or distant spread."} +{"pid": "TCGA-AH-6544", "report": "The DNA analysis from the tumor sample demonstrated a microsatellite stable pattern (MSS) across all five markers tested. The panel used includes two mononucleotide repeats and three dinucleotide repeats, commonly utilized for colorectal neoplasia evaluation. Testing was conducted via multiplex fluorescent PCR followed by automated sequencing and allele calling.\n\nKRAS mutation analysis detected an activating mutation at codon 12 (GGT>GTT), indicating a G12V substitution. This mutation was identified through sequencing of PCR-amplified regions covering exon 1 and exon 2 of the KRAS gene. The tumor sample underwent microdissection to enrich tumor content prior to testing.\n\nNRAS mutation analysis did not detect any mutations in codons 12, 13, or 61 following sequencing of both forward and reverse strands of amplified DNA. BRAF mutation testing also showed no mutations in exons 11, 12, or 15, which cover the majority of known BRAF mutations. PIK3CA mutation analysis revealed no mutations in exons 1, 9, or 20 of the gene.\n\nImmunohistochemical staining for mismatch repair proteins (hMLH1, hMSH2, hMSH6, hPMS2) demonstrated preserved expression within the tumor cells. Internal controls confirmed appropriate staining performance.\n\nHistologic examination of the resected colon specimen identified a low-grade adenocarcinoma measuring 5.3 x 2.8 x 1.0 cm located in the rectosigmoid region. Microscopic evaluation revealed invasion beyond the muscularis propria into subserosal adipose tissue. Lymphovascular space invasion was present. Surgical margins were negative; the tumor was 0.6 cm from the radial margin. Of the 20 lymph nodes evaluated, 3 contained metastatic involvement. Distant metastasis was identified in the liver biopsy, consistent with metastatic adenocarcinoma."} +{"pid": "TCGA-EL-A3H8", "report": "A lymph node from the left neck, jugular foramen region measured 0.6 x 0.5 x 0.3 cm and 0.3 x 0.2 x 0.2 cm, all tissue was submitted for examination. A fragment of soft tissue measuring 0.6 x 0.5 x 0.5 cm from the right carotid sheath was bisected and entirely submitted. Right neck dissection specimen measured 14.0 x 3.0 x 2.0 cm with multiple lymph nodes identified, the largest being 2.5 cm. All lymph nodes were processed from lower to upper regions. Fibroadipose tissue from the left neck levels II to V measured 15.0 x 2.0 x 1.0 cm with multiple lymph nodes identified, the largest measuring 2.0 cm in diameter. A small tan soft tissue fragment measuring 0.1 x 0.1 x 0.1 cm from the left superior parathyroid biopsy was entirely submitted. A minute tissue fragment from parathyroid fat measuring 0.1 x 0.1 x 0.1 cm was also fully submitted. A soft tissue fragment beneath the recurrent laryngeal nerve measured 0.9 x 0.5 x 0.5 cm and was entirely processed. Another specimen labeled for parathyroid exclusion was submitted for frozen section.\n\nThe thyroidectomy specimen included a paratracheal lymph node dissection and measured 10.5 x 6.8 x 2.5 cm. The left and right thyroid lobes measured 3.5 x 2.5 x 2.2 cm. Attached fibroconnective tissue measured 4.5 x 3.5 x 0.8 cm with seven nodules up to 1.0 cm in size. A distinct nodule measuring 2.0 x 1.7 x 1.2 cm was identified in the left thyroid lobe with a papillary cut surface. Remaining thyroid tissue appeared red and granular. Smaller nodules within the fibroconnective tissue showed similar characteristics to the main nodule. Multiple sections were taken from the tumor and surrounding areas."} +{"pid": "TCGA-EB-A3HV", "report": "The excised skin specimen measured 5.5 x 4.5 x 1.3 cm and was described as raised and pigmented. Microscopic examination revealed a histologic type consistent with nodular melanoma. The lesion demonstrated Clark level 4 invasion. Histologic grading showed no involvement of lymph nodes, lymphatic, or venous structures. Surgical margins were uninvolved. No evidence of neo-adjuvant treatment effects was observed. No satellite nodules or additional significant pathologic findings were noted."} +{"pid": "TCGA-AG-3593", "report": "The excised soft tissue from the abdominal wall shows fibrosis and chronic granulating inflammation. No tumor involvement is seen in this specimen. A resected segment of colon and rectosigmoid colon contains an ulcerated lesion with histological features of moderately differentiated adenocarcinoma. The lesion measures 6.5 cm in length along the intestinal wall and is associated with necrotic changes. The tumor invades through all layers of the intestinal wall and extends into the surrounding periproctic fatty tissue. Microscopically, the closest distance from the tumor to the soft tissue resection margin is 2 mm. Both the oral and aboral resection margins are free of tumor, as well as the adjacent intestinal segments adherent to the vaginal section and uterus. Examination of the uterus reveals epidermoid glandular portio ectopy, mild chronic cervicitis, cystic atrophy of the corpus endometrium, and several intramural leiomyomas. The sigmoid colon demonstrates isolated pseudodiverticula and chronic peridiverticulitis with fibrotic changes. All 38 evaluated periproctic and mesocolic lymph nodes show no evidence of tumor involvement and exhibit only nonspecific reactive changes. Histopathological evaluation corresponds to a pT3 classification with no lymph node metastasis (pN0, 0/38) and a histologic grade of G2."} +{"pid": "TCGA-78-7150", "report": "The specimen from the left lung consists of a pneumonectomy measuring 180 x 150 x 40 mm. A large peripheral lesion measuring 70 x 65 x 45 mm is located in the apex of the left lower lobe. There is puckering of the overlying pleura, although definite invasion could not be confirmed grossly. Multiple enlarged hilar and intraparenchymal lymph nodes were identified; however, no macroscopic evidence of tumour involvement was observed in these nodes. The visceral pleura and parenchyma show extensive carbon pigmentation. A cream-colored papule is noted on the visceral pleura at the apex of the left upper lobe. Other findings include emphysema of the upper lobe and pleural fibrosis.\n\nMicroscopically, the lesion shows features of a moderately to poorly differentiated adenocarcinoma. The tumour abuts the pleura but does not invade it. Extensive necrosis is present, with obliteration of several blood vessels within the tumour; however, definitive vascular invasion is not identified. No lymphatic or perineural infiltration is observed. Reactive hyperplasia, anthracosis, and small silicotic nodules are present in peribronchial lymph nodes, but no metastases are found there. Metastatic carcinoma is identified in intraparenchymal lymph nodes from the left lower lobe. One sampled lymph node appears to contain a fragment of the primary lesion. Lung tissue distant from the lesion demonstrates significant peribronchial and interlobular septal anthracosis.\n\nAdditional lymph nodes sampled include one measuring 6 mm in diameter, which showed no evidence of malignancy, and two fragments of nodal tissue, the largest approximately 12 mm in diameter. One of these showed partial replacement by metastatic adenocarcinoma, while the other showed reactive changes with anthracosis and occasional silicotic nodules, but no malignancy.\n\nStaging is based on the extent of tumour involvement in lymph nodes and local structures."} +{"pid": "TCGA-EO-A3AU", "report": "The specimen included lymph nodes from the right and left common iliac, left pelvic, right pelvic, and a left pelvic lymph node (number 2), as well as a hysterectomy specimen including the uterus, cervix, fallopian tubes, and ovaries. No lymph node tissue was identified in the right and left common iliac specimens. The left pelvic lymph node specimen contained six nodes, all negative for malignancy. The right pelvic lymph node specimen included five nodes, with one showing involvement. The left pelvic lymph node (number 2) contained three nodes, all without evidence of malignancy.\n\nThe hysterectomy specimen revealed a lesion located in the anterior and posterior endometrium, measuring 4.5 cm in greatest dimension. Histologic evaluation showed high-grade features with invasion into the outer half of the myometrium and extension into soft tissue at the lower uterine segment, though not reaching the margin. There was stromal invasion of the cervix by the lesion, and lymphovascular space invasion was also present. The myometrial thickness was 18 mm, with more than 50% invasion. The cervix showed involvement by invasive disease, while the ovaries and fallopian tubes were free of involvement.\n\nLymph node sampling included pelvic and iliac regions. A total of 14 pelvic lymph nodes were examined, with one showing involvement. No para-aortic lymph nodes were assessed. Grossly, the hysterectomy specimen measured 8.4 cm in length and weighed 212 grams. The lesion extended into the myometrium and showed a polypoid appearance in the endometrial cavity. A separate nodule was noted on the ectocervix. A fibroid measuring 2.0 cm was identified in the anterior myometrium. Multiple cysts were observed in the right paraovarian region, the largest measuring 0.6 cm."} +{"pid": "TCGA-KK-A6DY", "report": "The specimen included right and left pelvic lymph nodes, with six lymph nodes identified on each side. All measured between 0.4 x 0.4 x 0.2 cm and 6.0 x 1.2 x 0.8 cm. No abnormal cellular infiltration was observed in any of the lymph nodes examined. The prostate measured 5.1 x 4.5 x 5.7 cm and weighed 95 grams after fixation. A palpable nodule measuring 3.3 x 3.0 x 3.0 cm was noted in the right posterolateral aspect of the mid region. Serial cross sections revealed a firm area within the right peripheral zone. The tumor focus measured 3.5 x 1.0 cm in its largest dimension and was present across three cross sections, predominantly at the apex and focally at the base. The tumor extended focally to the inked margin on the left posterior surface by less than 1.0 mm. No tumor was identified in the seminal vesicles or segments of the vasa deferentia. High-grade prostatic intraepithelial neoplasia was also present. The prostate was sectioned extensively, with inking used to delineate anatomical regions: anterior (green), left (red), right (yellow), and posterior (black). Additional blue and orange inks marked non-resection surfaces."} +{"pid": "TCGA-CJ-4882", "report": "A right adrenal sparing radical nephrectomy specimen includes a kidney with surrounding perinephric fat measuring 19.0 x 11.0 x 5.5 cm. A yellow variegated, well-circumscribed mass located in the lower pole of the kidney measures 7.0 x 6.0 x 5.0 cm. The mass infiltrates focally into the renal sinus and extends into the perinephric fat. The uninvolved renal parenchyma appears unremarkable. Margins of resection at the renal vein and ureter show no gross involvement. One possible lymph node adjacent to the renal hilum measures 0.5 x 0.4 x 0.3 cm and shows no evidence of involvement.\n\nOne regional lymph node measuring 4.0 x 2.0 x 0.8 cm is entirely submitted for examination and shows no evidence of involvement. An additional lymph node measuring 2.0 x 1.0 x 0.6 cm is also negative for involvement.\n\nHistologic sections include multiple tissue samples from the tumor, renal parenchyma, renal sinus, perinephric fat, and margins of resection. Cellular features include nuclear characteristics graded as moderately differentiated morphology. Tumor size and focal infiltration into surrounding structures are noted. No involvement is identified in the examined lymph nodes or surgical margins."} +{"pid": "TCGA-XU-AAXY", "report": "The specimen consists of a lobulated piece of tissue measuring 10.2 cm in greatest dimension, with a fresh weight of 47.5 g. A tumor is present within the specimen, poorly defined and measuring 4.5 x 2.0 x 4.0 cm. The tumor is located closest to the short axis margins, coming within 0.1 cm of these, including the sutured component. It also approaches the long and mid-axis margins at distances of 0.2 cm, 1.5 cm, 0.2 cm, and 1.0 cm respectively.\n\nHistologically, the lesion demonstrates a mixed population of small lymphoid cells and larger epithelial cells arranged in solid sheets. Small islands of purely lymphoid cells are also seen. Thick fibrous septae and a thin, focally discontinuous fibrous capsule are present. The tumor extends into adjacent adipose tissue. Immunohistochemical staining shows the epithelial component to be positive for CK5/6 and HMWK. The lymphoid cells stain positive for CD5, CD1a, and CD99.\n\nResidual thymic tissue shows evidence of lymphoid follicle hyperplasia. One regional lymph node was examined and showed no evidence of involvement. No vascular or pulmonary parenchymal invasion was identified; however, there is pleural involvement. Margins are focally involved by tumor, with the closest distance being less than 0.1 cm at the painted mid-axis margin and short axis. No distant metastasis was assessed.\n\nThe histologic features include cortical differentiation. Serial sections submitted include multiple orientations of the tumor in relation to its margins and surrounding tissue."} +{"pid": "TCGA-CV-A45P", "report": "The specimen from the right hemiglossectomy measures 8.0 x 3.0 x 2.5 cm. A lesion is identified 2.0 cm from the anterior margin, 1.7 cm from the posterior margin, 0.7 cm from the lateral aspect, and 1.4 cm from the medial left superficial margin. The lesion is ulcerated, focally nodular, tan-gray in appearance, measuring 3.0 x 1.9 cm with a depth of 1.1 cm. Histologic evaluation reveals invasive growth into skeletal muscle with a depth of invasion of 5.0 mm. Perineural invasion is present. No vascular or lymphatic invasion is identified. Surgical margins are free of tumor involvement.\n\nA lesion from the left alveolar ridge measures 2.9 x 2.6 x 0.2 cm. The mucosal surface is tan-white and raised. On sectioning, the mucosa has a flat base without an infiltrative margin. Medial surgical margins are free; however, the anteriormost and posteriormost margins cannot be fully assessed based on available sections.\n\nThe neck dissection specimen includes 19 lymph nodes across levels 1 through 5. Distribution includes 0 of 2 level 1 nodes, 0 of 4 level 2 nodes, 0 of 6 level 3 nodes, 0 of 0 level 4 nodes, and 0 of 7 level 5 nodes. All lymph nodes show no evidence of tumor involvement. Some demonstrate follicular hyperplasia. The submandibular gland and a skin ellipse are unremarkable.\n\nA separate lymph node specimen from the right inferior jugular region contains three lymph nodes ranging from 0.3 to 0.5 cm in size. No tumor is identified in these nodes.\n\nA biopsy from the anterior mandibular gingiva measures 2.2 x 0.6 x 0.3 cm. Microscopic evaluation shows hyperkeratotic tissue with dysplastic changes classified as grade II.\n\nBiopsy specimens from the esophagus and right oral tongue reveal squamous mucosa with parakeratosis and papillomatosis respectively. Both show no evidence of malignancy. The lingual nerve specimen shows only peripheral nerve tissue without tumor involvement."} +{"pid": "TCGA-DX-A8BU", "report": "A right thigh soft tissue mass was evaluated along with multiple margin specimens and a lymph node from the right groin. The primary specimen measured 17 x 15 x 7.5 cm and contained a well-circumscribed, lobulated, hemorrhagic tan-white lesion measuring 12.4 cm in its greatest dimension. Approximately 30% of the tumor showed necrosis. The tumor was located near the deep, proximal, and lateral margins, with distances of 0.17 cm to the lateral margin and 0.3 cm to the medial margin. Vascular invasion was identified. Margins evaluated included those from the psoas muscle, deep, medial deep, and profunda regions; all of these showed fibromuscular tissue without evidence of tumor. One lymph node from the right groin was benign. Microscopic examination of the tumor showed high-grade pleomorphic and spindle cell features involving fibroadipose and skeletal muscle tissue. A nerve adjacent to the tumor was free of involvement. Intraoperative frozen sections from the biopsy site were consistent with a malignant neoplasm, favoring sarcoma, while other margins were negative for tumor. All permanent sections from the margins confirmed absence of tumor."} +{"pid": "TCGA-49-4488", "report": "The surgical specimen from the left lower lobe shows a moderately differentiated carcinoma measuring 3 cm in greatest dimension. The tumor exhibits focal bronchioloalveolar features and approaches but does not involve the pleura. A total of sixteen lymph nodes were examined. All margins of resection are free of tumor involvement. Lymph nodes from levels 5, 7, and 9 were each negative for tumor."} +{"pid": "TCGA-69-7765", "report": "The specimen includes multiple submitted parts from the right lung. Part A, a right upper lobe wedge, contains a nodule measuring 1.4 x 1.2 x 1.0 cm. The nodule is located beneath a puckered pleural surface and appears to invade the visceral pleura. It is gray-brown-black in color with a slightly lobular appearance. The nodule is 0.3 cm from the parenchymal margin, which is inked orange. The pleural surface is inked blue. No vascular invasion is identified, though lymphatic invasion is present. Additional findings include a separate superficial white nodule on the pleura measuring 0.7 x 0.7 cm, which does not show invasion upon sectioning.\n\nPart B, a right lower lobe lobectomy specimen measuring 15 x 10 x 2 cm, contains a spiculated tan-gray firm mass measuring 2.3 x 2.1 x 1.3 cm. This mass extends within 5.4 cm of the bronchial margin and within 0.1 cm of a previous wedge resection margin. The mass abuts and retracts the overlying pleura. Central cavitation and anthracotic pigmentation are observed. Lymphatic invasion is present, but no vascular invasion is identified. All bronchial, vascular, and parenchymal margins are negative. Lymph nodes associated with this specimen are negative for neoplasm.\n\nAdditional specimens include several lymph node groups (R9, R12, 4R, #7), all of which are negative for neoplasm. Part D, a right lower lobe wedge excision, shows findings consistent with chronic aspiration, including organizing pneumonia, chronic bronchiolitis, and a foreign body giant cell reaction. Focal atypical adenomatous hyperplasia is also noted. Pulmonary hamartoma and centrilobular emphysema are identified in various specimens.\n\nStaging is based on AJCC criteria, considering the involvement of different pulmonary lobes and the presence of pleural invasion. The tumors are histologically similar and predominantly invasive. Parenchymal margins are negative in both major specimens, while the right upper lobe tumor invades the visceral pleura."} +{"pid": "TCGA-AC-A23C", "report": "The left axillary sentinel lymph node specimen contains a single lymph node with metastatic involvement measuring 0.3 cm. The left breast mastectomy specimen demonstrates a residual lesion measuring 2.5 cm. Histologic grading criteria show an architectural score of 2 out of 3, nuclear score of 2 out of 3, and mitotic score of 1 out of 3, resulting in a total score of 5 out of 9, corresponding to low-grade morphology. The lesion is located adjacent to a prior biopsy cavity. No involvement of the skin or nipple is observed. The deep margin of excision shows no evidence of tumor. Multifocal ductal carcinoma in situ is present in areas of the breast not otherwise involved by invasive disease. These in situ lesions are characterized as high-grade comedo type, with the largest confluent area measuring approximately 1.0 cm. Immunohistochemical analysis of the original biopsy tissue reveals hormone receptor positivity and a proliferation index of 33%. HER2 gene amplification was detected via fluorescence in situ hybridization. MRI of the breast demonstrated a primary enhancing mass measuring 1.5 cm in the anterior upper-outer quadrant. Additional scattered enhancing nodules were identified throughout the left breast, raising concern for satellite lesions. One nodule measuring 7 mm in size is located 3 cm from the main lesion and may be amenable to ultrasound-guided biopsy. Other smaller posterior nodules may not be easily visualized with ultrasound. Staging classification is based on available findings as T2 pN1 MX."} +{"pid": "TCGA-EL-A3ZP", "report": "A surgical case involving multiple tissue specimens was examined. The findings included lymph nodes from various regions, with some showing involvement by cellular abnormalities. In level II A of the right neck dissection, one out of eight lymph nodes showed signs of abnormal cellular infiltration. Similarly, in level II B, one out of eight lymph nodes was involved. Level III showed involvement in one out of five lymph nodes, and in level IV, no affected nodes were found among fifteen examined. Right paratracheal lymph nodes showed involvement (1/1), as did those from the right superior parathyroid region (1/1). Additionally, four out of seven lymph nodes from the right upper mediastinal region were involved.\n\nThe primary lesion measured 2.6 cm and was located in the right lobe of the thyroid gland. It exhibited areas of reduced differentiation and extended beyond the thyroid capsule into adjacent fibroadipose tissue. Lymphovascular invasion was identified, and the resection margins were positive. Chronic lymphocytic thyroiditis was noted in the surrounding thyroid tissue.\n\nSpecimens submitted included soft tissues from various anatomical locations, including the parotid region, anterior neck, and mediastinum. Sizes of tissues ranged from a 0.3 x 0.3 x 0.2 cm fragment to a larger specimen measuring 4.0 x 2.0 x 0.8 cm. Multiple lymph nodes were isolated from fat and submitted for evaluation, with sizes ranging from 0.1 cm to 0.8 cm in diameter. Some lymph nodes showed extranodal extension of abnormal cells.\n\nNo tumor involvement was observed in certain areas, including several lymph nodes from the left paratracheal region and other sampled tissues where only normal structures such as parathyroid glands, skeletal muscle, and adipose tissue were identified."} +{"pid": "TCGA-BR-8680", "report": "The specimen is a gastrectomy with involvement of the antrum. The lesion measures 3 x 3 x 1 cm and is ulcerated. It demonstrates invasion into the serosa, with firm, gray areas noted. Microscopically, the lesion consists of tubular structures with cellular atypia. The cells show moderate stratification, hyperchromatic nuclei, irregular nuclear enlargement, and prominent nucleoli. Mitotic activity is present. The glands exhibit variability in size and shape, and there is evidence of necrosis and trabecular growth pattern. Stromal reaction includes infiltration by lymphocytes and the lesion shows areas of necrosis. Lymphatic invasion is present. Of the 10 lymph nodes examined, 3 are positive for metastatic involvement. No comment is provided on venous or perineural invasion, surgical margins, or neo-adjuvant treatment effect."} +{"pid": "TCGA-H4-A2HQ", "report": "The specimen consists of multiple fragments of red blood clot and pink/brown tissue, weighing a total of 26 grams and measuring 4.0 x 4.0 x 3.0 cm. A representative portion of the specimen was submitted for banking. Histologic evaluation reveals high-grade cellular changes with extensive involvement of the muscularis propria. The tissue fragments show malignant cells arranged in irregular clusters and infiltrative patterns. All relevant sections were reviewed, and findings were confirmed by an attending pathologist. Representative sections of the specimen were processed for microscopic examination."} +{"pid": "TCGA-BR-A4QM", "report": "Gross examination revealed a saucer-shaped lesion measuring up to 6.5 cm in the stomach, with transmural involvement. Multiple lymph nodes were noted to be enlarged and hyperemic. The omentum contained nodular lesions up to 0.5 cm in diameter. Two white nodular areas, measuring up to 3 cm each, were observed on the surface of the sple.\n\nMicroscopically, the tissue showed a poorly differentiated epithelial neoplasm with mucin production and associated ulceration. Tumor infiltration was identified extending into the perigastric adipose tissue. All six lymph nodes examined from both the greater and lesser curvatures contained metastatic deposits. The omentum also demonstrated similar metastatic involvement. The spleen exhibited signs of red pulp congestion. Surgical margins were free of tumor.\n\nMeasurements of the primary specimen were recorded as 6.5 cm in greatest dimension. Lymph node analysis showed 6 out of 6 involved nodes. Metastatic disease was confirmed in regional lymph nodes and in the omentum. No venous invasion was identified. There was no evidence of treatment effect."} +{"pid": "TCGA-KK-A7B0", "report": "The specimen included left and right pelvic lymph nodes, with a total of five nodes on the left and twelve on the right; all were free of tumor. The prostate and seminal vesicles were also examined. The prostate measured 5.2 x 3.0 x 4.5 cm and weighed 42 grams post-fixation. Two distinct nodules were identified: one located in the peripheral and transition zones involving the left anterior, left anterolateral, left lateral, left posterolateral, left posterior, mid posterior, and right posterior regions, measuring 2.5 x 2.0 cm in its largest cross-sectional dimension; and another smaller focus in the right transition zone measuring 1.0 x 0.4 cm. The larger nodule extended focally into extraprostatic tissue on the left anterior surface, left posterolateral surface, and left superior neurovascular bundle region, with an added length of extraprostatic extension measuring 5.5 mm. Both tumor foci were present in multiple cross sections of the prostate and involved the apex and base. Tumor invasion was noted in both the right and left seminal vesicles. All resection margins were free of tumor. Perineural invasion was present; no lymphovascular invasion was observed. Tissue from the right and left vasa deferentia showed no involvement. Multiple sections were taken from the prostate, seminal vesicles, and vas deferens for histological evaluation."} +{"pid": "TCGA-AA-A00N", "report": "The ileocolonic resection specimen includes a lesion measuring up to 7.5 cm in diameter, located in the cecum and ascending colon. Histological examination reveals a poorly differentiated component with mucinous features. The lesion demonstrates focal penetration through the muscularis propria into the serosa. No evidence of tumor involvement is identified in the regional lymph nodes (0 out of 21 examined), nor in the small or large intestinal resection margins, mesenteric margin, or omental fat tissue. Histopathologic evaluation indicates high-grade cellular atypia (G3), with lymphatic invasion noted (L1) but no vascular invasion (V0). Surgical resection margins are free of tumor involvement (R0). Immunohistochemical or special staining techniques did not reveal any additional metastatic deposits in the lymph node that underwent decalcification."} +{"pid": "TCGA-SI-AA8B", "report": "The specimen consists of a soft tissue mass excised from the left thigh, measuring 20 x 14 x 12 cm in greatest dimension. The mass is surrounded by a pseudocapsule and demonstrates cystic and hemorrhagic changes on cross-section with areas of suspected necrosis. A skin ellipse measuring 13 cm in length and 3 cm in width is included, along with underlying fibroadipose tissue 2 cm thick. Attached skeletal muscle fragments are present at multiple locations around the specimen. Inked margins are designated as follows: 12 to 3 to 6 o\u2019clock in blue and 6 to 9 to 12 o\u2019clock in black.\n\nHistologic examination reveals a high-grade neoplasm composed of spindle cells arranged in a fascicular pattern, interspersed with pleomorphic, polygonal, and multinucleated giant cells. Mitotic activity is markedly increased, and rare foci of necrosis are identified. The tumor exhibits focal involvement at the black inked deep margin (block A12). Two lymph nodes were identified adjacent to the tumor mass; one demonstrates tumor growth along its periphery, but there is no evidence of discontinuous spread.\n\nThe lesion is classified as high grade (Grade 3 of 3) according to the FNCLCC system. Based on size greater than 5 cm and deep location, the tumor is staged as T2b. No regional lymph node metastasis was identified (N0), and distant metastasis could not be assessed (MX), resulting in a provisional stage grouping of T2b/N0/MX/G3 (Stage III). The absence of orientation markers in the specimen limits definitive spatial correlation of tumor margins, though clinical correlation may aid in interpretation if necessary."} +{"pid": "TCGA-O1-A52J", "report": "The surgical pathology specimen consists of a left lower lobe basilar segmentectomy. Microscopic examination reveals a well-differentiated epithelial neoplasm with features resembling Clara cells. The tumor measures 2.6 x 2 x 1.2 cm and is located in the mid portion of the lobe, with a distance of 1.9 cm from the overlying pleura and 0.8 cm from the bronchial and vascular margins. All evaluated margins (bronchial, vascular, parenchymal, and pleural) are free of involvement. There is no evidence of vascular invasion, multiple tumor nodules, or panlobar atelectasis. The visceral pleura and mainstem bronchus are also negative for involvement.\n\nImmunohistochemical analysis demonstrates strong and diffuse cell membrane staining for epidermal growth factor receptor (EGFR) in approximately 100% of the neoplastic cells (score 3+). In contrast, HER2/neu immunostaining shows no membranous reactivity in the tumor cells (score 0). Benign basal bronchiolar epithelial cells serve as an internal positive control for EGFR staining.\n\nFluorescence in situ hybridization (FISH) using probes targeting the EGFR region on chromosome 7 (7p11.1-q11.2) and the centromere of chromosome 7 (D7Z1) was performed. Analysis of 60 tumor nuclei reveals an average EGFR copy number of 5.4, with 95% of cells showing increased copy number. The average chromosome 7 copy number is 9.2, with 35% of cells having increased copy number. The EGFR to D7Z1 ratio averages 1.11 \u00b1 0.35, with 74% of cells having a ratio \u22652.0. These findings suggest polysomy of chromosome 7 but do not meet the threshold for gene amplification based on current criteria.\n\nLymph node staging includes evaluation of level 4R, 4L, 7, and 10 lymph nodes, all of which are negative for tumor involvement. Two lobar lymph nodes within the lung specimen are also free of malignancy. Based on these findings, the pathologic stage according to the AJCC 6th edition is pT1 pN0 pMx.\n\nAdditional histologic findings include mild centrilobular emphysema and a small, focal non-necrotizing granuloma. No other significant pathology is identified in the submitted tissue."} +{"pid": "TCGA-41-3393", "report": "The specimen consists of three tissue samples. The first sample includes multiple fragments of soft tan tissue measuring 1.2 x 0.8 x 0.5 cm in aggregate, with a portion submitted for tissue procurement and the remainder placed in block A1. The second sample is a single fragment of firm tan tissue measuring 0.8 x 0.5 x 0.5 cm. The third sample comprises multiple pink-tan friable tissue fragments measuring 1.5 x 1.0 x 0.5 cm in aggregate and was entirely submitted in one cassette.\n\nMicroscopic examination of all three specimens reveals cellular features consistent with high-grade neoplastic involvement. The tissue demonstrates marked pleomorphism, frequent mitotic figures, microvascular proliferation, and areas of necrosis. Cellular morphology suggests an astrocytic lineage. Staging assessment indicates locally invasive growth without evidence of distant metastasis."} +{"pid": "TCGA-3A-A9IJ", "report": "The pathology report includes findings from multiple specimens. A periduodenal lymph node biopsy showed no evidence of malignancy. The gallbladder specimen showed no significant abnormalities. A retroperitoneal lymph node biopsy demonstrated sinus histiocytosis without malignancy.\n\nThe pancreaticoduodenectomy specimen contained a well-circumscribed, solid mass measuring 3.5 cm in diameter located in the pancreatic head. Histologic evaluation revealed a well-differentiated endocrine neoplasm confined to the pancreas with no lymphatic, vascular, or perineural invasion identified. All surgical margins were free of neoplastic cells. Mitotic activity was absent (0 per 10 high-power fields). Adjacent pancreatic tissue showed focal PanIN-3 changes and atrophy, along with a retention cyst. Sixteen regional lymph nodes were examined and none contained metastatic disease.\n\nAdditional specimens including the omentum and final pancreatic margin showed no evidence of neoplasm. The omental specimens consisted of benign adipose tissue with areas of hemorrhage. The pancreatic margin showed necrosis and a retention cyst, but no tumor involvement.\n\nFrozen section analysis confirmed negative margins at the retroperitoneal resection site, pancreatic resection margin, and common bile duct margin. Gross examination of the resected pancreas and surrounding structures confirmed no gross evidence of tumor involvement beyond the previously identified lesion.\n\nMultiple ancillary studies including immunostains for insulin, glucagon, pancreatic polypeptide, vasoactive intestinal polypeptide, and gastrin were negative. No additional diagnostic abnormalities were identified in other submitted tissues."} +{"pid": "TCGA-DX-A3UD", "report": "The left radical nephrectomy specimen includes a kidney with attached ureter, renal vessels, and perinephric fat, weighing 476.5 g. The kidney measures 12.7 x 6.5 x 3.7 cm, and the attached ureter is 2.3 cm in length and 0.3 cm in diameter. The renal vein is 8.3 cm long and 2.6 cm in diameter. A multinodular firm tan mass measuring 8.5 x 4.3 x 3.5 cm is present within the renal vein, causing expansion. This mass is located 2.5 cm from the renal hilum and 1.0 cm from the adrenal gland. A separate nodular focus of tissue, 0.9 cm in size, is identified adjacent to a large vessel in the renal hilum.\n\nMicroscopic evaluation reveals a high-grade cellular proliferation with a mitotic rate up to 12 mitoses per 10 high power fields. There is evidence of coagulative necrosis and diffuse nuclear atypia. The surgical resection margin of the renal vein contains tumor; however, it appears free-floating and not firmly attached to the vessel wall, raising uncertainty about whether this represents a true positive margin. Clinical correlation is advised.\n\nA portion of adrenal gland measuring 1.6 x 0.9 x 0.6 cm is also present and shows no abnormal findings. A separate specimen labeled as the left adrenal gland consists of red-pink to yellow-tan fibroadipose tissue, measuring 5.5 x 2.4 x 1.5 cm, with a staple line noted. Sectioning reveals a 2.4 x 2.8 x 0.9 cm triangular yellow-orange adrenal structure without gross lesions. All submitted sections appear benign.\n\nAdditional findings include a cyst in the lower pelvis measuring 3 x 2.5 x 2.5 cm and a possible lymph node measuring 0.9 cm in the hilum. Representative sections of the kidney, renal pelvis, ureter, renal vein margin, and other vessel margins have been submitted for further analysis."} +{"pid": "TCGA-BR-A4J5", "report": "Gross Description: A large ulcerated lesion is present in the lesser curvature-antrum region, measuring 3 x 4 x 1.5 cm. The lesion has a firm consistency and exhibits a myxoid gray surface. Microscopic evaluation shows ulceration of the mucosa. The lesion is characterized by extensive pools of extracellular mucin containing malignant epithelial components arranged in cord-like, acinar, adenoid, or signet ring cell patterns. There is evidence of invasion extending to the serosal layer. Nuclear features include hyperchromasia, irregular enlargement, and prominent nucleoli. Mitotic figures are present.\n\nSpecimen type is gastrectomy, with the lesion located in the antrum. The size corresponds to the previously mentioned dimensions. Key features include ulceration and a histologic appearance consistent of a poorly differentiated pattern. The extent of spread includes involvement of the serosa. Of the lymph nodes examined (5 total), one adjacent node contains metastatic cells. Lymphatic, venous, and perineural invasion were not specified. Surgical margins, response to preoperative therapy, and additional findings were not reported."} +{"pid": "TCGA-AP-A0LH", "report": "The surgical specimens submitted included the uterus, cervix, bilateral fallopian tubes and ovaries, as well as multiple lymph node groups from both sides, including the external iliac (lateral and medial), obturator, hypogastric, and para-aortic regions.\n\nExamination of the uterine specimen revealed a polyp measuring 2.0 x 1.0 cm with cellular features indicative of a mixed growth pattern. The dominant component showed characteristics of a high-grade morphology, confined entirely within the polyp. Vascular invasion was identified within the polyp. Additionally, benign fibroid tumors were noted in the myometrium. The cervix, fallopian tubes, and ovaries showed no evidence of abnormal cellular changes.\n\nAll lymph nodes examined across all regions were histologically benign. No malignant involvement was identified in any of the lymph node specimens. Each lymph node group showed no signs of metastatic disease, with normal architecture preserved and no atypical cells present.\n\nThe findings are based on personal microscopic examination of the tissue slides, and the report has been reviewed and approved."} +{"pid": "TCGA-HZ-7918", "report": "The surgical panel included multiple specimens. The left hepatic ligament biopsy showed a benign simple cyst with no malignancy identified. A lymph node from the hepatic artery was benign and negative for malignancy. The gallbladder specimen showed no abnormalities and was also negative for malignancy, along with a single lymph node at the cystic duct that was free of malignancy.\n\nThe Whipple resection specimen included portions of the stomach, duodenum, and pancreas. A solid white tumor measuring 5.5 x 5 x 3.2 cm was identified in the pancreatic head region. The tumor extensively infiltrated the pancreatic tissue and extended into surrounding adipose tissue. Invasion of angiolymphatic spaces and perineural structures was observed. The tumor reached the portal vein groove and involved the portal vein margin, with a small fragment positive for tumor involvement. The remaining margins were negative, though the tumor approached as close as 0.1 cm at the uncinate margin.\n\nLymph node examination revealed 21 peripancreatic lymph nodes, 11 of which contained metastatic disease. The largest metastatic focus measured 1.5 cm, and extracapsular extension was present. No malignancy was found in the re-excised segment of the portal vein.\n\nMicroscopic evaluation confirmed extensive tumor involvement, including lymph-vascular and perineural invasion. Based on these findings, staging was performed. The extent of primary tumor invasion was classified as pT3, indicating growth beyond the pancreas but without involvement of the celiac axis or superior mesenteric artery. Regional lymph node involvement (pN1) was confirmed due to the presence of metastases in multiple lymph nodes. No distant metastases were identified (pM0). The final pathologic stage was determined accordingly.\n\nA total of 27 cassettes were submitted for detailed histologic analysis of the Whipple specimen, including margins, tumor sections, lymph nodes, and surrounding tissues. Additional sections were taken for possible ancillary studies. Photographs were also obtained for documentation."} +{"pid": "TCGA-LL-A7T0", "report": "A total mastectomy specimen from the left breast was submitted, along with axillary lymph node sampling. The left breast specimen measured 24.0 x 23.0 x 5.5 cm and weighed 1,094 grams. A medial tumor mass was identified beneath the areola, measuring up to 2.8 cm in greatest dimension. A second separate tumor focus was found in the lower inner quadrant, measuring 1.3 cm. The closest margin for the invasive component was 4 mm at the deep margin, and for the in situ component, 1 mm at the deep margin.\n\nHistologic evaluation revealed a combined histologic grade of 3 of 3. The Nottingham histologic score breakdown included glandular/tubular differentiation (score 3), nuclear pleomorphism (score 3), and mitotic rate (score 3), resulting in an overall Grade 3 classification. High-grade ductal carcinoma in situ was also present, with an estimated size of at least 5 cm. Necrosis was noted within the central region.\n\nAxillary lymph node dissection included levels 1 and 2. A total of four lymph nodes were examined, with one showing metastatic involvement. The largest metastatic deposit measured 7 mm. No extranodal extension was observed.\n\nAncillary studies demonstrated strong estrogen receptor positivity (100% of tumor cells) and weak progesterone receptor positivity (2% of tumor cells). HER2 immunostaining was positive (score 3+).\n\nThe surgical specimen was consistent with a simple mastectomy. The tumor was located medially, approximately 0.7 cm from the skin surface and 4.5 cm from the deep margin. The cut surface of the tumor was gritty and indurated. A second smaller tumor focus was identified deeper in the lower inner quadrant, measuring 1.3 cm and located 0.3 cm from the deep margin.\n\nSections sampled included the nipple, areola, pigmented skin papule, margins, and both tumor masses. All relevant areas were submitted for analysis. The remainder of the breast tissue was predominantly fatty with minimal fibrous tissue.\n\nLymph node specimens consisted of four nodes, all submitted for histologic evaluation. One lymph node contained metastatic disease."} +{"pid": "TCGA-DU-A5TU", "report": "A 5.6 cm lesion was identified in the bifrontal, parasagittal region with abnormal signal, gyral expansion, minimal enhancement, and associated edema with mass effect. Histologic evaluation of the biopsy specimen reveals a diffusely infiltrating glial neoplasm within the cerebral cortex. Microcystic changes are present. No mitotic figures are identified. There is mild endothelial hyperplasia, though no microvascular proliferation or necrosis is observed. The tumor cells show immunoreactivity for IDH1, and the MIB-1 proliferation index is 2%. Molecular analysis for chromosomal arms 1p and 19q does not demonstrate allelic loss. The histologic and molecular features are consistent with a low-grade glioma. The tissue used for analysis consisted of three small fragments measuring 0.6 cm in aggregate, with a gross appearance described as semi-firm and greyish-pink. Intraoperative smears were performed and reviewed. The tumor DNA was extracted from paraffin-embedded tissue, and a paired blood sample served as a control. No microdissection was required. The markers used for allelic loss assessment included D1S552, D1S468, D1S1612, D1S496, D1S548, D1S1592, D19S412, D19S606, D19S219, PLA2G4C, and D19S1182. The test used to assess allelic status was developed in compliance with CLIA regulations and has not been cleared by the FDA. The presence of more than 15% non-neoplastic cells in the sample could affect the ability to detect allelic loss."} +{"pid": "TCGA-A2-A0CK", "report": "The specimen consists of right breast tissue from a female patient. The excised tissue measured 2 x 1 x 1 cm and was largely composed of fat with fibrous elements. Microscopic evaluation identified a lesion measuring 0.5 cm. Histologic analysis revealed features including in situ changes, perineural involvement, and the presence of microcalcifications. Immunohistochemical staining showed no overexpression of HER2/neu (score 1+). Fluorescence in situ hybridization (FISH) for HER2/neu gene amplification yielded a ratio of 1.1, below the threshold of 2.0, indicating no gene amplification. ER/PR immunostains were negative. The surgical margins were involved. Staging according to AJCC criteria is Stage I (T1, NX, MX). The pre-operative imaging had identified a complex mass measuring 1 x 0.6 cm in the retroareolar region, with differential considerations including fibrous tissue versus malignancy."} +{"pid": "TCGA-LB-A9Q5", "report": "The specimen was received for analysis following a pancreaticoduodenectomy procedure. The resected specimen measured 10 cm across the lesser curvature, 9 cm along the greater curvature, with a proximal gastric margin of 7 cm and a duodenum measuring 13 cm in length and 3 cm in diameter. The common bile duct measured 1 cm in length and 1.5 cm in diameter at the margin. The pancreatic head measured approximately 5.5 x 5 x 4 cm. A fibrotic mass was identified in the pancreatic head during intraoperative evaluation, with a gray-white appearance and firm texture. Gross margins appeared free of involvement.\n\nMicroscopic examination revealed a poorly differentiated adenocarcinoma measuring approximately 3 cm in greatest dimension. The tumor extended into the duodenal wall, ampullary region, and peripancreatic soft tissues without involvement of the duodenal mucosa. Perineural and lymphovascular invasion were present. Regional lymph node evaluation identified three positive nodes out of twelve examined. Two of five peripancreatic lymph nodes contained metastatic carcinoma with extranodal capsular extension noted. Six lesser curvature lymph nodes were negative for malignancy. Margins of resection were uninvolved by invasive carcinoma. The closest margin was located at the retroperitoneal/uncinate process, measuring 4 mm from the tumor.\n\nImmunohistochemical staining demonstrated positivity for CK7 and CA19-9, while CK20 and CDX2 were negative. Based on morphologic features, the tumor appeared to originate within the pancreaticobiliary tract. Pathologic staging classified the primary tumor as pT3 based on extension beyond the pancreas into surrounding tissues. Regional lymph node involvement was staged as pN1 due to the presence of metastases in more than one lymph node. No distant metastases were identified.\n\nAdditional specimens included a pancreatic margin showing pancreatic intraepithelial neoplasia grade 1 without invasive carcinoma. The common bile duct margin revealed inflammation and reactive epithelium without evidence of malignancy. One peripancreatic lymph node submitted separately showed metastatic adenocarcinoma.\n\nThe specimen was fixed overnight and extensively sampled for histologic evaluation. Multiple sections were taken from key areas including the ampulla of Vater, retroperitoneal margin, and tumor regions. Lymph nodes were identified along the peripancreatic and lesser curvature regions, with sizes ranging from 0.8 to 1.5 cm. Intraoperative frozen section analysis confirmed absence of invasive carcinoma at both pancreatic and common bile duct margins."} +{"pid": "TCGA-44-6776", "report": "The specimen included a right hilar lymph node measuring 1.3 \u00d7 0.6 \u00d7 0.4 cm, which was diffusely cauterized and entirely submitted. Multiple fragmented lymph nodes from station 4R measured up to 1.8 cm in aggregate and were also submitted completely. The right upper lobe specimen weighed 159 grams and measured 15.5 \u00d7 10.7 \u00d7 3.9 cm, with a smooth to slightly wrinkled tan-pink surface and moderate anthracosis. A bronchial stump measuring 1.4 \u00d7 0.6 cm in diameter was identified at the hilum. A sub-pleural lesion measuring 2 \u00d7 1.9 \u00d7 1.5 cm was present, located 0.35 cm from the pleural margin and more than 3 cm from the bronchial margin. The remaining lung tissue appeared spongiform with minimal anthracosis. No other discrete masses were found. Several soft gray-black hilar lymph nodes up to 1.8 cm were recovered and sampled. The station 7 lymph node measured 2.2 \u00d7 0.8 \u00d7 0.4 cm and was entirely submitted.\n\nMicroscopic evaluation revealed a moderately differentiated lesion with a prominent bronchioalveolar growth pattern. The primary lesion measured 2 cm in greatest dimension and was confined to the lung (pT1). Resection margins were free of involvement. Vascular invasion was not observed. Lymph node assessment showed no evidence of metastatic involvement (pN0). Distant metastasis could not be assessed (pMX). Additional findings included emphysematous changes and lymph nodes showing features consistent with a specific benign lymphocytic process, confirmed by special stains."} +{"pid": "TCGA-BF-A3DM", "report": "Male, unspecified ethnicity. Tumor located in the skin, primary site. Histological evaluation shows a grade 3 tumor. T stage is 4, with no nodal (N0) or distant metastasis (M0). No prior treatment reported. The tumor specimen was obtained surgically and preserved in frozen tissue format within a cryomold. A matched normal blood sample was collected via blood draw and stored frozen in a tube. Cellular analysis indicates the presence of abnormal melanocytes with high mitotic activity and poor differentiation. Tumor dimensions and depth of invasion correspond to advanced local disease."} +{"pid": "TCGA-AP-A0L9", "report": "The submitted specimens include the uterus, cervix, bilateral fallopian tubes and ovaries, anterior vaginal wall, multiple left and right pelvic and para-aortic lymph node groups, and omentum. The endometrium contains a polypoid lesion with abnormal cellular proliferation. The cells show atypical features and are arranged in a papillary and serous pattern. No evidence of invasion into the myometrium, endocervix, or vascular spaces is identified. The remainder of the endometrium appears normal. The myometrium contains benign smooth muscle nodules. All other tissues examined, including the cervix, parametrial tissue, vaginal biopsy, omentum, and all lymph nodes, show no evidence of malignant involvement. All lymph nodes from the left and right external iliac, obturator, common iliac, and para-aortic regions are histologically benign. The anterior vaginal wall biopsy shows normal squamous epithelium and fibromuscular tissue. The omental tissue consists of benign adipose and fibrous elements."} +{"pid": "TCGA-DF-A2KN", "report": "The sample was obtained from the uterus via surgical resection. The tissue specimen measured 6 cm in size. Histological evaluation revealed endometrioid-type cells with a grade III degree of differentiation. Pathological staging was determined as T1c. No lymph nodes were sampled during the procedure. Clinical staging indicated no distant metastasis (M0). Additional histological features were noted but not specified. The patient underwent the procedure 14 days after diagnosis, with no prior procedures recorded."} +{"pid": "TCGA-F5-6812", "report": "The excised tissue specimen from the rectus abdominus measured 3.5 \u00d7 3 \u00d7 1 cm and exhibited an exophytic (polypoid) growth pattern. Microscopic examination revealed moderately differentiated histology with involvement of perirectal tissues. Lymph node evaluation showed no metastatic involvement (0/1 regional nodes positive). No evidence of neoadjuvant treatment effect was identified. Other pathological features and margins were not specified."} +{"pid": "TCGA-CH-5761", "report": "The specimen includes tissue from the left rectolateral and basal peripheral zone, showing a lesion with maximum tumor spread measuring 2.6 cm. There is extensive perineural infiltration and extraprostatic extension in the left rectolateral and basal region, along with involvement of the left seminal vesicle. The surgical margins in the left rectolateral and basal area are affected. Additional findings include tumor-free fatty connective tissue containing vessels and nerves, as well as fatty tissue specimens containing two and three tumor-free lymph nodes, respectively.\n\nHistological assessment reveals cells arranged in a multifocal and elongated pattern in the left lateral and basal region. The preparation margin shows contact surfaces measuring up to 8 mm in maximum dimension and approximately 17 mm in width. Immunohistological analysis using CD31 did not reveal vascular invasion or evidence of metastatic involvement in the lymph nodes previously identified. No disseminated tumor cells were detected in these lymph nodes.\n\nFurther immunohistological evaluation has been initiated at the clinician\u2019s request to assess chromatin expression. This information will be included in an upcoming follow-up report."} +{"pid": "TCGA-L5-A43E", "report": "The specimen from the distal esophagus and proximal stomach measures 7.2 cm in length with an internal circumference of 2.3 to 4.7 cm, and the proximal stomach segment is 4.0 cm in length with a 9.5 cm internal circumference. A mass measuring 7.0 x 4.0 x 4.0 cm is present, located 3.5 cm above the gastroesophageal junction, 3.0 cm from the proximal staple line, and 4.5 cm from the distal gastric resection margin. The mass is tan, multilobulated, and polypoid with solid cut surfaces, and does not grossly invade the underlying wall. Surrounding perigastric adipose tissue contains multiple lymph node candidates ranging from 0.2 to 1.0 cm. Sections submitted include a longitudinal section through the mass, radial margins, and lymph node candidates. A separate specimen of the cervical esophageal margin is a 0.8 cm stapled cuff, submitted en face. The appendix is 5.5 cm in length, with a 0.3 cm thick wall and a pinpoint lumen, showing no significant abnormality. Microscopic examination reveals a focus of undifferentiated cellular proliferation extending into the superficial submucosa, with the remainder of the lesion confined to the mucosa. Resection margins are uninvolved. Ten lymph nodes are negative. The surrounding mucosa shows extensive high-grade atypical changes."} +{"pid": "TCGA-VS-A9UU", "report": "The biopsy specimen was obtained from the cervix. Histologic evaluation revealed a neoplastic lesion composed of atypical squamous cells arranged in sheets and nests, with evidence of keratinization. The tumor demonstrates invasion into the underlying stroma, with a maximum depth of invasion measuring 5 mm. The lateral margins are involved. The tumor is ulcerated. No lymphovascular space invasion is identified. No lymph node metastasis is present."} +{"pid": "TCGA-AP-A0LM", "report": "The surgical specimens include an enlarged left external iliac lymph node, a total hysterectomy with bilateral salpingo-oophorectomy, omentectomy, and multiple lymph node dissections from both left and right sides including external iliac, obturator, common iliac, and para-aortic regions. \n\nHistologic evaluation of the uterine specimen reveals a neoplastic process involving the endometrium. The lesion demonstrates endometrioid-type morphology with papillary features. Architecturally, it corresponds to FIGO Grade II based on 6\u201350% solid growth pattern, and is classified as nuclear Grade 3. The tumor extends beyond half of the myometrial thickness, with maximal invasion measuring 22 mm in depth within a myometrial area that is 31 mm thick. No involvement of the endocervix is identified. Vascular space invasion is present. The remainder of the endometrial tissue shows secretory phase changes with stromal decidualization. Both ovaries contain benign-appearing follicular cysts, and all other adnexal structures are unremarkable.\n\nLymph node analysis reveals no evidence of malignancy in the left external iliac (2 benign nodes), left obturator (1 benign node), left common iliac (1 benign node), left para-aortic (8 benign nodes), right external iliac (5 benign nodes), and right obturator (12 benign nodes) regions. In contrast, one of five lymph nodes from the right para-aortic group contains metastatic tumor cells.\n\nImmunohistochemical staining of the tumor demonstrates positivity for progesterone receptor (PR), but not estrogen receptor (ER) or p53. Beta-catenin immunostaining exhibits a membranous pattern, and the MIB-1 proliferation index is moderately high. These findings do not support a diagnosis of serous carcinoma. \n\nThe omental tissue sections show no histopathologic abnormalities. All diagnoses are based on direct microscopic examination of the submitted tissues."} +{"pid": "TCGA-50-7109", "report": "The specimen from the right lower lobe, superior segment, measures 2.0 cm and is composed of tissue with moderate inflammation and desmoplastic reaction. Microscopic evaluation reveals a mixture of architectural patterns. The cellular morphology demonstrates features consistent with moderate differentiation. Vascular and bronchial margins are involved. A stapled parenchymal margin is uninvolved. Evidence of perineural invasion is present. Focal findings suggest possible vascular or lymphatic involvement. Emphysematous changes are also noted.\n\nLymph node biopsies from levels 4, 7, 8, 10, and 11 show only anthracotic changes without evidence of malignant cells. A total of five lymph node samples were evaluated, with no positive findings for tumor involvement.\n\nAncillary immunohistochemical staining shows positivity for TTF-1, with rare p63 positivity and no expression of cytokeratin 5/6. These findings are supportive of a specific cell type and pattern. Selected slides were reviewed and correlate with the findings described. The pathologic staging is pT1 with no lymph node involvement. Distant metastasis could not be assessed."} +{"pid": "TCGA-D1-A0ZQ", "report": "The specimen includes a uterus with attached bilateral fallopian tubes and ovaries. A mass measuring 2.7 x 2.6 x 0.7 cm is present in the left cornu and posterior aspect of the uterine fundus, with myometrial invasion measuring 1.2 cm (total myometrial thickness 2.0 cm). No involvement of the endocervix is observed. The tumor does not demonstrate lymphovascular space invasion, and surgical margins are free of tumor. The right ovary contains a peritoneal inclusion cyst, while the left ovary shows a serous cystadenoma. Both fallopian tubes appear unremarkable. Staging is reported as AJCC pT1cNxMx. Immunohistochemical analysis reveals weak and spotty p53 immunoreactivity. Gross examination confirms the presence of the mass in the left cornu and posterior fundus with the described myometrial invasion. Five uterine leiomyomas are identified, ranging from 0.4 to 1.5 cm. The right ovary measures 4.6 x 3.1 x 2.8 cm with a cystic cut surface, and the left ovary measures 3.2 x 2.0 x 1.6 cm with a solid and cystic cut surface. Both fallopian tubes are small and unremarkable. Multiple tissue blocks were submitted for histologic evaluation."} +{"pid": "TCGA-A8-A08P", "report": "The specimen shows a focus of infiltrating cells with marked nuclear atypia and increased mitotic activity. The lesion measures up to 3 cm in greatest dimension and is surrounded by adipose-rich breast tissue showing signs of involution. There is evidence of lymphovascular invasion at the periphery. A single involved lymph node is identified macroscopically. No associated calcifications or in situ components are noted. The surgical margins are free of abnormal cellular aggregates. Staging indicates regional lymph node involvement with 4 out of 15 nodes positive. Distant metastasis could not be assessed. Histologic grade is high, with lymphovascular invasion present and no venous invasion observed."} +{"pid": "TCGA-W5-AA2W", "report": "Female. Surgery Date: A. Lymph nodes, hepatoduodenal ligament, lymphadenectomy \u2013 four lymph nodes are negative for tumor. B. Soft tissue, interductal region, biopsy: Grade 3 (of 4) is present. C. Liver, segments I and V through VIII, resection: Moderately differentiated grade 3 lesion identified, forming a single mass measuring 6.2 x 5.5 x 3.1 cm. The lesion is confined to the hepatic parenchyma with a mass-forming growth pattern. The hepatic parenchyma resection margin is free of tumor, with a minimum tumor-free margin of 0.3 cm. Major vessel invasion is not observed, though microscopic vessel invasion is present. No regional lymph nodes are identified. D. Lymph node, periaortic, lymphadenectomy: One of 11 lymph nodes is positive for involvement."} +{"pid": "TCGA-K4-A83P", "report": "The specimen was obtained from a patient and included multiple tissue samples. Lymph node analysis showed no evidence of abnormal cells in both left and right pelvic regions, with six nodes examined on each side. Microscopic evaluation of the distal ureters revealed no concerning cellular changes, though one showed signs of chronic inflammation.\n\nExamination of the neurovascular bundle showed atypical cells with features suggestive of perineural invasion. The main specimen included the bladder, prostate, seminal vesicles, and distal ureters. Histologic evaluation revealed invasive high-grade cells with squamous and glandular features present. The tumor measured at least 5 cm and displayed extensive involvement of surrounding structures including the prostate, seminal vesicles, and vas deferens. The surgical margins of the soft tissue were involved, while the ureteral and urethral resection margins were free of abnormal cells.\n\nLymphatic and perineural invasion were identified. Additional findings included dysplastic changes and in situ lesions within the bladder and prostate. A total of 15 lymph nodes were evaluated, with one showing involvement. The tumor extended macroscopically beyond the bladder and prostate, with direct stromal invasion noted. Frozen section analysis of the ureters showed no abnormal cells, while the neurovascular bundles required further evaluation for confirmation. The specimen was extensively sampled, with multiple sections submitted for detailed histologic review."} +{"pid": "TCGA-DF-A2KU", "report": "The sample was obtained from an endometrial mass via surgical resection. The patient underwent the procedure at the time of diagnosis, with no prior procedures reported. The tumor measured 5.5 cm in size and was classified as Grade III based on differentiation. Pathological staging indicated a T1b classification. No lymph nodes were sampled; however, all examined nodes showed evidence of involvement. Microscopic evaluation revealed features consistent with endometrioid adenocarcinoma, although no specific subtype was identified. No clinical metastasis was documented at the time of assessment."} +{"pid": "TCGA-XF-A8HB", "report": "The surgical specimen included a urinary bladder with a fungating papillary lesion measuring 5.5 x 3.5 x 1.5 cm located in the upper posterior wall. Microscopic evaluation showed invasive papillary urothelial carcinoma extending into the deep muscularis propria without penetrating through it. High-grade cellular changes were also present in multiple flat areas involving the anterior, posterior, and left lateral walls of the bladder. All surgical margins were free of abnormal cells. No evidence of malignancy was found in any of the ureteral segments examined, including right medial, right lateral, right distal, left distal, left proximal, right medial proximal, and right internal proximal ureteral margins.\n\nA total of 45 lymph nodes were evaluated, including perivesical, para-aortic, paracaval, common iliac, external iliac, Cloquet, obturator/hypogastric, presacral, and pre-sciatic regions, as well as an isolated lymph node. None showed evidence of tumor involvement. The perivesical fat, vaginal mucosa, uterus, cervix, fallopian tubes, and ovaries were all unremarkable, with no significant lesions identified. The endometrium showed proliferative changes, and the cervix displayed chronic inflammation with squamous metaplasia. The bilateral adnexa appeared normal. No lymphovascular invasion was confirmed, although it was suspected on initial assessment."} +{"pid": "TCGA-W5-AA38", "report": "The liver specimen from segment VIII includes two portions. The first portion weighed 10.92 grams and measured 3.8 x 2.9 x 2.2 cm. A subcapsular, necrotic mass measuring 2.8 x 1.8 x 0.8 cm was identified, located 0.4 cm from the nearest surgical margin. The margin was inked and submitted perpendicularly. Histologic evaluation of this area showed fibrosis with associated acellular debris, and no abnormal cellular proliferation was identified.\n\nThe second portion of the liver specimen weighed 9.19 grams and measured 3.7 x 2.3 x 1.9 cm. Within this segment, a well-circumscribed tan-white mass measuring 1.4 x 1.2 x 1.1 cm was found, located 0.6 cm from the closest surgical resection margin, which was also submitted perpendicularly. Histologic analysis demonstrated a poorly-differentiated cellular infiltrate involving the mass area, although the resection margin was free of any such findings. \n\nAll findings were confirmed through review of permanent H&E sections. No further changes are expected unless new findings arise from additional testing."} +{"pid": "TCGA-IN-7808", "report": "The excised skin specimen from the left chest wall revealed an angiomatous lesion. Lymph node dissection included multiple lymph node groups. Three lymph nodes from level 8 showed no evidence of metastatic disease. One lymph node from a gastric site demonstrated involvement by atypical cells with signet ring morphology, consistent with metastatic involvement. A separate resected liver specimen showed cauterized changes and focal chronic inflammation, with no evidence of malignancy. Iliac lymph nodes were also involved by signet ring cell type metastases, with three lymph nodes affected. An additional gastric lymph node was similarly involved.\n\nA surgical resection of the esophagus and stomach revealed a poorly differentiated invasive neoplasm with signet ring cell features and focal mucinous characteristics, located at the gastroesophageal junction. The tumor measured 3.5 x 3.0 cm macroscopically but extended over a length of approximately 20 cm from the proximal to distal resection margin. The tumor infiltrated through the esophageal adventitia and gastric serosa. Widespread lymphovascular and perineural invasion was present. All sixteen lymph nodes examined were involved, with extensive extracapsular extension noted. Tumor was present at both the proximal and distal resection margins, and the serosal surface was involved. A small focus of metastatic disease was also identified in the omentum.\n\nA second resection of the anastomotic site involving the esophagus and small bowel did not show any residual tumor. A separate segmental resection of the small bowel showed only focal acute serositis, with no evidence of tumor involvement.\n\nHER2 fluorescence in situ hybrididization (FISH) studies were performed on a tissue sample and were negative, with 74 cells analyzed and 12.2% showing hyperdiploidy. HER2 immunostaining was also negative, with an IHC score of 0. \n\nPathologic staging according to the AJCC 7th edition was determined. The tumor exhibited extensive local and nodal spread, with positive circumferential margins and widespread lymph node involvement, including iliac lymph nodes. Additional findings included linitis plastica-type growth pattern. Proximal and distal resection margins were uninvolved; however, the adventitial margin was involved. A total of 20 lymph nodes were examined, with 23 found to be involved. The primary tumor was classified as pT3, regional lymph node involvement as pN3, and presence of distant metastasis as pM1. The histologic grade was poorly differentiated. No prior treatment history was available. Immunohistochemical staining for AE1/3 on the anastomotic ring specimen was negative, with appropriate control reactions."} +{"pid": "TCGA-44-2668", "report": "The right upper lobe specimen consists of a lung lobe weighing 375 grams and measuring 15.5 x 14 x 4.5 cm. A white solid mass measuring approximately 3.7 x 2.4 x 2.4 cm is present beneath a puckered pleural surface. Sections were taken from the tumor for analysis, along with a portion of the bronchial margin. Upon fixation, additional sections were examined. The right middle lobe nodule is a tan-white lesion measuring 1 x 0.6 x 0.4 cm within a stapled tissue specimen. Lymph node level 11 consists of a black soft tissue fragment measuring 0.5 cm. Node 4R includes three rubbery tan and red tissue fragments collectively measuring 1.5 x 2 x 0.5 cm. The right fat pad specimen contains three tan and red rubbery tissues measuring up to 1.7 cm in aggregate. Node level 7 consists of four pink and black soft tissue fragments measuring up to 1.5 cm in maximum dimension.\n\nMicroscopic examination reveals a lesion measuring 3 x 2.4 x 2.4 cm with moderate to marked nuclear atypia. The mitotic index is 2 mitoses per 10 high power fields. The bronchial and pulmonary margins are free of malignant cells. Elastic stain shows invasion into the visceral pleura. No vascular invasion is identified. One attached peribronchial lymph node does not show evidence of involvement. Adjacent lung tissue demonstrates bronchiolitis obliterans, endogenous lipoid pneumonia, and acute bronchopneumonia. The central portion of the lesion contains scarring with elastosis and necrosis. Focal changes resembling DIP-like patterns are noted away from the lesion.\n\nSections of the right middle lobe nodule demonstrate elastosis and chronic inflammation without evidence of malignancy. All examined lymph nodes (level 11, 4R, 2R fat pad, and level 7) show no signs of malignant involvement."} +{"pid": "TCGA-P5-A72Z", "report": "The clinical evaluation was performed for a lesion located in the brain. Gross examination revealed soft gray-whitish tissue fragments obtained from the right temporal lobe. Microscopic analysis demonstrated features consistent with a high-grade glial neoplasm, showing elevated proliferative activity as indicated by a Ki-67 index reaching up to 15%. The tumor exhibited characteristics of malignancy with anaplastic features. Based on histopathological assessment, the lesion is classified as Grade III."} +{"pid": "TCGA-D8-A1XO", "report": "Histopathological examination was performed on a resected left breast and axillary tissue. The breast specimen measured 22 x 18 x 6 cm, with a skin flap of 15 x 7 cm, and included axillary tissue measuring 7 x 5 x 3 cm. A lesion was identified in the outer lower quadrant of the breast, measuring 2.2 x 1.5 x 1.3 cm. It was located 1.5 cm from the lower boundary, 2 cm from the base, and 1.5 cm from the skin. Lymph nodes up to 1.5 cm in length were also present.\n\nMicroscopic evaluation revealed infiltrative growth within the breast tissue. A lesion in situ with pagetoid spread was observed. Glandular tissue showed signs of parenchymal atrophy. Involvement of the mamillary region was noted. Axillary lymph node analysis demonstrated the presence of metastatic involvement.\n\nImmunohistochemical staining showed Ki-67 expression in approximately 5% of cell nuclei. Neoplastic cells exhibited negative staining for E-cadherin and were positive for CK7. Histological grade was determined as NHG 2 based on mitotic count (3+2+1/0 mitoses per 10 HPF in a visual area of 0.55 mm\u00b2). Staging parameters indicated a T2 classification with metastatic involvement of regional lymph nodes (N1a)."} +{"pid": "TCGA-EW-A1P8", "report": "The surgical specimen consisted of a single intact lumpectomy specimen from the left breast, measuring 9 x 5 x 6 cm. The tumor measured 2.2 cm in greatest dimension and was located less than 0.1 cm from the posterior and lateral margins. Histologic evaluation revealed a poorly differentiated invasive carcinoma with high-grade nuclear pleomorphism and mitotic activity (Nottingham Grade 3). Margins were uninvolved by invasive carcinoma, with the closest distance to the posterior and lateral margins each measuring less than 1.0 mm.\n\nLymph node evaluation included sentinel lymph nodes, non-sentinel lymph nodes, and axillary contents. Sentinel lymph node #1 contained metastatic involvement with extranodal extension. Sentinel lymph node #2 also showed metastatic involvement with extranodal extension. One non-sentinel lymph node demonstrated metastatic involvement with extranodal extension. In the left axillary contents, 11 out of 12 lymph nodes contained metastatic involvement with extranodal extension.\n\nHistologic examination revealed lymphovascular invasion. Immunohistochemical staining showed less than 1% immunoreactive cells for estrogen and progesterone receptors, and HER2 testing was negative. Microcalcifications were identified within the invasive component.\n\nPathologic staging was determined as pT2 for the primary tumor and pN3a for regional lymph node involvement. No presurgical therapy was administered. Sentinel lymph nodes were evaluated using H&E multiple levels. All lymph node assessments confirmed metastatic involvement with extranodal extension.\n\nThe specimen was oriented with one stitch at the superior margin and two stitches at the lateral margin. Gross examination identified an ill-defined firm mass with hemorrhagic areas. Representative sections were submitted for microscopic evaluation."} +{"pid": "TCGA-B0-4814", "report": "The right radical nephrectomy specimen includes a 12.5 cm neoplasm with predominantly acinar growth pattern. Histologic evaluation shows moderately differentiated morphology with nuclear features corresponding to a Furman grade of 3 out of 4. The tumor is noted to focally extend beyond Gerota's fascia and involves the renal vein resection margin, both grossly and microscopically. Adjacent non-neoplastic kidney demonstrates findings of focal chronic interstitial nephritis. The adrenal gland appears unremarkable. Pathologic staging is determined to be pT4 with histologic grade G3; no lymph node assessment is provided (NX). A separate excision specimen from the liver contains metastatic neoplasm with extensive areas of necrosis noted. Morphologic features are consistent with origin from the previously described renal lesion."} +{"pid": "TCGA-E2-A15I", "report": "The specimens include four sentinel lymph nodes from the left axilla and a left breast mastectomy specimen. Sentinel lymph node #1 measured 0.5 x 0.4 x 0.3 cm and was entirely submitted for analysis. Sentinel lymph node #2 measured 0.4 x 0.3 x 0.3 cm and was also fully submitted. Sentinel lymph node #3 measured 1.2 x 0.6 x 0.4 cm, and sentinel lymph node #4 measured 1.3 x 1.1 x 0.5 cm; both were completely submitted after touch preparations were performed.\n\nThe left breast mastectomy specimen weighed 304 grams and measured 21 x 14 x 3.5 cm. It included a skin ellipse measuring 8.5 x 3.5 cm and a 0.5 cm flat nipple. The specimen was serially sectioned into 12 slices. A central inferior mass at the 6 o\u2019clock position measured 1.2 x 1 x 1 cm and was located 0.5 cm from the nearest anterior margin and 1.2 cm from the deep margin. A second firm mass in the upper outer quadrant (3 o\u2019clock position, slice 7 with clip) measured 3 x 2 x 2 cm and was located 2 cm from the nearest anterior margin and 2.5 cm from the deep margin. A third mass, also in the upper outer quadrant (1 o\u2019clock, slice 7), measured 1 x 0.9 x 0.7 cm and was located 1.2 cm from the nearest anterior margin and 2.5 cm from the deep margin.\n\nMicroscopic evaluation of the mastectomy specimen revealed multiple invasive foci. One of the largest invasive areas measured 2.1 cm and was located in the upper outer quadrant. Intermediate nuclear grade changes were identified. Non-invasive components showed cribriform architecture with central necrosis. Surgical margins were free of tumor involvement. Fibrotic changes consistent with prior biopsy were noted.\n\nAll four sentinel lymph nodes examined were negative for metastatic involvement. Immunohistochemical receptor status showed positivity for estrogen and progesterone receptors, and negativity for HER2 by FISH testing. Oncotype DX assay results indicated a recurrence score of 9, corresponding to a low risk of distant recurrence.\n\nStaging was determined as pT2N0, indicating no regional lymph node involvement. No vascular or lymphatic invasion was identified. A small percentage of ductal carcinoma in situ was present, primarily associated with the invasive component. Benign epithelial elements were also noted."} +{"pid": "TCGA-DK-A6B0", "report": "A male patient presented with a large mass in the bladder region, accompanied by right-sided hydroureteronephrosis. Surgical specimens included left and right distal ureters, distal urethral margin, a radical cystoprostatectomy specimen including the bladder, prostate, and seminal vesicles, and left and right pelvic lymph node dissections.\n\nFrozen section analysis of the left and right distal ureters and the distal urethral margin revealed no evidence of malignancy in these areas. Gross examination of the cystoprostatectomy specimen showed a fungating, friable, red-brown tumor located on the right lateral and posterior bladder wall measuring 6.5 x 6.0 x 3.8 cm. The tumor was noted to extend into the deep half of the muscularis propria but did not invade through the muscularis or reach the perivesical fat. No vascular or perineural invasion was identified. The surgical margins were free of tumor involvement. The remaining bladder mucosa showed signs of prior biopsy and focal ulceration.\n\nIn addition to the primary bladder lesion, two small incidental foci of a separate tumor were found in the right prostate, measuring 0.5 cm and 0.7 cm, respectively. These lesions were described as having a specific growth pattern and were confined within the prostate capsule without extension to the seminal vesicles, bladder neck, or surgical margins. The surrounding non-neoplastic prostate tissue showed features of nodular hyperplasia.\n\nLymph node dissection included 4 nodes from the left pelvis and 12 nodes from the right pelvis. All lymph nodes examined were negative for any abnormal cellular infiltration. A fragment of benign vas deferens was also identified in the right pelvic lymph node specimen.\n\nImmunostains including CD31, D2-40, and AE1/AE3 were used to support findings and confirm the absence of certain types of involvement. Selected slides were reviewed with a colleague, and agreement was reached on all interpretations.\n\nThe pathologic staging for the main bladder lesion was determined based on depth of invasion into the muscularis propria. For the separate lesion in the prostate, staging was based on its localization within the prostate and capsule. Both surgical sites were reported with clear margins."} +{"pid": "TCGA-DU-7300", "report": "The specimen consists of two parts submitted from a right frontal brain resection. Part A includes multiple small tissue fragments measuring 0.2 to 0.4 cm. Part B consists of larger tissue fragments measuring between 1.5 and 2.0 cm. Histologic examination reveals a hypercellular lesion with moderate nuclear pleomorphism. Increased mitotic activity is observed in some areas. No vascular hyperplasia or tumor necrosis is identified. Immunohistochemical staining shows positivity for MIB-1 with labeling indices ranging from 25% to 30%. Staining for mGFAP is also performed. Molecular analysis detects promoter methylation of the MGMT gene following bisulfite treatment of DNA and PCR amplification with gel electrophoresis detection. The assay used has been developed and validated by the laboratory according to CLIA standards but has not received FDA clearance or approval. These findings are provided as part of the overall pathological assessment."} +{"pid": "TCGA-56-7823", "report": "The corrected report reflects an updated count of lymph nodes in part D, with a total of 18 lymph nodes identified across all specimens, including two involved lymph nodes from the lobectomy specimen. The prior diagnostic details remain unchanged.\n\nIn the lymph node evaluation, one of five lymph nodes at a certain level showed malignant involvement. At another level, five lymph nodes were examined and found to be benign. A third level also showed involvement in one of five lymph nodes. An additional level was represented by a single benign lymph node.\n\nThe lung specimen consisted of a right upper lobectomy measuring 16 x 10 x 2.5 cm and weighing 203 grams. Two distinct masses were identified within the lung tissue. The larger mass measured 2.8 x 2.5 x 2.0 cm and was located near the pleural surface, approximately 0.1 cm from the pleura, and within 0.5 cm of the bronchial margin. The smaller mass measured 2.6 x 2.5 x 2.0 cm and was also close to the pleural surface (within 0.1 cm), with evidence of pleural puckering. This lesion contained a central cavity measuring 1.7 cm and was located 4.2 cm from the bronchial margin. Both lesions were submitted for histologic examination along with surrounding uninvolved lung tissue and peribronchial lymph nodes.\n\nHistologically, the tumor was moderately to poorly differentiated. Lymphovascular space invasion was present, but there was no evidence of visceral pleural invasion. The tumor appeared confined to the lung, with no identifiable treatment effect. Multifocality was noted, and microscopic features suggested that the two masses were likely related, with one possibly representing intraparenchymal or lymphovascular spread rather than a separate primary lesion.\n\nSurgical margins were assessed: the tumor was 0.5 cm from the bronchial margin, 3.5 cm from the parenchymal (stapled) margin, and approximately 0.1 cm from the pleural surface.\n\nA total of 18 lymph nodes were evaluated across all specimens, with four showing evidence of metastatic involvement. No other significant findings were reported. The staging classification was pT1b, N1."} +{"pid": "TCGA-CJ-6028", "report": "The specimen consists of a radical nephrectomy measuring 26.0 x 17.0 x 12.0 cm, including the kidney, a segment of the renal artery, renal vein, ureter, and adrenal gland. The kidney measures 24.0 x 16.0 x 10.0 cm and contains a large, variegated, extensively necrotic mass located in the upper pole, measuring 17.0 x 15.0 x 8.0 cm. The mass exhibits multiple areas with varying appearances, including dark red and golden nodules, light tan friable nodules, and focal mahogany-colored regions. \n\nThe lesion extends into the perinephric adipose tissue and reaches the Gerota's fascia margin. It also invades the renal sinus. There is no gross involvement of the renal vein or ureteral margin. The adrenal gland is compressed but not directly invaded, and it appears unremarkable on examination. Small, well-circumscribed, light tan nodules are observed at the tumor periphery. The surrounding kidney tissue appears normal, and the pelvicalyceal system is compressed but otherwise unremarkable. No lymph nodes are identified within the renal hilum.\n\nHistologic evaluation includes multiple sections from various areas of the specimen, including margins, sinus, adjacent fat, and peripheral nodules. Nuclear grade 4 morphology is noted. The lesion involves hilar and pericapsular vessels and extends into hilar and pericapsular adipose tissue. Sections submitted include those from the tumor interface with the sinus, Gerota's fascia, renal vein and ureteral margin, fat, adjacent kidney, and multiple representative areas of the tumor."} +{"pid": "TCGA-B8-A54F", "report": "The specimen consists of a left radical nephrectomy from a female patient with a renal mass. The surgical specimen measures 17.2 x 11.0 x 6.5 cm and weighs 435 grams. The tumor is located in the mid portion of the kidney, measuring 3.5 x 3.0 x 2.9 cm. It is well-circumscribed, cystic, and hemorrhagic. The tumor is unifocal and confined entirely within the kidney without involvement of surrounding structures including perirenal adipose tissue, Gerota\u2019s fascia, renal sinus, renal vein, ureter, or major veins. No multicentricity is observed.\n\nHistologic evaluation reveals a lesion with clear cell morphology. Histologic grade is 2 out of 4. Sarcomatoid differentiation is not identified. Surgical margins\u2014including those of Gerota\u2019s fascia, renal vein, and ureter\u2014are free of tumor. No lymph nodes are present in the specimen. An incidental microscopic finding includes a small spindle cell nodule in the medullary region, measuring approximately 0.4 cm, located 1.5 cm inferior to the main lesion, which is consistent with a benign leiomyoma.\n\nStaging information indicates pT1a based on tumor size and confinement to the kidney. No lymph nodes are available for staging (pNx). These findings are based on available data and may be subject to revision pending clinical correlation."} +{"pid": "TCGA-EL-A3H5", "report": "A 1.8 x 1.0 x 0.5 cm tan rubbery fragment of tissue was identified at the upper pole of the left thyroid. Dissection of lymph nodes from various levels of the left neck showed metastatic involvement in level III, where 3 out of 13 lymph nodes contained foci measuring up to 1.3 cm with extracapsular extension. In level IV, 1 out of 5 lymph nodes contained a focus measuring 2.1 cm with extracapsular extension. No tumor was found in levels II (A and B), V, or in three other lymph nodes assessed in level V.\n\nA paratracheal nodule on the left side contained one involved lymph node. Resection of the larynx, trachea, and partial esophagus revealed multifocal disease involving both thyroid lobes and the isthmus, with extension into soft tissue and tracheal cartilage. One of two perithyroidal lymph nodes was involved, with a focus measuring 1.2 cm and extracapsular extension. A separate sclerotic colloid nodule was also noted.\n\nMargins were examined throughout the surgical specimen. Carcinomatous involvement was identified in the new medial tracheal margin, the superior margin (re-examined at inked site), and the posterior superior margin. Microscopic focus was also detected in the left inferior constrictor muscle margin. Other margins, including the left pharyngeal, right and left tracheal, inferior constrictor muscle, and remnant of the right strap muscle, showed no evidence of tumor.\n\nLymph node dissections included 19 lymph nodes in level II A (none positive), 5 in level II B (none positive), 13 in level III (3 positive), 5 in level IV (1 positive), and 3 in level V (none positive). The largest nodal focus measured 2.1 cm in level IV. Extracapsular extension was documented in levels III and IV.\n\nThe primary lesion measured 1.8 cm in greatest dimension in the left thyroid. Additional nodules were identified in the isthmus (1.0 cm) and the right and left lobes. Tissue fragments submitted for frozen section included margins from the larynx, trachea, and pharyngeal regions, with several confirmed positive for tumor involvement. Fibrosis, granulation tissue, and suture granuloma were present in the superior soft tissue without evidence of tumor.\n\nTissue measurements and findings were consistently reported with detailed histologic evaluation across multiple sections."} +{"pid": "TCGA-G6-A8L6", "report": "The left kidney specimen measured 21.5 x 12 x 7.8 cm and weighed 815 grams. The tumor measured 9.7 x 7.8 x 5.7 cm and was well-circumscribed, solid, and golden-orange with areas of hemorrhage and possible fibrosis. It was located in the mid portion of the kidney and pushed against the anterior and lateral capsule but did not grossly invade through it. The uninvolved renal parenchyma appeared tan-brown with a well-defined cortical-medullary junction and normal cortical striations and medullary rays. The pelvis and calyces were smooth. The adrenal gland measured 6.2 x 4.1 x 0.8 cm and showed no abnormalities. No lymph nodes or stones were identified.\n\nHistologically, the lesion exhibited nuclei with marked irregularity measuring approximately 20 microns with large, prominent nucleoli. There was no evidence of vascular or lymphatic invasion, and perinephric tissue was unaffected. Surgical margins were free of invasive disease, and the adrenal gland was uninvolved.\n\nThe tumor was confined to the kidney and measured greater than 7 cm but no more than 10 cm in greatest dimension. Based on these findings, the pathological staging was determined as pT2a. No regional lymph nodes were sampled."} +{"pid": "TCGA-A2-A04N", "report": "A female patient underwent wide local excision of the right breast along with lymph node biopsies. The excised specimen measured 9.0 x 8.0 x 3.0 cm and included a firm, tan, well-circumscribed mass measuring 1.7 cm located in the mid portion of the specimen, 0.8 cm from the deep margin. A second smaller nodule, 0.7 cm in diameter, was identified 0.5 cm superior anterior to the main mass. Histological evaluation showed no lymphovascular invasion and negative margins. The tissue showed benign changes including fibrocystic alterations with cysts, fibrosis, apocrine metaplasia, and duct ectasia. Multifocal fat necrosis was also noted.\n\nImmunohistochemical staining revealed strong positivity for ER/PR. HER2-neu testing by FISH showed no gene amplification with a ratio of 1.2. Cytokeratin staining was negative in sentinel lymph node specimens D and E.\n\nLymph node specimens were collected as follows: two non-sentinel lymph nodes (#1 and #2) each contained two lymph nodes, all negative for malignancy. Sentinel lymph node #1 was negative for malignancy based on immunohistochemical stains. Sentinel lymph node #2 was similarly negative. Non-sentinel lymph node #3 consisted of benign adipose tissue without lymphoid tissue present.\n\nPathologic staging was determined as Tlc NO MX. Clinically, the patient presented with a 2.5 cm mass in the right outer mid breast; fine needle aspiration revealed atypical cells consistent with a malignant process. Intraoperative frozen section confirmed the presence of an infiltrating malignancy. All findings were communicated directly to the treating physician."} +{"pid": "TCGA-LL-A442", "report": "The specimen consisted of a left simple mastectomy and sentinel lymph node biopsies. The mastectomy specimen weighed 481 grams and measured 17.0 x 16.0 x 4.5 cm. A 2.7 x 2.5 x 2.0 cm circumscribed red-brown mass was identified in the lower outer quadrant, located 0.5 cm from the nearest deep margin. A second smaller mass measuring 1.3 x 0.8 x 0.8 cm was found centrally between the upper and lower inner quadrants, 2.3 cm from the deep margin and marked with a localization clip. Both masses were submitted for tissue banking. The breast showed extensive fibrocystic change with dense white fibrous tissue comprising 60\u201375% of the parenchyma.\n\nMicroscopic evaluation of the larger mass revealed infiltrating ductal carcinoma with identical morphology at both foci. Histologic features included a modified Nottingham histologic grade 2 of 3, with a nuclear score of 2 of 3, tubular formation score of 3 of 3, and mitotic score of 1 of 3 (two mitotic figures per square millimeter). There was also extensive ductal carcinoma in situ, low grade with solid pattern. All surgical margins were free of tumor involvement. The closest margin to the invasive tumor was 0.5 cm.\n\nA total of four sentinel lymph nodes were examined. No tumor involvement was identified in any of the nodes, including those evaluated with multiple step sections, routine stains, pan keratin, and immunohistochemical studies. No macrometastases, micrometastases, or isolated tumor cells were identified.\n\nAncillary studies showed estrogen receptor positivity in 100% of tumor cells and progesterone receptor positivity. HER2 immunostaining was equivocal (score 2+), and in situ hybridization (FISH) did not show gene amplification.\n\nPathologic staging of the primary tumor was pT2. Lymph node staging was pN0(i-), with no evidence of metastatic disease. Distant metastasis was not applicable."} +{"pid": "TCGA-GS-A9TT", "report": "The orchiectomy specimen weighs 832.1 grams and measures 10 x 9 x 6 cm. The epididymis and a segment of the spermatic cord are present. On gross examination, a well-defined solid mass measuring 7 x 6.5 x 3.5 cm is observed, with hemorrhagic and whitish areas. The lesion occupies approximately 90% of the testicular volume. Histologically, the testicular parenchyma is infiltrated by an atypical lymphoid proliferation with extensive necrosis. The lesion consists of sheets of large atypical immunoblastic cells that replace nearly the entire testicular tissue. Immunohistochemical staining shows strong positivity for CD20, CD79a, BCL2, and MUM1, with variable expression of BCL6. Staining for CD10, CD3, and CD5 is negative. A kappa light chain restriction is present in the neoplastic cells. There is minimal intratumoral reactive T-cell infiltration, with CD3 and CD5 positivity noted in rare cells. The Ki67 proliferation index is 100%."} +{"pid": "TCGA-DH-A7US", "report": "The submitted specimens were obtained from a male patient undergoing craniotomy for a right-sided frontotemporal insular lesion. Two specimens labeled \"Brain tumor\" were received and processed.\n\nSpecimen A measured 2.5 x 2.0 x 1.5 cm and consisted of an aggregate of beige to pink-tan soft tissue. A representative portion was used for frozen section analysis, with the diagnosis deferred to permanent sections. The remaining tissue was submitted in cassettes A2 and A3.\n\nSpecimen B measured 1.8 x 1.5 x 1.0 cm and was composed of beige to gray-tan soft tissue with areas of hemorrhage. Representative sections were submitted for analysis and placed in cassettes B1 through B3.\n\nMicroscopic examination revealed an infiltrating tumor characterized by monomorphic cells with ovoid nuclei and perinuclear halos. Delicate vasculature resembling a \u201cchicken wire\u201d pattern was noted. No necrosis or microvascular proliferation was identified. Mitotic figures were not observed in the sections examined. The Ki-67 (MIB-1) proliferation index ranged from 1% to 7%.\n\nImmunohistochemical staining showed positive reactivity for GFAP in tumor cell processes. Tumor cells exhibited strong and diffuse positivity for IDH1. Staining for p53 demonstrated negative immunoreactivity in the majority of tumor cells.\n\nChromosomal analysis for 1p/19q status was initiated and results were to be reported separately in an addendum.\n\nAll gross and microscopic evaluations were personally reviewed and reported by the pathologist or qualified designee. Testing was performed in a CLIA-certified laboratory under high-complexity testing standards. Some assays used for analysis have not been cleared by the FDA but are utilized for clinical diagnostic purposes."} +{"pid": "TCGA-DV-5576", "report": "The specimen consists of three separate tissue samples obtained from the left kidney during partial nephrectomy. Tumor #1 is a red-tan soft tissue fragment measuring 0.6 x 0.5 x 0.2 cm. Tumor #2 measures 1.3 x 0.9 x 0.5 cm and has a cystic appearance. Tumor #3 is a larger mass measuring 2.5 x 2.4 x 1.0 cm, also showing cystic features and appears to have been bisected. All specimens were entirely submitted for histologic evaluation. Microscopic examination reveals cellular features consistent with a neoplastic process. The nuclear grade is classified as Fuhrman grade II across all specimens. No additional diagnoses or consultant evaluations are noted."} +{"pid": "TCGA-EW-A1J1", "report": "A total of six sentinel lymph nodes were evaluated along with axillary contents. One sentinel lymph node contained abnormal cellular infiltration extending beyond the capsule. All other lymph nodes, including ten additional nodes from the axillary contents, showed no evidence of abnormal cells. Immunohistochemical staining for keratin was performed on multiple lymph nodes and was negative.\n\nThe primary specimen from the right breast measured 9.5 cm in its largest dimension and included a well-defined mass measuring 3.5 cm. The cellular morphology demonstrated marked nuclear pleomorphism, high mitotic activity, and poor glandular differentiation, leading to a high histologic grade. No lymphovascular invasion was identified. Surgical margins were free of abnormal cells, and there was no involvement of the skin or skeletal muscle. A separate area of fibrosis was noted 1 cm away from the tumor.\n\nAdditional immunohistochemical studies were conducted using formalin-fixed, paraffin-embedded tissue. These included stains for hormone receptors and other markers; results indicated presence of immunoreactive cells for certain markers. The tumor did not show distant metastasis. Evaluation of sentinel lymph nodes was performed using both hematoxylin and eosin staining as well as immunohistochemistry. Tumor size and nodal findings corresponded to a stage based on criteria where the primary tumor was greater than 20 mm but less than 50 mm and there was involvement of one regional lymph node with metastasis larger than 2 mm."} +{"pid": "TCGA-27-1832", "report": "Female. Birth date. Tumor site: right fronto-temporal region. Histological examination reveals a highly cellular lesion with marked nuclear atypia and frequent mitotic figures. The tissue shows extensive necrosis and microvascular proliferation. Cellular morphology is consistent with a high-grade neoplasm. Tumor dimensions are approximately 5.2 cm in greatest diameter. There is infiltration into adjacent brain parenchyma. No lymph node involvement is identified. Distant metastasis is not detected. Staging classification indicates advanced local disease with no evidence of regional or distant spread."} +{"pid": "TCGA-EA-A5ZD", "report": "The specimen consists of cervix tissue. Grossly, there is a protruding lesion measuring 4x3x2 cm, with a soft consistency and white-gray surface. Microscopically, the lesion is composed of hyperplastic squamous cells that replace the normal epithelium and extend into the muscle propria. The tumor cells are arranged in groups, broad sheets, or trabecular patterns, interconnected with one another. The malignant cells exhibit abundant, lightly eosinophilic cytoplasm, with nuclei showing moderate pleomorphism, including variation in size and shape, coarse chromatin, and prominent nucleoli. Mitotic activity is evident. The stroma shows lymphocytic infiltration. Endocervical glands appear unremarkable. Histologic evaluation indicates an infiltrative growth pattern involving the outer half of the muscle propria. The lesion measures less than 4.0 cm in greatest dimension. Lymphatic invasion is present; venous invasion is not identified. Other features such as lymph node involvement, margin status, and evidence of neoadjuvant treatment are not specified."} +{"pid": "TCGA-HT-8107", "report": "The pathology report describes microscopic findings from sections labeled as \"parietal tumor or parietal pericystic.\" These sections show a diffusely infiltrating, mildly cellular neoplasm. The tumor cells have round nuclei without distinct processes or perinuclear halos. Additional sections from what is described as arising in one of two cysts demonstrate a markedly hypercellular lesion with similar histologic features. There is slightly increased nuclear staining density in these areas, though this may be due to higher cellularity. Mitotic activity is infrequent. No evidence of microvascular proliferation or necrosis is present.\n\nImmunohistochemical staining for MIB-1 shows variable proliferative activity throughout the tumor, ranging from 0.7% in less active regions to 9.7% in more active areas. While this variation raises concern for early atypical changes, it is not sufficient on its own to support a higher-grade classification."} +{"pid": "TCGA-BG-A0MI", "report": "The specimen consists of a total abdominal hysterectomy with bilateral salpingo-oophorectomy, along with multiple biopsies from various sites including bladder flap, uterine serosa, lymph nodes, rectosigmoid nodule, and omentum. All biopsied tissues are negative for malignancy.\n\nGross examination reveals a lesion located on the anterior aspect of the endometrium measuring 3.0 x 1.5 x 1.5 cm. Microscopically, the lesion demonstrates exophytic growth with focal superficial myometrial invasion. The depth of myometrial invasion is 0.2 cm within a myometrial thickness of 1.5 cm. No lymphovascular invasion is identified.\n\nAdditional findings include a proliferated endometrial polyp measuring up to 2.5 cm and a leiomyoma in the myometrium measuring 0.9 cm. The cervix shows mild endocervicitis without evidence of carcinoma. Both ovaries contain benign m\u00fcllerian glands, and both fallopian tubes are unremarkable.\n\nLymph node biopsies from external iliac, obturator, common iliac, and peri-aortic regions on both sides are negative for metastatic disease. A total of 15 lymph nodes are examined, with no positive nodes identified. The pelvic wash is also negative for malignant cells.\n\nHistologic evaluation shows a moderately differentiated tumor based on combined architectural and nuclear features. The architectural grade is moderately differentiated, and the nuclear grade is 2. The tumor involves approximately 100% of the endometrial surface on the anterior aspect. The depth of myometrial invasion is less than half the thickness of the myometrium. A pre-neoplastic background of complex endometrial hyperplasia with atypia is present. Other associated findings include an endometrial polyp and a leiomyoma.\n\nStaging is as follows: pathologic T stage pT1b, pathologic N stage pN0, and pathologic M stage pMX, corresponding to a FIGO stage IB."} +{"pid": "TCGA-AD-A5EJ", "report": "The specimen consists of a 23 cm segment of large bowel, including the cecum, along with 8 cm of attached terminal ileum. A grossly unremarkable vermiform appendix measuring 8.4 x 0.8 x 0.8 cm is present within pericolic and epiploic adipose tissue. The serosa is focally shaggy and tan pink with fibrofatty adhesions. At approximately 9 cm from the distal margin, there is a 3.3 x 3.2 cm area of indurated umbilication on the serosa. The bowel wall is up to 0.6 cm thickened and fibrotic. The mucosal surface is tan pink with preserved intestinal folds. Corresponding to the area of serosal change, at 8.6 cm from the distal margin and 3.8 cm from the ileocecal valve, there is a partially sectioned plaque-like lesion measuring 9.2 x 7.5 cm. It has a finely granular, centrally ulcerated surface with raised borders. The cut surface is gritty, gray-tan, and fibrotic, with thickness up to 3.2 cm. Microscopic evaluation shows that the lesion extends through the muscularis propria into subserosal adipose tissue. In areas of pericolic fat, the lesion extends focally through the wall, reaching as close as 0.9 cm to the outer surface margin. At its closest point on the serosa, the lesion approaches within 0.1 cm of the margin.\n\nAdditional findings include scattered tan-gray polypoid excrescences up to 0.8 cm in size, which are not fixed to the underlying muscularis. Sectioning of the surrounding adipose tissue reveals multiple poorly defined fleshy nodules up to 1.5 cm in diameter. No involvement is identified at the proximal or distal resection margins, or at the circumferential radial margin, although the tumor comes within 1 mm of this margin. No lymphovascular or perineural invasion is identified. A total of 32 lymph nodes are examined, none of which show evidence of metastatic involvement. Additional non-neoplastic findings include hyperplastic polyps, lymphoid aggregates, and an unremarkable appendix. The lesion does not show histologic evidence of treatment effect or macroscopic perforation. Multiple sections from various regions of the specimen, including margins, surrounding tissue, lymph nodes, and polyps, have been submitted for further analysis."} +{"pid": "TCGA-P3-A6T2", "report": "The clinical specimen consisted of a left neck dissection and excision of an oral lesion with reconstruction using a radial forearm free flap. The left level IB specimen measured 4 x 4 x 2.5 cm and contained a 4 cm salivary gland with tan lobulated cut surfaces. Surrounding adipose tissue contained three lymph nodes ranging from 0.8 to 1.4 cm, all with focally white indurated appearances upon sectioning. The left levels II and III specimen measured 8 x 3 x 2 cm and contained numerous lymph nodes ranging from 0.1 to 1.5 cm; no masses were identified. Larger lymph nodes showed unremarkable cut surfaces.\n\nA gingival mucosa specimen consisted of two small fragments measuring 0.2 and 0.3 cm and was entirely submitted for frozen section analysis. The left buccal mass measured 4.5 x 3.7 x 2.5 cm and had a tan and brown appearance. A 3.6 x 2.6 cm exophytic pale tan lesion was noted on the mucosal surface with adherent blood and elevation of 1.2 cm above adjacent mucosa. The lesion was bordered by smooth, glistening gray-brown mucosa on three sides but appeared transected at the fourth side. The deep surface contained fibrofatty tissue without identifiable tumor. Serial sectioning revealed a 2.6 cm (width) x 1.6 cm (depth) x 4.5 cm (length) lesion with a white cut surface. The lesion approached the black inked margin and was within 0.5 cm of the deep margin. Margins inked blue and green showed at least 0.6 cm and 0.4 cm of normal mucosa, respectively.\n\nMargins evaluated included superior buccal (two fragments up to 0.5 cm), inferior buccal (0.7 x 0.2 x 0.3 cm), and tongue margin (0.8 x 0.3 x 0.2 cm), all submitted entirely after intraoperative frozen section evaluation. No carcinoma was detected in these margins. A separate specimen containing a premolar tooth and associated soft tissue was submitted, with the soft tissue measuring 0.8 x 0.8 x 0.1 cm.\n\nIntraoperative consultation of cauterized fibrous tissue showed inflammatory cells and granulation tissue with squamous mucosa, but no carcinoma or high-grade dysplasia was identified. Frozen sections of all margins similarly revealed no evidence of carcinoma or dysplasia.\n\nMicroscopic examination of the primary lesion showed invasive moderately differentiated keratinizing morphology involving submucosal fat and skeletal muscle. An in-situ component was present. At the invasive front, malignant cells formed angulated cords. Perineural invasion was observed. The lesion extensively involved one arbitrarily designated margin, while other margins remained unaffected. Minor salivary glands showed no involvement.\n\nLymph node evaluation included 42 nodes across levels IB, II, and III. Two out of 42 nodes were positive for metastatic involvement: both were from level IB, with the largest focus measuring 1.0 cm and no extranodal extension observed. Levels II and III contained 34 and 5 nodes respectively, none of which showed metastasis. The greatest dimension of metastatic involvement in lymph nodes was 0.9 cm. Additional biopsies from gingival mucosa and surgical margins showed no evidence of malignancy."} +{"pid": "TCGA-ET-A4KN", "report": "The specimen includes lymph nodes anterior to the trachea, consisting of three lymph nodes, all negative for tumor. A total thyroidectomy was performed, with the tumor located in the right lobe. The histologic type shows features consistent with a recognized subtype of differentiated thyroid neoplasm. The tumor measures 2.0 cm and is unifocal. All four lymph nodes examined from the thyroid region are negative for tumor involvement. The primary tumor stage is pT3 based on minimal extension beyond the thyroid capsule. There is no evidence of regional lymph node metastasis (pN0). Surgical margins are free of tumor involvement, with the invasive component located less than 1 mm from the anterior margin. No vascular or lymphatic invasion is identified. Additionally, one thymic lymph node is also negative for tumor."} +{"pid": "TCGA-A5-A0GU", "report": "The specimen consisted of a total hysterectomy with bilateral adnexa, weighing 110 grams and measuring 6.7 x 5.0 x 4.3 cm. The cervix measured 3.0 cm in length and 3.7 cm in width. The endometrial cavity was 5.1 cm long and 4.5 cm wide. The myometrium had a maximum thickness of 2.8 cm, with the tumor extending 0.5 cm into the inner half of the myometrium. No lymphovascular invasion was identified.\n\nA tumor measuring 7.7 x 4.3 cm was observed within the uterine cavity, exophytic and papillary in appearance, tan-white with areas of hemorrhage, and raised 1.2 cm from the endometrial surface. It involved the anterior and posterior aspects of the lower uterine segment. On sectioning, the tumor appeared to involve the inner one-third of the myometrium without deeper invasion. No gross involvement of the cervix or serosa was noted.\n\nTwo leiomyomas were identified within the myometrium, measuring 0.2 cm and 0.7 cm. No necrosis or hemorrhage was present. The cervix contained multiple mucoid-filled cysts up to 0.8 cm in size. The right ovary measured 2.0 x 1.5 x 0.8 cm and contained three small unilocular cysts filled with yellow serous fluid. The right fallopian tube was 4.0 cm long and had a paratubal cyst measuring 0.2 cm in diameter. The left ovary was smaller at 1.3 x 1.2 x 0.3 cm and contained a bilocular cyst filled with clear serous fluid measuring 0.7 cm. The left fallopian tube also measured 4.0 cm and had a paratubal cyst measuring 0.8 cm. Both fallopian tubes showed external serosal congestion.\n\nSeven lymph nodes were identified in the right pelvic dissection, ranging from 0.3 to 1.0 cm in size. Three lymph nodes were found in the left pelvic dissection, measuring between 0.6 and 0.9 cm. No malignancy was identified in any of the lymph nodes. A separate pelvic nodule measuring 1.7 x 0.6 x 0.3 cm was submitted and found to contain fat necrosis with dystrophic calcification.\n\nHistologic evaluation showed well-differentiated cellular features. Representative sections were taken from multiple sites including the cervix, lower uterine segment, corpus, fundus, ovaries, fallopian tubes, and surrounding tissue. All sections from the cervix, ovaries, fallopian tubes, and lymph nodes showed no evidence of malignancy. The pathologic staging was determined as pT1b, pNO."} +{"pid": "TCGA-ZF-AA5N", "report": "The specimen consists of two parts: A and B. Part A is a 3 g sample of firm tissue chippings, while Part B is a single tissue fragment measuring 6 mm. Microscopic examination of Part A reveals a high-grade lesion within the bladder with an infiltrating growth pattern. The cells exhibit features consistent with urothelial carcinoma, including signet ring differentiation. Extensive necrosis is present. Muscle invasion is noted, indicating at least pT2 stage disease. No clear evidence of lymphovascular invasion is observed. In the surrounding tissue, cystitis cystica is identified in the urothelium, along with a small focus suggestive of a pre-invasive lesion. Part B, corresponding to the left ureteric orifice biopsy, does not show any definitive signs of a pre-invasive lesion or invasive disease."} +{"pid": "TCGA-XJ-A9DX", "report": "A prostatectomy specimen was received along with multiple lymph node samples from various anatomical locations including right and left external iliac, obturator, and hypogastric regions, as well as a hernia sac. The prostate measured 5.2 cm in width, 5.7 cm in depth, and 3.9 cm in height, and weighed 68 grams. The right seminal vesicle measured 3.8 x 1.9 x 0.9 cm and the left measured 3.0 x 1.4 x 0.7 cm. The vas deferens on the right was 4.3 cm long and 0.4 cm in diameter, while the left was 3.9 cm long and 0.5 cm in diameter.\n\nHistologic examination of the prostate showed a poorly differentiated cellular pattern. The primary histologic pattern was 5 and the secondary was 4. Tumor involvement was noted in approximately 60% of the prostatic tissue. Extraprostatic extension and invasion of the seminal vesicles were present. Resection margins on both the right and left posterior sides were involved by tumor, including the right seminal vesicle margin. Lymph-vascular invasion and perineural invasion were also identified.\n\nLymph node analysis included 22 nodes examined in total, with metastatic involvement found in two. Specifically, one of two nodes in the right hypogastric region and one of two nodes in the left hypogastric region contained abnormal cells, with extracapsular extension noted in the left side. No evidence of involvement was found in the other lymph node groups. The largest metastatic deposit measured 4 mm.\n\nPathologic staging was determined as pT3b for extraprostatic extension involving the seminal vesicles, and pN1 due to regional lymph node involvement. Distant metastasis could not be assessed. The pathologic stage is provisional and based solely on available data.\n\nThe hernia sac specimen was composed of fibrous tissue and did not show any significant abnormalities upon histologic review. All other findings were limited to the described features without additional pathologic changes noted."} +{"pid": "TCGA-27-2528", "report": "Birth date. Tumor site. Right temporo-mesial. Histological diagnosis. [Deleted]."} +{"pid": "TCGA-OR-A5JF", "report": "The specimen consists of a left adrenal mass measuring 57 x 40 x 63mm, with associated periadrenal fat. The total weight of the specimen is 110g, with the tumour estimated at 80g after subtracting the 30g fat component. The cut surface is tan and lobulated, with two areas of cystic and haemorrhagic change, the largest being 12mm in diameter. A wedge of tumour measuring 17 x 12 x 14mm was removed prior to receipt. At the edge of the lesion, there is a well-circumscribed area distinct from the main lesion, measuring 22 x 17 x 12mm. An area of haemorrhage or necrosis measuring 17 x 13 x 12mm is present. The tumour is well-circumscribed with an intact capsule in most areas, and normal adrenal tissue is focally seen within the fat adjacent to the lesion.\n\nMicroscopically, the tumour is composed of pleomorphic cells with prominent nucleoli and occasional multinucleated giant cells. Many cells have abundant eosinophilic (oncocytic) cytoplasm. Using the Weiss scoring system, a score of 4 is obtained based on high nuclear grade, atypical mitoses, predominantly eosinophilic cell type, and capsular invasion. Small foci of necrosis are present, but not sufficient for a coagulative necrosis point. No venous or sinusoidal invasion is identified. The mitotic count is 4 per 50 high-power fields. While much of the tumour is confined to the adrenal gland, there are areas of microscopic extension into the surrounding fat. Although the majority of the tumour is separated from the resection margin by an intact capsule or soft tissue plane, carcinoma is present at the soft tissue margins in some regions.\n\nImmunohistochemical staining shows positivity for calretinin, inhibin, and MelanA. IGF2 is negative. The Ki-67 proliferation index is high, reaching up to 30% in certain areas. Chromogranin and S-100 are negative. Fifteen blocks were submitted for analysis, including sections of normal adrenal, haemorrhagic/necrotic areas, and multiple regions of the lesion. Green ink marks the area where tumour was removed prior to receipt and does not represent a true margin. Black ink labels the capsular and fat surfaces."} +{"pid": "TCGA-XP-A8T8", "report": "The surgical specimen included the esophagus and a portion of the proximal stomach. The combined specimen measured 11.5 x 2.2 x 1.5 cm for the esophagus and 7.5 cm in length with a diameter of 3.1 cm for the stomach. The distal end was stapled. The outer surface of the esophagus appeared grayish and rough, without signs of infiltration. A thickening was noted in the middle third, with an ulcerated and infiltrative mucosal lesion measuring 2.1 cm in length. This lesion was located 4.1 cm from the closest surgical margin. The stomach mucosa was brown and wrinkled, with no macroscopic abnormalities observed. Surrounding fat tissue contained nodular, gray, fibroelastic structures ranging in size from 0.3 to 0.9 cm.\n\nOne lymph node was received, measuring 0.8 x 0.5 x 0.3 cm, with a smooth outer surface and no visible lesions on sectioning. A small fragment of liver tissue, measuring 0.5 x 0.3 x 0.3 cm, was also submitted; it was firm and discolored.\n\nMicroscopically, the esophageal lesion showed well-differentiated features with focal ulceration and an extensive in-situ component. The tumor exhibited a predominantly infiltrative and ulcerative growth pattern, with a maximum dimension of 2.2 x 2.1 cm. Invasion extended into the submucosa with minimal stromal reaction. No vascular or perineural invasion was identified, and no lymphoid aggregates were present in the surrounding stroma. All surgical margins were free of involvement. One out of ten lymph nodes examined showed evidence of tumor involvement. The gastric mucosa displayed moderate chronic inflammation, with focal activity and the presence of a small quantity of Helicobacter pylori. Liver histology revealed steatohepatitis, stage 3, with approximately 40% steatosis."} +{"pid": "TCGA-XF-A9SL", "report": "A segment of right distal ureter measuring 0.3 cm in length by 0.5 cm in diameter was entirely submitted for frozen section and no abnormal cellular proliferation or atypical features were identified. Similarly, a left distal ureter segment measuring 0.4 cm in length by 0.6 cm in diameter was also submitted for frozen section and showed no evidence of abnormal cells. A fragment of soft tissue from the apical urethral margin measuring 1.5 x 1.5 x 0.3 cm was submitted for frozen section and histological evaluation revealed benign prostatic parenchyma with no malignant features.\n\nThe main specimen included a urinary bladder with associated prostate and perivesical fatty tissue measuring 26 x 14 x 4 cm. The bladder itself measured 9.5 x 7.5 x 2 cm and contained an exophytic mass lesion measuring 1.7 x 1 x 1.5 cm located at the mid to left dome region. Adjacent to this lesion was an erythematous ulcerative area measuring 2.4 x 1.2 cm. Histologically, the mass demonstrated invasive growth through the muscularis propria into the perivesical soft tissue and extended to involve the peritoneum. The tumor exhibited high nuclear-cytoplasmic ratio with large pleomorphic nuclei arranged in solid sheets and single cells. Extensive desmoplastic stromal reaction and lymphovascular space invasion were noted. Additionally, multiple satellite tumor nodules were identified within the perivesical soft tissue. No in situ carcinoma or flat lesion was observed. The uninvolved bladder wall measured 0.9 cm in thickness. The surgical margins were free of tumor involvement.\n\nThe prostate measured 5.5 x 4.5 x 4 cm and showed focal prostatic intraepithelial neoplastic changes (PIN II and III), characterized by stratified layers of enlarged epithelial cells with prominent nuclei and nucleoli. No invasive adenocarcinoma was identified.\n\nLymph node evaluation was performed across multiple regions. In the right obturator region, metastatic involvement was identified in one of eleven nodes examined. In the left common iliac region, two of seven nodes showed metastatic involvement, and in the left external iliac region, three of four nodes were involved. All other lymph node groups, including right periaortic, right common iliac, right external iliac (non-obturator), right cloquet, left periaortic, left cloquet, presacral, and others, showed no evidence of metastatic disease. A total of 48 lymph nodes were evaluated across all regions.\n\nAdditional ureteral segments, including left and right proximal and distal portions, were histologically unremarkable with no evidence of high-grade cellular atypia or malignancy. Multiple sections of perivesical fatty tissue and prostate were also negative for tumor involvement.\n\nPathologic staging was determined as pT3aN2MX."} +{"pid": "TCGA-Q1-A73R", "report": "The cervical biopsy shows fragments of gland-forming carcinoma intermixed with areas of solid, non-glandular growth and increased mitotic activity. Some fragments exhibit architectural features suggestive of early in situ changes, while one fragment demonstrates significant glandular confluency indicative of invasion. The tumor cells in both the gland-forming and solid areas show strong immunoreactivity for p16, pan-keratin, and cytokeratin 8/18. Cytokeratin 5/6 staining is largely negative, with only rare patchy staining in the gland-forming component and no staining in the solid areas. Immunostains for neuroendocrine markers (chromogranin, synaptophysin, CD56) are negative. Lymphovascular invasion is not identified.\n\nThe endometrial biopsy contains small fragments of similar carcinoma, along with separate fragments of atrophic endometrium. The tumor fragments in this specimen share morphologic and immunophenotypic features with those seen in the cervical biopsy.\n\nGrossly, the cervical specimen consists of multiple pale tan tissue fragments with clotted blood, measuring 2 x 1.6 x 0.6 cm in total. The endometrial specimen is smaller, composed of minute tissue fragments with minimal clotted blood, measuring 2 x 0.7 x 0.2 cm in total. Both specimens were entirely submitted for evaluation."} +{"pid": "TCGA-CM-6167", "report": "The submitted right colon resection specimen includes a segment of terminal ileum, cecum with attached appendix, and ascending colon. The terminal ileum measures 11.5 cm in length and 3.3 cm in circumference at the proximal margin. The remaining colon measures 46 cm in length with a 7.5 cm circumference at the distal margin. The appendix is 5 cm long with an average diameter of 0.8 cm. A partially fungating and partially infiltrating lesion measuring 8.5 cm in length and 7.0 cm in width is identified in the cecum, located 11.5 cm from the proximal margin and 39 cm from the distal margin. The tumor invades into subserosal fibroadipose tissue with a maximal thickness of 1.1 cm. There is no gross evidence of perforation.\n\nHistologic evaluation reveals extensive tumor budding and lymphovascular invasion, including large venous and perineural invasion. The tumor margins are free of involvement. Examination of surrounding tissues shows three tumor deposits within pericolorectal soft tissue. A total of 40 lymph nodes are examined, with 11 showing metastatic involvement. Three polyps ranging from 0.2 to 2.5 cm are identified away from the main lesion; all show features consistent with tubulovillous adenoma. No increased tumor-infiltrating lymphocytes are noted. Non-neoplastic bowel and the appendix appear unremarkable.\n\nImmunohistochemical staining demonstrates positivity for CK20 and CDX2, with very focal positivity for CK7. The tumor is negative for synaptophysin, chromogranin, ER, and PR. These findings support the origin of the tumor as primary colonic. All tests were performed under CLIA-certified conditions and are used for clinical diagnostic purposes."} +{"pid": "TCGA-A2-A259", "report": "The specimen includes a sentinel lymph node biopsy and a left breast lumpectomy. Two lymph nodes were examined, both without evidence of metastasis based on histologic and immunohistochemical evaluation. The lumpectomy specimen contains a well-defined mass measuring 1.5 cm in greatest dimension. Histologic evaluation shows a Nottingham grade 2 lesion with a total score of 7 (tubules: 3, nuclei: 3, mitoses: 1; 4 mitotic figures per 10 high-power fields). Tumor necrosis is absent. Microcalcifications are present within the lesion as well as in benign ducts. There is no evidence of venous or lymphatic invasion. Margins are not involved but are close: the invasive tumor is 0.95 mm from the superior margin, while the intraductal component is 1.1 mm from the same margin. An intraductal component is present, characterized by ductal carcinoma in situ with focal necrosis, grade 2, comprising less than 20% of the lesion. Lobular carcinoma in situ is also identified. Estrogen and progesterone receptors are positive, and HER2 by immunohistochemistry is negative (1+). Additional findings include adenosis and changes consistent with prior biopsy. Pathologic staging is pT1cNO (i-) MX."} +{"pid": "TCGA-QR-A70P", "report": "The specimen labeled \"interaortocaval tumor\" (excision) is a single piece of red/purple, soft tissue measuring 5.5 x 4 x 3.5 cm with a smooth surface. The external dimensions were confirmed and the specimen weighed 39.1 grams. It was inked and opened to reveal a homogeneous, soft, dark purple cut surface. A 2 x 1 x 0.4 cm section from the central portion was procured for further study. The surgical pathology report indicates that the specimen was generously sampled, and representative sections were submitted in white cassettes. All inked surgical margins were found to be free of abnormal tissue. One lymph node was identified and showed no evidence of involvement. No adrenal tissue was observed in the specimen. The patient had a preoperative diagnosis of right retroperitoneal mass, which was carried through as the postoperative diagnosis. The operative findings were consistent with the clinical presentation."} +{"pid": "TCGA-AC-A3TM", "report": "The patient is a female who underwent a right modified radical mastectomy with sentinel lymph node mapping. A total of four sentinel lymph nodes were excised and examined. Sentinel lymph node #1 was a 1.5 cm yellow-tan nodule that showed involvement of the subcapsular sinuses by atypical cells detected only by pancytokeratin immunohistochemical staining; more than 200 individual cells were identified. Sentinel lymph node #2, measuring 0.7 cm, also showed involvement of the subcapsular sinus with fewer than 200 immunohistochemically positive cells. Sentinel lymph nodes #3 and #4, measuring 3.8 x 2.0 x 0.5 cm and 0.9 cm respectively, showed no evidence of involvement by atypical cells on routine sections or immunohistochemistry.\n\nThe right breast specimen weighed 625 grams and measured 22.0 x 14.5 x 4.0 cm. A well-delineated gray-white mass was identified, measuring 7.0 x 3.4 x 3.0 cm, located 2.5 cm beneath the skin and within 1.8 cm of the inked deep margin. Histologic evaluation revealed an invasive component with a Bloom-Richardson grade II classification (architectural score 3, nuclear grade 2, mitotic rate 1). No angiolymphatic invasion was identified. In addition to the main mass, a separate microscopic focus of invasive disease was found in a distant quadrant. All surgical margins were free of tumor involvement. The nipple showed extensive involvement of lactiferous ducts by atypical in situ cells.\n\nBased on these findings, the case is classified as pTNM Stage T3N1(mi). Specimens were evaluated using both routine histology and pancytokeratin immunohistochemistry. Prognostic markers are being re-evaluated due to the time elapsed since initial diagnosis, with results to be reported in a subsequent addendum."} +{"pid": "TCGA-FG-A60L", "report": "The submitted specimen consists of an irregular segment of tan soft tissue measuring 2.5 x 1.5 x 1 cm, obtained from the left temporal region. The cut surface appeared unremarkable without a distinct mass lesion. The entire specimen was processed for analysis, with one portion reserved for frozen section and the remainder submitted in formalin.\n\nMicroscopic evaluation of the tissue revealed moderate hypercellularity with mild nuclear pleomorphism. No mitotic activity was identified, and there was no evidence of vascular proliferation or necrosis. Immunohistochemical staining demonstrated a Ki-67 labeling index of 5%. No nuclear labeling was observed with p53 antibodies, while neoplastic cells showed reactivity for IDH1 (R132H).\n\nFluorescence in situ hybridization (FISH) analysis was performed on paraffin-embedded tissue sections to assess chromosomal loci. For chromosome 1p, the 1p36/1q25 signal ratio averaged 1.0 across 40 nuclei, indicating no allelic loss. Similarly, for chromosome 19q, the 19q13/19p13 ratio also averaged 1.0, with no evidence of allelic loss. Chromosome 7 FISH results showed EGFR and CEP7 signals with a ratio of 1.0, indicating no amplification of the EGFR gene. Aneusomy was not identified for chromosomes 1, 19, or 7.\n\nThe analysis was conducted using locus-specific probes targeting 1p36, 19q13, and EGFR, along with reference probes for 1q25, 19p13, and CEP7. Only atypical nuclei with two or more reference probe signals were included in the count. Loss was defined as a ratio \u22640.7, and aneusomy was defined as a mean reference signal count \u22653.0.\n\nAll tests were developed and validated by the laboratory. The U.S. Food and Drug Administration has not approved or cleared these tests, but such approval is not currently required for clinical use."} +{"pid": "TCGA-AX-A0IZ", "report": "The specimen from a total abdominal hysterectomy and bilateral salpingo-oophorectomy includes the cervix, which contains nabothian cysts. The myometrium shows findings consistent with adenomyosis. The endometrial lesion is characterized by high-grade architectural and nuclear features, with invasion into the myometrium measuring 5 mm in depth out of a total myometrial thickness of 20 mm. The tumor approaches within 1.5 cm of the serosa and extends into the lower uterine segment but does not involve the endocervix. The greatest dimension of the lesion is 4 cm. No vascular invasion is identified.\n\nThe fallopian tubes show evidence of prior tubal ligation; the right tube also has benign paratubal cysts. The ovaries are unremarkable, showing no significant pathology. The omentum and all lymph node groups examined (left pelvic: 8 nodes, right pelvic: 13 nodes, right common: 1 node, periaortic: 3 nodes) are benign, with no metastatic involvement identified. The surgical margins are free of invasive disease.\n\nHistologically, the lesion demonstrates FIGO architectural grade 3 and nuclear grade 3 features. Based on these findings, the staging classification is pT1b (IB) for the primary tumor, pN0 for regional lymph nodes (0 of 25 nodes involved), and pMX for distant metastasis, as no distant metastatic evaluation was performed. All other tissues and structures examined are uninvolved by malignancy."} +{"pid": "TCGA-E1-A7YI", "report": "The surgical pathology report describes a patient presenting with neurological symptoms including altered awareness of the left arm and facial fluttering. MRI demonstrated a large T2 hyperintense lesion predominantly involving the right posterior parietal lobe, extending across the callosal splenium into the left parietal white matter and reaching the subependymal surface of the right lateral ventricle atria and occipital horn. The lesion showed subtle heterogeneous enhancement along its anterior and lateral borders. On imaging, the mass measured approximately 7 cm in its anteroposterior dimension and 4.1 cm transversely. There was mild mass effect with effacement of the posterior aspect of the right lateral ventricle; no significant interval change in overall appearance was noted.\n\nAt the time of surgery, two tissue samples were submitted for analysis. Gross examination revealed fragments of brain tissue varying in size and color. Microscopic evaluation showed a highly cellular malignant glial neoplasm characterized by marked nuclear pleomorphism and increased mitotic activity. Microvascular proliferation and pseudopalisading necrosis were not observed. In one of the tissue sections, tumor cells were found to accumulate in the subarachnoid space.\n\nImmunohistochemical studies revealed variable expression among markers. A high proliferation index was noted, with 15% of tumor cells staining positive. MGMT expression was negative in 90% of tumor cells. EGFR wild-type expression was minimal (2% of tumor cells showing 2+ staining), and EGFR variant III was not detected. PTEN loss was identified in 40% of tumor cells with 2+ staining intensity. S6 was positive in 30% of tumor cells, AKT was negative, and MAPK showed positivity in 20% of tumor cells at 3+ intensity.\n\nCytogenetic analysis using FISH demonstrated polysomy of chromosome 7 in 47% of tumor cells and polysomy of EGFR in 51%. Chromosome 10 centromere and PTEN remained intact. Loss of 9p21 was present in 73% of tumor cells, and centromere loss of chromosome 9 was identified in 67% of tumor cells. Of four tested markers, two showed abnormal findings. Leukocyte common antigen (LCA) labeling indicated that 10% of cells were positive."} +{"pid": "TCGA-43-A56V", "report": "The surgical pathology report includes findings from three specimens obtained during a lobectomy procedure. Specimen A, a level XI lymph node, consists of multiple tissue fragments measuring 2.5 x 2.0 x 0.5 cm in aggregate. Microscopic evaluation shows no evidence of malignant cells in this specimen.\n\nSpecimen B is a right middle lobe lobectomy specimen measuring 14.0 x 7.5 x 4.5 cm. Gross examination reveals a white-gray-tan irregular mass measuring 4.5 x 3.5 x 3.5 cm and contiguous with an umbilication on the pleural surface. The mass has an ulcerated, hemorrhagic center and comes within 0.5 cm of the stapled edge. Histologic grade is moderately differentiated. The tumor involves the visceral pleura and extends into the hilar area of the right middle lobe. Lymphatic invasion is identified adjacent to the venous resection margin in block B-1. The bronchial margin is free of tumor; however, tumor is present near the vascular resection margins within the pulmonary parenchyma.\n\nSpecimen C includes lymph node biopsies from station R4, measuring 2.5 x 2.2 x 0.4 cm in aggregate. Microscopic evaluation reveals multiple involved lymph node fragments with presence of tumor beyond the lymph node capsules. No large vessel invasion is identified. Based on these findings, staging indicates involvement of deep margins and regional lymph nodes."} +{"pid": "TCGA-EY-A1H0", "report": "A lymph node specimen from the paraortic region consisted of a 3.5 x 2.2 x 1.5 cm packet of fibroadipose tissue and lymph node candidates. One out of four lymph nodes showed involvement with malignant cells, with the metastatic focus measuring 3 mm in size and no evidence of extracapsular extension. In another set of lymph nodes from the left pelvic region, one out of four contained similar malignant involvement, and endosalpingiosis was also noted. In the right pelvic lymph node specimen, two out of four lymph nodes were involved.\n\nThe uterus measured 17 cm in height, with an irregular and lobulated shape due to multiple leiomyomas. The endometrial cavity contained a mass measuring 9.3 x 6.5 x 3.5 cm, which appeared tan/white, solid, and papillary. This lesion extended into both the anterior and posterior endometrial surfaces and demonstrated myometrial invasion limited to the inner half. The depth of invasion was 0.8 cm, with a wall thickness of 3.5 cm at the deepest point, representing approximately 23% of the total wall thickness. No serosal involvement was identified, but there was involvement of the lower uterine segment. Cervical margins were negative. The vaginal margin was widely free of disease.\n\nHistologic evaluation revealed nuclear and architectural features consistent with grade 2 differentiation. Lymphovascular space invasion was present. A total of 12 regional lymph nodes were examined, with 4 showing involvement by malignant cells.\n\nImmunohistochemical staining showed expression of estrogen receptor (2+, 80%) and progesterone receptor (3+, 90%). Additional findings included multiple leiomyomas, the largest being a 4.4 x 3.5 x 4.1 cm firm calcified mass in the fundic region of the anterior myometrium, with the nearest distance to tumor measuring 0.3 cm. No tumor was identified in the bilateral ovaries or fallopian tubes. The cervical, vaginal, and adnexal margins were all free of tumor involvement.\n\nStaging information was provided based on available data and subject to possible revision upon further clinical review."} +{"pid": "TCGA-ZH-A8Y6", "report": "The surgical pathology report includes specimens from the gallbladder, portal lymph nodes, and a partial hepatectomy involving liver segments 4 and 5. The gallbladder specimen measured 7.5 x 3.0 x 2.5 cm and showed no significant pathological abnormalities. A single lymph node was identified within this specimen and was benign. No malignant cells were detected in the gallbladder specimen.\n\nThe portal lymph nodes specimen consisted of six fragments of benign lymph node tissue with no evidence of malignancy.\n\nThe hepatectomy specimen weighed 110 grams and measured 1.5 x 6.9 x 4.3 cm. It contained a well-circumscribed yellow/tan mass measuring 3.5 x 3.1 x 2.9 cm located between segments 4 and 5 of the liver. The mass had a focally hemorrhagic center and was unifocal in extent. Histologic evaluation revealed moderately differentiated cellular features. The tumor did not show necrosis or treatment effect, nor did it exhibit vascular invasion, perineural invasion, or capsular invasion. The tumor margins were free of involvement, with the closest distance being 0.5 cm from the segment 4 parenchymal margin. Surrounding liver tissue showed macrovesicular steatosis affecting approximately 65% of the hepatic parenchyma, along with grade 1 steatohepatitis; there was no indication of bridging fibrosis or cirrhosis based on H & E staining. Additional special stains performed on unaffected liver tissue showed no involvement by alpha-1-antitrypsin deficiency, no increased fibrosis, normal reticulin framework, and no abnormal iron deposition.\n\nBased on available findings, staging assessment was determined as pT1 pN0. This staging may be subject to revision pending further clinical review and additional information."} +{"pid": "TCGA-EM-A2CR", "report": "The specimen consisted of a total thyroidectomy, including right and left lobes and isthmus, with a total weight of 24.2 grams. The right lobe measured 5.0 cm in greatest dimension, with additional dimensions of 3.5 cm and 2.0 cm. The left lobe measured 4.0 cm x 2.4 cm x 1.5 cm, and the isthmus measured 3.4 cm x 2.3 cm x 1.0 cm. On gross examination, the thyroid contained a well-delineated nodule in the mid to lower right lobe measuring 2.6 cm x 2.4 cm x 2.2 cm. No parathyroid glands or lymph nodes were identified on initial gross inspection.\n\nMicroscopic evaluation revealed multiple distinct lesions. In the right lobe, the dominant lesion exhibited follicular architecture and classical cytomorphology. It was fully encapsulated with minimal capsular invasion noted. The tumor measured 2.6 cm in greatest dimension and was bilaterally multifocal with additional smaller foci present. Margins were uninvolved. No lymphovascular or perineural invasion was identified, and there was no evidence of extrathyroidal extension.\n\nA second lesion was identified in the left lobe measuring 0.1 cm. This lesion also displayed follicular architecture and classical cytologic features. It lacked a capsule and showed no invasion or vascular involvement. Margins were free of neoplastic cells.\n\nThree lymph nodes from the left paratracheal region were examined and showed no evidence of malignancy. Parathyroid tissue from both upper and lower poles was identified but did not demonstrate any pathological changes.\n\nStaging was based on AJCC/UICC TNM 7th Edition. The primary tumor was classified as pT2, indicating a tumor larger than 2 cm but not exceeding 4 cm confined to the thyroid. Regional lymph node staging was pN0 with no metastasis identified among the three nodes evaluated. Distant metastasis could not be assessed. The specimen was intact with adequate orientation for surgical margin assessment. Multiple sections were submitted for further analysis, and portions of the tissue were stored frozen."} +{"pid": "TCGA-VM-A8C9", "report": "The surgical pathology report describes a resected brain specimen from the left temporal lobe. The specimen consisted of three unoriented tan-white to gray tissue fragments measuring 3.0 x 2.5 x 1.0 cm. No focal lesions were identified upon serial sectioning, and the entire specimen was submitted for histologic evaluation.\n\nMicroscopic examination revealed areas of increased cellularity within both gray and white matter. These regions exhibited infiltrative borders and contained cells with irregularly shaped nuclei and moderate eosinophilic cytoplasm. Frequent pleomorphic and hyperchromatic nuclei, along with occasional multinucleated cells, were observed. No significant mitotic activity, necrosis, or vascular proliferation with hyperplasia was identified.\n\nImmunohistochemical staining demonstrated positivity for GFAP and negativity for synaptophysin and NeuN. The histologic features and immunophenotype were assessed in conjunction with clinical and radiologic findings. The greatest dimension of the resected specimen was 3.0 cm. No additional pathologic findings were noted."} +{"pid": "TCGA-5N-A9KI", "report": "The specimen consists of a cystectomy with attached uterus and adjacent tissues. The lesion involves a poorly differentiated morphology with in situ components present. Angiotropic and lymphangioinvasive features are noted. There is involvement of both ovaries, as well as infiltration into the uterus and cervix. The ureter shows no evidence of tumor involvement. Pathological staging according to the pTNM 2010 classification is pT4a NX L1 V1 Pn1. The histologic grade is high (G3). Surgical margins are negative (R0). Cellular morphology corresponds to a specific subtype, though not otherwise specified here."} +{"pid": "TCGA-EJ-5525", "report": "The patient is a male with a PSA value of 4 and a prior history of biopsy, which showed a high-grade prostatic neoplasm. A radical prostatectomy was performed following a preoperative assessment. The surgical specimen revealed an invasive poorly differentiated prostatic neoplasm with features predominantly consistent with ductal adenocarcinoma, with occasional foci of conventional acinar adenocarcinoma. The Gleason score was 4+5=9, with the higher grade component comprising approximately 98% of the tumor. The lesion measured 2.5 cm in greatest dimension and was present in both the right and left lobes of the prostate, involving approximately 20% of the tissue evaluated. The tumor was confined within the prostatic capsule, and all resection margins were free of tumor involvement. Bilateral seminal vesicles showed no evidence of neoplastic involvement. Perineural invasion was identified, and multifocal high-grade prostatic intraepithelial neoplasia was also noted. No angiolymphatic invasion or extraprostatic extension was observed. A total of eight lymph nodes were examined (five from the right pelvic region and three from the left), and none showed evidence of metastatic disease. The histologic grade was classified as G3-4, and the pathologic staging was determined as pT2c, pN0, pMX. The weight of the prostate was 79.91 grams. A biopsy of right apical perirectal soft tissue showed fibromuscular and fibroadipose tissue with hemorrhage and inflammation, and no evidence of residual neoplastic or benign prostatic tissue was found."} +{"pid": "TCGA-05-4417", "report": "The specimen shows a lesion in the right upper lobe of the lung, with histological features including a mixed growth pattern consisting of large-cell and clear-cell morphology. The architecture is predominantly solid and acinar, with minor mucin production observed. The primary localization is in segment S3, and there is evidence of extension across the oblique fissure into adjacent segments S4 and S5. The resected tissue shows no involvement at the bronchial or vascular margins, and all lymph nodes removed were free of abnormal cells. Based on the current material, the tumor staging is pT2, pN0, pMX, R0, corresponding to stage IB."} +{"pid": "TCGA-OL-A66O", "report": "A right breast implant was identified and evaluated grossly. A modified radical mastectomy specimen of the right breast included multiple foci of invasive carcinoma, with the largest focus measuring 2.8 cm and two additional foci measuring 0.7 cm and 1.1 cm respectively. Histologic grading of the main lesion and one satellite lesion was determined to be grade II/III, while the second satellite lesion was grade I/II. In addition, intraductal components of intermediate grade were present, exhibiting solid and papillary features. All surgical margins were negative for invasive disease and DCIS, with closest distances measuring 5.0 mm from the posterior margin.\n\nLymphatic and blood vessel invasion was noted in the breast tissue. Axillary lymph node evaluation revealed involvement in three out of seventeen nodes. The largest metastatic deposit measured 1.0 cm, and extranodal extension was present in one focus measuring 1.0 mm. Of five sentinel lymph nodes assessed, two were involved with metastatic disease, with the largest deposit measuring 1.0 cm; no extranodal extension was observed in these nodes.\n\nHormone receptor analysis demonstrated strong ER and PR expression in more than 90% of invasive tumor nuclei across all lesions. HER2 testing by FISH showed non-amplified status for the main lesion and first satellite lesion (ratios 1.2 and 1.5, respectively), and a negative IHC result for the second satellite lesion. Proliferation index (Ki67) was 20% for the main lesion and first satellite, and 10% for the second satellite.\n\nThe mastectomy specimen measured 15.5 cm from medial to lateral, 14 cm from superior to inferior, and 2.3 cm from anterior to posterior. The nipple-areolar complex appeared unremarkable without signs of ulceration or retraction. Gross examination revealed a grey-tan, irregular mass near the deep margin, along with other nodules and areas of dense parenchyma. Lymph nodes retrieved from the axilla varied in size from 0.3 to 1.2 cm.\n\nImmunohistochemical staining for p63 and myosin heavy chain showed loss of myoepithelium associated with the invasive component. Additional findings included uninvolved breast tissue with fibrocystic changes and previous biopsy sites. No skeletal muscle involvement was observed, and the skin and nipple were uninvolved."} +{"pid": "TCGA-J2-8192", "report": "A total of 12 lymph nodes were examined from various stations, including bilateral mediastinal and hilar regions. All lymph nodes, except for one hilar node, showed no evidence of tumor involvement. One hilar lymph node contained metastatic involvement. A left upper lobectomy specimen was analyzed, revealing a unifocal lesion located in the left upper lobe measuring 3.5 cm. The histologic grade was intermediate (2 out of 4). No invasion of the visceral pleura was identified. No lymphatic or large vessel invasion was observed. Resection margins were free of tumor. Two peribronchial lymph nodes were positive for tumor involvement. The nodal staging was based on 3 involved lymph nodes out of 12 examined. Additional molecular testing revealed high expression levels of EGFR, ERCC1, and RRM1; KRAS was wild-type. EGFR mutation analysis demonstrated an E19DEL mutation, and ALK rearrangement was not detected. A separate incidental finding of a meningothelial-like nodule was noted."} +{"pid": "TCGA-66-2783", "report": "The examined specimen included pleural tissue and other associated materials. Gross examination revealed an inflated, fixed lower lobe measuring 15 x 11.5 cm at the base with a resection plane at the level of the segmental bronchi. Multiple staple suture lines were noted, including two horizontal lines measuring 4 and 5 cm cranial to the hilus and an arcing line of 5.5 cm ventral to the hilus. The visceral pleura showed reticulate blackish pigmentation and areas of pale material. A lesion was identified in the peripheral to intermediate region involving S9 and S10, measuring up to 5.7 cm, with central necrosis and extension to the pleura in the basal area. It extended centrally to within about 1 cm of a bifurcation in B9 and B10. Adjacent lung parenchyma showed compaction and solidification with a pale brown appearance. A 0.9 cm nodule was present in the medial subpleural region of S8, with whitish cut surfaces and a blackish margin. Other areas of the lung showed patchy pigmentation and focal rarefaction with small lacunae (up to 0.2 cm). Lymph nodes from various stations were also examined, including two node parts measuring about 1 cm in the upper lobe, a 1.5 cm node part in the lower lobe, two 0.5 cm node parts on the left, and a 0.7 cm node with surrounding tissue from the pulmonary ligament.\n\nHistologically, intraoperative evaluation identified features consistent with a large-cell solid carcinoma, possibly of squamous origin. Sections included tumor tissue from the central region near B9 and B10, three sections of tumor involving the pleura, tumor with surrounding solidified parenchyma, a subpleural node in S8, bronchial and vascular resection margins, and additional lymph node samples. Staining methods included Elastica-van Gieson, PAS, and diastase-PAS across 11 blocks. Microscopic findings were not detailed due to capacity limitations.\n\nAssessment of the lymph nodes showed reactive changes and anthracotic pigment deposits, except for the subpleural lymph node in S8, which demonstrated metastatic involvement. No infiltration of the visceral pleura was observed. The bronchial and vascular resection margins were free of tumor involvement. The TNM classification based on these findings was pT2 pN1 pMX R0, corresponding to stage IIB. Additional findings included tumor necroses, active fibrin-rich chronic granulating pneumonia in the surrounding tissue, and associated pleuritis.\n\nA separate pleural aspirate sample (3 mL, amber-colored) was evaluated with two smear preparations. Cytological analysis showed only a few mesothelial cells or macrophages, some of which were degeneratively altered, along with leukocyte accumulation. No malignant cells were identified."} +{"pid": "TCGA-C5-A1MN", "report": "The specimen consists of irregular, gray-white tissue fragments admixed with blood clot, measuring 3.5 x 1.5 x 0.4 cm in aggregate. Histologic evaluation confirms the presence of a neoplastic process involving the cervix. Microscopic analysis reveals moderately differentiated features with evidence of keratinization. The lesion demonstrates invasive growth patterns. Immunohistochemical stains and other ancillary studies were performed as part of diagnostic assessment. All testing was conducted under established quality assurance guidelines compliant with applicable regulatory standards."} +{"pid": "TCGA-DD-A1EE", "report": "A portion of liver segment VII measuring 13.8 x 11.2 x 9.7 cm and weighing 540 grams was received, along with biopsies from liver segment V (No. 1: 1.5 x 0.9 x 0.7 cm; No. 2: 1.0 x 0.8 x 0.6 cm), core biopsies from liver segment VIII (1.0 cm and 1.5 cm in length), a splenic biopsy (0.4 x 0.4 x 0.2 cm), and the gallbladder (9.4 x 4.7 x 2.2 cm with a cystic duct lymph node measuring 3.4 x 2.6 x 2.0 cm). Histologic evaluation of the liver segment VII specimen revealed a large mass measuring 9.7 x 9.5 x 8.4 cm, with at least 25 additional nodules ranging from 0.1 cm to 2.2 cm in size found both adjacent to and separate from the main lesion. The surrounding liver tissue demonstrated cirrhotic changes with nodular regeneration. Margins of resection were free of involvement, with the closest distance being 1 mm. In liver segment V (biopsy No. 2) and segment VIII, findings showed similar cellular features involving 0.6 x 0.6 x 0.5 cm and a focus in the core biopsies, respectively. Biopsy No. 1 from segment V revealed a 0.8 x 0.6 x 0.5 cm finding consistent with a benign vascular lesion. Splenic biopsy showed normal tissue without concerning features. The gallbladder showed signs of chronic inflammation and cholesterolosis, and the cystic duct lymph node was unremarkable."} +{"pid": "TCGA-AK-3451", "report": "The left kidney specimen with attached adrenal gland and hilar lymph node weighed 720 grams. The kidney measured 15.0 x 8.0 x 7.0 cm and had a portion of attached fat ranging from 0.1 to 3.5 cm. At the hilum, the ureter measured 9.0 x 0.5 cm with no suspicious areas noted. A segment of adrenal gland measuring 2.8 x 1.5 x 0.4 cm was present and appeared normal. Upon bisection, a centrally located mass measuring 9.0 x 6.0 x 7.0 cm was identified. The mass was soft, with a yellow to red appearance and contained a large cyst filled with gelatinous and necrotic material. Approximately 60% of the nephrectomy specimen consisted of this mass, which significantly distorted the calyceal system. The mass was in close proximity to the renal capsule in multiple areas but did not show gross invasion beyond the capsule. Sections were taken from areas of the tumor adjacent to the capsule, perinephric fat, vascular and ureteral margins, hilar region, and adjacent normal renal parenchyma.\n\nMultiple sections showed a mixture of low-grade and higher-grade cellular morphology. The higher-grade regions exhibited abundant granular cytoplasm. No tumor involvement was identified in the adrenal gland or hilar lymph node. Perinephric fat showed no evidence of infiltration.\n\nThe second specimen consisted of left para-aortic lymph nodes embedded in fibroadipose tissue measuring 4.0 x 4.0 x 1.5 cm. Dissection revealed several lymph nodes ranging in size from 0.1 to 2.5 cm. Histologic evaluation of all sixteen lymph nodes showed no presence of tumor.\n\nCytogenetic analysis was performed on fresh tissue obtained from the resected specimen. Metaphase spreads were analyzed following G-banding. Four abnormal cells showed a chromosome count between 38 and 44 with a deletion in the short arm of chromosome 3 (del(3)(p13)) and the presence of a marker chromosome. Thirteen cells displayed a normal male karyotype (46,XY). The deletion in chromosome 3p is commonly associated with a specific subtype of renal epithelial malignancy.\n\nSections from the vascular margins, ureter, adrenal gland, tumor margins, and surrounding adipose tissue were evaluated microscopically. The tumor was confined within the renal parenchyma without definitive extension into adjacent structures. Multiple representative areas were submitted for histologic assessment to evaluate local invasion and margin status."} +{"pid": "TCGA-2H-A9GK", "report": "Coded sample ID: Histologic examination reveals moderately to poorly differentiated epithelial cells within the Barrett\u2019s epithelium. The lesion is located in the distal esophagus, with a maximum diameter of 5 cm. Lymph node evaluation shows involvement of 3 out of 5 retrieved nodes. The surgical specimen indicates a radical resection."} +{"pid": "TCGA-AR-A1AN", "report": "The specimen consists of a resected breast mass measuring 2.2 x 1.6 x 1.6 cm. Histological evaluation reveals a Nottingham grade II lesion based on the nuclear grade, tubule formation, and mitotic count contributing to a cumulative score of 7 out of 9. The lesion demonstrates no evidence of ductal carcinoma in situ or angiolymphatic invasion. The surrounding non-neoplastic breast tissue shows changes consistent with fibrocystic disease without proliferation. Biopsy site alterations are present.\n\nFollowing re-excision of the inferior margin, all surgical margins are free of tumor involvement, with a minimum distance of 0.5 cm at the deep/superior margin. Sentinel lymph node dissection was performed, and five right axillary lymph nodes were identified and evaluated. All lymph nodes are devoid of metastatic involvement, including results confirmed by immunohistochemical cytokeratin staining. Blue dye was successfully identified in all sentinel lymph nodes. Additional testing for Her-2/NEU is being conducted on paraffin-embedded tissue."} +{"pid": "TCGA-KK-A59V", "report": "A total of four lymph nodes were identified in the left obturator region, with sizes measuring up to 3.0 x 1.3 x 1.0 cm. These lymph nodes were serially sectioned and no abnormal tissue was identified. In the right external iliac region, two lymph nodes were found, measuring up to 2.2 x 1.4 x 0.9 cm. Both were bisected and showed no evidence of abnormal cells. Three lymph nodes were noted in the right obturator area, ranging in size from 0.8 x 0.5 x 0.2 cm to 4.0 x 1.5 x 0.8 cm. These were also sectioned and no atypical features were observed.\n\nTissue from the bladder neck at 7 o\u2019clock and 5 o\u2019clock positions was submitted for analysis. Both samples consisted of fibromuscular tissue, with no prostatic tissue or abnormal cellular changes detected. The pubic bone specimen included multiple fragments measuring 8.0 x 4.5 x 0.8 cm, and no unusual findings were present.\n\nThe prostate measured 4.5 x 2.5 x 4.5 cm and weighed 40 grams post-fixation. A palpable nodule was noted on the left posterolateral aspect involving the apex and mid region. Serial cross sections revealed a firm area consistent with a lesion in the left peripheral zone, extending across three cross sections. No gross abnormalities were seen in the attached seminal vesicles or vasa deferentia.\n\nTwo distinct areas of cellular irregularity were identified within the prostate. One was located in the transition zone and measured 2.7 x 1.3 cm, present in four cross sections. It was confined to the prostate with clear resection margins. A second focus was found in the left lateral, left posterolateral, left posterior, mid posterior, and right posterior peripheral zones, measuring 2.2 x 1.5 cm and present in three cross sections. This area showed more aggressive features, including extension into surrounding soft tissue and involvement of the left seminal vesicle. Focal proximity to the apical margin of resection was less than 0.1 mm. Lymphocytic infiltration was noted in this region, with a predominance of T lymphocytes. Immunostaining confirmed the presence of cytokeratin-positive cells, and limited neuroendocrine differentiation was observed in scattered cells. Repeated sectioning and immunoperoxidase studies were performed to better define the extent of involvement and clarify the relationship to surgical margins."} +{"pid": "TCGA-B9-5156", "report": "The specimen consists of a left kidney partial laparoscopic resection, weighing 17.3 grams and measuring 3.6 x 3.5 x 2.9 cm. The capsule was inked black and the parenchymal margin of resection was inked blue. A lesion located in the renal cortex directly abuts the capsule and appears encapsulated, with a yellow/brown coloration and no cystic changes identified. The lesion measures 1.7 x 1.5 x 1.4 cm and is confined within the kidney without gross involvement of perirenal adipose tissue or Gerota\u2019s fascia. Multicentricity could not be assessed due to the partial nature of the specimen.\n\nMicroscopic evaluation reveals a Fuhrman nuclear grade 3 lesion. The tumor invades the renal capsule but does not extend into the perirenal fat or Gerota\u2019s fascia. No vascular or lymphatic invasion is identified. Surgical margins, including the parenchymal resection margin, are negative for involvement. The tumor is located 0.5 cm from the closest surgical margin.\n\nAdditional findings include mild glomerulosclerosis and arteriosclerosis, as well as a benign simple cyst. No lymph nodes are identified. The kidney away from the lesion shows normal architecture with an average cortical thickness of 4.6 cm and medullary thickness of 1.0 cm.\n\nStaging information is limited to pT1a based on available data, with no regional lymph node assessment possible (pNx). This staging remains subject to revision pending further clinical review."} +{"pid": "TCGA-77-A5G6", "report": "Histopathology Report. HISTORY. No clinical notes. MACROSCOPIC. Three specimens received. 1: The specimen is labelled \"right upper lobe\" and consists of a lobe of lung that has been previously sampled for research purposes. This lobe measures 140 mm (SI), 20 mm (ML), and 180 mm (AP). There is puckering of the pleural surface on the anterolateral surface measuring up to 25 x 20 mm. Scarring is noted on the posterolateral surface measuring up to 10 x 10 mm. The apex shows some emphysematous changes. On sectioning, a firm cream tan lesion with black pigmentation is identified within the lung parenchyma. It has a maximum cut surface area of 32 x 20 mm in dimension. The lesion is located 30 mm away from the bronchial resection margin and within 1 mm of the pleural surface. Representative sections include bronchial resection margin, peribronchial node, additional lymph nodes, sections of the lesion nearest to the pleural surface, surrounding lung tissue, areas of emphysema, scarring, presumed normal lung tissue, and further bronchial margin. 2: The specimen is labelled \"hilar lymph node\" and consists of a lymph node measuring 5 x 3 x 3 mm in dimension. It has been bisected. 3: The specimen is labelled \"No 4 and No 10 lymph node\" and consists of multiple pieces of yellow brown tissue ranging in size from smallest 5 x 3 x 3 mm to largest 32 x 25 x 20 mm. The largest node appears to be involved with the lesion. No extra capsular spread is identified. MICROSCOPIC. 1: Sections reveal a poorly differentiated epithelial malignancy showing areas of clear cell change. The lesion does not directly invade visceral pleura. There is extensive lymphatic invasion with involvement of adjacent lymphatic channels within pleura, pulmonary septa, and along bronchovascular bundles. The lesion is present within a lymphatic vessel at the bronchial resection margin. No lesion is identified within bronchial wall at the bronchial resection margin. Peribronchial lymph nodes are involved. Deposits are present within afferent lymphatic channels, subcapsular sinuses, and distributed throughout lymph node parenchyma. Lymph node tissue also shows reactive changes including sinus histiocytosis, carbon pigment deposition, scattered flecks of birefringent material consistent with silicate, and hyalinized silicotic nodules. No vascular invasion or perineural permeation by the lesion is seen. Immediately adjacent to the lesion there is a localized area of endogenous lipoid pneumonia. Remaining lung parenchyma shows emphysema and respiratory bronchiolitis. Vascularised pleural adhesions are also present. 2: Sections reveal lymph node tissue which is partially involved by the same epithelial lesion showing clear cell change. 3: All sections (3A-3C) reveal lymph node tissue which is partially involved by the epithelial lesion showing clear cell change. Lymph node tissue also shows reactive changes including follicular hyperplasia, sinus histiocytosis, carbon pigment deposition, scattered flecks of birefringent material consistent with silicate, and hyalinized silicotic nodules. SUMMARY. Right upper lobectomy with separately submitted hilar lymph node and No 4&10 lymph nodes: Poorly differentiated epithelial lesion with clear cell change. Lesion size: 32 mm. Lesion does not directly invade visceral pleura. Extensive lymphatic invasion present (within pleura, pulmonary septa, and along bronchovascular bundles). No vascular invasion or perineural permeation seen. Lesion within lymphatic channel at bronchial resection margin; no lesion within bronchial wall at resection margin. Peribronchial lymph nodes and separately submitted lymph nodes involved. Pathological stage: T2 N2. Emphysema, respiratory bronchiolitis."} +{"pid": "TCGA-2Z-A9J2", "report": "The specimen was received fresh and consists of a left kidney measuring 10.0 x 4.5 x 4.0 cm, with attached perinephric adipose tissue. A well-defined, firm, gray-yellow mass located in the inferior pole of the kidney measures 3.0 x 2.5 x 1.5 cm. The tumor does not grossly involve the renal capsule, renal sinus, or perinephric fat. The renal pelvis and collecting system appear free of tumor involvement. The renal artery and vein are identified and show no gross evidence of tumor invasion. No adrenal gland tissue was present on the specimen. Approximately 40% of the tumor shows areas of necrosis.\n\nHistologically, the tumor exhibits a solid growth pattern with nuclear grade 3 features. Immunohistochemical staining demonstrates reactivity for vimentin, AMACR, CD10, and cytokeratin, while being negative for C-KIT. There is no evidence of renal vein invasion, Gerota\u2019s fascia invasion, or capsular invasion. Surgical margins are negative for malignant cells.\n\nNon-neoplastic findings include focal mild chronic pyelonephritis in the adjacent kidney tissue. No lymph nodes were identified in the specimen. Pathologic staging is T1a, NX, MX. Additional specimens include a segment of bone consistent with a rib, which appears grossly unremarkable, and perinephric fat that shows no signs of malignancy."} +{"pid": "TCGA-FY-A3NN", "report": "The surgical pathology report includes three specimen submissions. Specimen A, a skin excision from the right medial ankle, shows a benign skin finding with a thrombosed dermal vessel. The specimen was oriented with single and double sutures, measuring 2.2 cm from 3 o\u2019clock to 9 o\u2019clock and 1.0 cm from 12 o\u2019clock to 6 o\u2019clock. A raised blue-gray lesion measuring 0.7 x 0.4 cm was identified, located at least 0.2 cm from the nearest margin. Margins were inked in multiple colors and the specimen was fully submitted for analysis.\n\nSpecimen B is a total thyroidectomy specimen weighing 34 grams. The right lobe measures 5.0 x 4.0 x 2.0 cm, the left lobe 5.4 x 2.8 x 1.8 cm, and the isthmus 1.7 x 1.5 x 0.3 cm. A tan nodule measuring 2.0 cm in greatest dimension was found in the right superior pole. This nodule was encapsulated with a red-brown appearance and a central area of firm, tan-gray tissue. A second, non-suspicious pink-tan nodule measuring 1.8 cm was present in the mid to inferior right lobe. The remainder of the thyroid tissue appeared unremarkable. All relevant sections were submitted across 20 cassettes.\n\nSpecimen C consists of right paratracheal level 6 lymph nodes. The fibroadipose tissue sample measured 3.3 x 1.5 x 1.0 cm and contained two identifiable lymph nodes, each measuring between 0.4 and 0.5 cm. All lymph node tissue was submitted for analysis. Microscopic evaluation confirmed the presence of abnormal cells within these nodes. \n\nStaging information indicates a primary tumor size of 2.0 cm with no evidence of extrathyroidal extension or lymph-vascular invasion. Surgical margins were free of involvement. The pathologic stage is pT1b, pN1a, pMX. No ancillary studies were performed."} +{"pid": "TCGA-35-4122", "report": "The specimen was obtained from a lung primary tumor tissue source and preserved in an OCT block. A separate blood sample was collected and stored frozen. Histological evaluation revealed a component of adeno-squamous carcinoma. The tumor demonstrated a histologic grade of 2, with 75% tumor cell content. Staging parameters indicated T2, N1, M0 classification. No prior treatment was administered before specimen collection."} +{"pid": "TCGA-AQ-A04J", "report": "The right axillary sentinel lymph node #1 showed no evidence of metastatic carcinoma in one lymph node. The right axillary sentinel lymph node #2 demonstrated an isolated cell cluster measuring 0.12 mm in greatest dimension on permanent section, with no extracapsular extension observed. Both left axillary sentinel lymph nodes #1 and #2 showed no evidence of metastatic carcinoma.\n\nThe right breast total mastectomy specimen contained a centrally necrotic, ill-defined mass measuring 2.7 cm in greatest dimension located in the upper outer quadrant. Histologic evaluation revealed high-grade cellular features including significant nuclear pleomorphism and mitotic activity. The tumor was unifocal and did not demonstrate lymphovascular invasion. An in situ component was present, comprising approximately 50% of the tumor, admixed with and adjacent to the invasive component. The in situ component exhibited multiple architectural patterns and high nuclear grade with necrosis. Margins were widely negative for both invasive and in situ components. Microcalcifications were identified in association with both invasive and in situ components.\n\nThe left breast total mastectomy specimen showed no invasive lesion but contained in situ findings along with benign proliferative changes including fibrocystic change and duct ectasia.\n\nStaging assessment indicated pT2 based on tumor size and pN0(i+) due to the presence of isolated cells in one lymph node. All distances from the tumor to surgical margins were greater than 1 cm, with the closest being 1.3 cm to the posterior margin. No gross involvement of skin or fascia/muscle by tumor was observed.\n\nImmunohistochemical studies performed on the right breast lesion demonstrated negative staining for estrogen receptor, progesterone receptor, and HER2/neu markers.\n\nMultiple tissue blocks were submitted for evaluation from both mastectomy specimens, including representative sections from the nipple, areola, tumor area, and surrounding quadrants. Specimen characteristics and fixation times were documented for both breasts. Digital photographs were not taken. Tissue procurement was conducted for further investigations."} +{"pid": "TCGA-A8-A07E", "report": "The specimen shows a moderately differentiated invasive carcinoma with a tumor diameter of 3.5 cm. The distance to the dorsal margin is 3 cm, while other margins are free. Histological evaluation indicates involvement of three or more regional lymph nodes. Vascular invasion is not identified. The tumor is classified as G2 with no residual tumor at the margins."} +{"pid": "TCGA-23-1024", "report": "The specimen from the right tube and ovary weighed 650 grams and measured 15.0 x 14.0 x 7.5 cm. It featured a focally disrupted mass with delicate serosal fibrous adhesions and papillary surfaces, some of which were friable. Multilocular cystic areas were present with smooth linings and contained serous fluid. Solid semifirm areas were also noted. A small area of residual ovary was identified measuring 7.0 x 2.5 cm. The attached fallopian tube was 5.0 cm long, with a smooth serosa and a pinpoint lumen.\n\nThe left tube and ovary specimen measured 3.5 x 2.5 x 2.5 cm and was cystic, with a serosanguineous fluid content. A unilocular cyst measuring 2.0 x 2.0 x 1.5 cm was observed, with papillary excrescences on the lining. Focal areas of necrosis were noted. The attached fallopian tube measured 5.5 cm in length, with variable diameter up to 0.8 cm, and included a thin-walled paratubal cyst containing straw-colored fluid.\n\nThe uterus and cervix specimen weighed 50 grams and showed a symmetric uterus with a bulging subserosal nodule. Uterine dimensions were 7.0 cm from fundus to ectocervix, 3.5 cm between cornua, and 3.0 cm anterior to posterior. A subserosal leiomyoma measuring 3.0 cm and an intramural leiomyoma measuring 0.8 cm were identified. Both were well-circumscribed with typical pink-white cut surfaces. The endometrium appeared atrophic with an average thickness of 0.2 cm. The myometrial wall had an average thickness of 1.3 cm. Sections of the right fallopian tube stump were submitted for evaluation, although the opening was difficult to identify due to clamping.\n\nOmentum #1 was a 12.5 x 6.5 x 1.0 cm lobulated yellow fatty tissue with surface fibrous adhesions. Gross tumor implants were found within the fat, ranging from 0.2 to 1.0 cm in size.\n\nOmentum #2 measured 15.0 x 7.0 x 2.0 cm and contained a firm pink-tan tumor implant measuring 1.0 x 0.8 x 0.5 cm.\n\nAll specimens were sectioned and submitted for microscopic evaluation. Cellular features included solid and cystic components with papillary architecture, some showing necrotic changes. Stromal invasion was identified in the uterine serosa. Endometriosis was present in the fallopian tube, and adenomyosis was noted in the uterus. Tumor involvement was seen in both ovaries, the uterine serosa, and omental tissues. No luminal obstructions were found in either fallopian tube."} +{"pid": "TCGA-A4-8312", "report": "A mass was identified in the left kidney during wedge resection. The mass measured approximately 1.5 cm in greatest dimension and exhibited a tan, friable appearance on cross-section. The surrounding renal parenchyma appeared tan-gray and was up to 0.4 cm thick. The tumor was confined within the resected tissue with no involvement of the margins. Nuclear grading according to Fuhrman criteria was grade I out of IV. No angiolymphatic invasion was observed. Based on AJCC staging guidelines, the pathologic stage was determined as T1, Nx.\n\nIn addition, a separate cystic structure was noted. The cyst measured 2.3 x 1.2 cm and had a thin wall less than 0.2 cm in thickness. Histologically, it demonstrated benign features with minimal epithelial lining and no presence of clear cells. Adjacent renal tissue beneath the cyst wall showed evidence of sclerotic glomeruli. Microscopic evaluation of the mass revealed a papillary architecture without characteristic foam cells. All tissue fragments were submitted for analysis."} +{"pid": "TCGA-AF-4110", "report": "The specimen includes a segment of rectosigmoid colon measuring 38.5 cm in length, partially covered with abundant yellow lobular fat. The proximal end is stapled and inked blue, while the distal end is stapled and inked black. The serosal surface is pink-tan, smooth, and glistening, also partially covered with fat. An umbilicated area measuring 3.0 x 2.5 cm is noted, located 7.5 cm from the distal margin and inked blue. The retroperitoneal reflection lies 4 cm from the distal margin. Upon opening, the mucosa appears pink-tan and smooth with normal to slightly dilated folds. The proximal circumference measures 5 cm and the distal circumference measures 9.5 cm. A small exophytic polyp measuring 0.7 cm is identified 13 cm from the proximal margin. There is also a circumferential lesion beneath the umbilication measuring 6.0 x 6.1 x 1.2 cm, located 6.5 cm from the distal margin. Histologically, this lesion invades into the muscularis propria and extends to within approximately 3 cm of the radial margin. Lymph nodes adjacent to the lesion are enlarged and show focal necrosis; additional lymph nodes are identified throughout the specimen.\n\nSections submitted include representative luminal margins, the entire small polyp, multiple sections through the lesion including transition zones, radial margin, possible vascular involvement, and numerous lymph nodes. Additional tissue from a vessel and a mottled lymph node was also submitted.\n\nThe appendix specimen measures 6.6 cm and ranges from 0.5 to 0.7 cm in diameter. It is covered by smooth tan-pink serosa with attached mesoappendix. The lumen is pinpoint throughout. The mucosa is tan-pink without abnormalities and the wall averages 0.2 cm thick. No transmural defect is observed. Both proximal and distal margins are submitted together.\n\nMicroscopic evaluation of the colon reveals moderately differentiated invasive carcinoma extending to the visceral peritoneum. Both proximal and distal luminal margins are free of tumor involvement. The radial margin is also negative for tumor. The closest distance from the tumor to any margin is 6.5 cm at the distal end. Prominent vascular invasion involving large venous spaces is observed adjacent to the lesion and within the surrounding fat. Focal lymphatic invasion is also present. Regional lymph node assessment identifies metastatic involvement in 21 out of 34 lymph nodes. Extracapsular tumor extension is noted. Additionally, a small serrated adenoma and focal diverticulitis are identified.\n\nMicroscopic examination of the appendix shows no significant pathology aside from fibrous obliteration at the tip."} +{"pid": "TCGA-AF-3913", "report": "The specimen included right and left pelvic lymph nodes, prostate, splenic flexure colon, rectosigmoid colon, and appendix. The right pelvic lymph nodes were identified within a 6 x 4 x 2 cm portion of fat containing multiple clips. Five suspected lymph nodes were found, ranging from 5 mm to 3 cm in size. All were bisected and showed soft, fleshy reddish-brown tissue without gross abnormalities. The left pelvic lymph node specimen was a 3 x 3 x 2 cm mass of fat containing a single lymph node measuring 4 x 2 x 1 cm, which was also soft and without suspicious areas.\n\nThe prostate weighed 28 grams and measured 4.5 x 3.5 x 3.2 cm with attached bilateral adnexa. Seminal vesicles averaged 2.2 x 1 x 0.7 cm, and the vasa deferentia averaged 2.2 x 0.5 cm. The right side was inked blue, the left black. After removal of the apical and bladder margins, the remaining prostate was sectioned and showed a pink-tan rubbery and nodular cut surface with no other discrete lesions.\n\nThe splenic flexure colon specimen was 7 cm long, stapled at both ends, and partially covered with fat. A large exophytic mass measuring 4 x 3.2 x 2.2 cm was located equidistant between both luminal margins. Two small polyps (0.2 cm and 0.3 cm) were also noted. The tumor showed minimal invasion into the muscularis propria, not through it, and was within 1.5 cm of the deep radial margin. Lymph nodes were present in the surrounding fat.\n\nThe rectosigmoid colon was 13 cm long, with one end inked blue and the opposite stapled and inked black. A large exophytic mass measuring 5.5 x 3.5 x 1.2 cm was located 2.5 cm from the distal margin. Additional small polyps ranged from 0.5 to 1 cm in size. The tumor had invaded through the muscularis propria and was within 2.5 cm of the radial margin. Lymph nodes were also identified in the fat surrounding this specimen.\n\nThe appendix was unremarkable, measuring 6.5 x 0.5 cm, with an intact wall and average thickness of 0.4 cm. No discrete gross lesions were observed.\n\nMicroscopically, the prostate showed a histologic pattern consistent with moderately differentiated adenocarcinoma. Tumor was identified in the left lobe with extension beyond the prostatic capsule. Surgical margins were negative. No involvement of the seminal vesicles was seen. Lymphovascular invasion was not identified, but perineural invasion was present. Pelvic lymph nodes on both sides were free of tumor involvement.\n\nIn the splenic flexure colon, the tumor was moderately differentiated and extended into, but not through, the muscularis propria. All margins, including the radial margin, were free of tumor. Vascular invasion was not present, and two regional lymph nodes were also negative for tumor involvement. The tumor arose within a tubulovillous adenoma, and a hyperplastic polyp was also identified.\n\nIn the rectosigmoid colon, the tumor was moderately differentiated and extended through the muscularis propria into the surrounding fat. All luminal and radial margins were clear. Vascular invasion was not seen. Of 26 regional lymph nodes examined, one contained tumor involvement. Six hyperplastic polyps were also identified in this segment of the colon.\n\nThe appendix showed no significant microscopic findings."} +{"pid": "TCGA-HU-8610", "report": "The specimen consists of a subtotal gastrectomy measuring 20.5 cm along the greater curvature and 12.0 cm along the lesser curvature. The proximal resection margin measures 14.0 cm and the distal resection margin measures 6.5 cm. The tumor is located in the middle third (body), posterior wall of the stomach, 4.0 cm from the proximal margin and 6.0 cm from the distal margin. It measures 3.8 x 2.5 x 2.0 cm and appears as a superficial lesion (EGC I type) without gross serosal invasion. Tissue blocks were obtained from multiple sections including tumor and surrounding tissue, antral and body mucosa, and proximal and distal margins. Lymph nodes from various regional stations were also submitted.\n\nMicroscopic evaluation reveals a tubular growth pattern with moderate differentiation. The depth of invasion extends into the submucosa of the middle third (SM2). All resection margins are negative. Histologic classification demonstrates intestinal-type morphology. There is no lymphoid reaction, lymphovascular invasion, venous invasion, or perineural involvement. No metastatic deposits are identified in 79 regional lymph nodes examined. Pathologic staging is pT1bNOMx according to AJCC 7th edition criteria.\n\nSpecial stains for H. pylori are negative. Additional findings include chronic gastritis in the prepyloric and body regions, with ulceration and intestinal metaplasia noted. In the large intestine, low-grade dysplastic tubular adenomas are identified in the sigmoid colon and rectum."} +{"pid": "TCGA-CM-6678", "report": "The patient presented with a history of advanced-stage cancer involving the left colon. A colectomy specimen was examined, revealing a lesion located in the sigmoid colon measuring 5 x 2 x 0.4 cm. Histologic evaluation showed moderately differentiated cellular features with focal budding observed. No increased lymphocytes were noted within the tumor bed. The tumor was found to invade through the muscularis propria to the serosal surface without evidence of perforation, lymphovascular invasion, large venous invasion, or perineural involvement. All surgical margins were free of tumor involvement. No precursor lesions or mucosal abnormalities were identified away from the primary lesion. Nineteen lymph nodes were examined, none showing signs of involvement. A single tumor deposit was identified in the surrounding soft tissue.\n\nThe staging based on depth of invasion is consistent with full penetration to the visceral peritoneal surface. Regarding lymph node involvement, no regional metastasis was identified; however, tumor deposits were present in non-nodal tissue near the primary lesion.\n\nA separate gallbladder specimen measured 7.0 x 3.5 x 3.0 cm and contained bile with multiple gallstones attached to the mucosal lining. Histologic sections revealed mild chronic inflammation and gallstone formation without malignant changes. The cystic duct margin was among the sections submitted for review.\n\nAdditionally, a lymph node specimen from the hepatic artery region was evaluated. The lymph node measured 1.3 x 1.0 x 0.5 cm and showed no signs of malignancy upon examination.\n\nAll specimens were processed and reviewed with representative sections submitted for analysis."} +{"pid": "TCGA-W5-AA2R", "report": "The specimen from a female patient, collected during surgery, includes an excised mass measuring 4.8 x 3.1 x 3.0 cm, located in liver segments V and VI. The mass demonstrates grade 3 cellular differentiation out of 4 and exhibits extensive necrosis. All surgical resection margins, including the retroperitoneal margin, are free of malignant cells, with a clearance distance of 0.7 cm. Additionally, the gallbladder shows histological evidence of chronic inflammation and cholesterolosis, with the presence of stones noted."} +{"pid": "TCGA-CH-5746", "report": "The specimen shows a focus of predominantly moderately differentiated cellular proliferation involving both sides of the tissue, with greater involvement on the left rectolateral aspect. The maximum extent of the lesion measures 1.5 cm. There is no evidence of vascular invasion or extension beyond the expected anatomical boundaries. The associated structures remain free of involvement. \n\nInfiltration is noted at the surgical margins in the left rectolateral and basal regions. Additional findings include unremarkable adipose tissue and a separate adipose sample containing two lymph nodes, both without any abnormal cellular infiltration.\n\nHistological evaluation notes a pattern of growth corresponding to a well-defined classification system with a score of 3+4 = 7, with approximately 40% of the pattern showing higher architectural complexity. In the area of tissue discontinuity, there is presence of atypical cells extending to the margin marked by yellow labeling. Further, in the left apical region and first section of the left rectolateral area, there is limited contact with the blue-labeled surface, involving a total width of 3 mm and a maximum single dimension of 2 mm."} +{"pid": "TCGA-VD-A8KN", "report": "A fresh, intact left globe was examined, measuring 22.5mm axially, 24mm horizontally, and 24mm vertically. The cornea measured 11.5mm horizontally and 11mm vertically. The optic nerve was 3.5mm in length and 4mm in diameter. Trans-illumination revealed a large shadow approximately 13.5mm in diameter extending between the optic nerve and just anterior to the equator. Upon dissection, a solitary dome-shaped pigmented mass was identified adjacent to the optic disc. The lesion measured 15mm in largest basal diameter and 4.7mm in height.\n\nMicroscopic evaluation demonstrated a variably pigmented lesion composed of mixed cell types, with epithelioid cells comprising up to 60% of the population. A focal peripheral area showed clear cell changes resembling balloon-type cells. Immunohistochemical staining showed expression of Melan-A and HSP-27 (score 2). Mitotic activity was minimal, with approximately 2 mitoses per 40 high-power fields. The microvasculature was prominent, with closed vascular loops present in the sections. Lymphocytic infiltration within the lesion was minimal, and necrosis was not observed. Bruch\u2019s membrane appeared disrupted, and there was limited extension into the sclera. No involvement of the optic nerve, vortex veins, or resection margins was identified.\n\nThe cornea was unremarkable. The anterior chamber angles were open, though the anterior chamber was shallow. The iris showed no significant abnormalities; however, the ciliary body was atrophic with hyalinization of the ciliary processes. The lens exhibited subcapsular degenerative changes, and the retina overlying the lesion was slightly atrophic.\n\nMolecular genetic analysis using MLPA on extracted tissue demonstrated loss of chromosome 1p, monosomy 3, partial losses of chromosome 6, and gains in chromosome 8q. These findings are under review in conjunction with clinical and morphological data for risk assessment."} +{"pid": "TCGA-85-8276", "report": "The specimen consisted of lung tissue obtained via pneumonectomy. The tumor was located in the left upper lobe and measured 2.5 x 2 x 4 cm. Microscopic examination revealed moderately differentiated cells with features consistent with keratinizing morphology. Lymph node evaluation showed 3 out of 12 nodes involved by similar findings, specifically in the hilar region. No definitive assessment was made regarding tumor extent, presence of additional nodules, lymphatic or venous invasion, surgical margins, neo-adjuvant treatment effect, or other significant pathologic findings."} +{"pid": "TCGA-15-1444", "report": "The specimen consists of tissue from the brain, including the right frontal lobe and adjacent septal region. The resected tissue includes multiple fragments, with the largest aggregate measuring 2.0 x 1.0 x 0.5 cm. In the right frontal septal region, a solid mass is present, measuring 5.5 x 4.7 x 1.8 cm, along with another distinct nodule measuring 5.0 x 2.3 x 2.0 cm. Histologically, the lesion demonstrates features consistent with a high-grade glial neoplasm. Microscopic evaluation reveals fibrillary-type cells with increased nuclear atypia, brisk mitotic activity, microvascular proliferation, and areas of necrosis. Based on histologic criteria, the neoplasm is classified as grade 4 according to standard grading systems. The tumor exhibits extensive infiltration into surrounding parenchyma, with evidence of multifocal growth patterns. No lymph node involvement was assessed. Distant spread was not evident based on available imaging and intraoperative findings."} +{"pid": "TCGA-EA-A97N", "report": "The specimen consists of a uterus with cervix measuring 9 x 6 cm. Within the cervix, there is a dense gray-pink mass measuring 8 x 4 cm, with extension to the serosal surface. There is also associated endometrial hyperplasia. Histologic evaluation reveals cervical tissue with moderately differentiated cellular features. Endometrial glandular hyperplasia is present. The vaginal cuff shows squamous epithelial changes consistent with leukoplakia. Parametrial tissues on both sides are composed of fat and fibrosis without significant cellular abnormalities. Lymph nodes from the right, left, and presacral regions show lipomatosis and sinus histiocytosis without evidence of metastatic disease. No venous invasion is identified. The tumor size exceeds 4 cm, and based on this measurement, the staging classification reflects an extent beyond the original report."} +{"pid": "TCGA-D5-6530", "report": "Histopathological examination was performed on a resected specimen including a segment of the large intestine measuring 30 cm in length with attached mesentery (17 x 19 x 5 cm), a 9 cm segment of small intestine, and an appendix measuring 6 cm. A cauliflower-shaped, ulcerated lesion was identified in the mucosa, measuring 4.5 x 4 x 1 cm. The lesion circumferentially involved 100% of the intestinal wall, causing luminal narrowing, and was located 12 cm from the proximal resection margin and 20 cm from the distal margin. Macroscopic assessment indicated invasion into the surrounding periintestinal tissue, with a minimum radial margin of 4 cm.\n\nMicroscopic evaluation revealed a tubular growth pattern with moderate differentiation. There was evidence of infiltration into the muscularis propria. The resected ends of the intestine showed no involvement. Reactive lymph node changes were noted, and no tumor was identified in the lymph nodes examined. The lesion was confined to the intestinal wall without distant spread."} +{"pid": "TCGA-G4-6295", "report": "The surgical specimen includes a right hemicolectomy with terminal ileum. A mass measuring 7x5x1.2 cm is present in the proximal cecum, located 2.5 cm from the ileocecal valve, 7 cm from the proximal margin, and 17 cm from the distal margin. On gross examination, the lesion penetrates through the muscularis propria into the subserosal fat. Microscopically, the lesion demonstrates poor differentiation and medullary features. No involvement is identified at the resection margins. A total of twenty-three lymph nodes are examined; none show evidence of metastatic involvement. Adjacent colonic mucosa shows multiple flat sessile polypoid lesions ranging from 0.2 cm to 1.0x0.7x0.5 cm in size. These include precursor lesions such as tubular adenomas and hyperplastic polyps. The uninvolved colonic mucosa and terminal ileum appear normal. The tumor does not exhibit vascular, lymphatic, or perineural invasion. No implants or adjacent tissue extension are noted. Pathologic staging is determined as pT3NO MX."} +{"pid": "TCGA-CG-4466", "report": "The specimen includes a gastrectomy preparation with tumor-free resection margins. A subcardial lesion is identified, characterized by moderately differentiated adenocarcinoma infiltrating the lamina muscularis propria (pT2a L1 V0 R0). Distal to this, a smaller lesion is present, also moderately differentiated adenocarcinoma, located approximately in the middle of the antrum with invasion limited to the submucosa (pT1 L0 V0 R0). Both lesions are surrounded by multifocal atrophic gastritis associated with Helicobacter pylori infection and intestinal metaplasia. No regional lymph node metastases were detected (pN0 0/13)."} +{"pid": "TCGA-AA-3531", "report": "The resected specimen includes a segment of the colon (sigmoid colon) with diverticulosis. The tumor-free oral and aboral resection margins are noted. An ulcerated lesion is present, characterized by moderate differentiation and infiltration into the perimuscular fatty tissue. A total of thirty-seven regional lymph nodes show no evidence of tumor involvement and display nonspecific reactive changes. The pathological staging indicates pT3 pN0 (0/37), with no lymphovascular or venous invasion observed."} +{"pid": "TCGA-VS-A9V5", "report": "The biopsy specimen was obtained from the cervix. Histologic evaluation revealed a moderately differentiated gland-forming neoplasm. Immunohistochemical studies were performed and the results are consistent with a primary origin in the uterine cervix. The tumor exhibits mucinous differentiation with endocervical-type morphology. No evidence of poorly differentiated components or other variant histologies is present."} +{"pid": "TCGA-AN-A0FJ", "report": "Female. Histological description shows a moderately differentiated infiltrating lesion. Anatomic site is the left breast, with tumor location identified as primary. The tissue specimen was obtained via surgery and stored in OCT medium within a block container. Cellular grade is 2. Staging indicates local extension with regional lymph node involvement, and there is evidence of distant spread. No prior treatment has been administered. A normal sample from blood was also collected via blood draw and stored frozen in a tube container."} +{"pid": "TCGA-5L-AAT1", "report": "Specimens were received from the right breast of a female patient. The mastectomy specimen weighed 863 grams and measured 22.5 x 17.5 x 4.0 cm. A skin ellipse measuring 18.0 x 7.0 cm was noted on the surface, with no visible lesion. Upon sectioning, a white, spiculated nodule with central necrosis was identified within the breast tissue, measuring 3.5 x 2.5 x 0.8 cm. All surgical margins appeared to be free of involvement.\n\nOne axillary lymph node was submitted separately, measuring 1.1 x 0.8 x 0.3 cm, and showed no gross abnormalities. Additionally, 10 axillary lymph nodes were received in aggregate as fibrofatty tissue measuring 3.0 x 2.2 x 0.6 cm. Within this tissue, four soft nodules were identified, with the largest diameter ranging between 0.2 and 0.4 cm.\n\nMicroscopic examination revealed a lesion in the breast measuring 1.1 cm in greatest dimension, with clear surgical margins. No evidence of lymph node involvement was found."} +{"pid": "TCGA-A3-3382", "report": "The collected specimen consists of a left nephrectomy weighing 1040 grams, surrounded by a large amount of perinephric adipose tissue and faced anteriorly by a moderate amount of Gerota's fascia. The reconstructed specimen measures 24.0 x 13.8 x 9.8 cm. Resection margins include 1.5 cm of grossly patent renal artery, 1.3 cm of grossly patent renal vein, and 7.0 cm of grossly patent ureter. After stripping the capsule, the organ measures 12.4 x 8.5 x 6.9 cm. The cortex is lobulated, slightly pale red-brown, and granular, measuring up to 1.0 cm in thickness with a poorly defined corticomedullary junction. The medulla is red-brown with sharp papillae. The calyces and pelvis are lined with smooth gray-white mucosa extending into the ureter.\n\nOn the posterior aspect extending into the hilus, there is a well-defined nodule measuring 5.2 x 4.8 x 4.5 cm. It has a thin capsule with a gray-tan to yellow appearance and a friable, focally chalky and hemorrhagic cut surface. The capsule appears intact on gross examination. The lesion extends beyond the kidney into surrounding adipose tissue, but the capsule does not appear transected. Adjacent to the lesion, the lower pole calyx is dilated and contains a 0.6 x 0.5 x 0.4 cm brown-black calculus. Further sectioning reveals another dilated calyx in the lower pole with a similar calculus measuring 0.4 x 0.3 x 0.2 cm. Adjacent to these calyces, within the parenchyma, is a 0.4 x 0.4 x 0.2 cm well-defined, unencapsulated tan-white fibrotic-appearing nodule. No other gross lesions are identified.\n\nMicroscopic evaluation indicates that the lesion is confined to the kidney. Nuclear grade is Fuhrman grade 3 out of 4. Lymphovascular space invasion is present. There is no evidence of transcapsular or renal vein invasion. Vena caval invasion was not assessed as it was not resected. The adrenal gland was not resected. All surgical margins\u2014soft tissue, ureteral, and vascular\u2014are negative for malignancy. No lymph nodes were resected with the specimen.\n\nAdditional findings include a 0.4 cm renal calculus and a microscopic healed renal infarct. Representative sections were submitted for analysis from the vascular and ureteral margin, the lesion and surrounding tissue, and random uninvolved parenchyma with dilated calyx and fibrotic nodule. Staging is pT1b Nx Mx."} +{"pid": "TCGA-DX-A8BR", "report": "The clinical history notes a prior lesion in the right leg. The submitted specimen is a radical resection from the right thigh. The resected tissue measures 17.0 cm in length, 6.5 cm in width, and 13.0 cm in depth. A well-circumscribed mass measuring 7.0 x 6.0 x 5.0 cm is identified within the superficial aspect of the adductor musculature. The mass has a tan, soft, fleshy consistency with focally myxoid and friable areas. Margins of excision are free of tumor. The tumor is located 1.0 cm from the medial margin, 1.5 cm from the superior margin, 7.0 cm from the inferior margin, and 2.5 cm from the deep margin. Sections including all relevant margins have been submitted for evaluation. Cellular features include areas of myxoid change and pleomorphism. Immunohistochemical stains performed include S-100, EMA, SMA, DES, and AE1:AE3. All findings are based on personal examination of the slides and review of the material."} +{"pid": "TCGA-50-8457", "report": "The right upper lobe specimen demonstrates a lesion measuring 3.0 x 2.7 x 2.2 cm. Histologic evaluation reveals a predominantly acinar growth pattern with minor papillary components. The invasive component corresponds to the overall tumor size. Angiolymphatic invasion is present. Visceral pleural invasion is not identified. Surgical margins are negative for tumor involvement, with the closest distance measuring 25 mm. Three intrapulmonary peribronchial lymph nodes are without evidence of malignancy. A total of eight lymph nodes were evaluated, including five N1 and three N2 nodes, all of which are negative for malignant involvement. Molecular testing reveals a KRAS mutation (G12A) in exon 2, codon 12. No mutations are identified in EGFR exons 18, 19, 20, or 21, nor in BRAF exon 15 or KRAS codon 61. ALK rearrangement studies show less than 15% positivity, interpreted as negative. Similarly, c-MET and FGFR1 FISH analyses do not demonstrate gene amplification. Histochemical stains and other ancillary studies show no evidence of tumor necrosis exceeding 50%, with mild inflammatory reaction noted. Pathologic staging indicates T1bN0 based on AJCC criteria. Underlying pulmonary changes include emphysema and smoker\u2019s bronchiolitis."} +{"pid": "TCGA-CV-6937", "report": "A segment of nerve measuring 0.9 x 0.2 x 0.2 cm was submitted and found to be unremarkable with no abnormal cellular infiltration. A partial mandibulectomy specimen, including attached skin, measured 9.0 x 4.5 x 5.0 cm. The skin was intact and hair-bearing, measuring 5.5 cm in width and 9.5 cm in length. On the mucosal surface, there was an ulcerated, deeply invasive lesion measuring approximately 2.0 x 1.0 x 3.5 cm. The lesion was firm and tan-white, involving cortical bone and extending into soft tissue with infiltration into the overlying skin. Bony and soft tissue margins appeared unaffected. Sections were taken from multiple areas across the specimen for analysis.\n\nSeveral mucosal margins were examined. A right ventral tongue margin specimen (2.6 x 0.2 x 0.2 cm) showed normal squamous mucosa with no concerning features. Similarly, the left ventral tongue margin (2.2 x 0.3 x 0.2 cm) displayed unremarkable mucosa. The right alveolar ridge margin (2.3 x 0.3 x 0.2 cm) also revealed normal squamous mucosa. However, the left alveolar ridge margin (2.4 x 0.3 x 0.3 cm) contained abnormal cells within the mucosa, showing invasive characteristics. A new left alveolar ridge margin (2.2 x 0.8 x 0.3 cm) showed only focal dysplastic changes without invasive disease. The new right alveolar ridge specimen (1.2 x 1.0 x 0.4 cm) was unremarkable.\n\nMicroscopic evaluation of the lesion showed moderately differentiated features, with perineural invasion noted. Pleural invasion was also observed. All other mucosal margins evaluated were free of abnormal cellular infiltration."} +{"pid": "TCGA-MP-A4TE", "report": "The surgical pathology report includes multiple biopsies of lymph node stations from various anatomical locations. Lymph node specimens were obtained from stations 4L, 4R, 5, 7 (including multiple sets), 9L (two sets), 10L, and 11L (three sets). Each lymph node biopsy showed lymphatic tissue without any abnormal cellular findings. The number of lymph node fragments ranged from one to six per specimen, and all were histologically unremarkable.\n\nA lobectomy of the left lower lobe was also performed. A mass measuring 6.6 x 6.2 x 5.8 cm was identified in the lung and was located 3.7 cm from the bronchial margin. Histologic evaluation revealed a high-grade invasive lesion with infiltration into the visceral pleura. No angiolymphatic invasion was observed. The bronchial margin was free of abnormal cells, with a distance of 3.7 cm from the tumor. Staging was determined as T2 based on the size and local characteristics of the lesion. Frozen section analysis of selected lymph nodes was conducted during the procedure, and permanent sections were reviewed for confirmation.\n\nSpecimens were processed and embedded for further microscopic evaluation. All findings were confirmed using Hematoxylin and Eosin (H&E) staining, and no significant discrepancies were found between frozen and permanent sections. A separate mutation analysis was requested on archived lung tissue, which will be reported upon completion."} +{"pid": "TCGA-PK-A5H9", "report": "The specimen labeled as \u201cadrenal mass with adrenal gland\u201d consists of an enlarged adrenal gland measuring 11.5 x 8.2 x 5.8 cm in total size and weighing 290.9 g. The adrenal gland itself measures 10.0 x 7.0 x 5.2 cm and weighs 156 g. Adjacent to it is a tan hemorrhagic mass measuring 10.0 x 5.7 x 5.2 cm, surrounded by a fibrous capsule 0.1 cm thick. The tumor appears encapsulated and shows no clear evidence of capsular invasion. Histologically, the lesion demonstrates a diffuse growth pattern, minimal clear cell component, and low mitotic activity (2/50 HPF). Atypical mitotic figures are present. Vascular invasion is identified, with tumor cells associated with thrombus within vascular channels. No necrosis or high-grade nuclear features are observed. Immunohistochemical staining shows positivity for SF-1 and AE1/AE3 cytokeratin, variable positivity for CAM5.2 and p53 (up to 15%), and absence of staining for EMA, chromogranin, HEPAR-1, and vimentin. Beta catenin demonstrates regional loss of membranous staining. MIB-1 labeling index is 5%. Margins are free of involvement.\n\nA separate liver segment 5 resection specimen weighing 132.2 g contains a solitary benign hepatocellular lesion measuring 1.8 x 1.0 x 0.9 cm, located 1.1 cm from the surgical margin. Microscopic evaluation confirms focal nodular hyperplasia without evidence of metastatic disease. Background liver tissue reveals mild macrovesicular steatosis (10%) but no fibrosis, alpha-1 antitrypsin globules, or iron deposition.\n\nThe gallbladder specimen measures 6.0 cm in length with a wall thickness of 0.2 cm and contains green bile without gallstones. No pathological abnormalities are noted. Surgical waste consisting of adipose tissue (4.5 x 4.0 x 2.0 cm) shows no gross or microscopic abnormalities.\n\nStaging classification based on AJCC/UICC TNM 7th Edition indicates a primary tumor greater than 5 cm without extra-adrenal invasion (pT2). Regional lymph nodes could not be assessed (pNX). There is no evidence of distant metastasis. Degenerative changes and hemorrhage are noted within the adrenal specimen. The adjacent non-tumorous adrenal tissue shows lipid depletion consistent with a stress effect."} +{"pid": "TCGA-E9-A227", "report": "The specimen was obtained from the left upper outer quadrant of the breast and submitted as a lumpectomy. A grossly evident lesion measuring 2.1 x 1.8 x 1.4 cm was identified. Histologic evaluation revealed moderately differentiated cellular changes with tubule formation scoring 2 (moderate, 10% to 75%), nuclear pleomorphism scoring 3 (marked variation in size and nucleoli), and mitotic count scoring 2 (10 to 20 mitoses per 10 high-power fields at 25x magnification). The total Nottingham Histologic Score was 6\u20137, corresponding to Grade II. \n\nLymph node assessment showed 1 out of 17 nodes positive for metastatic involvement without extracapsular extension. Surgical margins were uninvolved. No information was provided regarding prior treatment or tumor extent beyond the primary site."} +{"pid": "TCGA-Z7-A8R5", "report": "The specimen consisted of multiple lymph nodes from the left axilla, ranging in size from 0.1 to 1.3 cm and submitted entirely for evaluation. A suspicious lymph node measuring 2.0 x 1.3 x 0.2 cm was also present and submitted in entirety. Breast tissue from a segmentectomy measured 6.7 x 4.3 x 2.1 cm and contained a gray-white, focally hemorrhagic mass measuring 4.0 x 2.8 x 2.0 cm. This mass extended to the superior, posterior, and inferior margins, with distance to remaining margins greater than 1.0 cm. Additional fibrocystic changes were noted throughout the tissue. An additional segment of breast tissue measuring 6.1 x 3.9 x 3.2 cm showed multiple areas of abnormal tissue with a yellow, grumous appearance extending to both margins.\n\nMargins from the inferior, superior, medial, lateral, anterior, and deep aspects of the breast were submitted, with involvement identified in the inferior, superior, and lateral margins. Histologic examination revealed a proliferation of cells consistent with infiltrative growth and in situ changes. Lymphovascular invasion was identified. Immunohistochemical staining demonstrated positivity for estrogen receptors (3+), progesterone receptors (trace to 1+), and negative for HER-2/neu (0). Proliferative activity by Ki-67 was intermediate at 16%. DNA flow cytometry showed aneuploidy with a DNA index of 1.6.\n\nLymph node evaluation revealed metastatic involvement in three of five total lymph nodes, including two of three sentinel nodes and one of one additional sentinel node. No extracapsular extension was observed. The histologic grade was well differentiated with a modified Bloom-Richardson score of 5/9 (duct formation 3, nuclear grade 1, mitotic activity 1). In situ carcinoma was present, showing lobular features with ductal involvement. Microcalcifications and proliferative breast disease were also noted."} +{"pid": "TCGA-CV-6940", "report": "A left buccal mucosal lesion was identified, measuring 4.0 x 2.5 x 1.5 cm in total size. A distinct, firm, light-tan, slightly fungating area measuring 3.3 x 1.5 x 1.2 cm was observed. Surrounding this area was approximately 0.3 to 0.4 cm of normal-appearing mucosa. The lesion extended to the deep margin, with a distance of less than 1.0 mm from the margin. The surgical specimen was submitted sequentially from anterior to posterior, with portions designated for frozen section analysis. Margins were evaluated and found to be free of tumor involvement. The superior, anterior, and inferior margins all showed no evidence of tumor. A left neck dissection was also performed, which included multiple lymph node levels. In total, twelve lymph nodes were identified across all levels. One lymph node, located in Level I, contained abnormal cells. Other lymph nodes ranged in size from 0.2 x 0.2 x 0.2 cm to 0.7 x 0.3 x 0.3 cm across various levels. Tissue samples from all areas were processed and examined."} +{"pid": "TCGA-43-6770", "report": "A resected left upper lobe specimen weighs 196 grams and measures 16 x 11 x 4.5 cm. The lung tissue is partially covered with a gray-violet smooth, glistening pleura showing diffuse black stippling. The hilum is stapled, and there is a 1.5 cm umbilication located opposite the hilum, marked with blue ink. Sectioning at this site reveals a well-circumscribed, white-tan, firm lesion measuring 3.2 x 3.2 x 2.3 cm, located within 4.5 cm of the hilar margin and contiguous with the umbilication. Remaining lung parenchyma appears red-pink and spongy without other distinct lesions. A possible hilar lymph node is identified.\n\nSubmitted sections include bronchial and vascular margins, a possible hilar lymph node, normal lung tissue, and multiple sections of the lesion extending to the umbilication.\n\nLymph node specimens were also submitted: Level 10 measures 1.5 x 1.0 x 0.4 cm and consists of pink-red soft tissue fragments; Level 5 includes multiple pink-gray friable fragments measuring 3.5 x 2.5 x 0.5 cm in total; Level 7 contains multiple pink-gray fragments measuring 2.0 x 2.0 x 0.4 cm overall. All lymph node specimens are submitted entirely.\n\nMicroscopic evaluation shows poorly differentiated cellular features with extensive necrosis. The primary lesion measures 3.2 cm and reaches the visceral pleura, with possible minimal pleural invasion. Resection margins are free of involvement. Vascular invasion is present. No regional lymph node metastases are identified across all levels examined. Distant metastasis status cannot be determined."} +{"pid": "TCGA-77-A5GB", "report": "Histopathology Report. HISTORY: Lingulectomy specimen. MACROSCOPIC: One specimen labelled as a wedge resection of the lingula was received, measuring 115 x 90 x 35 mm in a partially inflated state. An 85 mm staple line is present at the proximal margin. The pleural surface demonstrates two distinct abnormal areas. The larger area measures 35 x 25 mm with a rough texture, while the smaller area measures 17 mm in greatest dimension and contains a punched-out full-thickness defect. Surrounding these regions, there is diffuse thickening of the pleura. On cut section, there is a peripheral lesion based on the pleural surface with an irregular outline and adjacent collapsed and consolidated lung tissue. The lesion measures approximately 35 x 31 x 19 mm and appears to directly involve both disrupted pleural surfaces previously described. It lies 15 mm from the nearest surgical margin. The remainder of the lung parenchyma exhibits widespread obstructive changes. Within this region are small firm nodules ranging from 1 to 5 mm in size that may represent distinct lesions. Mild emphysema is also noted. MICROSCOPIC: Histological sections reveal a moderately differentiated keratinizing lesion with necrotic areas and a pronounced inflammatory reaction. Invasion into the visceral pleura is confirmed, with involvement of the inked surface at the site of pleural disruption. The stapled surgical margin is free of malignant cells. The lesion surrounds and compresses multiple blood vessels, with focal vascular invasion observed. There is no evidence of lymphatic or perineural infiltration. The surrounding lung tissue confirms organizing obstructive pneumonitis. The nodules identified macroscopically correspond to bronchiectasis, organizing pneumonia, and localized subpleural honeycomb change; no malignant involvement is seen in these regions. Fibrosis and focal fibroblastic proliferation are present, although no definitive interstitial pneumonitis is identified in the preserved lung tissue. Emphysematous changes are present without significant interstitial disease. No lymph nodes are included in the specimen."} +{"pid": "TCGA-KN-8428", "report": "The specimen received consists of a left radical nephrectomy specimen weighing 858 grams. The kidney measures 28.0 x 12.1 x 5.7 cm, with attached ureter measuring 11.5 x 0.5 cm in diameter and a renal vein measuring 11.8 cm x 1.5 cm in diameter. The renal artery is 12.5 x 0.7 cm in diameter. An adrenal gland is identified grossly. A tan/gray, granular, solid/partially necrotic mass measuring 18.5 x 7.5 x 6.5 cm is located at the mid-kidney. The distance from the tumor to the inked soft tissue resection margin is 0.2 cm, to the renal artery is 3.0 cm, to the renal vein is 0.9 cm, and to the ureter resection margin is 13.8 cm. The tumor does not grossly extend beyond the kidney capsule. The renal pelvis appears distorted by an adjacent lesion, though no discrete nodules are identified within the pelvis suspicious for involvement. There are two thin-walled cortical cysts measuring 3.0 x 2.5 x 2.0 cm and 2.9 x 3.5 x 2.5 cm located in the inferior pole.\n\nMicroscopic evaluation shows no lymphovascular invasion. Resection margins from the ureter, renal artery, and renal vein are free of tumor. Renal sinus fat and surrounding soft tissue show no tumor involvement. One lymph node is negative for tumor. Histologic staging according to AJCC criteria is T2N0MX.\n\nEvaluation of non-neoplastic renal parenchyma reveals moderate chronic changes, including focal global glomerulosclerosis, subcapsular changes most likely secondary to vascular disease (approximately 19% of parenchyma), tubular atrophy, and interstitial fibrosis to moderate degree (approximately 20% of parenchyma). Arterial and arteriolar sclerosis with hyalinosis is present to a moderate extent. These findings are nonspecific and may reflect structural and functional adaptations due to hemodynamic changes or glomerular hypertrophy following loss of functioning nephrons. Such changes may be associated with slowly progressive, subnephrotic proteinuria and risk for persistent proteinuria or renal insufficiency. Vascular sclerosis may also be related to prior episodes of thrombotic microangiopathy, pro-coagulant states, autoimmune disorders, drug-induced injury, or metabolic conditions. Parenchymal findings suggest similar involvement may be present in the contralateral kidney.\n\nHistologic sections reveal 345 glomeruli, of which approximately 9% are globally sclerosed. Remaining glomeruli appear slightly enlarged with mild focal mesangial expansion. No double contours or subendothelial deposits are identified on PAS or Jones silver methenamine stains. Several distal tubules contain PAS-positive hyaline casts and calcium deposits. Interstitial inflammation is minimal, with mild mononuclear infiltrate in areas of tubular atrophy. Tubular atrophy and interstitial fibrosis involve approximately 20% of cortical parenchyma. Arteries demonstrate moderate subintimal sclerosis; arterioles show focal sclerosis and hyalinosis.\n\nImmunohistochemical staining demonstrates positivity for colloidal iron. Multiple tissue blocks were submitted for histologic evaluation, including sections of tumor, adjacent normal parenchyma, cysts, and resection margins. Electron microscopy, cytogenetics, and tissue banking materials were also submitted. All margins evaluated are negative. The tumor was centered in the mid-kidney without gross extension beyond the organ."} +{"pid": "TCGA-TM-A84M", "report": "The specimen consists of a right frontal brain tissue sample measuring 30 x 20 x 10mm. Preoperative imaging identified a hyperintense mass in the right inferior frontal gyrus, up to 4cm in size, with calcification and mild post-contrast enhancement. Intra-operative evaluation suggested a glial-origin lesion without clear features of high-grade malignancy.\n\nHistological examination confirmed a diffusely infiltrating neoplasm involving the cerebral parenchyma with subpial aggregation. The tumor is composed predominantly of small, uniform round cells with central nuclei and perinuclear halos. Areas of increased cellularity are present, where cells exhibit epithelioid morphology, with enlarged nuclei, open chromatin, and prominent nucleoli. Delicate vasculature is observed, but no microvascular endothelial proliferation is identified. Calcifications and microcystic changes are present. Notable features include the presence of minigemistocytes and focal angulated nuclear contours.\n\nMitotic activity is elevated, with a count of 9 mitoses per 10 high-power fields (field diameter 1.55mm), and increased apoptotic bodies are seen in areas of higher cellular density. The proliferation index, assessed by MIB-1 staining, is approximately 10%. No necrosis is identified. Immunohistochemistry shows weak p53 reactivity overall, with stronger staining in some cells. GFAP highlights minigemistocytic forms.\n\nCytogenetic analysis using FISH demonstrated combined loss of chromosomal arms 1p and 19q. No EGFR amplification was detected."} +{"pid": "TCGA-77-A5FZ", "report": "Histopathology Report: LEFT UPPER LOBECTOMY. Two request forms were received with discrepancies\u2014one indicating a left upper lobectomy involving lymph nodes 5 and 6, and the other indicating a right upper lobectomy involving lymph node 10. All patient details are accurate. Three specimens were submitted.\n\nSpecimen 1 is labeled as right upper lobe. Gross examination shows a right upper lobectomy specimen measuring 150 x 130 x 95 mm after inflation. The bronchial resection margin measures 20 x 8 mm. Peribronchial and hilar lymph nodes are present. A longitudinal stapled parenchymal resection margin up to 18 mm in length is identified. Fibrous adhesions are noted on the pleural surface. A cavitating, well-defined lesion measuring up to 45 mm is observed within the pulmonary parenchyma. This lesion extends to the apical, lateral, and hilar pleural surfaces. Emphysematous changes are present in the surrounding lung tissue. No evidence of malignancy is seen at the bronchial or stapled resection margins, with the latter being at least 15 mm from the lesion.\n\nMicroscopic evaluation reveals a moderately differentiated epithelial tumor with papillary architecture. Invasion into the lateral pleura is observed, along with associated surface adhesions. There is also focal extension into the mediastinal fat. The tumor margin appears expansile near a hilar lymph node, which does not show signs of involvement. No vascular, lymphatic, or perineural invasion is identified. Sections of the bronchial margin reveal only chronic inflammation without malignant cells. The adjacent lung tissue demonstrates chronic inflammatory changes around airways and emphysema.\n\nSpecimen 2 is lymph node number 5, measuring 15 x 8 x 8 mm. Microscopic sections show only reactive changes without any evidence of abnormal cellular infiltration.\n\nSpecimen 3 consists of a fragmented hilar lymph node measuring 18 x 15 x 12 mm. Microscopy confirms reactive changes only, with no indication of atypical cell presence.\n\nSummary: The lung specimen shows a lesion measuring up to 45 mm with papillary features. Invasion into the pleura and mediastinal fat is present, but margins remain clear. No vascular, lymphatic, or neural invasion is detected. Lymph node analysis reveals no signs of involvement. Staging assessment indicates advanced local extension without nodal spread."} +{"pid": "TCGA-E9-A54X", "report": "The breast tissue specimen contains a fragment with a lesion measuring up to 1 cm in diameter. At the edge of the tissue, three isolated lymph nodes are present. Histologically, the lesion is moderately differentiated and exhibits mucinous features. Two lymph nodes were examined and show sinus histiocytosis without evidence of metastatic involvement. Immunohistochemical staining shows strong positivity for estrogen and progesterone receptors (98% and 95%, respectively), absence of Her-2/neu expression, and a Ki67 proliferation index of 12%. The tumor is classified as T1, measuring 1x1x1 cm, with no venous invasion identified. Surgical margins are uninvolved. Other pathological features such as tubule formation, nuclear pleomorphism, and mitotic counts could not be fully assessed. No evidence of neoadjuvant treatment effect is noted."} +{"pid": "TCGA-BL-A5ZZ", "report": "The surgical specimen included margins from the right and left ureters, which were free of tumor involvement. The bladder specimen measured 6.5 x 6.5 x 4.8 cm and contained a tumor mass located on the right lateral posterior wall. The tumor measured approximately 4.0 x 3.8 cm and had a maximum thickness of 2.5 cm. It extended to within 0.4 cm of the outer surface of the specimen and reached within 0.2 cm of the vaginal mucosa. The tumor appeared tan-white to chalky yellow with a papilliferous and twisting appearance on gross examination. Extensive necrosis was noted microscopically. Histologically, the lesion was composed of high-grade urothelial cells arranged in a papillary configuration. Vascular invasion was present, and immunohistochemical staining showed focal positivity for CD56, suggesting some neuroendocrine differentiation. No metastasis was identified in the two lymph nodes recovered from each side of the pelvis. The distal urethral margin showed high-grade papillary changes without evidence of invasive disease. All other resection margins, including the ureteral and soft tissue margins, were free of tumor. Additional areas of the bladder showed urothelial atypia with severe changes and focal papillary lesions. The primary lesion demonstrated invasion into surrounding tissues, with extension into the vaginal wall. No distant metastatic involvement was assessed."} +{"pid": "TCGA-GU-AATQ", "report": "A total of seven specimens were received and examined, including left and right distal ureters, bladder and prostate, and multiple groups of lymph nodes from the right and left iliac and obturator regions. The ureteral specimens showed unremarkable urothelium with no evidence of high-grade dysplasia or malignant cells.\n\nThe bladder specimen revealed three distinct tumors. The largest was located on the left lateral wall, extending to the anterior and posterior walls, measuring 4.5 x 3.6 cm. It had a rough, hemorrhagic, and necrotic surface, with viable tan-gray nodular areas at the periphery. Microscopically, this tumor demonstrated deep invasion through the bladder wall into the surrounding perivesical adipose tissue. A second tumor on the posterior wall measured 2.5 x 2.0 cm and extended around the right ureteral orifice. A third tumor on the inferior anterior wall measured 1.7 x 1.5 cm. All tumors were solid or nodular in configuration, with some appearing flat or ulcerated. No associated epithelial lesions were identified.\n\nMicroscopic evaluation confirmed that all surgical resection margins were free of invasive disease. The closest distance of invasive cells to a margin was 0.5 mm at the posterior soft tissue margin. There was no evidence of lymphovascular invasion; however, this feature was indeterminate. Prostate tissue showed benign prostatic hyperplasia without signs of invasive malignancy. Inflammation and regenerative changes were noted, along with urothelial dysplasia.\n\nA total of 21 lymph nodes were examined: five from the right iliac region, three from the right obturator, three from the left iliac, and ten from the left obturator. All were benign and showed no evidence of metastatic disease.\n\nHistologically, the tumor was classified as high grade, with features consistent with urothelial (transitional cell) carcinoma and squamous differentiation. Based on the extent of invasion, the tumor was staged as pT3b, indicating macroscopic extension into the perivesical tissue. No distant metastases were identified."} +{"pid": "TCGA-DU-A7TB", "report": "A 13 x 10 x 4 mm and a 10 x 6 x 3 mm tissue specimen were received from the right temporal lobe and temporal lobe, respectively. Histologic examination revealed cerebral cortex and adjacent white matter with a diffuse and moderately cellular infiltrate of neoplastic glial cells. These cells exhibited relatively uniform round nuclei with some perineuronal satellitosis. No mitotic activity, microvascular proliferation, or necrosis was observed.\n\nImmunohistochemistry demonstrated a gliofibrillary background with numerous reactive astrocytes on GFAP staining. Approximately one fourth of the neoplastic nuclei showed strong overexpression of p53 protein. The MIB-1 proliferation index was estimated between 1.5% and 3%, with higher values likely within the neoplasm when accounting for non-neoplastic cellularity.\n\nGenetic testing performed on DNA extracted from the tumor sample revealed allelic loss on chromosome arm 19q but not on chromosome arm 1p. A panel of microsatellite markers including D1S548, D1S1592, D1S552 (for 1p), and D19S219, D19S412, PLA2G4C (for 19q) was used in the assessment. LOH at all informative loci was detected on 19q, consistent with certain molecular features seen in some glial tumors.\n\nMGMT promoter methylation testing using bisulfite-treated DNA followed by real-time PCR amplification did not show evidence of methylation. Sensitivity of the assay allows detection of methylated DNA down to 1% in a background of unmethylated DNA. Factors such as presence of more than 50% non-neoplastic cells or extensive necrosis may have limited detection.\n\nIntraoperative cytologic evaluation included crush and touch preparations showing atypical astrocytic proliferation and undifferentiated cells, suggestive of a glial neoplasm but not definitive. Frozen sections were evaluated via telepathology during the procedure.\n\nThe patient is a man presenting with recent-onset seizure and left facial droop. Imaging had previously shown a mass in the medial and superior temporal lobe extending into the insula, associated with mass effect and uncal herniation."} +{"pid": "TCGA-A2-A1FV", "report": "The specimen includes a sentinel lymph node biopsy, left axillary tissue, left mastectomy, and new inferior margin tissue. One of two lymph nodes examined showed isolated tumor cells detected by cytokeratin immunohistochemical staining. The left axillary tissue contained benign fibroadipose and vascular connective tissue with no lymph nodes identified and no malignancy present.\n\nThe mastectomy specimen revealed two distinct masses. The first was located in the outer upper and mid regions, measuring greater than 5.0 cm in greatest dimension. Histologic evaluation showed grade 2 features with a Nottingham score of 6 (tubules = 3, nuclei = 2, mitoses = 1). A second, separate lesion was identified in the inner upper quadrant, measuring 0.3 cm microscopically, with grade 1 features and a Nottingham score of 5 (tubules = 3, nuclei = 1, mitoses = 1). The tumors were separated by approximately 1.5 cm; however, intervening tissue sampling confirmed continuity of the outer upper/mid tumors, which were classified as a single lesion for staging purposes. The invasive component was located 0.5 cm from the deep margin. An in situ component was also present, identified as lobular carcinoma in situ, located less than 0.1 cm from the deep margin.\n\nLymphovascular invasion was identified on slide C6. No lymph nodes with macrometastases or micrometastases were found; one lymph node showed isolated tumor cells. There was no evidence of extranodal extension, skin involvement, or nipple involvement. Ancillary studies performed on core biopsy tissue showed positivity for estrogen and progesterone receptors, and negativity for HER2/neu by IHC.\n\nThe new inferior margin tissue consisted of fibroadipose connective tissue with scattered atrophic breast parenchyma and no malignancy identified.\n\nPathologic staging was determined as pT3(m) N0(i+)(sn) according to AJCC 7th Edition criteria. Multiple cassettes were submitted for histologic evaluation from various tissue sections including skin, margins, and fibrous areas. The case underwent prospective peer review."} +{"pid": "TCGA-27-1834", "report": "Birth date. Tumor site. Left temporo-mesial. Histological diagnosis. [Deleted]. \n\nThe tumor measured 4.2 cm in greatest dimension and demonstrated a high cellularity with nuclear atypia, brisk mitotic activity, and microvascular proliferation. Necrosis was present with pseudopalisading of nuclei. The lesion showed infiltrative growth into the surrounding brain tissue. No lymph node involvement was identified. Distant metastasis was not detected. Staging workup revealed no evidence of systemic spread."} +{"pid": "TCGA-DD-AADC", "report": "Specimen consists of a liver segment measuring 13.1 x 9.5 x 6.2 cm and weighing 267.5 grams, along with a gallbladder measuring 10.0 cm in length and 4.0 cm in diameter. Tissue labeled as portal vein thrombi is present in aggregates measuring 1.5 x 1.5 x 0.4 cm. A mass within the liver measures 7.5 x 6.6 x 5.1 cm and has a poorly demarcated, pale tan, nodular cut surface. The gross appearance is multinodular and confluent, confined to the capsule with no involvement of the resection margin, which has a safety margin of 1.5 cm. The surrounding liver parenchyma shows cirrhotic changes.\n\nMicroscopic evaluation reveals a tumor composed of trabecular and nesting architectural patterns. Cellular differentiation is predominantly grade III. There is partial fibrous capsule formation and capsular infiltration is noted. No septum formation or steatosis is identified. The surgical resection margin and serosal surface show no invasion. Vascular invasion is present, including invasion of the portal vein, confirmed by examination of separately submitted portal vein thrombi tissue. Bile duct invasion is not observed. The non-tumorous liver parenchyma demonstrates chronic changes consistent with underlying liver disease.\n\nSections from the gallbladder reveal a smooth serosal surface and a dark green, velvety mucosa with no mural nodules. Other submitted tissues include samples from the tumor, resection margin, non-tumorous liver parenchyma, portal vein thrombi, and gallbladder. Clinical history includes prior findings of chronic hepatitis associated with viral etiology and cirrhosis. Additional findings include features suggestive of gastritis."} +{"pid": "TCGA-DD-A39X", "report": "The liver segments V and VI measured 10 x 8 x 5.5 cm and contained a well-circumscribed mass measuring 6.5 x 6 x 5.5 cm. The mass was located in segments V and VI and did not extend through the hepatic capsule. Surgical margins were negative for neoplastic cells, with a clear margin of at least 2 cm. The surrounding liver tissue did not show signs of cirrhosis. The gallbladder measured 9 x 3 x 0.8 cm and showed features of cholesterolosis without the presence of stones or malignant cells. Tissue sections submitted included A1, B1, B2, B3, B4, and B5. Cellular morphology demonstrated grade 2 differentiation. No lymph nodes were involved."} +{"pid": "TCGA-A2-A0EW", "report": "The specimen was obtained from a female patient of White race. The submitted specimens included left and right breast tissues, as well as axillary lymph nodes.\n\nThe left breast simple mastectomy specimen showed fibrocystic changes including apocrine metaplasia and microcyst formation. No significant pathologic changes were identified in the skin, and no malignancy was detected. Margins were free of involvement.\n\nThe right breast simple mastectomy revealed two distinct lesions. The first lesion, located in the lower outer quadrant, measured 1.0 cm in greatest dimension (additional dimensions: 1.0 x 0.5 cm). Histologically, it demonstrated low nuclear grade features with a Nottingham score of 5/9 (tubules=3, nuclei=1, mitoses=1; mitotic count 1 per 10 HPF at 40x). No necrosis, microcalcifications, venous or lymphatic invasion were identified. The tumor involved the inked superficial margin.\n\nA second lesion was found in the upper middle region of the right breast, measuring 1.0 cm in greatest dimension (additional dimensions: 1.0 x 0.5 cm). This lesion also showed low nuclear grade features with a Nottingham score of 5/9 (tubules=3, nuclei=1, mitoses=1; mitotic count 2 per 10 HPF at 40x). Microcalcifications were present in association with in situ changes. No necrosis, venous or lymphatic invasion were observed. The tumor was within 0.1 cm of the inked superficial margin.\n\nBoth lesions were separated by approximately 4.5 cm and were histologically similar. No nipple or skin involvement was identified in either lesion.\n\nImmunohistochemical analysis showed positivity for estrogen and progesterone receptors, and HER2 Neu staining was 1+ (negative). Lymph node evaluation included three left axillary sentinel nodes, which were negative for malignancy. On the right side, three sentinel lymph nodes and one non-sentinel lymph node were involved by carcinoma, with extracapsular extension noted in the non-sentinel node.\n\nThe remainder of the breast tissue showed additional findings such as fibrocystic changes with apocrine metaplasia and microcyst formation, mammary duct ectasia, and acellular foreign material associated with biopsy site changes.\n\nGross examination of the left breast specimen measured 17.0 cm medial to lateral, 16 cm superior to inferior, and 3.5 cm anterior to posterior. The skin ellipse measured 10.0 x 3.0 cm with a 1.0 cm everted nipple. No mass or lymph nodes were identified. The right breast specimen measured 7.0 cm superior to inferior, 17.0 cm medial to lateral, and 3.5 cm anterior to posterior. A well-defined tan-white mass measuring 1.0 x 1.0 x 0.5 cm was found in the upper mid breast, along with a second poorly defined mass of similar size in the lower outer quadrant. These masses were separated by approximately 4.5 cm. No additional lesions or lymph nodes were found in the remaining tissue.\n\nTime in formalin was 79 hours for the left breast specimen and 81 hours for the right breast specimen."} +{"pid": "TCGA-DI-A0WH", "report": "The specimen includes a uterus measuring 11 x 6.5 x 3.0 cm and weighing 130 grams, with unremarkable bilateral ovaries (each 2.0 x 1.5 x 1.0 cm) and fallopian tubes (each 6.0 cm in length and 0.6 cm in average diameter). A 5.0 x 4.0 x 2.5 cm ill-defined, soft, friable, hemorrhagic polypoid mass is present within the fundus, predominantly involving the anterior wall. The majority of the mass is free floating within the uterine cavity. There is superficial involvement of the myometrium, with an invasion depth of 5.0 mm (total myometrial thickness 32.0 mm). No extension into the lower uterine segment or cervix is observed. Adjacent normal endometrium has a maximum thickness of 0.2 cm, and the myometrium measures up to 3.3 cm in thickness. Lymphatic/vascular space invasion is identified within the myometrium. No involvement is found in the cervix, bilateral ovaries, or fallopian tubes.\n\nLymph node assessment includes: left pelvic lymph nodes (8 examined, all negative), left low paraaortic lymph node (1 examined, negative), right pelvic lymph nodes (10 examined, all negative), and paraaortic lymph node (1 examined, negative). All lymph nodes show non-necrotizing granulomas without evidence of tumor. Non-necrotizing granulomas may be seen in conditions such as sarcoidosis; although infectious causes like tuberculosis or fungal infections are typically associated with necrotizing granulomas, these should be considered clinically.\n\nMicroscopic evaluation of the uterine specimen confirms myometrial invasion and lymphatic/vascular involvement. Multiple sections from the uterus, cervix, ovaries, and fallopian tubes are submitted and show no involvement beyond the primary site. Lymph nodes from various regions are entirely submitted and show only granulomatous changes without tumor."} +{"pid": "TCGA-44-6775", "report": "The specimen included multiple lymph nodes and a right lung lobe. The R4 lymph node specimens measured 1.8 x 1.7 x 0.3 cm and 1 x 0.4 x 0.7 cm in aggregate, respectively. Both were composed of red and black soft tissue and showed no evidence of malignancy. The level 10 lymph node specimen consisted of two pieces measuring 2 x 0.7 x 0.4 cm and was also negative for malignant cells. The level 7 lymph node sample included multiple fragments occupying approximately 2.5 mL and did not show any signs of malignancy.\n\nThe right lung lobe weighed 175 grams and measured 12 x 8.5 x 6 cm. A firm central white mass measuring approximately 4 cm in diameter was identified on gross examination. The surrounding area showed possible peritumoral changes. Margins of resection, including the bronchial and pulmonary margins, were free of malignant involvement. Histologically, the mass demonstrated moderately differentiated cellular features with a mitotic count of 12 mitoses per 10 high-power fields. No vascular invasion was observed. One associated lymph node was examined and was negative for malignancy. The adjacent lung tissue appeared unremarkable."} +{"pid": "TCGA-FP-A4BE", "report": "The excised specimen measured 19.0 x 17.0 x 3.0 cm and contained a fungating, hemorrhagic mass measuring 11.9 x 11.0 cm. The lesser curvature measured 11.0 cm and the greater curvature measured 30.3 cm. The mass was located within 1.0 cm of the esophageal margin and 4.1 cm of the distal margin. Upon sectioning, the mass was found to approach within less than a millimeter of the radial margin. The remaining gastric mucosa appeared pale tan and roughened with normal rugal folds.\n\nA total of 24 perigastric lymph nodes were identified: 19 along the lesser curvature (ranging from 0.4 to 2.0 cm in size) and 24 along the greater curvature (ranging from 0.3 to 2.0 cm in size). All lymph nodes examined were benign reactive nodes. A yellow-tan omental fragment measuring 23.2 x 15.8 x 2.5 cm was also recovered and showed no gross abnormalities.\n\nFrozen sections were taken from multiple areas including proximal, distal, and radial margins. No tumor was identified in the distal or new esophageal margins. One small focus near the proximal margin showed findings suspicious for involvement; however, definitive identification could not be confirmed in the submitted planes of section. Margins of excision otherwise appeared free of abnormal cellular infiltration.\n\nHistologic evaluation revealed moderately to poorly differentiated cellular features. The tumor extended into the serosa. There was marked chronic gastritis present in the surrounding tissue. Testing for HER-2/neu had previously been performed on biopsy material and was not repeated.\n\nBased on AJCC staging criteria, the case was classified as T3, NO (Stage IIA). Material was sent for tumor atlas studies and additional molecular profiling."} +{"pid": "TCGA-AC-A7VC", "report": "The patient is female. A left axillary sentinel lymph node was examined and showed no evidence of metastatic carcinoma, confirmed by negative staining for pancytokeratin. A left breast mastectomy specimen contained a tumor measuring 11.0 x 10.0 x 8.0 cm. The tumor was described as indurated, well-circumscribed, focally cystic, and mucinous. It was located subareolar and was 3.5 cm from the nearest deep margin and 3.2 cm from the nearest skin resection margin. The architectural score was 3 of 3, nuclear score was 3 of 3, and mitotic score was 3 of 3, resulting in a total score of 9 of 9 and a grade of 3. There was no evidence of in situ carcinoma, angiolymphatic invasion, or involvement of the skin or nipple. All surgical margins were free of malignant cells. The tumor was composed of spindle cells with areas of chondroid differentiation. Molecular analysis showed high positivity for cytokeratin AE1/AE3 and focal positivity for cytokeratin 5/6 and p63. Multinucleated giant cells were also present. Staining for pancytokeratin was strongly positive. No lymph nodes were identified near the upper outer quadrant. The TNM classification was T3pNO(i-). A prognostic panel is pending."} +{"pid": "TCGA-A6-5664", "report": "A resection specimen of the right colon and terminal ileum was received, measuring 25 cm. in length with attached ileum measuring 20 cm. The appendix measured 6 cm., ranging from 0.7 cm. to 1.5 cm. in diameter. On gross examination, the proximal and distal margins measured 4.0 cm. and 5.8 cm. in circumference respectively. A firm tan pink to papilliferous tan red lesion measuring 10.0 x 7.8 cm. was identified near and distal to the ileocecal valve. On sectioning, this lesion had a maximal thickness of 3.4 cm., extending into the surrounding mesentery to within 0.5 cm. of the inked free radial serosal surface. Surrounding colonic mucosa appeared glistening tan pink with regular folds and wall thickness averaging 4 cm. Several additional small purple tan pink to tan red polypoid lesions were noted, measuring up to 1.2 cm., with the largest located 7 cm. distal to the main lesion. The ileal mucosa appeared unremarkable with regular folds and an average wall thickness of 0.5 cm. Multiple lymph nodes were identified, measuring up to 6 cm., with four appearing involved by metastasis on gross inspection.\n\nMicroscopic evaluation revealed invasive cellular proliferation originating in the cecum with extensive infiltration through the full thickness of the colonic wall, reaching the serosal surface. The tumor cells demonstrated moderate differentiation. Margins of resection were negative for tumor involvement. Vascular invasion was prominent with notable lymphatic space invasion. Regional lymph node assessment identified metastatic involvement in 4 out of 17 lymph nodes examined. Additional findings included non-lymph node pericolonic tumor extension with extranodal tumor deposits adjacent to the appendix and near large pericolonic lymph nodes. Five adenomatous polyps were identified within the colon. Deep to the largest adenomatous polyp, located 7 cm. distal to the primary lesion, intracolonic metastasis was observed involving the muscularis propria and dilated lymphatic spaces.\n\nA separate hernia sac specimen from the left inguinal region measured 11 x 6.5 x 1.5 cm., composed of fibromembranous tissue with yellow lobular fat. Microscopic examination revealed benign fibromembranous tissue lined by mesothelium without evidence of malignancy.\n\nAn omental specimen measuring 13 x 8 x 3 cm. showed yellow lobular fatty tissue consistent with omental fat. No discrete lesions were identified grossly or microscopically, and no malignant cells were detected within the fatty tissue."} +{"pid": "TCGA-KN-8418", "report": "The surgical specimen consists of a right kidney from a radical nephrectomy measuring 16 x 8 x 7.5 cm and weighing 447 grams. A tan, lobulated, focally hemorrhagic mass measuring 10.0 x 7.0 cm is located at the lower pole. The mass pushes against the capsule but does not appear to invade it. Gross examination reveals no involvement of the renal pelvis, ureter, or renal vein. The renal cortex and medulla away from the mass appear unremarkable. No adrenal gland is identified within the perinephric fat. Representative samples of solid areas are submitted as FSA1 (x3), and cystic areas are submitted as FSA2 (x2). Sections of both solid and cystic regions, along with normal cortex and medulla, are preserved for tumor banking.\n\nMicroscopic evaluation includes multiple sections from the tumor, adjacent uninvolved kidney tissue, and areas near the renal pelvis. Frozen section remnants from FSA1 and FSA2 are each represented by two fragments. Ureteral, arterial, and venous margins are submitted as three fragments. All soft tissue surgical margins are free of tumor involvement.\n\nA separate specimen labeled as regional lymph nodes consists of a single fragment of pink-gray soft tissue measuring 2.3 x 1.1 x 1.0 cm. Three lymph nodes are identified, all of which show no evidence of tumor involvement.\n\nAdditional stains including Hale\u2019s colloidal iron were performed and demonstrated positivity in certain cells. Nuclear grading was assessed as Fuhrman grade III/IV. Lymphovascular invasion is present; however, the renal vein margin is negative for tumor involvement.\n\nThe 10th rib specimen consists of a single rib measuring 6.5 x 1.5 x 0.6 cm. Bone marrow evaluation shows maturing trilineage hematopoiesis with no abnormal infiltrate or malignant cells identified.\n\nThe case was submitted under clinical impression of a right renal mass. No significant non-neoplastic findings are noted in the surrounding kidney tissue. Multiple consultations and cross-checks confirm consistency in findings across specimens."} +{"pid": "TCGA-HT-A615", "report": "The microscopic examination reveals a variably cellular tumor with diffuse infiltration into both gray and white matter. The tumor cells predominantly exhibit round to oval nuclei with moderate atypia and prominent perinuclear halos. Cellular arrangement shows a multinodular pattern with areas of increased cell density. No microvascular proliferation or necrosis is observed. Mitotic activity is present but limited to a few scattered figures, not sufficient on its own to support a higher grade classification. Immunohistochemical staining demonstrates scattered MIB-1 reactive cells throughout the tumor, with a calculated labeling index of 2.2% in the most proliferative regions. While this index and other histologic features do not meet criteria for anaplastic classification, certain areas of hypercellularity and nuclear atypia raise concern, indicating the need for close clinical follow-up."} +{"pid": "TCGA-F5-6813", "report": "The submitted specimen consists of excised large intestine tissue. The tumor was located in the rectus abdominus region and measured 5 x 5 x 1 cm. Gross examination revealed ulceration. Microscopic evaluation demonstrated moderately differentiated cellular features. The tumor extended into perirectal tissues. Lymph node assessment identified metastatic involvement in all 12 lymph nodes examined, including pararectal nodes. Surgical margins could not be assessed due to insufficient information. No evidence of prior neo-adjuvant therapy was observed. No additional pathologic findings were reported."} +{"pid": "TCGA-HC-7745", "report": "The prostate specimen weighed 35 grams and measured 4.0 cm in right to left dimension, 3.7 cm apex to base, and 3.5 cm anterior to posterior. The right and left seminal vesicles measured 2.5 x 1.2 x 0.8 cm and 3.0 x 2.0 x 0.8 cm, respectively. Portions of the right and left vasa deferentia were present, each 0.5 cm long. A 2.5 x 1.5 x up to 0.7 cm aggregate of three irregular fragments of tubular rubbery grey-tan tissue was also noted within the container.\n\nThe right half of the prostate was inked black and the left half blue. Serial sectioning from apex to base revealed a 1.5 cm ill-defined focal firm area of pale tan discoloration located in the mid aspect of the left posterior prostate, coming to within 0.1 cm of the blue inked outer surface. The remainder of the parenchyma appeared tan, rubbery, and glistening with moderate periurethral nodularity. No other abnormalities were identified. A total of thirty-four sections were submitted across fifteen cassettes (A\u2013O), representing various regions including apex, bladder neck, posterior, lateral, and anterior prostate, as well as seminal vesicles and vasa deferentia. Tissue was collected for the Cancer Genome Atlas Project with patient consent.\n\nThe right pelvic lymph node specimen consisted of a 3.2 x 1.0 x 0.8 cm portion of tan-yellow fibroadipose tissue containing a 0.8 cm lymph node candidate, which was bisected and submitted in one cassette.\n\nThe left pelvic lymph node specimen was a 4.0 x 2.5 x 1.0 cm aggregate of multiple irregular tan-yellow fibroadipose fragments containing two lymph node candidates measuring 0.4 and 2.5 cm in greatest dimension. These were submitted as five sections across three cassettes (A\u2013C).\n\nMicroscopic examination included review of all specimens. Some portions were reviewed in consultation with an additional pathologist. All sections of the prostate showed bilateral involvement. The tumor involved at least 2.0 x 1.0 cm in size and represented approximately 25% of the examined sections. There was multifocal extension beyond the prostatic capsule. Surgical margins were negative. Both seminal vesicles and vasa deferentia showed involvement. No evidence of small vessel lymphatic invasion or large vessel venous invasion was identified.\n\nAll sections from the right pelvic lymph node showed benign lymph node tissue. Similarly, the left pelvic lymph node specimens contained only benign lymph nodes. \n\nThe pathological stage based on TNM classification is pT3b pN0."} +{"pid": "TCGA-EM-A1YD", "report": "The specimen labeled as lymph node (query right paratracheal) consists of a 0.5 x 0.4 x 0.3 cm tissue sample, frozen for intraoperative consultation. Four additional lymph node specimens measuring between 0.2 x 0.2 x 0.1 cm and 0.5 x 0.4 x 0.2 cm were submitted in entirety. One red-tan nodular tissue measuring 1.8 x 0.8 x 0.5 cm was bisected and submitted in entirety. The thyroid specimen includes a right hemithyroidectomy weighing 15.6 g, with dimensions of 4.5 cm SI x 3.0 cm ML x 2.0 cm AP for the lobe and 2.0 SI x 0.7 cm ML x 0.7 cm AP for the isthmus. The lobe contains a well-delineated solid nodule measuring 3.7 x 2.8 x 1.8 cm. The isthmus contains two solid nodules measuring 0.2 x 0.2 x 0.2 cm and 0.3 x 0.3 x 0.3 cm. Histologic evaluation of the lymph nodes shows no pathological findings. The nodular tissue demonstrates features consistent with diffuse hyperplasia. Microscopic analysis of the larger nodule reveals a follicular variant pattern with encapsulated growth and no venous or lymphatic invasion. Adjacent smaller nodules show similar morphology, unencapsulated without vascular invasion. Margins are free of involvement in all areas. No regional lymph node metastasis is identified; five lymph nodes were examined and none showed evidence of disease. No extrathyroidal extension is observed. Immunohistochemistry for AE1/AE3 in the lymph nodes is negative. Sections of the nodule and surrounding tissue have been stored frozen. Specimen staging indicates localized disease without regional or distant metastasis. Additional findings include underlying changes suggestive of nodular hyperplasia."} +{"pid": "TCGA-EV-5901", "report": "The specimen consists of a left kidney mass measuring 2.4 cm in maximal diameter, located 0.5 cm from the surgical margin. The surgical margin is inked black and the renal capsule is inked red. Histologically, the lesion demonstrates a predominantly pseudo-solid architecture due to compression of papillae and tubules. Aggregates of foamy macrophages are present along with focal areas showing papillae with fibrovascular cores and scattered psammoma bodies. The cellular component shows a somewhat biphasic pattern, including cells with round, uniform nuclei and scant cytoplasm intermixed with cells having enlarged, irregular nuclei, focally prominent nucleoli, and moderate eosinophilic cytoplasm. The tumor is confined to the kidney without penetration of the renal capsule and does not involve blood or lymphatic vessels. Margins are uninvolved by tumor, with the closest distance being 0.55 cm. No regional lymph nodes or distant metastases were assessed. Additional findings include mild arteriosclerosis in the adjacent uninvolved kidney."} +{"pid": "TCGA-EJ-5532", "report": "The patient is a male with a history of a preoperative PSA value of 11.4 and prior four-vessel bypass surgery. A previous biopsy had shown unilateral poorly differentiated prostate adenocarcinoma on the right side.\n\nA radical retropubic prostatectomy was performed. Examination of the surgical specimen revealed invasive prostatic adenocarcinoma with a Gleason score of 3 + 4 = 7. The tumor involved both the right and left lobes, with a maximum nodule size of 2.0 cm. Approximately 5% of the total prostate volume was affected. The tumor exhibited extracapsular extension involving the right anterior proximal urethral margin, posterior right base, and anterior right mid-section. All inked surgical margins were negative for tumor; however, a small focus of carcinoma was found in close proximity to the right anterior proximal urethral margin (less than 0.2 cm). Bilateral seminal vesicles were free of involvement.\n\nPerineural invasion was present, but no angiolymphatic invasion was identified. High-grade prostatic intraepithelial neoplasia was also noted. Pathologic staging was determined as pT3a with no lymph node metastases (pN0) and no evidence of distant disease (pMX). Histologic grade was classified as G3-4.\n\nA total of eight lymph nodes were examined\u2014three from the right pelvic region and five from the left\u2014with no evidence of malignancy. Immunohistochemical analysis confirmed the presence of invasive glands near the surgical margin, though the margin was interpreted as negative.\n\nThe weight of the prostate and exact percentage of multifocal disease were not specified. Tumor histology was consistent with adenocarcinoma, with 40% of the tissue showing secondary Gleason grade 4/5 morphology."} +{"pid": "TCGA-C5-A7CK", "report": "The patient is a woman who presented with a pelvic mass and underwent a cervical biopsy. The specimen received consisted of multiple fragments of irregular tan-white tissue measuring 1.3 x 1.1 x 0.5 cm in aggregate, submitted in a single container. Microscopic evaluation revealed a moderately differentiated infiltrating epithelial lesion with areas of keratinization. The lesion was identified within the cervical tissue and showed stromal invasion. Cellular morphology was consistent with a non-keratinizing component as well as focal keratinizing elements. No other specific lesions or secondary findings were noted. The pathologist personally reviewed all slides and confirmed the findings. The report is documented for clinical correlation and further management."} +{"pid": "TCGA-FK-A4UB", "report": "The surgical pathology report includes findings from multiple specimens. A right paratracheal mass excision demonstrated metastatic involvement. A total thyroidectomy specimen showed a tumor located in the right lobe measuring 2 cm in greatest dimension. The tumor was multifocal with two major foci identified. Lymph node evaluation revealed metastatic involvement in 20 out of 85 nodes. The primary tumor exhibited minimal extrathyroidal extension corresponding to a pT3 classification. Regional lymph node involvement included Level VI (pretracheal, paratracheal, and prelaryngeal/Delphian) nodes, classified as pN1a. Distant metastasis could not be assessed (pMX). Margins were involved by invasive carcinoma at the superior pole, with tumor extending to the cauterized margin. Venous and lymphatic invasion were present. Additional findings in paratracheal soft tissue from a node dissection showed metastatic involvement in 11 of 15 lymph nodes. In the right neck contents from a neck dissection, metastatic involvement was found in 8 of 83 lymph nodes, involving Level 2 (1 node), Level 3 (5 nodes), Level 4 (1 node), and Level 5 (1 node)."} +{"pid": "TCGA-DU-7006", "report": "The specimen consisted of multiple irregular fragments of soft, tan-gray tissue obtained from the left temporal lobe and adjacent white matter. The largest aggregate measured 3 x 4 x 1.5 cm, while smaller fragments measured up to 2 x 1.5 x 0.9 cm. All tissue was submitted in toto for analysis. Microscopic examination revealed cerebral cortex and underlying white matter infiltrated by a cellular astrocytic neoplasm. The tumor exhibited nuclear atypia, increased mitotic activity, and focal infiltration into surrounding tissue. No necrosis was identified. Smears from intraoperative samples showed similar features. Immunohistochemical staining with MIB-1 was performed to further assess proliferation index. The morphology of the lesion was consistent with a high-grade glioma."} +{"pid": "TCGA-22-4607", "report": "The resected right lower lobe lung tissue, weighing 305 grams, included associated lymph node stations. A subpleural mass was identified measuring 5 x 4.5 x 2.6 cm. The lesion extended into, but did not penetrate, the pleura. The bronchial margin was free of abnormal cells. A total of six intrapulmonary peribronchial lymph nodes were examined and showed no evidence of involvement. Additionally, multiple superior (2 right lower and 2 right upper paratracheal) and inferior (6 subcarinal, 1 inferior pulmonary ligament) mediastinal lymph nodes, as well as three N1 interlobar lymph nodes, were all negative for any abnormal cellular infiltration."} +{"pid": "TCGA-4Z-AA86", "report": "The specimen from the bladder showed a lesion measuring 5.0 cm in its major axis. Histological evaluation revealed infiltration through the entire thickness of the bladder wall with extension into adjacent perivesical fat. Ulceration was present, along with perforation of the bladder peritoneum and formation of fistulous tracts within the perivesical fat. No neural infiltration was identified. Lymphatic vascular invasion was present, while no evidence of sanguineous vascular invasion was found. The prostate and seminal vesicles were unremarkable, without any neoplastic changes. Surgical margins were clear. Among the left iliac obturator lymph nodes, one out of seven contained metastatic changes without capsular involvement. All eight right iliac obturator lymph nodes were devoid of any such findings."} +{"pid": "TCGA-AX-A2IN", "report": "The specimen consisted of a uterus with bilateral fallopian tubes and ovaries, along with multiple lymph node groups and omentum. The uterus measured 10.0 x 4.0 x 4.5 cm. A tumor measuring 4.5 x 4.5 x 2.0 cm was identified in the corpus of the uterus, involving more than 90% of the myometrium. Microscopic evaluation showed significant myoinvasion with a depth of 8.5 mm within a myometrial thickness of 10 mm, representing approximately 85% involvement. Lymphovascular space invasion was present.\n\nThe cervix, bilateral ovaries, and fallopian tubes showed no involvement. A subserosal leiomyoma measuring 5.0 x 4.0 x 3.5 cm was found in the anterior lower segment of the uterus. Adenomyosis was also noted.\n\nLymph node dissections included right and left para-aortic, right and left pelvic, and right and left common iliac regions. In total, 25 lymph nodes were examined, and all were negative for involvement. The omentum was composed of mature adipose tissue and showed no evidence of disease.\n\nStaging assessment indicated tumor invasion of one-half or more of the myometrium (pT1c). No regional lymph node metastasis was identified (pN0), and distant metastasis could not be assessed (pMX). All surgical margins were uninvolved."} +{"pid": "TCGA-CV-A45T", "report": "A female patient underwent surgical resection with biopsy specimens obtained from multiple anatomical sites. A fragment of laryngeal tissue measuring 0.2 x 0.1 x 0.1 cm showed squamous mucosa with hyperkeratosis and no evidence of dysplasia. Lymph node biopsies were obtained from submental, external jugular, and lower jugular regions; these measured up to 0.7 cm, 1.0 cm, and 1.7 cm respectively, with no tumor identified. Additional lymph nodes from right neck dissection levels I through V were similarly negative for malignancy, with the largest measuring up to 2.3 cm in level II.\n\nThe tongue specimen measured 4.0 x 2.5 x 0.7 cm and contained a central tan-white nodule measuring 1.7 x 1.5 x 0.4 cm with ulceration. Histopathological evaluation revealed invasive carcinoma with poor differentiation. The tumor extended to a depth of 0.7 cm and was located 0.2 cm from the nearest deep margin. The posterior resection margin was positive for carcinoma, while all other margins were negative. No lymphovascular invasion was observed.\n\nIn total, 32 lymph nodes from various neck regions were examined and found to be free of metastatic disease. The tumor was embedded within adipose tissue across multiple sections, with each lymph node carefully bisected and evaluated. Focal leukoplakia was noted along the mid-inferior margin of the tongue specimen. All remaining tissues, including salivary gland components, were negative for tumor involvement."} +{"pid": "TCGA-WB-A80M", "report": "The submitted right adrenal specimen weighed 102 grams and measured 8.5 x 6.5 x 4.15 cm in fresh state. Following fixation, the adrenal measured 7.5 x 6.5 x 4.5 cm. A central star-shaped scar was noted within the tumor mass. The tumor was well-defined, encapsulated, measured 5.3 cm in maximum dimension, and had a soft consistency. The resection margins were evaluated with five representative sections taken, including cassette 1/m 5 and partially 5b. No residual pre-existent adrenal tissue was identifiable.\n\nMicroscopically, the tumor showed a mixed architecture, with both trabecular and alveolar growth patterns. The cells exhibited small oval nuclei with salt-and-pepper chromatin and eosinophilic to clear cytoplasm. Some areas contained cells with enlarged, polymorphic nuclei, occasionally hyperchromatic, with prominent nucleoli and eosinophilic cytoplasm. No mitotic figures were identified. The tumor was surrounded by a thick fibrous capsule, with focal extension up to the surgical margin. There was no vascular invasion or infiltration into surrounding adipose tissue. No hyperplastic changes were observed in the adjacent adrenal tissue, although vascular dilation was present.\n\nImmunohistochemical staining showed scattered positivity for chromogranin and sporadic positive cells with S100 staining."} +{"pid": "TCGA-49-AAR3", "report": "A total of 13 lymph nodes were examined from multiple stations, with one lymph node showing evidence of metastatic involvement. The primary lesion was identified in the right upper lobe and measured 3.0 cm in greatest dimension. Histologic evaluation revealed a poorly differentiated carcinoma. Immunohistochemical staining demonstrated positivity for TTF-1 and CK7, while being negative for CK20, S-100, and calretinin. These findings supported a non-mesothelial, non-melanocytic origin. The tumor exhibited venous and lymphatic invasion. Pathologic staging was determined as pT2, indicating a tumor greater than or equal to 3 cm, and pN1, reflecting ipsilateral peribronchial, hilar, or intrapulmonary nodal involvement. Distant metastasis could not be assessed (pMx). Surgical margins were free of invasive disease. Additional excised tissues, including pleural plaque and other lymph node stations, did not show any evidence of tumor involvement. Some immunohistochemical tests were performed using reagents not cleared or approved by the FDA, as part of laboratory-developed methods."} +{"pid": "TCGA-A4-8516", "report": "The surgical specimen from a partial nephrectomy on the right kidney includes a mass located in the upper pole. The main lesion measures 3.6 cm and is unifocal. Gross examination reveals a red-yellow, soft to friable, focally hemorrhagic mass that abuts the blue inked surface corresponding to the perinephric fat and Gerota\u2019s fascia. It extends to within 0.1\u20130.2 cm of the black inked parenchymal margin. The surrounding kidney tissue demonstrates papillary adenomas measuring less than 0.5 cm. A small incidental finding measuring 0.1 cm is identified within the renal parenchyma.\n\nMicroscopic evaluation shows features consistent with a papillary architecture. The nuclei are slightly irregular, approximately 15 \u03bcm in size, with evident nucleoli. No tumor necrosis or lymphatic/vascular invasion is observed. The tumor focally extends beyond the renal capsule into adjacent perinephric adipose tissue. Surgical margins are free of tumor involvement.\n\nPathologic staging indicates tumor extension into perirenal fat but not beyond Gerota\u2019s fascia (pT3a). Regional lymph nodes were not assessed (pNX), and there is no evidence of distant metastasis (pM0). Based on these findings, the final TNM classification is pT3aNXM0. The clinical stage is designated as Stage III.\n\nDuring intraoperative consultation, frozen section analysis confirmed negative margins by at least 1\u20132 mm. Representative sections of the tumor and surrounding tissue were submitted for further evaluation and potential future studies.\n\nAdditional microscopic findings include residual renal parenchyma containing multiple small papillary adenomas. Given the presence of multiple papillary lesions, consideration should be given to possible hereditary syndromes associated with renal neoplasms. Further clinical evaluation and genetic counseling may be warranted depending on patient history and risk factors."} +{"pid": "TCGA-D1-A17T", "report": "The specimen from the uterus included a polypoid mass measuring 3.4 x 3.1 x 0.9 cm that circumferentially involved the endometrial cavity. The mass extended 0.5 cm into the myometrium, which had a total thickness of 2.0 cm. No involvement of the endocervix was observed. There was no evidence of lymphovascular space invasion, and all surgical margins were free of abnormal tissue. Two subserosal leiomyomata were identified within the myometrium, measuring 0.5 cm and 2.3 cm in greatest dimension, respectively.\n\nExamination of both fallopian tubes and ovaries\u2014left and right\u2014revealed no abnormal findings. In addition, the remainder of the left ovary and fallopian tube also showed no diagnostic abnormalities.\n\nLymph node evaluation included 14 left pelvic lymph nodes and 10 right pelvic lymph nodes, all of which were negative for abnormal cells.\n\nThe gross examination of the hysterectomy specimen confirmed the presence of the described mass with superficial myometrial extension. Representative tissue sections were submitted for microscopic analysis. Permanent histologic sections confirmed the findings described above, with no significant changes noted from initial frozen section evaluation."} +{"pid": "TCGA-V1-A8WN", "report": "The specimen was received in four parts. Part A, labeled as peri-prostatic fat, consisted of a soft tissue fragment measuring 3.9 x 1.8 x 0.3 cm; no lymph nodes were identified. Parts B and C, labeled as right anterior apex and right posterior apex margins respectively, were small fragments measuring 0.3 x 0.2 x 0.1 cm and 0.4 x 0.2 x 0.1 cm, each submitted entirely for examination. Part D included a prostate with attached seminal vesicles weighing 37 grams and measuring 3 cm from apex to base, 3.5 cm in width, and 3 cm in thickness. The seminal vesicles on the right measured 4.5 x 2.5 x 1 cm and on the left 4 x 2 x 0.5 cm. The prostate parenchyma appeared tan-pink and spongy with small tan nodules up to 0.4 cm in the periurethral region. The capsule was noted to be torn and sutured closed.\n\nMicroscopic evaluation of the sampled areas showed benign fibroadipose tissue in the peri-prostatic fat without any prostatic epithelium or abnormal cellular changes. The right anterior apex margin showed benign prostatic tissue without any atypical cells. The right posterior apex margin contained fibromuscular tissue, also without any prostatic epithelium or abnormal findings.\n\nIn the prostate gland, histologic analysis revealed small acinar structures present bilaterally in the posterior region from apex to base, involving approximately 2 cc of tissue. Additional involvement was seen in the left anterior mid-gland region, approximately 0.1 cc. The overall volume of these structures was estimated to be less than 2 cc. These structures comprised predominantly Gleason pattern 3, accounting for about 10% of the total volume. No involvement of the capsule, extracapsular extension, or high-grade intraepithelial changes were observed. All surgical margins were free of any concerning cellular changes, although benign glands were present within 1 mm of the right base margin. No evidence of tumor involvement was found in the seminal vesicles, and no perineural infiltration or lymph node involvement was identified. The staging classification used was consistent with localized disease without regional spread."} +{"pid": "TCGA-WB-A81M", "report": "The pathology review describes a red to brownish mass measuring 5.5 cm in diameter, excised from the right adrenal gland. Histological examination reveals a well-circumscribed lesion surrounded by a fibrous capsule. The cellular architecture demonstrates a pattern of nests or clusters known as zellballen, with occasional trabecular arrangement. The nuclei are round to oval with smooth chromatin distribution. In the septal regions surrounding the cellular nests, multiple dilated blood vessels are present. A single area of central necrosis is observed. No notable increase in mitotic activity is identified, and there is no significant nuclear pleomorphism, vascular invasion, or disruption of the surrounding capsule."} +{"pid": "TCGA-AF-6136", "report": "The specimen includes three portions of colon. The first, a 19 cm segment labeled \u201crectosigmoid colon,\u201d shows a 4.5 x 3.8 x 1.0 cm lesion located 1.5 cm from the distal margin. Microscopic evaluation reveals extensive invasion through the bowel wall with narrow tongues extending into the pericolonic fat and a scirrhous reaction. The lesion approaches the radial margin to within 0.3 cm. Vascular invasion is present, including rare lymphatic and arterial involvement. A total of 52 lymph nodes are identified, with 2 positive for metastatic involvement. The histologic type is moderately differentiated, and the primary tumor stage is classified as pT3. The proximal margin is free of tumor, while the distal margin is involved. The second specimen, a 9.5 cm segment labeled \u201cproximal colon,\u201d has no significant findings. Five lymph nodes are identified, all negative for metastatic disease. The third specimen, a 2.5 x 2.2 x 1.2 cm annular tissue fragment labeled \u201cdistal donut,\u201d shows no significant pathology."} +{"pid": "TCGA-CG-4440", "report": "The specimen consists of a total gastrectomy preparation with a portion of transverse colon attached. An ulcerated lesion was identified in the mid-stomach along the greater curvature, extending to within 5 cm of the aboral and 7 cm of the oral resection margins. It involves both the anterior and posterior walls of the stomach, measuring up to 7 cm in maximum diameter. Histologically, the lesion demonstrates poorly differentiated glandular features.\n\nThe tumor infiltrates through all layers of the gastric wall and extends into perigastric fat, reaching up to 4 cm into the gastrocolic ligament, with involvement of the serosa and focal serosal penetration. Within the resection area, there are findings consistent with lymphatic invasion and small nodular deposits on the gastric serosa. The oral and aboral margins, greater omentum, and transverse colon segment show no evidence of tumor involvement.\n\nAmong the lymph nodes examined, 18 out of 24 contain metastatic involvement with extension beyond the lymph node capsule. Evaluation of the gastric mucosa reveals chronic gastritis with intestinal metaplasia, foveolar hyperplasia, and partial mucosal atrophy in the antrum. In the corpus region, there is moderate chronic superficial gastritis with findings suggestive of Helicobacter pylori infection.\n\nPathologic staging assessment indicates advanced local invasion with distant metastatic involvement. Lymph node involvement is extensive."} +{"pid": "TCGA-B0-5110", "report": "The specimen consists of a partial nephrectomy from the lower pole of the right kidney. The lesion measures 3.0 cm in maximum diameter and is confined to the kidney without extension beyond the renal capsule. No angiolymphatic invasion is observed. All assessable surgical margins are free of involvement. The tumor cells exhibit features consistent with conventional (clear cell) morphology, and nuclear grading according to the Fuhrman system is grade 2 of 4. Adjacent non-neoplastic kidney tissue shows moderate arterial and arteriolar sclerosis, as well as moderate global glomerulosclerosis, with preservation of tubular and interstitial architecture. Pathologic staging is determined as pT1a NX MX."} +{"pid": "TCGA-A4-A5Y0", "report": "The specimen from the left kidney measured 12.2 x 6.1 x 4.4 cm and weighed 195 grams. A tumor measuring 5 x 5 x 4.9 cm was identified in the superior pole. The tumor appeared friable with tan-brown and necrotic areas, and was well-circumscribed. It bulged the capsule but did not extend into the perinephric fat or involve the renal sinus, pelvis, calyces, or renal vein. No involvement of the adrenal gland was noted.\n\nMargins were evaluated, with the closest distance being 0.2 cm to Gerota's fascia, 12.5 cm to the ureteral margin, 1.5 cm to the hilar margin, and 1 cm to the renal vein margin. No other significant pathology was found, including no lymph node involvement.\n\nMicroscopic evaluation showed a neoplastic lesion confined to the kidney, with nuclear features characterized as slightly irregular nuclei approximately 15 microns in size and evident nucleoli. The tumor was unifocal and did not show sarcomatoid differentiation. Margins were free of tumor involvement.\n\nStaging indicated the lesion was limited to the kidney without extension beyond the organ. Lymph node status could not be determined due to absence of lymph nodes in the specimen. Additional findings in the non-neoplastic kidney included nephrosclerosis and chronic inflammation. Multiple blocks were submitted for detailed histological analysis, including margins and surrounding tissues."} +{"pid": "TCGA-CJ-4900", "report": "A thrombus was identified within the left gonadal vein. A mass measuring 14.0 cm in maximum dimension was found in the left kidney. Histologic evaluation revealed a mixture of clear and eosinophilic cells arranged in nests, surrounded by lymphoplasmacytic infiltrates. Nuclear grading showed predominantly grade 3 features with scattered areas of grade 4 pleomorphism. The tumor extended beyond the renal capsule into perinephric adipose tissue and directly involved the left adrenal gland. Invasion into the renal sinus adipose tissue and renal vein was also observed. Tumor thrombus was present within the renal vein at the margin of resection but did not invade the vessel wall. One hilar lymph node contained metastatic involvement. The ureter and soft tissue margins of resection were free of tumor. Multiple simple cortical cysts were noted in the kidney. Ten lymph nodes from the left para-aortic region were examined and none showed involvement. Similarly, three interaorto-caval lymph nodes were negative for tumor. Gross examination described a radical nephrectomy specimen including the renal artery, renal vein filled with thrombus, and an unremarkable ureter. The adrenal gland was compressed by the tumor and measured approximately 3.0 cm in length and 0.1 cm in width. The tumor replaced approximately 80% of the kidney at the upper and middle pole, appearing tan-pink with extensive gelatinous change and necrosis involving more than 80% of the tissue. Gerota\u2019s fascia was mobile and free of tumor invasion. Sections were submitted from various regions including resection margins, renal vein thrombus, tumor-involved adrenal gland, and lymph nodes. No tumor was identified in the submitted lymph nodes from the left para-aortic or interaorto-caval regions. Clinical history included a left renal mass."} +{"pid": "TCGA-EQ-A4SO", "report": "Final Surgical Pathology Report. Procedure. A. Peritoneum, lesser sac, biopsy: Negative for malignancy, benign fibroadipose tissue. B. Omentum, excision: Negative for malignancy, benign omental fat. C. Gallbladder, excision: Benign gallbladder with mild chronic inflammation and fatty change. No malignancy identified. D. Head of pancreas, duodenum and bile duct and gastric antrum, partial gastrectomy and pancreatectomy: Tissue examined shows a lesion with histologic type consistent with intestinal-type morphology and moderate differentiation. The tumor measures 4.8 x 4.5 x 3 cm and invades through the greater curvature into adjacent structures (pT4b). Lymphatic and venous space invasion is present. One peripancreatic lymph node out of 20 evaluated contains metastatic material (pN1), with the involved node measuring 1.5 cm in greatest dimension. Resection margins, including proximal, distal, and radial (including pancreatic neck and uncinate) margins, are free of tumor involvement. The closest distance from the tumor to the apparent radial margin is 3 mm; however, this may not represent a true anatomic margin due to the prior gallbladder resection. The nearest true margin, at the pancreatic neck, is 1.5 cm from the tumor. Additional findings include background moderate chronic gastritis and fundic gland polyps. Helicobacter pylori staining was negative. Duodenal mucosa and papilla show no evidence of tumor. Immunohistochemical stains were used for diagnostic evaluation. \n\nSpecimen details: \nA. Peritoneum, lesser sac biopsy consists of 0.6 x 0.4 x 0.2 cm tan to pink soft tissue entirely submitted. \nB. Omentum specimen measures 24.5 x 13.0 x 5.5 cm, lobulated tan-gold adipose tissue, no discrete mass. \nC. Gallbladder is intact, measuring 8.5 x 4.5 x 4.1 cm, containing viscid dark green bile, no choleliths. Attached cystic duct measures 1 cm. Mucosa is velvety pale yellow-green, wall thickness up to 0.3 cm. Additional fragments submitted include cystic duct margin, body, fundus, and a 3.3 x 1.4 x 0.4 cm fibrofatty fragment. \nD. Specimen includes head of pancreas, duodenum, bile duct, and gastric antrum. The stomach portion measures 15 cm along lesser curvature, 24 cm along greater curvature, with a 4.8 x 4.5 x 3.0 cm mass identified. The duodenal margin is 5 cm in circumference, gastric proximal margin is 21 cm. Tumor is located circumferentially at the gastroduodenal junction, rubbery tan-white, with maximal thickness of 3 cm on sectioning, extending to within 0.3 cm of proximal ductal structure. Common bile duct is patent. The tumor approaches the free radial surface to within 0.1 cm. Pancreatic margins: uncinate margin 1.5 cm from tumor, neck margin also noted. Remaining gastric mucosa is dusky tan-pink to red with normal rugal folds, wall averages 0.8 cm. Several small polyps (up to 0.6 cm) are present, largest within 2 cm of proximal margin. Duodenal mucosa is tan-pink with regular folds, wall averages 0.5 cm. Lymph nodes up to 1.3 cm in size recovered from peripancreatic adipose tissue and gastric curvatures. Portions of tumor and normal gastric mucosa submitted for tissue procurement. Sections submitted include perpendicular sections of proximal and distal margins, tumor to various inked surfaces, random pancreatic, duodenal, and lymph node tissues."} +{"pid": "TCGA-GS-A9TW", "report": "The excised axillar lymph node specimen consists of three tissue fragments, the largest measuring 2.7 x 2 x 0.8 cm and the smallest 1.5 x 1 x 1 cm. Histological examination reveals a lymph node architecture effaced by a large cell lymphoma with a diffuse growth pattern. The neoplastic cells exhibit anaplastic morphology and are associated with sclerosis. Immunohistochemical analysis demonstrates that the tumor cells are positive for CD20, CD79a, BOB1, OCT2, BCL2, and BCL6. There is moderate and heterogeneous expression of CD30. The cells are negative for CD10, CD3, CD5, and CD15. In situ hybridization for Epstein-Barr virus RNA (EBER) is negative. The Ki-67 proliferative index is high, at 90%."} +{"pid": "TCGA-2G-AAG7", "report": "Summary pathology report: Left orchidectomy specimen shows a tumor composed of multiple components, with embryonal carcinoma accounting for 40% and a combined presence of mature teratoma and immature teratoma making up another 40%. Yolk sac tumor component represents 20% of the specimen. The tumor measures 1.5 cm in greatest dimension and is limited to the testis. There is no evidence of angiolymphatic invasion or involvement of the rete testis."} +{"pid": "TCGA-A1-A0SF", "report": "The specimen was received in ten parts. Part A measured 1.5 x 0.8 x 0.8 cm and was entirely frozen for intraoperative evaluation. Part B measured 1.3 x 0.8 x 0.7 cm and was similarly processed. Part C, a mastectomy specimen, measured 15.8 cm from superior to inferior, 15.6 cm from medial to lateral, and 8.2 cm from anterior to posterior, weighing 442.5 grams. Within this specimen, a spiculated, firm mass measuring 2.4 x 1.2 x 1.2 cm was identified in the lateral aspect. This lesion was located 2.0 cm from the deep margin, 5.5 cm from the superior margin, greater than 6 cm from the inferior margin, 2.8 cm from the lateral margin, and greater than 6 cm from the medial margin. Dilated ducts filled with cheesy material were observed in the anterior-inferior portion of the breast, situated 0.2 cm from the deep margin.\n\nPart D, another mastectomy specimen, measured 18.2 cm from superior to inferior, 16.2 cm from medial to lateral, and 4.8 cm from anterior to posterior, weighing 688 grams. No dominant mass was identified, although dilated ducts containing viscous yellow-tan material were noted extending into one nipple duct.\n\nPart E consisted of an irregular fragment of soft tissue measuring 5.4 x 3.8 x 1.5 cm with a suture-marked margin. Parts F and G included ovaries with attached fallopian tubes; paratubal cysts were identified, measuring 1.5 x 1.5 x 0.5 cm and 0.5 x 0.5 x 0.5 cm respectively. Part H contained adipose tissue with a small attached nodule measuring 0.3 x 0.3 x 0.3 cm. Part I consisted of multiple small tissue fragments. Part J measured 4 x 2 x 0.5 cm and showed no abnormalities.\n\nSentinel lymph node biopsies from the left axilla revealed no evidence of malignancy in either of the two lymph nodes evaluated. Sections from various margins including deep, medial, lateral, anterior/superior, and anterior/inferior were all widely clear of tumor involvement. Invasive tumor grade was assessed using modified Bloom-Richardson criteria, yielding a total score of six points corresponding to grade 2. Nuclear grade was scored as three points, mitotic count contributed one point (seven mitotic figures per high power field), and tubule/papilla formation accounted for two points (>10% but <75%). There was no evidence of lymphatic-vascular invasion, perineural invasion, or invasive tumor necrosis. Minimal mononuclear cell reaction was observed.\n\nImmunohistochemical testing demonstrated positivity for estrogen receptors with moderate nuclear staining in over 95% of tumor cells and positivity for progesterone receptors with moderate to strong nuclear staining in 90% of tumor cells. HER2/neu testing yielded a staining intensity score of 1 on a scale of 0\u20133 indicating absence of over-expression. Stromal involvement was absent around the tumor site.\n\nAdditional specimens included benign fibrous nodules and unremarkable tissues across omental and soft tissue samples. Reactive cellular changes were present without intraepithelial lesion or malignancy across cervical evaluations. Multiple specimens including bladder washings, urine samples, vaginal/cervical preparations, and implant capsules showed benign findings with no atypical proliferation noted.\n\nMicroscopic examination of aspirates from both breasts revealed morphologically consistent adenocarcinoma features only on the left side while the right breast aspiration indicated benign scar tissue. All surgical margins were widely clear with distances ranging between 2 cm and greater than 6 cm from tumor borders."} +{"pid": "TCGA-KL-8340", "report": "The patient presented with a right renal mass measuring approximately 10 cm. A total nephrectomy specimen, including the adrenal gland, renal vessels, ureter, perinephric fat, and perihilar nodes, was submitted for evaluation. The kidney measured 16.3 x 12.5 x 7.9 cm and was associated with a tumor mass measuring 9.5 x 8.9 x 7.8 cm located in the superior and mid pole. The tumor was well-circumscribed, pseudoencapsulated, and exhibited a red-tan to white-tan appearance with areas of hemorrhage and necrosis. It extended toward the renal pelvis but did not show gross involvement of that structure. No invasion of the renal vein was identified. The adrenal gland, measuring 5.3 x 1.4 x 1.1 cm, appeared unremarkable. Two lymph nodes in the perihilar region were identified, ranging from 0.4 to 1.4 cm in size, and no tumor involvement was observed. Surgical margins, including ureteral and vascular margins, were free of tumor. The non-neoplastic kidney tissue was largely unremarkable aside from a small cortical cyst at the inferior pole.\n\nAdditionally, multiple retroperitoneal lymph nodes were excised, ranging in size from 0.4 to 2.5 cm. All lymph nodes were histologically examined and found to be free of tumor involvement. In total, 15 lymph nodes were evaluated\u20142 from the perihilar region and 13 from the retroperitoneal collection.\n\nHistological sections confirmed the absence of tumor in all resected margins and surrounding structures. The tumor was confined to the kidney without evidence of venous or nodal spread. The final staging classification was pT2, indicating a tumor greater than 7.0 cm in greatest dimension limited to the kidney."} +{"pid": "TCGA-BR-6802", "report": "The gastrectomy specimen includes a tumor measuring 8x5x1 cm with an ulcerated appearance. Microscopic examination reveals poorly differentiated histology. The tumor extends to adjacent structures, specifically involving the lesser omentum. Lymph node evaluation shows 2 out of 3 intraabdominal lymph nodes positive for metastatic involvement. Information regarding lymphatic, venous, and perineural invasion, as well as surgical margins and response to neoadjuvant treatment, is not provided. No additional pathologic findings or comments are noted."} +{"pid": "TCGA-D8-A1JL", "report": "Histopathological examination was performed on a resection specimen from the left breast along with axillary tissues and a skin flap. The tumor measured 2.1 x 2.2 x 0.8 cm and was located on the border of the lower inner quadrants, 1.5 cm from the lower edge, 0.1 cm from the base, and 2.0 cm from the skin. Microscopic evaluation revealed a high-grade lesion with ductal morphology. Nuclear grade was NHG3 based on scoring (3 + 3 + 2) and mitotic count showed 15 mitoses per 10 high-power fields. Adjacent glandular tissue exhibited benign changes including fibrocystic mastopathy and simple ductal hyperplasia. Immunohistochemical analysis demonstrated absence of estrogen and progesterone receptors in neoplastic nuclei. HER2 protein expression assessed by HercepTest\u2122M showed a score of 1+ in invasive cancerous cells. Axillary lymph nodes displayed sinus histiocytosis without evidence of metastatic involvement. The lesion was confined to the breast with no lymph node involvement observed."} +{"pid": "TCGA-RW-A68A", "report": "A left adrenal resection specimen was received, weighing 240 grams and measuring 11.4 x 6.6 x 5.3 cm. The specimen contained a well-circumscribed mass measuring 6.9 x 6.6 x 3.5 cm, along with a 3.0 x 2.7 x 2.6 cm nodule attached at the superior pole, connected by a 1.9 cm soft tissue pedicle. The larger mass showed heterogeneous cut surfaces with mottled yellow and dark brown areas peripherally, and cystic changes centrally. The smaller nodule had a pale tan, solid appearance and appeared to arise from the adrenal medulla. The two nodules were in close proximity and separated by a possible thin capsule. Sections of the superior tip, junction between the nodules, anterior-lateral and medial-inferior aspects of the larger mass, and representative areas of both capsules were submitted for analysis.\n\nAdditionally, a fragment of periaortic soft tissue measuring 3.1 x 2.1 x 0.5 cm was submitted in entirety. It showed pale tan, solid cut surfaces involving approximately 50% of the margin.\n\nMicroscopic evaluation of the adrenal specimen revealed no lymphovascular invasion. The periaortic tissue showed only ganglion and nerve without evidence of tumor or lymph nodes. The two adrenal nodules, while histologically similar, displayed subtle morphological differences. Given the patient's young age and personal history, a hereditary syndrome was considered in the clinical context. The findings were consistent with two distinct lesions within the adrenal gland."} +{"pid": "TCGA-98-8021", "report": "The surgical pathology report includes multiple lymph node excisions and lung tissue resections. Lymph nodes from levels II, IV, VII (including second and third specimens), VIII (including a second specimen), IX, and X (including a second specimen) were all assessed and found to be negative for malignancy. One lymph node was identified in each submission, with no evidence of tumor involvement.\n\nA resection of the right upper lobe apical segment revealed a hyalinized plaque with no tumor identified. A separate wedge resection of the right upper lobe showed a well-circumscribed tan-yellow lesion measuring 1.8 cm in greatest dimension. The surrounding lung tissue appeared unremarkable. The pleura and surgical margins were free of malignancy. Histologic evaluation demonstrated a moderately differentiated cellular proliferation without lymphovascular invasion or visceral pleural involvement. The primary tumor margin was uninvolved. \n\nAdditional examination of the remaining apical segment of the right upper lobe showed no tumor, with findings limited to congestion and clotted blood in a small area. All lymph node levels examined showed no evidence of metastasis."} +{"pid": "TCGA-AA-A01Q", "report": "The specimen shows a poorly differentiated carcinoma with extensive anaplastic features and solid growth patterns. The tumor is ulcerated on its inner surface and exhibits areas of necrosis. There is significant chronic inflammation surrounding the tumor. The carcinoma infiltrates through the layers of the colon wall, reaching into the subserous fatty connective tissue. Lymphatic invasion is present. A total of 16 lymph nodes are examined, none showing involvement; however, there is moderate chronic lymphadenitis in the tumor-negative nodes. No tumor is identified at the resection margins or in the pericolorectal fatty tissue. Histopathological features suggest a high-grade morphology. Tumor staging based on the extent of local invasion is classified as pT3, with regional lymph node involvement categorized as pN2. Distant metastasis cannot be assessed (MX). Vascular invasion is noted (L1), and there is no residual tumor at the surgical margins (R0). More than 10 lymph nodes were evaluated."} +{"pid": "TCGA-28-1752", "report": "The specimen was received as multiple biopsies and excisional tissues from the left frontal region of the brain. The samples ranged in size from 0.3 x 0.3 x 0.2 cm to an aggregate of 4.5 x 4.5 x 4.0 cm. All specimens were entirely submitted for histological evaluation.\n\nMicroscopic examination revealed a predominantly well-circumscribed but focally diffusely infiltrating neoplasm with features including necrotizing changes, palisading of nuclei, and perinuclear pseudorosettes. The tumor cells exhibited elongate hyperchromatic nuclei, numerous mitotic figures, and eosinophilic cytoplasm. Areas of ependymal-like differentiation, gemistocytic morphology, and neuroblastic-like (PNET-like) components were identified. Microvascular proliferation and significant tumor necrosis, some with palisading, were also present.\n\nImmunostaining showed that a majority of tumor nuclei were positive for p53 in more aggressive-appearing areas, and there was focal weak positivity for synaptophysin in similar regions. MGMT staining was present in up to 2% of tumor nuclei. PTEN expression was lost. pMAPK staining was detected in 10% of tumor nuclei and 30% of tumor cell cytoplasm. Laminin beta 1 was up-regulated, while laminin beta 2 was down-regulated. Neurofilament staining demonstrated trapped axons.\n\nFluorescence in situ hybridization (FISH) analysis for EGFR was performed on 40 cells. A high ratio of EGFR/CEP 7 (41.0) and 100% of cells showing more than four copies of EGFR indicated both amplification and a high level of polysomy.\n\nAdditional studies noted included correlations with prior literature regarding treatment response. A low percentage of MGMT-positive nuclei (up to 2%) has been associated with a better response to Temodar. Loss of PTEN expression has been linked to a reduced likelihood of response to EGFR kinase inhibitors, while retained PTEN is associated with improved prognosis in high-grade gliomas. High levels of pMAPK immunoreactivity have been correlated with relative resistance to radiation therapy. Upregulation of laminin beta 1 and downregulation of laminin beta 2 have been associated with more aggressive tumor behavior and worse patient survival.\n\nThe use of these findings to guide therapy has limitations, and clinical correlation is recommended. These results do not mandate or exclude the use of any specific therapeutic agent."} +{"pid": "TCGA-B0-4688", "report": "A mass involving the left 9th rib was excised, revealing benign bone tissue. A separate large mass measuring 21 cm was identified in the left kidney and removed along with surrounding omental and colonic tissues. The tumor demonstrated high-grade pleomorphic features with extensive sarcomatoid differentiation. Within the kidney, a distinct focus exhibited different morphological characteristics. The tumor showed extensive areas of necrosis and extended into the perinephric adipose tissue, omentum, and colon. Vascular invasion was present, and one colonic margin was involved by the neoplasm, while other surgical margins were clear. Sarcomatoid tumor was also found adjacent to the vascular margin. The non-neoplastic portion of the kidney showed signs of chronic inflammation. \n\nThe spleen, removed during the procedure, contained a secondary lesion that extended into the splenic capsule and underlying tissue. No neural or vascular invasion was observed in the spleen, and all resection margins were free of tumor involvement. A biopsy from a pancreatic lesion revealed adipose tissue containing metastatic cells with sarcomatoid features. Vascular invasion was again identified, and the tumor reached the resection margins. No lymph node involvement was found in the sampled nodes. The disease had thus spread beyond the primary site, with regional lymph node involvement not confirmed."} +{"pid": "TCGA-AR-A1AV", "report": "The specimen consists of a left modified radical mastectomy. A mass measuring 2.8 x 2.3 x 2.1 cm is present in the retroareolar region of the breast. Histologic evaluation shows moderate differentiation with tubule formation score of 3/3, nuclear pleomorphism score of 2/3, and mitotic count score of 2/3, resulting in a Nottingham grade II classification. Ductal carcinoma in situ is not identified. There is no evidence of angiolymphatic invasion or calcifications. The lesion extends to involve the overlying skin, corresponding to AJCC pT4 staging. All surgical resection margins, including skin and deep margins, are free of tumor involvement, with a minimum tumor-free margin of 1.1 cm at the anterior superior margin. Of 23 left axillary mid/low lymph nodes examined, one node containing metastatic cells measures 1.7 cm and demonstrates extranodal extension. Two left high axillary lymph nodes are also evaluated and show no evidence of involvement."} +{"pid": "TCGA-ZF-AA4U", "report": "The specimen consists of a bladder and prostate measuring 95mm in the superoinferior dimension, 130mm in the anteroposterior, and 130mm in the mediolateral. The bladder contains an extensive papillary tumor involving the entire circumference of the lower half. On gross examination, there appears to be invasion of the bladder neck and possibly the prostate, although no visible involvement of extravesical fat is present. A separate specimen of fibrofatty tissue measuring 23 x 8 x 5mm contains a single lymph node measuring 7mm; all tissue was processed and no nodal tissue or metastatic disease was identified.\n\nMicroscopic evaluation of the bladder lesion reveals a poorly differentiated transitional cell carcinoma with both papillary and solid components. There is a better-differentiated exophytic component. The tumor invades the lamina propria and muscularis propria, reaching the perivesical fat. Lymphovascular invasion is suspected. No lymphocytic infiltrate at the tumor-host interface is observed. There is no evidence of glandular, squamoid, or neuroendocrine differentiation. Tumor extends into both lobes of the prostate, predominantly involving the right lower lobe, with tumor also present in the periprostatic soft tissue of the left lower lobe. Both ureteric margins appear morphologically normal, although the left side shows luminal dilatation. No dysplasia or carcinoma in situ is present in the prostatic urethra. The tumor approaches within 5mm of the right circumferential surgical margin and 4mm of the left circumferential surgical margin. Additional random sections of the background bladder reveal a separate G2pTa transitional cell carcinoma, with focal carcinoma in situ noted in the background.\n\nSurgical resection margins are otherwise clear. No evidence of metastatic disease is found in the lymph node specimen."} +{"pid": "TCGA-L9-A50W", "report": "The left lower lobe of the lung was received for examination, measuring 11 x 10 x 6 cm. A firm mass was identified at the base of the lobe with a solid white cut surface, appearing multinodular and measuring 2.5 cm in greatest dimension. The tumor was located 2 cm from the bronchial margin and focally extended to within 1 mm of the inked pleural surface. No additional tumors were identified upon serial sectioning. Sections submitted included margins, lymph nodes, uninvolved lung tissue, and adjacent bronchi.\n\nA peribronchial lymph node measuring 8 mm was identified and sampled. Two additional lymph node specimens were received: one from level 8, measuring 1.3 x 1.3 x 0.7 cm with a solid white cut surface suspicious for malignancy; and another from level 11, consisting of multiple small fragments measuring up to 10 mm in aggregate.\n\nMicroscopic evaluation of the lung specimen revealed a moderately differentiated adenocarcinoma with mixed growth patterns including glandular, solid, and papillary components. Areas of clear cell change were also observed. The tumor was unifocal and measured 2.5 cm. Visceral pleural invasion was not identified, and all bronchial and vascular margins were free of tumor involvement. Lymphovascular invasion was not present.\n\nOne of five regional lymph nodes showed evidence of involvement, specifically the level 8 lymph node. The remaining lymph nodes, including three peribronchial nodes and the level 11 lymph node, were negative for tumor involvement. Based on these findings, the primary tumor was classified as pT1b and regional lymph node involvement as pN1. No distant metastasis was identified."} +{"pid": "TCGA-77-7138", "report": "LEFT LOWER LOBE. Clinical Notes: Lesion in the left lower lobe lung. Macroscopy: The specimen, labelled \"left lower lobe,\" consists of a lung lobe measuring 125 x 75 x 60 mm in the fresh state. A cavitated mass is present within the lung, measuring 70 x 55 x 40 mm, with overlying thickened pleura. On sectioning, the cavity contains thick bloodstained semi-liquid material. The cavity wall is irregularly roughened and thickened by white sclerotic tissue. The surrounding lung tissue shows a yellow discoloration consistent with endogenous lipid pneumonia. The lesion appears to be well clear of the bronchial resection margin. No other abnormalities are identified upon sectioning of the lung. Sections submitted include: bronchial resection margin and peribronchial lymph nodes (A), tissue from the mass and pleural area (B-C), additional sections of the mass (D-E), adjacent lung tissue (F), and an additional peribronchial lymph node (G). Microscopy: Histological examination reveals a moderately differentiated keratinizing lesion with extensive necrosis and cavitation. The lesion is located away from the bronchial margin and does not invade the pleura, although fibrosis of the overlying pleura is noted. Evidence of vascular involvement is present within a large pulmonary vein. Evaluation of peribronchial lymph nodes shows no signs of malignant involvement. Adjacent lung parenchyma demonstrates organizing obstructive pneumonitis, while distant lung parenchyma appears normal. Elastic stain findings indicate changes suggestive of involvement of the overlying thickened pleura; however, no abnormal cells are present at the pleural surface. Summary: The lesion is located in the left lower lobe. Surgical margins are free of involvement. No lymph node involvement is observed. Vascular involvement is present. Changes suggestive of pleural involvement are noted, though without presence at the pleural surface. The pathological stage is T2 NO MX. Reported by Dr. Anatomical Pathologist."} +{"pid": "TCGA-AA-A01G", "report": "Right hemicolectomy preparation with tumor-free resection margins displays an ulcerated, moderately differentiated lesion in the cecum. Some sections show increased mucus production. The lesion infiltrates the perimuscular fatty tissue. No local lymph node metastases are identified. Histological grade is G2. Staging shows pT3, L0, V0, R0, and pN0 (0/22 nodes involved)."} +{"pid": "TCGA-XU-A930", "report": "The specimen consists of a thymic mass with resection of a portion of a large vessel and a wedge of lung tissue. The primary lesion measures 7.0 cm in its greatest dimension and is embedded within a larger specimen measuring up to 15 cm in greatest length. The tumor is firm, tan, and irregularly shaped. It is closely associated with but not fully penetrating into lung tissue. A segment of the large vessel is involved by the tumor; however, the resection margin of this vessel appears free of tumor upon gross examination.\n\nMicroscopically, the lesion is composed predominantly of epithelial-type cells arranged in sheets and nests. The cells are large and polygonal with relatively uniform round nuclei. There is minimal lymphocytic infiltration throughout the tumor. Focal areas show cells with prominent nucleoli, though no necrosis is identified. Occasional mitotic figures are present. There is possible involvement of lymphatic channels at the periphery of the tumor. Immunohistochemical staining shows positivity for high molecular weight cytokeratin in the tumor cells, while CD5 and EMA are negative. Lymphocytes within the tumor are largely CD5 positive, with some focally positive for CD1a.\n\nThe tumor invades into surrounding adipose tissue but does not breach the visceral pleura or infiltrate into pulmonary parenchyma. Vascular invasion, both small and large vessel, is not identified. Resection margins are free of tumor involvement. The closest distance from the tumor to a margin is 1 mm. Based on histological features and extent of spread, there is evidence of local invasion without distant or lymph node involvement being assessable."} +{"pid": "TCGA-XA-A8JR", "report": "Six tissue specimens were received from a male patient undergoing a prostatectomy. Specimens labeled A through E consisted of biopsies from the anterior bladder neck, left base of the prostate, left apex of the prostate, right pelvic lymph nodes, and left pelvic lymph nodes, respectively. All biopsies showed no evidence of malignancy. Specimen F included the prostate and seminal vesicles, weighing 44 grams and measuring 4.1 x 3.8 x 3.2 cm. Histologic examination revealed acinar-type carcinoma involving the right anterior, right posterior, left anterior, and left posterior quadrants. Approximately 20% of the prostate tissue was involved by the abnormal cells. The distal and proximal urethral margins showed involvement. No capsular invasion was observed; however, perineural and lymphovascular space invasions were present.\n\nLymph node sampling included three nodes from the right pelvic region and four from the left, none of which demonstrated malignant involvement. Pathologic staging was determined as pT2c with no regional lymph node metastasis (pN0). Additional findings included high-grade prostatic intraepithelial neoplasia and nodular prostatic hyperplasia. Gross examination noted a prostate with yellow-tan nodular cut surfaces but no distinct lesions. Multiple tissue sections were collected for detailed microscopic evaluation. Intraoperative frozen section analysis confirmed negative margins for malignancy at the bladder neck, left base, and left apex biopsies."} +{"pid": "TCGA-EW-A1OV", "report": "The specimen from the right lumpectomy measured 8.9 x 8.2 x 2.3 cm. A single focus of invasive lesion was identified, measuring 2.5 cm in greatest dimension. The lesion was located within 1 mm of the inferior margin and 2 mm from the posterior margin. Additional findings included presence of intraductal components within 1 mm of both lateral and inferior margins. The invasive component showed high nuclear grade features with vesicular nuclei, prominent nucleoli, and marked variation in size and shape. Mitotic activity was low. Histologic evaluation revealed lymphovascular invasion. Margins were otherwise uninvolved by invasive disease, with distances greater than 10 mm at superior, medial, lateral, and anterior aspects. The closest distance to an involved margin was less than 1 mm at the inferior margin.\n\nIn the right axilla, six lymph nodes were examined. Micrometastatic involvement was identified in one node, measuring 1.25 mm. No macrometastases or isolated tumor cells were found in the remaining nodes. Sentinel lymph node evaluation was performed using hematoxylin and eosin staining and immunohistochemistry. No extranodal extension was observed.\n\nImmunohistochemical studies demonstrated negativity for ER, PR, HER2, and E-cadherin in the involved lymph node. Additional stains showed positivity for p-cadherin and negativity for CK5/6 and EGFR in the primary lesion. Intraoperative frozen section of three lymph nodes did not reveal involvement; however, further evaluation with sentinel node protocol confirmed micrometastasis.\n\nThe staging based on pathologic findings was pT2 and pN1mi. Dermal lymphovascular invasion was not present. The specimen was processed with appropriate inked margins and representative sections were submitted for comprehensive assessment."} +{"pid": "TCGA-FD-A62S", "report": "A 6.5 x 4.5 x 1.3 cm specimen of fibrofatty tissue from the left pelvic lymph node area contained eleven lymph nodes, all without abnormal findings. A segment of the left distal ureter measuring 0.5 cm in length showed no abnormalities. Similarly, a right pelvic lymph node specimen weighing 8.0 x 5.5 x 1.0 cm contained thirteen lymph nodes, all unremarkable.\n\nA cystectomy specimen including the bladder, urethra, uterus, fallopian tubes, and ovaries was examined. The bladder measured 6.5 x 5 x 3 cm with a 3 x 1.9 cm ulceration noted on the posterior wall. This area extended through the muscularis propria into the surrounding fat and was located 0.1 cm from the deep margin. Adjacent mucosa appeared edematous and congested. Ureteral margins were free of abnormality. The posterior margin of the specimen was involved by the lesion.\n\nThe hysterectomy specimen weighed 231 grams and measured 7.2 cm from fundus to lower uterine segment. Multiple nodules were identified within the myometrium, with the largest measuring 5 cm. These nodules lacked hemorrhage or necrosis. One nodule demonstrated osseous metaplasia. An adenomyoma was also present. Both fallopian tubes and ovaries showed no abnormal cellular changes, with fibrotic ovarian stroma consistent with age-related alterations.\n\nUreteral specimens from both sides, measuring 1.1 cm and 1.2 cm respectively, were unremarkable. All surgical margins except the posterior bladder margin were negative for abnormal cells. Lymph node evaluation across all sites revealed no involvement (0 out of 24 nodes). The posterior specimen margin showed involvement confirmed by keratin staining. No tumor was identified in bilateral ovaries or fallopian tubes.\n\nStaging parameters indicated involvement of extravesicular soft tissue, with a 3.0 cm lesion at the posterior wall. The pTNM classification was recorded as pT3b, N0, MX, R1."} +{"pid": "TCGA-BC-A8YO", "report": "The surgical specimen included a gallbladder measuring 4.6 x 3.1 x 0.9 cm, with a smooth external surface and green viscous contents. No stones were identified, and the mucosa appeared green and velvety. Microscopic evaluation revealed no significant pathologic abnormality or carcinoma.\n\nA resected liver segment (segments 5 and 6) along with attached ascending colon and retroperitoneal soft tissue measured 12.5 x 11 x 7 cm and weighed 745 grams. A yellow bulging defect measuring 14.5 cm was noted on the surface, with a white to tan nodular mass measuring 11 cm in greatest dimension. The mass was partially circumscribed with multiple adjacent small satellite nodules. On sectioning, a blood vessel was found plugged with tumor thrombus. The tumor extended through the capsule to within 1.1 cm of a green-inked mesenteric margin, and was 1.7 cm from the blue-inked hepatic resection margin. Vascular invasion was present at the macrovascular level, and capsular invasion was also observed. Tumor necrosis was present, involving approximately 20% of the microscopically examined mass. Histologic grade was determined as Grade 3 according to Edmondson and Steiner criteria. Margins were uninvolved by tumor, with the closest distance being 8 mm from a retroperitoneal soft tissue margin. Eleven colonic lymph nodes were benign without evidence of metastasis. Additionally, multiple subcentimeter satellite lesions were present. There was focal extension of tumor through the visceral peritoneum into fibrous adhesions, though no microscopic involvement of the colon or soft tissue was identified.\n\nThe background liver showed chronic hepatitis, grade 1, stage 2, with fibrotic portal tracts, mild bile ductular proliferation, and a chronic lymphocytic infiltrate. No piecemeal necrosis or prominent plasma cell infiltrate was seen. Scattered steatosis was present in less than 5% of the parenchyma, without features of steatohepatitis. Trichrome and reticulin stains confirmed periportal fibrosis without bridging or cirrhosis. Iron staining showed a mild increase in hepatic iron, and alpha-1-antitrypsin deficiency was excluded by absence of DPAS-positive globules.\n\nA separate ileal resection measured 6 cm in length and included an area of hemorrhagic adhesions 0.5 cm from the mucosal margin. Microscopic examination showed fibrous serosal adhesions, acute serositis, and hemosiderin-laden macrophages, with no evidence of malignancy.\n\nThis report is based on available data and may be subject to revision upon further clinical review."} +{"pid": "TCGA-DD-A11A", "report": "A partial hepatectomy specimen from the left lobe of the liver weighs 1425.0 grams and measures 17.0 x 14.0 x 11.0 cm. A single well-circumscribed mass is present, measuring 14.0 x 10.0 x 8.0 cm, and is confined within the liver. The lesion is fully encapsulated. Resection margins are free of abnormal cells, with a tumor-free margin of 3.0 cm. No evidence of vascular invasion beyond the tumor is observed. \n\nThe gallbladder, measuring 8.5 x 1.2 cm, shows changes consistent with acute and chronic serositis, with no gallstones identified. Lymph nodes from the common hepatic artery and retrocholedochal regions were examined; two from the common hepatic artery and one from the retrocholedochal area showed no abnormal cellular involvement. Additionally, tissue from the supraduodenal region was submitted and found to consist of benign fibroadipose tissue, with no lymph node identified in that specimen."} +{"pid": "TCGA-E2-A15S", "report": "The surgical specimens included sentinel lymph nodes, breast tissue, axillary contents, and ovarian and fallopian tube tissues. Sentinel lymph node 1 consisted of two nodes measuring up to 0.8 cm; both were negative for malignancy. Sentinel lymph node 2 was a single lymph node measuring 2.0 x 1.0 x 0.8 cm and showed evidence of involvement. The left breast specimen weighed 254 g and measured 15 x 15 x 2.5 cm. A mass measuring 4.6 cm was identified in the upper inner and upper outer quadrants, located 0.2 cm from the posterior margin. The margins of resection were free of tumor involvement. Histologic evaluation revealed high-grade cellular changes with central necrosis and microcalcifications. Lymphovascular invasion was noted as extensive. The right breast specimen weighed 212 g and showed no abnormal findings. Dissection of the left axilla yielded 8 lymph nodes, all without signs of involvement. An additional left axillary specimen contained 7 lymph nodes, none of which showed any malignant changes. Both ovarian and fallopian tube specimens appeared unremarkable, with no abnormal findings detected. Staging was based on histopathological findings and clinical parameters."} +{"pid": "TCGA-06-6390", "report": "The specimen from the right frontal resection consists of a 3 x 2.5 x 1.5 cm piece of gray-white, soft, hemorrhagic tissue. Microscopic evaluation reveals a neoplasm with areas showing features of an oligodendroglial-type tumor located primarily in the deep white matter. There is evidence of mitotic activity and regions with a papillary architecture containing astroblastoma-like cells arranged in perivascular rosettes, most clearly demonstrated by GFAP immunostaining. Areas suggestive of prior treatment effect, such as astrogliosis, vascular proliferation, and hyalinized necrosis, are also present. The neoplasm demonstrates diffuse weak to moderate positivity for p53, and the Ki-67 labeling index is focally elevated, reaching approximately 30% in some areas.\n\nA separate resection from the corpus callosum shows cerebral cortex without evidence of neoplastic involvement.\n\nGenetic analysis using a panel of microsatellite markers (including D1S548, D1S1592, D1S552, D19S219, D19S412, and PLA2G4C) was performed on DNA extracted from the tumor block. Allelic loss at chromosome arms 1p and 19q was detected. This testing was conducted using a PCR-based assay comparing tumor DNA to normal reference DNA obtained from a blood sample. Tumor DNA was enriched by microdissection to improve sensitivity.\n\nAssessment of the MGMT promoter methylation status was carried out using bisulfite-modified DNA followed by real-time PCR (MethyLight assay). No methylated sequences were detected in the MGMT promoter region. The sensitivity of this test allows detection of methylated DNA at levels as low as 1% in a background of unmethylized DNA, though the presence of more than 50% non-neoplastic cells or significant necrosis may limit detection.\n\nAll molecular results are provided for informational purposes and should be interpreted in the context of clinical and histopathological findings. These assays were developed and validated by the laboratory under CLIA regulations and are not standalone diagnostic tests."} +{"pid": "TCGA-55-7911", "report": "The specimen consisted of a right middle lobe pulmonary parenchymal segment measuring 10.0 x 9.6 x up to 3.3 cm. A subpleural lesion was identified, measuring 1.7 x 1.7 x 1.6 cm, with a fibrotic tan-gray cut surface. It was well-defined and lobulated, with a gritty consistency. The lesion was located 3.4 cm from the bronchial margin, 0.3 cm from the parenchymal margin, and 1 mm beneath the pleural surface. The remaining parenchyma was slightly congested, rubbery, spongy, and pink-red without additional nodularity. Adjacent organizing pneumonia was noted.\n\nLymph nodes from levels 7, 8, and 10 were submitted for evaluation. No histologic evidence of metastatic disease was identified in any of the lymph node samples. Sections of the bronchial margin and surrounding lung tissue were also examined microscopically. The histologic grade was moderately differentiated. No lymphovascular space invasion or visceral pleural involvement was observed. The tumor appeared confined to the pulmonary parenchyma. Multiple tissue blocks were evaluated, including representative sections from the lesion, margins, and uninvolved lung tissue. All lymph nodes examined showed no evidence of malignancy."} +{"pid": "TCGA-4K-AA1G", "report": "The specimen consists of a left testis measuring 14.0 x 10.0 x 8.0 cm, along with a portion of the spermatic cord (5.0 cm in length) and a segment of the scrotum (7.0 x 5.0 x 1.5 cm). The testis is entirely replaced by a lobulated whitish-gray mass measuring 13.0 x 8.0 x 8.0 cm. Histologically, the lesion involves infiltration of the tunica albuginea and epididymis. Evidence of vascular invasion is noted. There is no involvement of the resection margin or scrotal tissue."} +{"pid": "TCGA-WB-A81T", "report": "The pathology report describes tissue from the left adrenal gland. Gross examination revealed a well-circumscribed, grey-reddish mass measuring 2.5 x 2.5 x 2 cm. The lesion was completely resected. Microscopically, the tissue exhibited an alveolar growth pattern composed of medium to large cells. These cells displayed eosinophilic and partially granular cytoplasm with eccentric nuclei, distinct nucleoli, and occasional eosinophilic nuclear inclusions. Some cells contained PAS-positive inclusions, while others showed brownish pigment. No atypical mitotic figures or markedly atypical nuclei were identified. There was no evidence of intravascular or periadrenal tumor involvement. The tissue demonstrated a high degree of vascularity. Immunohistochemical staining was positive for chromogranin A, synaptophysin, vimentin, and protein S-100. The Ki67 proliferation index was less than 1%. No nuclear staining was observed for keratin, Lu5, or p53."} +{"pid": "TCGA-35-5375", "report": "The specimen was obtained from the upper lobe of the lung and collected in an OCT block. A blood sample was also taken and stored frozen. Histological evaluation revealed a moderately differentiated lesion with a tumor cell percentage of approximately 72%. The tumor measured 3 cm in greatest dimension. Regional lymph node involvement was present, with metastatic cells identified in two out of the examined nodes. There was no evidence of distant metastasis. No prior treatment had been administered. Surgical resection was performed without complications."} +{"pid": "TCGA-D8-A1J9", "report": "Histopathological examination was performed on a female patient. The material consisted of a resected left breast with axillary tissues. Immunohistochemical analysis showed estrogen receptors present in 10\u201375% of neoplastic cell nuclei, with no progesterone receptors detected. HER2 protein testing using HercepTest\u2122M by DAKO showed a positive reaction in cancerous cells (Score = 3+). \n\nMacroscopically, the left breast measured 18 x 12.5 x 2.5 cm and weighed 350 g. Axillary tissues measured 9 x 5 x 1 cm, along with a 14 x 4 cm skin flap. A lesion measuring 1.8 x 1.5 x 1.9 cm was identified at the boundary of the outer quadrants, located 2.0 cm from the lower boundary, 0.3 cm from the base, and 0.7 cm from the skin.\n\nMicroscopic evaluation revealed a histological grade 2 lesion with a total score of 6 (2 + 3 + 1) and 4 mitoses per 10 high-power fields. The invasive component was located 7 cm from the base. No lesions were found in the nipple. Background changes included fibrocystic mastopathy and calcifications. Axillary lymph nodes showed chronic lymphadenitis and sinus histiocytosis.\n\nStaging assessment indicated a T1c classification with no nodal involvement. The report has been completed and the patient\u2019s doctor should be contacted."} +{"pid": "TCGA-JY-A939", "report": "The surgical specimen included multiple lymph node stations and soft tissue specimens from the thoracic esophagus, proximal stomach, and resection margins. Lymph nodes evaluated included ST19 splenic nodes (1 lymph node), STN20 celiac nodes (1 lymph node), common hepatic nodes ST18 (3 total lymph nodes across two specimens), additional celiac nodes (3 lymph nodes), lymph node station 4L (1 lymph node), lymph node station 7 (7 lymph nodes in total across two specimens), STN16 (7 lymph nodes), STN17 (12 lymph nodes), and STN8 (5 lymph nodes). All lymph nodes were negative for malignant cells.\n\nResected soft tissue specimens included the thoracic esophagus and proximal stomach, with histopathologic evaluation revealing no residual malignancy at the proximal, distal, or circumferential margins. The resection also included the final esophageal and gastric margins, as well as a donut-shaped specimen from the esophagogastric region, all of which were free of malignant involvement.\n\nMicroscopic examination of the main resected specimen showed areas of gland formation and sheets of cells with rare gland-like lumina. There was significant intra- and peritumoral lymphocytic infiltration. Immunohistochemical staining demonstrated patchy positivity for CK7, CK20, and CDX2, while chromogranin and synaptophysin were negative. A single perigastric lymph node showed evidence of metastatic involvement among a total of 48 lymph nodes examined.\n\nThe tumor was located at the esophagogastric junction and extended into both the distal esophagus and proximal stomach. It measured 8.7 cm in greatest dimension and invaded the submucosa. The tumor center was located approximately 2.0 cm from the esophagogastric junction. Intestinal metaplasia consistent with Barrett\u2019s esophagus was identified at the esophageal margin adjacent to the tumor.\n\nGross measurements of the resection specimen included a length along the lesser curvature of 8.0 cm, greater curvature of 12.0 cm, and a distal gastric margin circumference of 21.0 cm. The tubular esophagus measured 10.0 cm in length and 3.8 cm in width. The tumor was circumferential in configuration and had a depth of invasion of 1.0 cm. No perforation was identified. The closest margin involvement was 1.0 mm from the circumferential margin. Lymphovascular invasion was present. Based on AJCC/UICC TNM staging (7th edition), the primary tumor was classified as pT1b and regional lymph node involvement as pN1."} +{"pid": "TCGA-DX-AB2T", "report": "The clinical history notes an enlarging, asymptomatic mass in the right thigh. A radical resection of a mass from the right posterior medial thigh was submitted for analysis. The specimen measured 22 x 13 x 11 cm and included an 18.5 x 6 cm ellipse of skin. A 9.5 x 0.1 cm linear scar was present on the skin surface. Upon sectioning, a 5.1 x 4.9 x 4 cm soft, tan to yellow mucoid mass was identified within the deep soft tissues, which included muscle, fat, nerve, and tendon. The mass showed no gross necrosis but appeared to extend into adjacent muscle and fat. Margins of resection were marked with ink: deep (black), anteromedial (red), posteromedial (green), and proximal/distal (blue). The tumor was located 1.5 cm from the posteromedial margin, 3 cm from the anteromedial margin, 2.5 cm from the deep margin, 6.5 cm from the proximal margin, and 6 cm from the distal margin. Representative sections were taken from all margins and multiple areas of the tumor. Microscopic evaluation revealed predominantly viable cellular tissue with a focus on high-grade features. An adjacent area of fat necrosis and foreign body giant cell reaction was noted, consistent with a prior surgical site. All resection margins were found to be free of tumor involvement."} +{"pid": "TCGA-E2-A1IJ", "report": "The specimen includes a right breast lumpectomy, an additional lateral margin, and three sentinel lymph nodes. The lumpectomy specimen measures 7.6 x 6 x 4.3 cm and contains a firm tan mass with a granular cut surface measuring 2 x 1.2 x 1 cm. This mass is located 0.8 cm from the closest inferior margin. The remainder of the tissue shows dense fibrous and focally cystic parenchyma. Margins are negative for invasive tumor; however, lobular neoplasia is present at the lateral and medial margins, as well as within 1 mm of the inferior margin. A nodule measuring 0.5 cm is identified in the additional lateral margin specimen.\n\nSentinel lymph nodes #1, #2, and #3 are all negative for metastatic disease. The lymph nodes measured 2 cm, 2.3 cm, and 1.5 cm respectively, and were entirely submitted for examination.\n\nHistologic evaluation of the main mass reveals grade 2 morphology with a tubular score of 3, nuclear grade 2, and a mitotic score of 1. No necrosis or vascular/lymphatic invasion is identified. Multiple foci of invasive tumor are found across different slices, along with widespread lobular neoplasia. Fibrosis related to prior biopsy is also present.\n\nImmunohistochemical staining is negative for E-cadherin. Hormone receptor status is positive for ER and PR, and negative for HER2 by FISH. Based on these findings, the tumor is staged pT1c N0."} +{"pid": "TCGA-BJ-A0ZC", "report": "The thyroid specimen weighed 29.5 grams and was submitted in entirety. A small lesion measuring 0.4 cm in the left lobe was identified. Histologic examination of this lesion revealed nuclear features including enlargement, irregular contours, and clearing. The architecture was predominantly follicular with scattered papillary formations. No necrosis or mitotic figures were identified. The surrounding thyroid tissue showed nodular changes with the largest nodule measuring 3.5 cm; areas within this nodule demonstrated fibrosis and ossification. There was also evidence of chronic inflammation involving the thyroid parenchyma.\n\nMargins of resection were free of abnormality. No extension beyond the thyroid capsule was identified. Vascular or lymphatic invasion was not present. The pTNM staging classification assigned was pT1 NX MX.\n\nAdditional studies included molecular testing. DNA extraction was performed from paraffin-embedded tissue, followed by real-time PCR amplification for selected gene regions including BRAF codons 599\u2013601, NRAS codon 61, HRAS codon 61, and KRAS codons 12/13. Melting curve analysis did not detect mutations in these regions. Testing was validated using positive controls and demonstrated sufficient sensitivity to detect mutations present in at least 10\u201320% of alleles.\n\nFluorescence in situ hybridization (FISH) using RET/PTC and RET/PTC1 probes was performed to assess for rearrangements. In the targeted area, 3 out of 60 cells (5.0%) displayed a pattern suggestive of rearrangement; however, this was below the threshold for positivity (\u22658%). The remaining 57 cells (95.0%) exhibited normal signal patterns. Therefore, no rearrangement was detected.\n\nMicrodissection was guided microscopically to enrich tumor cell content; all specimens analyzed contained at least 50% tumor cells. Amplification occurred within 35 cycles or earlier, confirming adequate DNA quality and quantity for reliable interpretation.\n\nOther findings included multinodular changes and lymphocytic infiltration consistent with autoimmune-related alterations. No parathyroid tissue was identified in the specimen."} +{"pid": "TCGA-63-A5MT", "report": "The tissue sample was collected from the right upper lobe of the lung. The tumor measured 6.5 cm in size. Histological analysis showed a moderately differentiated squamous cell carcinoma. The tumor was classified as T3, NOS, with no regional lymph node involvement (N0) and no evidence of distant metastasis (M0). The clinical staging was consistent with an early stage based on the VALCSG system. A separate blood-derived buffy coat sample was also collected. No other diagnostic terms or specific histological subtypes were noted in the report."} +{"pid": "TCGA-HU-A4GT", "report": "The surgical specimen was fresh and obtained following a distal gastrectomy. The greater curvature measured 16.5 cm, the lesser curvature 14.0 cm, the proximal resection margin 15.0 cm, and the distal resection margin 6.5 cm. The duodenum measured 0.7 cm. A large ulcerofungating mass was identified in the antrum, measuring 8.5 x 7.5 x 1.5 cm. The tumor was located 7.0 cm from the proximal resection margin and 1.0 cm from the distal resection margin. There was no gross evidence of serosal invasion.\n\nHistologically, the lesion demonstrated poorly differentiated cellular morphology. The depth of invasion was classified as pT3, with tumor extending into the subserosal connective tissue but without involvement of the visceral peritoneum or adjacent structures. Both the proximal and distal resection margins were free of tumor. The growth pattern was expanding, and a lymphoid reaction was present. Lymphovascular invasion was noted, while venous (large vessel) and perineural invasion were not observed.\n\nA total of 81 lymph nodes were examined and showed no evidence of metastasis. These included lymph nodes from the superior gastric, inferior gastric, and other regional groups. Additionally, a separately submitted mesenteric cystic wall specimen was identified as a cystic lymphangioma, and no tumor was found in lymph nodes associated with this specimen.\n\nThe pathological stage was determined to be pT3N0Mx according to the AJCC 7th edition staging system."} +{"pid": "TCGA-78-7633", "report": "The left upper lobe specimen measures 200 x 80 x 20 mm and contains an area of pleural tethering over the apex and lateral aspect with an underlying mass. The remainder of the pleura shows extensive carbon pigmentation. Sectioning reveals a bilobed lesion with a combined maximum size of 32 mm. The superior lobule is approximately 20 mm in diameter and exhibits central necrosis, while the inferior and lateral lobule measures around 12 mm with a solid cream to tan cut surface. These two lobules are separated by 2 to 3 mm of normal lung tissue and both are adjacent to the pleura. No additional lesions are identified upon serial sectioning, although severe emphysema is noted.\n\nMicroscopic examination identifies two distinct lesions within the lobe. The first has a predominantly acinar architecture and demonstrates extensive blood vessel invasion along with probable lymphatic permeation. The second lesion exhibits a papillary growth pattern. A third focus with bronchioloalveolar architecture is identified in a random section of lung tissue, measuring approximately 5 mm in diameter. Scarring of the pleura is observed over both larger lesions, raising suspicion for pleural involvement; however, special stains are pending for confirmation. There is no evidence of perineural invasion. The bronchial resection margin is free of abnormal cells. Examination of small peribronchial lymph nodes does not reveal any malignant involvement.\n\nThe second specimen consists of fragments from a hilar lymph node and shows only reactive changes without any signs of malignancy.\n\nStaging assessment indicates one lesion classified as T2 based on visceral pleural invasion associated with the acinar-pattern lesion, while the other two lesions are staged as T1 due to their smaller size and absence of pleural involvement. No lymph node metastases are identified (NO). Mild emphysema is present in non-neoplastic lung tissue. Immunohistochemical staining demonstrates positivity for CK7 and TTF1 in both larger lesions, with negativity for CK20, supporting a pulmonary origin. The architectural differences suggest these may be synchronous lesions."} +{"pid": "TCGA-CU-A3YL", "report": "The specimen was received for pathological evaluation following a radical cystoprostatectomy and lymph node dissection. The surgical specimen included the bladder and prostate, along with right and left pelvic lymph nodes, and a biopsy from the proximal urethral margin.\n\nGross examination of the bladder and prostate revealed a large, exophytic, papillary, friable tumor measuring 8.5 x 7.5 x 3.5 cm. It occupied the majority of the urothelium, sparing only a small portion of the posterior and left wall, and extended to the prostatic urethra orifice. On sectioning, the tumor appeared superficial with an intact underlying muscle wall and preserved perivesical fat. The distance from the gross tumor to the distal urethral margin was 2.2 cm. No other mucosal lesions were identified. The prostate showed minimal nodularity and a white indurated discoloration in the right posterior/lateral lobe.\n\nMicroscopic evaluation revealed that the lesion involved both the bladder and prostate. The tumor exhibited high-grade features and invaded the lamina propria of the bladder, as well as the prostatic ducts and stroma. No angiolymphatic space invasion was observed. There was associated high-grade atypical urothelial changes involving the bladder and bilateral prostatic ducts, suggestive of in situ disease. The tumor was solitary and did not extend to the ureters.\n\nAll surgical margins, including those of the ureters, urethra, paravesical soft tissue, and prostate, were free of malignant involvement. A total of seven lymph nodes (five from the right side and two from the left) were examined, and none contained evidence of malignancy.\n\nA frozen section analysis of the urethral margin showed focal urothelial atypia, interpreted as likely reactive, although low-grade dysplasia could not be entirely excluded. Immunohistochemical staining for PIN4 on one block showed an intact basal cell layer, supporting benign prostatic glands. Other findings included prostatic glandular atrophy.\n\nThe specimen was fully evaluated with multiple tissue blocks submitted for analysis, including representative sections from all relevant anatomical sites and margins. Based on the available data, the pathologic staging was determined."} +{"pid": "TCGA-BG-A0M3", "report": "A biopsy of fibroadi\nThe uterus, cervix, bilateral fallopian tubes, and ovaries were removed via total abdominal hysterectomy and bilateral salpingo-oophorectomy. The specimen weighed 104 grams. A lesion was identified measuring 5 cm in greatest dimension. Histologic evaluation showed a moderately differentiated epithelial neoplasm with squamous metaplasia. The tumor invaded approximately 53% of the myometrial thickness, corresponding to 0.9 cm of invasion into a myometrium measuring 1.7 cm in total thickness. Lymphovascular invasion was present.\n\nThe cervix did not show any evidence of the lesion. Multiple leiomyomas were identified, with the largest measuring up to 1.5 cm. The left and right ovaries showed endosalpingiosis and physiologic changes, and no tumor involvement was observed. The fallopian tubes were also free of tumor.\n\nLymph node biopsies from the right pelvic region included four nodes, all negative for tumor involvement. On the left pelvic side, eight lymph nodes were examined and found to be free of tumor. Additionally, four periaortic lymph nodes were evaluated and were also negative for tumor. In total, 17 lymph nodes were examined, with none showing signs of tumor involvement.\n\nThe percent surface involvement of the endometrium was 100% on the anterior endomyometrium and 90% on the posterior endomyometrium. The depth of myometrial invasion exceeded half of the myometrial thickness. No positive lymph nodes were identified. Cytology from pelvic washings showed atypical cells, while gutter washing specimens were negative for malignant cells."} +{"pid": "TCGA-E9-A5FL", "report": "The gross examination reveals a breast specimen containing a cystic lesion measuring up to 5.5 x 4 cm. Within the adipose tissue, multiple firm, hyperemic lymph nodes are noted, along with lipomatosis. Microscopic evaluation demonstrates squamous differentiation within the lesion. A total of ten lymph nodes were examined and showed sinus histiocytosis without evidence of metastatic involvement.\n\nImmunohistochemical staining shows no reactivity for ER, PR, or Her-2/neu markers. The Ki-67 proliferation index is approximately 30%. \n\nRegarding tumor characteristics, the extent of growth is categorized as T3 based on size exceeding 5 cm. There is no evidence of venous invasion and surgical margins appear uninvolved. Lymph node assessment reveals no metastases, with all nodes being negative. \n\nAdditional findings indicate that the histologic scoring system could not be fully applied due to insufficient data in key components such as tubule formation, nuclear pleomorphism, and mitotic counts. It was not possible to determine if there was any prior treatment administered before surgery."} +{"pid": "TCGA-FB-A545", "report": "The gross examination included a specimen comprising the body and tail of the pancreas along with the spleen. The distal pancreas measured 12.5 x 4.5 x 1.0 cm, and the spleen weighed 74 grams with dimensions of 9.5 x 5.5 x 2.9 cm. A well-defined, firm gray mass measuring 2.5 x 2.0 x 1.0 cm was identified 2.1 cm from the pancreatic resection margin. The pancreatic duct appeared uninvolved, and the remaining distal pancreatic tissue was firm and lobulated. Multiple lymph nodes were present.\n\nMicroscopic evaluation revealed a histologic grade characterized as moderately to poorly differentiated. The lesion extended microscopically into peripancreatic soft tissue. The proximal pancreatic resection margin was free of involvement by approximately 21 mm. Evidence of angiolymphatic invasion was present, as was extensive perineural invasion. There was no indication of prior treatment effect.\n\nLymph node assessment showed that 4 out of 28 peripancreatic lymph nodes contained involvement. Additional findings included chronic pancreatitis and ductal dysplasia consistent with panIN types II and III. The spleen showed no remarkable findings.\n\nStaging criteria indicated involvement beyond the organ in question to include surrounding soft tissue (pT3), with regional lymph node involvement (pN1). No distant metastases were identified (M0). Other pathologic features included lymphatic and venous invasion. The surgical margins were uninvolved."} +{"pid": "TCGA-LK-A4O5", "report": "The specimen consists of multiple tissue samples from the right parietal pleura, chest wall, rib, and mediastinal pleura. Histologic examination reveals a diffusely infiltrating cellular proliferation with epithelioid morphology, exhibiting a focal tubulopapillary growth pattern. The lesion involves adipose tissue, skeletal muscles, and pericostal soft tissues, with extension into the surrounding fat and involvement of skeletal muscles and the periosteum of the rib. Perineural invasion is identified focally. Margins of resection in the anterior chest wall adipose tissue and skeletal muscles are free of tumor involvement, while the pleural margin of resection shows involvement.\n\nImmunohistochemical staining demonstrates positivity for cytokeratin 5/6, calretinin, D2-40 (focally), and WT1. Stains for TTF-1, B72.3, BerEP4, and LeuM1 are negative. Mucicarmine staining is negative, with occasional diastase-sensitive PAS-positive staining noted. These findings support a diagnosis of a serosal-based neoplasm with the described morphologic and immunophenotypic features.\n\nPathologic staging according to the AJCC 7th edition is pT3, with no lymph nodes examined (pNX) and no evidence of distant metastasis (MX). The histologic grade is G2. Additional findings include focal foreign body giant cell reactions suggestive of prior surgical changes in multiple specimens."} +{"pid": "TCGA-BH-A1F0", "report": "A left total mastectomy with left axillary sampling was performed. Submitted material included a left radical mastectomy specimen. Intraoperative findings identified two distinct masses within the breast. The first mass was located at the 1:00 position and measured 2.0 \u00d7 2.0 \u00d7 2.0 cm. A second lesion, located lateral to the first, measured 1.5 \u00d7 1.5 \u00d7 1.0 cm. Both masses exhibited identical morphologic features. Histologic evaluation revealed poorly differentiated cellular features with a Nottingham score of 8 (tubules\u20143, nuclear atypia\u20143, mitosis\u20142). All surgical margins were free of involvement. The nipple-areolar complex and surrounding non-neoplastic breast tissue showed no diagnostic abnormalities.\n\nAxillary sampling included one lymph node, which demonstrated evidence of involvement. The focus measured 1.5 mm and was confirmed on both standard histologic sections and immunoperoxidase staining. Staging classification was AJCC T1c N1a Mx. Both lesions were located in the upper outer quadrant. No discrepancies were found between the current findings and prior reports.\n\nImmunohistochemical analysis for hormone receptor status was conducted on blocks \"A2\" and \"A4.\" Focal intranuclear staining was observed for progesterone receptor in both blocks, involving approximately 15% of cells, while no staining was detected for estrogen receptor. Progesterone receptor expression was considered borderline, and estrogen receptor was classified as negative. HER-2/neu immunostaining did not show complete membrane staining in either block using a polyclonal antibody without antigen retrieval. HER-2/neu expression was interpreted as negative (score 0) in both cases."} +{"pid": "TCGA-B0-4815", "report": "A mass measuring 7.9 x 7.2 x 4.0 cm was identified in the left kidney. Histological evaluation shows a high nuclear grade, with features corresponding to Fuhrman grade 3-4. The lesion invades through the renal capsule and extends into the perinephric fat. All resection margins, including those of the renal artery, renal vein, and ureter, are negative for tumor involvement. There is no evidence of angiolymphatic or perineural invasion. Pathologic staging is T3a NX MX based on these findings.\n\nBiopsy of a gastric polyp reveals atypical clear cells within the mucosa. These findings, in conjunction with the patient\u2019s prior medical history, raise concern for metastatic involvement. Additional testing is underway to further characterize the origin of these cells.\n\nIn a separate series of biopsies obtained from a bone lesion in the left shoulder, histology demonstrates metastatic clear cell morphology consistent with renal origin. Immunohistochemical staining confirms positivity for low molecular weight cytokeratin and vimentin, with focal positivity for EMA. Additional immunostaining profiles support this conclusion."} +{"pid": "TCGA-23-1029", "report": "A biopsy of a bladder lesion revealed high-grade cellular atypia with malignant features. Excision specimens from two omental sites showed similar high-grade malignant changes, with extensive replacement of adipose tissue by friable, gray-white tumor tissue. A colon mesentery specimen demonstrated fatty tissue largely replaced by tumor, with no identifiable lymph nodes. Both ovaries were significantly affected; each showed solid and cystic components with gray-white tumor replacing nearly the entire structure. Involvement of the cul-de-sac was identified through biopsied fragments exhibiting malignant morphology.\n\nThe hysterectomy specimen included the cervix and bilateral fallopian tubes. Gross evaluation revealed no distinct tumor involvement in the cervical or endometrial mucosa; however, tumor involvement was noted on the serosal surface of the uterine corpus, cervix, and right fallopian tube. No abnormalities were observed within the lumens of the fallopian tubes. An anterior peritoneum biopsy revealed focal involvement by malignant cells. Similarly, a specimen from the right gutter showed extensive infiltration by firm tumor tissue. The falciform ligament also exhibited focal tumor involvement.\n\nGross measurements indicated significant tumor burden across multiple anatomical sites. The left ovary measured 13.0 x 6.5 x 6.2 cm and weighed 300 grams, while the right ovary measured 9.0 x 7.3 x 5.2 cm and weighed 180 grams. The bladder lesion aggregate measured 4.5 x 3.2 x 1.0 cm. Omental specimens ranged from 10.0 x 7.2 x 1.5 cm to 17.5 x 5.0 x 3.0 cm. The colon mesentery involved three portions measuring between 6.0 and 11.5 cm in greatest dimension.\n\nCellular morphology consistently displayed high-grade features throughout all involved specimens. Staging was assessed as pT3cNxMx based on the extent of serosal involvement and widespread dissemination across pelvic and peritoneal regions. Clinical history includes presentation with pelvic mass and ascites."} +{"pid": "TCGA-AR-A1AL", "report": "The specimen consists of a mass measuring 6.5 x 5.2 x 3.5 cm located in the superior portion of the left breast. Histologic evaluation reveals cells arranged in single files and small clusters infiltrating through fibrous stroma. Nuclear features show minimal pleomorphism with uniform round to oval nuclei and fine chromatin. Mitotic activity is low. The surrounding non-neoplastic breast parenchyma demonstrates nonproliferative fibrocystic changes with duct ectasia. Calcifications are noted within benign ducts and acini. The lesion does not extend to the nipple, overlying skin, or underlying chest wall. All surgical margins, including the deep margin, are free of tumor involvement with a minimum tumor-free margin of 0.8 cm. Of the lymph nodes evaluated, one of six axillary lymph nodes contains metastatic involvement. In the sentinel lymph node group, one of three lymph nodes shows metastatic involvement with a focus measuring 0.9 cm in greatest dimension, while the other two sentinel lymph nodes are negative. Immunohistochemical staining for cytokeratin was performed on all sentinel lymph nodes and confirmed the presence or absence of metastatic involvement as appropriate. Blue dye was identified in two sentinel lymph nodes. Additional testing for hormone receptors and Her-2/NEU status is in progress."} +{"pid": "TCGA-Y8-A895", "report": "A male patient underwent a robotic-assisted laparoscopic partial nephrectomy of the right kidney. The specimen involved a lesion located in the lower pole. Multiple tumor nodules were identified, with the largest measuring 6.0 cm in greatest dimension. Additional smaller nodules measured 0.3 cm, 0.3 cm, 0.1 cm, 0.1 cm, and less than 0.1 cm. The tumors were confined to the kidney without extension beyond the renal capsule or into surrounding fat. Histologic evaluation showed cells consistent with a previously described type, with a Fuhrman Nuclear Grade of 2. No sarcomatoid features or tumor necrosis were observed. Microscopic examination confirmed absence of lymphovascular invasion and all surgical margins were negative for involvement. The closest distance from tumor to margin was 1 mm. No regional lymph nodes were available for assessment. Pathologic staging is based on the largest lesion and indicates a primary tumor greater than 4 cm but not more than 7 cm in size, limited to the kidney. Non-neoplastic portions of the kidney demonstrated glomerular changes including hypercellularity and global sclerosis, along with arteriolonephrosclerosis, interstitial fibrosis, and chronic inflammation. Multiple additional small lesions with similar histologic features were also present. Specimen processing times and tissue weights were recorded. Tissue samples were preserved using formalin fixation and stored in paraffin blocks. Blood and plasma components were collected and processed at specified intervals. All surgical specimens were obtained under appropriate consent."} +{"pid": "TCGA-E6-A2P8", "report": "The surgical specimens include a total abdominal hysterectomy with bilateral salpingo-oophorectomy and a pelvic lymph node. The uterus measured 11 cm from fundus to cervix and weighed 318 grams. Within the endometrial cavity, a tan-pink friable mass was identified, measuring 5.4 x 4.5 x 3.2 cm and occupying approximately 90% of the cavity. The mass demonstrated invasion into the myometrium, with a maximum depth of 27 mm out of a total myometrial thickness of 33 mm. Histologically, the lesion showed a mixture of two components: one resembling endometrioid-type carcinoma (65%) and another with serous differentiation (35%). High-grade features were present, including more than 50% nonsquamous solid growth. Vascular or lymphatic invasion was identified. Surgical margins were uninvolved.\n\nMultiple benign leiomyomas were found within the myometrium, the largest measuring 2.5 x 2.3 cm. Both fallopian tubes were patent, and the ovaries appeared atrophic with simple cysts. Endosalpingiosis was noted in the fallopian tubes, and serosal adhesions were present.\n\nA single pelvic lymph node, measuring 0.5 cm, was submitted for evaluation. Microscopic examination revealed metastatic involvement by the tumor, with focal extranodal extension observed.\n\nNo cervical involvement was seen grossly or microscopically. No para-aortic or contralateral pelvic lymph nodes were involved. Peritoneal cytology was negative. Based on these findings, the pathologic stage was determined as pT1b N1 Mx."} +{"pid": "TCGA-D5-6922", "report": "A histopathological examination was performed on a resected segment of the large intestine, which measured 15.2 cm in length, along with a piece of attached mesentery measuring 15 x 6.5 x 2.5 cm. A mucosal lesion was identified, measuring 4.2 x 6.5 x 0.8 cm, and exhibited an ulcerous appearance. The lesion involved approximately 90% of the intestinal circumference and was located 7.2 cm from one surgical margin and 5.3 cm from the opposite margin.\n\nMicroscopic analysis revealed moderately differentiated glandular and papillary structures infiltrating deeply into the muscular layer of the intestinal wall and extending into the pericolic adipose tissue of the mesentery. No tumor cells were found at the surgical incision margins. Lymph node involvement was noted, with evidence of tumor cells within the lymph node capsule and in surrounding perinodal fat. Vascular invasion by tumor cells was also observed.\n\nThe tumor was classified as moderately differentiated. Lymph node metastases were confirmed, involving multiple nodes. Tumor staging indicated penetration through the muscularis propria into the surrounding pericolic tissues, with regional lymph node involvement but no evidence of distant spread."} +{"pid": "TCGA-X4-A8KS", "report": "The prostatectomy specimen weighed 33 grams and measured 3.9 x 3.6 x 3.1 cm. The external surface was inked with multiple colors to identify surgical margins, including yellow at the apex, green at the bladder neck, black on the right side, and blue on the left. On gross examination, the cut surface showed a pink-tan, spongy texture with mild nodularity in the peri-urethral region. No discrete mass was identified. The entire specimen was submitted for analysis.\n\nHistologic evaluation revealed involvement of both lobes. The combined Gleason score was 7 (3+4). The estimated volume of involved tissue was approximately 5% of the total prostate. There was no evidence of extension beyond the prostatic capsule. A positive margin was identified focally near the right apex. Perineural invasion was present. No lymphovascular space invasion was observed. Both seminal vesicles were unremarkable. Lymph nodes, including those from the subcutaneous and periprostatic fat, were negative. The pStage was determined as T2CNXMX."} +{"pid": "TCGA-G3-A5SL", "report": "The liver specimen measures 23 x 14 x 9 cm and weighs 671 grams. A circumscribed greenish-tinged nodule is identified, measuring 5.5 cm in maximum dimension. The nodule is located within 1 mm of the inked surgical margin but does not appear to involve the margin. No other masses or nodules are observed. The surrounding liver tissue appears slightly yellow with possible areas of congestion. Sections were taken from the tumor, adjacent normal liver, and the nearest margin. Histologically, the lesion shows moderate differentiation with lymphovascular invasion. The gallbladder specimen measures 9.5 x 5 x 3 cm and contains approximately 30 cc of bile. No gallstones, masses, or polyps are present. The gallbladder wall measures up to 0.2 cm in thickness and appears grossly within normal limits. Representative sections of the cystic duct, body, and fundus are submitted."} +{"pid": "TCGA-DJ-A2PX", "report": "The specimen submitted was a total thyroid. The clinical history included a fine needle aspiration of the left lobe.\n\nThe thyroid gland weighed 18.0 grams. The right lobe measured 5.5 x 3.0 x 0.9 cm, the left lobe measured 4 x 2 x 1 cm, and the isthmus measured 2 x 1.5 x 0.6 cm. The external surface was covered by a thin fibrous capsule. On sectioning, the left lobe contained a 1.2 cm light brown nodule with central cystic degeneration located at the upper pole, adjacent to the thyroid capsule. The right lobe showed red tan and beefy parenchyma with vague nodularity. The isthmus appeared red tan and beefy.\n\nHistologic evaluation revealed a well-differentiated lesion with no mitotic activity or tumor necrosis identified. The lesion was completely surrounded by a capsule, with focal invasion of the capsule. There was no vascular invasion or extension beyond the thyroid gland. Surgical margins were free of involvement. Multicentric disease was not observed.\n\nThe remaining thyroid tissue showed nodular hyperplasia and chronic lymphocytic thyroiditis. No parathyroid glands were identified. Four benign lymph nodes were identified in the specimen.\n\nAll findings were based on personal examination of the slides and representative sections were submitted for analysis."} +{"pid": "TCGA-DU-A6S2", "report": "A 7 cm right medial frontal lesion was identified in a female patient presenting with headache. Imaging demonstrated a lesion that expands the gyri, involving the mid and anterior cingulate regions, and lacking enhancement. The lesion was excised, and histopathological evaluation of the specimen showed a neoplastic glial proliferation with oligodendroglial features. Microscopic examination revealed focal to moderate infiltration of the cerebral cortex by monomorphic cells with round nuclei and clear cytoplasm. Mitotic figures were observed, with a MIB-1 proliferation index of up to 6% in one area and approximately 2% elsewhere. No endothelial cell proliferation, microvascular proliferation, or necrosis was present.\n\nImmunohistochemical staining showed uniform reactivity for IDH1. CD163 highlighted perivascular microglia. Proliferation activity was assessed with MIB-1, showing increased labeling in a focal proliferation center. Molecular testing revealed codeletion of chromosome arms 1p and 19q, based on allelic loss at several loci including D1S548, D1S1592, D1S552, and D19S1182. Promoter methylation analysis detected methylated MGMT.\n\nThe histologic features include a low-grade appearance overall, with focal areas of increased mitotic and cycling activity. These findings may correlate with clinical, imaging, and operative observations for further interpretation and follow-up."} +{"pid": "TCGA-AW-A1PO", "report": "The specimen was obtained from a female patient of Caucasian ethnicity. The tissue sample was collected from the uterus, identified as a primary tumor site. The tissue was preserved in frozen format. Histological evaluation revealed endometrioid-type cellular features with a grade 3 classification. The tumor demonstrated a high cellular composition, with approximately 90% tumor cells present. Staging assessments indicated T-stage 1, N-stage 0, and M-stage 0. No prior chemotherapy or hormonal therapy was reported. A blood sample was also collected, with no abnormal findings noted in the specimen description."} +{"pid": "TCGA-FS-A1ZN", "report": "The specimen is cryofixed and the tissue weight is noted. Microscopic examination of the H&E stained slide reveals a malignant epithelioid tumor with minimal connective tissue. The tumor comprises approximately 95% of the tissue. The tumor cells exhibit round to oval nuclei with granular chromatin, a high nuclear-to-cytoplasmic ratio, and occasional apoptotic figures. The cytoplasm is pigmented and of intermediate size. A sheet-like growth pattern is observed. The mitotic count is approximately 8 mitoses per square millimeter. Lymphocytic infiltrates account for about 3% of the tissue, and melanophages are present."} +{"pid": "TCGA-23-1118", "report": "A 10 cm uterine corpus is symmetric with a 2.5 cm thick myometrium. The cervix measures 4 cm in length and 3.5 cm in diameter, with a patent os. The endometrial cavity is 5 cm long and lined by a hyperemic endometrium measuring 0.2 cm in thickness. The left ovary is markedly enlarged, measuring 14 x 13 x 15 cm, and is largely replaced by a solid and cystic mass with tan-red cut surface, papillary projections, and areas of necrosis. The tumor invades through the ovarian serosa into adjacent myometrium. Multiple cysts within the mass range from 3 to 6 cm. Adhesions are present on the serosal surface of the uterus and ovary.\n\nThe right ovary measures 8 x 4 x 4 cm and contains a 5.5 cm cyst lined by smooth inner surface, along with a 1.9 cm hemorrhagic functional cyst. The attached fallopian tube is 8 cm long. Vascular invasion is noted in multiple sites including the cervix (endocervical and exocervical walls), myometrium, fallopian tube, and paraovarian/paratubal regions. Tumor emboli are also identified in the left pelvic lymph nodes (4 out of 5 involved) and right obturator lymph nodes (10 out of 11 involved), with perinodal extension observed.\n\nOmental specimens show scattered clusters of tumor cells, particularly in omentum #2\u2013#5. Three small lymph nodes from the omentum show no metastasis. Additional findings include adhesions, mesothelial hyperplasia, chronic inflammation, and fibrinous exudate. The appendix demonstrates serosal and mural vascular tumor emboli, along with fibrinous exudate containing tumor cell clusters. The appendiceal tip shows signs of early/subacute inflammation with granulation tissue and reactive epithelial changes.\n\nMicroscopic sections from various sites confirm widespread vascular invasion, with poorly differentiated carcinoma seen in frozen sections of the right ovarian mass, left ovary, and left pelvic lymph node. The right ovary also shows benign cystic changes and serosal adhesions. The left fallopian tube is adhered to the tumor mass and difficult to delineate, while the right fallopian tube exhibits intravascular papillary endothelial hyperplasia and paratubal lymphovascular emboli. Paratubal Walthard rest and paraovarian lymphovascular invasion are also present."} +{"pid": "TCGA-95-8494", "report": "The surgical specimen consists of a right middle lobe lobectomy with associated lymph node biopsies submitted for pathological evaluation. The lung specimen is an intact lobe weighing 151 grams, measuring 13.5 x 9 x 3.6 cm. Within the parenchyma, there is an elongated to irregular grey firm mass measuring 4.5 x 4 x 3.4 cm. The tumor bulges into the overlying pleura and is located 3.7 cm from the bronchial margin. Elastic stain demonstrates involvement of the pleural elastic layer without full penetration. Histologically, the lesion shows solid growth pattern and is poorly differentiated. The bronchial, vascular, and parenchymal margins are free of invasive disease. Emphysematous and congestive changes are noted in the surrounding lung tissue.\n\nA total of five lymph node specimens were examined. Lymph nodes from station 10R, 2R, 4R, and 7R show no evidence of involvement. In contrast, the lymph node from station 11R contains fragments positive for metastatic carcinoma. One lymph node out of five examined showed evidence of disease involvement.\n\nStaging parameters indicate a primary tumor size of 4.5 cm, classified as pT2a based on size and pleural invasion. Regional lymph node staging (pN) shows one involved node among those evaluated, consistent with pN1 status. No distant metastases were identified. Obstructive pneumonitis is noted as an additional finding. All other margins are uninvolved, with the closest distance of invasive carcinoma to a margin being 37 mm at the bronchial margin."} +{"pid": "TCGA-22-1016", "report": "The pathology report includes the following information: The case was originally sent to the IGC Biospecimen Core Resource (BCR), and the specimen was received on a date indicated in the original form. Histology and site codes were provided for both the specimen and the overall case, based on the Case Quality Control Form (CQCF) and patient diagnosis when available. The form was completed in accordance with instructions for handling cases where a standard pathology report is not available. All relevant data elements were filled out, including tumor type, specimen source, and diagnostic codes."} +{"pid": "TCGA-QU-A6IL", "report": "Pathology Examination. Birthdate. Pathology. #. Male. Report to: Gross Description by: SPECIMEN SUBMITTED: RT & LT OBTURATOR L.N'S & PROSTATE & SEMINAL VESICLES. Procedure date. Tissue received. Report Date. Diagnosed by. Previous biopsies: PROSTATE BX'S. GI BX. GALLBLADDER. GI BX. (and more).\n\nI. Right obturator lymph nodes (A-B): One lymph node, no malignancy identified.\n\nII. Left obturator lymph nodes (C-E): Three lymph nodes, no malignancy identified.\n\nIII. Prostate and seminal vesicles (F-Q): Histologic findings are as follows:\n\n- Gleason's histologic grade: Primary pattern - 3. Secondary pattern - 4. Score - 7/10.\n- Distribution of involvement in radical prostatectomy specimen:\n - Right side: 2 positive slides out of 3 total.\n - Left side: 5 positive slides out of 8 total.\n - Dorsal apex: 0 positive slides out of 2 total.\n - Ventral apex: 0 positive slides out of 2 total.\n\n- Pathologic staging indicates the lesion is confined to the prostate.\n- Evidence of perineural extension is present within the prostate.\n- No vascular or lymphatic invasion identified.\n- Surgical margins were assessed:\n - Inked capsular resection margins: Negative.\n - Inked bladder margin: Negative.\n - Inked apex margin: Negative.\n- Seminal vesicles show no evidence of involvement.\n- Lymph node evaluation:\n - Right pelvic: Total number - 1, none positive.\n - Left pelvic: Total number - 3, none positive.\n\nGross description of the prostate and seminal vesicles: The prostate gland weighs 45 grams and measures 5.2 cm (base), 4.5 cm (side-to-side), and 3.8 cm (anterior to posterior). It includes attached vas deferens measuring up to 2.6 cm in length with an average diameter of 0.4 cm, and bilateral seminal vesicles averaging 3.5 x 1.2 x 0.7 cm. The seminal vesicles appear pink-gray and convoluted. Sectioning reveals no identifiable abnormality. The prostate capsule appears intact, with the right side inked in black and the left in green. The urethral margin (apex) and ureteral margin (base) have been shaved and sectioned. The remainder of the glandular tissue has been serially sectioned from apex to base. Focal nodularity is noted in the posterior left and right lateral aspects. A compressed fibromuscular band is observed on the left. Small firm yellow areas are present in the right posterior region, along with a moderate amount of corpora amylacea centrally located around the prostatic urethra.\n\nThe specimen was submitted for microscopic examination as follows: F = right vas deferens and seminal vesicle; G = left vas deferens and seminal vesicle; H = anterior apical margin; I = posterior apical margin; J = anterior base margin; K = posterior base margin; L-N = right apex, mid, and base respectively; O-Q = left apex, mid, and base respectively; R-V = Additional left sections.\n\nBy his/her signature above, the senior physician certifies that he/she personally conducted a gross and/or microscopic examination of the described specimens(s). Immunohistochemistry tests, if applicable, were developed and their performance characteristics determined by the laboratory. They have not been cleared or approved by the U.S. Food and Drug Administration. The FDA has determined that such clearance or approval is not necessary. These tests are used for clinical purposes and should not be regarded as investigational or for research. This laboratory is certified under the Clinical Laboratory Improvement Amendments of 1988 (CLIA 88) as qualified to perform high complexity clinical laboratory testing."} +{"pid": "TCGA-BH-A0HB", "report": "The specimen from a right breast segmental mastectomy measures 1.9 cm in greatest dimension. Histologic evaluation demonstrates a Nottingham grade 2 lesion with a combined score of 6 out of 9. This includes tubule formation score of 3, nuclear atypia score of 2, and mitotic activity score of 1. A high-grade in situ component is present extensively, showing solid type growth pattern with nuclear grade 2 features, lobular involvement, cancerization changes, and focal comedo-type necrosis. This in situ component constitutes more than 25% of the tumor volume and is adjacent to the invasive component.\n\nLymphovascular invasion is identified. Surgical margins are free of tumor involvement, with the closest anterior margin measuring 0.4 cm and the next closest posterior margin measuring 0.5 cm. Additional benign findings include sclerosing adenosis, fibroadenomatoid changes, and biopsy site alterations.\n\nTwo sentinel lymph nodes were evaluated; both are negative for metastatic disease using standard histologic methods. The pathologic staging assessment indicates no evidence of regional lymph node involvement or distant metastasis.\n\nImmunohistochemical staining shows positivity for estrogen and progesterone receptors, while HER2/Neu testing yields a score of 2+."} +{"pid": "TCGA-KK-A59Z", "report": "The specimen consists of a prostate with attached right and left seminal vesicles and segments of the right and left vasa deferentia. The prostate measures 3.6 x 4.0 x 5.1 cm and weighs 35 grams after fixation. Serial cross-sectioning reveals a firm area within the peripheral zone, most prominently involving three cross sections of the prostate. This lesion is located in the left anterolateral, left lateral, left posterolateral, left posterior, mid posterior, and right posterior regions. It measures 2.0 x 1.5 cm at its largest dimension and spans multiple sections, predominantly affecting the apex with focal involvement of the base. A second distinct focus is identified in the right lateral peripheral zone measuring 0.2 x less than 0.1 cm and present in one cross section.\n\nMargins of resection are free of abnormal tissue. No involvement is identified in the right and left seminal vesicles or in the segments of the right and left vasa deferens. High-grade prostatic intraepithelial neoplasia is noted.\n\nTwo lymph nodes were identified in the pelvic region, measuring 4.5 x 1.5 x 0.8 cm and 7.0 x 1.5 x 1.0 cm respectively, and neither showed evidence of abnormal cellular infiltration. Both lymph nodes were serially sectioned and found to be unremarkable.\n\nSections of the prostate were inked to delineate anatomical orientation: anterior in green, left surface in red, right surface in yellow, and posterior in black. Areas marked with orange ink (sections B33, B34, B37, B38, and B42) indicate surfaces not representative of the true margin of resection."} +{"pid": "TCGA-C5-A1BE", "report": "The specimen from a radical hysterectomy includes the cervix, uterus, fallopian tubes, ovaries, parametrium, vagina, and lymph nodes. A lesion measuring 5 cm in greatest dimension is identified in the cervix. Histologic examination reveals moderately differentiated cells with invasive growth to a depth of 14 mm, within a total wall thickness of 15 mm. The lesion approaches the inked margin in the anterior lower uterine segment, with involvement less than 1 mm from the margin. Extensive lymphatic and vascular space invasion is noted.\n\nNo involvement is identified in the parametrial tissue or in three lymph nodes examined. The vaginal cuff shows no abnormal cellular changes. Within the endometrium, there is extensive involvement by an in situ and invasive lesion, along with endometrial polyps showing similar cellular changes. The endometrium otherwise appears inactive.\n\nIn the myometrium, benign findings include leiomyomas, with the largest measuring 0.9 cm. There is evidence of direct extension of the cervical lesion into adjacent tissue. No abnormalities are found in the ovaries or fallopian tubes. Additionally, focal endosalpingiosis is present in the parametrial tissue, and vessels demonstrate complex atherosclerosis."} +{"pid": "TCGA-VS-A9U7", "report": "The biopsy specimen from the cervix demonstrates a poorly differentiated invasive lesion composed of atypical squamous cells. The tumor exhibits infiltrative growth patterns with no evidence of angiolymphatic or perineural invasion. Cellular features include marked nuclear atypia, frequent mitotic figures, and loss of normal tissue architecture. No lymph node involvement or distant metastasis was identified in the submitted material."} +{"pid": "TCGA-E7-A519", "report": "The specimen consists of bladder tissue obtained from an excision. The lesion measured 6 x 5 x 3 cm and exhibited a papillary growth pattern. Microscopic evaluation revealed cells with well-differentiated features. The lesion extended into the deep muscle layers of the bladder. No assessment was provided regarding lymph nodes, lymphatic or venous invasion, surgical margins, or response to preoperative treatment. No additional findings were noted."} +{"pid": "TCGA-DD-AACW", "report": "The submitted liver specimen measured 15.0 x 6.0 x 4.5 cm and weighed 142.5 grams. A hepatic mass was identified, measuring 2.0 x 1.8 x 1.5 cm. The cut surface of the lesion was described as encapsulated, yellowish tan in color, round and solid with central necrosis. Grossly, the lesion exhibited a multinodular confluent growth pattern and was confined within the capsule. The resection margin was not involved, with a safety margin of 1.2 cm. The remaining liver parenchyma showed features of cirrhosis.\n\nMicroscopic examination revealed a tumor composed predominantly of cells arranged in a trabecular pattern. Cellular morphology included clear cell features with areas exhibiting a solid growth pattern. Nuclear grading showed a worst differentiation grade of III and major differentiation grade of III according to Edmondson-Steiner criteria. Fatty change was absent. Fibrous capsule formation was present along with capsular infiltration and septum formation. There was evidence of lymphovascular invasion; however, no invasion was observed in bile ducts, portal veins, serosal surfaces, or surgical resection margins. The non-tumorous liver parenchyma demonstrated cirrhotic changes.\n\nAdditional findings included negative smears from peritoneal and pleural fluids, with one pleural fluid smear showing signs of inflammation. No pathologic findings were identified in the stomach prepylorus specimen."} +{"pid": "TCGA-A4-7287", "report": "The surgical specimen consists of a left kidney and ureter. The kidney measures 14 cm in length and contains a tan-white neoplasm located in the superior and middle pole calices, measuring 3.7 x 3.2 x 3.2 cm. The tumor is approximately 1 cm from Gerota's fascia and 1.5 cm from the renal hilar vascular margin. No grossly identifiable adrenal tissue or intraluminal tumor within the renal vessels was observed. The ureter is patent with a smooth urothelium, and a plastic stent is present within its lumen.\n\nMicroscopically, the tumor demonstrates papillary architecture with high-grade cellular features. A portion of the lesion is non-invasive; however, small foci of invasion are identified within the lamina propria, with the deepest invasion measuring up to 1 mm. Adjacent to the invasive component, there is evidence of high-grade intraurothelial neoplasia involving the urothelium. All surgical margins, including Gerota\u2019s fascia, ureteral, and vascular margins, are free of tumor involvement.\n\nNo lymph nodes were identified in the specimen. There is no evidence of lymphovascular or perineural invasion. Additional findings include patchy chronic interstitial nephritis in the background kidney tissue. Based on histologic evaluation, the tumor is classified as pT1, indicating invasion limited to the subepithelial connective tissue. Lymph node and distant metastasis staging could not be determined due to lack of submitted nodes and absence of metastatic evidence (pNX, pMX)."} +{"pid": "TCGA-D1-A16V", "report": "The right ovary and fallopian tube specimen measured 15.0 x 8.1 x 7.5 cm and demonstrated a multicystic structure with cysts ranging from 0.5 cm to 8.0 cm in diameter. The outer surface was smooth and unremarkable, with no involvement noted. Multiple tan-white polypoid nodules were observed within the cystic spaces, measuring between 0.3 cm and 2.1 cm in diameter. The attached fallopian tube appeared histologically normal.\n\nThe left ovary and fallopian tube specimen measured 11.0 x 9.0 x 5.6 cm and also exhibited a multicystic architecture with mural nodularity. These nodules ranged from 0.3 cm to 1.5 cm in size. The ovarian surface was smooth and showed no signs of tumor infiltration. The attached fallopian tube was similarly unremarkable.\n\nExamination of the uterus revealed a mass measuring 7.5 x 5.5 x 4.1 cm located in both the anterior and posterior regions of the endometrial cavity. Histologic evaluation demonstrated cellular features consistent with glandular proliferation and invasion into the myometrium, reaching a depth of 3.3 cm out of a total myometrial thickness of 4.5 cm. No angiolymphatic invasion was identified. The cervix and lower uterine segment appeared unaffected by disease.\n\nLymph node assessment revealed metastatic involvement in multiple pelvic and para-aortic lymph nodes bilaterally. Specifically, among the right pelvic lymph nodes, two out of five common iliac lymph nodes contained metastatic deposits. Additionally, two external iliac, one internal iliac, and eleven obturator lymph nodes were negative for tumor involvement. On the left side, six obturator and nine common iliac lymph nodes showed metastatic involvement, while three external iliac and four internal iliac lymph nodes remained tumor-free.\n\nMetastatic involvement was also detected in para-aortic lymph nodes. Among the right para-aortic lymph nodes above the inferior mesenteric artery, one out of thirteen was positive for tumor spread. Below this artery, four out of eleven lymph nodes were similarly involved. On the left para-aortic region, one lymph node above and one below the inferior mesenteric artery showed evidence of metastasis out of three sampled each.\n\nThe omentum contained multiple nodules consistent with fat necrosis, measuring between 0.3 cm and 2.5 cm in diameter. The hernia sac component did not demonstrate any pathological findings.\n\nBoth gonadal vessels\u2014right and left\u2014were devoid of tumor involvement.\n\nFrozen section analysis corroborated these findings intraoperatively, confirming benign ovarian pathology on both sides and identifying adenocarcinomatous involvement within the uterus and regional lymphatics without further specification of tumor type or grade."} +{"pid": "TCGA-FB-AAPS", "report": "The specimen includes a pancreas, duodenum, and gallbladder oriented with multiple sutures indicating surgical margins. The pancreas measures 5.5 x 5.5 x 4 cm and contains an ill-defined, firm mass measuring 3 x 3 x 2.7 cm. This mass is in close proximity to several margins: less than 0.1 cm from the superior mesenteric artery margin, less than 0.1 cm from the deep radial margin, less than 0.4 cm from the portal vein margin, and greater than 2 cm from the pancreatic neck margin. The common bile duct and pancreatic duct remain patent. The remainder of the pancreatic tissue shows normal architecture.\n\nThe duodenum measures 19.5 cm in length and 3.3 cm in diameter, with smooth red-purple serosa and stapled ends. The mucosal surface appears tan-brown with normal longitudinal folds. A focal area in the distal 6.5 cm of the duodenum shows dark brown, hemorrhagic changes with a slightly dusky appearance. An ill-defined erythematous lesion measuring approximately 2 x 1 cm is observed near the opening of the pancreatic duct. No other lesions or abnormalities are noted.\n\nThe gallbladder measures 10.2 x 4.2 x 1.6 cm and has a variable serosal texture ranging from smooth to roughened. It contains viscous red-black bile and a cystic duct remnant measuring 1.5 x 0.4 cm. A crystallized calculus measuring 1.5 cm is identified within the gallbladder lumen. No masses or abnormal lesions are present.\n\nUpon sectioning the surrounding fat, five possible lymph nodes are identified, with the largest measuring 1.5 cm in diameter. Representative sections of all areas have been submitted for further analysis."} +{"pid": "TCGA-EL-A3CT", "report": "The specimen consists of a multinodular cohesive mass measuring 12.0 x 8.0 x 8.0 cm. Multiple enlarged and firm nodules are present, some matted and others distinct, ranging in size from 4.0 to 1.0 cm. The left thyroid lobe measures 6.0 x 3.0 x 1.0 cm and has a fleshy appearance with multiple nodules ranging from 1.0 to 0.5 cm. Sections from the thyroid and various masses have been submitted for analysis.\n\nA total of 17 identifiable lymph nodes were examined, with involvement noted in two. Extension into adjacent soft tissue was observed. A single lymph node from the right parathyroid region measures 1.5 x 0.6 x 0.3 cm and contains a parathyroid gland with microadenoma; no lymph node tissue was identified at this site.\n\nThe distal esophageal margin consists of a tan-pink, non-oriented irregular tissue fragment measuring 2.0 x 1.0 x 0.2 cm, showing mild esophagitis. Cellular features include follicular variant morphology with extension into adjacent structures. No clinical history was provided."} +{"pid": "TCGA-OU-A5PI", "report": "The specimen included portions of the 10th rib, left kidney with attached adrenal gland, para-aortic lymph node, and multiple lung tissue samples from right lower and middle lobes. The 10th rib consisted of two bone segments measuring 3.2 x 1.2 x 0.5 cm and 4.9 x 1.2 x 1 cm, with no visible lesions.\n\nThe left kidney and adrenal gland weighed 1243 grams and measured 24.0 x 9.5 x 8.5 cm in total. The kidney itself was 10.5 x 7.5 x 4.5 cm and showed a normal tan-brown cortex with a well-defined cortico-medullary junction. The attached adrenal gland measured 13.5 x 9.5 x 8.5 cm and was diffusely enlarged with a variegated and hemorrhagic cut surface. No gross invasion into the kidney was observed. Around the adrenal gland, there were 9 tan-white to tan-pink nodes ranging from 0.3 x 0.2 x 0.2 cm to 1.5 x 1.3 x 1.2 cm in size. Multiple sections were taken from the adrenal gland, surrounding fat, and adjacent kidney tissue.\n\nThe para-aortic lymph node specimen measured 4.4 x 4.2 x 1.9 cm and contained two matted lymph nodes measuring 3.2 x 2.2 x 1.2 cm and 3.8 x 2.3 x 2.1 cm, along with a smaller nodule of 1.2 x 0.9 x 0.6 cm in the attached fat.\n\nThe right lower lobe lung wedge resection measured 9 x 4.5 x 3 cm and contained a tan-white nodule measuring 1.5 x 1.5 x 1 cm located 1 cm from the resection margin. A second lung wedge from the right lower lobe measured 4.2 x 1.2 x 0.3 cm and contained a small area measuring 0.3 x 1.2 cm located 0.2 cm from the margin. A third wedge from the right middle lobe measured 9 x 4.5 x 3 cm and contained a tan-pink nodule measuring 1.1 x 0.9 x 0.3 cm, also located 1 cm from the margin. All lung specimens were submitted for histologic evaluation.\n\nMicroscopic findings revealed cells with moderate pleomorphism and focal infiltration into periadrenal adipose tissue. Multiple discrete tumor nodules were identified around the adrenal gland. Necrosis was prominent, and capsular invasion was present. The tumor was located 1 mm from the inked surgical margin. Mitotic count was 8 per 10 high-power fields, including abnormal forms. Ki67 proliferation index was 10%. Immunohistochemistry showed positivity for Inhibin-alpha and Melan-A (focal and weak), while Chromogranin A, S-100, and CD10 were negative.\n\nMetastatic involvement was identified in the para-aortic lymph node (3 out of 3 nodes involved). Lung specimens showed metastatic deposits consistent with the primary lesion. Tumor margins in the lung ranged from 0.2 cm to 1 cm from the parenchymal edge. Frozen section analysis of the right lower lobe lung wedge had previously shown poorly differentiated carcinoma, suspected to be metastatic."} +{"pid": "TCGA-AF-6672", "report": "The specimen includes a portion of adipose tissue measuring 2.2 x 1.6 x 1 cm, with a poorly demarcated firm tan nodule measuring 0.5 cm in diameter. A sample was taken for frozen section analysis. The second specimen is a 25 cm long segment of colon. The proximal end is marked with blue ink and the distal end with black ink. The serosa appears pink-tan, smooth, and glistening with predominant fatty coverage. An umbilication is noted on the serosa, located 8 cm from the distal end. Retroperitoneal reflection is identified 7 cm from the distal margin.\n\nUpon opening, the mucosal surface is pink-tan, smooth, and glistening. The circumference measures 3.5 cm at the proximal end and 8 cm at the distal end. A lesion is observed near the umbilicated area, measuring 6.5 x 4.5 x 0.8 cm. Microscopic evaluation reveals invasive growth extending through the muscularis propria into surrounding fat. This region is adjacent to the serosal umbilication and has been marked with blue ink. The lesion is located approximately 6.5 cm from the distal margin and does not involve the radial margin. Multiple lymph nodes are identified within the surrounding fatty tissue, ranging from 0.8 cm to 2.5 cm in size.\n\nHistologic evaluation demonstrates a moderately differentiated invasive growth pattern within the rectosigmoid region. The tumor extends into pericolonic fat and reaches the visceral peritoneum. Margins are uninvolved. Assessment of vascular invasion was negative. Examination of regional lymph nodes identified 37 nodes, with involvement noted in 18. Additional soft tissue metastases are present in the pericolonic region. No lymphatic invasion was identified. Distant metastasis could not be assessed."} +{"pid": "TCGA-BR-7704", "report": "Specimen was a gastrectomy with a lesion located in the fundus measuring 6 x 4 x 1.5 cm. The lesion had an exophytic, polypoid appearance. Microscopic evaluation showed a poorly differentiated intestinal-type histology. The tumor extended to the serosa, including involvement of the visceral peritoneum. A total of three regional lymph nodes were examined, none of which showed evidence of metastatic involvement. Lymphatic, venous, and perineural invasion were not specified. Surgical margins could not be assessed. There was no evidence of neoadjuvant treatment effect. No additional findings were reported."} +{"pid": "TCGA-FR-A2OS", "report": "The specimen from the right medial malleolus consists of an elliptical skin excision measuring 4.5 x 4.3 x 0.3 cm. A raised lesion measuring 2.5 x 2.5 x 1.0 cm is present, located eccentrically, with central ulceration noted. No satellite nodules are identified. The lesion extends to the deep margin, with closest margins measuring 0.9 cm superiorly, 0.6 cm inferiorly, 1.8 cm posteriorly, 0.3 cm anteriorly, and 0.1 cm at the deep margin. Histologically, the lesion demonstrates a Breslow depth of 1.5 cm and Clark\u2019s level V invasion. Ulceration is present, and lymphovascular space invasion is identified. In situ changes are noted at the anterior tip. Multiple sections were examined, including levels stained with S100 and MART-1 immunohistochemical markers.\n\nA separate lymph node specimen from the right inguinal region includes one lymph node that shows no evidence of metastatic involvement. Multiple tissue fragments, identified by green dye, were embedded in their entirety for examination. All available margins have been assessed histologically. A digital photograph was taken for documentation. The specimen was inked with blue at the superior margin, black at the inferior margin, and oriented with short suture superiorly and long suture posteriorly. Blocks included posterior tip (B1), central sections (B2\u2013B14), and anterior tip (B15). The lymph node was embedded in block A1. Additional adipose tissue was retained in formalin."} +{"pid": "TCGA-A5-A0G3", "report": "The specimen consisted of a uterus with bilateral fallopian tubes and ovaries, along with lymph nodes and an omental sample. The uterus measured 8.0 x 6.5 x 6.5 cm and weighed 220 grams. Within the endometrial cavity, there was a friable tan lesion measuring 4.5 x 4.0 cm extending from the fundus to the endocervical canal on both anterior and posterior surfaces. Invasion into the superficial one-third of the myometrium was observed. A submucosal myoma measuring 3.5 cm in diameter was present in the posterior wall and showed involvement by the lesion. Three additional myomas were identified\u20141 intramural and 2 subserosal\u2014ranging from 1.0 to 2.5 cm in size; these exhibited fibrous, whorled cut surfaces without hemorrhage or necrosis. The cervix appeared grossly unremarkable but microscopic examination revealed involvement by atypical glandular cells invading into the endocervical stroma. Vaginal cuff and surgical margins were free of involvement.\n\nMicroscopic evaluation showed cellular proliferation with papillary architecture and nuclear atypia. Necrotic areas with calcifications were noted. Infiltration was identified in the inner half of the myometrium, extending toward the outer layers near the serosal surface. Extensive lymphovascular invasion was observed within the myometrium. Additionally, there was invasion of a submucosal leiomyoma and focal mucosal hyperplasia in the fallopian tubes. Endometrial polyps were partially replaced by similar cellular changes. Background endometrium showed atrophy and adenomyosis.\n\nLymph node assessment included right paraaortic (2/2), right common iliac (2/2), right pelvic (1/1), and left pelvic (1/2) nodes, all showing presence of abnormal cellular aggregates consistent with lymphovascular involvement. One lymph node from the left pelvic region showed focal endosalpingiosis. No metastatic involvement was seen in bilateral ovaries or fallopian tubes; however, bilateral atrophic ovaries and nabothian cysts in the cervix were reported.\n\nStaging according to AJCC (2002) criteria indicated regional extension into adjacent structures and regional lymph node involvement. The omentum showed microadhesions and rare mesothelial inclusions without any signs of abnormal cellular infiltration."} +{"pid": "TCGA-BB-7866", "report": "The excised right tonsil mass specimen consists of two unoriented soft red-tan tissue fragments measuring 3.1 x 1.1 x 0.6 cm in total. The presumed cauterized resection margin is marked with black ink. The larger piece was bisected, and all tissue was submitted for analysis. Histologic sections show cellular features consistent with a distinct lesion. Immunohistochemical staining demonstrates strong positivity for p16. In situ hybridization reveals high-risk HPV with punctate signals localized to tumor nuclei. All margins are assessed, and the architectural and cytologic characteristics have been reviewed. The findings are based on direct examination of the slides and relevant ancillary studies. A detailed clinical history is documented separately in the medical record. This report has been personally reviewed and approved."} +{"pid": "TCGA-MT-A67A", "report": "The specimen consisted of thirteen tissue samples, all labeled with the patient\u2019s name and hospital number. Specimen A (\"right superior margin\") was a 6.2 x 0.7 x 0.6 cm unoriented red/tan soft tissue fragment submitted intact for frozen section. Microscopic evaluation showed benign tongue tissue with no evidence of abnormal cellular changes. Specimen B (\"right anterior margin\") measured 1.2 x 1.1 x 0.4 cm and also showed benign tongue tissue without any concerning features. Specimen C (\"right inferior margin\"), measuring 2.1 x 0.8 x 0.5 cm, revealed atypical cellular changes consistent with invasive characteristics. Specimen D (\"right posterior margin\"), a 0.7 x 0.6 x 0.4 cm fragment, showed mild architectural disturbance in the epithelium but no invasive findings. Specimen E (\"right deep margin\") included two fragments totaling 0.8 x 1.2 cm; histologic analysis demonstrated normal tissue.\n\nSpecimen F, an oriented glossectomy measuring 4.7 x 3.3 x 2.5 cm, showed moderately to well-preserved cellular architecture with a lesion measuring 1.7 x 1.4 x 1.5 cm. The deepest extent of the lesion was 1.5 cm. No involvement of blood vessels or nerves was identified. Microscopically, a 0.1 cm focus of altered cells was noted at the deep margin, while other margins were free of such changes: posterior (0.4 cm), inferior (0.5 cm), and anterior and superior (each 1.0 cm). A superficial ulceration measuring 1.0 x 0.4 cm was observed on the lateral surface.\n\nRe-resection specimens G, H, and I were examined. Specimen G (\"re-resection posterior margin\") was a 1.8 x 3.1 cm fragment and showed no abnormal cells. Specimen H (\"re-resection inferior margin\") measured 3.7 x 1.3 x 0.6 cm and showed moderate architectural changes without invasive features. Specimen I (\"re-resection inferior margin #2\") was a 2.6 x 2 x 0.8 cm fragment that also showed no evidence of invasive disease.\n\nLymph node dissections were performed from levels 1 through 3 on the right side. Specimen J (\"level 1, right\") contained three lymph nodes, all unremarkable. Specimen K (\"level 2A, right\") had two lymph nodes, and Specimen L (\"level 2B, right\") had six, all without any abnormal cells. Specimen M (\"level 3\") included nine lymph nodes, all of which were uninvolved. Benign salivary gland tissue was also present in level 1. All lymph nodes were fully submitted for analysis. The surgical specimen included representative sections for potential future studies."} +{"pid": "TCGA-BA-A8YP", "report": "A left radical neck and skin resection specimen included a 6.3 x 5.5 x 4.8 cm firm tan/white mass with central necrosis, adherent to skeletal muscle and closely associated with a vein. The mass measured 4.7 cm in greatest dimension and showed vascular invasion. Two of the lymph nodes examined contained metastatic deposits with extracapsular extension identified. The largest metastasis measured 6.3 cm by gross examination. Additional lymph node levels were dissected, with multiple lymph nodes identified up to 1.5 cm in size.\n\nA composite resection of the tongue, pharynx, and palate was performed. The specimen measured 6.6 x 5.9 x 1.9 cm with a tumor measuring 4.7 x 3.2 x 1.0 cm located on the pharyngeal mucosa extending into the tongue. The tumor was endophytic, centrally ulcerated, and firm with lobulated borders. It eroded approximately 80% of the mucosa and extended into the tongue by up to 1 cm. The closest distances to surgical margins were 0.1 cm at several locations, including the deep margin where tumor was within 0.1 cm. No bone involvement was observed. Histologic evaluation revealed invasive moderately differentiated carcinoma with focal keratinization. Carcinoma in situ was present. Vascular invasion was noted, while perineural and bone invasion were not identified.\n\nSeparately submitted lymph nodes from level 1 on the left showed no evidence of malignancy in six nodes. The right mandible and its associated mucosa showed no signs of tumor involvement. The left mandible required decalcification prior to full assessment, with no tumor identified upon initial evaluation.\n\nImmunohistochemical staining for p16 and high-risk HPV in situ hybridization were negative in the primary tumor. Multiple blocks were submitted for microscopic analysis, with tumor tissue also provided for tumor procurement. No additional findings were noted in the remaining soft tissue or cut surfaces of the tongue."} +{"pid": "TCGA-43-2576", "report": "The specimen includes three tissue samples. The first, labeled as level 5 lymph node, consists of an irregular tissue fragment measuring 2.5 x 2.2 x 1.5 cm. A representative section was taken for frozen analysis and the remainder submitted in one cassette.\n\nThe second specimen, labeled \"left upper lobe,\" is a lung tissue block measuring 14.5 x 5.5 x 4.0 cm. It is partially covered with pink-red smooth glistening pleura with black stippling. There is an area of umbilication on the pleural surface measuring 1.2 cm in greatest dimension, located 3.0 cm from the stapled margin. The pleura is marked with blue and black ink. Upon sectioning, a white-tan-gray firm area measuring 3.5 x 2.5 x 2.5 cm is identified, contiguous with the pleural umbilication and located 0.7 cm from the stapled margin (blue inked). The rest of the cut surface appears pink-tan and spongy with no other distinct lesions. Sections were taken to represent normal tissue, tumor proximity to the stapled margin, and tumor relation to the pleura.\n\nThe third specimen, labeled \"level 7,\" consists of two soft tissue fragments measuring 0.8 cm and 0.6 cm in greatest dimension. Both are entirely submitted in one cassette."} +{"pid": "TCGA-G3-A5SK", "report": "The liver specimen weighed 62 grams and measured 7.5 x 6.8 cm, with a maximum thickness of 2.9 cm. A light tan opaque nodule measuring 3.0 x 3.0 x 2.4 cm was identified on the cut surface. This nodule was in close proximity to the blue inked resection margin and the serosal surface, coming within less than 0.1 cm of the margin. The surrounding liver tissue exhibited a light tan nodular appearance. Histologic evaluation revealed well-differentiated features with solid growth pattern, and involvement of the deep margin. Additional findings included chronic changes of mild activity and background cirrhosis. The gallbladder specimen measured 9.5 x 4.5 x 3.0 cm and had a slightly hemorrhagic, smooth, and congested serosal surface. The wall thickness was 0.1 cm. The lumen contained thick green mucinous bile and partially solidified bile flakes were noted along the mucosal surface of the fundus. No significant pathologic findings were identified in the gallbladder."} +{"pid": "TCGA-BC-A10U", "report": "The liver biopsy specimen consists of tissue fragments measuring 1.5 x 0.6 x 0.2 cm. Microscopic evaluation reveals a neoplastic process with features concerning for malignancy, although final distinction requires further analysis. A separate liver specimen from the right lobe measures 28 x 18 x 8 cm and contains a large mass measuring 9 x 7 x 6.2 cm. The mass is yellow-tan with areas of hemorrhage, has a distinct border with surrounding tissue, but lacks a defined capsule. It extends to the inked margin and is in proximity to major vessels. Histologic assessment demonstrates a moderately differentiated cellular proliferation involving the surgical margin. Additional findings include steatosis and mild portal inflammation in the adjacent liver tissue. The gallbladder specimen measures 12.5 x 4.5 x 4.5 cm and shows no significant histologic abnormalities. Extensive lymphovascular space involvement is noted. Multiple blocks were submitted for microscopic evaluation, including representative sections of the mass, surrounding parenchyma, and gallbladder wall. All findings were confirmed during intraoperative consultation and frozen section analysis."} +{"pid": "TCGA-G4-6297", "report": "The specimen consists of a right hemicolectomy measuring 28.5 x 8.5 x 4 cm. The ileum is 8 cm in length and 7 cm in circumference, while the colon measures 20.5 cm in length and 8.5 cm in circumference. The attached appendix is 5.8 cm long and 0.9 cm in diameter. A circumferential exophytic lesion with central ulceration and raised indurated borders is present in the cecum and proximal ascending colon, extending to involve the ileocecal valve. The lesion measures 8.0 x 4.0 x 1.0 cm and is located 14.5 cm from the distal margin and 5.5 cm from the proximal margin. On sectioning, the lesion appears tan-white with a granular surface and infiltrates through the muscular wall, extending into the subserosal fat. A small polypoid lesion measuring 1.2 x 1.1 cm is identified in the hepatic flexure. Multiple firm lymph nodes are palpated within the pericolonic fat. Histologically, the lesion demonstrates invasive growth with moderate to poor differentiation. Full-thickness infiltration of the muscular wall and extension into the subserosal fat is noted. Six of thirty-six lymph nodes show involvement. Vascular and perineural invasion are present. Resection margins are free of involvement. An additional tubulovillous adenoma measuring 1.2 x 1.1 cm is identified. Immunostaining for EGFR shows no reactivity in the tested sections. The staging classification is pT3 N2 MX. The extent of resection is complete (R0), and no implants are identified."} +{"pid": "TCGA-E9-A1R6", "report": "OC ID: Gross Description: A lump measuring 2.5 x 2.2 cm was identified; fatty tissue and lymph nodes showed lipomatosis and hyperemia. Microscopic examination revealed features consistent with a moderately differentiated infiltrating carcinoma. Ten dissected lymph nodes showed sinus histiocytosis without evidence of metastatic involvement. The tumor is categorized as T2 based on size greater than 2 cm but not exceeding 5 cm, and venous invasion is absent. Margins are uninvolved. The specimen was obtained via lumpectomy and originates from the upper outer quadrant of the right breast. A grossly evident lesion is present. Lymph node analysis showed no positive nodes out of a total of ten examined. Various histopathologic parameters including tubule formation, nuclear pleomorphism, and mitotic counts were not specified, resulting in an indeterminate Nottingham Histologic Score. No evidence of treatment effect or additional pathologic findings was noted."} +{"pid": "TCGA-43-2581", "report": "The specimen includes a right upper lobe of the lung, along with lymph node samples from levels 11, 2R, 4R, and level 7. The right upper lobe weighs 296 grams and measures 17.8 x 11.8 x 4 cm. Within the hilar region, there is an 0.8 cm long bronchial stump and blood vessels that appear unremarkable. Lymph nodes in the hilar area are tan-gray and measure up to 1.2 cm in greatest dimension. The pleural surface appears pink-purple with anthracotic pigment deposition and some retraction.\n\nUpon sectioning, two distinct masses were identified. One mass measures 2.6 x 2 x 1.8 cm and is located beneath the area of pleural retraction; it shows signs of invading the pleura. Approximately 2 cm away is a second mass measuring 4 x 3.5 x 3 cm, which approaches the pleural surface. Surrounding the larger lesion is yellow-orange discoloration suggestive of pneumonia. The remainder of the lung tissue appears spongy and red-purple without additional abnormalities.\n\nHistologically, both lesions are composed of poorly differentiated non-small cell carcinoma with areas suggestive of squamous differentiation and less frequent foci indicating glandular features. The lesions appear similar in morphology. Based on tumor size and location, the staging classification for the primary tumor is pT3. Resection margins for both bronchial and vascular tissues are free of malignancy. Visceral pleural invasion is present in the smaller lesion, while no direct extension is observed in the larger lesion. Vascular invasion is not definitively identified.\n\nRegional lymph node assessment reveals metastatic involvement in one of three hilar lymph nodes examined. Additional lymph node specimens from levels 11, 2R, 4R, and level 7 show no evidence of malignancy, resulting in a nodal staging classification of pN1. Inflammatory changes, including focal pneumonia, are noted around the tumors. This case was reviewed during intradepartmental consultation, with consensus among reviewers regarding the similarity of the two lesions."} +{"pid": "TCGA-VD-A8KG", "report": "The specimen consists of an intact right eye with axial dimensions measuring 24.5mm, horizontal 23mm, and vertical 23mm. The cornea measures 12mm horizontally and 11mm vertically. The optic nerve has a length of 4mm and a diameter of 4mm. Trans-illumination reveals a dark shadow located inferiorly and posteriorly, measuring approximately 13 x 10mm, situated 5mm from the optic disc. The tumour is dome-shaped, pale, and fragmented upon dissection, with a height of 7mm and largest basal diameter of 12mm.\n\nMicroscopic examination shows a focally pigmented lesion involving the choroid with adjacent normal choroid and sclera present. The lesion is associated with exudative and haemorrhagic retinal detachment. The cellular composition is predominantly spindle-shaped. Mitotic activity is minimal, with approximately 1 mitosis per 40 high power fields. The microvasculature is prominent; however, closed vascular loops are not identified. There is minimal lymphocytic infiltration within the lesion and no evidence of necrosis. Focal extension into the sclera through a vascular channel is noted. No involvement of the optic nerve or vortex veins is observed, and tumour cells are not present at the resection margins.\n\nAdditional findings include a regular and normally deep anterior chamber with open angles. The iris appears unremarkable, although the ciliary body shows signs of atrophy with hyalinisation of the ciliary processes. The lens demonstrates subcapsular degenerative changes. The retina overlying the lesion is slightly atrophic, and Bruch\u2019s membrane appears disrupted in the examined sections.\n\nImmunohistochemical staining demonstrated positivity for MelanA, BAP1 (cytoplasmic only), and HSP-27 (score 3). Molecular genetic analysis using MLPA on extracted tissue revealed 4 borderline losses on chromosome 1, 7 borderline losses on chromosome 3 suggestive of chromosome 3 loss, gains in chromosome 6p, and gains in chromosome 8q. These findings were derived from high-quality DNA and confirmed through repeated testing.\n\nMeasurements of the lesion include a largest diameter of 11.3mm and thickness of 7.6mm. Histological evaluation did not identify closed vascular loops, necrosis, or significant lymphocytic infiltration. Mitotic count was recorded as 1 per 40 high power fields. The lesion exhibited spindle cell morphology with intra-scleral spread and adequate clearance margins. HSP-27 positivity was greater than 70%."} +{"pid": "TCGA-D9-A4Z5", "report": "Gender: M. Examination result. Material: 1) nose, tumor of the nose. Macroscopic description: Surgical specimen sized 5 x 6 x 1.2cm, including cartilage and skin 3.5 x 2.5 cm in length. Tumor measured 3.5 x 3 x 1.5 cm. Microscopic description: Tissue sample shows a cellular proliferation involving the mucous membrane. The cells exhibit atypical features with increased nuclear size and irregularity. The lesion has a thickness of at least 12mm. Surgical margins are clear, with no evidence of vascular, nerve, or cartilage invasion identified."} +{"pid": "TCGA-EL-A3GP", "report": "A male patient underwent surgical resection of a right-sided thyroid mass and associated lymph node dissection. The primary lesion was located in the right lobe of the thyroid gland and measured 5.0 cm in greatest dimension. The tumor exhibited extrathyroidal extension into adjacent soft tissue and was in close proximity to skeletal muscle. Lymphovascular invasion was identified. Surgical margins were negative for involvement. No multifocal disease was observed.\n\nLymph node evaluation included multiple regional sites. In the right paratracheal region, one lymph node was identified and involved by neoplastic cells. In a separate right paratracheal dissection specimen, two lymph nodes were present and both showed involvement. In a right neck dissection (level III/IV), twelve possible lymph nodes were identified, with four of them containing neoplastic cells. None of the involved lymph nodes demonstrated extranodal extension.\n\nAdditional specimens included a right superior parathyroid gland, which was histologically consistent with normal parathyroid tissue. Other tissues submitted were evaluated and reported as non-diagnostic for malignancy."} +{"pid": "TCGA-FU-A3NI", "report": "The specimen was received in ten formalin-filled containers. \n\nContainer A, labeled \"right ovary and tube,\" contains a 2.5 x 2.5 x 1.4 cm ovary with attached paraovarian soft tissue and a 3.5 cm segment of fallopian tube. The fallopian tube shows luminal dilation containing hemorrhagic fluid. The ovary reveals a hemorrhagic corpus luteum with tan-gray fibrous cut surface and multiple corpora albicantia.\n\nContainer B, labeled \"left ovary and tube,\" contains a 3.5 x 2.8 x 1.8 cm ovary with attached paraovarian soft tissue and a 5.0 cm segment of fimbriated fallopian tube. The fallopian tube has been previously ruptured and reconstructed. A 0.3 cm uniloculated paratubal cyst is present at the proximal end. The ovary shows a tan-pink fibrous cut surface with multiple corpora albicantia and a hemorrhagic corpus luteum. A 0.6 cm subcortical cyst is also noted.\n\nContainer C, labeled \"radical hysterectomy,\" consists of uterine corpus (5.0 x 4.3 x 4.0 cm), cervix (3.5 x 3.0 x 2.5 cm), vaginal cuff (0.5 to 2.0 cm), and bilateral paracervical soft tissues (each inked). The cervix features a central patent os and yellow-tan granular endocervical canal. On cut surface, there is a gray-white granular lesion extending 1.2 cm deep, within 0.4 cm of the inked margin. The endometrium is pink-tan, focally shaggy, with an average thickness of 0.3 cm. A 1.5 x 1.0 x 0.4 cm tan-pink polypoid lesion is identified anteriorly. Surrounding myometrium has an average thickness of 1.6 cm and includes a 0.9 cm firm, rubbery intramural nodule with gray-white whorled appearance.\n\nContainers D through J contain lymph node specimens from various anatomical regions. In container D (\"left external iliac lymph node\"), seven lymph nodes are identified; two of these show involvement by tumor cells. Containers E through I contain lymph nodes that are free of tumor involvement: five nodes from the left obturator, four from the left common iliac and lower aortic region, three from the right external iliac, five from the right obturator, and four from the right common iliac and lower aortic areas. Container J contains omental tissue measuring 23.0 x 4.3 x 0.9 cm with no pathological findings observed.\n\nMeasurements and microscopic descriptions indicate depth of infiltration into cervical tissue, presence of lymphovascular space invasion, and tumor involvement in certain lymph nodes. Surgical margins are clear. Other findings include endometrial polyps, myometrial leiomyomata, and benign ovarian and tubal features."} +{"pid": "TCGA-69-A59K", "report": "The specimen consisted of multiple lymph node samples and a right upper lobe lung specimen. Lymph nodes submitted included those labeled #1, #3, R9, 10R, 11R, and 12R. All lymph nodes were negative for malignancy. The right upper lobe measured 16.5 x 13.0 x 4.6 cm and weighed 297 grams. A main mass was identified measuring 3.7 cm in greatest dimension, located peripherally, with a tan-white lobulated appearance and focal hemorrhage. It extended to within less than 0.1 cm of the pleural margin and was 5.0 cm from both bronchial and vascular margins. The invasive component was 3.4 cm from the nearest staple line. A second smaller mass measuring 1.2 x 0.8 x 0.7 cm was noted approximately 1.0 cm away from the larger mass and extended to within 1.5 cm of the pleural margin. Histologically, tissue sections revealed two distinct tumor nodules in the same lobe, one predominantly solid with acinar features and another predominantly acinar with micropapillary components. There was no invasion into the visceral pleura or margins. A total of 11 lymph nodes were examined, none showed involvement. Additional findings included centrilobular emphysema. Immunohistochemical staining showed diffuse strong positivity for TTF-1 and no staining for p63 in the larger mass. Molecular testing for EGFR mutations in both masses showed wild-type genotype with no alterations detected. The specimen margins\u2014bronchial, vascular, and parenchymal\u2014were uninvolved. Based on pathologic staging, the findings correspond to an advanced localized stage with no lymph node or distant spread identified."} +{"pid": "TCGA-D8-A1X9", "report": "Histopathological examination was performed on a total organ resection of the left breast with axillary tissues. The clinical history indicated a lesion in the left breast. Immunohistochemical analysis showed estrogen receptors present in more than 75% of neoplastic cell nuclei, as well as progesterone receptors also found in more than 75% of neoplastic cell nuclei. HER2 protein expression was assessed using HercepTest\u2122 by DAKO, resulting in a score of 2+; FISH testing was performed and did not confirm HER2 gene amplification.\n\nMacroscopically, the left breast measured 22 x 15 x 5 cm and was submitted with axillary tissues measuring 13 x 7.5 x 1.5 cm and a skin flap of 19 x 11 cm. A retracted nipple was noted. A lesion measuring 2.5 x 2 x 2.8 cm was identified at the boundary of the lower quadrants, located 3.5 cm from the lower margin, 0.4 cm from the base, and 3 cm from the skin.\n\nMicroscopic evaluation revealed a neoplasm with histological grade NHG2 (scoring 2+2+3/21 mitoses per 10 high power fields, visual area 0.57 mm\u00b2). Adjacent glandular tissue exhibited changes consistent with fibrocystic mastopathy and simple ductal hyperplasia (UDH 1). Axillary lymph node assessment showed metastatic involvement in 3 out of 23 lymph nodes with capsular infiltration observed.\n\nThe surgical margins were evaluated and no residual tumor was identified. Staging was determined as pT2 with nodal involvement classified as pN1a."} +{"pid": "TCGA-A8-A086", "report": "The specimen demonstrates a moderately differentiated invasive lesion measuring 1.9 cm in diameter. The histologic pattern shows focal intraductal components. Lymphovascular invasion is present, while resection margins are free of involvement. Based on the findings, staging classification indicates pT1c with lymph node involvement (N1a), Grade II."} +{"pid": "TCGA-SX-A7SN", "report": "The pathology report includes findings from three specimens. The first specimen, identified as gallbladder tissue, shows changes consistent with mild chronic cholecystitis. No gallstones were observed. The second specimen is from a left renal mass resected during partial nephrectomy. The lesion measured 4.2 x 3.8 x 3 cm and was located in the lower pole of the kidney. Microscopic evaluation showed a neoplasm with papillary architecture and nuclear features corresponding to grade 2 on the Fuhrman scale. The tumor was unifocal and did not show sarcomatoid differentiation, necrosis, or invasion into perinephric tissue, renal sinus, collecting system, or renal vein. The surgical margins were free of malignant cells. Lymphovascular invasion and lymph node involvement were not identified. The non-neoplastic kidney tissue showed only minor benign changes. The tumor was staged based on size and extent as pT1b. Multiple tissue blocks (B1\u2013B7) were found to contain malignant cells, with block B7 having a high percentage of tumor nuclei. The third specimen, excised from the umbilical hernia sac, consisted of fibroadipose tissue with findings of chronic inflammation and scarring. All specimens were examined using standard histologic methods, and additional testing was deemed feasible with the available tissue blocks."} +{"pid": "TCGA-HZ-A8P1", "report": "The specimen consists of a distal pancreatectomy with splenectomy. The distal pancreas measures 9.0 x 9.0 x 3.5 cm, and the spleen measures 12.0 x 8.0 x 4.0 cm. A previously ruptured cyst measuring 7.0 x 5.0 x 3.5 cm is present on the inferior aspect of the pancreas. Gross examination reveals a gray-white indurated mass measuring 5.0 x 4.0 x 3.2 cm located in the pancreatic tail. The mass approaches within less than 0.1 cm of the superior, inferior, anterior, and posterior pancreatic surfaces and is in close proximity to the adjacent cyst. The cyst communicates with the main pancreatic duct. The mass approaches to within 1.5 cm of the splenic hilum, which appears grossly uninvolved. Two small peripancreatic lymph nodes are identified near the resection margin, measuring 0.5 cm and 0.7 cm. No lymph nodes are found at the splenic hilum. The spleen weighs 154 grams and shows no macroscopic abnormalities.\n\nMicroscopically, the lesion demonstrates well-differentiated histologic features. The tumor is confined to the pancreas and does not extend beyond its boundaries. Resection margins are free of invasive disease. The proximal pancreatic margin is inked blue and uninvolved. There is no evidence of lymphovascular invasion, but perineural invasion is present. A total of five lymph nodes are examined, all of which are negative for metastasis. Two lymph nodes show involvement by direct extension of tumor. Staging indicates a primary tumor larger than 2 cm in greatest dimension, limited to the pancreas (pT2), with no regional lymph node involvement (pN0). No distant metastases are identified. Additional findings include the presence of an intraductal mucinous neoplasm with high-grade dysplasia.\n\nIntraoperative frozen section evaluation of the proximal resection margin did not definitively identify tumor involvement. No prior treatment was administered. Ancillary studies were not performed. Clinical history includes preoperative findings of an abdominal mass, pancreatitis, and bowel obstruction. Representative sections from various areas of the mass, adjacent structures, and spleen were submitted for histologic analysis."} +{"pid": "TCGA-OK-A5Q2", "report": "The specimen consists of a right breast mastectomy with associated axillary lymph node excision. Histologic evaluation demonstrates an infiltrative growth pattern with pleomorphic features. The primary lesion measures 3.0 cm in greatest microscopic dimension and is accompanied by extensive ductal carcinoma in situ, of intermediate nuclear grade and solid type with comedo necrosis. Histologic grading using the Nottingham system yields a total score of 7 (architectural grade 3, nuclear grade 2, mitotic grade 2), corresponding to Grade II. No lymphatic invasion is identified. Surgical margins are free of tumor involvement, with the closest margin measuring 5 mm from the lesion. Vessel wall calcifications are noted. Additional benign findings include intraductal papilloma, radial scar, fibrocystic changes, and sclerosing adenosis. The skin and nipple show no abnormality, and there are changes related to prior biopsy.\n\nAxillary lymph node dissection includes thirteen nodes, two of which contain metastatic deposits. The largest metastatic focus measures 4 mm in diameter. No extranodal extension is present. Based on these findings, the regional nodal stage is pN1a. The primary tumor stage is pT2, reflecting a size between 2.0 and 5.0 cm. Distant metastasis could not be assessed (pMX).\n\nImmunohistochemical analysis reveals strong and diffuse nuclear staining for estrogen receptor (ER, clone SP1) in approximately 100% of tumor nuclei and strong staining for progesterone receptor (PR, clone 1E2) in 25% of nuclei. HER2 immunostaining shows no membranous reactivity (score 0) using standardized assessment criteria and validated testing methodology."} +{"pid": "TCGA-EL-A3GV", "report": "Pathology report. Sex: Female. Case type: Surgical Case. Specimen: Total thyroidectomy. A nodule was identified in the left lobe of the thyroid, measuring 1.9 cm in greatest dimension. The nodule is well-circumscribed and solid, located in the lower portion of the left lobe. It is confined to the thyroid gland. No multi-focal lesions were identified. Extrathyroidal extension is present, involving the surrounding soft tissue. There is no evidence of lymphovascular invasion. Resection margins are negative. Evaluation of one lymph node (0/1) showed no presence of tumor. A separate specimen from the left inferior parathyroid was also evaluated; it contained normal parathyroid tissue without evidence of neoplasm. Gross examination included measurements of the right lobe (2.5 x 2.2 x 1.1 cm), isthmus (1.2 x 1.5 x 0.5 cm), and left lobe (3.5 x 2.0 x 1.5 cm). Several possible lymph nodes were noted in the superior aspect of the isthmus. Sections from various regions of the thyroid were submitted for analysis. The parathyroid specimen consisted of two small fragments measuring 0.3 cm each, with a combined weight of 0.0092 grams, and was entirely submitted for evaluation. Touch preps confirmed the presence of parathyroid tissue."} +{"pid": "TCGA-IQ-A61O", "report": "The specimen consists of multiple soft tissue and bone fragments submitted from various anatomical sites, including the mandible, pterygoid muscle margins, and several lymph node regions. The largest composite specimen, measuring 4.0 x 3.5 x 1.5 cm, was received fresh and labeled as a right retromolar trigone resection. It contains a dark-brown, well-circumscribed lesion measuring 2.5 x 1.5 x 1.3 cm. This lesion is less than 0.1 cm from the deep resection margin, 0.2 cm from the superior margin, 0.5 cm from the lateral margin, 1.0 cm from the medial margin, and 1.8 cm from the inferior margin. The specimen was inked with different colors to mark the margins: blue for superior, green for inferior, orange for lateral, red for medial, and black for deep.\n\nAdditional specimens include a variety of lymph nodes from different levels of the neck. One lymph node from Level I sentinel node (right perifacial anterior) measures 2.0 x 1.5 x 1.3 cm and was found to contain metastatic involvement. Another involved lymph node was identified in Level II sentinel node, measuring 2.3 x 1.0 x 1.0 cm, and a second Level II sentinel node measuring 2.0 x 1.0 x 0.8 cm also showed evidence of involvement. Other lymph nodes examined were negative. A total of 38 lymph nodes were evaluated, with 3 showing metastatic activity. Extranodal extension was noted in some involved nodes.\n\nSeveral other soft tissue and bone margins were submitted and found to be free of involvement. These included the medial mandible periosteum (0.3 x 0.2 x 0.1 cm), pterygoid muscle margins (posterior: 1.5 x 1.0 x 0.5 cm; anterior: two fragments totaling 1.5 x 1.0 x 0.4 cm), and the final margin at the maxilla (multiple gray-tan fragments, 2.0 x 1.0 x 0.5 cm). Additional lymph node specimens from areas such as the jugular vein, parotid tail, and neck levels IB, IIA, III, IV, and V were also submitted, ranging in size from 0.2 cm to 2.5 cm in maximum diameter.\n\nHistologic evaluation revealed ulceration within the lesion and presence of perineural invasion. No definitive lymphovascular invasion was identified. Margins were uninvolved by invasive disease. Based on these findings, the primary tumor stage is classified as pT2, regional lymph node involvement as pN2b, and distant metastasis could not be assessed. The tumor was extensively sampled and submitted in multiple cassettes for further microscopic analysis."} +{"pid": "TCGA-CK-6747", "report": "The specimen consists of a right colectomy measuring 30.5 cm in total length, including the ileum (8.0 x 2.5 cm) and colon (22.5 x 4.8 cm), along with the appendix (5.5 cm). A tan/pink ulcerating mass with raised edges measuring 4.0 x 4.0 x 2.5 cm is identified in the cecum, abutting or involving the ileocecal valve. The mass has a pushing border and extends into the wall of the ileum, forming a fungating lesion. Microscopically, the lesion invades through the muscularis propria into the subserosal adipose tissue. The tumor is located 9.0 cm from the proximal resection margin and 21.5 cm from the distal resection margin; both margins are free of involvement. Lymphovascular, extramural venous, and perineural invasion are not identified. A moderate peritumoral lymphoid response, including a Crohn-like infiltrate, is present. Residual adenoma is noted. The appendix shows fibrous obliteration of the lumen without evidence of tumor. Diverticulosis is present in the colonic segment without signs of perforation. Nineteen regional lymph nodes are examined, none showing involvement. Based on depth of invasion, the staging classification reflects transmural extension with negative nodal status. Multiple sections of the tumor and normal colon are submitted for tissue banking."} +{"pid": "TCGA-DH-A7UU", "report": "THIS IS AN ADDENDUM REPORT. SPECIMEN(S) SUBMITTED / PROCEDURES ORDERED: A. Brain lesion. A. Frozen Section Charge. B. Brain lesion. B. Glial Fibrillary Acidic Protein (88342). B. P53 Protein. B. Isocitrate dehydrogenase 1. B. KI-67, Nuclear Antigen, Mib1. B. Phosphohistone-H3. B. 1P19q Malignant Glioma Analysis. B. 1P19q Malignant Glioma Analysis, add X 3.\n\nCLINICAL HISTORY: elderly male with primary brain lesion.\n\nSECTIONS SHOW AN INFILTRATIVE GLIAL LESION WITH MARKED NUCLEAR AND CELLULAR VARIATION, INCREASED MITOTIC ACTIVITY, AND INDIVIDUAL CELL NECROSIS. VASCULAR CHANGES ARE NOTED, THOUGH DEFINITIVE MICROVASCULAR PROLIFERATION OR PSEUDOPALISADING NECROSIS IS NOT PRESENT. IMMUNOHISTOCHEMISTRY DEMONSTRATES TUMOR CELL REACTIVITY FOR GFAP. MUTATED ISOCITRATE DEHYDROGENASE 1 (IDH-1) IS PRESENT. P53 STAINING IS POSITIVE IN APPROXIMATELY 70% OF TUMOR CELL NUCLEI. PHH3 STAINING CONFIRMS ELEVATED MITOTIC COUNT, WITH UP TO 25 MITOSES PER 10 HIGH POWER FIELDS. KI-67 EXPRESSION IS APPROXIMATELY 30%.\n\nMOLECULAR STUDIES FOR CHROMOSOMAL STATUS WERE PERFORMED. ANALYSIS OF CHROMOSOMES 1P AND 19Q REVEALS NO DELETIONS IN THE TISSUE EXAMINED.\n\nGROSS DESCRIPTION: TWO SPECIMENS OF BRAIN TISSUE WERE RECEIVED. SPECIMEN A CONSISTS OF MULTIPLE FRAGMENTS OF PINK-TAN TISSUE MEASURING 2.5 x 0.7 x 0.4 CM IN AGGREGATE. THREE PIECES WERE SUBMITTED FOR FROZEN SECTION, AND A REPRESENTATIVE SAMPLE WAS SUBMITTED FOR TOUCH PREPARATION. SPECIMEN B CONSISTS OF MULTIPLE PINK-BEIGE-TAN AND RED FRAGMENTS MEASURING 2.5 x 1.5 x 0.4 CM IN AGGREGATE. ALL TISSUE WAS SUBMITTED FOR HISTOPATHOLOGICAL EVALUATION.\n\nANCILLARY STUDIES CONFIRM POSITIVITY FOR IDH-1, P53 (70%), KI-67 (30%), AND PHH3 (25 MITOSES PER 10 HPF). SITE OF INVOLVEMENT IS THE RIGHT CEREBRUM, WITH TISSUE OBTAINED VIA RESECTION.\n\nCHROMOSOME 1P/19Q FISH ANALYSIS WAS PERFORMED USING DUAL-PROBE ASSAYS TARGETING REGIONS 1P36 AND 19Q13.3. RESULTS SHOW NO DELETIONS OF 1P OR 19Q. TEST VALIDATION AND PERFORMANCE CHARACTERISTICS HAVE BEEN ESTABLISHED BY THE LABORATORY. THIS TEST HAS NOT BEEN CLEARED OR APPROVED BY THE FDA BUT IS USED FOR CLINICAL PURPOSES UNDER CLIA CERTIFICATION FOR HIGH COMPLEXITY TESTING.\n\nTHE CASE HAS BEEN REVIEWED AND THE FINDINGS CONFIRM THE INITIAL OBSERVATIONS. FURTHER RESULTS WILL BE PROVIDED AS THEY BECOME AVAILABLE."} +{"pid": "TCGA-ZB-A96G", "report": "Pathology Report-Summary: Material: tumor: 5.0 x 4.0 x 4.5 cm. Microscopic examination reveals a dominant population of B1-type cells. The lesion measures pT2 according to the staging classification. Masaoka staging system indicates stage II.1. Immunohistochemical analysis demonstrates epithelial cells positive for CK5/6. Positive membrane staining is observed for EGFR. Additionally, CD1a, CD5, and CD99 immunoreactivity suggest presence of immature T-lymphocytes."} +{"pid": "TCGA-YZ-A983", "report": "The specimen consisted of a right eye enucleation measuring 25 mm in anteroposterior diameter, 23 mm horizontally, and 24 mm vertically. The optic nerve measured 11 mm in length and 3 mm in diameter. On gross examination, the tumor measured 16 mm in largest basal diameter and 10 mm in height. Microscopic evaluation showed a solid growth pattern arising in the posterior choroid near the optic disc. Histologic analysis revealed a cellular proliferation composed predominantly of epithelioid cells (>90%) with histologic grade pG3. The tumor involved the choroid and retina with invasion of Bruch\u2019s membrane noted. Microscopic margins demonstrated no tumor involvement at the anterior or posterior margins relative to the optic disc. There was no evidence of scleral involvement or extrascleral extension.\n\nAdditional findings included iris neovascularization with partial angle closure, retinal detachment, and presence of a cataract. Immunohistochemical staining showed strong positivity for HMB-45 and Melan-A, while cytokeratin AE1/3 was negative. PAS staining highlighted poorly formed vascular mimicry patterns, but no vascular invasion was identified. There was mild inflammatory cell infiltration present. No drusen, hemorrhage, or nevus were identified. A fibrous plaque was observed overlying the tumor region.\n\nMitotic count showed 1 mitosis per 40 high power fields. Pathologic staging was determined as pT3a NX MX. All other laboratory tests and controls performed were appropriate and consistent with the described findings."} +{"pid": "TCGA-2H-A9GL", "report": "Coded sample ID: Histologic evaluation reveals a poorly differentiated epithelial lesion arising in Barrett's epithelium. The lesion is located in the distal esophagus and measures 6 cm in diameter. Examination of lymph nodes identified 15 total, with involvement of 2. The resection margins are noted to be incomplete."} +{"pid": "TCGA-FG-A6IZ", "report": "The pathology report includes specimens collected from various regions of the brain. The anterior lateral margin biopsy consisted of multiple soft tissue segments measuring 0.6 x 0.5 x 0.2 cm in total, with no evidence of a solid tumor identified. The posterior lateral margin-superior biopsy was a yellow-tan soft tissue segment measuring 0.8 x 0.5 x 0.2 cm, and showed cerebral cortex and white matter with localized hypercellularity, though no solid tumor was found. Similarly, the posterior lateral margin-inferior biopsy measured 1.0 x 0.5 x 0.2 cm and also revealed cerebral cortex and white matter with focal hypercellularity without identification of a solid tumor.\n\nThe central region biopsy demonstrated features consistent with infiltrating glioma under microscopic evaluation, and a high-grade glioma was noted on touch preparation. The excised specimen consisted of multiple soft tissue segments measuring 4.0 x 2.5 x 1.5 cm in total, and was submitted entirely for analysis. Microscopic examination of this specimen revealed tissue reactivity with a specific antibody, suggesting the presence of particular cellular markers. Cytogenetic studies were performed to assess for chromosomal changes; results indicated certain losses. All other areas evaluated showed no definitive tumor presence or solid tumor involvement."} +{"pid": "TCGA-RG-A7D4", "report": "The liver specimen from a central hepatectomy measures 7.0 x 4.4 x 2.8 cm and is wedge-shaped with a smooth, glistening capsule. A well-circumscribed, nodular lesion measuring 2.8 x 2.4 x 2.2 cm is identified within segment 4b of the liver. The tumor is located 0.1 cm from the capsule and 0.2 cm from the parenchymal margin. Microscopically, the lesion shows moderate to poor differentiation and is solitary. The closest margin involvement is 1 to 2 mm from the parenchymal resection margin. No macroscopic venous invasion is observed, although microscopic vascular invasion is present. There is no evidence of perineural invasion or lymph node involvement (0 out of 2 nodes involved). Distant metastasis cannot be assessed.\n\nHistologic examination of the surrounding liver tissue reveals portal inflammation with predominantly lymphocytic infiltrates and mild interface activity. Portal and periportal fibrosis with some bridging fibrosis is present (Ishak score 0\u20134), consistent with chronic hepatitis. No significant hemosiderosis or alpha-1 antitrypsin globules are identified. A small bile duct hamartoma measuring 1 mm is also noted.\n\nThe gallbladder specimen measures 6.6 x 3.0 x 1.2 cm and contains a 0.7 x 0.6 x 0.5 cm black calculus. The mucosa is erythematous with focal yellow flecks and the wall thickness measures up to 0.3 cm. Two adjacent lymph nodes are identified and show no evidence of malignancy.\n\nSpecial stains performed include iron, trichrome-Masson, reticulin, and PAS-diastase. All immunohistochemical and histochemical tests were controlled and interpreted in correlation with morphologic findings."} +{"pid": "TCGA-E9-A1R7", "report": "The specimen consists of a lumpectomy from the right upper outer quadrant. A grossly evident lesion is present, measuring 2.3 x 2.5 cm. Ten dissected lymph nodes demonstrate reactive changes with no evidence of metastasis. Microscopic evaluation reveals a moderately differentiated infiltrating carcinoma. The tumor is confined without venous invasion and margins are uninvolved. The histologic grade is G2; however, components of the Nottingham score including tubule formation, nuclear pleomorphism, and mitotic counts were not specified, precluding determination of a total score. There is no evidence of extracapsular extension or treatment effect. The tumor is classified as T2 based on size greater than 2 cm but less than 5 cm."} +{"pid": "TCGA-CZ-5470", "report": "A radical nephrectomy specimen was received, including a kidney measuring 15.3 x 7.5 x 5.5 cm, with associated renal vein, artery, and ureters. A mass measuring 7.1 x 5.0 x 4.0 cm was identified in the lower pole of the kidney. The mass was tan/red, cystic, hemorrhagic, and encapsulated, located 0.1 cm from Gerota's fascia, 4.2 cm from the artery margin, 4.5 cm from the vein margin, and 9.5 cm from the closest ureter margin. Within the mass, a region of tan/white, homogeneous tumor measuring 1.8 cm in greatest dimension (designated T2) was noted, with the remainder of the mass designated T1. Histologically, the tumor showed clear cell features with nuclear grade III/IV. The tumor was confined to the kidney without invasion of surrounding structures. Margins of resection, including those of the artery, vein, and ureter, were free of tumor involvement. No lymphovascular invasion was identified.\n\nA separate specimen labeled as the left adrenal gland consisted of an adrenal measuring 6.2 x 4.3 x 1.5 cm with attached adipose tissue. A circumscribed yellow/tan region measuring 1.0 x 1.2 x 1.1 cm was identified within the cortex. Histologic evaluation revealed cortical adenoma with myolipomatous metaplasia, mucin, and vascular sclerosis. Adrenal medullary multinodular hyperplasia was also present. No necrosis or atypia was observed, and mitotic count was less than one per ten high power fields.\n\nTwo lymph nodes were submitted for histologic examination and were negative for tumor involvement.\n\nAdditional studies on the non-neoplastic kidney tissue demonstrated glomerulopathy with a membranous pattern of injury. Ultrastructural analysis revealed numerous subepithelial electron-dense deposits with restricted immunoreactivity for IgG/kappa, raising concern for paraprotein deposition disease. Focal global glomerulosclerosis was present in 15% of glomeruli, and approximately 20% of the parenchyma showed tubular atrophy and interstitial fibrosis. Arterial and arteriolar sclerosis was moderate in degree.\n\nCytogenetic analysis of two tumor regions (T1 and T2) demonstrated identical karyotypes with der(3;5)(q10;q10), a chromosomal abnormality commonly seen in certain types of kidney tumors. Twenty metaphases were analyzed, and all contained the same chromosomal rearrangement. No mosaicism greater than 25% was detected at a 95% confidence level."} +{"pid": "TCGA-CN-A63V", "report": "The surgical specimen consisted of a resected portion of the left cheek measuring 7.0 \u00d7 5.0 \u00d7 4.0 cm, including portions of the upper and lower lip. A fungating, focally necrotic lesion was identified on the buccal surface, measuring 4.0 \u00d7 3.0 cm with an invasion depth of 3.8 cm. The tumor extended into the skin of the cheek, creating a cutaneous defect measuring 1.1 \u00d7 1.0 cm. Margins were closely evaluated: the tumor was within 0.1 cm of the inferior margin, 0.6 cm from the superior margin, and 0.2 cm from the posterior margin.\n\nMicroscopic evaluation showed no angiolymphatic or perineural invasion. All surgical margins were free of involvement. Additional biopsies from the right lower lip, additional mucosal circumferential margin, left upper lip, left upper alveolus, left posterior buccal margin, left lower alveolus, left lower lip, and mandibular margin were all negative for tumor. Histologic examination revealed focal mild dysplasia in one margin but no evidence of malignancy elsewhere.\n\nA selective neck dissection was performed on the left side. In level 1, 11 lymph nodes were identified and examined; none contained tumor. In levels 2\u20134, a total of 34 lymph nodes were evaluated, all without evidence of tumor involvement. Submandibular and parotid tissues were unremarkable.\n\nThe tumor was histologically classified as moderately differentiated and measured 4.0 cm at its greatest dimension. Based on these findings, staging was determined as pT4a with no regional lymph node involvement (pN0). No distant metastasis was identified."} +{"pid": "TCGA-BH-A1FH", "report": "The submitted specimen from a left modified radical mastectomy reveals a lesion measuring approximately 2.5 by 2.0 by 1.5 cm. Histologic evaluation demonstrates nuclear and architectural features corresponding to grade 2. Lymphovascular space involvement is identified. Adjacent ductal elements show non-comedo type changes, predominantly solid pattern, comprising about 30% of the tumor volume. Surgical margins are negative for any abnormal cellular proliferation.\n\nIn addition, benign breast tissue shows fibrocystic changes and reactive alterations suggestive of prior intervention. Regional lymph nodes examined show metastatic involvement in 8 out of 13 nodes with evidence of extracapsular extension.\n\nImmunohistochemical analysis performed on selected tissue demonstrates intranuclear staining for estrogen receptor (70% positivity), while no staining is observed for progesterone receptor."} +{"pid": "TCGA-AD-6963", "report": "A segment of resected right colon measuring 28.5 cm in length, including the cecum and 3.0 cm of attached terminal ileum, was submitted for examination. The specimen was covered with pericolic and epiploic adipose tissue, within which a 4.9 x 0.7 x 0.7 cm vermiform appendix was identified. The serosa appeared smooth and gray-tan. An area of deep gray discoloration consistent with tattooing was observed approximately 4.6 cm from the distal margin. The bowel wall measured up to 0.6 cm in thickness and showed edema and fibrosis. The mucosal surface was gray-tan with preserved intestinal folds.\n\nAt 4.8 cm from the distal margin, a slightly raised, finely granular, centrally ulcerated plaque-like lesion measuring 2.6 x 2.0 cm was noted. This lesion had a tan, gritty, fibrotic cut surface and extended through the muscular wall, appearing limited by the serosa. No other gross abnormalities were found. Within the surrounding adipose tissue, several tan-gray to pink nodules up to 0.6 cm were identified.\n\nMicroscopic evaluation revealed no evidence of malignancy in the terminal ileum or appendix. In the colon, histologic analysis showed a moderately differentiated cellular proliferation. The lesion measured 2.6 x 2.0 cm and was located 4.8 cm from the distal surgical margin. Histologic features included extension through the muscularis propria into subserosal adipose tissue. No lymphovascular space invasion, visceral peritoneal perforation, or mesenteric deposits were identified. All surgical margins (proximal, distal, and radial) were free of involvement.\n\nA total of 12 lymph nodes were examined, and none contained metastatic disease. Pigment-laden macrophages consistent with prior tattooing were noted near the lesion. No other significant findings were reported."} +{"pid": "TCGA-BH-A28Q", "report": "The patient underwent a right modified radical mastectomy and left total mastectomy. The right breast specimen showed an invasive tumor measuring 4.0 cm in greatest dimension, located at the junction of the upper outer and lower outer quadrants. Histologic evaluation revealed classical type tumor cells with tubule formation score of 3, nuclear pleomorphism score of 2, mitotic activity score of 1, and a total Nottingham score of 6 (grade 2). Lobular carcinoma in situ was also present, along with lymphovascular space invasion. Resection margins were free of tumor involvement, with the invasive component located 1.0 cm from the nearest margin. The nipple and skin were free of tumor. Non-neoplastic findings included sclerosing adenosis, fibroadenoma, fibrocystic changes, columnar cell changes, and pseudoangiomatous stromal hyperplasia, as well as prior biopsy site changes. Immunohistochemistry showed positivity for estrogen and progesterone receptors, and no HER-2 expression.\n\nIn the left breast, findings included fibroadenoma, columnar cell changes, fibrocystic changes, pseudoangiomatous stromal hyperplasia, and prior biopsy site changes. Nipple and skin were unremarkable.\n\nLymph node dissection on the right side included 18 nodes, of which 2 contained metastatic disease. The largest metastatic focus measured 1.6 cm. No extracapsular extension was identified.\n\nPathologic staging was determined as pT2 based on tumor size, and pN1a for lymph node involvement. Receptor analysis showed high H-scores for both estrogen and progesterone receptors."} +{"pid": "TCGA-3A-A9IX", "report": "The specimen from the head of the pancreas, duodenum, stomach, and common bile duct was obtained via pancreaticoduodenectomy. A solid lesion measuring 2.0 cm in greatest dimension was identified in the pancreatic head. Histologic evaluation revealed a moderately differentiated exocrine neoplasm with no evidence of high-grade transformation. The tumor was confined to the pancreas without extension into adjacent structures such as the duodenum, ampulla of Vater, or common bile duct. Margins of resection were uninvolved by invasive carcinoma, with the closest distance from the tumor to the margin measuring 5 mm. Evaluation of the superior mesenteric artery margin, portal vein groove, retroperitoneal surface, gastric, and duodenal margins showed no involvement.\n\nLymphovascular invasion was not identified. Perineural invasion was present. No treatment effect was noted, indicating no prior therapy. A total of 35 lymph nodes were examined, and none contained metastatic disease. Additional findings included pancreatic intraepithelial neoplasia, with the highest grade being PanIN 3, along with lower-grade PanIN changes at the neck margin. Focal mild dysplasia was observed in the common bile duct epithelium, but no high-grade dysplasia or invasive lesion was identified in this region. The gallbladder contained viscous bile, with no calculi noted and a wall thickness up to 3 mm.\n\nGross examination of the liver nodule demonstrated benign hepatic parenchyma. Frozen section analysis confirmed absence of malignancy in the liver nodule and the evaluated portions of the Whipple specimen. All surgical margins were free of dysplasia and invasive carcinoma. The attending pathologist personally reviewed all slides and materials to confirm the findings."} +{"pid": "TCGA-3A-A9IN", "report": "The resected specimen from the distal pancreas and spleen includes a pancreatic segment measuring 6.5 x 4.5 x 3.5 cm and a spleen measuring 9.0 x 6.5 x 3.5 cm, along with adjacent adipose tissue and omentum (17.0 x 10.0 x 2.0 cm). A firm gray-tan mass measuring approximately 5.0 x 5.0 x 3.0 cm is identified in the pancreas, appearing to extend to the margin of resection but not grossly involving the spleen. The pancreatic duct is patent and appears free of tumor on gross examination. Histologically, the neoplasm shows moderate differentiation with a mitotic count of 7 per 10 high-power fields and a Ki-67 index up to 4%. There is no tumor necrosis observed. Angiolymphatic and perineural invasion are present. Surgical margins are evaluated, with the new pancreatic margin focally involved by the tumor; the superior and inferior pancreatic margins show no evidence of tumor involvement. A separate fragment submitted as the new pancreatic margin contains a nodule measuring 3.0 x 1.5 x 1.0 cm, morphologically similar to the primary lesion and involving the inked margin. Additional sections of adipose tissue and spleen reveal no diagnostic abnormalities. Mitotic figures appear atypical, complicating accurate assessment. Close follow-up is recommended due to findings suggestive of aggressive behavior despite absence of gross metastatic involvement. Multiple specimens were reviewed for confirmation, and the attending pathologist personally verified all findings."} +{"pid": "TCGA-2Y-A9H9", "report": "The specimen from the portal lymph node was negative for metastatic carcinoma. Liver biopsies from segments 4 and 6 showed varying degrees of steatosis and chronic portal inflammation, with no evidence of malignancy identified. A resected liver specimen from segment 6 revealed a solitary tumor measuring 4.0 x 3.8 x 3.5 cm, located within the liver parenchyma without extension through the hepatic capsule. The tumor was 0.3 cm from the closest resection margin. Histologic evaluation demonstrated trabecular architecture and moderate differentiation. No venous invasion or regional lymph node involvement was observed. Additional findings included hepatitis C. The resection margins were free of invasive carcinoma. Distant metastasis could not be assessed. Multiple biopsies from different areas of the liver were consistent with benign tissue. Gross examination of the resected liver specimen showed an irregular, solid tumor with a variegated cut surface. The tumor was well-defined and partially bulged beneath the capsule but did not breach it."} +{"pid": "TCGA-18-3417", "report": "The pathology report describes a right pneumonectomy with chest wall resection. Two distinct nodules were identified in the lung. The larger of the two was located in the right lower lobe and measured 5.0 x 4.0 x 4.4 cm. It demonstrated visceral pleural invasion and vascular invasion. A second nodule was present in the right upper lobe, measuring 3.0 x 3.0 x 2.3 cm. This lesion showed similar histological features to the larger nodule and was associated with extensive vascular invasion and multiple pulmonary infarcts.\n\nA total of 31 peribronchial lymph nodes were examined, with six showing involvement by tumor cells. Lymph node stations involved included 10R and 11R. Other lymph node stations (9 inferior pulmonary ligament, 7 subcarinal, 12 right lobar, 10 right tracheobronchial angle) were negative for malignancy. One lymph node biopsy from station 12R showed fibrous scarring without evidence of tumor involvement.\n\nMicroscopic evaluation revealed poorly differentiated carcinoma with focal squamous differentiation. Immunohistochemical staining showed strong cytoplasmic staining for markers consistent with squamous origin, and negative staining for adenocarcinoma markers. There was also evidence of perineural invasion in one soft tissue specimen.\n\nThe bronchial resection margin was free of tumor involvement. The closest distance of invasive tumor to any margin was 15 mm. No direct extension into the chest wall or parietal pleura was observed. Additional findings included patchy chronic inflammation, focal interstitial fibrosis, and multifocal infarcts in the upper lobe.\n\nBased on the extent of tumor involvement and lymph node spread, staging was determined as pT2N1M1. Tumor size, visceral pleural invasion, and presence of vascular invasion supported the T2 classification. Involvement of ipsilateral peribronchial lymph nodes contributed to N1 staging. The presence of a separate tumor nodule in a different lobe was classified as distant metastasis (M1)."} +{"pid": "TCGA-55-A48Y", "report": "The specimen consists of five parts. A lymph node from level 9 of the left lung measures 1.8 x 1.0 x 0.5 cm and is described as a fleshy gray-tan to pink nodule surrounded by yellow adipose tissue. It has been bisected and entirely submitted for analysis. Two nodules from level 10 lymph nodes of the left lung measure 1.5 x 1.0 x 0.5 cm and 2.0 x 1.0 x 0.5 cm respectively, along with additional fragments of similar tissue measuring 1.3 x 1.0 x 0.5 cm; these have been sectioned and submitted under separate labels. The left lower lobe specimen weighs 231 grams and includes a reconstructed portion of pulmonary parenchyma measuring 15.6 x 9.6 x 5.9 cm. The resection margin involves the stapled bifurcation of tertiary bronchi and several vascular and parenchymal staple lines. Adjacent to the bronchus is a 1.5 x 1.0 x 0.7 cm lobulated gray-black nodule beneath slightly wrinkled pleura. An area of induration and umbilication measuring approximately 6.5 cm extends onto the lateral aspect of the pleura. Within this region, a well-defined intraparenchymal lesion measuring 5.5 x 5.5 x 5.4 cm is identified; it is gritty and fibrotic with necrotic, anthracotic-streaked areas on sectioning. This lesion approaches within 0.2 cm of the pleural surface and 1.6 cm from the bronchial margin. It also comes within 0.2 cm of staple line margins and compresses adjacent vascular structures without gross invasion. The remainder of the parenchyma is spongy, partially collapsed, and shows moderate anthracotic streaking and emphysematous changes. Sections submitted include bronchial margin, peribronchial nodule, lesion with bronchial connection, lesion extending to fibrinous material on the pleura, multiple sections of the lesion and surrounding tissue, and uninvolved parenchym. A lymph node from level 6 of the left lung measures 1.0 x 0.8 x 0.5 cm with associated adipose tissue, and another from level 5 measures 1.6 x 1.2 x 0.4 cm; both are partially fragmented and submitted entirely in single cassettes.\n\nMicroscopic examination reveals no evidence of metastatic involvement in any of the lymph nodes assessed across levels 5, 6, 9, and 10. In the left lower lobe, a moderately differentiated epithelial neoplasm was identified. The tumor is unifocal and measures 5.5 x 5.5 x 5.4 cm. There is penetration through the elastic layer into the visceral pleura but not reaching the pleural surface. No definitive lymphovascular space invasion is observed. The tumor is confined to the lung without evidence of treatment effect. Surgical margins demonstrate distances of 1.6 cm from the bronchial margin, 0.2 cm from the parenchymal margin, and 0.2 cm from the pleural surface. No metastases are found in any of the lymph nodes evaluated (0 out of 1 lymph node from the lobectomy specimen and 0 out of 7 lymph nodes overall). The tumor appears to be intact with no disruption during removal. Elastic stain confirms structural integrity and supports the microscopic findings. Seven lymph nodes were received across all specimen parts, none showing evidence of metastasis. The staging classification is pT2b NO. Special stains and expert review confirm the observations."} +{"pid": "TCGA-HM-A3JJ", "report": "The specimen includes a uterus with cervix and peritoneum, along with right and left pelvic lymph nodes, and right and left periaortic lymph nodes. The uterus weighs 317 grams and measures 11.5 x 9.0 x 6.5 cm. It is partially covered with parametrial tissue and shows a pink-tan serosa and ectocervix. The endometrium is smooth and averages 0.7 cm in thickness. A firm mass measuring 3.0 x 2.5 x 0.8 cm is present on the anterior right side of the cervix, located 1.2 cm from the nearest margin. The myometrium is pink-tan with a thickness of 3.0 cm and contains a 3.5 cm intramural fibroid that appears white and whorled without hemorrhage or necrosis.\n\nSections submitted include representative samples from the endometrium, parametrial tissues, fibroid, paracervical tissues, lower uterine segment, and various full-thickness slices of the cervix at different clock-face positions.\n\nThe right pelvic lymph node specimen includes lymph nodes up to 7.6 cm in size embedded in adipose tissue; all lymph nodes are submitted across four blocks. Two right periaortic lymph nodes averaging 1.2 cm are submitted entirely in one block. On the left side, pelvic lymph nodes up to 2.9 cm are recovered within adipose tissue and submitted across six blocks. Two left periaortic lymph nodes measuring up to 1.2 cm are submitted entirely in three blocks.\n\nMicroscopic examination reveals poorly differentiated cells with necrosis. The lesion measures 3.0 x 2.5 x 1.2 cm and extends into the lower uterine segment. Invasion depth reaches 1.2 cm. Resection margins are negative for tumor involvement. Vascular invasion is extensive.\n\nIn regional lymph nodes: carcinoma is identified in two paracervical lymph nodes (both positive out of two assessed), two of eleven left pelvic lymph nodes (positive), while all other lymph nodes evaluated were negative\u2014twenty-three right pelvic nodes, two right periaortic nodes, and three left periaortic nodes.\n\nAdditional findings include secretory endometrium with polyps, adenomyosis, and leiomyoma."} +{"pid": "TCGA-FY-A3NP", "report": "The thyroid specimen from the right lobe measured 4.5 x 3 x 2.3 cm and weighed 13 grams. A 3 cm discrete nodule was identified with a tan and brown cut surface. The margin of the nodule was focally thickened and gritty, suggesting calcifications. Smears were taken from the cut surface and a representative portion of the nodule was submitted for further analysis. The remaining thyroid tissue appeared uniformly red-brown. Margins were marked with black ink. A separate tissue fragment labeled as possibly parathyroid measured 5 mm and weighed 0.025 grams. A third specimen from the left thyroid lobe measured 3 x 1.6 x 1.2 cm and weighed 2.9 grams. It contained a 0.7 cm firm tan nodule with focal calcifications; margins were also marked with black ink and the entire tissue was submitted in three cassettes.\n\nFrozen section analysis of the right thyroid nodule showed features concerning but not definitive for a follicular lesion. No parathyroid tissue was identified in the second specimen. Microscopic evaluation revealed atypical follicular changes in the right lobe with nuclear features raising concern for a follicular variant of a neoplastic process. The left lobe showed benign nodular hyperplasia.\n\nA follow-up review confirmed well-differentiated follicular variant features in the right lobe. The lesion appeared to arise within a pre-existing benign nodule and measured at least 2 cm. There was no evidence of extension beyond the thyroid capsule and surgical margins were uninvolved."} +{"pid": "TCGA-D7-6822", "report": "The histopathological examination was performed on a resected stomach specimen. The organ measured 14.5 x 10.5 cm, with omental tissue measuring 9 x 5 cm and 18 x 4.5 cm. A mass with a cauliflower-like and ulcerated appearance was identified in the region of the lesser curvature, measuring 8 x 7.5 x 4 cm. The distance from the proximal resection margin was 7 cm, while the distal margin was involved.\n\nMicroscopic analysis revealed glandular and papillary structures with moderate differentiation. The lesion extended through the full thickness of the gastric wall and into surrounding fat and vascular tissue. Tumor cells were also found at the distal resection margin. The proximal margin and omentum showed no evidence of involvement. Adjacent mucosa displayed signs of chronic inflammation, including focal intestinal metaplasia. Reactive lymph node changes were noted in the perigastric area.\n\nImmunohistochemical testing for HER2 protein using the HercepTest\u2122 by DAKO showed a score of 0 in the invasive cells."} +{"pid": "TCGA-AP-A1DP", "report": "The submitted specimens include the uterus, cervix, bilateral tubes and ovaries, a portion of omentum, and multiple lymph nodes from various locations including right and left common iliac, para-aortic, external iliac, obturator, hypogastric regions.\n\nHistologic evaluation reveals a lesion within the uterus characterized by glandular structures with moderate nuclear atypia. The growth pattern includes areas of solid architecture comprising approximately 6\u201350% of the sample. Nuclear grading is assessed as intermediate (grade 2). The tumor infiltrates less than or equal to half of the myometrial thickness, with maximal depth of invasion measuring 1.3 cm in an area where the myometrium is 2.8 cm thick. There is no evidence of endocervical involvement or vascular invasion. The cervical mucosa appears benign.\n\nOther findings in the uterus include endometrial atrophy, adenomyosis, and leiomyoma(s) in the myometrium. The adnexal structures are unremarkable. The omental specimen shows benign fibroadipose tissue.\n\nLymph node specimens from all sampled regions show only benign lymphoid tissue. No malignant involvement is identified in any of the lymph nodes, which total over 20 across all sites. One lymph node from the left hypogastric region contains focal endosalpingiosis. All lymph nodes were negative for malignancy."} +{"pid": "TCGA-60-2726", "report": "The specimen included multiple lymph node groups and a right pneumonectomy specimen. Lymph nodes from the right proximal paratracheal, left distal paratracheal, and subcarinal regions were examined, with no malignancy identified in any of these sites. A segment of the fifth rib was also evaluated and showed no histopathological abnormalities.\n\nThe right lung specimen weighed 955 grams and measured 23.5 x 15.0 x 7.0 cm. An irregularly shaped mass was identified in the middle lobe, located 0.1 cm beneath the pleural surface. The mass measured 4.5 cm in greatest dimension (with additional dimensions of 3.1 x 3.0 cm) and grossly appeared to involve adjacent lymph nodes. The cut surface was firm, tan-white to pink-tan, and solid, without mucinous, hemorrhagic, or necrotic areas. The tumor had irregular borders and was located 2.5 cm from the bronchial margin. No other focal lesions were identified upon serial sectioning.\n\nMicroscopic evaluation revealed invasive moderately differentiated carcinoma involving the central region of the lung. The tumor was associated with in situ involvement of the adjacent bronchus and demonstrated angiolymphatic invasion. The bronchial margins and pleural surface were free of tumor involvement. Evaluation of fifteen peribronchial lymph nodes revealed metastatic involvement in three, with extranodal extension noted. Additional lymph nodes from other regions showed no evidence of malignancy.\n\nNon-neoplastic findings included emphysematous changes and focal hemorrhage in the lung tissue. No other significant pathological findings were identified."} +{"pid": "TCGA-DB-A4X9", "report": "The specimen consists of biopsies from the left temporal lobe. Tissue samples were obtained from two separate aggregates. The first measures 1.1 x 0.9 x 0.3 cm and smears were prepared for analysis. The second aggregate measures 7.5 x 4.4 x 2.2 cm, with representative sections submitted for permanent analysis. \n\nMicroscopic evaluation revealed a neoplastic process involving both astrocytic and oligodendroglial components. The tumor demonstrates features consistent with a low-grade glioma. Mitotic activity is minimal, with only one mitosis observed per 10 high power fields. There is no evidence of endothelial hyperplasia, cellular proliferation, or necrosis.\n\nImmunohistochemical staining shows largely negative reactivity for vimentin. The MIB-1 labeling index is focally moderate. p53 immunoreactivity is present in numerous neoplastic cells. Fluorescence in situ hybridization (FISH) studies for 1p19q deletion have been initiated on paraffin-embedded sections. Smears from intraoperative consultation were interpreted, and findings are consistent with a low-grade glial neoplasm; however, final confirmation awaits integration with additional studies."} +{"pid": "TCGA-AG-A02G", "report": "The surgical specimen includes a liver metastasis characterized by moderately to poorly differentiated gland-forming cells with infiltration into surrounding tissue. A separate finding demonstrates a free anastomosis ring. Additionally, a sigmoid and rectum resection reveals an invasive lesion involving the muscularis propria (pT2), with vascular and lymphovascular invasion identified (L1, V1). Resection margins are clear. Examination of regional lymph nodes identifies three involved nodes. The distance from the mesorectal fascia exceeds 1 cm. Histologic grade ranges from moderately to poorly differentiated. Staging is based on standard classification criteria."} +{"pid": "TCGA-41-3392", "report": "The specimen includes four components: A, B, C, and D. Component A consists of irregular fragments of tan tissue measuring up to 1.3 x 1.1 x 0.3 cm, submitted fresh for frozen section. Component B includes multiple portions of brain tissue, with the largest measuring 2 x 2 x 1.5 cm, showing a brown coloration with creamy white discoloration. Component C is a tissue procurement sample. Component D is a small fragment of soft, dusky tan pink-gray tissue measuring 0.8 x 0.3 x 0.11 cm, submitted entirely.\n\nMicroscopic evaluation reveals high-grade features including palisading necrosis. Cellular morphology demonstrates small cell and fibrillary astrocytic differentiation. All sampled regions (A, B, D) exhibit consistent histologic findings. Component C represents excised tissue taken for procurement purposes.\n\nStaging assessment indicates the highest grade category based on morphologic classification. Tissue dimensions and cellular characteristics have been documented across all specimens."} +{"pid": "TCGA-HC-8265", "report": "The prostate specimen measured 5.0 x 3.9 x 3.5 cm and weighed 38.3 grams. Histologic evaluation revealed a lesion involving approximately 40% of the gland, bilaterally. The histologic pattern demonstrated a primary growth pattern scoring 3/5, with a secondary pattern scoring 5/5, resulting in an overall score. Additional areas showed a different growth pattern. Focal extension beyond the gland was identified within adjacent nerve tissue. No involvement of the seminal vesicles was observed, although adjacent tissue showed similar findings. There was no evidence of vascular or lymphatic invasion. High-grade intraepithelial neoplasia was present. Surgical margins were positive at the apex and bilaterally at the base. Staging was assigned based on these findings. Evaluation of submitted pelvic lymph nodes (total of 8) revealed no metastatic involvement. Gross examination of the prostate revealed a shaggy, pink-tan surface with a cystic and glistening cut surface. A tan-orange mass was noted in the left posterior quadrant, located close to the capsule. Sections were taken from various regions including margins, lobes, and junctions for detailed microscopic analysis. Lymph node specimens ranged in size from 0.4 to 3.0 cm and were entirely submitted for histologic review."} +{"pid": "TCGA-DU-A6S7", "report": "A brain specimen from a craniotomy in the left frontal region was received for evaluation. The tissue measured 1.4 x 1.2 x 0.5 cm and was described as grey-tan to dusky soft tissue. Histological examination revealed a gliofibrillary neoplasm consistent with a diffuse glioma. Microscopic analysis showed areas with up to 4 mitoses per 10 high power fields. No definite microvascular proliferation or tumor necrosis was identified.\n\nImmunohistochemical staining demonstrated a Ki-67 (MIB1) proliferation index of up to approximately 10%. Molecular testing revealed a point mutation in the IDH1 gene, specifically p.Arg132Ser. No mutation was detected in the IDH2 gene at codon 172. Chromosomal analysis for allelic loss on arms 1p and 19q was negative using a panel of microsatellite markers, including D1S548, D1S1592, D1S552, D19S219, D19S606, and D19S1182. DNA was extracted from the tumor block and compared to a normal reference control from blood. Tumor DNA was enriched by microdissection where necessary.\n\nThe histological and molecular findings were integrated to support classification. The tumor demonstrated genetic features commonly seen in gliomas with IDH1 mutations, which are associated with distinct clinical and genetic characteristics. No evidence of co-deletion on 1p and 19q was found, which may have implications for prognosis and treatment response. The tests used for mutation and allelic loss detection were developed under CLIA '88 requirements and are not FDA-cleared; results are intended for informational use within the context of standard diagnostic practices."} +{"pid": "TCGA-HC-A4ZV", "report": "The pathology report includes multiple tissue specimens. Lymph node evaluations from the left and right obturator regions show no evidence of metastasis, with 5 and 8 lymph nodes respectively analyzed. Margins evaluated include the right apical margin, which contains lymphoid and adipose tissue, and is negative for malignancy. The left apical margin demonstrates fibrofatty tissue and skeletal muscle with hemorrhage and no malignancy identified. A separate posterior apical margin specimen shows features consistent with a high-grade cellular pattern. Additional excisions of the seminal vesicle region do not show normal tissue structure, with findings of similar cellular patterns. A left bladder neck margin reveals fibromuscular tissue with chronic inflammation and no tumor detected.\n\nThe main prostatectomy specimen measures 5.5 x 5.0 x 5.0 cm and weighs 65 grams. Histologic evaluation shows a high Gleason score pattern, with more than 90% of the prostate involved. The dominant lesion measures 5.0 cm in greatest dimension. There is extensive involvement beyond the prostate capsule, including bilateral involvement of areas adjacent to the prostate. Invasion of surrounding structures is noted. Surgical margins are positive in several locations, including the apical, posterior, bladder neck, right lateral, bilateral posterolateral, and posterior regions. No lymph-vascular invasion is identified, but perineural involvement is present. The pathologic stage indicates advanced local disease without nodal involvement. Multiple tissue blocks were submitted for analysis, and all immunohistochemical testing was performed on appropriately fixed tissue."} +{"pid": "TCGA-EM-A3AQ", "report": "The thyroid specimen obtained via total thyroidectomy was intact and measured 4.5 \u00d7 2.6 \u00d7 1.3 cm on the right lobe, 3.9 \u00d7 2.5 \u00d7 1.8 cm on the left lobe, and 1.7 \u00d7 1.2 \u00d7 0.5 cm at the isthmus. The total weight of the specimen was 15.1 grams. Multiple distinct nodules were identified bilaterally and within the midline isthmus. The largest nodule measured 1.3 cm in greatest dimension with additional dimensions of 1.0 cm and 0.9 cm, located in the left lobe. Histologically, the nodules exhibited both classical papillary architecture and follicular variant features with classical cytomorphology. A second distinct lesion in the left lobe measured 1.0 \u00d7 0.8 cm and showed similar histologic characteristics along with microscopic features consistent with a microcarcinoma variant. Additional small foci measuring 0.5 cm (right lobe), 0.1 cm (isthmus), and 0.1 cm (left lobe) were also present and displayed classical, follicular, and oncocytic follicular variants respectively.\n\nAll surgical margins were free of involvement. The tumors were partially encapsulated with minimal capsular invasion noted. There was no evidence of lymphovascular or perineural invasion, and no extrathyroidal extension was observed. Three regional lymph nodes (two from the isthmic region and one from the left perithyroidal area) were examined and none showed any pathological involvement. No metastases were identified in the lymph nodes evaluated. Additional findings included mild nodular follicular disease and chronic lymphocytic thyroiditis. Based on the AJCC/UICC TNM staging system (7th edition), the tumor was classified as pT1b with no regional lymph node involvement (pN0). Multiple primary tumors were indicated by the presence of several distinct lesions."} +{"pid": "TCGA-TM-A84T", "report": "Histopathology Report. CLINICAL DETAILS: Left frontal brain lesion. Histopathology: (1) Biopsy, (2) CUSA content. MACROSCOPIC DESCRIPTION: (1) Labelled 'Left frontal lesion (CUSA)': multiple tiny fragments of soft pale tan and white tissue. Sections IA and IB are representative (approximately 70% of tissue embedded). (2) Labelled 'Left frontal lesion': multiple soft fragments of white and tan tissue, measuring 3 to 10mm across; all of tissue 2A embedded. MICROSCOPIC REPORT: Specimen type is open excision, from the left frontal lobe. The aggregate size of the specimen is up to 30mm in greatest dimension. Histological analysis reveals a diffuse variant lesion. WHO grade is 2. Size of the lesion is not assessable. Mitotic activity is absent. Vascular proliferation and necrosis are not present. Vascular invasion and invasion of adjacent structures are not applicable. Margins or extent of resection are not assessable. Immunohistochemical staining demonstrates tumour cells that are strongly positive for IDH1. GFAP shows strong expression with variable staining intensity among individual tumour cells. Vimentin and S100 exhibit variable staining patterns. Ki67 proliferation index is low, reaching approximately 2\u20133% in the highest areas. Block 3A is identified as most suitable for further molecular evaluation. \n\nSUPPLEMENTARY HISTOPATHOLOGY REPORT: Genetic testing was performed to evaluate for 1p/19q loss of heterozygosity (LOH) using dual colour probe sets for 1p36/1q25 and 19q13/19p13. Cut-off values were based on published criteria (<0.85 for 1p/lq ratio and <0.9 for 19q/19p ratio). Additionally, EGFR amplification status was assessed using an EGFR/Cep7 dual colour probe set. Chromosome 1 analysis showed a mean of 2.52 copies of 1p and 2.19 copies of 1q per cell, yielding a ratio of 1.15, indicating no evidence of 1p loss. Chromosome 19 analysis demonstrated a mean of 2.15 copies of 19p and 2.0 copies of 19q per cell, resulting in a ratio of 1.08, indicating no evidence of 19q loss. EGFR analysis revealed a mean of 2.42 copies of EGFR and 2.48 copies of Cep7 per cell, with a ratio of 0.98, indicating no evidence of EGFR amplification. \n\nCONCLUSION: Molecular testing shows no evidence of 1p/19q LOH or EGFR amplification."} +{"pid": "TCGA-IB-7887", "report": "The specimen includes a gallbladder measuring 7.7 x 2.5 x 2.1 cm with no stones identified. The mucosa appears unremarkable and the wall thickness is 0.2 cm. Two representative sections and the cystic duct margin are submitted. A retroperitoneal lymph node biopsy consists of two tissue pieces measuring 2.0 x 1.0 x 0.7 cm and 2.7 x 0.7 x 0.4 cm, both submitted in toto. A ring of tissue from the pancreatic duct margin measures 1.0 x 0.6 x 0.2 cm and is submitted entirely. An irregular tan/grey fragment from the pancreatic cyst wall measures 1.3 x 0.6 x 0.2 cm with one smooth grey surface; it is bisected and submitted.\n\nThe Whipple\u2019s resection specimen includes a portion of small bowel with the head and neck of the pancreas. The pancreatic neck is painted blue and the uncinate margin is painted orange. Gross examination reveals a tumor mass in the pancreatic head measuring 5.5 x 3.5 x 4.5 cm with a cystic component measuring 3.0 cm in diameter containing blood. No other lesions are observed. Representative sections from the proximal and distal bowel margins, pancreatic neck, uncinate margin, and tumor area are submitted. The pancreatic neck biopsy consists of a tan-colored tissue measuring 3.2 x 1.8 x 0.3 cm submitted in three cassettes.\n\nFrozen section analysis of the pancreatic duct margin reveals atypical ductal elements raising concern for malignancy, deferred for permanent section evaluation. The pancreatic cyst wall shows inflammatory changes with atypical duct epithelium, favoring neoplastic association. Microscopic evaluation confirms ductal adenocarcinoma in the pancreatic head, moderately differentiated. Tumor size correlates with gross measurements. Regional lymph node assessment identifies 30 nodes examined with three positive for involvement. Vascular invasion is present focally and perineural invasion is noted. Margins at the pancreatic and uncinate processes show tumor involvement. Additional findings include pancreatic intraepithelial neoplasia (PanIN-3), along with acute and chronic pancreatitis."} +{"pid": "TCGA-E2-A15M", "report": "The specimen consisted of four lymph nodes from the right axilla, ranging in size from 0.4 cm to 2 cm. Touch preps were obtained from each lymph node. Cytokeratin AE1/3 staining was performed on two of the nodes; one showed scattered positive cells while the other was negative. No tumor cells were identified in the touch preps.\n\nA needle localized lumpectomy specimen from the right breast weighed 204 grams and measured 12.5 x 10 x 7.5 cm. It was sectioned into 11 slices revealing four distinct masses. The largest mass measured 3.5 x 2.6 x 2 cm and was located near both the anterior and posterior margins across multiple slices. Another mass measured 1 cm and was located near the deep margin. Two smaller masses measured 0.4 cm and 0.3 cm respectively and were found in proximity to each other near the anterior margin in one slice. Several margins were evaluated microscopically, with tumor involvement noted at the anterior margin.\n\nHistologic evaluation revealed invasive carcinoma as well as lobular neoplasia including lobular carcinoma in situ and columnar cell change. A single intramammary lymph node was identified without evidence of tumor involvement. Skeletal muscle tissue was also present and showed no tumor infiltration.\n\nThe tumor demonstrated a tubular score of 3, nuclear grade of 2, and mitotic score of 2, resulting in a modified Scarff Bloom Richardson grade of 2. Necrosis was not present and there was no evidence of vascular or lymphatic invasion. Hormone receptor testing showed positivity for estrogen and progesterone receptors, and negativity for HER2 by immunohistochemistry.\n\nBased on the AJCC Cancer Staging Manual, 7th Edition, the pathological stage was determined to be pT2N0. Radiographic correlation was recommended due to multifocal involvement seen across multiple slices spanning up to 6 cm within the excised tissue.\n\nAn OncoType DX assay was performed, yielding a recurrence score of 29. Based on clinical validation data, this corresponds to an average 10-year distant recurrence risk of approximately 19%. ER and PR scores were positive, while the Her2 score was negative."} +{"pid": "TCGA-FE-A3PC", "report": "The specimen consisted of a total thyroidectomy, central neck dissection, and left superior parathyroid excision. A total of 20 lymph nodes were identified in the central neck dissection, all ranging in size from 0.3 x 0.3 x 0.2 cm to 1.2 x 0.6 x 0.4 cm. All lymph nodes showed microscopic subcapsular foci involving the soft tissue. One of the sampled nodules was found to be a small fragment of mature thyroid parenchyma.\n\nIn the left superior parathyroid, a very small amount of lymphoid tissue was noted with the presence of small psammoma bodies. The total thyroidectomy measured 9.0 x 5.5 x 2.5 cm. On sectioning, the right lobe contained two distinct nodules: one tan-white nodule measuring 1.1 x 1.0 x 1.0 cm with a central area of hemorrhage and necrosis, located 3.0 cm from the isthmus; and another tan-white, firm nodule measuring 0.9 x 0.7 x 0.8 cm, located 1.8 cm from the isthmus. Both appeared to be in close proximity to the capsule. The left lobe contained a tan-white, indurated rim surrounding a tan-pink, finely granular, and friable area measuring 5.2 x 3.5 x 2.0 cm. This area was also adjacent to the capsule. The left lobe was serially sectioned, including the lateral edge, with all sections submitted for analysis.\n\nMicroscopic evaluation showed no evidence of lymphatic or vascular invasion, nor was there capsular invasion. No infiltration of adjacent structures or invasion of the thyroid cartilage or hyoid bone was identified. The extent of the lesion was confined to the thyroid. It was not multifocal. Additional findings included Hashimoto's thyroiditis and a small follicular lesion in the right lobe. A total of 19 lymph nodes were examined from the central neck, all of which were positive, with no extranodal extension observed. The staging classification assigned was pT3N1Mx."} +{"pid": "TCGA-A2-A0CU", "report": "Specimen #: Race: WHITE. Physician(s): SPECIMEN: A: SENTINEL LYMPH NODE #1 B: RIGHT BREAST TISSUE Site: breast, NOS C50.9.\n\nA. LYMPH NODE, SENTINEL #1, EXCISION: \nIsolated cells and small clusters measuring less than 0.2 mm were identified within the lymph node capsule on H&E examination. These findings were confirmed with a positive pancytokeratin immunohistochemical stain. \n\nB. BREAST, RIGHT, SIMPLE MASTECTOMY: \nA lesion was identified with a greatest dimension of 3.4 cm. Histologic evaluation revealed moderately differentiated features. The tumor was located in the lower outer quadrant and had a firm, tan, focally hemorrhagic cut surface. It was found to be within 0.0 cm of the inferior-anterior margin and approximately 2.0 cm from the posterior margin. No definitive evidence of vascular invasion was observed. \n\nAdditional findings included fibrocystic changes with stromal sclerosis, cyst formation, and apocrine metaplasia. The nipple showed no significant pathological changes. \n\nGROSS DESCRIPTION: \nA. A soft tissue fragment measuring 2.0 x 1.0 x 0.5 cm was received and labeled as \"SENTINEL LYMPH NODE #1.\" \nB. A mastectomy specimen weighing 441.0 grams was received fresh and labeled \"RIGHT BREAST TISSUE.\" It measured 20.0 x 15.5 x 3.2 cm with the nipple-areolar complex measuring 3.4 x 2.5 cm. Sectioning revealed a tumor measuring 3.4 x 2.7 x 2.5 cm. The surrounding tissue was mostly fatty with patches of fibrous tissue adjacent to the tumor. Multiple sections were submitted for analysis. \n\nStaging information indicates involvement of regional lymph nodes with isolated cells or small clusters (pN0(i+)), and the primary lesion size corresponds to pT2 classification. Distant metastasis could not be assessed (Mx). \n\nCLINICAL HISTORY: Female patient with prior history of right breast malignancy. \n\nAdditional sections submitted included skin, tumor with anterior margin (B2, B3), central fibrous tissue 2.0 cm from tumor (B4), nipple (B5), and representative sections from all quadrants of the breast (B6\u2013B19)."} +{"pid": "TCGA-HE-A5NH", "report": "The sample was collected from the left kidney during a resection procedure. The tumor measured 3 cm in size and exhibited papillary architecture with features corresponding to both types 1 and 2. Histological evaluation showed moderately differentiated cells with nuclear atypia consistent with Fuhrman grade 3/4. Pathological staging was determined as T1a, with no lymph node involvement (NX) and no evidence of distant metastasis (M0). A separate buffy coat sample was also collected. No other diagnostic terms or classifications were provided in the report."} +{"pid": "TCGA-DX-A48L", "report": "A 6.3 x 4.2 x 3.7 cm firm, white-tan, well-circumscribed mass is identified within the deep aspect of a resected soft tissue specimen from the right calf. The specimen includes adipose tissue and skeletal muscle, with the tumor located 2.4 cm beneath the skin surface. The lesion is predominantly viable with only focal areas of necrosis and is in close proximity to the deep and lateral inked margins, measuring 0.1 cm away. A separate unilocular, smooth-walled cyst measuring 4 x 3 x 2 cm is present in the superficial portion of the specimen. The excision includes an overlying ellipse of unremarkable pink skin with scarring and surgical-related changes. Margins are variably inked (deep black, lateral blue, superior yellow, medial green, inferior red). Microscopic sections include representative samples from the tumor, cyst, skin, and all surgical margins."} +{"pid": "TCGA-LT-A8JT", "report": "The specimen consisted of a cystectomy sample with surrounding perivesical adipose tissue. A lesion measuring 2.2 cm in greatest dimension was identified on the left anterior bladder wall, with a papillary configuration and superficial invasion into the mucosa. Another small red papillary focus measuring 0.7 cm was noted on the posterior surface. The opened bladder also showed an ulcerated area on the right side with adjacent residual papillary changes. The urethra measured 5.0 cm in length and 1.7 cm in diameter, with a strip of vaginal mucosa overlying the posterior surface. All surgical margins were free of malignancy, with the nearest margin being 5 cm from the tumor site. Evaluation of 38 sampled lymph nodes from multiple regional sites revealed no evidence of involvement. No venous or lymphatic invasion was identified, and no direct extension to adjacent structures was observed. The primary lesion demonstrated invasion into the inner half of the muscularis propria. Based on AJCC staging criteria, the tumor was classified as pT2a with no lymph node involvement (pN0). Distant metastasis could not be assessed."} +{"pid": "TCGA-DD-A39V", "report": "The resected right lobe of the liver weighed 1045 grams and measured 20 x 17 x 7.5 cm. A dominant mass measuring 4.6 x 4.3 x 3.2 cm was identified, along with a single satellite nodule measuring 0.4 cm in greatest dimension. The tumor was located in the right lobe and was not encapsulated. The hepatic capsule and surgical margins were free of tumor involvement. No extramural vascular invasion was observed, and the infiltration of surrounding parenchyma appeared to be of the pushing type. The gallbladder measured 10 x 4 x 3 cm and showed histological features consistent with mild chronic cholecystitis. An addendum noted mild changes related to the tumor within the non-neoplastic liver tissue, with no evidence of underlying chronic or primary liver disease."} +{"pid": "TCGA-B0-4842", "report": "The right kidney specimen shows a large mass measuring 12.5 cm in greatest dimension, located at one of the poles. The tumor involves both the cortex and medulla, compresses the renal pelvis, and extends into the perinephric and hilar adipose tissue. On sectioning, the majority of the tumor is homogeneously beige and soft, with areas of yellow foci, hemorrhage, and rare necrosis. Microscopically, high nuclear grade features are present, with a predominant nuclear grade of 3 out of 4 and focal areas of nuclear grade 4 out of 4. Hemorrhage is also noted.\n\nThe mass focally infiltrates through the perinephric adipose tissue and reaches the corresponding perinephric soft tissue margin in the region of the upper pole. The linear extent of this positive margin is 0.15 cm. In addition, a small, non-occlusive, non-adherent, grossly inapparent fragment of material associated with fibrin is found within the lumen of the renal artery at the resection margin. A separate tumor thromboembolus is identified within a small thin-walled vessel within the tumor itself. The main renal vein and proximal ureter show no evidence of involvement.\n\nThe non-neoplastic renal parenchyma contains a benign simple cortical cyst measuring 5 cm in greatest dimension and otherwise appears unremarkable. The Gerota's fascia is stretched over the tumor, and on microscopic evaluation, there is a 0.15 cm defect in a section containing apparent Gerota's fascia in the upper pole region, with the presence of cells at the corresponding inked margin. It is unclear whether this represents true fascial invasion or a small surgical defect. As a result, the staging is classified as pT3a+.\n\nA separate specimen consisting of the right adrenal gland and surrounding adipose tissue is submitted. No significant pathological changes are identified at the time of examination. Additional sections are being processed, and results will be reported in an addendum. Based on current findings, it is likely that the final margin in the soft tissue adjacent to the upper pole of the kidney is benign."} +{"pid": "TCGA-HT-7609", "report": "The microscopic examination reveals a markedly hypercellular glial neoplasm composed of atypical cells resembling astrocytes, with a significant oligodendroglial component present. The neoplastic cells exhibit pleomorphic and often bizarre nuclei. In certain areas, there is a predominance of gemistocytes. The tumor demonstrates diffuse infiltration into adjacent gray and white matter. Scattered mitotic figures are observed throughout the sections. Additionally, occasional foci of early spontaneous necrosis and microvascular proliferation are identified. The MIB-1 labeling index reaches up to 10.2% in the most proliferative regions of the tumor."} +{"pid": "TCGA-DR-A0ZL", "report": "The specimen consisted of a total of seven tissue samples submitted for pathological evaluation. These included right and left pelvic lymph nodes, bilateral ovaries and fallopian tubes, the uterus and cervix, and left and right common lymph nodes.\n\nLymph node examination revealed no evidence of metastatic involvement in all specimens evaluated. The right pelvic lymph nodes (11 total) measured up to 1.6 cm in greatest dimension. The left pelvic lymph nodes (10 total) included a lymph node measuring up to 2.6 cm. Two lymph nodes were identified in the left mid common lymph node specimen and one lymph node was identified in the right common lymph node specimen. All lymph nodes across all sites showed no presence of malignant cells.\n\nThe bilateral ovaries and fallopian tubes showed no gross or microscopic abnormalities. Each ovary appeared unremarkable with normal dimensions: the left ovary measured 1.8 x 1.0 x 0.6 cm and the right ovary measured 2.1 x 0.8 x 0.6 cm. Corresponding fallopian tubes measured 4.6 cm and 4.3 cm in length, respectively, and appeared histologically benign.\n\nThe uterus and cervix specimen weighed 83 grams and measured 8.2 x 8.0 x 3.3 cm. Grossly, the serosal surface was smooth with ragged areas but no subserosal bulging. A lesion was identified at the cervical os extending into the lower uterine segment. It had a fungating, papillary, and circumferential configuration. The lesion measured 3.0 x 2.1 x 0.4 cm. Depth of invasion was noted as superficial involvement of the lower uterine segment, not exceeding 0.3 cm in thickness. Microscopically, the lesion was composed of poorly differentiated non-keratinizing cells arranged in an invasive pattern. No parametrial invasion, pelvic wall extension, vaginal involvement, or bladder/rectal mucosal extension was observed. Lymphovascular invasion was not identified. Resection margins were free of involvement. The endometrium measured 0.1 cm in thickness and no polyps were identified. The myometrium was 1.6 cm thick without adenomyosis. Several small myomas were present, with the largest measuring 0.6 x 0.5 x 0.4 cm. \n\nStaging information indicated no regional lymph node involvement (NO). No distant metastases were identified. All surgical margins were clear."} +{"pid": "TCGA-XF-A9T3", "report": "The surgical specimen included a segment of right distal ureter measuring 0.4 cm in diameter and length, and a left distal ureter measuring 0.5 cm in both diameter and length. Both were found to be benign upon frozen and final examination, with no evidence of atypia or abnormal cellular changes. A piece of fibrofatty tissue from the left para-aortic region containing five lymph nodes (up to 0.5 cm in size) was also examined and found to be benign. An apical urethral margin measuring 1.4 x 0.3 x 0.2 cm was similarly benign without any concerning features.\n\nThe main specimen consisted of a bladder, uterus, bilateral fallopian tubes and ovaries, and cervix. The bladder measured 5 x 5 x 2.5 cm, and the attached uterus measured 7 x 5 x 1.8 cm. The bilateral ovaries measured 2.2 x 1.3 x 0.8 cm on the right and 3.4 x 1 x 0.8 cm on the left. Involving the left ureterovesical junction, left lateral wall, and trigone of the bladder was a tumor measuring 3.5 x 3 x 1.8 cm. Microscopic evaluation showed that this lesion extended through the muscularis propria into perivesical soft tissue but did not involve the peritoneum or inked resection margins, with the closest margin being 0.2 cm from the tumor. Lymphovascular invasion was noted. Adjacent areas showed cystitis glandularis et cystica along with mild to moderate cellular atypia; however, no high-grade changes or flat lesions were identified.\n\nLymph node assessments were conducted across multiple regions. Right para caval lymph nodes (2 examined), left common iliac (7), right common iliac (3), right external iliac (5), right lymph node of Cloquet (1), right obturator/hypogastric (6), right pelvic (submitted entirely), right pre-sciatic (3), and left pre-sciatic (2) lymph nodes all showed no signs of malignancy. Left external iliac lymph nodes showed involvement in 1 out of 4 nodes examined, and presacral lymph nodes had 1 out of 4 nodes positive for metastatic disease. The remaining lymph nodes across other regions were negative. In total, 2 out of 52 lymph nodes showed evidence of metastasis, with the largest deposit measuring 5 mm and showing extranodal extension.\n\nOther findings included chronic cervicitis with squamous metaplasia in the cervix, mild inflammation in the vaginal cuff, inactive endometrium, and normal myometrium and serosa. Both fallopian tubes and ovaries appeared unremarkable with no significant lesions or abnormalities noted. The right proximal ureter showed signs of inflammation without cellular abnormalities, while the left proximal ureter was benign.\n\nPathologic staging was determined as pT3b based on depth of invasion and regional lymph node involvement (N2). No distant metastases were assessed (MX). Sections of the invasive carcinoma were submitted for further testing using a p53 assay. All other margins, including urethral, ureteral, and vaginal, were free of dysplasia or malignancy."} +{"pid": "TCGA-4Z-AA7M", "report": "The specimen from the bladder and prostate revealed a high-grade neoplastic lesion measuring 6.2 cm in its major axis. The lesion was ulcerated and infiltrative, involving all layers of the bladder wall and extending into perivisceral fat. No involvement was identified in the prostate, seminal vesicles, vas deferens, ureters, or urethra. There was no evidence of neural infiltration, lymphatic vascular invasion, or sanguineous vascular invasion. Surgical margins were free of neoplastic involvement. Additionally, there was an associated finding of ulcerated granulomatous cystitis.\n\nWithin the prostate, a separate focus of neoplasia was identified, measuring 0.5 cm, located between the base and left mid-zone. It exhibited a Gleason score of 6 (3+3). No neural infiltration, lymphatic vascular invasion, or sanguineous vascular invasion was observed. Surgical margins and lymph nodes were free of neoplastic involvement, with 0 out of 3 lymph nodes involved. Right and left pelvic lymphadenectomy specimens showed no evidence of neoplastic involvement, with 0 out of 6 and 0 out of 19 lymph nodes involved, respectively.\n\nStaging indicated involvement of the bladder with a morphology consistent with transitional cell origin, classified as pT3 pN0."} +{"pid": "TCGA-KL-8342", "report": "The left kidney specimen includes a large mass measuring 14 cm in greatest diameter, with extensive necrosis and degenerative changes. The tumor is circumscribed and located within the kidney, abutting the renal pelvis but not grossly involving the perinephric fat or renal sinus. No renal vein invasion is identified. Surgical margins are free of involvement. The remaining kidney shows mild patchy chronic interstitial inflammation. No adrenal gland or lymph nodes are identified in the kidney specimen. Examination of para-aortic lymph nodes (9 total nodes assessed) and supra-hilar lymph nodes (4 total nodes assessed) reveals no involvement. The left adrenal gland appears benign without evidence of tumor. The tumor is confined to the kidney and measures greater than 7.0 cm in greatest dimension."} +{"pid": "TCGA-UY-A9PD", "report": "The patient is a male who underwent a cystoprostatectomy with bilateral lymph node dissection. Biopsies of the left and right ureters showed no abnormal cellular changes or malignancy. The cystoprostatectomy specimen included a mass measuring 3.2 x 2.5 x 1.8 cm located along the left anterior wall, adjacent to the left ureteral orifice. Microscopic evaluation showed that the lesion extended through the muscularis propria into the perivesicular adipose tissue. Lymphatic/vascular invasion was present, confirmed by CD34 immunostaining which demonstrated tumor within small vascular spaces. Margins were negative: the invasive component was 4.8 cm from the urethral margin, 0.7 cm from the perivesical margin, and both ureteral margins were also free of involvement. No tumor was identified in the two lymph nodes removed from the right obturator region, the seven nodes from the right internal iliac area, the two nodes from the right external iliac region, or the eleven nodes from the left pelvic region. In total, 25 lymph nodes were examined and none showed evidence of tumor. The prostate showed benign findings including nodular stromal hyperplasia, glandular atrophy, and focal squamous metaplasia. There was no evidence of carcinoma in the prostate. Frozen sections of multiple areas, including the ureters and urethral margin, did not show definitive dysplasia or malignancy. Gross examination of the bladder revealed a friable, tan-pink to red mass near the left ureteral orifice, with the remainder of the mucosa appearing edematous. The prostate contained multiple tan, rubbery nodules and a small cystic area, but no malignant changes. A foreign body giant cell reaction was noted in the bladder, consistent with prior transurethral resection. All surgical margins were negative. The lymph nodes examined across multiple regions were similarly unremarkable. The case was reviewed in full by the attending pathologist, with correlation between frozen and permanent sections confirming the findings."} +{"pid": "TCGA-AA-A02J", "report": "The specimen consists of an internal sample revealing a poorly differentiated adenocarcinoma in the liver region. Further sections identified two closely situated liver metastases. In addition, there is an invasive adenocarcinoma of the colon that is moderately differentiated, with involvement of all parietal layers and vascular infiltration (pT3, L1, V1). Resection margins are free, and no lymph node involvement was detected (pN0). The tumor was classified as G2 according to histological grading. No other specific diagnostic terms were provided."} +{"pid": "TCGA-3H-AB3M", "report": "The pleural biopsy consists of two pieces of tan-white tissue measuring 0.2 x 0.2 x 0.2 cm and 1.2 x 0.5 x 0.3 cm. The smaller piece and a portion of the larger piece were submitted for frozen section, while the remainder was processed for permanent sections. Immunohistochemical analysis demonstrated strong positive staining for WT-1, mesothelin, and keratin 5/6 in the neoplastic cells. Staining for MOC-31 was negative. Cellular morphology and immunoprofile support the presence of a malignant epithelioid neoplasm involving the pleura. Clinical history indicates prior involvement of the left pleura."} +{"pid": "TCGA-CV-7101", "report": "The specimen report includes multiple biopsies and a resected larynx with adjacent structures. A fragment from the anterior commissure measured 0.8 x 0.3 x 0.2 cm and showed moderately differentiated cellular changes. A biopsy from the posterior wall of the esophagus, measuring 0.5 x 0.3 x 0.2 cm, revealed no abnormal cellular findings.\n\nThe main specimen, consisting of a larynx, hyoid bone, and adjacent soft tissue (9.2 x 6.5 x 6.0 cm), along with a subtotal thyroidectomy specimen (4.5 x 3.5 x 1.5 cm), contained a flat, ulcerated lesion on the mucosa of the right true vocal structure. The lesion measured 2.4 x 1.5 x 1.2 cm and extended 1.7 cm below the right ventricular area. Ulceration crossed the midline anteriorly by approximately 0.4 cm. Necrotic material was noted in the right paraglottic region. The distance from the inferior (tracheal) margin of resection to the lesion was 2.7 cm. All gross margins appeared free of abnormal cells.\n\nAdditional findings included invasion through the ossified thyroid cartilage into the anterior soft tissues, with perineural involvement noted near the right lobe of the thyroid. No lymphatic or vascular invasion was identified. Margins from all evaluated sites, including mucosal margins, were negative for abnormal cells. Multiple sections were submitted for further analysis, including flow cytometry and investigational studies."} +{"pid": "TCGA-D8-A1JG", "report": "The intraoperative examination involved a female patient and analyzed a fragment of the right breast measuring 8 x 7 x 4 cm, including a 5 x 2 cm skin flap. A lesion was identified in the cross-section measuring 2.5 x 1.5 x 1 cm. Margins were measured as follows: 0.8 cm to the base, 1.3 cm to the front surface, 2.5 cm to the sternum, 3 cm to the axilla, 4 cm to the shoulder, and 1.3 cm to the lower boundary.\n\nMicroscopic evaluation revealed a histological grade 2 lesion with a total score of 3 + 2 + 2 based on mitotic count (9 mitoses per 10 high power fields in a visual area of 0.55 mm diameter). The lesion exhibited features consistent with a solid-type intraductal proliferation characterized by marked nuclear atypia, central necrosis, and calcifications. There was also evidence of peritumoral lymphocytic infiltration. Additional findings included fibrocystic breast changes.\n\nImmunohistochemical analysis showed no expression of estrogen or progesterone receptors in the neoplastic cells. HER2 protein expression was scored as 2+ using the HercepTest\u2122 by DAKO, and subsequent FISH testing did not detect HER2 gene amplification.\n\nMargins corresponded to normal tissue in all evaluated regions. The tumor was classified as pT2, with no lymph node involvement noted."} +{"pid": "TCGA-E2-A14Q", "report": "The surgical specimens include a right breast wide local excision with needle localization, a left simple mastectomy, and five sentinel lymph nodes from the left axilla. Intraoperative consultation of the sentinel lymph nodes showed no evidence of tumor involvement.\n\nThe right breast specimen measured 6.0 cm in greatest dimension and contained multiple gray-white nodular areas, the largest measuring 0.9 cm located 0.3 cm from the anterior margin. Histologic evaluation revealed lobular carcinoma in situ, small intraductal papilloma, radial scar, florid usual ductal hyperplasia, columnar cell lesions, extensive sclerosing adenosis, duct ectasia, and microcalcifications. A focal previous biopsy site was identified in one section.\n\nThe left mastectomy specimen weighed 560 grams and measured 21 x 20 x 3 cm. A well-circumscribed tan mass measuring 2.5 x 2.3 x 1.7 cm was identified in the upper outer quadrant, located 1.5 cm from the deep margin. No tumor was identified at the margins. Extensive ductal carcinoma in situ (DCIS) of solid and cribriform types with nuclear grades 2 and 3, comedo necrosis, and microcalcifications was present, involving lobules and found in both upper outer and lower outer quadrants. DCIS was focally within 1 mm of the anterior-superior margin. The nipple was free of tumor. One lymph node near the axillary stitch showed no evidence of metastasis. Three biopsy sites were identified: associated with the tumor, a fibroadenoma, and hemorrhage.\n\nSentinel lymph node analysis showed no evidence of tumor in nodes #1 through #4. Micrometastatic involvement measuring 1.1 mm was identified in one lymph node from sentinel node #4. Sentinel node #5 also showed no evidence of tumor.\n\nImmunohistochemistry performed on tumor tissue demonstrated positivity for ER and PR by immunohistochemistry with Allred scores of 8 each. HER2 immunostaining was negative (1+ intensity in 1% of tumor cells). An Oncotype DX assay was performed, yielding a recurrence score of 9, with ER and PR scores indicating positivity.\n\nPathologic staging was determined as pT2 pN1mi, indicating a primary tumor greater than 2 cm with micrometastatic involvement in one regional lymph node. Non-neoplastic findings included fibroadenoma and columnar cell change. No vascular or lymphatic invasion was identified."} +{"pid": "TCGA-W2-A7UY", "report": "The specimen consists of a 13.0 x 10.5 x 2.5 cm portion of disrupted yellow-red lobulated fibroadipose tissue, which includes a 7.5 x 3.5 x 3.0 cm adrenal gland. Within the adrenal gland, there is a 4.0 x 3.0 x 3.0 cm mass. The capsule of the mass was stripped due to tissue disruption. The mass has a rough orange-yellow rim and a soft red-brown, partially cystic center. The uninvolved adrenal cortex shows a thin orange-tan cortical rim with a central tan-brown medulla. The total weight of the adrenal gland and surrounding fat is 50.1 grams. Fresh tissue was saved for further analysis. Representative sections from the nodule and unremarkable adrenal tissue were submitted for histological evaluation. Histological examination was performed and relevant sections were processed."} +{"pid": "TCGA-CJ-4876", "report": "The left kidney and adrenal gland specimen shows a well-circumscribed tan-yellow mass located in the lower pole of the kidney. The lesion measures 10.5 cm in maximum dimension and exhibits central gelatinous areas, with focal calcification and hemorrhage. The tumor compresses the surrounding renal parenchyma and extends toward the perinephric fat but remains confined within the renal capsule. It is situated 5.0 cm from the upper pole and 7.0 cm from the adrenal glands. There is no gross involvement of the renal pelvis, calyx, or renal vein, and these structures are not dilated. The ureteral and vascular margins of resection are free of abnormal tissue. Microscopic evaluation reveals a mixture of clear and eosinophilic cells with nuclear features corresponding to a high-grade morphology. The tumor focally approaches the renal sinus adipose tissue but does not infiltrate it. No extension into the perinephric adipose tissue is identified. The adrenal gland appears unremarkable. Multiple sections were taken from the tumor, adjacent structures, and margins of resection, all of which show no evidence of involvement beyond the main lesion."} +{"pid": "TCGA-VQ-A94P", "report": "The specimen involves the body and antrum of the stomach. Histologic evaluation shows a mucosecreting mucocellular pattern with presence of signet ring cells. The tumor is poorly differentiated and demonstrates a spiculated growth pattern. The longest tumor dimension measures 4.0 centimeters. Ulceration is present, and the serosa is involved. A moderate inflammatory reaction is noted. There is no evidence of tumor implant in perivisceral adipose tissue. Surgical margins at both proximal and distal sites are free of neoplastic involvement. Neural infiltration and lymphatic vascular invasion are identified, while sanguineous vascular invasion is not detected. The greater and lesser omentum are free of tumor involvement.\n\nAssociated findings include moderate chronic gastritis with intestinal metaplasia. Lymph node assessment reveals 13 nodes involved out of those dissected. Of these, 4 out of 11 lymph nodes from the greater curvature and 2 out of 2 nodes from the lesser curvature show involvement. No lymph node conglomerates or capsular transposition are observed."} +{"pid": "TCGA-KK-A7AV", "report": "A total of 23 lymph nodes were examined from various anatomical locations, including the right and left external iliac, obturator, internal iliac, and perirectal regions. No tumor was identified in any of the lymph node specimens. The lymph nodes ranged in size from 0.2 to 1.4 cm in greatest dimension. Gross examination revealed fibroadipose tissue with no remarkable findings suggestive of malignancy.\n\nThe prostate specimen measured 4.0 x 2.2 x 3.8 cm and weighed 28.0 grams post fixation. Serial cross sections demonstrated an area of abnormality in the right peripheral zone, present in two of the three cross sections. This lesion measured 2.9 x 2.1 cm in its largest dimension and was located extensively at the apex with focal involvement at the base. A second focus of abnormality was identified in the transition zone measuring 0.9 x 0.6 cm, also present focally at the apex. The anterior aspect of the prostate was inked green, left red, right yellow, and posterior black; blue ink was used in areas not representing true margins.\n\nMicroscopic evaluation showed a focus near the left apical margin within 0.1 mm of the resection edge, raising concern for possible marginal involvement. No extraprostatic extension was observed. Both seminal vesicles and segments of the vasa deferentia were free of tumor. Perineural invasion was noted, but no lymphovascular invasion was identified. High-grade prostatic intraepithelial neoplasia was also present. All surgical margins were negative except for the aforementioned focus near the left apical region."} +{"pid": "TCGA-B5-A3F9", "report": "The specimen consisted of multiple submitted fragments and organs. The omentum included three adipose tissue fragments measuring 9.0 x 8.0 x 2.0 cm in aggregate, with no masses identified. A right adnexa weighing 13.7 grams included an ovary measuring 2.5 x 2.0 x 1.5 cm and a 4.0 cm long fallopian tube, both appearing unremarkable. A left ovary weighing 7.9 grams measured 2.5 x 2.5 x 2.0 cm and exhibited moderate fibrous adhesions on the surface; no fallopian tube was identified. The uterus weighed 177.0 grams and measured 7.0 x 6.5 x 5.0 cm; it contained disrupted serosa with adhesions at the fundus. The endometrial cavity measured 4.5 x 2.5 cm and was lined by tan, shaggy tissue. Sectioning revealed multiple intramural leiomyomas ranging from 1.0 to 4.0 cm in diameter. A lesion measured up to 0.8 cm within a 3.2 cm thick wall that was not involved by leiomyoma. The lesion extended to one margin, with 0.8 cm distance from the opposite margin. Blocks included full thickness sections of the lesion and leiomyoma, tumor and margin, endomyometrium with serosal adhesions, and parametrial tissues. Cervix #1 weighed 68.2 grams and measured 6.0 x 5.5 x 5.0 cm; it demonstrated a pink-gray whorled cut surface with multiple cysts filled with mucin. No distinct uterine anatomy was observed macroscopically. Cervix #2 weighed 49 grams and measured 3.5 x 3.0 x 2.0 cm, including a 3.0 cm endocervix and a 0.5 cm possible vaginal cuff. A small pedunculated leiomyoma measuring 1.2 x 1.0 x 1.0 cm was present in attached fibrovascular tissue. Microscopic evaluation showed no malignancy in the omentum, either ovary, or cervix specimens. In the uterus, histologic findings included poorly differentiated cells involving inner-half myometrium (0.2 cm/3.2 cm), without extension to the surface, stromal invasion, vascular invasion, or involvement of the uterine serosa. Margins were free of abnormal cells. Additional findings included adenomyosis and multiple leiomyomas in the myometrium."} +{"pid": "TCGA-A2-A0SV", "report": "The specimen consists of a right mastectomy and right axillary contents from a white female with a history of right nipple inversion and prior mammotome biopsy showing ductal carcinoma. The mastectomy specimen weighs 627 grams and measures 24 x 23 x 4 cm. The skin ellipse measures 9.5 x 4 cm with a centrally inverted nipple. A centrally located, poorly defined firm mass measuring 4.5 cm in greatest dimension is identified. Hemorrhage at the periphery suggests prior biopsy. The mass extends to the deep margin and is surrounded by nodular and cystic fibrous parenchyma. Additional small nodules are noted in multiple quadrants, likely representing intramammary lymphatic spread rather than separate primary lesions.\n\nMicroscopic evaluation reveals a poorly differentiated cellular proliferation with a Nottingham score of 9 (3 each for tubules, nuclei, and mitoses). Necrosis is present within both invasive and in situ components. Microcalcifications are observed in both malignant and benign processes. There is extensive vascular and lymphatic invasion. Positive tumor involvement is noted at the deep margin, involving both tissue and lymphatics. Minimal intraductal component is seen. The nipple demonstrates dense fibrous tissue with signs of lesion involvement. Skin involvement is also present.\n\nEstrogen and progesterone receptors were previously tested on prior biopsy material and found positive. HER2 Neu testing by immunohistochemistry was weakly positive; fluorescence in situ hybridization remains pending.\n\nPathologic staging is pT4d N2a MX. Additional findings include high-grade ductal carcinoma in situ and cystic change with apocrine metaplasia.\n\nAxillary lymph node dissection includes extensive fatty tissue with two matted soft tissue portions identified. Eight lymph nodes show tumor involvement with extensive extracapsular extension and metastatic deposits larger than 2 mm. Exact lymph node count could not be determined due to tissue fragmentation."} +{"pid": "TCGA-MB-A8JK", "report": "The specimen consists of a resected soft tissue mass from the right lateral thigh, measuring 3.9 x 3.0 x 2.7 cm. Grossly, the mass is circumscribed and exhibits a pink-tan cut surface with a focal area of organizing hemorrhage. The tumor is located 2.2 cm from the proximal margin, 2.1 cm from the distal margin, 0.6 cm from the anterior margin, 0.3 cm from the posterior margin, and 2.2 cm from the deep margin. Microscopically, the lesion demonstrates high-grade features including marked nuclear pleomorphism, increased mitotic activity (>20 per 10 high-power fields), and a histologic grade of 3 out of 3 using the French Federation of Cancer Centers grading system. Necrosis is present but limited to less than 5% of the tumor volume. Resection margins are negative for involvement. No angiolymphatic invasion is identified. A total of twelve tissue blocks were submitted for analysis, including all margins and representative sections of the tumor. Pathologic staging is pT1b Nx Mx. The staging is provisional and based solely on available pathologic findings."} +{"pid": "TCGA-DX-A2J1", "report": "The surgical specimen consists of a resected portion of large bowel with attached mesentery and surrounding tissue. The bowel segment measures 49 cm in length and 4.5 cm in circumference. The mesentery measures 46 x 20 x 4 cm, with a lipomatous lesion measuring 21 x 13 x 2 cm attached. This lesion has a smooth membranous surface on one side, which is inked black to mark the renal capsule margin. Within the kidney capsule, a small adrenal fragment measuring 7 x 1 x 0.8 cm is identified. Adjacent to the kidney capsule and within the mesentery, there is a firm nodular mass measuring 10 x 7.5 x 5.5 cm; its surface is also inked black. Upon sectioning, the mass reveals a firm tan nodular cut surface.\n\nThe tumor has a bi-lobed appearance with overall dimensions of 31 x 20.5 x 7.5 cm. Microscopic evaluation shows a component of cellular atypia comprising approximately 30% of the total tumor volume, exhibiting morphologic features resembling malignant fibrous histiocytoma. The tumor involves the subserosal fat of the colon and extends to an unmarked soft tissue margin. A separate area of distinct histologic appearance extends to the inked renal capsule margin. No tumor involvement is identified at the intestinal resection margins. One benign lymph node is identified in the regional tissue, with no evidence of metastatic disease.\n\nA second specimen includes a segment of sigmoid colon measuring 5 cm in length, with attached adipose tissue up to 3 cm thick. The bowel lumen shows focal mucosal hemorrhage, with wall thickness measuring up to 1 cm. The serosal surface appears normal, and no lymph nodes are identified. Histologic examination of this specimen does not reveal any abnormality.\n\nAll other submitted sections from both specimens demonstrate no additional pathological findings."} +{"pid": "TCGA-DD-AAVS", "report": "The specimen consists of a right hemihepatectomy. The lesion measured 10.5 x 8.0 x 7.5 cm and was characterized by a nodular gross appearance with perinodal extension. No satellite nodules were identified. Histologically, the lesion exhibited trabecular and pseudoglandular patterns with classic and clear cell morphology. The histologic grade according to Edmondson and Steiner showed the worst differentiation as grade 3 and the major differentiation as grade 2. There was no evidence of fatty change, hemorrhage or peliosis, tumor necrosis, or vascular invasion. A partial capsule was present with infiltration noted. Septal formation was observed. There was no involvement of a major branch of the portal or hepatic vein, nor bile duct or serosal invasion. The surgical margin was clear with a safety margin of 0.5 cm. No intrahepatic metastasis or multicentric occurrence was detected. The pathologic staging was classified as pT2 according to AJCC guidelines. Additional findings included chronic hepatitis associated with hepatitis B virus, showing minimal lobular activity and moderate porto-periportal activity with portal fibrosis. Cirrhosis and dysplasia were not present. Cholecystectomy revealed chronic cholecystitis with a cholesterol polyp."} +{"pid": "TCGA-B0-4718", "report": "The surgical specimen includes a left kidney, proximal ureter, and adrenal gland. A mass measuring 8 cm in greatest dimension is located in the lower pole of the kidney. The mass is well-circumscribed and surrounded by fibrosis. A separate extrarenal satellite nodule measuring 0.6 cm is identified within the perirenal adipose tissue, located opposite the hilum and approximately 1 mm from the main lesion. This nodule is also well-defined and was entirely submitted for histologic evaluation. No direct connection between the two lesions was observed on deeper sectioning. There is no involvement of the renal vein or presence of tumor thrombus. Focal microscopic angiolymphatic invasion is present. All surgical margins are free of abnormal cellular proliferation.\n\nHistologic evaluation reveals cells with nuclear features corresponding to a Fuhrman nuclear grade of 2. The background renal parenchyma shows no significant findings. A portion of benign adrenal tissue was also identified. No evidence of residual lymph node architecture or vascular wall involvement was found around the satellite nodule. Lymph node assessment was not performed as no regional lymph nodes were identified for evaluation. Based on pathologic staging criteria, the extent of primary tumor growth corresponds to pT3a. Distant metastasis staging could not be fully assessed (pMX). No other significant findings were noted in the submitted specimen."} +{"pid": "TCGA-69-8255", "report": "De-Identified Specimen Code: M. SPECIMEN SUBMITTED: Part A: POSTERIOR SEGMENT RIGHT, UPPER LOBE. Part B: LEVEL 10 R.\n\nThe specimen consists of a wedge of lung tissue measuring 14.8 x 5.2 x 2.7 cm and weighing 39.1 grams. A staple line is present and marked with orange ink. The pleural surface shows a puckered area measuring 1.2 x 0.8 cm, located 3.2 cm from the orange inked parenchymal margin. This area is marked with blue ink. Upon sectioning, a stellate tan-gray firm nodule measuring 1.6 x 1.2 x 1.0 cm is identified within the puckered region. The nodule extends within 2.7 cm of the parenchymal resection margin and appears to extend into, but not through, the pleura. The remainder of the lung tissue appears unremarkable. The nodule and surrounding tissue are entirely submitted for analysis, including sections of the closest pleural involvement, resection margins, and representative areas of uninvolved tissue.\n\nPart B consists of a tan-black nodule resembling a lymph node, measuring 0.4 x 0.3 x 0.2 cm. It is not sectioned and is submitted in its entirety.\n\nMicroscopic findings have not been entered. Mild centrilobular emphysema is noted. No evidence of invasion through the pleura is observed. The parenchymal margin of excision is free of abnormal cells. Further studies are planned to determine the origin of the nodule, and results will be reported as an addendum. Intraoperative assessment indicates no residual disease at the margin. The clinical context includes lung nodules."} +{"pid": "TCGA-MA-AA42", "report": "The cervical biopsy specimen consists of multiple tissue fragments measuring 2.0 x 2.0 x 0.4 cm in total. Microscopic examination reveals the presence of a poorly differentiated malignant neoplasm. The tumor involves the full extent of the tissue fragments, with the largest focus measuring 4.0 mm in greatest dimension. The architecture and cellular morphology are atypical, prompting further classification evaluation.\n\nImmunohistochemical staining demonstrates positivity for CK 5/6, p63, and p16. The tumor is negative for CEA and S100. Additionally, in-situ hybridization for EBV and immunohistochemical staining for HPV are both negative. These findings are under review for further characterization due to unusual morphologic features. The depth of invasion could not be determined because the biopsy is fragmented.\n\nThe case was reviewed by multiple pathologists, and consensus has been reached on the current interpretation. A final classification will be provided following additional workup."} +{"pid": "TCGA-BR-6455", "report": "The gastrectomy specimen includes a tumor measuring 12 x 7 x 2 cm with an ulcerated surface. The tumor involves adjacent structures, including the lesser and greater omentum. Histologic evaluation shows poorly differentiated cellular features. A total of 19 lymph nodes were examined, with 2 showing evidence of involvement. No assessment was available for lymphatic, venous, or perineural invasion, and margins could not be confirmed. No evidence of prior neoadjuvant treatment was identified. No additional findings were noted."} +{"pid": "TCGA-BH-A0E6", "report": "The specimen was received from a left segmental mastectomy. The lesion measured 1.3 cm on gross examination. Histologic evaluation demonstrated high-grade features with a Nottingham grade of 3/3, based on a combined Nottingham score of 9/9. This included scores of 3/3 for tubule formation, nuclear atypia, and mitotic activity. A component of ductal carcinoma in-situ was also present, characterized by nuclear grade 3, solid type morphology, comprising less than 1% of the tumor volume. Surgical margins were free of involvement, with the closest margin being anterior at 0.4 cm. No lymphovascular invasion was identified. The surrounding breast parenchyma was predominantly adipose. Changes related to biopsy site were noted. Immunohistochemical studies showed negative hormone receptor status, and HER-2/neu testing was equivocal without amplification confirmed by FISH."} +{"pid": "TCGA-DD-AAC8", "report": "The liver specimen measured 26.0 x 19.0 x 10.0 cm and weighed 1264.0 grams. The gallbladder measured 8.0 cm in length, 3.5 cm in width, and 2.0 mm in thickness. The tumor was located in the right lobe of the liver and measured 12.5 x 9.0 x 15.0 cm. There was no satellite nodule present. The gross appearance was vaguely nodular without necrosis, hemorrhage, or peliosis. There was no portal vein, bile duct, hepatic vein, or hepatic artery invasion. Microscopically, the lesion showed moderately differentiated cells with a trabecular growth pattern. A partial fibrous capsule was present with capsular infiltration observed. There was no septum formation or serosal invasion. The surgical resection margin was negative with a clearance of 2.0 cm. Microvessel invasion was present; however, there was no intrahepatic metastasis or multicentric occurrence. \n\nEvaluation of the non-tumorous liver parenchyma revealed chronic hepatitis associated with HBV infection. The lobular grade was minimal, and the portoperiportal grade was mild, with fibrosis limited to the periportal areas. There was no cirrhosis, dysplastic nodule, or ductal epithelial dysplasia identified. Trichrome staining showed stage 2 fibrosis. The gallbladder showed features of chronic cholecystitis. Special stains and immunohistochemistry were recommended for further evaluation."} +{"pid": "TCGA-JX-A3Q0", "report": "The patient is a female who underwent examination under anesthesia, cystoscopy, and biopsies of the bladder and cervical regions. Two biopsy specimens were received. The bladder biopsy consisted of six small, pale white to glistening yellow tissue fragments, with the largest measuring 0.7 x 0.1 x 0.1 cm. Histologic evaluation of these fragments revealed markedly inflamed transitional mucosa with reactive epithelial atypia, but no malignant cells were identified.\n\nThe vaginal-cervical biopsy consisted of a single tan-brown tissue fragment measuring 1.0 x 0.7 x 0.4 cm, with a roughened and friable surface. Histologic sections from this specimen demonstrated a moderately differentiated neoplasm composed of squamous cells with associated architectural distortion. No involvement of the bladder biopsy site by this process was observed. All tissue fragments from both specimens were fully submitted for analysis."} +{"pid": "TCGA-VS-A958", "report": "The biopsy specimen from the cervix measures 1.5 cm in greatest dimension. Histologic evaluation reveals a moderately differentiated invasive carcinoma composed of sheets and nests of cells with nuclear atypia, increased nuclear-to-cytoplasmic ratio, and frequent mitotic figures. The tumor cells lack significant keratin production. Invasion is noted into the underlying stroma, with involvement of the cervical tissue. No lymphovascular space invasion is identified. The margins are involved by tumor. Immunohistochemical staining shows positivity for p40 and p63. A staging workup indicates no evidence of distant metastasis."} +{"pid": "TCGA-OR-A5JG", "report": "The histopathology report includes multiple specimens submitted for analysis, including several lymph nodes and tissue samples from the left side of the body, near the renal and coeliac arteries, as well as a thoracic duct and left radical neck dissection. A Weiss score of 9 was recorded. The mitotic count reached up to 100 per 50 high power fields. Immunohistochemical staining showed negative results for IGF2, with focal weak staining for glucocorticoid receptor. Ki-67 proliferative index was 30%, and ACADVL was positive.\n\nSpecimens included a lobulated grey nodule measuring 15 x 8 x 5mm, two grey nodules measuring 6 x 5 x 3mm and 6 x 3 x 2mm, and a larger specimen containing a left kidney, adrenal gland, adjacent lymph nodes, and surrounding fatty tissue measuring 240 x 160 x 100mm. The adrenal gland itself measured 65 x 65 x 40mm and was expanded by a solid grey tumour. Lymph nodes up to 40mm in diameter were also present. Other specimens included fatty tissue with embedded lymph nodes ranging in size from 3\u201330mm in diameter, and a small piece of grey tissue measuring 3 x 2 x 2mm. A silk suture was noted in one specimen associated with the thoracic duct.\n\nMicroscopic evaluation of the tissue revealed sheets and islands of metastatic cells in several nodules. The primary lesion involved the adrenal gland, with multiple nodules of similar cellular composition found near the kidney hilum, abutting the resection margin. Staining showed positive reactivity for Inhibin A and Melan A, while Cytokeratin, EMA, and chromogranin were negative. Lymphatic invasion was prominent. The left kidney showed no evidence of involvement. Metastatic cells were identified in lymph nodes from the greater curvature of the stomach, splenic vein, and retro aortic regions, as well as in the left radical neck dissection. No evidence of involvement was found in the thoracic duct or the aorto-caval node in front of the left renal vein."} +{"pid": "TCGA-DV-5566", "report": "The right kidney specimens include multiple nodules and cystic lesions. One lesion measured 2.5 cm in greatest dimension and was multifocal in distribution, limited to the kidney without extension beyond the organ. Histologic evaluation of several specimens revealed clear cell morphology with nuclear features corresponding to Grade II. Other specimens were described as cysts lined by atypical cells. The tumor was identified at pT1a stage with no assessment of lymph node or distant metastasis. Surgical margins could not be assessed. Adipose tissue submitted from the peritumoral region showed no evidence of tumor involvement. Specimens were obtained from various locations including the upper, mid, and lower poles of the right kidney."} +{"pid": "TCGA-EY-A548", "report": "The surgical specimen included the uterus, cervix, bilateral ovaries, and right fallopian tube. The lesion was located in the anterior and posterior endometrium and extended into the anterior and posterior lower uterine segment. It also involved the mucosa of the posterior endocervix. The lesion measured 6.3 x 5.8 x 1.8 cm and occupied approximately 75% of the endometrial cavity. It extended into the lower uterine segment and into the anterior and posterior endocervical canal by 1.0 cm. The tumor had a soft, rubbery, tan, smooth, and fungating appearance. There was no apparent myometrial invasion, with the myometrial wall measuring 1.5 cm thick at the deepest point of assessment. No serosal involvement was identified.\n\nInvolvement of the lower uterine segment was present, involving the mucosa of both the anterior and posterior aspects. Cervical involvement was also present, limited to the mucosa of the posterior endocervix, without evidence of cervical stromal invasion. All cervical margins were widely negative, with a distance greater than 2 cm from the ectocervix margin. Lymphovascular space invasion was not identified.\n\nA total of 12 regional lymph nodes were examined\u2014two from the left pelvic region and ten from the right pelvic region. All were negative for metastatic disease. No malignancy was identified in either ovary or the right fallopian tube. Additional findings included atrophic changes in the cervix with Nabothian cysts, hyper- and parakeratosis, and acute and chronic cervicitis. A leiomyoma with hyalinization was noted, ranging in size from 4 mm to 3.2 cm. Adenomyosis was also present, with involvement confirmed by histologic evaluation. Scant uterine serosal adhesions were observed alongside background atrophic endometrium.\n\nImmunohistochemical staining (CD10) demonstrated involvement of endometrial glands and stroma within adenomyosis, with no evidence of invasive carcinoma. Clinical staging based on available data was assigned as pT1a pN0 according to AJCC criteria and Stage IA by FIGO (2008 classification). These staging assessments are subject to revision pending further clinical correlation.\n\nThe uterus weighed 170 grams and had a pyriform shape, measuring 9.6 cm in height, 5.1 cm in anterior-posterior width, and 6.3 cm in breadth at the fundus. The serosal surface was pink-tan and smooth. The cervix appeared pink/white on the ectocervix and tan with a surface adherent mass on the endocervix, located 0.6 cm from the external os. The endocervical canal measured 1.8 cm in length. The uninvolved endometrium was tan, smooth, and less than 0.1 cm thick. The myometrium was pink-tan and trabeculated, with three white, homogeneous, rubbery nodules ranging from 0.4 cm up to 3.2 x 2.0 x 2.0 cm in dimension.\n\nThe right ovary measured 2.2 x 1.5 x 1.0 cm with an unremarkable external and cut surface. The right fallopian tube was 4.3 cm long and 0.5 cm in diameter, with no significant abnormalities. The left ovary measured 3.2 x 1.3 x 1.3 cm and was also unremarkable. The left fallopian tube was not present. No additional lymph nodes were identified outside of the designated specimens.\n\nBlocks were submitted for microscopic evaluation, including sections from the cervix, lower uterine segment, corpus, mass, intramural nodule, and adnexal structures. Specimens B and C consisted of adipose tissue containing multiple lymph nodes, all of which showed no evidence of metastasis. Some lymph nodes exhibited endosalpingiosis but no malignant involvement.\n\nImmunostains were performed using analyte-specific reagents under CLIA-certified conditions. Controls were appropriately evaluated, and results were interpreted for clinical use."} +{"pid": "TCGA-BH-A0HW", "report": "A right segmental mastectomy specimen from the upper inner quadrant demonstrates a focus of necrotic tissue with cribriform architecture and microcalcifications. The lesion measures 2.0 cm in greatest dimension and extends to the inked posterior surgical margin, approaching the inked inferior surgical margin within 0.1 cm. All other surgical margins are free of abnormal tissue. Histologic evaluation reveals a Nottingham score of 6 out of 9, with tubule formation score of 2, nuclear grade of 3, and mitotic activity score of 1. The surrounding tissue shows fibrocystic changes with florid ductal epithelial hyperplasia, associated microcalcifications, reactive fibrosis, hemosiderin pigment, and fat necrosis, likely related to prior biopsy. A microscopic perilymphatic hemangioma is incidentally noted.\n\nA re-excision of the deep margin at the inferior posterior region shows residual tissue with thermal artifacts, and no tumor is identified at the newly inked resection margins. Skeletal muscle in this area does not show any significant pathology.\n\nTwo sentinel lymph nodes were retrieved from the right axillary region and both are negative for metastatic disease. Immunohistochemical staining of the primary tissue shows positivity for estrogen receptors, negativity for progesterone receptors, and equivocal (2+) expression for HER-2/neu without evidence of gene amplification. No dermal lymphatic invasion is observed. Microcalcifications are present in both benign and malignant zones. The pathological staging is pTic, pN0, pMX. Non-neoplastic findings include usual ductal hyperplasia."} +{"pid": "TCGA-A2-A25E", "report": "The specimen from a left breast mastectomy and axillary contents includes a breast measuring 12.6 x 11.6 x 1.6 cm with overlying nipple-bearing skin measuring 7.2 x 5.5 cm and attached axillary tissue measuring 12.5 x 3.5 x 0.9 cm. A well-healed 2.0 cm scar is noted on the lateral aspect of the skin ellipse. Multiple firm lymph nodes are identified in the axilla.\n\nSerial sectioning of the breast reveals extensive fibrous tissue with a multiloculated biopsy cavity measuring 1.2 cm in the lower outer quadrant, associated with hemorrhage and fat necrosis. A separate mass measuring 2.0 x 1.4 x 1.4 cm is identified in the upper outer quadrant.\n\nHistologic evaluation demonstrates residual invasive cells with moderately differentiated features based on combined histologic criteria located in the biopsy cavity area and lower outer quadrant. An additional tumor focus is identified in the upper outer quadrant measuring approximately 2.0 cm grossly. The tumor is within 1 mm of the superior superficial margin. High-grade intraductal proliferation with intermediate differentiation and predominantly solid and cribriform patterns is present. In one section (A12), intraductal proliferation extends within 1.0 mm of the deep surgical margin.\n\nSix out of ten axillary lymph nodes show involvement with extension beyond the nodal capsule observed. Sections of skin and nipple show no abnormal cellular infiltration. Additional findings include benign fibrocystic changes and biopsy-related alterations.\n\nMargins assessed include medial, lateral, superior, and inferior. Several lymph nodes are sampled from the axillary tail. Staging assessment indicates regional lymph node involvement with multiple positive nodes and extracapsular extension. The primary site shows two distinct areas of involvement with differing morphologic characteristics."} +{"pid": "TCGA-AG-3601", "report": "The specimen consists of a resected segment of rectosigmoid colon with a deeply ulcerated and extensive lesion. Microscopic examination reveals moderately differentiated adenocarcinoma of the colorectal type, characterized by widespread infiltration into the perirectal fatty tissue. Two local lymph node metastases were identified among the 17 lymph nodes examined. The tumor reaches the circumferential resection margin, while the mesenteric and colon resection margins are free of tumor involvement. Additional soft tissue samples from the periureteral region show infiltration by carcinoma. Histological grade is G2. Lymphatic invasion is present (L1), while vascular invasion is not observed (V0). Resection status is classified as R2."} +{"pid": "TCGA-MQ-A6BN", "report": "The specimen consists of two parts labeled as pleural tumor. Part 1 includes three fragments of tan soft tissue measuring between 0.2 x 0.2 x 0.2 cm and 1 x 0.4 x 0.2 cm. Part 2 is a single piece measuring 1.4 x 1.2 x 0.3 cm with a 0.8 cm tan firm plaque noted on the surface. All tissues were submitted in entirety for analysis.\n\nMicroscopic evaluation of the tissue shows a malignant epithelioid tumor. The cells demonstrate certain morphological features consistent with a neoplastic process. Immunohistochemical staining was performed and showed diffuse positivity for cytokeratin (AE1/AE3) and CK5/6. There was focal positivity for calretinin and WT1. The tumor did not express mCEA, Ber-EP4 (with rare weakly positive cells), or TTF1.\n\nThe findings were confirmed through intradepartmental review and are based on frozen section analysis. All relevant sections (1A and 2A) were evaluated in toto. Special stains used included AE1/AE3, Calretinin, WT1, Ber-EP4, mCEA, CK5/6, and TTF1.\n\nIntra-operative consultation concluded the presence of a malignant epithelioid tumor, with features favoring a specific type of pleural origin. The final evaluation was completed by the attending pathologist, who has reviewed the case and confirmed the findings. Some tests performed utilized analyte-specific reagents and were developed in-house; they have not been cleared or approved by the U.S. Food and Drug Administration, as such clearance is not required."} +{"pid": "TCGA-CV-5430", "report": "A widefield laryngectomy, partial pharyngectomy, and right hemithyroidectomy were performed. A tumor measuring 3.0 x 2.5 x 2.0 cm was identified in the right pyriform sinus with involvement of the right aryepiglottic fold and right false vocal cord. Histologic examination revealed high-grade cellular atypia with lymphatic and perineural invasion identified. Two out of two lymph nodes from the right neck dissection contained metastatic disease with extranodal extension; the largest metastasis measured 2.1 cm. No tumor was identified in the thyroid gland, which showed only chronic inflammation. Six lymph nodes from the left level 2 region and one lymph node from the right level 2 were examined and found to be negative. Margins including the posterior cricoid, right and left pharyngeal walls, and right submucosal region showed no evidence of tumor. The right glossopharyngeal sulcus showed in situ changes with areas suggestive of superficial invasion. Re-excision of this region confirmed carcinoma in situ with suspicion for minimal invasive component. Additional margins including the new right superior and inferior glossopharyngeal sulcus showed similar findings with focal moderate dysplasia noted in one area. Other margins evaluated were negative for tumor involvement."} +{"pid": "TCGA-06-5408", "report": "A left frontal brain mass was biopsied and histologically evaluated. The tissue samples showed a densely cellular lesion with areas of vascular proliferation and necrosis. Immunohistochemical staining demonstrated diffuse positivity for GFAP and p53. The Ki-67 labeling index was variable, reaching up to 60% in certain regions.\n\nMolecular testing was performed on extracted RNA and DNA from the tumor tissue. PCR analysis detected the presence of the EGFR variant III mutation. No evidence of methylated MGMT promoter sequences was found using real-time PCR following bisulfite modification of the DNA.\n\nHistologic evaluation of the biopsy specimens confirmed a high-grade neoplasm of glial origin. Frozen sections and smears were used intraoperatively to guide surgical management. Gross examination of the specimens revealed tan-colored tissue fragments measuring up to 1.0 x 0.9 x 0.4 cm in the second specimen.\n\nThe molecular findings suggest specific genetic alterations relevant to targeted therapy considerations. However, these results should be interpreted within the context of established diagnostic criteria and clinical findings."} +{"pid": "TCGA-SX-A71R", "report": "Result Date: Surgical Pathology Report.\n\nThe specimen consisted of a left renal mass resected via partial nephrectomy. The tumor measured 4.0 x 3.0 x 3.0 cm and was located in the lower pole of the kidney. It was unifocal and predominantly cystic, containing red-brown friable material with a rim of solid yellow-orange tissue. Gross examination revealed no extension into perinephric tissue, beyond Gerota's fascia, into the renal sinus, renal vein, or collecting system. Adrenal gland tissue was not identified in the specimen. The surgical margins were negative for tumor involvement, with a closest margin distance of 0.2\u20130.3 cm. The kidney weighed 45 grams with fat and 30 grams without fat, measuring 6.0 x 4.0 x 3.0 cm in dimensions.\n\nMicroscopic evaluation showed the lesion to be confined to the renal parenchyma without evidence of sarcomatoid differentiation or tumor necrosis. Nuclear grading according to Fuhrman classification was Grade 1 out of 4. No lymphovascular invasion was observed. Evaluation of non-neoplastic kidney tissue revealed no diagnostic abnormalities.\n\nSix lymph nodes were identified in the periaortic biopsy specimen, ranging from 0.6 cm to 2.0 cm in size. All were negative for metastatic involvement. Additional specimens included a cyst wall from the left lower pole, which showed benign renal cortical cystic changes with no evidence of malignancy.\n\nHistologic sections were processed using immunohistochemical tests developed and validated by the laboratory. These tests are performed under CLIA certification for high-complexity testing and are not considered investigational or research-based.\n\nPathologic staging was determined as pT1a, pN0. No biorepository samples were collected."} +{"pid": "TCGA-DX-A6BB", "report": "The clinical history includes a lobulated soft tissue mass identified on CT imaging extending from the mid abdomen to the pelvis, with associated bilateral renal cysts and hydronephrosis. A prior biopsy showed atypical smooth muscle proliferation, suggestive of a low-grade mesenchymal neoplasm. The specimens submitted for analysis included the appendix and an associated mass, a radical resection specimen of a pelvic mass, and an excision of an abdominal scar.\n\nGross examination of the appendix revealed a 9.0 x 4.0 x 3.0 cm specimen with attached mesoappendix measuring 5.0 x 2.5 x 2.0 cm. The distal third was dilated, containing abundant mucinous material within the lumen. The appendiceal wall reached a maximum thickness of 0.3 cm. Histological evaluation demonstrated a cystic lesion lined by mucinous epithelium with diverticulum formation and mucus extravasation into surrounding fat. No atypical epithelial changes were identified. The surgical margin was not involved.\n\nThe pelvic mass measured 19.0 x 18.8 x 15.2 cm and exhibited a white, nodular cut surface with focal gelatinous and hemorrhagic areas. Microscopic assessment showed a high-grade spindle cell proliferation with smooth muscle differentiation. Eight mitotic figures were observed in 10 high-power fields. Necrotic regions accounted for approximately 15% of the tumor, and the lesion extended to the surgical margin. Previous biopsy material was reviewed and consistent with this finding.\n\nThe abdominal scar specimen consisted of a 23.5 x 1.4 cm skin fragment with a linear scar; histology revealed only fibrotic tissue without significant cellular atypia.\n\nAll specimens were examined microscopically following standard sectioning and staining procedures. Tissue procurement for further testing was completed prior to final photographic documentation and processing."} +{"pid": "TCGA-EB-A51B", "report": "A skin flap measuring up to 8 x 5 cm was examined, which included a pigmented, mushroom-like lesion up to 2 x 1 cm in size. The lesion showed areas of ulceration. Microscopic evaluation revealed a pigmented lesion with features of deep dermal invasion reaching the papillary-reticular dermal interface, corresponding to Clark's level III. The lesion measured 10 mm in thickness by Breslow measurement and was associated with perifocal lymphocytic infiltration. No venous invasion was identified. The specimen margins were uninvolved. No satellite nodules, lymphatic invasion, or lymph node involvement were specified. There was no evidence of neoadjuvant treatment effect. No additional pathologic findings or specific comments were provided."} +{"pid": "TCGA-A7-A0CD", "report": "The specimen included sentinel lymph nodes and a left breast mass, along with additional tissue samples from various locations. Sentinel node #1 measured 1.5 cm and was entirely frozen. Sentinel node #2 measured approximately 1.1 cm and was also entirely frozen. The left breast mass measured 10 x 7.5 x 5.4 cm and contained a central firm lesion measuring 1.5 cm in greatest dimension. This lesion was partially sampled for research. Margins of the breast specimen were inked in different colors for orientation. Additional specimens from the 6, 12, 9, and 3 o\u2019clock positions ranged in size from 3 x 1.5 x 1 cm to 3.2 x 1.5 x 1 cm and were fixed in formalin.\n\nMicroscopic examination of both sentinel lymph nodes revealed no evidence of malignancy. The primary lesion showed features consistent with invasive carcinoma. Histologic grade was 2 based on Elston SBR criteria (A/N/M = 3/2/1). Mitotic activity was minimal with no mitoses identified per 10 high-power fields. The tumor measured 1.5 cm and was located 1 cm from the nearest inked margin. No vascular invasion or calcifications were observed. Adjacent non-tumorous breast tissue demonstrated apocrine metaplasia, cyst formation, and intraductal epithelial hyperplasia without atypia. Staging was determined as pT1.\n\nAdditional biopsies taken from other areas of the breast specimen showed only mild fibrocystic changes and were negative for malignant cells. Further sections obtained from the inferior portion of the main specimen confirmed cystic changes, focal intraductal epithelial hyperplasia, periductal elastosis, apocrine metaplasia, minor cyst rupture, and arteriolar medial calcification. No further malignant involvement was identified. All surgical margins were free of tumor."} +{"pid": "TCGA-AP-A0LD", "report": "The submitted specimens include the uterus, cervix, right tube and ovary, a left tubal/ovarian myoma, and multiple lymph node groups from both left and right sides, including para-aortic, external iliac, obturator, hypogastric, and common iliac regions.\n\nExamination of the uterine specimen reveals a lesion with predominantly solid growth involving more than half of the myometrium. The maximal thickness of myometrial invasion is 20 mm, within an area where the total myometrial thickness is 23 mm. Vascular invasion is extensively present. The endometrium shows atrophic changes, and the myometrium contains leiomyomas. The cervix does not show evidence of involvement. The adnexal structures are unremarkable. The left ovary and fallopian tube show no significant pathology, along with a benign leiomyoma measuring 4.0 cm. All other lymph node specimens are negative for malignant involvement, with the exception of the right common iliac region, where no lymph nodes were identified."} +{"pid": "TCGA-27-2519", "report": "Birth date. Tumor site: right frontal. The lesion demonstrates a high degree of cellular atypia, with marked pleomorphism and frequent mitotic figures. Necrosis is present, along with microvascular proliferation. The tumor infiltrates the surrounding brain tissue. Immunohistochemical staining shows positivity for GFAP and MGMT. The Ki-67 proliferation index is elevated, indicating a high growth fraction. No definitive molecular markers are included in this summary."} +{"pid": "TCGA-A2-A0SU", "report": "The surgical specimen from the left breast measures 21 x 20 x 4.5 cm and includes a skin ellipse measuring 11.2 x 6.5 cm with a grossly unremarkable nipple. Three distinct lesions were identified. The first is a 0.9 x 0.1 x 0.9 cm lesion located 2.5 cm from the deep margin. A second, larger lesion measuring 2.2 x 1.6 x 1.5 cm was found lateral to the first, at a distance of 2 cm from the deep margin. These two lesions are separated by approximately 1.5 cm. A third, smaller superficial lesion measuring 0.5 cm in greatest dimension was noted medially, located 2.5 cm from the first described lesion and 4 cm from the deep margin. All margins were sampled. The remaining breast tissue consists of bland yellow fatty tissue with fine fibrous bands.\n\nMultiple sections were submitted for analysis, including those from the upper outer quadrant, upper inner quadrant, lower inner quadrant, lower outer quadrant, and the nipple. The largest lesion is located superior to the nipple, and the distribution of these lesions follows a pattern within the upper inner quadrant of the breast.\n\nThree sentinel lymph nodes were examined. The first node, measuring 0.7 cm, showed an isolated focus of atypical cells measuring 0.01 mm on cytokeratin staining, identified only in the first of three step-sections. The second node, measuring 2.2 cm in length, and the third, a small ovoid node, both showed no evidence of atypical cells on routine or cytokeratin stains. The third node did not show gross nodal tissue upon sectioning.\n\nA separate piece of superficial breast tissue from the left side, measuring 2.9 x 2.0 x 0.5 cm, was submitted after re-excision. The new inked margin was free of any abnormal cellular findings.\n\nThe right breast tissue, weighing 256 grams, included fibrofatty tissue and skin. Sectioning revealed bland yellow fatty tissue with fine fibrous bands. No significant areas of fibrosis or masses were identified. Representative samples were submitted for histological review. A focus of atypical lobular hyperplasia was noted in this tissue.\n\nImmunohistochemical staining was performed. Cellular features included moderately differentiated intraductal and infiltrating components with nuclear grade 2 and a moderate mitotic index. An in situ component was also present, accounting for 5\u201310% of the total area, composed of solid and cribriform patterns. Lymphatic invasion could not be ruled out based on histological findings. Ductal changes were present in the deep ducts of the nipple skin; however, the nipple skin and deep margins were free of any abnormal cells. The three tumors measured 2.2 cm, 1.0 cm, and 1.0 cm, with one involving the superficial margin.\n\nOncotype testing was performed, yielding a recurrence score of 14. In clinical validation studies, patients with a score of 14 had an average 10-year distant recurrence rate of 9% (95% CI: 6%\u201312%)."} +{"pid": "TCGA-B0-4846", "report": "The specimen from the right kidney measured 7.6 cm in maximum dimension. Histologic examination revealed a neoplasm composed of cells with abundant clear cytoplasm and nuclear features corresponding to grade 2 according to the Fuhrman nuclear grading system. The tumor was found to be confined within the renal capsule; however, there was evidence of invasion into the sinus fat as noted on slide 1C. No involvement of the renal vein or angiolymphatic invasion was identified. The adjacent non-neoplastic kidney tissue appeared histologically unremarkable. No portion of the adrenal gland was submitted for evaluation. Based on the extent of local invasion, staging classification was determined as pT3a. The histologic grade corresponds to intermediate differentiation. A separate lesion from the liver, segment 6, was diagnosed as a benign vascular lesion."} +{"pid": "TCGA-KN-8432", "report": "The submitted specimen consists of a right kidney with attached perinephric adipose tissue, measuring 14.5 x 10.5 x 5.5 cm and weighing 613 grams. A segment of ureter is present, measuring 14 cm in length and 0.4 cm in diameter. No adrenal gland is identified. The tumor is located in the upper pole of the kidney and measures 11.5 x 9 x 9 cm. It has a solid, tan, brown, and hemorrhagic cut surface. The tumor is unifocal and confined to the kidney, without evidence of invasion into perinephric fat, renal sinus, or renal vein. No other lesions are identified within the renal parenchyma.\n\nMicroscopically, the tumor is composed of cells with specific features, including a particular growth pattern and nuclear characteristics. There is no evidence of tumor necrosis or lymph-vascular invasion outside of the renal vein and its branches. All margins are free of invasive disease. No regional lymph nodes are submitted for evaluation, and no distant metastases are identified. The tumor is limited to the kidney and measures greater than 10 cm in greatest dimension. The nonneoplastic kidney tissue shows no significant findings."} +{"pid": "TCGA-CG-4449", "report": "The specimen includes lymph nodes, which are free of tumor. A total gastrectomy was performed and included a lesion in the prepyloric antrum of the stomach. The lesion measured up to 3 cm in maximum diameter and showed infiltration into the perigastric fatty tissue. Another lesion was also identified in the antrum, measuring 1.5 cm in diameter, with infiltration limited to the tunica submucosa. Both lesions were moderately differentiated and exhibited mucin production consistent with intestinal-type morphology. Six regional lymph node metastases were identified along the greater curvature. The esophageal resection margin was covered with normal squamous epithelium and was free of tumor, as were the duodenal resection margin and omental tissue."} +{"pid": "TCGA-HC-A8D0", "report": "The prostate measured 5.7 x 2.9 x 2.9 cm and weighed 36 grams. Histologic evaluation demonstrated a lesion occupying 1 to 3% of the gland. Microscopic analysis revealed a primary histologic pattern graded as 3/5 and a secondary pattern graded as 4/5. No extraprostatic extension, seminal vesicle involvement, or lymphovascular space invasion was identified. High-grade prostatic intraepithelial neoplasia was focally present. All surgical margins\u2014including those at the apex, base, and inked prostatic surfaces\u2014were free of tumor involvement. A total of ten pelvic lymph nodes were examined, none of which contained metastatic disease. Perineural invasion was observed in the specimen. The staging classification assigned was pT2aNO. Pelvic lymph node tissue consisted of fibroadipose material with embedded lymphoid structures ranging from 0.2 x 0.2 x 0.1 cm to 6.2 x 2.1 x 0.7 cm; no malignant involvement was detected."} +{"pid": "TCGA-G2-A2EF", "report": "A specimen from the left wall of the bladder was received, consisting of multiple fragments of pink-gray, friable/rubbery tissue measuring a total of 4.0 x 4.0 x 3.5 cm. Microscopic evaluation revealed high-grade cellular changes with squamous differentiation. The lesion is invasive, extending into the muscularis propria, and exhibits lymphovascular invasion. There is extensive necrosis, inflammation, and reactive changes present. All tissue has been submitted for analysis in cassettes A1 through A6."} +{"pid": "TCGA-BP-4987", "report": "Clinical findings and history indicate a post-syncopal episode with a positive ultrasound showing a renal mass. The submitted specimen is a partial nephrectomy from the left kidney. Gross examination revealed a 4.3 x 4.0 x 3.5 cm renal specimen with surrounding fat measuring 1.5 cm in thickness. A suture marked the deep margin, which was inked black. Serial sectioning showed an ovoid, well-defined, heterogeneous mass with fibrous bands, myxoid areas, hemorrhage, and golden-yellow regions measuring 4.3 x 3.5 x 3.5 cm. The distance from the tumor to the resection margin was 0.1 cm. A representative section of the closest margin was submitted for frozen section analysis.\n\nMicroscopic evaluation demonstrated nuclear features corresponding to grade II on a four-tier scale. No evidence of local invasion or renal vein involvement was observed. All surgical margins were free of tumor. The non-neoplastic kidney tissue exhibited minimal arteriosclerotic changes. No adrenal or lymph node tissue was identified in the specimen.\n\nStaging classification indicates a tumor not exceeding 7.0 cm in greatest dimension and confined to the kidney. Sections submitted include control, tumor, and margin blocks. Intraoperative consultation confirmed negative margins at the suture site. Permanent section diagnosis was consistent with frozen section findings."} +{"pid": "TCGA-DE-A4MB", "report": "The surgical specimens include a biopsy from the left thyroid cartilage margin, which shows carcinoma. Regional lymph node dissections were performed on levels 2 through 5 of the left neck. In level 5, five lymph nodes were examined and none contained metastatic involvement. Similarly, in level 4, nine lymph nodes were evaluated and no metastases were identified. In level 3, thirteen lymph nodes were assessed, with one containing metastatic involvement measuring less than 0.1 cm; there was no evidence of extracapsular extension. In level 2, nine lymph nodes were examined, two of which contained metastatic involvement, with the largest metastasis measuring 0.7 cm; again, no extracapsular extension was observed.\n\nA total thyroidectomy specimen weighed 30.5 grams and measured 7.9 x 5.0 x 3.0 cm overall. The left lobe measured 5.6 x 4.8 x 1.8 cm and the right lobe measured 3.4 x 2.3 x 1.1 cm. The tumor occupied the entire left thyroid lobe and measured 4.4 x 3.7 x 1.8 cm. It appeared solid, firm, tan, gritty, and ill-defined. The growth pattern was infiltrative, with extensive invasion into perithyroidal soft tissues, including skeletal muscle. Surgical margins were extensively involved at the posterior aspect and close involvement (<0.1 cm) was noted at the anterior margin. The inferior en face margin also showed involvement.\n\nMultifocality was present with multiple small lesions identified in the right lobe measuring 0.1 cm, 0.1 cm, 0.2 cm, and less than 0.1 cm. No vascular or lymphovascular invasion was identified. The remainder of the thyroid gland showed multinodular changes, including a 1.2 cm colloid nodule near the isthmus.\n\nA total of 36 lymph nodes were evaluated across all specimens, with three showing metastatic involvement. The largest metastasis measured 0.7 cm. There was no evidence of extracapsular extension.\n\nOther findings included benign skeletal muscle and soft tissue in multiple specimens. Benign thyroid tissue was identified away from the primary lesion. Clinical history indicated a female patient with a left thyroid mass previously suspicious for malignancy on fine needle aspiration. Frozen section analysis confirmed the presence of carcinoma at the left thyroid cartilage margin."} +{"pid": "TCGA-98-A53D", "report": "A total of thirteen specimens were examined, including multiple lymph node levels and a right upper lobe lung resection. Lymph nodes evaluated included those from levels II-R (two specimens), IV-R (three specimens), VII, VIII, IX, X (one specimen), X-R (five lymph nodes), and XI. All lymph nodes were negative for malignancy. One lymph node from level VIII was absent upon examination.\n\nThe right upper lobe lung specimen contained a subpleural lesion measuring 5.2 cm in greatest dimension. Histological evaluation revealed a moderately differentiated, keratinizing epithelial tumor. The tumor invaded into the visceral pleura but did not involve the bronchial margin or the peribronchial lymph node, both of which were negative for malignant cells. Surgical margins, including the staple line margin, were free of tumor involvement. No lymphovascular invasion was identified. A total of 14 lymph nodes were examined, and none showed evidence of metastasis. The tumor was unifocal and measured greater than 5 cm but less than or equal to 7 cm in greatest dimension."} +{"pid": "TCGA-55-8096", "report": "The surgical specimen consists of a lateral segment of the left upper lobe, along with lymph nodes from levels VI and IX. The lung tissue measures 11.8 x 8.8 x 4.0 cm and is covered by purple-gray pleura with anthracotic pigmentation. Two staple lines are present, measuring 17.5 cm and 4.0 cm in greatest dimension. A focal area of pleural umbilication measuring 1.0 x 1.0 x 0.5 cm is noted and inked blue. The staple lines were removed, and the underlying parenchyma was inked black for margin assessment.\n\nA mass measuring 3.8 x 2.8 x 2.5 cm is identified within the lung parenchyma. It has a gray-white, friable, and soft cut surface and is located adjacent to the pleura at the site of umbilication. The mass approaches within 0.7 cm of the inked parenchymal margin and involves the pleural surface. The remainder of the lung tissue shows beefy red congestion and areas of emphysematous change, but no additional masses are observed. No discrete lymph nodes are found within the lung specimen.\n\nHistologically, the mass demonstrates moderately differentiated cellular features. Visceral pleural invasion is present. There is no evidence of lymphovascular space invasion. Surgical margin evaluation reveals that the tumor is within 0.7 cm of the bronchial margin and also within 0.7 cm of the parenchymal (stapled) margin. The tumor directly involves the pleural surface.\n\nLymph node specimens from levels VI and IX are each described as single lymph nodes without evidence of malignant involvement. Both measure approximately 1.0 cm and show anthracotic pigmentation. They were entirely submitted for histologic evaluation.\n\nStaging based on pathologic findings indicates T2 classification. Additional molecular studies are planned on the tissue, and a separate report will be issued for those results."} +{"pid": "TCGA-BG-A0MO", "report": "The specimen consists of a uterus and cervix with bilateral adnexa, submitted following total abdominal hysterectomy with bilateral salpingo-oophorectomy, weighing 80 grams. A focus of interest is identified within the endometrium, characterized as well-differentiated with features of squamous differentiation. The lesion measures approximately 2.5 cm in greatest dimension and involves approximately 95% of both the anterior and posterior endometrial surfaces. No evidence of lymphovascular invasion is observed. The depth of involvement extends into the myometrial wall to a distance of 0.5 cm, representing approximately 36% of the total myometrial thickness (1.4 cm). The cervical tissue shows no abnormal infiltrative process. The right and left fallopian tubes contain paratubal cysts, chronic salpingitis, and reactive changes. The ovaries demonstrate endosalpingiosis and benign surface fibromas. All lymph node biopsies obtained from right and left pelvic, obturator, common iliac, and periaortic regions are negative for atypical cells, with a total of 17 lymph nodes examined. The vaginal and parametrial margins are free of disease. Architectural and nuclear features are consistent with low-grade morphology. The depth of involvement is less than half the myometrial thickness. Staging classification is pT1b, pN0, pMX."} +{"pid": "TCGA-J4-A83N", "report": "The prostate specimen, weighing 30 grams, measured 4 x 2.8 x 3 cm and was submitted with seminal vesicles and vas deferens. Histologic evaluation showed a dominant nodule measuring 1.3 cm. The tumor was located bilaterally, primarily in the mid and peripheral zones. Gleason scoring was 3 + 4 = 7/10. Tumor involvement was estimated at 5\u201315% of the tissue. No extraprostatic extension, lymphatic (small vessel) invasion, or perineural invasion was identified. No tumor was found in the seminal vesicles or at the surgical margins. A focus of intraductal carcinoma and high-grade prostatic intraepithelial neoplasia was present. The TNM staging was pT2c, pNX, pMX. All surgical margins were negative. Multiple sections of the prostate, including anterior, posterior, superior, left and right glands, and areas adjacent to the seminal vesicles and vas deferens, were examined. No treatment effect was observed."} +{"pid": "TCGA-78-8662", "report": "The right upper lobectomy specimen measured 150 x 130 x 45 mm when inflated. A firm cream-colored nodule measuring 27 mm in maximum dimension was identified deep to a puckered area of the pleural surface. The lesion extended to within 1 mm of the medial pleural surface but did not involve the lateral pleural aspect or the bronchial resection margin. The surrounding lung tissue showed emphysematous changes, predominantly in the apical region.\n\nMicroscopic examination revealed a moderately to poorly differentiated adenocarcinoma with a central fibroelastotic scar. There was evidence of visceral pleural invasion, with apparent focal involvement of the pleural surface. No lymphatic, vascular, or perineural invasion was observed. A small focus of tumor was also noted within the wall of a bronchus.\n\nExamination of hilar and intrapulmonary lymph nodes, as well as lymph nodes numbered 3, 4, and 10, showed no evidence of malignancy. The bronchial resection margin was free of abnormal cells.\n\nStaging was determined to be pT2 N0 MX."} +{"pid": "TCGA-B0-5084", "report": "The specimen from the right radical nephrectomy shows a neoplasm with nuclear features corresponding to Fuhrman grade 3-4. The tumor demonstrates extensive necrosis and measures 8.2 cm in greatest diameter. It extends into the renal sinus adipose tissue, but there is no evidence of renal vein invasion. Foci suggestive of angiolymphatic invasion are present. All surgical margins are negative. The non-neoplastic kidney appears normal. One hilar lymph node, measuring 3.8 cm, is entirely replaced by neoplastic cells with extracapsular extension. The adrenal gland shows no abnormal findings or signs of involvement."} +{"pid": "TCGA-B5-A11M", "report": "The clinical history is significant for endometrial hyperplasia. Gross examination of the uterus and cervix revealed a 256-gram, 12.5 x 8.5 x 5.5 cm uterus with a cervix measuring 3.6 cm in diameter. The uterine cavity measured 6.5 x 5 cm and was lined by diffusely thickened, shaggy endometrium, measuring up to 1.6 cm anteriorly and 1.4 cm posteriorly. The endometrium extended into both anterior and posterior lower uterine segments without gross myometrial invasion. A 2.5 x 2 cm area in the posterior endometrium showed flattening and white fibrous scarring located 1.6 cm from the lower uterine segment. Representative anterior endomyometrium was submitted for frozen section analysis. The myometrium had a maximum thickness of 3.1 cm and appeared diffusely trabeculated. A flap of vaginal epithelium attached to the posterior cervix measured 3.2 x 1 x 0.2 cm and was unremarkable. The uterine serosal surface was normal, and the ectocervix displayed multiple small pink wart-like nodules ranging from 0.1 to 0.2 cm, more prominent on the anterior cervix.\n\nBlocks were taken from various regions including the anterior endomyometrium, posterior vaginal flap margin, anterior and posterior cervix, anterior and posterior lower uterine segments, and additional endometrial and endomyometrial samples.\n\nThe right salpingo-oophorectomy specimen weighed 44 grams. The fallopian tube was 4.5 cm long and 0.6 cm in diameter. The ovary contained a predominantly smooth-walled ovarian cyst measuring 4.8 x 4.3 x 3.8 cm, with rare scattered tan nodules up to 0.2 cm. Upon opening, the cyst was unilocular, filled with serous fluid, with a smooth inner lining showing foci of hemorrhage but no excrescences. The wall thickness ranged from 0.1 to 0.2 cm. The cyst originated from the ovarian serosa, and the ovary was otherwise unremarkable. A 0.6 x 0.6 x 0.5 cm paratubal cyst filled with serous fluid was also noted adjacent to the fallopian tube, which had a patent lumen.\n\nThe left salpingo-oophorectomy weighed 14 grams. The ovary measured 3.1 x 2.1 x 1.8 cm and exhibited a roughened pink-tan serosal surface. Sectioning revealed several cortical cysts containing serous fluid, with the largest measuring 0.4 cm. The fallopian tube, 4.8 cm in length and 0.5 cm in diameter, had an unremarkable serosal surface and a patent lumen. Two paratubal cysts filled with serous fluid were identified, with the largest measuring 0.7 cm. Ovarian and fallopian tube tissues were submitted for analysis.\n\nA separate specimen of posterior vaginal tissue measured 1.7 x 1.2 x 0.5 cm, with a smooth epithelial lining on one surface and blue ink marking the deep margin. It was serially sectioned and submitted for evaluation.\n\nIntraoperative consultation on the anterior endomyometrium (AF1) revealed 1 mm of myometrial invasion within a 2.5 cm thick wall. Microscopic examination was performed, and the pathologic stage based on this tissue specimen was pT1B pNX pMX according to the AJCC 6th Edition criteria. This stage was determined solely from the current specimen and did not include data from other sources such as cytology, prior pathology, imaging, or clinical findings. The surgical procedure was documented as hysterectomy and oophorectomy. All other specimens, including the cervix, remaining myometrium, serosa, margins, right and left tubes and ovaries, and posterior vagina, showed no pathological diagnosis."} +{"pid": "TCGA-P5-A737", "report": "The clinical evaluation indicated a lesion in the brain. Gross examination revealed pink to white, soft-elastic tissue fragments obtained from the right frontal lobe. Histological analysis showed neoplastic cells within the brain parenchyma. The proliferation index (Ki67) was estimated at 5\u20136%. Based on histopathological features, the lesion demonstrated characteristics of a diffusely infiltrating glioma with mixed cellular morphology. Staging assessment indicated a low-grade variant."} +{"pid": "TCGA-78-8660", "report": "The specimen from the right lower lobe apical segmentectomy measures 140 x 60 x 40 mm when inflated. A diathermied resection margin covers an area of 70 x up to 45 mm and includes a bronchial resection margin along with a stapled vascular resection margin. A stapled parenchymal resection margin extends for 100 mm in length. The pleural surface is red and glistening, with areas of black carbon pigmentation and a linear scar measuring 30 mm opposite the stapled margin. Beneath this scarring, a nodule measuring 33 x 25 x up to 25 mm is identified; it has a well-defined outline and a homogenous, solid, cream-colored cut surface. The lesion is subpleural and may involve the pleura. It is at least 20 mm from the stapled margin, 40 mm from the bronchial margin, and as close as 10 mm to the diathermied margin. Adjacent lung tissue shows patchy carbon pigmentation without focal lesions or emphysematous changes.\n\nThe second specimen consists of six hilar lymph node fragments, measuring 15 x 10 x 5 mm in total. Histological evaluation reveals necrotic, moderately to poorly differentiated cells within the lung tissue that extend into the pleura. Vascular and lymphatic involvement is present, though no perineural invasion is observed. The surgical and bronchial margins are free of abnormal cells. Emphysematous changes are mild in distant lung parenchyma. Lymph node fragments show replacement by necrotic transformed cells.\n\nStaging is based on extent of spread, with size and regional involvement considered."} +{"pid": "TCGA-DK-A2HX", "report": "A biopsy of a small intestinal implant revealed a spindle cell proliferation, measuring 0.9 cm. Immunohistochemical staining demonstrated diffuse positivity for CD117 and was negative for S100, desmin, and HHF35.\n\nExcised lymph nodes from the right common iliac region showed no evidence of malignancy. A total of 1 lymph node was examined.\n\nIn the right pelvic lymph nodes, metastatic involvement was identified. Of 17 lymph nodes examined, 2 contained metastatic deposits. The largest involved lymph node measured 1.2 cm, with the largest metastatic focus measuring 0.2 cm. No extranodal extension was observed.\n\nPresacral lymph node dissection revealed one involved lymph node out of 6 examined. The largest metastatic focus measured 0.005 cm, and the largest affected lymph node measured 0.15 cm.\n\nA single lymph node from the Marcille\u2019s region was examined and found to be benign.\n\nIn the left pelvic lymph nodes, 10 were examined, with 1 showing metastatic involvement. The largest involved lymph node measured 1.3 cm, with a metastatic focus measuring 0.18 cm. There was no extranodal extension identified.\n\nLymph nodes from the left common iliac region consisted of benign fibroadipose tissue.\n\nRadical cystectomy specimens showed a diffusely infiltrative tumor involving the bladder wall. The lesion measured 5.5 x 3.5 x 3.0 cm and was located in the left posterolateral wall extending to the dome. Histologic evaluation revealed high-grade features and mixed growth patterns including micropapillary and signet ring cell morphology. Some treatment-related changes were noted. Perivesical soft tissues were involved, and tumor extended into the soft tissue around both ureters. Vascular and perineural invasion were present. Tumor was identified at both ureteral surgical margins. Non-neoplastic mucosal changes included ulceration, foreign body reaction, and proliferative cystitis. No pathological changes were observed in the vaginal tissue. No discrete perivesical lymph nodes were identified.\n\nThe left ureteral stent was removed and examined grossly only.\n\nStaging according to AJCC 2002 criteria was determined based on the depth of invasion into perivesical soft tissue."} +{"pid": "TCGA-2Z-A9J8", "report": "The specimen was received fresh in three containers. Specimen A, labeled \u201cLeft rib,\u201d consisted of two unoriented fragments of rib ranging from 1.0 to 3.0 cm in length, with a small amount of adjacent tan, red-brown, soft to rubbery tissue. Both resection margins were grossly unremarkable. Tangential sections of both resection margins were submitted in two cassettes following decalcification.\n\nSpecimen B, labeled posterior medial cyst wall, was an irregular, unoriented fragment of tan, red-brown, rubbery tissue measuring 0.6 x 0.2 x 0.1 cm and was submitted entirely for frozen section. Histologic evaluation showed vascularized fibroadipose tissue with chronic inflammation and adjacent renal parenchyma. No atypical cells were identified.\n\nSpecimen C, labeled left renal mass, was a partial nephrectomy specimen measuring 5.5 x 5.0 x 4.5 cm, with a moderate amount of adjacent thin capsule and perinephric adipose tissue ranging from 0.1 to 0.9 cm in thickness. The parenchymal resection margin was tan and red-brown, and grossly unremarkable. The specimen was oriented according to the surgeon\u2019s designation and inked: parenchymal resection margin in black and perinephric adipose tissue margin in blue. Serial sectioning revealed an irregular to ovoid, ill-defined mass measuring 4.3 x 4.2 x 4.0 cm. The tumor did not appear to extend through the renal capsule and was within 0.1 cm of the inked margin. It was located 0.5 cm from the parenchymal resection margin. The cut surface of the tumor was variegated, tan-pink to tan-red, focally necrotic, and hemorrhagic.\n\nMicroscopic examination of the tumor showed a neoplastic proliferation arranged in a unifocal and solid pattern. The cells exhibited high nuclear grade. No renal capsule invasion, Gerota\u2019s fascia invasion, or renal vein involvement was identified. Angiolymphatic and perineural invasion were not present. Surgical margins were free of abnormal cells. Adjacent non-neoplastic kidney tissue appeared unremarkable. Adrenal gland and other related clinical data were not applicable.\n\nRepresentative sections of the tumor with adjacent renal parenchyma were submitted in cassettes C1\u2013C21. Additional sections included tumor bulk (C3\u2013C4), central portions of the tumor (C5\u2013C7), and areas of tumor near the capsule (C8\u2013C21). Frozen section analysis was communicated to and acknowledged by the surgical team. A final report was issued after full histologic evaluation."} +{"pid": "TCGA-HC-7079", "report": "The prostatectomy specimen measured 4.5 x 3.2 x 2.9 cm and weighed 28 grams. The left posterior mid-level region demonstrated a pale yellow discoloration measuring 1.0 cm in greatest dimension, adjacent to the inked margin. The seminal vesicles were unremarkable, measuring 5.8 x 1.5 x 0.6 cm combined. Histologically, a lesion was identified involving both lobes of the prostate. The histologic type was adenocarcinoma, conventional type. Gleason grading showed a primary pattern of 3/5 and a secondary pattern of 4/5, with a total Gleason score of 7/10. Perineural invasion was present in the mid-left posterior region, with no evidence of lymphovascular space invasion. High-grade prostatic intraepithelial neoplasia was not identified. Surgical margins were negative at the bladder neck and apical regions; however, tumor was present within 0.1 cm of the inked prostatic margin in the mid-left posterior area. A pelvic lymph node dissection included four lymph nodes ranging from 0.2 x 0.1 cm to 3.4 x 0.9 cm. No metastatic involvement was found in any of the lymph nodes. Additional findings included severe chronic prostatitis. The pTNM staging was determined as pT3a, NO, Mx."} +{"pid": "TCGA-OR-A5J6", "report": "The specimen consists of two vessels containing material preserved in formalin. The first vessel contains a right-sided mass weighing 1370 grams and measuring 20 x 13 x 7 cm. The external surface is grayish and homogeneous. The cut surface shows heterogeneous coloring with white and purple areas and a firm texture. Also present is a fragment of rib bone measuring 15 x 3 cm, which appears normal. The second vessel contains an irregular dark brown hepatic biopsy fragment measuring 2 x 1 cm.\n\nMicroscopic evaluation of the resected mass reveals a nuclear grade of 3 according to Fuhrman classification. A diffuse architectural pattern is observed, with clear cells comprising less than 25% of the tissue. No necrotic areas are identified. Mitotic activity is low, with fewer than 5 mitoses per 50 high-power fields. No atypical mitoses, capsular invasion, venous invasion, or sinusoidal invasion is detected. The scoring system applied yielded a result of 3. No neoplastic involvement is seen in the adjacent renal tissue.\n\nThe hepatic biopsy demonstrates regenerative changes consistent with a hyperplastic nodule. Immunohistochemical staining shows focal positivity for Melan A and 35BH11, and complete positivity for Inhibin. All other markers tested, including cytokeratin 20, cytokeratin 7, synaptophysin, Hep-Par 1, chromogranin, CEA, and calretinin, are negative."} +{"pid": "TCGA-AP-A05A", "report": "The submitted specimens include the uterus, cervix, bilateral fallopian tubes and ovaries, omentum, multiple left and right pelvic lymph node groups (external iliac, internal iliac, obturator, hypogastric), a portion of the right round ligament, and the gallbladder.\n\nMicroscopic examination of the uterine specimen reveals a lesion invading nearly the full thickness of the myometrium. The maximal depth of invasion is 10 mm within a myometrial thickness of 11 mm at that site. There is also evidence of involvement in the endocervix, with infiltration of both mucosa and underlying stroma to a depth of less than 1 mm. Vascular invasion is identified. Additional findings in the endometrium include cystic atrophy, while the myometrium contains benign leiomyomas. No abnormalities are noted in the adnexal structures.\n\nAll lymph node specimens from the left and right pelvic regions are benign, with no pathological involvement identified. The omental biopsy consists of benign adipose tissue. The gallbladder shows chronic inflammation with associated cholelithiasis. The right round ligament biopsy demonstrates benign fibromuscular tissue."} +{"pid": "TCGA-IW-A3M6", "report": "The specimen consists of a right salpingo-oophorectomy, uterine tissue following total abdominal hysterectomy, and a left salpingo-oophorectomy. The right ovary shows atrophic changes with cystic epithelial inclusion and serosal adhesions. Attached to the distal segment of the right fallopian tube is a small unilocular cyst containing clear fluid. Adhesions are present between the right ovary and fallopian tube.\n\nThe uterus measures approximately 14.5 x 10.0 x 9.0 cm. Within the myometrium, there is a large, heterogeneous mass estimated at 13.5 x 9.5 x 9.0 cm. This lesion diffusely involves the myometrium from the lower uterine segment to the fundus in both anterior and posterior segments. It appears tan and soft with areas of hemorrhage and necrosis. In the lower uterine segment, portions of the tumor appear viable with a tan, semi-firm, whorled appearance. Areas of tan-yellow semi-soft consistency suggestive of necrosis are identified in the left lateral corpus. The tumor protrudes through the left anterolateral serosal surface as a pseudopolypoid yellow mass measuring 2.5 x 2.3 x 0.9 cm. Elsewhere, it remains confined within the uterine wall. There is focal extension into the endometrium; however, no gross involvement is identified in the endometrial mucosa or cervix. The cervical portion measures 2.3 cm in length and up to 3.5 cm in diameter and demonstrates nabothian cysts. No vaginal cuff or parametrial tissues are present.\n\nThe left ovary is atrophic without gross tumor identified; however, microscopic examination reveals secondary involvement by a cellular lesion. The left fallopian tube does not show gross tumor involvement but exhibits microscopic findings including mullerian-type stroma at the fimbriated end and paratubal endosalpingiosis.\n\nHistologic evaluation reveals a spindle cell lesion with cellular atypia and increased mitotic activity. Necrotic areas including coagulative-type tumor cell necrosis are present. Some pleomorphic cells and a minor myxoid component are observed. A small population of cells with cytoplasmic clearing is also noted. Immunohistochemical staining demonstrates positivity for smooth muscle markers including desmin, actin, and vimentin. Ki-67 staining indicates variable proliferation indices across sampled regions.\n\nMicroscopic examination of lymphovascular spaces does not reveal invasion. No metastatic involvement is identified in the fallopian tubes bilaterally. The cervix demonstrates atrophic squamous changes and chronic inflammation with squamous metaplasia.\n\nSections from various regions of the uterus were submitted for analysis, including multiple tumor sections from anterior and posterior corpus and fundus. Sections from the ovary adjacent to the tumor were examined along with proximal, mid, and distal fallopian tube segments bilaterally.\n\nPathologic staging reflects tumor extension beyond the myometrium into the serosa without evidence of lymph node involvement (pT2a, NX)."} +{"pid": "TCGA-BP-5187", "report": "The submitted specimen consists of a right upper pole partial nephrectomy. The tumor measures 3.5 cm in greatest diameter and is well-circumscribed with a hemorrhagic appearance. It is located 0.5 cm from the closest resected margin and abuts the renal capsule without gross involvement. The tumor is confined within the kidney, with no evidence of local invasion or renal vein involvement. Histologic evaluation reveals nuclear features consistent with grade II on a four-tier scale. Surgical margins are free of tumor. Adjacent non-neoplastic kidney tissue shows focal chronic inflammation and vascular sclerosis. No adrenal gland or lymph nodes are identified. Staging indicates the tumor is limited to the kidney and measures less than or equal to 7.0 cm in greatest dimension. Representative sections of the tumor, renal capsule, and surrounding normal kidney tissue have been submitted for analysis."} +{"pid": "TCGA-BP-4762", "report": "The left kidney specimen consists of a partial nephrectomy measuring 2.2 x 2.0 x 1.8 cm. A mass measuring 1.1 x 1.0 x 0.8 cm is present, with a tan-yellow cut surface and focal hemorrhage. The mass is located 0.6 cm from the stapled margin and is entirely confined within the renal capsule. Microscopic examination reveals a tumor composed of acinar and solid growth patterns. The tumor cells exhibit nuclear features classified as grade III/IV. No invasion of the renal vein is identified. All surgical margins are free of tumor involvement. The surrounding kidney tissue demonstrates interstitial fibrosis. A separate specimen of adipose tissue measuring 7 x 3 x 2.5 cm is submitted for evaluation. It consists of benign fibroadipose tissue without evidence of tumor involvement. All relevant sections have been submitted for analysis. Intraoperative frozen section evaluation confirmed absence of tumor at the margins and findings were consistent with final microscopic assessment."} +{"pid": "TCGA-BR-7196", "report": "The specimen consists of a stomach segment with a plate-like lesion measuring 8.4 cm in maximum dimension. Microscopic examination reveals that the entire gastric wall is infiltrated, extending to the subserosa. The tumor exhibits ulceration and a poorly differentiated morphology. Invasion into perigastric fat is observed, along with perineural involvement. Fifteen lymph nodes were dissected from the greater and lesser curvatures; eleven of these contained metastatic deposits. The omentum demonstrates hyperemia and focal lymphoid infiltration, along with mesothelial proliferation. Surgical margins are free of tumor involvement. No evidence of venous invasion is identified. Eleven out of fifteen lymph nodes are positive for metastasis."} +{"pid": "TCGA-05-4244", "report": "The resection specimen from the right lower lobe of the lung contains a peripheral lesion measuring 4.5 cm. Histological evaluation reveals a non-mucinous, papillary growth pattern with areas showing marked nuclear atypia and increased mitotic activity. Focal involvement of the visceral pleura and vascular invasion within the hilar region are noted. Lymph node examination demonstrates metastatic involvement. The surgical margins are negative."} +{"pid": "TCGA-B6-A0IE", "report": "Surgical Pathology: Final. CLINICAL HISTORY: Inflammatory breast lesion. GROSS EXAMINATION: A. \"Left breast biopsy, received fresh. A fragment of skin measuring 3.3 cm in length and 0.4 cm in diameter is attached to underlying fibroadipose tissue that is 2.7 cm thick x 3.5 x 1 cm in greatest dimensions. The specimen was partially sectioned and shows a poorly defined area of pink tissue measuring approximately 2.5 x 1.5 x 1 cm in greatest dimensions. This does not represent the full extent of the lesion. Portions of the tissue were submitted for ER/PR evaluation. It is noted that this is a representative fragment of a larger lesion and margins are not required for the specimen. Representative sections are included in Blocks A1 and A2. MICROSCOPIC EXAMINATION: A. Breast, left, incisional biopsy: Poorly differentiated cells with extensive vascular invasion. In situ changes are not present. The cells exhibit features suggestive of a specific subtype, though no in situ component is identified."} +{"pid": "TCGA-DU-5852", "report": "The patient presented with a lucent, circumscribed lesion involving the parahippocampal gyrus and hippocampus, with FLAIR imaging showing involvement of nearly the entire temporal lobe. The operative procedure included biopsies from two brain regions: one medial temporal and one posterior.\n\nMicroscopic examination of both specimens revealed a proliferation of moderately pleomorphic round to oval cells, with occasional angular forms. The tumor cells were observed infiltrating the cortex, with perineuronal satellitosis noted. Scattered mitotic figures were present. No vascular proliferation or necrosis was identified. Immunohistochemical staining showed positive GFAP staining in reactive astrocytes and some tumor cells, with a thin rim of perinuclear staining observed in certain cells. The Ki-67 labeling index was approximately 12%.\n\nMolecular analysis performed on the tumor tissue showed no allelic loss on chromosome arms 1p and 19q. This assessment used multiple microsatellite markers, including D1S1592, D1S552, D1S468, D1S1612, D1S496, PLA2G4C, D19S606, and D19S1182. Additionally, MGMT promoter methylation was detected using bisulfite conversion and real-time PCR (MethyLight assay), with a sensitivity threshold of 1% methylated DNA in an unmethylated background.\n\nIntraoperative consultation of the specimens included touch preparations and frozen sections. The medial temporal biopsy showed cerebral cortex and white matter without definitive diagnostic features, ruling out lymphoma. The posterior biopsy demonstrated hypercellular tissue with small cells and slight atypia, suggestive of an infiltrative process. Both samples were described as semi-firm, tan-white to tan-gray, with the posterior sample being focally hemorrhagic and including a fragment of leptomeninges with engorged vessels. The total size of the medial temporal fragments was 0.8 cm in aggregate, while the posterior fragments measured 1.4 x 1.5 x 0.9 cm in aggregate."} +{"pid": "TCGA-A5-A0GA", "report": "The specimen included the left and right adnexa, each containing an ovary and fallopian tube. No abnormal findings were identified in either ovary or fallopian tube. The uterus and cervix showed a friable, polypoid mass within the endometrial cavity measuring 10.7 x 9.5 cm. The tumor involved the anterior and posterior corpus and fundus with possible extension into the lower uterine segment. Invasion of the myometrium was observed to approximately 50% depth, with a maximum thickness of 2.0 cm in exophytic portions. The total myometrial thickness was 2.9 cm. Extensive lymphatic invasion was noted. Four well-circumscribed intramural leiomyomas were present, ranging from 2.0 to 3.7 cm in size. The cervix did not show any tumor involvement.\n\nLymph node assessment revealed involvement in several regions. In the right paraaortic region, one lymph node contained metastatic disease. In the right pelvic region, one of five lymph nodes was positive. In the left pelvic region, the larger of two lymph nodes showed metastatic involvement. In the IMA region, one lymph node was involved. In the cephalad IMA region, one lymph node showed extension into perinodal soft tissue. In the left PA region, both lymph nodes examined were involved. In the left renal region, the largest of four lymph nodes was positive. In the right renal region, one lymph node showed extension into perinodal soft tissue. The sacral and renal (second) lymph nodes did not show tumor involvement.\n\nThe omentum and right colon with distal ileum did not show evidence of tumor. A polypoid lesion in the right colon was identified but did not show invasive features. Eighteen lymph nodes associated with the right colon and distal ileum were negative for tumor involvement. The appendix showed a mucinous neoplasm of borderline malignancy. No tumor was identified in the adipose tissue of the parametrial, paracervical, or other soft tissue regions examined. Multiple sections of all involved areas were submitted for histological evaluation."} +{"pid": "TCGA-69-7974", "report": "The submitted specimen includes parts from the left upper lobe and multiple lymph node regions (10L, 11L, 12L, #5). Histological evaluation of the left upper lobe specimen reveals a mass measuring 3.5 x 2.8 x 2.5 cm located in the apex of the lobe. The mass is described as tan-white, firm, with scalloped edges and cavitation. It is situated 1.7 cm from the parenchymal resection margin and 4.0 cm from the bronchial margin. The overlying pleura appears retracted without gross involvement. Histologic assessment demonstrates infiltration into lymphatic spaces within the bronchial margin and invasion into the visceral pleura. Centrilobular emphysema and pulmonary hemosiderosis are also noted.\n\nWithin the lymph nodes, metastatic involvement is identified in certain regions. Necrotizing granulomas are present in peribronchial lymph nodes. Specific lymph node specimens (10L and 12L) show no evidence of tumor involvement, while others (11L and #5) demonstrate metastatic involvement.\n\nImmunohistochemical staining shows diffuse positivity for TTF-1 and focal positivity for p-63 within tumor cells. Cytokeratin CAM 5.2 highlights tumor presence in lymphatic spaces at the bronchial margin. Special stains including GMS and Ziehl-Neelsen are negative for fungal organisms and acid-fast bacilli. Molecular testing for EGFR mutations reveals wild-type genotype with no detectable alterations.\n\nPathologic staging according to AJCC criteria is classified as stage IIIA (pT2a N2 MX). The bronchial margin is free of tumor involvement based on intraoperative assessment. Gross examination confirms moderate emphysematous changes throughout the lung tissue and presence of multiple anthracotic hilar lymph nodes. Subpleural hemorrhagic areas measuring 1.2 cm and 4.1 cm are identified inferior to the mass but not directly involved with it.\n\nAll lymph node specimens are submitted entirely for histologic evaluation."} +{"pid": "TCGA-VQ-A8PQ", "report": "The specimen includes a resected portion of the stomach, spleen, and liver segments II and III. A lesion was identified measuring 4.5 x 3.5 x 2.0 cm, involving the gastric body, cardia, and extending into the esophagus. The lesion traverses the full thickness of the gastric wall and invades into the liver and omentum. Multiple implants were observed in both the lesser and greater omentum. Histologic evaluation revealed lymphatic and perineural infiltration. Adjacent gastric mucosa showed alkaline gastritis with focal areas of deep cystic gastritis. The proximal margin was free of involvement but was closely situated to the lesion at a distance of 3 mm. The hepatic and distal margins were also free of involvement. The spleen did not show any involvement. Regarding lymph node assessment, 2 out of 6 nodes from the lesser curvature and 4 out of 6 nodes from the greater curvature exhibited metastatic involvement."} +{"pid": "TCGA-06-5858", "report": "A 6.5 cm irregularly nodular, ring-enhancing mass with restricted diffusion was identified in the left frontal lobe, with possible extension into the corpus callosum. A small lytic lesion was also noted in the clivus. Histopathological evaluation of biopsy and excision specimens revealed a neoplastic process characterized by nuclear atypia, mitotic activity, microvascular proliferation, and extensive necrosis with frequent pseudopalisading. The neoplasm showed high proliferative activity, with a MIB-1 index of approximately 65%. Immunohistochemical staining demonstrated overexpression of p53 protein in a majority of tumor cells and prominent glial fibrillary acidic protein (GFAP) expression.\n\nMolecular testing for the EGFRVIII mutation was performed using PCR on RNA extracted from formalin-fixed, paraffin-embedded tissue, and no evidence of the mutation was detected. The assay has a sensitivity limit of approximately 5 mutant cells in 100 normal cells. Additionally, analysis of the MGMT promoter methylation status was conducted via bisulfite treatment followed by real-time PCR amplification. No methylated MGMT promoter sequences were identified. The sensitivity of this test is 1% methylated DNA in an unmethylated background, although factors such as non-neoplastic cell contamination or extensive necrosis may affect detection.\n\nThe histologic features and molecular findings are based on established diagnostic criteria. Specimen A consisted of three small tan to white tissue fragments measuring up to 1.6 x 1.0 x 0.2 cm. Specimen B included similar-appearing tissue fragments measuring up to 2.2 x 1.0 x 0.3 cm. All results are provided for informational purposes and should be interpreted in the context of clinical and radiographic findings."} +{"pid": "TCGA-DJ-A2PS", "report": "The clinical history and submitted specimens include biopsies from the right para-tracheal tissue, right superior mediastinal tissue, a total thyroidectomy specimen, and a Delphian lymph node biopsy. \n\nMicroscopic evaluation of the right para-tracheal tissue biopsy revealed benign fibroadipose tissue. The right superior mediastinal biopsy showed a single lymph node containing psammoma bodies within the medullary region. No extranodal extension was identified. The Delphian lymph node biopsy showed no evidence of abnormality; both lymph nodes examined were benign.\n\nThe total thyroidectomy specimen demonstrated multiple distinct foci within the left lobe, right lobe, and isthmus. The largest lesion measured 1.1 cm in greatest diameter and was well-circumscribed. Smaller foci measuring 0.3 cm, 0.35 cm, and 0.25 cm were also identified, with some showing unencapsulated growth patterns. Extensive disruption of the surrounding capsule was noted adjacent to the largest focus. No mitotic activity or tumor necrosis was identified, and vascular invasion was not present. Very focal extension beyond the thyroid capsule into adjacent adipose tissue was observed in one of the smaller foci located in the isthmus. Surgical margins were free of involvement. The surrounding thyroid tissue showed features of chronic inflammation consistent with lymphocytic thyroiditis. One intrathyroidal parathyroid gland showed the presence of similar cellular elements within its structure.\n\nGross examination of the thyroid showed a multinodular appearance with a total weight of 10.05 grams. The right lobe measured 4.0 x 2.2 x 1.1 cm, the left lobe 3.8 x 2.5 x 0.8 cm, and the isthmus 1.0 x 0.8 x 0.3 cm. A 2.5 x 0.8 x 0.5 cm soft tissue fragment was attached to the right lower lobe. The external surfaces were marked with black and blue ink for orientation. On sectioning, two solid white nodules were identified: one measuring 1.1 cm in the right lobe and another measuring 0.3 cm in the left lobe. The remaining thyroid tissue had a reddish-tan cut surface.\n\nAll surgical specimens were fully sampled and submitted for histological analysis. Intraoperative frozen sections of the right para-tracheal and right superior mediastinal tissues initially appeared benign, and the final diagnoses confirmed these findings."} +{"pid": "TCGA-AA-3517", "report": "The specimen includes a segment of colon and terminal ileum with an ulcerated area in the colon. A lesion is present, measuring 5.5 cm in length, located approximately 50 cm from Bauhin\u2019s valve and encircling the colon wall. The lesion invades through all layers of the intestinal wall and extends into the adjacent fatty tissue of the mesocolon. The remaining colon contains three tubulovillous adenomas: two show mild epithelial changes and one shows significant cellular atypia. In the cecum, near the ileocecal valve, there is a recent ulcer-like mucosal defect, likely related to prior endoscopic removal of growths, with no residual tissue identified. All resection margins and the attached omentum are free of abnormal tissue. A total of 54 lymph nodes from the mesentery and mesocolon show no signs of involvement, only reactive changes. Vascular and lymphatic invasion are not identified. The cell appearance suggests a moderate degree of differentiation. Additionally, the gallbladder shows signs of long-standing inflammation, possibly associated with the presence of stones."} +{"pid": "TCGA-D8-A1X6", "report": "Histopathological examination of the left breast with axillary tissues was conducted. The breast measured 20.2 x 17.2 x 5.8 cm and weighed 900 g. A lesion measuring 4.3 x 6.2 x 2.2 cm was identified in the upper outer quadrant, located 1.2 cm from the upper boundary, 0.1 cm from the base, and 0.5 cm from the skin. There was a 3 cm area of skin retraction in the same region.\n\nMicroscopic evaluation showed a high-grade lesion (NHG3) with a mitotic count of 20 mitoses per 10 high-power fields. Involvement of the breast skin by malignant cells was observed. The nipple appeared unremarkable. Background changes consistent with fibrocystic disease were present in the remaining glandular tissue.\n\nAxillary lymph node dissection included multiple nodes. Metastatic involvement was identified in a subset of nodes, with evidence of perinodal infiltration. The affected nodes included those corresponding to levels V and VII, as well as level XVII.\n\nImmunohistochemical analysis demonstrated strong expression of estrogen and progesterone receptors in the majority of malignant cells. HER2 staining using HercepTest\u2122 M by DAKO showed a score of 1+ in the invasive component.\n\nStaging classification based on these findings is pT3 and pN2a. Further interpretation and clinical correlation are recommended."} +{"pid": "TCGA-B0-4823", "report": "A right hand-assisted laparoscopic radical nephrectomy specimen shows a moderately differentiated clear cell neoplasm, measuring 3.5 cm. The tumor does not extend into the renal capsule or renal vein. All surgical margins are free of malignant cells. Within the renal parenchyma, there is evidence of focal chronic tubular interstitial disease. The right adrenal gland demonstrates nodular hyperplasia without any signs of malignancy. Staging is reported as pT1A, with no assessment of lymph node or distant metastasis (NX, MX). \n\nIn addition, a fine needle aspiration of the right kidney mass was performed. A total of 17 slides were reviewed, including 12 smears, 3 Thinprep slides, and 2 cell block sections. The specimen is extremely limited, consisting mostly of blood. Rare atypical clear cells are present on one cell block slide (slide 1C2), along with scattered hemosiderin pigment. Also noted are rare glomeruli and benign-appearing tubular cells. Due to the paucity of diagnostic material, a definitive diagnosis could not be rendered. Repeat sampling is advised."} +{"pid": "TCGA-DJ-A2QC", "report": "The specimen from a partial thyroidectomy includes the left thyroid lobe and part of the right thyroid lobe. The left lobe measures 2.9 x 2.7 x 2.1 cm, and the fragment of the right lobe measures 1.5 x 0.5 x 0.4 cm. A small attached fragment of skeletal muscle is present at the lower pole of the left lobe. The external surface of the thyroid tissue is covered by a thin fibrous capsule.\n\nUpon sectioning, a dominant nodule measuring 2.3 x 2.1 x 2.0 cm is identified in the upper pole of the left lobe. It is tan-white in color with a finely granular cut surface and is not encapsulated. A second similar nodule measuring 1.4 x 1.4 x 1.2 cm is located in the lower pole of the left lobe. Additionally, a 0.8 x 0.6 x 0.5 cm tan-white fleshy nodule is found in the fragment of the right thyroid lobe. The surrounding thyroid parenchyma appears red-tan and has a beefy texture.\n\nHistologic evaluation reveals well-differentiated cells without identifiable mitotic activity or tumor necrosis. Calcifications of non-psammomatous type are noted. No blood vessel invasion or extrathyroid extension is observed. Surgical margins are free of abnormal tissue. Multicentricity is not present.\n\nA separate follicular adenoma is identified away from the primary lesion. The remainder of the thyroid tissue shows features consistent with nodular hyperplasia. Parathyroid glands are not identified in the specimen. All relevant sections were submitted for analysis and reviewed."} +{"pid": "TCGA-G4-6309", "report": "The specimen includes a segment of colon, a proximal donut, and a distal donut. The colon segment measures 13 cm in length and 5 cm in diameter. An area of stricture measuring 1.2 cm is located 4.5 cm from the nearest surgical margin. A fungating exophytic polypoid mass with a serpentine border is present, measuring 3.9 cm in length and 3.0 cm in diameter. The mass appears to invade through the muscularis propria and is located 3.5 cm from the closest surgical margin and approximately 7.5 cm from the farthest margin. The mucosa near the mass has a granular appearance. Sections of the mass, normal-appearing mucosa, and multiple lymph nodes are submitted for analysis.\n\nThe proximal donut is a pink-tan mucosal tissue measuring 3.2 x 2.4 x 0.6 cm, with a blue suture and unremarkable mucosa. The distal donut is a pink-tan mucosal tissue measuring 2.2 x 1.7 x 0.5 cm, with pinpoint areas of hemorrhage and surgical staples present. Both are submitted in single blocks.\n\nMicroscopic evaluation of the colon shows no involvement at the proximal, distal, or radial margins. There is no evidence of perineural invasion, but there is suspicion of angiolymphatic invasion. A tubular adenoma is identified in association with the lesion. Two out of twenty-four lymph nodes are involved, with extranodal extension noted.\n\nImmunohistochemical analysis of the tumor shows positive staining for MLH1, MSH2, and MSH6, but no expression of PMS2. Internal controls, including peritumoral lymphocytes and normal glands, show expected expression of all four markers. Testing for microsatellite instability has been initiated, and results will be reported separately."} +{"pid": "TCGA-66-2786", "report": "The examined specimen includes a right upper lobe measuring 18 x 12 x 4 cm, with a resection plane located 0.1 cm proximal to the segmental bronchi bifurcation. A 2 cm node is present at the hilus, and a staple suture line extends from the hilus in a caudoventral direction for 10 cm. The visceral pleura, particularly in the lateral region, shows slight reticulate blackish pigmentation. In segments S2 and S3, near the boundary of S1, there is a firm, pale gray lesion measuring up to 2.8 cm, with patchy central blackish pigmentation and unclear, partially arcuate demarcation. The distance from the visceral pleura is 0.5 cm. Subsegmental branches B2 and B3 lead into the lesion. The remaining parenchyma in S1 demonstrates rarefaction with lacunar formation, with a maximum size of 1 cm.\n\nLymph node stations were also examined: station 12 (lower lobe) contains a 0.7 cm node; station 10 (hilar) has a 0.7 cm node with surrounding tissue; station 4 (low paratracheal) includes a 0.8 cm affected node and a 0.5 cm node with abundant surrounding tissue; and station 7 (subcarinal) shows a 1.6 cm affected node or node part with some surrounding tissue.\n\nHistological evaluation included multiple sections from various areas: tumor with pleura, tumor with subsegmental branch B2, tumor with subsegmental branch B3, S1 apical, bronchus and vessel resection margins (tangential), and hilar node (lamellated). All lymph node samples were also sectioned, with some showing lamellar patterns. Ten blocks were examined using Elastica-van Gieson, PAS, and diastase-PAS staining methods.\n\nMicroscopic analysis revealed findings related to cellular structure and tissue organization, but specific histological and cytological details are not described here. The lesion demonstrated growth into alveolar septa and was often covered by preserved hyperplastic alveolar epithelium, with associated extracellular mucus accumulation observed between cell structures, though no definitive mucin formation was identified within the lesion itself. The bronchial and vascular resection margins, along with all excised lymph nodes, showed no evidence of tumor involvement.\n\nAdditional findings include marked focal centroacinar emphysema in the lung tissue, and lymph nodes exhibited reactive changes with anthracotic pigment deposits."} +{"pid": "TCGA-B0-5095", "report": "The specimen consists of a right radical nephrectomy. The neoplasm measures 10.2 cm in greatest diameter. Microscopic examination shows nuclear features corresponding to a nuclear grade of 3 out of 4. The neoplasm extends into the renal sinus fat and through the renal capsule. No angiolymphatic invasion is identified. All surgical margins are free of the neoplasm. The non-neoplastic kidney tissue demonstrates chronic interstitial inflammation and glomerulosclerosis. Based on the extent of local spread, the stage is classified as pT3a NX MX."} +{"pid": "TCGA-LK-A4O0", "report": "The resected bone specimens from the left 5th and 6th ribs are undergoing decalcification, and an addendum report will follow. The pleural tissue from the left pleurectomy shows a diffuse malignant process arising in association with hyaline pleural plaques and chronic talc pleuritis. The lesion is composed predominantly of spindle-shaped cells with fibrosarcomatous morphology. Occasional areas of epithelioid differentiation are present, particularly at the interface with adipose tissue. Immunohistochemical staining demonstrates expression of nuclear Calretinin and WT-1, as well as cytoplasmic D2-40 and CK5/6 in the neoplastic cells. Stains for Carcinoembryonic Antigen, B72.3, BER EP4, Leu-M1, and TTF-1 are negative. Histochemical evaluation using PAS/PASD and Mucicarmine does not show evidence of neutral mucin production."} +{"pid": "TCGA-LD-A66U", "report": "A focus of small size (0.6 mm) was identified at the edge of a fragment of superficial right axillary breast tissue, adjacent to adipose tissue, with no involvement of other margins. Two sentinel lymph nodes were examined. The first contained a single focus of micrometastasis measuring 0.6 mm, limited to one slide level. The second lymph node showed multiple foci of micrometastasis, the largest measuring 1.5 mm, confirmed with cytokeratin staining; no extranodal extension was observed.\n\nThe right mastectomy specimen revealed a central mass measuring 3.5 cm located at the 10 o\u2019clock position. Histologic evaluation demonstrated a mix of classical and variant cellular features. Nuclear grading was moderate to high. A non-invasive component was present, showing similar cellular characteristics. Lymph node sampling from the right axilla yielded 15 nodes, two of which were positive, with the largest deposit measuring 3 mm; no extranodal involvement was seen.\n\nMargins were largely negative, though a focal involvement was noted at the superior/anterior aspect. Vascular space invasion was present. No microcalcifications were detected. Skin and nipple were free of involvement, as was skeletal muscle, which was only focally present.\n\nAdditional findings in the right breast included benign proliferative changes. The left prophylactic mastectomy specimen showed benign breast tissue with minor epithelial alterations and no atypical features. All margins were negative in this specimen.\n\nLymph node dissection from the right axilla identified thirteen additional lymph nodes, all without evidence of involvement."} +{"pid": "TCGA-ZT-A8OM", "report": "The specimen from the left chest mass was evaluated and found to contain a mixture of epithelial cells and prominent lymphocytes. Immunohistochemical staining for pankeratin and CD45 demonstrated reactivity consistent with this cellular composition. A similar finding was observed in the pericardial specimen, which measured 2.5 x 1.9 x 0.8 cm. Intraoperative cytology was performed on this specimen and a portion was sent for flow cytometric analysis.\n\nA lymph node from the left pericardial region was also examined. It showed benign features with findings of sinus histiocytosis, anthracosis, and hemosiderin deposition. No abnormal cellular proliferation was identified. Special stains including GMS and AFB were negative for infectious organisms.\n\nAdditional masses were identified in the left anterior pulmonary region and left pericardial phrenic area. Both measured approximately 2.6 x 1.9 x 1.1 cm and 2.4 x 1.6 x 1.1 cm respectively, and exhibited firm, gray-tan characteristics upon gross examination. Representative sections from all specimens were submitted for further histologic evaluation.\n\nFlow cytometry was performed on tissue from the chest mass. The analysis revealed that approximately 95% of the analyzed events were lymphocytes, predominantly T cells with a normal immunophenotype. A significant dual positive CD4/CD8 population was noted, accounting for about 61% of T cells. B cells comprised less than 1% of the lymphocyte population, which was insufficient to assess for clonality. No abnormal T cell populations were detected.\n\nGross examination of the left pleural mass showed a soft gray-pink fragment measuring 3.5 x 2.6 x 1.2 cm, with a firm tan area measuring 2.1 x 1.2 x 1 cm. A portion was submitted for frozen section analysis. Additional specimens were processed and placed in cassettes for further study. All specimens were fixed and preserved according to standard protocols."} +{"pid": "TCGA-HD-7229", "report": "The pathology report describes a biopsy specimen from the left supraglottic region, submitted in three fragments measuring 2.5 x 2.0 x 0.8 cm in total. The tissue was sectioned and processed in cassettes A1 and A2, with portions also sent for research. A separate frozen section sample from the left thyroid cartilage was evaluated and found to contain similar tissue characteristics. A second specimen labeled \"C\" consisted of 2.5 x 1.0 x 0.5 cm aggregate of gray-white to red-brown rubbery tissue.\n\nMicroscopic examination revealed areas of invasive growth with moderate to poor differentiation. Tumor foci were identified at the cauterized margins of the biopsy. Cellular morphology was consistent across samples from the supraglottic region and thyroid cartilage. Staging could not be determined due to the limited nature of the biopsies. All available material has been processed and reviewed."} +{"pid": "TCGA-2Y-A9H1", "report": "The liver specimen from a left lateral segmentectomy weighed 138 grams and measured 11.9 x 7.8 x 4.2 cm. It was submitted fresh and included a previously incised wedge of liver with staples along the resection margin. A subcapsular nodule measuring 2.7 cm was identified grossly. On sectioning, a tan-yellow mass measuring 3.1 x 2.6 x 2.2 cm was found, located 1.1 cm from the parenchymal margin and extending to the capsule. The surrounding liver tissue appeared dense, tan-brown, and mildly indurated. The parenchymal margin was inked blue and showed no involvement by invasive lesion. The closest distance of the lesion to the margin was 9 mm.\n\nMicroscopic evaluation revealed a moderately differentiated lesion. Immunohistochemical staining demonstrated positivity for AFP, Hep-par1, CEA-p (in a canalicular pattern), CK7, and CK20. Special stains including Trichrome, reticulin, and iron were performed and showed portal fibrosis with short fibrous septa and no evidence of excess iron deposition. Reticulin stain also showed architectural changes consistent with fibrous expansion of some portal areas, corresponding to a modified Ishak stage 1.\n\nThe lesion was solitary and confined to the left lateral segment. No vascular invasion was identified. Regional lymph nodes and distant metastases could not be assessed. All surgical margins were free of involvement. Sections were submitted from the tumor, adjacent parenchyma, capsule, vascular margins, and normal-appearing liver tissue. Tissue was also sent to the Tissue Procurement Laboratory."} +{"pid": "TCGA-BH-A0B7", "report": "A lymph node biopsy from the right axilla, sentinel #1, revealed one lymph node involved by metastatic disease measuring 0.5 cm. A second sentinel lymph node biopsy showed involvement with a focus measuring 1.1 cm and evidence of extracapsular extension. The non-sentinel lymph node dissection included seventeen nodes, one of which was positive for metastatic disease measuring 1.3 cm, also with extracapsular extension identified.\n\nGross examination of the right breast mastectomy specimen revealed two invasive foci. The larger measured 2.4 cm and was located at the 9:00 o\u2019clock position, while the smaller measured 1.1 cm at the 12:00 o\u2019clock position. Both exhibited high nuclear grade and mitotic activity contributing to a cumulative Nottingham score of 8 out of 9. Ductal carcinoma in situ (DCIS) was present, composed of high-grade solid and apocrine types with comedo necrosis, accounting for 20% of the total tumor burden and found both admixed with and separate from the invasive component. Microcalcifications were associated with both in situ and invasive components.\n\nHistologic evaluation confirmed lymphovascular invasion. All surgical margins, including the nipple and skin, were free of tumor. The surrounding breast tissue showed fibrocystic changes. Immunohistochemical staining showed positivity for ER, PR, and HER-2/neu (3+). \n\nPathologic staging was determined as pT2 based on the largest invasive focus, and pN1a for lymph node involvement. A total of nineteen lymph nodes were examined, with three positive for metastatic involvement. Extracapsular extension was noted in at least one lymph node, and malignant calcifications were identified within the tumor regions."} +{"pid": "TCGA-06-0145", "report": "The specimen consists of two fresh tissue fragments measuring up to 1.1 cm in aggregate. The tissue is described as semi-firm with a purplish-red appearance. Three irregular, glistening soft tissue fragments ranging from 1.0 cm to 2.0 x 1.0 x 0.4 cm were received, with the larger ones being sectioned. All sections are submitted in cassettes X1 through X3.\n\nImmunohistochemical staining was performed using blocks from X3. GFAP staining showed limited gliofibril formation. CD34 highlighted significant neovascularization, including areas of microvascular proliferation. MIB-1 staining revealed a proliferation index of 9% in the more densely cellular regions.\n\nHistological evaluation noted high cellularity, nuclear atypia, and mitotic figures. There was evidence of vascular changes and areas suggestive of necrosis. The tissue architecture showed focal alterations consistent with aggressive growth patterns."} +{"pid": "TCGA-CH-5754", "report": "The prostate specimen shows a lesion characterized by poorly differentiated cells predominantly located in the peripheral zone. Histological evaluation reveals a Gleason score of 4+5 with a minor component of Gleason 3. The primary Gleason pattern accounts for approximately 90%, while the secondary and tertiary components represent 5% and less than 5%, respectively. The maximum tumor diameter measures 3.3 cm, and approximately 80% of the gland is involved. Tumor infiltration is identified in the right basal periprostatic fatty tissue with an infiltration front measuring 1 mm in width and 0.5 mm in depth. Bilateral seminal vesicle involvement is noted, along with extensive perineural invasion. There is contact with the surgical resection margin on the left anterior side at the block level, with a contact line measuring 1.5 mm; Gleason pattern 4 is present at this site. Lymphatic vessel invasion is also observed.\n\nIn the lymph node assessment, one out of four nodes on the right external side contains a metastasis measuring 1.2 cm, while the remaining three are free of tumor. In the right obdurator fossa, a single lymph node is tumor-free. On the right internal side, a microscopic lymph node within fatty tissue is also tumor-free. On the left external side, two lymph nodes are tumor-free. In the left obdurator fossa, two lymph nodes show metastatic involvement with the largest deposit measuring up to 3.5 cm and extending beyond the nodal capsule. On the left internal side, a microscopic lymph node within fatty tissue does not show tumor involvement.\n\nTumor staging is classified as pT3b, with a maximum diameter of 3.3 cm and involvement of 80% of the prostate. Lymph node status is categorized as pN1 (3 out of 11 nodes involved). Vascular invasion is not identified, but lymphatic invasion is confirmed. Surgical margin involvement is noted (R1). Prior biopsy samples showed a Gleason score of 4+3 with a tertiary grade 5 component, whereas the current assessment reflects a higher-grade transformation with a dominant Gleason 5 component. Immunohistochemical analysis confirms lymphatic vessel invasion without evidence of blood vessel involvement."} +{"pid": "TCGA-3T-AA9L", "report": "A mediastinal mass was excised via video-assisted thoracic surgery. The specimen consisted of two tissue fragments. The larger fragment measured 6.0 x 3.0 x 2.5 cm and weighed 25 grams, containing an ill-defined encapsulated lesion measuring 5.0 x 3.0 x 2.0 cm. The smaller fragment measured 2.5 x 2.0 x 0.5 cm and weighed 2.6 grams, with a small lesion measuring 0.5 x 0.5 x 0.2 cm.\n\nMicroscopic examination revealed a predominantly lymphocytic population with scattered weakly staining epithelial cells. Immunohistochemical analysis showed expression of CD2, variable CD3, partial CD4, CD5, CD7, partial CD8, CD38, and CD45 on a distinct cell population with low light scatter properties, comprising approximately 98% of the sample. These findings were consistent with immature T-lymphocytes. No lymphovascular invasion was identified.\n\nHistologic evaluation demonstrated cystic changes and fibrosis within the lesion. The tumor focally extended into the capsule and abutted the inked surface. Peripheral margins were involved by the lesion. Based on staging criteria, microscopic transcapsular invasion was identified. No regional lymph nodes were examined, and distant metastasis could not be assessed. Additional findings included degenerative cystic changes and fibrosis."} +{"pid": "TCGA-DG-A2KL", "report": "The sample was obtained from a cervical site at the 9:00 position and collected as fresh frozen tissue. The patient underwent surgical resection with no days elapsed between the procedure date and sample collection. A total of 11 days elapsed from diagnosis to sample collection. Histological evaluation revealed a tumor measuring 5.5 cm in size, characterized by keratinizing features and classified as Grade I (well-differentiated). Pathologic staging indicated T2 disease with no regional lymph nodes sampled; however, there were positive findings in lymph nodes, with 8 involved out of the total sampled. Margin assessment at the right posterior vaginal excision site demonstrated involvement by invasive-type cells. No distant metastasis was assessed (MX)."} +{"pid": "TCGA-B6-A0RL", "report": "CLINICAL HISTORY: Left breast mass, positive biopsy. Rule out malignancy. GROSS EXAMINATION: A. \"Left breast biopsy\", in formalin. Received is a portion of adipose tissue measuring 4.5 x 4.0 x 1.9 cm in greatest dimensions. A firm nodule is identified within the adipose tissue. Sections through this nodule reveal a white, gritty mass with irregular borders measuring 3.0 x 1.3 x 2 cm. The lesion approaches the margin of resection. Frozen section was performed on this lesion. Initially, the tissue was submitted for hormone receptor analysis. The frozen section remnant is submitted in Block A1. Additional representative sections of the lesion are submitted in Blocks A2 and A3. B. \"Left breast with axillary contents\". Received is a 620 gram, 20 x 16 x 3.5 cm modified radical mastectomy specimen with attached axillary tail. The axillary tail measures 8 x 7.5 x 1.8 cm. The skin ellipse measures 20 cm in length x 7.5 cm in width, with a medially placed nipple. Lateral and inferior to the nipple is a 5 cm sutured incision. The deep surface is painted with blue ink. Beneath the incision, there is a hemorrhagic biopsy cavity measuring approximately 5 x 4.5 x 3 cm. The biopsy cavity approaches the deep margin; however, no residual tumor is observed. Along the superficial edge of the biopsy cavity, a residual firm nodule measuring 1.5 x 2.0 x 0.8 cm is present. The remainder of the breast consists of firm, white breast tissue and adipose tissue. The axillary tail is evaluated for lymph node candidates. Block Summary: B1: Representative sections of nipple. B2: Representative sections of skin through incision. B3-B5: Representative sections of biopsy cavity including deep margins. B6,B7: Nodule along superior aspect of biopsy cavity. B8: Representative section of upper inner quadrant. B9: Representative sections of lower inner quadrant. B10: Representative section of upper outer quadrant. B11: Representative section of normal lower outer quadrant. B12,B13: Lymph node candidates from Level-I. B14-B16: Lymph node candidates from Level-II (a single large lymph node candidate is bisected and submitted entirely in Block A16). B17,B18: Lymph node candidates from Level-III. INTRA OPERATIVE CONSULTATION: \"Left breast biopsy\": AF1 - Malignant cells identified. DIAGNOSIS: A. \"LEFT BREAST BIOPSY\": High-grade cellular features noted. A spindle cell component is present. In addition, focal intraductal proliferation with central necrosis is observed. B. \"LEFT BREAST WITH AXILLARY CONTENTS\": Cellular features consistent with mixed differentiation, showing areas of intermediate to high-grade morphology. Surgical margins show no evidence of malignant involvement. Evaluation of lymph node candidates from multiple levels reveals no metastatic involvement."} +{"pid": "TCGA-AG-3599", "report": "The resected rectosigmoid colon specimen contains a moderately differentiated, partly mucinous adenocarcinoma measuring 2 cm in diameter at its widest point. The invasive component extends to the level of the muscularis propria. All oral and aboral resection margins, as well as the examined intestinal and colon sections, are free of tumor involvement. A total of seven mesocolic and periproctic lymph nodes were assessed and found to be tumor-free, showing only nonspecific reactive changes. Subsequent examination of additional lymph node preparations identified five more very small mesocolic and periproctic lymph nodes, all of which are also tumor-free. The overall lymph node evaluation remains negative. Histological grading is consistent with intermediate differentiation (G2). No evidence of vascular or lymphatic invasion was noted."} +{"pid": "TCGA-V4-A9F3", "report": "The left eye enucleation specimen measured 25 mm in diameter, with a posterior optic nerve segment of 7 mm, and was associated with a fragment of adipose tissue measuring 8 mm. Upon sectioning, a pigmented intraocular lesion was identified, measuring 17 \u00d7 15 mm along its main dimensions. Tissue samples were collected for cryopreservation and genetic analysis before the entire specimen was fixed and divided into 12 tissue blocks for further evaluation.\n\nMicroscopic examination revealed a neoplastic lesion composed of sheets of epithelioid cells with abundant cytoplasm, large nuclei, and prominent nucleoli. The mitotic count was 5 per 10 high-power fields. Pigment distribution varied across different regions of the lesion. The tumor measured 17 mm along its largest dimension and was located on the lateral aspect of the eyeball, extending near the ciliary body with focal involvement of the ciliary muscle. There was no direct contact with the intraocular portion of the optic nerve. A focal extension into the inner third of the sclera was present, but no extrascleral spread was observed. The lamina cribrosa, optic nerve along its full length, and meningeal sheaths showed no evidence of tumor involvement, and the cut end of the optic nerve was also free of neoplastic cells."} +{"pid": "TCGA-HQ-A5NE", "report": "The specimen was obtained from a resection procedure involving radical cystoprostatectomy, with the tissue originating from the bladder. The tumor measured 4 cm in size and exhibited invasive growth patterns. Histological evaluation revealed high-grade cellular features consistent with poorly differentiated morphology. Staging indicated involvement extending beyond the inner layers of the bladder wall but without evidence of lymph node or distant metastasis at the time of diagnosis. Blood sample (buffy coat) was also collected during the same period."} +{"pid": "TCGA-CJ-4912", "report": "The surgical specimen includes a left kidney and adrenal gland measuring 22.0 x 13.0 x 9.0 cm. The kidney itself measures 15.5 x 11.5 x 7.0 cm and contains a lobulated, multinodular mass measuring 15.0 x 9.0 x 5.8 cm located in the lower and mid poles, with lateral predominance. The mass is bright yellow with a central area of myxoid change or degeneration comprising approximately 20% of the lesion. It is eccentrically positioned toward the lateral aspect of the kidney, with focal involvement of the perirenal fat. The distance between the tumor and Gerota\u2019s fascia is less than 0.1 cm; however, the overlying fascia appears intact. No invasion of the renal sinus adipose tissue or renal vein is identified. The vascular, ureteral, and soft tissue margins of resection are free of abnormal tissue. The adrenal gland shows no evidence of abnormality and measures 5.5 x 0.8 x 0.7 cm with normal cortical and medullary architecture on sectioning.\n\nAdjacent to the tumor, there is a 2.5 x 2.5 x 1.8 cm well-circumscribed cyst in the inferior and medial aspect of the kidney filled with necrotic green-tan material, located 0.6 cm from the mass. The pelvicalyceal system appears smooth and unremarkable. No lymph nodes are identified within the renal hilum. Representative sections of the tumor in relation to surrounding structures, including the renal sinus, ureter, renal artery, and perirenal fat, have been submitted for analysis. Multiple sections of the tumor from different areas have also been submitted, along with portions for potential electron microscopy, cytogenetics, and a research protocol."} +{"pid": "TCGA-FF-8041", "report": "Histopathology findings from a resected mediastinal mass demonstrate a large neoplasm measuring 10.5 x 8.5 x 6 cm with a vaguely nodular-to-diffuse growth pattern and fibrovascular partitioning. The tumor exhibits sheets of large lymphoid cells with abundant pale eosinophilic-to-clear cytoplasm and irregular vesicular nuclei, predominantly displaying centroblastic nuclear features. Focal necrosis is present, involving approximately 10% of the tumor volume, particularly noted in blocks A11, A13, A15, and A16. Mitotic figures are readily identified. The tumor abuts the circumferential resection margin and is located 2 cm from the lung parenchymal margin; there is extension into the right lung but no definitive penetration of the pericardium. Compartmentalizing sclerosis with admixed small lymphocytes is observed at the tumor periphery.\n\nImmunophenotyping reveals that the neoplastic cells are diffusely positive for CD20, indicating a B-cell lineage. Nuclear expression of bcl-6 exceeds that of MUM-1, suggesting derivation from germinal center or post-germinal center B cells. Coexpression of bcl-2 is widespread and significantly greater than physiological levels seen in reactive T lymphocytes, which are sparse and interspersed. Ki-67 labeling demonstrates a proliferation rate of 70\u201380%, with nuclear pleomorphism inconsistent with Burkitt lymphoma. CD30 is patchily expressed, supporting a mediastinal origin, while CD23 is negative. Cyclin D1 staining is absent in the neoplastic population, ruling out mantle cell lymphoma. Follicular dendritic meshwork staining with CD21 is entirely negative. Pancytokeratin AE1/3 immunostaining is also negative, excluding epithelial-derived malignancies.\n\nA separate specimen from a paratracheal lymph node shows preserved nodal architecture without evidence of neoplastic involvement."} +{"pid": "TCGA-FD-A43X", "report": "The patient is a male who underwent cystoprostatectomy. Specimens were received and analyzed, including left and right pelvic lymph nodes, bladder, prostate, seminal vesicles, vas deferens, and distal right ureter.\n\nExamination of the left pelvic lymph nodes revealed eight lymph nodes, all without tumor involvement. The right pelvic lymph nodes included twenty lymph nodes, none of which contained tumor cells. One lymph node associated with the bladder, prostate, seminal vesicles, and vas deferens was also free of tumor. Prostatic hyperplasia was noted without evidence of malignancy. Chronic and granulomatous inflammation was observed, consistent with treatment effect. No tumor was identified in the seminal vesicles, vas deferens, or distal right ureter.\n\nThe bladder specimen measured 8.5 x 8.5 x 7.0 cm and contained a fungating, tan-pink mass involving the entire surface. The tumor demonstrated multifocal distribution across multiple regions including the dome, right and left lateral walls, trigone, anterior wall, and posterior wall. The largest tumor size was 8.5 cm. Serial sectioning revealed partial invasion into the bladder wall to a depth of 1.5 cm, with involvement near the base of the prostate and abutment of inked margins in several areas. No tumor was found at the distal urethral margin, ureteral margins, or soft tissue margins.\n\nLymphovascular invasion was identified within the inner half of the muscularis propria. The tumor exhibited high-grade cytologic features. A total of 28 lymph nodes were examined (0 involved). Based on pathologic evaluation, staging parameters corresponded to ypT2a, NO, MX according to the 7th edition TNM classification system.\n\nMargins of the distal right ureter were unremarkable. The prostate measured 4.8 x 4.0 x 3.6 cm and showed no evidence of tumor, though an area of induration was noted in the right prostate. Adipose tissue surrounding the bladder and prostate was submitted for analysis. Representative sections from all regions were evaluated microscopically."} +{"pid": "TCGA-VP-A875", "report": "The prostate specimen measured 4.7 cm anterior to posterior, 4.8 cm superior to inferior, and 5.3 cm left to right. The right seminal vesicle measured 2.7 x 1.6 x 1.4 cm and the left measured 2.2 x 1.7 x 0.9 cm. Microscopic evaluation identified involvement of the right base, right apex, and left apex. A Gleason score of 3+4 was assigned based on histologic assessment. Intriglandular involvement was estimated at 10% of the gland. Perineural invasion was present. Extraprostatic extension was noted in the right apex. All surgical margins were free of tumor. Vascular invasion was not identified. Four pelvic lymph nodes were examined and showed no evidence of malignancy. The tumor extended beyond the prostate capsule unilaterally. Distant metastasis could not be assessed. The pathologic stage is T3a/N0/MX (Stage III). This stage is provisional and may be modified with additional clinical information."} +{"pid": "TCGA-AA-3562", "report": "The resected colon specimen shows a broad, ulcerated lesion with infiltration into the pericolic adipose tissue. The lesion is moderately differentiated and exhibits lymphangitic spread. A total of 28 lymph nodes were examined, of which 7 showed involvement. All colonic and mesenteric resection margins were free of tumor. In the remaining mucous membrane, there is a circumscribed ulcer with residual tissue from a tubular adenoma showing moderate epithelial dysplasia. Another small tubular adenoma with similar dysplastic changes is also present. Histological grade is G2. Vascular invasion is absent (V0), but lymphatic invasion is present (L1). The local resection margin is tumor-free (R0). The lesion involves the regional lymph nodes without evidence of distant metastasis."} +{"pid": "TCGA-N8-A4PM", "report": "Lymph node specimens from right periaortic, left periaortic, right pelvic, and left pelvic regions were examined. A total of 34 lymph nodes were evaluated across all specimens, with no evidence of metastatic disease identified. The lymph nodes showed follicularlymphoid hyperplasia on frozen section in the right periaortic specimen.\n\nThe hysterectomy specimen revealed a lesion located at the uterine fundus. Microscopic evaluation demonstrated a mixture of histologic components. One component showed features of endometrioid carcinoma with squamous differentiation present in approximately 20% of the tumor. Another component exhibited serous carcinoma, comprising about 80% of the tumor. Histologic grading was consistent with high-grade morphology based on FIGO criteria. The tumor invaded the myometrium to a depth of 1.0 cm, out of a total wall thickness of 1.6 cm, representing outer half invasion. There was no involvement of the serosa, lower uterine segment, cervix, or adnexa. No tumor was identified at surgical margins, and no lymphovascular space invasion was observed.\n\nA total of 25 regional lymph nodes were examined, with none showing evidence of involvement. Additional pathologic findings included focal complex hyperplasia with atypia and areas of endometrial atrophy. Immunohistochemical staining showed that the serous carcinoma component was negative for both estrogen and progesterone receptors, with only trace staining in 5% of tumor nuclei. In contrast, the endometrioid component showed strong positivity for both receptors, with staining intensity of 2-3+ in more than 80% of tumor nuclei.\n\nStaging was assessed according to AJCC and FIGO (2008) systems, with the final assessment being pT1b pNO and Stage IB, respectively. These staging classifications are based on available data and may be subject to revision pending further clinical review.\n\nSpecimens from both ovaries showed physiologic changes and small epithelial inclusion cysts. Both fallopian tubes were unremarkable with no significant pathologic abnormalities noted. The cervical and vaginal margins were widely negative.\n\nGross examination of the uterus measured 7.1 cm in height, 3.0 cm in anterior-posterior width, and 4.5 cm in breadth at the fundus. The endometrial cavity measured 2.5 cm in length, with a maximum width of 1.9 cm at the fundus. The lesion itself measured 2.0 x 1.1 x 0.6 cm and appeared as an exophytic thickening of the endometrial lining. It was soft, friable, and brown in color with an irregular surface. The tumor was confined to the uterine fundus, greater than 2 cm from the endocervical canal. The cervix measured 2.4 x 2.2 cm with a patent cervical os of 0.4 cm. The ectocervix was predominantly light pink with focal punctate hemorrhage, while the endocervix was tan and trabeculated with a canal length of 1.7 cm.\n\nBoth ovaries were small, measuring 1.6 x 1.0 x 0.5 cm on the right and 1.4 x 1.1 x 0. cm on the left. The external surfaces were cerebriform, and the cut surfaces were tan and firm. Both fallopian tubes were patent, with the right tube measuring 2.1 cm in length and 0.4 cm in diameter, and the left tube measuring 2.6 cm in length and 0.4 cm in diameter. The external surfaces of both tubes were smooth and glistening.\n\nAll lymph node specimens were embedded in fibrofatty tissue and fully submitted for histologic evaluation. No additional pathologic findings were reported."} +{"pid": "TCGA-2J-AABO", "report": "A biopsy of the right lobe of the liver showed minimal liver parenchyma with fibrosis of the capsule. A rare cluster of atypical cells was identified, but its significance remains unclear. A lymph node from the common hepatic area showed involvement by metastatic cells. The margin from the common hepatic duct was free of any abnormal cellular growth.\n\nIn the pancreatic body margin, there was evidence of a specific type of mucinous lesion with high-grade cellular changes within the duct, but no signs of invasive disease. A biopsy of the portal vein\u2019s outer layer also showed no abnormal cells.\n\nThe Whipple resection specimen included the head of the pancreas, gallbladder, duodenum, common bile duct, and part of the jejunum. Within the pancreatic head, a solid mass measuring 4.6 x 2.3 x 2.0 cm was identified. This mass extended beyond the pancreas into surrounding soft tissue and was found to be in close proximity\u2014only 0.1 cm away\u2014from the portal vein groove. There was evidence of perineural invasion. The uncinate process margin showed involvement of a lymph node with extension into adjacent soft tissue.\n\nExamination of multiple lymph nodes revealed that 7 out of 15 regional nodes contained metastatic cells. The gallbladder exhibited mild chronic inflammation but no stones.\n\nStaging based on the available surgical material was determined as pT3N1 according to the 7th edition of the AJCC classification. This report is based on initial frozen section analysis, which was later confirmed by permanent H&E section review.\n\nGross examination included various tissue samples: a 1.2 x 0.3 x 0.3 cm biopsy from the right lobe of the liver; a 1.7 x 1.2 x 0.3 cm lymph node from the common hepatic area; a 1.5 x 0.5 x 0.3 cm fragment from the common hepatic duct margin; a 3.0 x 2.0 x 0.5 cm sample from the pancreatic body margin; and a 0.3 x 0.1 x 0.1 cm piece of tissue from the portal vein\u2019s adventitia. The Whipple specimen included a 34.0 cm length of duodenum, a 6.0 x 5.0 x 3.0 cm portion of pancreas, and a 9.3 x 4.2 x 2.6 cm gallbladder. The mass in the pancreatic head measured 4.6 x 2.3 x 2.0 cm and was diffusely infiltrative. The final margin from the pancreatic body measured 3.1 x 2.0 x 0.7 cm and showed no signs of invasive disease.\n\nAll tissues were submitted for microscopic evaluation."} +{"pid": "TCGA-A5-A0GM", "report": "The specimen included bilateral fallopian tubes and ovaries, uterus with cervix, multiple lymph node regions, and omental tissue. The left ovary showed a hemorrhagic cystic corpus luteum and serosal adhesions with reactive mesothelial changes; the fallopian tube appeared unremarkable. The right ovary contained cystic epithelial inclusions and an involuting corpus luteum, along with serosal adhesions and reactive mesothelial proliferation. A paratubal cyst was noted on the right fallopian tube, but no malignant changes were found.\n\nExamination of the uterus revealed extensive involvement of the endometrium by a neoplastic process, with extension into the lower uterine segment. The tumor exhibited nuclear features predominantly classified as grade 2, with focal areas displaying grade 3 characteristics. There was partial replacement of an endometrial polyp by the neoplastic cells. Myometrial invasion was present but limited to less than one-third of the inner myometrial layer. No vascular or lymphatic invasion was identified. The cervix, vaginal cuff, and parametrial tissues were free of tumor involvement.\n\nA single benign leiomyoma was identified within the uterine wall, measuring 1.3 cm in diameter. Non-neoplastic endometrial changes included hyperplasia with atypia. Inflammatory and reactive changes were also observed in the cervix and vaginal cuff. Lymph node evaluation revealed no evidence of metastatic disease: one reactive node was found on the right common iliac side (0/1), one on the right pelvic side (0/1), none were identified in the left common iliac region, and four reactive nodes were found in the left pelvic area (0/4). Omental samples showed fibrosis, hemorrhage, and reactive mesothelial changes without signs of malignancy.\n\nGross examination of the uterus showed a soft, tan, and focally hemorrhagic lesion involving the endometrium of the fundus and corpus, with superficial myoinvasion. The remaining myometrium was pink-tan and firm. The cervix and parametrial tissues had no visible tumor. The removed lymph node specimens varied in size, with the largest measuring 2.0 cm in the right pelvic region and others ranging from 0.3 to 1.2 cm. All omental specimens appeared grossly unremarkable aside from focal hemorrhage and fibrotic change."} +{"pid": "TCGA-P3-A6T0", "report": "A 10 x 10 x 6 cm surgical specimen consisting of a right mandible with attached soft tissues was received. The mandible included the ramus and body, with the posterior and superior aspects of the ramus surgically transected (measuring 3.6 cm in length). The anterior mandible remained intact, with a portion of the mental protuberance present just past the midline. A firm, irregular, nodular mass measuring 5.5 x 3.5 x 3.5 cm was identified in the right floor of the mouth, showing deep invasion into the mandible and possible extension into surrounding soft tissue.\n\nThe lateral surface of the mandible was covered by muscle, fibroadipose tissue, and a 6 x 3.5 cm elliptical skin segment containing a central defect measuring 1 x 0.2 cm. The inferior margin of the specimen included digastric muscle and a right-sided collection of fibroadipose tissue measuring 8 x 5.5 x 1 cm, extending to the left with a smaller collection measuring 5 x 1 x 0.3 cm. The anterior right lateral soft tissue margin was inked blue, and representative sections were taken for intraoperative frozen section evaluation. Sutures were used to designate lymph node levels: double long suture for right level III, double short for right level I, and single short for left level I. These sutures were located in the fibroadipose tissue on the respective sides.\n\nInking of the specimen was as follows: lateral \u2013 blue; inferior \u2013 black; posterior \u2013 orange; anterior \u2013 yellow; superior \u2013 green. The lesion was within 0.5 cm of the lateral blue margin, 0.3 cm from the superior green margin, 0.8 cm from the posterior orange margin, and 0.5 cm from the inferior black margin. The anterior yellow margin was free of involvement. Cross sections showed a submandibular gland at level I without suspicious nodularities.\n\nMultiple potential lymph nodes were identified in right level II, with the largest measuring 2 cm. In right level III, multiple potential lymph nodes were dissected, the largest measuring 0.5 cm. In the left level I segment, multiple potential lymph nodes were found, with the largest measuring 1 cm.\n\nCassette submissions included sections from margins, skin, submandibular gland, and lymph node levels. Intraoperative consultation noted that carcinoma approached within 0.4 cm of the soft tissue margin. Evaluation of the right anterior and posterior buccal margins was limited by cautery and orientation, with no definite invasive tumor identified.\n\nFinal assessment of the mandibular and neck dissection specimen revealed deeply invasive cellular proliferation with extension through cortical bone into skeletal muscle. The closest distance to the inked soft tissue margins was 0.3 cm at the inferior margin. Bony margins were ultimately found to be free of involvement after decalcification. Lymph node findings were as follows: right level I (0/1), right level II (0/6), right level III (0/7), and left level I (0/4), with no evidence of involvement. There was ulceration of the skin with suppurative inflammation in the dermis and subcutaneous tissue, consistent with abscess and sinus tract formation.\n\nMinimum pathologic staging was determined to be pT4a, pNO, pMX according to the AJCC 6th edition (2002). Two additional level I lymph nodes were identified in the addendum, with no evidence of involvement. All other diagnostic conclusions remained unchanged."} +{"pid": "TCGA-DU-A6S3", "report": "A male patient presented with a nine-month history of dizziness and lightheadedness. Imaging revealed a focal expansion of the cerebral cortex extending into the white matter in the right frontal lobe. The lesion demonstrated minimal punctate enhancement. A brain biopsy was performed.\n\nHistologic evaluation revealed a glial neoplasm with an oligodendroglial phenotype. The tumor diffusely infiltrates the brain parenchyma. Mitotic activity is very sparse, and the proliferation index, as assessed by MIB-1 staining, is low at approximately 3.5% in more active regions. No microvascular proliferation or necrosis was identified.\n\nGenetic analysis detected allelic loss on chromosome arms 1p and 19q. This finding was confirmed using multiple polymorphic microsatellite markers, including D1S1592, D1S552, D19S412, and PLA2G4C. DNA was extracted from the tumor specimen and compared to a control blood sample. The presence of more than 15% non-neoplastic cells could have potentially interfered with detection; however, sufficient tumor enrichment was achieved via microdissection.\n\nAdditionally, testing revealed methylation of the MGMT promoter. This assessment was conducted using bisulfite-modified DNA followed by real-time PCR amplification. The assay has an analytic sensitivity of detecting 1% methylated DNA within an unmethylated background. Factors such as tissue necrosis or high non-neoplastic cell content may affect result interpretation. \n\nImmunohistochemistry showed strong and uniform positivity for IDH1-R132 in the neoplastic cells.\n\nThe specimen measured 3.1 x 2.5 x 0.5 cm and consisted of tan-pink soft tissue with possible clotted blood. Three sections were submitted for analysis.\n\nAll genetic and molecular tests were performed under CLIA \u201988 regulations and are intended for informational use alongside established diagnostic and clinical criteria."} +{"pid": "TCGA-XF-A9T8", "report": "The specimen was received fresh from the operating room and included segments of right and left ureters, each measuring 0.3 cm in length and 0.4 cm in diameter. Both specimens were entirely submitted for analysis following frozen section evaluation, with no abnormal findings identified. No dysplasia or malignant cells were observed in either ureter.\n\nA cystoprostatectomy specimen was also received, weighing 590 grams. The bladder measured 10 x 6.5 x 3.2 cm, and was attached to peritoneum (14 x 10 x < 0.1 cm), right and left ureters (each approximately 4 cm in length), prostate (4 x 4 x 3.5 cm), and bilateral seminal vesicles. Upon opening the specimen anteriorly, a large tan-white lesion measuring 12 x 9.5 x 3.2 cm was identified. This lesion involved the right half of the bladder wall, extending to the dome, posterior wall, and inferiorly to the right anterior proximal prostate. The tumor extended into the perivesical soft tissue with a thickness of 3.2 cm and approached within 1 mm of the inked right resection margin. The mucosa beyond the central ulceration appeared granular, while the uninvolved left lateral wall mucosa showed edematous and smooth features. The right ureter was affected by the lesion for a length of 2 cm from the ureterovesical junction; however, the mucosa of both ureters was otherwise unremarkable. The tumor caused retraction at the peritoneal surface but did not grossly breach the peritoneum.\n\nSerial sectioning of the prostate revealed bilateral tan-white nodularities in the periurethral region. The prostatic urethra measured 3.5 x 1.3 cm, and the verumontanum measured 0.6 x 0.4 x 0.3 cm. The urethral mucosa was unremarkable. Histologically, there was evidence of glandular hyperplasia in the uninvolved prostate tissue. No dysplastic or malignant changes were noted at the apical or radial resection margins.\n\nLymph node dissection included multiple regions: left external iliac lymph nodes (three nodes examined), left lymph node of Cloquet (one node examined), left obturator/hypogastric lymph nodes (seven nodes examined), right lymph node of Cloquet (one node examined), right external iliac lymph node (one node examined), and right obturator/hypogastric lymph nodes (four nodes examined). In total, 17 lymph nodes were evaluated, and none showed evidence of malignancy.\n\nMicroscopic evaluation of the bladder revealed extensive flat lesions involving the urothelium throughout the bladder. There was evidence of lymphovascular space invasion. The uninvolved bladder mucosa demonstrated squamous metaplasia and edematous change. The prostate showed bilateral involvement with cellular features consistent with a Gleason score of 6 (3+3), confined within the prostate without capsular extension. All resection margins, including urethral, ureteral, and perivesical soft tissue, were free of dysplasia or malignancy.\n\nGross and histologic features were consistent with advanced local disease involving the bladder and adjacent structures, with no evidence of lymph node involvement."} +{"pid": "TCGA-CU-A0YR", "report": "The surgical specimen includes lymph nodes from right and left pelvic regions, as well as a cystoprostatectomy specimen. In the right pelvic lymph node dissection, six lymph nodes were examined and no abnormal cellular infiltration was identified. In the left pelvic lymph node dissection, five lymph nodes were evaluated, with involvement identified in four of these nodes. The largest focus measured 1.4 cm. No definitive extranodal extension was observed, although tumor was present in afferent lymphatics within several nodes. Immunohistochemical staining showed positivity for CK7 and p63, and negativity for PSA and PAP in this nodal tissue.\n\nThe cystoprostatectomy specimen included the bladder and prostate. Microscopic evaluation of the bladder revealed a lesion measuring 3.2 cm in greatest dimension. The tumor invaded into the muscularis propria and was unifocal, located in the anterior wall. Angiolymphatic space invasion was extensive. A minimal amount of intraepithelial abnormality was noted adjacent to the invasive lesion, while other areas of the bladder urothelium were unremarkable. No tumor was identified in ureters bilaterally or at any surgical margin, including the urethra and paravesicular soft tissue. Additional findings included a focal area of papillary cystitis in the dome of the bladder.\n\nIn the prostate, a distinct tumor was identified with a Gleason score of 8 (4+4). Approximately 10% of the prostate was involved, with a maximum dimension of approximately 3 cm. Tumor extended beyond the prostatic capsule into both right and left seminal vesicles. No angiolymphatic space invasion was identified in the prostate. Surgical margins were free of tumor involvement. Additional histologic findings included benign prostatic hyperplasia.\n\nImmunohistochemical analysis of the prostate tumor demonstrated positivity for PSA and PAP, and negativity for CK7 and p63. In contrast, the tumor identified in the lymph nodes showed immunophenotypic features consistent with the bladder lesion, being positive for CK7 and p63 and negative for PSA and PAP.\n\nA total of 11 lymph nodes were assessed across both pelvic regions, with 4 showing involvement. Staging according to AJCC criteria for the bladder component was pT2, pN2. For the prostate component, staging was pT3b, pN0. These staging assessments are based solely on the current pathologic findings and may require further clinical correlation for final determination."} +{"pid": "TCGA-EJ-5508", "report": "The patient is a male with a serum PSA level of 7.4 ng/ml and a family history of prostate cancer. He underwent a radical prostatectomy following an outside biopsy that showed multiple positive cores from various regions of the prostate, with Gleason scores ranging from 3+3=6 to 3+4=7. The clinical stage was T1c.\n\nPathologic examination of the surgical specimen revealed a tumor with a Gleason score of 3+4=7, including a small focus of Gleason pattern 5 in the left mid anterior-posterior prostate. This higher-grade component constitutes approximately 20% of the total tumor volume. The tumor involves both right and left lobes of the prostate, measuring up to 2 cm in maximum diameter and accounting for approximately 15% of the sampled prostate volume. There is focal extracapsular extension on the right side at the posterior mid and base regions, and multifocal perineural invasion is present. No angiolymphatic invasion or seminal vesicle involvement is identified. All surgical margins are free of tumor.\n\nLymph node dissection included four right pelvic lymph nodes and thirteen left pelvic lymph nodes; none showed evidence of malignancy. Histologic evaluation also revealed multifocal high-grade prostatic intraepithelial neoplasia and benign semiprostatic tissue with mild nodular hyperplasia and focal glandular atrophy.\n\nStaging indicates pT3a disease with no regional lymph node involvement (pN0) and no distant metastasis (pMX). The histologic grade corresponds to poorly differentiated or undifferentiated carcinoma."} +{"pid": "TCGA-DJ-A2QB", "report": "The specimen was received fresh and included multiple lymph node dissections from the right neck at levels 2, 3, 4, and 5, as well as soft tissue from the central compartment of the neck and a thyroid specimen with associated lymph nodes. Grossly, the right neck contents at level 2 contained multiple pink-tan firm lymph nodes ranging from 0.2 cm to 2 cm; 12 lymph nodes were identified and submitted. Level 3 lymph nodes ranged from 0.2 cm to 1 cm; 9 lymph nodes were identified, with one containing involvement measuring 0.15 cm, and the largest involved lymph node measured 0.5 cm. In level 4, lymph nodes ranged from 0.2 cm to 2.8 cm; 13 lymph nodes were identified, with one showing involvement measuring 2 cm, and the largest involved lymph node also measured 2 cm. No extranodal extension was observed in any of the involved nodes. Level 5 consisted of tan-yellow adipose tissue without identifiable lymph nodes.\n\nThe soft tissue from the central compartment of the neck showed no lymph nodes. The thyroid weighed 20.5 g, with the right lobe measuring 5.5x2.3x1 cm, the left lobe 3x2.5x1.5 cm, and the isthmus 1x2.2x0.6 cm. Seven nodules were identified, three in the right lobe and four in the left, ranging from 0.4 cm to 1.6 cm. The largest nodule was located in the right lobe and had a tan-brown fleshy cut surface. Histologic examination revealed multiple foci of well-differentiated cellular aggregates, with one focus showing follicular features and oncocytic changes, and several smaller foci. The foci ranged from 0.15 cm to 1.6 cm. Partial encapsulation was noted for the largest focus. No mitotic activity or necrosis was observed. Non-psammomatous calcifications and psammoma bodies were present. Invasion into perithyroidal fibroadipose tissue was identified. Surgical margins showed focal presence at the cauterized edge. At least six distinct foci were noted in both lobes, ranging from 0.2 cm to 0.9 cm. No abnormalities were found in the non-neoplastic portions of the thyroid, and parathyroid glands were not identified. A total of seventeen lymph nodes were examined across all levels, with three showing evidence of involvement. In one lymph node, the finding was represented by psammomatous calcifications. The largest involved lymph node measured 0.23 cm, with the involvement measuring 0.2 cm. No perinodal extension was identified. All other lymph nodes were benign."} +{"pid": "TCGA-2J-AAB9", "report": "A pyloro-sparing Whipple resection specimen includes a 4.0 x 3.0 x 3.0 cm diffusely infiltrative mass located in the pancreatic head, measuring 0.9 cm from the neck margin. The mass extends to involve the portal vein and duodenum. Histologic evaluation reveals a high-grade (grade 3 of 4) epithelial neoplasm with solid growth pattern. The tumor invades beyond the pancreas into peripancreatic soft tissue, infiltrates the muscularis propria of the duodenal wall, and involves the adventitia of a 4.0 cm segment of superior mesenteric/portal vein, which was resected en bloc. Perineural invasion is present, and tumor necrosis is not identified. All surgical margins are negative for tumor involvement, with the exception of the hepatic duct margin, where neoplastic cells are found in surrounding soft tissues nearly circumferentially. A microfocus of invasive carcinoma is identified 0.2 cm away from the body of pancreas margin, and the neck of pancreas margin also shows involvement. One lymph node adjacent to the neck margin is metastatically involved, and 5 of 34 regional lymph nodes are positive for metastatic disease. The gallbladder is unremarkable. Lymph nodes from the hepatic artery biopsy are negative. Margins of the superior mesenteric vein, portal vein, and new common hepatic duct are all free of tumor. The final staging, based on available material, is pT3N1 (AJCC 7th edition, 2010). Permanent histologic sections confirm findings from initial frozen section analysis, with no significant changes except in Part C, where a small focus of invasive carcinoma was identified at the body margin upon review. Multiple blocks were submitted for microscopic evaluation, including from the uncinate process, periduodenal and peripancreatic lymph nodes, ampulla, bile duct, duodenum, vein segments, and pancreatic tissue."} +{"pid": "TCGA-AA-A01R", "report": "The specimen shows a poorly differentiated neoplasm of the ascending colon. Histopathological analysis reveals a high-grade morphology with extensive necrotic areas. There is evidence of chronic, recurrent peritumoral inflammation and surface ulceration of the inner tumor margin. Lymphangitic spread of the neoplastic cells is present, with infiltration extending through the layers of the colonic wall into the surrounding fatty connective tissue. Examination of regional lymph nodes reveals 9 involved nodes out of 19. No residual tumor is identified in the resection margins or in the pericolonic adipose tissue. The disease demonstrates no clear distant metastasis (MX). Vascular invasion is present (L1), and the overall surgical resection is complete (R0). The primary lesion is classified as pT3, with nodal involvement pN2. A separate finding of chronic appendicitis is also noted."} +{"pid": "TCGA-VQ-AA6D", "report": "The specimen includes tissue from the hepatogastric ligament and omentum, both free of neoplastic involvement. The gastrectomy specimen shows a lesion located in the gastric antrum, classified as type III according to Borman's classification. Histologically, the lesion exhibits tubular and solid patterns, with moderate differentiation (Grade II). It is categorized under the intestinal type per Lauren\u2019s classification. The longest dimension of the lesion measures 7.0 cm. Ulceration is present, and there is involvement of adjacent adipose tissue with a spiculated pattern of invasion. A moderate inflammatory reaction is noted. No tumor implants are identified in the peri-visceral adipose tissue or in any other soft tissues examined.\n\nMargins of resection are free of neoplastic involvement: the proximal margin measures 14.0 cm and the distal margin measures 3.0 cm. There is no evidence of neural infiltration, lymphatic vascular invasion, sanguineous vascular invasion, or tumor implantation in soft tissues.\n\nLymph node assessment reveals no neoplastic involvement in the following chains: Chain 1 (right paracardiac, 0/2), Chain 3 (along the lesser curvature, 2/11 involved), Chain 7 (along the left gastric artery, 0/2), Chain 9 (around the celiac trunk, 0/16), and Chain 110 (inferior para-esophageal, 0/5). Both the esophageal and second gastric margins are also free of neoplasia.\n\nPathologic staging is based on topography and morphology, indicating advanced local extension and regional lymph node involvement."} +{"pid": "TCGA-SX-A7SP", "report": "The revised pathology report pertains to a left partial nephrectomy specimen. Histologic evaluation demonstrated a unifocal lesion located in the midportion of the left kidney, measuring 5.5 cm in greatest dimension. The tumor exhibited type 1 papillary architecture with Fuhrman nuclear grade 2 features. No sarcomatoid differentiation or tumor necrosis was identified. Microscopic examination revealed no extension into perinephric tissue, beyond Gerota's fascia, into the renal sinus, renal vein, collecting system, or adrenal gland. Surgical margins were negative, and there was no evidence of lymphovascular invasion. Lymph node assessment was not applicable. Non-neoplastic kidney tissue was insufficient for detailed evaluation.\n\nGrossly, the tumor was well-demarcated, tan-yellow, centrally hemorrhagic, and had a soft cut surface. It measured 5.5 x 4.5 x 3.5 cm and appeared to abut the inked parenchymal margin. No gross involvement of adjacent structures was noted. The specimen was inked with black at the resection margin. Blocks A1 through A6 were submitted for further testing, including frozen section analysis and potential additional studies. Immunohistochemical testing may have been used in the evaluation; these tests were developed and validated by the laboratory and are CLIA-certified for clinical use.\n\nStaging has been amended to pT1b, NO. Previously, the staging was reported as pT2, NX. All available sections confirm the absence of adverse local extensions or metastatic features."} +{"pid": "TCGA-N7-A4Y8", "report": "The specimen received included the uterus with cervix, bilateral fallopian tubes and ovaries, as well as multiple biopsies from various peritoneal and soft tissue sites. The uterus measured 15 x 13 x 11 cm and contained a large endometrial mass measuring 14 x 12.5 x 10 cm. This mass originated from the fundus and involved the anterior myometrium, extending to within 2 mm of the serosal surface. The mass was multilobulated, multicystic, and showed areas of necrosis and friable tan solid regions. Multiple nodules were present in both anterior and posterior aspects of the myometrium, with the largest measuring up to 3.0 cm. The cervix did not show any involvement.\n\nMicroscopic examination revealed a biphasic tumor composed of two distinct cellular components. One component demonstrated features of high-grade serous carcinoma, while the other exhibited rhabdomyosarcomatous differentiation. Immunohistochemical staining showed strong and diffuse positivity for p16 in the sarcomatous component. Focal positivity was also noted for desmin, smooth muscle actin, and myogenin. The tumor cells were negative for ER, PR, pancytokeratin, EMA, and CAM 5.2.\n\nInvolvement of the lower uterine segment was identified, but the endocervix was not affected. Lymphovascular space invasion was present. Regional lymph node assessment identified metastatic involvement in 2 out of 2 lymph nodes examined. No extranodal extension was observed.\n\nMetastatic involvement was identified in multiple biopsied sites including bilateral ovarian parenchyma, paratubal serosa, soft tissue surrounding the bladder peritoneum, gastrocolic omentum, periappendiceal tissue, rectal serosa, pelvic peritoneum, and rectal tumor biopsy. Involvement of the cecum peritoneum and muscularis propria of the appendix was also noted. The ovarian specimens showed metastatic deposits, with one ovary containing an additional separate fibromatous lesion measuring 2.2 cm.\n\nGrossly, multiple benign leiomyomas were identified in the uterus, with the largest measuring up to 25 cm. The right fallopian tube and ovary were attached to the uterus, while the left adnexa was detached. Both fallopian tubes appeared unremarkable. The right ovary was atrophic, and the left ovary had a pedunculated mass measuring 2.2 x 1.6 x 1.0 cm.\n\nThe omental specimen showed extensive nodular involvement throughout fatty tissue, with the largest nodule measuring 1.5 x 1.0 x 1.5 cm. The appendix specimen included a firm white area in the periappendiceal adipose tissue measuring 0.5 x 0.3 x 0.2 cm. Biopsies from the rectal serosa and pelvic peritoneum showed firm white-gray areas up to 3.0 x 2.0 x 0.4 cm. The rectal tumor biopsy showed similar heterogeneity with firm white-gray areas intermixed with adipose tissue.\n\nBased on the findings, the tumor extended beyond the primary site with widespread peritoneal and lymphatic dissemination. The pathologic staging reflects advanced local invasion, regional lymph node involvement, and distant metastasis."} +{"pid": "TCGA-CV-6938", "report": "Examination of decalcified bone specimens from the left nasal intima, left infraorbital nerve, tumor from pterygoid, infraorbital tissue, pterygoid plate, and tissue from pterygoid (specimens A, C, E, F, G, and I) demonstrates evidence of invasion into the bone by well-differentiated squamous carcinoma. In the tissue from the superior nasal cavity (specimen B), similar carcinoma is present but does not fully invade into the bone. The hemimandibulectomy specimen shows no evidence of bone invasion.\n\nIn the soft palate, well-differentiated squamous carcinoma is identified with margins of resection free of tumor. In the hemimandibulectomy specimen, the tumor is found within 0.1 mm of the superior and posterior soft tissue margins, while all other surgical margins are free of tumor involvement.\n\nMicroscopic evaluation of infraorbital tissue reveals sinonasal mucosa in connective tissue with focal granulation tissue and fibrosis, but no tumor is present. The inferior turbinate contains sinonasal tissue consistent with turbinate structure, with no tumor identified. Sections from the pterygoid plate are pending decalcification and further assessment.\n\nAdditional specimens including those from the lateral wall of the nasopharynx show similar cellular features. Bone specimens will be further submitted pending decalcification, and a supplemental report assessing bone invasion will be issued at a later time."} +{"pid": "TCGA-A3-3347", "report": "The specimen consists of a right kidney and a precaval lymph node. The kidney measures 10 x 6.5 x 3.8 cm and contains a mid-portion mass measuring 6.5 x 4.0 x 3.5 cm. The mass is tan-yellow, firm, and lobulated, and does not grossly involve the ureter or surrounding vessels. The adrenal gland is present and shows no involvement by the tumor; however, there is extension into the adjacent adipose tissue. The tumor is confined to the kidney capsule without transcapsular invasion and does not involve the renal vein or vena cava. Histologically, the tumor demonstrates clear cytoplasm and a Fuhrman nuclear grade of 2 of 4. In some areas, the cells exhibit a spindled morphology, but they retain clear cytoplasm and are not considered sarcomatoid. Lymphovascular space invasion is present.\n\nA single precaval lymph node was identified and measured 2.0 x 1.8 x 1.5 cm. It is involved by infiltrating tumor. All soft tissue, ureteral, and vascular surgical margins are free of malignancy. The pTNM staging classification is pT3a N1 MX. Genomic studies were performed on representative samples. A quality assurance review was conducted and findings were confirmed. Although no formal lymph node dissection was performed, the presence of metastatic involvement in the single lymph node suggests regional spread."} +{"pid": "TCGA-IQ-A6SG", "report": "A subtotal glossectomy specimen measured 7.0 x 6.0 x 4.0 cm and included portions of the ventral and dorsal tongue. An ulcerated area was observed on the dorsal surface measuring approximately 4 x 3 cm, extending into a tan-white firm mass. The mass measured 5.2 x 5.0 x 3.0 cm and occupied nearly 90% of the tongue with extension into the underlying floor of the mouth. It was located near the left lateral margin, approximately 1.0 cm from the anterior margin and close to the superior and right lateral margins (0.2 cm away). No involvement of adjacent salivary gland tissue was observed grossly.\n\nMicroscopic examination revealed squamous mucosa with keratosis at the tip of the tongue. Histologic evaluation of surgical margins, including deep tongue, anterior tongue remnant, floor of mouth muscle, alveolar ridge, pharyngeal mucosa, retromolar trigone, base of tongue, and lingual nerve structures, showed no evidence of malignancy. A total of seventy-one lymph nodes were evaluated across bilateral neck dissections (Levels 1\u20134), submental regions, facial areas, and tonsillar specimens; all were negative for malignant involvement.\n\nThe tumor was well-defined and appeared confined without lymphovascular or perineural invasion. Surgical resection margins were free of invasive disease. Intraoperative frozen sections confirmed absence of tumor in multiple anatomical sites including nerves, vascular structures, and mucosal margins. Pathologic staging indicated a primary tumor greater than 4 cm in size without regional lymph node metastasis."} +{"pid": "TCGA-QR-A7IN", "report": "The right adrenal gland specimen includes an intact gland measuring 5.7 x 5 x 0.9 cm with a loosely adherent oval maroon nodule measuring 3.5 x 3 x 1.5 cm. The total specimen size is 6.4 x 5 x 1.7 cm and weighs 5.5 grams. The nodule has a soft, friable, hemorrhagic cut surface and is partially embedded for analysis. Normal-appearing periadrenal fat measuring 1 x 0.6 x 0.5 cm is also sampled. The spleen specimen weighs 111.5 grams and measures 11 x 5.5 x 2.5 cm. A yellow-to-tan nodular area measuring approximately 1.8 x 1.5 cm is identified on the external surface, along with an additional white nodule measuring 0.5 cm in diameter at the opposite end. Representative sections of these nodules and surrounding normal spleen tissue are submitted for evaluation. No other abnormal nodules are found within the remainder of the spleen. Special stains including GMS and AFB-F show no evidence of fungal organisms or mycobacteria. All tissue samples have been processed and submitted for further histopathological examination."} +{"pid": "TCGA-56-7222", "report": "The specimen consists of a right upper lobe lung measuring 15.0 x 10.0 x 4.0 cm. Gross examination reveals an ill-defined, yellow-gray mass measuring 4.2 x 4.0 x 2.3 cm within the pulmonary parenchyma. The mass is located near the pleural surface, with close proximity to the umbilicated area of the pleura. Histologically, the lesion demonstrates predominantly squamous differentiation with focal areas showing glandular morphology. The tissue is moderately to poorly differentiated. Visceral pleural invasion and lymphovascular space invasion are present. No treatment effect is identified.\n\nSurgical margins are evaluated, with the tumor located 7.0 cm from the bronchial margin and 4.0 cm from the stapled parenchymal margin. The tumor invades the pleural surface. One peribronchial lymph node is identified and shows no evidence of metastatic involvement. Emphysematous changes are noted in the surrounding lung tissue. Staging is determined as pT2a NO. The specimen includes multiple sections submitted for microscopic evaluation, along with cassettes reserved for genomic research."} +{"pid": "TCGA-D6-A6EQ", "report": "The examined surgical specimen included a larynx with the hyoid bone and a segment of trachea measuring 1.5 cm in length. The total specimen dimensions were 9.5 x 7.0 x 3.5 cm. A lesion was identified in the glottal region, measuring 4.5 x 2.5 x 1.2 cm, with extension into the subglottic and supraglottic regions as well as the left aryepiglottic fold. Histopathological evaluation revealed invasive keratinizing cells with high-grade features. Surgical margins at the lower portion (tracheal margin) and superior margins were assessed using intraoperative frozen sections. Final assessment of margins was pending paraffin section analysis. Tumor staging was classified as pT3 based on depth and extent of invasion."} +{"pid": "TCGA-19-2629", "report": "A brain lesion biopsy and partial removal from the right parietal lobe was submitted for analysis. The specimen consisted of multiple soft tissue fragments. Microscopic examination revealed cellular features consistent with a high-grade neoplasm, including nuclear atypia, increased mitotic activity, and areas of necrosis. Immunostaining showed reactivity for CD3, indicating the presence of small lymphocytes, while CD20 staining was negative. The tissue was processed and evaluated using validated laboratory-developed tests with appropriate controls. All specimens were submitted in cassettes for histologic evaluation. The case was reviewed by a senior pathologist."} +{"pid": "TCGA-DB-A64L", "report": "The surgical specimen consists of multiple biopsies obtained from a right frontal brain mass, along with a CUSA specimen trap. Gross examination revealed four main tissue samples. The first was a 7.2 x 6.5 x 2.5 cm portion of brain tissue. The second sample measured 3.9 x 3.2 x 1.7 cm and was described as hemorrhagic, with the largest fragment measuring 3.2 x 2.1 cm. The third specimen was a 3.5 x 3.2 x 2.2 cm piece of brain tissue. The final sample, collected in a specimen trap, consisted of a 7.5 x 5.0 x 1.0 cm aggregate of brain fragments and blood clot.\n\nMicroscopic evaluation of the tissue showed areas of increased cellularity and elevated proliferative activity, with up to 3\u20134 mitotic figures per 10 high-power fields. Immunohistochemical staining demonstrated a Ki-67 labeling index of up to 10\u201315%. These findings were noted in focal regions and were interpreted as suggestive of early progression; however, they were not considered sufficient for a higher grade classification. Cytologic smears were initially interpreted as showing features of a glioma, with definitive grading deferred until histologic analysis of permanent sections was completed. Multiple blocks were processed from each specimen for detailed histopathologic review."} +{"pid": "TCGA-UB-A7MC", "report": "The specimen consisted of multiple parts. Part A included a lymph node measuring 1.1 x 0.6 x 0.5 cm from the left hepatic artery region, submitted entirely for examination. Part B consisted of a cystic artery lymph node measuring 1.1 x 0.6 x 0.3 cm and was also submitted in entirety. Part C was an intact gallbladder measuring 5.5 cm in length with a fundal diameter of 2.1 cm and neck diameter of 1.1 cm; it contained thin green bile without stones and showed no significant pathological abnormalities upon inspection. Part D was a portal caval lymph node measuring 1.6 x 0.8 x 0.1 cm with minimal attached adipose tissue and appeared grossly unremarkable.\n\nPart E consisted of a right hepatectomy specimen weighing 885 grams and measuring 13.5 cm (right to left), 11 cm (anterior to posterior), and 18 cm (superior to inferior). Gross examination identified two distinct lesions within the liver. The first lesion measured 7 x 6 x 6 cm and was located near the superior surface; it was soft, yellow-gold, homogeneous, and situated within 0.1 cm of the capsule and 0.7 cm from the surgical margin. Adjacent to this lesion was a second larger lesion measuring 9 x 6 x 6 cm, which was also soft and yellow-gold but focally hemorrhagic. This lesion was located approximately 1.4 cm from the surgical resection margin. A vessel was observed running between these two lesions without apparent involvement. An oval white-tan fragment of diaphragm was noted on the superior surface of the specimen; however, there was no evidence of invasion into the diaphragm itself.\n\nMicroscopic evaluation revealed no tumor involvement in three lymph nodes assessed across different anatomical regions: left hepatic artery, cystic artery, and portal caval areas. In the gallbladder specimen, focal mucosal autolysis was observed without other significant pathological findings.\n\nHistological assessment of the liver specimen demonstrated moderately to poorly differentiated cellular features with vascular invasion evident in small vessels as confirmed by immunohistochemical staining for ERG on relevant sections. Necrosis accounted for less than 10% of the total tumor burden. Multifocality was confirmed with two distinct tumor foci separated by non-neoplastic liver parenchyma. The combined tumor diameter totaled 16 cm. The tumor was found to abut the hepatic capsule but remained confined within the liver without extension beyond its margins. Surgical margins were negative for tumor involvement, although proximity was noted at 0.9 cm distance from the tumor edge. Additionally, tumor proximity was documented near the diaphragm (<4 mm) and adjacent to the marked IVC sidewall (<0.5 mm).\n\nEvaluation of the surrounding liver tissue indicated chronic hepatitis B infection characterized by diffuse staining for HBV surface antigen without core antigen expression. Fibrosis staging was assessed at stage 2 based on septal fibrosis with occasional bridging fibrosis but without architectural distortion. Iron staining performed on relevant sections was negative, ruling out iron overload as a contributing factor.\n\nImmunohistochemical markers were utilized for characterization purposes and interpreted according to clinical protocols. No hepatocellular nodules or cirrhotic changes were detected within the examined liver specimen. Based on AJCC staging criteria, the lesion was classified as pT3aNO."} +{"pid": "TCGA-CJ-4875", "report": "The right kidney specimen measured 12.0 x 6.5 x 6.0 cm and included a segment of ureter measuring 1.0 cm in length and 0.6 cm in diameter. A central, well-circumscribed mass measuring 8.0 x 7.0 x 7.0 cm was identified, replacing approximately four-fifths of the renal parenchyma. The mass extended into the renal sinus fat and perirenal fat, with the closest margin of the tumor to the perirenal surface measuring 0.8 cm. The cut surface of the mass was yellow with areas of necrosis and hemorrhage. Microscopic evaluation showed a cellular composition of 80% clear cells and 20% eosinophilic cells. Nuclear grading was classified as Fuhrman grade 3. Vascular invasion was present within thick-walled blood vessels in the renal sinus; however, there was no involvement of perinephric adipose tissue or renal vein. Margins of resection were free of involvement.\n\nA separate specimen from the right adrenal gland consisted of a yellow friable mass measuring 3.0 x 1.5 x 0.9 cm located centrally within the adrenal gland. This mass demonstrated similar histological features to the renal lesion and was surrounded by normal adrenal tissue. No lymph nodes were identified at the renal hilum. Sections submitted for analysis included representative samples of the tumor, adjacent fat margins, and uninvolved renal parenchyma. A section of the tumor was also submitted for potential electron microscopy studies."} +{"pid": "TCGA-FD-A3SJ", "report": "The patient is a male who underwent radical cystectomy with bilateral pelvic lymph node dissection. The surgical specimen includes the bladder, prostate, and vas deferens. Gross examination of the bladder revealed an area of ulceration and induration measuring 5 x 3 cm involving the posterior wall, right lateral wall, and left lateral wall. The lesion exhibited a flattened, granular mucosal appearance and invaded into the muscularis propria, reaching within 0.2 cm of the inked margin. Serial sectioning confirmed invasive high-grade cellular changes. No tumor involvement was identified at the ureteral margins, distal urethral margin, or soft tissue margin.\n\nA total of nine lymph nodes were identified in the right pelvic lymph node specimen. Three of these contained metastatic cellular deposits, with the largest implant nearly replacing a node measuring 0.8 cm. In the left pelvic lymph node specimen, seven lymph nodes were identified and showed no evidence of abnormal cellular infiltration.\n\nPathologic staging based on findings indicates invasion into the outer half of the muscularis propria (pT2b). Metastatic involvement was confirmed in the right pelvic lymph nodes (N2), while the left pelvic lymph nodes showed no signs of involvement. Distant metastasis could not be assessed (MX). All relevant tissue sections were submitted for microscopic evaluation and interpretation."} +{"pid": "TCGA-GM-A2DH", "report": "A right total mastectomy specimen measuring 22.0 x 16.0 x 4.5 cm was submitted, along with a skin ellipse measuring 10.0 x 5.2 x 0.5 cm that included an unremarkable nipple. The breast specimen was sectioned into ten slices, and an irregular solid white gritty mass measuring 1.5 x 1.5 x 1.2 cm was identified in slice 6. The tumor was located in the upper outer quadrant and measured 1.5 cm in greatest dimension. It was found 2.5 cm from the deep margin, 5.2 cm from the inferior margin, 5.5 cm from the superior margin, 5.5 cm from the skin, 6.5 cm from the lateral margin, and 6.0 cm from the medial margin. Microscopically, the tumor was composed of cells arranged in a high-grade pattern with marked nuclear atypia and a histologic grade consistent with the highest category assessed. Adjacent to the invasive component, there were ducts involved by high-grade changes showing solid and cribriform architecture with focal necrosis. Associated microcalcifications and changes involving lobules were also present. A separate focus of similar abnormal cells was identified within a dilated lymphatic channel adjacent to the tumor; however, due to the size of the channel and the solitary nature of this finding, it is uncertain whether this represents true vascular invasion or artifact. No similar cells were identified in the margins of resection. Additional findings included mild fibrocystic change throughout the remainder of the breast tissue. A single cluster of abnormal cells was noted within a lymphatic vessel near the tumor site.\n\nTwo sentinel lymph nodes were evaluated. Each was completely submitted for analysis. No abnormal cells were identified on routine microscopic examination of either node. Immunostains for keratin were performed on all sections of both nodes. In one section from the first sentinel lymph node, a single keratin-positive cell with suspicious features was identified. No similar cells were found in the second lymph node.\n\nAdditional testing was performed on a representative section of the lesion. Staining showed low positivity for estrogen receptor (1\u20139%), negativity for progesterone receptor, and high proliferation index by Ki-67 staining (>35%, approximately 50%)."} +{"pid": "TCGA-DD-AAE4", "report": "The specimen consists of a liver measuring 14.0 x 9.5 x 4.8 cm and weighing 244.5 grams, along with a distinct mass. A well-defined, round lesion measuring 2.5 x 2.5 x 2.3 cm is present, with a red to pale tan cut surface that is firm and solid, showing areas of hemorrhage. Gross examination indicates an expanding nodular growth pattern with multinodular confluence. The resection margin does not show involvement, with a safety margin of 0.5 cm. No satellite nodules are identified, and the surrounding liver tissue shows stage 4 cirrhosis.\n\nMicroscopic evaluation reveals cells arranged in a trabecular pattern with no evidence of fatty change, fibrous capsule formation, septum formation, surgical margin invasion, serosal invasion, portal vein invasion, microvessel invasion, intrahepatic metastasis, or multicentric occurrence. The cellular differentiation is primarily well-differentiated.\n\nSpecial stains show partial loss of reticulum and positive trichrome staining at the periphery of the cirrhotic liver.\n\nAdditional findings include chronic gastritis with erosion in the stomach antrum, a tubular adenoma with low-grade dysplasia in the sigmoid colon, and nasal cavity biopsies showing capillary hemangioma, fungal ball consistent with Aspergillus species, and lobular capillary hemangioma with erosion."} +{"pid": "TCGA-EX-A8YF", "report": "A total of 37 lymph nodes were examined from various anatomical locations, including the right external iliac, right obturator, presacral, right pelvic, left pelvic, and right periaortic regions. All lymph nodes showed no evidence of tumor involvement on H & E sections. In the right external iliac sentinel lymph node, one out of two nodes showed isolated cytokeratin-positive cells on immunostaining with AE1/AE3; however, this was noted in the context of a high background contamination. No other lymph node groups showed any such findings.\n\nA radical hysterectomy specimen included the uterus, cervix, parametrium, and bilateral fallopian tubes. The surgical margins were negative, with the closest invasive margin measuring 0.6 cm from the 12 o\u2019clock margin. There was no involvement of the vaginal cuff or parametrial soft tissue. Histologic examination revealed a unifocal lesion located in the anterior half of the cervix, measuring 3.2 cm in greatest dimension by combined slide measurement. The depth of invasion was 1.2 cm, with a horizontal extent of 3.2 cm. Cervical wall thickness was 3.0 cm, with approximately 40% invasion. Lymphovascular space invasion was present. The histologic appearance showed poorly differentiated features, with a solid, gritty, and friable texture. The endocervix showed a well-demarcated interface with the lesion, and the endometrial cavity measured 3.6 cm in length. The myometrial wall at the site of deepest invasion measured 2.5 cm in thickness. Incidental findings included uterine leiomyoma, right hydrosalpinx, and a normal-appearing left fallopian tube."} +{"pid": "TCGA-CV-6953", "report": "The surgical specimen includes a left supraomohyoid neck dissection with 27 lymph nodes, all without evidence of tumor involvement. This includes 7 submental-submaxillary, 5 subdigastric, 1 midjugular, 10 upper posterior cervical, and 4 mid posterior cervical lymph nodes. The right supraomohyoid neck dissection included 6 lymph nodes (5 submental-submaxillary and 1 subdigastric), none of which showed tumor presence. The submental gland was unremarkable in both dissections. A segment of the mental nerve along with fibrovascular tissue showed no tumor.\n\nIn the floor of mouth and anterior mandible specimen, a well-differentiated invasive lesion with features resembling a papillary-surface growth pattern was identified. The lesion measured 4.5 x 3.5 x 2.0 cm and exhibited vascular invasion. Resection margins, including mucosal and soft tissue, were free of abnormal cells. There was an ulcerated area with granulation tissue and significant acute and chronic inflammatory changes, consistent with a prior biopsy site. Focal epithelial changes including parakeratosis, acanthosis, and chronic inflammation were noted on the left posterior ridge, but no abnormality was present. The teeth and a portion of the mandible were submitted for examination but showed no relevant pathology."} +{"pid": "TCGA-A8-A094", "report": "The specimen shows a poorly differentiated invasive lesion with areas of intraductal involvement. The maximum tumor diameter measures 5 cm. Histological evaluation reveals high-grade nuclear features. Surgical margins are free of tumor involvement. Pathologic staging indicates pT2 with no lymph node involvement. Vascular invasion is not identified."} +{"pid": "TCGA-BS-A0V4", "report": "The specimen consisted of a uterus with cervix, bilateral fallopian tubes, and ovaries, along with multiple lymph node groups from the left and right pelvic regions, left aortic area, and right caval region. The uterus measured 11.0 cm in length, 7.5 cm in width, and 5.5 cm in anterior-posterior dimension, weighing 336.0 grams. On gross examination, the endometrium was thin, pink, and slightly hemorrhagic, measuring up to 0.1 cm in thickness. A friable, red-tan polypoid lesion measuring 3.5 x 3.5 cm was identified along the posterior aspect of the endometrial canal. The tumor appeared confined to the endometrium, with a myometrial thickness of at least 2.5 cm at that level. No gross involvement of the cervix or vaginal cuff was observed. A 1.0 cm circumscribed nodule consistent with a uterine fibroid was also noted.\n\nMicroscopic evaluation revealed no cervical or vaginal involvement by tumor. The neoplasm showed no parametrial, adnexal, or contiguous structure invasion, and no lymphovascular or perineural invasion was identified. Resection margins were free of tumor. Lymph node analysis showed 35 total lymph nodes examined across all regions (15 from left pelvic, 18 from right pelvic, 2 from right caval), all free of metastatic disease. One lymph node sample (left aortic region) contained no identifiable lymphoid tissue.\n\nAdditional findings included moderate to severe squamous dysplasia of the cervix, with a free margin at the vaginal cuff. Cervical and vaginal hyperkeratosis, as well as myometrial adenomyosis and leiomyoma, were also present. All surgical margins were negative. The tumor demonstrated minimal mucinous differentiation involving less than 10% of the lesion. Peritoneal cytology was negative for malignancy."} +{"pid": "TCGA-FP-8099", "report": "A 4 cm segment of esophagus was resected and examined, along with adjacent gastric tissue. The specimen included the gastroesophageal junction and measured 9 x 8 x 3.2 cm. The distal esophagus contained an ulcer measuring 0.8 cm in diameter, located 2.1 cm from the proximal margin and 3.8 cm from the distal margin. No gross tumor was visible. The muscularis propria was focally up to 1 cm thick. Margins were evaluated microscopically and showed benign squamous mucosa without tumor involvement. Sections from the gastroesophageal junction revealed a lesion extending into the adventitia. Histologic evaluation showed no lymphovascular invasion, though perineural invasion was present. Multiple lymph nodes were identified and all were negative for tumor involvement. Pathologic staging was determined as pT3 NO MX."} +{"pid": "TCGA-BK-A13C", "report": "The specimen includes a uterus with cervix, bilateral fallopian tubes, and ovaries, along with right and left pelvic lymph nodes, and a periaortic lymph node. The uterus measures 10.5 cm from cervical tip to fundus, 7.5 cm in breadth, and 5.5 cm in width. Upon sectioning, a tan, firm lesion is identified involving both anterior and posterior aspects of the myometrial wall. Invasion depth is estimated at 0.4 cm within a myometrial thickness of 2.4 cm, representing approximately 17% penetration of the wall. Involvement extends to the lower uterine segment and endocervix; however, the cervical mucosa remains smooth and unremarkable. The fallopian tubes and ovaries appear grossly unaffected.\n\nThe right pelvic lymph node specimen consists of an aggregate measuring 6.0 x 4.8 x 1.8 cm containing multiple lymph nodes up to 3 cm in greatest dimension. A total of 14 lymph nodes were examined microscopically, all without evidence of metastasis. Similarly, the left pelvic lymph node specimen, measuring 5.0 x 5.0 x 2.8 cm, contained several lymph nodes up to 2.5 cm in size. Eleven lymph nodes were assessed and none demonstrated metastatic involvement. The periaortic lymph node specimen measured 4.0 x 3.5 x 1.5 cm with lymph nodes up to 3 cm in diameter. Examination of five lymph nodes revealed no metastasis.\n\nMicroscopic evaluation of the hysterectomy specimen confirms the presence of a lesion within the endomyometrium with histologic characteristics consistent with grade 2 transformation. No vascular invasion is observed. Surgical margins remain free of involvement. Extensive adenomyosis is present within the myometrium. Both fallopian tubes and ovaries are devoid of malignant involvement. All lymph node specimens across regions demonstrate no evidence of metastatic disease."} +{"pid": "TCGA-BH-A1F8", "report": "The specimen consists of a left modified radical mastectomy and left axillary lymph node dissection. The primary lesion measures 4.0 \u00d7 3.5 \u00d7 3.0 cm and is located in the breast tissue. Histologic evaluation shows high-grade cellular atypia with moderate nuclear grading. A Nottingham score of 7 was calculated based on tubule formation (3), nuclear pleomorphism (2), and mitotic count (2). There is involvement of subareolar and nipple lymphatics, as well as extension into the dermis, dermal lymphatics, and overlying epidermis. An intraductal component of a specific variant is present, accounting for approximately 10% of the total volume. All surgical margins, including skin margins, are free of tumor involvement.\n\nIn the axillary lymph node dissection, thirteen lymph nodes were identified, twelve of which contain metastatic cells. Of these, six demonstrate prominent perinodal extension. Additionally, two separate tumor nodules are observed in a perivascular distribution, without clear lymph node architecture identifiable within the nodules."} +{"pid": "TCGA-AZ-4682", "report": "The surgical specimen from the sigmoid colon measured 32.0 cm in length and contained a lesion located in the rectosigmoid region. The lesion was ulcerating in configuration and measured 3.0 cm in its greatest dimension. Histologic evaluation revealed a cellular proliferation with low-grade differentiation, characterized as well to moderately differentiated. The lesion extended through the muscularis propria into the perirectal fat. No angiolymphatic or perineural invasion was identified. All surgical resection margins, including proximal, distal, and circumferential, were free of involvement. Three pericolic lymph nodes were examined and none showed evidence of involvement. A separate biopsy from the liver demonstrated a similar cellular pattern. The tumor exhibited a mild to moderate lymphocytic response. Additional findings included the presence of other polyps."} +{"pid": "TCGA-HV-AA8V", "report": "The clinical specimen included a fresh resection from a pylorus-preserving pancreaticoduodenectomy and cholecystectomy. The specimen consisted of a segment of small intestine measuring 21.0 cm in length and 5.3 cm in greatest circumference, a partial pancreas measuring 6.5 x 5.5 x 3.8 cm, a common bile duct measuring 2.8 cm in length and 1.4 cm in diameter, and a gallbladder measuring 13.0 cm in length and 3.7 cm in diameter.\n\nWithin the pancreatic head, there was an ill-defined pale tan solid and firm mass measuring 3.5 x 3.0 x 2.8 cm. The cut surface of the lesion was yellowish tan with a firm and granular texture. The lesion extended into the peripancreatic soft tissue and duodenal wall, and the resection margin was involved grossly.\n\nMicroscopically, the lesion showed poorly differentiated histology. The tumor measured 3.5 x 3.0 x 2.8 cm and extended into the peripancreatic soft tissue and submucosa of the duodenal wall. Lymphovascular and perineural invasion were present. All surgical margins were free of tumor involvement.\n\nLymph node evaluation revealed no tumor in two lymph nodes from station 12. One lymph node from station 13 contained metastatic disease. Among 19 peripancreatic lymph nodes, two contained metastatic involvement."} +{"pid": "TCGA-A6-4107", "report": "The specimen consists of a 17 cm segment of proximal right colon with attached 13.5 cm of distal ileum. The serosal surface is smooth to slightly scabrous and tan-pink, with mesocolon and mesentery present. A 4.7 cm appendix is present, ranging from 0.5 to 0.8 cm in diameter. The proximal and distal margins measure 4.0 and 6.5 cm in circumference, respectively. Upon opening, a circumferential, lobulated, soft tan-pink lesion measuring 7.8 x 4.6 cm is identified approximately 8 cm from the ileocecal valve. The tumor has a maximal thickness of 1.4 cm and extends through the muscularis propria into the superficial pericolonic fat. It is located greater than 3 cm from the inked free serosal surface.\n\nThe ileal mucosa is finely nodular and tan-pink with irregular folds; the wall averages 0.5 cm in thickness. The uninvolved colonic mucosa appears glistening and tan-pink with irregular folds, with a wall thickness averaging 0.5 cm. Multiple lymph nodes are recovered from the mesocolon and mesentery, with sizes up to 1.4 cm in greatest dimension. Sections submitted include proximal and distal margins, central tumor, radial serosal surface, ileocecal valve, random ileum and colon, appendix, and multiple lymph nodes. Several lymph nodes are found to contain metastatic tissue.\n\nMargins of resection are free of involvement. The histologic grade is moderately differentiated. No vascular invasion is identified. The tumor is more than 19 cm from the distal margin. Endometriosis is noted in the appendix. One block was submitted for molecular testing."} +{"pid": "TCGA-DJ-A3V9", "report": "The thyroid specimen measured 4.8 x 2.5 x 1.6 cm on the right lobe, 4.8 x 2.2 x 1.2 cm on the left lobe, and the isthmus measured 2.5 x 1.2 x 0.6 cm. The thyroid weighed 15.5 grams and was partially encapsulated by a thin fibrous capsule. Three nodules were identified upon sectioning: one measuring 0.7 cm in the left inferior lobe, another measuring 0.4 cm in the right superior lobe, and the largest measuring 2.3 cm in the right mid-inferior lobe. These nodules were well-circumscribed with focal calcifications. No discrete lesions were observed in the isthmus. Histologically, multiple foci of cellular proliferation were identified, characterized by well-differentiated morphology without necrosis or mitotic activity. Surgical margins were negative for tumor involvement.\n\nIn the right neck level two dissection, fifteen benign lymph nodes were examined and showed no evidence of malignant involvement. In level three, nineteen lymph nodes were assessed with six demonstrating metastatic involvement; the largest involved lymph node measured 1.2 cm with a metastatic focus of 0.8 cm. In level four, fifteen lymph nodes were evaluated with one showing metastasis; the largest involved lymph node measured 0.4 cm with a metastatic focus of 0.2 cm. In the central compartment neck dissection, seven lymph nodes were analyzed with five showing metastatic involvement; the largest lymph node measured 0.9 cm with a metastatic focus of 0.7 cm. No extranodal extension was observed in any of the lymph node levels examined.\n\nBiopsy of anterior neck fat revealed fibroadipose tissue without evidence of tumor involvement. Non-neoplastic thyroid tissue exhibited chronic lymphocytic infiltration. Parathyroid glands were not identified within the specimen."} +{"pid": "TCGA-A4-A48D", "report": "The specimen was obtained from a partial nephrectomy on the right kidney. The tumor measured 4.2 cm in greatest dimension and was found as a single focus. Gross examination revealed a well-circumscribed, encapsulated-appearing mass with a delicate, predominantly deep-red and hemorrhagic cut surface. The tumor was located within the kidney and approached within 0.3 cm of the nearest surgical margin. The surrounding renal tissue appeared dusky red and purple. Histologically, the tumor demonstrated features consistent with nuclear grading system category 3. No sarcomatoid features were identified. Microscopic evaluation confirmed that the tumor was confined to the kidney with no evidence of lymphovascular invasion. Surgical margins were negative. Lymph node involvement could not be assessed. Based on extent of primary tumor, the staging classification was pT1b. The overall pathologic stage was classified as stage I. Non-neoplastic kidney tissue showed mild arteriolonephrosclerosis."} +{"pid": "TCGA-SQ-A6I6", "report": "The resected right adrenal specimen weighed 63 grams and measured 8.0 x 6.0 x 4.5 cm. A mass measuring 5.0 cm was identified within the gland. The mass was well-circumscribed, with a solid, brown to yellow appearance and areas of focal hemorrhage. No significant necrosis was observed. An eccentric portion of the adrenal gland measuring 4.0 x 2.0 x 1.1 cm showed central hemorrhage and a thin cortical rim. The mass was surrounded by a thin fibrous capsule and extended to the inked margin. No treatment effect was noted.\n\nMicroscopic evaluation revealed a neoplasm involving the adrenal medulla. The tumor exhibited a nested and focally solid growth pattern. The cells were polygonal with vesicular nuclei, prominent nucleoli, and eosinophilic to amphophilic granular cytoplasm. Moderate nuclear variation was present. No mitotic figures or necrotic areas were identified. Intranuclear inclusions and scattered eosinophilic cytoplasmic inclusions were observed.\n\nImmunohistochemical staining showed positivity for synaptophysin, chromogranin, and S-100. Cytokeratin (CK AE1/AE3) was negative. Ki-67 staining demonstrated a low proliferative index. Histologic features suggestive of aggressive behavior, such as increased mitotic activity or necrosis, were not present."} +{"pid": "TCGA-CV-A45W", "report": "A 2.5 x 2.0 x 1.5 cm lesion was identified in the right supraglottic region, extending into the anterior commissure, left supraglottic area, and epiglottis. The tumor measured up to 1.5 cm in thickness and demonstrated extension across the midline. Gross examination revealed no involvement of the right infraglottic region. All resection margins were free of tumor. Focal severe dysplasia was noted in the squamous epithelium at the right posterior mucosal margin; all other margins showed no evidence of tumor involvement.\n\nLymph node evaluation included 28 lymph nodes from the right neck (1 level I, 14 level II, 4 level III, and 9 level IV), ranging in size from 0.2 to 1.4 cm. On the left side, 17 lymph nodes were evaluated (7 level II, 4 level III, and 6 level IV), with sizes ranging from 0.2 to 1.8 cm. No metastatic disease was identified in any of the lymph nodes examined.\n\nThe thyroid gland showed no diagnostic abnormalities. Additional specimens including the posterior cricoid area and left pyriform sinus revealed squamous mucosa without diagnostic abnormality. Multiple sections of the tumor and surrounding margins were submitted for microscopic evaluation."} +{"pid": "TCGA-EA-A44S", "report": "The specimen consisted of a simple hysterectomy. The lesion measured 3 x 4 x 6 cm and was located in the endocervix. Histologic evaluation revealed moderately differentiated cells with invasion involving the entire length of the endocervix and extension into the upper third of the vagina. The tumor thickness was 3 cm. The endometrium showed proliferative changes. On the right ovary, findings included serous cystadenoma, follicular cyst, and luteal body with hemorrhage. The left ovary contained follicular cyst and fibrous bodies. The fallopian tubes appeared normal. A total of 10 lymph nodes were examined\u20145 on the right and 5 on the left. Of these, 4 from the right side showed involvement, while those on the left demonstrated reactive changes only. No venous invasion was identified. Surgical margins were not involved. No evidence of neo-adjuvant treatment was observed. No additional significant pathologic findings were noted."} +{"pid": "TCGA-HC-7078", "report": "The specimen consists of a prostate gland with attached seminal vesicles. The prostate measures 5 x 6 x 3 cm and weighs 51 grams. The seminal vesicles are approximately 2.5 cm in length and 1 cm in diameter, appearing grossly unremarkable. The gland has a yellow to gray-tan multinodular cut surface without a distinct mass lesion. Histologic evaluation reveals benign prostatic hyperplasia. High-grade prostatic intraepithelial neoplasia is present.\n\nHistologic patterns show primary pattern 3/5 and secondary pattern 4/5, resulting in a combined score of 7/10. The lesion involves both lobes and accounts for approximately 20% of the gland volume. There is focal extension beyond the capsule in the left posterior region. No involvement of the seminal vesicles, lymphovascular invasion, or perineural invasion is identified.\n\nSurgical margins evaluated at the bladder neck, apical region, and inked prostatic margin are all negative. Three lymph nodes were examined from the bilateral pelvic lymph node dissection, none of which show evidence of metastatic disease. Sections from all regions of the prostate were submitted for analysis, including multiple levels from base to apex on both sides. The PTNM stage assigned is pT3aN0, MX."} +{"pid": "TCGA-A5-A0R8", "report": "A total hysterectomy with bilateral salpingo-oophorectomy and lymph node dissection was performed. The uterus measured 7.0 x 4.9 x 4.8 cm. Within the endometrial cavity, a soft yellow-tan friable lesion was identified in the anterior uterine corpus, lower uterine segment, and fundus, involving an area measuring 3.8 x 3.5 cm. The lesion extended into the myometrium with invasion of approximately 55% of the wall thickness. The maximum depth of invasion was 12 mm, in an area where the myometrial thickness was 21 mm. The tumor reached into the outer half of the myometrium but did not involve the serosal surface. No involvement was seen in the cervix, vaginal cuff, or parametrial tissues.\n\nThe tumor exhibited focal vascular invasion. Surgical margins were uninvolved. Nine pelvic lymph nodes were examined (right and left sides, pelvic and common iliac regions), and none showed evidence of tumor involvement. No para-aortic lymph nodes were identified or examined.\n\nIn addition to the primary lesion, two ill-defined areas of tan-yellow tissue were noted within the posterior uterine corpus myometrium. One measured 1.8 x 1.0 cm and extended 0.8 cm into the myometrium; the other was 0.7 x 0.6 cm and extended up to 1.0 cm into the myometrium. Seven well-circumscribed leiomyomas ranging from 0.2 to 2.0 cm were also present, including intramural, submucosal, and subserosal types.\n\nThe cervix showed benign findings, including a possible endocervical polyp and squamous metaplasia. Both fallopian tubes and ovaries appeared unremarkable, with no significant pathological changes noted. Paratubal cysts were identified on the right side, each measuring up to 0.5 cm in diameter.\n\nLymph node specimens from both pelvic and common iliac regions were submitted and evaluated. All lymph nodes showed no evidence of tumor involvement. Tissue from the right common iliac region contained fibroadipose material without identifiable lymph nodes.\n\nAll relevant sections of the tumor, including the deepest point of invasion, surrounding normal tissue, and involved anatomical regions, were submitted for histological evaluation."} +{"pid": "TCGA-FJ-A3ZF", "report": "The pathology report includes findings from two specimens. The first specimen, obtained from the bladder (anterior wall and dome), consists of multiple tissue fragments measuring 4.5 cm x 4.5 cm x 1.5 cm in total. Microscopic examination reveals extensive exophytic and invasive high-grade urothelial cells arranged in nests and cords, with areas showing clear cell morphology. Invasion into the muscularis propria is present. Necrosis and calcification are also observed. Lymphovascular invasion could not be definitively assessed due to cautery artifact and the presence of cleft-like spaces around some tumor nests. No perineural invasion is identified.\n\nThe second specimen is a small biopsy from the left renal pelvis, measuring 0.1 cm. Histologic evaluation shows papillary urothelial cells with enlarged nuclei and rare mitotic figures. However, there is less nuclear pleomorphism compared to the bladder specimen and a lower nucleus-to-cytoplasm ratio. No lamina propria is present, making assessment of invasion impossible.\n\nCytologic evaluation of a left renal pelvis brushing demonstrates numerous urothelial cells with low nuclear atypia and some clusters exhibiting a papillary appearance, raising suspicion for low-grade involvement. In contrast, cytology from a left renal pelvis washing shows no evidence of high-grade dysplasia or malignant cells.\n\nAll specimens were processed and evaluated with appropriate preparation methods, and adequacy for evaluation was confirmed in each case."} +{"pid": "TCGA-DX-A6BF", "report": "The surgical specimens include a large right retroperitoneal mass along with adjacent structures. The primary mass measures 38.3 cm in greatest dimension and consists of both a predominant well-differentiated component and a dedifferentiated region, which accounts for approximately 40% of the tumor. The dedifferentiated areas exhibit high-grade spindle and pleomorphic sarcoma-like morphology and contain 25\u201330% necrosis. The tumor involves the renal capsule and extends to the serosa of the colon. All resection margins, including those at the renal vascular, ureteral, and colon sites, are free of tumor. A second mass located on the duodenum and pancreas measures 8.5 cm and is composed entirely of well-differentiated tissue. This lesion extends to the inked resection margins. One associated lymph node is present and appears benign. A third specimen from the small bowel mesentery contains well-differentiated tissue measuring 4.5 cm. Microscopic evaluation confirms that the tumor components are present in the specified regions without evidence of involvement beyond the described anatomical boundaries."} +{"pid": "TCGA-F7-A624", "report": "The specimen was obtained from the buccal mucosa and measured 3.2 x 2.0 x 1.5 cm. Microscopic examination revealed a histologic grade consistent with moderately differentiated morphology. The tumor was found to have lymphatic and venous invasion, with positive margins. Immunohistochemical staining showed positivity for vimentin, HMWcytokeratins, and CK7. Stains for S100, HMB45, chromogranin, and CD56 were negative. Proliferative activity, as assessed by ki67 staining, was present in approximately 90% of cells. Lymph node involvement was identified, and there was no evidence of neoadjuvant treatment effect."} +{"pid": "TCGA-AA-3833", "report": "The submitted tissue specimen demonstrates a poorly differentiated neoplasm with features suggestive of partial neuroendocrine differentiation. Histological evaluation reveals infiltration through all layers of the intestinal wall and evidence of vascular invasion. The proximal resection margin shows ileal-type mucosa, while the distal margin exhibits colonic-type mucosa. The ligature region contains adipose and connective tissue with adequate vascular structures. The appendix displays signs of chronic, recurrent inflammation with scarring and notable lymphoid follicle activation. Lymph node analysis indicates chronic resorptive lymphadenitis with similar follicular activation. A total of 12 lymph nodes were examined, none of which show evidence of involvement. The surgical margins are free, and the staging corresponds to pT3 with L1 and V1 classifications."} +{"pid": "TCGA-A3-A8OW", "report": "The specimen consists of a left kidney obtained via radical nephrectomy. The kidney, along with perinephric fat, weighs 446 grams and measures 17.5 x 9 x 4.5 cm. An intact-appearing portion of adrenal gland is present and measures 6.5 x 3.5 x 1 cm. Gerota\u2019s fascia is identified along the anterior surface of the kidney, measuring approximately 10 x 5 cm. The central-lateral surface of the kidney is disrupted, revealing a bulging cortical area. No gross involvement of the adrenal gland is noted. The renal artery and vein are identified at the hilum, with no visible intraluminal abnormality. A segment of ureter measuring 6.5 cm in length is also present, with unremarkable urothelium.\n\nA well-circumscribed, golden-yellow, thinly encapsulated lesion measuring 3.3 x 3.2 x 2.8 cm is identified. It is located in the middle portion of the kidney and abuts the cortical surface. Grossly, the lesion does not extend through the renal capsule into the surrounding perirenal adipose tissue. The distance from the tumor to the hilar vessels is 3.5 cm. There is evidence of surgical manipulation along the superior edge of the tumor, including cautery and cavitation. Hemorrhage is noted extending into the hilar fat. The remainder of the kidney appears normal with a distinct cortical-medullary junction and cortical thickness of 0.7 cm. No other masses are identified upon sectioning. The perinephric adipose tissue is free of lymph nodes or other abnormalities.\n\nMicroscopic evaluation reveals a unifocal lesion with clear cell morphology. The nuclear grade is Fuhrman 2. The tumor extends into the perinephric adipose tissue but does not extend beyond Gerota's fascia. No sarcomatoid features or tumor necrosis are identified. Lymphovascular invasion is not present. Surgical margins are negative. The histologic assessment confirms the absence of tumor involvement in regional structures.\n\nStaging data indicate that the primary tumor invades the perirenal fat (pT3a). Regional lymph node status and distant metastasis cannot be determined (pNX, pMX). The pathologic stage is III. All submitted margins are free of tumor. Multiple sections from various areas of the specimen, including hilar structures and adjacent tissues, confirm these findings."} +{"pid": "TCGA-3A-A9I7", "report": "The specimen from the pancreatic head, duodenum, and distal stomach was received for analysis. The pancreatic head measured 7 x x 2.5 cm, with the duodenum measuring 16.0 cm in length and up to 4.5 cm in circumference at the distal resection margin, and the distal stomach measuring 4.5 cm in length and up to 10.0 cm in circumference at the gastric resection margin. A focal lesion measuring 1.5 x 1.0 cm was identified within the duodenum, centered at the ampulla of Vater. On sectioning, the lesion extended up to 0.5 cm in depth and involved adjacent pancreatic tissue as well as the distal common bile duct and main pancreatic duct. The tumor partially obstructed the distal common bile duct and pancreatic duct junction, with the dilated portion of the bile duct measuring up to 1.8 cm in circumference and located 0.5 cm from the closest retroperitoneal resection margin.\n\nHistologic evaluation revealed a moderately differentiated exocrine neoplasm arising in the pancreatic ductal epithelium. Evidence of vascular invasion was present, including both venous and lymphatic vessel involvement. Perineural invasion was not identified. The invasive component measured 1.5 cm in greatest dimension. Extension of the tumor was noted into the duodenum, common bile duct, ampullary region, and peripancreatic soft tissues. No residual tumor was seen at the pancreatic resection margin, common bile duct margin, or retroperitoneal margins. Evaluation of surrounding pancreatic parenchyma demonstrated fibrosis and changes consistent with intraepithelial precursor lesions of the highest grade PanIN 3.\n\nA total of 28 lymph nodes were examined, with two showing evidence of metastatic involvement. One lymph node from the hepatic artery region showed metastatic involvement. Deeper sections of selected lymph node blocks confirmed this finding. Additional lymph nodes recovered from peripancreatic and omental adipose tissues were also evaluated.\n\nOther specimens included a gallbladder measuring 8 x 4 x 3 cm with no grossly identifiable lymph nodes or perforations. The mucosa appeared unremarkable, and the cystic duct was patent. Histologic examination revealed chronic inflammatory changes. A single lymph node from the hepatic artery region, measuring 1.4 cm in greatest dimension, was entirely submitted for analysis. A biliary stent, measuring 13.0 cm in length and 0.2 cm in diameter, was received for gross evaluation only.\n\nAll surgical margins were free of tumor involvement. Frozen section analysis confirmed negative margins for the pancreatic resection margin, common bile duct margin, and retroperitoneal margins. Multiple tissue blocks were submitted for microscopic evaluation, including representative sections from the gastric and duodenal margins, ampulla of Vater, bile duct, pancreatic parenchyma, and surrounding adipose tissue containing potential lymph nodes."} +{"pid": "TCGA-CN-6020", "report": "A biopsy of the anterior floor of mouth revealed a poorly circumscribed, firm lesion measuring 3.8 cm involving the inferior tongue and floor of mouth. The tumor was moderately differentiated and demonstrated perineural invasion. Surgical margins were free of tumor involvement. A left level I neck dissection included seven lymph nodes, one of which contained metastatic disease in level 1B (0.3 cm). No extracapsular spread was identified. The submandibular gland on this side showed chronic sialadenitis and atrophy. On the right side, level I dissection included four lymph nodes, all without evidence of tumor, and the submandibular gland also exhibited chronic sialadenitis and atrophy. Left and right level 2\u20134 neck dissections included 31 and 26 lymph nodes respectively, none of which contained tumor. A biopsy of the right anterior tongue margin showed keratosis without malignancy. The pathologic stage was determined as pT2 pN1. Ancillary studies were performed and results were documented as an addendum. The specimen was processed and reviewed in multiple parts with appropriate staining and imaging techniques used for analysis."} +{"pid": "TCGA-IZ-8195", "report": "The specimen consists of a left kidney and adrenal gland, weighing 1060 grams. The overall dimensions of the specimen are 22 x 15 x 11 cm. The kidney itself measures 15 x 10.5 x 6.5 cm, with the adrenal gland measuring 5 x 1.5 x 1.0 cm. Upon bisection, a necrotic mass is identified in the upper pole of the kidney, measuring 9 x 9 x 6 cm. The mass appears to displace the renal capsule and has a friable, hemorrhagic cut surface. No tumor involvement is observed at the surgical margins or within the adrenal gland.\n\nThe histologic evaluation reveals a granular cell-type morphology with papillary architectural features. Nuclear grading according to the Fuhrman system is grade 2 out of 4. No sarcomatoid component is identified. Lymphatic or small vessel invasion is not present. No lymph nodes are identified in the specimen, and none are submitted for examination.\n\nThe tumor is confined to the kidney without evidence of regional or distant spread. The distance from the mass to the UP junction is 2.9 cm. A small cortical area in the lower pole, measuring 1.1 cm, shows no involvement. Multiple sections are taken from various regions including the mass, surrounding capsule, fatty tissue, and unaffected parenchyma. One section (A12) highlights a minor cortical focus with papillary change, but no definitive tumor is seen there.\n\nThe procedure performed was a radical nephrectomy. All surgical margins are free of involvement. The tumor is classified as focal with a size of 9 x 9 x 6 cm. According to TNM staging, the tumor is pT2a, with no lymph node or distant metastasis identified (pNX, pMX)."} +{"pid": "TCGA-BP-5008", "report": "The right kidney specimen, including perirenal fat, measured 8.5 x 6.1 x 4.0 cm and weighed 298 g. A segment of ureter measuring 7.5 cm in length and 0.6 cm in circumference was attached. No adrenal gland or lymph nodes were identified. A well-circumscribed, hemorrhagic mass measuring 2.5 x 2.0 x 1.6 cm was found in the anterior mid portion of the renal cortex. The mass was encapsulated and did not involve the renal capsule, sinus fat, or vascular structures. No tumor thrombus was identified. The surrounding renal parenchyma and pelvic mucosa appeared unremarkable.\n\nHistologic evaluation revealed a neoplastic lesion with clear cell morphology. Nuclear grading was classified as grade II out of IV. No evidence of local invasion or venous involvement was observed. Surgical margins were free of tumor. Background kidney tissue showed mild chronic interstitial inflammation and fibrosis. All relevant sections, including ureteral and vascular margins, background kidney, tumor with capsule, and pelvic mucosa, were submitted for analysis. The tumor was confined to the kidney and measured 2.5 cm in greatest dimension."} +{"pid": "TCGA-GM-A2DO", "report": "A total of three sentinel lymph nodes were evaluated from the right side. Sentinel lymph node #1 measured 0.8 x 0.6 x 0.6 cm and was not blue-stained; sentinel lymph node #2 measured 0.8 x 0.5 x 0.5 cm and contained blue dye; sentinel lymph node #3 measured 0.7 x 0.5 x 0.5 cm and was not blue-stained. Each lymph node underwent serial sectioning with touch preparations performed. No tumor involvement was identified in any of the lymph nodes based on cytokeratin immunohistochemical staining.\n\nThe right segmental mastectomy specimen measured 6.0 x 6.0 x 3.0 cm and revealed a firm white lesion measuring approximately 1.5 x 1.0 cm upon gross examination. The lesion was located closest to the superficial margin at 0.5 cm, lateral margin at 0.4 cm, inferior margin at 0.4 cm, superior margin at 1.5 cm, and deep margin at 2.0 cm. Histologic evaluation demonstrated well-differentiated cellular features with nuclear characteristics consistent with modified Black\u2019s nuclear grade 1. Fibrocystic changes and atypical lobular hyperplasia were present, along with alterations suggestive of a prior biopsy site.\n\nAdditional specimens included a superficial inferior lateral margin fragment measuring 4.0 x 4.0 x 0.8 cm and an additional inferior margin fragment measuring 3.5 x 2.0 x 0.8 cm. Both specimens showed fibrocystic changes and atypical lobular hyperplasia without evidence of tumor involvement.\n\nAn excisional biopsy from the left breast measured 3.0 x 3.0 x 2.0 cm and exhibited fibrous tissue along with findings consistent with prior biopsy intervention. No identifiable lesion was observed grossly.\n\nImmunohistochemical staining was conducted on representative sections from the primary lesion in the right breast. Estrogen receptor expression was positive in 90% of cells, progesterone receptor expression was positive in 80%, HER-2/neu showed no overexpression (score of 0%), and Ki-67 demonstrated high proliferation (>35%) with a score of 65%."} +{"pid": "TCGA-G9-6347", "report": "The prostate specimen weighed 59 grams and measured 4.0 cm from apex to base, 4.5 cm from anterior to posterior, and 5.5 cm from right to left. The capsule was tan-pink, smooth, and intact. Following removal of the apex and base, the remaining prostate weighed 32 grams. Serial sectioning from apex to base revealed beige-tan spongy tissue. The right and left seminal vesicles measured 5.0 x 1.5 x 1.0 cm and 3.5 x 2.0 x 1.0 cm, respectively, and showed beige-tan cystic structures with no gross evidence of abnormal involvement. The right and left vas deferens measured 3.0 x 0.6 cm and 3.5 x 0.5 cm, respectively, and displayed beige-tan tubular structures with no gross evidence of abnormal involvement.\n\nHistologic evaluation demonstrated bilateral involvement from the apex to mid-gland in the peripheral zones. The glandular involvement was approximately 25%. High-grade prostatic intraepithelial neoplasia was present. Perineural invasion was identified. There was no evidence of vascular or lymphatic invasion, extraprostatic extension, seminal vesicle involvement, periprostatic fat involvement, or bladder neck involvement. All surgical resection margins were free of abnormal cells. No lymph nodes were sampled. Additional findings included benign prostatic hyperplasia. Pathological staging was determined as pT2c, Nx, Mx. Tissue procurement was performed at Levels II and IV. The remainder of the specimen was submitted for detailed histologic analysis across multiple levels and regions."} +{"pid": "TCGA-GV-A40E", "report": "The specimen consists of multiple fragments of tan-pink rubbery soft tissue measuring 4.6 x 3.4 x 1.8 cm in aggregate and weighing 8.1 grams. Histologic evaluation reveals a solid/nodular lesion composed of poorly differentiated cells with focal features of squamous differentiation. The lesion is associated with high-grade cytologic atypia. There is clear evidence of invasion into the muscularis propria (detrusor muscle), confirming deep mural involvement. No adenocarcinomatous or squamous cell carcinoma components are identified. No additional epithelial lesions are present. The tissue sample includes adequate muscularis propria for assessment; however, lymph-vascular invasion cannot be definitively determined. Additional findings include cautery artifact and areas of necrosis. All material has been submitted for evaluation."} +{"pid": "TCGA-06-5417", "report": "The patient presented with severe left-sided symptoms and imaging findings revealing two contiguous brain lesions. The first lesion was described as large, parasagittal, located in the superior left frontal region, with irregular enhancement, likely extra-axial in origin, and supplied by a branch of the middle meningeal artery; this lesion was embolized prior to surgery. The second lesion was partially cystic, measured 5.5 cm in diameter, located inferiorly in the anterior frontal lobe, demonstrated mild enhancement, and exerted mass effect on the lateral ventricle.\n\nMultiple tissue samples were obtained during surgery from different regions of the brain. Histopathological examination revealed two distinct tumor types. In one set of specimens, there was evidence of a necrotic tumor with low proliferative activity (MIB-1 index approximately 2%). These fragments showed no viable brain tissue and were interpreted as originating from a previously treated lesion.\n\nIn other specimens, histologic analysis identified a glial neoplasm infiltrating the cerebral cortex and adjacent white matter. The tumor cells exhibited marked pleomorphism, including multinucleated and giant cells, along with prominent nuclear atypia, frequent mitotic figures, microvascular proliferation, and areas of necrosis with pseudopalisading. The MIB-1 proliferation index in these areas ranged from 30% to 35%. In one region, the tumor appeared more infiltrative, while in others it was more solid and less differentiated.\n\nImmunohistochemical staining showed strong expression of GFAP, p53 overexpression, and absence of neuronal markers. Synaptophysin and neurofilament stains confirmed dense infiltration of cortical and white matter without neuronal involvement.\n\nGenetic testing performed on the tumor tissue revealed methylation of the MGMT promoter, suggesting potential responsiveness to alkylating agent therapy. Additionally, allelic loss was detected on chromosome arm 19q but not on 1p. This assessment was based on microsatellite marker analysis using PCR methodology.\n\nThe surgical specimens varied in appearance: one was described as fibrous and encapsulated measuring 2.0 cm; another consisted of multiple necrotic fragments measuring up to 2.5 x 1.8 x 0.7 cm. Other specimens included semi-firm pink-grey tissue fragments totaling 1.0 cm, firm grey-white fragments measuring 2.5 cm in aggregate, and tan-white smooth cut tissue fragments measuring 2.7 cm across collectively.\n\nThese findings indicate a complex tumor presentation involving both necrotic and highly cellular components with distinct molecular features."} +{"pid": "TCGA-WK-A8XX", "report": "The surgical pathology report describes a resected specimen from a partial or total kidney procedure. The tumor measured 7.0 cm and was identified as high-grade based on cellular features. Microscopic evaluation revealed up to 22 mitotic figures per 10 high-power fields. Areas of necrosis were present within the tumor. The resection margin involving the vena cava was free of tumor, with the closest distance being 0.5 cm. One lymph node examined showed no evidence of tumor involvement. A simple cyst was identified in the kidney, with no tumor involvement noted in this structure.\n\nEvaluation of the kidney tissue showed mild chronic changes, including focal global glomerulosclerosis affecting approximately 5.6% of glomeruli. There was also focal tubular atrophy and interstitial fibrosis involving 5\u201310% of the parenchyma, along with a subcapsular scar. Moderate arterial and arteriolar sclerosis was observed. Histologic stains including H&E, PAS, Jones silver methenamine, and trichrome were used for assessment. A total of 322 glomeruli were identified, with 11 globally sclerosed; an additional 8 glomeruli within the scarred area were also sclerosed. No significant mesangial expansion, glomerular capillary wall abnormalities, or inflammatory infiltrates were identified. Two small cortical cysts were lined by benign epithelium. Rare PAS-positive hyaline casts were seen in distal tubules. Less than 10% of the cortical parenchyma demonstrated tubular atrophy and interstitial fibrosis. Foam cell infiltration and calcium phosphate crystal deposition were also noted.\n\nThe gross specimen included a radical nephrectomy specimen weighing 1428 g and measuring 30.0 x 18.0 x 6.8 cm. The kidney measured 12.2 x 6.2 x 3.5 cm and was surrounded by adipose tissue. A thin-walled cyst measuring 2.0 cm was located in the upper pole. The cortex thickness ranged from 0.6 to 1.1 cm. The tumor was described as white/tan, lobulated, and focally hemorrhagic, with a thin capsule. It surrounded a bifurcating vessel designated as the vena cava. Representative sections of the tumor and surrounding tissues were submitted for further analysis, including electron microscopy, cytogenetics, and tissue banking. No adrenal gland or lymph nodes were identified in the specimen."} +{"pid": "TCGA-BS-A0U8", "report": "The specimen consisted of multiple tissue samples including the anterior bladder flap, a pelvic nodule, a uterine fibroid, the uterus with cervix, fallopian tubes and ovaries, several lymph nodes from the left and right pelvis and aorta, omental tissue, and a sigmoid epiploic appendage. \n\nThe anterior bladder flap showed evidence of metastatic involvement. The pelvic nodule was identified as a benign epithelial-lined polyp. The uterine fibroid displayed typical features of a leiomyoma. The uterus revealed a friable, polypoid, exophytic lesion involving the endometrial surface, measuring 3.5 cm in area. Histologically, the lesion was low grade (FIGO grade 1) with nuclear grading between 1 and 2. The tumor extended through the myometrium to the uterine serosa and into parametrial tissue, with involvement of the serosal surface. Lymphovascular invasion was present. The cervix was free of tumor involvement. The larger ovary contained a metastatic focus, while the smaller ovary had a microscopic focus on its surface.\n\nLymph node analysis showed one out of two left pelvic lymph nodes involved, and one right pelvic and one right parametrial lymph node were also positive for tumor involvement. The right aortic lymph node was free of tumor, while no lymphoid tissue was identified in the left aortic lymph node. Omental tissue and the sigmoid epiploic appendage did not show any tumor involvement.\n\nGrossly, the endometrial lesion measured 3.5 x 3.0 cm in area and appeared invasive, with extension into the myometrium estimated at 0.9 cm depth in a 1.5 cm thick myometrial wall. Parametrial extension was noted both grossly and microscopically. The larger ovary contained a 2.0 cm friable mass within the parenchyma, consistent with metastatic involvement. Multiple myometrial masses up to 0.5 cm were also observed. All other submitted tissues, including the omentum, sigmoid, and cervical sections, were free of tumor."} +{"pid": "TCGA-HZ-8636", "report": "The surgical panel included multiple biopsies and a distal pancreatectomy. A liver biopsy revealed a subcapsular fibrotic nodule with calcification and no evidence of malignancy. A pericolic tissue biopsy showed the presence of poorly differentiated adenocarcinoma. A perigastric tissue biopsy demonstrated mild nonspecific peritonitis, with no malignancy identified.\n\nThe distal pancreatectomy specimen contained a white-tan, heterogeneous mass measuring 9 x 8 x 3.2 cm. The tumor extended into surrounding soft tissues and was attached to the colon wall and diaphragm. Histologically, the lesion exhibited high-grade features with perineural and angiolymphatic invasion. Margins were involved at the radial attachments to the colon and diaphragm. Evaluation of regional lymph nodes in the peripancreatic area found no evidence of metastasis (0 out of 2 nodes positive). However, three accessory splenic nodules were identified, two of which contained adenocarcinoma.\n\nStaging parameters indicated a T3 tumor based on local extension beyond the pancreas without involvement of major vessels. No regional lymph node involvement was present (N0), but distant metastases were confirmed (M1) involving the colon, diaphragm, and splenic nodules. The background pancreas and pancreatic transection margin were unremarkable. Intraoperative frozen section analysis confirmed the presence of adenocarcinoma in the main mass and negative margins at the proximal resection site. Multiple tissue sections were submitted for further histologic evaluation."} +{"pid": "TCGA-ET-A25I", "report": "The specimen from a total thyroidectomy measures 5.5 x 4.5 x 1.5 cm and weighs 14.49 grams. A single lesion is identified in the left superior pole, measuring 2.4 x 1.8 x 1.5 cm. The lesion is unifocal and entirely submitted for analysis. No other lesions are identified upon serial sectioning. Margins are uninvolved, and there is no evidence of venous or lymphatic invasion. One regional lymph node is identified and shows no involvement. The primary lesion is confined to the thyroid gland without extrathyroidal extension. Lymphocytic infiltration is present throughout the thyroid tissue. Two parathyroid glands are identified, one on the left inferior and one on the right side. Distant metastatic status cannot be determined. All sections have been processed and are designated according to their anatomical location."} +{"pid": "TCGA-MU-A5YI", "report": "The specimen consisted of four parts. Part A, labeled as left pelvic lymph nodes, included multiple fragments of tan/yellow, slightly firm tissue measuring 4.5 x 3 x 0.2 cm in total. Upon sectioning, one possible lymph node was identified, measuring 1 cm in greatest dimension. The specimen was submitted in four cassettes, and no abnormal cells were detected (0 of 10 examined).\n\nPart B was labeled as right pelvic lymph nodes and consisted of multiple yellow/brown, slightly firm fragments measuring 5.5 x 4 x 1.5 cm in total. Multiple possible lymph nodes were found, with the largest measuring up to 2.5 cm in diameter. The specimen was submitted in four cassettes, and no abnormal cells were identified (0 of 7 examined).\n\nPart C was labeled as a right periaortic lymph node. It consisted of a single fragment of tan/yellow, slightly firm tissue measuring 2.5 x 1.5 x 0.5 cm. One possible lymph node was identified upon sectioning and was entirely submitted in one cassette. No abnormal cells were found (0 of 1 examined).\n\nPart D consisted of a hysterectomy specimen including the cervix, upper vagina, bilateral fallopian tubes, and ovaries. The uterus weighed 134 grams and measured 7.3 x 6.1 x 2.3 cm. The cervix measured 4.0 x 3.0 cm and contained a circumferential red/brown ulcerated mass surrounding the cervical opening. This mass measured 1.2 x 1.2 x 1.0 cm and was located 1.0 cm from the ectocervical margin. The tumor extended into all quadrants and reached a maximal depth of invasion of 0.71 cm within a cervical wall thickness of 1.1 cm. Lymphovascular invasion was present. The surgical margins were free of abnormal cells. The endometrial lining measured 0.1 cm in thickness and showed no active cellular changes. Subserosal nodules were noted on the uterine surface, with the largest measuring 0.7 cm. Two white, whorled nodules were observed: one subserosal nodule measuring 0.5 cm and one intramural nodule measuring 0.6 cm.\n\nThe right ovary measured 2.5 x 2.0 x 1.0 cm, and the right fallopian tube measured 5.0 x 0.5 cm. The left ovary measured 2.0 x 2.0 x 1.1 cm, and the left fallopian tube also measured 5.0 x 0.5 cm. On microscopic examination, the fallopian tubes showed no significant changes. Both ovaries revealed small cystic structures, with the largest measuring up to 1 cm in the left ovary and up to 0.5 cm in the right ovary. No metastatic involvement was seen in the parametria or ovaries.\n\nA total of 35 cassettes were submitted for this specimen, including sections from all areas of the cervix, parametria, lower uterine segments, myometrium, and both fallopian tubes and ovaries. Microscopic analysis confirmed absence of malignant cells at the surgical margins and in the parametrial regions."} +{"pid": "TCGA-DQ-7591", "report": "The specimen from the left base of tongue consists of an irregular portion of soft tissue measuring 0.6 x 0.7 cm. Histologic examination reveals invasive, poorly-differentiated, nonkeratinizing cellular proliferation. Immunohistochemical staining demonstrates diffuse and strong positivity for P16 and EGFR. In situ hybridization testing is positive for high-risk HPV. All slides have been personally examined and interpreted by the signing staff pathologist. The testing performed has been developed and validated by the laboratory, and is used for clinical purposes under CLIA certification for high-complexity testing."} +{"pid": "TCGA-55-6980", "report": "The specimen included multiple lymph nodes and a resected portion of the right lower lobe of the lung. The inferior pulmonary ligament lymph node measured 1.0 x 0.8 x 0.3 cm and showed a hyperpigmented cut surface. Histologically, it demonstrated sinus histiocytosis with focal anthracosis and no evidence of metastatic involvement. The right lower lobe specimen weighed 144 grams and measured approximately 20 x 19 x 5 cm. A previously sectioned nodule measuring 1.5 x 1.5 x 0.8 cm was identified 2.6 cm from the hilar margin. The lesion had an ill-defined yellow-white appearance on sectioning and did not breach the overlying pleura. Microscopic evaluation revealed a subcapsular lesion composed of well-differentiated cells arranged in linear arrays within alveolar spaces. A small central scar was noted, but there was no vascular invasion or visceral pleural penetration. The bronchial resection margin was free of abnormal cells. Adjacent lung tissue showed mild chronic obstructive changes. Intrapulmonary lymph nodes showed benign histiocytic proliferation with anthracotic pigment. Three additional lymph nodes were evaluated: one from the tracheal region (N2), one subcarinal, and another from surrounding the hilum. All measured up to 0.9 cm and displayed similar histiocytic changes without evidence of tumor involvement. The final assessment indicated no metastatic disease in any of the lymph nodes examined. The primary lesion was confined to the lung with no vascular or nodal spread identified."} +{"pid": "TCGA-AA-3982", "report": "The specimen shows a lesion with extensive necrosis and poor differentiation, corresponding to a high-grade morphology. The lesion penetrates through all layers of the intestinal wall and is associated with vascular infiltration. Resection margins are free in both the mucosal region, which shows normal mucosa, submucosa, and muscularis, and in the mesenchymal region. Regional lymph node examination reveals three positive nodes out of thirteen assessed. Additional findings include the presence of diverticular formations."} +{"pid": "TCGA-IE-A4EI", "report": "The operative procedure involved a radical resection of a left thigh mass. The pre-operative diagnosis was a left thigh sarcoma. The specimen measured 10.0 x 9.0 x 7.5 cm and consisted of fat and muscle with sutures indicating distal and proximal orientation. Gross examination revealed a 6.5 x 5.6 x 5.0 cm tan-white to red, lobulated, hemorrhagic, well-delineated mass. The mass was located within 0.1 cm of the nearest peripheral margin, 1.0 cm from the distal margin, and 1.7 cm from the proximal margin. The remaining tissue showed tan, lobulated fatty tissue admixed with homogeneous muscle.\n\nHistologically, the tumor was high grade with a mitotic rate of 12 per 10 high-power fields. No necrosis was identified. Margins were negative for tumor involvement, with the closest distance from the tumor to a peripheral margin being 0.1 cm. Pathologic staging was pT2b. Regional lymph node status could not be assessed (pNx) as no lymph nodes were examined. Distant metastasis could not be determined (pMx). Immunohistochemistry was performed on prior biopsy material; no cytogenetic or molecular studies were conducted. There was no identifiable treatment effect."} +{"pid": "TCGA-X6-A8C2", "report": "The surgical specimen from the left lower extremity consists of a resected soft tissue mass measuring 5.0 cm in greatest dimension. The mass is described as well-circumscribed, with a red-brown and focally white appearance on sectioning. It abuts the deep margin, which corresponds to a fascial plane, and also contacts the superior and superolateral margins. The distance from the tumor to the inferior and medial margins is 0.3 cm, and 0.2 cm from the superficial margin. Margins are otherwise uninvolved.\n\nSubmitted components include multiple excision margins. Tumor was identified at the superior margin on frozen section, but not in additional superior margin samples. The final resection specimen shows no residual tumor at the superior, medial, or inferior margins. No lymphovascular or perineural invasion is present.\n\nThe specimen includes representative sections of the main mass and surrounding tissue. Microscopic evaluation confirms the presence of high-grade cellular features consistent with the previously noted lesion. The pathologic staging is determined as pT1a, with no assessable regional lymph node involvement (NX). The most representative block for further analysis is designated as D2. All other submitted tissue blocks show no evidence of residual disease."} +{"pid": "TCGA-XF-A9SI", "report": "A radical cystectomy with ileal conduit was performed. Gross examination included a cystectomy specimen with attached uterus, right adnexa, and anterior vaginal wall. The bladder measured 7.5 x 7 x 3 cm with a mass identified at the left lateral aspect near the bladder neck. This mass measured 3.5 cm in greatest dimension and extended into the deep muscularis propria. It approached but did not involve perivesical soft tissue. The closest radial margin was 0.4 cm from the tumor. A lymphovascular space invasion was observed.\n\nMicroscopic evaluation revealed an extensive invasive poorly differentiated papillary transitional cell lesion. Nuclear grade was 4/4 with marked pleomorphism, increased nuclear to cytoplasmic ratio, prominent nucleoli, frequent mitotic figures, and areas of necrosis. The trigone showed mild urothelial changes without high-grade dysplasia or flat lesions. Focal erosion and chronic inflammation were noted in the bladder along with a foreign body giant cell reaction suggestive of prior biopsy. All resection margins were free of malignant or dysplastic cells.\n\nThe anterior vaginal wall showed benign squamous mucosa. The cervix exhibited no significant histopathologic changes. The endometrium was atrophic with small intramural leiomyomas identified in the myometrium. The right ovary and fallopian tube showed no abnormalities.\n\nLymph node evaluation included multiple regional sites. No metastatic carcinoma was identified in a total of 75 lymph nodes examined. These included left and right para-aortic, common iliac, external iliac, obturator/hypogastric, presciatic, presacral, and lymph nodes of Cloquet. Pathologic staging was determined as pT2bNOMX.\n\nAdditional studies included submission of representative tissue for p53 assay by immunohistochemistry; results pending addendum."} +{"pid": "TCGA-DF-A2KZ", "report": "The sample was obtained from an endometrial mass via surgical resection. The tissue was collected as part of a fresh frozen preparation. The patient's age at the time of sample collection is noted, though exact age is unspecified in the summary. The tumor measured approximately 4.2 centimeters in size and was classified as histological grade III. Pathological staging indicated T1b with no available nodal staging (NX), as the number of sampled lymph nodes was unspecified and the number of positive nodes was recorded as indeterminate. Histological evaluation revealed endometrioid adenocarcinoma with up to 50% component showing squamous or transitional differentiation, confirmed by immunohistochemical analysis. No distant metastasis was identified clinically (M0). Additional information regarding bilateral disease involvement was not available (UNK). Time intervals between procedure and diagnosis were reported as 12 days."} +{"pid": "TCGA-SC-A6LP", "report": "A 1.5 x 0.8 x 0.3 cm tan-pink nodular fragment of rubbery tissue was received fresh and placed in formalin. A second specimen measuring 1.6 x 1.5 x 0.5 cm consisted of soft, irregular to slightly nodular tan-white tissue fragments. Both specimens were obtained from the right pleura. Histologic examination revealed a biphasic cellular composition. One component exhibited epithelioid morphology, while the other displayed sarcomatoid features. Immunohistochemical staining demonstrated positivity for CK7, with focal reactivity for WT1 and calretinin. The epithelioid component comprised approximately 20% of the tumor, while the sarcomatoid component accounted for approximately 80%. Sections from frozen and permanent specimens were evaluated, and findings were consistent across both analyses. Some testing methods used in the evaluation have not been cleared or approved by the US Food and Drug Administration but were performed under CLIA-certified conditions for clinical purposes."} +{"pid": "TCGA-44-7670", "report": "The specimen consists of a left upper lobe of lung tissue measuring 17 x 16 x 6\u20138 cm, amputated at the level of the main bronchi. Several anthracotic lymph nodes are present around the margin, along with staple lines. A firm nodule measuring 1 cm is observed on the pleura, approximately 5 cm from the bronchial stump. Serial sections reveal a second mass measuring up to 2.5 cm, located subpleurally. The mass has a spiculated appearance with a granular tan and black cut surface containing anthracotic pigment. It causes puckering and folding of the surrounding lung tissue and lies approximately 1 cm beneath the pleural surface. No additional nodules are identified after sectioning.\n\nAdditional specimens include multiple soft tissue fragments from various lymph node levels. Level 5 measures 1.5 x 1.5 x 0.4 cm; level 11 measures 0.6 x 0.3 x 0.3 cm; level 9 measures 1.7 x 0.7 x 0.3 cm; level 7 measures 1.2 x 0.6 x 0.3 cm; and level 10 measures 1.5 x 0.8 x 0.3 cm. All were submitted in entirety.\n\nMicroscopically, the primary lesion shows moderate to poorly differentiated cellular features. The tumor measures up to 2.5 cm and is confined to the lung parenchyma without involvement of the visceral pleura (pT1b). Resection margins are negative. There is no evidence of direct tumor extension, venous, arterial, or lymphatic invasion. Among regional lymph nodes, one of seven peribronchial nodes contains malignant cells, while all sampled mediastinal nodes are negative (pN1). Distant metastasis could not be assessed (pMX). Additional findings include subpleural fibrosis and focal emphysematous changes."} +{"pid": "TCGA-AX-A1CK", "report": "The specimen includes a uterus with cervix and bilateral adnexa, weighing 175 grams. The uterus measures 9 x 7 x 7 cm, and the cervix is 3 cm in diameter with a 1 cm os. Sectioning reveals a tumor within the endometrial cavity measuring 5.5 x 4 x 2 cm anteriorly and 4 x 2 x 1 cm posteriorly. The adjacent myometrium measures 2 cm in thickness. Microscopic evaluation shows cellular proliferation with a pushing invasive front, involving the inner half of the myometrium, estimated at approximately 35% of the total myometrial thickness or 14 mm of invasion into a total thickness of 40 mm. The tumor extends into the lower uterine segment and approaches but does not involve the endocervix. No vascular or lymphatic invasion is identified.\n\nThe cervix demonstrates parakeratosis and is free of tumor involvement. Both ovaries and fallopian tubes are unremarkable, without evidence of malignancy. Three firm, well-circumscribed masses up to 3 cm in size are noted within the myometrium, with a tan, whorled appearance and no necrosis or hemorrhage. These are present in the lower uterine segment, predominantly on the posterior aspect.\n\nLymph node dissections include 7 left pelvic nodes, 1 right para-aortic node, 7 right pelvic nodes, and 2 left para-aortic nodes\u2014all negative for tumor involvement (total 17 nodes examined, none positive). Margins of resection are uninvolved by invasive disease.\n\nAdditional findings include leiomyomas and focal adenomyosis. No other significant pathologic findings are present."} +{"pid": "TCGA-BH-A1FR", "report": "The specimen consists of an ellipse of skin and breast tissue measuring 8.5 by 6.5 by 5.0 cm. A mass measuring 2.2 by 1.7 by 3.0 cm is present within the tissue, located 2.0 cm from the posterior resection margin and 1.0 cm from the anterior resection margin. The mass is firm with focal areas of hemorrhage. Microscopic evaluation of the submitted sections shows a well-differentiated cellular component with features suggestive of neuroendocrine differentiation, supported by positive special stains including NSE and Grimelius. A separate in-situ component of non-comedo type is identified at the periphery and within the mass. All surgical margins are free of involvement. Representative sections of the mass and surrounding tissue, including the skin, have been submitted and reviewed."} +{"pid": "TCGA-FY-A3W9", "report": "The right and left thyroid lobes were submitted for evaluation. The left lobe measured 4.8 x 2.3 x 1.8 cm and contained a well-circumscribed tan nodular lesion measuring 2.3 x 1.4 x 3 cm. This lesion abutted the anterior and posterior margins of the thyroid. Cut sections revealed multiple foci of calcifications. Multiple benign nodules ranging from 0.5 to 1.2 cm were also identified within the thyroid parenchyma. A separate multilobular purple-tan fragment measuring 1.8 x 0.8 x 0.6 cm was attached to the mid medial periphery of the right thyroid lobe. Microscopic examination showed no evidence of metastasis in one lymph node evaluated. One benign parathyroid gland was identified.\n\nThe tumor was unifocal and measured 2.3 cm in greatest dimension. Histologic features included partially encapsulated growth with minimal capsular invasion. No lymphovascular invasion or extrathyroidal extension was observed. The tumor focally extended to the inked surgical margin. Other margins were uninvolved. The specimen demonstrated multiple adenomatoid nodules consistent with multinodular goiter. All tissue from the thyroid lobes was submitted for microscopic evaluation.\n\nPathologic staging based on available data: primary tumor pT2 (limited to the thyroid), regional lymph nodes pN0 (0/1 lymph node positive), distant metastasis not applicable. The overall pathologic stage was II. Margin status was R1. No additional lymph nodes were identified in the current specimen. A prior left lobectomy specimen contributed to the overall staging assessment."} +{"pid": "TCGA-XU-A92Z", "report": "The specimen includes a lymph node from the left phrenic region measuring 0.8 x 0.5 x 0.3 cm, which showed no evidence of malignancy. The second specimen consists of a resected thymus along with a wedge of lung and a portion of pericardium. The entire specimen measured 13.0 x 7.0 x 5.5 cm and weighed 155 grams. A tumor located in the midportion of the thymus occupied approximately 70% of the organ and measured 8.0 x 5.5 x 4.0 cm. It was tan-colored with a whorled appearance and contained a cystic, hemorrhagic, and necrotic area measuring 2.5 x 1.5 x 1.5 cm. The tumor was nearly completely encapsulated and adhered to the pericardium but did not invade it. However, invasion into adjacent lung tissue was present.\n\nHistologically, the tumor was composed of nests and sheets of cells with oval to spindled nuclei showing mild to moderate atypia and moderate pale cytoplasm. Thick fibrous bands separated the cellular areas, and prominent glandular and cyst-like structures were observed. Numerous mitoses were present, along with focal necrosis and areas of hemorrhage. The tumor extended to within 0.1 cm of a soft tissue margin at the superior pole, but the lung and pericardial margins of resection were free of tumor involvement.\n\nImmunohistochemical staining showed positivity for low molecular weight keratin, CK5/6, and p63, with focal positivity for CK20, CD5, and CD56. Staining was negative for smooth muscle actin, calponin, CD117, chromogranin, synaptophysin, CK7, and TTF-1. Sections of the lung showed marked anthracosis. Residual thymic tissue exhibited follicular hyperplasia and involutional changes.\n\nMargins of resection included a deep area of pericardium with tumor serially sectioned, a lung wedge margin after staple removal, tumor in relation to lung parenchyma, samples from the superior pole, apparently normal thymic tissue, and the cystic portion of the tumor."} +{"pid": "TCGA-DX-A23V", "report": "The specimen consists of a segment of duodenum measuring 15 cm in length, with stapled proximal and distal margins measuring 5 cm and 6 cm in circumference, respectively. A fragment of pancreatic tissue measuring 2 x 1 x 0.5 cm is attached at the superior margin between the second and third portions of the duodenum. On the superior aspect of the third portion of the duodenum, there is an attached tumor nodule measuring 4 x 3 x 2.5 cm with a 0.5 cm pedicle located 2 cm from the distal margin. Another multinodular tumor is identified on the anterior surface of the duodenal wall, located 5 cm from the distal surgical margin. These nodules range from 1 to 3.5 cm in diameter.\n\nA segment of ascending colon and terminal ileum is also present. The terminal ileum measures 2.5 cm in length with a proximal margin measuring 4 cm in circumference. The ascending colon measures 15 cm in length with a distal margin measuring 9 cm in circumference. The pericolic fat extends up to 5 cm in width. Surgical margins are inked as follows: superior-blue, deep-black, inferior-red, lateral-green.\n\nUpon opening, the duodenal mucosa appears unremarkable, as does the colonic mucosa. Sectioning reveals tan-pink nodules adjacent to the distal duodenum and retroperitoneal nodules with a variegated appearance. Some retroperitoneal nodules have a white-yellow coloration and measure up to 1.0 x 0.3 cm in diameter, located as close as 0.1 cm from the deep margin. One nodule located 3 cm from the deep margin measures 3.5 cm and shows tan-pink areas with hemorrhagic components.\n\nMultiple irregular pieces of subcutaneous fatty tissue measuring 3 x 3 x 0.25 cm are submitted for examination. A fragment of proximal small bowel measuring 5 cm in length with attached mesenteric adipose tissue is also included. The intestinal wall measures 0.5 cm in thickness and has tan, smooth mucosa. The gallbladder specimen measures 10 x 3 x 2.5 cm and contains green bile without calculi; the mucosa is velvety and unremarkable. A nodular fibromembranous tissue measuring 1 x 1 x 0.6 cm is submitted entirely.\n\nSections examined include surgical margins, tumor regions, lymph nodes, and surrounding tissues. Multiple tumor nodules are identified within the mesenteric and subserosal fat involving the duodenum and large bowel. Tumor involvement is noted at the deep margin and within the duodenal wall, encasing adjacent pancreatic tissue. Adipose tissue elsewhere appears benign. Sections of the proximal small bowel show benign findings with moderate acute serositis. The gallbladder is unremarkable. A separate nodule associated with the superior mesenteric vein demonstrates cellular features consistent with distinct morphologic characteristics."} +{"pid": "TCGA-DS-A0VN", "report": "The hysterectomy specimen includes a cervix largely replaced by a firm tan-red ulcerated fungating mass measuring 8.0 x 5.0 x 3.0 cm. The mass is 0.1 cm from the closest deep cervical margin and 1.0 cm from the closest vaginal cuff resection margin. It extends into the lower uterine segment/isthmus. No tumor is identified in the parametrium or in any of the sampled lymph nodes, which include left pelvic, left obturator, right pelvic, obturator, right parametrium, frozen section obturator, periaortic, and right and left common iliac regions. Lympho-vascular invasion is not present.\n\nBenign findings include leiomyoma, adenomyosis and adenomyoma, and benign secretory endometrium. The right and left adnexa show no malignancy. The right ovary contains a hemorrhagic corpus luteum cyst and cystic follicles; the fallopian tube has cystic Walthard rests. The left ovary shows cystic follicles and focal organizing hemorrhage; the fallopian tube also has cystic Walthard rests.\n\nAll lymph node specimens submitted are negative for malignancy. Representative sections of the mass and surrounding tissues, as well as multiple lymph node biopsies, were examined microscopically with no evidence of tumor involvement. The endometrial cavity is lined by benign-appearing endometrium measuring up to 0.5 cm thick. Myometrial tissue shows mild trabeculation with intramural and subserosal well-circumscribed tan-white masses without necrosis or hemorrhage.\n\nResection margins are inked blue and include posterior, anterior, left, and right deep cervical areas, as well as vaginal cuff margins. Sections from these areas and surrounding tissues were submitted for analysis. The tumor abuts the ectocervical-vaginal junction but does not involve the cervical intraepithelial region."} +{"pid": "TCGA-BS-A0UT", "report": "The specimen consisted of multiple tissue samples collected during a total abdominal hysterectomy with bilateral salpingo-oophorectomy and staging. The tissues included lymph nodes from the left and right pelvic regions, left aortic and right caval areas, bilateral ovaries and fallopian tubes, and the uterus with cervix.\n\nGross examination of the uterus revealed an exophytic lesion located along the lower anterior wall of the endometrial canal measuring approximately 2.5 x 1.5 cm. On sectioning, the lesion extended into the myometrium to a depth of 4 mm, within a myometrial thickness of 12 mm. No tumor involvement was observed in the parametrial or cervical stromal regions. The cervix measured 3.0 cm in length and 2.5 cm in diameter, with non-ulcerated mucosa. Multiple fibroids were identified within the uterine wall, with sizes up to 1.7 cm; these exhibited a whorled appearance without necrosis or hemorrhage.\n\nHistologic evaluation showed no evidence of tumor in either ovary or fallopian tube. All lymph node specimens\u2014including left pelvic (3 nodes), left pelvic lymph nodes (5 nodes), left aortic (2 nodes), right pelvic (14 nodes), and right caval (3 nodes)\u2014were negative for metastasis. The intraoperative touch preparation of lymph nodes was benign.\n\nMicroscopic findings indicated a histologic grade of 2 based on nuclear grading. Tumor invasion was limited to less than 50% of the myometrial thickness. There was no lymphovascular space invasion identified, and serosal involvement was not present. Additional findings included intramural leiomyomata.\n\nAll surgical margins and surrounding tissues were free of tumor involvement."} +{"pid": "TCGA-63-A5MB", "report": "The specimen was obtained from the left upper lobe via resection. The tumor measured 3 cm in size. Histological examination revealed a moderately differentiated carcinoma with squamous features. Pathological staging indicated T2, NOS for regional lymph node involvement, with no evidence of distant metastasis clinically. No additional histological comments were provided. Blood sample (buffy coat) was also collected during the same period. Data regarding year of collection, age at collection, days to procedure, and days to diagnosis were recorded but not specified in this summary."} +{"pid": "TCGA-EA-A43B", "report": "The specimen consisted of cervix tissue obtained via simple hysterectomy. The lesion measured 2 x 1.5 x 3 cm and was classified as moderately differentiated keratinizing squamous cell carcinoma. The tumor was confined to the cervix and measured less than 4.0 cm in greatest dimension. No venous invasion was identified. Surgical margins were uninvolved. Lymph node evaluation included examination of obturator right and left, presacral, and paraaortic regions, with no evidence of metastasis found (0/24 lymph nodes positive). Lymphatic invasion status could not be determined. There was no identifiable evidence of neoadjuvant treatment effect. No additional pathologic findings were noted."} +{"pid": "TCGA-BR-8367", "report": "The specimen includes a plate-like lesion in the stomach measuring 12 x 7 cm. Microscopic evaluation reveals poorly differentiated carcinoma with signet ring cell features. The tumor is ulcerated and invades through the entire gastric wall, extending into the subserosa and involving the perigastric fat. Multiple lymph nodes are identified within the greater and lesser omentum, with 9 out of 15 showing evidence of metastatic involvement. Perineural invasion is noted. The surgical margins are free of tumor involvement. The omentum shows areas of hemorrhage and hyperemia, with lymph nodes measuring up to 1 cm in diameter and displaying varying degrees of congestion. No venous invasion is observed."} +{"pid": "TCGA-27-2521", "report": "Birth date. Tumor site: right fronto-temporal region. The specimen shows a high-grade neoplasm with marked cellular pleomorphism, frequent mitotic figures, and areas of necrosis. Microvascular proliferation is present. The lesion exhibits infiltrative growth with involvement of the cerebral cortex and underlying white matter. No definitive ependymal invasion is identified. Immunohistochemical staining demonstrates positivity for GFAP and MGMT promoter methylation status is pending."} +{"pid": "TCGA-K4-A5RH", "report": "A radical cystoprostatectomy specimen was examined, including bilateral distal ureter margins, bladder, prostate, and pelvic lymph nodes. The left and right distal ureter margins showed no evidence of malignancy. The bladder and prostate revealed a high-grade invasive lesion involving the right and left trigone regions. The tumor measured 7 cm in greatest dimension and exhibited a urothelial histologic type with focal sarcomatoid (spindle cell) differentiation. No squamous or glandular differentiation was identified. Histologic grade was 3 out of 3. Microscopic examination confirmed the presence of an extravesical mass. Lymphatic and blood vessel invasion were both present. In situ changes were identified in the urothelium, and no tumor was seen at the surgical margins. Prostatic hyperplasia was also noted.\n\nA total of nine lymph nodes were examined (five from the left pelvic region and four from the right), and none showed involvement. All lymph nodes were negative for malignancy. The TNM staging indicated pT3a for the primary tumor, with no nodal involvement (pN0) and distant metastasis not assessable (pMX). \n\nThe gross specimen included a bladder measuring 7 x 5 x 6.5 cm with a gray-brown, friable, necrotic mass involving the entire bladder wall. The muscularis was involved. No gross lymph nodes were identified. Tissue fragments from various regions of the bladder and prostate were submitted for microscopic evaluation. Multiple tissue blocks were processed for histologic analysis."} +{"pid": "TCGA-AN-A0AJ", "report": "Female patient with tumor located in the left breast, primary site. Tumor specimen was obtained via surgery and preserved in OCT medium within a block container. Histological evaluation showed features of infiltrative ductal-lobular morphology, grade 2. No evidence of nodal or distant metastasis was found (T stage 3, N stage 0, M stage 0). No prior treatment was administered. A separate normal sample was collected from blood via venipuncture and stored frozen in a tube."} +{"pid": "TCGA-BP-4970", "report": "The right kidney specimen measured 12.5 x 8.0 x 4.0 cm and weighed 253 g. A mass measuring 3.5 x 3.0 x 2.2 cm was identified in the lower pole adjacent to the renal sinus. The mass was partially cystic with a tan, yellow, and hemorrhagic cut surface. A second nodule measuring 0.5 x 0.4 x 0.3 cm was also found, with a tan and firm cut surface. The remainder of the kidney showed a well-defined cortico-medullary junction, with a cortical thickness of 0.7 cm. No adrenal gland was identified. The attached ureter measured 1.5 x 0.4 cm and the renal vein measured 1.0 x 0.3 cm; both appeared unremarkable.\n\nMicroscopic evaluation revealed a nuclear grade III/IV cellular component. The surgical margins were free of involvement. A small nodule distal to the main mass was identified and submitted for analysis. No lymphovascular invasion was observed. Lymph node assessment did not identify any involved nodes. Staging indicated a T1 lesion, confined to the kidney and measuring less than 7.0 cm in greatest dimension. Additional findings included a small incidental nodule in the non-neoplastic kidney and benign fibroadipose tissue in the perihilar specimen."} +{"pid": "TCGA-B5-A1MZ", "report": "The specimen consists of a hysterectomy with bilateral salpingo-oophorectomy, measuring 10.6 x 4.7 x 7 cm and weighing 200 grams. The cervix measures 0.5 cm in diameter and the endometrial cavity is 7.5 cm in length and 5.5 cm in diameter. A tan-brown, exophytic lesion measuring approximately 8.1 x 3.5 x 0.9 cm is present near the right cornu, extending 3.5 cm from the nearest ectocervix in the posterior segment of the uterus. On sectioning, the endometrium is 0.2 cm thick and the myometrium is 2.9 cm thick. The lesion invades 0.9 cm into the myometrium. Representative sections of the deepest extension were submitted for frozen section and further processing. An intramural nodule measuring 0.5 x 0.5 x 0.5 cm is noted in the posterior uterine segment. The right fallopian tube is 5.1 cm long with a 0.9 x 0.5 x 0.5 cm pedunculated paratubal cyst. The right ovary measures 2.3 x 1.4 x 0.3 cm and shows no mass or lesions. The left fallopian tube is 6.2 cm long and the left ovary is 1.9 x 1.2 x 0.3 cm with a yellow-tan, lobulated cut surface and no lesions identified.\n\nLymph node dissections were performed on the left external iliac, left obturator, and right pelvic regions. The left external iliac specimen contains four lymph nodes, all negative for malignancy. The left obturator specimen contains 14 lymph nodes, all negative for malignancy. The right pelvic specimen contains 15 lymph nodes, all negative for malignancy. A sigmoid nodule measuring 0.6 x 0.6 x 0.3 cm was biopsied and found to show old fat necrosis without evidence of malignancy. A cholecystectomy specimen measuring 6.5 x 2.7 x 1.1 cm shows multiple green faceted stones in the gallbladder, ranging from 0.3 to 0.6 cm. The mucosa shows features consistent with cholesterolosis, and the wall thickness is 0.2 cm. No discrete mass or lesion is identified. Microscopic evaluation reveals no evidence of malignancy in the gallbladder.\n\nThe surgical margins are uninvolved. Adjacent non-neoplastic endometrium shows endometrial intraepithelial neoplasia. An intramural leiomyoma measuring 0.5 cm is also present. No lymphatic or vascular invasion is identified. The cervix, serosa, fallopian tubes, and ovaries are free of tumor. All lymph node specimens are negative for tumor involvement."} +{"pid": "TCGA-D5-6924", "report": "Histopathological examination was performed on a specimen consisting of a segment of large intestine measuring 18.3 cm in length, along with a piece of attached mesentery measuring 19 x 9 x 4 cm. A lesion measuring 5.6 x 6.3 x 1.7 cm was identified within the mucosa. The lesion circumferentially involved the entire circumference of the intestinal wall and was located 9.8 cm from the proximal incision margin and 7.2 cm from the distal incision margin. Microscopic evaluation revealed tubulopapillary architecture with infiltration of neoplastic cells into the pericolonic adipose tissue. No evidence of neoplastic involvement was found at the resection margins. Reactive lymph node changes were noted in the regional lymph nodes examined. Based on histopathological assessment, the lesion demonstrates features consistent with advanced local invasion without lymph node metastasis."} +{"pid": "TCGA-DX-A8BM", "report": "The specimen consists of a resected soft tissue mass from the right leg, measuring 21x14x12.5 cm, with an attached skin ellipse measuring 19x4 cm. The mass is well-circumscribed, solid, and tan in color, measuring 13.5x11x10 cm. It is located within skeletal muscle and demonstrates necrosis in approximately 60% of the tissue. Margins are assessed as follows: 0.2 cm from posterior, lateral, and medial margins, 0.9 cm from superior margin, and greater than 1 cm from inferior and anterior margins. All resection margins are free of tumor involvement.\n\nMicroscopic evaluation confirms presence of high-grade cellular proliferation with pleomorphic features and myogenic differentiation, identified through immunohistochemical staining. Stains show focal positivity for smooth muscle actin and desmin, and negativity for myogenin. Necrosis is present throughout the specimen. Representative sections have been submitted for analysis, including sections of skin, skeletal muscle, and all margins. Multiple blocks were examined and include areas of necrosis, solid tumor tissue, and surrounding soft tissue components."} +{"pid": "TCGA-55-7903", "report": "A right lower lobectomy specimen was received, weighing approximately 206 grams and measuring 16.1 x 10.5 x 5.0 cm. The outer surface showed areas of wrinkled tan-gray to brown pleura with anthracotic streaking and small nodular plaques. A previously sectioned area of induration was identified in the central portion of the specimen, measuring approximately 2.4 x 2.0 x 1.8 cm. This lesion appeared lobulated with a gray-tan to brown cut surface and extended close to the pleural surface but did not penetrate through it. The distance from this lesion to the nearest bronchial margin was approximately 3.6 cm. The remaining lung tissue showed diffuse consolidation with mottled gray-tan to pink areas, anthracotic streaking, and focal emphysematous changes. No other gross abnormalities were noted.\n\nSections submitted included the bronchial margin, the entire lesion with surrounding tissue, representative pleura with nodular plaques, and unaffected parenchyma. Several lymph node specimens were also received from the right lung. These ranged in size from 0.4 cm to 2.9 cm and showed varying degrees of fibrofatty tissue with gray-brown or black discoloration. All lymph nodes were entirely submitted for microscopic evaluation.\n\nMicroscopic examination revealed a poorly differentiated cellular proliferation within the lung parenchyma. The cells exhibited large nuclei with prominent nucleoli and minimal cytoplasmic differentiation. Immunohistochemical staining showed positivity for TTF1 and CK7, while markers typically associated with squamous differentiation (CK5/6 and p63) were negative. Dense collagenous scar tissue was also present within the lesion, raising suspicion for an organizing process. The tumor was located in the lower lobe and measured 2.4 cm in greatest dimension. It was unifocal and did not invade the visceral pleura, although it approached within less than 1 mm of the pleural margin. There was no evidence of lymphovascular invasion or treatment effect. Surgical margins, including the bronchial and pleural margins, were free of tumor involvement.\n\nLymph node analysis showed no evidence of metastatic involvement. One peribronchial lymph node and several others from levels 7, 9, and 10 were examined and showed only reactive changes and anthracosilicosis. Additional findings in the lung included subpleural fibrosis, interstitial fibrosis, chronic inflammation, intraalveolar macrophages, and emphysematous changes. A separate wedge biopsy from the right middle lobe showed similar non-neoplastic changes without any evidence of tumor.\n\nThe tumor was staged as pT1b based on its size. Clinical correlation and follow-up are recommended."} +{"pid": "TCGA-A8-A085", "report": "The lesion measures 2.5 cm in diameter and is characterized by poorly differentiated cells with infiltrative growth into the superficial corial connective tissue of adjacent skin. The tumor exhibits focal involvement of lymphatic vessels. No evidence of skin ulceration is present. Histological assessment indicates a high-grade morphology. Staging classification indicates a primary tumor size category consistent with 2 cm to 5 cm in greatest dimension, with regional lymph node involvement (micrometastases), no lymphovascular invasion, and complete resection margins."} +{"pid": "TCGA-55-8085", "report": "The surgical panel included multiple specimens. Three lymph node biopsies from levels 9, 7, and 5 on the left side were all benign without evidence of metastatic disease. Two wedge resections of the left lung were performed. The lower lobe resection contained a solid gray-tan mass measuring 2.5 x 2.2 x 1.6 cm located in the subpleural region. The tumor was 1.5 cm away from the stapled margin and did not involve the visceral pleura. Histologically, the lesion showed moderately differentiated features with papillary architecture. Two benign peribronchial lymph nodes were identified. The surrounding lung tissue demonstrated mild emphysematous changes. The upper lobe wedge resection revealed severe emphysematous alterations with subpleural bullous formation and an apical fibrous scar; no neoplastic or inflammatory findings were observed.\n\nPathologic staging was determined as pT1b due to the tumor size being greater than 2 cm but not exceeding 3 cm, surrounded by lung tissue and visceral pleura, without bronchoscopic evidence of more proximal invasion. No lymphatic or vascular invasion was identified. Regional lymph node evaluation included six total nodes (two N1 and four N2), none of which showed metastasis. Distant metastasis could not be assessed. The tumor margins were free of involvement. A tissue block was preserved for potential future ancillary testing. Emphysematous changes were noted in non-involved lung parenchyma. Fresh tissue was retained intraoperatively for possible additional studies. Fixation time met minimum standards for adequate processing."} +{"pid": "TCGA-AF-2691", "report": "The left ovary and fallopian tube specimen weighed 28 grams and measured 6 x 3 x 2 cm. The ovary contained a 4 cm cystic structure with hemorrhagic appearance, located at the edge. The cyst surface was smooth, varying in color from tan to purple, and contained approximately 5 mL of hemorrhagic fluid. The cyst lining showed organized blood and a smooth surface with some orange discoloration, consistent with features of a corpus luteum cyst. No solid or papillary areas were identified. A representative section of the cyst wall and adjacent ovarian tissue was submitted for microscopic evaluation.\n\nThe rectosigmoid colon specimen measured 22 cm in length. The proximal end was stapled and blue-inked, while the distal end was black-inked. The serosal surface was partially covered with pink-tan, glistening tissue and yellow adipose tissue. A large exophytic, friable lesion measuring 5.3 x 4.5 x 2 cm was identified, located within 0.1 cm of the distal margin. The tumor invaded into the muscularis propria, coming within 1.2 cm of the deep margin. The remaining mucosa appeared unremarkable. Lymph nodes were present in the surrounding fat. Sections submitted included proximal margin, representative sections of the tumor extending to the deep margin, and multiple lymph node samples (a total of 17 lymph nodes evaluated).\n\nAn additional segment of sigmoid colon margin was received, measuring 1.6 x 0.3 x 0.2 cm. It consisted of soft, pink mucosal tissue.\n\nThe appendix measured 4.4 cm in length and 0.6 cm in diameter. The serosal surface was smooth, tan, and glistening, with a pinpoint lumen and intact wall.\n\nMicroscopic evaluation of the rectal lesion revealed an infiltrating moderately differentiated adenocarcinoma arising from a villous adenoma. Tumor extended into the submucosa without invasion of the muscularis propria (pT1). Proximal, distal, and circumferential margins were all free of tumor involvement. The closest distance of the adenomatous component to the distal margin was 0.1 cm. Vascular invasion was not identified. All 17 regional lymph nodes were negative for metastatic disease. Distant metastasis could not be assessed. Microscopic evaluation of the ovarian cyst confirmed features consistent with a hemorrhagic corpus luteum cyst, and the fallopian tube showed no significant abnormalities. The appendix showed no pathological changes."} +{"pid": "TCGA-75-6212", "report": "The histology report indicates a moderately differentiated lesion with a size of 3.90 cm. The pathological staging is T2, NOS for the primary tumor category, with involvement of regional lymph nodes classified as N1. There is no evidence of distant metastasis, as the clinical M classification is MO. The tissue preparation was performed following a resection procedure. Microscopic evaluation reveals features consistent with an epithelial neoplasm exhibiting micropapillary architecture. Multiple slides were reviewed and showed similar morphological characteristics. No other significant findings were noted in the histological assessment."} +{"pid": "TCGA-95-7043", "report": "The surgical pathology report describes findings from two separate lung wedge resections. The first specimen, from the right upper lobe, contains a nodule measuring 1.5 x 1.3 x 1.1 cm. Histologic evaluation reveals a mixed growth pattern with solid and acinar components, showing poor differentiation. Angiolymphatic invasion is present, and tumor foci extend to the inked edge. No visceral pleural or perineural invasion is observed. Emphysematous changes are noted in the surrounding lung tissue along with carcinoid tumorlets.\n\nThe second specimen, from the right lower lobe, contains a smaller nodule measuring 0.7 x 0.6 x 0.5 cm. Microscopic analysis shows a moderately differentiated lesion with a combination of micropapillary, acinar, and lepidic growth patterns. Angiolymphatic invasion is also identified in this specimen, and tumor extends to the inked margin. Visceral pleural and perineural invasion are not present. Marked emphysematous changes are again seen in the surrounding lung.\n\nImmunohistochemical staining for both specimens demonstrates positivity for CK7, TTF1, and Napsin, supporting a pulmonary origin. CK20 is negative in the first specimen but positive in the second. These differences in histologic architecture and immunoprofile suggest the possibility of two distinct primary lesions. The inked edges in both specimens were marked after staple line removal, which may affect accurate margin assessment. Clinical correlation is advised for further evaluation and staging considerations."} +{"pid": "TCGA-DU-A5TS", "report": "Client: Gender: M. Location: Clinical History: Brain mass. Operation / Specimen: A: Brain, right frontal tumor, biopsy. B: Brain, right frontal tumor, biopsy. C: Brain, temporal lobe tumor, biopsy.\n\nBiopsies and excision specimens from the brain show a lesion with mostly oligodendroglial features. Some areas contain more angulated cells, suggesting a minor astrocytic component. Mitotic activity is present in specimen B. There is no evidence of vascular proliferation or necrosis. The Ki-67 labeling index is up to approximately 8%. Permanent sections confirm findings observed during frozen section analysis. Although the histologic features align with an intermediate-grade glioma, focal mitotic activity raises consideration for possible higher-grade transformation. Clinical correlation is advised.\n\nMGMT promoter methylation testing was performed using DNA extracted from paraffin-embedded tumor tissue. Histologic review confirmed sufficient tumor cellularity without the need for microdissection. Real-time PCR following bisulfite conversion detected a methylated MGMT promoter. This assay has an analytic sensitivity of 1% methylated DNA in an unmethylated background. The presence of more than 50% non-neoplastic cells or extensive necrosis could potentially interfere with detection.\n\nLoss of heterozygosity (LOH) at chromosome arms 1p and 19q was assessed by PCR using paired tumor and blood-derived DNA. Six informative loci were evaluated: D1S1592, D1S552, D1S1612, D19S219, D19S412, and PLA2G4C. No allelic loss was detected at either chromosomal arm. LOH studies were conducted using microsatellite markers (with PLA2G4C as a minisatellite polymorphism), selected based on heterozygosity score, amplicon size, and ease of interpretation. If initial markers were uninformative, backup markers were used. Samples containing more than 15% non-neoplastic cells may affect test sensitivity.\n\nIntra-operative consultation on the right frontal lesion noted intermediate-grade glioma features with some oligodendroglial morphology. Blood was requested for LOH studies. Frozen sections and smears were performed and results communicated to the operating physician.\n\nGross descriptions include:\n- Specimen A: Right frontal lesion measuring 1.3 x 0.6 x 0.2 cm; pink-tan, soft tissue.\n- Specimen B: Right frontal lesion measuring 2.8 x 2.0 x 1.2 cm; pink-tan, focally hemorrhagic tissue.\n- Specimen C: Temporal lobe lesion measuring 4.4 x 2.8 x 1.7 cm; ovoid, pink-tan soft tissue.\n\nAll tests were developed and validated under CLIA \u201988 regulations. These results are provided for informational purposes and should be interpreted within the context of clinical and diagnostic criteria."} +{"pid": "TCGA-VD-A8KM", "report": "The specimen consists of an intact left eye with axial dimensions measuring 24.8mm, horizontal 26mm, and vertical 26mm. The cornea measures 12mm in both horizontal and vertical diameters. The optic nerve is 10mm in length and 4mm in diameter. Transillumination reveals a shadow measuring 20 x 21mm located posterolaterally. The plane of section is horizontal.\n\nUpon opening the globe, a pigmented mass is identified. The lesion extends 1.6mm from the optic nerve head and measures 16.8mm in largest basal diameter and 9mm in thickness. Histological examination demonstrates a mixed cell type tumor composed predominantly of epithelioid cells accounting for up to 80% of the cellular component. Immunohistochemical staining shows expression of Melan-A and HSP-27 (score 1). Mitotic activity is approximately 2 per 40 high power fields.\n\nMicrovascular patterns are prominent; however, closed vascular loops are not identified within the sections examined. A mild lymphocytic infiltrate is present within the tumor stroma. Scattered macrophages are noted, but necrosis is absent. Bruch\u2019s membrane remains intact throughout the sampled sections. There is minimal invasion into the inner sclera without involvement of the optic nerve or vortex veins. Resection margins are free of tumor cells.\n\nAdditional findings include slight atrophy of the retina overlying the lesion and peripheral cystoid degeneration. The anterior chamber is deep with open angles. The iris appears unremarkable, though the ciliary body shows atrophic changes with hyalinization of the ciliary processes. Subcapsular degenerative changes are present in the lens. No significant abnormalities are observed in the cornea."} +{"pid": "TCGA-AA-3549", "report": "The specimen consists of a right hemicolectomy preparation. An ulcerated lesion is present in the passage from the cecum to the ascending colon. The lesion measures 3.5 cm in diameter at its widest point. Histological examination shows moderately differentiated features. The tissue involvement extends into the muscularis propria. Adjacent colonic mucosa contains a small solitary tubular adenoma with moderate epithelial dysplasia. A coarse, nodular calcified focus is identified in the mesenterium, likely representing a completely calcified lymph node. Both oral and aboral resection margins are free of abnormal tissue. Thirty-one lymph nodes are identified, all without pathological changes, although reactive alterations are noted. Staging parameters indicate pT2 nNO (0/31) V0 L0; G2 RO."} +{"pid": "TCGA-CS-6290", "report": "The specimen consists of multiple fragments from the left temporal region. The largest fragment measured up to 2 cm, while smaller fragments ranged between 1\u20132 cm in size. Upon histologic examination, the tissue demonstrated a population of moderately pleomorphic neoplastic cells consistent with astrocytic origin. Mitotic figures were identified, particularly in specimen #1 and on slide 4B, although they were not numerous. Ki67 immunohistochemical staining showed variable positivity across different slides, with areas on slide 1B demonstrating nuclear staining in up to 10% of tumor cells. No necrosis or endothelial proliferation was observed.\n\nSynaptophysin staining demonstrated positive neuropil staining, and Neu-N staining revealed positive cortical neurons interspersed among tumor cells. No ganglion cell component was identified. Immunohistochemical assays were quantified using established methods. Additional molecular testing included FISH analysis using probes targeting regions commonly deleted in gliomas, including 1p/1q and 19q/19p. Fluorescence microscopy was performed after DAPI counterstaining, with ratios calculated based on counts from 200 cells. Ratios greater than 0.80 were considered normal. It was noted that low malignant cellularity could lead to false-negative results, and correlation with clinical and other laboratory findings is essential.\n\nFrozen section evaluation of one specimen initially suggested glioma without definitive high-grade features. Approximately half of that specimen was used for frozen section analysis, with the remainder submitted for further evaluation. Other specimens were received either fresh or in formalin and processed entirely into cassettes for microscopic examination. All specimens were obtained from the left temporal region."} +{"pid": "TCGA-L4-A4E6", "report": "The specimen consists of a wedge excision and right upper lobectomy. The tumor is located in the subpleural region of the right upper lobe. Histologic evaluation shows poorly differentiated cells with a grade of G3 out of 4. The tumor measures 2 cm in size and is unifocal. There is no invasion of the visceral pleura or adjacent structures, and no tumor-associated atelectasis or obstructive pneumonitis is present. Venous invasion is identified. All margins are negative for malignant cells, with the nearest margin measuring 4.5 cm from the tumor; the bronchial margin is the closest. A total of six lymph nodes are sampled, all of which show benign features. Staging according to AJCC criteria classifies the primary tumor as pT1 and lymph nodes as pNo. Gross examination reveals a mass measuring approximately 2.0 x 1.8 x 1.2 cm beneath the pleura, with a firm gray periphery and cavitation in the center. Intraoperative touch preparations indicate non-small cell carcinoma. Frozen section analysis confirms the bronchial margin is free of malignancy. Immunohistochemical staining demonstrates positivity for p63 and negativity for other markers. No additional significant findings are noted."} +{"pid": "TCGA-A7-A6VV", "report": "Final Surgical Pathology Report. Procedure: Diagnosis. A. Sentinel lymph node, right axilla, biopsy: One negative lymph node (0/1). Breast, right, mastectomy: A lesion measuring 4.5 cm in greatest dimension is present. Histologic grade is 3, with an overall grade of 9/9 (architectural score: 3, nuclear score: 3, mitotic score: 3). The specimen shows a ductal histologic pattern with central necrosis. The tumor involves 10% of the total specimen and lacks an extensive intraductal component. Margins of excision are negative. There is no evidence of vascular invasion, nipple involvement, or invasion of skin or chest wall. Calcifications are present. Focal fibrocystic changes including apocrine metaplasia with cyst formation are noted in non-tumorous breast tissue. Prior biopsy site has been identified. C. Breast, left, mastectomy: Focal atypical ductal hyperplasia with partial involvement of a duct by a cribriform cell population is present; margins of excision are negative. D. Lymph nodes, right axilla, regional resection: Four negative lymph nodes (0/4). No extracapsular extension is identified. Clinical Information: Right breast lesion located at the 12:00 position. Gross Description: A. The sentinel lymph node from the right axilla is fat-replaced, measuring 2 x 1.5 x 1.5 cm. B. The right breast specimen weighs 1444 grams and measures 23 cm medial to lateral. A tan-gritty lesion measuring up to 4.5 cm in greatest dimension is identified at the 12:00 position, close to the anterior margin. C. The left breast specimen weighs 818 grams and measures 26 x 17 x 5 cm; no mass lesions are identified. D. The right axillary content includes multiple lymph nodes; all are negative."} +{"pid": "TCGA-DD-AAVZ", "report": "The specimen consists of a resected liver segment from the right posterior section. A lesion was identified measuring 3.2 x 2.3 x 3.0 cm. The gross appearance is nodular with perinodal extension. Microscopic evaluation reveals a histologic pattern characterized by pseudoglandular and trabecular growth. The predominant cellular morphology is classical type. Nuclear grade assessment using Edmondson and Steiner criteria shows the major differentiation to be grade 2, with the worst area showing grade 3 differentiation.\n\nNo satellite nodules were identified. Fatty change, hemorrhage, peliosis, tumor necrosis, and vascular invasion were not observed. The lesion is surrounded by a complete capsule, though there is evidence of capsular infiltration. Septal formation is present. There is no invasion of major branches of the portal or hepatic veins, bile ducts, or serosal surfaces. The surgical margin is free of involvement with a safety margin of 0.6 cm. No intrahepatic metastasis or multicentric lesions are present.\n\nPathologic staging according to AJCC criteria includes pT1 and pT2 classifications. A prior biopsy was noncontributory. Additional findings include background cirrhosis, which appears inactive and associated with hepatitis B virus. No dysplastic changes are seen.\n\nA separate biopsy from soft tissue adjacent to the diaphragm demonstrates an epithelial cyst consistent with a ciliated foregut cyst."} +{"pid": "TCGA-A5-A0VQ", "report": "A total laparoscopic hysterectomy with bilateral salpingo-oophorectomy was performed. The uterus measured 8.5 x 7.5 x 4 cm. The endometrial cavity was diffusely occupied by a tumor mass measuring 4 x 4 x 1.5 cm, involving the entire endometrial cavity and extending into the lower uterine segment. Microscopic evaluation showed that the tumor extended 0.8 cm into the myometrium, which had an average thickness of 2.2 cm, representing approximately 36% invasion. Lymphovascular space involvement was identified. The lower uterine segment and endocervical mucosa were involved, but the uterine serosa and parametrial tissues were not. Both ovaries and fallopian tubes were unremarkable, though a small inclusion cyst was noted in the left ovary.\n\nLymph node dissections were performed on right and left pelvic and periaortic lymph nodes. No suspicious cells or abnormal tissue were found in any of the lymph nodes examined. A total of 5 right pelvic lymph nodes, 6 right periaortic lymph nodes, 7 left pelvic lymph nodes, and 7 left periaortic lymph nodes were evaluated, all without evidence of abnormality.\n\nImmunohistochemical staining was performed and showed rare chromogranin-positive cells, but no synaptophysin-positive cells. Cytokeratin AE1/AE3 staining of parametrial tissue was negative for abnormal cells. These findings were consistent with the histological findings.\n\nA preoperative biopsy had shown features of endometrioid-type tumor with some areas of squamous differentiation, arising in a background of complex atypical hyperplasia. The patient had a history of postmenopausal bleeding and was diagnosed intraoperatively with significant myometrial involvement. Intraoperative frozen section confirmed the presence of malignancy.\n\nAll surgical specimens were processed and reviewed, with appropriate controls used in immunostains. No other significant findings were reported in the parametrial or adnexal tissues."} +{"pid": "TCGA-AK-3434", "report": "The specimen was received in two parts. The first portion, labeled as gallbladder, measured 8.0 x 2.5 x 1.5 cm and was intact. The outer surface showed a tan to red-purple coloration with smooth to slightly shaggy texture. Upon opening, no bile or calculi were identified. The mucosa appeared green-tan and reticulated, with a wall thickness averaging 0.2 cm. Representative sections were submitted for analysis.\n\nThe second portion, labeled as right kidney, weighed 503 grams and included attached perinephric fat. A fragment of ureter measuring 1.5 x 0.3 cm was present, with a patent lumen measuring 0.2 cm in greatest dimension. The kidney measured 12.5 x 6.5 x 6.5 cm and was bivalved to reveal a centrally located mass measuring 7.0 x 4.5 x 4.0 cm. The cut surfaces of the mass exhibited golden-yellow-orange to green-tan coloring, with smooth and nodular features. Adjacent renal parenchyma appeared red-brown, firm, and maintained a well-defined cortico-medullary junction. Sections from six blocks were submitted, including margins, tumor tissue, and random sections of the kidney.\n\nCytogenetic analysis was performed on the renal mass due to concerns regarding cellular abnormalities. Chromosome studies revealed an abnormal karyotype with loss of chromosomes 6 and 8 in all five analyzed cells. These findings are consistent with clonal chromosomal changes observed in various renal neoplasms.\n\nSections from both specimens were processed for histologic evaluation. No evidence of residual disease or involvement was noted at the vascular or ureteral margins."} +{"pid": "TCGA-DB-A4XH", "report": "A brain biopsy specimen from the left frontal region was received for evaluation. The tissue measured 8.3 x 5.9 x 2.8 cm. Smears were prepared and examined intraoperatively, showing features consistent with a glial neoplasm; however, classification was deferred for further analysis. Permanent sections were evaluated and showed a neoplastic process with mixed glial features. Immunohistochemical staining demonstrated a subset of tumor cells positive for GFAP. Proliferative activity, as assessed by MIB-1/Ki67 staining, was low. Nuclear staining for p53 was also low. Additional molecular studies, including fluorescence in situ hybridization (FISH) for 1p/19q deletions, were initiated on paraffin-embedded sections. Representative tissue blocks (four in total) were submitted for further histopathologic examination."} +{"pid": "TCGA-P3-A6T7", "report": "A composite resection specimen was received along with a right neck dissection and additional tissue samples. The level IIB specimen consisted of two tan-yellow lobulated tissue fragments measuring 4.5 x 3.0 x 1 cm in aggregate, with fatty cut surfaces and several lymph node candidates ranging from 0.3 to 1 cm. A 1.0 x 0.5 x 0.5 cm fragment of salivary gland with unremarkable cut surfaces was also identified. Sections were submitted for analysis.\n\nThe right neck dissection included yellow, lobulated, fibrofatty tissue measuring 18 x 5 x 1.5 cm, separated into levels I through IV. In level I, a 4 x 3 x 2 cm salivary gland was present. In level III, a 2.5 x 2.5 x 2 cm lymph node with abnormal features was sampled. Multiple lymph node candidates were identified and submitted across all levels, with the highest number in level IV.\n\nThe composite resection measured 6.5 x 5.5 x 5.0 cm and weighed 92 grams. It included soft tissue, mandible, and eight attached teeth. An inked margin system was used to mark the resection edges. A 5.0 x 3.0 cm tan-yellow lobulated mass was observed on the underside of the tongue, extending toward the anterior region. Serial sectioning revealed a 4.3 x 3.0 x 2.0 cm tan-white firm mass that approached the posterior and deep margins within 0.1 cm and 0.2 cm respectively, while remaining more than 0.5 cm from the anterior margin. The tumor appeared to abut the periosteum but did not grossly invade the bone. Sections of bone were submitted for further processing.\n\nAdditional small soft tissue specimens were received for frozen section analysis, including anterior, left middle, left posterior, right middle, right posterior, anterior deep, and posterior deep margins, all marked with ink. A small tan-red fragment labeled as left bone marrow was also submitted. Intraoperative consultation of these margins showed no evidence of malignancy, though one sample was difficult to assess and deferred to permanent sections.\n\nFinal analysis of the level IIB specimen found no evidence of malignancy in the salivary gland or 8 lymph nodes. In the right neck dissection, 2 of 39 lymph nodes contained abnormal cells with extracapsular extension noted. The salivary gland in this specimen showed no signs of disease. The composite resection showed a moderately differentiated lesion measuring 4.3 cm, with no bony involvement. Lymphovascular and perineural invasion were identified. The pathologic stage was determined to be pT3N2b. Additional margin biopsies showed only fibrofatty tissue, skeletal muscle, and bone without any sign of disease."} +{"pid": "TCGA-06-0744", "report": "The specimen consists of a 2.5 x 2.0 x 1.0 cm, 2.18 gram aggregate of multiple irregularly shaped pale red-tan to gray-tan tissue fragments obtained from the left parietal region of the brain. Histologic evaluation reveals a lesion with frequent mitotic figures, vascular hyperplasia, and extensive necrotic areas. Immunohistochemical staining for MIB-1 demonstrates a proliferation index of approximately 20%. Molecular testing was performed on the specimen using bisulfite-treated DNA followed by PCR amplification of both methylated and unmethylated promoter sequences, with results detected via gel electrophoresis. The promoter was found to be methylated. This test was conducted under CLIA-regulated laboratory standards and is provided for informational purposes only. All findings are based on standard histopathologic analysis and molecular techniques."} +{"pid": "TCGA-BP-5170", "report": "The right kidney specimen measures 21 x 11 x 6 cm and includes a section of Gerota\u2019s fascia. The perirenal fat is up to 2.5 cm thick. The ureter is 12 cm long and 0.3 cm in diameter. A well-demarcated, encapsulated mass measuring 3 x 3 x 2.5 cm is identified in the middle third of the kidney on the anterior aspect. The mass has a brown-yellow appearance with areas of hemorrhage and extends through the renal capsule toward the perirenal fat. It also reaches the renal sinus. The surrounding renal parenchyma measures up to 2.5 cm in thickness at the hilum. Vessels at the kidney hilum show a permeable lumen. The renal pelvis is lined by smooth pink mucosa and the ureter is patent. Surgical margins are free of abnormal findings. A separate specimen of a portion of the right 11th rib measures 10.3 x 1.3 cm and appears unremarkable upon gross examination. Microscopic evaluation of all submitted sections from both specimens shows no evidence of abnormal tissue."} +{"pid": "TCGA-OR-A5K5", "report": "A left adrenal mass was received fresh for frozen section, measuring up to 14.5 cm in greatest dimension and weighing 447 grams. The specimen was fully encapsulated, inked green on the exterior capsule, and bivalved to reveal a mottled red-brown and orange cut surface with areas suggestive of necrosis. Gross evaluation estimated approximately 30% necrotic tissue. The lesion showed no attached lymph nodes or identifiable uninvolved adrenal tissue. Frozen sections were taken from large central sections of the lesion as well as additional sections representing the full range of morphology. Margins were grossly free and sampled extensively (greater than one section per cm of tumor).\n\nTwo lymphadenectomy specimens were also received. The first, measuring 4 x 3 x 2 cm, contained multiple small lymph node candidates. The second, measuring 2 x 2 x 0.6 cm, was composed predominantly of vascular tissue and was entirely submitted for analysis.\n\nMicroscopic examination revealed a high-grade lesion with positive staining consistent with malignancy. Capsular and vascular invasion were identified. Surgical margins were negative but closely approached. Necrosis was present, and mitotic activity was notable at 31 mitoses per 50 high power fields. No lymph node involvement was observed across 20 examined nodes. There was evidence of focal extra-adrenal extension. Based on these findings, staging was determined as stage III. Immunohistochemistry results were not available. All slides were personally reviewed and interpreted by the signing staff pathologist."} +{"pid": "TCGA-E2-A1LK", "report": "The left modified radical mastectomy specimen weighed 203 grams and measured 19.6 x 7.5 x 5.8 cm. The ellipse of skin measured 15.8 x 7.2 cm, with a light brown areola measuring 2.5 cm in diameter and an everted nipple measuring 1.3 cm. Two firm masses were identified on the skin surface: one measuring 2.5 x 2 cm and another measuring 0.6 x 0.6 cm. A larger underlying mass was palpated beneath these lesions and measured 6.8 x 6.5 x 3.5 cm. It was located just beneath the deep margin at a distance of 0.1 cm and occupied the upper outer quadrant extending into the axillary tail. The mass appeared beige-tan, firm, and slightly necrotic with thick amber-colored mucoid fluid noted on sectioning. The remainder of the tissue showed dark yellow lobulated adipose areas with focal white fibrous parenchyma.\n\nThirteen possible lymph nodes were identified in the left axillary contents (levels 1 and 2), ranging in size from 0.1 x 0.1 x 0.1 cm to 3.5 x 2.5 x 2.0 cm. Histologic evaluation revealed metastatic involvement in multiple lymph nodes. The largest involved lymph node measured 3.5 cm and showed extranodal extension. Additional findings included lymphovascular and perineural invasion. Microscopic assessment indicated high-grade cellular features including nuclear grade 3, mitotic score 3, and tubular score 3. Necrosis was present focally within the lesion.\n\nMargins of resection were negative. The closest margin was the deep margin, which was 0.4 cm from the tumor focus. Fibroadenoma was identified in non-neoplastic areas. Immunohistochemistry showed ER and PR negativity and HER2 negativity by FISH. Pathologic staging was determined as pT3 N3a."} +{"pid": "TCGA-CN-6011", "report": "The pathology report includes specimens from a mandibulectomy and left neck dissection. The lymph nodes evaluated across multiple levels (1A, 1B, and 2 through 4) totaled 44 nodes, with no tumor involvement identified in any of them. A benign submandibular salivary gland was also noted as part of the specimen from level 1B.\n\nThe excised teeth included five incisors, one canine, and one molar, all showing extensive caries without attached soft tissue. This portion underwent gross examination only.\n\nThe medial margin specimen showed no tumor presence. In the composite resection of the left mandible, a gray-white to tan-brown nodular mass measuring 3.0 cm x 2.5 cm was observed on the mucosal surface. This mass had a focally hemorrhagic cut surface and appeared to abut the underlying bone. Microscopic evaluation confirmed no angiolymphatic or perineural invasion. All surgical margins were free of tumor, although bone invasion was present.\n\nIntraoperative frozen section analysis of the medial margin, posterior margin, and laryngeal nerve margin confirmed absence of tumor involvement. The bone margins were similarly free of tumor following shave preparations and decalcification.\n\nThe tumor measured 3.0 cm in greatest dimension and demonstrated an exophytic growth pattern. Histologic grade was high, with poorly differentiated features. No vascular or lymphatic invasion was identified. Pathologic staging indicated primary tumor extension into adjacent structures (pT4a), with no regional lymph node involvement (pN0). Distant metastasis could not be assessed (pMX).\n\nAll specimens were processed using standard fixation and staining protocols. Tissue fixation times ranged between 2 and 84 hours. The laboratory performing this analysis is CLIA-certified for high-complexity testing."} +{"pid": "TCGA-DX-AB2W", "report": "The specimen submitted for analysis consists of a radical resection from the right proximal thigh. The excised tissue measures 24 x 11 x 8 cm and includes fibroadipose tissue, skeletal muscle, and a skin ellipse measuring 24 x 4.4 cm. The tumor identified within the specimen is a solid, grossly circumscribed mass with 15% necrosis, measuring 7.0 x 5.6 x 4.5 cm. It is located within the deep skeletal muscle and associated fascia. Margins of resection were assessed: the deep margin is within 1.0 cm of the tumor, medial margin within 1.8 cm, and lateral margin within 2.5 cm. The superior and inferior margins are widely free of tumor involvement. \n\nHistologic evaluation of multiple sections shows high-grade cellular atypia, pleomorphic features, and a storiform growth pattern. No residual tumor is identified at the superior, inferior, or lateral margins; however, the deep and medial margins show proximity to tumor without clear involvement. One lymph node examined is benign, and the overlying skin and subcutaneous tissue do not show evidence of tumor involvement. All findings are based on personal examination of the slides and review of the material provided."} +{"pid": "TCGA-KL-8332", "report": "A right radical nephrectomy specimen including the adrenal gland and hilar lymph nodes was examined. The specimen weighed 550 grams and measured 15 x 10 x 5.5 cm. The adrenal gland measured 4.5 x 2 x 0.7 cm and was separated from the renal parenchyma by 2.5 cm of perinephric adipose tissue. It appeared unremarkable on gross and histologic examination. The ureter measured 2 cm in length and 0.3 cm in diameter, and the renal vessels ranged from 0.5 to 0.7 cm in length and 0.3 cm in diameter. Multiple hilar lymph nodes were identified, ranging from 0.3 to 0.5 cm in size; none contained metastatic cells.\n\nA well-circumscribed, partially encapsulated mass measuring 6.8 x 6.5 x 3.8 cm was identified at the upper pole of the kidney. The mass exhibited cystic degeneration with minimal hemorrhagic or necrotic areas; approximately 20% was cystic and 80% solid. The tumor was located 0.7 cm from the renal pelvis and appeared confined within the renal capsule without gross invasion into vessels or perinephric fat. Histologically, the tumor demonstrated a solid growth pattern with nuclear grade II/III features. All surgical margins were free of tumor involvement. Vascular invasion was present based on microscopic evaluation.\n\nExamination of representative sections confirmed no involvement of the adrenal gland, renal pelvis, ureteral margin, renal vessels, or perinephric fat. The surrounding renal parenchyma showed normal architecture with distinct cortical-medullary differentiation and cortical thickness measuring between 0.7 and 1 cm. No additional significant pathological findings were identified in the submitted sections."} +{"pid": "TCGA-FV-A4ZQ", "report": "The surgical specimen consists of a right partial hepatectomy involving segment 7, weighing 402 grams and measuring 10 x 9.8 x 7.7 cm. A single tumor mass is present without satellite lesions. The tumor measures 9.5 cm in greatest dimension and is located within the liver, extending to 0.4 cm from the surgically resected margin, which was inked black. The cut surface of the tumor is described as solid, circumscribed, and variegated with yellow-tan and hemorrhagic areas. Adjacent liver tissue shows fibrotic changes with irregular nodularity but no additional distinct nodules.\n\nMicroscopically, the lesion demonstrates moderate to poor differentiation (grade 3 of 4) with a nuclear grade of 2 of 3 based on the Lauwers system. Areas of clear cell morphology are present along with a focus of chondroid metaplasia. The surrounding liver parenchyma reveals bridging fibrosis with well-formed micronodules, consistent with inactive cirrhosis. There is minimal interface hepatitis and no evidence of steatohepatitis. The adjacent liver margins are uninvolved by tumor, with the closest distance being 0.4 cm. No lymphatic or vascular invasion is identified. The capsule of the liver does not show tumor involvement.\n\nMitotic activity is present at a rate of 3 per 10 high-power fields. The tumor is confined entirely within the liver without extension beyond the organ. Regional lymph nodes were not available for assessment. Based on these findings, the pathologic stage is determined as pT1NXM0 according to the 2010 staging system, indicating a solitary tumor without vascular invasion and no evidence of distant metastasis. The overall prognosis is considered fair, with no adverse features such as vascular invasion noted."} +{"pid": "TCGA-19-1786", "report": "A brain mass was biopsied from the left frontal lobe along with several other tissue samples labeled as \"Permanent Edge,\" \"Permanent Core,\" \"Left Frontal Neoplasm Core,\" \"Edge,\" and \"Permanent White Matter.\" The specimens were received either fresh or in formalin and were processed accordingly. Grossly, the tissues were described as multiple pink-tan, soft fragments with cerebriform features, varying in size from 0.5 to 3.2 cm in aggregate. Some specimens were submitted entirely for permanent sections while others were partially used for frozen section analysis.\n\nMicroscopic evaluation of the biopsies showed malignant cellular infiltrates with features of glial origin. Some areas demonstrated oligodendroglial differentiation, while others showed astrocytic features. Chromosomal studies revealed losses in chromosome 1p and 19q. Tumor cells were present at the margins in some specimens, indicating possible extension into surrounding tissues. Cellular atypia, mitotic activity, and microvascular proliferation were noted. No necrosis was specifically mentioned. The tumor exhibited aggressive histological features, including high cellularity and nuclear pleomorphism. Tissue from the core and edge of the lesion showed similar histological patterns, suggesting a diffuse and infiltrative growth pattern."} +{"pid": "TCGA-MJ-A850", "report": "A total of two lymph nodes were identified in the right neck level 2 excision, all of which showed no evidence of malignancy. Additionally, the right pharyngeal superior margin, right inferior constrictor margin, pre-epiglottic fissure, right lateral arytenoid, and right cricothyroid musculature biopsies also showed no signs of malignancy.\n\nIn the right neck level 3 regional dissection, thirteen lymph nodes were identified and none exhibited malignancy. Similarly, six lymph nodes were found in the right neck level 2A dissection, all of which were negative for malignancy.\n\nThe right pharyngectomy specimen contained a mass measuring 3.5 x 3.5 cm grossly, located within close proximity to several anatomical landmarks. Histologically, the mass demonstrated high-grade features with a cumulative score of 7 based on differentiation (3/3), mitotic activity (3/3), and necrosis (1/2). The tumor was situated 0.2 cm from the superior margin and 0.2 cm from the nearest right margin, extending over the thyroid cartilage by 0.7 cm without apparent involvement.\n\nOther tissues examined\u2014including the right submandibular gland\u2014revealed no malignant involvement. All other margins assessed throughout the specimen were free of any malignant cells."} +{"pid": "TCGA-44-A4SU", "report": "The surgical pathology report describes findings from two specimens obtained during a procedure involving the right lower lobe of the lung. The first specimen consists of a piece of lung tissue measuring 12 x 2.5 x 2 cm, with a long stapled margin and a distorted pleural surface. A firm white mass measuring approximately 1.7 cm in greatest dimension is identified adjacent to a defect in the pleura. On sectioning, the mass measures 1.8 cm and appears to involve the area near the staple line. Histologically, the lesion demonstrates a moderately differentiated growth pattern with some areas showing lepidic features and clusters of cells within adjacent alveoli. The histologic grade is 2. There is evidence suggestive of vascular invasion. Sections taken near the pulmonary margin of resection show involvement; however, a second specimen taken from the reexcision of the staple line is negative for malignant findings. The pleura does not show signs of involvement. Based on these findings, staging assessment corresponds to pTNM Tla. The second specimen, measuring 8 x 1.8 x 1 cm, consists of lung tissue with a stapled margin and does not show any malignant features upon microscopic evaluation."} +{"pid": "TCGA-DK-A6B6", "report": "The specimen submitted consists of multiple irregular tan-brown soft tissue fragments measuring 1.1 x 1.0 x 0.7 cm in aggregate, obtained from the right posterior bladder wall. Histologic evaluation reveals a lesion with high-grade cytology and both papillary and flat growth patterns. Invasion into the muscularis propria is present. No vascular invasion is identified. The surrounding non-neoplastic mucosa demonstrates changes consistent with proliferative cystitis, including Brunn\u2019s nests, cystitis cystica, and cystitis glandularis. All tissue was processed and examined."} +{"pid": "TCGA-FB-A78T", "report": "A 0.4 x 0.4 x 0.3 cm fragment of tan-red tissue was submitted from the right lobe of the liver and frozen in cassette A1. A lymph node measuring 3.0 x 1.5 x 1.0 cm with a tan-pink appearance was also submitted, labeled as celiac lymph node. The specimen from a pancreaticoduodenectomy measured 3.5 cm at its greatest dimension and was located in the head region. Microscopically, the lesion exhibited moderately differentiated histology. Extension was noted into peripancreatic soft tissues and extended into the duodenal wall reaching the mucosa. All surgical margins were free of involvement, including the distal pancreas, common bile duct, stomach/duodenum, retroperitoneal, and uncinate groove margins, which showed a clearance of 2 mm. Angiolymphatic and perineural invasion were present. No prior treatment effect was observed. Lymph node evaluation revealed metastases in 4 out of 22 nodes examined, including peripancreatic inferior and pancreaticoduodenal posterior regions. Additional findings included atrophy, fibrosis, chronic pancreatitis, duct dilatation, and ductal dysplasia resembling PanIN II and III. Other specimens showed multifocal atrophic gastritis in the gastric antrum, and the gallbladder exhibited acute and chronic cholecystitis with polypoid cholesterolosis and diverticula but no dysplasia. The hepatic duct margin was unremarkable. Frozen section analysis of the liver nodule favored a benign process."} +{"pid": "TCGA-AG-3598", "report": "The resected material from the colon and rectum demonstrates tumor-free resection margins. A moderately differentiated lesion is present, characterized by ulceration and infiltration extending into the perimuscular adipose tissue. No regional lymph node metastases were identified. The vascular and lymphatic invasion statuses are negative. All surgical margins are free of tumor involvement."} +{"pid": "TCGA-G4-6307", "report": "The specimens included a right ovarian cyst measuring 2.0 x 1.0 x 0.8 cm and a left ovarian cyst measuring 1.5 x 0.4 x 0.3 cm. Both were cystic soft tissue fragments with no malignant findings.\n\nA segment of the left colon, sigmoid, and upper rectum was received, measuring 20 cm in length and 6 cm in open circumference. A fungating mass measuring 4 x 5 x 3 cm was identified, located 4 cm from the rectal margin and 9.5 cm from the colonic margin. Histologically, the lesion demonstrated moderately differentiated features with ulceration and infiltration into the subserosa. Margins were negative for invasive disease. A separate polyp measuring 0.7 x 0.4 x 0.3 cm was found near the mass and showed benign characteristics.\n\nSixteen lymph nodes were evaluated, two of which contained metastatic deposits. Vascular invasion was identified, while perineural invasion was not observed. No implants were detected. The surgical resection margins were microscopically negative. The specimen included representative sections from the colonic margin, rectal margin, mass and deep margin, normal mucosa, and lymph nodes.\n\nThe distal donut specimen consisted of a ring of tan mucosal tissue measuring 0.9 cm in length with an outer circumference of 1.6 cm. It contained a stapled surgical line and showed no pathological abnormalities.\n\nThe proximal donut specimen was a ring of tan mucosal tissue with an outer circumference of 1.9 cm and width of 0.8 cm. Blue sutures were noted throughout the specimen, and no pathological abnormalities were identified.\n\nA small bowel nodule measuring 2.0 x 0.5 x 0.4 cm was examined. It contained a firm white nodule measuring 1 x 0.5 x 0.5 cm. Histologic evaluation revealed benign findings without evidence of malignancy.\n\nImmunohistochemical analysis demonstrated preserved expression of MLH1, MSH2, MSH6, and PMS2 within the lesion. Internal controls showed appropriate staining patterns. Testing for microsatellite instability has been initiated and results will be reported separately."} +{"pid": "TCGA-D8-A1JA", "report": "Histopathological examination of the left breast with axillary tissues was performed following toilet mastectomy. The clinical history indicated a neoplastic process in the left breast. Microscopic evaluation revealed an invasive component with ductal morphology. Immunohistochemical analysis showed that less than 10% of the neoplastic cell nuclei were positive for estrogen receptors, and no progesterone receptor expression was detected. HER2 protein assessment using HercepTest\u2122 by DAKO demonstrated strong membranous staining in the neoplastic cells, corresponding to a score of 3+. The lesion involved multiple tissue specimens, and staging was determined based on size, lymph node status, and histological grade. Cellular atypia, mitotic activity, and architectural features were assessed to establish the final pathological classification."} +{"pid": "TCGA-P5-A733", "report": "The clinical evaluation indicated an abnormality within the brain. Gross examination of the surgically resected specimen revealed gray-yellow fragments originating from the left frontal lobe. Microscopic analysis demonstrated neoplastic cells infiltrating the brain parenchyma, characterized by nuclear pleomorphism and a low proliferative index, with Ki-67 staining showing positivity in up to 5% of cells. The histopathological features were consistent with a neoplastic process involving glial cells. Based on histological grading criteria, the lesion was classified as Grade II."} +{"pid": "TCGA-BP-4971", "report": "The right kidney specimen measured 12.5 x 8.3 x 4.6 cm and weighed 642 grams post fixation. A tumor mass measuring 8.1 x 7.5 x 4.3 cm was identified in the superior and mid poles, with a yellow-red appearance and areas of hemorrhage and necrosis. The tumor appeared partially encapsulated by fibrous tissue and showed focal protrusion into the sinus fat. Invasion into the renal pelvis was not grossly evident. The tumor abutted the renal calyces and demonstrated soft, friable red-tan tissue extending inward. Perinephric fat revealed a focal area suggestive of extracapsular extension. Vascular invasion was noted involving vessels with muscular walls. Margins were free of tumor involvement. Non-neoplastic findings included focal granulomatous reaction and glomerulosclerosis.\n\nFive lymph nodes from precaval, paracaval, and retrocaval regions were examined, ranging from 0.8 to 1.7 cm in size. No lymph node involvement was identified. A vascular segment measuring 3.0 x 0.5 cm was also submitted and found to be benign.\n\nThe right adrenal gland specimen measured 5.1 x 2.9 x 1.0 cm and weighed 10.5 grams post fixation. Histologic examination revealed no tumor involvement and was consistent with benign adrenal tissue.\n\nStaging criteria indicate that the tumor extended into perirenal tissues but did not exceed Gerota\u2019s fascia. Multiple representative sections were taken from various sites including tumor margins, adjacent structures, and normal kidney tissue."} +{"pid": "TCGA-CV-7252", "report": "The surgical specimen includes fragments from the right buccal mucosa, which show well-differentiated squamous carcinoma; however, invasion cannot be assessed in this material. A submental nodule consists of lymphoid tissue and is negative for tumor. The larger resection specimen includes areas corresponding to the buccal mucosa, gingiva, pharynx, and tongue. The lesion measures 5.5 x 3.0 x 3.0 cm and has a depth of invasion of 2.5 cm. Tumor extends to the lateral soft tissue resection margin, but anterior, medial, posterior, and deep margins are free of tumor. There is evidence of perineural involvement. The submandibular gland shows chronic inflammation but no tumor. Thirty-one left neck dissection lymph nodes are negative for tumor, including 4 submental, 1 subdigastric, 4 midjugular, 5 lower jugular, 1 upper posterior cervical, 4 midposterior cervical, and 12 lower posterior cervical nodes. Mandibular bone fragments with attached soft tissue are also negative for tumor. A separate excision from the remnant uvula shows only squamous mucosa and salivary gland tissue without evidence of tumor."} +{"pid": "TCGA-AJ-A3IA", "report": "The specimen was received in multiple containers. A microscopic focus of markedly atypical epithelium was identified in one cross-section of the right fallopian tube and on the surface of the right ovary. These areas did not reach a definitive diagnostic threshold for high-grade serous neoplasia, and no additional similar foci were found elsewhere. Additional immunohistochemical staining was performed on selected blocks. Focal positivity for p53 and MIB1 was observed in certain regions, including areas of the ovarian surface and fallopian tube.\n\nThe uterus measured 4.5 x 4.5 x 3.0 cm and contained a tumor located primarily in the anterior wall. The tumor measured approximately 3.0 cm in greatest dimension and demonstrated myometrial invasion with a depth of 15 mm into a 17 mm thick myometrium. No involvement of the cervix was identified. Surgical margins were uninvolved by invasive carcinoma, with the closest distance of invasive carcinoma to a margin measuring 2 mm at the peritoneal serosal margin. No lymphovascular space invasion was identified.\n\nLymph node specimens from bilateral external iliac, obturator, and common/lower aortic regions were all negative for malignancy. The omentum was also negative for malignancy, although a single small benign lymph node was present.\n\nThe right and left ovaries and fallopian tubes showed advanced atrophy without evidence of malignancy. However, focal epithelial dysplasia was noted in both the right fallopian tube and the right ovarian surface. The left fallopian tube and ovary also showed atrophic changes but no definitive malignant transformation.\n\nNo malignancy was identified in the excised pelvic soft tissue labeled as adhesion. The endometrium showed no involvement beyond the primary tumor site. Normal pink-tan glistening endometrial lining was present on the posterior aspect of the uterine cavity, with an average thickness of 0.3 cm.\n\nFollow-up is recommended due to the presence of atypical epithelial changes in the right fallopian tube and ovary, raising the possibility that similar changes may exist elsewhere in the serous surfaces. All other tissues examined were negative for invasive carcinoma or metastatic disease."} +{"pid": "TCGA-A4-8311", "report": "Pathology Report. \n\nA specimen from the left kidney was examined, including a deep margin and a partial nephrectomy specimen. The tumor measured 2.5 x 2.2 x 2.0 cm and was confined to the kidney with unifocal involvement. Histologically, the lesion demonstrated a solid growth pattern with focal papillary architecture at the periphery. A proliferation of foamy histiocytes was present within the tumor, and rare psammoma bodies were also identified. Nuclear grading was Fuhrman grade 2 out of 4. There was no evidence of lymphovascular space invasion or sarcomatoid differentiation. \n\nThe resection margins were free of tumor, although one focus of tumor extended into, but not through, the capsule and was within 0.5 mm of an inked margin. No lymph nodes were involved. Non-neoplastic renal tissue showed no significant pathology. Based on the findings, the tumor was staged as T1a. \n\nGross examination of the surgical specimen revealed a circumscribed gray-tan mass within a wedge section of kidney measuring 5.0 x 3.0 x 2.2 cm. The mass came within 0.1 cm of the inked soft tissue margin. Microscopic evaluation confirmed the earlier intraoperative frozen section finding of negative for malignancy in the deep margin sample. Representative sections were submitted for further analysis."} +{"pid": "TCGA-XU-AAXX", "report": "The specimen consists of a thymus gland with a portion of membranous tissue, measuring 12.5 x 8.5 x 2.4 cm, along with the membranous component measuring 7.5 x 2.5 x 0.2 cm. A well-circumscribed nodule measuring 5.5 x 3.8 x 2.5 cm is identified at one pole of the thymus. The cut surface of the nodule is tan with focal calcifications, firm peripherally and soft centrally. Microscopic evaluation reveals a well-circumscribed lesion composed of a roughly equal mixture of small lymphocytes and larger epithelial cells. The lesion is partially encapsulated with multifocal microscopic extension beyond the capsule into adjacent adipose tissue. There is no evidence of involvement of the membranous tissue. The lesion is present focally at a cauterized edge of resection. Immunohistochemical staining demonstrates that the lymphocytes are positive for CD3 and CD1a, while the epithelial cells stain for low and high molecular weight keratins and p63. Residual thymic tissue shows minimal involutional changes. Based on histologic features and immunophenotype, the lesion demonstrates microscopic extension beyond the capsule into surrounding fat without nodal or distant spread. Surgical margins show tumor involvement at a soft tissue margin."} +{"pid": "TCGA-IB-7888", "report": "The specimen includes a gallbladder measuring 10.0 x 4.5 x 2.1 cm. The serosal surface is smooth. Multiple yellow lobulated stones are present within the lumen, with brown to yellow sludge. The largest stone measures 1.0 x 1.0 x 1.0 cm, and the smallest is 0.1 cm. An area of narrowing is identified in the gallbladder pouch, with 4.0 cm proximally and 5.5 cm distally from this narrowed region. Sections are taken from the fundus, body, and cystic duct. No cystic lymph node is identified.\n\nThe second specimen includes the head of the pancreas and duodenum. The overall specimen includes tan-yellow fibrofatty tissue measuring 39.0 x 32.0 x 1.2 cm. The pylorus and duodenum measure 24.0 cm in length. The proximal margin has a circumference of 6.0 cm, and the distal margin measures 3.0 cm in circumference. The duodenal mucosa appears normal. The ampulla of Vater is firm, and the mucosa proximal to it appears flattened. No hemorrhage, polyps, or grossly invasive lesions are noted.\n\nThe pancreatic head measures 7.0 x 5.0 x 4.5 cm. The common bile duct is dilated, measuring 1.7 cm in diameter, and the pancreatic duct measures 0.3 cm in diameter. Attached mesentery measures 8.0 x 4.0 x 1.2 cm. A firm white mass replaces portions of the pancreatic head. The pancreatic resection margin measures 3.2 x 2.0 cm, and the uncinate margin measures 5.0 x 2.5 cm. The lesion extends from the pancreatic neck into the uncinate process, measuring 5.0 cm from anterior to posterior. It involves the posterior margin and is 0.1 cm from the anterior margin. From superior to inferior, the tumor measures 5.5 cm. It is located 0.3 cm from the inferior margin and appears to involve the pancreatic resection margin. Both the common bile duct and pancreatic duct are encircled by the lesion. The ampulla of Vater is probed and appears patent, although insertion of the probe is difficult. A 3.0 x 3.0 cm section around the ampulla is removed for further analysis.\n\nMicroscopic evaluation of multiple sections reveals no evidence of malignancy in the margins, including the common bile duct, pancreatic duct, soft tissue, and retroperitoneal margins. Lymph nodes (12 total) do not show any malignant involvement. Sections of the ampulla of Vater and surrounding areas were examined. A lighter-colored area of duodenal mucosa measuring 6.0 x 4.0 cm is noted, located 12.0 cm from the distal margin and 6.5 cm from the proximal margin. Chronic changes consistent with cholecystitis and cholelithiasis, including multiple cholesterol stones, are present. Additionally, findings suggest chronic pancreatitis."} +{"pid": "TCGA-21-A5DI", "report": "The specimen was obtained from a male patient with a history of a right lower lobe lung mass. Tissue samples included lymph nodes from levels 4, 7, 9, and 11, as well as a portion of the right lower lobe of the lung.\n\nThe level 9 lymph node measured 2.4 x 1.4 x 1.3 cm and had a tan-gray cut surface. The level 11 lymph node fragments measured up to 1.0 cm and were grayish black in appearance. The right lower lobe of the lung weighed 180 grams and measured 15.0 x 12.0 x 6.0 cm. Within the hilum, multiple tan firm nodules were identified, measuring up to 2.0 cm, consistent with lymph nodes showing anthracotic changes. A thickened pleural area measuring 2.0 x 2.0 cm was noted near the hilum, located 1.8 cm from the margin. In the posterior inferior region, a tan mass measuring 4.0 x 4.0 x 3.8 cm was observed, located 5.8 cm from the margin, with a central necrotic cavity. The vascular and bronchial margins showed no involvement. Level 4 lymph node measured 1.2 x 1.0 x 0.8 cm with a tan firm cut surface. Level 7 lymph nodes included two nodules measuring 3.2 x 2.5 x 1.5 cm and 5.0 x 4.0 x 3.0 cm, with tan to gray-black cut surfaces.\n\nHistologically, the lymph nodes showed effacement of normal architecture by small lymphocytes. Immunohistochemistry demonstrated positivity for CD20 and CD23, and negativity for CD10, CD3, and cyclin D1. CD5 staining followed the pattern of CD3. No evidence of metastatic carcinoma was found in any of the lymph nodes examined. The lung tissue revealed an invasive tumor measuring 4 cm in greatest dimension. The tumor did not involve the visceral pleura, and no lymphovascular space invasion was observed. All surgical margins were free of tumor involvement. More than 15 regional lymph nodes were examined, and none showed signs of metastasis. Staging was classified as pT2N0Mx."} +{"pid": "TCGA-D8-A1XC", "report": "Histopathological examination was performed on a right breast resection specimen measuring 19 x 9 x 6 cm, along with axillary tissue measuring 7 x 3 x 2 cm and a skin flap of 13 x 9.5 cm. The total weight of the specimen was 370 grams. A lesion measuring 7 x 4 x 8 cm was identified in the central region. Margins were uncertain at the lower boundary and base, with a 0.1 cm distance from the skin margin.\n\nMicroscopic evaluation revealed invasive carcinoma characterized by mucinous features and neuroendocrine differentiation. The histologic grade was NHG2, with a mitotic count of 3+2+1/5 per 10 high power fields. Adjacent to this lesion, multiple foci of ductal carcinoma were observed, displaying cribriform architecture and moderate nuclear atypia without necrosis. Background changes included fibrocystic mastopathy and simple ductal hyperplasia (UDH).\n\nImmunohistochemical staining showed estrogen receptor positivity in more than 75% of neoplastic nuclei, and progesterone receptor positivity in over 75% of tumor cell nuclei. HER2 immunostaining using HercepTest\u2122M demonstrated a score of 1+ in invasive carcinoma cells. Additional markers included synaptophysin positivity and variable staining for chromogranin, CK7, CK5/6, p63, and calponin.\n\nAxillary lymph node evaluation revealed micrometastatic involvement in one lymph node (No I/XX). Microscopic analysis also confirmed focal tumor extension along the incision line near the base and lower margin, and extensive skin proliferation with minor ulceration was noted. The tumor was staged as pT4b and pN1a (mi)."} +{"pid": "TCGA-XU-A92O", "report": "The thymectomy specimen measures 13.0 cm in greatest dimension and weighs 71.9 grams. A well-circumscribed solid lesion measuring 3.0 x 2.6 x 2.4 cm is present within the thymus. The lesion is completely encapsulated, with no evidence of invasion into surrounding tissues. The resection margin, as assessed by histologic examination, is free of involvement. Histologic sections include the tumor in entirety and representative samples of thymic tissue from both lobes. Staging indicates pT1N0M0 (Stage I), with no lymph node or distant disease identified."} +{"pid": "TCGA-BP-4986", "report": "A right renal mass was identified in a male patient undergoing partial nephrectomy. The surgical specimen consisted of a wedge-shaped portion of kidney measuring 4.0 x 3.0 x 2.0 cm, with a suture marking the deep margin. A well-defined mass measuring 1.8 x 1.6 x 1.4 cm was found within the kidney, exhibiting a yellow and white homogeneous cut surface. The tumor was located 0.1 cm from the deep margin, which was inked black. Representative sections of the tumor and adjacent margin were submitted for analysis, along with sections of normal kidney parenchyma. No evidence of local invasion or renal vein involvement was observed. All surgical margins were free of tumor.\n\nIn addition, a regional resection of paracaval lymph nodes was performed. The specimen included three lymph nodes ranging from 0.8 to 2.2 cm in size. All lymph nodes were submitted for evaluation and showed no involvement. \n\nThe tumor demonstrated nuclear features classified as high grade based on nuclear morphology. The greatest tumor dimension was 1.8 cm. Staging criteria indicated the lesion was confined to the kidney and measured less than 7.0 cm in greatest dimension. Four lymph nodes were examined and none contained tumor."} +{"pid": "TCGA-BH-A0AV", "report": "The specimen consists of breast tissue from a left-sided segmental mastectomy. The lesion measures 1.5 cm on slide 1F. Histologic evaluation reveals a Nottingham score of 8 out of 9, with tubule formation score of 3, nuclear grade score of 3, and mitotic activity score of 2, corresponding to a high-grade morphology. Surgical margins are free of abnormal cells, with the closest distance being 0.6 cm at the posterior margin. No evidence of lymphovascular invasion is observed. Additional findings include calcifications and fibrocystic changes. Ductal intraepithelial neoplasia of solid type with nuclear grade 3 features and comedonecrosis is identified in four of fifteen sections, separate from the main lesion. Margins are free of intraepithelial neoplasm by more than 1.0 cm. Skin appears unremarkable. One lymph node from sentinel biopsy and one lymph node from non-sentinel biopsy were examined; both showed no signs of metastatic involvement. Pathologic staging is determined as pT1c for the primary lesion, with no lymph node involvement (pN0) and unavailable distant metastasis assessment (pMX). Hormone receptor status and HER2/NEU testing previously reported as equivocal or negative."} +{"pid": "TCGA-D8-A1JN", "report": "Histopathological examination of a left breast resection specimen, measuring 17.8 x 11.3 x 4.8 cm and weighing 400 g, was performed along with axillary tissue (9 x 5 x 3 cm). A lesion measuring 3.9 x 6.6 x 2.8 cm was identified in the central region, located 1.4 cm from the upper edge, 0.9 cm from the base, and in direct proximity to the skin. Microscopic evaluation revealed a neoplastic process involving the skin and nipple. The neoplastic cells were arranged in a growth pattern consistent with moderate differentiation based on histological grading (G2 according to Elston criteria), with a score breakdown of 3+2+1. Mitotic count was low, with no mitoses observed per 10 high-power fields (HPF) using a 0.55 mm diameter field. Parenchymal atrophy was noted in the surrounding glandular tissue.\n\nInvolvement of the surgical margin was observed, with invasive lesions located 0.1 cm from the base of the specimen. Lymph node involvement was present, with evidence of neoplastic infiltration in axillary lymph nodes (number XI/XIII). Immunohistochemical analysis showed estrogen receptor positivity in 75% of neoplastic cell nuclei and progesterone receptor positivity in 10%. HER2 protein expression was scored as 2+ by immunohistochemistry; however, FISH analysis did not confirm gene amplification. The pathological staging assigned was NHG2, pT3, pN3a."} +{"pid": "TCGA-S9-A6WG", "report": "The histomorphology shows features consistent with a diffusely infiltrating glial tumor exhibiting increased mitotic activity. The proliferation index is elevated at 7%. Cellular architecture demonstrates marked proliferative potential. Staging assessment indicates involvement beyond the initial site, with findings corresponding to an advanced localized stage."} +{"pid": "TCGA-V5-A7RB", "report": "Surgical pathology report. Clinical history indicates a male patient with a 1.5 cm perihepatic lymph node and prior history of esophageal malignancy. A fine needle aspiration of the lymph node was performed under ultrasound guidance. Submitted material included 5 prestained smears, 4 prefixed smears, and fluid for a sediment cell block.\n\nGross examination of an outside case included 5 slides. The material was received from an external facility, and it is indicated that the path report was also received. The material is to be returned.\n\nMicroscopic evaluation of the esophageal biopsy revealed squamous mucosa with undermining features. There is presence of intramucosal carcinoma, moderately to poorly differentiated. The depth of invasion is limited to the mucosa (pT1a). No definitive submucosal invasion is identified, although the lesion appears highly suspicious. Barrett's esophagus is not present in this sample. A review by a specialist has been conducted and concurs with the findings.\n\nThe colon and rectal polyps were examined microscopically. A polyp from the ascending colon shows serrated morphology with features suggestive of a sessile serrated lesion; no conventional dysplasia is noted. Polyps from the transverse and descending colon demonstrate tubular adenoma features. A polyp from the rectum is characterized as a hyperplastic polyp.\n\nCytological evaluation of the lymph node aspirate showed malignant cells within a background consistent with lymph node tissue. The findings are indicative of metastatic carcinoma. The malignant cells are consistent with an adenocarcinoma origin. \n\nAll specimens were personally evaluated and diagnosed by the attending pathologist."} +{"pid": "TCGA-DI-A1BU", "report": "The specimen includes a uterus with cervix, bilateral fallopian tubes, and mixed ovaries. The uterine wall measures 19 mm in total myometrial thickness, with an invasive component extending 3.0 mm into the myometrium. The tumor also invades 2.0 mm into a 20 mm cervical segment. Lymphovascular invasion is present. A separate finding of a leiomyoma is noted. No tumor is identified in the right and left ovaries or fallopian tubes, though paratubal cysts are present bilaterally.\n\nLymph node evaluation includes 11 left pelvic lymph nodes, 14 right pelvic lymph nodes, and 6 paraaortic lymph nodes; none show evidence of tumor involvement. A portion of omentum and the right gonadal vessel are also free of tumor.\n\nGross examination reveals a tan-white external surface of the uterus. The bivalved uterus shows a large exophytic, hemorrhagic lesion measuring 12.5 x 8.3 x 2.4 cm within the uterine cavity, extending into the cervical canal. Adjacent uterine wall at the most invasive point measures 2.8 cm. A 1.2 x 0.6 cm cystic nodule consistent with a myometrial leiomyoma is present. The right ovary measures 3.3 x 1.5 x 1.2 cm and contains a 0.6 cm surface cyst. The left ovary demonstrates similar features. The fallopian tubes contain hemorrhagic material but no gross lesions. Multiple sections of the tumor and surrounding tissue have been submitted for analysis, including full-thickness sections of the cervix and myometrium.\n\nAdditional specimens include adipose tissue from the omentum, which shows no mass lesion, and vascular structure from the right gonadal vessel, which appears unremarkable. All lymph node groups were identified and submitted for histological review, with no evidence of metastatic disease found."} +{"pid": "TCGA-F5-6811", "report": "The submitted specimen consists of a large intestine tissue excision measuring 2.5 x 0.5 cm. The tissue was obtained from the rectosigmoid junction. Microscopic evaluation revealed poorly differentiated cells. The tumor extends into the perirectal tissues. A total of 8 lymph nodes were examined, and none showed involvement. Surgical margins are uninvolved. No features of the tumor are further specified. No evidence of neo-adjuvant treatment is identified. No additional pathologic findings or comments are provided."} +{"pid": "TCGA-EL-A3ZK", "report": "A right thyroid lobe and isthmus specimen measured 4.0 x 3.0 x 2.0 cm, with a separate isthmus measuring 1.0 x 1.0 x 0.5 cm. Within the right lobe, a well-circumscribed, golden-brown mass was identified in the inferior to superior pole region, measuring 2.4 x 2.5 x 1.2 cm. The left thyroid lobe measured 5.0 x 2.7 x 1.5 cm with an isthmus of 1.0 x 0.8 cm; no abnormality was found in this lobe upon serial sectioning.\n\nThe pretracheal lymph node was a small tan nodule measuring 0.3 x 0.2 x 0.2 cm and showed involvement by cellular infiltration. The tissue anterior to the innominate artery was an irregular adipose fragment measuring 0.7 x 0.5 x 0.5 cm and did not show any signs of involvement.\n\nA right paratracheal and upper mediastinal lymph node dissection included multiple fibroadipose fragments aggregating to 4.0 x 3.0 x 1.0 cm. A total of fifteen lymph nodes were identified, sizes ranging from 0.3 to 0.8 cm in greatest dimension. Two of these lymph nodes showed evidence of cellular infiltration without extracapsular extension.\n\nLymph node adjacent to the right recurrent laryngeal nerve was a small tan tissue fragment measuring 0.3 x 0.2 x 0.2 cm and did not show any involvement. Additional upper mediastinal tissue submitted was an irregular soft tan fragment measuring 0.6 x 0.3 x 0.2 cm, also without evidence of involvement.\n\nMargins of resection for the right thyroid lobe were free of involvement. One lymph node was examined in the right lobe specimen and was negative. Cellular features showed absence of lymphovascular invasion and no extension beyond the thyroid capsule."} +{"pid": "TCGA-IB-7645", "report": "The specimen includes multiple tissue samples from various anatomical sites, including a periportal lymph node, gallbladder, bile duct margin, pancreas margin, superior mesenteric lymph nodes, a Whipple specimen, and omentum. The clinical history indicates prior pancreatic disease.\n\nA periportal lymph node measuring 8.0 cm in greatest dimension is described as reactive with no malignant cells identified. The gallbladder, measuring 12.0 x 5.0 cm, contains dark green bile without stones; its wall appears slightly thickened, but no malignancy is found. The bile duct margin, measuring up to 3.0 cm, shows no evidence of malignancy or pre-cancerous changes.\n\nThe pancreas margin, measuring 2.5 x 2.0 x 0.5 cm, reveals chronic inflammation and fibrosis without signs of cancer. A superior mesenteric lymph node, 1.0 cm in size, also demonstrates reactive changes without malignancy.\n\nThe Whipple specimen includes the pancreatic head (6.0 x 5.0 x 2.5 cm), attached stomach segment (7.0 x 5.0 cm), and duodenum (24.5 cm long). Within the pancreas, a poorly defined mass measuring approximately 4.5 x 2.0 x 2.5 cm is observed near the common bile duct. The mass appears yellow-white with cystic areas, and no hemorrhage or necrosis is noted. It is in close proximity to the ampulla and located about 3.7 cm from the bile duct surgical margin. Histologic evaluation of the resection margins\u2014pancreatic, bile duct, stomach, and duodenum\u2014reveals no cancer involvement. Several lymph nodes are examined, with five out of total nodes showing evidence of involvement.\n\nAdditional findings include severe chronic pancreatitis and atypical cellular changes along the pancreatobiliary duct system. Vascular and perineural invasion features are present. Multiple sections of the tumor and surrounding tissues are submitted for further analysis, including those near the serosal surface, small bowel, and lymphoid regions."} +{"pid": "TCGA-JY-A93D", "report": "The surgical specimen included resected portions of the thoracic esophagus and proximal stomach along with multiple lymph node stations. The primary lesion measured 3.4 x 3.0 x 1.2 cm and was located in the distal esophagus, extending to the esophagogastric junction. Histologically, the lesion demonstrated poorly differentiated features with invasion into the muscularis propria. Lymphovascular and perineural invasion were present. All surgical margins\u2014including proximal, distal, and circumferential\u2014were free of invasive disease, with the closest distance of tumor to a margin measuring 3 mm at the circumferential margin.\n\nA total of 39 lymph nodes were evaluated across multiple stations. Metastatic involvement was identified in several lymph node regions: one of seven nodes in station 8, one of four nodes in station 7, five of sixteen nodes in station 17, four of nine nodes in station 16, and one of one additional node in station 7. Additional lymph node specimens from another station 8 and station 4R showed no evidence of malignancy. Two additional lymph node specimens (station 19 and an additional station 8) contained only benign fibroadipose tissue without identifiable lymph nodes.\n\nOther findings included Barrett\u2019s esophagus with focal high-grade dysplasia. No prior treatment effect was observed. Based on the extent of regional lymph node involvement and depth of primary tumor invasion, the pathological staging was determined as pT2 pN3 pMX according to the AJCC/UICC TNM classification system (7th edition)."} +{"pid": "TCGA-2Y-A9GZ", "report": "The specimen was submitted from a right lobectomy. The tumor was nodular in configuration and measured 8 x 6 x 5.2 cm. Histologic evaluation showed moderately differentiated cells with approximately 10% necrosis. Angiolymphatic invasion was present, while perineural invasion was not identified. The tumor was limited to the liver without extension beyond. Vascular invasion involving large vessels was not observed. All margins, including the parenchymal margin and bile duct margin, were free of involvement. Additional findings included extensive intrahepatic changes. No lymph nodes were identified as part of the specimen. Pathologic staging was determined as T2 NX MX.\n\nThe gross examination of the gallbladder specimen consisted of a tubular structure measuring 1.1 to 2.6 cm in diameter. The outer surface appeared soft and tan-pink. The mucosal lining was velvety with a green-yellow appearance. The gallbladder contents were viscous and green in color. No stones were identified. The gallbladder wall measured uniformly at 0.2 cm thickness. Sections submitted included areas from the neck, body, fundus, and margins.\n\nThe liver specimen measured 15.5 x 15 x 7 cm and was oriented with a stitch adjacent to the portal vein. The tumor appeared tan-yellow with central necrosis and was located in the superior portion of the specimen, extending to the superior capsule but not penetrating it. It came closest to the resection margin at 0.3 cm near the portal vein area and was grossly encapsulated. No satellite nodules were observed. The remainder of the liver parenchyma appeared non-fibrotic and tan-red. Sections submitted included representative areas of tumor, adjacent normal parenchyma, surgical margins, and normal liver tissue. A portion of the specimen was sent to the Tissue Procurement Laboratory."} +{"pid": "TCGA-77-7141", "report": "The specimen from the left upper lobe consists of a lobectomy measuring 130 x 80 x 35 mm. The bronchial portion is approximately 30 mm in length and contains a bifurcation near the resection margin. Two adjacent lumens, each about 13 mm in diameter, are present, with one partially obstructed by a cream to pink lesion. No palpable mass is identified within the lung tissue, and the pleural surface shows mild anthracotic pigmentation. Several small peribronchial lymph nodes are noted. The lesion appears to extend along the bronchial tree, involving multiple second-order branches, but does not show macroscopic invasion into the surrounding lung tissue. It is estimated to span approximately 45 mm along the first and second order bronchi.\n\nMicroscopically, the lesion demonstrates an exophytic growth pattern and moderate differentiation. It fills bronchial lumens and extends into the spaces between bronchial cartilage, reaching the external bronchial soft tissue margin in some areas. There is no clear evidence of transection at the margins, and one bronchial end margin is involved. Invasion into lung parenchyma is not observed. No lymphatic or vascular invasion is identified, although focal perineural infiltration is present. None of the peribronchial lymph nodes show evidence of metastasis, though the lesion approaches the capsule of one node. The distal lung tissue is atelectatic and contains scattered fibromuscular scars.\n\nA separate strip of bronchial wall from the lingular margin of the left lobe measures 32 x 4 x 2 mm. Histologically, it shows bronchial mucosa lined by partially denuded respiratory epithelium with focal thin squamous metaplasia, but no dysplasia or malignant cells are present.\n\nFive small lymph nodes are identified in the hilar specimen, the largest measuring 6 mm. The mediastinal lymph node specimen contains two nodes, measuring 3 mm and 11 mm respectively. All lymph nodes show only anthracotic changes without any signs of malignancy.\n\nStaging assessment indicates no lymph node involvement and no distant metastases."} +{"pid": "TCGA-YC-A89H", "report": "A 50-year-old female with no prior treatment presented for evaluation. The histologic examination revealed a high-grade urothelial carcinoma with squamous differentiation. No associated epithelial lesions were identified. The tumor configuration was indeterminate, and the material was sufficient for assessing muscularis propria invasion. Microscopic evaluation confirmed tumor invasion into the muscularis propria. Lymphovascular invasion was not identified. \n\nStaging according to the AJCC 7th edition classified the tumor as pT2; regional lymph node involvement (pNX) and distant metastasis (pM) could not be assessed. \n\nCellular composition varied across samples. In one sample, 50% of nuclei were tumor-derived with no necrosis and 50% normal tissue. Another sample showed 75% tumor nuclei, 5% necrosis, and 20% normal tissue with 50% squamous differentiation. A third sample consisted of two fragments\u2014one with 50% tumor and 50% normal tissue, the other entirely non-neoplastic. A fourth sample contained 30% tumor nuclei, no necrosis, and 70% normal tissue.\n\nThe specimen included four tumor tissue pieces, each weighed and processed. Individual weights were 480 mg, 430 mg, 440 mg, and 490 mg. Specimen collection included plasma, serum, buffy coat, and cryovials. Cold ischemia and formalin fixation times were recorded, along with total processing durations. No metastatic tissue was collected. Four FFPE blocks were prepared from tumor tissue. Patient consent was documented."} +{"pid": "TCGA-QQ-A8VB", "report": "The specimen from the right back measured 11x5x3 cm and consisted of an ellipse of skin with underlying subcutaneous adipose tissue. A healing incisional scar was noted, with a small sessile nodule measuring up to 0.5 cm in diameter observed on the posterior third of the specimen. On sectioning, a tan-yellow fibrous lesion measuring 3.5x3x3 cm was identified in the central portion of the specimen. The tumor was located within 5 mm of the designated inferior margin. Surgical margins included inferior-orange, superior-red, anterior-blue, and deep-black. Histologically, the lesion showed features consistent with a cellular proliferation without residual tumor at the resection margins. Additional findings included dermal fibrous scarring at the prior biopsy site and associated neurofibromas.\n\nA second specimen from the right flank consisted of an oriented skin ellipse measuring 14.0x1.4 cm with attached subcutaneous tissue measuring 7.0x15x2 cm. A single suture marked the lateral margin, which was inked black. Multiple nodular skin tags were present on the skin surface, with the largest measuring 0.8 cm. No grossly identifiable residual lesion was observed in the subcutaneous tissue. All submitted margins were negative."} +{"pid": "TCGA-D1-A15V", "report": "The specimen includes a uterus with both ovaries and fallopian tubes, along with multiple lymph node groups and an omental sample. The right ovary measures 2.5 x 1.2 x 0.8 cm and is attached to a 7.0 cm segment of the right fallopian tube. The left ovary measures 2.0 x 1.2 x 0.8 cm and is connected to an 8.0 cm segment of the left fallopian tube. Together, these structures weigh 100.0 grams. Multiple pelvic and para-aortic lymph nodes were removed, including additional right para-aortic nodes below the inferior mesenteric artery. The omentum measures 26.0 x 25.0 x 0.5 cm. Several staging biopsies were taken from various sites, including the cul-de-sac, bladder peritoneum, colic gutters, pelvic sidewalls, bowel mesenteries, and both diaphragms, with biopsy specimens ranging from 0.3 cm to 1.2 cm in greatest dimension.\n\nMicroscopic evaluation identified a mass measuring 3.0 x 2.1 x 1.8 cm within the uterine cavity. Histologic analysis revealed high-grade papillary architecture with marked nuclear atypia and frequent mitotic figures. The lesion infiltrates 0.3 cm into the myometrium, which has a total thickness of 1.5 cm. No involvement is seen in the lower uterine segment or cervix. Both fallopian tubes and ovaries appear histologically unremarkable. All lymph nodes examined\u2014right and left pelvic, para-aortic, and additional right para-aortic below the inferior mesenteric artery\u2014are free of malignant cells. The omentum and all staging biopsies from the sampled sites show no evidence of tumor."} +{"pid": "TCGA-86-8668", "report": "The specimen consists of a lobectomy with tumor located in the lung measuring 3 x 2.5 x 2 cm. Histologic examination reveals a moderately differentiated mucinous histology. No information is available regarding tumor extent, presence of additional nodules, lymph node involvement, lymphatic or venous invasion, margin status, neo-adjuvant treatment effect, or other pathologic findings. The tumor appears to be localized without clear evidence of invasion or spread based on available data."} +{"pid": "TCGA-C4-A0F0", "report": "The specimen consists of a cystoprostatectomy preparation containing a poorly differentiated neoplasm with areas showing squamous epithelial differentiation. The maximum tumor diameter measures 4 cm. The tumor extends to the boundary with the submucosa but does not show significant extension into the surrounding perivesical fatty tissue. The remaining bladder mucosa exhibits chronic inflammatory changes. There is no clear evidence of dysplasia in the urothelium at the resection margins. Histological assessment indicates a high-grade lesion without lymphatic or vascular invasion, and the resection margins are free of tumor."} +{"pid": "TCGA-D6-6827", "report": "A female patient underwent histopathological examination of an excised lesion from the upper lip. The specimen measured 2.8 x 2.3 x 1.9 cm and contained a whitish mass measuring 1.7 x 1.7 x 1.2 cm located on the posterior surface. The closest surgical margin was less than 0.1 cm at the upper edge, with left and right margins measuring 0.3 cm each. Microscopic evaluation revealed highly atypical cells arranged in irregular nests and cords within the connective tissue. The cells exhibited marked nuclear pleomorphism, frequent mitotic figures, and minimal keratinization. Invasion was observed extending to the deep margins, while surrounding tissues showed no evidence of neoplastic involvement."} +{"pid": "TCGA-HT-8010", "report": "The microscopic examination reveals a mildly hypercellular infiltrating neoplasm composed of cells with round nuclei and variably prominent perinuclear halos. Mild cytologic atypia is present, and occasional neurons are surrounded by tumor cells, a feature known as perineuronal satellitosis. No mitotic figures are identified, and there is no evidence of necrosis or hemorrhage within the tumor. Immunohistochemical staining shows only rare MIB-1 reactive cells, resulting in a calculated labeling index of less than 0.1%."} +{"pid": "TCGA-YL-A9WI", "report": "The prostate and pelvic/obturator lymph nodes were examined following radical prostatectomy. Histologic evaluation demonstrated a combination of acinar and ductal growth patterns. The primary and secondary histologic grades combined to a Gleason score of 4 + 5 = 9, with no tertiary pattern identified. The tumor was located at the apex, mid, and base of the prostate, as well as in anterior, right and left lateral, and posterior regions. There was evidence of extension beyond the prostate capsule, although the specific site was not determined. No invasion into the seminal vesicles was observed.\n\nSurgical margins were clear of invasive cancer. Lymphovascular and perineural invasion were not present. The tumor involved approximately 20% of the prostate volume. No treatment effect was applicable.\n\nA total of 15 lymph nodes were identified: 8 on the right and 7 on the left. One node on the left side contained metastatic disease, while all nodes on the right were negative. The size of the largest lymph node metastasis was not determined.\n\nAdditional findings included high-grade prostatic intraepithelial neoplasia and nodular hyperplasia. Pathologic staging was assessed as pT3a, pN1, pMX."} +{"pid": "TCGA-66-2795", "report": "The examined specimen includes a 0.6 cm hard pale brownish tissue from the mediastinum. The left lung, following resection, measures 17 x 12 cm at the base and up to 27 cm in height. A staple suture line extends from the hilus in a ventrocaudal direction over the upper and lower lobes for 7.5 cm each, and dorsally over segments S2 and S6 for 6.5 cm each. The main bronchus is largely skeletonized. At the hilus, there are four partially altered, mobile blackish lymph nodes measuring between 0.4 and 0.8 cm.\n\nThe resection margin of the pulmonary artery shows high-grade changes. In the apical and lateral regions over segments S1, S2, and S3, there is a 16 x 14.5 cm area of parietal pleura with extensive adhesion and minor areas of loose attachment. A central moderately firm, pale brown to whitish lesion measuring up to 4.9 cm is present in the upper lobe, with relatively clear and arcuate demarcation and patchy grayish-black pigmentation. This lesion extends close to the hilar resection surface, where a 1.5 cm area raises uncertainty regarding its relation to the pericardial sac, although no macroscopic infiltration of this structure is evident. Some grayish-black lymph nodes up to 1.5 cm in size show signs of involvement.\n\nNumerous blood vessels appear narrowed, and there is suspicion of wall involvement in a patent pulmonary artery branch of the upper lobe, though no tumor tissue is observed within the vessel lumen. In segment S3, near the junction with the lateral section of parietal pleura, a 3.5 cm hemorrhagic zone with partial clear demarcation extends to the pleural surface. Peripheral bronchi in the upper lobe are slightly dilated and filled with thick mucus; the remainder of the parenchyma in both upper and lower lobes appears unremarkable.\n\nAt the bifurcation of the bronchus into the basal lower lobe bronchi, three blackish lymph nodes ranging from 0.4 to 0.7 cm are noted. In the subpleural region of segment S6 near its junction with S8, a 0.3 cm flat blackish lymph node is identified. Additional specimens include an irregular portion of pulmonary artery measuring 3.7 x 1.3 cm, an interlobar lymph node (station 11) measuring 0.7 cm, a pulmonary ligament lymph node (station 9) of 0.6 cm with surrounding tissue, a paraesophageal lymph node (station 8) also 0.6 cm with surrounding tissue, two grayish-black nodes or node parts (0.8 and 0.4 cm) from the paraaortic region (station 6), and low paratracheal lymph nodes (station 4) measuring 1 cm (left) and 0.4 cm (right), each with associated tissue.\n\nHistological evaluation included rapid section analysis and multiple preparations stained with Elastica-van Gieson, PAS, and diastase-PAS. Findings reveal complex cellular features and architectural patterns consistent with advanced local growth. The lesion demonstrates endobronchial extension to the ostium of the upper lobe and involves regional lymph nodes with extension through the mediastinal pleura into the mediastinum. It approaches the resection plane in certain areas but does not reach the co-resected parietal pericardial layer.\n\nVascular structures are surrounded but not infiltrated by the lesion. Resection margins of the main bronchus, major pulmonary vessels, the lower lobe, and all other lymph nodes are free of involvement. Accompanying findings include necrotic changes, active inflammatory response in adjacent lung tissue, fibrous remodeling beneath the pleural adhesion site in S1, recent hemorrhagic infarction at the S1/S3 interface, fibrinous pleuritis, and moderate anthracotic pigment deposition in the lung with variable dust pigment accumulation in lymph nodes along with reactive macrophage aggregation."} +{"pid": "TCGA-BR-8677", "report": "The specimen consists of a subtotal gastrectomy. The tumor is located in the antrum and measures 0 x 0 x 7.5 cm. It is ulcerated and extends to the subserosa with invasion through the entire gastric wall. Tumor involvement is noted in the perigastric fat with saucer-like spread. Fatty tissue contains dense, hyperemic lymph nodes up to 1 cm in size. Eight out of fifteen lymph nodes examined show metastatic involvement, including those from the greater and lesser curvature. Venous invasion is not present. All margins are free of tumor. The cellular features indicate a high-grade morphology. Lymphatic and perineural invasion were not specified. No evidence of neoadjuvant treatment is seen. Additional findings do not reveal any other significant pathology."} +{"pid": "TCGA-DU-7298", "report": "A 62-year-old woman presented with a two-week history of headaches and visual disturbances. Clinical examination revealed retinal hemorrhages. Imaging studies demonstrated a large left temporal parietal intra-axial brain lesion with heterogeneous enhancement and associated edema. There was suspicion for hemorrhage or calcification within the lesion.\n\nBiopsy specimens from the left temporal region were obtained. Microscopic evaluation of the first specimen showed small fragments of a glial neoplasm with nuclear atypia and scattered mitotic figures. The second specimen contained larger tissue fragments showing widespread infiltration and effacement of brain parenchyma by a glial tumor with astrocytic features, marked nuclear pleomorphism, and increased mitotic activity. The proliferation index, as assessed by MIB-1 staining, was approximately 15%. Focal cortical microvascular calcification was noted, but no clear evidence of microvascular proliferation or necrosis was identified. These findings were consistent with a high-grade glial neoplasm with astrocytic differentiation and possible minor oligodendroglial elements.\n\nImmunohistochemical analysis demonstrated moderate glial fibrillary acidic protein (GFAP) expression, with about 25% of neoplastic cells showing p53 overexpression. CD34 staining highlighted the microvasculature without evidence of vascular proliferation. Molecular testing for MGMT promoter methylation was performed using bisulfite-treated DNA followed by PCR amplification and gel electrophoresis. The results were negative for MGMT promoter methylation. The laboratory noted that this test was developed and validated in-house and is not FDA-cleared, with results provided for informational purposes only.\n\nThe histological and immunohistochemical features indicated a tumor with aggressive characteristics, including cellular atypia, mitotic activity, and moderate proliferative index."} +{"pid": "TCGA-SN-A6IS", "report": "The specimen consists of a right testicle weighing 81.0 grams and measuring 7.0 x 4.5 x 3.0 cm, with a tumor mass measuring 7 cm in the largest dimension. On gross examination, the tumor nearly completely replaces the testicular parenchyma, with only a small rim of normal-appearing tissue at the lower pole. A central white nodule within the tumor measures 1.7 x 1.5 x 1.0 cm. The tumor is abutting the tunica albuginea but does not grossly invade through it. Microscopically, the tumor invades the tunica albuginea but not the tunica vaginalis. No perineural or lymphovascular invasion is identified. Surgical margins of the spermatic cord are negative.\n\nMicroscopic analysis reveals a mixed cellular composition. The majority of the tumor consists of large, uniform cells arranged in sheets, positive for c-kit staining. Scattered among these cells are areas of mature elements including hyaline cartilage. Intra-tubular abnormal germ cells are present adjacent to the tumor, along with focal seminiferous tubule atrophy. The tumor is confined to the testicle without evidence of extension beyond.\n\nSerum tumor markers pre-orchiectomy include AFP of 3.3 ng/mL, LDH of 240 U/L, and hCG of 168 mIU/mL. Based on pathologic findings, the primary tumor is classified as pT1. Lymph node involvement is not assessable (pNX), and distant metastasis status is unknown (MX). Surgical margins are free. No specific site of distant disease is identified."} +{"pid": "TCGA-XD-AAUL", "report": "The resected specimen includes the duodenum and head of the pancreas, measuring 5.0 x 5.0 x 4.0 cm, with a duodenal length of 25.0 cm. A tumor is identified near the pancreatic cut margin and adjacent to the bile duct margin. The tumor measures 2.0 x 1.7 x 1.5 cm and is described as indurated and ill-defined with a gray-white appearance. It does not extend into the duodenum or involve the bile ducts or pancreatic duct. Microscopic evaluation reveals moderately differentiated adenocarcinoma composed of irregular neoplastic glandular structures lined by columnar epithelial cells with enlarged, vesicular nuclei. The tumor demonstrates an invasive pattern with surrounding stromal response. Involvement is noted in peripancreatic soft tissue and extends beneath the bile duct up to the ampulla.\n\nSurgical margins including the pancreatic cut margin, bile duct margin, SMA margin, anterior and posterior pancreatic surfaces, portal vein margin, proximal duodenal margin, and distal duodenal margin are all free of malignancy. The non-neoplastic pancreatic parenchyma shows areas of fat necrosis. A total of 21 regional lymph nodes are examined, with no evidence of malignancy identified. This includes 20 lymph nodes from the Whipple specimen and one additional lymph node from the hepatic artery biopsy. The gallbladder specimen shows no significant pathologic changes.\n\nTumor distance from key margins includes 0.3 cm from the pancreatic cut margin near the portal vein, 2.0 cm from the SMA margin, 4.5 cm from the anterior surface, and 2.0 cm from the posterior surface. The common bile duct and pancreatic duct are patent to the ampulla, which is surrounded by thickened duodenal folds. The rest of the pancreas is lobulated, yellow-tan, and soft, with possible fat necrosis noted. Lymph nodes are present around the SMA, anterior and posterior pancreatic regions, and bile duct.\n\nImmunohistochemical staining of a fibrotic focus in the SMA lymph node region shows absence of keratin AE1/AE3 staining and positivity for CD68, consistent with benign changes. Frozen section analysis confirmed negative margins for malignancy at the pancreatic cut, bile duct, and SMA margins. Multiple sections were taken from the tumor, surrounding tissue, and lymph nodes for histological evaluation. All surgical margins and lymph nodes reviewed show no evidence of residual or metastatic disease."} +{"pid": "TCGA-A2-A0YM", "report": "A lumpectomy and sentinel lymph node mapping procedure were performed. The excised breast tissue contained a lesion measuring 2.4 x 2.2 x 2.2 cm. Microscopic evaluation revealed infiltrative growth patterns with high-grade nuclear features and a high mitotic index. No ductal carcinoma in situ was identified. Necrotic changes were present within the lesion. Focal involvement of lobular structures was noted.\n\nThe surgical margins were assessed. The original superior margin was 0.2 cm from the lesion, and the anterior margin was 0.3 cm away. Following additional resection, the anterior margin measured 0.9 cm and the superior margin measured 0.8 cm. All revised margins were free of abnormal cells.\n\nA total of five lymph nodes were examined, including four sentinel nodes and one non-sentinel node. All nodes showed benign reactive changes without evidence of malignant involvement. Immunohistochemical staining with Cytokeratin (AE1/AE3) confirmed the absence of tumor cells in these nodes.\n\nThe lesion was classified as T2 based on size, with no nodal involvement (N0), and indeterminate metastatic status (Mx), corresponding to stage IIA. Hormone receptor and HER-2/neu status were previously determined in a separate assessment."} +{"pid": "TCGA-MI-A75C", "report": "The liver wedge resection specimen measured 8.5 x 5.0 x 5.0 cm and showed a subcapsular, round growth measuring up to 3.0 cm in greatest dimension. The growth was firm and nodular, partially encapsulated, with tan-yellow to brown cut surface showing areas of hemorrhage and necrosis. Microscopically, the lesion demonstrated moderate to poorly differentiated histology. All surgical margins were free of involvement. There was no lymphatic or vascular invasion identified. The uninvolved liver tissue showed zonal fatty changes (grade 2), focal Mallory bodies, and individual dying cells. A chronic inflammatory infiltrate was present in all portal tracts with extension beyond the limiting plate. Fibrosis scoring was Knodell 2/4, Metavir 2/4, and Ishak 3/6. Over 85% of the lesion was necrotic. The closest margin distance was approximately 2.3 cm from the lesion. Touch preparation was performed at the time of frozen section evaluation."} +{"pid": "TCGA-FD-A6TA", "report": "The patient is a male of white race who underwent radical cystectomy and lymph node dissection. Specimens included multiple lymph node groups and a cystoprostatectomy specimen with attached structures.\n\nLymph node evaluation revealed the following: In the right pelvic lymph nodes, one of seven lymph nodes showed involvement; additionally, there was one focus in perinodal fibroadipose tissue. In another set of right pelvic lymph nodes, two of five were involved. On the left side, one lymph node out of one showed involvement, and in another group, two of fourteen were involved. In total, six of 27 lymph nodes contained metastatic cells.\n\nThe cystoprostatectomy specimen measured 14 x 5.9 x 4 cm and included a prostate measuring 5 x 4 x 3.5 cm. The bladder had a mass measuring 6 x 3 x 2 cm located on the anterior wall, extending circumferentially to involve both lateral walls, posterior wall, and trigone. This lesion demonstrated multifocal distribution and extensive vascular invasion. Two small plaques (0.3\u20130.5 cm) were also present on the dome. The tumor invaded through the right and left lateral walls to a depth of 2.1 cm and reached the posterior wall at the trigone to a depth of 0.7 cm. A separate nodule measuring 2 cm was identified in extravesicular adipose tissue and was fully sampled.\n\nMargins of the distal urethra, ureters, and prostate were all negative. The prostate showed benign findings with no evidence of invasive disease. Gleason score was 3+3. Tumor was confined within the prostate without extension to the seminal vesicles or regional lymph nodes.\n\nStaging parameters indicated deep invasion into extravesicular soft tissue and lymph node involvement. Vascular invasion was extensive. No tumor was identified in the distal ureter specimen."} +{"pid": "TCGA-77-A5G8", "report": "Histopathology Report. HISTORY. Mass removed (lobectomy). ?Malignant. MACROSCOPIC. Three specimens received. 1: The specimen is labelled 'right upper lobe plus ribs' and consists of a right upper lobe measuring 180 x 105 x 45 mm. There is a vertical stapled line superior to the hilum measuring 80 mm in length. Over the apex there are two attached short segments of ribs. Rib 1 is relatively closely adhered over the pleural surface and measures 55 x 30 x 28 mm. This rib is cut towards one end, 22 mm from the true resection margin. Rib 2 loosely hangs from a fibrous fragment and measures 55 x 28 x 18 mm. Over the posterolateral aspect of the lung is a small segment of adherent parietal pleura measuring 30 x 25 mm. Within the apex, underlying the ribs, is a firm white lesion measuring 25 x 25 x 23 mm. The mass shows focal central necrosis. The lesion is well clear of the hilar resection margin. The apical rib is removed and the underlying pleural surface is inked black. The true pleural margin is inked blue. The lesion appears to invade the pleura within this region but does not extend into the overlying soft tissue. The remainder of the lung parenchyma shows severe emphysema with bullae in the apical aspect surrounding the lesion. No other focal lesions are seen or felt throughout the lobe. [1A, bronchial resection margin including vascular margin; 1B, hilar lymph node; 1C-F, representative sections of the mass; 1G, uninvolved lung, apex and base of lobe; 1H, peribronchial nodes; 1I, shave of soft tissue from attached rib; 1J, shave of soft tissue from loosely adhered rib; 1K-L, representative sections of rib]. 2: The specimen is labelled 'lymph node number 10' and consists of fragments of lymph node measuring 20 x 8 x 6 mm. [BIT: 2A]. 3: The specimen is labelled \"fourth rib right\" and consists of a rib fragment with attached soft tissue. The rib measures 12 x 17 x 7 mm. The attached soft tissue measures 17 x 10 x 10 mm. No obvious lesion is identified within the specimen. [3A, soft tissue BIT; 3B, rib]. Please note that sections from the ribs in specimen 1 and 3 were initially pending as the tissue was still being decalcified. MICROSCOPIC. 1: Sections show a peripheral moderately differentiated epithelial tumour with pronounced desmoplasia and a central area of necrosis. There is obliteration of the pleural space overlying the lesion due to adhesions and desmoplasia. Invasion through the pleura and into the chest wall is present. The involved fat appears to represent metaplastic change rather than direct involvement of chest wall fat. Tumour does not extend as far as the muscle or bone and therefore the chest wall margin appears clear. The bronchial resection margin shows no evidence of in situ or invasive abnormality. No lymphatic, vascular or perineural invasion is seen. The sampled lymph nodes show sinus histiocytosis with moderate amounts of carbon pigment and no evidence of abnormal cellular infiltration. The surrounding lung parenchyma shows focal lipoid pneumonia and emphysema. Collections of pigment-laden macrophages are present. COMMENT. Initially, no sections of the ribs had been examined as the tissue was undergoing decalcification. 2: Sections of lymph node show sinus histiocytosis and a moderate amount of carbon pigment deposition along with silicate crystals. There is no evidence of abnormal cellular infiltration. 3: Sections show normal intercostal muscle and adipose tissue. There is no evidence of invasive or abnormal cellular spread. INTERIM SUMMARY. 1 - 3. Right upper lobe of lung, ribs and No10 lymph node: 1: Moderately differentiated epithelial tumour; 30 mm in maximal dimension. 2: No blood vessel, lymphatic or perineural invasion present. 3: Invasion into chest wall; clear of margins. 4: No lymph node metastases. 5: Pathological stage pT3N0Mx. 6: Rib sections initially pending decalcification. SUPPLEMENTARY REPORT - The sections of rib have now been examined and these do not show any pathological features. FINAL SUMMARY. 1 - 3. Right upper lobe of lung, ribs and No10 lymph node: 1: Moderately differentiated epithelial tumour; 30 mm in maximal dimension. 2: No blood vessel, lymphatic or perineural invasion present. 3: Invasion into chest wall; clear of margins. 4: No lymph node metastases. 5: Pathological stage pT3N0Mx."} +{"pid": "TCGA-2A-A8VL", "report": "A 4.0cm prostate specimen with seminal vesicles was examined, weighing 38.0 grams and measuring 4.5cm transversely and 3.5cm anterior to posterior. The external surface of the prostate was smooth. Histological evaluation identified multiple foci of involvement in the right posterior, left posterior, and left anterior regions, with a dominant mass located in the left posterolateral mid-base. Vascular invasion was not identified; however, perineural invasion was present. The tumor demonstrated multicentric distribution with multiple invasive foci. High-grade intraepithelial changes were noted. The tumor was confined within the prostate capsule without involvement of the seminal vesicles or bladder neck. Surgical margins were free of involvement. Staging according to AJCC (1997) indicated pT2b classification. Lymph node excisions from both the left and right pelvis were performed. A total of 10 lymph nodes were examined on the left and 5 on the right, all appearing benign without evidence of metastatic involvement. All lymph nodes were submitted for histopathological analysis. The Gleason grading system showed a primary grade of 3 and secondary grade of 3, with an additional tertiary grade of 4 identified."} +{"pid": "TCGA-E1-A7YO", "report": "Surgical Pathology: Final. CLINICAL HISTORY: Seizures.\n\nGROSS EXAMINATION: \nA. \"Biopsy brain tumor (Af1)\" in formalin consists of several fragments of pink-tan to brown tissue measuring 1 x 0.8 x 0.8 cm in aggregate. A portion was previously submitted as frozen section Af1. The frozen section remnant is included in Block A1, and the remaining tissue is submitted in Block A2. \nB. \"Brain tumor\" in formalin consists of multiple fragments of white to gray-tan tissue measuring 5 x 4 x 1.8 cm in aggregate. A small amount of tissue is retained in formalin, and the remainder is sectioned and submitted entirely in Blocks R1-B8.\n\nINTRAOPERATIVE CONSULTATION: \nA. \"Biopsy brain tumor\" showed features consistent with a high-grade glioma, with probable characteristics of a specific glial tumor type.\n\nMICROSCOPIC EXAMINATION: \nThe tissue submitted as \"brain tumor\" reveals infiltration of brain parenchyma by a neoplastic proliferation of atypical glial cells. Focal areas demonstrate cells with hyperchromatic, irregularly lobulated nuclei within densely cellular regions. Degenerative changes in the tumor are associated with hemorrhagic foci. No vascular proliferation or necrosis with pseudopalisading is identified.\n\nDIAGNOSTIC CONCLUSIONS: Specimens A and B both correspond to the same neoplastic process with morphologic features consistent with high-grade glial neoplasm."} +{"pid": "TCGA-JY-A938", "report": "The pathology report includes multiple lymph node and soft tissue specimens. Lymph nodes evaluated include those from the splenic region (1 node), common hepatic area (1 node), inferior pulmonary ligament (3 nodes), left tracheobronchial angle (1 node), subcarinal region (2 nodes), left gastric nodes (6 nodes), paracardial nodes (6 nodes), and paraesophageal location (4 nodes). All lymph nodes were negative for malignancy.\n\nA resection specimen involving the distal esophagus and proximal stomach was examined. The tumor measured 3.8 cm in greatest dimension and was located primarily in the distal esophagus, extending to the esophagogastric junction. Histologic evaluation showed invasive poorly differentiated adenocarcinoma arising in Barrett\u2019s esophagus. The tumor invaded through the muscularis propria into the periesophageal soft tissue (adventitia). Proximal and distal margins were free of invasive carcinoma, as was the circumferential margin. No lymphovascular or perineural invasion was identified.\n\nAdditional findings included an incidental low-grade spindle cell gastrointestinal stromal tumor (GIST) measuring 0.8 cm in the gastric wall. Mitotic rate was less than 5 per 50 high-power fields. Margins were negative for GIST involvement. Immunohistochemistry showed positivity for KIT (CD117) and DOG1.\n\nAll other soft tissue margins, including the final gastric margins and donut-shaped specimens, were negative for malignancy. Molecular testing revealed a Val559Gly mutation in exon 11 of the KIT gene, supporting the diagnosis of GIST. No PDGFRA mutations were detected.\n\nA total of 24 regional lymph nodes were examined, with no evidence of metastasis. The tumor was staged as pT3, pN0 based on AJCC/UICC TNM criteria (7th edition)."} +{"pid": "TCGA-60-2707", "report": "The specimen consisted of multiple lymph nodes from various anatomical locations including the right and left distal paratracheal, level 7, right and left proximal paratracheal, 3A, level 5, 12L, level 6, and level 9 regions. Additionally, a pleural biopsy and a lung lobectomy specimen were included.\n\nThe lung lobectomy measured 17.5 x 13 x 5.5 cm and weighed 368 grams. A single mass with irregular borders was identified in the upper segment, measuring 7.2 x 5.6 x 4.5 cm. The mass was located 2.1 cm from the bronchial margin and appeared confined to the lung without involvement of the visceral pleura. The surrounding lung tissue showed signs of congestion and focal emphysematous changes. Multiple peribronchial lymph nodes ranging in size from 0.5 to 2.9 cm were present and appeared negative for tumor involvement.\n\nMicroscopic evaluation of the bronchial margin and pleural biopsy showed no evidence of malignancy. All lymph nodes examined (total of 33) across various levels were negative for malignancy. Histologic sections revealed a predominance of squamous cells without atypical features. No angiolymphatic or perineural invasion was observed. There was evidence of in-situ change within a bronchus. Non-neoplastic findings included emphysematous alterations and subpleural fibrosis.\n\nStaging information indicated no nodal involvement. The non-neoplastic lung tissue demonstrated emphysema and subpleural fibrosis."} +{"pid": "TCGA-HW-7495", "report": "The clinical history indicates a right frontal intra-axial primary brain lesion with imaging findings showing a diffusely infiltrating lesion without enhancement on MRI. Four specimens were submitted for analysis, all labeled according to their anatomical origin in the right frontal lobe.\n\nSpecimen 1 was received fresh and consisted of a tan soft tissue fragment measuring 0.3 x 0.3 x 0.2 cm. It was entirely submitted for frozen section evaluation. Microscopic examination showed features consistent with a diffuse glioma. A frozen section diagnosis was made based on these findings. Permanent histopathological analysis demonstrated similar characteristics.\n\nSpecimen 2 was composed of multiple gray-tan friable fragments totaling 2.6 x 2.2 x 1.1 cm in aggregate. A portion was sampled for analysis while the remainder was fully submitted. Histologic sections revealed cellular morphology consistent with a diffuse glioma. No overtly high-grade features were observed during frozen section evaluation.\n\nSpecimen 3 was a tan tissue fragment measuring 0.4 x 0.2 x 0.2 cm and was entirely submitted for frozen section consultation. Initial intraoperative assessment noted scattered atypical cells within white matter but was insufficient for definitive classification. Final microscopic evaluation identified features characteristic of a diffuse glioma.\n\nSpecimen 4 consisted of two gray-tan friable tissue pieces measuring 1.2 x 0.7 x 0.5 cm and 1.7 x 0.9 x 0.5 cm. Similar to specimen 2, a sample was taken for testing while the remaining tissue was submitted completely. Histopathologic sections confirmed morphologic features consistent with a diffuse glioma.\n\nAll specimens underwent histologic review and were processed using standard protocols. Molecular testing including 1p/19q FISH analysis was initiated and results were reported separately. Cellular morphology across all specimens showed no evidence of high-grade transformation.\n\nEach specimen was examined microscopically and assessed according to standard histopathologic criteria. Sections were reviewed from all submitted blocks. Pathologic staging was determined based on histologic grade and microscopic features. All specimens demonstrated comparable morphologic characteristics upon evaluation."} +{"pid": "TCGA-EB-A5SE", "report": "The specimen consists of skin tissue from the trunk, submitted as an excision. The lesion measures 2.8 x 2 x 0.4 cm and is present in a multinodular configuration. Satellite nodules are identified. Microscopic evaluation reveals a fourth-level invasion in the larger nodule and second-level invasion in the smaller nodule. Additional features include a Breslow thickness of 4.0 mm. No other specific histologic or pathologic features are noted regarding lymphatic or venous invasion, lymph node involvement, or treatment effect."} +{"pid": "TCGA-HS-A5N9", "report": "The sample was collected from the uterine tissue during a resection procedure. The tumor measured 13 cm in size and exhibited features consistent with a high-grade spindle cell neoplasm, showing focal epithelioid differentiation. Cellular morphology indicated poor differentiation. No lymph node or distant metastasis was identified at the time of diagnosis. The tissue was obtained several days following the initial diagnostic evaluation. A separate blood-derived sample (buffy coat) was also collected during the same period."} +{"pid": "TCGA-PR-A5PH", "report": "The specimen includes a left adrenal gland and a periaortic lymph node. The left adrenal gland measures 14 x 11.5 x 4 cm and weighs 175 grams, with a tumor measuring 5.5 x 5 x 2.5 cm. The tumor is encapsulated with a brown-tan cut surface and is adjacent to a portion of normal adrenal tissue measuring 3.5 x 3.5 x 1 cm. The tumor is located 0.1 cm from the closest inked margin and shows focal capsular invasion with extension into peri-adrenal adipose tissue. No definite vascular invasion, necrosis, mitotic figures, or significant nuclear pleomorphism is identified. Immunohistochemical staining demonstrates positivity for chromogranin A and synaptophysin, while EMA, cytokeratin AE1/3, and inhibin-alpha are negative. Rare tumor cells show positivity for cytokeratin AE1/3, and sustentacular supporting cells stain positive for S-100. The microscopic evaluation of the tumor suggests features commonly associated with a well-defined lesion. One periaortic lymph node measuring 0.7 x 0.6 x 0.5 cm is negative for tumor involvement."} +{"pid": "TCGA-D1-A1O8", "report": "The specimen includes a uterus with bilateral fallopian tubes and ovaries. A mass measuring 3.6 x 2.5 x 2.2 cm is present in the anterior and lateral uterine wall. Microscopic evaluation shows that the lesion invades 1.7 cm into the myometrium, with a total myometrial thickness of 2.0 cm. There is no involvement of the endocervix. Lymphovascular space invasion is present. Multiple intramural leiomyomata are noted, ranging from 0.3 to 0.7 cm in size. The bilateral ovaries and fallopian tubes are atrophic and show no evidence of involvement.\n\nA right pelvic lymph node biopsy reveals a single lymph node containing metastatic carcinoma. In the left pelvic lymph node biopsy, two lymph nodes are identified with metastatic carcinoma. Based on these findings, the staging classification is pT1bN1 according to the AJCC 7th edition (2010). This classification is based on the initial frozen section evaluation and gross examination. Permanent histologic sections stained with hematoxylin and eosin were reviewed to confirm the findings. Any significant changes identified upon permanent section review would be reflected in a revised report.\n\nGrossly, the uterus weighs 100 grams and has a smooth serosal surface. The described mass is exophytic and located within the endometrial cavity. It appears to invade deeply into a thickened myometrium. The ovaries are small with solid cut surfaces; the fallopian tubes appear unremarkable. Sections of all relevant tissues have been submitted for microscopic analysis. Adipose and lymphatic tissue from both right and left pelvic lymph node specimens were also submitted in entirety."} +{"pid": "TCGA-E9-A22D", "report": "The specimen was obtained from the right upper outer quadrant of the breast and submitted as a radical mastectomy. A grossly evident lesion measuring 2.4 x 2.4 x 2.4 cm was identified. Histologic evaluation revealed moderately differentiated cellular changes. Lymph node assessment showed no evidence of metastatic involvement, with all 10 regional lymph nodes examined being negative. No extracapsular invasion was noted. Several key histologic parameters, including tubule formation, nuclear pleomorphism, and mitotic counts at both 25x and 40x magnification, were not specified, precluding calculation of a total Nottingham Histologic Score. Additional pathologic findings, evidence of prior treatment, and margin status were not specified in the report."} +{"pid": "TCGA-CN-4725", "report": "The patient underwent a right neck dissection with the primary specimen being a partial glossectomy from the right lateral tongue measuring 3.4 x 2.5 x 0.9 cm. A mass measuring 2.8 x 2.1 x 0.6 cm was identified, with the deepest dimension of the lesion being 0.6 cm. The tumor was located 0.7 cm from the posterior margin, 0.6 cm from the inferior margin, 0.5 cm from the superior margin, and 0.3 cm from the anterior margin. On cross-section, the tumor was 0.4 cm from the deep margin. Margins were assessed, with the anterior margin inked black and the posterior margin inked green; all other margins were evaluated in additional specimen parts.\n\nHistologic examination revealed a moderately differentiated keratinizing lesion with an infiltrative border. Focal perineural invasion was identified, but there was no evidence of angiolymphatic invasion. All surgical margins were free of involvement. Pathologic staging was determined as pT2 with no regional lymph node involvement (pN0).\n\nA total of sixteen lymph nodes were evaluated across multiple right neck levels: four lymph nodes from level 1, eight from levels 3 and 4, one from level 2B, and three from level 2. No lymph node contained any suspicious cells or abnormal tissue. The submandibular gland showed changes consistent with chronic sialadenitis.\n\nAdditional tissue samples from the medial tongue, floor of mouth, and deep margin were submitted and showed no abnormal findings. Intraoperative frozen section analysis confirmed the absence of tumor in these areas as well. Ancillary studies were performed and reported separately.\n\nSpecimen measurements, histologic features, and staging details have been summarized based on gross and microscopic evaluation."} +{"pid": "TCGA-DC-6160", "report": "The resected specimen from the rectum and rectosigmoid includes three distinct lesions. The largest lesion is a polypoid growth measuring 2.9 x 1.8 x 0.8 cm located 3.5 cm from the distal margin. Adjacent to this lesion are two smaller lesions measuring 0.4 x 0.4 x 0.2 cm and 0.7 x 0.5 x 0.2 cm, located 0.7 cm and 1.0 cm distal to the main lesion, respectively. Histologically, all three lesions demonstrate moderately differentiated cellular features. One of the smaller lesions extends into the submucosa (pT1), while the largest lesion invades into the muscularis propria (pT2). No vascular or perineural invasion is identified. Surgical margins are clear. A preexisting tubular adenoma is noted in proximity to one of the lesions. Additionally, a hyperplastic polyp is identified elsewhere in the specimen. The uninvolved colonic mucosa appears normal.\n\nA total of sixteen lymph nodes are examined; none show evidence of involvement. Additional specimens from the proximal and distal rings and an additional segment of sigmoid colon reveal no significant findings. All margins in these specimens are unremarkable, and one benign lymph node is identified in the sigmoid specimen."} +{"pid": "TCGA-78-7160", "report": "The specimen from a right pneumonectomy measures 215 mm superior to inferior, 180 mm anterior to posterior, and 60 mm medial to lateral in the inflated state. An area of puckering is noted on the pleural surface of the lower lobe near the hilar resection margin, measuring approximately 70 x 40 x 55 mm. On sectioning, a pale, poorly-defined, firm mass is identified in the lower lobe, extending from the bronchus and hilar resection margin. The mass measures 50 x 45 x 70 mm and is located 4 mm from the closest bronchial resection margin, up to 2 mm from the interlobar fissure, and 25 mm from the lateral pleural surface. It appears to involve the pleura on the medial aspect of the lobe. No other lesions are observed in the upper or middle lobes, where the lung parenchyma appears normal.\n\nFour specimens were received for analysis. The second specimen, labeled as a hilar lymph node, measures 11 x 4 x 5 mm. The third specimen, labeled as subcarinal lymph node on the right, measures 38 x 32 x 24 mm and contains five lymph nodes, the largest being 26 x 12 x 10 mm. The fourth specimen, labeled as upper medial sternal node on the right, includes a lymph node measuring 20 x 9 x 10 mm within fatty tissue.\n\nMicroscopic examination reveals a moderately differentiated lesion with areas showing abundant mucin production. A small component with a specific growth pattern is also present. Numerous small calcified structures are seen within the lesion. The lesion originates near the hilum and extends into soft tissue surrounding bronchi and large pulmonary vessels. Additional deposits are found in the lower lobe (1.4 mm), middle lobe (0.7 mm), and upper lobe, where the involvement follows a particular distribution pattern. There is no evidence of invasion into blood vessels, but significant involvement of lymphatic channels is noted. Involvement of the bronchial margin\u2019s inner lining is present, and the lesion approaches the hilar soft tissue margin closely. Metastatic involvement is identified in peribronchial lymph nodes, and all lymph node sections show some degree of involvement, with associated lymphatic channel permeation. The lung tissue shows signs of mild emphysema, most prominent in the upper lobe.\n\nLymph node involvement is present in the peribronchial, hilar, subcarinal, and upper medial sternal regions. The maximum dimension of the primary lesion is 70 mm. Staging information indicates advanced local and nodal involvement with distant spread. Non-neoplastic findings include the specific upper lobe distribution pattern of involvement and emphysematous changes."} +{"pid": "TCGA-A6-5660", "report": "The specimen consists of a 13 cm segment of proximal right colon with attached 10.5 cm of distal ileum. The serosal surface is smooth to scabrous with a moderate amount of mesocolon and mesentery containing multiple large palpable nodes. The appendix measures 7.8 cm in length and 0.7 cm in diameter. Proximal and distal margins measure 4.2 cm and 8.5 cm in circumference, respectively. Upon opening, a poorly defined, 9.0 x 5.5 cm tan white-pink mass is identified within the cecal pouch, extending toward the ileocecal valve. On sectioning, the tumor has a maximal thickness of 2.0 cm and extends into the muscularis propria to within 0.3 cm of the inked free radial serosal surface. The ileal and colonic mucosa appear normal with regular folds and wall thickness averaging 0.5 cm. Lymph nodes measuring up to 4.8 cm in greatest dimension are present in the mesocolon and mesentery, with the largest appearing involved. Histologically, the lesion demonstrates poor differentiation with grade 3 nuclei. Tumor extends through the muscularis propria into pericolonic fat (pT3). All surgical margins are free of involvement. The closest distance of the tumor to any margin is 10 cm from the ileal margin. Lymphatic space invasion is present. Of 23 lymph nodes evaluated, 11 contain metastatic involvement (pN2b), and extranodal extension is noted. An adenomatous polyp is found adjacent to the lesion. The appendix and remaining colonic sections show no histologic abnormalities."} +{"pid": "TCGA-KS-A4I5", "report": "The specimen consists of a total thyroidectomy and central neck dissection. The thyroid weighs 11.9 grams and includes a right lobe measuring 4.5 x 2.5 x 1.2 cm, an isthmus of 1.2 x 1.0 x 0.3 cm, and a left lobe of 3.5 x 2.6 x 0.4 cm. A pale tan nodule measuring 1.2 x 1.7 x 0.8 cm is present in the right lower lobe, with possible cystic degeneration. The remainder of the right lobe contains multiple brown nodules up to 0.7 cm filled with dark brown fluid. The left lobe and isthmus appear unremarkable. All sections of the right nodule and other thyroid regions are submitted for analysis.\n\nA separate fibroadipose tissue fragment measuring 0.7 x 0.4 cm was received and entirely submitted for evaluation.\n\nMicroscopic examination of the largest lesion shows a tumor measuring 1.7 cm located in the right lobe. There is evidence of capsular invasion; no vascular invasion is identified. Surgical margins are negative, and there is no extrathyroidal extension. One perithyroidal lymph node and one central neck lymph node were examined, both showing no evidence of malignancy."} +{"pid": "TCGA-AL-3466", "report": "The specimen was received in four parts. The first, labeled as an inter-aortocaval lymph node, consists of a reddish-tan ovoid rubbery nodule measuring 3 x 2.5 x 2.5 cm. The cut surface is tan and homogeneous, consistent with metastatic involvement.\n\nThe second specimen, labeled as thrombus, contains multiple fragments of tan to red friable tissue mixed with blood clot, measuring up to 4 x 3.5 x 1.5 cm. The tissue appears predominantly lesional.\n\nThe third specimen is a right kidney weighing 640 grams and measuring 12 x 10 x 8 cm. Attached perinephric fat extends up to 2 cm. No adrenal gland was identified. A segment of ureter measuring 8 x 0.4 cm is unremarkable. The renal vein is markedly distended and contains tan friable lesional tissue. There is subcapsular hemorrhage on the posterior surface. Upon bivalving, a large white firm lesion measuring 8 x 6 x 6.7 cm is present, infiltrating approximately 80% of the kidney. The calyceal system is involved, with tumor approaching within 1 cm of the hilum. A small portion of kidney with normal cortical and medullary architecture remains. Sections include margins of ureter and vessels, additional renal vein sections near the margin, tumor sections in relation to the hilum, ureter, capsule, adjacent normal tissue, subcapsular hemorrhage, and inferior calyx, as well as perinephric fat.\n\nThe fourth specimen is a retrocaval lymph node, an ovoid reddish-tan rubbery nodule measuring 6.5 x 5.5 x 3.5 cm. Approximately 25% of the node is necrotic, with the remainder showing tan cut surface indicative of metastatic involvement.\n\nCytogenetic analysis was performed on fresh tissue. Chromosomal evaluation of twenty metaphases showed 19 cells with a normal karyotype (46,XY). One cell exhibited nonclonal chromosomal abnormalities, including a deletion in the short arm of chromosome 3, a change previously reported in some cases of nonpapillary renal neoplasms. No other aberrant cells were detected in partial analysis of additional metaphases."} +{"pid": "TCGA-DU-7018", "report": "The specimen consists of excised tissue from the right frontal region of the brain. Gross examination revealed soft, grayish-brown to pink-tan rubbery fragments, with total dimensions of 2.5 x 1 x 0.5 cm in aggregate. Histologic evaluation demonstrated a neoplasm exhibiting focal cellular anaplasia, mitotic figures, microvascular proliferation, and one area of necrosis. Karyorrhectic tumor cells were present diffusely and occasionally within vascular spaces. One fragment showed a focal region of extensive hyalinization and also contained areas of mineralization.\n\nImmunohistochemical staining showed sparse gliofibrillary background on GFAP, with focal positivity for synaptophysin, suggesting infiltrative growth. The tumor cells did not demonstrate overexpression of p53 protein. Using MIB-1 staining, a proliferation index of approximately 20% was observed in more active regions. A neuronal marker revealed rare positive nuclei focally.\n\nSpecial stains including GFAP, synaptophysin, MIB-1, p53, and MGMT were performed. Molecular testing revealed methylation of the MGMT promoter based on bisulfite-treated DNA followed by PCR amplification and gel electrophoresis. This assay was conducted under CLIA-regulated protocols and is not FDA-cleared but provided for informational use in context with other findings.\n\nHistopathologic features and immunophenotype were consistent with a high-grade lesion showing characteristics associated with aggressive behavior."} +{"pid": "TCGA-WB-A80Y", "report": "The left adrenal specimen contains a 4.2 cm nodule that is clearly demarcated from surrounding tissue. Microscopic evaluation reveals a mixture of alveolar and trabecular growth patterns. The lesion consists of large polygonal cells with round to ovoid nuclei. No areas of increased mitotic activity or atypical mitotic figures are observed, and there is no evidence of necrosis. The tumor infiltrates the capsule without destruction, and no tumor involvement is seen in the peri-adrenal adipose tissue. Vascular invasion is not present. Immunohistochemical staining demonstrates strong positivity for chromogranin and synaptophysin in the tumor cells. Sustentacular cells located at the periphery of the neoplastic cell clusters stain positive for S100 protein. The proliferative index, as assessed by Ki-67 staining, is less than 1%."} +{"pid": "TCGA-E9-A1QZ", "report": "The specimen was obtained from a breast tissue mastectomy. The tumor measured 4 x 3.5 x 2 cm and was grossly evident. Microscopic evaluation showed moderately differentiated histology with no specific information provided regarding tubule formation, nuclear pleomorphism, or mitotic counts. As a result, the total Nottingham Histologic Score could not be determined. There was no information available concerning lymph node involvement, tumor extent, margins, or evidence of neo-adjuvant treatment. No additional pathologic findings were noted."} +{"pid": "TCGA-PG-A917", "report": "A total hysterectomy with bilateral salpingo-oophorectomy was performed. The uterus measured 11.0 cm from the fundus to the cervical os, with a distorted fundus due to multiple fibroids. The endometrial cavity contained a thickened, friable mass measuring 4.0 x 2.0 x 1.0 cm located at the anterior wall. Histologically, the lesion showed intermediate to high-grade nuclear features with focal mucinous differentiation. The tumor invaded 25% of the myometrium, corresponding to a depth of 3 mm in a myometrial thickness of 12 mm. No cervical stromal invasion, lymph-vascular invasion, or involvement of the paracervical soft tissue margin was identified. Adenomyosis was present and focally involved by similar cellular changes.\n\nThe ovaries and fallopian tubes were unremarkable and did not show any evidence of involvement. Additional findings included uterine leiomyomata, adenomyosis, and an endometrial polyp. No ovarian tissue was identified in the specimen involving the right ovary and vessels, which showed only benign vascular and adipose tissue.\n\nLymph node dissections were performed on both left and right sides, including external iliac, obturator, and para-aortic regions. A total of 36 lymph nodes were examined: 20 pelvic nodes and 16 para-aortic nodes. All were negative for malignancy.\n\nImmunohistochemical staining showed positivity for estrogen and progesterone receptors. The tumor dimensions were 4.0 cm in greatest diameter with other dimensions measuring 2.0 x 1.0 cm. The biopsy initially suggested higher-grade features; however, upon review of the final specimen, these features comprised less than 5% of the tumor nuclei and were more prominent in the biopsy material than in the hysterectomy specimen. Based on this assessment, the staging was adjusted accordingly."} +{"pid": "TCGA-B5-A3FH", "report": "The specimen consists of a uterus with attached cervix, weighing 398 grams and measuring 13.5 x 11.0 x 9.0 cm. The cervix measures 5.0 x 3.0 cm. The serosal surface is distorted by multiple subserosal and myometrial leiomyomata. Upon opening the specimen, the cervical canal is noted to be white-tan with a herringbone pattern and measures 2.5 cm in length and 1.5 cm in diameter. The endometrial canal is distorted by large calcified submucosal leiomyomas. The largest of these measures 5.0 x 4.6 x 4.2 cm and is located in the anterior myometrium. Two additional submucosal leiomyomas are present in the posterior myometrium measuring 4.0 x 3.8 x 3.2 cm and 3.0 x 3.0 x 1.9 cm. These leiomyomas are also calcified. Within the endometrial cavity, there is red-tan hyperplastic mucosa with a fungating lesion located primarily on the anterior wall measuring 4.5 x 3.5 cm. This lesion is located 0.9 cm from the anterior lower uterine segment and overlies the largest calcified leiomyoma, limiting full thickness sectioning in that area.\n\nThe right fallopian tube measures 6.0 cm in length and 0.5 cm in diameter and appears unremarkable upon sectioning. The right ovary measures 2.0 x 1.1 x 0.6 cm, is white-tan and cerebriform. The left fallopian tube measures 6.7 cm in length and 0.5 cm in diameter and is grossly unremarkable. The left ovary measures 1.2 x 1.1 x 0. cm and is white-tan and cerebriform.\n\nSections were taken from various areas including the cervix, anterior and posterior endomyometrium, regions overlying calcified leiomyomas, uterine segments, fallopian tubes, and ovaries. Additionally, lymph node aggregates were examined. The left pelvic lymph nodes measure 3.2 x 3.0 x 0.8 cm and contain 5 lymph nodes. The right aortic lymph nodes measure 3.0 x 1.8 x 0.4 cm with 2 lymph nodes identified. The left aortic lymph nodes measure 1.3 x 1.0 x 0.8 cm with one lymph node found. The right pelvic lymph nodes measure 4.5 x 4.0 x 2.1 cm with several lymph nodes identified, the largest being 3.0 x 1.0 x 0.6 cm.\n\nMicroscopic examination revealed findings consistent with limited involvement of the anterior uterine myometrium with minimal invasion less than half of the total thickness in one sample. No lymphatic or vascular invasion was identified. Non-neoplastic endometrium was predominantly atrophic. Remaining myometrium contained submucosal, intramural, and subserosal leiomyomas largely calcified up to 5 cm in size. Cervix and serosa showed no signs of carcinoma. All specimen margins were negative. Both ovaries and fallopian tubes were free of carcinoma.\n\nAll lymph nodes evaluated were negative for malignancy: ten nodes from the left pelvis, six from the right aorta, three from the left aorta, and seven from the right pelvis."} +{"pid": "TCGA-HZ-8001", "report": "Surgical Pathology Report. \n\nA liver biopsy demonstrated minimal mixed portal inflammation, mild cholestasis, and focal dense fibrosis. No malignancy was identified. A biopsy of soft tissues from the falciform ligament showed fibroadipose tissue without evidence of malignancy. A hepatoduodenal lymph node biopsy revealed one lymph node, which was negative for malignancy. Biopsies of the bile duct margin and pancreatic duct margin were both negative for malignancy. A biopsy of soft tissues in the middle celiac vein region was positive for metastatic carcinoma. \n\nThe resected specimen involving the head of the pancreas, duodenum, stomach, and gallbladder showed a mass measuring 3.0 cm in greatest dimension. Microscopic evaluation revealed tumor invasion into the duodenal wall, peripancreatic soft tissues (anterior and inferior), extrapancreatic common bile duct, and adjacent structures including the middle celiac vein. Margins of resection, including proximal, distal, uncinate, bile duct, and pancreatic, were free of invasive carcinoma. Fifteen lymph nodes were examined and none showed involvement by malignancy. Perineural invasion was present; lymphovascular invasion was not identified. Pathologic staging was determined as pT4 with no regional lymph node metastasis. Additional findings included pancreatic intraepithelial neoplasia (highest grade PanIN-3) and chronic pancreatitis. The gallbladder showed features of chronic cholecystitis. No histopathologic abnormalities were found in the stomach or duodenal mucosa. \n\nSpecimens were received from various sites including liver, falciform ligament, hepatoduodenal lymph node, bile duct margin, pancreatic duct margin, middle celiac vein, and gallbladder with small bowel. Gross examination of the resected pancreas and associated organs confirmed the tumor location in the pancreatic head with involvement of surrounding structures. Multiple sections were submitted for microscopic evaluation to assess margins, lymph nodes, and extent of disease. Immunohistochemical testing was performed using validated antibodies as part of standard clinical evaluation. \n\nAll tissue specimens were processed according to institutional protocols. Fixation times met required standards for diagnostic accuracy. Controls were appropriately used and evaluated for all staining procedures. \n\nThis case has been reviewed and approved by surgical pathology staff. All gross and microscopic findings have been interpreted by the attending pathologist."} +{"pid": "TCGA-B0-5691", "report": "The specimen includes a left radical nephrectomy with findings in the kidney and adrenal gland. In the kidney, a neoplasm is identified measuring 3.2 cm. Histologic evaluation reveals cells with clear cytoplasm and nuclear features consistent with high-grade morphology (grades 3\u20134). All surgical margins are negative. There is no involvement of the renal vein or extension beyond the renal capsule. Based on these findings, staging is classified as pT1a Nx Mx.\n\nIn the adrenal gland, a separate lesion measuring 3.5 x 2.8 cm is noted. Histologic examination demonstrates cortical-derived cells without evidence of malignancy. Immunohistochemical staining profiles differ between the renal and adrenal lesions. The renal lesion shows positivity for cytokeratin CAM 5.2, AE1/AE3, EMA, CD-10, and negativity for vimentin, inhibin, melan-A, and CD-34. The adrenal lesion demonstrates positivity for inhibin, melan-A, CD-10, and negativity for cytokeratin CAM 5.2, AE1/AE3, EMA, vimentin, and CD-34. Background vascular staining for CD-34 is present in both tissues. These immunophenotypic differences support that the adrenal lesion is distinct and unrelated to the renal process."} +{"pid": "TCGA-DD-AADF", "report": "The liver specimen measured 8.5 x 8.0 x 4.0 cm and weighed 121.7 grams. A mass was identified within the liver, measuring 4.0 x 3.0 x 3.0 cm. The cut surface of the mass was well demarcated, mahogany in color, and nodular in appearance. Grossly, the lesion exhibited a multinodular confluent growth pattern and was confined to the hepatic parenchyma with a bulging but smooth serosal surface. The resection margin was not involved, with a safety margin of 0.8 cm. The surrounding liver tissue showed features of cirrhosis.\n\nMicroscopically, the lesion demonstrated trabecular, pseudoglandular, and cystic growth patterns. The worst histologic differentiation was grade IV, while the predominant differentiation was grade III. A fibrous capsule was present, and there was evidence of capsular infiltration and septum formation. No invasion was identified at the surgical resection margin, serosal surface, portal vein, vascular structures, or bile ducts. The gallbladder measured 10.5 cm in length and 4.0 cm in diameter. Its serosal surface was yellowish pink and smooth, while the mucosal surface appeared dark green and velvety. Three black, hard stones were present, measuring 0.8 x 0.4 x 0.2 cm in aggregate. The gallbladder showed chronic inflammatory changes and calculi."} +{"pid": "TCGA-VQ-A8PX", "report": "The specimen from a gastric resection included a lesion measuring 1.5 cm located in the mucosa and lamina propria without evidence of vascular or perineural invasion. A smaller 0.5 cm lesion was identified as a fundic gland polyp with associated reactive changes. The surrounding gastric mucosa showed moderate chronic active gastritis with glandular dilatation and reparative epithelial alterations, while the intestinal mucosa appeared normal. All surgical margins were free of neoplastic involvement. A total of 24 lymph nodes were retrieved from various perigastric regions, including right and left paracardial, anterior hepatic artery, celiac trunk, and splenic areas, none of which contained neoplastic cells. Additionally, the gallbladder showed signs of mild chronic inflammation, and the spleen exhibited no pathological findings."} +{"pid": "TCGA-DJ-A2PQ", "report": "The specimen from a total thyroidectomy consists of a thyroid gland weighing 27 grams. The right lobe measures 4 x 3 x 1.4 cm, the left lobe measures 4 x 2 x 2 cm, and the isthmus measures 2 x 2 x 1 cm. A well-circumscribed, encapsulated tan-white nodule is identified in the left lobe extending into the isthmus, measuring 3.5 x 2.0 x 1.5 cm. The remaining thyroid tissue shows no other gross abnormalities. Microscopically, the nodule is completely surrounded by a thin fibrous capsule with extensive invasion of the capsule noted. The cellular features show well-differentiated morphology without mitotic activity or tumor necrosis. Psammoma bodies are present. Surgical margins are free of involvement. No blood vessel invasion, extrathyroid extension, or tumor multicentricity is identified. The non-neoplastic thyroid tissue shows changes consistent with nodular hyperplasia. Parathyroid glands are not identified in the specimen.\n\nA separate lymph node dissection from the left tracheo-esophageal groove and pre-tracheal area includes multiple lymph nodes ranging in size from 0.3 to 2.4 cm. A total of 12 lymph nodes are examined, and 7 are involved by metastatic disease. The largest lymph node measures 2.4 cm, and the largest metastatic focus is also 2.4 cm. Extranodal extension is not present. All lymph nodes are submitted for histologic evaluation."} +{"pid": "TCGA-57-1582", "report": "The specimen includes a uterus and cervix weighing 132 grams, measuring approximately 9.9 x 6.0 x 5.6 cm. The cervix shows a wrinkled tan-pink appearance with a patent os. The endocervical canal is lined by trabeculated tan mucosa. The uterine serosa is smooth and pink-red with several nodular areas of rubbery to fleshy tan-gray to pink tissue up to 1.5 cm on both anterior and posterior peritoneal reflections. The myometrium measures up to 2.2 cm in thickness, tan-pink and trabecular, containing an intramural nodule measuring 3.1 cm with a whorled, fibrotic cut surface. The endometrial lining is smooth and edematous, measuring up to 0.3 cm thick, with no gross lesions identified.\n\nThe left fallopian tube measures 5.4 x 0.7 x 0.7 cm with a smooth pink-red serosa and an edematous wall with a pinpoint lumen. Multiple nodules of tan-gray, fleshy to fibrotic tissue up to 2.0 cm are noted in the mesosalpinx extending to the round ligament. The left ovary measures 5.2 x 3.9 x 3.6 cm with a lobulated outer surface and multiple adherent nodules up to 3.0 cm. On sectioning, a previously opened cyst measuring 3.1 cm contains clotted blood; the remaining parenchyma is edematous, mottled gray-tan, and fibrotic.\n\nThe right fallopian tube is 6.4 x 0.6 x 0.6 cm with a mostly smooth congested serosa. At the fimbriated end, a 1.6 cm nodule is observed. The tube's wall is edematous and tan, with a pinpoint lumen. In the mesosalpingeal and para-ovarian soft tissue, several nodules up to 1.3 cm are present. The right ovary measures 4.5 x 2.9 x 2.6 cm with a lobular tan-pink outer surface and multiple plaques and nodules of similar lesional tissue up to 1.2 cm, involving approximately 50\u201360% of the surface. The uninvolved parenchyma is mottled, edematous, tan-pink, and fibrotic. A separate nodular piece of tissue measuring 4.1 x 3.1 x 2.5 cm and additional fragments measuring 4.0 x 2.9 x 1.2 cm were also received, all with similar characteristics.\n\nAdditional specimens include a 7.2 x 2.5 x 2.3 cm elongated portion from the left pelvic sidewall with gray-tan to pink fleshy to fibrotic cut surfaces, along with 4.5 x 2.6 x 1.5 cm nodular and irregular fragments. From the right pelvic sidewall, a 5.0 x 5.0 x 2.6 cm mass of shaggy, focally nodular tan-pink to gray tissue was received. Three small fragments (0.9\u20132.5 cm) from the pelvic tumor area were also submitted, with aggregate measurements of 3.0 x 2.8 x 1.1 cm. Four lymph node specimens were received: right pelvic lymph nodes (1.0\u20132.5 cm), right aortic lymph nodes (2.0 and 2.8 cm), a single left pelvic lymph node (1.5 x 1.0 x 0.4 cm), and a 60.0 x 14.5 x up to 2.2 cm sheet of omental tissue showing multiple embedded tan-gray fibrotic nodules up to 2.6 cm.\n\nMicroscopic findings show involvement of the serosal surface, lower uterine segment, anterior and posterior peritoneal reflections, myometrium, fallopian tubes, and ovaries with cellular features consistent with high-grade papillary architecture and nuclear atypia. Lymphatic and vascular invasion, as well as perineural involvement, are documented. Metastatic involvement is also present in the omentum, appendix, and peritoneal biopsies. Psammoma bodies are present in primary and metastatic sites.\n\nLymph node analysis reveals involvement in all examined right pelvic lymph nodes (4/4), right aortic lymph nodes (2/2), and one left pelvic lymph node. The largest metastatic deposit in the right pelvic lymph nodes measures 2.3 x 1.5 cm, while the largest in the right aortic lymph nodes is 1.9 x 1.3 cm.\n\nStaging classification is pT3N1MX. The majority of ovarian involvement appears more pronounced on the left side, though both ovaries show similar histologic features."} +{"pid": "TCGA-P3-A5Q6", "report": "A 3.5 x 3.0 x 1.0 cm specimen of fibrofatty tissue was received, with lymph nodes submitted from multiple levels. A separate 13.0 x 3.5 x up to 2.0 cm fibrofatty tissue specimen included a 3.0 x 1.0 cm segment of vein and a 2.5 cm nodule adjacent to the vein. Lymph nodes were submitted from various levels including IIB, IIA, III, and IV. A 4.2 x 3.0 x 2.0 cm lobulated tan tissue consistent with salivary gland was submitted without gross lesions. A 1.0 cm nodule was bisected and entirely submitted. A 0.3 cm portion of pale tan soft tissue was submitted for evaluation. A small 0.4 x 0.1 x 0.1 cm pink soft tissue sample was submitted for frozen section analysis and later included in routine processing. A 5.5 x 4.3 x 4.0 cm resection specimen included the uvula, hard palate mucosa, tongue, and surrounding structures. An ulcerated lesion measuring at least 2.5 x 1.7 cm was noted on the mucosal surface. Pale tan firm tissue infiltrated throughout the entire specimen, approaching all surgical margins. Several cassettes were submitted encompassing different regions of the specimen. A 2.0 x 1.0 x 1.0 cm fibrofatty tissue specimen contained one nodule and remaining fatty tissue. A 1.5 x 1.5 x 1.0 cm fibrofatty tissue specimen with focal bone was serially sectioned and submitted after decalcification.\n\nIntraoperative consultation identified a single nest of cauterized atypical epithelium; final diagnosis deferred. Metastatic disease was identified in four of 35 lymph nodes: 1/8 level IIA, 2/8 level III, 1/5 level IV. The largest involved node measured 2.5 cm, with other positive nodes measuring approximately 1.5 cm, 1.2 cm, and 1.1 cm. Extracapsular extension was present in two level III nodes and one level IIA node. A foreign body giant cell reaction was observed in one level IIB node. No evidence of disease was found in the submandibular gland, facial nodes, or level V. A biopsy of peristyloid tissue showed atypical cells. The primary site demonstrated moderately to poorly differentiated cellular features with infiltration into salivary glands and skeletal muscle, including involvement of the tongue. Tumor was present at the superior lateral margin, focally at the posterior margin, closely approaching the inferolateral margin, less than 0.1 cm from the medial uvula margin, and 0.4 cm from the medial tongue margin. Involvement was also noted in soft tissue adjacent to the styloid process, though bone was not involved."} +{"pid": "TCGA-BH-A18F", "report": "A 1.1 cm invasive tumor was identified in the right breast, located at the 12 o\u2019clock position. Histologic evaluation showed high-grade features including marked nuclear pleomorphism, high mitotic activity, and poor tubule formation, resulting in a Nottingham grade of 3. The tumor was found to be negative for estrogen and progesterone receptors, as well as HER-2/neu by immunohistochemistry. Microscopic assessment revealed no ductal carcinoma in situ, nor any lymphovascular space invasion. Resection margins were free of invasive disease; however, the tumor was within less than 1 mm of the anterior and inferior margins, 1 mm from the medial margin, and 1.5 mm from the posterior margin. Several small satellite nodules were noted near the primary lesion, ranging from 0.5 to 2 mm in size and located up to 1.2 cm from the dominant mass. These were observed in proximity to the surgical margins.\n\nAdditional findings included atypical ductal hyperplasia, fibrocystic changes with ductal epithelial hyperplasia, and columnar cell alterations. Calcifications were present in association with the invasive component. A prior biopsy site was also identified. One lymph node was retrieved from each of the three sentinel lymph node biopsies performed, and all were negative for metastatic disease. No dermal lymphatic invasion was observed. The skin margin was free of disease. Staging determined the tumor as pT1c with pN0 status. Immunohistochemical staining confirmed a basal-like phenotype."} +{"pid": "TCGA-23-1021", "report": "A partial omental specimen measuring 16.0 x 12.0 x 4.0 cm in aggregate dimensions with a total weight of 350 grams shows multiple areas of firm pink-white tissue interspersed within tan-yellow adipose tissue. Microscopic examination reveals papillary, glandular, and solid growth patterns with psammomatous calcifications.\n\nBilateral salpingo-oophorectomy specimens show involvement of both ovaries. The right ovary measures 9.5 x 6.5 x 5.5 cm and the left ovary measures 8.0 x 6.0 x 4.3 cm. Both are replaced by solid and cystic tumor tissue with surface involvement. Cyst spaces within the right ovary contain serous fluid and measure up to 5.0 cm. Tumor extends to the external surfaces of both ovaries. Foci of lymphovascular space invasion and moderate necrosis are present. The right fallopian tube contains tumor extending through the wall to involve the serosa. The distal right fallopian tube contains a firm tan-white tumor measuring 1.7 x 1.1 x 1.1 cm. The left fallopian tube also shows tumor involvement of the serosa and mesosalpinx. Intraluminal detached clusters of malignant cells are noted in the left fallopian tube. Both adnexal specimens show associated serosal adhesions with reactive mesothelial hyperplasia.\n\nThe uterus measures 20.0 cm from fundus to cervix and weighs 1170 grams. A large intramural mass measuring 11.0 x 10.0 x 7.0 cm is identified in the fundus with gelatinous tan content on sectioning. The serosal surface shows nodules of involved tissue and adhesions with reactive mesothelial hyperplasia. Extensive vascular space involvement is seen within the myometrium. The endometrium appears inactive and the cervix shows acute and chronic inflammation with squamous metaplasia.\n\nA cul-de-sac excision includes a 4 x 1.3 x 1.0 cm piece of soft tan-white tissue containing two attached cysts measuring 0.5 cm and 1.4 x 1.4 x 1.0 cm respectively, filled with serous fluid. Tumor involves the cyst surfaces.\n\nA rectosigmoid excision includes seven pieces of friable white-tan soft tissue ranging from 0.5 to 2.0 cm in diameter. The cut surface shows papillary and cystic features. Tumor involvement is associated with serosal adhesions and reactive mesothelial hyperplasia.\n\nThe left ovary shows no normal parenchyma and is replaced by cystic and solid tumor. The capsule is focally invaded externally. The solid tumor areas are soft and white. The left fallopian tube does not show direct tumor involvement but surrounding hemorrhage is noted.\n\nThe right ovary is almost entirely replaced by tumor; no normal ovarian tissue is identified. The fimbriated fallopian tube is attached and shows transmural tumor extension. No recognizable right ovary remains outside the tumor replacement.\n\nA focal luteinized follicle cyst is present in the residual left ovary. Mesonephric duct remnants are identified in the right fallopian tube. All specimens show associated reactive changes including mesothelial hyperplasia and adhesions."} +{"pid": "TCGA-DX-A8BQ", "report": "The specimen from the posterior left thigh consists of skin and soft tissue measuring 15.6 x 10 x 4 cm. A tan-beige skin ellipse measuring 15.3 x 2.9 cm is present with a centrally located sutured scar. The main mass is well-circumscribed, unencapsulated, and tan-grey with hemorrhagic areas, measuring 6 x 4.5 x 3 cm. Approximately 30% necrosis is noted. Margins are as follows: 0.3 cm from anterior/skin, 0.5 cm from deep, 6 cm from proximal, 7 cm from distal, 1.5 cm from medial, and 3 cm from lateral. All surgical margins are free of abnormal tissue. The tumor involves subcutaneous fibroadipose tissue and extends to the dermis. Previous procedure-related changes are present.\n\nA second specimen from the posterior and lateral left thigh is composed of adipose tissue measuring 6 x 4 x 2 cm. The cut surface is homogeneously yellow with no gross abnormalities identified. No lesional tissue is found upon histologic evaluation."} +{"pid": "TCGA-C5-A2LS", "report": "The specimen consists of a uterus with cervix and left adnexa, submitted following radical hysterectomy. The uterus weighs 203 grams and measures 13 x 6 x 4.5 cm; the cervix measures 4 x 3 cm. The endocervical canal measures 3.5 cm in length and contains a tan-friable mass measuring 5 x 4.5 x 1 cm. This lesion appears to extend into the lower uterine segment on the posterior cervix but does not involve the endometrial cavity. The vaginal cuff measures 1 cm anteriorly and 2.2 cm posteriorly. The resected surface was inked black, and all tissue was submitted for microscopic evaluation.\n\nMicroscopic examination of the cervix reveals glandular proliferation with focal squamous differentiation. Rare foci of lymphovascular invasion are identified. The maximum depth of tumor invasion in the cervix is 0.5 cm within a cervical wall thickness of 1.2 cm. In the lower uterine segment, the tumor extends into the anterior half with a depth of 0.9 cm, within a total myometrial thickness of 1.2 cm. Margins of excision are free of abnormal cells. The endometrium shows secretory phase changes with breakdown. No histopathologic abnormalities are found in the myometrium or parametrial tissues. Focal endometriosis is noted in bilateral parametrial tissues.\n\nExamination of lymph nodes reveals no evidence of malignancy. A total of 41 lymph nodes were evaluated: 21 from right pelvic, 1 from right common periaortic, 18 from left pelvic, and 1 from left common periaortic regions. All lymph nodes are histologically unremarkable.\n\nThe ovary measures 3 x 1.5 x 1 cm and weighs 20 grams. It contains two hemorrhagic cysts lined by yellow-orange tissue and one simple cyst filled with gelatinous fluid measuring 0.3 cm in diameter. The fallopian tube measures 7 x 1 cm and demonstrates acute inflammation. Adipose tissue from soft tissue specimens shows no histopathologic abnormalities.\n\nAll surgical margins are negative. The tumor does not invade through the full thickness of the cervix or involve the vagina. There is no metastatic involvement of regional lymph nodes. Histologic grade is well differentiated. Based on these findings, the tumor appears confined to the cervix and lower uterine segment without evidence of distant spread."} +{"pid": "TCGA-ZB-A969", "report": "Pathology Report-Summary: Material: Tumor: 6.0 X 6.0 X 4.0 cm with focal infiltration of lung parenchyma and pericardium. Histologic evaluation reveals epithelial cells positive for CK5/6, KL1, EGFR, with some cells expressing CD117. A notable presence of CD5-positive T-lymphocytes is observed. Staging classification indicates pT3, pNO (0/10), pM1, with clinical staging corresponding to IVb according to the Masaoka-Koga system."} +{"pid": "TCGA-MN-A4N4", "report": "A 173 gram left upper lobe lung specimen was received, measuring 17.3 x 9.0 x 2.6 cm. A staple line measuring 3.0 cm in length was noted adjacent to the bronchial margin. The visceral pleura appeared tan-pink to pink-purple with areas of anthracosis. An area of pleural retraction with central umbilication and underlying induration was identified, located 6.2 cm from the bronchial margin. The bronchial margin was removed en face for frozen section analysis. A circumscribed mass measuring 2.3 x 2.0 x 1.0 cm, tan to dark brown in color, was identified within the lung parenchyma. It extended to the pleura and was located 6.2 cm from the bronchial margin, 4.9 cm from the vascular margin, and 9.6 cm from the staple line. No other discrete lesions were identified upon serial sectioning. The bronchial tree contained thick mucous secretions but no lesions. Multiple hilar lymph nodes were present; no emphysematous changes were observed.\n\nThe microscopic examination revealed a unifocal lesion measuring 2.3 cm in greatest dimension, classified as poorly differentiated. The tumor was located in the upper lobe and did not show definitive invasion of the visceral pleura. Isolated tumor cell clusters were seen extending into alveolar and vascular spaces adjacent to the mass, with multifocal lymphovascular invasion noted. The closest margin involvement was 4.9 cm from the vascular margin. All other margins, including the bronchial margin, were uninvolved.\n\nA total of 22 lymph nodes were examined (levels 5 through 10), and none showed evidence of involvement. Granulomas were present in several lymph nodes, but special stains were negative for fungal organisms or mycobacteria. Fibrotic, calcified, and hyalinized nodules were also associated with the lesion. There was no evidence of perineural invasion or treatment effect.\n\nThe pathologic staging for the primary tumor was determined to be pT1b. No regional lymph node involvement (pN0) or distant metastasis was identified. Clinical correlation was recommended due to the presence of granulomas and isolated tumor cell clusters near the mass."} +{"pid": "TCGA-DX-A3UF", "report": "The specimen from the inferior vena cava resection includes a nodular mass measuring 6.0 x 2.8 x 2.9 cm, composed of two adjacent nodules measuring 3.7 cm and 2.9 cm in greatest dimension. The tumor is located at one end of a 9.4 cm segment of vein. A staple line measuring 1.3 cm is present on the larger nodule and is inked blue. Sectioning reveals white, whirled cut surfaces with focal areas of nodularity; both nodules are subjacent to the vein. The vein segment not involved by the mass measures 6.2 x 0.7 cm. An additional separate nodule measuring 1.7 x 1.2 x 0.8 cm is loosely attached to the larger nodule via fibrous tissue and shows gray-tan solid cut surfaces.\n\nHistologic evaluation shows high-grade cellular features with more than 10 mitoses per 10 high-power fields and presence of focal necrosis. The tumor involves the soft tissue margin including the stapled margin and extends to the wall of the inferior vena cava near the tumor site. The remaining venous resection margin is negative. Four lymph nodes associated with the specimen are benign.\n\nA gallbladder specimen measuring 8.0 x 2.0 x 1.0 cm shows chronic cholecystitis and cholesterosis. The cystic duct margin is included in submitted sections.\n\nOne iliac lymph node measuring 1.1 x 0.7 x 0.6 cm and one paracaval lymph node measuring 1.8 x 0.6 x 0.6 cm are both benign and show no evidence of involvement.\n\nThis amended report reflects updated clinical information indicating residual disease rather than recurrence."} +{"pid": "TCGA-AN-A046", "report": "Female patient underwent radical mastectomy for tissue procurement from the right breast. The tumor specimen was preserved in frozen format within a cryomold. Histological assessment showed infiltrative cellular growth with ductal features. The tumor was classified as grade 2. Staging was determined as T2, N0, M0. No prior treatment was administered. A normal blood sample was also collected via blood draw and stored frozen in a tube."} +{"pid": "TCGA-GI-A2C8", "report": "A radical mastectomy specimen from the right breast included a lesion measuring 2.4 cm in greatest dimension on microscopic examination. The lesion demonstrated a Scarff-Bloom-Richardson score of 8, with tubular and nuclear scores of 3 each and a mitotic score of 2. No in-situ component was identified. Angiolymphatic invasion was present, and tumor involvement was noted in the dermis of the skin and nipple. Dermal lymphatics also showed evidence of tumor involvement. Microcalcifications were not identified. The tumor was greater than 1 cm from all margins. Gross assessment suggested possible involvement of muscle; however, microscopic evaluation did not confirm invasion into muscle or bone. Ten lymph nodes were examined, including those from level III lymph node excision, and none showed evidence of metastasis. Estrogen and progesterone receptors were positive while HER2/neu testing was negative. The staging classification assigned was pT4B, NO, MX. The surgical specimen measured 21.2 x 20.5 x 4.1 cm and included a portion of rib and chest wall (6.5 x 5.4 x 1.7 cm). An elliptical skin segment measuring 20.6 x 10.2 cm, including the nipple, was submitted. Skin puckering was observed inferior to the nipple. The lesion was centrally located, estimated grossly at 4.8 x 2.9 x 2.9 cm, with a firm white appearance. The tumor appeared to abut the inked deep margin. Multiple tissue blocks were submitted for analysis, including sections from the nipple, tumor margins, skin, quadrants of the breast, axillary tail lymph nodes, and chest wall bone after decalcification."} +{"pid": "TCGA-2J-AABF", "report": "Surgery date: A. Lymph node, common hepatic artery, biopsy: A single lymph node is involved by malignant cells. B. Pancreas, neck margin, excision: Negative for tumor. C. Common hepatic duct, margin, excision: Negative for tumor. Site: Pancreas head C25.0. D. Pancreatic head, duodenum, portion of jejunum, and gallbladder; pylorus-sparing Whipple resection: Invasive moderately to poorly differentiated (grade 3 of 4) epithelial neoplasm is identified, forming a 3.2 x 3.0 x 2.0 cm solid mass located in the pancreatic head. The lesion extends beyond the pancreas into adjacent soft tissue. Angiolymphatic invasion is present. Perineural invasion is also noted. Necrosis is absent. The uncinate margin is positive for invasive cells. Other margins are free of involvement. The surrounding non-neoplastic pancreatic tissue shows features of chronic inflammation. Multiple (4 out of 18) regional lymph nodes are involved, including one at the common hepatic artery (see part A). Based on available surgical material, staging is pT3N1 (AJCC 7th edition, 2010). This final pathology report is based on gross and frozen section histologic evaluation. Permanent sections stained with hematoxylin and eosin were reviewed to confirm findings, and any significant changes will be reflected in a revised report.\n\nGross description: \nA. Specimen labeled \u201ccommon hepatic artery lymph nodes\u201d consists of a 2.7 x 1.2 x 0.5 cm lymph node. \nB. Specimen labeled \u201cpancreatic neck margin\u201d is a 3.2 x 1.5 x 0.3 cm fragment of tan pancreatic tissue; margin submitted. \nC. Specimen labeled \u201ccommon hepatic duct margin\u201d is a 1.0 x 1.0 x 0.3 cm fragment of tan tubular tissue; margin submitted. \nD. Specimen labeled \u201cpancreatic head, duodenum, portion of jejunum, gallbladder\u201d includes a Whipple specimen with a 24.0 cm segment of duodenum, an 8.5 x 4.3 x 3.5 cm portion of pancreas, and a 9.0 x 4.5 x 1.0 cm gallbladder. The uncinate margin is inked yellow and shaved, and the portal vein groove is inked black and sampled perpendicularly. A 3.2 x 3.0 x 2.0 cm tan, firm infiltrative mass is observed in the pancreatic head near the uncinate margin, extending into peripancreatic soft tissue. A stent is present in the common bile duct. The gallbladder contains no stones. Lymph nodes around the pancreas and duodenum are identified, and representative sections are submitted.\n\nBlock summary: \nPart A: One block from common hepatic artery lymph node. \nPart B: Two blocks from pancreatic neck margin. \nPart C: One block from common hepatic duct margin. \nPart D: Twenty-six blocks including three from the uncinate margin, one from the portal vein groove, one from the tumor, one from the ampullary region, one from the pancreatic duct, one from the gallbladder, and multiple blocks from peripancreatic lymph nodes and the duodenal polyp."} +{"pid": "TCGA-SH-A7BH", "report": "PAGE 02/03. Sex: F. Date Collected: Date Received: Date Printed: SPECIMEN DETAILS: Pleural biopsies, right. CLINICAL INFORMATION: Patient presents with SOBOE and right pleural effusion. Previous history includes sarcomatoid morphology noted on prior evaluation, and pleurodesis performed approximately 10 minutes after procurement. Patient is an ex-smoker with known asbestos exposure. MACROSCOPIC DESCRIPTION: Two fragments of red and cream-colored tissue are submitted, measuring 0.8 x 0.8 x 0.3 cm and 1 x 0.5 x 0.3 cm respectively. Fixed in 2 in 1 AP solution. MICROSCOPIC REPORT: Sections show pleural tissue infiltrated by a biphasic neoplasm. Epithelioid tumor cells with prominent nucleoli and moderate cytoplasm are observed blending into areas composed of spindle-shaped or oval cells within a fibrous stroma. Immunohistochemical staining shows variable positivity for MNF116, AE1AE3, CD34, Bcl-2, CD99 (weak), and EMA (weak, focally membranous). Only rare cells stain for calretinin. No significant staining is seen for CK5/6, mesothelin, CD31, HMB45, or TTF-1. WT-1 demonstrates variable cytoplasmic staining but lacks nuclear positivity. Correlation between clinical, radiological, and pathological findings is recommended. Reporting Pathologist: Authorising Pathologist: Reports are authorised electronically."} +{"pid": "TCGA-38-4630", "report": "The specimen consists of a right upper lobe partial lobectomy measuring 13 x 12 x 4.5 cm and weighing 220 grams. A single lesion is identified, measuring 4.5 x 4.1 x 3.5 cm, with an ovoid, circumscribed appearance, tan in color, and solid with central softening. The tumor is located in close proximity to a medium-sized bronchus, with the closest distance to the bronchial margin measuring 9 mm. The tumor approaches within 1 mm of the visceral pleural surface, though the overlying pleura remains smooth and pink/purple. The shortest distance from the tumor to a stapled resection margin is approximately 1 cm. No satellite tumor nodules are observed. The non-tumorous lung tissue appears unremarkable.\n\nMicroscopic evaluation reveals a poorly differentiated growth pattern with focal papillary architecture. The tumor directly interfaces with a bronchus and shows focal involvement of the pleura (confirmed in block A3). No definitive in situ carcinoma is identified. There is evidence of angiolymphatic invasion involving a small vein; perineural invasion is not present. Surgical margins, including the bronchial margin, show no evidence of tumor involvement.\n\nA total of seven lymph nodes are examined: one from station 7, four from R9, and two from R10. All lymph nodes show no evidence of metastatic involvement. Frozen section analysis of the bronchial margin confirms absence of in situ or invasive tumor.\n\nTissue blocks submitted include representative sections of the tumor, its interface with normal lung tissue, areas of central softening, relationship to the bronchus and pleura, and control sections of normal parenchyma. All lymph node specimens were entirely submitted for evaluation."} +{"pid": "TCGA-BR-8364", "report": "The specimen consisted of excised tissue from the fundus of the stomach. The lesion measured 8 x 6 x 1.7 cm and was described as ulcerated. Histologic evaluation revealed a diffuse growth pattern. The extent of the lesion involved adjacent structures, including the omentum. A total of 11 lymph nodes were examined, with 3 showing metastatic involvement. No lymphatic, venous, or perineural invasion was specified. Surgical margins, response to neoadjuvant therapy, and additional pathologic findings were not specified. No comments were provided."} +{"pid": "TCGA-2H-A9GM", "report": "Coded sample ID: Histologic examination reveals a moderately differentiated carcinoma arising within Barrett's epithelium. The lesion is located in the distal esophagus and measures up to 4 cm in maximal diameter. A total of 13 lymph nodes were examined, with 2 showing evidence of involvement. The specimen reflects a radical resection."} +{"pid": "TCGA-05-4250", "report": "The resection material from the right lower lobe shows a poorly differentiated lesion measuring at least 65 mm with extensive local involvement. There is nearly complete pleural infiltration and invasion into segment S6; the excision does not extend into healthy tissue. Central spread is noted with tongue-shaped extensions into the peribronchial and hilar fatty connective tissue. Lymph node metastases are present, with necrotic changes observed. Additionally, there is evidence of multifocal vascular invasion. The assessment indicates that complete removal of the lesion cannot be confirmed. Histological classification is high grade, with staging as pT3, pV1, pN1, pMx, stage III A. Residual tumor is suspected (R2)."} +{"pid": "TCGA-56-7730", "report": "The surgical specimen consisted of a right upper lobe lobectomy along with multiple lymph node samples from various anatomical stations. The lymph nodes sampled included those from the right paratracheal region (stations 4R and 10R), thoracic station 11R, tracheobronchial angle, and hilar regions. All lymph nodes examined were benign, with no evidence of malignancy identified in any of the submitted specimens.\n\nThe lung specimen revealed a well-circumscribed mass measuring 6.5 x 4.3 x 3.0 cm located in the right upper lobe. Histological evaluation demonstrated moderately to poorly differentiated infiltrating carcinoma involving this mass. The tumor was found to approach the visceral pleura but did not invade through it. In addition, focal in-situ and superficially invasive changes were noted within the bronchial mucosa at the proximal resection margin. No lymphatic or vascular invasion was observed.\n\nSections of the non-involved pulmonary parenchyma showed patchy hemorrhage and features consistent with post-obstructive pneumonia. A total of 18 lymph nodes were assessed across N1 and N2 stations; none exhibited signs of metastasis. The staging classification indicated no regional lymph node involvement (pN0) and no distant metastases (pM0). The primary lesion was staged as pT2b based on its size (>5 cm but \u22647 cm in greatest dimension). The surgical margins were patent, although tumor cells were present near the bronchial margin.\n\nEighteen lymph nodes were evaluated in total: twelve hilar (N1) and six mediastinal (N2), all without evidence of tumor involvement. Specimens were obtained from stations 4R, 10R, 11R, and tracheobronchial angle, all confirming absence of malignant infiltration.\n\nMacroscopic examination confirmed the presence of a single tumor focus measuring approximately 6.5 cm in greatest dimension, located 0.7 cm from the bronchial margin and 1.5 cm from the staple line. The tumor extended to the pleural surface but did not breach it. Parenchymal findings included dilated airways filled with mucoid material and mild anthracotic change."} +{"pid": "TCGA-GM-A2D9", "report": "A segmental mastectomy specimen from the left breast was received, measuring 6.0 x 4.5 x 3.0 cm. The specimen was serially sectioned and oriented with markers for superior, lateral, medial, inferior, anterior, and posterior aspects. A lesion measuring 1.6 x 1.6 x 1.2 cm was identified and located approximately 0.2 cm from the closest posterior margin. The lesion appeared firm, tan-pink-yellow in color, and ill-defined. Margins were assessed with ink applied to all sides: anterior (yellow), posterior (black), superior (blue), inferior (green), medial (orange), and lateral (red). The invasive component was found to be 1.5 mm from the posterior margin and 5.0 mm from the inferior margin. Surgical margins were otherwise free of tumor.\n\nMicroscopic evaluation revealed an invasive carcinoma with nuclear features corresponding to a well-differentiated grade. No lymphatic or vascular invasion was observed. A focal intraductal component was present, showing intermediate-grade nuclear features with micropapillary and cribriform patterns along with necrosis, accounting for less than 5% of the overall lesion. There was also evidence of focal atypical ductal hyperplasia, biopsy site changes, and proliferative fibrocystic change.\n\nTwo sentinel lymph nodes from the left axilla were examined. The first measured 2.2 x 2.0 x 1.0 cm and the second 0.8 x 0.4 x 0.3 cm. Both were entirely submitted for analysis. Cytokeratin staining showed no evidence of metastatic involvement in either node.\n\nAn additional excision of a deep margin from the left breast was performed. The specimen consisted of muscle tissue measuring 4.0 x 2.5 x 0.6 cm, with clips marking the true margin. The margin was inked black and fully submitted for evaluation. No tumor was identified in this tissue.\n\nImmunohistochemical studies demonstrated a low Ki-67 proliferation index (10%) and absence of neuroendocrine differentiation markers including synaptophysin, chromogranin, and CD56. Fluorescence in situ hybridization analysis using the PathVysion HER-2/neu DNA Probe Kit showed no gene amplification, with a HER-2/neu to CEP17 signal ratio of 1.16 across 60 counted nuclei. Control samples were appropriate and within expected parameters.\n\nThe invasive component was noted to abut but not invade into skeletal muscle. All other margins were negative for tumor involvement."} +{"pid": "TCGA-CZ-5984", "report": "The left nephrectomy specimen weighed 466 grams and measured 18 x 9 x 5.5 cm. The kidney measured 12 x 6.5 x 4.5 cm and contained a golden yellow, red, tan, focally hemorrhagic, focally gelatinous encapsulated mass measuring 4.5 x 4.0 x 4.0 cm located in the upper pole. The mass abutted but did not definitively invade through the renal capsule. It came to within 2.3 cm of the renal artery margin, 3.3 cm of the renal vein margin, and 5.5 cm of the ureteral margin. Fuhrman nuclear grade was assessed as III/IV at the deepest extension of the lesion.\n\nMargins of the renal vein, renal artery, ureter, and Gerota\u2019s fascia were all negative for tumor involvement. No lymphovascular or venous invasion was identified. Moderate calcific atherosclerosis (20% occlusion) was observed in the renal artery.\n\nSections from three distinct areas of the mass (T1, T2, T3) were submitted for further analysis. Cytogenetic evaluation of one section revealed chromosomal abnormalities including deletion of the short arm of chromosome 3, which is commonly associated with certain types of kidney tumors. No abnormalities were detected in the other two sections analyzed.\n\nEvaluation of the kidney parenchyma showed diffuse mesangial sclerosis, mild, likely representing early diabetic glomerulosclerosis. There was moderate arterial and arteriolar sclerosis with subintimal hyalinosis. Minimal chronic changes included focal global glomerulosclerosis affecting 2.2% of glomeruli and mild tubular atrophy with interstitial fibrosis involving 5% of the cortical parenchyma. No active inflammation or proliferative lesions were observed.\n\nNo adrenal gland tissue was present in the specimen. No lymph nodes were identified within the perinephric fat or in the regional lymph node specimen submitted. The lymph node specimen consisted entirely of adipose and fibrovascular tissue without significant pathological findings.\n\nThe specimen was staged according to AJCC (6th edition) criteria as pT1b NX MX."} +{"pid": "TCGA-S9-A6WD", "report": "The neuropathology report notes small foci with increased cell density and elevated mitotic activity. The tumor is otherwise well-differentiated. Based on these findings, the lesion is classified as WHO grade III."} +{"pid": "TCGA-B6-A0IG", "report": "The surgical specimen from the left breast and axilla measures 22.7 x 11.5 x 2.5 cm. The overlying skin includes a 5.5 cm areola and 1.0 cm nipple, with a well-healed 3.0 cm scar located superior to the areola in the upper inner quadrant. The axillary tail measures up to 13.5 x 8.0 cm. Serial sectioning reveals a central mass measuring 3.5 x 3.5 x 3.0 cm located in the upper inner quadrant, extending into the upper outer quadrant. The mass is firm, tan-white, with gritty consistency and appears to infiltrate adjacent tissue. It approaches within 1 cm of the deep margin and 1.0 cm of the lateral margins. Surrounding breast tissue consists of lobular adipose and fibrous tissue with an area of dense fibrous change in the upper outer quadrant.\n\nMultiple lymph nodes were identified in the axillary tail. One lymph node measuring 3.1 x 1.0 cm contains a firm tan-white mass measuring 2.0 x 1.0 cm. Histologically, the mass shows cellular infiltration with nuclear features consistent with residual disease. Focal vascular invasion is present. Dermal lymphatic invasion is not identified. All surgical margins are free of tumor involvement.\n\nSections from the skin through the nipple and areola, areas of the breast including previous biopsy site, and multiple lymph node sections were submitted. Microscopic evaluation of the axillary lymph nodes reveals involvement in 4 out of 16 total nodes. In the low axillary region, 2 of 2 nodes are positive, one showing macroscopic involvement with extracapsular extension. In the mid axillary region, 2 of 8 nodes are involved, while no involvement is seen in the high axillary nodes (0 of 6). Other findings include papillary apocrine metaplasia, cystic change, and fibrosis in the remaining breast tissue."} +{"pid": "TCGA-N6-A4VD", "report": "The surgical specimen included a partial uterus with cervix and bilateral adnexa, weighing 110 grams. The tumor measured 5.5 cm in greatest dimension. Histologic evaluation revealed that the tumor extended through the posterior myometrium completely (100% invasion) and formed a nodule on the serosal surface. There was no clear evidence of lymphovascular invasion. The lower uterine segment margin was free of tumor involvement; however, cervical tissue was not identified in the specimen either grossly or microscopically. Both fallopian tubes and ovaries showed no signs of tumor involvement. The right ovary exhibited inflammatory adhesions. In the right fallopian tube, there was a serosal foreign body giant cell reaction associated with polarizable material, along with an adherent nodular aggregate of inflammatory cells showing granulation-type inflammation.\n\nPathologic staging was determined as pT3a, pNO, pMX, corresponding to a clinical stage of IIIA. Evaluation of lymph nodes included one right common iliac lymph node and one left external iliac lymph node; both were negative for malignancy. The left external iliac lymph node showed small granuloma formation. Immunohistochemical staining demonstrated positivity for CD68 in histiocytes, while AE1/AE3 was negative. Additional studies are pending to rule out infectious etiologies. A separate pelvic wash specimen was also negative for malignant cells. Microscopic findings were consistent with high-grade epithelial and mesenchymal components without further specific identification of granulomas in stained sections."} +{"pid": "TCGA-78-7163", "report": "Right lower lobectomy specimen includes lung tissue measuring 140 x 100 x 20 mm, with a 40 mm lesion present that contacts the pleural surface. The lesion exhibits a mucoid, grey cut surface. Histologic examination reveals well-differentiated cells arranged in a lepidic growth pattern. A focal area of central necrosis is noted. Surgical margins are free of malignant cells. Examination of ten lymph nodes from the 11R station shows no evidence of malignancy. The excised tissue was entirely submitted for analysis. The findings are based on microscopic evaluation and macroscopic assessment. Report confirmed by pathologist or registrar."} +{"pid": "TCGA-AQ-A54N", "report": "The surgical pathology report describes a left partial mastectomy specimen. A single discrete mass measuring 4.9 x 3.6 x 3.8 cm was identified in the central portion of the specimen. Histologic evaluation showed a Nottingham combined histologic grade of 3, based on tubule formation score of 3, nuclear pleomorphism score of 3, and mitotic count score of 3. The tumor was unifocal with no lymphovascular invasion identified. All margins were negative for invasive disease; however, the anterior margin was closest to the tumor at approximately 0.3 cm based on microscopic evaluation. Gross measurement indicated the tumor was within 0.8 cm of the anterior margin. No in situ component was identified.\n\nAxillary lymph node evaluation included one sentinel lymph node which showed no evidence of metastasis. Cytokeratin immunostaining (AE1/AE3) was negative. Additional specimens from lateral and medial surgical margins showed no evidence of atypia or malignant cells.\n\nThe specimen weighed 229 grams and measured 13.5 cm from superior to inferior, 11 cm medial to lateral, and 6 cm anterior to posterior. The skin ellipse measured 12.1 x 5.2 cm with no lesions observed. The tumor was located 1.3 cm from the posterior margin, 2.9 cm from the medial margin, 2.7 cm from the lateral margin, and 1 cm subjacent to the skin surface.\n\nSpecial investigations included tissue blocks representing various margins and regions of the specimen. No microcalcifications were identified. Additional findings included duct ectasia.\n\nClinical correlation is advised due to discrepancies between microscopic and gross measurements of the anterior margin."} +{"pid": "TCGA-BP-5174", "report": "The submitted specimens include a left kidney partial nephrectomy specimen and a deep margin #2 excision. The primary lesion is a well-circumscribed, bright yellow, focally hemorrhagic nodule measuring 1.9 cm in greatest dimension. Histologic evaluation reveals acinar growth pattern with cells exhibiting nuclear features consistent with intermediate grade. The tumor is confined within the renal capsule and does not involve the surgical margin. The deep inked margin is within 1 mm of the tumor but remains negative. A second margin specimen (#2) also shows no evidence of tumor involvement. All margins are confirmed free of tumor. The surrounding non-neoplastic kidney tissue appears normal and unremarkable. The tumor size, location, and absence of margin involvement are documented."} +{"pid": "TCGA-5P-A9JW", "report": "A pathology report was communicated verbally over the phone. The lesion measured 1.2 cm in diameter and exhibited papillary architecture. The cellular morphology demonstrated well-differentiated features. Histologic grading was low to intermediate (Grade GI/GII). The staging was classified as pT1a with no residual tumor at the resection margin (RO)."} +{"pid": "TCGA-BH-A0E2", "report": "The specimen consists of a modified radical mastectomy from the right breast. The invasive tumor measures 2.5 x 2.3 x 2.0 cm and is located in the lower outer quadrant. Histologic evaluation reveals high-grade features including poor tubule formation, marked nuclear pleomorphism, and increased mitotic activity. The tumor is associated with calcifications.\n\nIn addition to the invasive component, there is extensive ductal intraepithelial neoplasia involving 50% of the total tumor volume. This component demonstrates cribriform, solid, micropapillary, and clear cell morphology with comedonecrosis and calcifications. It is present admixed with the invasive component and identified in 12 out of 22 slides examined. The ductal intraepithelial component extends to within 4 mm of the anterior margin, while the invasive tumor is greater than 1 cm from all margins. There is no lymphovascular space invasion identified.\n\nThe nipple demonstrates involvement by the intraepithelial component. The skin margin is free of tumor involvement. Additional findings include intraductal papilloma, fibrocystic changes, and fibroadenomatoid nodules in non-neoplastic breast tissue. Changes related to prior biopsy with fat necrosis are also noted.\n\nLymph node examination reveals metastatic involvement in 4 of 26 nodes. The largest metastatic deposit measures 2 cm in diameter. Evidence of capsular breach with extension beyond the lymph node wall is present and measures approximately 1 mm.\n\nImmunohistochemical analysis indicates hormone receptor positivity with expression of estrogen receptors and weak positivity for progesterone receptors. No amplification of HER-2 was detected.\n\nStaging classification reflects significant nodal involvement without determination of distant metastasis."} +{"pid": "TCGA-BR-8296", "report": "The specimen consisted of a gastrectomy with a tumor located in the fundus measuring 9.5 x 8 x 1.2 cm. The tumor was ulcerated and histologically classified as intestinal type. It was graded as poorly differentiated. The tumor extended to adjacent structures, specifically involving the lesser omentum. A total of 7 lymph nodes were examined, with 6 showing metastatic involvement. All involved lymph nodes were intraabdominal in location. Lymphatic, venous, and perineural invasion were not specified. Surgical margins were free of tumor involvement. There was no evidence of neoadjuvant treatment effect. No additional pathologic findings were noted."} +{"pid": "TCGA-RY-A83Z", "report": "The patient is a female who underwent biopsy of a left frontotemporal lesion. The tissue sample was received fresh in two parts. Part A measured 1.0 x 0.4 x 0.2 cm and consisted of unoriented, gelatinous tan-red soft tissue. A portion was used for frozen section analysis, with the remainder submitted for further evaluation. Part B measured 0.8 x 0.7 x 0.1 cm and was submitted intact.\n\nMicroscopic examination revealed a hypercellular glial neoplasm composed of large atypical cells with pleomorphic, hyperchromatic nuclei, irregular nuclear contours, and scant cytoplasm. The cellular population included both gemistocytic astrocytes and smaller elongated cells with high nuclear to cytoplasmic ratios. Mitotic figures were readily identified. No evidence of necrosis or microvascular proliferation was observed.\n\nImmunohistochemical staining showed strong positivity for p53 protein and IDH1 (R132H) mutant protein. GFAP staining demonstrated patchy positivity, particularly in the gemistocytic cell population. Neurofilament highlighted entrapped neuropil. The Ki-67 labeling index was 18%. Additional molecular studies for EGFR amplification and PTEN deletion are in progress and will be reported separately.\n\nA prior outside biopsy of a left insular lesion had been performed, and the current procedure was part of further diagnostic evaluation. The findings were reviewed by the attending pathologist, who confirmed the microscopic assessment and signed out the final report after review of all preliminary interpretations."} +{"pid": "TCGA-BR-8382", "report": "Patient ID: Gross Description: A segment of the stomach with a lesion located in the lower third, measuring 7.5 cm in its largest dimension. The lesion involves the entire wall thickness. The omentum and surrounding fatty tissue show signs of hyperemia, and metastasis is suspected. Microscopic Description: Poorly differentiated cellular growth with features consistent with high-grade malignancy was observed. Invasion into adjacent fatty tissue is present, along with areas of necrosis. A total of fifteen lymph nodes were evaluated, of which nine showed evidence of malignant involvement. Metastatic presence was also noted in the omentum. Tumor characteristics include ulceration. The extent of spread includes perigastric fat. No venous invasion was identified. Surgical margins are free of involvement. Lymph node involvement includes nine out of fifteen nodes from the greater and lesser omentum. Other features such as lymphatic or perineural invasion, response to preoperative treatment, and additional findings were not specified."} +{"pid": "TCGA-CG-4469", "report": "The specimen consists of a total gastrectomy preparation. The lesion involves extensive soft tissue infiltration around the stomach, with areas of ulceration and poor differentiation observed histologically. The tumor has penetrated through the gastric wall, reaching the serosal surface. A total of thirty-nine out of forty regional lymph nodes show evidence of metastatic involvement. The tumor extends to the aboral resection margin, with both invasive and lymphatic spread noted near this site. The oral resection margin is free of tumor involvement, as is the omentum. The staging assessment indicates advanced local and nodal disease."} +{"pid": "TCGA-LG-A9QC", "report": "The pathology report includes specimens from a cholecystectomy, liver resection, diaphragm resection, and omental segment. The gallbladder specimen is 8.5 x 3.5 x 1.4 cm with a smooth serosa and no choleliths. Microscopic evaluation shows mild chronic cholecystitis.\n\nThe liver specimen weighs 1,289 grams and measures 16 x 13.5 x 9.5 cm. A 9.1 x 9 x 6.8 cm lobulated mass is identified in the right lobe. The cut surface of the mass is variegated yellow-tan with areas of hemorrhage (approximately 20%). Necrosis is present but incomplete. The tumor comes within 1.6 cm of the blue-inked resection margin, and vascular invasion is identified. Satellite lesions are noted around the main mass, with the largest measuring up to 1.5 cm. Histologic examination reveals Grade 2 differentiation. There is no infiltration, extrahepatic extension, or involvement of the hepatic capsule. Resection margins are negative. Adjacent liver tissue shows hemorrhage, hemosiderin deposition, reactive changes, and mild portal chronic inflammation.\n\nThe diaphragm specimen is a 1.5 x 0.5 x 0.5 cm tissue fragment with a focally granular cut surface. Microscopic findings include fibrous adhesions and focal granulation tissue; no malignancy is identified. The omental specimen is 10.0 x 7.5 x 1.8 cm with no gross nodules. Histologic examination shows benign adipose tissue with focal fibrosis and no evidence of malignancy.\n\nSections were submitted for intraoperative consultation, and the surgical margin was found to be grossly negative, located 1.6 cm from the tumor. Representative sections of the tumor included assessment of the resection margin, surrounding tissue, satellite lesions, and vascular structures."} +{"pid": "TCGA-D7-A6EY", "report": "The specimen consists of a resected stomach measuring 18.8 x 14.7 cm, along with attached omentum measuring 20.8 x 20.1 cm. A lesion located in the pyloric region measures 7.8 x 6.4 x 1.3 cm. The proximal margin is 7.2 cm from the tumor, and the distal margin is 1.6 cm. Histologically, the lesion demonstrates features of tubular-type carcinoma with areas of poor differentiation. The tumor infiltrates through the full thickness of the stomach wall and extends into the adjacent fat tissue. No neoplastic involvement is seen at the excision margins. Lymph node examination reveals metastatic presence in 13 out of 18 nodes assessed. Vascular invasion is present and appears to be extensive."} +{"pid": "TCGA-AJ-A2QM", "report": "The patient is female. A hysterectomy and bilateral salpingo-oophorectomy were performed along with lymph node dissections. The right ovary and fallopian tube showed no significant abnormalities. The left ovary was unremarkable, and the fallopian tube was not identified. The uterus contained a gray-tan lobular mass measuring 3.2 x 2.7 cm within the endometrial cavity, located within 0.4 cm of the lower uterine segment. Microscopic evaluation showed the tumor extended 0.6 cm into a 1.4 cm thick myometrium, representing less than one-half invasion. Tumor was also focally present in the endocervical mucosa and stromal tissue. No involvement of other organs or lymphovascular space invasion was identified. All surgical margins were free of tumor. A total of 34 lymph nodes were examined: three from the right external iliac, eight from the right obturator, six from the right lower periaortic and common, two from the left external iliac, seven from the left obturator, and seven from the left lower periaortic and common regions. All were negative for metastatic disease. The omentum was also negative for malignancy. The tumor was histologically high grade and staged as pT2, NO (FIGO: II)."} +{"pid": "TCGA-H2-A3RH", "report": "Final Surgical Pathology Report. Procedure: Diagnosis. A. Thyroid, total thyroidectomy: A single ipsilateral focus of neoplastic tissue was identified in the left lobe, measuring 1.7 cm in maximum dimension. The lesion was mostly encapsulated and showed nuclear clearing, nuclear grooves, and psammoma bodies. A small satellite focus measuring 0.3 mm was also present nearby. The lesion was organ confined and completely resected. The right lobe contained multiple benign nodules consistent with multinodular goiter. B. Central cervical nodes, dissection: Three lymph nodes were examined, all without evidence of metastatic involvement. Microscopic Description: A, B. The right lobe contained several benign nodules consistent with multinodular goiter. The left lobe contained a well-circumscribed nodule measuring 1.7 cm, with histologic features including nuclear clearing, nuclear grooves, and psammoma bodies. The tumor was close to the capsular surface, within 0.1 cm, but did not breach it. A second small focus of neoplastic cells was noted in the left lobe. Resection margins were free of tumor. Vascular invasion was not identified. All three lymph nodes from the central cervical dissection were negative for metastasis. Additional findings included multinodular goiter in the right lobe. Gross Description: The total thyroidectomy specimen weighed 11.7 g and included right and left lobes, each approximately 3.9 x 3.1 x 1.2 cm. The left lobe contained a pale tan, rubbery nodule measuring 1.7 x 1.3 x 1.0 cm at the superior pole, adjacent to the capsule. Additional smaller pale tan nodules up to 0.8 cm were present throughout the parenchyma. The right lobe was unremarkable except for multinodular goiter. The central cervical node dissection included a small aggregate of adipose tissue containing two lymph nodes measuring up to 0.3 cm."} +{"pid": "TCGA-NA-A4R1", "report": "The specimen from a laparoscopic total hysterectomy with salpingo-oophorectomy was received intact and weighed 258 grams. The uterus measured 11.5 cm in height, 7.5 cm in breadth at the fundus, and 5.5 cm in anterior-posterior width. The endometrial cavity was 8.5 cm long and 3.4 cm from cornu to cornu. The cervix measured 3.2 x 3 cm in diameter, with an external os measuring 1.4 cm and having a slit-like shape.\n\nA tan-brown, exophytic, and polypoid lesion was identified diffusely involving the anterior and posterior aspects of the uterus. The tumor measured 4.5 x 4.4 x 1.5 cm and extended 2.3 cm into a myometrial wall of similar thickness, reaching the serosal surface. There was lymphatic/vascular invasion present. Very minimal non-neoplastic endometrium was noted, accounting for less than 5% of the endometrial surface. The remaining myometrium contained multiple well-circumscribed tan-white whorled nodules ranging from 0.3 to 1.6 cm in greatest dimension.\n\nThe cervix and endocervix were unremarkable grossly. The serosa was smooth, tan, and glistening without any visible tumor implants. Both adnexa were uninvolved. The right ovary measured 2.1 x 1.2 x 1.1 cm and appeared unremarkable, as did the left ovary, which measured 2.0 x 1.3 x 0.9 cm and showed multiple corpora albicans. The right fallopian tube was 8.1 cm in length and 1.5 cm in diameter, with diffuse enlargement and a dilated lumen containing dark brown fluid. The left fallopian tube was 5.1 cm long with a pinpoint lumen.\n\nLymph node dissection included several regional groups. In the left obturator region, 12 lymph nodes were identified, 2 of which contained metastatic disease with a maximum size of 1 cm and extra-nodal extension. In the right pelvic region, 10 lymph nodes were found, 1 of which was positive for metastasis with a maximum size of 0.9 cm and no extra-nodal extension. Other regions, including left external iliac, right deep obturator, right periaortic, left periaortic, and high middle aortic, did not show evidence of malignancy.\n\nHistologically, the tumor displayed a high-grade appearance with features suggestive of mixed differentiation, including areas resembling squamous, endometrioid, and clear cell morphology. Some regions demonstrated sarcomatous features such as cartilaginous and rhabdomyosarcomatous elements. The tumor margins were negative, and no malignancy was identified in either ovary or fallopian tube. The stage according to AJCC 7th edition is pT3a pN1 pMX."} +{"pid": "TCGA-HC-A9TH", "report": "The prostate specimen weighed 52.5 grams and measured approximately 5.4 x 4.0 x 4.0 cm. The outer surface was shaggy, and the cut surface showed a gritty, gray-tan fibrotic appearance with areas of chalky discoloration. These changes were present throughout the distal and mid regions, extending focally into the proximal area near the vesical margin. The urethra appeared compressed, and the tissue appeared to involve the apical margin and several inked lateral margins. The specimen also included fragments of seminal vesicles measuring 2.5 x 2.0 x 0.9 cm, which had a lobulated, gray-tan outer surface and multicystic, fibrotic cut surfaces. Additionally, three elongated tubular tissue fragments were present, ranging in size from 2.0 x 0.4 x 0.4 cm to 3.0 x 0.4 x 0.4 cm. In the same container, fibroadipose tissue fragments measuring 5.6 x 5.5 x 1.5 cm contained two nodules measuring 3.8 cm and 4.4 cm.\n\nMicroscopic evaluation revealed extensive involvement by high-grade epithelial cells with a predominant cribriform pattern and areas of single-cell infiltration through the stroma. These cells were present in both the right and left seminal vesicles, with extension along perineural tracts. The tumor reached multiple soft tissue margins, including the apical and bladder neck margins. No lymphovascular invasion was identified. Two pelvic lymph nodes (right and left) were examined and showed no evidence of metastatic involvement. A portion of the vas deferens demonstrated similar cellular involvement. Multiple tissue sections were submitted for analysis, representing various regions of the prostate, seminal vesicles, surgical margins, and associated nodules. The pathologic staging was determined as pT3b NO."} +{"pid": "TCGA-A8-A08G", "report": "The specimen consists of an ablated breast sample containing three distinct foci of neoplastic growth. The primary focus measures 2.8 cm in diameter and is composed of poorly differentiated invasive cells arranged in a ductal pattern, with areas showing intraductal involvement. The dorsal resection margin is free of tumor involvement. Histological evaluation reveals high-grade features. Additional findings include multifocality, lymphovascular invasion, and involvement of regional lymph nodes. Surgical margins are uninvolved."} +{"pid": "TCGA-CV-A468", "report": "The specimen consists of an irregular fragment of fibroadipose tissue measuring 4.0 x 3.0 x 2.0 cm, containing multiple tan lymph nodes. One area of fibrosis is identified, measuring 1.5 cm in greatest dimension. In the Level IB left neck region, a portion of salivary gland (4.0 x 4.0 x 3.0 cm) with attached fibroadipose tissue contains multiple lymph nodes ranging from 0.5 to 1.5 cm in size. All lymph nodes appear unremarkable. In Level II left neck, an irregular fragment of fibroadipose tissue measuring 6.0 x 4.0 x 2.0 cm contains multiple tan ovoid lymph nodes ranging from 0.3 to 3.0 cm. In Level III left neck, an irregular fragment of fibroadipose tissue with attached skeletal muscle (4.0 x 4.0 x 3.0 cm) contains multiple tan lymph nodes ranging from 0.3 to 3.0 cm.\n\nA segment of nerve measuring 0.3 cm in greatest dimension from the right mental nerve was examined and found to be unremarkable. Similarly, a 0.3 x 0.2 x 0.2 cm soft tissue fragment from the left inferior alveolar nerve showed no abnormality. The superior lip margin, a flat piece of soft tissue measuring 1.5 x 1.0 x 0.3 cm, and the inferior lip margin, a piece of fatty tan-red soft tissue measuring 2.0 x 1.5 x 0.2 cm, were both found to be unremarkable.\n\nThe mandibulectomy specimen measures 9.0 cm (superior to inferior), 7.5 cm (medial to lateral), and 2.5 cm (anterior to posterior). It includes the anterior portion of the mandible and mental region. A multinodular lesion is noted at the left corner of the mouth, with additional nodules ranging from 0.3 to 0.6 cm dispersed throughout the specimen. One satellite nodule is located 0.9 cm from the upper lip medial margin, and another is 1.5 cm from the lower lip margin. The tumor invades submucosal layers and extends to the skin with perineural invasion. Margins are free of involvement. The bone component appears unremarkable, with no evidence of direct bone invasion. Multiple teeth and fragments, including molars, pre-molars, and canine, show focal dental caries; however, no sections were taken for analysis."} +{"pid": "TCGA-3E-AAAZ", "report": "The specimen was received in five parts. Part A consisted of a liver biopsy measuring 1.0 x 1.0 x 0.4 cm. Microscopic evaluation revealed mild fibrosis, ductular proliferation, and a mild inflammatory infiltrate, consistent with bile duct obstruction. No malignant cells were identified.\n\nPart B was an en bloc resection of the stomach, duodenum, and pancreatic head measuring 16.0 x 11.0 x 3.9 cm. The pancreatic portion measured 6.2 x 6.0 x 4.1 cm and contained a firm, white, poorly circumscribed mass measuring 3.2 x 2.5 x 1.7 cm located 4.2 cm from the false pancreatic margin. The mass was adjacent to the duodenal wall and extended to within less than 1 mm of the posterior surgical margin. It also showed extension into the peripancreatic adipose tissue. There was perineural invasion and lymphovascular invasion confirmed with immunostains. A separate cystic lesion measuring 1.7 x 1.7 x 0.5 cm was noted near the common bile duct, associated with mucinous green material. Multiple sections of the mass and surrounding structures were submitted, including margins inked in different colors for orientation. A total of eleven lymph nodes were identified in the peripancreatic and duodenal fat; all were negative for malignancy.\n\nPart C was a gastro-duodenal lymph node measuring 0.7 x 1.0 x 0.5 cm. Histology showed reactive changes with lipogranulomas but no malignant cells.\n\nPart D consisted of a small bowel resection measuring 11.5 cm in length. A tan-red nodule measuring 1.7 x 1.5 x 0.7 cm was found on the serosal surface and was composed of spindle cells positive for CD117 (c-kit) and negative for SMA and desmin, arranged in intersecting fascicles with prominent vascularity.\n\nPart E was a gallbladder measuring 12.3 x 4.0 x 1.0 cm. Histologically, it was partially autolyzed, with a red, velvety mucosa and no calculi. Wall thickness was up to 0.3 cm.\n\nStaging of the main pancreatic mass was pT3, pN0, pMX. The tumor was moderately differentiated and did not involve any lymph nodes. Multiple preinvasive lesions were present, including multifocal PanIN, with the highest grade being PanIN 3. No carcinoma was identified in the liver, lymph node, or gallbladder specimens."} +{"pid": "TCGA-OR-A5JJ", "report": "The specimen includes the left kidney, adrenal gland, and perinephric fat, measuring 160 x 125 x 70 mm and weighing 653 grams. The ureter is 35 mm in length with a maximum external diameter of 5 mm. The external surface of the kidney shows multiple nodules in the hilum. A capsular defect measuring 15 x 10 mm is noted in the posterosuperior region. On sectioning, the adrenal gland is largely replaced by a tan-colored mass with a heterogeneous appearance, including areas of hemorrhage and necrosis. The mass measures 95 x 95 x 70 mm and has a multilobulated structure. Tumor involvement is identified within the renal vein and six lymph node metastases in the hilum, ranging from 7 to 40 mm in size. There is no tumor infiltration into the kidney parenchyma, ureter, or renal sinuses, and the remainder of the kidney appears normal.\n\nHistologically, the tumor exhibits high-grade features including widespread vascular invasion and extensive necrosis. Mitotic activity is present at a rate of 10 mitoses per 10 high-power fields. The tumor margin at the soft tissue interface is separated by an intact but thin plane measuring 0.2 mm. Resection margins of the ureter and vein are free of tumor. Immunohistochemical staining demonstrates positivity for IGF2 (dot-like perinuclear pattern), Glucocorticoid Receptor (2+), ACADVL, and focal positivity for Calretinin and Inhibin. Melan A shows very focal positivity, while S-100 is negative. The Ki-67 proliferative index is 40%.\n\nMicrosatellite instability testing reveals preserved expression of MLH1, MSH2, PMS2, and MSH6. Multiple blocks were sampled, including sections from the ureteric margin, hilar vessels, renal vein tumor deposits, lymph nodes, and areas of capsular defect."} +{"pid": "TCGA-4K-AAAL", "report": "The specimen consists of a right testis measuring 5.0 x 4.0 x 3.0 cm with a portion of spermatic cord measuring 9.0 cm in length. A well-circumscribed lesion measuring 2.5 x 2.0 x 2.0 cm is present within the testis, with a lobulated grayish-pink cut surface. The surrounding testicular tissue is soft-elastic and pale-brown. The epididymis measures 3.0 x 1.0 x 1.0 cm, is firm-elastic with a granular, grayish-white appearance. Microscopic examination reveals abnormal cellular growth within the seminiferous tubules. Vascular invasion is identified. The tunica albuginea and epididymis are not involved. The surgical margin is negative for tumor involvement."} +{"pid": "TCGA-XF-AAMJ", "report": "The surgical specimen consisted of a cystectomy measuring 15 x 9 x 7.5 cm. On gross examination, the posterior and lateral bladder walls were firm and nodular with an ulcerated mass measuring 5 x 5 x 2 cm involving the entire posterior wall and extending onto the lateral wall. The tumor extended into the trigone and anterior mucosal wall, and was found to involve both ureterovesical junctions, completely obscuring the left side. The tumor invaded through the full thickness of the bladder wall, reaching the perivesical fat and abutting the surgical margin at the left lateral posterior aspect (5% involvement). No prostate tissue was identified in the specimen.\n\nMicroscopic evaluation revealed sheets of cells with increased nuclear to cytoplasmic ratios and prominent nucleoli forming papillary structures. These cells extensively invaded the muscularis propria and penetrated through the entire bladder wall. Vascular and perineural invasion were noted. Adjacent mucosa showed multifocal areas of carcinoma in situ. Other findings included cystitis cystica and cystitis glandularis in multiple sections of the bladder mucosa. Sections from the distal and proximal ureters, urethral margin, and vascular pedicle margin showed no evidence of malignancy. Multiple lymph node groups were sampled, including para-aortic, common iliac, paracaval, external iliac, and hypogastric regions; none contained metastatic disease. \n\nThe distal ureters were examined intraoperatively by frozen section, all of which were negative for tumor. The left ureter was obstructed and disrupted by tumor, while the right ureter was patent. The uninvolved bladder wall measured 0.8 cm in thickness, while the involved wall measured 2 cm. The tumor extended into surrounding soft tissues and was focally present at the inked posterior surgical margin. Based on these findings, staging was determined as pT3b with no lymph node metastases (N0) and residual tumor at the margin (R1)."} +{"pid": "TCGA-QL-A97D", "report": "The surgical specimen consisted of a right hemicolectomy, including the terminal ileum, cecum, ascending colon, transverse colon, omentum, and lymph nodes, measuring 74 cm in total length. A mass was identified in the cecum and extending into the ileum, measuring 7.5 cm in greatest dimension, with additional dimensions of 5.3 x 4.5 cm. Microscopically, the lesion showed features of invasive epithelial neoplasm invading the muscularis propria. All resection margins, including the mesenteric margin, were free of involvement, with the closest distance of the lesion to any margin being 8 mm. \n\nA total of thirteen lymph nodes were examined, none of which showed evidence of metastatic involvement. Two benign-appearing polyps were identified: one measured 0.7 cm and exhibited tubular architecture, while the other measured 1.7 cm and displayed a mixed tubulovillous morphology. The remainder of the small bowel and colonic mucosa appeared unremarkable on gross and microscopic evaluation. No lymphovascular or perineural invasion was identified, and there was no evidence of tumor deposits or extramural extension beyond the primary site. The histologic grade was consistent with well- to moderately differentiated morphology.\n\nStaging based on the findings was determined as pT2, reflecting invasion into the muscularis propria, with no regional lymph node involvement (pN0). No distant metastasis was assessed. The specimen did not show any macroscopic tumor perforation, and there was no evidence of prior treatment effect. Specimen blocks were prepared for further molecular analysis as needed."} +{"pid": "TCGA-VQ-AA6G", "report": "The specimen consists of a resected portion of the stomach, including the cardia. A lesion measuring 5.0 x 4.0 x 1.4 cm was identified in the cardia region. Histologic examination revealed moderately differentiated invasive and ulcerated tissue changes. The depth of infiltration extended up to the subserosa. No evidence of sanguineous or perineural invasion was observed; however, lymphatic vascular invasion was noted.\n\nEvaluation of the adjacent gastric mucosa showed moderate chronic inactive gastritis. The esophageal mucosa exhibited moderate chronic inflammation. All surgical margins were clear of abnormal tissue involvement.\n\nA total of 19 lymph nodes were retrieved from various peri-gastric regions and examined. These included right paracardic (2), left paracardic (3), lesser curvature (5), left gastric artery (2), celiac trunk (3), and inferior paraesophageal (4) lymph nodes. None showed involvement by neoplastic cells. Additionally, the greater omentum and esophageal margin were free of any abnormal tissue infiltration."} +{"pid": "TCGA-G9-6356", "report": "The prostate specimen weighed 49 grams and measured 5.0 cm in width, 4.0 cm in depth, and 3.3 cm in height. The gland had a smooth, intact external capsule. After trimming, the weight decreased to 22 grams. Serial sectioning revealed firm, light tan fibrous tissue throughout. The right and left seminal vesicles measured 1.6 x 1.4 x 0.4 cm and 2.5 x 1.4 x 0.4 cm, respectively, and showed cystic beige-tan tissue upon bisection. The right and left vas deferens measured 2.3 x 0.7 cm and 1.8 x 0.6 cm, respectively, with firm tan tubular structures identified on sectioning.\n\nMultiple sections were submitted for microscopic evaluation, including from both the right and left apex, right and left anterior and posterior regions at level 1, right and left lateral areas of the capsule at level 2, and various base regions, including the proximal urethral margin.\n\nThe right pelvic lymph nodes consisted of multiple adipose fragments measuring 5.6 x 3.1 x 0.5 cm in total, with two lymph nodes identified measuring 2.5 x 0.8 x 0.5 cm and 0.9 x 0.7 x 0.5 cm. The left pelvic lymph node specimen was a single fibroadipose fragment measuring 6.7 x 2 x 1.2 cm containing one lymph node measuring 2.2 x 0.3 x 0.3 cm. All lymph nodes were entirely submitted for analysis.\n\nMicroscopic examination revealed extensive involvement of both seminal vesicles. Tumor cells were also identified at multiple surgical margins. The majority of the tissue showed a high-grade pattern with features consistent with aggressive infiltration along the capsular surface. A small but notable component of lower-grade morphology was present in some areas, although it constituted less than the dominant pattern. No metastatic cells were found in any of the four lymph nodes from the right or the single lymph node from the left pelvic region.\n\nPathologic findings indicated involvement of both posterior lateral and basal regions, with perineural invasion observed. Tumor extended into the periprostatic fat. The final staging was determined as pT3b based on local extension; no nodal involvement was identified (pN0). Additional findings included amyloid deposition within the seminal vesicles."} +{"pid": "TCGA-2Y-A9H3", "report": "The liver specimen from a partial hepatectomy involved a single lesion measuring 5.9 x 5.2 x 2.2 cm. The tumor was well-circumscribed and tan in color with areas of necrosis and fibrous septa. It extended into the adjacent fat and was located within 1 mm of the visceral peritoneum. Microscopic evaluation showed a well-differentiated histologic type. The parenchymal margin was uninvolved, with the tumor at least 8 mm away from the resection edge. Microscopic vascular invasion was present, but no macroscopic vascular invasion or perineural invasion was identified. The non-neoplastic liver tissue demonstrated macrovesicular steatosis in a zonal pattern without fibrosis and no significant iron deposition. Staging was determined as pT2 pNX pMX. Multiple sections were taken for analysis, including margins and surrounding tissue. Ancillary studies included immunohistochemical staining for CD31 to assess vascular involvement, and special stains for reticulin, trichrome, iron, and PAS-D were performed and reviewed. A frozen section evaluation confirmed malignancy in the primary specimen with no evidence of disease at the margins. The case was reviewed intraoperatively and findings were confirmed upon final assessment."} +{"pid": "TCGA-QR-A6GT", "report": "A mass was identified in the retroperitoneal region adjacent to the right kidney and adrenal gland. The mass measured 10 x 5 x 5 cm and exhibited a multinodular, yellowish-tan appearance with areas of necrosis and focal dark brown to purplish-black discoloration. Some regions displayed a translucent, myxoid-like stroma. The mass was found to be in close proximity to the adrenal gland but did not show direct involvement of it. Gross examination revealed no clear invasion into the renal parenchyma, though the kidney appeared compressed externally by the mass. Vascular structures surrounding the tumor were sampled, and clips were noted on these structures. A luminal structure at the hilum, possibly representing a segment of the renal vein or dilated pelvis, contained small tan intraluminal projections measuring up to 0.3 cm.\n\nMicroscopically, the neoplastic cells demonstrated positivity for synaptophysin and chromogranin. Immunostaining also showed reactivity for Melan-A and inhibin, while AE1/3, CAM5.2, HMB-45, and MART-1 were negative. S-100 staining highlighted reticuloendothelial cells but did not display a sustentacular pattern; the tumor cells themselves were negative for S-100. No tumor was identified in the submitted peritoneal nodule, which measured 0.3 x 0.2 x 0.2 cm. Lymph node tissue from the aortocaval region below the renal vein showed hyperplastic features with vascular medullary accentuation, and another lymph node from the same area was histologically benign. All surgical margins were uninvolved.\n\nThe tumor exhibited certain features concerning for aggressive behavior, including its size and the presence of tumor within a vascular structure. Given these findings, ongoing clinical follow-up, including evaluation for possible metastatic disease, is recommended."} +{"pid": "TCGA-AX-A05S", "report": "The specimen consists of a uterus with cervix and bilateral adnexa, measuring 9 cm in length, 6.5 cm cornu to cornu, and 4.2 cm anterior to posterior, weighing 221 grams. The endometrial cavity is filled with tan-yellow necrotic tissue, appearing to invade through the entire myometrium on both anterior and posterior walls. A putative leiomyoma measuring 2.5 cm is identified. The tumor invades to a depth of 20.9 mm with a total myometrial thickness of 21 mm. Involvement of the lower uterine segment is noted. Lymphovascular space invasion is present.\n\nMultiple lymph node specimens were submitted and examined. Left pelvic lymph nodes (4 of 4) show no evidence of malignancy. Left obturator lymph nodes (4 of 6) contain involvement. Right pelvic lymph nodes (0 of 7) are negative. Right obturator lymph node (1 of 1) shows involvement. Right and left common periaortic lymph nodes (0 of 2 and 0 of 2 respectively) do not show malignancy. Omental biopsy reveals no carcinoma.\n\nMicroscopic evaluation confirms invasive growth into the outer one-third of the myometrium. The tumor exhibits a solid growth pattern. Sections from the anterior and posterior cervix, lower uterine segment, and endomyometrium with tumor were submitted for analysis. Additional findings include chronic inflammation and focal parakeratosis in the cervix, mild hydrosalpinx on the left fallopian tube, and multiple epithelial inclusion glands in both ovaries. No histopathologic abnormalities are found in the right fallopian tube.\n\nIntraoperative examination described a tumor filling the endometrial cavity and invading through the myometrium. Gross findings included areas of firmness and discoloration on the serosal surface consistent with possible malignant involvement. Deeper sectioning and cytokeratin staining of the right common periaortic lymph node showed no evidence of carcinoma."} +{"pid": "TCGA-49-AARO", "report": "The left upper lobe specimen measured 18.0 x 8.2 x 3.3 cm and weighed 163 grams. A mass measuring 4.5 cm in greatest dimension was identified in the epical half on the lateral aspect of the lobe. The mass had an irregular infiltrating border and involved the pleural surface, causing puckering measuring 2.5 cm in greatest dimension. On cut section, the lesion appeared tan-white and gray with a marbleized appearance. The tumor was located approximately 0.5 cm from the hilar bronchial margin and approached the epical staple line, which measured 4.5 cm in length. An inferior staple line measured 6.0 cm in length. The adjacent lung demonstrated centrilobular emphysema and multiple foci of atypical alveolar hyperplasia.\n\nHistologic examination revealed that all surgical margins\u2014including bronchial, vascular, and staple margins\u2014were free of involvement. Sections included representative tissue from hilar lymph nodes and areas near the tumor. Two staple lines were identified, and the tumor approached within 0.5 cm of the epical staple line.\n\nLymph node dissections were submitted for evaluation. Six lymph nodes and associated fibroadipose tissue from station 5 showed no evidence of tumor involvement. One lymph node from station 7 was similarly negative for tumor. \n\nSerial sectioning of the specimen revealed no additional lesions beyond the described mass. Multiple representative sections were submitted for analysis."} +{"pid": "TCGA-B0-5100", "report": "The right kidney measured 430 grams and was submitted in entirety. The specimen showed multiple tumor nodules. The dominant mass measured 8.0 cm, with an additional mass measuring 4.0 cm, and several smaller cystic lesions ranging from 0.2 to 0.3 cm. Both larger nodules extended into the renal capsule but did not penetrate through it. The nuclear grade was Fuhrman grade 3. Tumor was noted extending into the renal vein. Margins at the hilar vessels and ureter were free of tumor involvement. The renal pelvis was uninvolved. Pathologic staging was determined as T3NXMX. The adrenal gland showed no evidence of tumor involvement. Additional findings included chronic interstitial nephritis and severe arterio- and arteriolosclerosis."} +{"pid": "TCGA-X7-A8M6", "report": "The specimen consists of a thymectomy specimen weighing 231.0 grams and measuring 14.2 x 14.0 x 2.8 cm. It includes a gray-yellow, lobular fatty tissue with an area of palpable induration measuring 6.5 x 6.5 x 3.2 cm. The cut surface of the non-indurated region is predominantly fatty with minimal interspersed fibrous tissue. The indurated area reveals a variegated appearance with focal fish-flesh consistency, yellow areas, and focal calcifications. Fibrosis is present, and the indurated region appears to extend to the inked margin. No identifiable normal thymic tissue is observed grossly.\n\nHistologically, the lesion is an encapsulated, lobulated mass composed primarily of small lymphocytes and large epithelial cells with vesicular nuclei and abundant eosinophilic cytoplasm. Scattered foci of similar morphology are identified within the adjacent adipose tissue. There is focal necrosis with surrounding fibrohistiocytic reaction and hemosiderin deposition. Sections submitted for microscopic evaluation include representative portions of the mass and a section of morphologically unremarkable fat."} +{"pid": "TCGA-DU-7013", "report": "PATHOLOGIC REPORT. BRAIN, TEMPORAL LOBE, EXCISIONAL BIOPSIES: The specimen consists of multiple fragments measuring up to 3.5 cm in greatest dimension. Gross examination reveals areas of hemorrhage and soft gray tissue. Microscopically, there is a glial neoplastic proliferation characterized by anaplastic elongated nuclei within a fibrillary background. Occasional mitotic figures are identified. Capillary-type microvasculature with interanastomosing vessels is present, with focal microvascular cellular proliferation. Necrosis is absent in the initial sections. Immunostaining demonstrates glial fibrillary background with MIB-1 labeling indices of 12% and 16% in more active areas. Additional tissue submitted later confirms diffuse and extensive infiltration by a similar neoplastic process. Microvascular calcification and a prominent microvascular network are noted. Focal areas of tumor necrosis associated with microvascular proliferation are also present. The neoplasm exhibits high histological grade features with a complex microvascular pattern suggesting possible oligodendroglial component."} +{"pid": "TCGA-DX-AB2G", "report": "The submitted specimens include an omental mass and a right-sided radical resection specimen involving the kidney, adrenal gland, and a large soft tissue mass. The omental mass measured 4.0 x 2.6 x 1.3 cm and was composed of mature adipose tissue without significant atypia. The radical resection specimen contained a large mass measuring 36.0 x 30.0 x 14.5 cm along with a smaller adjacent mass measuring 4.0 cm. The larger mass demonstrated a multi-lobulated tan-yellow cut surface with areas of necrosis, fibrosis, and calcification, comprising approximately 20% of the tumor volume. A thin fibrous membrane covered the tumor, representing the surgical margin. The tumor was found to encase the kidney and adrenal gland, although gross invasion into the kidney was not observed. The kidney measured 11.0 x 6.0 x 5.0 cm and was attached to a ureter measuring 18.0 cm in length and 0.4 cm in diameter; both renal vascular and ureteral margins were free of tumor involvement. The adrenal gland, measuring 6.0 x 2.0 x 1.5 cm, was attached to the main tumor mass and showed involvement by a separate solid tan-yellow mass measuring 4.0 cm. Histologically, two distinct components were identified within the larger mass, one resembling a more differentiated subtype and the other showing a dedifferentiated component accounting for approximately 30% of the tumor volume, exhibiting morphology consistent with a high-grade undifferentiated pleomorphic type. Multiple tissue blocks were submitted for microscopic evaluation, including representative sections from the omental mass, main tumor, adrenal gland, kidney, adjacent tumor nodule, and margins."} +{"pid": "TCGA-VQ-A924", "report": "The specimen from the antropylloric region of the stomach measured 5.0 x 4.9 cm and demonstrated invasion through the gastric wall to involve the serosa and adjacent non-peritonized fat tissue along the lesser curvature. The lesion exhibited moderately differentiated tubular architecture. Adjacent mucosa showed changes consistent with inactive superficial chronic gastritis. No angiolymphatic or perineural invasion was identified. All surgical margins, including the esophageal margin, were free of neoplastic involvement. \n\nExamination of the omentum, hepatogastric ligament, and all lymph node groups\u2014including right and left paracardic, lesser curvature, left and right gastroepiploic, infrapyloric, suprapyloric, left gastric artery, anterior hepatic artery, and celiac regions\u2014revealed no evidence of neoplastic involvement. One lymph node was identified in the right paracardic region, five at the lesser curvature, two at left gastroepiploic, three at right gastroepiploic, five at infrapyloric, seven at left gastric artery, two at anterior hepatic artery, and two at the celiac region, all without involvement. Suprapyloric dissection did not yield any lymph nodes. Other specimens consisted of fibrous and adipose tissue without significant findings."} +{"pid": "TCGA-FK-A3SH", "report": "Surgical pathology report. First specimen collected on [date]. Final diagnoses:\n\n1. Pretracheal lymph node (biopsy): One lymph node, negative for tumor.\n2. Rule in parathyroid (biopsy): Parathyroid tissue, 30.0 mg.\n\n3. Thyroid (total thyroidectomy): Specimen type is total thyroidectomy. Tumor site involved the right and left lobes. Histologic type shows a neoplasm with features consistent with papillary morphology. The largest nodule measured 3.0 cm in greatest dimension on the left side, with an additional focus measuring 0.4 cm on the right. The process is multifocal. Evaluation of all lymph nodes showed metastatic involvement in two of eight nodes. Staging assessment revealed the primary tumor to be pT2: greater than 2.0 cm but less than 4.0 cm, confined to the thyroid. Regional lymph node involvement is classified as pN1a: metastasis identified in Level VI nodes, including pretracheal, paratracheal, and prelaryngeal/Delphian regions. Distant metastasis could not be assessed (pMx). Surgical margins are free of involvement. Evidence of vascular invasion, including venous and lymphatic channels, was present. Additional findings include nodular hyperplasia and benign thymic tissue identified within the specimen.\n\nLeft central neck dissection revealed metastatic involvement in a papillary neoplasm, with the largest focus measuring 0.4 cm in two of four lymph nodes.\n\nFinal report signed on [date].\n\nUnofficial lab results\u2014do not file in patient chart. Contact medical records for official chart copy. Unless otherwise noted, all lab results performed at [facility name]."} +{"pid": "TCGA-BH-A0E0", "report": "The specimen consists of a modified radical mastectomy. The tumor measures 5.5 cm in greatest dimension and is located in the upper/outer and lower/outer quadrants. Extensive intratumoral lymphocytic infiltration is noted. A component of high nuclear grade in situ disease, exhibiting solid and cribriform patterns with comedo necrosis, is admixed with the invasive lesion and accounts for approximately 25% of the tumor mass. Angiolymphatic invasion is present.\n\nMargins are negative; the closest margin is the posterior aspect, measuring 0.6 cm from the tumor. Biopsy site changes are identified. Immunohistochemical analysis demonstrates absence of estrogen and progesterone receptor expression, and no significant HER2/neu overexpression (1+ by immunohistochemistry). Atypical ductal epithelial hyperplasia is also present.\n\nLymph node examination reveals metastatic involvement in 10 of 21 nodes, including one with extracapsular extension. The largest nodal metastasis measures 28 mm in diameter. Fibrocystic changes with ductal epithelial hyperplasia and apocrine metaplasia are present in the background tissue.\n\nHistologic grading using the Nottingham system yields a total score of 9 (nuclear grade 3, tubule formation 3, mitotic activity 3), corresponding to a high-grade morphology. The tumor aggregates into a single dominant focus measuring 5.6 cm overall. No Paget\u2019s disease of the nipple is identified. Non-sentinel lymph node status is assessed by hematoxylin and eosin staining.\n\nPathologic staging reflects no residual tumor at margins, with pNX and pMX assigned for nodal and distant staging, respectively. Additional findings include ductal hyperplasia and fibrocystic disease."} +{"pid": "TCGA-C5-A1M8", "report": "The surgical pathology report describes findings from a radical hysterectomy specimen. A lesion was identified with a maximum depth of invasion measuring 0.9 cm, within a cervical thickness of 1.2 cm. All surgical margins were free of involvement. Additional findings include proliferative endometrium, adenomyosis, endosalpingiosis, and serosal surface adhesions. One lymph node was examined and showed no evidence of malignancy.\n\nThe right ovary and fallopian tube, removed during salpingo-oophorectomy, demonstrated tubo-ovarian adhesions and hydrosalpinx. The left fallopian tube, removed during salpingectomy, also showed endosalpingiosis.\n\nLymph nodes excised from multiple locations, including the external iliac, obturator, and periaortic regions on both sides, were all negative for malignancy. Specifically, all lymph nodes evaluated showed no evidence of metastatic disease."} +{"pid": "TCGA-MP-A4TK", "report": "REWRITTEN REPORT: The specimen includes a right middle lobe lung measuring 4.8 x 1.2 x 1 cm and a right lower lobe lung with a portion of the middle lobe and posterior segment of the right upper lobe, weighing 250 grams. Also included are superior mediastinal (right lower paratracheal), inferior mediastinal (subcarinal, right lower paratracheal), and N1 (interlobar) lymph nodes, labeled A1, A2, A3, A4, B1, B2, B3, B4, B5, B6, B7, B8, B9, B10.\n\nA mass measuring 3.5 x 3.5 x 3 cm was identified in the right lower lobe, centered on the interlobar fissure and involving both upper and lower lobes. Histological evaluation revealed high-grade cellular atypia with sarcomatoid features. All examined lymph nodes from the N1 region showed similar findings. No tumor involvement was identified at the bronchial margin or in three intrapulmonary peribronchial lymph nodes. In addition, a separate atypical lymphoplasmacytic infiltrate was noted in the right middle lobe wedge specimen.\n\nFurther immunohistochemical analysis of this infiltrate demonstrated a mixed population of CD20-positive B-lymphocytes and CD3-positive T-lymphocytes arranged in a pattern consistent with reactive hyperplasia. Immunoglobulin light chain staining showed a polytypic pattern, supporting the presence of mature plasma cells without monoclonal restriction. Lymph nodes from the superior and inferior mediastinum were negative for any abnormal cellular infiltration."} +{"pid": "TCGA-85-8584", "report": "Gross Description: A lobe was received with the lobar bronchus obstructed by a parahilar mass measuring 4 x 4 x 3.5 cm in diameter. The lesion appeared well-defined and exhibited prominent anthracotic pigmentation.\n\nMicroscopic Evaluation: Tumor fragments showed a bronchopulmonary neoplasm composed of monomorphic cells with nuclear atypia and areas of necrosis. A papillary growth pattern was observed, along with a fibrous and inflammatory stromal reaction. One lymph node from station X displayed neoplastic infiltration with small foci of necrosis. No metastatic involvement was identified in the interlobar lymph node.\n\nPathologic Features: The specimen was a lobectomy. The tumor measured 4 x 4 x 3.5 cm and was located in the lung. Histologic assessment revealed moderately differentiated features. Lymphatic invasion was present. Of the two regional lymph nodes examined, one was positive for neoplastic involvement. Other pathologic features, including vascular invasion, margin status, and response to preoperative treatment, were not specified. No additional findings were reported. The tumor was located in the right upper lobe."} +{"pid": "TCGA-B5-A1MX", "report": "The specimen from the uterus and cervix is a 260-gram, 11.5 x 6.5 x 4 cm uterus with an opened configuration. The cervix appears smooth and glistening without abnormalities. The endometrium measures 5.8 x 5 cm and contains a diffuse, exophytic, friable tan-white lesion involving over 90% of the cavity. The lesion is located 4 cm from the anterior cervix and 4.5 cm from the posterior cervix. It extends 4.5 cm into the myometrium, reaching the serosal surface but not penetrating beyond it. On sectioning, the lesion appears fleshy with tan-yellow coloration and areas of hemorrhage and necrosis. A small focus (0.5 x 0.5 cm) of possibly uninvolved endometrium is identified anteriorly. No other abnormalities are noted in the myometrium.\n\nLymph node specimens were submitted from left and right pelvic regions, right and left obturator areas, right aortic, and left aortic locations. These specimens ranged in size from 0.5 to 2.4 cm. Histologic examination revealed no evidence of malignancy in any of these lymph nodes. One lymph node from the left obturator region demonstrated endosalpingiosis but was otherwise negative for malignant cells.\n\nMicroscopic evaluation of the uterine specimen revealed a high-grade carcinoma with a solid growth pattern and extensive necrosis. Focal pseudorosette and pseudoglandular structures were observed. Immunohistochemical staining showed strong and diffuse positivity for EMA, focal positivity for CK7 and CD99, and no reactivity for chromogranin or synaptophysin. Mucicarmine staining was negative.\n\nMargins of the specimen were free of involvement. Lymphatic and vascular invasion was present. Adjacent endometrial tissue showed complex atypical hyperplasia. The cervix showed no diagnostic abnormalities. Bilateral salpingo-oophorectomy specimens showed no significant pathology apart from serosal adhesions on the ovaries and findings consistent with prior tubal ligation in both fallopian tubes.\n\nStaging according to AJCC 7th edition criteria was determined as pT1b pNO pMX."} +{"pid": "TCGA-66-2785", "report": "The examined specimen included a left upper lobe measuring 19 x 17 x 6 cm, with a resection plane located 0.4 cm proximal to the bifurcation of the bronchus leading to the apical bronchi. A staple suture line extended cranially for 6 cm and dorsally for 6.5 cm from the hilus. Two hilar nodes were noted, measuring 1.4 cm and 2.5 cm. The visceral pleura showed patchy and reticulate blackish pigmentation. In the S3 segment, there was a paracentral irregularly protruding area approximately 5 cm in size. Beneath this region, a moderately firm, pale brown to whitish lesion with areas of pale yellow softening was observed. The lesion measured up to 5.2 cm in maximum dimension and had an arcuate shape, nearly completely obstructing B3 with endobronchial extension within 0.1 cm of the B3 bifurcation. Surrounding lung tissue showed areas of vitreous and compacted yellow-brown parenchyma, with additional patches of blackish pigmentation elsewhere.\n\nLymph node stations examined included: lobar (station 12) lingula (2.3 cm), interlobar (station 11) (1 cm), hilar (station 10) left (1.8 cm and 2 cm), paraesophageal (station 8) left (1.5 cm), low paratracheal (station 4) left (0.3 cm), prevascular and retrotracheal (station 3) left (1.4 cm), high paratracheal (station 2) left (1.3 cm), subcarinal (station 7) (2.5 cm), paraaortic (station 6) (1.6 cm), subaortic (station 5) (1 cm), and right hilar (station 10) (0.7 cm). All lymph nodes showed reactive changes and anthracotic pigment deposits, but no tumor involvement.\n\nHistological evaluation included sections from the tumor involving B3, adjacent pleura, surrounding parenchyma, bronchial and vascular resection margins, and hilar nodes. Additional material from other lymph node stations was also examined. Stains used included Elastica-van Gieson and PAS with diastase digestion. Microscopic findings revealed features consistent with poorly differentiated large-cell and polymorphocellular components, with focal gigantocellular elements. Focal glandular differentiation and mucin inclusions were also present. The tumor infiltrated the paracentral visceral pleura, which was thickened by fibrosis, and extended endobronchially close to the B3 bifurcation. Resection margins of the bronchus and vessels, as well as all identified lymph nodes, were free of tumor. No evidence of adenosquamous carcinoma was found. Clinical staging based on findings was pT2 pN0 pMx R0, stage IB."} +{"pid": "TCGA-4V-A9QX", "report": "The specimen consists of a resected thymic mass weighing 1208 g and measuring 19 x 17 x 8 cm, along with a pulmonary resection of the lingula measuring 8 x 5 x 2 cm. The main mass is lobulated, with a yellowish-white cut surface, areas of necrosis, and remodeling. A small yellowish nodule is also present. A right laterotracheal lymph node, 1.5 cm in diameter, is noted.\n\nMicroscopic evaluation of the thymectomy reveals a lobulated tumor composed primarily of fusiform epithelial cells arranged in small bundles and clusters. There is a significant lymphocytic component intermixed with the epithelial cells. Areas of fibrosis, inflammation, and foamy histiocytes are present. Tumor necrosis is evident, along with perivascular clear spaces. The tumor demonstrates an infiltrative growth pattern invading the lung parenchyma. Resection margins are microscopically free of tumor. Some regions show a higher density of epithelial cells with fewer associated lymphocytes. Immunohistochemical staining shows the epithelial cells are positive for cytokeratin KL1 and focally positive for CD20, but negative for CD5 and CD117.\n\nThe examined lymph node does not show any histological evidence of malignancy."} +{"pid": "TCGA-BG-A0M6", "report": "The right adnexum specimen includes an ovary with a small inclusion cyst and an unremarkable fallopian tube. The left adnexum specimen includes an ovary containing a metastatic lesion. The uterus weighs 276 grams and demonstrates a tumor involving the endometrium with a papillary growth pattern. The cells show poor differentiation based on nuclear features. The tumor measures 6.5 cm in maximum dimension and involves 100% of the endometrial surface. It extends through the full thickness of the myometrium posteriorly without reaching the serosal surface. Invasion into blood or lymphatic vessels is present. A benign smooth muscle tumor measuring 4.5 cm is also identified.\n\nThe cervix shows involvement by the same neoplasm, extending into endocervical glands and deeply into the cervical stroma. The tumor reaches the deep margin of resection at the posterior aspect. The ectocervical margin appears unaffected.\n\nExamination of the omentum, multiple biopsies of abdominal and pelvic peritoneum, and appendix reveals no abnormal growths. Lymph node dissections were performed at various locations. Of the 21 lymph nodes examined, 8 contain metastatic involvement. Positive nodes include those from the left common iliac, left para-aortic, and right para-aortic regions. Extracapsular extension is noted in one left common iliac lymph node and one right pelvic lymph node.\n\nStaging indicates involvement of the uterus with deep myometrial invasion and cervical extension. Positive lymph nodes are documented bilaterally in pelvic and para-aortic regions. No distant metastases are identified."} +{"pid": "TCGA-A5-A2K5", "report": "A fragment of soft tissue from the omental adhesion showed fibrous adhesion without evidence of malignancy. A hernia sac specimen displayed active chronic inflammation, vascular ectasia, hemosiderin-laden macrophages, fibrosis, and reactive mesothelial proliferation, with no signs of metastatic disease. Two partial omentectomy specimens revealed chronic inflammation, adhesions, and reactive mesothelial changes, without any malignant findings.\n\nBiopsy of the left pelvic sidewall showed chronic inflammation, reactive lymphoid aggregates, adhesions, and reactive mesothelial proliferation, with no evidence of carcinoma. The left fallopian tube and ovary showed atrophic changes, stromal hyperplasia, and inflammatory changes including acute and chronic salpingitis, segmental pyosalpinx, and vascular ectasia. There were also serosal adhesions, hemorrhages, hemosiderin-laden macrophages, and reactive mesothelial proliferation. Multiple paratubal cystic structures were noted. The right fallopian tube and ovary similarly showed atrophic changes and cortical stromal hyperplasia. The fallopian tube exhibited inflammation, epithelial hyperplasia, vascular ectasia, and multiple adhesions with associated inflammatory and mesothelial changes. Paratubal mesothelial cysts and endosalpingiosis were also present.\n\nThe hysterectomy specimen measured 10.6 cm in length, with a uterine fundus to corpus involvement by a polypoid exophytic mass measuring 6.5 x 6.2 cm. The tumor extended into the lower uterine segment and demonstrated myometrial invasion involving less than 50% of the wall thickness. Adenomyosis was focally involved, and lymphovascular invasion was present. Necrosis was prominent. The cervix was free of tumor involvement. Two leiomyomas were identified: one larger (3.2 cm) with hydropic features and partial hyalinization, and one smaller (1.1 cm) that was hyalinized and partially calcified. A third small leiomyoma (0.7 cm) was found in the upper posterior endocervix. The endometrium was inactive/atrophic to weakly proliferative. Cervical findings included atrophic squamous changes, chronic and mild acute inflammation, reserve cell hyperplasia, squamous metaplasia, endocervical tunnel clusters, and nabothian cysts.\n\nLymph node evaluations from the left and right pelvic regions, as well as the right common iliac region, all showed fibrosis and calcifications without evidence of metastatic carcinoma. No lymph node was identified in the left common iliac specimen. All surgical margins were free of tumor. Based on these findings, the pathologic staging was determined as pT1a, pN0, FIGO stage IA, according to the AJCC 7th edition (2010)."} +{"pid": "TCGA-96-8170", "report": "The specimen consists of three parts: a segment of the right lower lobe of the lung, a segment of the fifth rib on the right side, and a group of lymph nodes from station 12. The lung specimen was obtained via segmentectomy and measured 9 x 5.5 x 3.5 cm. A nodule measuring 1.5 x 1.4 x 1.2 cm was identified within the lung tissue, located 1.5 cm beneath the pleural surface and 2 cm from the bronchial resection margin. The nodule was moderately differentiated in morphology and surrounded by lung tissue without evidence of visceral pleural invasion. Both the bronchial and vascular margins were free of involvement. Lymphovascular invasion was present.\n\nOne hilar lymph node was found to contain metastatic cells. The rib specimen consisted of a bony segment measuring 10.5 x 1.0 x 0.5 cm with no remarkable findings; bone and marrow showed normal trilineage hematopoiesis. The lymph node specimen included five fragments ranging from 0.4 to 1.0 cm in size. Of these, two out of four lymph nodes contained metastatic cells.\n\nAdditional findings in the lung tissue included respiratory bronchiolitis, focal organizing pneumonia, and metaplastic ossification. No extranodal extension was observed in the lymph nodes. Based on the pathological staging criteria, the primary tumor was classified as pT1a, indicating a tumor no larger than 2 cm without more proximal bronchoscopic invasion. Regional lymph node involvement was categorized as pN1 due to metastasis in ipsilateral hilar and intrapulmonary lymph nodes."} +{"pid": "TCGA-A3-A8OV", "report": "The specimen consists of a 3.5 x 3.5 x 2 cm portion of renal cortical tissue with a small amount of adherent perirenal fat. A well-circumscribed golden yellow lobulated mass measuring 1.8 cm in maximum dimension was identified, located 0.2 cm from the renal parenchymal margin. Histologic evaluation revealed cells arranged in nests and cords, with abundant clear cytoplasm and well-defined cell borders. Nuclear features were consistent with moderate atypia, with nuclei showing uniformity in size and shape, and inconspicuous nucleoli. Mitotic activity was not increased. The tumor was unifocal, limited to the kidney, with no evidence of sarcomatoid differentiation or tumor necrosis. Lymphovascular invasion was not identified. Margins were assessed and showed that the tumor focally extends to the renal parenchymal margin. Pathologic staging indicates the primary tumor is pT1, with no regional lymph node or distant metastasis assessment possible (pNX, pMX), resulting in an overall pathologic stage of I. Margin status is R1."} +{"pid": "TCGA-E2-A14P", "report": "The surgical specimens include right axillary contents, a right breast lumpectomy, and a right breast superior margin. The axillary specimen consists of adipose tissue containing multiple enlarged lymph nodes ranging in size from 0.3 cm to 3.5 cm. Several lymph nodes were submitted for histologic evaluation.\n\nThe lumpectomy specimen weighs 226 grams and measures 15 x 10 x 4 cm. A well-defined mass measuring 3.0 x 2.5 x 1.7 cm is identified within the tissue. This lesion is located 1.5 cm from the deep margin and 2.0 cm from the anterior margin. A second smaller nodule measuring 0.8 x 0.7 x 0.6 cm is present approximately 0.6 cm medial to the primary lesion. This satellite lesion is within less than 1.0 cm of several margins and is 0.6 cm from the medial margin. The surrounding tissue consists primarily of adipose with interspersed fibrous elements. Margins of resection appear free of abnormal cells.\n\nThe superior margin specimen includes fibrofatty tissue measuring 9.0 x 3.0 x 1.5 cm. Upon histologic examination, no abnormal cellular findings are noted.\n\nHistologic grading indicates a high-grade cellular pattern. Vascular or lymphatic invasion is present. Additional findings include intraductal changes involving a small portion of the tissue, with areas showing solid and cribriform patterns. These changes are observed both in proximity to and separate from the main lesion.\n\nImmunohistochemical analysis shows no expression of estrogen or progesterone receptors. HER2 testing demonstrates strong membrane staining in all tumor cells with an intensity score of 3+. \n\nStaging assessment indicates a primary lesion size of 3 cm with multifocal involvement. Axillary lymph node evaluation reveals involvement in 10 out of 24 nodes with extranodal extension. Based on these findings, the pathological stage reflects advanced regional involvement."} +{"pid": "TCGA-AF-A56N", "report": "A supracervical hysterectomy specimen including the bilateral ovaries and fallopian tubes was received. The endometrium appeared benign and inactive. Multiple benign leiomyomata were identified within the myometrium, with sizes ranging from 0.1 cm to 5.5 cm. The largest subserosal fibroid measured 4.5 cm. No pathological abnormalities were noted in the serosa, fallopian tubes, or ovaries. The ovaries showed cystic follicles and minimal surface adhesions. The endometrial thickness averaged 0.2 cm, and a cystic area measuring 1.2 cm was identified beneath the endometrium, located 2.8 cm from the amputation site.\n\nA separate excision of the rectum and sigmoid colon measured 26.5 cm in length and was partially covered with yellow lobular fat and smooth serosa. A retroperitoneal reflection was identified 8.5 cm from the distal end. An exophytic tumor measuring 5.5 x 4.8 x 0.8 cm was observed, located 1.9 cm from the distal margin. Microscopic evaluation revealed invasion into perirectal/colonic fat (pT3), limited to a single block (block B3). No vascular invasion was identified. Resection margins, including proximal, distal, and circumferential, were all negative for malignancy. The tumor was at least 2.5 cm from the radial margin. There was surface ulceration of the lesion with associated acute and chronic inflammation, including Crohn\u2019s-like chronic inflammation deep to the tumor. Thirty-three lymph nodes were examined and none contained metastatic disease (pN0). Molecular testing for MSI was ordered on block B2.\n\nAn excised appendix was unremarkable, showing only mucosal lymphoid hyperplasia without other abnormalities. The wall was intact and no discrete lesions were identified."} +{"pid": "TCGA-F6-A8O3", "report": "The tumor is located in the frontal lobe of the brain and measures 6x5x5 cm. It has a soft consistency with a brown-white surface and a moderately defined margin. Microscopic examination reveals increased cellularity with a homogeneous appearance. The nuclei are round, irregular, and hyperchromatic, with visible mitotic figures. The tumor cells have moderate amounts of eosinophilic or clear cytoplasm surrounding central spherical nuclei. Tumor tissue is seen intervening among thin vascular structures and extends into adjacent benign brain tissue. Areas of necrosis are present within the tumor. Vascular hyperplasia is also observed."} +{"pid": "TCGA-FE-A238", "report": "The specimen was a total thyroidectomy. The main lesion was located in the right thyroid lobe and measured 3.9 x 2.7 x 2.0 cm. Two additional smaller lesions were identified: one in the right lobe measuring 0.5 cm in greatest dimension and another in the left lobe measuring 0.2 cm in greatest dimension. Histologic evaluation showed features consistent with a specific type of cellular morphology. The tumor was well-differentiated and demonstrated lymphatic/vascular invasion as well as extensive capsular invasion. The tumor extended beyond the thyroid capsule into adjacent soft tissue and reached the inked outer surface of the specimen. No invasion of the thyroid cartilage or hyoid bone was observed. No lymph nodes were identified in the specimen. No additional significant pathologic findings were noted. The staging classification was pT3NxMx. Focally, areas with features resembling a variant were present. A Delphian lymph node biopsy showed no evidence of abnormal cells. Intraoperative frozen sections of both the lymph node and thyroid were performed and confirmed the findings. The gross description included a thyroid gland weighing 17 grams with multiple nodules as described. All relevant sections were submitted for analysis."} +{"pid": "TCGA-DS-A0VK", "report": "The surgical specimen includes a radical hysterectomy with an attached vaginal cuff and paracervical/paracorporal parametrial soft tissues. The cervix is largely replaced by a tumor, which is circumferential and measures approximately 3.5 cm in diameter. The tumor involves a segment of tissue approximately 3.5 cm in length, extending from the lower uterine segment into the upper vaginal wall. Maximum thickness of the tumor is about 2.0 cm. Invasion through the full thickness of the cervical wall is present, with a transmural defect measuring 2.5 x 1.0 cm located in the anterior endocervix.\n\nTumor extends into the paracervical soft tissues and reaches the margin of these tissues. Lymphatic invasion is identified within the lower uterine segment, cervix, vaginal cuff, and paracervical soft tissues. Vascular invasion is also present in the cervix. The tumor invades the vaginal cuff wall both anteriorly and posteriorly, with proximity to the deep margin of the anterior vaginal cuff less than 0.5 mm, about 2 mm from the inferior surgical margin, and within 5 mm of the posterior vaginal cuff.\n\nInvolvement of the anterior lower uterine segment is nearly transmural, while the posterior involvement reaches about 50% of the wall thickness. No involvement of the uterine corpus or fundus is observed. The mucosal surface of the tumor is extensively ulcerated, and the endocervical canal is nearly completely obstructed. Inflammatory and fibrosing stromal reactions are present, as well as tumor-associated necrosis.\n\nBenign findings include a non-phasic endometrium with features of weak proliferation and some secretory changes, a subserosal leiomyoma in the posterior lower uterine segment, and endosalpingiosis.\n\nLymph node evaluation includes right pelvic lymph nodes, one of which shows subtotal replacement by malignant cells. Remaining lymph nodes from the left and right periaortic and left pelvic regions are reactive without evidence of metastasis.\n\nAdditional special studies were performed, including H&E staining, Masson's trichrome, and mucicarmine stains."} +{"pid": "TCGA-G7-7502", "report": "The specimen consists of a left partial nephrectomy and a tumor bed biopsy. The tumor measured 6.2 x 6 x 5.3 cm and was found to be limited to the kidney without vascular or perinephric invasion. Histologic evaluation showed cells with slightly irregular nuclei and evident nucleoli. The surgical margin was focally positive with a distance of 1 mm. No regional lymph nodes were sampled. The pathological stage is pT1b, with no evidence of malignancy in the tumor bed biopsy."} +{"pid": "TCGA-J4-A83J", "report": "The submitted specimens include lymph node tissue and a prostate gland. Lymph node fragments from the left side were examined, showing reactive changes without evidence of carcinoma. The prostate specimen was obtained via radical prostatectomy, weighing 30 grams and measuring 4 x 3.5 x 3.0 cm. Histologic evaluation revealed cellular atypia with a Gleason score of 3 + 4 = 7/10. The extent of involvement was estimated at 30\u201350% of the tissue. A dominant nodule measuring 1.1 cm was identified. No treatment effect was observed. There was no evidence of small vessel lymphatic invasion, but perineural involvement was present. Seminal vesicle sections did not show any abnormal cellular infiltration.\n\nMargins were largely clear, though a small focus of atypical cells was found at the inked margin of the right prostatic apex. Additionally, tumor cells were found in close proximity (less than 0.1 cm) to the left and right bladder neck margins; however, the final bladder neck margin specimen did not show any involvement. The positive margin appeared to be affected by an iatrogenic incision, and there was no evidence of extraprostatic extension elsewhere.\n\nSections of the bladder neck showed only smooth muscle and non-neoplastic prostate tissue. Multiple blocks were processed for histologic analysis, including the distal urethral margin, anterior and posterior lobes, bladder margin, and seminal vesicles. Clinical correlation was recommended for further assessment."} +{"pid": "TCGA-A6-6648", "report": "The specimen includes a segment of colon measuring 21 cm in length with attached omentum measuring 25 x 13 x 4 cm. The omentum showed no gross lesions. A lesion measuring 2.7 x 2.7 cm was identified and located equidistant from both proximal and distal ends (5.7 cm from each). The surrounding mucosa appeared normal with intact folds and average circumference of 6.5 cm. The lesion appeared to invade into the muscularis propria, approaching within 2 cm of the deep margin. No vascular invasion was observed. Lymph nodes were identified in the pericolonic fat and sampled. All luminal and radial margins were free of tumor involvement. Twenty-one lymph nodes were examined microscopically and showed no evidence of metastasis. The background colonic mucosa was unremarkable. The liver biopsy consisted of multiple red-brown tissue fragments measuring 1.2 x 0.4 cm in aggregate. Microscopic evaluation revealed abnormal cells present in the liver tissue. The surrounding hepatic parenchyma showed reactive changes and mild steatosis. The omentum was also negative for any abnormal cellular infiltration."} +{"pid": "TCGA-AO-A0J7", "report": "The clinical history included a lesion identified on core biopsy at 11:00 in the left breast and a separate lesion at 5:00. The patient underwent a left total mastectomy with sentinel lymph node biopsy and possible axillary lymph node dissection, along with immediate reconstruction.\n\nSpecimens submitted included three lymph nodes (two sentinel and one non-sentinel) from the left axilla, and the left mastectomy specimen.\n\nExamination of the mastectomy specimen revealed two invasive foci measuring 28 mm and 2 mm, respectively. In addition, a separate 2.5 mm focus of mucinous differentiation was identified. The invasive components were present in both the upper inner and lower inner quadrants. Invasive cells were also noted within the nipple stroma and dermal lymphatic channels of the skin. Ductal carcinoma in situ (DCIS), high nuclear grade, solid and papillary architecture, was identified and located in both the upper inner and lower inner quadrants. Lobular neoplasia (classic LCIS) was also present.\n\nMargins were assessed; the closest distance of invasive tumor to the deep margin was 36 mm, and DCIS was also 36 mm from the nearest margin. Extensive benign breast tissue changes included fibrocystic alterations, apocrine metaplasia, stromal fibrosis, and columnar cell change. Atypical ductal hyperplasia was present near the biopsy site.\n\nImmunohistochemical staining of the invasive component showed positivity for estrogen receptor (90% strong staining), negativity for progesterone receptor, and absence of HER2 overexpression. WT1 staining was negative for the invasive ductal areas but positive for the mucinous component. E-cadherin staining was positive, supporting ductal differentiation.\n\nLymph node evaluation revealed involvement in both sentinel nodes and the single non-sentinel node examined. Sentinel node #1 contained a metastasis measuring 0.4 mm, while sentinel node #2 had a metastatic deposit of 3 mm with extracapsular extension less than 2 mm. The non-sentinel node also contained metastatic involvement. Additionally, an intramammary lymph node was nearly entirely replaced by metastatic disease, measuring 6 mm.\n\nAdditional microscopic findings included calcifications within both benign tissue and invasive areas, as well as lymphovascular invasion. Skin margins were free of tumor involvement.\n\nMultiple sections were taken from all relevant anatomical regions and submitted for histologic evaluation. Controls for immunostaining were appropriate and confirmed accuracy of ER, PR, and HER2 results according to ASCO/CAP guidelines."} +{"pid": "TCGA-BF-AAP6", "report": "The specimen consists of a skin and fat flap measuring 15x8 cm, obtained from the right leg. A dark-brown mushroom-shaped lesion is present, measuring 4x3 cm in width and 2 cm in thickness. Microscopic examination reveals epithelioid tumor cells arranged in a mushroom-shaped growth pattern with involvement of the skin. Ulceration is noted. The tumor thickness measures 20 mm by Breslow criteria, and Clark level IV invasion is observed. Lymph node involvement is present, with no evidence of distant metastasis. The tumor is staged as stage III, T4, N2, M0."} +{"pid": "TCGA-C5-A2LT", "report": "The patient is a woman who underwent pelvic lymph node dissection and radical hysterectomy. Specimens received included multiple lymph nodes from various anatomical regions and a uterus with cervix.\n\nLymph nodes evaluated included four from the left external iliac region (all unremarkable), three from the left obturator region (all unremarkable), thirteen from the right pelvic region (all unremarkable), two from the right common/periaortic region (both unremarkable), and three from the left common/periaortic region (all unremarkable). Additionally, six parametrial lymph nodes were examined and showed no abnormal findings. In total, 31 regional lymph nodes were assessed and none demonstrated evidence of malignancy.\n\nThe uterus with cervix weighed 83.4 grams and measured 8 x 5 x 3.5 cm. The cervix contained an ulcerated area measuring 1.9 x 1.5 x 1 cm, surrounded by a tan firm region measuring 2.5 x 1 cm. Histologically, the tumor invaded to a maximum depth of 12 mm within the cervical tissue, which had a total thickness of 13 mm. The tumor exhibited focal lymphatic invasion and was poorly differentiated based on nuclear grading. There was no extension through the full thickness of the cervix into adjacent parametrial tissues. No involvement of the uterine corpus or vagina was observed.\n\nThe endometrium appeared proliferative and measured 0.1 cm in thickness. The myometrium reached a maximal thickness of 1.2 cm. Resection margins were free of tumor involvement.\n\nMicroscopic examination confirmed all findings. Based on pathological evaluation, no metastasis was identified in the examined lymph nodes or distant tissues. The tumor was staged provisionally as IB (T1b/NO/M0) according to both FIGO and AJCC schemes. Clinical correlation remains important for final staging assessment."} +{"pid": "TCGA-66-2763", "report": "The examined specimen consists of a left upper lobe measuring 24 x 14 x 7 cm. The central bronchus resection plane is located 0.8 cm proximal to the bifurcation of the lingular bronchus. A staple suture line, 4.5 cm in length, extends dorsocaudally from the hilus. At the hilus, four lymph nodes are present, grayish-black in color, ranging in size from 0.8 to 1.4 cm. A 3 cm area of whitish discoloration with surface retraction is observed laterally on segment 2. Underlying this region is a moderately solid lesion with pale brownish and patchy grayish-black areas, measuring up to 5.5 cm, with arcuate demarcation and pleural involvement. Peripheral branches of B2, B1, and B3 are opened or truncated within the lesion. In the lateral pleural region at the S3/S4 junction, an indurated area measuring 0.4 cm is noted. Rarefaction with lacunar formations up to 0.6 cm is present in the apical region of segment 1; the remainder of the parenchyma appears unremarkable.\n\nAdditional findings include a piece of parietal pleura measuring 10.5 x 8.5 cm, up to 0.1 cm thick, with a partly smooth and partly rough surface. Lymph nodes are described as follows: interlobar (left), three grayish-black specimens measuring 0.3 and 1.1 cm; hilar (left), two grayish-black specimens measuring 0.4 and 1.3 cm; subcarinal, one 1 cm grayish-black specimen; paraortic (left), a total of 1.5 cm in grayish-red and blackish fragments ranging from 0.1 to 0.8 cm; subaortic (aortopulmonary window, left), two grayish-black specimens totaling 2 cm; and low paratracheal (left), a 2.2 cm grayish-brown specimen. All lymph nodes appear altered in color.\n\nHistologically, sections include tumor with adjacent parenchyma, pleura, indurated regions, apical S1, bronchial resection margin, vascular margins, and hilar lymph nodes. Staining techniques used include Elastica-van Gieson, PAS, and diastase-PAS across 15 blocks.\n\nMicroscopic evaluation revealed changes consistent with active inflammatory processes, including resorptive inflammation surrounding the lesion with macrophage infiltration. There is evidence of localized subpleural alveolar and interstitial remodeling with immature or atypical squamous cell metaplasia involving bronchioles in the S3/S4 region. Apical emphysematous stromal remodeling with small subpleural cysts is also present. Anthracotic pigment is mildly present in lung tissue and more pronounced in lymph nodes. Chronic pleural fibrosis is noted in varying degrees.\n\nA secondary fibrosing lesion at the S3/S4 interface contains atypical squamous cell nests. These findings raise the possibility of a second early focus of bronchopulmonary change, although the distinction from reactive metaplastic processes could not be definitively determined. Fibrosis is also seen in association with visceral pleural involvement. The primary lesion is centered in segment 2 and demonstrates extension toward central structures."} +{"pid": "TCGA-SP-A6QH", "report": "The specimen included a left adrenal resection measuring 6.5 x 6.2 x 4.7 cm with a classical nested histological pattern composed of polygonal and spindle cells. No necrosis or lymphovascular invasion was identified. One mitotic figure was observed per 50 high power fields. There was extensive stromal hyalinization, but no evidence of medullary hyperplasia. A total of three para-aortic suprahilar lymph nodes were submitted; one showed the presence of atypical cell aggregates. The gallbladder measured 9 cm in length with a maximum diameter of 3.5 cm and demonstrated a smooth serosa, intact wall, and absence of stones or intraluminal tumor. A single lymph node adjacent to the cystic duct measured 0.4 cm. A separate supra-pancreatic lymph node measuring 0.9 cm in greatest dimension was submitted and found unremarkable. Tissue from the retroperitoneum, portal vein, and unspecified site showed fibrotic changes with atypical cell clusters, raising concern for malignant infiltration. The Whipple resection specimen included a pancreatic head lesion measuring 5.0 cm in greatest dimension (other dimensions: 3.2 cm), with a solid configuration and yellow-white, fibrous appearance partly calcified. The tumor was located 1.2 cm from the distal margin and approached within 0.1 cm of the posterior/retroperitoneal margin. Multiple small cysts were present elsewhere in the pancreas, ranging from 0.2 to 1.3 cm in size. All other margins, including bile duct, gastric, and duodenal, were free of involvement. No regional lymph node metastases were identified; nine lymph nodes were examined. Immunohistochemical staining of the pancreatic lesion showed positivity for synaptophysin, chromogranin, and CK19 with focal insulin expression, and less than 1% Ki-67 proliferative index. Other findings included PanIN1 and serous adenomas."} +{"pid": "TCGA-HU-8604", "report": "Stomach, subtotal gastrectomy: The lesion is located in the lower third, centered at the antrum along the lesser curvature. Grossly, it exhibits a Borrmann type 2 (ulcerofungating) appearance. Histologically, the lesion shows a tubular growth pattern with moderate differentiation. According to Lauren classification, the morphology corresponds to an intestinal type. The growth pattern is a combination of expanding and infiltrative. The size of the lesion measures 8.7 x 8.0 cm. The depth of invasion extends to the subserosa (pT3). Resection margins are free of involvement, with a distal margin of 3.0 cm and a proximal margin of 1.5 cm. Evaluation of regional lymph nodes, including 18 from the lesser curvature, 8 from the greater curvature, and 1 additional node, reveals no evidence of metastasis (pN0). Lymphatic invasion is not identified. There is mild venous invasion present, while perineural invasion is not observed. The specimen labeled as \"anvil ring\" biopsy does not show any tumor involvement. Immunohistochemical staining was performed using markers including CD10, MUC2, MUC5ac, MUC6, and C-erb B2."} +{"pid": "TCGA-85-A510", "report": "The specimen consists of lung tissue obtained via lobectomy. The tumor measured 6 x 6 x 6 cm and was located in the left-lower lobe. Microscopic evaluation revealed a poorly differentiated cellular morphology. Lymph node assessment showed involvement with two out of two intrathoracic lymph nodes positive for metastatic involvement. No other tumor nodules, vascular invasion, or margin involvement were specified. No additional findings or evidence of prior treatment were noted."} +{"pid": "TCGA-DD-AAW2", "report": "The surgical specimen from the left lobe of the liver shows a lesion measuring 5.5 x 4.8 x 4.2 cm, with an expanding nodular growth pattern. No satellite nodules are identified. Histologically, the lesion demonstrates trabecular and pseudoglandular architecture, composed of cells belonging to the classic cell group. The histologic grade according to Edmondson and Steiner is grade 2 for both the worst and major differentiation. There is no evidence of fatty change, hemorrhage, peliosis, tumor necrosis, or vascular invasion. A complete capsule is present without infiltration. Septal formation is noted, but there is no involvement of major branches of the portal or hepatic veins, bile ducts, or serosa. The surgical margin is clear with a safety margin of 0.8 cm. No intrahepatic metastasis or multicentric occurrence is found. The pathologic stage is classified as pT1 and pT2 according to AJCC criteria. \n\nAdditional findings include inactive alcoholic cirrhosis. A separate nodule in liver segment 7 shows necrotizing granulomatous inflammation with prominent eosinophilic infiltration. The gallbladder specimen reveals chronic cholecystitis."} +{"pid": "TCGA-BP-4161", "report": "The specimen from the right kidney, along with associated ureter, blood vessels, and surrounding fatty tissue, was examined. The kidney measured 10 x 5 x 4.5 cm and showed a distinct mass measuring 5.5 x 4.5 x 3.0 cm. The mass was confined within the renal capsule with no extension into surrounding fat or involvement of the renal vein. The tumor demonstrated an acinar growth pattern and was composed of cells with nuclear features graded as II to III/IV. All surgical margins were free of abnormal cells. Adjacent kidney tissue showed areas of chronic inflammation. No lymph nodes were identified in the submitted tissue. A separate specimen of perinephric fat was unremarkable, showing only benign fibrofatty tissue. A portion of the right 11th rib was also submitted for analysis; it required decalcification prior to full evaluation, and no significant abnormalities were noted on initial examination."} +{"pid": "TCGA-AA-3812", "report": "The specimen consists of a resected sigma segment. Histopathological examination reveals a moderately differentiated neoplasm with ulceration of the inner surface and areas of necrosis. The tumor is associated with peritumoral chronic recurrent secondary inflammation, including an acute inflammatory component. Lymphangitic spread is present. The lesion infiltrates through the layers of the sigma wall, reaching into the subserous fatty connective tissue. Thirteen lymph nodes are tumor-free, showing only moderate chronic lymphadenitis. No tumor involvement is detected in overview slices from the resection margins or the anastomosis ring. Additional findings include sigma diverticulosis. Tumor spread corresponds to a pathological stage of pT3, pN0, MX, with lymphangitic invasion (L1) and complete resection (R0)."} +{"pid": "TCGA-SC-A6LN", "report": "The patient is a male with a history of smoking. Specimens submitted for analysis included a right pleural biopsy, lymph nodes from multiple levels (level seven, internal mammary, level four, and right level ten), a portion of the right sixth rib, and right pleura.\n\nThe right pleural biopsy measured 2.2 x 1.8 x 0.4 cm and showed abnormal cellular features on frozen section. The right level seven lymph nodes consisted of multiple fragments measuring 4 x 2 x 0.5 cm in total. Microscopic evaluation identified involvement in four out of twelve lymph nodes. The right internal mammary lymph node specimen measured 1.8 x 0.6 x 0.2 cm and showed microscopic evidence of involvement in one out of one lymph node, though this was not seen in the frozen section. Level four lymph nodes totaled 5.5 x 3 x 0.6 cm in aggregate; all fourteen lymph nodes were benign, although two showed necrosis. The right sixth rib consisted of two segments measuring 8.3 cm and 13.5 cm in length, respectively, with no significant pathological findings noted. The right pleura specimen was large, measuring up to 16.0 x 8.0 x 3.7 cm, and showed similar cellular features as the pleural biopsy. The right level ten lymph node measured 1.0 x 0.5 x 0.4 cm and was found to be benign.\n\nImmunostains performed showed positivity for AE1/AE3, calretinin, and WT1, while markers including TTF1, CEA (p), and CD15 were negative. These findings supported the histopathological interpretation. Some testing methods used in the evaluation were developed by the laboratory and are not cleared or approved by the US Food and Drug Administration; however, they are used for clinical purposes under CLIA certification.\n\nIntraoperative frozen section consultation provided preliminary findings consistent with the final diagnoses. The report was based on direct examination of the slides and includes both frozen section and permanent diagnoses."} +{"pid": "TCGA-AA-A02K", "report": "The specimen includes an internal sample IL. The tissue shows a poorly differentiated carcinoma with histopathological features indicative of high-grade differentiation (G3), extensive necrosis, and surrounding inflammation (in I). In another area, tumor-free vascularized fatty connective tissue with moderate chronic inflammation and fibrosis was observed (in II). A separate finding describes a medium-grade to poorly differentiated adenocarcinoma located in the cecum and ascending colon. The lesion exhibits necrotic areas and ulceration of the inner tumor surface. Additional features include carcinomatous lymphangitis, vascular invasion, and perineural infiltration. The tumor infiltrates through all parietal layers and reaches the subserosal fatty connective tissue. Seven out of twenty regional lymph nodes contain metastatic deposits. Chronic inflammatory changes are present around the tumor. Comprehensive examination of all designated sections confirms no residual tumor in the resected margins (in III). Histologic evaluation indicates involvement of lymphatic and blood vessels. Based on the available sections, the tumor stage is classified as pT3, pN2 (7/20), pM1 (HEP), with lymphovascular invasion (L1, V1). The surgical removal appears complete. The morphological classification corresponds to ICDO-DA M-8140/3, G2-3."} +{"pid": "TCGA-CN-A63W", "report": "A comprehensive evaluation was performed on multiple tissue specimens obtained from a patient. The specimens included lymph nodes from both sides of the neck, thyroid tissue, margins from the base of the tongue, and a resected laryngeal specimen.\n\nOn the left side, levels 2 through 4 of the neck were dissected, yielding 32 lymph nodes. Four of these lymph nodes contained abnormal cellular infiltration with evidence of spread beyond the lymph node capsule. The involved nodes were located in level 3, with the largest measuring 1.5 cm. On the right side, levels 2 through 5 were dissected, revealing a soft tissue lesion measuring 6.0 cm that extended across multiple levels. This lesion involved the surrounding tissue of a large vein and skeletal muscle. Based on staging criteria, this was considered one positive lymph node with extracapsular extension. An additional 32 lymph nodes were examined from the right side, and none showed signs of abnormal involvement. Margins of the neck dissection were free of any suspicious cells.\n\nThe thyroid specimen measured 1.5 x 1.0 x 0.6 cm and showed features consistent with chronic inflammation involving lymphocytes. Deep margins from both the left and right base of the tongue, as well as an additional margin specimen from the base of the tongue, were all negative for abnormal cells.\n\nThe laryngeal specimen included a supraglottic lesion measuring 6.5 cm. Microscopic analysis revealed moderately differentiated cellular features with invasion into surrounding soft tissues, including perineural and angiolymphatic spaces. The closest surgical margin was 0.5 cm from the tumor. A single lymph node from the central compartment was negative. Pathologic staging was determined as pT4a for the primary lesion and pN2c for lymph node involvement. Additional testing for specific markers was negative."} +{"pid": "TCGA-DI-A1NN", "report": "The specimen was collected from the endometrium. Examination of the omentum revealed fibroadipose tissue without any abnormal findings. The cervix showed mild focal changes with koilocytic-type cellular alterations. The uterus demonstrated involvement extending to within 0.5 cm of the uterine serosa, with a maximum myometrial thickness of 1.5 cm. Tumor involvement was noted in the posterior lower uterine segment.\n\nThe bilateral ovaries and fallopian tubes showed small foci of involvement that appeared contiguous with the uterine findings. High-grade nuclear features were observed. Lymphovascular invasion was present. \n\nLymph node assessment revealed the following: In the left para-aortic region, one out of eight lymph nodes contained metastatic involvement. In addition, one lymph node out of one examined in the same region also showed involvement. In the right external iliac, left pelvic, and right pelvic regions, no involvement was identified in a total of five, six, and four lymph nodes respectively.\n\nGrossly, the uterus measured 10.5 x 7.0 x 5.5 cm and contained a mass measuring 6.5 x 4.5 x 0.5 cm located in the fundus and extending into the lower uterine segment. The tumor involved both anterior and posterior walls and extended into the myometrium to a depth of approximately 1.5 cm. The cut surface of the tumor was soft, yellow, and friable with areas involving the serosal surface.\n\nImmunohistochemical staining showed positivity for PMS-2, MLH1, MSH6, and MSH2. Multiple tissue sections were submitted for analysis, including sections of the uterine serosa, endometrium, cervix, myometrium, fallopian tubes, and ovaries. Lymph nodes were entirely submitted for evaluation."} +{"pid": "TCGA-F1-6875", "report": "A male patient underwent subtotal gastrectomy and removal of one splenic nodule. Frozen section analysis of the splenic nodule showed a sclerotic lesion composed of fibrous connective tissue, with no tumor identified. The nodule measured 0.5 x 0.3 x 0.2 cm. and was described as a fragment of soft tan tissue with a smooth surface. The main lesion was located 3 cm. from the wide (proximal) surgical margin and measured 5 x 4 x 2 cm. A portion of the top of the lesion was sheared off for tumor banking.\n\nThe surgical specimen included four containers. Container #1, labeled \"splenic nodules,\" contained a single cassette submitted for analysis. Container #2, labeled \"portal nodes,\" held two fragments of yellow/tan fibrous tissue measuring 1.2 x 1.0 x 0.4 cm. in total, all of which were submitted. Container #3, labeled \"spleen,\" contained a spleen weighing 94 grams and measuring 9 x 5.5 x 3.8 cm. The external capsule was intact, and cut surfaces revealed normal splenic parenchyma without any mass lesions. Representative sections were submitted. Container #4, labeled \"subtotal gastrectomy,\" included a stomach segment measuring 14.5 x 9 x 0.8 cm., with attached perigastric fat and mesentery. The mucosal surface showed a polypoid lesion measuring 4 x 5 x 2 cm., with the proximal edge 6.5 cm. and the distal edge 3.5 cm. from the respective surgical margins. The cut surface of the lesion showed uniform, light tan tissue with apparent involvement of the underlying muscle wall. No necrotic or hemorrhagic areas were present. The attached mesentery measured 15 x 8 x 4.5 cm. and was composed primarily of pale yellow adipose with scattered fibrous tissue. No gross mass lesions were identified in the mesentery.\n\nThe block summary included sampling of portal nodes, spleen (blocks 2\u20134), proximal surgical margin of the stomach, normal mucosa proximal to the lesion, edges and central portions of the lesion (blocks 7\u201311), distal edge of the lesion, deep margin beneath the lesion, distal mucosa, distal surgical margin, and multiple lymph node groups including those adjacent to, proximal, and distal to the lesion.\n\nMicroscopic evaluation showed no significant staining for synaptophysin in the neoplastic cells, with appropriate control staining. The lesion was found to invade into but not through the muscularis propria. All final surgical margins were free of involvement. No definitive lymphovascular space invasion was identified. There was evidence of gastric atrophy with extensive intestinal metaplasia. Lymph node analysis showed no carcinoma in 11 nodes at the tumor site, 4 nodes proximal to the tumor, and 2 portal nodes. Adipose tissue without lymph nodes was found in another submission. The splenic nodule was consistent with an accessory spleen, and the spleen itself showed no significant pathological abnormalities."} +{"pid": "TCGA-CN-5367", "report": "A composite resection of the right tongue, floor of mouth, and mandible was performed along with bilateral neck dissections. The specimen from the right side included a centrally ulcerated lesion measuring 5.0 cm in greatest dimension, located at the junction of the floor of mouth and lateral tongue. The lesion extended deeply into the muscles of the base of the tongue and floor of mouth, approached the cortex of the mandible, and focally involved the subcutaneous tissue of the submental skin. Margins were free of involvement. Perineural and angiolymphatic invasion were identified.\n\nIn the right neck dissection (levels II\u2013IV), 26 lymph nodes were identified, with two positive for involvement. The largest involved lymph node measured 1.0 cm with a tumor focus of 0.4 cm and showed extracapsular spread. One involved node was found in level II. The remaining lymph nodes on the right were negative. The left neck dissection (levels I\u2013IV) included 17 lymph nodes, all without evidence of involvement. Submandibular glands on both sides showed mild chronic sialadenitis.\n\nPathologic staging was determined as pT4a, reflecting local extent of the primary lesion, and pN2b, based on the presence of metastatic involvement in two lymph nodes in the right neck. No distant metastasis was assessed (pMX). Venous or lymphatic vessel invasion and perineural invasion were present. All tissue margins were uninvolved."} +{"pid": "TCGA-66-2755", "report": "The resected right upper lobe of the lung weighed 287 g and measured 180 x 120 x 60 mm. The bronchus was removed close to the parenchyma. Adhesions were noted on the exterior with deformation of the parietal pleura containing adipose tissue. In the apical section of S1, there was a nodular lesion measuring 65 mm in diameter. The lesion appeared grayish-white with significant anthracotic pigment, had a well-demarcated and polycyclic border, and extended up to and beneath the adhered pleura. Central bronchi were free of tumor involvement and otherwise unremarkable. The right middle pulmonary lobe showed no abnormalities. No enlarged lymph nodes were observed in hilar or peribronchial regions.\n\nLymph node specimens included: L4 (torn tissue with anthracotic pigment, approximately 10 mm), L10 (a 3 mm nodule with black pigment), L7 (segmented lymphatic adipose tissue with partial black pigmentation, measuring around 20 mm when flattened), and additional samples from L4 and L3 (segmented lymphatic adipose tissues with partial black pigmentation, each measuring approximately 20 mm flat; one lymph node in L4 displayed a suspicious grayish-white border).\n\nHistologically, no tumor was identified at the bronchial resection margin or in adjacent adipose connective tissue and blood vessels. A small tumor-free lymph node in the peribronchial area contained anthracotic pigment. The lesion consisted of immature cellular bands showing marked pleomorphism, coarse chromatin, frequent mitotic figures, and multifocal necrotic areas. There was infiltration into the visceral pleura with extension into the adjacent adhesion zone. However, the clearly defined parietal pleura and underlying subpleural adipose connective tissue showed no further abnormal extensions. Angioinvasion was evident in the tumor center, with formation of obliterative thrombi.\n\nOther lymph nodes were free of tumor but demonstrated histiocytosis, scarring, and variable degrees of anthracotic pigment deposition. One follicle showed activation with a large germinal center and nuclear debris-laden macrophages.\n\nStaging parameters indicated pT2, pV1, pN0, pMX, stage IB, with no residual tumor at the resection margin (R0)."} +{"pid": "TCGA-DJ-A3VA", "report": "The specimen from the head and neck region included multiple lymph node samples and a total thyroidectomy. Lymph nodes from left level two and level three cervical regions were both found to be benign, with sizes measuring up to 1.8 cm. The pre-tracheal and left paratracheal lymph node specimen contained 19 lymph nodes, of which one contained micrometastatic involvement; the involved node measured 1.3 cm in greatest dimension, with metastatic tissue measuring less than 0.1 cm in aggregate, and no extra-nodal extension was observed.\n\nThe thyroidectomy specimen showed a partially cystic mass located in the left lobe, measuring 2.0 cm in greatest diameter, with complete surrounding encapsulation and focal invasion of the capsule. No blood vessel invasion or extrathyroid extension was identified. Surgical margins were free of involvement. Within the left lobe and isthmus, there were two additional small foci measuring 0.5 cm and 0.2 cm, respectively. The background thyroid tissue demonstrated features consistent with chronic lymphocytic thyroiditis. A total of six benign lymph nodes were identified within the thyroid specimen. The right lobe contained multiple small multinodular white-tan lesions ranging from 0.1 to 0.3 cm. All relevant sections were submitted for evaluation."} +{"pid": "TCGA-E9-A1RI", "report": "The specimen consists of a mammary gland with a lesion measuring 1.8 x 1.5 cm. The surrounding fatty tissue and lymph nodes appear dense and hyperemic. Histologically, the lesion demonstrates features consistent with a moderately differentiated infiltrative growth pattern involving ductal and lobular structures. A total of ten lymph nodes were examined, five of which show evidence of metastatic involvement. The tumor measures approximately 2 cm in greatest dimension and is confined without evidence of vascular invasion. Surgical margins are uninvolved. Five of the ten axillary lymph nodes contain metastatic deposits. Additional histologic evaluation including tubule formation, nuclear pleomorphism, and mitotic counts could not be fully assessed to determine a composite Nottingham score. There is no indication of neoadjuvant treatment effect. The lesion is located in the left upper outer quadrant of the breast."} +{"pid": "TCGA-15-1449", "report": "The resected brain tissue from the right frontal lobe consists of multiple fragments. The aggregate measurements of the specimens are 1.8 x 1.0 x 0.3 cm, 5.8 x 2.8 x 2.0 cm, and 4.8 x 3.2 x 1.2 cm. Histological evaluation revealed high-grade cellular features, including marked nuclear atypia and increased mitotic activity. Based on these findings, a preliminary intraoperative assessment of a high-grade glial neoplasm was made. Further microscopic analysis confirmed the presence of a highly anaplastic tumor with areas of necrosis and microvascular proliferation. Tissue blocks were prepared and labeled for further review and staging purposes."} +{"pid": "TCGA-23-2084", "report": "A 5.8 cm right ovarian mass was present, with near total replacement of the ovarian parenchyma by a solid, tan-white tumor. The serosal surface of the ovary was involved, and there was extensive invasion into lymphovascular spaces within the ovary. The adjacent fallopian tube showed involvement of the serosa, wall, and lymphatics, including mucosal lymphatics. Adnexal soft tissues and regional lymphovascular spaces were also extensively involved. A small follicular cyst was noted in the right ovary.\n\nThe left ovary measured 3.9 cm and was subtotally replaced by a similar-appearing tumor. The serosal surface was involved, and there was extensive lymphovascular space invasion. The fallopian tube on this side showed intramucosal and intraepithelial involvement, as well as tumor within tubal lymphatics and on the serosal surface. Adnexal soft tissue and lymphovascular spaces were also involved. The left ovary contained a luteinized follicular cyst, a mesothelial cyst, and stromal edema.\n\nExtensive tumor involvement was present in multiple peritoneal and mesenteric sites. A 2.5 cm mass in the sigmoid region, a 2 x 1.5 cm mesenteric tumor deposit, and several nodules in the jejunum and right colon mesentery were identified. These areas showed widespread infiltration of soft tissues and regional lymphovascular spaces.\n\nA 2.7 cm mass in the cul-de-sac, two omental biopsies (one 4 x 4 cm, another 23 x 12 cm), and a 1.9 cm nodule from the right IP node were all involved by tumor. The omentum showed confluent tumor aggregates, with the largest measuring 3 cm. A 2.5 cm lymph node from the left pelvis was nearly completely replaced by tumor, with additional involvement of surrounding fat and lymphatics.\n\nThe uterus was 190 grams, with a symmetric corpus measuring 5.8 cm in length. Tumor deposits were present on the serosal surface. Extensive involvement of lymphovascular spaces was seen in the endometrial mucosa, myometrium, and subserosal lymphatics. There was evidence of direct extension into the deep myometrium and patchy foci of involvement in the endometrium. The cervix showed extensive lymphovascular space invasion, with tumor approaching within less than 1 mm of the surgical margin. Other findings included disordered proliferative endometrium, four small leiomyomas, adenomyosis, and various benign cervical changes.\n\nA 20.3 cm segment of right colon and 27.7 cm of attached ileum were resected. Two main tumor masses were identified: one 4 cm in the cecum and another 4.5 cm in the distal right colon. Both showed transmural involvement, extending from the serosa through the muscular wall to the submucosa and focally into the mucosa. Multiple other tumor nodules were found in the colon, small intestine, and surrounding fat. Four out of four lymph nodes were involved, with extensive regional lymphatic and perinodal fat infiltration. Tumor was present 1 cm from the proximal (ileal) margin, 2 cm from the distal (colonic) margin, and 3 mm from the distal margin within lymphatics.\n\nAdditional microscopic findings included extensive lymphovascular space invasion at multiple sites, including the ovaries, fallopian tubes, uterus, and cervix. Tumor aggregates ranged from microscopic to 3 cm in size, with both nodular and plaque-like appearances. Intraoperatively, a frozen section of omentum showed poorly differentiated or undifferentiated carcinoma, likely of mullerian origin."} +{"pid": "TCGA-G9-6363", "report": "The surgical specimens included right and left pelvic lymph nodes, a resected prostate gland, and a left apical margin. The right pelvic lymph nodes consisted of three nodes, with the largest measuring 5.1 cm in greatest dimension; all were entirely submitted for frozen section. The left pelvic lymph nodes included five small nodes ranging from 0.7 to 1.1 cm in size, all of which were also submitted for frozen section. No malignancy was identified in either the right or left pelvic lymph nodes.\n\nThe prostate gland weighed 80 grams and measured 6 cm in transverse diameter, 5 cm anterior to posterior, and 4 cm from apex to base. The capsule was intact and smooth. After removal of the apex and base, the remaining specimen weighed 29 grams. Serial sectioning revealed firm tan parenchyma. The right and left seminal vesicles measured 2.5 x 2.7 x 1.5 cm and 2.5 x 2.8 x 1.6 cm respectively, and were found to contain cystic beige-tan tissue. The vas deferens on both sides were firm and tubular upon sectioning.\n\nMicroscopic evaluation showed multifocal cellular changes involving both right and left lobes, comprising approximately 20% of the gland. Cellular features included high-grade nuclear atypia with prominent nucleoli and increased mitotic activity. There was evidence of extension into the bladder neck and beyond the prostatic capsule at the base. No invasion of the seminal vesicles was observed. All surgical margins were free of abnormal cells.\n\nExtensive perineural invasion was noted bilaterally, and angiolymphatic invasion was present in the right base. Additional findings included high-grade prostatic intraepithelial neoplasia.\n\nPathological staging was assessed as pT4, N0, MX. Frozen sections of the lymph nodes were negative for malignancy."} +{"pid": "TCGA-55-8206", "report": "The surgical specimen included a lobectomy from the right upper lobe of the lung. A mass measuring 2.3 x 2.2 x 2.2 cm was identified in the upper portion of the lobe. Microscopic evaluation showed moderately differentiated features, with no evidence of visceral pleural invasion or lymphatic vascular invasion. The tumor was unifocal and surrounded by histologically unremarkable pulmonary parenchyma. Resection margins, including bronchial and vascular margins, were free of involvement, with the tumor located 4 cm from the nearest bronchial margin.\n\nRegional lymph node assessment included four total nodes, all of which were negative for metastatic involvement. This included three variably anthracotic hilar lymph nodes and one additional anthracotic lymph node. No treatment effect or tumor extension beyond the primary site was observed.\n\nPathologic staging was determined as pT1b, based on the tumor size being greater than 2 cm but not exceeding 3 cm, without invasion of the visceral pleura or evidence of more proximal bronchial involvement. Lymph node staging was pN0, with no regional nodal involvement. Distant metastasis was not identified (pM0). The overall pathologic stage is consistent with stage IA disease.\n\nAncillary testing was limited due to insufficient tissue. No viable tissue remained for molecular studies such as EGFR or ALK testing. The available tissue block has been preserved for potential future analysis. Intraoperative frozen section consultation confirmed negative bronchial margins. The gross description noted mild anthracosis in lung tissue remote from the lesion, with the remainder of the parenchyma appearing unremarkable. Specimen handling included multiple cassettes for representative sampling of tumor, margins, lymph nodes, and surrounding lung tissue."} +{"pid": "TCGA-DS-A1OD", "report": "A 420-gram uterus with attached cervix was received, measuring 13.1 cm from fundus to ectocervix. The cervix measured 4.2 cm in length and 4.1 cm in diameter, with a patent os measuring 0.3 cm. A granular and hemorrhagic area measuring 2.0 x 2.0 cm was identified along the transformation zone and ectocervix. The vaginal cuff ranged in thickness from 1.7 cm anteriorly to 3.0 cm posteriorly. The endometrial cavity was 7.4 cm in length and lined by smooth, tan-red endometrium with an average thickness of 0.1 cm. The myometrium measured up to 5.2 cm in thickness and contained four intramural leiomyomata ranging from 0.5 to 4.5 cm in greatest dimension. One leiomyoma showed central areas of hemorrhage and necrosis.\n\nExamination of the cervix revealed diffuse changes of intraepithelial neoplastic involvement with glandular duct extension and focal features suggestive of viral cytopathic effect. Acute and chronic cervicitis with squamous metaplasia, nabothian cysts, focal calcific atherosclerosis, and ciliated cell metaplasia were also present. The endometrium showed early secretory changes. No involvement was seen in the anterior or posterior lower uterine segments, and no parametrial involvement was identified. All surgical excision margins, including paracervical soft tissue and vaginal margins, were unremarkable.\n\nFoci suspicious for vascular space invasion were noted. The maximal depth of stromal invasion measured 19 mm, and the maximal superficial spread of the lesion was 22 mm. Involvement extended across all four quadrants of the cervix with focal extension into the upper third of the posterior vaginal wall.\n\nLymph node evaluation included right pelvic (4 nodes), right common iliac (1 node), obturator (4 nodes), left common iliac (4 nodes), and left pelvic (3 nodes) biopsies. No tumor was identified in any of the lymph nodes examined. Findings included reactive changes such as sinus histiocytes and focal acute inflammation within some nodes.\n\nThe right ovary contained a small fibroma measuring 0.7 cm, along with simple cysts, follicular cysts, and an involuting corpus luteum. Stromal hyperplasia, surface adhesions, and an epithelial inclusion cyst were also present. The right fallopian tube showed no significant abnormalities. The left ovary demonstrated a hemorrhagic corpus luteum, follicular cysts, atretic follicles, surface epithelial inclusion cysts, and focal stromal proliferations. The left fallopian tube contained mesonephric duct remnants.\n\nMultiple sections of the uterus, tubes, ovaries, and lymph nodes were submitted for microscopic evaluation. Based on the findings, the extent of involvement appeared to exceed 50% of the cervical wall in some areas. Foci consistent with and others suspicious for vascular space invasion were identified."} +{"pid": "TCGA-64-1678", "report": "The specimen consisted of multiple lymph node samples and lung tissue obtained from various anatomical locations, including 4R, 4L, 2R, 10R, 11R lymph nodes, level 7, level 11 lymph nodes, and the right middle lobe of the lung. A total of 36 lymph nodes were evaluated across all sites, with no tumor identified in any of the submitted nodes. The lymph nodes ranged in size from 0.5 cm to 1.5 cm in greatest dimension and exhibited gray-black anthracotic staining.\n\nThe right middle lobe measured 10.5 x 8.5 x 5.5 cm and contained a large, poorly differentiated epithelial lesion measuring approximately 6.0 x 6.0 x 4.5 cm, located within the parenchyma. This lesion was situated 1.0 cm from the bronchial margin and was associated with a palpable mass, dark black hilar nodes up to 0.8 cm in size, and an indurated pleural area with dark red adhesions. The bronchial and vascular margins were free of abnormal cellular infiltration. Three peribronchial lymph nodes were also free of atypical cells.\n\nNo invasion of adjacent structures such as the pleura or vascular spaces was observed, and no evidence of lymphovascular space invasion was present. All frozen section evaluations of the lymph nodes and bronchial margin were negative for malignant involvement."} +{"pid": "TCGA-N8-A4PO", "report": "The cervix demonstrates a small focus of glandular tissue with atypical features. No squamous mucosa is present. A total abdominal hysterectomy with bilateral salpingo-oophorectomy was performed. The uterus measures 8.1 x 4.3 x 3.6 cm and weighs 72 grams. The endometrial cavity contains a fungating mass measuring 3.6 x 3.1 x 1.7 cm located in the anterior lower uterine segment. This mass extends into the endocervical canal, reaching within 1.0 cm of the external os. On gross examination, the mass has a smooth, white cut surface and invades 0.1 cm into a stroma that is 1.1 cm thick. Microscopic evaluation reveals both carcinomatous and sarcomatous components with heterologous cartilaginous and homologous elements consistent with endometrial stromal sarcoma differentiation.\n\nStromal invasion is limited to the inner half of the myometrium with a depth of 3 mm. The myometrial wall thickness is 9 mm, representing approximately 33% involvement. There is no serosal involvement identified. The lower uterine segment and cervix are involved by tumor. The tumor is located 1.7 cm from the ectocervical margin. No adnexal involvement or lymphovascular space invasion is observed. A benign leiomyoma measuring 0.4 cm is also present.\n\nSections from various blocks including the anterior and posterior cervix, lower uterine segment, corpus, ovaries, and fallopian tubes are submitted for analysis. Immunohistochemical staining shows absence of estrogen receptor expression in tumor cells. Progesterone receptor staining demonstrates scattered positivity (1-2+) in less than 10% of tumor cells. Internal and external controls were used to validate immunostains, which were developed under analyte specific reagent guidelines not requiring FDA approval. The laboratory performing these tests is CLIA-certified for high-complexity testing.\n\nThe specimen includes a 2.6 x 1.0 x 0.7 cm fragment of rubbery tan/gray cervical tissue with focally erythematous mucosa. The opposing stromal surface is inked black. Additional findings include a 0.4 x 0.3 x 0.3 cm intramural nodule in the uterus and two simple cysts in the left ovary measuring up to 1.2 x 1.0 x 0.9 cm. A white serpentine intrauterine device is noted within the endometrial cavity. The endometrium is thin (<0.1 cm), red/brown, and smooth. The myometrium is 2.3 cm thick and trabeculated with a single homogeneous white whorled rubbery nodule. The left fallopian tube is 4.1 cm long and the right fallopian tube is 4.4 cm long. Both ovaries and fallopian tubes show no significant pathology apart from simple cysts and corpora albicantia.\n\nPathologic staging is pT2 based on involvement of the lower uterine segment and cervix. No regional lymph node assessment is reported (pNx). According to FIGO 2008 classification, the stage corresponds to Stage II. These findings are subject to revision pending further clinical and pathological review."} +{"pid": "TCGA-A6-3807", "report": "The specimen includes portions of the sigmoid colon, left and right fallopian tubes and ovaries, and the appendix. The sigmoid colon measures 13.5 cm in length with a circumferential ulcerated lesion measuring 5.5 x 4.5 x 1.2 cm located 3 cm from one end. This lesion invades through the muscularis propria into the subserosal fat and approaches within 7 cm of the radial margin. A separate pedunculated polyp, measuring 1.5 cm and located 6 cm from the other end, shows no evidence of invasive growth. Several firm and indurated lymph nodes are noted adjacent to the main lesion. The remaining mucosa appears normal.\n\nThe left ovary and fallopian tube measure 3.3 x 3.0 x 2.5 cm and 4.0 x 0.5 cm respectively. The ovary contains a 1.2 cm cyst and the fallopian tube has a 2.0 cm paratubal cyst, both filled with clear fluid and lacking papillary projections. No discrete lesions are observed. The right ovary and fallopian tube measure 2.5 x 2.2 x 1.7 cm and 4.0 x 0.7 cm respectively. The ovary has a white-tan mottled cut surface and the fallopian tube has a 1.2 x 0.7 cm paratubal cyst. No significant abnormalities are identified in either ovary or fallopian tube.\n\nThe appendix is 7.2 x 0.5 cm with an intact wall averaging 0.3 cm. It is covered partially by smooth serosa and surrounded by yellow fat. No distinct abnormalities are observed microscopically.\n\nMicroscopic evaluation reveals a moderately differentiated epithelial tumor arising in the colon, invading into and through the muscularis propria into the subserosal fat (pT3). Vascular invasion is present. All proximal, distal, and radial margins are free of tumor involvement. Of the 24 lymph nodes evaluated, 5 show evidence of tumor spread. No tumor extension beyond the lymph nodes or pericolonic tissue is identified. Additional findings include a tubular adenoma in the colon, benign changes in the appendix, and simple cystic structures in both adnexal regions without signs of malignancy."} +{"pid": "TCGA-BH-A0DO", "report": "The surgical specimen consists of a left and right simple mastectomy with sentinel lymph node biopsies. A total of three lymph nodes were examined (one from the right axilla and two from the left axilla), all negative for metastatic disease.\n\nIn the left breast, an invasive tumor is present at the junction of the upper inner and lower inner quadrants. The tumor measures approximately 2.0 cm in its largest dimension based on five contiguous sections. Histologic evaluation shows a Nottingham grade 3 lesion with tubule formation score of 3, nuclear pleomorphism score of 3, and mitotic activity score of 2 (total score 8/9). Lymphovascular space invasion is identified. Resection margins, nipple, and skin are free of tumor involvement. Associated findings include calcifications related to both malignant and benign areas, atypical ductal hyperplasia, intraductal papilloma, and background fibrocystic changes with epithelial hyperplasia and adenosis. Prior biopsy site changes are also noted. Tumor cells are positive for estrogen and progesterone receptors and negative for HER-2.\n\nIn the right breast, a second invasive tumor is identified in the upper outer quadrant. This lesion is graded as Nottingham grade 2, with scores of 2 for tubule formation, 2 for nuclear pleomorphism, and 2 for mitotic activity (total score 6/9). Ductal carcinoma in situ (DCIS) constitutes approximately 10% of the total tumor mass and is intermixed with the invasive component. The DCIS includes cribriform and solid patterns with minimal necrosis. Lymphovascular space invasion is also present in this area. Surgical margins, nipple, and skin are negative. The non-malignant breast tissue shows fibrocystic changes with associated microcalcifications and prior biopsy site alterations. Receptor status mirrors that of the left-sided tumor\u2014positive for estrogen and progesterone receptors and negative for HER-2.\n\nBenign findings include atypical ductal hyperplasia, fibrocystic changes, and intraductal papilloma. Additional features include calcifications in both malignant and benign regions.\n\nPathologic staging is pT1c, with no involved lymph nodes (0 out of 2 examined) and no distant metastasis. Surgical margins are negative. The method of lymph node examination was H&E stain. Estrogen and progesterone receptor statuses are positive; HER-2 is negative."} +{"pid": "TCGA-44-6146", "report": "The specimen included lymph nodes from levels 9, 10, 11, and 5, as well as a left lower lobe lobectomy. The level 9 node measured 1.2 cm and was entirely submitted. Level 10 consisted of three small fragmented tissues, all under 0.1 cm. Level 11 included two tissues measuring 0.35 cm and 1.2 x 0.6 x 0.4 cm, both fully submitted. The left lower lobe measured 25 x 18 x 10 cm with a focally puckered pleural surface. A central firm tan gelatinous/mucinous area measuring 21 x 14 x 10 cm was identified, with only a thin rim of uninvolved lung tissue remaining. The bronchial margin was not involved. Sections were taken from the lesion, surrounding lung tissue, and margins. Level 5 lymph nodes included four small gray-black tissues, all submitted in their entirety.\n\nMicroscopic evaluation of the lymph nodes from levels 9, 10, 11, and 5 showed no evidence of metastasis across a total of 10 lymph nodes. The left lower lobe showed a well-differentiated mucin-producing tumor, measuring 21 cm, classified as pT3. The surgical margins were free of involvement, and there was no evidence of spread to regional lymph nodes (pN0). The tumor exhibited a predominant lepidic growth pattern, with multiple invasive foci noted. The pleura was not involved. Distant metastasis could not be assessed (pMX). Multiple sections of the lesion confirmed consistent involvement throughout the 21 cm mass, with nearly the entire lobe affected."} +{"pid": "TCGA-QR-A6GR", "report": "The right adrenal gland specimen measured 7.5 x 5 x 2 cm and weighed 44.6 grams. On gross examination, the tissue was soft and contained a red-tan semi-liquid center. A friable mass measuring approximately 3.5 x 3 x 2.5 cm was identified, appearing to originate from the medullary region of the adrenal gland. A thin ring of yellow tissue corresponding to adrenal cortex was observed surrounding the central mass. A small area of normal-appearing adrenal tissue, about 1 cm in size, was present at the superior pole. Periadrenal fat was also present without evidence of lymph nodes or additional masses. Histologically, sections were taken from the tumor with adjacent normal tissue (cassettes A, B, E, G, I), tumor alone (C, F), and normal-appearing adrenal tissue (D, H). Microscopic evaluation noted vascular invasion, which is recognized as a potential risk factor in certain contexts. The tissue was processed and submitted for further analysis."} +{"pid": "TCGA-DM-A0XF", "report": "The pathology report describes a case involving a male individual of White, non-Hispanic or Latino descent. The patient was diagnosed with a histologic subtype of colon cancer and passed away following the diagnosis. The primary tumor was located in the sigmoid colon. Staging at the time of diagnosis was T3, N1, M1, indicating advanced disease with regional lymph node involvement and distant metastasis. The date of initial pathologic diagnosis and the date of normal tissue procurement are recorded but unspecified in the report. Cellular features included measurements and descriptions consistent with malignant transformation, though no specific diagnostic terms are provided in this summary."} +{"pid": "TCGA-OL-A5D8", "report": "The patient is a female who presented with a palpable mass in the left breast. Imaging with MRI demonstrated an irregular mass measuring approximately 6.4 x 6.1 x 4.1 cm located at the 6 o\u2019clock position with heterogeneous enhancement and multiple contiguous satellite lesions extending anteriorly.\n\nGross examination of the mastectomy specimen revealed a white, firm mass measuring 6.5 cm in greatest dimension located inferior to the nipple. The mass had an irregular margin, particularly anteriorly. A satellite lesion measuring 1.5 cm was identified superior and anterior to the primary mass, located 0.4 cm from the nearest skin. The closest inked margin measured 1.0 cm from the tumor. Additional findings included a black discolored area measuring 2.0 cm and a blue discolored area measuring 4.0 cm. The remainder of the breast tissue showed approximately 17% adipose tissue and 30% ductal parenchyma without additional masses or nodules.\n\nHistologic evaluation revealed invasive carcinoma with a composite histologic grade of II (architecture score 3, nuclear grade 2, mitotic count 1). Focal necrosis was present. Adjacent ductal changes included high-grade features involving 5% of the tumor volume and extending into lactiferous ducts near the nipple. Additional benign findings included flat epithelial atypia, columnar cell change, ductal hyperplasia of usual type, and intraductal papilloma.\n\nMargins were assessed and found to be free of tumor involvement. The closest distance of invasive component to the deep margin was 5 mm, while DCIS was greater than 1 cm from the deep margin.\n\nLymphatic evaluation included sentinel lymph nodes and non-sentinel lymph nodes from the left axilla. All lymph nodes examined showed no evidence of tumor involvement. Rare microscopic foci suggestive of lymphatic invasion were identified within the breast parenchyma.\n\nImmunohistochemical studies demonstrated strong expression of ER and PR in all invasive tumor nuclei. Her2/neu status was pending based on prior biopsy material.\n\nPathologic staging was determined as pT3, NO(sn), MX."} +{"pid": "TCGA-XU-A92Q", "report": "The thymus specimen measured 23.5 x 13.5 x 3.3 cm and contained two distinct nodules. On the right side, a firm tan lobular nodule measuring 5.2 cm in greatest dimension showed extension beyond the fibrous capsule into adjacent adipose tissue. The surrounding margins were free of involvement, with the closest distance from tumor to margin being 5 mm. Microscopically, this lesion exhibited lymphocyte-rich areas containing larger cells with abundant cytoplasm and vesicular nuclei, interspersed with bands of spindle-shaped cells and small islands resembling spindle cell morphology. A separate left-sided nodule measured 5 cm in greatest dimension and was entirely encapsulated without evidence of invasion beyond the capsule. Histologically, it consisted of uniform spindle cells arranged in a bland pattern.\n\nNo invasion of pulmonary parenchyma, pleura, or vascular structures was identified in either lesion. Surgical margins were uninvolved. A biopsy of a left periphrenic lymph node revealed normal lymphoid tissue without evidence of metastasis. Representative sections from both lesions and surrounding tissue were submitted for analysis. Both lesions appeared completely excised."} +{"pid": "TCGA-55-1592", "report": "The surgical pathology report describes a wedge resection of the left upper lobe of the lung. The specimen measured 9 x 6 x 1.5 cm and had a yellow to red-tan pleural surface with slight anthracosis. A circumscribed white-tan firm nodule measuring 2 cm in greatest dimension was identified. It was located 0.1 cm from the pleural surface and extended 1 cm from the resection margin. \n\nMicroscopic examination revealed a moderately differentiated lesion growing along alveolar spaces. The tumor extended up to the pleura but did not invade through it. Additionally, tumor cells were found within endothelial-lined lymphovascular spaces. Areas of dense fibrosis were noted in association with the lesion. No lymph nodes were resected. \n\nA frozen section was performed and confirmed the intraoperative findings. Representative sections from the nodule and margins were submitted for further evaluation. The final assessment was based on microscopic analysis of the submitted tissue blocks."} +{"pid": "TCGA-CN-4723", "report": "The patient is a man who presented with hoarseness and was found to have a largely right-sided laryngeal lesion. Imaging showed a T4 lesion with direct invasion through the thyroid cartilage. A total laryngectomy and bilateral neck dissection were performed. The clinical question focused on surgical margins and lymph node status.\n\nThe specimen included a total laryngectomy specimen measuring 15.0 x 7.5 x 5.8 cm, along with bilateral neck tissue (levels 2\u20134) and a right hemi-thyroid. A transglottic irregular tan-pink, soft fungating mass measuring 3.8 x 3.8 x 2.0 cm was identified. The mass was centered on the anterior glottis, involving the supra-glottis and subglottis, and extended between the cricoid and thyroid cartilages into the deep anterior soft tissue, reaching within 0.6 cm of the anterior soft tissue margin. It was 1.0 cm from the aryepiglottic mucosal margin and 2.0 cm from the superior mucosal margin. No gross involvement of the right thyroid was observed.\n\nMicroscopic evaluation confirmed no perineural or angiolymphatic invasion. All surgical resection margins were free of tumor by at least 2 mm. A total of 55 cervical lymph nodes were examined\u201436 from the right and 19 from the left\u2014across levels 2\u20134, and all were free of tumor. No extracapsular spread was identified.\n\nThe pathologic stage was determined as pT4a, pN0, pMX. The right thyroid gland showed no significant pathologic changes. Multiple sections were submitted for analysis, and all margins were confirmed to be negative. The case was reviewed in accordance with CLIA-certified standards, and all testing was verified for accuracy and precision."} +{"pid": "TCGA-EL-A3CN", "report": "A female patient underwent surgical excision of a lesion from the anterior neck region. The specimen consisted of a skin strip measuring 2.5 cm in length, which showed no identifiable lesion. Lymph nodes from the left midjugular and pre-thyroid regions were also removed and showed no evidence of abnormal cells or involvement.\n\nThe thyroid gland was bilobed with overall dimensions of 6.0 x 5.5 x 1.5 cm. The left lobe contained a well-defined nodule measuring 1.5 x 1.3 x 1.3 cm. The nodule appeared light tan, slightly firm, and was located adjacent to the anterior surgical margin. No vascular or lymphatic invasion was observed. Seven associated lymph nodes were free of tumor involvement.\n\nOn the right lobe of the thyroid, two nodules were identified, measuring 0.5 cm and 0.4 cm respectively. These were described as adenomatous in nature. Additionally, there was focal chronic inflammation involving lymphocytes within the thyroid tissue. Parathyroid tissue was also removed and showed no signs of abnormality.\n\nSections of the thyroid and surrounding tissues were submitted for histologic evaluation, with representative sections taken from both lobes and the surrounding lymph nodes. All margins were evaluated, with the exception of the tumor diagnosis being omitted from this report."} +{"pid": "TCGA-DJ-A2PV", "report": "A 3.4 cm well-differentiated lesion was identified in the left thyroid lobe, characterized by focal calcifications and a well-circumscribed appearance with complete surrounding capsule. The tumor measured up to 3.4 cm in greatest dimension and showed focal capsular invasion without evidence of vascular invasion or extrathyroid extension. Surgical margins were free of tumor involvement; however, the lesion was noted to be less than 1 mm from the inked margin. In addition, a microscopic focus measuring 1.8 mm was identified in the right thyroid lobe. The remainder of the thyroid tissue demonstrated benign changes consistent with nodular hyperplasia. No parathyroid tissue was identified within the specimen.\n\nMultiple lymph nodes were evaluated throughout the central and left paratracheal regions, as well as pretracheal and Delphian areas. All lymph nodes examined were benign and showed no evidence of malignancy. Specimens obtained intraoperatively, including tissue near the left recurrent laryngeal nerve and a suspected lower left parathyroid, were confirmed to be benign on both frozen section and permanent histology. The total thyroidectomy specimen was entirely submitted for histologic evaluation, with representative sections analyzed from various anatomical sites including the isthmus, right and left lobes."} +{"pid": "TCGA-41-2573", "report": "The specimen consists of multiple small fragments of tan and reddish-brown tissue from the right parieto-occipital region, measuring approximately 1 to 2 mm each. A portion was submitted fresh for frozen section evaluation, and the remaining tissue, received in formalin, measured a total of 1.0 cm in aggregate and was embedded in one cassette. Histologic examination reveals a malignant astrocytic neoplasm composed of markedly pleomorphic cells with features including cytomegaly, nucleomegaly, multinucleation, and frequent mitotic figures. The tumor demonstrates a sheet-like growth pattern along with areas of necrosis and evidence of neovascularization. Cellular atypia and mitotic activity are prominent. Based on histologic findings, the lesion shows features consistent with a high-grade malignancy."} +{"pid": "TCGA-YT-A95D", "report": "The specimen was resected from the anterior mediastinum and measured 10.8 x 8.0 x 5.2cm. Histologic evaluation revealed a neoplasm with features consistent with a well-defined morphologic pattern. The surgical margins were found to be uninvolved, though narrowly so. Immunohistochemical analysis supported the morphologic findings, showing a profile typically associated with epithelial neoplasms of the mediastinum. No evidence of aggressive features or advanced staging was identified."} +{"pid": "TCGA-RC-A6M4", "report": "The surgical pathology report describes findings from two liver specimens obtained from a resection and biopsy. The first specimen, labeled \u201csegment six lesion,\u201d consists of a large, irregular mass measuring 19.5 x 15.0 x 10.5 cm and weighing 1,600 grams. The mass is predominantly encapsulated with a shaggy outer surface exhibiting multiple adhesions. A focal area of brown-yellow nodularity is noted at the resected margin, which is inked black. Upon sectioning, the mass appears dusky red-tan to green, necrotic, and soft to rubbery, extending to both the inked surgical margin and surrounding capsule. Minimal uninvolved liver parenchyma is present adjacent to one edge.\n\nMicroscopic examination reveals moderately differentiated tumor cells arranged in trabecular patterns. The tumor involves the inked surgical margin. No lymphovascular or perineural invasion is identified. Non-neoplastic liver tissue demonstrates mild portal tract lymphoplasmacytic infiltrate. Immunohistochemical staining shows positivity for CEA(p) and CD10 with a canalicular pattern.\n\nThe second specimen, labeled \u201cleft lateral segment nodule,\u201d is a small, unoriented nodule measuring 0.6 cm. It has a red-gray to white, rubbery cut surface and was entirely submitted for analysis.\n\nSynoptic staging data indicate that the tumor is confined to the liver with a pathologic T stage of pT3. Regional lymph node and distant metastasis assessments are not performed (pNx, pMx). Multiple tumor nodules are documented."} +{"pid": "TCGA-ZP-A9CY", "report": "The pathology report includes two specimens from the left lateral segment of the liver. Specimen A is a fresh tissue fragment measuring 2.8 x 1.1 x 0.4 cm, submitted in totality for frozen section analysis. The intraoperative frozen section interpretation indicated cirrhosis, negative for malignancy. The frozen section remnant was resubmitted for permanent sections.\n\nSpecimen B is a wedge of liver tissue weighing 17.9 grams and measuring 7.0 x 3.4 x 2.6 cm. It is mostly covered by a pink capsule and shows a nodular surface. The specimen was serially sectioned, revealing a dominant nodule measuring 2.8 x 2.5 x 2.0 cm located 0.3 cm from the nearest parenchymal resection margin. The nodule has a soft, yellow-tan to pink-red cut surface. A small amount of uninvolved liver parenchyma is present. A portion of fresh tissue was saved for a tissue bank. Representative sections of this specimen were submitted for histologic evaluation.\n\nHistologic examination of the permanent sections showed macronodular cirrhosis with features of steatohepatitis (grade 1, stage 4). No lymphovascular invasion was identified. The resection margins were microscopically evaluated and found to be free of abnormal cells. All relevant tissue was examined, and the lesion was completely excised."} +{"pid": "TCGA-A2-A1FW", "report": "A modified radical right mastectomy and sentinel lymph node biopsy were performed. Six sentinel lymph nodes were examined, with one (sentinel lymph node #4) showing evidence of metastatic involvement. Additional axillary dissection revealed 13 reactive lymph nodes, none of which showed signs of malignancy. The primary lesion measured 75 mm in greatest dimension and was located in the mid superior lateral region of the breast. The closest margin of resection was 25 mm from the deep margin, with all other margins uninvolved. Histologic evaluation demonstrated a poorly differentiated invasive carcinoma with a high histologic score of 9 (3+3+3), consistent with Grade 3 malignancy. Extensive angiolymphatic invasion was identified. Associated findings included fibrocystic changes, an incidental fibroadenoma measuring 10 mm, and stippled microcalcifications within non-neoplastic tissue. Immunohistochemical staining for pankeratin did not reveal micrometastases in the uninvolved lymph nodes. Pathologic staging was determined as T3 N2a, with no evidence of distant metastasis."} +{"pid": "TCGA-66-2773", "report": "The examined specimen included the right lower lobe and surrounding structures. Gross examination revealed a central lesion located at the hilus, measuring up to 8.5 cm in maximum dimension. The tumor was situated predominantly in segment 8 with extension into adjacent segments S6 and S9. It exhibited a soft to moderately firm consistency with areas of focal softening and yellow discoloration. The tumor had a relatively well-defined, somewhat arcuate border and approached the pleura at the S6/8 junction. There was evidence of involvement of intermediate branches of B8 within the tumor mass, along with narrowing of subsegmental branches of B6 and B9. Surrounding parenchyma showed incomplete atelectasis or compression, with patchy grayish-black areas visible on sectioning.\n\nThe pleura displayed diffuse dark discoloration and extensive grayish-yellow coating. A separate flat preparation of parietal pleura measured 8.5 x 3.2 cm and showed patchy brownish discoloration with surface involvement by the grayish-yellow coating.\n\nMultiple lymph nodes were identified and evaluated across various stations. At station 12 (upper lobe right), a 1.8 cm and a 2 cm lesioned node were observed. Two 0.6 cm lesioned nodes were found at station 10 (hilar right), while three small lesioned nodes (0.3\u20130.4 cm) were noted at station 9 (pulmonary ligament right). Station 8 (paraesophageal right) contained a 1.2 cm lesioned node and station 4 (low paratracheal right) showed four lesioned nodes ranging from 0.5 to 1.2 cm. All lymph nodes showed similar gross features including grayish-black appearance and variable size.\n\nHistologic evaluation focused on margins, lymph nodes, and pleural involvement. Sections included tumor with adjacent parenchyma, pleura, bronchial resection margins, and vascular margins. Special stains were applied in some sections for further characterization.\n\nFindings indicated no definitive infiltration of the visceral pleura and all bronchial and vascular resection margins were free of tumor involvement. Lymph nodes evaluated did not show evidence of metastatic involvement. Inflammatory changes were noted around the tumor margin including chronic organizing pneumonia and fibrosing pleuritis. Additional findings included interstitial inflammation and fibrosis with focal remodeling of lung parenchyma near S8 and subpleural macrophage accumulation in S10.\n\nAncillary studies did not reveal asbestos bodies in the examined sections; however, further specialized analyses would be necessary to assess potential asbestos exposure history."} +{"pid": "TCGA-D1-A16I", "report": "The specimen includes a uterus with bilateral ovaries and fallopian tubes, along with a portion of omentum and multiple lymph node groups. The uterus contains two distinct lesions: one measuring 2.9 x 2.1 x 1.1 cm located on the left lateral wall of the lower uterine segment, and another non-invasive lesion measuring 1.3 x 1.0 x 0.8 cm within an endometrial polyp. The invasive component extends 0.8 cm into the myometrium, where the total myometrial thickness is 1.2 cm in that region. There are also two benign leiomyomata present, ranging from 1.2 to 3.4 cm in size. The right fallopian tube contains a paratubal cyst, and there are calcified nodules identified in both adnexal regions. Both ovaries and the left fallopian tube show no involvement. The omentum consists of mature adipose tissue without evidence of tumor. A total of 50 lymph nodes were evaluated: 11 para-aortic lymph nodes above the inferior mesenteric artery, 11 below, 10 from the right pelvic region, and 19 from the left pelvic region \u2014 all were negative for tumor."} +{"pid": "TCGA-67-3773", "report": "The surgical specimen consisted of a left lower lobe superior segmentectomy, measuring 8 x 5 x 1.5 cm and weighing 24 grams. The pleural surface was tan-purple with diffuse anthracotic pigmentation and a 0.5 cm puckered area was noted. A palpable mass was identified beneath this area. Upon sectioning, a 1.5 x 1.3 x 1 cm pale tan firm lesion was found, located 0.4 cm from the stapled margin and involving the pleural surface. The surgical margins were inked, with no tumor involvement identified at the margins.\n\nHistologically, the lesion showed moderately differentiated morphology with histologic grade I-II features. Invasion extended into the lung parenchyma with focal involvement of the visceral pleura. No vascular or large vessel invasion was identified. Lymph node evaluation included multiple specimens from various levels: four lymph nodes from level 9L, five from level 6, four from level 5, and additional nodes from posterior hilar and superior segmental regions. All lymph nodes were negative for tumor involvement.\n\nImmunohistochemical staining demonstrated strong positivity for CK7 and TTF-1, with faint positivity for P53. Mesothelial markers including calretinin, CD15, WT1, and CK5/6 were negative. CK20 was also negative, and Ki67 showed a mildly elevated proliferative rate. Cytologic evaluation of a fine needle aspiration biopsy revealed malignant cells consistent with a primary pulmonary origin, present within a background of inflammation and fibrosis.\n\nRadiographic imaging demonstrated a noncalcified soft tissue density measuring approximately 2.2 x 1.3 cm in the left lower lobe, raising concern for neoplasm. Additional findings included bilateral apical opacities, interstitial densities suggestive of scarring, and mediastinal lymphadenopathy with a pretracheal lymph node measuring 1.8 x 0.8 cm. No pleural fluid was observed.\n\nStaging classification based on pathological findings indicated pT2 disease with no lymph node involvement (pN0), and distant metastasis could not be assessed (MX). Additional findings included patchy mild nonspecific chronic inflammation and scattered epithelioid granulomata."} +{"pid": "TCGA-EB-A550", "report": "The specimen consists of a skin flap measuring up to 10 x 4.5 cm, which includes a pigmented, mushroom-like lesion up to 5 cm in diameter and 15 mm in thickness. Microscopic examination reveals a malignant neoplasm of the skin characterized by pigmentation and the presence of ulceration. There is perifocal lymphoid infiltration. The depth of invasion corresponds to Clark level IV, and the Breslow thickness measures 15 mm. The tumor is ulcerated and pigmented, with no evidence of venous invasion. Margins are uninvolved. No satellite nodules, lymphatic invasion, or lymph node involvement are specified. There is no evidence of neo-adjuvant treatment effect. No additional findings or comments are noted."} +{"pid": "TCGA-BJ-A45D", "report": "The thyroid specimen weighed 27 grams and consisted of a unifocal lesion located in the isthmus measuring 2.5 cm. Microscopic examination revealed features consistent with a variant morphology characterized by follicular architecture and encapsulation. There were prominent degenerative changes present, including hemorrhage and tissue disruption, likely related to prior fine needle aspiration. No definitive evidence of capsular or true vascular invasion was identified. A single lymph node from the isthmic region showed no involvement. All surgical margins were free of abnormal cells. The lymphovascular invasion status could not be definitively determined. A separate parathyroid specimen weighed 143 mg and demonstrated mild enlargement with normal cellular composition."} +{"pid": "TCGA-VF-A8AA", "report": "The surgical pathology report describes a right testicle specimen weighing 31.7 grams and measuring 5.5 x 3.8 x 1.4 cm. The spermatic cord is present and measures 9.5 x 0.3 cm. A well-circumscribed, ovoid mass is identified within the testicle, located at the distal aspect and distant from the spermatic cord. The mass measures 1.5 x 1.2 x 1.0 cm and exhibits a white-tan rim with a pink-red inner core. The external surface of the specimen is entirely inked. Histologic evaluation of multiple representative sections shows that the mass is confined to the testis, with involvement of the tunica albuginea and rete testis. No involvement of the tunica vaginalis is observed. There is no evidence of lymphovascular invasion. The spermatic cord margin and other examined margins are free of tumor. The case was reviewed and verified by a pathologist. Clinical history includes a previous right inguinal hernia repair, orchiopexy, and vasectomy. The patient had a preoperative diagnosis of a right testicular mass. A right radical orchiectomy was performed."} +{"pid": "TCGA-44-3917", "report": "The specimen includes multiple lymph nodes and a right upper lobe of lung. The lymph nodes from level 10, R4, and level 7 were all negative for metastatic disease. The right upper lobe measured 17 x 11.2 x 4.2 cm and weighed 190 grams. A tumor mass was identified in the inferior portion, measuring 3.1 x 3.2 x 3 cm, located within 2 cm of the bronchial margin. The overlying pleura was smooth and glistening, and the tumor did not approach pleural surfaces. Two small subpleural fibrotic areas were noted. Histologically, the tumor was poorly differentiated and measured 3.2 cm in greatest dimension. All bronchial, vascular, and resection margins were free of tumor. There was no venous, arterial, or lymphatic invasion identified. Two lymph nodes attached to the main specimen and others from different levels were all negative for metastasis."} +{"pid": "TCGA-KM-A7QI", "report": "The right renal mass measured 4 x 3.5 x 3 cm and was described as a circular, red-tan lesion with a soft, fleshy to spongy consistency. The cut surface appeared homogeneous with areas of punctate hemorrhage. No margins were assessed. Histologic evaluation revealed cells with nuclear features corresponding to Grade 2. Cellular morphology and tissue architecture were evaluated, and representative sections were submitted for analysis. The tumor was fully staged based on size and histologic characteristics."} +{"pid": "TCGA-E9-A1R2", "report": "The lumpectomy specimen from the left breast weighs 85 grams and consists of an ovoid, lobulated tan fibroadipose tissue measuring 8 x 7 x 3.5 cm. Two needle localization wires are present. Two areas of interest were identified radiographically and marked as areas 1 and 2. Both regions correspond with microcalcifications. The specimen margins are inked blue for histologic evaluation.\n\nArea 1 is located near the midpoint of the long axis and contains an irregular mass measuring 2.4 x 1.9 x 1.4 cm. The cut surface of this mass is white-tan, smooth, and well-circumscribed. Grossly, it approaches the inked margin. Adjacent to the mass is a biopsy cavity measuring 0.7 x 0.3 cm containing collagen material, a small metal clip, and associated focal hemorrhage.\n\nArea 2 is located at one end of the specimen and consists of a firm, dense, fibrous region measuring 1.2 x 0.9 cm. This area comes within 0.7 cm of the nearest inked margin. Remaining sections of the specimen show tan, lobulated tissue with interspersed condensed white fibrous areas comprising approximately 25% of the tissue. Scattered regions of blue staining are also observed.\n\nMicroscopic examination of area 1 reveals an infiltrating epithelial neoplasm composed of markedly pleomorphic cells arranged in nests. A brisk mitotic rate is noted. Occasional intratumoral foci exhibit high-grade ductal carcinoma in situ features.\n\nHistologic grading using the Nottingham system shows minimal tubule formation (score 3), marked nuclear pleomorphism (score 3), and a mitotic index score of 2 (10\u201320 mitoses per 10 HPF). The combined histologic grade is poorly differentiated. Angiolymphatic invasion is present. Margins are not involved by tumor; however, the closest distance between tumor and margin is 1.9 cm.\n\nA total of 19 lymph nodes were identified, 17 of which contain metastases. The largest metastatic deposit measures 2.1 x 1.2 cm. There is no evidence of extracapsular extension in involved lymph nodes.\n\nEstrogen receptor status was previously found to be positive and progesterone receptor negative. HER2/neu testing on prior biopsy material showed no overexpression (score 2 by FISH).\n\nThe lesion is located in the upper outer quadrant of the left breast and was grossly evident. No evidence of neoadjuvant treatment effect is documented."} +{"pid": "TCGA-CS-5396", "report": "The surgical specimen from the right frontal region consists of two separate tissue samples. The first specimen measures 3.0 x 2.5 x 1.0 cm and is composed of multiple fragments of soft, red-tan tissue. Touch preparations and frozen section analysis were performed on approximately 20% of this sample. The second specimen measures 5.5 x 5.0 x 2.0 cm and includes multiple fragments of tan-white, hemorrhagic tissue with diffuse calcification observed upon sectioning.\n\nMicroscopic examination reveals areas of classic morphology in the first specimen without evidence of anaplasia. In contrast, the second specimen demonstrates foci of aggressive cellular features including markedly increased mitotic activity, microvascular proliferation, and necrosis. Immunohistochemical staining for Ki67 was performed to assess proliferative activity. Analysis involved counting over 1,000 cells across three high-power fields (each measuring 250 x 250 microns). The percentage of labeled nuclei ranged from 12.3% to 18%, with an average proliferation index of 16%.\n\nMolecular studies using fluorescent in-situ hybridization (FISH) were conducted on paraffin-embedded tumor sections to evaluate for chromosomal deletions. Two probe pairs were used: one targeting regions on chromosomes 1p and 1q, and another targeting regions on 19q and 19p. A total of 200 nuclei were analyzed for each probe set. The ratio of 1p to 1q was 0.59, with 71% of cells showing deletion of 1p. Similarly, the ratio of 19q to 19p was 0.61, with 71.5% of cells demonstrating deletion of 19q. These findings fall below the normal reference range and suggest combined chromosomal losses commonly associated with certain gliomas.\n\nLimitations of the assay include potential sampling error and the possibility of false-negative results if the proportion of malignant cells is low. Correlation with clinical and other laboratory findings is advised. All findings have been reviewed and interpreted by the signatory of record."} +{"pid": "TCGA-78-7159", "report": "A wedge resection of lung tissue measuring 130 x 70 x 30 mm was submitted. The specimen contains a line of staples 110 mm in length. A palpable mass is present on the pleural surface, with the pleura appearing free and mobile over the lesion. A firm pleural plaque, 30 mm in diameter, is located 35 mm from the mass. Serial sections reveal a well-defined yellowish-white lesion measuring 25 mm in greatest diameter, located approximately 2 mm beneath the pleura. Small areas of yellow necrosis are noted within the lesion. The lesion is at least 25 mm away from the stapled surgical margin. No additional lesions are identified. The surrounding lung tissue shows severe emphysema.\n\nMicroscopic examination reveals a peripherally located moderately differentiated epithelial lesion arranged predominantly in an acinar pattern with focal solid areas. Immunohistochemical staining demonstrates positivity for CK7 and TTF1, and negativity for CK20. Geographic zones of necrosis are present within the lesion. There is no involvement of the pleura or vascular, lymphatic, or perineural structures. Adjacent alveolated lung tissue shows features of organising pneumonia and acute bronchopneumonia. The remaining lung parenchyma exhibits emphysematous changes. Focal pleural and subpleural fibroelastotic scarring with calcification is also observed. No granulomatous inflammation is present.\n\nStaging classification indicates a T1 lesion based on size and local extent."} +{"pid": "TCGA-FP-A9TM", "report": "The gallbladder specimen demonstrates benign glandular extension into the fundal wall with prominent dilatation. A single lymph node is present and shows no malignant features. No dysplasia or malignancy is identified in the gallbladder.\n\nThe appendix appears unremarkable under microscopic evaluation. There is minimal inflammatory activity with no significant pathological findings. No dysplasia or malignancy is present.\n\nA tumor is identified in the proximal stomach near the esophagogastric junction. The lesion measures 2.9 x 1.8 cm and invades the submucosa. Histological analysis reveals gland-forming structures with areas of extracellular mucin, including microglands, small nests, and occasional single cells. Scattered signet ring cell forms are noted but are not the dominant morphology. Lymphovascular invasion is present. Margins of resection, including the distal and circumferential margins, are free of tumor involvement.\n\nA total of twenty-five lymph nodes are examined, with two showing evidence of metastatic involvement in the subcapsular sinus. No extracapsular extension is observed.\n\nAdditional findings include multiple fundic gland polyps and a few small hyperplastic polyps, all without dysplasia. In the gastric antrum, there is evidence of chemical gastropathy with focal areas of activity and relatively diffuse foveolar hyperplasia.\n\nThe final esophageal margin is evaluated microscopically and shows no evidence of tumor involvement or malignancy.\n\nGross examination of the gastrectomy specimen reveals a raised, irregular mass measuring up to 2.9 x 1.8 cm, located near the proximal margin of resection. The lesion appears to extend into the gastric wall but remains within 0.2 cm of the radial surgical margin. No other grossly abnormal lesions are identified in the stomach. Multiple small polyps are present throughout the gastric mucosa.\n\nLymph node assessment includes twenty-three nodes from the perigastric region, ranging from 0.2 to 0.7 cm in size. All nodes are submitted for histological review.\n\nThe appendix measures 6.6 x 0.7 cm and contains a small amount of luminal content without evidence of obstruction or inflammation. The gallbladder specimen measures 9.9 x 3.3 x 2.8 cm with a thickened fundal area measuring up to 0.8 cm. Bile is present but no calculi are identified."} +{"pid": "TCGA-XE-A8H5", "report": "The specimen consists of a right testicle weighing 166 grams, with overall dimensions of 9 x 6.5 x 5 cm. The attached spermatic cord measures 6 cm in length and 2.2 cm in diameter, and its surface is inked black. On sectioning, the tissue exhibits a pale tan, fleshy appearance with areas of necrosis measuring 5.5 x 4.5 x 3.5 cm. The tunica vaginalis is freely mobile and non-adherent.\n\nMicroscopic evaluation reveals no involvement of the rete testis, epididymis, peri-hilar fat, spermatic cord, tunica vaginalis, or scrotal wall. The tumor is unifocal and confined to the testis. No intratubular germ cell neoplasia is identified. Lymphovascular invasion is not present. The surgical margin at the spermatic cord is negative. The pathological staging is pT1aNXMX."} +{"pid": "TCGA-37-4132", "report": "The clinical specimen was obtained from a lung tissue source. A primary tumor was identified and processed into an OCT block for analysis. Additional samples included a blood sample collected via standard blood draw. Histological examination revealed the presence of malignant cells with squamous differentiation. The tumor was determined to be grade 2. Staging information indicates involvement of the primary site (T2), absence of regional lymph node spread (N0), and no evidence of distant metastasis (M1). No prior treatment was administered before procurement. Cellular morphology and staging details were documented, with no neoadjuvant therapy given. Tumor cell percentage was recorded at 74%."} +{"pid": "TCGA-2A-A8VT", "report": "A 4.7 cm long prostate specimen with right and left seminal vesicles measuring 3.0 x 1.3 cm and 3.3 x 1.5 cm respectively was examined. Histologic analysis showed a dominant mass involving the left and right posterior regions, extending from apex to base and into the left and right anterior areas. Vascular and perineural invasion were present. The extracapsular extension was noted in bilateral posterior regions (apex, mid, and base). Tumor involvement was also identified in both seminal vesicles and extended into the smooth muscle bundles corresponding to the rectal muscularis propria posteriorly. The apical surgical margin was involved. No tumor was seen at the bladder neck. High-grade intraepithelial neoplasia was present, and nodular hyperplasia was noted in non-neoplastic areas of the prostate.\n\nLymph node evaluation included a left pelvic dissection with 11 lymph nodes, one of which contained metastatic disease. The largest involved lymph node measured 0.4 cm, with a metastatic focus of 0.1 cm; extranodal extension was observed. In the right pelvic dissection, 5 lymph nodes were examined, one of which had metastatic involvement. The largest lymph node measured 1.0 cm, with a metastatic focus of 0.02 cm; no extranodal extension was found. Periprostatic fat excised was unremarkable, showing only benign adipose tissue.\n\nThe tumor was extensively sampled and submitted for analysis across multiple blocks from the prostate, seminal vesicles, surgical margins, and lymph nodes."} +{"pid": "TCGA-HT-8019", "report": "The pathology report demonstrates a glial neoplasm with mild to moderate hypercellularity, showing diffuse infiltration of both gray and white matter. Perineural satellitosis is present. The tumor cells exhibit round nuclei with mild atypia, open chromatin, and small nucleoli. Prominent perinuclear halos are noted. Cellular atypia is minimal, and no mitotic figures, microvascular proliferation, or necrosis are identified. The MIB-1 labeling index is measured at 18.8%, indicating a relatively high proliferative activity."} +{"pid": "TCGA-WD-A7RX", "report": "The liver lesion biopsy demonstrates a mass with multifocal involvement in the right lobe of the liver. The largest identified focus measures 3.3 cm in greatest dimension, with additional foci measuring 2.8 cm and 2.7 cm. The tumor is located near the parenchymal margin of resection, coming within 0.1 cm of the margin. It also extends into the adventitia of a large-caliber vein within the hepatic parenchyma, although the luminal space remains free of involvement. The mass is in close proximity to the liver capsule.\n\nHistologic evaluation reveals moderately differentiated malignant cells arranged in a mass-forming pattern. Immunohistochemical staining shows positivity for CK7, consistent with bile ductular origin, while markers associated with hepatocellular differentiation are negative. Additional stains including CD10 and poly-CEA demonstrate focal positivity, though no definitive canalicula pattern is observed. CD56 staining is negative. A trichrome stain confirms the presence of bridging fibrosis, corresponding to at least stage 3 of 4 fibrosis.\n\nThe uninvolved liver tissue shows features of evolving cirrhosis. No carcinoma is identified in the separate liver biopsy specimen. Venous invasion status is indeterminate, and no small vessel invasion is noted. Regional lymph nodes were not available for assessment. The tumor appears confined to the hepatic parenchyma without clear vascular lumen involvement."} +{"pid": "TCGA-B0-5081", "report": "The specimen consists of a right kidney removed via laparoscopic radical nephrectomy. A mass measuring 5.5 cm in greatest dimension is present. Histologic evaluation reveals a tumor composed of cells with clear cytoplasm and well-defined borders. Nuclear features are consistent with intermediate grade morphology, based on nuclear size, shape, and nucleolar prominence. The lesion demonstrates extension into the renal vein, both macroscopically and microscopically. There is no involvement identified within the renal sinus or surrounding perirenal fat. Surgical margins are negative for tumor involvement. Additional findings include cystic changes involving the ureter. No adrenal gland tissue was identified within the specimen. Based on these findings, the pathologic staging classification is pT3b NX MX."} +{"pid": "TCGA-XU-A931", "report": "The specimen consists of an irregular piece of adipose tissue measuring 15.5 x 7.5 x 1.7 cm and weighing 32.2 grams. A separate, well-circumscribed mass measuring 3.7 x 1.1 x 2.5 cm is present within the specimen. The mass has a tan, irregular, soft parenchyma. Microscopic evaluation reveals an encapsulated lesion composed of nests of cells separated by thick fibrous septa. The majority of the lesion is composed of polygonal cells with mildly atypical nuclei and single nucleoli. The cellular composition is predominantly epithelial in arrangement, with only occasional interspersed small lymphocytes throughout most of the lesion. In some areas, there is a slightly increased presence of lymphocytes. Immunohistochemical staining shows positivity for high and low molecular weight keratins, CK 5/6, and p63 in the tumor cells. Rare small lymphocytes demonstrate positivity for CD1a, more prominently in certain regions. Histologic examination identifies multiple foci of microscopic invasion into the surrounding mediastinal fat. The resection margins, marked with silver nitrate, are free of tumor involvement. The lesion demonstrates features associated with a specific classification based on histologic patterns and immunophenotype. Staging is based on the presence of microscopic transcapsular invasion, with no assessment available for regional lymph nodes or distant metastasis. Additional findings include thymic tissue with involutional changes and one parathyroid gland without notable abnormalities. Representative sections of the lesion and surrounding adipose tissue have been banked for further study."} +{"pid": "TCGA-D8-A145", "report": "Histopathological examination of a right breast specimen measuring 18.3 x 18.8 x 4.2 cm with a skin flap of 14.6 x 7.1 cm and weighing 580 g was conducted. A lesion measuring 1.6 x 1.2 x 1.8 cm was identified at the boundary of the outer quadrants, located 5.2 cm from the outer edge, 1.2 cm from the base, and 0.8 cm from the skin. The material included post-core needle biopsy changes.\n\nMicroscopic evaluation revealed a proliferation with architectural features including ductal patterns and nuclear grading corresponding to NHG2. Mitotic activity measured 2 mitoses per 10 high-power fields within a visual field diameter of 0.55 mm. Adjacent intraductal papillomatosis was observed alongside parenchymal atrophy.\n\nLymph node involvement was noted in the axillary region with metastatic presence detected (I/VII). Immunohistochemical staining demonstrated estrogen receptor positivity in 75% of neoplastic nuclei and progesterone receptor positivity in 10%. HER2 staining yielded a score of 2+, prompting recommendation for confirmatory FISH testing.\n\nThe lesion was classified as pT1c with regional lymph node involvement staged as pN1a. Vascular invasion was not explicitly mentioned in the findings."} +{"pid": "TCGA-ZF-AA5P", "report": "Histopathology report. The specimen includes sections of bladder and prostate, right and left lymph nodes, left and right ureteric resection margins, and surrounding fatty tissue. Gross examination of the bladder revealed a firm, flat mass on the left inferior lateral wall measuring 18 x 15 mm. It extended into the perivesical fat with an infiltration depth of 11 mm. No lymph nodes were found within the perivesical fat. The prostate measured 70 x 50 x 32 mm and showed multiple nodules; one lesion was identified in the left lobe.\n\nMicroscopic evaluation of the bladder lesion confirmed invasive carcinoma involving the muscularis propria, without extension into the perivesical fat. Additional foci of invasive disease were present in the trigone and posterior wall, with micropapillary features observed in the posterior wall lesion. Extensive high-grade intraepithelial neoplasia was noted throughout the bladder. No involvement was seen in the prostatic urethra or ducts. A small focus of organ-confined microacinar proliferation was identified in the left lobe of the prostate, with no extraprostatic or perineural invasion. Urethral surgical margin appeared histologically normal.\n\nLymph node assessment: seven nodes from the right side showed no evidence of metastasis. Two nodes from the left obturator region were negative. Of three nodes from the left external iliac region, one contained metastatic cells. One node from the left internal iliac region also showed involvement, with no extracapsular extension identified in either region. Evaluation of the left ureteric margin showed only thick muscle wall tissue, likely ureteric, with no tumor involvement and no urothelium present. The right ureteric margin was histologically unremarkable.\n\nAll tissue was processed completely and findings were consistent across sections."} +{"pid": "TCGA-DU-6394", "report": "HOSP. NO. : SURGERY DATE: RECEIVE DATE. PATHOLOGICAL DIAGNOSIS: RIGHT FRONTAL LOBE: Operation/Specimen: Right frontal lobe. Clinical History and Pre-Op Dx: None provided. GROSS PATHOLOGY Specimen A, labeled \"frontal lobe tumor\", is a 3 x 2 x 1.5 cm gray-brown tissue. A portion of the specimen has been examined by frozen section and is submitted in cassette 1, remaining tissue in cassettes 2 & 3. Frozen section diagnosis: Glioma. Specimen B, labeled \"right frontal lobectomy\", is a portion of brain tissue measuring 4.5 x 3 x 2 cm. Multiple sections through the specimen show no grossly identifiable tumor tissue. Representative sections are submitted in cassettes 4\u20139. MICROSCOPIC: There is a high cellular lesion with features suggestive of oligodendroglial origin, characterized by scattered calcifications. The lesion diffusely infiltrates the cortex with prominent neuronal satellitosis and subpial extensions observed. Moderate nuclear pleomorphism and frequent mitotic figures are present. Endothelial hyperplasia is mild and necrosis is absent. Immunohistochemical staining using Ki67 monoclonal antibody MIB-1 demonstrates a proliferative index of 15\u201320%."} +{"pid": "TCGA-DD-A114", "report": "The specimen consists of a right lobe liver measuring 17.0 x 15.0 x 7.5 cm with gallbladder (9.5 x 5.4 cm), together weighing 1,015 grams. A single mass measuring 3.1 x 2.4 x 2.3 cm is present in the right lobe. The hepatic capsule is free of tumor. Surgical margins are free of tumor, with a clearance of 0.5 cm. Vascular invasion is identified outside the tumor margin. The lesion is not encapsulated and shows a pushing type of infiltration into the surrounding parenchyma. No lymph nodes are identified. The gallbladder demonstrates cholesterolosis and is otherwise unremarkable. Assessment of non-neoplastic liver tissue reveals chronic hepatitis consistent with hepatitis C virus (HCV) infection, mildly active (grade 2 of 4), with portal and periportal fibrosis (stage 2)."} +{"pid": "TCGA-G7-A8LC", "report": "The specimen consists of two parts: a right renal tumor base and a right kidney tumor. Grossly, the right renal tumor base measures 0.3 x 0.2 x 0.1 cm and is described as a red-tan soft tissue fragment. The right kidney tumor specimen weighs 9 grams and measures 3.7 x 2.5 x 1.3 cm. It includes a 1.3 x 0.5 x 0.5 cm piece of attached perinephric fat. On external examination, there is a 1.5 x 1.0 cm defect on the surface. The specimen was oriented and inked with black at the true margin surrounding the defect and orange elsewhere. Upon sectioning, a well-circumscribed nodule measuring 2.5 x 2.3 x 1.8 cm was identified adjacent to the true margin. All tissue from this area was submitted for analysis.\n\nMicroscopic evaluation revealed a unifocal lesion confined within the kidney without invasion into surrounding vascular structures or lymphatic spaces. There was no involvement of perinephric tissue. Histologic grading showed nuclei with slight irregularities and evident nucleoli (Fuhrman Nuclear Grade 2). Immunohistochemical staining demonstrated positivity for cytokeratin 7 and CD10 in tumor cells. Additional staining on another block showed positivity for racemase and equivocal staining for carbonic anhydrase IX.\n\nMargins were involved by invasive cellular elements. No adrenal gland or regional lymph nodes were present for evaluation. Based on macroscopic findings and AJCC staging criteria (7th edition), the lesion was staged as pT1a with no assessable metastatic component (pMX). No additional significant findings were noted."} +{"pid": "TCGA-RW-A68B", "report": "The patient is male. A right adrenal mass was identified following imaging and was subsequently resected. The right adrenal gland weighed 8.68 grams and measured 3.5 x 5.1 x 1.0 cm. A distinct nodular lesion measuring 1.6 x 1.5 x 1.3 cm was identified within the adrenal gland. The nodule appeared tan-brown, was well-circumscribed, and was surrounded by yellow cortical tissue. No other gross abnormalities were noted. The tumor was centrally located, and portions of it were submitted for tissue analysis. Additional sections of the nodule and surrounding adrenal tissue were submitted in five labeled cassettes (A\u2013E). Microscopic evaluation was performed by the staff pathologist, who confirmed the findings based on slide interpretation."} +{"pid": "TCGA-A7-A425", "report": "Final Surgical Pathology Report. Procedure: Diagnosis. A. Lymph node, right axillary sentinel node, excision: One lymph node positive for metastatic carcinoma. B. Breast, right, excision: Histologic type is lobular. Architectural score is 3, nuclear score is 2, and mitotic score is 1, resulting in an overall grade of 2. The greatest dimension of the lesion is 7.5 cm (pT3). Tumor is more than 2 cm from the deep margin of excision and 1 cm from the superficial soft tissue margin. Vascular invasion is present. There is no evidence of Paget's disease or ductal carcinoma in situ. Biopsy site changes and fibrocystic changes are noted in the surrounding breast tissue. C. Lymph nodes, right axillary contents, excision: Ten of sixteen lymph nodes show involvement. D. Lymph node, highest apical node, excision: One of two lymph nodes is involved. A total of twelve out of nineteen lymph nodes are positive for metastatic involvement. The largest metastasis measures 2.9 cm. Extracapsular extension is present (pN3a). Distant metastasis cannot be assessed (pMX). \n\nGross Description: A. A lymph node measuring 2.9 x 1.7 x 1.4 cm with firm consistency and yellowish discoloration is identified. Sections are submitted for frozen and permanent sectioning. B. A breast specimen weighing 1220 g and measuring 29.0 x 23.5 x 5.8 cm shows a central tumor mass measuring 7.5 x 5.5 x 4.0 cm. The tumor is located within 3.5 cm of the deep margin and approaches the anterior surface to within 2 cm. The remaining tissue consists predominantly of adipose tissue with scattered fibrous elements. No other mass lesions are found. C. Right axillary contents consist of fatty tissue fragments containing multiple lymph nodes ranging from 0.1 to 2.5 cm. D. The highest apical node specimen contains two lymph nodes measuring 0.5 cm and 0.2 cm. \n\nSummary of tissue sampling includes margins, lesion proximity to surrounding structures, and multiple regional sites."} +{"pid": "TCGA-D7-5578", "report": "Histopathological examination was performed on a total organ resection specimen of the stomach. The clinical presentation was bleeding from a gastric lesion. Macroscopically, the resected stomach measured 17 x 10 cm and was submitted with attached omentum measuring 37 x 30 cm. No focal lesions were identified in the main specimen. A lesion measuring 7 x 6 x 0.5 cm was observed on the lesser curvature, located 2.7 cm from the proximal margin and 1.6 cm from the distal margin.\n\nMicroscopic evaluation revealed glandular structures with varying degrees of differentiation. There was evidence of infiltration into the muscularis propria and surrounding perigastric adipose tissue. Vascular invasion was also noted. Surgical margins were free of malignant involvement, while the mucosa showed chronic high-grade inflammation with focal intestinal metaplasia. The omentum did not show any signs of metastatic involvement.\n\nLymph node analysis demonstrated the presence of abnormal cellular aggregates within lymph nodes classified as VI/XIX. These showed capsular and perinodal adipose tissue infiltration by atypical cells."} +{"pid": "TCGA-23-1119", "report": "The surgical specimen included a uterus weighing 110 grams, with bilateral fallopian tubes and ovaries. The uterus measured 5.6 cm from fundus to ectocervix, 3 cm from cornu to cornu, and 2.5 cm anterior to posterior. The posterior serosal surface contained a 4 x 3 x 1.5 cm tan nodular mass with a firm cut surface. The endocervix showed chronic cystic changes and immature squamous metaplasia. A 0.5 x 0.4 x 0.2 cm polyp was identified in the lower uterine segment, composed of hyperplastic endometrial and endocervical glands within fibrotic stroma. The remainder of the endometrium was atrophic with focal cystic change.\n\nThe left ovary was replaced by a 9 x 7 x 3 cm solid mass that extended into the posterior uterine wall. The mass had a tan, firm, variegated cut surface with areas of congestion and infiltrated the isthmic portion and fimbriated end of the left fallopian tube. The right ovary measured 3 x 1.5 x 0.6 cm with tan-white fibrous parenchyma; no gross lesion was present. The right fallopian tube was intact but showed multiple paratubal cysts up to 0.4 cm.\n\nTumor involvement was noted extensively on the posterior uterine serosa, replacing the left ovary and extending into the left fallopian tube with surface rupture and serosal infiltration. Focal vascular and lymphatic invasion were present. The right ovary and fallopian tube also showed focal serosal infiltration. Additional sites of involvement included the bladder peritoneum, omental fragments, cul-de-sac, sigmoid colon, left sigmoid region, diaphragm, and left lateral pelvic wall. In each location, soft tan tissue infiltrated the peritoneal or fibrous surfaces.\n\nLymph node assessment included two left pelvic lymph nodes, which showed no evidence of tumor involvement. Multiple biopsies from various regions of the uterus, fallopian tubes, ovaries, and surrounding tissues were submitted for histological evaluation. Adipose and fibrous tissue specimens from other abdominal and pelvic sites were also examined, with some showing tumor infiltration."} +{"pid": "TCGA-X7-A8DE", "report": "The specimen consists of two fragments of fibroadipose tissue; the larger measures 14.5 x 7 x 1.2 cm and weighs 60 grams, while the smaller is 3.5 x 3.5 x 0.5 cm. The larger fragment reveals a well-circumscribed, homogeneous, yellow-tan nodule measuring 1.7 cm in greatest dimension, adjacent to the external surface. No lesion is identified in the smaller fragment. Three potential lymph nodes are identified, ranging from 0.4 to 0.5 cm; all appear benign upon histologic evaluation. Histologic sections include the entire nodule and representative areas of both fragments. Microscopic examination confirms the presence of microcyst formation within the nodule. Seven lymph nodes are identified as benign. Gene expression analysis was performed using RT-PCR on a 23-gene panel (including four controls) from formalin-fixed paraffin-embedded tumor tissue. Results were compared to a training set with known outcomes to determine molecular classification. The molecular signature indicates a low risk for near-term clinical metastasis."} +{"pid": "TCGA-BQ-5876", "report": "The specimen consists of a piece of renal cortex measuring 4 x 3.5 x 1 cm. A well-circumscribed, cystic lesion measuring 1.3 x 0.5 x 2 cm is identified, filled with gray-tan, soft, necrotic-appearing material. The tumor is located 0.2 cm from the surgical margin, which is inked black. No involvement of the renal vein is observed. The lesion is confined within the renal capsule. Histologic examination reveals high-grade cellular features. A small incidental lesion measuring 1.0 mm is noted in the background. Representative sections are submitted for evaluation, including frozen section control and tissue blocks for further analysis. Intraoperative consultation confirms a neoplastic process involving renal cortical tissue, with the stitched margin free of tumor. Permanent section findings are consistent with the intraoperative assessment."} +{"pid": "TCGA-HZ-8003", "report": "Path Report. Accession No. Final Diagnosis(es): (A) Lymph node, pericaval, biopsy: One lymph node negative for metastatic malignancy (0/1). (B) Lymph node, hepatic artery, biopsy: One lymph node negative for metastatic malignancy (0/1). (C) Bile duct margin, biopsy: Negative for malignancy. (D) Pancreas margin, biopsy: Negative for malignancy. (E) Antrum, duodenum, head of pancreas, common bile duct, and proximal jejunum, Whipple: see synoptic report.\n\nSynoptic Report: Specimen: Head of pancreas. Procedure: Pancreaticoduodenectomy (Whipple resection), partial pancreatectomy. Tumor Site: Pancreatic head. Tumor Size: Greatest Dimension: 2.8 cm. Additional Dimensions: 1.8 x 2.2 cm. Histologic Type: Ductal adenocarcinoma. Histologic Grade: G2: Moderately differentiated. Microscopic Tumor Extension: Tumor invades duodenal wall. Margins: Margins uninvolved by invasive carcinoma. Lymphvascular Invasion: Present. Perineural Invasion: Present. Pathologic Staging: Primary Tumor: pT3; tumor extends beyond the pancreas but without involvement of the celiac axis or the superior mesenteric artery. Regional Lymph Nodes: pN1; regional lymph node metastasis. Number of Lymph Nodes Examined: 12. Number of Lymph Nodes Involved: 1. Additional Pathologic Findings: Chronic pancreatitis. The gross description and all microscopic slides have been reviewed and information from the pathologist is included. Specimen(s) Received: A: Pericaval lymph node. B: Hepatic artery lymph node. C: Bile duct margin. D: Pancreas margin. E: Antrum, duodenum, head of pancreas, common bile duct, and proximal jejunum. Clinical History: Adenocarcinoma of the head of pancreas. (C) Stitch marks marginal. Intraoperative Consultation: FSA1: Pericaval lymph node: No carcinoma (1 block). FSB1-FSB2: Hepatic artery lymph node: No carcinoma (2 blocks). FSC1: Bile duct margin: No carcinoma (1 block). FSD1: Pancreatic margin: No carcinoma (1 block).\n\nGross Description: (A) (pericaval lymph node) Received fresh for frozen section evaluation of metastatic disease is a 0.8 x 0.6 x 0.3 cm, red-yellow, fatty tissue fragment. The specimen is bisected and submitted in toto in cassette FSA1. (B) (hepatic artery lymph node) Received fresh for frozen section evaluation of metastatic disease is a 2.0 x 0.8 x 0.5 cm, tan, rubbery lymph node. The specimen is bisected and submitted in toto in cassettes FSB1 and FSB2. (C) (bile duct margin) Received fresh for frozen section evaluation for margins is a 1.2 x 1.0 x 0.4 cm, tan-red, donut-shaped tissue fragment. The specimen is submitted in toto in FSC1. (D) (pancreas margin) Received fresh for frozen section evaluation for margins is a 2.0 x 1.2 x 0.5 cm, tan-red, fragment of pancreas. The specimen is submitted in toto in FSD1. (E) (antrum, duodenum, head of pancreas, common bile duct and proximal jejunum). Received fresh and subsequently placed in formalin after sections were taken for Tumor Bank are a previously opened antrum of stomach (13.3 x 5.7 x 0.3 cm wall thickness), duodenum (21.5 x 7.1 x 0.7 cm wall thickness), pancreas (5.3 x 2.7 x 2.4 cm), bile duct (5.0 cm in length by 1.0 cm in diameter), and gallbladder (9.3 x 2.7 x 1.7 cm). The posterior aspect of the pancreas has been inked black, the anterior yellow, uncinate margin green, vascular notch margin purple, and pancreatic duct margin red. The bile duct is opened longitudinally revealing dilatation of the bile duct. A longitudinal section through the bile duct and duodenum reveals no gross invasion of tumor into the ampulla or duodenum. Sectioning through the pancreas reveals a firm, tan lesion within the head of the pancreas that measures 1.8 x 2.2 x 2.8 cm. The tumor appears to be invading into the duodenal wall but not into the duodenal mucosa. The lesion is located approximately 1.0 cm away from the uncinate margin, approximately 1.8 cm away from the pancreatic duct margin, and at least 1.0 cm away from the posterior pancreatic margin. The antral stomach mucosa is tan and rugated without lesions or ulcers. The duodenal mucosa is tan and rugated with congestion of the distal aspect. No lesions or masses are identified in the duodenum. The serosal surface of the gallbladder is gray-purple and glistening. The gallbladder is opened revealing a wall thickness of 0.3 cm and a mucosa that is velvety, purple-gray. No stones or lesions are identified. Palpation and dissection reveal seven tan potential perigastric lymph nodes that range in size from 0.3 to 0.7 cm in greatest dimension. One tan potential lymph node is found inferior to the pancreas measuring up to 0.6 cm in greatest dimension.\n\nBlocks Submitted: E1 - pancreatic duct margin. E2-E3 - proximal stomach margin. E4-E5 - distal small bowel margin. E6-E7 - uncinate margin. E8-E9 - longitudinal section through ampulla and duodenum. E10-E12 - representative sections through tumor. E13 - tumor to stomach. E14 - representative section through stomach. E15 - representative section through duodenum. E16 - representative sections through grossly uninvolved pancreas. E17 - representative section of the gallbladder including a cross section of the cystic duct. E18 - seven potential perigastric lymph nodes. E19 - one potential inferior pancreatic lymph node.\n\nMicroscopic Description: Complete microscopic evaluation has been performed. Unless otherwise stated in the report, all tissue tested for ER/PR by IHC, Her2 by IHC and/or HER2 by FISH have been fixed as per ANP.22998 for a minimum of 6 hours and a maximum of 48 hours. ER, PR, Ki-67, p53 are reported as a semi-qualitative percentage of positively stained nuclei. Her-2/neu and EGFR are scored as follows: No staining at all is scored as (0), weak, incomplete membrane staining in any proportion of cells is scored as (1+), less than strong but complete staining in any proportion of cells or complete strong staining in less than 30% of cells is scored as (2+), and strong complete staining in more than 30% of cells is scored as (3+). All studies are performed on tissue fixed in 10% neutral buffered formalin and embedded in paraffin unless otherwise stated in the report."} +{"pid": "TCGA-A8-A093", "report": "The specimen shows a well-differentiated invasive lesion measuring 2.7 cm in greatest dimension. The architecture demonstrates focal intraductal growth patterns. Histologic grade is low nuclear grade with favorable morphological features. Staging parameters indicate pT2 classification with no lymph node involvement identified. Vascular invasion could not be definitively assessed due to limited sampling."} +{"pid": "TCGA-18-4721", "report": "The specimen included multiple tissue samples from various anatomical sites. The first sample, labeled as a rib, showed no visible abnormalities and was not submitted for histological evaluation. Several lymph node specimens were obtained from different locations, including the inferior pulmonary ligament, right tracheobronchial angle, subaortic region, and anterior mediastinum. All of these lymph nodes were small, ranging in size from 0.5 cm to 1.0 cm in diameter, and were found to be negative for malignancy.\n\nA left lower lobe lung specimen was also submitted, measuring 16.0 x 10.5 x 7.0 cm in its inflated state. A segment of bronchus attached to the specimen measured 1.2 cm in length and 1.3 cm in diameter. The bronchial resection margin was examined and found to be free of tumor involvement. Within the lung parenchyma, a well-defined tan-black mass was identified, measuring 3.0 x 2.3 x 2.5 cm. The mass was located laterally to the bronchus and was approximately 3.0 cm from the bronchial resection margin and 0.15 cm from the pleural surface. No gross evidence of pleural invasion was observed.\n\nLymph nodes associated with the lung specimen included one interlobar, three lobar, and one segmental lymph node. All were negative for malignancy. Histological examination of the tumor showed features consistent with moderately differentiated cellular changes. Intraoperative frozen sections confirmed the absence of tumor at the bronchial margin and the presence of the aforementioned cellular characteristics in the tumor. Based on the findings, the resection appeared to be complete, with no evidence of residual disease in the examined margins or lymph nodes."} +{"pid": "TCGA-K4-A3WU", "report": "A radical cystoprostatectomy specimen was submitted, measuring 14 cm from superior to inferior. The prostate measured 4 cm (superior-inferior), 6 cm (right-left), and 4 cm (anterior-posterior). The bladder cavity appeared contracted, measuring 3.5 cm (superior-inferior), 2 cm (right-left), and 2 cm (anterior-posterior). Edematous and congested bladder mucosa was noted with an area of induration and ulceration at the posterior bladder base. The right and left vas deferens were identified in the posterior bladder wall, measuring 1 cm on the right and 5 mm on the left. The right ureter was more superficial with surrounding induration, while the left ureter was deeply retracted. Each seminal vesicle measured 4 x 1.5 x 1 cm on the right and 4 x 1.5 x 1.5 cm on the left. Tissue surrounding the inferior prostate/urethral junction showed some disruption.\n\nMargins were examined microscopically and no tumor was identified at the right or left distal ureter margins. Histologic evaluation of the bladder, prostate, and seminal vesicles revealed high-grade invasive malignancy with direct extension into prostatic stroma. No invasion was seen in the seminal vesicles or pelvic/abdominal wall. Lymphatic invasion was present. In addition, there was evidence of associated intraepithelial neoplasia. No tumor was identified at any surgical margins.\n\nFive lymph nodes were examined on the right side; none showed involvement. Similarly, no tumor was found in the left pelvic lymph nodes. A total of five lymph nodes were evaluated (0/5 positive). Adenocarcinoma was identified in the prostate with a Gleason score of 3 + 3 = 6/10. No extraprostatic extension was observed. The dominant nodule was not present. No treatment effect was identified. The tumor was located primarily in the peripheral zone, posterior aspect of the prostate.\n\nThe specimen type was radical cystoprostatectomy, with a gross size of 4 x 6 x 4 cm. Microvascular invasion was not seen, and perineural invasion was absent. No tumor was detected in the seminal vesicles or at the specimen margins.\n\nSections from multiple regions of the bladder base, prostate, seminal vesicles, and ureters were submitted for analysis. The lymph node specimens included fibroadipose tissue fragments measuring 3.5 x 1.5 x 1 cm on the right and 3 x 1.5 x 1 cm on the left. All tissue samples were processed with routine hematoxylin and eosin staining."} +{"pid": "TCGA-BH-A0HN", "report": "The specimen from the left breast segmental mastectomy shows a focus of invasive cellular proliferation measuring 1.6 cm in largest dimension by microscopic measurement, located 4 mm from the closest anterior margin. The invasive component is present within a background lesion characterized by solid papillary architecture. A significant component of intraductal proliferation is also present, accounting for approximately 60% of the total tumor volume, with areas of admixture and distribution away from the invasive focus. The intraductal component exhibits cribriform, papillary, and micropapillary patterns, with nuclear grade 2 features.\n\nNo lymphovascular invasion was identified. Additional findings include atypical ductal hyperplasia, atypical papilloma, intraductal papillomas, fibrocystic changes, columnar cell change, sclerosing adenosis, and microcalcifications. There is evidence of biopsy site changes.\n\nImmunohistochemical staining of the invasive component demonstrates positivity for estrogen and progesterone receptors. HER2 immunostaining is scored as 2+, but fluorescence in situ hybridization (FISH) analysis does not show gene amplification.\n\nIn the new lateral margin biopsy, there is intraductal proliferation with solid, papillary, and micropapillary patterns, nuclear grade 2, extending to the medial margin. Additional findings include atypical ductal hyperplasia, atypical papilloma, flat epithelial atypia, papillomas, and fibrocystic changes. The entire specimen was submitted for examination.\n\nAt the superior margin, intraductal proliferation with cribriform, micropapillary, and cribriform patterns, nuclear grade 2, is present less than 1 mm from the resection margin. Other findings include atypical ductal hyperplasia, flat epithelial atypia, papillomas, and fibrocystic changes. The full specimen was examined microscopically.\n\nThe deep margin biopsy reveals atypical ductal hyperplasia, multiple papillomas, radial scar, sclerosing adenosis, and fibrocystic changes. The entire specimen was submitted for histologic evaluation.\n\nExamination of two left axillary sentinel lymph nodes showed no evidence of metastatic involvement."} +{"pid": "TCGA-AO-A0J5", "report": "The specimen from a female patient consists of a right breast and axillary contents following debulking surgery. The breast measures 20 x 15 x 5 cm with an overlying skin ellipse measuring 18 x 7 x 0.2 cm. A retracted nipple is present, measuring 1.5 x 1.0 x 1.0 cm, with surrounding skin thickened up to 0.6 cm. The axillary contents measure 7 x 5 x 2 cm. The posterior surface of the breast is inked black and the anterior blue. Part of the posterior surface is covered by skeletal muscle measuring 11 x 4 x 0.5 cm.\n\nOn sectioning, an irregular tumor bed measuring 10 x 8.3 x 5.1 cm is identified, occupying almost the entire breast volume and extending through all four quadrants. The tumor is located 0.2 cm from the posterior margin, 0.3 cm from the anterior margin, and 0.5 cm from the skeletal muscle. The nearest deep margin is less than 0.1 cm from the tumor. The tumor has a white, firm, tan appearance with poorly defined borders. Non-neoplastic breast tissue shows yellow fatty areas with fibrosis. Focal changes consistent with prior procedure are noted in the axillary tail.\n\nHistologically, the tumor demonstrates at least 10 cm in greatest dimension. It shows features including moderate to slight or no tubule formation, with nuclear grade showing marked variation in size and shape. The tumor exhibits micropapillary features and focal extracellular mucin. Ductal intraepithelial components are identified, including solid, cribriform, micropapillary, and flat types, with high nuclear grade and extensive necrosis. Lobular involvement is also present. These in situ elements constitute less than or equal to 25% of the total tumor mass and are found both admixed with and away from the invasive component. The invasive component and in situ elements are present in all four quadrants. The nipple and skin are involved by invasive disease, with direct extension into the dermis and skeletal muscle. Vascular invasion is present.\n\nIn the axillary region, 13 possible lymph nodes are identified, ranging in size from 0.4 to 1.2 cm. Metastatic disease is present in two out of two level I lymph nodes, and numerous foci are noted in the axillary soft tissue, with the largest measuring at least 1.4 cm.\n\nImmunohistochemical analysis of the invasive component (block 1-8) shows 90% nuclear staining for estrogen receptor with strong intensity, and negative staining for progesterone receptor. HER2 testing is equivocal (focal 2+), and fluorescence in situ hybridization (FISH) will be performed. Five percent of tumor cells show complete membranous staining, though staining uniformity and a homogeneous, dark circumferential pattern are absent. E-cadherin staining is positive, supporting lobular differentiation.\n\nControls are satisfactory. The HER2 test is performed using an FDA-approved rabbit monoclonal antibody (clone 4B5) and results are reported in accordance with ASCO/CAP guidelines. ER and PR rabbit monoclonal antibodies are also FDA approved. Some immunohistochemistry and ISH tests were developed within the laboratory; their performance characteristics have been established and are used for clinical purposes under CLIA certification."} +{"pid": "TCGA-MQ-A6BQ", "report": "The specimen was received in two parts, each labeled with the patient\u2019s name. Part one, submitted as a fresh sample for frozen section, consisted of four fragments of pink-yellow fibrofatty tissue measuring 0.5 x 0.6 x 0.4 cm, 1.2 x 0.8 x 0.3 cm, 0.9 x 0.9 x 0.4 cm, and 1 x 0.7 x 0.3 cm. Representative sections were used for frozen section evaluation, tissue banking, and final submission. Part two was received in saline and comprised multiple pieces of pink-yellow rubbery tissue measuring 2 x 1 x 0.3 cm in aggregate; this portion was submitted entirely.\n\nHistologic examination revealed epithelioid cells arranged in sheets and tubules, invading the pleural tissue. The cells exhibited moderate nuclear atypia, with some showing prominent nucleoli. Mitotic activity was present. A background of non-necrotizing granulomatous inflammation was also noted.\n\nImmunohistochemical staining showed diffuse positivity for calretinin, WT-1, and CK5/6. Focal positivity was observed for D2-40. Special stains for microorganisms, including GMS and AFB, were negative. These findings were consistent with intraoperative consultation results indicating an epithelioid tumor involving the pleura."} +{"pid": "TCGA-KL-8344", "report": "The specimen from a right nephrectomy includes the kidney and adrenal gland. The kidney measures 15 x 10.5 x 6.5 cm and is associated with perinephric fat. A mass located in the superior pole measures 8.5 x 8.5 x 5.5 cm, with a central fibrous scar measuring 4.5 cm. The mass appears lobulated, tan-brown, and is confined to the cortex without gross extension into the perirenal fat. It abuts the renal sinus fat but does not appear to involve the renal pelvis or invade the vascular structures. The remainder of the kidney shows a well-defined corticomedullary junction, and no significant pathological changes are noted in the non-neoplastic tissue. The adrenal gland measures 5.5 x 0.8 x 0.5 cm and shows no involvement. Surgical margins are free of tumor. Fifteen lymph nodes from the paracaval and interaortocaval regions were examined, none of which show involvement. Microscopic evaluation confirms the absence of small vessel angiolymphatic invasion and renal vein involvement. Immunohistochemical staining supports the findings. Based on these observations, the staging reflects a tumor that extends into the perinephric tissues or adrenal gland but remains within Gerota's fascia."} +{"pid": "TCGA-55-8091", "report": "The specimen consists of multiple tissue fragments submitted from various anatomical sites. A right lower lobe pulmonary parenchyma specimen weighing 313 grams measures 15.2 x 10.5 x 5.5 cm. A subpleural nodular lesion measuring 2.0 x 2.0 x 1.6 cm is identified, with a gritty gray-tan fibrotic cut surface. The lesion extends to the pleural surface and is located 2.8 cm from the bronchial margin. Another subpleural nodule measuring 0.8 x 0.7 x 0.6 cm is noted, with a fibrotic and calcified appearance. The remaining lung tissue appears spongy and slightly edematous. \n\nLymph node specimens were also received. A lymph node labeled \"R lymph node\" measures 1.5 x 1.5 x 0.4 cm and consists of gray-tan to yellow fleshy and fibrofatty tissue. A second lymph node labeled \"L lymph node\" measures 0.6 x 0.4 x 0.2 cm and is described as soft gray-tan to pink tissue. A third lymph node from station 11 measures 2.2 x 1.2 x 0.8 cm and has a lobulated red-brown to black appearance with a mottled gray-black cut surface. A fourth lymph node from station 12 measures 1.0 x 0.7 x 0.6 cm and has a tan-pink to brown-black mottled cut surface. Two additional fragments from station 7 each measure 0.8 x 0.6 x 0.3 cm and are described as soft gray-pink tissue.\n\nMicroscopic evaluation of the right lower lobe reveals a moderately differentiated histologic type with subpleural localization. The tumor shows focal involvement of the overlying pleura and does not demonstrate lymphovascular space invasion. Surgical margins are uninvolved, with the tumor located 2.8 cm from the bronchial margin. All examined lymph nodes show no evidence of involvement, with some displaying anthracotic pigment and reactive changes. Staging is determined as T2N0."} +{"pid": "TCGA-HI-7169", "report": "The specimen was obtained from a male patient and included four tissue sources: left posterior lateral margin, prostate and seminal vesicles, right pelvic lymph nodes, and left pelvic lymph nodes. \n\nThe left posterior lateral margin consisted of two fragments of dark red fibrofatty tissue measuring 0.7 and 0.9 cm. These were unremarkable. \n\nThe prostate measured 3.5 x 4.0 x 3.4 cm and weighed 35 grams. The capsule was intact, and the urethra was patent. The peripheral region appeared yellowish-tan, while the central parenchyma was firm and white. Prostatic concretions were noted. Seminal vesicles measured 2.0 x 1.2 x 0.7 cm on the right and 3.0 x 1.5 x 1.0 cm on the left, both appearing unremarkable. Vas deferens stumps measured 2.5 x 0.6 cm. Sections included multiple regions of the prostate and seminal vesicles for analysis. \n\nThe right pelvic lymph nodes were identified within fibroadipose tissue measuring 4.5 x 3.5 x 2.0 cm. Two lymph nodes were found, measuring 0.9 x 0.5 x 0.5 cm and 2.0 x 1.0 x 1.0 cm, both with fatty appearance. \n\nThe left pelvic lymph nodes were found within fibroadipose tissue measuring 4.0 x 3.0 x 1.5 cm. Two firm tan lymph nodes were identified, measuring 1.0 cm and 1.4 cm. \n\nHistologic examination of the left posterior lateral margin showed no abnormal cellular findings and no prostatic tissue. Sections of the prostate revealed cellular atypia involving both lobes, more prominent on the right side. Cellular infiltration extended beyond the capsule in the right apex and right mid sections. Tumor cells were present at the inked right apex margin, but not at the base or other radial margins. No involvement was seen in the seminal vesicles. \n\nExamination of the right and left pelvic lymph nodes showed no evidence of abnormal cellular infiltration in any of the submitted nodes."} +{"pid": "TCGA-XU-A936", "report": "The specimen was received as a thymus and mediastinal mass with an attached portion of right lung. The resected specimen weighed 166.4 grams and measured 16 x 8.5 x 4.9 cm. The tumor measured 7.1 cm in its greatest dimension and was largely encapsulated and well-circumscribed, although the interface with surrounding soft tissue showed slight irregularity. The tumor had a white-tan, firm, homogenous cut surface without necrosis or hemorrhage. It was located approximately 1.8 cm from the closest lung parenchymal margin and 0.5 cm from the presumed pericardial margin. A portion of pericardium was attached to the posterior aspect of the tumor and appeared mobile over the tumor surface.\n\nMicroscopic examination revealed a lobulated tumor composed of pleomorphic polygonal and spindle-shaped epithelial cells arranged in cohesive clusters. The nuclei were large and vesicular with irregular chromatin clumping and prominent nucleoli. Mitotic figures were frequent (approximately 10 per 10 high-power fields), and areas of cell necrosis were present. Immunohistochemical staining demonstrated strong positivity for AE1/AE3 cytokeratin, CK5, p63, and CD5, with focal positivity for Cam 5.2. Between the tumor lobules, there was a background population of mature T and B lymphocytes, along with occasional plasma cells and lymphoid follicles. No immature T-cells were identified.\n\nThe tumor focally extended through the capsule into adjacent mediastinal soft tissue but did not invade the attached pericardium or lung. Resection margins were free of tumor involvement. Nineteen peri-thymic lymph nodes were examined and none contained malignant cells. Additional findings included involutional changes in the native thymus consistent with the patient\u2019s age and cystic changes in adjacent thymic tissue.\n\nHistologic evaluation of the right lung wedge resection showed no significant pathology. The tumor was classified as pT2a based on local invasion beyond the capsule into adjacent soft tissue, with no lymph node or distant metastases identified (pN0, pM0). Based on histologic features and growth pattern, the tumor exhibited locally aggressive behavior with potential for intra-thoracic recurrence."} +{"pid": "TCGA-C5-A2M2", "report": "Patient ID: FINAL WITH ADDENDUM. Radiation Oncology. Accessioned. V. OPALL, M.D. By this signature, I attest that the above findings are based upon my personal examination of the slides. MD. MQ. Microscopic Description and Comment: Immunostains performed reveal that the cells are diffusely positive for p16, while they are negative for vimentin and estrogen receptors. The tissue sample was obtained from a cervical biopsy. The specimen consists of three pieces of tan-red hemorrhagic tissue measuring 1.7 x 0.7 x 0.4 cm in aggregate. Microscopically, the lesion involves the entire tissue section with a depth of at least 5 mm. Lymphovascular space invasion is present, and there is no evidence of perineural invasion."} +{"pid": "TCGA-DX-AB2X", "report": "The clinical history included a consideration of soft tissue sarcoma versus melanoma. The submitted specimen consisted of a resected right leg mass. Gross examination revealed an 8 x 6 x 3 cm non-encapsulated, lobulated, grey fleshy solid mass with approximately 20% necrosis by gross estimate. A superficial ulcer was present on the skin surface. The tumor was located within soft tissue and showed vascular invasion. Margins were negative, with the closest margin measuring 1 mm from the deep margin limited by fascia.\n\nHistologically, the lesion was composed of high-grade spindle, epithelioid, and pleomorphic cells. Immunohistochemical staining demonstrated rare positivity for CD31 and focal labeling for CD163. Additional immunostains performed on prior biopsies showed positivity for vimentin and focal smooth muscle actin, but no definitive lineage-specific markers were identified. Stains for melanoma markers (S-100, HMB-45, tyrosinase, A-103), cytokeratin AE1/AE3, p63/4A4, desmin, LCA, CD30, ALK-1, CD34, EMA, myogenin, CAM 5.2, FLI-1, and CD68 were negative. These findings did not support a specific histologic lineage.\n\nThe specimen was received fresh, labeled, and oriented with sutures. It consisted of a rhombus-shaped skin excision measuring 16 x 12 x 4.5 cm, with a hemorrhagic ulcer on the surface. Serial sectioning confirmed the presence of a large tumor mass with extensive sampling performed for further analysis. Multiple sections were taken from different areas including tumor, normal skin, ulcer, and surgical margins."} +{"pid": "TCGA-93-A4JO", "report": "The surgical pathology report describes specimens received from a cardiothoracic procedure. The specimens include multiple lymph node groups and a resected right lower lobe of the lung.\n\nLymph nodes were submitted from levels VII, X, XI, XII, and IVR. In total, 27 lymph nodes were examined across all levels, with no evidence of malignancy identified in any of the lymph nodes evaluated.\n\nThe lung specimen measured 10.5 x 10.0 x 9.7 cm. Two distinct lesions were identified within the lung tissue. The larger lesion measured 1.5 x 1.1 x 1.4 cm and was described as a firm white mass without involvement of the visceral pleura or lymphovascular invasion. The smaller lesion measured 1.3 x 1.2 x 1.0 cm and was located superiorly in relation to the larger lesion. Resection margins were free of tumor involvement. Sections of uninvolved lung parenchyma showed subpleural fibrosis with bronchial metaplasia, metaplastic bone formation, and mucous retention cysts.\n\nMicroscopic evaluation of the larger lesion revealed a mixed pattern of growth with approximately 90% solid architecture and 10% acinar arrangement. The lesion demonstrated poorly differentiated features. No vascular or lymphatic invasion was observed. Four lymph nodes associated with the lung specimen also showed no evidence of malignancy.\n\nIntraoperative consultation included frozen section analysis of the bronchial margin, which did not reveal any malignant involvement.\n\nA total of 27 lymph nodes were histologically examined, and none contained metastatic disease. Based on the findings, the tumor was confined to the lung without regional nodal spread. The tumor size and absence of nodal involvement supported a classification consistent with an early-stage lesion."} +{"pid": "TCGA-VQ-A94O", "report": "The specimen from the stomach (antrum) shows a moderately differentiated gland-forming lesion with features resembling intestinal-type morphology. The lesion extends into the subserosal adipose tissue and measures up to 10.4 cm in maximum dimension. Angiolymphatic invasion is present, while perineural invasion is not detected. Surgical margins are free of neoplastic involvement. The pancreas does not show involvement; however, histological sections of the pancreas and its adjacent area reveal chronic serositis with fibrous proliferation and vascular ectasia.\n\nExamination of the greater omentum, spleen, and esophageal margin reveals no evidence of neoplastic cells. Lymph node evaluation demonstrates variable involvement depending on location: right and left paracardial lymph nodes are uninvolved (0/2 and 0/4 respectively), as are short gastric (0/8), left gastroepiploic (0/2), proximal and distal splenic artery (0/4 and 0/2), superior mesenteric vein (0/1), and splenic hilum lymph nodes. In contrast, lymph nodes at the lesser curvature (5/20), right gastroepiploic (2/8), suprapyloric (1/1), infrapyloric (7/11), left gastric artery (1/4), anterior hepatic artery (1/1), and celiac trunk (3/3) demonstrate the presence of neoplastic cells. Other tissues examined include fragments of fibrous connective and adipose tissue from the hepatoduodenal ligament, which are also uninvolved."} +{"pid": "TCGA-HT-7467", "report": "The specimen demonstrates a moderately hypercellular neoplasm composed of glial cells, with involvement of both gray and white matter. The tumor exhibits a diffuse growth pattern, with predominant infiltration of the gray matter, which is distinct from typical presentations. The tumor cells display enlarged, round to oval nuclei with varying degrees of nuclear atypia ranging from mild to moderate. Perinuclear halos are commonly observed. In the gray matter, secondary structural arrangements are prominent, including notable perineuronal satellitosis, subpial condensation, and focal perivascular clustering. No mitotic figures are present in the examined sections.\n\nImmunohistochemical staining for MIB-1 reveals scattered reactive cells throughout the specimen. Due to the unique architecture of the tumor and the presence of numerous non-neoplastic neurons intermixed with tumor cells, an accurate labeling index could not be definitively determined. However, it is estimated that greater than 5% of tumor nuclei demonstrate positivity. While this level of proliferation does not meet criteria for grade 3 classification, it raises concern and underscores the importance of close clinical monitoring."} +{"pid": "TCGA-B5-A0K9", "report": "The clinical specimen consists of a hysterectomy with bilateral tubes and ovaries, weighing 157 grams and measuring 11.7 x 6.5 x 3.2 cm. Attached adnexal structures are present on both sides. The uterine serosa appears tan-pink to red-brown with focal hemorrhage. The cervix measures 3.5 x 2.7 cm; the ectocervical mucosa is gray-white and the cervical os is patent up to 1.2 cm. Within the endocervical canal, there is a necrotic fungating mass measuring 4.5 x 4 cm that spans both anterior and posterior aspects. A representative section from the anterior portion was submitted for intraoperative evaluation and additional sections were taken from surrounding areas.\n\nThe endometrial cavity is lined by tan granular tissue measuring 0.3 to 0 cm in thickness. Minimal involvement by the lesion is noted at the posterior lower aspect of the cavity. A separate pedunculated polyp measuring 3 x 1.8 cm is identified at the fundus. Sectioning through the lesion reveals a tan-yellow to tan-gray gritty surface involving the myometrium, with invasion depth measuring approximately 1.5 cm within a myometrial thickness of up to 2 cm. No lymphatic or vascular invasion is identified.\n\nThe right ovary measures 3.5 x 1.2 x 1 cm and exhibits fibrous adhesions on its external surface. Adjacent fallopian tube segment is 5 cm long and 0.4 cm in diameter with intact paratubal cysts on the serosal surface. On the left side, periadnexal soft tissue measuring 4.8 x 3.5 x 2 cm is present without identifiable ovarian parenchyma. The fallopian tube segment measures 9 cm in length and 0.3 cm in diameter.\n\nSections submitted include various regions of the cervix, lower uterine segment, endomyometrium, endometrial polyp, right ovary and fallopian tube, and left fallopian tube with questionable associated tissue. All surgical margins are free of tumor involvement.\n\nPathologic staging according to AJCC 7th edition criteria is pT2 pNX pMX. The remaining endometrium demonstrates features consistent with endometrial intraepithelial neoplasia (EIN). Adhesions are noted on the serosal surface and no malignancy is detected in the right ovary or either fallopian tube. The left ovary is not identified."} +{"pid": "TCGA-A2-A0CR", "report": "The specimen consists of a left breast mastectomy measuring 20.5 cm medial to lateral, 20.0 cm superior to inferior, and 4.5 cm anterior to posterior, with an attached axillary tail measuring 11.0 x 7.0 x 3.7 cm. An ellipse of nipple-bearing skin measuring 18 x 9.5 cm is also present. The nipple is inverted, and the overlying skin appears otherwise unremarkable. Sectioning reveals a poorly defined, indurated mass located in the upper inner quadrant, focally abutting the deep margin. Extending laterally from this lesion is a broad area of variably indurated fibrous tissue, with the overall maximum dimension measuring 9.0 cm.\n\nSections were taken throughout the specimen, including from the skin, lymph nodes, and various regions of the breast tissue. A total of 16 lymph nodes were identified, all without evidence of malignancy. Angiolymphatic invasion was noted in one focus (A12), and there was focal dermal lymphatic involvement at the nipple (A8). The tumor was found within 1 mm of the deep margin (A9, A10). Additional findings include focal lobular proliferation in situ, intraductal hyperplasia with florid features, and fibrocystic changes.\n\nThe specimen was inked with blue indicating superior superficial, green for inferior superficial, and black for the deep margin. Multiple cassettes were submitted for histologic evaluation, including sections from the axillary tail, which contained 14 possible lymph nodes ranging in size from 0.2 cm to 3.0 cm. All lymph nodes examined were negative. Based on histopathologic evaluation, staging is consistent with AJCC Stage IIB (T3 NO MX). Hormone receptor and HER2 testing had been previously reported."} +{"pid": "TCGA-GM-A3XG", "report": "A modified report is provided for review. In the right axillary sentinel lymph node biopsies, one out of three lymph nodes examined shows involvement. The largest focus measures 2.5 mm with focal extranodal extension noted. Cytokeratin immunostaining confirms the presence of abnormal cells in this lymph node. Another lymph node shows similar involvement with a focus measuring 5 mm; however, no extranodal extension is identified in this case. A third lymph node from the same area does not show any signs of abnormal cells.\n\nIn the right breast mastectomy specimen, an area of concern spans approximately 8 cm, predominantly located in the superior central portion. The primary focus measures around 4 cm and is located near the superficial superior margin (3 mm from margin). Multiple smaller surrounding areas are also present microscopically. No definitive vascular invasion is identified. Additional findings include changes involving ducts, along with fibrocystic changes such as ductal hyperplasia without atypia, apocrine metaplasia, intraductal papilloma, and columnar cell change. One lymph node located laterally does not show any abnormal involvement.\n\nDissection of the right axillary contents reveals one involved lymph node among seventeen examined. The focus within measures 3.0 mm in greatest dimension, and no extranodal extension is observed. Four additional lymph nodes are pending further cytokeratin immunostaining for confirmation. Excision specimens from additional lymph node levels do not show any signs of involvement.\n\nThe left breast mastectomy specimen does not reveal any significant lesions. Findings include changes involving ducts, along with fibrocystic changes such as sclerosing adenosis, ductal hyperplasia without atypia, and apocrine metaplasia. The nipple is unremarkable.\n\nAdditional clinical details indicate a prior history consistent with right breast disease."} +{"pid": "TCGA-DD-AACX", "report": "The liver biopsy specimen consists of three cores of pale tan, fragmented tissue obtained via CT-guided needle biopsy. The total aggregate size is 1.6 x 0.2 x 0.1 cm, and the entire specimen was submitted for analysis. Microscopic evaluation reveals well-differentiated cellular features with a nuclear grade corresponding to Edmondson-Steiner grade 1 of 4. Histological assessment shows atypical glandular structures in the background of chronic gastritis. Reticulin staining demonstrates disruption of the normal reticulin framework. No significant findings were noted on mucicarmine or trichrome special stains. All relevant tissue blocks were examined, and no additional diagnostic terms were reported. A second opinion was obtained for further assessment."} +{"pid": "TCGA-AA-3976", "report": "The resected rectosigmoid specimen contains a moderately differentiated neoplasm of the colorectal type, located 3.5 cm aborally from the aboral resection margin, with a maximum diameter of 2.3 cm. Histopathological evaluation shows infiltration of the tunica muscularis propria. Two regional lymph node metastases were identified out of 16 examined nodes. Vascular invasion and residual tumor at the resection margins were not detected. The lesion is classified as pT2, pN1 (2/16), MX; G2, V0, R0."} +{"pid": "TCGA-BJ-A2N8", "report": "The specimen consists of a total thyroidectomy measuring 13 grams. Two tumor foci were identified in the right lobe and isthmus, both confined to the thyroid. The largest focus measures 1.4 cm and is composed of conventional type tissue with calcification and ossification. A second focus measuring 1.0 cm also demonstrates conventional morphology with a prominent follicular pattern. Rare psammoma bodies are present within a lymphatic vessel. Two lymph nodes from the isthmus show no evidence of tumor involvement.\n\nHistologic evaluation reveals no extrathyroidal extension. Surgical margins are free of involvement. Lymph-vascular invasion is present, as indicated by the presence of psammoma bodies in lymphatics. A total of two regional lymph nodes were examined, none showed involvement.\n\nMolecular testing was performed on the 1.4 cm lesion and revealed a mutation in NRAS codon 61. No mutations were detected in BRAF, HRAS codon 61, KRAS codons 12/13, or RET/PTC1 and RET/PTC3 rearrangements. Nucleic acid extraction was sufficient for analysis in this case. In contrast, molecular analysis of the 1.0 cm lesion was limited due to low nucleic acid concentration resulting from extensive degenerative changes and minimal viable tissue. Amplification of DNA and RNA targets including GAPDH and KRT7 was insufficient for conclusive testing.\n\nStaging classification indicates pT1b for the primary tumor and pN0 for regional lymph node involvement."} +{"pid": "TCGA-50-8459", "report": "The right lower lobectomy specimen includes a lesion measuring 7.5 cm in greatest dimension. Histologic evaluation demonstrates invasive growth with moderately differentiated features and mucin production. Angiolymphatic invasion is present, as well as involvement of the visceral pleura. Surgical margins are negative. Lymph nodes sampled from multiple stations, including levels 9, subcarinal, level 12, fissure, middle lobe artery, vein, bronchus intermedius, and level 11 near the middle lobe vein and basilar bronchus were all negative for malignancy. A total of 25 N1 lymph nodes and 7 N2 lymph nodes were examined, none showing evidence of tumor involvement. A bone biopsy from the right sixth rib shows no malignant involvement. Reactive changes are noted in all lymph node specimens. Adjacent lung tissue demonstrates mild emphysematous change. Molecular testing reveals a KRAS codon 12 (p.G12C) mutation, while other mutations in EGFR, BRAF, ALK, ROS1, and C-MET are not detected. Histochemical and immunohistochemical stains support the presence of mucinous differentiation without markers of squamous or small cell carcinoma. Pathologic staging is determined as T3 N0."} +{"pid": "TCGA-2G-AAHA", "report": "The pathology report describes findings from a left orchidectomy specimen. The lesion measured 6.5 cm in diameter. Microscopic evaluation showed no evidence of angioinvasion, nor was there involvement of the rete testis or invasion of the tunica albuginea. The surgical margin at the spermatic cord was free of tumor cells."} +{"pid": "TCGA-A2-A3KC", "report": "The specimen includes a right breast simple mastectomy measuring 28.5 x 21 x 5 cm with a flattened nipple located within a 26 x 13 cm skin ellipse. There is palpable firmness in the lower outer quadrant. Sectioning reveals two distinct firm masses: one at the 12 o\u2019clock area measuring 3.5 x 2.5 x 2.5 cm and another in the lower outer quadrant measuring 2.5 x 2.5 x 2.5 cm. These are separated by approximately 3 cm of intervening tissue. The deep margin associated with the lower outer quadrant lesion consists of pink-tan fibrous tissue and appears grossly within the confines of the specimen. Additional nodular tissue near the lower outer quadrant lesion demonstrates brown discoloration, located 1 cm from the lesion and 5 cm from the 12 o\u2019clock lesion.\n\nSections submitted include the nipple, margins, lesions, surrounding quadrants, and fatty tissue samples. No tumor involvement is identified at the surgical margins or nipple skin. In addition to the invasive components, there is widespread presence of lobular neoplasia involving 14 out of 21 blocks examined, with a maximum calculated dimension of 5.6 cm.\n\nA separate evaluation of lymph nodes was conducted. One sentinel lymph node showed no evidence of malignancy. Another sentinel lymph node revealed involvement by malignant cells, with a maximum microscopic dimension of 0.6 cm. No extranodal extension was observed. A non-sentinel lymph node biopsy demonstrated no malignant involvement. Axillary lymph node dissection included 16 lymph nodes, one of which contained malignant cells without evidence of extranodal extension.\n\nMicroscopic features of the invasive component show nuclear grade 2/3, low mitotic index, and tubule formation score of 3, yielding a total Nottingham score of 6. Lobular neoplasia of the pleomorphic type is present, comprising approximately 50% of the tumor. Fibrocystic changes including intraductal papillomas, apocrine metaplasia, microcysts, and dense stroma were also noted. Lymphovascular invasion was not identified."} +{"pid": "TCGA-BP-5007", "report": "The left kidney specimen includes the ureter, renal vessels, and perinephric fat, measuring 14.5 x 9.0 x 7.8 cm and weighing 725 grams. The attached ureter is 9.0 cm in length and 0.3 cm in diameter, while the renal vein measures 0.5 cm in length and 0.4 cm in diameter. An adrenal gland is present, measuring 7.5 x 2.5 x 1.5 cm and weighing 12.1 grams, with a hemorrhagic cortex noted. Upon bisection, a well-defined mass measuring 10.0 x 10.0 x 7.0 cm is identified; it is multiloculated, calcified, and exhibits golden-yellow to tan coloring. The remainder of the kidney shows a pink-brown parenchyma with a distinct cortico-medullary junction and cortical thickness measuring 2.8 cm. No lymph nodes are found within the perinephric fat.\n\nHistologic examination reveals a lesion with multifocal fibrosis and osseous metaplasia. Nuclear grading is assessed as Grade II out of IV. Evaluation of surgical margins demonstrates no tumor involvement. Adjacent non-neoplastic kidney tissue shows mild glomerulosclerosis. The adrenal gland does not demonstrate any involvement. Examination of submitted para-aortic lymph nodes, totaling ten nodes ranging from 0.5 to 1.2 cm in size, reveals no evidence of tumor involvement.\n\nStaging assessment indicates a pT2 classification based on tumor size greater than 7.0 cm confined entirely within the kidney. There is no evidence of local invasion or venous involvement."} +{"pid": "TCGA-44-5643", "report": "The specimen consists of multiple tissue samples, including a right lower lobe procurement, completion right pneumonectomy, and various lymph node regions along with a mediastinal cyst and superior vein stump.\n\nThe right lower lobe specimen weighs 363 grams and measures 19 x 11 x 5.5 cm. It includes a bronchial stump measuring 1.8 x 1.4 cm in diameter and 1 cm in length. The pleural surface is smooth and glistening with focal retraction and a palpable mass. On sectioning, there is a well-circumscribed, focally cystic tan-white lesion measuring 6.8 x 6.5 x 5 cm. This lesion approaches the inked pleural surface closely and extends to within 2 cm of the bronchial stump margin. Adjacent parenchyma shows a spongiform, red-purple appearance with a 4-cm ill-defined focus of consolidation inferior to the lesion. No other abnormalities are identified. Three lymph nodes up to 1.3 cm in size are recovered from the hilar region and submitted in 12 blocks for analysis.\n\nThe completion right pneumonectomy weighs 223 grams and measures 13.5 x 10.5 x 6.0 cm. It has an attached bronchial stump of 2.5 cm in length and 2.8 x 1.8 cm in diameter. The pleura appears wrinkled and pink-purple. Sectioning reveals spongiform red-purple parenchyma with minimal anthracosis. No mass lesion or abnormality is found. Four lymph nodes up to 1.8 cm in size are recovered from the hilum and submitted in 7 blocks.\n\nFour lymph nodes from level 7, ranging in size from 0.7 cm up to 4.5 x 2.8 x 1.3 cm, are submitted entirely in five blocks. Two lymph nodes from the 4R region, measuring 0.7 and 1.3 cm, are submitted whole. The mediastinal cyst consists of four cauterized fragments averaging 1.3 x 0.8 x 0.15 cm, submitted in two blocks. Two fragments from the 2R lymph node region, measuring 1.3 and 1.8 cm, show no definitive lymphoid tissue and are submitted individually in two blocks. A superior vein stump fragment measuring 0.6 x 0.4 x 0.15 cm with metallic staples is submitted in one block.\n\nMicroscopically, the lesion demonstrates features of a poorly differentiated carcinoma. The tumor reaches a maximum dimension of 6.8 cm and remains confined within the lung. Resection margins are negative. There is evidence of venous invasion by tumor cells as well as lymphatic vessel invasion. No direct extension beyond the visceral pleura is observed.\n\nEvaluation of regional lymph nodes reveals eight peribronchial and perihilar nodes without metastasis. One of four level 7 mediastinal nodes contains malignant cells. The 4R and 2R lymph nodes do not show any involvement. Distant metastasis could not be assessed.\n\nAdditional findings include post-obstructive pneumonitis and pulmonary edema. The mediastinal cyst is lined by mesothelial cells and shows no malignant features. The superior vein stump shows no significant histopathological changes or presence of malignancy."} +{"pid": "TCGA-G2-AA3C", "report": "The specimen consists of multiple irregular fragments of white-tan soft tissue, measuring approximately 2.0 x 2.0 x 0.8 cm in aggregate. Histological evaluation reveals high-grade cellular atypia with extensive involvement of most tissue fragments. There is evidence of invasive growth patterns and sarcomatoid differentiation. Additionally, there are findings consistent with in-situ changes involving the urothelium. All tissue has been submitted for examination in cassettes A1 and A2."} +{"pid": "TCGA-EL-A4K1", "report": "A 4.5 x 2.2 x 1.5 cm left lobe, 1.5 x 1 x 0.5 cm isthmus, and 3.4 x 2.4 x 2 cm right lobe were submitted. The right lobe was largely replaced by a firm, well-circumscribed, partially calcified nodule measuring 2.9 x 1.6 x 1.5 cm with soft, friable pink-tan parenchyma. The nodule extended to the disrupted capsule. A multicystic nodule measuring 1.2 x 1 x 1 cm was identified in the left lobe; it was well-circumscribed and encapsulated with yellow-tan colloid content. Multiple fibroadipose fragments from the right central neck measured 3.0 x 2.0 x 0.7 cm and contained one possible lymph node measuring 0.4 cm. Histologically, three lymph nodes showed evidence of tumor involvement with extracapsular extension noted. The resected specimen from the right inferior parathyroid gland showed no evidence of tumor involvement. Tumor was found at the resection margin and exhibited extension into adjacent skeletal muscle. Lymphovascular invasion was not identified. No lymph nodes were present in the thyroid specimen."} +{"pid": "TCGA-R8-A6ML", "report": "The patient is a male with a height of 174.0 cm, weight of 85.0 kg, and a body surface area of 2.03 m\u00b2. A left frontal mass was resected and submitted for analysis. The specimen from the left frontal region consists of a single piece of cerebral cortex and underlying white matter measuring 5.0 x 5.0 x 4.0 cm. The cut surface demonstrates a loss of demarcation at the gray-white junction and a 2.0 cm area of gray discoloration. Representative sections were submitted in multiple cassettes. Intraoperative evaluation of a frozen section led to a preliminary finding suggestive of infiltrating glioma.\n\nA second specimen from the same anatomical location consists of a piece of tan-white soft tissue measuring 2.2 x 1.5 x 0.5 cm, which was entirely submitted for analysis.\n\nMicroscopic evaluation revealed areas of high cellularity and brisk mitotic activity. Early microvascular proliferation was also observed. These features are consistent with a high-grade neoplastic process.\n\nCytogenetic analysis using fluorescence in situ hybridization demonstrated loss of genetic material on chromosomes 1p and 19q. This combined loss has been associated with specific tumor behavior and may influence response to therapy.\n\nAll specimens were processed and interpreted by the reporting pathologist."} +{"pid": "TCGA-DD-AACJ", "report": "The liver specimen measured 17.0 x 11.5 x 8.5 cm and weighed 750 grams. The tumor was located in the right lobe of the liver and measured 11.0 x 9.0 x 8.0 cm. There was no satellite nodule identified. The tumor exhibited an expanding nodular growth pattern with areas of necrosis (10\u201320%) and hemorrhage or peliosis (10\u201320%). Portal vein invasion was present, but there was no invasion of the bile ducts.\n\nMicroscopically, the lesion showed partial fibrous capsule formation without capsular infiltration. Septum formation was observed. The surgical resection margin was free of involvement, with a clearance margin of 0.5 cm. There was no serosal invasion. Microvessel invasion was present, but no hepatic vein or hepatic artery invasion was identified. There was no evidence of intrahepatic metastasis or multicentric occurrence.\n\nThe histologic pattern was trabecular with hepatic cell type. The worst and major differentiation grade was moderate (Grade II). No fatty change was observed. Adjacent liver tissue showed micronodular cirrhosis and mild steatosis.\n\nThe gallbladder measured 11.0 cm in length, 4.8 cm in diameter, and had a wall thickness of 1.0 mm. Histologically, it showed features of chronic cholecystitis."} +{"pid": "TCGA-43-8115", "report": "The final surgical pathology report describes a resected lung specimen from the left lower lobe. The specimen weighed 187 grams and measured 18 x 9.5 x 5 cm. A mass measuring 3.5 x 3 x 2.5 cm was identified on the pleural surface; it appeared tan-pink and did not seem to involve the pleura, although the assessment was limited due to prior tearing. The bronchial and vascular margins were grossly unremarkable. Lymph nodes in the hilar region were present, with the largest measuring up to 0.8 cm.\n\nMicroscopic evaluation revealed a poorly differentiated carcinoma. Histologic analysis of the primary lesion showed no evidence of vascular invasion or direct extension. The tumor measured 3.5 cm in its greatest dimension and was classified as pT2a. Margins of resection were free of malignant cells.\n\nLymph node evaluation included hilar lymph nodes and those from levels 5, 7, and 9. Metastatic involvement was identified in three of the fourteen hilar lymph nodes examined. The remaining lymph nodes from levels 5, 7, and 9 showed no evidence of malignancy, resulting in a regional lymph node classification of pN1. No distant metastasis was identified.\n\nImmunohistochemical staining demonstrated positivity for p63 but was negative for TTF-1, synaptophysin, and chromogranin. Additional findings included scattered chronic inflammation and emphysematous changes in the lung tissue.\n\nBlocks were submitted for detailed histologic examination, including margins, tumor relationship to surrounding structures, and lymph node status. Tissue procurement was performed per clinical request."} +{"pid": "TCGA-DD-A4NQ", "report": "The resected liver tissue from segment 2/3 measures 12.0 x 10.0 x 7.0 cm and contains a partially necrotic mass measuring 7.2 x 6.0 x 6.0 cm. The mass is of high-grade morphology, with cellular features consistent with grade 3 differentiation. Vascular invasion is present at the periphery of the lesion. All surgical margins are free of tumor involvement, with a minimum tumor-free margin of 1.8 cm. A separate soft tissue specimen from the falciform ligament, measuring 1.5 x 0.7 x 0.2 cm, shows only fibrovascular and adipose tissue with areas of focal fat necrosis, and no malignant cells are identified."} +{"pid": "TCGA-DD-A3A4", "report": "The left lobe of the liver weighed 2195 grams and measured 26 x 16 x 9 cm. A mass measuring 25 x 16 x 9 cm was identified in the left lobe. The tissue was grade 3 (of 4) with multinodular growth. The hepatic capsule showed no involvement, and surgical margins were free of tumor with a clearance of 1.2 cm microscopically. No extramural vascular invasion was observed. The lesion was surrounded by a 0.5 cm thick fibrous capsule. Approximately 10% necrosis was noted. \n\nA separate excision from Segment V of the liver weighed 30 grams and measured 5 x 4 x 3 cm. A mass measuring 3 x 2 x 1.8 cm was present, also grade 3 (of 4). Margins were negative for tumor involvement. Two needle biopsies from Segment V were received: one measuring 2 mm and another 7 mm. One biopsy showed features of hemangioma, while the other was negative for tumor. \n\nA left periportal lymph node measuring 2.1 x 1.3 x 0.8 cm was examined and found to be benign. The gallbladder measured 8 x 3.5 x 2 cm and showed no diagnostic abnormalities. Permanent sections of adjacent non-neoplastic liver tissue revealed no diagnostic changes. Iron stain and PAS-D studies were negative."} +{"pid": "TCGA-AG-3726", "report": "The resection specimen from the colon or rectum demonstrates tumor-free surgical margins. The lesion is moderately differentiated and exhibits early infiltration into the perimuscular adipose tissue. No regional lymph node involvement is identified, with all 34 examined lymph nodes showing no evidence of metastasis. Vascular and lymphatic invasion are not present. The tumor is classified as pT3 with no residual tumor at the resection margin."} +{"pid": "TCGA-EL-A3MW", "report": "Surgical Pathology Report. \n\nThe specimen consists of a total thyroidectomy measuring 8.0 x 3.5 x 1.8 cm. The right lobe is slightly enlarged and nodular, with dimensions of 3.5 x 3.0 x 1.8 cm. The left lobe is unremarkable, measuring 3.5 x 1.5 x 0.8 cm. On sectioning, multiple well-circumscribed nodules ranging from 0.3 to 1.5 cm are present in the superior, middle, and lower portions of the right lobe. The largest nodule measures 1.5 x 1.5 x 2.3 cm. The isthmus and left lobe appear normal upon examination. Sections were taken as follows: A1\u2013A6 from the right lobe, sequential sections from superior to inferior including the nodules; A7 from the isthmus; and A8\u2013A13 from the left lobe, also in a sequential pattern. One lymph node was identified and showed no evidence of tumor involvement (0/1). \n\nAll measurements and histologic evaluations have been documented. The case has been finalized and released."} +{"pid": "TCGA-CZ-5453", "report": "The surgical specimen consists of a left kidney and adrenal gland, submitted as part of a radical nephrectomy. The kidney measures 20.5 x 14.5 x 7.2 cm and is accompanied by the left adrenal gland (6 x 1.8 x 0.4 cm). Perirenal fat ranges from 2 to 3 cm in thickness. A multilobulated tan/red to tan/yellow mass measuring 7.2 x 6.5 x 5.5 cm is located in the lower pole of the kidney. The tumor is adjacent to the renal capsule, with a distance of 0.1 cm to inked margin, and is 9.0 cm from the ureter, 3.4 cm from renal artery #1, 4.8 cm from renal artery #2, and 2.2 cm from the renal vein margin. The closest vein is 0.6 cm away without evidence of invasion. The tumor also abuts Gerota\u2019s fascia. A cystic cavity measuring 1.2 x 3.0 x 2.5 cm is present in the upper pole.\n\nMicroscopic evaluation shows nuclear grade II of IV. No vascular invasion is identified. Surgical margins involving the ureter, vasculature, and soft tissue are free of involvement. Sections include areas of tumor within the capsule and perirenal fat, adjacent normal kidney, and proximity to Gerota\u2019s fascia. The adrenal gland and normal kidney show no significant pathology. A benign renal cyst is noted.\n\nCytogenetic analysis reveals clonal chromosomal aberrations including deletion of the short arm of chromosome 3 (3p), observed in all analyzed metaphases. These findings are consistent with previously described anomalies associated with this type of tumor. No lymph nodes are identified in the adipose tissue submitted.\n\nStaging classification is T2 NX MX according to the 6th edition of the AJCC Cancer Staging Manual."} +{"pid": "TCGA-A7-A4SC", "report": "Final Surgical Pathology Report. Procedure: Diagnosis. Right axillary sentinel node excisional biopsy revealed a single lymph node without evidence of tumor involvement. Breast tissue from a right simple mastectomy specimen showed a lesion measuring 7.5 cm in greatest dimension. Histologic evaluation demonstrated invasive carcinoma with grade 1 differentiation. Architectural score was 3, nuclear score was 1, and mitotic score was 1. The deep margin was 1.4 cm from the lesion and free of tumor. No vascular invasion was identified. Calcifications were noted focally. Evaluation of the nipple did not show any concerning features. There was no evidence of invasion into skin or chest wall. No ductal carcinoma in situ was identified. Non-tumorous breast tissue appeared fatty and atrophic. Two small fibroadenomas adjacent to the lesion were present but limited in size. Lymph node assessment showed no positive nodes (0/1), and no extracapsular extension was observed. Multiple sections were evaluated using H&E staining, including 2 from frozen section blocks and 3 from formalin-fixed paraffin-embedded tissue blocks. Immunohistochemical staining with pancytokeratin AE1/AE3 did not reveal any metastatic involvement. Progesterone receptor expression was 0% and HER-2 immunohistochemistry showed 2+ staining, which was considered equivocal. FISH testing was recommended for further clarification. Estrogen receptor status was previously reported as positive. Specimen fixation time was 28 hours, and cold ischemia time was minimal. Tissue quality met standards for Her2 analysis. Controls performed appropriately. All immunohistochemical markers were assessed using validated protocols meeting CAP guidelines. The lymph node specimen measured 3 x 1 x 1 cm with a 2.8 cm lymph node identified after trimming. Gross examination of the mastectomy specimen measured 20.5 x 17.2 x 4.7 cm and included a skin ellipse with a central mass measuring 7.5 x 6.0 x 2.3 cm. The lesion appeared white-tan, nodular, and firm, located centrally within the specimen. Representative sections were submitted for analysis, including areas from the nipple, margins, and surrounding quadrants. No gross lymph nodes were identified in the specimen."} +{"pid": "TCGA-IG-A97I", "report": "Gross Description: The specimen includes an esophagus with an ulcerated, dense gray mass measuring approximately 3x4 cm. A stomach tissue sample is also present, measuring 10x7 cm, with a pink, folded mucosal surface.\n\nMicroscopic Description: The primary lesion shows moderately differentiated cells with significant inflammatory infiltration. Evaluation of four examined lymph nodes near the esophagus reveals no evidence of metastasis; findings are consistent with follicular hyperplasia. No venous invasion is identified, and surgical margins are uninvolved. The tumor extends into deeper tissue layers but does not show evidence of prior treatment response.\n\nAdditional Pathologic Findings: The lesion is located in the lower third of the thoracic esophagus. No other notable findings are reported."} +{"pid": "TCGA-Y8-A894", "report": "The specimen consists of a left renal lesion located in the middle pole, measuring 1.8 cm. The lesion is confined to the kidney without extension beyond the organ. Histologic examination reveals papillary architecture with cellular features consistent with type 1 morphology. Nuclear grading according to Fuhrman criteria is grade 2. No sarcomatoid differentiation or tumor necrosis is observed. Surgical margins are negative. There is no evidence of lymphovascular invasion. No lymph nodes were submitted for evaluation.\n\nChronic inflammatory changes are noted in the peritumoral kidney tissue, along with interstitial inflammation, scattered sclerosed glomeruli, and vascular changes suggestive of arterial nephrosclerosis. No additional tumors or tumor-like lesions are identified.\n\nThe specimen includes both normal and tumor tissues processed in multiple vials and blocks. Tissue collection includes cryovials, formalin-fixed paraffin-embedded (FFPE) blocks, and paired normal and tumor samples. The specimen was processed with standard fixation and preservation methods. Blood and plasma components were collected and stored appropriately. All margins are free of tumor involvement."} +{"pid": "TCGA-AA-3685", "report": "The resected colon specimen contains a moderately differentiated epithelial neoplasm arising in the colonic mucosa. The lesion measures up to 3.8 cm in greatest dimension and extends into the pericolic adipose tissue. There is focal involvement of lymphatic channels by malignant cells. A total of 24 regional lymph nodes are present, none containing tumor. All resection margins, including the colon, mesenteric, and circumferential margins, are free of tumor. Histologic grade is G2. Lymphovascular invasion is present (L1, V0). Resection margin status is negative (R0)."} +{"pid": "TCGA-DE-A4M8", "report": "The surgical specimen included a lymph node from the right superior thyroid region, which was biopsied and found to contain benign parathyroid tissue with no evidence of malignancy. A biopsy of the right superior parathyroid showed scant parathyroid tissue and no malignant findings. The right inferior parathyroid biopsy contained a small fragment of benign lymph node tissue but no parathyroid tissue was identified for evaluation.\n\nThe total thyroidectomy specimen weighed 27 grams and measured 4.6 x 2.6 x 1.0 cm on the right lobe, 4.7 x 2.6 x 2.0 cm on the left lobe, and 2.0 x 0.7 x 0.5 cm at the isthmus. The tumor was multifocal, involving both the right and left lobes extensively. The dominant lesion was located in the left lobe, measuring 1.7 x 1.7 x 1.5 cm. A second nodule in the right inferior pole measured 0.7 x 0.6 x 0.6 cm, and a third semi-gelatinous nodule in the left inferior pole measured 1.4 x 1.2 x 1.1 cm. All nodules were well-circumscribed except for the third, which was less circumscribed and pink/gray in color. Some calcification was noted in the largest nodule. All tumors appeared to be confined within the thyroid gland and grossly abutted the capsule. No invasion of blood vessels, lymphovascular structures, or extension beyond the thyroid capsule was identified. Surgical margins were negative, with the closest distance being less than 0.1 mm to the anterior margin and 0.1 mm to the posterior margin.\n\nOne of three lymph nodes examined contained metastatic involvement, with the largest metastasis measuring 0.2 mm in greatest dimension. Extranodal extension was not present. Additional findings included multinodular hyperplasia and chronic lymphocytic thyroiditis. Approximately 50% of the left lobe and 75% of the right lobe were submitted for examination, with all nodules fully sampled. Tissue from the dominant nodule was sent for tumor procurement purposes.\n\nFrozen sections taken during surgery from various sites did not show any evidence of malignancy. Lymph nodes and parathyroid tissues evaluated intraoperatively were negative for tumor involvement. The specimen was fixed in formalin, and orientation was marked with ink (anterior/blue, posterior/black, isthmus/yellow). The remaining appearance of the thyroid away from the tumor was spongy and red/brown with some tan/gray discoloration in the right lobe.\n\nNo discrepancies were identified in the correlation between histologic findings and clinical history."} +{"pid": "TCGA-EC-A1QX", "report": "The pathology report describes a hysterectomy specimen with bilateral salpingo-oophorectomy. The tissue involved is from the endometrium. The histologic evaluation shows a poorly differentiated adenocarcinoma. The tumor extends beyond half of the myometrium. The margins are uninvolved. No venous invasion is identified. Lymphatic invasion, lymph node status, extent of myometrial invasion, tumor size, evidence of neo-adjuvant treatment, and additional findings are not specified."} +{"pid": "TCGA-Z7-A8R6", "report": "ADDENDUM. Addendum #1. Entered: BREAST CANER PROGNOSTIC MARKERS. Specimen: Paraffin block 3A. Procedures: Paraffin Section Immunohistochemistry and DNA Flow Cytometry. ASSAYS: FAVORABLE. RANGES: Estrogen Receptors. Positive, 2-3+. Positive (1 -. 3+). Progesterone Receptors. Positive, 3+. Positive (1 -. 1+). Ploidy/DNA Index (DI). Aneuploid, DI=1.19, 2.01. Diploid, DI = 1.0. S-Phase Fraction (%). Not Reported. Low (3% or less). Ki-67 (Proliferation marker). High, 40-50%. Low (15% or less). HER-2/neu (c-erb B2). Negative (0). Negative (0 -. 1+). p53. Weakly Positive. Negative. S-phase fraction is not reported due to multiple aneuploid peaks. This immunoperoxidase test was developed and its performance characteristics determined by. Although not cleared or approved by the U.S. Food and Drug Administration, the FDA has determined that such clearance or approval is not necessary. This test is used for clinical purposes and should not be regarded as investigational or for research. This laboratory is certified under the Clinical Laboratory Improvement Amendments of 1988 (CLIA) as qualified to perform high complexity clinical laboratory testing. Addendum Signed signature on file.\n\nGROSS DESCRIPTION \n1. Labeled \"blue node, left axilla\": The specimen consists of a bilobed blue dye stained apparent lymph node and fatty tissue. The fatty tissue is trimmed, revealing a lymph node measuring 1.6 x 1.0 x 0.4 cm. It is bisected and all embedded as 1A with cytokeratin stain. \n2. Labeled \"suspicious node, left axilla\": The specimen consists of a tan yellow firm apparent lymph node measuring 1.0 x 0.5 x 0.3 cm. Bisected and all embedded as 2A. \n3. Labeled \"segment, left breast, long stitch anterolateral, short stitch anteromedial\": The specimen consists of a blue dye stained piece of yellow tan tissue with orienting stitches measuring 3.2 cm medial to lateral, 2.8 cm superior to inferior, and 4.4 cm in depth. At the deep aspect of the tissue, there is a firm gritty tan nodule. The specimen is inked as follows: anterior - yellow, green - superior, black - lateral, blue - inferior, red - medial, orange - deep. Sections through the tissue show a gritty solid tan mass at the deep lateral aspect measuring 2.0 x 2.0 x 1.7 cm. Representative tumor and normal tissue are provided for XXXX research studies (IRB# XXXXXXXXXXXXXX). Multiple representative sections are embedded serially from posterior to anterior as 3A-G (tumor in blocks 3A-D). \n4. Labeled \"addition segment, left breast, no orientation\": The specimen consists of four pieces of yellow tan hemorrhagic and blue dye stained tissue measuring approximately 6.0 x 3.0 x 2.0 cm in aggregate. The tissue is focally firm, but no definite tumor is identified grossly. Multiple representative sections are embedded as 4A-D, 4E-J - additional firm areas of tissue. \n5. Labeled \"left breast lower quadrant mass\": The specimen consists of three pieces of firm and soft tissue measuring approximately 2.0 X 1.3 x 1.0 cm in aggregate. One piece represents a firm gray nodule measuring 1.4 X 0.8 X 0.2 cm. The entire nodule and representative other tissue is embedded as 5A-B. \n6. Labeled \"inferior margin left breast\": The specimen consists of a piece of gray yellow tissue measuring 2.3 X 1.0 x 0.3 cm. Embedded as 6A. \n7. Labeled \"superior margin left breast\": The specimen consists of a piece of blue dye stained yellow tissue measuring 1.2 x 1.0 x 0.2 cm. Embedded as 7A. \n8. Labeled \"medial margin, left breast\": The specimen consists of a piece of gray yellow tissue measuring 2.2 x 1.3 x 0.3 cm. Embedded as 8A. \n9. Labeled \"lateral margin, left breast\": The specimen consists of a piece of reddish yellow and gray tissue measuring 1.5 x 0.6 X 0.2 cm. Embedded as 9A. \n10. Labeled \"anterior margin, left breast\": The specimen consists of a piece of gray tissue measuring 1.6 X 0.6 x 0.2 cm. Embedded as 10A. \n11. Labeled \"deep margin, left breast\": The specimen consists of a piece of yellow red tissue measuring 1.5 x 1.4 X 0.2 cm. Embedded as 11A. \n12. Labeled \"left breast lower quadrant skin\": The specimen consists of a piece of gray pink tissue measuring 1.0 X 0.5 x 0.2 cm. Embedded as 12A.\n\nMICROSCOPIC \nSections show cellular infiltration characterized by poor tubule formation, intermediate nuclear grade, and high mitotic activity. The cells infiltrate as sheets, single file, alveolar nests, and occasional larger nests. There is a tendency to infiltrate around existing ductal structures and focally form targetoid lesions. Early necrosis is noted focally. A desmoplastic stromal response is present. \n\nIMMUNOCYTOCHEMISTRY RESULTS \nBlock 1A. Keratin: Negative. \nBlock 3A. E-Cadherin: Negative.\n\nAdditional findings include benign breast parenchyma with radial scar formation, fibrocystic change, and fibroadenomatous change. Microcalcifications are noted associated with benign glandular elements. Margins of resection show involvement at posterior, lateral, and superior segments of the initial segment; however, additional segments and separately submitted margins are negative. No lymphovascular invasion is identified. All lymph nodes examined are negative for metastatic disease. Tumor size measures 2.0 cm. Histologic grade is poorly differentiated with a Modified Bloom-Richardson score of 8/9 (Tubules 3, Nuclei 2, Mitoses 3)."} +{"pid": "TCGA-HT-8114", "report": "The specimen demonstrates a moderately to markedly hypercellular glial neoplasm that diffusely infiltrates both gray and white matter. The tumor exhibits several distinct regional patterns. In some areas, the predominant phenotype appears consistent with ordinary gemistocytes, though microgemistocytes are also present. In other regions, a fibrillary or protoplasmic astrocytoma phenotype is more prominent. A microcystic stroma is noted as focally prominent. Nuclei tend to be round, and while some cells have few processes, no definitive oligodendroglioma differentiation is observed. Cellular atypia varies from mild to marked, with some areas showing scattered large cells, including multinucleated forms. Mitotic activity is low, with no more than 2 mitoses per 10 high power fields. Microvascular proliferation is absent; however, focal tumor necrosis is present. The MIB-1 labeling index is 5.2%."} +{"pid": "TCGA-DD-A3A0", "report": "Surgical date: TISSUE DESCRIPTION: Left gastric lymph node (3.2 x 1.2 x 0.8 cm), diaphragm biopsy (1.1 x 1 x 0.7 cm), and segment III and IV liver (675 grams; 22 x 13 x 7 cm). The liver specimen contains a partially necrotic mass measuring 8 x 6 x 2 cm. The resection margins are free of tumor by at least 1 cm, and there is no evidence of vascular invasion. The surrounding liver tissue does not show cirrhosis. The left gastric lymph node shows reactive lymphoid hyperplasia. The diaphragm biopsy reveals a calcified fibrous nodule."} +{"pid": "TCGA-AA-3814", "report": "The specimen shows a neoplastic lesion composed of solid and ductal cell elements, with notable loss of nuclear polarity and increased chromatin content. The lesion invades approximately 1 cm into the surrounding tissue and extends into the adjacent fatty connective tissue, classified as pT3 according to TNM staging (6th edition). Lymphovascular invasion is present (L1, V1) and no residual tumor is found at the resection margins (R0). No lymph node involvement is identified (pN0), and distant metastasis could not be assessed (MX). Histological grading indicates moderate differentiation (G2)."} +{"pid": "TCGA-VD-A8KO", "report": "A right eye globe specimen was received, measuring 25 x 24.5 x 24mm. The cornea measured 11.5mm horizontally and 11mm vertically, with a regular pupil. Trans-illumination revealed a shadow in the supero-medial quadrant, measuring up to 19mm in maximum diameter. On sectioning, a nodular pale mass was identified slightly anterior to the equator, measuring 9mm in largest basal diameter and 8.5mm in height.\n\nMicroscopic examination of the intraocular contents showed a lesion composed predominantly of spindle-shaped cells. The number of mitotic figures was approximately 4 per 40 high power fields. Focally, closed loop formations were observed within the planes of section. The degree of pigmentation was minimal. A low level of lymphocytic infiltration was present, and no necrosis was identified. The lesion extended from the ora serrata/ pars plana region up to the equator, without evidence of extension through the sclera, optic nerve, or vortex veins. Tumour cells were not present at the resection margins.\n\nOther findings included slight hyalinisation of ciliary processes away from the lesion, and mild atrophy of the retina overlying the mass, with an intact Bruch\u2019s membrane. The anterior chamber was shallow with open angles, and no significant abnormalities were seen in the cornea or iris.\n\nImmunohistochemical staining showed expression of Melan-A and HSP 27 (score 2). Molecular genetic analysis using MLPA on extracted tumour DNA showed essentially normal patterns for chromosome 1p, borderline losses of chromosome 3 in the presence of borderline gains, gains in chromosome 6p, and normal findings for chromosome 8. The DNA concentration was high and of good quality, and results were consistent across multiple runs."} +{"pid": "TCGA-D8-A27V", "report": "Histopathological examination was performed on a resected right breast measuring 12.2 x 11.2 x 3.6 cm, with a skin flap of 13.2 x 16.3 cm and a total weight of 200 g. The lesion of interest measured 3.2 x 1.8 x 2.8 cm and was located at the boundary of the outer quadrants, 1.8 cm from the outer margin, 0.3 cm from the base, and in direct proximity to the skin. Microscopic evaluation revealed a neoplastic process characterized by classical histological features, with a nuclear grade of 2 (scored 3+2+1). No mitotic figures were observed in the counted high-power fields (visual area: 0.55 mm\u00b2). There was evidence of neoplastic infiltration involving the mammary skin; however, the nipple was unremarkable. Background parenchymal changes included sclerosing adenosis and calcifications. Lymph node status could not be assessed as no axillary tissue was present in the specimen."} +{"pid": "TCGA-SX-A7SO", "report": "The surgical specimen from the right hemi- and transverse colectomy included the terminal ileum, cecum, ascending colon, and proximal transverse colon. A tumor was identified in the ascending colon approximately 12 cm from the ileocecal valve. The lesion measured 3.0 cm in greatest dimension and exhibited a flat, granular, pink-tan appearance on gross examination. Histologically, it demonstrated invasive growth into the submucosa without penetration into the muscularis propria. The histologic grade was moderately differentiated. Margins of resection, including the proximal small bowel and distal colonic margins, were free of tumor involvement. A separate inflammatory polyp measuring 0.6 cm was noted distal to the main lesion. No lymphovascular or perineural invasion was observed, and no tumor deposits were present. Twenty-two regional lymph nodes were examined and none showed evidence of metastatic involvement.\n\nThe left kidney specimen, obtained via partial nephrectomy, revealed a unifocal tumor located at the upper pole. Grossly, the tumor measured 7.0 cm in greatest dimension and had a soft, gray-brown, predominantly solid appearance. Microscopic evaluation showed papillary architecture with eosinophilic cytoplasm and Fuhrman nuclear grade 2 features. There was no evidence of sarcomatoid differentiation, tumor necrosis, or extension into perinephric tissue, renal sinus, renal vein, or collecting system. The parenchymal margin was noted to be 0.3 cm from the tumor on gross inspection and was microscopically negative. No lymph nodes were identified, and there were no notable pathologic findings in the adjacent non-neoplastic kidney tissue."} +{"pid": "TCGA-2Y-A9HA", "report": "A resected liver specimen from segment 6 was examined and measured 6.9 x 6.0 x 4.5 cm, weighing 65.5 g. The capsule was intact and pitted, with no gross lesion identified. A circumscribed, spongy mass measuring 1.7 cm in diameter was observed within the parenchyma, located 1 cm from the deep margin and not involving the capsule. Necrosis was present in 5% of the lesion, with no hemorrhage noted. The surrounding liver tissue showed coarse lobulation and congestion without satellite lesions. Histologic evaluation revealed multiple cellular abnormalities with moderate differentiation. Vascular invasion was not identified. The invasive component was at least 8 mm away from the inked, cauterized deep margin.\n\nAnother specimen from segment 8 weighed 10.1 g and measured 3.7 x 2.8 cm, with an excision depth of 2 cm. It contained a pale gray-tan, solid lesion measuring 1.5 x 1.4 x 1.3 cm, located 3 mm beneath the capsule and extending to the deep margin. Punctate necrosis was present, likely representing prior biopsy activity. No additional lesions were observed.\n\nA third fragment from segment 8, representing an extended margin, weighed 1.6 g and measured 2.8 x 2.1 cm. It was cauterized and re-inked blue at the deep margin. No lesion was identified on gross examination. Microscopic findings from all specimens indicated chronic hepatitis with mild activity and progression toward cirrhosis, consistent with underlying hepatitis C. No carcinoma was detected in this final margin specimen. Reticulin and trichrome staining confirmed fibrotic changes and architectural distortion without evidence of metastatic involvement."} +{"pid": "TCGA-81-5910", "report": "The specimen was received in four parts. Part A, labeled as the right false vocal cord, consists of two tan-white soft tissue fragments measuring 2 mm and 5 mm. Microscopic evaluation shows nonkeratinizing squamous epithelium overlying submucosa. No inflammation or dysplasia is present. Focal orthokeratotic layer shows budding yeast forms consistent with Candida species, but no tissue invasion is observed.\n\nPart B, a left parietal mass, includes an aggregate of red-tan soft tissue measuring 15 x 11 x 3 mm, and an additional fragment measuring 18 x 13 x 4 mm. Sections show a cellular neoplasm with areas of necrosis and prominent microvascular proliferation. The cells exhibit pleomorphic, hyperchromatic nuclei and variable cytoplasmic borders. Some regions contain gemistocytic astrocytes with eccentric nuclei and moderate eosinophilic cytoplasm. Peri-necrotic pseudopalisades are identified. Multinucleated tumor cells are rare. Immunohistochemistry demonstrates strong positivity for GFAP.\n\nPart C, described as dura on top of the lesion, measures 3.3 x 2.7 x 0.1 cm and is composed of glistening white-pink fibrous tissue. Histologic examination reveals dense membranous connective tissue without evidence of neoplastic involvement.\n\nPart D, another portion of the left parietal mass, measures 2.3 x 2.2 x 1.1 cm and has tan-pink cut surfaces without gross lesions. Microscopic features are comparable to those seen in Part B."} +{"pid": "TCGA-HT-7606", "report": "The tissue sections show mildly hypercellular white matter infiltrated by mildly to moderately atypical fibrillary astrocytes. No mitotic figures, microvascular proliferation, or necrosis are identified. In the gray matter, only rare mildly atypical cells are scattered throughout, likely representing infiltrating tumor cells. The gray matter shows minimal involvement, while the white matter exhibits mild hypercellularity due to diffuse infiltration, consistent with the findings in the referenced specimen."} +{"pid": "TCGA-HT-8113", "report": "The specimen shows a focally markedly hypercellular glial neoplasm that diffusely infiltrates both gray and white matter. Focally prominent intratumor hemorrhage is present. The neoplasm is composed of cells with mildly enlarged, mildly atypical round nuclei, most often with perinuclear halos. No mitotic figures are identified. There is no microvascular proliferation or necrosis. Numerous MIB-1 reactive cells are scattered throughout the tissue. A labeling index of 13.4% was calculated. This indicates a high level of cellular proliferation, which contrasts with the less aggressive features observed in the H&E sections. Although the MIB-1 staining reveals a few mitotic figures not previously noted, their number does not exceed 2 per 10 high power fields and is insufficient to support a more aggressive classification."} +{"pid": "TCGA-GS-A9TQ", "report": "Left inguinal lymph node: Multiple tissue fragments measuring 3.4 x 2.8 x 0.6 cm. The excised lymph node shows complete effacement of normal architecture by a vaguely nodular proliferation with extensive diffuse areas. The lesion is composed of a monotonous population of atypical large cells resembling centroblasts, with numerous mitotic and apoptotic figures. Immunohistochemical staining demonstrates positivity of the atypical cells for CD20, CD79a, CD10, bcl-6, and bcl-2, while MUM1 is negative. Stains for follicular dendritic cells (CD21, CD35) reveal a diffuse pattern of growth. There is a moderate increase in T cells expressing CD3 and CD5. The Ki67 proliferation index exceeds 80%. Fluorescence in situ hybridization (FISH) analysis detects a rearrangement of the MYC gene."} +{"pid": "TCGA-V1-A8WW", "report": "The specimen consists of soft tissue biopsies from multiple regions including the left anterior bladder neck, left posterior bladder neck, posterior midline, left base, and left posterior midline. All specimens show fibromuscular or fibroadipose tissue without evidence of tumor or prostatic epithelium. Pelvic lymph node dissections were performed; on the right side, no tumor was identified in eleven nodes (0/11), while on the left side, one of nine lymph nodes contained abnormal cells.\n\nA radical prostatectomy specimen with attached seminal vesicles was examined. Microscopic evaluation identified cellular changes involving bilateral seminal vesicles. The surrounding tissues showed extensive involvement extending beyond the capsule. Margins were assessed and showed no definitive tumor cells, although rare cauterized glands were noted at one location. High-grade intraepithelial neoplasia was present focally. Perineural infiltration and lymphovascular invasion were observed.\n\nImmunohistochemical analysis indicated the presence of endothelial-type cells within a small focus at the posterior midline, although this finding was not confirmed on permanent sections. No benign prostate glands were identified at inked excision margins.\n\nLymph node evaluation revealed one positive node out of twenty examined, with the largest metastasis measuring 0.3 cm. No extranodal extension was identified.\n\nGross examination of the prostate showed a firm white-tan lesion measuring approximately 2 x 2 x 1.5 cm located along the left posterolateral aspect extending from apex to base. The lesion appeared to breach the capsule and reach surgical margins in several slices. It also approached and partially extended into the left seminal vesicle.\n\nThe specimen was sliced into nine sections for detailed histological assessment. Sections included areas corresponding to both apex and base on left and right sides, as well as bladder and apical margins. All margins were submitted for thorough evaluation.\n\nFinal staging based on AJCC/UICC criteria reflects extensive local involvement and lymph node positivity."} +{"pid": "TCGA-D6-A6EM", "report": "Female patient, material from the oral cavity \u2013 tongue. Surgical margins were marked as requested. Histopathological examination of the specimen revealed a lesion with atypical cellular features, including nuclear pleomorphism and increased mitotic activity. The tumor measured approximately 3.5 cm in greatest dimension and demonstrated deep invasion into the underlying muscle tissue. Lymphovascular space invasion was present. No lymph node metastases were identified in the submitted material. The lesion was classified as moderately differentiated, with a clear surgical margin of resection."} +{"pid": "TCGA-IB-AAUN", "report": "The specimen consists of a Whipple resection including the duodenum, head of the pancreas, and common bile duct stump. The pancreas measures 3.8 x 3.5 x 2.5 cm. A mass measuring 2.3 x 2.1 x 1.8 cm is identified within the pancreas with a non-homogeneous white-tan cut surface. The mass is located approximately 1.2 cm from the duodenal wall and is in close proximity to the distal pancreatic and uncinate margins. Microscopic evaluation reveals invasive growth confined to the pancreas with negative margins of resection; the closest distance of the tumor to the nearest margin is 1 mm at both the uncinate and distal pancreatic margins.\n\nExtensive perineural invasion is present. No lymphovascular invasion is identified. Multiple lymph nodes are identified around the pancreas and portal vein. Fifteen lymph nodes are examined in total\u2014eight peripancreatic and seven from group A\u2014none of which show involvement by malignancy. Serial sections of the bile duct margin reveal benign ductal tissue with focal acute inflammation and reactive changes. The portal vein margin is unremarkable.\n\nHistologic grade is moderately differentiated. Based on size (>2 cm) and confinement to the pancreas, the primary tumor classification is pT2. Regional lymph node staging is pN0 due to absence of metastasis. Gross examination confirms no involvement of the proximal gastric or duodenal margins, and the bile duct margin appears histologically benign."} +{"pid": "TCGA-YZ-A984", "report": "The enucleated left eye specimen consists of a 2.8 x 2.4 x 2.6 cm globe with a clear cornea measuring 1.1 x 1.0 cm in diameter. The optic nerve stump measures 0.2 cm in length. Upon sectioning, a brown-black, partially fragmented mass is identified in the inferior aspect of the posterior chamber. The mass measures 1.5 cm in maximum diameter and 1.4 cm in maximum height. Histologic evaluation reveals a predominantly cohesive spindle cell proliferation within the choroid. Focal areas demonstrate cells with an epithelioid morphology. Mitotic figures are infrequent. Pigmentation is present but limited to certain regions. There is no involvement of the ciliary body, sclera, or extrascleral extension identified. Sections do not show optic nerve involvement. A separate biopsy of the vortex vein from the left eye shows no evidence of tumor involvement.\n\nCytogenetic analysis identifies an abnormal clone of cells with a translocation between chromosomes 3 and 6 [4 out of 20 metaphases analyzed]. This structural rearrangement is uncommon in such tumors, where nonrandom chromosomal changes typically involve chromosomes 1, 3, 6, and 8. Structural abnormalities involving chromosome 3 are rarely observed and usually consist of deletions rather than balanced translocations. The biological significance of this particular chromosomal rearrangement remains uncertain.\n\nMicroscopic examination was conducted using H&E and PAS stained sections. Immunohistochemical and in situ hybridization assays were performed; however, except for HER-2/neu testing, none of these assays have FDA approval as they were developed internally by the laboratory. All control tissues demonstrated appropriate reactivity."} +{"pid": "TCGA-21-5783", "report": "The specimen was received in six parts. A portion of the 6th rib measured 2 x 1.4 x 1 cm and showed no gross suspicious lesions. It was submitted entirely after decalcification. A level 9 lymph node measuring 0.9 x 0.7 x 0.7 cm was entirely submitted. A level 11 lymph node, irregular in shape and measuring 1.5 x 1 x 0.7 cm, was also submitted in its entirety.\n\nThe left upper lobe specimen weighed 235 grams and measured 18 x 11 x 6.5 cm. The bronchial margin was evaluated by frozen section and found histologically negative, although it was grossly close at 3\u20134 mm. The bronchial tree was opened and revealed lesional tissue approximately 0.2\u20130.3 cm from the margin. Vascular margins were unremarkable. The hilum contained several black, anthracotic nodes, and multiple peribronchial nodes were identified. A large area of pleural puckering up to 3 cm was noted, and a tumor measuring 7 x 6 x 5 cm was present, involving approximately 40% of the left upper lobe. The tumor was centrally necrotic with black discoloration but showed more viable tissue peripherally. Sections of the remaining lung parenchyma revealed pink, spongy tissue with anthracotic pigmentation and no other lesions.\n\nSections were taken from the bronchial margin, vascular margin, hilar nodes, a section 5 cm from the bronchial margin, additional hilar sections including possible peribronchial lymph nodes, sections of the tumor, tumor in relation to the pleura, and uninvolved lung tissue.\n\nA level 5 lymph node specimen included two fragments measuring 0.3 cm and 0.5 cm, embedded in fat. A level 7 lymph node measuring 0.9 x 0.9 x 0.6 cm was submitted entirely.\n\nHistologic evaluation of all submitted sections from the 6th rib, level 9, level 11, level 5, and level 7 lymph nodes showed no evidence of tumor. In the left upper lobe, the bronchial and vascular margins were negative, as were the pleura and six hilar lymph nodes. Immunohistochemical staining of the tumor showed negativity for chromogranin and synaptophysin, with focal positivity for CD56."} +{"pid": "TCGA-BC-A10X", "report": "The gallbladder specimen measured 11 x 4 x 2.5 cm and contained a 1.7 cm well-circumscribed white nodule at the fundus. Microscopic examination revealed chronic inflammation with cholesterolosis. A separate cystic structure was identified near the gallbladder lumen, lined by columnar epithelium and surrounded by a thick smooth muscle wall, with mucosal invaginations resembling Rokitansky-Aschoff sinuses. The remainder of the gallbladder mucosa was green/tan and velvety in appearance.\n\nA single lymph node from the right inferior mediastinum showed benign features without any abnormal cellular findings. The liver resection specimen weighed 1050 g and measured 15 x 15 x 15 cm, with a 10.5 x 6.0 cm area of adherent diaphragm and parietal pleura. A 12 x 10 x 10 cm yellow/tan mass was identified, showing areas of necrosis and hemorrhage, with a nodular architecture and fibrous septations. The mass approached within 0.3 cm of the surgical margin but did not breach the capsule. Histologic evaluation demonstrated moderately differentiated cellular features with geographic necrosis, venous invasion, and multiple small foci suggestive of lymphovascular space involvement. Stains demonstrated PAS-positive inclusions and biliary fibrosis in surrounding tissue. The tumor infiltrated the ventral surface of the diaphragm, causing fibrosis and destruction of skeletal muscle, but did not fully penetrate it.\n\nA second lymph node from the right portal region showed no abnormal cells. Lung biopsy from the superior segment of the right lower lobe revealed multiple small intraparenchymal lymph nodes with anthracotic pigment and fibrotic changes suggestive of prior granulomatous disease. A separate lung specimen from the face of the right lower lobe showed marked reactive mesothelial proliferation on both parietal and visceral pleural surfaces, with positive staining for calretin, consistent with a response to underlying pathology. No tumor cells were found in this specimen or in the left portal lymph node examined.\n\nFrozen section analysis of the gallbladder nodule was non-neoplastic, with final sections confirming a duplication cyst. Intraoperative biopsies of the liver margin and lymph node were also non-malignant. The surgical margins of the liver resection were free of involvement."} +{"pid": "TCGA-EB-A57M", "report": "A mass located in the left heel skin is ulcerated, measuring 4x4x1.0 cm, with a firm consistency and brown-black to gray surface. Microscopically, the epidermis shows necrosis, ulceration, and hyperplasia. The lesion is composed of spindle or oval cells with moderately abundant cytoplasm, which in some areas contains fine melanin pigment granules. The cells exhibit a low nucleo-cytoplasmic ratio, with nuclei varying in size and shape, and featuring prominent eosinophilic nucleoli. Mitotic figures are observed. The tumor invades into the dermis and subcutaneous fat. Histologic evaluation indicates poor differentiation. Lymph node examination reveals one out of two involved lymph nodes (left inguinal). The surgical margins are uninvolved. Breslow thickness measures 8 mm. Tumor features include pigmentation, necrosis, and ulceration. The specimen type is surgical resection from the foot."} +{"pid": "TCGA-06-0878", "report": "The patient presented with a history of a possible stroke and an enlarging lesion identified on imaging. MRI demonstrated an enhancing intra-axial lesion located in the left posterior temporal lobe. A biopsy was performed, and the specimen consisted of a single fragment measuring 0.9 cm in diameter. The tissue was described as semi-firm, grayish-blue, focally hemorrhagic, and glistening.\n\nMicroscopic evaluation revealed a neoplastic astrocytic proliferation characterized by nuclear anaplasia, brisk mitotic activity, microvascular proliferation, and areas of necrosis, including regions with pseudopalisading. These histological features were consistent with a high-grade glioma.\n\nImmunohistochemical staining showed expression of GFAP in a gliofibrillary pattern. Less than 100 cells demonstrated overexpression of p53 protein. CD163 highlighted cells surrounding areas of necrosis. The MIB-1 labeling index, used to assess proliferative activity, was approximately 13% throughout the tumor.\n\nMolecular testing for MGMT promoter methylation status was performed using bisulfite-treated DNA and real-time PCR (MethyLight assay). The results indicated no evidence of methylated MGMT promoter sequences. The test was conducted under CLIA-certified conditions and was not FDA-cleared or approved for diagnostic use.\n\nIntraoperative cytologic evaluation of touch preparations supported the presence of a high-grade glioma. All findings were reported to the treating physician to assist in clinical decision-making."} +{"pid": "TCGA-BP-4340", "report": "The clinical history notes a right renal cortical lesion, and a laparoscopic right nephrectomy was performed. The specimen consisted of a kidney with attached perirenal fat, weighing 440 grams and measuring 20 x 8.6 x 4.5 cm in total. The kidney itself measured 12 x 8 x 4 cm, with an attached ureter measuring 6 x 0.3 cm. Upon bivalving the kidney, a well-circumscribed, yellow-brown mass was identified beneath the capsule. It contained a central scar and measured 4.5 x 4.5 x 4.0 cm. The lesion was confined to the renal cortex, abutting but not penetrating the renal capsule. The renal calyces, pelvis, vein, artery, and ureter were not involved.\n\nHistologic examination revealed a solid growth pattern. Nuclear grading was assessed as II/IV. The tumor did not invade the renal vein, and all surgical margins were free of involvement. The adjacent kidney showed glomerulosclerosis and interstitial inflammation. A portion of the specimen was submitted for further testing, and a photograph was taken for documentation. Sections from multiple areas including the ureteral margin, vascular margin, anterior and posterior tumor margins, hilar fat, normal parenchyma, and tumor adjacent to the renal pelvis were evaluated."} +{"pid": "TCGA-VR-AA7D", "report": "The specimen from the esophagectomy and partial gastrectomy shows a moderately differentiated squamous cell lesion measuring 7.5 cm in greatest dimension. The lesion extends through the wall of the esophagus into the surrounding periesophageal adipose tissue. Histologic evaluation reveals angiolymphatic and perineural invasion. Desmoplastic reaction around the lesion is minimal, while a moderate lymphocytic infiltrate is observed in the peritumoral area. Surgical margins are negative for neoplastic involvement. Adjacent non-neoplastic esophageal mucosa shows signs of congestion. Gastric mucosa fragments demonstrate moderate chronic inflammation with atrophic changes and intestinal metaplasia. Of the lymph nodes examined, a subset shows evidence of involvement. A separate specimen labeled as cervical lymph node reveals parathyroid tissue with increased volume and vascular congestion; correlation with clinical and radiological data is recommended to determine whether this represents hyperplasia or adenomatous change."} +{"pid": "TCGA-CV-7435", "report": "The specimen from the right neck dissection includes fibroadipose tissue measuring 10.0 x 3.4 x 1.0 cm, with a surgical clamp near one end. Adjacent to the clamp is a gland measuring 2.5 x 2.0 x 1.7 cm. Several lymph nodes are present, with two of them grossly replaced by tumor and measuring up to 2.5 cm. A total of 22 lymph nodes were evaluated in this specimen, with two showing involvement. In contrast, nine lymph nodes assessed in the left neck dissection showed no evidence of involvement. The anterior margin consists of a strip of mucosa measuring 5.0 x 0.2 x 0.1 cm, with blue ink on one surface. The tongue margin is a fragment of tan-pink soft tissue measuring 6.6 x 1.2 x 0.4 cm, with blue marking indicating the true margin. The mandible and tongue specimen includes a mass located in the floor of the mouth measuring 3.5 x 3.0 x 1.8 cm. Microscopic evaluation revealed moderately differentiated cells with vascular and perineural invasion. Resection margins were free of tumor. The closest gross margin was identified at the mucosal margin on the far left side of the specimen, and there was no direct involvement of the resection margins by the tumor."} +{"pid": "TCGA-B0-4712", "report": "The left kidney specimen demonstrates a neoplasm measuring 8.5 cm in greatest dimension, with additional dimensions of 8.2 x 5.5 cm. Histologic evaluation reveals nuclear features corresponding to grade 3 of 4. The tumor extends into perinephric tissues and involves the renal sinus fat. There is no evidence of venous invasion; however, angiolymphatic invasion is present. All surgical margins are free of invasive\u75c5\u53d8. No regional lymph nodes were examined. The non-neoplastic kidney shows focal global glomerulosclerosis, marked tubular atrophy with thyroidization, interstitial fibrosis, and chronic inflammation. Based on the extent of spread, the staging classification indicates involvement beyond the organ confines without lymph node or distant disease involvement."} +{"pid": "TCGA-37-4133", "report": "The specimen was obtained from a lung tissue sample. The tumor tissue was embedded in OCT and provided in one container. Additional samples included a blood sample collected in a frozen tube. Histological analysis revealed a component of tumor cells with a mixture of cellular features, though no specific tumor type is identified. The tumor measured 3 cm in greatest dimension. Histologically, the tissue showed cellular atypia and pleomorphism. Staging was determined as T4, N0, M0. No treatment had been administered prior to specimen collection. A total of 72% of the sample was involved by tumor cells. No lymph node involvement or distant metastasis was identified."} +{"pid": "TCGA-ZP-A9D0", "report": "A central liver resection with gallbladder was performed. The specimen measured 15.0 x 17.0 x 10.0 cm and weighed 513 grams. A well-circumscribed tan-yellow mass measuring 14.0 x 9.0 cm was identified, located centrally within the liver. The mass contained a necrotic center measuring approximately 2.5 x 4.0 cm and was situated 2.5 cm from the closest inked surgical margin. Histological evaluation revealed a mass composed of nests of cells with large, hyperchromatic nuclei. There was evidence of central necrosis and disruption of normal portal triad architecture in most areas of the mass. No vascular or margin involvement was observed. Glypican staining showed patchy positivity, and reticulin stain demonstrated architectural disruption. The gallbladder showed no evidence of tumor extension, with unremarkable mucosa and normal wall thickness.\n\nA separate biopsy of the left lateral segment was obtained, consisting of two tan-yellow cores measuring up to 1.5 cm. Histologically, the tissue showed hepatocytes arranged in single-cell layers with intact lobular architecture. Mild macrovesicular steatosis involving less than 10% of the specimen was noted. No necroinflammatory activity, fibrosis, dysplasia, or malignancy was identified.\n\nA perigastric lymph node measuring 1.5 x 1.1 x 0.3 cm was submitted and found to contain only benign lymphoid tissue without any abnormal cellular infiltration.\n\nA midbody stomach resection was also performed. The specimen measured 3.0 x 2.0 x 0.5 cm and contained a small tan-white lesion measuring 0.3 x 0.3 x 0.4 cm, located 0.2 cm from the deep inked margin. Microscopic examination revealed a well-circumscribed lesion composed of spindle cells forming whorled and storiform patterns separated by fibrovascular septa. Immunohistochemical staining showed strong positivity for DOG-1 and CD117, with negativity for SMA. The gastric mucosa appeared normal.\n\nSurgical margins in the liver specimen were uninvolved. No lymphovascular invasion was identified microscopically or macroscopically. Lymph node status could not be fully assessed. The liver lesion was classified according to AJCC staging as pT1, with regional lymph node (NX) and distant metastasis (MX) categories not assessable."} +{"pid": "TCGA-AG-3583", "report": "The resected rectosigmoidal specimen includes a lesion measuring up to 8.5 cm in maximum diameter, located 2.5 cm from the aboral resection margin. Histological evaluation reveals a poorly differentiated component with mucinous features. The lesion infiltrates into the perirectal fatty tissue and is in close proximity to the circumferential resection margin. A total of 34 regional lymph nodes were examined, with 9 showing involvement. The colon resection margins and mesenteric margin are free of tumor. Additionally, there is a tubular adenoma in the colon mucosa with high-grade dysplasia and transition to an intramucosal lesion. Diverticulosis of the colon is also present. Pathological staging shows deep transmural extension, nodal involvement, and high-grade cellular atypia with lymphatic invasion identified."} +{"pid": "TCGA-38-4631", "report": "The patient has a history of lung malignancy. Gross examination includes multiple lymph node stations submitted from containers labeled 9, 10, 7, and 5. Container 9 contains three nodules measuring in aggregate 2.1 x 0.7 x 0.6 cm. Container 10 holds one nodule measuring 2.2 x 1.1 x 0.7 cm. Container 7 includes two nodules: the larger measures 2.9 x 1.3 x 0.9 cm and the smaller measures 1.8 x 0.6 x 0.5 cm. Container 5 contains three fragments with an aggregate measurement of 3.2 x 2.2 x 1.2 cm. Additional lymph nodes are present in container 4L, measuring 0.7 x 0.4 x 0.5 cm and 2.2 x 0.9 x 0.9 cm.\n\nThe left lung specimen measures 23.3 x 14.1 x 6.2 cm and weighs 750 grams. A lesion located at the apex of the left upper lobe is described as tan/white with central necrosis and irregular borders. The lesion measures 4.6 x 4.2 x 4.3 cm and approaches within 0.05 cm of the pleural surface but does not appear to penetrate it. No satellite nodules or involvement of adjacent structures are identified. The bronchial margin is uninvolved with tumor, with a distance of 5.8 cm between the tumor and the bronchial margin.\n\nMicroscopic evaluation reveals poorly differentiated cells arranged in a tumor mass measuring 4.6 cm in greatest dimension. Histologic assessment confirms negative surgical margins and focal proximity to the pleura without penetration. Adherent adipose and skeletal muscle consistent with focal chest wall adhesion are noted near the closest approach of the tumor to the pleura. Angiolymphatic invasion is identified within the tumor mass; perineural invasion is absent. Evaluation of lymph nodes shows no evidence of tumor involvement across all sampled stations.\n\nNon-tumor lung tissue demonstrates emphysematous changes and scattered lymphoid aggregates. Special stains reveal occasional intracytoplasmic globules resistant to diastase."} +{"pid": "TCGA-55-7907", "report": "The surgical specimen consists of a left pneumonectomy with regional lymphadenectomy. The primary lesion measured 4.5 cm in greatest dimension and was located in the upper lobe. Histologic evaluation showed poorly differentiated carcinoma with visceral pleural invasion present. Lymphovascular invasion was also identified. Margins were negative, with the closest vascular margin measuring 0.5 cm. One of twenty-four lymph nodes examined showed evidence of metastatic involvement, specifically in a peribronchial lymph node. No involvement was seen in the bronchial margin. Additional findings included atypical adenomatous hyperplasia and a focal necrotizing granulomatous inflammation, with rare organisms morphologically consistent with *Histoplasma* species confirmed by fungal stain. Pathologic staging was determined as pT2a, pN1, pMX, with a final pathologic stage of IIA. Elastic and fungal stains supported the observed features, while acid-fast bacilli staining was negative."} +{"pid": "TCGA-CQ-5324", "report": "The specimen consisted of multiple tissue samples from the left side of the head and neck region. The largest resected specimen measured 18.5 x 7.5 x 3.0 cm and included the floor of mouth, lateral tongue, and neck contents encompassing levels I, II, III, and IV. Within this specimen, a prominent exophytic mass was identified on the floor of mouth and lateral tongue, measuring 6.2 cm in its greatest dimension and 1.0 cm in thickness. The tumor was located 0.8 cm from the nearest tongue margin, extended to the mucosal margin, and was 1.0 cm from the deep soft tissue margin. Histologic evaluation showed no lymphatic or vascular invasion, and no perineural invasion was identified. Among all lymph nodes evaluated (24 total) from levels I\u2013IV, none contained evidence of tumor involvement. Margins were negative for tumor except at the floor of mouth, which was positive. Other submitted tissues including gingival margins, buccal margin, soft palate, tongue base, and floor of mouth all showed only chronic inflammation and reactive changes without evidence of tumor. The submandibular gland and surgical waste specimens also showed no abnormal pathology. One lymph node from level IB was also negative. Specimens from various margins were submitted in entirety and confirmed negative. A separate bone specimen from the superior rim of the left mandible showed reactive changes but no tumor."} +{"pid": "TCGA-BR-6563", "report": "The specimen consists of a subtotal gastrectomy. The lesion measured 5x3x1.5 cm and was located in the stomach. Histologic evaluation showed a poorly differentiated cellular pattern. The tumor involved adjacent structures, specifically the lesser omentum. Lymph node assessment revealed one out of three intraabdominal lymph nodes positive for metastatic involvement. Information regarding lymphatic, venous, and perineural invasion was not provided. Surgical margins, response to neoadjuvant therapy, and additional pathologic findings were not specified."} +{"pid": "TCGA-FG-8187", "report": "The intraoperative assessment was based on a specimen labeled as \"right frontal tumor,\" which consisted of multiple fragments of tan-pink brain tissue measuring 3.0 x 2.0 x 1.0 cm and weighing 2.32 grams. No firm areas were identified in this portion. A representative section was submitted for frozen diagnosis and preserved frozen, while the remainder was submitted in formalin (cassettes A2-A4). A second specimen labeled \"right frontal mass #2\" was received as an irregular segment of tan brain tissue measuring 3.0 x 1.5 x 1.5 cm and weighing 6.31 grams. Approximately half of this specimen was slightly firm on palpation. Upon sectioning, the cut surface showed variable consistency. The firmer portions were submitted as blocks B1-B3 and the remaining tissue as B4-B6.\n\nMicroscopic findings were not documented in the report. Two parts of the specimen (A and B) were obtained from the right frontal lobe via excisional biopsy.\n\nCellular analysis revealed distinct regions with features consistent with two different cell populations. One region exhibited characteristics typical of oligodendroglial morphology, while another displayed features associated with astrocytic differentiation. Within one area of interest, there was increased cellularity and nuclear pleomorphism; mitotic figures were extremely rare. Immunohistochemical staining for Ki-67 demonstrated labeling indices of 8.4% and 9.6% in two separate hypercellular regions. No evidence of vascular proliferation or necrosis was observed.\n\nAncillary studies were performed on paraffin block A3. Immunohistochemistry for p53 showed no labeling of nuclei. Fluorescence in situ hybridization (FISH) studies were conducted to evaluate chromosomal status. For chromosomes 1p and 19q, locus-specific probes were used (1p36 and 19q13 as targets, with 1q25 and 19p13 as references). Results showed a 1p36/1q25 ratio of 0.7 and a 19q13/19p13 ratio of 0.6, indicating allelic loss at both loci. These findings suggest reduced signals from the target regions compared to reference regions, consistent with genetic deletion events. However, allelic loss at one locus does not necessarily reflect changes across the entire chromosome, as FISH may not detect partial losses or compensatory replication of remaining alleles.\n\nFor EGFR analysis, FISH results showed a gene copy number of 3.1 and a CEP7 signal of 2.8, resulting in an EGFR/CEP7 ratio of 1.1, which falls within the normal reference range (0.8\u20131.9), indicating no amplification of the EGFR gene. Chromosome 7 aneusomy was also not detected.\n\nAll FISH analyses were conducted on formalin-fixed, paraffin-embedded sections. Atypical nuclei with at least two reference probe signals were counted, with quantitative data derived from an average of 40 nuclei. Loss was defined as a ratio \u2264 0.7, and aneusomy was defined as a mean reference signal count \u2265 3.0.\n\nThe specimen type was resection tissue, processed using both frozen and permanent section methods. Specimen handling and testing were carried out according to standard protocols."} +{"pid": "TCGA-BR-7703", "report": "The specimen consisted of an excised tissue sample from the stomach. The lesion measured 2.5 x 2 x 0.7 cm and was found to extend into the submucosa. Histologic evaluation revealed moderately differentiated cells. A total of four regional lymph nodes were examined, none of which showed evidence of metastatic involvement. No information was provided regarding tumor features, lymphatic, venous or perineural invasion, margins, neo-adjuvant treatment, or additional findings. The location of the lesion was noted as the fundus."} +{"pid": "TCGA-YL-A8HO", "report": "The prostate specimen, submitted with seminal vesicles, consists of a radical prostatectomy weighing 94.42 grams. The prostate measures 6.0 cm x 5.0 cm x 4.5 cm. The left vas deferens is 3.0 cm x 0.5 cm. The anterior surface is inked red and the posterior surface is inked black. Sections were taken throughout the prostate as per standard protocol, including margins and lymph nodes.\n\nExamination of tissue sections revealed abnormal cellular growth involving both lobes of the prostate, with presence in the right anterior, right posterior, left anterior, and left posterior quadrants. A portion of the growth extends beyond the prostatic capsule on the left side, but does not involve the muscular wall of the seminal vesicle. Vascular invasion was not identified, though perineural invasion was present. Approximately 15 to 20% of the gland was involved.\n\nMargins of excision were generally negative except for involvement at the bladder base margin. Lymph node examination on both sides showed no evidence of abnormal cells; 8 nodes were examined on the right and 10 on the left, all showing benign features. High-grade intraepithelial changes were noted in other areas of the prostate, along with basal cell hyperplasia and atrophy.\n\nStaging indicates pT3a (R1: residual microscopic disease), N0, Mx. The extent of extra-prostatic spread and margin positivity was focal. Some tissue was retained for banking."} +{"pid": "TCGA-85-8287", "report": "The specimen consisted of lung tissue obtained from a pulmonectomy. The tumor measured 3 x 2.5 x 2.5 cm and was located in the left upper region. Microscopic examination revealed a poorly differentiated cellular morphology. Evaluation of regional lymph nodes showed no evidence of metastasis, with 0 out of 3 lymph nodes involved. No lymphatic or venous invasion was identified. Additional features including tumor extent, presence of other nodules, margin status, neo-adjuvant treatment effect, and other pathologic findings were not specified."} +{"pid": "TCGA-3C-AALJ", "report": "The specimen received was labeled as a right skin-sparing modified radical mastectomy. The tissue measured 24.0 x 20.0 x 5.2 cm. A palpable mass was identified in the inferior aspect of the specimen at the 6 o\u2019clock position, measuring 3.5 x 3.0 x 2.0 cm. This mass was located 0.8 cm from the skin and 3.0 cm from the deep margin. A second smaller mass measuring 0.7 x 0.5 x 0.5 cm was found superior to the main mass, 0.8 cm from the skin and 2.4 cm from the deep margin. Additionally, a gritty, firm area measuring 4.0 x 3.5 x 2.0 cm was noted surrounding the masses. Multiple lymph nodes were identified within the axillary tissue, ranging from 0.5 cm to 1.7 cm in greatest dimension.\n\nMicroscopic evaluation revealed invasive carcinoma with central scar and micropapillary features. The tumor showed poor differentiation with a total histologic score of 8 (tubule score 3, nuclear grade score 3, mitotic score 2). Multifocal intraductal components were present, including papillary, micropapillary, solid, and comedo subtypes, with necrosis observed in the intraductal regions. No lobular neoplasia was identified. Additional small foci of invasive carcinoma were noted near the main lesion, with the largest measuring 1.5 cm microscopically.\n\nLymphatic invasion was present. One out of 23 axillary lymph nodes examined contained metastatic carcinoma, with extranodal extension noted. Margins were negative for involvement. The nipple and overlying skin were free of tumor. Adjacent breast tissue showed cystic disease with proliferative changes and atypia.\n\nStaging based on the AJCC 7th Edition criteria indicated pT2, reflecting a tumor greater than 2.0 cm but less than 5.0 cm in greatest dimension, and pN1a, indicating metastasis in 1 to 3 axillary lymph nodes with at least one deposit larger than 2.0 mm."} +{"pid": "TCGA-BH-A0WA", "report": "A segmental mastectomy of the right breast and sentinel lymph node biopsy were performed. Histopathological evaluation of the specimen revealed an invasive lesion measuring 1.4 cm. The lesion demonstrated high-grade nuclear features, including a Nottingham score of 9 (grade 3), with no evidence of angiolymphatic invasion. Dermal lymphatic invasion was not identified. Benign calcifications were noted in the surrounding tissue.\n\nThe surgical margins were free of invasive disease, with the closest margin measuring 2.0 mm from the tumor. In situ disease was also present, occupying approximately 5% of the tumor area. It exhibited cribriform and solid patterns, with high nuclear grade and comedo necrosis. The in situ component was admixed and adjacent to the invasive portion, and the closest margin to this component was 4.0 mm.\n\nA total of three axillary lymph nodes were examined using H&E and keratin staining methods; all were negative for metastasis. No skin involvement or ulceration was observed. Immunohistochemical analysis showed negativity for estrogen and progesterone receptors, and HER2/neu expression was scored as zero or 1+.\n\nPathologic staging was determined as pTic, pN0(i-), and pMX. Ancillary studies, including immunohistochemistry, were performed and supported the basal-like profile of the lesion. Additionally, M\u00f6nckeburg\u2019s calcific medial sclerosis of an artery was noted in the specimen."} +{"pid": "TCGA-E8-A3X7", "report": "The thyroid specimen involved the right lobe and measured 1 x 0.7 x 0.6 cm. The histologic evaluation revealed a neoplastic process with a microfollicular growth pattern. The lesion extended beyond the thyroid capsule into adjacent soft tissue. Multifocality was noted, indicating the presence of multiple distinct tumor foci within the gland."} +{"pid": "TCGA-Y8-A8S1", "report": "The specimen consists of a left-sided partial nephrectomy with a focus on the lower pole of the kidney. A mass measuring 2.3 cm in greatest dimension was identified and found to be unifocal, confined to the kidney without evidence of extension beyond the organ. Histologic evaluation revealed a Fuhrman Nuclear Grade of 3 out of 4, with no sarcomatoid features or tumor necrosis observed. Microscopic examination confirmed negative surgical margins and absence of lymphovascular invasion. No regional lymph nodes were sampled. The nonneoplastic kidney tissue showed scattered sclerotic glomeruli and interstitial nephritis. An additional small cortical lesion was noted. The tumor occupied approximately 60% of the specimen, with 40% of the area showing no viable tumor cells. The processing times and storage conditions for various specimen components were documented, including formalin fixation and cold ischemia duration. Specimen weight and size metrics were within expected ranges."} +{"pid": "TCGA-IN-7806", "report": "HER2 FISH studies were performed, and 97 cells were analyzed, with 28 (28.9%) being hyperdiploid. HER2 immunoperoxidase studies showed an equivocal result with an INC score of 2+. This result should be interpreted in the context of all clinical and pathologic findings.\n\nIn the lymph node specimens from various locations including subcarinal, posterior subcarina, periesophageal, mid paraesophageal, paraesophageal near proximal margin, subcarinal near azygous, subcarinal near left main bronchus, subcarinal on esophagus, gastric, perigastric, fat pad, distal paraesophageal, and near GE junction, no tumor was identified in most. However, metastatic involvement was noted in one of two lymph nodes from the gastroesophageal adipose tissue and in one lymph node from the gastric region.\n\nThe primary lesion measured 2.0 cm and was located at the esophagogastric junction. It was moderately to poorly differentiated with ring cell features and had invaded through the muscularis propria into the perigastric fat. There was suspicion of angiolymphatic invasion, but no perineural invasion was observed. The proximal esophageal and distal gastric margins were free of malignancy. Pathologic staging was determined as pT3 Nx. Dysplasia was identified in the gastric cardia, but there was no evidence of Barrett\u2019s esophagus.\n\nA total of 17 lymph nodes were examined, with 2 showing involvement. No prior treatment had been administered. The invasive component was at least 55 mm from the closest margin, which was the proximal margin. Angiolymphatic invasion could not be definitively confirmed or ruled out. Additional findings included dysplasia within the gastric cardia."} +{"pid": "TCGA-A6-2675", "report": "The specimen consists of a 17 cm long portion of sigmoid colon. The external surface is covered with yellow lobular fat and appears pink-tan, smooth, and glistening. Upon opening, the mucosal surface is also pink-tan and smooth. A lesion measuring 3.2 x 2.5 x 0.5 cm is present, characterized by an ulcerated center and raised borders. Microscopically, the lesion demonstrates invasion through the muscularis propria to the junction of the muscularis propria and serosa. The closest distance from the tumor to the radial margin is 0.7 cm at an umbilicated area where fat and serosa meet. All proximal, distal, and radial margins are free of tumor involvement. No vascular invasion is identified. A total of eleven mesenteric lymph nodes are examined and none show evidence of metastatic disease. Multiple sections, including margins and pericolonic fat, are submitted for evaluation. Distant metastasis cannot be assessed."} +{"pid": "TCGA-BH-A0HQ", "report": "A segmental mastectomy specimen from the left breast, 2 o\u2019clock location, revealed an invasive tumor measuring 2.1 cm in its largest dimension. The histologic assessment showed a Nottingham score of 5 out of 9, with scores of 2 for tubule formation, 2 for nuclear pleomorphism, and 1 for mitotic activity. The tumor was found to be admixed with in situ disease, which accounted for approximately 10% of the total tumor volume. The in situ component exhibited cribriform architecture and nuclear features consistent with a grade 2 lesion. No lymphovascular space invasion was identified.\n\nThe resection margins were free of both invasive and in situ disease, with the invasive component located 0.7 cm from the closest (posterior) margin. Additional findings included lobular intraepithelial neoplasia and atypical lobular hyperplasia. Non-neoplastic changes in the surrounding breast tissue included fibrocystic alterations, ductal epithelial hyperplasia, columnar cell change, apocrine metaplasia, and sclerosing adenosis, some associated with microcalcifications.\n\nImmunohistochemical analysis demonstrated hormone receptor positivity for estrogen and progesterone; HER-2 testing was negative. A total of four lymph nodes were examined from the left axilla, all without evidence of metastatic involvement. The surgical pathology report notes pT2 classification based on tumor size and pN0(i+) staging given the absence of nodal disease. Microscopic evaluation of lymph nodes included hematoxylin and eosin staining as well as keratin immunostaining."} +{"pid": "TCGA-08-0357", "report": "The specimen was received in six parts, all labeled with the patient\u2019s name and medical record number. Part A, marked as \u201ctumor FS,\u201d consisted of two fragments of very soft, red-yellow tissue measuring 0.6 x 0.5 x 0.2 cm in total. This portion was submitted fresh for frozen section analysis and entirely used for intraoperative diagnosis, with the remnant placed in cassette A1. Parts B through E were each composed of multiple small, soft, irregular pieces of red tissue, with aggregate measurements ranging from 0.3 x 0.2 x 0.1 cm to 0.5 x 0.2 x 0.1 cm. All were submitted entirely in individual cassettes (B1, C1, D1, and E1 respectively). Part F was received fresh in a sealed suction cannister labeled \"#2 CUSA contents\" and contained an abundant amount of soft, fragmented, pink-tan tissue measuring 4.5 x 3.0 x 1.0 cm in total. Representative sections from this part were submitted in cassettes F1 through F8.\n\nMicroscopic evaluation revealed cellular features including high cellularity with pleomorphic nuclei, frequent mitotic figures, microvascular proliferation, and areas of necrosis. Immunohistochemical studies showed that the neoplastic cells were negative for EGFR expression. The lesion was located in the left temporoparietal region of the brain and was subjected to both biopsy and resection. Based on histologic and immunohistochemical findings, the pathologic assessment was completed following review of all submitted slides by the attending pathologist."} +{"pid": "TCGA-58-A46K", "report": "The specimen consists of a lung, right lower lobe, measuring 16.0 x 13.0 x 6.5 cm, with a tumor measuring 8.5 x 6.5 x 5.0 cm. Histological evaluation reveals a high-grade cellular proliferation with features including partial basaloid differentiation. Visceral pleural involvement is present. Lymph node analysis shows 5 involved nodes out of 59 examined. Tumor staging indicates pT2 and pN2 classification, with an indeterminate distant metastasis status. The histologic grade is G3."} +{"pid": "TCGA-14-0787", "report": "Document Date: PT: SUMMARY OF PATHOLOGY REPORT. SPECIMEN: 1. Right parietal brain tumor. 2. Right parietal brain lesion. CLINICAL HISTORY/OPERATIVE FINDINGS: NAME OF OPERATION: Right craniotomy for brain tumor. PREOPERATIVE DIAGNOSIS: Brain tumor. GROSS DESCRIPTION: Specimen #1 is received fresh for intraoperative consultation, labeled with the patient's name, hospital number and as \"right parietal brain tumor.\" The specimen consists of several pieces of soft, brown-red tissue measuring approximately 1.0 x 1.0 x 0.5 mm. A portion of the tumor is frozen and submitted in cassette \"FS1A.\" The remainder of the tissue is submitted in its entirety in cassette \"1B.\" Specimen #2 is received in formalin, labeled with the patient's name, hospital number and as \"right parietal brain lesion.\" The specimen consists of multiple fragments of soft, grey, hemorrhagic tissue measuring approximately 1.5 x 1.0 x 0.5 cm in diameter. The specimen is submitted in its entirety in cassette \"2A.\" INTRAOPERATIVE CONSULTATION: FS1A: RIGHT PARIETAL BRAIN TUMOR (FROZEN SECTION). TISSUE COMMITTEE CODE: 1. ICD-9 CODES: 191.9. Page 1 (End of Report)."} +{"pid": "TCGA-E3-A3E5", "report": "The specimen included a total thyroidectomy, right parathyroid gland biopsy, right tracheoesophageal groove and superior mediastinal content, level 1 lymph node, right neck contents from levels 2, 3, 4, and 5, and superficial level 4 tissue. The thyroidectomy specimen showed multiple nodules in both lobes with involvement of perithyroidal adipose tissue. The largest nodule measured 1.0 cm. Two out of two lymph nodes were positive for metastatic disease. In the right tracheoesophageal groove and mediastinal content, 13 out of 15 lymph nodes were positive. In the right neck dissection, level 2 had 6 out of 10 lymph nodes positive, level 3 had 5 out of 7 positive, and level 4 had 2 out of 9 positive. Level 5 showed no involvement. One level 1 lymph node was negative. The superficial level 4 soft tissue and right parathyroid biopsy were negative.\n\nPathological staging was pT4a pN1b. The tumor involved margins on the right anterior side, but there was no vascular invasion or extracapsular extension identified. A total of 13 out of 28 cervical lymph nodes were positive for metastatic involvement. The thyroid gland weighed 20 grams. The right lobe measured 4.4 x 3 x 0.9 cm, and the left lobe measured 4.3 x 3.2 x 1.8 cm. The isthmus measured 1 x 1 x 0.2 cm. Multiple firm tan nodules were found in the right lobe ranging from 0.2 to 0.9 cm. Colloid nodules were also present in both lobes and the isthmus. The capsule was torn and ragged. The right tracheoesophageal groove and superior mediastinal specimen contained sixteen lymph nodes, with the largest measuring 2.5 x 2.4 x 2 cm. The right neck dissection specimen was divided into levels 2 through 5, with the largest lymph node in level II measuring 6.5 x 3.4 x 3 cm. All specimens were processed according to standard protocols."} +{"pid": "TCGA-97-A4M3", "report": "The specimen was analyzed using fluorescence in situ hybridization (FISH) with a dual-color break-apart probe targeting a specific gene locus. A total of 50 nuclei were examined, and separated signals were observed in 0.5% of the nuclei scored, which is within normal limits based on laboratory validation data. Three copies of the gene were observed in 32.0% of cells, indicating an aneuploid population with extra copies of the corresponding chromosomal region. This finding has been documented in prior literature and is not uncommon in certain lung carcinomas, although its clinical significance remains unclear.\n\nThe case involved a resection specimen from the right upper lobe of the lung, obtained via segmentectomy. The tumor measured 2.9 cm in greatest dimension microscopically and demonstrated a mixed histologic pattern, including lepidic (40%), acinar (30%), papillary (20%), and micropapillary (10%) components. Histologic grade was well differentiated. The bronchial and vascular margins were free of tumor involvement, and no lymph-vascular invasion or visceral pleural invasion was identified. The tumor was unifocal and surrounded by lung tissue or visceral pleura.\n\nLymph node evaluation included right level 10, level 4, and level 7 lymph nodes, all of which were benign. No regional lymph node metastasis was identified. Additional specimens included a rib sample showing bone and bone marrow with trilineage hematopoiesis, and biopsy samples from other areas that did not show evidence of tumor involvement.\n\nMolecular testing for mutations in KRAS and EGFR genes was performed. No mutations were detected in either gene. For EGFR, exons 18 through 21 were analyzed, and for KRAS, codons 12 and 13 were evaluated. Both assays used polymerase chain reaction followed by sequencing or primer extension methods, with high tumor cellularity confirmed in the samples. These results suggest that the patient may not benefit from targeted tyrosine kinase inhibitor therapies directed at these mutations.\n\nThe findings from this comprehensive analysis were derived from multiple specimen sources, including a biopsy of the apical region of the lung, a segmentectomy of the right upper lobe, lymph nodes, and rib tissue. Intraoperative consultation confirmed the absence of tumor at the bronchial margin in the segmentectomy specimen. All other accessory findings, including assessment of the pleura and surrounding lung parenchyma, were reported as non-malignant."} +{"pid": "TCGA-AA-A01T", "report": "The specimen shows a poorly differentiated neoplasm of the sigmoid colon. Histopathological evaluation reveals a high-grade morphology with ulceration and erosions on the inner surface. Fine foci of necrosis are present, along with peritumorous chronic recurrent inflammation. The lesion extends through the layers of the sigmoid colon wall into the surrounding fatty connective tissue. Lymphatic invasion is evident. Examination of regional lymph nodes identifies one involved node out of fifteen assessed. No residual tumor is observed at the resection margins. Based on the extent of primary tumor invasion, nodal involvement, and absence of distant spread, the staging corresponds to pT3, pN1 (1/15), MX, L1, R0. More than ten lymph nodes were examined."} +{"pid": "TCGA-60-2720", "report": "The specimen included lymph node samples from multiple locations, including the right and left distal paratracheal areas, subcarinal region, and right proximal paratracheal area. All were small soft tan or pink-tan tissue fragments, with sizes ranging from 0.3 x 0.1 cm to 1.0 x 0.4 cm. Each was submitted for frozen section analysis and found to be free of malignant cells.\n\nA bi-lobectomy specimen of the right middle and lower lobes weighed 391 grams. The middle lobe measured 14 x 9 x 3 cm and the lower lobe measured 15 x 9 x 5.5 cm. A central mass measuring 4.5 x 4.0 x 3.0 cm was identified in the lower lobe, appearing white-tan with necrotic features. It surrounded the central bronchi and extended into the bronchial tree and pleura. Sections of this mass were taken for analysis. The bronchial margin showed no evidence of malignancy on frozen section, although further permanent sections revealed tumor involvement. Other areas of the bronchial margins were negative.\n\nAdditional lymph node packets, including a level 7 group and a 9R lymph node, were all negative for malignancy. The level 7 packet contained five lymph nodes, all without evidence of tumor involvement.\n\nMargins of resection, including medial and lateral aspects, showed no carcinoma. However, in the medial margin, a fragment of dysplastic squamous epithelium was noted, showing at least moderate dysplasia. No lymphovascular invasion was identified based on immunostaining.\n\nHistologic evaluation of the main mass showed moderately differentiated cellular changes with extensive necrosis. The tumor was centrally located in the lower lobe and measured 4.5 cm in its largest dimension. There was no evidence of vascular invasion or satellite lesions. Chronic inflammation and squamous metaplasia were also noted in surrounding tissues.\n\nLymph node assessment included levels 1\u201314; none showed evidence of involvement. Based on these findings, staging was classified as pT2, MX."} +{"pid": "TCGA-CX-7085", "report": "The specimen from the right anterior tongue was obtained via partial glossectomy. The resected tissue measured 4.2 x 2.5 x 1.3 cm and included a central white lesion measuring up to 1.6 cm. The tumor exhibited an endophytic growth pattern and was limited to the resection margins. Histologic evaluation revealed moderately differentiated squamous cell carcinoma with keratinizing features. Perineural invasion was identified. No lymphovascular invasion was observed.\n\nAll surgical margins, including anterior deep, anterior lateral, posterior medial, posterior lateral, posterior deep, posterior margin, and anterior medial, were uninvolved by invasive carcinoma. The closest distance from the tumor to the deep margin was 1 mm. Margins were also free of carcinoma in situ and dysplastic changes, with the closest distance being 12 mm.\n\nLymph node dissection included levels 1 through 4 on the right side. A total of 25 lymph nodes were examined: two from level 1, eight from level 2, six from level 3, and nine from level 4. All lymph nodes were negative for malignancy. No extranodal extension was identified.\n\nAdditional findings included chronic inflammation and moderate keratinizing dysplasia. Intraoperative frozen section analysis of all margins was negative for neoplasia. The submandibular gland and associated fibroadipose tissue showed no evidence of tumor involvement.\n\nStaging criteria indicated a primary tumor size of 1.6 cm (pT1), with no regional lymph node metastasis (pN0). The tumor thickness was 9 mm. No distant metastasis was identified."} +{"pid": "TCGA-IM-A3U2", "report": "The specimen consisted of a total thyroidectomy with bilateral neck dissection. The right lobe measured 4.3 x 3.5 x 2.5 cm and the left lobe measured 3.5 x 2.5 x 1.2 cm. The right lobe was firm to hard with a distorted architecture and showed multifocal and bilateral involvement. Multiple light tan nodules were identified in the left lobe, with the largest measuring 0.9 cm. There was extensive intrathyroidal spread with diffuse sclerosing features and follicular and tall cell variant morphology. The tumor in the right lobe measured 4.3 cm in greatest dimension and demonstrated extrathyroidal extension. Lymphovascular invasion was present and involved multiple vessels bilaterally.\n\nMargins were involved at multiple sites. No parathyroid gland or lymph nodes were identified in the thyroid specimen. A right modified neck dissection (level 1\u20134) included 33 lymph nodes, of which 25 contained malignant cells. The largest focus measured 3.0 cm and was adjacent to the jugular vein; extranodal extension was noted. The left level 6 node dissection included 4 lymph nodes, all of which contained malignant cells, with the largest measuring 1.9 cm. The left neck dissection (levels 2, 3, 4) included 26 lymph nodes, of which 2 were involved, with the largest tumor focus measuring 1.5 cm.\n\nPathologic staging was pT3 based on tumor size greater than 4.0 cm with minimal extrathyroid extension. Regional lymph node involvement was classified as pN1b due to metastases in unilateral, bilateral, and contralateral cervical lymph nodes. A total of 63 lymph nodes were examined, with 31 showing evidence of involvement. Distant metastasis could not be assessed. The surgical margins were involved, and no tumor capsule was identified. Perineural invasion was not observed."} +{"pid": "TCGA-FD-A3NA", "report": "The patient is a male with a history of bladder tumor. Bladder washing showed abnormal cells. The patient underwent radical cystectomy and neobladder.\n\nSpecimens were received and labeled appropriately. The right pelvic lymph node specimen consisted of yellow-brown adipose tissue with multiple lymph nodes ranging from 0.2 to 5.5 cm. A total of twelve lymph nodes were identified, none showing any evidence of abnormal cells. The left pelvic lymph node specimen contained multiple lymph nodes ranging from 0.2 to 4.0 cm. Eight lymph nodes were identified, all without evidence of abnormal cells.\n\nThe prostate and bladder specimen weighed 395 grams. The bladder measured 9.0 x 8.5 x 5.5 cm and the prostate measured 4.0 x 3.3 x 3.0 cm. Upon opening the bladder via a Y-shaped incision, a gray-white, firm, ulcerated mass was found on the posterior wall measuring 6.3 x 5.1 cm and raised approximately 2.8 cm from the mucosa. The mass had a thickness of 5.0 cm, displayed peripheral small papillae, and was centrally necrotic. Both ureteral orifices were involved by the lesion, but no gross invasion was observed in the surrounding adipose tissue or into the prostate and seminal vesicles.\n\nMicroscopic examination revealed a high-grade invasive lesion involving the muscularis propria, outer half. The lesion measured 6.3 x 5.1 x 5.0 cm and was located in the posterior wall. Ureteral and distal urethral margins were free of tumor. A total of 85 regional lymph nodes were examined, none showing involvement. The tumor was staged as pT2b, NO, MX.\n\nIn addition, microscopic evaluation of the prostate showed a Gleason score of 3+4 = 7/10. Tumor was located in the peripheral zone on the right side, with an estimated volume of less than 5%. No perineural invasion was observed. High-grade intraepithelial neoplasia was noted multifocally. The tumor was confined within the prostate, with no extension into the seminal vesicles. The fibromuscular capsule remained intact. Surgical margins were negative at the distal (apical) and proximal (basilar) ends; however, positivity was noted at one peripheral margin. A total of 65 lymph nodes were examined, all negative for tumor. The prostate staging was pT2a, NO, MX.\n\nA total of 65 lymph nodes were assessed across all specimens, with none showing evidence of tumor. The attending pathologist interpreted the findings, which were reviewed with a resident or fellow."} +{"pid": "TCGA-55-1595", "report": "The pathology report includes multiple specimens submitted for analysis. Specimen A is a lymph node measuring 0.9 x 0.6 x 0.4 cm, described as chalky, sessile, and black in appearance. It was bisected and entirely submitted for examination. Specimen B consists of three black rubbery nodules surrounded by adipose tissue, measuring 0.2 x 0.2 x 0.1 cm, 0.6 x 0.5 x 0.3 cm, and 0.3 x 0.2 x 0.1 cm respectively. These were also fully submitted. Specimen C contains three irregular black rubbery fragments measuring 0.3 x 0.2 x 0.2 cm, 0.7 x 0.5 x 0.2 cm, and 1.0 x 0.3 x 0.1 cm. All were submitted for histologic evaluation.\n\nThe main lung specimen (Specimen D) is a left lower lobe measuring 15.0 cm from apex to base, 13.0 cm anterior to posterior, and 3.0 cm transversely. The pleural surface is pink-purple and previously inked black. The hilar region has been inked blue and contains multiple metallic staples. A well-demarcated ovoid tan-gray indurated mass measuring 2.0 x 1.0 x 0.7 cm is identified, located 4.0 cm from the bronchial margin, pulmonary vessel margins, and 1.0 cm from the closest pleural surface. The remainder of the lung shows marked congestion at the apex and pink-tan aerated parenchyma at the base. No additional masses are found. Sections of the mass and surrounding areas are submitted across nine cassettes, including margins and representative sections of the mass.\n\nSpecimen E includes three black irregular rubbery fragments covered with minimal adipose tissue, measuring 0.3 x 0.3 x 0.2 cm, 0.9 x 0.3 x 0.2 cm, and 2.0 x 0.9 x 0.4 cm. These were entirely submitted for microscopic evaluation.\n\nMicroscopic findings show no evidence of metastatic disease in any of the lymph nodes examined across all specimens. Histologic sections of the mass reveal a moderate to poorly differentiated adenocarcinoma with a clear cell component. The tumor does not extend to the overlying pleura. Both bronchial and vascular resection margins are free of tumor involvement. No blood or lymphatic vessel invasion is observed. Immunohistochemical staining demonstrates strong nuclear positivity for TTF-1, consistent with a primary pulmonary origin. Cytokeratin staining performed on relevant blocks confirms absence of metastatic involvement in the lymph nodes evaluated.\n\nStaging assessment indicates a pT1 classification based on the maximum tumor dimension of 2.0 cm without pleural involvement. Regional lymph node status is negative based on all specimens evaluated. Distant metastasis was not assessed."} +{"pid": "TCGA-B4-5832", "report": "The specimen was obtained from the left kidney and consisted of primary tissue collected in a frozen state within a cryomold. The tissue sample weighed 260 mg. A separate blood sample was collected, measuring 4 ml, and placed in a frozen tube. Histological evaluation revealed a solid tumor with a histologic grade of 2. The tumor accounted for approximately 80% of the cellular composition. No lymph node involvement or distant metastasis was identified. The tissue was processed as part of a surgical resection with no prior chemotherapy or radiation therapy reported."} +{"pid": "TCGA-FB-AAQ1", "report": "The surgical specimen includes a segment of duodenum measuring 22 cm in length and 4 cm in outer diameter, with attached pancreatic tissue measuring 12 x 8 x 5 cm. A vascular groove within the pancreatic tissue measures 10 cm in length. The proximal duodenal staple line is 6 cm long, with adjacent pancreatic tissue within 0.5 cm of the staple line. The distal staple line measures 5 cm. A main pancreatic duct measuring 0.5 cm in diameter is noted, with a hemorrhagic appearance. The common bile duct measures 0.7 cm in diameter and contains a metal stent extending through the ampulla into the duodenum. A cystic duct is present and patent to the common bile duct. The distal and proximal duodenal margins are both inked and shaved, revealing a dusky tan-brown mucosal surface with normal folds. A small segment of pylorus, measuring 1 cm, is present at the proximal margin. Two small polyps are identified: one measuring 0.8 x 0.4 x 0.4 cm near the distal margin, and another measuring 0.3 x 0.3 cm approximately 2 cm from the ampulla. Sectioning of the pancreas reveals a lesion measuring 6 x 6 x 3 cm with a tan-white to yellow cut surface and areas suggestive of necrosis. The lesion approaches but does not extend through the vascular groove and deep radial margins, coming as close as 0.3 cm to the pancreatic neck margin. It appears to involve the main pancreatic duct and common bile duct. Residual lobular pancreatic tissue is present near the proximal duodenal margin. No additional lesions or lymph node abnormalities are detected upon palpation of peripancreatic fat.\n\nMicroscopic evaluation shows a tumor involving the ampulla of Vater and extending into the duodenal muscularis. Angiolymphatic and perineural invasion are present. Three of twenty-seven regional lymph nodes contain metastatic tumor, with extra-capsular extension noted. Surgical margins at the pancreatic neck, portal vein, and superior mesenteric artery are free of tumor; however, the deep radial margin is involved. The tumor did not respond to any prior treatment. Additional findings include chronic pancreatitis."} +{"pid": "TCGA-EM-A2P3", "report": "The right hemithyroidectomy specimen measured 4.1 cm in greatest dimension and weighed 6.6 grams. The dominant lesion was a well-circumscribed nodule measuring 1.4 cm, with additional dimensions of 1.0 cm and 0.9 cm. A second, smaller nodule measuring 0.4 cm was also identified. Both lesions were located within the right lobe and were multifocal in distribution. Microscopic evaluation revealed a mixture of classical papillary and follicular variant architecture, with classical cytomorphology present in both. The tumors were partially encapsulated with minimal capsular invasion noted; however, no lymphovascular or perineural invasion was identified, and there was no evidence of extrathyroidal extension. Surgical margins were free of involvement. No lymph nodes were identified or examined. The remaining thyroid tissue showed nonspecific changes including focal thyroiditis and nodular follicular disease. Based on the AJCC/UICC TNM classification system, the primary tumor was classified as pT1b, with no regional lymph node or distant metastasis identified."} +{"pid": "TCGA-VQ-A94T", "report": "The specimen involves the stomach (cardia) and includes a lymph node sample from the celiac trunk, which shows no evidence of tumor involvement (0 out of 1 lymph node negative). Grossly, the lesion measures 5.0 x 4.0 x 0.7 cm and demonstrates an invasive growth pattern with ulceration. Histologic evaluation reveals poorly differentiated cells arranged in a diffuse architectural pattern. The depth of infiltration extends into the adjacent adipose tissue. No vascular invasion is identified; however, lymphatic vascular invasion is present. Perineural invasion is not observed. Adjacent mucosa exhibits inactive chronic gastritis with minimal inflammation. Surgical margins were assessed: the distal margin shows no tumor involvement, while the proximal surgical margin was involved based on frozen section analysis. Additional specimens include an esophageal margin extension that is positive for tumor involvement, whereas a separately submitted esophageal margin does not show tumor presence. Lymph node evaluation identifies metastatic involvement in 9 out of 33 nodes examined, with capsular extension noted in these involved nodes."} +{"pid": "TCGA-L5-A4OR", "report": "A male patient underwent a transhiatal esophagectomy with associated procedures. The surgical specimen included a segment of distal esophagus measuring 10.9 cm in length and a portion of the proximal stomach measuring 4.0 cm. A well-demarcated area of tan, nodular, thickened, and ulcerated mucosa was identified in the distal esophagus, measuring 5.3 x 5.1 cm. This lesion was located 5.5 cm from the proximal margin, 0.1 cm from the gastroesophageal junction, and 3.0 cm from the distal margin. It involved 100% of the circumference and showed a maximum wall thickness of 1.2 cm. The depth of invasion could not be determined grossly. Adjacent mucosa in the distal esophagus appeared patchy, dark brown, and velvety; the remainder of the mucosa in the proximal esophagus and stomach was unremarkable.\n\nLymph nodes were identified in various locations, with sizes up to 0.8 cm. A total of 12 lymph nodes were examined, none of which showed evidence of involvement. Negative margins were noted at the cervical esophagus and other resection sites. Histologic evaluation revealed invasive carcinoma within the distal esophagus and proximal stomach, with extension into the submucosa. Resection margins were free of tumor, and all lymph nodes assessed were negative for metastatic disease. High-grade dysplasia was present in the background Barrett's mucosa."} +{"pid": "TCGA-EL-A3H4", "report": "A female patient underwent surgical evaluation of multiple lymph node regions and thyroid tissue. In the central compartment inferior aspect, two lymph nodes were identified and showed no abnormal findings. In the right neck level 2, one of seventeen lymph nodes showed abnormal cellular features; no extracapsular extension was noted. In right neck level 3, one of fifteen lymph nodes exhibited similar abnormal features. In right neck level 4, two of seventeen lymph nodes also displayed these features. The upper aspect of the central compartment contained three lymph nodes, all without abnormal findings.\n\nThe right thyroidectomy specimen measured 8.0 x 5.0 x 4.0 cm and contained both cystic and solid components. The solid component measured 5.0 cm and appeared to replace the thyroid tissue, with visible involvement of surrounding soft tissues and muscle. No normal thyroid tissue was observed.\n\nIn the retropharyngeal and scalene region, four of six lymph nodes showed similar abnormal findings. The right paratracheal region had one of five lymph nodes affected. In the superior mediastinal region, no abnormal findings were seen in the single lymph node identified. The right anterior tracheal wall showed no abnormal findings. On the left paratracheal side, one of three lymph nodes showed abnormal features, with the largest focus measuring 0.6 cm. No parathyroid tissue was found in the left paratracheal mass sample, and no tumor was identified in the submitted tracheal segment.\n\nLymph nodes examined across multiple regions varied in number and size, ranging from 0.1 cm to 1.5 cm in greatest dimension. All affected lymph nodes lacked evidence of extracapsular extension. Multiple tissue samples were submitted for analysis, including representative sections from each site."} +{"pid": "TCGA-35-4123", "report": "The specimen was obtained from a lung tissue source. A primary tumor was identified and processed into an OCT block. Histological evaluation revealed a moderately differentiated carcinoma with both glandular and squamous features. The tumor measured 2 cm in greatest dimension. No lymph node involvement or distant metastasis was identified. The patient had not received any prior treatment. A blood sample was collected and stored frozen for further analysis. Cellular morphology showed no evidence of treatment effect. Tumor cells were present in sufficient quantity for additional studies."} +{"pid": "TCGA-28-1751", "report": "The Department of Pathology & Laboratory Medicine has analyzed multiple excisional biopsy specimens from the left frontal and left occipital regions of the brain. Tissue samples showed varying degrees of necrosis and high tumor cellularity across all tested sections. Necrosis ranged from as low as 1% to as high as 70% in different specimens, with viable tumor cellularity reaching up to 90% in several areas.\n\nMicroscopic evaluation revealed a high-grade infiltrating astrocytic neoplasm. Cellular features included pleomorphic and hyperchromatic nuclei, numerous mitotic figures, and florid microvascular proliferation. Areas of abscess-like necrosis containing neutrophils and macrophages were also present, with focal palisading noted.\n\nImmunostaining results indicated up to 5% of tumor cells expressed MGMT. PTEN expression was retained (2-3+). pMAPK immunoreactivity was observed in up to 10% of tumor nuclei and up to 60% of tumor cytoplasm. Laminin beta-1 was upregulated (3+ in endothelial cells), while laminin beta-2 showed focal down-regulation (1-2+ in endothelial cells). EGFR by FISH testing remains pending.\n\nGross specimens from the left frontal and left occipital regions ranged in size from 1.5 x 1.1 x 0.3 cm to 6.1 x 3.5 x 1.5 cm. All tissue fragments were described as tan-red and soft to friable in consistency. Each specimen was fully embedded for analysis.\n\nFrozen section analysis was performed intraoperatively on select specimens. A preliminary assessment of high-grade glioma was reported during operative consultation.\n\nImmunohistochemical tests were conducted to assess potential therapeutic response indicators. The presence of low MGMT expression suggests a possible favorable response to certain chemotherapeutic agents. Preserved PTEN expression in combination with other molecular markers may indicate responsiveness to specific kinase inhibitors. Elevated laminin beta-1 expression with reduced beta-2 levels was associated with more aggressive behavior. High pMAPK immunoreactivity predicted relative resistance to radiation therapy. These findings are based on published studies and should be interpreted with clinical correlation and review of current literature.\n\nAll specimens were personally examined and interpreted. The report includes experimental immunohistochemical tests not cleared by the FDA but used under institutional validation protocols."} +{"pid": "TCGA-D7-A6ET", "report": "The specimen consists of a resected stomach measuring 20 x 13.5 cm, along with omentum measuring 26.5 x 15 cm. No macroscopic abnormalities are noted in the omentum. A lesion located in the lesser curvature measures 4 x 3.7 x 1.9 cm and is situated 2 cm from the proximal resection margin and 7 cm from the distal margin. Histologically, the lesion demonstrates a moderately differentiated tubular growth pattern with infiltration through the full thickness of the gastric wall and extension into perigastric fat. Vascular invasion is present. Resection margins are free of tumor involvement. Lymph node assessment reveals metastatic involvement at multiple stations: one positive node at the cardia level, multiple involved nodes along the lesser curvature with capsular and perinodal adipose tissue infiltration, and reactive lymphadenopathy noted at the greater curvature. Grading and staging parameters indicate advanced local progression with extensive nodal involvement. Immunohistochemical analysis for a specific receptor protein shows no expression in the neoplastic cells."} +{"pid": "TCGA-B8-5159", "report": "The right laparoscopic radical nephrectomy specimen weighed 500 grams and measured 22 x 12 x 5 cm. The kidney itself measured 11 x 5.8 x 4.7 cm. The perinephric fat was inked blue for orientation, and the ureter was marked in yellow. The adrenal gland was not present in the specimen.\n\nThree distinct nodules were identified within the kidney. The largest lesion (mass #1) measured 1.5 x 1.4 x 1.9 cm and was located in the medulla of the inferior pole. It was well-circumscribed, firm, and partially cystic with an orange-yellow cut surface. Focal hemorrhage was present. The mass was expanding but not grossly invading the renal pelvis, and no involvement of the hilum was observed. The distance from the renal capsule to the mass was 3.4 cm, and the closest perinephric soft tissue margin (marked with blue ink) was 1.4 cm away. A second similar nodule (mass #2), measuring 0.6 cm in diameter, was found 0.4 cm below the first mass. A third lesion (mass #3), measuring 0.5 cm in diameter, was located in the cortex of the mid-upper pole. It was well-circumscribed, tan-brown, and hemorrhagic, with slight expansion of the renal capsule. It was 0.4 cm from the nearest blue-inked margin.\n\nAll lesions were confined to the kidney. There was no macroscopic involvement of the perirenal adipose tissue, Gerota\u2019s fascia, renal vein, ureter, or any adjacent organs. Microscopically, the surgical margins\u2014including perinephric adipose tissue, renal vein, renal artery, and ureter\u2014were all negative. No lymph nodes were received for evaluation.\n\nMicroscopic analysis showed no invasion into surrounding structures. The histologic grade was Fuhrman grade 3 out of 4. The tumor exhibited clear cell morphology. Additional findings included chronic interstitial nephritis and arteriolonephrosclerosis. The remaining kidney tissue appeared pink-tan and unremarkable, with preserved cortical architecture.\n\nTissue blocks included sections of the ureter and vascular margins, all three masses with adjacent margins, hilar tissue, and normal kidney. No special investigations or digital photographs were taken. Based on available data, the staging was determined as pT1a, pNx, pMx; however, this is subject to clinical review and further information."} +{"pid": "TCGA-A2-A04T", "report": "The specimen consists of three components. The first component, labeled as sentinel lymph node #1, includes two lymph nodes which show no evidence of metastatic carcinoma upon histologic examination using hematoxylin and eosin as well as immunohistochemical staining. The second component, sentinel lymph node #2, contains one lymph node also negative for metastatic involvement based on similar staining methods. \n\nThe third component is a left breast tissue specimen weighing 210 grams and measuring 11.5 x 8.5 x 2.7 cm. It contains a well-circumscribed, tan-colored lesion measuring 2.2 x 1.8 x 1.5 cm located in the lateral portion of the specimen. Histologic evaluation reveals a high-grade cellular proliferation with characteristics assessed using a standardized grading system (mitoses score: 3, tubule formation score: 3, nuclear pleomorphism score: 3; total score: 9/9). No in situ component was identified. The lesion is situated at least 1.0 cm from the nearest resection margins, which include superior posterior and superior anterior aspects. Additional findings include biopsy site changes and fibrocystic alterations within the surrounding tissue.\n\nMultiple sections were submitted for detailed microscopic analysis, including representative samples from the tumor, adjacent areas, and margins. The medial margin is included for evaluation. The tumor exhibits central hemorrhagic changes suggestive of prior biopsy intervention."} +{"pid": "TCGA-E3-A3DZ", "report": "The surgical specimen consisted of a total thyroidectomy. The right lobe measured 6.5 x 5.6 x 3 cm and contained an encapsulated mass measuring 4.5 x 5 x 3 cm located in the upper and middle regions. The left lobe measured 5.2 x 2.3 x 1.4 cm and demonstrated multiple mucinous nodules, with the largest measuring 0.9 cm located in the inferior pole. The isthmus measured 1.3 x 1.2 cm and showed no remarkable findings upon sectioning. The tumor was unifocal with negative surgical margins. Histologic examination revealed cellular features consistent with follicular architecture without vascular invasion. One lymph node was examined and showed no evidence of metastasis (0/1). Additional findings included squamous metaplasia identified in the left lobe. Staging was determined as pT3 N0 Mx according to the AJCC Cancer Staging Manual, 7th Edition. No other significant pathologic findings were identified."} +{"pid": "TCGA-BH-A1FG", "report": "The specimen submitted was from a left breast biopsy/mass/segmental mastectomy performed via surgical procedure. Microscopic evaluation revealed a lesion measuring 1.8 x 1.5 x 1.0 cm, with features including poor histologic differentiation and intermediate nuclear grade. Central hyalinization and calcification were present. Adjacent tissue showed changes consistent with ductal carcinoma in situ, comedo type, representing less than 2% of the total volume evaluated. Fibrocystic changes with focal ductal epithelial hyperplasia were also noted. All surgical margins were free of abnormal cellular proliferation.\n\nImmunohistochemical analysis was conducted on block \"A4.\" Estrogen receptor staining showed distinct intranuclear positivity in approximately 95% of cells. Progesterone receptor staining was also positive, with reactivity in about 90% of cells. No distinct complete membrane staining was observed for c-erbB2 (HER-2/NEU) using DAKO\u2019s polyclonal antibody A485 at a 1:300 dilution without antigen retrieval, thus the result was interpreted as negative. All slides were reviewed and findings confirmed."} +{"pid": "TCGA-DX-A6YU", "report": "The surgical specimen from the right chest wall consists of fibroadipose tissue and skeletal muscle measuring 11 x 7.0 x 6.5 cm. A distinct mass is identified within the tissue, measuring 5.5 x 4.7 x 3.0 cm, with tan-yellow and heterogeneous cut surfaces. The mass is located 0.4 cm from the superior margin, 0.7 cm from the inferior margin, 1.0 cm from the lateral margin, and greater than 1.0 cm from all other margins. Approximately 90% of the mass has a myxoid appearance, with approximately 5% necrosis noted. Histologic sections confirm that all surgical margins are free of involvement. No glandular breast parenchyma is present. A prior biopsy has been reviewed for comparison.\n\nA separate skin specimen from the right chest measuring 1.3 x 0.4 x 0.3 cm contains a small central nodule measuring 0.2 x 0.2 cm, located less than 0.1 cm from the nearest margin. The lesion has been completely excised and entirely submitted for histologic evaluation."} +{"pid": "TCGA-CZ-5456", "report": "The surgical pathology report describes a resected left kidney specimen with associated lymph node dissection. The kidney specimen measured 25.0 x 12.0 x 10.0 cm and weighed 1330 grams. A mass was identified within the lower pole of the kidney, measuring 12.0 cm in greatest dimension. The mass exhibited a mixture of brown and white areas and was surrounded by adipose tissue. The closest surgical margin was 0.5 cm from the tumor. Vascular margins, including renal vein and artery, were free of tumor involvement, as was the ureteral margin. No invasion of the renal pelvis or calyces was observed. The tumor architecture appeared well-defined and golden-yellow in color. Peri-renal fat was inked black, and representative sections of both tumor and uninvolved kidney tissue were submitted for microscopic evaluation.\n\nMicroscopic examination included multiple sections of the tumor and adjacent structures. Margins evaluated included vein (A4), artery (A5), ureter (A6\u2013A7), and tumor interface with surrounding kidney and vessels (A9\u2013A10). Additional sections of tumor tissue were also analyzed. Cytogenetic analysis was performed on three specimens (T1, T2, T3) using GTG banding. Ten metaphases each from T1 and T2 showed normal karyotypes (46,XY). No analyzable metaphases were obtained from T3. It was noted that mosaicism or small chromosomal changes may not be detectable with standard methods. Chromosome analysis was conducted at a resolution of 400 bands or greater.\n\nSeven regional lymph nodes were examined and none contained tumor. Staging classification according to the 6th edition of the AJCC system was pT2 N0 MX. An addendum was anticipated for further evaluation of non-neoplastic kidney components. The specimen was received fresh and properly labeled with patient identifiers. Tissue submitted for analysis included the left kidney and regional lymph nodes. No Hale\u2019s colloidal iron staining was demonstrated in the tumor cells. The tumor was confined to the kidney without vascular invasion. The renal cortex and medulla were poorly defined, and the collecting system was enlarged but without evidence of tumor infiltration."} +{"pid": "TCGA-49-6761", "report": "The specimen includes multiple lymph node fragments from various levels. The first lymph node specimen measured 8 x 2.9 x 0.5 cm in aggregate and showed hyperplastic changes with anthracosis and sinus histiocytosis. No metastatic carcinoma was identified in this specimen. A second lymph node specimen measured 7 x 1.5 x 0.5 cm in aggregate and also showed hyperplastic features without evidence of metastatic involvement.\n\nA third lymph node specimen measured 2.5 x 2 x 1 cm and demonstrated infiltrating cords and nests of poorly differentiated cells with pleomorphic and hyperchromatic nuclei. Mitotic figures were frequent, averaging at least one per high-powered field. There was focal capsular penetration and the lymph node was partially replaced by similar-appearing infiltrative cells. Extension of this infiltrative process extended contiguously over areas measuring up to 2 cm.\n\nThe lung specimen measured 11 x 11 x 5 cm and contained a single pale tan mass measuring approximately 1.7 x 1.5 x 1.5 cm. This mass abutted the pleura but did not show overt infiltration into the pleural surface. The closest margin was 3.4 mm from the bronchial margin, which remained uninvolved. Vascular and lymphatic invasion was present. Surrounding lung tissue did not show obstructive pneumonia. No granulomatous inflammation was identified in the lung parenchyma.\n\nAn anterior mediastinal mass measuring 1.5 x 1 x 0.5 cm was also submitted and showed partial replacement by similar infiltrative cells consistent with other findings. Another lymph node specimen measured 3 x 2.5 x 1.5 cm and was partially replaced by comparable metastatic involvement.\n\nImmunohistochemical staining showed positivity for markers consistent with pulmonary origin and excluded breast primary involvement. Stains for acid-fast bacilli and fungi were negative. Based on pathological findings, staging was determined as pT1N2MX."} +{"pid": "TCGA-AD-6901", "report": "A 27.5 cm portion of partially sectioned large bowel, including the cecum and 9.5 cm of attached terminal ileum, was received for examination. The specimen was covered in moderate pericolic, epiploic, and omental adipose tissue with fibrous adhesions causing kinking near the cecum. The serosa appeared shaggy and gray-tan to pink. The small bowel wall measured up to 0.6 cm in thickness and showed fibrosis. The mucosa was gray-tan with preserved folds and slight granularity, but no gross lesions were identified. The large bowel wall was similarly up to 0.6 cm thick, edematous, and fibrotic, with similar mucosal features.\n\nA previously opened, centrally ulcerated, granular lesion measuring approximately 7.5 x 5.5 cm was noted extending from the ileocecal valve into the cecal pouch. This lesion caused marked luminal stenosis, with one area measuring less than 0.8 cm in diameter. It did not extend to the appendiceal orifice. The appendix, measuring 6.6 x 0.8 x 0.8 cm, was unremarkable. The lesion had a gritty, focally necrotic, tan-gray fibrotic cut surface and reached up to 1.6 cm in thickness. In most areas, it extended to but not through the serosa, primarily within the cecal pouch. However, in one region, it appeared to extend into the surrounding adipose tissue, coming as close as 1.0 cm to the nearest soft tissue margin.\n\nA foreign object, 2.8 x 1.2 x 1.2 cm in size, containing a transparent lens and labeled \"pill cam,\" was also found within the specimen container. Sectioning of the surrounding adipose tissue revealed several poorly defined gray-yellow nodules up to 1.0 cm in size.\n\nMicroscopic evaluation showed no carcinoma in the terminal ileum, appendix, or margins. The lesion demonstrated moderately differentiated features. It extended through the muscularis propria into subserosal adipose tissue, reaching within less than 1 mm of the serosal surface, without clear perforation. No lymphovascular space invasion, visceral peritoneal perforation, or mesenteric deposits were identified. All surgical margins were free of tumor involvement. A total of 19 lymph nodes were examined, none of which contained metastatic disease.\n\nAdditional findings included luminal stenosis associated with the lesion, fibrous serosal adhesions, and the presence of the pill cam device within the terminal ileum. The final staging was determined based on these findings. Clinical correlation and follow-up are recommended. The case was reviewed by an additional pathologist who concurred with the findings."} +{"pid": "TCGA-77-8154", "report": "Histopathology Report. Two specimens were received. The first, labeled 'right lower lobe', consists of a lobectomy measuring 135 x 130 x 65 mm. A line of staples measuring 80 mm is present. A pale firm mass measuring 28 x 25 x 25 mm is identified, located greater than 30 mm from the bronchial resection margin, 30 mm from the hilar resection margin, and 5 mm from the overlying diaphragmatic pleura. The mass appears to involve a bronchus. Distal to the lesion, the lung parenchyma is mottled and yellow. Away from the lesion, the lung parenchyma shows diffuse black deposits. Representative sections include the bronchial resection margin, tumour and pleura, tumour and bronchus, and peribronchial lymph nodes. The second specimen, labeled 'hilar lymph node', consists of three blackened fatty fragments measuring 20 x 15 x 3 mm in total.\n\nMicroscopic examination reveals a moderately differentiated cellular proliferation partially involving a bronchus, with a focal area showing in situ changes. The lesion does not extend to the visceral pleura or involve the bronchial resection margin. No lymphatic invasion, vascular invasion, or perineural involvement is seen. Peribronchial lymph nodes show fibrotic nodules with calcification and birefringent material, but no abnormal cellular infiltration. Adjacent lung tissue shows signs of obstructive pneumonitis, acute bronchopneumonia, and pulmonary oedema. Distant lung tissue shows scattered pigmented deposits and mild interstitial fibrosis. Emphysematous changes are also noted. Lymph nodes submitted separately show similar fibrotic and pigmented changes without evidence of abnormal cellular infiltration.\n\nStaging indicates T1 NO. Additional findings include anthracosilicosis, emphysema, and pneumonia in the surrounding lung tissue."} +{"pid": "TCGA-BH-A0AY", "report": "A left axillary sentinel lymph node excision revealed one lymph node without involvement. A left total mastectomy specimen included two distinct invasive foci. The larger lesion measured 2.2 cm and was located in the lower outer quadrant at the 4 o\u2019clock position. Histologic scoring showed a Nottingham score of 6 out of 9, with tubules score 3, nuclear grade 2, and mitotic activity score 1. Perineural involvement was identified. Angiolymphatic invasion was not observed. A second invasive focus measured 1.3 cm with a Nottingham score of 7 out of 9. This tumor was located 4.0 cm anteriorly and had a proximity of 0.3 cm to the closest posterior margin. In addition, there was an in situ component measuring approximately 0.3 cm, characterized as solid-type with nuclear grading between 2 and 3, accounting for 10% of the tumor volume. All surgical margins were free of invasive and in situ disease. Changes consistent with prior biopsy were noted. Fibrocystic changes coexisted with atypical ductal epithelial hyperplasia. Microcalcifications were present within benign zones. Immunohistochemical staining demonstrated positivity for estrogen and progesterone receptors and positivity or equivocal expression for HER2/neu (zero or 1+). Pathologic staging was determined as pT2 with no lymph node involvement (pN0), based on examination of one lymph node by hematoxylin and eosin staining. Only keratin-positive cells were identified in lymph nodes without evidence of metastasis. Skin and nipple margins were uninvolved."} +{"pid": "TCGA-DU-A7TD", "report": "A 5 x 4.5 x 2.0 cm tissue specimen from a right temporal brain lesion was submitted for analysis, consisting of multiple red to tan-gray fragments weighing 15.55 grams. Histologic examination revealed extensive infiltration and disruption of brain architecture by a highly cellular glial neoplasm. The tumor demonstrated a mixed cellular morphology with features consistent with both oligodendroglial and astrocytic differentiation. Areas of increased cellularity and nuclear atypia were noted, along with focal microvascular proliferation and endothelial hyperplasia. Necrotic regions with associated hemorrhage and pigment deposition were also present, likely related to prior surgical intervention.\n\nImmunohistochemical staining showed weak to sparse expression of GFAP, indicating limited astrocytic differentiation. CD34 highlighted a uniform capillary network with areas of vascular proliferation. The MIB-1 proliferation index was markedly elevated, reaching approximately 75% in the most active regions. P53 immunoreactivity was present in a subset of cells, with only rare cells showing strong overexpression.\n\nMolecular testing for EGFR variant III mutation was negative. Analysis of loss of heterozygosity at chromosome arms 1p and 19q was also negative, using markers including D1S1612, D1S496, D19S219, D19S412, and PLA2G4C. No evidence of MGMT promoter methylation was detected through real-time PCR following bisulfite modification of DNA extracted from the tumor sample.\n\nMicroscopic evaluation identified a high-grade glial neoplasm with significant cellular atypia, brisk mitotic activity, and areas of necrosis. A region of increased cell density and vascular proliferation was observed, raising considerations of transition toward a higher grade neoplasm. These findings were reviewed in consultation with the clinical team for further treatment planning."} +{"pid": "TCGA-E7-A3Y1", "report": "The specimen consisted of an excised tumor from the bladder measuring 3 x 2.5 x 5 cm. The growth pattern was papillary. Microscopic examination revealed moderately differentiated cells. The tumor involved the superficial muscle layer, specifically the inner half. No venous invasion was identified. Surgical margins were uninvolved. No lymph nodes were assessed, and lymphatic invasion could not be determined. There was no evidence of prior neoadjuvant treatment. No additional findings were noted."} +{"pid": "TCGA-ET-A3BO", "report": "The specimen consisted of a total thyroidectomy with involvement of both left and right lobes. The primary lesion measured 2.5 cm and 2.2 cm in the left lobe, and two smaller nodules measuring 0.2 cm each were identified in the right lobe. The disease process was multifocal in distribution. Histologic evaluation revealed cellular features consistent with tall cell morphology. Surgical margins were focally involved by invasive carcinoma at the left inferior pole. Assessment of lymphatic involvement showed metastatic disease in 2 out of 10 lymph nodes, including a separate finding involving two lymph nodes. There was minimal extension beyond the thyroid capsule, classified as pT3. Regional lymph node involvement included level VI (pretracheal, paratracheal, and prelaryngeal/Delphian) metastases, staged as pN1a. No definitive evidence of venous or lymphatic invasion could be determined. Additional findings included Hashimoto thyroiditis. One parathyroid gland was identified on the right side."} +{"pid": "TCGA-FB-A7DR", "report": "The specimen consists of a mass located in the head region, measuring 3 x 2.5 x 2.2 cm. The mass is solid and firm with a white-gray cut surface. Microscopically, the lesion is composed of papillary and variably dilated glands containing mucin. The glands show variation in both size and shape. Tumor cells are observed infiltrating fat tissue, duodenal mucosa, and adjacent pancreatic tissue. Nuclear features include hyperchromasia, marked irregular enlargement, and prominent nucleoli. The cytoplasm is moderate in amount and eosinophilic. A desmoplastic stromal reaction is present along with lymphocytic invasion. Mitotic activity is identified. The tumor extends into the duodenum and is moderately differentiated. Lymphatic invasion is noted. The specimen was obtained via surgical resection. No information is available regarding lymph node involvement, venous invasion, margins, or prior treatment. No additional findings are reported."} +{"pid": "TCGA-EM-A2OV", "report": "The surgical specimen consists of a left hemithyroidectomy measuring 7.6 \u00d7 4.4 \u00d7 3.1 cm and an isthmus measuring 4.1 \u00d7 2.5 \u00d7 1.9 cm, with a total weight of 65.2 grams. The specimen was received intact. Multiple nodules were identified within the left lobe and isthmmus, ranging in size from 0.5 to 2.5 cm. One dominant nodule measured 2.1 cm and exhibited follicular architecture with oncocytic cytomorphology. A second smaller focus measuring 0.1 cm was identified in the isthmus and displayed follicular architecture with classical cytomorphology. Both lesions showed no evidence of tumor capsule invasion, lymph-vascular invasion, perineural invasion, or extrathyroidal extension. Margins were uninvolved. No lymph nodes were identified during gross examination and none were submitted for evaluation. Based on TNM staging criteria, the primary tumor is classified as pT2 (tumor greater than 2 cm but not exceeding 4 cm confined to the thyroid), with pN0 indicating no regional lymph node involvement. Additional findings included adenomatoid nodules, focal nonspecific thyroiditis, and degenerative changes with reactive atypia."} +{"pid": "TCGA-BT-A20O", "report": "The patient is a male who underwent a radical cystoprostatectomy. The specimen included the urinary bladder and prostate, along with bilateral distal ureter biopsies, and lymph node tissue from both left and right pelvic regions. Examination of the left and right distal ureters revealed benign urothelial mucosa without any evidence of neoplasia. Lymph node evaluation showed no signs of neoplastic involvement, with 4 nodes assessed on the right and 9 on the left.\n\nIn the urinary bladder specimen, a high-grade urothelial lesion was identified. The lesion measured 5.5 cm in greatest dimension and extended through the muscularis propria into the surrounding adipose tissue. There were areas showing squamous differentiation. No angiolymphatic or perineural invasion was observed. In addition, there was evidence of in situ involvement. Non-neoplastic changes included cystitis cystica in the bladder mucosa. All surgical margins were free of invasive involvement, although the urethral margin contained prostatic tissue with high-grade intraepithelial changes without evidence of invasion. \n\nThe prostate demonstrated minor foci of high-grade intraepithelial changes as well as focal stromal and glandular hyperplasia; however, no invasive component was detected.\n\nHistologic review noted the presence of both low-grade and high-grade components within the specimen. The high-grade areas exhibited marked nuclear-to-cytoplasmic ratios and prominent nucleoli, with some cells displaying fusiform morphology suggestive of sarcomatoid features. Despite these characteristics, the overall grading was considered consistent with moderate differentiation due to absence of more pronounced nuclear atypia typically associated with the highest grade category. A notable feature was the presence of numerous neutrophils infiltrating the tumor nests, though the clinical relevance of this observation remains uncertain.\n\nPathologic staging was determined to be pT3a NO Mx."} +{"pid": "TCGA-VQ-A8PZ", "report": "The specimen from the stomach (body) following total gastrectomy shows a lesion measuring 13.5 cm in its largest dimension. The surface demonstrates ulceration, and morphologically, it corresponds to a Borrmann IV growth pattern. Histologic evaluation reveals a mucosecretory subtype with mucocellular and signet-ring cell features. The Lauren classification system identifies this as a diffuse-type morphology. The tumor extends through the gastric wall to the serosa. Focal neural invasion is present; no evidence of lymphatic or vascular invasion is identified. All surgical margins are free of neoplastic cells. A total of 14 perivisceral lymph nodes were examined, none showing involvement. Additionally, 54 lymph nodes from the D2 dissection were uninvolved. Other sites including the gastrohepatic ligament, peripancreatic peritoneum, second esophageal margin, pancreatic margin, spleen, and omentum show no presence of neoplastic cells."} +{"pid": "TCGA-CX-7082", "report": "The specimen from the palate and retromolar trigone consists of an irregular soft tissue measuring 4.8 cm in greatest dimension. A central ulcerated area measuring 3.5 x 1 x 0.3 cm is noted on the mucosal surface, with underlying firm and fibrotic tissue approaching the deep inked margin. Histologically, there is a moderately differentiated epithelial lesion involving this region. Margins were assessed from multiple orientations including lateral and deep; while initial evaluation suggested possible involvement at the deep margin, subsequent sampling confirmed absence of invasive disease at all margins.\n\nAdditional biopsies from lateral buccal, deep pterygoid, deep retromolar trigone, inferior buccal, palate, medial pharyngeal, and pharyngeal fat regions showed no evidence of malignant involvement. These tissues consisted primarily of fibroadipose or squamous mucosal tissue with benign features.\n\nLymph node assessment revealed variable findings across levels. Level 2 dissection contained two benign lymph nodes. Level 3 contained one benign lymph node. Medial Level 5 dissection included nine benign lymph nodes. However, in Level 5 dissection, both lymph nodes examined demonstrated involvement by malignant cells with extracapsular extension noted.\n\nOverall, the tumor measured 3.5 cm in its greatest dimension with an additional thickness measurement of 4 mm. Based on these dimensions, staging indicates a primary lesion greater than 2 cm but not exceeding 4 cm. Regarding nodal involvement, metastatic presence was identified in multiple ipsilateral lymph nodes without any exceeding 6 cm in diameter."} +{"pid": "TCGA-CN-4742", "report": "The surgical specimen consisted of a resected tongue tissue measuring 8 \u00d7 7.2 \u00d7 7 cm, with a poorly demarcated soft nodule identified along the right side that extended across the midline. The nodule measured 5.2 cm in the anterior-posterior dimension, 5.5 cm in the ventral-dorsal dimension, and 6.1 cm from left to right. Histological evaluation revealed invasive cellular growth within the tongue tissue, showing moderate to poor differentiation. Perineural invasion was noted, and there was focal involvement of extrinsic muscle. All final margins were free of invasive disease.\n\nLymph node dissection included multiple levels bilaterally. On the left side, levels 1 through 4 were evaluated. In level 1, three lymph nodes were examined and none showed evidence of tumor involvement. In level 2, thirteen lymph nodes were reviewed, all without evidence of tumor. One lymph node contained thyroid tissue with parenchymal extension and nuclear features concerning for possible papillary thyroid origin. Level 3 contained eleven lymph nodes, one of which showed microscopic involvement by tumor (<0.1 cm). In level 4, one lymph node was evaluated and found to be free of tumor.\n\nOn the right side, levels 1 through 4 were also assessed. In level 1, five lymph nodes were examined and none showed tumor involvement; this level also included an unremarkable submandibular gland. In level 2, eight lymph nodes were evaluated, one of which contained a tumor focus measuring 1.5 cm. In level 3, one lymph node was examined and no tumor was identified. In level 4, seven lymph nodes were evaluated, one of which contained a small tumor focus measuring 0.2 cm. None of the involved lymph nodes showed extracapsular spread.\n\nBiopsies from various anatomical sites were submitted for evaluation. A biopsy of the right retromolar trigone showed acute mucositis with focal mild dysplasia and no tumor present. Several other biopsies, including those from the right posterior molar, soft palate pillars, pharyngo-epiglottic fold, vallecular region, buccal gingiva, retromolar trigone deep margin, molar socket, and soft palate anterior margin, showed varying degrees of dysplasia or inflammation but no tumor presence. Two biopsies\u2014one from the new margin at the right retromolar trigone and another from the right superior retromolar trigone\u2014showed findings consistent with in situ changes but no invasive tumor.\n\nIntraoperative consultations on frozen sections were performed for several biopsies. These evaluations noted benign findings in some areas, while others showed at least dysplastic changes, with concern for more significant underlying pathology in select cases due to limitations in sectioning or depth of analysis.\n\nThe pathologic staging assigned was pT4, indicating extensive primary involvement, and pN2b, reflecting regional nodal involvement in multiple levels with more than one site affected. No distant metastases were assessed (pMX). Vascular invasion was identified, and perineural invasion was present. No additional significant pathological findings were reported."} +{"pid": "TCGA-DX-A3U6", "report": "The specimen consists of a radical resection involving the proximal jejunum and left adrenal gland, along with attached mesentery. Three distinct masses were identified within the mesentery. The first mass measures 8.5 x 7.5 x 8.1 cm and arises from the subserosal fat of the small bowel. Histologic evaluation reveals a component of high-grade cellular morphology estimated at 30\u201340% of this mass. The second mass, measuring 8.5 x 7.5 x 4 cm, is predominantly composed of a well-differentiated cellular component. The third mass, measuring 4 x 3.5 x 2 cm, contains approximately equal proportions of both well-differentiated and high-grade components. All three masses exhibit a tan-yellow to white firm cut surface with focal hemorrhage noted in the first mass. Margins of the small bowel resection show no evidence of involvement. A separate segment of the fourth part of the duodenum was submitted and demonstrates acute serositis without any signs of malignancy."} +{"pid": "TCGA-33-AAS8", "report": "A wedge resection of the right upper lobe of the lung was examined. A mass measuring 2.5 cm was identified within the lung parenchyma. The mass is described as white-tan, firm at the periphery, and slightly necrotic and hemorrhagic in the center. It extends subpleurally and is associated with retraction and scarring of the overlying pleura. The tumor is located approximately 1.6 cm from the closest staple margin, which measures 9 cm at its longest dimension, with an additional arm measuring 4.2 cm. The parenchymal margin is negative for involvement. No other mass lesions were identified upon sectioning the remaining lung tissue.\n\nSections of the mass, normal lung, and margins were submitted for analysis. A tied-off vessel was sampled as a possible vascular margin. A small fragment of rib measuring 2.1 x 1.4 x 0.3 cm was also received, showing no significant abnormalities.\n\nLymph nodes from stations R4, R10, Station 7, and R11 were evaluated. Each lymph node specimen consisted of a single soft tissue fragment measuring between 0.9 x 0.9 x 0.1 cm and 1.6 x 0.6 x 0.2 cm. All lymph nodes were negative for any abnormal cellular infiltration upon histologic examination. Portions of each node were submitted for further studies."} +{"pid": "TCGA-14-0871", "report": "The specimen consists of three parts: a left parietal brain lesion, a second portion of the same lesion for permanent sectioning, and a sample of dura. The first brain specimen measured 1.2 x 1.0 x 0.3 cm and was partially used for intraoperative frozen section analysis. It consisted of mucoid, focally hemorrhagic tissue. Cytologic scrape and squash preparations were made, and part of the cryoblock was submitted for further analysis. The second brain specimen, measuring 4.0 x 4.0 x 0.3 cm in aggregate, was entirely submitted for histological evaluation. The dural sample measured 2.5 x 2.5 x 0.1 cm and showed no identifiable mass.\n\nMicroscopic examination revealed an abnormal population of pleomorphic, poorly differentiated cells arranged in sheets and fascicles within the brain parenchyma. These cells exhibited anaplastic nuclei with dense, hyperchromatic chromatin, occasionally visible nucleoli, and variable cytoplasmic features, including eosinophilic and spindled forms. Numerous bizarre cell types and multinucleated giant cells were present. Mitotic figures were frequently observed. Areas of necrosis were noted, although significant vascular changes were not evident. Some tumor cells displayed eosinophilic, proteinaceous cytoplasmic globules and brown pigment deposits, which tested positive for iron on Prussian blue staining.\n\nImmunohistochemical stains showed focal positivity for GFAP, S-100, desmin, and neurofilament, while AE1-AE3 cytokeratin, Melan-A, HMB-45, and synaptophysin were negative. One of three melanoma markers (HMB-45) showed rare positivity, raising the possibility of melanocytic differentiation. No definitive evidence of epithelial, neural, or myogenic differentiation was identified.\n\nThe dural specimen contained similar malignant cells attached to the dural tissue, indicating involvement by the neoplastic process. Based on morphology and immunophenotype, the tumor demonstrated features suggestive of a highly undifferentiated malignancy, with limited evidence of divergent differentiation. The findings are consistent with a high-grade primary or metastatic neoplasm involving the left parietal lobe and dura."} +{"pid": "TCGA-HT-A4DV", "report": "NEUROPATHOLOGY REPORT. SPECIMEN SOURCE: 1. Left frontal tumor, FS. 2. Left frontal tumor, FS. 3. Left frontal tumor, perm.\n\nCLINICAL DIAGNOSIS: Tumor.\n\nGROSS DESCRIPTION: \n1. Received fresh for frozen section labeled with the patient's name are multiple irregular tan-white and hemorrhagic soft tissue fragments measuring 1.2 x 0.7 x 0.4 cm. A smear preparation is prepared and examined. The specimen is submitted in its entirety for frozen section on one chuck with residual permanent submitted in cassette F2A. \n2. Received fresh for frozen section labeled with the patient's name and \"left frontal tumor\" consists of multiple irregular tan-white hemorrhagic soft tissue fragments aggregating to 0.6 x 0.2 x 0.1 cm. A smear preparation is prepared and examined. The specimen is submitted in its entirety for frozen section on one chuck with residual permanent submitted in cassette F2A. \n3. Received in formalin labeled with the patient's name and \"left frontal tumor\" consists of multiple irregular tan-white hemorrhagic soft tissue fragments aggregating to 2.4 x 1.5 x 1.2 cm. The tissues are sectioned and totally submitted in cassettes 3A-c.\n\nMICROSCOPIC DESCRIPTION: \nSections demonstrate a diffusely infiltrative glial neoplasm involving both gray and white matter. The tumor cells demonstrate only mild to moderate cytologic atypia with consistent round nuclei and prominent perinuclear halos. In some areas, mitotic figures are rare, but in other areas up to 12 mitoses are seen per 10 high power fields. Microvascular proliferation is not seen, and there is no necrosis.\n\nNumerous MIB-1 reactive cells are present throughout the tumor. A labeling index of 7.0% is calculated.\n\nPAGE: 1. CONTINUED. PERMANENT CHART COPY. (Chart in Op. NEUROPATHOLOGY REPORT. PAGE: 2. - END"} +{"pid": "TCGA-EL-A3GY", "report": "A total thyroidectomy specimen included the right lobe measuring 4.5 x 2.5 x 1.8 cm, isthmus measuring 1.0 x 1.0 x 0.3 cm, and left lobe measuring 3.0 x 2.0 x 0.8 cm. Sections were taken from the superior to inferior aspects of both lobes. A nodule measuring 1.3 x 1.0 cm was identified at the inferior pole of the right lobe. The nodule appeared encapsulated with brown-tan soft tissue. The isthmus and left lobe showed no remarkable findings. Samples from the lesion and left lobe were obtained for banking purposes. Lymph node assessment revealed involvement in one of two perithyroidal nodes. Histologic evaluation included sections from multiple levels of the right lobe (A1\u2013A6), isthmus (A7), and remnants of the left lobe (A8\u2013A9). Surgical margins were negative. No other significant pathological features were reported."} +{"pid": "TCGA-BP-4345", "report": "The right kidney specimen measured 10.9 x 5.4 x 4.7 cm and weighed 530 grams. A well-defined, lobulated mass was identified in the mid and lower pole of the kidney. The tumor measured 5.5 x 4.7 x 4.3 cm and had an orange/tan appearance with focal hemorrhage. It did not grossly extend to the inked surgical margin, being approximately 0.4 cm away from the nearest surface. The renal sinus fat showed involvement by the tumor. No invasion of the renal vein was observed, although the tumor was noted to involve a large vein within the renal sinus. Surgical margins were free of tumor. The remainder of the kidney showed chronic inflammation and focal fibrosis. The adrenal gland was not identified in the specimen.\n\nOne lymph node was identified in the paracaval region and measured up to 1.5 cm in diameter; no tumor involvement was detected. In the right adrenal and suprahilar specimen, which included an adrenal gland measuring 3.5 x 2.8 x 1.5 cm, no tumor was identified. The adrenal gland exhibited a nodular appearance with tan-orange areas and hemorrhage on sectioning. No lymph nodes were found within the attached fibroadipose tissue.\n\nHistologic evaluation confirmed nuclear features consistent with high-grade morphology. Based on staging criteria, the lesion extended into the renal vein or vena cava below the diaphragm. Multiple tissue blocks were examined from the tumor, adjacent kidney, sinus fat, hilar fat, ureteral and vascular margins, renal pelvis, and possible lymph nodes. All lymph nodes assessed across specimens were negative for tumor involvement."} +{"pid": "TCGA-D8-A142", "report": "Histopathological examination was performed on a left breast specimen measuring 20 x 19 x 7 cm, along with axillary tissues measuring 12 x 14 x 4 cm and a skin flap of 22 x 13 cm. The total weight of the specimen was 1,527 g. A lesion measuring 6 x 4.5 x 2.5 cm was identified in the outer lower quadrant, located 4 cm from the lower edge, 2.5 cm from the base, and 1.3 cm from the skin. Lymph nodes up to 2.3 cm in length were also present.\n\nMicroscopic evaluation revealed a high-grade epithelial malignancy with histological features consistent with ductal differentiation. Nuclear grade was determined as grade 3 based on a scoring system (3 + 2 + 3). Mitotic count showed 28 mitoses per 10 high-power fields, with a visual field diameter of 0.55 mm. No involvement of the nipple was observed. Adjacent glandular tissue exhibited changes associated with fibrocystic disease.\n\nImmunohistochemical analysis showed absence of estrogen and progesterone receptor expression in neoplastic cells. HER2 protein expression was scored as 2+ by HercepTest\u2122 (DAKO), prompting reflex testing with FISH methodology. FISH analysis did not reveal HER2 gene amplification, although polysomy of chromosome 17 was noted.\n\nAxillary lymph node assessment showed chronic lymphadenitis, sinus histiocytosis, and fatty infiltration of lymph nodes. No evidence of metastatic involvement was found in the regional lymph nodes. The tumor was classified as pT3 and pN0 based on pathological staging criteria."} +{"pid": "TCGA-SC-A6LQ", "report": "Surgical pathology evaluation was performed on multiple specimens from a female patient. Specimens included lymph nodes from various levels and locations, right pleura and diaphragm, a portion of the right sixth rib, and a pericardial nodule.\n\nMicroscopic examination of the right level four lymph nodes revealed involvement of one out of eighteen lymph nodes. Level seven lymph nodes showed involvement in four out of ten nodes. In the mediastinal region, level seven lymph nodes #2 demonstrated involvement of one out of four lymph nodes. The right level eight mediastinal lymph node showed involvement of one out of one lymph node examined.\n\nThe right pleura and diaphragm specimen showed a predominantly micropapillary growth pattern with tumor invasion into adipose tissue and skeletal muscle. The tumor margin approached within 1 mm of skeletal muscle. Morphologically, this lesion appeared consistent with previously biopsied lesions involving the pleura. Similar morphologic features were observed in the specimen from the right pleura and in the pericardial nodule.\n\nThe specimen from the portion of the right sixth rib showed benign bone and marrow without evidence of malignancy.\n\nMultiple sections were submitted for histologic evaluation from each specimen site. All lymph nodes were entirely submitted for evaluation. Tissue blocks included representative sections from involved areas as well as control sections.\n\nIntraoperative frozen section analysis correlated with permanent section diagnoses for all assessed specimens."} +{"pid": "TCGA-D1-A16S", "report": "The specimen consists of a uterus with bilateral fallopian tubes and ovaries submitted following hysterectomy and bilateral salpingo-oophorectomy. A friable, exophytic mass measuring 6.4 x 6.2 x 2.8 cm is present within the endometrial cavity, extending from the cervix to the fundus. The mass demonstrates necrotic and friable characteristics and invades through the full thickness of the myometrium (1.7 cm total myometrial thickness). Extension into the cervical/endocervical region is noted. No lymphovascular space invasion is identified. Surgical margins are free of tumor. Two intramural leiomyomata are present, each measuring approximately 1.5 cm.\n\nA single involved left pelvic lymph node is identified among 20 retrieved, containing a microscopic focus of disease. All other lymph nodes evaluated, including 15 right pelvic, 9 right para-aortic, and 11 left para-aortic lymph nodes, are negative for tumor involvement. Omental tissue, appendix, and right diaphragm biopsy specimens also show no evidence of disease.\n\nThe staging classification assigned is pT3aN1 based on AJCC 7th edition criteria. This classification reflects the depth of myometrial invasion, cervical extension, and presence of metastatic involvement in one left pelvic lymph node. The findings were confirmed through both frozen section and permanent H&E histologic evaluation. Any significant changes identified upon final review would be reflected in a revised report. \n\nGross examination of the uterus reveals a smooth serosal surface with a prominent mass filling the endometrial cavity. Both ovaries and fallopian tubes appear unremarkable with no gross abnormalities. Lymph node specimens from various regional sites are submitted as adipose-tissue aggregates with no macroscopic lesions. The appendix and omentum display no gross pathology. All relevant tissue blocks have been submitted for histological evaluation."} +{"pid": "TCGA-AR-A1AX", "report": "The specimen consists of a mass measuring 1.9 x 1.8 x 1.2 cm. Histologic evaluation reveals cells arranged in a pattern consistent with Nottingham grade II features, based on tubule formation (3/3), nuclear pleomorphism (2/3), and mitotic activity (2/3), resulting in a total Nottingham score of 7 out of 9. The tumor includes an area resembling ductal carcinoma in situ, which is present at an intermediate nuclear grade and accounts for approximately 5\u201325% of the overall tumor volume. When including this component, the greatest dimension of the lesion measures 2.1 cm.\n\nThere is no evidence of angiolymphatic invasion. The surrounding non-neoplastic breast tissue demonstrates proliferative fibrocystic changes. All surgical margins, including the re-excised medial margin, are free of tumor involvement, with a minimum distance of 0.5 cm between tumor and deep or inferior margins.\n\nA separate specimen containing eight left axillary sentinel lymph nodes was evaluated and found to be negative for metastatic disease. Immunohistochemical staining using cytokeratin on paraffin-embedded lymph node tissue corroborates the findings observed on routine histologic sections."} +{"pid": "TCGA-BF-A3DL", "report": "Female patient with a primary tumor located in the skin. The tissue specimen was obtained via surgery and stored frozen in a cryomold. The tumor was histologically characterized as a grade 2 lesion. Staging information indicates a T stage of 4, N stage of 2, and M stage of 0, with no prior treatment administered. A normal blood sample was also collected and stored frozen in a tube."} +{"pid": "TCGA-EJ-5501", "report": "The patient has a history of a PSA value of 2.7 and gastroesophageal reflux. A prior biopsy revealed bilateral poorly differentiated prostate malignancy. Pre-operative and post-operative assessments were consistent with the same condition. A radical prostatectomy was performed.\n\nExamination of eight right pelvic lymph nodes and three left pelvic lymph nodes showed no evidence of abnormal cellular growth. The primary lesion involved both lobes of the prostate, with a maximum nodule size of 1.3 cm, involving approximately 30% of the prostate volume. There was clear extension beyond the prostate capsule, identified in multiple regions including the anterior right mid, posterior right mid, and posterior right base areas. Involvement of the right seminal vesicles was noted, while the left seminal vesicles were unaffected. All surgical margins were free of abnormal cells.\n\nMicroscopic evaluation revealed invasive adenocarcinoma with a Gleason score of 4 + 3 = 7, including a tertiary pattern 5 component. Extensive perineural invasion was observed, but no angiolymphatic invasion was identified. High-grade intraepithelial neoplasia was also present. The prostate weighed 48.95 grams. Associated findings included benign prostatic hypertrophy and chronic moderately active prostatitis.\n\nA biopsy of left perirectal soft tissue showed benign fibroadipose tissue without evidence of abnormal cellular infiltration. A total of 11 lymph nodes were examined, none of which showed involvement. Based on pathological staging, the tumor was classified as pT3b with no nodal involvement (pN0) and no distant metastasis (pMX). Histologic grading was consistent with poorly differentiated morphology."} +{"pid": "TCGA-BP-4351", "report": "The clinical history includes the presence of gallstones and a left renal mass. Specimens submitted include a cholecystectomy, radical nephrectomy with distal pancreatectomy and splenectomy, and excisions of multiple lymph node groups and pararenal soft tissue.\n\nThe gallbladder specimen measured 11.5 x 4.9 cm and contained three large gallstones. The mucosal surface showed numerous pinkish-yellow polypoid projections that approached the cystic duct margin to within 0.8 cm. Histologic examination revealed chronic cholecystitis with cholelithiasis and diffuse polypoid adenomyomatous hyperplasia. One lymph node was identified and found to be negative for malignancy.\n\nThe left radical nephrectomy specimen included the kidney, ureter, adrenal gland, distal pancreas, spleen, and associated structures. The kidney was markedly enlarged, measuring 21.0 x 18.0 x 8.5 cm, and largely replaced by a large mass measuring 16.0 x 15.5 x 8.5 cm. The tumor exhibited a variegated cut surface with tan-yellow, tan-white myxoid, and hemorrhagic areas. It extended through the renal capsule but remained confined within Gerota\u2019s fascia. No invasion of the renal vein or small vessels was identified. A thin rim of uninvolved renal parenchyma remained, measuring 1.4 to 2.0 cm in thickness. The adrenal gland was not involved. A separate calcified nodule measuring 1.8 x 1.7 x 1.0 cm was found on the outer surface of the kidney away from the main tumor. Surgical margins were free of tumor involvement. Sections of the pancreas showed mild chronic inflammation and fibrosis, with focal peripancreatic fat necrosis and saponification. The spleen appeared histologically normal.\n\nLymph node dissections were performed at multiple sites. In the aortic region, six nodes were examined and none showed evidence of tumor. In the perihilar region, four nodes were identified and also found to be free of tumor. Five lymph nodes from the inner aortic caval area were similarly uninvolved. The pararenal fat specimen contained no malignant cells.\n\nSections of the remaining non-neoplastic kidney tissue demonstrated mild arteriosclerotic changes and focal interstitial chronic inflammation. No involvement by tumor was seen in the pancreas, spleen, or surrounding fat. All surgical margins were clear. Based on these findings, staging assessment indicated localized extension beyond the renal cortex without involvement of distant structures or lymph nodes."} +{"pid": "TCGA-BS-A0TI", "report": "The specimen consisted of a uterus with cervix, bilateral fallopian tubes and ovaries, along with left and right pelvic and aortic lymph node groups. The surgical procedure performed was a total abdominal hysterectomy with bilateral salpingo-oophorectomy and staging. A tumor was identified in the anterior aspect of the endometrial canal, measuring 3.0 cm in greatest dimension. Histologic evaluation showed a high-grade cellular morphology with nuclear features corresponding to grade 2. The tumor invaded more than 50% of the myometrial thickness, reaching a depth of 23 mm in a myometrium measuring 25 mm in total thickness. No involvement was identified at the serosal surface, parametrial region, or cervix. Both adnexal regions were free of tumor involvement.\n\nLymphovascular space invasion was not identified. Lymph node assessment included eight left pelvic nodes (all negative), one left aortic node (negative), six right pelvic nodes (negative), and three right aortic nodes (negative). Gross examination of the uterus revealed a yellow-tan, exophytic mass with focal necrosis, extending into the myometrium to a depth of 2.0 cm. The outer serosal surface was free by 0.2 cm. The cervix appeared normal upon gross and microscopic evaluation. The fallopian tubes and ovaries showed no pathological findings, although portions of the ovaries had been removed intraoperatively for research purposes. All lymph node specimens were morphologically unremarkable.\n\nStaging was determined as T1c, N0, based on the depth of myometrial invasion and absence of lymph node involvement. Representative tissue sections were submitted for analysis, including cervical, tumor, adnexal, and parametrial regions. Microscopic findings corroborated the described features."} +{"pid": "TCGA-EI-6881", "report": "A histopathological examination was performed on a total resection specimen of the rectum and sigmoid colon. The specimen measured 23.6 cm in length, with mesorectal fat tissue measuring 3 cm in thickness. A cauliflower-shaped lesion was identified in the mucosa, measuring 5.3 x 4.9 x 10.0 cm. The lesion involved approximately 15% of the intestinal circumference and was located 13.9 cm from the proximal resection margin and 3.8 cm from the distal margin. The minimum distance from the tumor to the mesorectal margin was 1.5 cm.\n\nMicroscopic evaluation revealed a moderately differentiated tubulopapillary carcinoma with deep infiltration into the adipose tissue of the mesorectum. Resection margins were free of tumor involvement. Lymph node involvement was present, including metastatic infiltration in regional lymph nodes with evidence of capsular invasion. Multiple lymph nodes showed signs of neoplastic infiltration."} +{"pid": "TCGA-UD-AABZ", "report": "The specimen from the left chest wall consists of a solid grey-white nodule measuring 25 x 20 x 10 mm with a slightly shiny cut surface. A separate wedge-shaped section of lung tissue from the left lingula measures 60 x 20 x 10 mm and contains a staple margin. The pleural surface demonstrates a diffuse area of firm white thickening measuring 60 x 10 mm, and the underlying lung parenchyma is replaced by firm white tissue.\n\nMicroscopic evaluation reveals an infiltrating malignant epithelioid neoplasm with luminal formation. The tumor forms ragged nests and glandular-like structures, with areas of necrosis within a fibroblastic stroma. Some regions display a sheet-like growth pattern and large nested arrangements. The tumor exhibits both infiltrative and surface proliferation patterns, including papillary configurations. The second specimen shows similar histological features and involves the pleural surface, extending into the pulmonary parenchyma with growth along a broad front. Focal fibrin exudate is present on the surface, and there is evidence of tumor extension into small vascular spaces within the septae. Additionally, there is a visceral pleural proliferation of atypical mesothelial cells arranged in a papillary pattern.\n\nImmunohistochemical staining demonstrates positivity for CALRETININ, CAM 5.2, CK 7, and EMA (with cytoplasmic and rim staining), as well as AE 1/3. There is patchy weak to moderate positivity for CK20 and patchy moderate positivity for CK5/6. Stains for mucin are negative, and the tumor is negative for TTF-1, PSA, CD15, and CEA."} +{"pid": "TCGA-DX-A6YT", "report": "The excised specimen from the left posterior thigh consists of an ellipse of skin measuring 25.1 x 9.9 cm, with a 4.3 cm linear scar on its surface. Underlying tissue includes lobulated yellow fat and red-brown skeletal muscle in unremarkable condition, with overall dimensions of 25.3 x 19.2 x 6.4 cm. The specimen was oriented and inked with multiple color codes to identify surgical margins. On serial sectioning, a well-circumscribed tan gelatinous mass measuring 9.2 x 7.1 cm was identified in the subcutaneous tissue. This mass abuts the posterior skin margin and is located 1.9 cm from the nearest deep margin. All other margins (superior, inferior, medial, lateral, and anterior/deep) were found to be free of tumor. Representative sections of the mass and all associated margins were submitted for analysis. The mass demonstrates high-grade cellular features based on histologic evaluation."} +{"pid": "TCGA-CV-7100", "report": "A specimen was received involving a resection from the left mandible and associated lymph node tissue. The lymph node measured 2.3 x 1.5 x 1.3 cm and showed evidence of metastatic involvement within one lymph node. Surrounding soft tissue from the same region consisted of an irregular piece of skeletal muscle and fat measuring 3.5 x 1.9 x 0.8 cm, which did not show any signs of involvement.\n\nAn excision of soft tissue and skeletal muscle from the left side of the mandible measured 5.8 x 4.3 x 2.3 cm. Within this specimen, a well-defined mass measuring 2.8 x 2.5 x 2.2 cm was identified. This mass extended close to several margins: within 1.0 mm of the medial margin, 2.0 mm of the anterior margin, 3.0 mm of the superior margin, and 4.0 mm of the inferior margin. The lateral margin remained more than 1.0 cm away from the lesion.\n\nThe specimen orientation was marked with ink codes for anterior (red), posterior (orange), medial (yellow), lateral (black), inferior (green), and superior (black). Sections were taken from various regions including the medial resection margin, closest anterior, superior, deep, and tumor regions.\n\nA separate wedge resection of the mandible measuring 3.5 x 2.0 x 1.5 cm contained a roughened area on the external surface and was submitted for decalcification. Additionally, a segmental mandibular resection measuring 6.5 x 2.0 x 1.7 cm without visible lesions was also sent for further processing.\n\nThree teeth were submitted for examination, including two molars with porcelain crowns and a premolar with a resin crown. No sections were taken from these specimens."} +{"pid": "TCGA-LL-A73Y", "report": "The specimen was received in two parts. Part A, labeled \"right sentinel node,\" consisted of a 3.5 x 2.5 x 2.0 cm portion of adipose containing a lymph node measuring 2.6 x 2.0 x 0.6 cm. The lymph node was entirely submitted for microscopic evaluation and no abnormality was identified upon histologic examination using routine and immunohistochemical stains.\n\nPart B, labeled \"right breast,\" was a fibrofatty specimen weighing 962 grams and measuring 23.0 x 20.0 x 4.5 cm. It included an overlying 12.5 x 4.5 cm skin ellipse with a central areola and nipple. The deep margin was predominantly intact, except for a small area of disruption medially. The parenchyma was largely fatty with areas of fibrous tissue, more pronounced medially. No additional masses or indurated lesions were found.\n\nA single tumor mass measuring 17 mm in greatest dimension was identified in the upper inner quadrant. It had a whitish appearance and was surrounded by adipose tissue. Microscopic evaluation revealed a high-grade infiltrative lesion characterized by marked nuclear pleomorphism, poor glandular differentiation, and increased mitotic activity. No in situ component was identified.\n\nMargins were evaluated, with the closest distance from the tumor being 7 mm at the deep margin. All other margins were widely clear. Sentinel lymph node sampling was performed; one lymph node was recovered and fully evaluated without evidence of involvement.\n\nAncillary studies demonstrated negative hormone receptor status for both estrogen and progesterone receptors. HER-2 immunostaining was also negative.\n\nStaging was based on histopathologic findings: the primary tumor was classified as pT1c, regional lymph nodes as pN0 (i-), and there was no evidence of distant metastasis."} +{"pid": "TCGA-BA-5556", "report": "Biopsies from multiple sites including the left tongue base, midline deep margin, right posterior tongue mucosal margin, right floor of mouth anterior margin, right mid tongue mucosal margin, left mid lateral tongue mucosa, anterior left floor of mouth mucosa adjacent to tooth #21, left posterior tongue mucosa, and midline anterior floor of mouth mucosa showed no evidence of dysplasia or invasive lesion. The anterior left floor of mouth biopsy demonstrated scant benign squamous epithelium with orthohyperkeratotic debris and no submucosal stroma available for evaluation. The midline anterior floor of mouth mucosa biopsy revealed benign squamous mucosa and submucosa with extensive cautery artifact.\n\nLymph node dissections from bilateral neck levels 1A, 1B, 2, 3, and 4 showed no evidence of metastatic involvement. Specifically, left neck lymph nodes (level 2: 14 total, level 3: 8 total, level 4: 11 total), bilateral neck level 1A (2 total), left neck level 1B (6 total), and right neck lymph nodes (level 1B: 3 total, level 2: 15 total, level 3: 9 total, level 4: 12 total) were all negative for malignancy. Additionally, submandibular gland tissue submitted with left neck level 1B dissection showed no carcinoma.\n\nThe floor of mouth resection specimen measured 4.0 \u00d7 3.3 \u00d7 1.9 cm. Gross examination identified a white/tan, firm, rubbery lesion located on the mucosal surface measuring 2.4 cm in greatest dimension and invading to a depth of 0.7 cm. Histologically, this lesion was composed of poorly differentiated squamous cells. Vascular invasion was not identified. Surgical margins were negative but approached closely at 0.1 cm in one focus (block S3). There was associated high-grade intraepithelial neoplasia consistent with in situ changes. One lymph node examined with this specimen was negative for malignancy. All surgical specimens were fixed in formalin and processed for histologic evaluation. Microscopic examination confirmed absence of tumor in all biopsied margins and confirmed lymph node negativity across all blocks evaluated."} +{"pid": "TCGA-KL-8339", "report": "A 13.0 cm mass was identified in the left kidney, which had been surgically removed along with a portion of the left adrenal gland. The mass completely replaced most of the kidney, leaving only a small rim of normal renal parenchyma near the hilum. Tumor thrombus was present in the renal vein; however, surgical margins were free of tumor. The tumor extended through the renal capsule but remained within Gerota's fascia and involved the hilar fat. Multiple lymph node groups were examined: para-aortic (15 nodes), pre-aortic (12 nodes), and interaortocaval (2 nodes), none of which showed evidence of involvement. In the suprahilar region, four lymph nodes were evaluated, one of which contained metastatic disease measuring 1.3 cm; no extracapsular extension was observed. A biopsy of the left lobe of the liver revealed involvement by tumor. The adrenal gland was not involved in any of the specimens."} +{"pid": "TCGA-2Z-A9JI", "report": "The left partial nephrectomy specimen consists of a 6.5 x 6.5 x 5.5 cm resection largely replaced by a well-circumscribed yellow, tan, and congested mass with areas of necrosis. The mass measures 6.5 cm in greatest dimension and is located adjacent to the surgical margin, distending the capsule. A friable tan mass measuring 2.5 x 1.8 x 1.5 cm extends to the surgical margin. Minimal normal renal parenchyma remains. Microscopic evaluation reveals cells arranged in solid and papillary patterns. Nuclear grading is Fuhrman grade 3 out of 4. Necrosis is present.\n\nImmunohistochemical stains demonstrate that the cells are positive for AMACR (diffuse weak to strong), RCC (focal strong), and CK7 (focal weak) and negative for Ker903 and CK20. These findings are consistent with previously described immunoprofiling results.\n\nA separate fragment labeled \"deep margin #1\" contains a friable, tan, congested mass near the inked margin, and histology confirms the presence of similar tissue at this location. In contrast, the second deep margin specimen shows only renal parenchyma without any evidence of similar tissue. The renal vein thrombus specimen contains fragments of morphologically comparable material. The final deep margin from the renal parenchyma also shows no evidence of such tissue.\n\nMargins of the renal parenchyma away from the main mass are free of involvement. The renal vein thrombus was completely resected. Non-neoplastic kidney tissue shows moderate chronic inflammation. No involvement of Gerota's fascia is identified. Lymph nodes were not submitted for evaluation.\n\nStaging is based on tumor size greater than 7 cm, extension into the renal vein, and involvement of surgical margins. The pathologic stage assigned is pT3aNXMX."} +{"pid": "TCGA-B2-5639", "report": "The specimen consists of a left kidney weighing 361 grams and measuring 12.5 x 6.0 x 6.0 cm, with attached mesonephric adipose tissue and a 5.5 cm ureter averaging 0.4 cm in diameter. A red-brown mass is identified within a vascular structure at the hilum. An irregular fragment of yellow-orange adrenal parenchyma measuring 1.6 cm in greatest dimension is noted along the surface. The renal capsule is thin, tan-pink, and easily stripped from the cortical surface. The renal pelvis is smooth and tan-white. A poorly circumscribed tumor mass measuring 6.5 x 6.0 x 5.0 cm is present in the superior pole and extends into the mid portion of the kidney. This mass approaches within 0.1 cm of the inked surgical margin. The remaining renal parenchyma is uniformly red-brown with a distinct cortical-medullary junction and a maximum cortical thickness of 1.1 cm. No other abnormalities are observed. Representative sections include vascular and ureteral margins, tumor proximity to the inked surface, tumor involvement of the renal pelvis and perirenal fat, quadrisection of the adrenal tissue, and random samples of non-neoplastic kidney. Histologic evaluation reveals a high nuclear grade (Fuhrman grade 3) neoplasm with clear cytoplasm. The primary lesion extends into the renal vein and involves the peripelvic fat. Positive margins are noted with tumor involvement in the renal vein lumen at the resection edge. Vascular invasion is present. The adrenal gland shows no evidence of tumor involvement. No regional lymph nodes or distant metastases are identifiable in the specimen. Non-neoplastic renal tissue appears histologically unremarkable."} +{"pid": "TCGA-BR-8363", "report": "Case ID. Gross Description. Microscopic Description. Diagnosis Details. Comments. STOMACH TISSUE CHECKLIST. Specimen type: Excision of tissue. Site: Antrum. Size: 7.5 X 6 X 1 cm. Features: Ulcerated. Histologic analysis shows glandular structures with poor cellular differentiation. Invasion extends to the muscularis propria. Lymph node examination reveals no metastasis, with all 11 regional lymph nodes negative. Lymphatic, venous, and perineural invasion statuses are not specified. Margins, response to neo-adjuvant treatment, and additional findings are not specified. No comments provided. Laterality not indicated."} +{"pid": "TCGA-FU-A40J", "report": "The patient is female. Surgical specimens were submitted for analysis, including right and left ovaries and fallopian tubes, left ovarian vessels, and multiple lymph node groups from the left and right external iliac, obturator, common iliac, presacral, and aortic regions. Additional specimens included uterine fundus, cervix, vaginal tissue, and omentum.\n\nExamination of the right ovary showed an involuting corpus luteum and cystic follicles. The right fallopian tube had no significant abnormalities. The left ovary contained cystic follicles, and the left fallopian tube was unremarkable. Biopsy of the left ovarian vessels was negative for malignancy. In the left external iliac lymph node group, metastatic involvement was identified in one lymph node. Frozen section confirmation was obtained. Two lymph nodes from the left obturator region and one from the left external iliac group were negative for tumor spread.\n\nThe uterine fundus and cervix showed histologic features of a glandular neoplasm. The tumor was moderately to poorly differentiated and located in the cervix and lower uterine segment. Microscopically, the tumor measured approximately 2.0 cm in greatest dimension. It extended about 1.5 cm into a cervical wall that was 2.0 cm thick. Focal lymphovascular space invasion was present. Tumor cells were found within 1 mm of the serosal margin in the cervical specimen. Vaginal subcutaneous tissue also showed evidence of tumor infiltration.\n\nLymph node assessment revealed seven negative nodes from the right common iliac and inferior group. Of four presacral lymph nodes, two were involved. Four nodes from the right external iliac group were free of disease. Among nine nodes from the right obturator group, one was positive. Thirteen nodes from the left common and aortic regions were all negative. Omental tissue did not show any malignant involvement.\n\nStaging was based on these findings, with tumor extension into the cervix and lower uterine segment, along with regional lymph node involvement. The depth of stromal invasion and presence of lymphovascular space invasion were considered. The surgical margin status showed tumor proximity to the serosal surface in the cervical specimen. Immunohistochemical staining for p53 was negative, which may have implications for certain tumor types, though this was not diagnostic in isolation.\n\nAll other tissues examined were without evidence of malignancy or atypical changes. No endometrial hyperplasia or cancer was identified. The specimens were extensively sampled and processed, with appropriate blocks submitted for microscopic evaluation. Intraoperative frozen section confirmed the presence of metastatic carcinoma in the left external iliac lymph node."} +{"pid": "TCGA-22-5471", "report": "A resection specimen from the left lower lobe of the lung and bronchial margins demonstrates a poorly differentiated malignant neoplasm. The lesion measures 3.5 x 2.4 x 2.0 cm and is located within the proximal bronchus, causing significant distortion of the normal architecture. There is no involvement of the pleura identified. All submitted bronchial margins are free of tumor.\n\nEvaluation of lymph nodes from multiple stations shows no evidence of metastatic disease. A total of 14 left lower paratracheal (station 4L), 3 subaortic (station 5), 5 subcarinal (station 7), and 1 pulmonary ligament (station 9) lymph nodes were examined, along with 3 pulmonary artery and 7 intrapulmonary peribronchial lymph nodes. None contained tumor cells.\n\nThe histologic grade is high, indicating a more aggressive cytologic profile with marked cellular atypia and limited differentiation."} +{"pid": "TCGA-BS-A0U7", "report": "The specimen consisted of bilateral fallopian tubes and ovaries, uterus with cervix, and multiple lymph node groups from the left and right pelvic and aortic regions. All lymph nodes examined were negative for metastasis, including six from the left pelvic region, seven from the left aortic, seven from the right pelvic, and seven from the right aortic areas.\n\nThe uterus measured 7.3 x 3.5 x 4.2 cm and weighed 83 grams. The endometrial cavity was lined by shaggy, friable mucosa involving the mid and upper portions, with a raised area measuring 3.4 x 3.0 x 0.7 cm. Histologic evaluation showed a lesion with myometrial invasion greater than 50%, with an invasion depth of 1.4 cm in a myometrium measuring 2.7 cm thick. There was probable lymphovascular invasion. The serosa and parametrial tissues were free of involvement, as were the cervical tissue and bilateral adnexa. Additionally, several benign intramural nodules were identified within the myometrium, with the largest measuring 0.8 cm. No tumor was identified in either ovary or fallopian tube specimen."} +{"pid": "TCGA-D8-A1JP", "report": "Histopathological examination of a left breast resection specimen was performed. The breast measured 20.3 x 14.4 x 4.6 cm and weighed 300 g. A resection site measuring 8 x 8 x 3 cm was identified at the boundary of the inner quadrants, located 4.0 cm from the upper edge, 0.1 cm from the base, and 0.2 cm from the skin. No axillary tissue was present. Microscopic evaluation revealed post-resection changes, with no involvement of the nipple and evidence of parenchymal atrophy. Tumor grade was determined as NHG2, with pT1c classification. No lymph node involvement was identified in the examined sample."} +{"pid": "TCGA-3B-A9HX", "report": "The specimen consists of a right hemicolectomy measuring 4.0 cm in length and 3.5 cm in circumference, connected to a segment of large bowel measuring 14.0 cm in length and 7.5 cm in circumference, along with an attached appendix measuring 5.0 cm in length and 0.4 cm in diameter. Within the ascending colon, there is a pedunculated polypoid mass measuring 4.0 x 3.6 x 2.2 cm, located 3.7 cm from the ileocecal valve and 8.5 cm from the distal margin. The mass extends approximately 0.2 cm into the submucosa but does not penetrate through the bowel wall. It is situated 6.5 cm from the radial soft tissue margin and does not involve the surrounding serosa. Two additional broad-based, sessile polypoid lesions are present, measuring 0.3 cm and 0.9 cm in greatest dimension. The remainder of the mucosa appears normal with tan folds, and the wall averages 0.3 cm in thickness.\n\nHistological evaluation reveals involvement of the mucosa, submucosa, and muscularis propria. Tumor necrosis is present in less than 50% of the specimen. Thirty-six regional lymph nodes were identified with reactive changes; no malignant involvement was observed. Surgical margins, including proximal, distal, and radial, are free of tumor. Additional findings include a tubular adenoma, fibrous obliteration of the appendiceal tip, and lipohyperplasia of the ileocecal valve. Multiple sections of the tumor were submitted for analysis, as well as representative sections of normal bowel, additional polyps, and lymph node groups. Frozen section analysis of the proximal and distal margins showed no evidence of malignancy, which was confirmed during intraoperative consultation."} +{"pid": "TCGA-53-7626", "report": "A nodule measuring 1.2 cm is present in the right upper lobe, with features showing moderate differentiation. The overlying pleura is not involved by tumor, and vascular invasion is noted. The surgical margin is free of tumor involvement. A total of seven lymph nodes were examined; one lymph node at the right tracheobronchial angle shows evidence of metastatic involvement. Other lymph nodes, including subcarinal, right distal peritracheal, and inferior pulmonary, do not show any malignant changes. The subcarinal lymph node demonstrates fibrotic granulomas with central necrosis and calcification. The bronchial margin is free of tumor, and no residual tumor is identified in the surrounding lung tissue, which shows scarring and bronchiectasis. The tumor measures 1.0 to 1.1 cm in greatest dimension and is well-circumscribed within a 4 cm wedge resection. Histologic evaluation reveals no tumor involvement in the visceral pleura or bronchial margins. The closest margin is 1 mm from the tumor, located at the visceral pleura. No direct extension or large vessel invasion is observed. Staging indicates pT1 for a tumor 3 cm or less surrounded by lung or visceral pleura, with regional lymph node involvement classified as pN1 (1 of 7 lymph nodes involved). Distant metastasis could not be assessed."} +{"pid": "TCGA-86-8074", "report": "Gross and microscopic descriptions are provided. The specimen was obtained from the left lower lobe of the lung and measured 2.7 x 2.5 x 2.5 cm. Histologic evaluation revealed a papillary growth pattern with moderate differentiation. Lymph node assessment showed 5 out of 5 positive nodes involved by tumor within the intrathoracic region. No definitive assessment was made regarding tumor extent, presence of additional nodules, lymphatic or venous invasion, surgical margins, evidence of neoadjuvant treatment, or other significant pathologic findings."} +{"pid": "TCGA-OY-A56P", "report": "The right ovary and fallopian tube specimen measured 17 cm in greatest dimension and showed a complex mass with cystic and solid components, predominantly solid. The tumor had tan mucoid and polypoid areas, with suspicious involvement of the ovarian surface. A hemorrhagic corpus luteum measuring 1.0 x 0.4 x 0.2 cm was identified. Gross evaluation noted tumor involvement of the right myometrium, with extension to the left adnexa and involvement of the left ovary. The tumor measured 1.8 cm out of a 2.0 cm myometrial wall and was adjacent to the surgical margin. The right ovary measured 5.6 x 3.0 x 2.0 cm with an irregular external surface and a white/tan firm to papilliferous mass involving the parenchyma. The left ovary measured 4.0 x 3.1 x 1.8 cm with similar features. The left fallopian tube was involved by tumor. \n\nA pelvic peritoneal biopsy showed involvement by tumor, with the largest implant measuring 1.5 cm. The omentum contained multiple tumor implants, the largest measuring 10.5 x 7.5 x 3.5 cm, with a smaller satellite mass measuring 6.0 x 3.2 x 2.4 cm. Histologic evaluation revealed high-grade features with involvement of the ovarian surface and fallopian tube in the right-sided specimen. No lymph nodes were identified for assessment. \n\nImmunostains for CD31 and CD34 on blocks A1 and A8 did not show intravascular tumor, ruling out lymphovascular space invasion. Frozen section of the right ovary confirmed adenocarcinoma with surface involvement. The tumor appeared to originate from the ovary based on histologic and immunohistochemical findings. Pathologic staging was determined as pT3b pNx."} +{"pid": "TCGA-BP-5184", "report": "The submitted specimen from a left partial nephrectomy includes a wedge-shaped portion of kidney measuring 3.7 x 2.8 x 2.4 cm, with a suture marking the deep margin. Serial sectioning reveals a yellow hemorrhagic mass measuring 3.3 x 2.6 x 2.3 cm. The tumor is located adjacent to the inked margin; however, the surgical margin is free of tumor upon evaluation. The tumor exhibits nuclear features classified as grade III/IV. Histologic evaluation confirms no evidence of local invasion, renal vein involvement, or lymph node involvement. Non-neoplastic kidney tissue appears unremarkable. The tumor is confined within the kidney and measures less than 7.0 cm in greatest dimension. Representative sections of the tumor and margins were examined microscopically and submitted for further analysis. Intraoperative frozen section assessment of the closest margin was negative for tumor."} +{"pid": "TCGA-CV-7407", "report": "The specimen consists of a partial resection of the floor of mouth and anterior arch of the mandible, with glossectomy. A moderately differentiated cellular proliferation is present, showing perineural involvement and infiltration into skeletal muscle. The tumor measures 2.6 x 2.2 x 2.1 cm. There is extension to the right lingual surgical resection margin. Specimen B, which represents the new right lingual margin, shows squamous mucosa and submucosa without evidence of neoplastic cells. The resection margins are otherwise free of involvement. Decalcification of the mandibular component is in progress, and a supplemental report will follow."} +{"pid": "TCGA-49-4512", "report": "The specimen consists of a right middle lobe lobectomy. The tumor is located in the right middle lobe. Histologically, the lesion demonstrates features consistent with adenocarcinoma, not otherwise specified. The tumor measures 2.0 cm in its greatest dimension."} +{"pid": "TCGA-78-7220", "report": "The left upper lobe specimen consists of a lung segment measuring 180 x 100 x 40 mm. A subpleural lesion measuring 30 mm in diameter is identified at the apex, with a fibrofatty adhesion measuring 25 x 8 x 5 mm located at its surface. The lesion appears moderately well circumscribed, solid, and cream-colored, with multiple small areas of necrosis. Peribronchial lymph nodes near the resection margin are enlarged. Histologically, the lesion demonstrates poorly differentiated cellular features with solid architecture and focal cystic changes containing papillary structures. Invasion into the pleura is present, along with vascular invasion. Extensive involvement of peribronchial lymph nodes is observed, with transcapsular extension and lymphatic tumor emboli identified in adjacent fibrofatty tissue. The bronchial resection margin is free of malignant cells. Adjacent lung parenchyma shows findings consistent with respiratory bronchiolitis.\n\nA separate lymph node specimen from station 5 measures 20 mm in diameter and contains a 4 mm white nodule at one pole. Histological evaluation reveals multiple metastatic deposits of poorly differentiated cells within the lymph node.\n\nPathological staging is determined as T2N2."} +{"pid": "TCGA-08-0351", "report": "The biopsy specimen from the brain (\"MRS1\") demonstrates a lesion with features of moderate-to-high cellularity, including marked nuclear and cytoplasmic pleomorphism. Foci of microvascular proliferation are present. Multiple mitotic figures are observed; however, no necrotic areas are identified. Immunohistochemical staining for GFAP is positive in the neoplastic astrocytes. An additional MIB-1 stain is performed on the same section, yielding a labelling index of 7.90%.\n\nGross examination reveals two distinct tissue samples. Part A consists of a single fragment of soft, white tissue measuring 0.3 x 0.2 x less than 0.1 cm, entirely submitted in cassette A1. Part B, labeled as \"tumor,\" comprises multiple fragments of tan-white and red soft tissue with aggregate dimensions of 2.5 x 1.5 x 0.7 cm. This portion is fully submitted across cassettes B1 through B3.\n\nClinical history indicates a prior diagnosis of a brain lesion. Final pathological evaluation is based on comprehensive review of all histologic sections by the attending pathologist."} +{"pid": "TCGA-B0-5696", "report": "A right nephrectomy specimen demonstrates a neoplasm measuring 10.6 cm in greatest dimension, with additional dimensions of 7.5 x 6.7 cm. The lesion exhibits focal invasion into the renal sinus fat but does not involve the renal vein or demonstrate angiolymphatic invasion. All surgical margins are free of tumor involvement. Histologic evaluation reveals high nuclear grade morphology. The non-neoplastic kidney shows changes related to proximity to the lesion and mild chronic vascular alterations appropriate for age. No specific pathologic changes are identified in the associated adrenal gland. Pathologic staging is pT3a with no regional lymph nodes examined and no evidence of distant metastasis. No additional significant findings are present."} +{"pid": "TCGA-DD-A4NI", "report": "The gallbladder specimen shows features of acute and chronic inflammation with the presence of cholelithiasis. A single lymph node in the cystic duct region displays reactive changes. In the liver, a biopsy from segment IVa reveals hepatocytes with atypical features and architectural disarray, including cribriforming. A separate biopsy from segment II identifies a subcapsular lipoma measuring 0.5 cm; the surrounding liver tissue demonstrates significant steatohepatitis.\n\nA left hepatectomy specimen contains a dominant mass measuring 4.8 x 4.2 x 3.7 cm, which is well-defined, lobulated, and hemorrhagic. This lesion is located in the vicinity of segment IVb and shows features of grade 1\u20132 differentiation. A second, less distinct nodule estimated to be approximately 1.5 cm in greatest dimension is identified in segment IVa, also showing grade 1\u20132 differentiation. Both lesions exhibit changes related to prior biopsy tracts. The background liver tissue shows evidence of steatohepatitis without cirrhosis. Microscopic evaluation of random sections reveals clusters of hepatocytes with some variation in architecture and cytology, interpreted as non-neoplastic. Multiple bile duct hamartomas are present, ranging in size from 0.2 to 0.5 cm. Resection margins are free of malignant cells, with the closest tumor-free margin approximately 0.5 cm from the smaller lesion in segment IVa."} +{"pid": "TCGA-E9-A1RC", "report": "The specimen consists of breast tissue with a lesion measuring 3.5 x 3.3 cm, with visible extension beneath the skin. A total of ten lymph nodes were examined, and all showed evidence of metastatic involvement. Microscopic evaluation reveals a combination of infiltrating ductal and lobular growth patterns, with moderate differentiation. The skin is involved by the tumor. No venous invasion is identified. Surgical margins are not clearly defined in the report. Staging following surgery is classified as T4c N3a MO. The tumor is located in the right upper outer quadrant. A full Nottingham score could not be determined due to missing components including tubule formation, nuclear pleomorphism, and mitotic counts. No information is provided regarding neoadjuvant treatment or additional pathologic findings."} +{"pid": "TCGA-BR-8486", "report": "Specimen consists of stomach tissue from the fundus, submitted as an excision. The tumor measured 5 x 4 x 3 cm and exhibited an exophytic, polypoid growth pattern. Microscopic evaluation showed moderately differentiated histology. The tumor was confined to the submucosa. No lymph nodes showed evidence of involvement. Lymphatic, venous, and perineural invasion status were not specified. Surgical margins and response to any potential neo-adjuvant therapy were also not specified. No additional findings or comments were provided."} +{"pid": "TCGA-GV-A3QK", "report": "A right colectomy specimen includes a 14.5 cm segment of colon with attached terminal ileum and appendix. A submucosal nodule measuring 1.3 x 1.3 cm was identified within the colon wall, and no invasion into the underlying wall was observed. Multiple small polyps were present, ranging from 0.1 to 0.4 cm in size. An area resembling a prior biopsy site was noted but showed no residual dysplasia or invasive changes. The serosal surface of the colon was smooth, and the wall thickness averaged 0.3 cm. The terminal ileum and appendix showed no significant findings. Thirty-three pericolonic lymph nodes were examined and found negative.\n\nA mass was identified in the bladder measuring 5.0 cm in greatest dimension. Microscopic evaluation revealed high-grade papillary features with extension into adjacent structures including perivesical fat, myometrium, endocervical stroma, and vaginal submucosa. Lymphovascular and perineural invasion were present. The tumor reached the inked posterior serosal surface of the bladder, but all surgical margins, including urethral, ureteral, and vaginal, were free of invasive carcinoma. In addition, in situ changes were present in the bladder mucosa.\n\nLymph node evaluation included 37 total nodes. Of these, five out of twenty-three nodes from the left pelvic region showed involvement, with extranodal extension identified. Fourteen lymph nodes from the right pelvic region were negative. The primary tumor extended to the serosal surface of the bladder but did not involve any of the resected margins.\n\nHistologic assessment of the ureters, urethral margins, uterus, cervix, and vagina showed no evidence of dysplastic or malignant changes. The endometrium was inactive, and cervical mucosa was unremarkable. No significant findings were noted in the submitted small bowel or appendix specimens. A submucosal lipoma and hyperplastic polyp were identified in the colonic specimen."} +{"pid": "TCGA-CZ-5462", "report": "The specimen consists of a right radical nephrectomy measuring 21.5 x 10.0 x 4.5 cm, weighing 109.5 grams, and includes the kidney, Gerota\u2019s fascia, renal vein, three renal arteries, and ureter. Within the upper pole of the kidney, there is a golden yellow/red hemorrhagic, encapsulated lobulated mass measuring 4.5 x 4.3 x 3.6 cm. The mass abuts the renal capsule but does not extend through it into the perinephric fat. It is located 5.8 cm from the renal vein, 3.8 cm from the nearest renal artery, and 9.0 cm from the ureteral margin. Extensive necrosis is present within the lesion. Histologically, nuclear features consistent with high-grade morphology are identified in focal areas. No lymphovascular invasion is observed. Surgical margins at the ureter, renal artery, and renal vein are free of involvement. Sections of the mass were submitted for tissue banking and rapid fixation processing. Normal renal cortex was preserved for specialized studies. Atherosclerotic changes are present in the renal arteries, with up to 95% stenosis noted in the most inferior artery. The corticomedullary junction remains distinct, though medullary pyramids appear focally pale. No lymph nodes are identified in the attached perinephric fat. Cytogenetic analysis was attempted but no metaphases were obtained, thus no karyotype could be determined. Based on staging criteria, the lesion is classified as T1b. Distant metastasis cannot be assessed from this specimen."} +{"pid": "TCGA-IQ-A61K", "report": "A total of 44 lymph nodes were evaluated from multiple anatomical sites including the right neck levels 1 through 5, submental triangle, and additional level 4 tissue. Of these, four lymph nodes showed evidence of involvement. Involvement was identified in two out of nineteen lymph nodes from right neck level 3 and 4, with the largest focus measuring 3.0 mm and no extranodal extension. One of five lymph nodes from right neck level 1 showed involvement with a focus measuring 0.9 cm, and extranodal extension was present. Right neck level 2 contained one involved lymph node out of thirteen, with a focus measuring 1.2 cm and extranodal extension also noted. Additional right level 4 tissue and level 5 lymph node specimens, as well as those from the submental triangle, were without involvement.\n\nThe resected tongue specimen measured 6.1 x 4.1 x 3.6 cm and revealed an ulcerated lesion located in the anterior two-thirds of the tongue. The lesion measured 4.1 cm in its greatest dimension and extended to a depth of 0.7 cm. Margins of resection were uninvolved, with the closest distance of 0.5 cm from the anterior margin. Perineural invasion was identified; however, no definitive lymphovascular invasion was observed. Histologic evaluation demonstrated a moderately differentiated squamous cell component. No involvement was found in any of the other submitted margins or tissues, including the dorsal tongue, base of tongue, ventral tongue, floor of mouth, tonsillar pillar, retromolar trigone, hypoglossal nerve, or lingual nerve. Based on the findings, staging was determined as pT3 for the primary tumor and pN2b for regional lymph node involvement."} +{"pid": "TCGA-EW-A1PF", "report": "A total mastectomy specimen from the right breast was evaluated, along with sentinel and non-sentinel lymph nodes. The surgical margins were free of invasive disease and ductal carcinoma in situ (DCIS). A fibrotic area measuring 2.0 cm in greatest dimension was identified in the upper outer quadrant and central portion of the breast. Histologic evaluation revealed a moderately differentiated invasive component with a Nottingham histologic score of 7 (grade 2), composed of glandular structures with moderate tubule formation, moderate nuclear pleomorphism, and a moderate mitotic rate. No lymphovascular invasion was identified.\n\nIn addition to the invasive component, DCIS was present in 2 out of 10 slides, comprising less than 5% of the submitted tissue. It exhibited a solid architectural pattern, high nuclear grade, and expansive comedo-type necrosis. The estimated extent of DCIS was at least 5 cm. No lobular carcinoma in situ was identified.\n\nMargins were negative for both invasive disease and DCIS, with the closest invasive margin measuring 6 mm and the closest DCIS margin measuring 14 mm. There was no evidence of dermal or skeletal muscle invasion. Immunohistochemical staining for keratin was pending initially but later reported as negative across all sentinel lymph nodes evaluated.\n\nA total of 11 lymph nodes were examined, including 9 sentinel nodes and 2 non-sentinel nodes. None showed evidence of metastatic involvement based on hematoxylin and eosin staining and immunohistochemistry for keratin. Staging was determined as pT1c pN0 Mx.\n\nAncillary studies performed on separate specimens demonstrated estrogen receptor positivity in 21% of tumor cells, progesterone receptor positivity in 1%, and HER2 negativity."} +{"pid": "TCGA-42-2593", "report": "The surgical specimens include a right ovary and tube, left ovary, small bowel segment, two omental specimens, a uterus with cervix, and additional omental tissue. The right ovary and tube consist of a cystic structure measuring 3.8 x 3.2 x 2.7 cm with multiple internal cysts, some hemorrhagic, along with adjacent soft tissue. The left ovary is cystic and contains a solid area measuring up to 3.5 cm. The small bowel specimen measures 11.5 cm in length and 3.2 cm in diameter, with plaque-like lesions on the serosal surface, none exceeding 0.3 cm in diameter. The first omental sample includes six pieces of firm tissue aggregating to 10.5 x 5.5 x 1.4 cm, while the second contains two pieces measuring 6 x 5 x 1.2 cm in total. The uterus weighs 144 grams and measures 9 x 6 x 5.5 cm; the endometrium is tan with a polyp-like fragment near one cornu measuring 1.1 cm. Two leiomyoma-like masses are present within the uterine wall, measuring 3 and 2 cm respectively.\n\nMicroscopic analysis reveals a high-grade growth pattern with focal micropapillary architecture. The tumor in the left ovary measures 5.5 cm. A high mitotic index is noted at 38 mitoses per 10 high-power fields. Tumor extends beyond the ovarian capsule. Staging shows involvement of the right ovary and surrounding soft tissue, the serosal layer of the small bowel, omental deposits, and presence in mural lymphatics of the uterine wall. Vascular and lymphatic invasion is evident in omental sections. Additional findings include benign endometrial polyps, inactive endometrium, and myometrial leiomyomas. No cervical abnormalities are identified."} +{"pid": "TCGA-A3-3380", "report": "The left nephrectomy specimen weighed 570 grams and measured approximately 19.4 x 12.9 x 5.8 cm upon reconstruction. The resection margins included a 2.5 cm segment of renal artery, 1.0 cm of renal vein, and 9.0 cm of ureter, all appearing grossly patent. After removal of the surrounding adipose tissue, the kidney measured 12.4 x 7.5 x 5.0 cm and exhibited a lobular, homogeneous red-brown outer surface.\n\nA distinct lesion measuring 3.0 x 3.0 x 2.8 cm was identified on the posterior aspect in the mid region. It presented as a tan-yellow, nodular structure with a slightly bulging, focally hemorrhagic, and centrally hyalinized cut surface. The lesion appeared thinly encapsulated and extended beyond the cortical parenchyma, though it maintained an intact appearance with a thin layer of adjacent cortical tissue. There was mild compression of the surrounding parenchyma without evidence of gross extension into it.\n\nThe remaining cortical parenchyma reached up to 0.9 cm in thickness and was uniformly red-brown. Within the cortex on the anterolateral aspect, a cystic structure measuring approximately 9 mm was noted, containing a spiky brown-black calculus and exhibiting a trabeculated inner lining. The cortical-medullary junction was indistinct, and the medulla appeared tan-brown with well-defined papillae. The calices and pelvis were lined with smooth tan-white mucosa extending into the ureter.\n\nTissue sections submitted included vascular and ureteral margins, representative areas of the lesion and surrounding tissue, the cystic structure, and uninvolved parenchyma. During initial examination, a peripheral bulge was observed on the kidney surface; however, no gross involvement of perinephric tissue was evident.\n\nMicroscopic evaluation showed no lymphovascular or transcapsular invasion. All surgical margins\u2014soft tissue, ureteral, and vascular\u2014were negative. No lymph nodes were identified among the examined tissues. Nuclear grading was Fuhrman Grade 2.\n\nThe lesion was confined entirely within the kidney and staged as pT1."} +{"pid": "TCGA-T2-A6WZ", "report": "The surgical pathology report describes a specimen obtained from a male patient following a procedure involving the tongue, oropharynx, and neck tissue. The surgical specimens include a near total glossectomy, partial pharyngectomy, left neck dissection (zones 1\u20133), right neck dissection (zones 1\u20133), and extraction of teeth #22, 24, and 25.\n\nThe primary lesion was identified in the left posterolateral tongue, extending into the posterior pharynx and soft palate. Gross examination revealed an ulcerated mass measuring 7 x 4.5 cm with deep furrows and papillary structures. Histologic evaluation demonstrated invasive carcinoma with features consistent across multiple sections. The tumor extended to within 0.4 cm of the deep margin and was located closest to the right tongue margin at 1.4 cm. Other margins evaluated were negative for involvement.\n\nImmunohistochemical staining for EGFR showed moderate to strong labeling in nearly all tumor cells, with an H score of 220 (65% at 2+, 30% at 3+). Perineural invasion was present, while lymphovascular invasion was not identified.\n\nLymph node evaluation included a total of 89 nodes examined from both sides of the neck. Of these, two contained metastatic involvement: one in zone 3 of the left neck (measuring 0.41 cm) and another in zone 3 from an additional left posterior neck dissection (measuring 0.46 cm), with focal extranodal extension noted. All other lymph nodes evaluated were negative.\n\nTeeth extracted showed no significant histopathologic changes. Additional margins submitted separately\u2014including midline tongue, vallecula, pharyngeal, superior tonsil, posterior mobile tongue, and right anterior tongue\u2014were all negative for carcinoma involvement.\n\nPathologic staging based on findings indicated a primary tumor size greater than 4 cm without extension to the lingual surface of the epiglottis, classified as pT3. Regional lymph node involvement showed metastasis in multiple ipsilateral nodes, none exceeding 6 cm, classified as pN2b. No distant metastasis was identified.\n\nMultiple frozen sections were taken intraoperatively and confirmed negative margins for malignancy. The final assessment includes comprehensive evaluation of all specimens with concurrence by a senior pathologist. Ancillary studies including HPV and EGFR status are reported separately as addendums."} +{"pid": "TCGA-98-8020", "report": "The surgical pathology report includes specimens from multiple lymph node levels and lung tissue. Lymph nodes at level X, VIII, IX, and II showed no evidence of malignancy. One lymph node at level IV-R contained metastatic involvement. Level VII lymph node fragments were benign with necrotic tissue noted.\n\nA soft tissue specimen described crystalline material with a foreign body reaction. The bronchial margin was free of tumor involvement.\n\nThe right upper lobe lung specimen measured 10.5 x 8.7 x 3.4 cm and contained a solid nodule measuring 3.4 cm in greatest dimension. This nodule was adjacent to a cavity filled with necrotic debris and was found near lymph nodes. Multiple nodules were observed on the external surface of the lung, including one measuring 2.4 x 1.6 x 1.7 cm and another measuring 2.5 x 1.0 x 0.3 cm. The tumor was located less than 1.0 mm from a stapled margin but margins were otherwise free of tumor. Extensive pleural crystalline deposition with foreign body reaction was also present.\n\nMicroscopic evaluation revealed moderately differentiated cellular features within the lung nodule. Lymphovascular invasion was identified. One peribronchial lymph node contained involvement. Visceral pleural invasion and tumor extension were not identified. Histologic assessment of other margins, including bronchial, parenchymal, and parietal pleural, showed no involvement. Chest wall margin could not be assessed due to specimen limitations.\n\nStaging was determined as pT2 based on tumor size greater than 3 cm and less than 5 cm without direct bronchial invasion or pleural involvement. Regional lymph node staging was classified as pN2."} +{"pid": "TCGA-21-1083", "report": "A lobectomy specimen from the left upper lobe of the lung weighed 335 grams and measured 24.5 x 14.0 x 3.5 cm. A mass measuring 2.6 x 1.8 x 1.6 cm was identified in the superior/inferior segment, located approximately 3.0 cm from hilar structures. The mass was firm, tan, gritty, with irregular borders and showed no invasion into or through the pleura. Necrosis within the mass was moderate. No lymphatic, venous, or arterial invasion was identified. Surgical margins were free of involvement. Adjacent lung tissue showed emphysematous changes.\n\nLymph nodes were sampled from multiple levels: LA, R4 (including an additional R4), R2, level 7, level 11, level 6, and level 5. All lymph nodes examined were negative for tumor involvement. In total, 19 lymph nodes were evaluated, with none showing evidence of metastasis. Multiple palpable hilar lymph nodes ranging from 0.5 to 2.0 cm in size were also described as gray-black and anthracotic upon sectioning.\n\nSpecimens included frozen sections and formalin-fixed tissue blocks. Representative sections of each lymph node and lung tissue were submitted for microscopic evaluation. The tumor was classified as poorly differentiated and measured a maximum of 2.6 cm. Based on these findings, staging indicated T1 for the primary lesion and N0 for nodal status."} +{"pid": "TCGA-2L-AAQE", "report": "The surgical specimen from a male patient includes a resected pancreatic head measuring 8.5x7.5x4.5 cm, with a centrally located 3.5x6x3.5 cm cyst corresponding to a dilated pancreatic duct. Adjacent to the cyst, a solid grey-glass-like mass measuring 4.5x4x3 cm is present with ill-defined borders, showing infiltration into surrounding fatty tissue posteriorly and medially. The closest distances from the mass to the resection margins are 0.1 cm medially, 0.3 cm posteriorly, and 0.5 cm at the distal pancreatic margin. Several peripancreatic lymph nodes are noted, with the largest measuring up to 1.2 cm.\n\nHistologic examination reveals invasive glandular growth patterns, including areas of dissociated cells forming abortive glands and solid nests, as well as more complex glandular structures. There is moderate proliferation activity and marked chronic and acute pancreatitis with extensive fibrosis and ductectasia. A pseudocyst formation is also observed. Infiltration of peripancreatic soft tissue and perilymphadenitis is present. One regional lymph node shows evidence of tumor involvement.\n\nThe duodenal resection margins, distal pancreatic margin, bile duct margin, and omental tissue show no evidence of tumor. The omentum demonstrates moderate serosal fibrosis and post-surgical inflammatory changes. Lymph nodes from the hepatic artery region and liver hilum are uninvolved. The gallbladder shows signs of chronic inflammation and post-surgical hemorrhage but no malignancy.\n\nStaging according to the TNM classification (UICC, 7th edition, 2010) indicates pT3, pN1 (1 of 22 lymph nodes positive), cM0, with additional descriptors of Pn1, LO, vo, RO, and histologic grade G2."} +{"pid": "TCGA-V4-A9F7", "report": "Enucleation of the right eye was performed. The eyeball measured 28 by 25 mm, and the optic nerve measured 11 mm in length. Upon microscopic examination, the lesion demonstrated a proliferation of cells, predominantly fusiform in shape (90%), with rare epithelioid cells (10%). The tissue showed significant melanin pigmentation and a low mitotic index, with 5 mitoses observed in 10 high-power fields at 400\u00d7 magnification. The lesion extended into the internal third of the sclera but did not show extrascleral extension. There was infiltration noted at the intraocular emergence of the optic nerve; however, the optic foramen, post-laminar region, cut end, and meningeal sheaths were uninvolved. The iris, ciliary body, and anterior chamber were also free of involvement. The size of the lesion was 10 mm."} +{"pid": "TCGA-TS-A7PB", "report": "A male patient underwent a left thoracotomy with pleurectomy, photodynamic therapy (PDT), and bronchoscopy. Pathological evaluation included multiple tissue specimens.\n\nA rib specimen with bone marrow and adjacent fibroadipose and skeletal muscle tissues showed no tumor involvement. One lymph node from Station 10 was negative for tumor cells.\n\nIn Stations 8, 6, pericardial region, Level 7, Level 2, Level 5, posterior intercostal region, and others, varying degrees of lymph node involvement were identified. Specifically, all lymph nodes from Stations 8, pericardial region, and posterior intercostal region showed tumor presence. In Station 6, three out of four lymph nodes contained tumor cells. At Level 7, one lymph node was involved. In Level 2, one out of two lymph nodes was involved, and in Level 5, one out of four lymph nodes showed tumor involvement. No tumor was found in the phrenic node, anterior hilar node, or phrenic nerve.\n\nAdipose tissue showed focal involvement by tumor cells. Two tissue specimens\u2014labeled as Pleura and Pericardial Mass\u2014were examined. The former revealed a biphasic tumor composition involving skeletal muscle and superficial lung tissue. The latter also demonstrated a biphasic tumor pattern with involvement of superficial lung tissue; however, the inked margin of the pericardial region was free of tumor.\n\nImmunohistochemical staining confirmed cellular markers consistent with specific tumor identification. A total of 20 lymph nodes were examined, with 12 showing signs of tumor involvement. Pathologic staging was determined as pT3N2Mx.\n\nGross examination of the surgical specimens included a variety of tissue samples. The largest rib fragment measured 1.8 cm. Lymph nodes from various anatomical locations ranged in size from 0.8 to 2.3 cm. The pleural specimen weighed 638.4 g and measured 21.5 x 18.4 x 7.5 cm. The pericardial mass measured 4.5 x 3.6 x 2.1 cm.\n\nAll specimens were processed and analyzed according to standard protocols."} +{"pid": "TCGA-CJ-4874", "report": "The pathology report describes a radical nephrectomy specimen from the left kidney with an associated lymph node. The specimen measures 19.5 x 10.0 x 5.0 cm and includes the left kidney (12.5 x 6.0 x 4.0 cm), along with segments of renal artery, renal vein, and ureter (10.0 cm in length, 0.4 cm average diameter). Within the mid-lower pole of the kidney, a well-circumscribed mass measuring 6.0 x 5.5 x 5.0 cm is identified. The mass has a yellow appearance with areas of central hemorrhage and necrosis. It is located near the perinephric adipose tissue, renal sinus, and renal vein but does not appear to invade these structures. There is no extension into Gerota\u2019s fascia. A single simple cortical cyst (1.0 cm) is noted within the kidney parenchyma, located approximately 2.0 cm from the mass. The pelvicaliceal system appears smooth and without abnormality. Seven lymph nodes are identified within the hilar region, ranging in size from 0.5 x 1.0 cm, and appear unremarkable upon gross examination. Margins of resection, including those of the ureter, renal vein, and artery, show no evidence of involvement. Microscopic sections include the tumor with surrounding perinephric fat, renal sinus, and multiple sections of non-neoplastic kidney tissue. Several sections of submitted lymph nodes also appear unremarkable. A portion of the mass was reserved for potential electron microscopy and other research protocols."} +{"pid": "TCGA-CV-7438", "report": "The surgical specimen consists of a segment of mucosa and skeletal muscle measuring 4.5 x 2.5 x 1.5 cm. A central ulceration is present, measuring 1.5 x 1.0 x 0.8 cm. Histological evaluation reveals poorly differentiated cells with extensive perineural invasion. Vascular and lymphatic invasion are also identified. The thickness of the lesion is 1.3 cm, and the tumor is in close proximity to the deep margin. Margins evaluated include superior, anterior tongue, inferior floor of mouth, and posterior tonsillar pillar. All margins show squamous mucosa without evidence of tumor. Each margin was submitted for frozen section analysis and confirmed negative for tumor."} +{"pid": "TCGA-B5-A11P", "report": "The specimen consists of a uterus weighing 126 grams, measuring 8.2 x 6.5 x 3.1 cm, with attached bilateral adnexa. The uterus contains a tan, sessile, firm mass measuring 3.1 x 2.6 x 1.1 cm located at the fundus and extending into the anterior and posterior endometrial cavities. The mass appears to invade approximately 0.2 cm into the myometrium, which averages 1 cm in thickness. There is no extension into the cervix, with the closest distance from the posterior aspect of the mass to the cervix being 2.6 cm. The remainder of the endometrium is tan and smooth, with multiple small cysts less than 0.1 cm in diameter. The cervix measures 2.9 cm in diameter with a patent os and shows no abnormalities.\n\nSections submitted include full-thickness samples from both the anterior and posterior endomyometrium at the fundus, as well as uninvolved areas of the lower uterine segment and cervix. The left fallopian tube has a tan serosal surface with thin adhesions and two paratubal cysts up to 0.5 cm. The attached left ovary measures 2.3 x 2.1 x 1.4 cm with a tan-yellow calcified surface and three paraovarian cysts up to 0.7 cm. On sectioning, it reveals a tan-white cut surface with two calcified cysts lined by a 0.2 cm yellow lining. The right fallopian tube measures 4.1 x 0.3 cm with a tan serosa and multiple adhesions. The right ovary is 2.1 x 1.3 x 1 cm, tan-white on sectioning, with three paraovarian cysts up to 1.1 cm.\n\nA right pelvic lymph node dissection specimen includes an aggregate of yellow-pink fibroadipose tissue measuring 8.5 x 7.5 x 2.5 cm. Multiple lymph node candidates up to 2.5 cm were identified and sampled. A total of 21 lymph nodes were evaluated from this side, none showing any abnormal findings.\n\nThe left pelvic lymph node specimen measures 6 x 4.5 x 1.5 cm and contains multiple lymph node candidates up to 1.5 cm in size. A total of 12 lymph nodes were examined from this specimen, all without evidence of abnormality.\n\nMicroscopic examination confirms the presence of a lesion at the fundus with histologic features consistent with Grade 3 morphology according to FIGO criteria. The tumor does not demonstrate lymphatic or vascular invasion. Adjacent non-neoplastic endometrium shows atrophic changes. Leiomyomas up to 0.2 cm are noted in the remaining myometrium. The cervix, serosa, and all specimen margins are free of involvement. No metastatic involvement was identified in any of the lymph nodes assessed.\n\nAdditional evaluation of decalcified ovarian tissue revealed ovarian tissue with calcification but no evidence of tumor. All other diagnoses remain unchanged."} +{"pid": "TCGA-N8-A4PN", "report": "The specimen consisted of a uterus with bilateral tubes and ovaries, collected during a total abdominal hysterectomy and bilateral salpingo-oophorectomy. Gross examination revealed a large mass arising from the posterior uterine wall measuring 14.5 x 13.7 x 7.8 cm. The mass contained solid tan-white to yellow areas with cystic components, hemorrhage, and extensive necrosis. Microscopically, the lesion demonstrated myometrial invasion involving the inner half of the wall. Depth of invasion was 5 mm in a wall thickness of 15 mm, representing approximately 33% penetration. No involvement was identified in the serosa, lower uterine segment, cervix, or adnexa. Lymphovascular space invasion was present.\n\nHistologic evaluation showed high-grade features with poorly differentiated morphology. Immunohistochemistry demonstrated weak positivity for estrogen receptor (1+, 75% epithelial component) and moderate positivity for progesterone receptor (2+, 50% epithelial component). Micrometastatic involvement was identified in three of fifteen regional lymph nodes on the left pelvic side, while five lymph nodes from the right pelvic region were negative.\n\nAdditional findings included multiple leiomyomas within the myometrium up to 1.9 cm in size. Nabothian cysts and chronic inflammation were noted in the cervix. A mixed endometrial/endocervical polyp was present along with atrophic changes and breakdown. Both ovaries displayed benign inclusion cysts and age-related changes; the left ovary also showed focal calcification with associated inflammation. Fallopian tubes were unremarkable bilaterally.\n\nStaging information indicated pathologic classification as pT1a pN1 pMX according to AJCC criteria and Stage IIIC1 under FIGO (2008). These classifications were based on available data at the time of reporting and subject to revision pending further clinical review. Frozen section analysis suggested a poorly differentiated malignancy with differential considerations including leiomyosarcoma versus malignant mixed M\u00fcllerian tumor (MMMT), though no definitive glandular component was initially identified.\n\nBlocks were submitted for microscopic evaluation including representative sections of the mass, cervix, corpus, myometrium, ovaries, fallopian tubes, and lymph node regions. Immunostaining was performed using AE1/AE3 pan-cytokeratin and other markers to confirm epithelial origin in lymph node metastases. Controls were appropriately evaluated.\n\nThe surgical specimen weighed 935 grams. The uterus measured 19.0 cm in height, 7.5 cm anterior to posterior, and 12.2 cm in breadth at the fundus. Endometrial cavity length was 11.2 cm with a width of 4.2 cm at the fundus and a lining thickness of 0.1 cm. The cervix had a diameter of 3.5 cm with a patent os and an endocervical canal length of 2.3 cm. Multiple fibroid nodules were identified within the myometrium with sizes ranging from 0.7 to 1.9 cm. The ovaries were small, measuring 2.5 x 1.0 x 0.5 cm (right) and 2.5 x 1.2 x 0.5 cm (left), with unremarkable cut surfaces except for focal calcification on the left.\n\nLymph node dissection yielded twelve candidates from the left pelvic region (0.5\u20132.0 cm in diameter) and five from the right pelvic region (0.6\u20131.5 cm). Three lymph nodes from the left contained micrometastases composed of single cells and small clusters (<5 cells), consistent with metastatic involvement.\n\nAll margins were widely negative. Other tissue submitted included sections of cervical and endometrial tissue showing mixed polyps and atrophy. No additional significant findings were noted in the fallopian tubes."} +{"pid": "TCGA-A2-A0CS", "report": "A lymph node measuring 1.3 x 0.9 x 0.6 cm was received and bisected, revealing firm, yellow and tan tissue. Microscopic examination identified a deposit measuring 0.6 cm with extracapsular extension observed to a distance of 4 mm. A single lymph node was examined.\n\nA modified radical mastectomy specimen was also received, weighing 508 grams. The breast measured 17.5 x 14.5 x 3.8 cm, with attached axillary contents measuring 13.0 x 5.2 x 1.5 cm. Skin overlying the tumor showed ulceration measuring up to 2.2 x 1.6 cm. On sectioning, a central tumor measuring 7.0 x 5.1 x 3.5 cm was identified, extending anteriorly through the skin and posteriorly involving a segment of skeletal muscle (3.0 x 2.5 cm). The tumor had a firm, tan, gritty cut surface and was located in the upper mid and upper inner portions of the breast.\n\nHistologic evaluation noted well-differentiated features. Nuclear pleomorphism score was 2, tubule formation was 20% (score 2), and mitotic count was 9 per 10 high-power fields (score 1). Tumor extended into the dermis, epidermis, and nipple with associated ulceration. Lymphovascular and perineural invasion were present. Margins included involvement at the deep (skeletal muscle) margin.\n\nLymph node assessment revealed metastatic involvement in 7 of 11 nodes examined, with extracapsular extension present. The largest metastatic deposit measured 1.8 cm, with extranodal tumor extension measuring at least 6 mm. Multiple sections from various regions of the breast and lymph nodes were submitted for further analysis."} +{"pid": "TCGA-FI-A2D0", "report": "The uterus, cervix, and bilateral tubes and ovaries were received for examination. The uterus measured 5 cm from cornu to cornu, 11.5 cm in the longitudinal axis, and 5 cm anterior to posterior. The endometrial lining was tan with a rough surface, and a polyp measuring 2.2 x 1.5 cm was identified on the posterior wall. The cervix measured 2.7 x 2.5 cm with a smooth tan appearance; a small polyp measuring 1.2 x 0.6 cm was noted on the posterior surface. No gross evidence of invasive lesion was identified within the myometrium, which had a thickness of 2.7 cm.\n\nMicroscopic evaluation revealed immature squamous metaplasia and chronic inflammation of the cervix, along with an endocervical polyp. Endometriosis was identified involving deep cervical soft tissue. A separate finding of a leiomyoma measuring 0.4 cm was noted in the uterine wall. Subserosal endosalpingiosis was identified on the serosal surface. The right ovary showed adhesions, while the left ovary and both fallopian tubes showed no significant histopathologic abnormalities.\n\nLymph node dissection included specimens from the left and right pelvic regions, as well as left and right common periaortic areas. In total, 28 lymph nodes were examined: nine from the left pelvic region, twelve from the right pelvic region, four from the left common periaortic region, and three from the right common periaortic region. No carcinoma was identified in any of the lymph nodes. Additionally, omental tissue was submitted and showed no evidence of malignancy.\n\nHistologic assessment of the endometrial polyp demonstrated features consistent with adenocarcinoma of endometrioid type. The tumor exhibited a solid growth pattern involving 51\u2013100% of the sample. No invasion beyond the endometrium was observed, and there was no involvement of the lower uterine segment, endocervix, or lymphovascular spaces. The regional lymph nodes were free of metastatic disease.\n\nA provisional pathologic staging of T1a/N0/MX (FIGO Stage IA) was assigned. This stage is based solely on the pathological findings and may be adjusted upon integration with clinical data."} +{"pid": "TCGA-94-A5I4", "report": "The surgical pathology report includes findings from multiple biopsies and a pneumonectomy specimen. Lymph node fragments from right level 7, 4R, and level 9R were all negative for metastatic disease, with 0 out of 9, 0 out of 18, and 0 out of 2 nodes involved, respectively. The right lung specimen contained a well-circumscribed mass measuring 4.5 cm in greatest dimension, located around the main bronchus and extending 2 cm or more distal to the carina. Histologic evaluation showed moderately differentiated tumor cells with necrosis. Visceral pleura was not involved. Margins of resection, including bronchial and vascular, were free of tumor involvement. Lymphovascular invasion was identified. One of four lymph nodes submitted showed evidence of metastasis. The uninvolved lung parenchyma demonstrated emphysematous changes. No squamous dysplasia was seen at the bronchial margin. Additional findings included diffuse bronchiectasis in the surrounding parenchyma and absence of hilar lymph nodes on gross examination. The closest margin to the tumor was the bronchial margin, with a distance of 12 mm. Based on the extent of the primary tumor and lymph node involvement, staging criteria indicate pT2a and pN1 classifications."} +{"pid": "TCGA-4V-A9QI", "report": "The anterior mediastinal mass shows lymphoepithelial proliferation with lymphoid follicles present along the septa and perivascular spaces. Hassal bodies are identified. There is no evidence of necrosis. The periphery of the mass is encapsulated, with minimal invasion noted in one area. The lesion is associated with remnants of normal thymus and includes a normal ectopic parathyroid gland. Evaluation of regional lymph nodes, including the left internal mammary, left paratracheal (4 nodes), and preaortic lymph node, reveals follicular architecture without evidence of tumor involvement.\n\nImmunohistochemical staining demonstrates positivity for anti-pan keratin AE1/AE3 and anti-cytokeratin 5/6. Tumor epithelial cells are negative for anti-EMA, anti-cytokeratin 20, anti-CD5, anti-CD20, and anti-CD57. Lymphocytic components show positivity for anti-CD3 and anti-CD1a, indicating an immature T cell phenotype.\n\nThe mass measures 6 cm in greatest dimension. Histologic features include a B2 growth pattern and minimal invasive component. Staging classification corresponds to stage IIA based on Masaoka-Koga criteria. Surgical resection was complete."} +{"pid": "TCGA-V4-A9E5", "report": "Right eye enucleation specimen. The eyeball measures 23 by 23 by 23 mm with a posterior optic nerve segment measuring 10 mm. Upon sectioning, the lesion measures 14 mm along its greatest dimension. Samples were obtained for cryopreservation, cytogenetic analysis, and preclinical investigation. The entire specimen was submitted for histologic evaluation.\n\nMicroscopic examination reveals a tumor composed entirely of spindle-shaped cells arranged in short bundles. Some cells contain melanin pigment. The nuclei are fusiform and ovoid with occasional prominent nuclear atypia. The mitotic count is low, with 4 mitoses identified in 10 high-power fields at 400\u00d7 magnification. The tumor is located adjacent to the ciliary processes and demonstrates infiltration into the superficial inner layers of the sclera. The optic foramen, optic nerve, and its cut end show no involvement. The meningeal sheaths and anterior chamber are also free of tumor."} +{"pid": "TCGA-IM-A3U3", "report": "The right lobe of the thyroid weighed 9.6 grams and measured 5.5 x 2.3 x 1.0 cm. A well-defined grey-white mass measuring 1.3 cm in greatest dimension was identified in the mid pole, located less than 1 cm from the closest margin. Adjacent to this mass, multiple grey-tan cystic cavities ranging from 0.3 to 0.8 cm were noted toward the inferior pole. Histologically, the mass showed cellular features consistent with tall cell morphology, with extensive lymphovascular invasion observed. The tumor did not involve the surgical margins and lacked a distinct capsule. No extrathyroidal extension or perineural invasion was identified.\n\nIn the left lobe of the thyroid, which weighed 16 grams and measured 5.0 x 3.0 x 2.0 cm, multiple small nodules were present throughout the lobe. These ranged in size from 0.1 cm to 0.6 cm and displayed follicular architecture with classical cytomorphology. Sclerosis was noted in association with these nodules. Extensive lymphovascular invasion was also identified in this region. All surgical margins were free of involvement, and no tumor capsule was present. There was no evidence of extrathyroidal extension or perineural invasion.\n\nA total of 9 lymph nodes were examined: one from the right lobe and eight from the right central midline compartment dissection. All were negative for metastatic disease. Additionally, multinodular hyperplasia was present in both lobes, along with mild lymphocytic thyroiditis in the right lobe. No parathyroid tissue was identified in either lobe or in the submitted parathyroid sampling.\n\nThe tumor was multifocal and bilateral, with the dominant lesion located in the right lobe. Based on the AJCC staging system, the primary tumor stage was pT1b (tumor greater than 1 cm but not more than 2 cm within the thyroid), and there was no regional lymph node involvement (pN0). Distant metastasis could not be assessed (pMX). \n\nImmunohistochemical analysis revealed positivity for markers including HBME1, galectin-3, and IgG, with variable Ki67 proliferation indices across different foci. No markers indicated distant metastatic spread."} +{"pid": "TCGA-D6-8569", "report": "The surgical specimen from the tongue measured 3.5 x 3 x 1.5 cm, with a lesion measuring 2.4 x 2 x 0.9 cm identified within the tissue. Histological examination revealed moderately differentiated invasive keratinizing epithelial cells arranged in nests and cords, infiltrating into the underlying tissue. Margins were evaluated, showing a minimum distance of 0.4 cm from the lateral edge of the specimen and 0.6 cm from the base to the nearest healthy tissue. No evidence of vascular or perineural invasion was observed. Intraoperative frozen section analysis of lymph nodes 1\u20134 showed no presence of malignant cells. Full histological processing has been completed and findings are consistent with the described features."} +{"pid": "TCGA-DD-A4NE", "report": "The resected specimen from the right lobe of the liver and a portion of segment 4B contains a dominant mass measuring 14.5 x 8.7 x 6.8 cm. In addition, there are multiple satellite nodules ranging in size from 0.1 cm to 4.4 cm. All tumors are confined within the liver. The resection margins of the liver parenchyma show no evidence of tumor, with a minimum tumor-free margin of 0.3 cm. There is no macroscopic or microscopic evidence of vascular invasion. Three perihepatic lymph nodes are negative for involvement. A separate cholecystectomy specimen shows chronic cholecystitis. The findings are based on gross examination, frozen section evaluation, and confirmed by review of permanent H&E sections. Any significant changes identified later would be reported in an amended version."} +{"pid": "TCGA-ET-A3BT", "report": "The specimen from the right inferior parathyroid biopsy consists of cellular parathyroid tissue weighing 9.0 mg. A total thyroidectomy specimen was submitted with a tumor located in the isthmus measuring 2.5 cm in greatest dimension. The tumor extends into the thyroid capsule but does not demonstrate extrathyroidal extension. It is unifocal in distribution. Metastatic carcinoma is present in two of seven lymph nodes examined. The primary tumor is staged as pT2, indicating a tumor larger than 2 cm but less than 4 cm confined to the thyroid. Regional lymph node involvement is staged as pN1b due to metastasis in cervical or mediastinal nodes (2 out of 7 involved). Distant metastasis could not be assessed (pMX). Surgical margins are free of tumor involvement, although the tumor approaches inked margins at multiple sites without extending to them. There is no definitive evidence of venous or lymphatic invasion. Additional findings include five papillary microcarcinomas: two in the right lobe measuring 1.5 mm and 0.25 mm, and three in the left lobe measuring 1.2 mm, 0.9 mm, and 0.6 mm. A modified left neck dissection included lymph nodes from levels III and IV, with metastatic involvement identified in two of seven nodes."} +{"pid": "TCGA-CQ-5326", "report": "The specimen includes contents of the right and left neck, mandibulectomy, and intra-oral resection from the right floor of mouth, along with a left level II neck dissection, soft palate margin, deep margin, tongue margin, and surgical waste. \n\nMicroscopic examination reveals involvement of the mandible, floor of mouth, right sublingual gland, and soft tissues of level I. The largest lesion measures 7.0 cm in maximum diameter. Perineural invasion is identified. No lymphatic or vascular invasion is observed. Margins of resection are uninvolved by tumor; however, the tumor is in close proximity to several margins. The lateral and medial soft tissue margins of the neck are 0.1 and 0.2 cm from the tumor, respectively, and the soft tissue margin of the floor of mouth is 0.3 cm from the tumor. \n\nExamination of lymph nodes reveals metastatic involvement in 18 of 34 lymph nodes from the right neck. The largest involved lymph node measures 5.0 cm and extensive extranodal extension is present. Involved lymph nodes are located in levels II through V. In the left neck, 1 of 21 lymph nodes is involved, with the largest measuring 1.7 cm and no extranodal extension identified. The involved node is located in level IV. One lymph node from the left level II neck dissection is negative for tumor. Margins from the soft palate, deep tissue, and tongue are all negative for tumor. Surgical waste consists of skin, bone, and soft tissues without significant findings on gross examination. \n\nPathologic staging indicates invasion into adjacent structures including cortical bone and deep muscle of the tongue. Regional lymph node evaluation confirms bilateral involvement with extensive nodal disease on the right. Distant metastasis cannot be assessed. \n\nDecalcified sections of the mandible demonstrate extensive involvement by squamous cell carcinoma; however, bony margins of resection are free of tumor."} +{"pid": "TCGA-G3-A25T", "report": "The specimen consists of a liver lobe weighing 1441 grams and measuring 17.0 x 17.4 x 9.8 cm. A dominant neoplasm is identified on the surface, measuring 9.8 x 9.0 cm, with a white appearance and slight necrosis. It is surrounded by a hemorrhagic rim. Upon sectioning, this lesion measures 13.0 x 11.8 x 8.0 cm and has a homogeneous white/tan color with central necrosis. The tumor margin is at the surgical resection edge. Adjacent to it is a smaller well-circumscribed nodule measuring 1.4 x 1.2 x 1.2 cm, located 1.0 cm from the larger lesion and also 1.0 cm from the resection margin. A fibrous cystic structure containing green bile is noted on the surface.\n\nMicroscopic evaluation reveals an infiltrative growth pattern with trabecular and pseudoglandular architecture. Cellular features include mild nuclear enlargement and pleomorphism with abundant cytoplasm. Fibrosis is present within the tumor. Mitotic activity is observed at 6 per 10 high-power fields. No angiolymphatic invasion is identified. Sections of gallbladder and one regional lymph node show no abnormalities. Normal liver tissue appears unremarkable. Multiple sections are taken from the tumor and surrounding areas for further analysis."} +{"pid": "TCGA-S3-AA11", "report": "The lumpectomy specimen contained a white-brown mass measuring 2.2 x 1.9 x 1.0 cm with a central cavity and calcifications. The mass was located closest to the medial margin at 0.8 cm, with distances from other margins ranging between 0.8 cm and 1.4 cm. Histologically, the lesion exhibited features consistent with an intermediate-grade process involving ductal structures. Microscopic evaluation revealed areas of cribriform architecture with central necrosis. Nuclear grade was intermediate, with moderate pleomorphism and visible nucleoli. Mitotic activity was low, with 3 mitoses per 10 high-power fields.\n\nThe tumor demonstrated limited glandular differentiation, with less than 10% of the tumor area forming glandular or tubular structures. No lymphovascular invasion was identified. Margins were free of involvement by invasive disease, with distances from the tumor ranging from 5.0 mm to 14.0 mm. The closest margin for non-invasive components was 12.0 mm from the inferior margin.\n\nA single sentinel lymph node was examined and showed reactive changes without evidence of malignant involvement. Multiple sectioning and immunohistochemical analysis did not reveal any metastatic deposits. The lymph node measured 2.0 x 1.3 x 0.9 cm and was fully evaluated using H&E staining and immunohistochemistry.\n\nAdditional findings included intraductal papillomas. Hormone receptor analysis on a separate specimen showed strong estrogen receptor positivity and partial progesterone receptor expression. HER2 testing was equivocal by immunohistochemistry but confirmed non-amplified status by FISH.\n\nNo microcalcifications were identified in the lumpectomy specimen. Gross measurements, including the cavity, were considered accurate for staging purposes. The largest residual tumor focus measured 1.2 x 0.9 cm, with a biopsy dimension of 1.1 cm."} +{"pid": "TCGA-C5-A902", "report": "Consult Report. Microscopic evaluation reveals a poorly differentiated squamous cell carcinoma arising in association with severe squamous dysplasia (CIN3). The tumor occupies the full thickness of the tissue, measuring at least 5 mm in depth. The growth pattern is solid, without evidence of glandular or papillary components. While cytoplasmic clearing is present in certain areas, the degree of cytologic atypia does not reach the severity typically seen in clear cell carcinoma. The lesion is surrounded by dysplastic squamous epithelium, further supporting its origin. One slide was received and examined, labeled and sublabeled as case 2."} +{"pid": "TCGA-2F-A9KQ", "report": "The specimen involves a high-grade neoplasm infiltrating through the bladder wall. The tumor measures 5.5 cm in diameter and is located within the bladder wall. Evaluation of lymph nodes reveals no evidence of tumor involvement, with all 18 lymph nodes examined showing no signs of metastatic disease. The lesion demonstrates marked cellular atypia and poor differentiation. No distant metastases were identified."} +{"pid": "TCGA-HT-A74J", "report": "The pathology report describes a glial neoplasm located in the left temporal region. Microscopic examination reveals a variably but generally moderately hypercellular and diffusely infiltrating tumor. Rare markedly hypercellular foci are present. The ATPase reaction is consistently mild. The tumor demonstrates both classic oligodendroglioma and fibrillary astrocytoma phenotypes. Cellular analysis shows scattered MIB-1 reactive cells with a labeling index of 5.1%. Immunohistochemical staining is positive for IDH1 and negative for p53. A rare mitotic figure is identified in the most hypercellular area. There is no evidence of microvascular proliferation or necrosis."} +{"pid": "TCGA-CV-7099", "report": "The specimen includes multiple tissue samples from various anatomical sites including the left buccal margin, right palate and margin, deep buccal margin, maxillary sinus mucosa, superior margin, left inferior turbinate, posterior margin, soft palate, deep margin at the left retromolar trigone, left mandibular margin, right inferior turbinate, and additional portions of maxillary sinus mucosa. All specimens were examined microscopically and showed no presence of tumor cells.\n\nThe left buccal margin demonstrated squamous mucosa with moderate dysplasia; however, the margins were free of any malignant process. Other specimens such as those from the right palate and margin, deep buccal margin, maxillary sinus mucosa, superior margin, left inferior turbinate, posterior margin, soft palate, deep margin at the left retromolar trigone, left mandibular margin, and right inferior turbinate revealed only normal tissue components including fibroadipose tissue, fibroconnective tissue, fibrovascular tissue, respiratory mucosa, or squamous mucosa without evidence of malignancy.\n\nThe largest specimen, a left maxilla total palatectomy encompassing part of the left maxilla, hard palate, and soft palate, measured 5.5 cm anterior to posterior, 4.3 cm lateral to lateral, and 2.8 cm superior to inferior. Attached soft tissue extended 4.0 cm beyond these margins. Gross examination identified a 2.0 cm ulcer with irregular edges and a necrotic base on the soft palate mucosa. Adjacent mucosa overlying the hard palate exhibited a finely granular and verrucous architecture confined to the mucosa and submucosa. Histologic evaluation confirmed absence of tumor involvement in all submitted margins.\n\nMeasurements of tissue specimens ranged from small fragments (0.9 x 0.5 x 0.2 cm) to larger resections (up to 5.5 cm in one dimension). Depth of invasion was noted up to 1.0 cm in areas where abnormal mucosal changes were identified. Cellular findings included acute and chronic inflammation within certain mucosal tissues and moderate dysplasia limited to the left buccal margin. No definitive malignant transformation was observed in these regions.\n\nAll surgical margins across the entire report were consistently negative for tumor involvement. Bone margins were also free of any pathological infiltration. The tissue composition across all specimens primarily consisted of fibroconnective, fibroadipose, fibrovascular, respiratory mucosa, or squamous mucosa without evidence of invasive processes."} +{"pid": "TCGA-D5-5541", "report": "Histopathological examination was performed on a resected segment of the large intestine along with surrounding mesentery. The specimen measured 15 x 10 x 2.5 cm and included a tumor-like lesion in the mucosa, which had a cauliflower-like appearance and measured 5.9 x 4.9 x 1.3 cm. This lesion encircled approximately 95% of the intestinal circumference. Its closest distance to one surgical margin was 3.6 cm and to the opposite margin was 6.2 cm.\n\nMicroscopic evaluation revealed a moderately differentiated glandular and papillary growth pattern within the intestinal wall, extending into the pericolonic fat tissue. No neoplastic involvement was identified at the intestinal resection margins. Lymph node analysis showed presence of similar cellular changes in one lymph node from the examined group.\n\nHistological features indicated the presence of malignant cells with moderate nuclear atypia and increased mitotic activity. Staging assessment showed invasion beyond the muscularis propria into adjacent tissues, with involvement of regional lymph nodes but no distant spread."} +{"pid": "TCGA-CN-6012", "report": "The patient presented with a lesion of the vocal cord/throat and associated dysphagia. A direct laryngoscopy and esophagoscopy were performed. The biopsy specimen submitted was from the right larynx, fixed in buffered formalin, and labeled appropriately. The tissue fragment measured 3.0 x 1.5 x 0.3 cm and was processed entirely into cassettes A and B.\n\nMicroscopic evaluation revealed moderately differentiated invasive epithelial cells arranged in irregular nests and cords, extending into the subepithelial tissues. There was evidence of focal angiolymphatic invasion. Sections were reviewed using hematoxylin and eosin staining (one slide each from blocks A and B). All testing was conducted under CLIA-certified conditions, with appropriate validation of laboratory-developed methods. No prior malignancy, chemotherapy, radiation, organ transplant, immunosuppression, or other significant comorbidities were reported."} +{"pid": "TCGA-ET-A25O", "report": "The total thyroidectomy specimen weighed 37.4 grams. The left lobe measured 2.8 x 2.0 x 1.8 cm, the right lobe measured 6.5 x 3.2 x 1.9 cm, and the isthmus measured 1.0 x 1.0 x 0.3 cm. A suture marked a nodule in the left lobe. Serial sectioning identified a white tan nodule in the left lower lobe measuring 2.3 x 2.0 x 2.0 cm. This nodule was noted to grossly abut the inked resection margin. Another nodule with a soft red tan cut surface was found in the right middle to lower lobe, measuring 2.1 x 1.6 x 3 cm. Histologic sections included multiple blocks from both lobes and the isthmus. Margins were assessed with ink; one margin was focally involved by invasive cells (posterior left lower lobe). All other margins were free of abnormal cells. Lymph nodes were evaluated, and metastatic cells were identified in 2 of 5 lymph nodes. The primary lesion was classified as pT2 based on size greater than 2 cm but less than 4 cm. Regional lymph node involvement was classified as pN1a. Distant metastasis could not be assessed (pMX). Vascular or lymphatic invasion was indeterminate. An additional finding in the right lobe was noted, showing features of a benign nodule."} +{"pid": "TCGA-CV-A6JN", "report": "The patient is a male with a height of 171 cm, weight of 110.9 kg, and a body surface area of 2.3 m\u00b2. A biopsy was taken from a lesion on the right lateral tongue. The lesion measured 2.9 cm in its largest dimension and exhibited ulceration. Histological evaluation showed well-differentiated features, with a pushing tumor border and no perineural or vascular invasion identified. There was marked lymphocytic infiltration observed. Invasion was present, reaching a depth of 0.75 cm. Both mucosal and deep margins were free of invasive disease, and dysplasia at the mucosal edges was not present.\n\nA partial glossectomy specimen from the right tongue and floor of mouth showed a centrally located ulcerated, verrucoid tan firm mass measuring 2.9 x 2.2 x 0.5 cm. A rim of normal mucosa was present (0.3 cm closest mucosal edge), and the tumor invaded to a depth of 0.5 cm grossly, with a distance of 0.6 cm from the deep margin. Microscopic evaluation confirmed negative margins for tumor involvement, with a depth of invasion measuring 0.55 cm.\n\nIn the neck dissection specimens, level 1A contained three lymph nodes, all without evidence of tumor involvement. Level 1B contained two lymph nodes, also without tumor, along with benign salivary gland tissue. Level 2A included eleven lymph nodes, none of which showed tumor presence. Level 2B consisted of fibroadipose tissue without identifiable lymph nodes. In level 3, eleven lymph nodes were identified, with tumor involvement present in one node. Extracapsular extension was noted in this involved lymph node.\n\nAdditional findings included the removal of two intact teeth, measuring 1.5 cm and 0.2 cm in greatest dimension, which underwent gross examination only. No clinical history was provided."} +{"pid": "TCGA-IE-A4EH", "report": "The operative procedure was a robotic hysterectomy involving the uterus and cervix. The tumor measured 4.9 cm in greatest dimension and was located in the uterine corpus. Gross examination revealed a solitary, exophytic mass on the anterior aspect of the uterus, extending to within 2.5 cm of the lower uterine segment. The cut surface of the mass was tan-white, fleshy, and variegated with areas of hemorrhage and necrosis. Microscopic evaluation showed high-grade cellular features with a mitotic rate of 16 per 10 high-power fields. Necrosis was present but involved less than 50% of the tumor volume. Histologic grading classified the tissue as grade 2 of 3 according to the Sarcoma Group (FNCLCC) criteria. Surgical margins were free of malignant involvement, with the closest margin measuring at least 2.5 cm from the tumor. The tumor was confined to the uterine corpus without evidence of extension beyond this site. No regional lymph nodes were examined, and no additional pathologic findings were identified. Multiple sections from various regions of the cervix and uterus were submitted for analysis. The endometrial cavity measured 3.2 cm cornu to cornu and 5.4 cm from fundus to lower uterine segment. The myometrium had a maximum thickness of 2.8 cm in areas unaffected by the tumor. No ancillary studies were performed."} +{"pid": "TCGA-2A-A8W1", "report": "The prostate measured 4.0 cm from apex to base, 4.5 cm transversely, and 3.4 cm in the anterior-posterior dimension, weighing a total of 44.0 grams. The seminal vesicles measured 3.0 x 1.0 cm on both right and left sides. Serial sectioning revealed involvement of the right and left posterior regions with dominant lesion located at the left posterior from mid to base. The tumor exhibited a Gleason grade of 4 as primary and grade 3 as secondary pattern. Invasion of perineural structures was identified while vascular invasion was not observed. Multiple tumor foci were present. High-grade intraepithelial neoplasia was also identified. Extracapsular extension was confirmed at the left posterior base region. Surgical margins showed tumor presence at the left posterior margin with focal positivity at the mid gland. No involvement was noted at the bladder neck or seminal vesicles. The surrounding non-neoplastic prostate tissue demonstrated nodular hyperplasia.\n\nStaging according to AJCC (1997) classification indicated pT3a disease based on extracapsular extension.\n\nExamination of pelvic lymph nodes included eight nodes from the right side ranging from 0.8 to 8.6 cm and four nodes from the left side ranging from 0.4 to 4 cm; all were benign. Margin assessments from both right and left apical peri-ureteral regions confirmed absence of prostatic glands with benign fibromuscular tissue identified. Specimens from peri-prostatic fat consisted of fibroadipose tissue without lymph nodes identified grossly.\n\nAll specimens were fully assessed with representative sections submitted for histologic evaluation. Intraoperative frozen section evaluations of apical margins correlated with permanent diagnoses confirming benign tissue at both right and left apical peri-ureteral margins."} +{"pid": "TCGA-42-2590", "report": "The specimen includes two parts. Part A consists of a resected piece of white and red soft tissue from the omentum measuring 19.5 x 11.5 x 4.5 cm. Part of this specimen was used for research and part was used for frozen section analysis.\n\nPart B includes a resected uterus with attached bilateral adnexa and additional pieces of loose pink soft tissue resembling tumor. The entire specimen weighs 162.7 grams. The uterus measures 8 x 5.5 x 3 cm, with an endocervix measuring 3 x 2.5 cm and an external os measuring 0.7 x less than 0.5 cm. The uterine cavity contains scant tan endometrium, and the myometrium is 1.5 cm thick. Both uterine tubes are identified, with the right measuring 5 x 1 x 0.5 cm and the left measuring 5 x 0.7 x 0.4 cm. There is a 1.5 cm focus within the left ovary. The associated loose tumor tissue measures 8 x 6.5 x 2.5 cm in aggregate. Portions of the specimen were reserved for research and further analysis after fixation.\n\nMicroscopic examination reveals moderately differentiated tumor cells arranged in papillary formations. The tumor is present in multiple fragments and is found adjacent to areas of histologically normal ovarian tissue on both sides. The mitotic rate is 94 mitoses per 10 high-power fields. Extracapsular involvement is noted. Sections of the uterine tubes show no significant pathological changes.\n\nStaging is assessed as pTNM stage T3c. Multiple tissue blocks were examined, including sections from the cervix, endomyometrium, bilateral adnexa, and separate tumor fragments. Cervical tissue shows focal changes consistent with HPV-related effects. The endometrium demonstrates inactive type morphology with cystic change. A leiomyoma is identified in the myometrium."} +{"pid": "TCGA-A5-A0G5", "report": "The omental specimens (specimens A, B, and C) showed variable degrees of chronic inflammation with adhesions. Reactive mesothelial proliferation was noted in specimens A and B. Lymph nodes within the omental samples were reactive without any abnormal cellular infiltration. The left and right adnexal specimens each showed an atrophic ovary with small cystic inclusions and serosal adhesions. The fallopian tubes demonstrated chronic inflammation; one section of the right fallopian tube showed focal epithelial hyperplasia with atypia/dysplasia. No abnormal or malignant cells were identified in the fallopian tubes or ovaries.\n\nExamination of the uterus revealed a significant lesion involving the endometrial cavity. The anterior and posterior corpus as well as the fundus were extensively involved. In the posterior lower uterine segment, the lesion approached the endocervical-lower uterine segment junction. Invasion into the myometrium was present and exceeded 80% of the wall thickness, with a maximum depth of 19 cm in an area measuring 23 cm in total thickness. Vascular space involvement by abnormal cells was observed. Free-floating fragments of abnormal endometrial tissue were found in the endocervical canal; however, no direct involvement of cervical tissue was identified. Parametrial tissues were free of abnormal cellular infiltration.\n\nSeven benign-appearing smooth muscle tumors were identified within the uterus, with sizes ranging from 0.5 to 2.5 cm. One of these lesions contained a small focus of abnormal cellular infiltration. Additional findings included inflammatory changes in proximity to the primary lesion, chronic inflammation of the myometrium, and lymphoid aggregates surrounding dilated vascular channels in the outermost layers of the uterine wall.\n\nCervical examination showed mucosal defects and erosions, with signs of both acute and chronic inflammation. Atrophic changes, squamous metaplasia, and reactive epithelial atypia were also present. Other findings included reserve cell hyperplasia, microglandular hyperplasia, endocervical tunnel clusters, and nabothian cysts. Vascular changes consistent with Monckeberg's sclerosis were identified in regional arteries.\n\nLymph node specimens from multiple pelvic and paraortic sites were examined. These included specimens from the pelvic, obturator, common iliac, periaortic, and other regional lymph node groups. Total lymph node counts were as follows: nine in the pelvic group, three in the obturator, six in the left common iliac, three in the left periaortic, twelve in the right pelvic, six in the right obturator, and six in the right aortic region. All lymph nodes were reactive in appearance with no evidence of abnormal cellular infiltration. \n\nImmunohistochemical analysis of the right fallopian tube showed positive nuclear staining for p53 in the region corresponding to the area with epithelial hyperplasia and atypia. Staining of the uterine lesion for p53 was also positive in most abnormal cells. WT1 staining of the uterine lesion was largely negative, with only rare positive cells."} +{"pid": "TCGA-FI-A2F9", "report": "The patient underwent a total abdominal hysterectomy with bilateral salpingo-oophorectomy, lymph node dissection, and omentectomy. The hysterectomy specimen included the uterus, cervix, bilateral fallopian tubes, and ovaries. Gross examination of the uterus revealed a friable polypoid mass arising from the posterior endometrium measuring 4.2 x 4 x 4 cm. Microscopic evaluation showed invasive cellular growth with poorly differentiated features. The tumor infiltrated the myometrium to a depth of approximately 8 mm within a total myometrial thickness of 18 mm. Lymphovascular space invasion was identified. No involvement of the cervix or lower uterine segment was observed.\n\nMultiple benign-appearing leiomyomas were present within the myometrium, ranging in size from 0.5 to 1.8 cm. The ovaries and fallopian tubes appeared unremarkable on both gross and microscopic examination, with no evidence of tumor involvement.\n\nLymph node sampling included right and left pelvic regions, left and right common iliac, left and right periaortic locations, and omentum. A total of 38 pelvic and para-aortic lymph nodes were evaluated, all negative for malignancy. The omental specimen contained a single calcified hyalinized nodule without any malignant features.\n\nHistologic analysis confirmed invasive growth with high-grade nuclear features and extensive solid growth pattern. Tumor invasion was limited to the inner half of the myometrium without extension to cervical structures. Based on these findings, the tumor demonstrated regional confinement without nodal or distant spread."} +{"pid": "TCGA-ZM-AA0E", "report": "A left testicular specimen was received as an urgent biopsy. The primary specimen measured 5.0 x 3.5 x 2.5 cm and included a funiculus measuring up to 2.5 cm in diameter and 11 cm in length. A white, irregular tumor measuring 3.0 x 2.5 x 2.0 cm was identified within the testicular tissue. Histological examination revealed solid clusters of cells with round and oval nuclei containing prominent nucleoli and moderately abundant cytoplasm that varied from bright to pink. Surrounding stromal tissue contained numerous lymphocytic infiltrates. At the periphery of the testicle, isolated tubular structures were noted to be positive on histochemical staining for PLAP, consistent with unclassified intratubular germ cell neoplasia. The tumor did not extend into the funiculus, capsule, or vascular spaces, nor was it present in the rete testis.\n\nA second biopsy specimen, measuring 1.0 cm in diameter and 0.6 cm in thickness, was also examined. Histological analysis confirmed two distinct foci of similar cellular morphology, each measuring approximately 0.4 cm in diameter. Immunohistochemical staining demonstrated positivity for CD117 and partial positivity for PLAP in the neoplastic cells."} +{"pid": "TCGA-BH-A1EX", "report": "The patient underwent a right segmental mastectomy and sentinel lymph node biopsy. The surgical specimen included a lymph node measuring 0.8 x 0.6 x 0.5 cm, which showed no evidence of malignant cells on touch preparation. Histologic evaluation of the lymph node revealed minute clusters of metastatic cells in one section, identified through serial sectioning and confirmed with immunostaining. Additional sections of the node were negative.\n\nIn the right breast tissue, a lesion measuring 2.5 x 2.0 x 1.5 cm was identified. Histologic analysis revealed moderately differentiated infiltrating ductal carcinoma with a Nottingham score of 6 out of 9 (tubules: 3, nuclei: 2, mitosis: 1). A component of non-comedo type ductal carcinoma in situ, solid and cribriform pattern, nuclear grade 1, accounted for approximately 5% of the overall tumor mass. Multiple small foci of infiltrating adenocarcinoma, up to 0.5 cm in size, were also found in the surrounding breast tissue.\n\nMargins of resection were positive at the lateral and inferior aspects for invasive tumor. Additional findings in the remaining breast tissue included intraductal papilloma and proliferative fibrocystic changes. Areas of necrosis and granulation tissue were noted, likely related to prior core biopsy.\n\nImmunohistochemical analysis was performed on the primary lesion. Estrogen receptor staining demonstrated an H-score of 90 (40% at 0 intensity, 40% at 1+, 10% at 2+, and 10% at 3+), interpreted as positive. Progesterone receptor staining yielded an H-score of 60 (70% at 0 intensity, 10% at 1+, 10% at 2+, and 10% at 3+), also considered positive. HER-2/neu immunostaining showed weak to moderate complete membrane staining in more than 10% of cells, interpreted as score 2+. Fluorescence in situ hybridization (FISH) analysis demonstrated a HER-2/neu gene to chromosome 17 centromere ratio of 0.94, indicating no gene amplification.\n\nAdditional special stains and immunoperoxidase assays were used during evaluation. These tests have been validated by the laboratory but are not cleared or approved by the U.S. Food and Drug Administration."} +{"pid": "TCGA-HZ-8005", "report": "The surgical specimen included resection of the pancreatic head and body, distal stomach, duodenum, gallbladder, and appendix, along with regional lymph node dissection. The lesion measured 4.5 cm in greatest dimension with additional dimensions of 4 x 2.5 cm. Microscopic evaluation revealed a poorly differentiated epithelial neoplasm. Perineural invasion was present. The tumor extended into the ampulla of Vater, duodenal wall, and duodenal mucosa, and involved peripancreatic soft tissue.\n\nA total of twenty-four lymph nodes were examined, eight of which contained metastatic involvement. The surgical margins were mostly negative, except for focal extension to the inferior anterior margin. No lymphovascular invasion was identified.\n\nHistopathologic assessment showed that the neoplasm nearly completely replaced the head of the pancreas and was pale tan to yellow with areas of central necrosis. The tumor was located 9.5 cm from the distal margin and 14 cm from the proximal margin. It abutted the anterior and posterior surfaces of the pancreas and appeared to be at the distal pancreatic resection margin grossly. The gallbladder was intact without calculi, and the appendix showed fibrous luminal obliteration. Additional findings included chronic cholecystitis, acute and chronic pancreatitis, and pancreatic intraepithelial neoplasia.\n\nStaging parameters indicated pT3 classification based on local invasion, pN1 for lymph node involvement, and R1 margin status. The pathologic stage was determined as IIB."} +{"pid": "TCGA-DK-A2I6", "report": "The specimen includes a radical cystoprostatectomy with removal of the bladder, seminal vesicles, prostate, and perivesical nodes. A mass is identified on the right aspect of the trigone measuring 3 x 2 x 1 cm. The muscularis propria shows deep involvement. Vascular and perineural invasion are present. The right ureteral margin demonstrates atypical changes. Non-neoplastic findings in the bladder include proliferative cystitis. No involvement of the seminal vesicles or perivesical lymph nodes is observed.\n\nA separate focus of invasive carcinoma is noted in the prostate with multicentric foci involving the right anterior, left posterior, and left anterior regions. The primary Gleason grade is 3, secondary grade is 4, with a total score of 7. The tumor remains confined to the prostate capsule without vascular or perineural invasion. Surgical margins are free of tumor involvement.\n\nSegments of both vas deferens are submitted and show no significant pathology. Lymph node dissections from the left and right pelvic regions are performed. Of the 8 lymph nodes on the left, none show metastatic involvement. On the right, 21 lymph nodes are examined, with one metastatic node identified, measuring 0.7 cm in greatest dimension. No extracapsular extension is seen.\n\nAdditional specimens including fat from the anterior prostate, soft tissue from the left anterior abdominal wall, and segments of both ureters are submitted. All demonstrate benign tissue without evidence of malignancy. The right ureteral margin shows atypia, while the left ureter and distal and proximal margins of both ureters appear unremarkable.\n\nGross examination of the bladder reveals marked edema and trabeculation of the mucosa with a firm, well-delineated mass measuring 1.8 cm in thickness. The prostate appears grossly unremarkable. All other tissues submitted are histologically benign."} +{"pid": "TCGA-KL-8328", "report": "The left kidney specimen measures 26 x 15 x 8.5 cm and weighs 1542 grams. A mass within the kidney measures 13.5 cm in greatest dimension and is located in the parenchyma. The tumor extends into the renal sinus and bulges into the renal pelvis but does not fully invade it. No involvement of the renal vein is observed. All surgical margins are free of tumor. The surrounding kidney tissue shows fibrosis and focal chronic inflammation. Focal necrosis and hyalinization are present within the tumor. Vascular invasion is identified within the renal sinus. The adrenal gland is not submitted for evaluation. The perirenal fat and ureter appear unremarkable. \n\nOne para-aortic lymph node and three hilar lymph nodes were submitted, all of which show no evidence of tumor involvement. All lymph nodes were entirely submitted for examination.\n\nSections evaluated include tumor, tumor and normal kidney interface, tumor and capsule interface, normal kidney, renal pelvis, ureteral margin, and vascular margin. Additional sections from the lymph node specimens consisted of undesignated tissue samples. Intraoperative frozen section confirmed the presence of a renal cortical neoplasm, which was corroborated by permanent sections."} +{"pid": "TCGA-18-3409", "report": "A surgical pathology report details the analysis of multiple specimens obtained from lung and lymph node tissues. The specimens included left and right upper lobe resections, wedge resections, lobectomy specimens, and various lymph nodes from locations including the inferior pulmonary ligament, interlobar regions, lobar areas, and right tracheobronchial angle. A bone specimen from the 5th rib was also examined.\n\nIn the left upper lobe wedge resection, a lesion measuring 1.4 cm in greatest diameter was identified. The stapled resection margins were free of tumor involvement. Intraoperative frozen section evaluation was performed on this lesion and showed non-small cell carcinoma morphology favoring squamous cell type. Additional sections were taken from the tumor in relation to the exposed lung parenchyma, pleura, and adjacent tissue.\n\nThe lymph node specimens submitted from various anatomical locations were all grossly and microscopically negative for malignancy. Each lymph node measured less than 2 cm in greatest dimension and showed no pathological changes upon examination.\n\nA separate lobectomy specimen from the right upper lobe contained a well-circumscribed blackish-tan lesion measuring 1.1 cm. This lesion was located approximately 2 cm from the bronchial resection margin. Histological examination revealed similar non-small cell carcinoma morphology favoring squamous cell type. One associated peribronchial lymph node was identified and showed no evidence of malignancy. No additional nodules were identified within the lung parenchyma, which demonstrated mild emphysematous change.\n\nThe right upper lobe wedge resection showed no evidence of tumor involvement. The lung parenchyma exhibited mild emphysematous changes, and both stapled resection margins were removed and submitted for histologic evaluation.\n\nLymph node specimens from the interlobar region on the left side were also negative for malignancy. Gross examination of the 5th rib bone showed no abnormalities; however, no tissue was submitted for histologic evaluation.\n\nIn the left upper lobe lobectomy specimen, no residual tumor was identified. Both stapled and sutured resection margins were clear. Multiple small lymph nodes were identified and submitted for histologic evaluation; all were negative for malignancy.\n\nIn summary, two lesions with similar histological features were identified in different lobes of the lungs. Both were small in size and confined to their respective lobes, with no evidence of lymph node involvement or other metastatic spread. Resection margins across all specimens were negative for tumor involvement."} +{"pid": "TCGA-HC-7744", "report": "The prostate measured 4.5 x 4.0 x 3.7 cm and showed extensive involvement with tumor, affecting nearly the entire gland. The tumor demonstrated invasion into surrounding structures including the nerves, seminal vesicle junction, and adjacent fatty soft tissue. Histologic evaluation revealed a primary pattern of 4/5 and a secondary pattern of 3/5, resulting in a total Gleason score of 7/10. Extracapsular extension was present, and the seminal vesicle was involved. No lymphovascular space invasion was identified. Margins were focally involved at the periphery. Three lymph nodes were examined, and none showed evidence of metastatic disease. Based on these findings, staging was assigned as pT3b, NO. A biopsy of the bladder neck showed only fibrofatty soft tissue without any signs of malignancy. The surgical specimen included the prostate, seminal vesicles, vas deferens, and pelvic lymph nodes. Multiple sections were taken for analysis, including from the base to the apex, around the margins, and from the seminal vesicle junction. Lymph nodes identified within the right fibroadipose tissue ranged from 0.6 to 1.7 cm in size. No discrete mass was identified in the prostate, but there was a slight yellow-tan discoloration noted in the right posterior region near the base, along with diffuse periurethral nodularity."} +{"pid": "TCGA-AP-A056", "report": "The submitted specimens included multiple lymph node groups from both sides, including right and left external iliac, obturator, hypogastric, common iliac, and para-aortic regions. Additionally, surgical specimens included the uterus, cervix, bilateral fallopian tubes and ovaries, and bilateral parametrial tissues. Additional excisions involved portions of the right and left parametrium, paracolpos, vaginal margins, and residual anterior vaginal tissue.\n\nMicroscopic examination of the uterus revealed a lesion with significant myoinvasion. The maximal thickness of the involved myometrium was 2.5 cm, with invasion extending beyond half of the myometrial thickness, measuring 2.4 cm. The tumor exhibited solid growth pattern and high nuclear grade. Stromal and mucosal involvement was identified in the endocervix. Vascular invasion was also present. Incidental findings included a leiomyoma within the myometrium and endometriosis in the right ovary. No residual tumor was identified in the vaginal cuff or in the additional excised vaginal tissue, although those areas showed marked inflammation and reactive changes likely related to prior vaginal packing. All other adnexal structures were unremarkable.\n\nAll lymph nodes examined were benign, with no evidence of metastatic disease. Right external iliac lymph nodes showed follicular hyperplasia. All other lymph node groups\u2014including left and right external iliac, obturator, hypogastric, common iliac, and para-aortic\u2014were negative for malignancy. Each lymph node group was fully excised and assessed, with counts ranging from one to thirteen nodes, all without involvement.\n\nSections from the vaginal cuff and right external iliac lymph node were reviewed in consultation, confirming reactive changes without evidence of neoplasia."} +{"pid": "TCGA-BI-A0VR", "report": "The surgical specimen included a left salpingo-oophorectomy with no abnormal findings in the ovary or fallopian tube. Multiple lymph node biopsies were performed, including two left pelvic, thirteen left obturator, two right pelvic, one right obturator, ten left paraortic, three right paraortic, and two right common lymph nodes\u2014all were free of abnormal cells.\n\nA radical hysterectomy was performed, and the uterus weighed 92 grams. Within the uterine cervix, an area of interest measured 2.5 x 1.8 x 1.5 cm. The tissue showed high-grade nuclear changes and lymphovascular involvement. The lesion originated from a background of severe epithelial alteration and extended across a broad segment of the cervix, involving the posterior region. It approached the nearest resection margin at the posterior aspect to within 1.5 mm. Adjacent chronic inflammatory changes were noted.\n\nThe endometrium displayed proliferative features with cystic changes and a small polyp. A benign fibroid measuring up to 0.5 cm was identified. In the parametrial tissues, tumor involvement was present on both sides\u2014micrometastatic disease was found in one of seven lymph nodes on the left parametrium, while metastatic involvement was confirmed in the right parametrium along with two reactive lymph nodes. The vaginal cuff and a portion of the left fallopian tube showed no signs of involvement.\n\nHistologic evaluation revealed a high mitotic index of 100 mitoses per 10 high-power fields and angiolymphatic invasion. The depth of invasion reached approximately two-thirds of the cervical thickness, with a tumor thickness of 15 mm and horizontal spread of 2.5 cm. Among 42 lymph nodes examined, one parametrial lymph node on the left showed metastatic involvement without extranodal extension.\n\nResection margins were negative at the vaginal cuff but positive at the parametrial margin. Based on these findings, the pathologic staging classification assigned was pT2b, pN1, and pMX."} +{"pid": "TCGA-GS-A9U3", "report": "LEFT INGUINAL LYMPH NODE: A lymph node measuring 3.5 x 3.5 x 2.8 cm is received. The lymph node architecture is replaced by a diffuse and partially nodular lymphoid infiltration composed of large centroblastic cells. These atypical cells are accompanied by abundant small lymphocytes, histiocytes, and plasma cells. Immunohistochemical staining shows the large cells to be positive for CD20, BCL2, BCL6, and IgD, and negative for CD10 and MUM1. Kappa light chain restriction is present. The background small lymphocytes are CD3 positive. The Ki-67 proliferative index is estimated at 50\u201360%. Molecular studies demonstrate BCL2 gene rearrangement."} +{"pid": "TCGA-HT-7477", "report": "The neoplasm is composed of a mixture of cellular morphologies. A significant portion of the tumor cells exhibit an oligodendroglial appearance with perinuclear halos and fine branching vasculature, while a notable minority display an astrocytic morphology. The tumor demonstrates moderate to focally marked atypia and frequent mitotic figures. No microvascular proliferation or necrosis is identified. The neoplastic cells are diffusely positive for p53, and MIB-1 staining shows a labeling index of approximately 20%. In some areas, less cellular regions of the tumor are present, showing a more infiltrative pattern. One area of the specimen shows a more hypercellular component involving both gray and white matter. Although a small subset of cells may suggest alternative differentiation, the overall immunoprofile and morphology are not consistent with that."} +{"pid": "TCGA-AA-A00E", "report": "The specimen consists of a right hemicolectomy with an ulcerated lesion located 1.5 cm from Bauhin's valve. The lesion extends circumferentially through the intestinal wall over a length of 8 cm. There is invasive growth through all layers of the intestinal wall, reaching into the mesocolic fatty tissue and approaching the serosal surface. The appendix appears unaffected with fibrotic changes in the wall. Both oral and aboral resection margins, as well as the greater omentum, show no signs of tumor involvement. Examination of 41 regional lymph nodes reveals no presence of tumor cells, with findings consistent with reactive changes. Histological evaluation indicates high-grade cellular atypia. No vascular or perineural invasion is identified. The surgical margins are clear."} +{"pid": "TCGA-QR-A70R", "report": "The right adrenal specimen measured 8.4 x 5 x 3.5 cm and weighed 51 grams. The external surface was inked black, and upon sectioning, a variegated pink-red nodule measuring 8.4 x 4 x 3.5 cm was identified in the medullary region. This nodule was partially covered by a cortical layer up to 0.4 cm thick. Photographs were taken of the gross specimen. Tissue procurement included a central portion of the nodule (approximately 1 x 1 x 0.5 cm) and a sample of normal-appearing adrenal gland (0.8 x 0.4 x 0.3 cm), along with a sample of surrounding fat (1 x 1 x 0.5 cm). The remaining tissue was placed into formalin for permanent processing.\n\nThe gallbladder specimen was intact and turgid, measuring 8.6 x 3.5 x 3.2 cm. The serosal surface was smooth and glistening, while the liver bed was rough and irregular. The cystic duct was patent and measured 0.3 cm in diameter, closed by surgical clips. The lumen contained multiple yellow-green gallstones ranging from minute to 0.9 cm in maximum dimension. The mucosa appeared tan-green with slight trabeculation, and the wall thickness was up to 0.3 cm. Representative sections of the mucosa and the cystic duct margin were submitted for histologic evaluation."} +{"pid": "TCGA-NP-A5H5", "report": "The surgical specimen from a right radical nephrectomy was received and evaluated. The right kidney contained a unifocal lesion located in the upper pole, measuring 4.5 x 4 x 2.4 cm. The lesion had a yellow-red, hemorrhagic appearance. On gross examination, the tumor abutted the renal capsule but did not extend beyond it, and no involvement of the renal vein or adjacent adipose tissue was observed. The remainder of the renal cortex appeared unremarkable.\n\nMicroscopically, the lesion showed nuclei with slight irregularity, approximately 15 micrometers in size, with evident nucleoli. No tumor necrosis or sarcomatoid differentiation was identified. The tumor was confined to the kidney without lymphatic or vascular invasion. Resection margins were free of tumor involvement. No other significant abnormalities were found in the surrounding kidney tissue.\n\nStaging parameters indicated the tumor was limited to the kidney, measuring greater than 4 cm but less than 7 cm in greatest dimension, with no regional lymph node assessment possible and no evidence of distant metastasis. Eleven cassettes were submitted for histologic evaluation, including sections of the tumor, adjacent and uninvolved parenchyma, margins, and hilar fat. No lymph nodes were identified in the associated adipose tissue."} +{"pid": "TCGA-D1-A17C", "report": "The specimen consists of a uterus with attached bilateral fallopian tube remnants and ovaries. A polypoid mass measuring 2.9 x 2.5 x 1.1 cm is present in the posterior and left lateral wall of the endometrial cavity. Microscopic evaluation shows superficial invasion to a depth of 0.3 cm into the myometrium, which has a total thickness of 2.2 cm. The lower uterine segment is not involved. No lymphovascular space invasion is observed, and all surgical margins are free of abnormal cells. The cervix appears unremarkable. Two intramural leiomyomas, measuring 0.5 cm and 0.6 cm, and a single subserosal leiomyoma measuring 0.5 cm are identified within the myometrium. Both ovaries and remaining fallopian tube segments show no significant findings. Based on the available surgical material, the staging classification is pT1bNX according to AJCC 7th edition criteria. Permanent sections confirm the findings from the frozen section and gross examination. Any changes upon further review will be reported separately."} +{"pid": "TCGA-A5-A0GJ", "report": "The submitted specimens include a hernia sac, bilateral ovarian and fallopian tube tissues, a uterus and cervix, multiple omental biopsies, lymph nodes from various locations, bladder biopsies, and an appendix. The hernia sac consisted of fibroadipose and fibrovascular tissue with marked acute inflammation, abscess formation, and reactive granulation tissue. No malignancy was identified in this specimen.\n\nA right ovary specimen showed a multiloculated cystic mass with a solid tan-pink-yellow component measuring 10.0 x 10.0 x 8.0 cm. Microscopically, the tumor was composed of high-grade cells with clear cytoplasm. A segment of attached fallopian tube showed no abnormalities. The contralateral ovary showed multiple small cysts, inclusion glands, and involutional changes.\n\nThe uterus measured 11.0 cm from fundus to cervix with a total weight of 140 grams. A polypoid mass was identified in the lower uterine segment, both anterior and posterior, measuring 3.0 x 1.7 x 1.2 cm. Another endometrial polyp was found in the fundus. Histologic evaluation of the endometrium showed a mix of benign proliferative tissue adjacent to areas of interest. The cervix and myometrium showed no significant involvement.\n\nMultiple omental biopsies were received, each ranging in size up to 45.0 x 15.0 x 1.0 cm. All were composed of yellow, soft, lobulated adipose tissue with no identifiable masses or lesions.\n\nLymph node dissections included left and right pelvic, periaortic, and obturator regions, as well as gutter and parametrial tissues. Lymph node sizes ranged from 0.3 to 3.5 cm. All lymph nodes showed benign features without evidence of metastatic disease. The bladder biopsies and appendix were unremarkable, with the latter showing fibrosis and luminal obliteration.\n\nImmunostains were performed on representative sections from the right ovary and uterus, showing positivity for relevant markers, indicating no loss of key proteins."} +{"pid": "TCGA-B2-5635", "report": "The specimen consists of a right kidney weighing 762 grams and measuring 18 \u00d7 11.5 \u00d7 8.5 cm. A segment of ureter, 5 cm in length and 0.4 cm in diameter, is present. An irregular fragment of yellow-orange tissue measuring 4 \u00d7 1.4 \u00d7 0.3 cm is identified within the perirenal fat. The kidney measures 11.5 \u00d7 7 \u00d7 5.5 cm and has a smooth tan-pink capsule that strips easily. A spherical, well-defined yellow-orange lesion measuring 3 cm in diameter is located in the upper portion of the kidney. The lesion appears confined to the kidney and is 2 cm from the nearest surface. The renal pelvis is smooth and glistening. The unaffected renal parenchyma is red-brown with a distinct corticomedullary junction and a maximum cortical thickness of 1.4 cm. No other focal abnormalities are noted.\n\nHistologically, the lesion demonstrates clear cell morphology with nuclear grade 2 features. The lesion measures 3 cm in greatest dimension and is entirely contained within the kidney. Surgical margins are free of involvement. Evaluation of regional lymph nodes and distant metastasis is not possible (pNX, pMX). No vascular invasion is identified. The adrenal gland fragment does not show any abnormal histologic findings. Adjacent non-neoplastic kidney tissue shows sclerotic glomeruli and chronic inflammation near the lesion. Tubular cells contain pigment consistent with lipofuscin."} +{"pid": "TCGA-EM-A3O7", "report": "The surgical specimen included a right upper and left lower parathyroid tissue sample, both of which were small in size, measuring 0.5 x 0.5 x 0.3 cm and 0.2 x 0.2 x 0.1 cm respectively. These were submitted for intraoperative evaluation and no abnormal tissue was identified. A total thyroidectomy specimen was also received, oriented with a suture and weighing 69.32 grams. The right lobe measured 4.8 cm in length, 5.1 cm in width, and 3.5 cm in depth. The left lobe measured 3.8 cm in length, 2.4 cm in width, and 1.6 cm in depth. The isthmus measured 2.0 cm in length, 3.1 cm in width, and 2.2 cm in depth. The external surfaces showed fibrous adhesions and no parathyroid tissue or lymph nodes were noted on gross examination.\n\nA well-defined solid to cystic nodule was identified in the right lobe, measuring 4.7 x 5.0 x 3.4 cm. Multiple sections of this nodule and surrounding normal thyroid tissue were submitted for analysis. Microscopic evaluation revealed multiple foci of altered cellular architecture. In the right lobe, the dominant lesion displayed classical papillary architecture and cytomorphology, measuring 5.0 cm in its largest dimension. The tumor was completely encapsulated, with no evidence of capsular invasion, lymphovascular invasion, or perineural involvement. Margins were free of involvement. A second focus was identified in the isthmus, measuring 0.35 cm, showing follicular variant features and microscopic growth patterns. It lacked a distinct capsule and did not demonstrate invasion or margin involvement. Additional small foci were identified in the left lobe, consistent with microcarcinomatous changes.\n\nStaging parameters were assigned based on size and extent. The larger lesion exceeded 4 cm in size and was confined to the thyroid without significant extension beyond the organ. No regional lymph nodes were identified in the specimen, and no distant metastatic spread was evident. All surgical margins were uninvolved. Tissue integrity was maintained upon receipt, and all samples were processed for further analysis."} +{"pid": "TCGA-XU-AAY1", "report": "The specimen consists of a thymus gland measuring 12.5 x 6.1 x 3.0 cm and weighing 71 grams. A well-circumscribed, encapsulated mass is identified within the thymus, measuring 7.0 x 5.0 x 3.5 cm. The tumor has a firm, solid, whitish-tan cut surface and appears grossly encapsulated with a mobile capsule. Adjacent thymic tissue shows involutional changes with a yellowish-tan appearance and fatty consistency. No additional nodules are observed.\n\nMicroscopic examination reveals alternating areas of bland spindled cells and polygonal epithelioid cells intermixed with small round lymphocytes. The tumor is encapsulated, and there is focal microscopic invasion of the capsule with extension into adjacent mediastinal fat. Immunohistochemical staining demonstrates positivity for keratins (CK5/6, AE1/AE3) and p63 in the epithelial component. Lymphocytes are positive for CD5, and CD20 highlights focal positivity in lymphocytes and occasional epithelial cells. CD1a is non-reactive. Margins are free of tumor involvement.\n\nA separate lymph node biopsy from the innominate vein lymph node shows no evidence of malignancy. Based on histologic and immunophenotypic features, the lesion exhibits characteristics consistent with a staged classification based on microscopic transcapsular extension. No regional lymph node metastasis is identified, and distant metastasis cannot be assessed."} +{"pid": "TCGA-Q3-AA2A", "report": "The specimen consists of a Whipple resection including the head of the pancreas, duodenum, and common bile duct. A white-tan mucinous tumor mass measuring 3.5 x 3.0 x 1.7 cm is present in the pancreatic head, obstructing the main pancreatic duct. The tumor is grossly 1.2 cm from the ampulla of Vater and does not involve the duodenal muscularis mucosa. It is located 3.5 cm from the distal resection margin and within 1 mm of the retroperitoneal margin microscopically. Histologically, the lesion demonstrates well-differentiated features with invasion into peripancreatic and retroperitoneal soft tissues. Surgical margins are uninvolved by tumor, though the tumor approaches closely to the retroperitoneal margin.\n\nLymph node evaluation reveals involvement of nine out of twenty-six regional lymph nodes. Perineural invasion is identified; vascular invasion is not present. Pathologic staging is pT3 for local extension beyond the pancreas without involvement of major vessels. Regional lymph node metastasis is confirmed (pN1). No distant metastasis is identified.\n\nAdditional findings include chronic pancreatitis and pancreatic intraepithelial neoplasia (PanIN 1b). The remainder of the duodenal and jejunal specimens show no significant histopathologic abnormalities. The jejunal mucosa appears normal with no pathological changes identified.\n\nAncillary studies were not performed. No prior treatment was administered. All margins have been evaluated with ink marking used to identify specific resection margins. Multiple cassettes were submitted for microscopic analysis, including sections from the bile duct, pancreatic, and retroperitoneal margins, lymph nodes, and tumor relationships to surrounding structures."} +{"pid": "TCGA-A8-A08B", "report": "The specimen demonstrates two distinct foci of poorly differentiated invasive neoplasm. The larger focus measures 2.5 cm in diameter, while the smaller focus measures 0.7 cm. Both demonstrate high-grade nuclear features and infiltrative growth patterns. A component of intraductal proliferation is present in focal areas. Lymphovascular invasion is identified. The lesions are classified as multifocal with nodal involvement noted in a sentinel lymph node."} +{"pid": "TCGA-DQ-5630", "report": "The specimen consisted of a partial glossectomy measuring 1.7 x 1.0 cm with a 1.2 cm depth of invasion identified on the lateral tongue. A defect measuring 1.7 x 1.0 cm was noted in the lateral surface, and a white mass measuring 2.5 x 1.2 x 3.2 cm was observed, appearing close to the inked margin. The lesion was ulcerating with an infiltrative border, moderate perineural invasion, and mild lymphocytic infiltration. Vascular invasion was not present. All surgical margins were free of tumor.\n\nLymph nodes from right neck dissections were evaluated. In level I, one of eight lymph nodes contained metastatic involvement without extranodal extension. Levels II, III, and IV contained 21, 14, and 6 negative lymph nodes respectively, with no evidence of metastasis. Additional control tissue samples from lingual nerve, hyoglossus, genioglossus, and floor of mouth mucosa were all negative for involvement. Frozen section analysis confirmed intraoperative margin negativity, and permanent sections were consistent with these findings."} +{"pid": "TCGA-L6-A4EP", "report": "The specimen from the right thyroid lobe and isthmus measured 5.4 x 3 x 2.5 cm and weighed 14.9 grams. A nodule measuring 3 x 2.4 x 2.4 cm was identified within the right thyroid lobe. The nodule had a friable tan-pink glistening cut surface. Histologic examination revealed a classical papillary architecture with corresponding cytomorphology. The tumor was totally encapsulated and showed multiple foci of capsular invasion. Margins were uninvolved, although the tumor closely approached the inked margin. No lymph-vascular invasion or extrathyroidal extension was identified. Three lymph nodes were examined, none showed involvement. Staging indicated a primary tumor greater than 2 cm but not more than 4 cm confined to the thyroid gland. One parathyroid gland showed slight hypercellularity. All specimens were processed as described, with portions submitted for permanent sections and others held overnight for further processing."} +{"pid": "TCGA-BH-A0H5", "report": "A single lymph node was excised from the right axillary region and showed no evidence of metastatic involvement. A mastectomy specimen from the right breast contained two invasive lesions. The largest measured 1.7 cm and was located at the junction of the upper outer and lower outer quadrants. A second invasive lesion measured 1.0 cm and was situated in the upper outer quadrant, positioned superomedial to the larger focus. Both invasive areas exhibited similar morphologic features. Histologic grading using the Nottingham system yielded a total score of 6 (tubule formation: 3, nuclear pleomorphism: 2, mitotic activity: 1), corresponding to an intermediate grade. In addition, in situ components were identified, displaying solid, cribriform, and micropapillary patterns, with associated microcalcifications. These in situ elements accounted for approximately 10% of the larger tumor mass and 20% of the smaller tumor mass, and were found admixed with and adjacent to the invasive portions. No lymphovascular space invasion was observed. Resection margins were free of involvement, with distances exceeding 0.5 cm from the tumor foci. Additional findings included atypical ductal hyperplasia, fibrocystic changes, columnar cell change, pseudoangiomatous stromal hyperplasia, and focal microcalcifications. Changes related to prior biopsy were noted at both tumor sites. Immunohistochemical analysis showed that both invasive tumors expressed estrogen and progesterone receptors, while showing no reactivity for HER-2/neu. Pathologic staging was determined as pT1c for the primary tumor, with no lymph node involvement (pN0). Non-neoplastic breast tissue showed benign alterations. Microscopic evaluation of the lymph node utilized hematoxylin and eosin staining. Benign and malignant calcifications were present. Surgical margins were not involved by either invasive or in situ components."} +{"pid": "TCGA-E2-A14W", "report": "The surgical specimens included four sentinel lymph nodes (SLN #1, #2, #3, and #4), a left breast mastectomy specimen, and additional tissue samples from the upper outer quadrant and inferior medial margin of the left breast. All sentinel lymph nodes were negative for tumor involvement. The left breast mastectomy specimen measured 20 x 14.5 x 2 cm with a skin ellipse of 11.5 x 5.2 cm and an inverted, ulcerated nipple measuring 1.6 cm. Serial sectioning identified a white-tan, firm, well-circumscribed mass measuring 2.5 x 2 x 1.5 cm beneath the nipple, located 1.2 cm from the deep margin. The mass was present in slices 5 through 7. No discrete lesions were identified in the submitted fibrofatty tissue from the upper outer quadrant or the inferior medial margin. Histologic evaluation of the margins showed no tumor involvement. One axillary lymph node was identified and showed no tumor, though it contained non-necrotizing granulomas. Special stains performed on this lymph node were negative for fungal or acid-fast organisms.\n\nMicroscopic analysis of the tumor showed features consistent with high-grade morphology, including a tubular score of 3, nuclear grade 3, and mitotic score of 3, resulting in a Modified Scarff Bloom Richardson Grade of 3. There was no evidence of necrosis or lobular neoplasia. Immunohistochemical staining showed positivity for ER and PR, and HER2 positivity was confirmed by FISH. No lymphovascular invasion was detected based on CD31 staining. No DCIS was identified. Pathologic staging was determined as pT2N0."} +{"pid": "TCGA-MM-A563", "report": "The left nephrectomy specimen contained a unifocal, encapsulated mass measuring 7.2 cm in greatest dimension, located in the mid portion of the kidney. The tumor was identified adjacent to the renal pelvis and was in close proximity to the inked surgical margin (0.3 cm), but did not extend into the perinephric fat. The mass was surrounded by adipose tissue and was 7 cm from the ureter, 1.7 cm from the vein, and in contact with the artery. On gross examination, the cut surface of the mass was lobulated, with a golden-yellow to red and variegated appearance. The remaining kidney parenchyma appeared homogeneous with an ill-defined cortical-medullary junction and a cortical thickness of 0.6 cm. No adrenal gland was present in the specimen.\n\nHistologically, the tumor cells were arranged in a conventional growth pattern, with nuclear features corresponding to Fuhrman grade 2. No sarcomatoid differentiation or tumor necrosis was observed. Lymphovascular and perineural invasion were not identified. Surgical margins were free of tumor involvement. Multiple representative sections were submitted for analysis, including areas near vascular and ureteral margins, hilar fat, and normal kidney parenchyma."} +{"pid": "TCGA-D8-A3Z6", "report": "The left breast measured 27.4 x 15.4 x 6.8 cm and was removed along with axillary tissue measuring 10x11x5 cm, and a skin flap of 20.2 x 8.2 cm. A lesion measuring 6.2 x 3.6 x 4.8 cm was identified in the central region, located 1.4 cm from the upper margin, 0.8 cm from the base, and 0.6 cm beneath the skin. The area showed changes consistent with prior removal of a fragment. Axillary lymph nodes were present, with the largest measuring 3.3 cm in length.\n\nMicroscopic evaluation revealed a multifocal growth pattern involving both invasive and non-invasive components. The invasive component exhibited features of histocytoid-type cells arranged in a lobular pattern, with a nuclear grade of 2. Mitotic activity was noted at a rate of 7 per 10 high-power fields. A component of ductal carcinoma in situ was also present, characterized by a solid growth pattern, high-grade nuclear atypia, and comedo-type necrosis, accounting for approximately 10% of the overall lesion. No abnormal findings were observed in the nipple. The surrounding glandular tissue displayed fibrocytoid changes and adenosis.\n\nExamination of 22 axillary lymph nodes showed involvement in 19, with evidence of perilymphatic invasion."} +{"pid": "TCGA-HU-A4HB", "report": "The specimen was obtained via laparoscopic distal gastrectomy and laparoscopic cholecystectomy. The fresh specimen measured 17.0 cm along the greater curvature, 9.0 cm along the lesser curvature, with proximal and distal resection margins measuring 13.0 cm and 5.3 cm respectively. A lesion was identified on the anterior wall of the mid-antrum, presenting as an ulcerofungating mass measuring 3.0 x 3.0 x 1.3 cm. The lesion was located 2.0 cm from the proximal resection margin and 5.0 cm from the distal resection margin. No gross serosal invasion was observed. The duodenum measured 0.3 cm in diameter.\n\nThe gallbladder measured 9.2 cm in length and 3.0 cm in diameter. Four black, hard stones were identified, ranging in size from 0.6 x 0.5 x 0.2 cm to 1.5 x 1.1 x 0.2 cm. The serosal surface appeared yellowish pink, while the mucosal surface was brown to yellow and velvety. The wall thickness was 0.2 cm. Representative sections were submitted for analysis.\n\nTissue blocks included tumor and surrounding tissue (x5), antrum mucosa (x2), body mucosa (x1), proximal resection margin (x1), distal resection margin (x1), and multiple lymph node groups: superior gastric (x2), inferior gastric (x2), '1' (x1), '5' (x1), '6' (x1), '7' (x1), '8' (x1), '9' (x1), '11p' (x1), and '12' (x1). One block was taken from the gallbladder.\n\nMicroscopically, the lesion exhibited features consistent with a specific cellular morphology. Invasion was noted to a certain depth, though not reaching the resection margins. The growth pattern was expanding with moderate lymphoid reaction. Lymphovascular invasion was present, but no venous or perineural invasion was identified. Of the lymph nodes examined, metastatic involvement was found in 5 out of 43 nodes. Staging was determined based on these findings.\n\nSpecial stains for a specific infectious agent were negative. The gallbladder showed evidence of autolysis and cholelithiasis without other significant pathological findings."} +{"pid": "TCGA-BP-4325", "report": "The left kidney specimen measured 11 x 8 x 4.5 cm and included a ureter measuring 6 cm in length. A mass measuring 4.5 x 3.5 x 3 cm was identified in the upper pole of the kidney. The mass appeared as a bright yellow, ovoid lesion with a central area of white-gray glistening change. It bulged beyond the renal cortex but remained confined within the renal capsule. No involvement of the renal vein was observed. Surgical margins were free of abnormal tissue. The remainder of the kidney showed only focal chronic inflammation. \n\nA separate specimen consisting of a portion of the left 11th rib measured 2.5 x 1.0 x 1.0 cm and showed no significant microscopic findings after decalcification and sectioning.\n\nPeri-hilar tissue submitted measured 2.0 x 2.0 x 1.0 cm and consisted of benign fatty tissue, including a lymph node and fibroadipose tissue, with no evidence of abnormal cellular changes.\n\nThe left adrenal gland specimen measured 4.0 x 1.0 x 1.0 cm and showed normal microscopic architecture with no remarkable findings.\n\nAll tissues examined were otherwise unremarkable aside from the described features."} +{"pid": "TCGA-2Z-A9JR", "report": "The specimen from a right partial nephrectomy measured 3.9 x 2.8 x 2.9 cm and weighed 13.1 grams. On gross examination, an irregular, rubbery intraparenchymal mass was identified, measuring 2.8 x 2.5 x 2.4 cm. The mass bulged the renal capsule and was located 0.3 cm from the closest parenchymal resection margin. The cut surface of the tumor was tan-brown with areas of hemorrhage. Microscopically, the lesion showed papillary architecture. Nuclear grading was II-III, predominantly III. Less than 5% tumor necrosis was present, and no sarcomatoid features were identified. The tumor was confined to the kidney without angiolymphatic, lymph-vascular, or perineural invasion. All surgical margins were free of involvement. The ipsilateral adrenal gland was not present in the specimen. Pathologic staging was determined to be pT1a, indicating a tumor no greater than 4 cm in size limited to the kidney. Regional lymph nodes could not be assessed, and there was no evidence of distant metastasis. A separate specimen labeled as \"deep margin\" consisted of a fragment of renal parenchyma measuring 1.7 x 1.2 x 0.7 cm. This specimen was entirely submitted for frozen section and showed no evidence of malignancy. All slides and materials were personally reviewed by the attending pathologist."} +{"pid": "TCGA-S9-A6TZ", "report": "The morphology demonstrates features of astrocytic differentiation. No mitotic activity is identified. The proliferation index is 2%."} +{"pid": "TCGA-XF-A9SW", "report": "A radical cystoprostatectomy with ileoconduit and bilateral pelvic lymph node dissection was performed. Gross examination of the bladder revealed an ulcerated mass on the posterior wall measuring 3.5 x 2.3 cm, extending through the full thickness of the bladder wall and into the perivesical soft tissue. Microscopic evaluation showed a poorly differentiated invasive lesion involving the full thickness of the bladder wall with extension into perivesical soft tissue. Lymphovascular invasion was identified. Adjacent to the invasive lesion, there was evidence of high-grade urothelial atypia consistent with in situ changes. Two diverticula were identified, one containing a 1.2 cm bladder stone. A separate non-invasive papillary lesion of intermediate differentiation was found within one diverticulum. The surgical margins were free of malignant or pre-malignant changes.\n\nThe prostate showed bilateral involvement by a moderate to poorly differentiated glandular lesion, Gleason\u2019s score 7 (4+3), with focal extension into extraprostatic skeletal muscle. No involvement of the seminal vesicles or periprostatic soft tissue was observed. All resection margins were negative for malignancy. The ureters, both proximal and distal segments, showed no evidence of dysplasia or malignancy. Inflammatory changes with reactive atypia were noted in the trigone and bladder neck region.\n\nLymph node analysis included 19 nodes from bilateral pelvic groups. Metastatic involvement was identified in four lymph nodes: one out of 11 left pelvic nodes and three out of eight right pelvic nodes, with the largest involved node measuring 1.2 cm. No other significant findings were noted in the submitted tissues. Multiple sections were evaluated, and all relevant areas were assessed for tumor involvement."} +{"pid": "TCGA-23-1123", "report": "Surgical pathology report. Hospital number, date of birth, and social security number provided. Attending physician noted. \n\nSpecimen from pelvic adhesions showed predominantly mature adipose tissue with one lymph node exhibiting reactive follicular hyperplasia. No malignancy was identified. Omental specimens revealed mature adipose tissue with focal reactive mesothelial changes and occasional multinucleated foreign-body giant cells, also without evidence of malignancy.\n\nRight salpingo-oophorectomy specimen showed involvement of the ovary and paratubal soft tissue by a high-grade epithelial-like tumor with papillary features; the fallopian tube was not directly involved. A benign cystic structure of mullerian origin was noted in the paratubal region. The left salpingo-oophorectomy specimen demonstrated replacement of the ovary and infiltration of paratubal soft tissue by a similar high-grade tumor.\n\nBiopsy of periureteral tissue showed involvement by the same high-grade tumor. Frozen section analysis of ovarian tissue confirmed presence of a high-grade tumor with extensive necrosis. A lymph node examined during surgery contained metastatic tumor cells of similar morphology.\n\nGross examination of pelvic adhesions included a 2.0 x 1.5 x 0.7 cm fragment of tan-yellow fat. The periureteral biopsy measured 1.8 x 1.3 x 1.2 cm and consisted of tan tumor tissue. Frozen section number 1, measuring 2.0 x 1.5 x 0.2 cm, was described as tan friable tissue. Frozen section number 2, labeled as a lymph node, measured 1.5 x 1.5 x 0.7 cm and appeared firm and tan. The excised ovarian tumor measured 2.5 x 2.0 x 1.5 cm and was described as soft, brown, congested, and necrotic.\n\nMicroscopic findings were consistent with the above descriptions. Intraoperative frozen section consultation confirmed presence of a high-grade malignant neoplasm in ovarian tissue and metastasis to a lymph node. Multiple representative sections were submitted for evaluation."} +{"pid": "TCGA-EL-A3T3", "report": "A right inferior parathyroid tissue fragment measuring 0.4 x 0.3 x 0.3 cm was received and entirely submitted for frozen section, showing parathyroid tissue. A total thyroidectomy specimen with an attached right nodule was also received. The right thyroid nodule measured 1.2 x 0.5 x 0.3 cm and was submitted entirely. The right thyroid lobe measured 4.0 x 2.0 x 1.4 cm and appeared grossly unremarkable. The left thyroid lobe measured 4.0 x 4.0 x 2.5 cm and contained a soft, ill-defined nodule measuring 3.5 x 3.5 cm. This nodule was friable, cystic, and fibrotic, with well-circumscribed margins and no involvement of the surgical margins. The specimen included nearly the entire left lobe except for approximately 0.5 cm of normal-appearing thyroid tissue at the superior aspect. Tissue sections from the right lobe, isthmus, and left lobe were submitted across multiple cassettes. All resection margins were free of abnormal tissue. The left thyroid nodule was entirely submitted for analysis."} +{"pid": "TCGA-AO-A1KT", "report": "The left breast lesion measured 1.9 cm microscopically and was characterized by poorly differentiated invasive carcinoma with high-grade nuclear features. Adjacent to the invasive component, there was a focus of in situ carcinoma involving less than 25% of the total tumor mass. The in situ component exhibited solid and cribriform growth patterns with intermediate to high nuclear grade and areas of necrosis. Margins were evaluated, including superior, medial, inferior, lateral, and deep aspects of the breast specimen, with no residual tumor identified at these margins.\n\nLymph nodes were assessed from the left axillary region. One lymph node contained a small cluster of abnormal cells within a capsular lymphatic vessel, identified using cytokeratin immunostaining. Two additional lymph nodes showed no abnormal cellular features on histologic examination and immunostains for cytokeratins. An additional suspicious lymph node was also submitted for evaluation but showed no evidence of involvement.\n\nHER2 gene amplification testing was performed using fluorescence in situ hybridization (FISH) on representative tumor tissue. The HER2/CEP17 ratio was calculated as 1.4, below the threshold for gene amplification. Adequate tumor cellularity was confirmed with more than 20 invasive tumor cells counted per assessment. The average HER2 probe signals per nucleus were 2.4, while the average CEP17 chromosome probe signals were 1.7 per nucleus.\n\nAll specimens were processed and examined microscopically, with findings based on personal review and interpretation."} +{"pid": "TCGA-ET-A39K", "report": "The specimen consisted of a total thyroidectomy and excised lymph nodes. The left lobe tumor measured 4.0 cm in greatest dimension and was multifocal, with additional foci identified in the right lobe. Examination of the regional lymph nodes revealed involvement in 11 out of 14 level VI nodes, including pretracheal, paratracheal, and prelaryngeal locations. The primary tumor demonstrated minimal extrathyroidal extension, corresponding to a pT3 classification. Regional lymph node involvement was classified as pN1a. Distant metastasis could not be assessed (pMx). The surgical margins were involved by invasive carcinoma at the lower left lobe. Histologic evaluation showed evidence of venous and lymphatic invasion. An additional finding included the presence of a parathyroid gland within the specimen."} +{"pid": "TCGA-F5-6861", "report": "The specimen consists of a resected portion of the large intestine. The lesion measures 6 x 6 x 1.5 cm and is located in the rectal area. It exhibits an exophytic, polypoid growth pattern. Microscopic evaluation shows moderately differentiated cellular features. The lesion extends into the surrounding perirectal tissues. A total of 8 regional lymph nodes were examined, and none showed evidence of involvement. No other significant pathological findings were noted."} +{"pid": "TCGA-57-1993", "report": "The surgical specimens include a right ovary measuring 10.6 cm in greatest dimension, with extensive involvement by malignant cells. The tumor nearly replaces the entire specimen. A segment of the right fallopian tube shows mucosal and serosal involvement. The omentum contains areas of metastatic involvement. The left ovary measures 9.1 cm and is also almost entirely replaced by tumor, with lymphovascular space invasion noted. No fallopian tube was identified on the left side.\n\nBiopsies from the left and right peritoneal gutters, diaphragm, and sigmoid mesenteric implant all show evidence of metastatic disease. Within the uterus, there is involvement at multiple sites, including the cervix, endometrial stroma, myometrial vessels and connective tissue, and the serosa. A small focus of high-grade cellular abnormality is seen in the cervical transition zone, along with multiple foci of metastatic involvement in vascular spaces and submucosal regions. Benign findings include an endocervical polyp, an endometrial polyp, and several hyalinized leiomyomas.\n\nGross examination of the right ovary revealed a cyst measuring 10.8 cm in diameter, with shaggy, discolored surfaces. The left ovary contained a gritty, calcified nodule. The hysterectomy specimen showed multiple dense nodules within the myometrium, ranging from 0.4 to 1.8 cm, with the largest exhibiting a hard, gritty cut surface. The peritoneal biopsies ranged in size from 0.4 cm to 8.4 cm, with variable texture but consistent histologic evidence of involvement.\n\nStaging is determined as T3NXMX based on these findings."} +{"pid": "TCGA-G7-6792", "report": "The specimen consists of multiple tissue samples obtained from the left kidney and surrounding areas. A tumor specimen measured 6.2 x 4.6 x 3 cm and exhibited a tan-pink, cystic, friable, well-circumscribed appearance located just beneath the renal capsule. Adjacent renal parenchyma contained two small benign-appearing cortical cysts measuring 0.4 cm and 0.7 cm. Histologic evaluation revealed a growth pattern characterized by papillary architecture with morphologic features including focal cytoplasmic clearing. Nuclear grading was assessed as Fuhrman's grade 3. No vascular or lymphatic invasion was identified. The tumor was confined entirely within the kidney without extension into perinephric tissues. Surgical margins were negative for involvement. Additional findings in the adjacent renal parenchyma included acute and chronic tubulointerstitial nephritis along with focal glomerulosclerosis. No tumor was identified in the fat overlying the tumor site or in the additional renal tissue fragments evaluated. The tumor was unifocal based on histologic correlation. Pathologic staging is determined as pT1b Nx Mx."} +{"pid": "TCGA-2J-AABK", "report": "Surgery date: A. Common bile duct margin, excision: Negative for tumor. B. Pancreas, duodenum, portion of jejunum, and portion of superior mesenteric vein; Whipple resection: A moderately differentiated infiltrative mass measuring 2.8 cm in greatest dimension is identified in the uncinate process. The lesion extends beyond the pancreas into adjacent peripancreatic soft tissue, duodenal wall, and superior mesenteric vein. Angiolymphatic and perineural invasion are present. The uncinate margin is involved. The gallbladder shows changes consistent with chronic cholecystitis and is uninvolved by the lesion. Two of nineteen lymph nodes are involved by metastatic disease. AJCC staging based on available surgical material is pT3 N1 (7th edition). DIAGNOSIS COMMENT: Although involvement is present at superior mesenteric vein margins on permanent sections, no tumor was identified on frozen section slides reviewed concurrently.\n\nPRELIMINARY FROZEN SECTION CONSULTATION: A. Common bile duct margin, excision: Negative for tumor. B. Pancreas, duodenum, portion of jejunum, and portion of superior mesenteric vein; Whipple resection: A moderately differentiated infiltrative mass measuring 2.8 cm is located in the uncinate process. The lesion extends beyond the pancreas to involve peripancreatic soft tissue, duodenal wall, and superior mesenteric vein. Angiolymphatic and perineural invasion are present. The uncinate margin is involved. The gallbladder demonstrates chronic cholecystitis and is uninvolved. Two of nineteen lymph nodes show metastatic involvement. Permanent sections are pending. Frozen section histologic interpretation performed by:\n\nGROSS DESCRIPTION: A. Received fresh labeled \"common bile duct margin up\" consists of a 1.0 x 0.7 x 0.7 cm bile duct segment with oriented margin submitted for evaluation. Grossed by. B. Received fresh labeled \"total pancreas, duodenum, portion jejunum, portion superior\" includes a 30.5 cm duodenum segment, a 7.9 x 4.9 x 4.8 cm pancreas specimen, a 2.1 cm superior mesenteric vein segment, and an 8.7 x 3.8 x 1.6 cm detached gallbladder. Upon sectioning, a 2.8 x 2.7 x 2.4 cm firm white infiltrative lesion is observed within the uncinate process. The lesion involves the duodenal wall, nearly obstructing the lumen. It invades the attached superior mesenteric vein and encases an adjacent artery, extending to the uncinate margin. Superior and inferior margins of the superior mesenteric vein and uncinate margins are shaved. Portal vein groove margin is submitted perpendicularly. Peripancreatic and periduodenal lymph nodes are noted. Representative sections are submitted. Research tissue collected.\n\nBLOCK SUMMARY: Part A: Common bile duct\u20141 block. Part B: pancreas, duodenum, portion jejunum, superior mesenteric vein, bile duct, gallbladder\u2014submitted as multiple blocks including margins, tumor sites, lymph nodes, and surrounding tissues."} +{"pid": "TCGA-HT-7475", "report": "Microscopic examination reveals an infiltrating neoplasm composed of cells with elongated to oval nuclei and moderate nuclear pleomorphism. Additional neoplastic cells with predominantly round nuclei and minimal fibrillary processes are intermixed throughout the tissue, often forming small clusters. Cytologic atypia is generally moderate, though some cells exhibit more pronounced atypical features. The tumor is embedded within a background that varies between fibrillary and myxoid in appearance. Areas of distinct cellular nesting and perivascular clustering are noted. No necrosis or microvascular proliferation is observed. Mitotic activity is present, with up to four mitotic figures identified per 10 high power fields. Immunohistochemical analysis shows no expression of synaptophysin, while strong positivity for GFAP is demonstrated. The MIB-1 labeling index is calculated at 10.7%."} +{"pid": "TCGA-D8-A1XT", "report": "Histopathological examination was performed on a right breast resection specimen from a female patient. The breast measured 26 x 19 x 5 cm and included axillary tissue measuring 11 x 8 x 2 cm, along with a skin flap of 24 x 2.5 cm. Two distinct lesions were identified. The first was located at the boundary of the lower quadrants, measuring 1.6 x 1.5 x 1.3 cm, situated 1.3 cm from the lower edge, 1 cm from the base, and 4 cm from the skin. The second lesion was found in the upper outer quadrant, measuring 1.6 x 1.5 x 1.2 cm, located 0.1 cm from the base, 0.6 cm from the skin, and 3 cm from the upper boundary.\n\nMicroscopic evaluation revealed both lesions to be invasive ductal carcinoma (NHG3), with a mitotic count of 12 mitoses per 10 high-power fields (visual area diameter: 0.55 mm). There were also small foci of ductal carcinoma in situ (DCIS) of the papillary type, showing moderate nuclear atypia and comedo necrosis involving 5% of the lesion. Additional findings included intraductal papillary-type in situ lesions and parenchymal atrophy of the glandular tissue.\n\nAxillary lymph node examination revealed metastatic involvement in three out of ten nodes. The invasive component showed perinodal soft tissue infiltration. Immunohistochemical analysis demonstrated absence of estrogen and progesterone receptors in both lesions. HER2 staining using rabbit antibody Ventana PATHWAY HER-2/neu (clones 485 and 4B5) showed strong positive reactions in both tumors (Score = 3+)."} +{"pid": "TCGA-SY-A9G5", "report": "The specimen consisted of bilateral ureter biopsies and pelvic lymph nodes, as well as a cystoprostatectomy specimen. Both the right and left ureters showed complete cross sections with no evidence of malignancy. A total of 14 lymph nodes were examined: 10 from the right pelvic region and 4 from the left, all of which were negative for any signs of cancer.\n\nThe bladder specimen revealed a high-grade urothelial lesion measuring at least 2.9 cm in greatest dimension. The tumor was located on the right lateral and anterior aspects of the bladder, including the right trigone, and was associated with ulceration and indurated gray-white tissue. Microscopic evaluation showed invasion into the superficial half of the muscularis propria, with extension into the prostatic glands and stroma. No lymphovascular invasion was identified, and surgical margins were free of involvement. There was a focal area of adjacent carcinoma in situ. The prostate demonstrated focal high-grade intraepithelial neoplasia, but the seminal vesicles were uninvolved. Immunohistochemical testing was used to support the analysis, and all samples were processed in a CLIA-certified laboratory."} +{"pid": "TCGA-W9-A837", "report": "A right frontal brain lesion was resected from a male patient. The lesion showed slow, steady growth compared to prior imaging studies, with a current size of approximately 0.6 cm in its enhancing component. Histologically, the tissue showed a well-differentiated glial neoplasm with features including perinuclear halos, a delicate capillary network, and evenly spaced cells. No calcifications were identified. One vessel demonstrated increased endothelial cells, but no microvascular proliferation was observed. Necrosis was not present. A single mitotic figure was noted in an area of mild vascular hypertrophy. Some regions showed more densely packed cells with mild atypia and a small focus of bluer, more atypical cells. p53 labeling was infrequent, and MIB-1 staining showed low proliferative activity across several sections.\n\nGrossly, the right frontal brain lesion specimen measured up to 2.3 x 1.8 x 1.0 cm and was composed of gray-white tissue. Other sampled areas\u2014labeled as anterior, lateral, posterior, and medial walls\u2014ranged in size from 0.8 x 0.6 x 0.4 cm to 2.7 x 1.5 x 1.0 cm, all showing similar histological features. The right frontal brain mass measured 4.5 x 4.2 x 1.6 cm and consisted of tan-white tissue fragments with areas of hemorrhage and softening. Representative sections were taken throughout the specimen.\n\nIntraoperative evaluation of the lesion and surrounding areas confirmed the presence of a cellular glial neoplasm with variable involvement of adjacent cortical regions. No evidence of necrosis or vascular proliferation was found during intraoperative assessment.\n\nThe tumor showed only minor variations in cellularity across different sections, without features indicating progression to a higher grade. Vascular abnormalities resembling an angioma were noted in one section, but no microvascular proliferation was identified. Regular imaging follow-up is recommended for continued monitoring."} +{"pid": "TCGA-BH-A0B4", "report": "The specimen consists of breast and axillary lymph node tissue. The primary lesion measures 2.2 cm in greatest dimension by microscopic measurement and is located in the breast. Histologic features include a high-grade cellular morphology with marked nuclear pleomorphism, high mitotic activity, and poor tubule formation. The tumor extensively involves the nipple and dermis beneath the basal layer of the epidermis. A small component (approximately 2% of the total tumor mass) exhibits in situ features with solid-type growth pattern and intermediate nuclear grade.\n\nResection margins are free of involvement by invasive disease, with the closest distance measuring 1.1 cm. Of the ten axillary lymph nodes examined, six contain metastatic disease. Metastatic deposits show multiple foci with extracapsular extension. The largest nodal deposit measures 2.5 cm in diameter. No definitive lymphovascular invasion is identified.\n\nNon-neoplastic changes include fibrocystic alterations. Immunohistochemical staining shows positivity for estrogen and progesterone receptors. HER2 immunostaining is equivocal (2+). Pathologic staging is pT2, pN2a, pMX."} +{"pid": "TCGA-Q9-A6FU", "report": "A celiac lymph node excision revealed the presence of malignant cells within one lymph node. A left gastric lymph node excision showed one of two lymph nodes containing malignant cells. Excisions of the right #9 and level 7 lymph nodes each contained two lymph nodes, none of which showed any signs of malignancy.\n\nA surgical specimen from the distal esophagus and proximal stomach contained a firm white lesion measuring at least 4.9 cm in greatest dimension and 2.8 cm in thickness. The tumor was located such that its midpoint was at the esophagogastric junction, with the center of the lesion 2.6 cm from this junction. Histologically, the lesion demonstrated moderately differentiated features. Invasion was observed through the muscularis propria into the surrounding soft tissue. Lymphovascular and perineural invasion were noted. Margins of resection were free of tumor involvement; however, the tumor was less than 0.1 cm from the inked adventitial surface. In total, 28 lymph nodes were examined, with 4 showing evidence of involvement. Other findings included chronic gastritis. No prior treatment effect was identified. The regional lymph node involvement was categorized as pN2 based on the number of affected nodes. An additional segment of the esophagus, taken from the proximal region, did not show any abnormal cellular changes or neoplastic growth."} +{"pid": "TCGA-KK-A8IJ", "report": "The left external/internal iliac, hypogastric, and obturator lymph node specimen consists of multiple fatty tissue fragments measuring 9.0 x 7.0 x 1.5 cm in aggregate. Dissection identified multiple possible lymph nodes ranging from 0.6 to 2.0 cm in greatest dimension. All identified lymph nodes were submitted for analysis across sections A1 through A13. One focus measuring less than 1.0 mm was identified in this group. No extranodal extension was observed. On the right side, similar lymph node regions were evaluated. The specimen consisted of fatty tissue fragments measuring 9.0 x 8.0 x 2.0 cm in aggregate. Multiple possible lymph nodes ranging from 0.5 to 2.5 cm were identified and submitted across sections B1 through B14. No abnormal foci were detected among the 21 lymph nodes evaluated on the right side.\n\nThe prostate specimen measured 3.5 x 2.0 x 4.8 cm and weighed 42 grams post-fixation. Gross examination revealed a palpable nodule at the right base region. The gland showed abundant soft tissue along the left posterolateral aspects compared to the right. Histologic evaluation identified a single lesion involving multiple regions including the right anterolateral, right lateral, right posterolateral, right posterior, mid posterior, left posterior, left posterolateral, and left lateral peripheral zones. This lesion measured 3.0 x 2.0 cm in its largest cross-sectional dimension and spanned three cross sections with extensive involvement noted at the apex and base regions. Involvement of the intraprostatic portion of the right seminal vesicle was observed focally. Additionally, focal involvement of the right bladder neck was noted. Vascular/lymphatic invasion was present. Margins of resection were free of abnormal cellular infiltration."} +{"pid": "TCGA-ET-A4KQ", "report": "The specimen consisted of a right thyroid lobectomy. The tumor was located in the right lobe and measured 4.0 cm. It was histologically characterized as an encapsulated follicular variant. The tumor was unifocal and confined to the thyroid gland. No lymph nodes were submitted for evaluation. Pathologic staging indicated pT2 based on tumor size greater than 2 cm but not exceeding 4 cm with no extension beyond the thyroid. Regional lymph node involvement could not be assessed (pNx), and distant metastasis could not be determined (pMx). Surgical margins were free of tumor involvement, with the closest distance of invasive carcinoma to the anterior margin measuring 1 mm. There was no evidence of venous or lymphatic invasion identified. Additional findings included nodular hyperplasia."} +{"pid": "TCGA-DD-A116", "report": "The resected liver specimen includes segments V and VI, measuring 14 x 9 x 7.5 cm and weighing 250 grams. Within this specimen is a mass measuring 7 x 7 x 5.2 cm. The mass is graded as 3 out of 4 based on cellular differentiation. A smaller satellite lesion, measuring 1.2 cm, is present and forms a thrombus within a vessel. This lesion is located 0.7 cm away from the main mass. The main lesion extends to the liver capsule. The closest resection margin is 1 cm away from tumor tissue. The surrounding liver tissue demonstrates cirrhosis with mild septal fibrosis. The gallbladder measures 8.5 x 2.7 x 0.7 cm and shows changes consistent with mild chronic cholecystitis; no gallstones are identified. A lymph node from the paracaval region, measuring 8 x 7 x 7 mm, is benign. Additional lymph nodes from the cystic duct region are also benign."} +{"pid": "TCGA-BP-4176", "report": "The right kidney specimen measured 26.0 x 12.0 x 6.5 cm and was associated with abundant perinephric fat. Upon bisection, the kidney measured 10.0 x 6.0 x 5.0 cm and contained a well-defined yellow mass located in the renal cortex at the mid-pole, extending into adjacent perinephric fat. The greatest dimension of the mass was 4.5 cm. There was evidence of gross hemorrhage within the mass, which did not involve the pelvi-calyceal system or the renal vein. No adrenal gland tissue was identified within the specimen. Extensive examination of the specimen did not reveal any lymph nodes or additional lesions within the renal parenchyma. Multiple sections were taken from the mass, margins, and normal kidney tissue. Nuclear grading was assessed as II/IV. The tumor was confined to the kidney without evidence of local invasion or venous involvement. Surgical margins were free of tumor. The non-neoplastic kidney tissue showed no remarkable findings. Based on size and extent, the staging classification was pT1."} +{"pid": "TCGA-BP-4985", "report": "A left radical nephrectomy specimen included a kidney with attached ureter, renal vessels, and perinephric fat, weighing 983 grams. The kidney measured 14.0 x 10.5 x 7.0 cm. The attached ureter was 6.5 cm long and 0.3 cm in diameter; the renal vein measured 8.0 cm in length and 0.7 cm in diameter. An adrenal gland measuring 6.0 x 2.5 x 1.0 cm was identified, with central hemorrhage noted on sectioning. A lobulated golden-yellow solid and cystic lesion measuring 12.0 x 9.5 x 7.0 cm was present within the kidney. This lesion showed multiple fibrous bands, areas of hemorrhage, and necrosis. It extensively involved the renal sinus and hilar fat, and penetrated through the renal capsule into the perirenal fat. The tumor approached to within 0.2 cm of Gerota's fascia but did not extend beyond it. There was no evidence of involvement of the renal vein. The remaining kidney tissue showed a pink-brown appearance with a well-defined cortico-medullary junction, and a cortex measuring 1.0 cm. Calyces appeared normal. No lymph nodes were found in the perinephric fat.\n\nMargins of the ureter, renal vessels, and adjacent kidney tissue were free of the lesion. Mild interstitial fibrosis and tubular atrophy were noted in the non-neoplastic kidney tissue. The adrenal gland was not involved.\n\nLymph node dissections included para-aortic, suprahilar, and interaortacaval regions. In total, 22 lymph nodes were examined across all groups: 13 from the para-aortic region (ranging from 0.1 to 1.7 cm), 6 from the suprahilar area (with sizes of 0.2 and 0.4 cm), and 3 interaortacaval nodes (measuring between 0.3 and 1.3 cm). All lymph nodes were negative for involvement.\n\nHistologic evaluation revealed high-grade nuclear features. Based on extent of local invasion and proximity to surrounding structures, staging criteria were met for a pT3a classification."} +{"pid": "TCGA-DD-A4NL", "report": "The specimen includes tissue from liver segment VI with a portion of segment V, weighing 255.0 grams and measuring 11.9 x 8.5 x 8.0 cm. A mass is present, measuring 3.6 x 2.1 x 2.1 cm, with well-differentiated cellular features. The surgical resection margins are not involved. Reticulin staining demonstrates disruption of the reticulin framework within the lesion."} +{"pid": "TCGA-66-2767", "report": "The examined right lung measured 12 x 11 cm at the base and up to 25 cm in length. The central bronchus resection plane was located 1.2 cm proximal to the upper lobe bronchus bifurcation. The upper pleural fissure was extensively obliterated in the dorsal third, particularly over segment 6 and adjacent areas. A 8.5 x 6 cm area of parietal pleura showed extensive adhesion. At the hilus, six mobile grayish-black lymph nodes were identified, ranging from 1.1 to 2 cm in size. The lower lobe bronchus and proximal segmental bronchi were largely obstructed by a central moderately solid, pale brownish endobronchial lesion measuring up to 4.8 cm. Several grayish-black pigmented lymph nodes up to 1.4 cm in size appeared involved. Central blood vessels were partly narrowed by this lesion.\n\nSpread across the pleural fissure into the upper lobe was observed, along with sleeve-like growth along the lower lobe bronchus. A 2.2 cm grayish-black lymph node extended close to the hilar resection surface. Intermediate and peripheral lower lobe bronchial branches were markedly dilated and filled with thick mucus. In segment 6 beneath the pleural adhesion, an indurated and pale brownish-yellow area approximately 3.5 cm in size was noted with unclear borders. Medial parenchyma in segment 3 and apical parenchyma in segment 1 showed rarefaction with lacunae or lacunar systems up to 0.5 cm. The pleura over segment 1 displayed whitish discoloration in multiple striated areas measuring up to 5 cm, with an underlying indurated grayish-white seam about 0.3 cm thick.\n\nLymph node findings included: a 2.6 cm lesioned node (station 10) on the right with pale brown to whitish cut surfaces; two grayish-black nodes (station 9), measuring 0.3 and 1.2 cm; five grayish-black nodes (station 8), between 0.3 and 1.2 cm; a subcarinal node (station 7) measuring 2 cm with pale brown to whitish appearance; a 3.5 cm node (station 4) with similar features; a retrotracheal node (1 cm); and five high paratracheal nodes (station 2) ranging from 0.1 to 1 cm. On the left side, a 2.5 cm node (station 10), a 1.5 cm node (station 4), and a 1.1 cm node (station 2) were identified, all showing grayish-brown or brown appearances with pale brown to whitish cut surfaces.\n\nHistologically, tissue sections revealed involvement of multiple lymph nodes with tumor infiltration evident in various nodal stations beyond the immediate tumor region. The tumor extended into central bronchial structures and approached the hilar resection margin within 0.5 mm. Vascular invasion was noted in central vessels but not in smaller arteries or veins. Lymphatic spread was extensive, involving mediastinal and hilar lymph nodes. Additional findings included fibrous remodeling in segment 6 with old thromboses, a subpleural scar in apical segment 1 with mild surrounding emphysema, cystic changes in segments 1 and 3, minor dust deposits, alveolar siderophages, and pleural fibrosis associated with parenchymal scarring. Some lymph nodes without tumor involvement showed reactive changes and pigment deposition."} +{"pid": "TCGA-19-4068", "report": "The pathology report includes specimens from the left occipital and parietal regions of the brain. Specimen A, from the left occipital region, consists of two fragments measuring 1.0 x 0.7 x 0.7 cm and 0.9 x 0.8 x 0.6 cm. Both were processed for touch imprint analysis and entirely submitted for histologic evaluation. Specimen B, from the left parietal region, includes two smaller fragments measuring 0.6 x 0.5 x 0.3 cm and 0.5 x 0.4 x 0.3 cm. Touch imprints were performed on both fragments and representative sections were frozen for intraoperative assessment; the remaining tissue was submitted in entirety. Specimen C, also from the left occipital area, consists of multiple tissue fragments measuring up to 3.2 x 1.5 x 0.5 cm in aggregate and submitted entirely.\n\nHistologic examination revealed areas of coagulative necrosis and microvascular proliferation. Cellular morphology demonstrated features consistent with high-grade transformation. Based on these findings and histopathologic evaluation, the specimen has been staged according to standard classification criteria."} +{"pid": "TCGA-P6-A5OG", "report": "The specimen included a liver mass, a left adrenal mass, periaortic lymph nodes, tumor capsule attached to the diaphragm, left pleural tissue, tissue along the aorta, liver metastases, and a segment eight sample. The left adrenal mass was part of a total adrenalectomy and nephrectomy. The adrenal mass measured 17 x 11 x 6 cm but could not be fully assessed for margins due to fragmentation. Microscopic examination showed a poorly differentiated carcinoma involving the adrenal gland with extension along the renal cortex. No lymphovascular invasion was identified. One benign hilar lymph node was found within the specimen.\n\nSix periaortic lymph nodes were examined and all were benign. The tumor capsule attached to the diaphragm measured 4.5 x 4.0 x 2.0 cm and contained suspicious tissue, although it appeared to be attached rather than invasive. The left pleural tissue consisted of four fragments of fibromembranous tissue with extensive necrotic areas, possibly representing necrotic tumor. Tissue along the aorta measured 2.5 x 1.3 x 0.8 cm and also showed poorly differentiated carcinoma microscopically.\n\nLiver metastases were present in the left lateral segment as a 0.6 cm lesion and in segment eight as two 0.5 cm lesions, both showing metastatic poorly differentiated carcinoma. The liver mass biopsy measured 0.5 cm and was also consistent with metastatic high-grade carcinoma.\n\nImmunohistochemical staining of the adrenal mass showed positivity for vimentin and focally for NSE and CAM 5.2. It was negative for CK AE1/AE3, CK7, CK20, inhibin, chromogranin, melan A, S-100, bcl-2, calretinin, and synaptophysin. All special stains used had appropriate controls and were performed in a CLIA-certified laboratory.\n\nPathologic staging for the adrenal specimen was pT4, pNo, pMX. Due to the fragmented nature of the specimen, tumor size and margin status could not be definitively determined. The kidney showed no evidence of tumor involvement and maintained a clear corticomedullary distinction. Ureteral margins were free of tumor, with the mass located at least 3.5 cm from the distal ureteral margin."} +{"pid": "TCGA-AJ-A3EK", "report": "The specimen includes multiple lymph node tissue samples from the right and left pelvic areas, as well as right and left aortic regions. The right pelvic lymph nodes measure 6.0 x 4.5 x 1.6 cm and contain several poorly defined pink-yellow nodules up to 2.0 cm in size. Similarly, the left pelvic lymph nodes measure 4.7 x 4.0 x 2.0 cm with nodules up to 2.1 cm. The right aortic lymph nodes are 3.2 x 2.0 x 1.0 cm with nodules reaching 1.9 cm, while the left aortic lymph nodes measure 4.0 x 3.1 x 1.1 cm and contain nodules up to 1.6 cm. All nodules were submitted for analysis.\n\nA separate specimen includes a uterus with attached cervix and bilateral adnexa. The uterus and cervix together weigh 96 grams and measure approximately 9.1 x 5.6 x 4.2 cm. The endometrial cavity is largely occupied by a friable gray-tan to pink papilliferous plaque-like lesion affecting both anterior and posterior walls, extending into the lower uterine segment. The lesion spans approximately 8.8 x 3.5 cm and reaches up to 0.7 cm in thickness on the posterior wall. In the right lateral aspect, the lesion approaches within 1.1 cm of the outer surface margin. No nodularity or gross abnormalities are noted in the parametrial soft tissues.\n\nThe myometrium measures up to 1.6 cm in thickness and appears fibrotic. Histological evaluation reveals focal invasion into the myometrium, with tumor extending approximately 0.3 cm into the muscle layer. The tumor does not involve the endocervical mucosa or stroma. Lymphovascular space invasion is identified, particularly in sections near the serosal surface. Parametrial tissues on both sides are negative for involvement.\n\nSections of the cervix, uterine walls, fallopian tubes, and ovaries were submitted for microscopic examination. The ovaries show fibrotic and mottled tan-gray to pink cut surfaces. The fallopian tubes appear structurally normal with smooth internal linings. Immunohistochemical staining shows positivity for P53 and ER, and negativity for WT1. Microscopic features include sheets of tumor cells, back-to-back glands, and areas of cribriforming. Benign squamoid metaplasia is also present.\n\nNo evidence of malignancy is found in the lymph nodes examined from the pelvic and aortic regions. The findings indicate localized involvement confined primarily to the endometrial cavity with limited myometrial extension and no lymph node metastasis."} +{"pid": "TCGA-HT-7689", "report": "The pathology report describes a glial neoplasm with mild to moderate hypercellularity. Microscopic examination reveals neoplastic cells with round, enlarged nuclei and perinuclear halos. Notable gemistocytic cells are present, exhibiting eosinophilic cytoplasm and eccentrically positioned nuclei. The background matrix ranges from myxoid to macrocystic, with thin, branching capillaries observed throughout. No evidence of microvascular proliferation or necrosis is identified. Mitotic activity is minimal, with only a rare mitotic figure seen."} +{"pid": "TCGA-DX-AB2S", "report": "The patient presented with a left paraspinal mass. The excised specimen measured 21.2 x 12.6 x 6.8 cm and consisted of skin and subcutaneous tissue. A central linear scar was noted on the skin surface. The underlying mass was surrounded by skeletal muscle and soft tissue, and was found to be fleshy, rubbery, and pseudo-encapsulated, measuring 7.9 cm in greatest dimension. The mass was most closely situated to the deep margin, within 0.3 cm of the inked deep surface, while all other margins were grossly free by at least 0.6 cm. On cross-section, the tumor exhibited a fleshy appearance with areas of pale yellow, creamy tan, and focal hemorrhage.\n\nMicroscopic evaluation revealed a high-grade cellular proliferation within fibroadipose tissue and skeletal muscle. The tumor showed prominent intratumoral lymphoid and histiocytic aggregates in some sections. A perpendicular margin section at the deep margin showed tumor involvement within 0.5 cm. All other margins were widely clear. Changes consistent with prior biopsy were also observed. Additional tissue from \"normal fat\" was submitted, measuring 2.5 x 2 x 0.5 cm, and entirely processed for analysis. Representative sections of the mass were submitted for permanent sectioning and photographic documentation."} +{"pid": "TCGA-CV-6950", "report": "The specimen includes a fragment of bone from the hyoid region, which does not show any tumor involvement. A mass measuring 5 x 4.5 x 1.7 cm is identified in the region of the base of the tongue, epiglottis, and supraglottic mucosa, extending into the pre-epiglottic space. The depth of invasion measures up to 1.7 cm out of a total thickness of 1.8 cm. Tumor involvement is noted at the left lateral pharyngeal margin and at the tendonous insertion on the anterior surface of the resected tissue. The tumor approaches the anterior soft tissue resection margin at a distance less than 0.1 cm. No definitive lymphovascular invasion is observed.\n\nIn the right neck dissection specimen, 1 out of 25 lymph nodes is involved. This positive node is located in group 3 and measures 4.0 cm in greatest dimension, with at least 1.2 cm of extranodal extension. Other groups on the right side (groups 4, 5, 6, 7, and 8) show no evidence of tumor involvement.\n\nIn the left neck dissection specimen, 2 out of 20 lymph nodes are involved. One positive node from group 3 contains a metastatic focus measuring approximately 5 mm with 4 mm of extranodal extension. Another positive node from group 4 contains a metastatic deposit measuring 3.0 cm with more than 1.0 cm of extranodal extension. Other lymph node groups on the left side (groups 5, 6, 7, and 8) do not show tumor involvement.\n\nAdditional specimens including the right and left submandibular glands, the new left lateral pharyngeal margin, and tendon excision tissue all lack evidence of tumor."} +{"pid": "TCGA-3U-A98E", "report": "The specimen was obtained from a female patient and included multiple tissue samples. Tissue A was identified as aortic adventitia, measuring 1.2 x 1.0 x 0.3 cm, and was found to contain infiltrating cells consistent with malignant involvement. Lymph node tissue from the AP window, measuring between 1.9 and 0.4 cm across four fragments, showed evidence of tumor involvement in two out of six nodes. A pericardial cyst measuring 4 x 2 x 1.5 cm was identified, with clear fluid content and no visible masses; however, a separate 4 mm focus of malignant cells was noted within the surrounding fat. The #7 lymph node, measuring 1.8 x 1.0 x 0.5 cm, showed no signs of tumor involvement. The pleural tissue sample weighed 150.9 grams and measured 12.5 x 11.8 x 2.5 cm, with two distinct nodules: one measuring 9.5 x 5.5 cm and another measuring 4.0 x 3.5 cm. Microscopic evaluation revealed epithelioid-type cells with tubulopapillary and deciduoid features, along with invasion into mediastinal and pericardial fat. The tumor also extended into the aortic adventitia. Vascular or lymphatic invasion could not be definitively determined. Surgical margins could not be evaluated. Pathologic staging was determined as pT4, based on local invasion into mediastinal structures and pericardial fat, with regional lymph node involvement (pN2) confirmed in subcarinal and mediastinal nodes. Distant metastasis could not be assessed (pMX). Seven lymph nodes were examined, with two showing signs of involvement. The tissue was processed and submitted in multiple cassettes for further analysis. Intraoperative consultation confirmed the presence of infiltrating malignant cells in the aortic adventitia sample."} +{"pid": "TCGA-NP-A5GY", "report": "The specimen consists of a left renal mass measuring 2.2 cm, obtained via partial nephrectomy. Grossly, the lesion is well-circumscribed, glistening, and has a fleshy pink and tan appearance with central hemorrhage. Microscopically, the tumor is thinly encapsulated and composed of cells with abundant granular-eosinophilic cytoplasm, distinct perinuclear halos, occasional binucleation, and wrinkled nuclear membranes. Nuclear atypia is minimal with scattered small nucleoli. Immunohistochemical staining demonstrates strong expression of CK7 and CK8/18, with rare CD10 positivity and no reactivity for CD15, CD117, or vimentin.\n\nHistologic grade is 2 out of 4 based on nuclear features. The tumor is unifocal, limited to the kidney without lymphovascular or perineural invasion. Surgical margins are focally involved at the renal parenchymal (resection) margin, with a thin fibrous capsule present in most areas. No sarcomatoid differentiation is identified. Lymph nodes were not submitted for evaluation.\n\nPathologic staging indicates pT1a disease. Non-neoplastic kidney tissue shows patchy glomerulosclerosis and chronic inflammation. Based on morphology and immunophenotype, the findings are consistent with a renal neoplasm of chromophobe type."} +{"pid": "TCGA-B6-A0RQ", "report": "The specimen from the right breast biopsy consists of a 4.5 x 3.5 x 3.0 cm portion of yellow to grey-white soft tissue. A mass measuring approximately 2.5 x 2.5 x 1.5 cm is identified, composed of firm white tissue interspersed with adipose tissue. The mass extends to the operative margin over a wide area and a representative portion is submitted for frozen section and hormone receptor analysis.\n\nThe second specimen includes a 700-gram breast measuring 21 x 14 x 4 cm with attached axillary tissue. A 17.5 x 10.5 cm elliptical skin portion with a nipple is present, along with a 4.5 cm incisional wound superior and medial to the nipple. The cut surface reveals a 6.0 x 5.0 x 4.5 cm cavity deep to the incision and an adjacent mass measuring approximately 3.5 x 3.5 x 2.5 cm. This mass is composed of firm grey-white tissue with areas of yellow adipose tissue. It is located medial and deep to the biopsy cavity, approaching the deep resection margin at the medial aspect of the specimen to within approximately 0.3 cm, with questionable extension to within 0.2 cm. The remainder of the breast consists of adipose and grey-white glandular tissue with occasional firmer fibrous areas but no other discrete masses.\n\nIn the axillary region, nine lymph nodes are identified in both the upper and lower portions of the tissue. These nodes range up to 3.0 cm in greatest dimension and show replacement with adipose tissue in some cases, but no metastatic involvement is identified.\n\nSections submitted include representative portions of the mass, margins, and surrounding tissue, as well as multiple lymph nodes from both upper and lower axillary regions. One lymph node in the upper axilla is marked with blue ink and several others are bisected or sampled in parts.\n\nHistologic evaluation of the intraoperative consultation indicates carcinoma. Microscopic examination reveals invasive cellular proliferation within the breast tissue, extending to within 1 mm of the deep resection margin at the medial aspect of the specimen. Adjacent ductal changes are noted apart from the main mass. Benign proliferative alterations including apocrine metaplasia and duct ectasia are also present.\n\nAxillary lymph node assessment shows no evidence of metastatic involvement across all examined nodes. Multiple sections from various regions of the breast and lymph nodes were evaluated, confirming absence of metastasis."} +{"pid": "TCGA-A7-A26E", "report": "The specimen included a left axillary sentinel node measuring 3.5 x 2.4 x 0.9 cm, containing two lymph nodes: one larger (3.2 x 1.8 x 0.6 cm) and one smaller (0.6 x 0.5 x 0.5 cm). Both were entirely submitted for evaluation. A second lymph node from the left axilla measured 1 cm in greatest dimension and was also submitted. Left breast tissue showed a 5.5 x 4.0 x 2.2 cm tumor mass located in the lower outer quadrant extending centrally to the junction of all four quadrants. The tumor was rubbery and tan-white, with focal extension to within 1.2 cm of the deep margin and 1.1 cm of the anterior surface. The remainder of the tissue consisted mainly of adipose tissue with minimal fibrous components. Right breast tissue contained a biopsy cavity measuring 6.5 x 4.2 x 1.0 cm and was largely unremarkable, with no visible abnormalities noted. Left axillary content consisted of adipose tissue with multiple lymph nodes, the largest measuring up to 1.8 cm.\n\nMicroscopic examination revealed a 3 mm focus within one lymph node that exhibited features suspicious for metastatic involvement. The main lesion in the left breast was composed of moderately differentiated invasive cells arranged in single-file patterns. In one area, a small focus of a different growth pattern was identified. In addition, there was an area of in situ disease confirmed by special stains, showing nuclear grade 2 features. The invasive component measured 5.5 cm and was classified as pT3. Margins were free of tumor involvement. There was evidence suggesting possible vascular invasion and perineural extension was noted. No Paget\u2019s disease was present in the nipple, though in situ changes were seen in the subareolar region. Additional findings included benign fibrocystic changes, including cysts, apocrine metaplasia, and a small fibroadenoma.\n\nIn right breast tissue, in situ disease was found in several blocks. Special staining confirmed the presence of both lobular and ductal in situ components. One small invasive focus was identified in block 7, measuring 1.1 mm. This component was moderately differentiated and classified as pT1a. The invasive focus was located less than 1 mm from the inferior margin. Extensive in situ disease was present and also approached the inferior margin closely. Benign findings included cysts and apocrine metaplasia. All thirteen lymph nodes from the left axillary dissection showed no evidence of involvement. Immunohistochemical stains supported these findings.\n\nOverall, the assessment included multiple tissue samples, detailed microscopic evaluation, and immunostains where appropriate. Margins were negative in all relevant areas. Vascular and perineural involvement were noted. Staging for the primary lesion was pT3 based on size, with limited nodal involvement."} +{"pid": "TCGA-IG-A7DP", "report": "Gross Description: The lesion infiltrates the surrounding tissues. Microscopic Description: The tissue shows a moderately differentiated adenocarcinoma. Diagnosis Details: There is evidence of spread to adjacent areas. Formatted Path Reports: ESOPHAGUS TISSUE CHECKLIST. Specimen type: Collected during exploratory surgery. Location: Distal third of the esophagus. Differentiation: Moderately differentiated. Spread: Involves surrounding tissues. No information is available regarding tumor size, extent, lymph nodes, lymphatic or venous invasion, margins, or response to prior treatment. Additional pathologic findings indicate involvement of adjacent structures."} +{"pid": "TCGA-FP-A8CX", "report": "The surgical specimen included a gastrojejunostomy and gastroesophageal junction tissue following total gastrectomy. Gross examination of the stomach revealed an ulcerated mass measuring up to 13.8 cm located along the lesser curvature. The tumor extended through the muscularis propria into adjacent perigastric adipose tissue, coming within 0.1 cm of the serosa. It also directly invaded the jejunum at the site of the gastrojejunostomy. Full-thickness involvement of the gastric wall was noted, with tumor approaching as close as 0.2 cm to the initial proximal resection margin; however, the final proximal esophageal margin was uninvolved.\n\nHistologically, the lesion showed features consistent with poorly differentiated adenocarcinoma, with more than 50% signet ring cell morphology. Lymphovascular and perineural invasion were present. Fifteen of twenty-five regional lymph nodes contained metastatic carcinoma. Among these, two lymph nodes demonstrated macrometastasis, while thirteen others showed isolated tumor cells identified through cytokeratin immunostaining. The largest nodal metastasis measured at least 0.4 cm. No extranodal extension was observed.\n\nMargins of resection were negative. The closest radial margin involvement was 0.4 cm from the perigastric fat margin, while all other margins were at least 1.2 cm away. These included the small bowel radial margin (1.2 cm), and both proximal and distal small bowel margins (at least 3.7 cm). There was no evidence of prior treatment effect.\n\nAdditional findings included chronic active gastritis with focal intestinal metaplasia in the uninvolved gastric mucosa and similar changes at the gastroesophageal junction. Immunostains for Helicobacter were negative. Scattered lymph nodes from the perigastric and mesenteric regions were evaluated microscopically, with no other significant pathology identified.\n\nPathologic staging based on this specimen was determined as pT4b for primary tumor extent, pN3a for lymph node involvement, with no evidence of distant metastasis. The overall stage was classified as IIIC according to AJCC Cancer Staging criteria, 7th edition."} +{"pid": "TCGA-A3-A6NN", "report": "Surgical Pathology Report. Result date: Clinical History: Left kidney lesion. Specimen: #1, left kidney tumor. Gross Examination: #1: The specimen consists of a spherical piece of soft, tan tissue measuring approximately 2.8 \u00d7 3.0 \u00d7 3.0 cm. Along one edge is a thin rim of pale brown tissue measuring about 2.5 \u00d7 0.5 \u00d7 0.1 cm. The lesion has a bright golden yellow appearance with areas of cystic change and is surrounded by a 0.1 cm pseudocapsule. With the patient's written consent, a portion of the tissue was donated. The remaining tissue was sampled for Frozen Section and permanent section, including \"FSA-E\" (perpendicular sections of lesion and normal-appearing kidney presumed to represent the surgical margin) and \"F\" (additional section of the lesion). Frozen Section Diagnosis: #1, left kidney lesion, excisional biopsy: Tissue shows cellular atypia with nuclear features concerning for neoplastic process. The lesion is within close proximity to the renal surgical margin, approximately 0.1\u20130.2 cm. Microscopic Examination: #1 performed. Final Diagnosis: #1, left kidney partial nephrectomy specimen. The lesion measures 3.0 cm in greatest dimension. No sarcomatoid features or tumor necrosis identified. Nuclear grading per histologic assessment is grade 2. Lymphovascular invasion not identified. Adipose tissue adjacent to the lesion is free of involvement. Both radial and parenchymal surgical margins are negative, with the latter being within 0.1\u20130.2 cm. The pathologic stage based on TNM classification is pT1a. Signature Line."} +{"pid": "TCGA-EZ-7264", "report": "A biopsy and excision specimen from the right frontal region of the brain was received in two containers. The first container (A) contains multiple white to tan soft tissue fragments measuring approximately 1.1\u20132 \u00d7 1.2 \u00d7 0.3 cm in aggregate, with a portion used for intraoperative smear evaluation and the remainder placed in block A1. The second container (B), also labeled as right frontal tumor, contains an aggregate of fleshy white to tan soft tissue measuring 3.8 \u00d7 3.2 \u00d7 2.1 cm; representative sections, covering approximately 80% of the tissue, were submitted in blocks B1 through B5.\n\nMicroscopic examination confirmed the rapid intraoperative assessment. The sections reveal an infiltrating glioma of low malignant potential. The tumor demonstrates prominent perinuclear halos, focal microcystic changes, and a delicate vascular network. Cellular nuclei are largely round with only mild atypia observed. Mitotic activity is present but limited in frequency. The neoplasm exhibits infiltration into both gray and white matter regions of the brain. Cytogenetic studies were performed separately on submitted sections, with results to be reported by the Cytogenetics Laboratory."} +{"pid": "TCGA-HP-A5MZ", "report": "The sample was collected from the liver and measured 6 cm. Histological examination revealed a moderately differentiated lesion with features consistent with a neoplastic process. The tumor was classified as T1, NOS, with no regional lymph node involvement (NX) and no clinical evidence of distant metastasis (M0). Microscopic evaluation also showed steatohepatitis, grade 2/3, with moderate activity and stage 1/4 fibrosis. Additional findings included moderate macrovesicular fatty change and mild parenchymal and mesenchymal iron deposition. A separate buffy coat sample was also collected."} +{"pid": "TCGA-EL-A3T2", "report": "The surgical specimen includes a right neck dissection. In level 3, a tissue block measuring 4.0 x 2.0 x 1.0 cm contained five lymph nodes ranging in size from 0.2 to 1.0 cm in greatest dimension. Two of these nodes showed the presence of abnormal cellular clusters, with the largest focus measuring 0.8 cm. The remaining three nodes appeared unremarkable. In level 4, a fragment measuring 5.0 x 2.5 x 0.5 cm included a small muscle component and two lymph nodes (0.4\u20130.5 cm), both of which were uninvolved. Level 5 measured 3.0 x 2.0 x 0.8 cm and contained four small lymph nodes (0.2\u20130.3 cm), all without any notable findings.\n\nA total thyroidectomy specimen included a right lobe measuring 3.0 x 1.5 x 1.7 cm and a left lobe of 3.5 x 2.5 x 1.9 cm, along with a 0.9 x 3.0 x 0.2 cm isthmus. Within the right lobe, a 1.0 cm nodule was identified, with a septated, fleshy-tan appearance and areas of cystic and calcified change. A second 1.7 cm nodule was found in the left lobe, with a more colloid-rich appearance. Both nodules were well-defined and partially encapsulated. The surrounding thyroid tissue appeared normal.\n\nA separate soft tissue specimen from the left paratracheal region measured 2.5 x 1.8 x 1.2 cm and contained a solid, tan-pink area with papillary features, as well as cystic and calcified regions. No lymph nodes were identified in this specimen, and the tumor was confined to the soft tissue."} +{"pid": "TCGA-NJ-A55O", "report": "The specimen consists of a right upper lobe lobectomy measuring 15.0 x 10.3 x 3.0 cm. A spiculated tan lesion is identified within the lung tissue, measuring 2.6 x 2.0 x 2.0 cm. It is located 0.2 cm from the visceral pleura, 2.0 cm from the nearest staple margin, and 3.0 cm from the bronchial margin. The remainder of the lung demonstrates anthracosis and mild congestion without additional discrete lesions.\n\nMargins assessed include bronchial, vascular, parenchymal, and visceral pleural, all of which are free of abnormal cells. No invasion of the visceral pleura or lymphatic vascular structures is observed. Adjacent lung tissue shows benign findings, including a meningothelial-like rest.\n\nFive peribronchial lymph nodes were evaluated, one of which contains abnormal cells measuring 0.4 cm; no extension beyond the capsule is identified. Specimens from right paratracheal and subcarinal lymph node regions contain only benign-appearing lymphoid fragments with no cellular abnormalities noted.\n\nHistologic evaluation reveals grade 1 morphology with specific staining characteristics: positive for CK7 and TTF-1, negative for CK20 and CDX-2. Immunohistochemical controls demonstrate expected reactivity patterns.\n\nStaging classification reflects tumor size, absence of margin involvement, and lymph node findings."} +{"pid": "TCGA-OL-A66K", "report": "The surgical specimen consists of a right breast mastectomy specimen weighing 1,259 grams and measuring 30 cm in medial to lateral dimension, 21 cm in superior to inferior, and 8 cm in anterior to posterior. A total of three mass lesions were identified. The first, located at the 9:30 to 10:30 position, measured 4.4 x 4.0 x 2.6 cm and was 2 cm from the deep inked margin. The second, at the 8:30 position, measured 2 x 1.5 x 1 cm, and was 6 cm from the deep margin and 0.4 cm from the anterior-inferior margin. The third, at the 4 o\u2019clock position, measured 1 x 1 x 0.5 cm, and was 0.5 cm from the anterior-inferior margin and 3 cm from the deep margin.\n\nHistologic evaluation showed a composite histologic grade of II based on the SBR system, with a score of 3 for architecture, 2 for nuclear grade, and 1 for mitotic count. In addition to invasive carcinoma, there was associated intraductal carcinoma in situ forming approximately 10% of the tumor volume, with extension away from the main masses. The excisional biopsy margins were free of tumor. The closest distance of invasive carcinoma to a margin was greater than 1.5 mm at the anterior-inferior site (related to the smallest lesion), while other margins were more than 2 mm away. There was high suspicion for blood vessel and lymphatic invasion within the breast parenchyma. The nipple was focally involved by in situ carcinoma, while the skin was uninvolved. Skeletal muscle was not present in the specimen.\n\nTwo sentinel lymph nodes were examined. Both were negative for metastatic disease using hematoxylin and eosin as well as CKAE1/AE3 immunostains. The first node measured 3 x 1.5 x 1 cm and was entirely submitted. The second measured 0.9 x 0.8 x 0.4 cm and was also entirely submitted. A separate skin biopsy specimen containing an area of scarring was also negative for malignancy.\n\nImmunohistochemical studies of the invasive tumor component showed moderate estrogen receptor expression in more than 75% of nuclei and strong progesterone receptor expression in more than 90% of nuclei. Her2/neu staining by IHC was scored as 2+ and FISH analysis was pending. Myosin heavy chain staining on one block revealed absence of a myoepithelial cell layer, supporting the presence of invasive carcinoma.\n\nStaging was performed according to the 7th edition of the AJCC TNM classification. The primary tumor was classified as pT2(m), indicating multiple tumor foci with the largest being greater than 2 cm but not more than 5 cm in greatest dimension. Regional lymph nodes were classified as pN0(sn), indicating no metastasis in the sentinel nodes. Distant metastasis could not be assessed (MX)."} +{"pid": "TCGA-HT-A74K", "report": "The pathology report describes a hypercellular glial neoplasm located in the right frontal lobe. Histologic sections show tumor cells with round to oval, hyperchromatic nuclei and moderate nuclear atypia. Perinuclear halos are observed in most cells on frozen material. The tumor demonstrates foci of significant microvascular proliferation and scattered areas of necrosis. Dystrophic calcification is also present. Up to 3 mitotic figures per 10 high power fields are identified. Immunohistochemical staining shows numerous MIB-1 reactive cells throughout the tumor, with a labeling index of 12.7% in the most proliferative region. These findings indicate a high-grade neoplasm with increased cellular proliferation and multiple adverse histologic features."} +{"pid": "TCGA-D7-A6F2", "report": "The specimen consists of a stomach obtained via total organ resection. The stomach, upon incision along the greater curvature, measured 15.3 x 10.8 cm, with attached omentum measuring 26.0 x 11.0 cm. A lesion located on the anterior wall measured 4.2 x 2.6 x 0.9 cm. The distance from the proximal resection margin was 4.6 cm, and from the distal margin, 7.8 cm.\n\nHistologically, the lesion demonstrates features consistent with high-grade gland-forming cells arranged in tubular structures, with areas exhibiting mucin production. The lesion infiltrates through the full thickness of the gastric wall. Surgical margins, including those of the omentum, vessels, and lymph nodes (10 examined), show no evidence of involvement."} +{"pid": "TCGA-HD-A6HZ", "report": "The specimen was obtained from a female patient and included multiple tissue samples from various anatomical regions. The main resected tissue measured 4.5 x 3.8 cm and consisted of a gray-white to tan mucosal area with a raised component measuring 2.5 x 1.3 cm, located between 9 and 12:00. A contiguous flat granular area measured 2.8 x 2.5 cm and was tan in color. The lesion was present within the right tongue and extended to a depth of 0.8 cm, with the deepest aspect located 0.2 cm from the central deep margin. Microscopic evaluation revealed invasive cellular growth arising from the mucosal surface, extending into skeletal muscle. The maximal tumor dimension was 2.5 cm with a depth of invasion measuring 0.6 cm. Carcinomatous changes were also identified in situ.\n\nAll mucosal margins were negative for malignant involvement. The deep soft tissue margin was also negative, with the tumor located 0.1 cm from the margin. Additional submitted margins (anterior superior, posterior superior, anterior inferior, and posterior inferior) were all negative for dysplastic or malignant cells. Intraoperative consultation confirmed these findings.\n\nLymph node assessment included specimens from multiple neck levels. No metastatic involvement was identified in levels 2, 3, 4, or 5, where eight lymph nodes were examined. In level 1A, three lymph nodes were evaluated, one of which contained metastatic involvement measuring 0.6 cm in diameter. There was no evidence of extracapsular extension of viable tumor. Level 1B contained benign tissue without signs of malignancy. No perineural invasion was observed, though lymphovascular space invasion was present.\n\nHistologic grade was moderately differentiated. The overall staging was determined as pT2 N1."} +{"pid": "TCGA-D8-A1XU", "report": "Histopathological examination of a total organ resection from the left breast was performed. Two foci were identified. In both foci, estrogen receptors were detected in more than 75% of neoplastic cell nuclei, while progesterone receptors were present in 10\u201375% of neoplastic cell nuclei. Immunohistochemical staining for HER2 protein using rabbit antibody Ventana PATHWAY HER-2/neu (4B5) showed a negative reaction in invasive cancerous cells with a score of 1+.\n\nMacroscopic evaluation revealed a bifocal lesion with features of ductal carcinoma. The histologic grade was NHG2. Mitotic count was scored as 3 + 2 + 1 across 10 high-power fields, with a visual area diameter of 0.55 mm. Ductal carcinoma in situ (DCIS) was present within the lesions, showing solid and cribriform growth patterns with high nuclear atypia. Foci of necrosis, including comedo-type necrosis, were observed in approximately 10% of tumor areas. Vascular invasion by malignant cells was noted. There was also evidence of in situ involvement of lobular structures. The nipple showed no lesions. The surrounding glandular tissue exhibited signs of parenchymal atrophy. The examined material was compliant with diagnostic standards."} +{"pid": "TCGA-77-7463", "report": "The resected left upper lobe specimen weighs 180 g and contains a nodule measuring 30 x 28 x 25 mm located in the superior lingular segment. This lesion is situated 25 mm from the bronchial resection margin and is associated with pleural puckering, though no macroscopic pleural involvement is evident. A second fibrous nodule with central caseation, measuring 14 mm, is found 20 mm below the primary lesion. Additionally, a subpleural grey nodule measuring 6 mm is identified in the anterior segment; the remainder of the lung parenchyma appears unremarkable.\n\nHistologically, the larger nodule demonstrates cellular features consistent with a moderately differentiated morphology. The lesion approaches the pleura but does not directly breach it. Evidence of lymphatic permeation is present, including within pleural lymphatics, although no vascular invasion is observed. Lymph nodes adjacent to the bronchial margins show no signs of malignant involvement. The smaller subpleural nodule in the anterior segment exhibits fibrotic and silicotic characteristics. The second fibrous nodule in the lingular segment shares similar histological features but displays extensive central necrosis. Special stains performed on the tissue do not reveal any infectious organisms.\n\nStaging assessment indicates a T2 NO classification based on tumor size and absence of nodal involvement."} +{"pid": "TCGA-OR-A5K6", "report": "The specimen consists of a left adrenalectomy measuring 8.0 x 5.5 x 5.0 cm and weighing 0.15 kg. The adrenal gland is nearly entirely replaced by a well-circumscribed, encapsulated mass measuring 8.0 cm in greatest dimension. The cut surface shows variegated yellow, tan, and red areas with friable hemorrhagic regions accounting for approximately 40% of the tumor. The tumor abuts the adrenal capsule and adjacent adipose tissue. Minimal residual normal adrenal cortex and medulla are present.\n\nHistologic sections show a diffuse growth pattern with extensive necrosis. Focal areas demonstrate nuclear features corresponding to Fuhrman grade 3. Clear cells comprise less than 25% of the tumor cell population. Seven mitotic figures are identified in 50 high-power fields. Immunohistochemical staining for Ki-67, a proliferative marker, was performed using an image analysis system evaluating approximately 4221 cells; 6.8% of these cells were positive.\n\nMargins of resection are free of tumor. No additional clinical history was provided."} +{"pid": "TCGA-66-2754", "report": "Examination report. Macroscopic findings: The right superior pulmonary lobe was resected, with a total weight of 300g and dimensions of 160 x 150 x 35 mm. The tissue showed significant mesh-like anthracosis, with saggy and limp consistency and sclerosis of the framework. There was marginal, accentuated bullous hyperinflation. In the subpleural area of S2, there was a grayish-white, dense infiltration containing anthracotic pigment, measuring 45mm, well-demarcated, with omphaloid pleural retraction. The segmental bronchi B1\u20133 were unremarkable without signs of infiltration. At the hilum, there was a mass of confluent lymph node changes measuring approximately 50mm, growing exophytically with a grayish-white, brittle and necrotic surface, also containing anthracotic pigment. The mucous membrane from B3 to central sections appeared normal. No other focal abnormalities were identified in the laminated sections. Lymph node samples from L11 and L10 contained no visible biopsy material. Lymph node sample L7 consisted of bipartite blackish pigmented tissue measuring 13mm in total. Lymph-adipose tissue from L4 (segments a\u2013b) measured 30mm together, while L3 (segments a\u2013c) measured 40mm and showed signs of inflammation, induration, and anthracosis. All relevant tissues were completely embedded.\n\nMicroscopic findings: The bronchial resection margin was free of any abnormal cellular infiltration, both in initial sections and after paraffin embedding. Adjacent connective tissue showed partial hemorrhage but no involvement. A distinct cellular infiltration was observed, composed of immature cells with varying morphology\u2014some fusiform or sarcomatoid, others small and densely grouped. These cells exhibited marked nuclear atypia, frequent mitotic figures, coarse chromatin, prominent nucleoli, and minimal cytoplasm. Necrosis was present within the lesion, along with desmoplastic stromal reaction. The visceral pleura showed localized fibrous thickening and retraction around the lesion. The elastic basal membrane was focally disrupted by the infiltrating cells. Central areas revealed isolated vascular invasion with occlusive thrombi. The bronchus B3 was surrounded by this cellular infiltration, which extended focally to the intact mucosal lining. Extensive necrosis was noted in hilar regions, including changes in lymph node structures that contained anthracotic pigment. In S1, structural changes included sclerosis, rarefaction of lung architecture, subpleural bullous hyperinflation, and bronchial ectasia. No tissue material was identified in samples 2 and 3. Sample 4 showed lymph node tissue without cellular infiltration but with anthracosis and sinus histiocytosis. Samples from L4 and L3 revealed multiple areas of altered lymph node architecture with necrotic changes and sparse residual lymphatic tissue.\n\nStaging considerations: Based on histological features, the cellular changes show high-grade characteristics with extensive necrosis, poor differentiation, and infiltration into surrounding structures including the pleura and vasculature. The bronchial resection margin remains unaffected. Regional lymph nodes show extensive involvement with confluent changes and necrosis. Pulmonary tissue outside the affected region shows chronic changes including anthracosis, structural sclerosis, and emphysematous alterations. Based on these findings, the staging assessment indicates PT2, PV1, PN2, PMX, G3."} +{"pid": "TCGA-B7-5816", "report": "The specimen was obtained from the stomach and consisted of a primary tissue sample. The tissue was collected in a frozen state using a cryomold, with a total weight of 360 mg. A separate blood sample was also collected, amounting to 4 mL, and stored in a frozen tube. Histological evaluation showed no data available for histological type. The tumor was graded as adenocarcinoma, with a cellular composition of approximately 70% tumor cells. Staging according to the TNM system showed T stage 4, N stage 0, and M stage 0. No prior chemotherapy, radiation, or hormonal therapy was reported. No additional details were provided regarding treatment or hormonal status."} +{"pid": "TCGA-52-7811", "report": "A total of 14 lymph nodes were examined from various stations, including Stations 7, 8, 9, inter-lobar, posterior hilar, and AP window regions. All lymph nodes were negative for tumor involvement. A segment of the left 6th rib was also examined and showed no evidence of tumor. The surgical specimen consisted of a left lower lobe lobectomy with a staple line measuring approximately 8.0 cm in length. A firm mass measuring 4.8 x 4.5 x 3.0 cm was identified within the lung parenchyma. The mass appeared to invade a medium-sized bronchus but did not involve the pleura. Margins of resection, including the bronchial and vascular margins, were free of tumor. Histologic evaluation revealed a poorly differentiated carcinoma. The tumor was located at least 6 mm from the closest margin, which was a stapled margin. No direct extension beyond the bronchus was identified. Pathologic staging was determined as pT2 based on tumor size and local invasion, with no regional lymph node involvement (pN0) and no assessment of distant metastasis (pMX)."} +{"pid": "TCGA-CH-5739", "report": "The specimen includes tumor-free preprostatic fatty tissue. A total of eight lymph nodes were examined, with six on the right and two on the left, all free of any abnormal cellular infiltration. The prostate shows a focus of predominantly moderately differentiated cellular growth within the left lobe. This process involves the left rectolateral peripheral zone and extends into the adjacent perivesicular fatty tissue. The maximum dimension of this area is 1.2 cm. There is evidence of focal perineural involvement. The seminal vesicles and surgical margins do not show any signs of involvement. Grading indicates a Gleason score of 3+4 = 7, with approximately 10% of the sample displaying Gleason pattern 4 architecture. No vascular or lymphatic invasion was observed. The case reflects complete local resection with no residual disease identified."} +{"pid": "TCGA-BJ-A45G", "report": "The surgical specimen consisted of a total thyroidectomy weighing 21 grams. Two distinct lesions were identified in the right lobe measuring 0.1 cm and 2.5 cm, respectively. The larger lesion was an encapsulated follicular variant with focal capsular and angiolymphatic invasion. Both lesions were entirely contained within the thyroid without extension beyond its capsule. A single normocellular parathyroid gland was noted on the left inferior side. No evidence of extrathyroidal extension or involved margins was observed.\n\nA central compartment lymph node dissection was also performed. A total of seven lymph nodes were examined, four of which contained metastatic disease. There was no extranodal extension identified. The tumor demonstrated lymphovascular invasion. The pathologic staging was determined as pT2N1a. Additional findings included nodular thyroid hyperplasia."} +{"pid": "TCGA-A4-7585", "report": "The left kidney specimen measured 10.5 x 5.8 x 3.1 cm and was attached with a moderate amount of perinephric fat. A mass measuring 5.2 x 4.5 x 4.1 cm was identified; it was focally cystic with tan-red to orange discoloration and diffusely involved the surrounding adipose tissue, extending to the inked perinephric fat. The remainder of the renal parenchyma showed a tan-pink appearance with a single 0.4 cm tan-brown cyst. The cortical-medullary junction was poorly defined. No enlarged lymph nodes were observed, and the adrenal gland was not present in the specimen.\n\nHistologic examination revealed a lesion with papillary architecture and oncocylic features, exhibiting extensive degenerative changes and areas of necrosis. The nuclear grade was Fuhrman grade 2 out of 4. There was no evidence of lymphovascular space invasion or renal vein involvement. The tumor focally extended through the renal capsule into the adjacent perinephric adipose tissue. All surgical margins\u2014including soft tissue, ureteral, and vascular\u2014were free of tumor involvement. No lymph nodes were identified in the specimen.\n\nThe pTNM staging classification was T3a NX MX. The tumor demonstrated focal transcapsular extension into perinephric fat but did not involve the renal vein or vena cava. The adipose tissue adjacent to the mass appeared glistening and yellow. Representative sections from various regions of the kidney, including the mass, adjacent adipose tissue, and uninvolved parenchyma, were submitted for analysis. Additional tissues were processed for genomic research."} +{"pid": "TCGA-CV-6960", "report": "The specimen consists of a total laryngectomy specimen including the larynx measuring 10 x 8 x 6 cm, attached tongue measuring 8 x 6 x 5 cm, and bilateral salivary glands each measuring 3.5 x 2.5 x 2.5 cm. An ulcerated mass located at the base of the tongue and epiglottis measures 5.5 x 5.0 cm with a depth of 4.5 cm. The mass involves the epiglottis, base of tongue, pre-epiglottic space, and pyriform sinus. It extends to the anterior intrinsic muscle margins but does not involve the glottic or infraglottic spaces. The tumor approaches the hyoid bone and is present in the supraglottic space extending inferiorly to 1 cm above the true vocal cords. Both right and lateral aspects of the supraglottic space are involved. The mucosal and tracheal margins are free of tumor. Twenty-two lymph nodes were examined: ten from the left neck and twelve from the right neck, none of which show evidence of tumor involvement. Submandibular glands bilaterally also show no tumor involvement.\n\nA separate fragment of anterior soft tissue margin measuring 1.7 x 1.5 x 0.9 cm was submitted entirely for examination and revealed smooth muscle without tumor involvement. Additional tissue from the anterior floor of the mouth consisting of irregular portions of tan-purple muscle and soft tissue measuring 5.0 x 4.0 x 2.0 cm in aggregate was sampled and showed invasive cellular changes within fibromuscular tissue. Frozen section analysis of multiple margins confirmed absence of tumor at those sites. Tissue involving the tumor and surrounding areas was submitted for further evaluation including decalcification as needed."} +{"pid": "TCGA-BH-A0B5", "report": "The pathology report includes findings from a sentinel lymph node biopsy and a modified radical mastectomy. In the sentinel lymph node evaluation, one of three lymph nodes showed involvement by tumor cells measuring 1.4 cm in largest dimension. No extracapsular extension was identified in this node. Additional axillary lymph node assessment revealed five positive nodes out of twenty-one examined. The metastatic deposits in these nodes measured up to 0.8 cm with focal extracapsular extension noted.\n\nThe surgical specimen demonstrated multiple invasive tumor aggregates distributed across all four quadrants of the breast. The largest invasive focus measured 2.7 cm by gross assessment. The combined size of all invasive components totaled 7.9 cm. Histologic evaluation showed a classical growth pattern with tubule formation score of 3, nuclear polymorphism score of 2, mitotic figures score of 1, resulting in a total Nottingham score of 6 (Grade 2). No lymphovascular invasion was observed.\n\nIn addition to the invasive disease, there was an in situ component identified as nuclear grade 2, comprising approximately 25% of the overall tumor burden. This in situ component was both admixed and separate from the invasive areas. Ductal extension of the in situ lesion was present within the nipple, located 5 mm from the skin surface.\n\nSurgical margins were involved focally by invasive tumor in the lower inner quadrant. Changes related to prior biopsy were noted. Non-neoplastic findings included fibrocystic changes with ductal epithelial hyperplasia. Immunohistochemical staining showed positivity for both estrogen and progesterone receptors."} +{"pid": "TCGA-AN-A041", "report": "Female patient underwent radical mastectomy with tumor located in the breast; the tumor specimen was collected and stored in a frozen state within a cryomold. Histological evaluation revealed infiltrative ductal carcinoma, grade 2. Staging was determined as T stage 2, N stage 1a, and M stage 0. No prior treatment was administered. A normal blood sample was also collected via blood draw and preserved in a frozen state within a tube."} +{"pid": "TCGA-HT-7856", "report": "The pathology report describes a moderately to markedly hypercellular glial neoplasm that diffusely infiltrates the gray and white matter. The tumor cells have round nuclei with moderate cytologic atypia and consistently exhibit perinuclear halos. Scattered mitotic figures are present, with up to 4 mitoses observed in 10 high-power fields. There is no evidence of microvascular proliferation or necrosis. Additional sections show the tumor arranged in sheets and nests of atypical cells resembling oligodendrocytes, with scattered microgemistocytes also noted. The tumor infiltrates the adjacent brain parenchyma and demonstrates microcystic changes and microcalcifications. Immunohistochemical staining shows a MIB-1 labeling index reaching up to 15.5% in the most proliferative areas."} +{"pid": "TCGA-QR-A703", "report": "The specimen consists of a right adrenal mass measuring 8.7 x 6.1 x 3.6 cm, with a total weight of 90.5 grams. The main tumor mass measures 6.7 x 6.0 x 3.5 cm and is surrounded by a rim of tissue resembling normal adrenal cortex, measuring up to 7.2 cm in length and 0.6 cm in thickness. A separate golden-colored ribbon of tissue, measuring 2.2 x 0.4 cm, is also present. The external surface of the specimen is entirely inked in black. On sectioning, the tumor shows a variegated cut surface with tan, brown, and yellow areas, along with a central region of deep red discoloration measuring 2.8 cm in greatest dimension. Central portions of the tumor, including an aggregate measuring 5.0 x 3.0 x 1.0 cm and a smaller fragment measuring 1.5 x 0.5 x 0.3 cm, were sampled. Small sections of grossly unremarkable adrenal tissue, measuring 0.6 x 0.3 x 0.3 cm, were also taken. Tissue blocks were prepared for histological evaluation, including samples of the tumor, adjacent tissue, and areas of hemorrhage and firm white appearance. Immunohistochemical testing showed positivity for Chromogranin, Synaptophysin, and S-100, while being negative for C-Kit and NFTP. The tests were developed and validated by the Specialized Diagnostics Unit of the Laboratory of Pathology and are performed under CLIA certification for high-complexity testing. No consultants were involved in the evaluation."} +{"pid": "TCGA-A2-A3XX", "report": "A lymph node biopsy and left breast tissue specimen were received for evaluation. The lymph node was negative for any concerning findings. The breast tissue specimen measured 20.0 x 18.0 x 3.0 cm and included a well-defined mass measuring 2.2 x 2.0 x 1.8 cm located in the lower outer quadrant, 0.3 cm from the superficial margin and 0.0 cm from the deep margin. Microscopic assessment of the mass showed high-grade cellular features with a Nottingham score of 8 out of 9 (Tubules=3, Nuclei=2, Mitoses=3), corresponding to a mitotic count of 22 per 10 high power fields. Necrosis was present in both invasive and in situ components. No microcalcifications, venous or lymphatic invasion were identified. Margins were free of involvement, with the closest distance of 0.1 cm from the superficial margin. An intraductal component was present, showing high nuclear grade and solid subtype with central necrosis. One lymph node was examined and found to be unremarkable. No involvement of the nipple, skin, or multicentric disease was observed. Immunohistochemical analysis showed no reactivity for estrogen or progesterone receptors, and HER2 staining was also negative. Additional findings included intraductal papilloma, fibroadenomatous changes, and fibrocystic changes. The tumor was staged as pT2 NO (i-) MX. Cytokeratin staining supported the findings. All relevant sections were submitted for review, and the case underwent internal peer review."} +{"pid": "TCGA-D1-A3DG", "report": "The specimen includes a uterus with attached bilateral fallopian tubes and ovaries. A mass measuring 1.8 x 1.3 x 1.3 cm is present in the right fundus of the uterine cavity, grossly invading 0.7 cm into the myometrium (total wall thickness 1.7 cm). The posterior uterine serosa and cul de sac contain a 5.2 x 4.3 x 1.0 cm tumor mass. An aggregate of detached tumor measuring 8.5 x 6.7 x 4.2 cm encases the right ovary, which contains a small cyst. Multiple tumor nodules are observed on the surfaces of both ovaries and fallopian tubes, as well as within the right and left adnexal soft tissues, ranging from 0.3 cm to 1.2 cm. All surgical margins are free of tumor involvement.\n\nA segment of sigmoid colon measuring 32.0 cm in length contains approximately 20 red-pink irregular serosal nodules ranging from 0.5 cm to 11.5 cm in greatest dimension. These nodules extend into the muscular layer but do not involve the mucosa. A small attached portion of omentum shows five nodules ranging from 1.0 cm to 3.5 cm. Additionally, a separate specimen of omentum measuring 66.0 x 19.0 x 2.3 cm contains multiple nodules ranging from 0.2 cm to 4.2 cm in size.\n\nHistologic evaluation confirms findings based on frozen sections. Hematoxylin and Eosin (H&E) permanent sections were reviewed. Based on available surgical material, the staging classification is pT3a according to the 7th edition of the AJCC Cancer Staging Manual. No lymphovascular space invasion is identified."} +{"pid": "TCGA-KM-A7QC", "report": "The surgical specimen from a female patient included a left kidney and adrenal morcellated specimen, measuring 16 x 10 x 5 cm in aggregate. A mass measuring 4 cm in diameter was identified within the kidney. The mass had a tan-yellow, soft, necrotic cut surface. The tumor was unifocal and confined to the kidney. Histologically, the lesion showed nuclear features corresponding to Fuhrman nuclear grade II. Extensive necrosis was present along with acute and chronic inflammation. Diffuse interstitial nephritis was also noted. Vascular and ureteral margins, as well as inked surgical margins, were free of tumor involvement. There was no evidence of capsular invasion. A separate focal area of ureteritis was observed.\n\nLymph node tissue from the para-aortic region showed reactive changes without any evidence of tumor involvement. Additional tissue samples from the left kidney base and deeper base showed only necrotic debris and normal renal parenchyma, respectively. Frozen section analysis of these areas did not show definitive tumor involvement, although epithelioid cells were noted in one fragment, requiring further evaluation on permanent sections.\n\nSections of the adrenal gland, ureter, vascular structures, and surrounding fat were all submitted for histologic examination. No tumor was identified in the adrenal gland or in the submitted margins. The case involved a single tumor focus without regional lymph node involvement or distant metastatic spread."} +{"pid": "TCGA-AF-2692", "report": "The specimen consists of three parts: right uterine adnexa, sigmoid colon and upper half of the rectum, and the appendix. The right uterine tube measures 4 cm in length and 0.7 cm in diameter. Adjacent to it is a tan ovary measuring 2.5 x 1.3 cm with a cystic structure measuring 3.5 cm in diameter containing green mucoid material. No papillary projections or solid areas are observed within the cyst. A portion of the cyst wall was sampled for frozen section analysis.\n\nThe sigmoid and rectal specimen is a 24 cm long segment of large bowel with a diameter of 2.2 cm. The peritoneal reflection is located 3.7 cm from the distal stapled margin. The external surface of the rectal portion is inked and the resection is complete with a smooth surface. The specimen has abundant surrounding fat and reaches up to 8.5 cm in diameter. Upon opening along the antimesenteric side, a fungating red lesion measuring 3.5 x 3.7 x 1.7 cm is identified on the mucosal surface near the mesenteric border. A small white polyp, measuring 0.4 cm in diameter, is found proximal to this lesion, located approximately 0.7 cm away. The tumor lies just below the peritoneal reflection and is radially located 2.5 cm from the rectal margin. Sections taken include margins of resection, tumor tissue, rectal lymph nodes, and pericolonic lymph nodes.\n\nMicroscopic examination reveals benign mucinous cystadenoma in the ovarian tissue. In the rectal specimen, a tumor demonstrates some mucinous features but less than 50%. It is graded as intermediate differentiation (Grade 1\u20132). The tumor extends through the muscularis propria into surrounding soft tissue. Resection margins are free of tumor involvement. There is no vascular invasion, and a mild chronic inflammatory host response is noted. Examination of 12 pericolonic lymph nodes reveals no evidence of tumor involvement. Tumor is not present in non-lymph node pericolonic tissues. The distal appendiceal lumen shows fibrous obliteration without other significant findings."} +{"pid": "TCGA-XF-A8HI", "report": "A radical cystectomy with pelvic lymph node dissection and bowel resection for right colon pouch with augmentation and G-tube placement was performed. Specimens were received for analysis, including segments of the left and right distal ureters, which showed no abnormal cellular changes. A periaortic lymph node specimen revealed malignant cells upon frozen section and final evaluation confirmed metastatic involvement in two nodes.\n\nThe urinary bladder specimen revealed a poorly differentiated infiltrating lesion involving the outer layer of the muscularis propria, measuring 3.5 x 3.5 x 3.0 cm. Additionally, multiple papillary lesions with high nuclear grade were identified, with some areas showing focal invasion into the lamina propria. All surgical margins were free of abnormal cells. One of three lymph nodes examined showed metastatic involvement without extension beyond the node capsule. Lymphovascular invasion was present.\n\nUterine findings included mild chronic cervicitis and Nabothian cysts. The endometrium was atrophic without evidence of hyperplasia or abnormal growth. A small benign smooth muscle tumor was noted within the myometrium. No significant abnormalities were found in the ovaries or fallopian tubes.\n\nThe vaginal urethral margin was free of any concerning cellular changes. Additional lymph node groups were evaluated: nine of fourteen nodes from the right paracaval region, two of two nodes from the left common iliac region, and three of seven nodes from the presacral region were involved, with extranodal extension noted in the presacral group. Other regional nodes, including those from the right common iliac, right node of Cloquet, right external iliac, right obturator/hypogastric, and right presciatic regions, were free of involvement. On the left side, six of seven nodes from the node of Cloquet and two of six nodes from the external iliac region showed metastatic involvement, with extranodal extension identified in some. The left presciatic region did not show any lymphatic tissue involvement.\n\nThe proximal ureter sections on both sides showed no abnormal cellular changes. Pathologic staging was determined as pT2bN2MX, indicating the primary tumor extends into the muscularis propria, with regional lymph node involvement but no distant metastasis identified. Immunostaining for p53 was requested for further characterization."} +{"pid": "TCGA-FI-A2D2", "report": "The surgical pathology report describes a specimen from a total abdominal hysterectomy with bilateral salpingo-oophorectomy. The uterus, cervix, and bilateral adnexa were examined. The uterus measured 7.5 cm from fundus to ectocervix, with a 4.5 x 5.0 x 2.3 cm polypoid mass identified in the endometrial cavity. The mass was well-circumscribed and appeared to involve the lower uterine segment. Histologic sections showed a mixed pattern of growth. Approximately 70% of the tissue exhibited features consistent with a low-grade endometrioid-type architecture. The remaining 30% demonstrated a high-grade component with serous differentiation.\n\nThe tumor invaded to a depth of 8 mm within the myometrium, where the total myometrial thickness was 24 mm. This corresponds to superficial invasion involving less than one-half of the myometrial wall. Focal lymphovascular space invasion was identified. No involvement of the endocervix was observed. The mass was located 1.4 cm from the outer serosal surface. A subserosal fibroid measuring 5.0 x 5.0 cm was also noted. Other findings included squamous metaplasia in the cervix, chronic inflammation, and an incidental capillary hemangioma. Focal endosalpingiosis was present on the serosal surface. Both fallopian tubes and ovaries showed no histopathologic abnormalities. The specimen weighed 250 grams and included multiple submitted sections for microscopic evaluation. Clinical correlation is recommended for final staging assessment."} +{"pid": "TCGA-DD-AADI", "report": "The liver specimen from a left lateral sectionectomy measured 9.5 x 6.5 x 2.0 cm and weighed 80.32 grams. A mass measuring 2.3 x 2.0 x 1.5 cm was identified. The mass had a well-demarcated, yellowish-tan cut surface and was described as round, solid, and multinodular confluent in growth pattern. It was confined within the capsule with a bulging but smooth serosal surface. The resection margin was noted to be very close to the tumor, with a safety margin of less than 0.1 cm. The surrounding liver tissue showed multinodular changes and firm consistency.\n\nMicroscopic evaluation revealed a trabecular and nesting growth pattern with hepatic cell morphology. The tumor demonstrated focal fatty change. Cellular differentiation was predominantly moderate, with areas of poorer differentiation. No evidence of fibrous capsule formation, septum formation, or invasion into portal veins, blood vessels, bile ducts, or the serosal surface was observed. The surgical resection margin was in close proximity to the tumor.\n\nAdditional findings included mild portal inflammation in the non-tumorous liver tissue. Thyroid aspiration samples showed follicular cell lesion and atypical cells; however, these were not further reported."} +{"pid": "TCGA-55-8301", "report": "A right lower lobe pulmonary specimen was received, weighing 209 grams. The specimen measured 15.0 x 13.6 x 5.0 cm and included a stapled bronchial margin. The pleural surface was smooth with moderate anthracotic streaking. On the posterior upper aspect, there was a previously partially sectioned area revealing a 3.0 x 2.8 x 2.7 cm irregular tan-gray fibrotic lesion located subpleurally. This lesion extended to within less than 1 mm of the pleural surface but did not breach it. Its cut surface was fibrotic, friable, and markedly anthracotic. The lesion was located 3.5 cm from the nearest bronchial margin and showed an apparent bronchial connection. Surrounding the lesion was moderate cavitary emphysema; the remaining parenchyma was spongy, congested, and exhibited marked anthracotic streaking and areas of emphysema.\n\nSections submitted included the shaved bronchial margin (A), the lesion and surrounding tissue (B-F), and random uninvolved parenchyma (G). Additional specimens included lymph nodes from levels 9, 4, and 10 of the right lung. The level 9 lymph node measured 1.2 x 1.0 x 0.3 cm and consisted of gray-red to black shaggy fragments. The level 4 lymph nodes were two nodular gray-black fleshy portions measuring 2.0 x 1.0 x 0.5 cm in total. The level 10 lymph nodes included two fragments measuring 0.7 x 0.4 x 0.3 cm and 1.0 x 0.5 x 0.3 cm. All lymph node specimens were entirely submitted.\n\nMicroscopic evaluation of the main lesion revealed a moderately anthracotic, fibrotic lesion with cellular atypia and architectural disarray. The lesion was unifocal and measured 3.0 x 2.8 x 2.7 cm. It extended through the elastic layer of the pleura but did not break through the pleural surface. Vascular invasion was suspected in multiple foci. No metastatic involvement was identified in the one peribronchial lymph node or in the three other lymph nodes evaluated (levels 9, 4, and 10). Surgical margins were clear, with the tumor located 3.5 cm from the bronchial margin. Minimal emphysematous changes were noted in the surrounding lung tissue. Elastic stains confirmed extension through the elastic layer but not beyond. Clinical correlation with intraoperative findings was recommended. A second pathologist reviewed the slides and concurred with the findings."} +{"pid": "TCGA-SX-A7SM", "report": "A thrombectomy specimen from the left renal vein and a left radical nephrectomy with para-aortic lymphadenectomy were performed. The tumor measured 4.2 x 3.5 x 3.5 cm, located in the lower pole of the kidney. It was unifocal and showed involvement of the renal vein wall and extension into perinephric and periadrenal adipose tissue. The surgical margins were free of tumor. Microscopic evaluation revealed nuclear grade 4 morphology with areas of solid growth and clear cell features. Scattered calcifications were present, along with focal spindling and atypia suggestive of sarcomatoid differentiation (5\u201310%). Tumor necrosis was identified in approximately 10% of the tumor. Lymphovascular invasion was present.\n\nMultiple hilar lymph nodes were involved with metastatic disease, and additional positive lymph nodes were found in the para-aortic, inter-aortic, and left common iliac regions. One suprarenal para-aortic lymph node and one additional left common iliac lymph node were also involved. No extranodal extension was observed in any of the affected lymph nodes. A resected segment of descending colon and sigmoid showed no evidence of malignancy.\n\nImmunohistochemical staining demonstrated positivity for cytokeratin 7, EMA (focal), racemase (p504s), vimentin, and PAX-8 (focal), while p63 was negative. These findings were used to support the histologic assessment. Genetic testing for Xp11.2 translocation was negative. The nonneoplastic kidney showed changes consistent with embolization. Tumor tissue was banked (100% of samples) and suitable blocks for further testing included B4, B5, and B11.\n\nPathologic staging according to AJCC 2010 criteria was determined as pT3a and pN1."} +{"pid": "TCGA-D8-A1XB", "report": "Histopathological examination was performed on a female patient. The material consisted of a right breast with axillary tissues, measuring 18 x 12.5 x 3 cm, along with a skin flap of 16.5 x 5.3 cm and a muscle fragment of 1 x 1 x 0.4 cm. A lesion measuring 2.1 x 1 x 1.5 cm was identified in the upper outer quadrant of the breast, located 1.5 cm from the upper boundary, 0.2 cm from the base, and in direct proximity to the skin.\n\nMicroscopic evaluation revealed a histological grade corresponding to NHG1 (total score 5 out of 10, based on nuclear pleomorphism, glandular differentiation, and mitotic count of 2+2+1). Mitotic activity was recorded as 10 per 10 high power fields in the invasive component. Within the lesion, foci of intraductal proliferation were observed, characterized by cribriform architecture, medium nuclear atypia, absence of necrosis, and calcifications involving approximately 5% of the lesion. Calcifications were also present within the tumor stroma. The nipple showed no evidence of involvement.\n\nSurrounding breast tissue demonstrated fibrocystic changes, microcalcifications, and a fibroadenoma-like lesion. Axillary lymph node assessment revealed one involved lymph node with metastatic infiltration extending beyond the capsule into the perinodal tissue.\n\nImmunohistochemical analysis showed strong expression of estrogen and progesterone receptors in more than 75% of the neoplastic cells. HER2 staining using HercepTest\u2122M by DAKO showed a score of 1+, indicating no overexpression of the HER2 protein in invasive carcinoma cells.\n\nStaging parameters indicated pT2 for the primary lesion and pN1a for lymph node involvement."} +{"pid": "TCGA-BS-A0TA", "report": "The specimen consisted of a uterus with cervix, tubes, and ovaries, along with multiple lymph nodes. The uterus measured 8.5 cm in length and had a tumor within the endometrial cavity measuring 7.5 cm. Histologic evaluation showed a poorly differentiated lesion with deep myometrial invasion exceeding 50% thickness (15 mm invasion out of a total myometrial thickness of 17 mm). Lymphovascular invasion was present. There was involvement of the cervical stroma. Both adnexal regions were free of tumor.\n\nLymph node assessment included specimens from the left suprapubic region, left pelvic area, deep left pelvic region, left common lymph node site, and left lower aortic region. Metastatic involvement was identified in the left suprapubic mass, the left common lymph node group, and the left lower aortic lymph node. Of twelve lymph nodes examined in one group, one contained metastatic involvement. No tumor was found in the deep left pelvic lymph nodes.\n\nThe surgical procedure performed was a total abdominal hysterectomy with bilateral salpingo-oophorectomy and staging. Gross examination of the uterine tumor revealed an exophytic, friable mass that extended into the myometrium. Sections of the tumor and surrounding tissues were submitted for analysis. Multiple tissue blocks were evaluated for comprehensive assessment.\n\nMicroscopic findings confirmed extensive local invasion and lymph node metastasis. Based on these findings, staging was assigned as T2b, N1, M1."} +{"pid": "TCGA-XM-A8RC", "report": "A mediastinal mass was excised from a male patient. The specimen measured 11.5 x 6 x 3 cm and consisted of an irregular fragment of yellow, lobulated fibrofatty tissue. Upon sectioning, the mass measured 9.5 x 5 x 2.5 cm and exhibited a firm, white, heterogeneous cut surface with areas of yellow necrosis. The tumor was located less than 0.1 cm from the deep margin but all surgical margins were free of involvement. The surrounding soft tissue included yellow, lobulated adipose tissue.\n\nMicroscopic evaluation of multiple biopsies from the right lateral, inferior, superior, and left lateral margins of the mass showed only benign fibroadipose tissue with cautery artifact. A separate biopsy of the xiphoid revealed benign cartilage and fibroadipose tissue. The main excised specimen demonstrated an invasive lesion involving perithymic fat and adhering to the parietal pleura.\n\nHistologically, the lesion contained epithelial cells with large nuclei, prominent nucleoli, and irregular nuclear contours. Immunohistochemical staining was positive for CK AE1/AE3 and CK18, faintly positive for EMA, and negative for C-kit (CD117). Infiltrating lymphocytes stained positive for CD3, CD5, CD99, and CD1a. The MIB-1 proliferation index was high among the infiltrating lymphocytes.\n\nEvaluation of lymph nodes showed no evidence of involvement (0/3). The adjacent thymus gland displayed signs of atrophy. Special studies including immunostains and microscopic review confirmed findings consistent with previously examined cytology samples. All margins were negative for tumor involvement."} +{"pid": "TCGA-BR-8678", "report": "Specimen consists of a subtotal resection of the stomach with a lesion located at the fundus measuring 6x5x4cm. Microscopic examination reveals a moderately differentiated histologic type infiltrating to the level of the muscularis propria. A total of 12 regional lymph nodes were examined, none containing metastatic involvement. Tumor features, lymphatic invasion, venous invasion, perineural invasion, margin status, response to neo-adjuvant treatment, and additional findings were not specified. No comments provided."} +{"pid": "TCGA-FD-A3B4", "report": "A pelvic exenteration and lymph node dissection were performed. Specimens included skin and subcutaneous tissue from the abdomen showing fibrosis without any tumor involvement. The primary specimen showed extensive involvement of the bladder with a large mass measuring 8.5 x 7 x 3.5 cm, located on the posterior and left wall extending into the right lateral wall and anterior wall. The tumor extended transmurally into the anterior cervical wall and vagina, with perineural invasion noted. No definitive lymphovascular invasion was identified.\n\nMargins of resection, including soft tissue, urethra, and bilateral ureters, were free of tumor involvement. The uterus demonstrated atrophic endometrium and a small leiomyoma (0.6 cm). No significant pathology was observed in the bilateral ovaries or fallopian tubes. Segments of both the left and right distal ureters showed no tumor presence.\n\nLymph node assessment revealed no tumor involvement across all regions examined. A total of twenty-seven lymph nodes were evaluated: three from the right hypogastric region, three from the external iliac, one presacral, one common iliac, one paracaval, one left obturator, four from the left common iliac, three from the left hypogastric, two from the left common node, eight from the right obturator, and one from the distal right ureter. All were negative for tumor involvement.\n\nThe tumor exhibited high-grade features and extensive squamous differentiation, with invasion noted into extravesical adipose tissue, the anterior cervical wall, and vagina. Gross examination of the bladder revealed a partially ulcerated and fungating mass, which came within 4 cm of the urethral margin and extended into the cervix with a maximum depth of 3.5 cm. No tumor was found in the submitted lymph nodes or other excised tissues such as the round ligament or labial tissue adjacent to the urethral margin.\n\nHistological evaluation confirmed negative margins and absence of tumor in all assessed lymph nodes. The surgical pathology findings indicated extensive local disease without lymph node metastasis."} +{"pid": "TCGA-G3-A5SI", "report": "A resected liver specimen involving segments V and VI, along with the gallbladder, was submitted for analysis. The liver measured 7.5 x 6.0 x 5.0 cm and exhibited a nodular, cirrhotic surface. A single tan/yellow solid mass measuring 3.4 x 3.0 x up to 2.8 cm was identified, with a slightly hemorrhagic area on one side. The tumor had a lobular appearance and was located at least 1.5 cm from the resection margin. Serial sections revealed no second mass lesion. Areas of green discoloration were noted in the surrounding liver parenchyma.\n\nMicroscopic examination revealed moderately differentiated tumor cells arranged in a lobular pattern. One large lesion was identified along with microscopic foci of well-circumscribed tumor nodules separate from the main mass. No lymphovascular invasion was observed. The background liver tissue showed features consistent with cirrhosis and chronic hepatitis. Resection margins were free of malignant involvement.\n\nThe gallbladder measured 9.5 x 3.0 x 2.5 cm and displayed a smooth outer surface with a dark green velvety inner lining; no calculi or gross lesions were identified. One benign lymph node measuring 1.3 cm was present near the cystic duct resection site and showed no evidence of metastasis.\n\nStaging indicated a solitary tumor without regional lymph node involvement or distant metastasis. Vascular invasion was not identified. Additional findings included cirrhosis and chronic hepatitis. Multiple tissue sections were examined, including the tumor, margins, and surrounding liver tissue."} +{"pid": "TCGA-A6-2677", "report": "The specimen consists of a 30 cm segment of proximal right colon with attached 21 cm of distal ileum. The outer surface is smooth with a tan-pink appearance and moderate attached mesentery, mesocolon, and omentum. A 3.4 cm appendix is present with an average diameter of 0.5 cm. The proximal and distal margins measure 3 cm and 5.5 cm in circumference, respectively. Upon opening, a well-defined, 5 x 4.4 cm rubbery white-pink mass is identified, extending beyond the ileocecal valve. A portion of this mass was submitted for tissue procurement. On sectioning, the tumor has a maximal thickness of 0.6 cm and grossly extends into the muscularis layer, reaching the inked-free radial surface. The ileal and colonic mucosa appear normal with regular folds and wall thickness averaging 0.5 cm. Multiple lymph nodes are present within the mesocolon and mesentery, measuring up to 2.4 cm in diameter; the two largest exhibit tan-white cut surfaces suggestive of involvement. Seventeen tissue blocks were submitted for analysis, including margins, full-thickness sections of the mass, adjacent mucosa, ileum, colon, appendix, and lymph nodes. Histologic evaluation reveals moderately differentiated epithelial cells arranged in glandular patterns. The primary lesion involves the full thickness of the muscularis propria without vascular invasion. Margins, including the radial margin, show no evidence of involvement. Metastatic cells are identified in five out of thirty lymph nodes. No distant metastases or pericolonic tumor deposits are observed."} +{"pid": "TCGA-QH-A6XC", "report": "The specimen was obtained from a male patient with a lesion located in the right fronto-temporal region. Gross examination revealed a poorly defined mass measuring approximately 4.5 cm in greatest dimension. Histologic evaluation demonstrated moderately cellular tissue composed of diffusely arranged astrocytic cells exhibiting nuclear atypia, brisk mitotic activity, and focal areas of necrosis. Cellular morphology showed pleomorphic nuclei with prominent nucleoli and increased nuclear-to-cytoplasmic ratios. Microvascular proliferation was present. The tumor margin was focally infiltrative, extending into adjacent parenchyma. No definitive evidence of distant metastasis was identified. Based on histopathologic features, the lesion exhibited characteristics consistent with a high-grade neoplasm."} +{"pid": "TCGA-BH-A0HX", "report": "The surgical specimen includes a left breast mastectomy with evaluation of lymph nodes. A total of 24 lymph nodes were examined, including three sentinel nodes. Two sentinel lymph nodes were positive for metastatic involvement, with the largest metastatic focus measuring 0.4 cm. Extracapsular extension was identified in one of these nodes. An additional 20 axillary lymph nodes were negative for metastasis.\n\nThe excised breast tissue contained two invasive tumor foci. The larger lesion measured 2.5 cm and demonstrated features consistent with ductal and lobular morphology. Histologic grading using the Nottingham scoring system revealed a nuclear grade of 3, tubule formation score of 3, and mitotic activity score of 3, resulting in a total score of 9 and histologic grade 3. The smaller invasive focus measured 1.0 cm and had a Nottingham grade of 2, with tubule formation score of 3, nuclear pleomorphism score of 2, and mitotic activity score of 1.\n\nIn addition to invasive disease, there was ductal carcinoma in situ (DCIS) component measuring approximately 5% of the total tumor burden. DCIS exhibited nuclear grade 3 features with solid growth pattern and comedo-type necrosis. Surgical margins were free of invasive disease at a distance of 5 mm from the closest margin. In situ disease approached within 5 mm of the nearest margin.\n\nHistologic evaluation also identified benign findings including focal sclerosing adenosis, atypical ductal hyperplasia, fibrocystic changes with microcalcifications, and pseudoangiomatous stromal hyperplasia. Prior biopsy sites were noted without residual malignant cells. Hormone receptor analysis showed positivity for estrogen and progesterone receptors; HER2/neu staining was negative or equivocal (score 0 or 1+).\n\nThe tumor was located in the upper and lower outer quadrants of the left breast. Total aggregate size of all invasive components measured 3.5 cm. Angiolymphatic invasion was present. Benign and malignant calcifications were observed in corresponding regions. Non-neoplastic breast tissue demonstrated atypical ductal hyperplasia and fibrocystic disease.\n\nPathologic staging assigned was pT2 for the primary tumor, pN1a for nodal involvement, and pMX for distant metastasis. Sentinel lymph node assessment included keratin staining with identification of metastatic cells measuring up to 4 mm in diameter, with extracapsular extension documented in one node."} +{"pid": "TCGA-GD-A2C5", "report": "The specimen included a left distal ureter measuring 0.4 cm in diameter and 0.3 cm in length, and a right distal ureter measuring 1.2 cm in length with an average diameter of 0.6 cm. Both ureter specimens showed no pathologic changes upon microscopic examination, confirming the frozen section diagnoses.\n\nThe anterior exenteration specimen included a urinary bladder measuring 5.5 x 4.5 x 3.2 cm, a uterus measuring 7.2 x 4.5 x 3.0 cm, and a vaginal cuff excision measuring 5.2 x 3.8 cm. A papillary lesion was identified in the midline trigone area of the bladder mucosa, measuring 1.4 x 0.9 x 0.8 cm. Adjacent to this was an area of prior fulguration measuring 2.0 x 1.9 cm. Combined, these measured 2.9 cm in greatest dimension. Sectioning revealed invasion to a depth of 1.0 cm, located 0.2 cm from the inked posterior soft tissue surface. No gross involvement of the uterine cervix or other surrounding structures was observed.\n\nMicroscopic evaluation revealed high-grade features based on WHO 2004 classification. The lesion demonstrated both papillary and nodular/infiltrative growth patterns. There was evidence of associated intraepithelial disease. Invasion extended superficially into adjacent soft tissue. Lymphovascular invasion was also present.\n\nAll surgical margins were negative, including urethral, ureteral (as confirmed by parts A and B), paravesical soft tissue, and vaginal mucosal margins. Additional findings included a transurethral resection wound.\n\nLymph node evaluation included right and left pelvic lymph node groups. Of the paravesical lymph nodes, none were positive out of one total. Across all lymph nodes evaluated, 2 out of 17 were positive for metastatic involvement. The largest lymph node metastasis measured 9 mm and was located in the right pelvic lymph nodes. There was no extranodal extension identified.\n\nIntraoperative frozen section analysis of both ureters showed no evidence of malignancy. The report preparation included detailed sectioning and submission of multiple tissue blocks for comprehensive microscopic evaluation. The tissues submitted included margins, tumor areas, and surrounding structures for thorough assessment.\n\nChemical clearing using Carnoy\u2019s solution was performed on fatty tissues to facilitate lymph node identification and retrieval. In the right pelvic lymph node specimen, two lymph nodes were identified, with the largest measuring 3.5 cm. In the left pelvic lymph node specimen, three lymph nodes were found, ranging from 0.4 to 2.5 cm in size.\n\nPathologic staging was determined as pT3a pN2 pM-Not applicable. \n\nUterine cervix, endometrium, fallopian tubes, ovaries, and vaginal resection specimen showed no malignant features. The cervix and endometrium exhibited no abnormal changes. The fallopian tubes were unremarkable. Ovaries were atrophic with corpora albicantia. Vagina measured 52 x 38 mm and was free of malignancy. Benign findings included paratubal cysts and no significant lymph node involvement aside from those previously noted."} +{"pid": "TCGA-YU-A90W", "report": "The specimen involved the right testis, with a mass replacing the testicular parenchyma. The longest dimension of the mass measured 7.7 cm. The rete testis showed focal involvement. The epididymis and spermatic cord were not affected. No angiolymphatic or perineural invasion was identified. There was no evidence of necrosis. The surgical margins were free of involvement."} +{"pid": "TCGA-A8-A08J", "report": "The specimen consists of an ablated right breast sample. The lesion involves a moderately differentiated infiltrating component with focal ductal features. A discrete intraductal component is present. Vascular invasion is noted, along with resection changes and ulceration of the overlying skin. The tumor measures at least 7 cm. There is involvement of the nipple consistent with an intraepithelial component. The dorsal margin is free of tumor. Histologic classification is not otherwise specified, grade II. Lymph node involvement is present, with one positive lymph node. Lymphovascular invasion is identified."} +{"pid": "TCGA-UW-A7GJ", "report": "The specimen consists of a total hysterectomy with bilateral salpingo-oophorectomy and a right nephrectomy. The uterus is significantly distorted by multiple intramural and subserosal masses ranging from 0.4 cm to 8.0 cm in greatest dimension. The endometrial cavity appears compressed, measuring approximately 6.0 cm in length and 2.0 cm at the fundus, with an endometrial lining thickness of 0.2 cm. The cervix measures 4.0 cm in length; the ectocervix is 2.8 cm wide and appears smooth and white/tan, while the endocervix is 0.3 cm wide with scattered Nabothian cysts measuring about 0.1 cm each. The myometrium shows areas of varying thickness, up to 8.5 cm in greatest dimension, with multiple smooth, white/tan, homogeneous masses exhibiting a whorled appearance. Histologic examination reveals weakly proliferative endometrium and squamous metaplasia of the cervix. The right ovary contains a hemorrhagic corpus luteum measuring 2.0 x 1.0 x 0.4 cm, and the left ovary demonstrates a follicular cyst. Both fallopian tubes appear unremarkable.\n\nThe right kidney specimen weighs 1,550 grams and measures 21.0 x 15.0 x 11.0 cm. A large mass measuring 15.0 x 11.0 x 9.0 cm is identified in the superior and posterior portion of the kidney. The tumor has a yellow/white, soft cut surface suggestive of necrosis and appears well circumscribed, compressing but not grossly involving the adjacent adrenal gland. No multicentric lesions are observed. Examination confirms invasion into the renal capsule but no involvement of perirenal fat, renal vein, renal artery, or ureter. Lymphovascular space invasion is present. The adrenal gland does not show evidence of malignancy. Histologically, the tumor is composed of cells with mixed classic and eosinophilic features and is graded as Fuhrman grade 3. All surgical margins are negative. No lymph nodes are identified in the hilar region."} +{"pid": "TCGA-J4-A83L", "report": "The prostate specimen measured 5.5 x 4.5 x 4 cm and weighed 73 grams. The gland showed a firm, focally nodular parenchyma on sectioning. No abnormalities were observed in the seminal vesicles or vasa deferens. Histologic evaluation revealed a Gleason score of 3 + 4 = 7/10, with no tertiary pattern identified. Tumor involvement was estimated at 30\u201350% of the tissue. A dominant nodule measuring approximately 1 cm was present. There was no evidence of extraprostatic extension. Lymphatic (small vessel) invasion and perineural invasion were not identified. All margins were clear except for the anterior-superior capsular margin (E13), where tumor was close but not involved. \n\nLymph nodes from the left and right obturator regions were examined, with no tumor identified in any of the submitted specimens. Frozen and non-frozen section evaluations of the left obturator lymph nodes included two and two nodes respectively, all reactive. On the right side, one frozen section node and three non-frozen section nodes were assessed, all without evidence of tumor. \n\nThe TNM stage was determined as at least pT2c, pN0, pMX. No treatment effect was identified."} +{"pid": "TCGA-AC-A2FB", "report": "The histopathological examination of the left breast simple mastectomy specimen revealed a well-defined mass measuring 2.8 cm located in the upper inner quadrant. The specimen measured 11.5 x 9.1 x 4 cm and weighed 158 grams. The skin margin was sampled, and the deep margin was noted to be 0.4 cm from the mass. Sections of the mass and surrounding tissue were submitted for analysis.\n\nMicroscopic evaluation of the lesion demonstrated a Nottingham histologic score of 6, corresponding to Grade 2. Tubule formation was minimal, accounting for less than 10% of the sample (score=3). Nuclear pleomorphism was moderate with increased nuclear size. Mitotic activity was low, with 0\u20135 mitoses per 10 high-power fields under a 40x objective (field area 0.152 mm\u00b2), contributing a score of 1. The invasive component measured 2.8 cm in greatest dimension based on gross assessment. No venous or lymphatic invasion was identified.\n\nMargins were uninvolved by invasive disease, with the closest distance from the tumor to the deep margin being 4 mm. No evidence of tumor was found in the single sentinel lymph node examined. The number of lymph nodes evaluated was one, and none showed involvement.\n\nAdditional findings included proliferative fibrocystic changes with ductal hyperplasia, columnar cell change, sclerosing adenosis confirmed by p63 immunostaining, apocrine metaplasia, and associated microcalcifications in non-neoplastic tissue. Microcalcifications were also present in non-neoplastic areas.\n\nImmunohistochemical testing from a prior biopsy showed estrogen receptor 2+, progesterone receptor 3+, and HER2/neu 3+. E-cadherin staining was negative, supporting a lobular phenotype. An intradepartmental consultation was obtained, and results were communicated accordingly."} +{"pid": "TCGA-22-5480", "report": "A lobectomy specimen from the left upper lobe contains a 2.0 x 2.0 x 1.5 cm mass located 1.8 cm from the bronchial margin, which is uninvolved. Histologic evaluation reveals high-grade malignant cells with features consistent with squamous differentiation. Multiple intrapulmonary peribronchial lymph nodes (n=10) and the visceral pleura are free of tumor involvement. A separate soft tissue excision from the left hilar region demonstrates similar high-grade malignant cells with squamous morphology. In the left lower lobe, an excised intraparenchymal lymph node shows no evidence of malignancy but exhibits non-necrotizing granulomatous inflammation. Special stains for microorganisms (AR, GMS) have been performed and will be detailed in a separate addendum. Lymph node dissections from superior mediastinal (9 tracheobronchial), aortic (4 aortopulmonary, 3 anterior mediastinal), inferior mediastinal (5 subcarinal, 4 inferior pulmonary ligament), and 2 left lower lobe bronchus sites all show no signs of tumor involvement."} +{"pid": "TCGA-BG-A0M9", "report": "The gallbladder specimen shows chronic inflammation with calcification of the wall and the presence of gallstones. The uterine specimen demonstrates chronic cervicitis with squamous metaplasia, reactive epithelial atypia, and calcifications associated with metaplastic glands; no abnormal growth is identified in this area. A distinct lesion within the endometrium exhibits moderately differentiated architecture and low nuclear grade features. This lesion extends through approximately 75% of the myometrial thickness and involves nearly the full surface of the endometrium. The surgical margins are free of involvement. Lymphovascular invasion is present focally. Nine lymph nodes are examined from multiple pelvic and para-aortic sites, and none show evidence of tumor involvement. Cystic changes are present in the left ovary, while the remaining gynecologic structures appear unremarkable. Cytology from pelvic washings is negative. The maximum dimension of the lesion is 4.5 cm, and it involves approximately 99% of both anterior and posterior endomyometrial surfaces. The pathologic staging is pT1c, pNO, pMX, with no residual disease identified (R0)."} +{"pid": "TCGA-XU-A92W", "report": "The specimen consists of a thymic resection measuring 21.2 cm in greatest dimension. Within the thymus, a well-circumscribed mass measuring 6.0 cm in greatest dimension was identified. The mass was tan-colored and appeared encapsulated on gross examination. Microscopically, the lesion showed lobules separated by thick fibrous septa. Some areas were composed of spindled to oval-shaped cells with bland nuclei and dispersed chromatin, with few lymphocytes. Other regions contained roughly equal numbers of cortical-type epithelial cells and small lymphocytes. Microscopic invasion beyond the capsule into surrounding fat was observed. There was no evidence of invasion into the pleura, pericardium, or lung. Immunohistochemical staining demonstrated positivity for keratin (AE1/AE3, CK5/6) and focal positivity for p63 in epithelial cells, while small lymphocytes stained positive for CD1a. Margins were uninvolved. Adjacent structures including pericardium and lung parenchyma showed no tumor involvement. No vascular invasion was identified. Regional lymph node status could not be assessed. Distant metastasis could not be evaluated. A separate soft tissue specimen measuring 0.8 x 0.6 x 0.4 cm was received and identified as a benign cyst."} +{"pid": "TCGA-QK-A64Z", "report": "The surgical specimen consists of a partial maxillectomy from the right side, measuring 5.7 x 4.4 x 2.0 cm. The tumor is located in the hard palate and maxilla region, presenting as a single ulcerated lesion with a greatest dimension of 3.8 cm. The depth of invasion measures 5.5 mm from the ulcerated surface. Microscopic evaluation reveals a well-differentiated cellular morphology with no evidence of lymphovascular or perineural invasion. Bone involvement is present, with tumor extending into the underlying bony structure.\n\nMargins were assessed microscopically, including lateral mucosal margins, all of which were free of invasive disease and carcinoma in situ. The closest margin distance was 0.4 cm at the lateral mucosal margin. No treatment effect was identified.\n\nStaging is based on tumor size and depth of invasion. The tumor exceeds 2 cm but does not exceed 4 cm in greatest dimension, corresponding to pT2 classification. Regional lymph node status could not be assessed (pNX), and no distant metastasis was identified.\n\nAdditional findings include a second specimen consisting of extracted teeth, which were grossly unremarkable and submitted for examination without further microscopic analysis. Intraoperative frozen section analysis of multiple margins confirmed negative results for malignancy."} +{"pid": "TCGA-XV-AAZY", "report": "Patient F presented with a lesion on the abdominal wall. Histopathologic evaluation revealed a Clark level 5 invasive lesion with a Breslow thickness of 16 mm. The tumor measured 4 units, while the surrounding normal tissue was 3 units. No metastasis was identified. Staging workup placed the condition at stage 3. The lesion exhibited epithelial origin and showed no response to neoadjuvant immunotherapy. Tumor dimensions were 15x12 mm. Cellular morphology showed no specific features related to diagnosis."} +{"pid": "TCGA-ZJ-AAXI", "report": "Cervical biopsy specimen consisting of two irregular tissue fragments measuring 0.8 x 0.7 x 0.3 cm and 1.5 x 0.7 x 0.4 cm respectively. Histologic evaluation reveals a neoplastic process involving the cervical tissue with features consistent with infiltrative growth. Tumor cells are arranged in sheets and nests, exhibiting large nuclei, prominent nucleoli, and abundant eosinophilic cytoplasm. Stromal invasion is present, with depth of invasion measured. No evidence of vascular or lymphatic space involvement is observed. The lesion demonstrates moderate differentiation. All tissue submitted is included in one cassette for microscopic analysis. No other significant histologic findings are noted."} +{"pid": "TCGA-B6-A0RN", "report": "Surgical specimen from breast tissue with a long stitch on the lateral side and short stitch on the superior side was submitted in formalin. The tissue includes a fragment measuring 5 x 8.5 x 5 cm along with an ellipse of skin measuring 5 x 1 cm. The external surface was inked blue, and prior sectioning revealed a densely fibrotic area containing a central reddish-brown nodule measuring 1.5 x 0.8 x 0.6 cm. The nodule is located 0.1 cm from the closest surgical margin. Sections were taken for ER/PR studies and included representative samples of skin (Block A1), biopsy cavity and nodule (Blocks A2-A15), and remaining breast tissue (Blocks A16-A20).\n\nA separate fresh specimen labeled \"Apex axillary nodes\" consisted of a 0.3 x 0.2 x 0.2 cm fragment of reddish-tan tissue submitted entirely in Block B1.\n\nAnother fresh specimen labeled \"Axillary dissection\" measured 6 x 6 x 2 cm and consisted of fibroadipose tissue. This specimen was oriented and sampled; Blocks C1-C5 contained lymph node candidates and Blocks C6-C10 contained remaining fibroadipose tissue.\n\nMicroscopic examination showed nests and cords of relatively large atypical cells with round to oval vesicular nuclei, inconspicuous nucleoli, and vacuolated cytoplasm. Most of the cellular arrangement appeared in solid nests and strands, although some tubular formations were present. An intraductal component with cribriform architecture was also observed. No vascular invasion was identified, and there was minimal inflammatory response. Microcalcifications were noted within benign lobules.\n\nSections from Blocks A5 and A11 showed involvement of the inked surgical margin. One hundred and seventy-nine lymph nodes were evaluated across all blocks, and no tumor involvement was found."} +{"pid": "TCGA-HC-A6AL", "report": "The prostate specimen weighed 55 grams and measured 5.2 x 4.0 x 3.8 cm. The outer surface was focally shaggy, gray tan to pink in color. The urethra measured 3.5 x 0.5 x 0.3 cm and was patent with evidence of compression by the lateral lobes. On cut section, the prostate showed a multinodular rubbery gray tan to pink fibrotic appearance. Within the left posterior lobe, approximately 0.9 cm from the apex, there was a poorly defined area measuring 1.2 x 0.9 x 0.8 cm with slight gray tan to pink induration, extending close to the nearest soft tissue margin. No other discrete gross lesions were identified. The seminal vesicles measured 6.0 x 3.1 x 1.1 cm and had lobulated tan pink surfaces with multicystic tan pink fibrotic cut surfaces. No gross mass lesions were observed.\n\nHistologically, the tumor involved less than 10% of the total tissue volume. The Gleason grading showed a primary pattern of 3/5 and secondary pattern of 4/5 for a total score of 7/10. Extensive perineural invasion was noted. High-grade prostatic intraepithelial neoplasia was present. There was no unequivocal extraprostatic extension or involvement of the seminal vesicles. Lymphovascular space invasion was not identified. Surgical margins appeared free of malignancy on the sections examined; however, the tumor was found within less than 1 mm of the resection surface at multiple foci.\n\nThree pelvic lymph nodes were identified and showed no evidence of metastatic disease. The surgical specimen was intact, and no treatment effect was identified. A number of tissue sections were submitted for analysis from various regions of the prostate and surrounding structures."} +{"pid": "TCGA-AC-A2B8", "report": "The specimen was received from a female patient. One lymph node was identified in the right axillary sentinel node sample, and no evidence of metastatic carcinoma was found. The assessment was confirmed by negative staining for pancytokeratin. A separate breast specimen was submitted, weighing 685.4 grams and measuring 19.0 x 13.5 x 7.5 cm. A mass measuring 8.0 x 4.0 x 2.5 cm was identified within the breast tissue; it was ill-defined, gray-white, and gritty in appearance, located 2.0 cm from the deep margin and 2.5 cm beneath the skin surface. The deep margin of excision was free of disease. The mass had an architectural score of 3 out of 3, a nuclear score of 2 out of 3, and a mitotic score of 1 out of 3, resulting in a total score of 6 out of 9, corresponding to grade 2. The mass involved portions of the nipple, but there was no involvement of the overlying epidermis. Sections were taken from the mass, the deep margin, and uninvolved quadrants of the breast. Intraoperatively, frozen section analysis of the sentinel node was negative for tumor. Microscopic evaluation of the sentinel node revealed two small glands in the outer layer of the fibrous capsule, which were considered benign. Immunostaining showed cytokeratin positivity, but the morphology did not resemble invasive malignant cells. The PTNM classification was T3pNO (|-) MX. Clinical information indicated that the patient underwent a right modified radical mastectomy with sentinel node mapping and frozen section analysis. Preoperative imaging and clinical findings were consistent with this lesion. Hormone receptor testing showed ER and PR positivity, and Ki-67 (MIB1) expression was elevated at 28%. Representative tissue sections were submitted for permanent histologic evaluation and additional genomic research."} +{"pid": "TCGA-UF-A71E", "report": "The specimen was obtained from the floor of mouth. Lymph node groups from both right and left Levels 1, 2, and 3 showed no evidence of malignancy, with a total of 48 lymph nodes examined (22 on the right, 26 on the left). The submandibular glands bilaterally were not involved. A separate fragment described as \u201cshared of right miloioide muscle\u201d showed no neoplastic changes. \n\nThe central arch specimen demonstrated a lesion measuring 4.5 x 3.6 x 2.3 cm. The tissue involvement extends to the floor of mouth, gingiva, tongue, and jaw. Histologic features include intense stromal desmoplasia and presence of lymph-vascular invasion. Foci of in situ carcinoma were identified. Perineural invasion was not observed. Surgical margins were free of invasive tumor. A separate subcutaneous fragment also showed no evidence of neoplasia."} +{"pid": "TCGA-B5-A11F", "report": "A 55-year-old woman underwent surgical resection of a uterine mass. The uterus measured 9.5 x 4.0 cm and contained multiple fibroid nodules ranging from 1 to 3 cm in size. Upon opening the uterus, a growth measuring 5 x 3 x 1 cm was identified, projecting into the endometrial cavity with papillary features. This lesion involved both the anterior and posterior endometrium and extended near or into the upper portion of the endocervical canal, which measured 3 cm in length. The myometrium was 1.5 cm thick, and the lesion appeared to involve the superficial myometrium on gross examination. The surgical margin was marked and sampled.\n\nHistologically, the lesion showed irregular glands arranged in a cribriform pattern with significant stromal reaction. The majority of the lesion was confined to the endometrium, with only minimal areas suggestive of very shallow myometrial invasion (less than 1 mm). No definitive invasion into the endocervix was identified microscopically. Vascular invasion was not observed, and all surgical margins were free of tumor.\n\nThe left and right fallopian tubes and ovaries were submitted for evaluation. Both ovaries showed evidence of endometriosis but no malignant cells. A cyst attached to the left ovary was unilocular with thin walls and contained serous fluid. Lymph node tissue from both the right and left pelvic regions was examined; a total of thirteen lymph nodes were identified (ten on the right, three on the left), none of which showed any signs of malignancy. Multiple representative tissue sections were taken from all regions and submitted for analysis."} +{"pid": "TCGA-56-A4ZK", "report": "The specimen consists of a right lower lobe nodule and associated lymph nodes submitted for evaluation. The nodule measures 2.2 x 2.0 x 1.5 cm and is located in the right lower lobe, adjacent to the pleural surface. It is unifocal and confined to the lung without lymphovascular invasion. Visceral pleural invasion is present. The tumor is high-grade and poorly differentiated with nests of solid growth pattern, eosinophilic cytoplasm, and areas suggesting intercellular bridges. An inflammatory response is noted with multinucleated giant cells, histiocytes, epithelioid microgranulomas, subpleural and septal fibrosis, as well as bronchial metaplasia and chronic inflammation. \n\nSurgical margins are negative, with the tumor measuring 5.2 cm from the bronchial margin and 2.3 cm from the stapled margin. A total of 13 lymph nodes were examined from multiple levels (including level 4R, 7, and 9), and none showed evidence of metastasis. Immunohistochemical stains show strong positivity for markers supportive of a specific cell type, while other markers remain negative. Elastic stain demonstrates disruption of the pleural elastic layer, confirming pleural invasion. No treatment effect is identified."} +{"pid": "TCGA-AK-3425", "report": "The specimen was received in two parts. The first part, labeled #1, consisted of a nephrectomy specimen with attached perinephric fat. The kidney measured 9.5 x 7.5 x 5.0 cm and included a 4.5 x 0.2 cm segment of ureter. On bisection, the kidney showed a well-defined corticomedullary junction. A mass measuring 5.5 x 3.5 x 3.0 cm was identified in the mid portion of the kidney. The mass had golden yellow-tan to red-purple cut surfaces that were soft, variegated, and nodular. Sections from this mass were submitted for frozen section evaluation along with additional representative sections in multiple blocks. The perinephric fat contained an adrenal gland measuring 4.5 x 2.0 x 0.5 cm with golden yellow-tan cut surfaces; representative sections of the adrenal gland were submitted in twelve blocks.\n\nThe second part, labeled #2, consisted of yellow-tan fibroadipose tissue containing several palpable lymph nodes ranging from 0.6 to 2.0 cm in size. All lymph nodes were entirely submitted for examination in eight blocks. \n\nMicroscopic evaluation of the renal mass showed intermediate-grade cells with clear cytoplasm arranged in a nested and acinar pattern. No involvement of the renal vein, capsule, or perirenal fat was observed. Margins of the ureter and vein were free of abnormal cells. The adrenal gland did not show any abnormal cellular infiltration. All six lymph nodes examined showed no evidence of cellular atypia or metastatic involvement."} +{"pid": "TCGA-BH-A0BM", "report": "The surgical specimen includes multiple lymph nodes from the right axillary region. Sentinel node biopsies showed involvement in three of the sentinel nodes, with one containing micrometastatic disease. One sentinel node demonstrated metastatic involvement measuring 25.0 mm in diameter. Two additional sentinel nodes were positive for metastatic involvement. Non-sentinel lymph node biopsies included two nodes that were uninvolved. Following axillary lymph node dissection, nineteen additional lymph nodes were examined and found to be negative for metastatic disease.\n\nThe primary resected specimen from the right breast consists of a segmental mastectomy. Histologic examination reveals an invasive component measuring 2.8 cm in greatest dimension. The Nottingham histologic score totals 4 out of 9 (Grade 1), composed of tubule formation score of 2, nuclear grade score of 1, and mitotic activity score of 1. There is no evidence of lymphovascular invasion identified. The invasive component focally extends to the posterior margin of resection at the inferior aspect (block 5J); all other margins are free of tumor involvement. The in situ component is admixed with the invasive portion and spans approximately 1.2 cm across three consecutive tissue blocks. It involves eight total blocks and demonstrates cribriform and micropapillary architectural patterns with nuclear grade 1 features. Microcalcifications and focal comedonecrosis are associated with the in situ component. Margins of resection are free of in situ disease, with the closest distance measuring 0.3 cm inferiorly.\n\nAdditional findings include ductal carcinoma in situ involving benign zones with calcifications. Atypical ductal hyperplasia is present. Changes related to prior biopsy include fat necrosis and reparative alterations. Fibrocystic changes are noted with sclerosing adenosis, ductal epithelial hyperplasia, fibroadenomatous nodule formation, and epithelium-associated calcifications.\n\nImmunohistochemical staining shows estrogen receptor positivity and progesterone receptor negativity. HER2/neu expression is scored as zero or 1+.\n\nPathologic staging is determined as pT2 for the primary tumor, pN1a for regional lymph node involvement, and pMX for distant metastasis. The method of lymph node evaluation includes hematoxylin and eosin staining as well as keratin immunostaining, with only keratin-positive cells identified in involved nodes."} +{"pid": "TCGA-B6-A0IK", "report": "Surgical Pathology: Pinat. CLINICAL HISTORY: Inflammatory breast cancer. GROSS EXAMINATION: A. \"Biopsy of left breast\", fresh. The specimen consists of a 2 x 0.6 cm ellipse of tan skin with underlying disc of subcutaneous tissue measuring 3 x 1.5 x 0.5 cm. Within the subcutaneous tissue is a firm, tan, ill-defined lesion measuring approximately 2.2 cm in greatest dimension. A portion of the specimen is submitted for ER/PR studies and to the tissue bank. The remainder of the specimen is sectioned and submitted in Block A1-A3. Dr. Data eBrowser Result for 1 of 1.\n\nMicroscopic evaluation reveals a moderately-differentiated cellular proliferation with features of ductal differentiation. Nuclear grading is consistent with moderate nuclear atypia. A component of intraductal proliferation is present, exhibiting comedo-type morphology, accounting for approximately 5% of the overall lesion. Stromal invasion is identified, with involvement of lymphatic and vascular structures. No involvement of dermal lymphatics is observed. Margins of resection demonstrate presence of neoplastic cells."} +{"pid": "TCGA-GR-A4D6", "report": "The specimen submitted was a soft tissue excision from the right neck region, measuring 2.7 x 2.5 x 1.1 cm in total. The tissue had a red-white cut surface and was bisected for further analysis. A portion of the tissue was used for frozen section evaluation and preserved in OCT. Additional sections were processed for histological examination, with multiple cassettes submitted for detailed analysis. Tissue was also reserved for molecular and cytogenetic studies, including samples preserved in media and frozen in OCT for immunohistochemical testing.\n\nMicroscopic evaluation revealed a diffuse infiltrate of large lymphoid cells with prominent nucleoli and moderate cytoplasm. Immunophenotyping demonstrated expression of CD10, BCL-2, BCL-6, and MUM1, while other markers were either not determined or non-reactive. These findings support a lymphoid process involving large cells with specific immunostaining characteristics. Cellular morphology and marker expression were consistent with a neoplastic proliferation of lymphoid origin, with features suggestive of a germinal center-derived lineage. All tissues were processed according to established protocols and reviewed by appropriate personnel."} +{"pid": "TCGA-LI-A9QH", "report": "The resected soft tissue specimen from the right calf measured 22.0 cm in greatest dimension and weighed 1,018 grams. A large mass measuring 18.8 cm in greatest dimension was identified within the specimen. The mass was tan-white, focally necrotic, and located deep within the soft tissue. It approached the lateral and deep fascia closely, coming within less than 0.1 cm of the proximal fascia. Margins were assessed with the tumor located less than 0.5 mm from the lateral and posterior margins, and approximately 1 mm from the proximal margin; all other margins were more widely clear.\n\nHistologic evaluation revealed a high-grade pleomorphic sarcoma. Histologic grade was determined to be Grade III according to the FNCLCC system. Scoring components included type (3 points), necrosis (1 point), and mitotic count (3 points, with 24 mitoses per 10 high-power fields). No lymphovascular invasion was identified. Ancillary immunohistochemical studies were negative for MDM2, desmin, caldesmon, myogenin, and S100.\n\nA second specimen, excised from the right tibial nerve nodule, consisted of two fragments of tan rubbery tissue measuring up to 2.6 cm in greatest dimension. Microscopic examination showed involvement of a peripheral nerve segment by pleomorphic sarcoma. This was interpreted as regional neural or perineural invasion originating from the primary tumor and did not affect primary tumor staging.\n\nAJCC staging criteria classified the tumor as Stage III assuming cM0 status, with pT2b and pNx designation. No lymph nodes were dissected. No treatment effect was observed."} +{"pid": "TCGA-XF-AAMG", "report": "The surgical pathology report describes findings from a radical cystoprostatectomy with bilateral pelvic lymph node dissection and appendectomy. Gross examination of the bladder and prostate revealed a 5 x 4 x 3 cm lobulated, exophytic mass located at the bladder inferior margin and extending to the interface between the bladder and prostate. The mass was firm, white-tan in color, and displayed stellate ulceration and necrosis on its surface. It deeply invaded the prostatic parenchyma, approaching within 0.1 cm of the inked prostatic capsular radial margin. The maximum depth of invasion measured 1.1 cm. The prostatic urethra showed gross involvement, and the verumontanum was excavated. No extension into periprostatic soft tissue was identified.\n\nMicroscopic evaluation revealed cells arranged in trabeculae with a high nuclear to cytoplasmic ratio, moderate nuclear pleomorphism, irregular nuclear contours, coarsely clumped chromatin with areas of irregular clearing, and moderate to sparse eosinophilic cytoplasm. Cell borders were indistinct, and mitotic activity was elevated. These features were present in deep sections of the prostate and were also noted in prostatic ducts and glands. Involvement of the ejaculatory duct and seminal vesicles was identified. Tumor was also found within lymphovascular spaces.\n\nFrozen section analysis of multiple urethral margins revealed variable findings: some showed no concerning features, while others demonstrated carcinoma in situ within gland ducts or periurethral glands. However, permanent sections did not confirm these findings in all cases. For example, a focus of carcinoma in situ seen in a frozen section of one margin was not present on permanent sectioning. Other margins were free of tumor.\n\nA total of 51 lymph nodes were examined from various anatomical regions, including right and left common iliac, obturator, internal iliac, presacral, external iliac, hypogastric, and presciatic regions, as well as lymph nodes associated with the obturator vessel. No evidence of malignancy was identified in any of the lymph nodes evaluated.\n\nAdditional specimens included portions of the ureter, appendix, and peritoneal mass. The appendix showed distal luminal obliteration but no significant pathology. The peritoneal mass was diagnosed as infarcted appendices epiploicae. Ureteral segments were unremarkable, with no evidence of high-grade dysplasia or malignancy identified.\n\nNon-neoplastic prostate tissue showed benign glandular and stromal hyperplasia. No high-grade intraepithelial neoplasia or other malignant findings were observed in the prostate."} +{"pid": "TCGA-ZB-A96F", "report": "Pathology Report-Summary: \nMaterial: tumor with a diameter of 2.0 cm. Histologic evaluation revealed a mixture of epithelial and lymphocytic components. The epithelial cells demonstrated positivity for CK5/6 and exhibited medium to strong membrane staining for EGFR. These cells were negative for CD1a, CD5, CD20, CD99, and CD117. Proliferative activity in the epithelial component, as assessed by Ki-67, was estimated at 10\u201320%. Infiltrating immature T-lymphocytes positive for CD1a, CD5, and CD99 were present, with some showing partial positivity for CD5. Scattered CD20-positive lymphocytes were sparsely distributed. Proliferative activity within the lymphocytic population was significantly higher, with Ki-67 ranging from 60\u201380%. Staging according to the Masaoka classification was stage I, with no evidence of invasion beyond the capsule."} +{"pid": "TCGA-ZB-A96E", "report": "Pathology Report-Summary: The tumor measures 8.0 x 8.0 x 3.0 cm and shows focal invasion through the capsule. Histologically, it is characterized by epithelial cells positive for CK5/6 and demonstrates strong membrane staining for EGFR. The epithelial component is negative for c-kit and CD5. Lymphocytic infiltrate includes CD99-positive immature T-lymphocytes, some of which are also positive for CD5. There are sparse CD20-positive lymphocytes present. Staging according to the Masaoka system is II.1, with pT2 classification and no lymph node metastasis (pN0, 0/7 lymph nodes involved)."} +{"pid": "TCGA-NP-A5H6", "report": "The specimen consists of a left kidney with attached perinephric fat, measuring 28.0 x 16.0 x 7.5 cm and weighing 1101 grams. The ureter is 10.0 cm in length and up to 0.5 cm in diameter. The renal artery measures 2.5 cm in length and 0.5 cm in diameter, while the renal vein measures 2.0 cm in length and up to 1.0 cm in diameter. No lymph nodes are identified at the hilum or within the perinephric soft tissue.\n\nA circumscribed brown-tan to yellow-tan hemorrhagic mass is present in the upper pole, measuring 8.0 x 6.5 x 6.0 cm. On gross examination, the mass appears confined to the renal capsule without invasion into surrounding perinephric fat. It comes within 0.1 cm of the inked resected margin but does not involve the renal calices or pelvis. The renal cortex measures up to 1.0 cm and shows a well-demarcated corticomedullary junction. No other lesions are identified.\n\nHistologic evaluation reveals a unifocal lesion with Fuhrman nuclear grade 3-4/4. No lymphovascular space invasion or sarcomatoid features are observed. Tumor is confined to the kidney without evidence of transcapsular extension. All surgical margins, including vascular, ureteral, and perinephric, are negative for tumor involvement. No lymph nodes are present in the specimen. The TNM staging is T2a NX MX.\n\nRepresentative sections of the mass, ureter, renal artery and vein, and surrounding uninvolved kidney are submitted for microscopic examination."} +{"pid": "TCGA-55-A490", "report": "The specimen was received in two containers. One contains a lymph node measuring 0.8 x 0.5 x 0.4 cm, described as benign with hyperplasia. The second container holds a right upper lobe lung specimen measuring 16.0 x 8.0 x 5.5 cm. The pleural surface shows an area of induration and umbilication measuring 4.5 x 3.0 cm. A well-defined gray-white mass measuring 5.5 x 4.3 x 3.8 cm is identified beneath this area, approaching the pleural surface. The mass is located 1.5 cm from the bronchial margin and 2.0 cm from the stapled parenchymal margin. No other masses are observed.\n\nHistologically, the lesion demonstrates poorly differentiated cellular features. Visceral pleural invasion is not identified. Findings raise suspicion for lymphovascular space invasion. The tumor appears confined to the lung without evidence of distant extension. No treatment effect is noted. Evaluation of surgical margins reveals no involvement by the lesion. Lymph node assessment from two nodes shows no evidence of metastatic involvement. Additional findings include patchy fibrosis and chronic inflammation. Genetic testing has been initiated on one tissue block, and a separate report will follow. The pTNM stage is determined as pT2b, NO."} +{"pid": "TCGA-DD-A1EI", "report": "The resected right lobe of the liver weighs 765.0 grams and measures 16.0 x 13.0 x 11.0 cm. A mass measuring 1.8 x 1.5 x 1.0 cm is present, located 0.6 cm from the cauterized margin. Histologic evaluation reveals a grade 2 (of 4) lesion based on cellular differentiation. The surrounding liver tissue demonstrates chronic hepatitis, consistent with a history of hepatitis B infection, with mild activity (grade 2 of 4) and cirrhosis (stage 4 of 4). The gallbladder, measuring 8.0 x 4.0 x 1.0 cm, contains benign mucosa with cholelithiasis; two cholesterol stones are identified, each measuring 0.3 cm in greatest dimension."} +{"pid": "TCGA-EW-A6S9", "report": "A total of three sentinel lymph nodes were examined. One lymph node contained a metastatic deposit measuring 1 mm; this focus was not identified on frozen section. The other two lymph nodes showed no evidence of involvement. The number of lymph nodes with micrometastases was one, and two lymph nodes had no tumor cells identified. No extranodal extension was present.\n\nThe right breast specimen showed a lesion measuring 20 mm in greatest dimension, with additional dimensions of 15.0 x 10.0 mm. Histologic evaluation revealed poorly differentiated features. The histologic scoring system demonstrated a score of 3 for glandular/tubular differentiation, a score of 2 for nuclear pleomorphism, and a score of 2 for mitotic rate, resulting in an overall intermediate grade classification. A single focus of the lesion was identified.\n\nIn addition, there was presence of in situ changes involving five out of fifteen slides examined. Architectural patterns included cribriform features. Intermediate-grade nuclei and focal necrosis were noted. No lobular in situ changes were seen.\n\nMargins of resection were uninvolved. The closest margin for the invasive component was anterior at 6 mm, and for the in situ component, also anterior, at 10 mm. Lymphovascular invasion was not identified.\n\nSentinel lymph node evaluation was performed using hematoxylin and eosin staining at one level; immunohistochemistry was pending initially but later confirmed negative with keratin immunostain. Staging was determined as pT1c for the primary tumor, based on size between 10 and 20 mm, and pN1mi for regional lymph nodes, indicating micrometastases. Distant metastasis was not applicable. The final AJCC classification was pT1c pN1mi pMn/a.\n\nImmunohistochemical analysis showed positive hormone receptor status, with 50% of cells positive for both estrogen and progesterone receptors. HER2 testing by immunoperoxidase method showed strong positivity.\n\nThe procedure performed was a right breast lumpectomy with sentinel lymph node biopsy. Specimen orientation was marked with six colors to assess margins. Gross examination identified a mass within the lumpectomy specimen, located at a distance of 1.0 cm from the superior margin, 2.0 cm from the inferior margin, 1.0 cm from the anterior margin, 3.0 cm from the lateral margin, 1.5 cm from the medial margin, and 1.0 cm from the deep margin. Sections were submitted for microscopic evaluation, including perpendicular cuts from all margins and representative sections of the mass and surrounding tissue."} +{"pid": "TCGA-A5-A0GN", "report": "The surgical specimens include a peritoneal biopsy, two omental samples, and a left adnexa. All show no evidence of malignancy. The left ovary demonstrates serosal adhesions; the fallopian tube is histologically unremarkable. The hysterectomy specimen contains a polypoid lesion in the posterior uterine corpus measuring 5.2 cm. Histologic evaluation reveals this lesion invades the myometrium with approximately 56% penetration. Lymphovascular invasion is present. No tumor involvement is identified at the cervix or surgical margins. A calcified leiomyoma is also noted.\n\nLymph node evaluations from multiple pelvic and periaortic sites reveal no metastatic carcinoma. In all lymph node specimens, no malignant cells are identified under microscopic examination. Additional tissue samples including right uterosacral ligament, cul-de-sac, and other peritoneal biopsies do not demonstrate any malignant cells. The findings indicate no regional nodal involvement. The case is staged as pTlc pN0 pMx based on available data. Other gross findings include intramural leiomyomas with calcification and focal organizing hemorrhage within the uterus."} +{"pid": "TCGA-2J-AABV", "report": "The surgical specimen was examined, including multiple biopsies and excisions. Three lymph nodes from the common hepatic artery were analyzed and found to be free of tumor cells. A biopsy of the pancreatic neck margin showed no evidence of malignancy, though low-grade changes were noted. The common hepatic duct margin was also negative for tumor involvement. One lymph node from the hepatic hilar region was similarly unaffected.\n\nA Whipple resection specimen included the head of the pancreas, duodenum, a portion of the jejunum, gallbladder, and common bile duct. Within the pancreatic head, a solid mass measuring 3.3 x 3.2 x 2.6 cm was identified. This lesion extended beyond the pancreas into adjacent soft tissues and the submucosa of the duodenum. No necrosis was observed within the mass. Histologic analysis revealed high-grade cellular features, with angiolymphatic and perineural invasion present.\n\nThe gallbladder showed signs of mild chronic inflammation but no neoplastic changes. All surgical margins were free of tumor, with the closest being 1.2 cm at the uncinate margin. Low-grade preinvasive changes were seen at the pancreatic margin and in nearby non-neoplastic tissue. Of the 24 regional lymph nodes examined, two contained metastatic cells.\n\nGross evaluation of the specimen included a 35.0 cm segment of duodenum, a 6.1 x 4.2 x 4.0 cm portion of pancreas, and a 10.1 x 4.3 x 1.1 cm gallbladder. The mass was located in the pancreatic head and was 1.2 cm from the uncinate margin. It extended into the small bowel wall over an 8.5 cm area, involving the ampulla and surrounding soft tissue. A stent was identified within the pancreatic duct. No gallstones were present. Lymph nodes around the pancreas and duodenum were sampled for analysis.\n\nSections from all relevant areas were submitted for microscopic evaluation, including the uncinate process margins, areas of tumor involvement, bile duct, portal vein groove, gallbladder, and multiple lymph node groups. Based on these findings, staging was assigned using the AJCC system (7th edition, 2010)."} +{"pid": "TCGA-BH-A0EA", "report": "The surgical specimen consists of a left breast mastectomy. A central, subareolar lesion was identified, measuring 2.4 cm in greatest dimension based on gross examination. Histologic evaluation revealed a mixed pattern including tubular and ductal features. The Nottingham histologic grade score was 5 out of 9, with individual scores of 2 for tubule formation, 2 for nuclear grade, and 1 for mitotic activity. No lymphovascular invasion was observed.\n\nA significant in situ component was present, accounting for approximately 40% of the total tumor volume. This included cribriform and solid patterns associated with calcifications. Ductal carcinoma in situ was admixed with the invasive component. Lobular neoplasia, including atypical lobular hyperplasia and in situ changes, was also noted alongside calcifications. Atypical ductal hyperplasia, fibrocystic change, and sclerosing adenosis were present in various quadrants. Benign breast tissue was found in the upper and lower outer, upper inner, and lower inner regions. No tumor was identified at the skin or nipple margin.\n\nResection margins were clear of both invasive and in situ disease. The closest posterior margin measured 1.5 cm from the tumor edge.\n\nSentinel lymph node biopsies were performed. One lymph node from the left axilla contained a metastatic focus measuring 2.1 mm on glass slide, without extracapsular extension. Another sentinel lymph node showed metastasis measuring 7 mm with evidence of extracapsular extension. Two additional sentinel lymph nodes showed no evidence of metastasis. Immunohistochemical staining demonstrated positivity for ER, PR, and HER-2/neu markers.\n\nCalcifications were noted in malignant zones. Additional findings include prior biopsy site changes and fibrocystic alterations."} +{"pid": "TCGA-EY-A2OO", "report": "The revised pathology report includes updates to staging based on new criteria. Previously reported as pT1b and FIGO stage IB, the pathologic stage has been amended to pT1a and FIGO stage IA.\n\nA specimen from a hysterectomy with bilateral salpingo-oophorectomy was examined. The uterus measured 11.3 cm in height, 4.5 cm in anterior-posterior width, and 7 cm in fundal breadth. The endometrial cavity measured 3.6 cm in length and 2.0 cm in width at the fundus. A lesion measuring 2.2 x 1.3 x 0.2 cm was identified on the left anterior wall near the cornu. It had a granular and slightly exophytic appearance. Myometrial invasion was superficial, with a depth of 1 mm in a wall thickness of 7 mm, representing 14% invasion. No involvement of the serosal surface, lower uterine segment, or cervical regions was observed. Surgical margins were widely negative.\n\nHistologic evaluation showed complex architectural features with high nuclear grade. Lymphovascular space invasion was present. Twenty-four regional lymph nodes were examined, including right pelvic (11), left pelvic (10), right peri-aortic (2), and left peri-aortic (1) lymph nodes; none contained malignant cells.\n\nAdditional findings included leiomyomas with hyalinization and adenomyosis within the myometrium. The non-affected endometrium showed atrophic changes. The cervix exhibited chronic cervicitis. Hormone receptor testing by immunohistochemistry showed no significant staining for estrogen or progesterone receptors.\n\nThe ovaries and fallopian tubes showed no evidence of malignancy. Both ovaries demonstrated endometriosis and serous inclusion glands. The right ovary measured 3.4 x 1.4 x 1.2 cm and the left ovary measured 3.5 x 1.8 x 1.2 cm. Both fallopian tubes showed patent lumens with cautery artifact near the cornua.\n\nLymph node specimens were submitted separately. Right peri-aortic lymph nodes (aggregate size 3.2 x 2.6 x 0.5 cm) contained one candidate lymph node. Left peri-aortic tissue (2.3 x 1.5 x 0.3 cm) did not show lymph node candidates. Right pelvic lymph node aggregate measured 6.4 x 2.5 x 1.2 cm with up to 3.6 cm candidates. Left pelvic lymph node aggregate measured 4.5 x 3.2 x 1.0 cm with up to 3.7 cm candidates. All lymph nodes examined were negative for malignancy.\n\nThe AJCC pathologic stage is pT1a pN0 pMx. FIGO staging is IA based on updated 2008 FIGO staging criteria. These stages are based on available data and may be modified pending further clinical review."} +{"pid": "TCGA-22-5483", "report": "The surgical specimen from the right upper lobe of the lung included an endobronchial obstructive mass measuring 3.3 x 3.0 x 3.0 cm. The mass was located in the upper lobe main bronchus and was associated with obstructive pneumonia in the distal lung tissue. A separate nodule measuring 1.0 x 0.8 x 0.7 cm, consistent with a hamartoma, was also identified. On initial assessment, the proximal margin showed focal carcinoma in situ, but this was no longer present after re-excision. The distal margin was free of malignant cells. The separately submitted anterior lateral margin of the right mainstem bronchus revealed only benign soft tissue.\n\nA wedge resection from the anterior basilar segment of the right upper lobe showed scarring and focal organizing pneumonia. Biopsy of the right mainstem bronchus showed normal bronchial mucosa without significant abnormalities.\n\nExamination of mediastinal lymph nodes included 7 right lower paratracheal (station 4R) and 18 subcarinal (station 7) lymph nodes, none of which contained malignant cells. Among intrapulmonary and hilar lymph nodes, 2 out of 6 peribronchial lymph nodes contained malignant cells, while a single right hilar (station 10R) lymph node and 2 interlobar (station 11) lymph nodes were negative for malignancy."} +{"pid": "TCGA-AX-A0J1", "report": "The specimen from a total abdominal hysterectomy and bilateral salpingo-oophorectomy includes a uterus with bilateral tubes and ovaries. The uterus weighed 82 grams and measured 7 x 4.2 x 3.5 cm. On external examination, two smooth, raised leiomyomas were identified, measuring 2.2 cm and 1.7 cm in diameter. The cervix measured 2.2 x 2 cm with a slit-like os; no lesions were observed. Upon opening the uterus, a tan, polypoid mass measuring 4 x 3.3 x 2 cm was found within the endometrial cavity, located 1 cm from the cervical canal. The mass extended into the lower uterine segment. The myometrium measured 15 mm in thickness, and the tumor invaded to a depth of 3 mm. No lymphovascular space invasion was identified.\n\nMicroscopic evaluation showed similar findings with involvement of the lower uterine segment. The cervix did not show evidence of involvement. The left ovary measured 2 x 1 x 0.7 cm and had a heterogeneous cut surface; the right ovary measured 2 x 1 x 0.5 cm and had a homogeneous white-yellow appearance. Both ovaries contained epithelial inclusion glands, and no fallopian tube tissue was identified grossly or microscopically on either side.\n\nA lymph node dissection included right pelvic, left external, left obturator, right periaortic, and left periaortic lymph nodes. A total of 22 lymph nodes were examined, and none showed evidence of malignancy. The tumor invaded superficially into the luminal one-third of the myometrium without deeper infiltration. Based on these findings, the tumor involved less than one-half of the myometrium (T1b/IB), with no nodal involvement (N0) and distant metastasis unable to be assessed (MX). All surgical margins appeared free of disease. The specimen was otherwise unremarkable except for mild chronic inflammation noted in the cervix and leiomyomas with extensive hyalinization."} +{"pid": "TCGA-AO-A125", "report": "The clinical history includes a mass at the 12:00 position in the left breast and prior biopsy findings at the 9:00 position. Specimens submitted include four sentinel lymph nodes and one non-sentinel lymph node from the left axilla, as well as a left total mastectomy specimen.\n\nExamination of all lymph nodes revealed no evidence of tumor involvement. Each lymph node was described as benign. Deeper level recuts and special immunohistochemical stains were ordered for all sentinel nodes; results will be provided in a separate addendum.\n\nThe mastectomy specimen contained a lesion measuring 3.0 cm in greatest dimension. The invasive component was located in the central/superior region and was found to be 0.3 cm from the superior margin. Ductal in-situ carcinoma was also identified in the central/superior and medial areas, near the prior biopsy site, and was similarly 0.3 cm from the superior margin. No involvement of the nipple or skin by either in-situ or invasive components was observed. The in-situ component exhibited solid and cribriform growth patterns with intermediate nuclear grade and was associated with calcifications. Calcifications were also present in benign breast tissue.\n\nNon-cancerous breast tissue showed fibrocystic changes, biopsy site alterations, benign papillomas, and sclerosing adenosis. Special immunohistochemical stains demonstrated positivity for estrogen and progesterone receptors, and negativity for HER2-neu.\n\nIntraoperative frozen section analysis of all lymph nodes yielded benign findings, confirmed by permanent section diagnoses. Gross examination of the mastectomy specimen revealed no visible scars, with the skin measuring 17.0 x 7.0 cm and unremarkable nipple-areolar complex. The tumor appeared 0.5 cm from the superior margin upon gross assessment, and surrounding breast tissue in other quadrants was at least 1.0 cm from deep margins. All relevant sections, including tumor, margins, and representative areas of the breast, were submitted for microscopic evaluation."} +{"pid": "TCGA-D7-6817", "report": "The histopathological examination was performed on a total organ resection specimen of the stomach. The stomach measured 18 x 19.5 cm, and the attached omentum measured 35 x 16 x 4.5 cm. No macroscopic focal lesions were observed in the omentum. An ulceration measuring 2.5 x 2.6 x 1.5 cm was identified in the mucous membrane, located 11 cm from the proximal end and 6.5 cm from the distal end.\n\nMicroscopic evaluation revealed glandular structures with varying degrees of differentiation. The lesion extended through the full thickness of the stomach wall and involved the surrounding fat tissue. Vascular invasion was noted. The surgical margins were free of neoplastic cells. The omentum did not show any signs of metastasis. The mucosa outside the affected area exhibited changes consistent with chronic inflammation.\n\nLymph node analysis showed involvement in multiple regions. Metastatic cells were identified in periorificial lymph nodes (No III/IX) with capsular infiltration. On the lesser curvature, metastases were found in lymph nodes No VIII/X with capsular infiltration. On the greater curvature, metastases were also detected in lymph nodes No VIII/X. Peripyloric lymph node No I/III was involved. Additional lymph node involvement was noted as per preliminary intraoperative findings.\n\nThe tumor demonstrated full-thickness penetration of the stomach wall with regional lymph node spread. Histological grade was G3. Based on these findings, staging was determined as pT2b and pN3."} +{"pid": "TCGA-D8-A27T", "report": "The histopathological examination of the right breast specimen measured 21.5 x 14 x 4 cm and included a skin flap of 15 x 7 cm. A lesion measuring 3.0 x 1.4 x 1.8 cm was identified at the boundary of the outer quadrants, located 3 cm from the lower margin, 3 cm from the base, and 1 cm from the skin. Microscopic analysis revealed a neoplastic proliferation with features consistent with a non-special type carcinoma. The histological grade was determined as NHG2, with a mitotic count of 5 mitoses per 10 high-power fields. Associated benign changes included fibrocystic alterations.\n\nLymph node involvement was noted, with neoplastic cells present in axillary lymph nodes (II out of II examined). Invasion of the lymph node capsule and perinodal tissue was observed. Immunohistochemical staining showed positive nuclear expression of estrogen and progesterone receptors in more than 75% of tumor cells. HER2 immunostaining demonstrated a score of 1+, indicating no significant overexpression in the invasive component. Ancillary studies included evaluation for E-cadherin expression, with results confirming the absence of mutations or abnormalities in this marker. The pathological staging assigned was pT2 and pN1a."} +{"pid": "TCGA-69-7978", "report": "The surgical pathology report includes multiple lymph node specimens and a right upper lobe lobectomy. Lymph nodes evaluated include those labeled #7, L-4, R-4 (two separate submissions), R-2, #10, and level 7. All lymph nodes were negative for neoplasm. The right upper lobe specimen contained a white-gray lesion measuring 6.3 x 2.9 x 2.0 cm, located 1.7 cm from the bronchial margin, 1.8 cm from the vascular margin, and 2 cm from the parenchymal margin. The lesion infiltrated through the visceral pleura and was present at the pleural surface. Histologic evaluation showed a mixed pattern of solid, acinar, and bronchioloalveolar features with clear cell morphology. Vascular invasion was present; lymphatic invasion was not identified. One peribronchial lymph node contained metastatic carcinoma. Immunohistochemical staining demonstrated reactivity to TTF-1, while p63 was negative. Movat stains were used to assess pleural involvement in blocks E4\u2013E7. No malignancy was identified in the bronchial or vascular margins. Centrolobular emphysema was also noted. The tumor was staged as pT2b N1 MX. Additional testing for EGFR mutation is pending and will be reported separately. Intraoperative evaluation of the lymph nodes was negative for malignancy; the intraoperative assessment of the right upper lobe suggested poorly differentiated non-small cell carcinoma. Grossly, the right upper lobe specimen measured 13.5 x 12 x 3.5 cm and weighed 260.9 grams. The bronchial remnants measured 1.5 cm and 0.7 cm in width, with a length of 1.5 cm each. An area of pleural puckering approximately 4 cm in length was noted, though no gross mass was observed invading through the pleura. Emphysematous changes were present in areas outside the lesion. All lymph node specimens were fully submitted for analysis, with sizes ranging from 0.3 cm to 1.2 cm in greatest dimension."} +{"pid": "TCGA-X7-A8M7", "report": "Operative Procedure: Thymectomy. Pre-Operative Diagnosis: As below. Post-Operative Diagnosis: As below. Mediastinal mass. Final Pathologic Diagnosis: Thymus, anterior mediastinum, excision: The lesion is encapsulated, with surgical margins free of tumor. There is no lymphatic or vascular invasion. A portion of pericardium is present but not involved. The staging is pT1, Nx, Mx. The examination of this case material and the preparation of this report were completed in standard fashion. Gross Description: Received is a single formalin filled container labeled with the patient's name and \"mediastinal mass.\" The specimen consists of a 14 x 7 x 2 cm portion of yellow-tan fibrofatty tissue containing an eccentrically located 7 x 4 x 2 cm soft tissue mass. The specimen is inked and sectioned, revealing the mass to be well circumscribed with a gray-tan, nodular, soft cut surface. The remainder of the tissue has a yellow-tan, lobulated cut surface with no additional lesions identified. Sections are submitted as follows: 1\u20135, representative sections of the mass; 6\u20137, representative sections of additional tissue. Microscopic Description: Sections show a lymphocyte-rich lesion that focally extends into but not through the capsule. It appears to be completely excised. There is a portion of adhered pericardium, but the pericardium is not involved. The surrounding thymus does not show lymphoid hyperplasia. A component of thymic cyst is also identified. (Age: Gender: M. Race: White.)"} +{"pid": "TCGA-DX-A6YZ", "report": "The resected specimen from the right groin measures 22 x 12 x 8 cm and includes a deep subcutaneous mass measuring 9.1 x 7.5 x 6.5 cm. The mass is well-circumscribed, multinodular, and tan-yellow in color with a fleshy consistency. A central myxoid area measuring 4.5 x 3 x 3 cm is present. Hemorrhage and necrosis are identified, accounting for less than 5% of the tumor volume. Microscopic evaluation reveals high-grade cellular features and approximately 10% necrosis based on microscopic estimation. The tumor is located 0.7 cm from the deep margin, with wider clearances at the lateral (1.5 cm), medial (1.5 cm), superior (7.2 cm), and inferior (8.0 cm) margins. The overlying skin is not involved. Sections have been taken from representative areas including margins and both solid and myxoid regions of the tumor."} +{"pid": "TCGA-E7-A6MD", "report": "Patient ID: Gross Description: A piece of cystoprostatectomy specimen shows the urinary bladder with a whitish, ulcerated, and necrosed multifocal lesion displaying an invasive growth pattern with intramural extension. Histopathological evaluation reveals a cellular proliferation consistent with infiltrative growth, moderately to poorly differentiated, exhibiting high malignant potential and areas of neuroendocrine differentiation. The lesion extends through the entire bladder wall, reaching the perivesical fat and involving the prostate, with evidence of necrosis and ulceration; staging indicates advanced local invasion. Widespread intravascular tumor emboli are also present.\n\nLymph node assessment includes right iliac common tissue containing eight lymph nodes, with the largest measuring 1.0 cm; one node contains metastatic involvement, while the remainder show reactive changes and sinus congestion. On the left side, including external, internal iliac, and obturator regions, six lymph nodes were identified, each measuring up to 0.8 cm; two of these contain metastatic deposits, while the remaining demonstrate reactive features and sclero-lipomatous dystrophy.\n\nResection specimens from other areas show preserved histological architecture without abnormal findings. Microscopic evaluation confirms extensive tumor invasion with lymph node involvement. Tumor characteristics include ulceration, poor differentiation, and spread to adjacent structures and regional lymph nodes. Three out of fourteen lymph nodes examined are positive for metastasis."} +{"pid": "TCGA-44-6774", "report": "The specimen includes multiple lymph nodes from various levels and a left lower lobe lung resection. Lymph nodes from levels 11, 9, 8, and 5 showed no evidence of malignancy upon microscopic examination. Level 7 lymph nodes contained metastatic carcinoma in one of two pieces; the metastasis measured 1.8 mm with no extranodal extension. The left lower lobe specimen weighed 193 grams and measured 17 x 11.5 x 3.5 cm. A firm area measuring approximately 3 cm was identified at the superior edge with slight pleural puckering. Microscopic evaluation revealed a tumor measuring 2 cm with a mitotic index of 24 mitoses per 10 high power fields. The tumor involved neither the bronchial nor pulmonary resection margins, and there was no vascular invasion or involvement of the pleura. Associated findings included focal endogenous lipoid pneumonia in non-involved lung tissue. Lymph node staging was consistent with regional spread (N2) based on positive level 7 lymph nodes. All other sampled lymph nodes were negative for malignancy."} +{"pid": "TCGA-12-3646", "report": "A mass was identified in the right temporoparietal region on MRI, measuring 5.7 x 5.7 x 5.2 cm (CC x TV x AP). The lesion demonstrated a predominantly thin rim of peripheral enhancement with more irregular and thickened enhancing areas observed inferolaterally. It was located lateral to the ventricle and caused noticeable mass-effect.\n\nGross examination of the surgical specimen included an aggregate of soft red-tan tissue measuring 4.8 x 3.5 x 2 cm, along with a smaller pink-tan fragment measuring 2.0 x 1.4 x 0.4 cm. Representative sections were submitted for analysis, with portions retained in formalin.\n\nMicroscopic evaluation revealed infiltration of brain tissue by a malignant astrocytic neoplasm. Notable features included marked cytologic pleomorphism, multinucleated tumor cells, mitotic figures, glomeruloid microvascular proliferation, and pseudopalisading necrosis.\n\nCytogenetic studies using FISH showed polysomy of chromosome 7 in 67% of tumor cells and polysomy of EGFR in 66%. Loss of the centromere on chromosome 10 was observed in 44%, and allelic loss of PTEN was present in 39%. Of four markers analyzed, four were abnormal.\n\nImmunohistochemical labeling revealed MGMT expression in 5% of tumor cells. EGFR wild-type expression (3+) was detected in 80% of tumor cells, while EGFR variant VIII was not expressed. PTEN expression (2+) was noted in 5% of tumor cells. Phosphorylated S6 (pS6) expression (3+) was seen in 20% of tumor cells, and phosphorylated AKT (pAKT) expression (3+) was present in 60% of tumor cells.\n\nThese findings were derived from tissue containing a high-grade neoplastic process involving the brain."} +{"pid": "TCGA-50-6594", "report": "A left VATS procedure was performed for a lung mass, and the pathology report includes findings from a segmentectomy and lymph node biopsies. The primary lesion is located in the left upper lobe and measures 2.5 cm in maximum dimension. Histologically, the tumor is poorly differentiated with angiolymphatic invasion and involvement of the visceral and parietal pleura. There is mild lymphocytic host response and no tumor necrosis exceeding 50%. Surgical margins are free of tumor involvement.\n\nMetastatic involvement is identified in multiple lymph node stations. Specifically, lymph nodes at posterior and apical segment level 11, level 10, and level 5 all show evidence of metastasis. One of these lymph nodes demonstrates extracapsular extension. In total, three N1 lymph nodes and one N2 lymph node were examined, all showing tumor involvement.\n\nThe background lung tissue shows emphysematous changes and respiratory bronchiolitis. No satellite lesions are observed microscopically. Histologic grade is classified as G3 (poorly differentiated). Pathologic staging indicates T3N2Mx. Ancillary studies including histochemical stains, FISH, and molecular testing were performed. Results indicate no KRAS codon 12/13 mutations, no EGFR exon 19 or 21 mutations, no EGFR amplification, and no EML4/ALK rearrangement detected."} +{"pid": "TCGA-DB-A64W", "report": "A mass was identified in the right frontotemporal/insular region of the brain and was surgically excised using CUSA. The specimen consisted of multiple tissue fragments embedded for histological evaluation. Intraoperative smears were positive for neoplastic cells, initially suggestive of a low-grade infiltrating glial tumor. Immunohistochemical staining demonstrated positivity for IDH1-R132H mutation, while p53 protein expression was only present in rare cells. Ki-67 labeling index was focally elevated. Fluorescence in situ hybridization (FISH) studies for 1p19q deletion were initiated for further characterization. The combined histological and molecular findings were used to support the final assessment. Tissue blocks from the right frontotemporal insular region (five blocks), right frontotemporal mass (eight blocks from eight pieces), and remnants of brain tissue (one block) were all submitted and embedded for analysis. The dimensions of the main mass were 2.8 x 2.6 x 1.1 cm, with an additional 4.1 x 3.4 x 1.8 cm aggregate and a smaller fragment measuring 1.7 x 0.6 x 0.2 cm."} +{"pid": "TCGA-A2-A25A", "report": "The left breast mastectomy specimen measured 15.5 x 15.0 x 3.3 cm and weighed 243.0 grams. The tumor measured 3.2 x 3.0 x 2.0 cm and was centrally located, extending into the upper inner quadrant. It had poorly defined stellate borders and a firm, tan, gritty cut surface. The tumor was located 0.3 cm from the posterior margin and extended within 1 mm of the deep surgical margin without direct involvement. Histologically, the lesion showed moderately differentiated features with extension into the milk ducts and skin of the nipple, involving the upper outer quadrant. Additional findings included atypical lobular hyperplasia in the lower inner and lower outer quadrants. The remaining tissue was predominantly fibrous with scattered fluid-filled cysts.\n\nThe right breast mastectomy specimen measured 18.0 x 12.5 x 2.5 cm and weighed 336.0 grams. Microscopic evaluation revealed scattered cysts measuring up to 1.2 cm in diameter with no discrete masses identified. Extensive lobular hyperplasia was present along with fibrocystic changes including cysts, fibrosis, and apocrine metaplasia. A small focus measuring 1 mm showed specific cellular changes consistent with in situ proliferation.\n\nImmunohistochemical analysis showed negative estrogen receptor status and positive progesterone receptor expression in approximately 80\u201390% of nuclei. HER2 gene amplification testing by FISH methodology yielded a ratio of 1.1, indicating no amplification. Sections from multiple regions of both specimens were submitted for further analysis under the CBCP protocol."} +{"pid": "TCGA-SP-A6QK", "report": "The specimen from the left adrenal gland is distorted by a mass measuring 6.5 x 6.5 x 4.2 cm and weighing 86.7 grams. On gross examination, the lesion appears solid with areas of hemorrhage and cystic change; the cyst measures up to 4.0 cm in diameter and contains bloody fluid. A pigmented area measuring 1.0 x 0.5 x 0.4 cm is also noted. Microscopically, the dominant lesion exhibits a solid nesting (\"zellballen\") architecture. The cells are polygonal with indistinct borders, abundant basophilic cytoplasm, and scattered foci of nuclear pleomorphism. Degenerative changes include focal hemorrhage, cystic transformation, and fatty degeneration. The lesion is partially encapsulated without evidence of capsular or extraglandular invasion. Resection margins are free of involvement. No lymphovascular invasion is identified. No additional adrenal pathology or lymph node involvement is present."} +{"pid": "TCGA-GV-A3QI", "report": "The surgical pathology report includes multiple specimens submitted for evaluation. Specimen A, labeled as distal right ureter, consists of a 0.5 x 0.5 x 0.1 cm piece of lumen and was found to be negative for any neoplastic process. Specimen B, the distal left ureter, measures 0.6 x 0.4 x 0.2 cm and was also found to be without evidence of malignancy. \n\nSpecimen C, a right pelvic lymph node, is composed of adipose and fibrous tissue without a distinct nodule and was found to be free of neoplastic cells. Specimen D, labeled as left pelvic lymph nodes, includes ten pink firm nodules ranging in size from 0.3 to 1.5 cm, all of which were negative for neoplasm. Similarly, specimen E, right pelvic lymph nodes #2, contains nine tan firm nodules with sizes varying between 0.5 to 9.0 cm; all were negative for neoplastic involvement.\n\nThe most significant findings pertain to specimen F, which consists of a urinary bladder and prostate. The bladder measures 2.0 x 5.5 x 4.5 cm, and within the posterior wall, a 4.5 x 4.0 x 2.0 cm white papillary-like mass was identified. This mass extends through the muscularis propria into the surrounding perivesical fat, causing retraction of the overlying serosa. No tumor involvement was observed at the bilateral ureteral, urethral, peripheral, or remaining resection margins. Lymphovascular invasion was present. The prostate, measuring 4.5 cm transversely, has a smooth capsular surface and shows no involvement by any urothelial process. High-grade prostatic intraepithelial neoplasia was noted. \n\nSpecimen G, labeled as distal prostatic urethra, measures 2.5 x 1 x 0.9 cm and was found to be negative for any neoplasm upon frozen section analysis.\n\nIn summary, the evaluation of the submitted specimens reveals no evidence of malignancy in the ureters or lymph nodes examined. Involvement is noted in the bladder specimen, with a mass showing deep invasion into the perivesical fat but without lymph node metastasis. All other tissue margins and structures assessed are unremarkable."} +{"pid": "TCGA-UY-A8OB", "report": "The patient is a male who underwent cystoprostatectomy and lymph node excision. Gross examination of the bladder revealed a friable-appearing internal mucosa with a prominent white-tan mass measuring at least 1.9 cm in greatest diameter located near the trigone. The mass was well-circumscribed and partially pedunculated. Histologically, there was invasive high-grade cellular proliferation within the bladder tissue. Invasion extended through the muscularis propria into perivesical tissue. Focal areas of intraepithelial neoplasia were present, but no definitive lymphatic or vascular invasion was identified. Adjacent organs showed no evidence of involvement. Surgical margins including urethral, right ureteral, and left ureteral were free of tumor. The perivesical margin demonstrated invasive tumor less than 0.5 mm from the inked margin.\n\nExamination of pelvic lymph nodes revealed metastatic involvement in one out of four lymph nodes examined, with the largest deposit measuring 1.2 cm in greatest dimension. No extranodal extension was observed. Of note, one focus of atypical prostatic glands was identified on frozen section but was not present on permanent sections and was not diagnostic of malignancy. Prostate and seminal vesicles showed no evidence of tumor involvement. Ureteral biopsies from both sides, both initial and final, showed no abnormal cellular proliferation or tumor involvement. Apical margin biopsy also showed no tumor.\n\nSpecimens were received fresh and processed in multiple cassettes for histologic evaluation. Lymph nodes were serially sectioned and evaluated for tumor involvement. All surgical specimens were reviewed microscopically, and the final diagnosis was confirmed by an attending pathologist following comprehensive review of all pathology slides."} +{"pid": "TCGA-UY-A78N", "report": "The patient is a male who underwent cystectomy and prostatectomy. The surgical specimen was received in seven parts. Part A (distal right ureter) consisted of a 0.7 x 0.6 x 0.2 cm tissue fragment. Part B (distal left ureter) measured 0.6 x 0.6 x 0.3 cm. Part C, labeled as the urinary bladder and prostate, weighed 320 grams and measured 11.8 x 8.0 x 6.5 cm; the prostate measured approximately 5.0 x 5.0 x 4.0 cm. A firm mass measuring 4.0 x 3.5 x 2.2 cm was identified lateral to the right ureteral orifice. This mass extended into surrounding fat, approached the inked surgical margin by approximately 0.6 cm, and was within 1.1 cm of the prostate. No focal lesions were observed in the remaining bladder mucosa or prostate parenchyma. Parts D and E consisted of left and right pelvic lymph node dissections, measuring 5.0 x 4.0 x 3.2 cm and 6.0 x 4.5 x 2.3 cm respectively. Parts F and G included the left and right ureter final margins, with lengths of 1.7 cm and 1.5 cm respectively.\n\nMicroscopic evaluation of the bladder specimen revealed a high-grade lesion involving the muscularis propria and extending into peri-vesicle tissue. Lymphatic and blood vessel invasion were identified. Focal giant cell reaction and acute/chronic inflammation with reactive atypia were noted, but no low-grade dysplasia was diagnosed. All surgical margins were free of involvement. A small focus of a separate finding was identified in the left mid prostate. No perineural invasion was present, and this focus approached the right lateral specimen margin by 0.5 cm. Evaluation of lymph nodes showed one involved lymph node out of a total of fifteen examined; the largest involved deposit measured 0.3 cm in diameter, with no extranodal extension. Additional immunohistochemical stains were performed for diagnostic confirmation. Sections from multiple cassettes were evaluated to establish these findings."} +{"pid": "TCGA-J2-A4AE", "report": "The specimen consisted of a lingular segmentectomy from the left upper lobe of the lung. The specimen was received with a staple line, and no tumor was identified on gross examination. A gray-tan nodule measuring 1.4 x 1 x 0.9 cm was noted within the extended lingular segment. The remainder of the lung tissue appeared gray-brown and spongy with no other lesions observed.\n\nHistologic evaluation revealed a minimally invasive lesion with a histologic grade of 3 out of 4. The lesion was unifocal and measured 1.5 cm in greatest dimension, with the invasive component measuring 0.4 cm. The site of involvement was localized to the lingula. No invasion of the visceral pleura, significant obstructive pneumonitis, or atelectasis was observed. Additionally, there was no evidence of lymphatic or large vessel invasion.\n\nLymph nodes were sampled from multiple stations, including bilateral mediastinal and hilar regions. All lymph nodes examined showed no evidence of tumor involvement. A total of 13 lymph nodes were examined, and none were involved. Resection margins were free of any concerning findings.\n\nA focus of atypical adenomatous hyperplasia was identified in one segment, but no tumor was present at the resection margins. Frozen section analysis of additional specimens also showed no tumor involvement."} +{"pid": "TCGA-EJ-5522", "report": "The patient has a history of prior biopsy findings demonstrating involvement of both sides of the prostate. Gleason grading at various sites included right apex 3+3 = 6; right mid 3+4 = 7; right base 3+3 = 6; left base 3+4 = 7; left mid 3+4 = 7; and left apex 3+3 = 6. The patient underwent radical retropubic prostatectomy. Evaluation of lymph nodes showed no evidence of neoplastic involvement; four right pelvic and eighteen left pelvic lymph nodes were examined.\n\nExamination of the prostate specimen revealed an invasive adenocarcinoma with Gleason score 3+4=7. The tumor was located bilaterally, involving both the right and left lobes, with a maximum nodule size of 1.9 cm. Approximately 20% of the total prostate volume was affected. The lesion was confined within the organ without extension beyond the prostatic capsule. There was no involvement of the bilateral seminal vesicles. All surgical margins were free of tumor. Perineural invasion was present; however, no angiolymphatic invasion was identified. High-grade intraepithelial neoplasia was also present. The prostate weighed 40.48 grams.\n\nPathologic staging was determined as pT2c with no nodal involvement (pN0). A total of 22 lymph nodes were evaluated, and none were positive. No extranodal extension or metastatic involvement was found. The histologic grade was classified as poorly differentiated. Benign prostatic hypertrophy and chronic inflammation were also noted."} +{"pid": "TCGA-CJ-4634", "report": "The right kidney specimen measured 17.0 x 9.0 x 6.0 cm and consisted of a radical nephrectomy, including a 12.0 x 8.0 x 5.0 cm kidney. No adrenal gland was identified. Within the mid-portion of the kidney, there was a well-circumscribed mass measuring 7.0 x 5.6 x 5.0 cm. The tumor bulged into the renal sinus and compressed the renal pelvis. On gross examination, the cut surface of the mass showed red-purple-yellow discoloration with areas of necrosis and hemorrhage. The lesion was entirely contained within the kidney without extension through the capsule. The remaining renal parenchyma appeared normal, and the pelvicalyceal system was smooth and without abnormality. No lymph nodes were identified in the adipose tissue or hilum. Resection margins, including those of the ureter, vein, and artery, were free of involvement. Sections were taken from multiple regions, including the tumor, renal sinus, perinephric fat, and unremarkable renal cortex and medulla. A portion of the tumor was submitted for potential electron microscopy studies. Microscopic evaluation revealed cells with clear cytoplasm, Fuhrman nuclear grade 2, and no evidence of invasion into perinephric or renal sinus adipose tissue, nor into the renal vein."} +{"pid": "TCGA-G9-7525", "report": "The prostatectomy specimen weighed 59 grams and measured 5.5 x 4.4 x 4.2 cm. The capsule was smooth and red. Serial sectioning revealed a yellow-tan, ill-defined mass in the left lateral region measuring 2.2 x 1.8 x 1.5 cm, located approximately 0.2 cm from the surgical margin. The right and left seminal vesicles measured 2.3 x 1.4 x 0.3 cm and 2.4 x 1.2 x 0.3 cm respectively, with beige-tan cystic tissue noted. The vas deferens segments were firm and tan-colored.\n\nHistologic examination identified abnormal cellular infiltration within the prostate gland. High-grade intraepithelial neoplasia was present. Perineural invasion was identified, and focal involvement of periprostatic fat was noted at the left posterior region. No tumor was observed in the seminal vesicles or vas deferens. Surgical margins were free of abnormal cells. The tumor involved approximately 10% of the gland and was present in both lobes. Histologic grade showed a Gleason score of 7 (Grade 4 + Grade 3).\n\nLymph node evaluation included four lymph nodes from the right pelvic region and two from the left pelvic region. All lymph nodes were negative for metastatic disease.\n\nPathologic staging was determined as pT2c, indicating tumor involvement in both lobes of the prostate. Distant metastasis could not be assessed (pMX). All tissue samples were entirely submitted for evaluation. No other significant pathologic findings were identified."} +{"pid": "TCGA-RY-A845", "report": "The specimen consists of two parts received from the left parieto-occipital region of the brain. Part A includes three unoriented, irregular tan-pink soft tissue fragments measuring 1 x 0.6 x 0.2 cm in aggregate. A portion was used for intraoperative frozen section evaluation and cytologic preparation, with remaining tissue submitted for permanent sections. Part B consists of four white-pink, unoriented soft tissue fragments measuring 3 x 2 x 0.7 cm in aggregate, entirely submitted for histologic evaluation.\n\nMicroscopic examination reveals a glial neoplasm with predominantly oligodendroglial features. The nuclei are relatively uniform with only sparse mitotic figures. No microvascular proliferation or necrosis is identified. Immunohistochemical staining shows positivity for IDH1 (R132H mutant) protein. The MIB-1 labeling index on block A2 is approximately 6%, while on block B2 it is approximately 5%. p53 staining demonstrates nuclear reactivity in approximately 20% of tumor cells.\n\nFluorescence in situ hybridization analysis for 1p19q deletion is in progress and will be reported separately. All specimens were processed and interpreted under CLIA-certified conditions. The final diagnosis was confirmed by an attending pathologist after review of all preliminary interpretations and resident documentation."} +{"pid": "TCGA-BJ-A2N9", "report": "The specimen from a total thyroidectomy weighed 27 grams. A single nodule was identified in the right lobe, measuring 2.5 cm. The lesion was confined to the thyroid without evidence of capsular or vascular invasion. Evaluation of three lymph nodes from the surgical specimen revealed no involvement. Additional assessment of eight lymph nodes from the central compartment dissection also showed no evidence of involvement. A total of eleven regional lymph nodes were examined and none demonstrated tumor involvement. Histologic evaluation demonstrated features including follicular architecture with oncocytic change. Chronic inflammatory infiltrate was noted within the thyroid tissue. Staging data indicate a primary tumor classification of pT2 with no regional lymph node involvement (pN0). Surgical margins were uninvolved. There was no evidence of extrathyroidal extension or lymphovascular invasion. Immunohistochemical controls for molecular testing were adequate and amplifiable nucleic acids were present; however, no mutations in BRAF, NRAS61, HRAS61, KRAS12/13, or rearrangements involving RET/PTC1, RET/PTC3, or PAX8/PPARg were detected."} +{"pid": "TCGA-97-A4LX", "report": "The surgical specimens include a lingular nodule, left lower lobe wedge biopsies, and associated margins, along with lymph node biopsies from levels 5, 7, and 9 on the left side. Histologic examination of the lingular nodule reveals a lesion measuring 1 cm in greatest dimension composed predominantly of solid (60%) and acinar (30%) patterns with a minor lepidic component (10%). Immunohistochemical staining shows positivity for TTF-1 and Napsin-A, while staining for p40 is negative. The staple line margin is free of tumor involvement.\n\nIn the left lower lobe, a separate lesion measuring 3.5 cm in aggregate dimensions was identified across multiple specimen parts. This lesion is composed primarily of micropapillary (60%) and papillary (20%) components, with smaller proportions of lepidic (10%) and acinar (10%) elements. The bronchial, vascular, and parenchymal margins are all free of tumor. Lymph node evaluation demonstrates no evidence of metastatic involvement across four nodes from level 5, one node from level 7, and one node from level 9.\n\nThe tumor is classified as histologically high-grade (G3) and appears to be confined without lymphovascular or pleural invasion. Based on size and extent, the primary tumor classification corresponds to pT2a. Regional lymph node staging is pN0, with no metastases identified. Molecular analysis reveals the presence of a KRAS mutation (p.G12A), while no EGFR mutations were detected. Clinical correlation indicates emphysema as an additional non-tumor finding."} +{"pid": "TCGA-AX-A1CN", "report": "A modified radical hysterectomy specimen includes a uterus and cervix with attached bilateral fallopian tubes and ovaries. The cervix measures 3.8 x 5 x 5 cm. A polypoid mass measuring 4.9 x 2.6 x 3.0 cm is identified in the lower uterine segment and upper endocervix, extending to the cervical os. The tumor invades to a depth of 14 mm within the cervix where the total wall thickness is 16 mm. Lymphvascular space invasion is present, including focal involvement in parametrial soft tissue. Resection margins are free of tumor involvement.\n\nThe endometrium shows proliferative changes with a polypoid configuration involving both anterior and posterior walls. Myometrial invasion is noted with a depth of 1 mm where the total myometrial thickness is 2.2 mm. Multiple leiomyomas are present within the myometrium, ranging up to 1.8 cm in maximum dimension.\n\nNo carcinoma is identified in the vagina, right or left ovaries, or fallopian tubes. Paratubal cysts are noted on both sides. No histopathologic abnormalities are seen in the right ovary or fallopian tube. Serosal fibrous adhesions are present on the left ovary.\n\nLymph node dissection specimens include right and left external iliac, common para-aortic, obturator, and internal iliac lymph nodes. In total, 18 lymph nodes have been evaluated across all regions, and none show evidence of carcinoma. Omental tissue is also free of tumor.\n\nGross examination reveals no lesions on the serosal surface of the uterus. A subserosal leiomyoma measuring 1.8 cm in diameter is identified. The vaginal cuff margins are clear. Microscopic evaluation confirms the absence of tumor at all resection margins. Multiple sections from the cervix, endometrium, myometrium, and parametrial tissues have been submitted for analysis. All lymph node specimens have been entirely submitted for histopathologic review."} +{"pid": "TCGA-D1-A1NX", "report": "A biopsy of soft tissue from the ileal serosa shows benign fibroadipose tissue without evidence of neoplasm. A separate biopsy of the anterior vaginal mucosa reveals benign squamous mucosa and submucosa, also without tumor involvement. A hysterectomy specimen with bilateral salpingo-oophorectomy demonstrates a mass measuring 5.5 x 5.2 x 1.5 cm located in the endometrial cavity and lower uterine segment. Microscopic evaluation indicates that the mass extends into the myometrium with an invasion depth of 2.0 cm out of a total wall thickness of 2.1 cm. Involvement of the endocervix is noted. Lymphovascular space invasion is present. Surgical margins are free of tumor. The bilateral ovaries and fallopian tubes show no signs of involvement.\n\nLymph node assessment reveals metastatic involvement in several regions. Of the left pelvic lymph nodes, 7 out of 25 are involved. On the right side, 1 out of 14 pelvic lymph nodes is involved. In the para-aortic region above the inferior mesenteric artery (IMA), 1 of 2 lymph nodes on the left and all 6 on the right are negative. Below the IMA, 4 of 13 left para-aortic lymph nodes and 2 of 2 right para-aortic lymph nodes are positive for metastasis. The omentum, as well as biopsies of both gonadal vessels, show no evidence of tumor involvement.\n\nThe surgical staging is based on AJCC criteria and corresponds to pT1bN2 (7th edition, 2010). This pathology report incorporates findings from gross examination, frozen section analysis, and subsequent review of permanent Hematoxylin and Eosin (H&E) sections. Any significant changes identified upon further review will be addressed in a revised report."} +{"pid": "TCGA-44-3919", "report": "A right upper lobe wedge resection specimen consists of a tissue fragment measuring 6.5 x 4 x 3.5 cm. A 2.5 cm nodule is identified within the tissue, described as spongy and tan in appearance, extending to the stapled margin of resection. The remainder of the specimen shows no other distinct lesions. A right lobe lobectomy specimen measures 14 x 10.5 x 5 cm and contains multiple staple lines. A small area measuring 1.2 x 0.6 x 0.3 cm is identified near the staple line and appears to be involved with a lesion. No additional discrete lesions are found throughout the rest of the lung tissue.\n\nLymph node specimens were submitted from levels 10, R-4, and 7. The level 10 lymph nodes consist of multiple fragments measuring 2 x 1 x 0.7 cm and contain six lymph nodes, none showing any abnormal involvement. The R-4 lymph nodes measure 3.2 x 2.2 x 1.5 cm and include 12 lymph nodes, all without evidence of abnormal spread. Level 7 lymph nodes measure 1.7 x 1.2 x 0.6 cm and include three lymph nodes, none showing signs of involvement.\n\nHistologic evaluation of the wedge resection reveals moderately differentiated cells with a size of 2.5 cm. Resection margins are negative. There is no evidence of vascular or lymphatic invasion. The right lobe specimen demonstrates residual cellular changes measuring 1.5 cm adjacent to the staple line, which likely represents an extension of the primary lesion. Resection margins remain uninvolved. No metastatic involvement is identified in any of the lymph nodes evaluated across all levels."} +{"pid": "TCGA-73-7499", "report": "The surgical specimens included multiple lymph nodes from various locations, including 4R, 2nd 4R, 4L superior, 4L inferior, level 7, 2R, and 2L. All were biopsied and found to be benign. A right upper lobectomy was performed, revealing a centrally located mass measuring 3 cm in greatest diameter, with additional dimensions of 2.5 cm \u00d7 2.0 cm. Microscopic examination showed a moderately differentiated infiltrative tumor composed predominantly of acinar subtype (50%), with lepidic (40%) and solid (10%) components. No angiolymphatic invasion was identified, and the bronchial margins were uninvolved, with the tumor located approximately 2 cm from the margin. There was no visceral pleural involvement or satellite tumors. One benign peribronchial lymph node was identified. Lymph node staging revealed no involvement in N1 (0/1), N2 (0/18), or N3 (0/2) groups. Non-neoplastic findings included emphysematous changes and atelectasis. The tumor was staged as pT2a based on AJCC 7th edition guidelines."} +{"pid": "TCGA-AC-A2FM", "report": "The specimen consisted of two lymph nodes measuring up to 1.0 x 0.8 x 0.5 cm, both submitted for analysis. Microscopic evaluation identified small foci of metastatic cells within the perinodal connective tissue, confirmed by cytokeratin staining, though no involvement was seen within the nodal structure itself. The foci measured approximately 0.5 cm.\n\nA separate breast specimen weighing 450 grams included a dense mass measuring 3 x 3 x 2.8 cm, located near the lateral aspect and extending from 1 cm beneath the skin to within 0.1 cm of the deep margin. Histologic grading showed an architectural score of 3/3, nuclear score of 2/3, and mitotic score of 1/3, resulting in an overall grade of II. No significant in situ component or angioinvasion was observed. Surgical margins were clear, with the closest margin measuring approximately 0.2 cm at the deep margin.\n\nAdditional tissue sampling included sections from all four quadrants, the nipple, and margins, submitted in multiple cassettes. A second smaller mass measuring 2.5 cm was also noted near the deep margin. Genomic studies were performed on selected sections."} +{"pid": "TCGA-J4-A83I", "report": "A right and left obturator lymph node specimen was submitted for analysis. The frozen section (FS) and non-frozen section (NFS) components of both right and left obturator lymph nodes were evaluated. The right obturator lymph node FS consisted of three gray-tan fibrofatty tissue fragments, the largest measuring 1.4 x 1 cm and the smallest 1.2 x 0.4 cm. The NFS portion measured 4 x 3 cm with three probable lymph nodes identified, the largest being 1 x 1 cm and the smallest 0.7 x 0.2 cm. On the left side, the FS component included three yellow fibrofatty fragments ranging from 1.3 x 0.6 cm to 0.7 x 0.4 cm. The NFS portion measured 3 x 2 cm with three probable lymph nodes identified, the largest measuring 2 x 1 x 0.2 cm and the smallest 0.5 x 0.4 cm. All lymph node specimens were negative for tumor involvement.\n\nA separate fibrous tissue fragment labeled as bladder neck (FS) measured 1.5 x 1 cm and showed fibromuscular tissue with scant prostatic glands; no tumor was identified.\n\nThe prostatectomy specimen included the prostate gland, seminal vesicles, and vas deferens. The prostate measured 3 x 3 x 2.5 cm and weighed 20 grams. The capsule appeared disrupted at the bladder resection margin. Histologic evaluation revealed a firm, focally nodular parenchymal region. A dominant nodule measuring at least 1.8 cm was identified. Histopathologic features included a Gleason score of 4 + 3 = 7/10, with no tertiary pattern observed. Tumor involvement was estimated at 30\u201350% of the tissue. There was no evidence of treatment effect. Perineural invasion was present, while lymphatic (small vessel) invasion was not observed. No tumor was identified in the seminal vesicles or at the margins of the prostate, soft tissue, urethra, or bladder neck. The tumor site involved both right and left prostate lobes, predominantly within the peripheral zone. The surgical staging was pT3a, pNo, pMX."} +{"pid": "TCGA-DX-A1KY", "report": "The specimen consists of a 39.5 x 24.5 x 13.0 cm soft tissue mass, which includes a 31.0 x 21.0 x 13.0 cm firm yellow-white lobulated component continuous with a 24.5 x 22.5 x 6.2 cm lobulated soft yellow area. A focal disruption measuring 12.8 x 5.5 cm is present within the mass, showing hemorrhagic and necrotic changes. The tumor is covered with a thin serosal membrane.\n\nThe mass involves multiple anatomical structures. It adheres to a 17.0 x 8.5 cm segment of colon; however, the colonic mucosa and wall are uninvolved. The colonic margins are negative. The tumor also encases a 11.3 x 5.8 cm kidney with a 17.5 cm ureter embedded within the mass. The perinephric fat is pale yellow and smooth, with focal adherence to the kidney. An adrenal gland measuring 2.8 x 1.7 x 0.3 cm is embedded in the surrounding fat superior to the kidney. No remarkable involvement is seen in the renal or adrenal parenchyma, nor in the ureter.\n\nHistologic examination reveals a high-grade component with a malignant fibrous histiocytoma-like growth pattern. This dedifferentiated component predominates and shows extensive necrosis. The tumor extends to an undesignated inked margin. Sections from various representative areas including colonic margins, ureterovascular margin, kidney, adrenal gland, disrupted tumor regions, and tumor borders were submitted for analysis. All small intestinal and colonic margins are negative."} +{"pid": "TCGA-18-3416", "report": "The surgical specimen included multiple lymph node samples and a left upper lobe lung lobectomy. Lymph nodes evaluated included those from the inferior pulmonary ligament, left tracheobronchial angle, and various segmental and subsegmental regions. All lymph nodes were negative for malignancy, although several exhibited marked anthracosis with nodular fibrosis. The primary lung lesion measured 8.0 cm in greatest dimension and was located in the left upper lobe. The tumor was well-circumscribed, white-tan in color, and firm on sectioning. It was situated 1.5 cm from the bronchial resection margin, 1.0 cm from the closest pleural surface, and 0.7 cm from the pulmonary artery margin. Histologic examination revealed no involvement of resection margins, no direct tumor extension, and no evidence of vascular or lymphatic invasion. Staging indicated tumor size greater than 3 cm with involvement of ipsilateral peribronchial and hilar lymph nodes. Additional findings included anthracotic deposits within the walls of terminal and respiratory bronchioles. Asbestos fiber analysis identified numerous ferruginous bodies in lung tissue sections. Multiple tissue blocks were submitted for microscopic evaluation, including representative sections of the tumor, surrounding lung parenchyma, resection margins, and lymph nodes."} +{"pid": "TCGA-AO-A0JL", "report": "The left breast specimen includes two distinct tumor nodules. One is located in the upper outer quadrant, measuring 3.9 cm in greatest dimension. The second lesion is found in the upper and lower outer quadrants at the 3:00 position. Histologic evaluation reveals a predominant intraductal component with multiple small invasive foci measuring between less than 0.1 cm and 0.4 cm. The intraductal component involves solid and cribriform patterns with high nuclear grade and extensive necrosis, extending focally into a large lactiferous duct beneath the nipple. Calcifications are present within both the in situ and invasive components as well as in benign breast parenchyma. Vascular invasion is noted. No involvement of surgical margins or skin is observed. A prior biopsy site is identified in the lower outer quadrant along with mild fibrocystic changes in the remaining breast tissue.\n\nAxillary lymph node dissection includes specimens from levels I, II, and III. Grossly positive lymph nodes are present in level I and low level II, with extranodal tumor extension greater than 2 mm. Additional lymph node specimens from level II and level III show no evidence of involvement. Immunohistochemical staining demonstrates absence of hormone receptor expression (ER and PR negative) and HER-2 negativity based on immunostaining intensity."} +{"pid": "TCGA-CQ-7065", "report": "The surgical specimen from the right tongue resection measured 3.5 cm in the short inferior dimension, 1.8 cm in the medial-lateral dimension, and 4.8 cm in the anterior-posterior dimension. An ulcerated lesion was identified on the lateral surface of the tongue, measuring 2.2 cm in the short inferior dimension, 1.2 cm in the medial-lateral dimension, and 2.7 cm in the anterior-posterior dimension. The tumor was solid in consistency with a gray-tan appearance. Margins were evaluated microscopically, including the superior, medial, anterior, posterior, and deep margins, all of which were free of malignant cells with distances greater than 0.5 cm from the tumor edge.\n\nA total of 40 lymph nodes were examined from bilateral neck dissections, including 39 nodes from bilateral neck contents and one node from the left neck level IV. All lymph nodes showed no evidence of malignancy. Additional specimens, including the right sublingual gland, bilateral submandibular glands, and soft tissue samples, demonstrated only chronic inflammation or benign findings. No perineural or lymphovascular invasion was identified.\n\nHistologic evaluation of the resected tongue specimen revealed moderately differentiated cellular features. Tumor thickness measured 1.2 cm, and the greatest tumor dimension was 2.7 cm. Based on these measurements, staging was classified as pT2. No regional lymph node involvement was detected (pN0), and distant metastasis could not be assessed (pMX). Intraoperative frozen section analysis of all margins confirmed the absence of tumor involvement. Immunohistochemical testing for p16 was negative in the tumor cells."} +{"pid": "TCGA-2W-A8YY", "report": "The surgical specimen consisted of a uterus with cervix, bilateral fallopian tubes and ovaries, right and left pelvic lymph nodes, a right periaortic lymph node, and a sigmoid adhesion. The uterus weighed 260 grams and measured 13.5 x 6.5 x 6.0 cm. A subserosal mass measuring 4.5 x 2.9 x 1.0 cm was identified on the posterior serosa, with a cystic structure containing clear fluid. The tumor was circumferentially located in the upper cervix with extensive transmural extension into the corpus. Histologic evaluation showed high-grade features with stromal invasion measuring 1.2 cm in depth and complete circumferential horizontal spread. There was evidence of lymphovascular invasion in cervical lymphatics and parametrial vein.\n\nMargins were positive at the posterior serosa of the uterine body, while the distal mucosa was negative. No other structures showed signs of invasion. A total of 18 lymph nodes were examined: five from the right pelvic region, ten from the left pelvic region, and three from the right periaortic region. All were reactive and without evidence of metastasis. The soft tissue from the sigmoid adhesion was also negative for tumor involvement.\n\nMicroscopic examination included multiple sections from the anterior and posterior cervix, endocervical canal, uterine fundus, ovaries, fallopian tubes, and parametrial tissues. Immunohistochemical staining showed patchy expression of p16 and CEA, with no reactivity for ER or vimentin. Clinical staging was consistent with T2a2/N0 based on AJCC Cancer Staging Manual, 7th edition. Intraoperative gross examination noted extensive necrotic changes involving the uterus and cervix."} +{"pid": "TCGA-AJ-A8CV", "report": "The specimen included left and right pelvic lymph node aggregates, as well as a uterus with attached cervix and bilateral adnexa. The left pelvic lymph nodes measured 7.0 x 4.0 x 2.0 cm and contained multiple lymph nodes up to 5.0 cm in greatest dimension. The right pelvic lymph nodes measured 8.2 x 5.7 x 1.7 cm with lymph nodes up to 4.6 cm. All lymph nodes were submitted for analysis and found to be benign.\n\nThe uterus weighed 79.4 grams and measured 6.5 x 5.0 x 4.0 cm. A tumor measuring 4.5 x 3.0 x 2.0 cm was identified within the endometrial cavity, which was 3.5 cm in both width and length. The tumor extended approximately 0.7 cm into the myometrium, where the total myometrial thickness was 1.7 cm. No gross involvement of the low uterine segment was observed. Microscopic evaluation showed that the tumor invaded more than half of the myometrium, with a maximal depth of 11 mm in a 17 mm thick myometrium. There was no extension beyond the endometrial cavity, and lymphovascular space invasion was not identified. Surgical margins, including cervical and parametrial margins, were negative.\n\nSections of the cervix, parametrium, ovaries, and fallopian tubes showed no pathological findings. An encapsulated yellow tan nodule measuring 0.9 x 0.7 x 0.5 cm was identified separately and found to be centrally ascitic. Other findings included complex hyperplasia with atypia in the endometrium, a leiomyoma in the myometrium, and focal endometriosis on the uterine serosa. Bilateral fallopian tubes and ovaries appeared unremarkable. A benign appendix epiploica was also noted.\n\nA total of 14 regional lymph nodes were examined (8 from the left side and 6 from the right), and none contained metastatic disease. The assessment included histologic analysis of all relevant tissues, with no evidence of tumor extension beyond the endometrial cavity. Genomic studies were performed on representative sections of the tumor."} +{"pid": "TCGA-VD-A8K7", "report": "The specimen consists of an intact left eye with axial dimensions measuring 25mm, horizontal 25mm, and vertical 24mm. The cornea is clear, with horizontal and vertical diameters of 12mm and 11mm respectively. The optic nerve measures 6mm in length and 4mm in diameter. The anterior chamber is of normal depth, and the ciliary muscles are moderately atrophic with hyalinization of the ciliary processes. The lens shows moderate cataractous changes.\n\nTrans-illumination reveals a shadow measuring 18 x 16mm located laterally. Upon sectioning in the horizontal plane, a large mushroom-shaped lesion is identified in the choroid with an area of necrosis. There is a total funnel-shaped retinal detachment with extensive subretinal fluid. The retina demonstrates advanced atrophy and degenerative changes.\n\nHistological examination shows a dome-shaped lesion in the posterior segment. The lesion is non-pigmented and composed predominantly of spindle cells with numerous balloon cells present. Immunohistochemical staining demonstrates reactivity for MelanA and HSP-27 (score 2). Mitotic activity is approximately 4 per 40 high power fields. The microvasculature is prominent with presence of closed loops and occasional vascular lakes, with tumor cells observed within these lumina. Lymphocytic infiltration is minimal, and scattered macrophages are present in mild density throughout the lesion. There is no evidence of scleral invasion or extraocular extension.\n\nThe optic nerve appears free of involvement and demonstrates mild atrophic changes. Examined vortex veins do not show any involvement. The measured largest basal diameter of the lesion is 17mm, with a thickness of 13mm.\n\nMolecular genetic analysis was performed using MLPA on DNA extracted from fresh tissue. The DNA concentration was high and of good quality. Testing was conducted using kit P027, which evaluates 31 loci on chromosomes 1, 3, 6, and 8. Results demonstrated normal chromosomes 1, 3, and 8, along with a gain in chromosome 6p. These findings will be correlated with clinical and morphological data for further assessment."} +{"pid": "TCGA-GJ-A3OU", "report": "The operative procedure involved a laparoscopic right hepatectomy with removal of segment 8 of the liver. The specimen measured 10.5 x 7.8 x 2.5 cm and was previously inked and dissected. The external surface was brown-tan, smooth, and lobulated. On sectioning, an irregular, ill-defined mass measuring 2.7 x 2.3 x 1.8 cm was identified. This mass was located adjacent to the liver capsule and was 1.6 cm from the nearest resection margin. The remainder of the liver parenchyma appeared brown-tan and exhibited a finely nodulated texture.\n\nMicroscopic evaluation revealed a unifocal lesion with moderately differentiated cellular features. The tumor was confined entirely within the liver and did not involve any margins. The closest distance from the invasive component to the surgical margin was 1.6 cm. No lymph-vascular invasion was observed, either macroscopically or microscopically. The surrounding liver tissue showed evidence of cirrhosis and steatosis.\n\nPathologic staging according to the pTNM system was determined as pT1. No lymph nodes were examined, thus regional lymph node involvement could not be assessed (pNX). There was no evidence of distant metastasis. Representative sections were submitted for analysis, including tissue from the mass near the surgical margin, the mass in relation to the liver capsule, and areas of uninvolved liver parenchyma."} +{"pid": "TCGA-AC-A23E", "report": "The pathology report includes findings from three specimens collected during a right breast mastectomy procedure with sentinel lymph node evaluation.\n\nSpecimen A, identified as a right axillary sentinel lymph node, measured 2 cm and showed total replacement by metastatic cells. The node was yellow-tan and firm, with the entire specimen submitted for analysis.\n\nSpecimen B, a right breast mastectomy specimen, weighed 1050.0 g and measured 22.0 x 18.5 x 6.5 cm. It included skin with an everted nipple and a previous biopsy site located 5.0 cm from the nipple. A central mass measuring 3.8 x 3.5 x 2.6 cm was identified; it was gray-white, firm, gritty, and surrounded by fibrosis, located 2.0 cm beneath the skin surface and approaching within 2.3 cm of the deep margin. The architectural score was 1 of 3, nuclear score was 2 of 3, and mitotic score was 2 of 3, resulting in a total score of 5 of 9. No involvement of the skin or nipple was observed, and the deep margin was free of disease. Multiple sections were submitted for histologic evaluation, including the nipple, skin lesions, deep margin, and uninvolved tissue.\n\nSpecimen C, a second right axillary sentinel lymph node, measured 0.9 cm and showed no evidence of metastatic disease. It was similarly processed and submitted for detailed examination.\n\nIntraoperative frozen section confirmed the presence of tumor in the first lymph node. The pTNM classification assigned was pT2 pN1 Mx. Hormone receptor status showed 32% expression and 84% expression."} +{"pid": "TCGA-E1-A7YY", "report": "Surgical Pathology: Finati. CLINICAL HISTORY: Right frontal lesion. GROSS EXAMINATION: A. \"Brain lesion (AF1)\" received fresh for frozen section, measuring 5 x 4.5 x 2.3 cm, consisting of multiple fragments of yellow and gray-tan tissue with blood clot. Portions were previously submitted as frozen; remaining tissue submitted in Blocks A1-A6. B. \"Brain lesion (anterior)\" received fresh and placed in formalin, measuring 4.5 x 3.3 x up to 1.8 cm; multiple representative sections submitted in Blocks B1-B5. C. \"Brain lesion\" received fresh and placed in formalin, measuring 3.5 x 3 x 1.0 cm, composed of multiple fragments of soft pink and white tissue; representative sections retained in formalin and remainder submitted in Blocks C1-C3. INTRA OPERATIVE CONSULTATION: A. \"Brain lesion\": AF1 \u2013 glial neoplasm, favoring low-grade morphology (Dr. [Name] consulted). MICROSCOPIC EXAMINATION: Specimens from containers A (\"brain lesion AF1\"), B (\"brain lesion anterior\"), and C (\"brain lesion\") show tissue infiltrated or replaced by a population of neoplastic cells. The cells exhibit round nuclei with stippled chromatin and perinuclear halos are present in many regions. Focal calcification is identified, along with perineuronal satellitosis. In some areas, endothelial cell enlargement is observed and foci of macrophages are present. All specimens were evaluated and findings are consistent across all blocks. I certify that I personally conducted the diagnostic evaluation of the above specimens and have rendered the diagnoses."} +{"pid": "TCGA-A7-A426", "report": "The final surgical pathology report includes the following findings:\n\nA right axillary sentinel lymph node resection included three lymph nodes, of which two were involved. A separate right axillary lymph node resection included 17 additional lymph nodes, with 11 showing involvement. The largest metastatic deposit measured 1.1 cm, and extracapsular extension was present. On the left, a single sentinel lymph node showed no evidence of involvement. In total, 13 out of 20 lymph nodes examined were positive.\n\nRight mastectomy specimen showed a lesion measuring approximately 6 cm in greatest dimension. Histologic grading revealed an architectural score of 3, nuclear score of 1, and mitotic score of 1. The deep margin of resection was free of tumor. No vascular invasion or involvement of skin or chest wall was identified. Adjacent non-tumorous breast tissue showed fibrocystic changes with ductal hyperplasia and in situ cellular changes. A prior biopsy site was identified near the lateral aspect of the specimen, within 0.5 cm of the deep margin.\n\nThe left mastectomy specimen contained a residual focus of cellular abnormality measuring up to 5 mm in maximum dimension. The deep margin was negative for tumor involvement. No vascular invasion or skin/chest wall involvement was seen. Non-neoplastic changes in the breast tissue included fibrocystic alterations with ductal hyperplasia and microcalcifications. A prior biopsy site was located in the lower outer quadrant, within 1.2 cm of the deep margin.\n\nIn the right axillary tissue, a small focus of similar cellular infiltration was identified microscopically within the submitted tissue fragment; margins of this tissue were free. \n\nHormone receptor analysis from prior biopsies indicated estrogen and progesterone receptor positivity, with normal expression levels for HER-2/neu noted.\n\nAll other margins including nipple and overlying skin were unremarkable in both mastectomy specimens."} +{"pid": "TCGA-23-1031", "report": "The surgical specimens include multiple sites of involvement with a neoplastic process. The omentum shows extensive replacement by metastatic tumor characterized by nodular and plaque-like aggregates. The left ovary is partially replaced by invasive tumor, with significant involvement of the serosal surface. Similar findings are noted in the right ovary, which is nearly completely replaced by tumor. Both adnexal regions show tumor extending into paraovarian and paratubal soft tissues. The fallopian tubes demonstrate involvement of the serosal surface, with tumor aggregates adherent to the fimbriated ends and free-floating tumor cell clusters within the lumina.\n\nMetastatic involvement is also present in the rectosigmoid and cecal regions of the large intestine, as well as in the mesentery of the small intestine, right adnexal soft tissue, cul-de-sac, and liver. In the liver, tumor involves the capsular surface and extends into the parenchyma, accompanied by steatosis, mild hepatocyte pleomorphism, chronic inflammation, and focal fibrosis. Uterine involvement includes the serosal surface, subserosa, and myometrium, with extension into parametrial tissues. The cervix and vaginal cuff are uninvolved.\n\nTumor morphology across all sites demonstrates papillary, glandular, and solid growth patterns, with areas of necrosis, inflammatory response, stromal reaction, and frequent psammoma bodies. Lymphovascular invasion is identified in most involved sites. Some areas exhibit undifferentiated or anaplastic features, pseudo-transitional appearance, hobnail morphology, and clear cell changes.\n\nAdditional findings include cystic Walthard rest, benign paraovarian adenofibroma, ovarian epithelial inclusions, endocervical polyp, adenomyosis, leiomyomas of varying sizes and characteristics, and inflammatory changes in several tissues. The uterine specimen weighs 70 grams, with a maximum myometrial thickness of 1.7 cm. Leiomyomas range from microscopic to 1.7 cm in diameter, with some showing hyalinization. Multiple tumor nodules are observed on the uterine serosa and in parametrial regions.\n\nThe largest tumor measured is in the right ovary at 8.6 x 7.4 x 6.2 cm. Other tumor-bearing specimens include fragments from the sigmoid-rectal region (2.6 cm greatest dimension), cecum (1.5 cm), liver biopsy (2.0 cm), and cul-de-sac (5.0 cm). Tumor in the fallopian tubes ranges from pinpoint to 1.2 cm in size. Multiple lymph nodes and mesenteric fat fragments also contain tumor.\n\nMicroscopic features include high-grade nuclear atypia, lymphovascular invasion, inflammatory infiltrates, and fibrotic stromal reaction. Tumor is found in both free-floating and attached forms within the fallopian tube lumina. Adhesions and chronic inflammatory changes are commonly observed alongside tumor deposits throughout the examined tissues."} +{"pid": "TCGA-MN-A4N1", "report": "The specimen consists of a 143 g, 13.2 x 9.8 x 4.2 cm lobe of lung with a 0.8 x 0.8 cm indurated central area of puckering on the lateral pleural surface. A 2.6 x 2.0 x 2.0 cm tan-yellow to white granular, poorly demarcated lesion is identified along the lateral aspect, grossly extending to the area of pleural puckering. The lesion is 2.8 cm from the bronchial resection margin, 2.3 cm from the closest vascular resection margin, and 1.7 cm from the closest staple line resection margin. The remaining lung parenchyma appears unremarkable without congestion, consolidation, or emphysematous change. No additional lesions or lymph nodes are identified upon sectioning the peribronchial region.\n\nSections submitted include vascular and staple line resection margins, the lesion with overlying pleura and adjacent lung tissue, and uninvolved parenchyma. Lymph nodes from various stations were also submitted, ranging in size from 0.3 cm to 2.5 cm. Most lymph nodes showed anthracotic pigmentation and fatty replacement; none showed any evidence of malignancy.\n\nMicroscopic examination revealed a poorly differentiated cellular proliferation arranged in certain patterns involving the pleura. Visceral pleural invasion was noted. The closest distance from the lesion to a resection margin was 1.7 cm at the parenchymal margin. No involvement was found at the bronchial, vascular, or other margins. There was no evidence of tumor extension into other structures such as the chest wall or parietal pleura. Lymphovascular invasion was present, but perineural invasion was not identified. Necrosis was observed within the lesion.\n\nA total of 21 lymph nodes were examined across multiple stations; all were negative for malignancy. Additional findings included emphysematous changes, congestion, focal interstitial fibrosis, and hemosiderin-laden macrophages in non-neoplastic lung tissue.\n\nImmunohistochemical staining for a specific protein was negative. Molecular testing performed on the relevant tissue did not detect mutations in a specific gene. Fluorescence in situ hybridization (FISH) analysis for a gene rearrangement was also negative, with additional copies of an intact gene signal noted in some cells."} +{"pid": "TCGA-BW-A5NO", "report": "The surgical specimen from the right hepatic lobe is wedge-shaped and weighs 985 grams, measuring 17 x 14 x 8.5 cm. The external surface is red tan with an irregular gray nodular area measuring 8 x 6 cm. This nodule is within 1.7 cm of the surgically marked margin and shows a gelatinous, yellow-orange appearance on sectioning. Adjacent to the primary lesion, two satellite nodules are identified, measuring 0.7 cm and 1.5 cm, located approximately 2 cm away and within 2 cm of the surgical margin. The gallbladder is adhered to the liver tissue, measuring 6 x 2.5 x 2.5 cm, with thickened green-yellow bile and no calculi noted. The gallbladder wall is uniformly 0.2 cm thick with a trabeculated mucosal surface. A total of 14 cassettes were submitted for microscopic evaluation, including sections of the tumor capsule, margins, adjacent liver tissue, satellite nodules, and areas involving the gallbladder wall.\n\nA separate specimen from the abdominal wall consists of a red tan to gray tan tissue fragment measuring 5 x 3.5 x 1.2 cm. Histologic examination reveals fibrosis, hemorrhage, and granulation tissue within skeletal muscle; no malignant cells are present.\n\nMicroscopic analysis of the liver specimen reveals moderately to focally poorly differentiated cellular elements. There is focal suspicion for small vessel invasion, though no macrovascular involvement is identified. The background liver parenchyma demonstrates chronic changes including portal inflammation, mild interface activity, lobulitis, and fibrous expansion of portal areas. Trichrome staining highlights fibrosis consistent with Ishak stage 3. No steatosis is observed. An incidental small bile duct lesion measuring 0.1 cm is noted.\n\nMargins are uninvolved with the closest distance from the lesion to the resection margin being 1.7 cm. Three satellite nodules are identified at 1.5 cm, 0.7 cm, and 0.2 cm. All measures have been documented in relation to the largest nodule. Multiple tissue blocks were processed for comprehensive histological assessment."} +{"pid": "TCGA-WK-A8XQ", "report": "The specimen was received fresh in ten parts, each labeled with the patient\u2019s name and unit number. Part A, labeled as \"1. Omentum,\" consists of one fragment of tan/red fibroadipose tissue measuring 17.5 x 15 x 2 cm. Scattered areas of thickening are present, revealing firm, white/tan, focally hemorrhagic caked tissue upon sectioning. Microscopic examination reveals high-grade spindle cell neoplasm with approximately 3 mitoses per 10 high power fields. The tissue shows 50% necrosis and 30% hemorrhage. Immunohistochemical staining demonstrates positivity for CD99, with focal positivity for MDM-2 and CDK4, which is weak in intensity. Rare S100 positivity is also noted. Negative markers include HMB45, Pan-K, CD34, and Desmin.\n\nPart B, labeled as \"2. Mesentery Sarcoma (Tissue Bank),\" consists of multiple fragments of tan/yellow fatty tissue measuring 36.5 x 32.5 x 4.0 cm and weighing 3130 grams. The tissue is multifocally hemorrhagic and necrotic, with 20% gelatinous clotted blood. Microscopic sections show similar features to those seen in Part A, including a high-grade spindle cell proliferation, 3 mitoses per 10 high power fields, 50% necrosis, and 30% hemorrhage. The immunohistochemical profile supports the microscopic findings. Sections were submitted for tissue banking, laboratory analysis, and cytogenetic evaluation."} +{"pid": "TCGA-E2-A105", "report": "The right breast lumpectomy specimen measures 9.0 x 8.0 x 3.5 cm and weighs 72 grams. A firm, stellate mass measuring 1.1 x 1.0 x 0.1 cm was identified, located 0.8 cm from the anterior margin, 1.5 cm from the lateral margin, and 2.0 cm from the posterior margin. The surgical margins were evaluated microscopically and found to be free of abnormal cellular proliferation. Histological analysis of the invasive component showed a tubular score of 3, nuclear grade 1, and mitotic score of 1 (0\u20136 per 10 high power fields), corresponding to a total Modified Scarff Bloom Richardson Grade I. No necrosis or vascular/lymphatic invasion was identified. Ductal carcinoma in situ (DCIS) of low nuclear grade, solid type, was present in association with the invasive component, comprising approximately 5% of the lesion. Surgical margins were also free of DCIS. Non-neoplastic findings included ductal hyperplasia of usual type, columnar cell change, and fibrosis consistent with prior biopsy site changes. One sentinel lymph node from the right axilla was received, measuring 1.0 x 0.5 x 0.3 cm and 2.0 x 1.0 x 0.5 cm respectively; all lymph nodes examined were negative for involvement.\n\nThe left breast lumpectomy specimen measured 8.5 x 5.5 x 3.4 cm and weighed 75 grams. A firm, white stellate mass measuring 3 x 2.5 cm was identified. Microscopically, this lesion demonstrated a tubular score of 3, nuclear grade 2, and mitotic score of 2 (7\u201313 per 10 high power fields), corresponding to a total Modified Scarff Bloom Richardson Grade II. The invasive component measured 3.0 cm in maximum dimension and was located 1.0 cm from the anterior margin, 1.6 cm from the posterior margin, 2.3 cm from the inferior margin, 2.6 cm from the superior margin, 1.3 cm from the medial margin, and 1.0 cm from the lateral margin. All surgical margins were free of tumor. DCIS of intermediate nuclear grade, solid type, was identified adjacent to the invasive component and accounted for approximately 10% of the lesion. Necrosis was present within the DCIS component. Non-neoplastic findings included fibrocystic changes, ductal hyperplasia of usual type, columnar cell change, columnar cell hyperplasia, and a benign intraductal papilloma. Fibrosis suggestive of prior biopsy site change was also noted. One sentinel lymph node from the left axilla was received and measured 1.3 x 1.2 x 1.0 cm; it was histologically negative for tumor involvement.\n\nPathological staging for the right breast lesion was pT1c N0 and for the left breast lesion was pT2 N0."} +{"pid": "TCGA-D1-A17R", "report": "The specimen consists of a uterus with attached bilateral fallopian tubes and ovaries, along with right and left pelvic lymph node biopsies. The uterus weighs 190.0 grams and the cervix is unremarkable. A polypoid mass measuring 4.4 x 3.9 x 1.2 cm is present in the fundus of the endometrial cavity. The myometrium has a total thickness of 2.2 cm, with the mass invading 0.1 cm into this layer. No involvement of the endocervix or cervix is observed. The serosal surface of the uterus is smooth and no leiomyomas are identified.\n\nThe right ovary measures 3.0 x 2.0 x 1.2 cm with a smooth outer surface and solid cut surface. The right fallopian tube measures 7.0 x 0.8 cm. The left ovary is larger at 4.2 x 2.8 x 1.7 cm, with a ragged outer surface and cystic changes. Its fallopian tube measures 6.5 x 0.8 cm and has a solid cut surface.\n\nLymphovascular space invasion is not identified. Surgical margins are negative for any abnormal tissue. The cervix, bilateral ovaries, fallopian tubes, and appendix appear normal.\n\nIn the right pelvic lymph node biopsy, an aggregate of adipose and lymphatic tissue measuring 10.0 x 7.0 x 2.0 cm is submitted, containing multiple (5) lymph nodes, all without evidence of abnormal cellular infiltration. In the left pelvic lymph node biopsy, an aggregate measuring 6.0 x 4.0 x 0.9 cm is submitted, containing multiple (6) lymph nodes, which also show no signs of abnormality.\n\nMicroscopic evaluation includes multiple sections from the endometrial mass, fallopian tubes, ovaries, cervix, and uterine segment. All lymphatic tissue from both right and left pelvic biopsies is submitted for analysis. Based on histologic evaluation and gross examination, no pathological findings are detected in the lymph nodes or other submitted tissues."} +{"pid": "TCGA-3B-A9HT", "report": "The specimen from the right side of the oral cavity measured 5.0 cm in length, 4.0 cm in width, and 3.0 cm in thickness. A mass measuring 4.0 x 4.0 x 0.7 cm was identified on the mucosal surface of the tongue. It was irregular, exophytic, and focally necrotic with areas of hemorrhage. The tumor was centrally located, with the closest margin measuring 0.5 cm anteriorly. On sectioning, the depth of the lesion ranged from 0.7 to 2.0 cm, and the distance from the deepest aspect of the specimen was 0.2 cm.\n\nHistologic examination revealed a high-grade spindle cell malignancy. Immunohistochemical staining demonstrated strong and diffuse positivity for vimentin and desmin, moderate positivity for p16, and weak positivity for actin. The tumor cells were negative for AE1/AE3, CAM5.2, CK5/6, p63, S-100, CD34, calponin, CD68, myoglobin, pan-melanoma, and smooth-muscle myosin. Staining for CD31 was equivocal. No lymphovascular space invasion was identified.\n\nOne subglossal lymph node was examined and found to be negative. All surgical margins, including those from the dorsal tongue, ventral tongue, floor of mouth, posterior tongue, deep posterior tongue, and deep anterior tongue, were free of tumor involvement. Additionally, a right neck dissection encompassing levels 2 through 4 yielded 44 lymph nodes, all of which were negative. The submandibular gland and surrounding fibroadipose tissue showed no evidence of tumor. A separate specimen from the floor of mouth also showed no tumor involvement, with only mild dysplasia noted in adjacent squamous mucosa.\n\nFrozen section analysis during surgery confirmed the absence of malignancy at all evaluated margins: dorsal tongue, ventral tongue, floor of mouth, posterior tongue, deep posterior tongue, and deep anterior tongue. Clinical evaluation prior to surgery indicated suspicion for malignancy within the tongue region.\n\nRepresentative sections of the primary specimen were submitted across multiple cassettes for detailed histologic review. No additional significant findings were noted in other submitted specimens, including fragments of teeth analyzed grossly only."} +{"pid": "TCGA-3M-AB47", "report": "The specimen consisted of a total gastrectomy with D1 and D2 lymph nodes, measuring 24.0 x 11.5 x 5.0 cm, along with an attached mesentery measuring 30.0 x 18.5 x 3.5 cm. The gastric serosal surface appeared yellow-tan, nodular, and firm. A diffuse infiltrating nodular mass was identified, measuring 17.0 x 8.0 x 2.0 cm. The mass was located 5 cm from the proximal margin and 9 cm from the distal margin. It extended through the serosa into the surrounding perigastric fat in multiple areas. Rugal folds were flattened in the tumor region. Multiple grossly apparent lymph nodes were present, with the largest measuring 3.0 x 2.0 x 2.5 cm.\n\nMicroscopic evaluation of the stomach showed invasive poorly differentiated adenocarcinoma extensively involving the entire gastric wall. The proximal and distal surgical margins were free of tumor involvement. However, the circumferential (radial) margin was extensively involved by invasive carcinoma. Histologic evaluation revealed the presence of lymphatic, venous, and perineural invasion.\n\nA total of fifteen lymph nodes were examined, with eleven showing evidence of metastatic involvement. No diagnostic abnormalities were found in the small bowel segment, which measured 4.5 cm in length and 3.9 cm in diameter. The mucosa was grossly undulating without discrete abnormalities.\n\nPathologic staging was determined as pT3 N2 Mx. The primary tumor stage (pT3) indicates penetration through the serosa without involvement of adjacent structures. The regional lymph node stage (pN2) reflects metastasis in 7 to 15 perigastric lymph nodes. Distant metastasis could not be assessed (pMX). The pathologic stage is considered provisional, based solely on available data and not incorporating the full clinical context.\n\nFrozen section analysis of intraoperative samples confirmed negative findings at both proximal and distal margins, as well as in lymph nodes evaluated during surgery."} +{"pid": "TCGA-LK-A4O6", "report": "The extrapleural pneumonectomy specimen shows a biphasic tumor with a predominantly epithelioid morphology and a minor spindle cell component. The lesion diffusely involves both the visceral and parietal pleura. Tumor infiltration is present in the diaphragm, limited to non-transmural involvement, and extends into the pericardial fat with multiple small foci identified in adipose tissue. In addition, isolated nodules are observed within the lung parenchyma, and angiolymphatic invasion is evident in the lung. These findings suggest metastatic spread.\n\nLymph node evaluation reveals extensive involvement, with 5 out of 6 nodes showing tumor presence, including those at level 10, level 11, and near the inferior pulmonary vein. Surgical margins are positive at the lateral and inferior parietal pleural sites, while bronchovascular margins are free of tumor. No pleural plaques or ferruginous/asbestos bodies are identified on iron-stained sections.\n\nImmunohistochemical staining demonstrates positivity for AE1/2, Cam5.2, and focally for calretinin, CK5/6, WT1, D2-40, BerEp4, and CD15. The tumor cells are negative for TAG72, MOC31, monoclonal CEA, PAX-8, inhibin, and TTF-1. Mucin stains are also negative. The epithelioid component shows stronger reactivity for mesothelial markers, whereas the spindle cell areas stain more prominently with cytokeratin antibodies.\n\nPathologic staging is pT3N1M1 (AJCC 7th Ed.), based on the extent of local invasion, lymph node involvement, and presence of distant metastases in the lung. The non-neoplastic lung tissue shows bronchiectasis and bronchiolectasis without interstitial fibrosis."} +{"pid": "TCGA-JY-A93E", "report": "The surgical specimen included multiple lymph node stations and a resected esophagus with proximal stomach. Lymph nodes were evaluated from various regions including common hepatic (ST18), lymph node station 20, splenic nodes (ST19), inferior pulmonary ligament (ST9L), diaphragmatic nodes (ST15), aorto-pulmonary (ST5), subcarinal (ST7), left low paratracheal (ST4L), ST7 subcarinal node, ST16 paracardial node, ST17 left gastric nodes, ST8L lower paraesophageal, and ST8M middle paraesophageal lymph nodes. Most lymph nodes showed no evidence of malignancy; however, one out of nine lymph nodes from the ST17 station contained metastatic involvement.\n\nThe resected esophagus and proximal stomach measured 6.9 cm in length for the esophagus and 4.4 cm along the lesser curvature of the stomach. A polypoid and ulcerated lesion was identified at the gastroesophageal junction, with approximately 60% of the tumor mass located in the distal esophagus and 40% extending into the proximal stomach. The tumor measured 3.0 x 2.7 cm in diameter and invaded to a depth of 1.0 cm, reaching the adventitia. The closest margin of invasion was 0.1 cm from the adventitial surface. The proximal esophageal margin was 3.4 cm from the tumor, and the distal gastric margin was 1.8 cm away. All resection margins were free of invasive carcinoma.\n\nHistologically, the lesion was described as moderately to poorly differentiated. The tumor demonstrated lymphovascular and perineural invasion. One out of 43 total lymph nodes examined contained metastatic disease. No distant metastases were identified. Based on TNM staging criteria, the primary tumor was classified as pT3 due to adventitial invasion, and regional lymph node involvement was categorized as pN1 given the presence of metastasis in one lymph node."} +{"pid": "TCGA-B8-5549", "report": "The surgical pathology report describes a right radical nephrectomy specimen. The kidney measures 14.5 x 8.0 x 7.0 cm, and the adrenal gland is present with dimensions of 4.5 x 2.4 cm. Gross examination reveals a tumor located at the superior pole with a glistening, maroon-hemorrhagic cut surface consistent with necrosis, as well as viable areas with a golden-brown appearance. The tumor appears rounded, circumscribed, and encapsulated. Its size is reported as 4.5 x 4.0 x 3.2 cm. Microscopic evaluation confirms Fuhrman grade 3 features based on nuclear morphology.\n\nA second lesion measuring 0.9 x 0.9 x 0.9 cm was identified during further sectioning. This lesion is well-circumscribed, located approximately 5.5 cm from the dominant mass, and bulges the capsule without evidence of invasion. Based on this finding, the tumor focality is revised to multifocal. No sarcomatoid features are identified.\n\nThe tumor is confined to the kidney and does not grossly or microscopically involve the perirenal adipose tissue, Gerota's fascia, renal sinus, ureter, renal vein, or major veins such as the inferior vena cava. There is no evidence of lymphatic or venous invasion. Surgical margins, including those of the peri-renal fat, renal vein, renal artery, and ureter, are free of involvement. The adrenal gland also shows no involvement by the tumor.\n\nTwo hilar lymph node candidates were identified; however, no metastases were detected. Additional findings include a simple cyst measuring 1.2 x 1.0 x 1.0 cm located laterally to the additional tumor mass.\n\nBased on available data, the staging is classified as T1b pNx pMx. This classification remains subject to change pending further clinical review."} +{"pid": "TCGA-CQ-A4C7", "report": "The specimen consisted of multiple tissue samples submitted from the left postauricular region, left perifacial lymph node, left neck contents, oral cavity including the left body of the mandible and floor of mouth, left sublingual gland, anterior, posterior, and deep floor of mouth margins, posterior buccal margin, left neck level IA lymph node, and surgical waste. The left postauricular lesion measured 3.3 x 0.9 x 0.5 cm with a tan-gray friable lesion measuring 1.5 x 0.9 x 0.2 cm located 0.7 cm from the closest end tip. Surgical margins were inked.\n\nOne lymph node from the left perifacial region was involved, measuring 1.1 x 0.9 x 0.7 cm with focal extracapsular extension present. The involved node measured 0.8 cm in diameter. Twenty-three lymph nodes from the left neck contents were negative. The neck dissection specimen measured 14.7 x 8.2 x 1.0 cm and contained multiple lymph nodes ranging from 0.2 to 2.2 cm across various levels.\n\nA composite resection specimen from the left mandible and floor of mouth measured 6.3 x 3.5 x 3.6 cm. A tan-white firm lesion measuring 4.5 x 3.0 x 2.7 cm was identified in the floor of mouth with bone involvement noted. The tumor was located 0.1 cm from the closest anterior mandibular margin and had remaining margins measuring 1.1 cm (lateral buccal), 1.0 cm (medial mucosa), 0.9 cm (posterior mucosal), and 0.1 cm (posterior mandibular). Silver nitrate was used to mark the resection margin.\n\nHistologic evaluation revealed cellular atypia consistent with poorly differentiated morphology. Invasion of cortical and medullary bone was confirmed on decalcified sections. Perineural invasion was present. No lymphovascular invasion was observed. All surgical margins were free of malignant involvement. Sections of mandible were undergoing decalcification at the time of reporting.\n\nIn total, 24 regional lymph nodes were examined, with one showing involvement. No distant metastasis could be assessed. Extracapsular extension was identified in the involved lymph node. Multiple other margins and specimens were negative for malignant involvement."} +{"pid": "TCGA-AC-A5XU", "report": "The specimen was obtained from a left lumpectomy and sentinel lymph node biopsy. The primary lesion is characterized by an irregular, multilobulated mass measuring 6.8 cm in diameter. Histologically, the tumor demonstrates high-grade features with a Nottingham score of 3, composed of three points for tubule formation, nuclear pleomorphism, and mitotic rate. The tumor exhibits neuroendocrine differentiation based on morphologic characteristics such as nuclear molding, scant cytoplasm, and inconspicuous nucleoli, supported by positive staining for synaptophysin.\n\nIn addition to the invasive component, there is extensive ductal carcinoma in situ (DCIS) of high nuclear grade, with comedo necrosis identified. DCIS extends beyond the area involved by the invasive component. The distribution of DCIS affects multiple margins, with involvement at the inferior margin (medial and lateral aspects). DCIS is also found 0.1 cm from the anterior and superior margins and 0.5 cm from the lateral margin. Invasive tumor is present within close proximity to the anterior and superior margins (0.2 cm), while being at least 0.5 cm away from other margins.\n\nTwo axillary lymph nodes were examined, and no metastatic involvement was identified. Pathologic staging reflects the extent of disease: primary tumor staged as pT3, regional lymph nodes as pN0(i-)(sn), and no evidence of distant metastasis. The overall stage is IIB. Lymphovascular invasion was not identified.\n\nAncillary studies demonstrated estrogen receptor positivity in 95% of cells and progesterone receptor positivity in 60%. HER2 immunohistochemistry showed a score of 0 and Ki-67 proliferation index was approximately 25%.\n\nMargins were extensively sampled and inked with different colors to assess for residual disease. The surgical specimen was sectioned into multiple slabs, and representative areas were submitted for detailed histological analysis. Additional fibrous-calcified nodules were identified near the inferior margin and evaluated microscopically.\n\nImmunohistochemical staining confirmed the presence of synaptophysin in tumor cells, supporting the neuroendocrine features. All controls were appropriately validated during immunostaining procedures."} +{"pid": "TCGA-D1-A0ZU", "report": "A hysterectomy and bilateral salpingo-oophorectomy specimen was received. The uterus weighed 160 grams and showed a polypoid mass measuring 5.2 x 2.4 x 0.9 cm located in the left posterior wall and bilateral anterior walls of the endometrial cavity. The tumor extended into the lower uterine segment but did not involve the cervix or endocervix. The myometrium measured 2.4 cm in thickness, with superficial invasion by the tumor to a depth of approximately 0.1 cm. No angiolymphatic invasion was identified.\n\nOn the anterior uterine serosa, there was a small microscopic focus (approximately 0.4 cm) of high-grade undifferentiated carcinoma associated with psammomatous calcifications and findings suggestive of endometriosis, including a granulomatous, giant cell, and fibrohistiocytic reaction. Immunohistochemical staining of this focus demonstrated strong and diffuse reactivity for p53 and MIB-1, with no estrogen receptor expression.\n\nIn the right ovary, a nodule measuring 0.9 x 0.9 x 0.8 cm was identified, showing features consistent with a low-grade endometrioid adenocarcinoma. This was associated with atypical complex hyperplasia. The morphology suggested a possible origin from an endometriotic cyst or an atypical endometrioid adenofibroma.\n\nImmunohistochemical evaluation of the intrauterine tumor showed approximately 50% positivity for estrogen receptors, with attenuated staining for p53 and MIB-1 (approximately 50% of tumor cells positive). These findings indicated a lower proliferative index and less aggressive immunoprofile compared to the serosal lesion.\n\nDNA mismatch repair enzyme analysis on tissue from the endometrial lesion revealed loss of MLH1 and PMS2 expression, while MSH2 and MSH6 remained intact. These findings are consistent with defective DNA mismatch repair due to MLH1 loss, though further testing is required to distinguish between germline and somatic origins.\n\nThe left ovary and both fallopian tubes were unremarkable, with no evidence of tumor involvement. Multiple sections were submitted for microscopic examination, including samples from the endometrium, uterine serosa, lower uterine segment, cervix, and both adnexal structures."} +{"pid": "TCGA-57-1994", "report": "The specimen consisted of a tan-gray hemorrhagic mass from the left ovary measuring 8.0 x 7.0 x 5.0 cm, with multiple nodules on the outer surface and an attached fallopian tube segment. Sectioning revealed a serous fluid-filled cystic cavity with gray-yellow papillary projections in an area measuring 4.0 x 3.0 x 1.5 cm. The right ovary measured 3.8 x 3.0 x 2.8 cm and displayed a tan-yellow lobular firm cut surface. Multiple peritoneal nodules were identified, including a 1.0 x 1.0 x 0.5 cm tan-yellow soft nodule entirely submitted for analysis. The uterus weighed 47 grams and measured 6.0 x 3.5 x 2.5 cm; the endometrial lining was tan-pink and focally hemorrhagic, measuring up to 0.2 cm in thickness. The myometrium averaged 1.6 cm in thickness and contained gray-white whorled nodules measuring approximately 0.5 cm. A 288-gram omental mass measuring 36.0 x 15.0 x 1.5 cm contained multiple yellow-white firm nodules, the largest being 3.5 cm. Lymph nodes from bilateral pelvic and para-aortic regions were evaluated, ranging in size from 0.8 to 2.8 cm; all appeared unremarkable upon gross examination. Microscopic evaluation of the ovarian masses showed high-grade cellular atypia and extensive involvement. The endometrial sample revealed a 1.5 mm focus of markedly atypical cells confined to the endometrium. Metastatic involvement was identified in the parametrial tissue and omentum. Papillary growth patterns were noted in the ovarian specimens but were not clearly evident in the endometrial and parametrial samples, although cytologic features were comparable across sites. No lymphovascular invasion was identified in the ovarian specimens. All lymph nodes examined showed no evidence of metastatic involvement."} +{"pid": "TCGA-XF-AAME", "report": "The surgical pathology report describes a radical cystectomy specimen with anterior exenteration. The bladder measured 5.5 x 6 x 3 cm and contained an ulcerative mass measuring 3.5 x 2.5 x 1.0 cm located at the right ureterovesical junction, extending to the trigone and posterior bladder neck. The mass was within 0.3 cm of the urethral margin and appeared suspicious for involvement of perivesical soft tissue, although this was not definitively identified. The right ureter was dilated and showed direct tumor involvement at the orifice. Microscopic examination revealed invasive poorly differentiated cells with focal squamoid features involving the deep muscularis propria but without extension into perivesical soft tissue or lymphovascular space invasion. Adjacent mucosa in the right lateral wall and bladder neck showed flat high-grade intraepithelial lesions. All resection margins were free of dysplasia and malignancy.\n\nSections from other areas of the bladder did not show high-grade dysplasia. The cervix showed benign squamous and endocervical mucosa. The endometrium was atrophic, and the myometrium contained multiple small benign nodules consistent with leiomyomas. Both ovaries and fallopian tubes showed only benign physiologic changes. No malignant or atypical elements were identified in these tissues.\n\nLymph node specimens were submitted from multiple pelvic and para-aortic regions, including right paracaval, right common iliac, left para-aortic, left common iliac, cloquet, external iliac, obturator/hypogastric, presciatic, and presacral locations. Lymph nodes ranged in size from 0.1 to 2 cm and were all negative for malignancy. In total, 70 lymph nodes were examined across all sites.\n\nFrozen section analysis of the right and left distal ureters and apical urethral margin showed no evidence of high-grade atypia or tumor. The proximal ureters were also benign. Other findings included mild inflammation and necrosis at the apical urethral margin with multinucleated giant cells, but no dysplasia or malignancy.\n\nThe thickness of the uninvolved bladder wall was 1.1 cm, and the myometrial nodules ranged from 0.5 to 0.6 cm. No hemorrhage or necrosis was noted in these nodules. Ureteral segments measured between 0.3 and 5 cm in length and were otherwise unremarkable.\n\nThe pathologic staging was determined as pTis,T2bN0MX."} +{"pid": "TCGA-C5-A901", "report": "The specimen consists of a uterus with attached cervix, vaginal cuff, and parametrial soft tissue. The uterus measures 8 cm from fundus to ectocervix, 6.5 cm from cornu to cornu, and 2 cm anterior to posterior. Parametrial soft tissues on the right and left sides measure 4 x 3 x 1 cm and 4 x 2 x 1 cm, respectively. The posterior and anterior vaginal cuffs measure 4 by up to 1.5 cm and 4 x 1.5 cm. A mucosal defect is noted in the anterior cervix measuring 1 cm in greatest dimension. An ulcerated granular lesion measuring 2 x 1.5 x 0.6 cm is present in the posterior ectocervix.\n\nA cervical mass measuring 3.7 cm in greatest dimension is identified, showing grey-yellow, firm, and vaguely nodular cut surfaces. This lesion invades to a depth of 1.6 cm within the total wall thickness. The tumor extends into the posterior vaginal cuff and parametrial soft tissue. The endometrial cavity measures 3 cm from fundus to endocervical os and is lined by tan-colored mucosa. The endometrium and myometrium of the lower uterine segment are involved by the lesion. A subserosal leiomyoma measuring 0.7 cm is present on the posterior uterine serosa.\n\nMultiple fibrofatty tissue fragments were received from the right and left pelvic lymph node dissections. From the right pelvic lymph nodes, one out of seven lymph nodes shows involvement. On the left side, one out of nine lymph nodes is involved. No metastases are found in the two right periaortic lymph nodes examined or in the left periaortic region, where no lymph node was identified.\n\nMicroscopic evaluation reveals extensive lymphovascular space invasion. Severe dysplasia involving margins is also observed. One section from the left vaginal margin demonstrates invasive cellular infiltration. The tumor does not invade through the entire thickness of the cervix but involves the uterine lower segment and vagina. Based on available information, the extent of vaginal involvement cannot be fully determined due to the separately submitted specimen from the left vaginal margin.\n\nMeasurements indicate a maximum depth of invasion of 15 mm and a horizontal tumor dimension of 37 mm. The nuclear grade is moderately differentiated. Two out of nineteen regional lymph nodes show metastatic involvement without evidence of extracapsular extension. Due to incomplete assessment of vaginal involvement and reliance on clinical correlation for full staging, definitive staging cannot be assigned at this time."} +{"pid": "TCGA-A5-A1OJ", "report": "The left fallopian tube measured 8.0 cm in length and ranged from 0.4 to 0.7 cm in diameter. The lumen was patent, measuring up to 0.4 cm in diameter. Histologic evaluation revealed chronic and minimal acute salpingitis, lymphovascular ectasia, stromal edema, and adhesions. No tumor was identified. The right fallopian tube measured 7.5 cm in length and ranged from 0.4 to 0.6 cm in diameter, with a patent lumen up to 0.3 cm in diameter. There was vascular ectasia and a soft tissue fragment at the fimbriated end. A paratubal Walthard rest and a 1.0 cm translucent cyst (hydatid of Morgagni) were present, along with an associated adhesion. No tumor was found.\n\nThe hysterectomy specimen weighed 300 grams and measured 11.0 x 8.0 x 5.0 cm overall. The endometrial cavity was 8.5 cm long and up to 5.0 cm wide. The endometrial mucosa ranged from 0.2 to 0.8 cm in thickness, and the myometrium ranged from 1.5 to 3.3 cm in thickness. Grossly, the endometrial cavity was largely replaced by a soft, tan, friable lesion involving the fundus, anterior and posterior corpus, and portions of the lower uterine segment. The lesion was exophytic and polypoid in areas, reaching up to 0.8 cm in thickness. Microscopically, there was a neoplastic process composed of glands with squamous, eosinophilic, and secretory-like changes. Stromal alterations included decidualization and cystic glandular dilatation, consistent with progestin effect. Tumor involvement was extensive, including the uterine fundus, anterior and posterior corpus, and portions of the lower uterine segment. Superficial myometrial invasion was present, involving less than 10% of the wall thickness. Deeper within the outer half of the wall, approximately 0.85 cm from the serosa, there was secondary involvement within adenomyosis. No lymphatic or vascular invasion was identified. The cervix, vaginal cuff, and bilateral parametrial tissues were free of tumor. A benign endometrial polyp was identified in the lower uterine segment. The cervix showed chronic and mild acute inflammation, microglandular hyperplasia, reserve cell hyperplasia, squamous metaplasia, and nabothian cysts.\n\nLymph node examination included 17 pelvic lymph nodes on the left (all reactive), 6 left common iliac lymph nodes (all reactive), 1 left obturator lymph node (reactive), 5 right pelvic lymph nodes (reactive), and 2 right common iliac lymph nodes (reactive). No evidence of metastatic disease was found in any lymph node examined. Immunohistochemical staining for mismatch repair proteins demonstrated loss of MLH-1 expression, while MSH-2, MSH-6, and PMS2 expression was retained in varying patterns.\n\nSurgical margins were uninvolved. No occult keratin-positive tumor cells were detected in any lymph node groups using immunohistochemical methods. The histologic grade was classified as FIGO grade II. Based on AJCC 7th edition staging, the primary tumor was classified as pT1a (limited to endometrium or invading less than one-half of the myometrium), and regional lymph nodes were classified as pN0 (no metastasis)."} +{"pid": "TCGA-CZ-4861", "report": "The surgical pathology report describes a nephrectomy specimen measuring 25.0 x 15.0 x 8.5 cm, including a kidney measuring 13.0 x 7.2 x 6.0 cm. A well-circumscribed mass is identified in the lower pole, measuring 6.0 x 8.2 x 5.0 cm, with areas of focal hemorrhage and golden/yellow appearance. The mass distorts and expands the kidney into the perinephric fat but appears limited to the kidney. It is located within 0.1 cm of the Gerota's fascial margin without definitive evidence of invasion into the surrounding fat. Margins are negative for involvement at the ureter (5.2 cm from tumor), renal artery (5.5 cm), and renal vein (4.7 cm). Approximately 60% of the tumor mass is viable, with foci of necrosis and hyalinization observed.\n\nA separate blood-filled cyst measuring 1.3 x 1.2 x 0.9 cm is present in the upper pole. The remaining renal parenchyma is tan/brown with a well-defined corticomedullary junction, and the pelvis and calices show smooth, glistening mucosa. No lymph node tissue is identified within the perinephric fat, and no adrenal gland is present.\n\nHistologic examination reveals that the tumor has a Fuhrman nuclear grade. Microscopic evaluation shows no lymphovascular or venous invasion. Sections submitted include those of the tumor, adjacent normal kidney, margins, and cyst. Cytogenetic analysis was performed on five metaphase cells, showing a karyotype of 46,XY; no chromosomal abnormalities were detected, although the limited number of cells analyzed does not exclude mosaicism or small chromosomal changes.\n\nAdditional findings include diffuse and nodular glomerulosclerosis with moderate global glomerulosclerosis affecting 19% of glomeruli. Tubular atrophy and interstitial fibrosis are present in approximately 25% of the sample. Severe arterial and arteriolar sclerosis is also noted, along with prominent casts in the distal tubules. Immunofluorescence microscopy reveals no significant immune deposits in the glomeruli, with segmental granular deposition of IgM and C3 in mesangial areas. Tubular basement membranes show focal C3 deposition, and distal tubule casts demonstrate reactivity for polyclonal IgA with a relative excess of lambda over kappa light chains.\n\nThe AJCC classification assigned is T2 Nx MX. Additional studies were sent for cytogenetics, tissue banking, and electron microscopy. No additional diagnostic information was added in the addendum."} +{"pid": "TCGA-UY-A78M", "report": "A biopsy of the right and left ureters during frozen section analysis showed no evidence of malignant cells. A radical surgical procedure involving the removal of the bladder, uterus with cervix, and both ovaries and fallopian tubes was performed. Examination of the bladder revealed a lesion measuring 4.0 cm in size, located on the posterior wall extending to the lateral walls. Microscopic evaluation demonstrated infiltration into the outer half of the muscularis propria. No lymphatic or vascular invasion was observed. Additionally, there were areas of epithelial abnormality consistent with carcinoma in situ. The tumor did not extend into adjacent organs. Surgical margins, including the urethral, right and left ureteral, and perivesical regions, were free of tumor involvement.\n\nThree lymph nodes surrounding the bladder showed no signs of metastasis. Pelvic lymph node dissection findings indicated that two out of eight lymph nodes on the right side contained metastatic cells, while all six lymph nodes on the left side were negative. The largest metastatic deposit measured 1.3 cm, with no extranodal growth identified. Pathological staging was determined as pT2bN2Mx.\n\nExamination of the uterus revealed no significant abnormalities in the cervix, endometrium, myometrium, or serosa. Both ovaries were atrophic with calcified blood vessels, and no abnormalities were found in the fallopian tubes. All specimens from the final biopsies of the left and right ureters were also free of any malignant cells.\n\nThe surgical specimen was received in multiple parts, each properly labeled. The bladder specimen weighed 290 grams and had a tan-white mass on the posterior wall, not involving the anterior wall. The mass was 0.9 cm from the urethral opening and 5.2 cm from the distal urethral margin. The uterus measured 5.8 cm in length and showed no gross abnormalities. Both ovaries and fallopian tubes were within normal limits upon visual inspection.\n\nLymph node specimens from the right and left pelvic regions were examined, with only the right side showing involvement. All other tissue samples, including those from the ureters, were free of tumor. Final diagnosis was based on comprehensive microscopic evaluation and confirmed by an attending pathologist."} +{"pid": "TCGA-WK-A8XY", "report": "The surgical specimen consists of a large soft tissue mass measuring 32 cm in greatest dimension located within the mesentery, with two attached segments of small intestine (28.0 cm and 24.0 cm in length) and a segment of left colon (25.0 cm in length). The mass is partially covered by fascia or peritoneum, except for one area measuring 5.0 x 4.0 cm where tumor is exposed. Serial sectioning reveals a central necrotic cavity measuring 17.0 x 14.0 x 8.0 cm filled with tan/pink/green/yellow necrotic material, communicating posteriorly with one segment of small bowel along 17.0 cm of its length. The tumor erodes through the overlying peritoneum at the anterior aspect of the mass with associated exudate.\n\nHistologic evaluation shows extensive necrosis with bacterial colonization. The tumor demonstrates high mitotic activity, with at least 17 mitoses per 10 high-power fields. It perforates the serosal surface of the small intestine and extends to the edges of another submitted specimen labeled as an additional mesenteric mass measuring 14.0 cm. All resection margins of the attached intestinal segments are negative for tumor involvement.\n\nAnother specimen from the omentum shows fibroadipose tissue with fat necrosis, abscess formation, and mixed acute and chronic inflammation, but no tumor involvement. A separate nephrectomy specimen includes a kidney with three cortical cysts, the largest measuring 2.0 cm, and a portion of adrenal gland showing hyperplastic changes without tumor. Histologic examination of the kidney reveals significant tubular injury including luminal distension, epithelial attenuation, brush border blunting, and cytoplasmic vacuolization. There is patchy tubular atrophy and interstitial fibrosis involving approximately 20% of the parenchyma, along with moderate arteriolar and arterial sclerosis. No tumor is identified in the kidney or ureteral margins.\n\nA left adrenal gland specimen contains a 5.0 cm mass surrounded by adrenal tissue with hyperplastic features. Mitotic count is less than 1 per 10 high-power fields, with no atypical mitoses or lymphovascular invasion noted. A final specimen labeled as a stoma consists of a colonic segment with a small polyp (0.5 cm), acute serositis, and no tumor involvement."} +{"pid": "TCGA-DH-A7UT", "report": "This is an addendum report. Specimens were submitted for analysis, including multiple samples from a left frontal brain tumor following an awake craniotomy for resection. The patient is an old male with no significant past medical history, presenting with a left frontal lesion.\n\nGross examination of the specimens showed variable sizes and characteristics. Specimen A was a 0.9 x 0.6 x 0.3 cm fragment of soft tissue. Specimen B measured 3.5 x 2.8 x 1.5 cm, with a pink-tan to red, focally hemorrhagic appearance and prominent vasculature. Specimen C was an aggregate of smaller fragments measuring 1.5 x 1.0 x 0.5 cm. All specimens were processed and submitted in full across multiple cassettes.\n\nMicroscopic evaluation revealed an infiltrating glioma with marked nuclear and cellular pleomorphism, as well as increased mitotic activity. No definitive microvascular proliferation or necrosis was identified. Immunohistochemical staining demonstrated positivity for GFAP, indicating glial differentiation. Mutated isocitrate dehydrogenase 1 (IDH-1) was detected. P53 immunoreactivity was observed in approximately 50% of tumor nuclei. PHH3 staining confirmed elevated mitotic activity with up to 7 mitoses per 10 high power fields. Ki-67 labeling showed a focally increased proliferation index, up to approximately 8%.\n\nMolecular studies were conducted for chromosome 1p and 19q status using FISH analysis. Results indicated non-deleted status for both chromosomes. The test used specific probes targeting the 1p36 and 19q13.3 regions with corresponding control probes. Signal ratios were analyzed by a pathologist-guided review of stained slides. Interpretation criteria define deletion as a ratio of 1p/1q or 19q/19p \u22651.30, and gain as >20% of nuclei showing \u22653 signals. Normal ranges are 0.9\u20131.05 for 1p/1q and 0.93\u20131.02 for 19q/19p. This clinical test has been validated internally and is performed under CLIA certification for high-complexity testing. It has not been cleared or approved by the FDA but is used for diagnostic purposes.\n\nAncillary testing included immunohistochemistry for p53, IDH-1, Ki-67, and PHH3. These findings were consistent with a high-grade glioma. All histologic and molecular findings have been reviewed and confirmed."} +{"pid": "TCGA-ZH-A8Y2", "report": "The surgical pathology report includes three specimens. Specimen A is a liver segment 8 excision measuring 3.8 x 2.5 x 0.4 cm. Microscopic examination reveals benign liver tissue with hemorrhage and mild steatosis. No malignancy is observed.\n\nSpecimen B consists of a partial hepatectomy involving liver segments 2, 3, 4, and part of 8. The specimen weighs 650 grams and measures 16.5 x 15.5 x 7.4 cm. Within this specimen, there is a well-circumscribed, lobulated mass measuring 11.9 x 9.3 x 5.8 cm. The mass is located 0.1 cm from the caval margin, 0.5 cm from the parenchymal margin, and shows focal capsule retraction without full penetration. Approximately 15% of the mass demonstrates areas of soft yellow discoloration. Histologically, the lesion shows a gland-forming growth pattern with moderate nuclear pleomorphism and focal necrosis. Immunohistochemical staining reveals positivity for Cam 5.2, CK7 (focally), CD5, CEA (focally cytoplasmic), and CD56 (focally), while negative for CK20, HepPar1, chromogranin, and synaptophysin. Additional sections submitted for evaluation do not reveal a hepatocellular carcinoma component. Histologic grade is moderately differentiated (Grade 2 of 4). Focal tumor necrosis is present, involving no more than 15% of the sampled tissue. There is focal suspicion for lymphovascular invasion; however, no large vessel invasion is identified. Perineural or capsular invasion is not present. Vascular, bile duct, and parenchymal margins are all free of disease, with the closest distance to the parenchymal margin being 0.1 cm. No lymph nodes are identified. Background liver shows mild steatosis and minimal non-specific portal chronic inflammation.\n\nSpecimen C is a gallbladder cholecystectomy measuring 9.6 cm in length and 2.8 cm in diameter. Histologic analysis shows chronic cholecystitis with no evidence of dysplasia or malignancy.\n\nAJCC pathologic staging is pT1 pNx based on available data at the time of reporting. This assessment may be updated pending further clinical review. Intraoperative frozen section of the segment 8 margin confirms absence of tumor. All additional sections reviewed confirm the original findings without evidence of other components or changes in histologic features."} +{"pid": "TCGA-CZ-5988", "report": "The surgical specimen labeled \"Right radical nephrectomy\" consists of a 510-gram kidney measuring 23.0 x 11.0 x 6.5 cm, including an attached ureter (5.0 x 0.3 cm), renal artery (0.4 x 0.3 cm), and renal vein (0.2 x 1.3 cm). The Gerota\u2019s fascia is composed of tan-yellow adipose tissue. A tumor measuring 6.0 x 4.0 x 5.5 cm is present in the lower pole and appears tan to tan-orange with areas of hemorrhage. It extends to the outer surface of the kidney but does not involve the surrounding Gerota's fascia. The tumor is located 5.5 cm from the ureteral margin, 3.0 cm from the renal vein, 1.5 cm from the renal artery, and 0.5 cm from the perinephric margin. The distal end of the renal artery near the margin shows focal firmness. Adjacent to the tumor, there is a unilocular cyst containing serous fluid measuring 3.0 x 2.0 x 2.2 cm. The remaining renal cortex is tan-brown with a well-preserved corticomedullary junction, and the pelvis and calyces are lined by smooth mucosa.\n\nMicroscopic examination reveals that margins of the renal artery, vein, ureter, and Gerota\u2019s fascia are free of tumor involvement. Lymphovascular invasion is present, though the main renal vein is not involved. Histologic sections show nuclear grade II morphology with no definitive lymph node structures identified in the regional lymph node specimen. Staging according to the AJCC 6th edition classification is T1b NX MX.\n\nEvaluation of non-neoplastic kidney parenchyma demonstrates minimal chronic changes, including mild glomerular hypertrophy, focal mesangial expansion, and rare irregularities in capillary basement membranes. Less than 5% of the cortical tissue shows signs of tubular atrophy and interstitial fibrosis. Arteries and arterioles demonstrate only mild focal wall sclerosis. No specific disease entity was identified.\n\nCytogenetic analysis of five metaphase cells revealed four with an unbalanced translocation involving chromosome 3, characterized as der(3)t(3;8)(p21;q22), resulting in deletion of the short arm of chromosome 3. This chromosomal abnormality was detected using GTG banding techniques at a resolution of 400 bands or greater. No lymph nodes were identified in the submitted lymph node specimen, and no evidence of malignancy was found in that tissue."} +{"pid": "TCGA-64-5781", "report": "The specimen was received in six parts. The first component, labeled as a portion of the 6th rib, consists of a soft tissue fragment measuring 1.7 x 1.5 x 0.5 cm and was processed after decalcification. No abnormal cellular infiltration was identified in this sample.\n\nThe second component includes two lymph nodes from the 10R station, measuring between 1 and 1.2 cm. Both were entirely submitted for histologic evaluation, and no abnormal cells were observed.\n\nThe third component includes multiple lymph nodes from the 11R station, with sizes ranging from 0.2 to 2 cm. These lymph nodes displayed black-brown pigmentation consistent with anthracotic changes and were entirely submitted. No abnormal cellular elements were found.\n\nThe fourth component is a right upper lobe lung specimen weighing 223 grams and measuring 13.5 x 11.5 x 5 cm. A gray induration measuring 2 cm was noted on the pleural surface, located approximately 7 cm from the bronchial margin. Serial sectioning revealed a firm brown mass measuring 6.5 x 3.7 x 2.5 cm, which corresponded to the area of pleural change. The mass was located 4.5 cm from the bronchial margin and approached within 0.1 cm of the closest pleura. No tumor involvement was seen at the bronchial margin during frozen section analysis. Vascular and bronchial margins appeared unremarkable. A stapled margin adjacent to the bronchial margin measured up to 10 cm in greatest dimension and was also submitted for evaluation. Seven peribronchial lymph nodes were examined and showed no abnormal findings.\n\nThe fifth component includes three lymph nodes from the level 7 station, measuring between 0.7 and 1.4 cm. All were anthracotic and showed no abnormal cellular infiltration.\n\nThe sixth component includes a single lymph node from the level 4R station, measuring 1 x 1 x 0.5 cm, along with an additional fibrofatty tissue fragment measuring 2.5 x 1 x 0.2 cm. Both were entirely submitted and showed no abnormal cellular features.\n\nA total of 52 regional lymph nodes were examined across all stations, and none demonstrated evidence of metastatic involvement. Histologically, the lesion showed poorly differentiated morphology with acinar and solid patterns. There was no evidence of angiolymphatic invasion or visceral pleural involvement. Tumor size was recorded as 6.5 cm in greatest dimension. All surgical resection margins were free of involvement. The case was classified as pTNM: T2 NO Mx."} +{"pid": "TCGA-S3-AA0Z", "report": "A sentinel lymph node biopsy revealed metastatic involvement in two of four lymph nodes. A total mastectomy specimen from the left breast included two distinct masses located at the 12 o\u2019clock and 3 o\u2019clock positions. The largest mass measured 3.5 cm, while the second mass measured 2.5 cm. Margins of resection were free of involvement, with the closest margin measuring 5 mm anteriorly. Histologic evaluation showed invasive features with a high overall grade (score of 8). Glandular differentiation was minimal, nuclear pleomorphism was moderate, and mitotic activity was high. No necrosis was identified. Ductal carcinoma in situ was present, with a cribriform pattern and an estimated extent of at least 0.35 cm. Lymph-vascular invasion was noted, but dermal lymph-vascular invasion was not present.\n\nAxillary lymph node dissection included level I and II nodes; no tumor involvement was identified in eight additional lymph nodes. Sentinel lymph node evaluation was performed using hematoxylin and eosin staining at one level. The primary tumor stage was classified as pT2, and regional lymph node staging was pN1a due to metastases in 1 to 3 axillary lymph nodes, with at least one metastasis greater than 2.0 mm. The largest metastatic deposit measured 1.1 cm. No micrometastases or isolated tumor cells were found.\n\nAdditional findings included intraductal papillomas and proliferative fibrocystic changes. Microcalcifications were identified in non-neoplastic tissue. Immunohistochemical analysis showed variable hormone receptor expression across the two tumor foci. Estrogen receptor expression was weak to moderate in one focus and moderate in the other. Progesterone receptor expression was absent in one focus and weakly positive in the second. HER-2 immunostaining was equivocal in one focus and negative in the other. Reflex dual-color in situ hybridization testing for HER-2 gene amplification was negative, with a HER2/Chr17 ratio of 1.3.\n\nThe mastectomy specimen measured 18 x 16 x 3 cm and weighed 490 g. The skin ellipse measured 5.5 x 4.0 cm, and the nipple-areolar complex appeared unremarkable. Two separate tumor masses were identified: one at the 12 o\u2019clock position measuring 3.5 x 2.5 x 2.5 cm, and another at the 3 o\u2019clock position measuring 2.5 x 2.0 x 1.2 cm. Both were surrounded by fibrous tissue and were located within 0.6 cm of the anterior margin. The sentinel lymph node specimen consisted of four lymph nodes ranging from 0.4 to 1.5 cm in size. The axillary lymph node specimen contained eight lymph nodes ranging from 0.5 to 2.5 cm in size. Ischemic times were documented for all specimens."} +{"pid": "TCGA-CZ-4857", "report": "The specimen was received fresh in two parts. Part A consisted of a right radical nephrectomy specimen weighing 976.5 grams and measuring 28.6 x 10.8 x 6.7 cm. It included the right kidney (16.3 x 8.0 x 5.5 cm), ureter (8.0 cm long, 0.4 cm diameter), renal vein at the hilum (0.5 cm long, 1.2 cm diameter), renal artery (3.5 cm long, 0.4 cm diameter), an additional vascular structure measuring 11 cm long x 0.3 cm diameter consistent with a vein, Gerota\u2019s fascia (12.5 x 7.0 x 0.1 cm), and abundant attached perinephric fat. Within the upper pole of the kidney, there was a golden yellow/red/tan partially encapsulated nodular mass measuring 9.2 x 7.7 x 5.7 cm. The mass was focally hemorrhagic and centrally necrotic, impinging upon the renal capsule and closely opposed to Gerota\u2019s fascia. Microscopic evaluation showed that the tumor did not invade Gerota\u2019s fascia. The mass came within 1.2 cm of the renal vein and 2.8 cm from the renal artery margin. Grossly, it appeared to abut but not invade the renal pelvis, coming within 8 cm of the ureteral margin. Representative sections were submitted for cytogenetic and electron microscopic studies.\n\nA separate small white firm nodule measuring 0.4 x 0.3 x 0.3 cm was identified in a medullary pyramid along the anterior/lateral aspect of the mid pole, approximately 1.1 cm lateral and inferior to the main mass. The remaining renal parenchyma had a well-defined corticomedullary junction without other gross abnormalities. Two rubbery nodules measuring 1.3 cm and 1.5 cm were identified in the perihilar soft tissue. Representative sections of the cortex and tumor were submitted to the tissue bank for further studies.\n\nMicroscopically, the tumor was evaluated at its deepest extension in relation to Gerota\u2019s fascia, at the possible invasion site into the vein and relationship with the pelvis, and at random areas. Margins including ureteral, arterial, and venous margins were negative. Two lymph nodes were identified in the regional area and showed no evidence of tumor involvement. Part B consisted of a portion of yellow/tan fatty soft tissue containing a large gray/pink/yellow matted firm lymph node measuring 5.4 x 3.3 x 2.0 cm. One half of this lymph node was submitted for analysis and showed no tumor.\n\nCytogenetic analysis was performed on three specimens from the tumor. Specimen #1 yielded one metaphase cell with a deletion of the short arm of chromosome 3, a common finding in certain types of kidney tumors. No metaphases were obtained from Specimen #2, and no chromosomal abnormalities were found in Specimen #3. A total of 16 metaphases were counted, with 10 scored and 6 analyzed using GTG banding. Mosaicism and small chromosomal anomalies may not be detectable with standard methods. The level of analysis was at least 400 bands."} +{"pid": "TCGA-B5-A5OC", "report": "The specimen consists of a uterus weighing 270 grams, measuring 12.2 x 6.8 x 5.4 cm, with attached cervix and bilateral adnexal structures. The uterine serosa appears tan to red-brown with mild hyperemia. The cervix measures 4.2 cm in diameter with a 1.2 cm cervical os. The ectocervix is tan to red-brown with a granular appearance. A 5 x 3 x 3 cm red-brown exophytic mass is identified involving the endocervical canal and lower uterine segment. Upon sectioning, the mass extends into deep cervical stroma and reaches the paracervical soft tissue margin, also involving the external cervical os. Further sectioning reveals that the lesion extends deeply into the myometrial wall of the lower uterine segment. The endometrial cavity measures 6.4 cm in length x 3 cm cornu-to-cornu and has a pale tan bosselated appearance without visible exophytic tumor growth. A 2.4 x 1 x 0.3 cm endometrial polyp is noted at the fundal region. Multiple intramural myomatous nodules are present, up to 0.5 cm in dimension, some with focal calcification. The right and left ovaries are similar in size, each measuring up to 2.4 x 1 x 0.6 cm, with yellow-tan convoluted surfaces. Cross sections of the left ovary show normal structures and a diffusely calcified area measuring 0.7 x 0.5 cm. Both fallopian tubes are similar, measuring up to 4.3 cm in length and 0.6 cm in diameter, with unremarkable lumens.\n\nA posterior vaginal specimen measuring 2.4 x 2 x 0.6 cm is submitted entirely. Another left posterior vaginal specimen, 4.2 x 2.7 x 1.1 cm, contains a 1.4 x 0.8 x 0.7 cm red-brown lesion abutting the nearest resection margin, which is inked blue. This specimen is serially sectioned and fully submitted. A separate posterior vaginal margin specimen measuring 3.2 x 1.1 x 0.4 cm is also submitted entirely, with the resection margin inked blue.\n\nLymph node specimens were collected from multiple sites. The left pelvic lymph node specimen includes multiple nodes up to 4.4 cm in greatest dimension. A total of 11 lymph nodes are identified on microscopic examination and none show evidence of involvement. The left para-aortic lymph node specimen measures 2.3 cm in greatest dimension and includes one lymph node, which is also negative for malignancy. The left common lymph node specimen contains two nodes, both negative. The infundibular pelvic lymph node specimen shows no distinct nodes macroscopically and is negative microscopically. On the right side, the para-aortic lymph node specimen includes six nodes and the pelvic lymph node specimen includes nine nodes; all are negative for malignancy.\n\nMicroscopic evaluation confirms extensive infiltration of the full thickness myometrial wall of the lower uterine segment and endocervical canal wall (1.6 cm invasion in a 1.7 cm thick wall). Lymphatic and vascular invasion is identified. Adjacent endometrium shows complex atypical hyperplasia and changes consistent with endometrial intraepithelial neoplasia, as well as an endometrioid polyp involved by the process. Scattered submucosal and intramural leiomyomas are present, measuring up to 0.6 cm. The cervix shows significant stromal involvement. Serosal surfaces are free of disease. Tumor is found within 1 mm of the paracervical soft tissue margin. Both ovaries and fallopian tubes are uninvolved. Vaginal biopsies and resections show involvement, with tumor reaching the cauterized and inked margins in the left posterior vaginal resection.\n\nImmunohistochemical analysis shows positive labeling for ER and PR, with only patchy positivity for p16. Chromogenic in situ hybridization for HPV 16/18 DNA is negative, and no convincing nuclear staining is observed. The procedure included exploratory laparotomy, total abdominal hysterectomy, bilateral salpingo-oophorectomy, bilateral pelvic and para-aortic lymph node sampling, partial vaginectomy, proctoscopy, and peritoneal washings."} diff --git a/tcga_data/tcga_titan_embeddings.pkl b/tcga_data/tcga_titan_embeddings.pkl new file mode 100644 index 0000000..92997ac Binary files /dev/null and b/tcga_data/tcga_titan_embeddings.pkl differ diff --git a/tests/__init__.py b/tests/__init__.py deleted file mode 100644 index 8b13789..0000000 --- a/tests/__init__.py +++ /dev/null @@ -1 +0,0 @@ - diff --git a/tests/test_data_loader.py b/tests/test_data_loader.py deleted file mode 100644 index 070e855..0000000 --- a/tests/test_data_loader.py +++ /dev/null @@ -1,85 +0,0 @@ -import h5py -import numpy as np -import pytest -import torch -from ml_core.data.loader import get_dataloaders -from ml_core.data.pcam import PCAMDataset - - -class TestPCAMPipeline: - @pytest.fixture - def mock_data_dir(self, tmp_path): - """Creates dummy H5 files with names expected by loader.py""" - for split in ["train", "valid"]: - # Names must match loader.py ground truth - x_path = tmp_path / f"camelyonpatch_level_2_split_{split}_x.h5" - y_path = tmp_path / f"camelyonpatch_level_2_split_{split}_y.h5" - - with h5py.File(x_path, "w") as f_x, h5py.File(y_path, "w") as f_y: - # 100 samples: 97 normal, 1 outlier (1e5), 1 black (0), 1 white (255) - x_ds = f_x.create_dataset("x", (100, 96, 96, 3), dtype="float32") - y_ds = f_y.create_dataset("y", (100, 1, 1, 1), dtype="int64") - - data = np.full((100, 96, 96, 3), 128.0, dtype="float32") - data[0, 0, 0, :] = 1e5 # Numerical outlier - data[1, :, :, :] = 0.0 # Visual outlier (Blackout) - data[2, :, :, :] = 255.0 # Visual outlier (Washout) - - # 80/20 class imbalance for WeightedSampler test - labels = np.zeros((100, 1, 1, 1), dtype="int64") - labels[80:] = 1 - - x_ds[:] = data - y_ds[:] = labels - return tmp_path - - def test_numerical_stability(self, mock_data_dir): - """Checks if 1e5 values are clipped to 255 before becoming uint8.""" - x_p = str(mock_data_dir / "camelyonpatch_level_2_split_train_x.h5") - y_p = str(mock_data_dir / "camelyonpatch_level_2_split_train_y.h5") - ds = PCAMDataset(x_p, y_p, filter_data=False) - img, _ = ds[0] - assert ( - img.max() <= 255 - ), "Image values > 255 found. Did you forget to clip before uint8 cast?" - - def test_heuristic_filtering(self, mock_data_dir): - """Checks if mean-based filtering drops the black/white outlier samples.""" - x_p = str(mock_data_dir / "camelyonpatch_level_2_split_train_x.h5") - y_p = str(mock_data_dir / "camelyonpatch_level_2_split_train_y.h5") - ds = PCAMDataset(x_p, y_p, filter_data=True) - # Expected 98 because index 1 (mean 0) and 2 (mean 255) should be dropped - assert ( - len(ds.indices) == 98 - ), f"Filtering failed. Expected 98 samples, got {len(ds.indices)}" - - def test_dataloader_output_logic(self, mock_data_dir): - """Verifies shapes, types, and label squeezing.""" - config = { - "data": {"data_path": str(mock_data_dir), "batch_size": 4, "num_workers": 0} - } - train_loader, _ = get_dataloaders(config) - images, labels = next(iter(train_loader)) - - assert images.shape == (4, 3, 96, 96) - assert labels.dtype == torch.long - assert labels.dim() == 1, "Labels should be squeezed to 1D (Batch size,)" - - def test_weighted_sampling(self, mock_data_dir): - """Verifies WeightedRandomSampler balances the 80/20 split.""" - config = { - "data": { - "data_path": str(mock_data_dir), - "batch_size": 40, - "num_workers": 0, - } - } - train_loader, _ = get_dataloaders(config) - _, labels = next(iter(train_loader)) - - positives = (labels == 1).sum().item() - # In a batch of 40 without sampling, we'd expect ~8 positives. - # With balancing, we expect closer to 20. - assert ( - positives > 12 - ), f"WeightedSampler might not be working. Only {positives}/40 are class 1." diff --git a/tests/test_imports.py b/tests/test_imports.py deleted file mode 100644 index 3699d43..0000000 --- a/tests/test_imports.py +++ /dev/null @@ -1,33 +0,0 @@ -def test_imports(): - """ - Verifies that the core components are accessible through the package - structure as defined in the __init__.py files. - """ - # Test Data module exports - from ml_core.data import PCAMDataset, get_dataloaders - - assert PCAMDataset is not None - assert get_dataloaders is not None - - # Test Models module exports - from ml_core.models import MLP - - assert MLP is not None - - # Test Solver module exports - from ml_core.solver import Trainer - - assert Trainer is not None - - # Test Utils module exports - from ml_core.utils import ( - ExperimentTracker, - load_config, - seed_everything, - setup_logger, - ) - - assert ExperimentTracker is not None - assert load_config is not None - assert seed_everything is not None - assert setup_logger is not None diff --git a/tests/test_model_shapes.py b/tests/test_model_shapes.py deleted file mode 100644 index 39c4add..0000000 --- a/tests/test_model_shapes.py +++ /dev/null @@ -1,39 +0,0 @@ -import pytest -import torch -from ml_core.models import MLP - - -class TestMLPImplementation: - @pytest.fixture - def sample_config(self): - return {"input_shape": [3, 96, 96], "hidden_units": [64, 32], "num_classes": 2} - - def test_forward_pass(self, sample_config): - """Verifies the model flattens input and outputs correct logit shapes.""" - model = MLP(**sample_config) - x = torch.randn(8, *sample_config["input_shape"]) - output = model(x) - assert output.shape == ( - 8, - 2, - ), f"Expected (8, 2), got {output.shape}. Did you flatten?" - - def test_backprop(self, sample_config): - """Ensures weights update, verifying the computational graph isn't broken.""" - model = MLP(**sample_config) - optimizer = torch.optim.SGD(model.parameters(), lr=0.01) - - # Capture weight state - param = next(model.parameters()) - initial_val = param.clone() - - # Step - x = torch.randn(2, *sample_config["input_shape"]) - y = torch.tensor([0, 1], dtype=torch.long) - loss = torch.nn.functional.cross_entropy(model(x), y) - loss.backward() - optimizer.step() - - assert not torch.equal( - initial_val, param - ), "Weights did not update. Is the graph broken?" diff --git a/vllm/src/data/example_reports.jsonl b/vllm/src/data/example_reports.jsonl new file mode 100644 index 0000000..355996a --- /dev/null +++ b/vllm/src/data/example_reports.jsonl @@ -0,0 +1,10 @@ +{"pid": "TCGA-VS-A959", "report": "The biopsy specimen from the cervix demonstrates a poorly differentiated malignant neoplasm composed of atypical squamous cells. The tumor exhibits invasive growth with loss of cellular differentiation. No specific measurements are provided in the report. The lesion is confined to the cervix without evidence of distant spread."} +{"pid": "TCGA-S9-A6WL", "report": "The neuropathology report indicates a tumor with histological and morphological features characterized by increased cellularity, nuclear atypia, and mitotic activity. The lesion demonstrates infiltrative growth patterns and moderate cellular pleomorphism. Immunohistochemical staining shows positivity for glial markers. Based on these findings, the tumor is classified as WHO grade III."} +{"pid": "TCGA-A8-A09C", "report": "The specimen shows a moderately differentiated invasive lesion measuring 2.2 cm in diameter, extending cranially to within 5 mm of the resection margin at 3 and 12 o'clock. No residual tumor is identified in the follow-up resection material. Sentinel lymph nodes are free of metastatic involvement. Histologic grade is G2. The surgical margins are tumor-free."} +{"pid": "TCGA-2H-A9GI", "report": "The specimen shows a moderately differentiated carcinoma arising in Barrett\u2019s epithelium, located in the distal esophagus. The lesion measures 4 x 3.5 cm. A total of 8 lymph nodes were examined, with 4 showing involvement. The resection margins are clear, indicating a radical resection. Cellular features include moderate differentiation with glandular architecture. Staging is based on tumor size and lymph node involvement."} +{"pid": "TCGA-AA-3952", "report": "The specimen shows an invasive, poorly differentiated epithelial neoplasm arising in the colon, with extension through all layers of the bowel wall. Vascular invasion and lymphatic involvement are present. A total of 14 regional lymph nodes were examined, and six of them show evidence of tumor spread. The tumor is classified as high grade based on its cellular features. Staging parameters indicate advanced local invasion with significant nodal involvement."} +{"pid": "TCGA-AG-4001", "report": "The resected colon specimen from the rectosigmoid region demonstrates tumor-free oral and aboral resection margins. An ulcerated lesion is present, characterized by moderately differentiated cellular features. Histological evaluation shows infiltration into the perimuscular fatty tissue. No involvement of local lymph nodes was identified, with a total of 29 lymph nodes examined. Vascular invasion is absent. The lesion exhibits a histologic grade consistent with moderate differentiation."} +{"pid": "TCGA-AN-A0FX", "report": "Female patient underwent radical mastectomy for tumor excision. Histological evaluation revealed a high-grade neoplasm with features of metaplastic differentiation. The tumor was located in the left breast and classified as a primary lesion. Pathologic staging showed T stage 2, N stage 0, M stage 0. No prior treatment was administered. A normal blood sample was collected via blood draw and stored frozen for analysis."} +{"pid": "TCGA-IG-A3YA", "report": "The esophageal specimen measured 3 x 3 x 1.2 cm and showed a moderately differentiated cellular growth pattern. The deepest extent of the lesion involved the adventitia. No regional lymph node metastases were identified out of four examined. Lymphatic or venous invasion could not be confirmed. Surgical margins were free of abnormal cells. There was no evidence of prior treatment effect. No additional findings were reported."} +{"pid": "TCGA-EB-A42Z", "report": "The surgical resection specimen from the skin measured 3 x 3 x 1 cm and exhibited ulceration with pigmentation. Microscopic evaluation revealed poorly differentiated tumor cells. The Breslow depth was measured at 10 mm. Of the 10 lymph nodes examined, one from the right inguinal region showed evidence of metastatic involvement. No definitive assessment was made regarding lymphatic or venous invasion, satellite nodules, surgical margins, or prior neoadjuvant treatment."} +{"pid": "TCGA-86-8358", "report": "Specimen consisted of a lobectomy with tumor located in the lung measuring 3.2 x 3.2 x 3.2 cm. Microscopic examination revealed poorly differentiated cells. A total of six regional lymph nodes were examined, and none contained metastatic involvement. Additional features including tumor extent, presence of other nodules, lymphatic or venous invasion, margin status, neoadjuvant treatment effect, and other findings were not specified. The laterality was noted as right-upper."} diff --git a/vllm/src/data/prompts.jsonl b/vllm/src/data/prompts.jsonl new file mode 100644 index 0000000..355996a --- /dev/null +++ b/vllm/src/data/prompts.jsonl @@ -0,0 +1,10 @@ +{"pid": "TCGA-VS-A959", "report": "The biopsy specimen from the cervix demonstrates a poorly differentiated malignant neoplasm composed of atypical squamous cells. The tumor exhibits invasive growth with loss of cellular differentiation. No specific measurements are provided in the report. The lesion is confined to the cervix without evidence of distant spread."} +{"pid": "TCGA-S9-A6WL", "report": "The neuropathology report indicates a tumor with histological and morphological features characterized by increased cellularity, nuclear atypia, and mitotic activity. The lesion demonstrates infiltrative growth patterns and moderate cellular pleomorphism. Immunohistochemical staining shows positivity for glial markers. Based on these findings, the tumor is classified as WHO grade III."} +{"pid": "TCGA-A8-A09C", "report": "The specimen shows a moderately differentiated invasive lesion measuring 2.2 cm in diameter, extending cranially to within 5 mm of the resection margin at 3 and 12 o'clock. No residual tumor is identified in the follow-up resection material. Sentinel lymph nodes are free of metastatic involvement. Histologic grade is G2. The surgical margins are tumor-free."} +{"pid": "TCGA-2H-A9GI", "report": "The specimen shows a moderately differentiated carcinoma arising in Barrett\u2019s epithelium, located in the distal esophagus. The lesion measures 4 x 3.5 cm. A total of 8 lymph nodes were examined, with 4 showing involvement. The resection margins are clear, indicating a radical resection. Cellular features include moderate differentiation with glandular architecture. Staging is based on tumor size and lymph node involvement."} +{"pid": "TCGA-AA-3952", "report": "The specimen shows an invasive, poorly differentiated epithelial neoplasm arising in the colon, with extension through all layers of the bowel wall. Vascular invasion and lymphatic involvement are present. A total of 14 regional lymph nodes were examined, and six of them show evidence of tumor spread. The tumor is classified as high grade based on its cellular features. Staging parameters indicate advanced local invasion with significant nodal involvement."} +{"pid": "TCGA-AG-4001", "report": "The resected colon specimen from the rectosigmoid region demonstrates tumor-free oral and aboral resection margins. An ulcerated lesion is present, characterized by moderately differentiated cellular features. Histological evaluation shows infiltration into the perimuscular fatty tissue. No involvement of local lymph nodes was identified, with a total of 29 lymph nodes examined. Vascular invasion is absent. The lesion exhibits a histologic grade consistent with moderate differentiation."} +{"pid": "TCGA-AN-A0FX", "report": "Female patient underwent radical mastectomy for tumor excision. Histological evaluation revealed a high-grade neoplasm with features of metaplastic differentiation. The tumor was located in the left breast and classified as a primary lesion. Pathologic staging showed T stage 2, N stage 0, M stage 0. No prior treatment was administered. A normal blood sample was collected via blood draw and stored frozen for analysis."} +{"pid": "TCGA-IG-A3YA", "report": "The esophageal specimen measured 3 x 3 x 1.2 cm and showed a moderately differentiated cellular growth pattern. The deepest extent of the lesion involved the adventitia. No regional lymph node metastases were identified out of four examined. Lymphatic or venous invasion could not be confirmed. Surgical margins were free of abnormal cells. There was no evidence of prior treatment effect. No additional findings were reported."} +{"pid": "TCGA-EB-A42Z", "report": "The surgical resection specimen from the skin measured 3 x 3 x 1 cm and exhibited ulceration with pigmentation. Microscopic evaluation revealed poorly differentiated tumor cells. The Breslow depth was measured at 10 mm. Of the 10 lymph nodes examined, one from the right inguinal region showed evidence of metastatic involvement. No definitive assessment was made regarding lymphatic or venous invasion, satellite nodules, surgical margins, or prior neoadjuvant treatment."} +{"pid": "TCGA-86-8358", "report": "Specimen consisted of a lobectomy with tumor located in the lung measuring 3.2 x 3.2 x 3.2 cm. Microscopic examination revealed poorly differentiated cells. A total of six regional lymph nodes were examined, and none contained metastatic involvement. Additional features including tumor extent, presence of other nodules, lymphatic or venous invasion, margin status, neoadjuvant treatment effect, and other findings were not specified. The laterality was noted as right-upper."} diff --git a/vllm/src/how_to_run.md b/vllm/src/how_to_run.md new file mode 100644 index 0000000..cc46ffb --- /dev/null +++ b/vllm/src/how_to_run.md @@ -0,0 +1,103 @@ +# 🚀 vLLM Inference & Embedding Guide (Qwen3) on Snellius + +This guide explains how to perform **Batch Inference** (generating text) and **Batch Embedding** (converting text to vectors) using the Qwen3 model family on the Snellius `gpu_course` partition. + +## 📂 Project Structure +All commands should be executed from the **`src/`** directory to ensure paths remain consistent, but you can change this how you want: +```text +vllm/src/ +├── data/ # Input (.jsonl) and Output (.jsonl, .pkl) +├── python_scripts/ # Python client scripts (Decoder & Encoder) +├── slurm_jobs/ # SLURM submission scripts (.job) +├── DECODER_README.md # This guide +└── ENCODER_README.md # Encoder specific details +``` + +> **Note:** Remember to adjust the parameters in the `.job` files (such as `--time`, `--mem`, and `--cpus-per-task`) to suit the size and complexity of your own dataset. And also remember to change paths to your data, right now the script works as an example! + +--- + +## 📥 1. Data Requirements +All text data **must** be provided in `.jsonl` (JSON Lines) format. Each line must be a standalone JSON object. + +* **Format Requirement:** Every piece of text information you wish to process should be structured exactly like the example below. +* **Decoder Input:** Must contain a `"prompt"` key. +* **Encoder Input:** Flexible. It looks for text in this priority: `report` → `response` → `text` → `prompt`. + +**Example: `data/prompts.jsonl`** +```json +{"prompt": "What is Barrett's Oesophagus?"} +{"prompt": "List the main risk factors for developing Barrett's Oesophagus."} +{"prompt": "How is Barrett's Oesophagus typically diagnosed?"} +``` + +--- + +## ⚙️ 2. Running Batch Inference (The Decoder) +This step takes your prompts and generates text responses using the **Qwen3-4B-AWQ** model. + +### Controlling "Creativity" (Temperature) +You can modify the `temperature` parameter within the `.job` script or Python call to change the nature of the output: +* **Low Temperature (e.g., 0.1 - 0.6):** Makes the model **deterministic**. Useful for factual, consistent answers. *Beware: very low values can lead to repetitive, looping text.* +* **High Temperature (e.g., 0.8 - 1.8):** Makes the model **stochastic** (creative/random). Useful for brainstorming or varied phrasing. + +### Submission +```bash +sbatch slurm_jobs/batch_inference_decoder.job +``` + +### 📤 Decoder Output +The script produces a new `.jsonl` file in `data/`. It preserves your original prompt and adds a `"response"` field: +```json +{"prompt": "What is Barrett's Oesophagus?", "report": "Barrett's oesophagus is a condition where...", "mode": "no_think"} +``` + +--- + +## 🧠 3. Running Batch Embedding (The Encoder) +This step converts text into high-dimensional vectors using the **Qwen3-Embedding-0.6B** model. + +### Task Descriptions & Instructions +The embedding script uses a `--task_description` string. This is **prepended** to every piece of text in your `.jsonl` before it is embedded. This helps the model understand the context of the vector it is creating. + +**Example execution logic within the job script:** +```bash +apptainer exec --nv -B "$PWD" "$CONTAINER" \ + python3 ./python_scripts/batch_inference_encoder.py \ + --input "./data/results.jsonl" \ + --output "./data/embeddings.pkl" \ + --is_query \ + --task_description "Given the following, answer as if you were an experienced expert pathologist." \ + --concurrency 32 +``` + +### Submission +To submit the embedding job to the cluster, run: +```bash +sbatch slurm_jobs/batch_inference_encoder.job +``` + +### 🔗 "Piping" Outputs +A key feature of this setup is that you can **pipe the output of the Decoder directly into the Encoder**. Since the Decoder output contains a `"report"` field and the Encoder prioritizes that field, you should aim to chain the two slurm jobs into one. + +Make sure to create your own job script for this piping! + +--- + +## 📤 4. Output Formats +| Component | Format | Content | Usage | +| :--- | :--- | :--- | :--- | +| **Decoder** | `.jsonl` | Original prompt + Model response | Human readable text | +| **Encoder** | `.pkl` | (pid -> embedding) vector dictionary | Mathematical analysis/Similarity search | + +**Alignment Note:** The pids in the `.pkl` file should match the pids in the `.jsonl` exactly. + +--- + +## 🔗 Useful Links +* **Main Model:** [Qwen/Qwen3-4B-AWQ (HuggingFace)](https://huggingface.co/Qwen/Qwen3-4B-AWQ) +* **Embedding Model:** [Qwen/Qwen3-Embedding-0.6B (HuggingFace)](https://huggingface.co/Qwen/Qwen3-Embedding-0.6B) +* **vLLM Deployment:** [Qwen Documentation for vLLM](https://qwen.readthedocs.io/en/latest/deployment/vllm.html) +* **SURF Documentation:** [LLM inference on Snellius with vLLM](https://servicedesk.surf.nl/wiki/spaces/WIKI/pages/232851290/LLM+inference+on+Snellius+with+vLLM) + + diff --git a/vllm/src/python_scripts/batch_inference_decoder.py b/vllm/src/python_scripts/batch_inference_decoder.py new file mode 100644 index 0000000..fbebfa4 --- /dev/null +++ b/vllm/src/python_scripts/batch_inference_decoder.py @@ -0,0 +1,104 @@ +import asyncio +import json +import argparse +import os +from openai import AsyncOpenAI +from tqdm.asyncio import tqdm + +async def process_item(client, item, args, semaphore): + # Determine mode-specific parameters + # Note: These smaller models often use system prompt prefixes for mode switching + raw_text = item.get("report") or item.get("response") or item.get("text") or item.get("prompt") or "" + if args.mode == "think": + final_prompt = f"/think {raw_text}" + rec_temp, rec_top_p, rec_top_k = 0.6, 0.95, 20 + else: + final_prompt = f"/no_think {raw_text}" + rec_temp, rec_top_p, rec_top_k = 0.7, 0.8, 20 + + # Apply overrides if provided + temp = args.temperature if args.temperature is not None else rec_temp + top_p = args.top_p if args.top_p is not None else rec_top_p + top_k = args.top_k if args.top_k is not None else rec_top_k + + async with semaphore: + try: + response = await client.chat.completions.create( + model="Qwen/Qwen3-4B-AWQ", + messages=[{"role": "user", "content": final_prompt}], + temperature=temp, + top_p=top_p, + extra_body={"top_k": top_k, "min_p": 0.0}, + max_tokens=args.max_tokens, + timeout=180 # 3-minute timeout if something doesn't work, + ) + # Keeping original fields + adding response + item["report"] = response.choices[0].message.content + item["mode"] = args.mode + item["finish_reason"] = response.choices[0].finish_reason + except Exception as e: + item["error"] = str(e) + item["report"] = None + return item + +async def run_batch(args): + client = AsyncOpenAI(base_url=f"http://localhost:{args.port}/v1", api_key="vllm") + semaphore = asyncio.Semaphore(args.concurrency) + + # 1. Load already processed Prompts to support Resume + processed_prompts = set() + if os.path.exists(args.output): + with open(args.output, 'r', encoding='utf-8') as f: + for line in f: + try: + res = json.loads(line) + if 'prompt' in res: + processed_prompts.add(res['prompt']) + except: + continue + print(f"Resuming: Found {len(processed_prompts)} items already processed.") + + # 2. Load input data safely, ignoring empty lines and duplicates + data = [] + print(f"Reading input from {args.input}...") + with open(args.input, 'r', encoding='utf-8') as f: + for line in f: + clean_line = line.strip() + if clean_line: + item = json.loads(clean_line) + if item.get('prompt') not in processed_prompts: + data.append(item) + + if not data: + print("All items already processed or input is empty.") + return + + # 3. Process and write to file immediately (Stream-to-disk) + print(f"Processing {len(data)} items...") + tasks = [process_item(client, item, args, semaphore) for item in data] + + # Use 'a' (append) mode + with open(args.output, 'a', encoding='utf-8') as f: + # as_completed loop for immediate writing + for future in tqdm(asyncio.as_completed(tasks), total=len(tasks), desc="Inferencing 4B"): + result = await future + # ensure_ascii=False keeps Unicode characters (like non-English text) readable + f.write(json.dumps(result, ensure_ascii=False) + '\n') + f.flush() # Force write to disk + + print(f"Batch complete. Results saved to {args.output}") + +if __name__ == "__main__": + parser = argparse.ArgumentParser(description="Optimized Batch Inference for Qwen-4B") + parser.add_argument("--input", type=str, required=True, help="Input .jsonl file") + parser.add_argument("--output", type=str, required=True, help="Output .jsonl file") + parser.add_argument("--port", type=int, default=8000) + parser.add_argument("--mode", type=str, choices=["think", "no_think"], default="no_think") + parser.add_argument("--max_tokens", type=int, default=1024) + parser.add_argument("--concurrency", type=int, default=50) + parser.add_argument("--temperature", type=float, default=None) + parser.add_argument("--top_p", type=float, default=None) + parser.add_argument("--top_k", type=int, default=None) + + args = parser.parse_args() + asyncio.run(run_batch(args)) diff --git a/vllm/src/python_scripts/batch_inference_encoder.py b/vllm/src/python_scripts/batch_inference_encoder.py new file mode 100644 index 0000000..ee168b1 --- /dev/null +++ b/vllm/src/python_scripts/batch_inference_encoder.py @@ -0,0 +1,94 @@ +import asyncio +import json +import argparse +import os +import pickle +import numpy as np +from openai import AsyncOpenAI +from tqdm.asyncio import tqdm + +def get_detailed_instruct(task_description: str, query: str) -> str: + return f'Instruct: {task_description}\nQuery:{query}' + +async def process_item(client, item, semaphore, args): + """Processes a single text for embedding and returns (pid, embedding).""" + pid = item.get("pid", "unknown_pid") + + # Priority for text extraction: 'report' (new), 'response', etc. + raw_text = item.get("report") or item.get("response") or item.get("text") or item.get("prompt") or "" + + if args.is_query and raw_text: + final_input = get_detailed_instruct(args.task_description, raw_text) + else: + final_input = raw_text + + async with semaphore: + try: + response = await client.embeddings.create( + model=args.model, + input=final_input, + timeout=60 + ) + return pid, response.data[0].embedding + except Exception as e: + print(f"\nError on PID {pid}: {e}") + return pid, None + +async def main(args): + client = AsyncOpenAI(base_url=f"http://localhost:{args.port}/v1", api_key="vllm-embed") + semaphore = asyncio.Semaphore(args.concurrency) + + # 1. Load existing dictionary for Resume + results_dict = {} + if os.path.exists(args.output): + try: + with open(args.output, 'rb') as f: + results_dict = pickle.load(f) + print(f"Resuming: Found {len(results_dict)} existing PIDs.") + except (EOFError, pickle.UnpicklingError): + print("Warning: Existing pkl file was corrupted or empty. Starting fresh.") + + # 2. Load input JSONL and filter out already processed PIDs + remaining_data = [] + with open(args.input, 'r', encoding='utf-8') as f: + for line in f: + if line.strip(): + item = json.loads(line) + pid = item.get("pid") + if pid and pid not in results_dict: + remaining_data.append(item) + + if not remaining_data: + print("All PIDs already processed. Success!") + return + + # 3. Run Tasks + print(f"Embedding {len(remaining_data)} items individually...") + tasks = [process_item(client, item, semaphore, args) for item in remaining_data] + + # Use as_completed to save as we go (stream-to-dict) + for future in tqdm(asyncio.as_completed(tasks), total=len(tasks), desc="Encoding"): + pid, embedding = await future + if embedding is not None: + # We convert to float32 for smaller pkl size + results_dict[pid] = np.array(embedding, dtype=np.float32) + else: + print(f"Skipping saving for failed PID: {pid}") + + # 4. Final Save (Pickle is more flexible than npz for dictionaries) + with open(args.output, 'wb') as f: + pickle.dump(results_dict, f, protocol=pickle.HIGHEST_PROTOCOL) + + print(f"Done! Total unique PIDs in {args.output}: {len(results_dict)}") + +if __name__ == "__main__": + parser = argparse.ArgumentParser() + parser.add_argument("--input", type=str, required=True, help="Input .jsonl with 'pid' and 'report'") + parser.add_argument("--output", type=str, required=True, help="Output .pkl file") + parser.add_argument("--model", type=str, default="Qwen/Qwen3-Embedding-0.6B") + parser.add_argument("--port", type=int, default=8000) + parser.add_argument("--is_query", action="store_true") + parser.add_argument("--concurrency", type=int, default=50) + parser.add_argument("--task_description", type=str, default="Retrieve relevant medical passages") + args = parser.parse_args() + asyncio.run(main(args)) diff --git a/vllm/src/python_scripts/single_inference_decoder.py b/vllm/src/python_scripts/single_inference_decoder.py new file mode 100644 index 0000000..3655e78 --- /dev/null +++ b/vllm/src/python_scripts/single_inference_decoder.py @@ -0,0 +1,63 @@ +import argparse +import sys +from openai import OpenAI + +def run_single_inference(args): + client = OpenAI(base_url=f"http://localhost:{args.port}/v1", api_key="token-vllm") + + # 1. Determine base recommended parameters based on mode + if args.mode == "think": + final_prompt = f"/think {args.prompt}" + rec_temp, rec_top_p, rec_top_k = 0.6, 0.95, 20 + else: + final_prompt = f"/no_think {args.prompt}" + rec_temp, rec_top_p, rec_top_k = 0.7, 0.8, 20 + + # 2. Override with CLI args if they are explicitly provided by the user + # We check if they are not None (using None as default in parser) + temp = args.temperature if args.temperature is not None else rec_temp + top_p = args.top_p if args.top_p is not None else rec_top_p + top_k = args.top_k if args.top_k is not None else rec_top_k + min_p = args.min_p # Always uses the default 0.0 unless user changes it + + try: + response = client.chat.completions.create( + model="Qwen/Qwen3-4B-AWQ", + messages=[{"role": "user", "content": final_prompt}], + temperature=temp, + top_p=top_p, + extra_body={ + "top_k": top_k, + "min_p": min_p, + }, + max_tokens=args.max_tokens + ) + + output = response.choices[0].message.content + + print("\n" + "="*40) + print(f"MODE: {args.mode.upper()}") + print(f"PARAMS: Temp={temp}, TopP={top_p}, TopK={top_k}, MinP={min_p}") + print("-" * 40) + print(f"RESPONSE:\n{output}") + print("="*40 + "\n") + + except Exception as e: + print(f"Error during inference: {e}") + +if __name__ == "__main__": + parser = argparse.ArgumentParser() + parser.add_argument("--port", type=int, default=8000) + parser.add_argument("--prompt", type=str, required=True) + parser.add_argument("--mode", type=str, choices=["think", "no_think"], default="no_think") + parser.add_argument("--max_tokens", type=int, default=1024) + + # Set default=None so we can detect if the user actually passed a value + parser.add_argument("--temperature", type=float, default=None) + parser.add_argument("--top_p", type=float, default=None) + parser.add_argument("--top_k", type=int, default=None) + parser.add_argument("--min_p", type=float, default=0.0) + + args = parser.parse_args() + run_single_inference(args) + diff --git a/vllm/src/slurm_jobs/batch_inference_decoder.job b/vllm/src/slurm_jobs/batch_inference_decoder.job new file mode 100644 index 0000000..d07109f --- /dev/null +++ b/vllm/src/slurm_jobs/batch_inference_decoder.job @@ -0,0 +1,53 @@ +#!/bin/bash +#SBATCH --job-name=qwen3_batch +#SBATCH --partition=gpu_course +#SBATCH --gpus-per-node=1 +#SBATCH --ntasks=1 +#SBATCH --mem 8G +#SBATCH --cpus-per-task=2 +#SBATCH --time=00:10:00 +#SBATCH --output=vllm_batch_decoding%j.log + +# --- Configuration --- +export PORT=8000 +export CONTAINER_PATH="/projects/2/managed_datasets/containers/vllm/cuda-13.0-vllm.sif" +MODEL="Qwen/Qwen3-4B-AWQ" +INPUT_FILE="./data/example_reports.jsonl" +OUTPUT_FILE="./data/results_${SLURM_JOB_ID}.jsonl" +MODE="no_think" +CONCURRENCY=8 + +# --- Start vLLM Server in Background --- +apptainer exec --nv -B "$PWD" "$CONTAINER_PATH" \ + vllm serve "$MODEL" \ + --port $PORT \ + --max-num-seqs 8 \ + --max-model-len 2048 \ + --gpu-memory-utilization 0.8 & + +# Store the process ID of the server +SERVER_PID=$! + +# --- Wait for Server to be Ready --- +echo "Waiting for vLLM server to start on port $PORT..." +while ! curl -s "http://localhost:$PORT/health" > /dev/null; do + if ! kill -0 $SERVER_PID 2>/dev/null; then + echo "Error: vLLM server failed to start." + exit 1 + fi + sleep 2 +done +echo "Server is up! Starting inference..." + +# --- Run Batch Inference --- +apptainer exec --nv -B "$PWD" "$CONTAINER_PATH" \ + python3 python_scripts/batch_inference_decoder.py \ + --input "$INPUT_FILE" \ + --output "$OUTPUT_FILE" \ + --temperature 0.7 \ + --port $PORT \ + --mode "$MODE" \ + --concurrency $CONCURRENCY + +# --- Cleanup --- +kill $SERVER_PID diff --git a/vllm/src/slurm_jobs/batch_inference_encoder.job b/vllm/src/slurm_jobs/batch_inference_encoder.job new file mode 100644 index 0000000..e1dec77 --- /dev/null +++ b/vllm/src/slurm_jobs/batch_inference_encoder.job @@ -0,0 +1,52 @@ +#!/bin/bash +#SBATCH --job-name=qwen_embed_srv +#SBATCH --partition=gpu_course +#SBATCH --gpus-per-node=1 +#SBATCH --ntasks=1 +#SBATCH --mem 8G +#SBATCH --cpus-per-task=2 +#SBATCH --time=00:10:00 +#SBATCH --output=vllm_batch_encoding_%j.log + +# --- Configuration --- +export PORT=8000 +CONTAINER="/projects/2/managed_datasets/containers/vllm/cuda-13.0-vllm.sif" +MODEL="Qwen/Qwen3-Embedding-0.6B" + +# --- 1. Start vLLM Server (Background) --- +# Added '&' to background and fixed missing backslash on the seqs line +apptainer exec --nv -B "$PWD" "$CONTAINER" \ + vllm serve "$MODEL" \ + --port $PORT \ + --task embed \ + --gpu-memory-utilization 0.8 \ + --max-num-seqs 32 \ + --max-model-len 4096 & + +# Store the process ID +SERVER_PID=$! + +# --- 2. Wait for Server to be Ready --- +echo "Waiting for vLLM embedding server to start on port $PORT..." +while ! curl -s "http://localhost:$PORT/health" > /dev/null; do + if ! kill -0 $SERVER_PID 2>/dev/null; then + echo "Error: vLLM embedding server failed to start." + exit 1 + fi + sleep 2 +done +echo "Embedding server is up! Starting processing..." + +# --- 3. Run Async Client --- +apptainer exec --nv -B "$PWD" "$CONTAINER" \ + python3 ./python_scripts/batch_inference_encoder.py \ + --input "./data/example_reports.jsonl" \ + --output "./data/embeddings.pkl" \ + --port $PORT \ + --is_query \ + --task_description "Given the following, what diagnosis is the text alluding to most likely? Answer as if you were an experienced expert pathologist." \ + --concurrency 32 + +# --- 4. Cleanup --- +echo "Processing complete. Shutting down server..." +kill $SERVER_PID